PMID- 6840138 TI - Facilitating myasthenic syndrome and quadriceps myopathy. AB - A patient presented with myasthenic syndrome apparently not related to any neoplasia. A peculiar myopathy characterized by absolute predominance (99.50%) and atrophy of type 2A muscle fibers was found in both quadriceps muscles. It is difficult to determine the relation between the myasthenic syndrome and the localized quadriceps myopathy for which a congenital nature is suggested. PMID- 6840139 TI - Effect of dantrolene sodium in myotonic dystrophy. AB - The effect of dantrolene sodium, using a dosage of 120 mg/day, was investigated in 3 patients suffering from myotonic dystrophy. These patients showed a marked reversible deterioration of the clinical symptoms, caused by a reduction of the isometric strength. Dantrolene sodium showed no influence on myotonic discharges and on the latency of the electrical and mechanical muscle response of the adductor pollicis muscle after electrical stimulation of the ulnar nerve. On the other hand a shortening of the relaxation time (in 2 patients) could be observed. The effect of dantrolene sodium on the contractile mechanism without having any influence on the electrical activity is confirmed. Although the relaxation time is shortened, a clinical deterioration is observed, caused by a reduction of the strength. This phenomenon can be explained by a reduction of the calcium release from the sarcoplasmic reticulum after drug application. PMID- 6840140 TI - Clinical and CSF findings in multiple sclerosis patients with or without IgG oligoclonal bands at isoelectric focusing examination of CSF and serum proteins. AB - The IgG oligoclonal bands in CSF can be found in high percentage of MS patients but the existence of a limited number of cases with CSF normal IgG profile is known as well. In the present study 63 out of 70 patients with definite MS and 24 out of 35 with probable MS had oligoclonal bands in the CSF at the isoelectric focusing examination. The 18 patients with normal CSF IgG pattern did not show any statistically significant difference as concerns the age at onset and the duration of the disease, the functional disability, the course of the disease and the quantitative CSF parameters (IgG index, IgG synthesis and serum/CSF albumin quotient). The oligoclonal pattern does not seem of value to discriminate different groups of MS patients but it remains essentially of great diagnostic importance in this disease. PMID- 6840141 TI - Mitochondrial function in myasthenia gravis. AB - We determined the respiration rate, respiratory control and ADP/O ratios, with different substrates in mitochondria isolated from 2 patients with myasthenia gravis and compared them with normal human muscle. In all cases studied, a severe alteration of the respiratory control with variable derangement of oxidative phosphorylation was found. This abnormality of mitochondrial metabolism was referred to by Luft as 'loosely coupled' and was reported in other neuromuscular diseases. In our opinion this defective oxidative metabolism is nonspecific. PMID- 6840142 TI - Progressive idiopathic strio-pallido-dentate calcinosis (Fahr's disease) with autosomal recessive inheritance. Report of three siblings. AB - 3 siblings with symmetrical calcifications in the strio-pallido-dentate system are described. Parathyroid function was normal and there were no signs of central or peripheral myelinopathy. This is the 9th family reported with autosomal recessive idiopathic strio-pallido-dentate calcinosis and the first to be investigated by computerized tomography (CT). CT scans appeared to be superior to plain skull radiograms to assess the localization and the extent of the calcifications in vivo. The calcifications were the least extensive in the youngest and the most extensive in the eldest. It is suggested that the calcifying process is a progressive disorder. It seems to start in the dentate nuclei and pons, and subsequently extends to the basal ganglia and to the radiation of the corpus callosum. PMID- 6840143 TI - Unilateral scapulohumeral muscular atrophy. AB - A peculiar form of chronic spinal muscular atrophy is described, 5 unrelated young males developed muscle wasting of the left shoulder and upper arm region, mainly in the distribution of myotomes C5 and C6. This muscle atrophy remained confined to the primary site for 13-18 years, being followed in 4 cases by a mild muscle atrophy of the right upper arm or or the left forearm and hand and in 1 case by atrophy of the legs and the facial muscles. On EMG examination, muscle involvement was always found to be more widespread than on clinical examination. The repeated and extensive EMG examinations gave results typical of an anterior horn cell disease. Pyramidal signs were absent. During the observation period of 21-40 years the course was benign and at least partial working capacity was retained until retiring age. PMID- 6840144 TI - Angiographic findings in relation to clinical course and results of computed tomography in cerebrovascular disease. AB - Clinical course, results of angiography and computerized tomography (CT) were compared in 204 patients with focal cerebral ischemias. The extent and the importance of the radiological results depend on the localization of the affected area, whereby essential differences exist between extra- and intracranial arteries as well as between the vertebrobasilar and the carotid arterial flow region. As to the carotid arterial system there appear to be significant correlations between the size of the infarction on the CT and the extent of the vessel stenosis on angiography. Furthermore the likelihood of deficit recovery is inversely proportional to the degree of pathology seen in both radiologic examinations. It is discussed whether these correlations, obtained from the examination of a great number of patients, can help to evaluate the significance of equivocal angiographic findings in individual cases. PMID- 6840145 TI - In vitro IgG synthesis by peripheral blood lymphocytes of multiple sclerosis patients and normal individuals. Effect of multiple sclerosis and non-multiple sclerosis brain antigens. AB - In vitro IgG synthesis by peripheral blood lymphocytes cultured for 7 days in serum-free medium was determined by enzyme-linked immunosorbent assay. IgG synthesis by lymphocytes of multiple sclerosis (MS) patients and normal individuals in the presence of MS and non-MS brain antigens and in the absence of brain antigens was investigated. In vitro IgG synthesis by lymphocytes in the absence of any antigen was found to be similar for both groups. Non-MS brain antigens stimulated IgG synthesis by normal lymphocytes but not by MS lymphocytes. MS brain antigens were not found to stimulate IgG synthesis by lymphocytes of either group. The significance of the above-mentioned finding is discussed. PMID- 6840146 TI - Pasteurella ureae meningitis associated with endocarditis. Report of a case and review of the literature. AB - The first reported case of Pasteurella ureae meningitis associated with endocarditis is described. The patient pursued a fulminant deteriorating course despite appropriate antibiotic therapy begun within 24 h of presentation. Previous reports of Pasteurella ureae meningitis are reviewed. This organism should be considered in the differential diagnosis of gram-negative meningitis, since it is usually responsive to most antibiotics, including penicillin. PMID- 6840147 TI - Cerebro-circulatory effects of so-called 'vasodilators' in the anaesthetised rat. AB - The cerebro-vascular effects of various agents used in the treatment of cerebral disorders (dihydroergotoxine, ifenprodil, naftidrofuryl, nicardipine, nicergoline, papaverine and vincamine) were studied in the anaesthetised rat. The agents effected an increase in global cerebral blood flow, each to a different magnitude, in a dose-related manner. The changes in flow induced in the normal brain are unlikely to be of much relevance to the use of these compounds in the treatment of focal cerebral ischaemia. PMID- 6840149 TI - A case of aphasia following left thalamic hemorrhage. AB - In a patient without fluent speech, good comprehension, aphasia and frequent neologisms, computerized tomography (CT scan) demonstrated a left posterior thalamic hemorrhage sparing other language areas. We discuss the existence and the anatomical and pathogenetic mechanisms of thalamic aphasia. PMID- 6840148 TI - Trace elements in whole blood of multiple sclerosis. AB - Fe, Zn, and Cu were determined by atomic absorption spectrometry in samples of whole blood after weighing and wet ashing with HNO3. 35 healthy persons were compared with 119 multiple sclerosis (MS) patients and 13 patients with other diseases of the CNS. The values from normal persons are in full agreement with those cited in the literature, men showing a significantly higher level of Fe than women, whereas for Zn and Cu there is no significant sex difference. In comparison with the reference group the patients show no difference at all for Fe and only a minor one for Cu, but Zn values are greatly increased in MS patients (by 25-75%). The increase is higher in the relapsing form of MS than in the chronic form, suggesting some connection with the activity of the disease. On the other hand, the duration of the illness and (implicitly) the age of the patient seem to be unimportant. As patients with other diseases of the CNS show a similar though somewhat smaller increase, we conclude that Zn elevation in whole blood is not a feature specific for MS. From the present results, however, we cannot decide if such deviations are causally connected with affections of the CNS or if they are only a concomitant manifestation. PMID- 6840150 TI - The concentration of prealbumin in cerebrospinal fluid (CSF), indicator of CSF circulation disorders. AB - Prealbumin, was determined in serum, lumbar and ventricular cerebrospinal fluid (CSF) and compared with albumin and IgG. The measured concentrations of prealbumin in the CSF indicate that there are two sources of prealbumin: a minor fraction enters the CSF via the blood-cerebrospinal fluid (B-CSF) barrier like albumin, and the major fraction enters the CSF at the ventricles, probably during production of the CSF in the ventricles. The two fractions can be calculated from the CSF concentration of prealbumin, serum prealbumin and the concentration gradient (serum/CSF) of albumin. The B-CSF barrier-independent prealbumin can be used as an indicator of CSF circulation. This was proved by the investigation of several special cases. PMID- 6840151 TI - Auscultation of bowel sounds in patients with suspected acute appendicitis--an aid in the diagnosis? Preliminary results. AB - In 12 patients with suspected acute appendicitis undergoing appendectomy the bowel sounds were registrated pre- and postoperatively with a microphone placed on the abdominal wall. The results show that auscultation and registration of bowel sounds may aid in the diagnosis of acute appendicitis. However, these results cannot be applied to the clinical situation. Further evaluation of this method is essential. PMID- 6840152 TI - Experimental pancreatitis in the rat. Development of pancreatic necrosis, ischemia and edema after intraductal sodium taurocholate injection. AB - Acute hemorrhagic pancreatitis was induced in rats by injecting sodium taurocholate into the common biliopancreatic duct. The extent of pancreatic necrosis was quantified in histological sections during the course of the disease. The proportion of necrotic acini was low, although the amount of necrosis increased from 3.3% of pancreatic parenchyma at 15 min to 10.5% at 12 h. The degree of ischemia in the inflamed pancreas was estimated by extracting intravenously injected toluidine blue from the gland. The amount of the dye in the gland decreased progressively during 12 h to 58.8% of the amount in normal pancreas. The development of pancreatic edema was studied by recording the water content of the gland. The edema was maximal at 3 h and resolved partly in 12 h after the induction of the disease. Necrosis and ischemia become progressively more pronounced in the edematous pancreas during sodium taurocholate-induced acute hemorrhagic pancreatitis. This kind of pathophysiologic course is also thought to characterize human pancreatitis. The present simple model of acute hemorrhagic pancreatitis in the rat is suitable for quantitative observations on the development of pancreatic damage under various experimental conditions. PMID- 6840153 TI - Adolescent suicide. PMID- 6840155 TI - Cascade of Services Model and emotionally disabled students. PMID- 6840154 TI - Adolescent pregnancy and special education. PMID- 6840156 TI - Parents coping with genetically handicapped children: use of early recollections. PMID- 6840157 TI - An attributional perspective on labeling. PMID- 6840158 TI - The special education evaluation process as a moderator of false positives. PMID- 6840159 TI - Acute antihypertensive effect and pharmacokinetics of a tablet preparation of nifedipine. AB - A tablet formulation of nifedipine was given to 8 hospitalized hypertensive men, W.H.O. stage I or II, mean age 45 years. After an initial placebo test, nifedipine 20, 40 or 60 mg was given in random order at 72-h intervals, in a single administration crossover study. The placebo and the active drug were given at 8 a.m. Blood pressure and heart rate were measured twice by the same observer, every 20 min from 7 to 8 a.m., and then hourly until 8 p.m., first in recumbency and again after 1 min of standing upright. Plasma nifedipine was assayed in samples taken hourly from 8 a.m. to noon, every 2 h from noon to 8 p.m., and 24 and 48 h after drug administration. All 3 doses significantly lowered blood pressure; the fall during recumbency was significantly larger (-18%) and lasted longer (12 h) after 60 mg than after 20 mg (-11% and 7 h). All 3 doses caused a similar increase in heart rate (+29 to +38%), which reached its maximum after 2 h and lasted for 5 h. The maximum plasma concentration and the area under the plasma concentration--time curve were dose-dependent despite large inter-subject variation. Absorption, bioavailability and elimination were linear between the 20 and 60 mg doses. Plasma nifedipine levels were strongly correlated with the concomitant decrease in mean arterial blood pressure (r = 0.61, p less than 0.001). Four patients experienced mild side effects (headaches, flushes, drowsiness or weakness). This tablet form of nifedipine has a potent antihypertensive action which lasts longer than that of the capsule presentation. PMID- 6840160 TI - Antihypertensive effect of diazoxide given intravenously in small repeated doses. AB - Seven patients with acutely elevated diastolic blood pressure (DBP greater than or equal to 135 mmHg) were treated with repeated injections of diazoxide 1 mg/kg body weight i.v. at 10-min intervals. If the DBP was not reduced to 110 mmHg or less after 5 injections, a dose of 5 mg/kg was given. Serum diazoxide (total and unbound) was determined by high pressure liquid chromatography. In all the patients it was possible to reduce the blood pressure to a satisfactory level (i.e. DBP less than 110 mmHg). The individual plasma diazoxide concentrations necessary to achieve the desired response ranged from 20 to 85 micrograms/ml. A significant correlation was found between the initial venous concentration and the initial reduction in blood pressure (p less than 0.02). A high initial concentration in venous blood was associated with high protein binding ("transport function", p less than 0.05), and so were the elimination half-lives, which ranged from 14.7 to 61.3 h ("depot function", p less than 0.05). It is concluded that the previously recommended therapy of injection of 5 mg/kg as a bolus should be given only to patients who do not respond to small repeated doses. PMID- 6840161 TI - Cadralazine (ISF 2469): dose-related antihypertensive activity after single oral administration to patients. AB - Cadralazine (ISF 2469) was administered to 24 hypertensive patients in single oral doses of 7.5, 10, 15, 20 and 30 mg, according to a single-blind, placebo controlled, within-patient change-over design. The study was done in 2 stages: in the first a range including the upper and lower doses was studied (7.5, 15, 30 mg and placebo), and in the second the range of doses was restricted (10, 15, 20 mg and placebo). The drug produced a significant decrease in blood pressure in the supine and standing positions. The decrease became clinically important starting from the 15 mg dose. Its action was still significant 12 h after administration. A significant increase in heart rate was also observed. All the effects were correlated with the dose. Side effects occurred mainly after the 30 mg dose. Thus, cadralazine, in a single oral dose in man, showed good antihypertensive activity starting from the 15 mg dose, and its effect was dose-related, slow in onset and long-lasting. PMID- 6840162 TI - Acute haemodynamic effects of a single intravenous dose of piretanide in congestive heart failure. AB - The haemodynamic effect of a single 12 mg intravenous dose of piretanide was assessed in 11 patients with congestive heart failure. It did not cause any change in cardiac output, heart rate or systemic vascular resistance, whereas the pulmonary wedge, mean pulmonary and right atrial pressures and pulmonary blood volume fell progressively, the difference from the control values being significant 5 minutes after the injection. The temporal evolution of the ratios pulmonary wedge pressure/total blood volume, pulmonary blood volume/total blood volume, right atrial pressure/total blood volume was chiefly determined by the numerator, which in all cases showed a more rapid decrease than total blood volume. Serum electrolytes remained unchanged 1 hour after the injection of the drug, except for potassium which fell from 4.9 to 4.1 mEq/l, while urinary sodium and potassium excretion were greatly increased. This high ceiling diuretic appears to have renal and venodilator properties close to those of furosemide. PMID- 6840163 TI - Haemodynamic and clinical effects of isosorbide-dinitrate in patients with severe effort angina on beta-blocking treatment. AB - The effect of isosorbide-dinitrate (ISDN) 20 mg 4 times daily against placebo has been tested in 12 patients with stable effort induced angina pectoris receiving prophylactic treatment with metoprolol. ISDN did not decrease the attack rate or nitroglycerine consumption, nor was exercise tolerance increased after it. Left ventricular function, assessed by radionuclide ventriculography, increased in 6 out of 8 patients (p less than 0.1). It is concluded that ISDN has no place in the treatment of haemodynamically intact patients with severe angina pectoris in spite of beta-blocking treatment, but that it may be of value in the treatment of patients with left ventricular failure, including those whose left ventricular failure has been brought about by beta-blocking treatment necessitated by angina pectoris. PMID- 6840164 TI - Systolic time intervals: the effect of stroke volume in healthy young men. AB - 1. Positional change and exercise were used to gain a range of heart rates and stroke volumes in 20 healthy male subjects, and a regression plane computed for the 3 principal systolic time intervals. The addition of stroke volume as a second physiological variable was shown to result in an increase in the coefficient of determination of 13% for the LVET and 10% for the PEP. The QS2 was found to be dependent only on heart rate. It is concluded from this preliminary study that the addition of stroke volume and the derivation of a planar regression equation would allow calculation of potentially more useful index values for the LVET and PEP. PMID- 6840165 TI - Pharmacodynamic and pharmacokinetic evaluation in man of the new sympathomimetic amezinium. AB - Blood pressure, ECG and plasma concentration were determined for up to 12 h following single i.v. (10 mg) and oral (20 mg) doses of amezinium (Regulton) in 8 healthy, male volunteers. The i.v. and oral doses were almost equi-active in significantly increasing systolic blood pressure (SBP) by 14.5 and 15.6 mmHg, respectively. The maximum SBP after the i.v. dose was reached after 45 min, and 105 min after oral administration. The heart rate fell reflexly. The increases in mean and diastolic blood pressures were not significant. Pulse pressure was enhanced after both i.v. and oral administration. The effect on systolic blood pressure lasted for about 4 h. There was a slight shortening of the QTc duration, which could not be explained as a drug effect. Other ECG time intervals were not altered. Multiple regression analysis showed a significant positive correlation between the log plasma concentration and the increase in SBP between 0.5 and 5 h after oral administration (r = 0.78, p less than 0.001) and between 0.75 and 5 h after i.v. administration (r = 0.83, p less than 0.001). 30 min after amezinium p.o. the mean SBP began to rise, when a plasma level of about 30 ng/ml was reached. PMID- 6840166 TI - A naturalistic study of hypertension in a rural U.K. community. 2 Years results. AB - A naturalistic study was set up to screen, identify and treat hypertensive patients aged 20-60 years in a rural general practice. 3,222 patients (92%) of a stable population of 3,489 were screened by 2 nurse research assistants and of these 455 patients (14%) were found to be hypertensive or borderline hypertensive. After careful assessment, 192 of these patients were found suitable for treatment and subsequently 138 entered the study. Two well recognised treatment regimes were used and no significant difference between patient response resulted. 84 patients (60.9%) completed the 2 year duration of the study discussed here. The cost of the study is not feasible in an average general practice, but day to day running of such a project, run along clearly defined treatment regimes was managed easily by 2 research assistants: this reduced, therefore, the work load on individual general practitioners. PMID- 6840167 TI - Plasma concentration of disopyramide given as capsules and controlled release tablets. AB - Steady state plasma levels and clinical effects of disopyramide have been compared following administration of standard capsules and controlled release (CR) tablets. Nineteen patients (29-70 years) with atrial or ventricular arrhythmias were treated for two weeks with disopyramide capsules 200 mg t.i.d. and then with CR tablets 300 mg b.i.d. for 14 weeks. After treatment either with capsules or CR tablets, plasma concentrations of disopyramide and its metabolite N-deisopropyldisopyramide were similar within 1 dosage interval. Maximum and minimum concentrations of the parent drug were 10.1 +/- 0.9 mumol/l (mean +/- SEM) and 5.7 +/- 0.5 mumol/l with CR tablets, and 10.2 +/- 0.5 mumol/l and 5.6 +/ 0.5 mumol/l with standard capsules. The bioavailability of disopyramide was the same after capsules and CR tablets. Disopyramide, independent of the formulation, produced good antiarrhythmic effects. The side-effects reported on questioning were mainly of the anti-cholinergic type and there was no significant difference between the formulations with respect to their incidence, type or severity. Of 16 patients who stated a preference for one of the dosage forms, 11 prefered the CR tablets. The study confirms the good antiarrhythmic effect of disopyramide and shows that the CR preparation permits twice daily administration of disopyramide. PMID- 6840168 TI - Sustained serum theophylline concentrations during chronic twice daily administration of a slow release preparation. AB - Theophylline concentrations were measured in a clinical setting in 15 patients given a slow release theophylline preparation (Theo-Dur) every 12 h for reversible obstructive airways disease. Doses of 300-600 mg (464 +/- 134), 12 hourly, resulted in mean serum concentrations which increased from 11.2 +/- 2.9 micrograms/ml at 0 h to a peak of 15.5 +/- 4.6 micrograms/ml at 6 h and decreased again to 10.4 +/- 2.9 micrograms/ml at 12 h. The mean percentage fluctuation of serum concentrations (maximum minus minimum expressed as a % of the maximum) was 38.6 +/- 10.1%, range 20.3% to 54.9%. There was a significant positive correlation between % fluctuation and theophylline steady-state clearance determinations. Excluding a single heavy smoker, theophylline clearance also showed a significant inverse relationship with age. These data suggest that when this slow release preparation is given 12 hourly, satisfactorily sustained serum theophylline concentrations will be achieved in most adults. PMID- 6840169 TI - Pharmacokinetics of Sobrerol in chronic bronchitis. Comparison of serum and bronchial mucus levels. AB - The pharmacokinetic profile of Sobrerol, a mucolytic drug, has been studied in patients with acute exacerbations of chronic bronchitis and dense sputum. In addition to measurement of serum and urine levels, the concentration in bronchial mucus was also examined, and their correlation was calculated. Mass fragmentographic analysis was used to assay free sobrerol and its principal urinary metabolites hydrated carvone and glucuronidated sobrerol. After the doses and administration routes used, there appeared to be accumulation of sobrerol in bronchial mucus. This is a feature of great interest and value for a drug which has the specific action of liquifying mucus. PMID- 6840170 TI - Increased oral clearance of metoprolol in pregnancy. AB - The disposition of oral metoprolol was studied in 5 women during the last trimester of pregnancy and 3 to 5 months after delivery. After a single oral dose of 100 mg the individual peak plasma concentration in the pregnant state was only 20-40% of that after pregnancy. The plasma half-lives of metoprolol were about the same during (average 1.3 h) and after pregnancy (average 1.7 h). By contrast, the area under the plasma concentration versus time curve was much smaller during (mean 262 nmol/1 X h) than after (mean 1298 nmol/1 X h) pregnancy, resulting in an average apparent oral clearance (Clo) of metoprolol that was 4.4 times higher during (362 ml X kg-1 body-weight X min-1) than after pregnancy. The increased Clo in pregnancy is assumed to be due to enhanced hepatic metabolism of the drug. The possible clinical consequence of the difference in the disposition of metoprolol is discussed. PMID- 6840171 TI - Pharmacokinetics of metoprolol and its metabolite alpha-OH-metoprolol in healthy, non-smoking, elderly individuals. AB - The absorption and disposition of metoprolol have been evaluated in 10 healthy, non-smoking, elderly individuals (mean age 73.1 years) by simultaneous determination of [3H]-metoprolol and unlabelled metoprolol. The labelled drug was given as an intravenous tracer dose, immediately followed by oral metoprolol 25 mg. The experiment was preceded by administration of metoprolol 25 mg b.i.d. for 3 days. The volume of distribution, elimination half-life and total body clearance were almost the same as previously observed in healthy, young subjects. The mean systemic availability was about 39% in the elderly, which is lower than the mean of 55% observed in a control group of young volunteers who received 50 mg b.i.d. In the elderly, the mean plasma concentration of alpha-OH-metoprolol was about twice as high as that of the parent drug, whereas the opposite was true of the control group. The results indicate that age-related physiological changes have a negligible effect on the pharmacokinetics of metoprolol. PMID- 6840172 TI - Pharmacokinetic interactions of timolol with vasodilating drugs, food and phenobarbitone in healthy human volunteers. AB - Pharmacokinetic interactions of oral timolol maleate 10 mg, with food (3566 kJ), single oral doses of prazosin 1 mg and dihydralazine 25 mg, and with a 1 week pretreatment with phenobarbitone 100 mg daily were examined in a randomized crossover study in 12 healthy volunteers. After fasting, the peak level (Cmax = 29.1 +/- 3.2 ng/ml; mean +/- SEM) was reached at 1.3 +/- 0.1 h (Tmax). The total area under the serum concentration-time curve (AUC0-infinity) was 154.4 +/- 33.8 ng x h/ml, total clearance (Cltot) 751.5 +/- 90.6 ml/min, renal clearance (Clren) 97.2 +/- 10.1 ml/min, elimination half-life (t1/2) 2.9 +/- 0.3 h and 24-h recovery in urine (X0u-24) 11.1 +/- 1.4% of the dose. Food and prazosin did not significantly affect the fate of timolol maleate. Dihydralazine enhanced Cmax (38.2 +/- 4.6 ng/ml) only when compared to phenobarbitone treatment, and did not affect any other parameters. Phenobarbitone pretreatment somewhat lowered Cmax (25.5 +/- 3.9 ng/ml), AUC0-infinity (117.5 +/- 22.1; p less than 0.05 vs food) and X0u-24 (8.7 +/- 1.2%), evidently by increasing Cltot (957.5 +/- 116.9 ml/min; p less than 0.05 vs food), but it did not affect Clren. It is concluded that the pharmacokinetics of timolol maleate can be altered to a limited extent in opposite directions by dihydralazine and phenobarbitone. PMID- 6840173 TI - Plasma levels of sulfinpyrazone and of two of its metabolites after a single dose and during the steady state. AB - The pharmacokinetics of sulfinpyrazone, and the plasma levels of its sulfide and sulfone metabolites, have been determined after a single oral dose (400 mg) and during steady-state conditions (4 x 200 mg daily for 6 days) in healthy female volunteers. The plasma half-lives of sulfinpyrazone, the sulfone and the sulfide were 3.7, 3.2 and 14.7 h, respectively, during steady-state. After a single dose and during steady state conditions the half-lives of sulfinpyrazone and the sulfone did not differ significantly. The trough plasma levels of the sulfide metabolite exceeded those of the parent compound in four of the six volunteers on the last day of the study. The data suggest that in man the most likely candidate for the prolonged inhibition of platelet aggregation observed after treatment with sulfinpyrazone is its sulfide metabolite, because of its prolonged elimination. PMID- 6840174 TI - Plasma chlorpropamide: a critical factor in chlorpropamide-alcohol flush. AB - The chlorpropamide-alcohol flush (CPAF) phenomenon was quantitatively related to blood levels of acetaldehyde and chlorpropamide in 105 Type II diabetics, of whom 74 had not previously taken the drug and 31 were on chronic treatment. Standardized skin temperature recordings were made with a sensitive probe. Plasma ethanol and acetaldehyde concentrations were determined by gas chromatography, and those of chlorpropamide by high-pressure liquid chromatography. There were significant positive correlations between plasma acetaldehyde and the skin temperature increase, between plasma chlorpropamide and plasma acetaldehyde, and between plasma chlorpropamide and the skin temperature increase. CPAF-positive patients became CPAF-negative and vice versa following reduction and increase, respectively, in the dose of chlorpropamide. Thus, the CPAF reaction is a consequence of chlorpropamide inhibition of the oxidation of ethanol-generated acetaldehyde, and it appears that the plasma concentration of chlorpropamide is critical. It remains an open question whether the CPAF test has any prognostic value. PMID- 6840176 TI - Pharmacokinetics of chlorambucil in man after administration of the free drug and its prednisolone ester (prednimustine, Leo 1031). AB - The pharmacokinetics of chlorambucil has been investigated in a cross over study after oral administration of the free drug (10 mg) and its prednisolone ester (prednimustine, 100 mg). The bioavailability of chlorambucil was about five times lower when given as prednimustine as compared to administration of the free drug. The peak plasma concentration was about twice as high and it was obtained more rapidly when the free drug was given. No intact prednimustine could be detected in plasma. PMID- 6840175 TI - Enzyme-inducing drug combinations and their effects on liver microsomal enzyme activity in man. AB - The effect of 2 different drug combinations on liver microsomal activity was investigated in healthy volunteers by administering antipyrine 1200 mg and phenobarbitone 100 mg, or the same dose of antipyrine with rifampicin 600 mg daily for 14 days. The effect of rifampicin 1200 mg given for only 8 days was also studied. Before and after each drug regimen, estimates were made of the total body clearance of antipyrine, gamma-glutamyl-transferase (gamma-GT) and urinary excretion of 6-beta-hydroxycortisol as in vivo parameters of liver microsomal enzyme activity. Following combined antipyrine and phenobarbitone administration, the antipyrine clearance was increased by 80%, after antipyrine with rifampicin by 128%, and after rifampicin alone by 104%. 6-beta hydroxycortisol, corrected for 17-hydroxycorticosteroids, increased from 2.6% to 8% following antipyrine plus phenobarbitone, from 4.4% to 27.9% following antipyrine plus rifampicin, and from 5.4% to 29.7% after rifampicin given alone. Based on previous studies, antipyrine given with phenobarbitone produced slightly more induction than phenobarbitone given alone. Following antipyrine 1200 mg with rifampicin 600 mg for 14 days a significantly greater increase in antipyrine clearance and 6-beta-hydroxycortisol excretion was observed than when either drug was given alone. PMID- 6840177 TI - Doxorubicin and 5-fluorouracil plasma concentrations and detectability in parotid saliva. AB - Doxorubicin and 5-fluorouracil pharmacokinetics were studied in 19 volunteers with various advanced neoplastic diseases who received 50-90 mg doxorubicin or 600-1000 mg 5-fluorouracil intravenously, followed by plasma and parotid saliva collection over a 75 min period. The extent to which these chemotherapeutic agents are bound to plasma proteins, at concentrations chosen to approximate plasma concentrations, was measured by equilibrium dialysis. Both agents were quantitated by high-performance liquid chromatography. As reported previously, a wide range of plasma levels were found among patients receiving similar doses of either doxorubicin or 5-fluorouracil. It appears that in addition to being quickly cleared from the plasma both chemotherapeutic agents are excreted in detectable amounts in parotid saliva, a route of elimination heretofore given little or no attention. Excretion in the saliva exposes the mucosa of the upper gastrointestinal tract to 5-fluorouracil after intravenous administration and may play a part in causing stomatitis in patients receiving it by this route. Since there are huge interindividual and pronounced intraindividual differences in S/P ratios mostly not systematically related to the drugs' concentration in plasma, the concentration in parotid saliva was not useful in predicting the level of free doxorubicin or 5-fluorouracil in plasma. PMID- 6840179 TI - Chloroquine kinetics in the undernourished. AB - The plasma and whole blood kinetics of chloroquine was studied in 7 normal and 8 undernourished subjects following a single oral dose of 600 mg. The terminal half lives were similar in both groups. The AUC was also similar in the 2 groups, even though a higher dose per kg body weight was administered to the undernourished. This was probably because of faster clearance in this group. Chloroquine uptake by erythrocytes, its main site of action in malaria, was also comparable in the two groups. The plasma concentration of chloroquine over a period of time was found to be similar in 4 normal and 4 undernourished subjects following administration of 1.5 g of the drug in divided doses. The undernourished appear, therefore, to handle chloroquine in such a way that they do not suffer a greater risk of toxicity than normals. PMID- 6840178 TI - Clinical effect and pharmacokinetics of trimethoprim-sulphadiazine in children with urinary tract infections. AB - The clinical effect and pharmacokinetics of the combination trimethoprim (TMP) sulphadiazine (SD) were studied in 18 children with acute urinary tract infections (UTI), aged 2-56 months. A suspension of TMP-SD (9 + 41 mg/ml) was taken orally twice daily for 10 days. Various doses of TMP (2.9-3.7 mg/kg/day) and SD (12.9-16.7 mg/kg/day) were also given to children of different ages. After 2-4 days of treatment, bacterial cultures of urine were negative and C-reactive protein in serum, WBC count and ESR in all patients had become normal. Steady state serum levels for both components were reached after 4 or more days of treatment. At steady state, mean peak serum concentrations of TMP and SD of 1.4 micrograms/ml and 27 micrograms/ml, respectively, were found within 2-4 h after a fasting morning dose. The biological half-lives of TMP and SD were of the same order of magnitude, but the total clearance of TMP was 5 times greater than that of SD. The concentrations of TMP-SD in urine were invariably more than 10 times the minimum inhibitory concentrations (MIC) for the causative organisms (tested at the ratios 1:20 and 1:4 of TMP and SD). Non-metabolized SD constituted 77% of total SD in urine of infants, and 55% of total SD in children of 1 year or more. The TMP-SD combination showed a satisfactory clinical effect and favourable pharmacokinetic properties in children with UTI. PMID- 6840180 TI - Unwanted symptoms in depressed patients treated with viloxazine: an algorithm for identification of illness-related symptoms. AB - Ninety-six depressed outpatients from 5 centres were given viloxazine 200-400 mg/day. The treatment produced significant clinical improvement as evaluated by the Hamilton Rating Scale for Depression. Thirteen patients dropped-out because of possible side effects. Many untoward symptoms were described by all the patients. To distinguish between illness-related symptoms (IRSs) and potential side effect symptoms (SESs) a new approach was taken, using an algorithm that provides a decision strategy based on the time course both of the symptom and the illness. By this procedure, 90 of the 187 claimed untoward symptoms were identified as IRSs. Of the 97 potential SESs, only 36 were spontaneously volunteered, and the remaining 61 symptoms were elicited on specific questioning. Whenever possible, volunteered potential SESs were assessed to determine the relationship between the drug treatment and the adverse reaction. It was found that only a few instances of gastric disturbance and exacerbation of anxiety were probably viloxazine-related. PMID- 6840181 TI - The pharmacokinetics of melphalan in patients with multiple myeloma: an intravenous/oral study using a conventional dose regimen. AB - The pharmacokinetics of melphalan have been studied after intravenous and oral dosing (10 mg) in 6 patients with multiple myeloma. After intravenous administration, mean plasma t0.5 alpha was 8.0 +/- 2.3 min, t0,5 beta was 63.3 +/ 8.7 min, and total systemic clearance was 510.4 +/- 57.9 ml/min. After oral administration, the drug was rapidly absorbed (lag-time = 18.4 +/- 3.7 min, absorption rate constant = 0.0547 +/- 0.0166 min-1, Tmax = 59.3 +/- 6.6 min), but there was considerable variation in its bioavailability (61.5 - 102.0% mean 78.3 +/- 6.3%). Variability in drug absorption may be responsible, at least in part, for variation in response to this drug. PMID- 6840182 TI - Role of the endothelium in the vasodilator response of rat thoracic aorta to histamine. AB - Despite their potent vasodilating action in vivo, acetylcholine and histamine often show a vasoconstricting action in vitro. As the endothelium has an important role in the vasodilating effect of acetylcholine, we investigated the possible role of the endothelium in the vasodilating effect of histamine in comparison to acetylcholine. Experiments were done on ring segments of rat thoracic aorta mounted for isometric tension measurements. We demonstrated that relaxation by histamine and acetylcholine of pre-contracted rat aorta segments required the presence of endothelial cells. Acetylcholine acting on muscarinic receptors, and histamine acting on H1-receptors seemed to initiate the production of mediator(s) from the endothelial cells, which leads to relaxation of the vascular smooth muscle cells. This production appeared to be depressed by ETYA and hydroquinone, and under hypoxic conditions. PMID- 6840183 TI - Effects of cholinomimetics on glucose utilization in rat brain optic systems. AB - Physostigmine and oxotremorine effects on local cerebral glucose utilization (LCGU) in rat brain optic systems were examined by the [14C]2-deoxy-D-glucose procedure. Both drugs significantly stimulated LCGU in the superior colliculus (superficial layer) and nucleus of the optic tract, but not in the visual cortex. Physostigmine, but not oxotremorine, stimulated LCGU in components of the accessory optic system. The effects in the accessory optic system apparently result from nicotinic actions of physostigmine. PMID- 6840184 TI - Antigen sensitization does not alter response of guinea-pig lung strips to noradrenaline. AB - Guinea-pigs were sensitized to ovalbumin by an intraperitoneal injection, followed 3 weeks later by daily aerosol exposure for 4 weeks. Noradrenaline induced contractions of peripheral lung strips from sensitized and unsensitized guinea-pigs were compared. There were no differences in sensitized or unsensitized strips with respect to maximal tension generated, concentration of noradrenaline for threshold or maximal responses or EC50. These results suggest that any changes in the population of alpha-adrenoceptors consequent upon immunological sensitization did not influence contractile responses to noradrenaline. PMID- 6840185 TI - Effects of chronic sino-aortic denervation in male rats on regional catecholamine levels and turnover and on neuroendocrine function. AB - A four week sino-aortic denervation produces an increase of adrenaline (A) turnover in the anterior but not the posterior hypothalamus and a selective reduction of dopamine stores in the anterior hypothalamus. Furthermore, the mean arterial blood pressure and heart rate are unchanged in conscious animals, and a selective increase in LH secretion is observed. The activation of a compensatory vasodepressor adrenergic mechanism in the anterior hypothalamus may in part be responsible for the maintenance of a normal mean arterial blood pressure after chronic sino-aortic denervation. The neurochemical changes in the hypothalamic area may also be related to the increase in LH secretion found after chronic sino aortic denervation. PMID- 6840186 TI - Inhibition by d-amphetamine of the electrically evoked release of [3H]acetylcholine from slices of the rat striatum: involvement of dopamine receptors. PMID- 6840187 TI - Comparison of the bradycardic effects of alinidine (St 567), AQ-A 39 and verapamil on guinea-pig sinoatrial node superfused with different Ca2+ and NaCl solutions. AB - Two new substances, alinidine (St 567) and AQ-A 39, previously described as 'specific bradycardic agents' were investigated with respect to their effects on the rate of electrical discharges from sinus nodes of isolated right guinea-pig atria. Both substances decreased the discharge rate concentration dependently within a wide range (3-100 micrograms/ml). Low external Ca2+ (0.18 mM) increased and low external NaCl (62 mM) decreased the rate lowering effect of alinidine as well as of AQ-A 39. In contrast, the reference compound verapamil (an inhibitor of slow inward current) was less effective in low Ca2+ and more effective in low NaCl. The similar reactions of alinidine and AQ-A 39 are discussed with respect to their different chemical structure and different electrophysiological action patterns as described so far. PMID- 6840189 TI - Anticonvulsant activity of some 2-aminoethanesulphonic acid (taurine) derivatives. AB - A number of aliphatic 2-aminoethanesulphonic acid (taurine) derivatives were tested for their anticonvulsant activity in maximal electroshock seizure and pentylenetetrazole seizure threshold tests in mice. Certain piperidino, benzamido, phthalimido and phenylsuccinylimido derivatives were effective. Phthalimidoethanesulphon-N-methylamide, which inhibited the binding of both taurine and GABA to isolated synaptic membranes, appeared the best anticonvulsant among the derivatives tested. PMID- 6840188 TI - Ex vivo binding to glucocorticoid receptors in the thymus of the adrenalectomized rat. AB - The interaction of glucocorticoids with thymic cytosol receptors in the adrenalectomized rat was studied by a method based on their capacity to deplete cytosol receptors when administered in vivo. Three h after a single oral administration of reference steroids at various dose levels, thymus cytosol aliquots were incubated with a saturating concentration of [3H]dexamethasone (30 nM) for 24 h at 0-2 degrees C with and without 2000 nM unlabeled dexamethasone. Bound radioactivity was determined by dextran-coated charcoal adsorption. The depletion of cytosol receptors was dose-dependent for each glucocorticoid, with the following ED50 (mg/kg): fluocinolone acetonide 0.032, dexamethasone 0.09, triamcinolone acetonide 0.12, betamethasone 0.24, deflazacort 0.55, triamcinolone 1.6, prednisolone 4.0, hydrocortisone 17.0. A striking correlation (r 0.991) between ex vivo receptor binding and thymolytic effect was observed. When data from in vitro competition studies were compared with those obtained in ex vivo experiments, the latter were correlated more tightly with the biological response. PMID- 6840190 TI - The relaxing effect of caerulein on isolated human internal anal sphincter. AB - In the attempt to find a pharmacological treatment for the spasm of the internal anal sphincter, usually associated with anal fissures, the activity of caerulein on human internal and sphincter was investigated in vitro and in vivo. In the isolated distal part of the internal and sphincter, caerulein (0.61 microM) depressed resting muscle tone and caused marked relaxation of norepinephrine contracted preparations. The effect of caerulein was reduced by atropine and increased by physostigmine, suggesting that it was largely due to the release of acetylcholine. In vivo, intravenous infusion of caerulein, both to healthy volunteers and to subjects affected by anal fissures and anal sphincter hypertone, did not modify the values of internal anal sphincter pressure. The lack of spasmolytic effect of caerulein in vivo may have been due to the relatively unimportant influence of cholinergic neurons on the control of internal anal sphincter tone. Alternatively, the presence of fibrosis caused by anal fissures could hinder sphincter relaxation. PMID- 6840191 TI - Systemic apomorphine reverses intrastriatal dopamine-induced contralateral deviation. AB - Contralateral deviation induced by unilateral injection of 25 micrograms or 100 micrograms dopamine into the dorsal CPU was reversed to ipsilateral deviation by apomorphine administered systemically (1 mg/kg s.c.) before, at the same time, or after the dopamine. Contralateral deviation to a unilateral intrastriatal injection of 6.25 micrograms apomorphine was also reversed to ipsilateral deviation by systemically administered apomorphine. No significant effects on postural deviation were found when a control solution was injected unilaterally into the striatum, followed by systemic apomorphine. Contralateral deviation to the unilateral intrastriatal dopamine injection continued following a further bilateral intrastriatal injection of either dopamine or apomorphine. These results suggest that intrastriatal dopamine indirectly affects sites receptive to dopamine outside the striatum. PMID- 6840192 TI - Circadian rhythm of [3H]imipramine binding in the rat suprachiasmatic nuclei. AB - High affinity imipramine binding undergoes circadian variations of ca. 35% amplitude in many rat brain nuclei. The suprachiasmatic nuclei of the anterior hypothalamus (considered to be the circadian pacemaker driving many overt rhythms) has highest imipramine binding at the end of the dark and lowest at the end of the light phase. A similar circadian rhythm has previously been observed for serotonin uptake in the suprachiasmatic nuclei. In conjunction with other findings, these data indicate that serotonergic turnover in the suprachiasmatic nuclei decreases at lights on and increases at lights off. PMID- 6840193 TI - Subcellular distribution of high affinity [3H]imipramine binding and [3H]serotonin uptake in rat brain. AB - The binding of [3H]imipramine to various subcellular fractions of rat brain was investigated. Using sodium free buffer or 0.5 microM chlorimipramine to define nonspecific binding, the specific binding was found to be associated with the synaptosomal fraction, as was the uptake of [3H]serotonin. A significant quantity of 'displaceable' binding was observed in the myelin and nuclear fractions when 'specific' binding was defined using only one concentration of [3H]imipramine and a large molar excess of chlorimipramine. This 'pseudospecific' binding was of low affinity and was not affected by the presence or absence of sodium. PMID- 6840194 TI - Enhancement by histamine of the contractile effects of leukotriene D4 on extralobar pulmonary arteries isolated from the guinea pig. AB - A 5 min pretreatment of the proximal half of the main pulmonary artery (PM) with a concentration of histamine that produced a small degree of contraction (about 8% of maximum) resulted in a large increase in the contractile responses produced by cumulatively increasing concentrations of leukotriene D4 (LTD4). LTD4-induced responses in the distal half of the main artery and the right and left main arterial branches were not markedly altered by concentrations of histamine that produced a magnitude of contraction similar to that produced in the PM segment. The data demonstrate that the potentiative interaction between histamine and LTD4 is not dependent on the contractile event per se. PMID- 6840195 TI - Altered hindlimb extension in the rat after DSP-4: a useful marker of central noradrenergic depletion. AB - Rats treated with DSP-4, a selective noradrenergic neurotoxin, usually exhibited an attenuation of hindlimb extension when suspended by the tail. Those animals showing the reduced extension had no post-decapitation reflex (PDR), whereas those animals having a normal extension had the PDR. On this basis, rats injected with DSP-4 can be readily screened for an effective or ineffective noradrenergic lesion. Preliminary evidence suggests that the alpha 2-adrenoceptor is involved in the regulation of hindlimb extension. PMID- 6840196 TI - Effects of adenosine on [3H]norepinephrine release from perfused mesenteric arteries of SHR and renal hypertensive rats. AB - Adenosine (10-30 microM) inhibited the 3H-efflux evoked by sympathetic nerve stimulation in the perfused rat mesenteric arteries preincubated with [3H]norepinephrine. The inhibition was smaller in the prehypertensive (5 weeks old) as well as hypertensive (15-18 weeks) SHR (spontaneously hypertensive rats), compared with age-matched normotensive Wistar Kyoto rats. However, it was not diminished in Wistar rats rendered hypertensive by left renal artery occlusion. Thus, a diminished adenosine-mediated presynaptic inhibition of adrenergic transmission appears to be genetically inherent in SHR. PMID- 6840197 TI - Chinese hamster metaphase chromosomes isolated under physiological conditions. A partial characterization of associated non-histone proteins and protein cores. AB - In a previous report [2] we have described a non-histone protein core which could be isolated from Chinese hamster metaphase chromosomes. This core structure maintained the overall morphology of the metaphase chromosome even after removal of all of the histones, together with many of the non-histone proteins and the bulk of the DNA. As part of our work on the characterization of these core structures, we have developed a novel procedure for the isolation of metaphase chromosomes which avoids the use of high pH buffers and hexylene glycol, as well as eliminating the numerous centrifugation and resuspension steps previously employed. Chromosome cores prepared by 2 M NaCl extraction and DNase I digestion from metaphase chromosomes isolated under these more gentle, quasi-physiological conditions, are shown to contain a relatively simple subset of non-histone proteins. One-dimensional SDS-polyacrylamide gel electrophoresis shows two major groups of polypeptides having molecular weights 48 000-52 000 and 65 000-72 000 D respectively, with similarities in mobilities to the nuclear pore complex-lamina polypeptides and tubulins. However, more detailed analysis by two-dimensional gel electrophoresis and peptide mapping has failed to detect these proteins. A 52 000 D polypeptide component of the core is tentatively identified as the intermediate filament protein vimentin. The in vivo significance of chromosome cores is discussed. PMID- 6840198 TI - Proteins of de-membraned protamine-depleted mouse sperm. Homology with proteins of somatic cell nuclear envelope/matrix. AB - Following treatment with Triton X/1 M NaCl/2-mercaptoethanol, mouse sperm heads are divested of protamines and other basic proteins; the residual structure is one in which the general morphological organization of the decondensed chromatin and the nuclear boundaries are conserved [1]. In this study, the protein complement of that residual structure has been characterized and subdivided into two sets: 1. Those that are sperm-unique, including constituents of the sperm head that may be intrinsically nuclear (or extra-nuclear, but exceedingly adherent to the nuclear envelope). 2. Those that display corresponding electrophoretic properties and immunologic cross-reactivity with proteins of similarly treated mouse somatic cell nuclei. Among the latter are proteins of molecular weight 52, 63 and 69 kD, two of which (63 and 69 kD) appear to be homologous to polypeptides of somatic nuclear envelope/pore complex lamina. Absence from sperm nuclei of the third of the characteristic predominant triplet of somatic nuclear lamina polypeptides of mammalian cells, here designated 67 kD, indicates cell-type variation in these structures. On the other hand, the identification of homologous polypeptides in the sperm and somatic complements suggests that those are specific instances of conservation and may represent the paternal contribution to the pool of polypeptides for assembly of the envelopes of the pronuclei of the one-cell embryo. PMID- 6840199 TI - Internalization and recycling of plasma membrane glycoconjugates during pinocytosis in the macrophage cell line, P388D1. Kinetic evidence for compartmentation of internalized membranes. AB - An analysis was made of the pinocytosis-derived internalization and recycling of membrane in the macrophage cell line, P388D1. Plasma membrane glycoconjugates, reversibly labelled with [3H]galactose, were used as a membrane marker. Label internalized with the plasma membrane was no longer accessible to release by externally added beta-galactosidase and could therefore be distinguished quantitatively from label remaining on the cell surface. Direct experimental evidence for membrane recycling was obtained by demonstrating that previously internalized label reappeared at the cell surface. The composition of labelled membrane glycoconjugates, as analysed by SDS-polyacrylamide gel electrophoresis, remained unaltered before and after internalization. The label remained membrane bound in an unmodified way during the entire period of 8 h investigated, corresponding to about twenty-four cycles of membrane flow. Membrane flow led to a steady-state distribution of label between the plasma membrane and intracellular membranes. The redistribution of label occurred with biphasic kinetics, which could be described as the sum of two exponential functions. This behavior is explained by presenting a model of membrane flow between the plasma membrane and two consecutive intracellular membrane compartments, which we assume to consist of pinosomal membranes and of pinosome-derived membrane of secondary lysosomes. The relative membrane surface areas turn out to be in the ratio of 100:12.5:7.3, respectively. At the observed rate of pinocytosis, the equivalent of the plasma membrane is internalized once every 21 min, in the form of primary pinosomes of the size 0.24 micrometer. The residence time of membranes in the pinosome compartment is about 3 min. The rate at which membranes enter the lysosomal compartment is 31 times lower than the rate of membrane internalization. We conclude that only 3% of the amount of membrane internalized at any one time subsequently enters the secondary lysosome compartment. After a residence time of 49 min this membrane fraction is finally recycled to the cell surface. The results are discussed in terms of mixing and sorting-out of pinosomal and lysosomal membranes. PMID- 6840200 TI - Ultrastructural studies on autolysosomes in rat hepatocytes after leupeptin treatment. AB - We have studied the morphological alterations of the lysosomal compartment in rat hepatocytes following intraperitoneal administration of leupeptin, using electron microscopy and cytochemical techniques. At 30 min after the injection, autophagic vacuoles (autophagosomes and autolysosomes), containing cytoplasmic organelles, increased in number in the vicinity of bile canaliculi and also near the Golgi apparatus. At 1 h, most of the autophagic vacuoles were autolysosomes, single membrane-limited bodies positive for acid phosphatase activity. Development of the autolysosomes was accompanied by the reciprocal disappearance of pre-existing secondary lysosomes. From 1 to 8 h, the autolysosomes varied to a great extent in both size and shape as a result of coalescence. Segregated organelles within the autolysosomes were gradually degraded into electron-lucent unidentifiable debris. At later, residual bodies were abundant in the cytoplasm, and occasionally, their contents were discharged into the space of Disse. From 9 to 12 h, the autolysosomes decreased in the volume and number and secondary lysosomes of normal shape and size appeared. The autolysosomes seem to persist for long periods because of a retarded degradation of sequestered materials in leupeptin treated hepatocytes. PMID- 6840201 TI - Identification and changes in activity of five thymidine kinase forms during the cell cycle of Physarum polycephalum. AB - Five forms of thymidine kinase have been identified on isoelectric focusing gels of Physarum polycephalum supernatants. Their isoelectric points are 5.9, 6.4, 6.7, 6.9 and 7.1. All are inhibited by deoxythymidine 5'-triphosphate (dTTP). The activity of the pI 7.1 form does not change significantly during the cell cycle. The other four forms change in activity. About 1 h before metaphase the activity of the four more acidic forms is first detected. Their activity peaks during telophase, and by 1 h after metaphase there is a 50% decrease in activity of the 5.9 form. By 3 h after metaphase the activity of the 6.4 form has dropped more sharply than the activity of the 6.7 form. By 6 h after metaphase only the activity of the 6.9 form is present in significant amounts in addition to the 7.1 form. The activity of these new acidic forms probably accounts for the reported increase in total thymidine kinase activity during mitosis and early S phase. PMID- 6840202 TI - Progress through G1 and S in relation to net protein accumulation in human NHIK 3025 cells. AB - We have investigated whether human NHIK 3025 cells are dependent upon a net increase in cellular protein content in order to traverse G1 and S. The increase in DNA and protein content was studied by means of two-parameter flow cytometry using populations of cells synchronized by mitotic selection. By adding 1 microM cycloheximide to the medium protein synthesis was partially inhibited, resulting in negligible net accumulation of protein. The cells were able to enter S and progress through S under such conditions. The latter was the case whether the cells had been accumulating protein during G1 or not. The results further indicate that the larger cells enter S earlier and traverse S at a higher rate than the smaller cells. Our conclusion is that net accumulation of protein does not seem to be a prerequisite for traverse through G1 and S, i.e. DNA replication may be dissociated from the general growth of cell mass. PMID- 6840203 TI - An ultrastructural study of the interaction of liposomes with plant protoplasts. AB - A one-step procedure using a mixture of glutaraldehyde and osmium tetroxide was devised to fix in situ large unilamellar liposomes of phosphatidylserine for transmission electron microscopy (TEM), since the conventional fixation method was found to be inadequate in this respect. The new fixation procedure enabled us to visualize the sequence of events in the interaction of liposomes with protoplasts from Vinca rosea suspension cultures in the presence of polyethylene glycol. Liposomes were thus found adhering to the surface of protoplasts, in association with invaginating plasmalemma, and within intracellular vesicles. These observations showed that liposomes enter plant protoplasts via endocytosis. Ultrastructural profiles indicating fusion of liposomes with protoplasts were not observed. PMID- 6840204 TI - Induction of DNA synthesis and mitosis in the absence of cellular enlargement. AB - Swiss 3T3 cells, starved to quiescence in low serum concentration, initiate DNA synthesis and undergo mitosis in low serum concentration (less than 0.1%) after a short exposure (2-10 min) to alkaline medium (pH 8.5-10). This study shows that initiation of DNA synthesis and mitosis can be dissociated from growth in cell size. Alkaline-stimulated cells do not increase in size before mitosis (unbalanced growth) in contrast to quiescent cells stimulated by 10% serum, which approximately double their protein content before mitosis (balanced growth). The exposure to the alkaline medium per se does not render the cells incapable of growing in size, since alkaline-treated cells, which are subsequently cultured in 10% serum, undergo balanced growth to the same extent as cells only stimulated by 10% serum without alkaline pretreatment. This study also shows that the small proportion of cells undergoing background proliferation in low serum concentration (less than 0.1%) do not increase in size before mitosis. The extent to which alkaline-stimulated cells, as well as cells undergoing background proliferation, grow in size before mitosis, is correlated to the serum concentration in the culture medium (DMEM). In 0.1% serum or less the cells do not grow in size. In 0.5% serum the cells increase in size by 30% before mitosis and complete balanced growth is achieved in medium containing 2% serum or more. These findings indicate that some macromolecular factor or factors in serum are required for growth in cell size before mitosis. PMID- 6840205 TI - Synthesis and secretion of ovalbumin by mouse-growing oocytes following microinjection of chick ovalbumin mRNA. AB - Mouse-growing oocytes were injected with chick ovalbumin mRNA. The oocytes were cultured for 18 h in the presence of [3H]leucine and the labeled ovalbumin was measured by immunoprecipitation. Two types of ovalbumin were precipitated by antibody to ovalbumin; one co-migrated with authentic, glycosylated ovalbumin in an 18% polyacrylamide gel and was estimated to be 45 000 D, whereas the other migrated faster with an apparent MW of 41 500 D. Both types of ovalbumin were also detected in the culture medium. This study demonstrates that mouse-growing oocytes can translate exogenous mRNA coding for a secreted protein and secrete two forms of the product. PMID- 6840206 TI - Disappearance of visible bile canaliculi caused by vinblastine in primary cultures of rat hepatocytes. AB - Treatment of cultured hepatocytes with vinblastine resulted in the inhibition of the reformation of biliary spaces (at times earlier than 16 h) or in the disappearance of preformed bile canaliculi (at times later than 24 h) detectable on both the light and electron microscopical level. Concomitantly the preferential localization of leucine aminopeptidase around the lucid biliary spaces was lost without any change in the specific activity of this enzyme. Despite these alterations the performance of the cultured cells (e.g., urea synthesis) was not impaired by the exposure to the drug. The effect of vinblastine was mimicked by colchicine, but not by lumicolchicine, indicating that microtubules might play a role in the structural organization of the biliary pole. PMID- 6840207 TI - Endothelial cells are a site of uptake and degradation of hyaluronic acid in the liver. PMID- 6840209 TI - Establishment of nucleolar deficient sublines of PtK2 (Potorous tridactylis) by ultraviolet laser microirradiation. AB - One of the two nucleoli of tetraploid PtK2 WA cells in early prophase was irradiated with an ultraviolet (UV) laser microbeam. The daughter cells that maintained the nucleolar deficiency were isolated and cloned. Five nucleolar deficient sublines of PtK2 WA were established, thus providing an experimental system to study the ribosomal gene-nucleolar organizer complex. PMID- 6840208 TI - Regression of autophagic vacuoles in seminal vesicle cells following cycloheximide treatment. AB - A 0.25% fraction of cytoplasm was present in the autophagic vacuole compartment of the seminal vesicle cells of fasted and estrogen-treated mice. Autophagic vacuoles regressed rapidly after administration of 0.2 mg/g body weight cycloheximide to the animals and the decay appeared to follow first-order kinetics (average half-life 5.8 min, rate constant of regression 0.120 min-1). Our observations suggest that the drug suppressed the formation of autophagosomes. The fraction of cytoplasm removed by autophagy from the cells was estimated to be about 1.8% h under steady-state conditions. PMID- 6840210 TI - Nuclear differentiation in Paramecium tetraurelia. Transplantation of vegetative micronuclei into early exconjugants. AB - The micronucleus of Paramecium tetraurelia normally gives rise to the macronucleus by going through the series of nuclear events of meiosis, mitosis and fusion during sexual reproduction. By transplanting the micronucleus from vegetative cells into early exconjugants, we have persuaded the micronucleus to take a short cut to differentiate directly into a macronucleus. This demonstrates that the course of development of the micronucleus is flexible and can be altered by stage-specific cytoplasmic factors. PMID- 6840212 TI - PCC technique reveals severe chromatin lesions and repair in G2-arrested cells after alpha irradiation. AB - Exponentially growing Chinese hamster V79 cells were exposed to 4 MeV alpha particles emitted by an americium-241 source. The chromatin of cells arrested in G2 by alpha irradiation is severely damaged, though all cells were still capable to condensate their chromatin after fusion with mitotic cells. In addition to the common types of aberrations (breaks, gaps, dicentrics and exchanges) cells were found possessing one or more chromosomes with long stretches of undercondensed chromatin. Repair of these lesions was indicated by site-specific unscheduled DNA synthesis and by the observation that condensation of these regions improved during G2 arrest. PMID- 6840211 TI - Effect of the structural components of basement membranes on the attachment of teratocarcinoma-derived endodermal cells. AB - The effect of biochemically purified basement membrane components as mediators of cell attachment is studied in vitro using an endodermal PYS-2 cell line known to produce a basement membrane-like insoluble matrix. Fibronectin is shown to be as effective as laminin as an attachment-promoting protein, although the latter is a major product of these cells and the former is not produced by them in any detectable amount. Fibronectin also increases the attachment of the cells to type IV collagen-coated plates, but laminin lacks this effect. Protein synthesis blocking agents such as cycloheximide totally abolish the attachment-promoting effect of extracellularly supplied laminin, but not that of extracellular fibronectin. Type IV collagen alone is no better a substratum for these cells than type I collagen or the plastic surface of the dish itself. The importance of an intact tertiary structure for the attachment is obvious in the case of both fibronectin and laminin. Denatured molecules or smaller fragments of these molecules do not promote cell attachment. PMID- 6840213 TI - Isolation and preliminary characterization of the synaptonemal complex from rat pachytene spermatocytes. AB - A method for preparation of the morphologically intact synaptonemal complex from rat pachytene spermatocytes is described. Pachytene spermatocytes were fractionated from rat testicular cells by centrifugal elutriation. Nuclei from fractionated pachytene cells were prepared and extensively digested with micrococcal nuclease. The digested nuclei were sedimented through 20% (w/v) sucrose containing 2 M NaCl by centrifugation. About 10% of total nuclear proteins and 1-2% of total genomic DNA was found to be associated with the residual structure. The residual structure, which contains mainly the synaptonemal complex, but may be still contaminated with other nuclear components including membrane and matrix, was stained with silver and examined under light microscopy. It was found that a silver-staining component of the synaptonemal complex is not grossly different from that in pachytene nuclei not subjected to digestion and extraction. Sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis revealed that virtually all the proteins in the residual structure are non-histones. The DNA isolated from the residual structure was about 135 base pairs (bp), long. The DNA was end-labeled and hybridized with a large excess of sonicated rat genomic DNA. The hybridization displayed a kinetics virtually identical to that of total nuclear DNA. We also prepared restricted DNA fragments associated with the residual structure. Southern blot analyses using a probe made from a recombinant DNA clone containing the albumin gene revealed that the DNA associated with the residual structure was not enriched (or depleted) in this gene sequence. Our results strongly suggest that (1) the synaptomenal complex may play a structural role to support the chromatin domains inside pachytene nucleus; and (2) a simple common DNA sequence in the chromatin domain is not required for association with the residual structure which contains morphologically intact synaptonemal complex in rat spermatocytes. PMID- 6840214 TI - Preparation of tetramethylrhodaminyl-phalloidin and uptake of the toxin into short-term cultured hepatocytes by endocytosis. AB - A fluorescent phallotoxin with high photostability, tetramethylrhodaminyl phalloidin (Rh-phalloidin), has been prepared. The affinity of this compound to rabbit muscle actin has been determined to be about 6 times lower than that of phalloidin. In freshly isolated hepatocytes the internalized fluorescent toxin stains the cellular actin. In contrary, there is no actin staining visible in cultured hepatocytes. Short-term cultured hepatocytes (5 h of culturing) incorporate the toxin by endocytosis; it is kept sealed in the endocytotic vesicles, which are usually found accumulated at the sites where cells touch after reaggregation. PMID- 6840215 TI - Isolation and characterization of Chinese hamster cells defective in cell-cell coupling via gap junctions. AB - Chinese hamster Wg3-h-o cells which were descended from DON cells have been mutagenized and selected for derivatives defective in metabolic cooperation via gap junctions (i.e., mec-). The selection protocol included four consecutive cycles of cocultivating mutagenized cells, deficient in hypoxanthine phosphoribosyltransferase (HPRT) and wild-type cells in the presence of thioguanine (cf Slack, C, Morgan, R H M & Hooper, M L, Exp cell res 117 (1978) 195-205) [8]. We carried out the last two selection cycles in the presence of 1 mM dibutyryl cyclic adenosine monophosphate (db-cAMP). The isolated Chinese hamster CI-4 cells which expressed the mec- phenotype most stringently showed the following characteristics: 1. In standard culture medium no cell-cell coupling was detected among CI-4 cells when assayed by injections of the fluorescent dye Lucifer yellow or by electrical measurements. Between 73 and 100% of the mec+ parental cells were coupled under these conditions. Up to 14% positive contacts were found between CI-4 cells and Chinese hamster Don cells (mec+). Confluent CI 4 cells grown in the presence of 1 mM db-cAMP showed 9% coupled cells. 2. No gap junction plaques were found on electron micrographs of freeze-fractured, confluent CI-4 cells. The mec+ parental cells showed small gap junction plaques (0.013% of the total cell surface analyzed). 3. CI-4 cells exhibited 16% positive contacts and the parental Wg3-h-o cells showed 92% positive contacts in autoradiographic measurements of metabolic cooperation with DON cells. On an extracellular matrix, prepared from normal embryonic fibroblasts, metabolic cooperation between CI-4 and DON cells was autoradiographically measured to be 68%. Other cells of spontaneous mec- phenotype (for example mouse L cells or human fibrosarcoma HT1080 cells) also appeared to exhibit increased metabolic cooperation when grown on an extracellular matrix and assayed by autoradiographic measurements. When tested by Lucifer yellow injections, however, only very few positive contacts were found for CI-4/DON cell pairs and no positive contacts were found among mouse L cells grown on an extracellular matrix. 4. The mec- defect in the genome of CI-4 cells was cured in somatic cell hybrids with mouse embryonic fibroblasts or with mouse embryonal carcinoma cells. The results of isozyme and karyotype studies of mec-, as well as mec+ somatic cell hybrids suggest that mouse chromosome 16 may be involved in complementation of the mec- defect. PMID- 6840216 TI - Inhibition of second meiotic division and a switching over to flagellar formation in secondary spermatocytes of newt by cycloheximide. AB - 10.0 micro M cycloheximide (CH) was found to completely inhibit the second meiotic division of newt spermatocytes. Under continuous incubation with CH from the beginning of interphase II, secondary spermatocytes fail to initiate chromosomal condensation and thus remain in interphase II. After 12-15 h of incubation, a single motile flagellum, about 5 micrometers in length, was observed on each of the secondary spermatocytes. These flagella grew to a length of 60-80 micrometers, but thereafter ceased to grow, whereas ordinarily spermatids grew flagella up to 500 micrometers in length in the absence of CH [1]. When CH was applied within 2 h following telophase I, the percentage of meiosis II inhibition was almost 100% and when applied even later, it became less, which showed that the early half period during interphase II was sensitive to CH. Regardless of the length of incubation time with CH, flagella were found to grow within a period of 12-15 h following telophase I. Upon removal of CH, even after 60 h of incubation, the flagella of the secondary spermatocytes shortened and disappeared completely. These spermatocytes underwent the second meiotic divisions. Also, flagella grew on the resulting spermatids. The possibility that a particular centriole which participated in the first meiotic division changes into a basal body for flagellar formation under the influence of CH and vice versa upon removal of it, is discussed in the following. PMID- 6840217 TI - Both nerve growth factor and high K+ concentrations support the survival of chick embryo sympathetic neurons. Evidence for a common mechanism of action. AB - Neurons were dissociated from the sympathetic ganglia of embryonic chicks, and cultured in the absence of non-neuronal cells. Both nerve growth factor (NGF) and high concentrations of extracellular K+ supported neuronal survival, and these effects were independent of the presence of serum in the culture medium. Only 60% of the neurons survived in response to 35 mM K+, and survival was not increased when both NGF and K+ were present together. It was, however, possible to maintain essentially all the neurons in culture with either NGF or high K+ concentrations if the culture substrate had been pretreated with heart cell-conditioned medium (which did not itself support neuronal survival). These observations are consistent with a common mechanism of action of both K+ and NGF for the survival of cultured embryonic neurons. PMID- 6840218 TI - Response of the dTMP-synthesizing enzymes to differentiation processes in Physarum polycephalum. AB - Synthesis of deoxythymidylate (dTMP) is a rate-limiting step in DNA synthesis; there are two main enzymes which are responsible for dTMP production, thymidylate synthetase (ts) and thymidine kinase (tk). Both enzymes were studied during several differentiation processes of the myxomycete Physarum polycephalum. In all stages of proliferation (microplasmodia, macroplasmodia, germinating microsclerotia and germinating spores) tk is the dominant enzyme in terms of activity, whereas ts is the predominant enzyme in quiescent stages (microsclerotia, sporangia, respectively spores); this is expressed by calculating the tk/ts ratio. This ratio is greater than 1 during proliferation and much less than 1 during quiescence. Our results clearly show that ts is the basic enzyme for dTMP production during all differentiation stages, whereas tk, if required, is shut on and represents an additional potential for dTMP synthesis during rapid proliferation. PMID- 6840219 TI - The timing of synthesis of proteins required for mitosis in the cell cycle of the sea urchin embryo. AB - The protein synthesis inhibitor emetine was used to establish the times of synthesis of mitotic proteins, whose presence in the cell are essential in the mitotic processes of chromosome condensation, nuclear membrane breakdown, and possibly, chromosome alignment at metaphase. In embryos of the purple sea urchin, Strongylocentrotus purpuratus, protein synthesis required for chromosome condensation and nuclear membrane breakdown occurs between 20 and 35 min after fertilization. In Lytechinus variegatus embryos the time of synthesis of the mitotic proteins is more variable, occurring between 4 and 15 min after fertilization. Furthermore, in both species the mitosis of each cell cycle requires new synthesis of these proteins with the synthesis occurring at the beginning of each cycle. This observation indicates that the mitotic proteins, which are active at prophase and metaphase, lose their activity at late ana- and telophase. PMID- 6840220 TI - In vitro culture of mouse primordial germ cells. AB - Germ cells were isolated from mouse fetal gonads 11 1/2-16 1/2 days post coitum (dpc), and exposed to various methods of in vitro culture. From 13 1/2 dpc onwards, both male and female germ cells survived well at 37 degrees C for several days. During the culture period the proportion of female germ cells in meiosis increased and later stages of meiotic prophase were seen. The gonadal environment is therefore not essential for the progress of meiosis. Male germ cells in vitro did not enter meiosis. Germ cells isolated from gonads 11 1/2 or 12 1/2 dpc did not survive at 37 degrees C in any of the three culture systems used (Petri dishes, microtest plate wells, drops under oil); cell density, substrate and culture medium were varied, and several additives tested, but no improvement in viability was detected. Below 30 degrees C, on the other hand, 11 1/2 and 12 1/2 day germ cells survived in vitro for at least a week. They did not enter meiosis in culture, but continued to undergo mitotic proliferation. PMID- 6840221 TI - Human diploid fibroblasts (HDF) can induce DNA synthesis in cycling HDF but not in quiescent HDF or senescent HDF. AB - HeLa cells in S phase induce DNA synthesis in cycling cells, serum-deprived quiescent cells, and non-replicative senescent cells following cell fusion. In contrast normal human diploid fibroblasts (HDF) do not induce DNA synthesis in either quiescent cells or senescent cells. Instead, the replicative HDF nuclei are inhibited from entering S phase in heterokaryons formed with these two types of non-replicative cells. These differences in the inducing capabilities of normal HDF and HeLa cells raise the question whether normal HDF in S phase can induce DNA synthesis in cycling cells. This paper demonstrates that young HDF in S phase can induce DNA synthesis in cycling HDF. Thus, the hypothesis that initiation of DNA synthesis in cycling cells is positively controlled by inducer molecules appears to be valid for normal HDF as well as for transformed cells such as HeLa. PMID- 6840222 TI - Investigation of the attachment of bovine corneal endothelial cells to collagens and other components of the subendothelium. Role of fibronectin. AB - Bovine corneal endothelial cells adhered equally well to a variety of collagens (types I, III, IV and V) consistent with a role for fibronectin in this process. They did not exhibit a preferential binding to collagen type IV--as might be anticipated if laminin were to play a significant role in their adhesion. Inhibition studies with anti-fibronectin antibodies demonstrated the importance of endogenous fibronectin in the mediation of attachment. Consistent with this, binding did not appear to require the presence of exogenous protein, since cells bound to collagens equally well in the presence or absence of added fibronectin and binding was not stimulated by pretreatment of collagens with this protein. PMID- 6840223 TI - Assessment of cell viability by flow cytometric analysis using DNase exclusion. AB - A new method was developed for selective measurement of DNA distributions in viable cell populations. The method is based on the fact that non-viable cells lose membrane integrity and treatment of such cells with DNase should remove their DNA. The DNase-treated cells were stained with DNA fluorochrome 4'-6 diamidino-2-phenylindole (DAPI) in the presence of Triton X-100. DNA distribution was measured by flow cytometry prior to and after treatment with DNase. Percentage of cells stained after DNase treatment was considered as an index of cell viability. Optimal conditions for DNase treatment and application of DNase exclusion test for the analysis of spontaneous cell death, selective death of cells arrested in S/G2 phases, instant cell disintegration induced by cytotoxic compounds and cell death induced by hyperthermia are described. PMID- 6840224 TI - Differential expression of lectin receptors in germ layers of the mouse egg cylinder and teratocarcinomas. AB - Receptors for three lectins with restricted specificities, namely fucose-binding protein of Lotus tetragonolobus (FBP), peanut agglutinin (PNA) and Dolichos biflorus agglutinin (DBA), were distinctively located in 6- and 7-day mouse embryos and in embryoid bodies of teratocarcinoma OTT6050 grown in vivo. Thus, FBP reacted mainly with the inner cells (embryonic ectoderm and teratocarcinoma stem cells), DBA reacted with the outer cells (endoderm) and PNA reacted with all the germ layers including mesoderm. Upon in vitro culture of the embryoid bodies, the exposed stem cells express DBA receptors. Since the receptors for the three lectins in teratocarcinomas are known to be carried by the large carbohydrate chains characteristic of early embryonic cells, the present result suggests that terminal structure of the large carbohydrates is altered according to the direction of the differentiation or to the position of the cells in embryos and in teratocarcinomas. PMID- 6840225 TI - Differentiation properties of pure populations of human dystrophic muscle cells. AB - The interpretation of the majority of studies of Duchenne muscular dystrophy (DMD) has been complicated by the heterogeneous composition of the cultures used. In addition to muscle cells, muscle tissue contains adipocytes and fibroblasts and the proportion of these cell types varies, especially in disease states. To overcome this problem we developed culture conditions which permitted isolation and characterization of pure populations of clonally derived human muscle cells [1, 2]. Here we report the successful application of these methods to muscle cells from biopsies of individuals with diagnosed DMD. The normal and mutant human muscle cells were used in experiments of muscle differentiation in the same manner as cell lines. Frozen-stored cells were thawed, plated in a series of replicate plates, and allowed to differentiate under similar culture conditions. Yet, in contrast with cell lines, the cells were karyotypically normal, not altered by adaptation to long-term culture, and had a finite lifespan. We have systematically analysed specific properties of the normal and DMD muscle cells which differentiated in culture. The kinetics and extent of myoblast fusion, myotube morphology, and the accumulation and distribution of membrane acetylcholine receptors were monitored. In addition, the isozyme composition of creatine kinase and its intracellular and extracellular distribution were determined. Our results indicate that DMD muscle cells are fully capable of initiating myogenesis in culture and do not differ from normal muscle in several important parameters of differentiation. PMID- 6840226 TI - Organ distribution of circulating very low density lipoproteins (VLDL): fate of hematopoietic growth inhibitory VLDL in the rat. AB - The organ distribution of very low density lipoproteins, with known hematopoietic cell growth inhibitory effects, was studied in the rat. Animals received intravenous injections of 125I-labelled VLDL and tissue uptake was monitored over 4 days. Uptake into 8 organs was studied using a technique that excluded blood associated radioactivity. While we demonstrated that the liver predominated in tissue uptake of radioactivity on a total organ basis, bone marrow had the greatest 125I-VLDL uptake per gram of tissue, six times greater for bone marrow than liver. Thus we have demonstrated that the bone marrow is a very active organ in terms of uptake of VLDL. This suggests that the in vitro inhibitory effect of rat VLDL on bone marrow cell proliferation may have physiologic significance in the in vivo regulation of marrow cell proliferation. PMID- 6840227 TI - Alteration of activities of delta-aminolevulinic acid synthase, delta aminolevulinic acid dehydratase and delta-aminolevulinic acid dehydratase inhibitor in the bone marrow cells of lead poisoned rats. AB - A new modified method for the determination of delta-aminolevulinic acid (ALA) dehydratase activity has been developed. This modified method involves addition of 0.1 mM Zn2+ and then preheating the enzyme solution at 60 degrees C for 5 min before following commonly used procedures. The ALA dehydratase activity in the peripheral blood of lead poisoned rats, determined by this procedure, was approximately 7.5-fold higher than control values. The activity of ALA dehydratase in the bone marrow cells of lead poisoned rats increased approximately 2-fold. These increases were accompanied by a simultaneous decrease in an inhibitor specific for ALA dehydratase. Consequently, these results suggest that ALA dehydratase is induced after the reduction of ALA dehydratase activity, and that ALA dehydratase activity is controlled by a new specific ALA dehydratase inhibitor. PMID- 6840228 TI - MBM-1, a differentiation marker of mouse hemopoietic cells defined by a rat monoclonal antibody. AB - Hybridoma clones were isolated after the fusion of mouse myeloma cells with spleen cells from a rat immunized with mouse bone marrow. One of them produced a monoclonal antibody reacting with a murine cell surface differentiation antigen that we have termed MBM-1 (Mouse Bone Marrow-1). This antigen is present on eosinophils, on neutrophils, and on subpopulations of lymphocytes and macrophages, but appears to be absent from erythroid cells. Precursor cell analysis, after sorting of bone marrow cells using a fluorescence-activated cell sorter, suggests that the antigen is absent from most progenitors with the exception of certain cells in the macrophage lineage. PMID- 6840229 TI - Serum neutrophil chemotactic activity and exercise induced asthma. AB - The changes in serum neutrophil chemotactic activity were studied in 16 asthmatics and in 6 healthy, non-atopic controls. Eight asthmatics gave positive response to exercise challenge. The neutrophil chemotactic activity was determined by a method described by Boyden. The specific airway conductance was used as a lung function parameter. There was a significant increase in the serum neutrophil chemotactic activity after exercise challenge in asthmatic subjects. The increase was less in the asthmatic patients with negative response to exercise (20.8 +/- 6.8), than in those with positive, (41.1 +/- 15). There was also a difference in time course: the maximal value was recorded at 15 min in patients with negative response to exercise and at 6 min in patients with positive. The neutrophil chemotactic activity did not alter significantly in healthy non-atopic controls. The clinical significance of the serum neutrophil chemotactic activity in bronchial asthma is discussed. PMID- 6840230 TI - Plasma glucagon response during exercise-induced asthma. AB - Plasma glucagon levels and peak expiratory flow rates (PEF) were determined before and after treadmill exercise test in 5 atopic patients with exercise induced asthma (EIA) and in 10 non-atopic patients with EIA, and also in 14 controls without exercise-induced bronchoconstriction. In addition, changes in plasma glucagon were determined during an allergen-inhalation challenge test in 5 asthmatics. Plasma glucagon was determined by radioimmunoassay using antiserum and 125I-labelled glucagon. Plasma glucagon level of atopic asthmatics at rest was significantly lower (P less than 0.05) than in non-atopic EIA patients. In the atopic EIA patients the plasma glucagon level increased by 41 per cent 10 minutes after exercise, whereas in the nonatopic EIA patients it decreased by about 19 per cent. In the controls there were only insignificant exercise-induced changes in the plasma glucagon level. The exercise-induced changes of the plasma glucagon in the atopic EIA patients differed significantly from those in the non atopic EIA patients (P less than 0.05). No change in plasma glucagon was observed in five asthmatics during inhalation challenge tests with a known positive allergen. The results suggest that the rise in glucagon is a defence mechanism against exercise-induced broncho-constriction. PMID- 6840231 TI - Serum lysosomal enzyme activities in silicosis and asbestosis. AB - The serum activities of two lysosomal enzymes, beta-N-acetylglucosaminidase (EC 3.2.1.30) and beta-glucuronidase (EC 3.2.1.31) were analyzed for 28 silicosis and 34 asbestosis patients. The enzyme activities of the patients were compared with those of age-, sex- and exposure-matched controls with no radiological signs of pneumoconiosis, and with an additional reference group of blood donors. The serum activity of beta-N-acetylglucosaminidase was higher in the silicosis patients (32.5 +/- 11.7 U/l) than in the asbestosis patients (21.7 +/- 7.9 U/l, p less than 0.001), in the silica exposed controls (27.1 +/- 6.7 U/l, p less than 0.05) or in the blood donors (24.8 +/- 6.3 U/l, p less than 0.05). No significant differences were found in the serum activity of beta-glucuronidase in the studied groups. Although the mechanisms causing different levels of serum beta-N acetylglucosaminidase activity in silicosis and asbestosis patients remain unresolved, they may be related to the different mechanisms of action of the two dusts on lung (10). PMID- 6840232 TI - Grain exposure--symptoms and lung function. AB - Eighty dock workers handling grains and other cargoes were surveyed by respiratory and occupational questionnaires, spirometry, skin tests with common allergens and grain extracts, and serological tests. Sixty-nine of the men reported chest symptoms during exposure to barley dust and 13 men reported evening feverish episodes after handling barley. Symptoms were not related to smoking or atopic status. No gross deficits in lung function were detected. Six men handling barley and four handling non-dusty cargoes had their lung function measured over two working days. Falls in ventilatory capacity occurred in the six workers handling barley but not in the four handling non-dusty cargoes. Six previously unexposed subjects spent 2 h in a barley dust atmosphere of a silo and had lung function measured before and after the exposure. All subjects had falls in ventilatory capacity. In four these lasted 24 h or more and were associated with systemic symptoms. As with cotton dust the agent(s) responsible for symptoms from grain dust exposure remains uncertain. Our findings on the dock workers suggest that specific immunological responses are not involved. PMID- 6840233 TI - Bronchial response to inhaled histamine in asymptomatic young smokers. AB - Non-specific bronchial response to inhaled histamine was measured in 21 young (21.2 +/- 1.9 years) asymptomatic smokers (2.9 +/- 2.1 pack years) and in 21 age, sex, and height matched asymptomatic controls. Following a 2 min inhalation of histamine 8 mg/ml, the smokers showed smaller reduction in FEV1 (3.4 +/- 3.3% vs 7.0 +/- 6.2%, p less than 0.05) and in MMF (7.6 +/- 15.6% vs 21.1 +/- 17.3%, p less than 0.02) than did the non-smokers. The threshold concentration of histamine was defined as that concentration where FEV1 consistently was greater than 2 SD below the mean of that obtained from 5 to 7 prehistamine spirograms. A histamine threshold between 2 and 8 mg/ml was detectable in seven smokers, and a threshold between 1 and 8 mg/ml was seen in 14 non-smokers. Histamine threshold was not measurable (i.e. greater than 8 mg/ml) in 14 smokers and seven non smokers (p less than 0.05). Thus, these young asymptomatic smokers of brief duration failed to show increased response to histamine; in fact, they appeared to respond less to histamine than did matched controls. This may be the result of selection (who chooses to smoke) or alternatively it may be due to an acquired loss of sensitivity (development of tolerance) to inhaled irritants. PMID- 6840234 TI - Smoking and influenza in the elderly: a sero-epidemiological study. AB - Two blood samples were taken at an interval of five years in a continuing epidemiological study of a rural population with an age range of 40-64 years at commencement. Paired sera of 111 light smokers and their non-smoker controls, matched for age and sex, and of 68 heavy smokers and their respective controls were tested for haemagglutination inhibiting antibodies against four different influenza strains. Antibodies were detected in the baseline specimens more frequently and in higher titres among the smokers than among the controls. Significant rises in titre between the baseline specimens and the follow-up specimens occurred slightly more frequently among the smokers. PMID- 6840235 TI - Surgical treatment and complications of thoracic hydatid disease. Report of 61 cases. AB - Echinococcus cysts in the thoracic cavity were diagnosed and treated in 61 patients. Diagnosis was usually made by clinical and radiological manifestations of hydatid disease. Empyema, broncho-biliary, and biliary-pleural fistulae are complications of thoracic echinococcosis. Portal hypertension, systemic venous obstruction, paraplegia, arterial emboli due to endocardial cysts are complications of echinococcus cysts. In 40 patients with uncomplicated cysts, cystectomy-capitonnage was performed. Lobectomy or segmental resection was undertaken for complicated cysts and destroyed lung parenchyma, in ten patients. Extirpation of the cyst is preferred for extrapulmonary location, and median sternotomy is applied for bilateral multiple pulmonary hydatid cysts. In our series, the incidence of surgical complications was low and there was no surgical mortality. Recurrence or pleural implantation of pulmonary echinococcus cyst have not been found during an average nine-months follow up. PMID- 6840236 TI - Severe alcoholism and asbestos exposure: report of two cases. PMID- 6840237 TI - Caudate morphology and behavior of rats exposed to carbon monoxide in utero. AB - Postnatal morphologic damage was found in the caudate nucleus of rats exposed 2 or 3 h to carbon monoxide on gestational day 15. There were gross abnormalities in the form of ecotopic swellings of caudate tissue into the lateral ventricles. The incidence of caudate ectopias was about 20% in rats exposed 2 h as fetuses and 70% from 3 h of exposure. In addition, in the body of the caudate the number of dendritic branches was reduced in Golgi type II neurons. Postnatal behavior of the exposed rats was not significantly altered in a series of behavioral tests of motor function. Growth rate was not retarded. The failure to detect behavioral changes may be due to insensitivity of these tests detecting functional damage or to compensation by the developing brain, resulting in normal function. PMID- 6840239 TI - Reduction of postsynaptic inhibition tolerated before seizure initiation: spinal cord. AB - The reduction of postsynaptic inhibition tolerated before initiation of intrinsic spinal seizures was assessed using intracellular recording from lumbar motoneurons in spinal cats anesthetized by pentobarbital or alpha-chloralose or decerebrated and unanesthetized. The amplitude of antagonist group Ia and recurrent (Renshaw) IPSPs was monitored while incremental doses of the specific glycine antagonist, strychnine, were injected until seizures developed. Both kinds of IPSPs were reduced to less than 25% of control at seizure onset, independent of anesthesia. Assuming the recorded pathways were representative of all glycine-mediated spinal pathways, the results suggested that postsynaptic inhibition could be virtually eliminated before intrinsic spinal seizures were triggered. These results place a constraint on theories of spinal seizures initiation due to reduction of postsynaptic inhibition. PMID- 6840238 TI - Effects of steroid hormones on muscle reinnervation after nerve crush in rabbit. AB - The ability of an association of three steroid hormones to influence the reinnervation process and the trophism of rabbit muscles denervated by crush of the sciatic nerve was investigated. The beginning of reinnervation was established with electromyographic recordings from the tibialis anterior muscle. The distance from the site of crushing to the point where the motor nerve enters the tibialis anterior muscle was then measured in each animal, and the nerve regeneration velocity (mm/day) was calculated: a slightly but significantly higher (P less than 0.001) mean value was found in treated animals compared with untreated ones. When soleus and extensor digitorum longus (EDL) muscles were histochemically examined 50 days after lesion, a larger mean diameter of type 2c fibers was found in treated than in untreated animals, pointing out a possible useful effect of the treatment. On the contrary, the size reduction of EDL type 2b fibers was more pronounced in treated rabbits, indicating a catabolic influence of the drugs on this fiber type. PMID- 6840240 TI - Reduction of postsynaptic inhibition tolerated before seizure initiation: brain stem. AB - The reduction of GABA-mediated postsynaptic inhibition tolerated before seizure initiation was assessed using the GABA-mediated, disynaptic, inhibitory pathway from the ipsilateral vestibular nerve to trochlear motoneurons in pentobarbital anesthetized cats. The amplitude of intracellularly recorded IPSPs or the corresponding extracellular field potential was monitored while incremental doses of the specific GABA antagonist, bicuculline, were injected intravenously. Cortical seizures (measured by ECoG activity) and spontaneous trochlear motoneuron bursting occurred at bicuculline doses which reduced inhibitory vestibular-trochlear field potentials by 10% or less. After midbrain transection trochlear motoneurons no longer participated in the cortical seizures. Rather, a widespread, paroxysmal increase of intrinsic brain stem activity, including motoneuron bursting, occurred after injection of additional bicuculline sufficient to reduce the vestibular-trochlear inhibition to 25% of control or less. Thus, postsynaptic inhibition could be virtually eliminated before intrinsic brain stem seizures were triggered, but the brain stem could participate in cortical seizures in spite of the integrity of inhibitory brain stem pathways. Because the cortex seized when inhibitory potentials were only slightly reduced in the brain stem, we suggest that factors such as different GABA receptor properties or altered membrane properties may contribute to the greater sensitivity of cortex to bicuculline. PMID- 6840241 TI - Regulation of postnatal growth of motor end plates in rat soleus muscle. AB - The question of whether or not postnatal growth in the length of end-plate acetylcholinesterase plaques in rat soleus muscle is controlled by the nerve or by the muscle was studied. When muscles with intact innervation were tenotomized in young rats, the muscles failed to grow in length and diameter and the end plate esterase plaques remained short when the animals attained adulthood. When muscles in young rats were denervated the fibers also failed to grow in diameter and end-plate esterase plaques failed to attain the length of control plaques in normal innervated muscle. We conclude that growth of postnatal muscle fiber is an important determinant of end plate and motor terminal growth. PMID- 6840242 TI - Plasma acetylcholinesterase in Duchenne muscular dystrophy. AB - Muscle acetylcholinesterase (AChE) in unregulated in animal and human muscular dystrophies and its activity is elevated in plasma of dystrophic chickens, probably due to a leakage from affected muscles. It is possible to measure AChE activity in human plasma in spite of high butyrylcholinesterase activity if acetyl-beta-methylcholine is used as the substrate and butyrylcholinesterase is inhibited by iso-OMPA. It has been found that, unlike in chickens, the plasma AChE activity in human newborns is not higher than that in adults. The AChE activity in plasma of children afflicted by Duchenne muscular dystrophy does not differ from that found in plasma of normal boys of the same age. In this respect Duchenne muscular dystrophy differs from chicken muscular dystrophy as well as from a neurogenic muscle disease (amyotrophic lateral sclerosis) in man. PMID- 6840243 TI - Acceleration of the regeneration of the crushed hypoglossal nerve by testosterone. AB - The effect of testosterone propionate (TP) on regeneration of the crushed hypoglossal nerve was studied in young adult rats. The TP treatment promoted axonal outgrowth as measured by an increase in the proportion of hypoglossal neurons labeled by retrograde transport of horseradish peroxidase injected into the tongue at selected postlesion periods compared with that in controls. The result indicated that TP exerts its effect on regeneration primarily by increasing the metabolic activity in hormone target neurons. The somatotopic organization of the hypoglossal nucleus and its projection into the major nerve branches were unaltered subsequent to crush injury. The maintenance of specificity was attributed to the intact perineurial and endoneurial sheaths which guided regenerating fibers to their original targets. PMID- 6840244 TI - Ultrastructural changes in muscle and motor end-plate of the dystrophic mouse. AB - A comparative study of dystrophic mice (C57BL/6J-dy2J) and normal littermates, 6 to 9 months old, has revealed numerous ultrastructural changes in the dystrophic soleus. Vacuoles, swollen mitochondria, vesicular aggregates, membranous bodies, Z-line degradation, localized hypercontraction, myofibrillar disorientation, and focal necrosis were common. We report here new observations. Discontinuous, dense bands (240 A wide) were observed rarely between inner and outer membranes in some nuclei. Closely associated with infoldings of nuclear membrane were paracrystalline, vesicular structures, actin-like filaments, and autophagic vacuoles. With the degeneration of the nuclear membrane, actin-like filaments were observed within the nucleus. The primary synaptic clefts were widened and contained osmophilic-dense granules (diameter 0.2 to 0.7 micrometer). There was loss of secondary synaptic folds. Discontinuity of pre- and postsynaptic membranes could be observed, though rarely. Lysosome-like dense bodies were present among myofilaments. The myeloid bodies and autophagic vacuoles that were associated with nuclei, sarcoplasmic reticulum, and mitochondria gave a positive acid phosphatase reaction. Such degeneration changes were not observed in the normal soleus. PMID- 6840245 TI - Trophic action of nerve extract on denervated skeletal muscle in vivo: dose dependency, species specificity, and timing of treatment. AB - Atrophy in a denervated muscle results from the disuse caused by paralysis of the muscle, and from the loss of special neurotrophic substances. Proteins extracted from rats' sciatic nerves have been shown to prevent the nondisuse atrophy of denervated rats' extensor digitorum longus (EDL) muscles when administered by intramuscular injection. The present investigation elicited more information about this neurotrophic phenomenon. Extract of liver failed to affect the rate of atrophy of denervated EDL muscles. Injection of various doses of extract of rats' or sheep's sciatic nerves indicated that the action of the extract was dose dependent but not species-specific. Muscles denervated for 14 days and injected with extract on all 14 days or only on the first or last 7 days all exhibited significantly less atrophy than those that were not injected. PMID- 6840246 TI - Afferent fibers to the cingular vocalization region in the squirrel monkey. AB - Three squirrel monkeys (Saimiri sciureus) received horseradish peroxidase injections in the anterior cingulate cortex at the level of the genu of the corpus callosum, a region yielding vocalization when electrically stimulated. Retrogradely labeled neurons were found at the cortical level within the dorsomedial and lateral prefrontal cortex (areas 9 and 10), orbital cortex (area 11), premotor cortex (areas 44, 6b, and 8), frontoparietal operculum, insula, cortex of the superior temporal sulcus, piriform cortex, subiculum, posterior cingulate, and retrosplenial cortex. Subcortical telencephalic projections came from the the claustrum, diagonal band of Broca, nucleus basalis Meynert, nuclei basalis lateralis and accessorius amygdalae, and cells at the periphery of globus pallidus. Diencephalic structures projecting to the anterior cingulate cortex were the thalamic nuclei anterior medialis, anterior ventralis, ventralis anterior, ventralis lateralis pars medialis, medialis dorsalis, pulvinaris medialis, centralis superior lateralis and limitans; the intralaminar nuclei paracentralis, centralis lateralis and parafascicularis; and the midline nuclei periventricularis, parataenialis, centralis superior, centralis inferior, centralis medialis, and reuniens. In the hypothalamus, projections came from the periventricular, lateral and posterior part, as well as the supramamillary nucleus. Midbrain afferent fibers came from the ventral tegmental area of Tsai, medial substantia nigra, reticular formation, area praerubralis, nucleus peripeduncularis, and periaqueductal gray. The most posterior labeled neurons were found in the locus ceruleus, dorsal tegmental nucleus of Gudden, nucleus annularis, nucleus centralis superior Bechterew, nucleus dorsalis raphae and the most dorsomedial part of the nucleus reticularis tegmenti pontis. Some of those projections have functional significance in the light of the hypothesis that the cingular cortex is involved in the volitional control of emotional reactions on the one hand and the influence of primary emotional reactions on intentional behavior on the other. PMID- 6840247 TI - Reinnervation of the gastrocnemius muscle by the contralateral S1 nerve root. AB - Functional regeneration after transposition of a ventral nerve root was established in the adult cat. Reconstruction of the ventral root, using microsurgical methods, directed the right S1 ventral nerve root to innervate the left gastrocnemius muscle. Stimulus-induced unit responses were recorded from the left gastrocnemius muscle 5 to 8 months after the root cross, demonstrating the reestablishment of neuromuscular connections. The innervation of the left gastrocnemius muscle by neurons in the right ventral horn of the spinal cord was verified by injecting horseradish peroxidase into the muscle. Horseradish peroxidase reaction product was located in alpha and gamma motor neurons in the right S1 segment of the spinal cord. Computer-assisted determination of the soma area of the labeled neurons was compared with a normal S1 innervation of the gastrocnemius muscle. Analysis of the percentage of cells of a given soma area demonstrated an overall decrease in soma area in the operated animals. Because ventral root reconstruction can result in innervation of a foreign muscle, studies such as this may encourage repair or reconstruction of nerve roots to gain some functional recovery after spinal cord or nerve root injuries. PMID- 6840248 TI - Single-cell and multiunit activity in freely moving rats after corticosterone administration. AB - With the purpose of correlating possible electrophysiologic changes in the brain with the negative feedback effect of glucocorticoids on neuroendocrine functions, the effects of corticosterone on multiunit (MUA) and single-cell activity in freely moving rats were studied in the hypothalamus, amygdala, and midbrain reticular formation. The hormone changed the MUA in all regions studied causing mainly an increase in the rate of firing. In the hypothalamus there was a predominance in overall inhibition, when the sensory responsiveness to acoustic stimulation was compared before and after corticosterone administration. No such effect was observed in the amygdala and midbrain reticular formation. The hormonally induced changes in MUA in the hypothalamus were confirmed by analysis of single-cell activity in the freely moving rats which showed also changes in the pattern of firing, as demonstrated by autocorrelations. These findings in the hypothalamus are significant and may represent the electrophysiologic correlates of changes in corticotrophin releasing factor in this region. PMID- 6840249 TI - Involvement of dopamine in amygdaloid kindling. AB - The concentrations of dopamine, noradrenaline, and dihydroxyphenylacetic acid were determined in the amygdala, neostriatum, neocortex, hippocampus, brain stem, and hypothalamus of cats, which had had 9 to 14 tonic-clonic kindled seizures. No significant biochemical changes were observed compared to control cats. Pharmacological manipulations of dopamine receptors (haloperidol, apomorphine) did not modify the kindling procedure. According to the data it seems unlikely that dopamine plays a major role in amygdaloid kindling. PMID- 6840250 TI - Changes in isometric contractile properties of fast-twitch and slow-twitch skeletal muscle of C57BL/6J dy2J/dy2J dystrophic mice during postnatal development. AB - Our primary aim was to determine if there exists a preferential involvement of the fast-twitch or slow-twitch skeletal muscle fibers in the dy2J/dy2J strain of murine dystrophy. The changes in the contractile properties of the slow-twitch soleus (SOL) and the fast-twitch extensor digitorum longus (EDL) muscles of normal and dystrophic mice were studied at 4, 8, 12, and 32 weeks of age. Isometric twitch and tetanus tension were decreased in the 4- and 8-week-old dystrophic EDL compared with controls, this situation being reversed in the older animals. At 12 weeks, the dystrophic EDL generated 15% more tetanic tension than normal EDL and by 32 weeks no significant difference was seen between normal and dystrophic EDL twitch or tetanus tension. By 8 weeks, dystrophic EDL exhibited a prolonged time-to-peak twitch tension (TTP) and half-relaxation time (1/2RT) of the isometric twitch which continued to 32 weeks. For the dystrophic SOL, decreased twitch and tetanus tension was observed from 4 to 32 weeks. At 8 and 12 weeks, TTP and 1/2RT of dystrophic SOL were prolonged. However, by 32 weeks there was no longer a significant difference seen in TTP or 1/2RT between normal and dystrophic SOL. Our results appear to indicate that a loss of the primary control which is determining the fiber composition of the individual muscles is occurring as the dystrophic process advances. PMID- 6840251 TI - Contrast of time courses of changes in muscular potentials to prolonged stimulation at 5 Hz in rat medial gastrocnemius and soleus muscles. AB - Time courses of changes in muscular potentials to repetitive stimulation at 5 Hz for 10 min were compared between rat medial gastrocnemius (MG) and soleus (SOL) muscles. Stimuli were applied to a sciatic nerve near the entrance of the MG and lateral gastrocnemius (LG) muscles and its exit segment from the LG to the SOL muscles. Muscular potentials were generally evoked in the form of a biphasic wave at the MG muscle and were always of a simple biphasic pattern at the SOL muscle. It was found that, due to prolonged stimulation, muscular potentials were rapidly and notably reduced in the MG muscle, whereas they were gradually facilitated in the SOL muscle. This contrast was similar to differences in the time course of changes in muscular potentials under these conditions in the MG muscle of dystrophic and littermate normal mice. PMID- 6840252 TI - Amygdala kindling after ligation of the middle cerebral artery in the rat. AB - Cerebral infarcts were produced in rats by ligation of the right or left middle cerebral artery. A significant increase in seizure threshold and in the number of days required to develop kindled seizures was found in rats stimulated in the amygdala contralateral to the infarct. However, no significant changes in threshold or kindling rates were found in animals kindled ipsilateral to the ligation. These results were found to be independent of whether the infarct was in the right or left cerebral cortex. These data suggest that contralateral frontoparietal cerebral infarct may have inhibitory influences on seizures originating from the amygdala. PMID- 6840253 TI - Morphometric ultrastructural evaluation of the axonal endings in the neuromuscular junctions of pigeons after long lasting limitation of movement. AB - Ultrastructural quantitative and qualitative evaluations of axonal endings in the neuromuscular junctions of latissimus dorsi posterior muscle in the birds kept under limited mobility are performed. The investigation showed that as the time of hypodynamia is prolonged the degenerative changes appear in most of the axonal endings. In the earlier period of limited mobility the number and volume of internal structures of the axonal endings (mitochondria and synaptic vesicles) decreased. In the longer period of hypodynamia fragmentation of axonal endings and their resorption by the Schwann cell were observed. These changes are considered as the third, final period of degeneration of the investigated structures. PMID- 6840254 TI - Kidney tubule cell injury of male rats after estrogen treatment. AB - Ultrastructural changes in the tubular epithelium of the rat kidney following a large dose of estrogen (300 micrograms per week for 20 weeks) were studied by means of electron microscopy. The ultrastructural changes in estrogen-treated rats were confined to the proximal tubule. The changes consisted of intracytoplasmic vacuoles and dilatation of the intracellular space between adjacent tubule cells. The cisternae of the endoplasmic reticulum exhibited some degree of vesiculation characterized by club-like formations. In addition, large masses of collagen could be observed within the peritubular capillaries. In contrast to the controls the tubular cells of estrogen-treated rats exhibited large areas or granules with dense inclusions and membranous, filamentous material in a process of being transformed into an autolysosome and residual body. The results are discussed in the light of those of other authors. PMID- 6840255 TI - Effects of chronic salt intake on the capillaries in the cerebral cortex of spontaneously hypertensive rats (SHRs): an ultrastructural study. AB - Fine structural changes of capillaries in spontaneously hypertensive rats (SHRs) under the influence of 1% NaCl were studied. In SHRs (control), 30 weeks and older, capillaries showed deformed lumina, hypertrophy of endothelial cells and matrical alterations of mitochondria. Deformed capillary lumina, fibrosis in upper stream vessels and swelling of astrocytic processes were observed in the saline-treated SHRs. The significance of these findings is discussed. PMID- 6840256 TI - Electron microscopic study of adenocarcinoma of the small bowel associated with Crohn's disease. AB - "Crohn's Carcinoma" of a 34-year-old patient is presented in this paper. The fine structure of the tumour is discussed in detail, because there have been no previous reports of electron microscopic studies of this tumour. The adenocarcinoma cells were electron microscopically less differentiated than expected on the basis of light microscopic examinations. In the tumor cells, several round dense granules were observed. Similar granules were also described in the cells of intestinal type gastric and colon cancers, being considered a sign of pathologic mucus secretion. In a part of the tumour cells, intracisternal parallel tubular inclusions were seen like those described in malignant melanoma and osteosarcoma. In the dysplastic small-bowel mucosa adjacent to the tumour, the maturation disorder of the epithelial cells was similar to changes described in the precancerous states of the colon. PMID- 6840257 TI - Assaultive adolescents: family decision-making parameters. AB - This article presents the results of a pilot study that investigated the family decision-making styles of families with a violent adolescent (17) and families with a normal adolescent (12). The results, utilizing an unrevealed differences family interactional test, showed that families with an assaultive teenager when contrasted with normal families had: (a) less agreement when making choices as a group; (b) less agreement between mother and violent son when making choices about activities; (c) sons who had less influence in the families' choice of activities; and, (d) mothers who "dictated" the families' decisions more often. The meanings of these findings and others are discussed by the authors as they relate to the problem of assaultive youths. PMID- 6840258 TI - Getting and giving information: analysis of a family-interview strategy. AB - This paper reports on a videotape study of particular aspects of the two-part interview developed by Selvini-Palazzoli et al. (8, 9). The first segment is a "search for information," the second part the application of an intervention based on the information gathered in the first part. The study focused on the strategies of information retrieval on the premise that they are significant for the quality of information gathered and for the criteria implicitly conveyed by the therapist that in turn have their own substantial impact on the system. We have employed theories of communication, particularly conversational analysis, that are a departure from the epistemological premises of systems theory and communication pragmatics proposed by Selvini-Palazzoli et al. as the theoretical underpinning of their interview technique. PMID- 6840259 TI - Material, myth, and magic: a cultural approach to family therapy. AB - This paper presents a model for a therapeutic approach to the cultural systems of families. Using anthropologically derived concepts of material and ideational planes of culture, magic, and ritualistic intervention, the inducement of culture change in frozen familial systems is framed in dialectical terms. Four brief case studies are presented describing the systems engaged, the material-ideational rituals employed, and the cultural transformations induced. The paper concludes with a brief discussion of some of the theoretical and practical implications of this cultural approach to the family in therapy. PMID- 6840260 TI - Joint custody: parental problems and satisfactions. AB - Joint custody, the total care of children by each parent part of the time, enables both parents to be "custodial" parents after divorce. Increasingly it has become a solution to custody problems, allowing both parents major involvement in their childrens' lives as well as freedom for themselves. This research addresses joint custody from the parents' perspective, exploring the salient issues. The problems and satisfactions are discussed, and the sex differences are highlighted. PMID- 6840261 TI - The family and the child with epilepsy. AB - Reports documenting psychosocial epiphenomena of chronic illness in individuals with that illness have been common in recent years. Few studies, however, have been concerned with how illness might affect the family. Those that have appeared in the literature often lack critical controls (i.e., control groups) and often fail to investigate possible links between illness-specific variables (i.e. chronicity, inhibition of mobility) and psychosocial outcomes on the family. The present study of 45 families focused on how children with epilepsy affect their families' functioning relative to families with a child with diabetes and families with no chronically ill members. The results suggest several areas of child and family adjustment (i.e. child self-concept, family communication, family cohesion) in which the families of epileptic children have great difficulty. Implications of these results are discussed with regard to differential influences of various chronic illnesses on families and family-based preventive and remedial treatment programs. PMID- 6840262 TI - Therapeutic approaches to families of young Israeli soldiers. PMID- 6840263 TI - Circumplex model of marital and family systems: VI. Theoretical update. AB - This paper updates the theoretical work on the Circumplex Model and provides revised and new hypotheses. Similarities and contrasts to the Beavers Systems Model are made along with comments regarding Beavers and Voeller's critique. FACES II, a newly revised assessment tool, provides both "perceived" and "ideal" family assessment that is useful empirically and clinically. PMID- 6840264 TI - Family models: comparing and contrasting the Olson Circumplex Model with the Beavers Systems Model. AB - There is an increasing interest in and need for family models. One such model is the Olson Circumplex Model, previously reported in this journal (18). This model is compared and contrasted with the Beavers Systems Model, which was also developed from empirical data and has had extensive use in family assessment. Though both are cross-sectional, process-oriented, and capable of providing structure for family research, we believe there are certain short-comings in the Olson model that make it less clinically useful than the Beavers Systems Model. These include definitional problems and a total reliance on curvilinear dimensions with a grid approach to family typology that does not acknowledge a separation/individuation continuum. Our model avoids these deficiencies and includes a continuum of functional competence that reflects the development and differentiation of many living systems, including the family. PMID- 6840266 TI - [Pharmacokinetics and prodrugs]. PMID- 6840265 TI - Family treatment of an obsessive-compulsive child: a case report. AB - This paper presents a family therapy approach to the treatment of an obsessive compulsive child. Psychodynamic, behavioral and family therapy approaches to the etiology and treatment of this dysfunction are described briefly, and a detailed case report of a 15-session treatment utilizing behavioral interventions designed to change the family context is presented. Various procedures for dealing with the obsessive-compulsive behavior have been reported in the literature, including eliminating it directly by interruption or ordeal and modifying it. In this case, the author proceeded by ignoring the compulsive behaviors and concentrating on more functional ones using a paradoxical charting intervention. At one-year follow-up, the child was symptom free. Relationship factors, technical interventions, and stylistic aspects of the therapy are discussed, and the importance of rapid symptom alleviation in these children is underscored. PMID- 6840268 TI - [Cyclic analogs of ethambutol with antimycobacterial activity]. PMID- 6840267 TI - [Water-soluble sulfonamides for parenteral use. Synthesis of Schiff bases of sulfamides with aromatic aldehydes having acid groups, and study of the properties of their sodium salts]. PMID- 6840269 TI - Esters of 1,3,3-trimethyl-6-cis-piperidino-2-oxabicyclo[2.2.2]octan-5-cis-ol endowed with hypotensive activity. PMID- 6840270 TI - [Nonsteroidal anti-inflammatory agents. II. Synthesis and pharmacologic activity of non acidic arylpyrrole derivatives]. PMID- 6840271 TI - An essential role of cytosolic thioltransferase in protection of pyruvate kinase from rabbit liver against oxidative inactivation. AB - Pyruvate kinase from rabbit liver is inactivated spontaneously in the presence of air. Glutathione in physiological concentrations gives partial protection against inactivation. Full protection is obtained with glutathione and purified cytosolic thioltransferase supplemented with a glutathione-regenerating system. It is suggested that thioltransferase plus glutathione serve a general function in protecting protein thiol groups against oxidation. PMID- 6840272 TI - The nuclear-associated endoplasmic reticulum is an early target for the action of the tumor promoter 12-O-tetradecanoyl phorbol-13-acetate in C3H/10T1/2 fibroblasts. AB - 12-O-Tetradecanoyl-phorbol-13-acetate (TPA) had a dual effect on the cellular membranes of C3H/10T1/2 cells in that it caused both a stimulation of [3H]choline incorporation and an enhancement of the solubilization of choline from prelabelled cells. Subfractionation studies showed that the release of [3H]choline occurred almost exclusively from nuclear-associated endoplasmic reticulum. The release was dependent on the presence of Mg2+ and Ca2+, indicating an enzyme-mediated reaction. In vivo, TPA stimulated the incorporation of [3H]choline into all subcellular fractions. The data indicate that the nuclear associated endoplasmic reticulum represents an early target for TPA action. PMID- 6840273 TI - Carbon monoxide fixation into the carboxyl group of acetyl coenzyme A during autotrophic growth of Methanobacterium. PMID- 6840274 TI - An abnormal phospholipid in rat organs after ethanol treatment. PMID- 6840276 TI - The effect of a ribonuclease inhibitor from human placenta on the in vitro synthesis of human placental proteins. AB - Addition of a ribonuclease inhibitor (10 micrograms/ml) from human placenta caused 2-3-fold increase of [3H]leucine incorporation in the wheat germ extract as directed by human placental poly (A)-mRNA. Analysis of the translated products by sodium dodecyl sulfate/polyacrylamide gel electrophoresis/fluorography revealed that the inhibitor preferentially increased the yields of the larger proteins, particularly those of larger than Mr 40 000. In the presence of the inhibitor, yields of two placental proteins (human placental lactogen and human chorionic gonadotropin) were increased about 70-80% as detected by immunoprecipitation with specific homologous antisera. The method provided an improvement of translation system for studying biosynthesis of other human placental proteins. PMID- 6840275 TI - Characteristics of a precursor to vasopressin-associated bovine neurophysin. PMID- 6840277 TI - Energy-linked spectral shift of ferrocytochrome b in beef heart submitochondrial particles. PMID- 6840278 TI - Seminalplasmin inhibits transcription and translation of phi80 DNA in vitro. AB - Seminalplasmin, an antimicrobial protein from bovine seminal plasma that has been earlier shown to inhibit transcription in whole cells and by purified RNA polymerase in vitro, but not translation in whole cells, is now shown to inhibit both transcription and translation independently of each other, in a coupled transcription-translation system from E. coli using phi80dphoAlacZ DNA as the template. PMID- 6840279 TI - Definitive 15N NMR evidence that water serves as a source of 'O' during nitrite oxidation by Nitrobacter agilis. PMID- 6840280 TI - Vitamin K-dependent carboxylase: synthesis of an inhibitor of the glutamyl binding site. AB - Liver microsomes contain a vitamin K and O2-dependent carboxylase that converts peptide-bound glutamyl residues to gamma-carboxyglutamate residues. The peptide Boc-O-phospho-Ser-O-phospho-Ser-Leu-OMe has now been synthesized. This peptide inhibits the carboxylation of endogenous protein precursors by a detergent solubilized preparation of the carboxylase and is an apparent competitive inhibitor of the carboxylation of Phe-Leu-Glu-Glu-Leu. PMID- 6840281 TI - Streptozotocin diabetes results in increased responsiveness of adipocyte lipolysis to glucagon. AB - Adipocytes from streptozotocin-diabetic rats are approximately 50-times more sensitive to the lipolytic action of glucagon. This change is only perceived in the presence of a small quantity of adenosine deaminase which itself has little effect on basal lipolysis. Insulin treatment restores glucagon sensitivity to normal. PMID- 6840282 TI - Muscarinic stimulation of phospholipid turnover in dissociated avian salt gland cells. AB - Addition of carbamylcholine to 32P-prelabeled dissociated avian salt gland cells resulted in increased turnover of phosphatidic acid, phosphatidylinositol, phosphatidylinositol 4-phosphate and phosphatidylinositol 4,5-bisphosphate, which could be prevented by the inclusion of atropine. Carbamylcholine had no discernable effect on protein phosphorylation, measured either in the total preparation or in subcellular fractions. It is concluded that for the avian salt gland, no obligatory link is indicated between protein phosphorylation and either phospholipid turnover or salt secretion. PMID- 6840283 TI - Nucleotide sequence of 5 S rRNA from gonads of a Japanese ascidian, Holocynthia roretzi. AB - The nucleotide sequence of 5 S rRNa from gonads of an ascidian Holocynthia roretzi has been determined. The sequence is almost equally related to those of vertebrates and most of the multicellular animal groups. The secondary structure of this 5 S rRNA fits in with the general structural model for multicellular 5 S rRNA. PMID- 6840285 TI - Modulation of the relative trypsin sensitivities of the core histone 'tails'. AB - The order in which the core histone tails in chicken erythrocyte chromatin are attacked by trypsin has been reinvestigated. Results are presented to demonstrate that in the absence of linker histones H1 and H5 the relative order of core histone degradation by trypsin can be altered by changing the salt environment. In native chromatin, the presence of linker histones H1 and H5 inhibits this salt dependent transition. PMID- 6840286 TI - Renal concentrating mechanism. Introduction. PMID- 6840284 TI - The effect of non-muscle tropomyosin on the interaction of filamin with F-actin. PMID- 6840287 TI - Structural organization of the renal medullary counterflow system. AB - The microscopic structure of the various nephron segments comprising the medullary counterflow system is described. The architectural organization of the tubules and blood vessels in the inner and outer medulla is also described. Species differences are noted. A hypothesis that the thicker parts of the descending limbs of Henle actively secrete salt is advanced. PMID- 6840288 TI - The renal concentrating mechanism: fundamental theoretical concepts. AB - Five theoretical principles that follow from qualitative consideration of renal architecture and tubular permeabilities are proposed to explain the concentration of urine in the mammalian kidney. These are: 1) The medullary loop of the doubly folded S-shaped configuration of the nephron permits solute supplied by ascending Henle's limb (AHL) to extract water from descending Henle's limb (DHL) and collecting duct (CD). 2) The cortical loop allows the diluted AHL fluid to return to isotonicity with cortical plasma before returning to the medulla. 3) The folded vasa recta and surrounding interstitium (the central core) provide an expansion chamber for the performance of osmotic work and a mixing chamber for salt and urea. This mixing induces passive salt transport out of AHL. 4) Overall, the system acts as a solute cycling multiplier from the AHL to vascular core and the osmotically equilibrated DHL and CD. 5) The short-looped nephrons provide urea to drive salt transport out of AHL of long nephrons in the inner medulla. PMID- 6840290 TI - Roles of plasmalemmal vesicles in cells: a multidisciplinary approach. Introductory remarks. PMID- 6840289 TI - Computer simulation of renal countercurrent systems. AB - The history of mathematical modeling of renal countercurrent systems is briefly outlined. Several examples are cited and discussed. These include efforts at parameter estimation and experimental design with models. The goal of this work was the evaluation of hypotheses of hypertonic urine formation. The argument is made that computer simulation with reasonably isomorphic models can be used in a variety of ways, but that one indispensable role for this approach is to provide a test of the quantitative sufficiency of hypotheses. Hypotheses of hypertonic urine formation that do not consider active transport in thin ascending limbs do not pass this test. A new proposal is suggested in which the energy for NaCl reabsorption from thin ascending limbs is derived from dissipation of a urea gradient via an antiport. PMID- 6840291 TI - Proteins and vesicular transport in capillary endothelium. AB - Plasma proteins interact with vascular endothelium in such a way as to render it less permeable to other macromolecules. Evidence from a variety of sources indicates that this may result from interaction of the circulating macromolecules with the negatively charged glycoprotein layer on the surface of endothelial cells, and that this layer may be responsible for some of the known molecular sieving properties attributed to the endothelium. Experiments with the fluorocarbon exchange-transfused rat are described, which suggest that there may be mechanisms other than vesicular translocation that facilitate the passage of macromolecules across endothelium. Such mechanisms include, among others, the formation of transient transendothelial channels that appear to be less sensitive than pinocytotic vesicles to the concentration of ambient protein. Recent evidence suggests that, in addition to molecular size and charge, glycosylation of protein molecules and cell membranes themselves may facilitate vesicular uptake. PMID- 6840292 TI - Vesicular transport in capillary endothelium: does it occur? AB - A revised picture of the organization of endothelial plasmalemmal vesicles is presented. Three-dimensional reconstructions of endothelial segments from frog mesenteric capillaries and rat heart capillaries based on ultrathin serial sectioning have shown that plasmalemmal vesicles are not true vesicles but parts of an elaborate system of invaginations of the surface membrane. The revised picture probably applies to capillary endothelia in general. The absence of free cytoplasmic vesicles implies that vesicular transport is unlikely to occur. A reinterpretation of previous studies of vesicular transport shows that they are equally compatible with the present view that plasmalemmal vesicles are static elements of invaginations of the endothelial surface membrane. PMID- 6840293 TI - Vesicular diffusion and thermal forces. AB - The concept that an endothelial vesicular shuttle serves much if not all the function of the large pores of the microcirculation for macromolecular transport has been current for 2 decades. Morphologists have expended much ingenuity in the study of plasmalemmal vesicles by the use of nonenzymatic and enzymatic tracers combined with electron microscopy. Several theoretical models of vesicular transport have been suggested, all of which assume vesicular migration by Brownian or thermal motion. Two such models based on simple diffusion are described, and more recent models in which vesicular diffusion is constrained by long-range hydrodynamic interaction with the plasmalemma are discussed. Theoretical models agree in predicting a vesicular transport time of the order of seconds. Only recently has experimental evidence appeared that tends to corroborate such predictions. Reports that frog mesenteric capillary endothelium fixed with formaldehyde-glutaraldehyde contains very few (approximately 1%) free vesicles are at variance with many in vivo tracer studies and inconsistent with the shuttle theory. It is possible that aldehyde fixation gives a poor representation of the state of the endothelium in vivo. It would seem that more instantaneous methods of fixation, such as rapid freezing, combined with tracer studies and serial sectioning, may be required to resolve this contradiction. PMID- 6840294 TI - Pulmonary transport of water and solutes: functional and structural correlations. AB - Assessment of endothelial barrier parameters is based on formulations derived from the thermodynamics of irreversible processes. These formulations contain simplifying assumptions that, with uncertainties concerning the surface area involved in the transport, preclude definitive modeling with respect to the possible pathways. In the development of edema in isolated lung preparations perfused at 37 C, changes of structural features such as increases of vesicle volume density can be associated with changes of barrier parameters such as increased filtration coefficients and increased permeability coefficients to sodium ion. However, that edema can develop at 15 C without increased vesiculation and that cuffing of extraalveolar vessels also occurs in vivo with circulatory overload without increased vesiculation do not suggest that vesicles play a determining role in the development of edema. Available evidence indicates that the exchange of water across the endothelium is at a rate approximating the flow rate of blood and therefore must involve the entire endothelial surface. Separation or noncommunality of pathways for water and solutes makes modeling of the pathways from current formations even less certain. PMID- 6840295 TI - Equivalent pore modeling: vesicles and channels. AB - The methods used to estimate equivalent pores in capillary walls using lymph protein flux analyses are presented. The capillary walls in several different organs can be described by a two-pore model that incorporates pores of radii 50 80 and 200-250 A. The most likely ultrastructural correlates of these physiological pores appear to be the transendothelial channels. In addition, the positive charge associated with endogenous protein transport in intestinal and lung capillaries may reflect the positive charge located on the inner walls of the transendothelial channel. PMID- 6840296 TI - Effect of drugs on myocardial metabolism. Introduction. PMID- 6840297 TI - Arrhythmogenic properties of phospholipid metabolites associated with myocardial ischemia. AB - Several observations suggest that the accumulation of metabolites within ischemic regions may contribute to the electrophysiological derangements characteristic of ischemic myocardium. We, and more recently others, have detected an increase in lysophosphoglycerides (LPGs) in ischemic tissue in vivo as well as in effluents from ischemic regions. At comparable concentrations, LPGs induce electrophysiological alterations in vitro analogous to changes seen in vivo with ischemia. Experiments with [14C]lysophosphatidylcholine indicated that incorporation comprising less than 1% of total cellular phospholipid is sufficient to induce electrophysiological derangements in isolated ventricular muscle. Reduction of pH to 6.7, analogous to the fall seen within minutes in ischemic tissue in vivo, potentiates the electrophysiological actions markedly without increasing membrane incorporation. In recent studies the activity of enzymes potentially responsible for the accumulation of LPGs during ischemia has been found to be altered by concomitants of ischemia, including increased concentrations of H+ and long-chain acyl carnitine. Thus, accumulation of LPGs and related compounds may contribute substantially to induction of electrophysiological derangements accompanying ischemia and may be amenable to therapeutic manipulation designed to alleviate malignant ventricular dysrhythmia. PMID- 6840298 TI - Herpesvirus-induced atherosclerosis in chickens. AB - Repeated experiments have established that infection with Marek's disease herpesvirus (MDV) leads to atherosclerosis in specific pathogen free (SPF) normocholesterolemic chickens. Neither normocholesterolemic nor hypercholesterolemic uninfected SPF chickens develop this disease. The MDV induced arterial disease is remarkably similar to chronic human atherosclerosis. Cholesterol and saturated cholesteryl esters accumulated in cultured arterial smooth muscle cells (SMC) infected with MDV. Similar preliminary observations were made in vivo. These findings suggest that MDV-induced alteration of SMC lipid metabolism is of major importance in the pathogenesis of MDV-induced atherosclerosis. In addition, immunization with turkey herpesvirus, used commercially to prevent MDV-induced tumors in chickens, also protected against MDV-induced atherosclerosis. This animal model has introduced important new dimensions and tools in atherosclerosis research: a defined etiologic agent (MDV) that causes atherosclerosis in a defined animal of known genetic susceptibility to the etiologic agent. With these tools, important mechanisms in the pathogenesis of atherosclerosis may be established in a relatively short period of time. Further, this animal model should be considered important in other models of atherosclerosis research because herpesvirus infections are ubiquitous in these animals. Finally, because humans are widely and persistently infected with up to five herpesviruses, these studies may lead to the understanding and eventual control of human atherosclerosis. PMID- 6840299 TI - Metabolic changes in the arterial wall associated with atherosclerosis in the pigeon. AB - White Carneau (WC) pigeons are susceptible to both naturally occurring and cholesterol-aggravated aortic atherosclerosis whereas Show Racers (SR) are resistant. These differences are independent of total plasma cholesterol concentrations and appear to be genetically mediated as evidenced by the fact that offspring of WC and SR crosses have an intermediate level of susceptibility. Studies of the interaction of pigeon lipoproteins with pigeon peritoneal macrophages and aortic smooth muscle cells have shown that macrophages may be particularly important in the pathogenesis of cholesterol-aggravated atherosclerosis, especially when abnormal lipo-proteins such as cholesteryl ester rich beta-very low density lipoproteins are present in the plasma. It is likely, however, that different pathogenic mechanisms are involved in naturally occurring pigeon atherosclerosis. If these mechanisms can be elucidated in the pigeon they should provide important clues into the pathological processes responsible for the individuality in atherosclerosis susceptibility in human beings. PMID- 6840300 TI - Basophil and mast cell degranulation: ultrastructural analysis of mechanisms of mediator release. AB - During anaphylactic degranulation, basophilic leukocytes and mast cells stimulated by specific antigen or other appropriate agents rapidly undergo a series of ultrastructural alterations that expose the contents of their cytoplasmic granules to the external milieu. This noncytolytic process results in the release of several potent inflammatory mediators whose combined local and systemic effects largely determine the clinical manifestations of allergic disorders of immediate hypersensitivity. In this report we briefly review our ultrastructural studies of anaphylactic degranulation in basophils purified from the peripheral blood of guinea pigs and humans and in mast cells purified from human lung. PMID- 6840301 TI - Collection of human oocytes by the use of sonography. AB - A technique for ultrasonically guided percutaneous oocyte aspiration was developed utilizing standard real-time, linear-array ultrasound equipment. Forty four patients attending our in vitro fertilization and embryo transfer (IVF-ET) program were included in this study. In 38 patients, follicular puncture was performed under general anesthesia and in 6 cases performed under local anesthesia. Fifty-two follicles with a mean diameter greater than or equal to 18 mm were punctured, and 40 mature oocytes were recovered corresponding to a success rate of 77% per follicle. Six of the punctured follicles were considered cystic when the aspirated granulosa cells were examined microscopically and, if these were excluded, the corrected recovery rate was 87% per follicle. In two patients, ovulation had occurred at the time for oocyte collection. In one of these patients, a mature oocyte was, however, recovered from the pouch of Douglas by the use of sonography. On the basis of these results, ultrasonically guided puncture of follicles for collection of human oocytes in our IVF-ET program seems suitable for use in all cases where laparoscopy is presently used and, moreover, in cases with severe adhesions, where laparoscopy may fail. PMID- 6840302 TI - Experience with 143 cases of tubal surgery. AB - Results of tubal reconstructive surgery must be periodically reviewed. This approach permits evaluation of improvements in individual techniques as well as comparison with the results of others performing similar surgery. It also enables meaningful dialogue between physician and patient regarding prospects for success in the physician's own hands. The senior author's experience with 143 cases of tubal reconstructive surgery is presented. Results of four distinct tubal reconstructive procedures are compared with results reported in the available microsurgical and macrosurgical literature. The term pregnancy rate was 45.7% for those who underwent lysis of adhesions, 50.0% among the tubal anastomosis group, and 20.8% among patients treated with a two-stage salpingostomy. PMID- 6840303 TI - Analysis of failure of microsurgical anastomosis after midsegment, non coagulation tubal ligation. AB - Improved prognosis of tubal anastomosis after midsegment tubal ligation is an important goal. A review of the causes of failure in 124 patients operated on from 1974 through 1978 is presented. All patients were ovulatory and had normal results in postcoital tests and semen analyses. All tubal ligations had been non coagulation. The overall pregnancy rate was 74.2%. The follow-up period was 18 months to 5 years. Of the 32 failures, 6 had bilaterally occluded tubes, 3 had severe ovulatory dysfunction, in 12 the husbands had not previously fathered a child, and 11 were unexplained. In 20.7% of successes and in 37.5% of failures the husband had not previously fathered a child. This significant difference suggests an undefined male factor. PMID- 6840304 TI - Hysteroscopic metroplasty: surgical technique and obstetric outcome. AB - Congenital Mullerian abnormalities, particularly the septate uterus, may result in recurrent abortion or premature labor. Twenty-five patients found to have a septate uterus during evaluation for infertility or recurrent abortion were treated by hysteroscopic metroplasty with laparoscopic visualization. Surgical outcome was excellent, intraoperative and postoperative morbidity was negligible, and the postoperative course was similar to that following laparoscopy alone. Preoperative fetal wastage in 17 previously fertile patients was 90%. Of 11 patients, 6 or more months postoperatively, 10 had conceived: 5 delivered vaginally at term, 2 delivered by cesarean section, and 2 pregnancies are in progress. One pregnancy miscarried at 21 weeks secondary to an incompetent cervix. With hysteroscopic metroplasty, septa can be incised successfully with lower morbidity and as good a surgical outcome as with abdominal procedures. If further studies confirm the pregnancy outcome reported, then hysteroscopic metroplasty should become the treatment of choice for the septate uterus. PMID- 6840305 TI - Sex steroids and endurance running in women. AB - The effects of endurance training on body composition, menstrual cycles, and sex steroids were studied in 19 healthy, regularly menstruating women. Body composition and midfollicular plasma concentrations of estradiol (E2), estrone (E1), and testosterone (T) were examined at baseline and after each subject's weekly mileage had increased 30 miles (delta 30) and 50 miles (delta 50) above baseline. Total body weight did not change, but the subjects became leaner. Mean +/- standard error of the mean E2 decreased from 70.6 +/- 13.9 pg/ml at baseline to 33.6 +/- 4.8 pg/ml at delta 50 (P = 0.03). Mean E1 decreased progressively, but not significantly, while T did not change. Eighteen women developed menstrual changes (mainly oligomenorrhea), but not amenorrhea. Endurance running in women results in frequent menstrual dysfunction and is associated with a significant decrease in E2 concentrations. PMID- 6840306 TI - Physiologic and psychologic profiles in a survey of women runners. AB - The purpose of the present study is to report physiologic and psychologic factors in a survey of women runners. Psychologic factors were used in an investigation of differences in perceived emotional distress within a group of women runners. The psychologic information was compared with the results of two groups of infertility patients and a group of fertile control subjects. Among the physiologic factors, there was a significant difference in the mean weight and the height/weight ratio between amenorrheic and regularly cycling runners (P less than 0.001) and amenorrheic runners and runners with irregular cycles (P less than 0.01). The psychologic data showed no difference between runners and fertile control subjects. When runners were divided according to menstrual intervals or miles run per week, there were differences in perceived emotional distress. PMID- 6840307 TI - A comparison of methods to interpret the basal body temperature graph. AB - Specific criteria are given for several methods of determining the basal body temperature shift. The specific criteria selected have been coded for a uniform interpretation by computer, and interpretations have been compared for 8496 charts. Our results indicate that the method that defines the temperature shift as 0.3 degrees F or more above the running low average for at least 3 consecutive days provides the best concurrent chart interpretation method. A method that creates a smoothed curve that transects the average of all temperatures on a completed graph provides a good retrospective method for identifying the temperature shift. Both the temperature averaging technique and curve smoothing technique identified a temperature shift in more than 95% of the charts with complete temperature readings. PMID- 6840308 TI - Temporal relationships between indices of the fertile period. AB - The intra- and interwoman variation in nine physiologic or biochemical indices of the fertile period has been studied over 58 menstrual cycles from 13 experienced users of the symptothermal method of family planning by periodic abstinence. The time and duration of a possible fertile period have been determined by five methods (symptothermal, cervical mucus, basal body temperature plus calendar calculation, defined changes in the concentration of estrone-3-glucuronide and the ratio of estrone-3-glucuronide to pregnanediol-3 alpha-glucuronide as determined by immunochemical tests on daily samples of early morning urine). The values were compared with a period of probable fertility (day of urinary luteotropin [LH] peak -3 to day of LH peak +2). The duration of the possible fertile period by each method (mean +/- standard deviation) was 13.4 (2.9), 11.9 (2.9), 11.8 (3.3), 9.3 (2.2), and 10.9 (2.3) days, respectively, while the percentage of the probable fertile periods covered entirely by each approach was 98%, 91%, 90%, 83%, and 84%, respectively. The results warrant the initiation of clinical trials to ascertain the practical value of the individual or combined tests for family planning and the management of infertility. PMID- 6840309 TI - The relationship of endometriosis to spontaneous abortion. AB - Seventy-seven of 226 pregnancies (34%) conceived prior to conservative surgical treatment of endometriosis ended in first-trimester spontaneous abortion. Mild endometriosis was associated with a significantly greater proportion of abortions (49% in 87 pregnancies) than moderate (25% in 32 pregnancies) or severe disease (24% in 107 pregnancies). Following operation, only 7 of 76 pregnancies (9%) conceived by the same group of patients ended in spontaneous abortion. In primary infertility patients, 17 of 128 pregnancies (13%) ended in abortion following operation. The postoperative abortion rates were not significantly different between degree of severity of endometriosis. Speculation is presented on the mechanism of the increased preoperative abortion rate in patients with mild endometriosis. PMID- 6840310 TI - Penetration of zona-free hamster ova and bovine cervical mucus by fresh and frozen human spermatozoa. AB - Semen samples from 25 fertile donors and 34 infertility patients were analyzed and evaluated both fresh and frozen with the zona-free hamster egg penetration test (EPT) and the bovine cervical mucus penetration test (MPT). Cryopreserved sperm penetrated 47.2% (average) of the hamster eggs, and fresh sperm penetrated 55.9%. Frozen sperm retained 86% of the fresh EPT values (P, not significant), but only 38% of the fresh MPT values (P less than 0.001). Cryopreserved sperm yielded the same fertility classification as fresh sperm in 94% of the cases with the EPT but only 43% with the MPT. The use of cryopreserved sperm simplifies the procedure and should enable more laboratories to utilize the EPT, but the poor results with the MPT preclude utilization of cryopreserved sperm for routine fertility evaluation with the MPT. PMID- 6840311 TI - Histology and fertility after microsurgical anastomosis of the rabbit fallopian tube with nylon and polyglactin sutures. AB - Polyglactin and nylon suture material were compared in microsurgical anastomosis of oviduct of rabbits with regard to the histologic reaction, adhesion formation, and nidation index. Thirty days after surgery, the tissue inflammatory response was very similar in both groups. At 90 days, polyglactin had been totally absorbed in 80% of the cases, and no inflammatory reaction persisted at the site of the suture. At this time, multinucleated giant cell reaction to nylon sutures was persistent but minimal. The results reveal no significant functional differences between oviduct reanastomosed with nylon versus polyglactin suture. No significant difference in subsequent fertility due to suture selection was demonstrated. PMID- 6840312 TI - Luteal phase defects in infertility patients with endometriosis. PMID- 6840313 TI - Aberrant results of serum beta-human chorionic gonadotropin assays: an infrequent but vexing problem. PMID- 6840314 TI - Scoring morphology using the scanning microscope. PMID- 6840315 TI - Effect of saliva on sperm motility. PMID- 6840316 TI - Harmful effects of smoking on spermatogenesis and steroidogenesis. PMID- 6840317 TI - Oil versus aqueous media for hysterosalpingography. PMID- 6840318 TI - [Horseradish peroxidase-labeled afferent projections to the amygdaloid complex in the cat]. PMID- 6840319 TI - [Afferent projections from the telencephalon and mesencephalon to the amygdaloid complex in the cat]. PMID- 6840320 TI - [Reaction of pyramidal neuron apical dendrites in the sensorimotor cortex to prolonged rhythmic electric stimulation of a relay thalamic nucleus]. PMID- 6840321 TI - [Evoked neuronal activity of the cat neostriatum following lesions of the afferent acoustic pathways]. PMID- 6840322 TI - [Characteristics of burst electric activity in different thalamic nuclei]. PMID- 6840323 TI - [Modulating effects of the orbitofrontal cortex on the generation of the burst electric activity in the brain]. PMID- 6840324 TI - [Responses of the neurons in an isolated strip of cat association cortex (area 5) to intracortical stimulation]. PMID- 6840325 TI - [Characteristics of muscle reinnervation after suturing of the sciatic nerve or after reimplantation of the hindlimb in the rat]. PMID- 6840327 TI - [Physiological mechanisms of fatigue during strenuous muscular activity]. PMID- 6840326 TI - [Afferent impulses in the cardiac branches of the vagus nerve after intracoronary and intravenous administration of anticardiac cytotoxic serum]. PMID- 6840328 TI - [Gamma-aminobutyric acid content and glutamate decarboxylase activity in the brain of intact and adrenalectomized rats after cyproheptadine administration]. PMID- 6840329 TI - [Quantitative evaluation of bioelectric activity of the vagus nerve in a chronic experiment]. PMID- 6840330 TI - [Effect of apamin on the generation of action potentials in smooth muscle cells of the ureter]. PMID- 6840331 TI - [Effect of electric stimulation of the hypothalamus on DNA methylation in the rat liver]. PMID- 6840332 TI - [Activities of the enzymes of energy metabolism in the muscles of the normal tongue and in the tongue with impaired sensory and motor innervation]. PMID- 6840333 TI - [Glandular system of a vesicular area of the frontal air sac of the sperm whale]. PMID- 6840334 TI - [A method of increasing the sensitivity of the acetylcholine bioassay]. PMID- 6840336 TI - [Metrological possibilities of the method of tetrapolar transthoracic impedance rheoplethysmography under clinical conditions]. PMID- 6840335 TI - [A device for the formation and analysis of spherical artificial phospholipid membranes]. PMID- 6840337 TI - [Determination of blood minute volume by thermodilution method]. PMID- 6840338 TI - [Method of evaluating a temperature profile in the local cooling of medulla oblongata]. PMID- 6840341 TI - [Eye movements of the cat induced by electrical stimulation of the lateral geniculate body]. PMID- 6840339 TI - [Methods for obtaining isolated smooth muscle cells]. PMID- 6840342 TI - [Patterns of the reaction of the inferior colliculus to the movement of a sound source in the cat]. AB - Series of slicks simulating source sound movement caused 82% of the posterior colliculus' EPs to alter gradually their amplitude and/or shape ("the movement effect"). The markedness of ipsilateral effect was about 1.5 times higher than that of the contralateral one. The effect occurred within large range of velocities: no lower than 3.4 rad/sec in 65% of observations. The most effective were the velocities over 6.8 rad/sec in 78%. Difference in responses to opposite directions of the sound source movement occurred in 26%. The movement effect obviously depended on the site of EP recording. PMID- 6840340 TI - [Cortico-striatal relations in the interaction of monomodal afferent volleys]. AB - EPs on the stimulation of one or both hands simultaneously were studied in the caudate nucleus, frontal and somatosensory cortex in alert monkeys. The types of interaction of afferent volleys were found to be as follows: facilitation, summation and depression. The amplitude and peak latency of the EP in the caudate nucleus correlated mainly with the EP in the frontal cortex. The role of the frontal and somatosensory cortex in forming the sensory responses in the caudate nucleus, is discussed. PMID- 6840343 TI - [Localization of cold thermoreceptors in various layers of the skin]. AB - Impulses from cold thermoreceptors were recorded during changes of the temperature in superficial and deep skin layers of the rabbit upper lip. The temperature of stimulating thermodes was sharply changed from 20 degrees C to 40 degrees C and back again in each of the thermodes. 7 out of 10 receptors revealed sharp alterations in the impulse flow following changes of the temperature in the surface thermode, whereas changes of temperature in the deep thermode (2-3 mm under the skin) induced slow alterations in the activity of the same receptor. 3 receptors responded only to changes in the deep thermode. The data suggest that thermoreceptors can be found in different skin layers and register the skin temperature gradient or the heat flows across the skin. This enables to propose a new regard on the mechanism of temperature homeostasis maintenance. PMID- 6840344 TI - [Effect of stretching of the cat gastrocnemius muscle on its tetany, postcontraction hyperemia and energy metabolism indices]. AB - Longitudinal stretch of the muscle in the range E = 0.11-0.17 (111-117% of the initial length) is followed by increase in passive strength and in mechanical displays of the 15-sec isometric Blood flow in the muscle vessels decreases at rest in the longitudinal stretching whereas O2 extraction from the blood increases; O2 consumption and ration of arterio-venous differences in the lactate and pyruvate concentration do not change. Additional posttetanic blood supply in the muscle, posttetanic alteration of the O2 consumption in it and the lactate/pyruvate ratio in longitudinal stretch do not differ from the analogous parameters in the initial--length muscle. The data obtained are in accordance with the metabolic theory of the hyperemia mechanisms but can hardly be explained from the standpoint of the histomechanical theory. PMID- 6840345 TI - [Architectonics of the arterial bed of the cerebral hemispheres in the normal rat and following a stay at an "altitude" of 5600 m]. AB - Post mortem morphometric study of the arterial bed of the brain hemispheres in rats after 90-day stay at "the altitude" 5600 m revealed a noticeably larger diameter of arteries (D), a greater coefficient of their branching, lesser distances between branches (L), larger angles of branch deviation and a longer capillary bed. Calculations based on these data show that amount of arterial vessels and capillaries must increase in hypoxia, their length and linear blood flow velocity (V) must diminish, and the value of V/D2 and epsilon (LV/D2) characterizing the gradient of impetuous pressure and total losses of the impetuosity in the vascular bed must decrease. PMID- 6840346 TI - [Analysis of systemic hemodynamics in altered hydraulic resistance of the initial portion of the aorta]. AB - The changes of cardio- and hemodynamics on increase of hydraulic resistance in the initial part of aorta under conditions of external occlusion (EO) of the ascending aorta or internal occlusion (IO) of aortic valve opening or of the ascending aorta lumen, were studied in anesthetized cats. Under EO to 50% of square section of the ascending aorta a considerable increase of cardiac output (CO) with small rise of aortic pressure proximal to site of occlusion (AP-1) was observed. Further EO was accompanied by a decrease of CO with a more pronounced rise of AP-1. AP distal to EO kept unchanged within wide range of aorta narrowing. 10 of ascending aorta lumen caused similar correlations of CO, left ventricle systolic pressure (LVP) and AP distal to the occlusion site. Under 10 of aortic valve opening, progressive decrease of CO with simultaneous increase of LVP and lowering of AP takes place. The role of the coronary blood flow as a factor increasing the myocardial contractility under increase of AP and the significance of baroreceptor reflexes, are discussed. PMID- 6840347 TI - [Adaptation rate of intestinal disaccharidases to carbohydrates in poultry]. PMID- 6840348 TI - [Efficiency of the physiological changes of heat conduction and heat mass transfer in human skin during thermoregulation]. PMID- 6840349 TI - [Thermoregulatory activity of the intercostal muscles under a hypercapnic load]. AB - In experiments on anesthetized cats, the reactions elicited by CO2 inhalation were studied in single motor units of the intercostal muscles activated during shivering. The excitation of the bulbar respiratory center during shivering was found to modify the activity of the respiratory and tonic motor units. Most of the respiratory motor units in a hypercapnic state increased the mean firing rate by 1.5/sec. The tonic motor units both diminished the mean firing rate and changed the pattern of activity: they began to produce bursts of spikes synchronous with the respiratory rhythm. The problems of supraspinal regulation of activity of the intercostal muscles motoneuron pool are discussed. PMID- 6840351 TI - [Device for the automatic classification of the degree of brain activation]. PMID- 6840350 TI - [Transmembrane potentials of rat cardiac cells in fibrillation induced by decreased extracellular sodium]. PMID- 6840352 TI - [Universal electrostimulator with digital control]. PMID- 6840353 TI - [Suction electrode with internal perfusion]. PMID- 6840354 TI - [Attachment to a stimulator for shaping a counted series of impulses]. PMID- 6840355 TI - [Simple method of contactless recording of the movements of individual vibrissae]. PMID- 6840356 TI - The origin of life and the evolution of macromolecules. PMID- 6840357 TI - Genes in cancer. PMID- 6840358 TI - Trisomy 18 (Edwards syndrome) in Delaware. PMID- 6840359 TI - What's new in nuclear medicine? PMID- 6840360 TI - Fever of unknown origin in the elderly. PMID- 6840361 TI - Milwaukee Shoulder syndrome: a new crystal-induced arthritis syndrome associated with hydroxyapatite crystals--a case report. PMID- 6840362 TI - Incidence and survival rates: cancer in Delaware. PMID- 6840363 TI - Short stature: medical progress and ethical dilemmas. PMID- 6840364 TI - It's time you heard about: psychotherapy with the deaf. PMID- 6840365 TI - What's new in gynecology? PMID- 6840366 TI - [Clinico-diagnostic accuracy in malignant melanoma of the skin]. PMID- 6840367 TI - [Case contribution on infantile digital fibromatosis]. PMID- 6840368 TI - [Biochemistry of the regression and latent phase of porphyria cutanea tarda]. PMID- 6840369 TI - [Enzyme rhythm studies in melanoma patients]. PMID- 6840370 TI - Activation of fibroblasts induced by mononuclear cells from patients with systemic scleroderma and inactivation by mitogen stimulation. AB - Unstimulated mononuclear cell supernatants from patients with systemic scleroderma significantly augmented the DNA and collagen biosynthesis of 3T3 cells compared to normal mononuclear cells. This increase was suppressed by either a particular glycosaminoglycan, which from previous studies, has appeared to act as one of the tissue antigens in sclerotic skin, or concanavalin A stimulation. PMID- 6840371 TI - Familial continual skin peeling. AB - A clinical picture of familial continual peeling of the skin is described and discussed together with light and ultramicroscopic manifestations in one of the probands. The pattern of splitting distinguishes this condition from keratolysis exfoliativa. The ultramicroscopy exhibited mainly predominance of low-density keratocytes in the corneal layer, abnormalities in distribution of lamellar granules and disrupted coating of the cells in the intercellular spaces of the corneal layer. PMID- 6840372 TI - Elastosis perforans serpiginosa. Report of a family. AB - Two brothers with typical, symmetrical lesions of elastosis perforans serpiginosa are presented. Familial occurrence has been reported only once. In neither family was the disease associated with heritable disorders of the connective tissue. The pedigree analysis suggests an autosomal-recessive pattern of inheritance. PMID- 6840373 TI - Lupus tumidus involving facial skin, nasal cavity, throat and eye (with 1 color plate). PMID- 6840374 TI - [A case of atypical cutaneous leishmaniasis of the back]. PMID- 6840375 TI - Urticaria and giardiasis. PMID- 6840376 TI - Effect of oral aromatic retinoid (Ro 10-9359) on human papilloma virus-2-induced common warts. AB - Persisting human papilloma virus (HPV) 2 induced common warts of a chronic lymphatic leukemia patient were orally treated with aromatic retinoid Ro 10-9359 (Tigason). Clinically, the lesions improved rapidly. Virus-specific cytopathogenic effects (CPE), virus particles and viral DNA were no longer detectable. Therapy was discontinued because of the development of a liposarcoma, which led to a complete relapse of the cutaneous lesions. HPV-2 specific parameters, CPE and viral DNA, were restored. Comparison of the restriction enzyme cleavage patterns revealed that warts before and after therapy contained the same HPV-2 subtype. The implications of the observation on the effect of Tigason on virus-induced papillomas are discussed. PMID- 6840377 TI - [Lyell's syndrome (T.E.N.) and "lyellization" of other exanthematous dermatoses (secondary epidermal necrolysis). Apropos of the work of Kint et al]. PMID- 6840378 TI - Serological characterization of humoral lectins from the freshwater prawn Macrobrachium rosenbergii. AB - We have detected and partially characterized multiple lectins present in the serum of the freshwater prawn Macrobrachium rosenbergii. Since agglutination of erythrocytes (RBC) is not abolished by treatment with Vibrio cholerae neuraminidase (VCN), Macrobrachium shows an agglutination pattern different from that of other sialic acid-specific lectins such as Limulus polyphemus lectin. However, after absorption with primate and bird VCN-treated RBC, Macrobrachium serum exhibits high titers with untreated and pronase-treated RBC and no agglutination of VCN-treated RBC, suggesting a typical sialic acid specific lectin agglutination profile. Hemagglutination-inhibition tests indicate that sialic acid containing compounds are the best inhibitors for Macrobrachium lectins. Subterminal sugars and type of linkage are probably important for the lectin binding since bovine submaxillary mucin (containing mainly terminal NANA alpha-2 6-GalNAc-) is a better inhibitor than fetuin (containing mainly terminal NANA-alpha-2 leads to 3-Gal-) and colominic acid (-NANA-alpha-2 leads to 8-NANA-) is a weak inhibitor. PMID- 6840379 TI - Inhibition of Limulus agglutinins with N-acetyl-neuraminic acid and derivatives. PMID- 6840380 TI - Infection of rainbow trout by opportunist pathogens following subcutaneous injection of Freund's adjuvant. PMID- 6840381 TI - Complement-like activity in sea urchin coelomic fluid. AB - A complement-like activity in echinoid coelomic cell-free fluid is described. The activity is detected by the lytic action on rabbit erythrocytes (RRBC), and by the opsonic effect on echinoid coelomic phagocytes and mouse peritoneal macrophages. This activity is very heat-labile, being completely destroyed at 37 degrees C 1/2 hr, and is inhibited by Ca2+ concentrations below 10 mM and by low pH. Lysis was complete within 3-4 min, and the titer (10(7) RRBC/ml) was 20-60 between animals. Various substances known to inhibit human complement also inhibited the lytic and opsonic activities in echinoid fluid. RRBC opsonized with echinoid fluid were attached to mouse macrophages without being internalized, an effect which resemble complement opsonization. It is concluded that an activity is present in echinoid coelomic fluid, which strongly resembles mammalian complement activated via the alternative pathway. A lectin-like activity with specificity for D-fucose was detected by the agglutination of RRBC (titer 300 600). Hemagglutination was inhibited by sugars which did not inhibit the lytic and opsonic process. On the other hand, hemagglutination was resistant to various physio-chemical treatments which led to inactivation of the complement-like system; thus these two activities seem to be unrelated. The lectin-like activity did not mediate any opsonic effect. PMID- 6840382 TI - Studies on lectins of amago (Oncorhyncus rhodurus). I. Amago ova lectin and its receptor on homologous macrophages. AB - A lectin was found in the ova of amago, a Japanese trout (Oncorhyncus rhodurus), which agglutinates rabbit, rat and human B-type erythrocytes. The hemagglutination was specifically inhibited by monosaccharides, L-rhamnose, D galactose, and their C2 and C4 analogs, and p-nitrophenyl-alpha-D-galactoside and melibiose, indicating a binding specificity for alpha-L-rhamnosyl or alpha-D galactosyl type sugar moiety. To study its interaction with homologous cells, amago peritoneal macrophages were isolated from corn starch-stimulated peritoneal exudates. The lectin-rabbit erythrocyte complexes were found to adhere onto the macrophages harvested on the 4th day or later after the stimulation, but not to those obtained within 3 days; the latter macrophages acquired the complex-binding capacity when cultured for 3 to 4 days in vitro. These findings indicated that a lectin receptor is expressed on peritoneal macrophages after inflammatory stimulation. Similar lectin receptor-bearing macrophage-like-cells were also detected during in vitro amago head kidney culture. This suggested that the inflammatory induced peritoneal macrophages may be differentiated from the head kidney macrophage precursor cells and during this process the ova lectin receptors also become expressed. PMID- 6840383 TI - The relationship between spontaneous and induced abortion and the occurrence of second-trimester abortion in subsequent pregnancies. PMID- 6840384 TI - Maternal and fetal prostaglandins during acute fetal acidosis. AB - Prostaglandins have been detected in high levels in the fetal circulation. These substances are known to cause marked changes in the fetal and uterine circulations. The present study demonstrated an increase in fetal and maternal circulating levels of i prostaglandin F2 alpha in fetal lambs with acute acidosis. Both levels correlated with the degree of fetal acidosis. No consistent change in levels of i PGE were noted. Prostaglandins may play a role in the pathogenesis of response to fetal stress. PMID- 6840385 TI - Partition of maternal nutrients to the placenta and fetus in the sheep. AB - Utilizing the Fick Principle, the fluxes of oxygen and glucose leaving the uterine circulation and entering the fetal umbilical circulation were measured simultaneously in 35 chronically catheterized sheep. Additionally, the distribution of placentally produced lactate into the uterine and umbilical circulations was measured by the same techniques. Under unstressed conditions, placental oxygen consumption accounted for approximately half the oxygen exiting the uterine circulation. Placental glucose consumption averaged 75% of the glucose exiting the uterine circulation, and this proportion increased with decreasing glucose concentration in the maternal artery. Lactate was produced at a high rate by all placentae, and distributed disproportionately to the fetus, in spite of higher fetal lactate concentration. Fetal metabolism was aerobic, as demonstrated by a high rate of net oxygen consumption and a high rate of net lactate consumption. Fetal oxygen metabolism correlated well with fetal weight and with the sum of net fetal lactate and glucose consumption. PMID- 6840386 TI - Blood cells and their role in regeneration. II. Effects of putative immunological manipulations on circulating blood cell counts during regeneration. AB - The participation of leukocytes in regeneration was studied by determining changes in circulating leukocyte counts following putative immunological manipulations. Splenectomy failed to produce leukopenia during regeneration, although a 24-35% reduction in leukocytes occurred in otherwise intact newts. Bovine serum albumin and anti-lymphocyte serum produced initial lympho- and granulocytopenias, but blood counts soon returned to more normal levels. Lymphocytosis followed treatment with cobra venom factor, but marked lymphopenia occurred shortly thereafter. Regeneration occurred in all cases. These data failed to establish a clear correlation between the nature of quantitative changes in circulating leukocyte levels following these treatments and regenerative capacity. PMID- 6840387 TI - The effect of oral contraceptives on sister chromatid exchange, blast transformation, mitotic index and micronuclei formation. AB - Lymphocytes from 5 individuals were cultured to study the effect of mestranol and norethindrone on sister chromatid exchange (SCE), blast transformation, mitotic index and micronuclei formation. Four combinations of the drugs were compared to water and ethanol controls. Some steroid combinations increased the SCE frequency compared to ethanol controls. There was no uniform effect on blast transformation or mitotic index. In 3 individuals, micronuclei formation was reduced in treated cultures. In conclusion, contraceptive steroids may be mutagenic in some individuals. PMID- 6840388 TI - Histopathologic evaluation of response to treatment of human tumors grown in the nude mouse. AB - The histopathologic changes following chemotherapy treatment of a number of human tumors grown in nude mice were evaluated. On the basis of the histopathologic profile, three response levels were recognized--a mild response, a moderate response and a severe response. Severe response was characterized by arrest of cell division and profound nuclear-cytoplasmic degenerative changes. Regrowth of effectively treated tumors originated in clusters of cells most probably representing resistant tumor cell clones. Histopathologic changes represent a sensitive indicator of the response of nude mouse grown human tumors to anticancer agents. Availability and correct interpretation of the post-treatment histopathologic picture is of importance in selecting the proper combination treatment which would maximize tumor response. PMID- 6840389 TI - Action of adenosine triphosphate on human skin and gingival fibroblasts. Protective action of fibronectin. AB - If cultured in media supplemented with adenosine triphosphate (ATP), EDTA, trypsin, thrombin, or incubated at 0-15 degrees C, human skin fibroblasts (HSF) and human gingival fibroblasts (HGF) change from long attached elliptical to round floating cell cultures. Also, if treated with ATP, EDTA, trypsin, thrombin, or incubated at 0-15 degrees C, the attached HFS or HGF monolayers detach from plastic substratum and form floating round cells that progressively aggregate together and die. The described experiments examined the role of cellular and extracellular ATP on HSF and HGF attachment. These two types of fibroblasts differed in their cellular ATP levels and their response to metabolic inhibitors. ATP causes destruction of microtubules as monitored by colcemid uptake and cellular detachment. Fibronectin protects both HSF and HGF from the effects of extracellular ATP. PMID- 6840390 TI - Sources of population and family planning assistance. PMID- 6840391 TI - Imbalanced triacyglycerol metabolism in fat cells from estrogen-treated rats. PMID- 6840392 TI - Effect of androgens on protein synthesis and secretion in various regions of the rat epididymis, as analysed by two-dimensional gel electrophoresis. AB - Protein synthesis and secretion has been quantified in three regions of the rat epididymis (initial segment, caput and cauda) by measuring the rate of incorporation of radioactive methionine by tissue pieces in vitro. The effect of androgens on protein synthesis and secretion was assessed by comparing tissue from untreated animals, castrated animals, and castrated animals receiving injections of testosterone propionate. Androgens caused up to a 2-fold increase in protein synthesis per unit wet weight of tissue. Qualitative effects of androgens on the types of proteins synthesized and secreted were assessed by two dimensional gel electrophoresis. Androgens induced a differential response in the synthesis of secretory proteins in that some secretory proteins were androgen regulated whereas others were not. Evidence was also obtained that protein synthesis and secretion in the initial segments of the epididymis responded to some local testicular factor in addition to androgen. The rate of decline in the synthesis of androgen-dependent secretory proteins following castration varied according to the protein. Moreover, the rate of decline in synthesis of the same protein varied markedly in different regions of the epididymis. PMID- 6840393 TI - Quantitative analysis of mRNA synthesis during early cortisol action on rat thymocytes: restricted size of a possible hormone response. AB - Complete inhibition of cortisol-induced pycnosis was seen by actinomycin D and cycloheximide only when added during the initial period of hormone action. This phenomenon, being a characteristic of steroid hormone effects in general, is often taken as indirect evidence for early steroid-induced mRNA synthesis. The lack of direct evidence for this theory has been tested for significance. Approximately 133 newly synthesized mRNA molecules were found to accumulate in the cytoplasm/min/cell, suggesting an average synthesis rate for individual mRNA species of about 1 copy/h/cell. Electrophoretic fractionation of double labelled RNA failed to reveal any changes of the isotope ratio of single fractions during the first 15-45 min of cortisol action, within an experimental error corresponding to +/- 2- +/- 20 molecules/cell. Possible effects of cortisol are thus restricted to changes in the range of constitutive mRNA synthesis rates. In contrast, the RNA labelling pattern was differentially changed after 45 min treatment with 10(-5) M cycloheximide. PMID- 6840394 TI - Nuclear testosterone receptors in the ovine testis. AB - Nuclear [3H] testosterone-receptor complexes were demonstrated in hypophysectomized ram testis after in vitro direct labelling. The nuclear binding was maximal after a 45 min incubation of the tissue. The receptors are extractable by 0.4 M KC1 or NaSCN with a 25-30% efficiency. They migrate towards the anodic region during electrophoresis on agar gel. Nuclear androgen receptors were characterized in intact lamb testis by a testosterone exchange assay. After precipitation by protamine sulphate, the receptors were labelled with [3H]testosterone during a 12 h incubation at 4 degrees C. The exchange activity was linear between 0.1 and 0.9 mg of DNA per ml of incubation buffer. The receptors bind testosterone with a limited capacity (40-180 fmoles per mg DNA) and a dissociation constant Kd of 2 x 10(-9) M. Their relative affinities for steroids are dihydrotestosterone greater than testosterone greater than estradiol greater than progesterone greater than 5 alpha-androstanediol greater than cyproterone acute greater than R5020. PMID- 6840395 TI - Analysis of population cytokinetics of chick myocardial cells in tissue culture. AB - The growth of embryonic chick cardiac myocytes and fibroblasts in tissue culture was evaluated by the kinetics of nuclear labeling during continuous exposure to [3H]thymidine. The fraction of mitotically active cells, the mean intermitotic period and the population doubling times were determined in each cell type during 3 weeks in culture. After 24 hr in culture, 90% of the muscle cells were mitotically active with minimal population doubling times of 65 hr. By 17 days in culture only 5% of the myocytes continued to divide with population doubling times greater than 3000 hr. Primarily, the lengthening of doubling times was due to a withdrawal of cells from the mitotic cycle and much less to a lengthening of the intermitotic period. Growth of cardiac muscle cells from embryonic hearts from 4 to 10 days of development was also compared. Muscle cells from younger hearts displayed greater mitotic activity than those from older hearts at equivalent times in culture. PMID- 6840396 TI - Clonal analysis of corn plant development. I. The development of the tassel and the ear shoot. AB - The development of the tassel and the ear shoot has been investigated in corn (Zea mays L.). X irradiation of dry kernels and seedlings heterozygous for anthocyanin markers or for factors altering tassel and ear morphology results in the formation of clones (sectors) from cells of the apical meristem. Most tassels develop from 4 +/- 1 cells of the mature embryo. The expression of ramosa-1, tunicate, tassel seed-6, and vestigial is cell autonomous in the tassel. These genes act late in development and modify the developmental fate or decision of an individual clone and not of the whole group of cells producing a tassel. The ear shoot develops from lineages of one to three cells derived each from the L-I (outmost cell layer) and L-II (second cell layer) of the apical meristem. Typically the clones start in the ear shoot (in the husks and possibly in the cob), extend upward in an internode, continue along the margin of the leaf sheath or leaf blade at the node above, and terminate in this or the next higher leaf. The separation of lineages for ear shoot and internode occurs in the period around 13 days after sowing. The analysis of clonal boundaries shows that a small number of embryonic cells become isolated in their developmental capacity. This commitment process appears to be analogous to the process of compartmentation in the imaginal disks of fruit flies. The extent of proliferation of individual cells within a group of highly flexible and any particular clone does not generate a specific part of a tassel or an ear shoot. There must be cellular communication between various clones so that the overall size and morphology of an organ remain normal and more or less fixed. Thus the process of development in plants is also highly regulative in nature and shares many features in common with development in fruit flies. PMID- 6840397 TI - Alterations in lung basement membrane during fetal growth and type 2 cell development. AB - We studied basement membrane development in the late fetal and in the neonatal rat lung, from the 18th day of gestation (term = 22 days) through the 8th postnatal day, with particular emphasis on the gas-exchange region of the lung. In the periphery of the lung, as type 2 cells differentiate, the continuous basement membrane develops openings beneath these cells. Basal cytoplasmic foot processes extend through these discontinuities into the underlying interstitium, often approaching interstitial cells closely. These discontinuities and extensive foot processes are associated only with type 2 epithelial cells and not with either differentiated airway cells or with the type 1 alveolar lining cells derived from type 2 cells. The type 2 cell basement membrane discontinuities and penetrating foot processes are maximal in the perinatal period and decrease in the week after birth. The appearance of openings in type 2 cell basement membrane and changes in distribution, linear density, and ruthenium red staining of anionic sites suggest that the epithelial basement membrane undergoes continuous remodeling throughout development, particularly in association with type 2 cell differentiation and growth of lung surface area. Epithelial cell foot processes may interact with underlying interstitial cells and affect the coordination of lung surface growth with the development of its connective tissue framework. PMID- 6840398 TI - An experimental study of the somitomeric organization of the avian segmental plate. AB - The segmental plate mesoderm of chicken and Japanese quail embryos HH stages 9 to 16 was studied with scanning electron microscopy (SEM) imaging. The segmental plates were found to exhibit a metameric pattern consisting of tandemly stacked somitomeres. It was found that the numbers of somitomeres in segmental plates removed from the same embryo were nearly identical. Furthermore, the number of somitomeres in a segmental plate was found to be quite consistent (10.0 +/- 1.5) and independent of the length of the segmental plate. These results are very similar to those obtained in previous experimental studies in which "prospective somites" were detected in avian segmental plates. Further experiments showed that for each somite that is formed by a cultured segmental plate-containing explant, the somitomere complement of the segmental plate is reduced by one. It was concluded that the segmental plate mesoderm is already organized into a metameric pattern consisting of somitomeres and that the somitomeres undergo further morphogenesis to become somites. The specification of the somite pattern in birds may occur at the level of Hensen's node and the cephalic primitive streak. PMID- 6840399 TI - Endogenous electrical current leaves the limb and prelimb region of the Xenopus embryo. AB - The electrical current pattern around the developing Xenopus laevis embryo was mapped with a vibrating probe. Current (taken as the movement of positive charge) was found to leave the emerging hind limb bud and to enter the gill region of the stage 47 embryo. The magnitude of the current leaving the limb was about 7 microA/cm2 and the current entering the gill was about 60 microA/cm2. Other regions of smaller outward current were found between the limb and gill. At stage 43, prior to the appearance of the limb bud, a highly localized region of the outward current existed in the general area from which the bud would later emerge. The inward current was localized to the gill bud, as in the older embryo. The ionic basis of the currents could not be determined. In about one-third of the cases studied, the inward current was sodium sensitive since the removal of external sodium or the addition of amiloride reversably blocked the current. In the remaining cases, however, removal of sodium did not change (or else increased) the current. No other external ion (Ca2+, Mg2+, K+) could be identified as the current-carrying ion; the possibility of an outward movement of some anion such as Cl- or HCO-2 remains. PMID- 6840401 TI - American Diabetes Association. 43rd annual meeting, June 12-16, 1983, San Antonio. Abstracts. PMID- 6840400 TI - Lack of glucagon response to hypoglycemia in type I diabetics after long-term optimal therapy with a continuous subcutaneous insulin infusion pump. AB - Counterregulatory hormonal responses were studied in six patients after 4-18 mo treatment with a continuous subcutaneous insulin infusion pump. In response to insulin-induced hypoglycemia, significant increases in epinephrine, norepinephrine, cortisol, and growth hormone were measured in all subjects, while in five of the six patients glucagon levels did not increase at all. The persistence of these abnormal glucagon responses despite long-term optimal glucose control suggests that they are not due to hyperglycemia per se, but are due rather to a specific alpha cell abnormality. The high incidence of asymptomatic hypoglycemia in these patients emphasizes that caution is necessary to avoid serious hypoglycemia when striving for near-normal glucose control with insulin infusion pump therapy. PMID- 6840402 TI - Ileal enteroglucagon cells after ileal-duodenal transposition in the rat. AB - The changes occurring in the ileal wall and in enteroglucagon cells were studied in a rat model of intestinal adaptation, obtained by the transposition of a segment of distal ileum into the mid-duodenum (6 rats, compared with 6 transected controls). After 40 days, the transposed ileal segment, compared to the equivalent segment in the controls, showed striking increase in weight, especially of the epithelium (1,585 +/- 127 vs. 305 +/- 42 mg, mean +/- SEM, p less than 0.0005). The calculated weight of enteroglucagon cells in the segment showed a smaller, but significant increase (1.7 +/- 0.3 vs. 0.8 +/- 0.2 micrograms, p less than 0.05). Plasma enteroglucagon was markedly raised (239 +/- 28 vs. 61 +/- 7.1 pmol/l, p less than 0.0005) and showed a greatly increased meal stimulated response (1,521 +/- 284 vs. 83 +/- 43 pmol, p less than 0.0005), thus suggesting hyperactivity of enteroglucagon cells. PMID- 6840403 TI - Simultaneous recording of myoelectrical activity and resistance from the human colon. AB - A system used to record myoelectrical activity from the rectosigmoid colon has been modified so that a continuous recording of electrical resistance is obtained simultaneously. Normal subjects, patients with diverticular disease and patients with the irritable colon syndrome have been studied by this method. There were variations in resistance in the form of waves for 74.7, 88.5 and 89.0% of the time in the three groups. These changes were abolished by intravenous glucagon. The predominant frequency of the waves was 2-4 c/min and often coincided with myoelectrical waves of the same frequency. It is concluded that the resistance changes are produced by local movement in the colonic wall at the electrode site and that this technique may be valuable in studying colonic motility. PMID- 6840405 TI - Monosaccharide absorption and water secretion during disaccharide perfusion of the human jejunum. AB - During jejunal perfusion of normal subjects with isotonic mannitol-saline containing glucose, maltose or sucrose (112 mmol/l), monosaccharide absorption from disaccharides was greater than expected from the intraluminal concentration of free monosaccharides, and water secretion was greater than with glucose. With equimolar (112 mmol/l) glucose + disaccharide mixtures, intraluminal glucose concentrations were similar to but total glucose absorption less than expected from experiments with the individual sugars. The results favour sequential hydrolysis-absorption whereby high concentrations of monosaccharide accumulate at the brush border and promote sugar uptake by conventional rather than 'disaccharidase-related' transport, and stimulate water secretion by local osmotic effects. PMID- 6840404 TI - Investigations on common bile duct stones. AB - Common bile duct stones from 59 consecutive patients who underwent cholecystectomy more than 1 year before radiological detection of choledocholithiasis (group I) and from 31 consecutive patients with choledocholithiasis and gallbladder in situ (group II) were subjected to chemical analysis and compared with the composition of gallbladder stones from the same population (two consecutive biopsy and autopsy series, n = 343). In contrast to cholecystolithiasis, inorganic calcium salts were infrequent in choledocholithiasis while calcium bilirubinate and fatty acid calcium salts played an important role in the composition of common bile duct stones. This is of particular importance in terms of litholysis. With respect to stone pathogenesis, clinical and radiological data were analyzed, as was hepatic bile lipid composition. There was no significant difference in the lithogenic index (percent cholesterol saturation) in cholecystectomized and in non cholecystectomized patients with choledocholithiasis. The most important cause of stone recurrence in the common duct after surgery was incrustation of unabsorbed suture material, which was the case in 30.5% of group-I patients. PMID- 6840406 TI - Effects of 16,16-dimethyl-PGE2-methyl ester on aspirin- and indomethacin-induced gastric and intestinal lesions in mini pigs. AB - Aspirin, 100 mg/kg, given only twice at intervals of 16 h to fasted mini pigs induced lesions in the body but had no effect on the antrum and small intestine. Indomethacin, 40 mg/kg, given once daily for 10 consecutive days to non-fasted mini pigs very weakly irritated the pig stomach but induced multiple superficial lesions in the jejunum and ileum. 16,16-Dimethyl-PGE2-methyl ester, 10 micrograms/kg in two divided doses or 20 micrograms/kg in four divided doses for 10 days, markedly inhibited the aspirin- or indomethacin-induced gastric and intestinal lesions in mini pigs, respectively. PMID- 6840407 TI - Dose-related effect of bombesin on serum cationic trypsinogen levels. AB - The present study has been addressed to study the serum cationic trypsinogen (CT) response after the ingestion of a mixed meal and following the infusion of caerulein and bombesin. On the first day of study a mixed meal was administered to 12 normal volunteers. On the following day 6 of these subjects received bombesin infusion in stepwise increasing doses (18.7, 37.5, 75 and 150 pM/kg/h) every 30 min, while the remaining 6 subjects received caerulein infusion (18, 37, 75 and 150 ng/kg/h). The time course of the serum CT response to bombesin (150 pM/kg/h) was also studied in 6 patients with distal gastrectomy. Serum CT levels did not vary after the ingestion of the meal or the infusion of caerulein. Bombesin infusion was followed by a dose-related increase on serum CT levels, but it had no effect on serum amylase and isoamylases. The CT concentrations peaked 30 min after starting the infusion and remained unchanged as long as bombesin was administered. It is suggested that the bombesin action on the pancreatic acinar cells may be direct and not mediated through cholecystokinin or gastrin release. PMID- 6840408 TI - Beer and wine but not whisky and pure ethanol do stimulate release of gastrin in humans. AB - In humans, the action of ethanol on gastrin release is still unclear and that of alcoholic beverages greatly unknown. We studied the effect of a drink of various concentrations of pure ethanol and several commonly ingested alcoholic beverages on plasma levels of immunoreactive gastrin in 6 healthy human volunteers and compared the results to a protein-rich meal. A drink of distilled water (250 ml) and of pure ethanol (250 ml or 125 ml in the case of 40% v/v ethanol) in concentrations (4, 10, 20 and 40% v/v) normally present in beer, wine, liquor and whisky did not stimulate plasma gastrin levels above basal. Of the alcoholic beverages given only whisky (125 ml) did not stimulate gastrin release. Beer, red and white wine (250 ml each) caused a rapid increase in plasma gastrin concentrations with a peak at 15-20 min, basal levels being reached 60 min after starting the drink. The 60-min integrated plasma gastrin response to beer, red and white wine was about 50% of the gastrin response to the protein-rich (steak) meal (883 +/- 297 pmol X min X 1(-1); mean +/- SE). A drink of 250 ml of white wine together with the meal did not cause a significantly higher integrated gastrin response than the protein meal with 250 ml of distilled water. We conclude that commonly ingested alcoholic beverages such as beer, red and white wine, but not whisky, are potent stimulants of gastrin release in humans. The ethanol content of these beverages cannot be responsible for the increase in plasma gastrin levels, since oral ingestion of pure ethanol in equivalent concentrations and amounts did not elicit a rise in plasma gastrin levels. Some unknown ingredients present in beer and wine are most likely responsible for the gastrin release by both alcoholic beverages. PMID- 6840409 TI - Hepatic secretion of bilirubin and biliary lipids in patients with alcoholic cirrhosis of the liver. AB - In patients with cirrhosis of the liver elevated bilirubin concentrations in the plasma could be the result of decreased bilirubin excretion or an overproduction of bilirubin with insufficient excretion of the increased amounts of bilirubin. Under steady state conditions with constant serum bilirubin concentrations bilirubin synthesis equals biliary and urinary bilirubin excretion. In the present study in 10 healthy volunteers and 11 patients with alcoholic cirrhosis of the liver and serum bilirubin concentrations of 7.0 +/- 1.9 mg/dl the biliary excretion of bilirubin was studied by the intestinal perfusion method and compared with the excretion of bile lipids. Biliary excretion of bilirubin in the cirrhotics was 38.7 +/- 8.8 mumol/h, the 10 healthy controls excreted 17.9 +/- 0.9 mumol/h bilirubin. Only minor amounts of bilirubin were excreted in urine. In 4 of the 11 cirrhotics 51Cr-red blood cell half-lives were studied revealing ongoing hemolysis. Bilirubin production calculated from red cell life span was identical to biliary excretion of bilirubin with an error less than 5%. The data indicate that in patients with alcoholic cirrhosis of the liver serum concentrations of bilirubin may be elevated due to overproduction of bilirubin and a concomitant decrease of the biliary transport capacity of bilirubin. PMID- 6840410 TI - Calcium secretion from the feline pancreas. Influence of hormonal and cholinergic secretagogues and of serum calcium. AB - The influences of secretagogues and of elevated serum calcium concentrations on the calcium secretion from the cat pancreas have been studied in vivo. During a high and constant fluid secretion rate evoked by a background infusion of secretin, additional infusions of both cholecystokinin-pancreozymin and urecholine led to a dose-dependent increase in calcium secretion in pancreatic juice parallel to the rise of protein. The amount of calcium in pancreatic juice associated to 1 mg protein (18.3 nmol/mg protein) calculated from regression analysis was independent of dose or kind of stimulus used. The protein independent pancreatic juice calcium fraction was 0.184 mM in normocalcemia. During an episode of hypercalcemia produced by an intravenous calcium infusion, the protein-independent calcium fraction was increased and correlated linearly to the serum calcium concentration. We conclude that pancreatic juice calcium consists of two major fractions, one being associated with the enzyme protein and stimulated by secretagogues, and the other being protein independent and directly dependent on the extracellular calcium concentration. PMID- 6840411 TI - Effect of a pretest listening exposure on the ascending-descending gap at most comfortable loudness levels. AB - The effect of approach mode (ascending versus descending, A-D) on comfortable loudness was determined for a 1000 Hz pure tone using Bekesy audiometry. Two groups (experimental and control) of 10 normal-hearing young adult subjects measured their most comfortable loudness (MCL) levels pre- and post-treatment. The experimental group received a treatment of a listening exposure to a 70 dB intensity range before the test. The results demonstrated a statistically significant change of the A-D gap in the experimental group while the A-D gap for the control group remained essentially unchanged. It is proposed that MCL is underestimated in the ascending approach and overestimated on the descending testing, which results in the A-D gap. In addition, the results demonstrate the importance of the procedures used in research and clinic of the MCL. PMID- 6840412 TI - Influence of electrode impedance on auditory brain stem response recordings in the intensive care nursery. AB - ABR results from 400 newborns were examined for skin contact-electrode impedance effects on screening results. Neither high electrode impedance nor unbalanced impedance between the active electrodes appeared to have a significant effect on the screening results. Caution is advised in interpreting the results of this study. The authors are not advocating poor skin-electrode contact. However, satisfactory responses have been recorded with higher than previously reported optimal electrode impedance. PMID- 6840413 TI - False air-bone gap. AB - A single case is reported of a severely hearing-impaired child with a finding of a large air-bone gap on pure-tone audiometry on multiple tests. Exploratory surgery found normal middle ear function. Subsequent audiometry indicated the presence of a false air-bone gap resulting from vibrotactile responses. Test procedures for identifying vibrotactile responses are discussed. PMID- 6840414 TI - Improving brain stem auditory evoked potential recordings by digital filtering. AB - Digital filters that have been in clinical use for about 3 yrs are described, and their effects on the waveforms of brain stem auditory evoked potentials and their ability to suppress noise are compared to the effects of analog filters on brain stem auditory evoked potential waveforms and the ability of analog filters to suppress noise. PMID- 6840415 TI - Assessment of central auditory dysfunction: the dichotic digit test revisited. AB - A dichotic digit test was administered to 21 subjects with intracranial lesions. Twelve subjects had lesions limited to the cortex and nine had brain stem disorders. The dichotic digit test appeared to be a sensitive measure for detecting cortex and brain stem lesions. Laterality data indicated markedly reduced performance for the ear contralateral to the hemispheric lesion. Overall results were similar to previous reports on dichotic digits, supporting the use of this test as a screening procedure or part of a test battery for CNS evaluation. PMID- 6840416 TI - Delayed feedback audiometry: reliability of repeated measures. AB - The test-retest reliability of hearing thresholds at 1000 Hz measured by a delayed auditory feedback procedure was compared with the reliability of thresholds obtained with voluntary responses to the same signal in 10 adults with normal hearing sensitivity. Thresholds for each procedure were obtained three times on each of 5 different days. Although the delayed feedback procedure yielded estimates of threshold which averaged 4.6 dB greater than those estimated by voluntary responses (p less than 0.05), there was no evidence that experience over time resulted in a change for the poorer in the precision of the test. PMID- 6840417 TI - Telephone listening ability in a noisy background. AB - Telephone handsets have a built-in side-tone feedback because the transmitter feeds back sound through the receiver, allowing users to monitor their voice levels. However, the side-tone feedback system also picks up background noise which interferes with the incoming speech signal. This study investigated the influence of side-tone feedback on the telephone listening ability of 30 normal hearing subjects in a background of multitalker (MT) and white noise (WN) presented at 65, 75, and 85 dB SPL in two conditions where the side-tone feedback was present and in three conditions where the side-tone was eliminated. Telephone listening ability significantly decreased as the level of the noise increased for both MT and WN and for all listening conditions. Telephone listening ability was significantly poorer in the background of MT than WN for each noise level and listening condition. The primary finding was that telephone listening ability in a background of MT or WN at the higher levels was significantly improved when the side-tone feedback was eliminated by electronically disengaging or more simply by occluding the transmitter with the palm of the hand. PMID- 6840418 TI - Interlist equivalency of the CID W-22 word lists presented in quiet and in noise. AB - The interlist equivalency of the CID W-22 word lists administered in quiet and in a background of noise was investigated using 48 normal-hearing subjects. All four word lists were administered at 20 dB SL in quiet and in the presence of a multitalker babble (0 dB signal-to-noise ratio). In the statistical analyses, word performance and subject performance were used as the dependent measures. The results indicated that: (1) the lists are equivalent when administered in quiet; (2) the lists are not equivalent when administered in a background of multitalker babble; (3) the addition of noise changes the relationship among the word lists in a nonpredictive manner; and (4) the addition of noise changes the level of difficulty of some words of each list to a greater degree, relative to the other words. The results are discussed relative to their implications for hearing evaluation and hearing aid evaluation procedures. PMID- 6840419 TI - High-frequency sensitization of the acoustic reflex. AB - High-frequency sensitization of the acoustic reflex was studied in 10 normal hearing subjects. The procedure involved pairing a subreflex 6000 Hz sensitizing tone with activating frequencies of 500, 1000, and 2000 Hz. Both threshold and growth of amplitude of the acoustic reflex were examined. Acoustic reflex threshold was reduced by an average of 10 to 12 dB in the presence of a 6000 Hz sensitizing tone, an amount significantly less than previously reported in similar investigations. Variations in the method used to adjust the presentation level of the high-frequency sensitizing tone probably account for these differences. Growth of acoustic reflex amplitude was also found to be influenced by sensitizing stimulation, with the greatest effect occurring near acoustic reflex threshold. PMID- 6840420 TI - Imprecision of new criteria for the oral glucose tolerance test. AB - Subjects selected from a centre specializing in diabetes detection have been classified using nine different methods of diagnosis including the recent criteria of the National Diabetes Data Group and the World Health Organization. The applicability of these two new criteria have been evaluated and compared with seven other previous criteria. The agreements and discrepancies between these criteria have been assessed. Application of the new criteria result in a major redistribution of subjects with abnormal glucose tolerance into a rare category of diabetes mellitus and a large category of 'impaired glucose tolerance'. An important percentage of our population (33%) is excluded from the three clinical classes circumscribed by the criteria of the National Diabetes Data Group. Among these subjects, two-thirds correspond to the subjects named 'non-diagnostic' by these authors and one-third are not classifiable. The need to allow for all possible oral glucose tolerance test responses is emphasized. PMID- 6840421 TI - Hyperglycaemia induced by glucose infusion in the unrestrained pregnant rat: effect on body weight and lipid synthesis in post-mature fetuses. AB - Mild hyperglycaemia was induced in unrestrained pregnant rats from day 20.5 to day 23.5 of pregnancy, using a continuous glucose infusion. Control rats were infused with distilled water. In post-mature fetuses from glucose-infused rats, raised plasma glucose and insulin concentrations were related to increased body weight (6.03 +/- 0.07 g) and total carcass fat (2.02 +/- 0.04% of fresh weight) compared with control fetuses of the same age (5.35 +/- 0.07 and 1.5 +/- 0.04 g, respectively). Concurrently, the rate of lipogenesis in the carcass, estimated from the incorporation of tritium from tritiated water into fatty acids, was significantly increased in fetuses from glucose infused rats compared with control rats (6.00 +/- 0.34 versus 2.62 +/- 0.27 and 3H2O X h-1 X g tissue-1, respectively. PMID- 6840422 TI - Human growth hormone response to a fall in plasma glucose concentration in normal and diabetic subjects. PMID- 6840423 TI - No linkage between HLA and maturity onset hyperglycemia in the young. PMID- 6840424 TI - Short-term changes in levels of circulating T3 and reverse T3 in type 1 (insulin dependent) diabetic patients. PMID- 6840425 TI - Correlation of serum unconjugated oestriol to red cell 2,3-diphosphoglycerate levels in diabetic pregnancy. AB - In order to evaluate the possible underlying factors for the increase in red cell 2,3-diphosphoglycerate content observed in late diabetic pregnancy, its relationship with serum unconjugated oestriol, human placental lactogen, haemoglobin and hydrogen ion concentrations was investigated in 42 pregnant diabetic women. A significant correlation was found between red cell 2,3 diphosphoglycerate and serum unconjugated oestriol (r = 0.54, p less than 0.001), whereas no correlation was present between 2,3-diphosphoglycerate and the following variables: arterial pH, haemoglobin concentration and human placental lactogen. The content of 2,3-diphosphoglycerate correlated significantly with haemoglobin-oxygen affinity expressed as P50 at pH 7.4 (r = 0.34, p less than 0.05). The results of this study indicate that serum unconjugated oestriol may participate in the regulation of red cell 2,3-diphosphoglycerate content and thereby of the maternal blood oxygen release to the fetus. PMID- 6840426 TI - Sexual responsiveness in diabetic women. AB - Sexual responsiveness in 82 Type 1 (insulin-dependent) diabetic women was compared with that of 47 normal control subjects, using an interview method for rating various aspects of sexual response, and attitude questionnaires. The diabetic women were questioned about symptoms of autonomic neuropathy, and cardiovascular autonomic nerve function tests were performed. There were differences between the two groups in the reports of vaginal lubrication, but in most other respects the groups were similar. The diabetic women were not less orgasmic, and reported significantly fewer unpleasant feelings during sexual intercourse. They saw themselves and their husbands as less 'potent' than did the normal subjects. The possible enhancing effect of diabetes on the marriage of some diabetic women possibly counteracted the relatively mild physiological deficits involved. There was very little difference in sexual response between women with and without symptomatic autonomic neuropathy. PMID- 6840427 TI - Chlorpropamide-alcohol flushing and plasma chlorpropamide concentrations in diabetic patients on maintenance chlorpropamide therapy. AB - Forty-three diabetic patients on maintenance chlorpropamide (100-750 mg daily) drank 0.2 ml/kg 90% ethanol after equilibration in a room controlled at 20 degrees C. Twenty-five patients had already noted marked alcohol flushing since starting chlorpropamide therapy (group A), while 13 had not observed this (group B). The remainder were teetotal or unsure of their reaction. Cheek temperature rise correlated with plasma chlorpropamide concentration (r = 0.6, p less than 0.001) in all patients and was inversely related to basal cheek temperature (r = 0.35, p less than 0.02). Plasma chlorpropamide correlated with daily chlorpropamide dose (r = 0.8, p less than 0.001) but not with basal cheek temperature. The correlation between chlorpropamide level and cheek temperature rise was strengthened on analysis of group A alone (r = 0.7, p less than 0.001) and absent in group B (r = 0.2, p greater than 0.3) who tended to have lower chlorpropamide levels and cheek temperature rise than group A. PMID- 6840428 TI - Glucagon induced hyperkalemia in diabetes. PMID- 6840429 TI - Serum IgA in diabetes. PMID- 6840430 TI - Concentration-dependent differential effect of retinoic acid on intercellular metabolic cooperation. AB - A vitamin A analog, 13-cis-retinoic acid (13-cis-RA), was tested for effect on intercellular metabolic cooperation between 6-thioguanine-resistant and sensitive V79 Chinese hamster cells. Most typical tumor promoters have been reported to inhibit metabolic cooperation. 13-cis-RA was found to enhance metabolic cooperation of cells treated with a potent tumor promoter, 12-O tetradecanoyl-phorbol-13-acetate. However, inhibition of metabolic cooperation was noticed when 13-cis-RA was used at higher concentrations. PMID- 6840431 TI - A micro-occlusion technique for measurement of the microvascular pressure in tumor and subcutis. AB - A new technique for indirect measurement of microvascular pressure in normal and tumor tissue was developed, by using a microneedle which occludes the microvessels without disturbing the microcirculation system. Thus, the microvascular pressure either in normal subcutis or in tumor tissue can be measured precisely at the single vessel level. There was a considerable drop of the pressure in the smaller arterioles (less than 40 microns in diameter) in proportion to their diameters, while the pressure profile in venules was almost flat irrespective of their diameters. The mean pressure of venules 10-50 microns in diameter was 12.0 +/- 5.2 cm H2O, and some preliminary data obtained in pressure measurement of tumor vessels are also presented. PMID- 6840432 TI - In vivo and in vitro effects of Nocardia rubra cell wall skeleton on natural killer activity in mice. AB - The in vivo and in vitro effects of Nocardia rubra cell wall skeleton (N-CWS) on natural killer (NK) activity of spleen and peritoneal lymphocytes of C57BL/6 mice were studied. The NK activity of spleen and peritoneal lymphocytes against YAC-1 lymphoma cells and cultured B-16 melanoma cells peaked at 3 days after intraperitoneal or intravenous administration of N-CWS, and returned to the normal value 7 days later. The NK activity of spleen lymphocytes was augmented by in vitro incubation with N-CWS. The appropriate concentration of N-CWS for the in vitro stimulation of NK activity in spleen lymphocytes was 2-5 micrograms/ml. PMID- 6840433 TI - Combined treatment of autochthonous 3-methylcholanthrene-induced murine tumors by immunotherapy and radiotherapy. AB - C57BL/6J mice with autochthonous 3-methylcholanthrene-induced tumors were given combined therapy with 2,000 rad of local irradiation and regional injections of cell-wall skeleton of Nocardia rubra (N-CWS). The greatest suppression of the tumor growth and the highest survival rate were observed in the combined treatment group as compared to the non-treated control, regional injections of N CWS alone and irradiation alone groups. In addition, pulmonary metastasis was significantly suppressed by the combined therapy. PMID- 6840434 TI - Antitumor activity of macrophages grown in tumorous ascitic fluid. AB - Peritoneal macrophages from mice injected with glycogen proliferated in vitro in the presence of cell-free tumorous ascites. DNA synthesis of macrophages was also induced by ascitic fluid, but did not occur in the absence of the fluid. However, macrophage growth was inhibited at a higher concentration of ascitic fluid (greater than 20%). The growth stimulating activity of this fluid was stable on heat treatment. The adherent cultured cells that proliferated were typical macrophages, as indicated by nonspecific esterase staining, pinocytosis and phagocytosis. These macrophages showed cytolytic activity against a murine tumor in the presence of wheat germ agglutinin. However, their cytotoxicity with antitumor antibody decreased during the culture period. These results indicate that tumorous ascitic fluid contains a macrophage growth factor(s) and that macrophages cultured with, and induced to proliferate by, ascitic fluid can kill tumor cells in cooperation with lectin but not antibody. PMID- 6840435 TI - The therapeutic effect of the antileukemia drug busulfan as an immunomodulator on transplanted fibrosarcoma KMT-17 in WKA rats. AB - Enhancement of specific transplantation resistance to a syngeneic tumor (KMT-17) was observed in WKA rats treated with the antileukemia drug busulfan (BU) (15 or 8 mg/kg) 5 days after immunization with X-irradiated KMT-17 cells. Similar enhancement was also produced by treatment with mitomycin C (1 mg/kg), but not cyclophosphamide (40 or 20 mg/kg), adriamycin (3 mg/kg), or BU (4 mg/kg). The therapeutic effect of BU on transplanted KMT-17 tumor in WKA rats was relatively weak, but the therapeutic efficacy of BU as an immunomodulator appeared to be almost equal to that of PS-K, lentinan, or neurotropin. By means of the tumor neutralizing assay using spleen cells, a stronger antitumor immune response was observed in BU-treated tumor-bearing rats than in the BU-untreated control group. An improvement of the therapeutic effect was obtained by combining neurotropin with BU, although its monotherapeutic effect was insufficient. PMID- 6840436 TI - Chemosensitivity of established human bladder carcinoma cell lines in vitro. AB - The cytotoxic effects of 3-[(4-amino-2-methyl-5-pyrimidinyl)methyl]-1-nitrosourea hydrochloride, thio-TEPA, 4'-dimethyl-epipodophyllotoxin-beta-D-ethylidine glucoside, bleomycin, cis-platinum, mitomycin C, adriamycin and carbazilquinone on asynchronous cells of established human bladder carcinoma lines (KK-47, KW-103 and RT4) were investigated by the in vitro colony formation technique. The dose survival curves were classified into 2 types: biphasic type (bleomycin) and exponential decrease type (the others). These types and the 50 and 90% growth inhibition doses of the drugs may offer a guide to chemotherapeutic design as well as to the selection of possibly effective agents for bladder cancer therapy. PMID- 6840437 TI - Effect of high salt diet on rat gastric carcinogenesis induced by N-methyl-N' nitro-N-nitrosoguanidine. AB - The influence of sodium chloride on chemical carcinogenesis of the gastroduodenal tract was examined in male outbred Wistar rats exposed to N-methyl-N'-nitro-N nitrosoguanidine (MNNG) in the drinking water (100 mg/liter) for 20 weeks. Sodium chloride given concomitantly with MNNG during the first 20 weeks of the experiment increased both the incidence and the size of tumors at 40 weeks. However, sodium chloride given after MNNG during the second 20 weeks of the experiment did not enhance tumor development. This study indicates that, although sodium chloride given with MNNG enhances tumor development, sodium chloride does not promote gastric carcinogenesis. PMID- 6840438 TI - Species variations in the metabolism of N-butyl-N-(4-hydroxybutyl) nitrosamine and related compounds in relation to urinary bladder carcinogenesis. AB - Species variations in response to urinary bladder carcinogens, N-butyl-N-(4 hydroxybutyl)nitrosamine (BBN), N-ethyl-N-(4-hydroxybutyl)nitrosamine (EHBN), and N,N-dibutylnitrosamine (DBN), were investigated in several animal species from the metabolic point of view. Since N-butyl-N-(3-carboxypropyl) nitrosamine (BCPN) and N-ethyl-N-(3-carboxypropyl) nitrosamine (ECPN) had been found to be the principal urinary metabolites which are responsible for the induction of bladder tumors by BBN or DBN and EHBN, respectively, in rats, acidic urinary metabolites with the N-nitroso moiety were isolated and determined by a colorimetric method after oral administration of these nitrosamines to rats, mice, hamsters, guinea pigs, and dogs. Qualitatively almost no species differences were observed among these animals in regard to the urinary metabolites except in the case of mice, in which the glycine conjugate of BCPN was isolated from the urine and identified as the principal metabolite of BBN and DBN. However, appreciable quantitative differences in the urinary excretion of BCPN or ECPN were found among these animal species, indicating that the differences in the susceptibilities of different animal species to urinary bladder carcinogenesis induced by BBN, DBN and EHBN may be closely related to the different extents of urinary excretion of the active metabolites of these nitrosamines. PMID- 6840439 TI - Establishment and characterization of rat cell lines transformed by the left-end DNA fragments of adenovirus type 31. AB - A rat cell line, 3Y1, was transfected with the left-end DNA fragments of adenovirus (Ad) 31 DNA and transformed cell lines were established. A cell line 31BY4-1, which was induced by Ad31 BamHI-B (left-most 17.4% of the genome), showed typical transformation phenotypes, while cell lines 31GY1-2, 31GY2-5, and 31GY3-4, which were induced by Ad31 HindIII-G (left-most 6.7% of the genome), showed intermediate phenotypes between transformed and untransformed cells, with the following properties: (1) percent plating efficiencies in Eagle's minimum essential medium with 2% fetal calf serum and in soft-agar culture were extremely low, like those of 3Y1 cells; (2) they form tumors in newborn rats only after long latent periods. Southern blot hybridization revealed that, in all the transformed cell lines, viral DNA sequences were integrated at multiple loci in large-molecular-weight cell DNAs. Northern blot hybridization showed that viral mRNAs of early region 1A (E1A) and early region 1B (E1B) were both transcribed in 31BY4-1 cells as well as in KB cells early after infection with Ad31. On the other hand, E1B viral mRNA was present in a much lesser amount in 31GY cell lines, or was undetectable. PMID- 6840440 TI - Differences in susceptibility to sodium saccharin among various strains of rats and other animal species. AB - Differences in the susceptibilities to sodium saccharin of the urinary bladder epithelium in various strains of rats and other animal species were examined. In Experiment 1, male ACI, Wistar, F344 and Sprague-Dawley rats were administered 5.0% sodium saccharin in the diet for 52 weeks. Rats were killed after weeks 12, 24, 36 and 52. In ACI rats, sodium saccharin induced not only preneoplastic lesions of the urinary bladder, but also tumors. However, in other strains it did not. The urinary bladder of ACI rats given sodium saccharin had the most marked lesions under scanning electron microscopy, with less marked changes in Wistar and F344 rats. Sprague-Dawley rats were resistant to sodium saccharin. In Experiment 2, male F344 rats, B6C3F1 mice, Syrian golden hamsters, and Hartley guinea pigs were given 5.0% sodium saccharin in the diet for 20 weeks. The animals were sacrificed sequentially. Rats developed urinary bladder lesions during the experiment, as detected by light microscopy and scanning electron microscopy. Increased DNA synthesis of the urinary bladder epithelium was detected in rats by autoradiography. However, mice, hamsters and guinea pigs were resistant to sodium saccharin. These results indicate that there are strain and species differences in the urinary bladder response to sodium saccharin. PMID- 6840441 TI - Difference in polynucleation of cultured cells from human mammary tumors and normal mammary glands on treatment with cytochalasin B. AB - In order to study the biological nature of various mammary tumors, differences in the formation of polynuclear cells after the administration of cytochalasin B were investigated in cultures of human mammary tumors and normal mammary gland. When cytochalasin B was applied to the cultures, polynuclear cells increased in all cancer cases (6.1% on average), but relatively little effect was seen in cases of benign tumors and normal mammary gland (less than 1.1% on average). From these results, it appears that the difference in polynucleation on treatment with cytochalasin B may be useful as a biological means to distinguish human malignant and benign mammary tumors. PMID- 6840442 TI - Function and structure of long-term ileal reservoirs in rats. PMID- 6840443 TI - [Atrophic fundic gastritis unrecognized in gastroscopy: detection by local deposition of bromocresol green and pH-metry of the mucous lumen]. PMID- 6840444 TI - [Heterotopic gastric mucosa in the rectum with ulceration]. PMID- 6840445 TI - [Chronic calcifying pancreatitis: an anatomopathological reality has arrived at the molecular stage of knowledge]. PMID- 6840446 TI - [Optic and electron microscopic study of the anal glands in man]. PMID- 6840447 TI - [Protein-losing enteropathy and nodular lymphoid hyperplasia of the small intestine]. PMID- 6840448 TI - [Immune complexes and liver diseases]. PMID- 6840449 TI - [Circulating immune complexes and alcoholic liver disease: relation between the presence of circulating immune complexes and the degree of histologic involvement of the liver]. PMID- 6840450 TI - [Natural history of chronic pancreatitis: A study of 120 cases]. PMID- 6840451 TI - [Crohn's disease and Yersinia serology]. PMID- 6840452 TI - [Turcot's syndrome]. PMID- 6840453 TI - [Hemocholecyst: rare complication of oral anticoagulation]. PMID- 6840454 TI - [A new fatal case of hepatitis caused by clometacin]. PMID- 6840455 TI - [Hepatitis B virus markers and cryptogenic enterocolitis]. PMID- 6840456 TI - [Does endoscopic sphincterotomy have an important role in the treatment of biliary lithiasis?]. PMID- 6840457 TI - [Echographic study of thrombosis of the portal system in the adult]. PMID- 6840458 TI - [Cholestasis and inflammatory syndrome in a 55-year-old woman]. PMID- 6840460 TI - [Value of endoscopic biopsy in the diagnosis of primary malignant lymphoma of the stomach: study of 29 cases]. PMID- 6840459 TI - [Experimental gastric lesions and cytoprotection: role of the retrodiffusion of H+ ions]. PMID- 6840461 TI - [Intramucosal hemolysis in the gastric necrotic lesion induced by absolute alcohol in the rat]. PMID- 6840462 TI - [Results of cytodiagnosis guided under endoscopic control in 248 cases of digestive cancer]. PMID- 6840463 TI - [Adaptation of gastrin secretion to a protein meal in the premature and term newborn infant]. PMID- 6840464 TI - [Glandulocystic polyps of the fundus: 7 cases]. PMID- 6840465 TI - [Survey about the Forum on Research in Gastroenterology]. PMID- 6840466 TI - [Immunoallergic hepatitis induced by flumequine]. PMID- 6840467 TI - [Demonstration of different transport systems for the biliary secretion of rose bengal and conjugated bilirubin in humans]. PMID- 6840469 TI - Chronic liver disease in patients with lymphoma. PMID- 6840468 TI - [Hepatic toxicity of new antidepressive drugs. Apropos of a case]. PMID- 6840470 TI - [Mechanisms for increased clearance of dyes (BSP, ICG) by the liver]. PMID- 6840471 TI - [May an anomaly of the intestinal flora be a factor aggravating vitamin B12 deficiency in achlorhydric gastritis?]. PMID- 6840472 TI - [Is Behcet's syndrome really a possible etiology of colitis with epitheliogigantocellular granuloma?]. PMID- 6840473 TI - [Malignant melanoma of the anal canal]. PMID- 6840474 TI - [18th Forum on Gastroenterology Research and 7th French-language seminar on hepato-gastroenterology. Marseilles, 2-5 March 1983. Abstracts]. PMID- 6840475 TI - Hemochromatosis: genetic or alcohol-induced? AB - To evaluate the roles of alcohol and genetic factors in hepatic iron overload, we studied prospectively 61 patients selected solely on the basis of increased stainable hepatic iron (grade 3 or 4). Independent comparisons were made between alcoholic (n = 20) and nonalcoholic (n = 41) patients, and between patients wih affected relatives (n = 25) and those without (n = 36). For the entire group, the mean value for mobilizable iron was 19.6 g and the prevalence of HLA-A3 was 69.6%, both findings compatible with genetic hemochromatosis. Subgroups were no different in clinical features (diabetes, pigmentation, cardiomyopathy, hypogonadism, or arthropaty), histologic findings (fat, inflammation, fibrosis), indexes of iron metabolism (serum iron, transferrin saturation, chelatable iron, and mobilizable iron stores), or frequency of HLA-A3 and HLA-B7. The only exception was that mean hepatic iron concentration was lower in alcoholic patients than in nonalcoholic patients (17,344 vs. 28,553 micrograms/g dry wt, p less than 0.001). Similarity between subgroups in almost all parameters examined is consistent with the hypothesis that heavy deposition of hepatic iron, as observed in our patients, is an indication of genetic hemochromatosis, regardless of alcohol consumption or the findings of affected relatives. The lower concentrations of hepatic iron in alcoholic patients, despite equal body stores in both groups, suggest that alcohol may alter the distribution of storage iron in genetic hemochromatosis. PMID- 6840476 TI - Antibody to hepatitis B surface antigen in nonprimate animal species. AB - The hepatitis B virus infects only humans and higher apes. Viruses similar to the human hepatitis B virus (hepadna viruses) have been discovered in several nonprimate species including woodchucks, ground squirrels, and domesticated ducks. To search for other models of hepatitis B virus infection, we screened serum specimens from 64 exotic animals (24 species), 56 domesticated animals (6 species), and 52 laboratory animals (3 species). Samples were tested for deoxyribonucleic acid polymerase by enzymatic assay and for hepatitis B surface antigen and antibody and antibody to hepatitis B core antigen by radioimmunoassays. All sera were negative for deoxyribonucleic acid polymerase, hepatitis B surface antigen, and antibody to hepatis B core antigen suggesting that none of these animals harbored hepadna viruses in serum. However, 48% of the sera from 58% of the 33 species were reactive for antibody to hepatitis B surface antigen. This reactivity was blocked by human serum positive for hepatitis B surface antigen but not by control human serum. The antibody to hepatitis B surface antigen was generally present in low titer (95% were less than or equal to 1:16) and was often directed against subdeterminants of hepatitis B surface antigen (anti-d, anti-y, or anti-w). Characterization of the antibody to hepatitis B surface antigen by gel chromatography, sucrose density ultracentrifugation, affinity chromatography, and chemical inactivation suggested that it was entirely or predominantly immunoglobulin M antibody. Thus, many animals species have naturally occurring immunoglobulin M antibody to hepatitis B surface antigen detectable by radioimmunoassay. This antibody could arise as a result of either the intermittent spontaneous maturation of clones of antibody to hepatitis B surface antigen forming lymphocytes or exposure to environmental antigens that share epitopes with hepatitis B surface antigen. Similar naturally occurring antibody to hepatitis B surface antigen may be present in some humans. PMID- 6840477 TI - Serum antibodies against porphyric hepatocytes in patients with porphyria cutanea tarda and liver disease. AB - The existence of serum antibodies against porphyric or normal rat hepatocytes was investigated in patients with porphyria cutanea tarda and in other forms of chronic liver disease. Ten patients with porphyria cutanea tarda, 7 of them with chronic active hepatitis or cirrhosis (group 1a) and 3 without significant liver damage (group 1b), 8 patients with nonporphyric chronic active hepatitis (group 2), and 8 alcoholic cirrhotics, 3 of them with superimposed severe alcoholic hepatitis (group 3), were studied. In an antibody-dependent cell-mediated cytotoxicity test using isolated hepatocytes from normal and hexachlorobenzene treated (porphyric) rats as targets, it was found that sera from group 1a produced high cytotoxicity against porphyric hepatocytes and low or zero cytotoxicity against normal hepatocytes (p less than 0.001). The opposite cytotoxic pattern was observed when sera from group 2 was tested. Sera from groups 1b and 3 failed to produce cytotoxicity against both targets. The cytotoxic effect on porphyric hepatocytes was significantly reduced by preincubation of serum with free uroporphyrin or by serum absorption with a sepharose-uroporphyrin immunosorbent. Immunofluorescence studies confirmed the existence of antiporphyric hepatocyte antibodies in group 1a. In conclusion, our results show that antiporphyric hepatocytes antibodies are present in some patients with porphyria cutanea tarda and indicate that hepatocellular porphyrin might be partially responsible for the antigenicity of the liver cells. The role of these antibodies in the pathogenesis of the liver lesion remains to be elucidated. PMID- 6840478 TI - Ultrasonography, computed tomography, and cholescintigraphy in suspected obstructive jaundice--a prospective comparative study. AB - In order to compare their capacity to visualize the bile ducts, ultrasonography, computed tomography, and cholescintigraphy were performed in 56 consecutive jaundiced patients in whom extrahepatic cholestasis was clinically suspected. The predictions as to the patency of the large bill ducts were compared with the final diagnoses made on the basis of direct cholangiography together with autopsy, biopsy, operative findings, and the clinical course. Thirty-nine patients (70%) had obstructed bile ducts, and 17 (30%) had patent large bile ducts. Using a simple scoring scale with 112 points as the maximum, ultrasonography obtained 72 points, computed tomography received 56 points, and cholescintigraphy totalled 37 points. Nonsignificant trends were found in favor of ultrasonography as compared with computed tomography and of computed tomography as compared with cholescintigraphy (p greater than 0.05), whereas ultrasonography was significantly better than cholescintigraphy (p = 0.01). However, because computed tomography is expensive and may imply a higher number of secondary direct cholangiographies than ultrasonography, we recommend ultrasonography as the first choice for noninvasive bile duct visualization. Computed tomography is an alternative method, whereas cholescintigraphy cannot be recommended. PMID- 6840479 TI - A blinded prospective study comparing four current noninvasive approaches in the differential diagnosis of medical versus surgical jaundice. AB - A prospective study was undertaken to compare the diagnostic accuracy of clinical evaluation, ultrasound, computed tomography, and technetium 99m-HIDA or -PIPIDA biliary scans in distinguishing between intrahepatic and extrahepatic jaundice. A final diagnosis was established in each of the 50 patients who completed the study, among whom 29 had intrahepatic cholestasis and 21 had extrahepatic obstruction. In the diagnosis of extrahepatic obstruction, the sensitivities of clinical evaluation, ultrasound, computed tomography, and nuclear medicine biliary scan were 95%, 55%, 63%, and 41%, respectively; the specificities were 76%, 93%, 93%, and 88%; and the overall accuracies were 84%, 78%, 81%, and 68%. These data support the conclusion that when the clinical evaluation is carefully performed, it is the single most effective noninvasive means of detecting extrahepatic biliary obstruction in a jaundiced patient. Although ultrasound, computed tomography, and radionuclide biliary scan are less sensitive, they are highly reliable if they indicate that extrahepatic obstruction is present. A flow chart of invasive and noninvasive approaches for evaluation of the jaundiced patient is presented. PMID- 6840480 TI - Effect of exorphins on gastrointestinal function, hormonal release, and appetite. AB - Peptic digestion of gluten results in the production of substances having opiatelike activity in bio- and receptor assays. These substances have been termed exorphins. In this study, we determined the effect of gluten, hydrolyzed gluten, and hydrolyzed gluten plus the opiate blocker naloxone on a variety of hormonal parameters, gastrointestinal transit time, small bowel mucosal integrity, and satiety. Hydrolyzed gluten prolonged intestinal transit time, and this effect was reversed by concomitant administration of naloxone. Hydrolyzed gluten also produced a naloxone-reversible increase in plasma somatostatinlike activity, which may have been responsible for the delayed transit time. No effects of the "exorphins" could be demonstrated on serum gastrin, cortisol, carbohydrate metabolism, or small bowel mucosal integrity. Although a number of studies have suggested a role for endogenous opiates in appetite regulation, we could not demonstrate any effect of "exorphins" on the amount of calories ingested nor on the perception of satiety. This study defines a potential role for small opiatelike peptides in foodstuffs in the regulation of intestinal function. PMID- 6840481 TI - Medical and surgical options in the management of patients with gastrinoma. AB - We reexamined our experience with the surgical and medical management of 53 patients with Zollinger-Ellison syndrome due to gastrinoma during the past decade. Surgical "cure" (defined here as resection of all identifiable tumor with normalization of serum gastrin and gastric secretory variables) appeared possible in 7 patients (of 44 explored, or 16%). Five of the 7 "cured" patients had duodenal wall tumors. Currently, these 7 receive no therapy, and none has apparent metastasis or multiple endocrine neoplasia, type 1. Excluding patients who have metastasis or multiple endocrine neoplasia, type 1 by preoperative screening would have increased the relative chance of surgical "cure" from 16% to 20% (7 of 35). Patients with unresectable or recurrent gastrinomas had a much worse prognosis than did patients whose tumors did not recur after resection or patients with a negative laparotomy. In any case, therapy with H2-receptor antagonists offered a satisfactory fallback position for management of gastric hypersecretion and its consequences. Adequate control by their use was achieved in 16 of 18 patients who were followed up an average of 28.9 mo (range 7-59 mo) without major side effects. Total gastrectomy, while undoubtedly the most effective therapy of gastric hypersecretion, is not free of significant sequelae, as evidenced by long-term follow-up of 18 gastrectomized patients. We concluded that (a) patients with Zollinger-Ellison syndrome without multiple endocrine neoplasia, type 1 or metastasis should undergo exploratory laparotomy and potential resection of identifiable gastrinomas, (b) chronic therapy with H2 receptor antagonists is preferable to total gastrectomy and satisfactory control may be achieved in most patients, and (c) tumor death is currently the major threat to survival for patients with unresectable gastrinomas, particularly nonmultiple endocrine neoplasia, type 1. PMID- 6840482 TI - Clinical spectrum of "solitary ulcer" of the rectum. AB - A review of 40 patients with "solitary ulcer" of the rectum confirmed by rectal biopsy has provided information about the natural history of this unusual condition. At presentation, symptoms usually were the passage of blood and mucus per rectum, alteration in bowel habits, and anorectal pain. Solitary or multiple ulcers were found within 13 cm of the anal margin in 27 patients and were usually sited anteriorly; in 13 patients macroscopic ulceration was absent, though the histopathology of the rectal biopsy specimens was otherwise similar. Rectal mucosal prolapse was found in 25 of 29 patients examined specifically for this. Thirty-one patients were followed-up for a mean period of 4.8 yr (range 1-15 yr). In 22 patients, rectal ulceration was observed at presentation. In 14 of these patients, ulceration persisted despite treatment. In 9 patients presenting without macroscopic ulceration, rectal ulcers were not observed during follow-up; thus two patient groups were apparent. Neither medical nor local surgical treatment consistently achieved relief of symptoms or healing of the lesion. PMID- 6840483 TI - Changing mortality of peptic ulcer disease in Germany. AB - This study examines mortality of gastric ulcer and duodenal ulcer in the Federal Republic of Germany during the period 1952-1980. The data originate from tabulations of the German Federal Office of Statistics. In women, mortality due to gastric and duodenal ulcer increased; in men, duodenal ulcer mortality remained constant and gastric ulcer mortality declined. Overall mortality of peptic ulcer declined from 7.0 to 6.0 deaths per 100,000 inhabitants and year. Since 1952, the average age at death has increased for both ulcer types and sexes. This was due to an increase of mortality in the older age groups; in men, mortality concomitantly decreased in the younger age groups. Women died of peptic ulcer older than men. In the 1950s none but the group of women gastric ulcer patients died as old as the nonulcer subjects, all other groups of peptide ulcer (female duodenal ulcer, male gastric ulcer and duodenal ulcer) died younger than the nonulcer subjects. In more recent years, both male and female gastric ulcer and duodenal ulcer patients died at the same age or even older than nonulcer subjects. It is concluded that peptic ulcer has changed from a lethal disease of the mid- and old-age groups to a lethal disease predominantly in the old- and very-old-age groups. The time-course of peptic ulcer mortality is different in the Federal Republic of Germany from what has been described in other Western States, especially in the United States and England. This difference suggests that, similar to healing, mortality of peptic ulcer is characterized by geographic variations, and that the time-course observed in one country does not necessarily hold true for other countries. PMID- 6840484 TI - Gastric mucosal blood distribution and its changes in the healing process of gastric ulcer. AB - Changes in gastric mucosal blood volume in the healing process of ulcers were investigated by organ reflectance spectrophotometry performed during endoscopy. Spectra were taken from 24 regions in the stomach in 42 patients with gastric ulcers located at the angle of the stomach. Fifty-one patients with no gastric lesions were used as normal controls. In patients with active gastric ulcers, mucosal blood volume decreased significantly in most regions in the stomach. During the healing process, mucosal blood volume returned to the same levels as those of the controls. On the other hand, mucosal blood volume around the gastric ulcer increased significantly as compared with that of surrounding mucosal at the healing stage. The rise in mucosal blood volume of the ulcer margin at the healing stage (H2 stage) was 33% in cases where gastric ulcers healed within 3 mo, and 2% in cases where the gastric ulcer failed to heal after 3 mo of therapy. It was concluded that the mucosal blood volume changes during the healing process of gastric ulcer and that an increased blood supply to the ulcer margin at the healing stage has a strong effect on the healing periods of ulcer. The reduction of mucosal blood volume at the active stage of the ulcer may also be implicated in the pathogenesis of gastric ulcers. PMID- 6840485 TI - Trends in hospital admission, perforation and mortality of peptic ulcer in Hong Kong from 1970 to 1980. AB - During 1970-1980, admissions for peptic ulcers per 100,000 population to all government and government-assisted hospitals in Hong Kong increased by 21% from 152 to 185. At the same time, peptic ulcer perforations per 100,000 population increased by 71% from 9.3 to 15.9. The percentage of men greater than 60 yr of age with ulcer perforation rose from 18.1 to 24.4, while that in the general population rose from 2.9 to 3.9. However, the male/female ratio has remained stable at approximately 6:1. During the same period, mortality rate per 100,000 population due to peptic ulcer declined by 26% from 4.2 to 3.1. Thus, while the hospitalization and perforation rates for peptic ulcer appeared to be falling in the United States and the United Kingdom over the past decade, the opposite has occurred in Hong Kong. PMID- 6840486 TI - Autoradiographic demonstration of estrogen receptors in the esophagus of baboons. AB - Previous reports have indicated that certain sex steroids are intimately involved in the physiologic activities of the gastrointestinal tract. We performed autoradiographic studies using [3H]estradiol and [3H]dihydrotestosterone on male and female baboons for the purpose of identifying estrogen or androgen receptors, or both, in the lower and midregions of the esophagus. Discrete sites of localization of exposed photographic emulsion were observed over nuclei of skeletal muscle and interstitial cells of male baboons injected with the estrogen. No localization of receptors was observed in these same cells in females given estrogen nor in any male and females injected with the androgen. These observations suggest that skeletal muscle and interstitial cells of the male baboon contain specific high-affinity estrogen receptors that might have a direct effect on the skeletal muscle cells and may modulate their cellular activities. PMID- 6840487 TI - Effect of gastrointestinal intubation on the passage of a solid meal through the stomach and small intestine in humans. AB - The effect of a gastrointestinal tube on the passage of a radiolabeled solid meal through the stomach and small intestine was investigated in 22 healthy volunteers using the gamma camera and breath hydrogen analysis. Gastric emptying was significantly retarded in 12 subjects, who had an intestinal tube in situ compared with 10 control subjects, who were not intubated (t 1/2 = 1.5 +/- 0.1 vs. 1.2 +/- 0.1 h; p less than 0.02). On the other hand, colonic filling was significantly accelerated in the intubated subjects (onset: 1.2 +/- 0.2 vs. 2.9 +/- 0.4 h; p less than 0.001; t 1/2: 4.1 +/- 0.3 vs. 5.6 +/- 0.5 h; p less than 0.001). Values for small bowel residence were significantly reduced in the intubated subjects (5.3 +/- 0.5 vs. 6.5 +/- 0.6 food hours; p less than 0.001). Paired studies, carried out in an additional 11 normal subjects, confirmed that small bowel transit time was significantly shortened during intestinal intubation in the same individuals (2.0 +/- 0.3 vs. 3.6 +/- 0.4 h). These results suggest that intubating the gastrointestinal tract may profoundly affect its function. PMID- 6840488 TI - Effect of 1-phenylpentanol on release of secretin and exocrine pancreatic secretion in dogs and humans. AB - 1-Phenyl-1-hydroxy-N-pentane is a synthetic derivative of an ingredient of Curcuma longa that is used as a condiment and dye. The effects of 1-phenyl-1- hydroxy-N-pentane on release of secretin, gastrin, and pancreatic secretion of bicarbonate and protein were studied in both dogs and humans. In fasting dogs with gastric fistulas and modified Herrera's pancreatic fistulas, intraduodenal administration of 1-phenyl-1-hydroxy-N-pentane (pH 6.7) in three different doses (25, 50, and 100 mg/kg) resulted in significant increases in both plasma secretin concentration and bicarbonate output. The increases in the two variables were dose related. The bicarbonate output and plasma secretin concentration produced by the doses of 1-phenyl-1-hydroxy-N-pentane correlated well. No significant change occurred in either protein output or plasma gastrin concentration. The effect of intragastric 1-phenyl-1-hydroxy-N-pentane on release of secretin and pancreatic secretion was also studied in the digestive state. While gastric pH was maintained at 5.5 by intragastric titration with 1 N NaOH after intragastric administration of 5% liver extract solution, intragastric administration of 1 phenyl-1-hydroxy-N-pentane (100 mg/kg) resulted in significant increases in both plasma secretin concentrations and pancreatic bicarbonate output. In the same experiment, the plasma gastrin concentration did not change significantly, whereas gastric acid secretion decreased significantly after the 1-phenyl-1 hydroxy-N-pentane administration. In 6 human volunteers, both plasma secretin concentration and pancreatic bicarbonate output significantly increased when 2% 1 phenyl-1-hydroxy-N-pentane solution, 30 ml/30 min, was infused in the upper jejunum. Again, no increase in the protein output was apparent. These studies indicate that endogenous secretin is released by an agent other than acid and suggest strongly that the increased pancreatic bicarbonate secretion is attributed to the increased plasma concentration of secretin. 1-Phenyl-1-hydroxy N-pentane may be a useful agent for release of secretin in subjects with achlorhydria, severe hyposecretory state, or total gastrectomy. PMID- 6840489 TI - Case report: fourteen-year follow-up of an apudoma of the bile ducts at the hilum of the liver. AB - A patient presented with a sclerosing tumor at the bifurcation of the main hepatic ducts and was followed for 14 yr after the initial symptoms. Palliative surgery was performed in 1968, followed by a remission of 10 yr. A reintervention in 1979 showed an impressive fibrotic mass that could be extirpated. The patient is again in complete remission for almost 3 yr. A tumor biopsy specimen, obtained at the second intervention, showed an apudoma-type tumor. This was confirmed by a positive Grimelius stain and by immunohistochemical investigation. PMID- 6840490 TI - Biliary tree in cystic fibrosis. Biliary tract abnormalities in cystic fibrosis demonstrated by endoscopic retrograde cholangiography. AB - Two female adolescents with cystic fibrosis were investigated by endoscopic retrograde cholangiography for recurrent abdominal pain. The cholangiogram of 1 patient demonstrated multiple irregular filling defects throughout the biliary tree representing thickened bile and mucus as well as stones. The cholangiogram of the other case illustrated cystic dilatation of the intrahepatic bile ducts with intrahepatic cholelithiasis as well as extensive irregularities of the smaller proximal ductules secondary to recurrent cholangitis or focal biliary cirrhosis, or both. Endoscopic papillotomy resulted in drainage of tenacious bile and mucus and stones in both cases. Sustained clinical improvement did not follow papillotomy in either case, whereas radiologic improvement was demonstrated in 1 case. PMID- 6840491 TI - Peritoneal encapsulation and abdominal cocoon. Case reports and a review of the literature. AB - Peritoneal encapsulation and abdominal cocoon are rare entities, with only 7 and 13 cases, respectively, having so far been reported. A case of each of these conditions is emphasized. Peritoneal encapsulation is probably a development abnormality, largely asymptomatic, and found incidentally at laparotomy or autopsy. The accessory membrane present in front of the small bowel can be easily removed, but excision may not be necessary. Abdominal cocoon is a total or partial encapsulation of the small bowel. It has a tropical or subtropical distribution and presents in young girls as acute or chronic bowel obstruction. Complete recovery is the rule after removal of the membrane. The first example of preoperative radiologic diagnosis is presented. An infective etiology is suggested. PMID- 6840492 TI - Why do animals have antibodies to hepatitis B surface antigen? PMID- 6840493 TI - Approach to the jaundiced patient. PMID- 6840494 TI - Of gastrinomas and their management. PMID- 6840495 TI - What in the world is happening to ulcers? PMID- 6840496 TI - Mechanisms of water retention in cirrhosis. PMID- 6840497 TI - Esophageal spikes--to be or not to be. PMID- 6840498 TI - Gastrointestinal dysfunction in multiple sclerosis. PMID- 6840499 TI - Description of human zinc absorption. PMID- 6840500 TI - Morphologic correlates of "cytoprotection". PMID- 6840501 TI - Brucellosis hepatic abscesses and pregnancy. PMID- 6840502 TI - [Lymphocyte subpopulations in chronic lympholeukemia in the treatment process]. PMID- 6840504 TI - [Disorders in the circadian biorhythms of the cell count in the peripheral blood in experimental leukemia]. PMID- 6840503 TI - [Congenital leukemias in children]. PMID- 6840505 TI - [Salivary gland involvement in the pathological process in mice with leukemias induced by the Rauscher virus and endogenous carcinogens]. PMID- 6840506 TI - [Melatonin as a possible endogenous leukemogenic (blastomogenic) agent]. PMID- 6840507 TI - [Analysis of fatal cases in hematological diseases]. PMID- 6840508 TI - [Use of the Soviet PK-0.5 apparatus for gravitational surgery of the blood]. PMID- 6840509 TI - The effect of diltiazem, a calcium channel blocking agent, on vasoconstrictor responses to norepinephrine, serotonin and potassium depolarization in canine coronary and femoral arteries. AB - 1. Diltiazem produced a dose-dependent inhibition of contractions due to norepinephrine (NE), serotonin (5HT) and high potassium depolarization in both coronary and femoral artery rings. 2. Diltiazem was a more potent and efficacious blocker of all 3 agonists in the coronary arteries. 3. Dose response curves to NE and 5HT indicated that diltiazem produced a noncompetitive type of blockade. 4. Diltiazem blocked contractions produced by 5HT more easily than those produced by NE in both coronary and femoral artery rings. 5. That diltiazem was more potent in coronary than femoral arteries suggests a basic difference in calcium regulation in the two vessels. PMID- 6840510 TI - Effects of an extract of Ginkgo biloba and diverse substances on the phasic and tonic components of the contraction of an isolated rabbit aorta. AB - 1. The effects of phentolamine, propranolol, D 600, theophylline, papaverine and an extract of Ginkgo biloba were studied with respect to the two phases of the contractile response induced by norepinephrine in an isolated rabbit aorta. 2. Phentolamine (3 x 10(-6) M) inhibits the rapid phase of the contraction of the rabbit aorta brought on by norepinephrine (NE) 10(-5) M more strongly than the tonic phase. Propranolol (10(-6) M) potentiates this rapid phase. 3. D 600 inhibits the slow phase with an EC50 = to 3.8 x 10(-8) M. 4. Papaverine and theophylline increase the relaxation that follows the rapid phase of contraction. The slow phase is inhibited only by papaverine. 5. The extract of Ginkgo biloba (Gb) at a concentration of 3 mg/ml has the same type of effect as papaverine 3 X 10(-5) M. PMID- 6840511 TI - Effects of aminooxyacetic acid on in vivo gamma-aminobutyric acid system of rat oviduct. PMID- 6840512 TI - Cholinesterase levels in two stocks of Wistar rats, effect of hypophysectomy. PMID- 6840513 TI - Influence of dopamine on strychnine-induced seizures in the domestic fowl (Gallus domesticus). PMID- 6840514 TI - In vivo estrogen synthesis by the developing chicken (Gallus gallus) embryo. AB - The concentrations of unconjugated and conjugated estrogens in the allantoic and amniotic fluids of chicken embryos have been followed during incubation. The estrogens estrone, estradiol-17 beta and estradiol-17 alpha were present as their conjugates in the allantoic fluid of female embryos but not of male embryos. No estrogens were detectable in the amniotic fluid of embryos of either sex. Estradiol-17 beta glucuronide, the most abundant estrogen present in female allantoic fluid, was first detectable (159 pg/ml) at Stage 35 of development increasing in concentration to 4210 pg/ml at Stage 45. The concentration of estrogen in allantoic fluid of the partially decapitated embryos at Day 18 (Stage 41) of incubation was not significantly different from that of the intact Stage 41, approximately Day 15 embryo. PMID- 6840515 TI - Concentration of triiodothyronine in the sera of the sea lamprey, Petromyzon marinus, and the brook lamprey, Lampetra lamottenii, at various phases of the life cycle. AB - Triiodothyronine (T3) was measured by double antibody radioimmunoassay in the sera of individuals of all stages of the life cycle in the sea lamprey, Petromyzon marinus, and in larval (ammocoetes) and metamorphosing individuals of the brook lamprey, Lampetra lamottenii. There was no significant difference in results from the two species. Although serum T3 concentration did not vary significantly in ammocoetes maintained at the same temperature throughout the year, concentrations in ammocoetes displayed an inverse response to fluctuations in water temperature. Ammocoetes maintained at temperatures of 7 to 10 degrees and 19 to 21 degrees exhibited significantly different circulating T3 levels of 2400 and 1550 ng dl-1, respectively. Therefore, it is expected that there may be some seasonal variation in the levels of the hormone in ammocoetes in their natural environment. A precipitous collapse of the serum levels of T3 was observed by an early stage of metamorphosis (100 ng dl-1) and no significant difference in levels was observed throughout the remaining period of this phase. Young parasitic adults and adult lampreys collected during their spawning migration (upstream migrants) exhibited circulating T3 concentrations of 40 and 30 ng dl-1, respectively. T3 levels in some upstream migrants were below the limit of detection (less than 5 ng dl-1). The metamorphic decline in serum T3 may simply mark the beginning of the lower T3 levels that characterizes the adult serum. PMID- 6840516 TI - Impairment of early ovarian growth in landlocked Atlantic salmon by an antibody to carbohydrate-rich gonadotropin. AB - The role of the carbohydrate-rich gonadotropin (Con AII GtH) in an early phase of ovarian growth in landlocked Atlantic salmon (Salmo salar) was investigated by treating in vivo with an antibody to chum salmon (Oncorhynchus keta) Con AII GtH (anti-Con AII). Anti-Con AII treatment significantly inhibited ovarian growth but did not consistently lower serum levels of vitellogenin. This suggests that Con AII GtH is necessary for early ovarian growth and, has one or more functions in early ovarian growth in addition to stimulation, via estrogen, of vitellogenin production. PMID- 6840517 TI - [Maturational glycoprotein gonadotropin and estradiol-17-beta during the reproductive cycle of the female brown trout (Salmo trutta)]. AB - Female brown trout were sacrificed every month or twice a month during the reproductive season. Plasma gonadotropin (GtH) and estradiol-17 beta (E2-17 beta) were measured using radioimmunological techniques, in relation with the state of gametogenesis. From ovulation to July egg's diameters remained less than 1 mm, and ovogenesis was characterized from the histological appearance of three types of vitellus: glycoproteique (type I), lipidique (type II), lipidoproteique (type III), and the immunological plasma detection of the vitellogenin. During this period GtH levels remained lower than 1 ng/ml except in March, when they increased around 5 ng/ml, both with pituitary GtH and plasma E2 17 beta. This rise occurred just before the appearance of the type III vitellus within the oocyte, and might correspond to a critical phase of the reproductive cycle during which vitellogenin could not be detected in 70% of the animals. During rapid growth of the oocyte from 1 to 5 mm, mean GtH levels increased from 0.75 to 2.5 ng/ml when those of the E2-17 beta increased more rapidly but began to drop before the end of vitellogenesis. Maturation and ovulation were accompanied by a rise of the GtH level, in correlation with the lower levels of E2-17 beta measured during the cycle, GtH remained high even after ovulation, and more in fish which had kept their eggs within the body cavity. Correlation among GtH, E2 17 beta, and the diameters of eggs had been calculated. There was a positive correlation among GtH, E2-17 beta levels, and the diameters of eggs during exogenous vitellogenesis, and a negative between GtH and E2-17 beta at the end of the reproductive cycle. These results were discussed, in relation to the existence of a pulsatile mode of GtH secretion. PMID- 6840518 TI - Effects of hypophysectomy on the plasma ionic and osmotic balance in rainbow trout, Salmo gairdneri. AB - The effects of hypophysectomy on the plasma ionic and osmotic balance in juvenile rainbow trout (Salmo gairdneri) kept in 1/3 sea water for various periods were studied. Hypophysectomy caused a decrease in the plasma levels of ionized calcium and chloride within a week after the operation. At 2-5 weeks after hypophysectomy, the plasma levels of ionized calcium and chloride were still significantly lower in hypophysectomized fish when compared to sham-operated controls. Hypophysectomy had no effects on the plasma levels of sodium, total calcium, total magnesium, inorganic phosphate, plasma proteins, or plasma osmolality. When 1/3 sea water adapted (1-4 weeks), hypophysectomized and sham operated fish were exposed to fresh water for 2 weeks, the plasma levels of ionized calcium, chloride, sodium, and plasma osmolality were significantly lower in hypophysectomized fish when compared to sham-operated fish, while the plasma levels of total calcium, total magnesium, and proteins were higher. No effects were noted on the plasma levels of potassium and inorganic phosphate. The presented data indicate that the pituitary gland plays a significant role in the regulation of plasma calcium and chloride levels in S. gairdneri, while its role in the regulation of plasma magnesium and sodium is less clear. The pituitary gland seems to play a minimal role in the plasma regulation of inorganic phosphate and potassium. PMID- 6840519 TI - Effect of the photoperiod on the time schedule of egg mass production in Lymnaea stagnalis, as induced by ovulation hormone injections. AB - In the pulmonate snail Lymnaea stagnalis the neurosecretory caudo-dorsal cells (CDC) produce an ovulation hormone (CDCH) which is released at the periphery of the cerebral commissure (COM). Time schedules of the successive stages of the egg mass production following CDCH injection (COM extract) were determined at 20 degrees. Ovulation is performed rapidly, within 10 to 20 min. The latencies of the other stages are: egg formation, 20-30 min; egg mass formation, 60-90 min; and oviposition, about 120 min. The duration of oviposition is dependent on the size of the egg mass and varies from 5 to 20 min. At a 16-hr photoperiod all stages start 10 min earlier than at a 12-hr photoperiod. It is suggested that the effect of the photoperiod is achieved by a change of release activities of dorsal bodies and/or of CDC. The possibility that a nervous mechanism is involved in the control of the packaging of the egg cells is discussed. PMID- 6840520 TI - Binding of 125I-hCG to rainbow trout (Salmo gairdneri) testis in vitro. AB - Homogenates of maturing rainbow trout testes show specific binding sites for 125J labeled hCG (= 125I-labeled hCG). The binding is competitively inhibited by unlabeled hCG and by a hypophyseal extract of rainbow trout. It could be demonstrated that the tissue 125J-hCG binding specificity is restricted to the gonadal preparation. The trout testis was characterized by determining affinity and capacity from Scatchard plot analysis giving a high constant of dissociation Kd 3.65 x 10(-10)/M and a low binding capacity of 0.88 x 10(-15) M/mg tissue. The test system is markedly dependent on temperature, incubation-time, and pH. The maximum binding was found at 37 degrees during 2 hr of incubation in a buffer of pH 7.5. PMID- 6840521 TI - Factors affecting prolactin secretion during breeding and incubation in the domestic duck (Anas platyrhynchos). AB - The plasma concentrations of prolactin were measured by radioimmunoassay throughout the breeding cycle in female domestic ducks. Prolactin levels increased significantly during egg laying from 5 to 15 ng/ml and again at the start of incubation to about 28 ng/ml. Prolactin levels remained consistently high throughout incubation and fell sharply around the time the eggs hatched. Local anaesthesia of the incubation patches of incubating females for 9 hr caused a significant decrease in plasma prolactin. It is suggested that tactile stimulation from the eggs in the nest may cause the rise in prolactin during the egg laying period and also maintain prolactin secretion during incubation. PMID- 6840522 TI - Isolation of the biosynthetic products of the PAS positive pars intermedia cells in the cichlid teleost Sarotherodon mossambicus. AB - The pars intermedia of teleosts contains two types of granular cells with the predominant type being similar to the pars intermedia cells in other vertebrate groups and containing peptides derived from the pro-opiomelanocortin precursor molecule. The function and products of the second cell type, the PAS positive cells, are unknown. This study reports on the identification of biosynthetic products of the PAS positive cells of the cichlid teleost Sarotherodon mossambicus. The experimental regimen took advantage of earlier morphometric analyses which showed marked differences in metabolic activity of the PAS positive cells resulting from adaptation to different background colours and illumination. Autoradiography at the light microscopic level showed that both cell types of the pars intermedia incorporate labeled amino acids during in vitro incubation. To identify the products synthesized by the PAS positive cells, labeled products of the pars intermedia tissue were analysed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and high-pressure liquid chromatography. Comparison of pulse incubations of pars intermedia tissue of fish adapted to different backgrounds and conditions of illumination revealed that an increase in the number and metabolic activity of the PAS positive cells, as deduced from morphometric data, was paralleled by an increase of the amount of label incorporated into 27K and 25K molecules. Pulse--chase experiments with pars intermedia lobes of white and black background adapted fish showed that these two products, unlike the other newly synthesized products, were not involved in any precursor-product relationship. Our data, therefore, suggest that the 27K and 25K peptides were synthesized by the PAS positive cells. PMID- 6840523 TI - Plasma gonadal steroid levels in wild starlings (Sturnus vulgaris) during the annual cycle and in relation to the stages of breeding. AB - Blood samples were collected from male and female free-living starlings in every month during the year and at all stages of the breeding cycle. The samples from females were assayed for oestradiol-17 beta, oestrone, and progesterone, and the samples from males were assayed for testosterone and 5 alpha-dihydrotestosterone. The testicular weights were recorded. All hormones other than oestrone showed a pronounced unimodal cycle. In females, oestradiol was highest in April, corresponding to the period of greatest nest-building activity. It decreased during the later stages of the breeding cycle and maintained low levels until the autumn when levels began to increase. Progesterone was highest in laying birds and reached a peak in May. During the rest of the year it remained at a lower but fairly constant level. Oestrone was normally only detectable in laying birds. In males, testicular weight and plasma concentrations of testosterone and 5 alpha dihydrotestosterone were all highest during April. Plasma testosterone and 5 alpha-dihydrotestosterone were highest in nest-builders. They decreased during the later stages of breeding, remained low during the summer and increased slightly in the autumn. Testicular weight was high in nest-builders, but peaked during laying, by which time testosterone and 5 alpha-dihydrotestosterone had decreased significantly. Testicular weight decreased during incubation and feeding the young and remained low until the following year. PMID- 6840524 TI - Drinking induced by angiotensin II in fishes. AB - Among 20 species of freshwater fishes examined, Pseudorasbora parva, Rhodeus ocellatus, Cobitis anguillicaudatus, Carassius auratus, Oryzias latipes, Gambusia affinis, and Gyrinocheilus anymonieri were found to drink water like seawater fishes, while 13 remaining species did not drink. For fish species found exclusively in fresh water, angiotensin II (AII) treatment did not induce drinking. In contrast, those freshwater fishes which survive in estuarine brackish water (Leuciscus hakonensis, C. carassius, Parasilurus asotus, G. affinis, Chaenogobius annularis, Tridentiger obscurus, and G. anymonieri responded to AII by drinking. Furthermore, some freshwater fishes which survive either in hypertonic water (C. auratus) or in sea water (Anguilla japonica and O. latipes) also responded to AII by drinking. Of 17 seawater fishes examined, Eptatretus burgeri, Triakis scyllia, and Heterodontus japonicus failed to drink water, and for Trachurus japonicus, Platichthys bicoloratus, and Glossogobius giuris fasciatopunctatus, water intake was minor (similar to freshwater fishes). The 11 remaining seawater fishes drank water. AII did not induce drinking in fishes living exclusively in sea water. However, seawater fishes which survive either in tide pools (Chasmichthys dolichognathus gulosus) or in brackish water (Sillago japonica, Mugil cephalus, G. giuris fasciatopunctatus) responded to AII by drinking. P. bicoloratus, Acanthopagrus schlegeli, and Fugu niphobles were exceptional, in that they survive in brackish water, but did not respond to AII. Although some exceptions exist, it is generally concluded that a drinking response to AII is characteristic of fishes which encounter water more hypertonic than that in which they typically reside. Accordingly, a drinking mechanism induced by AII may be a compensatory emergency reaction to dehydration stress. PMID- 6840525 TI - Endocrine control of galactogen synthesis in the albumen gland of the slug, Limax maximus. AB - An in vitro method for culturing Limax maximus albumen glands is described in which the biosynthetic activity of the slug albumen gland was monitored by measuring the incorporation of [14C]glucose into galactogen. Homogenates of the central nervous system were shown to cause a 3.5- to 12-fold increase in galactogen synthesis in albumen gland explants as compared to controls. The major sources of the galactogen-synthesis stimulating factor (Gal-SF) were found to be the cerebral ganglia and their surrounding connective tissue. Gal-SF was demonstrated to be peptidase sensitive and heat labile suggesting that it is probably a polypeptide. Autoradiographs of semithin araldite sections supported the incorporation data: in albumen gland explants cultured with cerebral ganglion homogenate considerably more label was found over secretory granules than in control-cultured explants. The possible cellular source of Gal-SF is discussed in relation to its possible origin in other investigated pulmonates. PMID- 6840526 TI - The prehatching development of the thyroid gland of the fathead minnow, Pimephales promelas (Rafinesque). AB - The prehatching development of the thyroid gland in the fathead minnow, Pimephales promelas, has been studied using histochemical and autoradiographic methods. The thyroid arises as a solid nodular bud from the pharyngeal epithelium at the posterior border of the hyomandibular junction and then grows ventrocaudally into a tractus thyroglossus from which the follicles eventually form. During subsequent development, the follicles exhibit an exponential increase in number, migrate from the subhyoid region, become diffusely distributed throughout the pharynx and at ectopic loci, and show an increase in the size of the follicular lumina with an accumulation of colloid and a decrease in follicular cell heights due to follicular emptying. Autoradiographic studies suggest that thyroid tissue traps and concentrates iodine prior to the appearance of histochemically demonstrable colloid. Histochemical observations suggest that the formation of thyroid follicles is preceded by the secretion of colloid in the intercellular space and into the tractus thyroglossus. PMID- 6840527 TI - Role of thyroid in tissue respiration of birds. AB - Thyroidectomy after 1 week, 1 month, and 13 months significantly depressed and low level of L-T4 significantly elevated the oxygen uptake of the liver and skeletal muscle of spotted munia and common myna. A higher dose of L-T4 had no effect on the rate of respiration. A reexamination of the published results on submammalian vertebrates together with those presented here suggests that an uniform pattern of response of skeletal muscle emerges if the values from thyroidectomized animals are compared not only with the final controls but also with the initial controls. It is, therefore, suggested that all the earlier works be reexamined and reinterpreted. PMID- 6840528 TI - [Osmoregulation in Hirudinea Rhynchobdellida Theromyzon tessulatum (O.F.M.). Experimental localization of the secretory zone of a regulation factor of water balance]. AB - The body water content of Theromyzon tessulatum changes considerably during the life cycle. Water content is low and undergoes little change during the first stages, but it strongly and regularly increases during the last stage prior to reproduction. It is controlled by a water balance factor (FRBH) released by the brain. With selective removals of nervous follicles, the site of production of this hormone has been localized in the posterior paramedial follicles (follicles 4). PMID- 6840529 TI - Pituitary gonadotropic hormone from a chondrostean fish, starred sturgeon (Acipenser stellatus Pall.) III. Polymorphism. AB - Four biologically active fractions of gonadotropic hormone (aci-GTH-A, -B, -C, D) were isolated and purified from acetonized pituitaries of the starred sturgeon (Acipenser stellatus Pall.). Their separation was achieved by DEAE-cellulose chromatography. Disc-electrophoresis and especially isoelectric focusing in polyacrylamide gel showed that each fraction contained several components. Not less than 15 different components as a whole with isoelectric points ranging from 4.5 to 7.0 could be counted in four aci-GTH preparations. All these components were active in toad oocyte maturation test. Only two of four preparations (aci GTH-A and -D) were practically free of common components. All aci-GTH preparations were shown to be homogeneous and identical by molecular weight, sedimentation coefficient, sialic acid content, and some immunological properties. N-terminal amino acid analysis revealed tyrosine and leucine in all aci-GTH preparations, with the only exception of aci-GTH-D that contained an additional polypeptide with N-terminal glycine. No differences in the spectra of aci-GTH isoforms were found when pituitary extract, newly purified or 3 years older hormone preparations were submitted to isoelectric focusing. PMID- 6840530 TI - Ultrastructural comparison of the perisympathetic organs in three Coleoptera: Chrysocarabus auronitens F., Oryctes rhinoceros L. and Tenebrio molitor L. AB - Ultrastructural comparison of different types of perisympathetic organs (POs) in three species of Coleoptera (Chrysocarabus auronitens, Oryctes rhinoceros, and Tenebrio molitor) showed that the structure of these organs was not related to their morphological types but to their topography. Two kinds of PO structure may be distinguished: compact median and diffuse lateral. They were similar in that both were surrounded by thin neural lamellae and exhibited numerous glial cells originating in the perineurium (type I perineurial cells) as well as abundant neurosecretory endings. They were different in as much as in median POs, the neurosecretory endings were generally surrounded by perineurial processes but in transverse POs, these endings were sheathless. Only one type of neurosecretory axon was distinguished in the median organs but three or four in the transverse. The nature of the processes by which neurosecretory granules are released may depend on the type of neurosecretory axon. For instance, exocytosis always occurred for dense spherical granules, and granule fragmentation was visualized for granules of smaller size. PMID- 6840531 TI - Binding of triiodothyronine to hepatocyte nuclei from sea lampreys, Petromyzon marinus L., at various stages of the life cycle. AB - The in vitro binding capacity of triiodothyronine (T3) to hepatocyte nuclei was determined for lampreys (Petromyzon marinus L.) at different phases of the life cycle. The binding of T3 to nuclei in ammocoetes (larvae) is of high affinity (Kd = 2.9 X 10(-10) M) with a maximum binding capacity of 1.89 pg T3 X micrograms DNA 1. Binding capacities of metamorphosing individuals, young parasitic adults, and upstream-migrant adults were 2.40, 0.78, and 0.12 pg T3 X micrograms DNA-1, respectively. With the exception of the value obtained from the upstream migrants, the hepatocytes of lampreys have a higher binding capacity for T3 than most other vertebrates. The decline in serum T3 at the beginning of metamorphosis cannot be accounted for by increased binding of this hormone in the liver. It is still unclear whether T3 plays any role in lamprey metamorphosis. PMID- 6840532 TI - Nervous and humoral inhibition of C16 juvenile hormone synthesis in last instar females of the viviparous cockroach, Diploptera punctata. AB - The control of the decline in C16 juvenile hormone (C16JH) synthesis in the final larval stadium of the viviparous cockroach Diploptera punctata Eschscholtz was investigated to establish how nervous and humoral signals affect the activity of the corpora allata (CA) before metamorphosis. Denervation of the CA in young last instars caused an increase in the rate of JH biosynthesis as monitored by an in vitro radiochemical assay and resulted in a supernumerary larval form at the following ecdysis. However, when larval CA were transplanted into corpus allatectomized adults, they exhibited a further 5- to 10-fold stimulation in synthetic rate and supported host oocyte development at near normal rates. Conversely, adult CA implanted into young and old last instars were inhibited in comparison to those implanted into penultimate instars and adults. These experiments suggest that in D. punctata, an unfavorable humoral environment as well as nervously transmitted inhibitory signals maintain low rates of JH synthesis prior to the imaginal molt. PMID- 6840533 TI - Effects of exogenous ecdysterone upon moulting, proecdysial development, and limb regeneration in the prawn Palaemon elegans. AB - Injection of small doses of ecdysterone accelerated moulting and proecdysis in the prawn Palaemon elegans. Injection of large doses of ecdysterone (1-10 micrograms) markedly accelerated proecdysis, but death always occurred prior to or during moulting and was accompanied by abnormal setal development and retarded cuticle formation. Dose-response curves were obtained for a range of hormone doses from 10 to 0.01 micrograms by administering ecdysterone during postmoult (stages A-B) and early premoult (stages DE0-DL0). Accelerated proecdysis and viable moulting were more marked in the group injected during early premoult (stages DE0-DL0). The sensitivity threshold for prawns injected during this time was less than 40 ng g-1 but could not be determined more precisely in view of the range of ecdysterone concentrations used. In contrast, the sensitivity threshold for ecdysterone administered during postmoult (stages A-B) was much higher, between 0.4 and 2 micrograms g-1. The possible mechanisms controlling sensitivity thresholds for ecdysterone are discussed. The effect of ecdysterone on limb regeneration was also studied. Within the concentration range used, ecdysterone was found to have no effect on the rate of limb regeneration. PMID- 6840534 TI - In vitro metabolism of estradiol-17 beta by liver microsomes from juvenile rainbow trout, Salmo gairdneri. AB - The metabolism of [4-14C]estradiol-17 beta by liver microsomes from, Salmo gairdneri, was studied in vitro. The following metabolites were identified by gas chromatography--mass spectrometry: estrone, estra-1,3,5(10)-triene-3,16 beta,17 beta-triol, and estra-1,3,5(10)-triene-3,7 alpha,17 beta-triol. The presence of additional polar metabolites hydroxylated at positions 6 alpha and 6 beta was indicated. The formation of the hydroxylated metabolites was inhibited by CO indicating the participation of cytochrome P-450-dependent enzymes. PMID- 6840535 TI - An examination of Kagan's risk hypothesis for conceptual tempo. AB - Third grade children (40 females and 40 males) were first classified with the Matching Familiar Figures Test and then were given an Incomplete Figures Test designed to test Kagan's risk hypothesis for conceptual tempo. In the latter test, the children were shown sets of line drawings in which each successive drawing in a set revealed progressively more of the given object. They were required to guess the identity of the object after seeing each drawing by making either a high risk "outloud" guess (scored with feedback) or a low risk "whisper" guess (scored with no feedback). As predicted, reflective children made significantly fewer incorrect outloud guesses and significantly more correct whisper guesses than the impulsive children. This demonstrated that the reflective children followed a more cautious guessing strategy than the impulsive children, which provided support for Kagan's risk hypothesis. PMID- 6840536 TI - Selection for the alpha-thalassemia genes. AB - Extremely high incidences of single and double deletions of alpha-globin genes are known among Asian populations. To study possible mechanisms for the maintenance of such deletions, mathematical analyses have been conducted. It has been shown that a stable polymorphism can be achieved easily through heterozygote advantage using deterministic models. The results strongly suggest that high incidences of single and double deletion of alpha-globin genes among Asian populations are maintained by some type of heterozygote advantage. PMID- 6840537 TI - Relationship of mean and variance of genotypic values with heterozygosity per individual in a natural population. PMID- 6840538 TI - A major role for bacteriophage T4 DNA polymerase in frameshift mutagenesis. AB - T4 DNA polymerase strongly influences the frequency and specificity of frameshift mutagenesis. Fifteen of 19 temperature-sensitive alleles of the DNA polymerase gene substantially influenced the reversion frequencies of frameshift mutations measured in the T4 rII genes. Most polymerase mutants increased frameshift frequencies, but a few alleles (previously noted as antimutators for base substitution mutations) decreased the frequencies of certain frameshifts while increasing the frequencies of others. The various patterns of enhanced or decreased frameshift mutation frequencies suggest that T4 DNA polymerase is likely to play a variety of roles in the metabolic events leading to frameshift mutation. A detailed genetic study of the specificity of the mutator properties of three DNA polymerase alleles (tsL56, tsL98 and tsL88) demonstrated that each produces a distinctive frameshift spectrum. Differences in frameshift frequencies at similar DNA sequences within the rII genes, the influence of mutant polymerase alleles on these frequencies, and the presence or absence of the dinucleotide sequence associated with initiation of Okazaki pieces at the frameshift site has led us to suggest that the discontinuities associated with discontinuous DNA replication may contribute to spontaneous frameshift mutation frequencies in T4. PMID- 6840539 TI - An approach to population and evolutionary genetic theory for genes in mitochondria and chloroplasts, and some results. AB - We developed population genetic theory for organelle genes, using an infinite alleles model appropriate for molecular genetic data, and considering the effects of mutation and random drift on the frequencies of selectively neutral alleles. The effects of maternal inheritance and vegetative segregation of organelle genes are dealt with by defining new effective gene numbers, and substituting these for 2N(e) in classical theory of nuclear genes for diploid organisms. We define three different effective gene numbers. The most general is N(lambda), defined as a function of population size, number of organelle genomes per cell, and proportions of genes contributed by male and female gametes to the zygote. In many organisms, vegetative segregation of organelle genomes and intracellular random drift of organelle gene frequencies combine to produce a predominance of homoplasmic cells within individuals in the population. Then, the effective number of organelle genes is N(eo), a simple function of the numbers of males and females and of the maternal and paternal contributions to the zygote. Finally, when the paternal contribution is very small, N( eo) is closely approximated by the number of females, N( f). Then if the sex ratio is 1, the mean time to fixation or loss of new mutations is approximately two times longer for nuclear genes than for organelle genes, and gene diversity is approximately four times greater. The difference between nuclear and organelle genes disappears or is reversed in animals in which males have large harems. The differences between nuclear and organelle gene behavior caused by maternal inheritance and vegetative segregation are generally small and may be overshadowed by differences in mutation rates to neutral alleles. For monoecious organisms, the effective number of organelle genes is approximately equal to the total population size N. We also show that a population can be effectively subdivided for organelle genes at migration rates which result in panmixis for nuclear genes, especially if males migrate more than females. PMID- 6840540 TI - Models of evolution of reproductive isolation. AB - Mathematical models are presented for the evolution of postmating and premating reproductive isolation. In the case of postmating isolation it is assumed that hybrid sterility or inviability is caused by incompatibility of alleles at one or two loci, and evolution of reproductive isolation occurs by random fixation of different incompatibility alleles in different populations. Mutations are assumed to occur following either the stepwise mutation model or the infinite-allele model. Computer simulations by using Ito's stochastic differential equations have shown that in the model used the reproductive isolation mechanism evolves faster in small populations than in large populations when the mutation rate remains the same. In populations of a given size it evolves faster when the number of loci involved is large than when this is small. In general, however, evolution of isolation mechanisms is a very slow process, and it would take thousands to millions of generations if the mutation rate is of the order of 10(-5) per generation. Since gene substitution occurs as a stochastic process, the time required for the establishment of reproductive isolation has a large variance. Although the average time of evolution of isolation mechanisms is very long, substitution of incompatibility genes in a population occurs rather quickly once it starts. The intrapopulational fertility or viability is always very high. In the model of premating isolation it is assumed that mating preference or compatibility is determined by male- and female-limited characters, each of which is controlled by a single locus with multiple alleles, and mating occurs only when the male and female characters are compatible with each other. Computer simulations have shown that the dynamics of evolution of premating isolation mechanism is very similar to that of postmating isolation mechanism, and the mean and variance of the time required for establishment of premating isolation are very large. Theoretical predictions obtained from the present study about the speed of evolution of reproductive isolation are consistent with empirical data available from vertebrate organisms. PMID- 6840541 TI - Psychiatry--family practice liaison: a collaborative approach to clinical training. AB - In view of the growing need for effective liaison between psychiatry and family practice programs, some of the models for educational and clinical liaison are discussed, and a clinical training program is described in which psychiatry and family practice educators work collaboratively in the training of both family practice and psychiatry residents and medical students. The program is offered as a model for providing comprehensive clinical training to residents and students and comprehensive clinical care to patients. PMID- 6840542 TI - The prevalence of emotional and cognitive dysfunction in a general medical population: using the MMSE, GHQ, and BDI. AB - The Mini Mental Status Examination, General Health Questionnaire-30, and Beck Depression Inventory were administered to 335 randomly selected hospitalized medical patients. Twenty-eight percent of the population had evidence of cognitive dysfunction on the Mini Mental Status Examination, 61% showed emotional dysfunction on the General Health Questionnaire-30, and 36% were depressed as measured by the Beck Depression Inventory. Only 29% of the patients had no evidence of emotional or cognitive dysfunction. Medical resident diagnostic concordance with these tests was poor. The effects of demographic variables on these test scores were also determined. PMID- 6840543 TI - Self-amputation and restitution. AB - This paper reports two cases of psychotically induced self-amputation of the hand, and discusses the psychological issues for the patient and staff involved in replantation and adaptation. The psychiatrist's role in facilitating patients' and staffs' utilization of restorative innovative techniques is also addressed. PMID- 6840545 TI - The suicidal patient on the surgical ward: a multidisciplinary case conference. AB - A multidisciplinary conference was held concerning a young woman hospitalized with multiple injuries resulting from a suicide attempt. This case demonstrates the usefulness of a unified biopsychosocial approach to the care of a suicidal patient requiring treatment by numerous services in the general hospital. PMID- 6840544 TI - Family characteristics in high and low health care utilization. AB - Despite the position of the family as the basic social unit, the majority of studies of medical care utilization focus on individuals. In this preliminary study, nine families of high utilizers and 12 families of low utilizers were compared using the Moos Family Environment Scale and a semistructured interview. Significant differences were seen in structure, interactional patterns, and health-related behavior. The high utilizer families, as a whole, saw themselves as less expressive and more achievement-oriented. High utilizer children saw much more parental control than did low utilizer children. There was greater divergence in perspective between husbands and wives of high utilizing families than between spouses in low utilizing families. High utilizer families were less social than low utilizer families. There was greater use of tranquilizers and greater dissatisfaction with doctors in the high utilizer families as well. PMID- 6840546 TI - Changing hospital work environments: an example of a burn unit. AB - A liaison psychiatrist invited to help a burn unit staff explore problems affecting morale and patient care employed a four-step procedure: (1) assess the work environment systematically; (2) give the staff feedback from this assessment; (3) help the staff plan and institute changes; and (4) reassess. To assess the work environment, the staff completed the Work Environment Scale (WES), a 90-item, true/false questionnaire that measures ten dimensions of the actual and preferred work environment. At the second of 12 bi-weekly meetings, the psychiatrist presented the unit's WES profile and began helping the staff explore and resolve problems. Reassessment six months later revealed statistically significant changes on several pertinent WES scales and reduced discrepancies between actual and preferred work environments on nine of the ten scales. The findings indicate that systemmatic assessment and feedback procedures may help liaison programs improve the quality of hospital work environments and thereby enhance staff performance and morale. PMID- 6840547 TI - Theoretical study on the accumulation of selfish DNA. PMID- 6840548 TI - Genetic analysis of transmission ratio distortion by t-haplotypes in the mouse. PMID- 6840549 TI - X-chromosome activity in female mouse embryos heterozygous for Pgk-1 and Searle's translocation, T(X; 16) 16H. PMID- 6840550 TI - X-chromosome segregation, maternal age and aneuploidy in the XO mouse. PMID- 6840551 TI - Common remedy for an uncommon disorder. PMID- 6840552 TI - Syncope in the elderly: a pragmatic approach. AB - Carotid massage should be performed in elderly patients only if other diagnostic studies have not been helpful, since in rare instances, transient and permanent neurologic deficits have been precipitated by this maneuver. Patients with auscultatory findings of cardiovascular disease should certainly undergo further evaluation with appropriate studies such as echocardiography, stress testing, or cardiac catheterization. PMID- 6840553 TI - Skin problems of aging. AB - It is not practical to treat diffuse areas of sun damage with liquid nitrogen. Patients with actinic keratoses require painstaking instruction and numerous visits to guide them through a course of 5-fluorouracil (5-Fu) therapy. While basal cell carcinoma rarely metastasizes, its potential for localized destruction and its tendency to recur after therapy should not be underestimated. In certain locations, the tumor does not have a benign clinical course. PMID- 6840554 TI - Geriatric headaches. AB - Headaches, although common occurrences in the elderly, can be the symptoms of a serious problem. Specific headaches found in this population need careful consideration and diagnosis. When the diagnosis is elusive, or the headache is sudden, severe, and incapacitating, a neurologist or neurosurgeon should be consulted. PMID- 6840555 TI - Atypical presentations of malignant disease. AB - The presenting signs and symptoms of malignancy may be easily mistaken for more common medical problems. There are many clinical problems common to geriatric practice that can be secondary to an underlying malignancy. Weight loss in the elderly can be the result of a wide variety of medical and psychosocial factors- from poorly fitting dentures to an inability to afford, procure, or prepare foods. But in this population, a possible neoplasm underlying weight loss is always a serious concern. PMID- 6840556 TI - Managing geriatric vision disorders: where to get help. PMID- 6840557 TI - Carbohydrate metabolism of the brain in the ageing male garden lizard: effect of cold shock on mitochondrial respiration and lactate/pyruvate ratio. AB - Mitochondrial respiration with succinate as substrate increased and the mitochondrial protein content declined in the brain of the ageing male garden lizard. The lactate/pyruvate ratio of both blood and brain did not show appreciable changes with advancing age. Cold-shock treatment induced a significant rise in the respiratory rate of brain mitochondria of young but not appreciably in that of middle-aged and old lizards. On the other hand both mitochondrial protein content and lactate/pyruvate ratio increased only in the brain of cold-shocked lizards of the old age-group. The lactate/pyruvate ratio in blood remained unaltered following cold-shock treatment of lizards of all three age-groups. PMID- 6840558 TI - Superoxide dismutase, longevity and specific metabolic rate. A reply. AB - Sullivan [1982] has stated without reservation that our paper [Tolmasoff et al., 1980] did not present data supporting the possibility that superoxide dismutase has a role in determining longevity in mammalian species. He states that the data instead support the hypothesis that there is no association between superoxide dismutase and lifespan. On reading his arguments, I find no errors in our data analysis or in the conclusion made. Instead, I find he has failed to recognize the critical components of our data and has consequently misinterpreted the results. Because similar oversight might be made by other readers of this paper, I have included a brief review of the rationale underlying our investigation of longevity determinants in mammalian species along with the reply to Sullivan's criticisms. PMID- 6840560 TI - Bacteraemia in a geriatric unit. AB - A retrospective study was made of 50 consecutive cases of bacteraemia treated in a geriatric unit. The mortality rate was 24%, the highest incidence occurring amongst the cases of hospital-acquired bacteraemia where only 1 of 7 cases survived the infection. Pyrexia, acute confusion, and falls were the commonest presenting symptoms. The most frequently identified tissue sources for the bacteraemia were the genito-urinary tract (24%) and the lungs (22%). In 20% of cases the source of infection was unidentified. PMID- 6840559 TI - Proteinuria in the elderly. AB - In a representative sample of 624 people, 65-84 years of age, from six regions of Croatia, Yugoslavia, proteinuria was investigated on the basis of certain medical characteristics. Established proteinuria was seen in 30.8% of females and 27.4% of males. Proteinuria was found to be significantly more common in people with urinary tract infections. Arterial hypertension with heart failure was more often seen in patients with than in patients without proteinuria, but the difference was not statistically significant. PMID- 6840561 TI - A disturbance of serum lipids in three cases of Werner's syndrome. AB - 3 cases of Werner's syndrome were studied on serum lipid metabolism in comparison with clinical manifestation. These 3 cases showed hyperlipemia all with hypertriglycemia and increased level of very low density lipoprotein. The lipoprotein lipase activity was shown after intravenous injection of heparin. These results indicate a possible pathogenic facet of Werner's syndrome from the lipid metabolic point of view. PMID- 6840562 TI - Genetic effects on the longevity of cultured human fibroblasts. I. Werner's syndrome. AB - Fibroblast cultures were established from skin biopsies from 4 male Werner's syndrome patients, aged 45-50. Several subcultures were obtained from each primary outgrowth and these were passaged to the end of their in vitro lifespan. Their average longevity was significantly less than control skin fibroblasts, but there was extreme variability amongst parallel cultures. In the most thoroughly studied case, the longevity of 19 subcultures derived from a single biopsy varied from 5 to 26 passages, showing that there was considerable heterogeneity in the growth potential of the cells in the primary culture. Moreover, the growth rate from any one culture was not uniform, since long periods of slow growth were sometimes succeeded by much more rapid proliferation. These features of Werner's syndrome fibroblast populations are not seen in cultures from normal individuals. The longevity of fibroblasts from one progeria patient was also shown to be much shorter than controls. Metaphases from 3 Werner's patients demonstrated a much higher frequency of chromosome abnormalities than in normal fibroblasts and also provided evidence of subclones containing a characteristic 'marker' chromosome. PMID- 6840563 TI - Genetic effects on the longevity of cultured human fibroblasts. II. DNA repair deficient syndromes. AB - The lifespan of fibroblasts from genetic syndromes with reduced DNA repair or chromosome stability has been measured. Cells from Bloom's syndrome, Cockayne's syndrome, Fanconi's anaemia and 2 out of 3 cases of ataxia telangiectasia had a significantly reduced growth potential in comparison to controls. In each case the longevity of several parallel populations was measured and the greatest variability in lifespan was observed with Cockayne's syndrome cells. The fibroblasts from 1 ataxia telangiectasia patient and a Friedreich's ataxia patient grew to the passage levels seen in control cultures. The results suggest that repair processes are necessary for cells to achieve their maximum in vitro lifespan, and support the error theory rather than the programme theory of ageing. PMID- 6840565 TI - Genetic effects on the longevity of cultured human fibroblasts. IV. Enhanced growth potential of cystic fibrosis cells. AB - The in vitro longevity of skin fibroblasts in several parallel cultures from each of 4 cystic fibrosis (CF) patients and 3 control patients was measured by serial passages. The control cultures reached 51-56 passages before growth ceased. 1 CF strain achieved an average of 69 passages and another 64 passages. Both of these longevities are significantly greater than the controls. 2 CF strains had significantly shorter longevities than the controls. The results indicate that the CF gene is expressed in cultured fibroblasts and provide further evidence that there may be more than one form of the disease. PMID- 6840564 TI - Genetic effects on the longevity of cultured human fibroblasts. III. Correlations with altered glucose-6-phosphate dehydrogenase. AB - The level of heat-labile glucose-6-phosphate dehydrogenase (G6PD) has been measured in skin fibroblast cultures from premature ageing or DNA repair deficient genetic syndromes. The short in vitro longevity of Werner's syndrome, progeria, Cockayne's syndrome, ataxia telangiectasia, Fanconi's anaemia, and Bloom's syndrome cultures was correlated with the appearance of a significant fraction of heat-labile enzyme. Long-lived control cultures contain a low level of altered enzyme until they become senescent. The evidence that heat-labile G6PD molecules are derived from errors in synthesis, or from other causes, is critically assessed. It is shown that normal cells grown in medium containing the antibiotic, paromomycin, which is known to reduce the fidelity of ribosomal translation, produce a significant fraction of altered G6PD. PMID- 6840566 TI - [Methodical approaches to evaluation of the mutagenic effect of electromagnetic factors]. PMID- 6840567 TI - [Hygienic characteristics of the working conditions in coal processing for coke production]. PMID- 6840568 TI - [Indicators of the functional state of the cardiovascular system in the research personnel during professional activities]. PMID- 6840569 TI - [Hygienic characteristics of the working conditions of girls engaged in the construction of industrial complexes]. PMID- 6840570 TI - [Teaching the methods of complex sanitary control in the children's institutions]. PMID- 6840571 TI - [Improving the educational process at the Chair of children's and adolescents' hygiene]. PMID- 6840572 TI - [Circadian rhythm of physiological functions of the body as a criterion of the evaluation of the adaptation of schoolchildren to the changes in various environmental factors]. PMID- 6840573 TI - [Current problems of hygiene in the aspect of intensive economic development of the Siberian regions]. PMID- 6840574 TI - [Gas-chromatographic determination of caffeine in the air]. PMID- 6840576 TI - ["Clean" method of obtaining plantar prints]. PMID- 6840575 TI - [Ensuring the reliability of the data obtained by the photometric methods]. PMID- 6840578 TI - [Rapid method for evaluation the translocation indicator of toxicity in hygienic standardization for heavy metals in the soil]. PMID- 6840577 TI - [Comparative evaluation of the methods of gas-chromatographic determination of carbon monoxide in the air]. PMID- 6840579 TI - [International activities with regard to chemical safety]. PMID- 6840580 TI - [Concerning the article by A.M. Skorobogatova, G.M. Tarasova and G.F. Chumakov "Evaluation of the functional state of the cardiovascular system of persons working under various systems of air ionization"]. PMID- 6840581 TI - [Anthropometric parameters as the criteria of information on the general principles of human development]. PMID- 6840582 TI - [Activities of the sanitary epidemiological station with regard to atmospheric air protection from methylmercaptan pollution produced by gas discharge from the underground storage station]. PMID- 6840583 TI - [Sanitary control of the soil in the area of industrial plant]. PMID- 6840584 TI - [Work hygiene and physiology of workers engaged in cutting of hop roots]. PMID- 6840585 TI - [Organization of laboratory sanitary control]. PMID- 6840586 TI - [Isolation of Yersinia from various water sources in the Primor'e Territory]. PMID- 6840587 TI - [Acinetobacter calcoaceticus strains in the environmental objects of a burn unit]. PMID- 6840588 TI - [Method of evaluation of physical fatigue in miners]. PMID- 6840589 TI - [Methodical approaches to hygienic substantiation of distribution of the production forces in the developing territories]. PMID- 6840590 TI - [Hygienic characteristics of the working conditions in the "Amurles" lumber industry]. PMID- 6840591 TI - [Role of occupational environment in the etiology of allergic diseases]. PMID- 6840592 TI - [Detection of arterial hypertension during preventive examinations of transportation workers]. PMID- 6840593 TI - [Effect of sports on scholastic progress of schoolchildren]. PMID- 6840594 TI - [Changes in the N-demethylase activity in the liver and 11-hydroxycorticosteroid content in the plasma after exposure to dihydrol]. PMID- 6840595 TI - [Rate of elimination of cobalt from the body of rats depending on the diet]. PMID- 6840596 TI - [Radiation hygiene aspects of ensuring safe working conditions at atomic electric power stations]. PMID- 6840597 TI - [Main results in the development and the prospective problems of the hygiene of work physiology and occupational pathology in railroad transportation]. PMID- 6840598 TI - [Drug therapy of hypertension in locomotive engineers]. PMID- 6840599 TI - [Diagnosis of the initial stage of chronic occupational poisoning]. PMID- 6840600 TI - [Importance of the morphological study of the blood at different levels of lead exposure]. PMID- 6840602 TI - [Rational job placement for pregnant workers in machine tool occupations]. PMID- 6840601 TI - [Industrial hygiene of women in the textile processing of polyamide cord]. PMID- 6840603 TI - [Establishment of the optimal human irradiation intensities at low environmental temperatures at work sites]. PMID- 6840604 TI - [Hygienic aspects of the international transport of radioactive substances]. PMID- 6840605 TI - [Diagnosis of the subclinical stage of vibration disease]. PMID- 6840606 TI - [Changes in beta-glucuronidase activity in the leukocytes of workers in contact with organic solvents]. PMID- 6840608 TI - [Information from the Soviet Toxicology Center]. PMID- 6840607 TI - [Determination of Donbass-1 inhibitor in the air by a thin-layer chromatographic method]. PMID- 6840609 TI - [Integral determination of changes in central nervous system function during intellectual work]. PMID- 6840610 TI - Reticuloendothelial function in coeliac disease and ulcerative colitis. AB - Patients with ulcerative colitis and coeliac disease who had been shown by impaired clearance of heat damaged red cells to have diminished splenic phagocytosis, were examined for evidence of more generalised reticuloendothelial malfunction by measuring their circulatory clearance of micro-aggregated albumin. Although in animals micro-aggregated albumin is largely removed by Kupffer cells, we found impaired clearance in otherwise normal subjects who had previously had surgical splenectomy. In patients with hyposplenism because of bowel disease there was no additional impairment of micro-aggregated albumin clearance, indicating that their hyposplenism is an isolated phenomenon and not part of a generalised reticuloendothelial atrophy. Patients with coeliac disease and normal splenic function had increased reticuloendothelial catabolic activity; this was not present in patients with coeliac disease and abnormal splenic function. PMID- 6840611 TI - Similar prevalence of coeliac disease in children and middle-aged adults in a district of Sweden. AB - Coeliac disease in children and adults is considered to be a variety of the same disorder. This gains epidemiological support in the present study, which reports on the observed prevalence of coeliac disease in an area of Sweden (population, 140 500). On 1 July 1981, the prevalence rate was found to be 104/100 000 (1:960) among children, and the same figure, 106/00 000 (1:950), was found for coeliac disease unaccompanied by dermatitis herpetiformis in the middle-aged population. The figures were obtained in patients seeking medical are and thus represent minimum rates, and it is likely that the actual prevalence of coeliac disease in Sweden will prove still higher. PMID- 6840612 TI - Functional and structural studies of ileal reservoirs used for continent urostomy and ileostomy. AB - The structure and function of the mucosa has been studied in continent ileostomy and urostomy reservoirs, the latter being a receptacle for diverted urine constructed out of ileal tissue. Morphometric evaluation was performed by a microdissection technique and functional studies involved the assessment of L phenylalanine absorption by the whole pouch in vivo and the uptake of the same amino acid by biopsy samples in vitro. Endoscopic examination revealed fairly homogeneous villous structure in the ileostomy reservoirs. In the urostomies, there was a gradual appearance, as a function of the postoperative time interval, of areas of flat mucosa intermingled with villous regions. When possible, biopsies of the two types of mucosa were studied separately. Even in the villous regions of the urostomies, the size of the villi was smaller in all dimensions than the villi of ileostomy samples. The uptake of phenylalanine in vitro, however, was the same in villous samples from urostomies and in ileostomy biopsies. The absorption of phenylalanine in vivo by the whole pouch was lower in the urostomies. There was a good correlation between amino acid absorption in vivo and in vitro in the ileostomies, but not in the urostomies. This is attributed principally to the variable proportions of avillar and villous mucosa in the latter material, as there is a clear reduction in absorption in vivo in the longest established urostomy pouches. PMID- 6840613 TI - Effect of alcohol on the integrity of the intestinal epithelium. AB - The absorption of macromolecules from the small intestine of rats was studied in terms of the amount of peroxidase activity that appeared in thoracic duct lymph after a 10 mg dose of horseradish peroxidase had been injected directly into the lumen of the duodenum. When the horseradish peroxidase was injected as a solution in saline no peroxidase activity was detected in the lymph. When ethyl alcohol was included in the dose at final concentrations of 12.5-16% the flow rate of the lymph increased markedly for an hour or so and during this time peroxidase activity was detected in the lymph. An electronmicroscope study of the duodenal epithelium that had been exposed to alcoholic solutions of horseradish peroxidase showed that the enzyme had penetrated between the enterocytes. It was concluded that the presence in the intestine of substantial amounts of alcohol temporarily destabilises the intercellular junctions of the epithelium and thus promotes the absorption of materials which are normally excluded. PMID- 6840614 TI - Irritable bowel syndrome: relationship of disorders in the transit of a single solid meal to symptom patterns. AB - The time taken for a solid meal to pass through the stomach, small intestine, and colon was measured in 61 patients with irritable bowel syndrome, subdivided according to their presenting symptoms, and in 53 healthy volunteers. Small bowel transit times were significantly shorter in patients who complained predominantly of diarrhoea (3.3 +/- 0.3 vs 4.2 +/- 0.2 h; p = 0.01; n = 21) and significantly longer in patients who complained predominantly of constipation (5.4 +/- 0.3 vs 4.2 +/- 0.2 h; p less than 0.01; n = 23) or pain and distension (5.4 +/- 0.4 vs 4.2 +/- 0.2 h; p less than 0.01; n = 17) compared with controls. Whole gut transit times were shorter in patients who complained of diarrhoea (35 +/- 5 vs 53 +/- 4 h; p less than 0.01), and longer in patients with constipation (87 +/- 13 vs 53 +/- 4 h; p less than 0.05) compared with controls. No significant differences in gastric emptying rates were shown between any of the patient groups and normal controls. Thirty-four patients reported pain, particularly in the right iliac fossa, during the meal transit test, and in 25 of these (74%), the onset of the pain was associated with the arrival of residues of the test meal in the caecum. Our results indicate that irritable bowel syndrome should be considered a disease of the small intestine as well as the colon. PMID- 6840615 TI - Coagulopathy of peritoneovenous shunts: studies on the pathogenic role of ascitic fluid collagen and value of antiplatelet therapy. AB - The role of ascitic fluid collagen in the pathogenesis of the coagulopathy that follows peritoneovenous shunting was examined. Collagen was partially purified from ascitic fluid and infused into rabbits. All animals developed changes in their haemostatic profile consistent with intravascular coagulation. Aspirin therapy, for five days before the collagen infusion, prevented these changes. Seven patients undergoing a total of eight peritoneovenous shunts for intractable ascites received antiplatelet therapy (aspirin and dipyridamole) in the immediate pre- and postoperative period. After six shunts no thrombocytopenia or prolongation of clotting times developed to suggest decompensated consumptive coagulopathy. Complicating factors may have contributed to the deterioration in haemostasis in the other two patients. There was no early shunt occlusion. The results support the hypothesis that ascitic fluid collagen is important in the pathogenesis of intravascular coagulation postascitic fluid infusion and indicate that antiplatelet drugs may be of value in preventing this complication. PMID- 6840616 TI - Radionuclide transit studies in the detection of oesophageal dysmotility. AB - A scintigraphic method is described to measure the transit of a fluid bolus through the oesophagus. Transit times in 16 normal subjects ranged from five to 15 seconds and were highly reproducible. Prolonged transit times were observed in 16 of 19 patients with known oesophageal motility disorders, and in these patients inspection of the time activity curves frequently permitted an adynamic oesophagus to be distinguished from one showing excessive incoordinate contractions. The technique was then applied prospectively to 50 patients referred for oesophageal motility studies and a comparison made between the oesophageal transit measurements and the findings on conventional oesophageal manometry. There was agreement between these tests in 42 (84%) of the 50 patients. The measurement of oesophageal transit may be made quickly and safely, without causing discomfort to the patient, and it appears to be at least as sensitive as manometry in the detection of oesophageal motility disorders. PMID- 6840617 TI - Ulcerative enteritis and liver disease in a patient with coeliac disease. AB - We report a fatal case of adult coeliac disease complicated by ulcerative enteritis and chronic liver disease. Macroscopically the liver was characterised by multiple, small depressions over the whole surface. The portal tracts were infiltrated by mononuclear cells and also scattered, large atypical cells of uncertain origin. Neither feature has been reported previously. PMID- 6840618 TI - Varicocoele caused by a pancreatic pseudocyst. AB - Pseudocysts of the pancreas, when large, can compress adjacent structures giving rise to a series of clinical symptoms and signs. We present a patient whose pseudocyst compressed the left renal and testicular veins, resulting in a left sided varicocoele. We can find no evidence of such a complication having been previously reported. PMID- 6840619 TI - Malignant histiocytosis and encephalomyeloradiculopathy complicating coeliac disease. AB - A 62 year old Irish woman with an eight year history of probable coeliac disease developed brain stem signs, unilateral facial numbness and weakness, wasting and anaesthesia in both lower limbs. Over the next two years, a progressive deterioration in neurological function and in intestinal absorption, and the development of anaemia led to a suspicion of malignancy. Bone marrow biopsy revealed malignant histiocytosis. Treatment with cytotoxic drugs led to a transient, marked improvement in intestinal structure and function, and in power of the lower limbs. Relapse was associated with bone marrow failure, resulting in overwhelming infection. Post mortem examination confirmed the presence of an unusual demyelinating encephalomyelopathy affecting the brain stem and the posterior columns of the spinal cord. PMID- 6840620 TI - Two patients with pancreatic apudomas secreting neurotensin and VIP. AB - Two patients have been studied with a two and a half and nine year history of metastatic pancreatic apudoma. In both patients the main feature was chronic watery diarrhoea with remissions after partial tumour resection and streptozotocin therapy. Plasma levels of circulating VIP and neurotensin were persistently raised in both patients. Chromatographic analysis of the plasma showed that a significant proportion of the raised immunoreactivity of both peptides eluted in an identical position to pure VIP and neurotensin. The extremely high concentrations of neurotensin did not appear to result in any feature which would allow distinction from the classical VIPoma syndrome. PMID- 6840621 TI - Radiological demonstration of colonic aphthoid ulcers in a patient with intestinal tuberculosis. AB - The case is described of a young Asian woman with massive rectal haemorrhage during and after pregnancy. Barium radiology showed aphthoid ulcers in the colon and changes in the ileum suggesting tuberculosis. Colonoscopy revealed hyperplastic ulceration in the terminal ileum and culture of biopsies from this area grew Mycobacterium tuberculosis. The patient made a full and rapid recovery on anti-tuberculous therapy. Colonic aphthoid ulceration has not previously been recorded, radiologically, in intestinal tuberculosis. PMID- 6840622 TI - Mathematical models for determining intestinal permeability using polyethylene glycol. PMID- 6840623 TI - Fibrinolytic activity in the walls of foot veins in women using combined contraceptive pills. AB - In the present study, the fibrinolytic activity of dorsal foot veins (FAV) was histochemically determined in 46 young and middle-aged healthy women, 26 of whom were using combined contraceptive pills (CCP). Significantly reduced FAV was demonstrated in women with a history of previous thrombophlebitis or family manifestation of deep venous thrombosis irrespective of age, as well as in middle aged women using CCP, whereas the FAV of young women was uninfluenced by CCP and smoking. The FAV of the smoking middle-aged pill users was significantly reduced as compared to that of the young smoking pill users. With reference to this significant reduction of FAV it might be concluded that the combined contraceptive pill is unsuitable for middle-aged female smokers. PMID- 6840624 TI - Determination of prothrombin by a micro-coagulation method. AB - In contrast to earlier assays, the prothrombin determination described here uses a two-step reaction: first, prothrombin is activated with human factor Xa, phospholipids, Ca++ and factor V; second, the amount of activated prothrombin is assayed by the proteolysis of added fibrinogen. The assay is dependent only on prothrombin, and independent of other components of thrombin generation. Carboxy- and decarboxyprothrombin can be differentiated by means of using Echis carinatus venom instead of factor Xa as activator. The micro-coagulation assay is compared with a conventional one-stage coagulation test, with a prothrombin determination using chromogenic substrate and immunologically by Laurell electrophoresis. PMID- 6840625 TI - X-ray microprobe analysis of platelets. Principles, methods and review of the literature. AB - Platelets are well suited to X-ray microanalysis as there is no need for chemical fixation or sectioning, and the concentrations of calcium and phosphorus are above 10(-3). The principles of the technique, the methods of specimen preparation, instrumental conditions during analysis and ways of quantitation are described. This is followed by a review of published reports and a brief summary of the author's own work in the field. PMID- 6840626 TI - Uptake of 125I-Lys-plasminogen by in vitro thrombi. AB - The specificity, distribution and rate of uptake of radiolabelled 125I-Lys plasminogen by in vitro thrombi was investigated. 125I-Lys-plasminogen was added to whole blood perfusion mediums containing preformed thrombi and to whole blood prior to thrombus formation. Uptake was assessed by means of radioisotopic analysis and autoradiography. The plasminogen was taken up by thrombi during and after their formation. The largest percentage was in the fibrin component. epsilon-Aminocaproic acid-blocking experiments confirmed the specificity of plasminogen binding to fibrin. Autoradiography of the thrombi revealed plasminogen in the RBC-fibrin part and in platelet-fibrin aggregates. Plasminogen uptake and penetration into preformed thrombi were found to increase as a function of time. However, formation of thrombi from plasminogen-enriched blood was a more effective means for increasing the plasminogen content of thrombi than perfusion of preformed thrombi in a plasminogen-enriched medium, over the time period studied. PMID- 6840627 TI - Nonenzymatic glycosylation of collagen in diabetes: incidence on increased normal platelet aggregation. AB - The effect of normal and nonenzymatically glycosylated rat type I acid-soluble collagen on normal human platelets was investigated. Glycosylated collagen was obtained either after in vitro incubation with glucose or from rats made diabetic by streptozotocin. The amount of nonenzymatically bound glucose was as follows: normal 2.3, diabetic 7.6 and in vitro glycosylated collagen 9.0 nmol/mg. When investigated under conditions leading to identical diameters and molecular packings for all the samples, the aggregation potency was markedly stronger for diabetic and glycosylated collagens than for normal ones. These results show the potential role of this posttranslational modification of collagen which can be considered as a risk factor in the thrombotic pathogeny of diabetes. PMID- 6840628 TI - Medicine vs. religion: the case of Jehovah's Witnesses. AB - When a Jehovah's Witness refuses to consent to needed medical treatment on religious grounds, a hospital's treatment team confronts a variety of ethical, legal, and medical dilemmas. This article explores the background and issues relating to cases in which Jehovah's Witnesses have refused treatment and discusses how the worker can effectively perform the tasks of case preparation, intervention, and advocacy with these clients. PMID- 6840629 TI - Health agencies and a school of social work: practice and research in partnership. AB - Growing out of their joint recognition of the need for evaluation, accountability, and definition of social work's interdisciplinary contributions, a school of social work and Boston-area health agencies formed a research partnership. Fifty-five studies involving graduate students' research resulted in reportings, publications, and utilizations of findings. PMID- 6840630 TI - The practice-research partnership: is it compatible with teaching? AB - This commentary discusses possible conflicts that can develop among the needs of students, those of a school of social work's faculty, and those of health care agencies involved in a joint practice-research model. It also discusses the needs for schools of social work and the profession as a whole to develop funded research for social work in health care. PMID- 6840631 TI - A psychosocial assessment framework for cancer patients and their families. AB - This article describes four areas of knowledge for social work assessments that cover the ecological system of the patient and psychodynamics. In addition, it addresses the area of dis-synchrony, which causes stress for many patients. The author focuses on the area of dis-synchrony because she believes that social workers must be clear about the differences between reactions of pathological patients and strong reactions of psychologically normal patients to extraordinary circumstances. The literature on stress has begun to look at this aspect but is still open to a pathology bias. The social work profession needs to evolve new ways of thinking about normal people and their environments. The unique access that social workers have to the range of patients in a variety of settings creates the opportunity for them to make a significant contribution to the understanding of the full range of human experiences. Moreover, the sharing of knowledge between workers in mental health settings and those in medical settings is relevant not only in the provision of direct service, but also in the development of hospital policies and national policies regarding health care for individuals and their families. PMID- 6840632 TI - Finding of Cryptosporidium sp. in calves in the USSR. PMID- 6840633 TI - Studies on the low and fundamental populations of the warble fly Hypoderma bovis (De Geer) (Diptera, Hypodermatidae). AB - During control measures against cattle hypodermatosis low populations of warble flies with incidence of infestation (extensity, percentage) up to 2-5% persist after a rapid decrease of the degree of infestation. In order to study these low populations isolated warble fly populations were experimentally created under conditions of Central Europe. Fundamental populations observed originated from one ovipositing female in a herd of heifers and included 17, 25, 42 and 83 larvae with 11-52% of infestation and mean infestation of 1.1-1.6 larvae per infested host (intensity of infestation). With the increasing age of heifers from one to 2.5 years the numbers of fundamental populations decreased to one quarter, the extensity of infestation to one fifth, while the mean infestation per infested host remained nearly at the same level. The persistence of low warble fly populations was caused by an internal system regulating the numbers of parasites in the host populations. The distribution of larvae of fundamental warble fly population in a cattle herd agrees with the Poisson distribution as well as the negative binomial distribution. The direct significance of the results obtained for the control of hypodermatosis is pointed out. PMID- 6840634 TI - Polygraphs: erosion of the privacy right. AB - The polygraph is a machine which invades previously private regions in the human being. Its operation is often viewed simplistically and lacking in danger. Such naivete is the subject of this comment. The paper considers the mechanics of polygraph operation, and its theoretical basis; the legal admissibility of the polygraph in a variety of settings, and lastly the impact the polygraph has upon our private lives. Clearly, the polygraph intrudes on the private regions of each individual, and this frightening fact is cause enough to consider the human, social and constitutional implications of its use. The project considers the reliability factor of the polygraph and its questionable use in personnel and business settings; its use in disciplinary procedures and labor arbitration, as well as reviews its place in judicial process and criminal review. Most critically the paper attempts to arrive at a constitutional basis for restrictions on its use in the private sector. Ingenious arguments have been made by opponents of the polygraph, and this paper reviews the substance and content of these constitutional arguments. PMID- 6840635 TI - [Ultrastructure of intravital, postmortem and autolysed fibrin]. AB - Investigations on animal experimental and human tissue material (skin, musculature, liver) with the scanning electron microscope are reported. These studies were carried out to clarify open questions on extravascular fibrin structures after blunt and sharp traumatization of vital and postmortem nature. The network formation which was already characterized earlier as typically vital and the irregular structure of postmortem coagula could be demonstrated even with modification of the traumatization, especially in tissue hematomas. Experimental investigations on autolysis revealed an exceedingly good preservation of the structure of vital coagulum material with massive damage and granular decomposition of fibrin fiber structures produced postmortem. The structural differences in the mode of interlinking of the fibrin was shown up especially clearly by the autolysis, which suggests an application as preparation technique for the question specified. Special modifications of the preparation technique (fixation according to Karnovsky, critical-point drying) did not provide such substantial advantages for routine investigations that they might be generally recommended. PMID- 6840636 TI - Lactate dehydrogenase isozymes in vaginal swab extracts: a problem for the identification of menstrual blood. AB - Extracts of vaginal swabs free of both blood and semen, collected from three donors throughout several menstrual cycles, have been examined by cellulose acetate membrane electrophoresis for the presence of lactate dehydrogenase (LDH) isozymes. LDH activity, predominantly in the form of LDH-5 was detected in some extracts. Mixtures of these particular extracts with peripheral blood gave LDH patterns similar to those observed for menstrual blood. The results indicate that LDH isozyme patterns cannot be used to differentiate between stains of menstrual blood and bloodstains that have become mixed or contaminated with vaginal secretions. PMID- 6840637 TI - Immunological analysis of human placental lactogen in blood stains and its application to forensic science. PMID- 6840638 TI - Diatoms and drowning--once more. AB - The content of diatoms in 5 samples: lung-, kidney- and liver-tissue plus columna and femur-marrow from each of four drowned and four non-drowned persons has been investigated. Diatom valves were found in all the samples. It seems, however, impossible to point out any characteristic differences between the composition of the diatom 'flora' in drowned and non-drowned persons. Consequently it will not be possible by means of diatoms to prove that a person died by drowning. PMID- 6840639 TI - Homicide and suicide by aircraft. PMID- 6840640 TI - Differentiation between inks of the same brand by infrared luminescence photography of their thin-layer chromatograms. PMID- 6840641 TI - [Child abuse. 3 cases of child death caused by negligence and starvation]. PMID- 6840642 TI - Opiate levels in hair. AB - By means of radioimmunoassay-technique, hair samples of users, drug related fatalities, carcinoma patients receiving morphine and of experimental guinea pigs receiving codeine were investigated for opiates. The RIA-investigations require a minimum of material; our routine procedures need only 50 mg of hair. No correlation existed between administered doses of opiates and their concentrations in hair of both human and experimental animals. By sectioning the hair, the approximate period of drug use in man could be detected. However, these findings could not be confirmed by the animal experiments. The growth rate of the hair, diffusion and adhesion processes may influence the transport of drugs along the hair. External contaminations and washing procedures were shown to increase or diminish the drug concentration of the samples. PMID- 6840643 TI - [Radionuclide ventriculography in coronary heart disease]. AB - Heart function can be investigated non-invasively and without risk for the patient by means of radionuclide ventriculography. Coronary artery disease can be diagnosed with high sensitivity and distinguished from other diseases of the heart with high specificity by typical alterations of heart function as seen in rest and/or exercise scans. The hemodynamic significance of invasively proven stenoses of coronary arteries can de demonstrated and the function and functional capacity of surviving vital myocardium after myocardial infarction can be quantified scintigraphically. The efficacy of medical and surgical therapy can be documented and the course of disease can be followed up. PMID- 6840644 TI - [Radionuclide kidney diagnosis]. PMID- 6840645 TI - [Radionuclide liver diagnosis]. PMID- 6840646 TI - [Value of skeletal scintigraphy in the follow-up of breast cancer]. AB - In a retrospective study of 728 patients with breast cancer up to 3 years after primary treatment skeletal scintigraphy yielded 15.8% (n = 115) bone metastases. By scintigraphic differentiation between a typical and an untypical pattern of bone metastasis a diagnostic accuracy of 99% was found. Depending on the local stage of tumor the rate of osseous metastases rises with increasing tumor size and with the extent of metastatic involvement of the lymph nodes. The frequency of bone metastasis proved to be also dependent on the histological type of tumor; it was highest in scirrhous carcinomas. By evaluating the scintigraphic behaviour of skeletal metastases under treatment in 122 patients we revealed an obvious decrease of metastatic deposits or complete normalization in 11.5% (n = 14), an unchanged finding in 32% (n = 39) and a progression of metastasis in 56.5% (n = 69). Therefore scintigraphic bone imaging in follow-up of breast cancer can be recommended for early detection of osseous metastases and for assessing the response of skeletal metastases to treatment. PMID- 6840648 TI - [Diltiazem in angina pectoris]. PMID- 6840647 TI - [Use of bronchodilators in the therapy of obstructive respiratory diseases]. PMID- 6840649 TI - [Therapy of hypertension with timolol, hydrochlorothiazide and amiloride]. AB - The effectiveness of fixed combination tablets of timolol 10 mg. hydrochlorothiazide 25 mg and amiloride 2.5 mg (Moducrin) once daily in the control of blood pressure has been assessed in fully ambulant hypertensives by the technique of continuous intra-arterial recording. Highly significant blood pressure reduction (p less than 0.001) was obtained consistently throughout the whole day, confirming the potency and usefulness of the preparation for those patients who need more than one drug to control their blood pressure. 2. Blood pressure responses to both isometric and dynamic forms of exercise were also significantly lowered by combination therapy. 3. The addition of a diuretic to a beta-adrenoceptor blocker appears to be an advantage if the aim of treatment in hypertension is 24 h blood pressure control. PMID- 6840650 TI - [Waste water problems in infectious disease hygiene]. PMID- 6840651 TI - [Orientation aid for the classification of growth retardation]. PMID- 6840652 TI - [Therapy in neurology. 15. Coma - unconsciousness - apallic syndrome]. PMID- 6840653 TI - [Early diagnosis of acoustic neuroma with quantitative neuro-otology and refined radiological diagnosis]. PMID- 6840654 TI - [Long-term therapy in leukemias and malignant lymphomas]. PMID- 6840655 TI - [Prevention of thromboembolism with low-dose heparin in retinal and vitreous body surgery]. PMID- 6840656 TI - [Antihypertensive therapy using urapidil in patients with obstructive lung diseases]. PMID- 6840657 TI - ["Accuracy of diagnosis" to "truth at the bedside"]. PMID- 6840658 TI - [Corrective radius operations. Indications and results]. AB - Posttraumatic malunion usually results from incorrect treatment of Colles or Smith fracture. Chronic pains, limited motion and impaired power can be avoided and cosmetic appearance of the hand improved by restoration of the functional anatomy of the wrist. The malalignment is corrected by open wedge osteotomy of the distal end of the radius. A small iliae cortico-cancellus bone graft is inserted at the osteotomy site. By using this technique it is usually possible to avoid additional resection of the distal ulna. The surgical approach dorsal or volar is determined by the type of dislocation. The small T-plate offers stable fixation. The results are illustrated by 41 cases. PMID- 6840659 TI - [Antimycotic therapy. 1: Classification, antimycotic drugs: flucytosine, tolnaftate]. PMID- 6840660 TI - [Ultrasonic diagnosis of internal organs including directed fine needle biopsy]. PMID- 6840661 TI - [100 years of female employment. 2: Problems of the present from the occupational medicine viewpoint]. PMID- 6840662 TI - [Visuo-morphologic analysis of cerebral electric behavior in patients with manic depressive and schizoaffective psychoses under lithium prophylaxis]. PMID- 6840663 TI - [Atraumatic measurement of regional cerebral circulation: method and reliability testing]. PMID- 6840664 TI - [Bacterial pollution in the indoor air. (2) Airborne Staphylococci]. PMID- 6840665 TI - [Relationship between the pharmacokinetics of verapamil and its electrocardiographic effects]. PMID- 6840666 TI - [Clinical significance of HBeAg and anti-HBe in HBsAg positive liver diseases]. AB - Variation of incidence of HBe antigen (HBeAg) and HBe antibody (anti-HBe) was examined by use of RIA in 72 patients with HBsAg positive liver diseases. 1) Percentage of positive HBeAg was highest (71.5%) in chronic active hepatitis with lobular distortion, followed by chronic active hapatitis without lobular distortion (70.0%) and acute hepatitis in asymptomatic HBsAg carriers (66.7%). In contrast, it was low in chronic inactive hepatitis (35.7%) and liver cirrhosis (38.5%). None of liver cancers showed HBeAg positive reaction. 2) Percentage of positive HBe antibody (anti-HBe) was highest in liver cancer (100%), followed by liver cirrhosis (61.5%) and chronic inactive hepatitis (50.0%). In acute hepatitis from asymptomatic HBsAg carriers no anti-HBe was found. In chronic active hepatitis the percentage of positive anti-HBe was low, 21.4 and 30.0% with and without lobular distortion, respectively. 3) In 45 patients with persistently positive HBsAg liver diseases, fluctuations of HBeAg and anti-HBe were followed over a period of one year in relation to serum GPT values, an indicator of clinical conditions. Serum GPT tended to fluctuate or to remain high in patients with persistently positive HBeAg or with sporadically positive HBeAg or anti-HBe, whereas it tended to become low or normal with persistently positive anti-HBe or with seroconversion from HBeAg to anti-HBe. However, there were some exceptions to this tendency. From these results we concluded that it is clinically of significant value to determine HBeAg and anti-HBe levels for the effective assessment of the activity and time course of HBsAg positive liver diseases. PMID- 6840668 TI - [Bacterial pollution in the indoor air. (1) Airborne bacteria]. PMID- 6840667 TI - [Experimental and clinical studies on pathophysiology and treatment of cerebral ischemia caused by occlusive cerebrovascular disease]. PMID- 6840669 TI - Acute and transient activation of pituitary-thyroid axis during unforced restriction in rats: component of nonshivering thermogenesis in conscious animals? AB - Groups of 6-8 male Wistar Olac SPF rats weighing about 300 g were subjected to unforced restriction (UR) in small cages with a metallic bottom and a Plexiglas cover for various intervals from 2 min to 72 h. An acute activation of the pituitary-thyroid axis was found which was manifested by an increase of thyrotropin (TSH) and thyroxine (T4) levels at 2-5 min of UR. This was presumably due to the emotional effect of a rapid transfer and to the placing of the animals into restriction cages. Later, between 3 and 6 h of UR, another, and more pronounced period of activation of the pituitary-thyroid axis and of the peripheral thyroid hormone metabolism was repeatedly observed which lasted until about 36-48 h and was manifested by a highly significant increase of TSH, T4, 3,5,3'-triiodothyronine (T3) and 3,3',5'-triiodothyronine (rT3) levels. It was concluded that this phenomenon presumably may be a component of nonshivering thermogenesis resulting from a decreased muscular activity and resembling the conditions occurring under cold stress. Such a view was supported by findings of highly increased nonesterified fatty acid levels in plasma in restricted animals, by unchanged levels of TSH and thyroid hormones found in unrestricted animals kept individually in regular group cages and, finally, by a preventive effect of ambient temperature of 32 degrees C on the pituitary-thyroid activation at 6 h of UR. In some experiments, no substantial differences in hormone levels were found between the animals kept in Plexiglas or stainless wire-mesh restriction cages. Finally, a multifold increase of prolactin level in plasma was found as early as 2 min of UR, the peak being observed between 5 and 20 min and a decrease to about the initial level at about 360 min. PMID- 6840670 TI - Thyroidal responses to human chorionic gonadotropin in the chick and rat. AB - The thyrotropic activity of human chorionic gonadotropin (hCG) has been examined in the chick and the rat. Uptake of 32PO4 by chick thyroid increased significantly with injection of bovine thyrotropin (bTSH) with a maximum response at 2.4 mU per chick. On the other hand, no significant stimulation of 32PO4 uptake was detected with injection of graded doses of highly purified hCG up to 0.25 mg per chick. 1 mg of partially purified hCG, equivalent in biological potency to the maximum dose of highly purified hCG used in the chick, did induce a significant increase in 32PO4 uptake. In rats, highly purified hCG stimulated a very significant release (p less than 0.001) of 125I from the thyroid and partially purified hCG had a thyrotropic activity equivalent to 0.42 microU bTSH/U hCG, identical to the value we reported in mice, 0.42 microU bTSH/U hCG. The duration of hCG action on thyroidal release of 125I in the rat was longer than that for bTSH, as it is in the mouse. hCG also induced a significant rise in the serum level of triiodothyronine in rats. We conclude that pure hCG is a weak thyrotropic substance in the rat but not in the chick. These results and other evidence suggest an inhibitory role for the densely glycosylated 30 amino acid residue C-terminal extension on the beta-subunit of hCG which limits, by steric hindrance, the interaction of the TSH-like hCG 'core' with thyrotropin receptors. PMID- 6840671 TI - Effect of stress on the acetylcholinesterase activity of the hypothalamus pituitary-adrenal axis in the rat. AB - Acetylcholinesterase (AchE, EC 3.1.1.7) activity was determined in cerebral cortex, hypothalamus, adenohypophysis and adrenal gland in response to acute and chronic stress. Chronic exposure of animals to cold stress (at 4 degrees C for 7 days) resulted in significant decline of AchE activity in all tissues studied. Similar results were obtained when animals were exposed to acute immobilization and cold stress (at 4 degrees C) simultaneously. In another experiment, animals were treated with 2 mg/kg of corticosterone prior to AchE determination. Corticosterone administration resulted in a significant decline in AchE activity of the cortex, the hypothalamus and the adrenal but failed to affect the adenohypophysis AchE level. Exposing adrenalectomized animals to acute stress resulted in no significant changes in the cortex and the hypothalamus but caused a significant decline in AchE of the adenohypophysis. It was concluded from this study that corticosterone might mediate the stress effect on AchE activity. PMID- 6840672 TI - Lack of rapid effects of cortisol on parathyroid hormone levels in cattle. AB - Experiments were performed to study plasma concentrations of parathyroid hormone in association with short-term changes of cortisol and dexamethasone. Parathyroid hormone was not significantly modified during 3-hour intravenous infusions of cortisol, leading to marked elevations (p less than 0.001) of plasma cortisol levels, and during intravenous administration of dexamethasone. Thus glucocorticoids, at least in cattle, apparently cause no short-term changes of plasma parathyroid hormone levels. PMID- 6840673 TI - Transplantation of human pituitary adenomas into nude mice. AB - In vitro studies with human pituitary adenomas are limited by the small amount of tissue obtained, which may be contaminated by the surrounding normal pituitary tissue. In this study we investigated if the passage of adenoma tissue via thymusless nude mice could solve some of these problems. The secretory capacity of the transplanted human pituitary adenomas was demonstrated by the presence of hGH and/or hPRL in the plasma of the host mouse, while other human pituitary hormones (TSH, LH and FSH) were undetectable. The transplants, however, decreased in size with time although histologically viable adenoma tissue was recovered that resembled the original tumor. Upon trypsinization of the small tissue fragments no viable adenoma cells could be obtained. In contrast, an experimental malignant rat pituitary tumor grew steadily with time, resulting in high levels of rPRL in the nude mice recipients. Large numbers of viable tumor cells were recovered from these tumors. Thus, human pituitary adenomas transplanted in nude mice continue to release hormone(s), but the transplants decrease in size and cannot be used to isolate dispersed tumor cells for in vitro studies. PMID- 6840674 TI - Plasma vasopressin during normal menstrual cycle. AB - Plasma vasopressin concentrations were measured on days 5-7, 11-13, 15-17 and 21 23 of the normal menstrual cycle in 14 healthy women. The four determinations of vasopressin concentrations did not differ significantly. Plasma vasopressin showed, however, a tendency to increase on days 11-13, when the peak concentration of serum estradiol occurs. After the ovulation a decreasing tendency was seen. There was no significant correlation between circulating vasopressin and 17 beta-estradiol studied in four stages of the menstrual cycle. PMID- 6840675 TI - Detection of hepatitis B virus DNA in serum by a simple spot hybridization technique: comparison with results for other viral markers. AB - A simplified spot method for determination in serum of hepatitis B virus DNA (HBV DNA) by molecular hybridization is proposed. For simultaneous testing of 30 serum samples, it reduced to about 1 hr the duration of the steps preceding hybridization proper. The method also greatly reduced the loss of DNA during these steps and allowed more sensitive detection in samples of only 25 or 50 microliters. HBV DNA was determined in 181 serum samples by this method, and the results were pooled with 67 previous determinations by the Southern blot technique. Results for the pool were then compared to those obtained with radioimmunoassay for serological HBV markers. Ninety-six of the 248 samples were HBV DNA positive. Eleven others gave variable or inconclusive results, probably due to low viral particle titers. Seventy-two HBsAg- and HBeAg-positive sera contained HBV DNA, confirming that HBeAg is a marker of active viral replication. Fourteen other HBsAg- and HBeAg-positive sera, obtained from eight patients, were either HBV DNA negative or oscillated between negative and positive, or, again, were weakly positive; serological follow-up in 7 patients showed seroconversion to anti-HBe in 5, 3 of which became HBsAg negative. Eight of the HBsAg-positive sera were negative or borderline for HBeAg but contained HBV DNA and may, therefore, have been infective; seven of these sera had anti-HBe. Six HBsAg negative sera contained HBV DNA and may also have been infective; five of these exhibited HBV antibodies. These results indicate that molecular hybridization not only provides a more sensitive and direct method for detecting hepatitis B virus in serum but also defines additional serological patterns with predictive or epidemiological value. PMID- 6840676 TI - Abnormal matrix recognition by Morris hepatomas correlates with low glucagon binding capacity. AB - Liver biomatrix contains a group of connective tissue components needed for attachment, survival, and maintenance of liver-specific functions of adult rat hepatocytes in culture. An acidic extract of liver biomatrix that contains a group of glycoproteins can replace intact biomatrix in promoting attachment and survival of hepatocytes. However, except for albumin synthesis, liver-specific functions have not been tested. Acidic extracts of biomatrices prepared from heart, kidney, lung, and spleen (heterologous) contain a similar group of glycoproteins, but differ with respect to liver glycoproteins in their capacity to sustain hepatocyte binding. Normal hepatocytes attach poorly to heterologous glycoprotein extracts, although regenerating and tumoral hepatocytes attach to liver glycoproteins and adhere equally well or with greater efficiency to heterologous glycoprotein extracts. The increased efficiency of hepatocytes to attach to kidney biomatrix-derived glycoproteins showed a linear correlation with the decreased glucagon binding capacity of their isolated plasma membranes. An epithelioid cell-line derived from kidney (MDCK) attached with higher efficiency to kidney than to liver glycoproteins. These results suggest that biomatrices may contain specific glycoproteins needed for attachment and survival of their epithelial cells. This specificity is lost during the proliferative state of regenerating and tumoral hepatocytes and could be important in the general mechanism of tumor dissemination and metastases. PMID- 6840677 TI - Evidence for the hormone dependency of hepatic hyperplastic nodules: inhibition of malignant transformation after exogenous 17 beta-estradiol and tamoxifen. AB - Hepatic hyperplastic nodules (HHNs) in rats were studied as an experimental prototype of oral contraceptive-related hepatic tumors. We have found cytoplasmic estrogen receptors in HHNs produced by acetylaminofluorene (AAF) (four cycles of 0.02% in diet). Rats with AAF-induced HHNs were randomized into four groups: (i) AAF-treated control; (ii) estrogen alone (estradiol-17 beta); (iii) tamoxifen alone, and (iv) estrogen + tamoxifen. After 8 months of treatment with estrogen (estradiol-17 beta) in combination with tamoxifen, there was regression of nodular involvement and no evidence of malignant transformation. Decreased nodular proliferation also occurred after 2 and 4 months treatment with estradiol 17 beta and after 8 months of tamoxifen administration. The incidence of hepatocellular carcinoma after 8 months of treatment was significantly less after treatment with estrogen (40%) or tamoxifen (42.9%) when compared to AAF-treated controls (87.5%). The number of gamma-glutamyltranspeptidase-positive foci were reduced in all treatment groups after 2, 4, and 8 months of treatment; these changes were most pronounced in the estrogen-treated group and did not directly correlate with the per cent inhibition of malignant transformation. Our results suggest that the malignant transformation of estrogen receptor-positive HHNs is hormone dependent. PMID- 6840678 TI - Development and use of a rat albumin cDNA clone to evaluate the effect of chronic ethanol administration on hepatic protein synthesis. AB - A rat albumin cDNA probe (pBR alb 149) was developed in order to investigate the molecular mechanisms responsible for changes in hepatic protein synthesis after chronic administration of ethanol to rats. Rats fed a diet for up to 1 year in which 36% of calories were from ethanol, developed fatty livers but not cirrhosis. Cell-free protein synthesis with liver membrane-bound polysomes of ethanol-fed rats was increased as compared to control membrane-bound polysomes, whereas protein synthesis with free polysomes was unchanged. Total RNA extracted from liver membrane-bound polysomes and translated in a rabbit reticulocyte mRNA dependent system showed a marked increase in albumin synthesis in the ethanol-fed group. Analysis of RNA molecules separated according to molecular weight by gel electrophoresis and hybridized with recombinant-cloned albumin cDNA demonstrated an increase in full-sized albumin mRNA species in ethanol-fed animals. Therefore, chronic ethanol administration appears to increase albumin synthesis by increasing the steady-state level of biologically active albumin mRNA in liver membrane-bound polysomes. Despite development of fatty liver, the protein synthesis machinery functions normally. PMID- 6840679 TI - High-density lipoprotein cholesterol and liver disease. AB - To establish whether there is any significant relationship between high-density lipoprotein cholesterol (HDLC) concentrations and biopsy-documented liver disease, 169 patients had needle biopsies, serum cholesterol, and HDLC evaluated. Twenty-four patients had serial cholesterol, HDLC, prothrombin, and aminotransferase levels and activities examined. In both men and women, HDLC decreased strikingly and significantly in acute alcoholic hepatitis and in acute viral hepatitis, compared to controls (p less than 0.001). Men and women with inactive alcoholic liver disease and chronic active hepatitis showed moderate decreased in HDLC (p less than 0.001). Patients with primary and metastatic hepatic neoplasms also had strikingly decreased HDLC (p less than 0.001). Serial testing showed an excellent direct correlation between HDLC and prothrombin activity, r values ranging from 0.71 to 0.98. Although alcohol intake is known to correlate positively with HDLC concentrations, our data shows that this association is not absolute, and in most cases is reversed once liver disease becomes apparent. PMID- 6840680 TI - Plasma lipid and lipoprotein response to fat feeding in alcoholic liver disease. AB - Serum lipids and lipoproteins were analyzed after an overnight fast, and following a fatty meal in 10 patients with cirrhosis, 5 with fatty liver, and 5 normal subjects. Cirrhotic patients were divided into two groups of five on the basis of serum lecithin-cholesterol acyltransferase activity. Fasting triglyceride levels were similar in all four groups. In all but cirrhotic patients with low lecithin-cholesterol acyltransferase activity, most fasting triglyceride was found in very low density lipoproteins; in the latter group, most of it was found in low density lipoproteins. We confirmed that patients with fatty liver have a higher serum triglyceride response to fat feeding than normal subjects, but we did not find higher levels in cirrhotic patients. Cirrhotic patients with "normal" lecithin-cholesterol acyltransferase activity had a normal triglyceride response to dietary fat. In patients with cirrhosis and low lecithin cholesterol acyltransferase activity, the increase in triglyceride was less than in normal subjects. In this group, most of the extra triglyceride was carried in low density lipoprotein, and not in chylomicrons and very low density lipoprotein, as in the other groups. PMID- 6840681 TI - The effect of progesterone on the regulatory mechanisms of biliary cholesterol secretion in the rat. AB - We tested the hypothesis that progesterone, an inhibitor of cholesterol esterification in liver microsomes, increases biliary cholesterol output by increasing the availability of cholesterol. Initial bile samples of 20 min were obtained from acute bile fistula rats after seven daily doses of progesterone (5 to 55 mg per kg of body weight). Biliary cholesterol output correlated with the doses of progesterone, r = 0.64 (p less than 0.005). A 100% increment in biliary cholesterol output was obtained with progesterone doses of 30 to 55 mg per kg of body weight. Under these conditions, biliary phospholipid output increased 50% (p less than 0.02), but bile salt output remained normal. The relationship between biliary cholesterol and phospholipids as a function of bile salt output was studied after acute depletion of the bile salt pool. A rectangular hyperbola was the best curve fitting for the experimental data in control and progesterone injected rats. In the physiological range of bile salt output, between 60 and 120 nmoles per gm per min, progesterone-injected rats secreted 100% more biliary cholesterol than did controls. The calculated theoretical maximal cholesterol and phospholipid outputs were significantly increased in progesterone-injected animals. Serum and hepatic cholesterol pool, free and ester fractions, remained normal. The acyl-CoA: cholesterol acyltransferase reaction was 30% inhibited in hepatic microsomes of progesterone-injected rats, (p less than 0.05). The changes in biliary phospholipids and cholesterol output produced by progesterone were rapidly reversed by either 0.5% cholesterol feeding or 2 mg per kg of body weight ethynyl estradiol injection. These manipulations simultaneously produced a 100% increment in the microsomal acyl-CoA: cholesterol acyltransferase activity (p less than 0.005) and increased 4-fold the concentration of hepatic cholesterol esters. This experimental model suggests a functional interrelationship between biliary cholesterol output and the rate at which the liver esterifies cholesterol. PMID- 6840682 TI - Increased synthesis of rat liver alkaline phosphatase by bile duct ligation. AB - The following studies were done to determine the mechanism of the increase in rat liver alkaline phosphatase activity after bile duct ligation. Antiserum was raised in rabbits to highly purified rat liver alkaline phosphatase. In immune titration experiments, the 350% increase in rat liver alkaline phosphatase activity caused by bile duct ligation was paralleled by a similar increase in immunoprecipitated alkaline phosphatase protein. In a second set of experiments, rat liver alkaline phosphatase was labeled with L-[3H]leucine injected into portal veins. Alkaline phosphatase was purified by antibody affinity chromatography followed by immunoprecipitation. The incorporation of L [3H]leucine into alkaline phosphatase was significantly higher in bile duct ligated rats than in controls, 68,357 +/- 7,144 vs. 19,297 +/- 3,076 dpm per gm liver (p less than 0.001) and 349 +/- 36 vs. 104 +/- 17 dpm per gm protein (p less than 0.001). In a third set of experiments, the incorporation of L-3H-amino acid into highly purified rat liver alkaline phosphatase was measured. Rat liver alkaline phosphatase was purified by means of sequential N-butanol extraction, antibody affinity column chromatography, preparative polyacrylamide gel electrophoresis, and sodium dodecyl sulfate-polyacrylamide gel electrophoresis. There was significantly more L-3H-amino acid incorporated into alkaline phosphatase in bile duct-ligated rats compared to sham-operated rats, 3,565 vs. 704 dpm per gm liver and 19,656 vs. 3,843 dpm/gm protein. The data suggest that bile duct ligation increases the synthesis of rat liver alkaline phosphatase. PMID- 6840683 TI - Mucin glycoprotein content of human pigment gallstones. AB - Mucin glycoproteins, a secretory product of the gallbladder, are thought to contribute to the matrix or nucleus of gallstones. Human black pigment stones originate in the gallbladder and have as their major constituent calcium bilirubinate, as well as inorganic salts and small amounts of cholesterol. The object of this study was to estimate the amount of glycoprotein in black pigment stones and to isolate gallbladder mucin from dissolved stones. Black pigment stones containing 18 to 65% calcium bilirubinate were first dissolved in 12.5 mM EDTA/0.1 N NaOH and decolorized, then subjected to glycoprotein assay. The mean glycoprotein content of eight stones was 12.4%. In separate experiments, pigment stones were partially dissolved by brief exposure to EDTA/NaOH to minimize glycoprotein breakdown, and the glycoproteins isolated by gel filtration and ultracentrifugation. Pigment stones contained two glycoprotein fractions on Sepharose 4B; a high molecular weight mucin glycoprotein in the void volume and a lower molecular fraction in the included volume. Mucin was further purified by density gradient ultracentrifugation in cesium chloride. Three separate mucin fractions had an average buoyant density of 1.48 gm per ml which is typical for these glycoproteins. Bile pigment was associated with high molecular weight mucin even after extensive dialysis, gel filtration, and density gradient ultracentrifugation. The identity of mucin was further established by beta elimination of glycoproteins in alkaline borohydride which yielded galactosaminitol from cleavage of O-glycosidic bonds. Our results indicate that mucin glycoproteins are present in significant concentrations in human black pigment stones and can be purified from stones solubilized in EDTA/NaOH. The association of bile pigment with gallbladder mucin, even after extensive purification, is consistent with the hypothesis that mucin contributes to the matrix of pigment gallstones. PMID- 6840684 TI - Similarities and differences between models of extrahepatic biliary obstruction and complete biliary retention without obstruction in the rat. AB - Biliary obstruction in the rat causes known biochemical and morphological abnormalities. These abnormalities might be caused simply by retention of biliary constituents or might require other factors such as high biliary pressure, interruption of the normal flux of fluid, ions, and other biliary constituents through the hepatocyte and/or changes in intracellular concentrations, binding, and distribution of biliary constituents. We studied a choledochocaval (CC) fistula rat model characterized by complete biliary retention without bile stasis. CC fistula animals were compared with biliary obstructed rats over a 46 hr period. Bile flow and bile acid excretion rate reached high levels by hour 5 and remained high in CC fistula rats. Urinary bile acid excretion, shrinkage of the rapidly exchangeable bile acid pool, and serum bile acid and bilirubin concentrations were equivalent in the two models. Serum cholesterol concentration was higher and serum alkaline phosphatase and 5'-nucleotidase activities lower in obstructed rats. The percentage of beta-muricholate rose and the percentage of cholate decreased in bile acid from obstructed rats. This was associated with increased microsomal 6 beta-hydroxylase activity. Bile acid composition and microsomal 6 beta-hydroxylase activity changed little in CC fistula rats. Morphological examination revealed greater damage in obstructed rat livers. These data indicate that factors other than simple retention of biliary constituents contribute to the abnormalities observed in extrahepatic biliary obstruction. PMID- 6840685 TI - Cholic acid amelioration of light and electron microscopic hepatic lesions in experimental protoporphyria. AB - We studied the effects of cholic acid treatment on hepatic histology and ultrastructure in mice with griseofulvin-induced protoporphyria. After 5 weeks of feeding griseofulvin alone, control mice developed darkly pigmented livers which by light microscopy showed birefringent, brown pigment deposits in bile ducts and ductules, sinusoidal Kupffer cell aggregates, and occasionally in hepatocytes and bile canaliculi. Electron microscopy demonstrated aggregated protoporphyrin crystals at these sites as well as membrane blebs and reduction of microvilli in bile canaliculi. In contrast, experimental mice that were concomitantly fed cholic acid and griseofulvin developed no detectable pigment on light microscopy, only rare protoporphyrin crystals on electron microscopy and minimal bile canalicular abnormalities. This study suggests that protoporphyrin transport into bile is enhanced by cholic acid treatment and results in a significant reduction in hepatic protoporphyrin deposition and associated abnormalities of liver morphology. PMID- 6840686 TI - Seroimmunologic classification of chronic hepatitis in 57 children. AB - A seroimmunologic evaluation of 57 children with chronic hepatitis is presented. Twenty-one patients had chronic persistent hepatitis and 36 had chronic active hepatitis. Serum samples obtained before treatment were tested for HBsAg, anti HBs, anti-HBc, smooth muscle antibody, and antibody to endoplasmic reticulum. A persistently positive HBsAg was observed in the serum of 18 of the 21 patients with chronic persistent hepatitis. The chronic active hepatitis group was divided into three subgroups according to the presence of hepatitis B-virus markers (7 patients), smooth muscle antibody (10 patients), and endoplasmic reticulum antibody (9 patients). Determination of these markers could be useful for classifying children with chronic hepatitis. PMID- 6840687 TI - Abnormal glucuronidation of zomepirac in patients with cirrhosis of the liver. AB - The disposition of zomepirac was investigated in 18 patients with various liver diseases and in 10 healthy normal subjects in order to further test the hypothesis that glucuronidation of drugs may be spared in liver disease. Severity of the liver disease was assessed by the galactose elimination capacity. Following oral administration of zomepirac (200 mg), plasma and urinary drug concentrations were measured by high-pressure liquid chromatography. Urine was assayed before and after alkaline hydrolysis. The apparent oral clearance of zomepirac was 3.7 +/- S.D. 1.2, 3.0 +/- 0.8, and 1.8 +/- 0.6 ml . min-1 . kg-1 in normal subjects, patients with mild liver disease, and cases with cirrhosis, respectively. In patients with liver disease, the reduction in zomepirac clearance was significantly correlated with the abnormalities in galactose elimination capacity (r = 0.83, n = 18), suggesting that the functioning liver cell mass was the major determinant of the rate of zomepirac disposition. These results are not consistent with the original hypothesis but suggest that--in contrast to ether-glucuronidation--ester-glucuronidation may be abnormal in liver disease. Dosage adjustments may, therefore, be necessary in patients with cirrhosis of the liver. PMID- 6840688 TI - Quantitation of hepatic granulomas and epithelioid cells in primary biliary cirrhosis. AB - The number of granulomas and loosely arranged epithelioid cell foci in wedge liver biopsy specimens of 39 patients with primary biliary cirrhosis were counted and correlated with other hepatic lesions. Granulomas and cell foci were present in 76.9 and 87.2% of the patients, respectively; their numbers varied greatly from case to case (mean +/- S.D.: 2.4 +/- 3.4 per cm2 and 4.7 +/- 5.5 per cm2 of liver section; range: 0 to 18.5 per cm2 and 0 to 23.3 per cm2, respectively) and decreased as bile duct loss progressed. There was positive correlation between the number of cell foci with the extent of florid duct lesions, and negative correlation with hepatic fibrosis and deposition of copper granules. PMID- 6840689 TI - Hepatitis B virus infection: the impact of molecular biology. AB - Assays for the detection of nucleic acid in serum are likely to be better systems for determining infectivity than indirect ones dependent on detection of virus encoded proteins such as HBeAg. The hybridization assays are particularly useful in monitoring spontaneous or treatment-related conversion from the "replicative" to "nonreplicative" phase of HBV infection. The simplified technology described in the papers reported in this issue of Hepatology (9, 14) and their future adaptation to nonisotopic systems will rapidly bring these techniques into everyday clinical practice. PMID- 6840690 TI - Renal prostaglandins in cirrhosis. PMID- 6840691 TI - Aminopyrine breath test. PMID- 6840692 TI - Noninvasive measurement of nutrient portal blood shunting. PMID- 6840693 TI - Propranolol in portal hypertension. PMID- 6840694 TI - Degradation of carboxanilide fungicides by a Nocardia species. PMID- 6840695 TI - [Primary structure of alpha and beta chains from the major hemoglobin component of the magpie goose (Anseranas semipalmata, Anatidae)]. AB - The amino acid sequence of the alpha and beta chains from the major hemoglobin component (HbA) of Australian Magpie Goose (Anseranas semipalmata) is given. The minor component with the alpha D chains was detected, but only found in low concentrations. By homologous comparison, Greylag Goose hemoglobin (Anser anser) and Australian Magpie Goose alpha chains differ by 13 amino acids or 17 nucleotide (4 two point mutations) exchanges, beta chains by 6 exchanges. Seven alpha 1 beta 1 contacts are modified by substitutions in positions alpha 30 (B11)Glu leads to Gln, alpha 34(B15)Thr leads to Gln, alpha 35(B16)-Ala leads to Thr, alpha 36(B17)Tyr leads to Phe, beta 55(D6)Leu leads to Ile, beta 119(GH2)Ala leads to Ser and beta 125(H3)Glu leads to Asp. Further, one alpha 1 beta 2 contact point was changed in beta 39(C5)Gln leads to Glu. Mutation in this position, except in two abnormal human hemoglobins, was not found in any species. Amino acid exchanges between hemoglobin of Australian Magpie Goose and other birds are discussed. PMID- 6840696 TI - Glycosaminoglycan synthesis by smooth muscle cells cultured in the absence and presence of ascorbic acid. PMID- 6840697 TI - Purification by salting-out chromatography and properties of phenylalanyl-tRNA synthetase from turkey liver. PMID- 6840698 TI - Affinity chromatography on immobilized fibrin monomer, IV. Two fibrin-binding peptides of a chymotryptic digest of human plasma fibronectin. PMID- 6840699 TI - Amino-acid sequence of two trypsin isoinhibitors, ITD I and ITD III from squash seeds (Cucurbita maxima). AB - The amino-acid sequences of two trypsin isoinhibitors, ITD I and ITD III, from squash seeds (Cucurbita maxima) were determined. Both isoinhibitors contain 29 amino-acid residues, including 6 half cystine residues. They differ only by one amino acid. Lysine in position 9 of ITD III is substituted by glutamic acid in ITD I. Arginine in position 5 is present at the reactive site of both isoinhibitors. The previously published sequence of ITD III has been shown to be incorrect. PMID- 6840700 TI - Interactions of purified human ceruloplasmin with Lathyrus odoratus, Lens culinaris and Canavalia ensiformis lectins. AB - Human ceruloplasmin was isolated from normal serum by fractional polyethylene glycol precipitation and subsequent ion exchange chromatography. The molecular mass determined by ultracentrifugation was 132 kDa and an optical density ratio (A610/A280) of 0.046 was observed in the preparation. Immunoelectrophoresis, agarose-gel electrophoresis and N-terminal amino-acid sequence analyses showed that the ceruloplasmin preparation was highly purified, while dodecyl sulphate polyacrylamide-gel electrophoresis indicated some degradation of the protein. Affinity chromatography showed that only a fraction of ceruloplasmin was bound to Lens culinaris or Lathyrus odoratus lectin-Sepharose, whereas nearly all the protein was bound to Canavalia ensiformis lectin-Sepharose. The carbohydrate composition of the ceruloplasmin fractions was analysed. It is suggested that fucose might be a determinant for the microheterogeneity in the carbohydrate chains of ceruloplasmin. PMID- 6840701 TI - [Primary structures of the alpha and beta chains from the major hemoglobin component of the ostrich (Struthio camelus) and American rhea (Rhea americana) (Struthioformes). Aspects of respiratory physiology and taxonomy]. AB - The primary structures of the alpha A- und beta-chains from the major hemoglobin component of the Ostrich (Struthio camelus) and American Rhea (Rhea americana) are given. The minor component with the alpha D-chains was detected in Ostrich in several concentrations, in American Rhea as in chicken and pheasant (about 40%). By homologous comparison, Greylag Goose (Anser anser) hemoglobin and Ostrich alpha A-chains differ by 15 amino acids or 16 nucleotide (1 two-point mutation) exchanges, beta-chains by 4 exchanges. Four substitutions modify alpha 1 beta 1 contacts and one phosphate contact. American Rhea and Greylag Goose hemoglobin alpha A-chains differ by 20 amino acids or 23 nucleotides (3 two-point mutations), beta-chains by 4 exchanges. Two substitutions modify alpha 1 beta 1 contacts, one phosphate contact and one heme contact. Oxygen affinity of three hemoglobin components of Ostrich are measured and the results are discussed. Systematic and evolution of Ostrich and American Rhea are discussed. PMID- 6840702 TI - Effect of alterations in vitro and in vivo of the cholesterol content in rat liver microsomes on the activity of 3-hydroxy-3-methylglutaryl-CoA reductase. AB - 3-Hydroxy-3-methylglutaryl-CoA reductase, the regulatory enzyme of cholesterol synthesis in liver, is bound to the microsomal fraction. Lipoprotein-bound cholesterol (from human serum) in vitro inhibits the microsomal bound 3-hydroxy-3 methylglutaryl-CoA reductase. The solubilized enzyme, however, is not inhibited. Immunotitration of the microsomal enzyme with a monospecific antibody reveals that the loss in enzyme activity caused by cholesterol corresponds well with the lowering of the equivalence points. In contrast, the equivalence points of the solubilized enzyme remain unchanged. This indicates that the inhibitory effect of cholesterol is restricted to the microsomal bound enzyme. In vivo different physiological conditions lead to relatively small changes in the cholesterol content in the microsomes while drastic changes in the activity of 3-hydroxy-3 methylglutaryl-CoA reductase are observed. When microsomes from these rats are incubated with exogenous cholesterol, the activity of the enzyme is always found to be decreased to the same extent independent of the physiological condition of the animals. The findings suggest that 3-hydroxy-3-methylglutaryl-CoA reductase may be "masked" by a cholesterol-mediated modification of the microsomal membrane. PMID- 6840703 TI - [Syntheses of human little gastrin-I and its leucine-15, norleucine-15 and methoxinine-15 analogs]. AB - Human little gastrin-I is known to exhibit a high tendency to air-oxidation of its methionine-15 residue to the corresponding S-oxide derivative, with concomitant loss of biological activity. Since its leucine-15 analog, even if fully biologically active, differs significantly from the parent hormone in the immunological properties, the norleucine-15 and methoxinine-15 analogues were synthetized. For the required comparative analyses new syntheses of human little gastrin-I and of its leucine-15 analog were additionally elaborated. Upon an optimized condensation of the fragments, followed by the deprotection step, partition chromatography as well as preparative high-performance liquid chromatography led to the desired gastrins in satisfactory yields and high degree of purity as judged by the expected and known side products. PMID- 6840704 TI - Influence of fatty acids on microsomal diacylglycerol acyltransferase activity in primary cultures of hepatocytes. AB - The regulation of triacylglycerol synthesis by various long-chain fatty acids was studied using primary cultures of hepatocytes. The activity of diacylglycerol acyltransferase was measured after 72-h incubation with various fatty acids in equimolar concentrations (0.5 mM): oleate, linoleate, linolenate, palmitate, stearate and arachidonate increased enzyme activity to 191%, 161%, 148%, 124%, 116% and 114%, respectively, compared to controls. Cellular triacylglycerol levels showed the same changes, suggesting a regulatory function of diacylglycerol acyltransferase in triacylglycerol synthesis. Elaidate lowered the enzyme activity by 57%. The addition of different fatty acids to the incubation medium did not influence the distribution of enzyme activity in the 30 000 x g pellet which was routinely discarded and the microsomal fraction (105 000 x g), where the enzyme was predominantly localized (91%). The release of lactate dehydrogenase into the culture medium of hepatocyte monolayers as well as ketone body production was not affected by any of the fatty acids. PMID- 6840705 TI - Primary malignant mesenchymal tumour of the liver in an elderly female. AB - A case of primary malignant mesenchymal tumour of the liver occurring in an 86 year-old woman is described. This very uncommon tumour has previously only been described in children and young adults, the previous oldest being 28 years of age. The tumour was large, rapidly growing though well circumscribed and extensively necrotic. Microscopically it was mostly composed of spindle cell sarcoma without differentiating features. Epithelial lined ductules were seen throughout the tumour and degenerate hepatocytes were enveloped in the tumour peripherally. Intracytoplasmic and extracellular PAS-positive, diastase-resistant bodies were present, some showing positive staining for alpha-I-antitrypsin. The tumour is compared with previous reports and its differential diagnosis and nomenclature discussed. PMID- 6840706 TI - An unusual variant of squamous cell carcinoma (inverted verrucous carcinoma) arising in a pilonidal sinus. PMID- 6840707 TI - Malakoplakia of middle ear: a case report. PMID- 6840709 TI - The pathogenicity of intestinal spirochaetosis. PMID- 6840708 TI - Circulating megakaryocytes. PMID- 6840710 TI - Biopsy appearances easily mistaken for malignancy in gastrointestinal endoscopy. PMID- 6840711 TI - Carcinoid tumour of the breast. PMID- 6840712 TI - The endoscopically abnormal duodenum in patients with dyspepsia: biopsy findings in 60 cases. AB - Biopsies from 60 patients with dyspepsia and endoscopically abnormal first part of duodenum were examined. The main endoscopic findings were duodenitis (35 cases), chronic ulceration (eight) and abnormal mucosal patterns (17). The latter included mucosal atrophy, thickening, irregularity, nodularity and polypoid formation. The main histological findings were duodenitis (40), gastric metaplasia (42) and gastric heterotopia (seven). The first two were commonly seen together. Heterotopia was not associated with inflammation. Good correlation existed between endoscopic and histological findings. PMID- 6840713 TI - Sinus histiocytosis with massive lymphadenopathy in Rwanda: report of eight cases with immunohistochemical and ultrastructural studies. AB - The clinico-pathological, immunohistochemical and ultrastructural features of eight cases of sinus histiocytosis with massive lymphadenopathy (SHML) recorded in Rwanda from 1975 to 1980 are reported. The main histopathological features were a massive enlargement of the lymph node sinuses which were filled with large histiocytes, a great number of which phagocytosed blood cells, especially lymphocytes, and an important proliferation of plasma cells in the medullary cords. The pathogenesis of this syndrome is discussed, particularly the role of immunological disorders challenged by a chronic, but non-specific, infectious state. The ultrastructural study revealed no micro-organisms and no Langerhans' granules. Immunohistochemical staining revealed two interesting features: the presence of immunoglobulins in the cytoplasm of the histiocytes indicating the presence of an immune phagocytosis and the absence of lysozyme and alpha 1 antichymotrypsin (alpha 1-AC) from the histiocytes. The significance of the latter phenomenon is still unknown. PMID- 6840714 TI - A scanning and transmission electron microscopic study of human nodular goitre. PMID- 6840715 TI - Glandular (tubular and follicular) variants of medullary carcinoma of the thyroid. AB - The original descriptions of medullary carcinoma stressed the lack of papillary and follicular differentiation and the presence of amyloid. During the last few years, the spectrum of histological features seen in tumours of C cell origin has broadened, and papillary and anaplastic forms have been reported. We have recently studied three cases of medullary carcinoma with a major 'tubular' or 'follicular' component, giving a microscopic picture suggestive of follicular carcinoma of the thyroid. These cases were studied with routine techniques, electron microscopy, and immunohistological methods using antibodies to calcitonin and thyroglobulin. In all three cases the calcitonin localization was positive, and apart from included peripheral thyroid follicles, the thyroglobulin was negative--even in the tumour with large follicles containing PAS positive colloid. In the cases with tubular lumina, electron microscopy showed a concentration of granules in the apical portion of the cells, with corresponding immunolocalization of calcitonin in a ring about the lumen. We conclude that medullary carcinoma should be considered in the differential diagnosis of every unusual thyroid carcinoma, even those showing glandular differentiation and containing apparent follicles, and that immunolocalization techniques using calcitonin and thyroglobulin are essential for accurate diagnosis of thyroid carcinomas. PMID- 6840716 TI - Angiomyelolipoma of the liver. PMID- 6840717 TI - Autistic thinking about schizophrenia. PMID- 6840718 TI - Patient's dramatic mood swings present challenge for therapist. PMID- 6840719 TI - Schizophrenia: a review of diagnostic and biological issues. I. Diagnosis and prognosis. AB - Schizophrenia, a term that encompasses a diverse and seemingly unrelated class of psychopathologic conditions, has been the object of extensive research. This two part paper reviews developments in specific areas of schizophrenia research. In Part I the authors discuss research into diagnosis and prognosis. They outline the studies that have been done on the major diagnostic systems including the first-rank symptoms, the flexible system, the New Haven Schizophrenia Index, the Feighner criteria, the Research Diagnostic Criteria, and the Diagnostic and Statistical Manual of Mental Disorders, third edition. They also report on the studies that have compared the utility and reliability of these diagnostic approaches. In Part II, to be published in the May issue, the authors cover the neuropathological studies of the disorder, the genetic research, and the various biological hypotheses of the etiology of schizophrenia. PMID- 6840720 TI - Distinguishing bipolar disorder from schizophrenia in clinical practice: guidelines and case reports. AB - Through the use of more refined diagnostic criteria and biological tests, researchers are finding that affective illness afflicts far more patients and schizophrenia far fewer patients than was formerly believed. The presence of putative "schizophrenic" symptoms is no longer held to be valuable in distinguishing between manic-depressive illness and schizophrenia. The author briefly reviews studies dealing with manic-depressive and schizophrenic symptomatology as well as tentative evidence from treatment-response studies and laboratory studies. Three case reports illustrate the tragedy of misdiagnosis. PMID- 6840721 TI - A brief review of organic diseases masquerading as functional illness. AB - A wide variety of physical diseases masquerade as psychiatric disorders. Clinicians may be distracted by a patient's chief complaint of anxiety, depression, or personality change and fail to pursue the possibility of organic disease. The author provides a brief review of physical diseases that produce psychiatric symptoms. He stresses the danger of misdiagnosis and urges clinicians to remain alert to etiological clues during examination, especially when treating patients who have a history of depression, neurotic reactions, or psychosis. PMID- 6840722 TI - Recent developments in the care, treatment, and rehabilitation of the chronic mentally ill in Norway. AB - As in most other Western nations, the ideology shaping mental health care in Norway has shifted since World War II from a traditional institutional approach to a community-based concept of treatment for the chronic patient. And as in many other countries, communities have been poorly equipped to deal with the influx of deinstitutionalized patients. Few appropriate community alternatives have been developed to care for hospitalized patients, many of whom must remain institutionalized. The author reports on a 1979 census of Norway's mental patients which showed that about half of the mental hospital patients could be expected to remain in the hospital because adequate community facilities did not exist. However, the author says, there is a new interest in Norway in reducing the number of hospital beds and transferring more patients to community programs; one large mental hospital has recently been closed. Legislation focusing on patients' rights and new research on "quality of life" of patients are also pushing mental health care into the community, he says. PMID- 6840724 TI - A study of employees in transition from hospital to community programs. PMID- 6840723 TI - Confidentiality in psychiatry: a study of the patient's view. AB - The views of patients on the degree of confidentiality that is necessary for effective psychiatric care have not been empirically investigated, despite their potential importance to the debate. This study examines the views of 30 psychiatric inpatients on issues related to confidentiality. Patients were found to value confidentiality highly and to be concerned about the possibility of unauthorized disclosures but to have little knowledge of their legal rights or recourses should breaches of confidentiality occur. The data support contentions about the importance of confidentiality and suggest the need for further patient education. PMID- 6840725 TI - Getting alcoholics to treatment by social network intervention. PMID- 6840726 TI - Modifying psychotherapeutic techniques to meet the needs of chronic schizophrenics. PMID- 6840727 TI - Outlaws, bandits, and renegades: treatment of alcoholics and drug addicts. PMID- 6840728 TI - Decline reported in staffing, use of VA day programs. PMID- 6840729 TI - Congress eyes health insurance for jobless. PMID- 6840730 TI - Hospital installs dial-an-x ray system. PMID- 6840731 TI - Rehabilitation pavilion features 'open plan' therapy gym. PMID- 6840732 TI - Competition spurs ambulatory choice. PMID- 6840733 TI - The ambulatory response. PMID- 6840734 TI - Mono's mountain medicine. PMID- 6840735 TI - Active and passive liability. PMID- 6840736 TI - Marketing and materials management mix. PMID- 6840737 TI - Wellness messages are payday bonus for many employees in Akron area. PMID- 6840738 TI - Help wanted: engineer. PMID- 6840739 TI - Is malpractice suit's harm to defendants overstated? PMID- 6840740 TI - A portfolio of progress. PMID- 6840741 TI - Civilian-military partners. PMID- 6840742 TI - Mortality patterns in anthropological populations. PMID- 6840743 TI - The relationship of nutritional status to oxygen transport and growth in highland Bolivian children. PMID- 6840744 TI - Dermatoglyphic affinities of the Lithuanians. PMID- 6840745 TI - Does anemia in infancy affect achievement on developmental and intelligence tests? PMID- 6840746 TI - Pre-reproductive mortality and family structure: Sanday, Orkney Islands 1855 1974. PMID- 6840747 TI - A comparison of mortality patterns in human populations residing under diverse ecological conditions: a time series analysis. PMID- 6840748 TI - Estimating vital rates for incomplete pedigrees. PMID- 6840749 TI - Skeletal age at death: accuracy of determination and implications for human demography. PMID- 6840750 TI - Mortality changes in the Hutterite Brethren of Alberta and Saskatchewan, Canada. PMID- 6840751 TI - Clinical and biologic significance of antibodies to Ro/SSA. AB - Study of the clinical associations of antibodies to the soluble antigens Ro/SSA and La/SSB leads to several conclusions. Production of such antibodies are linked to the D locus antigens DR2 and DR3, suggesting involvement of disease susceptibility or immune response genes in the regulation of their synthesis. Genetics therefore provides one of the factors that contribute to the disease expression and the clinical heterogeneity that characterize systemic lupus erythematosus (SLE). The uniform presence of anti-Ro/SSA in neonatal lupus and the almost uniform presence of these antibodies in the vasculitis of Sjogren's syndrome suggest the participation of these antibodies in the immunopathogenesis of these particular clinical manifestations. Finally, identification of the molecular nature of these antigens as RNA-protein conjugates and the ability of the antibodies to La/SSB to bind viral-specific RNA-protein conjugates provide clues that may lead to elucidation of etiologic events in the development of SLE. PMID- 6840752 TI - Immunology of myasthenia gravis. AB - Anti-acetylcholine-receptor antibody is demonstrable in more than 90 per cent of patients with myasthenia gravis. Serum antibody titers do not show a direct correlation with disease severity, although in certain patients antibody levels increase in association with disease activity. Impairment of neuromuscular transmission results from the loss of junctional receptors, either as a result of receptor internalization or destruction of junctional folds containing the acetylcholine receptor. Myasthenia gravis manifests immunologic, genetic, and clinical similarities to rheumatic syndromes, suggesting a generic immune dysfunction common to these disorders. PMID- 6840753 TI - Liver disease in alcoholic cardiomyopathy: evidence against cirrhosis. AB - The authors examined in detail the clinical and laboratory data and pathologic findings for 12 patients with alcoholic cardiomyopathy who were autopsied in the preceding ten years to determine the types of liver disease prevalent in this population. Neither alcoholic hepatitis nor cirrhosis was present in any patient, and most of the hepatic changes could be related to the effects of acute and chronic congestive heart failure. The major hepatic lesions included centrilobular congestion and/or ischemic necrosis, cardiac sclerosis (fibrosis about central veins and in perisinusoidal spaces), mild canalicular cholestasis, portal fibrosis, and nodular regenerative hyperplasia. This last finding may account for macroscopic nodularity resembling cirrhosis as well as portal hypertension in patients with alcoholic cardiomyopathy. Although alcoholic cardiomyopathy and alcoholic hepatitis or cirrhosis were mutually exclusive in the patients studied, the factors responsible for this are at present uncertain. PMID- 6840754 TI - Serotonin-immunoreactive cells in the lamina propria plexus of the appendix. AB - The lamina propria of the human appendix possesses a recently defined ganglionated neural plexus with neurosecretory-type component cells. In order to elucidate the functional role of this plexus, immunohistochemical light and electron microscopic studies were performed on 21 appendixes. By light microscopy, 18 specimens showed within the lamina propria neuron-like and neurosecretory-type cells that stained positively with lead hematoxylin and were positive for serotonin. The number of these cells varied from specimen to specimen. No correlation between the number of serotonin-immunoreactive intraepithelial enterochromaffin cells and the number of plexus cells could be established. Electron microscopic examination revealed identical pleomorphic neurosecretory granules within enterochromaffin cells and plexus cells. The site of serotonin storage in these granules was revealed by electron immunocytochemical methods. It is suggested that, under physiologic conditions, the lamina propria plexus has a modulatory role between the epithelium and the deeper mural enteric nervous system mediated by serotonin neurotransmission. Uncontrolled release of serotonin by the plexus may initiate inflammation and elicit pain related to the appendix. PMID- 6840755 TI - Failure of diepoxybutane to enhance sister chromatid exchange levels in Fanconi's anemia patients and heterozygotes. AB - Peripheral lymphocytes of three Fanconi's anemia (FA) patients and of five heterozygotes have been tested for their susceptibility to chromosomal breakage and sister chromatid exchange (SCE) induction by diepoxybutane (DEB). As previously shown, DEB dramatically increases the chromosomal breakage level in both homozygotes and heterozygotes. Slightly, but significantly, reduced spontaneous levels of SCE were found in cultures from FA patients and FA gene carriers as compared with controls. SCE rates were not enhanced in lymphocytes grown in the presence of DEB, irrespective of the time at which it had been added to the culture, and were comparable in cells of FA patients and FA heterozygotes. This was in contrast with SCE rates in control cells, which showed increases positively related to the length of DEB treatment. PMID- 6840756 TI - Basic defect in the expression of adenosine deaminase in ADA-SCID disease. II. Deficiency of ADA-CRM detected in heterozygote human-Chinese hamster cell hybrids. AB - A specific competitive radioimmunoassay (RIA) was employed to quantify human adenosine deaminase molecules produced in human-Chinese hamster somatic cell hybrids. Studies on a set of hybrids in which the normal and aberrant expressions of adenosine deaminase (assigned earlier to human chromosome 20) were segregating, have demonstrated that in the patient with ADA-SCID disease reported by Herbschleb-Voogt et al. (1981 a), the deficiency of ADA activity was associated with a comparable deficiency of adenosine deaminase specific immuno crossreacting material (ADA-CRM). PMID- 6840757 TI - Genetic linkage relations of the human plasminogen gene. AB - No evidence for close linkage was found between the human plasminogen (PLGN) locus and 35 other marker genes using the LIPED 3 computer program of Ott (1974). Although positive lod scores were found for PLGN-GC relations in females, the lack of linkage between the two loci in males demands that the reported assignment of the PLGN locus to chromosome 4 (Eiberg et al. 1981) should be considered with reservations. PMID- 6840758 TI - A cytogenetic study of a population of mentally retarded males with special reference to the marker (X) syndrome. AB - A cytogenetic survey of a population of 274 mentally retarded males on community placement is described. Thirty-five had an aneuploid chromosome constitution and five had the mar(X) syndrome. The range of clinical variation among the mar(X) probands and their affected relatives is described. Family studies were possible for four of the five mar(X) probands and in two families the mar(X) gene was apparently transmitted through a clinically normal male, suggesting that this type of male transmission may be a not uncommon phenomenon. PMID- 6840759 TI - The effect of chromosome constitution on growth in culture of human spontaneous abortions. AB - The effect of chromosome constitution on growth in culture was evaluated by comparing the length of time in culture until cytogenetic analysis among chromosomally normal and abnormal spontaneous abortions. We observed a significant effect of both tissue type and cell type, but not chromosome constitution, on the rate of growth of the cultures. PMID- 6840760 TI - Types and subtypes of haptoglobin in the Chinese population. AB - Haptoglobin phenotypes of 1121 unrelated Chinese blood donors in Beijing were determined. The gene frequency of Hp1 was 0.270. A rare variant, which we identified as Hp1S-J, was found. Two hundred and two samples of this population were submitted to haptoglobin subtyping, and no Hp1F allele was found among them. PMID- 6840761 TI - Langer-Giedion syndrome, in a child with complex structural aberration of chromosome 8. AB - A patient with typical features of the Langer-Giedion syndrome (tricho-rhino phalangeal syndrome, type II) is described. In the karyotype an interstitial deletion of the long arm of chromosome 8 (band 8q22) was observed as the result of a complex rearrangement of chromosomes 1 and 8: 46,XY inv(8)(q23 leads to q242), del(8)(q221 leads to q223), ins(8;1) (q221;p321 p341;q242). Previously reported cases of Langer-Giedion syndrome with deletion of 8q are compared with the present one. PMID- 6840762 TI - Heterochromatic regions on chromosomes 1, 9, 16, and Y in children with some disturbances occurring during embryo development. AB - Some reduction of C-segment lengths and their variability on chromosomes 1, 9, 16, and Y was exhibited by children who had had some disturbances at early stages of morphogenesis. The data obtained might suggest a certain activity of the heterochromatic regions during embryo development. Based on this data one may also suppose that reduction of the amount of heterochromatin might affect the normal morphogenetic processes. PMID- 6840763 TI - Effect of temperature variation on sister chromatid exchange frequency in cultured human lymphocytes. AB - The effect of temperature variation on sister chromatid exchange (SCE) frequencies in human lymphocytes was studied. An increase as well as decrease in incubation temperature of cells leads to a higher frequency of sister chromatid exchanges than in cultures grown at 37 degrees C. In addition, it was observed that mitotic index and cell cycle duration were affected by low temperature. PMID- 6840765 TI - Familial Robertsonian translocation t13q/15q. PMID- 6840764 TI - Incidence of chromosomal aberrations in patients under combined tuberculostatic chemotherapy. AB - Chromosome studies were carried out on the peripheral blood lymphocytes of ten tuberculosis (tb) patients receiving combined tuberculostatic chemotherapy for long intervals (3-10 months) and on those of two control groups, one of ten healthy subjects and the second of ten other tb patients in whom the tuberculostatic treatment had been discontinued 10-19 months previously. An increased proportion of aberrations, particularly chromosomal breaks and achromatic gaps, were observed in the patients under treatment, suggesting a possible synergic interaction of INH and RMA in the production of chromosomal damage. PMID- 6840766 TI - Evaluation of 20 workload measures using a psychomotor task in a moving-base aircraft simulator. PMID- 6840767 TI - Driver steering reaction time to abrupt-onset crosswinds, as measured in a moving base driving simulator. PMID- 6840768 TI - Sign registration in daytime and nighttime driving. PMID- 6840769 TI - Capacity demands in short-term memory for synthetic and natural speech. PMID- 6840770 TI - Maximum acceptable weight of lift as a function of material density, center of gravity location, hand preference, and frequency. PMID- 6840771 TI - Energy expenditure and aerobic fitness of male low seam coal miners. PMID- 6840772 TI - An evaluation of "talking signs" for the blind. PMID- 6840773 TI - Whole-body vibration and International Standard ISO 2631: a critique. PMID- 6840774 TI - The dark focus of the human eye and its relationship to age and visual defect. PMID- 6840775 TI - A descriptive model of visual search. PMID- 6840776 TI - An exact statistical test for the ABO system. AB - An exact test is proposed for the hypothesis stating that the ABO blood group distribution follows the Hardy-Weinberg law. The test is based on the conditional distribution of the observed phenotypic frequencies, given the estimated gene frequencies. For sample sizes of 20 or less, the exact test can be carried out with the aid of a table that lists the significant outcomes. PMID- 6840777 TI - The inter- and intra-tribal distribution of red cell G6PD phenotypes in Sudan. AB - 1,416 males and 564 female subjects from four Negroid and five Arab tribes and a group of mixed tribes of the Sudan were investigated for the phenotypic distribution of red cell glucose-6-phosphate dehydrogenase by starch gel electrophoresis. In general, the tribes of Negroid origin had higher frequency of GdA compared to the tribes of Arab ancestry. However, the Nilotes showed a lower frequency of GdA allele and the Mahass tribe claiming an Arab origin had a higher frequency of GdA. The immigrant groups from the neighbouring African countries also had a higher frequency of GdA. GdB (Khartoum) was present in low frequencies in both the Arab and Negroid tribes. A great deal of intratribal variation in the phenotypic distribution of G6PD was observed in the Nuba and Gaali tribes from different localities. PMID- 6840778 TI - Blood groups, haptoglobins and red cell isoenzymes of the Jat Sikhs of Ludhiana District, Panjab, India. AB - Blood samples from 156 Jat Sikhs were examined for the ABO, MNS, Rhesus, Duffy and Kell blood groups. Serum and lysate samples were prepared and electrophoretically tested for haptoglobin, esterase D, adenylate kinase, phosphoglucomutase and the acid phosphatase systems. Comparisons were made with other populations of the Indian sub-continent and of contiguous regions. PMID- 6840779 TI - Gc subtypes in Icelanders. AB - Isoelectric focusing was used to determine the frequencies of Gc subtypes in Icelanders. The gene frequencies observed were Gc1F = 0.107, Gc1S = 0.631 and Gc2 = 0.262. An Icelandic Gc variant allele (Gc Iceland) is shown to have a different isoelectric point from the variant allele Gc-Norway. Gc-Iceland has been detected in 3 unrelated individuals giving the allelic frequency of 0.004 in the Icelandic population. Studies of 65 mother-child pairs confirm the assumed three-allelic mode of inheritance. PMID- 6840780 TI - Comparative study of phenotypes on activity and plasma concentration in the genetic system of plasminogen. AB - Plasma antigen concentration of plasminogen was approximately 11-13 mg/100 ml in all phenotypes. Specific activities of common PLG 1-1 and second common PLG 2-1 were 16.52 +/- 1.43 U/mg (caseinolytic activity/milligram antigen concentration, mean +/- SD) and 17.22 +/- 2.14 U/mg, respectively. Caseinolytic activity, antigen concentration and specific activity of PLG 1-B were 0.80 +/- 0.23 U/ml, 11.39 +/- 2.44 mg/100 ml and 6.95 +/- 0.96 U/mg. Plasma plasminogen levels of three rare phenotypes (PLG 3-1, PLG 1-C and PLG 1-M) were at least in the normal ranges by immunological and biological assay. PMID- 6840781 TI - A higher incidence of congenital structural talipes equinovarus in gypsies. PMID- 6840782 TI - Digital dermatoglyphics of Koyas: a population study. PMID- 6840783 TI - Polymorphism of delta-aminolevulinic acid dehydratase in various populations. PMID- 6840784 TI - Glucose tolerance in patients with cerebrovascular accidents and their blood relatives. AB - The present study was undertaken to examine whether there is any hereditary correlation, with reference to the abnormal glucose metabolism, between patients with cerebrovascular accidents and their healthy blood relatives in respect to the occurrence of cerebrovascular disease. The investigation was carried out by intravenous glucose tolerance test (IV-GTT) and prednisolone-primed glucose tolerance test (PP-GTT) in 83 subjects. Of these, 20 were healthy (control) persons (group A), matched in age and sex with 50 patients with cerebrovascular accidents (group B) and 13 family relatives of group B (group C) showing unequivocal GTT or PP-GTT. In controls, the IV-GTT criterion, i.e. k value, was found generally to be 2.82 +/- 0.43 and in persons less than 50 and over 50 years old, it was found to be related with age, i.e. 3.1 +/- 0.73 and 2.53 +/- 0.43, respectively. The 21 patients of group B with normal GTT response had a k value of 2.53 +/- 1.88 and the 29 patients with abnormal GTT response had a k value of 1.2 +/- 0.33. Among the 21 patients of group B, 11 had normal IV-GTT and their PP GTT was found to be 125 +/- 12.5 mg%. The other 10 patients with abnormal IV-GTT exhibited a PP-GTT of 173.4 +/- 26.43 mg%. In 14 and 15 patients, the time-lapse difference of 7 and 8-21 days after stroke showed an abnormal GTT response and in 6 and 15 patients it showed a normal response. Among 13 healthy relatives of group B (group C), only 1 subject was found to have abnormal IV-GTT (k value of 1.386) and 2 were found to have abnormal PP-GTT (182.8 and 388.0 mg%), thus indicating pre-symptomatic diabetics. PMID- 6840785 TI - Is there a positive assortative mating for the P blood group? AB - A sample of 350 families from paternity cases, analyzed for the P blood group system, was studied in order to confirm a previously found tendency to positive assortative mating. No significant deviations from random mating were found. However, when combined with materials from previously published reports, a significant deviation in favour of matings between likes was obtained. PMID- 6840786 TI - Pattern of uptake of americium-241 by the rat skeleton and its subsequent redistribution and retention: implications for human dosimetry and toxicology. AB - The distribution and retention of intravenously injected 241Am in the skeleton of the female rat has been investigated using autoradiographic and radiochemical techniques. The studies were designed to assess the dosimetric and toxicologic implications of an 241Am intake by man. They showed that in the rat approximately one third of the intravenously injected 241Am was deposited in the skeleton where it appeared to be retained with a long biological half-time. The studies also showed: 1 241Am is initially deposited onto all types of bone surface including endosteal surfaces, periosteal surfaces and those of the vascular canals within cortical bone, but seems to be preferentially deposited onto those that are resorbing, 2 Bone accretion results in the burial of surface deposits of 241Am, 3 Bone resorption causes the removal of 241Am from surfaces, 4 Resorbed 241Am is retained by phagocytic cells (probably macrophages) in the bone marrow, 5 The transfer of 241Am from the phagocytic cells in the marrow to adjacent bone surfaces seems to occur, (local recycling). 6 The possibility that some of the 241Am removed from the bone surfaces enters the blood and is redeposited in bone, (systemic recycling) cannot be dismissed. These results show that 241Am deposition and redistribution in bone shares many characteristics with other 'bone surface-seeking radionuclides' typified by 239Pu. Consequently, it is suggested that a similar model to that used to calculate annual limits of intake for 239Pu in man would be suitable for the calculation of corresponding values for the 241Am isotopes. PMID- 6840787 TI - Chronic arsenic poisoning in the north of Mexico. AB - 1 We compared the prevalence of signs and symptoms of chronic arsenic poisoning in two rural populations. 2 The arsenic concentration in the drinking water of the exposed population was 0.41 mg/l, and 0.007 mg/l in the control population. 3 The arsenic was present mainly (70%) in its pentavalent form. 4 The objective was to quantitate health effects and risks derived from chronic ingestion of arsenic in contaminated water. 5 In the exposed population, 21.6% of the sample, showed at least one of the cutaneous signs of chronic arsenic poisoning against 2.2% in the control town. 6 Non-specific symptoms were more prevalent in the exposed population and they occurred more frequently in those individuals with skin signs. 7 The relative risk of suffering a particular manifestation of poisoning, ranged from 1.9 to 36 times higher in the exposed population. 8 We estimated the risks above mentioned, which were derived from exposure to minute quantities of arsenic in a known proportion of its oxidation states during a life time period. PMID- 6840788 TI - Therapeutic, toxic and fatal blood concentration ranges of antiepileptic drugs as an aid to the interpretation of analytical data. AB - 1 Problems associated with the interpretation of analytical results are often related to the ineffective presentation of reference information. Concentration response curves overcome many of the problems by presenting all available information concisely and by allowing clear comparisons between drug concentrations associated with different pharmacological responses. Although visual comparison of such curves is possible, it can be advantageous to represent them numerically. 2 Numerical representations are used in the present work to compare sub-therapeutic, optimally therapeutic, toxic (side-effects and severe effects), and fatal blood concentrations of the commonly prescribed antiepileptic drugs. 3 Blood drug concentrations accounting for 50% of the population (EC50) are expressed in relation to the concentrations accounting for 10% (EC10) and 90% (EC90) of the population in each clinical category. 4 Such EC10-EC50-EC90 ranges are shown to represent adequately the concentration-response curves. They demonstrate the overlap between drug blood concentrations associated with the various responses and give a good indication of the expected response at any concentration. The concentration ranges are therefore a very useful interpretative aid in therapeutic drug monitoring, emergency toxicology, and forensic toxicology. PMID- 6840789 TI - Antithyroid effect of chlorpropamide? AB - 1 The relationship between plasma chlorpropamide concentration and thyroid function was examined in 87 maturity onset diabetic patients receiving chronic therapy. 2 Although plasma chlorpropamide concentration was weakly negatively correlated with serum thyroxine (r = 0.33, P less than 0.01) the mean serum thyroxine and thyrotrophin (TSH) were not different from that of a matched control group of diabetics treated with diet alone. 3 Serum thyroxine was negatively correlated with the duration of diabetes in both groups. 4 These results suggest that chlorpropamide does not have a clinically significant antithyroid effect. PMID- 6840790 TI - Effect of calorie restriction on the fate of hyperplastic liver nodules induced by concurrent administration of lasiocarpine and thioacetamide. AB - 1 Hyperplastic liver nodules were induced in F-344 rats by concurrent administration of lasiocarpine (50 ppm in diet) and thioacetamide (50 mg/kg body weight twice weekly) for 15 weeks. 2 The effect of carbohydrate calorie and total calorie restriction on the fate of hyperplastic liver nodules was examined. 3 The incidence of hepatocellular carcinoma was the same in all groups of rats irrespective of the magnitude of carbohydrate calorie restriction and 50% total calorie restriction. 4 These studies demonstrate that carbohydrate or total calorie restriction has no effect on the progression of hyperplastic nodules to hepatocellular carcinoma. PMID- 6840791 TI - Effect of ethanol in fatal carbon monoxide poisonings. PMID- 6840792 TI - Evaluation of selected hypolipidemic agents for the induction of peroxisomal enzymes and peroxisome proliferation in the rat liver. AB - There is a considerable interest in developing potent and safe hypolipidemic drugs for the prevention and management of coronary heart disease in man. In rodents, many of these hypolipidemic compounds induce hepatomegaly, proliferation of peroxisomes and a polypeptide with an approximate mol. wt. of 80000 in liver cells. In the present study, we have examined 10 hypolipidemic compounds for the induction of peroxisome proliferation associated 80000 mol. wt. polypeptide (polypeptide PPA-80), peroxisomal enzymes and peroxisome proliferation in rat liver, in view of the emerging evidence that hepatic peroxisome proliferators as a class are carcinogenic in rats and mice. All ten compounds, fenofibrate (isopropyl-[4-(p-chlorobenzoyl)2-phenoxy-2-methyl] propionate; LS 2265 (taurine derivative of fenofibrate); bezafibrate (2-(4-(2-[4-chlorobenzamido)ethyl] phenoxy)-methyl propionic acid; gemfibrozil (5-2[2,5-dimethylphenoxy]2-2 dimethylpentanoic acid); methyl clofenapate (methyl-2-[4-(p-chlorophenyl)phenoxy] 2-methyl propionate); DG 5685 (5-[4-phenoxybenzyl]trans-2-(3-pyridyl)1,3 dioxane); DH 6463 (5-[4-phenoxybenzyl] trans-2-(3-pyrimidinyl)-1,3-dioxane); tiadenol(bis[hydroxyethylthio]-7, 10-decane); ciprofibrate (2,-[4-(2,2 dichlorocyclopropyl)-phenoxy]2-methyl propionic acid) and RMI-14,514 ( [5 tetradecycloxy]-2-furancarboxylic acid), produced a marked but variable increase in the activities of peroxisomal enzymes catalase, carnitine acetyltransferase, heat-labile enoyl-CoA hydratase and the fatty acid beta-oxidation system and in the amount of polypeptide PPA-80 as demonstrated by SDS-polyacrylamide gel electrophoresis. The peptide map patterns of polypeptide PPA-80 in liver induced by these compounds were strikingly similar. The ultrastructural studies demonstrate that fenofibrate, ciprofibrate, LS 2265, DG 5685 and DH 6463 can induce proliferation of peroxisomes in liver cells of rats, and further confirm the previous reports of hepatic peroxisome proliferative activity of methyl clofenapate, tiadenol, bezafibrate, gemfibrozil and RMI-14514, as shown morphologically. Whether these structurally unrelated chemicals or their metabolite(s) directly activate the peroxisome specific genes to induce this multi-enzyme system or they exert their action on peroxisomes indirectly by causing fatty acid overload in hepatocytes remains to be elucidated. These chemicals offer a simple and reproducible means of stimulating peroxisomal enzymes in liver and should serve as useful tools, for evaluating the implications of hepatic peroxisome proliferation and in elucidating the mechanism of peroxisome proliferator-induced carcinogenesis. PMID- 6840793 TI - Quantification of the interaction between barbiturates and alcohol and interpretation of fatal blood concentrations. AB - Barbiturates and alcohol are frequently found in combination in cases of accidental or intentional fatal self-poisoning. Unfortunately, the lack of any precise knowledge concerning their interaction creates difficult problems when an interpretation of toxicological data is sought. 1 In the following work the joint action of single barbiturates and alcohol is examined and a means of quantifying it is presented. 2 The effects of different amounts of alcohol on fatal amylobarbitone, butobarbitone, pentobarbitone, phenobarbitone and quinalbarbitone blood concentrations are compared. 3 Combined alcohol-barbiturate blood concentration curves connecting those concentration pairs equally effective in causing death are used to quantify the increase in toxicity. The quantitative effects of alcohol appear to be greater with the shorter- and longer-acting barbiturates than with the intermediate-acting derivatives. The different modes of interaction are discussed in terms of the physico-chemical and pharmacokinetic properties of the drugs. PMID- 6840794 TI - Maternal anti-nauseants and clefts of lip and palate. AB - 1 Data on drug prescriptions were obtained from the general practitioners of 196 women who had had infants with clefts of lip or palate and those of 407 control women, matched for age, parity, social class and year of delivery. 2 There was no excess of index women who had presented with nausea or vomiting. 3 There was a significant excess (12 cases, nine controls, P less than 0.02) of women who had been prescribed Debendox (the 3-constituent, or pre-1976, formulation of Bendectin) in early pregnancy. 4 This result was not thought to be conclusive evidence of a teratogenic effect but caution in prescribing is advised pending more extensive studies. PMID- 6840795 TI - Dieldrin pollution of a human food chain. AB - 1 An incident is described in which excessive mortality amongst a poultry flock alerted veterinarians. Investigation revealed dieldrin in the carcasses and in the wood litter used in the nesting boxes. 2 Because high levels of dieldrin were found also in eggs the Department of Community Medicine was alerted. 3 Those most at risk were the workers who could have absorbed dieldrin by inhalation and percutaneously, and by eating contaminated eggs. A number of other people were at risk having eaten contaminated eggs. 4 Twenty-one workers or members of their families were investigated by case histories and blood levels. They were all clinically well. The highest estimated daily intake of dieldrin in the diet was 3.8 mgm. The highest blood dieldrin level found was 0.016 microgram/ml. This intake was of the same order as the upper limit of no-toxic-effect of long-term daily dosage, but the blood level is well below the level at which symptoms may be expected. The fall in mean blood level over a year is consistent with a long half-life of dieldrin in the human. 5 The conflict of interest in conducting a comprehensive investigation and preventing undue public alarm is discussed, and how this was resolved in this episode is described. PMID- 6840796 TI - Flicker fusion test and occupational toxicology: performance evaluation in workers exposed to lead and solvents. AB - 1 In a group of 108 workers professionally exposed to low lead levels and in 35 shoe factory workers exposed to a mixture of solvents, neurotoxic effects were evaluated by means of Critical Flicker Frequency, used as single test of psychophysiological performance. 2 A statistically significant lowering of CFF threshold was observed and, in the lead exposed group, this decrease is related to the biological parameter zinc protoporphyrin. 3 The usefulness of CFF measure in environmental toxicology, together with other neurophysiological tests, is considered. PMID- 6840797 TI - The early distribution of 239Pu, 241Am and 233U in the soft tissues and skeleton of old rats. A comparative study. AB - 1 Female and male rats of the Sprague-Dawley strain, aged about 13 months, were injected intravenously with monomeric 239Pu-(0.83 muCi/kg), 241Am-(1.48 muCi/kg) or 233U-citrate (1.53 muCi/kg) and sacrificed 7 days and 28 days after injection. 2 The wet weights and the radionuclide contents of the organs and the different bones were measured. Whereas in the soft tissue organs the radionuclide activity differs between female and male rats and between 7 days and 28 days, in the bones the relative radionuclide contents show no differences except in the femora of the 239Pu and 233U animals which are significantly different at 7 days and 28 days. PMID- 6840798 TI - Thirty-fourth annual meeting of the Tissue Culture Association. June 12-16, 1983, Orlando, FL [Abstracts]. PMID- 6840799 TI - Inhibition of phagocytosis by erythrocyte membrane sialoglycoprotein on target liposomes. AB - Sialoglycoprotein (GP) of human erythrocytes was incorporated into liposomes and its effect on the Fc receptor-mediated phagocytic reaction of human PMN cells was examined. Whereas liposomes carrying 2,4-dinitrophenylated lipid were, upon opsonization with rabbit anti-DNP, readily ingested by PMN cells and induced the NBT-reducing reaction, these reactions were markedly suppressed when GP was incorporated into the target liposomes. The inhibitory activity was found in the glycophorin A and B fractions, but the latter was more active than the former on a weight basis. It was estimated that incorporation of only a single molecule of GP per vesicle of 6000 lipid molecules may be sufficient to protect the particle from phagocytosis, but there was an apparent antagonism between the suppressive GP and opsonizing antibody as, with more antibody, more GP became necessary to inhibit phagocytosis. The effect of GP was largely abolished by trypsin treatment of GP-bearing liposomes or by the addition of F(ab')2 of anti-GP. PMID- 6840800 TI - Dengue virus-induced cytotoxic factor induces macrophages to produce a cytotoxin. AB - In our earlier studies we have observed that T lymphocytes of dengue type 2 virus (DV)-infected mouse spleen produce a cytotoxic factor (CF). In the present study it has been observed that CF induces mouse spleen and peritoneal macrophages to produce a cytotoxin (CF2) as has been revealed by DEAE-cellulose chromatography. CF2 is produced by an induction process and is present intracellularly as well as leaking out of the cells. CF2 kills most of the macrophages and some of the T cells, as observed with CF. It appears that CF2 is produced to amplify the effect of CF and/or for cooperative action with CF. PMID- 6840801 TI - A chemotactic inhibitor in synovial fluid. AB - Synovial fluid was found to contain an inhibitor of neutrophil chemotaxis. The activity of this inhibitor was masked in native synovial fluid, but could be detected in fluid in which complement had been deactivated by mild heating. The inhibitor was most effective against the chemotactic activity of zymosan activated serum (C5ades arg). It had little effect when N-formyl-methionyl-leucyl phenylalanine served as chemoattractant. Inhibition was not the result of a direct effect on the neutrophils, since incubation of cells with synovial fluid did not alter their chemotactic response. The inhibitory activity was destroyed by boiling the synovial fluid or treating it with trypsin, suggesting that it is a protein (or proteins); it was not affected by hyaluronidase treatment. Gel filtration revealed that the inhibitor was present in native as well as decomplemented synovial fluid, and that its molecular weight was in the vicinity of 25,000. It is proposed that this inhibitory activity plays a role in the regulation of the inflammatory response in joints. PMID- 6840802 TI - Effects of cyclosporin A on the metabolism of unstimulated and mitogen-activated lymphocytes. AB - The immunosuppressive drug cyclosporin A (CS-A) reduces the magnitude of T lymphocyte activation by all mitogenic lectins tested. However, in all cases a proportion of the activation observed is resistant even to very high concentrations of the drug. This proportion depends on the mitogen used, the responses to concanavalin A (Con A) and soybean agglutinin (SBA) being much more strongly inhibited than the responses to phytohaemagglutinin (PHA) or pokeweed mitogen (PWM). The differential effects of CS-A on lymphocyte activation by these mitogens could not be accounted for by the magnitude of the mitogenic response, the mitogen concentration used or the dependence of the responses on the presence of accessory cells, and they were maintained when several different procedures were used to assess the degree of activation. CS-A effectively inhibited inhibited lymphocyte activation. CS-A effectively inhibited lymphocyte activation only when added prior to, or very shortly after, the mitogen. Its ability to inhibit the response to PHA was lost more rapidly than that of Con A. The rate of protein synthesis by unstimulated lymphocytes was also affected by CS-A over the concentration range required to inhibit activation by mitogens. Although this effect was smaller than the inhibition of mitogen activation, it was highly significant and reproducible, and could not be accounted for by inhibition of spontaneous activation occurring in the unstimulated cultures. PMID- 6840803 TI - Exacerbation of antigen-induced arthritis after challenge with intravenous antigen. AB - The occurrence and morphology of flare-up of arthritis after intravenous (i.v.) antigen administration was investigated in mice with on-going antigen-induced arthritis (AIA). Intravenous injection of 300 micrograms methylated bovine serum albumin (mBSA) in mice with unilateral arthritis induced by mBSA, elicited 6 weeks previously, caused clear flare-up of the smouldering joint inflammation without affecting the contralateral non-arthritic knee joint. Histological signs of the flare-up reaction were already present at 6 hr after i.v. challenge and lasted for at least 4 days. Characteristic features are the presence of large numbers of granulocytes just beneath the synovial lining layer, inflammatory foci in adjacent periarticular tissues, and deposits of fibrin-like material in the joint space. Variations in the severity of the preceding arthritis and in the interval (4-12 weeks) between AIA induction and i.v. challenge had no major influence on the occurrence and degree of the flare-up phenomenon. Since exacerbations of joint inflammation are seen in rheumatoid arthritis, this phenomenon may be of importance in this disease. PMID- 6840804 TI - Human peripheral blood monocyte-derived macrophages produce haemolytically active C3 in vitro. AB - The third component of complement (C3) synthesized by human monocyte-derived macrophages has been shown to have the same size and sub-unit structure as serum C3, but haemolytic activity has not been demonstrated. Human monocyte-derived macrophages were cultured from days 4 to 7 in medium without serum, and the conditioned medium was dialysed to remove inhibitors of the C3 assay and concentrated to enhance detection of low amounts of C3. Using these techniques C3 activity was detected routinely. The amount of C3 was 3.4 x 10(7) effective C3 molecules/ml of concentrated tissue culture medium (range 1.0-7.5 x 10(7)), and the number of C3 molecules synthesized by each cell was 4.4 x 10(5), assuming that each cell synthesized C3. The specific activity of the C3 synthesized by the monocytes was the same as the specific activity of C3 that had been purified from serum and then incubated with the cells and processed in the same manner as the monocyte media. Synthesis as the basis for the presence of the C3 activity in the medium was indicated by an inhibition of production of the C3 activity of 66 +/- 16% by cycloheximide, 2 micrograms/ml. Thus, human blood monocytes that migrate into areas of inflammation can mature into cells capable of producing C3 which can participate in the complement sequence and thus potentiate inflammation. PMID- 6840805 TI - A vascular endothelial cell antigen with restricted distribution in human foetal, adult and malignant tissues. AB - Human vascular endothelial cells were isolated by collagenase digestion of umbilical veins. Hybridomas secreting monoclonal antibodies were raised by fusing a mouse myeloma cell line to spleen cells from mice immunized with the isolated endothelial cells. A clone was selected which produced an antibody binding strongly to human umbilical vein endothelial cells. This antibody, EN 3, was shown to be directed against a major antigen on the surface of the cells, and appeared to be distinct from other antigens previously described on vascular tissues. The antibody bound to a lesser extent to umbilical artery endothelial cells and syncytiotrophoblast. Capillary endothelial cells in adult oesophageal tissues and tonsil were also labelled by the antibody, as were capillaries in a seminoma and infiltrating duct carcinoma of the breast. This well defined distribution in some foetal, adult and malignant tissues suggests that there is structural heterogeneity amongst endothelial cells in different sites, which may be linked to differences in differentiation or function. PMID- 6840806 TI - Analysis of maternal IgG subpopulations which are transported into the chicken oocyte. AB - Chicken serum and oocyte IgG were compared. Purified intact IgG and mercuripapain produced Fc fragments of yolk and serum IgG were analysed by isoelectric focusing. All IgG bands were identical, indicating that all subpopulations of serum IgG were present in the yolk. Upon papain hydrolysis of both serum and yolk IgG, four identical Fc bands were produced from all serum and yolk samples. Sialic acid measurements showed that there was no significant difference in sialic acid content between serum and oocyte IgG. From these results we conclude that: (i) ovarian IgG receptor(s) selectively transports all subpopulations of maternal IgG; (ii) there is no selective destruction of IgG during transport; and (iii) yolk IgG has the same amount of sialic acid as the serum IgG. PMID- 6840807 TI - Experimental allergic orchitis induced by unilateral intratesticular bacterial infection in guinea-pigs. AB - Inoculation of 1 X 10(3) viable Listeria monocytogenes into unilateral testis induced pathological changes in the contralateral testis and epididymis in guinea pigs. Because L. Monocytogenes was not detected in the contralateral testis, liver or spleen during the period of the experiment, that is, bacterial growth was limited to the inoculated site, the pathological changes in the contralateral testis may be due to autoimmune mechanisms, but not due to bacterial inflammation. The pathological changes in our system were similar to those observed after the injection of testicular antigen in Freund's complete adjuvant. Delayed-in-onset erythematous skin reaction against testicular antigen and antisperm antibody in sera were detected in the guinea-pigs. The animal model in our system is a new one in which experimental autoimmune orchitis is induced by bacterial infection. PMID- 6840808 TI - Antigen trapping in the spleen of the turtle, Chrysemys scripta elegans. AB - Using horse-radish peroxidase (HRP)-anti-HRP immune complexes, 'antigen trapping' was studied in the spleen of the turtle, Chrysemys scripta elegans. It was found that antigen-trapping cells were situated in the periellipsoidal lymphocyte sheath of the white pulp only. The antigen-trapping cells have a dendritic character and a large lobulated nucleus. Carbon injections revealed that these cells do not phagocytose. The results are discussed with respect to the phylogeny of antigen-trapping cells. PMID- 6840809 TI - IgE and IgD antibodies to cow milk and soy protein in duodenal fluid: effects of pancreozymin and secretin. AB - Duodenal fluid IgE was reported to be increased in food allergy and in inflammatory conditions of the bowel. We studied the presence and specificity of IgE and IgD antibodies against alpha-casein, beta-lactoglobulin A, alpha lactalbumin, bovine serum albumin and soy bean agglutinin using an enzyme-linked immunoassay (ELISA). Thirteen children with various intestinal diseases and thirteen normal adult volunteers were examined. In resting duodenal fluids, 8/13 of the children had IgE and 5/13 had IgD, while only 1/13 of the adults showed detectable IgE and IgD. After pancreozymin, 4/6 of the children and 4/8 of the adults showed detectable IgE and IgD in their duodenal fluids. After secretin, the duodenal fluids from 1/8 of the children and 2/8 of the adults had detectable IgE, while 6/13 children and 1/10 of the adults had IgD. The results indicate an increase in duodenal contents of IgE and IgD antibodies specific to cow's milk and soy protein after pancreozymin. Since this mediator is normally released during digestion, it is suggested that IgE and IgD antibodies specific for food proteins, may be involved in the physiological processing of foods in the intestine. In infants and children with gastrointestinal disease, the incidence of IgE and IgD antibodies specific for milk and soy proteins is higher in basal and pancreozymin-stimulated duodenal fluid when compared with control adults. PMID- 6840810 TI - Study of blood group B antigen with a specific monoclonal antibody (anti-B, b 183). AB - A murine anti-B monoclonal antibody was obtained by the hybridoma technique. This antibody called anti-B (b-183) is of IgM nature; it is capable of agglutinating normal B, B3, Bx, cis AB and some acquired B red cells. Its association constant is 1.1 X 10(8) l/mol, and appears high compared to those of the monoclonal anti A. This monoclonal anti-B was used to determine the number of B sites on B3 and Bx red cells. PMID- 6840811 TI - The recirculating lymphocyte pool of the rat: a systematic description of the migratory behaviour of recirculating lymphocytes. AB - A comprehensive study of lymphocyte traffic in AO rats was performed under conditions as near to the physiological state as was practicable. In the light of previous results on the effect of environmental factors on the migratory behaviour of lymphocytes, thoracic duct cells were passed from blood to lymph in an intermediate rat before injection into a series of recipients for examination at time intervals from 1 min to 24 hr. At 1, 2 and 5 min after injection most of the labelled cells were in the blood, lungs and liver. The concentrations in these compartments fell over the next 25 min as the cells entered the spleen, lymph nodes (LN) and Peyer's patches according to a regular pattern. The peak localization in these latter organs occurred between 1 hr and 18 hr. Each organ had a characteristic time pattern of lymphocyte localization. Entry into mesenteric LN lagged behind other LN until 2.5 hr after injection following which mesenteric LN localization easily outstripped that in other LN to reach a delayed peak at 18 hr. Intravenously injected lymphocytes began to reappear in thoracic duct lymph in large numbers earlier than in previous studies so that the time taken for most T lymphocytes to cross LN from blood to lymph fell within the broad time band of 4-18 hr. Lymphocytes took on average 5-10 min to cross high endothelial venules when entering LN from the blood. PMID- 6840812 TI - Fine specificity and idiotypic expression of monoclonal antibodies directed against poly(Tyr,Glu)-poly(DLAla)--poly(Lys) and its ordered analogue (Tyr-Tyr Glu-Glu)-poly(DLAla)--poly(Lys). AB - In order to study the repertoire of poly(Tyr,Glu)-poly(DLAla)--poly(Lys) [(T,G)-A -L] specific antibodies, monoclonal antibodies were prepared by fusing myeloma cells with spleen cells from C3H.SW mice immunized with (T,G)-A--L and boosted with (Tyr-Tyr-Glu-Glu)-poly(DLAla)--poly(Lys)](T-T-G-G)-A--L]. Eleven clones which secreted homogeneous antibodies were obtained. In general, two families of monoclonal antibodies were detected: those which bind exclusively (T-T-G-G)-A--L and those which bind both (T-T-G-G)-A--L and (T,G)-A--L. Analysis for idiotypic expression revealed that only two antibodies (clones no. 103 and 160), which were found to be similar in their fine specificity, cross-reacted with antibodies against the major idiotypes of (T,G)A--L specific antibodies. Guinea-pig antibodies against clone no. 160 reacted with the polyclonal (T,G)-A--L specific antibodies, whereas antibodies against 103 monoclonal antibodies did not react with C3H.SW anti-(T,G)-A--L antibodies, but did cross-react with four other monoclonal antibodies. It appears that the idiotypic determinants expressed on polyclonal (T,G)-A--L specific antibodies are heterogeneous, and consist of at least two serologically different idiotypes detected by clones no. 103 and 160. PMID- 6840814 TI - Increased humoral and cellular immunity in mice inoculated with allogeneic tumor cells attached to microcarrier beads. AB - A murine carcinoma cell line was grown in a microcarrier culture and was used for immunization of allogeneic mice. It was found that inoculation of cells attached to microcarrier beads resulted in heightened serum titers of cytotoxic antibodies and in a stronger cell-mediated cytotoxic reactivity in the spleen compared to cells detached from the substrate. It is proposed that immunization of animals with anchorage-dependent cells should be carried out while the cells are still adherent to the culture microcarriers. PMID- 6840813 TI - Hapten, carrier recognition and response by immunocytes of the primitive vertebrate, Notophthalmus viridescens. AB - These experiments were designed to test whether newt (Notophthalmus viridescens) immunocytes are able to recognize the hapten, 2,4,6-trinitrophenyl (TNP), separately from a heterologous erythrocyte (RBC) carrier. While a single priming injection with an erythrocyte species which is unrelated to the carrier of the TNP fails to stimulate amplification of the anti-TNP response, sequential (2X) priming provides about 50% as much amplification as a single priming injection of RBC homologous with the carrier. The anti-carrier response is not increased by sequential priming with the unrelated RBC. Moreover, sequential priming with RBC homologous with the carrier species initiates a suppression of the anti-hapten response without affecting anti-carrier activity levels. Thus the recognition and regulation of responses to a hapten and its carrier may be unlinked in this species. PMID- 6840815 TI - Circulating immune complexes as "tumor marker" in hepatoma-bearing rats (Yoshida AH 130). AB - The presence of circulating immune complexes (CIC) in a large number of malignancies was investigated in relation to the activity, the extent and the clinical course of the tumor clone. The aim of this study was to explore the relation between CIC serum levels and tumor growth in rats bearing the 130 Yoshida ascites hepatoma. For the assay of C3biCIC levels all samples were tested by a new competitive immunoenzymatic test. Experiments carried out on normal rats and on hepatoma-bearing ones, showed that during tumor growth values of CIC serum levels expressed as percent coefficient of inhibition are significantly higher in hepatoma-bearing rats (mean = 60.2) than in the normal controls (mean = 29.5). Furthermore CIC level and tumor proliferation are strictly correlated r = 0.9559. In this view sequential measurements of CIC levels may be valuable in establishing diagnosis, estimating prognosis and monitoring the behavior of neoplasia. PMID- 6840816 TI - Genetic analysis of the T-H-2 region in non-t chromosomes. I. Two new congenic strains isolate Qglo-1 from H-2. AB - A general breeding protocol useful in the construction of congenic lines of mice disparate in the 15 cM T-H-2 region of chromosome 17 in non-t chromosomes is described. Two such congenic lines, B6.TC2/Rn and B6.TC3/Rn, were derived from the C57BL/6J and B6.C-H-2d/By strains using this protocol. Both B6.TC2 and B6.TC3 dissociate the quantitative activity locus for glyoxalase I (Qglo-1) from the H-2 complex, and hence possess BALB/cBy DNA centromeric to H-2. However, neither new strain is able to map any H-2-associated restriction fragment length polymorphism with an H-2 cDNA probe even though both strains are recombinant in the 2 cM Qglo 1-H-2K interval. PMID- 6840817 TI - Hybrid immune response to parental liver tissue grafts. AB - Parental-to-F1-hybrid liver tissue grafts in like-sex donor-recipient combinations survive indefinitely, although several F1 recipients demonstrate an immunological response to the parental graft. Female F1 recipients, particularly those carrying the H-2b haplotype, respond vigorously to male parental liver grafts. However F1 female responses to male parental liver tissue grafts differ substantively from the responses of parental females to syngeneic male grafts. C3H male liver grafts are rejected vigorously by F1 females as long as the F1 carries the H-2b haplotype. These findings support previous reports of strong immunological responses to C3H H-Y antigen in female F1 and C3H.SW animals, a response which is absent in C3H females. Female F1 hybrids carrying the H-2b haplotype do not reject grafts of B10 or B6 male liver as rapidly as do B10 or B6 parental females. This reduced F1 response may be related to the formation of hybrid antigens and consequent alteration of the anti-H-Y response. Alternatively, cells that specifically suppress the anti-H-Y response may be present in F1 hybrids. Factors responsible for suppression appear to be controlled by non-MHC antigens, at least in (C3H X B6 or B10)F1 hybrids. PMID- 6840818 TI - Progressive hypertension in dogs by avoidance conditioning and saline infusion. AB - A group of dogs was trained on a free-operant avoidance-conditioning task that evoked acute increases in arterial pressure and heart rate during each of three daily 30-minute sessions. After 15 days of exposure to this procedure under conditions of normal sodium intake, 24-hour mean levels of arterial pressure remained unchanged. Another group of dogs received continuous intrarterial infusion of isotonic saline at a constant rate of 185 mEq/24 hrs for 15 days, but no avoidance sessions. Again, 24-hour mean levels of arterial pressure did not change significantly. However, 24-hour mean levels of systolic (19.5 +/- 6.2 mm Hg) and diastolic (13.7 +/- 2.9 mm Hg) pressure rose progressively over a 15-day period in a third group of dogs exposed concurrently to the avoidance schedule and saline infusion procedure. The progressive hypertension was accompanied by no consistent changes in heart rate. These experiments indicate that behavioral stress can potentiate sodium hypertension and provide a new method for the study of physiological and behavioral factors in long-term blood pressure control. PMID- 6840819 TI - Structural and functional changes in cerebral arteries from spontaneously hypertensive rats. AB - Segments of basilar arteries from both spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto (WKY) rats were studied in vitro utilizing a microvessel apparatus. At similar levels of passive force, basilar arteries from SHR developed less force in response to depolarizing solution (130 mM K+) compared to basilar arteries from WKY. Arterial segments from the hypertensive animals required less stretch to achieve each level of passive force. Basilar arteries from SHR but not WKY typically displayed both phasic and tonic spontaneous activity which was inhibited in a reversible manner by washing the tissues in physiological salt solution without added Ca++ (EGTA, 1 mM). There was a significant shift to the left in the EC50 of serotonin and a greater maximal response to this agonist in basilar arteries from SHR compared to those from WKY (p less than 0.01). The EC50 to Ca++ (added to a depolarizing solution) was shifted to the right in the arteries from SHR compared to the normotensive controls (p less than 0.05). There was no difference between the arteries from the two groups of animals in the relaxation response produced by isoproterenol. However, contracted basilar arteries from SHR were less sensitive to the relaxant effects of elevated Ca++ than contracted basilar arteries from WKY (p less than 0.05). These results demonstrate the existence of both structural and functional difference between cerebral vessels of SHR and WKY. Our findings also demonstrate the complex nature of the changes in calcium dynamics in blood vessels from hypertensive animals. PMID- 6840820 TI - Norepinephrine-induced potentiation of arginine vasopressin reactivity in arterioles of the spontaneously hypertensive rat. AB - We have studied microvascular reactivity to vasopressin alone and in combination with norepinephrine in young (6- to 8-week-old) spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto (WKY) controls. Closed-circuit TV microscopy was used to quantify the in vivo diameter responses of small arterioles (17 to 26 mu) to vasopressin (1.25 X 10(-8) to 3.75 X 10(-7) M) injected intraarterially alone and with simultaneous topical suffusion of a subthreshold concentration of norepinephrine in the cremaster muscle microcirculation. Percent decrease in luminal diameter was integrated over a 30-second period to obtain log concentration response curves. The vasoconstrictor response to vasopressin was concentration-dependent in both groups (p less than 0.001). A significant increase in reactivity to vasopressin alone was exhibited by the SHR arterioles compared to the WKY vessels (p less than 0.02). Maximum constriction was 55% higher in the SHR (p less than 0.04). The SHR also demonstrated a greater sensitivity to vasopressin (p less than 0.02). Vasopressin-induced vasoconstriction was potentiated by norepinephrine in the SHR, demonstrated by the significant shift of the curve up and to the left of the SHR response curve to vasopressin alone (p less than 0.01). The maximum response was 38% greater (p less than 0.02). Sensitivity was significantly enhanced (p less than 0.01). Additionally, the presence of norepinephrine stimulated a three-fold greater incidence of complete closure. In contrast to SHR results, topical suffusion of norepinephrine did not significantly alter the reactivity of the WKY arterioles to vasopressin-induced constriction. Our results support a role for vasopressin as a potential vasoconstrictor in the developing stage of SHR hypertension which may be modulated by norepinephrine and thus contribute to the elevated total peripheral resistance observed. PMID- 6840821 TI - Dietary sodium and potassium-induced transient changes in blood pressure and catecholamine excretion in the Sprague-Dawley rat. AB - When Sprague-Dawley derived rats were changed from a chow type diet to a moderately high sodium diet, rapid transient changes in blood pressure (BP) and catecholamine excretion were observed. After 1 dietary week, BP increased from 122 +/- .1 mm Hg to approximately 145 mm Hg (p less than 0.001), and there was a concomitant 20% reduction in urinary norepinephrine (UNEV) and epinephrine (UEV) excretion (p less than 0.05). Heart rates were reduced (p less than 0.05). These data suggest that sodium-induced increases in BP were initially associated with suppressed sympathetic nervous system activity. During dietary Weeks 2 and 3, some animals had a persistent moderate elevation in BP (BP less than or equal to 150 mm Hg), while others developed more severe increases. UNEV in moderately hypertensive animals returned to control levels during this period; but UEV and heart rates remained suppressed. UNEV in severely hypertensive animals exceeded (13% +/- 3%, p less than 0.05) that of controls. This increase coincided with their most severe hypertension (171 +/- 1 mm Hg, p less than 0.001). UE values and heart rate data indicate that systemic adrenergic tone was likely suppressed at this time and that the increased UNEV was renal in origin. By dietary Week 4, the BP of severely hypertensive animals had begun to fall, and indices of sympathetic nervous system tone were indistinguishable among all groups. Inclusion of a dietary potassium supplement ameliorated the development of hypertension only in those animals that became severely hypertensive, and appeared to prevent the early suppression of indices of sympathetic activity. PMID- 6840822 TI - Central resetting of baroreflex in the spontaneously hypertensive rat. AB - The role of central nervous system in the resetting of baroreflex was investigated in 5-month-old spontaneously hypertensive rats (SHR) of Okamoto strain. Age-matched Wistar-Kyoto (WKY) rats were used as normotensive controls. The aortic nerves, which in the rat, contain few or no chemoreceptor fibers, were stimulated electrically using a wide range of stimulus frequencies. The depressor responses (expressed as percent decrease in blood pressure as compared to its blood pressure value prior to aortic nerve stimulation) produced by these stimulations were significantly smaller in SHR than those in WKY. In another series of experiments, changes in the efferent limb of the baroreflex arc (i.e., greater splanchnic nerve activity) in response to stimulation of the baroreceptor afferents in the aortic nerve were recorded. Inhibition of the greater splanchnic nerve activity due to aortic nerve stimulation was found to be significantly smaller in SHR than in the WKY. Control sympathetic nerve activity was greater in SHR than in WKY. These results suggest that the central bulbospinal nervous system may be another site for resetting of baroreflex in hypertension. PMID- 6840823 TI - Abnormal red blood cell ion transport and hypertension. The People's Gas Company study. AB - A population-based survey of 134 white men, recruited from the Chicago People's Gas Company labor force, was carried out to examine the association between sodium-lithium (Na-Li) countertransport and hypertension. Of the 134 participants in this industry-sponsored periodic health examination, 64 were normotensive and 70 were either taking antihypertensive medications or had a systolic pressure greater than or equal to 140 or a diastolic pressure greater than or equal to 90 mm Hg. The hypertensives were older and more overweight. Countertransport was significantly higher in hypertensives than in normotensives. Among the three subgroups of hypertensives--untreated, borderline (140/90 to 160/95 mm Hg), untreated definite (over 160/95 mm Hg), and treated--an increase in countertransport was consistently observed, significant for the latter two groups. The relationship between countertransport and hypertension was independent of overweight, with countertransport being significantly related to both blood pressure and overweight. Altered ion transport may play an important role in the etiology and/or pathophysiology of hypertension. PMID- 6840824 TI - Intrarenal pressure and sodium excretion in hypertension of chronic glomerulonephritis in humans. AB - The relationship between the fractional excretion of filtered sodium (FENa) and the peritubular capillary physical factors (PCPF) in the hypertension (HT) of chronic glomerulonephritis (GN) was examined in hydropenia (C) and during sustained isotonic saline volume expansion (E; 3% net increase of body weight) in 32 GN patients (16 with HT), and compared with our previous findings in 20 normal individuals (NORM) and 19 patients with essential hypertension (EH). Fourteen GN patients (seven with HT) had a 75% reduction of glomerular filtration rate (GFR), the others (nine with HT) had normal or near normal GFR. The PCPF were estimated from the intrarenal venous (wedged) pressure (IRVP) and the calculated efferent arteriolar protein concentration (EAPC). In C, IRVP correlated to GFR (r = 0.682, p less than 0.001) and (FENa) (r = -0.357, p less than 0.05), but IRVP and EAPC were similar in HT and normotension at comparable levels of GFR. The increase of FENa during E (delta FENa) was exaggerated in all HT groups even at reduced levels of GRF, and could not be related to changes in renal hemodynamics or PCPF. delta FENa correlated with mean arterial pressure in C both in GN (r1 = 0.702, p less than 0.01) and in the combined NORM/EH group (r2 = 0.478, p less than 0.01), with r1 greater than r2 (p less than 0.005). The findings indicate that the pathogenesis of hypertension of chronic glomerulonephritis is independent of changes in the PCPF, and are compatible with the idea that humoral factors are the main mediators of the altered sodium excretion during saline volume expansion in the HT of both chronic GN and EH. PMID- 6840825 TI - Guidelines for the treatment of mild hypertension. Memorandum from a WHO/ISH meeting. AB - The present guidelines were endorsed by the participants at the Third Mild Hypertension Conference, held at Burgenstock, Switzerland, September 27-29, 1982. They include the definition of mild hypertension, and describe blood pressure measurement, factors influencing the decision to begin treatment, methods of treatment, and follow-up. The guidelines are based on the best available scientific evidence, and will be updated in the future to keep abreast of future developments in this field. PMID- 6840826 TI - Hyperacute pulmonary vasculitis in rabbits receiving prolonged infusions of activated complement. A possible model for triggering events in adult respiratory distress syndrome. AB - We have postulated a role for activated plasma complement and for stimulated granulocytes in the triggering events of the adult respiratory distress syndrome (ARDS). Because brief periods of complement activation have proved to be pale mimics of the clinical syndrome, we extended our earlier models by infusing potently activated plasma complement into rabbits over a prolonged period of time (3 h). The expected leukostasis occurred, but pulmonary dysfunction remained modest. Nonetheless, piecemeal microvascular necrosis did develop, rendering this current model more credible than former models as a mimic of triggering events in ARDS; longer-term follow-up of such animals will be necessary to determine if this is indeed the case. Perhaps of even greater interest, the neutrophilic leukostasis was observed to progress over the 3 h to a predominantly lymphocytic leukostasis, a dramatically more rapid progression than is typical of such immune complex diseases as serum sickness and the Arthus reaction; further studies are in progress to elucidate the mechanism of this lymphostasis. PMID- 6840827 TI - Neutrophil migration in response to chemotactic factors: effects of generation conditions and chemotherapeutic agents. AB - The effects of various chemotactic factor generation conditions and several chemotherapeutic agents on neutrophil migration were determined using in vitro assay systems designed as models for inflammatory processes occurring in the synovial cavities of patients with rheumatoid arthritis. The microtubule promoting agent concanavalin A and the microfilament-disrupting agent cytochalasin B were shown in these systems to inhibit neutrophil migration towards zymosan-activated serum-derived chemotactic factors. Neutrophils, immunoglobulin G aggregates, and serum were required for maximum generation of comparable chemotactic factors. Insoluble immunoglobulin G aggregates with or without rheumatoid factor produced more chemotactic factor activity on interaction with neutrophils than soluble immunoglobulin G aggregates. Exposure of neutrophils to supratherapeutic levels of the nonsteroidal antiinflammatory agent aspirin decreased neutrophil response to chemotactic factors while exposure to the slow-acting or immunomodulating agents gold, D-penicillamine, or azathioprine had no effect on this neutrophil function. In vitro systems employing neutrophils, insoluble aggregates, and serum may offer useful means for assaying drug effects on important functional components of the rheumatoid inflammatory process. PMID- 6840829 TI - [Heparin elimination in intraoperative autotransfusion with the haemonetics cell saver]. AB - Intraoperative autotransfusion has proved useful in decreasing decisively the need of donor blood in major operations. Due to an important technical development of the equipment used including the possibility to separate red blood cells and to wash them in physiological saline, typical problems occurring during intraoperative autotransfusion seem to be overcome for the most part. One of these problems is the retransfusion of the citrate or heparin added for anticoagulation of blood. Heparin itself may be responsible for a disturbance of coagulation. The efficiency of eliminating heparin by washing it in the Haemonetics Cell Saver was tested by means of a high sensitive heparin test. Partly the samples were totally free of heparin, partly small remains of heparin could be found. Even the maximum value of 60 I.E. measured in one autologous red blood cell concentrate is of no importance for the daily clinical practice. Intraoperative autotransfusion with the Haemonetics Cell Saver is also superior to a homologous transfusion of blood with its unavoidable share of citrate. PMID- 6840830 TI - [Crossmatching for vital indications]. AB - The importance of the indirect Coombs procedure for compatibility testing is emphasised. According to the results of our own antibody-screening the risk of the hemolytic transfusion reaction is calculated if the complete crossmatch can not be performed because of the lack of time. Alternative antibody-screening tests (enzyme, liss) can be done as a supplementary test but should never replace the Coombs technic. The reaction patterns of the investigated antibodies demonstrate the high risk of a blood transfusion after the "first step" (saline phase) of the crossmatch. PMID- 6840828 TI - Aggregation, chemotaxis, and chemiluminescence of canine granulocytes. Studies utilizing improved cell preparation techniques. AB - Wishing to extrapolate in vitro observations of granulocyte function and pharmacology made with human cells to animal models of diseases in which we believe granulocyte stimulation to play a major role, we examined techniques for preparation of canine granulocytes and conducted a survey of the function and pharmacology of those cells. Isotonic density gradients of Percoll proved a simple and highly satisfactory method of preparation. Canine granulocytes in most respects paralleled human cells in function and pharmacology, except that canine cells lacked receptors for formylated oligopeptides and resisted them as stimuli; canine plasma contained a heat-labile inhibitor of canine PMN aggregation, oxidative metabolism, and myeloperoxidase release; canine PMNs were not inhibited in aggregation by protease inhibitors such as aprotinin; canine response to ibuprofen and steroids was more variable than that of human cells, and synergy between those agents was less readily demonstrated; heterologous stimulation (canine cells by human C5a or vice versa) led to a different time course and maximum response from those observed in the homologous systems. Canine granulocytes were readily marked with indium-111, and functioned normally in vitro and survived well in vivo after marking. We conclude that the dog is a suitable animal for studying the role of stimulated PMNs in disease, as long as the observed differences are taken into account in experimental design and data interpretation. PMID- 6840831 TI - [Correction of amino acid imbalances as adjuvant therapy in septic peritonitis]. AB - A prospective and randomized study was performed in 18 patients with septic peritonitis to investigate the behavior of free amino acids in serum before and during parenteral nutrition with 2 different amino acid solutions. One group received a so called "liver-solution" with 45% branched chain amino acids and reduced aromatic and sulphur-containing amino acids, the other group a conventional solution with 10,5% branched chain amino acids. Amino acid imbalances typically in sepsis--elevation of aromatic and sulphur-containing amino acids as well as alanine and proline, normal or decreased branched chain amino acids--could be observed only to some extend, because the influence of preceding operative trauma was overlapping. However, with conventional parenteral nutrition these imbalances then became clearly apparent. On the other hand, in patients treated with the special amino acid solution nearly complete normalization of amino acid levels took place. This effect was mainly due to the increased supplementation of branched chain amino acids positively influencing protein metabolism, and less produced by the changes in amino acid proportions supplied. Clinically these patients also had a clear improvement of consciousness status. The positive effect of such balanced solution on amino acid metabolism and mental situation of septic patients could be confirmed. Their use in septic peritonitis during necessary parenteral nutrition as an adjunctive treatment therefore seems to be efficient. PMID- 6840832 TI - Purification and properties of pyruvate kinase from Streptococcus sanguis and activator specificity of pyruvate kinase from oral streptococci. AB - It was found that pyruvate kinases with two different regulatory characteristics were distributed among oral streptococci. The pyruvate kinases of Streptococcus mutans, Streptococcus salivarius, and Streptococcus bovis were activated by glucose 6-phosphate, whereas the enzymes of both Streptococcus sanguis and Streptococcus mitis were activated by fructose 1,6-bisphosphate. Pyruvate kinase (EC 2.7.1.40) from S. sanguis NCTC 10904 was purified, giving a single band on sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The enzyme had a molecular weight of 250,000 to 260,000 and consisted of four identical subunits. Whereas the pyruvate kinase from S. mutans was completely dependent on glucose 6 phosphate (K. Abbe and T. Yamada, J. Bacteriol. 149:299-305, 1982), the enzyme from S. sanguis was activated by fructose 1,6-bisphosphate. In the presence of 0.5 mM fructose 1,6-bisphosphate, the saturation curves for the substrates, phosphoenolpyruvate and ADP, were hyperbolic, and the Km values were 0.13 and 0.30 mM, respectively. Without fructose 1,6-bisphosphate, however, saturation curves for both substrates were sigmoidal. GDP, IDP, and UDP could replace ADP. Like the enzyme from S. mutans, the enzyme from S. sanguis required a divalent cation, Mg2+ or Mn2+, and a monovalent cation, K+ or NH4+, for activity, and it was strongly inhibited by Pi. When the concentration of Pi was increased, the half-saturating concentration and Hill coefficient for fructose 1,6-bisphosphate increased. The remarkable fluctuation of intracellular levels of fructose 1,6 bisphosphate and phosphoenolpyruvate observed in the cells growing under glucose limitation and nitrogen limitation implies that the intracellular concentration of fructose 1,6-bisphosphate, in cooperation with that of Pi, may regulate pyruvate kinase activity in S. sanguis in vivo. PMID- 6840833 TI - Characterization of surface properties of Vibrio cholerae. AB - A number of isolates of Vibrio cholerae were examined with respect to their (i) surface hydrophobicity as measured by hydrophobic interaction chromatography, (ii) capacity to agglutinate erythrocytes, and (iii) ability to bind to an ion exchange matrix. V. cholerae isolates, cultured under a variety of growth conditions, were conspicuously hydrophobic. The hydrophobicity was accentuated when these strains were (i) cultivated in a chemically defined synthetic medium, (ii) harvested at the exponential phase of growth, and (iii) cultured at a lower temperature. Rough strains were more hydrophobic than smooth strains. Of the various surface components examined, the outer membrane proteins were conspicuously hydrophobic. The cell-bound hemagglutinating activity of V. cholerae strains was increased when these strains were cultured in synthetic medium and harvested at the stationary phase of growth. This property was unaffected by the growth temperature. Only D-mannose, at a high concentration, inhibited hemagglutination of 80% of the isolates examined. L-Fucose did not inhibit the hemagglutinating activity. V. cholerae strains adhered strongly to the anion-exchange matrix DEAE-cellulose. The surface charge density was accentuated when these strains were grown in synthetic medium. These results suggest that the V. cholerae surface contains both specific (hemagglutinating) and nonspecific (hydrophobic and ionic) factors which may influence its eventual adherence to the host cell surface. PMID- 6840834 TI - Chemical characterization of extracellular polysaccharides produced by Actinomyces viscosus T14V and T14Av. AB - The human isolates Actinomyces viscosus T14V and T14Av produced extracellular polysaccharides in the absence of sucrose. In contrast to strain T14V, strain T14Av produced abundant viscous slime polysaccharide in the culture supernatant fluids when grown in a chemically defined medium containing glucose. After resolution of the T14Av polysaccharides into seven fractions, it was demonstrated that two of these exhibited viscous properties and lacked methylpentose and muramic acid. The major slime polysaccharide purified by gel filtration and ion exchange column chromatography contained 39% (moles percent carbohydrate) galactose, 37% N-acetylglucosamine, 19% glucose, and 5% mannose. Only trace amounts of protein and phosphorus were detected in this preparation. On the other hand, strain T14V produced negligible slime polysaccharide under the same culture conditions. The major extracellular polysaccharide fraction from this strain contained methylpentoses, hexoses, hexosamines, muramic acid, protein, and phosphorus, suggesting that this fraction might be derived from the cell wall. PMID- 6840835 TI - Advantages of measuring changes in the number of viable parasites in murine models of experimental cutaneous leishmaniasis. AB - Previously published studies of experimental cutaneous leishmaniasis in the mouse have relied almost exclusively on measuring changes in lesion size to follow the course of the infection. The purposes of the studies reported here were to develop a technique to quantitate the number of viable organisms in the tissues and to use the technique to follow the development and resolution of the primary infection as well as the development of acquired resistance to Leishmania tropica in a resistant (C3H/He) and a susceptible (BALB/c) mouse strain. It was found that individual L. tropica amastigotes derived from infected tissues would transform to promastigotes and repeatedly divide to form discrete, countable colonies on rabbit blood agar. The plating efficiency was approximately 88%. Using the blood agar plating technique to quantitate the organism against time of the infection, we obtained data that suggest that acquired resistance develops in C3H/He mice earlier than is suggested by reduction in lesion size. In addition, although this resistance eliminates the parasites from the primary lesion in 10 weeks, 1,000 to 10,000 parasites persist for months in the lymph node draining the lesion site. In these studies, we found no evidence of acquired resistance in the susceptible BALB/c mice. The organism grows progressively, and the infection can disseminate to the spleen within 2 weeks. These studies illustrate the advantages of quantitating viable parasites in studies of immunity in cutaneous leishmaniasis. PMID- 6840837 TI - Cysteine toxicity for oral streptococci and effect of branched-chain amino acids. AB - Cysteine was bactericidal to strains of Streptococcus mutans and S. salivarius in concentrations that were nontoxic to S. sanguis, S. milleri, or S. mitior when these microorganisms were incubated in a saliva protein-based synthetic medium. Cysteine toxicity for S. mutans also occurred after incubation in synthetic base medium supplemented with amino acids as the nitrogen source for growth. The bactericidal effect of cysteine for S. mutans or S. salivarius in the saliva protein medium was influenced by the cysteine oxidative activity associated with the saliva protein fraction. Valine alone or in combination with leucine or isoleucine was effective in overcoming cysteine toxicity for susceptible strains of S. mutans or S. salivarius. Cysteine toxicity for these oral streptococci may be due to cysteine inhibition of an enzymatic step in the valine-leucine biosynthetic pathway. PMID- 6840836 TI - Influence of physicochemical parameters on adsorption of Actinomyces viscosus to hydroxyapatite surfaces. AB - Adsorption of Actinomyces viscosus strains T14V and T14AV to saliva-treated and untreated hydroxyapatite (HA) under various environmental conditions was studied. Strain T14V adsorption to saliva-treated HA was not influenced by pH, whereas strain T14AV adsorbed in higher numbers under acidic conditions. The addition of cations inhibited adsorption of strains T14V and T14AV to saliva-treated HA. Strain T14V possessed a greater affinity for hydrophobic gels than did strain T14AV, but incorporation of non-ionic detergents, which inhibit hydrophobic interactions, did not influence adsorption of strain T14V to saliva-treated HA. Adsorption of strain T14V to saliva-treated HA increased in the presence of an anionic detergent; however, strain T14AV adsorption was not affected. Strain T14V adsorption decreased in the presence of a cationic detergent, whereas strain T14AV adsorption increased. Collectively, these data suggest that electrostatic interactions, but not hydrophobic interactions, are of major importance in the adsorption of strain T14V to saliva-treated HA. PMID- 6840838 TI - Molecular factors associated with virulence of marine vibrios isolated from striped bass in Chesapeake Bay. AB - On the basis of cultural and biochemical properties as well as DNA homology assays, 81 Vibrio strains isolated from diseased striped bass and from Chesapeake Bay water were assigned to eight distinct groups. All organisms belonging to two of the groups were pathogenic for striped bass and were identified as Vibrio anguillarum, whereas organisms classified in the other six groups were nonpathogenic and were designated as Vibrio spp. Unlike the pathogenic V. anguillarum strain 775 isolated in the Pacific Northwest, strains pathogenic for striped bass did not contain any plasmids; however, they were similar to the Northwest isolates in that virulence was correlated with their ability to grow in the presence of nonimmune striped bass serum or under conditions of iron limitation. Sodium dodecyl sulfate-polyacrylamide gel electrophoretic analysis of outer membranes showed that additional proteins were induced in those organisms capable of growth under conditions of iron limitation. It was of interest that 22 of the nonpathogenic isolates harbored one or more plasmids which, by restriction endonuclease analyses, were shown to be clearly different from the virulence plasmid pJM1. PMID- 6840839 TI - Effect of highly purified coagulase and culture filtrate on virulence and immunity of a coagulase-negative mutant of staphylococcus aureus BB. AB - The virulence of the coagulase-deficient mutant BB-Cgl- 1301 (50% lethal dose [LD50] for mice by the intravenous route) was compared with that of its parental strain, Staphylococcus aureus BB. The BB strain produced free coagulase of serotype I, whereas the mutant 1301 did not. Mice were infected with strain 1301, alone or in combination with a highly purified coagulase type I or type II solution, or with concentrated culture filtrates of parent strain BB or mutant strain 1301. The ratios of the LD50S of 1301 and its combinations to that of BB ranged from 34.9 to 461. Combining strain 1301 with a concentrated culture filtrate of BB (BB-CF2.5) was the most effective for enhancement of its virulence. When mice were infected with a combination of strain 1301 and BB CF2.5, the LD50 of strain 1301 (1.72 mg of cells [wet weight]) was decreased to 0.13 mg (1.3 x 10(8) CFU). This LD50 yielded the smallest ratio, 34.9, as compared with the LD50 of BB (0.00373 mg). In contrast, when the mice subcutaneously immunized with strain 1301 and BB-CF50 were intravenously challenged by strain BB, the LD50 for the immunized mice was 17.4 times the LD50 for the unimmunized control mice (0.0429 mg as compared with 0.00246 mg), indicating that combination was the most effective for enhancement of mouse immunization with strain 1301. However, combining strain 1301 with the highly purified sample of coagulase increased neither the virulence nor the immunizing power of mutant strain 1301. PMID- 6840840 TI - Failure to detect cell-mediated cytotoxicity against Chlamydia trachomatis infected cells. AB - Mice were infected with Chlamydia trachomatis (L2/434) and at various intervals after infection their lymphoid cells were tested directly for cytotoxic activity against Chlamydia-infected L929 cells. In a modified cell-mediated lympholysis assay, splenic, lymph node, and peritoneal exudate cells did not significantly cause the destruction of the infected targets, although infection did result in the formation of antichlamydial antibodies. Whereas chlamydial antigens are capable of activating cell-mediated immunity in other experimental models, our results show that either this chlamydial infection does not induce the generation of cytotoxic effector cells or chlamydial antigens are absent from the surface of infected cells. PMID- 6840841 TI - Adjuvant-induced arthritis in the temporomandibular joint of rats. AB - When Lewis rats were immunized by intradermal injection into the parietal scalp rather than into the footpad with mycobacterial delipidated cells in squalene, arthritis could be produced in the temporomandibular joint (TMJ) with a maximum incidence of 60%, accompanied by systemic polyarthritis. Other methods of immunization including intradermal injection into the tail, posterior cervical region, or intra-inguinal lymph nodes did not induce arthritis in the TMJ. A combination of this inoculation and hemiocclusal loss markedly increased the incidence of arthritis in the TMJ. This arthritis in the TMJ was, however, milder than that in other joints and was apparent only histologically. The group given intradermal injection of adjuvants into the parietal scalp showed definite suppression of body weight gain. Since the method of intradermal injection into the parietal scalp can induce a high incidence of arthritis in the TMJ, our study presents a unique experimental model for study of arthritis in the TMJ. PMID- 6840842 TI - Pseudomembranous colitis in Clostridium difficile-monoassociated rats. AB - Germfree rats were monoassociated with either a toxin-producing strain of Clostridium difficile (Tox+) or a variant of this strain (ToxR) which produced much less toxin (1/10,000) in vivo and in vitro. Monoassociation of germfree rats with C. difficile Tox+ resulted in mortality (17%) and in pathology to the small and large intestines, livers, and lungs. Cecal filtrates from the Tox+ monoassociated rats were cytotoxic for tissue culture cells. The cytotoxicity of cecal filtrates could be blocked by sera from Tox+-monoassociated rats. Monoassociation of rats with C. difficile ToxR resulted in no deaths or pathology, and much less toxin was detected in the cecal filtrates of these animals than in those of rats colonized with the Tox+ strain. This gnotobiotic model may be useful for investigating the etiology, prophylaxis, therapy, and exacerbation of C. difficile-induced pseudomembranous colitis. PMID- 6840843 TI - Interactions of lipid a and liposome-associated lipid A with Limulus polyphemus amoebocytes. AB - Lipid A or lipid A fractions and liposomes containing lipid A were tested for the ability to gel Limulus amoebocyte lysates and for effects on intact Limulus amoebocytes. Liposomes having a relatively low concentration of lipid A did not produce coagulation of lysate and were designated as Limulus-negative, but liposomes having a high concentration of lipid A were Limulus-positive. Limulus negative liposomes had no effect on intact amoebocytes. Limulus-positive liposomes caused a striking transformation in the appearance of amoebocytes in that the cells sent out long filamentous extensions that formed a tangled network of processes between cells. The filamentous projections were similar to those that have been previously observed in the presence of gram-negative bacteria. We conclude that amoebocytes have the ability to recognize Limulus-positive liposomes, but the lack of activation of Limulus lysate or the absence of amoebocyte recognition does not prove the absence of liposomal lipid A. We also found that individual lipid A fractions were heterogeneous in their ability to gel lysate. Of eight fractions tested, one (fraction 1) had no detectable activity above the background, and the seven others had activity that ranged from 10-fold to 10,000-fold above the background. The heterogeneity of lipid A fractions detected in assays with amoebocyte lysate was consistent with the finding of heterogeneity in other functional assays of lipid A fractions. PMID- 6840844 TI - Fibronectin levels during intraperitoneal inflammation. AB - Fibronectin is a high-molecular-weight opsonic protein known to influence macrophage uptake of nonbacterial particulate matter. The concentration of fibronectin in serum and the quantity of fibronectin in the inflamed peritoneal space were examined in rats after intraperitoneal casein injection. Fibronectin levels were studied in relation to the opsonic activity of the serum, as assayed by the uptake of gelatin-coated. 51Cr-labeled, fixed sheep erythrocytes by adherent peritoneal macrophage monolayers. Intraperitoneal inflammation resulted in a marked increase in peritoneal fluid fibronectin that lasted throughout a 4 day observation period. The opsonic activity of serum also increased after casein challenge at 24, 48, and 72 h. The elevation in the level of fibronectin in the peritoneal space appeared to coincide with or closely precede the maximal increase in concentration of inflammatory peritoneal macrophages. After casein injection, when serum immunoreactive fibronectin increased, an enhancement in phagocytic clearance of blood-borne gelatin-coated test particles was also observed. It is suggested that the elevation of fibronectin in blood during intraperitoneal inflammation may mediate enhanced liver phagocytic function. The increased amount of fibronectin in the inflamed peritoneal space may also influence the phagocytic activity of peritoneal macrophages. PMID- 6840845 TI - Crossed immunoelectrophoretic analysis of Legionella pneumophila serogroup 1 antigens. AB - By crossed immunoelectrophoresis, 85 different antigens were demonstrated in sonicated preparations of Legionella pneumophila serogroup 1 (Lp1). The precipitin patterns of 82 anodic-migrating antigens were numbered and were designated the Lp1 reference system. Eleven antigens were stable to boiling, and seven of these were shown to be surface antigens. One heat-stable surface antigen (antigen no. 61) was highly reactive with limulus amoebocyte lysates and formed a precipitin resembling lipopolysaccharide. Serum from an isolation confirmed case of Lp1 infection and serogroup-specific rabbit antiserum reacted specifically with antigen no. 61, which was designated the serogroup-specific antigen. Normal human and rabbit sera commonly had antibodies to antigen no. 66 of the Lp1 reference system. This antigen is antigenically related to the "common antigen" of Pseudomonas aeruginosa. PMID- 6840846 TI - Correlation of host immune response with quantitative recovery of Chlamydia trachomatis from the human endocervix. AB - We studied 95 women with uncomplicated Chlamydia trachomatis cervical infection. Quantitative isolation of C. trachomatis was performed in HeLa 229 cells, and the results were correlated with serum immunoglobulin M and immunoglobulin G antibody to the organism. We found that quantitative cultures for C. trachomatis can provide a meaningful measurement by which to evaluate the effect of the acquired immune response. In particular, secretory immunoglobulin A antibody to C. trachomatis in cervical secretion demonstrated a striking and inverse correlation with recovery of the organism from the cervix. It is suggested that this component of the immune response may regulate shedding of the organism. PMID- 6840847 TI - Occurrence of plasmid DNA in serologically defined strains of Campylobacter jejuni and Campylobacter coli. AB - Forty Campylobacter jejuni and 17 Campylobacter coli strains that constitute the set of reference strains for our serotyping scheme were each examined for the presence of plasmid DNA. Agarose gel electrophoresis of alkaline-extracted DNA showed the occurrence of 29 bands in 11 C. jejuni strains and 40 bands in C. coli strains. Plasmids ranged in size from 1.6 to 70 megadaltons. Most strains that carried plasmids had between 2 and 6 of them; however, one strain had 14 plasmids, and two strains contained only 1 plasmid each. Repeated electrophoresis demonstrated that all plasmid profiles were stable. A different plasmid profile was seen for each of the 19 plasmid-carrying strains, but it was clear that plasmids of the same or similar molecular weight could be found in different strains. On the basis of these findings, we are persuaded that plasmid profiles determined by a rapid procedure for DNA extraction will play a significant role in resolving complexities among strains that are difficult to serotype and could be useful in epidemiological studies in which the implicated isolates are plasmid bearers. PMID- 6840848 TI - Inhibition of Chlamydia psittaci in oxidatively active thioglycolate-elicited macrophages: distinction between lymphokine-mediated oxygen-dependent and oxygen independent macrophage activation. AB - Immune sensitization of spleen cells was required to generate lymphokines (LK) that activated thioglycolate-elicited peritoneal macrophages (thio MACs) to respond via both oxygen-dependent and oxygen-independent systems. LK produced by incubating spleen cells from immunized A/J and LAF mice with concanavalin A stimulated a response by thio MACs to phorbol-12-myristate-13-acetate (PMA) induced chemiluminescence and activated these cells to inhibit intracellular Chlamydia psittaci replication. Concanavalin A-incubated spleen cell preparations from unimmunized animals stimulated neither PMA-induced chemiluminescence nor antichlamydial activity. Activated thio MACs demonstrated a rapid chemiluminescence response to the intracellular protozoan Toxoplasma gondii, but C. psittaci did not induce chemiluminescence in LK-activated thio MACs, although cells exposed to C. psittaci retained their responsiveness to PMA-induced chemiluminescence. The PMA-induced response was inhibited by the addition of exogenous superoxide dismutase and catalase and was therefore related to the production of superoxide anion (O2 . -) and H2O2 by these cells. LK preparations incubated at 56 degrees C before macrophage treatment retained antichlamydial activity, but heated preparations no longer stimulated thio MACs to respond in the chemiluminescence assay. These data provide evidence that macrophage oxygen dependent and oxygen-independent systems are simultaneously activated by LK, and these preparations comprise at least two distinct activities. The portion responsible for activating oxygen-dependent systems (PMA-induced chemiluminescence) is heat labile, whereas the portion responsible for activating oxygen-independent systems is heat stable. It is the latter system that results in restriction of chlamydial growth and in vitro parasite persistence. PMID- 6840849 TI - Streptococcal growth and toxin production in vivo. AB - Streptococcal growth in vivo was studied with inoculated micropore filter chambers which were implanted into the peritoneal cavities of mice. Eight of nine group A strains and one group B strain grew in vivo, achieving concentrations of 10(7) to 10(9) CFU/ml in the chambers. Experiments with the Richards strain showed that the number of viable organisms remained high at 5 and 8 weeks after infection. The use of specific inhibitors and appropriate toxin-negative strains demonstrated that both cytolytic toxins produced by group A streptococci, streptolysin S and streptolysin O, were present in the culture fluids harvested from the chambers. This finding represents the first evidence that streptolysin S is produced in vivo. The host response to streptococci growing in vivo was examined by following the increase in serum antistreptolysin O levels. The response was first detected 2 weeks after chamber implantation and appeared to be maximal after 5 weeks. In addition, the production of antibody to streptococcal cell surface antigens was demonstrated indirectly with fluorescein-labeled anti mouse immunoglobulin G. PMID- 6840850 TI - Effect of methylamine and monodansylcadaverine on the susceptibility of McCoy cells to Chlamydia trachomatis infection. AB - We used inhibitors of receptor-mediated endocytosis to study the mechanisms of infectivity, especially the uptake mechanism, of Chlamydia trachomatis for cultured cells. The effect of methylamine and monodansylcadaverine on the different stages of the chlamydial growth cycle in McCoy cells was examined. There was a dose-related decrease in the number of chlamydial inclusions in the presence of these agents. Monodansylcadaverine also decreased the chlamydia dependent uptake of radioactive amino acids. The agents did not affect the attachment of chlamydiae to the cells, but they increased the protease-removable fraction of cell-bound chlamydiae. The amines reduced the number of inclusions when added at different times during the first 24 h of infection. However, this effect was influenced by host cell density, so that the effect of the amines at the early infectious phase was nullified in confluent monolayers, whereas, during later phases, the effect was comparatively independent of host cell density. This indicates that the amines have different modes of action at different infectious stages. The effect of the amines was reversible, and they had no effect on the infectivity of pretreated chlamydial elementary bodies. These experiments suggest that methylamine and monodansylcadaverine inhibit both the internalization of chlamydiae into McCoy cells and their intracellular development. These results are consistent with the hypothesis that chlamydiae utilize a constitutive cellular process, such as receptor-mediated endocytosis, to enter cells. PMID- 6840851 TI - Effect of immunization with pneumolysin on survival time of mice challenged with Streptococcus pneumoniae. AB - The role of the cytolytic toxin pneumolysin in the pathogenicity of Streptococcus pneumoniae was investigated. Pneumolysin was purified to homogeneity and used to immunize mice. When these mice were subsequently challenged via the nasal route with virulent S. pneumoniae, they survived significantly longer than control mice. The mean survival times were 5.52 and 2.48 days for immunized and control mice, respectively. This work provides direct evidence for the involvement of pneumolysin in pneumococcal pathogenicity. PMID- 6840852 TI - Monoclonal antibodies to cholera toxin with special reference to cross-reactions with Escherichia coli heat-labile enterotoxin. AB - Seventy monoclonal antibodies to cholera toxin were prepared and characterized. All were of immunoglobulin G (IgG) isotypes (39 IgG1, 29 IgG2, and 2 IgG3). A total of 61 clones produced antibody directed against the B subunit, and 9 clones produced antibodies with specificity for the cholera toxin A subunit. Among both the anti-B and anti-A antibodies, there were representatives which showed full cross-reactivity with the heat-labile enterotoxin of Escherichia coli (14 clones), others which gave partial cross-reactions (12), and still others (44) which did not cross-react. Although 24 of 25 tested anti-B monoclonal antibodies could neutralize cholera toxin, none of the 9 anti-A clones had any detectable neutralizing ability. Among the anti-B antibodies, those which cross-reacted completely with E. coli heat-labile enterotoxin all had strong cholera toxin neutralizing capacity, whereas those with lesser or no degree of cross-reactivity varied more in their neutralizing potency. The isolation of monoclonal antibodies that distinguish between enterotoxins of different bacterial origin suggests the possibility of developing immunodiagnostic methods allowing species-specific enterotoxin detection in stools of patients with diarrheal disease. PMID- 6840854 TI - Immunogenicity of a low-virulence vaccinal strain against Salmonella abortus-ovis infection in mice. AB - Strain Rv6, a streptomycin-independent reverse mutant of Salmonella abortus-ovis, multiplied and disseminated in vivo to a lesser extent than the virulent parental strain 15/5, as determined by subcutaneous inoculation of two outbred strains of mice with different susceptibilities to salmonella infection. This lower virulence of strain Rv6 was not modified by 10 passages in susceptible mice. Vaccination with strain Rv6 induced a dose-dependent capacity of mice to control subsequent infection with the virulent parental strain. Induced resistance began as early as 3 days after vaccination and lasted at least 11 months. Its efficiency was controlled by different routes and doses of challenge. Strain Rv6 induced a greater protection than that conferred by heat-killed bacteria or by tested commercial killed vaccines. PMID- 6840853 TI - Effective immunity to dental caries: enhancement of salivary anti-Streptococcus mutans antibody responses with oral adjuvants. AB - In the present study, we compared the ability of the soluble adjuvants concanavalin A (ConA), muramyl dipeptide (MDP), and peptidoglycan (PG) to enhance immune responses to orally administered particulate antigens of Streptococcus mutans 6715 in gnotobiotic rats. The isotype and levels of antibody in saliva and in serum from experimental rats were determined by an enzyme-linked immunosorbent assay using S. mutans whole cells (WC) as the coating antigen. The specificities of salivary and serum immunoglobulin A (IgA) antibodies to particulate S. mutans antigens, lipoteichoic acid, S. mutans serotype g carbohydrate, and dextran were also determined. When 50 micrograms of ConA was used as the oral adjuvant with S. mutans 6715 WC immunogen, a slight enhancement of immune responses was obtained. A higher dose of ConA suppressed humoral responses to the immunogen. Enhanced immune responses, especially of the IgA isotype, in both serum and saliva were induced in gnotobiotic rats given MDP and either S. mutans 6715 WC or purified cell walls (CW) by gastric intubation. Elevated IgA antibody levels to CW, lipoteichoic acid, and carbohydrate were observed in rats given S. mutans WC and MDP by gastric intubation, whereas oral immunization with S. mutans CW and MDP resulted in higher antibody levels to CW and carbohydrate and lower levels to lipoteichoic acid when compared with the antibody levels in rats given antigen alone. Rats orally immunized with either S. mutans WC or CW and MDP and challenged with virulent S. mutans 6715 exhibited significantly (P less than or equal to 0.05) lower plaque scores, numbers of viable S. mutans in plaque, and caries scores than did rats immunized with antigen alone or in infected-only controls. In another series of experiments, a PG fraction derived from S. mutans 6715 CW was assessed for adjuvant properties. The oral administration of PG and either S. mutans WC or CW induced good salivary and serum IgA antibody responses. The specificity of the antibodies was similar to that obtained in rats given antigen and MDP. Rats receiving either S. mutans WC or CW and PG and challenged with virulent S. mutans 6715 had lower plaque scores, fewer numbers of viable S. mutans in plaque, and lower caries activity than did infected rats receiving S. mutans WC or CW immunogen alone. These results provide evidence that soluble adjuvants derived from the gram-positive bacterial CW, e.g., MDP and PG, are effective oral adjuvants and augment IgA immune responses to particulate S. mutans antigens which are protective against the mucosally associated disease, dental caries. PMID- 6840855 TI - Specificities of monoclonal antibodies against the activated delta-endotoxin of Bacillus thuringiensis var. thuringiensis. AB - Eight hybrid cell lines secreting monoclonal antibodies directed against the activated delta-endotoxin of Bacillus thuringiensis var. thuringiensis were grown in BALB/c mice. Ascites fluids were collected, and the antibodies were purified by antigen-affinity chromatography. The specificity of each monoclonal antibody for the toxin and protoxin was established by the indirect enzyme-linked immunosorbent assay. All the antibodies consisted of gamma 1 heavy and kappa light chains. They were reactive with both the native toxin and the protoxin. In contrast to specific goat antiserum, they failed, however, to bind to heat and sodium dodecyl sulfate denatured antigen. These eight cloned cell lines gave rise to five kinds of antibodies distinguished by isoelectric focusing. Competitive antibody binding studies revealed that these five antibodies recognize at least four distinct antigenic determinants of the native toxin and the protoxin. Two of the epitopes are unrelated, whereas three antibodies compete for binding to their antigenic determinants. In the bioassay with larvae of Pieris brassicae, one antibody was found to block the toxin and protoxin activity completely. A second inhibited it partially, whereas the other three antibodies did not affect it at all. PMID- 6840856 TI - Down regulation of hepatic glucocorticoid receptors after endotoxin treatment. AB - The mechanism by which endotoxin administration results in hypoglycemia was evaluated by characterizing [3H]dexamethasone binding and phosphoenolpyruvate carboxykinase activity in hepatic cytosol preparations from treated and control mice. Starved mice were given Escherichia coli O111:B4 endotoxin or saline intraperitoneally on day 3 after bilateral adrenalectomy. [3H]dexamethasone binding was measured by the charcoal method after the incubation of cytosol preparations with [3H]dexamethasone in the presence or absence of unlabeled dexamethasone. Changes in [3H]dexamethasone binding were found to be time and dose dependent in treated mice. When mice given different doses of endotoxin reached the same stage of morbidity, as indicated by the average time of death, significantly lower glucocorticoid binding was measured. Scatchard analysis of binding isotherms defined a single class of binding sites. Association and dissociation rate constants and the equilibrium dissociation constant (Kd) were not altered, but the maximum number of binding sites was depressed by endotoxin. The rank order of potency of competitors for [3H]dexamethasone binding, dexamethasone greater than hydrocortisone = corticosterone greater than deoxycorticosterone greater than progesterone greater than testosterone = estradiol, was consistent with a glucocorticoid receptor, although the competition was not altered by endotoxin. Endotoxin treatment prevented the glucocorticoid-induced increase in hepatic phosphoenolpyruvate carboxykinase activity. We conclude that the hypoglycemia of endotoxin poisoning is effected, in part, by the inhibition of the glucocorticoid-mediated induction of phosphoenolpyruvate carboxykinase via the down regulation of hepatic glucocorticoid receptors. PMID- 6840858 TI - Neutrophil circulation and release from bone marrow during hypothermia. AB - The effect of hypothermia on neutrophil circulation and release from bone marrow has been studied. Pigs were anesthetized and maintained at 37 degrees C or surface cooled to 29 degrees C over 60 min. As the core temperature was reduced to 29 degrees C, the number of circulating neutrophils (X 10(9) per liter) fell from 6.0 +/- 0.6 to 2.3 +/- 0.3 by 60 min. No significant change in the number of circulating mature or immature neutrophils was observed over the 4 h of observation at 29 degrees C. Neutrophil demargination after administration of intravenous catecholamines was similar at 37 and 29 degrees C. Steroid stimulation of bone marrow to release neutrophils was markedly impaired at 29 degrees C. Circulating mature neutrophils in normothermic pigs increased from 5.6 +/- 1.2 to 10.4 +/- 1.2 by 120 min after administration of intravenous hydrocortisone sodium succinate. Circulating immature neutrophils increased from 1.7 +/- 0.3 to 5.3 +/- 0.4. At 29 degrees C, no significant changes in the number of circulating mature or immature neutrophils occurred. Endotoxin also failed to stimulate neutrophil release from the bone marrow. Furthermore, a marked neutropenia occurred in hypothermic pigs after intravenous endotoxin, which persisted for the 3 h of observation. Neutrophil circulation and release from bone marrow are compromised by hypothermia, which may increase the risk for bacterial infection. PMID- 6840857 TI - Activation of macrophages by quinonyl-N-acetylmuramyl dipeptide. AB - The effect of 6-O-QS-10-N-acetylmuramyl-L-valyl-D-isoglutamine methyl ester (quinonyl-MDP-66) on various functions of macrophages was examined. Mouse peritoneal macrophages, when treated either in vitro or in vivo with quinonyl-MDP 66 suspended in phosphate-buffered saline, showed a capacity for cytolysis and cytostasis against tumor targets and released H2O2 in the presence of phorbol myristate acetate. The macrophages induced by quinonyl-MDP-66 also had both antibody-dependent cell-mediated cytotoxicity and phagocytic activity against erythroid targets. The fact that synthetic quinonyl-MDP-66 stimulates the macrophages to become more cytotoxic than do other MDP analogs suggests that the lipophilic residue (QS-10) in quinonyl-MDP-66 may be important for the development of this activity. PMID- 6840859 TI - Immunomodulation by Blastomyces dermatitidis: functional activity of murine peritoneal macrophages. AB - Cell-mediated immunity plays the dominant role in the immune response of mice to Blastomyces dermatitidis infections. Since macrophages play an important role in cell-mediated immunity, the interactions between sensitized murine peritoneal macrophages and the yeast phase of B. dermatitidis were investigated. Scanning electron microscopy showed that the sensitized macrophages readily phagocytized B. dermatitidis yeast cells. In addition, there appeared to be activation of metabolic pathways within the sensitized macrophages, as indicated by increased chemiluminescence activity during phagocytosis. Sensitized macrophages were significantly better at controlling intracellular proliferation of the yeast cells when compared to nonsensitized cells. This was determined by disruption of macrophages and plating for viable yeasts. Scanning electron microscope observations offered further substantiation. Experiments with Candida albicans indicated that B. dermatitidis non-specifically activated macrophages. At 2 h postphagocytosis, 30% fewer C. albicans in B. dermatitidis-activated macrophages were able to form germ tubes. These studies demonstrated the multiple potential of activated macrophages with regard to their functional activity. PMID- 6840861 TI - Experimental infection of the New World owl monkey (Aotus trivirgatus) with hepatitis A virus. AB - Epidemiological studies have demonstrated the susceptibility of the owl monkey (Aotus trivirgatus) to hepatitis A virus, but have not shown an association between infection and histopathological or chemical evidence of liver disease. Therefore, 12 seronegative, colony-bred monkeys were inoculated intravenously with a fecal suspension containing either PA33 strain hepatitis A virus (a strain recovered from a naturally infected Aotus sp.) or HM-175 virus (recovered from a human). Viral antigen was detected by radioimmunoassay in the feces of six monkeys 6 to 17 days after inoculation with PA33 virus, and by 9 to 21 days serum aminotransferase activities were significantly elevated in each. Antibody to the virus developed in each monkey by 28 days after inoculation. Similar findings were noted in five of six monkeys inoculated with HM-175 virus, although the incubation period preceding aminotransferase elevations was somewhat longer (25 to 39 days). Liver biopsies obtained from the 11 infected monkeys demonstrated mild to moderate portal inflammation, as well as random areas of focal necrosis and inflammation extending outward from the portal region. These data confirm the susceptibility of Aotus sp. to hepatitis A virus and indicate that the infection of this primate provides a useful animal model of human hepatitis A. PMID- 6840860 TI - Chlamydia psittaci elementary body envelopes: ingestion and inhibition of phagolysosome fusion. AB - The cell surface of Chlamydia psittaci seems important for establishing infection since (i) UV-treated elementary bodies (EB) attach to and are ingested by L cells and (ii) heat or antibody treatment decreases attachment to L cells and promotes the fusion of chlamydiae-containing phagosomes with lysosomes in macrophages. In the studies reported here, [3H]uridine-labeled UV-treated EB also persisted in mouse resident peritoneal macrophages and L cells, suggesting that phagosome lysosome fusion is inhibited. We therefore chose to investigate the ingestion and internal fate of isolated purified EB envelopes in both nonprofessional and professional phagocytic cells. EB envelopes are internalized by target host cells as efficiently as are whole EB. Transmission electron microscopy of macrophages whose lysosomes were marked with ferritin revealed the persistence of individual envelopes in phagosomes devoid of ferritin for the 3-h observation period. In contrast, EB envelopes heated to 56 degrees C for 15 min were consistently found in ferritin-labeled phagolysosomes as early as 30 min. As another index of persistence, isolated EB envelopes were radioisotopically labeled with a Bolton Hunter analog, [3H]N-succinimidyl propionate, and their fate as trichloroacetic acid-precipitable material was followed. A third probe, employed to detect the persistence of non-biodegradable antigen, was indirect immunofluorescence. Fluorescein-positive antigens were brightly visible for 7 days in both macrophages and L cells when they were inoculated with untreated EB or EB maintained in penicillin. But L cells inoculated with EB envelopes or EB treated with UV or chloramphenicol, all of which prevent the conversion of infectious EB into the metabolically active reticulate bodies, displayed reduced internal fluorescence by 2 days and the appearance of fluorescent material on the cell surface. This release of EB envelope material occurred in the absence of phagolysosome fusion. The data add credence to the belief that the spontaneous breakdown or autolytic enzyme release of EB envelope components must occur preparatory to the conversion of EB to reticulate bodies. PMID- 6840862 TI - Genetic mapping of the tox-1000 locus of Vibrio cholerae El Tor strain RJ1. AB - The results of a genetic cross between a Vibrio cholerae RJ1 donor and a V. cholerae 3083-2 recipient suggest that the map position of tox-1000 is between his and trp. PMID- 6840863 TI - The significance of the HBe system in an area highly endemic for hepatitis B virus. AB - A group of 164 consecutive patients with chronic liver disease and 60 healthy HBsAg carriers were investigated in an area highly endemic for hepatitis B virus (HBV). Eighty-two of the 164 patients (50%) were found to be HBsAg-positive and only 39 (24%) had no HBV markers. A statistically significant correlation was found in the HBsAg-positive patients between the HBe system, their age and the time which had elapsed since their acute episode. Thus, the prevalence of HBeAg decreased with increasing age and with increasing time since their acute episodes. Furthermore, a statistically significant correlation was found between the presence of HBeAg and active chronic liver disease. Of the patients with chronic active hepatitis with or without cirrhosis, all patients below the age of 13 years were HBsAg-positive and 72% were also HBeAg-positive. The data suggest that the HBeAg-positivity in HBsAg carriers is of limited duration and that the seroconversion from HBeAg to anti-HBe is related to a histologically less active or inactive stage of the disease. PMID- 6840864 TI - Human echinococcosis: follow-up of 23 patients treated with mebendazole. PMID- 6840865 TI - Azathioprine treatment in a patient with HBsAg-positive acute viral hepatitis complicated by bridging necrosis. AB - A patient with HBsAg-positive subacute hepatitis who presented a progressively deteriorating clinical condition was treated with azathioprine (100 mg/day) for eight months. Although the clinical symptoms disappeared and the biochemical abnormalities decreased, the disease nevertheless progressed to chronic active hepatitis. Moreover, azathioprine favoured hepatitis B virus replication since titers of HBsAg, HBeAg and Dane-particle-associated core-antigen, as detected by radioimmunoassay, increased during treatment. In all, this drug was only of moderate use to our patient. PMID- 6840867 TI - Inherited coagulation disorders in the dog. PMID- 6840866 TI - Lactic dehydrogenase isoenzymes in urinary tract infections and aminoglycoside nephrotoxicity. PMID- 6840868 TI - Helminth diseases of cattle. PMID- 6840869 TI - Antigen release from Thermoactinomyces vulgaris by lysozyme treatment. AB - Lysozyme treatment was used to release antigenic material from Thermoactinomyces vulgaris, one of the microbes associated with farmer's lung. Lysozyme caused degradation of the murein layer visualized as changes and disappearance of the bacterial morphology in scanning electron microscopy. Enrichment of different antigenic components in the lysozyme extract and in the cell residue, respectively, was detected by immunoprecipitation. When lysozyme extract and cell residue antigens were used in enzyme-linked immunosorbent assay to test sera of farmer's lung patients and control persons, it became evident that there was no significant difference between the reactions against the two antigens. However, a number of sera reacted preferentially against one or the other of the two antigens. PMID- 6840871 TI - Airway response to leukotriene D4 in rhesus monkeys. AB - We studied the effect of leukotriene D4(LTD4) given by aerosol challenge on asthmatic and normal monkeys. The response to LTD4 occurred within 2 min., was prolonged at higher concentrations, was reversed by epinephrine, and more closely resembled an antigen response than a histamine response. Since LTD4 concentrations of 30-100 micrograms/ml produced a response similar to 2-20 mg/ml of histamine, the LTD4 was 300-900 times as potent as histamine on a molar basis. Thus, LTD4, which appears to reproduce an antigen-induced response in rhesus monkeys, may be a mediator of allergic asthma in these animals. PMID- 6840870 TI - Time course of morphometric changes after acute allergic bronchoconstriction in the guinea pig. AB - Experimental allergic bronchoconstriction was induced in guinea pigs by passive sensitization with a standard dose of homologous antiserum followed by challenge with aerosolized antigen. Lungs were removed from animals at intervals of up to 6 days thereafter, and several parameters of the reaction were assessed morphometrically by comparison with lungs from unsensitized guinea pigs. We determined all changes in volume of the lung tissue resulting from fixation through to the preparation of histologic sections, but no significant differences were observed between the time course subgroups. The size of both large and small airways was assessed by a point-counting technique, as well as by measurement of the percentage of the diameter of the airways contributed by the mean thickness of the muscular layer. Maximal bronchoconstriction was observed morphometrically to correspond with the peak of a response as determined clinically by the use of a strain gauge around the chest. This was followed by a return to normal of the airway size. The number of mast cells and eosinophils around large and small airways, around branches of the pulmonary artery and in random fields of the lung parenchyma was tabulated. The maximal decrease in mast cells was seen in animals which died immediately following challenge, but the numbers were not restored to the control level even in animals which had survived for 6 days. The greatest increase in eosinophil response occurred in lungs obtained 10 min following challenge. This model will be of value in determining the effects at the tissue level of pharmacological inhibitors of this reaction. PMID- 6840872 TI - In vitro generation of mast cell-like cells from human peripheral mononuclear phagocytes. AB - An in vitro culture method, previously shown to induce the transformation of rat macrophages to mast cells, has been adapted to humans. Adherent peripheral human blood mononuclear cells were cultured in a medium supplemented with 30% L-cell supernatant and 30% horse serum. During the first week of culture, the cells were phagocytic (80%), lacked histamine, were not metachromatic and stained faintly for naphthol-AS-D-chloroacetate esterase, primarily in a paranuclear location. During the first 2 weeks of culture, the cells grew in size, synthesized DNA, became nonadherent and developed cytoplasmic chloroacetate esterase staining which was strongly positive in 50-60% of the cells during the third week. Intracellular histamine levels increased steadily during culture, and electron dense metachromatic cytoplasmic granules were present during the third week. Human peripheral blood mononuclear cells contain therefore a subpopulation of cells that can differentiate into mast cells-like cells under specific in vitro culture conditions. PMID- 6840873 TI - Evaluation of the pulmonary immune response by analysis of bronchoalveolar fluids obtained by serial lung lavage. AB - Lavage fluids were obtained from Beagle dogs by serial bronchoalveolar lavage from immunized and control lung lobes 3-21 days after local deposition of sheep red blood cells. Results showed that immunized lobes contained more total protein, albumin, IgG and antigen-specific antibody than did unimmunized control lobes or lobes that received autologous red cells in saline. Antigen-specific antibody was present in the lavage fluid from 7 through 21 days after immunization. Mercaptoethanol treatment of lavage fluid had little effect on the antibody titer, suggesting that IgG, and possibly IgA, were the predominant immunoglobulin classes in the antigen-specific antibody pool throughout the course of the serial lavage study. The data suggest that most of the antigen specific antibody was made locally by cells in the lung. PMID- 6840874 TI - Monoclonal antibodies against gastrointestinal tumour-associated antigens isolated as monosialogangliosides. AB - Monoclonal antibodies were produced after immunization of mice with a colorectal adenocarcinoma cell line or liver metastasis membranes from a patient with colon adenocarcinoma. Many monoclonal antibodies were found to react with colorectal adenocarcinoma cells but not with normal colon mucosa, blood lymphocytes, myeloma cells or lung epithelial carcinoma cells. Three of these 'colorectal tumour specific' antibodies appear to define different antigens that were found in the complex monosialoganglioside fraction from 60 to 90% of the colorectal and pancreatic adenocarcinoma tumours or metastases examined but essentially lacking in normal colon mucosa and other normal or tumour tissues tested. PMID- 6840875 TI - Half-life of murine IgE antibodies in the mouse. AB - The half-life of intravenously injected murine anti-DNP IgE antibody was determined in recipient mice by sequential bleeding and was found to be 12 h. Intradermally injected IgE antibody persisted much longer, the half-life was 6 days. PMID- 6840876 TI - Zinc content of maturing spermatozoa in oestrogen treated rats. AB - Zinc content of spermatozoa collected from the caput and cauda portions of the rat epididymis was determined by atomic absorption spectroscopy. The results showed about 60% reduction in the spermatozoal zinc content by the time they reach the cauda epididymis. This reduction was inhibited in rats receiving micro dose oestrogen which induced 'functional' sterility. It appears that the fall in zinc content of spermatozoa during their transport in the epididymis is related to sperm maturation and that oestrogen treatment interferes with this reduction in sperm zinc content. PMID- 6840877 TI - Effects of gossypol acetic acid on the activity of LDH-C4 from human and rabbit spermatozoa. PMID- 6840878 TI - Testicular development in Macaca irus after birth. AB - The seminiferous epithelium of 34 pre-pubertal, 1 pubertal and 6 adult Macaca irus (syn. Macaca fascicularis, cynomolgus monkey) was studied histologically. The testicular weight roughly doubled each year up to 3.5 years after birth, whereafter a 25-fold increase occurred with puberty. During the first year, the abundant interstitial connective tissue present at birth, was replaced by seminiferous cords that expanded by longitudinal growth. Few changes were seen within the tubules up to 3 years. Adark and Apale spermatogonia were already present in the stillborn monkeys. Before puberty much more Adark than Apale spermatogonia were counted, the Ad/Ap ratio varying between 1.5 and 6.9 before puberty and between 0.8 and 1.3 in the adult. B spermatogonia were present in small numbers after the first year. At puberty large numbers of spermatocytes and spermatids were found. Small testis fragments were incubated with [3H]thymidine and processed for autoradiography. Very few labelled Adark spermatogonia were found both before and after puberty. The Labelling Index (L.I.) for Apale spermatogonia was constant before puberty (6.5%), but increased to 14.9% thereafter. The L.I. for B spermatogonia was 18.7% in the adult. Before puberty the L.I. of Sertoli cells was low (0.27%) but constant. No labelled Sertoli cells were observed in adult monkeys. It is discussed that proliferating adult type A spermatogonia are present between birth and puberty but that, in contrast to the adult situation, differentiation of these cells into B spermatogonia is limited. PMID- 6840879 TI - The effect of norepinephrine, isoprenaline and acetylcholine on the testicular and epididymal circulation in the pig. AB - Blood flow to the testis and epididymis of 7 anaesthetized male pigs was measured using electromagnetic blood flow sensors. An average blood flow to the testis of 12 ml/min/100 g and in the epididymal arteries of 19 ml/min/100 g was measured. The effect of intravenously administered norepinephrine, isoprenaline and acetylcholine on alpha and beta 2 adrenergic and cholinergic receptor sites, respectively, was investigated. As neither norepinephrine nor isoprenaline, nor acetylcholine changed vascular conductance of the testis, we could not demonstrate adrenergic and cholinergic receptor activity. The possibility of autonomic regulation by the nonvascular smooth muscles of the spermatic cord and the inner layer of the tunica albuginea has been discussed. PMID- 6840880 TI - Paracrine regulation of Leydig cells by the seminiferous tubules. AB - Testes of adult control and unilateral cryptorchid rats were fixed by vascular perfusion. The cell profile area of peritubular Leydig cells surrounding tubules in different stages of spermatogenesis, and the cell profile area of perivascular Leydig cells were determined. The size of peritubular Leydig cells was dependent on which type of tubulus the cells were surrounding. Some peritubular Leydig cells, especially those surrounding stages VII-VIII (88.1 +/- 7.1 micrometers2, mean +/- SD, n = 6 rats), were larger than perivascular Leydig cells (69.3 +/- 5.9 micrometers2). The size of Leydig cells surrounding stages IX-XIV was similar to that of perivascular cells. In the abdominal testes no spermatogenic cycle was present and the sizes of peritubular and perivascular Leydig cells were equal (63.0 +/- 5.1, vs 66.7 +/- 7.3 micrometers2, mean +/- SD, n = 5 rats). It is suggested that the tubules and the spermatogenic cycle locally modulate Leydig cell activity and that Leydig cell malfunction in abdominal testes may be due to a decreased stimulatory influence from the damaged tubules. PMID- 6840882 TI - Hemofiltration: present status and prospects. PMID- 6840881 TI - Early effects of efferent ductule ligation on the proximal segment of the rat epididymis. AB - The effects on the proximal caput epididymidis of efferent ductule ligation were studied. After 6 h there was a slight increase in autophagocytosis in the initial segment proper (1A). After 12 h this segment showed cell death and cytoplasmic regression and after 24 h large amounts of necrotic cells and focal degeneration in the epithelium, and desquamated cells and debris in the lumen. After 48 h the epithelium was lower, but degeneration less obvious. Segments 1B, 1C and 2 showed marked cell death and cytoplasmic degeneration. This was more evident after 3 days, especially in 1B. After 5 and 7 days some degeneration was still seen, but essentially regional differences had disappeared, leaving a lower, inactive epithelium throughout. Except for an increase in glycogen granules in segment 1C after 48 h, marked focal degeneration always appeared before general cytoplasmic alterations. Sham operation produced no changes. The regression might be caused by the cut supply of androgen binding protein or a growth factor in rete testis fluid. PMID- 6840883 TI - Three years of experience with on-line preparation of sterile pyrogen free infusate for hemofiltration. PMID- 6840884 TI - Hemodynamics in hemofiltration. AB - To study the established but not well understood phenomenon of improved intratreatment vascular stability during hemofiltration the same 10 stable hemodialysis patients were investigated during one hemodialysis and one hemofiltration treatment. Both treatments were matched in regard to linear fluid withdrawal (3 kg/240 minutes), small molecule removal rate (Curea 120 ml/min). Sodium (140 meq/l) and acetate (35 meq/l) concentration in dialysate and replacement fluid were identical. Outcome measures included mean arterial blood pressure, total peripheral vascular resistance by thermodilution, plasma noradrenaline concentration as index of sympathetic activity and sodium loss per treatment. Blood pressure was maintained during hemofiltration, while total peripheral vascular resistance and plasma noradrenaline concentrations increased. During hemodialysis mean arterial blood pressure fell significantly, total peripheral resistance and plasma noradrenaline concentrations remained unchanged. During both treatment modalities sodium loss was comparable. It is concluded, that the improved hemodynamic stability during hemofiltration is due to a maintained physiologic response to ultrafiltration, which is impaired during hemodialysis. Vascular stability during hemofiltration is not due to sodium retention relative to hemodialysis. PMID- 6840885 TI - Prospects of hemofiltration. PMID- 6840886 TI - Sodium balance in hemofiltration. PMID- 6840888 TI - Complications of hemofiltration. PMID- 6840887 TI - Blood temperature and cardiovascular stability in hemofiltration. AB - Temperature (T) changes in the blood flowing through the extracorporeal circuit markedly affect cardiovascular tolerance to fluid removal during either hemodialysis (HD) and isolated ultrafiltration. In this study we investigated the effect of blood T changes during postdilutional hemofiltration (HF). To this purpose we compared the changes in mean arterial pressure (MAP) and heart rate (HR) during HF and HD carried out at equivalent T of blood in the venous segment of the extracorporeal circuit. Results show that HF entails some heat loss from blood flowing in the extracorporeal circuit; if heat loss is made similar, HD affords nearly as much blood pressure protection as HF does. On the other hand at equivalent heat gain, HF causes nearly as much hypotension as HD does. We conclude that blood T changes in the extracorporeal circuit affect vascular stability (VS) even in HF. The marginal benefit of HF over HD, still observed at equalized T changes, remains to be elucidated. PMID- 6840889 TI - Solute kinetics and fluid removal in hemofiltration. PMID- 6840890 TI - High efficiency in maintenance hemofiltration. PMID- 6840891 TI - The rebirth of bicarbonate. PMID- 6840892 TI - Gram negative peritonitis. PMID- 6840894 TI - Fistula survival in single needle hemodialysis. AB - This study presents an average follow up per patient of 33.5 +/- 3.7 and 70.1 +/- 5.9 months (hospital and home dialysis) showing an actuarial fistula survival rate of 86.2% and 85.5% respectively after 5 years. The data suggest a satisfactory survival rate of the fistula when a single needle technique is used in comparison to the survival observed with the two needles technique. PMID- 6840893 TI - Isotachophoretic pattern of LDH inhibiting fractions obtained from uremic ultrafiltrate by gelchromatography. AB - Uremic ultrafiltrate was fractioned by chromatography on Sephadex G15; two fractions were highly inhibiting the total lactate dehydrogenase activity in rat kidney homogenate. The inhibiting fractions were eluates number 10 and 11 with an elution volume of respectively 17.4 ml and 19.3 ml and a Kav of 0.17 and 0.25. Both fractions presented a different pattern on analysis by analytical isotachophoresis. PMID- 6840895 TI - Failure to show a temperature-dependent vascular stability during hemofiltration. AB - The effect of different blood temperatures on the vascular stability during hemofiltration was evaluated in 10 patients being in the regular chronic hemofiltration program. In contrast to recent data, no differences could be observed with regard to the heart rate, systolic blood pressure or mean arterial pressure, when the blood returned to the patient either with a temperature of 34.68 degrees C or 36.22 degrees C. According to these data it is therefore presently not justified to consider differences in the blood temperature as a critical determinant for the vascular stability during HF. PMID- 6840896 TI - Origin of glycosylated hemoglobin A1 in chronic renal failure. AB - In chronic renal failure both HbA1 and HbA1c levels have been reported to be elevated. In order to investigate the causes of such increase we measured HbA1 (cation-exchange chromatography), blood urea nitrogen, arterial blood pH, plasma bicarbonate, phosphatemia, serum iron and serum ferritin before dialysis in 60 uremic patients receiving long term hemodialysis. The increased levels of HbA1 do not correlate with glucose intolerance, phosphatemia, blood urea nitrogen, time averaged concentration of urea, serum iron and serum ferritin. On the contrary the presence of a highly significant correlation between HbA1 and arterial blood pH (p less than 0.001) and between HbA1 and plasma bicarbonate (p less than 0.001) seems to emphasize a major role for acidosis in increasing the HbA1 levels in uremic patients on long term hemodialysis. PMID- 6840897 TI - A method for the study of cryoglobulin solubilization curves at 37 degrees C. Preliminary studies and application to plasma exchange in cryoglobulinemic syndromes. AB - A simple method for the study of kinetic solubility curves of cryoglobulins is presented. In its first application to the study of 21 patients with cryoglobulinemia, it was possible to ascertain that clinical condition roughly correlates with decreased solubility whereas no correlation is found with per cent cryocrit. In the group of patients we studied, 6 underwent plasma exchange treatment when glomerulonephritis, acute renal insufficiency, cerebritis and polyneuropathy appeared: in these patients, following 2 to 5 apheretic sessions, solubility increased showing a sort of correlation with clinical benefits determined by treatment. The preliminarity of this study is underlined. PMID- 6840898 TI - Hollow fiber immobilized L-asparaginase: in vivo and in vitro immunological studies. AB - The enzyme L-asparaginase was covalently immobilized on the inner surface of the hollow fibers utilized in a commercially available dialyzer by the periodate method. After sterilization with gamma radiation the bioreactor was able to metabolize in vivo, 90 per cent of circulating asparagine in two hours. The absence in blood of asparaginase-related protein fragments, released from the hollow fiber immobilized enzyme, was monitored using a specific enzyme-linked immunosorbent assay (ELISA). PMID- 6840899 TI - Failure of peritoneal dialysis due to peritoneal sclerosis. PMID- 6840900 TI - Fibronectin and dialysis-induced hypoxemia. PMID- 6840901 TI - Right ventricular function in Chagas disease. AB - To study right ventricular function, we performed cardiac catheterization, and right and left cineventriculograms in 60 chagasic patients and 15 non-chagasic, non-heart disease patients. Chagasic patients with normal electrocardiograms and left cineventriculograms also had normal right ventricular function. Nine of 14 chagasic patients with normal Ecg's and early left ventricular damage had right ventricular dilatation and/or segmental inferior-apical asynergy. Fourteen of 19 chagasic patients with abnormal Ecg's and advanced left ventricular damage, but without signs of congestive heart failure, and all chagasic patients with congestive heart failure, had marked right ventricular dilatation, severe right contractility depression and abnormal right apical or para-apical motion. These findings indicate that Chagas disease is a diffuse cardiomyopathy in which the left ventricle seems to be affected earlier and to a greater extent than the right ventricle. Since segmental abnormalities were predominantly observed in apical and para-apical areas of the ventricles, performance of right and left cineventriculograms is recommended before implantation of cardiac pacemakers. PMID- 6840902 TI - Dilazep-induced reduction of ischemic necrosis in rats with coronary artery occlusion. AB - To assess whether dilazep reduces myocardial necrosis we assigned 72 rats that survived coronary artery occlusion to 3 groups. The first control group (n = 26) received coronary occlusion and was untreated. The second group (n = 21) received coronary occlusion and was treated with dilazep (150 micrograms/kg s.c.) every 8 hours for 48 hours. The third group (n = 25) was sham-operated. Forty-eight hours later the creatine-kinase activity of the left ventricle was measured. The calculated left ventricular fraction that survived the occlusion was larger in dilazep-treated rats (44.5 +/- 4.1% of left ventricle) than in controls (31.2 +/- 3.2%; P less than 0.05). Twenty-six more rats also underwent coronary occlusion; 12 were controls and the remaining 14 were treated with dilazep at the same time and dose as before and killed 21 days after occlusion. Infarct size was evaluated on histological sections of the hearts by planimetry. The amount of left ventricle preserved from necrosis was larger in dilazep-treated rats, 82.1 +/- 0.9%, compared to controls 69.5 +/- 1.4% (P less than 0.05). Dilazep seems effective in preserving myocardial tissue from ischemic necrosis, and its beneficial effects are long-lasting, producing permanent reduction of infarct size. PMID- 6840903 TI - Thrombotic complications with pacemakers. AB - To analyze thrombotic complications, we performed brachial phlebographies in 100 consecutive patients (group 1), about 44 months after permanent pacemakers had been installed. Thirty-nine patients showed thrombotic lesions in the veins used to pass the stimulation electrode into the right ventricle. In 10 patients the medical history and in 12 patients clinical symptoms and signs indicated an impairment of venous flow. Fifteen of the 39 patients showed complete occlusion of one venous segment; collateral vessel formation was found dependent on the site and the extent of the occlusion. In the remaining 24 patients only partial occlusion without collateralization was demonstrated. Group 2 comprised 12 patients in whom the pacing lead originally inserted via right-sided veins had been severed and the free distal end left unsecured intraluminally when the second electrode was inserted via the left-sided cephalic vein. In all these patients phlebography about 19 months later revealed thrombotic complications, while 11 presented with clinical symptoms and signs. The incidence of thrombotic complications including segmental occlusion after the application of permanent pacer leads is only one-third of patients with segmental occlusion symptoms. However, since severed leads produce severe symptomatic complications in almost all cases their removal is mandatory. PMID- 6840905 TI - The title. What's in a name? PMID- 6840904 TI - Desmethylimipramine and imipramine on left ventricular function and the ECG: a randomized crossover design. AB - Sixteen severely depressed patients participated in a double-blind randomized, crossover study to compare the effects of desmethylimipramine and imipramine on left ventricular function and the electrocardiogram. Following a drug-free week, patients had 3 weeks of therapy each with desmethylimipramine and imipramine. During each treatment period systolic time intervals, echocardiograms and high fidelity electrocardiograms were recorded. There was no difference between desmethylimipramine and imipramine on (1) systolic time intervals, (2) shortening fraction or mean velocity of circumferential shortening, or (3) the electrocardiogram. There was a difference between the drug-free period and desmethylimipramine or imipramine on the PEPc (P less than 0.05) and the PEP/LVET ratio (P less than 0.05); on the R-R (P less than 0.05), PR (P less than 0.05), QRS (P less than 0.05), and QTc (P less than 0.05) intervals; but no difference on the LVETc or shortening fraction or the mean velocity of circumferential shortening. Drugs such as desmethylimipramine and imipramine which prolong intraventricular conduction can probably be expected to prolong the PEP and PEP/LVET. For this reason systolic time intervals have limitations in assessing myocardial function and the echocardiogram more reliably estimates myocardial performance in patients receiving tricyclic antidepressants. PMID- 6840906 TI - Treatment of malignant ventricular tachyarrhythmias with the automatic implantable defibrillator. PMID- 6840907 TI - Treatment of reentrant tachycardia using a fully implantable automatic scanning pacemaker. PMID- 6840908 TI - Ultrasonic examination of the coronary arteries. PMID- 6840910 TI - Weasel words in paediatric cardiology. PMID- 6840909 TI - Myocardial rupture. PMID- 6840911 TI - Geographic cardiology: a comparison between the East and the West. PMID- 6840912 TI - Mexiletine for treatment of sustained recurrent ventricular tachycardia. PMID- 6840913 TI - Triggered automaticity in canine myocardial infarction. PMID- 6840914 TI - Two-dimensional echocardiographic recognition of an atrial septal aneurysm. PMID- 6840915 TI - Ventricular function in a child with arterial switch for transposition of the great arteries. PMID- 6840916 TI - Estimation of infarct size with MB rather than total CK. AB - We estimated infarct size in 95 patients with clinically uncomplicated infarction from total CK and results were compared to infarct size index based on plasma MB CK. Among patients with relatively low infarct size index indicative of relatively small infarctions (less than or equal to 20), estimates with total CK correlated closely with those based on MB CK (r = 0.88). In contrast, among patients with larger infarcts (infarct size index greater than 20) the correlation was poor. In this group, values for infarct size index based on total CK were 67 +/- 4 (SE)% greater than those based on MB CK. In the overall population, infarct size index based on MB (14 +/- 1 (SE) CK-gram-equivalents/m2) was less than that based on total CK (21 +/- 2). These disparities appear to reflect occult release of non-cardiac CK in patients with more extensive infarction. Thus, even in patients without overt clinical complications enzymatic estimates of infarct size are more accurate when based on MB rather than total plasma CK. PMID- 6840918 TI - Closed-chest ablation of the atrioventricular conduction system. PMID- 6840917 TI - Assessment of ventricular function by combined noninvasive measures: factors accounting for methodologic disparities. AB - We studied the predictive accuracy and disparities among cineventriculographic ejection fraction, pre-ejection period over left ventricular ejection time (PEP/LVET) obtained from the systolic time intervals and the percent shortening of the internal echocardiographic diameter (% delta D) in assessing left ventricular performance in 453 consecutive patients without valvular heart disease. In 308 patients all three tests were normal, and in 78 patients all three tests were abnormal. Overall agreement (predictive accuracy) among ejection fraction (normal greater than or equal to 57), % delta D (normal greater than or equal to 28%) and PEP/LVET (normal less than or equal to 0.42) was 85%. In 67 patients disparities among the tests as measures of global left ventricular performance were found. The major mechanisms accounting for such disparities were: (a) large segmental contraction abnormalities which selectively distort the % delta D and ejection fraction and (b) diminished isovolumic pressure (less than 45 mmHg) which distorts PEP/LVET. When patients with segmental contraction abnormalities and low isovolumic pressure were excluded the agreement between PEP/LVET and ejection fraction was 97%, ejection fraction and % delta D 98% and PEP/LVET and % delta D 97%. The combined uses of systolic time intervals and echocardiogram minimizes error due to segmental contraction abnormalities and isovolumic pressure. If both PEP/LVET and % delta D are concordant the agreement with ejection fraction is 94% for normal and 99% for abnormal left ventricular function. PMID- 6840919 TI - Does training post-infarct patients reduce the risk of reinfarction? PMID- 6840920 TI - Complete left bundle branch block: is the diagnosis of myocardial infarction possible? PMID- 6840921 TI - The ambulatory electrocardiographic ST segment. PMID- 6840922 TI - Echocardiography in constrictive pericarditis - another test or a diagnostic advance? PMID- 6840923 TI - Diuretics: first line treatment for hypertension. PMID- 6840925 TI - Kinetics of low-dose intravenous antipyrine: use of liquid chromatography. AB - Rapid and sensitive quantitation of antipyrine in plasma is achieved by high pressure liquid chromatography. Antipyrine and phenacetin, the internal standard, are readily extracted from alkalinized plasma into ethyl acetate. After evaporation of the organic solvent, the redissolved residue is chromatographed using a reverse-phase C-18 column. The sensitivity limit is approximately 0.25 micrograms antipyrine per ml plasma, with a coefficient of variation for identical samples not exceeding 3%. Using the automated sampling system, one person can analyze up to 100 samples per day. The method is reliable and sensitive enough to allow human pharmacokinetic studies of antipyrine using doses considerably less than utilized in previous studies. The disposition kinetics of a single i.v. dose of antipyrine in four human volunteers were essentially identical over a 5-fold range of doses. PMID- 6840924 TI - Coronary occlusion during cineangiocardiogram in a child with ventricular septal defect without pulmonary hypertension. PMID- 6840926 TI - The bioavailability of flufenamic acid and its dissolution rate from capsules. AB - The bioavailabilities of five commercially available flufenamic acid (FA) capsules were studied in humans and beagle dogs. The dissolution rates of these capsules were determined by several methods. Experiments on in vitro/in vivo and humans/dogs correlations were performed to evaluate the dissolution test methods and the values of beagle dogs as models for predicting bioavailability of weak acid drugs in humans. Significant differences in the rates and extents of bioavailability of the different capsules were observed both in humans and dogs, but results in humans differed from those in dogs. The dissolution rates, determined by dissolution methods involving pretreatment with acidic solutions, correlated significantly with bioavailabilities in humans and dogs; however, those obtained by the rotating basket and paddle methods without any surface active agents did not correlate with in vivo data. PMID- 6840927 TI - Pharmacokinetic properties of a new sustained-release theophylline preparation. AB - A newly developed compressed theophylline tablet with slow in vitro dissolution rate was investigated in six healthy volunteers. The mean bioavailability of theophylline during a single oral dose was 97%, which did not significantly differ from the i.v. reference. The bioavailability of Teovent-SR measured during a dosing interval at steady state was on the average 110%, significantly (p less than 0.05) higher than the i.v. standard. This points to the possibility of a lower total clearance under conditions of multiple dosing of theophylline. Thus a single i.v. dose may not be the proper reference for evaluating bioavailability of theophylline during steady state. During maintenance administration of the tablet every 12 h the maximum plasma level of theophylline was reached after 4 h. The maximum concentration during a dosage interval at steady state was on the average 22% (range 14-32) higher than the mean concentration, whereas the trough level was on the average 28% (range 20-43) below the mean. During 8.5 h, i.e., 70% of the 12 h dosing interval, at least 75% of the maximum concentration was maintained. This theophylline formulation has a complete bioavailability and slow release characteristics that produce reasonably stable plasma concentrations over a dosing interval of 8-12 h. PMID- 6840928 TI - Effect of sotalol withdrawal on serum lipids and lipoprotein lipase activity. AB - Serum total cholesterol, HDL cholesterol, triglycerides, and adipose tissue lipoprotein lipase activity were analyzed in seven hypertensive subjects using 160-480 mg sotalol daily, before and after a 3-week pause in the treatment. Triglycerides decreased and HDL cholesterol increased significantly during the break in sotalol treatment, whereas no changes occurred in total cholesterol and lipoprotein lipase. A positive correlation was found after the interruption between the lipoprotein lipase activity and the HDL cholesterol concentration. This correlation did not exist before the break in the drug treatment. On the basis of these results the effects of sotalol on lipoprotein metabolism do not seem to be mediated by lipoprotein lipase. PMID- 6840929 TI - The use of clofibrate in patients with renal insufficiency. AB - Serum clofibrinic acid (CPIB) levels after single and multiple oral doses of clofibrate were studied in 28 patients with elevated serum creatinine values. The half-life of CPIB was prolonged in proportion to the serum creatinine level (r = 0.818 p less than 0.001). Peak CPIB concentrations in serum were not affected by azotemia, although CPIB levels 24 h after a single dose and under steady-state conditions correlated well with the serum creatinine level. The proportion of unbound CPIB was higher in patients with renal insufficiency than in controls (13.9% vs 4.3%), although this difference did not correlate with the serum creatinine level. Hypolipidemic medication is indicated in dyslipoproteinemias associated with renal insufficiency. If a reduced dose is given, clofibrate can be used safely in renal patients, although a CPIB concentration of 70 mg/l in serum should not be exceeded unless the unbound fraction has been measured and found not to exceed a safe level (i.e., 6 mg/l CPIB). PMID- 6840930 TI - Age-associated pharmacokinetic changes of metronidazole. AB - Serum concentration and urinary excretion of metronidazole were determined after p.o. administration of 500 mg to 15 young (20-25 years old) and 20 elderly (over 70) subjects. Serum levels were consistently higher and the AUCs were almost doubled in the aged group. One of the effects underlying the decrease in total clearance is the diminished renal excretion; however, the role of the reduction of distribution volume seems to be more important. Red cell binding of metronidazole significantly decreased in the aged group; this may also contribute to the reduction of distribution volume. Reduction of the standard dose of metronidazole by 30-40% is recommended in elderly patients. PMID- 6840931 TI - New aspects in the use of atropine. AB - Several new factors have recently been shown to influence the pharmacokinetics of atropine. Age appears to have a clear effect on the elimination of atropine: for example, prolonged elimination has been found in children under 2 years of age and in the elderly. The higher sensitivity of these patients to the effects of atropine can be explained, at least partly, by this phenomenon. Due to the fast placental transfer of atropine, i.v. administration before cesarean section can have strong effects on the newborn. Most important, however, it decreases the barrier pressure of the lower cardioesophageal sphincter (pulmonary aspiration). Thus, routine atropine premedication is contraindicated before cesarean section. On the other hand, children appear to need a routine anticholinergic premedicant. Without it profuse salivary secretion may interfere with anesthesia. The use of atropine in premedication of healthy adult patients is controversial. Because peroral premedication (benzodiazepines) is nowadays increasing in the adult patient, especially in the elderly, routine use of atropine should be avoided. PMID- 6840932 TI - In vitro and in vivo effect of sisomicin and gentamycin on polymorphonuclear chemotaxis and phagocytosis. AB - Ten patients with acute bacterial infections were studied to demonstrate the influence of two aminoglycosides, sisomicin and gentamycin on polymorphonuclear (PMN) chemotactic and phagocytic functions. Five of these subjects were treated with gentamycin and five with sisomicin both at a dosage of 2.5 mg kg-1 day-1. The assays were performed before and after 5 days of therapy. Before beginning treatment, the in vitro action of the aminoglycoside antibiotics (20 micrograms ml-1) was also tested. Granulocytes from 8 healthy people were used as controls. After therapy, no significant difference in basic values was found in either the gentamycin treated or in the sisomicin treated group. Similar results were obtained in incubation tests on both patients and healthy subjects. In conclusion, we conclude that the use of these mentioned aminoglycoside antibiotics, at the therapeutical doses employed, does not interfere with the PMN functions. PMID- 6840933 TI - The effect of cyclophosphamide on autoimmune response to rats immunized with modified accessory glands. AB - It was found that the organ specific hemagglutinating autoantibodies to rat male accessory glands can be suppressed by the injection of a single dose of cyclophosphamide applied 3 days after the first immunization. On the other hand, injection of the drug 3 days before immunization did not modify the response, that is, there were comparable incidence and titers in both treated and the control animals. Cyclophosphamide did not appear to act on the homocytotropic antibodies. These results indicate that cyclophosphamide acts only when it is administered after antigenic stimulation, to suppress hemagglutinating antibodies production. PMID- 6840934 TI - C5a and antigen-induced tracheal contraction: effect of a combination of an antihistamine and cyclo-oxygenase inhibitors. AB - Our previous studies with C5a, a cleavage product of the fifth component of complement, have shown that the antihistamine diphenhydramine and the cyclo oxygenase inhibitor aspirin do not inhibit the C5a-induced contraction of isolated guinea pig trachea (Regal, Eastman & Pickering, 1980; Regal & Pickering, 1981). We investigated the effect of cyclo-oxygenase inhibitors in the presence of diphenhydramine to determine if cyclo-oxygenase products were contributing to the contraction beyond any effect they might have on histamine release. A combination of a cyclo-oxygenase inhibitor and diphenhydramine caused a delay in onset and decrease in magnitude and duration of the C5a-induced contraction. Indomethacin itself also caused a slight inhibition. In contrast, a combination of aspirin and diphenhydramine did not inhibit the initial portion of antigen induced tracheal contraction any more than diphenhydramine alone and enhanced the later portion just as aspirin alone. Cross tachyphylaxis experiments demonstrated that antigen pretreatment significantly inhibited a subsequent C5a-induced tracheal contraction, though C5a pretreatment did not affect a subsequent antigen induced contraction. Thus, cyclo-oxygenase products do contribute to C5a-induced tracheal contraction, and histamine participation in the presence of cyclo oxygenase inhibitors is suggested. Our studies demonstrate the dissimilarities of C5a and antigen-induced contraction as regards inhibition by aspirin plus diphenhydramine, yet suggest common pathways leading to the contractile response as evidenced by cross tachyphylaxis experiments. PMID- 6840935 TI - Observations on the immunomodulator NPT 15392 in New Zealand Black mice. AB - NPT 15392, an experimental drug with immunomodulatory activities, was administered to New Zealand Black (NZB) mice over an extended period of time. Anti-erythrocyte antibody levels and spleen weights increased with age in NZB mice, while hematocrits (Hct) declined slightly. In addition, both antierythrocyte antibody and spleen weights were negatively correlated with Hct ( 0.545 and -0.848, respectively). NPT 15392 therapy retarded the development of anti-erythrocyte antibody in young mice (11 weeks old), and reduced the levels of this autoantibody in 38 week old animals. The slight improvement in the index of anemia in the older treated mice was also accompanied by a substantially lower spleen weight. No significant effect of NPT 15392 therapy was observed on Hct levels. These results indicate that NPT 15392 has a modifying effect on the evolution of the autoimmune process in this strain of mouse. PMID- 6840936 TI - Bone marrow iron depression in competitive distance runners. AB - Suboptimal hemoglobin and serum iron have been reported in endurance athletes. In the present study peripheral blood, bone marrow cellularity and hemosiderin, serum iron and serum iron binding capacity were observed in 12 competitive distance runners. Hemoglobin, hematocrit, mean corpuscular volume and concentration, serum iron and iron binding capacity were within normal range. Peripheral blood showed mild hypochromia in six runners, bone marrow cellularity was reduced in two, while bone marrow hemosiderin granules were absent in seven and traces were seen in five. These data suggest that a proportion of highly trained distance runners have insufficient iron stores and need supplementation to balance their iron requirements. PMID- 6840937 TI - The effects of heat acclimation on plasma volume and plasma protein of females. AB - Four females were studied during a 10-day heat acclimation regimen consisting of 2 h per day of stationary cycle riding (means = 46% VO2 max) in a hot environment (40 degrees C, 50% RH) to determine the effects of heat acclimation on changes in plasma volume and vascular protein both at rest and during exercise. Changes in plasma volume were calculated from hematocrit and hemoglobin measurements. Plasma volume decreased during each 2-h session on baseline days through heat day 6 ( 4.9% to -1.2%). On heat days 8 and 10, there was an expansion of plasma volume during the session (1.4% and 0.8%). This hemodilution was significantly different (P less than 0.05) from the hemoconcentration on baseline through heat day 4. The gain of protein during the 2-h session was not significantly different on any of the heat days from that on baseline days. With acclimation of females to work in the heat, there is an increased ability to maintain the fluid of the vascular compartment during a 2-h exercise session in the heat. PMID- 6840938 TI - Semi-automatic blood lactate assay: experiences from an exercise laboratory. AB - A semi-automatic system based on flow injection analysis (FIA) for the transportation of small sample aliquots has been combined with fluorometric, enzymatic methods for blood lactate determination and has been described earlier. In the present study duplicate blood samples were obtained from exercising subjects to enable a comparison of lactate concentrations between neutralized and non-neutralized samples. Duplicate samples were also obtained to enable FIA lactate values to be compared to those obtained with a manual enzymatic method, and with a colorimetric method. No significant change was observed if the sample was not neutralized, enabling a more rapid sample turnover. The FIA method was reliable, with a coefficient of variation of 4.9% between duplicate blood samples. FIA lactate values were valid when compared to two other manual assays. FIA has been shown to be a rapid (60 samples x h-1) means of accurately determining blood lactate concentrations with 25 microliter blood samples and is of particular relevance to the exercise laboratory. PMID- 6840939 TI - Pathogenesis of Behcet's disease. PMID- 6840940 TI - Fibrin deposits and fibrinolytic activity in Schonlein-Henoch syndrome. AB - Previous reports have shown that alterations in cutaneous and plasmatic fibrinolytic activity are found in cutaneous necrotizing vasculitis (CNV). In a combined investigation with direct immunofluorescence and autohistographic evaluation of tissue fibrinolytic activity in the lesional skin of 20 subjects affected by Schonlein-Henoch (SH) syndrome, there was a marked decrease in cutaneous fibrinolytic activity in SH syndrome accompanied by deposits of fibrin like material at the dermo-epidermal junction and around the small blood vessels of dermis in affected skin. These data suggest some interactions between decreased fibrinolytic activity, fibrin deposits, and the tissue damage in the development of skin changes in SH syndrome. PMID- 6840941 TI - Dermatophytic infection of the scalp in the region of Butare (Rwanda). AB - We examined samples of hairs taken from 60 children presenting with the clinical picture of tinea capitis. In 53 cases, direct microscopic examination showed either ectothrix or endothrix parasitism, and we were able to grow the causative dermatophyte. We had 34 strains of Trichophyton violaceum, 19 of Microsporom langeroni, and two of Trichophyton verrucosum. The latter is found for the first time in this region to be a cause of ringworm in humans. PMID- 6840942 TI - Syringoma of the forehead. PMID- 6840943 TI - Ingrowing toenails of infancy. PMID- 6840944 TI - Phrynoderma. PMID- 6840945 TI - Unusual hair changes with minoxidil therapy. PMID- 6840946 TI - A comparison of miconazole nitrate and selenium disulfide as anti-dandruff agents. AB - The anti-dandruff efficacy of two shampoos containing 2% miconazole nitrate and 2.5% selenium disulfide was compared in 15 subjects and eight subjects, respectively. The antifungal drug, miconazole nitrate, was found to possess anti dandruff activity similar to selenium sulfide, a cytostatic compound. For evaluation, techniques of clinical grading and the corneocyte count were used and the latter was found inaccurate. Instead, clinical assessment by grading the severity, supplemented by cytodiagnosis by smear examination was found more helpful. The latter helps to evaluate both the altered pathophysiologic and microbial factors operating in a given case of dandruff, which is a symptom complex brought about by multiple etiologic factors. PMID- 6840947 TI - Skin mycoses--geographic distribution and present-day pathomorphosis. PMID- 6840948 TI - Vitamin D and the metabolism of epidermis. PMID- 6840949 TI - Decreased microfilarial load and its effect on the calculation of prevalence and the rate of false negatives in the detection of onchocerciasis. AB - It has been shown in the epidemiological evaluation of onchocerciasis that the method of taking two or more snips per person contains information about the probabilities of false negatives which can be extracted and used to improve the prevalence estimates. Using the method of maximum likelihood, one can obtain expressions for estimating the prevalence, adjusted for the false negatives, and for estimating the proportion of false negatives. The variances of all estimates are also available, making confidence interval estimation possible. PMID- 6840950 TI - Respiratory disease amongst Aborigines in the Pilbara. AB - Aboriginal communities have a high prevalence of upper and lower respiratory tract disease. One thousand two hundred and eighty seven West Australian Aborigines and 265 non-Aborigines were examined. Twenty nine per cent of Aborigines had lower respiratory tract abnormalities. Amongst 635 Aboriginal children less than 15 years of age, 23% had lower respiratory tract signs--four times the prevalence in 174 non-Aborigines. Twenty six per cent of Aborigines under 10 years of age had signs of otitis media, compared to 3% amongst non Aborigines. Two hundred and thirty eight (53%) of Aboriginal children less than 10 years of age had nasal discharge, compared to 1.6% of the non-Aboriginal children. PMID- 6840951 TI - Smoking and menstrual disorders. AB - An association between cigarette smoking and menstrual disorders was observed during 1981 in a sample of 1367 women between the ages of 18 and 44 years in selected communities of Los Angeles County. Relevant questions were asked as part of a survey conducted to investigate the general health status of women living in these communities. The five-year period prevalence of physician-attended menstrual disorders, as reported in the survey, was 20.3%; the prevalence of menstrual disorders was higher among smokers (25.1%) than among nonsmokers (18.6%). Women who smoked 1 1/2 packs of cigarettes or more per day were twice as likely to report past menstrual disorders as women who were nonsmokers. The results, though inconclusive, warrant further investigation. PMID- 6840952 TI - Pipe, commercial and hand-rolled cigarette smoking in oesophageal cancer. AB - The relative risks of oesophageal cancer involved in the smoking of pipe, commercial and hand-rolled cigarettes were examined after adjustment for age, alcohol and total tobacco consumption. In contrast with what has been observed for lung and laryngeal cancer, pipe and hand-rolled cigarettes entail a risk of oesophageal cancer that is not inferior and probably greater than commercial cigarette smoking. This indicates that the mode of action of tobacco on the oesophagus may be related to the swallowing of smoke condensates. PMID- 6840953 TI - Re-evaluate the evaluation of logistic multiple regression and alternatives: longitudinal models for chronic disease risk. PMID- 6840954 TI - Dietary prevention of coronary heart disease in women: the Finnish mental hospital study. AB - A controlled intervention trial, with the purpose of testing the hypothesis that the incidence of coronary heart disease (CHD) could be decreased by the use of a serum-cholesterol-lowering (SCL) diet, was carried out in two mental hospitals near Helsinki in 1959-71. The subjects were hospitalized middle-aged women. One of the hospitals received the SCL diet, ie a diet low in saturated fats and cholesterol and relatively high in poly-unsaturated fats, while the other served as the control with a normal hospital diet. Six years later the diets were reversed, and the trial was continued another six years. The use of the SCL diet was associated with markedly lowered serum cholesterol values. The incidence of CHD, as measured by the appearance of certain electrocardiographic patterns and by the occurrence of coronary deaths, was in both hospitals during the SCL-diet periods lower than during the normal-diet periods. The differences, however, failed to reach statistical significance. An examination of a number of potential confounding variables indicated that the changes in them were small and failed to account for the reduction in the incidence of CHD. Although the results of this trial do not permit firm conclusions, they support the idea that also among female populations the SCL diet exerts a preventive effect on CHD. PMID- 6840955 TI - Relation of serum cholesterol and triglycerides to the risk of acute myocardial infarction, cerebral stroke and death in eastern Finnish male population. AB - A random population sample from two countries of eastern Finland was studied in 1972, measuring eg the serum total cholesterol and triglycerides, blood pressure, and smoking. The participation rate among men aged 30 to 59 was 92%. Men who had had a myocardial infarction, angina or cerebral stroke in the preceding 12 months were excluded. During the seven-year follow-up 211 men had an acute myocardial infarction (AMI), 59 men had a cerebral stroke and 185 men died of any disease. The serum total cholesterol (greater than or equal to 8.0 mmol/l) had a positive association with the risk of AMI (relative risk RR = 2.8, 95% Cl = 1.8-4.3) and the risk of death (RR = 2.2, 95% Cl = 1.3-3.7) among men aged 30-49 but only with the risk of AMI (RR = 2.0, 95% Cl = 1.3-3.1) among those aged 50-59 based on multiple logistic models including also age, serum triglycerides, diastolic blood pressure, smoking and obesity. Serum triglycerides (greater than or equal to 2.8 mmol/l) had a positive risk factor-adjusted association with the risk of cerebral stroke (RR = 2.7, 95% Cl = 1.0-7.1) among men aged 30-49, but no independent association with the risk of AMI or death. PMID- 6840956 TI - Clinical epidemiology for developing countries. PMID- 6840958 TI - Inappropriate terminology. PMID- 6840959 TI - Health and employment of a female population in an urban area. AB - The authors discuss the results of a survey of women aged 25 to 50 living in a university town in southern France (Montpellier). Morbidity of these women (reported health problems, consultation with health care professionals etc) was analysed as a function of whether or not they were employed out of the home. Overall, differences were minimal; after correction for demographic factors, the only significant difference was more frequent reports of fatigue, overwork or nervousness in the employed women. Satisfaction with life situations was more closely correlated with health than was employment per se. A great similarity was seen between, on the one hand, employed women satisfied with their occupational conditions and housewives who did not report boredom, and on the other hand, between employed women dissatisfied with their occupational conditions and housewives who reported boredom. PMID- 6840957 TI - Variability of mineral intakes from drinking water: a possible explanation for the controversy over the relationship of water quality to cardiovascular disease. AB - The assumption that people using the same water supply have similar intakes of minerals from drinking water is examined. Duplicate samples of all water drunk during a 24 hour period, including that boiled for beverage preparation, were collected by 109 adult subjects. The results showed that there may be more than a tenfold variation in the amount of water people drink daily. In addition it was found that the mineral concentrations in the 24 hour samples can vary markedly from those in water collected from the source or supply or from household taps which are the usual sampling points for epidemiological studies. The convention of using total hardness as an indicator of mineral intakes from hard and soft water is questioned. PMID- 6840960 TI - What should be done about occupational accidents and diseases? AB - This paper argues that the perspective of economics is valuable in assessing the desirability, purpose and effectiveness of public intervention to reduce occupational accidents and diseases and suggests that the concept of efficiency provides one (although not the only) important criterion by which to judge policy in this field. Despite the incentives to adopt preventive measures that risk premia on wages in hazardous occupations will give to firms, it is argued that, without public intervention, these will be insufficient to bring down occupational accident and disease rates to their optimal levels. The paper then analyses the various methods by which the state might intervene in order to reduce these rates, such as by providing information on risks and stipulating legally enforceable standards, and suggests that a tax on employers for accidents and diseases that arise at work may also have advantages. PMID- 6840961 TI - Correcting for misclassification in two-way tables and matched-pair studies. AB - Barron has presented a matrix formula that allows correction for nondifferential misclassification in two-by-two tables. We show how extensions of his result can be applied to situations involving differential misclassification, matched data, and arbitrary two-way tables. We also discuss some important limitations in the application of algebraic corrections for misclassification. In particular, we show that study misclassification rates need not reflect population misclassification rates if the distribution of the misclassified variable is determined by aspects of the study design. PMID- 6840962 TI - Obesity in young Dutch adults: I, socio-demographic variables and body mass index. AB - The simultaneous contribution of various socio-demographic variables to body mass index (BMI; weight/height) was studied in young adults in three age groups (19 21, 24-26 and 29-31 yr) in a Dutch population. Medians of the BMI of males (n = 1765) and females (n = 2092) were 23.1 and 21.8 kg/m2, respectively. The prevalence of severe obesity (BMI greater than or equal to 30.0 kg/m2) was 2 per cent in both sexes. There was a positive relationship between age and BMI, while level of education and level of father's occupation were inversely related to BMI in both sexes. Married females who had given birth to two or more children weighed more than those with one or no children. The mean BMI of the males in the rural area was higher than that of the males in the urban area. Both the Lutheran males and females weighed more than the non-Lutherans. The mean BMI was lower in males attending church more frequently than once a month. There were no independent relationships between BMI and the other socio-demographic variables (marital status, main daily occupation, size of family of origin and birth order) in either sex. In conclusion, it can be stated that age and socio-economic status were the most important socio-demographic determinants of BMI. Socio-economic status can be useful in directed prevention of obesity. PMID- 6840963 TI - Obesity in young Dutch adults: II, daily life-style and body mass index. AB - The relationships between aspects of daily life-style and age, level of education, and body mass index (BMI; weight/height) were studied in young adult males (n = 1765) and females (n = 2092) in three age groups (19-21, 24-26 and 29 31 yr) in a Dutch population. By means of principal-components analysis five conceptually meaningful factors could be distinguished within the aspects of daily life-style which were considered. These factors were interpreted as constructs of: (1) slimming behaviour; (2) behaviour characterized by the consumption of coffee and alcohol, smoking habits and the number of hours sleep per night (CASS behaviour); (3) eating sweet and savoury snacks between meals; (4) health-conscious behaviour; and (5) physical activity. After adjustments were made for age and level of education, multiple regression analysis showed that slimming behaviour was positively related to BMI in both sexes, CASS behaviour was positively related to BMI in males, and health-conscious behaviour was inversely related to BMI in both sexes. An observed positive relationship between BMI and occupational physical activity in males could be explained by a confounding effect of socio-economic status. The observed weak positive relationship between number of hours active sport per month and BMI in males is possibly due to a difference in lean body mass. The consumption of sweet and savoury snacks was not related to BMI in either sex. These findings suggest that the daily life-style variables should be interpreted as indicators of more general types of behaviour, some of which may be important determinants of obesity. PMID- 6840965 TI - Physiologic responses to exercise in normal and obese women. AB - The present study examines the possibility that the reduced activity commonly found in obese individuals could stem from a reduced physiological responsiveness to exercise. Responses to bicycle ergometer exercise (300 kpm/min) of four obese and four normal weight women were observed in a metabolic ward. This resulted in decreases in exercise heart rate and oxygen consumption, indicating an improvement in mechanical efficiency and suggesting an increase in physical working capacity. It also resulted in some decreases of resting oral temperature. The differences in the response to exercise between the obese and the normal weight groups were small and not statistically significant. The normal weight subjects showed a trend for greater decreases in heart rate and O2 consumption during exercise, while in the obese resting oral temperature tended to be more reduced. The results suggest that obesity in our subjects was not related to a deranged physiological response to physical activity. PMID- 6840966 TI - Absence of detrimental changes of cognitive parameters during fasting. AB - During the first 10 d of a total fast the changes in a series of cognitive parameters: short-term memory, long-term memory, speed of information processing, vigilance, and mental control were tested in 14 obese inpatients and compared with a control group. Ten days of fasting induced no detrimental changes. An improvement in the subtest 'Repetition of digits' was interpreted as improved motivation as a consequence of successful weight reduction. In contrast to the experience of normal weight people during famine periods, obese patients seem to tolerate short-term fasting periods without negative intellectual effects. PMID- 6840964 TI - Dopamine excretion during natriuresis of starvation. AB - Five obese subjects were studied when they were on a 3.35 MJ (800 kcal)-diet, 1.67 MJ (400 kcal) diet and during total starvation. Urine excretion of sodium and dopamine and plasma renin activity (PRA) and plasma aldosterone levels were measured. Urine sodium excretion increased from 88 +/- 9.8 mmol/d before starvation to 150 +/- 15.7 mmol/d on day 4 of starvation. Dopamine excretion increased from 0.92 +/- 0.23 mumol/d before starvation to 1.56 +/- 0.24 mumol/d on day 1 of starvation (P less than 0.01). These results suggest that dopamine excretion is increased in early starvation and may play a role in the natriuresis of starvation. PMID- 6840967 TI - Psychosocial functioning of two groups of morbidly obese patients. AB - Fourteen morbidly obese women who were candidates for intestinal bypass surgery were compared in terms of psychosocial functioning and dietary behavior to 14 morbidly obese women who elected not to undergo the bypass procedure. Each patient underwent a psychiatric evaluation which included a developmental and dietary history, a mental status exam, and the administration of the MMPI. Diagnoses were based on the DSM-III multi-axial system. There was no difference between the bypass group and the non-bypass group on the Axis I diagnoses, however the bypass group did have a significantly higher frequency of Axis II diagnoses. The bypass group demonstrated significantly higher levels of psychosocial stressors (Axis IV) and lower levels of adaptive functioning (Axis V) when compared to the non-bypass group. The bypass patients also had a significantly higher frequency of past suicide attempts. On the MMPI, the bypass group had significantly higher elevations on scales 2 (depression), 4 (psychopathic deviate), 6 (paranoia), and 0 (social introversion). There were no significant differences between the groups in terms of dietary history and behavior, except that significantly fewer bypass patients could place a numerical estimate on their daily energy intake. These results were discussed in terms of their implications for the assessment and treatment of morbidly obese patients. PMID- 6840968 TI - Body composition, physical work capacity and physical activity habits at 18-month follow-up of middle-aged women participating in an exercise intervention program. AB - Thirty-six sedentary women (29-47 yr) participated in a 12-week, 4-d/week physical conditioning program (CP) involving 15-25 min/d of walking/jogging at a heart rate corresponding to 75 percent of aerobic capacity (VO2max). Twenty-three were classified obese (O, greater than 30 percent body fat, mean = 38 percent) and 13 normal (N, less than 30 percent body fat, mean = 25 percent). Significant post-CP changes included increased VO2max and decreased body fat. At 18 months post-CP a volunteer subgroup of the original 36 subjects (Ss) were re-evaluated, 19 being hydrostatically weighed, 21 exercise-tested and 28 interviewed to assess physical activity over the preceding eight quarterly periods. At CP termination 80 percent of N and 78 percent of O had intended to continue jogging, but by follow-up only 40 percent of N and 33 percent of O were so engaged, none at CP frequency, many at reduced duration and intensity. There was no significant difference between follow-up and pre-CP mean h/week of jogging for the entire follow-up group, even though eight of them (28 percent) increased their jogging over pre-CP levels. Follow-up VO2max and percent body fat means were also not significantly different from pre-CP values. It is suggested that the majority of middle-aged women participating in supervised walk-jog conditioning interventions may regress to pre-program physiologic status when left to exercise ad libitum. PMID- 6840969 TI - Body size estimation and locus of control in obese adolescent boys undergoing weight reduction. AB - Body size estimation (BSE) and locus of control (LOC) were studied in 18 obese adolescent boys undergoing weight reduction. The subjects attended a seven-week summer camp which offered both increased activity and a 1200 kcal (5023 kJ)/d diet, resulting in an average weight loss of 29.2 +/- 6.3 lb (13.3 +/- 2.9 kg) and a decrease in body fat from 39.0 percent +/- 0.6 percent to 27.5 percent +/- 4.3 percent. Fatness was correlated with poor physical performance [1.5 mile (2.4 km) runs]. Weight reduction and decreased body fat resulted in an improved running time. BSE was assessed using self photographs distorted by an anamorphic lens. While subjects could correctly estimate their body size prior to weight reduction, after weight reduction they significantly underestimated body size. This finding contrasts with adults with juvenile-onset obesity who overestimate body size after weight reduction. LOC (measured by Nowicki-Strickland LOC Inventory) changed in the direction of internality after weight reduction. The use of exercise with the weight loss program may thus improve feelings of control and prevent overestimation of body size. PMID- 6840970 TI - Postrotatory nystagmus in the full-term and premature infant. AB - Postrotatory nystagmus (PR-N) is an easily elicited reflex reported to be abnormal in developmentally delayed children. PR-N has been recorded in newborns, but methodological difficulties have compromised its full understanding. Eight healthy adults were compared with 15 full-term and 12 premature infants, all neurologically normal, who were tested serially during the first year of life. All subjects were positioned in a rotational chair, spun for 1 min at a constant angular velocity (150 degrees/s) and then abruptly stopped. Primary and secondary PR-N was electronically recorded. Results for full-terms and prematures were similar in all variables, but the number and frequency of beats in both primary and secondary PR-N were significantly greater in adults. Angular displacement and velocity of each beat was significantly higher in infants of all ages. All components of PR-N, whether primary or secondary, can be identified in infants under 1 year of age and are clearly different from those observed in adults. These differences may reflect anatomical and neurophysiological immaturity of eye movement control in the infant. PMID- 6840971 TI - Serial dilation compared to elective laryngo-tracheoplasty in the treatment of acquired subglottic stenosis in children. AB - Acquired incomplete subglottic stenosis in children has historically been managed by serial bouginage of the strictured region sometimes accompanied by injection or systemic administration of corticosteroid medications. The forceful stretching of the scar whilst awaiting growth of the region to compensate for scar contracture, however, dooms that child to a prolonged period of waiting for an unpredictable result with a tracheotomy in place. Recently, laryngo-tracheoplasty has been undertaken in younger age groups and in a review of 30 children, with very similar types of stenosis, it was noted that the 19 children managed only by bouginage (with or without steroids) (1) had a much less predictable result, (2) were only able to be ultimately decannulated 52.6% of the time, and (3) had a mean time from the initiation of treatment to decannulation of 620.1 days. This contrasted very sharply with 11 children who underwent an elective laryngo tracheoplasty of whom 81.8% were able to be decannulated with a mean time from the initiation of treatment of 82.33 days. It was noteworthy that of those managed by dilation alone 9 children (47.4%) were tracheotomy-dependent following treatment and 7 of these were aphonic (36.8% of the total group), whereas in the surgically managed group, 2 were tracheotomy-dependent (18.2% of the total), and all could talk around their tracheotomy tube. The methods and mechanics of such therapeutic approaches are examined and discussed. PMID- 6840972 TI - Immunobiological aspects of acute subglottic laryngitis in children. AB - In the pathogenetic evaluation of acute subglottic laryngitis (ASL) the anatomy of the child's larynx should be taken into consideration: its absolute size need not necessarily be smaller than that of the adult, but its relative size with respect to the developmental stage of other organs, is. The most frequently seen anaphylactic reaction of the larynx in ASL is edema. Since 1975, 284 children with ASL have been treated in our Department of Otorhinolaryngology. They have been divided into the following groups: Group A--196 children with diseases of unknown etiology; Group B--20 children with identified viral infections; and Group C--68 children with allergic reactions. All children had their histories taken and they were all submitted to clinical examination, endoscopy, laboratory tests and allergy tests. Immunological and serological determinations, as well as lung function tests markedly facilitate the identification of etiologic factors in ASL and are of considerable help in planning a therapy and preventing any relapse of the disease. PMID- 6840973 TI - First branchial cleft anomaly and congenital aural sinus--a case report. AB - A case of first branchial cleft anomaly is reported. The case presented classical signs and symptoms and further had a family history of congenital aural sinuses through 3 successive generations. Clinical features of the patient are briefly described and the embryological relationship between first branchial cleft anomaly and congenital aural sinus is discussed. PMID- 6840974 TI - Lateral preferences of hand, eye and foot: relation to cerebral dominance. AB - Patterns of lateral preferences of hand, eye and foot were analyzed on 7364 children, differing in race (black and white) and sex. Right hand and foot preferences were found in over 80%, and right eye preferences were found in over 50% of the subjects. No sex or race differences appeared in left-right preferences. However, significantly more females than males, and more blacks than whites, showed variable foot preference. Further analyses of cross preferences indicated that about 40% of the subjects showed consistent lateral preferences of hand, eye, and foot (about 37% right, and about 3% left), whereas the other 60% were divided among ten groups of different preference combinations. The three lateral measures were correlated to differing degrees. The data were interpreted as showing the effects of cerebral dominance on lateral preferences of hand, eye and foot. The effects seemed to be considerably stronger for hand and foot than for eye preferences. Due to a lack of supporting data, interpretation of race differences in variable foot preference must be considered tentative. PMID- 6840975 TI - Changes in patterns of hemispheric electrophysiological activity as a function of instructional set. AB - Investigations of differential hemispheric functioning which have used auditory event-related potentials (AERPs) typically employ paradigms in which two or more conditions are used. In these paradigms, conditions typically differ from each other with respect to both the physical aspects of the stimuli and the operations the subject must perform on these stimuli. Because both the subject's task and the physical properties of the stimuli change from one condition to another, it is unclear whether different patterns of AERP cerebral asymmetries obtained between conditions are primarily a function of differences in the stimuli (e.g., verbal vs. musical stimuli) or of endogenous factors such as the subject's cognitive approach to the processing of the stimuli. In the present study, two conditions with identical stimuli were employed but different instructions were given about how to process these stimuli. Music and paired tones were simultaneously presented in both conditions. In the Music Condition, subjects performed a task which involved attending to the music and ignoring the tones. In the Tones Sequence Condition, subjects counted specified sequences of tones and ignored the music. The results indicated that there were different patterns of left-right hemispheric AERP relationships between the two conditions. These findings support the hypothesis that endogeneous factors play a significant role in differential hemispheric functioning and that the AERP technique employed in this paradigm is a sensitive index of changes in electrophysiological activity associated with these endogeneous factors. PMID- 6840976 TI - REM sleep and ambient temperature in man. AB - Five young adult males slept two consecutive nights under each of the five ambient temperatures chosen within the usual range: 13 degrees C, 16 degrees C, 19 degrees C, 22 degrees C, and 25 degrees C. Bedding and other ambient parameters were kept constant under all five ambient temperature conditions. The average REM cycle length significantly decreased when the ambient temperature increased from 13 degrees C to 25 degrees C. Other REM sleep characteristics such as total duration of REM sleep, average REM period, and REM sleep latency did not significantly differ from one ambient temperature condition to another. PMID- 6840978 TI - Haloperidol antagonism of amphetamine-induced effects on event-related slow potentials from rat cortex. AB - Slow potential (SP) responses to a click followed after 2 sec by rewarding stimulation of the medial forebrain bundle were recorded from the frontal cortex of rats with permanently implanted electrodes. The SP responses were frequently enhanced by haloperidol (0.0125 to 0.1 mg/kg). Both haloperidol and alpha methyltyrosine antagonized amphetamine-induced suppression of the SP responses. The results are consistent with the idea that dopamine (and possibly norepinephrine) exerts an inhibitory influence on the mechanisms involved in generation of event-related slow potentials. PMID- 6840977 TI - The effects of chronic diazepam treatment on body weight and food intake in rats. AB - A series of experiments are reported in all of which the effects of chronic (14 18 days) diazepam treatment on body weight were evaluated under various conditions, and one experiment in which weight gain and daily food intake were monitored simultaneously. The effect of diazepam treatment on body weight was compared to that of vehicle treatment in the following groups: (1) young adult females, (2) pregnant females, (3) shock treated young males (4) nonshocked young males. The effect of diazepam treatment on prenatally diazepam exposed and nonexposed males and females was investigated at seven months of age. Food intake was also measured during chronic diazepam and vehicle treatment. The findings show consistent and reliable differences between diazepam and vehicle treatment. Diazepam treated animals eat less in the long run and gain less weight than vehicle treated controls. Prenatal exposure to diazepam enhances the effect of diazepam treatment in adulthood. PMID- 6840980 TI - The combined effect of quipazine and haloperidol on plasma prolactin release. AB - The possible dopaminergic properties of the central serotonergic agonist quipazine was examined using plasma prolactin release as a model to determine whether quipazine exerts an agonist effect on only serotonin receptors or on dopamine receptors as well. Drugs acting on two different receptors have only an additive effect on the same parameter while different drugs acting on the same receptor exert a synergistic effect. Therefore we determined whether combining quipazine with haloperidol, which has no effect on serotonin receptors, would produce a synergistic or only an additive effect on prolactin release, relative to the release induced by quipazine alone. A distinct synergism was produced, suggesting that quipazine acts on both DA and 5-HT receptors. Moreover, the model used may be useful for distinguishing whether a given drug acts on one or two receptors concurrently. PMID- 6840979 TI - Acute administration of individual optimal dose of physostigmine fails to improve mnesic performances in Alzheimers Presenile Dementia. AB - Eight patients affected by Alzheimer's Presenile Dementia (AD) received acute administration of physostigmine individual optimal dose per os (n = 4) or subcutaneously (n = 4). The individual physostigmine dose was assessed by means of serum cholinesterase activity monitoring. The possible beneficial effects after treatment were evaluated by using two memory tests: Reys' 15 words and Digit Span from Wechsler memory scale. Although a slight behavioral activation was noted in all patients after treatment, the comparison between mean scores obtained by AD patients in mnesic tests before and after the acute physostigmine administration, with either therapeutic modality, failed to reach the level of statistical significance. Some implications of these disappointing results are briefly discussed. PMID- 6840982 TI - Brain laterality and the subliminal perception of facial expression. AB - Right-handed subjects were presented simultaneously with: (1) a face expressing positive, neutral, or negative affect in the left or right visual field and, (2) the outlines of the face containing visual noise, in the opposite visual field. A range of stimulus presentation durations was used to sample above and below threshold processing. On each trial subjects responded to two forced choice questions: (1) Which side was the face on? and (2) What was the emotion expressed by the face? The results revealed a left visual field advantage for locating the face. There was only suggestive evidence in favour of a right hemisphere superiority in the processing of facial expression per se. The most important finding was that when subjects' performance locating the face represented chance (i.e., there was no reportable awareness of stimulus cues needed to discriminate a face from a nonface), they were significantly above chance identifying the facial expression. PMID- 6840981 TI - A short-portable version of the Category Test. AB - This study validates the use of a shortened version of the booklet form of the Category Test developed by DeFillipis, McCampbell and Rogers (1979). In a sample of 85 subjects the estimated total score (using the Calsyn, O'Leary and Chaney (1980) regression equation) correlated 0.93 with the actual total error score. It was also found that the estimated score could reliably predict who would exceed the cutoff of 51 errors on the entire test with an overall accuracy of 86%. The results support the use of a brief booklet version of the Category Test. PMID- 6840983 TI - Does single Kanji process dominantly in the right hemisphere? Some implication from Stroop-test results. AB - Naming times to single character Kanji, which consisted of small alphabetic letters, Kanji (Stroop stimuli), and solid lines, presented in the left or the right visual field were measured. When subjects tried to respond to Alphabet Stroop stimuli, they showed a greater interference effect in the case of right visual field presentation. Kanji Stroop stimuli yielded no visual field difference in the size of interference effect. These findings suggest that Kanji has a different property from phonetic symbols and a specialization of the right hemisphere for single character Kanji processing. PMID- 6840984 TI - Commentary: somatosensory evoked potentials and magnetic fields. AB - Evidence is offered for the requirement of more careful comparisons between the new event related magnetic fields of the brain (ERMFb) and their conventional counterparts the event related brain potentials (ERBP), in the somato-sensory (SEP) and auditory (AEP) modalities at least, because the existing ERBP literature contains a wealth of well-documented data on these crucial issues: (1) Contralateral and ipsilateral SEP; (2) the relevance of "background" intrinsic periodicity; and (3) the relevance of stimulus parameters, receptive fields, and subjective perceptual status to variations in the waveforms. The importance of the new 2nd derivative magnetic gradiometry for better spatiotemporal resolution of sources and for functional understanding of cerebral electrophysiology cannot be overestimated. So it may be equally important to ensure that existing, historical data from conventional scalp-conductance, systematically recorded and analyzed during the past twenty years, are not ignored at the inception of essential comparisons using complementary electromagnetic techniques. PMID- 6840985 TI - Electrical stimulation of the superior olivary complex can produce cortical evoked potential and behavioral discrimination correlates of pitch perception in the rat. AB - Patterned electrical stimulation of the superior olivary complex (SOC) which simulated the neural frequency following response (FFR) extracellular potential was used as a stimulus in behavioral frequency discrimination and cortical evoked potential studies. Behavioral judgments of SOC stimulation frequency were found to be as accurate as those obtained for 80 dB acoustic stimuli within the spectral band of the FFR (200 to 3800 Hz). Cortical evoked potentials elicited by acoustic and electrical stimulation of the SOC were then compared for preservation of waveform similarity. Frequency dependent similarity was observed in slow wave events elicited by stimuli with frequencies in the FFR band. A 3 msec time lag was found between acoustic and SOC stimulation produced waveforms which can be accounted for by forward stimulation of the auditory pathway. Our study supports the idea that integrated extracellular waveforms of the FFR index low frequency representations in the auditory brainstem, perhaps by selecting patches of SOC cell transmembrane potential changes. Because bilateral cochlear damage did not prevent behavioral discrimination of SOC electrical stimulation, feedback to the ear is not necessary for perceptual significance of simulated FFR extracellular field potentials in the SOC. PMID- 6840986 TI - Hemispheric differences in preferred modes of information processing and the aging process. AB - The notion of "preferred modes of information processing" as indexed by direction of lateral eye movements during information processing, and the finding of significant declines in "fluid" as compared to "crystallized" intelligence as a function of the aging process, are related in this paper. Results suggest differential declines in information processing abilities as a function of preferred mode of information processing in older subjects. Old right movers perform significantly better than old left movers on tasks tapping both fluid and crystallized intelligence. Old left movers perform significantly more poorly on these tasks when compared to young left movers, while no differences between young and old right movers obtain. The results suggest that old persons may be more at the mercy of their preferred mode of information processing than young subjects and that those who prefer to process information in their right hemisphere are more detrimentally affected by this preference. PMID- 6840987 TI - Life events and depression in transit populations. AB - Undesirable recent life events in the period of three months preceding primary depressive illness were studied in two Arabian Gulf countries: Qatar (235 patients) and Kuwait (164 patients). Transit population patients, who come to these countries from employment, differ from native patients in the significant predominance of work as a source of recent life events. The difference is discussed in relation to the existential committments and attitudes to work among native and transient populations. Intergenerational conflict as an undesirable recent life event is prevalent among family recent life events in native patients where rapid sociocultural changes are associated with conflict of traditional and modern value systems. PMID- 6840988 TI - Demographic characteristics and mental morbidity amongst different castes in West Bengal. PMID- 6840989 TI - Outcome of mental illness following repatriation: a predictive study. AB - A study is made of indices which predict the outcome of psychotic mental illness among migrant patients who had become ill in England and who were repatriated home to Jamaica. The findings of a field survey among 55 cases showed that a poor outcome had taken place in 32. This may have been predicted by indices of chronicity and the resulting poor employment history in England. Prediction in Jamaica is associated with socio-economic hardship and psychological attitudes of relatives who had agreed to accommodate patients. Diagnosis of illness and a history of this in the family are not associated with outcome. It is of interest that evidence of adequate intelligence predicts a poor outcome. These findings are discussed. The purpose of the present paper is to make an investigation of those factors which may be of significance in predicting the outcome of psychosis among patients who had been repatriated to Jamaica from England. It is widely believed that in countries like Jamaica the socio-cultural environment of the predominantly rural areas allows higher rates of recovery from psychosis than will be found in industrial cities in the western world (Barahona Fernandes et al., 1967; Murphy and Raman, 1972). These findings would indicate that when patients become ill in these developed countries their repatriation may be in their medical interest. None the less, in an early study of this problem Frey (1961) concluded that returning home had not altered the course of illness among Algerian mine-workers who had become acutely psychotic in France. Asuni (1968) traced 70 per cent of a group of Nigerian students who had become psychotic in London and who were repatriated home because of the unlikelihood that they would have been able to complete their courses of study. He concluded that repatriation had been of therapeutic benefit in the majority of these students. The most recent study of this problem was carried out in Jamaica by the present author. The findings indicated that a poor outcome had occurred among three-fifths of a consecutive series of patients (Burke, 1982). If these findings are found to be associated with diagnosis then particular groups of patients would be considered to be eligible for repatriation. PMID- 6840991 TI - Sharing past traumas: a comparison of communication behaviours in two groups of Holocaust survivors. PMID- 6840990 TI - Psychiatry in Iran and China. PMID- 6840992 TI - How psychiatric patients view their own treatment: a study of 50 day hospital patients. PMID- 6840993 TI - Psychoanalytic case-studies of a political phenomenon: the perils of this approach. PMID- 6840994 TI - Economic Oedipus Complex. (The libidinal aspects of economic strength). PMID- 6840995 TI - The importance of artifactual factors in the relationship between sex and mental disorders. AB - This study is based on a representative sample of 1,536 subjects (15 years of age and older) in three communities of Upper Bavaria. The rate of refusal was 6.8%. Independent of the sex of the interviewer the rate of mental illness among women was higher than among men. However, male interviewers diagnosed mental disorders for women slightly more often than did the female interviewers. Using a self rating scale, we found a tendency indicating that women report more symptoms than do men when psychiatric respectively somatic diagnoses are held constant. 28.9% of the women and 22.1% of the men who, in cross-section, demonstrated a mental disorder, had been treated psychiatrically before. Men were more often than women admitted to psychiatric hospitals. Voluntary help-seeking seems to be more prevalent among women with emotional problems. PMID- 6840996 TI - The biology, pathology, and immunology of syphilis. PMID- 6840997 TI - Pathogenesis of acute renal failure. PMID- 6840998 TI - Experimental chronic bronchitis. PMID- 6840999 TI - Phosphatic metabolites of the intact cornea by phosphorus-31 nuclear magnetic resonance. AB - The principal low molecular weight phosphatic metabolites of the intact cornea were identified and quantitated nondestructively by phosphorus-31 nuclear magnetic resonance (P-31 NMR) spectroscopy. As part of this analytical procedure, the intracorneal pH was approximated from the resonance shift position of inorganic orthophosphate. In addition the metabolic and pH stability of incubated corneas at 37 C in MK medium was evaluated during an 8-hr time course and compared to similar dynamic analyses performed on corneas with denuded endothelium. Perchloric acid extracts prepared from these same corneas were analyzed by P-31 NMR to verify the metabolite peak assignments and to quantitate the concentrations of minor corneal metabolites. The concentrations of phosphatic metabolites of the cornea, including three previously unidentified phosphorus containing substances, were determined for freshly excised corneas. The initial corneal spectroscopic profile was not altered by removal of the endothelium. At 37 C the MK media-incubated intact whole corneas experienced a time-dependent decline in ATP levels with a concomitant rise in inorganic orthophosphate; however, the tissue levels of the other principal phosphatic metabolites were not altered by prolonged incubation. In contrast, removal of the endothelial layer of the cornea-induced progressive metabolic deterioration of intact corneas characterized, most prominantly, by time-dependent declines in ATP and glycerol 3 phosphorylcholine levels and concomitant increases in ADP and inorganic orthophosphate levels relative to intact whole corneas. This study has established the feasibility of monitoring the metabolic status of intact rabbit corneas nondestructively and noninvasively. As such, P-31 NMR spectroscopy offers a promising method that may enable analysis of the metabolic viability of intact human donor corneas to provide a basis for selecting donor corneas for transplantation. PMID- 6841000 TI - Morphogenesis of rabbit corneal stroma. AB - Corneas of fetal and young albino rabbits were examined by light and transmission electron microscopy. In addition, DNA and hydroxyproline content were measured in developing stroma. The results were compared with similar data from healing corneas in adult rabbits and from developing corneas of other animal species. In the fetal rabbit, the prospective corneal stroma region contains an unorganized, sparse extracellular matrix until about the 13th day of gestation, when mesenchymal cells and capillaries from the hyaloid vessels move in to form the vascular pupillary membrane, endothelium, and stroma. Stromal growth is due to alteration in the density and morphology of the cell population early in development, along with a sequential thickening and thinning of the whole stroma. These events are similar to those reported in primates, but differ markedly from those reported in avian species. Normal developing cornea and healing adult cornea both involve migration of stomal fibroblasts and deposition of extracellular matrix. Stromal fibroblasts in the rabbit fetus are oriented with their long axis parallel to the corneal surface early in development compared with randomly oriented fibroblasts in the early healing wound of adult rabbit corneas. Although collagen and cell number progressively increase throughout the developmental periods studied, the ratio of cells to collagen is high initially but decreases with development. In contrast, the proportion of cells to collagen in the young scar tissue of adult cornea is low initially, indicating a marked deposition of collagen in comparison to that in the early normal developing stroma. The results suggest that the healing tissue differs from the normal fetal stroma in its coordination of cell population growth with collagen deposition and cellular organization. PMID- 6841001 TI - Secondary aqueous humor stimulates the proliferation of cultured bovine corneal endothelial cells. AB - Secondary aqueous humor (2 degrees AH) is known to contain elevated levels of serum macromolecules and has been shown to stimulate the proliferation of lens epithelial cells both in vivo and in vitro as well as corneal endothelial cells in vitro. The purpose of this study was to characterize the response of bovine corneal endothelial cells to 2 degrees AH from rabbits and to compare the effect when the cells were grown on plastic dishes covered with an extracellular matrix or on plastic alone. The addition of varying amounts of 2 degrees AH protein (0.1 to 10 mg/ml) to bovine corneal endothelial cells (cultured in MEM plus 1% serum) resulted in a dose dependent proliferative response as measured by the incorporation of 3H-thymidine into DNA. Except for a 2-hr lag phase, the proliferative response increased with increasing time of exposure (6-18 hrs) of the cells to 2 degrees AH containing a constant amount (2.0 mg/ml) of protein. The generation time and final density of the cells, but not the plating efficiency, was significantly greater when the cells were grown in the presence of 2 degrees AH protein on an extracellular matrix rather than plastic alone. Selective adsorption of prostaglandins and aromatic compounds from 2 degrees AH reduced its ability to produce a proliferative response to control levels. These results indicate that 2 degrees AH can alter or regulate events in the cell cycle of corneal endothelial cells. The responsible factor(s) could be involved in control of cellular regeneration in the eye following injury. PMID- 6841002 TI - Corneal re-epithelialization in galactosemic rats. AB - Abnormalities in corneal epithelial healing in diabetic patients have been described recently. Defects in corneal re-epithelialization in diabetic rats have been reported, and it was found that treatment with aldose reductase (AR) inhibitors effectively prevented these defects. Experiments using galactosemic rats to study further the role of AR in these defects, since AR is known to be the common factor involved in sugar cataractogeneses, are reported herein. Similar defects in corneal re-epithelialization in galactosemic rats as in diabetic rats were found. The delay in re-epithelialization was documented by computer planimetry. Light microscopy showed marked corneal stroma edema and wider intercellular spaces in the epithelium after complete re-epithelialization, while scanning electron microscopy revealed fewer filopodia projecting from the leading margin during the active migration stage. These defects were prevented by treating galactosemic rats with the aldose reductase inhibitor, Pfizer's Sorbinil. These suggest that AR plays a role in the defects in corneal re epithelialization observed in diabetes. PMID- 6841003 TI - Surface features of the conjunctiva and cornea. AB - Guinea pig corneal and conjunctival surfaces were examined by transmission electron microscopy and cytochemistry. Some specimens of cornea and conjunctiva were examined morphologically; others were stained with ruthenium red or tannic acid before examination to enhance the detection of glycoproteins at cell surfaces. The epithelia were covered by microvilli and on the cornea also by microplicae. These surface projections were the shortest (150 nm) over the central cornea, and became progressively longer (approximately 300 nm) over the tarsal and fornical conjunctiva. There was a filamentous cell coat (glycocalyx) on the microvilli and microplicae that was best demonstrated in specimens stained with tannic acid. The glycocalyx extended approximately 300 nm from the tips and lateral surfaces of the microvilli and microplicae. Although there were slight local variations in its thickness, the maximum thickness of the cell coat was uniform over the cornea and conjunctiva. Heavy deposits at the cell surface after ruthenium red staining indicated that the cell coat contained many highly charged polyanions. The density of the ruthenium red stain obscured the fine structure of the filaments in the cell coat. The glycocalyx forms a scaffolding that is believed to bind mucus, with its content of immunoglobulins, by weak chemical interactions to the epithelial surface. Therefore, the microvilli, microplicae, and glycocalyx that were demonstrated in this study provide the structural framework that supports and binds a complex of related factors, including tears, mucus, and immunoglobulins, that have the common function of protecting the eye. PMID- 6841004 TI - Aerobic responses of the cornea to alkali measured in vivo. AB - With the use of a micropolarographic system, the effects of a series of unbuffered sodium hydroxide concentrations on oxygen uptake by the corneal epithelium of rabbit were measured in vivo. Based on an exposure model of 10 sec. followed by a saline rinse, concentrations of greater than 0.10 N were found to cause an abrupt and severe decline in oxygen uptake, with oxygen flux responses associated with 0.13 N and greater being indistinguishable 10 min later from those of a cornea completely denuded of epithelium. Initial flux variations, characteristic of exposure responses to concentrations of 0.10 N or less, gradually diminished, however, stabilizing within 1 hr to levels not significantly different (P less than 0.01) from pre-exposure fluxes or those of saline controls. PMID- 6841005 TI - Posterior corneal rings in monkeys. AB - Contact wide-field specular microscopy was performed on 27 monkeys of known ages. The induction of posterior corneal rings as a result of applanation pressure to be age-dependent. There was a total absence of these folds in animals under two years of age, and they usually occurred only in animals older than four years of age. PMID- 6841006 TI - Biologic properties of the thymocyte-activating factor (CETAF) produced by a rabbit corneal cell line (SIRC). AB - Rabbit corneal epithelial cell cultures produce a cytokine (CETAF) that greatly enhances the proliferation of C3H/HeJ mouse thymocytes. The rabbit corneal cell line SIRC was used to generate CETAF activity in the culture supernatant. CETAF was then partially purified by Sephacryl S-200 gel filtration, where peaks of activity eluted in a molecular weight range of 95,000-55,000 (CETAF I) and 30,000 15,000 (CETAF II). Similar to the epidermal cell-derived thymocyte-activating factor (ETAF), CETAF (I and II) stimulated the growth of a human dermal fibroblast line (CRL 1445) in a dose-dependent manner, but failed to enhance the proliferation of an Interleukin 2 (IL 2)-dependent T-cell line (CT 6). Although CETAF did not exhibit any IL 2 activity, it clearly enhanced the IL 2 production by C3H/HeJ mouse splenocytes stimulated with suboptimal doses of lectins. Crude SIRC supernatants as well as the partially purified CETAF preparations showed a marked inhibition of polymorphonuclear neutrophil migration at high concentrations, but were significantly chemotactic when diluted samples were tested. CETAF release by SIRC cells was increased by stimulation with mitomycin C, phorbolmyristate acetate, hydroxyurea, silica, lipopolysaccaride B, and when the cells were cultured under serum-free conditions. These observations suggest that corneal epithelial cells may not only interact with the immune system in a way similar to keratinocytes, but may also stimulate corneal stromal cell through the production of CETAF. PMID- 6841007 TI - Epithelial characteristics of the endothelium in Chandler's syndrome. AB - The cells lining the posterior surface of a corneal button obtained from a patient with Chandler's syndrome were examined by transmission and scanning electron microscopy, and by keratin staining. The ultrastructural appearance with intracytoplasmic 8 nm filaments, desmosomes, microvillous projections, and positive keratin staining suggests that these may be epithelial cells. Clinical specular microscopy of this cornea prior to transplantation revealed characteristic changes that were seen to be related to the density of microvillous projections on the cell membrane. PMID- 6841009 TI - How do tears exit? AB - The mechanisms of tear flow, blinking, and tear drainage were studied employing high speed slit-lamp cinematography using a polystyrene microsphere suspension as a tracer of tear movement. It was demonstrated that: (1) Tears are drawn into the canaliculi during the relaxation phase of blinking. (2) Both superior and inferior puncta function as normal tear drainage routes. (3) The superior punctum alone is sufficient to handle tear drainage. (4) There is some regurgitation of tears from the canaliculi. (5) An intact blink mechanism is necessary for effective tear drainage. (6) There is an actual closure of the puncta during blinking. This is sufficient to effect tear exit without the lids meeting. The clinical impression that in order to effectively prevent tear drainage in the treatment of dry eyes, it is necessary to occlude both the superior and inferior puncta was confirmed. PMID- 6841008 TI - Conjunctival goblet cell frequency after alkali injury is not accurately reflected by aqueous tear mucin content. AB - Goblet cell counts have been used to evaluate the suitability of conjunctiva as a source of ocular surface epithelial cells. However, since tear mucin content can be determined without tissue excision, it seemed that the concentration of those compounds might be a useful indicator of conjunctival vitality. To test the extent to which aqueous tear composition reflects conjunctival goblet cell frequency, goblet cell frequency and aqueous tear mucin content were measured after alkali injury in rabbits. Mild alkali injury (0.1 N NaOH for 30 sec) caused a transient but substantial decrease in goblet cells (to 25% of normal at day 7) with a return to normal by six weeks. Tear mucin content was decreased to a lesser degree, from a normal value of 6.4 +/- 0.47 nmol oligosaccharide per microliter (n = 10) to a minimal value of 4.7 +/- 0.64 (n = 7) (73% of normal) at day 7, returning to normal 4 weeks after injury. Thus, the direction of the change was the same, but the magnitudes were quite different. These results suggest that conjunctival goblet cell frequency is not accurately reflected by aqueous tear mucin content, and therefore, that tear mucin content cannot be used directly as an indicator of conjunctival health. PMID- 6841010 TI - Origin and biosynthesis of human tear fluid proteins. AB - In tear fluid, a large number of proteins can be detected with electrophoretic or immunologic techniques. The composition of serum proteins in tears resembles that of whole serum. By comparison of the protein patterns resulting from different sampling methods, it was shown that serum albumin is not present in the secretion of the lacrimal gland, but is mixed with the tear fluid in the conjunctival sac. The in vitro synthesis and excretion of more than 20 protein components by the lacrimal gland could be demonstrated. Among these were lactoferrin, tear-specific prealbumin, lysozyme, and secretory IgA. The complexity of the electrophoretic protein pattern of tear fluid can be explained from the combination of the secretory activity of the lacrimal gland and the leakage of serum proteins from the circulation into the tear fluid. PMID- 6841011 TI - Factors influencing the vitreous potassium concentration in the rat. AB - The vitreous of the intact eye of the rate was perfused with artificial medium to study factors that influence the vitreous potassium concentration. The vitreous potassium concentration in anesthetized rats was 5.07 mM. Perfusion with media containing higher or lower potassium concentrations led to passive diffusion of potassium out of or into the vitreous, respectively. Ouabain caused a release of potassium from the retina into the vitreous. Photic stimulation reduced the vitreous potassium concentration, presumably as a result of neuronal hyperpolarization. Glutamate raised and glycine lowered the vitreous potassium concentration, effects that also may be related to retinal depolarization and hyperpolarization, respectively. PMID- 6841012 TI - The penetration of gentamicin into the vitreous humor in man. AB - Twenty-two patients received gentamicin intramuscularly or subconjunctivally 35 220 min prior to undergoing ocular surgery. There were no detectable gentamicin levels in the vitreous humor of patients who received the drug systemically. Of the patients who received gentamicin subconjunctivally, three quarters had no detectable gentamicin levels, only three of these patients had therapeutic concentrations in their vitreous humor. These results confirm kinetic drug studies performed in animals in which low or absent vitreal gentamicin levels were observed following systemic and subconjunctival administrations. It is suggested that intravitreal injection of aminoglycosides is required in the treatment of bacterial endophthalmitis. PMID- 6841013 TI - Reversal of galactose cataract with Sorbinil in rats. AB - Sorbinil, a potent aldose reductase inhibitor, can effectively block the progression of a galactose cataract even though the cataractous process is well underway. The prevention of dulcitol accumulation by Sorbinil is just as effective in reversing the cataract as the removal of galactose from the diet. The progression and reversal of the cataract were followed by ophthalmoscopy and histology. The results also further support the concept that in galactosemia the cataract is not caused by the toxic effects of galactose per se but by the consequence of the aldose reductase reaction. PMID- 6841014 TI - Oxygen permeability of rabbit and human corneal stroma. AB - Oxygen permeability (Dk) of 15 rabbit and 19 human cornea stromal samples was measured by conventional polarographic means at 36 C. Hydration and thickness were also measured. Rabbit stromal permeability was found to be about 26 X 10( 11) ml O2 cm2/sec ml mmHg at normal in vivo hydration; in vivo human cornea stromal permeability is probably less than 29 X 10(-11) ml O2 cm2/sec ml mmHg. PMID- 6841015 TI - An animal model of trachoma: IV. The failure of local immunosuppression to reveal inapparent infection. AB - Repeated inoculation with live chlamydia trachomatis is necessary to develop a model of trachoma in monkeys. However, it is not possible to reisolate chlamydia from the monkey's eye after the first 1 or 2 months of weekly reinoculation. The effect of subconjunctival steroid injections in monkeys that had received weekly inoculations with live chlamydia is reported. Despite a profound suppression of local inflammation, steroid treatment did not produce a reactivation of identifiable chlamydial infection as determined by repeated chlamydial cultures and cytologic examinations. PMID- 6841016 TI - Macrophage mediated damage to rat lenses in culture: a possible model for uveitis associated cataract. AB - Rat lenses incubated in the presence of "activated" murine peritoneal macrophages are markedly impaired in their ability to accumulate certain radio-labeled compounds from the culture medium whereas incubation with resident macrophages has no such effect. The damage to the lens can be prevented in part by addition of certain antioxidants to the culture medium. The results suggest that mediators released by activated macrophages may be involved in initiation of the cataracts associated with chronic ocular inflammation. PMID- 6841017 TI - Slit-lamp assessment of onset of cataracts in black-eyed, black-hooded retinal dystrophic rats. AB - Various types of hereditary retinal degeneration have associated posterior subcapsular cataract (PSC). It has been claimed that in the Royal College of Surgeons (RCS) rat model of hereditary retinal dystrophy, the cataract is manifested unpredictably and does not display Mendelian inheritance. It ws shown previously, however, that 100% of pink-eyed retinal dystrophic RCS rats had an onset of bilateral PSC at 7 to 8 weeks of postnatal age, and by 9 to 11 months, 23% of the animals had cataracts visible to the unaided eye. The congenic black eyed retinal dystrophic RCS rat, however, is a better model for the generally more pigmented human eye. In the present work, it was found that 100% of black eyed RCS rats had bilateral slit-lamp-detectable PSC beginning at 8 weeks of postnatal age, just as the pink-eyed rats did, despite the fact that dark-eye pigmentation is associated with a 10- to 35-day delay in the rate of degeneration in retinal areas other than the peripheral part of the inferior hemisphere. A higher incidence of mature cataracts in pink-eyed rats (23%) as compared with black-eyed rats (3%) suggests that the amount or intensity of light reaching the lens, retina, and pigmented epithelium may influence maturation of the cataract. However, if light is important in initiating the PSC, its influence was not decreased by dark pigmentation of the eye. RCS rats may be a model for an early onset type of human autosomal recessive retinal degeneration having a constant association of PSC. PMID- 6841018 TI - Phasic eye movement control appears before tonic control in human fetal development. PMID- 6841019 TI - Spontaneous aorto-caval fistula due to athero-sclerotic aneurysm. PMID- 6841020 TI - Experiences with nicotine chewing-gum in resistant smokers. PMID- 6841021 TI - Dependency in the elderly. PMID- 6841022 TI - Anthropometric standards for Irish newborn. PMID- 6841024 TI - Advanced extra-uterine pregnancy--two cases and a review of the literature. PMID- 6841023 TI - Thyroid function in oral contraception: is there cyclic variation? PMID- 6841025 TI - Myasthenia gravis and pre-eclampsia. PMID- 6841026 TI - The emergence of maternal drug addiction as a problem in Ireland 1981. PMID- 6841027 TI - Toxic-shock syndrome associated with post-partum staphylococcal endometritis. PMID- 6841028 TI - The value of fundal height measurement in prediction of fetal growth retardation. PMID- 6841029 TI - University entrance performance and medical school progress. PMID- 6841030 TI - A biobehavioral-biotelemetry system. AB - A multiple computer system and implantable biotelemetry permit on-line monitoring of physiological data while observational data is collected on social group living unrestrained monkey infants in studies of the physiological correlates of behavior. Experimental data may be collected for up to 40 days on each experimental animal, with statistical data presented as the experiment progresses. Data are used to describe normal baseline and various experimentally induced changes in biological and behavioral variables. PMID- 6841031 TI - Trends in surgical research. PMID- 6841032 TI - Improvement of skin flap survival by local injections of Regitine and propranolol. An experimental study in the rat. AB - An increase in the surviving area of skin flaps was achieved by local injections of alpha-adrenergic and beta-adrenergic blocking agents. Dorsal skin flaps of albino rats were injected postoperatively at their bases with Regitine (Ciba Geigy, Switzerland), propranolol and a combination of these two drugs, two or three times daily for 6 days. All the pharmacologically treated animals showed a significantly better flap survival rate than did the control group (P less than 0.001). More frequent injections gave increasing flap survival areas. However, a combination of the above-mentioned drugs did not improve the results when compared with propranolol administered alone, and was less effective than Regitine administered alone. PMID- 6841033 TI - Upper dorsal sympathectomy for palmar hyperhidrosis. AB - The treatment results in 133 patients who underwent bilateral upper dorsal sympathectomy (BUDS) for palmar hyperhidrosis (HH) are reported. Group 1 (67 patients) was followed for 5 to 10 yr (mean 7) and Group 2 (66 patients) was followed for 1 to 4 yr (mean 2). Early results and complications, early and late sequelae, late recurrence and patient satisfaction with the results of the operation were analyzed. The immediate success rate was 98%, and late recurrence of HH was noted in 5.3% of the patients. The incidence of technical complications was lower in Group 2 than in Group 1, otherwise both groups were similar. Persistent, severe Horner's syndrome was present in only one patient at late follow-up. Troublesome compensatory HH persisted in one-third of the patients. Overall patient satisfaction was good, and only 10 patients regretted having undergone the operation. BUDS appears to be the best solution for severe palmar HH in properly selected patients. PMID- 6841034 TI - Primary repair of colon injuries. AB - Colonic injuries are usually treated by exteriorization, resection and colostomy, or primary repair with proximal colostomy. However, many cases of successful treatment of colonic wounds by primary suture without colostomy have been reported. Yet, these repairs are usually restricted to civilian injuries, stab wounds, perforations of the right colon, cases with few or no other organ injuries, a short time interval between injury and operation, absence of shock, and minimal fecal soiling. We considered lack of fecal spillage to be the only important factor for 12 consecutive patients, the majority war casualties, and performed primary colon repairs on them. All the other commonly accepted limiting factors were disregarded. There were no complications related to the bowel repair. Using these more liberal guidelines, the number of primary repairs of colonic injuries may be increased, thus reducing hospitalization time and cost, and more important, reducing morbidity and mortality associated with the creation and subsequent closure of colostomies. PMID- 6841036 TI - The fate of patients with lung cancer: five-year review of 250 cases. AB - Two hundred fifty patients with bronchogenic carcinoma were followed for at least 5 yr after diagnosis. In 187 (75%), the tumor was diagnosed within 6 mo of the first clinical manifestation. Among 205 patients who were not operated on because of tumor spread or because of poor general condition, 139 (67.5%) died during the first year, 15 (7.5%) during the second year, and 51 (25%) were not available for follow-up and are presumed dead. Forty-five patients underwent curative resection, with one early death. Of the 44 survivors, 30 had lobectomy, 1 had sleeve lobectomy and 13 pneumonectomy. The cancer-free survival rate in this group was 32% at 5 yr and 30% at 7 yr. Except for small cell carcinoma, there was no correlation between tumor histology and prognosis. Due to the late appearance of symptoms, early diagnosis of lung cancer is impossible with present-day methods. PMID- 6841037 TI - Sleeve lobectomy for bronchial tumors. AB - Six patients underwent sleeve lobectomy for bronchial tumors. Five had bronchogenic carcinoma, one had a carcinoid. All neoplastic tissue was resected, with maximum preservation of functioning lung parenchyma. There were no hospital deaths and no complications. Ten months after surgery, one patient died of cancer; one died of apparently unrelated causes 60 mo after surgery; a third was lost to follow-up 14 mo after operation. The remaining three patients are well, without evidence of recurrence. Sleeve lobectomy is a safe operation, enabling adequate resection with maximum preservation of functioning lung parenchyma. It is equally applicable to lung cancer and to other bronchial neoplasms and, when feasible, should be used in preference to pneumonectomy. Careful selection of patients and meticulous operative technique are mandatory. PMID- 6841035 TI - Peranal sleeve anastomosis for low rectal cancer. AB - Over a 3-yr period, 13 patients underwent surgery for a rectal tumor located between 5 and 7 cm from the anal verge. We modified Parks' procedure for a peranal sleeve anastomosis in order to avoid tension and retraction. Until now, the preferred operation for tumors at this location was abdominoperineal excision as devised by Miles. In the light of present-day knowledge, some of the lesions situated at a slightly lower level in the midrectum can be treated with a less mutilating surgical approach which is associated with continence and satisfactory sphincter function. There was no postoperative mortality. During a 5-yr follow-up period, 2 of the 13 patients died; there was no recurrence of local tumors. PMID- 6841038 TI - Surgical treatment of primary hyperparathyroidism in the elderly patient. AB - The treatment of 11 elderly patients with primary hyperparathyroidism is described. All the patients underwent exploration of the neck and removal of a parathyroid adenoma, and the operation was well tolerated. After surgery, serum Ca concentrations returned to normal. The commonest symptoms in these elderly patients before operation included extreme fatigue, muscle weakness, mental disturbances, personality changes, severe depression, psychosomatic retardation and mild-to-severe dementia; all improved dramatically. PMID- 6841041 TI - Silicone ectoprostheses for correction of facial defects. AB - Twenty-two patients with congenital and acquired defects, rehabilitated with silicone ectoprostheses, were followed up for 6 mo to 4 yr. The simplicity of the procedure, its good results and the early physical and social rehabilitation attained, favor its use when adequately indicated. PMID- 6841039 TI - Successful parathyroid gland autotransplantation after total parathyroidectomy in dialysis patients. AB - Secondary hyperparathyroidism is one of the major complications encountered in patients on maintenance dialysis. Medical management is frequently unsuccessful, and there is often a need to perform a parathyroidectomy. Recurrent clinical secondary hyperparathyroidism may occur as a sequela of subtotal parathyroidectomy and necessitate a reexploration of the neck. Total parathyroidectomy followed by autotransplantation of parathyroid tissue into the patient's forearm bypasses the need for a second operation, and it provides a simple ambulatory procedure, under local anesthesia, for the removal of hyperplastic parathyroid tissue. The results in six patients indicate that this new procedure should be considered the treatment of choice for this condition. PMID- 6841040 TI - Thyroglossal duct remnant carcinoma. AB - Thyroglossal duct remnant carcinoma is a very rare malignancy arising from aberrant thyroid tissue. This diagnosis, however, should be considered in patients presenting with anterior neck masses. If there is no invasion of the capsule of the tumor, local excision with diligent follow-up is recommended as the treatment of choice. PMID- 6841042 TI - Lumbar spinal stenosis: surgical intervention for the older person. AB - Twenty-one patients, aged 50 to 75 yr, received orthopedic surgery for lumbar spinal stenosis during the period of 1975-79. Presentation and management are discussed and surgical results evaluated clinically. Twenty of these patients had subjective pain relief as well as functional improvement, indicating that decompressive laminectomy offers an improved quality of life for the older person with a relatively safe, simple procedure and few postoperative complications. PMID- 6841043 TI - Scoring system for assessing the treatment of supracondylar fractures of the humerus. AB - This study follows up supracondylar fractures of the humerus in 41 children. Twenty-one boys and 20 girls were observed over an average period of 4.6 yr. The ages at the time of the fracture varied between 1 and 15 yr, the highest incidence occurring between 5 and 8 yr. Twenty-four patients were treated by closed reduction and long arm cast fixation, and 17 were handled by closed reduction after overhead skeletal traction. The children who were treated with skeletal traction had comparatively more-severe fractures. Although the results have no statistical significance, a greater range of motion was regained in the elbows treated by the skeletal traction method. Following treatment, none of the patients had complications from infection or from neurovascular problems. One of the problems this study posed was in comparing our work to similar published reports. We therefore developed a new scoring system for evaluating the results achieved in treatment of this type of fracture. PMID- 6841045 TI - Computerized tomography for ascertaining osteocartilagenous intraarticular (slice) fractures of the femoral head. AB - Posterior dislocation of the hip joint is the result of severe trauma and leaves those affected with a significant degree of morbidity. Avascular necrosis of the femoral head is its most feared, and yet difficult to diagnose, complication, mainly in the immediate postinjury period. Intraarticular (slice) fractures of the posteroinferior and inferomedial aspects of the femoral head associated with such dislocations may cause the same clinical symptomatology as the sequelae of avascular necrosis, yet need a different approach and have a different prognosis. Since these slice fractures occur in a blind spot area for routine radiographic examinations of the hip, they are often missed and consequently underdiagnosed. Computerized tomography of the hip following posterior dislocation has become a most useful tool in ascertaining the diagnosis in these patients because it very clearly delineates such "slice" fractures, thus enhancing the correct assessment of this severe and often crippling injury. PMID- 6841044 TI - Scapulectomy revisited: soft part sarcomas of the posterior shoulder. AB - Scapulectomy with muscle group resection and axillary lymphadenectomy for soft part sarcomas of the posterior shoulder is described. This rarely utilized procedure gives satisfactory tumor control and good functional results in carefully selected patients. The indications and technique for the procedure are discussed. PMID- 6841046 TI - Control of massive retroperitoneal bleeding associated with pelvic fractures by angiographic embolization. AB - Continuous retroperitoneal bleeding may be an immediate life-threatening complication of pelvic fractures. While surgical control of the bleeding vessels has been advocated in these cases, today angiographic embolization of the branches of the internal iliac arteries is proving to be the treatment of choice. This is a relatively simple, safe, prompt and effective method of controlling the hemorrhage. It avoids the disadvantages of surgery, general anesthesia, loss of the tamponade effect of the retroperitoneum when opened, and the not uncommon difficulty of identifying and ligating the bleeding vessels. Two cases in which massive retroperitoneal bleeding associated with pelvic fractures was controlled by angiographic embolization are described, illustrating the importance of early angiography. PMID- 6841047 TI - Terrorist bombing experience during 1975-79. Casualties admitted to the Shaare Zedek Medical Center. AB - During a period of 4 1/2 yr, 24 terrorist explosions occurred in Jerusalem. Of the 511 casualties, 340 were evacuated to the Department of Emergency in our hospital. A total of 272 admissions were graded by the "Injury Severity Score" (1), with a breakdown into light injuries (87%), medium (3%) and severe (10%). The high proportion of light injuries may be explained by the evacuation of all casualties to the nearest hospital without on-site triage. Injuries to the head and neck comprised 19.3%, and to the extremities 39% of all injuries. PMID- 6841048 TI - External electroenterography--an experimental study in induced pathological conditions in the monkey. PMID- 6841049 TI - One-stage technique for chronic hemodynamic and lung-lymphatic cannulation in sheep. PMID- 6841051 TI - Prophylactic antibiotic regimen for ileal conduit urinary diversion. PMID- 6841050 TI - Malignant lymphangioma of the spleen. PMID- 6841052 TI - Late hematogenous infection: a constant threat to total joint replacement. PMID- 6841053 TI - Type I choledochal cyst in adults. PMID- 6841054 TI - Preaortic left iliac vein: a rare hazard in abdominal aortic aneurysm surgery. PMID- 6841055 TI - Congenital absence of the vermiform appendix. PMID- 6841056 TI - Ethics and social inquiry. PMID- 6841057 TI - Social science and the policy-making process. PMID- 6841058 TI - Toward ethical guidelines for policy research. PMID- 6841059 TI - 'Up agen middle class morality'. PMID- 6841061 TI - Defining death: there ought to be a law. PMID- 6841060 TI - The tiniest newborns. PMID- 6841062 TI - AID and the single welfare mother. PMID- 6841063 TI - The limits of confidentiality. PMID- 6841064 TI - Warning: screening workers for genetic risk. PMID- 6841065 TI - Health care and the 'deserving poor'. PMID- 6841066 TI - Prostate cancer: the paradox of early diagnosis. PMID- 6841068 TI - Has the NHS failed? PMID- 6841067 TI - Clinical usefulness of the first heart sound (with a new diagnostic finding). PMID- 6841069 TI - Review of postgraduate training in South East Scotland by trainers and trainees, 1981. PMID- 6841070 TI - Young persons' contraceptive clinic, 1975 to 1980: patterns of use. PMID- 6841071 TI - Referrals to the psychiatric services by general practitioners in relation to the introduction of sessions by psychiatrists in Health Centres. PMID- 6841072 TI - Review of drug overdosage in West Lothian. PMID- 6841073 TI - [Possibilities and limits of chemotherapy of diseases caused by herpes simplex and varicella-zoster virus]. AB - The available antiviral chemotherapeutic agents for the treatment of herpes simplex type 1 and 2 and varicella zoster virus infections are discussed in respect of their mechanism of action, clinical effects, and side effects. Although effective under experimental conditions most of the antiherpetic drugs need further evaluation of clinical efficacy in controlled trials. It is possible to reduce initial herpetic pain mainly in patients with zoster by topical application of 5% 5-iodo-2'-deoxyuridine solved in dimethylsulphoxide when treatment starts within the first 3 days of blister eruption. The postzosteric neuralgia is not influenced. A shortening of pain seems also possible in primary herpes simplex virus type 2 infection. For recurrent herpes simplex there is no proven effect on duration or frequency of recurrences with available antiherpetic drugs. The indication for antiviral chemotherapy is limited not only by the unpredictable, mainly self-limited, course of herpes simplex and zoster but also by the possible side effects of chemotherapeutic agents. Severe and life threatening herpes disease, e.g., in immunosuppressed patients or newborns, can be defeated with vidarabin applied i.v. and, in the near future, with acyclovir. PMID- 6841074 TI - [Acantholysis and eosinophilic spongiosis: pemphigus herpetiformis. Successful retinoid therapy]. AB - Pemphigus herpetiformis is an unusual variant of the pemphigus group, showing acantholytic bulla formation together with marked eosinophilic spongiosis. The clinical picture shows erythematous and pruritic papulovesicular bullous lesions affecting the skin and the oral mucosa. It most closely resembles dermatitis herpetiformis or bullous pemphigoid. In contrast, the presence of acantholysis and of antiepithelial antibodies indicate pemphigus. Three patients, all women, showing this unusual variant of pemphigus, were seen during the last 3 years, a fourth is reported here. One patient responded well to dapsone; the three others did not. Oral treatment with aromatic retinoid (Ro 10-9359) was clearly effective in the last patient, leading to full remission of the skin lesions in a few days. The oral mucosa improved only partly. Discontinuation of the aromatic retinoid treatment and replacement of the drug by placebo was followed by a relapse both of mucosal and skin lesions. Aromatic retinoid possibly inhibits eosinophilic migration into the epidermis and impedes acantholysis associated with this phenomenon. PMID- 6841075 TI - [Circumscribed urethritis plasmacellularis (Zoon) of the navicular fossa]. PMID- 6841076 TI - [Relations between sperm findings and fertility prognosis in childless couples]. AB - In eight andrological centres more than 2,000 childless married men were examined catamnestically. Fertility was compared with the findings of the routine spermatograms. Conception rate is reduced significantly if sperm density is below 10 million, in motility of spermatozoa under 50% and in ejaculates with less than 60% normal-shaped spermatozoa. However, lower values of spermatozoa must not be compared with absolute infertility. PMID- 6841077 TI - [HLA system and disorders of spermatogenesis]. AB - Concerning the question of associations between HLA-antigens and idiopathic disturbancies of the spermatogenesis the HLA-ABC and DR-antigens were determined in 65 patients. All patients had less than 5 mio/ml spermatozoa in at least two semen samples. Significantly higher frequencies of certain HLA antigens were not found within the group of patients, when compared with unrelated healthy control individuals. Suggestions from other authors, that a part of idiopathic spermatogenetic disorders are associated with HLA-antigens, are not confirmed by our results. One family in which three brothers suffered from azoospermia was also HLA-typed. None of the four parental haplotypes was shared by all of the three brothers. PMID- 6841078 TI - [Euthyroid circumscript symmetric myxedema of the upper lip]. AB - An unusual case of circumscribed mucinosis without thyroid dysfunction or paraproteinemia is reported. The lesions were localized symmetrically on the upper lip sparing the philtrum. Histopathologie findings suggest that the mucinous deposits are caused by a disturbance of the vascular circulation. PMID- 6841079 TI - [External coproma and its differentiation from malignant melanoma]. PMID- 6841080 TI - [Immunological functions of Langerhans cells]. AB - Langerhans cells are the body's outer-most immunologic bastion against harmful environmental substances. They are a dendritie bone-marrow-derived subgroup of the mononuclear macrophages and serve an important immune regulating function. Langerhans cells are the antigen-presenting cells in the epidermis and play an important role in the induction and elicitation of delayed allergic hypersensitivity reactions against contact allergens, microbial antigens in the skin and antigens formed by cutaneous tumors. PMID- 6841081 TI - [Toxic shock syndrome]. AB - The toxic-shock syndrome (TSS) is a recently recognized syndrome characterized by sudden onset of high fever, vomiting, and diarrhea with rapid progression to hypotension and shock. It is caused by one or more not yet clearly defined exotoxins from staphylococcus aureus. The disease primarily affects young women using tampons during their menstrual periods, although it occurs also in non menstruating women and in men. In these cases extragenital staphylococcus aureus infections are found. Since 1981 the toxic-shock syndrome associated with menstruation has occurred less frequently, whereas the non-menses-related toxic shock syndrome appears with similar frequency. The syndrome resembles Kawasaki disease (mucocutaneous lymph node syndrome) in several aspects, namely fever, rash with subsequent desquamation, and cardiovascular involvement. However, shock, which is prominent in toxic-shock syndrome, is not usually seen in Kawasaki disease. PMID- 6841082 TI - [Thalidomide in dermatology]. AB - Based on present publications we review indications of the therapy of dermatoses with thalidomide as well as possible mechanisms of action and side effects of this drug. In reactional states of leprosy the use of thalidomide is established. Further indications are chronic cutaneous lupus erythematosus, prurigo nodularis, and eventually recurrent aphthosis and certain photodermatoses not responding to usual treatment. Therapeutical trials of thalidomide in diseases in which such a treatment is only occasionally or not at all mentioned in the literature will be reported. Concerning the mechanisms of action emphasis is put on a possible immunosuppression by thalidomide. Among the side effects the thalidomide neuropathy is stressed. PMID- 6841083 TI - [Anaphylaxis following ingestion of coffee, chronic urticaria and analgesics idiosyncrasy]. AB - In a 45-year-old woman with chronic urticaria anaphylactoid reactions occurred after (1) ingestion of coffee and (2) taking an analgesic drug. Prick testing in the patient and passive cutaneous anaphylaxis with coffee extract in the monkey Macacus nemestrinus were positive. With regard to further prick tests and oral provocation tests there is conclusive evidence that anaphylactic hypersensitivity to coffee was co-existing with idiosyncrasy to acetylsalicylic acid, indomethacne, metamizole (dipyrone), and caffeine. PMID- 6841085 TI - [Treatment of Behcet's disease with colchicine]. PMID- 6841084 TI - [Nosology of confluent and reticulated papillomatosis (Gougerot-Carteaud)]. AB - The detection of amyloid in skin lesions in three patients suffering from papillomatose papuleuse confluente et reticulee Gougerot-Carteaud requires a discussion of its meaning for the nosology in this rare dermatosis. Several hypotheses are possible. Papillomatose papuleuse confluente et reticulee can be regarded as reaction cutanee according to Brocq. The histopathological findings allow to group the three patients under the nosological entity of biphasic primary localized amyloidosis. PMID- 6841086 TI - [Clear cell carcinoma with unusual skin involvement]. AB - Clear-cell sarcoma of tendons and aponeuroses represents a rare, malignant tumor. Its knowledge and differential diagnosis is of importance in order to initiate early treatment. A typical case and in particular the histological differential diagnosis will be discussed. PMID- 6841087 TI - [Tumor-like organ manifestations of actinomycosis]. AB - This report describes a 36-year-old male suffering from a disease which began with subcutaneous nodules and tumors that opened to form fistulae for past 5 years. These lesions, localized in various areas, were combined with tumorlike symptoms of brain, lungs and liver. The histologic examination of one subcutaneous nodule led to the diagnosis of actinomycosis. The differential diagnosis of various forms of actinomycosis are discussed. PMID- 6841088 TI - Life-table factors for use in estimating the cancer risk of radiation exposure to workers. AB - Recent publications have discussed the use of life-tables in estimating the risks of radiation-induced cancer (Bu81; Ha81). These studies have been useful in estimating the hazards to groups of individuals exposed to radiation. However, they are not always presented in a way which is useful to health physicists. Life table factors are presented here which may be of use in calculating such risks to individuals or groups. PMID- 6841089 TI - Intake and subsequent fate of a ceramic particle containing 2.85 microCi 241Am: a case study. AB - Intake of 241Am was reported in a young female technologist. External monitoring, whole body counting, urinalysis and fecal analysis were performed to determine the subsequent fate of the contaminant. Five days later, more than 99.5% of the radioactivity was voided in a fecal sample. A single particle, containing 2.85 microCi of 241AmO2 incorporated in a ceramic matrix, was isolated from the fecal sample. Brief descriptions of the radioanalytical results and dosimetry implications are presented. A shadow shield whole body counter was conveniently used to make an early estimate of the intake. This initial estimate enabled staff to decide that it was not necessary to artifically remove the contaminant. It was estimated that the lower large intestine was the organ which received the highest dose due to the passage of the ceramic particle. Systemic uptake of 241Am was indicated by urinalysis. The fractional transfer of 241Am from the GI tract to the blood was estimated to be less than 6 X 10(-5). This maximum estimate is limited by the MDA of the analytical procedures used. The fractional transfer of the 241Am from the GI tract to blood in this case is about an order of magnitude less than recent ICRP recommendations for "all compounds of americium". PMID- 6841090 TI - Retention and dosimetry of 106Ru inhaled along with inert particles by Fischer 344 rats. AB - This study was done to provide data useful for predicting the deposition, retention and radiation dose patterns for humans who might be exposed to an aerosol containing 106RuO4 and respirable particles. Ruthenium-106 tetroxide was introduced into air containing inert particles. The inert particles were monodisperse. 0.69 micrometer diameter fused aluminosilicate and very small residue particles from nebulized droplets. A complex exposure atmosphere resulted. In addition to condensation of 106RuO4 on pre-existing particles, self nucleation occurred, presumably resulting from the formation of RuO2. It appears there was a significant amount of 106RuO4 present in the inhalation exposure system. When a group of Fischer-344 rats inhaled this exposure atmosphere, approx. 12% of the initial body burden reached the pulmonary region of the respiratory tract. Of the remaining 88% of the initial burden, 60% was deposited in the upper respiratory tract, 10% in the tracheobronchial region and 18% was external contamination, primarily on the nares and head skin. Most of the initial body burden was cleared via the gastrointestinal system and excreted via feces. Clearance of 106Ru from the pulmonary region had an effective half-time of approx. 30 days and was predominantly by dissolution. Relative radiation doses accumulated to 100 days after inhalation exposure, normalized to a lung dose of 1.0, were nasopharyngeal mucosa, 11; trachea and larynx, 5; lower large intestine, 5; upper large intestine, 2; liver, 0.9; and kidneys, 0.9. Other tissues and organs received lesser relative doses. Comparable results are predicted for man inhaling a similar exposure atmosphere, which could be encountered under certain circumstances in nuclear industry operations. PMID- 6841091 TI - Deposition and retention of 141Ce and 134Cs aerosols on cool desert vegetation. AB - Deposition velocities and retention times were obtained for submicron aerosols of 141Ce and 13l4Cs deposited on two cool desert plant species, big sagebrush (Artemisia tridentata) and bottlebrush grass (Sitanion hystrix). Mean deposition velocities for sagebrush were 0.18 cm/s (141Ce) and 0.13 cm/s (134Cs). Mean deposition velocities for grass were 0.022 (141Ce) and 0.023 cm/s (134Cs). Species differences were significant (p less than 0.05), however, nuclide differences were not significant. The loss of activity on the vegetation consisted of two components. A rapid initial loss was found with effective half times of approx. 1 d (1-8 d for 141Ce and 0.6 d for 134Cs) on sagebrush and approx. 2 d (2.8 d for 141Ce and 2.3 d for 134Cs) on grass. This was followed by a slower, long-term loss with effective half-times ranging from 11 d for 141Ce and 15 d for 134Cs on sagebrush to 9 d for 141 Ce and 11 d for 134Cs on grass. PMID- 6841092 TI - Preliminary observations on californium-252 behaviour in sea water, sediments and zooplankton. AB - We carried out radiotracer experiments on the behaviour of 252Cf in the marine environment. The particulate fraction of californium in sea water approached 45% after four days. Californium rapidly adsorbed onto marine coastal and deep-sea sediments with Kd values from 1.4 X 10(4) to greater than or equal to 1 X 10(5). The concentration of 252Cf in euphausiids reached near-equilibrium factors of 3 X 10(2) in water after one week; in contrast, the assimilation from food was very low. Excreted fecal pellets, molts and zooplankton carcasses are potentially important vectors for californium re-distribution in the oceans. PMID- 6841094 TI - Estimation of shallow-dose equivalent using a two-element dosimeter. AB - Estimation of shallow-dose equivalent using a two-element dosimeter is described under the guidelines of a standard adopted by the Health Physics Society Standards Committee and the dosimetry practices followed by most dosimeter processors. This standard is to be used in a future mandatory testing program in the U.S. A mathematical formulation, correlating dosimeter response and "shallow dose equivalent factors" at different energies, is presented. A thermoluminescent dosimeter (TLD), currently used at the Idaho National Engineering Laboratory, is examined for determining shallow-dose equivalent response and the results are discussed for beta as well as photon responses. PMID- 6841093 TI - An exact solution to the Gaussian cloud approximation for gamma absorbed dose due to a ground-level release. AB - An exact solution is presented for the classical Gaussian cloud approximation for long-term averaged estimates of gamma absorbed dose due to a ground-level release of radioactive gases and particles. The solution is in the form of relatively simple functions and is much easier to implement than the traditional solution. Also, it is shown that the Gaussian cloud approximation predicts lower absorbed dose than the uniform cloud approximation. The difference is significant when the product of gamma attenuation coefficient and vertical dispersion coefficient is small. Since the Gaussian cloud approximation is based on a more realistic concentration distribution than the uniform cloud approximation, the calculations using the former should give more accurate estimates of the long-term averaged dose for the sector-averaged plume. PMID- 6841095 TI - Spicer: a sensitive radiation survey instrument. AB - A compact, portable field instrument for measuring environmental gamma-ray exposure rates has been developed. Based on an 18 cm diameter pressurized ionization chamber, a temperature compensated MOFSET electrometer and a digital readout with selectable integration times, it is a considerable improvement over previously used larger and bulkier instruments of this type. PMID- 6841097 TI - Depth-dose curves for 90Sr and natural and depleted uranium in Mylar. AB - Strontium and uranium are common sources used to calibrate personal dosimeters and survey meters for beta radiation. Since the absorbed dose rate of low penetrating beta radiation decreases significantly with increased depth in tissue or dosimeters, it is necessary to describe the dose rate accurately as a function of depth. Complete depth dose information from zero to 1000 mg/cm2 is currently unavailable for strontium and uranium. This paper describes the generation of accurate depth-dose curves in Mylar for 90Sr and slabs of natural and depleted uranium from 0 to 1000 mg/cm2, utilizing an extrapolation chamber. The absorbed dose rate produced by natural uranium was found to decrease from 235 mrad/hr at a depth of 7 mg/cm2 to 43 mrad/hr at 300 mg/cm2 to 4.8 mrad/hr at 1000 mg/cm2. The dose rate produced by depleted uranium was found to decrease from 205 mrad/hr at 7 mg/cm2 to 34 mrad/hr at 300 mg/cm2 to 2.3 mrad/hr at 1000 mg/cm2. A 1-mCi extended area 90Sr source (encapsulated in 50 mg/cm2 AG) was found to produce an absorbed dose rate of 16,997 mrad/hr at 57 mg/cm2, 5000 mrad/hr at 300 mg/cm2, and 27.1 mrad/hr at 1050 mg/cm2. Doses to deep organs have been determined historically at depths ranging from 300 to 1000 mg/cm2. The results of this study show that 90Sr and uranium produce significant absorbed dose rates at a depth of 300 mg/cm2. Thus, if doses for deep depths are determined at 300 mg/cm2 for mixed beta-gamma exposures, the dose will be overestimated due to the presence of the beta component. The depth-dose curves generated in this study can be used by dosimeter processors to normalize the response of their dosimeters to the shallow (7 mg/cm2) and deep (1000 mg/cm2) depths defined by the U.S. Nuclear Regulatory Commission. PMID- 6841096 TI - A new phosphor Li2B4O7: Cu for TLD. AB - The phosphor Li2B4O7: Cu (0.03% by weight) has an effective atomic number of 7.3, which is very similar to that of tissue (7.4). This suggests that the phosphor should have excellent properties for thermoluminescent dosimetry. The phosphor prepared by a sintering method shows two glow peaks composed of a dosimetric peak at 205 degrees C and a shoulder at 120 degrees C, and a broad emission band peaking at 368 nm. The material based on the stoichiometric compound of Li2O . 2B2O3 has a good moisture resistant property. The dosimetric characteristics are as follows: (1) The sensitivity of gamma rays is about 20 times higher than that of Li2B4O2: Mn prepared by the conventional melting method. (2) The dosimetry peak of 205 degrees C fades less than 9% in intensity at 25 degrees C after 60 days in dark. (3) The TL output is linear with exposure to about 10(5) R, becoming sublinear above it. (4) The sensitivity loss caused by humidity is about 10-25% after 2-6 months of storage in air of 90% relative humidity at 25 degrees C. (5) The energy dependence of TL output for photons is flat within the limit of 10% from 40 keV to 7 MeV. (6) The light induced fading is 10% after 3 h room lighting at 1000 lux. PMID- 6841098 TI - Multi-element dosimeters for radiation protection measurements. PMID- 6841099 TI - A suspected case of over-exposure at the nuclear chemistry laboratory of the Nuclear Research Centre of Egypt. PMID- 6841100 TI - Biologically and physically recorded doses after an accidental exposure to 60Co gamma rays. PMID- 6841101 TI - Problems with the linear-quadratic dose-response relationship. PMID- 6841102 TI - RADOK: an integrating, passive radon monitor. PMID- 6841103 TI - Influence of sealants on 222radon emanation rate from building materials. PMID- 6841104 TI - Removal of particles deposited in human nasal passages by nose blowing. PMID- 6841105 TI - Distribution of alpha-emitting radionuclides in cigarette filters: a preliminary report. PMID- 6841106 TI - Absorption of thorium and protactinium from the gastrointestinal tract in adult mice and rats and neonatal rats. PMID- 6841108 TI - Microwaves and neoplasia in mice: analysis of a reported risk. PMID- 6841107 TI - Reduction in the gastrointestinal uptake of alkaline earth radionuclides by DTPA immobilized on cellulose. PMID- 6841109 TI - Response to "genetic effects of the atomic bombs: a reappraisal". PMID- 6841110 TI - Ground scattering contribution in neutron calibrations. PMID- 6841111 TI - Commentary on the management implications of "Effectiveness in Professional Organizations: the impact of surgeons and surgical staff organizations on the quality of care in hospitals". PMID- 6841112 TI - Compensation of hospital-based physicians. AB - This study is concerned with methods of compensating hospital-based physicians (HBPs) in five medical specialties: anesthesiology, pathology, radiology, cardiology, and emergency medicine. Data on 2232 nonfederal, short-term general hospitals came from a mail questionnaire survey conducted in Fall 1979. The data indicate that numerous compensation methods exist but these methods, without much loss of precision, can be reduced to salary, percentage of department revenue, and fee-for-service. When HBPs are compensated by salary or percentage methods, most patient billing is conducted by the hospital. In contrast, most fee-for service HBPs bill their patients directly. Determinants of HBP compensation methods are investigated via multinomial logit analysis. This analysis indicates that choice of HBP compensation methods are investigated via multinomial logit analysis. This analysis indicates that choice of HBP compensation methods is sensitive to a number of hospital characteristics and attributes of both the hospital and physicians' services markets. The empirical findings are discussed in light of past conceptual and empirical research on physician compensation, and current policy issues in the health services sector. PMID- 6841113 TI - Exploring dimensions of access to medical care. AB - This paper examines the dimensions of the access concept with particular attention to the extent to which more parsimonious indicators of access can be developed. This process is especially useful to health policy makers, planners and researchers in need of cost-effective social indicators of access to monitor the need for and impact of innovative health care programs. Three stages of data reduction are used in the analysis, resulting in a reduced set of key indicators of the concept. Implication for subsequent data collection and measurement of access are discussed. PMID- 6841114 TI - Commentary on "Effectiveness in Professional Organizations" by Flood, Scott, Ewy and Forrest. PMID- 6841115 TI - The hospital and medical practice: a study of physician staff appointments among specialists and generalists. AB - The names, specialties, and appointment status of physicians with privileges in 161 North Carolina hospitals were obtained and compared to the file of licensed, active, patient-care physicians practicing in the State for the year 1978. The listings were examined to determine the number of physicians without a hospital privilege by age, race, sex, specialty, and geographic location. Overall, only 11 percent of all active physicians did not have some form of hospital appointment. Among family and general practitioners, 29 percent had either a restricted hospital privilege or no hospital appointment at all. A greater number of nonwhite and female physicians were also without privileges. These data have implications for the training of physicians in a system that emphasizes hospital care and includes inpatient treatment within the purview of primary care. PMID- 6841116 TI - Melanoma of the head and neck in Queensland. AB - The incidence of melanoma in Queensland, 40 cases per 100,000 population, is the highest in the world. In this series of 740 melanomas over a 7-year period at the Royal Brisbane Hospital, 21.75% occurred on the head and neck. Of these, 46.5% arose in Hutchinson's melanotic freckle and 54.8% were histologically superficial, that is, Clark Levels I and II or less than 0.76 mm in thickness, or both. As local recurrence and distant metastasis is infrequent in superficial melanoma, less radical surgical excision of these lesions is advocated than for thicker lesions or those exhibiting a greater depth of invasion, where aggressive excision and even regional node dissection may be required. Anatomical variations in areas such as the nose, eyelid, ear, and scalp influence patterns of spread and necessitate differences in treatment at each site. PMID- 6841117 TI - Local control of T1 vocal cord cancer with radiation therapy: the importance of tumor character vs. treatment parameters. AB - Ninety-one patients with T1 vocal cord carcinoma received primary irradiation treatment. The 5- and 10-year determinate disease-free survival was 80%; the 5- and 10-year determinate survival including surgical salvage was 92%. Tumors involving more than one-half of a vocal cord or involving the anterior commissure or exhibiting an exophytic growth pattern had numerically, but not statistically, higher local failure rates than tumors without these characteristics. Precise radiation treatment technique appears more important for local control (LC) than tumor character. The crucial treatment factors for high LC with few radiation complications are reproducible daily patient positioning, use of contour compensating devices (wedges), field size of 5 X 5 cm, and a radiation prescription with a time-dose fractionation value of 101 to 106. PMID- 6841118 TI - An approach to face-lift surgery. AB - An approach to the aging face based upon an analysis of surgical principles and dynamics is presented. This approach emphasizes that the face-lift operation should be directed toward areas in which its potential for improvement is greatest, that is, the jowl and neck. Correction of associated manifestations of aging is best accomplished using ancillary procedures specifically designed for rejuvenating these areas rather than by extension of the face-lift operation per se. PMID- 6841119 TI - Sternoclavicular joint hypertrophy following radical neck dissection. AB - The classic radical neck dissection continues to dominate therapy for cervical metastasis. While the morbidity, complications, and sequelae of this procedure are well documented, sternoclavicular joint hypertrophy appears to have escaped attention. In order to establish the true incidence of this frequently noted but poorly documented condition, 50 randomly selected patients who had undergone radical neck dissection were evaluated retrospectively. Significant sternoclavicular hypertrophy was noted in 54% of the patients, but in only 4 (8%) was the condition severe enough to cause patient or physician concern. Surgical exploration was performed in 2 cases. The etiology of this condition is discussed, as are the radiologic findings, which may be suggestive of metastasis. The major clinical significance is an awareness of the condition and avoidance of over investigation and surgical exploration except in the most suspicious circumstances. PMID- 6841120 TI - Benign lipoblastoma in the mandible. AB - Large benign tumors and cysts of the mandible cause such massive bulging in the soft tissue of the cheek that one is tempted to try to find an external approach to the tumor. In our experience an oral approach has proven to be sufficient and advantageous in most cases of benign mandibular tumors even when they were very large. This is demonstrated in an unusual case of lipoblastoma of the ascending mandibular ramus. It is the first endosteal case of this rare tumor in the literature. PMID- 6841121 TI - Acral lentiginous melanoma of the oral cavity. AB - Lentiginous melanomas may be classified clinicopathologically as either lentigo maligna melanomas or acral lentiginous melanomas. Lentigo maligna melanoma is generally characterized by its slow rate of growth, lateness of metastasis, and relatively good prognosis. Acral lentiginous melanoma, while demonstrating a radial growth phase which is histologically similar to that of lentigo maligna, appears biologically more similar to superficially spreading malignant melanoma once the vertical growth phase supervenes. Mucous membrane melanomas with lentiginous characteristics are likely to be aggressive lesions with a marked propensity for metastasis and a uniformly poor prognosis, much like the acral lentiginous type of melanoma. It would seem, therefore, that superficial melanomas of the oral mucous membranes with a lentiginous pattern should best be termed acral lentiginous melanomas instead of lentigo maligna melanomas so as to more accurately predict their true biologic potential. An amelanotic case is presented which we believe illustrates this point. PMID- 6841122 TI - Treatment of a large hemangioma in the head and neck region. PMID- 6841123 TI - Retrieval of the parathyroid glands during thyroidectomy. AB - A recommended technique of intraoperative search of the removed thyroid lobe or entire gland for attached parathyroid glands is presented. Diligent examination of the thyroid capsule and folds of the thyroid gland is made in the sterile operative field. Any recovered parathyroid gland or glands are then finely sectioned and reimplanted in a location which is not likely to be violated in any future surgical procedure. This technique has significantly reduced the incidence of permanent hypoparathyroidism after total thyroidectomy. PMID- 6841124 TI - Prosimian hemoglobins I. The primary structure of the beta-globin chain of Lemur catta. AB - The primary structure of the beta chain from the hemoglobin of a prosimian primate, Lemur catta, has been determined by automated Edman degradation of intact polypeptide chain and fragments produced by tryptic, cyanogen bromide and acid cleavage, and by homology with the sequence of Lemur fulvus. The sequence presented here differs from the human beta-globin sequence at 26 sites. This is the same degree of divergence previously reported for the beta-globin chain of Lemur fulvus. The sequences of the two congeneric lemuroid beta-globin chains are surprisingly divergent, differing at 18 sites. Of the 26 positions where L. catta differs from Homo sapiens, 7 are at positions with defined function. Of these 7 positions, 4 (2-Phe, 54-Ile, 94-Val, 112-Ile) are unique to L. catta among the primate beta-globin chains of established sequence. Residue 112-Ile is consistent with the prediction of Beard and Goodman (19) of an isoleucyl residue in this position in the ancestral primate beta-globin chain. PMID- 6841125 TI - Hb Winnipeg or alpha 2 75(EF4)Asp leads to Tyr beta 2 in a large Caucasian family living in Georgia, USA. PMID- 6841126 TI - The primary sequence of the beta chain of Hb type III of the Virginia white tailed deer (Odocoilus Virginianus), a comparison with putative sequences of the beta chains from four additional deer hemoglobins, types II, IV, V, and VIII, and relationships between intermolecular contacts, primary sequence and sickling of deer hemoglobins. PMID- 6841128 TI - A second case of hemoglobin McKees Rocks (beta 145 Tyr leads to Term). A variant with premature termination of the beta-chain. PMID- 6841127 TI - Oxygen equilibrium studies of Hb Willamette alpha 2 beta (2)51(D2)Pro leads to Arg. AB - The homotropic and heterotropic effects of isolated Hb Willamette were studied using an automatic recording oxygen equilibrium analyzer. The results indicate that Hb Willamette displays normal intrinsic oxygen binding in the stripped condition. An apparent decrease of the Bohr effect is explained by the decrease of allosteric effects in this abnormal hemoglobin. Furthermore, the lack of clinical manifestations in the original patient is consistent with the red cell oxygen equilibrium studies. PMID- 6841129 TI - Nutrient intake and associated biochemical status of pregnant Asians in the United Kingdom. AB - Forty-six women (17 Pakistanis, 19 Indians, ten Bangladeshis) at 8 to 20 weeks of pregnancy were studied during November to January. Dietary intake was assessed by the diet history method. Mean energy intakes (+/- s.d.) for the Pakistanis, Indians and Bangladeshis were 9.80 (1.99), 8.08 (1.59) and 6.95 (1.70) MJ. Intakes of protein, calcium, phosphorus and iron were positively correlated with energy intake. Vitamin D intake was similar in all groups, mean (+/- s.d) = 2.15 (1.39). Mean serum (+/- s.d.) protein, phosphorus and calcium were 70.9 (6.5) g/l; 2.27 (0.12) mmol/l; 1.00 (0.21) mmol/l and fell within the lower normal range. Mean haemoglobin was 12.2 (1.1) g/dl. Mean (+/- s.d.) serum 25-OHD for Pakistanis, Indians and Bangladeshi respectively was 3.80 (2.25), 4.04 (2.64) and 5.22 (2.47) ng/ml. These are within the range found for patients with osteomalacia (less than 10 ng/ml) and substantially lower than values of 14.6 (2.6) ng/l reported by Bashir et al. (1981) for September and October. PMID- 6841130 TI - Controlled studies of nutritional intake in patients with malignant disease undergoing treatment. AB - Ninety-seven patients with cancer, undergoing radiation treatment, were studied. Forty-two were given special dietary counseling and supplements of Sustagen or Isocal; 42 controls received no special advice or supplements. Thirteen patients were excluded because of poor prognoses and the ethical need for food supplements. Nutrient intake of all groups was assessed by 3-d diet records in household measures in the first and the last week of treatment. Intake was significantly higher in the adjunctive than the control group. The excluded group, despite supplementation, had intakes similar to the control group. No difference was observed between the control and adjunctive groups in clinical status at the end of treatment or in long-term outcome. PMID- 6841131 TI - Dietary intake of advanced cancer patients. AB - A state registered dietitian assessed the voluntary dietary intake of 13 advanced cancer inpatients on one ward of St. Christopher's Hospice for five consecutive days. There were 11 females, two males; median age 74 years (range 56 to 83). Two patients died on the fourth day of the study. A partially individualised weighed technique was used. Standard sized scoops and spoons were used to serve the food in small, medium or large standard portions (depending on appetite) and were weighed as served. Individual plate waste (by weight) was subtracted to give estimated individual intake. Foods provided by visitors was not included. The median and range of individual mean daily intakes (estimated) were: energy 5760 (938-8945) kJ, 1376 (224-2137) kcal; protein 44 (11-86) g; fat 52 (9-93) g; carbohydrate 169 (21-194) g; calcium 748 (268-1457) mg; iron 4.8 (0.5-21.0) mg; dietary fibre 5.0 (0.5-21.0) g. Compared to recommended amounts, energy, iron and dietary fibre intakes were low; calcium intake was high. Nutritional status may affect prognosis and/or subjective well-being in advanced cancer. The value of nutritional supplementation and the role of appetite stimulants in improving nutritional status needs investigation. PMID- 6841132 TI - The conduct of metabolic balances during simulated deep dives. AB - Metabolic balance studies were carried out during a series of simulated deep saturation dives at a Government Research Laboratory at which the physiology of deep diving is under investigation. The methodology employed in controlling diets in the hyperbaric helium-oxygen atmosphere is described in detail. The discussion covers two main areas: dietary problems - including anorexia, changes in taste and food texture - and physiological effects - including nausea and high pressure nervous syndrome (HPNS). PMID- 6841133 TI - Nutrition education for children under 12 years old in North Staffordshire. AB - The paper presents and comments upon findings of a survey carried out in North Staffordshire to ascertain what is taught in and out of school to children under 12 years old about nutrition. The findings include how often nutrition is taught, how and with which subjects it is taught, the type of meals and snacks provided in school and the role of the dietitian in nutrition education. PMID- 6841134 TI - The conflict between advertising message and nutrition education in developing countries. PMID- 6841135 TI - Analytical versus food table values for vitamin C in foods: the effect on calculated vitamin C intake of elderly subjects. AB - During a longitudinal study of vitamin C nutrition in 23 healthy elderly people, samples of cooked vegetables and liver, canned meats, canned vegetables and fruit drinks were analysed for vitamin C content. The analytical data are presented here and the effect on calculated daily intake of vitamin C of using the analytical values in place of food table values is assessed. For cooked foods the analysed values were close to food table values; exceptions were spring cabbage, cauliflower and canned potatoes. Fortified fruit drinks contained 20-60 mg vitamin C per 100 ml and made an important contribution to intake. Canned meats contained 0.3-61.4 mg per 100 g (mean 14.9 mg), but their contribution to intake was considered small. The difference between daily intakes calculated using analytical and food table values was greater than 5 mg in 37 per cent of 1-day periods and in 17 per cent of 7-day periods. These differences were not sufficient to significantly alter the correlations between intake and biochemical indices found in the original study. Nevertheless, given the discrepancies between calculated and analysed vitamin C intakes reported in the literature, analytical work is probably essential in studies of vitamin C nutrition. PMID- 6841136 TI - Dietary supplementation of lactating Gambian women. II. Effect on maternal health, nutritional status and biochemistry. AB - The effect of a high-energy dietary supplement provided under carefully controlled conditions to 130 lactating Gambian women was assessed with respect to changes in maternal health, nutritional status and biochemistry. The supplement resulted in a net increase in energy intake of 723 kcal/d (3.03 MJ/d) and corrected deficits in the intake of protein, riboflavin, vitamin A, vitamin C and calcium. Supplemented women complained of fewer health problems when attending postnatal clinics (P less than 0.001). In particular the incidence of gastrointestinal problems was lower (P less than 0.001). The supplement caused a net body weight gain of only 1.8 kg averaged over a year, and women still lost weight during the farming season. Fasting serum levels of non-esterified fatty acids were increased and of glucose were decreased by the supplement. Plasma concentrations of prolactin, cortisol, insulin and T3 were found to be decreased after supplementation at one or more points during lactation, but growth hormone values remained unchanged. It is suggested that these changes reflect a relaxation from a state of high metabolic efficiency and that much of the additional energy derived from the supplement was simply wasted through a decreased efficiency in the women. PMID- 6841137 TI - Angiotensinase A in the renomedullary interstitial cells. AB - Aminopeptidase A (angiotensinase A; APA) was demonstrated by histochemical means in the renomedullary interstitial cells of the golden hamster, rat, guinea pig and hare. The highest APA activities were shown in the interstitial cells of the hamster. Ultracytochemical studies of the kidney medulla of the hamster indicated that APA is localized mainly on the cell membranes of interstitial cells. Reaction product was also observed intracellularly in the nuclear membrane region. Besides the interstitial cells, APA was demonstrable ultracytochemically in the endothelial cell membranes of medullary blood vessels. Biochemical studies of APA in the renal medulla of experimental animals (sodium loaded and sodium depleted hamsters) have shown that significant changes of APA activities were available only after sodium loading, namely a decrease of APA activities in comparison to control animals. - APA through its degradation of angiotensin, is presumed, to have a bearing on the angiotensin induced prostaglandin biosynthesis of renomedullary interstitial cells. PMID- 6841138 TI - A new fluid switching flow sorter. AB - Conventional cell sorters produce potentially hazardous microdroplets containing dyes and radiolabeled compounds commonly used to identify and trace subpopulations of cells. Many of these substances are potential toxins, mutagens, or carcinogens constituting a risk to personal associated with the sorting device. The separation of living cells for continued study of cell growth from an "in air" sample stream includes the risk of contamination with microorganisms altering the following cultures. To avoid those risks, we have constructed a new capsular flow cytometer sorter which consists of a small chamber completely encasing the sorting mechanism. Data acquisition, analysis, and processing are accomplished by using a microcomputer-based pulse height analyser. PMID- 6841140 TI - Histochemical studies on the regeneration of aminergic nerves in rat cerebral artery after superior cervical ganglionectomy. AB - The course of regeneration of aminergic nerves in rat cerebral arteries was studied by means of histochemical methods, after uni- or bilateral cervical sympathectomy. Degeneration of aminergic nerves started on day 1 and was complete between days 3 and 7 after surgery. Between weeks 4 and 6, regenerating nerves started to appear from the proximal internal carotid artery. Regenerated aminergic nerve fibres were generally unbeaded and intensity of fluorescence was weak. The circular nerves appeared earlier than the longitudinal ones. The number of regenerating nerves reached the maximum, between months 9 and 12, at about half the normal level. AChE activity of the cerebral arteries showed no significant changes at any stage. PMID- 6841139 TI - Cytochemical observations on mannose-specific binding sites for horseradish peroxidase in liver sinusoidal cells. AB - Paraformaldehyde-fixed, frozen sections of the liver of rats were processed for the detection of mannose-specific binding sites of horseradish peroxidase (HRP) by a method reported previously, with some modifications resulting in a more intense binding reaction. Before staining for peroxidase activity, the sections were held in buffered solutions of physiological saline at different temperatures and pH's, and in the presence or absence of added Ca2+, mannose or galactose. The gradual decrease and final disappearance of the binding reaction were observed. The release of HRP from the binding sites as determined by the disappearance of the cytochemical reaction was 50-100 times faster at 22 degrees C than at 4 degrees C and was 5-10 times faster at 37 degrees C than at 22 degrees C. The release was approximately twice as fast at pH 7.0 than at pH 9.0 and 20-30 times faster at pH 6.0 than at pH 7.0. The release of HRP was 10-15 times faster in the absence of 1 mM Ca2+ in the buffer solution and was approximately 100 times faster in the presence of 0.1 M D-mannose as compared to 0.1 M D-galactose. Pretreatment of the sections with trypsin abolished the binding reaction whereas neuraminidase, phospholipases A2 and C, and chondroitinase ABC were without effect. An acidic isoenzyme of HRP, Sigma type VIII, was bound more intensely and more widely to liver sinusoidal cells than another acidic isoenzyme, Sigma type VII, a basic isoenzyme, Sigma type IX, and the routinely used preparation, Sigma type VI. The effect of the temperature on the binding reaction was re-examined with an improved procedure. In contradistinction to the previous finding, strong binding of HRP after 2-4 h incubation at 4 degrees C was observed. PMID- 6841141 TI - Calcium movements and intracellular calcium distribution in neoplastic GH3 cells. AB - Experiments were carried out to investigate the nature of the calcium homeostatic mechanisms in neoplastic GH3 rat pituitary cells. GH3 cells grown and maintained in Ham's F10 culture medium contained 35 nmoles calcium/mg cell protein. When stimulated by thyrotropin releasing hormone (TRH) or elevated K+ concentrations, only the latter caused cell calcium levels to rise although both resulted in hormone release. When exposed to EGTA, the GH3 cells lost calcium. When the temperature was lowered to 4 degrees C, the cells gained calcium and when rewarmed were able to extrude the previously accumulated calcium. The increased cell calcium following cold exposure could be blocked by prior treatment with rotenone. If rotenone was added subsequent to the cold exposure, it did not block the extrusion seen upon rewarming. In the absence of glucose in the medium, the GH3 cells took up more calcium upon exposure to 4 degrees C, and upon rewarming the cells could not return to their previous low levels. There are thus significant differences in calcium homeostasis between the neoplastic GH3 cells and their normal pituitary counterparts. When intracellular calcium was localized with the potassium pyroantimonate technique, there was calcium found in/on mitochondria, membrane bound vesicles and plasma membrane. Nuclear staining was sparse, and nucleolar staining was virtually absent. Upon stimulation with TRH, there was a decrease in mitochondrial calcium along with increases in both plasma membrane and nucleolar calcium levels. Since total calcium is unchanged, this indicates a significant calcium redistribution in response to TRH. The increased nucleolar calcium may reflect a calcium dependent increase in mRNA synthesis as has been reported. Since TRH presumably acts at a surface receptor, the increased plasma membrane calcium might be functionally related to receptor activation. PMID- 6841142 TI - Enhanced membrane fluorescence of CDC-labelled paramecium subsequent to removal of surface components. AB - Cytofluorimetric analysis of cycloheptaamylose-dansyl chloride (CDC) labelled Paramecium indicates that after mild trypsin removal of surface components the localization of CDC on the outer surface of living cells was not modified by the treatment. After such treatment the intensity of fluorescence emission was found about 3-fold higher in treated single cell than in the untreated one. These findings indicate that CDC labelling can be used to follow alteration occurred on the membrane of the living cell prior to labelling. PMID- 6841143 TI - The specificity of angiotensin-antisera. A cautionary note. AB - Apparently monospecific antisera against the decapeptide angiotensin I (ANG-I) have been analyzed for their crossreactivity to the octapeptide angiotensin II (ANG-II). Whereas in the conventional displacement reaction of labeled ANG-I by ANG-II crossreactivities were in the order of 0.01%, the direct binding assay revealed crossreactivities of up to 20%. Both labeled ANG-I and ANG-II can be displaced completely from the antibody by an excess of either ANG-I or ANG-II. A similar relationship was seen with respect to the crossreactivity of ANG-II antisera to ANG-I. - The data demonstrate that false positive immunocytochemical reactions may be obtained if the specificity of the reaction relies on the displacement reaction and the preabsorption of the antisera with the respective peptide. - These results may be pertinent for peptides other than the angiotensins. PMID- 6841144 TI - Ultrastructural localization of calcitonin in control and stimulated thyroid C cells of the rat using protein A-gold immunocytochemical technique. AB - Using anti-human calcitonin serum and a protein A - gold technique, calcitonin was localized at the ultrastructural level in control and calcium gluconate stimulated thyroid C cells of the rat. In control rats calcitonin was detected within a majority of the secretory granules while in experimental animals it was demonstrated also within prosecretory granules present in Golgi apparatus. PMID- 6841145 TI - Health effects of ferrite and the raw materials dust. PMID- 6841146 TI - Embryonic and fetal death after in utero methylmercury exposure and resultant organ mercury concentrations in mice. PMID- 6841147 TI - On the biological half-time of hexavalent chromium in rats. PMID- 6841149 TI - Cadmium excretion in urine and feces of rats at different levels of cadmium toxicity. PMID- 6841148 TI - Low-molecular-weight, chromium-binding substance in rat lungs and its possible role in chromium movement. PMID- 6841150 TI - [Characteristics of inhalation therapy in the ENT field]. AB - Nowadays the therapy of inhalation can be considered the most effective physical therapy in the field of ENT. However the basic requirements are the following ones: --A clear basic knowledge of medicine and physics. --An exact instruction and control of the patient concerning the procedure of inhalation. --The availability of appropriate inhalation equipment (UDV) and of trained personnel. PMID- 6841151 TI - [Operative treatment of subacute unilateral frontal sinusitis]. AB - If in the treatment of acute frontal sinusitis drilling a hole according to Kummel-Beck does not promote the complete healing of the diseased sinus, an enlarged opening of the sinus according to Ogston with resection of the interfrontal septum has proved valuable. This admits air to and ensures sufficient drainage from the afflicted sinus. The procedure is simple, can be performed under local anaesthesia. PMID- 6841152 TI - [Traumatic lesions of the nose-ethmoid-forehead region]. AB - The treatment of this kind of lesion further remains difficult and requires work of several specialists: Neurosurgeon, Ophthalmologist, and ENT-surgeon. As for our opinion the reconstruction of anatomy and normal function of the frontal sinus is unequivocal, and performing it in the majority of cases renders in outstanding results. PMID- 6841153 TI - [Heterotopic pharyngeal hypophyseal adenoma]. AB - Juvenile fibroma, carcinoma and sarcoma are the most frequent tumors of the nasopharynx. Ontogenetic tumors that originate from the base of the skull are found very rarely. The case reported deals with a heterotopic pharyngeal pituitary adenoma, that started growing from the epipharynx. PMID- 6841154 TI - [Rhinomanometric results following operative procedures on the nose]. AB - Rhinomanometry is described (anterior self breathing technique). At 84 nose operated patients anamnesis, clinical state and rhinomanometry result are compared. Furthermore pre- and postoperative rhinomanometry results are contrasted by means of a standardized anamnesis and standardized criterions to obtain the clinical state. In nearly three quarters of all check ups the result is conformity with anamnesis, clinical state and rhinomanometric result. PMID- 6841155 TI - [The repair of extensive deformities of the ventrocaudal septum segment in children]. AB - In children severe deformities of the nasal septum requiring surgical repair are often limited to the caudal portion of the septal cartilage only. Such deformities can be rarely corrected sufficiently by Cottle's method, because the usually severely deformed caudal part of the septum cannot be straightened by mobilization only and because additional incisions within this section will weaken its supporting function for the nasal tip. For that reason we prefer another surgical technique in such cases: the deviated portion is resected and replaced by a free cartilaginous graft taken from the remaining portion of the septal cartilage; the resected portion is straightened by crushing and re implanted between the mucoperichondrial flaps. This method, which we call "reconstructive septoplasty", does not injure the important ossification area between the perpendicular plate and the cartilage, because in children the septal cartilage is relatively much larger than in adults. Until now this method has proved a success in 18 children (4-12 years old). Postoperative follow-up (more than 3 years in 4 cases) showed only in one case a slight saddling of the dorsum of the nose after one year. PMID- 6841156 TI - [The reconstruction of the sound conduction chain]. PMID- 6841157 TI - [Otalgia]. AB - Based on the sensibel innervation of the external and middle ear, the causes and therapy of otalgia are discussed. As a result, the classical definition of otalgia: "pain in the auricular area without concomitant ear pathology" should be maintained. PMID- 6841158 TI - [The intratympanic pressure ratio modified by nitrous oxide and dependent upon retrotympanic volume]. AB - We measured the middle ear pressure of patients with intact middle ear during general anaesthesia with Halothane and N2O. The Madsen-Impedance-Measuring Instrument ZO 73 was used. The planimetric size of the mastoid bone cavity was determined on radiograms in Schuller projection. The pressure in the middle ear space was found dependent from the size of the mastoid bone. The height of the middle ear pressure during tympanoplasty is not without problems, this will be discussed, and the advantages of local-anesthesia will be pointed out as well. PMID- 6841159 TI - [Head trauma with resultant irreversible deafness on one side and reversible hearing impairment on the other side. A case report]. AB - Following a severe head trauma, a 27-year-old man immediately suffered from bilateral hearing loss and impaired balance. On examination there was a complete loss of hearing on the right side. On the left side a subtotal hearing loss of sensorineural origin occurred and became total after a few days. The vestibular function was absent on both sides. Following treatment with prednisolone, hearing recovered in the left ear and reached an average tone threshold of 55 dB. The vestibular function remained lost from the onset of the trauma. At follow up two years later the subtotal hearing loss in the left ear was unchanged as was also the vestibular impairment. PMID- 6841160 TI - [Data telecommunication in electric response audiometry (ERA)]. AB - Telephone-lines suit for the transmission also of digital data along long distances. In ERA this technique is favourable. --because the application of a computer is necessary anyway and the primarily analogous data have to be transformed to digital ones anyhow and --because the expenses for purchase, maintainance and operation of the complete equipment stress practices and small hospitals disproportionately. To test "ERA via telephone" we established outstations, the peripheral measuring equipment of which was composed of commercially available devices (Digital Equ. Corp.); only the computer controlled stimulator originated from our own construction. The communication software between central and peripheral station was written in a way that the realtime feature of the registration was preserved and, therefore, only about 30 min are necessary to obtain the intensity-latency time-function (P6/JV) of both ears. PMID- 6841161 TI - [Audiometry by parents. Informal hearing testing by parents]. AB - The parent audiometry deals with an informal hearing test administered by the parents, which is suitable for infants and small children (up to two years of age) with high degrees or unclear hearing damages. In such cases, the parents should record their multiple to be repeated behavioral observations in a delivered scheme. The binaural hearing ability is tested in distances up to ten meters for low, middle, and high sounds and ringings. The results of the parent audiometry are integrated in the subjective and objective investigation findings and alleviate the pedaudiological longitudinal judgment of children with hearing damages. The work is conceived in reference to the practicing otologist; however, the assistance of the parents is not to be disregarded concerning early recognition and early diagnosis of children with hearing damages. PMID- 6841162 TI - Detection of HLA antigens on lymphoblastoid and epithelial cell lines and cross reactivity of HLA-Cw5 and HLA-Cw8. AB - Antibody-dependent cell-mediated cytotoxicity was used to detect HLA antigens on tissue cultured lymphoblastoid cells (phytohemagglutin blasts and Epstein-Barr virus lines) and transitional cell carcinomas. The results agreed with those obtained on fresh peripheral blood lymphocytes by conventional HLA typing. The same HLA antigens were detected on cells from an individual irrespective of their tissue origin or length of time in vitro. Antibody-dependent cell-mediated cytotoxicity (ADCC) showed that HLA-Cw5 and HLA-Cw8 were cross-reactive. An HLA Cw5 antiserum that was negative for HLA-Cw8 positive cells in complement-mediated lymphocytotoxicity reacted strongly with HLA-Cw8 donor cells in ADCC. Similarly HLA-Cw8 antibodies were detected in HLA-B14 antisera, which reacted on all HLA Cw5-positive donor cells. Absorption of sera with HLA-Cw5-positive lymphoid cells removed HLA-Cw5 and HLA-Cw8 specificities but spared HLA-B14. Absorption of HLA B14 antisera with HLA-B14/Cw8-positive cells removed HLA-Cw5, HLA-Cw8, and HLA B14 reactivities. Sequential immune precipitation and gel electrophoresis confirmed that HLA-Cw5 and HLA-Cw8 were cross-reactive and that HLA-B14 was physically separable from HLA-Cw8. PMID- 6841163 TI - Update on acquired immune deficiency syndrome. PMID- 6841164 TI - Noninvasive detection of right atrial hypertension by transcutaneous Doppler ultrasound. PMID- 6841165 TI - Sweet's syndrome (acute febrile neutrophilic dermatosis): report of two cases. PMID- 6841166 TI - Gallstone ileus: report of case. PMID- 6841167 TI - Pelvimetry: assessment of its use in the gravida patient. PMID- 6841168 TI - Intraoperative pterygo-palatine interstitial 125I seed implants. PMID- 6841170 TI - An endocavitary irradiator: two modifications for improved utility. AB - Two modifications to an endocavitary treatment cone are described, i) Viewing optics are incorporated which allow the treatment area to be observed at all times. ii) The cone is coupled to the tube housing by means of an electromagnetic clamp. These modifications make it easier to define and maintain a given treatment field during the setup procedure. The field can be verified after the X ray tube is in place, and if desired it can be monitored continuously during the application of therapy. PMID- 6841169 TI - Radiation induced sarcomas of bone following therapeutic radiation. AB - Because of new therapeutic trends of multi-modality and the importance of late effects, we have updated our series of radiation induced bone sarcomas seen at Memorial Sloan-Kettering Cancer Center over the past four decades. A total of 37 cases of bone sarcoma arising from normal bone in the irradiated field was analyzed. The median for latent period from irradiation to diagnosis of bone sarcoma was 11 years with a minimum latent period of four years. The median radiation dose for the bone sarcoma was 6000 rad in 6 weeks with a minimum total radiation dose of 3000 rad in 3 weeks. We have found nine patients who developed bone sarcomas in the radiation field after successful treatment of Hodgkin's disease. Criteria for radiation induced bone sarcomas and the magnitude of the risk of bone sarcomas are briefly discussed. PMID- 6841171 TI - Total lymphoid irradiation in the Wistar rat: technique and dosimetry. AB - The technical and dosimetric aspects of total lymphoid irradiation (TLI) in the Wistar rat were evaluated as part of a set-up to develop a new model for tumor xenotransplantation. Information obtained from anatomical dissections, radionuclide imaging of the spleen, lymphography and chromolymphography was used to standardize the localization of lymph nodes, thymus and spleen. A practical advantage was found in the simultaneous irradiation through two portals cut out in a lead plate. The two portals encompassed the lymphoid tissue above and below the diaphragm. A specially designed masonite phantom was used to measure the dose distribution in the simulated target volumes. Ionization chamber dosimetry, thermoluminescence dosimetry and film densitometry were used for measuring exposure and absorbed dose. Irradiation was performed with 250 kV X rays (HVL 3.1 mm Cu). The dose rate was regulated by adjusting the treatment distance. The dose inhomogeneity measured in the target volumes varied between 80-100%. The side scatter dose to non target tissues under the shielded area between the two portals ranged between 20-30%. The technique and dosimetry of total lymphoid irradiation in Wistar rats are now standardized and validated and pave the way for tumor xenotransplantation experiments. PMID- 6841172 TI - Postoperative axillary lymphoscintigraphy in the management of breast cancer. AB - Postoperative axillary lymphoscintigrams have been performed according to a technique of two-staged injection in 313 patients who had undergone a radical mastectomy with axillary dissection for breast cancer. Total absence of visualization of residual nodes suggests that dissection could be said to be complete in only 35.8% of the investigated patients, or because of metastatic disease causing blockage. The visualized residual nodes in patients represent a risk of developing nodal relapse, especially with positive pathological demonstration of axillary node invasion and without nodal irradiation. On the other hand, when the investigation showed the interruption of the lymphatic pathways of the arm, patients developed upper limb edemas more frequently. It is concluded that this simple and non traumatic technique is of value in order to assess the immediate postoperative axillary nodal status, and that it may influence the treatment of the patients. PMID- 6841173 TI - Curability of gastrointestinal lymphoma with combined surgery and radiation. PMID- 6841174 TI - Myelopathy following radiotherapy of bronchial carcinoma with large single fractions: a retrospective study. AB - A series of 387 patients with bronchial carcinoma treated with a concentrated split course regimen was surveyed for radiation myelitis. The total dose was 38 Gy. Three fractions of 6 Gy were given the first week. After a three-week interval the patients had a second course of radiotherapy with fractions of 4 Gy on 5 consecutive days. A spinal shield was used in 230 patients for the last two fractions of radiotherapy. The median survival for all patients was 9.4 months. Seventeen cases of radiation myelopathy were found. The life table method was used to calculate the risk of myelopathy in surviving patients, showing risk levels of 30 +/- 15% in patients surviving three years or more. The average age of the patients with myelopathy was 57.6 years, compared to 62.9% years in the total population. Statistical analysis showed a borderline significant increased risk for myelopathy in females, and a significant increased risk in younger patients (P = 0.03). No difference in the incidence of myelopathy was found in patients treated with or without a spinal shield. PMID- 6841175 TI - Carcinoma of the cervix stage IB: results of treatment with radiation therapy. AB - An analysis has been made of 101 patients treated with radiation therapy for epidermoid carcinoma of the cervix Stage IB (FIGO) from January 1970 through December 1976. The patients were treated with a combination of intracavitary therapy and external beam therapy delivering a total combined dose of 8000 rad to the paracervical areas (Points AR and AL) and 5500 rad to the pelvic lymph nodes (Points IR and IL). The cumulative, disease-free survival at 2, 3 and 5 years was 89%, 87% and 84%. Sixteen failures were recorded in this group of patients, of which 3 were a result of loco-regional disease, 5 loco-regional disease plus distant metastasis and 8 distant metastasis only. The failure rate was greater among the patients who had lesions 4 or more cm in diameter and in patients who received doses of external beam therapy to the whole pelvis of 4000 rad or more. Eighteen patients developed complications; however, one patient had a recto vaginal and a vesico-vaginal fistula; thus 19 complications were recorded. The complications were divided according to their severity into three groups: Grade I (mild), Grade II (moderate) and Grade III (severe). There were 10 Grade I, 4 Grade II and 5 Grade III complications. PMID- 6841176 TI - The in vitro selective concentration of an 125I-iodinated compound in human tumor cells. AB - Uptake studies of the potential endoradiotherapeutic agent, 6-125I-iodo-2-methyl 1,4-naphthoquinol bis(diammonium phosphate) have been carried out in vitro on a wide range of normal and malignant human cells. In general, for a standardized dose of 0.1 microCi/ml, the uptake of the compound into normal cells was 0.0015 0.135 pCi/cell. Uptake into malignant cells was significantly higher than normal cells; uptakes of 0.89-11.3 pCi/cell were noted for melanoma, teratoma of testis, osteosarcoma and adenocarcinoma of colon and pancreas. Comparative uptake ratios for melanoma: Chang liver cells and testicular teratoma:normal testis were 29 23, respectively. Larger uptake ratios are usually observed with higher doses. PMID- 6841177 TI - Attempts to develop radioactive anticancer drugs. PMID- 6841179 TI - Biological response across a ridge filter carbon ion Bragg peak. AB - The dose distribution of carbon ion beams was modified to cover 14 cm peak width using a ridge filter suitable for clinical application. The results of cell survival as a function of depth of penetration of carbon ions and the mouse skin (foot) response at the proximal-, mid-, and distal-peak positions using four daily fractions are reported. The objective of these studies is to verify whether the dose distribution in the peak region is properly compensated to produce uniform biological effect. The implications of the shape of the dose distribution in the peak region to radiotherapy application are discussed. PMID- 6841178 TI - Mitogenesis in human lymphocytes following brief exposure to hyperthermia. PMID- 6841181 TI - Repair of potentially lethal X ray damage and possible applications to clinical radiotherapy. AB - The relationship of potentially lethal damage repair (PLDR) to clinical radiotherapy has not been studied in great detail. We have therefore examined the cellular and molecular basis of PLDR in bacterial, animal and human tumor systems and attempted to relate laboratory data to clinical fractionation schemes. We also have examined how the repair of potentially lethal damage may alter the therapeutic ratio by altering tumor radiocurability and normal tissue tolerance. PMID- 6841180 TI - Biological effects of pion therapy beams: I. Cultured cells. AB - The results of cell killing by pion beams of different peak widths, ranges and sizes used in therapy are reported. Cultured hamster cells (V79) suspended in gelatin were used. The results indicate that: 1) there are no significant differences in cell-killing between pion beams of different ranges but of the same peak width; 2) there is a slight decrease in biological effectiveness with increasing peak width; and 3) the range-modulation functions used to produce uniform cell-killing are satisfactory for intermediate-range pion beams, but slight corrections may be required for shorter- and longer-range pion beams. PMID- 6841182 TI - Carcinoma of the prostate irradiated by combined I125 and external irradiation. Analysis of failure and significance of positive biopsy one year or more after therapy. AB - Sixty-three patients with cancer of the prostate T2 or T3 were evaluated. The protocol of treatment called for pelvic lymphadenectomy, 10,000 rad from I125 implant and 4000 rad in 20 fractions using a Cobalt60 machine. They were followed for 1 to 5 years with a plan to rebiopsy the prostate 1 to 2 years after therapy. Six of 59 evaluable patients (10%) showed progressive disease. Distinctive prognostic features in the failure group were younger age, larger prostate, more advanced stage, poorer differentiation, more possibility of positive pelvic lymph nodes, and if the nodes were positive, the involvement of more than two pelvic lymph nodes. On the other hand, the patients with controlled disease with or without positive prostatic biopsy on follow-up showed identical features regarding age, size of prostate, stage, differentiation, involvement of pelvic lymph nodes, and if the nodes were positive, only one or two nodes involved. Positive biopsy 1 to 2 years after radical irradiation in otherwise controlled disease is considered of no prognostic value. PMID- 6841183 TI - The influence of the number of fractions and of overall treatment time on local control and late complication rate in squamous cell carcinoma of the larynx. AB - Three hundred and ten patients with T3/T4, N0, M0 squamous cell carcinoma were irradiated with 200 kV X rays with total doses ranging from 4,900 to 6,200 rad, given in 21 to 35 fractions in 32-63 days. After a minimum follow-up period of 3 years, the local control rate was 50%; 21 severe late complications were observed among the patients. The dependence of local control rate and of late complication rate on the dose per fraction and on overall treatment time was analyzed by various statistical methods. Whereas the late complication rate depended significantly on dose per fraction, local tumor control depended strongly on overall treatment time. PMID- 6841184 TI - The primary treatment of advanced vocal cord cancer: laryngectomy or radiotherapy? AB - When different treatment modalities yield equal results in cancer treatment, the least mutilating is preferred. If results are different, however, the survival rate after treatment must be weighed against the quality of life. Considerable controversy exists concerning the primary treatment modality for advanced glottic cancer, with some authors defending surgery (with or without radiotherapy) and others defending radiotherapy as sole treatment, with laryngectomy reversed for local failures. From a group of 102 patients with T3 and T4 tumors, 65 were treated with a laryngectomy. Uncorrected survival at 5 years was 48%, local control was 75%. A group of 35 patients was treated with radiotherapy. Survival was 22% at 5 years, local control 23%, with rescue surgery 37%. These unfavorable results are related to the negative selection of patients for radiotherapy (inoperable, bad cooperation). In 14 patients who were operable but refused laryngectomy the final local control was 53%, with voice preservation in 34%; survival, however, remained low (27% at 5 years). Primary surgery seems to provide better chances for ultimate survival than radiotherapy alone. At the moment, it is not yet clear if a proportion of patients can be selected for whom a more conservative attitude can be allowed, with laryngectomy reserved for poor regression or recurrences after radiotherapy. PMID- 6841185 TI - The quality of life of patients following treatment for laryngeal cancer. AB - One hundred and twenty-nine patients have been interviewed 9 to 15 months following treatment for laryngeal cancer to determine the post treatment quality of voice and life. The patients were subdivided into 3 groups, successfully irradiated T1 and T2 patients, (89 patients), successfully irradiated T3 and T4 patients (24 patients) and those treated by surgery (16 patients). Ninety-three percent of T1 and T2 patients and 79% of T3 and T4 patients are working following treatment as compared to 44% of the surgery patients. Ninety-eight percent of the T1 and T2 and 87.5% of the T3 and T4 patients were able to use the telephone normally as compared to 12% of the surgery patients. Similarly major differences between the successfully irradiated patients and the surgically treated patients in terms of ability to live a normal social life have been noted. The patients also rated their voice in terms of volume, pitch, ability to communicate, quality, rate of speech, flow of speech and dry throat. In every parameter of rating of the voice, with the exception of dryness of the throat, the successfully irradiated patients in all stage groupings had better ratings than the surgery group. Since, in Toronto, survival in advanced glottic and supraglottic cancer is the same using radical radiation with surgery in reserve as survival with primary surgery, it is concluded in view of the superior quality of voice and life in the successfully irradiated patients that irradiation with surgery in reserve is the optimal treatment for these patients. We also conclude that the measurement of quality of life in patients with cancer of the larynx is of vital importance in determining optimal treatment and that further studies in this area are indicated. PMID- 6841186 TI - Axillary sampling in the definitive treatment of breast cancer by radiation therapy and lumpectomy. AB - Between January, 1967 and July, 1980, 176 women who were referred to the Joint Center for Radiation Therapy (JCRT) for definitive breast irradiation underwent low axillary dissection. A typical operative technique is described. The dissection stops short of the axillary vein although the vein is usually visualized. One hundred thirty-two axillae were thought to be N0 or N1a. Forty six axillae were felt to be N1b. Seventeen percent of the T1 N0 patients had pathologically positive nodes. Twenty-seven percent of the T2 N0 patients had positive nodes. When 5 or less nodes were removed at axillary sampling the incidence of nodal involvement was very low. There were no differences in nodal positivity when comparing upper quadrant to lower or central lesions. Lateral lesions appeared to have higher positivity rates compared with either medial or central lesions. Ninety-four percent of axillae with N1b lesions were pathologically confirmed. The complication rate for this procedure was low. There were 5 transient non-surgical complications and 1 cellulitis resulting in a frozen shoulder, which required corrective surgery. There were no cases of moderate or severe arm edema. Axillary sampling is compared to axillary dissection as a diagnostic procedure. Axillary sampling may underestimate the true pathologic positive rate, but diagnostic accuracy appears excellent if level 1 and 2 nodes are sampled. PMID- 6841187 TI - Treatment of carcinoma of the uterine cervix by remotely controlled afterloading intracavitary radiotherapy with high-dose rate: a comparative study with a low dose rate system. AB - From September, 1974 through December, 1979, a total of 249 patients with carcinoma of the cervix uteri Stage IIb and III were randomly allocated to either remotely controlled high-dose-rate intracavitary radiotherapy or manual afterloading low-dose-rate therapy, with radiotherapy of 20 Gy in 2 weeks to Point A to whole pelvis and 40 Gy in 4 weeks to the parametria. The dose to Point A by intracavitary radiotherapy was 40-60 Gy with one or two fractions in the low dose-rate group and 30 Gy for the high-dose-rate group by 3 fractions with a once a week schedule. The purpose of this paper is to compare the results between the groups and to clarify the problems in the high-dose-rate group clinically. The local control rate was higher in the high-dose-rate group; however, the complication rate was also higher in this group than in the low-dose-rate group. The dose schedule and the place of rectal dose measurement is discussed. The overall cumulative survival rate was nearly the same in both groups (55% at 5 years), although some difference was noted in each stage. The most common cause of death was distant metastasis outside the pelvis and the second most common was intercurrent disease in Stage IIb and local failure in Stage III. PMID- 6841188 TI - Adenocarcinoma of the cecum: natural history and clinical patterns of recurrence following radical surgery. AB - One hundred and forty-three patients with previously untreated primary adenocarcinomas of the cecum were analyzed. Fifty-three patients manifesting disseminated disease at diagnosis were analyzed to define mechanisms of disease spread. Ninety patients were analyzed following attempted curative resection to determine anatomical distribution of initial clinical recurrences. Twenty-eight patients recurred (31%), of whom 9 underwent a second laparotomy. Nineteen of the 28 patients who recurred (68%) demonstrated an initial pattern of relapse clinically confined to the abdomen, liver, and retroperitoneum. Analysis was performed to determine the influence of stage and grade of the primary tumor on prognosis. Implications for adjuvant therapy are discussed. PMID- 6841189 TI - Adenocarcinoma of the retroperitoneal ascending and descending colon: sites of initial dissemination and clinical patterns of recurrence following surgery alone. AB - One hundred twenty-seven patients with previously untreated primary carcinomas of proximal, retroperitoneal large bowel were retrospectively analyzed. Sites of involvement in 33 patients with surgically incurable (disseminated) disease were analyzed to define patterns of initial spread. Ninety-four patients were analyzed following attempted curative resection to determine anatomical distribution of initial clinical recurrences. Thirty-one patients recurred (33%). Twenty-four of these patients (77.5%) demonstrated an initial pattern of relapse clinically confined to the abdomen and retroperitoneum. Analysis was performed to identify factors of prognostic significance. Implications for adjuvant therapy are discussed. PMID- 6841192 TI - The 1982 status of training of therapeutic radiologists in the United States. PMID- 6841191 TI - Assessment of local tumor control using censored tumor response data. AB - When animals die in the course of tumor control assays, the loss of information need not be absolute. Actuarial survival curves may be used to estimate local tumor control fractions, and these unbiased estimates may be weighted and used to estimate the parameters of dose/cure functions. The current standard procedure of discarding from analysis animals who do not complete a pre-assigned observation period is biased, and should not be used. PMID- 6841193 TI - Hyperfractionated radiotherapy in advanced squamous cell carcinoma of the head and neck. AB - From January, 1976 to January, 1980, 141 patients (135 males and 6 females) with Stage III and IV squamous cell carcinoma of the head and neck received a split course of hyperfractionated radiotherapy (HFR). In the first group, involving 91 patients, the therapeutic schedule was as follows: first and fourth week, 7.2 Gy per day in 8 sessions of .9 Gy from Monday to Friday, the second and third week no irradiation was given. Thus, patients were given 72 Gy total dose, fractionated into 80 sessions. Mucosal necrosis and severe hemorrhage were responsible for the death of 26 patients (28%). Therefore the therapeutic protocol was altered for the 50 patients of the second group: during the first and sixth week 6.6 Gy per day in 6 sessions of 1.1 Gy from Monday to Friday. The total dose was thus reduced to 66 Gy fractionated into 60 sessions, resulting in the decrease of toxicity. Regardless of the therapeutic protocol and site of primary, 114 patients (80%) achieved a complete remission and 8 showed a partial remission (greater than 50%), whereas no change was seen for the 19 remainders. Local recurrence appeared in 60 patients (48%). Acute mucositis and laryngeal edema regularly occurred a week after every course of HFR and were considered severe in 40 patients. In spite of toxicity, the median survival is 14 months and 22 patients are still alive in November 1981: 19 without disease, and 8 of these patients have a survival time of at least 3 years. PMID- 6841190 TI - Hyperthermia with implanted electrodes: in vitro and in vivo correlations. AB - Hyperthermia as a treatment for cancer has elicited much recent interest. However, major difficulties persist both in the technology for heating deep seated tumors, and in thermal dosimetry. We have investigated a heating technique for deep-seated neoplasms that employs an internal implanted electrode and an external electrode to apply radiofrequency current to a tumor mass. The internal electrode consists of an array of stainless steel needles or wires which define a Faraday cage within the tumor, while the external electrode consists of a variety of electrical conductors at the skin surface. Phantom measurements have closely reproduced calculated temperature distributions. The temperature profiles within the volume enclosed by the internal electrode show relatively homogenous heating. Temperature measurements in a rat tumor model have demonstrated that significant heating within such an internal electrode array is easily obtained. The heating may extend some centimeters outside the electrode. Using a dog model we have shown that with such a treatment technique the temperature profiles obtained are reproducible both spatially and temporally. A case report of a clinical application is presented. A 5 cm bronchogenic carcinoma was easily heated without significant heating of the surrounding normal lung, and without apparent toxicity. Such a technique may be applicable to a variety of operable but unresectable neoplasms. The reproducibility and relative homogeneity of heating suggest possible usefulness in combined modality trials. PMID- 6841194 TI - Comparative cost analysis of hemilaryngectomy and irradiation for early glottic carcinoma. AB - The cost of hemilaryngectomy (15 patients) was compared to that of radiation treatment (18 patients) in epidermoid carcinoma confined to the true vocal cord with normal mobility (T1N0). An average of $3,495 was saved if radiation therapy was chosen; savings in terms of working hours were also substantial. We maintain that, if different treatment methods yield the same cure rate and quality of life, then cost should be the next strong consideration in choosing a particular treatment method. PMID- 6841196 TI - Chemotherapy for breast cancer--a new reality for radiation therapists. PMID- 6841195 TI - Interstitial therapy of perineal and gynecological malignancies. AB - Thirty-five patients, 38 to 88 years of age, were treated with 125-Iodine or 192 Iridium interstitial implants at Stanford University Medical Center between July 1974, and December, 1978. There were 25 primary epithelial malignancies, eight extensions from intrapelvic organs and two metastatic tumors (hypernephroma and Hodgkin's disease). The involved sites were: urethra (6 patients); vulva (9 patients); vagina (8 patients); anus (7 patients); cervix (5 patients). Implantation was usually performed to treat evident or microscopic disease in conjunction with external beam pelvic treatment with or without local excision. Computerized implant preplanning was used. 125-Iodine seeds were inserted either directly or within absorbable suture Polyglactin 910; 192-Iridium in nylon carriers was placed by suture or transperineal template. Two patients were lost to follow-up leaving 33 patients, 27 of whom are alive and free of local disease from 37 to 76 months. The overall local control rate was 88%, or 29/33 patients. All four local recurrences appeared before 24 months. Minor complications included: 10 patients with transient mucositis, four with superficial ulcers, and one patient with infection at the implanted site. Two major complications occurred: a necrotic rectal ulcer requiring a colostomy and a contracted, painful bladder necessitating a urinary diversion. We conclude that in selected cases interstitial irradiation provides good local control of perineal and gynecological malignancies with low morbidity in this elderly and quite often fragile group of patients. PMID- 6841197 TI - The need for every modality treatment to prevent catastrophic local and regional failures in advanced breast cancer. PMID- 6841198 TI - Dose-response relationship for supraglottic laryngeal carcinoma. PMID- 6841199 TI - Patients seeking alternatives to mastectomy. PMID- 6841200 TI - The psychobiology of transference. PMID- 6841201 TI - A contribution to the theory of treatment of personality disorders. PMID- 6841202 TI - Tears of joy. PMID- 6841203 TI - Entitlement attitudes: psychosocial and therapeutic implications. PMID- 6841204 TI - On the nature of marriage and marriage therapy. PMID- 6841205 TI - Can psychoanalytic treatment change dreams? PMID- 6841206 TI - Gas mixing within the acinus of the lung. AB - The subject is reviewed with an emphasis on recent developments in model analyses. Application of computer technology has facilitated the study of simultaneous convection and diffusion within a complex geometry approximating the airways and air spaces of the lung. During an inspiration of fresh gas the diffusion front separating inspired from "alveolar" gas is stationed within a portion of the acinus where the magnitudes of gas transport by convection and diffusion are similar. This constitutes the peripheral boundary of the Fowler dead space. Asymmetry of intra-acinar branching results in an inequality of gas concentrations within alveolar gas, despite homogeneous volume expansion. This is due to an interaction between diffusion and convection at branch points subtending units of unequal lengths. During a respiratory cycle a "diffusive Pendelluft" between these units results in a "first in-first out" pattern and a sloping alveolar plateau on the expired tracing, despite synchronous and homogeneous volume changes. Experimental results suggest that incomplete alveolar gas mixing constitutes a measurable limitation to gas exchange in the normal lung. PMID- 6841207 TI - Effect of height on alveolar liquid pressure in isolated edematous dog lung. PMID- 6841208 TI - Nonapneic mechanisms of arterial oxygen desaturation during rapid-eye-movement sleep. PMID- 6841209 TI - Responses of the lung periphery to ozone and histamine. AB - We studied the effects of ozone (O3) and histamine on the lung periphery. A fiber optic bronchoscope was wedged in a segmental airway of anesthetized male mongrel dogs. Measurements of collateral resistance (Rcoll) were used to monitor responses to O3 and to histamine. Both agents were delivered locally through the bronchoscope. During a 30-min exposure to 0.1 ppm O3, Rcoll increased 31.5 +/- 5.1% within 2 min and then gradually decreased toward control levels in spite of continued exposure to O3. Within 15 min after the exposure ceased, Rcoll had returned to base line. Subsequent exposure to 0.1 ppm O3 did not increase Rcoll. During a 30-min exposure to 1.5 X 10(-6) mg/min histamine aerosol, Rcoll increased 21.5 +/- 5.0% within 2 min and persisted at an elevated level throughout the exposure. Subsequent exposures to histamine produced similar increases in Rcoll. Bilateral cervical vagotomy or pretreatment with atropine aerosol (0.1 mg) prevented responses to O3 but did not prevent responses to histamine. These results indicate that responses to O3, unlike responses to histamine in the lung periphery, are characterized by the rapid development of adaptation and tolerance and are mediated through the vagus nerves. PMID- 6841211 TI - Adaptation of vascular pressure-flow-volume hysteresis in isolated rabbit lungs. AB - Hysteresis within two pairs of variables describing the state of the lung vascular system [pulmonary arterial pressure (Ppa) and flow (Q) and Ppa and change in vascular volume (delta Vvasc)] was investigated in isolated plasma perfused rabbit lungs. Q was increased and decreased stepwise, in series of five cycles each, while pulmonary venous pressure (Ppv) and lung volume were held constant. Changes in Vvasc were estimated from changes in fluid volume of the venous reservoir. The relationships within pairs of variables over each complete cycle were described by loops whose areas and widths were used to quantify the hysteresis. In successive cycles, these parameters decreased toward constant values (limit cycles), most of the change occurring by the second cycle. Areas of Ppa-delta Vvasc loops correlated closely with areas of Ppa-Q loops over all five cycles of a series. For Ppa-Q loops, the ratio of average pressure-width to total pressure excursion decreased from 0.15 initially to around 0.05 in the fifth cycle. It was concluded that the relationships between Ppa and Q and Ppa and delta Vvasc are markedly sensitive to vascular pressure or flow history. PMID- 6841210 TI - Roles of stress and adaptation in the elicitation of face-immersion bradycardia. AB - Thirteen young healthy human volunteers immersed their faces in warm or cold water on one day while breathing through a snorkel and on another day while breath holding. The magnitude of the elicited bradycardia was most prominently due to water temperature, with apnea playing a less important role. Perceived stress could affect the magnitude of the response, but it was less important than the other variables. Thus statistically significant nonparametric correlations were found for the group but not for most individuals between a scoring technique that assessed perceived stress and heart rate. In contrast to animals, these data indicate that bradycardia may be reliably elicited in humans by face immersion in cold water and that stress is neither necessary nor sufficient to produce this phenomenon. Adaptation did not seem to play a role in the development of this physiological response. PMID- 6841212 TI - Hypoxic pulmonary hypertension in the mast cell-deficient mouse. PMID- 6841214 TI - Distribution of histamine receptors in isolated canine airways. AB - The distribution of histamine receptors was examined in isolated trachealis smooth muscle strips and helical strips of large (5 mm) and small (1.5 mm) intrapulmonary airways. All airways contracted in response to histamine, but the sensitivity to this agent was significantly greater in intrapulmonary airways than in trachealis strips. A dose-dependent tachyphylaxis to histamine occurred when airways were exposed repeatedly to 10(-4) M histamine but not to 5 X 10(-6) M histamine. The H1-agonist, 2-methylhistamine, also caused airway contractions, although they were less forceful than those caused by histamine. Both histamine- and 2-methylhistamine-induced contractions were blocked by the H1-antagonist, pyrilamine. The H2-agonists, 4-methylhistamine and dimaprit, as well as histamine in the presence of pyrilamine failed to relax both acetylcholine- and 5 hydroxytryptamine-induced contractions. Moreover, the H2-antagonist, metiamide, had no effect on histamine-induced contractions. We conclude that histamine H1 receptors are present in both extrapulmonary and intrapulmonary airways of the dog and cause contraction when stimulated. In contrast, histamine H2-receptor activity could not be demonstrated in the airways of this species. PMID- 6841213 TI - Inhibition of breathing movements in fetal sheep by prostaglandins. AB - We studied the effects of infusions (duration 13.4 +/- 2.9 h) of prostaglandins (PG) on fetal breathing movements (FBM) in 12 fetal sheep at 122-141 days gestation. We gave similar doses (1.1 +/- 0.7 microgram . kg-1 . min-1) of PGE2 (8 studies), PGF2 alpha (5 studies), and cyclic endoperoxide analogues (6 studies). During control periods (304 h), incidence of FBM was 41%; this decreased during every infusion. With PGE2, incidence of FBM markedly decreased to 9.8% of control (P less than 0.001). With the other agents the decrease was less profound; incidence of FBM with PGF2 alpha was 63.7% of control and with endoperoxide analogues 69.4% of control (P less than 0.05 for both). During infusions there were no changes in fetal heart rate, arterial blood pressure, pH, or blood gas tensions. In three fetuses (5 infusions) with electrocorticogram recordings, incidence of low-voltage fast activity was unchanged from control values. Inhibition of FBM by PGE2, combined with previous results showing stimulation of FBM by PG synthetase inhibitors, suggests that endogenous PG may inhibit breathing movements in utero and that a change in PG metabolism may contribute to the change in control of breathing at birth. PMID- 6841215 TI - Increased oxygen consumption associated with breathing activity in fetal lambs. AB - To examine the relationship between fetal O2 consumption and fetal breathing movements, we measured O2 consumption, umbilical blood flow, and cardiovascular and blood gas data before, during, and after fetal breathing movements in conscious chronically catheterized fetal lambs. During fetal breathing movements, O2 consumption increased by 30% from a control value of 7.7 +/- 0.7 (SE) ml X min 1 X kg-1. Umbilical blood flow was 210 +/- 21 ml X min-1 X kg-1 before fetal breathing movements; in 9 of 16 samples it increased by 52 +/- 12 ml X min-1 X kg 1, while in the other 7 it decreased by 23 +/- 9 ml X min-1 X kg-1. Umbilical arterial and venous O2 partial pressures and pH fell during fetal breathing movements, and the fall was greater when umbilical blood flow was decreased. Partial CO2 pressure rose in both vessels, and again the increase was greatest when umbilical blood flow fell during fetal breathing movements. Also associated with a fall in umbilical blood flow was the transition from low-amplitude irregular to large-amplitude regular fetal breathing movements. It is concluded that fetal breathing movements increase fetal O2 demands and are associated with a transient deterioration in fetal blood gas status, which is most severe during large-amplitude breathing movements. PMID- 6841217 TI - Determination of forces in extensor pollicis longus and flexor pollicis longus of the thumb. PMID- 6841218 TI - Multiparameter monitoring of the awake brain under hyperbaric oxygenation. PMID- 6841216 TI - Partitioning of respiratory mechanics in anesthetized cats. PMID- 6841219 TI - Lobar flow patterns in a hollow cast of canine central airways. AB - To demonstrate that the regional partitioning of flow in central airways is direction dependent, we compared inspiratory and expiratory lobar flows in a hollow rigid cast of canine lungs. Lobar flows were measured by a hot-wire anemometer, simultaneous tracheal flows by a pneumotachograph, and data displayed as (lobar) flow-(tracheal) flow curves. For tracheal airflows between 50 and 370 ml/s, we found that inspiratory apical flows were smaller, and basal flows larger, than corresponding expiratory distributions. This effect was largely extinguished by substituting a gas mixture of 85% He-15% N2; resulting regional flows were comparable to expiratory distributions obtained on room air. Thus canine central airways structure induces a kinematically irreversible flow pattern, consistent with a model of "cascade flow" in which branching structure modifies the distribution only of inspiratory flow. These results support Fowler's concept that lung regions fill and empty sequentially and may be pertinent to analyses of regional washout. PMID- 6841221 TI - Efficiency, maximal blood flow, and aerobic work capacity of canine diaphragm. PMID- 6841222 TI - Total airway resistance and respiratory muscle activity during sleep. PMID- 6841220 TI - Exercise training, sex hormones, and lipoprotein relationships in men. PMID- 6841223 TI - Morphometric changes in rabbit lungs before and after pneumonectomy and exposure to ozone. PMID- 6841224 TI - Mechanical properties of alveolar wall after pneumonectomy and ozone exposure. PMID- 6841225 TI - Cardiovascular responses to treadmill exercise in rats: effects of training. PMID- 6841226 TI - Skeletal muscle mitochondria and myoglobin, endurance, and intensity of training. PMID- 6841228 TI - Dopamine and carotid body function in the newborn lamb. AB - The effect of dopamine on the acute ventilatory response to hypoxia was investigated in four newborn lambs studied on the 1st day of postnatal life and eight lambs studied between 7 and 12 days of age. Studies were accomplished during nonrapid-eye-movement sleep in unanesthetized tracheotomized animals. Changes in minute ventilation (VE/kg), tidal volume, and frequency induced by intravenous bolus injection of dopamine (10 micrograms/kg) or saline control were assessed while animals were breathing room air or N2, before and after carotid body denervation (CBD). Dopamine depressed resting ventilation at both postnatal ages. This effect was greater in the older animals. Dopamine blunted the hypoxia induced increase in VE/kg at both ages. The magnitude of this depression did not vary with postnatal age. Dopamine induced cessation of respiratory effort at end expiration (apnea) during room air and N2 breathing significantly more often in the older animals. The effect of dopamine was mediated at the carotid body. CBD decreased ventilation by an increase in breath-to-breath interval in older animals, suggesting carotid sinus nerve afferent activity is more important during eucapnic respiration in older animals than in the immediate newborn period. PMID- 6841227 TI - Effects of acute hypercapnia on the central and peripheral circulation of conscious sheep. AB - We studied the cardiorespiratory effects of acute hypercapnia in 10 unanesthetized sheep. After a 15-min exposure to either 7.3 or 10% CO2 in air, we measured arterial blood gases, minute ventilation (VE), O2 consumption (VO2), cardiac output (Q), heart rate (HR), an index of left ventricular contractility [(dP/dt)/P], and vascular pressures. In addition, regional flows to all major organs were determined by injecting 15-microns radiolabeled microspheres into the left heart. Exposure to 7.3% CO2 (arterial CO2 partial pressure, PaCO2, 58 Torr) resulted in increased VE, (dP/dt)/P, and higher blood flows to the brain and respiratory muscles. All other variables remained unchanged. Exposure to 10% CO2 (PaCO2 75 Torr) resulted in a further augmentation of VE and a 48% increase in Q, which was associated with a tachycardia, a decrease in systemic vascular resistance, and an increase in VO2. Coronary and respiratory muscle flows increased, but all other variables remained unchanged. Thus the hemodynamic effects of hypercapnia are not related linearly to the level of PaCO2. PMID- 6841229 TI - Impaired red cell filterability with elimination of old red blood cells during a 100-km race. PMID- 6841230 TI - Role of surface area-to-mass ratio and work efficiency in heat intolerance. PMID- 6841231 TI - Alveolar size as a determinant of pulmonary distensibility in mammalian lungs. AB - Pulmonary distensibility depends on surface tension and tissue elastic forces, but the relative contribution of each to total lung recoil remains incompletely defined. By applying an exponential analysis to static pressure-volume curves obtained from the excised lungs of cats, dogs, and rats with air and saline filling, the exponential constant K (an index of lung distensibility) was related to the mean linear intercept Lm (a morphometric estimate of the mean size of peripheral air spaces at maximal inflation). K for air filling (Ka) was unrelated to K for saline filling (Ks), and Ks was unrelated to Lm, but similar highly significant regressions of Ka on Lm were found in each species, and the common regression was similar to that described previously for human lungs. Approximately 86% of the variance in lung distensibility (Ka) within and between species was explained by Lm. Because Lm determines the size of air spaces, and therefore the alveolar surface-to-volume ratio, the findings indicate that the density of surface forces is the major determinant of lung distensibility in the air-filled state. PMID- 6841232 TI - Estimation of effective pulmonary capillary pressure in intact lungs. PMID- 6841233 TI - Misconceptions and missed perceptions of the anaerobic threshold. PMID- 6841234 TI - Anorexia nervosa presenting as growth retardation in adolescents. AB - Two adolescent males and one adolescent female were referred for evaluation of short stature. Extensive laboratory studies, often performed over several years, were unremarkable. After several years of observation, the diagnosis of anorexia nervosa was established. We emphasize the necessity to consider anorexia nervosa in the differential diagnosis of growth retardation in young adolescents. PMID- 6841235 TI - Interdisciplinary model for the inpatient treatment of adolescents with anorexia nervosa. AB - This paper describes the inpatient phase of an anorexia nervosa treatment program in an adolescent unit of a children's hospital. This program focuses on four goals: improving eating behavior, improving socialization, achieving initial weight gain, and engaging the patient and her family with an outpatient psychotherapist. The patients were divided into three groups according to severity. All five Group I patients (less than 25% body weight loss) had a composite 100% achievement of the four goals. Twenty out of 21 Group II patients (greater than 25% body weight loss) had 100% achievement of the four goals. Three out of six Group III patients (greater than 25% body weight loss and requiring hyperalimentation) had 100% achievement of the four goals. The success of this inpatient program is felt to be due to the pediatric-psychiatric collaboration, the involvement of the family during the inpatient phase, the therapeutic use of an interdisciplinary team and of the social system of the inpatient unit including other patients and recreation therapist. PMID- 6841236 TI - Diagnosis of anorexia nervosa in the adolescent male. AB - Sporadic cases of anorexia nervosa in the male patient have been described. We present three cases of weight loss in adolescent males. The first is a typical case of primary anorexia nervosa. The second illustrates weight loss in the competitive adolescent athlete. The third was mistakenly thought to have primary anorexia nervosa. At autopsy, he had regional enteritis. These patients are compared to call attention to the differential diagnosis of anorexia nervosa in the adolescent male. PMID- 6841237 TI - Anorexia nervosa: staff subversion of therapy. AB - The treatment of anorexia nervosa (AN) is often complicated by the subversion of therapy by the patient. We describe the undermining of treatment by ward personnel as a result of their lack of understanding of the psychodynamics of AN and their perception of these patients as not being "sick" in the traditional sense and therefore not entitled to the "sick role." The incidents which occurred in our center are discussed as to their possible origins, the patient's response, and the remediation employed. The remedial approaches which may have the most promise are presented. PMID- 6841238 TI - Rib fractures and anorexia nervosa. AB - A twenty-five year old patient with long standing anorexia nervosa and recent forced vomiting presented with a pulling sensation in her lower anterior thorax. Seven months later, callus formation over the left tenth rib was documented. Chest x-ray revealed healing fractures of the seventh, ninth, and tenth ribs. Since her oral intake of calcium was low, she was started on a regimen of milk and sun bathing. We postulate her rib fractures were the result of forced vomiting in an individual with fragile bones. The osteoporotic state may have been induced by her malnourished low-estrogen state. PMID- 6841239 TI - Potentially life-threatening hypophosphatemia in anorexia nervosa. AB - An anorexia nervosa patient with hypophosphatemia secondary to starvation and laxative abuse is reported. During the course of refeeding by tube with a high caloric balanced formula, the patient's serum phosphorous dropped from low normal on admission (2.7 mg/dl) to 0.4 mg/dl aggravated by an overdose of laxative she had stolen from the medicine cart. This required ICU monitoring during intravenous phosphorous administration. This case points out the potential hazard of oral realimentation in a severely cachectic anorectic. PMID- 6841240 TI - Clinical spectrum of pharyngeal gonorrhea in children and adolescents: a report of sixteen patients. AB - Pharyngeal gonorrhea in children and adolescents is probably increasing. During a 1-year period, 16 patients were diagnosed and treated for pharyngeal gonorrhea. This was the result of a search among a high-risk group, consisting of victims of sex abuse, patients suspected of homosexual practices, and adolescents with symptoms or signs suggestive of sexually transmitted diseases. Of the 16 positive throat cultures, 75% represented pharyngeal colonization while only 25% had clinical symptoms. Pharyngeal gonorrhea was found to be a marker in screening for psychosocial pathology, leading in two-thirds of the cases to the discovery of instances of incest, sexual abuse, chaotic family situations, or severe depression, all of which had been previously denied, ignored, or neglected. The purpose of this article is to alert health care providers to the clinical spectrum of pharyngeal gonorrhea in children and adolescents. PMID- 6841241 TI - The relationship between physical activity and serum lipids and lipoproteins in black children and adolescents. AB - This study assesses the association between the serum lipid and lipoprotein levels of 62 black children and 37 black adolescents and their reported levels of habitual physical activity, 24-hour dietary intake, and physical measurements. In the children physical activity was not correlated with serum lipid and lipoprotein levels. Indicators of physical activity had a positive correlation (P less than 0.02) with high-density-lipoprotein cholesterol and negative correlations (P less than 0.05) with the total serum cholesterol/high-density lipoprotein cholesterol and low-density-lipoprotein cholesterol/high-density lipoprotein cholesterol ratios in the adolescents. Subjects were stratified into "low activity" and "high activity" groups. High-activity subjects had lower (P less than 0.05) total serum cholesterol/high-density-lipoprotein cholesterol and low-density-lipoprotein cholesterol/high-density-lipoprotein cholesterol ratios than less active subjects. Subjects that ran track had lower (P less than 0.02) total serum cholesterol and low-density-lipoprotein cholesterol than non-track participants. The results suggest that increased habitual physical activity may have a favorable effect on serum lipid and lipoprotein levels in black adolescents. PMID- 6841242 TI - Attachment interaction behavior between young teenage mothers and their infants. AB - Behavioral interaction between teenage mothers and their infants was explored. Twenty-six (low income level) Hispanic teenage mothers (mean age 15 years) and their infants (mean age 13.5 months) were compared with an older control group of 30 mothers (mean age 26 years) and their infants (mean age 14.0 months). Infant attachment, exploration, and stress-adaptation behaviors and maternal ability to contact, encourage, and comfort the infant were evaluated. Twenty-six percent of the control infants showed limited ability to cope with stress compared to 47% of infants of teenage mothers. Control mothers differed significantly from teenage mothers in effective eye, verbal, physical contact, and smiling behaviors. These findings suggest that limited teenage maternal behaviors may potentially have a negative psychologic effect for both infants and their young mothers. PMID- 6841243 TI - Cardiac function in adolescents and young adults with anorexia nervosa. AB - Twelve patients with anorexia nervosa (mean age 17.6 years) underwent noninvasive cardiac evaluation. All patients had normal sinus rhythm at rest, during exercise, and following 24-hr electrocardiographic monitoring. The chest roentgenograms demonstrated a small heart secondary to a loss of left ventricular mass. Three of four patients studied had left ventricular mass measurements less than 100 g (normal is 90-360 g). Most patients had an elevated heart rate response to exercise with a slightly blunted systolic and a normal diastolic blood pressure response. Eleven of the 12 patients had reduced overall maximal working capacity. All but one had normal left ventricular ejection fraction at rest. There was no evidence of arrhythmias at rest, during exercise, or with continuous electrocardiographic recording. Young patients with anorexia nervosa appeared to have essentially normal cardiac function with a reduction in left ventricular muscle mass. PMID- 6841244 TI - Court finds USDA made false or misleading statements in 1970 report on whey antibody preparation. PMID- 6841245 TI - Regard for animal life. PMID- 6841246 TI - Animals for teaching surgery. PMID- 6841248 TI - A client's emotional distress. PMID- 6841247 TI - Considerations on the use of placebos in veterinary medicine. PMID- 6841249 TI - Interagency collaboration regarding the safety of animal-derived human food. PMID- 6841252 TI - Effect of yohimbine on xylazine-induced central nervous system depression in dogs. AB - Yohimbine was studied at various dosages to examine its effectiveness in reversing as well as preventing xylazine-induced CNS depression. Intravenous injection of xylazine (1 to 10 mg/kg) induced a dose-dependent CNS depression that was prevented by a low dosage of yohimbine (0.1 mg/kg, IV). Xylazine at a dosage of 10 mg/kg induced convulsions in 3 of 5 dogs. In addition, the CNS depressant effect of xylazine (1 to 10 mg/kg, IV) was reversed by yohimbine at dosages ranging from 0.01 to 1.0 mg/kg. Yohimbine alone at dosages of greater than or equal to 0.33 mg/kg appeared to cause apprehension for 20 to 60 minutes. The results indicated that yohimbine can be used as an antagonist to control the duration and depth of xylazine-induced CNS depression. For this purpose, it seemed that yohimbine at a dosage of 0.1 mg/kg is suitable. PMID- 6841250 TI - Fatal interaction between thiamylal sodium and a proprietary antidiarrheal preparation in the dog. AB - A drug interaction involving thiamylal sodium and a proprietary antidiarrheal preparation caused fatal ventricular fibrillation in a dog. Trials involving 4 dogs were conducted to recreate the interaction, and 1 of the 4 dogs died after ventricular fibrillation developed. The nature of the interaction was hypothesized to be mediated through the anticholinergic drug diphemanil methylsulfate, producing an autonomic imbalance. PMID- 6841253 TI - Gastric dilatation and volvulus in a dog--a case justifying electrolyte and acid base assessment. PMID- 6841251 TI - Congenital myasthenia gravis in 13 smooth fox terriers. AB - In 13 Smooth Fox Terriers with a congenital form of myasthenia gravis, clinical signs included intermittent, progressive muscle weakness that became more pronounced with exercise; muscle wasting; megaesophagus; and aspiration pneumonia. Neurologic abnormalities were apparent only during periods of weakness and included inability to retract the fore- and hindlimbs from painful stimuli. A decrement of the compound muscle action potential was evident during repetitive supramaximal nerve stimulation. Intravenous injection of a short-acting cholinesterase inhibitor evoked immediate improvement of clinical and electromyographic signs. Intracellular microelectrode studies of a biopsied external intercostal muscle revealed reduced amplitude of miniature end-plate potentials, as occurs in acquired myasthenia gravis. However, in contrast to acquired myasthenia gravis, antibodies directed against acetylcholine receptors were not demonstrable in serum and were not bound to acetylcholine receptors in muscle. Despite lack of complexing with immunoglobulin, the amount of acetylcholine receptor protein in biopsied external intercostal muscles from 9 affected pups was less than 25% of the amount in 5 unaffected littermates. The latter finding accounted for the reduction in amplitude of miniature end-plate potential and the failure of neuromuscular transmission. Treatment with a long acting cholinesterase inhibitor in 6 cases resulted in temporary improvement in muscle strength. PMID- 6841254 TI - Metastatic canine hemangiopericytoma. PMID- 6841255 TI - Urinary incontinence associated with an ectopic ureter in a female cat. PMID- 6841256 TI - Physeal injuries in the dog: a review of 135 cases. PMID- 6841257 TI - Sclerosing cholangitis in a cat. PMID- 6841258 TI - Sudden death in a horse following fracture of the acetabulum and iliac artery laceration. PMID- 6841259 TI - Bilateral granulosa cell tumor in a mare. PMID- 6841260 TI - Surgical removal of choleliths in a horse. PMID- 6841261 TI - Late-onset cerebellar degeneration in a dog. PMID- 6841262 TI - Intussusception of the large colon in a horse. PMID- 6841263 TI - Peritonitis associated with peritoneal dialysis: diagnosis and treatment. PMID- 6841264 TI - What is your diagnosis? Oblique fracture of the radius. PMID- 6841265 TI - Missions and goals of allied health educational institutions. PMID- 6841266 TI - Locus of decision making and job satisfaction of department chairpersons in schools of allied health. AB - In an era of ample resources in higher education, an estimated 80% of all administrative decisions occurred at the departmental level rather than at higher levels in the administrative hierarchy. As financial resources have become limited, it appears that the locus of decision making has begun to change in the university setting. This study explored the relationship between allied health department chairpersons' perceptions of the locus of decision making in their universities and their job satisfaction. Chairpersons who perceived the level of decision making to reside at the faculty level were shown to be less satisfied with their jobs than chairpersons whose perceived locus of decision making was at the chair level. In addition, as the locus of decision making moved away from the chairperson, either to the faculty or to more central levels of the administration, satisfaction with both the administrative and academic aspects of the chair appeared to diminish. From this study, allied health chairpersons appear to be more comfortable with clear decision-making powers than general academic chairs. This finding has implications for the structuring of the allied health chairperson's role and for the advancement and development of the allied health fields within educational institutions. Future limitations in financial resources may bring about closer alignment in the role and job satisfaction of general academic and allied health chairs. PMID- 6841267 TI - Allied health education: employer/employee perspective. PMID- 6841268 TI - Faculty development for clinical instructors in allied health: an inservice approach. AB - Allied health faculty in the clinical setting are traditionally practitioners with both service and teaching responsibilities. Much effort is expended on ensuring quality performance by the practitioner in his or her health care specialty with little emphasis on the faculty member's preparation for teaching. This article describes an inservice program designed to provide applied teaching techniques for clinical faculty members faced with such a situation. The inservice program addresses four areas of interest to clinical faculty: orientation to the educational process, development and implementation of behavioral objective, selection of the most effective clinical teaching method, and evaluation of student clinical performance. The effectiveness of the inservice program in meeting its objectives was estimated by use of gain scores between pre- and posttest performance. PMID- 6841269 TI - Allied health student and faculty attitudes regarding faculty evaluation. AB - Faculty and students of undergraduate programs in medical technology, nursing, occupational therapy, physical therapy, and social work were surveyed to determine the perceived importance of faculty participation in 24 teaching, professional service, and scholarly and administrative activities. Results indicate that both groups view teaching activities as most important, faculty tended to assign more importance to scholarly and administrative activities than did students, and students tended to assign more importance to professional service than did faculty. An overall tendency toward similarity was found. PMID- 6841270 TI - Learning style preferences of allied health practitioners in a teacher education program. AB - This article reports findings of a three-year study of learning style preferences of allied health practitioners in a university teacher education program. The Learning Preference Inventory (LPI) designed by Rezler and French was used as the survey instrument. Ten health fields were represented in the total population of 309 students who participated in the study. Analysis of variance was used to test the significance of the differences of the six LPI mean scores on abstract/concrete, teacher-centered/student-centered, and individual/interpersonal categories across the variables of age, sex, teaching experience, class location, class standing, and health field. Results of this study paralleled the findings of the 1975 Rezler and French study regarding medical technologists and physical therapists in that these two groups indicated they preferred concrete and teacher centered learning styles. Several other significant differences between health fields and other variables are discussed. PMID- 6841271 TI - A comparison of cognitive achievement: an interdisciplinary approach to emergency medical care. PMID- 6841272 TI - American Society of Andrology eighth annual meeting. Abstracts. PMID- 6841274 TI - Middle-ear mechanics in the CF-bat Rhinolophus ferrumequinum. AB - The acoustic vibrations of the eardrum at the umbo and of the stapes have been measured in the greater horseshoe bat. The displacement amplitude response of the eardrum shows a second-order low-pass characteristic, typical of a lumped mass and stiffness system with a resonance frequency of about 55 kHz. The effective mass was calculated to be about 8 micrograms, and the specific stiffness 40 X 10(6) dyne/cm3, which is one hundred times greater than guinea pig. The measured level ratio appears to be greater (3X - 5X) than the geometric ratio (2X) probably due to flexing of the manubrium. The umbo-stapes phase lag exceeds 1 cycle at high frequencies, suggesting a system of at least four reactances. This is not consistent with the relatively slight change in lever ratio with frequency. One possibility for reconciling the two results is that the distributed mass and stiffness of the ossicles act as a transmission line for transverse vibrations. There is no evidence for a sharply peaked middle-ear response (although it is more sharply tuned than some species), nor for resonant absorption by the cochlea in the region of 83 kHz - the 'constant' frequency of this bat. The eardrum shows theoretically optimal matching to the air at 55 kHz and is reasonably efficient from 15 kHz to at least 110 kHz. PMID- 6841273 TI - Characterization of boar sperm plasma membranes by two-dimensional PAGE and isolation of specific groups of polypeptides by anion exchange chromatography and lectin affinity chromatography. AB - High resolution, two-dimensional PAGE was used to characterize purified plasma membranes (PM) from boar spermatozoa. In addition to the abundance of polypeptides resolved, unusual features of PM discerned in gel patterns include a large number of basic polypeptides and the presence of at least three polypeptides with molecular weights in excess of 200 K daltons. In order to reduce these large numbers of polypeptides into smaller fractions, an important step in developing a surface map of these membranes, detergent-solubilized membranes were fractionated by the techniques of ion exchange chromatography and lectin affinity chromatography. PM polypeptides, solubilized in the nonionic detergents, were fractionated on DEAE Sephadex using phosphate ion gradients containing EDTA. Most of the major acidic polypeptides were eluted as a group at high phosphate ion concentrations. Membrane polypeptides can be separated into smaller populations by affinity chromatography on wheat germ agglutinin-agarose (WGA) or by Concanavalin A-agarose. Concanavalin A-agarose binds most PM glycoproteins, but partial purification of an important group of very basic proteins was obtained by repeated chromatography of polypeptides that failed to bind to this lectin. Since biologic activity (including immunologic potency) is often retained in the detergents used, the ability to fractionate the major polypeptide of the boar sperm PM into different and much smaller populations in large quantity and to characterize these proteins by electrophoresis provides a starting point for determining the functional significance and location of the major surface proteins of the boar sperm PM. PMID- 6841275 TI - The influence of Mossbauer source size and position on phase and amplitude measurements of the guinea pig basilar membrane. AB - Phase and amplitude measurements were made from the incus and basilar membrane in guinea pig using the Mossbauer technique. The basilar membrane/incus ratio had a maximum of about 60 dB and a phase accumulation of between 9 and 12 radians to CF. Two source sizes were used (60 X 85 and 20 X 60 microns) and the source was placed either on the modiolar edge of the basilar membrane or in the middle. Notches in plots of the basilar membrane/incus ratio occur at stimulus frequencies that appear to be associated with source size rather than position, suggesting that artefacts could be produced by the presence of the Mossbauer source. PMID- 6841276 TI - The efferent innervation of the avian cochlea. AB - The efferent auditory innervation of the budgerigar (Melopsittacus undulatus) was investigated by means of acetylcholinesterase staining. The course of the efferent fibres is described: the single terminal fibre regularly branches out to innervate several hair cells. Three types of efferent, axosomatic synapses could be distinguished: small outer hair cells bear large cup-like efferent synapses, intermediate hair cells with cone-shaped synapses, and tall inner hair cells with small, knob-like synapses. In the basal part of the cochlea the small hair cells with heavy efferent endings predominate, while in the apex only tall inner hair cells with small efferent terminals exist. There are more intermediate hair cells in the apical area than in the basal area. PMID- 6841277 TI - Basilar membrane tuning properties in the specialised cochlea of the CF-bat, Rhinolophus ferrumequinum. AB - The greater horseshoe bat has greatly expanded frequency mapping, and morphological specialisations, in the first half turn of its cochlea and a sudden transition to normal mapping. Amplitude and phase of vibration have been measured on various structures in the expanded and normal regions and have not revealed any sharply tuned responses. Amplitudes are much lower than those found in other species and frequently show a deep notch in the 77-84 kHz region. The high frequency cut-off frequencies are tonotopically organised but deviate from the Bruns map, so that hair-cell tuning appears to occur at a frequency at which basilar membrane vibration is small. In the basal region, phase differences were frequently found between the inner and outer parts of the basilar membrane. These appear to be due to interaction between two components of motion and are probably not indicative of a further filtering mechanism. There is no evidence for reflection of the travelling wave at the transition. PMID- 6841278 TI - Response patterns of auditory nerve fibers during temporary threshold shift. AB - Temporary threshold shifts were studied in chinchillas exposed to noise (octave band noise centered at 500 Hz, 95 dB SPL, 5 days duration) and the response properties of their auditory nerve fibers were measured. The threshold shifts of the fibers were approximately 35 to 65 dB; these values were equal to or slightly greater than those measured behaviorally. Most units had broad V-shaped tuning curves due to a greater loss in sensitivity near the characteristic frequency (CF) than in the low-frequency tail. In 17% of the units, the thresholds were actually lower in the tail than at CF, so that the tuning curves were W-shaped. The latencies of the fibers were within normal limits in terms of absolute intensity, but shorter than normal in terms of intensity relative to threshold. Other measures such as the spontaneous discharge rate, the discharge rate intensity functions, and the firing patterns to tone bursts at CF appeared normal. These results indicate that neural response patterns during noise-induced temporary threshold shift are similar to those measured during permanent threshold shift. PMID- 6841279 TI - Neural mechanisms in sound detection and temporal summation. AB - The psychophysics and neurophysiology of sound detection in quiet and under noise masking were studied in goldfish. Psychophysical masking is a linear function of masker level. For long duration signals, signal-to-noise ratios (S/N) at threshold are 15.5, 19, and 22.5 dB for 200, 400 and 800 Hz signals, respectively, and is -5 dB for a noise signal. Threshold declines with signal duration to about 700 ms. The slopes of the masked temporal summation functions are about unity, indicating that energy is constant at threshold. In quiet however, the slopes are generally less than 0.5, indicating that shorter signals are detected at lower energy. Neural correlates of the masked S/Ns and the slopes of temporal summation functions were sought in the response patterns of single saccular neurons. Rate- and synchronization-intensity functions were obtained for tone and noise signals in quiet and in noise. S/Ns at behavioral threshold correspond closely to those required to raise spike rate just above that evoked by the masker alone, but are well above those required to cause clear synchronization. Therefore, sound detection is probably based on spike rate and not synchronization criteria. The equivalence of behavioral and neural thresholds indicates that the filters used in behavioral sound detection are simply the bandwidths of saccular fibers. A model outlined by Zwislocki which predicts the rate of temporal summation from the rate of growth of neural activity with intensity accounts quite well for the observed slopes of temporal summation functions both in quiet and in noise. PMID- 6841280 TI - Comparison between the tuning properties of inner hair cells and basilar membrane motion. AB - Measurements were made of inner hair cell receptor potentials and basilar membrane motion in the 17-21 kHz region of the guinea pig cochlea. The latter were made using the Mossbauer technique. Isoamplitude curves at 0.9 mV d.c. receptor potential were compared with isovelocity curves at 0.04 mm/s and the corresponding basilar membrane displacement at CF. The Mossbauer source (20 X 60 or 60 X 85 microns) was placed either in the middle of the basilar membrane or on the extreme modiolar edge. These two source positions yielded broad and narrow mechanical tuning curves, respectively. The latter approximated the receptor potential curves most closely but deviated by 10-15 dB on the low frequency side of the tuning curve tip. PMID- 6841281 TI - Delayed effects of noise on the ear. AB - The possibility that a delayed onset hearing loss may occur after noise exposure was investigated in 20 normotensive (N) and 20 spontaneously hypertensive (SH) Wistar rats. Half of the rats of each strain were first exposed to noise at 3 months of age and half were first exposed at 12 months of age. All rats were exposed for a total of 3 months to a noise of 100 dB Leq (lin) (a narrowband noise, sweeping from 3 to 30 kHz at a rate of 0.5 Hz). Hearing thresholds were determined with a behavioral technique, and also on certain selected animals by brainstem audiometry, using pulses of 1/3-octave filtered sine waves. One to two weeks after exposure to noise animals had a 30-50 dB hearing loss. The hearing loss remained stable or progressed only slightly in normotensive animals up to 12 months after end of exposure. Generally the SH animals suffered a slight additional loss of hearing over the 12 months after noise exposure. When tested at 18 months of age 3 of the 10 SH rats exposed to noise from 12 to 15 months of age suffered a hearing loss which covered the whole range of observed frequencies from 1.5 to 44 kHz and which had progressed noticeably. These results suggest that while the delayed effects of noise are normally small, exposure might trigger a pronounced hearing loss in subjects with fragile ears. PMID- 6841282 TI - Effects of N-acetylcysteine on kanamycin ototoxicity in the guinea pig. PMID- 6841283 TI - Functional significance of dendritic swelling after loud sounds in the guinea pig cochlea. AB - Exposure of the guinea pig cochlea to loud pure tones caused a dramatic swelling of afferent dendrites beneath the inner hair cell (IHC). This swelling occurred in a restricted region of the cochlea basalward of the exposure frequency location. For a 110 dB tone swelling was just detectable in 1 micron sections for a 18 3/4 min exposure and was clearly visible after a 22 1/2 min exposure. Swelling was reversible. Exposures which caused swelling produced a loss in sensitivity of the flat low frequency 'tail' of the frequency-threshold curves of single auditory neurons whose most sensitive frequency was a 1/2 octave higher than the exposure frequency. The findings are consistent with the notion that dendritic swelling causes a non-selective decrease in sensitivity to all frequencies of sound. PMID- 6841284 TI - Crossed cochlear influences on monaural temporary threshold shifts. AB - Temporary threshold shifts (TTS) of the cochlear action potential in one (ipsilateral) ear, caused by a brief intense pure tone, were reduced either by (1) contralateral acoustic stimulation at the same frequency, or (2) destruction of the contralateral cochlea. The effect of contralateral cochlear destruction persisted, though slightly reduced in effect, after a delay of one hour between the destruction and the ipsilateral exposure. Contralateral acoustic stimulation had no effect after a delay of 10 min. The effect of contralateral cochlear destruction could be blocked by strychnine, a known antagonist of auditory efferent activity. However, contralateral cochlear destruction resulted in none of the effects upon normal ipsilateral thresholds or input-output curves for the action potential classically seen when the efferent pathways are stimulated. The results suggest that the crossed effects reported here are due to a complex interaction between the activity in both cochleas, possibly resulting in a reduction in a central inhibitory influence on an efferent feedback pathway that is then expressed during the ipsilateral exposure. PMID- 6841285 TI - Aspirin can potentiate the temporary hearing loss induced by intense sounds. AB - Aspirin is known to produce a reversible loss of hearing that can be as great as 40 dB, depending upon the dose and the individual subject. Here we show that aspirin-induced losses exacerbate the temporary hearing loss induced by exposure to intense sound. EXPOSUREs that ordinarily produce about 14 dB of temporary threshold shift (TTS) will produce about 18-27 dB of TTS if the listener has been taking 3.9 g of aspirin for the past two days or more. A lesser dose or a shorter duration of use produces a smaller, or no, increment in temporary hearing loss. This greater TTS, and an apparent prolongation of recovery from exposure, make chronic aspirin use ill-advised for people routinely exposed to intense sounds. EXPOSURE: 2500 Hz, 10 min, varying intensity. TTS frequency: 3550 Hz. Psychophysical method: 2IFC, adaptive. PMID- 6841286 TI - Intercellular communication in the supporting cells of the organ of Corti. AB - We have directly tested the concept that the supporting cells of the organ of Corti are functionally coupled through gap junctions. In vitro and in vivo preparations were evaluated. Electrical measurements clearly show that the cells are coupled ionically. Voltage drops measured in neighboring cells in response to intracellular current injections indicate that current spread decays rapidly. Despite the existence of electrical coupling, fluorescent dye injection studies revealed no dye spread into adjacent cells, other than a few instances which were clearly artifactual. However, it is possible that dye spread is very slow and that dye in adjacent cells is diluted below visual detectability. In any case, dye coupling is remarkably poor compared to other electrically coupled tissues. The role of coupling in the supporting cells may be nutritive, considering the avascular nature of Corti's organ. PMID- 6841287 TI - Prediction of daily total digestible nutrient requirement of beef cows in northern climates. PMID- 6841288 TI - Estimation of repeatability, heritability and breed differences for lamb production. AB - Production records of crossbred ewes, including weight at mating (WTM), fertility (FRT), number of lambs born per ewe lambing (BRN), number of lambs weaned (WEN), litter weight in April (WTA) and litter weight at weaning (WTW), were analyzed for the estimation of breed differences, genotype x environment interactions and repeatability and heritability of ewe production. All ewes were from Suffolk- or Columbia-type dams. Breed of sire of ewe was Finnsheep, Dorset, North Country Cheviot or Romney, Suffolk-cross (SX) ewes were heavier at mating than Columbia cross (CX) ewes. Cheviot-cross (NX) and Finnsheep-cross (FX) ewes were the most fertile on hill pastures, while Dorset-cross (DX) ewes were the most fertile on irrigated pastures. The FX ewes had larger litters at birth and at weaning. Columbia-cross ewes had larger litters than SX ewes on hill pastures, but the SX ewes had larger litters than CX ewes on irrigated pastures. Finnsheep-cross ewes on both types of pastures and DX ewes on irrigated pastures had heavier litter weights than NX or Romney-cross ewes at weaning. Repeatability estimates for WTM, FRT, BRN, WEN, WTA and WTW were .61, .15, .19, .08, .07 and .09, respectively. Heritabilities, from the sire-of-ewe component, were .40, .02, .12, .0, -.02 and .05 for WTM, FRT, BRN, WEN, WTA and WTW, respectively. PMID- 6841289 TI - Yearling trait comparisons among inbred lines and selected noninbred and randomly bred control groups of Rambouillet, Targhee and Columbia ewes. AB - Inbreeding with concurrent selection was used to develop 26 Rambouillet, 20 Targhee and 10 Columbia inbred lines of sheep. Inbreeding coefficients averaged 30, 29 and 30% for the three breeds, respectively, at the conclusion of the study. A selected noninbred control group and a randomly bred unselected control group were maintained for each breed. Yearling traits were evaluated for 545 Rambouillet, 572 Targhee and 411 Columbia yearling ewes, each belonging to one of the inbred lines or control groups. In each breed, the selected controls were generally of greatest overall merit, the unselected controls intermediate and the inbred lines of least merit. Only a few yearling traits of only a few inbred lines were superior (P less than .05) to those of their appropriate selected control groups. Selection within inbred lines was generally ineffective in offsetting inbreeding depression. However, single trait selection for traits of high heritability, notably yearling weight, clean fleece weight and staple length, appeared to compensate for inbreeding effects on those traits. Deleterious consequences of inbreeding were particularly apparent in yearling weight, average daily gain, type and condition scores, grease and clean fleece weights and index of overall merit. Inbreeding also resulted in fewer neck folds among inbreds of all three breeds. Correlations between the rankings of inbred lines at weaning and yearling ages were high for traits of higher heritability. Superiority of the selected controls in most traits was of about the same magnitude at weaning and yearling ages. In no case did the final overall merit (index value) of an inbred line of any of the three breeds significantly exceed the overall merit of its respective selected control group. PMID- 6841290 TI - Weaning pigs at an early age decreases cellular immunity. AB - An experiment involving 118 pigs was conducted to evaluate the influence of weaning pigs at four different ages on in vivo and in vitro cell-mediated immunity. One-half of each litter was weaned at 2, 3, 4 or 5 wk of age; the other one-half remained with the sow as nonweaned controls. Phytohemagglutinin skin test responses were determined on all pigs. Blastogenic responses of mitogen stimulated lymphocyte cultures were determined before and after weaning. The intradermal response to phytohemagglutinin was reduced (P less than .001) in pigs weaned when 2 or 3 wk old and was suppressed (P less than .05) in those weaned when 4 wk old. In vivo cellular immunity was not altered by weaning in 5-wk-old pigs. The capability of lymphocytes to undergo blastogenesis in response to phytohemagglutinin was decreased in pigs weaned at 2 and 3 wk of age (P less than .001 and P less than .01, respectively). Pokeweed mitogen-stimulated blastogenesis was lower (P less than .01) in pigs weaned at 2 wk of age. Mitogen stimulated lymphocyte blastogenesis was similar (P greater than .10) in control pigs and those weaned when 5 wk old. These data suggested that weaning pigs when younger than 5 wk old causes physiological changes detrimental to cellular immune reactivity. Those changes could alter disease susceptibility in young pigs. PMID- 6841291 TI - Dietary calcium and phosphorus for developing boars. PMID- 6841292 TI - Characterization of hormonal patterns in the beef cow during postpartum anestrus. PMID- 6841293 TI - Influence of feed intake level on site of digestion in steers fed a high concentrate diet. AB - A high concentrate diet was fed at 1.2, 1.5, 1.8 and 2.1% of body weight to four Angus steers (258 kg) equipped with cannulas in the proximal duodenum and distal ileum. As level of feed intake increased, flow of N, nonammonia N, microbial N and feed N to the small intestine increased linearly (P less than .05). Bypass of feed N increased from 44 to 71% of fed N. At the highest intake level, ruminal protein degradation and protein solubility were almost equal. At lower intake levels, feed protein degradation exceeded N use by microbes, but at the higher level of intake, microbial protein synthesis exceeded N available from protein degradation. Microbial efficiency increased as feed intake was increased to 1.8% of body weight. Apparent digestion of N in the small intestine increased with feed intake. Starch digestion in the rumen increased slightly with feed intake while organic matter and acid detergent fiber (ADF) digestibility declined. At the highest level of feed intake, no ADF disappearance occurred in the rumen. Results suggest that level of feed intake markedly alters 1) bypass and supply of intestinally digested protein, 2) need for degradable N in the rumen, 3) efficiency of microbial growth and 4) ruminal fiber digestion. Both retention time and contingent characteristics of fermentation in the rumen appear to be involved in these alterations. PMID- 6841294 TI - Lipogenesis and adipose tissue cellularity in steers switched from alfalfa hay to high concentrate diets. AB - An experiment was conducted to 1) evaluate the effects of diet (alfalfa hay vs high concentrate) on adipose tissue cellularity and rates of in vitro lipogenesis and 2) determine if there was a relationship between in vitro lipogenic rates from acetate and lactate and rates of L- or D-lactate disappearance from plasma. Number of adipose cells/g of tissue decreased with time on experiment; however, hay-fed steers had fewer, but larger cells/g of subcutaneous adipose tissue compared with concentrate-fed steers (.78 +/- .04 vs 1.20 +/- .13 X 10(-6)/g, respectively). These results, however, are likely due to a higher (approximately 25%) intake of dry matter and metabolizable energy by the hay-fed steers. Carcass data obtained at slaughter (460 kg) indicated that the concentrate-fed steers had as much or more adipose tissue compared with the hay-fed steers. Characteristics describing D- or L-lactate disappearance from plasma were not highly correlated with lactate utilization for fatty acid synthesis. Utilization of acetate as a substrate for fatty acid synthesis in vitro was correlated (r = .64) with the rate of lactate utilization for fatty acid synthesis. PMID- 6841295 TI - Response of swine to periparturient vitamin C supplementation. AB - Two experiments were conducted, involving 68 third-litter sows and 20 first litter gilts in Exp. 1 and 82 first-litter gilts in Exp. 2. On d 108 of gestation, the dams were moved into individual crates, stratified by parity and breed, and randomly assigned within strata, to one of two treatments: (1) fed a basal 16% protein corn-soybean meal diet, 1.8 and 2.7 kg once daily before farrowing and for the first 7 d of lactation, respectively, and then ad libitum until pigs were weaned at 28 d of age, and (2) fed the basal diet plus 1 g of L ascorbic acid (vitamin C)/dam daily from d 108 of gestation through d 7 of lactation and on the same feeding schedule as for treatment 1. In Exp. 1, no effect of vitamin C supplementation was observed in sows or gilts on total pigs born/litter, number of live pigs/litter or average live pig weight at birth, 7 or 28 d of age, or on plasma vitamin C concentration of dams at d 108 of gestation or d 7 of lactation or of pigs at birth, 7 or 28 d of age. However, there was a lower (P less than .01) plasma vitamin C concentration of the dams at d 7 of lactation than at d 108 of gestation. Plasma vitamin C concentration also declined (P less than .01) as pigs aged. In Exp. 2, with all gilts, vitamin C supplementation again showed no effect on any of the reproductive traits measured in Exp. 1. It is concluded that daily supplementation of 1 g of vitamin C to either sows or gilts from d 108 of gestation through d 7 of lactation has no beneficial effect on the reproductive or lactation performance of swine. PMID- 6841296 TI - Effects of graded levels of dietary copper on copper and iron concentrations in swine tissues. AB - In a dose-response study, 120 weanling, crossbred pigs were used to determine the effect of 7.5, 15, 30, 60, 120 and 240 ppm total dietary Cu on animal performance and Cu and Fe stores in selected tissues. Pigs were killed at 56 or 91 kg average body weight. Average daily gain was not affected by dietary treatment. Dietary Cu concentrations of 7.5, 15, 30 and 60 ppm had no appreciable effect on Cu and Fe concentrations in liver and kidney of pigs slaughtered at 91 kg. However, 120 and 240 ppm dietary Cu increased (P less than or equal to .01) liver Cu 4.5- and 16 fold and decreased (P less than or equal to .05) liver Fe by 50 and 60%, respectively, compared with the other dietary treatments. A fit of liver Cu and Fe data to linear plateau models resulted in an inflection point of approximately 60 ppm dietary Cu. Kidney Cu was also increased (P less than or equal to .05) by 120 and 240 ppm dietary Cu, but the magnitude of the change was smaller than that of liver Cu. Muscle Cu and Fe were not significantly affected by dietary Cu. PMID- 6841297 TI - Efficacy of vitamin C supplementation for weanling swine. PMID- 6841298 TI - Comparison of gleptoferron with iron dextran for anemia prevention in young pigs. AB - Gleptoferron, a sterile aqueous colloidal solution of beta-ferric oxyhydroxide and dextran glucoheptonic acid, was compared with iron dextran for the prevention of Fe deficiency anemia in young pigs. Using 26 litters, pigs (within each litter) were randomly allotted to one of three treatments: 1) control (no Fe), 2) iron dextran (200 mg) and 3) gleptoferron (200 mg). Blood was collected at 0, 10, 21 and 50 d post-treatment for red blood cell count (RBC), hematocrit (HCT), hemoglobin (HGB) concentration, serum Fe concentration (Fe) and serum Fe-binding capacity (IBC). At 21 d, 30 pigs (one pig/treatment from each of 10 litters) were killed to determine milligrams nonheme Fe (NHFe) in liver and spleen, bile IBC and concentrations of bile and fecal Fe. There were no differences (P greater than .05) between Fe sources in 3- or 8-wk body weight or in any of the blood or tissue characteristics. In contrast, control pigs gained less (P less than .05) weight and had lower (P less than .05) RBC, HGB, HCT, serum Fe and liver and spleen NHFe than those that received iron dextran or gleptoferron. Serum IBC was greater (P less than .05) for the control than for Fe-treated pigs. These results demonstrate that the iron from iron dextran and gleptoferron is used with similar efficiency for anemia prevention in young pigs. PMID- 6841299 TI - Effect of sheep rumen fermentation and methane inhibition on the toxicity of Senecio jacobaea. AB - Senecio jacobaea (SJ) was incubated in sheep rumen fluid-buffer mixtures to determine if metabolism and(or) detoxication of pyrrolizidine alkaloids (PA) was occurring. The nontoxic reduction metabolite, 7 beta-hydroxy-l-methylene-8 alpha pyrrolizidine, was not detected when SJ-rumen fluid incubation extracts were subjected to high performance liquid chromatography and mass spectrographic analysis. Rats were used as assay animals in another experiment to assess the toxicity of SJ incubated in rumen fluid. Incubation treatments were: Rumen fluid (RF) from a sheep not fed SJ (RF-0); RF autoclaved before incubation (RF-0A); RF from sheep fed 50% SJ for 1 wk (RF-1); RF from a sheep fed 50% SJ for 5 wk (RF 5), and RF-5 with 5 microM iodoform in the incubation medium (RF-5I). The SJ treatments were included in rat diets at the 10% level. Dietary treatment and mean rat survival times (days) were: control, no mortality; 10% untreated SJ, 43; RF-0, 53; RF-0A, 55; RF-1, 44; RF-5, 56; RF-5I, 44, There were no significant differences in survival time. This indicates that SJ was not detoxified as a result of incubation in sheep RF in vitro, and suggests that rumen detoxification does not account for resistance of sheep to SJ. The pH and volatile fatty acid concentrations of the incubation mixtures were measured before and after incubation. Acetate/propionate and pH following incubation were respectively: RF 0A, 7.3, 4.3; RF-0, 4.2, 4.4; RF-1, 2.7, 4.5; RF-5, 2.6, 4.5; RF-5I, 2.4, 4.5. These data show that although pretreatment of the rumen fluid donor with dietary SJ and addition of iodoform to the incubation mixture favor reductive rumen metabolism, detoxification of PA from SJ does not occur during in vitro sheep rumen fermentation. PMID- 6841300 TI - Enhanced progesterone and pregnancy rate after gonadotropin administration in lactating ewes. AB - Estrus was induced during March and April in 50 lactating ewes that were 20 to 31 d postpartum. Following estrus induction, ewes were treated with either saline or human chorionic gonadotropin (hCG; 100 IU) on d 11, 12 and 13 after mating. Regardless of whether ewes were later diagnosed as pregnant or not, treatment with hCG increased serum progesterone concentrations compared with concentrations observed in saline-treated ewes on d 12, 14 and 16 after mating (P less than .01). Pregnancy rate was higher in ewes treated with hCG than that of ewes treated with saline (58 vs 29%; P less than 0.5). Data from the present study indicate that it is possible to increase pregnancy rate in lactating, anestrous ewes after artificially-induced estrus by administering hCG. PMID- 6841301 TI - Blood flow, steroid secretion and nutrient uptake of the gravid bovine uterus and fetus. PMID- 6841302 TI - Nutrient digestibility of brewers single cell protein. AB - Six growing wethers were used in a total collection digestion trial to estimate the nutrient digestibility of brewers single cell protein (BSCP). The BSCP product was obtained by allowing microbial growth to occur aerobically on the effluent wash waters of a brewery and then harvesting the solids through a spray drying procedure. This process produced a dry powder product containing 50% crude protein. Wethers were fed a corn-based diet with BSCP replacing corn at 0, 20 and 40% of the diet in a 3 X 3 replicated Latin square design. There were no consumption or palatability problems encountered when wethers were fed BSCP containing diets. Nutrient digestibility of BSCP was estimated by a least-squares analysis regressing apparent digestibility of each nutrient on BSCP content. Digestion coefficients of BSCP for dry matter, energy and crude protein were calculated as 66.6, 73.3 and 86.5%, respectively. The addition of BSCP to corn based diets decreased the overall diet digestibility of dry matter, energy and carbohydrate (P less than .05). Diet crude protein digestibility was not significantly affected by the BSCP addition. Nutrient digestibilities indicate brewers single cell protein is a satisfactory source of supplemental protein, approximately equivalent to cottonseed meal on a weight basis. PMID- 6841303 TI - The role of antibiotics given by inhalation in chronic chest disease. PMID- 6841304 TI - Acyclovir in hepatitis B antigen-positive chronic liver disease: inhibition of viral replication and transient renal impairment with iv bolus administration. AB - Six patients with hepatitis B virus (HBV) related chronic liver disease were treated with acyclovir, 5-15 mg/kg 8 hourly, given as an iv bolus or iv infusion over 1 h for up to 7 days. Two patients treated with 10 and 15 mg/kg 8 hourly showed a decrease in HBV-DNA polymerase and HBV-DNA when mean trough acyclovir plasma concentrations of 5.0 +/- 0.6 and 13.2 +/- 3.0 microM were attained. Inhibition of viral replication was not seen in patients treated with lower doses. Transient renal impairment was seen in two patients who received high dosage by the iv bolus mode of administration. This complication may be prevented by a high oral fluid intake or iv infusion of the drug over 1 h. Further study with acyclovir 15 mg/kg 8-hourly given as an iv infusion for longer periods is warranted. PMID- 6841305 TI - Effect of protein binding on antibiotic activity in vivo. AB - Using a group of penicillins all belonging to the same chemical class, antibacterial activity against Staphylococcus aureus was determined in vitro and also in vivo by use of an intraperitoneal infection in mice. The compounds all showed essentially the same level of activity in vitro but differed markedly in their activity in vivo. This activity in vivo could be correlated directly with the extent of binding in mouse serum. PMID- 6841306 TI - The influence of steroids on the penetration of antibiotics into brain tissue and brain abscesses. An experimental study in rats. AB - The interaction between glucocorticoids and antibiotics in the treatment of brain abscesses has been examined in rats. After stereotactic inoculation of Bacteroides melaninogenicus in the right frontal lobe to induce abscess formation, the animals were divided into two groups those treated with antibiotics alone and those treated with both antibiotics and corticosteroids. The antibiotics used, injected 4 days after the bacterial inoculation, were benzylpenicillin, 3H-lymecycline and 14C-metronidazole. The left hemisphere in each animal served as control. Finally a group of animals were inoculated in the right hemisphere with saline and served as controls. Antibiotic assays showed that the use of steroids reduced antibiotic concentration in uninfected and infected tissue with significant reduction in the infected tissue of animals treated with benzylpenicillin and lymecycline. In animals treated with metronidazole, no significant alteration of concentration levels was found. The use of steroids in the treatment of brain abscesses seems to only partially inhibit adequate concentrations of antibiotics in brain tissue dependent upon the antibiotics used. PMID- 6841307 TI - The effects of irradiation and probenecid on cerebrospinal fluid transport of penicillin. AB - A hitherto unrecognized interaction between whole brain irradiation and probenecid on cerebrospinal fluid (CSF) transport of benzylpenicillin has been demonstrated in rabbits. Healthy adult rabbits received 10 Gy (1000 rad) to the whole brain as a single dose. At different time intervals after irradiation the animals were subjected to single intravenous injections of benzylpenicillin. Studies on benzylpenicillin concentrations in CSF showed increasing values one week after irradiation suggesting disturbance in blood-CSF barriers. Additionally, groups of rabbits were subjected to either irradiation, probenecid injections or both prior to antibiotic administration. All these treatments resulted in increased CSF concentration of benzylpenicillin relative to the concurrent serum levels. The increase of the CSF benzylpenicillin levels in the preirradiated animals was less pronounced in the animals treated with probenecid, compared to those who were irradiated only. The mode by which probenecid and irradiation interacts on the CSF kinetics of benzylpenicillin should be further evaluated. PMID- 6841308 TI - Effect of amphotericin B on natural killer cell activity in vitro. AB - Incubation of murine peritoneal and spleen natural killer cells with amphotericin B at concentrations of 2.5, 5 and 10 mg/l in vitro, resulted in depression of their tumoricidal activity which had been augmented in vivo by infection with Toxoplasma gondii. In contrast, amphotericin B at the same concentrations had little or no effect on spontaneous natural killer cell activity in vitro. These in-vitro data suggest amphotericin B may have adverse effects on natural killer cell function in vivo. PMID- 6841309 TI - Gentamicin resistance in Staphylococcus aureus--a new mechanism? AB - Six multiply-resistant strains of Staphylococcus aureus were cured of their gentamicin resistance. For three strains, the loss or reduction of aminoglycoside modifying enzymes in the sensitive variants was accompanied by an increase in intracellular gentamicin accumulation, confirming that modification of the antibiotic was associated with its impaired uptake. Resistance in the other three strains, however, did not show this association. For one strain the loss of gentamicin resistance was associated with a loss of enzyme production, but both resistant and sensitive variants accumulated [3H] gentamicin at the same rate. The sensitive variants of the two remaining strains showed no increase in [3H] gentamicin accumulation but still produced aminoglycoside-modifying enzymes, and it is suggested that the broad-spectrum aminoglycoside resistance of these two strains is due to some hitherto undescribed mechanisms of resistance rather than an alteration of the ribosomal target. PMID- 6841310 TI - Antibacterial activity of a new thiatetracycline. PMID- 6841311 TI - Initiation of wall assembly sites in Streptococcus faecium. AB - In electron micrographs of replicas of Streptococcus faecium, sites of wall growth are located between pairs of raised equatorial bands. Analysis of cells taken from cultures with mass doubling times between 30 and 125 min indicates that rounds of wall synthesis are initiated at a time close to division, which is temporally unrelated to the initiation or termination of chromosome replication. Growth sites are initiated at a relatively constant volume independent of growth rate when the volume contained within the two segments of wall adjoining an equatorial band marker approaches ca. 0.26 micrometer 3. PMID- 6841312 TI - Activation of the methylreductase system from Methanobacterium bryantii by ATP. AB - The methylreductase of Methanobacterium bryantii required ATP for activity. There was sufficient ATP synthesis in extracts to account for the observed activity. Hexokinase inhibited the methylreductase by competing for endogenously synthesized ATP. The uncoupler, carbonyl cyanide p-trifluoromethyoxyphenyl hydrazone, inhibited only at concentrations greater than 0.5 mM, and detergents and non-halogenated membrane-permeable-ions did not inhibit. Thus, membrane proton gradients are not important in activation. In addition, maximal activation was obtained with less than 0.25 mM ATP, was inhibited by beta, gamma-imido ATP, and was strongly temperature dependent. The activated state was very unstable, having a half-life of 5 to 15 min. After gel filtration at 5 degrees C, the methylreductase retained partial activity for a short time in the absence of ATP. These observations indicate that activation involves the modification of a protein or protein-bound cofactor of the methylreductase system. PMID- 6841313 TI - Aldohexuronate transport system in Erwinia carotovora. AB - The biochemical and physiological aspects of hexuronate transport in Erwinia carotovora were studied to approach the genetic regulation of the hexuronate degradative pathway in this bacterial species. An active transport system for glucuronate and galacturonate uptake exists in E. carotovora. The glucuronate entry reaction displayed saturation kinetics with an apparent Km of 0.05 mM (at 25 degrees C; pH 7). Galacturonate appeared to be a competitive inhibitor of glucuronate uptake with a Ki of 0.1 mM. Glucuronate permeation was not induced by glucuronate itself in wild-type strains. Galacturonate induced the uptake of glucuronate (about fivefold). The induced synthesis of the transport system was sensitive to catabolite repression by glucose. Mutants able to grow on glucuronate as the sole carbon source showed constitutive synthesis of the hexuronate transport system. PMID- 6841314 TI - Podospora mutant defective in glucose-dependent growth control. AB - A mutation (modE), previously described as a membrane mutation, results in several modifications of the female developmental cycle: a high density of protoperithecia, the unscheduled development of protoperithecia into sterile perithecia on the homokaryons of each mating type, and the independence of ascospore outgrowth from the substances normally required for germination. Cultured in liquid medium, the modE strain showed two additional specific features: a higher growth yield than that of wild-type cultures (plus 10% of dry weight) and an extreme reduction of cell life span. Both mutant traits were specific to glucose limitation. Despite the large difference existing in the sensitivity of cells to glucose starvation, the glycogen and trehalose reserves of mutant and wild-type cells were nearly identical. Considered together, these results suggest that the primary effect of the mutation lies in the disruption of a glucose-dependent regulation controlling the transition of the metabolic pattern of cells from growth to quiescence. PMID- 6841315 TI - Transformation of Kluyveromyces lactis by killer plasmid DNA. AB - Some strains of Kluyveromyces lactis contain two linear double-stranded DNA plasmids, k1 and k2. The presence of the two plasmids confer on the cell a "killer" character, due to the production of a toxin that kills the sensitive cells. We have used one of these linear DNA molecules as a gene vector to transform K. lactis cells. Hybrid plasmids containing parts of the k1 plasmid and the URA3 gene of Saccharomyces cerevisiae have been constructed. We have found that the hybrid plasmids were able to transform a uracil-requiring strain of K. lactis (uraA mutant) to a prototrophic form. The transformed phenotype cosegregated with the hybrid plasmids. The transforming plasmids contained the sequence of one or both ends of the linear k1 DNA, but they were integrated into a circular molecule. PMID- 6841316 TI - Fluoride, hydrogen, and formate activate ribulosebisphosphate carboxylase formation in Alcaligenes eutrophus. AB - Alcaligenes eutrophus formed ribulosebisphosphate carboxylase (RuBPCase; EC 4.1.1.39) when grown on fructose. Addition of sodium fluoride (NaF) to fructose minimal medium resulted in a slightly decreased growth rate and a rapid fivefold increase in RuBPCase specific activity. With citrate, a glucogenic carbon source, RuBPCase was also formed, However, addition of NaF to cells growing on citrate resulted in a 50% decrease in RuBPCase specific activity. Among the enzymes of fructose catabolism, NaF (10 mM) inhibited enolase in vitro by 98% and gluconate 6-phosphate dehydratase by 87%. Inhibition of the dehydratase by NaF was insignificant in vivo, as determined with a mutant defective in phosphoglycerate mutase activity. Growth of this mutant on fructose was not inhibited by NaF, and only a minor increase in RuBPCase activity was observed. From these results, we concluded that the product of the enolase reaction, phosphoenolpyruvate, played a role in RuBPCase formation. Addition of H2 or formate to the wild type growing on fructose or citrate did not affect the growth rate but resulted in rapid formation of RuBPCase activity. Mutants impaired in H2 metabolism formed RuBPCase at a low rate during growth on fructose plus H2 but at a high rate on formate. Apparently, additional reductant from H2 or formate metabolism induced RuBPCase formation in A. eutrophus. PMID- 6841317 TI - Protoporphyrin formation in Rhizobium japonicum. AB - The obligately aerobic soybean root nodule bacterium Rhizobium japonicum produces large amounts of heme (iron protoporphyrin) only under low oxygen tensions, such as exist in the symbiotic root nodule. Aerobically incubated suspensions of both laboratory-cultured and symbiotic bacteria (bacteroids) metabolize delta aminolevulinic acid to uroporphyrin, coproporphyrin, and protoporphyrin. Under anaerobic conditions, suspensions of laboratory-cultured bacteria form greatly reduced amounts of protoporphyrin from delta-aminolevulinic acid, whereas protoporphyrin formation by bacteroid suspensions is unaffected by anaerobiosis, suggesting that bacteroids form protoporphyrin under anaerobic conditions more readily than do free-living bacteria. Oxygen is the major terminal electron acceptor for coproporphyrinogen oxidation in cell-free extracts of both bacteroids and free-living bacteria. In the absence of oxygen, ATP, NADP, Mg2+, and L-methionine are required for protoporphyrin formation in vitro. In the presence of these supplements, coproporphyrinogenase activity under anaerobic conditions is 5 to 10% of that observed under aerobic conditions. Two mechanisms for coproporphyrinogen oxidation exist in R. japonicum: an oxygen-dependent process and an anaerobic oxidation in which electrons are transferred to NADP. The significance of these findings with regard to heme biosynthesis in the microaerophilic soybean root nodule is discussed. PMID- 6841318 TI - Characterization of the folic acid C9-N10-cleaving enzyme of Dictyostelium minutum V3. AB - Folic acid is a chemoattractant for the slime mold Dictyostelium minutum V3. The activity of extracellular folic acid is regulated by a folic acid C9-N10 splitting enzyme (FAS). The products were identified as pterin-6-aldehyde and p amino-benzoylglutamic acid. The enzyme was stabilized by EDTA. For the extracellular enzyme, the Km was 10(-7) M, and the optimal pH was 4.0. During starvation, FAS activity was mainly secreted into the medium; after 3 h, a plateau was reached. The membrane-bound activity was constant, but only 12% of the extracellular activity at 3 h. Intracellular activity also increased up to 3 h to a level of 23% of the extracellular FAS. The substrate recognition of FAS was found to be based on 4-O or N3 or both, N5 or N8 or both, N10, and the p aminobenzoic acid moiety, whereas 2-NH2, N1, and the glutamic acid moiety were not recognized. Other slime mold species were found to secrete FAS with 20-fold or more reduced activity than D. minutum V3. PMID- 6841319 TI - Characterization of intracellular inclusions formed by Pseudomonas oleovorans during growth on octane. AB - The growth of Pseudomonas oleovorans on n-octane was characterized by the formation of intracellular structures. These inclusions were isolated and characterized. Morphologically, they resembled the poly-beta-hydroxybutyrate granules found in Bacillus cereus, as shown by freeze-fracture electron microscopy. The elemental analysis of isolated granules showed, however, that they do not contain poly-beta-hydroxybutyric acid. Instead, the analysis was consistent with a C8 polyester, which interpretation was supported by the fatty acid analysis of hydrolyzed granules. From the evidence presented here, we conclude that P. oleovorans forms poly-beta-hydroxyoctanoate granules when grown on n-octane. PMID- 6841320 TI - Streptococcus faecium ATCC 9790 penicillin-binding proteins and penicillin sensitivity are heavily influenced by growth conditions: proposal for an indirect mechanism of growth inhibition by beta-lactams. AB - The effects of variations in growth conditions on the penicillin response of Streptococcus faecium ATCC 9790 were studied. Changes in the growth temperature and medium composition were found to cause striking changes in the bacterial generation time, cellular penicillin sensitivity (minimum inhibitory concentration), sensitivity of peptidoglycan synthesis to inhibition by penicillin, rate of autolysis, and labeling pattern of penicillin-binding proteins. However, no constant relationship between these parameters and the minimum inhibitory concentration could be observed. Similar electrophoretic patterns for penicillin-binding proteins were observed in cells grown in different media at the optimal growth temperature. Inhibition of cell division by penicillin in cells grown at this temperature (but not at higher or lower temperatures) caused filamentation of the bacteria. In cells grown in a chemically defined medium at the optimal temperature (but not at temperatures above or below), complete inhibition of cell division was associated with only partial inhibition (34% after 150 min) of peptidoglycan synthesis. It is suggested that the status and physiological importance of individual penicillin binding proteins in S. faecium are heavily influenced by growth conditions. Depending on the growth conditions, different penicillin-binding proteins may perform the cellular function, indispensible for bacterial growth. PMID- 6841321 TI - "Nonfibrillar" chitin associated with walls and septa of Trichophyton mentagrophytes arthrospores. AB - Two morphologically distinct forms of chitin were found in the arthrospore walls and septa of Trichophyton mentagrophytes. Two-thirds of the total wall chitin was the microfibrillar and chitinase-sensitive form. The remaining chitin existed in a previously uncharacterized "nonfibrillar" form and was insensitive to the action of Streptomyces chitinase. Exhaustive digestion of the arthrospore walls and septa with beta (1 leads to 3)-glucanase and chitinase followed by extraction with NaOH (1 N, 100 degrees C, 3 h) resulted in a fraction which retained the original wall shape. This fraction consisted of 85% N-acetylglucosamine, 2.0% galactosamine, 2.5% glucose, and 0.4% amino acids, 74% of which were lysine. Both its infrared spectrum and its X-ray diffraction pattern were almost identical to those of authentic chitin. There was no evidence of the presence of muramic acid, hexuronic acid, phosphate, or sulfate in this fraction. Its resistance to chitinase was due neither to the presence of protective wall layers or melanin nor to its close or covalent association with beta-glucan. Aside from its nonfibrillarity, this hexosamine polymer differed from authentic chitin in that it was soluble in 6 N HCl and 7.5 N NaOH. The development of this nonfibrillar chitin layer in the cell wall during arthrosporogenesis of T. mentagrophytes may be related to the arthrospores being resistant to a variety of antifungal agents. PMID- 6841322 TI - Disulfide-linked oligomers of the major outer membrane protein of chlamydiae. AB - The major outer membrane protein of chlamydial elementary bodies was identified in dimer, trimer, and other multimeric forms. These natural multimers were stabilized by disulfide-mediated cross-linking. Such cross-linking of outer membrane proteins may play an important role in the formation and evolution of chlamydial cell wall structure. PMID- 6841323 TI - Electron microscopic study on the structures formed by mixtures containing synthetic glyceroglycolipids. AB - Structures of aqueous dispersions prepared from monoglycosyldiglycerides and from mixtures of monoglycosyldiglyceride and phosphatidylcholine were studied by freeze-fracture electron microscopy. Aqueous dispersions of glucosyl or galactosyl dipalmitylglycerol formed lamellar structures when quenched both from below and above the gel-liquid crystalline phase transition temperature. With mixtures of monoglycosyl dipalmitylglycerol and dipalmitoylphosphatidylcholine, tubular structures could be observed in the extended bilayer structures. Diglucosyl dipalmitylglycerols showed only a smooth fracture surface, however, when mixed with dipalmitoylphosphatidylcholine. In the fractured face of dispersions composed of egg yolk phosphatidylcholine and glucosyl dipalmitylglycerol, particles having a diameter of 3-6 nm, instead of tubular structures, were observed, suggesting that the occurrence of tubular structure may depend on the fatty acid compositions of the mixtures. A mixture of dipalmitoylphosphatidylcholine and galactosylceramide did not show any distinct tubular or globular structures on the fractured face. These findings indicate that structure in the polar group of molecules as well as structure in the non polar group may be important for the formation of a non-bilayer, tubular structure. PMID- 6841324 TI - Amino acid sequence studies of the light subunit of methylamine dehydrogenase from Pseudomonas AM1: existence of two residues binding the prosthetic group. AB - The methylamine dehydrogenase from Pseudomonas AM1 is a tetramer composed of two subunits, light(L)- and heavy-subunits. The amino acid sequence of the L-subunit was determined by sequence analyses of trypsin, chymotrypsin, staphylococcal protease, and thermolysin peptides of Cm-protein. The subunit consisted of a single polypeptide chain of 129 amino acid residues, with alanine and serine at the amino(N)- and carboxyl(C)-terminus, respectively. Yellow-colored peptides containing a prosthetic group were composed of two polypeptide chains and the prosthetic group was covalently bound to two residues at positions 55 and 106, which could not be identified yet. The molecular weight of the subunit was 13,500 excluding the binding residues and the prosthetic group. Various structural features are discussed. PMID- 6841325 TI - Toyopearl HW-65C: ammonium sulfate as a new column chromatographic adsorbent for enzyme purification. AB - We found that Toyopearl HW-65C gel matrix adsorbed ferredoxin and ferredoxin NADP+ reductase in the presence of concentrated ammonium sulfate. Ferredoxin was strongly adsorbed on the gel in 80% saturated ammonium sulfate, and ferredoxin NADP+ reductase was adsorbed in 40% saturated ammonium sulfate. The phenomenon was utilized for purification of ferredoxin and the reductase on a Toyopearl HW 65C: ammonium sulfate column. The technique greatly simplified the early stage of purification of ferredoxin and the reductase. The improved purification methods further involved column treatments with DEAE-Toyopearl 650M and Matrex Red A. The effectiveness of the columns is reported. Since a number of other proteins such as cytochrome c, myoglobin, chymotrypsinogen A, ovalbumin, and glucose oxidase were also adsorbed well in an appropriately concentrated ammonium sulfate solution, the method may be of general use in enzyme purification. PMID- 6841326 TI - A simple procedure for the purification of calmodulin bound to membranes; calmodulin bound to the particulate fraction of AH-66 hepatoma ascites cells. AB - We have demonstrated the identity of calmodulin tightly bound to the particulate fractions of AH-66 hepatoma cells and normal liver with authentic soluble calmodulin and have compared the particulate calmodulin content of AH-66 cells with that of normal liver. Calmodulin bound to the particulate fractions of the hepatoma and normal liver cells was purified to electrophoretic homogeneity by a simple procedure which involves solubilization of the particulate fractions with LIS, extraction of the solubilized solution with 37.5% phenol, gel filtration, and affinity chromatography on Fluphenazine-Sepharose. There were no detectable differences between the particulate calmodulin thus purified and authentic soluble calmodulin of rat brain. The particulate calmodulin in the hepatoma and normal liver cells was assayed based on its ability to activate calmodulin deficient phosphodiesterase after partial purification of calmodulin from the particulate fractions by solubilization with LIS and extraction with phenol as described above. In addition, the particulate calmodulin content in the hepatoma and normal liver cells was also measured after solubilization of the particulate fractions with Lubrol PX. The results obtained by these two different procedures indicate that calmodulin content in the particulate fraction as well as in the soluble fraction of the hepatoma is significantly higher than that in the corresponding fractions of normal liver. PMID- 6841327 TI - Kinetic studies on the reduction of metmyoglobins by ascorbic acid. AB - The kinetics of the reduction of metmyoglobins by ascorbic acid (H2A) were studied under a nitrogen atmosphere at 25 degrees C, at an ionic strength of 0.30 M (NaCl), and between pH 7.18 and 8.09. Neither Tris-HCl nor phosphate buffers had any effect on the reduction of metmyoglobin. Imidazol and 1-methylimidazol accelerated this reaction, but N3- and CN- ions inhibited it. It is concluded that the reduction of imidazolmetmyoglobin or 1-methylimidazolmetmyoglobin is faster than that of aquametmyoglobin and that neither azidometmyoglobin nor cyanometmyoglobin can be reduced by ascorbate under the present experimental conditions. The second-order rate constants were determined for the reductions of aqua-, imidazol-, and 1-methylimidazolmetmyoglobin by ascorbate (HA- and A2-). The higher reactivity of imidazolmetmyoglobin with ascorbate may be due to the easy transfer of an electron of ascorbate to partially exposed imidazol or porphyrin ring because of expansion of the heme pocket induced by the coordination of imidazol. PMID- 6841328 TI - Inhibition of p-hydroxybenzoate hydroxylase by anions: possible existence of two anion-binding sites in the site for reduced nicotinamide adenine dinucleotide phosphate. AB - Certain anions were found to inhibit p-hydroxybenzoate hydroxylase from Pseudomonas desmolytica. The inhibition was of competitive or mixed type with respect to NADPH (apparent Ki = 4-30 mM). Among the anions, monovalent anions such as halogen ions and azide inhibited ionization of the phenolic hydroxyl group of the substrate (p-hydroxybenzoate) on binding with the enzyme . substrate complex of p-hydroxybenzoate hydroxylase, without dissociating the substrate from the enzyme. On the other hand, multivalent anions (anions of polybasic acids), such as inorganic phosphate, borate, and sulfate, did not inhibit the ionization. Halogen ions induced remarkable spectral changes in the FAD moiety of the enzyme on binding, while the change due to inorganic phosphate was only slight. Chloride inhibited the binding of NADH with the enzyme as well as that of NADPH, whereas borate inhibited the binding of only NADPH. These results indicate that the monovalent and multivalent anions probably bind to the sites in the enzyme which interact, respectively, with the pyrophosphate and 2'-phosphate moieties of NADPH. The results provide strong support for the catalytic mechanism in which the phenolate anion of p-hydroxybenzoate participates in the process of substrate hydroxylation by C (4a) peroxyflavin. The results also suggest that repeated ionization/neutralization of the phenolic hydroxyl group of the substrate may occur during one cycle of the catalytic turnover. PMID- 6841329 TI - Release of tetrodotoxin and paralytic shellfish poison from puffer liver by RNase. AB - A nontoxic high-molecular fraction was separated from the extracts of toxic liver of a puffer, Takifugu poecilonotus, by Sephadex G-50 gel filtration. This fraction became toxic when digested with RNase T2. The toxins were partially purified by activated charcoal treatment, followed by chromatography on Bio-Gel P 2 and Bio-Rex 70, and were analyzed by TLC and electrophoresis. The results showed that most of the toxicity is accounted for by tetrodotoxin, and the remainder by saxitoxin and other unidentified toxins. The corresponding high molecular fraction separated from nontoxic liver of another puffer, T. rubripes, did not release any toxin on RNase digestion. PMID- 6841330 TI - Detection of DNA replicase activity in rat thymoma cells. AB - A DNA polymerase which was active with unprimed poly(dC) as a template was detected in the DNA polymerase alpha fraction from rat thymoma tissue. The activity was dependent on rGTP and associated with ribonucleotide polymerizing activity. The activity was partially sensitive to aphidicolin and dideoxy GTP and resistant to alpha-amanitin. Thus, this is a rat "replicase" which is very similar to that found in mouse cells. The replicase activity with poly(dT) or phage fd single stranded circular DNA was greatly enhanced by the mouse replicase stimulating factor beyond the species difference. PMID- 6841331 TI - Isolation and characterization of Physarum profilin. AB - A protein that functionally resembles mammalian and Acanthamoeba profilins, has been purified from Physarum plasmodia. Physarum profilin consists of a single polypeptide with a molecular weight of 11,000-13,000. It has an isoelectric point of 5.35-5.40 under denaturing conditions. The amino acid composition of this protein is similar to those of profilins isolated from other sources. Physarum profilin prolongs the process of actin polymerization in a concentration dependent fashion. This effect is much stronger for Physarum G-actin than for muscle G-actin. PMID- 6841332 TI - Increase in norepinephrine-induced formation of phosphatidic acid in rat vas deferens after denervation. AB - Surgical denervation of rat vas deferens causes supersensitivity in that the tissue sensitivity and the maximum response to a variety of agonists increase. To understand the molecular mechanism of supersensitivity in smooth muscle, norepinephrine(NE)-induced alteration in phospholipid metabolism was studied using control and denervated vasa deferentia. When the tissue was stimulated by NE, only [32P]Pi incorporation into phosphatidic acid(PA) was increased in proportion to the increase in NE concentration without any significant effect on that into other phospholipids. This PA labeling was significantly accelerated by denervation. In the denervated tissue, PA labeling was stimulated by lower concentrations of NE and the maximum response to NE was increased compared to the control. The breakdown of phosphatidylinositol 4-monophosphate(DPI) and phosphatidylinositol 4,5-diphosphate (TPI) was also accelerated by NE. But the influence of denervation on this NE-induced DPI and TPI was not marked. Therefore, it is likely that denervation clearly enhanced NE-induced PA labeling without an appreciable effect on that of the other phospholipids. Furthermore, the absolute amount of PA was also increased by NE, and this increase was exaggerated by denervation. Considering that PA can behave as a Ca2+ ionophore in the plasma membrane, these results suggest that the stimulated accumulation of PA plays an important role in receptor-linked supersensitivity in smooth muscle. PMID- 6841333 TI - Decrease in adipose S-100 protein levels by epinephrine in rat. AB - Soluble S-100 protein levels in epididymal adipose tissue of male rats (1.3 +/- 0.1 micrograms/mg protein) were markedly decreased (to 0.15 +/- 0.06 microgram/mg protein) by serial injection of epinephrine (0.1 mg/day for 9 days). But injection of insulin in a similar manner (4 U/day for 9 days) had little effect on the adipose S-100 protein levels (1.1 +/- 0.2 micrograms/mg protein). The S 100 protein levels in cerebrum, spleen, and adrenal gland were not affected by epinephrine or insulin administration. These results strongly suggested that S 100 protein levels in adipose tissue are regulated hormonally. PMID- 6841334 TI - Secondary ion mass spectra of neutral sphingoglycolipids. AB - Secondary ion mass spectra of underivatized neutral sphingoglycolipids are presented. In the spectra of mono- and di-glycosylceramide, ions (M + H)+ and (M + H-H2O)+ were observed as relatively intense quasimolecular ions, whereas in the spectra of higher glycolipids, the quasimolecular ion species were predominantly (M + Na)+. Ions due to the ceramide moiety were observed as intense peaks comparable to quasimolecular ions. Ions derived from the fragments cleaved at the glycosidic linkages were hardly detected due to their low intensities. In general, secondary ion mass spectrometry provides good stable spectra for a long time during analysis. PMID- 6841335 TI - 1,1,3,3-Tetramethylurea and triethanolamine as a new useful matrix for fast atom bombardment mass spectrometry of gangliosides and neutral glycosphingolipids. AB - Analysis of gangliosides from bovine brain was successfully performed by a newly developed method of fast atom bombardment mass spectrometry (FAB-MS). The use of triethanolamine with a few drops of 1,1,3,3-tetramethylurea as the matrix solution gave intense molecular ions of intact gangliosides tested, namely, GM1 and GD1a, corresponding to (M + Na)+ and (M + 2Na-H)+. Glycerol, that is usually used as a matrix solution for FAB-mass spectrometry, was not suitable for the analysis of gangliosides. Along with the molecular ion species, the ions pertaining to the carbohydrate sequence also appeared on the spectrum. The method was found to be useful for structural analysis using intact molecules of gangliosides and neutral glycosphingolipids. PMID- 6841336 TI - Sex-related difference in the hepatic glutathione level and related enzyme activities in rat. AB - Age and sex differences in the hepatic glutathione level and related enzyme activities in rats of both sexes were investigated. At 7 weeks of age there was no significant difference in GSH levels between males and females, although a higher level of intracellular GSH was observed in male rats at 12 weeks of age. Hepatic gamma-glutamyl transpeptidase activities were significantly higher in females than in males at only 7 weeks of age. Glutathione peroxidase showed higher activities in females than in males. Conversely, glutathione S transferase, glutathione reductase and glutathione synthesis rates were markedly higher in males than in females. PMID- 6841337 TI - Affinity chromatography of chymotrypsin on a sepharose derivative coupled with a chymostatin analogue. AB - A Sepharose derivative coupled with a chymostatin analogue, Gly-Gly-L-Leu-L phenylalaninal (Pheal), was prepared. A number of native and chemically modified proteases were applied on a column of the adsorbent. Bovine chymotrypsins [EC 3.4.21.1] and Streptomyces griseus protease B were adsorbed strongly at pH 8.2. The affinities of these enzymes under various conditions were measured quantitatively by frontal chromatography in terms of the dissociation constant (Kd) of the enzyme-immobilized ligand complex. The pH dependence of the Kd value of alpha-chymotrypsin was consistent with that of the inhibition constant (Ki) of the enzyme for a corresponding soluble peptide aldehyde. Anhydro-chymotrypsin, in which the active site Ser-195 is converted to dehydroalanine, was not adsorbed. Ser-195 proved to be essential for the binding. The frontal chromatography method also gave the amount of the immobilized ligand that can interact with the enzyme. It was extremely small compared with the amount of the immobilized ligand determined by amino acid analysis. This was explained on the basis of the structural features of the agarose gel. PMID- 6841338 TI - Characterization of anion permeability in AH-66 hepatoma ascites cells. AB - The sulfate transport in AH-66 hepatoma ascites cells was examined under various controlled conditions using 35SO42- as a tracer. The sulfate efflux rate was dependent on temperature, pH and anion species of the cell suspending medium. The efflux rate became saturated as the concentration of extracellular anions was increased. The efflux of anion was inhibited by some chemical reagents specifically reactive with amino or sulfhydryl groups. The results obtained in this study suggest that sulfate anions were transported by a facilitated transport system(s), and that some membrane protein(s) is involved in the anion transport system(s) of AH-66 cells. Both amino and sulfhydryl groups are thought to play a determinant role at the sulfate transport site in AH-66 cells. PMID- 6841339 TI - Interpretation of the stokes radius of macromolecules determined by gel filtration chromatography. AB - From a comparison of the gel chromatographic properties of large randomly-coiled polypeptides in 6 M guanidine hydrochloride and of large globular proteins, we found that the distribution coefficient was more closely correlated with the intrinsic viscosity-based Stokes radius than with the translational frictional coefficient-based Stokes radius. This means that the effect of the hydrodynamic flow of dissolved molecules during gel chromatography should be considered. The ratio of transport of solute by bulk flow as compared with that by net diffusion (i.e., Brownian motion) is large under some conditions. On the other hand, we consider that the distribution coefficient obtained in static equilibrium experiments should be determined by the translational frictional coefficient based Stokes radius, since the solvent does not flow. On this basis, we discuss the meaning of the Stokes radius and the separation mechanism of macromolecules by gel filtration. PMID- 6841342 TI - Isolation of three creatine kinases MM from porcine skeletal muscle. AB - The purified creatine kinase MM of porcine skeletal muscle [Takasawa, T. & Shiokawa, H. (1981) J. Biochem. 90, 195-204] was separated into three distinct fractions by isoelectric focusing (IEF) in a sucrose gradient column, and the three active fractions were isolated by repeated IEF. There were one major fraction with isoelectric point (pI) 6.57 and two minor fractions with pI 6.74 and pI 6.34, respectively. No differences were observed in the IEF pattern of the enzyme in the presence and absence of dithiothreitol throughout the column. There was no interconversion from one form to another during IEF. The distribution of the three forms on IEF was not affected by adding protease inhibitor to the extraction medium. Of the three fractions, the major fraction had the highest specific activity. The three fractions differed from one another in their amino acid compositions. Not only porcine muscle but also rabbit muscle creatine kinase displayed this type of heterogeneity. Such microheterogeneities may occur widely in muscle creatine kinases. PMID- 6841340 TI - Characterization of the thymidine kinase of Physarum polycephalum. AB - Thymidine kinase [ATP: thymidine 5'-phosphotransferase, EC 2.7.1.21] has been purified more than 3,500 fold from microplasmodia of Physarum polycephalum. Properties of the enzyme were determined on preparations purified 1,400 fold. Thymidine was transformed to dTMP while a stoichiometric quantity of ATP was transformed to ADP. 5-Iododeoxyuridine, 5-bromodeoxyuridine, and 5 fluorodeoxyuridine acted as competitive inhibitors for the thymidine substrate while 5-bromodeoxyuridine could be used as a substrate. In contrast uridine did not inhibit the enzymatic activity while deoxyuridine was a very poor competitive inhibitor in agreement with the observation that deoxyuridine could not be used as a substrate. Two apparent Michaelis constants were found for thymidine. Only the highest Michaelis constant could be decreased in the presence of increasing concentrations of ATP. Among the various nucleoside mono, di, or triphosphates studied only ATP and to a less extent dATP could be used as phosphate donors. A non competitive inhibition for thymidine was observed with dTTP. dTMP, dTDP, and dTTP acted as competitive inhibitors for ATP. None of the nucleoside mono, di, or triphosphates studied showed an activatory effect at low concentrations of ATP, even in the presence of dTTP. However, dUTP and dGDP acted as competitive inhibitors for ATP. PMID- 6841341 TI - Chymotryptic subfragments of troponin T from rabbit skeletal muscle. Interaction with tropomyosin, troponin I and troponin C. AB - The binding of the chymotryptic troponin T subfragments to tropomyosin, troponin I, and troponin C was semiquantitatively examined by using affinity chromatography, and also by co-sedimentation with F-actin and polyacrylamide gel electrophoresis in 14 mM Tris/90 mM glycine. Circular dichroism spectra of the subfragments were measured to confirm that the subfragments retained their conformational structures. Based on these results, the binding sites of tropomyosin, troponin I, and troponin C on the troponin T sequence were elucidated. Tropomyosin bound mainly to the region of troponin T1 (residues 1 158) with the same binding strength as to the original troponin T. The C-terminal region of troponin T (residues 243-259) was the second binding site to tropomyosin under physiological conditions. The binding site of troponin I was concluded to be the region including residues 223-227. The binding of troponin C was dependent on Ca2+ ion concentration. The C-terminal region of troponin T2 (residues 159-259) was indicated to be the Ca2+-independent troponin C-binding site and the N-terminal side of troponin T2 to be the Ca2+-dependent site. PMID- 6841343 TI - Dimer structure of three creatine kinases MM from porcine skeletal muscle. AB - Three active fractions, FI, FII, and FIII, of porcine muscle creatine kinase MM isozyme, which had been isolated as single peaks by repeated isoelectric focusing (IEF), were subjected to reconstitution experiments to study their dimer structure. The specific activities of the three fractions were almost uninfluenced by a dissociation-reassociation procedure. Only one component was observed on IEF after reassociation of the subunits of FII. Three components were observed on IEF after reassociation of subunits of FI and FIII. These results show that FII, with isoelectric point (pI) 6.57, has a homodimeric structure (M2M2), consisting of two identical subunits. FI and FIII, with pI 6.74 and pI 6.34, respectively, have heterodimeric structures (M1M2 and M2M3, respectively), consisting of two nonidentical subunits. PMID- 6841344 TI - 8-Fluoro-8-demethylriboflavin as a potential active-site-directed reagent for flavoprotein. Reaction with some amino acids. AB - 8-Fluoro-8-demethylriboflavin was shown to be a potential active-site-directed reagent for flavoproteins. It reacted with the nucleophiles of N-acetylcysteine ( SH), N-acetyltyrosine (-OH), alpha-N-acetyllysine, and glycine (epsilon- and alpha-NH2, respectively) under fairly mild conditions, and the reaction products were identified. The reactivity of the fluoroflavin was higher than that of 8 chloro-8-demethylriboflavin, which reacted only with the cysteine derivative among the amino acid derivatives used, and whose pseudo first order rate constant at 23 degrees C was 1/23 of that of the fluoroflavin. The reactivity of the fluoroflavin was also estimated by 13C and 19F NMR spectroscopy. The results showed that this compound is more reactive than the chloroflavin. PMID- 6841345 TI - Biosynthesis and turnover of carnitine acetyltransferase in rat liver. AB - Male Wistar rats were fed on a diet with and without di(2-ethylhexyl)phthalate (DEHP) for 2 weeks. Carnitine acetyltransferase in the liver was increased about 100-fold by administration of DEHP. The results of in vivo experiments showed that the incorporation of L-[4,5-3H]leucine into the enzyme was 12-fold higher and the half-life of the labeled enzyme was elongated by a factor 4.6. The results of in vitro translation experiments with total hepatic RNA in a rabbit reticulocytelysate system and the results concerning the synthesis of the enzyme in isolated hepatocytes indicate that the translatable mRNA for the enzyme was increased upon administration of DEHP and that the enzyme is synthesized as a precursor (Mw = 69,000) larger than the mature enzyme (Mw = 67,500). RNA in the free polysomes directed the synthesis of the enzyme precursor five times more actively than RNA in membrane-bound polysomes. PMID- 6841346 TI - Investigation of actin in Tetrahymena cells. A comparison with skeletal muscle actin by a devised two-dimensional gel electrophoresis method. AB - Total protein constituents of Tetrahymena thermophila strain B1868 III were studied by two-dimensional agarose-polyacrylamide gel electrophoresis to detect actin among the constituents. In the attempts to prepare a whole-cell extract of Tetrahymena, it was found that protease activity in the extract was so high that high molecular components were quickly digested with the endogenous protease into small peptides unless the homogenization and heat-treatment in a sodium dodecylsulfate solution were performed within 5 s. It was eventually found that employment of 8 M guanidine hydrochloride (HCl) in the homogenization of cells perfectly prevented the degradation of protein components, even through a long preparation procedure. A devised two-dimensional agarose-polyacrylamide gel electrophoresis of the guanidine HCl extract gave a 'protein map' on which most proteins were located in their respective positions, including proteins with more than 200,000 mol. wt. Addition of rabbit skeletal muscle actin on the protein map revealed that no protein with isoelectric point and molecular weight identical with those of the actin was contained in the whole Tetrahymena extract, suggesting that Tetrahymena actin may have characteristics far different from those of skeletal muscle actin. PMID- 6841347 TI - Amino acid sequence of a trypsin-chymotrypsin inhibitor, B-III, of peanut (Arachis hypogaea). AB - The amino acid sequence of peanut trypsin-chymotrypsin inhibitor, B-III, was determined by conventional methods. The limited proteolysis of B-III with trypsin indicated the reactive sites of B-III for trypsin to be Arg(10)-Arg(11) and Arg(38)-Ser(39). Comparison of the established sequence of B-III with those of other Bowman-Birk type double-headed protease inhibitors indicated that B-III has four amino acid insertions and one amino acid deletion. It is especially interesting that the amino acid residue in the P1' position (No. 11) of the first reactive site for trypsin is arginine instead of serine, which seems to be conserved at the P1' position of the reactive sites of all Bowman-Birk type protease inhibitors. PMID- 6841348 TI - Quantitative analysis of calcium binding to porcine intestinal calcium-binding protein. AB - An equilibrium dialysis study has revealed that porcine intestinal calcium binding protein (CaBP) has two binding sites for Ca2+ whose dissociation constants (Kd) are the same, 0.56 microM. The intrinsic fluorescence spectrum of the CaBP shows a peak (at 303 nm) in tyrosine band. Ca2+ binding to the CaBP induces a monophasic increase in the intensity of intrinsic fluorescence without any shift to either excitation or emission maximum. The change in the fluorescence intensity induced by Ca2+ binding is complete at a bound Ca2+/CaBP molar ratio of about 2, and the apparent Kd value is 0.51 microM. The same bound Ca2+/CaBP molar ratio has been obtained from the maximal changes in UV absorption and CD spectrum of the CaBP upon addition of Ca2+. A CD study has shown an about 5% increase in alpha-helix content in the CaBP at the maximal binding of Ca2+. All these results indicate that the porcine intestinal CaBP has two high-affinity binding sites with equal affinity for Ca2+ and suggest that it undergoes a quantitative conformation change accompanying Ca2+ binding in the vicinity of single tyrosine and phenylalanine residues of the protein molecule. PMID- 6841349 TI - Complete amino acid sequence of a basic proline-rich peptide, P-D, from human parotid saliva. PMID- 6841350 TI - Purification and properties of adenosine 5'-triphosphate-dependent deoxyribonuclease from Thermus thermophilus HB8. AB - An ATP-dependent DNase has been purified from Thermus thermophilus HB8 by a procedure involving streptomycin precipitation, DEAE-cellulose chromatography, Sephadex G-200 gel filtration and heparin-agarose affinity chromatography. ATP dependent DNase activity was separated into two distinct peaks, Peak A and Peak B, by heparin-agarose affinity chromatography. Each peak fraction was further purified by ATP-agarose affinity chromatography. Peak A and Peak B were eluted from an ATP-agarose column at 0.14 M and 0.28 M KCl, respectively, each as a single peak. Both enzyme activities require ATP and Mg2+ for the degradation of double- and single-stranded DNAs, and degrade denatured DNA about 1.5 times faster than native DNA. The two peaks are optimally active at 69 degrees C and have similar optimal pH ranges from 8.2 to 9.2. The two purified peaks were unstable on storage at -20 degrees C, but were remarkably stabilized by addition of 0.4 mg/ml bovine serum albumin. Ammonium sulfate strongly inhibits the activities of both peaks. The molecular weights of Peak A and Peak B are about 170,000 as estimated by glycerol gradient sedimentation. The average chain lengths of denatured DNA produced by Peak A and Peak B were 4.2 and 3.6, respectively, and the products were terminated by 5'-phosphoryl and 3'-hydroxyl groups. The limit-digested products of denatured DNA produced by Peak B consist of mono-, di-, tri-, tetra-, and pentanucleotides along with some larger fragments. The mode of action of both activities is processive and Peak A does not attack double-stranded circular DNA. PMID- 6841351 TI - Artificial structure of chromatin derived in the preparation process. AB - Nuclei were isolated from mouse lymphoma L5178Y cells in the exponential growth phase, and chromatin was prepared by mechanical treatment of the nuclei. The nuclei and the chromatin were then digested to various extents with micrococcal nuclease and the resulting mono- and dinucleosome fractions of the two preparations were compared. During progressive digestion mononucleosomes from chromatin retained H1 histone and a DNA length of 165 base pairs, whereas those from nuclei released H1 histone and the length of their DNA decreased to 140 base pairs at an early stage of digestion. These nucleosomal preparations were always associated with nonhistone proteins. The dinucleosomes from nuclei contained larger amounts of nonhistone proteins than those from chromatin, but half of these proteins was released during the process of cleavage into mononucleosomes. The final mononucleosome preparation from nuclei retained 20% less nonhistone proteins than that from chromatin. The contents of nonhistone proteins in mono- and dinucleosomes from chromatin were the same. The electrophoretical distributions of molecular species of nonhistone proteins in mononucleosomes from nuclei and chromatin were different from each other: during digestion the profile of the former changed, whereas that of the latter remained constant. It is tentatively concluded that both H1 histone and nonhistone proteins were bound to nucleosomes more or less loosely in intact nuclei in situ, but that when the nuclear structure was disrupted these proteins became more tightly bound. PMID- 6841352 TI - A rapid and simplified method for the preparation of lysosomal membranes from rat liver. AB - A rapid and simplified method for the preparation of lysosomal membranes from rat livers was developed. Enzymic characterization showed that the lysosomal membrane preparation isolated by this procedure was almost free from mitochondria, peroxisomes, and endoplasmic reticulum. Acid phosphatase was used as a marker enzyme for lysosomal membrane, because about 40% of the total acid phosphatase activity in the lysosomes was associated with the membranes. With this method, the yield of the purified membrane was 115 micrograms/g wet weight of liver and the relative specific activity of acid phosphatase in the purified membrane was 105-110. On SDS-polyacrylamide gel electrophoretic analysis, the purified membrane revealed glycoprotein bands in the region of M.W. between 60,000 and 110,000, which were characteristic of the tritosomal membrane. Our lysosomal membrane preparation was compared with lysosomal membranes prepared from normal rat liver lysosomes isolated by the method of Wattiaux et al. [(1978) J. Cell Biol. 78, 349-368]. Although the specific activity of acid phosphatase in our membrane preparation was higher than that in the membrane prepared by the existing method, the electrophoretic profiles of both membrane preparations were quite similar. PMID- 6841353 TI - Purification and properties of 2-pyrone-4,6-dicarboxylate hydrolase. AB - A hydrolase which catalyzes specifically the interconversion between 2-pyrone-4,6 dicarboxylate and 4-oxalmesaconate was purified about 410-fold with a 16% yield from cell-free extracts of Pseudomonas ochraceae grown with phthalate. Upon disc gel electrophoresis, the enzyme preparation gave a single band which was coincident with the enzyme activity. The molecular weight of the enzyme was estimated to be 31,000 by gel filtration on Sephadex G-75 and 33,000 by sodium dodecyl sulfate gel electrophoresis. The isoelectric point of the enzyme was determined to be at pH 5.49 by isoelectric focusing. The enzyme is specific for 2 pyrone-4,6-dicarboxylate, and various other lactones did not serve as substrates. The stoichiometry of 2-pyrone-4,6-dicarboxylate hydrolysis, 4-oxalmesaconate formation and proton production was approximately 1:1:1. The optimum pHs are 8.5 and 6.0 for hydrolysis and synthesis of 2-pyrone-4,6-dicarboxylate, respectively. Km values are 87 and 26 microM for 2-pyrone-4,6-dicarboxylate and 4 oxalmesaconate, respectively. At pH 8.5, the ratio of 4-oxalmesaconate to 2 pyrone-4,6-dicarboxylate at equilibrium is about 2.2. Thiol reagents such as HgCl2 and p-chloromercuribenzoate strongly inhibit the enzyme activity. PMID- 6841354 TI - Enzymes responsible for degradation of 4-oxalmesaconic acid in Pseudomonas ochraceae. AB - The enzyme responsible for the degradation of 4-oxalmesaconate was partially purified from Pseudomonas ochraceae grown with phthalate. Column chromatography on DEAE-cellulose caused separation into two distinct enzymes, I and II. 4 Oxalmesaconate was converted into pyruvate and oxalacetate in the presence of MgCl2 and enzymes I and II. Optimum pH of the reaction was observed at pH 8.2 in Tris-HCl buffer. MgCl2 could be replaced by MnCl2 or CoCl2. Both enzymes were stable to heat-treatment at 65 degrees C for 10 min. Analyses of time course, products and substrate specificity of the enzyme reaction accounted for the functions of two enzymes. Enzyme I (molecular weight 55,000, isoelectric point 5.1) hydrated 4-oxalmesaconate to give 4-oxalcitramate and may be classified as a hydrolyase. Enzyme II (160,000, 5.0) catalyzed the aldolitic cleavage of 4 oxalcitramalate to pyruvate and oxalacetate in the presence of MgCl2. Enzyme II also cleaved 4-hydroxy-4-methyl-2-oxoglutarate into pyruvate. Stoichiometry of the enzyme reaction suggested that enzyme II-catalyzed cleavage occurred on only one enantiomer of the substrates. Furthermore, the metabolic pathway for the dissimilation of protocatechuate in P. ochraceae is presented and discussed in comparison with the pathway postulated previously by other workers. PMID- 6841355 TI - Role of endogenous lipid droplets of fat cells in epinephrine-induced lipolysis. AB - Endogenous lipid droplets were prepared by subjecting fat cells to hypotonic shock and to Triton X-100 treatment. The structure of the endogenous lipid droplet fraction was examined by scanning and transmission electron microscopies. Neither intact fat cells nor disrupted cell membranes were detectable in the endogenous lipid droplet fraction. With this endogenous substrate, epinephrine elicited lipolysis with either hormone-sensitive lipase or lipoprotein lipase, but no cyclic AMP-protein kinase mediated stimulation of lipolysis was observed. On the other hand, epinephrine did not stimulate lipolysis when triolein emulsified with arabic gum was used as substrate. With the latter exogenous substrate, however, cyclic AMP-protein kinase was found to stimulate lipolysis with hormone-sensitive lipase as enzyme. These results agree with the proposal of Wise and Jungas that the epinephrine-stimulated increase of hydrolysis of endogenous fat is not mediated through cyclic AMP-protein kinase. A possible mechanism of hydrolysis of endogenous fat by induction of lipolysis by epinephrine in fat cells is discussed. PMID- 6841356 TI - Role of polyamines in expression of the differentiated phenotype of chondrocytes: effect of DL-alpha-hydrazino-delta-aminovaleric acid (DL-HAVA), an inhibitor of ornithine decarboxylase, on chondrocytes treated with parathyroid hormone. AB - Previously, it was demonstrated that parathyroid hormone (PTH) induces a series of events, successive increases of the level of cyclic AMP, the activity of ornithine decarboxylase [ODC; EC 4.1.1.17] and glycosaminoglycan synthesis, a characteristic chondrocyte phenotype, in rabbit costal chondrocytes in culture. Cyclic AMP analogues also increase ODC activity and glycosaminoglycan synthesis in these cells. Therefore, in the present work, the role of polyamines in expression of the differentiated phenotype of chondrocytes was investigated. DL alpha-Hydrazino-delta-aminovaleric acid (DL-HAVA), a potent inhibitor of ODC, inhibited the increase in polyamine levels of quiescent cultures of chondrocytes treated with PTH. DL-HAVA also inhibited stimulation of expression of the differentiated phenotype of chondrocytes by PTH, as judged by decreases in glycosaminoglycan synthesis and metachromasia on toluidine blue staining. Similarly, DL-HAVA inhibited stimulation of expression of the differentiated phenotype of chondrocytes by dibutyryl cyclic AMP. The inhibitory effect on expression of the differentiated phenotype of chondrocytes by DL-HAVA was effectively diminished by addition of polyamines. Under the same conditions, PTH, DL-HAVA, or polyamines had little effect on DNA synthesis. These findings suggest that the rise in polyamine levels induced by PTH, which is mediated by an increase of cyclic AMP concentration, is essential for expression of the differentiated phenotype of chondrocytes. PMID- 6841357 TI - The Ca2+-dependent dissociation of [3H]dopamine bound to an acidic glycoprotein present in the synaptosomal cytoplasm of rat brain. AB - The interaction of [3H]dopamine with acidic proteins present in the synaptosomal cytoplasm of rat brain was studied from the point of view of Ca2+-dependent release of dopamine as a neurotransmitter. Some of the proteins were glycoproteins and showed various affinities for [3H]dopamine. [3H]Dopamine bound to an acidic protein with a molecular weight of about 45,000 daltons became reversibly unbound in the presence of Ca2+, while that bound to other proteins did not. The amount of [3H]dopamine bound to the 45,000-dalton glycoprotein was 48.7 pmol/mg protein, and the Ca2+-concentration required to release half of the bound dopamine was found to be 0.2 to 0.25 mM under the experimental conditions. However, Ca2+ did not bind to any component of the acidic proteins and it is likely that the cation dissociates the bound dopamine by forming a complex with it. No calmodulin (-like protein) was detectable among the acidic proteins. Possible roles of the glycoproteins are discussed in relation to a Ca2+-dependent mechanism of neurotransmitter release. PMID- 6841358 TI - Human NADH-cytochrome b5 reductases: comparison among those of erythrocyte membrane, erythrocyte cytosol, and liver microsomes. AB - NADH-cytochrome b5 reductases purified from human red cell membranes and cytosol were compared with those prepared from human liver microsomes. Minimal molecular weights of the membrane and the cytosol enzymes as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) were 36,000 and 32,000 daltons, respectively, which are comparable to those of the detergent-solubilized reductase (dfp) and the protease-solubilized one (tfp) of liver microsomes, respectively. All the enzymes contained FAD and had essentially the same turnover numbers and apparent Km values for NADH and protease-solubilized cytochrome b5. The membrane enzyme and liver dfp reduced cytochrome c in the presence of detergent-solubilized cytochrome b5 70-80 times faster than in the presence of trypsin-solubilized cytochrome b5, whereas the cytosol enzyme and liver tfp showed essentially the same low activities with both preparations of cytochrome b5. SDS-PAGE mapping of the limited proteolytic products of the reductases obtained by digestion with staphylococcal protease or a-chymotrypsin showed essentially the same patterns of peptides between the red cell membrane enzyme and liver dfp and between the red cell cytosol enzyme and liver tfp. These results suggest that the NADH-cytochrome b5 reductase of human red cell membranes is identical with that of liver microsomes and that the enzyme of red cell cytosol is a proteolytic product of the membrane enzyme. PMID- 6841360 TI - Partial purification and properties of phospholipase A2 from rat liver mitochondria. AB - Phospholipase A2 of rat liver mitochondria was purified approximately 1,400-fold by extraction with KCl, and chromatographies on a Sephadex G-75 column and a diacyl-glycerophosphocholine-Sepharose affinity column. The purified enzyme was very labile when incubated either at 37 degrees C or 0 degrees C, and lost its activity within a few hours. Phospholipids or detergents in the solution protected the enzyme against inactivation. The purified phospholipase A2 preferentially hydrolyzed phosphatidylethanolamine, especially if it contained linoleic acid. The enzyme showed low activity for phosphatidylcholine or phosphatidylinositol. PMID- 6841359 TI - A novel trisialosyl ganglioside, IV3 alpha (NeuAc)3nLcOse4Cer, from hog kidney cortex. PMID- 6841361 TI - Bundling of microtubules in vitro by a high molecular weight protein prepared from the squid axon. AB - A high molecular weight protein has been partially purified from sheaths of squid giant axons. This protein fraction was capable of restoring the membrane excitability of the squid axon which had been destroyed by internal perfusion of microtubule poison, when perfused along with microtubule proteins (Matsumoto et al. (1979) J. Biochem. 86, 1155-1158). This protein, designated as 260 K protein, was purified by gel filtration and Con A-Sepharose affinity chromatography. The apparent molecular weight of the axonal protein was estimated to be 260,000 by electrophoresis in the presence of sodium dodecylsulfate. This protein was revealed to be a glycoprotein. When phosphocellulose-purified tubulin was incubated with 260 K protein at 36 degrees C in the presence of dimethylsulfoxide, turbidity of the solution was much increased. 260 K protein co sedimented with microtubles assembled from purified tubulin. Light microscopic and electron microscopic observations revealed that the high turbidity was due to bundling of microtubules which was caused by 260 K protein. On the other hand, the effect of this protein on the turbidity increase was not so prominent when microtubules were assembled from microtubule proteins consisting of tubulin and microtubule-associated proteins. High shear and low shear viscometry and co sedimentation experiments revealed that 260 K protein had little effect on actin polymerization under the same medium conditions as used in tubulin polymerization. PMID- 6841362 TI - Occurrence of acid-labile sulfide in cadmium-binding peptide 1 from fission yeast. AB - Two kinds of Cd-binding peptides (Cd-BP1 and Cd-BP2) are induced in fission yeast upon addition of CdCl2 to the culture medium (l). It was also reported that Cd BP1 and Cd-BP2 consisted of the same components, unit peptides (Cys3, Glu3, Gly1) and Cd atoms, though the respective amounts of components in each molecule were different (1, 2). Now, we have found that Cd-BP1 contains about 1 mol of acid labile sulfide per mol, and Cd-BP2 contains no labile sulfide. The existence of the labile sulfide explains the unique physicochemical characteristics of Cd-BP1. Since acid-labile sulfide has not been found in metallothioneins or other metallothionein-like metal-binding proteins, the occurrence of labile sulfide in Cd-BP1 is the first instance in this field. PMID- 6841363 TI - Dynamics of DNA in chromatin and DNA binding mode to core protein. AB - We have studied the dynamics of DNA in nucleosome core particles and in the linker region of chromatin using nanosecond fluorescence anisotropy decay measurements of intercalated ethidium. DNA in the core undergoes torsional motions to the same extent as the linker DNA in extended chromatin. We therefore concluded that the binding of DNA to the histone octamer is relatively weak or limited to a few points; stretches of at least several tens of base pairs exist which can move as freely as DNA in solution. PMID- 6841364 TI - Effect of surface texture on the soft tissue response to polymer implants. AB - The ion beam etching process produces micro hairlike filaments on PTFE without causing any chemical or physiochemical alterations to the material. Implantation of this textured material subcutaneously, altered the interfacial cells and the kinetics of fibrous capsule development. Interfacial cells associated with textured interfaces (shown to be monocytic phagocytes) display increases in adhesion, vacuolization, filopodia formation, cytoplasmic-to-nuclear ratio, metabolism, acid phosphatase activity, and increased FBGC formation. The fibrous capsule associated with textured implants is reduced in thickness at 8 weeks but is similar to smooth controls at later time periods. The results of this investigation demonstrate that the surface texture of an implant is a critical variable in determining the soft tissue response to a material. PMID- 6841365 TI - A novel process for the manufacturing of porous grafts: process description and product evaluation. AB - A novel process has been developed for the manufacture of porous vascular grafts from solutions or melts of polymers. It allows the manufacture of grafts with controllable porosity, pore size, and mechanical properties. In this process, the polymer melt or polymer solution is extruded through fine orifices; the fibers are then stretched and wound on a rotating mandril. Fiber-fiber bonding takes place, resulting in the formation of stable porous tubes. The effects of the process variables on the physical properties of the resulting graft have been studied and preliminary in vivo evaluation in dogs has demonstrated graft patency with a thin, stable neointima in both small (4 mm) and large (10 mm) caliber configurations. PMID- 6841367 TI - Analysis of deposits on high water content contact lenses. AB - Deposits on soft contact lenses of high water content were investigated morphologically and chemically and compared with those on conventional soft contact lenses of poly (2-hydroxyethyl methacrylate). The material of the lenses examined in this investigation was the crosslinked copolymer of methyl methacrylate and N-vinylpyrrolidone with a water content higher than 70%. Morphologically, the deposits on the lenses with high water content were found to have no characteristics distinguishable from those on conventional lenses. By the electron microscopic observation of the cross section of a lens that had become opaque, it was confirmed that the deposit was on the lens surface and that no deposit was within the lens. Some spots on the lenses were recognized as colonies of microorganisms, but the majority of the spots had no involvement by microorganisms. Surface analysis with Fourier transform infrared spectrometer (FT IR) confirmed that the main component of the filmy deposit was protein. Protein was detected in most of the deposits. The amino acid compositions of the proteins were found to be close to that of lysozyme. From the elemental analysis of several spots, silicon, aluminum, iron, and some other elements were detected. The structural analysis of some spots by a laser Raman microprobe (MOLE) revealed the existence of lipids. In several cases, the deposits were found to have grown around a defect of the lens surface. A mechanism for the formation of deposits is suggested. PMID- 6841366 TI - Structural evidences of the microfilled composites. AB - The new composite concept of microfilled composites has certain advantages, such as polishability, permanent smoothness, and high abrasion resistance. In the mouth, however, these new materials are not perfect and they often fail in stress bearing restorations. In the present study, the weak links and imperfections of these materials are determined by means of direct and indirect SEM techniques. The chemical adhesion between polymer blocks and polymer matrix is questionable; fractures occur most often at the filler-matrix interface. In vivo, there is still a certain preferential wear of the resin matrix. In Estic Microfill, rear weak zones with starlike condensations are observed, which could be related to a certain incompatibility of its composing resins and/or to incomplete and inhomogeneous polymerization. In a fractured Isopast restoration, the polymer blocks are clearly revealed, scattered in a three-dimensional polymerized matrix network. PMID- 6841368 TI - Polymerization kinetics of resin-based restorative materials. AB - The kinetics and mechanism of cure of resin-based restorative materials have been investigated by incorporating into commercial materials additional amounts of inhibitor, initiator, and accelerator. The polymerization was monitored by IR spectroscopy, viscosity measurements, and an oscillating rheometer. The rate of initiation of the polymerization was found to be first order with respect to the initiator and accelerator concentration. The inhibitor was found to be responsible for the induction period during which no polymerization occurred. The duration of this period was proportional to the inhibitor concentration. It was also found that the efficiency of the inhibitor affected the difference between the initial and final set times so that with one particularly effective inhibitor a "snap-set" behavior could be obtained. PMID- 6841369 TI - Setting of dental polyelectrolyte cements--viscosity studies of model systems. AB - In order to gain information on the setting of dental cements, the influence of Ca2+, Mg2+, Zn2+, and Al3+ ions on the viscosity of concentrated solutions of partly neutralized poly(carboxylic acids) has been measured. The increase in viscosity with increasing cation concentration was semi-quantitatively interpreted in terms of chain growth and branching due to intermolecular bridging of the carboxylate groups by the metal ions. The concentration of cation required to produce gelation was considerably greater than expected and may be due to the wastage of cations by the formation of intramolecular links. The incorporation of tartrate ion into the polyacid solution retarded the reaction between Al3+ and the polyacid and may explain some features of the setting of glass ionomer cements. PMID- 6841370 TI - Strength testing of dental stone: a comparison of compressive, tensile, transverse, and shear strength tests. AB - The strength of two dental stones under three standard test regimens and two novel testing modes is reported. It was found under all test regimens that the water/powder ratio significantly affected the strength of the two gypsum products in a similar manner. It was established that the new central fulcrum loading mode gave strength data directly related to that determined in the conventional transverse strength test which requires larger test specimens. PMID- 6841371 TI - In vivo biocompatibility studies. I. The cage implant system and a biodegradable hydrogel. AB - A cage implant system has been utilized to examine the in vivo biocompatibility of a biodegradable hydrogel, poly(2-hydroxy-ethyl-L-glutamine) (PHEG). This system permits the quantitative determination of the components of the inflammatory exudate which surrounds the implanted polymer within the cage system. This system permits the serial examination of exudate components without sacrificing the animal. In addition, this system allows the subsequent removal of the polymer for surface and mechanical studies. Following implantation of the biodegradable hydrogel, quantitative and differential white cell counts of the exudates were determined over a 21-day period. In addition, concomitant extracellular enzyme analyses for alkaline phosphatase, acid phosphatase, prostatic acid phosphatase, leucine amino-peptidase, and Cathepsin B1 were determined. Corresponding control samples from exudates of the cage implant without the polymer were also determined. The two-tailed Student's t-test for unpaired samples was used to statistically compare the control and implanted polymer values for these respective analyses at the various time periods. A comparison of the cellular response for the control system and the PHEG system did not show statistically significant differences during the first 7 days following implantation. The acute inflammatory response, polymorphonuclear leukocyte predominant, was followed by a mild chronic inflammatory response, macrophage and lymphocyte predominant, and during this time period, 8-14 days, macrophages were present in significantly larger numbers for the PHEG system when compared to the control values. Enzymic analysis of the exudates revealed statistically significant differences between control and PHEG values at time intervals where no differences were noted in cell density or population. These results are discussed in terms of cell-polymer interactions leading to cellular activation and enhanced enzyme exocytosis by the inflammatory cells. Stress strain measurements on implanted PHEG samples showed that significant in vivo degradation had occurred during the acute inflammatory phase of the response, i.e., the first 7 days. PMID- 6841372 TI - Preparation of etched tantalum semimicro capacitor stimulation electrodes. AB - The ideal electrode for stimulation of the nervous system is one that will inject charge by purely capacitive processes. One approach is to exploit the type of metal-oxide combination used in electrolytic capacitors, e.g., Ta/Ta2O5. For this purpose, fine tantalum wire (0.25 mm diam) was etched electrolytically at constant current in a methanol solution of NH4Br containing 1.5 wt % H2O. Electrolytic etching produced a conical tip with a length of ca. 0.5 mm and shaft diameters ranging from 0.10 to 0.16 mm. The etched electrodes were anodized to 10 V (vs. SCE) in 0.1 vol % H3PO4. The capacitance values normalized to geometric area of etched electrodes ranged from 0.13 to 0.33 micro F mm-2. Comparison of these values to the capacitance of "smooth" tantalum anodized to 10 V (0.011 micro F mm-2) indicated that the degree of surface enhancement, or etch ratio, was 12-30. The surface roughness was confirmed by scanning electron microscopy studies which revealed an intricate array of irregularly shaped surface projections about 1-2 micrometers wide. The etched electrodes were capable of delivering 0.06-0.1 micro C of charge with 0.1 ms pulses at a pulse repetition rate of 400 Hz when operated at 50% of the anodization voltage. This quantity of charge corresponded to volumetric charge densities of 20-30 micro C mm-3 and area charge densities of 0.55-0.88 micro C mm-2. Charge storage was proportionately higher at higher fractional values of the formation voltage. Leakage currents at 5 V were ca. 2 nA. Neither long-term passive storage (1500 h) nor extended pulsing time (18 h) had a deleterious effect on electrode performance. The trend in electrical stimulation work is toward smaller electrodes. The procedures developed in this study should be particularly well-suited to the fabrication of even smaller electrodes because of the favorable electrical and geometric characteristics of the etched surface. PMID- 6841373 TI - Properties of a heparin-poly(vinyl alcohol) hydrogel coating. AB - Some physical, chemical, and biological characteristics of a heparin-PVA hydrogel potentially useful as a thromboresistant coating for the preparation of small diameter vascular prostheses and blood-sampling catheters have been determined. The molecular weight between crosslinks in the acetal crosslinked gel was approximately 8000, permitting proteins the size of albumin to enter the interior of the gel. The release rate of heparin from a gel containing 7 mg/g gel was 10( 2) micrograms/g min which was significantly lower than the reported minimum required for thromboresistance of ionically heparinized materials. Nevertheless, in vitro biological activity was observed in both thrombin time and plasma recalcification time assays, which could not be attributed to the release of heparin into the incubated plasma. Correlation of final heparin contents with the amount of terminal amino acid residues in three samples of heparin suggests that the heparin is bound to the PVA in the gel through the amino acid terminus; this provides a plausible explanation for the retention of biological activity by the immobilized heparin. PMID- 6841374 TI - Comments on the origin of platelet deposition and on cell adhesion to biomaterial surfaces. PMID- 6841375 TI - Effect of crystallinity of polyamides on adhesion-separation behavior of granulocytes. PMID- 6841376 TI - The dilemma of patient exposure to ubiquitous foreign particles. PMID- 6841377 TI - Unwanted pregnancies amongst teenagers. PMID- 6841378 TI - Behavioural patterns in women requesting postcoital contraception. PMID- 6841379 TI - Orientations towards voluntary childlessness. PMID- 6841380 TI - Artificial insemination by donor: a survey of attitudes and knowledge in medical students and infertile couples. PMID- 6841381 TI - Menstruation and marital sex. PMID- 6841383 TI - Social mobility and psychometric variation in a group of Oxfordshire villages. PMID- 6841382 TI - Demographic and maternal correlates of infant and child mortality in Bangladesh. PMID- 6841384 TI - Admixture and heterozygosity in West Alaskan populations. PMID- 6841385 TI - Repeat and first abortion seekers: single women in Brisbane, Australia. PMID- 6841386 TI - Demography and evolution in an immigrant ethnic community: Hungarian Settlement, Louisiana, USA. PMID- 6841387 TI - Population dynamics among the Totos of West Bengal: a positive response to culture contact. PMID- 6841388 TI - Acute septic arthritis in infancy and childhood. PMID- 6841389 TI - A clinical review of the orthotic treatment of myelomeningocele patients. AB - High myelomeningocele lesions do not preclude an acceptable level of functional walking provided that an integrated programme of surgical treatment and bracing is adopted. Clinical analysis of 100 patients with myelomeningocele shows that the development of the "swivel walker" and "hip guidance orthosis" has been associated with an improved level of function. Over 30 per cent of patients with thoracic lesions and 68 per cent of those with lumbar lesions achieved independent walking. For this reason the criteria used at present by paediatricians to govern the selection of infants for non-active treatment may require reconsideration. PMID- 6841390 TI - The effect of the adolescent growth spurt on early posterior spinal fusion in infantile and juvenile idiopathic scoliosis. AB - Twenty-four children with infantile or juvenile idiopathic scoliosis had their spines corrected and solidly fused posteriorly before the age of eleven years. The growth of the fusion area was then accurately measured for a mean of 4.5 years during the adolescent growth spurt. During this period all longitudinal growth in the posterior elements ceased. The vertebral bodies continued to grow anteriorly, but the thick posterior fusion prevented the development of a lordosis. Initially the anterior growth was accommodated by narrowing of the intervertebral disc spaces, but eventually the vertebral bodies bulged laterally towards the convexity and pivoted on the posterior fusion, giving rise to loss of correction, increasing vertebral rotation and recurrence of the rib hump. PMID- 6841391 TI - The use of induced hypotension to control bleeding during posterior fusion for scoliosis. AB - The operative and anaesthesic technique for 44 patients undergoing posterior spinal fusion with Harrington rod instrumentation for idiopathic scoliosis is described. There were two groups of 21 and 23 patients, matched for diagnosis and status before operation. The management of both groups was similar but in one group anaesthesia with induced hypotension was employed, using a mixture of sodium nitroprusside and trimetaphan. The mean blood loss at operation and after operation in this group was significantly lower than in the other group, with a consequent reduction in the transfusion requirement. No adverse sequelae were observed. All patients showed a drop in haemoglobin concentration after operation, despite clinically adequate blood transfusion. PMID- 6841392 TI - The relationship of complications to the time between myelography and discectomy. AB - This paper describes the relationship between post-myelographic symptoms and the timing of a subsequent spinal operation. A prospective study was performed comparing the post-operative symptoms of patients who underwent discectomy within 48 hours of myelography (Group 1) with those of patients who underwent discectomy at least seven days after myelography (Group 2). After myelography there was no statistical difference in the incidence of nausea and headache in the two groups. However, after operation the incidence of headache and nausea was significantly greater in patients who underwent early discectomy. The incidence of urinary retention was significantly greater in Group 1 at 24 hours after operation but not at 48 and 72 hours. We conclude that the temptation to perform discectomy shortly after myelography should be resisted until at least one week has elapsed between the two procedures, except in emergency situations. PMID- 6841393 TI - Treatment of intertrochanteric fractures of the femur. A comparison of the Richards screw-plate with the Jewett nail-plate. AB - One hundred and seven patients with intertrochanteric fractures of the femur treated with a Richards screw-plate were compared retrospectively with 103 patients treated with a Jewett nail-plate. The mortality and morbidity were similar in the two groups. In patients with comparable fractures, those treated with a Richards device mobilised more quickly and left hospital sooner, and more of them returned to their homes. Failures of stabilisation, both clinically and radiographically, were fewer in this group. The reliability of fixation with a correctly positioned Richards screw-plate could justify the omission of outpatient follow-up in all but a small group of patients with severe unstable fractures or grossly defective bone stock. The higher cost of a Richards implant and the slightly longer operative procedure were outweighed by savings in occupancy of acute and long-stay hospital beds. PMID- 6841394 TI - Mechanical failure of intramedullary nails after fracture union. AB - The case reports of four patients with breakage of the intramedullary nail of the femur are presented. In all four patients the nail broke after consolidation of the fracture of the femoral shaft. All the nails broke at the same place: the junction between the round cross-section and the cloverleaf cross-section. PMID- 6841395 TI - Treatment of femoral fracture in the child with head injury. AB - The outcome of various types of treatment for femoral fracture in children with head injury was studied retrospectively in 51 patients with 56 fractures. Of these, 36 patients (71 per cent) were in deep coma and scored 5 to 7 on the Glasgow scale. Forty-three children (84 per cent) were eventually able to walk freely. Open reduction and internal fixation proved an attractive solution for femoral fractures in children with head injury who could tolerate general anaesthesia: intramedullary nailing was safe and gave satisfactory results in 16 fractures but infection complicated three of the five fractures which were plated. PMID- 6841396 TI - The opposite hip in congenital dislocation of the hip. AB - A retrospective study of the development of the hip opposite a congenitally dislocated hip was carried out to identify at an early age those hips which would develop abnormally. Recognised radiological measurements were used showing the development of the joints with age. The development was compared with that of a control group of normal hips. Single measurements were shown to be unreliable in predicting the development of the hip. A simple hip ratio is proposed which predicts, at an early age and with a high degree of accuracy, the developmental outcome. PMID- 6841397 TI - The sagging rope sign: a critical appraisal. AB - Certain features of the sagging rope sign recently analysed by Apley and Weintroub (1981) are examined in detail. Evidence is presented to show that the line is a radiological shadow cast by the lateral edge of a severely deformed femoral head rather than a condensation of the spongiosa within the neck. An explanation is offered to explain the common association of the presence of this radiological sign with premature epiphysial fusion. PMID- 6841398 TI - Domiciliary gallows traction for femoral shaft fractures in young children. Feasibility, safety and advantages. AB - Over 15 years (1967 to 1982) 140 uncomplicated femoral shaft fractures in children under four years of age were successfully treated using Bryant's traction. Forty of these children were treated after the introduction of the domiciliary management policy in 1976; 13 children were managed at hospital and 27 were managed at home. No significant complications occurred. The advantages to the family, and the safety and economy of domiciliary management lead us to recommend its adoption in favourable cases. Treatment at home relies on an efficient and experienced home nursing service. Possible complications of the injury and treatment with recommendations to prevent them are discussed. PMID- 6841399 TI - Surgical reconstruction of the upper limb in traumatic tetraplegia. A review of 41 patients. AB - A review is presented of 41 patients with traumatic tetraplegia on whom reconstructive surgery of the upper limb was carried out. Twelve patients were followed up for more than 10 years after operation and the average period overall was seven and a half years. Tendon transfers were made with the aim of providing extension of the elbow or restoring a useful grasp or a combination of both. The assessment was carried out on four main aspects: the function of the elbow, the function of the hand, the ability to carry out the activities of daily living and the effect of the surgical reconstruction on the personal and social achievement of the patient. PMID- 6841400 TI - The clinical, arthroscopic and histological findings after replacement of the anterior cruciate ligament with carbon-fibre. AB - Thirty-nine patients underwent reconstruction of the anterior cruciate ligament with carbon-fibre and a MacIntosh repair; all had a negative pivot shift test after operation. Some patients had persistent pain, mild effusion and synovial thickening; in 10 of these patients the symptoms warranted arthroscopic examination and biopsy at a mean of 16.9 months after the repair. Arthroscopy revealed that the carbon-fibre had not induced the formation of a "new ligament" and that the repair was merely covered by a thin, fibrous sheath. Histological investigations confirmed this finding, with only a suggestion of a fibroblastic response to carbon-fibre found in two patients. Particles of carbon-fibre were found scattered through the knees. Synovitis and breakdown of the skin over subcutaneous carbon-fibre complicated treatment. Failure of the carbon-fibre to bond to bone was detected radiographically. PMID- 6841401 TI - Isolated anterior dislocation of the proximal tibiofibular joint. AB - Three cases of isolated anterior dislocation in the proximal tibiofibular joint are presented. The common aetiological feature was that injury occurred with the knee in hyperflexion and the foot inverted and extended. The symptoms of locking, pain and giving way may lead to an erroneous diagnosis of meniscal injury. Early diagnosis in the acute case enabled easy reduction. In the inveterate cases, resection of the head of the fibula gave complete relief of symptoms. PMID- 6841402 TI - How stiff should semi-rigid fixation of the human tibia be? A clue to the answer. AB - Test results on carbon-fibre-reinforced plastic plates are presented, all of which had been used as semi-rigid fixation in a series of fractures of the middle third of the human tibia. Symptoms of pain experienced by the patients were found to be related to the stiffness of the plates and it is suggested that a stiffness of 2.0 newton-metres per degree is most suitable for this type of fixation of the tibia. PMID- 6841403 TI - Congenital dislocation of the peroneal tendons in the calcaneovalgus foot. AB - Congenital dislocation of the peroneal tendons is a rare and infrequently reported deformity of the foot in the neonate. Four cases of this deformity associated with a congenital calcaneovalgus deformity of the foot have been treated and followed to the resolution of both of the deformities. The calcaneovalgus foot proved more resistant to correction and required more prolonged and aggressive treatment than was usual when it was found as an isolated deformity. All four patients demonstrated other stigmata of intra uterine malposition and oligohydramnios or both. Our anatomical studies suggested that the superior peroneal retinacular ligament was the critical stabilising structure for the peroneal tendons. A concept of the pathogenesis of this deformity is discussed and a proven regimen for its treatment presented. PMID- 6841404 TI - Neonatal operative treatment of club foot. A preliminary report. AB - A total of 67 patients with 94 resistant club feet were treated operatively as soon after birth as all other postnatal problems could be excluded, the mean age of the patients being 12 days. No treatment was attempted before operation. The results, after a follow-up period of a minimum of two years (mean 4.4 years) are comparable with the best published results. This method of treatment has many advantages but cannot be recommended for general use without reservations. PMID- 6841405 TI - Hindfoot disability after a tibial shaft fracture treated by internal fixation. AB - One hundred patients who had sustained a fracture of the tibial shaft and had been treated by internal fixation were reviewed to obtain information on residual ankle and subtalar disability. This study reinforces the belief that early mobilisation of patients with tibial shaft fractures does help to preserve subtalar movement. PMID- 6841406 TI - Idiopathic avascular necrosis of the scaphoid. A report of two cases. AB - Two cases of idiopathic avascular necrosis of the scaphoid are reported and it is suggested that the aetiology could be the same as that recently described for Keinboeck's disease by Beckenbaugh et al. (1980). The condition described in this paper is a different entity from that described by Preiser (1910), which was probably not an osteochondritis but an undiagnosed fracture. PMID- 6841407 TI - The pneumatic tourniquet and deep venous thrombosis. AB - The effect of the pneumatic tourniquet on the incidence of postoperative deep venous thrombosis is uncertain. We carried out a controlled study comparing the incidence of deep venous thrombosis when a tourniquet was used with the incidence when a tourniquet was not used. Thrombosis was detected by radioisotope venography. The results of the study showed no difference in incidence and we concluded that the pneumatic tourniquet has no influence on the formation of a thrombus in a deep vein. PMID- 6841408 TI - Venous thrombosis produced by the local injection of fat. AB - An experimental study performed in 16 mongrel dogs is presented, which shows that when venous stasis is combined with the local injection of non-esterified fatty acid an intense thrombosis results. This response is not produced by venous stasis alone, nor by the combination of venous stasis and triacylglycerol. Histologically it is quite different from the response produced by an inert intraluminal foreign body. It does resemble venous thrombosis described experimentally and in patients. The clinical relevance of these findings is that during accidental or operative trauma to a long bone, fat is commonly forced into the local venous circulation. If this event is combined with venous stasis or a tourniquet is used, then the circumstances of this experiment are reproduced. It is suggested that the venous thrombosis which commonly complicates long-bone injury or operation is in part caused by the thrombogenic nature of the introduced fat. PMID- 6841409 TI - A long-term review of children with congenital and acquired upper limb deficiency. AB - A long-term review of 131 children fitted with upper limb prostheses at the Ontario Crippled Children's Centre between 1965 and 1975 is reported. There were 116 children with congenital deficiencies and 15 who had had amputations. Follow up ranged from 7 to 17 years. A total of 42 children had abandoned their prostheses, 37 of whom had congenital deformities and five were amputees. The level of deficiency was of fundamental importance in determining whether the prosthesis would be accepted; in the forearm, the longer the stump, the more likely it was that the child would discard the prosthesis. Overall, 50 per cent of children fitted over the age of two years abandoned their prostheses compared with only 22 per cent of patients who had been fitted before the age of two years. The highest drop-out rate was at the age of 13 years when the children became more conscious of their cosmetic appearance. Suggestions for reducing the high drop-out rate in the early teens are put forward. PMID- 6841410 TI - Dysplasia epiphysialis hemimelica. A clinical and genetic study. AB - The clinical features of nine new patients with dysplasia epiphysialis hemimelica are reported, with a long-term follow-up on a further seven patients who were described in the earliest case reports of this disease. Each of these 16 patients had only one leg involved, but 12 had multiple epiphyses affected. The distal femur, distal tibia and talus were the commonest sites and most patients presented with painless swelling or deformity. Wasting of the muscles of the affected leg was a common finding, and was occasionally disproportionate to the degree of disuse. One patient had the unique combination of involvement of the lateral and medial halves of different epiphyses in the same limb and another had unusual metaphysial changes. Diagnosis was often delayed despite typical radiographic appearances. There was no evidence for a genetic component in the aetiology nor was any common environmental factor identified. Treatment by local excision was generally effective for lesions in the vicinity of the knee, but some patients with involvement of the talus required arthrodesis around the ankle. The long-term prognosis appears to be good and so far only two of these patients have developed premature osteoarthritis. PMID- 6841412 TI - Iliac aneurysm after total hip arthroplasty. Surgical management. AB - We report two cases of aneurysm of the external iliac artery after arthroplasty of the hip. In each case the patients suffered from severe, seropositive, rheumatoid arthritis, had been treated with oral corticosteroids and had defects in the acetabular floor which were complicated by sepsis. In these circumstances bleeding from the wound in the hip should be investigated by immediate arteriography with anteroposterior and lateral views. Though vascular injury during operations on the hip is rare, recognition is important as safe and satisfactory treatment can be achieved. In the surgical management of these cases the following points should be noted: an alternative blood supply to the limb must be established using separate surgical incisions; to reduce the risk of sepsis these incisions should be closed and dressed before exploring the aneurysm; the aneurysmal vessel must be isolated and ligated, no attempt being made at primary repair; the aneurysm should be opened longitudinally to avoid damaging the femoral nerve which overlies it; and all foreign material should be removed from the hip. PMID- 6841411 TI - Isometric training in human elbow flexor muscles. The effects on voluntary and electrically evoked forces. AB - The elbow flexor muscles of four men were trained using maximal voluntary isometric contractions. Thirty contractions a day were performed for five weeks. The four men and four control subjects were tested once a week: measurements of the supramaximally stimulated isometric twitch force, the time taken for the twitch force to peak and the tetanic force were carried out; simultaneously, measurements of the force of maximal voluntary isometric contraction and resistance to fatigue were made. The testing sessions produced no training effect on control subjects. Training produced a 20 per cent increase in the force of maximal voluntary isometric contraction after five weeks, but the forces of electrically evoked twitch and tetanus showed no increase. It was concluded that the increase in the force of maximal voluntary isometric contraction must be related to factors other than the force-generating capacity of the muscle fibres themselves. PMID- 6841413 TI - Cross-sectional anatomy of the adult bony acetabulum. AB - Cross-sectional cuts through the acetabulum of a cadaveric pelvis were obtained to evaluate the bony anatomy. There are six slices of 1 cm thickness which define the acetabulum. This information has been important to us primarily to assess acetabular fractures with computerized tomography. PMID- 6841414 TI - Acetabular fracture assessment with computerized tomography. AB - Twenty-four patients have been evaluated to demonstrate the role of computerized tomography (CT) in assessment of acetabular fractures. CT is important in defining the articular dome, intraarticular and femoral head abnormalities, associated sacroiliac damage and soft-tissue injury. The CT examination can be obtained with minimal additional discomfort to the patient. PMID- 6841415 TI - Metrizamide myelography in conjoined lumbosacral nerve roots. AB - Conjoined lumbosacral nerve roots are a congenital anomaly found at 1% of lumbar disc operations. They are usually present at the L5-S1 level and may or may not be associated with herniated intervertebral discs. Previously it had been thought that the preoperative myelogram was not helpful in diagnosis but using metrizamide myelography the diagnosis should be made more often by observing: (a) an asymmetric subarachnoid space, (b) a common axillary pouch exiting between opposite upper and lower nerve root sheaths, (c) a widened axillary pouch, and (d) two or more individual nerve roots in the axillary pouch. PMID- 6841416 TI - Ultrasonographic assessment of hydronephrosis of pregnancy. AB - We examined 100 consecutive patients presenting for gestational assessment by ultrasonography for hydronephrosis. Hydronephrosis in these patients was assessed in respect of its incidence, degree, laterality, and its relation to stage of gestation. Hydronephrosis was found to be present in approximately half of our patients particularly in the second and third trimesters. Hydronephrosis was more prevalent on the right than on the left side. We believe that hydronephrosis of pregnancy is physiologic and that both mechanical and hormonal factors contribute to its occurrence. PMID- 6841417 TI - Iatrogenic lesions of the upper airway in the newborn. AB - A retrospective study of 140 babies who survived the first week of life and who had endotracheal intubation showed that 65 of them had either or both of the following complications of endotracheal tube therapy: (a) Collapse of one or more lobes with the tube in place or within the first two days following extubation and lasting less than 24 hours. When collapse lasted more than 48 hours, it often required repeated intubation for tracheal cleansing. The right lung, especially its upper lobe, was predominantly affected. (b) Tracheal lesions and nasal necrosis. A statistical comparison with intubated babies of similar age without complications showed the following factors to predispose to lobar collapse: younger gestational age, maximal high oxygen concentration administered, and prolonged duration of intubation. The results of endotracheal tube cultures bore no relation to the complication rate. PMID- 6841418 TI - Gastroparesis diabeticorum. AB - Fifteen patients with gastroparesis diabeticorum were studied retrospectively. The radiographic findings on barium examination of the stomach and small bowel were tabulated and correlated with clinical data. Of these 15 patients, 12 were insulin-dependent. The other three received only oral hypoglycemic agents. Control of the diabetes was poor in seven patients, fair in six, and good in two. There was no correlation between the severity of the radiographic findings and the duration, degree of control, or method of treatment of the disease. Four patients had follow-up studies. Of these, three showed radiographic evidence of improvement or return to normal. The fourth patient showed evidence of gastroparesis unchanged over five years. PMID- 6841419 TI - Style. PMID- 6841420 TI - Unilateral rheumatoid arthritis in hemiplegia. AB - Rheumatoid arthritis is generally a symmetrical polyarthritis characteristically involving small joints. Unilateral disease may occur when limbs are protected by a neurologic defect. Unilateral rheumatoid arthritis occurring in a patient with hemiplegia is here described. PMID- 6841421 TI - Renal calculus ileus. AB - Mechanical duodenal obstruction due to perirenal adhesions following infection of the upper urinary tract has been reported. I here report a patient in whom a renal calculus passed through a fistula from the right renal pelvis and obstructed the lumen of the duodenum. PMID- 6841423 TI - Acute rupture of a cystic ovarian teratoma complicating premature labor. AB - A cystic ovarian teratoma (COT), previously undiagnosed either clinically or by ultrasonography, presented as acute intra-abdominal disease complicating premature labor. This report emphasizes the potentially catastrophic complications of COT and stresses that, despite the availability of ultrasonography, there is still a need for conventional radiography in abdominal catastrophes in pregnant women. PMID- 6841422 TI - Postoperative residual ovary syndrome: an uncommon cause of pelvic mass. AB - We report two patients with an ovarian mass following hysterectomy. These represent part of the spectrum of the "residual ovary syndrome." The retroperitoneal incarceration of a residual ovary and the presence of adhesions, preventing free access to the peritoneal cavity, result in an accumulation of follicular products locally and, thus, a mass with cystic and solid components. Differential diagnostic considerations include functional and dysfunctional ovaries, benign and malignant ovarian tumors, and endometriosis. PMID- 6841424 TI - Use of contrast through a fiberoptic colonoscope for demonstration of a colonic stricture. PMID- 6841425 TI - Bowel displacement due to psoas muscle hypertrophy. AB - Extrinsic compression of the medial border of the ascending colon and bilateral small bowel displacement at the lumbosacral level were observed in a sportswoman. Psoas muscle hypertrophy was confirmed by computed tomography. This entity should be added to the differential diagnosis of bowel displacement. PMID- 6841426 TI - Ultrasonic demonstration of appendicolith. AB - We report three patients with appendicitis in whom the diagnosis was difficult to establish. Ultrasonography helped in the management of these patients. To the best of our knowledge, this is the first report of the detection of appendicolith by ultrasonography. PMID- 6841427 TI - Colitis cystica profunda. AB - The clinical, pathologic and radiologic features of colitis cystica profunda (CCP) in a 60-year-old woman are presented. This benign lesion, although rare, is usually misdiagnosed and consequently treated as a carcinoma. It should be included in the differential diagnosis of submucosal rectal lesions. PMID- 6841429 TI - The practice of radiology. PMID- 6841428 TI - Hamartoma of Brunner's gland causing partial obstruction of the ileum. PMID- 6841430 TI - The disparate diameter. A sign of rotational deformity in fractures. AB - Although clinical assessment is usually better than radiographic evaluation in detecting rotational deformity at a fracture site, the forearm is an exception to this rule. A simple radiologic sign is here described which may uncover rotational fracture deformity: in the absence of comminution, whenever the diameter of a long bone changes abruptly across a fracture line, a significant rotational deformity must be considered. The basis for and applications of this sign are described. PMID- 6841431 TI - Early clinical results of the modified human umbilical cord vein homograft (Dardik Biograft). AB - Fifty-six reconstructions using Biograft were performed in 45 cases with peripheral arterial occlusion. These consisted of 11 femoro-popliteal bypasses above the knee, 19 femoro-popliteal below the knee, 10 femoro-tibial or peroneal and 16 other miscellaneous procedures including aorto-femoral and extra-anatomic bypasses. Overall patency rates for each type of procedure were 81.8%, 78.9%, 30.0%, and 93.8%, respectively. The cumulative patency rate (calculated by the life table method) for the total group was 70.5% at 56 months. Early failure was thought to relate to technical factors in most instances. The majority of late failures was due to intimal hyperplasia at the distal anastomotic site. One of 9 late failures was successfully treated by patch angioplasty at 23 months following initial operation. Therefore, in order to attain better late results, early discovery of developing stenosis by noninvasive examination techniques and arteriography is important. PMID- 6841432 TI - Profundaplasty in the ischemic extremity. AB - 107 patients underwent vascular reconstruction for ischemic peripheral vascular disease distal to the inguinal ligament at the North Carolina Memorial Hospital from 1973 to 1979. All patients were evaluated with pre-operative Doppler arterial pressures and arteriography. 93 underwent femoral bypass grafting. 14 patients who were not felt to be candidates for bypass and were selected for primary profundaplasty form the subject of this report. Patients presented with a chief complaint of claudication, acute onset of rest pain secondary to acute occlusion or gangrene. Ankle/brachial ratio was as follows: Claudication, 0.56; chronic rest pain, 0.29; gangrene, 0.43, acute occlusion, 0.36. Outcome by patient group showed that both patients who presented with acute onset of rest pain had successful outcomes; 1 success and 2 patients with no change in symptoms in the group who presented with claudication; all patients with gangrene failed to improve and underwent major amputation. The best preoperative predictor was the patient's presenting complaint. Neither Doppler arterial pressures, the presence of diabetes nor arteriography were helpful in selecting patients for favorable outcomes. In our experience, few patients with severe peripheral vascular disease distal to the inguinal ligament unreconstructible by other means will benefit from primary profundaplasty. A possible exception are patients who present with acute arterial occlusion. PMID- 6841433 TI - Critical analysis of the digitalized pulse timing oculoplethysmography. AB - To critically analyze the accuracy of the OPG/Zira unit in the diagnosis of significant carotid artery stenosis, 135 patients (270 carotid arteries) were reviewed in comparison with the biplane carotid arteriograms. For practical purposes the radiological findings were divided into two categories; the first category included patients with normal carotids or carotids with less than 40% stenosis and the second category included patients who had carotid stenosis of greater than 40% (significant stenosis). The 136 arteries with significant stenosis on the arteriograms had positive OPG (136/160); i.e., 85.0% sensitivity, 101/110 arteries had negative arteriograms and negative OPG; i.e., 91.8% specificity. There was 6.2% false positive rate (9/145) and 19.2% false negative (24/125). The overall diagnostic accuracy was 87.7% (237/270). PMID- 6841434 TI - The sequential pneumatic compression device in surgery for lymphedema of the limbs. AB - A modified technique for operations for lymphedema of the limbs is presented and illustrated in three cases. The technique consists of using the Lympha-Press, a new sequential pneumatic compression apparatus, which was used before operation for reduction of lymphedema, facilitating the surgical procedure, during operation to enlarge the lymphatic vessels, making creation of the lymphatico venous anastomosis easier, and after operation to avoid early occlusion of the anastomosis, serous accumulation, pain, wound infection and ugly scars. PMID- 6841435 TI - The management of prosthetic valve endocarditis. AB - During the period 1970 to 1980 2,945 patients underwent valve replacement at the Brompton Hospital. Thirty-one (1%) patients subsequently developed prosthetic valve endocarditis (P.V.E.). Twenty-one (0.7%) patients developed endocarditis within two months of valve replacement. Ten patients were treated medically, with seven deaths, whilst four of the eleven surgical cases died. There were ten cases of late P.V.E. occurring between two months and eight years after initial valve replacement (0.12% per annum). Eight patients were treated surgically, with two deaths, whilst both medical cases died. Thus 67% patients were effectively treated by immediate valve replacement, whilst only 25% medical cases survived. Actuarial survival curves predict a 41% five-year survival following surgery for P.V.E. We stress the importance of early diagnosis of this condition and recommend immediate valve replacement in all patients with P.V.E. developing signs of haemodynamic failure. PMID- 6841436 TI - Degenerative changes in glutaraldehyde preserved pericardium used for the experimental replacement of anterior chordae of mitral valve. AB - Plastic repair of the mitral valve after rupture of the anterior chordae can only be performed when less that one third of the anterior leaflet has lost its chordal support. This experimental study was designed to examine a method for chordal replacement utilizing gluteraldehyde preserved pericardium (Bovine pericardium supplied by Hancock Laboratories). The correct length of the "new chorda" was determined by the use of anatomical rules. In applying these rules we adopted the hypothesis that the chordae were under tension throughout diastole. The anterior chordae were replaced in eight dogs. At the end of the procedure the valve was tested and found to be competent in every case. Two dogs died before restudy because of the development of bacterial endocarditis confirmed histologically. Five dogs were restudied four months to two years after chordal replacement. There was no evidence of mitral incompetence and the mean left atrial pressure was within the normal range in each of the five dogs restudied. Histological examination of the new chordae demonstrated both cartilage formation and calcification. Electron microscopy demonstrated excellent healing of both suture sites with ingrowth of native collagen fibres between the fibres of the preserved pericardium. We conclude that excellent haemodynamic results can be obtained after chordal replacement and are maintained in spite of degenerative changes. Early calcification is known to occur in biological materials implanted in dogs and the use of this technique in man will be determined by the specific biological environment. PMID- 6841437 TI - Aortic valve replacement with Smeloff-Cutter prosthesis: 1 to 8 year follow-up. AB - Two hundred patients had an aortic valve replacement with the Smeloff-Cutter prosthesis between 1972 and 1980. One hundred and seventy six patients had aortic valve replacement alone (mortality 2.8%) and 24 patients had additional procedures. The overall mortality was 6.5%. One hundred and eighty seven patients have been followed up for from 4 months to 8 years (mean 33 months). The 14 patients who died later are analysed; half of these deaths were prosthesis related. There has been no instance of structural failure, ball variance or massive thrombosis in this series. All but 4 of the survivors showed functional improvement. We consider the Smeloff-Cutter valve a good choice for aortic valve replacement. PMID- 6841438 TI - Mitral valve surgery in infants and children. AB - The pre-operative findings and surgical results of forty-three patients under thirteen years of age undergoing mitral valve surgery, are presented. Eight underwent surgery for mitral stenosis. Four had open mitral valvotomy with a satisfactory result, one developed severe regurgitation which required mitral valve replacement. Two had primary valve replacement and two had excision of a mitral subvalvar diaphragm. Thirty five children underwent surgery for mitral regurgitation. Twelve had a mitral annuloplasty. Two of these developed further regurgitation which required mitral valve replacement. Twenty one children had primary mitral valve replacement. The results and choice of valve replacement are discussed. PMID- 6841439 TI - Clinical evaluation of the interpulse low resistance microporous membrane oxygenator. AB - The Interpulse microporous membrane oxygenator has been used in 100 patients for cardiac surgery. This oxygenator features transverse furrows in the membrane and a back and forth motion of the blood as it flows between the membranes. This pulsing motion causes secondary flows or vortices to occur in the furrows of the membrane. These secondary flows promote mixing of the blood in the film. This oxygenator has been used in a single pump circuit for perfusions for up to 343 minutes at a flow rate up to 5.9 l/min. Oxygen saturation has always been 98% or greater. The pulser rate of the oxygenator influences oxygen transfer, and the pulser rate has been regulated between 80 and 225 pulses per minute to achieve a mean arterial PaO2 of 207 mmHg. Carbon dioxide transfer is affected by the oxygen flow through the device and has been adjusted to between 0.2 and 7 l/min to obtain a mean PaCO2 of 40 mmHg in this series. This device has proved to be safe and effective in perfusions for cardiac surgery. PMID- 6841440 TI - Bioprosthetic endocarditis due to Cryptococcus neoformans. AB - Fungal prosthetic endocarditis continues to be a lethal complication of cardiac valve replacement. We describe a patient with culture-proved Cryptococcal endocarditis and myocarditis whose non-regurgitant xenograft aortic prosthesis was successfully replaced urgently upon the occurrence of new 1st degree A-V block in the third postoperative week. Operative intervention, including vigorous debridement of the aortic root, is effective in postoperative prosthetic fungal infections involving the myocardium. The patient described herein is now infection-free, with a non-regurgitant valve, one and one-half years following operation. PMID- 6841441 TI - Open heart surgery with factor VII deficiency. AB - A case with marked factor VII deficiency, undergoing open heart surgery for atrial myxoma, is reported. The syndrome was unknown to the patient and only pre operative routine coagulation studies showed a low prothrombin activity (22%). Further investigations revealed a severe factor VII deficiency. The operation was carried out under factor VII concentrate administration and no bleeding complication occurred. PMID- 6841442 TI - Traumatic ventricular septal defect with tricuspid incompetence. Surgical treatment. AB - The authors report a case of traumatic ventricular septal defect associated with tricuspid incompetence after blunt injury of the chest. This case is the third one described in the literature. This case includes several unusual features: (1) the patient was a 52 year old man. Wounds of the heart usually happen to younger people; (2) clinical manifestations were immediately important; (3) there was a left bundle branch block on the electrocardiogram; (4) surgical treatment was performed as an emergency (less than a fortnight after the accident). PMID- 6841443 TI - The use of a balloon catheter in the treatment of an iatrogenic pseudo-aneurysm of the subclavian artery. AB - The use of an angiographic balloon catheter to achieve proximal control of the left subclavian artery as an adjunct to surgery is described. By this application of interventional radiology combined with surgery, successful treatment of a pseudo-aneurysm of the subclavian artery in a gravely ill patient was made possible without resort to thoracotomy. PMID- 6841444 TI - A simplified approach for correction of bilateral renal and aortoiliac occlusive disease. AB - Aortorenal bypass procedures have utilized autogenous artery, vein, and synthetic materials in the surgical management of atherosclerotic renal artery occlusive disease. When concomitant bilateral renal artery and aortic occlusive disease is identified, transaortic bilateral renal artery endarterectomy and aortoiliac/femoral bypass grafting is a safe and simplified technique which does not share the attendant problem and technical difficulties of aortorenal bypass operations. PMID- 6841445 TI - Classification and surgical treatment of dissecting aortic aneurysms. AB - A classification of dissecting aortic aneurysms is presented. It allows one to determine more accurately any given pathology in any patient. It helps the surgeon select the most appropriate operative variant and to define tactics of treatment. For example, to discuss the necessity of repeated reconstruction. Our clinical cases have confirmed it. PMID- 6841446 TI - Specialization of the macrophage plasma membrane at sites of interaction with opsonized erythrocytes. AB - We incubated mouse peritoneal macrophages for 3-8 min at 37 degrees C with antibody-coated sheep erythrocytes and examined regions of close interaction between the two cell types by electron microscopy. At sites of focal macrophage erythrocyte contact we observed a distinctive specialization of the macrophage plasma membrane consisting of a prominent subplasmalemmal band of electron-dense material, approximately 25-35 nm in thickness. In many instances, this band showed a periodic substructure similar to that seen in clathrin coats. Moreover, many slender erythrocyte processes penetrated into invaginations of the macrophage surface which were bristle-coated at their blind extremity. As previously shown for clathrin-coated pits, the segments of the macrophage plasma membrane beneath which the defense material was found were selectively resistant to the membrane-perturbing effect of the antibiotic, filipin. This structural specialization of the macrophage plasma membrane at sites of ligand-receptor interaction during immune phagocytosis of antibody-coated erythrocytes may represent the morphological counterpart of the zipper mechanism of phagocytosis previously demonstrated by functional studies. PMID- 6841447 TI - Epithelial permeability and the transepithelial migration of human neutrophils. AB - Although polymorphonuclear leukocytes (PMN's) can migrate through every epithelium in the body regardless of its permeability, very little is known about the effect of epithelial permeability on PMN migration and the effect of emigrating PMN's on the permeability of the epithelium. In an in vitro model system of transepithelial migration, human PMN's were stimulated by 0.1 micrometer fMet-Leu-Phe to traverse confluent, polarized canine kidney epithelial monolayers of varying permeabilities. Epithelial permeability was determined by both conductance measurement and horseradish peroxidase (HRP) tracer studies. As epithelial permeability increased, the number of PMN invasion sites as well as the number of PMN's that traversed the monolayer increased. The effect of PMN migration on epithelial permeability was examined using the ultrastructural tracers HRP and lanthanum nitrate. PMN's traversing the monolayer made close cell to-cell contacts with other invading PMNs and with adjacent epithelial cells. These close contacts appeared to prevent leakage of tracer across invasion sites. Following PMN emigration, epithelial junctional membranes reapproximated and were impermeable to the tracers. These results indicated that, in the absence of serum and connective tissue factors, (a) the number of PMN invasion sites and the number of PMN's that traversed an epithelium were a function of the conductance of the epithelium and (b) PMN's in the process of transepithelial migration maintained close cell-cell contacts and prevented the leakage of particles (greater than 5 nm in diameter) across the invasion site. PMID- 6841448 TI - Firm structural associations between migratory pigment granules and microtubules in crayfish retinula cells. AB - The morphology of associations between mobile pigment granules and microtubules of the crayfish retinula cells was examined with transmission electron microscopy. Many pigment granules were found associated with microtubules through linkages of fuzzy appearance in thin sections. The linkages were revealed as discrete strands of variable shape in rotary-shadowed replicas of freeze fractured and deep-etched specimens. The only feature of constant morphology among these connections consisted of 2-4-nm filaments projecting laterally from the microtubules. The firmness of the pigment granule-microtubule associations was judged by their ability to hold up during cell disruption procedures of increasing disaggregation effects in a low-Ca++ stabilization buffer. The results of these tests were inspected with scanning electron microscopy and with transmission electron microscopy of negatively stained preparations. Numerous pigment granules remained associated with a stable microtubule framework after the plasma membrane had been stripped away. Moreover, granule-microtubule attachments survived breakdown of this framework into free fascicles of microtubules. The pigment granules were associated with the free microtubules either individually or as clusters entangled in a fibrous material interwoven with 10-nm filaments. These findings attest that many pigment granules are bound to microtubules through linkages that constitute effective attachments. Further, it is demonstrated that a highly cohesive substance associates the pigment granules with one another. These conclusions are discussed in terms of a pigment transport mechanism in which a network of interconnected granules would establish firm transient interactions with a supporting skeleton of microtubules. PMID- 6841449 TI - Identification and localization of cholecystokinin-binding sites on rat pancreatic plasma membranes and acinar cells: a biochemical and autoradiographic study. AB - Using the combined approaches of affinity labeling and light and electron microscopic autoradiography, we investigated the identification and localization of cholecystokinin (CCK)-binding sites on rat pancreatic acinar cells. To define the molecular properties of the CCK-binding site, we incubated rat pancreatic plasma membranes with 125-I-CCK-33 for 15 min at 23 degrees C followed by washing and cross-linking with disuccinimidyl suberate. Specific labeling of a major Mr 85,000 component was revealed as assessed by SDS PAGE under reducing conditions and autoradiography of the dried gels. Components of Mr greater than 200,000, Mr 130,000-140,000, and, Mr 55,000 were labeled under maximal cross-linking conditions. The labeling of all components was specifically inhibited by CCK-8 in a dose-dependent manner (Kd approximately 9 nM). The Mr 85,000 component had identical electrophoretic mobilities under reducing and nonreducing conditions indicating that it likely does not contain intramolecular disulfide bonds. The larger labeled species may be cross-linked oligomers of this binding protein or complexes between it and neighboring polypeptides. For studies on the distribution of CCK-binding sites, pancreatic acini were incubated with 125I-CCK 33 (0.1 nM) in the absence or presence of CCK-8 (1 microM) for 2 or 15 min at 37 degrees C, washed, and fixed in 2% glutaraldehyde. Quantitative autoradiographic analysis indicated that approximately 60% of the total grains were located within +/- 1 HD (1 HD = 100 nm) of the lateral and basal plasmalemma with little or no labeling of the apical plasmalemma. From these data, it was estimated that each acinar cell possesses at least 5,000-10,000 CCK-binding sites on its basolateral plasmalemma. The remaining grains showed no preferential concentration over the cytoplasm or nucleus. Together, these data indicate that CCK interacts with a Mr 85,000 protein located on the basolateral plasmalemma of the pancreatic acinar cell. PMID- 6841450 TI - Degradation of acetylcholine receptors in muscle cells: effect of leupeptin on turnover rate, intracellular pool sizes, and receptor properties. AB - The cellular mechanisms of degradation of a transmembrane protein, the acetylcholine receptor (AChR), have been examined in a mouse muscle cell line, BC3H-1. The halftime of degradation of cell surface receptors labeled with [125I] alpha-Bungarotoxin ([125I] alpha-BuTx) is 11-16 h. Leupeptin, a lysosomal protease inhibitor, slows the degradation rate two- to sixfold, depending on the concentration of inhibitor used. The inhibition is reversible since the normal degradation rate is regained within 20 h after removal of the inhibitor. Cells incubated with leupeptin accumulate AChR. Little change in the number of surface AChR occurs but the amount of intracellular AChR increases two- to threefold. Accumulated AChR are unable to bind [125I] alpha-BuTx if excess, unlabeled alpha BuTx is present in the culture medium during leupeptin treatment. Thus, leupeptin causes the accumulation of a surface-derived receptor population not previously described in these cells. Subcellular fractionation studies utilizing Percoll and metrizamide gradient centrifugation in addition to molecular exclusion chromatography suggest that the accumulated AChR reside in a compartment with lysosomal characteristics. In contrast, the subcellular component containing another intracellular pool of AChR not derived from the surface is clearly separated from lysosomes on Percoll gradients. The sedimentation properties of AChR solubilized from the plasma membrane and the lysosomal fraction have been compared. The plasma membrane AChR exhibits a sedimentation coefficient of 9S in sucrose gradients containing Triton, whereas the AChR derived from the lysosomal fraction exists in part in a high molecular weight form. The large aggregate and the organelle in which it resides may represent important intermediates in the degradative pathway of this membrane protein. PMID- 6841451 TI - The distribution of intracellular ions in the avian salt gland. AB - To investigate the mechanism of salt secretion in the avian salt gland, we used quantitative electron probe microanalysis to measure the intracellular elemental concentrations in dry cryosections of unspecialized and partially specialized secretory epithelial cells from fresh water- and salt water-adapted ducklings, respectively. In conjunction with this, human and duckling erythrocytes were also analyzed, since these provided the experimental basis for using in situ erythrocytes as standards for determining the local water content of epithelia from the analysis of dried cryosections. The microprobe results from both types of erythrocytes compared favorably with chemical determinations of elemental concentrations. The nucleated avian erythrocytes, whose wet-weight elemental concentrations were determined by a compartmental analysis that required neither a peripheral standard nor a measure of the local mass, revealed a marked accumulation of P and K in the nucleus (388 and 190 mmol/kg wet wt, respectively) relative to the cytoplasm (67 and 85 mmol/kg wet wt). In both developmental states of the epithelial cells, the nucleus and apical cytoplasm had essentially similar and unremarkable concentrations of Na (76 and 83 mmol/kg dry wt, respectively, in the adapted cells vs. 72 and 81 mmol/kg dry wt in the control cells) and K (602 and 423 mmol/kg dry wt vs. 451 and 442 mmol/kg dry wt). Chloride, however, which was in general rather high, was significantly depressed in the apical cytoplasm of adapted cells only (164 and 124 mmol/kg dry wt in the nucleus and cytoplasm, respectively, of adapted cells (P less than 0.05) vs. 138 and 157 mmol/kg dry wt for control cells (P less than 0.05). Cation concentrations (Na + K) were elevated approximately 15% in the basal regions of adapted cells as compared with apical cytoplasm. When tissue water variations are accounted for, the results suggest that: (a) an active, energy-requiring process is responsible for chloride accumulation in this cell; (b) the apical membrane is a regulatory site for secretion; and (c) there are regional distinctions in the distribution of ions and water, particularly in the salt water-adapted cell. These conclusions are consistent with active chloride transport as the basis for salt secretion in this tissue. PMID- 6841452 TI - Effect of cell shape change on the function and differentiation of rabbit mammary cells in culture. AB - We examined the role of cell shape, cytodifferentiation, and tissue topography on the induction and maintenance of functional differentiation in rabbit mammary cells grown as primary cultures on two-dimensional collagen surfaces or in three dimensional collagen matrices. Mammary glands from mid-pregnant rabbits were dissociated into single cells, and epithelial cells were enriched by isopycnic centrifugation. Small spheroids of epithelial cells (approximately 50 cells) that formed on a rotary shaker were plated on or embedded in collagen gels. The cells were cultured for 1 d in serum-containing medium and then for up to 25 d in chemically defined medium. In some experiments, epithelial monolayers on gels were mechanically freed from the dishes on day 2 or 5. These gels retracted and formed floating collagen gels. On attached collagen gels, flat monolayers of a single cell type developed within a few days. The cells synthesized DNA until the achievement of confluence but did not accumulate milk proteins. No morphological changes were induced by prolactin (PRL). On floating gels, two cell types appeared in the absence of cell proliferation. The cells in direct contact with the medium became cuboidal and developed intracellular organelles typical of secretory cells. PRL-induced lipogenesis, resulting in large fat droplets filling the apical cytoplasm and accumulation of casein and alpha-lactalbumin in vesicles surrounding the fat droplets. We detected tranferrin in the presence or absence of PRL intracellularly in small vesicles but also in the collagen matrix in contact with the cell layer. The second cell type, rich in microfilaments and reminiscent of the myoepithelial cells, was situated between the secretory cell layer and the collagen matrix. In embedding gels, the cells formed hollow ductlike structures, which grew continuously in size. Secretory cells formed typical lumina distended by secretory products. We found few microfilament-rich cells in contact with the collagen gels. Storage and secretion of fat, caseins and alpha-lactalbumin required the presence of PRL, whereas the accumulation and vectorial discharge of transferrin was prolactin independent. There was no differentiation gradient between the tip and the cent of the outgrowth, since DNA synthesis and milk protein storage were random along the tubular structures. These results indicate that establishment of functional polarity and induction of cytodifferentiation are influenced by the nature of the interaction of the cells with the collagen structure. The morphological differentiation in turn plays an important role in the synthesis, storage, and secretion of fat and milk proteins. PMID- 6841453 TI - Cell proliferation and milk protein gene expression in rabbit mammary cell cultures. AB - We analyzed the synthesis of DNA, the rate of cell proliferation, and the expression of milk protein genes in mammary cells grown as primary cultures on or in collagen gels in chemically defined media. We assessed DNA synthesis and cell growth, measured by [(3) H]- thymidine incorporation into acid-insoluble material, DNA content, and cell counts, in a progesterone- and prolactin containing medium. In some experiments, cultures were pulsed for 1 h with [(3)H]thymidine and dissociated into individual cells which were cytocentrifuged and processed for immunocytochemistry and autoradiography. We analyzed expression of milk protein genes at the transcriptional, translation and posttranslational levels in progesterone-depleted medium in the presence or absence of prolactin. We measured protein secretion by radioimmunoassays with antisera directed against caseins, alpha-lactalbumin and milk transferrin1. We determined protein synthesis by incorporating radio-labeled amino acids into acid-precipitable material and by immunoprecipitating biosynthetically labeled milk proteins. We assessed the accumulation of casein mRNA by hybridizing total cellular RNA extracted from cultured cells with (32)P-labeled casein cDNA probes. On attached collagen gels, the cells synthesized DNA and replicated until they became confluent. The overall protein synthetic activity was low, and no milk proteins were synthesized or secreted even in the presence of prolactin. The block in milk protein gene expression was not restricted to translational or posttranslational events but also included transcription, since no casein mRNA accumulated in these cells. On floating gels, protein synthesis was threefold higher than in cells from attached gels. Overall protein synthesis as well as casein and alpha-lactalbumin synthesis and secretion were prolactin-dependent with maximal stimulation at around 10(-9) M. A marked inhibition occurred at higher hormone concentrations. Casein mRNA accumulated in these cells, provided prolactin was present in the medium. In contrast, these cells did not synthesize DNA, nor did they replicate. In embedding gels, the rate of cell proliferation was exponential over 25 d with a doubling time of approximately 70 h. The overall protein synthesis increase was parallel in time with the increase in cell number. Caseins and alpha-lactalbumin (in contrast to transferrin) were synthesized only in the presence of prolactin. We observed the same hormone dependency as with cells growing on floating gels. The number of casein- and transferring-positive cells was measured after dissociating the cell cultures. At day 12, 60 percent of the total cells stored transferring in small cytoplasmic vesicles, whereas only 25 percent of the cells accumulated casein. Differences in the organization and in the shape of mammary cells depending on cell surface conditions suggest that the geometry of the cells, their interaction with extracellular matrix constituents, and cell-to-cell interactions play a role in the expression of two mammary functions: DNA synthesis and growth, as well as milk protein gene expression. PMID- 6841454 TI - Proteoglycan and glycosaminoglycan synthesis in embryonic mouse salivary glands: effects of beta-D-xyloside, an inhibitor of branching morphogenesis. AB - The proteoglycans and glycosaminoglycans synthesized by embryonic mouse salivary glands during normal morphogenesis and in the presence of beta-xyloside, an inhibitor of branching morphogenesis, have been partially characterized. Control and rho-nitrophenyl-beta-D-xyloside-treated salivary rudiments synthesize proteoglycans that are qualitatively similar, based on mobility on Sepharose CL 4B under dissociative conditions and glycosaminoglycan composition. However, beta xyloside inhibits total proteoglycan-associated glycosaminoglycan synthesis by 50%, and also stimulates synthesis of large amounts of free chondroitin (dermatan) sulfate. This free glycosaminoglycan accounts for the threefold stimulation of total glycosaminoglycan synthesis in beta-xyloside-treated cultures. Several observations suggest that the disruption of proteoglycan synthesis rather than the presence of large amounts of free glycosaminoglycan is responsible for the inhibition of branching morphogenesis. (a) We have been unable to inhibit branching activity by adding large amounts of chondroitin (dermatan) sulfate, extracted from beta-xyloside-treated cultures, to the medium of salivary rudiments undergoing morphogenesis. (b) In the range of 0.1-0.4 mM beta-xyloside, the dose-dependent inhibition of branching morphogenesis is directly correlated with the inhibition of proteoglycan synthesis. The stimulation of free glycosaminoglycan synthesis is independent of dose in this range, since stimulation is maximal even at the lowest concentration used, 0.1 mM. The data strongly suggest that the inhibition of branching morphogenesis is caused by the disruption of proteoglycan synthesis in beta-xyloside-treated salivary glands. PMID- 6841455 TI - Sites of synthesis of chloroplast ribosomal proteins in Chlamydomonas. AB - Cells of Chlamydomonas reinhardtii were pulse-labeled in vivo in the presence of inhibitors of cytoplasmic (anisomycin) or chloroplast (lincomycin) protein synthesis to ascertain the sites of synthesis of chloroplast ribosomal proteins. Fluorographs of the labeled proteins, resolved on two-dimensional (2-D) charge/SDS and one-dimensional (1-D) SDS-urea gradient gels, demonstrated that five to six of the large subunit proteins are products of chloroplast protein synthesis while 26 to 27 of the large subunit proteins are synthesized on cytoplasmic ribosomes. Similarly, 14 of 31 small subunit proteins are products of chloroplast protein synthesis, while the remainder are synthesized in the cytoplasm. The 20 ribosomal proteins shown to be made in the chloroplast of Chlamydomonas more than double the number of proteins known to be synthesized in the chloroplast of this alga. PMID- 6841456 TI - The spectrin-related molecule, TW-260/240, cross-links the actin bundles of the microvillus rootlets in the brush borders of intestinal epithelial cells. AB - Previous studies have shown that molecules related to erythrocyte spectrin are present in the cortical cytoplasm of nonerythroid cells. We report here the localization by immunoelectron microscopy of one such molecule, TW-260/240, in the brush border of intestinal epithelial cells. Using highly specific antibodies against TW-260 and TW-240 as well as antibodies against fodrin, another spectrinlike molecule, we have found that the TW-260/240 molecules are displayed between rootlets at all levels of the terminal web. Occasionally, extended structures appear labeled suggestive of the fine filaments known to cross-link actin bundles. These results are in line with previous in vitro studies showing that TW-260/240 binds to, and cross-links, actin filaments. The results are discussed in terms of a model in which rootlets are immobilized in the terminal web in a matrix of TW-260/240. PMID- 6841457 TI - Persistence of the mitogenic response to platelet-derived growth factor (competence) does not reflect a long-term interaction between the growth factor and the target cell. AB - Quiescent BALB/c-3T3 cells exposed briefly to platelet-derived growth factor (PDGF) become "competent" to replicate their DNA even if PDGF is removed from cell culture medium prior to the onset of DNA synthesis. We have suggested that persistence of the PDGF-induced competent state reflects a rapidly induced and relatively stable biochemical change within the target cells. Others suggest that the phenomenon reflects a long-term association between PDGF and its target cells or perhaps between PDGF and the cell culture dish. This controversy has been addressed (a) by examining the effect of anti-PDGF antibodies on PDGF-induced competence and (b) by studying the chemical fate of 125I-labeled PDGF. Anti-PDGF antibodies inactive both soluble and surface-bound PDGF. However, if quiescent 3T3 cells are exposed to PDGF for as little as 30 min, subsequent addition of these antibodies to the culture medium does not prevent the mitogenic response. Under conditions where the PDGF-induced competent state decays stochastically with a t1/2 of 18-20 h, cell-associated 125I-PDGF decays with a t1/2 of approximately 50 min. These data do not support the concept that persistence of the PDGF-induced competent state reflects a long-term association between PDGF and the target cells or between PDGF and the culture dish. PMID- 6841458 TI - Induction of thermotolerance and enhanced heat shock protein synthesis in Chinese hamster fibroblasts by sodium arsenite and by ethanol. AB - Synthesis of a family of proteins called "heat shock" proteins is enhanced in cells in response to a wide variety of environmental stresses. This suggests that these proteins may have functions essential to cell survival under stressful conditions. A causative relationship between heat shock protein synthesis and development of thermotolerance would imply that agents known to induce heat shock protein synthesis, such as sodium arsenite, also induce thermotolerance. Conversely, agents known to induce thermotolerance, such as ethanol, would also enhance heat shock protein synthesis. To test this hypothesis, I have examined the effect of sodium arsenite or ethanol treatment on protein synthesis and cell survival in Chinese hamster ovary HA-1 cells. After either sodium arsenite or ethanol treatment, the synthesis of heat shock proteins was greatly enhanced over that of untreated cells. In parallel, cell survival was increased as much as 10(4)-fold when cells exposed to either agent were challenged by a subsequent heat treatment. The synthesis of heat shock proteins correlated well with the development of thermotolerance. A qualitative analysis of individual proteins suggests that the synthesis of 70,000 and 87,000 molecular weight proteins most closely mirrored the development of thermotolerance. The results, therefore, strongly reinforce the hypothesis that a causal relationship exists between the enhanced synthesis of heat shock protein and cell survival under specific stresses. PMID- 6841459 TI - Glycosyl acceptors in intact and permeabilized normal and cystic fibrosis fibroblasts. AB - Using cell permeabilization, a technique which allows addition of exogenously supplied radiolabeled sugar nucleotides to serve as direct glycosyl donors, oligosaccharide biosynthesis was examined in fibroblasts obtained from normal and cystic fibrosis (CF) subjects. Incubation of logarithmically growing cells with either radiolabeled leucine or xylose has indicated that there was a difference in the synthetic rate between the cell types. Protein synthesis in normal cells made permeable with 50 micrograms/ml lysolecithin (LL) was demonstrated to be absent, and could not be induced to take place by adding exogenous components, including energy sources and amino acids, normally required for protein synthesis. Thus radiolabeled sugars were being added to peptide acceptors which were already present at the time of LL addition. Both permeable and intact fibroblasts were exposed to labeled UDP-xylose, UDP-galactose, and UDP-glucuronic acid, all donors of mucopolysaccharide precursors. The uptake of xylose into protein was the same for both normal and CF cells, but permeable CF fibroblasts incorporated statistically greater amounts of sugar from UDP-galactose and UDP glucuronic acid. Intact CF cells were also labeled using these two sugar nucleotides. Trypan blue exclusion indicated CF and normal fibroblasts were equally intact. This and the fact that preincubation of CF cells with the appropriate cold sugar nucleotide eliminated the differences in incorporation between the normal and CF cells suggested that CF fibroblasts had more cell surface acceptor than the normal cells. PMID- 6841460 TI - Coordinate secretion of rat and mouse albumin by mouse hepatoma x rat hepatoma hybrid cells directly reflects the intracellular concentration of the corresponding mRNAs. AB - The ratio of mouse to rat albumin secreted by mouse hepatoma x rat hepatoma hybrid cells is constant (of the order of 5.0) irrespective of the total amounts produced. The present results establish for seven independent hybrid clones that the coordination in the ratio of mouse to rat product applies also at the level of accumulation of albumin mRNAs of the two species. The interpretation that coordinate synthesis reflects coordinate transcription of the relevant genes is thus reinforced. PMID- 6841461 TI - Factors influencing survival and growth of mammalian cells exposed to hypothermia. I. Effects of temperature and membrane lipid perturbers. AB - The Arrhenius plot of the rate of V79 Chinese hamster cell inactivation due to hypothermia has a "break" around 7-10 degrees C with optimum storage temperature for unprotected cells being about 10 degrees C. Addition of the membrane lipid perturber, butylated hydroxytoluene, improves survival of cells when compared to controls at temperatures below this break but not above. Arrhenius plots of growth rates of the cells show breaks at 30 and 40 degrees C. Measurements of membrane fluidity by electron spin resonance or membrane polarization anisotropy by fluorescence spectrophotometry techniques as a function of temperature in these cells also reveal "breaks" centered around 8 and 30 degrees C. Hence, the changes in the rate of cell inactivation and growth as a function of temperature may be related to membrane lipid phase changes. PMID- 6841462 TI - Comparative effects of acute and chronic administration of amphetamine on local cerebral glucose utilization in the conscious rat. AB - The 2-deoxyglucose method was employed in rats following either acute or chronic administration of d-amphetamine. The drug was given either by a single intravenous and/or repeated daily intraperitoneal injections or by osmotic pumps implanted subcutaneously. Each mode of administration resulted in a specific constellation of metabolic effects. Acute doses of d-amphetamine, 5 mg/kg, stimulated glucose utilization in a number of cerebral structures, particularly the components of the extrapyramidal motor system. No effects were observed in components of the mesolimbic dopaminergic system. Repeated daily doses of 5 mg/kg for 2 weeks had no effects unless the dosage was progressively increased to toxic levels of 15 mg/kg over a 3-week period. Dosage sustained by osmotic pumps (12-15 mg/kg/day for 1 week or 6-7 mg/kg/day for 2 weeks), however, resulted in a selected increase in glucose utilization in the nucleus accumbens, an important component of the mesolimbic system. This finding may be of significance to the mechanism of amphetamine psychosis, which is sometimes regarded as a model of schizophrenia and is considered to be evidence in support of the dopamine hypothesis of the disease. PMID- 6841463 TI - Effect of topically administered epinephrine, norepinephrine, and acetylcholine on cerebrocortical circulation and the NAD/NADH redox state. AB - We investigated the effects of topically administered catecholamines and acetylcholine (ACh) on the cerebrocortical microcirculation and NAD/NADH redox state in chloralose-anesthetized cats. NADH fluorescence of the brain cortex and the volume of small intracortical vessels were measured by fluororeflectometry, and in most of the experiments the pial vessels were photographed simultaneously through a cranial window. Cerebrocortical vascular volume (CVV) and the diameter of the pial vessels were decreased, and NADH was oxidized by concentrations of epinephrine and norepinephrine as low as 3 x 10(-8) M. Pial veins constricted approximately twice as much as pial arteries. ACh dilatated pial arteries, slightly constricted pial veins, and increased CVV, but had no effect on the NAD/NADH redox state. Since pial and intracortical vessels were constricted markedly by catecholamines, and since these vascular reactions appeared at a lower concentration than is presumed to occur in the synaptic cleft, our results support the regulating role of these substances in cerebral circulation. NADH oxidation, obtained with catecholamines, was interpreted to be due to enhanced tissue respiration. The finding that ACh dilatated pial arteries and increased CVV, but failed to influence the NAD/NADH redox state, might indicate that the brain cortices of normal animals are bioenergetically nonhypoxic. If cortical microregions where the oxygen tension is close to zero were biochemically hypoxic, NADH oxidation should have occurred during ACh administration. PMID- 6841464 TI - Local cerebral blood flow in the recovery period following complete cerebral ischemia in the rat. AB - This study examines reflow patterns in the recirculation period following complete, global ischemia. Cerebrospinal fluid (CSF) compression ischemia was induced in ventilated rats for 5-30 min, and local cerebral blood flow (CBF) was measured autoradiographically after 5, 60, and 90 min of recirculation. Ischemia of 15 min duration was induced by four-vessel occlusion combined with arterial hypotension in two additional groups, with recovery periods of 5 or 60 min. In the immediate recirculation period (5 min), following 15 min of ischemia, local CBF was markedly heterogeneous. Thus, whereas most structures gave clear evidence of "reactive hyperemia," others showed perfusion defects of the "no-reflow" type. Typically these defects affected the striatum, thalamus, and hippocampus, as well as the frontal, sensorimotor, and parietal cortices. Areas of no-reflow appeared after 10 min, were more extensive after 15 min, and occupied a major part of the brain after 30 min of ischemia. When recirculation was instituted for 60 or 90 min, following 15 min of ischemia, flow returned in previously unperfused areas. However, a delayed hypoperfusion developed, which differed widely between structures (range of CBF values, 20-80% of control). When the ischemic period was prolonged to 30 min, some perfusion defects remained, even after 90 min of recirculation. PMID- 6841465 TI - Recirculation in the rat brain following incomplete ischemia. AB - The objective of this study was to characterize local cerebral blood flow (CBF) in the recirculation period following incomplete forebrain ischemia. Specifically, we wished to determine whether perfusion defects developed in the immediate recirculation period, to study how initial hyperemia and delayed hypoperfusion at the local level were related to the severity of the preceding ischemia, and to find out whether reflow was influenced by the nutritional state of the animals. To that end, forebrain ischemia of 15 min duration was induced in fed and fasted ventilated rats under 70% N2O. Local CBF was measured with an autoradiographic technique at the end of ischemia, as well as at 5 and 60 min following the start of recirculation. Control experiments were performed to examine the influence of ischemia on cerebral metabolic state in fed and fasted animals. The ischemia reduced CBF to excessively low values (less than 5% of control) in many forebrain structures, including the cerebral cortices, caudoputamen, and hippocampus. In spite of this, perfusion defects failed to appear after 5 min of recirculation. Instead, moderate to marked hyperemia was present in all previously ischemic structures. After 60 min of recirculation, pronounced hypoperfusion developed. The magnitude of the initial hyperemia was poorly related to the severity of the preceding ischemia, but the latter partly determined the degree of delayed hypoperfusion. Thus, little or no hypoperfusion developed in structures whose flow rates exceeded 30-40% of control during ischemia. Fasted animals had a better preserved flow to many structures than did fed animals, indicating that the detrimental effect of feeding (or glucose infusion) is also reflected in lower perfusion rates. PMID- 6841466 TI - Simultaneous determination of regional cerebral blood flow and blood--brain glucose transport kinetics in the gerbil. AB - Cerebral blood flow (CBF) and unidirectional transport of glucose from blood to brain were measured simultaneously in four brain regions of the pentobarbital anesthetized gerbil. The method consisted of the intravenous injection of a bolus containing [14C]butanol and [3H]glucose, followed by continuous withdrawal of arterial blood and sampling of brain 25 s later. CBF was lowest in the cerebral cortex (50 ml 100 g-1 min-1), highest in the brainstem (89 ml 100 g-1 min-1), and intermediate in the basal ganglia and cerebellum (66 and 69 ml 100 g-1 min-1, respectively). The kinetics of blood-to-brain glucose transport were measured in animals whose blood glucose concentration had been altered by glucose or insulin injections. The half-saturation constant for glucose transport (Km) was similar in all brain regions (7.37-8.14 mM), while the maximal rate of transport (Vmax) was lowest in the cerebral cortex (1.55 mumol g-1 min-1) and significantly higher in the basal ganglia, cerebellum, and brainstem (1.81-2.02 mumol g-1 min-1). These values for CBF and glucose transport are similar to those reported in the literature for other pentobarbital-anesthetized animals. The method provides a simple and rapid technique for determining the effect of ischemia and alterations in CBF on blood-to-brain glucose transport. PMID- 6841467 TI - Ischemia reduces blood-to-brain glucose transport in the gerbil. AB - The effect of carotid occlusion on cerebral blood flow (CBF), brain plasma volume for sucrose (Vplsuc), and unidirectional transport of glucose from blood to brain was measured in four regions of gerbil brain. Unilateral common carotid artery occlusion caused a variable decrease in CBF to the ipsilateral cerebral cortex and basal ganglia, with no change in CBF to the contralateral structures; cerebellum, or brainstem. One hour of bilateral carotid artery occlusion reduced flow to near zero in the cerebral cortex and to 30% of control in the basal ganglia, while increasing CBF to the cerebellum and brainstem. There was a significant decrease in the Vplsuc of the cerebral cortex and basal ganglia after 1 h of ischemia, perhaps due to compression of the intravascular space by edema fluid. Blood-to-brain glucose transport, 1 min after release from 1 h of bilateral carotid occlusion, was decreased in the cerebral cortex and basal ganglia, but not in the cerebellum or brainstem. These data indicate that 1 h of complete or incomplete ischemia reduces the rate of unidirectional glucose transport from blood to brain. PMID- 6841468 TI - Respiratory activity of isolated rat brain mitochondria following in vitro exposure to oxygen radicals. AB - Respiratory activity of isolated rat brain mitochondria was measured following in vitro exposure to oxygen radicals. The radicals were generated by hypoxanthine and xanthine oxidase in the presence of a suitable iron chelate and caused a severe inhibition of respiration stimulated by phosphate plus ADP (with malate + glutamate as substrate). The damage could be prevented by catalase or high concentrations of mannitol, but not by superoxide dismutase. A similar effect was observed when hypoxanthine and xanthine oxidase were replaced by glucose and glucose oxidase or by hydrogen peroxide. Most of the findings indicate that the hydroxyl radical is the damaging agent. It is concluded that brain mitochondria exposed to oxygen radicals in vitro show an inhibition of respiratory activity similar to that reported by other investigators as occurring in mitochondria in vivo following transient cerebral ischemia. Therefore, oxygen radicals may contribute to this type of cell damage. PMID- 6841469 TI - Selection of experimental conditions for the accurate determination of blood- brain transfer constants from single-time experiments: a theoretical analysis. AB - Reliable blood-brain transfer constants can be determined from data obtained in single-time experiments (i.e., a single experimental time for tissue sampling). The accuracy of such measurements depends on factors such as the test molecule used and the experimental time chosen; therefore, the selection of optimal experimental conditions is important. In this presentation, a model of transport across the blood--brain barrier (BBB) was developed and used to determine appropriate experimental protocols for single-time experiments. Transfer numbers derived from published data with alpha-aminoisobutyric acid (AIB; a compound of low BBB permeability that is readily taken up by brain cells) and diethylenetriaminepentaacetic acid (DTPA; a compound of very low BBB permeability that is not taken up by brain cells) were inserted into the model and apparent blood-to-brain transfer constants (K1) were obtained. In addition, the two basic sets of transfer numbers were altered to mimic various experimental and pathological changes in blood--brain transport. The results of this analysis indicate that moderate to large transfer rates across the BBB (0.01-1.0 ml g-1 min-1) are more easily and reliably measured by AIB-like compounds. In contrast, compounds like DTPA are better test-molecules for measuring small changes in the BBB transfer rate (0.0001-0.001 ml g-1 min-1), provided an appropriate experimental time is chosen. PMID- 6841470 TI - Cerebral veins: fluorescence histochemistry, electron microscopy, and in vitro reactivity. AB - Pial veins, choroid plexus veins, and the cerebri magna vein were investigated with regard to their ultrastructural organization, adrenergic nerve supply, and in vitro reactivity. The vessel walls consisted of a continuous layer of endothelial cells, large amounts of collagenous material, and occasional pericytes. Smooth muscle cells were observed only in a few specimens from the cerebri magna vein. All veins were surrounded by adrenergic nerve fibres. Potassium (124 mM) and noradrenaline (10(-5) - 10(-4) M) induced small contractions (0.2-0.5 mN) of isolated veins during in vitro conditions. The magnitude of these responses was less than one-tenth of that obtained in small pial arteries. PMID- 6841471 TI - Effects of bradykinin on pial arteries and arterioles in vitro and in situ. AB - The effect of bradykinin on cerebrovascular resistance vessels was investigated by the use of in vitro and in situ preparations. Bradykinin, in the range of 10( 10) to 10(-5) M, elicited a concentration-dependent vasodilatation on both feline and human pial arteries in vitro; the half-maximal response was found to be approximately at 2.8 X 10(-7) M and 1.3 X 10(-8) M (EC50), respectively. This dilatatory effect of bradykinin in vitro was found only in arteries preconstricted with prostaglandin F2 alpha or 5-hydroxytryptamine. In order to determine the effects of bradykinin on the diameter of cat pial arteries in situ, perivascular microapplication was employed. The dose-response curves obtained showed vasodilatation; the EC50 and the maximal response (EAm) were 4.4 X 10(-7) M and 45.5% at 10(-5) M, respectively. Statistically significant (p less than 0.01) reactions were observed at 10(-7) M and higher concentrations of bradykinin. The observed effects were independent of initial vessel size (80-260 microns). These in situ findings are very similar to those found in vitro. The isolated guinea pig ileum was used to check the stability of the bradykinin solutions. In this instance, a concentration-dependent contraction was found when "freshly prepared" or "5 hours stored" bradykinin was applied, indicating no measureable degradation of bradykinin. We conclude that bradykinin is a powerful vasodilator of both human and feline pial arteries. PMID- 6841472 TI - Cerebral glucose metabolism as a function of age in man: influence of the rate constants in the fluorodeoxyglucose method. AB - Measurement of the local cerebral metabolic rate of glucose (LCMRGlc) with the fluorodeoxyglucose (FDG) method requires the utilization of appropriate values for the rate constants of the transport and phosphorylation processes. We measured these rate constants as a function of age to determine whether a decline in LCMRGlc as a function of age, in prior studies with the FDG method, actually represents changes in the rate constants. We found that measurements of LCMRGlc are not significantly affected by changes in rate constants as a function of aging, and that LCMRGlc did not change significantly with age. PMID- 6841473 TI - Regional brain blood flow, blood volume, and haematocrit values in the adult rat. AB - Measurements of red cell volume, plasma volume, and tissue haematocrit (Hct) were made in 14 brain regions in adult rats using 51Cr-tagged red cells and 125I labeled human serum albumin. The mean large vessel (systemic artery) Hct was 41.8, total body Hct was 35.3, and of the brain regions, the lowest value (septal nucleus) was 25.91 and the highest (visual cortex) was 32.05. The lowest blood volume was 6.29 microliters g-1 (caudate putamen) and the highest was 14.44 microliters g-1 (inferior colliculus). There was a significant difference between regions in both blood volume and tissue blood Hct. When brain regions were ranked in order of blood volume, this did not coincide with the order for blood flow. PMID- 6841474 TI - [Development of biliary surgery. Clinical and therapeutic deductions]. PMID- 6841475 TI - [Segmental replacement of the main bile duct in dogs by a silicone prosthesis. Preliminary study of materials conceived for biliary drainage]. PMID- 6841476 TI - [Choledochocele in adults]. AB - Choledochocele are cystic polypoid lesions of the end portion of the common bile duct. The occurrence of choledochocele is 4 p. cent among choledochal cysts. One case is presented in a 78-year-old woman. The treatment was surgical excision. This case was unusual by the age of the patient and by the diagnosis missed at the time of a cholecystectomy performed one year previously. PMID- 6841477 TI - [Surgery of bone metastases in the limbs. A series of 254 operated metastases. Current attitude]. PMID- 6841478 TI - [Rare lesions caused by seat belts]. AB - The authors report a number of rare traumatic lesions which can be described under the heading of "safety belt syndrome". The superficial haematoma which is invariably present ("seat belt sign") would seem to be a reliable indication of improper wearing of the seat belt which has been attached too loosely. The lesions seen were a vertebral arteriovenous fistula after cervical contusion, a closed rupture of a rectus abdominis muscle, associated with rupture of the homolateral renal artery and finally pelvi-ureteric disinsertion with laceration of the renal pelvis. It is important to be aware of such lesions which must be suspected in case of accident with a seat belt since the diagnosis is often difficult. The superficial haematoma is a valuable sign which should suggest the possibility of underlying deep lesions. PMID- 6841479 TI - [Colonic occlusions. Retrospective cooperative study of 497 cases]. AB - A retrospective multicenter study involving 12 digestive surgery centers was conducted on 497 cases of colon obstruction. The most frequent cause of colon obstruction was colo-rectal cancer (71 p. cent of cases), but many other etiologies were involved, including 61 cases of torsion and 37 patients with occlusive sigmoiditis. Differential clinical and radiological features in each etiological group are discussed, the results of therapy undertaken analyzed, and a reasonable line of conduct proposed, adapted to each situation, with the objective of attempting to reduce mortality which still affects 25 p. cent of cases operated upon. PMID- 6841480 TI - [Severe dumping syndrome after vagotomy and pyloroplasty, cured by pyloric canal reconstruction]. PMID- 6841481 TI - [Multiple paradoxical pulmonary and arterial emboli complicating phlebitis. Apropos of a surgical case]. PMID- 6841482 TI - [Acute pancreatitis. Apropos of 210 cases operated on between 1970 and 1980]. PMID- 6841483 TI - The prosody of maternal speech: infant age and context related changes. PMID- 6841484 TI - The acquisition of Hebrew plurals: the case of the missing gender category. PMID- 6841485 TI - A discourse analysis of deixis: pragmatic, cognitive and semantic factors in the comprehension of 'this', 'that', 'here' and 'there'. PMID- 6841486 TI - Noun phrases and coherence in child narratives. PMID- 6841487 TI - Children's judgements of the functional acceptability of referential communications in discourse contexts. PMID- 6841488 TI - Bierwisch's analysis as a test of the SFH. PMID- 6841489 TI - Mothers' speech to prelingual infants: a pragmatic analysis. PMID- 6841490 TI - Asking children to ask; an experimental investigation of the pragmatics of relayed questions. PMID- 6841491 TI - Comprehending surface and deep structure subjects: children's understanding of implied vs. explicitly stated nouns. PMID- 6841493 TI - Informational functions of mother-child discourse: knowing them when we see them. PMID- 6841492 TI - Children's comprehension of Italian comparative forms and the three-term problem solution. PMID- 6841494 TI - Concepts and methods in the study of conversation: a reply to Lynda Olsen-Fulero. PMID- 6841495 TI - Reduplication in child phonology. PMID- 6841496 TI - Mothers' and fathers' speech to their young children: similar or different? PMID- 6841497 TI - Conditional statements in young children's spontaneous speech. PMID- 6841498 TI - Context-related age changes in mothers' speech: joint book reading. PMID- 6841499 TI - The relationship of pragmatic dimensions of mothers' speech to the referential expressive distinction. PMID- 6841500 TI - Mothers' use of fantasy in speech to young children. PMID- 6841501 TI - The role of input frequency in lexical acquisition. PMID- 6841502 TI - Characteristics of adult speech which predict children's language development. PMID- 6841503 TI - Prefix versus suffix information processing in the comprehension of tense and aspect. PMID- 6841504 TI - The word order myth. PMID- 6841505 TI - Children with reading disorders--I. Efficacy of reading remediation. AB - The efficacy of reading remediation, which emphasized phonetic decoding, was investigated in children with pure reading disorders, controlling for the influence on non-specific treatment effects. Sixty-one children were randomly assigned to receive instruction in reading or in other subjects for four months. Children were re-evaluated immediately after, and two and eight months after, the cessation of the intervention. At the end of treatment, the children who had received reading remediation obtained significantly higher scores than the controls on all reading tests. Some of the treatment advantages were maintained beyond the treatment period. Results clearly support the efficacy of reading remediation which emphasizes phonetic skills. The study does not address itself to whether this treatment method differs from other remedial interventions. PMID- 6841506 TI - Children with reading disorders--II. Effects of methylphenidate in combination with reading remediation. AB - Sixty-six children received individual reading instruction for 18 weeks, in combination with methylphenidate (mean daily dose 44.2 mg/day) or a placebo. Assignment to medication was random and double blind. Children were re-evaluated at the end of treatment, and two and eight months later. Only occasional and weak methylphenidate effects were obtained on measures of reading performance. Highly significant improvement in some tests of mathematics was found. No treatment differences occurred at follow-up. The results do not support the hypothesis that the enhancement of attention with stimulant treatment facilitates the acquisition of reading skills in children with pure reading disorders. PMID- 6841507 TI - Factor structure of the Rutter 'Children's Behaviour Questionnaire' in a primary school population in a developing country. PMID- 6841508 TI - Some factors associated with increased risk of smoking by children. PMID- 6841509 TI - Hyperkinetic disorders in seven-year-old children with perceptual, motor and attentional deficits. AB - One hundred and forty-one seven-year-old Swedish children took part in an extensive neuropsychiatric study involving total population samples of children who had shown perceptual, motor and attentional deficits in pre-school, and blindly examined comparison children. The present paper reports on generalized hyperkinesis, i.e. hyperactivity in the child in all of three different assessment settings. About a third of children diagnosed according to strict criteria as suffering from 'Minimal Brain Dysfunction' showed generalized hyperkinesis. In children without perceptual-motor deficits, hyperkinesis was very much rarer. A total population frequency for generalized hyperkinesis in the range of 1-3% is reported as probable. Heredity for delayed maturation, non optimal pre-, peri- and neonatal factors and adverse psychosocial factors were found to interact in the shaping of the disorder. PMID- 6841510 TI - Going to the doctor: a developmental study of stress and coping. PMID- 6841511 TI - Child psychiatric emergencies: a research note. AB - In a controlled study, emergency referrals to a child psychiatric clinic showed increased depressive and suicidal symptomatology and more perceptual abnormalities. There was also more commonly a recent deterioration in the presenting condition. Parents rated themselves as depressed more frequently and there were more problems in the father-child relationship. There were no significant associations between emergency referrals and ratings of family dysfunction, availability of an extended family or contact with social agencies, but there was a trend towards increased use of the latter by the emergency group. The results highlight the need for early child-centred psychiatric intervention in a minority of conditions of children and adolescents. PMID- 6841512 TI - Children's questions and adults' answers. AB - Radio-recordings were made of the conversation of 30 girls, aged just under four, at school with their teachers and at home with their mothers. Half the girls were middle class and half working class. The frequency and type of question asked by the children and the frequency and type of answer given by the adults were analysed. Particular attention was paid to passages of persistent questioning by the child. There were home-school and social class differences in all these measures. The significance of the findings for education is discussed. PMID- 6841513 TI - The incidence of attachment objects and oral habits at bedtime in two longitudinal samples of children aged 1.5-7 years. PMID- 6841514 TI - A case report in relation to access. PMID- 6841515 TI - Biological preprogramming of infant behaviour. PMID- 6841517 TI - Gas chromatographic assay of atropine in formulations containing atropine sulphate and cholinesterase reactivators. PMID- 6841516 TI - Detection of neutral and aminosugars from glycoproteins and polysaccharides as their alditol acetates. AB - A new method for the preparation and separation of alditol acetates from neutral sugars has been applied to aminosugars. Reduced aminosugars were rapidly acetylated using 1-methylimidazole as the catalyst without removal of borate formed during reduction. The alditol acetates were separated by glass capillary gas chromatography on Silar 10C. The alditol acetates of aminosugars had retention times much longer than those of neutral sugars. However, the alditol acetates of the deamination products of aminosugars had shorter retention times and were resolved from those of neutral sugars. This method was used for the simultaneous detection of neutral and aminosugars in acid hydrolysates of chitin and the glycoproteins, ovalbumin and peroxidase. PMID- 6841518 TI - Minor component tablet analysis by high-performance thin-layer chromatography. PMID- 6841519 TI - Separation and determination of macrocyclic pyrrolizidine alkaloids of the otonecine type present in the edible plant Petasites japonicus by reversed-phase high-performance liquid chromatography. PMID- 6841520 TI - Determination of benzomate in plant tissues by high-performance liquid chromatography. PMID- 6841521 TI - Determination of quinine in hair preparations by reversed-phase high-performance liquid chromatography. PMID- 6841522 TI - Use of high-performance liquid chromatography to study the caeruloplasmin catalysed oxidation of biogenic amines. II. Multiple substrate systems. PMID- 6841523 TI - Simultaneous measurement of four testicular delta 4-3-ketosteroids by isocratic high-performance liquid chromatography with on-line ultraviolet absorbance detection. AB - A method is described for the simultaneous measurement of testosterone, androstenedione, 17 alpha-hydroxyprogesterone and progesterone in venous effluent from in vitro perfused rat testes. The assay uses a non-radioisotopic internal standard (11 beta-hydroxyandrostenedione), isocratic high-performance liquid chromatography (HPLC) and UV absorbance detection at 240 nm. Either of two isocratic HPLC systems described in this report (tetrahydrofuran-methanol-water, 16:28:56; methanol-acetonitrile-water, 9:36:55; v/v/v) may be used, and assay specificity is the same in each. The separation and measurement of all four steroids are completed in 25 min. Sensitivity of the method is 10 ng for testosterone, androstenedione and 17 alpha-hydroxyprogesterone and 25 ng for progesterone. The linear range of the assay extends through 1600 ng which is the upper amount of each steroid tested. Average inter-assay coefficient of variation was 3.3% and average intra-assay coefficient of variation was 3.6%. This rapid, specific and reliable method requires minimal sample preparation and may be performed by inexperienced personnel. PMID- 6841524 TI - Micro high-performance liquid chromatographic separations of bile acids. AB - Separations of bile acids by micro high-performance liquid chromatography (micro HPLC) using an immobilized 3 alpha-hydroxysteroid dehydrogenase post-column and a spectrofluorimeter are described. The sensitivity of detection is greatly increased by pre-mixing beta-nicotinamide adenine dinucleotide with the mobile phase, using a single pump. The detection limit is 0.04-0.7 ng, depending on the solute. Instruments suitable for the analysis of bile acids in micro-HPLC are discussed. PMID- 6841525 TI - Determination of Leu-enkephalin degradation by a soluble enzyme preparation from calf-brain striatum using reversed-phase high-performance liquid chromatography. AB - A rapid procedure for the determination of Leu-enkephalin (Tyr-Gly-Gly-Phe-Leu) and its main metabolic degradation products (Tyr, Tyr-Gly-Gly and Tyr-Gly) by reversed-phase high-performance liquid chromatography was developed. The method has good precision, the coefficient of variation determined in the range 6-20 pmole being 1.5-3% (n = 8), and a very low detection limit of ca. 10 fmole for each metabolite. An unexpectedly high percentage of Tyr-Gly production is observed after enzymatic degradation of Leu-enkephalin by a solubilized enzyme preparation of calf-brain striatum. PMID- 6841526 TI - Purification of human erythrocyte phosphoglycerate kinase by dye ligand affinity chromatography. AB - A new method for the purification of human erythrocyte phosphoglycerate-kinase involving affinity chromatography on dye-ligand media (Red A), in the presence of 3-phosphoglycerate and ATP, is described. The method is rapid and technically simple. The purity of the enzyme was verified by electrophoresis in polyacrylamide gel in the presence of sodium dodecylsulphate, by amino acid analysis and by immunoprecipitation in Ouchterlony plates. Peptide mapping of tryptic digests of the purified enzyme was performed and the immunoneutralization of the enzyme activity evaluated with rabbit antibodies. PMID- 6841527 TI - Analysis of barbiturates in plasma and urine using gas chromatography without prior derivatization. PMID- 6841528 TI - Comparative gas chromatographic analysis of narcotics. IV. Methamphetamine hydrochloride. PMID- 6841529 TI - Analysis of sialic acids by gas chromatography of the mannosamine derivatives released by the action of N-acetylneuraminate lyase. AB - A convenient method for the analysis of sialic acids is proposed, which is based on their dissociation into pyruvate and N-acylmannosamines by the action of N acetylneuraminate lyase, followed by gas-chromatographic analysis of the latter products as trimethylsilylated diethyl dithioacetals. Conjugated sialic acids should be freed with neuraminidase before being subjected to the action of the lyase, but these sequential enzymic reactions may be performed in one pot. N Acetyl-, N-glycolyl- and N,O-diacetylneuraminic acids gave the corresponding mannosamines, and the dithioacetal derivatives of these mannosamines were well separated on a column of silicone OV-1. Quantitation of this enzymic and gas chromatographic method indicated that the error and coefficient of variation for free N-acetylneuraminic acid were 1.1% and 2.5%, respectively, for ten determinations at the 100 nmol level. The values for conjugated N acetylneuraminic acid in N-acetylneuraminlactose were 2.9% and 5.9%, respectively. This method was applied to the analysis of sialic acids in some biological samples, and the results were compared with those obtained by the conventional colorimetric method. Preliminary data on urinary sialic acids indicated that cancerous patients gave significantly higher levels of urinary N acetylneuraminic acid than normal subjects. PMID- 6841530 TI - Gas chromatographic determination of metoprolol in human plasma. AB - A method for the determination of metoprolol at concentrations down to 10 ng/ml in human plasma is described. After addition of oxprenolol as internal standard, both compounds are extracted into diethyl ether--dichloromethane (4:1, v/v) at basic pH, transferred into an acidic aqueous solution and back-extracted at basic pH into diethyl ether--dichloromethane. They are then derivatized with heptafluorobutyric anhydride. The derivatives are quantitatively determined by gas chromatography using a 63Ni electron-capture detector. The linearity was demonstrated, and the technique was formally validated in the concentration range 10-500 ng/ml. The technique was applied in a study of the bioavailability of metoprolol after oral administration to man; mean plasma concentrations are reported. PMID- 6841531 TI - An investigation of high-performance liquid chromatographic methods for the analysis of amphetamines. AB - Three pre-column derivatization reagents, namely o-phthalaldehyde, 4-chloro-7 nitro-benz-2,1,3-oxadiazole, sodium naphthaquinone-4-sulphonate and two ion-pair reagents, namely, naphthalene-2-sulphonate and sodium dodecylsulphate have been investigated for their suitability for the qualitative and quantitative analysis of urine and plasma samples containing amphetamines. The derivatization method employing sodium naphthaquinone-4-sulphonate was found to be selective and sufficiently sensitive for the routine determination of amphetamine and methylamphetamine in urine and plasma samples at the ng/ml level. PMID- 6841532 TI - Determination of isosorbide dinitrate and its mononitrate metabolites in human plasma by high-performance liquid chromatography-thermal energy analysis. AB - An accurate and sensitive method for the simultaneous determination of isosorbide dinitrate and its 2- and 5-mononitrates in human plasma has been developed. Following extraction of 3.0 ml of plasma with 12.0 ml of dichloromethane-ethyl acetate (1:1) the extract is subjected to high-performance liquid chromatography employing a Zorbax NH2 column. The eluent stream is introduced into a thermal energy analyser, employing chemiluminescence as a specific means of detection. The minimum quantifiable level of the compound in plasma is 200 pg/ml allowing the quantitation of isosorbide dinitrate in human plasma following single oral administration. Nitroglycerin is employed as internal standard. PMID- 6841533 TI - Distribution of chloroquine and its metabolite desethyl-chloroquine in human blood cells and its implication for the quantitative determination of these compounds in serum and plasma. AB - The amount of chloroquine and desethyl-chloroquine was determined in samples of total blood and in blood cell fractions from three normal subjects after one oral dose of 1000 mg of chloroquine diphosphate. About 70-85% of the total whole blood content of chloroquine and its metabolite desethyl-chloroquine were recovered in blood cells isolated from whole blood, indicating that these compounds have a high cell/plasma concentration ratio. They were mainly present in thrombocytes and granulocytes. A study of 40 patients taking chloroquine regularly as a treatment for rheumatoid arthritis showed significantly higher concentrations of chloroquine and desethyl-chloroquine in serum than in plasma. The concentration of chloroquine was about two times higher in serum than in plasma and for desethyl-chloroquine the concentration was about four times higher in serum than in plasma. These differences may be explained by a release of chloroquine and desethyl-chloroquine from thrombocytes during the coagulation of blood. The practical implication of the results is that the samples taken for chloroquine determination must be clearly identified as serum or plasma. PMID- 6841534 TI - High-performance liquid chromatographic analysis of diltiazem and its metabolite in plasma. AB - A rapid, selective and reproducible high-performance liquid chromatographic method for the analysis in plasma of the calcium channel blocking agent, diltiazem, and one of its metabolites, deacetyldiltiazem is described. The method involves extraction with the methyl tert.-butyl ether of the drugs and the internal standard (verapamil), back-extraction into sulphuric acid and reversed phase chromatography with UV detection. Over a concentration range of 10-1000 ng/ml the average coefficient of variation for diltiazem was 5.4% and for deacetyldiltiazem was 8.3%. PMID- 6841535 TI - Determination of fluphenazine in plasma by high-performance thin-layer chromatography. AB - Determination of fluphenazine in blood plasma by in situ fluorescent detection after separation by high-performance thin-layer chromatography is described. Enhancement of fluorescent emission of the drug is accomplished by exposure to UV light in the presence of paraffin oil which permits a limit of detectability of approximately 0.1 ng/ml in blood plasma. Thirty samples or more can be processed in a 7-h period with excellent precision (less than 3% relative standard deviation at 2.5 ng/ml). Investigation of extraction procedures, chromatographic conditions, photodevelopment, and fluorescent detection are described. PMID- 6841537 TI - Analysis of corticosterone in the serum of mice and rats using high-performance liquid chromatography. PMID- 6841536 TI - Simple gas chromatographic analysis of 3-methylthiopropionate in human urine. PMID- 6841538 TI - Determination of indeloxazine, a new antidepressant agent, in human plasma by gas liquid chromatography with electron-capture detection. PMID- 6841539 TI - Gas chromatographic determination of the glucuronide of 2-(1-hydroxy-ethyl)-7-(2 hydroxy-3-isopropyl-aminopropoxy)-benzofuran, a metabolite of befunolol, in human urine. PMID- 6841540 TI - [Quantitative determination of 5-methoxypsoralen in plasma by liquid chromatography and spectrofluorometric detection]. PMID- 6841541 TI - Determination of the biological response modifier MVE-2 (AD-022) in biological fluids by high-performance liquid chromatography. PMID- 6841544 TI - Analysis of plasma physostigmine concentrations by liquid chromatography. PMID- 6841542 TI - Rapid determination of metoprolol and alpha-hydroxymetoprolol in human plasma and urine by high-performance liquid chromatography. PMID- 6841543 TI - Reversed-phase high-performance liquid chromatographic assay for zomepirac in urine. PMID- 6841545 TI - High-performance liquid chromatographic determination of 4-aminopyridine and 3,4 diaminopyridine in rat cerebrospinal fluid and serum. PMID- 6841546 TI - Fluorescence high-performance liquid chromatographic determination of free and conjugated bile acids in serum and bile using 1-bromoacetylpyrene as a pre labeling reagent. AB - A fluorescence high-performance liquid chromatographic method is described for the determination of free and conjugated bile acids in serum and bile. Free and conjugated bile acids are extracted from serum or bile using a Sep-Pak C18 cartridge and then fractionated on a piperidinohydroxypropyl Sephadex LH-20 column. Free and glycine-conjugated bile acids are labeled with 1 bromoacetylpyrene in acetonitrile using dicyclohexyl-18-crown-6-ether as catalyst. Taurine-conjugated bile acids are hydrolyzed by cholylglycine hydrolase and then derivatized by the same reagent. Derivatized bile acids are separated stepwise on a reversed-phase column (Radial Pak A) using acetonitrile-methanol water (A) (100 : 50 : 40) and (B) (100 : 50 : 20) as mobile phase. The eluate is monitored by a fluorophotometer at 370 nm (excitation) and 440 nm (emission). Linearities of fluorescence intensities (peak heights) with the amounts of free and conjugated bile acids were obtained between 50 pmol and 200 pmol for free bile acids and between 25 pmol and 100 pmol for glycine-conjugated bile acids, respectively. Recoveries from serum and bile samples are not less than 90%. This method is sensitive, reliable and useful for the simultaneous determination of free and conjugated bile acids in serum and bile. PMID- 6841547 TI - Investigation of the heterogeneity of hemoglobin by cation-exchange chromatography on Bio-REX 70. AB - The use of Bio-Rex 70 cation-exchange resin for chromatography of normal and diabetic hemoglobin provides a reproducible pattern of the "fast components". Particular attention to the choice of sample preparation, pH of elution, and the increase of ionic strength by sodium chloride linear gradients results in the separation of Hb-A1b into two components and in the isolation of a new component eluting between Hb-A1c and Hb-A0. Experiments with [3H]glucose and the colorimetric test (thiobarbituric acid) normally used to determine the extent of non-enzymatic glycosylation, as well as an increase of this component in diabetic samples compared with normoglycemic ones and a significant linear correlation with Hb-A1c, indicate that this component should be a part of the hemoglobins glucosylated on the epsilon-NH2 group of the lysines of both chains and/or the hemoglobin glucosylated on the alpha-NH2 of the valine of the alpha-chain. We propose to call this component Hb-A1x, pending confirmation of its identity. Normally Hb-A1x accounts for about 3% of Hb-A, but up to 5-7% of glucosylated hemoglobins should be confined to the early part of Hb-A0. In diabetics, the percentage of Hb-A1x rises to 4-5% and that of the other glucosylated hemoglobins increases to 12-16%. PMID- 6841548 TI - Determination of 4-methylumbelliferone after separation from its conjugates by high-performance liquid chromatography. Application to lysosomal enzyme activity assays. AB - A high-performance liquid chromatographic method is described for the separation and estimation of 4-methylumbelliferone in the presence of its conjugates. The technique utilizes a simple, isocratic eluent and fluorometric detection. Percentages of 4-methylumbelliferone in the conjugates and fluorescences of the conjugates are reported. 4-Methylumbelliferone, liberated under currently used conditions for enzyme activity in urine and fibroblasts, can be measured by this procedure because these materials contain no substances interfering with the 4 methylumbelliferone peak. Applied to lysosomal enzymatic activity analyses, this procedure eliminates substrate background fluorescence. Determinations of eight lysosomal enzymes in urine and fibroblasts are presented in bar graph form. PMID- 6841549 TI - High-performance liquid chromatographic resolution of p-nitrobenzyloxyamine derivatives of brain gangliosides. AB - A new quantitative procedure for the high-performance liquid chromatographic (HPLC) resolution of human brain gangliosides employing reversed-phase chromatography is described. To provide a derivative which can be determined by UV absorption techniques, p-nitrobenzyloxyamine was coupled to the gangliosides. Derivatization involves ozonation and cleavage of the ceramide double bond followed by oxime formation to the nascent aldehyde. Individual gangliosides, as they were resolved by HPLC, were collected. These fractions were then identified by thin-layer chromatography (TLC) and by gas chromatography of their monosaccharides. Quantitative results were obtained along with a marked increase in sensitivity over conventional resorcinol-hydrochloric acid quantitation of TLC resolved gangliosides. PMID- 6841550 TI - Gas-liquid chromatographic evaluation of fenquizone in biological samples for pharmacokinetic investigations. AB - Extractive alkylation was carried out on fenquizone, a sulphonamide diuretic, in order to devise a suitable method for its determination in pharmacokinetic and bioavailability studies. After extraction as a tetramethyl derivative, fenquizone was evaluated by gas-liquid chromatography with a 63Ni electron-capture detector, which enables a limit of detection of 2 ng/ml of plasma or urine to be achieved. Linearity was verified in a range of 50- 10,000 pg for each injection with a fenquizone/internal standard ratio ranging from 4:1 to 1:4. Determination is very rapid, as one analysis only takes 5 min. The preliminary results of the pharmacokinetic study performed in a volunteer human subject after a single oral administration of the drug are presented in this paper in terms of the plasma levels and the cumulative urinary excretion. PMID- 6841551 TI - Evidence for lactotroph dopamine resistance in idiopathic hyperprolactinemia. AB - Previous studies in patients with idiopathic hyperprolactinemia (IH) that have suggested the presence of decreased central dopaminergic tone have assumed normal responsiveness of lactotrophs to dopamine (DA). We have examined DA sensitivity in 17 women with IH and 19 female controls by evaluating the plasma PRL responses to successive infusions of increasing concentrations of DA (4, 40, and 400 ng/kg . min) as well as to a dopaminergic agonist, bromocriptine (2.5 mg, orally), and to a dopaminergic agonist, bromocriptine (2.5 mg, orally), and to a dopaminergic receptor blocker, domperidone (2 mg, iv). PRL levels in controls were unchanged during a saline infusion, but decreased by 34 +/- 7% (mean +/- SE) at the end of the lowest DA infusion (P less than 0.05 vs. saline). Progressive PRL suppression was produced with each increasing dose. In contrast, in patients with IH, the lowest dose produced no significant suppression from basal PRL levels (P less than 0.001 vs. controls); at 40 ng/kg . min DA, fractional suppression was evident but was less than that in controls (P less than 0.01); at 400 ng/kg . min, fractional PRL suppression in IH patients was indistinguishable from that in controls (70 +/- 6% vs. 73 +/- 4%). Patients with IH also exhibited markedly reduced and delayed PRL response to domperidone (P less than 0.02 vs. controls). Significant impairment of the PRL-lowering effect of bromocriptine was observed in the IH patients between 1 and 2 h (P less than 0.02 vs. controls), and their responses to bromocriptine were again delayed. The results indicate the presence of a relative resistance to DA in patients with IH. This resistance is compatible with a decrease in the number or affinity of lactotroph DA receptors. PMID- 6841552 TI - Different types of melatonin circadian secretory rhythms in some blind subjects. AB - Six of 10 blind subjects had unusual melatonin circadian secretory patterns. One of these subjects, studied longitudinally, appeared to have a free-running melatonin secretory rhythm with a period of 24.7 h. Another subject, also studied longitudinally, appeared to secrete melatonin during the day (instead of during the night). Therefore, some blind subjects appear to have different types of circadian rhythm abnormalities. These findings along with previous work demonstrating suppression of human melatonin secretion by light suggest that the light-dark cycle may be important in the regulation of the human melatonin circadian secretory rhythm. These findings may stimulate more research on the endocrinological consequences of blindness as well as on the biological effects of light in humans. PMID- 6841553 TI - Increases in dietary cholesterol and fat raise levels of apoprotein E-containing lipoproteins in the plasma of man. AB - Previous studies from this laboratory have determined that diets containing the usual amounts of fat to which are added 750-1500 mg/day cholesterol elevate the plasma cholesterol concentration by variable amounts, depending upon the ratio of polyunsaturated to saturated fatty acids (P/S ratio) of the diet. Diets with P/S ratios of 0.25-0.4 are accompanied by elevations of low density lipoprotein (LDL) cholesterol, whereas diets with a P/S ratio of 2.5 produce no significant changes in cholesterol levels. On the low P/S ratio diets, the structure, composition, and interaction with cultured fibroblasts of LDL are not significantly changed. Plasma high density lipoprotein (HDL) cholesterol levels remain constant, but HDL2 increase relative to HDL3. In the present study, not only dietary cholesterol but also total dietary fat was altered. Six normal young men were fed a basal diet consisting of 18% protein, 51% carbohydrate, and 30% fat, containing 250 mg/day cholesterol. After 2 weeks, an experimental diet consisting of 18% protein, 42% carbohydrate, and 39% fat, containing 1760 mg/day cholesterol, was fed for 4 weeks. The P/S ratios of both diets were about 0.4. Plasma samples were taken twice during each dietary period from 12- to 14-h-fasted subjects and analyzed for their contents of lipoprotein lipids. Plasma levels of LDL and HDL cholesterol increased by 30 and 13 mg/dl, respectively; total and very low density lipoprotein (VLDL) triglyceride concentrations were unaltered. The plasma concentrations of apoproteins (apo) B, E. and A-I, but not A-II, were elevated. Plasma samples also were studied by zonal ultracentrifugation, gel permeation column chromatography, and Pevikon electrophoresis. Although on zonal ultracentrifugation the total concentrations of LDL were increased, the flotation properties and chemical compositions of LDL were not changed. By contrast, HDL2 and HDL3L concentrations increased, and HDL2 became enriched with cholesteryl esters. On gel permeation chromatography, with the subjects on the basal diet, plasma cholesterol eluted in two peaks, corresponding to LDL and HDL. The sizes of the peaks increased on the experimental diet. ApoE eluted in two peaks: one at the leading edge of LDL (corresponding to VLDL or IDL) and the other in the area between LDL and HDL, corresponding to HDLC. On the experimental diet, the apoE peak between LDL and HDL increased. On Pevikon electrophoresis apoE migrated between the LDL and HDL bands. This apoE peak was increased on the experimental diet. These findings suggest that increasing the concentrations of both dietary cholesterol and total fat can increase the levels of plasma LDL, HDL2, and HDLC in fasting normal subjects. Thus, the concentrations of some putatively atherogenic as well as antiatherogenic lipoproteins increased in plasma, and the apparent paradox between the epidemiological and metabolic behaviors of some lipoproteins remains. Clearly, more work is needed to resolve the roles of various lipoproteins in plasma in atherosclerosis. PMID- 6841554 TI - A double blind cross-over study on the effects of ORG OD14 compared to estradiol valerate and placebo on the fatty acid composition of serum lecithin and cholesterol ester in oophorectomized women. AB - Twenty-two women, oophorectomized in connection with surgical treatment for cervical carcinoma in clinical stage IB or IIA, were given ORG OD14 [(7 alpha,17 alpha)17-hydroxy-7-methyl-19-norpregn-5-(10)20-yn-3-one; 2.5 mg/day], a placebo, and estradiol valerate (2 mg/day), six weeks each, in a double blind, cross-over study. ORG OD14 is a synthetic steroid for continuous treatment of climacteric symptoms which in traditional bioassays has been shown to have weak estrogenic and progestogenic as well as very weak androgenic-anabolic properties. The aim of this study was to evaluate its effects on serum lecithin as well as on the relative fatty acid composition of serum lecithin and serum cholesterol ester. In serum lecithin, OD14 induced an increase in palmitic acid and a decrease in stearic acid, effects typical of 17-C-alkylated steroids, compared to both placebo and estradiol valerate. Furthermore, there was an increase in linoleic acid and a decrease in both arachidonic and dihomo-gamma-linolenic acid after OD14 administration. This decrease is interpreted as an inhibitory action of the steroid on the mechanisms of elongation and desaturation of linoleic acid and is considered to be an androgenic influence. The relative decrease is further accentuated by the decrease in total serum lecithin induced by OD14. Since these fatty acids are the major precursors for prostaglandin synthesis, these findings might have relevance in that context. PMID- 6841556 TI - Peripheral metabolism of thyroid hormones in man. I. Direct measurement of the conversion rate of thyroxine to 3,5,3'-triiodothyronine (T3) and determination of the peripheral and thyroidal production of T3. AB - We describe here a new method for the direct measurement of the conversion rate of T4 to T3 in man. The metabolic study was performed in 23 subjects: 13 healthy controls, 7 T4-treated hypothyroids, and 3 sick euthyroid patients. The experimental protocol involved the simultaneous iv bolus injection of [125I]T4 and [131I]T3, and the use of Sephadex G-25 column chromatography to determine the plasma concentrations of [125I]T4, [131I]T3, and [125I]T3 newly formed through 5' monodeiodination of labeled T4 in the peripheral tissues. The T4 and T3 kinetic parameters were determined by noncompartmental analysis. The conversion rate of T4 to T3 was computed by a method based on the precursor-product relationship, using the [131I]T3 disappearance curve for correcting the concentrations of newly formed [125I]T3 (convolution method). The conversion rate of T4 to T3 was 0.2541 +/- 0.0125 (mean +/- SEM) in the control group and was significantly reduced (0.1283 +/- 0.0204; P less than 0.001) in the sick euthyroid patients, while it was slightly, though not significantly, increased in the T4-treated patients (0.2932 +/- 0.0220). A close agreement was found between the values for the conversion rate obtained by the convolution approach and those derived from the ratio between the serum concentrations of [125I]T3 and [125I]T4 at equilibrium. The conversion rates obtained by the convolution approach were also in good agreement with the values estimated from the molar ratio between the turnover rates of T3 and T4. In the control group, 72.0 +/- 3.6% of the circulating T3 was produced by 5'-monodeiodination of T4 in the peripheral tissues, and 28.0 +/- 3.6% of the circulating T3 derived from direct thyroidal secretion. The sick euthyroid patients showed a significantly smaller proportion of circulating T3 deriving from peripheral conversion of T4 (52.5 +/- 3.9%; P less than 0.025). PMID- 6841555 TI - Impact of therapy for differentiated carcinoma of the thyroid: an analysis of 706 cases. AB - A retrospective analysis of clinical and pathological data was conducted on 706 patients (514 females and 192 males) treated for differentiated thyroid carcinoma at The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston from 1951 to 1975 and followed to 1981. The histological diagnoses were mixed papillary/follicular carcinoma (66.7%), papillary carcinoma (14.6%), follicular carcinoma (15.3%), or Hurthle cell carcinoma (3.4%). Patients diagnosed before the age of 40 yr lived significantly longer than those diagnosed over the age of 40 yr, and females lived longer than males. According to survival analyses and disease-free intervals, the order of increasing aggressiveness of the tumors was papillary, mixed, follicular, and Hurthle cell. Total thyroidectomy was associated with longer disease-free intervals and fewer recurrences. The 136 patients who received ablative 131I after surgery had fewer recurrences than a matched group who did not, but the disease-free interval and survival rate showed no significant difference. Further classification showed that patients with follicular and mixed tumors, and those who underwent total thyroidectomy benefited from 131I. There were 78 deaths attributed to thyroid cancer in the whole group. Approximately two thirds occurred in the first 10 yr after diagnosis. In conclusion, total thyroidectomy is recommended, when feasible, for differentiated thyroid cancer, followed by ablative 131I therapy, at least for follicular and mixed varieties. PMID- 6841557 TI - Interrelationships among human chorionic gonadotropin (hCG), 17 beta-estradiol, progesterone, and estriol in maternal serum: evidence for an inhibitory effect of the fetal adrenal on secretion of hCG. AB - In normal pregnancy, maternal serum hCG reaches a maximum concentration about 8 10 weeks after the last menstrual period and then decreases. To investigate the possibility that this decrease in hCG is produced by an inhibitory effect of steroids originating in the feto-placental unit, hCG, progesterone, 17 beta estradiol, and estriol were determined by specific RIAs in 341 serum specimens obtained from 229 different pregnancies. Expressions for predicted hCG as a function of estimated trophoblastic mass and percent predicted hCG were determined to correct for the increase in hCG with increasing trophoblastic mass. The relationships between hCG and progesterone, 17 beta-estradiol, estriol, or estimated trophoblastic mass were not linear. Expression of the hCG data as percent predicted hCG produced linear relationships between hCG and each of the above steroids. Both hCG itself and percent predicted hCG were shown to have a negative regression on estriol (P less than 0.001) and a positive regression on progesterone (P less than 0.001), but not on 17 beta-estradiol (P greater than 0.05), in a multiple linear regression on all three steroids. These data suggest that hCG production is inhibited by a steroid originating in the fetal adrenal. This inhibitory effect plateaus in late pregnancy, allowing a minor late increase in hCG due to increasing trophoblastic mass. PMID- 6841558 TI - Androgen binding capacity and 5 alpha-reductase activity in pubic skin fibroblasts from hirsute patients. AB - We have measured the total (cytosolic plus nuclear) androgen binding capacity of pubic skin fibroblasts from nine patients with hirsutism of various origin. Confluent intact cell monolayers were incubated with increasing concentrations (0.05-2 nM) of [3H]dihydrotestosterone ([3H]DHT) with or without a 200-fold excess of unlabeled DHT. The androgen binding capacities (mean +/- SD) were similar in normal men (411 +/- 171 fmol/mg DNA), women (310 +/- 103 fmol/mg DNA), and hirsute patients (313 +/- 141 fmol/mg DNA) regardless of the plasma androgen levels. In contrast, the 5 alpha-reductase level in pubic skin fibroblasts (mean +/- SD) was, as previously described, higher in hirsute women (3.3 +/- 2.6 fmol/micrograms DNA . h) than in normal women (1.1 +/- 0.6 fmol/microgram DNA . h; P less than 0.05). We conclude from these data that: 1) increased androgen binding capacity cannot be held responsible for hypersensitivity to androgens in hirsutism; 2) the androgen receptor is not regulated by androgens in human skin, as similar levels are observed in men, women, and hirsute patients; 3) this contrasts with 5 alpha-reductase activity and emphasizes the importance of this enzyme as an amplifier of androgen action in areas where it is stimulated by androgens, such as pubic skin. PMID- 6841559 TI - Primary cortisol resistance: a family study. AB - Primary cortisol resistance is an autosomal disease characterized by increased plasma cortisol concentration and high urinary free cortisol, resistance to adrenal suppression by dexamethasone, and the absence of clinical stigmata of Cushing's syndrome. The proband with the severe form had hypertension and hypokalemic alkalosis. In subjects with a less severe resistance to cortisol, there are no clinical abnormalities and the condition is revealed only by detailed examination of several parameters of cortisol secretion. PMID- 6841560 TI - Rapid pituitary and peripheral tissue responses to intravenous L-triiodothyronine in hypothyroidism. AB - Acute cardiovascular, renal, pulmonary, metabolic, and pituitary responses to therapy of hypothyroidism with 25 micrograms iv T3 (group I G-I, n = 11) or 50 micrograms iv T3 (group II, G-II, n = 10)/day for 1 week have been studied. Serum T3 levels were acutely normalized in both groups with the mean basal serum T3 levels (X +/- SE) after 7 days, 98 +/- 10 micrograms/dl and 229 +/- 19 ng/dl, respectively. Myocardial performance, noninvasively assessed by the pulse wave arrival time (QKd) and the phonocardiographic systolic time interval ratio was significantly altered after 1 day of therapy (QKd for G-I = -10 +/- 4 msec, P less than 0.05; and for G-II = -18 +/- 14 msec, P less than 0.01). After 7 treatment days, both the mean QKd (203 +/- 7 msec, P less than 0.001) and phonocardiographic systolic time interval ratio (0.41 +/- 0.02, P less than 0.01) were within the normal range in G-II. Abnormal pretreatment renal excretion of an oral water load (G-I, 65 +/- 6%; and G-II, 57 +/- 6%) was also reversed after 1 week (G-I, 84 +/- 5%, P less than 0.05; and G-II, 89 +/- 5%, P less than 0.01). Patients with blunted hypercapnic (n = 6) and hypoxic (n = 4) ventilatory drives were improved in both groups after 6 days. The mean basal metabolic rate, serum cholesterol, and serum creatine phosphokinase were altered by the week of therapy in a dose-response manner, and were in the normal range in G-II. Pituitary TSH secretion was promptly suppressed in both groups. Two hours after the first T3 dose, the mean serum TSH for G-I and G-II decreased to 85% (P less than 0.02) and 70% (P less than 0.001) of their respective pretreatment values. After 7 days of therapy, the mean basal TSH levels had declined to 75% (P less than 0.001) and 5% (P less than 0.001%) of pretreatment, respectively. In comparison with previous observations of responses to 100 micrograms/day iv T4 for 1 week, the 25 micrograms dose T3 was equivalent in terms of changes in basal serum T3 and peripheral (nonpituitary) tissue responses, but less effective than T4 in lowering serum TSH. Based on these parameters, 50 micrograms/day iv T3 was the most effective of the three regimens within this time frame. The implications of these observations in the clinical management of severe complicated myxedema are discussed. PMID- 6841562 TI - Loss of circadian rhythmicity in blood testosterone levels with aging in normal men. AB - Previous studies concerning the relationship of serum testosterone levels to aging in normal men have yielded apparently inconsistent results. Studies performing blood sampling in the morning have often shown an age-related decrease in testosterone levels, while those using afternoon samples have failed to show such a decrease. These results suggested to us the possibility that the circadian rhythm in serum testosterone levels might be altered with normal aging in men. Hourly blood samples were obtained for 24 h from 1 young (mean age, 52.2 yr) and 12 old (mean age, 17 yr) healthy men. Total testosterone levels were measured by RIA. The circadian rhythm in serum testosterone levels found in normal young men was markedly attenuated or absent in healthy elderly men; the early morning rise in testosterone levels characteristic of young men was not present in old age. Mean testosterone levels for the entire 24-h day were lower in healthy old men than in young men. These results demonstrate a clear decrease in serum testosterone levels in healthy old men compared to those in young men and provide an explanation for the inability to demonstrate an age-related decline in testosterone levels in earlier studies using serum samples obtained in the afternoon. PMID- 6841561 TI - Modulation of arginine-induced glucagon release by epinephrine and glucose levels in man. AB - To assess how physiological epinephrine (EPI) elevations and EPI-induced hyperglycemia interact in the regulation of glucagon secretion, we measured acute glucagon responses (AGR) to arginine at controlled glucose levels during EPI infusions in man. With glucose levels matched at 166 +/- 5 mg/dl using glucose clamp techniques, the AGR (mean change at 2-5 min) to a 5-g iv arginine injection was greater in each subject during the infusion of 15 ng/kg . min EPI (low EPI) than during the control glucose infusion and was still greater during the infusion of 80 ng/kg . min EPI (high EPI; 69 +/- 15, 76 +/- 13, and 142 +/- 22 pg/ml, respectively; n = 8; P less than 0.003). With glucose levels matched at 256 +/- 5 mg/dl, a similar dose-related enhancement of AGR by EPI was seen (control, 53 +/- 12 pg/ml; low EPI, 63 +/- 5 pg/ml; high EPI, 130 +/- 20 pg/ml; P less than 0.008). During control infusions, raising the glucose level from 102 +/ 2 to 166 +/- 5 to 256 +/- 5 mg/dl suppressed AGR from 77 +/- 17 to 69 +/- 15 to 53 +/- 12 pg/ml (P less than 0.002). During low EPI, the same glycemic increments lowered GR from 108 +/- 19 to 76 +/- 13 to 63 +/- 5 pg/ml (P less than 0.02). This suppression of AGR by hyperglycemia was sufficient to obscure stimulation by EPI: at a glucose level of 102 +/- 2 mg/dl during control infusions, AGR was 77 +/- 17 pg/ml, compared to only 76 +/- 13 pg/ml during low EPI with the glucose level higher (166 +/- 5 mg/dl). Multiple linear regression analysis showed a highly significant dependence of AGR on both EPI and glucose levels, accounting for 80% of the within-subject variation in AGR (P less than 0.0001). These data show that 1) EPI is a dose-dependent amplifier of arginine-induced glucagon secretion in man, and 2) hyperglycemia suppresses arginine-induced glucagon secretion, potentially masking the stimulation caused by EPI. The findings suggest that the feedback effect of hyperglycemia on glucagon secretion may help regulate the level of hyperglycemia resulting from adrenergic stimulation. PMID- 6841563 TI - The presence of myoglobin in human thyroid tissue. AB - In the present study we sought to determine the presence of myoglobin in human thyroid tissue. When reacted with antihuman myoglobin antibody on the Ouchterlony plate, homogenates of human thyroid tissue formed a precipitation line. When the human thyroid extract was included in human myoglobin RIA, the dilution curve of thyroid extract was parallel to the standard curve of myoglobin. When the myoglobin immunoreactivity in thyroid extract was fractionated with Sephadex G 75 column, the immunoreactivity was eluted in a peak identical with authentic myoglobin. The position of the peak was different from that of thyroglobulin. Myoglobin concentration in thyroid tissue was estimated to be 0.7-110 mg/g wet wt, being about 1/6000 to 1/40 of that in skeletal muscle. Histochemical studies demonstrated the presence of myoglobin immunoreactivity in thyroid tissue, especially in the apical border of thyroid epithelial cells, implying a functional role in iodinating process or exocytotic-endocytotic process. PMID- 6841564 TI - Effect of the benzodiazepine derivative, diazepam, on the clonidine-stimulated human growth hormone secretion. AB - gamma-Aminobutyric acid (GABA) has both stimulatory and inhibitory effect on human GH secretion. We previously reported that the benzodiazepine derivative diazepam, which exerts its main pharmacological effect by facilitating GABA mediated transmission, is able to reduce the GH response to L-dopa and apomorphine. To establish whether diazepam affects the alpha-adrenergic regulation of GH secretion, the GH response to clonidine (an alpha-agonist) was investigated in seven volunteers after placebo and diazepam premedications. After placebo pretreatment, clonidine (0.15 mg iv infused over 20 min) significantly stimulated GH secretion: the mean serum GH level rose from a basal level of 4.7 +/- 1.1 (+/- SEM) ng/ml to a maximum of 10.8 +/- 1.6 ng/ml (P less than 0.025). After 3 days of diazepam treatment, a similar GH response to clonidine was observed; the mean serum GH level rose from a basal value of 2.3 +/- 0.3 ng/ml to a maximum of 9.4 +/- 1.3 ng/ml. It is concluded that the inhibitory effect of diazepam on human GH secretion is mediated via inhibition of dopaminergic transmission, whereas the alpha-adrenergic control of GH release is not affected. Since diazepam potentiates GABAergic transmission, its effect may reflect the role of endogenous GABA in human GH secretion. PMID- 6841565 TI - Preparation of synthetic bovine parathyroid hormone fragment 1-34 for parenteral use in human studies. AB - There is growing interest in use of synthetic parathyroid hormone peptides such as the aminoterminal 1-34 fragment (PTH 1-34) in human studies, since bovine parathyroid extract is no longer commercially available. We found no data concerning how to sterilize and dilute the synthetic bovine PTH 1-34 (bPTH 1-34) to minimize adsorptive losses and maximize conservation of bioactivity. Therefore, we examined adsorptive losses of electrolytically-labelled, biologically-active bPTH 1-34 onto sterile filtration devices (Millex GV, Millipore Corp.) in solutions of 0.1 M acetic acid containing varying human serum albumin (HSA) concentrations (0.1-5.0%, w/v) and varying hormone concentrations (1-50 micrograms bPTH 1-34/ml). We also assessed preservation of bPTH 1-34 bioactivity (canine renal cortical plasma membranes) in diluted, sterile-filtered solutions refrigerated for 4 days. Adsorptive losses were inversely related to bPTH 1-34 concentrations, being least with 50 micrograms bPTH 1-34/ml, at all concentrations of HSA. Losses during filtration were essentially indistinguishable at HSA concentrations of 0.1 - 1.0%, but were, surprisingly, increased by 2.5 and 5.0% HSA. There were no important differences in adsorptive losses among five different lots of Millex-GV filters. Full bioactivity was preserved over 4 days of refrigeration at a bPTH 1-34 concentration of 20 micrograms/ml. The data suggest that bPTH 1-34 should be sterile-filtered at a concentration of greater than or equal to 20 micrograms/ml in 0.1M acetic acid containing 0.1 - 1.0% HSA. Such sterile solutions are stable at 4 degrees C for at least 4 days. PMID- 6841566 TI - Plasma lipotropin increase in man after growth hormone administration. Comparison between extractive and biosynthetic hormones. AB - The action of human growth hormone (hGH) on plasma lipotropins (beta-and gamma LPH) in 15 GH deficient patients was studied by comparing the effects induced by the acute administration of the extracted and biosynthetic molecules. The purified extracted preparation (6 mg/m2 im) induced a dramatic rise in plasma LPH: basal (49 +/- 12 pg/ml (mean +/- SEM); peak 1,658 +/- 262 pg/ml. The same dose of biosynthetic methionyl-hGH (met-hGH) induced no significant change in plasma LPH. Both preparations caused identical plasma GH increases. Six different commercially available extracted hGH preparations (Choay, France; Serono, Italy; France Hypophyse, France; Kabi, Sweden; Nordisk, Denmark; International Standard, Great Britain) all showed definite cross-reactivity in the LPH radioimmunoasay, varying from 0.1 to 1.0%, on a weight basis. No cross reactivity was found with met-hGH (less than 0.0001%). On gel exclusion chromatography, the LPH immunoreactivity of the purified preparations was dissociated from the GH immunoreactivity and eluted at the position of beta-and gamma-LPH. These data show that extracted hGH preparations are all contaminated with LPH and raise the question of the possible consequences of chronically elevated plasma LPH in treated patients. The use of biosynthetic met-hGH should prevent this occurence. PMID- 6841567 TI - [A study of the stomach X-ray of elderly patients]. PMID- 6841568 TI - [Study of physical fitness in high school girls tested at regular intervals. (1). Comparison of a densely populated region with a rural region]. PMID- 6841569 TI - [Study of physical fitness in high school girls tested at regular intervals. (2). Relationship between physical performance and defensive strength]. PMID- 6841570 TI - Usefulness of transplanted glioma cells in the subcutaneous tissue of the nude mice, for assessment of therapeutic effect of the anti-tumor chemotherapy. PMID- 6841571 TI - [Studies on serum ferritin concentration and bone marrow iron stores in the healthy aged]. PMID- 6841572 TI - [An electroencephalological study of fluctuation in brain activity levels during waking hours]. PMID- 6841573 TI - [Evaluation of tumor response to radiation therapy combined with bronchial artery infusion in primary lung cancer]. PMID- 6841575 TI - [Effects of transection, local cooling and electrical stimulation of the mid pontine region upon the hippocampal theta rhythm in the rabbit]. PMID- 6841574 TI - [A study on placental ferritin and its influence on iron nutrition of the mother and her normally delivered newborn]. PMID- 6841576 TI - [Comparison of hydroxyapatite contained in the formalin-fixed and untreated sialoliths]. PMID- 6841577 TI - [CT comparison of cerebral atrophy in alcoholic groups]. PMID- 6841578 TI - Association of iota-like toxin and Clostridium spiroforme with both spontaneous and antibiotic-associated diarrhea and colitis in rabbits. AB - A helically coiled, anaerobic, gram-positive sporeforming bacillus, identified as Clostridium spiroforme, was isolated from the cecal contents of all of 27 rabbits with spontaneous diarrhea, at a mean concentration of 10(6.0) spores per g of material. All of these rabbits also had a toxin present in their cecal contents that was neutralized by anti-Clostridium perfringens type E iota toxin, but not by other clostridial antitoxins. In addition, four rabbits with clindamycin associated colitis were positive for C. spiroforme at a mean concentration of 10(4.5). All of these animals also had iota-like toxin present. Iota-like toxin was not detected in the cecal contents of 72 healthy animals, although C. spiroforme was found in two of these animals at a mean concentration of 10(6.0). C. spiroforme was shown to produce a toxin in vitro that was lethal to mice and caused dermonecrosis in guinea pigs. In all cases, this toxin was neutralized by anti-C. perfringens type E iota toxin. PMID- 6841580 TI - Collaborative evaluation of the microbial profile system for quantitative antimicrobial susceptibility testing. AB - This three-center collaborative study was conducted to evaluate samples of the Microbial Profile System (MPS) antimicrobial microdilution panels [previously produced by Minnesota Mining & Manufacturing Co., (3M Co.), St. Paul, Minn. and currently produced by Flow Laboratories, Inc., Rockville, Md.). This was a three phase study. In phase I, the inter- and intralaboratory agreement was determined by using strains with selected ranges of susceptibility. The MPS and reference microdilution minimum inhibitory concentrations were within acceptable variation, +/- 1 dilution for 97.7% for the MPS and 98.8% for the reference microdilution panels for the intralaboratory comparisons. The percentage of strains with minimum inhibitory concentrations in the acceptable range for the interlaboratory variation was 96.2% for the MPS and 96.0% for the reference microdilution panels. The phase II studies used strains with known resistance mechanisms. The percent agreement with these strains was: Enterobacteriaceae, 94.5%; nonenteric gram negative rods, 95.4%; staphylococci, 92.3%; and streptococci, 96.6%. The overall agreement within acceptable limits was 94.7% with these strains. When testing 359 clinical isolates, the frequency of strains within the acceptable range of agreement between the two methods was 97.3%. The MPS panels gave results in each of the three study phases equivalent to those obtained with the reference microdilution panels. PMID- 6841579 TI - Aeromonas hydrophila typing scheme based on patterns of agglutination with erythrocytes and yeast cells. AB - An agglutination typing scheme has been developed for strains of Aeromonas hydrophila. Primary agglutination typing is based on testing agar-grown A. hydrophila cells with human, horse, rat, and guinea pig erythrocytes and Saccharomyces cerevisiae cells. Further subdivision of primary groups is based firstly on whether yeast cell agglutination is inhibited by a D-mannose polymer, yeast mannan, and secondly on patterns of inhibition of hemagglutination by yeast mannan and the monomeric sugars L-fucose, D-galactose, and D-mannose. A total of 320 isolates were tested, and these were divisible into 39 distinct types on the basis of this scheme. Application of this typing scheme in the future to isolates of A. hydrophila known to be associated with human infection may enable correlations to be made between particular agglutination types and human pathogenicity. PMID- 6841582 TI - Rapid test for detection of rabies antibodies in human serum. AB - A simple, sensitive, rapid method based on the principle of immunoadherence hemagglutination (IAHA) has been devised for the detection of rabies antibody. In this test, fixation of complement to complexes of rabies antigen with specific antibodies is readily detected by agglutination of human erythrocytes bearing receptors for C3. Sera from individuals undergoing preexposure rabies immunization were tested for rabies antibodies by the IAHA method and by a virus neutralization test performed in tissue culture, the rapid fluorescent focus inhibition test. IAHA titers showed a high degree of correlation with rapid fluorescent focus inhibition test titers, although it is not known whether results of the IAHA test represent the detection of neutralizing antibodies. An advantage of the IAHA test over the rapid fluorescent focus inhibition test was that results were obtained in a shorter period of time. In some instances, this can be of clinical significance in determining antibody levels to rabies virus. Furthermore, the IAHA test is most applicable as a rapid screening tool for the detection and quantitation of rabies antibodies in vaccinated subjects. PMID- 6841581 TI - Inoculum standardization in antimicrobial susceptibility testing: evaluation of overnight agar cultures and the Rapid Inoculum Standardization System. AB - Using the Rapid Inoculum Standardization System [RISS; Minnesota Mining & Manufacturing Co. (3M Co.)], we investigated the use of overnight agar cultures in the preparation of inocula for disk diffusion and microdilution susceptibility tests and compared our results with susceptibility results obtained with the standard methods. The 3M system consists of an inoculation wand, with which a reproducible number of bacteria can be removed from an agar plate, and a diluent in which to suspend the organisms. We used 25 gram-positive cocci, 75 enteric and nonfermentive gram-negative bacilli, and 40 more fastidious bacteria (Haemophilus, Neisseria, and pneumococci) for the evaluation. The geometric mean inoculum size for all organisms tested was 9.7 X 10(7) CFU/ml by the standard method and 1.1 X 10(8) CFU/ml for the RISS. The categories of susceptibility obtained by both methods in the disk diffusion tests were comparable, as were the minimal inhibitory concentrations. We recommend that the use of overnight agar cultures and the use of the RISS to prepare inocula for susceptibility tests be acceptable alternative procedures in the standard methods for susceptibility tests. PMID- 6841583 TI - Comparison of four rapid methods for identification of Enterobacteriaceae from blood cultures. AB - Positive blood cultures containing gram-negative bacilli were utilized for direct identification by two automated systems, the AutoMicrobic system (Vitek Systems, Inc., Hazelwood, Mo.) and the MS-2 (Abbott Diagnostics, Dallas, Tex.), and two commercial kits, the Micro-ID system (General Diagnostics, Warner-Lambert Co., Morris Plains, N.J.) and the same-day API 20E (Analytab Products, Plainview, N.Y.). Samples of 10 to 15 ml were aseptically removed from radiometrically positive BACTEC bottles (Johnston Laboratories, Cockeysville, Md.) and divided among four sterile tubes. The tubes were centrifuged at 107 X g for 10 min. The supernatants were centrifuged at 1,510 X g for 10 min, and pellets were tested for cytochrome oxidase by means of Pathotec strips. Oxidase-negative pellets were suspended in appropriate media as suggested by the manufacturers. All systems were inoculated, incubated, and interpreted according to the instructions of the manufacturers. The Micro-ID system was read after 4 h of incubation; the three remaining systems were read after 5 h. Results were compared with those of the 18 h API 20E inoculated from pure subcultures of the organisms. Correlation of 90% or more with the API 20E was achieved by the AutoMicrobic and Micro-ID systems. The same-day API 20E and the MS-2 demonstrated 60 and 44% correlation, respectively, with the 18-h API 20E. PMID- 6841584 TI - Cross-reactivity of Haemophilus somnus antibody in agglutination and complement fixation tests and in the enzyme-linked immunosorbent assay. AB - The specificity and sensitivity of agglutination, complement fixation, and enzyme linked immunosorbent assay (ELISA) procedures in the detection of antibodies to Haemophilus somnus was investigated. H. somnus rabbit immune sera were found to agglutinate Pasteurella multocida, Staphylococcus aureus, and Haemophilus agni and, in some instances, also Pasteurella haemolytica, Salmonella dublin, Streptococcus agalactiae, and Corynebacterium pyogenes. In complement fixation tests with saline extracts as antigens, only H. agni reacted with H. somnus antisera to any significant degree. In ELISA tests with sonicated or heat extracted antigens, cross-reactions were seen with the two Pasteurella spp. and with H. agni. When whole cells and saline extracts were used as antigens in ELISAs, only H. agni showed any cross-reactivity. The greatest specificity in distinguishing homologous from heterologous reactions was achieved by ELISA with saline extracts as antigens. Escherichia coli and Brucella abortus antigens failed to react with H. somnus antibody in any of the tests. A rabbit serum containing antibody to bovine type isolates of P. multocida, P. haemolytica, S. aureus, S. agalactiae, S. dublin, C. pyogenes, and E. coli gave no positive reaction in ELISA tests with saline extract of H. somnus as antigen. It is concluded that such saline extract, which appears to consist largely of H. somnus common antigen, has the potential of being a useful diagnostic reagent in the study by ELISA of antibody response to H. somnus. PMID- 6841585 TI - Competitive enzyme immunoassay for detection of complement-fixing antibodies in diagnostic virology. AB - A competitive enzyme immunoassay was developed to detect serum complement-fixing antibodies in virus diseases. This assay utilized conglutinin-covered plastic beads as the solid phase to detect specific antibody-antigen complexes that competed for complement with a probe complex comprised of Escherichia coli beta galactosidase and its specific antibody. Binding to the solid phase is C3bi mediated, and when specific antibody-antigen complexes are not present the probe is bound and an enzymatic reaction ensues. This type of competitive assay was introduced in the field of immunopathology for investigating circulating immune complexes by Manca et al. (Clin. Immunol. Immunopathol. 16:131-141, 1980). The assay gave satisfactory results in terms of specificity, reproducibility, and handling, enabling laboratories to obtain results in 5 h. The sensitivity of the method coincided with that of the complement fixation test. However, this technique offers several advantages over conventional complement fixation because it requires less time, is easier to perform, and gives more reliable quantitative results. The data obtained indicated that this competition assay offers a feasible alternative to conventional complement fixation tests and should be useful in routine diagnostic applications and in seroepidemiological surveys. PMID- 6841586 TI - Comparison of the Staph-Ident system with a conventional method for species identification of urine and blood isolates of coagulase-negative staphylococci. AB - The Staph-Ident system (Analytab Products) for species identification of coagulase-negative staphylococci was compared with the conventional method of Kloos and Schleifer (21). A total of 101 clinical isolates from urine cultures and 95 clinical isolates from blood cultures were studied: overall agreement between the two methods was 86%. We concluded that the Staph-Ident system is a practical test for most clinical microbiology laboratories and that results obtained from this rapid test are comparable to those obtained from the more cumbersome conventional method. Additional investigations are needed to determine the clinical relevance of such species identification. PMID- 6841587 TI - Characterization of the hemolytic activity of Staphylococcus aureus strains associated with toxic shock syndrome. AB - The hemolytic activity of 32 vaginal isolates of Staphylococcus aureus from patients with typical toxic shock syndrome (TSS) was contrasted with that of 50 vaginal isolates from patients without TSS, using a standardized inoculum (10(5) CFU) on 5% sheep blood agar after 48 h of incubation under 30% CO2. Additionally, 7 nongenital isolates from patients with nonmenstrual TSS and 57 strains of nongenital control isolates were included for comparison. Vaginal TSS strains were significantly less hemolytic than non-TSS S. aureus strains of either genital (P less than 0.001) or nongenital (P less than 0.01) origin. Vaginal TSS S. aureus strains were also less hemolytic than were nongenital TSS S. aureus strains (P less than 0.02). This reduced hemolytic activity of genital TSS S. aureus strains may provide a useful marker for screening and further delineation of toxigenic S. aureus associated with menstrually related TSS. PMID- 6841588 TI - Simple method for demonstration of differential colony morphology of plasmid associated virulent clones of Yersinia enterocolitica. AB - Virulent (plasmid-associated) strains of Yersinia enterocolitica grown on RPMI 1640 agar (RPMI-1640 medium [Flow Laboratories] with 40 mM HEPES and 1.5% [wt/vol] purified agar [Difco]) dissociated into small and large colonies. The autoagglutination test (a marker of virulence) is regularly positive with small colonies and negative with large colonies. Avirulent Y. enterocolitica strains gave only large colonies on RPMI 1640 agar. PMID- 6841589 TI - Rapid determination of novobiocin resistance of coagulase-negative staphylococci with the MS-2 system. AB - Special novobiocin elution disks were prepared for testing of coagulase-negative staphylococci in the MS-2 system (Abbott Laboratories, Diagnostics Div., Irving, Tex.). The MS-2 system correctly classified 91.5% of 82 isolates as either susceptible or resistant to novobiocin in an average time of 5.8 h. PMID- 6841590 TI - Spontaneous contractions and stretch-evoked responses of isolated lymph nodes. AB - In this study the spontaneous activities of prescapular lymph nodes, which were isolated from calves, goats and sheep and mesenteric lymph nodes of guinea-pigs were recorded and analysed in the frequency domain. Stretch-evoked contractions of the mesenteric lymph nodes were also recorded and their frequency characteristics analysed. The preparations were placed in a Krebs solution which was kept at 37 degrees C and bubbled continuously with a mixture of 95% O2 and 5% CO2. The tension changes occurring in the lymph nodes were recorded. The patterns obtained were initially transformed into numerical values which were then used to obtain autocorrelation functions and power spectra, according to the time series analysis method. A passive stretch of 100 s duration was applied to the mesenteric lymph nodes and the responses were examined using the transient response-frequency characteristics method. It was observed that prescapular and mesenteric lymph nodes had spontaneous activities due to the contractions of the smooth muscles within the nodes. A frequency analysis of these contractions indicated that at least three contractile components were responsible for the contractions; these components contract within the frequency bands of 0.01-0.04 Hz, 0.05-0.07 Hz and 0.09-0.14 Hz respectively. It was also observed that the spontaneous activities could be regulated and synchronized by stretch. It is suggested that these contractions of the lymph nodes play an essential role in lymph propulsion within the nodes. PMID- 6841591 TI - Co-ordinated electron microscopy and X-ray studies of glycerinated insect flight muscle. I. X-ray diffraction monitoring during preparation for electron microscopy of muscle fibres fixed in rigor, in ATP and in AMPPNP. AB - Synchrotron radiation was used for low-angle X-ray diffraction to monitor structural changes produced in insect flight muscle during fixation, dehydration and embedding for electron microscopy of thin sections. Fibre bundles were fixed by cold glutaraldehyde in one of three states, namely rigor, ATP or AMPPNP, followed by additional cross-linking treatment. No heavy metals were used before embedding. During fixation-embedding, all specimens lost the continuous actin layer lines of spacing 11-5 nm, shrank 18-21% in lattice spacing, shrank 0.5-2.5% in axial spacings and showed equatorial intensity changes which were similar for all three states, while the well-sampled inner layer lines (39-13 nm) were preserved with different fidelity in each state, highest for rigor and lowest for ATP. In different AMPPNP bundles, these layer lines indicated different degrees of unexplained shift (from slight to total) towards the structure of muscle fixed in ATP. Fixation in ATP caused obvious gain of intensity on 39, 19 and 13 nm layer lines, which can be interpreted as trapping of myosin crossbridge attachments to actin; this artifact was unchanged by seven variations in fixation conditions. Fixation in rigor gave no indication of crossbridge detachment nor of the presence or alteration of any significant population of non-bridging myosin heads. X-ray monitoring allowed selection of best-preserved samples for subsequent electron microscopy. The rapid pattern-recording possible with synchrotron X-ray intensity allowed us to complete and compare experiments with many fibre bundles from a single glycerinated Lethocerus muscle. PMID- 6841593 TI - Measurement of the translational diffusion constant of G-actin by photon correlation spectroscopy. AB - Photon correlation spectroscopic measurements on monomeric actin have yielded a translational diffusion constant of 8.13 X 10(-7) cm2 s-1 after correction for the contribution of the back-reflections of the main beam. This value corresponds to a sphere with a radius of 2.6 nm and 50% hydration, or to a prolate ellipsoid with axes 2.0 and 4.0 nm and 30% hydration. PMID- 6841592 TI - Co-ordinated electron microscopy and X-ray studies of glycerinated insect flight muscle. II. Electron microscopy and image reconstruction of muscle fibres fixed in rigor, in ATP and in AMPPNP. AB - This paper presents electron microscopy, supported by optical diffraction and filtering of images from 100 nm and 25 nm sections, to complement the companion report of X-ray diffraction monitoring (immediately preceding this article) performed on the same insect flight muscle specimens during fixation, dehydration and embedding. Glycerinated Lethocerus fibre bundles initially fixed in rigor, in ATP relaxing buffer, or in 1 mM AMPPNP at 2 degrees C, gave thin-section images from each state whose optical transforms match the distinctive X-ray diffraction patterns from the embedded samples. For rigor and relaxed states, this extends and confirms a long-known correlation between X-ray patterns and EM image regularities. For the AMPPNP state, such correlation is here fully developed for the first time, and involves a new and distinctive EM image pattern of the crossbridge array, clearly different from a previously reported structure in AMPPNP-treated muscles that appears identical to fixed relaxed muscle. We found this latter artifact of 'AMPPNP-relaxed structure' in many fibres from our best AMPPNP specimen, but could identify other fibres which retained the distinctive AMPPNP structure, known to be dominant in this specimen from the X-ray pattern. The true AMPPNP structure shows features of both the ATP-relaxed and rigor crossbridge patterns, not as separate patches, but hybridized uniformly along each filament and throughout each affected sarcomere and fibre. It presents a 14.5 nm repeat of striping and lateral projections along thick filaments, together with variously angled crossbridge attachments to actin that form a 38.7 nm repeat of diffuse chevrons or deltoids replacing the more clearly delinated rigor double chevrons. The associated optical transform has the typical AMPPNP features, that is, it has in common with rigor a strong 19.3 nm layer line and strong second to fourth row line sampling on the 38.7 nm layer line, it has in common with relaxed patterns a strong 14.5 nm meridional and layer line, but it uniquely shows no intensity at the first row line on the 38.7 nm layer line (the 10.3 X-ray reflection), where rigor and relaxed transforms always show high intensity. The processing artifacts which intensify the 10.3 reflection, and produce the weak 19.3 nm layer line (a gain of intensity for ATP but a loss for the AMPPNP state), throughout ATP specimens and in those analogue-treated fibres showing AMPPNP-relaxed structure, might indicate trapping and accumulation of minority populations within the native equilibrium distribution of crossbridge conformations in each nucleotide state. PMID- 6841594 TI - Ligamentous disruption of the knee associated with avulsion of the patellar tendon in a 12-year-old boy. PMID- 6841595 TI - Hospital for Joint Diseases' traction system for preliminary treatment of congenital dislocation of the hip. PMID- 6841596 TI - A method of treating clubfeet with malleable splints. PMID- 6841598 TI - Acetabular floor thickening and femoral head enlargement in congenital dislocation of the hip: lateral displacement of femoral head. AB - The thickness of the acetabular floor and the horizontal diameter of the femoral head often appear enlarged on X-ray films of congenitally dislocated hips, particularly in the later stages. These distances were, therefore, measured and compared with the normal side in 49 strictly unilateral cases. Increased floor thickness was an early change and usually persisted, often in spite of a satisfactory reduction. Increased head diameter was detectable later and these two features together increased the distance between the centre of the femoral head and the midline of the body. This lateral displacement, even when the head is well covered, increases abductor effort and force transmitted to the femoral head on weight bearing and may have an adverse effect on the joint's long term future. PMID- 6841597 TI - Metatarsus adductus: classification and relationship to outcomes of treatment. AB - In a retrospective study of results of treatment in 160 children (265 feet) who had metatarsus adductus prospectively defined by severity and flexibility, we found that in 147 patients treated with plaster casts or casts followed by derotation splints the only significant predictor of a good outcome was the age of the patient. Results were statistically significantly better when treatment was begun from ages 1 day to 8 months. No significant correlations with poor results were found using the severity and flexibility grading systems. Given the public attitude toward deformity, it seems wiser to treat in infancy those feet graded "moderate" or "severe." If treatment is not commenced until the child is old enough to preclude conservative treatment, extensive surgery will be necessary to correct a "severe" deformity. PMID- 6841599 TI - Osteochondroma of the femoral neck in Perthes disease. AB - Three out of 480 hips with Legg-Calve-Perthes disease have been found to have intraarticular osteochondroma-like lesions of the femoral neck. In all three cases, the osteochondroma unexpectedly diminished in size during the last phase of reossification and, therefore, did not require surgical excision. The occurrence of osteochondroma of the femoral neck with Perthes disease is rare, and resolution has not been previously reported. PMID- 6841600 TI - Spinal cord monitoring during spinal surgery using somatosensory spinal evoked potentials. AB - Intraoperative monitoring of spinal cord function has been carried out in 59 patients during spinal instrumentation for scoliosis. Posterior tibial nerve stimulation in the popliteal space was performed and spinal evoked potentials from electrodes in the spinous processes observed. A rod artifact problem causing partial obliteration of the wave form can be minimized or eliminated by careful selection of the insertion of the fixation device. A drop in amplitude of the signal occurred in many of the tracings from control to distraction observations but did not result in neurologic deficit. One patient had a loss of the signal after maximum distraction with a Harrington rod and a return with release of distraction. This patient awoke with paralytic urinary bladder retention which resolved spontaneously but no other neurologic deficit. This method has been used for monitoring of spinal cord function during Harrington rod instrumentation, using both compression and distraction systems as well as Luque rod instrumentation. This method is safe, simple, and provides consistent and predictable wave forms; it appears to be reliable in indicating continuation of spinal cord function during the procedure. PMID- 6841601 TI - Functional status in ulnar deficiency. AB - Function is the most important consideration in the evaluation of patients with congenital ulnar deficiency. The upper extremity function of 8 patients with ulnar deficiency was evaluated. None of these patients had been treated with surgical procedures directed to the elbow, forearm, or wrist. The functional criteria included: (a) active ranges of elbow, forearm, and wrist motion, (b) power grip, (c) prehension, (d) dexterity, and (e) a patient's activities questionnaire. The averaged total active range of joint motion was 229 degrees or 46% of predicted normal active motion. Power grip averaged 27% of the contralateral extremity, and prehension tests were generally well performed. Timed tests were completed an average of 11.6 s slower than the contralateral control hand. Our patients did not report any deficiencies in bimanual activities. Patients performed most poorly when their congenital anomaly included radiohumeral synostosis or congenital absence, deformity, or contracture of the ipsilateral digits. The radiographic appearances or classification of the ulnar deficiency, in the absence of radiohumeral synostosis, did not correlate well with patient function. PMID- 6841603 TI - Congenital abnormalities of the femur and related lower extremity malformations: classification and treatment. AB - Congenital abnormalities of the femur vary from a deficiency of the entire femur with abnormal development of the pelvis to a hypoplastic femur of normal configuration. Previous classification systems that have focused on either congenital coxa vara, hypoplastic femur, or proximal femoral focal deficiency provide a limited definition of congenital abnormalities and are included within the combined classification system outlined in this text. This system, based on embryological, teratological, biological, and anatomical considerations of 125 patients with 139 affected femora, classifies deficiencies of the proximal end, middle, and distal end of the femur and associated lower extremity abnormalities. Unlike previous classification systems, congenital femoral abnormalities principally involving the middle and distal end of the femur are recognized in distinct classes when appropriate. Associated abnormalities range from severe growth retardation of the tibia and an absent fibula accompanied by a deficiency of ischiopubic structures with an absent acetabulum to a mild tibial and fibular growth retardation. Treatment objectives include pelvic-femoral stability, prosthetic management, extremity length equality, knee stability, ankle and foot stability, and anatomical alignment. PMID- 6841604 TI - Adolescent traumatic dislocations of the shoulder with open epiphyses. AB - Nine of 212 cases of traumatic anterior shoulder dislocations occurred in children with clearly open epiphyses (4.7% incidence). All cases associated with psychological or physical abnormalities were excluded. A high recurrence rate of 80% (8 of 10) was noted requiring operative intervention. Two of the three remaining unoperated cases had a history of "subluxation" after their initial dislocation. PMID- 6841605 TI - Pattern of growth retardation after Blount stapling: a roentgen stereophotogrammetric analysis. AB - The roentgen stereophotogrammetric method has been used in 19 children treated by Blount stapling for progressive leg length discrepancy. The growth plates of distal femur and/or proximal tibia were stapled with a total of 31 growth regions stapled. Longitudinal growth rate of 25 intact growth regions of distal femur and proximal tibia was determined and correlated well to growth rates as derived from growth tables of Green and Anderson and Kember and Sissons. In stapled growth regions, a uniform pattern of growth retardation was found and correlated well to skeletal age: the more advanced the skeletal age at time of stapling, the more pronounced and rapid initial growth retardation and the lower basal growth rate. Significant asymmetric growth was registered in 5 of 31 stapled growth regions, especially in three patients who developed loosening of staples. In five patients the staple tip motion was analyzed. Widening of staples and staple tip movements within the bony epiphysis and metaphysis were small. In the skeletally younger cases the widening and tip movement were more pronounced than in the older cases. In summary, the roentgen stereophotogrammetric method was used in order to analyze pre- and postoperative growth pattern and was found valuable in checking growth rates after Blount stapling to detect early complications such as asymmetric growth and loosening of staples. Furthermore, the movements and the deformation of the staples by the growth process could be evaluated with high precision. PMID- 6841602 TI - Validity of torsional profile examination. PMID- 6841606 TI - Child abuse in a military population. AB - A retrospective review of all Child Advocacy Committee records at Naval Regional Medical Center, Portsmouth, Virginia, was carried out in an attempt to characterize abuse in a military population. We found little difference between our 273 cases of documented abuse and previous reports from civilian institutions as far as patient age, death rate, types of injuries, and social factors involved. We attributed our low incidence of fractures (11%) to our active Child Advocacy Committee. Spiral fractures in children less than 3 years old were the most common orthopedic injury and we concluded that a high index of suspicion should be maintained in young children with spiral fractures. PMID- 6841607 TI - Triplane fracture of the distal humeral epiphysis. AB - An 11-year-2-month-old girl sustained a triplane fracture in the distal humeral epiphysis. Open reduction and internal fixation were performed, producing an excellent result, after closed manipulation failed to achieve complete reduction. The triplane fracture can occur in areas other than the distal tibia. PMID- 6841609 TI - Radial lengthening for septic growth arrest. AB - A case is presented of a child who sustained septic growth arrest of the distal radial epiphysis following osteomyelitis at 5 weeks of age. At age 8 years and 8 months radial lengthening using the Wagner apparatus was performed. Two and one half centimeters of total length (18% of original length) was gained. No significant complications were encountered and normal function has been maintained. Although follow-up is short and additional lengthening is anticipated, this report illustrates the technical considerations for performing this procedure. PMID- 6841608 TI - Early operation for congenital subluxation of the knee. PMID- 6841610 TI - Irreducible Salter-Harris II fracture of the proximal tibia. PMID- 6841611 TI - Humeroradial synostosis. PMID- 6841612 TI - Dislocation of the hip joint complicating repeated hemarthrosis in hemophilia. PMID- 6841613 TI - Community adjustment of older schizophrenics. AB - Community adjustment among older schizophrenics is a virtually unresearched area. This study addressed two questions related to this problem: Does the community adjustment of older schizophrenics differ from that of younger schizophrenics?, and Do "older" old schizophrenics differ from "younger" old schizophrenics? Patients from 79 psychiatric wards across the country completed a self-rating adjustment scale within 5 days of admission to the hospital and again 3 months after discharge. Significant others rated these patients for adjustment also. For the first analysis two groups were selected: Those patients diagnosed schizophrenic and at least 55 years of age and those below the age of 55. A second analysis divided patients into "younger" old (between 55 and 60) and "older" old (greater than 60). Results show that older schizophrenics adjust about as well as those younger on self-ratings, but less well when rated by others. Also, "older" old schizophrenics adjust better than the "younger" old in both self- and significant other ratings. These findings are discussed. PMID- 6841614 TI - Humorous stimuli and depression: an examination of Beck's premise. AB - Investigated the premise that an ancillary characteristic of depression is a diminished humor response (N = 40). A 2 X 2 X 2 (High-Low Beck Depression Inventory Scores X Aggressive-Non-aggressive Cartoon X Self-Other Humor Target) design was used. Results indicated that there were no differences between those with higher and lower scores on the Beck in ratings of the cartoons in terms of enjoyment, funniness, or laughter. Additional analyses that used the Multiple Affect Adjective Checklist revealed relationships between the affects of anxiety, hostility, and depression, and cartoon type and target. The results raise questions, too, as to the relationship of responses to humorous stimuli and depression. PMID- 6841615 TI - Utility of MMPI indices of schizophrenia with adolescents. AB - Assessed the utility of empirically derived MMPI criteria for the diagnosis of schizophrenia with a sample of hospitalized adolescent patients (N = 89). The criterion diagnosis was established through the use of a standardized structured interview and a diagnostic system for schizophrenia based on the use of discriminant function analysis. Results were quite disappointing because only 23% of the sample obtained an MMPI profile that fit the above criteria. PMID- 6841616 TI - A process approach to the Bender-Gestalt test and its use in differentiating schizophrenic, brain-damaged, and medical patients. AB - Developed a processing model that would account for the shifting of attention that occurs as individuals copy Bender-Gestalt designs. Process-oriented variations of the Bender-Gestalt test were designed that emphasized each of the three processes hypothesized to contribute to Bender-Gestalt performance: Perceptual-motor integration, attentional factors, and short-term memory. A standard Bender-Gestalt and the three variations were administered to 24 schizophrenics, 24 brain-damaged patients, and 24 medical patients, matched for intelligence and sex. Protocols were scored blindly by the Pascal-Suttell and Hain methods. Discriminant function analysis based upon the four versions of the Bender-Gestalt test classified patients as schizophrenic or brain-damaged at a significantly higher rate than the standard Bender-Gestalt scored by either the Pascal-Suttell or Hain system. PMID- 6841617 TI - Marital intimacy and self-disclosure. AB - Examined the relationship between the qualitative aspects of marital intimacy among 20 couples and a quantitative, microanalysis of their self-disclosing behavior. Two interview segments and their combination were scored for the basic parameters of self-disclosure using the Self-Disclosure Coding System (SDCS). These scores served as predictor variables for each of 12 intimacy dimensions derived from the standardized, structured Victoria Hospital Intimacy Interview in stepwise multiple regression analyses. The resulting multiple Rs ranged from .357 for Sexuality in segment I to .853 for Identity in segment II. Analysis of the couples' self-disclosures across segments I and II yielded multiple Rs from .446 to .850, with the intimacy dimensions of Expressiveness, Compatibility, Behavior, and Identity the highest correlates. These results suggest that although self disclosure and intimacy are not synonymous, self-disclosing behavior is a major determinant of various aspects of marital intimacy and accounts for more than 50% of the variance in at least four dimensions. Explanations for these findings and their clinical relevance are discussed. PMID- 6841618 TI - Comparative efficacy of biofeedback and stress inoculation for stress reduction. AB - Evaluated the comparative effectiveness of frontalis electromyographic (EMG) biofeedback, a primarily somatic intervention, and stress inoculation, a self instructional form of cognitive-behavior therapy. Both treatments were compared with a waiting list control group on systolic and diastolic blood pressure, the Taylor Manifest Anxiety Scale, and the Teaching Anxiety Scale (N = 24). Multivariate assessment on all four dependent measures indicated that both the frontalis feedback and stress inoculation groups improved significantly more than the no treatment control, but did not differ overall from one another. The stress inoculation group showed more improvement in self-reported anxiety than the EMG group, while the EMG group tended to do better than the stress inoculation group on blood pressure measures. The untreated control group regressed somewhat across all measures. It was proposed that each treatment may have specific effects that might suggest which treatment would be indicated for a particular client. PMID- 6841619 TI - The effects of rational and irrational self-verbalizations on performance efficiency and levels of anxiety. AB - Investigated the effects of rational vs. irrational belief systems (as measured by the Ellis Irrational Values Scale) and rational vs. irrational self verbalizations on levels of anxiety and persistence on a performance task. Ss (N = 40) were instructed to assemble a virtually insolvable task call Soma. The variables of interest were how long each S would persist on this task and how much anxiety (as measured by the A-State portion of the State-Trait Anxiety Inventory) was aroused in working on this task. Following a baseline trial trying to solve Soma, Ss were assigned to either a rational or irrational self-talk condition and were led to believe that such self-talk would help in a second attempt to solve Soma. In line with cognitive models of psychology, it was found that rational self-talk Ss showed a significant decrease in levels of state anxiety compared to irrational self-talk Ss in attempting to solve Soma in the second trial. Contrary to cognitive models of psychology, scores obtained from the EIVS and the A-Trait portion of the STAI were not found to be related to persistence. PMID- 6841620 TI - Effects of progressive muscle relaxation and music on stress as measured by finger temperature response. AB - Measured the efficacy of music, progressive muscle relaxation, and a combination of both variables on tension reduction. Ss were three sections (N = 76) of an introductory music class. Each section received either sedative music (M), progressive muscle relaxation (PMR), or both (M + PMR) as treatment. Vasoconstriction, or finger temperature, was used to measure stress level prior to and after the intervention. All three groups evidenced significant increases in finger temperature. There was no significant difference among treatment groups, although the M + PMR group's mean increase was greater than the grand mean, while the M and PMR groups' increases were below the grand mean. PMID- 6841621 TI - Videotape and verbal feedback in behavioral couple therapy: a review. AB - Reviewed the experimental evidence for the efficacy of videotape and verbal feedback in behavioral couple therapy; it is concluded that research to date does not permit definitive conclusions concerning the efficacy of either procedure. Studies on behavioral differences between happy and distressed couples also were summarized. The evidence indicates that it is, as yet, difficult to ascertain just how the communication behaviors of happy and distressed couples differ. PMID- 6841622 TI - Effect of therapist expectations and need for approval on self-disclosure. AB - Previous therapy analogue studies of self-disclosure have treated Ss as a homogeneous group without examining possibly relevant S variables. In the present study, 68 female students identified as high or low in need for approval listened to a tape-recorded interview between a high self-disclosing therapist and a female client under one of two therapist expectation conditions: Clear expectation of high self-disclosure vs. ambiguous expectation. Ss then indicated on the Jourard Self-Disclosure Questionnaire the degrees to which they would be willing to disclose to the therapist. It was predicted that high need for approval Ss would disclose most under the clear expectation condition, while low need for approval Ss would not be affected by the therapist expectation. A significant Need Approval X Therapist expectation interaction supported this prediction. Further analysis indicated that items for the Work, Money, and Personality subsections of the disclosure questionnaire contributed most to the interaction. Implications for differential treatment of high need for approval Ss who were entering therapy were discussed. PMID- 6841623 TI - Age group differences in depression on MMPI D scale. AB - Much of the work that has been done to the present in exploring age differences in the assessment of depression has utilized normally aging populations. This research has indicated that present depression scales may yield many false positives for depression because of the large number of somatic items that these scales contain. An important question is whether this same finding would hold in psychiatric populations, which are the ones most likely to be subject to diagnosis. The present study was designed to supply information in that area. The D-scale responses of the MMPI for 6,964 patients were factor-analyzed. Results indicated significant differences in the expression of depression for three age groups--20-39, 40-59 and 60+ years. A central core of items that accounted for one-half of the variances for all three groups was found. Additional items appeared across the age groups with greater to lesser significance in terms of the variance accounted for producing distinct qualitative differences. Concern over declining physical well-being was not part of the central core of depression for the older group in this psychiatric population. PMID- 6841624 TI - Marital MMPI characteristics: a test of Arnold's signs. AB - Investigated the usefulness of Arnold's Signs (certain MMPI personality characteristics) in examining marital discord among three clinical groups of married couples (N = 72). Couples who were parents of children brought to a mental health facility, couples who were seeking marital counseling, and couples in the process of divorce. While it was predicted that the divorcing group would reveal the most amount of discord, results revealed that the counseling group was consistently higher on all of the signs that reached significance. Possible explanations and recommendations for the use of Arnold's Signs are made. PMID- 6841625 TI - Response consistency among high F scale scorers on the MMPI. AB - Classified male psychiatric inpatients (N = 200) with high (T greater than 90) scores on the MMPI F scale as either consistent or inconsistent responders using the Test-Retest (TR) Index. As predicted, consistent MMPI responders appeared to exaggerate pathology, while inconsistent responders' profiles were indicative of random responding on the MMPI. Results supported use of the TR Index in enhancing interpretation of MMPI profiles with very high F scale scores. PMID- 6841626 TI - Assessing depressive symptoms across cultures: Italian validation of the CES-D self-rating scale. AB - Although several self-rating scales for depression have been proposed in the past two decades, very few have been validated on non-English-speaking populations. The present study was carried out in northern Italy in order to examine the validity of the CES-D self-rating scale for depression in another language and culture. The scale was used with 40 depressives and 40 normals who were matched. The Hamilton Rating Scale for Depression (HRSD) was used as an additional test of concurrent validity. The results show that the CES-D is a valid measure in that it sensitively discriminates between depressed patients and normals and presents satisfactory correlations with the observer rating scale (HRSD) in both groups. The scale in its Italian translation is likely to be helpful in the assessment of depression of Italian immigrants in North America and Australia, especially in those whose English is poor. PMID- 6841627 TI - Obese and non-obese American Indian and Caucasian performance on the mini-mult MMPI and I-E scale. AB - Recent concerns over high incidences of obesity among various American Indian tribes and groups have been ignored by the psychological literature. Relationships between obesity and MMPI and I-E Scale scores have been reported without regard for ethnicity. This study compared urbanized obese and non-obese American Indians and Caucasians on the Mini-Mult MMPI and I-E Scale (N = 160). Major findings included such results as the fact that the Indian sample had higher Hypomania scale scores than the Caucasian sample and that males had higher Depression and Hypochondriasis scale scores than females. Mini-Mult and I-E Scale scores were similar across weight conditions. These results are discussed in terms of the complexity of obesity in general as well as ethnic/cultural and sex difference factors. PMID- 6841628 TI - Malingering or random? A research note on obvious vs. subtle subscales of the MMPI. PMID- 6841629 TI - Clinical utility of a WAIS-R short form. AB - Investigated the validity of the Vocabulary-Block Design subtest combination as an estimate of the WAIS-R Full Scale IQ in a sample of 30 psychiatric patients. The correlation between the short form IQ and the WAIS-R Full Scale IQ was highly significant, r(28) = .87, p less than .001. A pairwise t-test computed between the mean IQs for the standard and short form was nonsignificant, t(29) less than 1. One-half of the Ss showed changes in intelligence classification when the short form was used. The short form should not be used when precise IQ estimates are required. However, the short form appears useful as a screening device to discriminate between patients with normal and subnormal intelligence. With respect to the detection of normal vs. subnormal intelligence, the short form achieved a correct classification rate of 87%. PMID- 6841630 TI - Digit repetition in learning-disabled children. AB - Investigated digit repetition performance in learning-disabled children in an effort to assess its clinical and theoretical significance. Clinically, learning disabled children were found to demonstrate a higher than expected incidence of large verbal-performance discrepancies, although mean overall digit repetition performance did not differ appreciably from that expected on the basis of intelligence (N = 100). Children with large discrepancies did not differ from those with no such discrepancies when compared on a variety of psychometric and neurobehavioral factors. Theoretically, a hemispheric specialization model and a neuropsychological function model have been proposed to underlie performance on the two somewhat different digit repetition tasks (forward and backward repetition). Some support was found for the neuropsychological function model, with significant correlations obtained between digits forward and a measure of language function and between digits backward and a test of visual constructional ability. Stronger evidence that could have been provided by a double dissociation of correlational findings was limited by a smaller, but significant, correlation between digits forward and Bender Gestalt errors. However, the results are consistent with previous research in suggesting that digit repetition can be an avenue to the study of brain-behavior relationships. PMID- 6841631 TI - The problem of art quality in the use of human figure drawing tests. AB - Sixteen clinicians evaluated figure drawings and attempted to determine which were done by psychiatric patients (N = 32) and which were done by matched normal Ss (N = 32). Half of the clinicians received a warning with regard to the error of assessing art ability. Despite the warning, the informed judges relied on art quality in evaluating the drawings, as did the naive judges. The judges achieved a hit rate of 58% (p less than .05). These findings indicate that both the proponents and the critics of figure drawing tests are correct. These tests do have some validity, although limited. At the same time, drawing tests do mistakenly assess art ability. Further, the failure of the effort to decrease the use of art quality indicates that this shortcoming is very difficult to control. PMID- 6841632 TI - Comparative validity of three Wechsler short forms for delinquents. AB - Investigated the validity of Vocabulary-Block Design short forms for the WISC-R, WAIS, and WAIS-R in a clinical population of 126 adjudicated male delinquents age 16 years. The difference between the means of each short form and its corresponding Full Scale IQ was small and nonsignificant. The correlations between each short form and corresponding Full Scale IQ ranged between .88 and .92 and therefore accounted for between 77% and 84% of the variance shared by the measures. The WAIS and WAIS-R were superior to the WISC-R in correctly classifying Ss by intelligence category. It was concluded that Wechsler short forms, especially the WAIS and WAIS-R, are useful as screening devices for older delinquents, but inadequate for making individual treatment program decisions. PMID- 6841633 TI - Field dependency, n power and locus of control variables in alcohol aversion. AB - Male volunteer alcoholics (N = 47) were given I-E Scale, Embedded Figures Test and a newly devised n Power inventory in a 20-trials, 10-day electroconditioning aversion program. Some were given vodka, some preferred beverage, some both shock and covert sensitization. Follow-up was 2 months by interview, 6 months by letter, with combination therapy more effective. External control and field dependency were associated with being older. Internals and hard liquor drinkers tended to be abstinent for both periods as predicted. Field dependency was a more unstable variable for outcome. A non-preferred beverage generalizes to preferred beverage abstinence. PMID- 6841634 TI - A study of the reliability and validity of the Holmes alcoholism scale. AB - The Holmes Am Scale was found to have low internal consistency reliability when a Likert-type response format was employed in both a college and in an alcoholic sample (N = 116). Comparison of AM scores between the alcoholic and college groups revealed a significant point-biserial correlation between Am scores and group; alcoholics had the higher mean score. Discriminant analysis resulted in 76.3% correct classification of respondents into their respective group (alcoholic vs. college) on the basis of Am scores. In addition, Am scores were found to be related modestly to self-reports of quantity and frequency of alcohol use in the college sample. Although these results provide support for the validity of the Am scale, its reliability is yet to be established. PMID- 6841635 TI - A conjoint measurement analysis of clinical predictions. AB - A lack of impressive theories in clinical psychology has been attributed to an excessive reliance on significance testing. Conjoint measurement is a worthwhile alternative to significance testing. Conjoint measurement determines whether data obey the ordinal properties of a model that contains main effect terms, interaction terms, or a combination of the two. Unlike hypothesis testing, with conjoint measurement an increase in statistical power leads to a greater risk of refuting a theory. In this study, conjoint measurement was used to describe how systems-oriented therapists predict the occurrence of suicide. Although the systems approach emphasizes the interaction between an individual and a system, all 10 clinicians were described by an additive model. PMID- 6841636 TI - A note on experiential learning in professional training. PMID- 6841637 TI - Structure side-effect sorting of drugs. VI. Ototoxicities. AB - From a literature survey, over 130 (about 7.8%) drugs and chemicals have been associated with ototoxicities. The major classes are basic aminoglycoside and other antibiotics, anti-inflammatory drugs, antimalarials, beta-blockers, antineoplastic agents, heavy metals, diuretics, some topical agents and various miscellaneous drugs. Possible mechanisms of action are presented and discussed. These include inhibition of protein synthesis, the glycolytic cycle, the TCA cycle, energy utilization, energy generation and the respiratory system within the mitochondria membrane of the hair cell, and also alteration of the permeability of the endolymphatic membrane or alteration of the excretion system for the basic aminoglycosides in the lateral wall of the membranous cochlea. The relative rank order of ototoxicity and reactivity toward mucopolysaccharides of five aminoglycosides is found to be related to the number of basic groups in each molecule. PMID- 6841638 TI - The Hereford Hospital prescribing study: hospital activity analysis as a source of adverse drug reaction data. PMID- 6841639 TI - The comparative bioavailability of slow release oral theophylline preparations. AB - Plasma concentrations of theophylline were determined in healthy volunteers following a single oral dose of six slow release preparations, immediately following a standard breakfast. There were no significant differences between the different preparations. The time taken to reach maximum plasma concentration, tmax, was found to be longer than in previous studies in which the drug was administered on an empty stomach. PMID- 6841640 TI - The effect of flavour on acceptability of antacid tablets. AB - One hundred healthy volunteers recorded their subjective impressions of taste, mouth feel, after-taste and preference, after receiving in turn two tablets of each of four commonly-used antacids. The subjects remained unaware of the appearance of name of the products. The orange flavoured tablets, Asilone Orange, were shown to have a more acceptable taste, mouth feel and after-taste than three other commonly used antacids, Gaviscon, Altacite Plus, and Aluminium Hydroxide B.P., and these differences were highly significant (P less than 0.0001). Furthermore, 93% of cases expressed a willingness to take the orange flavoured tablets again, on a long term basis if necessary. PMID- 6841641 TI - Age and weight as determinants of warfarin requirements. AB - A survey of patients attending anticoagulant clinics at a District General Hospital showed the maintenance dose of warfarin to increase with weight and decrease with age. A significant correlation was observed between age and weight considered together and the maintenance dose. It is proposed that consideration of age and weight may be of value when prescribing loading or starting doses of warfarin at initiation of therapy. PMID- 6841642 TI - Degradation of hydrocortisone in a zinc oxide lotion. AB - An extemporaneous topical steroid formulation, prepared from a zinc oxide lotion and hydrocortisone lotion BPC, had poor stability. Hydrocortisone decomposed mainly to the 21-aldehyde, but other degradation products were also identified by HPLC. The decomposition process could be described by first-order kinetics. Stabilization methods employing pH adjustment, antioxidants and chelating agents were unsuccessful. The study emphasizes the dangers of diluting commercial formulations with unrecommended bases and indicates the modes of decomposition of hydrocortisone in a formulation. PMID- 6841643 TI - Raised 5-hydroxytryptamine concentrations in enterochromaffin cells in adult coeliac disease. AB - We measured cytofluorometrically the concentration of 5-hydroxytryptamine (5-HT, serotonin) of individual enterochromaffin (EC) cells in adult coeliac and non coeliac small intestinal mucosa. The distributions of 5-HT concentration within populations of EC cells in control and coeliac mucosae were log normal and thus contained one single population of EC cells. The median 5-HT concentration per EC cell, and the number of EC cells both increased in coeliac disease, but showed signs of normalisation when gluten was withdrawn from the diet. The results indicate that, besides inducing EC cell hyperplasia, gluten is capable of producing reversible changes in functions of EC cells in adult coeliac disease. PMID- 6841644 TI - Benign mesenchymoma of the stomach. AB - Benign mesenchymoma is a mixed tumour of mesenchymal derivatives composed of a mixture of two or more mesenchymal elements in addition to fibrous tissue. Two cases of this tumour of the stomach are reported. As far as can be ascertained, there has been no previous report of gastric mesenchymoma. PMID- 6841645 TI - Polyamines in colorectal cancer--a clinical and experimental approach. AB - The urinary polyamines putrescine, spermidine and spermine were measured prior to operation in 10 patients with colorectal cancer and 10 control subjects. Carcinoembryonic antigen assays were also performed in an attempt to correlate these values with polyamine excretion. The total polyamine rates in patients with colorectal cancer were 3.2 +/- 1.5 (SD) mg/24 h and 2.6 +/- 1.2 (SD) mg/24 h in the controls. The difference between the group with colorectal cancer and the controls was not statistically significant. Urinary polyamines were also measured in an experimental animal model for colorectal cancer in which tumour cell mass could be assessed. Only marginal differences occurred in polyamine rates between animals with extensive tumours and controls. These findings suggest that urinary polyamine measurement is unlikely to be a useful procedure to assess tumour cell mass in patients with colorectal cancer. PMID- 6841646 TI - Muscle morphology and metabolism in hypothyroid myopathy: effects of treatment. AB - Needle biopsies from vastus lateralis in untreated hypothyroid patients with muscle weakness confirmed by quadriceps force measurements (n = 11) were repeated when the patients had taken L-thyroxine for a mean period of 9.2 months (range 5.3-13.3 months, n = 8) and had been continuously biochemically euthyroid for a mean period of 4.9 months (range 2-11 months). Biopsies were analysed biochemically for mitochondrial function. On light microscopy, histochemical examination, mean fibre areas and fibre percentages of type I and type II fibres were determined. Electronmicroscopy was also performed. Abnormalities on light microscopy occurred in eight patients of which type II fibre atrophy was the commonest and of the remainder two patients showed a myopathic electromyogram (EMG) and a raised plasma creatine kinase activity and one ultrastructural change on biopsy. After treatment resolution of pathological changes was often slow and half the patients had persistent abnormalities when rebiopsied. The type I mean fibre area was significantly increased in the eight hypothyroid females (p less than 0.05) and type II mean fibre areas tended to be low and in females this was significant (p less than 0.05). After treatment the type I mean fibre area was significantly reduced (p = 0.05). The type II mean fibre area also tended to fall but this was not significant (p greater than 0.05). No change in the fibre percentages occurred. A myopathic EMG, a raised plasma creatine kinase activity, ultrastructural changes and low mitochondrial enzyme activities on needle biopsy were other common findings and their significance is discussed. PMID- 6841647 TI - Towards an automated procedure for the quantitative cytological screening of cervical neoplasms. AB - Integrating microdensitometry has been used to quantify the glycoprotein, epithelial membrane antigen (EMA), which is frequently expressed on the cytoplasmic membrane of neoplastic cells of the cervix uteri. The technique was able to identify and quantify the antigen over a wide concentration range and could also be semi-automated using a microcomputer interfaced to the microdensitometer and programmed with the simple high level language BASIC. PMID- 6841648 TI - Prevalence and distribution of ringed sideroblasts in primary myelodysplastic syndromes. AB - In order to determine the prevalence and percentage distribution of ringed sideroblasts in primary myelodysplastic syndromes, the results of Prussian blue staining were analysed in 133 cases. Ringed sideroblasts ranging from 1 to 86% of cells were found in 76 (57%) cases. The cases of primary myelodysplastic syndrome corresponding to the group entitled "acquired idiopathic sideroblastic anaemia" had between 21 and 86% ringed sideroblasts; these were also found in 40% (26/65) cases corresponding to refractory anaemia with excess of blasts. Seven of the 22 cases having morphological features of refractory anaemia with excess of blasts in transformation had ringed sideroblasts. It would appear that cases of acquired idiopathic sideroblastic anaemia have at least 20% ringed sideroblasts; they also seem to occur frequently in refractory anaemia with excess of blasts. PMID- 6841649 TI - Enzyme-linked immunosorbent assay (ELISA) for the detection of hepatitis Be antigen and antibody: report of a field trial. AB - A field trial of an enzyme-linked immunosorbent assay (ELISA) for the detection of the hepatitis Be markers is reported. It is simple to perform, is designed to be read by eye and does not require any expensive apparatus. When compared with a commercially available RIA kit for the detection of the same markers, ELISA was shown to be as sensitive as RIA for the detection of anti-HBe but slightly less sensitive for the detection of HBeAg. However if all specimens negative for both HBeAg and anti-HBe by ELISA are considered to be potentially infectious, the ELISA should prove to be as useful as RIA for determining the "e" status of HBsAg positive patients and, therefore, provide a reliable indication of the risk of secondary spread of hepatitis B infection to contacts by needle stick accident, close personal contact or perinatal transmission. PMID- 6841650 TI - Comparison of the effects of filtration leucapheresis and discontinuous flow centrifugation leucapheresis on granulocyte microbicidal function. AB - In an investigation of the in vitro phagocytic and microbicidal function of granulocytes collected by filtration leucapheresis (FL) from 18 donors and by discontinuous flow centrifugation leucapheresis (DFC) from six donors, comparison was made with the function of granulocytes obtained from the same donors by venepuncture and density gradient centrifugation over Ficoll-Isopaque (FI). No significant impairment of the phagocytosis or killing of Candida guilliermondii by either FL- or DFC-granulocytes was observed. Although the ability of FL granulocytes to phagocytose and kill Staphylococcus aureus did not differ significantly from the function of control FI-granulocytes, DFC-granulocytes were significantly less active. PMID- 6841651 TI - A selective medium for Pasteurella multocida and its use with animal and human specimens. AB - A selective medium (CGT medium), containing clindamycin, gentamicin, potassium tellurite and amphotericin B in 5% horse-blood agar, allowed unimpaired growth of almost all strains of Pasteurella multocida, and P pneumotropica, while inhibiting other bacteria that might be encountered in upper respiratory tract secretions. With its use, P multocida was readily detected in oral swabs from four of 23 dogs, and 10 of 25 cats, but not detected in oral swabs from 47 human subjects. One of 500 sputum specimens yielded P pneumotropica. PMID- 6841652 TI - Measurement of bilirubin, cholesterol and creatinine in serum and plasma, by solid-phase reflectance spectroscopy. AB - The Seralyzer chemistries for total bilirubin, cholesterol, and creatinine have been examined in the routine hospital laboratory, and have demonstrated good correlation and precision when compared to established routine methodologies. The system has proved to be reliable and easy to use. PMID- 6841653 TI - Purification of Toxoplasma gondii from host cells. PMID- 6841654 TI - Internal birefringence and the recognition of Leishmania parasites. PMID- 6841656 TI - An electrophysiologic study of the digoxin--quinidine interaction. AB - To study the electrophysiologic mechanisms responsible for the digitalis quinidine interaction, 27 mongrel dogs were given either quinidine alone, digoxin alone, or digoxin followed by the digoxin-quinidine combination, via the oral route for sufficient time to permit accumulation of steady-state plasma levels. As anticipated, digoxin levels increased significantly in the presence of quinidine (P less than 0.05). Whereas digoxin alone had no significant effect on the ECG, quinidine alone prolonged the Q-T interval (P less than 0.05), and the combination prolonged both the QRS complex and the Q-T interval (P less than 0.05). Digoxin alone had no significant effect on the Purkinje fiber transmembrane potential, whereas quinidine reduced action potential (AP) amplitude and maximum upstroke velocity (Vmax) significantly. The combination significantly reduced AP amplitude Vmax, and maximum diastolic potential and prolonged AP reduced AP amplitude, Vmax, and maximum diastolic potential and prolonged AP duration. The changes induced by the drug combination appeared to be the sum of changes induced by each drug alone. PMID- 6841655 TI - A selective agent for anaerobic cocci. PMID- 6841657 TI - Effect of desipramine and cocaine on plasma norepinephrine and pressor responses to adrenergic stimulation in pithed rats. AB - Sympathetic neuronally released norepinephrine appears to act at intrajunctional alpha 1-adrenoceptors, whereas administered norepinephrine acts mostly at extrajunctional alpha 2-adrenoceptors. We examined the effects of inhibition of neuronal uptake of norepinephrine by desipramine (0.3 mg/kg iv) and cocaine (5 mg/kg iv) on the pressor effects and on plasma norepinephrine levels in pithed rats after the administration of norepinephrine (0.1, 0.3, and 1.0 micrograms/kg iv) or during stimulation of sympathetic outflow (0.1, 0.3, and 1.0 Hz at 50 V for 1 minute). Desipramine and cocaine potentiated the cardiovascular effects of administered norepinephrine to a greater extent than they potentiated the effects of sympathetic stimulation. Plasma levels of norepinephrine during sympathetic stimulation or after iv administration of norepinephrine were increased significantly after either desipramine or cocaine. The cardiovascular effects of sympathetic stimulation, but not of exogenous norepinephrine, were reduced in adrenomedullectomized rats compared to intact rats. In adrenomedullectomized rats, desipramine potentiates the pressor responses and enhances the increase in plasma norepinephrine levels during sympathetic stimulation to the same extent as in intact pithed rats. The preferential potentiation of administered norepinephrine by uptake inhibition is most likely due to enhancement of accessibility of circulating norepinephrine to otherwise inaccessible intrajunctional alpha 1-adrenoceptors. The higher concentrations of norepinephrine in the region of the nerve-ending limit release of the neurotransmitter by feedback inhibition via presynaptic alpha 2-adrenoceptors, thereby masking potentiation by uptake inhibition of the postsynaptic responses to sympathetic stimulation. PMID- 6841658 TI - Plasma levels and analgesia following deltoid and gluteal injections of methadone and morphine. AB - The objective was to determine whether deltoid as compared to gluteal injection of morphine and methadone produce differential plasma levels and analgesic effects. Thirty-two postoperative cancer patients received deltoid and gluteal injections of morphine, 8 and 16 mg, within a double-blind, twin crossover design. Forty-four patients received deltoid or gluteal methadone, 10 mg. Deltoid morphine resulted in peak plasma levels 1.8 times (P less than 0.05) those observed following gluteal morphine. Deltoid methadone resulted in peak levels 2.5 times (P less than 0.005) those following gluteal injection. Deltoid morphine resulted in an area under the drug level-time (0 to 4 hours) curve 1.4 times (N.S.) the area observed following gluteal injection. Deltoid methadone resulted in an area under the drug level-time (0 to 4 hours) curve 2.2 times (P less 0.001) the area observed following gluteal injection. Deltoid methadone, but not morphine, provided greater (1.7-fold, P less than 0.05) pain relief than gluteal injection. If more rapid and enhanced analgesia is indicated, then the deltoid site may be preferable over the gluteal site for standard doses of methadone and other lipid soluble analgesics. In addition, the relative potency of compounds of widely differing lipid solubility may depend upon the site of intramuscular injection. PMID- 6841659 TI - A furosemide test in the functional evaluation of the human nephron in vivo. PMID- 6841660 TI - Effects of carbamazepine on serum electrolytes: clinical and theoretical implications. PMID- 6841661 TI - Nightmares during phenelzine withdrawal. PMID- 6841662 TI - Differential effects of tricyclic antidepressants on mean arterial pressure in a hypertensive patient. PMID- 6841663 TI - Can lithium cause hair loss? PMID- 6841664 TI - Imidazobenzodiazepines: sleep and performance studies in humans. AB - For hypnotics in which a fast elimination phase dominates the plasma decay, the initial fall in concentration from the peak value may nevertheless be slower than that of compounds with a sustained and rapid distribution. Drugs with fast elimination may therefore improve sleep throughout the rest period, even though residual sequelae, if any, around awakening will disappear rapidly. In the context of the balance between efficacy and residual effects, the activity of two imidazobenzodiazepines, loprazolam (0.5, 1.0, and 1.5 mg) and midazolam (10, 20, and 30 mg), each with fast elimination (about 6 and 2 hours, respectively) has been studied in healthy men with sleep electroencephalography, measures of performance, and assessments of mood. Loprazolam may be appropriate when a sustained hypnotic effect is required and when some residual activity is acceptable, while midazolam is likely to be suitable for those involved in skilled activity and may be useful in the management of sleep disturbance associated with shift work. PMID- 6841666 TI - The projections of the lateral geniculate nucleus of the squirrel monkey: studies of the interlaminar zones and the S layers. AB - Anterograde and retrograde tracing techniques were used to reveal that axons arising from neurons within the interlaminar zones and the S layers of the lateral geniculate nucleus of the squirrel monkey terminate within the supragranular layers of area 17. Specifically, our data indicate that the axons of the neurons housed within the S layers end in a patchlike fashion in cortical layers IIIa and IIIb, while neurons in the interlaminar zones project primarily to layer I. Both pathways may convey W-cell information from the retina and the superior colliculus to the striate cortex. PMID- 6841665 TI - A type of aspiny neuron in the rat neostriatum accumulates [3H]gamma-aminobutyric acid: combination of Golgi-staining, autoradiography, and electron microscopy. AB - Light microscopic autoradiography was used to identify cells in the neostriatum that became labelled after the local injection of [3H]gamma-aminobutyrate (GABA). The GABA-accumulating cells comprised up to 15% of the total population of neurons. Thirty-seven of these cells were examined in the electron microscope and it was found that they all had similar cytological characteristics, i.e., prominent nuclear indentations, a moderate volume of cytoplasm, rich in organelles, and sparse synaptic input to the perikaryon. Nine of the cells that had accumulated GABA were also impregnated following Golgi staining. These Golgi impregnated neurons were of medium size and all had dendrites that were aspiny, often varicose, and that occasionally followed a recurving path. After gold toning, the Golgi-impregnated, GABA-accumulating neurons were examined in the electron microscope and were found to receive boutons forming symmetrical or asymmetrical synaptic contacts on their somata and dendrites; the symmetrical synapses were most common on the cell body and proximal dendrites, while the distal dendrites mainly received boutons forming asymmetrical contacts. We conclude that one type of GABAergic neuron in the neostriatum is a type of medium sized aspiny neuron and that this neuron is likely to receive synaptic input both from neurons within the striatum and from neurons in distant brain regions. We suggest that this neuron is a local circuit neuron in the neostriatum since its morphological features are quite distinct from those of identified projecting neurons. PMID- 6841667 TI - Fetal development of primate chemosensory corpuscles. I. Synaptic relationships in late gestation. AB - Fetal macaque chemosensory corpuscles during the last part of gestation contained chemosensory, sustentacular, and undifferentiated basal cells. Sustentacular cells had apical secretory granules and no specialized contacts with axons. Chemosensory cells contained basal collections of 80-100 nm dense core granules, and specialized axonal contacts of three types--afferent synapses, efferent synapses, and subsurface cisternae. Afferent synapses were commonly present on electron opaque cells with many 80-100-nm granules, typical 40-60-nm synaptic vesicles, and a few cisternae of smooth or granular endoplasmic reticulum. Cells with subsurface cisternae and/or efferent synapses were usually electron lucent, lacked vesicles and granules, and contained numerous intracytoplasmic cisternal elements. A continuum of intermediate forms was observed. It is postulated that transition of synaptic arrays accompanies the maturation of individual chemosensory cells. PMID- 6841668 TI - Structure of the piriform cortex of the opossum. I. Description of neuron types with Golgi methods. PMID- 6841669 TI - The cell masses in the brainstem of the South African clawed frog Xenopus laevis: a topographical and topological analysis. PMID- 6841670 TI - Topological analysis of the brainstem of the reedfish, Erpetoichthys calabaricus. PMID- 6841671 TI - Axonal branching in the projections from precerebellar nuclei to the lobulus simplex of the rat's cerebellum investigated by retrograde fluorescent double labeling. AB - The projections to lobulus simplex and Crus I of the cerebellum from various brainstem nuclei have been examined in adult rats by using the retrograde fluorescent double labeling technique. True blue was injected into the lobulus simplex on one side and nuclear yellow on the other and the brainstem was examined for labeled neurons. The lateral reticular nucleus, pontine tegmental reticular nucleus, and nucleus praepositus hypoglossi were similar to the equivalent nuclei in other species but all contained double- as well as single labeled neurons and it was concluded that these nuclei have neurons whose axons branch to both sides of the cerebellum. More neurons in the rostral part of the lateral reticular nucleus were bilaterally projecting than in the caudal and the significance of this in relation to its afferents is considered. The individual neurons in the pontine nuclei, inferior olivary nucleus, and cuneate nuclei only appear to project to one side and the recent evidence for axonal branching of pontine neurons in the cat is discussed. PMID- 6841672 TI - Organization of the afferent projections to the Wulst in the pigeon. AB - The afferent connections to the Wulst, a well-defined bulge in the forebrain roof, were studied in the pigeon. Cells of origin were identified by horseradish peroxidase retrograde tracing, after placing multiple injections in the Wulst. The results demonstrate a bilateral intratelencephalic pathway arising from the archistriatum intermedium (Ai) in the basal forebrain. Labeled cells in n. superficialis parvocellularis (SPC) and n. dorsolateralis posterior (DLP) on both sides of the brain, provide anatomical evidence for a bilateral forebrain projection of the somatosensory thalamus. A sparse ipsilateral input of unknown function from the medial thalamus originates in n. dorsomedialis anterior (DMA) and n. dorsolateralis medialis (DLM). We provide confirming evidence of the bilateral thalamofugal visual pathway ascending from nuclei of the dorsolateral thalamus (DLAmc and DLL). Projections from several brainstem structures are described, including: griseum centrale (GCt), medial and lateral reticular formation (FRM and FRL), area ventralis of Tsai (AVT), n. annularis (Anl), locus coeruleus (LoC), and the avian homologue of the raphe nucleus, n. linearis caudalis (LC). The account provides a direct anatomical demonstration of a Wulst input from the basal forebrain, the somatosensory thalamus, and the brainstem. The projection cells in the brainstem reside in structures known to contribute to ascending catecholaminergic and serotoninergic pathways. PMID- 6841673 TI - Corticothalamic projections from postcruciate area 4 in the dog. AB - Corticothalamic projections from postcruciate area 4, located on the rostral part of the posterior sigmoid gyrus, were traced with the autoradiographic technique in the dog. Injections of tritiated amino acids were made into the lateral and medial parts of area 4 in regions corresponding to the forelimb and hindlimb areas of the primary motor cortex, respectively. In cases with injections placed in the lateral part of area 4, dense accumulations of label were present in the lateral part of the ventral anterior nucleus (VA), the central part of the ventral lateral nucleus (VL), the ventral half of the ventral posterior inferior nucleus (VPI), the caudal part of the central lateral nucleus (CL), and the centrum medianum (CM). Lighter label was also present in the lateral part of the cytoarchitectonically distinct VL region bordering the ventrobasal complex (VB), as well as in the ventrolateral part of the mediodorsal nucleus (MD), and in the lateral posterior nucleus (LP). In one case in which the injection site involved an adjacent part of area 3a, label was also seen ventrally in the medial division of the posterior nuclear group (POm). However, no detectable differences in VL, MD, or intralaminar labeling patterns were noted between this case and the four other cases with injections confined to the lateral part of area 4. In two cases with injections restricted to the medial part of area 4, dense label was present in the lateralmost part of VL, the ventral part of VPI, the caudal part of CL, and CM. Lighter label was also present in the VL region bordering the dorsolateral edge of VB and in LP. An additional case in which the injection also involved the rostral border of area 3a showed a similar pattern of thalamic labeling. Projections from both the lateral and medial parts of area 4 were also noted in the subthalamic nucleus, zona incerta, and nucleus of Darkschewitsch. These results suggest that corticothalamic projections from postcruciate area 4 to VL are organized topographically such that projections from the lateral part of area 4 project centrally within VL while those from the medial part of area 4 project more laterally. Both parts of area 4 also project topographically to a cytoarchitectonically distinct region of VL located immediately adjacent to VB. In contrast, the projections to the intralaminar nuclei do not appear to be topographically organized. The data from cases involving spread of the injection into area 3a suggest that projection patterns from area 3a to ventral, intralaminar, and medial thalamic nuclei are similar to those from area 4. However, it appears that at least the lateral part of area 3a also projects to POm. PMID- 6841674 TI - Morphology and origin of axonal endings in nucleus laminaris of the chicken. AB - The axonal endings on the somata and dendrites of third-order auditory neurons in nucleus laminaris (NL) were measured and classified in thin-sectioned material from adult chickens. Two methods were used to determine which ending types arise from second-order auditory neurons in nucleus magnocellularis (NM): 1) degeneration of axonal endings in NL after transection of the crossed dorsal cochlear tract (CTrX) carrying the axons of each NM to the contralateral NL, and 2) injection of horseradish peroxidase (HRP) into NM or the CTrX to label endings in NL by anterograde transport. About 42% of the perikaryl surface of NL neurons and 63% of the dendritic surface are apposed by axon terminals arising from NM; these endings are also prevalent on the axon hillock and initial segment. The NM endings are characterized by round, clear synaptic vesicles distributed at an average density of 76/microns2 behind small punctate synaptic junctions with thick synaptic densities. These endings degenerate preferentially after transection of the CTrX and are the only endings consistently labeled after HRP injections. About 31% of the perikaryl surface of NL and 10% of the distal dendritic surface are apposed by a prominent non-NM axonal ending type. This ending is characterized by a synaptic vesicle density of 135/microns2 and a single large area of synaptic contact which bears very slight densities on both pre- and postsynaptic membranes. On the perikaryon, about 80% of these non-NM terminals end on the cell body proper, with the rest found on proximal dendrites or capping the short somatic processes or spines occasionally seen in NL. The distribution of the two ending types does not differ significantly along the posterior-to-anterior axis of NL. PMID- 6841676 TI - Effects of visual deprivation upon the geniculocortical W-cell pathway in the cat: area 19 and its afferent input. AB - We studied the receptive field properties of 206 single units in area 19 of normal cats and 228 single units in area 19 of cats deprived of vision for 9-14 months by monocular lid suture. The ocular dominance of a sample of cells in area 17 of normal cats was studied for comparison. In some of these monocularly deprived animals, we also studied the sizes of relay cells in the parvocellular C laminae of the dorsal lateral geniculate nucleus labeled by electrophoretic injections of horseradish peroxidase into area 19. In area 19 of normal cats, the large majority of cells, regardless of their laminar location and the retinal eccentricity of their receptive fields, were binocular. Most responded equally well to the two eyes. In area 17, (see also Leventhal and Hirsch, '78, '80) but not in area 19, the cells which had the narrowest receptive fields tended to be activated unequally by the two eyes. In area 19 of monocularly deprived cats, virtually all cells (97%), regardless of their laminar location and receptive field eccentricity, responded only to stimulation of the normal eye. Thus, the effects of monocular deprivation upon area 19 are apparently more severe than those reported for area 17. In area 17 significant numbers of neurons in layer 4 can be activated by the deprived eye (Shatz and Stryker, '78). Within the limits of our technique, measurements of relay cells in the parvocellular C laminae labeled by injections into area 19 of deprived cats indicated that cell size in the deprived C laminae was unaffected by the deprivation. In contrast, cells in the deprived A laminae of these cats were severely shrunken. These findings suggest that the types of relay found in the parvocellular C laminae (referred to collectively as W-cells) are not affected by visual deprivation as severely as are the X- and Y-cells in the A laminae. Since laminar location and receptive field width are related to binocularity in area 17 but not in area 19 and the sizes of relay cells in the parvocellular C laminae (see also Hickey, '80) are not seriously affected by monocular deprivation, it is suggested that binocular interactions in area 19 are mainly determined by connections among cortical cells. PMID- 6841675 TI - Supramedullary afferents of the nucleus raphe magnus in the rat: a study using the transcannula HRP gel and autoradiographic techniques. AB - Afferents of the nucleus raphe magnus (NRM) were retrogradely labelled by using a transcannula HRP gel technique in conjunction with tetramethylbenzidine neurohistochemistry to determine the sources of inputs to the nucleus which could potentially influence the descending antiociceptive raphe-spinal system. Large numbers of HRP-labelled neurons were seen in the frontal cortex, dorsomedial nucleus of the hypothalamus, zona incerta, nucleus parafascicularis prerubralis (NPfPr), pretectum, dorsal and lateral periaqueductal gray, nucleus cuneiformis (NC), deep superior colliculus (dSC), a paraoculomotor cell group which may be the medial accessory nucleus of Bechterew, dorsal column nuclei, and spinal trigeminal nucleus. Smaller numbers of labelled cells were also observed in the preoptic area, nucleus of Darkschewitsch, ventral peri(third)ventricular gray, nucleus reticularis pontis oralis and caudalis, medial and lateral vestibular nuclei, and a subdivision of the hypoglossal nucleus. Confirmational anterograde autoradiographic studies were performed by injecting tritiated leucine into two of the principal sources of afferents to NRM: NPfPr, and dSC/NC. The results are compared with control HRP gel implants in the inferior olive, spinal cord, nucleus reticularis paragigantocellularis, and medial facial nucleus. Comments are also made concerning the parcellation of the ventromedial medulla and the possible role of both NRM and its afferents in central analgesic mechanisms. PMID- 6841677 TI - Numbers of axons in lateral and ventral funiculi of rat sacral spinal cord. AB - The present study determines the numbers of myelinated and unmyelinated axons in the ventral and lateral funiculi of rat sacral spinal cord. On average, there are 55,000 myelinated and 110,000 unmyelinated axons in the lateral funiculus and 26,000 myelinated and 9,000 unmyelinated axons in the ventral funiculus at these levels. These figures combined with data from earlier studies of the posterior funiculus and the tract of Lissauer give approximate figures of 88,500 myelinated and 131,500 unmyelinated axons for the entire white matter of one side of the rat sacral spinal cord. Thus unmyelinated axons predominate in the white matter of the rat sacral spinal cord. The majority of axons, particularly the unmyelinated axons, are located in the lateral funiculus. The axons are concentrated in the dorsolateral part of the lateral funiculus, and so the dorsal part of the lateral funiculus, often referred to as the dorsolateral funiculus, contains more than half the fibers in the white matter of the spinal cord. A small nick in the dorsal and lateral part of the lateral funiculus, which is often done for various experimental reasons, could thus remove 40% of the axons in the white matter of rat sacral spinal cord. The data reported in the present paper will serve as a basis for future studies on the white matter of the isolated spinal cord. PMID- 6841678 TI - Origin of the rubrospinal tract in neonatal, developing, and mature rats. AB - This investigation describes the origin of the rubrospinal tract in neonatal (1 10 days old), developing (15-20 days old), and mature (2-4 months old) rats studied by using the horseradish peroxidase (HRP) method of tracing neuronal connections. HRP was administered in the cervical or lumbosacral segments of the spinal cord either in the crystal or solution form. The results showed that the rubrospinal tract extended to the lumbosacral part of the spinal cord at birth. There appeared to be no difference in the pattern of labelled rubrospinal (RS) neurons following the administration of HRP in the cervical or the lumbosacral cord segment of the neonatal, developing, and mature rats. In rats of these three age groups, labelled neurons were found bilaterally in the red nucleus, with a contralateral predominance, and they were found in both the parvicellular and magnocellular portions of the red nucleus. There was a somatotopic arrangement in the labelled RS neurons: Those projecting to the cervical cord segments were located in the dorsal and dorsomedial regions of the red nucleus and those projecting to the lumbosacral cord segments were located in the ventral and ventrolateral regions of the nucleus. PMID- 6841679 TI - Midbrain nuclei projecting to the medial medulla oblongata in the monkey. AB - To identify the midbrain nuclei that project to the medial part of the lower brainstem in the monkey, labeled cells were mapped in the midbrain following the injection of horseradish peroxidase into the medial medulla oblongata. After the general distribution of labeled cells was observed in three animals with large injections, more discrete injections of HRP were made in different locations in six additional animals. The small injections were centered in the nucleus raphe magnus, nucleus reticularis gigantocellularis, or nucleus medullae oblongatae centralis. The five labeled midbrain nuclei were the periaqueductal gray, nucleus cuneiformis, deep layers of the superior colliculus, nucleus of Darkschewitsch, and the interstitial nucleus of Cajal. In addition, the parvocellular division of the red nucleus and the posterior pretectal nucleus contained large numbers of cells when the injection spread into the inferior olive. No major differences in the distribution of labeled cells between different injection sites were found with the exception that the superior colliculus did not contain any labeled cells when the injection was restricted to midline structures. The functional implications of these anatomical findings are discussed in relation to the descending control of pain. PMID- 6841680 TI - The cell bodies of origin of sympathetic and sensory axons in some skin and muscle nerves of the cat hindlimb. AB - Cell bodies of sensory and sympathetic axons projecting to skin and skeletal muscle of the cat hindlimb have been labeled retrogradely with horseradish peroxidase (HRP) in order to study location, size, and numbers of the somata of these neurons. HRP was applied to the freshly transected axons of nerves supplying hairy skin (superficial peroneal, SP; sural, Su), hairy and hairless skin of the paw (medial plantar, MP), or skeletal muscle (gastrocnemius-soleus, GS). Serial sections of lumbosacral dorsal root and sympathetic ganglia were studied after standard histochemical processing. Additionally, the numbers of myelinated fibers in the same nerves were determined. All sensory somata and 99.4% of sympathetic cell bodies were located ipsilaterally. Sensory somata were commonly restricted to two adjacent dorsal root ganglia (usually L6-7 for SP, MP; L7-S1 for Su, GS). Although sympathetic somata were more widely distributed rostrocaudally, their maximum frequency always occurred in the segmental ganglia immediately rostral to the sensory outflows, i.e., corresponding to rami communicantes grisei. Dimensions of sympathetic somata varied little between populations projecting to different tissues and were unimodally distributed. The size distributions of sensory somata were characterized by a peak between 10 and 20 microns radius, similar to sympathetic somata, and a varying smaller number of cells ranging up to 60 microns radius. Each nerve had a characteristic distribution profile of afferent somata. A population of very small cells was only present in GS, while the largest sensory somata in GS and MP were bigger than those in SP and Su. Numerical analysis of the data disclosed the characteristic composition of both myelinated and unmyelinated fibers in each nerve studied. PMID- 6841681 TI - Ascending auditory projections to the inferior colliculus in the adult gerbil, Meriones unguiculatus. AB - Ascending auditory projections to the inferior colliculus (IC) of the adult gerbil were studied using the retrograde transport of horseradish peroxidase. Our results indicate that in gerbils, the IC receives afferent projections from most brainstem auditory nuclei. A strong contralateral projection originates in the cochlear nuclear complex (CN). A smaller but consistent projection from all three divisions of ipsilateral CN is also present. The medial superior olive (MSO), superior parolivary nucleus, and ventral nucleus of the lateral lemniscus all maintain ipsilateral projections to the IC. Bilateral projections arise from the lateral superior olive, lateral nucleus of the trapezoid body, and dorsal nucleus of the lateral lemniscus. Previous investigations in other mammalian species provide conflicting data concerning the magnitude of a direct ipsilateral projection from CN to the IC. Our quantitative data indicate that the ipsilateral projection from CN in the gerbil is nearly one third as large as the projection from ipsilateral MSO. The projection from contralateral CN is six times larger than the MSO projection. The distribution of labeled cells across the rostrocaudal extent of MSO and the three divisions of the cochlear nuclear complex are presented. PMID- 6841682 TI - Ascending projections to the inferior colliculus following unilateral cochlear ablation in the neonatal gerbil, Meriones unguiculatus. AB - We evaluated the consequences of neonatal cochlear destruction upon ascending projections to the inferior colliculi. Unilateral cochlear ablations were performed in both neonatal and adult gerbils. Four to 12 months later, the inferior colliculus (IC) was examined physiologically and injected unilaterally with horseradish peroxidase (HRP). The number of labeled cells was determined bilaterally in all three divisions of cochlear nucleus (CN) and in the medial superior olive (MSO). In both experimental groups, transneuronal changes within the deafferented CN were greater in the ventral divisions than in the dorsal division. On the unoperated side the magnitude of projections from CN to the inferior colliculi was altered in animals lesioned as neonates. Following HRP injections into the IC on the unoperated side, the number of ipsilaterally labeled cells in CN (unoperated side) was significantly greater in the neonatal experimental group than in adult experimental and control animals. These anatomical changes were accompanied by increased ipsilaterally evoked excitatory activity recorded in the IC on the unoperated side. Following HRP injections into the IC on the ablated side, the number of contralaterally labeled cells in CN (unoperated side) was significantly reduced in animals lesioned as neonates as compared with control animals. The number of labeled cells in ipsilateral MSO was not significantly different across groups. Our interpretation is that unilateral cochlear ablation in neonatal gerbils results in an increase in the magnitude of ipsilateral projections and a decrease in the magnitude of contralateral projections from CN on the unoperated side to the inferior colliculi. These data suggest that the normal pattern of innervation of the IC results, in part, from interactions among afferent projections. PMID- 6841683 TI - Cholinergic innervation of cortex by the basal forebrain: cytochemistry and cortical connections of the septal area, diagonal band nuclei, nucleus basalis (substantia innominata), and hypothalamus in the rhesus monkey. PMID- 6841684 TI - A system of rat spinal cord lamina 1 cells projecting through the contralateral dorsolateral funiculus. AB - The aim of these experiments was to sample the properties of lamina I neurones with long ascending projections. Recordings have been made from 136 units at the L4/5 level, with ascending axons reaching C2. More than 80% of the units projected via the contralateral dorsolateral white matter and only 10% via the contralateral ventral quadrant. None projected via the dorsal columns. Receptive fields were typically 1-2 cm2 and although a substantial number of units responded to a limited range of intense stimuli, a greater number of units were fired by both low- and high-threshold stimulation. In contrast to cells of deeper laminae, the majority of units were excited following activation of descending pathways in the dorsolateral funiculus. The functional role of these units is not obvious, but the location of the ascending projection and the influence of descending pathways does not support the notion that the output of lamina 1 constitutes a simple "pain pathway." PMID- 6841685 TI - Differentiation of granule cell dendrites in the dentate gyrus of the rhesus monkey: a quantitative Golgi study. AB - The differentiation of granule cell dendrites in the dentate gyrus of the hippocampal region was studied in a series of developing fetal and postnatal rhesus monkeys whose brains were processed by the rapid Golgi method. The total combined lengths of dendrites, the total number of dendritic spines, and their density on the proximal, middle, and distal thirds of the dendritic shafts were determined at embryonic days 58, 95, 120, 153, term (165), postnatal days 3, 20, 60, 150, 365, and adults. At all ages examined, granule cells exhibited various levels of maturation with the more differentiated cells being situated in the superficial strata of the granular layer and the less mature cells lying in progressively deeper positions, thus conforming to the outside-to-inside spatiotemporal gradient of their genesis. Quantitative analysis shows that, in this primate, hippocampal granule cells differentiate mainly in the second half of gestation with all measured parameters attaining mature values by the time of birth. However, the analysis also reveals a transient phase of exuberant postnatal development which involves excessive dendritic branching, regional changes in dendritic length, overproduction of dendritic spines, and redistribution of spines within the molecular layer. After reaching peak values around the middle of the first year of life, these parameters decrease and in adult monkeys fall back to the neonatal level. PMID- 6841686 TI - Scanning electron microscope studies on preparations of bovine cornea exposed to Moraxella bovis. AB - Preparations of bovine cornea were studied by scanning electron microscopy before and after in vitro exposure to Moraxella bovis. The bacteria were observed in association with the surface of the corneal epithelium; they showed a predilection for dark cells relatively devoid of surface structure. Pit-like depressions related to the presence of individual bacteria were produced in these cells. An evident association with corneal epithelium was shown by 2 strains known to be pathogenic experimentally in cattle but not by 2 non-pathogenic strains. PMID- 6841687 TI - Spontaneous ovarian teratomas in laboratory mice. PMID- 6841688 TI - An in vivo method of assay for Dermatophilus congolensis. AB - An in vivo method of assay for Dermatophitus congolensis in rats is described. The optimal conditions for preparing skin before infection and subsequently harvesting the zoospores from infected skin were investigated. These experiments showed that clipping the skin had no effect on infection with this bacterium and that when the infected skin was soaked in water, increased amounts of dissolved CO2 had no effect on the release of zoospores, which was maximal within 2.5 h of immersion. Vaccination studies demonstrated that this assay gave results comparable to previously published data, where these data were quantitative. Infection with D. congolensis was not related to the production of exudate on the skin surface. This is the first report that D. congolensis can infect skin without producing an exudate. Hypotheses linking skin damage and susceptibility to infection with this bacterium are discussed in the light of this observation. PMID- 6841689 TI - Isolation of orthoreoviruses from psittacine birds. AB - Orthoreoviridae were regularly isolated from imported psittacine birds in the absence of other pathogens or in combination with salmonella. These viruses grew in embryonated eggs, in chicken embryo fibroblasts and in hepatic cell cultures. The viral isolates were classified as orthoreoviridae on the basis of their morphological and physico-chemical properties. PMID- 6841690 TI - The effect of copper deficiency on the resistance of mice to infection with Pasteurella haemolytica. AB - Mice adjudged copper deficient on the basis of significantly decreased blood and tissue copper content and superoxide dismutase activity, but generally showing no clinical signs of deficiency, were infected intraperitoneally with Pasteurella haemolytica. In 3 separate experiments the LD50 for deficient animals was significantly depressed below that of copper-sufficient controls. Furthermore, in mice surviving challenge at doses near to the LD50, spleen weights were significantly increased and body temperatures depressed in the copper-deficient animals. These results indicate that subclinical copper deficiency in the mouse, is associated with an increased susceptibility to experimental infections with P. haemolytica. PMID- 6841692 TI - Ultrastructural features of lung lesions in sheep dipped in a carbolic dip. AB - Ultrastructural changes in the lungs of 3 young sheep which became acutely ill with respiratory distress and severe pulmonary lesions 4 to 5 days after dipping in a proprietary carbolic sheep dip consisted of extensive alveolar damage associated with regenerative changes. Damage to alveolar epithelium was associated with accumulations of plasma fluid and cell debris in alveolar spaces, which also contained neutrophils and macrophages. Concurrently, damage to capillary endothelium resulted in liberation of plasma fluid and erythrocytes into the tissues and alveoli. Interstitial oedema was also present. Regeneration took the form of hyperplasia of type II alveolar epithelial cells, many of which were in mitosis, and which often lined alveolar spaces completely. Many of these cells were undergoing early metaplasia into type I pneumocytes, as shown by the development of elongated cytoplasmic extensions which increased the thickness of the blood-air barrier. Interstitial fibrosis was not a prominent feature. It is presumed that these effects resulted from skin absorption of an unknown toxic substance in the dip. PMID- 6841691 TI - Effects of fenthion on the blood and tissue chemistry of a teleost fish (Heteropneustes fossilis). AB - Exposure of a freshwater teleost, Heteropneustes fossilis, to a concentration of 14 . 625 mg per 1 (0.9 of 96 h LC50) fenthion induced muscle and hepatic glycogenolysis with concomitant hyperglycaemia at 2, 6, 12 and 48 h after treatment. The pesticide evoked an initial fall (at 2 and 6 h) and later a rise (at 48 and 96 h) in blood chloride concentration. The treatment also caused anaemia with simultaneous increase in ESR and hypo-coagulability of whole-blood. The results are compared with organophosphate poisoning in this and in other fish species. PMID- 6841693 TI - Congenital tremor type AI: light and electron microscopical observations on the spinal cords of affected piglets. AB - The histology and ultrastructure of the spinal white matter from the dorsolateral funiculus of the third cervical segment was studied in normal control pigs and pigs whose dams were inoculated with the Weybridge congenital tremor strain of swine fever virus in early pregnancy. Only inoculated sows produced abnormal piglets. These showed congenital tremors and ataxia. The severity of clinical signs was related to the degree of spinal myelin deficiency. Morphologically this was quantified by determination of the thickness of myelin investing axons classed according to their diameter. In clinically affected pigs fewer axons were myelinated than normal. Though the myelin sheath thickness increased with increasing axon diameter in all pigs whether clinically normal or not, the increase was less in moderately affected and much less in severely affected pigs. The deficiency of spinal myelin was probably due to delayed or sub-normal myelination accompanied by paranodal myelin abnormalities, myelin degeneration and remyelination. PMID- 6841694 TI - Absorption and secretion of calcium and phosphorus in the alimentary tract of lambs infected with daily doses of Trichostrongylus colubriformis or Ostertagia circumcincta larvae. AB - The flows of endogenous and exogenous calcium and phosphorus in the digesta at the abomasum, ileum and in the faeces were measured in growing lambs infected daily with 3000 T. colubriformis larvae (TC), 5000 O. circumcincta larvae or no larvae. The lambs were given 0.70 or 1.0 kg per day of a pelleted diet and the flow rates were measured by reference to soluble and particulate radioactive markers. The fraction of Ca and P in digesta of endogenous origin was measured by the method of isotope dilution involving a single intravenous dose of 45Ca or 32P. Ostertagia circumcincta infection was without effect on the absorption and secretion of Ca and P in the digestive tract, other than producing a small but significant increase in the endogenous faecal Ca excretion. There was, however, a striking increase in the flow of digesta at the abomasum, the DM and Na content of which was consistent with an increased secretion from the mucus-type cells in the abomasal mucosa. The extra digesta was absorbed in the small intestine. Trichostrongylus colubriformis infections reduced the absorption of exogenous P by about 30 per cent and increased losses of endogenous P due to the action of worms on the mucosa of the small intestine. The net effect of this was to induce a P deficiency in TC lambs, leading to a reduced flow of salivary P and a reduction in the plasma concentrations of P. The effect of TC on Ca metabolism was limited to an increase in endogenous faecal excretion. PMID- 6841695 TI - The absorption of labelled molybdenum compounds in sheep fitted with re-entrant cannulae in the ascending duodenum. AB - The absorption of labelled molybdenum compounds was studied in pairs of sheep exchanging digesta via re-entrant duodenal cannulae. Tri- and tetrathiomolybdate 99Mo were rapidly absorbed from the rumen to circulate in plasma in a protein bound and in a TCA-insoluble form. The compounds were also absorbed from the small intestine although some breakdown was evident. Initially, molybdate was poorly absorbed from the rumen but after several hours the concentration of protein-bound, TCA-insoluble 99Mo increased in plasma. This provides evidence of rumen thiomolybdate synthesis. The results indicate that thiomolybdates are absorbed directly from the rumen and despite the sensitivity of the compounds to acid, some absorption from the small intestine occurs after passage through the abomasum. Rumen absorption could be a contributory factor to ruminant sensitivity to the effects of Mo compounds. PMID- 6841696 TI - Experimental pyelonephritis in the cat: 3. Collagen alterations in renal fibrosis. AB - Chronic pyelonephritis was induced in young adult cats by the intravenous injection of a human or a feline strain of Escherichia coli after ligation of one ureter for 24 or 48 h. In the 3 cats infected with the feline strain, scarred kidneys from the obstructed side were removed at necropsy 3, 4 and 5 months later. Collagen was extracted from pyelonephritic and normal kidney tissue with dilute acetic acid and limited proteolysis with pepsin. Scarred kidneys gave higher yields of both acid-soluble collagen (normal = 0.57 +/- 0.12 mg per g tissue; scarred = 0.88 +/- 0.10 mg per g tissue) and pepsin-solubilized collagen (normal = 9.69 +/- 1.79 mg per g tissue; scarred = 20.02 +/- 2.84 mg per g tissue). There was no significant increase in the collagen yield from the kidneys of the 2 cats in which mild focal lesions were found 14 and 16 months after infection with the human strain of E. coli. Pepsin released collagens were separated by fractional salt precipitation and identified by agarose gel chromatography and polyacrylamide gel electrophoresis. Normal kidney was shown to contain collagen of Types I, IV and V (AB). The Type IV collagen extracted consisted of a mixture of 4 major pepsin-resistant chains of apparent molecular weights of 150 000, 115 000, 85 000 and 60 000. The collagen extracted from scarred kidneys was predominantly Type I, only trace amounts of Type IV and V components being present. These findings suggest that basement membrane collagens of the kidney are selectively degraded during the atrophy and scarring of chronic feline pyelonephritis and are preferentially replaced by interstitial Type I collagen. PMID- 6841697 TI - Canine biliary carcinoma: epidemiological comparisons with man. AB - A retrospective study of abstracted data representing 1.1 million hospital examinations of dogs at veterinary university teaching facilities identified 77 with bile duct carcinoma. Using the hospital population, based on patient years at risk, as the expected frequency of particular zoographic characteristics, there was a suggestion of a familial (breed) predisposition in Labrador retrievers and limited evidence of a sex differential. Because mongrel dogs displayed about the same frequency of bile duct cancer as all breeds combined, other causal factors, besides genetics, are implied. A possible association was detected between canine cholangiocarcinoma and host infection by canine hookworms and/or whipworms. Human infection from hookworms (Necator americanus) and whipworms (Trichuris trichiura) is common in the southern rural areas of the U.S.A. (e.g. Appalachia), and tropical and sub-tropical countries of Africa, Central and South America, where there have been unexplained high rates reported for human biliary cancer. It is possible that the presence of these blood-letting nematodes, like a number of other parasites (ascarids, flukes and protozoa), may be related to the occurrence of human cholangiocarcinoma. PMID- 6841698 TI - Signal, noise, and contrast in nuclear magnetic resonance (NMR) imaging. AB - Calculations of the sensitivity of the saturation recovery and inversion recovery pulse sequences used in nuclear magnetic resonance imaging show the former to be superior in discriminating between tissues with the same proton density but different T1's. Two other pulse sequences, which are combinations of the above, have also been analyzed. These have lower T1 discrimination sensitivity, but other considerations, such as self-normalization, may still make them attractive. The calculations are only valid for selective excitation pulse sequences in which the selected slice profiles are approximately rectangular, and thus a sin(bt)/t radiofrequency excitation is desirable. In order to ensure that the saturation recovery sequence gives valid results for pulse repetition times comparable to or shorter than T2, it is necessary to destroy the coherence between pulse applications. For this purpose we use a series of "spoiler" gradient pulses between pulse trains. The saturation recovery pulse sequence also has the advantage that, by the correct choice of interpulse spacing, sensitivity close to the optimum T1 discrimination can be achieved over a wide range of T1 values. This has the potential advantage to the clinician of simplifying his choice of parameters for imaging. PMID- 6841699 TI - Experimental lung nodule model: CT numbers, nodule size, and actual calcium content. AB - An experimental pulmonary nodule model was developed to study the effect of nodule size, nodule environment, and calcium content on the attenuation values in two computed tomography (CT) scanners. The experimental results show that (a) calcium is the moiety most responsible for the CT number, (b) small nodules may have falsely low CT numbers, (c) CT numbers vary from scanner to scanner when scanning the same nodule, and (d) higher CT numbers are obtained when experimental nodules are scanned in air rather than water. PMID- 6841700 TI - CT attenuation values of lung density in sarcoidosis. AB - Mean lung density (MLD), as determined by a chest computed tomographic sector method, was evaluated in 12 patients with sarcoidosis and diffuse interstitial lung disease. The results demonstrate that MLD in sarcoidosis was -610.9 +/- 57.3 Hounsfield units (HU), significantly different (p less than 0.001) from a control group MLD of -748.1 +/- 31.9 HU. There was also a significant inverse correlation between the forced vital capacity and total lung capacity in the sarcoidosis group. Our data suggest that a major factor determining MLD in a diffuse interstitial process such as sarcoidosis is pulmonary gas volume. PMID- 6841701 TI - CT demonstration of the phrenic nerve. AB - Twenty-four consecutive patients examined with whole lung computed tomography (CT) using a high resolution scanner were evaluated for detection of the phrenic nerve. The phrenic nerve was considered to be demonstrable when a 1-3 mm rounded structure was identified adjacent to the pericardium on at least two contiguous sections. The phrenic nerve was thus indicated in 13 patients, eight children and five adults. The nerve was found on the left side in 11 patients, the right side in one patient, and bilaterally in one patient. It is important to recognize the normal course of the phrenic nerve on CT in patients being evaluated for pulmonary metastases. PMID- 6841702 TI - CT assessment of the adult extrathoracic trachea. AB - A total of 40 neck computed tomographic (CT) scans in adult patients were retrospectively reviewed and absolute measurements made of the anteroposterior (TRAP) and transverse (TRTR) air spaces at the first tracheal cartilage. For each patient, ratio measurements were calculated of the anteroposterior (TRAP/TC) and transverse (TRTR/TC) tracheal air space relative to the glottic air space at the true cord level. Mean TRAP (2.01 cm) and TRTR (1.84 cm) measurements for normal patients agreed closely with figures reported in prior cadaver preparation studies. The lower normal limit found for absolute tracheal diameter was 1.5 cm (TRAP) and 1.4 cm (TRTR), whereas lower normal limits for relative tracheal to glottic air space diameters were 0.7 (TRAP/TC) and 0.6 (TRTR/TC). PMID- 6841703 TI - CT findings in Mirizzi syndrome. AB - Six cases of Mirizzi syndrome have been studied by computed tomography (CT). Although not specific, CT frequently reveals an irregular cavity near the gallbladder neck and calculi outside the viscus. Emphasis is placed on the possibility of recognizing this entity by CT prior to surgery. PMID- 6841704 TI - Prediction of splenic volume by a simple CT measurement: a statistical study. AB - The width, thickness, and areas of the spleen were obtained by abdominal computed tomography on 50 patients. Several simple linear equations were used to predict the splenic volume and were correlated with a previously published method for volume estimation based on summing areas of multiple contiguous scans. This was used as a standard and demonstrated an excellent linear correlation (r = 0.95) with an estimate based on a product of length and maximal width. Correlation was even better (r = 0.991) with an estimate based on length, maximal width, and thickness. PMID- 6841705 TI - Computed tomography of diverticulitis. AB - Computed tomography (CT) is capable of imaging diverticulitis of the colon. Localized wall thickening, soft tissue density in the pericolic fat, and large soft tissue masses that may or may not contain gas have been observed in diverticulitis. Because of its noninvasive nature, CT may have an advantage in the acute phase of diverticulitis when there may be reluctance to do a barium enema. More experience will be needed to see if CT will be predictive of a need for surgery. PMID- 6841706 TI - Computed tomography and appendiceal abscess: special applicability in the elderly. AB - Five cases are presented in which appendiceal abscesses were demonstrated by computed tomography (CT) and confirmed at surgery. In another, a feces-filled cecum led to a false positive diagnosis of appendiceal abscess, and this is included as an instructive case. Three of the patients were elderly, with an atypical presentation; in these, CT was especially important in clarifying the diagnosis by including appendiceal abscess in the differential diagnosis of pelvic pathology. PMID- 6841707 TI - Intraabdominal abscesses in pseudomyxoma peritonei: the value of computed tomography. AB - Two cases of pseudomyxoma peritonei with intraabdominal abscess formation are presented. In both cases the presence and the extent of abscess were diagnosed by computed tomography (CT). In addition, in each case the source of the abscess was also suggested by CT. PMID- 6841708 TI - CT findings in angioimmunoblastic lymphadenopathy. AB - Two cases of angioimmunoblastic lymphadenopathy with intraabdominal involvement are presented. Lymphadenopathy indistinguishable from lymphoma and leukemia was evident on computed tomography. The pathological features are discussed. PMID- 6841709 TI - Nuclear magnetic resonance (NMR) imaging of the brain in systemic lupus erythematosus. AB - Nuclear magnetic resonance (NMR) and X-ray computed tomographic (CT) imaging of the brain were performed on nine patients with clinical evidence of cerebral involvement by systemic lupus erythematosus (SLE). Focal lesions were demonstrated in eight patients by NMR and in six by CT. The examinations with both techniques were negative in one patient and showed essentially identical pathological conditions in three patients. In three patients NMR demonstrated more numerous lesions than CT. All lesions seen on CT were also seen on NMR, mostly with greater clarity and extent. In view of the limited number of patients, this study is preliminary, but it appears that NMR demonstrates more accurately the degree of brain involvement in SLE than CT. PMID- 6841710 TI - Nuclear magnetic resonance (NMR) tomography of the central nervous system: comparison of two imaging sequences. AB - A brief description of a nuclear magnetic resonance (NMR) imaging system and preliminary results from its clinical evaluation in the study of various central nervous system diseases are presented. Particular attention is paid to NMR capabilities for soft tissue discrimination, topographical demarcation, and specificity of diagnosis. Two imaging sequences were used: (a) Spin echo measurements with four sets of imaging parameters revealed the different appearances of normal and pathological structures. (b) Inversion recovery images showed marked gray-white matter contrast and clear depiction of pathological lesions. Finally, a number of measurements of longitudinal (T1) and transverse (T2) relaxation times of normal and pathological tissues were carried out. PMID- 6841712 TI - Dense dermoids in craniocervical region. AB - Computed tomography of dermoids and epidermoids usually demonstrates areas of variable hypodensity, located most frequently in the sellar region and in the cerebellopontine angle. This report presents two cases of hyperdense dermoids of the craniocervical region which are compared with six other cases described in the literature. PMID- 6841711 TI - CT demonstration of cerebral subcortical calcifications. AB - Neurological abnormalities are a major cause of the morbidity associated with renal failure. Substantial elevations in parathormone levels have been found to accompany significant increases in brain content of calcium. Two cases of cerebral subcortical calcifications are demonstrated by computed tomography in patients with severe chronic renal failure. To our knowledge this finding has not been described previously. PMID- 6841714 TI - High resolution computed tomography of the osseous external auditory canal: 1. Normal anatomy. AB - This study of 34 normal ears was conducted in order to define more precisely the normal computed tomographic (CT) anatomy of the osseous external auditory canal. Great variability was found in canal configuration and its relationship to the temporal squama. The understanding of normal CT appearance of the various fissures along the anterior wall of the external canal is important to avoid mistaking fissures for fractures. PMID- 6841715 TI - High resolution computed tomography of the osseous external auditory canal: 2. Pathology. PMID- 6841716 TI - Computed tomography of cystic neck masses. AB - Computed tomography (CT) of the neck has been primarily applied to the assessment of malignant disease with few reports describing its utility in benign conditions. The authors report 13 cases of cystic neck masses evaluated by CT. Pathological conditions included brachial cleft cyst, laryngocele, thyroglossal duct cyst, cavernous lymphangioma, necrotic lymphadenopathy, and asymmetric jugular veins. Computed tomography was helpful in correctly predicting the etiology by determining the exact location of these masses in relation to the normal anatomic structures in the neck. PMID- 6841713 TI - Computed tomography of axial myopia. AB - Computed tomography (CT) is the primary imaging modality for evaluation of an orbital mass presenting as proptosis. Axial myopia is a benign cause of unilateral proptosis frequently encountered by the ophthalmologist. Identification of this condition by CT avoids additional investigation of the cause of the proptosis. PMID- 6841719 TI - Spondylolysis of C2: CT and plain film findings. PMID- 6841717 TI - Ellipsoidal body phantom for evaluation of CT scanners. AB - A phantom for study of uniformity, artifacts from dense structures, and consistency in pixel values was constructed. On-site studies of eight computed tomographs belonging to the second, third, and fourth generations showed that the phantom was appropriate for such measurements. The results indicate certain inherent shortcomings in some of the present designs. PMID- 6841718 TI - Noninvasive CT diagnosis of infantile Alexander disease: pathologic correlation. AB - Noninvasive computed tomography provided the initial, accurate diagnosis of a necropsy-proven case of infantile Alexander disease, demonstrated serial changes in the intensity and distribution of leukodystrophy, and documented a progressive alteration of brain density from abnormally high attenuation to abnormally low attenuation as the disease advanced. PMID- 6841720 TI - CT diagnosis of cystic hygroma of the neck. AB - Cystic hygromas of the neck can simulate other benign lesions and occasionally extend into the mediastinum. Using computed tomography, we were able to confirm the suspected diagnosis, exclude other diagnostic considerations, and clearly demonstrate absence of mediastinal extension. PMID- 6841721 TI - Primary sarcoma of the pulmonary trunk: CT findings. AB - A case of primary leiomyosarcoma of the pulmonary trunk is described. Following bolus injection of contrast medium, computed tomography was useful in demonstrating metastatic deposits, pulmonary oligaemia, and also the primary tumour itself. Comparison with conventional radiology is made. PMID- 6841722 TI - CT diagnosis of false aneurysm of the pulmonary artery not demonstrated by angiography. AB - A 17-year-old patient with tricuspid atresia, palliatively corrected by a right Glenn and a left Potts anastomosis during his early childhood and a banding of the left pulmonary artery 6 years ago, developed a false aneurysm of the left pulmonary artery secondary to the erosion of the band fabric through the vascular wall with subsequent thrombosis, infection, and leakage. The diagnosis was confused by both chest roentgenography and angiography but was accurately made by postcontrast computed tomography (CT). We stress the importance and usefulness of CT in the diagnosis of a false aneurysm, not demonstrated by angiography. PMID- 6841723 TI - CT diagnosis of a splenic artery pseudoaneurysm: a complication of chronic pancreatitis and pseudocyst formation. PMID- 6841724 TI - CT appearance of the liver in a patient with biliary cirrhosis and cystic fibrosis. PMID- 6841725 TI - Spontaneous pancreatic decalcification. PMID- 6841726 TI - Subcapsular pancreatic pseudocyst of the kidney. AB - Pancreatic pseudocysts are a well-known complication of pancreatitis and may occur in unusual locations. We report a case of a child with hereditary pancreatitis who developed a subcapsular pseudocyst of the left kidney. The constellation of findings of calcific pancreatitis and a left renal subcapsular fluid collection should raise the possibility of a subcapsular pseudocyst. PMID- 6841727 TI - CT diagnosis of renal cyst wall tumor. AB - Renal cysts are common lesions especially in the older population. Although the occurrence of a tumor within the wall of an otherwise benign cyst is rare, its accurate diagnosis is difficult. We present such a case, diagnosed preoperatively by computed tomography. PMID- 6841728 TI - CT appearance of bladder malakoplakia. AB - The computed tomographic (CT) findings of malakoplakia of the bladder are presented. Although the CT findings were not considered specific for this condition, the presence of a solid bladder mass with or without extension beyond the confines of the bladder in a young woman with urinary tract infection should suggest the possibility of this diagnosis. PMID- 6841729 TI - CT findings in lingual abscess. PMID- 6841730 TI - CT findings in metastatic adenocarcinoma of the skeletal muscles. PMID- 6841731 TI - CT diagnosis of intraosseous lipoma of the calcaneus. PMID- 6841732 TI - The nevoid basal cell carcinoma syndrome. Histopathology of the basal cell tumors. AB - 126 basal cell carcinomas from 7 patients with nevoid basal cell carcinoma syndrome were examined histologically and--using a scoring system--compared with 54 solitary basal cell carcinomas. The solid subtype formed 78.9% of all tumors in the head and neck region and 48.9% of those located elsewhere. A broader spectrum of histological subtypes was noticed in tumors from patients with the syndrome. As multiple, keratinizing odontogenic and epidermal cysts are often seen in the nevoid basal cell carcinoma syndrome it was interesting to see that multiple keratinizing cysts within skin tumors were recorded more often in this group. PMID- 6841733 TI - Melanoma histogenesis. PMID- 6841734 TI - Kinetic studies of in vivo digestion of bovine unheated skim-milk proteins in the rat stomach. AB - The in vivo action of gastric proteinases on bovine milk proteins was studied in rats fed with skim-milk, by analysing gastric contents after 30, 60 and 240 min of digestion. Gastric proteolysis was already marked after 30 min of digestion and liberated a large number of peptides with different molecular weights. alpha S1-Casein and beta-casein were still the main components of the stomach contents together with alpha-lactalbumin and beta-lactoglobulin, which were little degraded, even after 240 min of digestion. A statistical analysis (multivariate method), made on several parameters (such as pH, N, and NPN) showed changes in the stomach contents during the digestion. The amino acid composition of the protein fraction was close to that of the diet, whilst that of the non-protein fraction was very different, being between the amino acid composition of the endogenous proteins and that of the diet. PMID- 6841735 TI - Use of lyophilized skin for testing the bactericidal activity of teat disinfectants. AB - The bactericidal activities of various concentrations of 3 disinfectants commonly used for teat disinfection were compared in vitro using small discs of pig skin previously contaminated with Staphylococcus aureus. Solutions containing 40 g/l Na hypochlorite, 25 or 50 g/l chlorhexidine digluconate or iodophor containing 5 g/l iodine were found to have equivalent or superior bactericidal activity to a solution containing 10 g/l Na hypochlorite. This in vitro technique offers a convenient alternative to in vivo tests for teat disinfectants and with minor modifications could be applicable to the testing of skin antiseptics in general. PMID- 6841736 TI - Glucose levels in bovine colostrum. PMID- 6841737 TI - Life stress, family support and adolescent disturbance. PMID- 6841738 TI - Some techniques for working with resistant families of adolescents. AB - This paper reviews some of the causes of resistance in families of adolescents being seen in conjoint family therapy. Two main types of resistance are described: resistance due to excessively high anxiety and resistance due to excessively low anxiety. Techniques for dealing with such resistance are then discussed: first, directive techniques designed to lower or heighten anxiety and secondly, strategic techniques designed to exploit resistance to a therapeutic end. PMID- 6841739 TI - Leadership in low intensity Intermediate Treatment groups. AB - One of the significant developments in social work over the last 10 years has been the growth of work in small groups with adolescents, under the aegis of intermediate treatment. A typical model has been a group of eight members, with two adult leaders meeting once a week for approximately six months. Although recently overshadowed by the demand for, and subsequent development of, more intensive provision as an alternative to detention centre and care orders, much of this low-intensity work still continues. This paper explores the problems posed in leading such groups and how some of them have arisen from the historical development of the approach and the effect of fundamental attitudes in social work. It offers a three stage developmental model for exploring leadership styles in such groups. PMID- 6841740 TI - The extent of solvent abuse in a regional secure unit sample. AB - Because of concern over the increasing number of teenage boys being admitted to secure facilities with a background of solvent abuse this study set out to compare such boys with a sample drawn from a drop-in youth centre. It was discovered that the secure unit boys were more likely to have habitually abused solvents than their youth centre counterparts. However their drinking and smoking habits were similar. A measure of neuropsychiatric and psychosomatic symptoms showed that the "sniffers" had a higher mean score than "non-sniffers" in the secure unit--although the difference was not statistically significant. Sniffing was associated with heightened emotions, with approximately half the "sniffers" associating sniffing with pleasant feelings and the other half with unpleasant experiences. It was suggested that those who construe sniffing positively are more likely to have socially determined reasons for abuse, whereas those who construe it negatively may have psychologically determined reasons. Finally, results from a Delinquency Implications Matrix suggested that sniffing was viewed as part of a delinquent syndrome and not as a discrete activity by the boys concerned. PMID- 6841741 TI - Sex and personality differences in self-reported social skills among British adolescents. AB - Despite the fact that a considerable amount of research has been done, both in America and Britain, on social skills training and assessment, few studies have looked at either sex differences or personality correlates of social skills. A homogeneous group of over 200 normal British adolescents were administered a standard British personality and social skills questionnaire. Although there seemed very little evidence of sex differences in self-reported social anxiety, two personality variables--extraversion and neuroticism--were clearly related to social anxiety. Factor analysis of the social skills scale produced five clearly interpretable factors. The results were discussed in terms of social skills assessment and training. PMID- 6841742 TI - Are there psychological differences between persistent solvent-abusing delinquents and delinquents who do not abuse solvents? PMID- 6841743 TI - How conformist Senegalese adolescents consider themselves to be. AB - Conformism seems to be of negative value in most European cultures as it is understood to rule out originality and creativity. In "transitional" societies such as the Senegalese one, at the crossroads of diverse influences, Western, Eastern and traditional African, the conception of conformism is slightly different, as we found when we investigated a group of schoolgoing adolescents. Results show that group pressure, though very strong, does not exclude individual initiative and a fair amount of free-will, and that this is in keeping with the traditional systems of values, understood in their appropriate context and meaning. PMID- 6841744 TI - Induction of milk lipolysis by lipoprotein components of bovine blood serum. AB - The major blood lipid component responsible for activation of milk lipolysis was high density lipoprotein with density of 1.063 to 1.21 g . ml-1. Its low molecular weight apolipoprotein fraction, apo C, which activates milk lipoprotein lipase in vitro, was unable to induce milk lipolysis under normal conditions. Mechanical treatment of the milk rendered it highly susceptible to apo C stimulated lipolysis. Low and very low density lipoprotein fractions, which also contain apo C, showed negligible effect on milk lipolysis. Apo C in combination with serum or heparin induced high lipolysis in normal milk. Also, lysolecithin influenced the degree of serum activated lipolysis. Antiserum raised against bovine apolipoprotein A-I, which does not activate lipoprotein lipase, removed the activating ability of serum. Induction of milk lipolysis is preceded by redistribution of lipoprotein lipase, thus increasing the accessibility of the enzyme to its substrates. PMID- 6841745 TI - Isolation and characterization of lipoprotein lipase activators from bovine blood serum. AB - Bovine serum lipoproteins were fractionated into high density and low and very low density lipoproteins by precipitation with sodium phosphotungstate and magnesium chloride. From each lipoprotein fraction seven apo C peptides were isolated by gel filtration and ion exchange chromatography. The two lipoprotein fractions probably contain identical apo C peptides but in different proportions. Two of the apo C peptides activated lipoprotein lipase from milk in vitro. Their specific activities were about 2000 times as high as that of the original serum. The apo C fraction from low-very low density lipoproteins had a specific activity three times that from high density lipoproteins. Also, the activator peptides from low and very low density lipoproteins gave one band on alkaline urea gel electrophoresis whereas corresponding peptides from high density lipoproteins were slightly heterogeneous. The low and very low density lipoproteins, therefore, seem to be the fraction of choice for isolation of activators for lipoprotein lipase. PMID- 6841746 TI - Influence of lactose concentration of milk and yogurt on growth rate of rats. AB - Growth rates of rats fed lyophilized diets of yogurt, milk, 100% lactose hydrolyzed milk, and 100% lactose-hydrolyzed yogurt were compared. No differences were significant in weight gains between the animals fed lactose-hydrolyzed diets over 3 wk. Further more, rats fed the lactose-hydrolyzed diets had significantly larger weight gains during the 1st wk than those fed unhydrolyzed diets. This may have been from the deleterious effect of lactose, which was in concentrations of 43% in milk and 36% in yogurt. However, by the 2nd wk, rats fed yogurt had growth rates similar to those fed lactose-hydrolyzed diets, and by the 3rd wk, no differences of growth rates were significant. Continued consumption of high concentrations of lactose improved digestion of lactose. Yogurt fermentation produced growth benefit as compared to the milk from which it was made by reducing the lactose content and by supplying microbial lactase activity. PMID- 6841747 TI - Contribution of Streptococcus thermophilus to growth-stimulating effect of yogurt on rats. AB - The origin of the growth-stimulating factor in yogurt was studied in rats fed liquid or freeze-dried diets of milk, yogurt, milks fermented individually by Streptococcus thermophilus and Lactobacillus bulgaricus, milks to which cells of Streptococcus thermophilus and Lactobacillus bulgaricus were added. Diets containing sonicated cells, cell supernatant, and cell fractions also were fed. Milk fermented by Streptococcus thermophilus and milk plus Streptococcus thermophilus cells stimulated growth as effectively as did yogurt. That finding and the absence of stimulation in rats fed Lactobacillus bulgaricus showed that Streptococcus thermophilus is responsible for stimulation of growth by yogurt. Growth was stimulated by an intracellular factor and not by fermentative changes in the milk. PMID- 6841748 TI - Influence of dietary energy and protein on yield and composition of milk from cows fed methionine hydroxy analog. AB - In three trials in consecutive years, 45, 59, and 63 lactating Holstein cows were fed grain mixtures containing either 0 or .25% methionine hydroxy analog with or without protein supplement. In Trial 1, diets were approximately 40% concentrate, and dietary protein averaged 13.2 and 15.8% (dry). Ration dry matter consisted of either 40 or 60% concentrate, and dietary protein averaged 13.5 or 17.3% in Trial 2 whereas concentrate was maintained at 60% of dry matter in Trial 3 with dietary protein at either 13.0, 15.0, or 17.5%. In Trial 1, milk yield or composition did not differ with methionine analog or protein supplementation. Protein supplementation increased milk yield on the 60% concentrate diets in Trial 2, and methionine analog increased milk fat percentage on the 60% concentrate diets. Cows fed 17.5% crude protein in Trial 3 produced more milk than those fed the two lower protein diets. Methionine analog increased milk fat percentage, and this increase was consistent at each percentage of dietary protein. Data from 179 lactations were combined and analyzed for response milk yield and composition to methionine analog included at either 0 or .25 to .30% of grain mixtures in 60% concentrate diets. Cows fed methionine analog produced milk higher in fat content and yielded more total fat and fat-corrected milk than controls. PMID- 6841749 TI - Performance of dairy cows in midlactation fed high quality grass pasture and concentrate at three percents of energy requirements. AB - Thirty multiparous cows rotationally grazed high quality grass pastures (predominantly Dactylis glomerata and Poa pratensis) for 140 days. Stage of lactation was 54 to 192 days at beginning of trial. Cows were offered concentrates to supply 33, 66, or 100% of requirements for net energy for lactation above maintenance; daily intakes by the three groups averaged 3.5, 7.7, and 11.5 kg. Refusal of concentrate tended to increase with supplementation. Average milk production was 19.2, 20.4, and 21.5 kg. When individual yields were compared with an initial 2-wk period prior to trial, there was no difference in decline in milk flow, except for one 28-day period in midsummer when decline by the 33% group was greater than that by the 100% group. Milk fat yields were similar. Milk protein yields by the 100% group were significantly higher than those by the 33% group. Body weight changes were similar among groups. Quality of forage was high, and yields were adequate. Changes in milk flow attributable to movement of cows to fresh pastures were +1.35 kg per cow daily. Variations in in vitro dry matter disappearance, crude protein, and dry matter of forage were positively associated with changes in milk flow. PMID- 6841750 TI - Intestinal absorption of fatty acids, and blood lipid composition in sheep. AB - Interrelationships between intestinal uptake of fatty acids and their concentrations in lipids of blood plasma of sheep were assessed by quantities of individual fatty acids that flowed through and were absorbed from the intestinal tract under different dietary conditions. Major long-chain fatty acids were approximately 90% digested, thus demonstrating that dietary fatty acids of high melting points can be absorbed efficiently by ruminants provided they are well dispersed. Relationships were linear between uptakes of 16:0, 18:0, 18:1, and 18:2 fatty acids from the gut and their concentrations in both triglycerides and triglyceride-free plasma lipids. The proportion of each transferred to triglyceride-free plasma lipids was in order 18: 2 greater than 18:1 greater than 16:0 greater than 18:0, whereas in plasma triglycerides the order was 16:0 = 18:0 = 18:2 less than 18:1. Interconversion of 18:0 to 18:1 by intestinal mucosa may explain the anomalous behavior of 18:1 triglycerides. These results are consistent with the hypothesis that the intrinsic nature of the fatty acid primarily determines the composition of triglyceride-free plasma lipids whereas the relative amount of each acid absorbed by the intestine determines that of plasma triglycerides and, hence, of milk and depot fats of ruminants. PMID- 6841751 TI - Effect of dietary fat supplement on lipid metabolism of Holstein Heifers. AB - Twenty Holstein heifers were fed four rations containing 0, 10, 20, and 30% whole sunflower seed as a source of dietary fat. All rations consisted of alfalfa hay, sunflower hulls, and grain mixtures and were isonitrogenous at 12% crude protein and isocaloric at 2.6 Mcal metabolizable energy per kilogram dry matter. Average body weight gains were not different among treatment groups. Heifers fed sunflower seed (fat) diets consumed less total dry matter, significantly improving growth efficiency (gain/feed). Concentration of total lipid and urea nitrogen in blood serum were increased whereas glucose was depressed with higher amounts of dietary fat. High fat diets (20 and 30%) elevated total lipid, triglyceride, and nonesterified fatty acids in the blood. Total and free cholesterol in blood also were increased, but high density lipoprotein cholesterol remained unchanged with increasing concentration of dietary fat. Dietary fat was correlated positively with lipid components of blood serum and negatively with glucose. PMID- 6841752 TI - Lactation stage, parity, and infection affecting somatic cells, electrical conductivity, and serum albumin in milk. AB - Effects of stage of lactation and parity on cell concentration, electrical conductivity, and serum albumin concentration of milk from quarters of known infection status were examined. For quarters free from infection, somatic cell concentration rose from 80 to 160 x 10(3) cells/ml between 35 and infected with Staphylococcus aureus the increase was from 250 to about 1000 x 10(3) cells/ml. As lactation number advanced, there was little change in cell concentration for quarters free from infection, whereas for quarters infected with Staphylococcus aureus, cell concentration rose from approximately 450 x 10(3) cells/ml for first lactation to about 1500 x 10(3) cells/ml for cows in their sixth or more lactations. Trends in electrical conductivity were similar to those for cell concentration, with the main influence on electrical conductivity being Staphylococcus aureus infection. For serum albumin concentration only the effect os stage of lactation was significant. Concentration of serum albumin rose from 150 mg/liter at the beginning of lactation to 280 mg/liter at 215 days postpartum. Effects of stage and number of lactation were minor compared with effects of infection by Staphylococcus aureus. PMID- 6841753 TI - Somatic cell count, electrical conductivity, and serum albumin concentration for detecting bovine mastitis. AB - Cell concentration, electrical conductivity, and serum albumin concentration of milk were evaluated for predicting infection status of quarters in three herds. Probability of misclassifying quarters was lowest for cell concentration. For discriminating quarters infected with Staphylococcus aureus from quarters free from infection, probability of misclassification for cell concentration ranged from 8 to 20% among herds. For electrical conductivity probability of misclassification ranged between 22 and 32%, whereas for serum albumin the range among herds was from 15 to 48%. Among herds there was also considerable variation of the trait, which minimized the probability of misclassification. Cell concentrations for the three herds were 158, 200, and 251 x 10(3) cells/ml whereas for electrical conductivity counts were 4.6, 5.8, and 6.5 mS/cm. For electrical conductivity and serum albumin comparisons within cow by differences and ratios from different quarters yielded little advantage over absolute estimations. For a single sampling, cell concentration provided the most accurate prediction of quarter infection status. We suggest that 200 x 10(3) cells/ml should be the threshold above which quarters are considered likely to be infected with a major pathogen. PMID- 6841754 TI - Factors affecting performance of Nili-Ravi buffaloes in Pakistan. AB - Effects of herd, year, age, season, and lactation length on milk yield and reproductive efficiency for the Nili-Ravi breed of buffalo were determined by analysis of variance of 5,716 lactation records from two herds in Pakistan. Herds differed in all traits. Herd average milk yields were 1,702 and 2,064 kg. Year, season, herd, parity number, days in milk, days open, age, and sire all influenced milk yield. Herd, year, season, and parity number also had significant effects on days open and calving interval. Month of calving was important for time until return to estrus. Percentages of variance in milk yield attributed to herd, year, sire, cow, and residual were 20.3, 11.4, 4.3, 17.0, and 47.0. Classification of lactation length (greater than 60, greater than 250, or at least 305 days) markedly influenced the sire component of variance suggesting some interdependence of milk yield and lactation length. Total variance for milk yield was 466,911 kg2. Within herd heritability for milk yield was .25, and repeatability was low (.31). Predicted breeding values for sires for 250 to 305 day milk ranged from -172 kg to +260. Cows in Herd 1 completed 5.58 lactations with an average herd life of 12.3 yr; Herd 2 cows completed 4.52 lactations with culling at 10.6 yr. Frequency of termination of lactations because of mastitis, reproductive problems, or health was similar to frequencies for cattle. Factors affecting milk yield in buffaloes are similar to those of cattle. PMID- 6841755 TI - Associations among progeny tests of single or pooled lactations. AB - Genetic correlations between Predicted Difference for first and second, first and third, and second and third lactations milk were .82, .62, and .94 and for Predicted Difference percent fat .94 for the three associations. Regression coefficients for following on previous lactation Predicted Difference were less than unity; thus, Predicted Difference from first lactation might be overweighted when age adjusted and pooled with second and third lactations. Regressions of Predicted Difference milk of sons on sires for first, second, third, and pooled lactation records were .32 +/- 18, .42 +/- .21, .56 +/- .31, .35 +/- .15, and intraclass correlations between half brothers were .09 +/- .08, .28 +/- .11, .25 +/- .11, and .12 +/- 10. Predicted Differences for second and third lactations were, thus, near the theoretical expectation of .5 and .25 for regressions of son on sire and between half-brother correlations but lower for Predicted Differences of first and pooled lactations. Variance of Predicted Difference of first lactation between sires of sons was small compared with the variance of sons within sires. It was postulated that effective selection on the sire-to-sire path on Predicted Difference of first lactation had reduced predictability on the sire to-sire improvement path. An interaction of sire by number of lactations may be inferred from the incomplete genetic correlations between Predicted Differences of first and following lactations and from the reduction in the variance between sire in first but not in later lactations. Progeny tests of single lactation seem warranted for the production profile of dairy sires. PMID- 6841756 TI - Effects of adjustment for mate's yield, mate's sire's merit, and days open in sire evaluation. AB - First lactations were from the North Carolina Institutional Breeding project sine 1955 for cows and their dams where Modified Contemporary Comparisons were available for sires of both females. Each sire of cows was required to have a minimum of 20 progeny in the data. A total of 1771 cow-dam pairs by 33 sires in 7 herds and 217 herd-year-seasons passed all edits. Models including combinations of Predicted Difference milk for sire and maternal grandsire, dam's milk yield deviated from herd-year-season mean, and dam's age at cow's birth were used to predict cow's milk yield deviated from herd-year-season mean. Adjustment of yields of cow and dam for days open also was examined. Predicted Difference milk of her sire was the most important variable for predicting cow's yield; next was dam's yield. Predicted Difference of maternal grandsire and dam's age at cow's birth were not significant. Adjustment for days open reduced the percent of variation of cow's yield explained by sire's Predicted Difference. Sire's contributions to yield also were obtained by least squares and mixed model procedures in the various models with Predicted Difference milk of sire omitted. Maximum change in ranks among the 33 sires was four places, and maximum change of differences among sires was 129 kg when mate's yield and mate's sire's Predicted Difference were included in the model. Dam's yield was more useful than maternal grandsire's merit in predicting cow's yield. Differences among sires changed as much as 185 kg when cow's yield was adjusted for days open. PMID- 6841757 TI - Relationships among type of parturition, type of discharge from genital tract, involution of cervix, and subsequent reproductive performance in Holstein cows. AB - Data were from 492 Holstein cows calved between October, 1976, and May, 1977, in eight herds in Michigan. Diameter of the cervix of each cow was estimated by palpation at 8 to 21 days postpartum and again 2 wk later. Parturition and postpartum discharge from the genital tract were classified as normal or abnormal. Size of the cervix between 12 and 26 days postpartum was classified as small, medium, or large within two parity groups. Incidence of abnormal parturition and incidence of abnormal postpartum discharge were 14.1 and 38.0%. Involution of the cervix was affected by parity and type of postpartum discharge. Involution of the cervix occurred sooner postpartum in primiparous than in multiparous cows and sooner postpartum in cows with normal discharge than in cows with abnormal discharge. The greatest difference in cervix diameter between cows with normal or abnormal discharges was 10 mm at 3 wk postpartum. Days from parturition to first detected estrus and first service were extended by abnormal postpartum discharge but not by abnormal parturition. First-service conception rate was lower and days from parturition to conception were higher in cows with medium or large cervices compared to cows with small cervices. Type of postpartum discharge and size of cervix early postpartum may be useful for predicting subsequent reproductive performance in dairy cows. PMID- 6841758 TI - Determination of added water and bovine milk to caprine milk. AB - Increased production of commercial goat milk in Ontario stimulated an investigation to determine a base freezing point for goat milk for quantifying added water. A method also was developed for detection and estimation of degree of adulteration of goat milk with bovine milk. The mean freezing point based on 228 fresh herd samples of goat milk taken over 1 yr was -.5527 degrees C (-.5719 degrees H). This mean was used to generate an added water table. A simple and direct polyacrylamide disc gel electrophoretic method was devised to determine semi-quantitatively bovine milk adulteration down to 5%. Both of these methods are currently in use for routine monitoring of goat milk adulteration in the province of Ontario. PMID- 6841759 TI - Pituitary and thyroid hormone responses of heifers after ferulic acid administration. AB - I evaluated effects of ferulic acid on concentrations of endocrine hormones of eight Holstein heifers. Cattle were fitted with indwelling jugular cannulae 24 h before experimentation. After control blood samples were taken, animals were assigned randomly to groups of four and infused with 100 or 500 mg of ferulic acid. Prolactin, growth hormone, luteinizing hormone, and thyroid hormones were measured in sera from blood samples. Blood sampling or ethanol infusion did not affect serum concentrations of prolactin. Serum prolactin was elevated 5 min after infusion of ferulic acid. Peak serum prolactin concentrations were 15 min after 100 mg of ferulic acid and between 10 and 30 min after 500 mg ferulic acid. Prolactin remained high until 120 min post drug administration. Control bleeding and ethanol administration did not alter serum growth hormone concentrations. Serum growth hormone concentrations were elevated slightly by ferulic acid. The increase was 5 min after drug administration. Baseline concentrations were established 60 to 90 min after administration. Ferulic acid did not affect luteinizing hormone or thyroid hormones. Ferulic acid, a constituent of corn and wheat germ, may affect release of pituitary hormones in cattle. PMID- 6841760 TI - Comparison of dams' estimated transmitting abilities from first lactation herdmates or all records of herdmates to predict sons' milk evaluations. AB - Multiple regression of genetic evaluations for milk yields of first lactations of 159 Holstein bulls on sire, dam, and maternal grandsire evaluations indicates that the weight for estimated transmitting ability of the dam calculated from the first record of the dam and first records of her herdmates is about as theoretically expected and is markedly superior both to estimated transmitting ability computed from the first record of the dam and all records of her herdmates and to estimated transmitting ability computed from all records of the dam and her herdmates. The latter two procedures gave similar results. PMID- 6841761 TI - Vital statistics and reasons for disposal of United States and Canadian artificial insemination dairy sires. AB - Vital statistics were evaluated for artificial insemination sires leaving service during 1939 through 1974. Data consisted of 11,704 sires of six breeds. The major cause for leaving service was reproductive failure at a frequency of 32.5%; next ranked was undesirable characteristics of offspring with a frequency of 20.7%. Overall culling rate for low yields of daughters was 14.8%, but after 1965 this cause accounted for about 30%. Mean life span was 3.4 yr with small differences among years. Breed differences were detected for service life and causes for leaving service. Modifications of classic life table techniques are needed to reflect entry of sires into service at various ages and evaluation of vital statistics subsequent to 1974. PMID- 6841762 TI - Experimental and clinical treatments of writing blocks. PMID- 6841763 TI - Modifying the Type A coronary-prone behavior pattern. PMID- 6841764 TI - Measuring masculine gender identity in females. PMID- 6841765 TI - Magical ideation as an indicator of schizotypy. PMID- 6841766 TI - Behavioral weight-loss intervention at the worksite: feasibility and maintenance. PMID- 6841767 TI - Does switching to low tar/nicotine/carbon monoxide-yield cigarettes decrease alveolar carbon monoxide measures? A randomized controlled trial. PMID- 6841768 TI - Monetary contracts in weight control: effectiveness of group and individual contracts of varying size. PMID- 6841769 TI - Alcohol-related expectancies versus demographic/background variables in the prediction of adolescent drinking. PMID- 6841770 TI - Effectiveness of cotherapists versus single therapists and immediate versus delayed treatment in behavioral marital therapy. PMID- 6841771 TI - Does the computer make a difference? Computerized versus face-to-face versus self report assessment of alcohol, drug, and tobacco use. PMID- 6841772 TI - Reasons for staying alive when you are thinking of killing yourself: the reasons for living inventory. PMID- 6841773 TI - Success and failure in the behavioral treatment of obsessive-compulsives. PMID- 6841774 TI - Factor analysis of the WAIS-R at nine age levels between 16 and 74 years. PMID- 6841775 TI - Predicting outcome in parent training. PMID- 6841776 TI - Behavioral and physiological effects of low-nicotine cigarettes during rapid smoking. PMID- 6841777 TI - Cognitive and behavioral characteristics of physically abused children. PMID- 6841778 TI - Comparison of the Wechsler Adult Intelligence Scale and the Wechsler Adult Intelligence Scale-Revised. PMID- 6841780 TI - WISC-R discrimination of learning-disabled and emotionally disturbed children: an intragroup and intergroup analysis. PMID- 6841779 TI - Hamilton Rating Scale for Depression: reliability and validity of judgments of novice raters. PMID- 6841781 TI - A note on "premorbid competence in schizophrenia: what is being measured"? PMID- 6841782 TI - Five-year follow-up to a behavioral weight-loss program. PMID- 6841783 TI - Monitoring respirations for outpatient surgery. PMID- 6841784 TI - Chemosurgical reports: lateral rhinotomy in the treatment of nasal mucous membrane carcinomas. PMID- 6841785 TI - A supplemental technique for the use of injectable collagen. PMID- 6841786 TI - Cryosurgery for cutaneous leishmaniasis. PMID- 6841788 TI - Keratoacanthoma following pneumococcal vaccination: a case report. AB - A woman with chronic pulmonary disease was immunized with polyvalent pneumococcal polysaccharide vaccine. She developed a keratoacanthoma at the injection site. Such an occurrence would seem to be a rare complication of pneumococcal vaccination. PMID- 6841787 TI - Malignant melanoma prognostic factors 1: use of photography. PMID- 6841789 TI - The square-to-Z flap. PMID- 6841790 TI - Concomitant mini reductions in punch hair transplanting. PMID- 6841791 TI - Histologic evaluation of horizontal frozen sections: microanatomy of the eyelid. AB - The histologic appearance of tissues may be altered in horizontal frozen sections. In areas of specialized structures such as the eyelid, this can create confusion. The microanatomy of the eyelid in vertical paraffin sections and in horizontal frozen sections is presented. PMID- 6841793 TI - Time of day noise adjustments or "penalties". PMID- 6841792 TI - Combination of topical 5-fluorouracil with cryotherapy for treatment of actinic keratoses. PMID- 6841794 TI - Relative hazard of weapons impulses. AB - Arguments in favor of a theoretically based damage-risk criterion (DRC) for intense noise [G.R. Price, J. Acoust. Soc. Am. 69, 171-177 (1981); 66, 456-465 (1979); J. Acoust. Soc. Am. Suppl. 1 62, S95 (1977)] are further developed here to make a crucial prediction. Based on measured spectral differences, it was predicted that rifle impulses would cause permanent threshold shifts at approximately 9 dB lower peak pressures than cannon impulses. In contrast, DRCs in use in the world predict that the cannon would be more hazardous than the rifle by 7 to 10 dB. Electrophysiological measures of sensitivity were used in 38 cats (76 ears) which were exposed to 60 impulses, approximately 3 s apart, at various peak pressures, from either a rifle or a 105-mm Howitzer. Hearing changes were followed until recovery was complete (2 months). Permanent threshold shifts began at about 140 dB for rifle impulses and 150-155 dB for cannon impulses, confirming the prediction and supporting the contention that there is a spectrally dependent critical level for the ear at high intensities. Implications for present DRCs and future risk assessment schemes are discussed. PMID- 6841795 TI - No sharpening? a challenge for cochlear mechanics. AB - Recent data on mechanical movements of the basilar membrane (BM) suggest that the part played in cochlear physiology by a sharpening mechanism is much less important than hitherto has been thought. In an extreme view, one could dispense with a sharpening mechanism completely and assume that (near the threshold) hair cell excitation is proportional to BM velocity, or a very simple linear transform of it. In the present paper the consequences of this idea are worked out. A theoretical cochlear movement pattern is constructed that shows the same frequency selectivity as an average reverse-correlation function of an auditory nerve fiber. This response is called a revcor-spectrumlike response. Cochlear mechanics is then simplified to a pure shortwave model. It is shown that, if the cochlea model should present a revcor-spectrumlike response, this can only be achieved when the resistance component of the BM impedance is negative over a part of the length of the cochlea. This result is refined in several respects, and it is shown that a model equipped with the right kind of BM impedance function can have a response of the required type. It remains difficult to conceive of a physiological mechanism that would cause the desired effect on the BM impedance. PMID- 6841796 TI - On active and passive cochlear models--toward a generalized analysis. AB - Simple cochlear models can show a peak in their response but only of a limited magnitude. The constraints limiting the size of this peak are studied in this note, for the short-wave as well as the long-wave case. It is found that a sharply rising response is impossible in a model in which the basilar membrane can only absorb acoustical energy. To attain a model response that is comparable to the response found in the most recent experiments, the basilar membrane must be assumed to be capable of adding acoustic energy to the fluid waves. PMID- 6841797 TI - Power amplification in an active model of the cochlea--short-wave case. AB - To account for the most recent experimental results on cochlear mechanics, a mathematical model should include an active source of vibrational energy. In this note the energy gain of such a model is computed, for the case that only short waves are supported. It is shown how, via a so-called criterion function, the required energy gain can be found from the basilar-membrane velocity response. PMID- 6841798 TI - Relation between discharges in auditory nerve fibers and the whole-nerve response shown by forward masking: an empirical model for the AP. AB - Whole-nerve action potentials evoked by a standard click were recorded from a gross electrode on the RW and the discharges of auditory nerve fibers to the same standard click were recorded from micropipette electrodes in the auditory nerve. The effect of a preceding tone burst (2, 4, or 8 kHz) upon the responses was measured for forward-masker intensities from 20 to 80 dB SPL. All forward maskers reduced the discharges of auditory nerve fibers to the standard click with the greatest reduction occurring for fibers with characteristic frequencies (CFs) near the masker frequency. The 4- and 8-kHz forward maskers produced similar effects on N1, P1, and N2 of the RW response. However, the 2-kHz forward masker produced enhancement at P1 and N2 in the RW response to the standard click. An empirical summation model of estimated elemental waveforms at latencies dependent on CF produces synthesized AP response waveforms which are similar to the observed RW response. The model permits the exclusion of discharges from segments along the cochlear partition in a manner similar to the effect of a forward masker. Alterations in the synthesized waveforms due to the exclusion of segments are similar in direction to the alterations observed in the RW responses for forward masking. PMID- 6841799 TI - Cochlear microphonic responses to acoustic clicks in guinea pig and their relation with microphonic responses to pure tones. AB - Cochlear microphonic (CM) responses to acoustic transient stimuli were studied at the three more basal turns of the cochlea in the guinea pig. The responses to rarefaction and condensation pressure pulses of less than 100-mus duration were recorded using the differential electrode technique. In some animals the CM response to pure tones was recorded at the same position at which the transient response was obtained. The transient responses recorded at the three turns of the cochlea displayed a damped oscillation at a frequency consistent with the values of cutoff frequency already known for the electrode positions. Some of the responses were significantly less damped than click responses previously reported. There was a good correlation between the cutoff frequency in the frequency response curve and the frequency of oscillation in the transient response for recordings obtained at the same position in the cochlea. A nonlinear effect was observed for changes in stimulus intensity. There was a less than proportional decrease in amplitude of the initial part of the damped oscillation for a decrease of the stimulus intensity, while the late part of the response behaved almost linearly. This nonlinearity observed in the CM transient response could not be explained by a nonlinear characteristic of the sort reported in the basilar membrane of the squirrel monkey by Robles et al. [J. Acoust. Soc. Am. 59, 926-939 (1976)]; rather it seems to be a saturation nonlinearity similar to the one known for sinusoidal stimulation. PMID- 6841800 TI - Responses of auditory-nerve fibers to consonant-vowel syllables. AB - The discharge patterns elicited by a set of synthesized consonant-vowel (CV) syllables were studied in the auditory nerve of the cat. The syllables, heard as /ba/, /da/, or /ga/, included a 25-, 50-, or 75-ms formant transition followed by a segment of steady-state vowel. The data were analyzed in terms of average discharge rate and in terms of the synchrony of discharges with respect to various spectral components of the stimuli. The results differ slightly from those of previous reports of the responses to vowels [Sachs and Young, J. Acoust. Soc. Am. 66, 470-479 (1979); Young and Sachs, J. Acoust. Soc. Am. 66, 1381-1403 (1979)], in that average discharge rates appear to provide more information about the spectra of formant transitions than they do about the spectra of steady-state vowels. This difference reflects changes in the spectrum of the syllable produced by movements of the formants. The synchrony of discharges, however, may provide more detailed information about the spectra of CVs than does average discharge rate. Each fiber's response at a particular peristimulus time may be characterized by the "dominant response component," the largest peak in the Fourier transform of the period histogram. The trajectories of the first three formants can be inferred from changes in the "dominant components" in a sample of fibers. PMID- 6841801 TI - Acoustically derived auditory nerve action potential evoked by electrical stimulation: an estimation of the waveform of single unit contribution. AB - An experimental study of the electrical stimulation of the guinea pig cochlea is made using an electrode on the round window for both stimulation and recording. The neural response is separated from the electrical artifact with a masking procedure combined with a low amplification, "statistical" averaging method [Charlet de Sauvage et al., Hear. Res. 2, 343-346 (1980)]. The high electrical impedance required for recording physiological responses implies the use of a current pulse generator. Monitoring of evoked potentials from the auditory cortex provides evidence that the effects of electrical stimulation (and of masking noise) are of auditory origin. The electrically evoked round window response is of very short latency (less than 0.2 ms). There is a response threshold for both electrical stimulus and masking noise. The response amplitude varies monotonically as a function of masking noise or electrical stimulus intensity. Experiments with high-pass noise masking suggest that the electrical stimulus is mainly acting on basal fibers. The response latency and waveform are independent of electrical stimulus intensity, repetition rate, masker level, or spectrum. Little intersubject variation is noted. Our experiments (reciprocal forward masking by electrical and acoustic stimuli) suggest that a direct, instantaneous electrical stimulation of the fibers occurs. We believe that this response to electrical stimulation represents the mean unit response of the auditory nerve fibers. This approach may be useful in the separate study of cochlear and VIIIth nerve functions and in the analysis (deconvolution) of the acoustically evoked compound AP. PMID- 6841802 TI - Effective masking bandwidths at low frequencies. AB - Masking of low-frequency sinusoids of varying durations by Gaussian noise of varying spectral shape was measured in three different studies. Common solutions to technical problems associated with control and specification of low-frequency signals were used in the three studies. If interpreted in terms of Fletcher's critical ratio assumptions, data from the first study lead to the inference that the masking bandwidth is inversely related to signal frequency below about 200 Hz. Data from the second study rule out the likelihood that the apparent increase in masking bandwidth is attributable to changes in auditory integration times at low frequencies. The data of the third study suggest that the apparent increase in auditory filter bandwidth at low frequencies is more adequately explained by a decrease in observers' detection efficiency than by broadening of the filter bandpass. PMID- 6841803 TI - Successive versus simultaneous comparison in auditory intensity discrimination. AB - The ability to discriminate between two brief sounds having identical frequency components, but differing in the intensity of one or more of the components, is studied. The stimulus manipulations include randomizing the overall intensity of the sounds, varying the number and spacing of the components, and varying the interval of time between the sounds. The results from the experiment in which interstimulus interval is manipulated clearly support a profile analysis mechanism that computes two rough spectral analyses, stores a classification of these spectra in memory, and compares the two stores. This profile mechanism involves a simultaneous comparison of different components of the complex, some remote from the signal frequency, rather than a successive comparison of the difference in intensity at the signal frequency. The simultaneous comparison process is more sensitive when the profile is composed of many components spaced over a wide frequency range. PMID- 6841804 TI - Detection of interaural differences of time in trains of high-frequency clicks as a function of interclick interval and number. AB - Listeners were asked to detect interaural differences of time in trains of 4000 Hz clicks as the interclick interval (ICI) was varied from 10 to 1 ms and the number of clicks in a train (n) was varied from 1 to 32. Plots of log interaural threshold versus log n produce straight lines whose absolute slopes decrease toward 0.0 with decreasing ICI. These results are shown to fit a saturation model which argues that as the click rate increases, the evoked neural activity moves from a response that is tonic toward one which is more phasic. The need to postulate neural compression is based in part on the fact that the three most commonly cited models of the limitations imposed by high frequency--reduction in the depth of modulations due to narrow-band filtering within the auditory system, neural refractoriness, and nonindependence of successive samples of internal noise--do not predict a change in slope with rate. PMID- 6841805 TI - Relations between auditory functions in impaired hearing. AB - Relations between auditory functions, as expressed by coefficients of correlation, were studied for a group of 22 sensorineurally hearing-impaired subjects with moderate losses. In addition to the audiogram, we measured frequency resolution, temporal resolution, and speech reception in quiet and in noise. Frequency resolution was derived from masking with comb-filtered noise and from the psychophysical tuning curve, for both paradigms in simultaneous and in nonsimultaneous masking. The critical ratio was also determined. Temporal resolution was determined with intensity-modulated noise and from backward and forward masking. All tests were performed at 1000 Hz. Correlations among tests were gathered in a matrix and subjected to a principal-components analysis. It turned out that tests on frequency resolution form a cluster, and are approximately independent of audiometric loss. Furthermore, hearing loss for speech in noise is closely allied to frequency resolution, whereas hearing loss for speech in quiet is governed by audiometric loss. PMID- 6841806 TI - A procedure for detecting variability of psychophysical thresholds. AB - In adaptive psychophysical testing, it is desirable to identify experimental runs during which the subject's threshold changes. This is not easy to do, because the testing level changes during the course of the run. The following screening procedure can assist in detecting threshold variability. At the conclusion of the run, determine for each trial the discrepancy between observed and expected response. Next, determine the linear regression of this discrepancy upon trial number. If the subject's response behavior is stable and well described by the psychometric function, then the expected value of slope of the linear regression is equal to zero. If the observed slope differs greatly from zero, then it is unlikely that the subject's response behavior is stable. Results from computer simulations and psychophysical experiments are presented. PMID- 6841807 TI - Pressure-flow relationships in two models of the larynx having rectangular glottal shapes. AB - The pressure-flow equations used in computer simulation studies of phonation lack experimental validation. Two polyester resin models of the laryngeal airway with rectangular glottal ducts were constructed in order to obtain the relationships between translaryngeal pressure drop and volume flow through the airway. The results are in disagreement with the early estimates of Wegel [Bell Syst. Tech. J. 9, 207-227 (1930)], but match the predictions given by Ishizaka and Matsudaira [SCRL Monograph No. 8 (1972)] to within approximately +/- 10% for typical translaryngeal pressures for speech, with larger discrepancies being found for the model with the larger glottal diameter. The equation given by van den Berg et al. [J. Acoust. Soc. Am. 29, 626-631 (1957)] may not be properly compared because their supraglottal pressure hole location may have been different from that used in the present study. The data from the two models also are compared to recent empirical studies using an enlarged model of the larynx [J. Gauffin et al., Conference on Vocal Fold Physiology, Madison (1981)]. PMID- 6841808 TI - Pitch shifts contingent on the modulation frequency of an adaptation tone. AB - Following adaptation to a frequency-modulated tone, the perceived pitch of a similarly modulated tone of slightly higher frequency is shifted upwards, while that of a tone of lower frequency is shifted downwards. These shifts are greatly reduced or absent when the adaptation and test tones are frequency modulated at different rates. PMID- 6841809 TI - Onset spectra and formant transitions in the adult's and child's perception of place of articulation in stop consonants. AB - Stevens and Blumstein [Perspectives on the Study of Speech (Erlbaum, Hillsdale, NJ, 1981)] have proposed that the global shape of the CV syllable onset spectrum provides the listener with a primary and contextually invariant cue for place of stop consonant articulation. Contextually variable formant transitions are, in contrast, claimed to constitute secondary cues to place of articulation that, during development, are learned through their co-occurrence with the primary spectral ones. In the two experiments reported here, these claims about the relative importance of the onset spectrum and formant transition information were assessed by obtaining adults' and young children's identifications of synthetic stimuli in which these two potential cues specified different places of articulation. In general, the responses of both adults and children appeared to be determined by the formant transitions of the stimuli. These results provide little support for the claim that sensitivity to the global properties of the onset spectrum (as described by Stevens and Blumstein) underlie place of articulation perception or for Stevens and Blumstein's primary versus secondary cue distinction. Rather, these findings are consistent with the view that dynamic, time-varying information is important in the perception of place of articulation. PMID- 6841810 TI - Description of regular twelve-tone musical tunings. AB - A framework is presented for the systematic description of musical tunings, based on the music-theoretical and on the frequency-ratio concept of musical intervals. All intervals are described as sums of octaves and fifths. Since the octave is always pure (2:1) knowledge of the sizes of the fifths is sufficient to determine the sizes of other intervals. In regular 12-tone tunings, 11 out of the 12 fifths are equal in size, either pure or tempered. Rules are given by which the size of the consonant intervals, and other intervals, can be derived from a single variable, the main fifth. Tunings are evaluated with the help of mean temperings of the consonant intervals in the major triads, mean temperings of all the triads in a tuning, and mean temperings of triads weighted with respect to a certain key. This is a theoretical study, which should be supplemented by observations from practice and perceptual experiments. PMID- 6841811 TI - Discrete lung sounds: crackles (rales) as stress-relaxation quadrupoles. AB - We modeled discrete emission of sound from lung parenchyma as a point source in an ideal medium. The point source, a quadrupole, represents the stress anomaly in lung parenchyma in the neighborhood of a collapsed airway, and its time course when the airway opens. The dynamics of the airway opening event are characterized by a single time constant. The ideal medium, lung parenchyma, was modeled as a homogeneous linearly elastic lossless nondispersive continuum of infinite extent undergoing infinitesimal strains. Despite its simplicity, this elementary model leads to predictions of crackle waveforms, spectral densities, and spatial intensity distributions which are consistent with observations. In particular, the model predicts changes of waveform shape and polarity with observation position relative to the source, dramatic influences of transduction processes, and successive increases in zero crossing time intervals. PMID- 6841812 TI - Effects of frequency-modulated auditory tones on the voice fundamental frequency in humans. AB - The sensitivity of audio-laryngeal reflex pathways to sinusoidal changes in the fundamental frequency of complex auditory tones (AF0) was assessed indirectly in three young adult human subjects. The subjects sustained phonation at constant voice fundamental frequency (VF0) and voice intensity while listening to a sawtooth tone whose AF0 varied over time in a sinusoidal fashion (rates = 5-13 Hz). The subjects phonated at a low voice intensity so that the intensity of the auditory tone (80-85 dB SL) completely masked their voice. Using computer signal averaging and Fourier analysis techniques it was found that the sinusoidally modulated AF0 induced similar modulations in the VF0 signal. The VF0 modulations were extremely small in amplitude and showed large phase shifts relative to the auditory input. These findings are discussed in relation to the role of auditory feedback in phonatory control. PMID- 6841813 TI - Sleep disturbance before and after traffic noise attenuation in an apartment building. AB - A study on traffic noise sleep disturbance was made in an apartment building before and after the installation of noise insulating windows. Three tenants completed a questionnaire each morning one week before and one week after the insulation of windows, and body movements during sleep were recorded during these periods. All persons demonstrated a decrease in the number of body movements after the windows had been insulated and two reported improved sleep quality. The results suggest that subjectively judged sleep quality as well as recordings of bed movements are useful tools for evaluating actions to reduce noise. PMID- 6841814 TI - Do off-frequency simultaneous maskers suppress the signal? AB - Psychophysical tuning curves obtained in forward masking show greater tuning than those obtained in simultaneous masking. This difference is often attributed to the contribution of suppression to the masking produced by off-frequency simultaneous maskers. In this experiment, simultaneous-masking tuning curves were obtained using a 195-ms, 1-kHz sinusoidal signal presented at 40 dB SPL. If the maskers identified in this procedure reduce signal detectability by suppressing the response to the signal, then it should be possible to demonstrate suppression effects between stimuli with the parameters of the masker and signal. One conventional method for demonstrating suppression is to show a reduction in the amount of forward masking produced by one stimulus when a second stimulus is added to it. When used to test the effect of the masker upon the signal, this procedure does not show the suppression supposedly produced by the off-frequency maskers. These data are consistent with an alternative explanation involving only excitatory interactions between masker and signal. PMID- 6841815 TI - Monaural and binaural auditory frequency resolution measured using bandlimited noise and notched-noise masking. AB - Several studies using bandlimited masking noise have indicated that NOSO frequency resolution is better than that for NOS pi. The present study examined NOSO and NOS pi frequency resolution with two different masking methods: bandlimited noise and notched noise. Noise spectrum levels of 10, 30, and 50 dB/Hz were used. Thresholds were determined for a 500-Hz signal, using a three alternative forced-choice adaptive procedure, as a function of masker bandwidth and notchwidth. For NOSO presentation, 3-dB down points were comparable for the notched-noise and bandlimiting methods. For NOS pi presentation, 3-dB down points were generally greater for the bandlimiting method than the notched noise method. Furthermore, for NOS pi presentation, the 3-dB down estimate increased as noise level increased for the bandlimiting method, but stayed constant for the notched noise method. It is suggested that the two masking methods measured different aspects of binaural processing. PMID- 6841816 TI - Simultaneous masking and unmasking with bandlimited noise. AB - This study examines how simultaneous masking of a tone by bandlimited noise may be affected by nonlinear interactions among spectral components of the noise. Simultaneous masking patterns (signal threshold versus signal frequency) were obtained with three types of maskers: (A) a narrow-band noise, 50 Hz wide with variable center frequency fv, (B) pairs of narrow-band noises, each band 50 Hz wide with center frequencies fl and fu, and (C) wide-band noise formed by filling the spectral gap between the two bands of (B). The variable frequency fv was set to 1.0, 1.1, 1.2, and 1.3 kHz: fl was fixed at 1.0 kHz, and fu had values of 1.1, 1.2, and 1.3 kHz. In most conditions, the two-band maskers and the wideband maskers produced more masking than would be predicted from the masking produced by the single narrow-band maskers. For certain signal frequencies below the maskers, adding noise to fill the spectral gap of the two-band masker actually resulted in a 3- to 15-dB release from masking. These results reveal factors that may operate to confound modern measures of frequency selectivity. PMID- 6841817 TI - Temporary threshold shifts produced by exposure to low-frequency noises. AB - Groups of human subjects were exposed for 8 or 24 h to an octave-band noise centered at 63, 125, or 250 Hz. For a 24-h exposure at 84 dBA, temporary threshold shifts (TTS) increased for 8-12 h and then either decreased or remained constant. Although TTS was less than 20 dB, complete recovery for many of the subjects required as long as 48 h. Accordingly, the higher level exposure which was planned at 94 dBA for 24 h was reduced to 90 dBA for 8 h. For this condition TTS increased throughout the 8-h exposure. TTS from the 90-dBA noise for 8 h exceeded the TTS produced by the 84 dBA; however, recovery from the 24-h exposure required as long as 48 h, whereas recovery from the 8-h exposure required only 12 24 h. Thus the time required for recovery is determined in part by the duration of exposure. TTS was not always maximal 1/2-1 oct above the band of noise, but was maximal in the frequency regions of better auditory sensitivity (350 to 750 Hz). For the 250-Hz condition, TTS increased about 1.5 dB per dB increase in noise level, whereas for the 63- and 125-Hz conditions TTS increased less than 1 dB per dB increase in noise level. More data are needed to specify the relation between TTS and the level of low-frequency noises. PMID- 6841818 TI - Pitch of components of complex tones. AB - Subjects made pitch matches to individual components in complex tones consisting of either the 4th to 7th or the 1st to 7th harmonics of a 200-Hz fundamental. All components were at equal levels (either 31-, 51-, or 71-dB SPL per component) and the matching pure tone was equal in level to the component being matched. Attention was drawn to the component to be matched either by giving the matching tone an initial frequency close to that of the component (standard condition) or by suppressing and then introducing the component (emergent condition). The pitch matches did not differ significantly for the two conditions, and did not change with overall level. For two subjects, matches to components in the context of the complexes were very close to matches obtained for the components presented in isolation. For a third subject, matches in context were shifted slightly upwards for the lowest component, and downwards for the highest component. A control condition showed that subjects were able accurately to match a small shift in frequency of one component in a four-tone complex. An adaptive forced-choice method described by Jesteadt [Percept. Psychophys. 28, 85-88 (1980)] was also used to estimate the pitches of the components. A very slight bias was apparent in the results, but the pitches of components in context were again found to be very close to those of components in isolation. PMID- 6841819 TI - Psychophysical measures of two-tone suppression and distortion products (2f1-f2) and (f2-f1). AB - Psychophysical two-tone suppression and the growth of the (2f1-f2) and (f2-f1) distortion products were measured in four normal-hearing young adults using a forward-masking paradigm. The stimulus parameters investigated were: (1) f1 = 750 and 3000 Hz; (2) f2/f1 = 1.11, 1.26, and 1.41; (3) L1 = 50, 65, 80, and 90 dB SPL; and (4) L2 - L1 varied from -20 to +20 dB in 10-dB increments. It appears that the p-law class of nonlinearity, which maintains that suppression and growth functions for the distortion products are directly related, is not supported by the data. Of existing models of aural nonlinearity, Goldstein's [J. Acoust. Soc. Am. 41, 458-479 (1967)] normalized power series appears to provide the most accurate description of the data, especially when modifications brought about by suppression are incorporated into the model. PMID- 6841820 TI - Detecting a repeated tone burst in repeated noise. AB - Samples of wideband noise 0.05, 0.1, 0.2, or 0.4 s in duration were digitized and then replayed cyclically to produce repeated-noise maskers. The signal was a repeating tone burst (0.4 or 1.6 kHz). It was half the duration of the noise sample, centered in the noise temporally, and it was repeated at the same point in each repetition of the noise. In the antiphasic conditions of the experiment, either the noise sample or the tone burst was inverted in alternate repetitions of the masker; in the homophasic conditions both the tone burst and noise, or neither, were inverted in alternative repetitions. If the auditory system were capable of storing detailed waveforms of sufficient length, alternate repetitions could be added or subtracted and we might expect a release from masking in the antiphasic conditions. The results show a small but significant advantage for the antiphasic conditions when the signal frequency was 0.4 kHz, but no difference with the 1.6-kHz signal. PMID- 6841821 TI - Lateralization based on interaural phase differences: effects of frequency, amplitude, duration, and shape of rise/decay. AB - Experiments in lateralization were performed to evaluate the relative contribution of envelope and phase cues in binaural hearing with particular reference to the effects of frequency, amplitude, shape of rise/decay, and duration of peak amplitude. Pure-tone signals were presented with interaural phase shifts ranging between 90 degrees and 360 degrees. For a given value of phase shift, the leading signal was presented randomly to the right or left ear over a block of 100 trials, and the laterality of the resultant image was judged. Rise/decay time was varied from 5 to 200 ms across blocks. The results confirmed our previous finding that a rise/decay time of at least 200 ms is required to secure a psychophysically steady-state signal. This value will, however, depend on the values chosen for the other signal parameters. Within limits, decreasing intensity could be compensated for by decreasing rise/decay, suggesting the psychophysical importance of the initial segment of the signal (precedence effect). For low frequencies of 650 to 1250 Hz, performance is sensitive to interaural phase shift and largely independent of frequency. For higher frequencies of 1500 and 2000 Hz, lateralization is independent of the phase cue and also largely insensitive to change in rise/decay time. Finally, performance remains unchanged with variation in peak duration ranging from 25 to 200 ms. PMID- 6841822 TI - Tuning curves and pitch matches in a listener with a unilateral, low-frequency hearing loss. AB - Psychoacoustical tuning curves and interaural pitch matches were measured in a listener with a unilateral, moderately severe hearing loss of primarily cochlear origin below 2 kHz. The psychoacoustical tuning curves, measured in a simultaneous-masking paradigm, were obtained at 1 kHz for probe levels of 4.5-, 7 , and 13-dB SL in the impaired ear, and 7-dB SL in the impaired ear, and 7-dB SL in the normal ear. Results show that as the level of the probe increased from 4.5 to 13-dB SL in the impaired ear, (1) the frequency location of the tip of the tuning curve decreased from approximately 2.85 to 2.20 kHz and (2) the lowest level of the masker required to just mask the probe increased from 49- to 83-dB SPL. The tuning curve in the normal ear was comparable to data from other normal listeners. The interaural pitch matches were measured from 0.5 to 6 kHz at 10-dB SL in the impaired ear and approximately 15- to 20-dB SL in the normal ear. Results show reasonable identity matches (e.g., a 500-Hz tone in the impaired ear was matched close to a 500-Hz tone in the normal ear), although variability was significantly greater for pitch matches below 2 kHz. The results are discussed in terms of their implications for models of pitch perception. PMID- 6841823 TI - Pure tone pitch perception and low-frequency hearing loss. AB - Pitch perception for pure tones was investigated in a group of listeners with low frequency sensorineural hearing loss. Pitch judgments from each listener were compared with results from psycho-acoustic tasks which provide information on the "place" of cochlear response. The pitch measures employed were: (1) binaural pure tone pitch matching in a listener with unilateral hearing loss, (2) octave judgments in listeners with musical ability, and (3) pitch-intensity functions in other listeners. Cochlear place of response was inferred from psychophysical tuning curves (PTC's). Two distinct types of PTC's for low-frequency probe tones were observed. Three listeners demonstrated "abnormally tuned" PTC's. For these listeners the frequencies that were most effective at masking the probe were considerably higher than the probe frequency. The three remaining listeners demonstrated "normally tuned" PTC's. Listeners with abnormally tuned PTC's were suspected of having an extremely abnormal place of response for low-frequency tones; this response pattern being located more toward the base of the cochlea than in the listeners with normally tuned PTC's. Sensitivity thresholds measured in the presence of high-pass masking noise supported this hypothesis. Small pitch frequency irregularities were observed in many listeners, although they were not consistently related to the inferred place of response for that frequency. The individual listeners' pitch judgments failed to distinguish between two types of PTC's. In particular, listeners who demonstrated abnormally tuned PTC's did not exhibit correspondingly large pitch irregularities. These results are difficult to explain on the basis of a classical "place" theory of pitch perception. PMID- 6841824 TI - Production and perception of rise time in the voiceless affricate/fricative distinction. AB - Rise times of voiceless affricates and fricatives were measured when the test material occurred in sentences, in isolated words, and in isolated nonsense syllables. As has been reported previously the rise times of affricates were significantly shorter than those of fricatives. Rise times varied with the type of test material and for all types of material were significantly longer than those reported by L.J. Gerstman [unpublished doctoral dissertation, New York University (1957)]. Differences in the way the previous measurements were made do not appear to explain the discrepancy. Because rise time varies with type of test material, no auditory sensitivity at a single rise time value can be responsible for the perceptual distinction between voiceless affricates and fricatives. This conclusion was also supported by the results of a perceptual experiment in which listeners were asked to label speech or nonspeech stimuli drawn from a continuum varying in rise time. Substantially different estimates of the category boundary were obtained when the range of rise times covered by the stimuli differed. PMID- 6841825 TI - Relationship between acute respiratory illness and air pollution in an Indian industrial city. PMID- 6841826 TI - Effect of atropine on the bronchial response of asthmatic subjects to the inhalation of ultrasonically nebulized distilled water. AB - To determine whether atropine provides protection against the bronchoconstriction that develops in asthmatic subjects after inhalation of ultrasonically nebulized distilled water, we exposed six asthmatic patients to this stimulus with and without pretreatment with atropine (0.04 mg/kg). The mean FEV1 decreased from 3.32 to 2.39 L (-28%) without and from 3.49 to 3.18 L (-9%) with atropine. This protective effect was statistically significant (p less than 0.05), suggesting that cholinergic pathways are involved in the obstructive response to the inhalation of ultrasonically nebulized distilled water. PMID- 6841827 TI - Role of immediate food hypersensitivity in the pathogenesis of atopic dermatitis. AB - Twenty-six children with atopic dermatitis and markedly elevated serum IgE concentrations were evaluated for clinical evidence of hypersensitivity to foods with double-blind placebo-controlled food challenges. Selection of foods for challenges was based on positive prick skin tests (greater than 3 mm wheal) or a convincing history. At least one positive skin test to a food antigen was found in 24/26 patients. A total of 111 double-blind placebo-controlled challenges were performed in these children after suspect foods were eliminated from their diets for 10 to 14 days. There were 23 positive challenges in 15 children, 21 of which manifested as cutaneous symptoms, primarily pruritus and an erythematous macular and/or maculopapular rash involving 5% (or greater) of the body surface. In all, 14 children (54%) developed cutaneous symptoms after food challenges. All symptoms occurred within 10 min to 2 hr of challenge; nasal symptoms, mild wheezing, and gastrointestinal symptoms were seen in some children. No symptoms occurred in 104 placebo challenges. There were 86/111 clinically insignificant positive skin tests (77%) and three false-negative skin tests. These studies demonstrate that in some children with atopic dermatitis, immediate food hypersensitivity can provoke cutaneous pruritus and erythema, which leads to scratching and subsequent eczematoid lesions. PMID- 6841828 TI - Sensitivity to ingested metabisulfite: variations in clinical presentation. AB - Two patients presented with histories compatible with an anaphylactic reaction temporally related to meals. Detailed allergy and immunologic studies indicated that the episodes were caused by sensitivity to metabisulfites. Some of the clinical implications are briefly discussed. PMID- 6841829 TI - Postprandial exercise-induced anaphylaxis. AB - A variety of systemic reactions associated with exercise are increasingly being recognized. We studied an atopic individual whose job-related activities involved strenuous running that often terminated in an episode of syncope and hypotension preceded by cutaneous pruritus, warmth, urticaria, and angioedema. These attacks occurred only after meals, but no foods appeared to elicit symptoms without subsequent exercise. The subject underwent three exercise challenges in the laboratory under the following conditions: (1) fasting state, with heat dissipating clothing. (2) fasting, with heat-retention clothes, and (3) after a meal. Blood pressure decreases and minimum skin reactivity were observed for (1) and (2), and reproduction of syncope, hypotension, and further cutaneous manifestation were observed only after (3). Venous and arterial plasma determinations for complement activation (C4, C4d, and CH50) and histamine before, during, and after exercise were not abnormal. Although other vasodepressor mediators may have been liberated, at least part of the mechanism for postprandial exercise-related syncope may be attributed to a shift of blood flow to the splanchnic as well as skeletal muscle vasculature. PMID- 6841830 TI - Unlabeled use of approved drugs. PMID- 6841831 TI - A comprehensive approach to anorexia nervosa. PMID- 6841832 TI - A family systems orientation to the treatment of anorexia nervosa. PMID- 6841833 TI - Varieties of parenting failure in anorexia nervosa: protection and parentectomy, revisited. PMID- 6841834 TI - Academic deficits in emotionally disturbed children revisited. PMID- 6841835 TI - Psychological intervention with the severely burned child: report of an experimental comparison of two approaches and their effects on psychological sequelae. PMID- 6841836 TI - Assessment of childhood depression: correspondence of child and parent ratings. PMID- 6841837 TI - Language disorders in children referred for psychiatric services. PMID- 6841838 TI - The nuclear family, suburban neurosis, and iatrogenesis in Auckland mothers of young children. PMID- 6841839 TI - The therapist's role in child custody disputes. PMID- 6841840 TI - Rural child psychiatry. PMID- 6841841 TI - The sensitivity of a peer-nomination technique in assessing changes in children's social behavior: a case study. PMID- 6841843 TI - Child psychiatry and burn care. PMID- 6841842 TI - The sexual development of the adolescent daughter of a homosexual mother. PMID- 6841844 TI - Eating disorders. Introduction. PMID- 6841845 TI - Computerized nutrient data bases: I. Comparison of nutrient analysis systems. AB - Food composition tables now being compiled include a wide range of food items and nutrients. This trend is paralleled in the development of computer-stored nutrient data bases that are being utilized for numerous applications, such as cost-optimized menu planning, dietary record analysis, and nutritional assessment. In 1976, several participants at the National Nutrient Data Bank Conference agreed to cooperate in a comparative study to analyze a common one-day dietary record. The results of three subsequent analyses indicated that the values for nutrients varied considerably even after elimination of coding judgments relative to portion size and selection of food items. The results of the study indicated the need for an assessment methodology suitable for evaluating performance of a computerized nutrient analysis system. PMID- 6841846 TI - Copper content of tea. AB - Published data for copper content of tea are contradictory. To resolve the issue, various brands and flavors of four different types of tea were prepared in two kinds of containers and analyzed for copper. Copper concentrations averaged from 0.14 p.p.m. for herbal and instant teas to 0.19 for brewed regular tea, plain or flavored. All concentrations were well below a previously reported value for tea as a beverage. PMID- 6841847 TI - Selenium intake and urinary excretion in persons living near a high selenium area. AB - Selenium intake by adults consuming self-selected levels of four different diets averaged 209 micrograms. per day and correlated well with caloric and protein intake. Urinary selenium concentration averaged 0.108 microgram. per milliliter, and 24-hour excretion for the various diets averaged 58.0% to 88.6% of the intake. The data suggest that the RDA upper limit of 200 micrograms. of selenium per day and the suggested maximum urine selenium concentration may be too restrictive. The data further indicate that even though there are differences in the absorption of selenium from different sources, the average is about 70% for foods purchased in the Northern Great Plains area. PMID- 6841848 TI - Bentonite-water dispersions--an effective dietetic research tool. AB - Quiche were heat processed in a food service convection oven in four different oven load sizes (4, 8, 12, and 16 quiche) to determine evaporation losses and energy usage. The experiment was repeated using models made from bentonite to simulate quiche. Bentonite-water dispersions, prepared with 82.7% distilled water and 17.3% dry bentonite powder by weight, were shaped into standardized models. On a per quiche basis, no differences in energy consumption were revealed for any load. Savings in research costs for both food and labor were documented. Recommendations are made as to how administrative dietitians might use the data. PMID- 6841849 TI - Food service and management strategies in nutrition programs for older Americans. PMID- 6841850 TI - Developing new options in home-delivered meals: the SMOC demonstration elderly nutrition project. AB - The purpose of this project was to design and test alternative approaches to in home nutrition services for the elderly. Two meals systems--weekly delivery of five frozen meals and the daily delivery of hot meals--were evaluated for client approval, effect on clients' social contacts, and costefficiency. The alternative frozen meals system met with clients' acceptance, maintained clients' usual social patterns, and produced a cost savings of at least 16%. The development of a more flexible approach to home-delivered meals offers possibilities both for better serving clients' needs and for improving cost efficiency. It therefore has implications for elderly nutrition services nationwide. PMID- 6841851 TI - Nutrition and the older primigravida. AB - The numbers of older primigravidas, women pregnant for the first time at age 35 or later, are increasing. The main potential complication of such pregnancies is an increased incidence of pre-gravid essential hypertension. Published materials on hypertension in pregnancy emphasize control by antihypertensive drugs. Dietary recommendations for the hypertensive pregnant woman are identical with those for the normotensive gravida. A higher incidence of overweight at the time of conception might be predicted among older women. Because weight control reduces both blood pressure and obstetrical risk, there are implications for preventive nutrition counseling among nonpregnant women of childbearing years. Declining metabolic rate with age may dictate a slightly decreased caloric need among older primigravidas. Dietitians, nurses, nutritionists, physicians, and other members of the health care team should be aware of the societal trend toward postponed childbearing. Weight control and monitoring of the blood pressure of nonpregnant women of childbearing years might be emphasized as preventive measures to reduce possible complications when and if the women become pregnant. Such information might be incorporated into health screening, fitness, nutrition education, or weight control programs or be provided as part of a care plan following nutritional assessment. Support groups for women might include such information in their programs. Special nutritional needs of the older primipara should be considered by dietitians, nutritionists, nurses, nurse-midwives, obstetricians, and other health care personnel. PMID- 6841852 TI - Introducing international students to the American food supply. PMID- 6841853 TI - Screening for cognitive deficits in a sample of hospitalized geriatric patients: a re-evaluation of a brief mental status questionnaire. AB - A 30-item screening examination for cognitive deficits was administered to 65 hospitalized elderly patients and to 60 elderly controls. A high proportion (73 per cent) of the hospitalized patients were found to have low cognitive scores indicative of probable organic mental syndrome (OMS). Especially high deficits were found among the patients with orthopedic and cerebrovascular conditions. The test correctly identified the 15 cases of established OMS. The percentage of false positive results in the normal controls was reasonably low. The importance of routine cognitive measurements in medical wards is stressed. PMID- 6841854 TI - Effects of chronic medical illness and dementia on the dexamethasone suppression test. AB - The dexamethasone suppression test (DST) was performed on 26 elderly male outpatients in a geriatric medical clinic. Patients with depression were excluded. All patients had two or more medical diagnoses. Fourteen patients also met DSM-III criteria for dementia. No patient had an abnormal DST result. The authors suggest that neither chronic medical illness nor dementia causes false positive DST results in this patient population in an outpatient setting, and discuss the findings in relation to previous reports. PMID- 6841855 TI - Effects of age on responses to treatment and survival of patients with multiple myeloma. AB - The elderly patient with malignancy is often considered a poor risk for treatment. To assess the effect of age on the treatment of one such disease, multiple myeloma (a disease with increased incidence in the elderly), a study was made of 280 patients treated with 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU), cyclophosphamide and prednisone on a Southeastern Cancer Study Group protocol. Initial response rates after six months of treatment were equivalent for the older compared with the younger age groups, with a slightly longer remission duration for those over 70. Likewise, survival was equivalent for the older patients. This was not the result of selection of older patients with less advanced disease, since the proportion with both good and poor risk factors are not significantly different in the various age groups. Moreover, for patients with each of the prognostic factors, older patients responded at least as well as younger patients. There were no significant differences among the age groups in gastrointestinal, skin, hair, or hematologic toxicity, although there was a slightly higher incidence of mild granulocyte and platelet toxicity in patients over 60. These findings are in contrast to the widely held belief that older patients cannot tolerate chemotherapy. On the contrary, they suggest that the elderly patient with myeloma may be expected to respond and survive, without excessive toxicity, at least as well as a younger counterpart with similar prognostic factors. PMID- 6841856 TI - The nonuse of urethral catheterization in the management of urinary incontinence in the teaching nursing home. AB - A survey of all patients in a 527-bed skilled nursing facility was carried out to determine the prevalence of bladder catheterization. The institution surveyed is a teaching nursing home and rehabilitation center comprising three intermediate stay and rehabilitation units of 126 beds and nine long-term care units. The institutional prevalence of recurrent urinary incontinence was 46 per cent, or 243 patients. The prevalence of chronic indwelling urethral catheters was 2.5 per cent, or 13 patients. The prevalence of urethral catheterization was further reduced to 1.5 per cent on the long-term care units, where the rate of recurrent urinary incontinence exceeded 60 per cent. The results of our survey were then compared with similar surveys at the institution during the years 1975 through 1980. Despite a fluctuating but increasing prevalence of incontinence over the years studied, a favorable trend was shown toward a reduction in the number of patients with indwelling urethral catheters. This study indicates that unless specific complicating factors are present, urinary incontinence in all but a very few of the elderly can be successfully managed without chronic indwelling catheterization. The authors believe that the introduction and growth of an education and research program in the nursing home environment has led to improvement in the standards of medical and nursing care. PMID- 6841857 TI - The outcome of hospitalization for acute illness in the elderly. AB - The use of acute-care hospitals by the elderly is rising rapidly, particularly in the age group 75 and older. Any changes that will reduce the length of stay could result in considerable savings in health care costs. It is imperative to look at present policies and explore possible changes that could reduce costs by reducing the total hospital days. A study was conducted in a 290-bed county-founded community hospital in California that serves the majority of disadvantaged and poor elderly residing in an area with a population of approximately 300,000 persons. The objective was to determine what demographic, medical, and sociologic characteristics of elderly patients recorded at admission would be of value in predicting those most likely to change their functional status. It was found that the most important predictors of deterioration of function are (1) older age, especially 85+, and (2) abnormal mental status. Patients admitted from nursing homes had a longer than average length of stay, and those who survived (80 per cent) returned to a nursing home. It was concluded that routine assessment of elderly patients admitted for acute illness or injury could facilitate discharge planning by an early prediction of the level of care that will be required after discharge. This assessment should include preadmission mental and functional status; identification of causes for, and correction of, acute confusional states; and an assessment of the impact of the present illness or injury on future level of function following rehabilitation. This could result in a reduced length of average hospital stay. PMID- 6841858 TI - Current leads in research on the osteoarthritic joint. PMID- 6841859 TI - Medical students' attitudes toward the elderly. AB - A study was designed to examine the relationship between students' attitudes, their willingness to work with elderly patients, and the impact of a geriatric rotation on a randomly selected subset of the group. A pretest/post-test design was used in which 148 third-year medical students completed a multidimensional questionnaire on two occasions eight weeks apart. Highly significant correlations were found between the expressed intention of the student to work with the elderly and positive feelings about previous professional contact (r = .26, P less than .001), previous personal contact (r = .17, P less than .002), belief that working with the elderly is rewarding (r = .30, P less than .0001), high degree of comfort in working with the elderly (r = .21, P less than .01), and positive stereotypes about the elderly (r = .14, P less than .05). Despite the students' positive rating of the geriatric rotation, multiple regression analysis indicated that the best predictor of an index of intentions to work with elderly patients on the post-test was this same index of intentions on the pretest (multiple r = .58, P less than .001). These findings, as well as the actual attitudes and stereotypes held by the students, have major implications for the planning and development of medical students' experiences in geriatrics. PMID- 6841861 TI - The concept of pseudodementia. PMID- 6841860 TI - The elderly in Kuwait. PMID- 6841862 TI - The problem of assertiveness. PMID- 6841863 TI - Abortion attitudes in medical students. PMID- 6841864 TI - Fetal alcohol effects: an overview. PMID- 6841865 TI - An evaluation of the Cavitron Autorefractor 7 with contact lenses and non contact lens wearing patients. AB - The Autorefractor 7 is a microcomputor assisted electro-mechanical optical system recently introduced to the professions for the subjective measurement of refractive error, phorias, and accommodative capacity. In this study of 450 eyes, 150 were wearing hard contact lenses, 150 wearing soft lenses, and 150 habitually wore a spectacle correction. Comparisons involved only the subjective refractive feature of the instrument and indicated no predictable difference in the three groups. Comparison of the Autorefractor 7 and clinical subjective refraction with the phoropter, however, showed that the instrument is reliable in the majority of cases but has a tendency to overcorrect myopia and astigmatism. PMID- 6841866 TI - Ocular signs and symptoms of altered blood lipids. AB - Several eye signs may present secondary to altered blood lipid levels. It is important to recognize these signs and their implications relative to both primary and secondary hyperlipoproteinemias. The significance of corneal arcus is age related, while isolated xanthelasma implies altered blood lipid levels in 30 50% of the cases. Eruptive xanthomas imply triglyceride levels in excess of 1500 mg% while lipemia retinalis presents when triglyceride levels exceed 2500 mg%. Retinal emboli present as a sign of an eroding atheroma and as such an indicator of the possibility of an impending stroke. Altered blood lipid levels represent a threat to life and must be recognized as early as possible to institute therapy. Therapy may be directed to either the primary or secondary causes of hyperlipoproteinemias. PMID- 6841867 TI - Calcium: I. Ocular and systemic metabolism. AB - The research cited above has shown that calcium and related minerals play a significant role in the maintenance of ocular and systemic health. While it is difficult to obtain a complete picture of calcium metabolism in any given patient, the tests previously discussed (most of which can be performed by or at the direction of an optometrist) do serve to differentiate patients with normal versus aberrant calcium dynamics. Since calcium is important to the proper function of the visual system, the optometrist should be alert to signs and symptoms which can indicate calcium metabolic or nutriture imbalances, and test, counsel or refer suspect patients appropriately. PMID- 6841868 TI - Calcium: II. Role in keratoconus. AB - Calcium metabolism was assessed in 18 keratoconic and 18 age- and sex-matched control subjects using four types of analyses: diet, serum, urine and hair. There was no significant difference between the two groups for dietary intake, serum, urine and hair parameters of calcium, and related minerals. Although the control group had a higher daily intake of vitamin D than did the keratoconus group, the serum levels of the active vitamin D hormone, 1,25-(OH)2 vitamin D3, were the same in both groups. These findings suggest that systemic calcium or vitamin D metabolic imbalances are not involved in maintaining eyes in a keratoconic state. PMID- 6841869 TI - Treatment of an unusual case of Aniseikonia. PMID- 6841871 TI - Flexure of rigid contact lenses on toric corneas as a function of base curve fitting relationship. AB - This study examined flexure of contact lenses while varying the base curve corneal relationship. Identical 9.5 mm lens designs of Polycon I, Polycon II and PMMA and Polycon I 9.0 mm lenses were fitted to corneas with toricities of between 0.75 and 5.00 D. It was found that the amount and direction of the flexure were determined by the base curve fitting relationship. As lenses were fitted steeper than K, with-the-rule flexure occurred, and flatter than K, against-the-rule flexure. If the upper lid covers the superior portion of the lens, an against-the-rule flexure component is usually introduced. PMID- 6841870 TI - Therapy for early acquired noncomitant esotropia. A case report. AB - A 7 year-old female demonstrated a noncomitant esotropia secondary to an early acquired lateral rectus paresis. Sensory fusion testing indicated that the patient was capable of maintaining single binocular vision only with a pronounced head turn. Prism and surgical therapy reduced the abnormal head posture and permitted fusion and stereopsis in the primary position. PMID- 6841872 TI - Management and fitting the aphakic with contact lenses. PMID- 6841873 TI - Effect of blinking on the level of oxygen beneath hard and soft gas-permeable contact lenses. AB - The oxygen tension, which can also be stated as the equivalent oxygen percentage (EOP), was measured beneath a variety of hard and soft gas-permeable contact lenses following static and dynamic wearing conditions. The significant increases in EOP beneath rigid lenses upon blinking were to be expected in view of the tear pumping mechanisms known to exist with such lenses. However, blinking was found to have a minimal effect on the EOP beneath hydrogen lenses, confirming earlier predictions. PMID- 6841874 TI - Fitting aphakic children with contact lenses. AB - Young children occasionally suffer from cataracts. Etiology may be trauma or heredity, but surgical removal and proper contact lens care are now considered imperative for visual development. This paper describes the author's method for fitting and caring for young aphakic children. PMID- 6841875 TI - Immediate refitting with gas permeable lenses. AB - Handling long-term polymethylmethacrylate (PMMA) lens wearers, especially those suffering severe corneal oxygen deprivation, has been a problem much relieved by the introduction of oxygen permeable rigid lenses. Previous methods including lens modifications, discontinuation of lens wear, and de-adaptation possessed limitations which could cause the patient to experience permanent corneal curvature and refractive changes. Immediately refitting these patients with gas permeable lenses has been a procedure which appears to have eliminated many of the previous problems and has achieved rapid approval from contact lens practitioners the past few years. This paper discusses how this procedure can be performed to the satisfaction of both the optometrist and the patient. PMID- 6841876 TI - Nanoliter tracking of the tears. AB - Microliter sampling opened the way in the 1970's for at least limited quantitative studies of the tear fluid. Now, nanoliter sampling offers a much less imposing technique for viewing even more subtle changes within the eye's most immediate environment. Examples, based on nanoliter sampling, are given of certain transient effects that even a soft lens can induce during the earliest periods of wear. PMID- 6841877 TI - Aphakic patient response to extended wear contact lenses. AB - 65 aphakic patients (89 eyes) wore extended wear contact lenses for an average period of 22.8 months. 74% of the patients developed one or more readily detectable ocular changes during the course of the study. These complications, their frequency, cause and management are described and discussed. In spite of the large number of complications, 82% of the patients were still wearing lenses at the termination of the study period. None of the complications were serious enough to produce ocular tissue damage that resulted in any permanent loss of vision. Careful patient management and frequent follow-up visits were the key to achieving successful wearing results. PMID- 6841878 TI - Measured power distribution across the Bausch and Lomb Soflens (PAI) Bifocal. AB - The power distribution across Bausch and Lomb Soflens PAI Bifocal lenses was measured using a series of double aperture stops on a lensometer. The add power at different distances from the lens center is presented. A gradual increase in plus power approximately equivalent to an aspheric back surface of an eccentricity of 0.75 was found. The change in add with change in apical radius (lens distance power) is also reported. The measured change is compared to the calculated power change over the same radius range. PMID- 6841879 TI - Risk of loss of Soflens during water skiing. AB - Ten soft contact lens wearers, who were also water skiers, each skied a minimum of ten times while wearing soft contact lenses (Bausch and Lomb Soflens). There was good subjective comfort and visual acuity for all subjects. Data relating to falls while skiing were recorded for each trial (total 119). No lenses were lost by any participant even though in ninety-one (76%) of the 119 trials, the skier's head became submerged. The data suggest that the risk of Soflens loss following a water-skiing fall is extremely low. PMID- 6841880 TI - In and out of office communication for more efficient care (presbyopia). PMID- 6841881 TI - The surgical anatomy of the first ray. Part I: the distal segment. PMID- 6841882 TI - Prevalence of non-painful heel spur and its relation to postural foot position. PMID- 6841883 TI - Severe pes valgus in spastic diplegia. A case report. PMID- 6841884 TI - Plantar fibromatosis. Surgical considerations and a case report. PMID- 6841885 TI - Subcutaneous granuloma annulare of the foot. An atypical case report. PMID- 6841886 TI - Tumoral calcinosis in the foot and hand. A case report. PMID- 6841887 TI - A potential cause of hallux adductus in bi-correctional austin bunionectomies. PMID- 6841888 TI - Recurrent anterior tibial compartment syndrome in an athlete. A case report. PMID- 6841889 TI - A statistical analysis of a group of runners. PMID- 6841890 TI - Congenital convex pes valgus. PMID- 6841891 TI - Peg in hole arthrodesis. PMID- 6841892 TI - A correction for short fourth metatarsal. PMID- 6841893 TI - Intravenous regional anesthesia. PMID- 6841894 TI - Rheumatoid nodule. An unusual variant. PMID- 6841895 TI - A large osteochondroma of the third toe. PMID- 6841896 TI - Skin Staple usage in podiatric surgery. PMID- 6841897 TI - Kaposi's sarcoma of the foot. A six-year follow-up. PMID- 6841898 TI - The incident report form in a private office. PMID- 6841899 TI - Double oblique lesser metatarsal osteotomy. PMID- 6841900 TI - Continuing podiatric education: the Podiatrist's Recognition Award. PMID- 6841901 TI - The chromaffin granule as a model for membrane fusion: implications for exocytosis. AB - Rapid freeze/freeze-fracture and thin section electron micrographic studies of the Ca2+-promoted aggregation and fusion of isolated bovine adrenal medullary chromaffin granule membranes show that the granules undergo a series of morphological changes. The contact region becomes quite extensive and the membrane curvature changes radically at the edge of the contact site. The core material retracts away from the contact site leaving an electron lucent "stripe"; however, it remains adjacent to the membrane in the non-contact areas. The pentalaminar double membrane of the contact region often shows breaks. Close examination reveals that the two granule membranes have fused and become one continuous membrane. Rearrangement of large membrane associated particles (MAPs) can be seen by freeze fracture after Ca2+-promoted granule-granule contact. The broken pentalaminar septum becomes smaller and may break down into globular structures. These observations suggest a series of reactions in which the granules first form an encounter complex, then a stable complex. The membranes within the contact region undergo lateral displacement of the proteins and phase separations of the lipids, and then fuse. Analysis of the kinetics of turbidity and fluorescence changes during granule aggregation and fusion support the main postulates of the model. The initial events of aggregation are facilitated by putative recognition proteins and K+ will promote all activities except fusion. Recent observations that several soluble proteins (synexin, and albumin) will act as fusogens are discussed in terms of the relevance to exocytosis in vivo. PMID- 6841902 TI - Health information and education for inpatients and outpatients via CCTV. PMID- 6841903 TI - Experience with a microcomputer in a medical illustration department. PMID- 6841904 TI - Economical inhouse E6 processing for the small scale user. PMID- 6841905 TI - A modification to Bell and Howell film projectors to accommodate a more economical lamp. PMID- 6841906 TI - Photography as an aid to the study of otitis media. PMID- 6841907 TI - The colour preservation and photography of gross specimens. PMID- 6841908 TI - [Acute insufficiency of the chorioretinal circulation]. AB - This is a study of 6 cases of sudden drop in visual acuity manifested by a central scotoma. Fundus examination showed ischemic oedema of the posterior pole and in 3 cases the presence of cotton wool bodies. Fluorescein angiography shows a constant delay in choroidal injection associated or not with a delay in central retinal arterial injection. All these patients have carotid artery circulatory insufficiency. We present a discussion of the pathogenesis, the possible role played by choroidal artery obstruction in the macular injury. PMID- 6841909 TI - [Lichen of the conjunctiva]. AB - Lichen planus may occasionally involve the conjunctiva or other mucous membranes. Three new cases are described. Generally, white ridges appear on the palpebral conjunctiva, histological examination revealing inflammatory infiltration of the basal membrane, which is eroded by the infiltrate. The disease could be more frequent than indicated by the literature, but its treatment is usually disappointing. PMID- 6841910 TI - [A case of deep annular granuloma of the eyelid]. PMID- 6841911 TI - [Unexpected culture media for fungi: the hydrophilic contact lenses]. PMID- 6841912 TI - [Philosophy of permanent wearing of soft hydrophilic lenses, 1981-1982]. PMID- 6841913 TI - [The chondromucosal graft. Its use in the correction of entropion caused by tarsoconjunctival cicatrix, trichiasis and distichiasis]. AB - The use of chondromucosal grafts is the classical treatment for reconstruction of the eyelids, whereas these grafts are less employed for correction of tarso conjunctival scars due to either disease or surgery. The ideal nasal graft is the triangular cartilage, as its mucosa is more delicate and more adhesive than that of the septum, and it separation and positioning do not involve any problems if certain rules are followed. The technique appears attractive to us, as it is simple to perform, there is a lack of postoperative complications and it is logical (replacing a pathological tissue or a missing tissue by an identical one, keeping the lids framework). It appears to be not enough employed in trachomatous entropion (both eyelids being generally affected). However, the technique is useful: during first intention surgery (whether associated or not with tarsectomy); in all cases of recurrence, where it appears to be the only worthwhile treatment (trachomatous eyelids already operated upon by another method, tarsectomy alone). PMID- 6841914 TI - [The correction of supra-tarsal depression after enucleation]. AB - Supra-tarsal depression after enucleation is a frequent occurrence, and many surgical methods have been applied to correct this anomaly, which results from the relative smallness of the implant, and its downward migration. As subperiosteal orbital floor implants provided unsatisfactory results a mould of the supra- tarsal depression was taken to attempt direct correction of the anomaly, by means of a silicone-gel custom-made prothesis. The prothesis is implanted behind the septum orbitale, above the levator muscle and in front of the recessed orbital fat. Good results have been obtained in the 6 cases treated in this manner, and no complications have been reported. PMID- 6841915 TI - Circadian as well as circannual rhythms of circulating aldosterone have decreased amplitude in aging women. AB - Age differences in the characteristics of the circadian rhythm in circulating radioimmunoassayable aldosterone were studied on nine 20 to 26 year-old and ten 70 to 78 year-old women and ten 23 to 26 year old and ten 70 to 80 year old men in Wurzburg, West Germany. These diurnally active-nocturnally resting subjects were sampled every 3 hours for 15 hours. A classical analysis of variance and a multivariate analysis of rhythm characteristics revealed major effects of age exerted on the circadian aldosterone amplitude in women (p = 0.003) but not in concomitantly sampled men. These observations complement the study of circadian and circannual rhythms in 8 young adults (15-21 years), 10 mature adults (29-36 years) and 10 post-menopausal (44-59 years) North American women, sampled at 100 minute intervals for 24 hours, once in each season, and document that the adrenocortical aldosterone-producing system remains rhythmic with at least two frequencies up to the late decades of human life, although in women it may be characterized by a reduction in the extent of spectral change after 70 years of age. PMID- 6841916 TI - Reenlargement of macroprolactinomas during bromocriptine treatment: report of two cases. AB - We report two cases with macroprolactinoma who during medical treatment with bromocriptine showed a normalization of PRL levels and a reduction of tumor size as documented by computed tomography. After a few months of therapy both patients suddenly complained of worsening of their visual fields and a computed tomography demonstrated a reenlargement of the tumor mass; whereas in one patient PRL levels remained always within normal range, in the other patient, who was taking spiramycin for an intercurrent illness, there was also an escape of the hormonal secretion from the inhibitory effect of bromocriptine. The first patient underwent surgery, whereas in the second patient continuation of bromocriptine and interruption of antibiotic treatment resulted in progressive improvement in visual fields and a reduction of tumor size again. We want to stress that in patients with macroprolactinomas responsive to the medical treatment both in terms of PRL secretion and of tumor size reduction, an escape from the effects of bromocriptine, although infrequently, may occur. PMID- 6841917 TI - Congenital adrenal hypoplasia: two new cases. AB - Two male adolescents with the X-linked form of congenital adrenal hypoplasia are described. Both grew slowly during childhood and adolescence and did not undergo pubertal development because of hypogonadotropic hypogonadism associated with the congenital adrenal hypoplasia. The severely delayed bone age in childhood is probably due to the adrenal androgen deficiency and suggests a role of these hormones in the prepubertal skeletal maturation. The failure of gonadotropin secretion still remains unexplained. A hypothalamic defect has been suggested, but further studies are necessary to clarify this hypothesis. PMID- 6841918 TI - Plasma membrane transport of thyroid hormone: its possible pathophysiological significance. PMID- 6841920 TI - Lens morphology, aging, and cataract. AB - The human lens is a uniquely transparent, biconvex, avascular structure responsible for focussing the image onto the retina. It is enclosed by a thick capsular basement membrane. The accommodative process in the lens is dependent upon the inherent elasticity of the lens capsule and the contractile property of the lens cells or fibers. In contrast to the ocular dimensions, the lens shows marked changes in size and weight with aging. Impairment in lens transparency and significant morphologic changes in the nucleus, cortex, and capsule occur with aging process. The optical zones of discontinuities of the lens result from light scatter through the various parts of the lens and are of great clinical significance in the assessment of cataract. The lens preserves its entire population of cells from fetal life until death and provides an excellent model for defining aging parameters of other ectodermally derived structures. PMID- 6841919 TI - Influence of dopaminergic mechanisms on 24-hour secretory patterns of prolactin, luteinizing hormone and testosterone in recumbent men. PMID- 6841921 TI - Lens metabolism and aging: enzyme activities and enzyme alterations in lenses of different species during the process of aging. AB - Extensive investigations on the metabolism of animal lenses over the life span indicate various changes that, regarded collectively, suggest a decrease in metabolic energy. A factor analytic interpretation and discussion of these results indicate that enzyme modifications might be one of the fundamental causes of the age-related changes in lens metabolism. Detailed investigations on the kinetic and physicochemical properties of certain enzymes of the carbohydrate breakdown in lenses of different ages verify this assumption. Since the changes observed are found mostly in the lens nucleus protein neosynthesis no longer takes place, posttranslational modifications appear to be responsible. PMID- 6841922 TI - Phase separation and lens cell age. AB - Using laser light scattering spectroscopy, we are studying age-related changes in the microstructure of lens cytoplasm. We have established in animal models that one of the earliest identifiable stages in cataract development is the presence of a phase transition in the lens cytoplasm. As a result of the phase transition, the cytoplasm separates into microvolumes that differ in their protein concentration. These microvolumes scatter light and cause the lens to become opaque. This phase separation occurs in normal lens cells at a characteristic temperature, Tcat, which varies across the lens with the cell age. As the animal becomes older, the Tcat for the nuclear cells decreases to a value well below body temperature. In X-irradiated eyes, however, Tcat increases with animal age until the phase separation occurs at or near body temperature. At this point, a well-developed nuclear cataract appears. We are now attempting to understand the biochemical basis for the differences between Tcat of normal and Tcat of X irradiated lens cells during the aging process. PMID- 6841923 TI - Effects of low-dose antihypertensive therapy in elderly patients with predominant systolic hypertension. AB - Patients over 60 years of age (M = 70 years) with the predominant systolic form of essential hypertension (systolic blood pressure greater than 160 mm Hg; diastolic blood pressure less than 100 mm Hg) were treated with a combination of low doses of the diuretic chlorthalidone and the centrally-acting sympatholytic agent clonidine. In this randomized double-blind study, patients received either active treatment (n = 14) or placebo (n = 16). Baseline systolic blood pressure in the treatment group averaged 172 mm Hg and was controlled (fall in systolic blood pressure to less than 140 mm Hg or by at least 10%) in 13 of the 14 patients; in eight patients, control was achieved with a single daily dose (given at night) of the clonidine (.1 mg)-chlorthalidone (15 mg) combination. The active drug was significantly superior to placebo in decreasing systolic blood pressure. Changes measured in the standing position did not differ from those in the supine position. Side effects were mild and transient for both the placebo and the treatment groups. Low-dose combination therapy appears to be a highly effective approach for the management of older patients with predominant systolic hypertension of mild-to-moderate degree. PMID- 6841924 TI - Longitudinal chest x-ray changes in normal men. AB - To determine the changes on chest x-ray attributable to the aging process, we evaluated cardiovascular and pulmonary structures on two standard postero anterior chest x-rays taken at least 10 years apart (M = 16.9 years) in 67 carefully screened healthy men initially aged 23 to 76 years. The aortic knob diameter increased in 79% of subjects. Although mean cardiothoracic ratio increased overall, only 3% of men developed a cardiothoracic ratio greater than .50, and none exceeded .51. Pulmonary abnormalities on initial chest x-ray consisted mainly of hyperinflation (27%) and increased markings (19%), both of which doubled in prevalence during follow-up. Kerley B lines and enlarged pulmonary arteries were rare initially but increased three- to five-fold. The prevalence of these findings did not differ between smokers and nonsmokers. Based on commonly accepted x-ray criteria, chronic obstructive lung disease was suggested in 15% of the initial films and 21% of the final films despite the absence of clinical or spirometric abnormalities. PMID- 6841925 TI - Plasma norepinephrine responses to posture and isometric exercise increase with age in the absence of obesity. AB - This study examines the effects of age on plasma norepinephrine (NE) responses to upright posture and isometric handgrip exercise in nonobese men. Increasing age was associated with increased basal levels of plasma NE as well as increased NE responses to upright posture. These results suggest that aging affects sympathetic system activity by mechanisms largely independent of the increasing adiposity generally associated with aging. PMID- 6841926 TI - The effect of increasing age on the latency for saccadic eye movements. AB - The latency for saccadic eye movements to a visual stimulus was studied in 59 adults whose ages ranged from 20.7 to 79.5 years. All were free of neurologic disease and drug use. Horizontal eye movements were recorded by electrooculography and the latency from the onset of a peripheral visual stimulus to the onset of a saccadic refixation eye movement was determined. A linear regression analysis revealed a correlation between increasing age and increasing latency for saccadic refixation eye movements. The direct relationship between increasing age and increasing latency for saccadic eye movements is a factor that should be taken into account in eye-movement studies as well as other methodologies such as tachistoscopic studies in which saccadic eye movements play a role in study design. PMID- 6841927 TI - Hearing acuity in a healthy elderly population: effects on emotional, cognitive, and social status. AB - Hearing acuity and the relationships between untreated hearing deficits and emotional state, cognitive functioning, and social integration were examined in 239 physically healthy, independent-living elderly men and women with a mean age of 72 years. Air-conduction, pure-tone thresholds in both ears were determined at high- and mid-frequencies, and participants were also given the Speech Perception in Noise test. Multivariate techniques were used to test for associations between hearing acuity and scores from the Kellner-Sheffield Symptom Questionnaire, the Jacobs Cognitive Screening Exam, the Halstead Category Test, the Wechsler Memory Scale, and the Interview Schedule for Social Interaction. No deleterious effects of untreated hearing deficits on emotional status or social integration were found. The findings suggest that those with a hearing loss perform less well on verbal but not on nonverbal tests of cognition. PMID- 6841928 TI - Age differences in the use of imagery in integrating new and old information in memory. AB - A syllogistic reasoning task was used to assess the ability of two adult age groups to use imagery. Answers to memory and inference test questions depended on explicitly provided information, but answers to integration test questions required the use of information drawn from semantic memory. Overall, older adults obtained significantly lower scores than younger adults. However, imagery instructions facilitated the memory score for spatial relations in the paragraph condition for both age groups, suggesting that there may be no deficit in the ability to use imagery as a semantic feature. Imagery instructions also facilitated integration and inference scores in both paragraph and sentence presentation for young adults but facilitated only the integration score in the paragraph condition for older adults. These results suggest that older adults can use imagery as a control process but are less likely than younger adults to use imagery as a strategy in abstract situations. PMID- 6841929 TI - Reliability and validity of five mental health scales in older persons. AB - Five scales were assessed as mental health measures for older persons: Affect Balance, The Center for Epidemiological Studies Depression Scale, General Well Being, LSI-Z Life Satisfaction, and Trait-Anxiety Inventory. These scales were administered to a community sample of 279 older persons and a clinical sample of 109 older persons who were in psychiatric inpatient units. In both samples, the internal consistency reliabilities for the anxiety, depression, and well-being scales were moderately high to high, for the life satisfaction scale they were acceptable, but the reliabilities for the affect balance scale suggest some caution in its use. For validity, multivariate analyses of variance found that all scales significantly discriminated between the two samples. The well-being and then depression scales were the strongest discriminators while the life satisfaction scale had the weakest validity. Cutting points for the well-being and depression scales are suggested for estimating the proportions of older persons who would be probable at-risk for disorder that requires intervention. PMID- 6841930 TI - The relative impact of age and attractiveness stereotypes on persuasion. AB - The relative impact of the old-age and attractiveness stereotypes on persuasion was investigated. College students read essays that contained either cogent or specious arguments that were attributed either to young or old, socially attractive or unattractive authors. Evaluations of the essay itself were affected only by the quality of the arguments presented. Argument quality and attractiveness interacted to determine perceptions of the author and opinions on the position advocated in the essay: attractive authors were rated higher and were more persuasive than unattractive authors when the essay was strong, but were derogated and unpersuasive relative to unattractive authors when the essay was weak. Age of the author had an impact only on a few of the author-evaluation scales. A hierarchy of stereotype potency in which social attractiveness is prepotent over age is offered tentatively. PMID- 6841931 TI - Validation of a Caregiver Strain Index. AB - This paper outlines the development of a Caregiver Strain Index (CSI) with a sample of spouses, family, friends, and neighbors, aged 22 to 83, who provided varying degrees of care to recently hospitalized hip surgery and heart patients aged 65 and over. Internal consistency (Cronbach's alpha) for the 13-item CSI on 81 cases was .86. Evidence of construct validity was obtained in three areas: ex patient characteristics; subjective perceptions of the care-taking relationship by caregivers; and emotional health of caregivers. These results indicate that the CSI is a brief, easily administered instrument which identified strain within our sample of informal care providers. Further development of the CSI is being undertaken for predicting specific caregiver populations at risk. This simple index might be usefully included in any interview or assessment package that examines intergenerational relations involving dependency and care. PMID- 6841932 TI - Aging and perceived health status. AB - Using a probability sample of 660 adults in Illinois, this study focuses on the relationship between age and perceived health status. According to age stratification theory, age groups need to be analyzed as age-specific entities that exist in relation to other sets of age groups. Following this perspective these data examine differences across the spectrum of adult age groups in this sample in regard to self-assessments of health. Number of symptoms was the strongest predictor of perceived health status employed in this analysis, followed by age, education, and race. It was found that those persons belonging to age groups over the age of 60 tend to perceive their own health in a significantly more positive fashion than members of younger adult age groups. The more educated elderly persons and those with the fewest symptoms, however, were most likely to hold this perception. One important area in which people appear to adjust their perception in later life is in their evaluation of personal health status. PMID- 6841933 TI - Perceived health, life satisfaction, and activity in urban elderly: a controlled study of the impact of part-time work. AB - To determine whether part-time employment affects the perceived health, life satisfaction and activity of urban retirees, 25 experimental and 30 control subjects were selected randomly from a pool of 98 elderly applicants in a demonstration employment program for retirees. Program participants were hired to perform park maintenance and beautification work for 20 hours per week. Structured interviews conducted at the end of the 6-month program revealed significant, positive effects of paid employment on measures of perceived health and life satisfaction. Only one of the control subjects had found alternative part-time employment 6 months following randomization. These findings suggest that the provision of optional, paid employment opportunities can have demonstrably positive effects upon the well-being of retirees. PMID- 6841934 TI - A job club for older job seekers: an experimental evaluation. AB - Labor market trends and expert opinion have recently highlighted the existence of an "older worker problem" that will require policy and programmatic remedies. This study details the findings of a longitudinal field experiment on the effectiveness of a promising behavioral/self-help job-finding program --the job club. Employment service clients (N = 46) were randomly assigned to receive the job club program or normally available (control) services. Twelve week follow-up data revealed a 74% employment rate for job club participants versus 22% for controls. Both groups obtained comparable placements. Study findings indicate the job club is an effective employment service for older job seekers. PMID- 6841935 TI - Retrospective life span analysis: a method for studying extreme old age. AB - To seek information about people who were born last century, an attempt was made to locate the total population of eligible age in a particular Australian suburb (Toowong, Brisbane). Three-hundred-and-forty people of this age cohort were located by a doorknock survey in 1978-1979, and tape recorded interviews exploring their life histories and present circumstances were obtained from 204 people. These were transcribed and coded for computer analysis of structural and temporal dimensions. In this paper sources of bias arising from variable interview situations and from the interaction between individual respondents and their interviewers are discussed. It is recommended that further research regarding this rapidly increasing segment of modern populations should take place along similar lines. PMID- 6841936 TI - Sleep disorders. PMID- 6841937 TI - Invisible hand or fatherly hand? Problems of paternalism in the New Perspective on health. AB - This article examines the charge that the "New Perspective" on health (as exemplified by the Lalonde Report in Canada, by Prevention and Health in the United Kingdom) represents an abandonment of liberal principles in favor of a collectivist and paternalistic role for the state. It looks first at the problems confronting modern health policy, and at the reasoning behind the New Perspective's approach. It then explores whether and how the charge of paternalism applies to that approach, and just what such a charge implies. The article concludes with a discussion of the "liberal paternalist" viewpoint towards health policy, a viewpoint that combines respect for individual liberty with an interest in taking effective public action to improve the health status of modern populations. PMID- 6841938 TI - Corporate health benefits and the indexing of the personal income tax. AB - This note focuses on the role of the personal income tax in reducing the effective price of health care benefits. Tax-bracket creep is shown to provide a cushion that absorbs relatively large increases in health benefit costs, thus reducing the impetus for employer initiatives to control health care costs. It is hypothesized that the Economic Recovery Tax Act of 1981, with its provision for the indexing of tax brackets, will increase employer concern, and may therefore spur the development of effective employer initiatives to reduce the costs of health benefits. PMID- 6841939 TI - Tax-deductible alcohol: an issue of public health policy and prevention strategy. AB - In 1982 U.S. businesses will spend over $10 billion (12 percent of the total retail alcohol market) on alcoholic beverages which will be consumed by top executives, professionals, and other white-collar employees in a variety of business and personal settings. The Internal Revenue Service, through a series of vaguely defined tax deduction categories, permits these expenditures to be deducted from corporate and individual taxes as "ordinary and necessary" to the conduct of business, costing U.S. taxpayers between $3 and $5 billion annually in lost tax receipts. This article examines the scope and legal underpinnings of the IRS tax expenditure policy; its impact on drinking habits and drinking problems among the nation's business and professional elite; the arguments for permitting the subsidization of corporate drinking habits; reform measures that are available to policymakers; and the barriers to effective implementation. PMID- 6841940 TI - Structural determinants of union activity in hospitals. AB - This study uses national data from the American Hospital Association and the National Labor Relations Board in a multivariate framework to assess the impact of various structural factors on union activity in hospitals. The theoretical framework includes both management and union perspectives in evaluating (1) whether the hospital had a signed collective-bargaining contract in 1980; (2) whether a union election had been held; and (3) whether the union won the election. The results indicate that certain structural characteristics (hospital size, ownership, teaching status, and location) have had a significant impact on union activity in hospitals, while other characteristics (third-party reimbursement and area factors) have not. The results also show that prospective reimbursement has a positive impact on union activity. PMID- 6841941 TI - Can the diagnosis of irritable bowel syndrome be improved by rectosigmoid motility studies? PMID- 6841942 TI - Is discrimination between type A and B atrophic gastritis clinically useful in achlorhydria? AB - We tested the validity of the concept that chronic atrophic gastritis can be subdivided into type A and B in hospital patients and normal subjects with proven pentagastrin-refractory achlorhydria. Classification was based on the determination of the basal serum gastrin and parietal cell antibodies. Of 59 hospital patients with achlorhydria, 71% could be classified as belonging to either type A or B; for 29% the criteria for neither type were fulfilled. Of 14 asymptomatic persons with achlorhydria found in 564 normal persons, five could be classified as having type A gastritis, and one as type B gastritis. In eight (53%) persons, an elevated serum gastrin was found in the absence of parietal cell antibodies, representing an intermediate type of atrophic gastritis. Because one-third of the hospital patients and more than half the persons with achlorhydria in a normal population had to be classified as belonging to an intermediate type, the discrimination between type A and B atrophic gastritis in achlorhydria seems to be of limited practical value. PMID- 6841943 TI - The effect of a gastrin-receptor antagonist on gastric acid secretion and serum gastrin in the Zollinger-Ellison syndrome. AB - We studied the effect of intravenous administration of a gastrin-receptor antagonist (proglumide) on gastric acid secretion and serum gastrin in three patients with Zollinger-Ellison syndrome. Proglumide administered as a bolus injection (50 mg/kg) or as an infusion (50 mg/kg hour and 100 mg/kg hour) or as a combination of bolus injection and infusion (50 mg/kg I.V. followed by 50 mg/kg hour) inhibited gastric acid secretion by 13-62%. Cimetidine (2 mg/kg I.V. followed by 2 mg/kg hour) inhibited gastric acid secretion by 83-86%. Neither proglumide nor cimetidine significantly influenced serum gastrin concentrations. We conclude that proglumide is a relatively weak inhibitor of gastric acid secretion in patients with the Zollinger-Ellison syndrome. PMID- 6841944 TI - Endoscopic prognosis in gastric cancer. AB - Sixty-eight patients with gastric adenocarcinoma underwent upper gastrointestinal endoscopy from 1968 to 1975. Tumors were divided into two categories according to their gross characteristics at endoscopy (mass-ulcer or infiltrative), to try to correlate gross morphology and stage at presentation with survival. The median survival in the mass-ulcer group was 31 months, in the infiltrative group, 4.7 months. Mucosal biopsies were positive in 88% of the mass-ulcer group and in 64% of the infiltrative group. Ninety-four percent of patients with infiltrative lesions had stage III or IV disease (regional lymphatic or distant metastasis) at the time of diagnosis, compared to only 55% of the mass-ulcer patients. Endoscopic features consistent with an infiltrating tumor suggest an advanced stage of tumor with a poor prognosis. PMID- 6841945 TI - Influence of age on the clinical presentation of acute biliary tract disease. AB - The influence of age on the presenting manifestation of acute biliary tract disease was evaluated by retrospective review of all cases in which this diagnosis was confirmed at operation over a 30-month period. Results indicated that acute biliary tract diseases in elderly patients presents in a manner not statistically significantly different from younger patients (p greater than 0.05 for all parameters studied). Although such disorders in the elderly occasionally present in an unusual fashion, the majority of older patients present with abnormalities such as pain, jaundice, fever, and leukocytosis as commonly or even more frequently than younger patients. PMID- 6841946 TI - Anomalous pancreatic ducts causing "pseudomass" of the pancreas. AB - Computerized axial tomography (CT scan) of the abdomen is a sensitive method for examining the pancreas. Its sensitivity, however, may lead to the discovery of small mass lesions which do not represent neoplastic or inflammatory lesions. We describe our experience with 21 patients in whom mass lesions seen by CT scan were proven by endoscopic retrograde pancreatography (ERCP) to represent anomalies of the pancreatic duct. We call such lesions "pseudomasses." Our findings support the need for opacification of the pancreatic duct system to rule out lesions arising from the duct whenever lesions of the pancreas are suspected on CT scan. PMID- 6841947 TI - Pressures in the sphincter of Oddi in patients with gallstones, common duct stones, and recurrent pancreatitis. AB - To determine the significance of manometric pressure, measurements of the sphincter of Oddi in a control group and in patients with cholelithiasis with common duct stones with and without recurrent pancreatitis were studied. Sphincter of Oddi pressure was recorded continuously and by station pull-through by a triple lumen catheter. The basal sphincter of Oddi pressure, the mean pressure gradient between common duct and duodenum, and the sphincter of Oddi wave amplitude were measured. There was no significant difference between control subjects and patients with gallstones and common duct stones. In patients with common duct stones and recurrent pancreatitis the basal sphincter of Oddi pressure, the pressure gradient between common duct and duodenum, and the wave amplitude were significantly increased over control patients. These studies suggest that abnormalities in the sphincter of Oddi motor function are more common in patients with common duct stones with recurrent pancreatitis than in similar patients without pancreatitis. PMID- 6841948 TI - Primary and adjuvant radiation therapy in gallbladder and extrahepatic biliary tract carcinoma. AB - The natural history and pathways by which carcinomas of the gallbladder and extrahepatic bile ducts spread after attempted curative surgery offer a rationale for postoperative radiation therapy. We review: 1) the increasing use of primary curative radiation therapy for these cancers, along with 2) the early results of innovative intraoperative irradiation and the transluminal insertion of radioactive sources into transhepatic catheters, 3) the efficacy of irradiation for metastases to the portahepatis, and 4) the overall effects of irradiation on the gallbladder and extrahepatic biliary system. PMID- 6841949 TI - Nonhealing duodenal ulceration due to candida. AB - An important role for candida in gastric and duodenal ulcer disease is being increasingly recognized. Causative factors implicated include the frequent use of cimetidine, and immunosuppressive or antibiotic therapy. Concerning cimetidine, there is no clear-cut evidence that the drug depresses cell mediated immunity; on the contrary, there is evidence that delayed hypersensitivity is enhanced. Acid reduction is the alternate and more likely explanation for any role of cimetidine in gastric and duodenal candidiasis. We report a patient with a duodenal ulcer, which repeatedly bled and failed to heal in hospital on standard antacid and cimetidine therapy. Candida was identified in the ulcer and treated, using mycostatin suspension, resulting in complete healing. We feel that candida involvement of duodenal ulcers may be more common than is generally recognized, and may be the cause for nonhealing in certain patients already on optimum therapy. PMID- 6841950 TI - Necrotizing granulomatous gastritis and gastric perforation of unknown etiology: a first case report. AB - A unique case of granulomatous gastritis of unknown etiology is reported. The patient, a 43-year-old Haitian woman, suffered a gastric perforation from a disease process limited to the stomach. The stomach was markedly enlarged and edematous with transmural, serpiginous granulomatous tracks throughout the gastric wall, but most numerous in the fundic region. Accompanying acute and chronic inflammatory infiltrates were scant. No microorganisms, parasites, foreign body particles, or other known granulogenic materials could be identified. Clinical and pathologic features also differed markedly from granulomatous gastritis seen in sarcoidosis, Crohn's disease, or isolated granulomatous gastritis as defined by Fahmi et al. Infection by a parasite for which man is not the definitive host seems the most likely etiology. PMID- 6841951 TI - Gastrin-producing ovarian mucinous cystadenoma. AB - We report a patient with abdominal pain, diarrhea, and edema of the small intestine all of which disappeared after resection of an ovarian mucinous cystadenoma of borderline malignancy. Preoperatively, the serum gastrin level was high and it decreased to normal afterwards; subsequent immunohistochemical studies of the tumor revealed cytoplasmic hormone granules containing gastrin like immunoreactivity. We believe that the symptoms in our patient were the result of an ectopic ovarian gastrin-producing tumor. PMID- 6841952 TI - Quadruple cancer in a columnar-lined (Barrett) esophagus. AB - In a 28-year-old man with a long history of esophageal reflux, two polypoid lesions in a columnar-lined (Barrett) esophagus proved to be adenopapillary cancer. Despite extensive preoperative endoscopic evaluation, no other malignant foci were found until after complete postoperative dissection of the esophageal specimen, when two more small flat lesions were diagnosed as adenocarcinoma. Dysplastic changes of specialized columnar epithelium and junctional epithelium were mild, except around the tumors. In the preoperative assessment of patients with a columnar-lined esophagus, physicians should be aware of the possibility of multifocal development of tumors either exophytic or superficial spreading, and multiple biopsies should be taken from normal-looking areas. PMID- 6841953 TI - Toxic shock syndrome presenting as postoperative diarrhea in a postmenopausal woman. AB - Three days after laminectomy, toxic shock syndrome (TSS) presented as acute diarrhea, rash, and fever in a 62-year-old postmenopausal woman. Forty-eight hours later, the full syndrome of TSS developed. Exploration of a benign appearing wound revealed an occult Staphylococcus aureus infection. This report and literature review underscore the need to consider TSS in the differential diagnosis of acute diarrhea regardless of age, sex, race, and menstrual status, particularly when there has been recent soft tissue infection, injury, or surgery of any type. PMID- 6841954 TI - Recurrent pneumoperitoneum after hysterectomy. AB - In most instances, patients with an acute abdomen and pneumoperitoneum have a perforated hollow viscus as the underlying cause. Clinicians must not forget, however, some of the less common causes of free air in the abdomen. We describe pneumoperitoneum from a vaginoperitoneal fistula, developing after hysterectomy, well known to gynecologists, but rarely noted in the medical literature. PMID- 6841955 TI - Hepatic portal venous gas: a benign finding in a patient with ulcerative colitis. AB - Hepatic portal vein gas (HPVG) usually occurs in conjunction with an abdominal catastrophe such as bowel infarction or necrotizing enterocolitis. We describe this finding after air contrast barium enema in a patient with stable chronic ulcerative colitis who had no symptoms, morbidity, or sequelae, and discuss the diagnostic and therapeutic implications of HPVG. PMID- 6841956 TI - Observations on the effect of anthelmintic treatment on the transmission of Hyostrongylus rubidus and Oesophagostomum spp. among sows at pasture. AB - The transmission of Hyostrongylus rubidus and Oesophagostomum spp. following anthelmintic treatment was studied over a period of two years in a herd of sows kept out-of-doors on a commercial farm in south-eastern England. The sows were moved on to a clean pasture each autumn and at the same time were treated with an anthelmintic. The treatment was repeated six months later when the faecal worm egg count was rising. Contamination of the pasture with worm eggs was both light and intermittent. The pasture herbage remained free of infective larvae until the early summer; subsequently the herbage became lightly infected with larvae so that transmission of the parasites was possible, but limited. The level of infection on the herbage was much lower than was seen in earlier observations when the more commonly used system of treating groups of sows at different times of the year, in between farrowings, was used. PMID- 6841957 TI - Role of oesophageal glands in the digestive physiology of two rumen amphistomes Orthocoelium scoliocoelium and Paramphistomum cervi. AB - Histochemical techniques have been used to study the chemical composition of the oesophageal gland secretions of Orthocoelium scoliocoelium and Paramphistomum cervi. Results suggest that the secretions contain numerous enzymes, e.g., non specific alkaline and acid phosphatases, ATPase, TPPase, esterase (Cathepsin C like), beta-galactosidase, beta-glucuronidase and N-acetyl-beta-glucosaminidase. The role of these enzymes in the digestion of food in these amphistomes is discussed. On the basis of histological and histochemical studies the caecal epithelium of the two amphistomes has been found to be syncytial bearing regularly arranged numerous, long but equal-sized and closely packed cylindrical microvilli. The role of various hydrolytic enzymes in well fed and starved flukes in relation to their gastrodermis and microvilli has also been discussed. PMID- 6841959 TI - Immunity to Schistosoma incognitum in mice by previous exposure to S. spindale. PMID- 6841958 TI - Comparative activity of anticestode drugs--praziquantel, niclosamide and Compound 77-6, against Hymenolepis nana. AB - The activity, in terms of speed of action, of three anticestode drugs against Hymenolepis nana, both in vivo and in vitro, was investigated. Praziquantel was most effective in vivo, but had little action on adult worms and cysticercoids in vitro. Niclosamide, the least effective in vivo, was highly toxic in vitro. Compound 77-6 killed adult worms and cysticercoids in vitro in 10 min and 15 min respectively at 1000 micrograms/ml of drug concentration, but its in vivo effect was intermediate between that of praziquantel and niclosamide. PMID- 6841960 TI - Histochemical localization of esterases in Avitellina lahorea Woodland, 1927 (Cestoda: Anoplocephalida). AB - Specific and non-specific esterases have been localized in sections and whole mounts of Avitellina lahorea, an intestinal parasite of sheep and goats. Non specific esterases (NSE) were found in the sucker muscles, post-acetabular ganglia, nerve trunks, tegument, excretory canals, cirrus sac, vagina, uterus and the inner membrane of the embryophore. Acetylcholinesterase (AChE) was observed in all the above organs, including vas deferens and sperm ducts, but was absent from excretory canals and eggs. Tests with acetylthiocholine iodide (AThChI) revealed the nervous system, vas deferens, sperm ducts, uterus, cirrus sac and the vagina. The intensity of activity of AChE and AThChI was weak compared to NSE. PMID- 6841961 TI - In vitro tapeworm extract-induced proliferative responses of gut-associated lymphoid cells from Hymenolepis diminuta infected mice. AB - The development of lymphoid cells reactive to tapeworm-associated antigens during the course of Hymenolepis diminuta rejection from mice was studied using an in vitro tapeworm extract (TWE)-induced cell proliferation culture system. Mice infected with three cysticercoids on day 0 developed three adult worms by day 7 but worms were rejected by day 21 post-infection. Concomitant with worm rejection was the development of TWE-sensitized lymphoid cells which responded by proliferation when stimulated in vitro with TWE. Sensitized cells were detected in gut-associated mesenteric lymph nodes but were not detected in spleen, axillary lymph nodes, or Peyer's patches of infected mice, or in lymphoid organs of non-infected mice. These studies suggest that rejection of H. diminuta from mice is associated with the activities of gut-associated, tapeworm antigen sensitized immune cells localized in the mesenteric lymph nodes. PMID- 6841962 TI - Moniezia expansa: the interproglottidal glands and their secretions. AB - Acetylcholinesterase (EC 3:1:1:7) and alkaline phosphatase (EC 3:1:3:1) were detected in secretions of Moniezia expansa maintained in vitro. Ultrastructural cytochemical studies demonstrated acetylcholinesterase activity on the surface of the microtriches at the base of the interproglittidal glands and in the gland lumen but not in the distal tegument or the gland cells. Alkaline phosphatase activity was demonstrated in the cytoplasm of the gland cells and especially in their protoplasmic connections with the distal tegument. Activity was also found in the distal tegument and the microtriches. It is suggested that the acetylcholinesterase secreted by M. expansa performs a metabolic role at the worm's surface. PMID- 6841963 TI - Amino-acids of Amoebotaenia cuneata (Cestoda: Dilepidoidea Wardle McLeod & Radinovsky, 1974). PMID- 6841964 TI - Hyperspiny Purkinje cell, a new neurological mutation in the mouse. AB - Hyperspiny Purkinje cell (hpc) is a new autosomal recessive mutation of the laboratory mouse. Homozygotes exhibit abnormal motor behavior, with predominance of cerebellar symptoms, about 10 days after birth. Morphological analysis disclosed a slightly reduced cerebellum with selective alteration of Purkinje cells. All these neurons have an atrophic dendritic tree. The proximal dendritic branches and the cell bodies, instead of being smooth, are studded with spines. Most of the axon terminals belonging to this neuronal population undergo progressive degenerative changes. Cell death is observed in only a small proportion of Purkinje cells. Electrophysiological study revealed that the synapses between climbing fibers and Purkinje cells are functional with no gross abnormality. PMID- 6841965 TI - Hemolytic anemia in the mouse. Report of a new mutation and clarification of its genetics. AB - A new mutation causing spherocytic, hemolytic anemia has been discovered in the house mouse. It is inherited as a single autosomal recessive gene, allelic with both sph and ha, which, in turn, were shown to be allelic with each other. A revised nomenclature for the three apparent alleles is proposed: sph (formerly sph), sphha (formerly ha), and sph2Bc (the new mutation). Like the other murine hemolytic anemias, sph2Bc involves a defect in the red blood cell membrane protein, spectrin. PMID- 6841966 TI - Genetic study of norepinephrine in brains of mice selected for differences in blood pressure. AB - Norepinephrine concentration of the whole brain was found to be statistically different between the HBP and LBP mouse stains that had been selectively bred for high and low systolic blood pressure, respectively. Crosses between these strains resulted in statistically different NE levels between the reciprocal F1 males and the genetical analysis revealed a significant sex-linked factor or factors. Dissection of the brain into eight regions and subsequent biochemical analyses revealed statistically higher NE content in the LBP compared to the HBP for midbrain and cerebellum. Midbrain NE was also significantly different between the reciprocal F1's. NE concentration was then related to known behavioral characteristics in these strains. PMID- 6841967 TI - Ultrastructural localization of phenothiazines and tetracycline: a new histochemical approach. AB - To provide high resolution information on the subcellular localization of the phenothiazines and tetracycline, we have developed a new histochemical method that circumvents the difficulties inherent in classical electron microscopic tissue preparatory procedures. Specific and reliable localizations of these drugs were accomplished by their rapid precipitation with phosphotungstic acid (PTA) at pH 7. A cell suspension of Ehrlich ascites carcinoma cells was incubated with a given drug (2.5 x 10(-4) M) and then briefly cross-linked with 1% glutaraldehyde at 4 degrees C. After washing, the cells were exposed to 2% PTA (pH 7) to precipitate the drug at its binding sites. Then the samples were rapidly dehydrates in 80% ethylene glycol (4 degrees C) and embedded in the polyester, Vestopal W. This protocol provides a low denaturation, low extraction approach to tissue preparation. Control samples (without drug) demonstrated an amorphous distribution of PTA throughout the cell and no specific dense precipitates. Those cells treated with the phenothiazines (chlorpromazine or fluphenazine) or tetracycline demonstrated very discrete (4-8 nm), electron-dense drug-PTA reaction products associated with different nuclear components as well as several cytoplasmic organelles. These subcellular localizations verify the binding sites reported by the biochemical literature. In addition, several previously unresolvable binding sites are reported. The rationale and limitations of this procedure are presented. This new histochemical methodology may have broad applications in the study of drug distribution, receptors, and drug-induced pathology and toxicity that may provide new information regarding drug action and design. PMID- 6841968 TI - Membrane-integrated proteins at preformed exocytosis sites. AB - Parameters tetraurelia cells were used for analyzing the crucial but also controversial question regarding the organization of those sites of the cell membrane that undergo fusion during exocytosis. Paramecia are unique in that they display a "rosette" of from eight to ten MIPs (Membrane-intercalated particles, as seen on freeze-fracture replicas) at each of their numerous preformed exocytosis sites. We analyzed these structures by exposing slightly fixed cells to various enzymes and by subsequent freeze fracturing. We show that "rosette" MIPs are selectively sensitive to proteolytic enzymes. Since "rosettes" are known to be necessary for membrane fusion, this cytochemical result would be in line with the assumption that membrane-integrated proteins may play an active role in regulating exocytotic membrane fusion. PMID- 6841969 TI - Alkaline phosphatase biosynthesis in the endoplasmic reticulum and its transport through the Golgi apparatus to the plasma membrane: cytochemical evidence. AB - Enzyme induction of HeLa cell placental alkaline phosphatase with various agents such as prednisolone, sodium butyrate, hyperosmolality (NaCl), or combination of these inducers resulted in the appearance of enzyme activity in the rough endoplasmic reticulum, nuclear envelope, Golgi apparatus, and plasma membrane. In the Golgi apparatus, intense reaction product deposits tended to be concentrated on its trans side, with small vesicles and granules also being positively stained. Inhibition of protein synthesis with cycloheximide was followed by the disappearance of enzyme activity from these cytoplasmic organelles but not from the plasma membrane. Treatment with monensin, a secretory protein transport inhibitor, uniformly increased activity in the rough endoplasmic reticulum while causing marked dilatation of the intensely positive Golgi cisternae. These results suggest that intracellular alkaline phosphatase is newly synthesized in the endoplasmic reticulum and then passes en route through the Golgi apparatus to the plasma membrane. Accordingly, the present system could represent the biosynthesis, transport, and incorporation of the model cell surface enzyme protein to add to the vesicular stomatitus virus glyco-1 (VSV-G) protein and acetylcholine receptor model systems for studying the dynamics of cell surface protein genesis, transport, and membrane integration. PMID- 6841970 TI - Effect of monensin on secretory pathway in GH3 prolactin cells. A cytochemical study. AB - The effects of the carboxylic ionophore monensin have been studied on a rat prolactin cell line (GH3 cells) under basal conditions or after acute stimulation by thyrotropin-releasing hormone (TRH). It was found that 1) monensin induces a rapid dilatation of Golgi elements in these endocrine cells; 2) secretory product, prolactin, is localized by electron microscope immunocytochemistry attached to the inner face of the membrane of these dilated vacuoles; 3) monensin induces preferentially a dilatation of the cis face of the Golgi zone, since the "GERL" complex identified by acid phosphate cytochemistry is disorganized or fragmented rather than vacuolized; and 4) monensin decreases strongly the basal release of prolactin in the culture medium but does not prevent the stimulating effect of TRH on this release. This suggests that monensin blocks preferentially the pathway of release of secretory product under basal conditions in GH3 cells but that another pathway less sensitive to monensin is involved under acute stimulation by TRH. PMID- 6841971 TI - Laminin in cultured mouse C1300 neuroblastoma cells: immunocytochemical localization by pre- and postembedding electron microscope procedures. AB - Laminin was localized in cultured mouse C1300 neuroblastoma cells by applying the peroxidase-antiperoxidase technique in preembedding electron microscopy. The results were compared to those obtained by indirect immunofluorescence and by the colloidal gold second antibody method on Epon-embedded ultrathin sections. Laminin was found in the cell membranes and within the rough endoplasmic reticulum as well as in intracytoplasmic vacuoles. Plasma membranes of the neuroblastoma cells showed a patchy localization of laminin that was apparently involved in cell-to-substrate attachment and in gap junction-like intercellular connections. Under normal conditions, the Golgi cisternae contained no laminin. Pretreatment of cells with micromolar concentrations of monensin, however, lead to an accumulation of laminin within the Golgi cisternae. These results support a role for laminin as an adhesion protein in cultured neuroblastoma cells and indicate that laminin is transported through the Golgi complex. PMID- 6841972 TI - Pericellular matrix of growth plate chondrocytes: a study using postfixation with osmium-ferrocyanide. AB - The pericellular matrix surrounding chondrocytes from all zones of epiphyseal growth plate cartilage, as well as from articular, tracheal, and auricular cartilage, was examined using a number of variations of osmium ferrocyanide postfixation of aldehyde-fixed tissues. Comparisons were made with other fixative techniques, including ruthenium red, safranin O, and lanthanum nitrate, all of which have previously been reported to stabilize a variety of lacunar matrix components. An electron-dense material was preserved uniquely by osmium ferrocyanide in the lacunar matrix of mid and late zone hypertrophying chondrocytes and was absent from all other zones of the growth plate as well as from the other types of cartilage examined. Because of its highly restricted distribution, this electron-dense material is hypothesized to represent a pericellular matrix component involved with either matrix calcification or metaphyseal capillary penetration. Several hypotheses are presented as to its specific composition. PMID- 6841973 TI - Tritium autoradiography of cell surfaces in smear preparations. AB - Experiments were performed in order to find out whether tritium-labeled cell surface markers can be quantified at the single cell level in autoradiographs of smear preparations. Mouse thymocytes were incubated with 3H-concanavalin A and subsequently spread on microscopic slides. The spreading techniques, either by cytocentrifugation or by the use of cover slips, were performed in such a way as to achieve preparations in which the mean flatness of the cells varied. By means of incident light microphotometry, the cellular areas and the grain counts of individual cells were determined. The results show a strong dependence of the mean grain yield per slide on the mean cellular area. Cytocentrifuge preparations resulted in larger mean cellular areas and higher mean grain counts than cover slip preparations. With the use of cytocentrifugation, however, the differences in the flatness of the cells were of such a magnitude that a reproducible quantification of 3H-labeled cell surface markers was not possible. Conventional techniques of spreading cells on slides failed to provide a degree of flatness that could approach the saturation grain count per cell without completely destroying the cellular morphology. PMID- 6841974 TI - Dye interactions. A basis for specific detection and histochemistry of polysaccharides. AB - Specific histochemical staining can be related to specific interactions of dyes and polysaccharides in solution. Specificity evidently depends upon polysaccharide conformation and the need for a close "fit" between polysaccharide and ligand. As a consequence, microscopic identification of cereal beta-(1 leads to 4)(1 leads to 3)-D-glucan and beta-(1 leads to 3)-D-glucan is possible, and is demonstrated. PMID- 6841975 TI - Immuno-identification of plasma proteins in hepatocytes. PMID- 6841976 TI - Direct visual detection of protein antigen: importance of surface concentration. AB - A new type of commercially available substrate was used for visualization of antigen binding to antibodies immobilized on the substrate surface. Addition of antigen induced sufficient increase of the protein layer to allow direct visualization, provided that the antibodies immobilized at the surface were immunosorbent isolated. This finding shows the importance of the surface concentration for direct optical visualization of antigen. The results are discussed in relation to previous reports that it is not possible to visualize directly the binding of protein antigen to surface-immobilized antibodies. PMID- 6841977 TI - Separation of mouse lymphoblasts by discontinuous density centrifugation on Percoll gradients. AB - Mouse lymphoblasts generated in vivo by a topical application of the contact sensitizer oxazolone or by the contents of the gut lumen were separated by discontinuous density centrifugation on Percoll gradients. A 3-step gradient was used to divide the cells into two subpopulations. For cells from oxazolone stimulated lymph nodes, the low density band contained 20-30% of the initial cell number applied to the gradient; 25-40% of this population were in S phase and nearly all the large and pyroninophilic cells were confined to this layer. The high density step cells (70-80% of initial cell number) were predominantly small lymphocytes with less than 0.5% in S phase. Similar results were obtained using cells from picryl chloride stimulated lymph nodes or from mesenteric lymph nodes. PMID- 6841978 TI - A hemolytic assay for clinical investigation of human C2. AB - The heat lability of early acting components of human complement was studied in detail. Kinetic disappearance of individual components was monitored by hemolytic assay. C2 and factor B were the most heat labile components. We took advantage of the difference in heat stability between C2 and C1 to develop a hemolytic assay for human C2. PMID- 6841979 TI - Immunoglobulin allotypes in aboriginal populations of the Taimir Peninsula. AB - Serum blood samples from 563 of the total 700 Nganasans, members of the isolate in the northern-most part of Siberia were tested for G1m (z,a,x,f), G2m (n), G3m (g,b0,b1,b3,b5,s,t), and Km (1) allotypic determinants. Additionally, 78 Yenisey Samoyeds (Entsi) who are the Nganasan's western neighbours were studied. Both populations are remarkable for high frequency of 'Northern Oriental' Gm (za;..;b0b3b5st) which appears to be the most frequent haplotype in the Nganasans (0 . 486), and is the second frequent in Yenisey Samoyeds (0 . 276). The Gm (f;b) generalized haplotype which used to be considered as an indicator of Caucasian gene flow occurred in the Nganasans in the very low frequency of 0 . 008, versus 0 . 045 revealed in adjoining Yenisey Samoyeds. Both populations also differ in the frequency of Km1 which is two times lower in the Nganasans (0 . 048), than in Yenisey Samoyeds (0 . 103). When segregation ratios for the Gm locus were inspected in 67 Nganasan families, no apparent deviations from Mendelian expectations, and no recombinant phenotypes were observed. PMID- 6841980 TI - Evidence for the existence of a diverse family of immunoglobulin-related recognition molecules. AB - All classes of molecule postulated to play a role in recognition or to have some structural homology to immunoglobulins were compared by the S delta Q index of differences in amino acid composition. The results suggest that there is a wide family of immunoglobulin-related molecules that includes vertebrate immunoglobulins, T cell receptors, MHC products, C-reactive proteins, and (some) invertebrate lectins. PMID- 6841981 TI - HLA and reproduction? AB - In mice it has been shown that mating preference is genetically associated with the Major Histocompatibility Complex (MHC). In the present study, an approach is described to study homologous aspects of the MHC in man. After selection of families with one or more children, a given parental HLA antigen was selected and the frequencies of the spouse's HLA antigens were determined. Assuming a random distribution, these frequencies should not be statistically different from those of the total population. Evidence is presented that this distribution is not random for a number of maternal and paternal HLA antigens. PMID- 6841982 TI - Monoclonal anti-B produced by the immunization of mice with soluble salivary glycoproteins. AB - IgM and IgG mouse monoclonal antibodies with specificity for the blood group B determinant have been produced by immunization of mice with a partially purified salivary glycoprotein. These antibodies have been characterized and one of the IgM antibodies showed potential as a grouping reagent. The ready availability of these salivary blood group substances offers the potential to produce a wide range of related monoclonal antibodies. PMID- 6841983 TI - Ovarian defect in rats carrying the growth and reproduction complex. AB - The growth and reproduction complex contains recessive genes (grc) which influence body weight and gonadal development. Homozygous males are sterile, and they have an arrest of spermatogenesis at the primary spermatocyte stage. Homozygous females are fertile but have a reduced reproductive capacity. The data presented in this paper show that the latter defect is associated with a decrease in the relative number of secondary ovarian follicles and an increase in the number of atretic follicles. This finding indicates that most of the primary follicles do not mature properly. Thus, the genetic defect in gametogenesis controlled by the grc appears to occur at the same stage of development in both females and males. PMID- 6841984 TI - C6 linkage studies. PMID- 6841985 TI - [Role of radiotherapy in the treatment of bladder cancer. Comments apropos of 178 cases]. AB - In the light of their experience involving 178 patients suffering from carcinoma of the bladder and a study of the literature, the authors attempt to determine the role of radiotherapy in the treatment of carcinoma of the bladder. A number of points emerge: --the possibility of stopping the progression of a recurrent multifocal superficial malignant tumour by 2 flashes of 6.5 Gy; --the efficacy of curative doses of radiotherapy associated with transurethral resection of the tumour in 20% of cases. These figures rise to 50% in anaplastic carcinomas. 20% efficacy of radiotherapy alone without surgery is a high figure. It tends to restore the radiotherapy sensitivity test suggested by R. Couvelaire to its true value; --when combined with excision surgery (partial cystectomy or total prostato-cystectomy), high doses of radiation do not give a better result than limited radiation. In view of the gravity of radiotherapy complications which may occur in up to 20% of cases where high doses of radiation have been administered, the authors would be inclined to limit radiotherapy when treatment of the tumour must be mixed, with surgery. A preoperative flash of 6.5 Gy followed by postoperative radiotherapy up to a total of 45 Gy when partial cystectomy is used. When a decision is made to perform cutaneous implantation of the ureters, the technique should consist of concentrated radiotherapy of 20 Gy in one week followed by excision by total prostato-cystectomy the next week. When urinary bypass is to involve uretero-colonic implantation or bladder replacement, flash radiotherapy of 6.5 Gy once or twice. No additional postoperative radiotherapy. Sandwich radiotherapy is too dangerous. PMID- 6841986 TI - [Peroperative ultrasound echotomography of the kidney]. AB - The authors report their experience of seeking calyceal lithiasis and venous neoplastic spread in carcinomas of the kidney by peroperative echotomography. The reliability of the method was excellent since it led to exact localisation of residual stones in 10 cases out of 11 with a definition of the order of a millimetre. A simple and effective method, echotomography should be of great value in lithiasis surgery. Ultrasound is also of value in surgery for carcinoma of the kidney, both for verification of the state of venous flow as well as investigation of the quality of the remaining parenchyma following conservative surgery. PMID- 6841987 TI - [Tomodensitometry in the diagnosis of perinephritic phlegmon]. AB - Twenty-nine patients with perinephric abscess were treated during the last 15 years. Twenty-seven abscesses were cured by drainage performed as soon as the diagnosis has been made. One patient died from septicemia in spite of the treatment. One patient died because the correct diagnosis was not revealed until the autopsy. Ten patients had a nephrectomy performed on them later on. Staphylococcus and gram negative bacilli were equally isolated. Stones were present in twenty patients. Eleven patients were diabetic. The clinical picture is not always clear, and diagnosis might be difficult. The different radiological signs help to reach a correct and prompt diagnosis. To these classical signs we can add during these last years Gallium-67 radionuclide studies, ultrasound and computerized tomography, each of these having its indication and usefulness. PMID- 6841988 TI - [Accidental urethral rupture during coitus]. AB - Emergency surgery in three cases of accidental urethral rupture during coitus involved suture of the tunica albuginea corpus cavernosum and immediate repair of the urethra under cover of a urethral guide and a cystostomy. The three perfect results obtained, with normal micturition and more particularly normal erections, together with data from reports in the published literature, strongly suggest the need for urgent repair of traumatic lesions of the corpora cavernosae during coitus. The possibility of a urethral rupture makes urgent operation even more essential, before the patient urinates, to avoid transformation of a traumatic hematoma into a urohematoma. PMID- 6841989 TI - [Inverted urothelial papilloma]. AB - Three cases of inverted urothelial papilloma are reported. In one case this lesion, commonly considered as benign, was associated with a transitional cell carcinoma. In an other case inverted papilloma presented histological features of a malignant tumor. The possibility of common etiologic factors of inverted papilloma and other urothelial tumors, explaining their association, is discussed. Considering these results, patients with inverted papilloma must be carefully followed in the same way as patients with low grade urothelial tumors. PMID- 6841990 TI - [Importance of tomodensitometry in the diagnosis of retroperitoneal tumors]. AB - 3 patients are presented who were admitted with the suspected urographic diagnosis of a "retroperitoneal tumor". A battery of additional investigations had not led to a definite diagnosis in the patients with an aortic aneurysm, a large dermoid cyst and a small bowel sarcoma infiltrating into the retroperitoneum. Among the 3 cases, only the dermoid cyst, could not be recognized angiographically. CT, however, provided the correct diagnosis in all 3 patients. Only one additional barium study in a patient with a small bowel sarcoma was necessary for further confirmation of the diagnosis. PMID- 6841991 TI - [Bifid ureter with a blind branch. A propos of a case]. PMID- 6841992 TI - [Eosinophilic cystitis]. AB - The author reports a case of severe disturbance of micturition due to a cystitis in a 17 years old adolescent. As no cause was found, a biopsy was taken by endoscopy which revealed an inflammatory process involving the full thickness of the bladder wall with a great many eosinophils. The particular interest of this case presentation resides in the effectiveness of the immuno-suppressive treatment. Three tablets of Imuran for six weeks led to the cure of this patient. The authors review the literature of this rarely published condition. They classify it into the broader group of interstitial cystitis. The authors cite their case as an argument in favour of the auto-immune origin of these interstitial cystitis. The effectiveness of immuno-suppressive therapy is the best proof. PMID- 6841993 TI - Larvicidal activity of Bacillus thuringiensis subsp. israelensis, serovar H14 in Aedes aegypti: histopathological studies. PMID- 6841994 TI - Studies on the prolonged storage of Metarhizium anisopliae conidia: effect of temperature and relative humidity on conidial viability and virulence against mosquitoes. PMID- 6841995 TI - Effect of formulation on the viability of Metarhizium anisopliae conidia. PMID- 6841996 TI - Studies on the prolonged storage of Metarhizium anisopliae conidia: effect of growth substrate on conidial survival and virulence against mosquitoes. PMID- 6841997 TI - Studies on histamine metabolism in mastocytosis. AB - The urinary excretion of histamine and its main metabolite, 1-methyl-4 imidazoleacetic acid (MeImAA), was determined in 30 adult patients with the clinical diagnosis of urticaria pigmentosa (UP). Clinical and laboratory investigations including skin histology, bone marrow examination, and scintigraphy of the skeleton, liver, and spleen revealed systemic manifestations in 14 cases. Among the 16 cases with dermal proliferation of mast cells only 3 cases classified as telangiectasia macularis eruptiva perstans (TMEP). All patients with systemic mastocytosis and UP excreted increased amounts of MeImAA in the urine while normal amounts were found in 2 of the patients with TMEP. A significant correlation existed between MeImAA excretion and the extent of mast cell infiltration in skin and internal organs. No such correlation was found for urinary histamine. Urinary MeImAA but not histamine is therefore considered a useful indicator of systemic involvement by reflecting the size of the mast cell histamine pool. The main symptom of the patients was pruritus, which was moderate to severe in 17 and mild or absent in 13 cases. Gastrointestinal symptoms were present in 14 patients. However, there was no obvious correlation between the excretion of MeImAA and any of the symptoms recorded. Neither was the severity of pruritus correlated to the histamine content of the skin, which was measured in both lesional and unaffected skin in 23 of the patients. Thus, symptoms possibly caused by histamine in mastocytosis patients are not directly related to urinary histamine metabolite excretion or tissue histamine content. PMID- 6841998 TI - Effect of varying dose of UV radiation on mammalian skin: simulation of decreasing stratospheric ozone. AB - To better understand the dependence of the incidence of squamous cell carcinoma on changes in solar spectral distribution and dose regimen, we exposed SK-1 hairless mice to solar-simulating radiation (290-400 nm). Selective UV filtration was accomplished by passing this radiation through Schott WG-320 cutoff filters of 0, 0.5, 1.0, 2.0, and 3.0 mm thickness. Minimal erythema doses (MED) were determined for each filter combination. Starting with 0.5 and with 0.9 MED, groups of 20 mice were irradiated 5 days per week; this was increased by 20% increments (of the original dose) every 6th day for 40 days ("0.5 MED" and "0.9 MED" experimental groups, respectively). Other groups of mice were irradiated with the same incremental increases, starting at 6.5 J/cm2 ("equal dose" regimen). The salient results were: (1) shorter wavelength components appear to preferentially produce tumors; (2) resultant observable dose-response behavior for each regimen is a complicated function of concurrent "light" and "dark" reactions; (3) time-dose reciprocity is absent; and (4) there are no straightforward relationships among tumor efficiency, dose fractionation, and spectral distribution of excitation radiation. These results indicate that photocarcinogenesis is a dynamic process, in which events that result in tumor growth compete with those that cause tumor regression. PMID- 6841999 TI - In vivo spectrophotometric evaluation of normal, lesional, and laser-treated skin in patients with port-wine stains. AB - The influence of patient age and argon laser therapy on port-wine stains (PWS) was studied quantitatively in 16 patients aged 15-64 years using a spectrophotometer and computer graphics/statistics program. Normalized reflectance curves revealed a 10-20% decrease with age in the reflectance of normal skin from 400 nm to 650 nm, with an even more pronounced reflectance decrease in the region of peak deoxyhemoglobin absorption at approximately 555 nm. In each patient, PWS reflectance was less than that in the normal skin, as expected, and the average discrepancy increased with age from approximately 25% to 50%, with further reduction at 555 nm. The data suggest that with advancing age, both normal skin and PWS have a greater total hemoglobin content and an increased proportion of deoxyhemoglobin, consistent with increasing vascular dilation and tortuosity; and that the age-associated changes in PWS are an exaggeration of those in normal skin. Laser-treated PWS in both young and old patients had reflectance curves indistinguishable from those of untreated PWS in young patients. This implies, contrary to published clinical impressions, that in the absence of scarring the results of argon laser therapy are the same in young and old patients, but that only older patients experience a significant color shift in the lesion. PMID- 6842000 TI - Localization of melanoma-associated antigen p97 in cultured human melanoma, as visualized by light and electron microscopy. AB - The expression of a human melanoma-associated antigen, p97, in cultured melanoma cells was investigated using a modification of the Sternberger peroxidase antiperoxidase (PAP) technique. Explant cultures of two skin melanomas were found to consist of a mixture of cells, some positive and some negative, for the expression of p97. From two other melanomas two cell lines were newly established. All cells from these lines expressed detectable p97 over a period up to 18 months. With the cell lines and the explant cultures we have initiated an investigation of the expression of p97 at the ultrastructural level, using the PAP technique. Antigen expression was detected as a continuous, strongly stained band at the cell surface of the melanoma cells. PMID- 6842001 TI - Antimicrobial prophylaxis against infection in neutropenic patients. PMID- 6842002 TI - Selective antimicrobial modulation of the intestinal flora of patients with acute nonlymphocytic leukemia: a double-blind, placebo-controlled study. AB - Thirty-three patients with acute nonlymphocytic leukemia were studied during remission-induction treatment in a double-blind, placebo-controlled, randomized study to ascertain the effect on the incidence of infection of an oral regimen of selective antimicrobial modulation (SAM). A decrease in the number of major acquired infections was observed: three infections occurred in 16 patients receiving the SAM regimen compared with eight infections in 17 patients given the placebo. The reduction of infection was correlated with a reduction of fever, with a reduction of the frequency of administration of antimicrobial agents for the treatment of infection, and with the selective elimination of aerobic and facultative anaerobic gram-negative rods from the digestive tract. Substantial unfavorable side effects were not observed. PMID- 6842003 TI - Selective antimicrobial modulation as prophylaxis against infection during granulocytopenia: trimethoprim-sulfamethoxazole vs. nalidixic acid. AB - Sixty-two profoundly granulocytopenic patients with acute leukemia undergoing induction chemotherapy were prospectively randomized to receive either trimethoprim-sulfamethoxazole plus nystatin or nalidixic acid plus nystatin for prevention of infection. Patients given trimethoprim-sulfamethoxazole plus nystatin during initial remission induction experienced an increased duration (22.6 vs. 13.6 days) of profound granulocytopenia (less than 100 granulocytes/mm3; P = 0.007). Acquisition of gram-negative bacilli was more frequent among patients treated with nalidixic acid plus nystatin while filamentous fungi were acquired more frequently by patients receiving trimethoprim-sulfamethoxazole plus nystatin (P = 0.05). The median duration of on study time prior to documentation of first infection was longer for patients receiving trimethoprim-sulfamethoxazole plus nystatin (17 days) than for those receiving nalidixic acid plus nystatin (eight days) (P = 0.0002). Three infection related deaths occurred among patients receiving nalidixic acid; seven occurred among patients receiving trimethoprim-sulfamethoxazole, five of which were secondary to pneumonia due to Aspergillus flavus. Both of these methods of selective antimicrobial modulation have apparent advantages, but each has disadvantages serious enough to limit their routine use. PMID- 6842004 TI - Nosocomial infection and death in a neonatal intensive care unit. AB - Based on five years of prospective surveillance in a neonatal intensive care unit (NICU), the association of nosocomial infection with death during hospitalization was studied. Low birth weight and patent ductus arteriosus (PDA) were the variables most strongly associated with nosocomial infection. After stratification for these variables, there was a persistent association between nosocomial infection and increased risk of death (relative risk = 1.96; 95% confidence interval, 1.09-4.44; P = 0.03). The relative risk of mortality with nosocomial infection was significantly modified (P = 0.02) by the presence of PDA (relative risk = 3.42; 95% confidence interval, 1.68-6.95 for infants without PDA; no effect for infants with PDA). Relocation of the NICU to an improved, better-staffed facility was associated with a significant decrease in the adjusted nosocomial infection rate (relative risk [old NICU/new NICU] = 9.73; 95% confidence interval, 4.30-22.0). This improvement was accompanied by a statistically insignificant reduction in the overall mortality because other causes of death, such as low birth weight and serious underlying disease, are much more common in this population and thus are more important determinants of outcome. PMID- 6842005 TI - A controlled study of genital mycoplasmas in amniotic fluid from patients with intra-amniotic infection. AB - Amniotic fluid (AF) was collected via a transcervical, intrauterine catheter from 52 patients with clinical intra-amniotic infection (IAI) and from 52 matched, uninfected controls. The AF was cultured for Mycoplasma hominis and Ureaplasma urealyticum as well as for aerobic and anaerobic bacteria. Eighteen (35%) patients with IAI and four (8%) controls had M. hominis in AF (P less than 0.001). Twenty-six (50%) patients with IAI and 26 (50%) control patients had U. urealyticum in AF (difference not significant). In the AF specimens of patients with IAI, 15 (83%) of the 18 with M. hominis also contained greater than or equal to 10(2) colony-forming units (cfu) of a high-virulence bacterial isolate/ml (P less than 0.05). Within the limitations of the experimental design, U. urealyticum in AF is not associated with clinical IAI, whereas, with qualitative cultures, M. hominis in AF is. However, in IAI, M. hominis is isolated most commonly from the AF of patients with greater than or equal to 10(2) cfu of a high-virulence bacterial isolate/ml. PMID- 6842006 TI - Polio-like motor paralysis associated with acute hemorrhagic conjunctivitis in an outbreak in 1981 in Bombay, India: clinical and serologic studies. AB - High and rising neutralizing antibody titers (NATs) to enterovirus type 70 (EV70) were detected in the serum and cerebrospinal fluid (CSF) of patients with polio like motor paralysis accompanying acute hemorrhagic conjunctivitis (AHC) in an outbreak of AHC in 1981 in Bombay, India. Fifty-four (88.5%) of 61 patients with AHC with or without neurologic disease had serum NATs of greater than or equal to 1:16, and some paired sera from these patients showed significant increases in NAT. Serum from noninfected control subjects had no significant neutralizing antibody to EV70. Thirty-six (94.7%) of 38 CSF specimens from 30 patients with spinal or a combination of spinal and cranial motor paralysis associated with AHC had NATs ranging from 1:2 to 1:256. No neutralizing antibody was found in CSF specimens from patients with AHC alone or in those from non-infected control subjects, and a reduced ratio of serum NAT to CSF NAT was detected in patients with neurologic disease. Therefore, it is highly likely that intrathecal synthesis of antibody occurred in response to direct invasion of the central nervous system by EV70. The results represent strong laboratory evidence of the neurovirulence of EV70. PMID- 6842007 TI - Measles mortality, state of nutrition, and family structure: a community study from Guinea-Bissau. AB - In an urban area of Guinea-Bissau where the general state of nutrition seemed fairly good, the case fatality rate for measles among children less than three years of age who were examined clinically during an epidemic was 25.0%. Nutritional indicators (weight-for-age, height-for-age, and weight-for-height ratios) measured a few months before the epidemic were about equal both for the group of 60 children who subsequently died of measles and for the general child population. Because no community study has demonstrated that the nutritional state influences the outcome of measles, the assumed importance of the state of nutrition for measles fatality rates is questioned. Children in monogamous households had a lower risk of dying of measles. It is suggested that measles may be more severe in polygamous families because several children can have the disease simultaneously. PMID- 6842008 TI - Stimulation of particle-induced chemiluminescence in human polymorphonuclear leukocytes by staphylococcal alpha toxin. AB - Staphylococcal alpha toxin is known to be involved in the pathogenicity of Staphylococcus aureus, although the mode of action is not clearly understood. In the present investigation the interaction of alpha toxin with human polymorphonuclear leukocytes (PMNLs) has been followed in vitro by measuring the ability of these cells to trigger a chemiluminescence response in the presence and absence of active phagocytosis. The alpha toxin does not stimulate chemiluminescence when added to nonphagocytizing PMNLs. At low concentrations alpha toxin stimulates chemiluminescence of PMNLs actively phagocytizing opsonized staphylococci. The increased chemiluminescence has two phases, one being immediate and short lived and the other delayed and longer lasting. These responses are dose-related and suggest an action of alpha toxin on the plasma membrane of PMNLs. PMID- 6842009 TI - Antagonism of toxigenic Clostridium difficile by nontoxigenic C. difficile. AB - Cefoxitin-treated hamsters were first colonized with a nontoxigenic strain of Clostridium difficile, and then a toxigenic strain of C. difficile was administered. Toxigenic C. difficile was suppressed to a mean cecal population level of less than 0.2% of that found in control animals given only toxigenic C. difficile after cefoxitin treatment. Colonization with nontoxigenic C. difficile before toxigenic C. difficile was associated with 93% survival, as opposed to 21% survival of the control animals. Simultaneous administration of nontoxigenic and toxigenic C. difficile did not lead to suppression of toxigenic C. difficile and conferred no protection. These results are in keeping with previously established concepts of bacterial interactions on body surfaces and may have therapeutic implications. PMID- 6842010 TI - Comparison of bacterial isolation, cytotoxicity assay, and counterimmunoelectrophoresis for the detection of Clostridium difficile and its toxin. PMID- 6842011 TI - Failure of antisera to thermostable direct hemolysin and cholera enterotoxin to prevent accumulation of fluid caused by Vibrio parahaemolyticus. PMID- 6842012 TI - Quantitating functional capacity of mature and immature (nonsegmented) neutrophils. PMID- 6842013 TI - "Alice in Wonderland" syndrome in a patient with infectious mononucleosis. PMID- 6842014 TI - The pet hamster as a potential reservoir of human campylobacteriosis. PMID- 6842015 TI - Toxic effects of amphotericin B methyl ester. PMID- 6842016 TI - Cheese made from raw milk. PMID- 6842017 TI - Immunologic aspects of otitis media with effusion. II. Nature of cell-mediated immunosuppressive activity in middle ear fluid. AB - The effects of middle ear effusions from patients with serous, seromucoid, mucoid, and purulent forms of otitis media with effusion on lymphoproliferative responses and polyclonal immunoglobulin synthesis were determined in peripheral blood and adenoidal lymphocytes. The responses were studied after stimulation of lymphocytes by phytohemagglutinin, pokeweed mitogen, purified protein derivative, herpes simplex virus, sheep red blood cells, or ovalbumin. Serous and seromucoid middle ear effusions resulted in significant suppression of proliferative responses to phytohemagglutinin, purified protein derivative, and herpes simplex virus and of polyclonal immunoglobulin synthesis in response to pokeweed mitogen, sheep red blood cells, and ovalbumin. The suppressive activity appeared to be associated with low-molecular-weight soluble products liberated by esterase positive adherent population of cells in middle ear fluid. PMID- 6842018 TI - Studies on the role of Ureaplasma urealyticum and Mycoplasma hominis in prostatitis. AB - It has definitely been demonstrated that Ureaplasma urealyticum is one etiologic agent of nongonococcal urethritis, a sexually transmitted disease. For this reason it seemed possible that the organisms might cause ascending inflammatory reactions of the prostate. Quantitative determinations of ureaplasmas and Mycoplasma hominis, together with localization studies, were therefore performed to elucidate the importance of these microorganisms in patients with chronic prostatitis. U. urealyticum was found in high numbers in expressed prostatic secretions and urine voided after prostatic massage from 82 (13.7%) of 597 patients with chronic prostatitis. Because numbers of ureaplasmas in first-voided urine and midstream urine were significantly lower, the source of the organisms in these patients was assumed to be the prostate. These data and the results of tetracycline treatment provide sufficient evidence for the etiologic importance of ureaplasmas in chronic prostatitis. PMID- 6842019 TI - Serologic study of two clusters of infection due to Campylobacter jejuni. AB - The serologic responses to Campylobacter jejuni in persons involved in two clusters of infection and in control subjects were studied. In the first cluster, in which previously unexposed persons drank raw milk, the attack rate was high and elevated complement-fixing (CF) and specific IgG and IgM antibodies were demonstrated. In the second cluster, involving farmers who chronically drank raw milk, the attack rate was low, but titers of CF and IgG antibodies were high in both affected and unaffected persons. At a control dairy farm, where raw milk was drunk regularly, asymptomatic infection and high CF titers were demonstrated. In contrast to the findings in the first cluster, the titers of IgM antibody among the dairy farmers were low. These studies suggest that chronic exposure to C. jejuni may lead to immunity that may possibly be mediated by IgG. PMID- 6842020 TI - Three-step stool examination for cryptosporidiosis in 10 homosexual men with protracted watery diarrhea. AB - Cryptosporidiosis, a zoonosis caused by Cryptosporidium species, is a newly recognized coccidial protozoan infection causing severe protracted watery diarrhea in humans. In August 1981, the first case of cryptosporidiosis in a homosexual man with acquired immune deficiency syndrome (AIDS) was reported; diagnosis was determined by intestinal biopsy. It is necessary to adopt a simple laboratory diagnostic procedure to screen large numbers of suspected cases. A three-step stool examination was developed to demonstrate Cryptosporidium oocysts and the diagnostic and infective stages of the infection in 10 homosexual men with AIDS. This is a less invasive, less costly, and more sensitive test than intestinal biopsy and has been designed to prevent confusion caused by yeast cells that are frequently present in stool, leading to a false diagnosis. The examination consists of preliminary differential determination by iodine wet mount, definitive identification by modified Kinyoun acid-fast staining, and a more effective method of concentrating oocysts, by Sheather's sugar cover-slip flotation method. PMID- 6842021 TI - The role of the flagellum in the adherence of Vibrio cholerae. AB - The role of the flagellar structure in the in vitro adherence and in vivo colonization of Vibrio cholerae was studied by comparing the behavior of pairs of related motility variants. Although the presence of the flagellum seemed essential for in vitro attachment, the property of motility was neither necessary nor sufficient. Since it was possible to demonstrate independently both motility and binding capacities associated with this structure, it was concluded that the flagellum functions as the carrier of the moieties that promote adherence. Studies using the infant mouse cholera model unequivocally demonstrated the in vivo significance of a functional flagellum and suggested that this structure enhances virulence by facilitating the initial colonization of the small bowel. PMID- 6842022 TI - The specificity of Vibrio cholerae adherence and the significance of the slime agglutinin as a second mediator of in vitro attachment. AB - The aim of the present studies was to clarify Vibrio cholerae adherence by elucidating the basis for the apparently variable nature of in vitro attachment. An examination of the purported specificity of vibrio adherence did not support the concept of host receptor structures; organisms selected for their capacity to adhere to inert substrates simultaneously acquired the capacity to bind to intestinal tissue in vitro. Further investigation of the bacterial factors involved in adherence confirmed the in vitro significance of the slime agglutinin, although this moiety appeared to have no pathogenic relevance. The conflicting descriptions of V. cholerae attachment are discussed in terms of the nature of the factor responsible for binding in each system. PMID- 6842023 TI - Ocular and systemic complications of diethylcarbamazine therapy for onchocerciasis: association with circulating immune complexes. AB - Diethylcarbamazine (DEC) therapy for Onchocerca volvulus infection results in frequent ocular and systemic complications, but the pathogenesis of these complications is unclear. Twenty men with O. volvulus infection were treated over a period of six months with DEC given daily for one week and weekly thereafter. Major systemic and ocular complications included proteinuria, severe pruritus, visual field constriction, optic nerve pallor, chorioretinitis, anterior uveitis, and punctate keratitis. Levels of circulating immune complexes (CICs) were increased (greater than 11% [125I]C1q binding) in 14 of the 20 men prior to treatment. Persons with pretreatment C1q binding activity of greater than 30% were at increased risk to develop constriction of visual fields (P less than 0.05) and proteinuria (P less than 0.015). Linear regression analysis revealed a striking correlation between pretreatment levels of CICs and the total number of both systemic and ocular complications (P less than 0.001) and ocular complications alone (P less than 0.005). These results suggest that CICs may be important in the pathogenesis of the delayed systemic and ocular complications following DEC therapy for O. volvulus infection. PMID- 6842024 TI - Pathophysiology and immunology of the Jarisch-Herxheimer-like reaction in louse borne relapsing fever: comparison of tetracycline and slow-release penicillin. AB - Twelve men with louse-borne relapsing fever were treated with single doses of procaine penicillin plus aluminum monostearate (PAM) intramuscularly or of tetracycline intravenously. All patients experienced a definite Jarisch Herxheimer-like reaction. Fever and spirochetemia were significantly prolonged and peak temperature was lower and occurred later in the PAM-treated group. Peak pulmonary ventilation, metabolic rate, and arterial PO2 were significantly higher in the tetracycline-treated group. Circulatory changes were similar in the two groups but were prolonged in the PAM-treated patients. Thus, tetracycline is recommended for treatment because it is more rapidly effective in eliminating Borrelia spirochetes and produces a reaction no more stressful physiologically than the one after PAM. There was no evidence of complement activation, and there was no change in immunoglobulin levels throughout the reaction. Immune complexes were detected in serum of five patients before treatment, but in fewer patients at the peak of the reaction and subsequently. PMID- 6842025 TI - Impact of dosing intervals on activity of gentamicin and ticarcillin against Pseudomonas aeruginosa in granulocytopenic mice. AB - The influence of dosing intervals on the activity of gentamicin and ticarcillin against Pseudomonas aeruginosa was studied in vivo. Granulocytopenic mice infected with P. aeruginosa in the thigh muscle were treated with 1-hr or 3-hr injections of gentamicin, ticarcillin, or gentamicin-ticarcillin. Plasma pharmacokinetics of the drugs were correlated with antibacterial activity. Gentamicin injected every 1 hr tended to be less active than gentamicin injected at longer intervals. In contrast, ticarcillin given every 1 hr was significantly more efficacious than equivalent total doses injected every 3 hr. The dosing schedule of gentamicin-ticarcillin was again important for ticarcillin but did not appreciably affect the antibacterial activity of gentamicin. Thus, antimicrobial chemotherapy of P. aeruginosa infections in the granulocytopenic host might be improved by administering ticarcillin rather than gentamicin as a constant infusion. PMID- 6842026 TI - In vivo antiviral activity of recombinant type alpha interferon A in monkeys with infections due to simian varicella virus. AB - Recombinant type alpha interferon A (rIFN-alpha-A) administered to African green monkeys (Cercopithecus aethiops) intramuscularly in a dose of 3 X 10(6) units/kg of body weight resulted in substantial blood levels of interferon. Peak levels of greater than 1,000 units/ml of serum appeared at 1 and 2 hr after inoculation and interferon was detectable for as long as 12 hr after inoculation. Injection of rIFN-alpha-A at a dose of 10(6) units/kg twice daily for eight days effectively inhibited simian varicella virus infection of the African green monkey. Antiviral activity was demonstrated in monkeys with prophylactic treatment begun 4 hr prior to virus inoculation or with therapeutic treatment deferred until 44 hr after virus inoculation. No adverse effects of treatment were observed. PMID- 6842028 TI - Does the risk of tuberculosis increase in old age? PMID- 6842027 TI - Treatment and prophylaxis of disseminated infection due to Candida albicans in mice with liposome-encapsulated amphotericin B. AB - The toxicology of liposome-encapsulated amphotericin B in mice and its efficacy in the treatment and prophylaxis of systemic candidiasis in these animals were studied. The toxicology studies indicated that the maximal tolerated dose of free amphotericin B was 0.8 mg/kg of body weight and the 50% lethal dose (LD50) was reached at 1.2 mg/kg, while neither the maximal tolerated dose nor the LD50 for the liposomal amphotericin B was reached at a dose of 12 mg/kg. No abnormalities in blood chemistry or histology were observed in the animals injected with encapsulated amphotericin B, while the administration of free amphotericin B was associated with nephrocalcinosis and renal parenchymal edema. The encapsulated drug was as effective as the free drug when used in similar concentrations, while the animals treated with higher concentrations of liposomal amphotericin B (4 mg/kg) had a longer survival time. Thus, an improved therapeutic index resulted by encapsulating amphotericin B in liposomes. PMID- 6842029 TI - Effects of human alveolar macrophages and peripheral blood monocytes on Toxoplasma gondii. PMID- 6842030 TI - Agglutinin directed against Bordetella pertussis in a Chicago population. PMID- 6842031 TI - Bacteriuria and hematuria in infections due to Schistosoma haematobium. PMID- 6842032 TI - Cryptogenic liver abscess due to Listeria monocytogenes. PMID- 6842033 TI - Toxinogenic vaginal infections due to Staphylococcus aureus in menstruating rhesus monkeys without toxic-shock syndrome. PMID- 6842034 TI - Incidence of plasmid DNA in strains of Campylobacter jejuni isolated from stool specimens at 37 C and 43 C. PMID- 6842035 TI - Basic emergency medical care--proposed legislation. PMID- 6842036 TI - Toxic megacolon. PMID- 6842037 TI - Use of Schedule II controlled substances in Iowa--1977 to 1981. PMID- 6842038 TI - Modulation of natural killer activity by aspirin: I. In vitro effect of aspirin. AB - It has been previously shown that the Natural Killer (NK) cell activity of peripheral blood mononuclear cells (NMC) from healthy donors can be augmented by in vitro coculture of MNC with melanoma cells. This augmentation was not seen when the blood donors had taken acetylsalicylic acid (ASA) 12 h before venipuncture. To examine the direct action of ASA on the NK cell activity we treated MNC in vitro by ASA and tested the cytotoxic activity on NK-sensitive target cells. Neither the spontaneous NK cell activity nor the in vitro stimulation of NK cell activity by beta-interferon (IFN) was influenced by ASA treatment in vitro. PMID- 6842039 TI - Compatibility of P-IF interferon with an implantable pump. PMID- 6842040 TI - Concerted evolution of human interferon alpha genes. AB - Multiple interferon (IFN) alpha genes characterize divergent animal species, yet human interferon alpha (HuIFN-alpha) genes are closely related in nucleotide sequence. Either the IFN-alpha genes derived from common ancestor sequences after divergence of these animals, or the HuIFN-alpha genes that have been studied underwent concerted evolution. Evidence suggesting that concerted evolution did occur to some unknown extent raises doubts about the important conclusion of recent divergence of the HuIFN-alpha gene family. PMID- 6842041 TI - [A simple washer for plastic microcentrifuge tubes and micropipette tips]. PMID- 6842042 TI - Benign biliary strictures. Nonoperative dilatation with balloon catheter. PMID- 6842043 TI - Congenital heart disease. Recent advances in surgical management. PMID- 6842044 TI - Depression in children. Effects of antidepressant therapy. PMID- 6842045 TI - Ureteral calculus extraction. A non-surgical percutaneous approach. PMID- 6842046 TI - Colorectal carcinoma. The role of radiation therapy. PMID- 6842047 TI - Breast cancer screening. Evaluation of Kansas program data. PMID- 6842048 TI - The great imposter. Munchausen's syndrome and other factitious disease. PMID- 6842049 TI - This way out: the physician's role in life and death. PMID- 6842050 TI - Women physicians. The career/family dilemma. PMID- 6842051 TI - Hypertrophic pulmonary osteoarthropathy and pachydermoperiostosis. PMID- 6842052 TI - Barbiturate-augmented neurointensive care of intracranial hypertension in meningitis. PMID- 6842053 TI - Biliary tract infections. PMID- 6842055 TI - Practice management. PMID- 6842054 TI - The dignity of the patient. PMID- 6842056 TI - Aminoglutethimide and dexamethasone therapy (medical adrenalectomy) for metastatic breast carcinoma. PMID- 6842057 TI - A new systolic murmur in acute myocardial infarction. PMID- 6842058 TI - Glossopharyngeal neuralgia with syncope. PMID- 6842059 TI - Fulminant hepatic failure. PMID- 6842060 TI - Surgical management of tumors of the middle ear and mastoid. AB - The author has presented the two most common tumors of the ear, cancer of the ear and glomus tumors. Most experience has been with extensive carcinomas involving the temporal bone and indeed the author has treated 132 cases with cancer of the ear, of which 105 cases were resectable. The total experience yielded a cure rate of 28 per cent. The best management program should entail an en bloc resection of the temporal bone followed by post-operative radiation therapy. Glomus tumors are generally benign and when confined to the middle ear present no surgical problem. However, when extension occurs into the jugular bulb region and into the jugular vein, the surgery becomes more formidable and the extent of the tumor should be established before surgery. Wide surgical exposure should avoid entering into the tumor prematurely and thereby compromising a total resection. Advanced extension of the tumor intracranially mandates a combined neurosurgical and otolaryngological approach. Radiotherapy, while not destroying the glomus tumor, will shrink down the size of the tumor by causing thrombosis in its blood vessels and subsequent fibrosis of the tumor itself. The management of each tumor should be individualized according to its size, location, and the general status and age of the patient. PMID- 6842061 TI - The management of tumours of the middle ear. AB - On the basis of a small number of cases, the majority of which were advanced, it would seem that extended surgery has a very definite place in the management of advanced glomus jugulare tumours, but very little place in the management of cancer of the middle ear with obvious signs of spread to adjacent parts. PMID- 6842062 TI - Surgical salvage of radiation failures in cancer of the larynx. PMID- 6842063 TI - Hemangiopericytoma of the nasal cavity: electron-optic study and clinical correlations. AB - A case of a hemangiopericytoma of the nasal cavity in a 79-year-old woman is presented. Ultrastructural examination confirmed the pericytic origin of the tumor. Most of the reported hemangiopericytomas of the sinonasal tract are histologically low-grade and their biologic course is in concert with their appearance. PMID- 6842064 TI - The unilateral thick-walled antrum. A previously unrecognized entity? PMID- 6842065 TI - Benign and malignant pseudothyroiditis. AB - Benign and malignant lesions of the thyroid gland and its adjacent structures may present clinical, biochemical and radio-active scan features resembling subacute thyroiditis. An irregular clinical course, unexpected laboratory findings and unresponsiveness to medical treatment may indicate the true nature of the disease. Whenever a subacute or chronic thyroid inflammatory process is diagnosed, the possibility of benign or malignant lesions of the thyroid or of the surrounding organs should be kept in mind. If doubt is raised, further investigations should be carried out if indicated including exploratory surgery. PMID- 6842066 TI - Cholesterol granuloma in a thyroglossal duct cyst. A case report. AB - A case of cholesterol granuloma (CG) in a thyroglossal duct cyst is presented. The main pathogenic theories of this entity are described. It is suggested that chronic or recurrent infection and inflammation may play the major part in the pathogenesis of CG. PMID- 6842067 TI - Spontaneous emphysema of the neck. AB - A case of spontaneous emphysema in the neck in a 17-year-old male was reported. Pathogenesis and management are discussed. Although it is a benign and self limiting condition, it may carry a potential for serious complications. PMID- 6842068 TI - Spelling error profiles of able and disabled readers. PMID- 6842069 TI - The speech of hyperactive children and their mothers: comparison with normal children and stimulant drug effects. PMID- 6842070 TI - Toward a behavioral model of academic remediation with learning disabled children. PMID- 6842071 TI - A day in the resource room with a minicomputer. PMID- 6842072 TI - The loneliness of the special education teacher. PMID- 6842073 TI - Giving permission. PMID- 6842074 TI - The aggressive, severely behavior disordered child. PMID- 6842075 TI - Reading disabilities: can we blame the written language? PMID- 6842076 TI - Once is not enough. PMID- 6842077 TI - The method of repeated readings: expanding the neurological impress method for use with disabled readers. PMID- 6842078 TI - Special education and medicine: a survey of physicians. PMID- 6842079 TI - Cognitive development and cognitive style. PMID- 6842080 TI - Adipose tissue cellularity and histochemistry in fetal swine as affected by genetic selection for high or low backfat. AB - Adipose tissue development was studied histochemically and histologically in fetuses from lean and obese sows. At 110 days of gestation, fetuses were removed from Ossabaw (obese-feral) sows and from sows selected for high backfat (obese domestic) and for low backfat (lean) thickness. Body weights were similar for lean (916 +/- 225 g) and obese (822 +/- 167 g) domestic fetuses, whereas obese feral fetuses were smaller (631 +/- 70 g). Histological and histochemical analysis was conducted on subcutaneous tissue from over the shoulder. Staining for lipid-containing fat cells indicated similar concentrations of fat cells throughout the depth of the subcutaneous tissue from obese (domestic and feral) and lean fetuses. Adipocytes from obese fetuses were slightly larger (domestic 23 +/- 0.22 microns, feral 21.8 +/- 0.26 microns) than cells from lean fetuses (20.7 +/- 0.42 microns). The percentage glycogen positive (PAS) adipocytes was low and similar from all three fetal strains. Less than 10% of adipocytes from lean and obese domestic fetuses were esterase-positive, whereas 42% of adipocytes from obese feral fetuses were esterase-positive. All adipocytes from obese fetuses (domestic and feral) were lipoprotein lipase (LPL)-positive whereas all cells from lean fetuses were negative for LPL activity. Therefore, cellular and metabolic differences exist in adipose tissue of lean and obese pigs during the prenatal period of growth and development. PMID- 6842081 TI - Movement of lipolytic products to mitochondria in brown adipose tissue of young rats: an electron microscope study. AB - Lipolysis occurred and lamellar structures with a periodicity of 40 A developed in glutaraldehyde-fixed brown adipose tissue of suckling rats when the tissue was incubated at 25 degrees C. The lamellar structures were found in capillaries, associated with chylomicrons, in intracellular channels of capillary endothelium, in extracellular space, and in channels near lipid droplets in adipocytes in tissue of fed rats injected intravenously with chylomicrons. They were also found in channels near mitochondria and inside mitochondria in adipocytes in incubated fixed tissue of rats exposed to 4 degrees C for 2 hr or unsuckled overnight. In addition, aqueous spaces developed adjacent to lipid droplets in incubated tissue of cold-exposed and unsuckled rats. Development of lamellar structures under conditions causing lipolysis and accumulation of fatty acids in fixed tissue indicated the lamellae were composed primarily of fatty acids. We conclude that fatty acids formed by lipolysis of chylomicrons in tissue from fed rats accumulated in a continuum of the outer leaflets of cell membranes extending from capillary lumen to lipid droplets of adipocytes, and fatty acids formed by lipolysis of intracellular lipid in tissue from cold-exposed or unsuckled rats accumulated mostly in a continuum extending from lipid droplets to the interior of mitochondria. When fatty acids overcrowded the continuum in fixed tissue, they formed lamellar extensions of the continuum at different sites along its course through the tissue. PMID- 6842082 TI - Interaction of serum lipoproteins with the intestine. Evidence for specific high density lipoprotein-binding sites on isolated rat intestinal mucosal cells. AB - To determine if plasma lipoproteins interact and therefore possibly regulate intestinal lipoprotein metabolism, we investigated the binding, internalization, and degradation of 125I-labeled low density lipoprotein (LDL) and high density lipoprotein (HDL) by enzyme-dispersed rat intestinal mucosal cells. Both human and rat LDL and HDL were bound, internalized, and degraded in a concentration dependent manner with calculated half-saturation occurring at approximately 30, 35, 35, and 15 micrograms/ml for human LDL, rat LDL, human HDL, and rat HDL, respectively. Isolated brush border membranes had no saturable or specific binding sites for 125I-labeled HDL or LDL, suggesting that lipoproteins may be bound to receptors on lateral or basal membranes of mucosal cells. Compared with HDL, LDL binding was characterized by a large non-specific component. LDL of human and the rat were not only displaced by excess LDL but at least as effectively by excess HDL of their own species. Labeled HDL was displaced by corresponding unlabeled lipoproteins, but human LDL could produce only minor displacement of human HDL3. ApoE-deficient rat HDL, separated by heparin Sepharose affinity chromatography also showed highly specific saturable binding to intestinal cells. Thus, apparently two different lipoprotein binding sites exist in intestinal plasma membranes, one recognizing B and/or E apoproteins present in human and rat LDL and rat HDL while another binds human HDL3 and apoE deficient rat HDL which contain A apoproteins as major components. PMID- 6842083 TI - Differential absorption of exogenous and endogenous cholesterol in man. AB - Cholesterol absorption was measured in six patients by a triple-lumen intubation technique: 1) to determine whether isotopic exchange between radiolabeled lumenal cholesterol and unlabeled mucosal cholesterol occurs during cholesterol absorption measurements, and 2) to differentiate the rates of absorption of endogenous cholesterol ([1,2-3H]cholesterol marker given intravenously 6 weeks prior to the tests), exogenous cholesterol ([4-14C]cholesterol marker infused into the proximal duodenum), and total cholesterol mass (sitosterol marker incorporated in the infusion mixture). Measurements of endogenous cholesterol absorption during infusion of a cholesterol-free formula produced identical results whether calculated by the [1,2-3H]cholesterol marker (46.2 +/- 18.2%) or sitosterol marker (44.3 +/- 16.9%) in eight studies. When exogenous cholesterol was administered in liquid formula, its absorption was significantly lower than that of endogenous cholesterol in six out of nine experiments (endogenous = 46.4 +/- 15.4%; exogenous = 33.6 +/- 8.3%; total = 40.9 +/- 10.0%). When exogenous cholesterol was dissolved and administered in triglycerol monooleate, its absorption was higher than that of endogenous cholesterol in four of seven experiments (endogenous = 29.6 +/- 14.5%; exogenous = 33.4 +/- 9.1%; total = 29.9 +/- 12.0%). These comparisons indicate that differential absorption of endogenous and exogenous cholesterol can occur over a 1- or 2-meter segment of the upper small intestine, and that the rate of cholesterol absorption is critically dependent on the physicochemical state of the intralumenal contents. Our results indicate that currently available methods for measurement of cholesterol absorption (most of which are based on the use of radioisotopic sterols for differentiating exogenous from endogenous cholesterol) reliably quantitate the absorption of dietary cholesterol, and that the results of such tests are not significantly confounded by in vivo isotopic exchange. PMID- 6842084 TI - Facilitation of phosphatidylcholine transfer into high density lipoproteins by an apolipoprotein in the density 1.20-1.26 g/ml fraction of plasma. AB - Incubation of unilamellar vesicles of egg phosphatidylcholine (PC) in human plasma results in rapid transfer of phospholipid into high density lipoproteins (HDL). A similar but much slower transfer occurs upon incubation of PC vesicles with centrifugally isolated HDL. Experiments were conducted to characterize a plasma factor that might facilitate PC transfer into HDL. Addition of the d greater than 1.21 g/ml fraction of plasma to isolated HDL caused a marked increase in the rate of transfer of PC from vesicles to HDL. Fractionation of plasma by vertical rotor density gradient ultracentrifugation revealed that the factor that facilitated transfer of PC into HDL resided in the density 1.20-1.26 g/ml fraction, associated with a lipoprotein particle of apparent Stokes' diameter 10.2 nm. This fraction caused facilitated transfer of PC mass from vesicles into HDL3, resulting in formation of larger, less dense "HDL2a"-like particles. A partially purified preparation of phospholipid transfer activity was obtained from the d 1.20-1.26 g/ml fraction by a sequence of phenyl-Sepharose, heparin-Sepharose, and carboxymethylcellulose chromatography. The most purified fraction facilitated transfer of 4 micrograms of 14C-labeled PC/microgram protein per 60 min and also promoted transfer of radioactive cholesteryl esters from HDL to LDL. The results suggest that during lipoprotein metabolism the insertion of PC molecules into HDL may be facilitated by a plasma lipid transfer protein. PMID- 6842085 TI - A model for cholesterol absorption: isotope vs. mass; single dose vs. constant infusion. AB - A study is presented to evaluate the relative merits of isotope and cholesterol mass measurements for cholesterol absorption. In this study, cholesterol absorption is simulated as a sequence of 10 two-pool segments in which a concentration gradient of cholesterol mass and/or label exists between the site of exogenous cholesterol entry and that of fecal loss. The model is governed by first order rate constants both for label and for mass. The appearance of labeled cholesterol in lymph and feces provides a reliable measure of the cholesterol mass increment in lymph due to exogenous cholesterol absorption. Net cholesterol absorption, calculated from constant infusion experiments, differs numerically from this mass increment. A dual isotope fecal ratio method agrees with other labeling techniques, but gives reliable information only when feces are collected for a sufficiently long time. PMID- 6842086 TI - Sterol synthesis in vivo in 18 tissues of the squirrel monkey, guinea pig, rabbit, hamster, and rat. AB - This study was undertaken to measure and compare the rates at which digitonin precipitable sterols (DPS) were synthesized in vivo in the major organs of five different animal species. These rates were assessed by measuring the velocity at which [3H]water was incorporated into DPS in the intact animal. The animals used were chosen to include species that carried most of their plasma cholesterol either predominantly in high (rat, hamster) or low (guinea pig) density lipoproteins (HDL and LDL, respectively) or more evenly distributed between the LDL and HDL fractions (monkey and rabbit). Whole animal sterol synthesis was much higher in the rat (16.1 mumol/hr) than in the other four species (2.9-4.6 mumol/hr) when normalized to a constant body weight of 100 g. This uniquely high rate of sterol synthesis could be attributed predominantly to an extremely high rate of incorporation of [3H]water into DPS by the liver of the rat. When expressed per g of tissue, the highest content of newly synthesized sterol in all species was found in tissues such as adrenal gland, ovary, and gastrointestinal tract. However, the content of [3H]DPS in the liver varied markedly from a high of 2279 nmol/hr per g in the rat to a low of only 109 nmol/hr per g in the guinea pig. Consequently, when expressed as a percentage of total body synthesis, the whole liver of the rat contained 51% of the [3H]DPS while this figure was much lower in the monkey (40%), hamster (27%), rabbit (18%), and guinea pig (16%). Thus, in all species except the rat, the major sites for sterol synthesis appeared to be the gastrointestinal tract, carcass (predominantly the muscle), and skin. In addition, even though the content of newly synthesized sterol per g of adrenal gland was higher than in nearly any other tissue in all of the species examined, it was further demonstrated that in the rat most of this [3H]DPS was derived from the blood (and, therefore, ultimately from the liver) whereas in the other species it was largely synthesized locally within the gland. Thus, these studies demonstrated that in many species the liver is quantitatively far less important as a site for sterol synthesis than previously believed and, as a correlate of this, most sterol utilized by extrahepatic tissues is largely synthesized locally within those tissues. PMID- 6842087 TI - Bile acids and lipids in isolated rat hepatocytes. II. Source of cholesterol used for bile acid formation, estimated by incorporation of tritium from tritiated water, and by the effect of ML-236B. AB - After incubation in the presence of tritiated water, incorporation of tritium into cholesterol and into different bile acids was several-fold higher using hepatocytes of cholestyramine-fed rats than that found using hepatocytes of control rats. Labeling of the trihydroxylated cholic and beta-muricholic acids was markedly greater than that of dihydroxycholanoic acid. The total amount of label in all bile acids was 30% or less of that in free cholesterol, in both types of hepatocytes. In combination with the data on bile acids mass production we could calculate the average number (N(a)) of tritium atoms incorporated per molecule of newly-formed bile acid. The experimental values of N(a) for cholic and beta-muricholic acid were compared with values of N(n) or N(o), theoretically predicted if these bile acids were derived entirely from newly made or pre existent cholesterol, respectively. It was deduced for hepatocytes of cholestyramine-fed rats that the bile acids produced in the first hour of incubation should be totally derived from pre-existent cholesterol, whereas 50% and 25% of the cholic and beta-muricholic acid, respectively, produced during the second and third hours of incubation should be derived from newly synthesized cholesterol. The contribution of newly made cholesterol as substrate for bile acid production was also estimated by using ML-236B. In a concentration of 12 micro M, it depressed cholesterol synthesis by 90% during 1 or 3 hours of incubation of hepatocytes of cholestyramine-fed rats. Mass production of cholic acid was depressed by 25% and that of beta-muricholic acid was not inhibited at all by ML-236B during the first hour of incubation, while they were depressed by 71 and 52%, respectively, during the second plus third hours of incubation. It is concluded that 1) in isolated hepatocytes newly made cholesterol can be a significant substrate for bile acid formation; 2) there are separate cholesterol substrate pools for the productions of cholic or beta-muricholic acid; 3) of the total carbon flux directed into cholesterol synthesis, the major part ends up as free cholesterol and only a minor part as bile acids, even in hepatocytes with a derepressed bile acid production.-Kempen, H. J., M. Vos-van Holstein, and J. de Lange. Bile acids and lipids in isolated rat hepatocytes. II. Source of cholesterol used for bile acid formation, estimated by incorporation of tritium from tritiated water, and by the effect of ML-236B. PMID- 6842088 TI - Quantitation of hepatic fatty acid-binding proteins by post-chromatographic ligand binding assay. AB - A new procedure for the detection and quantitation of small molecular weight cytosolic fatty acid-binding proteins (FABP) in chromatographic fractions is described. Aliquots of the fractionated cytosol are incubated with radiolabeled palmitate and the unbound fatty acid ligand is quickly removed by addition of a dextran-gelatin-coated charcoal suspension. Quantitation of the FABP is accomplished by counting the protein-bound radioactivity in the supernatant fraction after a brief centrifugation step. Validation studies have shown the assay to be linear over a range of 10-40 micrograms or 20-80 micrograms of FABP depending on specific activity of [14C]palmitate used. Bovine serum albumin can be included as an external binding protein to correct for the nominal day-to-day variation in the assay system. The assay has been found to give consistent results with a wide variety of buffer salts, ionic strength, and pH, and therefore is compatible with the usual conditions of gel filtration, ion exchange, and affinity chromatography. Compared to detection methods involving prechromatographic addition of bromosulfophthalein or radiolabeled fatty acids to cytosolic proteins, the post-chromatographic binding assay offers the advantage of leaving the bulk of the FABP preparation free of these marker ligands. PMID- 6842089 TI - An improved gas-liquid chromatographic method for the determination of fecal neutral sterols. AB - The analysis of fecal neutral sterols has been improved by use of a highly selective gas-liquid chromatography column packed with SP-2401. This chromatographic column allows separation of cholesterol and cholestanol and delta 5-5 alpha plant sterol homologs without employing silver nitrate thin-layer chromatography. Furthermore, there is no need to derivatize neutral sterols before injection. The main fecal neutral sterols are well resolved; retention times are reproducible; detector response is reproducible, linear, and sensitive to 0.2 micrograms. This method, successfully used for fecal samples, may be suggested as a routine method for the clinical study of cholesterol metabolism. PMID- 6842090 TI - [Etiology of acute ischemia of the lower limbs]. AB - The most frequent cause of acute ischaemia of the lower limbs is arterial: thrombotic, embolic and spastic. In cases of arterial embolism, the site of origin is the left side of the heart in 9 cases out of 10: ischaemic heart disease in 2/3 of cases, with atrial fibrillation (A.F.) in 50% of cases, rheumatic valvular disease with A.F. in 1/5 of cases and more rarely, idiopathic A.F., auricular disease and cardiomyopathies. Arterial emboli can be fragments from a wall thrombus (aortic or arterial aneurysm), or atheromatous material from an ulcerated plaque. In 11% of cases the origin of the embolus is never found. Arterial thrombosis is due to chronic vascular disease in 1/3 of cases, popliteal aneurysm and thromboangiitis obliterans. The iatrogenic causes are rare: use of the arterial route, and arterial prosthesis, accidental intra-arterial injection during sclerotherapy for varicose veins. Arterial spasm is seen in cases of phlegmatia caerulea dolens. It ben be iatrogenic (ergotamine tartrate, dihydroergotamine, methysergide), toxic (L.S.D.) or spontaneous. PMID- 6842091 TI - [Acute ischemia of the lower limbs. Clinical diagnosis]. AB - Acute ischemia of lower limbs is severe: 25% lethality, 34% amputations (mean of 42 recent statistics). Initial clinical examination is the main point: it diagnoses acute ischemia, localizes the point of occlusion, picks up etiologic informations, assesses the repercussion of ischemia on the local and general status. The therapeutic decision is an emergency. Some particular aspects are pointed out: diagnostic between embolization and thrombosis, arterial spasm, distal ischemia with present pulses ("blue toe syndrom"), arterial dissections, complications of aneurysms. Prognosis depends on age, general condition, localization of ischemia, status of the limb, multiplicity or recurrence of embolization, but above all on early diagnostic and therapeutic. PMID- 6842092 TI - [Acute ischemia of the lower limbs. Paraclinical non-invasive examination (arteries, veins, capillaries)]. AB - The author defines the conditions under which vascular function studies may have a place in the presence of acute ischaemia of the lower limbs (essentially due to obstruction of a main artery). Ultrasound methods (Doppler, echography) seem to be the most valuable. Digital plethysmographic pulse and measurement of pO2 are used for the early surveillance of the results of treatment. Function studies should be a useful addition to clinical and angiographic findings within a vascular team, by improving estimation of the perfusion of the distal system taken as a whole. PMID- 6842093 TI - [Morphological abnormalities of nailbed capillaries in connective tissue diseases]. AB - The Capillaroscopy Unit of Broussais Hospital has carried out more than 6,000 examinations involving all areas of pathology and more particularly the special role which the method plays in connective tissue diseases. This experience was used to attempt to define the characteristics of the morphological abnormalities of the nailbed capillaries in connective tissue diseases in the adult. The study was deliberately limited to abnormalities of the capillaries themselves, with the exclusion of abnormalities of the pericapillary spaces, abnormalities of blood flow and abnormalities capable of manifesting themselves in the cold; though bearing in mind that the interpretation of a capillaroscopic examination can be perfectly credible only if all such anomalies are taken into consideration. The following capillaroscopic appearances have been included under the heading "morphological abnormalities": dystrophies, dilatations of the loops without megacapillaries, megacapillaries, telangiectasia, filiform loops, regressive capillaries, long loops and microaneurysms. Groups of these morphological abnormalities form more or less typical associations in connective tissue diseases. PMID- 6842094 TI - [Digital capillaroscopy in idiopathic Raynaud's disease]. AB - Nail-fold capillaroscopy is performed on 135 patients with primary Raynaud's disease. There is no significant difference between patients with long clinical story and new ones. The capillaroscopy is highly correlated with severity of vasomotor troubles. Parameters of bad prognosis are a high frequency of morphological abnormalities, venodilation, sludge phenomenon and hemorrhagies. PMID- 6842096 TI - [Automatic recording of venous hysteresis. Results in the normal subject and in varicose patients]. AB - The measurement of the venous distensibility by straingauge plethysmography during a semi-continuous variation (3 mm Hg every 20 seconds) of the cuff pressure during its inflation from 0 to 100 mm Hg and its deflation allow to record the venous hysteresis and to determine accurately the venous pressure. The standardized and automatic (Periflow J.S.I.) new method is highly discriminative between controls and varicose patients. PMID- 6842095 TI - [Paradoxical systemic emboli. 5 case reports]. AB - Paradoxical systemic embolism by venous emboli in the arterial circulation can be explained by a right-left shunt. In 5 patients, the diagnosis of paradoxical emboli was definite in three cases, and suspected in two others. Venous, arterial and cardiac angiography define the anatomical criteria which alone can confirm the diagnosis. The introduction of a caval filter can prevent recurrent emboli which has a serious prognosis. PMID- 6842098 TI - [Echographic study in the exploration of supra-aortic trunks. Comparative study with doppler velocimetry and their respective roles in functional vascular explorations]. AB - Over the last six months, 1,311 doppler examinations of the supra-aortic trunks have been performed with confrontation doppler, ultrasound, arteriography and intra-operative examination according to the cases. We studied these cases with the following questions in mind: Does real time ultrasound of the supra-aortic trunks give more valuable information than the classical doppler examination? Is the diagnosis simplified? Is the therapeutic management altered? We are able to conclude: 1. In the case of a mildly stenotic plaque (less than 50%), the doppler examination gives an acoustic and graphic representation which is rich and not differentiated for stenoses of between 10% and 50%, which corresponds to an ultrasound plaque of 1 mm to 4-5 mm: the ultrasound supports the diagnosis. 2. However, in stenoses greater than 50%, there is good correlation between the doppler examination, ultrasound and arteriography. Ultrasound enables the exact extent of the plaque to be visualised in sagittal and transverse planes. It can diagnose aneurysmal lesions and suggest ulcerated lesions. 3. Finally, the doppler examination seems to be indispensable in cases of pre-thrombosis or fresh thrombosis of the carotid. Ultrasound can be negative at this early stage. PMID- 6842097 TI - [Evaluation of the extension of iliac or iliocaval phlebitis. Value of tomodensitometry]. AB - Before operating on a case of iliac or ilio-caval phlebitis with or without pulmonary embolism, three questions need to be asked about the condition of the inferior vena cava: is it involved? is there a local cause? where is the superior pole of the thrombus in relation to the renal veins? The study of 10 cases of recent phlebitis benefitting from phlebography and C.T. scan reveals the value of this investigation. In 7 cases the condition of the lumen of the inferior vena cava was defined and in the 3 cases in which it was thrombosed, the position of the thrombus in relation to the renal veins was visualised. In 2 cases, the inferior vena cava was laminated by an extrinsic compression which was defined by the C.T. In only one case was the vena cava not seen, due to the presence of a large collateral channel. The indications for C.T. scan should remain selective: cases where direct ilio-cavography is impossible and where descending cavography is undesirable or impossible. PMID- 6842099 TI - [Analysis of the rebound phenomenon during outflow in plethysmography following programmed venous occlusion]. AB - The venous outflow curve obtained using strain gauge plethysmography (Periflow JSI) frequently displays a slope change which modifies the classic exponential pattern: The semi-continuous arterial blood flow measurement together with an ECG triggered plethysmography let the authors show the arterial origin of this slope change they called "the rebound phenomenon". Venous occlusion induces an ischemia which creates a reactive hyperemia when the venous blood current is let free. All the venous outflow curves stem from both a venous and arterial phenomenon. This latter may sometimes be of importance and has to be considered in plethysmography studies. PMID- 6842100 TI - [Necrotic angiodermatitis]. AB - Necrotic angiodermatitis, as defined and described by the School of Lyon and especially by D. Colomb, stays at the confines of dermatology and angiology. Its diagnosis is easy in front of such "cutaneous gangrene in superficial plates". In fact it is a microangiohistopathy, it appears like an infarction of the skin, due to atherosclerosis and so to senescence, it means a low flow of perfusion and perhaps relates to immunology. PMID- 6842101 TI - [Management of carotid bruits]. AB - The search for a carotid bruit should be routine in any examination of an atheromatous subject or of a subject at risk. However, clinical examination is not sufficient and the authors stress the importance of non-invasive investigations, in particular, the doppler which has become part of current practice. Once the diagnosis of a carotid lesion has been made, the management depends on three conditions: --An understanding of the pathophysiology or its embolic origin; --A good definition of the clinical symptoms: asymptomatic, transient ischaemic attacks, cerebral softening; --A good knowledge of the spontaneous risk and the operative risk. PMID- 6842103 TI - [Indications for and medical treatment modalities in the thoracic outlet syndrome]. AB - The thoracic outlet syndromes comprise a group of diseases with varied manifestations: nervous, venous or arterial. The definitive diagnosis is difficult and the clinical picture is more important than complementary examinations. There are very precise indications for the various modalities of medical and surgical treatment. PMID- 6842102 TI - [Discrete distal gangrene]. AB - The authors present their statistical findings from 114 cases of discrete distal gangrene. They stress the importance of a rigorous methodology to detect mechanical causes from the thoracic outlet syndrome and immunological causes, predominantly scleroderma, especially in women. It is important not to overlook blood diseases nor those cases which are a presentation of underlying cancer. Finally, the iatrogenic cause is now well known. Treatment depends on the causes of this distal lesion. However, in cases of severe connective tissue disease, the use of plasmapheresis is beginning to give interesting results. PMID- 6842104 TI - [Full popliteal fossa]. AB - Many reasons of clinical discussions about a filling of the popliteal fossa arise from this special anatomical area which is encumbered, so often requested by the activity of joints and muscles and so, since the embryological development. Although rare, perhaps because unrecognised, ischemic disorders, venous signs, swollen legs, permanent or intermittent full fossa . . . are the more frequent clinical aspects. The main patterns are arterial, rarely venous and more rarely arteriovenous aneurysms, adventitial cystic disease, lipoma, synovial or sebaceous cyst . . . malignant tumours, exostosis . . . Serious examination, functional techniques of which Doppler, angiographies . . . So, quite a lot of diagnostic discussions, even during surgical interventions. PMID- 6842105 TI - [Acute symmetric polygangrene of the extremities]. AB - The authors stress the importance, in acute symmetric polygangrene of the extremities, of systemic disease accompanied by decreased perfusion with its physicochemical consequences on parietal structures and the liquid contents of vessels and tissues developing rapidly in the extremities. In the first chapter, they recall the various aetiologies proposed in the literature. They then describe 3 personal case studies which they have chosen for their extreme age range and their varying aetiology. They present the various pathogenic factors which can occur either in isolation or in combination: parietal factors, abnormalities of the various elements of the blood, plasma factors, all of which are responsible for rheological disturbances which, when combined with decreased perfusion, lead to the development of gangrene. Finally, they present their ideas about treatment which sould be a function of the aetiology and the stage of the disease at the time of diagnosis. PMID- 6842106 TI - The public speaks--Part III. PMID- 6842107 TI - An interview with Dr. Alton V. Hallum, Jr. PMID- 6842108 TI - Anniversary reactions with death. PMID- 6842110 TI - Dental treatment of cardiac patients. PMID- 6842109 TI - The case for community chemotherapy. PMID- 6842111 TI - Georgia's medical malpractice statute of limitations declared unconstitutional as applied to wrongful death actions. PMID- 6842112 TI - Prostatic 125I implantation--new approach in the management of prostatic cancer. PMID- 6842113 TI - Diagnosis and treatment of syphilis. PMID- 6842114 TI - The sooner, the better: identification and rehabilitation of the child with bilateral sensorineural hearing impairment. PMID- 6842115 TI - Intrauterine testicular extravasation? PMID- 6842116 TI - Victims of terrorism: the physical, psychological and spiritual-existential effects. PMID- 6842117 TI - Rocky Mountain Spotted Fever--a reminder. PMID- 6842118 TI - Genes encoding actin in higher plants: intron positions are highly conserved but the coding sequences are not. AB - We have isolated actin genes from genomic libraries of two highly diverged plants, maize and soybean. The complete nucleotide sequences of a maize actin gene, MAc1, and a soybean actin gene, SAc1, were determined. The nucleotide sequences of these two actin genes and of a previously sequenced soybean actin gene were compared with the actin gene sequences from a wide spectrum of evolutionarily diverged eukaryotes. Some striking features pertinent to the evolution and function of the plant actin gene families have emerged. The deduced amino acid sequence of the plant actins resembles both cytoplasmic- and muscle specific actins. DNA sequence analysis as well as genomic blotting experiments using cloned actin sequences as probes show that large sequence heterogeneity exists among members of the plant actin multigene families and between genes from two highly diverged plant species. The sequences of the first nine amino acids at the amino terminal end of the plant actins are far more conserved between distant plant actins than the corresponding sequences in distantly related animal actin genes, suggesting a unique and conserved function for the NH2 terminal sequence in higher plants. The soybean and maize actin genes examined each contain three introns in precisely the same positions, quite contrary to the divergent placement of introns observed in animal, protozoan, and fungal actins. The position of the first intron in soybean and maize actin genes corresponds precisely to the position of an intron found in a nematode actin gene. The position of the second intron coincides with one found in rat and chicken skeletal actin genes. These data suggest that the numerous introns found in all actins are of ancient origin. The degree of silent substitution and replacement substitution was compared among plant actin genes and to those of animal, protozoan, and yeast actin genes. It is clear that the silent substitution sites are saturated among all the genes compared, whereas the replacement sites have diverged in only 5-17% of their possible positions. By these criteria the most distant animal actins are only 6% diverged. The three plant actin genes examined are 8-10% diverged in replacement sites from each other and approximately 14% diverged in replacement sites from any of the animal actins examined. The data in this manuscript suggest that the families of soybean and maize actin genes may have diverged from a single common ancestral actin gene long before the divergence of monocots and dicots. PMID- 6842119 TI - Transcription in vivo from SV40 early promoter deletion mutants without repression by large T antigen. AB - Transfection of monkey cells with recombinant plasmids containing a beta-globin coding region fused to wild-type or deleted simian virus 40 (SV40) early region promoters has allowed an analysis of the transcriptional activity of these promoters in the absence of repression by large T antigen. We find that deletion of the TATA sequence does not reduce the transcriptional effectiveness of the promoter; however, the 5' ends of the transcripts are heterogeneous rather than being restricted to the usual sites. The short GC-rich repeat sequences between nucleotides 37 and 107 and the tandemly repeated 72-bp segment between nucleotides 107 and 250 are each essential for promoter function. The GC-rich repeats are functionally redundant and probably interchangeable, since several subsets of two or three of the GC-rich segments are sufficient. One copy of the 72-bp sequence is sufficient to permit transcription. Moreover, the 72-bp repeat sequences function normally even if they are inverted relative to their normal orientation. PMID- 6842120 TI - Posttranscriptional block to synthesis of a human adenovirus capsid protein in abortively infected monkey cells. AB - The synthesis of fiber protein in CV1 (monkey) cells abortively infected with human adenovirus serotype 2 (Ad2) is at least 100-fold less than the synthesis of fiber protein in CV1 cells productively infected with a host range mutant of Ad2 (Ad2hr400) or coinfected with Ad2 plus simian virus 40. However, the amount of fiber mRNA present in the cytoplasm of abortively infected CV1 cells is only 5- to 10-fold less than that in productively infected CV1 cells. Whereas fiber mRNA in abortively infected CV1 cells is utilized poorly as a template for synthesis of fiber protein in vivo, fiber mRNA from abortively infected CV1 cells serves just as efficiently as a template for fiber synthesis in vitro as fiber mRNA from productively infected cells. This was observed both in a nuclease-treated rabbit reticulocyte lysate to which purified fiber mRNA or cytoplasmic ribonucleoprotein complex was added as exogenous template for fiber synthesis, and in S10 extracts of infected CV1 cells utilizing endogenous message as a template. Since translation initiation inhibitors did not diminish synthesis of fiber in S10 extracts of abortively infected CV1 cells, fiber mRNA probably is associated with ribosomes in abortively infected CV1 cells. This conclusion was supported by Northern blot analysis, which showed that in both abortively and productively infected CV1 cells, the same proportion of cytoplasmic fiber mRNA cosedimented with polyribosomes. Although the possibility of extremely rapid fiber turnover in abortively infected monkey cells cannot be rigorously excluded, preliminary data suggest that this is not the case. Thus, these results may imply that translation of the fiber message in abortively infected monkey cells is blocked after formation of the mRNA-ribosome complex. PMID- 6842121 TI - Neurotensin release from rat hypothalamus in vitro. AB - Neurotensin is a hypothalamic peptide which inhibits secretion of TSH in the rat in vivo. We have demonstrated a calcium-dependent release of neurotensin from incubated rat hypothalamus in response to depolarizing stimuli, as well as a dose dependent stimulatory effect of tri-iodothyronine (T3) on neurotensin secretion. We suggest that part of the neuroendocrine control of TSH secretion involves the interaction of T3, neurotensin and TSH; the presence of neurotensin in extracts of anterior pituitary gland is further evidence for its hypophysiotrophic role. PMID- 6842122 TI - Abnormalities in the plasma concentrations of thyroxine, tri-iodothyronine and growth hormone in sex-linked dwarf and autosomal dwarf White Leghorn domestic fowl (Gallus domesticus). AB - Plasma concentrations of GH were high in young birds (2-12 weeks old) and low in older birds (15 and 18 weeks old) in the control Cornell K strain of White Leghorn fowl. There was little variation in the plasma concentrations of tri iodothyronine (T3) and thyroxine (T4) with age in this strain. Similar patterns of plasma hormone concentrations with age were observed in autosomal recessive dwarf chickens. However, the plasma concentrations of T3 and T4 tended to be depressed while that of GH was raised. There was little age-related change in the plasma concentrations of GH, T3 and T4 in sex-linked recessive dwarf chickens. Throughout growth and maturation the plasma concentrations of T3 in the sex linked dwarf birds were less 40% of those observed in the control strain. Plasma concentrations of T4 tended to be raised relative to the control in the sex linked dwarf at each age examined. The plasma concentration of GH was raised only in older (12, 15 and 18 weeks old) sex-linked dwarfs. Liver T4-5' monodeiodinase activity was slightly depressed in autosomal dwarf chickens and very low in the sex-linked dwarf fowl. Neither autosomal nor sex-linked dwarfism appears to be due to hypopituitarism. It is probable that the depressed liver 5' monodeiodinase activity and the concomitant low plasma concentrations of T3 are a causative factor in the reduced growth and stature of the sex-linked dwarf chicken. PMID- 6842123 TI - Episodic secretion of luteinizing hormone and androgen in male rats. PMID- 6842124 TI - Effects of parathyroid hormone and the synthetic 1-34 amino-terminal fragment in rats and dogs. AB - Since the structural requirements for all known biological activities of parathyroid hormone (PTH(1-84)) are virtually satisfied by the amino-terminal 34 amino acid fragment, PTH(1-34), we investigated whether this fragment could elaborate the overall actions of the intact hormone in the whole animal by comparing the effects of equimolar infusions of each peptide to dogs and rats. Infusion of bovine PTH(1-84) (bPTH(1-84)) at 17 pmol/kg per h for 20 h to three dogs or at 100 and 200 pmol/kg per h to groups of six rats for 5 days produced greater hypercalcaemia (3.02 +/- 0.03, 2.52 +/- 0.07 and 3.24 +/- 0.11 mmol/l respectively) than equimolar infusions of human PTH(1-34) (hPTH(1-34)) (2.61 +/- 0.03, 2.46 +/- 0.05 and 2.71 +/- 0.09 mmol/l respectively). A significant calcium rise was not observed in dogs until after 4 h of PTH infusion. No rise in plasma calcium was apparent in rats, however, until the third day of PTH infusion. Only in parathyroidectomized rats was there a rise in plasma calcium within 24 h of starting an infusion of PTH. The hypercalciuria and plasma phosphate responses in dogs during equimolar infusions of hPTH(1-34) and bPTH(1-84) were not significantly different. However, by day 5 of infusion in rats greater hypercalciuria was produced by bPTH(1-84). Although infusion of hPTH(1-34) and bPTH(1-84) caused rises in urinary cyclic AMP excretion (measured only in the dog) of immediate onset and equal magnitude, bPTH(1-84) tended to produce greater phosphaturia than hPTH(1-34) in both species. If the assumption is correct that the half-lives of hPTH(1-34) and bPTH(1-84) in the circulation are similar and provided that hPTH does not inherently have less biological activity than bPTH, then during equimolar infusions of these peptides into dogs and rats, the greater responses observed with bPTH(1-84) suggest that intact PTH may have a direct action of its own in vivo before being metabolized into smaller biologically active fragments. In additional experiments using parathyroidectomized rats, the infusion rate of bPTH(1-84) required to restore normocalcaemia was 26 pmol/kg per h. Although near-normal calcaemia and intestinal calcium absorption could still be maintained when the infusion rate was increased to 39 pmol/kg per h, hypercalciuria and phosphaturia became apparent. PMID- 6842125 TI - Identification and measurement of testosterone in plasma and follicular fluid of the mare, using gas chromatography-mass spectrometry associated with isotope dilution. AB - Testosterone has been identified by mass spectrometry in blood and follicular fluid aspirated from mature Graafian follicles of mares. Quantitative measurements made by gas chromatography-mass spectrometry have validated the determination of plasma testosterone made by radioimmunoassay. However, because of high levels of epitestosterone (17 alpha-hydroxyandrost-4-en-3-one) in the follicular fluid, radioimmunoassay overestimates the true concentrations of testosterone. The occurrence of testosterone in mare follicular fluid at a concentration which is two orders of magnitude higher than that in peripheral plasma suggests that the follicle may contribute to the production of circulating testosterone. A biosynthetic pathway for oestradiol-17 beta which involves testosterone is therefore likely to occur in the mare ovary as in many other mammalian species. PMID- 6842126 TI - Failure of rat placenta to inhibit prolactin secretion by ectopic pituitary gland. AB - At mid-pregnancy in the rat, episodic secretion of pituitary prolactin ceases when the placenta is sufficiently developed. At this time, sufficient placental lactogen is secreted by the placenta to inhibit prolactin secretion. The present study tested whether the fully developed placenta at mid-pregnancy can inhibit prolactin secreted by a donor pituitary gland implanted under the kidney capsule. Three pituitary glands were implanted in rats on day 7 of pregnancy; muscle fragments were implanted in controls. Blood was collected during the first and second halves of pregnancy. It was found that prolactin concentrations in the animals with the pituitary implants were high on days 9 and 10 of pregnancy and remained raised during the second half of pregnancy while in control animals nocturnal surges were absent in the second half of pregnancy, the last one occurring on day 10. This observation indicates that the placental hormone cannot act directly on the pituitary gland to inhibit prolactin secretion, but presumably exerts its suppressive effect on prolactin secretion through the hypothalamus. PMID- 6842127 TI - Timing the second response in two-response avoidance. AB - Rats were trained on a free-operant avoidance task requiring two lever presses within R seconds, with the opportunity for each response distinguished by differing stimuli. Response latencies at a variety of response-shock intervals were found to be proportional to the time available for the response. These results are shown to be consonant with a scalar expectancy model of timing behavior. PMID- 6842128 TI - Conditional discrimination with ambiguous stimuli. AB - Five pigeons learned a two-key conditional discrimination. When background color on both keys was red, pecks on the key with a horizontal line produced food. When the color was green, pecks on the key with a vertical line produced food. During part of the experiment, color was presented on only one of the keys. It was found that accuracy was higher when color was combined with the line stimulus correlated with nonreinforcement. In another part of the experiment, color was presented on both keys but a line was present only on one. Accuracy was higher when the line accompanied the nonreinforced option than when the line accompanied the reinforced option. Superior performance when the combined stimuli were displayed on the nonfood key may be explained by the association of different components of the compound stimuli with reinforcement or as the result of rules pigeons follow in solving conditional discriminations. PMID- 6842129 TI - Frequency judgment accuracy as a function of age and school achievement (learning disabled versus non-learning-disabled) patterns. AB - The accuracy of children's judgments of relative situational frequency was examined in two experiments. In Experiment 1 children with normal achievement in Grades 2 and 3 were compared with such children in Grades K and 5, as well as with three groups of low-achieving children in Grades 2 and 3. These latter groups consisted of children low in reading achievement, those low in math achievement, and those identified as learning disabled. Frequency judgment accuracy increased from kindergarten to Grades 2 and 3. No other comparisons yielded significant differences. Experiment 2 confirmed both the above age difference and the absence of any frequency judgment deficiency on the part of the low-achieving groups. PMID- 6842130 TI - The development of handedness and dichotic ear listening asymmetries in relation to school achievement: a longitudinal study. AB - To assess the development of dichotic ear asymmetries and handedness, 208 male school children were evaluated in kindergarten and at Grades 2 and 5 (ages 66, 92, and 130 months of age, respectively) with a dichotic listening task and a hand preference test. The Wide Range Achievement Test (WRAT) also was administered at each of the three grade levels. There was significant variability in handedness scores over time only for those subjects whose scores at initial testing, that is, in kindergarten, identified them as non-right-handers. Both right and left handers had a significant increase in dichotic listening scores over time; however, only right handers had a significant right ear advantage at each evaluation. Regression analyses showed that combined hand preference scores and ear recall scores at each probe when combined accounted for almost 44% of the variance in WRAT achievement scores at Grade 5. Ear asymmetry scores, however, were not predictive of school achievement. PMID- 6842131 TI - Speech perception and memory coding in relation to reading ability. AB - Previous work has demonstrated that children who are poor readers have short-term memory deficits in tasks in which the stimuli lend themselves to phonetic coding. The aim of the present study was to explore whether the poor readers' memory deficit may have its origin in perception with the encoding of the stimuli. Three experiments were conducted with third grade good and poor readers. As in earlier experiments, the poor readers were found to perform less well on recall of random word strings and to be less affected by the phonetic characteristics (rhyming or not rhyming) of the items (Experiment 1). In addition, the poor readers produced more errors of transposition (in the nonrhyming strings) than did the good readers, a further indication of the poor readers' problems with memory for order. The subjects were tested on two auditory perception tasks, one employing words (Experiment 2) and the other nonspeech environmental sounds (Experiment 3). Each was presented under two conditions: with a favorable signal-to-noise ratio and with masking. The poor readers made significantly more errors than the good readers when listening to speech in noise, but did not differ in perception of speech without noise or in perception of nonspeech environmental sounds, whether noise-masked or not. Together, the results of the perception studies suggest that poor readers have a perceptual difficulty that is specific to speech. It is suggested that the short-term memory deficits characteristic of poor readers may stem from material-specific problems of perceptual processing. PMID- 6842132 TI - A test of the Pfanzagl bisection model in rats. AB - The bisection method of animal psychophysical scaling was examined as a measurement procedure. The critical assumptions of bisection scaling, as described by Pfanzagl (1968), were tested to determine if a valid equal-interval scale could be derived. A valid scale was derived in which subjective time for the rat was a power function of real time. Bisection points were found to be context dependent, because the spacing of stimuli significantly affected the bisection points. Such context effects were directly related to the size of the interval bisected, whereas measurement errors in estimates of the exponent of the power function were an inverse function of interval size. PMID- 6842133 TI - Signaled tailshock is perceived as similar to a stronger unsignaled tailshock: implications for a functional analysis of classical conditioning. AB - Water-deprived rats given fixed-electrode, variable-intensity tailshock at random times rated each trial by pressing either a "high-aversiveness" or "low aversiveness" lever in order to obtain water. Trials on which a warning signal preceded tailshock resulted in more "high-aversiveness" leverpressing than did otherwise equivalent unsignaled trials. The magnitude of this effect increased and decreased as a function of several parameters including signal-shock interval, signal duration, and range and absolute value of shock intensities but was never reversed despite efforts to achieve such a reversal. Variation in the size of the effect as a function of signal parameters as well as lick suppression scores indicated that the signal had acquired aversive characteristics, which suggests that the effect of the signal on lever choice was due largely to the aversiveness of the signal summating with the aversiveness of the tailshock. Several hypotheses concerning factors that might have either masked or prevented classically conditioned preparatory responses elicited by the signal from reducing tailshock aversiveness were tested and rejected. Despite the greater aversiveness of the signaled condition, when given the choice of receiving or not receiving the signal, the animals displayed a preference for signaled tailshock. Implications for the role of preparatory responding both in the preference-for signaled-shock phenomenon and in classical conditioning are discussed. PMID- 6842134 TI - Exposure to the unconditioned stimulus alone: effects on retention and acquisition of conditioned suppression. AB - Three experiments demonstrated that repeated exposure to an electric-shock unconditioned stimulus (US) resulted in a decrement in retention of conditioned suppression evoked by a previously established excitatory conditioned stimulus (CS) and retarded subsequent acquisition of conditioned suppression to a novel CS paired with shock. Experiment 1 showed that 10 sessions of exposure to shock alone were required to produce a decrement in retention of conditioned suppression, whereas retardation in the acquisition of conditioned suppression was obtained following either 5 or 10 sessions of exposure to shock alone. Experiment 2 demonstrated that the magnitude of both the decrement in retention of conditioned suppression and the retardation in the acquisition of conditioned suppression produced by exposure to shock alone was directly related to the intensity of those shocks. Experiment 3 demonstrated that the decrement in retention of conditioned suppression produced by 10 sessions of exposure to shock alone was inversely related to the interval between the last exposure to shock and the test of the target CS. These findings are discussed in terms of associative and nonassociative accounts of the effects of US-alone procedures. PMID- 6842135 TI - Bisection of temporal intervals by pigeons. AB - Two experiments investigated temporal bisection in pigeons using a procedure similar to that of Stubbs (1976). This procedure measures the point in time at which the bird switches from the shorter to the longer valued of two fixed interval reinforcement schedules with a common starting point. The first experiment substantiated previous findings of switching at the geometric mean of the two interval values and strengthened identification of this switching with bisection by eliminating the possibility that the birds simply switched to the longer interval when the shorter one was perceived to have expired. The experiment also extended the range of values for which temporal intervals have been found to be bisected at their geometric mean. A second experiment demonstrated that the usefulness of the present procedure for determining temporal bisection points is limited to cases in which the longer interval is no more than four times the duration of the shorter interval. Greater separation of the two interval durations produced a period of nonresponding during which the location of the switching or bisection point was totally ambiguous. PMID- 6842137 TI - Sequential effects in pigeon delayed matching-to-sample performance. AB - Pigeons were tested in a three-alternative delayed matching-to-sample task in which second-choices were permitted following first-choice errors. Sequences of responses both within and between trials were examined in three experiments. The first experiment demonstrates that the sample information contained in first choice errors is not sufficient to account for the observed pattern of second choices. This result implies that second-choices following first-choice errors are based on a second examination of the contents of working memory. Proactive interference was found in the second experiment in the form of a dependency, beyond that expected on the basis of trial independent response bias, of first choices from one trial on the first-choice emitted on the previous trial. Samples from the previous trial were not found to exert a significant influence on later trials. The magnitude of the intertrial association (Experiment 3) did not depend on the duration of the intertrial interval. In contrast, longer intertrial intervals and longer sample durations did facilitate choice accuracy, by strengthening the association between current samples and choices. These results are incompatible with a trace-decay and competition model; they suggest strongly that multiple influences act simultaneously and independently to control delayed matching-to-sample responding. These multiple influences include memory for the choice occurring on the previous trial, memory for the sample, and general effects of trial spacing. PMID- 6842136 TI - Selective adjustment of the speed of internal clock and memory processes. AB - Four experiments studied the scaling of time by rats. The purpose was to determine if internal clock and memory processes could be selectively adjusted by pharmacological manipulations. All of the experiments used a temporal discrimination procedure in which one response ("short") was reinforced following a 2-sec noise signal and a different response ("long") was reinforced following an 8-sec noise signal; unreinforced signals of intermediate duration were also presented. The proportion of "long" responses increased as a function of signal duration. All drugs were administered intraperitoneally (ip) and their effect on clock or memory processes was inferred from the observed pattern of change in the point of subjective equality of the psychophysical functions under training and testing conditions. Experiment 1 demonstrated that methamphetamine (1.5 mg/kg) can selectively increase clock speed and that haloperidol (.12 mg/kg) can selectively decrease clock speed. Experiment 2 demonstrated that footshock stress (.2 mA) can selectively increase clock speed during continuous administration but leads to a decrease in clock speed below control values when the footshock is abruptly terminated. Experiment 3 demonstrated that vasopressin (.07 pressor units/kg) and oxytocin (.02 pressor units/kg) can selectively decrease the remembered durations of reinforced times, which suggests that memory storage speed increased. Experiment 4 demonstrated that physostigmine (.01 mg/kg) can selectively decrease the remembered durations of reinforced times and that atropine (.05 mg/kg) can selectively increase these remembered durations, which suggests that memory storage speed was differentially affected. The conclusion is that internal clock and memory processes can be dissociated by selectively adjusting their speed of operation and that these changes can be quantitatively modeled by a scalar timing theory. PMID- 6842138 TI - Effects of blood and urine on lead analyzed by flameless atomic absorption. AB - About a 10-15% difference was observed by comparing (CDC) bovine blood to a lead standard addition curve using human blood. Results similar to the mean of the CDC survey were obtained by adding lead directly to the bovine blood using standard addition techniques. These results indicate that standard additions of lead should be made to the same matrix and that matrix effects can occur when blood from different species is compared. Analyses of both CDC bovine blood and human blood with added Triton X-100 showed greater sensitivity and reproducibility than similar blood without added Triton X-100. (NH4)2HPO4 greatly enhanced the signal height of lead in urine while nitric acid had a much less effect. The enhancement by (NH4)2HPO4 of the lead signal was at final concentrations greater than 10 g/l. At less than 10 g/l enhancement rapidly decreased. Triton X-100 did not enhance the signal height of lead in urine. Calcium ion and chloride ion did not decrease the lead absorption peak in urine, but magnesium ion did decrease the height of the absorption peak in urine. PMID- 6842140 TI - [Organ preservation with heavy water--effect of D2O concentration and temperature on organ swelling]. PMID- 6842139 TI - Methyl 17 beta-carboxyester derivatives of natural and synthetic glucocorticoids: correlation between receptor binding and inhibition of in vitro phytohaemagglutinin-induced lymphocyte blastogenesis. AB - Several methyl 17 beta-carboxyester derivatives of natural and fluorinated glucocorticoids were synthesized in order to compare their potency to compete for [3H]dexamethasone binding sites in human spleen tumour cytosols (as a source of large quantities of white blood cells) with their potency to inhibit phytohaemagglutinin-induced blastogenesis of normal human peripheral lymphocytes. The 17 beta-carboxylic acids neither show binding activity nor inhibition of blastogenesis. Methylation partially restores the binding capacity and the intensity of this effect depends on the kind of ring substitutions. The sequence of binding potency is identical compared to that of parent steroids and was found to be in the following order: desoxymethasone greater than dexamethasone greater than corticosterone greater than cortisol greater than progesterone greater than 17-hydroxyprogesterone. The phytohaemagglutinin-induced stimulation of [3H]thymidine incorporation resembles the order of binding potency. The methyl 17 beta-carboxyester derivatives of progesterone, 17-hydroxyprogesterone and betamethasone are inactive. The N-benzyl 17 beta-carboxamide analogs of dexamethasone and betamethasone behave like their corresponding carboxyesters, suggesting an important influence of the side chain conformation of 17 beta carboxyl derivatives on glucocorticoid receptor binding. PMID- 6842141 TI - Fibrinopeptide A radioimmunoassay: a rapid and sensitive measurement of fibrin generation in vivo. PMID- 6842142 TI - [Evaluation and comparison of 2 kinetic UV tests and 3 endpoint tests with visualization of the NAD dependent reaction by tetrazolium salts for the determination of triglycerides in serum]. PMID- 6842143 TI - In-toeing and out-toeing in children. AB - Torsional problems are common in children but rare in adults. Most resolve spontaneously; however, some require treatment. The primary care physician should be able to determine the cause of the deformity. A general screening examination is performed to rule out hip dysplasia and other skeletal defects, estimate in toeing or out-toeing, determine hip rotation as a measure of femoral torsion, and observe the shape of the foot. These observations determine the torsional profile. The site and severity of the deformity can be ascertained from the information on the torsional profile. The common problems encountered in clinical practice include metatarsus adductus, out-toeing in early infancy, medial tibial torsion, and medial femoral torsion. The persisting or severe forms of these torsional deformities are probably genetically determined. Shoe modifications are useless; bracing is ineffective. Surgical rotational osteotomies are effective, but risky, and indicated only for severe, persisting deformities. PMID- 6842144 TI - Myopathic presentation of thyroiditis. PMID- 6842145 TI - A four-year experience with Hemoccult testing kits in a family medicine center. PMID- 6842146 TI - Treatment of chemical dependency in family practice. PMID- 6842147 TI - Public policy arguments for government subsidy of primary care residency training. PMID- 6842148 TI - Follow-up care of the premature infant: the family physician's role. PMID- 6842149 TI - Outcomes of three birthing rooms. AB - For women who are prescreened to be at low risk, the birthing room located in a hospital can provide a home-like environment as well as proximity to the regular obstetrical unit in case of an unforeseen complication. Charts of 356 pairs of infants and mothers who were admitted to birthing rooms at three different hospitals were reviewed. The average age of the mother was 25.9 years. Approximately 20 percent of the women had complications requiring their transfer from the birthing room. Fifteen required a cesarean section. The mean Apgar scores of infants born to all women admitted to the birthing room (including those who were subsequently transferred) were 7.7 at one minute and 8.8 at five minutes. Neonatal complications included meconium aspiration (1), sepsis (1), a question of sepsis (1), congenital heart disease (1), and transient tachypnea of the newborn (1). Four infants and one mother required readmission. Although mothers were prescreened to be at low risk, complications did arise for both mother and infant that made proximity to the regular obstetrical and neonatal units advantageous. PMID- 6842150 TI - The effect of chlorpropamide hyponatremia on mental status in a nursing home population. AB - Fifty-nine nursing home patients (average age, 79.9 +/- .9 years) receiving chlorpropamide were screened with a serum sodium determination. Nine patients (15.3 percent) had a serum sodium concentration less than 135 mEq/L; six of these patients (10.2 percent) had a serum sodium equal to or less than 130 mEq/L; none of the patients had a serum sodium less than 125 mEq/L. Five hyponatremic patients (Na less than or equal to 130 mEq/L) and nine normonatremic patients (Na greater than or equal to 135 mEq/L) were screened with a standardized mental status examination and additional laboratory studies. The hyponatremic patients were switched to tolazamide after a one-week wash-out period, and the mental status examination and laboratory studies were repeated in both groups four weeks later. One patient in the hyponatremic group died during the course of the study; the other four became normonatremic on tolazamide. Mental status scores increased significantly in the hyponatremic group, 16.0 +/- 3.6 to 20 +/- 4.6 (a 37.3 +/- 21.5 percent increase), compared with the normonatremic group, 14.5 +/- 2.6 to 15.8 +/- 2.9 (a 7.8 +/- 3.2 percent increase). There were no significant differences in serum glucose, creatinine, chlorpropamide, or antidiuretic hormone concentrations between the two groups. It is recommended that periodic serum sodium determinations be obtained in geriatric patients receiving chlorpropamide. PMID- 6842151 TI - Newborn care in family practice. AB - Official guidelines regarding the training of family practice residents in newborn medicine have been meager and general. Guidelines have traditionally focused on defining the requisite duration rather than the content of nursery rotations. A competency-based curriculum in newborn medicine is needed that defines requisite knowledge, skills, and attitudes; defines the appropriate role for the family physician in managing newborn problems; reflects the actual newborn experience of family physicians; is incorporated into residency training on a daily basis; and can be utilized in documenting resident competency in newborn health care. This paper describes the development, content, and daily implementation of a newborn curriculum that addresses these issues. PMID- 6842152 TI - Transport patterns and complications in an isolated Alaska practice. AB - This study reviews the patterns of transport and complications that occurred in 169 cases of transporting patients over a four-year period for a small, isolated Alaskan community in which the physicians as a matter of policy attempted to avoid heroic emergency surgery. Case descriptions are included describing transport-related complications and mortality and morbidity of patients transferred. A low incidence of mortality and relatively little long-term morbidity was experienced, supporting the feasibility of transferring severely ill patients rather than attempting heroic surgery under marginal circumstances. Although the lack of comparable studies limits the usefulness of these findings in assessing the overall quality of care, appropriate utilization of transport as an extension of the physician's capabilities resulted in a low incidence of complications during the study period. PMID- 6842153 TI - When is it helpful to convene the family? AB - There are three factors supporting current efforts to bring the family into the mainstream of American medicine: (1) research capabilities of the discipline of epidemiology, (2) the intervention skills developed by family therapy, and (3) pressures to provide cost-effective care as economic resources diminish. The fundamental question addressed in this paper is, when can it be helpful for the family physician to convene the family in the consultation room? Physicians in the field and residents in training are often reluctant to take this step because of time constraints, awkwardness in talking to two or more members of the family, and unfamiliarity with what to do with the information that is gathered. From currently available research data, a list of 14 medical conditions is presented in which it can be predicted that family functioning or nonfunctioning is contributing to the cause of disease, or that the family will experience a major reaction to the illness. These medical conditions offer an ideal opportunity to begin working with families. A specific case history illustrating this approach is presented to demonstrate that convening the family can be an important dimension of family medicine. PMID- 6842154 TI - Teaching occupational health to medical students. AB - Occupational and environmental disease and injury are both widespread and preventable, yet their study has been traditionally neglected in undergraduate medical education. Because family physicians will encounter many working patients who are subject to varying degrees of risk as a result of their job, home, or community environment, family practice faculty must play an important role in teaching occupational and environmental health to medical students. Goals for the longitudinal integration of occupational and environmental health over the four year curriculum include sensitizing students to the relationship between work and health, introducing and reinforcing the importance of the occupational and environmental history in patient care, integrating occupational and environmental health principles and examples with existing course work, and providing appropriate clinical, research, and didactic activities for interested students. Goal achievement will vary with the availability of curricular time and teaching faculty. Strategies for implementing occupational and environmental health curriculum in the face of these two variables are discussed. PMID- 6842155 TI - Botulism. AB - Clostridium botulinum is ubiquitous in the environment, yet symptoms of botulism occur in humans only if toxin A, B, or E is ingested, absorbed in the intestine, and bound and eventually internalized in the neuronal receptors, producing neuromuscular blockade. Clinically, botulism is divided into four types: food borne, infantile, wound, and unclassified. Systemic neurological symptoms occur within 72 hours of gastrointestinal symptoms and can progress rapidly to respiratory paralysis. Diagnosis depends on a high index of suspicion, but cultures and special tests may be helpful. Treatment remains mostly supportive with good respiratory care emphasized. Use of botulism antitoxin and guanidine may be helpful in some cases. PMID- 6842156 TI - Catalytic properties of the sperm-specific lactate dehydrogenase (LDH X or C4) from different species. AB - A comparative study of catalytic properties of the sperm-specific lactate dehydrogenase (EC 1.1.1.27) isozyme X or C4 from a variety of animals (boar, bull, goat, Guinea pig, man, mouse, pigeon, rabbit, and rat) is presented. Optimum concentration and Km values for pyruvate, inhibition by substrate, and activity against analog substrates (alpha-ketoacids with linear and branched chains from 4 to 6 carbon atoms) for isozyme X of different species showed significant differences. The observed properties are correlated with available evidence on the metabolic role of the enzyme. PMID- 6842157 TI - Thyroid and skin-shedding in the rat snake (Ptyas korros). AB - Epidermal-thyroid relationships were studied in thyroidectomized (Tx) Ptyas korros kept at 23 degrees C by observing changes in shedding frequency (SF), body weight, oxygen consumption rate (OCR), and postsurgical survival. Tx animals showed increased SFs but lost weight and eventually died, as did Tx animals receiving 3-mono-iodotyrosine injections. However, injections of 3, 5 diiodothyronine inhibited shedding and the animals survived longer. OCRs were similar in all control and experimental groups. It is concluded that among thyroid secretions, only iodothyronines inhibit shedding. Snake shedding is concluded not to reflect general metabolic status as it does in lizards. PMID- 6842158 TI - Thiosemicarbazide-induced osteolathyrism in metamorphosing Xenopus laevis. AB - Exposure of Xenopus laevis tadpoles to thiosemicarbazide (TSC), at concentrations from 10 to 75 mg/liter, causes an inhibition of metamorphosis and produces the classic manifestations of the experimental disease, osteolathyrism. Concentration dependent effects of TSC exposure are observed in growth rate and in the severity of the osteolathyrogenic effect. Concentrations allowing the most rapid growth produce the more extreme osteolathyrogenic defects. Osteolathyrism in these animals is identical in characteristics to the condition described in a wide variety of vertebrate species. In Xenopus, osteolathyrism is expressed morphologically as anomalies in bone development, skeletal conformation, and abnormal connective tissue organization in the aorta wall. The underlying defect responsible for these observations is apparently a perturbation of collagen fiber formation and maturation, as evidenced ultrastructurally by aberrant distribution and packing of collagen fibers. It is suspected that TSC produces this effect by altering the availability of copper ion, a cofactor to lysyl oxidase, an essential enzyme for intermolecular cross-linking of procollagen. This step in collagen metabolism has been consistently implicated as the site of action of several osteolathyrogenic agents. Xenopus tadpoles present a classic response to this known osteolathyrogen and demonstrate a high degree of uniformity of response within the experimental groups. In view of the developmentally significant events accessible with this system and inherent logistic and economical advantages, the metamorphosing tadpole of Xenopus holds considerable potential for the experimental analysis of teratogenic agents and events. PMID- 6842159 TI - A histological and dynamic study of the gastric region of Discoglossus pictus larvae, cultured with or without thyroxine. AB - The organotypic culture of the gastric region is carried out on premetamorphic Discoglossus pictus larvae. Adding thyroxine to the culture medium provokes various transformations. On the cytological level, the reactions observed, which are variable depending on the cell category concerned, can be divided into two types of phenomena: histolytic and histogenetic. Autophagia linked to lysosome intervention is frequently found among the histolytic processes. Autophagic vacuoles and residual bodies are observed. The gastric lumen is filled with deteriorated cells that probably come from the degeneration of the tadpole epithelium (primary epithelium). The incorporation of tritiated thymidine makes it possible to study the evolution of cell proliferation in the control and in the thyroxinated cultures. After a 1-2 day latency period, possibly due to the adjustment of the tissue to the culture environment, the incorporation of the radioprecursor H3-thymidine into the epithelium and the tunica muscularis of thyroxine-treated gut tissue increased on day 3, reached a maximum on day 5, and then dropped slightly on day 7. In the control cultures H3-thymidine incorporation showed the same pattern but lower levels on the same days. The histolytic phenomena induced by thyroxine in vitro are comparable to those of natural metamorphosis. On the other hand, the histogenetic phenomena are incomplete. Proliferating and transitional phases occur but neoformated (or secondary) epithelium does not replace the degenerated primary epithelium, whatever the culture time. PMID- 6842160 TI - Limb regeneration to digit stages occurs in well-fed adult newts after hypophysectomy. AB - Experiments were designed to determine the maximum survival time and extent of limb regeneration of well-fed adult newts (Notophthalmus viridescens) after complete hypophysectomy. Adult newts were either well-fed or fasted for 3 weeks at which time hypophysectomies were performed. Forelimbs were amputated 5 days posthypophysectomy. Fasted hypophysectomized newts did not survive beyond 4 weeks, and limb regeneration was either absent or abortive. All of the well-fed newts survived to 3 weeks posthypophysectomy, and even at 6 weeks posthypophysectomy showed 30% survival. In the complete absence of the pituitary gland, many of the fed newts regenerated limbs to digit stages. It is concluded that pituitary hormones are not an absolute requirement for limb regeneration of adult newts. Newts in good nutritional condition at the time of hypophysectomy survive longer and their limbs regenerate to more advanced stages. PMID- 6842162 TI - Determination of the rate of rRNA synthesis in Xenopus laevis triploid embryos produced by low-temperature treatment. AB - Triploid embryos of Xenopus laevis were obtained by cold-temperature shocking of the fertilized eggs, and the rate of the ribosomal RNA (rRNA) synthesis was determined for comparison with that in diploid embryos. For this purpose, both triploid and diploid embryos were dissociated into cells at the neurula stage, and then labeled with (3H)uridine for varying lengths of time. The rate of rRNA synthesis, as estimated after determination of (3H)UTP specific radioactivity and the total label incorporation into the purified rRNA, was about 0.1 pg/cell/hr for both diploid and triploid embryo cells. Nuclei of triploid embryo cells contained three nucleoli of apparently similar sizes--an indication of the functioning of all the three rRNA gene clusters to a more or less similar extent. Also, rates of synthesis of 4S RNA and 5S RNA were determined: Both rates did not change appreciably between triploid and diploid embryo cells. Based on these results, it appears that transcription of these redundant genes occurs at a constant rate on a per cell basis irrespective of the presence of 1.5 times as many genes as the control. PMID- 6842161 TI - Adhesion of mouse blastocysts to uterine epithelium in culture: a requirement for mutual surface interactions. AB - Blastocysts readily adhered to inert materials in culture, but they resisted adhesion to living cells even after several days under conditions which encouraged cell aggregation. As far as could be determined by observing their spreading behavior on polylysine- and polyglutamate-coated dishes, the mechanism of adhesion of blastocysts to inert surfaces was similar to that of freshly dissociated cells and cell lines. However, their adhesion to vesicles of isolated uterine epithelium, which was encouraged by hanging drop culture, was by a different mechanism that involved microvilli on both the embryonic and maternal surfaces. This interactive step, which was similar to that seen during attachment in vivo, was followed by a brief period of close trophoblast-epithelial contact which led ultimately to phagocytosis of sloughed epithelium. Blastocysts showed a clear preference for adhesion to cultured epithelium in vesicles that had begun to collapse. In this case the cells showed a columnar profile with sharply defined microvillous apexes, unlike the flattened cells in fully expanded vesicles or on culture dishes. We conclude that the preimplantation adhesion of mouse blastocysts requires specific changes on both the embryonic and maternal surfaces to overcome the mutual nonadhesiveness typical of epithelia. The relatively rapid adhesion of blastocysts to a culture dish, on the other hand, is more typical of the well-known spreading behavior of cells on a highly attractive surface. PMID- 6842163 TI - Localization of actin in the sperm head of the plains mouse, Pseudomys australis. AB - Actin was localized in the sperm head of the plains mouse, Pseudomys australis, using NBD-phallacidin, a fluorescent-labeled phallotoxin. It was found to be present in the two ventral hooks in sperm from the testis, epididymis, and vas deferens. Faint fluorescence was observed in other regions of the sperm head, whereas autofluorescence occurred in the midpiece of the tail in some preparations. The material in the ventral hooks was also found to be birefringent, which is consistent with it showing preferential orientation. PMID- 6842164 TI - Effects of protease inhibitors on early events in the conjugation of paramecium caudatum. AB - The effects of 11 different protease inhibitors on mating reactivity and pair formation in the conjugation process of the ciliated protozoan Paramecium caudatum were investigated. Of the 11 inhibitors tested, six microbial and three synthetic inhibitors showed no effect on either pair formation or mating reactivity even at their highest concentrations. Soybean trypsin inhibitor and ovomucoid also showed no effect on pair formation even though they temporarily repressed mating reactivity. These results indicate that the process of pair formation during the conjugation process does not involve an extracellular proteolytic reaction. PMID- 6842165 TI - Reassortment of cells according to position in mouse morulae. AB - Sixteen-cell mouse morulae were disaggregated and blastomeres originally occupying outer or inner positions were separated. Outer, inner, or unsorted populations of blastomeres were labeled with either trinitrobenzene sulphonic acid (TNP) or fluorescein isothiocyanate (FITC) and individual blastomeres aggregated to unlabelled partially decompact eight- to ten-cell morulae. After up to 6 h in culture, the positions of the labelled blastomeres within the aggregates were examined. The combined results demonstrated that between 86 and 92% of outer cells remained on the surface of the aggregate and flattened into extensive polygonal shapes, whereas 76-77% of the inner cells had become engulfed by the host morula cells and retained their initial spherical shape. Using unsorted cells, 33-37% were internalised, which is compatible with the most recent estimates of the presence of six to eight inner cells at the 16-cell stage. The possibility that differential adhesiveness of the outer and inner cells is involved in the allocation of cells to the trophectoderm and inner cell mass of the blastocyst is discussed. PMID- 6842166 TI - Report of the FMA committee on professional liability. PMID- 6842167 TI - Your reciprocal reports. PMID- 6842168 TI - A measure of crisis. PMID- 6842169 TI - Medical malpractice claims frequency, severity and causes. PMID- 6842170 TI - Medicine today and tomorrow. PMID- 6842171 TI - Regulation of calcium sensitivity in perforated mammalian cardiac cells. AB - Sarcolemmal perforations can be produced in bundles of rat right ventricular cells by either perfusion of the heart or soaking of the bundles with a solution containing 10 mM EGTA. All cells are affected and lose approximately 40% of the surface membrane. In these cells it is possible to show cAMP regulation of contractility (maximum Ca-activated force) without cAMP regulation of Ca sensitivity (pCa for 50% of maximum Ca-activated force). Therefore, the target molecule for cAMP is different for the two regulatory systems. Both regulatory systems can be slowly washed out of the cell by 10 mM EGTA solution but not by relaxing or contraction solutions. A model for regulation of Ca sensitivity is proposed. PMID- 6842172 TI - Osmotic water permeability of the human red cell. Dependence on direction of water flow and cell volume. AB - The osmotic permeability coefficient (Pf) was measured with a stopped-flow light scattering technique. There is an artifactual light-scattering signal produced by the initial mixing that decays with a half-time of approximately 0.2 s. This seriously interferes with the measurement of the osmotically induced change in cell volume, which has a similar half-time. This "injection artifact" is associated with the biconcave shape of the cells. It is negligible for cells that have been made nearly spherical by swelling them in 160 mosmol. The dependence of this artifact on the cell volume may explain the previously observed dependence of Pf on the cell volume. When cells are made echinocytic (and therefore spherically symmetric), this injection artifact becomes negligible at all cell volumes and Pf can be accurately measured. The Pf of echinocytic cells was nearly constant, varying by less than 10% with the direction of flow and the medium osmolarity (160-360 mosmol). The average value of Pf was 2.0 X 10(-2) cm/s (T = 23 degrees C). PMID- 6842173 TI - Urea and ethylene glycol-facilitated transport systems in the human red cell membrane. Saturation, competition, and asymmetry. AB - The equilibrium exchange of [14C]urea and ethylene glycol was measured using a new type of fast flow system. Approximately equal volumes of saline and air were mixed to form a segmented fluid stream into which 14C-loaded red cells are injected. The stream flows through three filter chambers which allow sampling of the 14C in the extracellular fluid at three time points. The chambers are designed so that they do not disrupt the segmented bubble pattern. The alternating air and saline segments prevent laminar dispersion in the flowing stream and ensure good mixing at the injection and sampling sites. The equilibrium exchange of both urea and ethylene glycol showed saturation kinetics. The maximum permeability (Po) measured in the limit of zero solute concentration is 1.6 X 10(-3) cm/s for urea and 4.8 X 10(-4) cm/s for ethylene glycol (T = 23 degrees C). The apparent dissociation constant (Km) was 218 mM for urea and 175 mM for ethylene glycol. The Po for thiourea is 2.3 X 10(-6) cm/s and the Km is 19 mM. Urea and thiourea inhibit the transport of each other and the inhibition constant (KI) is approximately equal to the Km for both compounds. 53 other analogues of urea were screened for their inhibition of urea or thiourea transport. Several analogues [e.g., 1-(3,4-dichloro-phenyl)-2-thiourea] had a KI in the range of 0.03 mM. The affinity of the inhibitor increased as it was made more hydrophobic. The urea analogues did not significantly inhibit the ethylene glycol or osmotic permeability. Glycerol inhibited ethylene glycol permeability with a KI of 1,200 mM. PMID- 6842174 TI - Reflection coefficient and permeability of urea and ethylene glycol in the human red cell membrane. AB - The reflection coefficient (sigma) and permeability (P) of urea and ethylene glycol were determined by fitting the equations of Kedem and Katchalsky (1958) to the change in light scattering produced by adding a permeable solute to a red cell suspension. The measurements incorporated three important modifications: (a) the injection artifact was eliminated by using echinocyte cells; (b) the use of an additional adjustable parameter (Km), the effective dissociation constant at the inner side of the membrane; (c) the light scattering is not directly proportional to cell volume (as is usually assumed) because refractive index and scattering properties of the cell depend on the intracellular permeable solute concentration. This necessitates calibrating for known changes in refractive index (by the addition of dextran) and cell volume (by varying the NaCl concentration). The best fit was for sigma = 0.95, Po = 8.3 X 10(-4) cm/s, and Km = 100 mM for urea and sigma = 1.0, Po = 3.9 X 10(-4) cm/s, and Km = 30 mM for ethylene glycol. The effects of the inhibitors copper, phloretin, p chloromercuriphenylsulfonate, and 5,5'-dithiobis (2-nitro) benzoic acid on the urea, ethylene glycol, and water permeability were determined. The results suggest that there are three separate, independent transport systems: one for water, one for urea and related compounds, and one for ethylene glycol and glycerol. PMID- 6842176 TI - Arterial bifurcations in the cardiovascular system of a rat. AB - Arterial bifurcations in the cardiovascular system of a rat were studied, using a resin cast of the entire arterial tree. At each bifurcation, measurements were made of the diameters of the three vessels involved, the two branching angles, and the angle delta, which the parent artery makes with the plane containing the two branches. The results were found to be consistent with those reported previously in man and monkey. In addition, measurements of delta in the present study indicate that arterial bifurcations are mostly two dimensional. PMID- 6842175 TI - Permeability of human red cells to a homologous series of aliphatic alcohols. Limitations of the continuous flow-tube method. AB - Human red cell permeability to the homologous series of methanol, ethanol, n propanol, n-butanol, and n-hexanol was determined in tracer efflux experiments by the continuous flow tube method, whose time resolution is 2-3 ms. Control experiments showed that unstirred layers in the cell suspension were less than 2 X 10(-4) cm, and that permeabilities less than or equal to 10(-2) cm s-1 can be determined with the method. Alcohol permeability varied with the chain length (25 degrees C): Pmeth 3.7 X 10(-3) cm s-1, Peth 2.1 X 10(-3) cm s-1, Pprop 6.5 X 10( 3) cm s-1, Pbut less than or equal to 61 X 10(-3) cm s-1, Phex 8.7 X 10(-3) cm s 1. The permeability for methanol, ethanol, and n-propanol was concentration independent (1-500 mM). The permeability to n-butanol and n-hexanol, however, increased above the upper limit of determination at alcohol concentrations of 100 and 25 mM, respectively. The activation energies for the permeability to methanol, n-propanol, and n-hexanol were similar, 50-63 kJ mol-1. Methanol permeability was not reduced by p-chloromercuribenzene sulfonate (PCMBS), thiourea, or phloretin, which inhibit transport of water or hydrophilic nonelectrolytes. It is concluded (a) that all the alcohols predominantly permeate the membrane lipid bilayer structure; (b) that both the distribution coefficient and the diffusion coefficient of the alcohols within the membrane determine the permeability, and (c) that the relative importance of the two factors varies with changes in the chain length. PMID- 6842179 TI - Aminopeptidase activity of Leptospira strains. AB - A total of 15 cultures of Leptospira were examined for aminopeptidase activity using 22 aminoacyl-beta-naphthylamde substrates. Activity was demonstrated in each of the cultures. Extracts from serovars of Leptospira interrogans preferentially hydrolysed the same range of substrates. The level of hydrolysis of the preferred substrates for the seven strains of L. interrogans was distinctively higher than that demonstrated for the six Leptospira biflexa strains. Extracts from cultures of Leptospira illini and Leptospira parva sp. nov. exhibited profiles different to those demonstrated for the other 13 leptospiral cultures examined. PMID- 6842177 TI - Stoichiometry and ion dependencies of the intracellular-pH-regulating mechanism in squid giant axons. AB - The ion transport system responsible for intracellular pH (pHi) regulation in squid giant axons was examined in experiments with pH-sensitive microelectrodes and isotopic fluxes of Na+ and Cl-. In one study, axons were acid-loaded and the rate of the subsequent pHi recovery was used to calculate the acid extrusion rate. There was an absolute dependence of acid extrusion on external Na+, external HCO-3 (at constant pH), and internal Cl-. Furthermore, the dependence of the acid extrusion rate on each of these three parameters was described by Michaelis-Menten kinetics. Acid extrusion was stimulated by an acid pHi, required internal ATP, and was blocked by external 4-acetamido-4'-isothiocyanostilbene 2,2'-disulfonate (SITS). Under a standard set of conditions (i.e., [HCO-3]o = 12 mM, pHo = 8.00, [Na+]o = 425 mM, [Cl-]i = 150 mM, [ATP]i = 4 mM, pHi = 6.5, and 16 degrees C), the mean acid extrusion rate was 7.5 pmol X cm-2 X s-1. In a second study under the above standard conditions, the unidirectional Na+ efflux (measured with 22Na) mediated by the pHi-regulating system was found to be approximately 0, whereas the mean influx was about 3.4 pmol X cm-2 X s-1. This net influx required external HCO-3, internal Cl-, and acid pHi, internal ATP, and was blocked by SITS. In the final series of experiments under the above standard conditions, the unidirectional Cl- influx (measured with 36Cl) mediated by the pHi-regulating system was found to be approximately 0, whereas the mean efflux was approximately 3.9 pmol X cm-2 X s-1. This net efflux required external HCO-3, external Na+, an acid pHi, internal ATP, and was blocked by SITS. We conclude that the pHi-regulating system mediates the obligate net influx of HCO-3 (or equivalent species) and Na+ and the net efflux of Cl- in the stoichiometry of 2:1:1. The transport system is stimulated by intracellular acid loads, requires ATP, and is blocked by SITS. PMID- 6842178 TI - Anion transport inhibitor binding to band 3 in red blood cell membranes. AB - The inhibitor of anion exchange 4,4'-dibenzoamido-2,2'-disulfonic stilbene (DBDS) binds to band 3, the anion transport protein in human red cell ghost membranes, and undergoes a large increase in fluorescence intensity when bound to band 3. Equilibrium binding studies performed in the absence of transportable anions show that DBDS binds to both a class of high-affinity (65 nM) and low-affinity (820 nM) sites with stoichiometry equivalent to 1.6 nmol/mg ghost protein for each site, which is consistent with one DBDS site on each band 3 monomer. The kinetics of DBDS binding were studied both by stopped-flow and temperature-jump experiments. The stopped-flow data indicate that DBDS binding to the apparent high-affinity site involves association with a low-affinity site (3 microM) followed by a slow (4 s-1) conformational change that locks the DBDS molecule in place. A detailed, quantitative fit of the temperature-jump data to several binding mechanisms supports a sequential-binding model, in which a first DBDS molecule binds to one monomer and induces a conformational change. A second DBDS molecule then binds to the second monomer. If the two monomers are assumed to be initially identical, thermodynamic characterization of the binding sites shows that the conformational change induces an interaction between the two monomers that modifies the characteristics of the second DBDS binding site. PMID- 6842180 TI - Determination of fatty acids and carbohydrate monomers in micro-organisms by means of glass capillary gas chromatography: analysis of Mycobacterium gordonae and Mycobacterium scrofulaceum. AB - Trifluoroacetylated whole-cell methanolysates of four strains each of Mycobacterium gordonae and Mycobacterium scrofulaceum were analysed by gas chromatography, using a glass capillary column. The major chromatographic peaks were identified by mass spectrometry as derivatives of fatty acids and carbohydrates. In addition, two predominant peaks, present in chromatograms representing M. scrofulaceum, were identified as 2-octadecanol and 2-eicosanol. These secondary alcohols were not found in any of the strains of M. gordonae studied. The amount of tuberculostearic acid in the latter species was less than 1% of that in M. scrofulaceum. PMID- 6842181 TI - The influence of ionic strength, pH and a protein layer on the interaction between Streptococcus mutans and glass surfaces. AB - The initial interaction between Streptococcus mutans and hard surfaces has been investigated using a rotating disc technique. The deposition to clean and BSA coated glass of two strains of S. mutans, FA-1 (serotype b) and KPSK2 (serotype c), which exhibit different surface properties, was studied. Organisms were harvested from cultures grown in a chemostat at a dilution rate of 0.06 h-1 and suspended in NaCl solutions of defined ionic strengths and pH values. The deposition of both strains showed a strong dependence on electrolyte concentration, particularly at low ionic strengths, which was inversely related to the zeta potentials of the organisms. Similarly, the ionic strength at which maximum deposition was first noted (critical coagulation concentration) for the two strains correlated with their relative potentials. Deposition was insensitive to changes in pH at an electrolyte concentration of 0.05 M. The maximum observed deposition did not approach values predicted by theory, suggesting that a further barrier to deposition, other than electrostatic repulsion, might exist. Under all experimental conditions, some of the deposited bacteria were observed to be oscillating, suggesting that they were held at a distance from the collector surface. The cells did not, however, appear to be deposited in a secondary minimum predicted by DLVO theory hence it may be that long-range polymer interactions are also involved in the deposition of these organisms. PMID- 6842182 TI - Isolation and characterization of the outer and cytoplasmic membranes of Pseudomonas cepacia. AB - A method is described for the separation of the outer membrane (OM) from the cytoplasmic membrane (CM) of Pseudomonas cepacia grown in nutrient broth and in chemically defined media under different nutrient depletions. The method is particularly valuable since it is effective when applied to stationary phase cells. Enzyme activities indicated that the contamination of the OM with the CM was less than 5%. The OM protein profile of magnesium-depleted cells was much simpler than that of the iron-depleted and nutrient broth grown cells. The apparent molecular weights of the OM proteins of magnesium-depleted cells were: 40 000, 36 000, 24 500 and 14 500. Iron depletion induced the synthesis of an OM protein with apparent molecular weight of 66 000. The OM proteins with apparent molecular weights of 40 000, 36 000 and 24 500 were heat-modifiable and the 24 500 dalton protein was found also to be affected by the presence of 2 mercaptoethanol. The OM consisted of 50% protein and 20% phospholipid and the rest was probably LPS while the CM consisted of 80% phospholipid and 20% protein. The major phospholipid in both membranes was phosphatidylethanolamine with a smaller amount of phosphatidylglycerol and a trace amount of phosphatidylcholine; the OM contained more phosphatidylethanolamine than the CM. PMID- 6842183 TI - A conditional aerial mycelium-negative mutant of Streptomyces fradiae with deficient ornithine carbamoyltransferase activity. PMID- 6842184 TI - Protection of newborn mice against herpes simplex virus infection by prenatal and postnatal transmission of antibody. AB - Pre- and postnatally acquired protection against herpes simplex virus type 2(HSV 2) infection mediated by maternal antibody was investigated in the newborn mouse. Newborn mice, 2 days old, were inoculated with HSV-2 intraperitoneally after maternal immunization with live or inactivated virus. The survival rates improved in proportion to the maternal neutralizing antibody titres. Ninety-three percent of animals delivered by Caesarean section from immune mothers and suckled by non immune mothers survived viral infection, whereas 7% of control animals survived. The same was true with animals born to non-immune mothers and nursed by immune mothers. In foetal sera and milk of immunized mice, anti-HSV activity was associated primarily with antibody of the IgG class as measured by enzyme-linked immunosorbent assay (ELISA). In addition, oral administration of antibody conferred protection on newborn mice. These studies indicate that maternal IgG, acquired not only postnatally but also prenatally, plays an important role in protecting newborn mice against HSV infection. PMID- 6842186 TI - Studies on the phosphorylation of the 58000 dalton early region 1B protein of human adenovirus type 5. AB - The 58000 dalton (58K) protein coded for by early region 1B of human adenovirus type 5 (Ad5) was found to be phosphorylated. At least three major tryptic phosphopeptides were identified and the average number of phosphates per 58K molecule was estimated to be between two and three. Thus, it was possible that each phosphopeptide contained just one phosphate group. The ratio of phosphoserine to phosphothreonine was about 2 to 1 on average and essentially no phosphotyrosine was detected. No evidence was found to suggest that cAMP dependent protein kinase was involved in the phosphorylation of 58K. Previous studies have shown that 58K was phosphorylated when immunoprecipitates containing Ad5 early region 1 proteins were incubated in vitro with [gamma-32P]ATP. Analysis of the phosphopeptides of 58K labelled under these conditions indicated a large number of phosphorylation sites which differed from those found in vivo. Thus, the action of kinases in the in vitro phosphorylation of 58K in immunoprecipitates did not mimic the enzymic activity responsible for 58K phosphorylation in vivo. PMID- 6842185 TI - Maturation of parvovirus LuIII in a subcellular system. I. Optimal conditions for in vitro synthesis and encapsidation of viral DNA. AB - The development of an in vitro system prepared by lysis of LuIII virus-infected cells with Brij-58 has enabled the study of the assembly pathway of a parvovirus. Under optimal conditions, radioactive precursors are incorporated both into viral replicative form double-stranded DNA and into progeny viral DNA (vDNA) during pulses as short as 30 s. Labelled 110S particles can be isolated at the end of such pulses. Therefore, synthesis and encapsidation of progeny viral DNA into pre existing empty viral capsids appear to be closely related processes. Up to about 10 min after incorporation of vDNA, the 110S particles band at 1.44 g/ml and are relatively unstable in 3.5 M-CsCl. Moreover, newly synthesized vDNA molecules show an abnormal electrophoretic behaviour probably due to the presence of a covalently linked terminal protein. This so far uncharacterized alkali-stable polypeptide is lost (cleaved off?) concomitant with the maturation of the 110S virus particles. Maturation is reflected by a change in the virus stability in CsCl and a shift in density from 1.44 to 1.41 g/ml around 10 to 15 min after encapsidation of progeny vDNA. PMID- 6842187 TI - A biochemical comparison of the in vitro replication of a virulent and an avirulent strain of Venezuelan encephalitis virus. AB - The virulent Venezuelan equine encephalitis (VEE) virus strain, Trinidad donkey (TRD) and its vaccine derivative strain TC-83, demonstrated biological and biochemical differences in their replication. These two viruses had similarly shaped growth curves; however, TRD virus-infected cells produced significantly more infectious virus than did the TC-83 virus-infected cells during the very early period of the replication cycle. TRD virus inhibited host cell protein synthesis in Vero cells earlier than did TC-83 virus as measured by the incorporation of [35S]methionine into cellular proteins. Virus-specified proteins were detected 1 to 2 h earlier in TRD virus-infected cells than in the TC-83 virus-infected cells; however, pulse-chase studies failed to show differences in the processing of the viral structural proteins in cells infected by either of the viruses. TRD virus-infected cells produced more virus RNA than did the TC-83 virus-infected cells, and analysis of the intracellular viral RNA species showed an increased synthesis of 26S RNA in the TRD virus-infected cells. The difference in amounts of 26S virus RNA produced was most pronounced early during the infection and may explain why TRD virus infection resulted in an earlier production of viral proteins and inhibition of cellular protein synthesis than was observed in the cells infected with the avirulent vaccine strain of VEE virus. PMID- 6842188 TI - Conformational changes in Sindbis virus E1 glycoprotein induced by monoclonal antibody binding. AB - A monoclonal antibody (30.2) raised against Sindbis virus is able to precipitate both E1 and PE2 from [35S]methionine-labelled infected cells solubilized with non ionic detergent. Addition of SDS to the lysate abolishes the precipitation of PE2 without affecting that of E1, thus demonstrating that the antibody is specific for E1. Other Sindbis E1-specific monoclonal antibodies (30.11 and 30.12) precipitate only E1, even from lysates containing only non-ionic detergent, and their presence in such a lysate prevents precipitation of PE2 by antibody 30.2. These data indicate that E1-PE2 complexes stable in the presence of non-ionic detergent can be precipitated as such by one antibody, but that binding of the other antibodies induces dissociation of E1 and PE2. Competition experiments using 125I-labelled antibodies indicate that all three antibodies bind to distinct antigenic sites on the E1 molecule. Antibodies 30.11 and 30.12 stimulate each other's binding in such experiments, which suggests that binding of either of these antibodies alters the conformation of E1 in such a way as to increase its affinity for the other, and at the same time to release PE2. Antibody 30.2 also enhances binding of the other two antibodies, but this stimulation is only weakly reciprocated. PMID- 6842189 TI - Mechanism of uncoating of influenza B virus in MDCK cells: action of chloroquine. AB - Exposure of influenza B virus-infected MDCK cells to chloroquine at the time of infection resulted in significant inhibition of infection. The appearance of input virus in the intracellular vesicles was not affected in the presence of the drug, but primary transcription of the virus genome did not occur. Chloroquine caused a rapid rise in the pH inside the lysosomes of MDCK cells, to 6.5 from the physiological pH 5.6. In contrast, exposure of infected cells incubated in acidic medium (pH 6.0) to chloroquine did not cause an increase in lysosomal pH and this low pH treatment during the chloroquine-sensitive phase was followed by virus production. Influenza B virus induced haemolysis of chick erythrocytes at low pH values (5.0 to 5.9) which was associated with cell-cell membrane fusion. It is likely that chloroquine prevents the uncoating of influenza B virus by increasing the lysosomal pH above the critical value required for inducing fusion between the virus envelope and the lysosomal membrane. PMID- 6842190 TI - Comparative studies of the immunogenic activity of hepatitis B surface antigen (HBsAg) and HBsAg polypeptides. AB - Three hepatitis B surface antigen (HBsAg) preparations were compared: purified intact 22-nm HBsAg particles; HBsAg-derived, sodium dodecyl sulfate (SDS) denatured P25 + GP30 polypeptide pool; and nondenatured P25 + GP30 micelles. The micelles had the same polypeptide composition as the P25 + GP30 pool. The immunogenicity in mice of each preparation, administered either in saline suspension or adsorbed to aluminum gel, was compared. The SDS-denatured polypeptides were less immunogenic than intact HBsAg particles, whereas the micelles were more immunogenic. High anti-HBs titers were observed in mice immunized with micelle preparations in either saline suspension or adsorbed to aluminum gel for as long as 200 days after a booster inoculation, administered 26 days after the primary dose. PMID- 6842191 TI - Hepatitis B infection in Vietnamese families. AB - The occurrence of hepatitis B infection as measured by sensitive serological tests for HBsAg, HBeAg and hepatitis B-specific antibodies was studied in Vietnamese refugee families. HBsAg was found in 10% of 301 children studied. Totally 74% of all HBsAg-positive children had an HBsAg-positive mother or father and an additional 7% had a positive sibling. The distribution of these cases indicated that the risk of HBs-antigenemia was increased 11-fold for those who had an HBsAg-positive mother compared with all other children. The presence of HBeAg in the HBsAg-positive parents was associated with a threefold higher risk of HBs-antigenemia in children as compared with the presence of anti-HBe. It was thus documented that HBV in this population is spread primarily by intrafamilial routes and prophylactic measures within risk families should largely be able to control the appearance of new HBsAg carriers. PMID- 6842192 TI - Complexes between HBsAg and IgM in serum of patients with acute hepatitis. AB - HBsAg bound to IgM was measured in the serum of HBsAg carriers with acute hepatitis using a radioimmunoassay based on selective absorption of IgM on solid phase coated with antiserum to human IgM. HBsAg/IgM was detected in 94 (100%) patients with acute type B hepatitis during the acute phase of infection and persisted after the fourth week only in 13 of them, who developed chronic liver disease. HBsAg/IgM was detected only in 1 patient out of 15 carriers of the HBsAg with superimposed non-B hepatitis. No activity was found in serum of 20 patients with acute HBsAg-negative hepatitis. The nature of the IgM component of the complex is uncertain, however, blocking experiments of the HBsAg/IgM reaction with polymerized human albumin suggest that the IgM component of the complex might represent antibody to the denatured protein. Persistent HBsAg/IgM complex detection in patients with acute type B hepatitis provides a useful tool to predict transition of HBV infection to chronicity. Its absence in patients with acute HBsAg-positive hepatitis is indicative of non-B hepatitis in chronic carriers of the HBsAg. PMID- 6842193 TI - Malice's wonderland: research funding and peer review. PMID- 6842194 TI - The migrant sensory neuritis of Wartenberg. AB - Six cases are reported that conform to Wartenberg's description of migrant sensory neuritis. This is a benign relapsing and remitting condition in which pain and subsequent loss of sensation in the distribution of individual cutaneous nerves is induced by movement of the limbs inducing stretch. Sural nerve biopsy in one case showed loss of large myelinated fibres, axonal sprouting and some changes suggestive of ischaemia. PMID- 6842195 TI - Cerebrospinal fluid arginine vasopressin in degenerative disorders and other neurological diseases. AB - Arginine vasopressin (AVP) was determined in plasma and lumbar CSF from 46 patients with Parkinson's disease, dementia, cerebrovascular disease, multiple sclerosis and other, mostly peripheral neurological disorders. The mean plasma concentration of AVP was 1.62 microU/ml, the CSF concentration 1.14 microU/ml and the gradient CSF/plasma 0.72. There was a good correlation between the plasma and the CSF values in most patients. No sex difference could be found. A slight decrease of the CSF values could be found with increasing age. Significantly higher CSF-AVP values were found in patients with cerebrovascular disease, whereas lower CSF values were found in patients with dementia and Parkinson's disease. However there were decreased CSF/plasma gradients in patients with dementia and Parkinson's disease to about 0.30 compared to 0.98 in patients with peripheral neurological disorders. Patients with multiple sclerosis had an increased IgG index indicating an intrathecal IgG production but there was no obvious correlation between this and the AVP concentrations in plasma and CSF, nor with the total CSF protein content, nor with the albumin and IgG concentrations in plasma and CSF. PMID- 6842196 TI - Visual evoked potentials in neurosyphilis. AB - The visual evoked potential (VEP) to pattern reversal was recorded in 79 patients with neurosyphilis. Sixteen patients (20%) had abnormal VEP latencies with a predominance of pathological VEP values in the group of tabes dorsalis (50%) as compared to general paresis (18%) or meningovascular forms (13%). A comparison of the frequency of abnormal VEPs with that of other ophthalmological tests (visual acuity, visual field, central campimetry, pupillary reactions, dark adaptation, optic fundus) yielded no diagnostic superiority of VEP. PMID- 6842198 TI - The behaviour of the long-latency stretch reflex in patients with Parkinson's disease. AB - The size of the long-latency stretch reflex was measured in a proximal (triceps) and distal (flexor pollicis longus) muscle in 47 patients with Parkinson's disease, and was compared with that seen in a group of 12 age-matched normal control subjects. The patients were classified clinically into four groups according to the degree of rigidity at the elbow or tremor. Stretch reflexes were evaluated while the subject was exerting a small force against a constant preload supplied by a torque motor, and the size of the reflex response was measured as fractional increase over basal levels of activity. When stretches were given at random intervals by increasing the force exerted by the motor by a factor of 2 or 3, there was a clear trend for the more severely affected patients to have larger long latency responses in the triceps muscle, although there was no change in the size of the short-latency, spinal component of the response. In contrast, there was no change in the size of the long-latency response of the flexor pollicis longus in any group of patients with Parkinson's disease. Despite any differences in reflex size, the inherent muscle stiffness of both muscles appeared to be normal in all groups of patients with Parkinson's disease, since the displacement trajectory of the limb following the force increase was the same as control values in the short (25 ms) period before reflex compensation could intervene. In 20 of the patients and in seven of the control subjects, servo-controlled, ramp positional disturbances were given to the thumb. Up to a velocity of 300 degrees /s, the size of the long-latency stretch reflex was proportional to the log velocity of stretch. This technique revealed, in both moderately and severely rigid patients, increases in the reflex sensitivity of the flexor pollicis longus, which had not been clear using step torque stretches alone. However, whether using ramp or step displacements, long latency stretch reflex gain was not closely related to rigidity; reflex size was within the normal range in many patients with severe rigidity. Enhanced long latency stretch reflexes thus contribute to, but may not be solely responsible for, rigidity in Parkinson's disease. PMID- 6842197 TI - Neurological features and computed tomography of the brain in children with ornithine carbamoyl transferase deficiency. AB - The clinical features and the computed tomographic appearances of the brain in seven children with ornithine carbamoyl transferase deficiency are described. Episodic vomiting and drowsiness, acute encephalopathy, failure to thrive and developmental retardation were common, but focal neurological symptoms and signs were also observed. The CT appearances were non-specific with generalised or focal changes. They were related to the severity, the duration and the age of onset of the hyperammonaemia. Since the CT changes may suggest conditions other than metabolic disease, the emergency investigation of a child with an encephalopathy should include the estimation of plasma ammonium and, if elevated, the appropriate investigations to establish the cause. PMID- 6842199 TI - Physiological mechanisms of rigidity in Parkinson's disease. AB - Electromyographic responses of triceps surae and tibialis anterior produced by dorsiflexion stretch were studied in 17 patients with Parkinson's disease. Most patients showed increased muscular activity when attempting to relax. A few patients showed an increase of short-latency reflexes when relaxed and when exerting a voluntary plantarflexion prior to the stretch. Many patients showed long-latency reflexes when relaxed and all but one showed long-latency reflexes with voluntary contraction; and these reflexes were often larger in magnitude and longer in duration than those seen in normal subjects. Unlike the short-latency reflex, the long-latency reflex did not disappear with vibration applied to the Achilles tendon. The long-latency reflexes and continuous responses to slow ramp stretches were diminished at a latency similar to the beginning of long-latency reflexes when the stretching was quickly reversed. Dorsiflexion stretch also frequently produced a shortening reaction in tibialis anterior. Of all the abnormal behavior exhibited by the Parkinsonian patients only the long-latency reflex magnitude and duration correlated with the clinical impression of increased tone. The mechanism of the long-latency reflex to stretch which is responsible for rigidity is not certain, but the present results are consistent with a group II mediated tonic response. PMID- 6842200 TI - Recovery after stroke. AB - One hundred and sixty-two patients were referred to a rehabilitation unit after an acute stroke. The patterns of recovery of overall functional ability, arm function, walking and speech in 92 of 101 survivors have been analysed. In all modalities the majority of recovery occurs within 3 months; although improvement is seen thereafter it does not reach statistical significance. Possible reasons for the apparent lack of late recovery are discussed. PMID- 6842201 TI - Stretch reflexes of triceps surae in patients with upper motor neuron syndromes. AB - Electromyographic responses of triceps surae to dorsiflexion stretch were studied in 47 patients with a variety of lesions producing an upper motor neuron syndrome. The short latency spinal reflexes, both when the patient was at rest and when he was exerting a voluntary plantarflexion, were frequently enhanced in magnitude and the rate of increase with acceleration was also enhanced. Long latency reflexes were uncommon at rest. With background force long-latency reflexes were present unless the short latency reflex was very large. Long latency reflexes often were normal, but in some patients they were either excessively larger or even of abnormal shape with prolonged continuous activity. The clinical assessment of the ankle jerk correlated with the magnitude of the short latency reflex. The clinical assessment of tone correlated with the magnitude of the short latency reflex, the magnitude of the long latency reflex and the duration of the long latency reflex. There appear to be multiple physiological mechanisms underlying the clinical phenomenon of spasticity. PMID- 6842202 TI - The relationship between disordered pursuit and vestibulo-ocular reflex suppression. AB - The performance of the smooth pursuit reflex and the ability to suppress the vestibulo-ocular reflex were assessed in 10 normal subjects and in patients with a variety of diseases of the central nervous system. Pursuit was measured as the maximum velocity of slow phase eye movement in response to a laser target moving sinusoidally at various frequencies up to 1 Hz and with amplitudes stepped up to 35 degrees peak. Suppression of the vestibulo-ocular reflex was assessed with subjects seated in a Barany chair rotating sinusoidally in yaw at matching frequencies. The breakpoint of vestibulo-ocular reflex supression was defined as the peak velocity of oscillation at which nystagmus appeared on electro oculographic recording as determined by the method of ascending and descending thresholds. For normal subjects, at all frequencies, the breakpoint of suppression corresponded closely with the peak velocity of pursuit at the corresponding frequency of target oscillation. In some patients pursuit and suppression were comparably impaired. In others either pursuit or suppression could be selectively impaired with the other function left intact. The results demonstrate that the mechanisms of pursuit and visual suppression of the vestibulo-ocular reflex have similar dynamics and share a common pathway at least to the level of the cerebellum. Thereafter, there is presumably an anatomical and functional dissociation of the signals mediating the two functions. The key area involved appears to be the flocculus for lesions of this structure alone cause impairment of both functions. The findings also indicate that the appropriate way to test smooth pursuit in relationship to suppression is to increase the amplitude of target oscillation until the peak slow eye movement velocity is determined for each frequency. The finding that increasing excursion increases maximum pursuit velocity supports the view that pursuit has an acceleration limit which is more critical in determining performance than velocity limitations. The results establish the assessment of vestibulo-ocular reflex suppression as a powerful test of the integrity of CNS function independent of its previous association with disordered pursuit. PMID- 6842203 TI - Direct and reflex responses in perineal muscles on electrical stimulation. AB - Responses in the external anal and urethral sphincters as well as in the bulbocavernosus muscle have been evoked by supramaximal electrical stimulation of the penis (or clitoris), perineum and the peri-anal region and recorded electromyographically in 82 male subjects 5 to 73 years old and in nine female subjects 18 to 55 years old, who had no systemic diseases or demonstrable sacral nervous system lesion. On perineal stimulation (including the penis or clitoris) reflex responses with a typical latency of 33 ms and which exhibit no habituation were obtained in all muscles examined. Stimulation of the peri-anal region gave habituating reflex responses with a typical latency of 55 ms in all muscles examined. On perineal, and sometimes also peri-anal stimulation, stable short latency responses with typical latencies of 5 and 13 ms were recorded; both were considered to be direct responses. The different evoked muscle responses obtained by stimulation in the perineal and peri-anal region have to be distinguished when the bulbocavernosus and anal reflexes are recorded for evaluation of sacral nervous system lesions. PMID- 6842204 TI - Unilateral occipital infarction: evaluation of the risks of developing bilateral loss of vision. AB - Fifty-eight patients with a unilateral infarction in the superficial area supplied by a posterior cerebral artery were followed (mean: 39.6 months). Thirteen (22.4%) developed cortical blindness associated with a delayed contralateral occipital infarction. Advanced age, general vascular risk, a history of strokes, Sylvian border-zone extension of the initial infarct, and an absence of improvement of initial visual field defects were strongly associated with spread to the other side. The lack of visual field improvement most accurately predicted a high risk of cortical blindness. A careful follow-up and controlled medical therapy is particularly indicated in these patients. PMID- 6842205 TI - Pontocerebellitis--a rare manifestation of mononucleosis. AB - A patient with pontocerebellitis associated with infectious mononucleosis is described. The clinical picture with transitory limb and truncal ataxia was compatible with previous reports of cerebellitis. CT showed wide pontocerebellar cisterns and a hypodense area in the pons. PMID- 6842206 TI - Persistent visual hallucinations secondary to chronic solvent encephalopathy: case report and review of the literature. AB - A case of solvent encephalopathy presenting with persistent visual hallucinations, and characterised by a diffusely abnormal EEG and delayed visually evoked responses to checkerboard pattern reversal (VERs), is described. Abnormalities in the EEG and VERs showed minimal improvement over many months of abstinence from glue sniffing. The literature on the neurological sequelae of solvent abuse is reviewed. PMID- 6842207 TI - Intellectual ability of adults after lifelong intestinal malabsorption due to coeliac disease. AB - The intellectual impact of lifelong intestinal malabsorption was examined in a consecutive series of 19 adults (mean age, 48 +/- 11 years) with untreated coeliac disease. Using a comprehensive test battery no consistent signs of cognitive impairment were found and in the light of recent observations on coeliacs, aspects of nutritional deficiency may prove more pertinent to other forms of cerebral dysfunction. PMID- 6842208 TI - Accuracy of clinical diagnosis in primary degenerative dementia: correlation with neuropathological findings. AB - Neuropathological features and causes of death are presented in 27 deceased patients belonging to a prospective series of 71 hospitalised patients with primary degenerative dementia. The clinical criteria for primary degenerative dementia used in the present study were accurate enough to exclude patients with multi-infarct dementia. At necropsy, 82% of the cases had neuropathological changes of Alzheimer's disease. The clinical features of patients with other neuropathological changes are described. The most common immediate cause of death was bronchopneumonia which accounted for 59% of deaths in Alzheimer's disease. PMID- 6842209 TI - Measurement of motor conduction velocity with Hopf's technique in myotonic dystrophy. AB - Hopf's technique was used to measure maximal and minimal motor nerve conduction velocities, and the percentage of fibres with intermediate velocity, in the posterior tibial nerve in patients with myotonic dystrophy. A reduction of maximal and minimal conduction velocities was found. The distribution of fibres with intermediate velocity was nearly identical to that of the control group and the dispersion values were normal. These data do not support the hypothesis that a primary disturbance of the motor neurons is responsible for the muscle changes in myotonic dystrophy. The reduction of the motor nerve conduction velocity, which was an inconstant finding, should not be considered an indication of a neurogenic aetiology of myotonic dystrophy, but only one of the many disorders of a multisystem disease. PMID- 6842210 TI - Serotonin nerve cells in Alzheimer's disease. PMID- 6842211 TI - Alcaptonuria with seizures. PMID- 6842212 TI - High dose intravenous methyl prednisolone in acute exacerbations of multiple sclerosis. PMID- 6842213 TI - Subacute sensory neuropathy with remission: an association with lymphoma. PMID- 6842214 TI - Sequential changes in oligoclonal patterns during the course of multiple sclerosis. AB - The majority of patients with multiple sclerosis have an abnormality of their spinal fluid immunoglobulins. This alteration is manifested as patterns of diffuse protein bands in the gamma globulin region following electrophoresis. This pattern has been termed one of restricted heterogeneity, or an oligoclonal pattern. We have found changes in the banding pattern of some patients studied longitudinally. Since the significance of these findings may be relevant to the pathogenesis of this notoriously waxing and waning disease, we discuss the importance of methodologies as well as the concept that IgM and IgA may be relevant to the interpretation of these observations. PMID- 6842215 TI - Basilar artery dissection. AB - Dissection of the basilar artery caused sudden coma and death in a 40-year-old man. Atypical clinical features were explained at necropsy. A ventral dissection of the artery within its outer layers resulted in destruction of the pontine tegmentum with sparing of the basis pontis. An unsuspected defect in the internal elastic lamina in the left internal carotid artery was also found suggesting a more generalised disorder of arterial walls. Basilar artery dissection should be considered in the diagnosis of coma in young people. PMID- 6842216 TI - Prognostic indicators and the pattern of recovery of communication in aphasic stroke patients. AB - Communication abilities were assessed on a wide range of tests in 56 aphasic stroke patients, 33 classified as "moderate" and 23 as "severe". Thirty-six of the patients had received language treatment. The biographical variables of age, months post-onset and handedness were shown to be differentially correlated with improvements. In particular, there were some significant trends of decreasing improvement with increasing months post-onset on expressive verbal tasks in treated moderate aphasics and on comprehension tasks in treated severe aphasics. Untreated patients did not show the same clear pattern of trends; however, these patients were reassessed after a shorter period and covered a smaller range of months post-onset. The role of treatment deserves further clarification. The results also indicate that language recovery is relatively independent of age and of handedness. PMID- 6842217 TI - Speech therapy for Parkinson's disease. AB - Twenty-six patients with the speech disorder of Parkinson's disease received daily speech therapy (prosodic exercises) at home for 2 to 3 weeks. There were significant improvements in speech as assessed by scores for prosodic abnormality and intelligibility' and these were maintained in part for up to 3 months. The degree of improvement was clinically and psychologically important, and relatives commented on the social benefits. The use of a visual reinforcement device produced limited benefit over and above that from prosodic exercises alone, except to patients with severe speech disorder. PMID- 6842218 TI - Perceptual motor dysfunction in Parkinson's disease: a deficit in sequential and predictive voluntary movement. AB - We studied the ability of Parkinsonian patients and controls to generate voluntary movements on a tracing task. Subjects were videotaped while tracing designs of increasing complexity, presented on a vertical, transparent screen. Some designs were presented in a degraded form and subjects filled in their missing sections. Subjects also received a constructional task and a test of general intellectual ability. The quality of errors on the tracing task differed in the Parkinsonian and control groups. Parkinsonian patients made two distinct types of errors. One probably related to the motor disorders of the disease, but another seemed to be related to a higher level of control over sequential and predictive movements. The latter correlated with performance on the constructional and general intellectual tasks. These results suggest that Parkinson's disease may affect basal ganglia structures that are necessary for voluntary movements which require sequencing or planning. Clinically this may be observed in perceptual motor tasks since they require both voluntary movement and sequential organisation of behaviour. PMID- 6842219 TI - Motor neglect. AB - Motor neglect is characterised by an underutilisation of one side, without defects of strength, reflexes or sensibility. Twenty cases of frontal, parietal and thalamic lesions causing motor neglect, but all without sensory neglect, are reported. It is proposed that the cerebral structures involved in motor neglect are the same as those for sensory neglect and for the preparation of movement. As in sensory neglect, the multiplicity of the structures concerned suggests that this interconnection is necessary to maintain a sufficient level of activity. Predominance of left sided neglect by right sided lesions suggests that the left hemisphere is dominant for deliberate activity; hemispheric dominance could be applied to sensory neglect where conscious awareness would play the role of deliberate activity. PMID- 6842220 TI - Daytime polysomnogram diagnosis of sleep disorders. AB - The daytime polysomnogram was used to evaluate 310 consecutive patients with suspected sleep disorders, referred mainly because of excessive daytime sleepiness. Abnormalities consistent with pathologic sleep apnoea were present in 102 cases, and with narcolepsy-cataplexy in 49 cases. The daytime polysomnogram is a readily accessible, accurate, and cost-effective method for diagnosing many sleep disorders. PMID- 6842221 TI - Comparison of three primitive reflexes in neurological patients and in normal individuals. AB - Two hundred and sixty-five normal individuals and patients with clinical signs of extracranial disease, 174 patients with intracranial disease without signs of basal ganglia involvement and 126 patients with signs of basal ganglia disorders were examined clinically for the occurrence of the activation phenomenon of rigidity, the palmomental reflex and the glabella tap response. A comparison between the three groups, decade for decade, showed that the activation phenomenon was so common in the first two groups that its presence was unlikely to be the first sign of Parkinson's disease. A tendency to increasing frequency with increasing age was noted. The palmomental reflex and glabella tap response were more frequent in the last group, but also so common in the first two, that the clinical significance was marginal. No tendency to increasing occurrence with increasing age was noted. PMID- 6842223 TI - Congenital fibre type disproportion with unusual clinico-pathologic manifestations. AB - Two cases with congenital fibre type disproportion are presented. The cases are unusual in that there were significant dysmorphic features in case 1, and both cases showed electromyographic abnormalities suggestive of denervation. A third case, the father of the second patient, showed clinical features of congenital fibre type disproportion in early life but later developed the rigid spine syndrome. The spinal cord of case 3 showed atrophy and degeneration of medial neuronal group in the lumbosacral segments. The clinical and pathological features in these cases further extend the view that congenital fibre type disproportion may be seen in a variety of patients. PMID- 6842222 TI - Sequence of demyelination-remyelination in Guillain-Barre disease. AB - A detailed investigation of nerve conduction was made in a patient with Guillain Barre disease. Conduction velocity and configuration of the compound action potential in distal (median), intermediate (tibial) and central (sciatic) nerve segments were studied serially as the patient weakened and then recovered. Demyelination was found to follow a centripetal pattern, occurring first in the most distal portion of nerve and progressing, as the patient weakened, to the spinal root level. Motor and sensory fibres were equally affected although clinically motor weakness predominated. During recovery, central conduction was the first to improve. The pattern of demyelination-remyelination in Guillain Barre disease appears to be one in which clinical recovery follows remyelination at the spinal root level and in which the first nerve segments to be demyelinated are the last to be remyelinated. PMID- 6842225 TI - Subdural metastases from prostatic adenocarcinoma. PMID- 6842226 TI - Subacute sclerosing panencephalitis presenting as transient homonymous hemianopia. PMID- 6842224 TI - Cerebellar syndrome following neuroleptic induced heat stroke. AB - We report a patient in whom extreme hyperthermia, rhabdomyolysis, acute renal failure and a residual pancerebellar syndrome occurred while taking a combination of perphenazine and amitriptyline. We postulate that impaired thermoregulation due to psychotropic drugs was responsible for the development of heat stroke and that the cerebellar syndrome resulted directly from the elevated temperature. PMID- 6842227 TI - Sagittal sinus thrombosis and occult malignancy. PMID- 6842228 TI - Motor neuron disease in England and Wales, 1959-1979. AB - Mortality rates from motor neuron disease in England and Wales for the years 1959 1979 were studied through death certification data supplied by the Office of Population Censuses and Surveys. The age- and sex-adjusted mortality rate increased over the period from 1.2 per 100 000 per year in 1959-61 to 1.6 in 1977 79, the increase being most apparent in women over age 45 years and men over 60 years. The ratio of the sex-specific mortality rates remained fairly constant at 1.6:1 (male to female). The distribution of motor neuron disease deaths within England and Wales showed more variation between counties and between Hospital Regions than expected, and areas of high motor neuron disease mortality along the south coast and low mortality in the Midlands could be identified. The variation was most marked in those aged over 65 years at death. Examination of occupation, as listed on the death certificates, showed an excess of motor neuron disease deaths in leather workers in all three periods for which data were available (1959-63, 1970-72 and 1975). A small study of the certified cause of death of 56 motor neuron disease patients showed that a high percentage (88%) had motor neuron disease given as the cause of death. PMID- 6842229 TI - Premonitory symptoms of stroke in evolution to the locked-in state. AB - Three patients, who subsequently developed the locked-in state characterised by quadriplegia and mutism with an alert sensorium, initially had mild dysarthria and uncrossed hemisensory or hemimotor deficits involving the face and ipsilateral extremities. Case one initially mimicked a left cerebral lesion with right hemisensory deficits, a mild right facial paresis and a right homonymous field deficit. Case two initially developed both left hemimotor and hemisensory deficits and later developed a paresis of right conjugate gaze. Case three presented with left hemimotor deficit, and mild paresis of conjugate gaze to the right. All three patients died. Rostral brainstem infarctions were found at necropsy in cases one and two. Case three had a radiolucent area of the brainstem demonstrated by CT Scan. Hemisensory and hemimotor deficits also have been noted to precede reported cases of pontine infarction with the locked-in state. Acute onset of uncrossed hemisensory and hemimotor deficits with dysarthria may be caused by infarction of the pons which may predispose to the locked-in state. PMID- 6842230 TI - Anticonvulsant serum levels: relationship to impairments of cognitive functioning. AB - Twenty-eight patients with epilepsy were seen on two occasions at an interval of three months. On one session anticonvulsant serum levels were high and on the other session the serum levels were lower. On each of the two sessions patients performed a series of psychological tests and had a blood sample taken for the analysis of anticonvulsant serum concentrations. Seizure frequency in the previous three months was documented and several patients had an EEG recording made. Deficits in psychological test performance were found at high serum concentrations. Furthermore, lower serum level concentrations did not appear to be accompanied by worsened seizure control. PMID- 6842231 TI - Somatosensory evoked responses in the diagnosis of thoracic outlet syndrome. AB - A study was made of 11 patients with cervical rib, and one patient with Klippel Fiel syndrome and enlarged transverse processes to determine whether evoked potentials recorded from both Erb's points and the cervical spine in response to median and ulnar nerve stimulation provided information additional to that obtained by EMG and peripheral conduction studies. It was found that in seven patients who had pain and paraesthesias but no objective neurological signs both the peripheral and central conduction studies were within normal limits. By contrast, of five patients who had objective signs, conventional EMG and conduction studies were abnormal in three patients, but abnormalities of the evoked potentials obtained from ulnar nerve stimulation were obtained in all five patients. It is suggested that this application of evoked potential estimation is a useful addition to the more conventional peripheral investigations. PMID- 6842232 TI - Syndromes of abnormal muscular activity: overlap between continuous muscle fibre activity and the stiff man syndrome. AB - Four patients with muscular pain, fasciculations, contractures or cramps are presented. Evidence of peripheral nerve involvement was revealed by electromyography and nerve conduction studies. Muscle biopsy showed mild signs of denervation and reinnervation and, at electron microscopy, dilatations of terminal cisternae were found. All patients showed a remarkable improvement after therapy with diphenylhydantoin or carbamazepine. These clinical, neurophysiological and morphological data underline the role of peripheral nerve pathology in various syndromes of abnormal continuous muscular activity. PMID- 6842233 TI - Progressive leptomeningeal fibrosis: a clinico-pathological case report. AB - A female patient developed persistent facial pain beginning at age 19 years. Intermittent motor and sensory disturbances referable to one hemisphere began nine years later and by the age of 41 she had developed signs of increased intracranial pressure. Exploratory craniotomy revealed replacement of the leptomeninges by thick, fibrous tissue. The histological appearance was that of a chronic, benign and minimally infiltrative process with a mild, non-specific inflammatory component, underlying cortical ischaemic changes, and white matter oedema. The lesion resembled nodular fasciitis, a soft tissue process. No cause of the reactive fibrosis of the meninges in this case is known. PMID- 6842234 TI - Hemimasticatory spasm--a peripheral paroxysmal cranial neuropathy? AB - The clinical and electrophysiological features of a case of hemimasticatory spasm are presented. The findings are in many respects similar to those described in hemifacial spasm. A peripheral cranial neuropathy as proposed in hemifacial spasm also may be responsible for hemimasticatory spasm. PMID- 6842236 TI - A method for detecting functional weakness. AB - A simple electrophysiological method is described for detecting weaknes of psychiatric origin. The method involves the interpolation of a single indirect stimulus to a muscle during the course of a supposedly maximal voluntary contraction. Incomplete motor activation is revealed by the presence of a twitch superimposed on the recording of voluntary torque. PMID- 6842235 TI - Femoral pain of solitary neurofibromatous origin: a report of three cases. AB - Three patients, each with a solitary neurofibroma in the thigh, are described. The presenting complaint in each case was pain. A neurofibroma of a branch of the femoral nerve was found in two cases and an intraosseous neurofibroma of the femoral shaft was present in the third. An excellent recovery was observed in each of these three patients following surgical excision of the tumour. Attention is drawn to the unduly long interval between the onset of painful symptoms and the achievement of a clinical diagnosis leading to a surgical cure in each instance. PMID- 6842237 TI - Homocystinuria and dystonia. PMID- 6842238 TI - The effect of lumbar puncture on the electroencephalogram. PMID- 6842239 TI - Giant aneurysm of the intracavernous carotid artery and bilateral carotid fibromuscular dysplasia. PMID- 6842241 TI - Telemetered EEG in schizophrenia. PMID- 6842240 TI - Levodopa induced chorea in Meige syndrome. PMID- 6842242 TI - Responses to electrical stimulation of denervated human muscle fibres recorded with single fibre EMG. AB - Denervated muscle fibres were stimulated electrically with needle electrodes introduced close to a recording single fibre electrode. The denervated muscle fibre could be driven with rates up to 100 Hz. The jitter was large at threshold but low at suprathreshold stimulus strength. There was evidence of discrete low threshold sites along the denervated muscle fibre, seen as stepwise latency change on smoothly changing stimulus strength, hepatic activation from other fibres and also as extra-discharges originating from such sites. PMID- 6842243 TI - Bizarre repetitive discharges recorded with single fibre EMG. AB - Single fibre EMG was used to record bizarre repetitive discharges in patients with chronic denervation or muscle disorders. The low variability of intervals between individual spike components on successive discharges suggests that the bizarre repetitive discharges are based on ephaptic impulse transmission from the muscle fibre starting the discharge (principal pacemaker) to the adjacent muscle fibres. The low variability of the interdischarge intervals is explained by ephaptic reactivation of the principal pacemaker by one of the fibres participating in the previous discharge (a co-pacemaker). Secondary activator fibres may spread activity to more fibres. The bizarre repetitive discharge stops when either the principal pacemaker or the co-pacemaker become sufficiently subnormal to block. The co-pacemaker may be missing in cases of low frequency bizarre repetitive discharges, particularly in those with irregular interdischarge intervals. PMID- 6842244 TI - Effects of prior activity on the conduction in single motor units in man. AB - The slowing of the conduction of an impulse travelling in the relative refractory period of a prior impulse was studied in single short toe extensor motor units in man. Paired electrical stimuli were delivered to the peroneal nerve and single motor unit recordings were achieved by special electromyographic techniques. The delay of the second impulse, propagated during the relative refractory period of the prior impulse, limited the unit discharge, frequency. The shortest motor unit response interval ranged from 3 to 5 ms and was inversely related to the axonal conduction velocity. The delay of the second impulse in the proximal nerve segment was most pronounced close to the stimulus point but continued during propagation for several milliseconds. Further delay occurred distally. The slowing of the conduction of the second impulse after delivering paired electrical nerve stimuli offers a new parameter in single motor unit studies and also makes it possible to measure the axonal refractory period after electrical nerve excitation without using blocking nerve impulses. PMID- 6842245 TI - The effect of temporal frequency variation on threshold contrast sensitivity deficits in optic neuritis. AB - The effect of increasing temporal frequency on contrast sensitivity anomalies in unilateral optic neuritis has been investigated. For 4 c/deg gratings no change in the deficit was observed at any temporal frequency whereas there was a tendency for the deficit to decrease with increase in temporal frequency for 0-5 c/deg gratings. The latter effect was not observed in a case of optic neuritis with severe deficit and not in two cases of other optic nerve pathology. An explanation based on the assumption that "threshold scotomata" might be present in cases of demyelinating optic nerve disease is proposed. PMID- 6842246 TI - Personality and behavioural change after severe blunt head injury--a relative's view. AB - A close relative of 55 severely head injured adults rated the personality of the patient at 3, 6 and 12 months after injury, using a Yes/No judgement, and analogue scales comprising bipolar adjectives. The relative assessed the "current" as well as the "premorbid" personality at each time. Personality change was associated with many negative scores on the analogue scale, and increasing negative scores were associated with high "subjective burden" on the relative. Severity of injury (post-traumatic amnesia) was of no significance in predicting the extent or pattern of personality change. PMID- 6842247 TI - Focal paroxysmal kinesigenic choreoathetosis. AB - Three cases of paroxysmal kinesigenic choreoathetosis are described in whom unilateral attacks were focally induced, together with a case in whom bilateral attacks only occured. Treatment with phenytoin was effective in all cases. The aspects of the literature relating to focal and generalised attacks in paroxysmal kinesigenic choreoathetosis are reviewed. PMID- 6842248 TI - Progressive optic neuropathy and sensorineural hearing loss due to chronic glue sniffing. AB - A 27-year-old male developed cerebral and cerebellar atrophy over a period of five years of extensive glue sniffing. He also developed bilateral optic atrophy with blindness and severe sensorineural hearing loss. Investigation failed to show any other cause for the visual or hearing loss. Peripheral polyneuropathy and central nervous system damage may follow chronic toluene toxicity, but these auditory and visual complications have not previously been described. PMID- 6842249 TI - A case of sarcoma of the central nervous system presenting as a Guillain-Barre syndrome. AB - A case of widespread spinal sarcoma is described with meningeal infiltration, involvement of the anterior cranial fossa complicated by aplastic anaemia and visceral metastases. PMID- 6842250 TI - Quadriceps myopathy: a variant of the limb-girdle dystrophy syndrome. AB - The clinical and pathological features in a patient with quadriceps myopathy are presented. The pattern of progression of the disorder, during a period of 18 years observation, suggests that it represents an unusual and perhaps specific syndrome within the clinical spectrum of the limb-girdle muscular dystophies. PMID- 6842251 TI - Proximal myopathy due to discrete carcinomatous metastases in muscle. AB - Two patients are described with proximal muscle weakness and electromyographic evidence of a myopathic process. In both, discrete carcinomatous metastatic deposits were found in proximal muscles. The possible clinical implications are discussed. PMID- 6842253 TI - Syringomyelia, an hypothesis and proposed method of treatment. PMID- 6842254 TI - Ruptured intracranial aneurysms. PMID- 6842252 TI - HLA antigens and myasthenia gravis in north India. AB - The HLA antigen distribution was studied in 37 north Indian patients with myasthenia gravis. The control group consisted of 118 normal, healthy individuals of the same ethnic group. The antigens showing the highest frequency were Bw21 (18.9% vs 4.2% p less than 0.005), Bw35 (24.3% vs 6.8%, p less than 0.005) and A9 (51.3% vs 30.5%, p less than 0.025). HLA-B8 was increased nearly two fold in the myasthenia gravis patients (RR = 2.4) and was confined mainly to the young females without thymoma. The possibility that Bw21 and Bw35 might be the markers for susceptibility to autoimmune disorders in India is discussed. The observations also support those of others that HLA-B8 linked susceptibility gene is more frequently found in myasthenia gravis patients with thymic hyperplasia. PMID- 6842255 TI - The treatment of acute polyneuropathy by plasma exchange. PMID- 6842256 TI - The application of organotypic nerve cultures to problems in neurology with special reference to their potential use in research into neuromuscular diseases. AB - In organotypic nerve cell cultures there is production of central and peripheral myelin as well as synapse formation and long-term survival (months) of neuronal cell types and their associated glia. These cultures can be viewed continuously by light microscopy and are amenable to both electron microscopy and electrophysiology. Organotypic cultures have been used in studies of myelin formation and of demyelination by "toxic" sera, in the search for a neurotoxic factor in motor neurone disease and in studies of neurotrophic viruses. They have also been used to demonstrate the effects of toxins such as cyanide, lead, various industrial chemicals and neurotransmitter analogues (such as kainic acid) on myelin, axons and neurones in culture. They are currently being used in conjunction with small bundles of teased adult mammalian muscle fibres. Such bundles, cultured alone, do not regenerate. However, in the presence of various foetal tissues (neuronal or non-neuronal), the muscle regenerates to form new myotubes. Only in the presence of foetal spinal cord neurones will these myotubes differentiate further to form cross-striated, contracting muscle fibres. If the spinal cord tissue is removed when contractions have just begun, the muscle fibres revert to undifferentiated myotubes. PMID- 6842257 TI - The infrapiriformis foramen syndrome resulting from intragluteal injection. AB - The authors describe a syndrome resulting from a lesion at the level of the infrapiriform foramen due to intramuscular injection, with involvement of the sciatic nerve, the inferior gluteal nerve, the posterior femoral cutaneous nerve and the pudendal nerve. This appears to be the first case of a complete syndrome of the infrapiriform foramen to be reported. In a second case the pudendal nerve was not involved and a releasing neurolysis was performed with remarkable postoperative relief. All the reported cases with involvement of the inferior gluteal nerve are associated with a more or less complete injury of the sciatic nerve. Conversely, the cases of injection injury to the superior gluteal nerve are rarely associated with injury of the sciatic nerve. The anatomic reasons that might explain both kinds of lesion are given. Finally some aspects of 131 cases of sciatic paralysis resulting from injection are also examined. PMID- 6842258 TI - Biochemical changes during graded brain ischemia in gerbils. Part 2. Regional evaluation of cerebral blood flow and brain metabolites. AB - Regional changes of cerebral blood flow and biochemical substrates were assessed in the gerbil brain following different grades of cerebral ischemia. Ischemia was produced by occlusion of the right common carotid and left external carotid arteries. Gerbils were classified according to the severity of neurological symptoms as animals without, with mild and with severe neurological deficits. Brains were frozen in situ, sliced in 20-microns sections and processed for pictorial presentation of glucose and ATP, using bioluminescence techniques. Cerebral blood flow was determined in adjacent brain sections, using [14C]iodoantipyrine autoradiography. NADH fluorescence was recorded by illuminating the surface of the tissue block with ultraviolet light. Most animals without visible neurological symptoms exhibited reduced blood flow in circumscribed regions of cortex and basal ganglia of the right hemisphere without concomitant changes of biochemical substrates. In animals with mild neurological symptoms, blood flow in the right hemisphere was reduced, glucose and ATP decreased, and NADH fluorescence unhomogeneously enhanced. In animals with severe neurological symptoms blood flow was almost arrested in the right hemisphere and was distinctly reduced in the medial parts of the left hemisphere. The ischemic tissue was depleted from glucose and ATP, and exhibited bright NADH fluorescence. The severity of neurological symptoms, in consequence, correlated closely with both the degree and the size of biochemical lesions observed in the ischemic territory. PMID- 6842259 TI - Eosinophil cationic protein (ECP) in the cerebrospinal fluid. AB - ECP (eosinophil cationic protein) has been measured by means of a specific radioimmunoassay in the cerebrospinal fluid (CSF) from 210 individuals with various diseases affecting the central nervous system. In the same specimens lactoferrin and albumin were measured as well, as indicators of neutrophil involved inflammation and damage to the blood-brain barrier. From a patient reference group (n = 39) the upper "normal" limit for ECP was estimated to 1.7 microgram/l. In patients with acute cerebrovascular disease (n = 108) ECP levels were elevated in 38% of the cases which was a significantly (P less than 0.001) greater proportion than seen for lactoferrin (7%). In patients with acute infections of the CNS (n = 30) 67% had raised ECP levels with significantly higher levels (P less than 0.001) in those having bacterial infections. The ECP levels were significantly correlated (P less than 0.001) to the lactoferrin levels in the whole infectious group. In patients with tumours (n = 25) raised levels of ECP were found in 67% of those with malignant and in 6% of those having benign tumours. This difference was statistically significant (P = 0.001). The ECP levels were closely related to those of lactoferrin (P less than 0.001) and albumin (P less than 0.005). Of the patients with multiple sclerosis (n = 19) 25% had raised ECP levels. This proportion was not significantly different from those having raised lactoferrin levels. In three patients extremely high ECP levels (70 455 micrograms/l) were found and a causal relationship between ECP and the brain tissue damage in these patients is suggested. In comparison with the neutrophil related data the findings suggest a preferential involvement of eosinophils in some diseases affecting the central nervous system. PMID- 6842260 TI - Investigative strategies for muscle pain. AB - Muscle pain is the presenting symptom in patients with a wide variety of conditions. Such patients often pose problems in diagnosis and management and a rational scheme for their investigation is needed. The results of muscle biopsy, electromyography, exercise and strength testing and blood measurements in 109 consecutive patients presenting with myalgia are reported. By determining the sensitivity and specificity of the tests in identifying patients with specific muscle abnormalities, a rational investigative protocol has been constructed. Creatine kinase and erythrocyte sedimentation rate are the most useful screening tests and if either is abnormal, muscle biopsy, electromyography, muscle strength and exercise testing are then performed. Despite exhaustive investigation, specific muscle abnormalities were found in only one-third of the patients; whilst many of the remaining patients undoubtedly had a psychogenic component to their pain, it is likely that a number of unidentified specific metabolic defects remain as causes of myalgia. PMID- 6842261 TI - Neuropathologic findings in the spinal cords of 10 infants with arthrogryposis. AB - The lumbosacral cord segments of 10 infants with varying clinical forms of neurogenic arthrogryposis were compared with similar spinal cord segments from an infant with congenital contractures secondary to uterine constraint, 8 infants with Werdnig-Hoffman syndrome, and 11 age-matched controls. Neuronal numbers, sizes, and distribution were measured within the anterior horns. In addition to the classical reduction in the numbers of alpha motor neurons in both pathologic states, this study found the smaller neurons of the anterior horn were absent or diminished in Werdnig-Hoffman syndrome, while those cells were present in increased numbers with abnormal histology in all the patients with arthrogryposis. In 5 of the patients with arthrogryposis, the pathologic pattern was consistent throughout each cord segment; in 5 others, normal alpha neurons were retained and unequally distributed in the anterior horn segments. This unequal distribution predicted the muscle group involvement and suggested the mechanism for intrauterine joint fixation in these patients. The pathologic changes in the patients with arthrogryposis appear to be unique in spite of the heterogeneity of etiology and the clinical presentation. PMID- 6842263 TI - Different types of antibrain antibodies in multiple sclerosis. Studies employing myelin-deficient mutants of mice. PMID- 6842262 TI - Nerve fibres in spinal cord impact injuries. Part 1. Changes in the myelin sheath during the initial 5 weeks. AB - The spinal cords of cats were subjected to an impact injury using a "weight dropping" technique and sequential changes in the sheaths of non-degenerate myelinated fibres studied over a 3-week period. By 1 1/2 h after impact fibres showed retraction of some lateral loops from one paranode. The extent and severity of this change increased over the first week so that partial and full thickness demyelination were seen frequently. Partial demyelination most commonly resulted from the internodal termination of the innermost lamellae at an internodal location often associated with a Schmidt-Lantermann incisure. Remyelination by both Schwann cells and oligodendroglia occurred at the end of the second week. Oligodendroglial myelin showed many features of immaturity, similar to those found during development. It is suggested that the very earliest myelin damage is mechanical but is aggravated by other factor(s) one of which is probably ischaemia. Within the most severely injured areas there is death of oligodendroglia and any surviving axons are remyelinated principally by Schwann cells. In intermediate and minimally damaged areas of white matter oligodendroglial remyelination predominates. PMID- 6842265 TI - Anti-acetylcholine receptor antibodies in myasthenia gravis. Part 2. Clinical and serological follow-up of individual patients. AB - Circulating antibodies to acetylcholine receptor protein (anti-AChR) were measured in the sera collected from 75 patients (53 women, 22 men, ages 9-83 year, 20 with a thymoma) with myasthenia gravis (MG) during 5-44 (mean 25) months. The clinical state of each patient was graded on a 6-point scale. Anti AChR concentrations were measured by a radioimmunoassay with human antigen. We analysed the relation between the change in clinical state and the change in anti AChR concentration in 155 periods (1-7, mean 2.1 per patient). The change in clinical state is given as the difference in score at the onset and at the end of this period. The change in anti-AChR concentration is expressed as the percentage of the original concentration at the onset of the period. The results were analysed in relation to the therapy and to the severity of the MG at the onset of each period. A strong correlation between a change in anti-AChR concentration and a change in clinical condition existed during treatment with prednisone or immunosuppression and in the period after thymectomy, while a weaker correlation was present in periods without immunosuppression. In only 3 patients did the changes in anti-AChR concentration precede the clinical change. No changes in anti-AChR concentrations were found if improvement was due to the effect of anticholinesterases or if deterioration was caused by infection or emotion. The serial measurement of anti-AChR may be a valuable method of following the basic trend of the MG in severely affected patients. PMID- 6842264 TI - Anti-acetylcholine receptor antibodies in myasthenia gravis. Part 1. Relation to clinical parameters in 250 patients. AB - We examined the significance of the presence or absence of anti-acetylcholine receptor (anti-AChR) antibodies in 250 myasthenia gravis (MG) patients and the relation between clinical features and anti-AChR levels. We found high anti-AChR levels in 2 out of 11 thymoma patients without MG, while 37 out of 250 MG patients had no detectable anti-AChR. The absence of these antibodies was related to purely ocular disease and to steroid therapy and/or thymectomy. Differences in anti-AChR levels did not correspond significantly to differences in disease activity when single measurements in patients were analysed. However, the results were influenced by both the presence or absence of a thymoma, the age at onset of disease and by steroid therapy. The thymic pathology and age at onset seemed to act independently. Early onset of disease was associated with high anti-AChR levels and absence of antibodies to striated muscle (anti-SM), whereas late onset was associated with low anti-AChR and the presence of anti-SM. Thymomas both have high anti-AChR and high anti-SM. The effect of steroid therapy on antibody levels was seen in all patient groups but was strongest in thymoma patients with early onset of disease. PMID- 6842266 TI - Caprine beta-mannosidosis: clinical and pathological features. AB - Beta-mannosidosis, an inherited defect of glycoprotein catabolism associated with deficiency of tissue beta-mannosidase and accumulation of Man(beta 1-4)GlcNAc and Man(beta 1-4)GlcNAc(beta 1-4)GlcNAc, appeared in four of 13 offspring of a single pair of clinically normal, related Nubian goats. Neurological examinations revealed that all four affected goats were unable to rise or walk. All had facial dysmorphism, dome-shaped skulls, small palpebral fissures, carpal contractures, hyperextension of the pastern joints, proximal muscle atrophy, intermittent ocular oscillations resembling pendular nystagmus, marked intention tremor, and deafness. With intensive care, three affected kids were hand-reared and then killed at 1, 7, and 21 days of age. Macroscopically, there were paucity of myelin in the cerebral and cerebellar hemispheres and ventricular dilatation. Microscopically, the extent and distribution of cytoplasmic vacuolation, myelin paucity, axonal spheroids, and filamentous expansions were evaluated in the cerebrum, cerebellum, brainstem, spinal cord, and peripheral nerves of the four affected kids and two age-matched, clinically normal kids. Widespread cytoplasmic vacuolation correlated with the previously reported accumulation of oligosaccharides in the brain and kidney and the deficiency of tissue beta mannosidase. beta-Mannosidosis, not yet identified in man or other species, is characterized by distinctive neonatal clinical, pathological and biochemical features which differentiate it from the alpha-mannosidosis and other inherited diseases of glycoprotein catabolism. PMID- 6842267 TI - Canine neuroaxonal dystrophy. AB - Canine neuroaxonal dystrophy, a newly recognized familial disorder in Rottweiler dogs, is characterized by progressive sensory ataxia. Two of four dogs studied clinically were autopsied and the cerebellum was mildly atrophic. Massive numbers of axonal spheroids were present in many regions of the neuraxis but were most prominent in the dorsal horn of the spinal cord and the nuclei gracilis and cuneatus. Ultrastructurally, spheroids appeared to be swellings of distal axons which were filled with accumulations of smooth membrane-bound vesicles, membranous lamellae, dense bodies, and other organelles. Neuropathological changes were similar to those identified in human neuroaxonal dystrophy. PMID- 6842268 TI - American Association of Neuropathologists. Abstracts of the 59th annual meeting, June 9-12, 1983 St. Louis, Missouri. PMID- 6842270 TI - Scanning and light microscopic study of age changes at a neuromuscular junction in the mouse. AB - From previous work, it appears that synaptic transmission is well preserved at aging mouse neuromuscular junctions despite profound ultrastructural changes. Scanning and light microscopy have been used to determine whether expansion or sprouting of nerve terminals or postsynaptic reorganization play a role in this apparent compensatory mechanism. The number and length of nerve terminal branches in the extensor digitorum longus of young (7 months) and old (29 months) mice were studied with a combined silver-cholinesterase method. In aged animals, there were increases in nerve terminal length and number of intrasynaptic branches, with no change in muscle fibre diameter or numbers of axons entering the junction. Neither collateral sprouting nor collateral innervation, hallmarks of partial denervation, were present. Motor endplates visualized by scanning electron microscopy appeared as slightly elevated, elliptical plateaux ('raised areas') with smooth surfaces into which the synaptic clefts were etched. In the aged endplates more than in young endplates, the primary clefts were often interrupted by narrow short outpouchings approximately perpendicular to the long axis of the primary cleft. In addition, oval primary cleft islets were more frequent and there was increased randomness and branching of secondary clefts. Both light and scanning microscopy gave concordant quantitative evidence that nerve terminals and the underlying postsynaptic cleft are longer and more branched in aged mice. The increased length of synaptic nerve terminal approximately balances the loss of girth previously reported leaving nerve terminal volume unchanged. The observed expansion of the synaptic area in the aged neuromuscular junction may be compensatory, preserving neuromuscular function. The data also point to plasticity of adult neuromuscular synaptic structure. PMID- 6842269 TI - The ultrastructure and connections of blood vessels supplying the rat carotid body and carotid sinus. PMID- 6842271 TI - A morphometric analysis of blood vessels and perivascular nerves in the rat carotid body. PMID- 6842272 TI - Retrograde transneuronal regulation of the afferent innervation to the rat superior cervical sympathetic ganglion. AB - The superior cervical sympathetic ganglion of the rat receives its preganglionic afferent innervation through the cervical sympathetic trunk, and sends most of its postganglionic axons through two major nerves, the internal (ICN) and external carotid nerves (ECN). In the present study, the ICN alone or both the ICN and the ECN were cut in neonatal and adult rats. Two months after these lesions, ganglionic neurons, synapses and preganglionic axons were counted and compared with unoperated control values. After cutting the ICN alone in neonatal rats, ganglionic neurons were reduced in number by 70% and synapses were reduced by 50%, but there was no change in the number of preganglionic axons. Cutting both the ICN and ECN in neonates resulted in an 88% reduction of ganglionic neurons and an 83% reduction of synapses. In this case there was a 63% reduction in the number of preganglionic axons. After cutting either the ICN alone or both the ICN and the ECN in neonates, there was a hyperinnervation (increased number of synapses) of the remaining ganglionic neurons. In the adult rat, cutting either the ICN alone or both the ICN and ECN resulted in a smaller loss of ganglionic neurons, and there was no loss of preganglionic axons. There was no hyperinnervation of surviving neurons in adult rats. Thus, the response by preganglionic axons to a reduced number of ganglionic neurons differs in the neonate and adult rat. In the developing animal, the degenerative response to injury is much more severe than in the adult, but the reorganizational response is also greater. PMID- 6842273 TI - Ultrastructural features of six types of neurons in rat dorsal root ganglia. AB - Sections of glutaraldehyde-fixed lumbar dorsal root ganglia of the rat were examined in the electron microscope following impregnation with the uranyl-lead copper technique or postfixation in potassium ferrocyanide-reduced osmium. Three types of ganglion cells (A, B, C) were identified on the basis of their size and the distribution of their organelles. They were further subdivided into six subtypes according to the arrangement and three-dimensional organization of the Nissl bodies and Golgi apparatus in the perikarya. Type A1 cells were large, clear neurons in which Nissl bodies, separated from each other by pale narrow strands of cytoplasm containing small stacks of Golgi saccules and rod-like mitochondria, were evenly distributed throughout the perikaryon. In type A2, the Nissl bodies assumed a similar distribution but were separated by much wider strands of cytoplasm. Type A3, the smallest of the type A category, displayed densely packed Nissl bodies and long stacks of Golgi saccules which formed a perinuclear ring in the midportion of the perikaryon. Type B cells were smaller and showed a concentric zonation of their organelles. In type B1, large Nissl bodies located in an outer cytoplasmic zone were made of long piles of parallel cisternae interrupted by curved Golgi stacks. Type B2 was characterized by a ring like Golgi apparatus separating the perikaryon in a cortical zone composed mainly of Nissl substance and a juxtanuclear zone containing mitochondria and smooth endoplasmic reticulum. Type C cells were the smallest of the ganglion cells and contained small, poorly demarcated Nissl bodies and a juxtanuclear Golgi apparatus. PMID- 6842274 TI - Freeze-fracture ultrastructure of developing and adult non-myelinated ganglion cell axolemma in the retinal nerve fibre layer. AB - The ultrastructure of non-myelinated ganglion cell axolemma in the retinal nerve fibre layer from developing and adult rats was examined by freeze-fracture electron microscopy. The axolemma of fibres from neonatal (2-8 days) rats had a moderate density (510-556/micrometers 2) of intramembranous particles (IMPs) on the P-fracture face, while there was a low density (101-146/micrometers 2) of particles on the E-fracture face. Particle density on the P-face increased with development, such that by 28 days the density of IMPs was 1281/micrometers 2. Adult fibres had a high (1741/micrometers 2) density of particles on the P-face. On the E-face, the density of IMPs did not change substantially throughout development, and remained less than 225/micrometers 2 at all ages. Mean particle diameters were compiled for P- and E-fracture faces at the various developmental ages and were greatest in fibres from adult animals. P-face particle density of non-myelinated axons in the retinal nerve fibre layer changed at approximately the time that myelination occurred in distal (optic nerve) segments of these axons. The alteration in membrane structure during development of non-myelinated axons in the retinal nerve fibre layer suggests that conduction properties may also change with development. PMID- 6842275 TI - The fine structure of neuroglia in the lamina ganglionaris of the housefly, Musca domestica L. AB - Six morphologically distinct glial cell layers are described in the housefly lamina ganglionaris, a region previously thought to be composed of only three. 1. The external glial layer abuts the basement membrane of the retina. The cells of this layer have a highly involuted surface membrane and an abundance of ribosomes and rough endoplasmic reticulum (ER) throughout their cytoplasm. They envelop the traversing photoreceptor and mechanoreceptor axons as well as the large tracheoblast cells of the fenestrated layer. They are referred to as the fenestrated layer glia. 2. The second glial layer is composed of large, horizontally elongated cells with large elongate nuclei. They contain large membrane-bounded vacuoles and extensive arrays of parallel-running microtubules and smooth ER. These glia invest the photoreceptor axons through much of the multiple chiasmatic (pseudocartridge) region and are thus designated as the pseudocartridge glia. 3-4. Satellite glia comprise the third and fourth glial layers. Thin cytoplasmic processes of these multipolar glia intervene between the tightly packed monopolar neuron somata and the photoreceptor axons of the nuclear layer. The satellite glia are distinguished into two sub-groups: distal and proximal. The distal satellite glia are exclusively responsible for the large glial invaginations of the type I monopolar cell bodies. Multilaminated processes of the proximal layer of satellite glia surround the photoreceptor axons and the neurite neck of the monopolar neurons prior to their entry into the plexiform layer. The proximal satellite glia also contain prominent lipid deposits. 5. Epithelial glia are columnar cells that occupy the plexiform layer. They envelop the optic cartridges of the neuropil and are the substrate for two characteristic glial-neuronal invaginations; i.e. the capitate projection and the 'gnarl'. The cytoplasm of the epithelial glia is electron dense and contains numerous stacked arrays of infolded membrane. 6. Marginal glia form the proximal boundary of the optic neuropil. They invest the axons entering or leaving through the base of the lamina ganglionaris. Marginal glia contain large numbers of parallel microtubules and numerous polyribosomes. Fine structural evidence is presented relevant to the role of these six glial layers in the maintenance of ionic and metabolic homeostasis across the retina-lamina barrier. PMID- 6842277 TI - The organization of pyramidal and non-pyramidal cell dendrites in relation to thalamic afferent terminations in the monkey somatic sensory cortex. PMID- 6842276 TI - Glial membrane specializations and the compartmentalization of the lamina ganglionaris of the housefly compound eye. AB - Membrane specializations in the lamina ganglionaris of the housefly are investigated using conventional thin-section EM, freeze-fracture replication and the diffusion of colloidal lanthanum. All glial cells in the lamina are coupled by gap junctions. Desmosomes also link all glia except the epithelial glia. Extensive glia-glial and glia-neuronal septate junctions are present in the pseudocartridge zone and nuclear layer. Septate junctions in the nuclear layer intermingle with bands of interglial and glia-neuronal tight junctions. Tight junctions are also found between satellite and epithelial glia at the border of the nuclear and plexiform layers, between adjacent epithelial glial cells in the plexiform layer, between epithelial and marginal glia at the proximal boundary of the optic neuropil, between marginal glial cells, and between marginal glia and axons. Colloidal lanthanum, introduced through an incision in the cornea, penetrates the retina but is occluded from the neuropil by septate junctions in the pseudocartridge zone. The disposition of tight and septate junctions is described in relation to the compartmentalization of the lamina. Two major compartments are delineated. The first represents the nuclear layer and contains the cell bodies of second-order visual neurons (monopolar neurons). The second compartment constitutes the plexiform layer of the lamina. Within the plexiform layer, each optic cartridge is partitioned into a separate subcompartment. Also, tracheoles and axons of long visual fibres are isolated from the optic cartridges by glial tight junctions. Morphological evidence for compartmentalization is correlated with previously established electrical properties of the insect lamina ganglionaris. PMID- 6842278 TI - Normal variations in presynaptic active zones of frog neuromuscular junctions. AB - Neuromuscular junctions of frog cutaneous pectoris muscles were examined by the complementary-replica freeze-fracture technique. The large number of active zones revealed in this way permitted quantitation of normal and disrupted zones in control muscles and in muscles deprived of external calcium for periods of up to eight hours. Although some 87% of the active zones examined had the usual appearance of two double rows of intramembrane particles flanking a low ridge, several varieties of disrupted active zones appeared in which the rows were interrupted, dispersed, rotated, or reduced to single rows. The frequency of disruptions was not increased by calcium deprivation. Disorganized active zones at tips of neuromuscular junctions may represent normal remodelling of the junctions. PMID- 6842279 TI - Enkephalin reduces calcium action potentials in Rohon-Beard neurons in vivo. AB - Rohon-Beard neurons of the Xenopus spinal cord develop somatic Ca++-dependent action potentials at early embryonic stages. Because many Ca++-dependent events are blocked or reduced by enkephalin in other neuronal systems, we tested the effect of met-enkephalin on the Ca++ spikes of Rohon-Beard cells. Our results indicate that met-enkephalin, which has no effect on the resting membrane potential or conductance in these cells, reversibly and specifically shortens their Ca++ action potentials, probably by decreasing the Ca++ conductance. Enkephalin has a similar effect on Xenopus dorsal root ganglion cells in vivo. Examination of Rohon-Beard cells at various stages of development shows that enkephalin shortens Ca++ spikes from the earliest times that the spikes appear (approximately 21 hr after fertilization) to the latest times they are detectable (7 to 9 days). This very early response suggests either that enkephalin binds directly to the Ca++ channels or that an "enkephalin receptor" is among the earliest neuronal phenotypes to appear in these cells. PMID- 6842280 TI - Clonal organization of the central nervous system of the frog. III. Clones stemming from individual blastomeres of the 128-, 256-, and 512-cell stages. AB - Horseradish peroxidase injected into individual blastomeres of 128-, 256-, and 512-cell embyros of Xenopus laevis was identified in cells of the central nervous system (CNS) at early to middle larval stages. Labeled cells were dispersed, mingled with unlabeled cells. Four boundaries in the CNS could be defined by the behavior of clones of labeled cells: in the transverse plane at the level of the isthmus; in the horizontal plane between dorsal and ventral regions extending the entire length of the CNS; in the dorsal midline extending the entire length; and in the ventral midline of rhombencephalon and spinal cord but absent more rostrally. Cells injected with HRP at the 512-cell stage produced clones that, with rare exceptions, did not cross any boundary, whereas labeled clones initiated at earlier stages frequently crossed boundaries. Axons and dendrites were not restricted by these boundaries. These boundaries subdivided the CNS into seven compartments, each of which was occupied exclusively by the descendants of a group of 14 to 26 blastomeres in the 512-cell embryo. These groups of blastomeres formed a bilaterally symmetrical pattern composed of a single anterior median group straddling the dorsal midline near the animal pole and three groups on each side. Because cells mingled in each compartment but not across compartmental boundaries, there was a one-to-one relationship between individual blastomeres and CNS compartments but one-many and many-one relationships between individual blastomeres and neuroanatomical subdivisions smaller than a compartment. There was no constant relationship between phenotypes of nerve cells and their ancestry from individual blastomeres of the 512-cell or earlier stages. PMID- 6842281 TI - Acoustic parameters underlying the responses of song-specific neurons in the white-crowned sparrow. AB - Songbirds such as the white-crowned sparrow memorize the song of conspecific adults during a critical period early in life and later in life develop song by utilizing auditory feedback. Neurons in one of the telencephalic nuclei controlling song have recently been shown to respond to acoustic stimuli. I investigated the auditory response properties of units in this nucleus using a technique that permitted great flexibility in manipulating complex stimuli such as song. A few of the units exhibited considerable selectivity for the individual's own song. In wild-caught birds, song-specific units exhibited intradialect selectivity. In those birds that sang abnormal songs due to laboratory manipulation of song exposure during the critical period for song learning, units were selective for the abnormal songs. By systematic modification of a song, and by construction of complex synthetic sounds mimicking song, the acoustic parameters responsible for the response selectivity were identified. Song-specific units responded to sequences of two song parts but not to the parts in isolation. Modification of the frequencies of either part of the sequence, or increasing the interval between the parts, varied the strength of the response. Thus, temporal as well as spectral parameters were important for the response. When sequences of synthetic sounds mimicking song were effective in evoking an excitatory response, the response was sensitive to the aforementioned manipulations. Wih these techniques it was possible to elucidate the acoustic parameters required to excite song-specific units. All songs of the repertoire eliciting a strong excitatory response contained the appropriate parameters, which were missing from all weakly effective, ineffective, or inhibitory songs. PMID- 6842282 TI - Postembryonic growth of the optic tectum in goldfish. I. Location of germinal cells and numbers of neurons produced. AB - The growth and morphology of the optic tectum of adult goldfish were studied with light and electron microscopy and with thymidine radioautography. The tectum is roughly hemispheric in shape, with a smaller radius of curvature rostrally than caudally. A narrow region containing proliferating cells (the germinal zone) is found along two-thirds of the rim of the tectal hemisphere but is absent rostrally, adjacent to the tectal region which receives input from the rostral visual field. New cells generated in the germinal zone are added to the tectum appositionally in crescent-shaped increments; these was no evidence of migration of new cells into the rostral region which lacks a germinal zone. Some of the new cells added to the adult tectum were shown to be neurons on the basis of cytological and ultrastructural features. Counts of tectal neurons likewise demonstrated that new cells were added with growth of the tectum; large goldfish (25 cm long) had 27% more tectal neurons than did small fish (4 cm long). Spreading apart of existing cells also contributed to overall growth of the tectum. These results confirm and extend those of R. L. Meyer ((1978) Exp. Neurol. 59: 99-111). The topological dissimilarity of the patterns of growth of retina (which adds cells appositionally around its entire perimeter) and tectum supports the suggestion that retinotectal terminals must continually move (Gaze R. M., M. J. Keating, A. Ostberg, and S. H. Chung (1979) J. Embryol. Exp. Morphol. 53: 103-143). Our estimates of cell numbers and tectal areas lead to predictions about the directions and magnitudes of these displacements. PMID- 6842283 TI - Postembryonic growth of the optic tectum in goldfish. II. Modulation of cell proliferation by retinal fiber input. AB - The proliferation of cells in the germinal zone of the optic tectum of adult goldfish was studied following unilateral optic nerve crush or removal of one eye. Dividing germinal cells were labeled with [3H]thymidine, which was injected at various times (0 to 30 days) following surgery; fish were sacrificed after short (48 hr) survival times. The numbers of labeled nuclei in the tectal germinal zones were compared on the two sides (intact and denervated). We show that permanent removal of optic input (by enucleation) resulted in a sustained depression of [3H]thymidine incorporation in the tectal germinal zone on the denervated compared to the intact side. Temporary denervation (by optic nerve crush) initially had a similar effect; however, upon reinnervation of the tectum by regenerating optic fibers, proliferation was enhanced on the experimental side compared to the intact side. Because cells in the germinal zone are known to produce new tectal cells, neurons as well as glia, in the normal growing adult brain (Raymond, P. A. and S. S. Easter, Jr. (1983) J. Neurosci. 3: 1077-1091), some of the proliferating cells may have been generating neurons. This inference is supported by the observation that in two fish whose right eye had been removed more than 2 years earlier, there were fewer neurons in the denervated tectum than in the intact tectum. Thus, it is likely that the observed decrease in incorporation of [3H]thymidine by cells in the germinal zone of the denervated optic tectum resulted in a slower rate of addition of new tectal cells on the affected side. We conclude that cytogenesis in the germinal zone of the growing optic tectum of adult goldfish is regulated by optic fiber input. This mechanism may be important in matching the rates of growth of retina and tectum in the normal brain of the growing adult fish. PMID- 6842284 TI - Neuron-specific enolase as an index of neuronal regeneration and reinnervation. AB - Neuron-specific enolase (NSE) is a glycolytic isoenzyme which is located in central and peripheral neurons and neuroendocrine cells. Another enolase isoenzyme, non-neuronal enolase (NNE), occurs in glial cells. The purpose of this study was to follow any changes in NSE and/or NNE in cranial motor neurons after separation of their cell bodies from their axon terminals. One hypoglossal nerve in the rat and the cynomolgus monkey was thus crushed or cut and, after a given period, the brains were perfusion fixed. Immunocytochemistry, using anti-rat NSE and NNE or anti-human NSE and NNE, was performed on Vibratome-sectioned specimens of the hypoglossal nuclei. In the rat, NSE immunostaining decreased in the affected neurons 2 to 10 days following axonal injury. The change was greatest on the 10th day. Twenty days following nerve crush. NSE staining began to recover on the operated side and by the 45th day had returned to normal levels. NSE changes in the monkey were similar to those in the rat. In rats, where the nerve was cut and the proximal stump was translocated to a normally innervated muscle to inhibit re-formation of synaptic contacts, the NSE remained low for 60 days after nerve injury. As NSE levels fell during degeneration, there was a slight increase in NNE in some of the monkey specimens but not in others; the NNE alterations were, therefore, equivocal. The results demonstrate that the content of NSE in neurons serves as a molecular marker of axon injury, regeneration, and target reinnervation. PMID- 6842285 TI - Competence to form electrical connections is restricted to growing neurites in the snail, Helisoma. AB - Identified neurons of the snail, Helisoma, undergo extensive remodeling in response to axotomy, including the formation of specific sets of novel electrical connections. This communication addresses the question of why, under the conditions employed, some neurons readily form new connections with a single "test" neurons, whereas others do not. The present experiments are a test of the hypothesis that, for these adult neurons, competence to form electrical connections is restricted to pairs of neurons with interacting regions of active outgrowth. Morphological observations demonstrated profuse overlapping outgrowth from neurons which formed electrical connections, whereas neurons which did not connect displayed no simultaneous new outgrowth, although there could be regions of physical overlap or proximity. The causal relationship between growth and the ability to form new connections was tested more directly by two means: (1) Previously nonconnecting neurons were recruited into the connectivity pattern by axotomy-induced growth. (2) Previously connecting neurons did not connect when they were not induced to grow. Thus, growth or lack of growth is an effective discriminator for determining specific sets of interconnected neurons. PMID- 6842286 TI - A regional analysis of estrogen binding to hypothalamic cell nuclei in relation to masculinization and defeminization. AB - Gonadal steroids masculinize and defeminize neuroendocrine development, including behavior. Defeminization makes males less sensitive than females to estrogen for showing female sexual behavior and cyclic gonadotropin secretion. Masculinization makes males more sensitive than females to estrogen for showing male sexual behavior. Thus masculinization and defeminization produce opposite effects on estrogen sensitivity. To study the relationship between estrogen sensitivity and estrogen binding, we studied sex differences in estrogen binding to hypothalamic cell nuclei on a regional and temporal basis. We measured the amount of estradiol (E2) bound to cell nuclei in the preoptic area (POA), mediobasal hypothalamus (MBH), corticomedial amygdala, and cortex of gonadectomized male and female rats 30 and 60 min after [3H]E2 was injected intravenously. In the MBH, males consistently bound less E2 than females did. In the POA, males bound less E2 than females after 60 min, but they bound more E2 than females after 30 min. Decreased estrogen binding in the MBH may underlie defeminized sexual behavior. Similarly, decreased estrogen binding in the POA at 60 min may be a correlate of defeminized gonadotropin secretion, whereas increased estrogen binding in the POA at 30 min may be a correlate of masculinized sexual behavior. To test the hypothesis that decreased estrogen binding in the MBH and POA are correlates of defeminization, we measured E2 binding at 60 min in female rats in which masculinization and defeminization were manipulated independently. Defeminization decreased E2 binding to cell nuclei in both the POA and MBH to the level seen in males at this time point. Masculinization had no effect at this time point. The data suggest that sex differences in E2 binding to hypothalamic cell nuclei correlate reliably with sex differences in estrogen sensitivity even though masculinization and defeminization produce opposing effects on these parameters. PMID- 6842287 TI - Effects of perturbations on accuracy of arm movements. AB - This study was carried out to test the hypothesis that the magnitude of perturbation-induced disruption of active movement depends upon the size of the active movement, with small movements being more disrupted than large ones. Human subjects performed pronating or supinating arm movements of 3 degrees, 10 degrees, and 30 degrees in a discrete visual tracking task. When the movements were briefly stopped or reversed, the resultant errors in trajectory and static position (expressed relative to the movement size) were greater for small as compared to large movements. These findings demonstrate that peripheral kinesthetic disturbances modify movement trajectory and end point error, with small movements being more affected than large movements. PMID- 6842289 TI - Proceedings of the 30th annual meeting of the Society of Nuclear Medicine. June 7 10, 1983, St. Louis, Missouri. Abstracts. PMID- 6842288 TI - High affinity choline uptake and calcium-dependent acetylcholine release in proteoliposomes derived from rat cortical synaptosomes. AB - Proteoliposomes were prepared from rat cortical synaptic plasma membranes that retained high and low affinity choline transport. High affinity transport was inhibited by hemicholinium-3 in a competitive manner and was apparently dependent on membrane potential or ion gradients. Proteoliposomes supplemented with an acetylcholine-generating system were able to synthesize [3H]ACh de novo from [3H]choline taken up by high or low affinity transport; however, we were able to specifically load proteoliposomes derived from cholinergic membranes by using a low choline concentration. [3H]ACh, but not [3H]choline, was subsequently released in a calcium-dependent manner by K+ depolarization. This preparation offers a simplified membrane system for studying functional high affinity choline transport and nonvesicular ACh release. PMID- 6842290 TI - Effects of dietary magnesium deficiency on thallium-20 1 kinetics and distribution in rat myocardium: concise communication. AB - Kinetics and distribution of TI-201 were studied in myocardium of rats with chronic dietary induced Mg deficiency. Rats were fed the Mg-deficient diet for 30 days and were then injected intravenously with 0.2 mCi of TI-201. Comparable control animals were fed a standard laboratory diet. One-half hour after injection, rats were killed and a segment of myocardium was washed with nonradioactive Krebs solution in a special chamber. Radioactivity in the tissue was recorded continuously for 1 hr. A three-compartment model (extracellular, main intracellular, and subcellular) was found to describe adequately the kinetics of TI-201. In myocardium of Mg-deficient animals, significant changes in values of transport rate constants and compartment sizes for TI-201 indicated a moderate decrease in extracellular compartment and a threefold enlargement in subcellular compartment (presumably mitochondrial) at the expense of the main intracellular compartment, which underwent a marked reduction. Bulk TI-201 uptake in myocardium of Mg-deficient rats was unchanged. The findings are interpreted as being consistent with mitochondrial alterations reported in Mg-deficient animals. Clinical implications are discussed. PMID- 6842291 TI - A structure-distribution-relationship approach leading to the development of Tc 99m mebrofenin: an improved cholescintigraphic agent. AB - Thirty-three HIDA (hepatobiliary IDA) derivatives were tested and correlations drawn between physicochemical parameters, structural effects, and in vivo characteristics. Capacity factors of the ligands on reverse-phase HPLC were used as a measure of lipophilicity, and to predict protein binding and in vivo distribution of the complexes. Fragmentary pi values were used to derive theoretical lipophilicities, which showed that ortho substituents have reduced lipophilic activity, probably because of self-shielding. Ortho substitution was found to affect hepatocellular transit times. Various combinations of substituents with the desired overall lipophilicity were tested. The best compound, Tc-3-bromo-2,4,6-trimethyl HIDA, possessed high hepatic specificity, and rapid hepatocellular transit; it was also resistant to competition for hepatobiliary excretion from bilirubin. PMID- 6842293 TI - Statistics for nuclear medicine. Part 5: Survivorship studies. PMID- 6842292 TI - New perspectives in localizing enlarged parathyroids by technetium-thallium subtraction scan. AB - Double-tracer scanning (Tc-99m as pertechnetate and Tl-201 as chloride) with an Anger camera and computerized image subtraction was performed in 61 patients whose clinical and biochemical findings had suggested primary hyperparathyroidism. This study showed intra- or extrathyroidal focal uptake of thallium in 37 cases. Among these, 24 patients underwent surgery, and 18 parathyroid adenomas, five carcinomas, and one hyperplastic gland were found exactly in the sites predicted by scintigraphy. Among 24 patients with negative scans, only two underwent surgery; a hyperplastic parathyroid gland (diam less than 0.5 cm) was found in both. The success rate was 92% in the cases in which operation was performed. We believe that the new method may be useful in the preoperative detection of parathyroid enlargements. PMID- 6842294 TI - Re: The radiation dosimetry of 2-[F-18]fluoro-2-deoxy-D-glucose in man. PMID- 6842295 TI - Unmasking of asymmetrical renal perfusion after exercise in unilateral renovascular hypertension. PMID- 6842296 TI - Hepatobiliary imaging: pyeloureterectasis. PMID- 6842297 TI - Purine synthesis and reutilization in folate-deficient rat hepatocytes. AB - Although folic acid is known to be involved in the pathways of purine metabolism, the precise changes brought about in purine synthesis, reutilization, pool sizes, and ratios by experimental folate deficiency are not clear. Consequently, these aspects of purine metabolism were measured in hepatocytes from control and folate deficient rats fed an amino acid diet with and without folic acid, respectively. Purine synthesis and reutilization were measured as the rates of incorporation of [U-14C]glycine and [G-3H]hypoxanthine, respectively, into the adenine and guanine pools of freshly isolated hepatocytes after a 3-hour incubation in folate-free, as well as folate- and/or thymidine-supplemented culture media. Hepatocytes from folate-deficient rats had the same rates of purine synthesis as those from control rats. Purine reutilization, purine pool sizes, and the adenine:guanine ratios were lower in hepatocytes from deficient compared with control rats. Purine synthesis was increased when folic acid or thymidine was added to the culture medium. Although hepatocytes from folate-deficient rats had a lower rate of purine reutilization compared with those from control rats, the reutilization rates did not respond to the addition of folic acid or thymidine to the culture medium. The data suggest that purine synthesis was not impaired but purine reutilization was diminished in folate deficiency. Thymidine was as effective as folic acid in stimulating purine synthesis in both control and folate-deficient hepatocytes. PMID- 6842298 TI - Utilization of intravenously administered beta-cellobiose and maltose by young pigs. AB - Intravenous solutions of glucose oligosaccharides are potential sources of carbohydrate-derived energy for patients requiring intravenous feeding. Relatively little is known about utilization of glucose oligosaccharides linked by beta-glucosidic bonds. We compared the utilization of maltose (alpha-D glucosyl-1,4-D-glucose) and beta-cellobiose (beta-D-glucosyl-1,4-D-glucose) when administered intravenously (19 g per day) to young pigs for a 5-day period. Animals infused with maltose excreted 15% of the infused disaccharide over the 5 day infusion period. No evidence of maltose accumulation was noted in plasma, and kidney morphology was normal. Animals infused with beta-cellobiose excreted 95% of the infused disaccharide in the urine. The mean (+/- SD) plasma total glucose concentration increased significantly over base-line values of 114 +/- 39 mg/dl to a value of 180 +/- 28 mg/dl during cellobiose infusion, indicating accumulation of cellobiose in body water. Kidney morphology in cellobiose-infused animals was normal. Intravenously infused beta-cellobiose is poorly utilized by the pig when compared with the utilization of its alpha-1,4 linked isomer, maltose. PMID- 6842299 TI - Effect of early nutrition on serum cholesterol levels in adult rats challenged with high fat diet. AB - Early exposure to cholesterol-enriched, high fat diets has been reported to affect serum cholesterol levels in adult rats. In this study, we investigated the role of dietary fat alone, without cholesterol, by feeding to pregnant rats (from day 18 of gestation) experimental diets containing either high fat (corn oil), low sucrose (HF) or low fat, high sucrose (HS). After birth, mothers and pups were fed the diets until weaning (30 days), when serum cholesterol levels were the same in both groups of pups. Animals were fed stock diet until 7 months. At that time, half the animals from each original group (HF or HS) were challenged with HF diet for 3 days; the other half were fed stock diet. There was no significant difference in serum cholesterol between HF and HS animals fed stock diet: HF, 73 +/- 7 mg/dl (n = 11); HS, 80 +/- 19 (6); P greater than 0.25. Animals originally fed HF diet significantly raised serum cholesterol in response to late HF challenge (140 +/- 31 mg/dl, n = 10, P less than 0.001 vs. stock fed); the original HS-fed group did not (93 +/- 7 mg/dl, n = 5, P greater than 0.19). Early exposure to HF diet, even without cholesterol, could evoke a hypercholesterolemic response in adulthood following challenge by brief exposure to HF diet. PMID- 6842300 TI - Prenatal and early postnatal sodium chloride intake modifies the solution preferences of adult rats. AB - To determine whether the concentration of sodium chloride (NaCl) consumed early in life influences the degree of NaCl preference later in life, adult female rats were maintained on diets containing either 0.12, 1.0, or 3.0% NaCl throughout pregnancy; their offspring were continued on these same diets to day 30 of life. Thereafter, all offspring were maintained on a diet containing 1.0% NaCl. At 90 days of age the animals were given a two-bottle preference test between water and various concentrations of NaCl, glucose, and KCl solutions. After preference testing the livers and adrenal glands were removed and weighed. Both male and female offspring raised on the high salt diet showed an elevated preference for NaCl solutions as adults. The effect was nonspecific as the males also exhibited an enhanced preference for glucose solutions. Furthermore, the elevated preferences could be accounted for not by increases in absolute NaCl or glucose intake, but by decreases in water intake. The adrenal gland weights were significantly lower for males in the highest salt group. There is an early period in development during which fluid regulation may be influenced permanently by dietary sodium levels. PMID- 6842301 TI - The effect of alterations in ketone body availability on the utilization of beta hydroxybutyrate by developing rat brain. AB - The effect of alterations in ketone body availability during the early postnatal period on the in vitro and in vivo utilization of beta-hydroxybutyrate (beta OHB) by developing rat brain was determined. Ketone body availability was prolonged by feeding a high fat diet during pregnancy and lactation and to pups after weaning. Availability was decreased by early weaning pups at 16 days to a low fat liquid diet. In the in vitro studies, oxidation of [14C]beta OHB to CO2 and incorporation into brain lipid was determined at 7, 14, 21, and 35 days of age. In the in vivo studies incorporation of [14C]beta OHB and [3H]glucose into brain lipid was measured. The results indicate that it is possible to alter the brain's utilization of beta OHB for lipid synthesis and energy metabolism during the developmental period. This was particularly evident in the in vivo studies. The in vivo results also suggest a relationship between beta OHB availability in the blood and incorporation into brain lipid. When availability was decreased by early weaning pups to the low fat diet, incorporation of beta OHB into lipid was also decreased. Likewise, when availability was increased, such as was seen in the high fat feeding study, incorporation was increased. PMID- 6842302 TI - Impaired glucose tolerance in copper-deficient rats. AB - Forty-eight male weanling Sprague-Dawley rats were randomly and equally divided into two dietary treatments (copper-deficient and adequate: 0.85 mg and 8 mg of Cu/kg diet). Deionized water and diet were provided ad libitum. After 5 weeks, the rats were fasted for 18 hours, anesthetized with sodium pentobarbitol and injected intravenously with glucose (1 g/kg body wt in a 50% wt/vol solution). Six rats from each treatment were killed by exsanguination at 0, 30, 60 and 120 minutes after glucose injection. Liver copper was measured by atomic absorption spectrophotometry. Reduction in liver copper content and elevation in heart weight confirmed that the rats fed the test diet were copper-deficient. Plasma glucose levels in copper-deficient rats were significantly higher at 30 and 60 minutes compared to controls. After 2 hours there were no significant differences between treatments. Plasma insulin levels measured by radioimmunoassay were significantly lower at 30 minutes, but higher at 60 and 120 minutes in rats fed the test diet as compared to controls. It would thus appear likely that copper deficiency interferes with normal glucose utilization. PMID- 6842304 TI - The effect of quality and quantity of dietary fat on the immune system. AB - The effect of the quality and quantity of dietary fats on the morphology and function of the immune system of Sprague-Dawley rats fed either 5% mixed fat, 24% saturated fat, 24% polyunsaturated fat, or 24% partially saturated fat was examined. After 2.5 months of dietary treatment high fat groups showed evidence of splenic hyperplasia, however, no consistent morphologic changes were seen in the mesenteric lymph nodes (MLN). Splenocytes from rats fed the 24% polyunsaturated fat diet were cultured in fetal bovine serum (FBS) and had a depressed lymphocyte transformation response, which persisted after 5 months of dietary treatment. Supplementing the culture medium with 10% rat serum altered the transformation response profile, but high fat serum did not have an immunosuppressive effect. MLN lymphocytes from rats fed the 24% partially saturated diet for 2.5 months had an enhanced response to concanavalin A; at five months the response was elevated in the groups fed saturated as well as partially saturated fat diets. These results suggest that the modulating effect of fat on the immune system depends on the duration of feeding, the type of fat consumed and the organ examined. PMID- 6842303 TI - Effect of diet restriction on some biochemical parameters related to aging in mice. AB - The effects of chronic diet restriction in mice on some biochemical parameters related to aging have been investigated. Restriction of food intake to about one half of the ad libitum consumption resulted in a significantly decreased growth rate immediately after weaning. In the experimental mice killed after different periods on a restricted diet up to 12 months, in vitro lipoperoxidation, the percent free activities of lysosomal enzymes and the accumulation of lipofuscins in tissues such as brain and heart were lower in comparison to those of the control animals. The superoxide dismutase activity in liver and brain did not show any consistent variations due to diet restrictions. These beneficial influences of decreased food intake on some free radical-mediated cellular damage may underlie its reported effects on longevity, in conformity with the free radical theory of aging. PMID- 6842305 TI - Zinc absorption, intraluminal zinc and intestinal metallothionein levels in zinc deficient and zinc-replete rodents. AB - Zinc absorption, endogenous luminal zinc and intestinal metallothionein were examined in rats and mice fed zinc-deficient and zinc-replete diets for 5-7 days. Small intestinal luminal washings from undosed rodents fed the replete diet contained 18- to 20-fold more zinc than those from zinc-deficient animals. Isotope dilution by this endogenous zinc could account for apparent differences between the groups in absorption of 65Zn from oral doses of 0.1-0.2 mumol 65Zn. With larger (1-2 mumol) oral doses of 65Zn in mice, no difference between the dietary groups was found, although zinc-deficient rats still absorbed more zinc than zinc-replete controls. In mice, zinc absorption from perfused duodenum, jejunum and ileum also was not increased by zinc deficiency. With oral doses, food generally lowered zinc absorption where endogenous or exogenous zinc was present in the gastrointestinal tract; food in perfusates lowered uptake more than transfer. Polarographically determined metallothionein was highest in duodenum of mice. It was lowered by feeding the deficient diet for 5 days without an increase in zinc absorption. It was concluded that zinc absorption is homeostatically increased by zinc deficiency in rats but not in mice and that intestinal metallothionein levels do not affect zinc absorption in mice. PMID- 6842307 TI - The toxicity of Upstate New York talc. PMID- 6842306 TI - Chronic suppression of cholesterol 7 alpha-hydroxylase by dietary chenodeoxycholic acid in neonatal guinea pigs: its effect on subsequent bile acid metabolism in the adult. AB - Treatment of neonatal guinea pigs with cholestyramine persistently increases the activity of hepatic cholesterol 7 alpha-hydroxylase (CH-7 alpha), the rate limiting enzyme of bile acid biosynthesis. In this study, we examined whether CH 7 alpha activity could be persistently inhibited by manipulations (chenodeoxycholic acid feeding) during neonatal life. Male Hartley guinea pigs (2 3 days old) were fed 0.25% chenodeoxycholic acid (CDCA)-supplemented diet for 10 days or 6 weeks. Feeding CDCA for 10 days increased plasma cholesterol [controls (C), 25 +/- 3 vs. CDCA, 34 +/- 2 mg/dl]. Bile acid pool in animals fed CDCA for 10 days was nearly fivefold greater than controls (C, 5.8 +/- 0.3 vs. CDCA, 29.1 +/- 0.9 mg/100 g body weight), whereas CH-7 alpha activity was almost completely inhibited [C, 1.83 +/- 0.4 vs. CDCA, 0.02 +/- 0.02 pmol/(mg . minute)]. Four weeks after stopping CDCA feeding, CH-7 alpha was greater in the CDCA-fed animals (C, 0.47 +/- 0.03 vs. CDCA, 0.67 +/- 0.05). This was associated with a greater bile acid pool in these animals (C, 3.0 +/- 0.2 vs. CDCA, 5.8 +/- 0.4). We conclude that CDCA fed to neonatal guinea pigs inhibits CH-7 alpha activity. This inhibition is not permanent, however, since CH-7 alpha activity increases following withdrawal from chronic CDCA feeding. PMID- 6842308 TI - Unidentified risk factor? PMID- 6842309 TI - Effect of dust exposure in the cotton felt industry. AB - Respiratory histories and preshift and postshift spirometry were recorded for 90 cotton felt workers and 54 brick workers. Environmental monitoring included area sampling by vertical elutriator and cyclone and personal sampling for respirable dust by cyclone. The prevalence of mill fever and byssinosis was 31% and 5%, respectively, in the cotton workers. Significant dose-response effects were detected for both elutriator and cyclone dust measurements and change in forced expiratory volume at 1 s over the shift. A dose-response relationship was also found for the brick workers. PMID- 6842310 TI - Epidemiological aspects of beryllium-induced nonmalignant lung disease: a 30-year update. AB - The unusual epidemiology of beryllium disease observed in the early studies of beryllium disease led in 1951 to the hypothesis that the chronic form of the disease is the result of an acquired sensitization to beryllium or its compounds. After 30 years, the role of sensitization has been confirmed in a number of laboratory and clinical studies. The unusual epidemiological features first summarized by Sterner and Eisenbud continue to be evident. The early studies also led to formulation of standards that have resulted in effective control of both the acute and chronic pulmonary forms of beryllium disease. No case of acute chemical pneumonitis has been reported among beryllium workers in about 15 years, and the number of chronic cases has diminished greatly despite a marked increase in the use of beryllium. PMID- 6842311 TI - Biohazards of ultraviolet, visible and infrared radiation. AB - It has long been recognized that optical radiation may be harmful to the eye; however, the precise exposure conditions, wavelengths and irradiation levels required to injure the cornea, lens and retina have not always been well understood. Ultraviolet (UV) radiation levels that elicit UV photokeratoconjunctivitis are dramatically dependent on wavelength. The damage is the result of a photochemical effect. Lenticular opacities produced in laboratory animals appear to be produced only within a narrow waveband near 300 nm by UV radiation or by extremely high-exposure doses of infrared radiation. Wavelengths between 400 and 1,400 nm may reach the retina in the normal eye, and at sufficient irradiance levels can cause a retinal "burn." Short-wavelength light (blue-violet) can cause a retinal photochemical burn, whereas longer wavelengths and short pulses of light appear to be capable of injuring the retina by a thermal damage mechanism. It has only recently been appreciated that the geometry of the light source and the direction of exposure (e.g., overhead v direct) play important roles in determining the likelihood of ocular injury. PMID- 6842312 TI - Measurement of IgG antibody and airborne antigen to control an industrial outbreak of hypersensitivity pneumonitis. AB - An outbreak of hypersensitivity pneumonitis in a textile plant was attributed on epidemiological grounds to a chilled water air-conditioning system where a slime was growing in the chilled water sump and on demister vanes. All of the patients and about 80% of their asymptomatic co-workers had strongly positive precipitin tests to extracts of the slime. An adaptation of a radioiodinated staphylococcal protein A solid-phase radioimmunoassay was applied to monitor antigen and specific antibody. To control the outbreak, a variety of cleaning and water treatment measures were taken between 1977 and 1979 to reduce the amount of antigen in the water and in the air. The amount of slime in the water was greatly reduced though the antigen content per gram of slime did not change. Airborne antigen in the affected work areas decreased progressively. PMID- 6842313 TI - Equal opportunity for a geriatric labor force: some observations on marine surveying. AB - The issue of mandatory retirement is reviewed in the context of a physically arduous task with major implications for the safety of both life and property (marine surveying). The main physiological factor limiting the inspections of vessels and cargo is the individual's aerobic power. Over an eight-hour shift, the net energy expenditure can amount to 4 megajoule (MJ), equivalent ot 37% of aerobic power for an unfit 65-year-old employee. It is argued that the majority of marine surveyors should retire at about the age of 65 years, on grounds of (1) heavy physical demand, (2) ensuring continuity of operations through the recruitment of young, formally trained employees, and (3) public safety in the face of growing time pressures and a rapidly changing technology. Nevertheless, careful physiological tests may distinguish exceptional individuals who can continue with their work for a longer period. PMID- 6842314 TI - Results of AOMA member survey on medical care cost containment. PMID- 6842315 TI - Impotence: a surgically manageable disease. PMID- 6842316 TI - [Interaction of the skin and bone in animal experiment on bone destruction]. PMID- 6842317 TI - [Morphology and functions of blood vessels in nasal mucosa]. PMID- 6842318 TI - [Nasal polyps and appearance of basophilic cells on the mucosal surface of nose]. PMID- 6842319 TI - [Reconstruction of hypopharynx and cervical esophagus using free jejunal graft]. PMID- 6842320 TI - Second International Conference on Neonatal Thyroid Screening: progress report. PMID- 6842321 TI - Gastroesophageal reflux during sleep in asthmatic patients. AB - To determine what relationship might exist between gastroesophageal reflux and nocturnal asthma, we studied nine patients with asthma and seven control subjects overnight in the sleep laboratory, monitoring sleep state, esophageal pH, tidal volume (including the relative contribution of rib cage and abdomen), and oxygen saturation. There were 15 episodes of gastroesophageal reflux, in three patients with asthma and four control subjects. There were no significant differences between the two groups in the number of reflux episodes, duration of the longest episode, and the percentage of reflux time. Thirteen of the 15 episodes occurred during the awake state or after movement arousal. None of the episodes caused coughing, wheezing, or changes in oxygen saturation in any of the subjects. These patients with chronic asthma did not have an increased incidence of gastroesophageal reflux at night, and reflux did not play any role in the production of their nighttime symptoms. PMID- 6842322 TI - Fetal and postnatal growth of children born to narcotic-dependent women. AB - We studied the effect of heroin and methadone on birth length and 3-year stature of children of untreated heroin addicts (n = 22), women receiving methadone maintenance therapy (95% were polydrug users) (n = 21), and a drug-free comparison group (n = 28), after adjustment for biologic, demographic, and health variables. The mean birth lengths of both groups of drug-exposed infants were significantly below that of a comparison group; however, group means were similar after adjustment for sex, race, prenatal care, pregnancy weight gain, obstetrical risk, maternal education, and smoking. At 3 years of age the mean height was comparable for all groups. When adjusted for birth length, parental height, and smoking, the methadone group was significantly shorter than children exposed to heroin in utero, and the comparison group assumed an intermediate position. These data indicate that the effect of heroin and methadone on intrauterine growth cannot be differentiated from that of associated factors, and that postnatal growth of children exposed to narcotics during pregnancy is no more impaired than that of a high-risk comparison group. Children of all three groups deserve continued observation and efforts to improve their environment in order that their full potential might be achieved. PMID- 6842323 TI - Anemia and hemoglobinopathies in Southeast Asian refugee children. AB - Hematologic evaluations of 254 Southeast Asian refugee children from 163 families are reported. Hemoglobin E trait was common in Cambodians (19%) and Laotians (18%), but rare in Vietnamese (1%). beta-Thalassemia trait was most prevalent in Vietnamese (8%), and less common in Cambodians and Laotians (3%). alpha Thalassemia was prevalent in all three groups. Hemoglobin concentrations and mean corpuscular volumes seen with hemoglobinopathies were compared with those of Southeast Asian children with normal hemoglobin. Both Hb AE and Hb EE were shown to be benign conditions resulting in microcytosis and mild, if any, anemia. In children with Hb AE, mean corpuscular volume ranged from 64 to 78 ft and Hb E from 27% to 34%. In those with Hb EE, microcytosis was more marked (50 to 63 ft). In 15 children with Hb EE, there was a delayed fall in fetal hemoglobin, which can cause diagnostic difficulties in infants. PMID- 6842324 TI - Epidemiologic observations in idiopathic pulmonary hemosiderosis. AB - We did an epidemiologic survey of 30 children in whom idiopathic pulmonary hemosiderosis was diagnosed. Eighteen patients had died; 12 patients were still living. The majority of the cases were diagnosed in between 1962 and 1971, mainly in the spring and fall. Eighty percent of the patient lived in villages, whereas only 30% of the total population resided in the same type of rural area. Only one (5%) of the deceased children lived in the city, whereas four (33%) of the living children were city dwellers. The socioeconomic conditions were poor, and in 50% of the cases continuous exposure to highly toxic insecticides was elicited by history and investigation of housing conditions. The incidence of newly diagnosed cases decreased with the improvement of living conditions and the prohibition of the use of certain insecticides. We believe that environmental factors, perhaps insecticides, may cause idiopathic pulmonary hemosiderosis in genetically predisposed persons. An epidemiologic history and genetic investigation should be included in the evaluation of patients with any disease when the cause is obscure. PMID- 6842325 TI - Cardiac output determination in the neonate. PMID- 6842326 TI - Gliadin antibodies in celiac disease. PMID- 6842327 TI - C-reactive protein in rapid differentiation of acute epiglottitis from spasmodic croup and acute laryngotracheitis: a preliminary report. PMID- 6842328 TI - Cerebrospinal fluid C-reactive protein in neonatal meningitis. PMID- 6842329 TI - Use of serum C-reactive protein in differentiating septic from aseptic meningitis in children. PMID- 6842330 TI - Human serum "parvovirus": a specific cause of aplastic crisis in children with hereditary spherocytosis. PMID- 6842331 TI - Narcolepsy in a 7-year-old child. PMID- 6842332 TI - Diet-responsive proconvertin (factor VII) deficiency in homocystinuria. PMID- 6842333 TI - A prospective study of serum zinc concentration in children with celiac disease. PMID- 6842334 TI - Small-droplet steatosis and intracranial hypertension in argininosuccinic lyase deficiency. PMID- 6842335 TI - Effect of patent ductus arteriosus on left ventricular output in premature infants. AB - A 5 MHz range-gated portable pulsed Doppler velocity meter was used to measure mean ascending aortic blood flow velocity noninvasively. Studies were performed from a suprasternal approach in 18 preterm infants with patent ductus arteriosus. Measurements were made in each patient before and after medical or surgical closure of the PDA. The internal ascending aortic diameter was determined echocardiographically and aortic cross-sectional area calculated according to the equation AAo = pi d2/4. Ascending aortic blood flow was computed as QAo (ml/min) = VAo (cm/sec) x AAo (cm2) x 60 (sec/min). Prior to PDA closure, QAo averaged 343 ml/min/kg, well above predicted normal values. After PDA closure, QAo fell to 252 ml/min/kg, significantly lower than the preclosure level (P less than 0.001), but slightly higher than the mean cardiac output of healthy newborn infants. The mean QAo after surgical ligation of the PDA was closer to the predicted normal value than after treatment with indomethacin alone. This study reflects the effect of left-to-right ductus shunting on left ventricular output and emphasizes the demands placed on the neonatal left ventricle by PDA. PMID- 6842336 TI - Pulmonary effects of furosemide in preterm infants with lung disease. AB - Twenty preterm infants recovering from respiratory distress syndrome at 1 week of age were randomized in this study either to a control or a treatment group. Those treated received a single daily dose of furosemide (1 mg/kg) intravenously. Pulmonary compliance was observed to improve significantly at two hours in the treated group, as compared with that in the controls. The calculated alveolar arterial oxygen gradient was noted to decrease two hours after furosemide and to remain decreased over the four-day period in the treated group. This improvement in lung function was not secondary to diuresis in the infants treated with furosemide. We conclude that furosemide may have a direct pulmonary effect and improve lung function acutely as well as with chronic administration. PMID- 6842337 TI - Comparison of various methods of blood sugar screening in newborn infants. AB - We evaluated two reagent strips, Dextrostix and Chemstrip-BG, and the reflectance meter technique, Stat-tek Photometer, in the screening of blood sugar values in newborn infants at high risk and compared them with laboratory glucose determination using an automatic analyzer (glucose oxidase method). The visual inspection provided by the Chemstrip-BG was the best screening method and correlated best with laboratory blood sugar concentrations, with a correlation coefficient of 0.885. This value was statistically better than for Dextrostix (r = 0.797) and Stat-tek (r = 0.777). When we compared the blood sugar values less than 50 mg/dl, the correlation coefficient for Stat-tek was 0.670, which was not statistically different than for Dextrostix (r = 0.502); Chemstrip-BG correlated best with true glucose values (r = 0.843). We believe that Chemstrip-BG is more accurate and technically easier to perform than either Dextrostix or Stat-tek. PMID- 6842338 TI - A prenatal study of fetal platelet count and size with application to fetus at risk for Wiskott-Aldrich syndrome. AB - Platelet counts and platelet size were determined in midtrimester fetuses to obtain reference values to be used in prenatal diagnosis of inheritable platelet disorders. In 17- to 21-week fetuses, platelet counts ranged between 135 and 283 x 10(9)/L, and thus did not differ from those of newborn infants and adults. Mean platelet volume fell between 6.0 and 7.0 fl, which is in the range for adults. The data were used to exclude Wiskott-Aldrich syndrome in an 18-week fetus at 50% risk of being affected. PMID- 6842339 TI - Plasma fibronectin in healthy newborn infants: respiratory distress syndrome and perinatal asphyxia. PMID- 6842342 TI - Minimal change nephrotic syndrome: treatment with low doses of hydrocortisone. PMID- 6842341 TI - Disposition of sodium benzoate in newborn infants with hyperammonemia. AB - Sodium benzoate lowers serum ammonia concentrations by the activation of a non urea cycle pathway of ammonia removal. The disposition of sodium benzoate was monitored in four hyperammonemic newborn infants, using a simple and newly developed assay for benzoate and hippurate, to assess (1) the metabolic capability of patients of this age to utilize this pathway for nitrogen removal, (2) the potential risks of benzoate toxicity at clinically achieved serum benzoate concentrations, and (3) the value of routine monitoring of serum benzoate concentrations in this patient population. In three of the four infants, more than half of the administered benzoate was converted to hippurate. Hippurate was effectively cleared by the neonatal kidney, although removal of unconjugated benzoate by peritoneal dialysis or urinary excretion was slow compared with the metabolic conversion to hippurate. There was a considerable interpatient variability in benzoate metabolism; consequently, an eight-fold range in serum benzoate concentrations (2.14 to 16.0 mM/L) was found after patients had received benzoate for longer than 24 hours. These serum benzoate concentrations were calculated to be capable of producing substantial (four to 25 times) increases in free bilirubin concentrations in jaundiced infants. Although sodium benzoate offers considerable promise for the treatment of hyperammonemia, toxicity appears likely in some infants receiving this drug in currently recommended doses. Monitoring of serum concentrations appears to be warranted. Dosage reduction in jaundiced infants and in those with demonstrated insufficiency of benzoate metabolism is recommended. PMID- 6842340 TI - Trial of low doses of aspirin as prophylaxis in sickle cell disease. AB - The effects of low doses of aspirin on the frequency and severity of painful vaso occlusive crises were evaluated in children with sickle hemoglobinopathies. Aspirin was compared with placebo in 49 patients in a double-blind crossover study. Careful monitoring of patients revealed an average of 1.1 painful crises per patient year. During the 21 months of study, 70% of patients had a maximum of two painful crises, and 25% experienced four or more. The frequency and severity of crises were not affected by aspirin therapy. In view of aspirin's demonstrated effect on platelet function, we suggest that platelets do not contribute to the initiation or progression of the vaso-occlusive process. PMID- 6842343 TI - Veno-occlusive disease of the liver associated with cysteamine treatment of nephropathic cystinosis. PMID- 6842344 TI - Pantethine depletes cystinotic fibroblasts of cystine. PMID- 6842345 TI - Virologic, immunologic, and genetic factors in insulin-dependent diabetes mellitus. PMID- 6842346 TI - Waardenburg and Hirschsprung syndromes. PMID- 6842347 TI - Oral solutions for rehydration of patients with diarrhea. PMID- 6842348 TI - Children's conceptions of death and personal mortality. PMID- 6842349 TI - An investigation of grief and adaptation in parents whose children have died from cancer. PMID- 6842350 TI - Disparities in disease-related perceptions of adolescent cancer patients and their parents. PMID- 6842351 TI - Achievement and intelligence test-retest performance in pediatric cancer patients at diagnosis and one year later. PMID- 6842352 TI - Maternal ratings of activity level and symptomatic behaviors in a nonclinical sample of young children. PMID- 6842353 TI - Deaf child-hearing mother interaction: extensiveness and reciprocity. PMID- 6842354 TI - Reanalysis of weight changes in behavior modification and nutrition education for childhood obesity. PMID- 6842355 TI - Microprocessor-based long term cardiorespirography. I. Heart rate changes and apneic attacks. AB - Cardiorespirography is a well-known method of continuous monitoring in neonatal intensive care. Apneic attacks, bradycardia and tachycardia are registered. In our experience we connected a cardiorespirography recorder to a microprocessor system. The processor consisted of a hardware part including a program (software) and a printer which provided printouts of alarm events. As alarm situations, which cause an alarm printout, we defined: 1. apneic episodes (duration 10, 20 or 30 seconds) 2. tachycardiac (beat-to-beat rate greater than 180/minute) 3. V shaped and U-shaped bradycardia (beat-to-beat heart rate less than 80/min) and combinations. The reliability of the system of recognizing and classifying alarm situations was tested by comparing the alarm printouts with the simultaneously recorded cardiorespirograms. Fifty eight 12 hour records of 41 patients were evaluated. Six hundred alarm situations were counted. The alarm printouts were found in concordance with the cardiograms in all tachycardia alarms. Nearly all bradycardia (V-shaped, U-shaped bradycardia, combination of bradycardia and apnea) were correctly classified. A preset apnea duration of 10 seconds resulted in many false positive alarm printouts. With 20 second apnea time only few false positive alarms were seen, but nine apneic attacks were not recognized. Altogether 81.5% of alarm printouts were correct, 16.8% were false alarms, or V shaped bradycardia were really U-bradycardia. Only 2% of all alarms were not recognized by the microprocessor system. We suggest to combine the microprocessor with a special alarm recorder, which is able to store beat-to-beat heart rate and respiration wave before alarm situations. PMID- 6842356 TI - Home deliveries in The Netherlands. Present situation and sequelae. PMID- 6842357 TI - Microprocessor-based long term cardiorespirography. II. Status evaluation in term and premature newborns. AB - In 1965 URBACH et al. and RUDOLPH et al. [35, 39] described a loss of heart rate variability in severely ill neonates. In this study we investigated the correlation between instantaneous heart rate patterns and status diagnosis. We used a microprocessor-based cardiorespirography system. Seventy five newborn infants (51 prematures and 24 term neonates) were studied for about 12 hours each. Twenty nine patients had a second record after the first investigation. Parameters were: Type of frequency and oscillation, long time variability (LTV), short time variability (STV) and the newly introduced P-value (maximal difference between two successive R-peaks in five minutes). We found clear differences between the study groups. With increasing severity of illness mean values ("group mean values") of long time variability, short time variability and P-value decreased. Fixed heart rate became predominant. The most pronounced loss of heart rate variability was seen in infants with severe intracranial bleeding, thus offering a tentative diagnosis. For statistical analysis long time variability and the silent oscillation type have been proved as best parameters for this diagnosis. Severely decreased heart rate variations also have been seen in infants with acute renal failure--possibly because of brain edema--, after application of muscle relaxants, repeated doses of sedatives, and after prolonged anesthesia. Otherwise, the heart rate variability was probably dependent on age and gestational age in prematures and newborn infants without intracranial bleeding. It is possible to use microprocessor-based long time cardiorespirography as a simple screening method for the diagnosis of neonatal intracerebral bleeding. In future experiences transcutaneous measurements of oxygen tension should be included. PMID- 6842358 TI - Fetal oxygen affinity and its parameters in a random obstetric population. AB - Fetal oxygenation studies have provided the obstetrician with some basic information regarding oxygen supply to the fetus. Although standard values for normal fetuses at term have been made, little has been done to evaluate any changes occurring with fetal and neonatal abnormality. Twenty-two sets of analyses were performed to measure oxygen affinity (P50) 2,3-diphosphoglycerate concentration and full blood gas analysis on umbilical arterial and venous samples. The samples were taken from a random obstetric population. All babies were at term or post term by antenatal data and paediatric assessment at delivery. A further study was performed on a group of normal and growth retarded term infants, assessing the same parameters as the random population. Following analysis, 2 cases of cardio-pulmonary abnormality, resulting in neonatal death, were found to have the highest oxygen affinity, the remaining oxygenation parameters of PO2, PCO2, pH and 2,3-diphosphoglycerate concentration were found to be similar to the rest of the group. The results of this study agree with previous investigative findings for the normal babies. The finding of low P50 (or high oxygen affinity) in these 2 cases is an unusual finding and may reflect an adaptive function towards extra-uterine life. No alteration of fetal oxygen affinity was found in a small group of growth retarded babies despite the lowering of the 2,3-diphosphoglycerate concentration. The latter finding probably reflects the lowered intrauterine fetal blood pH found with growth retarded babies. Further research is required to elucidate the comples process of fetal oxygenation that occurs in the presence of fetal abnormality. PMID- 6842359 TI - Should blood glucose monitoring be done in overweight and/or giant infants of non diabetic mothers? AB - Monitoring of serum glucose levels in 60 asymptomatic overweight (4.000-4.499 g) and giant (greater than 4.500 g) newborns of non-diabetic mothers during the first 72 hours of life did not reveal pathological values. The mean result of giant infants was lower than that of the group less than 4.500 g. In mothers of overweight infants diabetes mellitus should always be kept in mind. However, the diagnosis may be difficult particularly in its latent form due to metabolic alterations caused by pregnancy. For this reason it is necessary to monitor blood glucose levels for hypoglycemia in these newborns just as in infants of mothers having a manifest diabetes mellitus. PMID- 6842360 TI - State of acidity as an indicator of quality care in obstetrics. PMID- 6842361 TI - Predicting and understanding mothers' infant-feeding intentions and behavior: testing the theory of reasoned action. AB - The present study examines the applicability of Fishbein and Ajzen's theory of reasoned action to the prediction and understanding of how primiparous and multiparous mothers intended to feed their infants and how they actually fed these infants during the 6 weeks following delivery. Measures of attitudes to behavior, subjective norms, and behavioral intentions were taken during the last trimester of pregnancy. Behavior was assessed by self-report 6 weeks postpartum. In most respects the findings supported the theory of reasoned action. However, attitudes to behavior were found to make an independent and significant contribution to the prediction of infant-feeding behavior, and the previous behavior of multiparous mothers explained an independent and significant proportion of variation in their behavioral intentions. The relative importance of the attitudinal and normative components of the theoretical model tended to vary according to whether the mothers had direct experience of the criterion behavior. Further analysis revealed that mothers who breast-fed during the 6-week postpartum period differed from those who bottle-fed exclusively during this period on a number of behavioral beliefs, outcome evaluations, and normative beliefs, and on one measure of motivation to comply. The implications of these findings for the theory of reasoned action are discussed. PMID- 6842362 TI - Attraction in aversive environments: some evidence for classical conditioning and negative reinforcement. AB - Predictions derived from misattribution and negative-reinforcement theories concerning the mediators of attraction in aversive environments were examined. Male subjects, expecting to receive either high- or low-intensity shocks, participated with either a male or female confederate who was or was not present during the description of shock intensity. Subjects' arousal, attributions for their arousal, and attraction to the confederate were measured. Results were not consistent with the misattribution hypothesis. The negative-reinforcement hypothesis accurately predicted the arousal and attribution measures. The presence of the confederate did reduce the perceived aversiveness of the shock and made the subjects feel more calm. Additionally, subjects attributed their arousal to the threat and a calming influence to the confederate. Attraction to the confederate was most consistent with an incorporation of both negative reinforcement and classical conditioning processes. Confederates who were absent during the high-shock threat were found to be most attractive and significantly more attractive than those who were present during the threat. This suggests that although both confederates reduced arousal, the one present during threat also took on some of the negative qualities of that threat, as would be expected to result from classical conditioning processes. PMID- 6842363 TI - Secondary baby talk: judgments by institutionalized elderly and their caregivers. AB - Elderly care receivers and their caregivers judged vocal nonverbal messages prepared from audiotapes of caregivers interacting with their co-workers and elderly nursing home residents. This study investigated the relationship between these judgments and, respectively, the functional ability of the aged judges and the expectations of the elderly held by the caregivers. The stimulus tape judged consisted of three types of messages: caregivers' speech to care receivers in baby talk, caregivers' speech to care receivers not in baby talk, and speech to other caregivers assumed to be in normal adult speech. For the elderly judges, lower functional ability scores were found to be associated with a greater liking for baby talk speech as compared to other speech, but no relationships were found for their judgments of "soothing" or "irritating." For caregivers, expectancy was associated with their predictions of elderly residents' liking for baby talk speech and caregivers' endorsements that adult speech would not be effective for interacting with care receivers. The pattern of results suggests that variations in caregiver expectancy may operate through a common social stereotype of the elderly. PMID- 6842364 TI - Sex role orientation and self-esteem: a critical meta-analytic review. AB - Research on the relation between sex role orientation and psychological well being has been guided by one of three models. The traditional congruence model holds that psychological well-being is fostered only when one's sex role orientation is congruent with one's gender; the androgyny model proposes that well-being is maximized when one's sex role orientation incorporates a high degree of both masculinity and femininity regardless of one's gender; the masculinity model posits that well-being is a function of the extent to which one has a masculine sex role orientation. The adequacy of these three models was tested by means of a meta-analysis of 35 studies of the relation between sex role orientation and self-esteem, the indicator of psychological well-being most widely used in sex role studies. The results of the meta-analysis were most supportive of the masculinity model and showed that the strength of observed relations between sex role orientation and self-esteem varied as a function of both the sex role measure and the type of self-esteem measure used in the studies. In addition, a number of methodological issues was identified that should be taken into consideration in future research. PMID- 6842365 TI - The self-serving function of hypochondriacal complaints: physical symptoms as self-handicapping strategies. AB - The present experiment tested the hypothesis that hypochondriacal individuals commonly use reports of physical illness and symptoms as a strategy to control attributions made about their performances in evaluative settings (i.e., self handicapping strategies). Specifically, it was predicted that hypochondriacal individuals would report more recent physical illness and complaints and more current physical symptoms in an evaluative setting in which poor health could serve as an alternative explanation for poor performance than would either individuals in an evaluative setting in which poor health was precluded as an excuse or individuals in a nonevaluative setting. As predicted, results supported this self-protective pattern of complaints in a hypochondriacal sample but not in a nonhypochondriacal group. The self-protective role of hypochondriacal behavior is discussed in relation to other theory and research on the nature and treatment of hypochondriasis. PMID- 6842366 TI - Social confirmation of dysphoria: shared and private reactions to depression. AB - Social responses to dysphoria were investigated. Subjects conversed for 15 minutes with persons selected on the basis of the presence or absence of depressed mood. Following the conversations, mood measures were administered along with social perception questionnaires that were described as either being confidential or to be shared with the other person. Subjects who interacted with depressed persons were anxious, depressed, and hostile, and the subjects rejected them. Contrary to predictions, subjects were willing to share their negative responses with the depressed persons. The depressed persons correctly anticipated rejection and reciprocated. The authors argue that cognitive models of depression need to be integrated with a conception of the social environment as being active and responsive. Judgments of cognitive distortion cannot be made without an understanding of the feedback typically available from the social environment. PMID- 6842367 TI - More aggressive cartoons are funnier. AB - Independent rankings of humor and aggressiveness were obtained for sets of cartoons drawn randomly from two different magazines. The correlation of median humor and median aggressiveness rankings ranged from .49 to .90 in six studies involving six different sets of cartoons and six different groups of subjects, including children and adults, high and low socioeconomic status (SES) individuals, and native- and foreign-born individuals. This correlation is consistent with Freudian, arousal, and superiority theories of humor. Another prediction of Freudian theory, that high-SES subjects should be more appreciative of aggressive humor than low-SES subjects, was not supported. PMID- 6842368 TI - Impact of divorce on locus of control orientation in adult women: a longitudinal study. AB - Using longitudinal data for adult women from the National Longitudinal Surveys of Labor Market Experience, this study examined the relation between getting divorced and changes in the individual's locus of control orientation. The sample contained 1,814 white women ages 32-46 years who were in their first marriage in 1969. Marital status and locus of control (an 11-item abbreviated version of Rotter's Internal-External Locus of Control Scale) were measured in 1969, 1972, and 1977. Based on previous literature on locus of control and life events and on divorce, stress, and mental health, the author hypothesized that divorced people, in comparison with those who remained married, would show a short-term increase in externality from 1969-1972, followed by a return over the next 5 years to levels of locus of control comparable to that of the group who remained married. It was also hypothesized that locus of control scores would not predict the likelihood of becoming divorced over the 8-year period. All three hypotheses were confirmed. The findings were discussed in the context of two larger theoretical issues: the influence of important life events on locus of control and the causal direction in the well-documented association between divorce and mental health. PMID- 6842369 TI - Dimensions of subjective female orgasmic responsiveness. AB - Results of recent psychological research have been at odds with the major physiological evidence on the nature of female orgasmic responsiveness. Although female orgasm appears to be a single process physiologically, subjective reports by women indicate that individual differences in their experience is multidimensional. The basis for the discrepant findings is analyzed via two studies of reported orgasmic experiences in women. One sample of 115 sexually experienced women yielded data that replicated the finding that coital and masturbatory orgasmic responsiveness can be statistically distinguished and independently assessed, thus indicating that sample selection associated with prior research could not explain the result. A separate sample of 101 sexually experienced women were given an instrument that assessed coital responsiveness but differentiated masturbatory responsiveness into dimensions associated with masturbation when alone and with a partner without intercourse. A confirmatory factor analysis substantiated the existence of the three dimensions of female orgasm. However, female orgasmic responsiveness was highly correlated across the three dimensions so that it was possible to isolate a large second-order factor of general orgasmic responsiveness that is consistent with most of the physiological evidence on the unitary nature of orgasm. Correlates of the orgasm scales with background data revealed some discriminant validity for the three dimensions of responsiveness. PMID- 6842370 TI - Renal clearance of inorganic sulfate in rats: effect of acetaminophen-induced depletion of endogenous sulfate. PMID- 6842371 TI - Effects of breed, season, temperature, and solvents on the permeability of frozen and reconstituted cattle skin to levamisole. AB - In vitro measurements have been made of the permeability of frozen and reconstituted cattle skins to levamisole. Breeds used were Red Poll cross, Hereford/Shorthorn cross, Hereford/Santa Gatrudis cross (or Brahman), Friesian (or Friesian/Jersey cross), and Hereford cattle killed in early fall, early summer, or winter. Inter- and intrabreed differences in skin permeability were small, but skin permeability in summer and fall was appreciably greater than in winter. Increases in skin temperature also increased skin permeability. The solvent properties of the skin toward neutral molecules appeared to be similar to those of water, suggesting that skin is a relatively polar barrier. PMID- 6842372 TI - Determination of antimicrobial preservatives in pharmaceutical formulations using reverse-phase liquid chromatography. AB - A specific stability-indicating reverse-phase high-performance liquid chromatographic analytical method has been developed to quantitate the antimicrobial preservatives methylparaben, propylparaben, butylparaben, sorbic acid, and benzoic acid in a series of typical pharmaceutical formulations. The mobile phase of this system is a water-acetonitrile mixture, modified by various acids and buffers. The proportions of water and acetonitrile as well as the type and amounts of modifiers are varied in order to achieve optimum chromatography. This method has been used successfully to quantitate preservatives in solutions, suspensions, creams, lotions, and ointments, and can be readily adapted to routine automated assays, either for routine product evaluation or stability programs. PMID- 6842374 TI - Analysis of theophylline by automated multidimensional high-performance liquid chromatography involving direct plasma injection. AB - A procedure of direct injection of whole plasma for the analysis of theophylline by an automated multidimensional high-performance liquid chromatographic (HPLC) technique is described. The procedure requires as little as 30 microliters of plasma sample and has a linear range of 0.25-30 micrograms/ml. Unknown plasma samples, after the addition of internal standard, are directly injected into the HPLC system. The chromatographic procedure is fully automated, thus the attention and time required from the analyst is reduced to a minimum. About 70 samples can be analyzed per day with approximately 3 hr of analyst time. PMID- 6842375 TI - Esterase activities in adult rabbit eyes. AB - The rational design of prodrugs to improve the therapeutic efficacy of existing drugs would be expedited if the nature of the in vivo enzymatic conditions that regenerate the drugs from their prodrugs is known. Using albino and pigmented rabbits as models, this research seeks to delineate the esterase activities in their corneas, irises, ciliary bodies, and aqueous humor, which are intimately involved in the disposition of drugs from topical dosing. This was achieved by monitoring the hydrolysis kinetics of alpha-naphthyl acetate, both in the presence and absence of esterase inhibitors, upon incubation with aqueous humor and homogenates of cornea, iris, and ciliary body. It was found that in both breeds of rabbits, esterase activity was the highest in the iris-ciliary body followed by the cornea and then the aqueous humor, and that multiple esterases probably existed in the aqueous humor, and the ocular tissues studied. However, the esterase activity in the cornea and iris-ciliary body of the pigmented rabbit was greater when compared with the albino rabbit. Based on these results, drugs and prodrugs containing ester linkages can undergo varying extents of esterase mediated hydrolysis while permeating the cornea and upon entering the aqueous humor, iris, and ciliary body. Moreover, in view of the differences in esterase activity that exist between the albino and pigmented rabbits, it would be necessary to employ both breeds of rabbits in evaluating the rate and extent to which ocular ester prodrugs would be converted to their parent compounds. PMID- 6842373 TI - Conformational study of two polymorphs of spiperone: possible consequences on the interpretation of pharmacological activity. AB - A second polymorph of spiperone, 8-[3-(p-fluorobenzoyl)-propyl]-1-phenyl-1,3,8 triazaspiro[4,5] decan-4-one, has been isolated and characterized by thermal analysis and IR spectrometry. Its structure was solved by X-ray diffraction analysis. The results are compared with those previously obtained on spiperone, the main difference being in the conformation of the side chain and in the nature of the hydrogen bonding. PMID- 6842376 TI - Bilirubin-displacing effect of ampicillin, indomethacin, chlorpromazine, gentamicin, and parabens in vitro and in newborn infants. AB - Displacement of bilirubin bound to human serum albumin by ampicillin, indomethacin, chlorpromazine, gentamicin, methylparaben, and propylparaben was investigated quantitatively. Two methods were used in vitro: measurement of bilirubin displacement by studying the rate of bilirubin oxidation with hydrogen peroxide and peroxidase and determination of the albumin reserve for binding of bilirubin by observation of the dialysis rate of an added trace amount of a deputy ligand monoacetyldapsone (p-acetamido-p'-aminodiphenyl sulfone). The latter method was also used for the determination of the albumin reserve in sera from treated newborn infants. The following doses were given: ampicillin, 100 mg/kg iv; indomethacin, 0.2 mg/kg iv; chlorpromazine hydrochloride, 0.7 mg/kg im; gentamicin sulfate, 2.5 mg/kg im. The parabens were present in injectable preparations of chlorpromazine and gentamicin and were therefore given in the following doses: methylparaben, 0.35 mg/kg, and propylparaben, 0.05 mg/kg. All drugs were given in a single dose. A few additional additives and metabolites were studied in vitro. Ampicillin, given to 19 infants, produced a small, significant decrease in plasma albumin reserve, to 82% of the pretreatment level and, thus, had a slight bilirubin-displacing effect, quantitatively consistent with a weak displacing effect measured in vitro. None of the other substances showed any measurable displacement in vivo, likewise in agreement with the results from in vitro studies. PMID- 6842377 TI - Elementary osmotic pump for indomethacin. AB - Based on the principles of an elementary osmotic pump, systems were designed to deliver indomethacin in solution at a constant rate, Z, to contain a total amount of drug, Mt, and to deliver 80% of their content at time t80. To allow selection of the optimal delivery rate into the body, three different prototypes were prepared with respective values for Z, Mt, and t80 of: 7 mg/hr, 85 mg, 11 hr; 9 mg/hr, 85 mg, 8 hr; and 12 mg/hr, 85 mg, 6 hr. These systems were found to deliver 70% of each system's contents at zero-order rates. Delivery rates were independent of pH, method of measurement, and stirring rate. In keeping with these results, the systems in the GI tract of dogs delivered at the same rate as in vitro, which qualifies the in vitro test as a bioanalogous method predictive of the in vivo performance of the dosage forms. Preliminary results in normal volunteers yielded similar urinary recoveries, while plasma profiles were different from each other and distinct from those following conventional capsules. PMID- 6842378 TI - Prediction of stability in pharmaceutical preparations XX: stability evaluation and bioanalysis of cocaine and benzoylecgonine by high-performance liquid chromatography. AB - Specific, sensitive, reverse-phase high-performance liquid chromatographic (HPLC) assays of cocaine (I) and its hydrolysis products, benzoylecgonine (II) and benzoic acid (III), have been devised with analytical sensitivities as low as 15 ng/ml of plasma for I using spectrophotometric detection at 232 nm. Cocaine can be separated from its hydrolysis products by extraction at pH 7.5 with haloalkanes. Benzoylecgonine and benzoic acid can be extracted at pH 3.0 with 1 butanol. The evaporated residues were reconstituted in acetonitrile-water for HPLC assay. The assay was used to determine the stabilities of I and II in aqueous solutions, to establish log k-pH profiles at various temperatures, and to evaluate Arrhenius' parameters. Hydrolyses were by specific acid-base catalysis. Cocaine showed hydrogen and hydroxyl ion attack on protonated I with 40 and 90% proceeding through the benzoylecgonine route, respectively, as well as hydroxyl ion attack on neutral cocaine, with only 6% proceeding through the benzoylecgonine route. Cocaine is relatively unstable in the neutral pH range with a half-life of 5 hr in buffer at pH 7.25 and 40 degrees. Similar half-lives were observed in fresh dog plasma at 300 and 30 micrograms/ml, although one study at 0.5 microgram/ml indicated a doubling of the rate. PMID- 6842379 TI - Analysis of chlorobutanol in ophthalmic ointments and aqueous solutions by reverse-phase high-performance liquid chromatography. AB - A reverse-phase high-performance liquid chromatographic assay for chlorobutanol was developed and found suitable for the routine analysis of ophthalmic ointments and aqueous solutions. The method utilized a column packed with 10-microns octadecylsilane with a mobile phase of methanol-water (50:50). Peak detection was by UV absorption at 210 nm. In this chromatographic system, chlorobutanol had a capacity factor (K') of 4.1. Standard curves obtained in the presence of ointment vehicle containing an aminoglycoside were linear, intercepted at zero, and averaged 99.4% recovery. Degradation studies indicated that the method was stability indicating. The analytical results for a complete experimental ophthalmic ointment and an aqueous ophthalmic diluent are presented. This high performance liquid chromatographic method of analysis represents an alternative to GC procedures for determining chlorobutanol. PMID- 6842380 TI - Analysis and prediction of partition coefficients of meta- and para-disubstituted benzenes in terms of substituent effects. AB - The hydrophobic substituent parameter for a system of meta- and para disubstituted benzenes, XC6H4Y, defined as pi X/PhY = log PXC6H4Y - log PC6H5Y, where P is the octanol-water partition coefficient and X and Y are variable and fixed substituents, respectively, varies from one system to another, according to the variation in substituent effects on the hydrogen bonding association of substituents with solvents. Using parameters from monosubstituted benzenes, pi X/PhH as the reference, the pi X values were analyzed by such relations as pi X/PhY = a pi X/PhH + rho Y sigma X + rho X sigma Y, where rho Y and rho X are susceptibilities of the relative hydrogen bonding association of substituents Y and X with two partitioning solvents to the electronic effect of X and Y, respectively. For substituents incapable of hydrogen bonding such as alkyl and halogen, the rho value is 0. The parameter a is a constant congruent to 1. The relationship was applied in calculating log P values of disubstituted benzenes. PMID- 6842381 TI - Determination of benzalkonium chloride by chemical ionization mass spectroscopy. PMID- 6842382 TI - Solubility in binary solvent systems III: predictive expressions based on molecular surface areas. AB - The nearly ideal binary solvent model, which has led to successful predictive equations for the partial molar Gibbs free energy of the solute in binary solvent mixtures, was extended to include molecular surface areas as weighting factors. Two additional expressions were derived and compared to previously developed equations (based on molar volumes as weighting factors) for their ability to predict anthracene and naphthalene solubilities in mixed solvents from measurements in the pure solvents. The most successful equation in terms of goodness of fit involved a surface fraction average of the excess Gibbs free energy relative to Raoult's law and predicted experimental solubilities in 25 systems with an average deviation of 1.7% and a maximum deviation of 7.5%. Two expressions approximating weighting factors with molar volumes provided accurate predictions in many of the systems studied but failed in their ability to predict anthracene solubilities in solvent mixtures containing benzene. PMID- 6842383 TI - High-performance liquid chromatography of preparations of ribonucleic acid inactivator(s) from cupric ion and hydroquinone before and after treatment with histidine. AB - Preparations of viral RNA inactivator(s) produced during the cupric ion-catalyzed oxidation of hydroquinone were analyzed by high-performance liquid chromatography (HPLC) using UV and electrochemical (EC) detectors. In addition to hydroquinone and the main oxidation product (p-benzoquinone), which is known not to be the inactivator(s), the analysis showed three unidentified components (I-III). Partial UV absorption spectra of I-III were determined by HPLC with the UV detector set at various wavelengths. Components II and III, but not I, were highly unstable in the presence of L-histidine, which is an excellent chelator of cupric ion and can promptly stop ongoing viral RNA inactivation by the inactivator(s). The product p-benzoquinone was also highly unstable in the presence of L-histidine; the reaction between these two compounds (with or without copper) resulted in a cascade of products. The possibility that the inactivator(s) is II or III, or both, is discussed. PMID- 6842384 TI - Phenytoin II: in vitro-in vivo bioequivalence standard for 100-mg phenytoin sodium capsules. AB - A bioequivalence study was undertaken using an oral solution, a fast-dissolving capsule and a slow-dissolving phenytoin sodium capsule. The AUC, tmax and Cmax correlated with in vitro dissolution data. The results of the present studies substantiate the presence of two types of phenytoin sodium products on the market. On the basis of these studies, in vitro specifications for fast- and slow dissolving phenytoin sodium capsules as well as the in vivo bioequivalence requirements for these two types of products are recommended. PMID- 6842385 TI - Improved microscopic techniques for droplet size determination of emulsions. AB - A novel, disposable cell for microscopic determination of the droplet size of emulsions is described. It is made from a piece of adhesive tape in which a hole has been punched which is placed between a glass slide and a cover glass. This cell is easier to fill with emulsions thickened to reduce Brownian motion and creaming than commercial counting chambers, and it prevents field flow. Droplet size averages and distributions obtained with this cell and another counting chamber agreed, provided that the emulsion viscosity was approximately 20 cp or higher. The sample size required to provide arithmetic mean diameters with a specified accuracy at a preselected confidence probability was calculated. PMID- 6842386 TI - Effect of different water-soluble additives on water sorption into silicone rubber. AB - The ability of ethylene glycol; glycerin; polyethylene glycols 200, 400, and 6000; polysorbate 80; and lactose dispersed in silicone rubber, to promote water sorption into the polymer was investigated in water and in isotonic (pH 7.4) phosphate buffer. Polyethylene glycols 200 and 400, lactose, and, especially, glycerin were effective water carriers. Marked differences in the kinetics of rubber swelling were observed, depending on the carrier. The swelling patterns relative to ethylene glycol, glycerin, and polyethylene glycol 200 showed a maximum due to significant leaching of these additives from the polymer. Steady swelling degrees were afforded by polyethylene glycols 400 and 6000 and by polysorbate 80. The interdependent processes of polymer imbibition and carrier release were speeded up without altering their kinetic patterns by increasing the initial surface-volume ratio of the devices. A proportionality resulted between maximal swelling and initial carrier concentration, although the swelling patterns were substantially unaffected by this variable. PMID- 6842388 TI - Thermal decomposition of aspirin: formation of linear oligomeric salicylate esters. PMID- 6842387 TI - Potential anticonvulsants VI: condensation of isatins with cyclohexanone and other cyclic ketones. PMID- 6842389 TI - Biologically reversible phosphate-protective groups. PMID- 6842390 TI - Estimation of the extent of drug-excipient interactions involving croscarmellose sodium. PMID- 6842391 TI - Modification of behavioral effects of morphine, meperidine and normeperidine by naloxone and by morphine tolerance. AB - Lever-press responding of morphine-tolerant and nontolerant squirrel monkeys was maintained under a multiple fixed-interval 5-min, fixed-interval 5-min schedule of food or electric shock presentation. Under the multiple schedule, the first response after a 5-min interval produced either food or shock depending on the prevailing stimulus. Responding maintained by either food or shock was characterized by patterns of positively accelerated responding during the 5-min interval. Morphine (0.1-1.0 mg/kg), meperidine (0.3-10.0 mg/kg) and normeperidine (1.0-17.0 mg/kg) produced dose-related decreases in rates of responding and produced small changes in the temporal pattern of responding in monkeys not tolerant to morphine. Food- and shock-maintained responding generally were affected similarly. Naloxone (0.1-3.0 mg/kg) had no effect when given alone to nontolerant monkeys. Both morphine tolerance and naloxone administration reversed the rate-decreasing effects of morphine and shifted the morphine dose-effect function to the right. Naloxone administration and morphine tolerance also reversed the rate-decreasing effects of meperidine and normeperidine, but unlike with morphine, combinations of naloxone and meperidine or normeperidine disrupted temporal patterns of responding and, at the higher doses, increased rates of responding well above control values. Drug effects in morphine-tolerant or naloxone-treated monkeys were not dependent on the event maintaining responding as comparable local rates of responding maintained by food or shock presentation were affected similarly. It was concluded that meperidine and normeperidine possess behavioral effects in common with those of morphine as well as pronounced non-morphine-like effects which are revealed by interference with the receptors upon which morphine acts. PMID- 6842392 TI - Sodium and chloride dependency of dibucaine- and procaine-induced choleresis in isolated perfused rat livers. AB - The effect of local anesthetics, dibucaine and procaine, on hepatic bile formation was studied in the isolated perfused rat liver. Perfusate Na+ and Cl- were replaced by other ions to define the possible mechanism of action. A single dose (50 mumol) of dibucaine produced an initial cholestasis followed by choleresis. Whereas dibucaine produced only choleresis at a lower dose (10 mumol), only the cholestatic effect was seen at a higher dose (100 mumol). Procaine, on the other hand, produced only choleresis at all doses (1, 10 and 100 mumol); this choleresis was associated with biliary secretion of procaine and its metabolites. Neither dibucaine nor procaine affected the low endogenous bile acid secretion in these studies. The diffusion permeability coefficient of [carboxy 14C]inulin was not altered significantly by dibucaine and procaine, suggesting no significant alteration of biliary permeability. Biliary secretion of Na+ or Cl- declined during cholestasis and increased during choleresis. The initial cholestatic effect of dibucaine was still present when perfusates Na+ and Cl- were replaced by permeable Li+ or NO3-, but declined when Cl- was replaced by relatively impermeable isethionate, suggesting a nonspecific effect. The choleretic effect of both dibucaine and procaine, however, declined significantly when Na+ or Cl- was replaced by Li+, NO3- or isethionate-. These ion substitutions did not affect significantly the biliary secretion of procaine and its metabolites. The ability to induce biliary secretion of Na+ and Cl- also decreased when Cl- was replaced by NO3- or isethionate and when Na+ was replaced by Li+, respectively. These results suggest that a part of the choleretic effect of both dibucaine and procaine is specifically dependent on Na+ and Cl-. This fraction is thus unlikely to be due to the osmotic effect of the secreted drug. Further studies showed that dibucaine inhibited Na+-dependent hepatic uptake of taurocholate, suggesting possible interference with other Na+-dependent transport processes. It is proposed that although a part of the choleresis is due to the osmotic effect of the secreted drug, the specific dependency of a portion of the choleretic effect on Na+ and Cl- is due to inhibition of Na+-coupled Cl- reabsorption from the canaliculi. PMID- 6842393 TI - Characterization of binding of the Ca++ channel antagonist, [3H]nitrendipine, to guinea-pig ileal smooth muscle. AB - A chemically heterogeneous group of compounds, the Ca++ channel antagonists, which includes verapamil, diltiazem and nifedipine inhibits excitation contraction coupling in smooth and cardiac muscle by blocking Ca+ entry at a specific class of Ca++ channels. The binding of the nifedipine analog, [3H]nitrendipine, to a microsomal fraction from guinea-pig longitudinal smooth muscle has been characterized. Specific binding was saturable, linear with protein concentration and reversible. The apparent equilibrium dissociation constant was 1.63 +/- 0.06 X 10(-10)M and the maximum site density was 1.13 +/- 0.03 pmol/mg of protein determined from Scatchard analysis of equilibrium binding at 25 degrees C. Inhibition of binding was specific and stereoselective for Ca++ channel antagonist drugs and was unaffected by a variety of receptor active ligands. Correlations between binding and inhibition of mechanical response to methylfurmethide- and K+-stimulation in a series of nifedipine analogs were determined. A 1:1 correlation was found for the K+ tonic response, but for the phasic component of the K+ response and for both components of the methylfurmethide response the antagonists were more active as inhibitors of [3H]nitrendipine binding than as inhibitors of mechanical response. [3H]Nitrendipine binding was sensitive to other Ca++ channel antagonists including verapamil, D-600, diltiazem, flunarizine, lidoflazine and bepridil. Interaction with these agents suggests, consistent with previous reports, that more than one binding site for Ca++ antagonists exists. A variety of inorganic divalent and trivalent cations (Mn++, Co++, Ni++, Pb++, UO2++, Zn++, Cd++, Cu++, Tm+++ and La+++) inhibit specific [3H]nitrendipine binding. The data suggest that [3H]nitrendipine binding in smooth muscle is to a site which mediates the pharmacologic response. PMID- 6842394 TI - Effect of calcium antagonists on leukotriene D4-induced contractions of the guinea-pig trachea and lung parenchyma. AB - The directly mediated contractile activity of leukotriene (LT) D4 on isolated guinea-pig trachea and lung parenchyma was dependent upon the presence of calcium in the bathing buffer. Whereas 8-(N,N-diethylamino)-octyl-3,4,5 trimethoxybenzoate (TMB-8), a calcium antagonist believed to act intracellularly, completely antagonized the LTD4-induced contraction, the calcium channel entry blockers, nifedipine and verapamil, only partially inhibited LTD4 contractile activity; diltiazem was inactive. TMB-8, nifedipine and verapamil were more effective in blocking the contraction of the trachea elicited by KCl-induced membrane depolarization than the contraction induced by LTD4. Of the channel entry blockers, only nifedipine appeared capable of partially relaxing an established LTD4-contracted trachea, whereas TMB-8 almost completely reversed the LTD4 contraction. On the lung parenchyma, the LTD4-induced contraction was suppressed, but not abolished in Ca++-free buffer; this contraction was antagonized by meclofenamic acid, thus suggesting it could be due in part to the indirect thromboxane (Tx) A2-mediated pathway of LT action. In Ca++-free buffer, LTD4 was still capable of generating TxB2, although lower amounts were found when compared to Ca++-containing buffer. Incremental addition of calcium to the parenchyma in Ca++-free buffer containing LTD4 elicited greater than control LTD4 induced contraction and TxB2 generation. Neither the contraction of the parenchyma nor the generation of TxB2 was antagonized by nifedipine; conversely, TMB-8 blocked both completely. Thus, based upon the use of pharmacological antagonists of calcium, these results suggest that LTD4 contractile activity in the respiratory system is dependent upon calcium, with calcium of intracellular origin potentially of significance. PMID- 6842395 TI - Formation of methylamines from ingested choline and lecithin. AB - Humans ingest substantial amounts of choline and lecithin as part of common foods. Physicians have recently begun administering large doses of these compounds to individuals with neurological diseases. A significant fraction of ingested choline is destroyed by enzymes within gut bacteria, forming trimethylamine (TMA), dimethylamine (DMA) and monomethylamine (MMA). Some of these methylamines are eventually excreted into the urine, presumably after being absorbed and carried to the kidneys via the bloodstream. The methylamines formed after choline is eaten could be substrates for the formation of nitrosamines, which have marked carcinogenic activity. Twenty-seven millimoles of choline chloride, choline stearate or lecithin were administered to healthy human subjects. It was found that these treatments markedly increased the urinary excretion of TMA, DMA and MMA, with choline chloride having the greatest effect. Rats were treated with 2 mmol/kg b.wt. of choline chloride or lecithin, and it was found that these treatments significantly increased urinary TMA excretion and did not alter DMA or MMA excretion. Our choline chloride preparation contained no MMA, DMA or TMA; however, it was found that our choline stearate and all the commercially available lecithins tested were contaminated with methylamines. Prior removal of methylamines from our lecithin preparation minimized the effect of oral administration of this compound on methylamine excretion in urine of rats and humans. PMID- 6842396 TI - Effect of morphine on the responses to and disposition of phencyclidine in mice. I. Enhancement of phencyclidine effects by acute morphine administration. AB - Morphine elicited a dose-related increase in the duration of phencyclidine (PCP) induced motor incoordination. In the open field behavioral observations, morphine enhanced the PCP-induced decrease in the number of ambulation and rearing. Morphine potentiated the PCP-induced decrease in body temperature. The LD50 of PCP was significantly decreased in the presence of morphine. An opiate antagonist, naloxone, antagonized the morphine-induced effects without influencing the pharmacological actions of PCP itself. The levels of hepatic microsomal cytochrome P-450 and cytochrome b5 and the activities of NADPH dehydrogenase and NADPH cytochrome c reductase were unaffected by morphine treatment. The half-lives of PCP in serum and brain were increased by the concurrent administration of morphine. The ratio of the liver weight to body weight and aniline hydroxylase activity in hepatic microsomal fraction were decreased in the morphine-treated group compared with the control group; this is indicative of a possible reduction in the oxidative metabolism of PCP. The results indicate that acute administration of morphine enhances a variety of pharmacological effects of PCP; an inhibition of PCP disposition by morphine may be a mechanism involved in this process. PMID- 6842397 TI - Effects of phencyclidine on the release of radioactivity from rat striatal slices labeled with [3H]choline. AB - Phencyclidine (PCP) has been shown to antagonize the effects of acetylcholine (ACh) in a variety of systems and to inhibit the binding of muscarinic antagonists to brain membranes. Therefore, we have studied the effects of PCP on ACh release from rat striatal slices in order to characterize the effect of PCP in a central cholinergic system. After incubation with [3H]choline, striatal slices were superfused and the superfusate was assayed for radioactivity. The presence of PCP led to dose-related inhibition of K+-stimulated ACh release. This may be due to the reported ability of PCP to enhance dopamine release as both direct (pergolide) and indirect (amphetamine) dopamine agonists also inhibited striatal ACh release. Haloperidol blocked the inhibitory effects of PCP, amphetamine and pergolide on ACh release, supporting the notion that the decrease in ACh release produced by PCP is mediated indirectly via the release of dopamine onto cholinergic neurons. PMID- 6842398 TI - Pharmacokinetics and pharmacodynamics of 4-aminopyridine in anesthetized dogs. AB - The pharmacokinetics and pharmacodynamics of 4-aminopyridine (4-AP), a drug which antagonizes nondepolarizing neuromuscular blockade, were studied in seven anesthetized dogs. Using a constant infusion of pancuronium, force of the anterior tibialis contraction in response to stimulation of the sciatic nerve was depressed to 10% of the control tension (90% depression of twitch tension). After 20 min of steady state, 4-AP (1.0 mg/kg) was administered i.v. Serum, urine and bile samples were analyzed for 4-AP concentration at several intervals for 10 hr after administration of 4-AP, using a sensitive high-performance liquid chromatographic assay (1 ng/ml). Serum data best fit a three-compartment pharmacokinetic model. The volume of the central compartment was 412 +/- 352 ml/kg (mean +/- S.D.) and the volume of distribution at steady state was 2517 +/- 363 ml/kg. Initial half-lives were 1.1 +/- 0.7 and 25.4 +/- 11 min. The terminal elimination half-life was 125 +/- 23 min and total clearance was 21 +/- 4 ml/kg/min. Of the injected dose, 60 +/- 9% was recovered in the urine and only 0.01 +/- 0.01% of the dose was recovered in the bile in 10 hr. Inasmuch as renal clearance of 4-AP exceeded glomerular filtration rate we conclude that 4-AP undergoes tubular secretion into the urine. The pharmacodynamic results included an onset time of 14 +/- 8 min, peak effect (maximum percentage of antagonism of twitch tension depression) 97 +/- 27% and duration of action 219 +/- 54 min. We conclude that 4-AP has a longer serum elimination half-life and a longer and more variable duration of action than other antagonists (i.e., neostigmine and pyridostigmine) of nondepolarizing neuromuscular blockade. PMID- 6842399 TI - Pharmacokinetics of pentobarbital in the dog. AB - The pharmacokinetics of pentobarbital were studied after i.v. administration of a 30-mg/kg dose to five dogs. Pentobarbital plasma concentrations were measured with a new gas chromatographic method, utilizing on-column methylation of pentobarbital and as a butabarbital internal standard. The kinetics of pentobarbital distribution and elimination were analyzed with a three-compartment open mammillary model. The elimination-phase half-life of pentobarbital was 8.2 +/- 2.2 hr. The steady-state volume of pentobarbital distribution was 1.08 +/- 0.21 liters/kg and the elimination clearance was 0.0013 +/- 0.0004 liters/min X kg. Threshold pentobarbital concentrations required to suppress the corneal reflex and withdrawal response to pain were 26.4 +/- 4.6 and 23.0 +/- 2.9 micrograms/ml, respectively. These results should facilitate the design of i.v. anesthetic regimens with pentobarbital. PMID- 6842400 TI - Simultaneous modulation of hippocampal cholinergic activity and extinction by intraseptal muscimol. AB - The relationship between regulation of acetylcholine metabolism in the septal hippocampal pathway and extinction of a food reinforced lever press response was investigated by comparing the turnover rate of acetylcholine (TRACh) in the rat hippocampus with the amount of responding during extinction after intraseptal injection of the gamma-aminobutyric acid receptor agonist muscimol. Doses (0.3 3.0 nmol) which decreased the TRACh in the hippocampus also increased the responding during extinction over that of saline controls. Responding during the continuous reinforcement schedule before extinction was also increased, but to a lesser extent. Higher doses (10-30 nmol) further decreased the TRACh in the hippocampus, decreased it in the cortex and were accompanied by irregular responding and sedation. The TRACh in the hippocampus was also measured in drug free rats undergoing extinction after training on a continuous reinforcement or variable interval 60 sec reinforcement schedule. Although the variable interval 60 sec reinforcement schedule rats responded more than the continuous reinforcement rats during extinction, there were no differences between the TRACh in the hippocampus. The present results indicate that the decrease in the hippocampal TRACh which is produced by intraseptal muscimol is accompanied by an increase in the response rate during extinction, but that operantly induced differences in this behavior are not accompanied by detectable changes in hippocampal TRACh. PMID- 6842401 TI - Pharmacokinetics of chlorimipramine and its demethylated metabolite in blood and brain regions of rats treated acutely and chronically with chlorimipramine. AB - The pharmacokinetic profiles for chlorimipramine (CIM) and its demethylated metabolite desmethylchlorimipramine (DCIM) in blood and in specific brain regions were obtained in rats after acute or chronic treatment with 15 mg/kg of the tricyclic antidepressant CIM. In blood, chronic drug treatment resulted in 1) a decrease in the time to maximal concentration of DCIM; 2) increases in maximal concentrations of CIM and of DCIM; and 3) a decrease in T1/2 of elimination of both CIM and DCIM. These changes induced a small reduction in the area under the CIM curve and a 4-fold increase in the area under the DCIM curve. In brain, both CIM and DCIM were unevenly distributed after both treatment schedules. Maximal accumulations of CIM and DCIM elimination were greatly enhanced in all brain areas by the chronic treatment. In brain, the area under the CIM concentration time curve was only slightly affected by the chronic treatment, chronic drug treatment induced a 4-fold increase in the DCIM area. The subcellular distribution of CIM and DCIM in brain was similar in the acutely and chronically treated animals. The highest specific activity was found in the soluble fraction. These results demonstrate 1) regional brain differences in CIM and DCIM distribution and accumulation; 2) differences in pharmacokinetics between acute and chronic tricyclic antidepressant drug treatment regimens; and 3) differences between blood and brain drug and metabolite pharmacokinetics were observed which suggest that generalizations based on blood parameters should be made with great caution. PMID- 6842402 TI - Subclasses of opioids based on body temperature change in rats: acute subcutaneous administration. AB - Morphine and a number of opioid agonists and agonist-antagonists were injected into rats to examine their effects on body temperature after acute systemic administration. Dose- and time-response curves were constructed for each drug alone and in the presence of the antagonist naloxone. Based on these data, the opioids could be subdivided into several groups. The first group, made up of morphine, heroin, l-methadone, etorphine, fentanyl and levorphanol, caused hyperthermia at lower doses and hypothermia at higher ones. Both effects could be blocked by naloxone. A second group, consisting of buprenorphine, nalbuphine and l-pentazocine, produced only a naloxone-sensitive increase in body temperature, whereas the group comprising ethylketazocine, ketazocine, l-cyclazocine and normeperidine caused only a decrease. This fall in temperature was relatively less sensitive to naloxone blockade. Still another group of drugs (meperidine, normorphine and d-pentazocine) had little effect themselves but, in combination with naloxone, induced hypothermia. The fifth group (N-allylnormetazocine, d cyclazocine, dextrorphan and d-methadone) had no effect whether alone or in the presence of the antagonist. These findings can be explained in terms of a two receptor model by ascribing distinct thermoregulatory functions to each receptor type. PMID- 6842403 TI - Kainic acid selectively stimulates the release of endogenous excitatory acidic amino acids. AB - Kainic acid (KA) exhibits both neuroexcitatory and neurotoxic actions when applied to the brain. Whereas the neuroexcitatory actions are direct, the neurotoxic effects require the integrity of excitatory afferents. In addition, specific receptors for KA have been demonstrated on both pre- and postsynaptic neuronal elements. In the current study, both KA and KCl are shown to stimulate selectively and in a Ca++-dependent manner the efflux of endogenous Glu and Asp from hippocampal, striatal and cerebellar slices incubated in vitro. Unlike the release of other amino acids, the efflux induced by KCl, but not by KA, is attenuated by tetrodotoxin, suggesting that the action of KA is direct. Furthermore, the action of KA is not mimicked by GABAergic, cholinergic, dopaminergic or serotonergic agonists or antagonists, nor by the excitotoxins N methyl-DL-aspartic acid or ibotenic acid. Both dihydrokainic acid and allokainic acid, which have low affinity for the KA receptor, also fail to stimulate Glu and Asp efflux. In the case of cerebella from 10-day-old rats, which lack a mature parallel fiber system, KA stimulated the efflux of several amino acids including Asp, but not Glu. Similarly, in slices prepared from adult granulo-prival mice, KA caused an efflux of Asp comparable with that observed in intact cerebellum, whereas the release of Glu was reduced by 75%. On the basis of these studies, the primary source of KA-stimulated Glu efflux in the cerebellar slices appears to be the granule cell-parallel fiber system. A hypothesis is proposed that KA stimulates the release of excitatory amino acids, independent of impulse flow, by activating presynaptic receptors located on excitatory nerve terminals. This additional site of action of KA at excitatory afferents may contribute to the potent but uneven neurotoxic effects of this compound. PMID- 6842405 TI - Scales for measuring subjective distance in children and adults in a large open field. AB - Five age levels (6, 8, 10, 12 years, and adults, N = 127) estimated distance in a large open field by the fractionation method. Scales for subjective distance were derived for each group. It was found that (a) the adults differed from all the other groups, (b) the 12-year-olds differed from the six-year-olds, (c) all the exponents were smaller than 1, (d) perceived distance in a large open field was characterized by underconstancy, and (e) underconstancy was greater for the younger subjects. PMID- 6842404 TI - Studies on mechanisms of diltiazem-induced protection of the ischemic myocardium: selective myocardial depressant action of diltiazem on an ischemic isolated blood perfused canine papillary muscle preparation. AB - The effect of diltiazem on the contractile and vascular responses to 2 min of total occlusion and reperfusion was investigated in isolated blood-perfused canine papillary muscle preparations. Diltiazem, in doses (3 and 10 micrograms/min) that increased coronary blood flow but did not change developed tension and maximum rate of tension development (dT/dt) in papillary muscle before occlusion, attenuated tension development between 40 and 120 sec of ischemia. At-60 sec postocclusion, developed tension was at 36 +/- 4, 37 +/- 5 and 44 +/- 4% below preocclusion levels for 3, 10 and 100 micrograms/min of diltiazem, respectively (nondiltiazem treated = 24 +/- 3%). The dT/dt increased to 22 +/- 6% above preocclusion value during ischemia in nondiltiazem-treated preparations. This was blocked by diltiazem in a dose-dependent fashion. Propranolol and nitroprusside did not modify the developed tension and the increase in dT/dt of the papillary muscle during occlusion. On reperfusion, an overshoot in developed tension to 22 +/- 4% above preocclusion level was observed. This was significantly reduced by diltiazem and propranolol but not by nitroprusside. Diltiazem inhibited the maximal peak reactive hyperemia response after 2 min of occlusion by 30 to 38%. Both propranolol and nitroprusside did not change this response. The results show that diltiazem selectively depresses the inotropic state of the ischemic myocardium and suggest that a diltiazem-induced reduction in myocardial oxygen consumption during ischemia may contribute to the protection of ischemic myocardium and the reduction in reactive hypermia response in the ischemic heart. PMID- 6842407 TI - The effects of trait anxiety and test difficulty on undergraduates' state anxiety. AB - The purpose of this study was to determine the effects of trait anxiety (stable anxiety resulting from personality characteristics which predisposes an individual to anxiety) and test difficulty on state anxiety (transitory anxiety that results from particular situations which are regarded as difficult or dangerous) of 32 undergraduates. The Test Anxiety Inventory assessed trait anxiety, a modified version of the State-Trait Anxiety Inventory assessed state anxiety, and a specially developed Educational Psychology Recall Test assessed task difficulty. Results indicated that trait anxiety and test difficulty level affected state anxiety. Trait anxiety and test difficulty level did not interact to affect state anxiety. PMID- 6842406 TI - Gastric lesions in rats selectively bred for differential alcohol sensitivity. AB - Two lines of rats selectively bred for motor impairment in response to a subhypnotic dose of ethanol were compared for gastric lesion susceptibility using a tailshock-restraint induction technique. There was no significant difference in stomach pathology between the two lines. PMID- 6842408 TI - Children's comprehension of semantic constraints on temporal prepositions. AB - Children's comprehension of the semantic rules for temporal prepositions was investigated. The temporal prepositions were in, on, and at. Leech's (1969) semantic analysis was used as the framework for the study. The contextual property [(x)] leads to TIM[PERI] with its related constraints indicates the ill formedness of phrases like in noon, on January and at Saturday. Correct usage of these prepositions is based on the implicit distinction between time with or without duration (period versus moment). Comprehension differences among the prepositions, based on semantic differences were hypothesized, as well as developmental differences across age levels. Thirty-five children at each of three levels (kindergarten, grades 2, and 4) in Experiment 1, and 24 grade 4 children in Experiment 2, judged the appropriateness of sentences containing temporal prepositions and attempted to revise the ill-formed sentences. Significant developmental differences were observed. Kindergarten children could not discriminate between well- and ill-formed sentences; second grade children could discriminate but could not identify the reason for their discrimination, nor could they revise the ill-formed sentences. Fourth grade children could discriminate and identify or revise the ill-formedness. Ability to revise the prepositions was found to be related to cognitive developmental level. None of the children in either experiment were able to articulate the periodicity-moment temporal distinction which provides the basis for the semantic constraints. The awareness of semantic rules for temporal prepositions may be relatively late in developing, perhaps between the ages of 8 and 10 years. An advanced awareness of these rules may develop considerably later. PMID- 6842409 TI - "I mell a kunk!" --Evidence that children have more complex representations of word pronunciations which they simplify. AB - A case study is reported in which a child (3 years; 4 months old) who produced forms such as mell and kunk (for smell and skunk, respectively) was asked to choose between his own forms and correct forms in a comprehension task. The results demonstrate that the child understood the correct forms to be the correct forms, suggesting that the child had greater competence than performance in regard to these phonological forms. PMID- 6842410 TI - Using sentences to convey spatial information. AB - Individuals listened to pairwise relationships (e.g., AB, BC, CD) and learned the underlying spatial ordering (e.g., ABCD). Previous work shows that the order in which information is presented strongly affects the success of learning and that these presentation order effects are different when the information occurs in sentences (e.g., "The B is to the left of the C") instead of pairs (e.g., "B-C"). By using a number of different presentation orders and both kinds of input, the present work reveals that these sentence-pair differences can be attributed to the presence of a stated relationship (e.g., the adjective "left") in the sentence and the corresponding facilitation of basic processes by linguistic structures. The role of language in the learning of spatial relationships is discussed. PMID- 6842411 TI - A retrospective survey of proven cases of tuberculous meningitis in the Northern Region, 1970-1980. PMID- 6842412 TI - Natural history of coal-workers' pneumoconiosis in men over 65. AB - Between 1975 and 1977, 107 Kent miners aged 65 or over who had coal-workers' pneumoconiosis (CWP) were examined for current disability. The men had worked an average of 43 years underground. Forty-nine had simple CWP, and 48 complicated (33 'A', 25 'B' and 'C' shadows). In only 34 had their CWP category increased during the last 21 years, though 62 had had their disability percentage increased (by an average of 20 per cent). Seventy-two of the 95 men tested by spirometry showed normal results for their ages. No clear relationship existed between spirometry results and category of CWP. The complicating effects of obstructive airways disease or cigarette-smoking were difficult to disentangle from those of CWP. Coal-workers' pneumoconiosis is increasingly a disease of elderly miners, and can be more benign than was previously thought. It is in these miners' interests that other (perhaps treatable) causes should be sought for any chest symptoms. PMID- 6842413 TI - Management of asthma in out-patients. AB - Five hundred and twenty-nine patients attended five different clinics supervised in three different ways in two adjacent, but socially different, health districts. Performance was apparently better in the clinics supervised by the consultant personally or by specialised junior staff. Non-atopic asthma appeared to be more frequent in clinics attended by patients with a social advantage, where it also appeared to be more easily controlled. This difference in control was less apparent in atopic asthma. These differences and deliberate selection probably account for the differences in performance between the clinics. Prescription policy appeared to be uniform throughout the clinics, though there was a tendency for drugs to be given at a lower level of pulmonary function in those clinics where performance was generally worse. Five per cent of all patients failed to achieve satisfactory treatment after a whole year's observation. This was not influenced by supervision or social group. Analysis of the pulmonary function of patients for whom drugs had been prescribed suggested that there was possible under-use of disodium cromoglycate as opposed to inhaled corticosteroids. The exercise proved a rapid and useful assessment of the performance of the clinics supervising asthma. PMID- 6842414 TI - The effect of chelation therapy on the amino aciduria and peptiduria of Wilson's disease. AB - 1. There is an excess urinary output of free amino acids and of urinary peptides in most cases of untreated Wilson's disease. Studies of 11 patients have shown that both these abnormalities are greatly improved by two years of standard chelation therapy. 2. The reduction in excretion of both free amino acids and peptides is purely quantitative, there being no significant change in the percentage composition of amino acids, either free or combined, in relation to their total urinary output. 3. Arguments are advanced that the peptiduria of the disease is usually due to a proximal renal tubular reabsorption defect, but in rare cases it may be due to excess bone breakdown or even to a combination of bone and renal tubular disease in the same patient. PMID- 6842415 TI - Investigation of neuromuscular disorders. PMID- 6842416 TI - Fact and fiction in occupational epidemiology. The Lucas Lecture 1982. PMID- 6842417 TI - Health for all: a role for the community. PMID- 6842419 TI - Conversion of SS Uganda to a hospital ship. PMID- 6842418 TI - Research ethical committees in 1981. PMID- 6842420 TI - Assessment of ships taken up from trade and other ships for use as emergency facilities in wartime. PMID- 6842421 TI - Hospital ship SS Uganda--at war in the South Atlantic. PMID- 6842422 TI - Medical officer's journal--HMS Hecla. PMID- 6842423 TI - South Georgia--surgery at sea. PMID- 6842424 TI - Ajax Bay. PMID- 6842425 TI - A dental officer with 40 Commando. PMID- 6842426 TI - UK support for the Falkland's casualties. PMID- 6842427 TI - The Falklands campaign--a medical overview. PMID- 6842428 TI - [Abdominal echography in the diagnosis and monitoring of retroperitoneal fibrosis. Apropos of 2 cases]. AB - The authors report 2 new cases of unilateral ureteral obstruction due to a retroperitoneal fibrosis diagnosed by ultrasound examination. Retroperitoneal fibrosis presents as a hypo-echogenic, homogeneous mass, anterior to the sacral promontary, extending more or less cranially or caudally around the aorta and the iliac vessels where it gets a circumferential appearance. The complete regression of the mass has been followed by ultrasound on one patient. The authors underline the diagnostic problem posed with the R.P.F. secondary to metastatic neoplasm and discuss the place of ultrasound guided fine needle biopsy performed on one patient for the diagnosis of the affection. PMID- 6842430 TI - [Radiological anomalies in Wildervanck's syndrome]. PMID- 6842429 TI - [Association of intracranial arterial aneurysms and intracranial arteriovenous malformations. A propos of 8 cases]. PMID- 6842431 TI - [Correlation between standard radiology and computed tomography in the demonstration of mediastinal lines]. AB - The mediastinal lines correspond to the contours of the middle and upper mediastinum, and represent the edges of a dense, pleural covered structure marginated by the air within the lung. The mediastinal lines derive their names from the adjacent organs: 1) The posterior mediastinal junction line (where both lungs meet posteriorly, just before the vertebral column). 2) The anterior mediastinal junction line (where both lungs meet anteriorly, behind the sternum). 3) The right paratracheal stripe (where the right lung meets the trachea). 4) The esophageal-pleural stripe (which disappears at the level of the arch of the Azygos vein that divides the right lung from the esophagus. 5) The Azygos-pleural line (where the arch of the Azygos vein meets the right lung). 6) The esophageal pleural line (where the right esophageal wall meets the right lung). 7) The para aortic line (that is the most constant). 8) and 9) The left and right paraspinous lines (whereof the right is the most often visible). The absence of one of the mediastinal lines is sometimes insignificant, since it can be caused by anatomical variations or by the conditions of the picture. C.T. explains the formation's mechanism of these mediastinal lines, explains the anatomic reasons for their possible absence or displacement and often provides us with their etiology. C.T. offers a simple, reliable and atraumatic method in cases of displaced or vanished mediastinal lines, and should replace standard tomography of the mediastinum. PMID- 6842432 TI - [Place of computed tomography in the diagnosis and assessment of the spread of malignant kidney tumors]. AB - The value of computed tomography was assessed in 52 patients with malignant kidney tumors, of whom 34 had undergone nephrectomy. Findings on the CT scan in a small group of 9 patients, when it was employed mainly for diagnostic purposes, gave true results in 7 cases, its contribution being decisive in 3 of these 7 cases. Scanning replaced arteriography for evaluation of tumor spread in 40 patients, where it was found to be very effective for assessment of perirenal, pararenal and lymph node extension. A high percentage of doubtful results were obtained during the first few years of use of the CT scan for determining state of veins (renal vein and inferior vena cava). Subsequent refinements in technique markedly improved the incidence of positive results. Computed tomography should be employed as the method of first choice for determining the stage of malignant kidney tumors. PMID- 6842433 TI - [Echography in the study of renal tuberculosis]. AB - 34 patients suffering from renal tuberculosis of different degree were examined by ultrasound. The ultrasonographic aspects were compared with the urographic pictures. It was not possible to show by ultrasound the papillar erosions at the initial stage of the infection. In the advanced stage it was possible to evaluate the alterations of the excretory system and the parenchymal damage. The role of the method to study the tuberculous kidney, not visualized at urography, is essential. The typical aspect caused by the coarctated pelvis with dilated calyces allows nearly always to formulate a diagnosis. The achieved results make ultrasonography a very important investigation for the diagnosis and the prognosis of the renal tuberculous infection. PMID- 6842434 TI - Evaluation of the RCGP report on the prevention of arterial disease. AB - For this pilot study 349 patients aged between 20 and 64 years were seen following their consultations with their own general practitioners. The recommendations of the recent RCGP report on the prevention of arterial disease in general practice were carried out. An average of seven minutes was spent with each patient. A considerable number of patients had risk factors for arterial disease; 25 per cent of the sample were smokers, 32 per cent were obese and 15 per cent had a single blood pressure reading greater than 150/90. Two new cases of diabetes were discovered.Case-finding for risk factors for arterial disease, as recommended in the RCGP report, was considered worthwhile but might be most effectively carried out by a suitably trained practice nurse. PMID- 6842435 TI - Consultation length and outcome in two group general practices. AB - Two group general practices were located which, while similar in a number of important respects, differed in the number of appointment consultations arranged per hour, and data was collected to see if corresponding differences in consultation outcome could be found. Information on all appointment consultations offered during a four-week period was analysed, and the number of patients returning for further attention in a subsequent four-week period was also determined. The practice offering longer consultations had a lower proportion of appointment consultations ending with a prescription, required a lower proportion of patients to return for a follow-up appointment, and had a lower proportion of patients themselves returning to seek a further appointment within four weeks of presenting with a new illness episode. PMID- 6842437 TI - Delay in the diagnosis of colorectal cancer. AB - Investigation of factors affecting the speed of diagnosis, referral and treatment of 113 patients with colorectal cancer shows that failure to examine the patient was significantly associated with delay. Patients who were not given a rectal or abdominal examination at their first medical consultation experienced considerably more delay in being referred for specialist opinion. Factors affecting the decision to examine are described. PMID- 6842436 TI - A community study of diabetes in Oxfordshire. AB - A mailed questionnaire was used to identify people with diagnosed diabetes in a population of approximately 14,000. A response rate of 90 per cent was obtained and the prevalence of diabetes was found to be 0.8 per cent. The questionnaire method compared favourably with other methods of identifying diabetics in the area.Eighty-two diabetics were interviewed and examined for diabetic complications and 55 of these completed a questionnaire on their attitudes to diabetes and its care.The medical records of all 108 diabetics identified were examined. A greater proportion of patients who attended either a general practice mini-clinic or a hospital diabetic clinic had examination for complications recorded than patients attending their general practitioner in ordinary surgery time. Patients attending on demand were seen less often and had fewer observations recorded when they came.Comparison of measures of control between hospital and general practice patients showed that hospital patients tended to be more tightly controlled even though most were on insulin and likely to have more severe diabetes.Half of non-insulin diabetics and a quarter of those on insulin considered that their diabetes should be managed solely by their general practitioner.This was a pilot study and caution should be exercised in interpreting results from comparatively small numbers. The study has since been extended to a larger population. f10sl60 PMID- 6842438 TI - Reluctance to seek medical advice about breast symptoms. AB - A third of a sample of women with breast symptoms referred by general practitioners to a hospital clinic said they had been reluctant to consult their doctor. Fear, being a nuisance to the doctor, and embarrassment were the three most frequently mentioned reasons for their reluctance. Nearly half of those questioned were prompted to seek medical advice either solely, or partly, because of the thought of breast cancer. PMID- 6842440 TI - Problems of fertility and their management. AB - Subfertility is common. Its management is almost invariably stressful. With the aid of an Upjohn Travelling Fellowship, it was hoped that a more structured role for the general practitioner could be developed, which would be adaptable for use in different areas and which would improve the management of subfertile couples. By personal visits to many hospitals and reviewing recent literature on subfertility, constructive criticism has been made of the service that is provided.The treatment of subfertility in many cases is still largely empirical. Comparative trials of the management of the subfertile are rarely available.Recommendations have been made which, it is hoped, will be studied by all those involved in the management of the subfertile. Poor communication is often the root problem, and attention has been paid to devising a remedy for this. PMID- 6842441 TI - Why not hold a faculty public meeting? PMID- 6842439 TI - Polymyalgia rheumatica: a general practice experience. AB - In the eight years from April 1974 to April 1982, 10 diagnoses of polymyalgia rheumatica were made in an urban general practice. The natural history of the condition, diagnostic problems and occasional unpredictability of outcome are discussed. It is suggested that general practice research may provide answers to some unsolved questions. PMID- 6842445 TI - Egg transfer in the Mongolian gerbil (Meriones unguiculatus) during lactational delay of implantation. AB - Lactating pregnant gerbils in which one oviduct was ligated during early pregnancy were used on Day 6-14 p.c. as recipients for eggs (morulae and blastocysts) recovered on Day 6-12 p.c. from lactating donors. Eggs were transferred to the ligated (experimental) horn and the litter was removed. About half of the recipients had implantations in the non-ligated (control) horn 15 days after litter removal. Of these 40 females, 37 had implantations in the experimental horn and 32 had some normal fetuses present. Of 179 eggs transferred into the ligated uteri, 61% implanted and 41% developed into normal fetuses. The time after copulation of recipient and donor did not appear to influence the number of implantations or post-implantation development of the transferred eggs. PMID- 6842446 TI - Transport and development of embryos transferred to the oviducts and uteri of entire and ovariectomized ewes. PMID- 6842443 TI - Sexual behaviour of ewes with clover disease treated repeatedly with oestradiol benzoate or testosterone propionate after ovariectomy. AB - Ovariectomized ewes, 14 with permanent clover disease infertility (affected ewes) and 14 controls, were injected daily with 40 micrograms oestradiol benzoate for 12 days, and run with 2 rams fitted with marking crayons. The control ewes were mated sooner (P less than 0.05) but both groups became refractory at a similar rate. In a second experiment, 20 similar affected ewes and 19 controls were injected daily with 5 mg testosterone propionate for 31 days and observed daily for 50 min with rams. Affected ewes again were slower to show female behaviour (P less than 0.05) but faster (P less than 0.05) to show aggression against the rams and other ewes. Over the 31 days, the incidence of female sexual behaviour declined at a similar rate in affected and control ewes. When examined in individual pen tests with oestrous ewes on Day 28, affected ewes showed more male like courting behaviour than did controls (P less than 0.05). The changes in behaviour are too slight to account for the infertility but they do support the hypothesis that phyto-oestrogens can act on the ewe by some of the pathways of sexual differentiation, even after puberty. PMID- 6842444 TI - Photoperiod and ovulatory menstrual cycles in female macaque monkeys. AB - Macaques (Macaca mulatta and M. assamensis) which had been maintained on a 12L :12D light cycle for the previous 4 years and had 25-35-day menstrual cycles were randomly assigned to two groups. Those in Group 1 were kept in 12L :12D for 13 months. Those in Group 2 were subjected to three successive 5-month periods of 20L :4D, 4L :20D and 20L :4D. There were no significant differences between the two groups in the frequency, duration and percentage of ovulatory menstrual cycles, suggesting that photoperiod is not the sole regulator of seasonal breeding in these animals. PMID- 6842442 TI - Relationship between semen characteristics and fertility in electroejaculated mice. AB - Ejaculates were obtained from C57BL mice by applying two successive series of electrical stimuli which were delivered via a bipolar rectal probe. The ejaculates thus collected contained fertile spermatozoa as indicated by results from in-vitro fertilization. Once separated from the seminal plasma, ejaculated spermatozoa possessed the same in-vitro fertilization rate as epididymal sperm. Ejaculates were analysed for coagulum weight, ejaculate volume, sperm count, sperm motility, acid phosphatase content and fructose content. Significant differences were present between several of these values for fertile and infertile mice, and values were therefore empirically assigned to represent minimal amounts for 'normal' fertility (1.5 microliters ejaculate volume; 10.2 mg coagulum weight; 2.5 x 10(6) spermatozoa/ml; 2.3 x 10(3) motile spermatozoa/ejaculate). One half of the fertile animals had no deficiencies in any of the characteristics measured, whereas 97% of the infertile animals had at least one deficiency. No fertile male had more than 2 deficiencies. These data show that the characteristics of mouse semen obtained by the present method of electroejaculation are related to the fertility status of the animal. PMID- 6842448 TI - Histochemical study of beta-glucuronidase in the rat uterus during implantation and pseudopregnancy. AB - On Day 5 of pregnancy and pseudopregnancy, beta-glucuronidase activity in pseudopregnant uteri and in the inter-implantation zones from pregnant animals was found mainly in stromal and glandular epithelial cells. The luminal epithelium also showed an intense enzyme-positive reaction, particularly in the apical regions of these cells. Blastocyst attachment was associated with marked depletion of beta-glucuronidase activity from epithelial cells lying adjacent to the blastocyst, suggesting a possible involvement of this lysosomal enzyme in the blastocyst-endometrium attachment reaction. PMID- 6842447 TI - The passage of spermatozoa to regional lymph nodes in testicular lymph following vasectomy in rams and boars. PMID- 6842449 TI - Viability and development of 'tube-locked' mouse embryos. AB - 'Tube-locked' morulae and blastocysts were recovered from the ampulla of the oviduct of centchroman-treated mice between Days 4 and 12 post coitum and transferred to the uteri of pseudopregnant female mice. Pregnancy and implantation rates were lower and the post-implantation resorption rate was higher in the treated than in the control group. There was little difference in the pregnancy or implantation rates between embryos recovered on Days 4 or 12 post coitum, but the resorption rate increased with increasing duration of embryos in the oviducts and was 100% for the Day-12 embryos. The resorption rate was similar even when these embryos were transferred to the sterile uterine horn of unilaterally pregnant mice. Centchroman did not produce any deleterious effect on embryos which survived until Day 19 of pregnancy in foster mothers. The average fetal weight was also comparable to those of control fetuses. PMID- 6842450 TI - Concentrations of testosterone and androsterone in peripheral and umbilical venous plasma of fetal rats. AB - Mean +/- s.d. testosterone concentrations in the peripheral plasma of 21- and 22 day-old male fetuses (1.32 +/- 0.43 ng/ml) were significantly (P less than 0.05) higher than those in the umbilical venous plasma (0.37 +/- 0.08 ng/ml). Testosterone concentrations in umbilical venous plasma of male and female (0.29 +/- 0.06 ng/ml) fetuses and in peripheral plasma of female fetuses (0.36 +/- 0.10 ng/ml) were not significantly different. Androsterone levels measured in umbilical venous plasma of male (11.5 +/- 2.5 ng/ml) and female (12.3 +/- 2.1 ng/ml) fetuses were nearly as high as those in peripheral plasma (males, 12.9 +/- 3.1; females, 13.3 +/- 3.5 ng/ml). There were high concentrations of androsterone in the placentas of male (33 +/- 4 ng/g) and female (33 +/- 5 ng/ml) fetuses, suggesting that this organ is the major source of fetal androsterone. We also conclude that a major part of the testosterone present in female fetuses is secreted by the placentas. PMID- 6842451 TI - Relationship of uterine closure to ovarian hormones and endocytosis in the rat. AB - Ovariectomized rats were treated with various hormonal regimens. The first stage of uterine closure and epithelial cell endocytosis were observed in ovariectomized rats treated with progesterone or progesterone after oestrogen priming but not in hormonally untreated rats or those treated with oestrogen alone. The simultaneous appearance of closure and endocytosis in response to the same physiological conditions is consistent with the proposal that the endocytotic activity in the uterine epithelial cells may remove fluid from the uterine lumen and thus mediate the first stage of uterine closure. PMID- 6842452 TI - Electrical and mechanical activity of the cervix in the ewe during pregnancy and parturition. PMID- 6842453 TI - Immunoelectrophoretic analysis of the porcine zona pellucida. AB - Antigens of the porcine zona pellucida were evaluated by 2-dimensional and line immunoelectrophoretic techniques. Zona antigen preparations studied included heat solubilized isolated zonae pellucidae (SIZP), a purified 60 000 Mr glycoprotein (PPZA, purified pig zona antigen), and two fractions of this 60 000 Mr zona component which had been exposed to SDS (ZP3-E1C and ZP3-E2C). Antisera were raised to intact zonae pellucidae (IZP), SIZP and PPZA. Collectively, electrophoretic data revealed that the porcine zona system is antigenically complex with each zona antiserum tested detecting numerous antigens in the various zona preparations. These antigens, however, all had similar electrophoretic mobilities, and this limited the resolution of these techniques. The 60 000 Mr pig zona macromolecule (ZP3) appeared to be the most immunogenic of the three major pig zona glycoproteins since antisera prepared against IZP or SIZP reacted primarily with this component. However, the 60 000 Mr component does share antigenic determinants with the other major zona glycoproteins as revealed by cross-reactions of the antisera with the various zona preparations. Electrophoretic studies also suggested that the various zona antisera could distinguish, with different degrees of sensitivity, multiple antigenic determinants on the individual zona macromolecules. These studies also indicated that SDS treatment of zona glycoproteins does alter the antigenicity of the macromolecule, both with respect to the total number and individual identity of antigens detected. PMID- 6842454 TI - Plasma melatonin in ewes after ovariectomy. AB - Six ewes were ovariectomized in late November and kept in natural light with 5 intact controls. LH levels were monitored approximately weekly. On Days 16 and 58 after ovariectomy plasma melatonin was determined at 3-h intervals for 24 h in all the ewes. Plasma melatonin concentrations were greater in the ovariectomized ewes than in the controls especially at 16 days when total 24 h secretion was almost 3 times that in the control ewes. These data indicate that, in the ewe, the gonads exert an inhibitory influence on melatonin secretion. PMID- 6842455 TI - Plasma progesterone concentrations in pregnant and non-pregnant black bears (Ursus americanus). AB - Plasma levels of progesterone were determined from serial samples taken from 2 black bears over 3 consecutive fall periods. Each animal was pregnant during the 1st and 3rd years. Variations in progesterone levels were seen between animals and within each animal between pregnancies. Average baseline levels during the mid-to-late preimplantation period were 5.0-12.5 ng/ml and increased 2-3 fold at the approximate time of implantation. Values during non-pregnancy were detectable but much lower (0.6-2.5 ng/ml). The observed pattern of progesterone secretion in this species appears consistent with that reported for other species exhibiting obligate delayed implantation. PMID- 6842456 TI - In-vitro fertilization of rabbit ova ovulated in vitro during ovarian perfusion. AB - During in-vitro perfusion of rabbit ovaries, ova that ovulated in response to hCG were recovered and cultured with spermatozoa capacitated in vivo. After culture for 30 h, 113 (48.8%) of the ova underwent cleavage and were not degenerate. Of these 113 zygotes, 75 were successfully transferred to the oviducts of 14 gonadotrophin-treated host rabbits. On Day 14 after transfer there were 14 implantation sites and 9 pregnancies proceeded to term. These data indicate that in-vitro ovulated ova can be fertilized in vitro and be used to establish normal pregnancies in a host rabbit. PMID- 6842457 TI - Influence of egg investments on in-vitro penetration of mouse eggs by misshapen spermatozoa. AB - Three groups of eggs, intact, cumulus-free and zona-free, were inseminated in vitro with spermatozoa from C57BL/Kw male mice and incubated for 1-2 h. In fixed, toluidine blue-stained preparations, spermatozoa surrounding the eggs or attached to them remained colourless, while sperm heads that had penetrated the vitellus were deeply stained. Those in the early stage with still condensed chromatin were used to evaluate the head shapes. In zona-free and in cumulus-free eggs, only severely misshapen sperm heads appeared at a lower frequency than in the samples used for insemination. The proportion of abnormal sperm heads of all classes was significantly lower in intact than in cumulus-free eggs and most severely abnormal forms were not found in intact eggs. The results suggest that abnormal spermatozoa are able to participate in fertilization, although their chances of penetrating the ova in vitro are greatly reduced in the presence of egg investments, especially of the cumulus. PMID- 6842458 TI - Secretory piece and plasma proteins in human cervical mucus during the cycle. AB - Proteins of human cervical mucus were quantified on polyacrylamide gels and their concentrations relative to the mucous glycoprotein were calculated. In contrast with the cyclic variation to be expected in the ratio between albumin and the mucous glycoprotein, we found a constant ratio between IgA-related secretory piece and mucous glycoprotein. Secretory piece appeared to be an important protein in the mucus with respect to its concentration. No significant differences in the amount of mucus, its cyclic variation, protein concentration and composition could be found when normal mucus was compared from women sterilized by tubal ligation. PMID- 6842459 TI - Cyclic variations in glycoprotein synthesis in the columnar cells of the human cervix. AB - The rate of glycoprotein synthesis by the columnar cells of the human endocervix was measured during one cycle in 12 women by autoradiography. An increase in the rate of synthesis was associated with an increase in the plasma oestradiol concentration. A change in progesterone concentration in the blood did not seem to influence cervical glycoprotein synthesis. The ratio between the different cell types in the epithelium, basal cells, ciliated cells and mucus cells did not show cyclic variation in the cycles studied. PMID- 6842460 TI - Effects of coelomic and seminal fluids and various saline diluents on the fertilizing ability of spermatozoa in the rainbow trout, Salmo gairdneri. AB - When trout (Salmo gairdneri) spermatozoa were diluted in coelomic fluid or saline diluents at high dilution rates of 10(-3) and 10(-2) for increasing periods of time before insemination, there was a rapid decline and loss of fertilizing ability. At a lower dilution rate of 10(-1), there was partial or no loss of fertility. Dilution in a KCl-enriched saline diluent to inhibit sperm motility produced a slight decrease in fertility at a 10(-3) dilution rate, indicating that the spermatozoa, although sensitive to dilution, were less so when they were kept immotile. A partial loss of fertility was observed after the spermatozoa or eggs had been washed with saline diluents. The loss of fertility was total when both gametes were washed. Removing the seminal fluid by centrifugation led to a significant decrease in the fertilizing ability of the spermatozoa when insemination was carried out in saline diluent but not in coelomic fluid. Adding BSA at high doses (10 mg BSA/ml) into the diluent led to longer survival of the diluted spermatozoa. We conclude that (1) sperm dilution rate is a major factor in the maintenance of fertilizing ability of diluted salmonid spermatozoa, (2) as reported in the literature, coelomic fluid is superior to mineral diluents only when the gametes have been washed, and (3) some substances (possibly proteins) present in seminal and coelomic fluids play a role in gamete protection. These findings may explain the discrepancies in the literature concerning the duration of motility and fertilizing ability of salmonid spermatozoa. PMID- 6842461 TI - Gonadal responses to food restriction in intact and pinealectomized male golden hamsters. AB - Male golden hamsters underfed for 11-16 weeks showed a 30% decrease in body weight accompanied by significant testicular regression. Pinealectomy did not prevent underfeeding-induced gonadal regression. Resumption of ad-libitum feeding restored body weights to near control levels and permitted testicular redevelopment in animals with previously regressed tests. These data indicate that chronic food restriction can affect the reproductive status of hamsters and that this effect does not depend on an intact pineal gland. Body weight changes may serve as a secondary proximate cue in addition to photoperiod for timing the hamster seasonal breeding cycle. PMID- 6842462 TI - Distribution of sperm counts in suspected infertile men. AB - Probit plots of sperm concentration for 1711 suspected infertile men (those with azoospermia being excluded) were compared for the untransformed and loge-, square root- and cube root-transformed values. For the distribution of sperm concentrations, which was highly skewed towards low values, the square-root transformation produced the most normal (Gaussian) distribution. Loge and cube root transformations caused skewing towards high values. Such treatment of the data should always be considered before using parametric statistical tests to make comparisons between sperm concentrations of groups of men. PMID- 6842463 TI - Autoradiographic analysis of lymphocyte migration into the mammary epithelium and milk of lactating female rats. AB - Adoptively transferred radiolabeled lymphoid cells migrating to the lactating mammary gland were shown to enter the alveolar epithelium and ultimately the milk. Lactating female rats were injected intravenously with [3H]uridine-labeled syngeneic mesenteric lymph node cells, and the distribution of the cells 24 and 48 h later within intestinal and mammary tissues and their presence in milk were assessed autoradiographically. At both time periods, numerous labeled cells were found in the Peyer's patches and mesenteric lymph nodes. The mammary tissue and intestinal mucosa (lamina propria and epithelium) contained fewer labeled cells per unit area than those sites. Labeled cells within the mammary tissue were distributed equally between the alveolar epithelium and the intralobular connective tissue, where they were seen in both blood vessels and in the loose connective tissue. Occasional labeled cells were observed among the mononuclear cells seen in the alveolar lumina, and an average of 4.8% of the cells harvested from milk samples were labeled. Labeled cells within the secretory epithelium and milk always had the morphologic characteristics of mononuclear leukocytes. Thus, at least a portion of the lymphoid cells which have been shown to migrate to the mammary tissue in increased numbers during lactation actually enter and traverse the epithelium and contribute to the lymphoid component of mammary secretions. PMID- 6842464 TI - Intracellular fate of phase I Coxiella burnetii in guniea pig peritoneal macrophages. AB - Cultivated guinea pig peritoneal macrophages were infected with radio-labeled phase I Coxiella burnetii in order to assess the intracellular distribution of ingested rickettsiae. Localization of organisms was determined by fractionation of macrophage homogenates by equilibrium density centrifugation on sucrose gradients. Macrophages isolated from either nonimmune or immune guinea pigs and infected with C burnetii opsonized with immune serum yielded equilibrium density distribution for rickettsiae similar to lysosomal enzymes, suggesting sequestration within macrophage lysosomes. To confirm these observations nonimmune or immune guinea pigs were injected with Triton WR-1339 prior to macrophage harvest to decrease the density of macrophage lysosomes. Triton-laden macrophages infected with opsonized rickettsiae resulted in equilibrium density distribution for lysosomal enzymes and organisms in less dense regions of the gradient. In contrast, when either nonimmune or immune macrophages were infected in the presence of normal guinea pig serum, the distribution of labeled rickettsiae in the gradient did not correspond with lysosomes. We conclude that in the absence of immune serum, ingested C burnetii are not sequestered within macrophage lysosomes. Phagolysomal fusion and subsequent degradation of rickettsiae within the lysosomes of the macrophages appear to occur only when C burnetii are opsonized with immune serum. PMID- 6842466 TI - Clearance of lactate dehydrogenase by SJL/J mice infected with lactate dehydrogenase-elevating virus. AB - The plasma level of lactate dehydrogenase (LDH) activity rises to about ten times the normal level by 4 days after infection of mice with lactate-dehydrogenase elevating virus (LDV). The levels of seven other enzymes are also increased, but to a lesser degree. SJL/J mice demonstrate a unique, genetically controlled 20 fold increase in the plasma level of LDH enzyme after LDV infection, as well as enhanced levels of the other plasma enzymes elevated by LDV infection. Comparison of virus infection in SJL/J and Swiss mice as well as in cultures of peritoneal exudate cells made from them indicated that the time course and extent of virus replication was similar for the two strains of mice. The rate of clearance of intravenously injected rabbit or mouse LDH was found to be impaired to a similar extent in LDV-infected SJL/J and Swiss mice. The effect of LDV infection on the levels of endogenous LDH released as a result of injection of carbon tetrachloride or tumor growth was also similar in the two strains of mice. These results suggest that LDV infection may specifically induce a greater influx of LDH into the plasma of SJL/J mice from an as-yet-unknown source than in other strains of mice. PMID- 6842465 TI - Interaction of latex-insolubilized endotoxins with murine macrophages: phagocytic responses of endotoxin-responsive (C3HeB/FeJ) and -unresponsive (C3H/HeJ) macrophages in vitro. AB - Insolubilized lipopolysaccharides (LPS) were prepared by covalently coupling LPS from polysaccharide-deficient S. minnesota R595 and polysaccharide-rich E. coli 055:B5 to carboxylated latex particles. The stability of these LPS-latex complexes was determined using several assays to detect soluble LPS following incubation at ambient and elevated temperatures. Resident and thioglycollate elicited macrophages from both LPS-responder C3HeB/FeJ and LPS nonresponder C3H/HeJ mice were examined for their capacity to phagocytose the LPS particles following in vitro culture for various time periods. Uptake was demonstrated by an increase in the number of particles within the macrophages with increasing time of incubation. Rough polysaccharide-deficient LPS-latex particles were found to be more readily phagocytosed than control particles, whereas smooth polysaccharide-rich LPS particles were phagocytosed less readily than the controls. Qualitatively similar results were found in the relative rate of uptake of particles by the macrophages from the endotoxin-responsive and -unresponsive mouse strains used in this study. PMID- 6842467 TI - The Petrified Man. PMID- 6842468 TI - An outbreak of Campylobacter enteritis--a rheumatological followup survey. AB - One hundred and thirty individuals with bacteriologically proven Campylobacter jejuni enteric infection in a single outbreak were studied. Eighty-eight patients had gastrointestinal symptoms. One probable example of reactive arthritis was found. This is a frequency similar to that found in other comparable series of Salmonella typhimurium and Shigella flexneri infections, suggesting a common pathogenesis for the reactive arthritis associated with these 3 infections. PMID- 6842469 TI - Dimethyl sulfoxide does not suppress the clinical manifestations of collagen arthritis. AB - Parenteral administration of dimethyl sulfoxide (DMSO) to rats did not diminish the incidence or severity of collagen arthritis compared to groups receiving either saline injections or no injections. In contrast, hemagglutinating antibody responses to collagen were significantly (p less than 0.0001) decreased in the DMSO group. Delayed-type hypersensitivity responses to collagen were similar in the 3 groups. These data extend the previous finding that DMSO can decrease antireceptor antibody titers in experimental myasthenia gravis in rats. PMID- 6842470 TI - Morphometric analysis of peripheral blood and synovial fluid lymphocytes of patients with rheumatic disease. AB - A morphometric analysis of lymphocytes from the peripheral blood and the synovial fluid (SF) of patients with rheumatoid arthritis (RA) was based on a determination of the nuclear contour index (NCI = perimeter divided by the square root of the area of the nucleus). Use of this method showed that a particular type of lymphocyte, the cerebriform mononuclear cell (CMC), occurred in higher percentages in the SF than in the peripheral blood of patients with RA. The mean NCI of the lymphocytes (non-CMC) was also higher in the SF. These findings indicate that lymphocytes in the inflammatory compartment are morphologically altered, compared to the corresponding cells in the peripheral blood of the same patients, the change probably expressing an alteration in functional status. PMID- 6842471 TI - Dermatomyositis associated with platelet thrombi formation and responsive to antiplatelet therapy. PMID- 6842472 TI - Salmonella dublin arthritis: an initial case presentation. AB - Salmonella dublin is a rare pathogen in man usually causing an enteric fever syndrome. We report a 32-year-old black male who developed septic polyarthritis with Salmonella dublin. The clinical features are similar to those seen with other Salmonella serotypes reported to cause arthritis. The initial presentation is suggestive of a reactive arthritis that is immunologically mediated. PMID- 6842473 TI - Septic arthritis due to Arizona hinshawii. AB - Arizona hinshawii, a gram negative bacillus which bears antigenic similarities to genus Salmonella is an uncommon cause of human disease. We report 3 patients who in an immunocompromised state developed septic arthritis due to Arizona hinshawii. Treatment with systemic antibiotics and repeated joint aspiration was successful. The infection was recurrent in 2 patients and 1 died of septicemia. Previous cases of Arizona hinshawii septic arthritis are reviewed. PMID- 6842474 TI - Septic arthritis due to Fusarium solani. AB - A case of Fusarium arthritis is reported. Fusarium, a mold ubiquitous in soil and on plants commonly causes keratomycosis and infects burns. Recent reports demonstrate that Fusarium may produce serious visceral infection in compromised hosts. Disseminated infection has been universally fatal. In contrast, our case and several others with localized visceral infection were cured by intravenous amphotericin B and drainage. Although Fusarium grows readily on mycologic media, blood and other cultures have usually been negative in disseminated infection. Physicians should be aware of this uncommon but potentially lethal pathogen because deep fungal infections may first appear as arthritis. PMID- 6842475 TI - Summary of the Third International Conference on Behcet's Disease, Tokyo, Japan, October 23-24, 1981. AB - Behcet's disease was associated with HLA-B5, DR5, and MT2 antigens in Japanese. No virus or other agent was clearly implicated. Pathologic studies showed brainstem strokes and gut perforation from discrete ulcers. There was a significant reduction in T4 inducer-helper lymphocytes. Immune complexes in serum were detected in 30 to 50% of patients, and antibodies to the glycolipid GA1 were found in 91% of patients with neurologic involvement. Although several neutrophil functions were enhanced, for example, chemotaxis, phagocytosis, and generation of oxygen intermediates, mononuclear cells seemed to be of primary immunopathogenic importance. Treatment with chlorambucil appeared superior to other reported treatments of uveitis and meningoencephalitis. PMID- 6842476 TI - Septic arthritis due to Fusobacterium varium in a patient with sickle-cell anemia. PMID- 6842477 TI - Septic arthritis of the sternoclavicular joint due to Citrobacter diversus. PMID- 6842478 TI - Subacute infrapatellar tendon rupture in systemic lupus erythematosus. PMID- 6842479 TI - Minimal response to propantheline bromide therapy in hypertrophic pulmonary osteoarthropathy: a double-blind controlled case study. PMID- 6842480 TI - Marked digital skin temperature increase mediated by thermal biofeedback in advanced scleroderma. PMID- 6842481 TI - Immune complexes in juvenile rheumatoid arthritis: a comparison of 4 methods. PMID- 6842482 TI - Erythema multiforme induced by meclofenamate sodium (Meclomen) PMID- 6842483 TI - Ankylosing spondylitis. A disease in search of microbes. PMID- 6842485 TI - Rheumatoid cervical myelopathy: evaluation by computerized tomography with multiplanar reconstruction. AB - Rheumatoid cervical myelopathy was studied in 14 patients, clinically, radiographically and by computerized tomography with multiplanar reconstruction (CT/MPR). CT/MPR demonstrated significant unsuspected areas of compromise in 9 of the 14 patients, and altered the surgical procedure in 7 of these 9 patients. CT/MPR clearly identifies all levels of involvement including rotary subluxation. CT/MPR also allows assessment of the spinal nerve canal/foramen and the alignment of the foramina transversaria. CT/MPR is an essential addition to the evaluation of rheumatoid cervical myelopathy. PMID- 6842484 TI - Computerized tomography in evaluation of atlantoaxial subluxation in rheumatoid arthritis. AB - Nineteen patients with rheumatoid C1-C2 subluxation of greater than or equal to 5mm were studied by computerized tomography (CT). CT demonstration of spinal cord compression as defined by loss of posterior subarachnoid space was present in 11/19 (CT+) and absent in 8/19 (CT-). Fourteen patients were examined by a blinded neurologist. Cord compression by CT correlated better with clinical neurologic status than did routine radiographic studies. Absent superficial abdominal reflexes and history of bladder dysfunction correlated highly with cord compression by CT. Two CT+ patients developed neurologic deterioration requiring spinal fusion. Our data suggest that CT is a useful, noninvasive adjunct in management of patients with rheumatoid C1-C2 subluxation. PMID- 6842486 TI - Lymphocytotoxic and phagocytotoxic activity in progressive systemic sclerosis. AB - Sera of 66 patients with progressive systemic sclerosis (PSS) were tested for cold and warm reacting lymphocytotoxins (LCT). Cold LCT were found in 30 (45%) patients, 18 of whom also had warm LCT. Warm LCT alone were found in 14 patients. Twenty-nine sera with cold LCT were tested and reacted with both peripheral B and T lymphocytes. There was predominant killing of B cells in 52% and of T cells in 14%. Ten cold LCT were absorbed to and eluted from peripheral blood lymphocytes. All eluates were cytotoxic to B and T cells; 1 killed predominantly T cells and 2 killed predominantly B cells. Clinical-laboratory and HLA correlations with cold LCT showed no significant differences between the LCT-positive group and the LCT negative group. Granulocytotoxins were rare in PSS, but warm reacting monocytotoxins were found in 33 cases (57%). Crossreactivity of cytotoxins was tested using eluates from various cells. The majority of eluates from lymphocytes were cytotoxic against polymorphonuclears (PMN) and monocytes. Some eluates from PMN and from monocytes had lymphocytotoxic activity. This suggests existence of common antigenic determinants on various cells against which cytotoxins are directed. PMID- 6842487 TI - The child's perception of the disease and the experience of pain in juvenile chronic arthritis. AB - Interviews conducted among 39 children with juvenile chronic arthritis supported the hypothesis that the meaning which the child attributes to sensations originating in his joints influences the extent to which those sensations constitute pain. Children in both 6-11 and 12-17 age groups reported similar qualities of sensation from their affected joints, but the older children attributed a more unpleasant meaning to their sensations because of their greater understanding of the significance of internal pathology. By association, the 12 17s consequently reported joint sensations specifically, as more unpleasant and stronger than did the 6-11s. PMID- 6842488 TI - Hypouricemia and intravenous infusions. AB - The clinical significance of hypouricemia in hospitalized patients was studied retrospectively and prospectively. Two thousand two hundred patients routinely screened for serum uric acid were reviewed: 88 (4%) had serum uric acid levels below 2.5 mg/dl and 23 (1%) below 2 mg/dl. We found that 32 (36.4%) patients with serum uric acid below 2.5 mg/dl were patients treated with forced diuresis. Thereafter, to confirm the importance of perfusions in the evaluation of serum uric acid levels, 20 suicide-attempt patients and 7 patients with renal colic all treated with forced diuresis, were prospectively studied. Our results show that perfusions significantly increased the fractional excretion of uric acid that was responsible for the observed decrease of serum uric acid level. PMID- 6842489 TI - Intraarticular hyaluronic acid injection and synovial prostaglandins in experimental immune synovitis. AB - In vitro studies suggest that synovial fluid hyaluronic acid may have a role in reducing joint inflammation. The effect of intraarticular injection of sodium hyaluronate in a model of experimental immune synovitis was assessed. In addition, tissue prostaglandin content of synovia with and without immune synovitis was compared. Intraarticular hyaluronic acid administered at 2 doses was not effective in reducing the induced inflammation. With immune synovitis there was an increase in the total synovial prostaglandins. When related to total prostaglandins, prostacyclin was decreased, prostaglandin F2 alpha and thromboxane were increased and prostaglandin E2 was the same in synovitis as compared to controls. PMID- 6842490 TI - Fatal coccidioidomycosis in collagen vascular diseases. AB - Ten patients who died from coccidioidomycosis in Arizona from 1968 to 1975 had underlying collagen vascular diseases: 4 with rheumatoid arthritis, 4 with systemic lupus erythematosus, and 2 with dermatomyositis. All 10 patients had been treated with corticosteroids; 2 were taking cytotoxic drugs. Collagen vascular diseases and the use of corticosteroids and cytotoxic drugs may be associated with the depression of cell-mediated immunity. The potential for opportunistic coccidioidomycosis should be noted when corticosteroids and cytotoxic drugs are used for treating collagen vascular disease in patients residing in or coming from areas where coccidioidomycosis is endemic. PMID- 6842491 TI - Cutaneous vasculitis in adult polymyositis/dermatomyositis. AB - Seven (9.2%) of 76 patients with adult-onset polymyositis/dermatomyositis (PM/DM) seen over an 11-year period had cutaneous vasculitis. This was manifest by dermal and/or subcutaneous nodules in 4, periungual infarcts in 3 and digital ulceration in 2. When these 7 patients were compared to the remaining 69, a significant association was noted between cutaneous vasculitis and DM (p = .025); only 1 of 31 patients with primary PM and none of 18 with overlap syndromes had vasculitis. Furthermore, 2 (28.6%) of those with vasculitis had an associated malignancy compared to only 4 (5.8%) of those without vasculitis. These data document the occurrence of cutaneous vasculitis in adult-onset PM/DM and suggest that its presence may be a marker of an underlying malignancy. PMID- 6842492 TI - Bioavailability and pharmacokinetics of D-penicillamine. AB - The absolute and the relative bioavailability of D-penicillamine, available from different dosage forms and products, was studied in 10 healthy volunteers. Plasma levels and urine excretion of D-penicillamine were determined up to 8 h after administration by high performance liquid chromatography after intravenous administration of 250 mg and after oral administration of 250 mg (2 products) and 150 mg (1 product) D-penicillamine. The absolute bioavailability on oral administration was 50-70%. No statistical difference was found between the relative bioavailabilities of the different dosage forms tested. PMID- 6842493 TI - Influence of food on the bioavailability of penicillamine. AB - The relative bioavailability of D-penicillamine was determined after single 500 mg oral doses of commercial tablets to healthy male volunteers under fasting and nonfasting conditions. In fasted individuals the mean maximum penicillamine level in plasma of 3.05 mcg/ml occurred at 3.8 h, and the area under the 0-12 h plasma curve was 14.7 mcg/h/ml. In nonfasted individuals the mean maximum penicillamine level of 1.52 mcg/ml occurred at 2.3 h, and the area under the 0-12 h plasma curve was reduced to 7.16 mcg/h/ml. Thus under these conditions food reduced systemic penicillamine availability by 1/2, but did not reduce the apparent absorption rate. PMID- 6842494 TI - Cellular immunity in ankylosing spondylitis. Lack of response to spinal tissue antigens. AB - In the studies reported here, peripheral blood lymphoid cells from 14 ankylosing spondylitis (AS) patients and 14 normal control subjects were examined for immune responses to the mitogens concanavalin A, phytohemagglutinin-P and pokeweed mitogen, as well as to primate spinal ligament, disc, and sacroiliac cartilage whole antigens. AS lymphocytes responded normally to mitogens and did not proliferate on exposure to spinal antigens. Assay for released supernatant proliferation inhibitory factor, tested on human HeLa cells monolayers failed to detect lymphokine release by AS lymphoid cells during exposure to spinal antigens. PMID- 6842495 TI - Microvascular transfer of fibular bone grafts. PMID- 6842496 TI - Radiological management of abdominal abscess. AB - Forty-two abdominal and retroperitoneal abscesses were drained percutaneously under ultrasound guidance. A success rate of 85.7% was achieved. Subsequent surgery was required in only 5 patients. Postoperative and spontaneous abscesses did equally well. Most intra-abdominal and retroperitoneal abscesses are amenable to this form of percutaneous drainage. The procedure requires only local anaesthesia and is well tolerated. Surgical management should probably now be reserved for those cases which are considered unsuitable for percutaneous drainage or which fail to resolve following this procedure. PMID- 6842497 TI - Effects of using a Charnley-Howorth enclosure in a district general hospital. AB - A high rate of infection was found to occur when total hip replacement were performed in an operating theatre used by a variety of surgical specialities. Because of this, a downward displacement laminar flow enclosure was installed to provide ultraclean air operating conditions. Retrospective examination of 419 total hip replacements, carried out over a six-year period during which the enclosure was installed, showed a reduction in the infection rate from 3.2% to 0.4% (P = 0.05) when using the enclosure. The infections were associated with a postoperative wound discharge and with revision surgery but were less frequent when the enclosure was used. Prosthetic loosening was found to be common when metal-to-metal prostheses were used. Working in an enclosure with side panels, wearing body exhaust units, was generally considered to be so noisy as to restrict communication. PMID- 6842498 TI - Urban violence in the United States--implications for health and for Britain in the future: discussion paper. PMID- 6842499 TI - Legal aspects of iatrogenic disorders: discussion paper. PMID- 6842500 TI - Niemann-Pick type III and Crohn's disease. PMID- 6842501 TI - Investigation of brian death with Doppler-shift ultrasound. PMID- 6842502 TI - Bilateral Madelung's disease of the wrist: a familial condition? PMID- 6842503 TI - Data on lung cancer in radiation workers. PMID- 6842504 TI - Synthesis of N-(Substituted-phenyl)-D-xylopyranosylamines as potential modifiers of the formation of glycosaminoglycans. AB - N-(Substituted-phenyl)-D-xylopyranosylamines and their O-peracetyl derivatives have been synthesized and tested for their ability (a) to inhibit the replication of cultured B16 melanoma cells and (b) to modify the synthesis of glycosaminoglycans by these neoplastic cells. The most cytotoxic compound synthesized was N-(p-methoxyphenyl)-D-xylopyranosylamine (6), which produced 50% inhibition of cellular proliferation at a concentration of 2 microM; a number of other compounds were relatively cytotoxic, causing 50% inhibition of cell replication at levels of 12 to 25 microM. Several of the synthesized xylosides appeared to be capable of serving as artificial initiators of glycosaminoglycan synthesis, with the most active agents causing approximately 2- to 4-fold increases in the incorporation of [35S]sulfate into the glycosaminoglycans of B16 melanoma cells excreted into the culture medium. PMID- 6842505 TI - Synthesis and antihypertensive activity of 4'-substituted spiro[4H-3,1 benzoxazine-4,4'-piperidin]-2(1H)-ones. AB - A series of 4'-substituted spiro[4H-3,1-benzoxazine-4,4'-piperidin]-2(1H)-ones was prepared and evaluated for antihypertensive activity in the spontaneously hypertensive rat (SHR). The basic ring system was prepared in one step by condensation of dilithiated (tert-butoxycarbonyl)aniline (3) with (tert butoxycarbonyl)piperidinone. Deprotection afforded 6, which was condensed with expoxides or alkyl halides to furnish the title compounds. The most active compound was dl-erythro-4'-[2-(1,4-benzodioxan-2-yl)-2-hydroxyethyl]spiro [4H-3,1 benzoxazine-4,4'-piperidin]-2(1H)-one (9), and various modifications of this compound were made in order to elucidate the structure-activity relationships in the series. Preliminary indications are that 9 may act by both central and peripheral mechanisms. PMID- 6842506 TI - Stereospecific synthesis of chiral metabolites of ifosfamide and their determination in the urine. AB - The stereospecific synthesis of two chiral metabolites of ifosfamide (2), 4 ketoifosfamide (5) and 2-amino-3-(2-chloroethyl)tetrahydro-2H-1,3, 2 oxazaphosphorine 2-oxide (9), is reported. The absolute configuration of both compounds was assigned on the basis of chemical correlation. In addition, two other achiral metabolites of 2, carboxyifosfamide (6) and IPAM (7), were synthesized. These and other organophosphorus metabolites of ifosfamide were found, by 31P NMR, in the urine of patients to whom racemic 2 was administered. The measurements performed in the presence of optically active lanthanide shift reagent [Eu(tfc)3] showed considerable stereoselectivity of in vivo formation of some chiral metabolites of ifosfamide. PMID- 6842507 TI - Activated cyclophosphamide anticancer drugs: molecular structures of cis- and trans-4-hydroperoxyisophosphamides. AB - Molecular structures of two stereoisomers of 4-hydroperoxyisophosphamide (HPIPA) have been determined by single-crystal X-ray diffraction. These isomers are active cytostatic agents closely related to an active metabolite of the antitumor drug isophosphamide, an analogue of cyclophosphamide. Both isomers crystallize in monoclinic space group P21/c with cell dimensions for cis-HPIPA of a = 8.999 (2), b = 8.743 (2), c = 17.078 (4) A; beta = 107.91 (2) degrees, and Z = 4 molecules per unit cell, and cell dimensions for trans-HPIPA of a = 15.184 (3), b = 10.345 (3), c = 18.205 (3) A, beta = 114.15 (1) degrees, and Z = 8. The structures were solved by direct methods and refined by anisotropic least squares to a discrepancy index R = 0.048 for cis-HPIPA and R = 0.065 for trans-HPIPA. In both isomers the 4-hydroperoxy group is situated axial to the ring. The phosphoryl oxygen atom is situated axial to the ring and, thus, cis to the C(4) oxygen in the cis-HPIPA isomer. In the trans-HPIPA isomer, the phosphoryl oxygen is equatorial to the ring and trans to the C(4) oxygen. PMID- 6842508 TI - Structures of two isomeric bicyclic derivatives of 4-hydroperoxyisophosphamide. AB - Crystal structure determinations of C4-oxygen-substituted cytotoxic derivatives of the anticancer drug cyclophosphamide have all found the oxygen to be in the axial position, suggesting an inherent stability for this geometry. Recently, two isomeric bicyclic derivatives of 4-hydroperoxyisophosphamide (cyclized cis- and trans-HPIPA) have been obtained for which NMR coupling constants imply that the trans isomer has the C4-oxygen substituent in the equatorial position. Crystal structure determinations of both bicyclic compounds have now been performed. They show that the cis isomer has phosphoryl oxygen and C4-peroxy group both axial, similar to the conformation of the uncyclized HPIPA precursor and to the expectation based on NMR data; the trans isomer, however, has a phosphoryl oxygen equatorial, C4-peroxy group axial conformation, similar to its uncyclized HPIPA precursor but opposite in conformation at both positions to the NMR-based inferences. The oxazaphosphorinane ring in each isomer has a half-chair conformation, with the trans isomer probably flipping between two equally probable half-chairs; this disorder may account for the observed differences in the NMR C4-hydrogen coupling constants in the two isomers. The peroxy-containing ring adopts a chair conformation in both molecules. PMID- 6842509 TI - Quantitative structure--activity relationship of double alkyl chain drugs. AB - The quantitative structure--activity relationship of double alkyl chain drugs, including alkanols, aliphatic esters, ketones, barbiturates, amphetamines, butyrylcholinesterase inhibitors, antimalarials, and rifamycin amides, is investigated. A series of double-chain homologues, CnH2n+1XCmH2m+1, in which n changes, keeping m constant, is classified into three types: in type IIL, n greater than m; in type IIE, n = m; in type IIS, n less than m. When a linear relationship, vis., log (1/C) = an + b, holds, the slope a depends on the type; aI greater than or equal to aIIL greater than aIIE greater than aIIS. Here aI means the slope for single-chain homologues. The same order is observed for the equation, log hydrophobicity = an + b, where the hydrophobicity of drug denotes the water solubility, the critical micelle concentration, and the partition coefficient for the 1-octanol--water phases. Therefore, decreased biological activity of a double-chain drug relative to that of a single-chain isomer can be explained by a decreased hydrophobicity of the double-chain drug, due to the intramolecular association of these chains in water. When a parabolic relationship between log (1/C) and n holds, the optimum n depends on the type: nopI less than nopIIL less than nopIIE. This order is also explicable on the basis of a decreased hydrophobicity of double-chain drug. The N-dealklation rate of amphetamines in vivo appears to be affected by the steric factor as well as the hydrophobic factor. A decreased hydrophobicity of double-chain compounds should be taken into consideration for estimating their partition coefficients. PMID- 6842510 TI - Studies on v-triazoles. 9. Antiallergic 4,9-dihydro-4,9-dioxo-1H-naphtho[2,3-d]-v triazoles. AB - A short series of the title compounds was prepared and evaluated for antiallergic activity in the rat passive cutaneous anaphylaxis screen. All but the two N methylated derivatives were active in this screen by the intravenous route, the most potent being the symmetrical dimethyl compound, 4,9-dihydro-6,7-dimethyl-4,9 dioxo-1H-naphtho[2,3-d]-v-triazole, and its 5-nitro derivative. The latter two compounds were noticeably more potent than disodium cromoglycate, and one of these, the unnitrated material, was selected for further evaluation as a potential antiasthmatic drug. PMID- 6842511 TI - Structure-activity correlations for a series of antiallergy agents. 2. Geometric and electronic characterization of some oxamic and dioxamic acids. AB - Hartree-Fock self-consistent field calculations using the ab initio molecular fragment technique have been performed on some phenyloxamic and m phenylenedioxamic acids, which exhibit markedly different activities in the rat passive cutaneous anaphylaxis (PCA) assay. Attention is focused upon structural features that are most likely to affect the drug-receptor interactions, such as the preferred molecular geometry, the electronic charge distribution, and the nature of the higher occupied (HOMO) and lower unoccupied (LUMO) molecular orbitals. Judging from the regions of high density in HOMOs and LUMOs, the benzene ring would preferably act as an electron acceptor, while the oxamic acid moiety would serve best as an electron donor. Factors affecting the relative PCA activities of oxamic and dioxamic acids are discussed. PMID- 6842512 TI - Structure-activity correlations for a series of antiallergy agents. 3. Development of a quantitative model. AB - A nonlinear regression model has been employed to investigate the activity of a series of 51 drugs in the rat passive cutaneous anaphylaxis assay. Although several classes of molecules are represented in the sample, there are certain common structural features that enable detailed geometric and electronic comparisons to be made. Ab initio Hartree-Fock SCF calculations were performed by using the molecular fragment approach to characterize the electronic structure and preferred conformations of the molecules. The statistical results establish the importance of nine structural factors in determining the potency as inhibitors of histamine release. Both the conformation of a drug and its capacity to act effectively as an electron acceptor in charge-transfer interactions are shown to be critical for high activity. PMID- 6842513 TI - Synthesis and biological distribution of radiolabeled ammineruthenium (III)-amino acid complexes as potential pancreatic imaging agents. AB - Complexes of ammine[103Ru]ruthenium(III) with L-histidine, beta-(4-pyridyl)-alpha alanine, and S-[beta-(4-pyridyl)ethyl]-L-cysteine were synthesized in low specific activity and evaluated in mice as potential radiodiagnostic agents for pancreatic imaging. The biological distribution of each complex was determined in normal mice at 15 min, 1 h, and 2 h following intravenous administration. All four complexes were rapidly cleared through the kidneys, with 50% of the injected dose concentrated in the urine within 15 min. None of the complexes showed a tendency to accumulate in any major organ. Major differences in distribution were found in lungs, heart, spleen, stomach, intestine, bone, and soft tissues. A significant relative difference in pancreatic uptake was observed. Only the beta (4-pyridyl)-alpha-alanine complex exhibited pancreas to liver ratios significantly greater than 1. The pancreas to liver ratio of 17 was reached 1 h following injection of this ruthenium complex, which is considerably higher than commonly reported values of 2.5 for [75Se]selenomethionine. The beta-(4-pyridyl) alpha-alanine complex is therefore a promising candidate for evaluation as a pancreatic imaging agent when labeled with cyclotron-produced ruthenium-97. PMID- 6842514 TI - Potential cerebral perfusion agents: synthesis and evaluation of a radioiodinated vinylalkylbarbituric acid analogue. AB - A new iodinated barbiturate has been prepared. Treatment of 5-chloropentyne and propargyl bromide with diethyl 2-ethyl-2-sodiomalonate (DESM) provided diethyl 2 ethyl-2-(1-pentyn-5-yl)malonate (3) and diethyl 2-ethyl-2-propargylmalonate (4), respectively. Similar condensation of DESM with (E)-(5-iodo-1-penten-1-yl)boronic acid (9) or the reaction of catecholborane with 3 provided diethyl (E)-2-ethyl-2 (1-borono-1-penten-5-yl)malonate (8). The direct sodium iodide-chloramine-T iodination of 8 or the treatment of (E)-1,5-diiodo-1-pentene (10) with DESM provided diethyl (E)-2-ethyl-2-(1-iodo-1-penten-5-yl)malonate (11). The condensation of functionalized malonates 3, 4, and 11 with urea in the presence of a base provided the corresponding barbiturates, 5-ethyl-5-(1-pentyn-5-yl)-(5), 5-ethyl-5-propargyl- (6), and (E)-5-ethyl-5-(1-iodo-1-penten-5-yl)barbituric acid (12), respectively. (E)-6-(Ethoxycarbonyl)-1-iodo-1-octene-6-carboxylic acid (13) was isolated as the hydrolytic byproduct of 11. Compound 13 decarboxylated under vacuum to provide ethyl (E)-1-iodo-1-octene-6-carboxylate (14). The 125I-labeled congeners of 12 and 13 were synthesized in the same manner and evaluated in rats. The barbiturate 12 exhibited significant brain uptake (approximately 1% dose after 5 min), demonstrating that iodinated barbiturates freely cross the intact blood-brain barrier. PMID- 6842515 TI - Sulfur analogues of psychotomimetic agents. 2. Analogues of (2,5-dimethoxy-4 methylphenyl)-and (2,5-dimethoxy-4-ethylphenyl)isopropylamine. AB - The two thio analogues of each of the well-known psychotomimetic drugs DOM [(2,5 dimethoxy-4-methylphenyl)isopropylamine] and DOET [(2,5-dimethoxy-4 ethylphenyl)isopropylamine] have been synthesized and pharmacologically evaluated in man. The 5-thio isomers are more potent as psychotomimetic agents than the 2 thio isomers but still represent a drop of an order of magnitude in potency from the sulfur-free counterparts. The dithio analogue of DOM was synthesized and found to be without central activity at a dosage of approximately 50 times the mean effective dose of DOM. PMID- 6842516 TI - Oscillations in some linear free energy relationships derived from partition coefficients of phenols between octanol and water. AB - In the partition of some resorcinol alkyl ethers between water and 1-octanol, the values of delta Gtrs do not increase in a regular way. Odd and even chain alkyl compounds show different, regular increases in delta Gtrs for addition of each methylene group. The unrecognized occurrence of this phenomenon in earlier data is pointed out, and its possible significance in medicinal chemistry is discussed. PMID- 6842517 TI - Synthesis and analgesic properties of two leucine-enkephalin analogues containing a conformationally restrained N-terminal tyrosine residue. AB - Two analogues of Leu-enkephalin, in which the terminal tyrosine-1 residue has been replaced by a conformationally restrained tyrosine analogue, have been synthesized by classical solution methods, and their opiate agonist potencies on electrically stimulated guinea pig ileum and mouse vas deferens preparations were determined in comparison with Leu-enkephalin. The restriction in the degree of freedom of the tyrosine moiety in [(2-amino-6-hydroxy-2 tetralinyl)carbonyl]glycylglycylphenylalanylleucine methyl ester (3e) leads to a 7 to 8 times higher agonist activity at the mu-receptor subtype in guinea pig ileum when compared to Leu-enkephalin, and an almost 30-fold decrease in potency, vs. Leu-enkephalin, on mouse vas deferens preparation. [(2-Amino-5-hydroxy-2 indanyl)carbonyl]-glycylglycylphenylalanylleucine methyl ester (2e) was inactive in the above tests. These results demonstrate the differential effect of restricting conformational flexibility on receptor recognition. Neither analogue had any analgesic properties when evaluated by the hot-plate test in mice after sc and icv administration. PMID- 6842518 TI - Antidepressant activity of 5-aryl-2,3,5,6-tetrahydroimidazo[2,1-a]isoquinolin-5 ols. AB - A series of 5-aryl-2,3,5,6-tetrahydroimidazo[2,1-a]isoquinolin-5-ols was prepared and evaluated for potential antidepressant activity in the reserpine-induced hypothermia model and selected central nervous system and autonomic activity tests. Several members of the series, notably the 4-chloro- and 4-fluorophenyl analogues, demonstrated pharmacological activity in the range of imipramine. Both compounds provided a marked potentiation of the 5-hydroxytryptophan-facilitated monosynaptic spike in the spinal cat preparation. PMID- 6842519 TI - 1-[1-[2-[(3-Chlorobenzyl)oxy]phenyl]vinyl]-1H-imidazole hydrochloride, a new potent antifungal agent. AB - The synthesis and antifungal properties of 1-[1-[2-[(3 chlorobenzyl)oxy]phenyl]vinyl]-1H-imidazole hydrochloride (1 . HCl) are described. Topical application of cream and gel formulation of 1 . HCl showed high efficacy against guinea pig dermatophytosis. PMID- 6842520 TI - Development by the laboratory rodent host of humoral antibody activity to Cuterebra fontinella (Diptera; Cuterebridae) larval antigens. PMID- 6842521 TI - Seasonal survival of AEDES africanus (Diptera: Culicidae) in Nigeria. PMID- 6842522 TI - Mating regulation and reproductive isolation in the ticks Hyalomma dromedarii and H, anatolicum excavatum (acari: ixodoidea: Ixodidae). PMID- 6842524 TI - Differentiation of host-seeking behavior from blood-feeding behavior in overwintering Culex pipiens (Diptera: Culicidae) and observations on gonotrophic dissociation. PMID- 6842523 TI - Epidemic of urticaria associated with first-instar larvae of the gypsy moth (Lepidoptera: Lymantriidae). PMID- 6842525 TI - Laboratory blood feeding of Culicoides mississippiensis (Diptera: Ceratopogonidae) through a reinforced silicone membrane. PMID- 6842526 TI - Field observations on the gonotrophic cycle of Anopheles darlingi (Diptera: Culicidae). PMID- 6842527 TI - Development of a continuous cell line from the sand fly Lutzomyia longipalpis (Diptera: Psychodidae), and its susceptibility to infection with arboviruses. PMID- 6842528 TI - Nonreplication of Jamestown Canyon and Keystone (California group) viruses in tabanids (Diptera: Tabanidae). PMID- 6842529 TI - Effect of age and ovarian development of mating in the black blow fly (Diptera: Calliphoridae). PMID- 6842530 TI - The genetic status of mothers of isolated cases of Duchenne muscular dystrophy. AB - Classical genetic theory, based on assumed equal mutation rates in males and females, predicts that one-third of all cases of Duchenne muscular dystrophy (DMD) in a generation are born as new mutants to non-carrier mothers. Furthermore, less than half the mothers of apparently isolated cases appear to be carriers on the basis of raised serum creatine kinase levels. We have analysed the pedigrees of 61 families of DMD boys seen in the Duke Neuromuscular Research Clinic and 45 DMD families followed at the University of Virginia. The frequency of affected boys among the next born male sibs of 37 initially isolated DMD cases in two clinic populations was significantly greater than predicted by Haldane's theory (p = 0.029) and the estimated proportion of new mutant cases in the combined clinic population of 106 families was 0.127 (SE 0.111). The absence of affected males in earlier generations in families of isolated cases may be explained in part by a high ratio of male to female stillbirths and infant deaths, which was more than three times that of the normal population in this study. These data suggest that new mutant cases are less common than expected and current predictions may underestimate genetic risks in mothers of isolated cases. PMID- 6842531 TI - Investigation of malignant hyperthermia: analysis of skeletal muscle proteins from normal and halothane sensitive pigs by two dimensional gel electrophoresis. AB - Two dimensional gel analysis of skeletal muscles from normal pigs and from pigs which were homozygous for halothane sensitivity showed no obvious differences in the patterns of spots attributed to the major contractile proteins and glycolytic enzymes. In muscle from a sensitive pig which died of heat shock under anaesthesia there was a selective loss of glyceraldehyde-3-phosphate dehydrogenase and aldolase, presumably owing to proteolytic activity. The progressive loss of these enzymes under anaesthesia could contribute to the mechanism of heat production by diverting fructose 1,6 diphosphate into a futile cycle. PMID- 6842532 TI - Phenotypic variation in the familial atypical multiple mole-melanoma syndrome (FAMMM). AB - The familial atypical multiple mole-melanoma syndrome (FAMMM) is characterised by an autosomal dominantly inherited susceptibility to multiple atypical moles which show variable colouration ranging from black to brown, tan, red, or pink, with occasional variegation. These compound naevi may be macular or papular, with regular or irregular borders, and measure 1 cm or more in size. They may be few in number or absent or may exceed 100 in a given patient. They are located predominantly on areas not exposed to the sun. Dysplastic changes in melanocytes, fibroplasia, focal chronic inflammatory cell infiltrate, and new blood vessel formation of the papillary dermis characterise their histopathology. These findings are not uniformly present. Because of these distinctive features, coupled with their propensity for transformation to cutaneous malignant melanoma, little attention has been given to the possibility of either minimal or absent cutaneous expression of the phenotype or more diverse neoplastic involvement in this disease. These latter phenomena, which we ascribe to the pleiotropic effects of the cancer-prone FAMMM genotype, were observed in a single FAMMM kindred, the subject of this report. PMID- 6842533 TI - Acetylator phenotypes in Papua New Guinea. PMID- 6842534 TI - Chromosome changes in Alzheimer's presenile dementia. AB - Lymphocyte chromosomes were examined in 36 patients with Alzheimer's presenile dementia, 36 healthy, age and sex matched controls, and 36 sex matched, non demented, elderly controls, approximately 20 years older than the Alzheimer patients. Increased chromosome aneuploidy was found in females with Alzheimer's disease but not in male subjects. Chromosome abnormalities observed in female patients were similar to those observed in elderly controls, though in this latter group there was an increase in the frequency of cells that had lost an X chromosome. In the female Alzheimer patients and the elderly controls, there was an increase in the frequency of autosomal aneuploid cells but no single chromosome was preferentially affected. Because the chromosome abnormalities found in Alzheimer's disease are similar in nature but not as extensive as those observed in senescence in the absence of dementia, it is argued that chromosome aneuploidy is more likely to be related to processes concerned with ageing rather than being specifically linked to the dementia of Alzheimer's disease. PMID- 6842535 TI - Consanguineous matings in the Egyptian population. AB - A total of 26 554 Egyptians was ascertained to study the incidence of consanguineous marriages. They were of different ages, different socioeconomic standards, and from different areas. There were 7646 from urban areas, 11 280 from suburban areas, and 7628 from rural areas. The incidence of consanguineous matings in the general population was found to be 28.96% with an average inbreeding coefficient of 0.010, which could be considered high. The highest incidence was that in the rural areas. First cousin marriages occurred more often than the other types of consanguinity. PMID- 6842536 TI - Dissection of the aorta in Turner's syndrome. AB - Three deaths from dissection of the aorta in a series of 157 adult women with Turner's syndrome are reported. These are greatly in excess of the numbers expected. None of the three patients had a coarctation of the aorta. One had aortic regurgitation but there was no reason to believe that the aorta in the other two patients had been subjected to unusual haemodynamic stresses. Cystic medial necrosis of the aorta was described in two patients on whom necropsies were carried out. It is concluded that there is probably a greatly increased risk of dissection of the aorta in Turner's syndrome even in the absence of any other abnormality of the aorta and aortic valve. Previously reported cases of aortic dissection in Turner's syndrome are discussed. PMID- 6842537 TI - A new alopecia/mental retardation syndrome. PMID- 6842538 TI - A female infant with features of Mohr and Majewski syndromes: variable expression, a genetic compound, or a distinct entity? PMID- 6842540 TI - Charcot-Marie-Tooth disease. PMID- 6842539 TI - Monosomy 22 with humoral immunodeficiency: is there an immunoglobulin chain deficit? AB - The cytogenetic analysis of a patient with selective deficit of IgA and decrease in IgM, IgE, and IgG is presented. Using trypsin-Giemsa banding the karyotype showed monosomy 22 (45,XX,-22). The interest of this case lies in the rarity of the illness and in the association of monosomy 22 with hypogammaglobulinaemia and selective deficit of IgA, particularly as this chromosome is known to contain genes coding for immunoglobulin chains. PMID- 6842541 TI - Evidence against a female specific class of neural tube defect. PMID- 6842542 TI - Hypostatic ulcers in 47,XXY Klinefelter's syndrome. PMID- 6842543 TI - Racial variation of a non-fluorescent segment of the Y chromosome in East Indians. AB - Seventy normal male East Indians were selected to study the length of the fluorescent (f), non-fluorescent (nf), and total length of the Y chromosome by the QFQ technique. The length of the Y chromosome was classified into five groups using subjectively defined criteria, namely, very small, small, average, large, and very large. The frequencies of Y/F indices for these groups were 0.0%, 1.42%, 15.71%, 58.57%, and 24.28%, respectively. The variation in the total length of the Y chromosome was accounted for by variations in the length of the nf as well as the f segments. The mean Y/F, f/F, and nf/F indices for East Indians were 1.20, 0.47, and 0.73, respectively. A longer Y was noted in East Indians primarily owing to an increase in size of the nf segment in comparison to normal black and Caucasian populations. Furthermore, it is emphasised that the definition of 'average' or 'large' Y varies from race to race. PMID- 6842544 TI - Partial monosomy of chromosome 10 short arms. AB - Two children with monosomy 10p13 are reported. In the first case the monosomy was the result of a maternal balanced translocation t(3;10) (p27;p13) while the second case was a de novo mutation. We reviewed clinical details of cases reported so far and found that certain symptoms are typical of the deletion of a comparatively large segment of chromosome 10 short arms. These symptoms include mental and growth retardation, skull abnormalities, antimongoloid slant of the eyes, ear abnormalities, anteverted nostrils, abnormalities of the hands and feet, cryptorchidism in boys, and, primarily, hypoplasia or aplasia of the olfactory bulbs and olfactory tracts as well as narrow palpebral fissures or eyelid ptosis. PMID- 6842545 TI - A recessively inherited windmill-vane camptodactyly/ichthyosis syndrome. PMID- 6842546 TI - Recessively inherited brachydactyly type C. PMID- 6842547 TI - Philtrum length and intercommissural distance in newborn infants. AB - In order to define standards for philtrum length and mouth width in the newborn infant, 198 term and preterm infants (27 to 41 gestational weeks) were examined. In every case the gestational age was determined chronologically and clinically and the philtrum length and mouth width (oral intercommissural distance) were measured by two observers using standard measurement techniques. Normal values are presented by plotting the mean +/- 2 SD for each gestational week versus the gestational age. PMID- 6842548 TI - Aberrant melanoblast migration associated with trisomy 18 mosaicism. AB - A patient is reported with mental retardation, facial and body asymmetry, and hyperpigmented areas limited to the right side of the body. Cytogenetic studies revealed trisomy 18 in 50% of peripheral blood lymphocytes; fibroblast cultures from the hyperpigmented area showed pure trisomy 18, while the karyotype on the unaffected side was normal. This could be an example of the 'lines of Blaschko', considered to be a form of 'human mosaicism', in which an abnormality occurred in melanocytes migrating from the neural crest. Non-disjunction of one chromosome 18 appears to be associated with the mutational event that caused abnormal migration of melanoblasts. PMID- 6842549 TI - De novo tandem duplication 17p11 leads to cen. PMID- 6842550 TI - Ring chromosome 10 and its clinical features. AB - A 2-year-old boy with mental and growth retardation is presented; he has a 46,XY,r(10)(p15q26) chromosome complement. Five previously reported cases of ring chromosome 10 were reviewed and compared with the present case in an attempt to delineate a clinical syndrome. Since the first description, identified by Giemsa banding by Lansky et al, four other r(10) patients have been described. Their common features were mental and growth retardation, low birth weight, microcephaly, stubby nose, hypertelorism, strabismus, wide set nipples, single transverse palmar creases, undescended testes, and hypoplastic scrotum. In some of the cases congenital heart disease was present. PMID- 6842551 TI - Tetrasomy 18p: tentative delineation of a syndrome. PMID- 6842552 TI - Distal monosomy 14 not associated with ring formation. AB - A 12-year-old boy with congenital heart disease, short stature, mildly dysmorphic facies, and mild intellectual impairment was found to have a de novo terminal deletion (14)(q32.3). Although his phenotype resembles that of six reported patients with a similar breakpoint, his CNS involvement is milder. He appears to be the first reported case of a terminal deletion of chromosome 14 not associated with ring 14 formation. Advanced parental ages and maternal origin of the chromosome with the deletion are noted. PMID- 6842553 TI - A case of the G syndrome. PMID- 6842554 TI - Translocation t(1;20)(q21;q13) in an azoospermic man. PMID- 6842556 TI - Craniosynostosis. PMID- 6842555 TI - Familial Poland anomaly. PMID- 6842557 TI - Pericentric inversion of chromosome 13. PMID- 6842558 TI - Adjacent 2 translocation involving 13q and 21q. PMID- 6842559 TI - Pyloric stenosis: children vs sibs. PMID- 6842560 TI - Delineation of trisomy 9 syndrome. PMID- 6842561 TI - The effect of the male contraceptive agent Gossypol on human lymphocytes in vitro: traditional chromosome breakage, micronuclei, sister chromatid exchange, and cell kinetics. AB - The male antifertility agent Gossypol did not affect the level of traditional chromosome breakage or number of micronuclei in 66-hour lymphocyte cultures at concentrations up to 40 micrograms/ml. It did increase the frequency of SCE slightly, although the inter-individual variation was greater than the increase resulting from Gossypol, and, even at the highest concentration (40 micrograms/ml), the SCE rate was still within the normal range. It also affected cell kinetics, reducing the mitotic index and the proportion of second and third metaphases after BUdR incorporation. PMID- 6842563 TI - New techniques for the treatment and disruption of renal calculi. AB - Kidney stones are a major cause of morbidity and affect 3 to 4% of Western Europeans. Two new techniques have been developed in the last five years which reduce the morbidity, hospital stay and convalescent period of patients compared with those undergoing conventional renal surgery. These methods, percutaneous nephrolithotomy and extracorporeal stone disintegration, are examined with particular reference to the equipment necessary for stone disintegration. There is little doubt that these techniques will supersede conventional surgical procedures in the near future. PMID- 6842562 TI - Partial trisomy 12q: a clinically recognisable syndrome. Genetic risks associated with translocations of chromosome 12q. AB - A newborn child with an unusual facial appearance and multiple abnormalities was found to be trisomic for a large part of 12q as a result of adjacent 1 segregation of a familial translocation, t(9;12) (p24;q21.2). A combination of cytogenetic analysis, clinical features, and enzyme marker studies allows an accurate assessment of the breakpoints. Although trisomic for a considerably larger area of 12q than other reported cases, there are many similar features suggesting that trisomy 12q is a clinically recognisable syndrome. The frequency and mode of segregation of 12q translocations and their implications for genetic counselling are discussed. PMID- 6842564 TI - Evaluation of defibrillators. PMID- 6842566 TI - Corrosive effect of carbon-fibre reinforced plastic on stainless-steel screws during implantation into man. AB - The corrosion of stainless-steel screws used to fix carbon-fibre reinforced plastic (CFRP) plates to human fractures was compared with the corrosion on similar screws used to fix stainless-steel AO plates. Corrosive changes were noted in both sets of screws with similar frequency and severity; however, the stainless-steel plates were 'in situ' almost twice as long as the CFRP ones, showing that the corrosive changes occurred more rapidly on screws in contact with CFRP. Nevertheless, over the implantation time necessary for bone healing, corrosion was very mild and there is no clinical contra-indication to the use of stainless-steel and CFRP together in this particular application. PMID- 6842565 TI - A temperature-sensitive cardiac pacemaker. AB - An artificial cardiac pacemaker which is sensitive to the temperature of blood in the right atrium has been fabricated. For a temperature change of 20 degrees C the circuit achieves 90% of its final response within a period of 18 s. In the authors' opinion this is satisfactory since changes in blood temperature are generally small. Cardiac output in dogs rose from 2.37 +/- 0.65 to 4.54 +/- 1.15 l/min when the rate was increased from 202.6 beats/min(b.p.m.) at 37.6 degrees C to 231.6 b.p.m. at 41 degrees C. Cardiac output was found, from statistical observation, to be improved at temperatures over 39.6 degrees C. PMID- 6842568 TI - Proceedings of the Pathological Society of Great Britain and Ireland. Birmingham, 5-7 January 1983. Synopses of papers of microbiological interest. PMID- 6842567 TI - A hydraulic seat-rise wheelchair. AB - A hydraulic seat-rise wheelchair constructed for a patient experiencing severe difficulty getting into and out of a wheelchair is described. The seat-rise mechanism, activated by a hydraulic cylinder, is constructed to locate within a wheelchair frame replacing the seat and back of a normal manual wheelchair. Patient control of the lifting and lowering feature is maintained by controls fitted to the arm of the wheelchair. A wheelchair of this design is most suitable for use by patients who, by virtue of their disability, require it to achieve greater independence. PMID- 6842569 TI - Phagocytosis of Trypanosoma brucei rhodesiense by peritoneal macrophages: a study by scanning electronmicroscopy. AB - Phagocytosis of Trypanosoma brucei rhodesiense by peritoneal macrophages takes place by seizure of the trypomastigote by either end but usually by the anterior. A lamellar sheath similar to that seen in phagocytosis of the promastigote of Leishmania is observed, but it is smaller and does not proceed to envelop the living parasite. The attached trypomastigote becomes pitted and appears to have been killed and partially destroyed before it is completely engulfed. PMID- 6842570 TI - Characteristics of motile curved rods in vaginal secretions. AB - Motile curved rods seen in vaginal secretions have been isolated on Columbia agar supplemented with 5% human blood and vitamin K. Growth occurred anaerobically and in 5% oxygen but not in more aerobic conditions. There were two distinct groups of these organisms, distinguishable by morphology, biochemical activity and susceptibility to metronidazole. All isolates were sensitive to a wide range of antimicrobial agents, with the exception of nalidixic acid and polymyxin, but one group was resistant to metronidazole. There was little difference between the results of tests of susceptibility to aminoglycosides or to metronidazole performed in anaerobic and microaerophilic conditions. Motile curved rods were isolated from 18 of 80 patients with a clinical diagnosis of non-specific vaginitis, but from only two of 39 without the disease. PMID- 6842571 TI - Biological activities of the lipopolysaccharide and lipid A from Acinetobacter calcoaceticus. PMID- 6842572 TI - The urinary bacterial flora in patients with three types of urinary tract diversion. AB - There is known to be a high risk of malignancy at uretero-colic anastomoses and it has been postulated that bacteria catalyse both the local formation and the activation of carcinogens such as N-nitrosamines. If this theory is correct, then the risk of malignancy should be greatest when the prevalence of mixed urinary tract infection is greatest. Bacterial culture was performed on samples of urine obtained from 56 patients with three forms of urinary tract diversion: ureterosigmoidostomy, isolated ileal and colon conduits. As expected, the rectal urine of all patients with a ureterosigmoidostomy had a rich bacterial flora. However, 11 of the 15 patients with ileal conduits (73%) had significant mixed growths of bacteria in the loop urine, whereas only six out of 16 colon loop urines (37.5%) were infected, all being monobacterial infections. The implications of these bacteriological findings for carcinogenesis associated with urinary diversion are discussed. PMID- 6842574 TI - Separation of capsulate and non-capsulate Bacteroides fragilis on a discontinuous density gradient. PMID- 6842573 TI - Duration of hepatitis B surface antigenaemia and its correlation with the histopathological and clinical outcome in acute and chronic hepatitis. AB - The persistence of Hepatitis B surface antigen (HBsAg) in 156 patients with histopathologically proven acute viral hepatitis and 27 patients with chronic active hepatitis was assessed and correlated with their clinical and histopathological outcome; 1387 sequential serum samples were tested for HBsAg and its antibody (anti HBs). In the group with acute viral hepatitis, 86% of the patients who recovered, 67% of the patients who deteriorated histopathologically and 67% of the fatal cases carried HBsAg for up to 8 weeks only. While 56% of patients with chronic active hepatitis harboured HBsAg for 13-80 weeks, only 10% of the group with acute viral hepatitis did so. Of patients with chronic active hepatitis 37% deteriorated to cirrhosis and 11% died. Diverse anti-HBs-response patterns are reported and may have clinical significance. PMID- 6842575 TI - Defective cell-mediated immune response in spontaneous diabetes mellitus in the guinea pig. AB - The proliferative responses of splenic lymphocytes from spontaneously diabetic, recovered and normal guinea pigs were compared after in vitro stimulation with two different T cell mitogens--PHA and Con-A. The in vitro lymphocyte responses were significantly depressed in diabetic guinea pigs as compared to normal controls. On remission of hyperglycemia, the proliferative responses of lymphocytes returned to normal or to above normal levels. The implication of such a defect in cellular immunity in diabetes is discussed. The guinea pig model of spontaneous diabetes mellitus may be useful for studies on immune competence in juvenile diabetes. PMID- 6842576 TI - Immunodeficiency measles encephalitis. AB - The first case of measles encephalitis occurring in an adult with late onset primary hypogammaglobulinaemia is described. This diagnosis was confirmed by examination of the parietal cortex at autopsy with the electron microscope. As the fatal outcome of this case might have been prevented with immunoglobulin replacement therapy, we suggest that such therapy be commenced following the diagnosis even if the patient has only minor infective episodes. PMID- 6842578 TI - Central nervous system and blood lymphocytes in experimental allergic encephalomyelitis. PMID- 6842577 TI - Defective natural killer (NK) and killer (K) cell function in systemic lupus erythematosus. AB - Two aspects of lymphocyte function, natural killer (NK) and killer (K) cell activity have been studied in 21 normal subjects, 20 patients with systemic lupus erythematosus (SLE) and 6 patients with uraemia caused by non-immunological disorders. NK cell function was assessed by lymphocyte cytotoxicity of K 562 and Molt 4 target cells, and K cell function by killing of antibody coated Chang cells. Severely impaired NK and K cell activity was found in SLE (p = less than 0.001 for all target cells). In patients with uraemia (non SLE) NK cell cytotoxicity was normal, and K cell cytotoxicity was reduced but not as much as in the SLE group. Good correlation was found in normal subjects between NK and K cell activity. These results could not be directly related to disease activity, although NK and K cell function was lower in patients with active SLE than in patients with inactive disease, nor to treatment, for impaired killing was found in untreated patients in relapse and in patients in remission of all therapy. There was also no correlation between the level of circulating immune complexes and the defect in killing. These NK and K cell abnormalities could contribute to the pathogenesis of SLE by, for example, impairing mechanisms responsible for elimination of virus infected cells. PMID- 6842579 TI - Autoantibodies in viral infection. PMID- 6842580 TI - The mechanism of Na+-L-lactate cotransport by brush border membrane vesicles from horse kidney: analysis of rapid equilibrium kinetics in absence of membrane potential. AB - Membrane transport of lactate was studied using vesicles prepared from horse kidney brush border. It is shown that the carrier-mediated transport of L-lactate is Na dependent and the D-lactate Na dependence seems weaker than the L stereoisomer. Augmented transport rate is observed following imposition of an artificial chemical Na+ gradient of electrical potential difference. The effect of Na+ chemical gradient on the L-lactate uptake was analyzed using membrane vesicles incubated with 50 mM KCl and valinomycin in order to short circuit any contribution of transmembrane electrical potential to the transport. Kinetics results and principally the absence of linearity between l/v (lactate) versus l/Na+ show that the L-lactate transport mechanism fit the properties of an ordered process with two Na+ ions cotransported with one L-lactate anion. The L lactate and sodium affinities (Km) determined under Na+ chemical gradient were 1.05 and 48 mM for L-lactate and Na, respectively. The sodium activation was shown to be highly cooperative with a Hill number of 2 although no "sigmoidal" activation effect was observed. PMID- 6842583 TI - An expeditious procedure for the accurate alignment and assembly of stereo micrographs. PMID- 6842581 TI - Chloride secretion by canine tracheal epithelium: III. Membrane resistances and electromotive forces. PMID- 6842582 TI - Inhibition of chloride secretion by furosemide in canine tracheal epithelium. PMID- 6842584 TI - Intra-abdominal gas gangrene occurring during cancer chemotherapy. PMID- 6842585 TI - Radiological seminar CCXXVII: computerized intravenous angiography--a first month's experience. PMID- 6842586 TI - Random sequences. AB - The comparison of protein or nucleic acid sequences frequently leads to observations whose improbability can be tested only by Monte Carlo techniques that require randomizing the sequences being compared. Two decisions need to be made. One is whether one demands a resulting random sequence to have the properties of the original sequence (a shuffled sequence) or only expects it to have them (a representative sequence). The second decision concerns the properties of the sequence of which two are composition and nearest-neighbor frequencies. It is shown that biased nearest-neighbor frequencies can significantly affect the probability of observing a given result. Methods for producing random sequences according to these decisions are given. PMID- 6842587 TI - Equivalence of the projected structure of thin catalase crystals preserved for electron microscopy by negative stain, glucose or embedding in the presence of tannic acid. AB - Thin crystals of beef liver catalase have been examined by electron microscopy following various preservation procedures. In the first part of this investigation, micrographs of three principal projections were obtained from thin sections of micro-crystals embedded in the presence of tannic acid. Computer reconstructions confirmed the space group assignment of P2(1)2(1)2(1) and permitted the packing arrangement of the catalase tetramers to be deduced to a resolution of about 20 A. These results corroborate the packing model for this crystal form proposed by Unwin (1975) on the basis of molecular modeling of one projection. In the second part of this investigation, the projected structures of the thin crystals in various preserving media were compared. The negative contrasting of crystals embedded in the presence of tannic acid was confirmed by direct comparison with non-embedded, negatively stained thin platelet crystals. In addition, good agreement at 20 A resolution was observed between the structure of negatively stained crystals and the structure of crystal platelets preserved in glucose and examined by low-dose methods, while moderate agreement was established with the published data of Taylor (1978) for crystals embedded in thin ice films. Tannic acid alone was also found to serve as a suitable medium for preserving catalase crystals to a resolution of 3 X 7 A as judged by electron diffraction. Overall, we demonstrate that projections obtained from thin sections of catalase crystals embedded in the presence of tannic acid can provide a reliable, negatively contrasted representation of the protein structure to 20 A resolution. Examination of sectioned crystals could thus provide a useful adjunct to X-ray crystallographic studies of protein crystals and three-dimensional reconstruction of crystal thin sections should ultimately be possible. PMID- 6842588 TI - Representation of short and long-range handedness in protein structures by signed distance maps. AB - A new representation is proposed of short and long-range handedness in protein structures, by signed distance maps. This representation, based on the co ordinates of the C alpha atoms of proteins, does not require the assignment of specific regular structures. The short-range handedness along the chain in alpha helical, beta-strand and turn segments is shown, as well as the handedness between two strands of beta-sheet structures and for crossover connections. Results are given for a beta alpha beta alpha beta folding unit of flavodoxin, a beta alpha beta unit of subtilisin, which contains a left-handed crossover connection, and the domain 1 of bovine beta-trypsin. PMID- 6842589 TI - Assignment of the 1H nuclear magnetic resonance spectrum of the trypsin inhibitor homologue K from Dendroaspis polylepis polylepis. Two-dimensional nuclear magnetic resonance at 360 and 500 MHz. AB - The assignment of the 1H nuclear magnetic resonance (n.m.r.) spectrum of the trypsin inhibitor homologue K from the venom of Dendroaspis polylepis polylepis is described and documented. The assignments are based entirely on the amino acid sequence and on 2-dimensional n.m.r. experiments at 360 and 500 M Hz. Individual assignments were obtained for the backbone and C beta protons of all 57 residues of the inhibitor homologue K, with the exceptions of the N-terminal amino group, the amide protons of Arg16, Gly37 and Gly40 and the C beta protons of Arg16 and Pro19. The assignments for the non-labile protons of the amino acid side-chains are complete, with the exception of Gln29, Glu49 and all the proline, lysine and arginine residues. For Asn and Trp the labile side-chain protons have also been assigned. The chemical shifts for the assigned resonances are listed for an aqueous solution at 50 degrees C and pH 3.4. PMID- 6842590 TI - Complementary DNA sequence of a human cytoplasmic actin. Interspecies divergence of 3' non-coding regions. AB - We have isolated and sequenced a cloned complementary DNA insert complementary to the messenger RNA of a cytoplasmic actin expressed in human epidermal cells. This provides the first cytoplasmic actin complementary DNA sequence for a vertebrate organism. The actin amino acid sequence predicted from this complementary DNA is identical to that of a bovine cytoplasmic actin and shows 98 and 85% homology with a Dictyostelium and a yeast actin, respectively. The complementary DNA sequence indicates that the 3' end of the mRNA contains an unusually long (greater than 400 nucleotides) 3' non-translated region. A comparison of this 3' non-coding region with those of recently determined actin complementary DNA sequences from other species reveals little or no homology among these sequences. Thus, these results indicate that although the actin amino acid sequences are extremely conserved, the non-coding regions of the mRNAs diverge rapidly. PMID- 6842591 TI - Simple model to account for the deoxy-versus ribodimer stacking quotient data. Estimation of apparent and intrinsic equilibrium quotients for intramolecular stacking association of purine deoxy- and ribodinucleoside monophosphates. AB - Stacking equilibrium quotients were evaluated for three purine deoxyribo-dimers, d-ApA, d-m6Apm6A and d-GpG, using procedures developed in earlier studies, and compared with those for the corresponding ribo-dimers. It was shown that the deoxyribo-dimers were apparently more strongly stacked than the corresponding ribo-dimers at 25 degrees C. To explain the observed difference in stability (as measured by the apparent stacking quotient) in the two series of dimers a new extended two-state model is advanced, that the differences in the apparent stacking quotients are due to a limited availability of the number of the sugar ring puckering modes in the stacked ribo-dimers as compared with the case in the stacked deoxyribo-counterparts. The intrinsic stacking quotients, which are interrelated with the apparent stacking quotients by the microscopic sugar puckering equilibrium constants, were also evaluated for the purine deoxy- and ribo-dimers, and were found to be the same in any pair of these dimers. PMID- 6842592 TI - Novel form of non-muscle tropomyosin in human fibroblasts. AB - The cytoskeletal extracts of cultured human fibroblasts were found to contain at least four distinct polypeptides, each of which demonstrated the resistance to denaturation and the acidic isoelectric point characteristic of tropomyosin. One of these, hscp 36 (heat-stable cytoskeletal protein having an apparent molecular weight of 36,000), cross-reacted efficiently with an antiserum to chicken skeletal muscle tropomyosin. Furthermore, the messenger RNA coding for hscp 36 was selected by a chicken complementary DNA clone containing a tropomyosin sequence. The abundance of mRNA coding for hscp 36 was found to be similar in both normal and simian virus 40 (SV40) transformed human fibroblasts. The apparent molecular weight of hscp 36 is different from non-muscle tropomyosins previously isolated from human sources, which show the apparent molecular weight of 30,000 normally associated with non-muscle tropomyosin. This, together with the complexity of the heat-stable cytoskeletal proteins present in human fibroblasts, suggests the existence of multiple genes coding for human non-muscle tropomyosins. PMID- 6842593 TI - Stages of tubulin assembly and disassembly studied by time-resolved synchrotron X ray scattering. PMID- 6842596 TI - Transcription in bacteriophage f1-infected Escherichia coli. Messenger populations in the infected cell. AB - Transcription of bacteriophage f1 DNA in vivo occurs in two independent regions. They are separated from one another by a strong terminator just downstream from gene VIII on one side, and by the filamentous phage intergenic space on the other. One of these regions contains genes II, V, VII, IX and VIII, and is actively transcribed. In this region there are a number of promoters but only one effective terminator. Thus, most of the RNAs that come from this region overlap and share sequences close to the termination site. The other region, which contains genes III, VI, I and IV, is transcribed much less actively. This region gives rise to a long (approximately 4 X 10(3) bases) RNA that covers the entire region, and several RNAs that overlap in the region closest to their 5' termini. Several other RNAs appear to overlap only with the 4 X 10(3) base transcript. Thus, not only the frequency but the organization of transcription differs in the two portions of the genome. PMID- 6842595 TI - Preliminary crystallographic data for plastocyanins from an alga (Enteromorpha prolifera) and from cucumber (Cucumis sativus). AB - The plastocyanins from a green alga (Enteromorpha prolifera) and cucumber (Cucumis sativus) have been crystallized. Crystal data are as follows: E. prolifera plastocyanin, space group I4, a = b = 53.9 A, c = 59.4 A, Z = 8; C. sativus plastocyanin, space group P4(1) (or P4(3) ), a = b = 66.7 A, c = 46.0 A, Z = 8. Accordingly, the asymmetric units of the crystals contain one and two molecules, respectively. PMID- 6842594 TI - Low dose electron microscopy of the crotoxin complex thin crystal. AB - The crotoxin complex from Crotalus d. terrificus rattlesnake venom was crystallized in the form of thin platelets. These crystals were prepared by the glucose embedding technique and examined by low dose electron microscopy. Electron diffraction patterns and images have been recorded to 2.2 and 4.5 A, respectively. By a combination of electron and X-ray diffraction techniques, the space group of this crystal was determined to be P4(2)22 with eight crotoxin complex molecules in one unit cell with dimensions of 38.8 A x 38.8 A x 256.8 A. The Patterson maps and the symmetry reliability factors calculated from the electron diffraction intensities clearly showed the existence of three types of electron diffraction patterns in different crystals. The phases in the computer calculated transform of the low dose images also show the variation in symmetry among crystals. These phenomena are explained by the presence of crystals consisting of one-half, three-quarter and one unit cell in thickness. The interpretation of the computer reconstructed two-dimensional density map was limited, partly because of the similarity in density between the protein and the embedding glucose and partly because of the non-uniqueness in relating projected structure to the three-dimensional structure. PMID- 6842598 TI - Preference of oxygenation between alpha and beta subunits of haemoglobin. Results of multidimensional spectroscopic observation. AB - The distribution of oxygen between the subunits of haemoglobin was studied spectrophotometrically. The difficulty in discriminating the spectral changes upon oxygen binding to the alpha or beta subunit can be surmounted by means of multidimensional spectroscopic observations and a correlation analysis of the data. M-type abnormal haemoglobins are used as a control against normal haemoglobin because only one type of its subunits can bind oxygen. A multidimensional spectroscopic measuring system, which has been developed in our laboratory, makes it possible to carry out simultaneous and continuous acquisition of a set of spectroscopic data at several wavelengths on one sample solution during the course of increasing or decreasing the partial pressure of oxygen. The data-storing function of a magnetic disk memory provides enough precision for a rigorous investigation of the correlation of oxygen equilibrium curves measured at several wavelengths. No chemical modification to enhance the spectral difference between subunits is necessary. In conclusion, by detecting slight differences between the oxygenation-sensitive bands of alpha and beta subunits, the beta subunits are found to have a higher affinity for oxygen than the alpha subunits. PMID- 6842597 TI - Analysis of rabbit beta-like globin gene transcripts during development. AB - We have analyzed the differential expression of a family of beta-like globin genes during the development of rabbits, from four days post implantation to one week before birth. The family is composed of four genes, arranged 5'-beta 4-beta 3-psi beta 2-beta 1-3' on the chromosome; psi beta 2 is an inactive pseudogene. Using the technique of hybrid-arrested translation in vitro, we have identified the embryo-specific globin polypeptides encoded by genes beta 3 and beta 4. The beta 3 and beta 4 globins are replaced by the adult beta 1 globin halfway through gestation; this corresponds temporally with the switch in site of erythropoiesis from the embryonic yolk sac to the fetal liver. The decline in production of beta 3 globin polypeptide precedes the decline in beta 4 globin. Transcripts from genes beta 1, beta 3 and beta 4 were analyzed at progressive stages of gestation by a blot-hybridization assay and by an S1 nuclease protection assay. Mature messenger RNA and presumptive precursor RNAs from genes beta 3 and beta 4 are synthesized abundantly in embryonic erythroid cells but only at very low levels later in fetal development. Conversely, precursor and mature mRNA from gene beta 1 are found at very low levels in embryos but are abundant in fetal and adult erythroid cells. The co-ordinate appearance of precursor RNA, mRNA and polypeptide from all three active genes indicates that the primary developmental regulation of this gene family is exerted at the level of transcription. RNA species larger than the expected precursors were observed when the RNA was denatured with formaldehyde but not when methylmercury was the denaturant. These large RNAs are a formaldehyde-generated artifact, possibly a result of cross linking globin transcripts to ribosomal RNA. We observe no extensive stable transcripts from the 5' or 3' flanking regions of these genes. PMID- 6842599 TI - Structure and function of haemoglobin Barcelona Asp FG1(94) beta leads to His. PMID- 6842600 TI - Self-assembly of brome mosaic virus protein into capsids. Initial and final states of aggregation. AB - The pH and ionic strength dependence of the states of aggregation of brome mosaic virus protein has been investigated by small angle neutron scattering, quasielastic light-scattering, analytical centrifugation and electron microscopy. At pH above neutrality, protein oligomers are found in dynamical equilibrium, comprising monomers, dimers and aggregates of higher molecular weight. By lowering the pH, capsids assemble spontaneously with dimensions in solution which depend on ionic strength. If formed by dialysis, they contain 180 monomers, but are 30 A larger in diameter than the native virus. If formed by pH-jump, they contain less monomers: the deficiency decreases with decreasing the final pH and the initial protein concentration. Upon dehydration for electron microscopy, capsids contract by 10%. PMID- 6842601 TI - Dimeric and tetrameric hemoglobins from the mollusc Scapharca inaequivalvis. The oxidation reaction. AB - The oxidation by ferricyanide of the dimeric (HbI) and tetrameric (HbII) hemoglobins from the bivalve mollusc Scapharca inaequivalvis has been studied in static and kinetic experiments. Both hemoglobins give rise to hemichromes as stable oxidation products. Oxidation of deoxyHbI yields a hemichrome by a simple bimolecular process. No intermediate Met form can be detected during the reaction even in rapid mixing experiments. The HbI hemichrome undergoes a reversible pH dependent dissociation into monomers. A simple model has been proposed to account for the linkage between proton binding and subunit dissociation. In the case of tetrameric HbII, oxidation yields an intermediate Met form. Thus, the kinetics of the oxidation reaction are always biphasic; the fast reaction is a bimolecular process and yields the Met derivative. The slow reaction is a monomolecular process and corresponds to the conversion of the Met form into the hemichrome; its rate is independent of the state of ligation of the ferrous protein and decreases with increase of pH. The HbII hemichrome is tetrameric when newly formed; it tends to dissociate into lower molecular weight species with the same optical properties. The rate of dissociation is relatively fast at neutral pH (t 1/2 approximately equal to 12 min) and markedly less at alkaline pH values. The HbI and HbII hemichromes are reduced by dithionite yielding the spectra of the native deoxygenated proteins; in the case of HbII, the tetrameric structure of the native protein is re-acquired. PMID- 6842602 TI - Self-assembly of brome mosaic virus capsids. Kinetic study using neutron and X ray solution scattering. AB - The self-assembly of brome mosaic virus capsid has been studied kinetically by means of X-ray and neutron scattering. It appears to be a very fast process: for the concentrations used (5 to 8 mg/ml) the forward scattering reaches 50% of its maximal value in less than one second. Further, the assembly seems to proceed through intermediate states whose nature is still speculative. PMID- 6842603 TI - X-ray absorption near edge structure (XANES) determination of calcium sites of troponin C and parvalbumin. AB - Using synchrotron radiation at the Frascati storage ring ADONE, the X-ray Absorption Near Edge Structure (XANES) has been applied to determine homologies and modifications of the local structure of the calcium binding sites of troponin C. In all four calcium binding sites, Ca2+ appears to be co-ordinated to carboxyl and carbonyl groups in a characteristic configuration. No structural difference has been found between high and low-affinity sites. A distortion of the Ca2+ site geometry by binding of Mg2+ has been observed. The XANES of parvalbumin has been measured and found to be different from troponin C. A tentative identification of the characteristic XANES spectra of the two different Ca2+ sites in this protein is reported. PMID- 6842604 TI - A new approach to the measurement of sigmoid curves with enzyme kinetic and ligand binding data. AB - 1. It is shown that the extent of sigmoidicity in kinetic or binding curves can always be characterized by two parameters, omega and delta, even when substrate inhibition or other causes of deviations from hyperbolic character are present. 2. The parameter omega is defined in such a way as to measure the fraction of the vertical span of the curve that is sigmoid. 3. The parameter delta is defined in such a way as to measure the S-shaped character in the sigmoid region. 4. It is shown that limits exist to the maximum values of omega and delta for degree n : n and so any individual v(S) or y(x) curve can be described as being barely sigmoid or very sigmoid by a comparison of measured omega and delta values with the limiting values. 5. Monte Carlo simulations of 12 kinetic mechanisms and 6 binding models were performed and the probability density functions and cumulative distribution functions for omega and delta were calculated. 6. An empirical study was performed on the delta values required before experimentalists can recognize a set of data points with error as being sigmoid. 7. The probability with which representative kinetic mechanisms or binding schemes give rise to complex curve shape features has been estimated before. Here using the parameters omega and delta, we calculate the conditional probabilities that sigmoid curves can occur in physiological ranges of substrate or ligand concentration and be sufficiently exaggerated to be recognized as S-shaped. 8. It is shown that some mechanisms, e.g. the random bi bi one, are very unlikely to give strongly sigmoid curves. Such exaggerated curves were found to be more typical of simple sequential kinetic schemes and binding models. 9. It is shown that omega and delta values measured experimentally can sometimes be used in model discrimination and fixing the minimum degree of rate equations. 10. A very powerful result is that in saturation functions of order n the maximum height of the curve that can be sigmoid is (n - 1)/n, and a possible evolutionary significance for this is suggested. PMID- 6842605 TI - Crystallization of the Fab fragment of a monoclonal anti-digoxin antibody and its complex with digoxin. PMID- 6842606 TI - Coenzyme binding in crystals of glyceraldehyde-3-phosphate dehydrogenase. AB - Apo-glyceraldehyde-3-phosphate dehydrogenase from Bacillus stearothermophilus and the partially saturated holo-enzyme can be crystallized isomorphously with the entire tetramer occupying the crystal asymmetric unit. For crystals that contain one molecule of NAD+ per tetramer the coenzyme is bound uniquely in one of the four available sites. The presence of NAD+ gives rise to nonequivalence in the binding of a heavy-atom compound to the subunits of the tetramer while for the apo-enzyme this binding is clearly symmetric. These results suggest that NAD binding gives rise to sequential ligand-induced structural changes of the tetramer, which may be responsible for the observed negative cooperativity in coenzyme binding. PMID- 6842607 TI - Preliminary crystallographic study of the Fab fragment of a monoclonal anti phenylarsonate antibody. AB - Preliminary crystallographic data are given for the Fab fragment of a monoclonal anti-p-phenylarsonate antibody. This crystalline Fab fragment was found by screening a number of monoclonal anti-arsonate antibodies obtained from hybrids of A/J immune spleen cells with a non-secreting mouse myeloma line. The protein crystallizes in the monoclinic space group P21 with a = 86.2 +/- 0.1 A, b = 80.4 +/- 0.2 A, c = 75.8 +/- 0.1 A, beta = 90.3 +/- 0.1 degrees. Precession photographs show X-ray reflections extending to a resolution of 3 A. PMID- 6842608 TI - The molecular structure of the 9S mRNA from early region 1A of adenovirus serotype 2. PMID- 6842609 TI - Structure of azurin from Alcaligenes denitrificans at 2.5 A resolution. AB - The structure of the blue copper protein, azurin, from Alcaligenes denitrificans has been determined from an electron density map at a nominal resolution of 3.0 A. Four isomorphous heavy-atom derivatives, prepared with KAu(CN)2, uranyl acetate, Hg(NH3)2Cl2 and KAu(CN)2 + uranyl acetate (a double derivative) were used to calculate phases by the method of isomorphous replacement. The overall figure of merit was 0.61. The two molecules in the asymmetric unit are related by an approximate 2-fold axis. Independent interpretations of the density were made for the two molecules, and the structures have since been partially refined. After 12 refinement cycles, using the Hendrickson-Konnert restrained least squares program, the R factor is 0.318 for data to 2.5 A resolution and there are no major conformational differences between the two molecules. Refinement is continuing. Eight extended strands of the polypeptide chain form a beta-barrel structure whose topology is the same as that of plastocyanin and the alternative folding proposed for Pseudomonas aeruginosa azurin. As in the latter two proteins, the copper atom forms three short bonds, with His-46 N delta 1, His117 N delta 1 and Cys112 S gamma, and one longer bond, with Met121 S delta, these four ligands forming a very distorted tetrahedron. A possible additional interaction, between copper and the carbonyl oxygen of Gly45, cannot be discounted at the present stage of the analysis. A surface hydrophobic patch, around the edge of the imidazole ring of His117 appears the most likely electron transfer locus. The sequences of azurin and plastocyanin have been aligned and the homology between the two proteins is discussed. PMID- 6842610 TI - The number of E2-E1(6) isomers. PMID- 6842611 TI - A comparative ultrastructural study of the trigeminal ganglion in the rat and chicken. AB - The neurons of the trigeminal ganglia of the rat and chicken were characterized by means of light microscopic, electron microscopic, and histochemical methods. Light microscopy disclosed four types of neurons, based on the characteristics of Nissl granules: (1) large neurons with diffusely distributed and very fine granules, (2) neurons containing coarse and sparsely distributed Nissl granules, (3) neurons containing dense Nissl granules of varying size, and (4) small neurons with granules concentrated peripherally. Electron microscopy allowed further definition of these four types of neurons by the length and arrangement of flattened cisterns of granular endoplasmic reticulum (gER) and the number of neurofilaments. Type 1 cells were largest, with a mean nuclear area of 139.8 +/- 28.3 micron2. Type 4 cells were smallest, with a mean nuclear area of 74.6 +/- 20.9 micron2. The mean nuclear areas of type 2 and 3 cells were intermediate to those of the type 1 and 4 cells. Type 3 and 4 neurons lacked neurofilaments. Four forms of Golgi apparatus were found: (1) large bent grains forming a network throughout the soma, (2) dispersed fine granular deposits, (3) fine or small granules, and (4) coarse bent deposits arranged confluently in the perinuclear zone. In some rat neurons, the concentration of acid phosphatase reaction products suggested a high enzymatic activity, whereas the chicken ganglion cells showed no such concentration. These findings are discussed and compared with the classifications of previous studies. PMID- 6842612 TI - Terminal airway embryology of the delphinid porpoises, Stenella attenuata and S. longirostris. AB - A light microscopic investigation of the histological development of the terminal airways of 18 Stenella attenuata and two S. longirostris showed the lungs to be in a glandular stage of development until 3 months postimplantation (p.i.) age. By 3.5 months (p.i.) the lung was at the canalicular stage. At 4 months mesenchymal rings and muscular bands were in a sphincterlike arrangement around terminal bronchioles. At 7 months (p.i.) the alveolar stage occurred. About 8-9 months cartilaginous rings were present and in association with myoelastic sphincters. Their function remains an enigma, even though many hypotheses as to function have been proposed. We suggest that the presence of well-developed sphincters and cartilage in the neonate may give clues to their function as well as offer potential experiments that would not be as suitable in the adult porpoise. PMID- 6842613 TI - Structure-function relationships of the flexor carpi radialis muscle compared among four species of mammals. AB - Investigations of the structure and function of the flexor carpi radialis muscle (FCR) in the cat have led to the hypothesis that the compartmentalized (nonuniform) distribution of fiber types within the muscle relate to the complex motor skills of the cat. To test this hypothesis a study was undertaken to compare the FCR in four mammalian species of similar body size but with different forelimb motor tasks. The species chosen were: dog, opossum, armadillo, and cat. Comparisons were made among species with regard to general muscle morphology, fiber types and sizes, fiber proportions, and fiber distributions. The FCR of all species was morphologically similar and contained three muscle fiber types (SO, FOG, and FG). The mean area of muscle fibers was largest in opossum, while the FCR fibers of dogs were smallest. The percentage of SO fibers in the dog FCR was greater than in the other species studied. The opossum FCR also contained a high percentage of SO fibers. The armadillo FCR consisted of a high percentage of FG fibers. In the cat FCR the percentages of all three fiber types were similar. For each species, individual fiber proportions were in agreement with the results for fiber percentages. Compartmentalized distribution of fiber types existed in each species with the dog having the most compartmentalized fiber type distribution and the cat the least compartmentalized distribution. Therefore it seems that the compartmentalized organization of the FCR is not related to any specialized motor task, but may be a generalized pattern associated with motor patterns shared among all species studied. PMID- 6842614 TI - Changes in DNA content, number of nuclei and cellular dimensions of young rat atrial myocytes in response to left coronary artery ligation. AB - Studies of enzymatically isolated myocytes from atria of young male Sprague Dawley rats at 11 days after left coronary artery ligation show that a major response of atrial myocytes to ventricular infarction is binucleation. In sham operated animals, 23.2% of left and 15.5% of right atrial myocytes were binucleated, compared to 77.8% of left and 40.5% of right atrial myocytes of infarcted animals. Examination of 150 g and 250 g unoperated control animals indicate that this response is occurring at a time when a small but significant amount of binucleation is also occurring as a normal part of growth. Using a Feulgen-acriflavine-SO2 method for cytofluorometry, a significant increase in ploidy was seen in left atrial myocytes of infarcted animals over those of sham or control animals. The number of left atrial myocytes in infarcted animals having a ploidy level above 3C was 10.8% above sham values. The mean length of binucleated myocytes of left atrium was significantly greater in infarcted animals (119.8 microns) than in sham-operated animals (97 microns) and the mean length of mononucleated myocytes was greater in infarcted animals (104.1 microns) than in sham-operated animals (77 microns). Thus, cardiac myocytes are capable of a substantial response to a stressful situation by increases in cell length, number of nuclei and ploidy. Study of a model system such as the rat atrium may yield an understanding of the mechanisms involved in the induction of these nuclear changes. PMID- 6842615 TI - Phosphorylation of a 43 kdaltons protein from rat heart by a calmodulin-dependent protein kinase. AB - The Ca2+ -dependent phosphorylation of proteins has been recognized as a major regulatory mechanism of biological processes. In the heart, protein kinases that are activated by Ca2+ include phosphorylase kinase, myosin light chain kinase, phospholamban kinase [review in 4], and the kinases responsible for phosphorylation of endogenous proteins in the membrane [11] and soluble [6] fractions of the cell. All of these Ca2+-dependent enzymes require the presence, either as an enzyme subunit or as a cofactor, of calmodulin, a Ca2+-binding protein which is involved in various other Ca2+-requiring reactions or processes [review in 3]. We demonstrate here the presence, in the rat heart, of a soluble calmodulin-dependent protein kinase which seems different from those already described in this tissue. The substrate for this enzyme is a 43 kdaltons protein, present in the same soluble fraction. PMID- 6842616 TI - Quantitative correlation between carcinogenicity and sister chromatid exchange induction in vivo for a group of 11 N-nitroso derivatives. AB - The quantitative correlation between induction of sister chromatid exchanges (SCEs) in vivo and carcinogenic potency was examined for 11 nitroso derivatives and was compared with the correlation of alkaline DNA fragmentation in liver DNA in vivo and with the Ames test. The correlation between DNA adducts and SCEs was also evaluated. DNA damage was slightly more predictive and the Ames test less predictive than SCE evaluation. The predictivity of these tests for this class of compounds was compared with the predictivity shown for different classes of chemical compounds. PMID- 6842617 TI - Persistence of symptoms after mild to moderate acute organophosphate poisoning among 19 farm field workers. AB - Exposure to 2 organophosphate pesticides occurred when entry into a cauliflower field was permitted 4 h after application of highly toxic chemicals. It resulted in acute illness of mild to moderate degree in 19 farm workers, including 3 children and 1 pregnant woman. There were no fatalities. Two to three months were required for recovery from major symptoms and return to normal acetylcholinesterase levels. An exception was the persistence of eye symptoms in the majority 4 mo after the day of exposure. PMID- 6842618 TI - Rat hepatic microsomal enzyme induction by pretreatment with toxaphene and toxaphene fractions. AB - The levels of hepatic microsomal induction caused by toxaphene were determined. Young Sprague-Dawley rats (70 g) were administered toxaphene (ip injection, daily for 5 d) at 0, 5, 25, and 100 mg/kg. All doses caused increases in liver/body weight ratio, cytochrome P-450 level, aminopyrine demethylation, and aldrin epoxidation. The aldrin epoxidase activity increased almost 700% at the 100-mg/kg dose. Toxaphene was separated into nonpolar (S-A) and polar (S-B) fractions and administered as before at 25 mg/kg. All treatments caused significant increases in cytochrome P-450, aminopyrine demethylation, and aldrin epoxidation. A comparison of the treatments, however, did not reveal any significant differences between the treatments. PMID- 6842619 TI - Mutagenicity and cytotoxicity of dimethyl and monomethyl sulfates in the CHO/HGPRT system. AB - It has recently been shown that coal fly ash collected from coal-fired plants contains dimethyl sulfate (DMS) and monomethyl sulfate (MS) at concentrations as high as 830 ppm. Both these compounds were tested in the CHO/HGPRT system, and it was found that only DMS was cytotoxic and mutagenic to CHO cells. On a molar basis, DMS is twice a mutagenic as methyl methanesulfonate (MMS). Under our treatment conditions, maximum mutation induction and cytotoxicity were obtained after approximately 1 h. The Mutagenic potency of DMS was more stable in aqueous solutions at 4 degrees C than at the ambient temperature of 22 degrees C, but was least stable in DMSO solutions at 22 degrees C. Near-ultraviolet (near-UV) light caused an approximately twofold decrease in the mutagenic and cytotoxic effects of DMS. Although DMS produced by coal combustion could be rendered innocuous by environmental agents in a short span of time, this compound could still pose a health risk to workers closely involved in coal-combustion technology. PMID- 6842621 TI - Fate of water-insoluble and water-soluble dichlorobenzidine-based pigments in Fisher 344 rats. AB - The fate of two water-insoluble (WI) dichlorobenzidine-based pigments, chlorodiane blue (CDB) and pigment yellow 12 (PY12), and of their sulfonated water-soluble (WS) analogs was studied in male Fischer 344 rats. Water-soluble analogs of chlorodiane blue and pigment yellow 12 were synthesized in order to study the effect of water solubility on the absorption and metabolism of dichlorobenzidine-based pigments. [14C]WI-CBD, [14C]WI-PY12, and the water soluble analogs [14C]WS-CDB and [14C]WS-PY12 were administered by gastric intubation or dermal application at doses of 1.24-2.65 mumol/kg. Neither [14C]WI CDB nor [14C]WI-[Y12 could be detected in any tissue at time points up to 1 d. The entire dose was accounted for in the feces after oral administration, and at the application site after dermal administration. Water-insoluble CDB is a component of a photoconductor (Weaver, 1981). Approximately 4.1% of [14C]CDB was observed and located primarily in the urine and liver after oral administration, but no detectable amount was absorbed after dermal application. Metabolites of [14C]WS-CDB identified in the urine were 3,3'-dichlorobenzidine diacetate, 3.3' dichlorobenzidine and its glucuronide conjugate, and 3,3'-dichlorobenzidine monacetate and its glucuronide conjugate. Only 0.02% of [14C]WS-PY12 was absorbed after oral administration. Thus, some degree of water solubility was prerequisite for even a small amount of absorption or metabolism in vivo. PMID- 6842620 TI - The influence of cold restraint stress on some components of the antioxidant defence system in the tissues of rats of various ages. AB - Rats of various ages were subjected to stress by confinement in restraining cages at 2-4 degrees C. Analysis of the plasma of these animals revealed an elevation in corticosteroids of approximately 50% above the control level. The livers of all the groups of cold-restrained animals contained significantly more lipoperoxide (estimated as thiobarbituric-acid-reactive material) than did control hepatic tissue. The plasma of the 12-, 24-, and 32-wk-old groups of rats subjected to stressful treatment also contained significantly higher lipoperoxide levels. There was no significant difference between the lipoperoxide levels of the brain tissue of control or stress-treated rats. The activities of both glutathione peroxidase and glutathione reductase were increased in hepatic, but not brain, tissue of the stressed animals. The perturbation of the activities of these enzymes did not produce any significant change in the ratio of reduced, oxidized glutathione. The livers of the stressed animals had significantly less total glutathione than those of the controls. PMID- 6842622 TI - Effect of thiamine deficiency and undernutrition on the lipid composition of rat spinal cord at 21 days of age. AB - Maternal thiamine deficiency and undernutrition are found to cause significant deficits in body and spinal cord weights of the offspring at 21 days of age. The concentration of different lipids is found to be decreased significantly in both experimental groups as compared to normal controls. However, these deficits do not seem to differ between the undernourished and the thiamine-deficient groups. The results suggest a general effect of growth retardation rather than thiamine deficiency per se on the lipid composition of spinal cord. PMID- 6842623 TI - Dose effects of morphine on the spontaneous unit activity recorded from the thalamus, hypothalamus, septum, hippocampus, reticular formation, central gray, and caudate nucleus. AB - Spontaneous activity was recorded from 652 units in 8 subcortical structures of unanesthetized rats. Recordings were obtained in central gray, mesencephalic reticular formation, parafasciculus thalami, caudate nucleus, anterior and ventromedial hypothalamus, lateral septum, and dorsal hippocampus. Eighty recordings were obtained from untreated animals and 80 from saline-injected controls, none of which showed any significant changes of unit activity during the 4- 5-hr observation period. The effect of morphine, given in 5 incremental doses from 0.5 to 30.0 mg/kg ip, was followed in 492 units. Morphine enhanced or depressed spontaneous discharge rates, or caused biphasic effects, ie enhancement alternating with depression and vice versa. Naloxone induced increase in firing after either effect of morphine, or reduced spontaneous activity after morphine induced increases. However, when morphine reduced neuronal discharges, naloxone never caused further depression. In 86 units, morphine at any dosage failed to alter neuronal activity, but in 54 of these units naloxone nevertheless induced alterations in firing rates. The pattern of responses to morphine differed between all 8 brain regions examined and was characteristic for each individual structure. This is the first systematic study describing the dose-response characteristics of morphine in 8 brain sites recorded simultaneously. Furthermore, it utilized freely behaving animals without the interference of anesthetics, which are themselves known to interact with opiates. The variety of response patterns seen supports the neuropharmacological evidence for multiple opiate receptors or multiple sites of opiate action. PMID- 6842624 TI - Long-term effect of electroshock treatment on the entry of calcium into the cerebroventricular fluid in the rat. AB - The rate of appearance (Ra) of calcium (Ca) in the cerebroventricular compartment of urethane-anesthesized rats was determined by two methods: one is measurement of isotope dilution during ventricular-cisternal perfusion with artificial cerebrospinal fluid (CSF) containing 45Ca, the other is estimation of the rate of entry of 45Ca from plasma after rapid injection of tracer 45CaCl2 intravenously. Electroshock treatment (EST) for 3 successive days resulted in a marked increase in the rate of entry of calcium from blood to CSF. The effect of EST on the permeability of the blood-CSF barrier to Ca could be observed even 24 hr after the generalized seizure induced by electroshock has terminated. PMID- 6842625 TI - Acetylation of polyamines in mouse brain: subcellular and regional distribution. AB - The acetylation of putrescine, cadaverine, spermidine, and spermine was examined in different subcellular fractions and regions of the mouse brain. Acetylation activity was confined to nuclear and microsomal fractions, which can acetylate all of these compounds. These fractions catalyze the formation of N8 but not N1 acetylspermidine. For the nuclear fraction the Km for putrescine was 3.5 mM; for cadaverine, 4.0 mM; for spermidine, 1.0 mM; and for spermine, 2.5 mM. The Vmax obtained were (pmol/mg protein/10 min): putrescine, 424; cadaverine, 705; spermidine, 239; and spermine, 467. The acetylation of spermidine was highest in the olfactory bulb and cerebellum. Putrescine and cadaverine acetylation were high in these areas, as well as in the midbrain. Spermine acetylation was rather uniform in all areas examined, except in the brain stem (pons-medulla) where enzyme activity was very low. PMID- 6842626 TI - Increased phosphorylation of nuclear protein in myonuclei isolated from denervated skeletal muscle. AB - The slow-twitch soleus muscle of the rat hindlimb was denervated by cutting the sciatic nerve in the midthigh on one side. A sham operation was performed on the contralateral side to provide a control soleus muscle. At 24, 48, 72, and 120 hours after these surgical procedures, the animals were sacrificed and the nuclei which were isolated from these muscles incubated in a phosphorylating medium containing [gamma-32P]ATP. At the 48 hour denervation period only, the in vitro phosphorylation of TCA-precipitable nuclear proteins was significantly increased compared to control values. Resolution of the SDS-solubilized nuclear proteins by polyacrylamide gel electrophoresis revealed that the increased phosphorylation was more marked in some phosphoproteins than others. The significance of these early denervation changes are discussed with respect to increases in the activities of the nuclear RNA polymerases and changes in the phosphorylation of cytosolic protein. PMID- 6842628 TI - Oxygen radical dependent lung damage following thermal injury of rat skin. AB - Acute thermal injury (70 degrees C, 30 sec) to rat skin results in progressive consumptive depletion of the complement system. Individual complement components (C3, C4, C6) each show reductions in hemolytic activity. Crossed immunoelectrophoresis analysis of serum from thermally injured rats reveals conversion of C3 compatible with activation of the complement system. During the first hour following thermal injury, C5a-related chemotactic activity appears in the serum and is temporally related to the development of neutropenia. Lung injury, as revealed by increases in lung permeability, develops progressively during a 6-hour period and parallels changes in complement levels. Morphologically, lung changes include leukoaggregates within pulmonary capillaries and the presence of intra-alveolar hemorrhage. Protection from lung injury following remote thermal injury to skin is afforded by depleting animals of complement or neutrophils, or by systemic treatment of animals with a combination of catalase and superoxide dismutase. Antihistamine drugs have no protective effect. These data suggest that acute thermal injury leads to systemic complement activation, neutrophil activation, and acute lung injury that is related to production of toxic oxygen products by activated blood neutrophils. PMID- 6842627 TI - Regional difference in density of monoamine-accumulating cells of carp and catfish retinas. AB - By means of a histofluorescence technique, a comparative study was conducted on the regional density of dopaminergic (DA) and indoleamine-accumulating (IA) cells in carp (Cyprinus carpio) and catfish (Ictalurus punctatus) retinas. In order to enhance detection of fluorescent cells, noradrenaline (NA; 5.0 micrograms) or a mixture of NA (2.5 micrograms) and 5,6-dihydroxytryptamine (5,6-DHT; 2.5 micrograms) was intravitreally injected into the eyes 2-3 hr before enucleation. DA and IA cells were counted systematically in space on flat-mounted preparations. Both classes of cells were found to be distributed similarly in the two species of fish; the cell density is highest in the circumferential margin of the retina, and is slightly higher in a region dorsal to the optic disc than in the surrounding area. Differences in the distribution pattern of the cells between carp and catfish retinas were as follows: (a) the DA cell density is higher over the whole retinal field in carp (the mean density +/- SD = 34 +/- 16 cells/mm2) than in catfish (13 +/- 7 cells/mm2); (b) the region where the density is slightly higher than in the surrounding area is restricted to a small area immediately dorsolateral to the optic disc in carp, while it is relatively broadly placed dorsal to the optic discs, forming a horizontal band in catfish; (c) the density ratio of DA cells to IA cells is 1:1 in carp but 1:2 in catfish; and (d) catfish DA cells seem to be more irregular than carp DA cells in shape, size, dendritic arborization, uptake preference for monoamines intravitreally injected, and also in depth location seen in radial cryosections. PMID- 6842629 TI - Gastric mucosal cytoprotection by splanchnicectomy is based on protection of gastric mucosal blood flow. AB - Prior reports have shown the protective effect of splanchnicectomy against stress related gastric mucosal injury. The present study evaluated the possible relation of such cytoprotection with an effect on gastric acid secretion and gastric mucosal blood flow (GMBF). Miniature swine were divided into sham-operated and celiac ganglionectomy groups. Three weeks postoperatively all animals underwent hemorrhagic shock stress. Neither basal nor peak gastric acids was affected by splanchnicectomy or sham operations. Significant GMBF reductions occurred in early shock in both treatment groups. In the sham pigs these GMBF reductions persisted, while in the splanchnicectomy pigs, GMBF in late shock returned to normotensive levels. These results demonstrate that splanchnicectomy: 1) has no effect on basal or maximally stimulated gastric acid secretion, and 2) is associated with reestablishment of GMBF to preshock levels during sustained hypotension. These results indicate a beneficial effect on GMBF as a factor in gastric cytoprotection afforded by splanchnicectomy. PMID- 6842630 TI - Arterial injuries below the knee: fifty-one patients with 82 injuries. AB - Clinical features of tibial and peroneal artery injuries are characterized in a review of 51 patients with 82 injured arteries. Injuries were penetrating in 34 (67%) patients and blunt in 17 (33%). Physical findings suggested arterial injuries in 42 (82%) patients, but nine had no signs of vascular trauma. Nineteen patients with no palpable distal pulses had average preoperative delays of nearly 5 hours, suggesting a lack of appreciation for the morbid potential of these injuries. Operations included ligations of single-vessel injuries and arterial reconstructions in the 21 (41%) patients with two or more injured vessels. Amputations were necessary in eight (16%) patients. Limb loss was more frequent with blunt trauma (23%), shotgun wounds (33%), initial absent pulses (32%), and three injured vessels (60%). The frequency of limb loss with these injuries emphasizes the importance of early diagnosis, expedient operation, and thorough revascularization. PMID- 6842631 TI - Assessment of mediastinal widening associated with traumatic rupture of the aorta. AB - In order to best determine the reliability and usefulness of widening of the mediastinum (WMED) and other radiographic abnormalities in the selection of trauma patients for aortography to detect traumatic rupture of the aorta (TRA), we designed a blind study in which a panel of radiologists and surgeons reviewed 149 chest films of trauma victims who subsequently underwent aortography to rule out TRA. Sixteen patients had TRA. Panelists identified mediastinal widening (WMED) in 83 of 93 observations on films in cases of TRA (89%). There was a significant association between WMED and TRA found both for the panel as a whole and for each panelist individually (p = 0.0000), making this an extremely reliable sign both in terms of detectability and in signalling the need for aortography. Significant associations with TRA were also found overall for six other radiographic abnormalities but none of these was reliable for all panelists or was as sensitive as WMED in the detection of TRA. Despite the reliability of these signs, panelists making decisions based on the chest film alone failed to recommend aortography in seven of 93 instances of TRA. Direct mediastinal measurements varied by at least 2 cm among panelists in one half of the cases of TRA, and 25% of these (4/16) had at least two measurements of mediastinal width of 7 cm or less. Of all the radiographic signs associated with TRA, widening of the mediastinum is the most reliable, but in this study all observers would not have detected all cases of ruptured aorta using radiographic signs alone. Clinical judgment and consideration of the forces involved in the injury must continue to play an important role in the selection of patients for aortography. PMID- 6842632 TI - Failure of topical prostaglandin inhibitors to improve wound healing following deep partial-thickness burns. AB - The present study was designed to determine the efficacy of topical inhibitors of prostaglandins on wound healing. Two uniform deep partial-thickness burns were inflicted on mirror-image areas of guinea pig backs by an aluminum template heated to 75 degrees C and applied for 10 seconds. Indomethacin was tested extensively in a wide range of concentrations in groups of six or more animals each. The healing rates measured at 21 days postburn showed that topical indomethacin at each concentration tested was not effective for improving wound healing. In fact, the treated sites were consistently worse than the control sites. Moreover, the drug adversely affected the healing process proportional to the concentration and was associated with death, which was related to perforations of the GI tract. Also, the India ink filling in the dermal microcirculation was no better in the experimental wounds than in the controls. The evaluations for hair growth were definitely in favor of the controls. The other tested inhibitors, ibuprofen, flurbiprofen, tolmetin, zomepirac, piroxicam, and dipyridamole, also failed to show any benefit. PMID- 6842633 TI - Hematuria after blunt trauma: when is pyelography useful? AB - Blood in the urine is common following blunt abdominal trauma. Most trauma centers routinely perform limited intravenous pyelography (IVP), usually with cystography, in such individuals presenting with any degree of hematuria in order to identify urinary tract injury. The observation that the yield of positive IVPs is small among such individuals, and the suspicion that a positive IVP rarely leads to a substantive change in outcome, resulted in the following retrospective study. We reviewed our Trauma Center's records for all patients undergoing IVP following blunt trauma in a 1-year period. Virtually all individuals had a cystogram performed. Positive studies were defined by various kidney, ureteral, bladder, or urethral abnormalities; bladder deviation by extrinsic pelvic hematoma was not counted as a positive finding. Among 156 patients undergoing IVP for hematuria in this period, 13 (8.3%) had an abnormal IVP or cystogram. Of these 13 patients ten (77%) had either gross or 4+ hematuria. Five patients (3%) required further diagnostic or therapeutic intervention. One patient (0.6%) required nephrectomy when exploration revealed renal artery thrombosis causing irreversible kidney ischemia. All five patients who required further evaluation or therapy presented with gross or 4+ hematuria. Had screening IVP been performed only in blunt trauma victims presenting with gross or 4+ hematuria, no patients with significant urinary tract injury would have been missed, and 119 (75%) of the patients in this series would have been spared the expenditure of time and money, and the radiation and dye exposure, resulting from their negative studies. Individuals in whom the possibility of renal injury is high following blunt trauma (flank pain or hematoma, low rib fractures) should undergo rapid limited IVP for diagnosis of significant genitourinary tract injury. Such evaluation should also be carried out in asymptomatic individuals who present with gross or 4+ hematuria. Microscopic hematuria alone, however, is a poor predictor of significant genitourinary tract damage. Our review suggests that asymptomatic victims of blunt trauma who have only small amounts of blood in the urine may safely be observed without routine emergency IVP. PMID- 6842634 TI - Effect of hemorrhage and anoxia on hepatic gluconeogenesis and potassium balance in the rat. AB - Previous investigations have demonstrated impairment of hepatic gluconeogenic activity during both hypovolemia and sepsis, but the mechanisms responsible remain unclear. The present study was designed to determine the influence of lack of oxygen on gluconeogenesis independent of humoral factors, products of ischemic peripheral tissues or pH changes. Livers obtained from Sprague-Dawley rats fasted 24 hours were perfused with Krebs-Henseleit buffer containing 5 mM lactate for 30 minutes. In the control group (n = 8) perfusion was continued; in others, anoxia was induced by perfusing with buffer equilibrated with 95% N2 and 5% CO2 for periods of 15, 30, or 60 minutes (n = 4, 5, and 5, respectively). The initial conditions were then reinstituted for an additional 45 minutes. Anoxia caused hepatic release of K+, indicative of disordered hepatic cellular ionic gradients and an abrupt cessation of gluconeogenesis. Reoxygenation partially reversed these alterations but some impairment of gluconeogenesis persisted and the degree of uptake of K+ from the perfusion media was decreased as the duration of anoxia increased. The degree of restoration of gluconeogenesis after a period of anoxia was closely associated with restoration of cellular uptake of K+. By comparison, livers taken from hypovolemic animals maintained at a mean arterial blood pressure of 40 mm Hg until the beginning of the decompensatory stage of shock exhibited a gluconeogenic capacity of only 41% of control animals and was comparable to the compromise induced by between 30 and 60 minutes of anoxia. These results suggest that the abilities to restore hepatic electrolyte balance and gluconeogenesis after oxygen deprivation are affected in parallel and may reflect a common dependence on the restoration of ATP stores after the insult. PMID- 6842635 TI - A field evaluation of the Esophageal Obturator Airway. AB - The Esophageal Obturator Airway (EOA) has been considered an effective ventilatory technique for cardiopulmonary resuscitation; however, few studies of its field effectiveness have been performed. We evaluated the EOA in 158 cases of prehospital cardiac arrest resuscitated by EMT II personnel utilizing the EOA for airway maintenance. The time of insertion from arrival of the unit and the number of unsuccessful attempts were recorded. The EOA took longer than 4 minutes to insert in 47% of cases. It was incapable of being placed in 18.3% of cases, and required two or more attempts at insertion in 30%. There were six survivors in this series (3.7%). Subsequently, we measured arterial blood gas levels during ventilation with the EOA and after endotracheal intubation in 13 patients. Arterial oxygen tension greater than 60 mm Hg was achieved in only four of 13 patients with the EOA. All patients were hypercarbic and acidotic using the EOA. There was marked improvement in all parameters following ET intubation. The EOA presents technical problems which make it inferior to ET tubes in resuscitation of individuals in the field with cardiac arrest. Close monitoring of its use should be undertaken in areas where it is the primary method for airway maintenance. PMID- 6842636 TI - Fat release after femur nailing in the dog. AB - Internal fixation of fractures in the first few hours following injury has important advantages. It can diminish continued blood loss, improve patient mobility, and may help avoid pulmonary and cardiovascular complications of multiple trauma. Fear of increased risk of fat embolism has limited its use. We studied the release of fat during intramedullary reaming and nailing of the femur in dogs. Comparing fat release from an intact and a fractured femur in each dog, significantly more triglyceride was released from the intact bone than from the fractured femur. Thus, reaming a fractured bone produces minimal embolization. The presence of a fracture may decompress the pressure in the medullary canal, minimizing the release of fat into the circulation during acute internal fixation. This could help to explain the low incidence of clinical fat embolism syndrome associated with immediate intramedullary nailing of the femur. PMID- 6842637 TI - External fixation of complex hand and wrist fractures. AB - From 1977 to 1980 fixation with an external fixateur was performed in 33 injuries of the upper extremity: ten fractures of the hand, 22 Colles' fractures, and one osteotomy for Madelung's deformity. Application was primary in 19 patients and after another type of fixation (cast or Kirschner wire) had failed to hold reduction in 14 patients. All ten hand fractures healed in 4 to 12 weeks, and the distal radius fractures united in 6 to 10 weeks. The external fixateur for unstable fractures of the hand and wrist with bone or soft-tissue loss provides rigid skeletal stabilization, accessibility for wound care, and early joint mobilization. PMID- 6842638 TI - A rural regional trauma center. AB - New developments in the organization of trauma care management at the Mayo Clinic are presented along with a review of the first 4 years' experience of a Regional Trauma Center at the Mayo Clinic-affiliated Saint Marys Hospital. Application of the Injury Severity Score (ISS) in the analysis of blunt traumatic deaths has permitted an internal evaluation of trauma care, as well as comparison with other reported emergency trauma care delivery systems. Although additional challenges remain, results indicate that the trauma center concept can be applied just as effectively in a rurally located tertiary facility as in a large metropolitan area. PMID- 6842639 TI - Free vascularized bone transplants in problematic nonunions of fractures. AB - Three cases with nonunion of long bones and problems of bone loss or infection, when conventional bone graft would probably not have been successful, were treated successfully by free vascularized bone transplant to provide a vascular bed in the nonunion site and internal splint, the donor bone being the composite rib graft based on posterior intercostal vessels and proximal fibula based on its peroneal vascular pedicle. The operative technique was divided into five stages, and each stage posed different problems at the donor and recipient areas and vessel anastomoses. Despite these disadvantages, all three cases proceeded to solid bony union in less than 4 months after surgery. Thus the patients were able to be rehabilitated early to retain satisfactory limb function within a relatively short period of time. PMID- 6842640 TI - Traumatic rupture of the right hemidiaphragm: case report of an unusual means of diagnosis. AB - It has been reported that 10 to 20% of all traumatic diaphragmatic ruptures are missed on initial evaluation, only to be discovered at a later date (1). In the chronic state an abnormal chest X-ray, symptomatic visceral incarceration, or barium contrast studies often lead to the correct diagnosis. This is a case of chronic diaphragmatic injury secondary to trauma being discovered when a diagnostic thoracentesis yielded viscous bile. With the needle left in situ a dye study was performed which demonstrated not only a normal cholangiogram, but also a chronic diaphragmatic rupture with partial herniation of the liver. We feel that this case represents a very unusual presentation of an uncommon injury. PMID- 6842641 TI - Blunt traumatic rupture of the right atrium and the right superior pulmonary vein. AB - Blunt trauma to the chest may produce a spectrum of cardiac lesions extending from asymptomatic myocardial contusion to rapidly fatal cardiac rupture. A case is discussed in which a patient with signs of cardiac tamponade after blunt trauma was found to have a rupture of the atrium. During repair of the cardiac injury, an unusual tear of the right superior pulmonary vein was also discovered. Both injuries were successfully repaired and the patient recovered. PMID- 6842642 TI - Traumatic abdominal wall hernia. AB - Traumatic herniation of the abdominal wall is an unusual injury. Early morbidity is related to associated intra-abdominal organ injuries which are common. Late complications due to intestinal incarceration and strangulation can occur. Immediate celiotomy is necessary for hernia reduction and repair and for evaluation of intra-abdominal organ injury. This approach obviates any late complications. PMID- 6842643 TI - Basal bodies in the immotile-cilia syndrome. PMID- 6842644 TI - Structure and motility of the 9 + 0 flagellum of eel spermatozoa. AB - Scanning and electron microscopic study of the spermatozoon of the eel, Anguilla anguilla, has shown that the large oblong head is attached eccentrically by one end to the basal end of the true flagellum and contains a pseudoflagellum that splits into two groups of tubules as it passes around the nucleus. The 9+0 axoneme of the true flagellum lacks outer dynein arms and the radial spoke complex. The movement of Anguilla sperm is characterized by rapid forward progression that is the result of left-handed helicoidal waves propagated distally at a beat frequency at 21 degrees of about 95 Hz. Thus, these sperm flagella, although reduced in structure, propagate three dimensional rather than planar waves as in sea urchin sperm flagella, and beat at a frequency which so far as we know is the highest observed in eukaryotic flagella. PMID- 6842645 TI - The structure and function of sensory cilia. PMID- 6842646 TI - Evolution of filipin-sterol complexes and intramembrane particle distribution during ciliogenesis. AB - Membrane events during ciliogenesis were studied in the quail oviduct cells. Two membrane domains differentiate during ciliogenesis: the ciliary necklace progressively composed of one to six rows of intramembranous particle (IMPs), and the shaft membrane poor in IMPs but characterized by a high content of sterol. Membrane sterol can be detected by the use of filipin which forms filipin-sterol complexes (f-c complexes) visible in electron microscopy on both freeze fracture replicas and thin sections. During ciliary growth, the necklace IMP rows are progressively organized in an area completely devoid of f-c complexes whereas the membrane of growing shaft shows a high density of f-c complexes except at the ciliary tip. PMID- 6842647 TI - Microtubule assembly onto dissociated structures of mouse spermatids and spermatozoa. PMID- 6842648 TI - Localized reactivation of the principal piece of demembranated hamster sperm by iontophoretic application of ATP. AB - Mature hamster sperm were demembranated with Triton X-100, and the principal piece of the flagellum was reactivated by iontophoretic application of ATP. The response was a brief local straightening of a short length of the flagellum followed by the formation of a pair of bends at the two ends of the straight region. The formation of a PR (principal and reverse bends in a proximo-distal sequence) or an RP bend-pair is interpreted as a result of active sliding of doublet subset (1-4) or (6-9) respectively in the interbend region. The percentage of PR responses increased with the initial local curvature of the resting R bend and the distance of the stimulated site from the flagellar base, and decreased with the age of the preparation. PMID- 6842649 TI - Tubulin amino acid sequence and consequences. AB - The 451 residues of alpha-tubulin from pig brain and the 445 residues of the beta subunit display 41% sequence identity. Although the primary structure is highly conserved during evolution, several positions in each of the chains are heterogeneous, indicating four alpha-variants and two of the beta-polypeptide. Both C-terminal parts are highly acidic. Small regions can be correlated to sequences of nucleotide binding proteins. Cysteine beta 201 may be involved in the colchicine binding site. PMID- 6842650 TI - Motile spermatid flagella during differentiation. AB - Flagella of living early human and rat spermatids show slight differences in duration of motion as revealed by phasecontrast microscopy and videotechnique. Wave-like motion of these 9+2-axonema becomes restricted to bending at later stages in the rat, whereas spermatozoa were found immotile in both species. Additional results were obtained from freely swimming spermatids of the rat and from the inner surface of rat seminiferous tubules, rinsed free of spermatozoa prior to scanning electron microscopy. Obviously, spermatids from some kind of flagellated cell layer that could be involved in liberating mature stages and in facilitating spermatozoa to glide more easily along seminiferous tubules. PMID- 6842652 TI - Recurrent vestibulopathy. PMID- 6842651 TI - Cinematographic analysis of bovine epididymal sperm motility: epididymal maturation and forward motility protein. PMID- 6842653 TI - Melanomas of the head and neck. AB - Melanomas of the skin and mucous membranes of the head and neck region are an uncommon problem for most clinicians. The article emphasizes the differences in terms of biological aggressiveness and treatment between lentigo maligna (LM) and lentigo maligna melanoma (LMM), superficial spreading melanoma (SSM), and nodular melanoma de novo. The results of radiotherapy in the treatment of melanoma of the head and neck are reviewed, and indications are suggested for the use of irradiation in the management of patients with this tumor. A brief discussion of the results of treatment of mucosal melanomas is given. PMID- 6842654 TI - [Comparative ultrastructural study of spermiogenesis in Monogenea. 1. Megalocotyle (Monopisthocotylea Capsalidae)]. AB - In Megalocotyle the zones of differentiation (ZD) are short and incomplete; there is no median cytoplasmic process or free flagella. Some peripheral microtubules are present in early ZD, but they disappear. Each nucleus of the common cytoplasmic mass inserts one extremity into a ZD. The mitochondria fuse around this extremity and form a beadlike perforated sphere. Later this sphere slides along the nucleus away from the plasmic membrane like a bead on a string. Each mitochondrial bead (MB), as it moves, trails part of its bulk in the form of a solid streamer; two parallel centrioles follow the MB, each generating a trailing 9 + "1" flagellum. The result is a four-part ensemble extending from each MB to each ZD: the two axonemes, the streamer, and the nucleus, with no membrane separating it from the surrounding cytoplasm. Subsequently a cytoplasmic canal (CC) is formed. The arching membranes, originally located at the base of the ZD, migrate along the four-part ensembles as far as the MB, leaving behind two membranes which define the CC. This formation of the CC is remarkable in that it occurs after migration of the centrioles. At the end of spermiogenesis, the cytoplasmic mass reveals 64 parallel CC each containing an immature spermatozoid whose free rear extremity lengthens out. Each spermatozoid is then detached at its anterior extremity set in the cytoplasmic mass. As in most monopisthocotylean monogeneans, the mature spermatozoid of Megalocotyle lacks peripheral microtubules, although its early ZD has microtubules which subsequently disappear. This feature distinguishes it from trematodes and polyopisthocotylean monogeneans, whose mature spermatozoid keep their ZD microtubules. PMID- 6842655 TI - Stereoscopic scanning electron microscopy of the chromosomes in Vicia faba (broad beans). AB - Metaphase chromosomes of Vicia faba (broad beans) were observed in situ with a scanning electron microscope by cryofracturing the cell. The chromosome is composed of tortuous fibers 500 A in diameter. They may be seen distributed randomly, but sometimes they are seen running parallel in the chromosome. The parallel fibers spiral around the main body of the chromosome, whereas they run longitudinally in the secondary constriction. If a chromosome is composed of a single strand (unineme hypothesis for the chromosome), the parallel fiber arrangement may imply that a single fiber is looping back and forth in the chromosome. PMID- 6842656 TI - Analysis of erythrocyte-mediated microinjection by backscattered electron imaging. AB - The process of chicken erythrocyte-mediated microinjection of cultured BHK cells was studied by correlative secondary and backscattered electron imaging. The intense staining of the chicken erythrocyte nucleus by uranyl acetate was found to produce a backscattered electron signal sufficient to follow its position during cell fusion and microinjection. Initially, the erythrocyte ghosts were found to bind to the target cell surfaces. The microinjection process was complete within 2 to 4 hr, as evidenced by the presence of the erythrocyte nucleus within the cytoplasm of the target cell. By 24 hr, the internalized erythrocyte nuclei were difficult to distinguish by backscattered electron imaging. Some erythrocyte ghosts entered the cells intact by some method other than cell fusion, presumably phagocytosis. PMID- 6842657 TI - Banded fibers in tropoelastin coacervates at physiological temperatures. AB - Tropoelastin was purified from aortas of chicks grown on a beta aminopropionitrile-containing diet. The preparation could be considered pure following the criteria of amino acid composition and gel electrophoresis. When aqueous solutions of tropoelastin (5 mg/ml) were warmed to 40 degrees C (physiological temperature for chicken) for 10 min, and observed by negative staining electron microscopy, it revealed the presence of two kinds of ordered structures. One consisted of densely packed parallel filaments with a center-to center distance of about 5 nm, and the other of banded fibers, 100-150 nm in diameter, with a cross periodicity of about 55 nm. In some areas the fibers appeared to be formed by lateral aggregation of 1.5-2-nm-thick microfilaments. The fibers were similar to those previously obtained with the synthetic polypentapeptide of elastin (Val-Pro-Gly-Val-Gly)n and degradation products of elastin at temperatures much higher than the physiological one. The results indicate that the property of tropoelastin to form ordered structures is intrinsic to some of the polypeptide sequences of the molecule and that hydrophobic forces are involved in the formation of the aggregates. PMID- 6842659 TI - Ultrasonographic findings in diseases of the appendix. AB - Ultrasonographic findings in patients with diseases of the appendix, including acute appendicitis, suspected appendiceal abscess, and palpable right-lower quadrant abdominal mass, are described. An appendiceal abscess may manifest as a cystic mass, a mixed solid and cystic mass, or a hypoechoic solid mass. An appendiceal calculus within an abscess can be recognized as a hyperechoic structure with acoustic shadowing. On ultrasonography, acute appendicitis in female patients may mimic tubo-ovarian disease. Ultrasonographic features of isolated Crohn's disease of the appendix and mucocele of the appendix are also described. PMID- 6842658 TI - Intrauterine bleeding following transplacental amniocentesis. PMID- 6842661 TI - Real-time ultrasonography of the posterior fossa. AB - The authors ultrasonographically identified abnormalities of the posterior fossa associated with meningomyelocele (Arnold-Chiari type II malformation), Dandy Walker malformation, extracerebellar hemorrhage, and post-hemorrhagic enlargement of the fourth ventricle. Normal anatomic and pathologic features of the posterior fossa are illustrated, and the use of realtime ultrasonographic sector scanning in the posterior fossa is discussed. PMID- 6842662 TI - Gallbladder wall thickening secondary to focal lymphatic obstruction. AB - Gallbladder wall thickening (3 mm or greater) has been described as a sign of acute or chronic inflammatory disease of the gallbladder. However, gallbladder wall thickening is a nonspecific finding in contracted, postprandial gallbladders and in cases of hypoproteinemia, elevated portal venous pressure, congestive heart failure, multiple myeloma, and hepatitis. This report describes the case of a patient who had a markedly thickened gallbladder wall secondary to focal obstruction of gallbladder lymphatic drainage by malignant lymphoma in the portal lymph nodes. PMID- 6842660 TI - Mobile intraluminal masses of the gallbladder. PMID- 6842663 TI - Polyorchidism diagnosed preoperatively by ultrasonography. AB - Polyorchidism, or multiple testes, is a rare condition that has been referred to in both medical literature and mythological folklore. Curious attributes have been ascribed to men with this condition, including supposed increased sexual prowess and virility. In the medical literature, the examples of supernumerary testicles have demonstrated only one additional testis. The first proven case of an extra testicle was by Lane, in 1895. Boggon reviewed 11 additional cases in 1933, and numerous other cases have been reported since then. To date, there has not been a preoperative ultrasonographic study that adequately describes this phenomenon. PMID- 6842664 TI - Chorioangioma of the placenta causing intrauterine fetal demise. PMID- 6842665 TI - Legal suits involving ultrasound. PMID- 6842666 TI - Ultrasonographic demonstration of floating particles in amniotic fluid. AB - This prospective study of 131 pregnant women was designed to determine the incidence and significance of floating particles in amniotic fluid. Floating particles ranging in size from 1 to 5 mm were seen in the amniotic fluid of pregnant women at 15 to 40 weeks' gestation. Since vernix is rarely present before 35 weeks' gestation, a source other than flakes of vernix must be sought to explain the floating particles in amniotic fluid in early gestations. There was no significant difference in the sizes or numbers of particles at different gestational ages (from 15 to 40 weeks). Therefore, it is concluded that ultrasonographic demonstration of floating particles in amniotic fluid cannot be considered an indicator of fetal maturity. PMID- 6842667 TI - A prospective evaluation of fetal femur length as a predictor of gestational age. AB - Variability (+/- 2 SD) in prediction of fetal gestational age from ultrasonographic measurements of fetal femur length was evaluated prospectively in 287 fetuses between 18 and 42 weeks' gestation. Variability increased throughout pregnancy, ranging from +/- 11.6 days between 18 and 24 weeks to +/- 22.7 days in the last six weeks of pregnancy. These findings are comparable with variability in prediction of gestational age from biparietal diameter measurement between 18 and 42 weeks, which indicates that the femur length may serve as an adequate alternative for prediction of gestational age in cases in which the biparietal diameter cannot, for technical reasons, be obtained. PMID- 6842668 TI - Estimation of volume and weight of the perinate: relationship to morphometric measurement by ultrasonography. AB - A method of determining fetal weight in utero was developed by use of real-time ultrasonography. A volume model representing trunk and limbs as cylinders with dimensions related to morphometric parameters was tested on 60 neonates. Head volumes in these 60 neonates were determined from equations relating head morphometric measures to head volume in 30 neonatal autopsy specimens. Head density and trunk and limb density were determined separately on the 60 neonates by study of the variation in overall density with body proportions. From these density and volume values, total body mass was estimated. The deviation of neonatal weight estimates from actual weights at three days postpartum was +/- 4.1 per cent (1 SD). The validity of this method for fetal weight determination was tested by in utero ultrasonographic measurement of 31 fetuses before delivery by cesarean section. The deviation of the weight estimate from the actual weight at three days postpartum was +/- 8.1 per cent (1 SD), or +/- 7.4 per cent (absolute mean error). PMID- 6842669 TI - Effect of display format on detectability. AB - The effects of black-echo (black dots on white background) and white-echo (white dots on black background) display formats on detectability of a wire embedded in an echogenic test object were compared. Trained observers were asked to note the presence or absence of the wire on a randomized series of 528 B scans (264 black echo and 264 white-echo images), half of which contained a wire. The scans not containing a wire were used as controls. The specificity of the white-echo display (75 per cent) exceeded that of the black-echo display (54 per cent), with statistical significance at the 99 per cent confidence level. There was no measurable difference in sensitivity. These results are explained in terms of principles of visual physiology. PMID- 6842670 TI - An ultrasonographically solid, tumor-like appearance of echinococcal cysts in the liver. PMID- 6842672 TI - Echocardiographic demonstration of pericardial fluid adjacent to the right atrial wall. PMID- 6842671 TI - Relationship between Grade III placentas and biparietal diameter determinations. AB - Grade III placentas were found in 133 (12 per cent) of 1,082 pregnant women evaluated ultrasonographically after 20 weeks of gestation. Associated biparietal diameter measurements ranged from 7.2 to 10 cm. In 11 women with no complications known to accelerate fetal lung maturity or to induce premature placental maturation, grade III placentas were observed between 30 and 33 weeks of gestation. Gestational ages determined according to the growth adjusted sonographic age method of Sabbagha were accurate within one to three days. Considering the risk of hyaline membrane disease at those gestational ages, a grade III placenta cannot be equated with fetal lung maturity. Criteria other than placental grading should be used to assess the pulmonary status of the fetus. PMID- 6842673 TI - Systemic lupus erythematosus: another etiology of the target sign. PMID- 6842674 TI - Ultrasonographic diagnosis of cervical ectopic pregnancy. PMID- 6842675 TI - Ultrasonographic demonstration of pelvic tuberculosis. PMID- 6842676 TI - Intraventricular hemorrhage following ventriculoperitoneal shunt placement: real time ultrasonographic demonstration. PMID- 6842677 TI - Ultrasonographic diagnosis of second-trimester skeletal dysplasias: a prospective analysis in a high-risk population. AB - Sixteen pregnancies in 15 women at high genetic risk for having fetuses with skeletal dysplasias were examined by use of ultrasonography during the second trimester. In addition to the routine examination of fetal head and body, the fetal calvarium, spine, ribs, pelvis, and long bones were specifically evaluated for bone brightness, deformity, fractures, and inappropriate growth. It was determined that 11 of the 16 fetuses were normal and five were abnormal. At birth, all 11 ultrasonographically determined normal fetuses were normal, and at birth or elective termination of pregnancy the other five were abnormal. All abnormalities detected by ultrasonography in the affected fetuses were found at delivery, including decreased bone brightness, deformity of the head and long bones, and fractures and abnormal growth of the long bones. On the basis of this study, it is felt that ultrasonography is highly accurate for the diagnosis of many second-trimester skeletal dysplasias. PMID- 6842680 TI - Structural relationships between minor and major proteins of hepatitis B surface antigen. AB - The minor glycoproteins from hepatitis B surface antigen, GP33 and GP36, contain at their carboxy-terminal part the sequence of the major protein P24. They have 55 additional amino acids at the amino-terminal part which are coded by the pre-S region of the viral DNA. PMID- 6842679 TI - Nucleotide sequence of the vaccinia virus thymidine kinase gene and the nature of spontaneous frameshift mutations. AB - Nucleotide sequencing of a 1,300-base-pair vaccinia virus DNA segment previously shown to contain a thymidine kinase (TK) gene revealed an uninterrupted reading frame of 177 codons capable of producing a polypeptide with a molecular weight of 20,102. Mapping of the TK mRNA by primer extension indicated a unique 5' end that precedes the initiation codon by only six nucleotides. Multiple 3' ends within a 10-nucleotide region, about 30 nucleotides beyond the termination codon, were located by nuclease digestion of DNA-RNA hybrids, and the length of the TK transcript, exclusive of polyadenylate, was estimated to be approximately 570 nucleotides. The region preceding the TK mRNA start site is extremely A + T rich and has sequence homologies with three other early genes. Genetic information is so compressed in this region of the DNA that the putative transcriptional regulatory sequence of the TK gene overlaps the coding sequence of a late gene. Only nine nucleotides separate the termination codon of the late gene from the initiation codon of the TK gene. Downstream, 66 nucleotides separate the TK termination codon from the apparent initiation codon of another early gene. The nature of three independent TK- mutants was revealed by nucleotide sequencing. Each has a nucleotide reiteration leading to a +1 frameshift and a nonsense codon downstream. The location of one frameshift mutation provided evidence that the first ATG is used for initiation of protein synthesis. PMID- 6842678 TI - Role of antibodies and host cells in plaque enhancement of Murray Valley encephalitis virus. AB - Chicken antisera to Murray Valley encephalitis (MVE) virus, when incubated with virus and assayed for plaques on chicken embryo (CE) monolayers, neutralized MVE virus at high concentrations of antibody, but caused increases in plaque counts at low concentrations of antibody. Plaque enhancement did not occur when the same virus-antibody mixtures were assayed on a continuous line of rhesus monkey kidney cells (LLC-MK2), nor when the anti-MVE antibody was of mammalian origin and the assay system was CE monolayers. Correspondingly, chicken anti-MVE did not enhance the plaque formation of MVE virus in a stable line of mouse macrophages, P-388D1, whereas rabbit and mouse anti-MVE did enhance plaque formation. This enhancing activity was associated with noncytophilic immunoglobulin G (IgG). The Fc terminus of the IgG molecule was required, as no plaque enhancement occurred with chicken anti-MVE Fab. These data indicate that there is a requirement for taxonomic complementarity between Fc termini and Fc receptors in the above systems. CE cell monolayers were found to contain approximately 2% of Fc receptor bearing cells among the fibroblast-like cells. Fc receptor-bearing cells in CE monolayers were isolated and found to be of the mononuclear phagocytic lineage. These mononuclear phagocytes, which originate in lymphoid tissues and blood associated with CE tissue fragments, are integrated into primary CE monolayers and form infectious centers in the presence of virus and low dilutions of antibody. PMID- 6842681 TI - Evidence that bacteriophage T4 eph1 is a missense hoc mutation. AB - An electrophoretic mutation of bacteriophage T4, eph1, appears to code for a missense hoc (highly antigenic outer capsid) protein. This is based on the observation that particles lacking hoc protein (hoc- particles), after incubation in a crude extract of Escherichia coli infected with phage carrying the eph1 mutation acquired the electrophoretic mobility of the eph1 strain (the electrophoretic mobility of the eph1 strain itself is slower than that of hoc- particles). Thus, it is likely that during infection of E. coli with the eph1 strain, a hoc protein is made that has a lower negative charge than normal hoc protein but can nevertheless bind to particles lacking hoc protein. These results confirm that eph1 is a hoc mutation. PMID- 6842682 TI - Isolation of a nondefective recombinant between adenovirus type 5 and early region 1A of adenovirus type 12. AB - A nondefective recombinant between adenovirus type 5 (Ad5) and type 12 (Ad12), rc 1 (Ad5 dl312, carrying the Ad12 E1A gene), was isolated from hamster cell foci transformed by a defective recombinant, rcB-1 (dl312, carrying the Ad12 E1 gene). The recombinant rc-1 grew in human embryo kidney and KB cells in the absence of helper and synthesized Ad12 T antigen g, the product of the E1A gene. The genome of rc-1 has a deletion between 79.9 and 82.5 map units of Ad5 dl312 DNA with an insertion of 0.1 to 5.5 map units of Ad12 DNA at the deletion site. The mRNAs of Ad12 E1A were transcribed from the Ad12 E1A promoter, and unusual RNAs were abundantly transcribed from the Ad5 E3 promoter on the opposite strand. The frequency of cell transformation with rc-1 was lower than those with Ad5 and Ad12 wild types. PMID- 6842683 TI - Structural proteins and cell-free translation products of total RNA and hybrid selected RNA from two DNA variants of vaccinia virus. AB - Two major variants of vaccinia virus, large (L) and small (S), differ by a deletion of 9.7 kilobase pairs. The structural proteins and the translation products of RNA transcribed in vitro from each of these variants were analyzed by gel electrophoresis. Recombinant plasmids were used to select RNA transcribed from the L variant sequences corresponding to the deletion. This RNA yielded translation products indicating that a minimum of 11 polypeptides, including two structural proteins, map within the deletion. PMID- 6842684 TI - On the sequential packaging of bacteriophage P22 DNA. AB - Bacteriophage P22 is thought to package daughter chromosomes serially along concatemeric DNA. We present experiments which show that the average DNA packaging series length increases with time after infection, which supports this model. In addition, we have analyzed the effect on average series length of lowering the amount of the various individual proteins involved in DNA packaging. These results support the notion that the protein products of gene 2 and gene 3 are both more stringently required for initiation of sequential DNA packaging series than for their extension, and they are compatible with a model for the control of series length in which that length is determined, at least in part, by a competition between series initiation events and extension events. PMID- 6842685 TI - Varicocele: still an enigma. PMID- 6842686 TI - Polycystic disease of the renal sinus: structural characteristics. AB - Based on a series of 32 identified cases the radiologic, sonographic and anatomic features of polycystic disease of the renal sinus are described. This entity is a bilateral accumulation of thin-walled clear fluid-filled cysts, intertwined with the caliceal infundibula and usually confused radiologically with adult polycystic kidney disease or with renal sinus lipomatosis. Computerized tomography and sonography demonstrate the parenchyma to be free of cystic disease and the hilus to be free of fat accumulation. This newly recognized entity has a completely benign natural history. PMID- 6842687 TI - Complications of transabdominal radical nephrectomy for renal cell carcinoma. AB - Our data from 193 patients demonstrate that most renal cell carcinomas can be removed with acceptable mortality and morbidity by transabdominal, transperitoneal radical nephrectomy through an upper midline incision. During this study only 12 tumors were removed via a different approach. Four patients, all with stage IV disease, died postoperatively, for an operative mortality of 2.1 per cent. The intraoperative and postoperative complication rates were 20.7 and 19.1 per cent, respectively. The most common complication was injury to the spleen, which occurred in 24 patients (12.4 per cent) and probably represents the greatest potential disadvantage of this approach. PMID- 6842689 TI - Ureterocolic diversion of urine: management of some difficult problems. AB - During the last 11 years 37 patients were treated with ureterocolic diversion of the urine by means other than classic ureterosigmoidostomy. By altering the technique of joining the ureters to the colon this method of internal urinary diversion is possible even in cases when it would not be feasible by more traditional methods. PMID- 6842688 TI - Pyeloplasty for ureteropelvic junction obstruction in adults: correlation of radiographic and clinical results. AB - Pyeloplasty for hydronephrosis secondary to ureteropelvic junction obstruction is a proved efficacious procedure. In many cases the clinical improvement effected by technically successful pyeloplasty in children has been reported to exceed substantially radiographic improvement in caliceal appearance. To address this issue in the adult population we did a retrospective review of 52 patients who had undergone pyeloplasty for ureteropelvic junction obstruction. In 91 per cent of the patients the clinical result was satisfactory, while improvement was observed in 92 per cent of the renal units that could have been expected to benefit. The caliceal appearance on the postoperative excretory urogram was normal in only 25 per cent of the cases, showed diminution of calicectasis in 65 per cent, was unchanged in 30 per cent and deteriorated in 5 per cent. Earlier appearance of contrast medium in the upper ureter on the postoperative excretory urogram was seen in all patients who had a satisfactory clinical result. Deterioration of caliceal grade or delayed appearance of contrast medium in the ureter in the postoperative excretory urogram always was associated with a poor clinical result and/or further parenchymal loss. While a salutary effect of a technically successful operation on the clinical manifestations of hydronephrosis secondary to ureteropelvic junction obstruction is not necessarily correlated with improved or normal caliceal appearance it does correlate strongly with improvement of drainage as manifested by earlier appearance of contrast medium in the ureter. Deterioration of the caliceal grade or delayed appearance of contrast medium in the ureter implies that effective drainage is not present, which presages a poor clinical outcome and further loss of renal parenchyma. PMID- 6842690 TI - Treatment of the epispadias-exstrophy complex with the AS792 artificial urinary sphincter. AB - The AS792 artificial urinary sphincter was implanted in 11 incontinent patients with the epispadias-exstrophy complex. To date 10 patients (91 per cent) are totally continent of urine with normal renal function and intact urinary systems. The recent reports concerning success with bladder neck reconstruction in this syndrome are reviewed. Owing to the relatively poor success of this procedure in achieving total urinary continence it is recommended strongly that insertion of the artificial urinary sphincter be the initial anti-incontinence procedure for these patients. The success rate with the artificial sphincter currently is superior to any form of bladder neck reconstruction in patients with the epispadias-exstrophy complex. PMID- 6842691 TI - The hemodynamics of erection at the level of the penis and its local deterioration. AB - We have studied penile structure in 300 specimens from cadavers, 3,000 patients undergoing general physical examination and more than 700 patients operated on for organic impotence. Special attention has been focused on the closure mechanism of the corpora cavernosa during erection. Venous outlets of the corpora cavernosa normally are situated only on the distal third of the ventral penile surface. A firm, lasting erection requires a tight albuginea of the corpora cavernosa, with perfect closure of the venous outlets. During life use of the penis or, eventually, misuse by repeated long-lasting, firm erections (high pressure in the corpora cavernosa) results in deterioration of the tightness of the albuginea, especially when the albuginea is thin (25 per cent of the cases). We have found that a leakage factor of the corpora cavernosa is the most frequent cause of organic impotence in aging men. PMID- 6842692 TI - Topical beta-aminopropionitrile in the treatment of Peyronie's disease. AB - We treated 9 patients with Peyronie's disease for 1 to 8 years in duration with a 4-week course of beta-aminopropionitrile free base as the pure liquid. The drug was applied topically to the plaques twice daily. Patients were followed with ultrasound imaging of the plaques and saline inflations of the corpora cavernosa with photographic documentation of the deformity. No significant adverse effect was noted. Three patients experienced a subjective response but did not demonstrate objective change on the aforementioned studies. It was concluded that topical beta-aminopropionitrile was not effective in reversing the deformity of Peyronie's disease. Further investigation into specific anti-collagen drugs for the treatment of this condition may be warranted. PMID- 6842693 TI - Venous tension patterns in cord veins. II. After varicocele correction. AB - We studied 60 patients to evaluate the success of surgical correction of varicocele in lowering the venous tension in cord veins and to define the relationship of venous tension improvement to restoration of testicular function. Preoperative semen examination, testicular biopsy and venous tension measurements were performed. All patients had venous hypertension and reflux in the left cord. Venous tension was normal on the right side except in 6 patients with venous hypertension despite absent cord varicosities and reflux. An operation was done on the left side in all patients. Postoperative venous tension measurements and semen examination were performed. Of the 53 patients with improved venous tension postoperatively 39 had normal sperm counts with 17 resultant pregnancies. The semen quality in the 7 patients with persistent venous hypertension on the left side did not change except after surgical revision, which resulted in marked improvement in 4 patients with 2 pregnancies. The postoperative venous tension in the right cord veins remained normal. The 6 patients with venous hypertension on the right side had no change until an operation lowered the venous tension to normal, with subsequent improvement in semen quality in 4. The importance of varicosity and reflux in the evaluation of postoperative venous tension is emphasized. The factors involved in the prognosis after varicocele correction are mentioned. The cause of nonimprovement of semen character after a varicocele operation despite normalization of venous tension is discussed. The indications for postoperative venous tension measurement are outlined. PMID- 6842694 TI - Treatment of advanced seminoma with pre-radiation chemotherapy. AB - Seminoma is one of the most radiosensitive of solid tumors. However, the survival rate of patients with clinically advanced stages B3 and C disease is poor. Because of this dismal prognosis we instituted a protocol of pre-radiation chemotherapy in an attempt to improve the survival rates. A chemotherapeutic regimen, consisting of 2 to 3 courses of vincristine, actinomycin D and cyclophosphamide, was administered before radiotherapy. Of 16 patients studied 15 (93.7 per cent) had a complete response to the combined treatment regimen. We believe that pre-radiation chemotherapy is indicated in all patients with advanced seminoma. PMID- 6842695 TI - Scrotal reconstruction using thigh pedicle flaps. AB - A technique is described for reconstructing the scrotum in patients who have sustained massive loss of the skin overlying the scrotum and perineum. Scrotal reconstruction with superior and laterally based thigh flaps was done in 3 patients and all 3 had an acceptable cosmetic result. The procedure has the advantage of simplicity, early closure of the wound, excellent cosmetic appearance and maintenance of testicular function. PMID- 6842696 TI - Vasectomy and the incidence of hospitalized illness. AB - To determine the long-term effects of vasectomy on health we studied the incidence of hospitalized illness in 4,385 vasectomized and 13,155 age and race matched nonvasectomized men. In none of the 16 disease groupings we examined was the incidence of hospitalized illness in the vasectomized men significantly different from that in the nonvasectomized men, considering men with all durations of vasectomy. Neither the incidence of acute myocardial infarction, other ischemic heart disease nor that of all atherosclerotic diseases considered as a group was significantly different between the vasectomized and nonvasectomized men, even in those whose duration of vasectomy was 10 years or more. These data are reassuring, providing no evidence for an adverse health effect of vasectomy in men. PMID- 6842697 TI - Surgical treatment of stage A2 prostatic carcinoma: significance of tumor grade and extent. AB - Patients with stage A2 carcinoma of the prostate are a heterogeneous population and not all of them progress to clinically manifest disease. We found a similar variability in terms of the pathological findings in a group of 34 patients with stage A2 disease undergoing pelvic lymphadenectomy and radical prostatectomy. While 8 patients (24 per cent) had metastatic disease on staging lymphadenectomy, 9 patients (27 per cent) had negative lymphadenectomy, with minimal or no residual tumor in the radical specimen. The histologic grade and extent of tumor on transurethral resection did not predict reliably patients with stage A2 disease and minimally invasive cancer at radical prostatectomy. It appears that present criteria for separating stage A tumors into focal and diffuse categories are adequate for selecting therapy for patients with incidental carcinoma of the prostate. PMID- 6842698 TI - Urodynamic characterization of incontinence in the elderly by bladder volume. AB - Incontinence in the elderly patient usually is of the urgency pattern owing to inappropriate detrusor contraction often termed detrusor instability. We herein describe a bladder volume-based method of urodynamic assessment that may help to characterize subsets of incontinent patients with detrusor instability. The conventional parameters of flow, pressure and electromyography are more difficult to measure and may be less appropriate for selection of therapy. PMID- 6842699 TI - Long-term followup of spinal cord injury patients managed by intermittent catheterization. AB - Intermittent catheterization was used for permanent management in 41 patients with neurogenic vesical dysfunction. Patients with reflex and areflexic vesical dysfunction were managed satisfactorily by the technique. Positive urine cultures were relatively infrequent, febrile urinary tract infections were rare and upper urinary tract function was stable. PMID- 6842700 TI - Urodynamic patterns after acute spinal cord injury: association with bladder trabeculation in male patients. AB - A study was done on 80 male acute spinal cord injury patients with reflex bladder voiding to demonstrate an association between the development of radiological bladder trabeculation and serial urodynamic pressure/flow measurements. All patients were evaluated with cystograms and urodynamic studies during 1 to 3, 4 to 9 and 10 to 24 months after injury. Urodynamic measurements from those patients with bladder trabeculation were compared to those who retained normal appearing bladders on x-ray. A high percentage of patients (70 per cent) suffered trabeculation by 24 months after injury. Post-void residual urine volumes were not clinically helpful in identifying those patients with bladder deterioration. However, analysis of the urodynamic pressure/flow measurements revealed significant differences between patients who had trabeculation and those who maintained normal bladders on x-ray during the 3 sequential intervals after injury. PMID- 6842701 TI - Neurologic implications of the pathologically open bladder neck. AB - Normally the bladder neck remains closed except during voiding. We reviewed 550 consecutive patients who underwent synchronous video/flow/pressure/electromyography studies to identify whether neurologic factors are involved in the pathogenesis of an abnormally open bladder neck. A total of 33 patients who had not undergone prior bladder neck surgery had an open bladder neck at rest. The prevalence of neurologic lesions in patients with an open bladder neck was significantly greater than in those with a normal bladder neck. However, there was no correlation between any specific lesion and the incidence of an open bladder neck. Patients with myelodysplasia had an inordinately high incidence of open bladder neck. We conclude that abnormalities of bladder neck innervation may result in a pathologically open bladder neck. PMID- 6842702 TI - Renal growth and scarring in kidneys with reflux and a concentrating defect. AB - A study was done to determine if kidneys with reflux and an associated renal concentrating defect grew less well and had more scars than kidneys with reflux but no renal concentrating defect. To test our hypothesis we measured renal growth and assessed radiographs for renal scars in 11 children with and 20 children without a renal concentrating defect. Kidneys with reflux and a renal concentrating defect grew less well and had more scars than those kidneys with reflux but no renal concentrating defect. A persistent renal concentrating defect may be a predictor of kidneys more likely to have impaired growth and renal scars. PMID- 6842703 TI - Application of the pull-through technique of transverse advancement ureteral reimplantation. AB - In the pull-through technique of ureteral reimplantation the ureter is divided at the hiatus and pulled through into the bladder. It is then advanced transversely as described previously for megaloureter but the technique also may be used for routine cases. The technique is particularly suitable for ureteral reimplantation in patients with urethral valves and neurogenic bladder. Pull-through ureteral reimplantation also may be used to reimplant the orthotopic ureter in complete ureteral duplication with ectopic ureterocele or with orthotopic reflux. PMID- 6842704 TI - Chronic fistula developing 2 years after nephrectomy for pyonephrosis. PMID- 6842705 TI - Collecting system laceration following percutaneous renal biopsy. AB - Percutaneous renal biopsy is used frequently in the investigation of renal disease. While the usual complications include flank pain, hematuria and retroperitoneal hematoma, collecting system injuries rarely are reported. The diagnosis and treatment of such an injury are discussed. PMID- 6842707 TI - Arteriovenous aneurysm of the kidney: a case report. PMID- 6842706 TI - Concomitant carotid, mesenteric and renal artery stenosis due to primary intimal fibroplasia. AB - We report 2 cases of primary intimal fibroplasia involving the carotid, mesenteric and renal arteries. These patients presented with hypertension and neurological symptoms. Clinical and histologic features of neurofibromatosis or Takayasu's arteritis were absent. In both cases successful staged carotid and renovascular reconstruction was performed. Primary intimal fibroplasia may be a more generalized process than has been considered previously. PMID- 6842708 TI - Percutaneous vaso-occlusion for nonmalignant renal lesions. AB - Transarterial renal embolization has been used in the management of renal cancer. We report on 9 patients who underwent selective and superselective renal arterial embolization for nonmalignant renal lesions. Embolization was done in 5 patients for hemorrhage owing to renal angiomas, renal artery, pseudoaneurysm, percutaneous renal biopsy and adult polycystic kidney disease, and in 2 patients with end stage renal disease because of massive proteinuria. Another chronic renal failure patient with severe hypertension was treated successfully with bilateral renal embolization. A postoperative renal arteriovenous fistula was treated successfully by catheter vaso-occlusion. Renal embolization may be a suitable alternative to surgery in poor operative risk patients and for technically difficult benign lesions. Renal infection is a contraindication to embolization. PMID- 6842709 TI - Rupture of renal angiomyolipoma: conservative surgery. PMID- 6842710 TI - Accelerated obstruction at the ureteropelvic junction in adults. AB - Accelerated obstruction at the initially normal or minimally abnormal ureteropelvic junction was seen in 5 kidneys in 4 women after intervals of 2 to 15 years. Three kidneys had to be removed although the patients had been under observation. Hydronephrosis from ureteropelvic junction obstruction does not always progress gradually from the prenatal period but may rapidly increase in the adult without adequate warning. PMID- 6842711 TI - Inflammatory ureteral strictures after ureteroileal diversion. AB - We describe 2 patients in whom histologically proved inflammatory strictures of the ureter developed after ureteroileal diversion. The dense impassable strictures were located proximal to the ureteroileal junction. The clinical onset was preceded by acute urosepsis and septicemia. Judicious use of percutaneous nephrostomy and antegrade studies is emphasized in establishing the diagnosis. PMID- 6842714 TI - New surgical treatment for micropenis. PMID- 6842712 TI - Upper urinary tract deterioration in patients with myelodysplasia and detrusor hypertonia: a followup study. AB - We report on 6 patients with myelodysplasia who had undergone previously urodynamic evaluation that demonstrated detrusor hypertonia. At the time of the initial studies no patient had vesicoureteral reflux or significant upper urinary tract dilatation. Subsequently, upper urinary tract deterioration and/or vesicoureteral reflux developed in all patients and persisting detrusor hypertonia was demonstrated on followup urodynamic testing. Marked clinical and radiographic improvement followed treatment by intermittent catheterization with concomitant pharmacologic therapy. Our experience indicates that detrusor hypertonia can lead to ureteral complications in patients with previously radiographically normal upper urinary tracts. We believe that detrusor hypertonia should be treated with anticholinergic medication, frequently in conjunction with intermittent catheterization. The clinical presentation of upper tract deterioration after many years of normality, and occurring as late as the mid teenage years, demonstrates that these patients require prolonged and careful urologic and radiographic followup. PMID- 6842713 TI - Bladder carcinosarcoma: histologic variation in metastatic lesions. AB - Carcinosarcoma is a tumor composed of malignant epithelial and mesenchymal elements, which occurs rarely in the bladder. Although the prognosis of bladder carcinosarcoma is known to be poor the histology of metastatic lesions is not well described. We report 2 cases of bladder carcinosarcoma with pelvic lymph node involvement. Pure sarcomatous metastasis was present in 1 patient and only carcinoma in the other. The histologic composition of metastatic lesions may be of significance in treatment planning in patients with bladder carcinosarcoma. PMID- 6842715 TI - Improvement of ejaculatory incompetence with bromocriptine in a man with prolactin-secreting pituitary tumor. AB - We report a case of a prolactin-secreting pituitary tumor in a man whose characteristic findings were ejaculatory incompetence and no response of gonadotropin to clomiphene. After treatment with bromocriptine ejaculation was normal, gonadotropin responded slightly to clomiphene and the high level of plasma prolactin returned to normal. A Hardy operation was performed to remove the pituitary tumor. The patient continues to receive 2.5 mg. bromocriptine daily to maintain normal ejaculation. PMID- 6842716 TI - The effect of sympathomimetic drugs on post-lymphadenectomy aspermia. AB - A double-blind controlled study of the effects on semen quality of 4 alpha adrenergic agents with and without antihistamines was conducted in a patient who had failure of emission secondary to retroperitoneal lymphadenectomy for testis cancer. No other controlled studies are available. All of the alpha-adrenergic drugs allowed the patient to produce an ejaculate. The effects were similar. The addition of antihistamine did not improve the semen quality. Four days of treatment were consistently more effective than a single dose, especially for sperm motility. A pregnancy resulted. It is concluded that long-term treatment with alpha-adrenergic drugs is indicated in men with failure of emission secondary to retroperitoneal lymphadenectomy. PMID- 6842717 TI - A geographic cluster of testicular seminomas. AB - There have been many reports of space-time clusters of patients with Hodgkin's disease, childhood leukemia and Burkitt's lymphoma. We present a tight space cluster of 4 men with pathologically confirmed testicular seminomas. None of the men had any known reason to be at increased risk for testicular cancer. They all lived in the same immediate neighborhood for at least 7 years. There were 2 sources of potential carcinogens in the area. It is concluded that testicular cancer may have developed in these men as a result of exposure to environmental carcinogens. PMID- 6842718 TI - Juvenile xanthogranuloma of the scrotum. PMID- 6842719 TI - Epididymal neoplasms: a case report and review. PMID- 6842720 TI - Anesthesia for scrotal surgery. PMID- 6842721 TI - Re: varicocele: still an enigma. PMID- 6842722 TI - Ascorbic acid and methenamine mandelate on the urinary pH of spinal cord injury patients. PMID- 6842724 TI - Mulberry particles formed by red blood cells in human weddelite stones. AB - In a series of electron microscopic studies of human urinary stones, mulberry shaped particles were observed in 5 out of 51 calcium oxalate dihydrate (COD) containing stones. The mulberries were crenation products of red blood cells which adhered to the surface of bipyramid COD crystals, followed by impregnation of the COD. The red cells appeared to participate in the crystal growth by creating foci of surface nucleation, or by formation of a layer of crust on the surface of the bipyramids which caused deposition of an additional layer of calcium oxalate. The lipid containing organic matrix seems to have a role in COD crystal growth. PMID- 6842723 TI - The effect of spironolactone on the elemental composition of the intraluminal fluids of the seminiferous tubules, rete testis and epididymis of the rat. AB - Embryologically, the epididymis and renal collecting tubules develop from the mesonephric duct. Aldosterone enhances the reabsorption of sodium from the collecting tubule, and there is evidence that sodium is removed from the epididymal lumen against a concentration gradient. Rats were treated with spironolactone, an aldosterone antagonist, and the concentrations of seven elements, including sodium, were measured in intraluminal fluids from the testis and epididymis. The sodium concentration in caput epididymidal fluid rose (102.5 +/- 4.4 to 128.0 +/- 6.8 mmol./l., p less than 0.01) after 14 days of spironolactone treatment. This finding is consistent with the hypothesis that aldosterone acts on the caput epididymidis, like the collecting tubule, to augment the removal of sodium from luminal fluid. PMID- 6842725 TI - Characteristics of normal and refluxing ureterovesical junctions. AB - In order to quantitatively define the mechanism of urereterovesical junction (UVJ) competence and vesicoureteral reflux, we measured ureteral pressures using a continuously perfused catheter with a single side opening. Studies were performed under general anesthesia on 11 competent and 9 refluxing UVJs. The amplitude of ureteral contractions was essentially the same in refluxing and non refluxing systems, but peristaltic frequency was significantly lower in the presence of even the milder forms of reflux. With the bladder empty, a high pressure zone was observed at the UVJ in both refluxing and non-refluxing systems, with no significant pressure difference between the 2 groups. No relaxation was observed during urine transport across the UVJ. With bladder filling, a greater increase in profile pressure occurred at the UVJ of non refluxing than refluxing systems. The UVJ-bladder pressure gradient of non refluxing systems increased with bladder filling, whereas the gradient in the refluxing systems decreased. It appears that refluxing ureters have a decreased peristaltic frequency and fail to maintain a pressure gradient at the UVJ with bladder filling. PMID- 6842726 TI - Adriamycin permeability of the rat bladder under different conditions. AB - Fifty female Sprague-Dawley rats were treated with 1.4 or 2.4 mg. adriamycin intravesically. Radioimmunological measurement of serum concentrations were performed up to 3 hours post-instillation in normal bladder mucosa, cystitis, and after electrocoagulation, under different filling conditions, as well as with the use of a detergent (Tween 80). The serum concentrations achieved were markedly higher after electrocoagulation or cystitis; altogether they reached only 1/6,000 of the instilled concentration. These studies on the rat bladder suggest that perioperative instillation of adriamycin to prevent recurrence is not contraindicated shortly before or after transurethral resection (TUR) of superficial bladder tumors. PMID- 6842729 TI - Serologic testing of badgers to monitor plague in southwestern Idaho. AB - Serologic testing of badgers (Taxidea taxus) was used to monitor plague (Yersinia pestis) in a Townsend ground squirrel (Spermophilus townsendi) population in 10,000 ha of the Snake River Birds of Prey Study Area, Idaho. Eighty-six percent of the 294 sera tested in 1975 and in 1976 were positive. Significantly fewer (72%) seropositives occurred in 1977. Seasonal changes in the percentage of seropositives and the decline in 1977 were probably due to the phenology of the Townsend ground squirrel and the proportion of that species in the badger's diet. Eight Townsend ground squirrels found dead had positive bacteriologic tests for plague; however, a high mortality in the ground squirrel population was not observed. Food habits and movement patterns of badgers made them ideal for documenting the geographical and temporal characteristics of the plague focus. PMID- 6842727 TI - Effect of diethylstilbestrol on bladder contractility in male rats. AB - The effect of diethylstilbestrol (DES) on bladder contractility was studied in vitro in 8 rats while 5 untreated animals were used as normal controls. Of the treated animals, 4 received 0.05 mg./day of DES during 8 weeks while another 4 were treated for 14 weeks with the same dose. We studied the animals by cutting consecutive rings from each bladder and testing them in a muscle chamber, under conditions of maximal electrical stimulation which had been previously determined in 3 animals. Parameters that produced maximal contractions were: 100 V, 40 Hz, and 2 msec. For each ring, we obtained full force-length relationships by stretching the rings in successive increments until length of maximal active force development was reached. For each bladder, alternate rings were tested in the muscle chambers while the remaining rings were used to determine collagen percentage with Woessner assay. In all animals, the ring with the largest diameter which was obtained from the widest portion of the bladder gave the highest contraction. The maximal active force of this ring was taken as a measure of contractility of the bladder. For controls, the maximal active force was 7.30 +/- 0.3 g. After 8 weeks of DES treatment, it decreased to 5.9 +/- 0.79 g and after 14 weeks, it further decreased to 2.15 +/- 0.99 g. The reduction in active force from controls after 8 and 14 weeks were statistically significant. Passive force and collagen content, however, did not change after either 8 or 14 weeks. In conclusion, these data show that DES decreases bladder contractility in male rats without affecting passive forces and muscle-collagen ratio. PMID- 6842730 TI - Helminth parasites of pine marten, Martes americana (Turton), from Manitoba, Canada. AB - Five species of helminths were recovered during a survey of 139 North American pine marten (Martes americana) from three areas of Manitoba: Alaria taxideae in 75 marten; Taenia sp. (cf. martis martis) in 16; Taenia mustelae in nine; Baylisascaris devosi in one; Trichinella sp. larvae in one. Taenia mustelae and Taenia sp. (cf. martis martis) were found in two different areas of the province, Taenia sp. (cf. martis martis) being isolated from the more northerly regions. Alaria taxideae, the most prevalent parasite in the survey, was common to all three areas. The intensity of infection and prevalence level of A. taxideae was significantly higher (P less than 0.05) in the southern region of this study. Altogether, male marten had a significantly higher intensity of A. taxideae compared to females, although there was no significant difference in prevalence level. When data for A. taxideae was combined for sexes and for regions a significantly higher prevalence level in young-of-the-year marten was noted compared to juveniles or adults, but no significant difference in intensities among the three age classes was found. No significant differences were detected in the prevalence of A. taxideae, Taenia sp. (cf. martis martis), or T. mustelae between sexes or among age classes from any of the three areas. PMID- 6842728 TI - Immunoglobulin in seminal fluid of fertile, infertile, vasectomy and vasectomy reversal patients. AB - We measured the concentrations of IgG, IgA, and IgM, in the seminal fluid of 16 fertile men, 77 men of infertile marriages, 21 men who had undergone vasectomy reversal and 5 men who had undergone vasectomy only. The lower limits of sensitivity of the assay was 0.04 mg./dl. IgG (mean concentration 3.29 mg./dl., range 0.48 to 15.41 mg./dl.) and IgA (mean concentration 1.11 mg./dl., range 0.05 to 19.11 mg./dl.) were measureable in all specimens, but IgM (range 0.04 to 0.76 mg./dl.) was measureable in only 20 per cent. Intrasubject variability of IgG and IgA concentrations expressed as the coefficients of variation of serial determinations ranged from 18 to 40 per cent and 29 to 52 per cent, respectively. Discrepancies between the presence or absence of measurable IgM in serial determinations were unusual. The mean concentrations of seminal fluid IgG and IgA in the fertile group were not significantly different from the other patient groups. However, IgM was measurable in only 13 per cent of specimens from the fertile patients but in 62 per cent of specimens from the vasectomy reversal patients (p = 0.003). This suggests disruption of the blood-genital tract barrier following vasectomy and continuing after vasectomy reversal. PMID- 6842732 TI - Skeletal lesions and deformities in large sharks. AB - Four blunt-snouted sandbar sharks (Carcharhinus plumbeus) were noted among 555 examined over a 13-yr period. Radiographs of one specimen revealed that the three rostral cartilage rods were abnormally short and failed to join at the anterior tip. The deformity appeared to be congenital. Four cases of vertebral lesions were noted in three species of shark (Carcharhinus plumbeus, Negaprion brevirostris and Odontaspis taurus). The vertebral columns had fused centra, ribs and neural arches, extra deposition and erosion of calcified material in the centra, and in one case, compression of centra. The causes of the vertebral lesions are unknown. PMID- 6842733 TI - Hematology and blood chemistry in the sea otter (Enhydra lutris). PMID- 6842731 TI - Metazoan parasites of the eastern cottontail rabbit in western Kentucky. AB - Forty-five eastern cottontail rabbits (Sylvilagus floridanus Allen), collected over a 15 mo period from two areas of western Kentucky, were examined for disease conditions, helminth and arthropod parasites. A single lymphosarcoma, two cutaneous papillomas and the following parasites were identified: Hasstilesia tricolor, Taenia pisiformis, Cittotaenia variabilis, Raillietina stilesiella, Obeliscoides cuniculi, Trichuris leporis, Longistriata noviberiae, Trichostrongylus calcaratus, Dermatoxys veligera, Odontopsyllus multispinosus, Cediopsylla simplex, Haemaphysalis leporispalustris, Ixodes dentatus, Amblyomma americanum, and Dermacentor variabilis. Simpson's Indices indicated that parasite communities were fairly diverse, with some degree of dominance exhibited by O. cuniculi, T. pisiformis and H. leporispalustris. The parasite faunas of rabbits from the two areas were similar. Hasstilesia tricolor was associated with the absence of kidney fat. PMID- 6842734 TI - Helminths of the coyote (Canis Iatrans Say) in Montana. PMID- 6842735 TI - Some helminth parasites of sandhill cranes from mid-continental North America. PMID- 6842736 TI - Parasites of fishes in the Gila River drainage in southwestern New Mexico. PMID- 6842737 TI - Intestinal microflora of young greater flamingos (Phoenicopterus ruber roseus pallas) in the Camargue. PMID- 6842738 TI - Isolation of Campylobacter fetus subsp. jejuni from the common puffin (fratercula arctica) in Norway. PMID- 6842739 TI - Abdominal hernia in a moose from Alaska. PMID- 6842740 TI - Blindness associated with retinal dysplasia in a prairie falcon, falco mexicanus. PMID- 6842741 TI - Immobilization of wolves using ketamine in combination with xylazine or promazine. PMID- 6842742 TI - The Baermann technique for estimating Protostrongylus infection in bighorn sheep: effect of laboratory procedures. AB - The modified Baermann funnel technique was evaluated to determine the effects of time of baermannization, fecal preparation, type and size of funnel, and type of filter on the number of first stage larvae of Protostrongylus spp. recovered from feces of Rocky Mountain bighorn sheep (Ovis canadensis). More larvae were recovered when fecal pellets were baermannized for 24 hr compared to 8 hr, and when feces were crushed than when left intact. Use of small funnels resulted in the recovery of more larvae per gram of feces than larger funnels, and glass funnels more than plastic ones. There was no difference in recovery of larvae between cheesecloth filters and cellulose filters. PMID- 6842743 TI - Worksite anti-alcoholism saves jobs, money. PMID- 6842744 TI - Sound, shock waves shatter kidney stones. PMID- 6842745 TI - Leads from the MMWR. Measles outbreak on university campuses--Indiana, Ohio, Texas. PMID- 6842746 TI - Leads from the MMWR. Antigenic analysis of recent influenza virus isolates. PMID- 6842747 TI - Diabetes in Rhode Island: a statewide registry. PMID- 6842748 TI - Bicyclist's nipples. PMID- 6842749 TI - Treatment of depression. PMID- 6842750 TI - Anorectal cancer and homosexuality. PMID- 6842751 TI - Graduate medical education. PMID- 6842752 TI - Injuries from fireworks. PMID- 6842753 TI - The hazard of ingested alkaline disk batteries in children. AB - We have treated eight cases of childhood ingestion of alkaline disk batteries, one resulting in an esophagotracheal fistula. These batteries are capable of rapid tissue destruction on contact with moist membranes. We recommend that packaging include proper warning of this hazard and urge that retained batteries be promptly removed from the esophagus and stomach by endoscopy or laparotomy. If the battery has reached the small intestine, further transit should be monitored carefully by roentgenographic studies until recovery. Perforation is possible after eight-hour retention at a specific site. PMID- 6842755 TI - The success of alcoholism treatment. The stigma and the need for hard data. PMID- 6842754 TI - Effects of swimming pool water on the cornea. AB - Eye examinations performed on 50 subjects immediately before and after swimming in a chlorinated pool showed that 34 subjects (68%) saw rainbows and/or halos around lights after swimming, a symptom indicating the presence of corneal edema. Forty-seven subjects (94%) had corneal epithelial erosions in a punctate or linear pattern demonstrated by fluorescein staining on slit-lamp examination. No subject experienced a measurable decrease in visual acuity. PMID- 6842756 TI - Disk battery ingestion. PMID- 6842757 TI - Fetal effects of maternal alcohol use. PMID- 6842758 TI - The diagnosis of testicular torsion. AB - Prompt diagnosis of testicular torsion remains difficult. Since warning symptoms occur in one third of patients and salvage rates correspond to the interval between symptom onset and operation, higher salvage rates should be achievable. Separating torsion from epididymitis is complicated by overlapping ages of peak incidence, shared symptoms, and the need for rapid distinction of the two. Doppler studies (88% accuracy) and nuclear scans (95% accuracy) help confirm the diagnosis, but correct technique is essential, and their use should not delay prompt operation. The diagnosis of epididymitis should be made cautiously in persons younger than the age of 35 years. PMID- 6842759 TI - Plant tumors. PMID- 6842762 TI - Leads from the MMWR. Interstate measles importation. PMID- 6842761 TI - Leads from the MMWR. Acute illness epidemic. West Bank--Jerusalem. PMID- 6842760 TI - Efficacy tests ahead for antimetastatic agent. PMID- 6842763 TI - Quantifying the meanings of words. PMID- 6842764 TI - Cause of death in very old people. PMID- 6842765 TI - Classification of calcium antagonists. PMID- 6842766 TI - Community-oriented primary care. PMID- 6842767 TI - Computed tomographic premedication in children. PMID- 6842768 TI - Controversial practices in allergy. PMID- 6842769 TI - Esophageal angina. PMID- 6842770 TI - Traumatic myopathy: a benign cause of pseudohypertrophy of the calves. PMID- 6842771 TI - Employee rubella screening programs in Arizona hospitals. AB - One year after voluntary guidelines on rubella screening of hospital employees were issued by the Arizona Department of Health, a survey of 68 members of the Arizona Hospital Association was conducted, with an 81% response. Some form of employee rubella screening was present in only 49% of responding hospitals. Of the screening hospitals, 70% of programs had a mandatory aspect for selected employees. Administrative logistics, cost, problems encountered, and the quality and coverage of the program varied substantially among the different hospitals. Fewer than half of the screening hospitals had programs for physicians, students, or volunteers. Verbal histories of immunization or serological tests, although notoriously unreliable, were accepted by 14% of the screening hospitals. Half of the nonscreening hospitals plan to implement programs in the future. Reasons given for not establishing rubella screening programs include cost, no pediatric or obstetric service, liability issues, high turnover, and no previous case of rubella in an employee. Three hospitals (all screening) reported they had had a case of rubella in an employee. The data suggest slow partial compliance with recommendations for rubella screening in hospitals. PMID- 6842772 TI - Intramuscular hemangioma. AB - In two cases of intramuscular hemangioma of the paraspinous muscles, the tumors were treated with arteriographic embolization followed by immediate local excision. We found that this technique creates a hypovascular surgical field and facilitates the dissection. We believe this approach will decrease morbidity and potential mortality. PMID- 6842773 TI - Soccerball-induced eye injuries. AB - We report a series of 24 confusion eye injuries resulting from soccerball impact. Hyphema (50%), vitreous hemorrhage (29%), corneal abrasion (21%), angle recession (8%), and retinal tear (4%) were experienced. When compared with a combined hyphema series and with hockey and racquet sports, our group had fewer serious injuries and no permanent visual acuity loss resulted. Although the incidence of eye injuries is low and the use of eye protectors may be inconvenient, we strongly recommend protective eyewear be worn in competitive sports involving large and small projectiles. PMID- 6842774 TI - Craniocerebral injuries from dog bites. AB - Dog bites are a common cause of injury in infants and children, with the face and head frequently involved. While scalp injuries may be extensive and severe, only five cases of compound depressed skull fractures caused by dog bites have been reported, to our knowledge. Four cases are presented to point out the potential risks of cranial penetration and underlying brain injury when infants and children suffer dog bites to the head. The principles for management of these injuries are outlined. PMID- 6842775 TI - Prospects for broad-spectrum chemotherapy of serious viral respiratory infections. PMID- 6842776 TI - A 31-year-old woman with cough, hemoptysis, and bilateral hilar adenopathy. PMID- 6842777 TI - More questions, not answers, emerge from Agent Orange studies. PMID- 6842778 TI - Adding seeds to the diet may keep cancer at bay. PMID- 6842780 TI - Only CT finds some ovarian cancer spread. PMID- 6842781 TI - Leads from the MMWR. Pelvic inflammatory disease among Dalkon Shield users. PMID- 6842779 TI - Sperm swim singly after vitamin C therapy. PMID- 6842782 TI - Leads from the MMWR. Rocky Mountain spotted fever. PMID- 6842783 TI - Boxing. PMID- 6842785 TI - Malaria prophylaxis. PMID- 6842784 TI - Rectal injury during barium enema examination. PMID- 6842786 TI - Possible role of the brain stem in sudden infant death syndrome. PMID- 6842787 TI - The prognostic value of ambulatory blood pressures. AB - We reviewed the course of 1,076 patients with essential hypertension whose condition had been initially evaluated with both ambulatory BP (ABP) and office BP (OBP) measurements. During the period of follow-up (mean, five years), fatal cardiovascular events occurred in 75 patients, and nonfatal events occurred in 153. Each patient was classified according to the difference between the mean observed ABP at entry and that predicted from the mean OBP at entry by means of an equation for the linear regression of ABP on OBP. Life-table analyses demonstrated a significantly greater estimated cumulative ten-year incidence of both fatal and nonfatal events among patients with higher than predicted ABPs than among those with lower than predicted ABPs. Because OBPs were comparable in the two groups, we conclude that ABP was an important determinant of clinical outcome. PMID- 6842789 TI - Magnesium sulfate and digitalis-toxic arrhythmias. AB - Seven patients with congestive heart failure receiving long-term diuretic treatment (more than three years) experienced idionodal tachycardia in the presence of apparently normal serum digoxin levels. Intravenous bolus administration of magnesium (Mg) sulfate, followed by intramuscular Mg repletion, abolished the digitalis-toxic arrhythmia. The finding of decreased lymphocyte Mg and potassium contents proved the existence of cellular Mg depletion associated with normal serum Mg levels in five patients and with hypomagnesemia in the other two. Decreased cellular Mg content with normal serum Mg level predisposes to digitalis-toxic arrhythmias. PMID- 6842788 TI - Treatment of intra-atrial cardiac tumors. AB - Intracavitary tumors of the atria are rare, generally diagnosed as myxoma, and considered benign. Of 20 such tumors presenting for surgery between Jan 1, 1967, and Jan 1, 1982, sixteen were myxomas: 13 in the left and three in the right atrium. Four additional patients operated on for suspected right atrial myxoma had other lesions: two thrombus (simulating myxoma), one leiomyoma originating in the right iliac vein, and one clear cell adenocarcinoma from the left kidney. One initially benign myxoma underwent malignant transformation. Eighteen hospital survivors were followed up from one month to 134 months (mean, 61 months). All are New York Heart Association class I. We recommend inferior vena cavagram for right-sided lesions. For patients older than 40 years, coronary angiography and appropriate bypass grafting should be performed. Surgery must include resection of all abnormal tissue. Follow-up with echocardiography should continue for five years. PMID- 6842790 TI - Recurrent oral erythema multiforme. Clinical experience with 11 patients. AB - Recurrent oral erythema multiforme is a distinct, but less-well-recognized variant of the erythema multiforme group of diseases. It is characterized by recurrent blistering of the mouth, periodic recurrences, prolonged duration, and considerable morbidity. The cause is unknown; however, a number of precipitating factors have been suggested. Patients with severe involvement usually require orally administered corticosteroids for adequate control. PMID- 6842791 TI - Zomepirac-induced serum sickness. A report of two cases. AB - Two patients, after several weeks of zomepirac sodium use, experienced acute toxic eruption, fever, lymphadenopathy, arthralgias, angioedema of the hands, and eosinophilia. We believe that these cases represent type 3 allergic reactions to zomepirac. PMID- 6842793 TI - Platelet volume/count relationship aids thrombocytopenia prognosis. PMID- 6842792 TI - Airway constriction in normal humans produced by inhalation of leukotriene D. Potency, time course, and effect of aspirin therapy. AB - Five normal human subjects inhaled aerosols generated from solutions of leukotriene D (LTD) to determine the bronchoconstrictor potency and the time course of airway obstruction produced by this constituent of slow-reacting substance of anaphylaxis. The dose-effect and time-effect curves were compared with curves similarly generated for the well-characterized airway constrictor histamine. Leukotriene D was, on average, 5,900 times more potent than histamine on a molar basis in producing an identical decrement in maximal expiratory flow rate at 30% of control vital capacity above residual volume. In addition, although LTD had a rapid onset of effect, similar to that of histamine, the airway obstruction produced by LTD was longer lasting, thereby reflecting more closely the response of asthmatic allergic individuals to antigen inhalation. The response of these subjects to inhalation of LTD was not altered by ingestion of aspirin, suggesting that the airway obstruction was not mediated by cyclooxygenase products of arachidonic acid. PMID- 6842794 TI - Deeper problems for Darsee: Emory probe. PMID- 6842795 TI - The paper chase. PMID- 6842796 TI - Leads from the MMWR. Measles--United States. First 13 weeks of 1983. PMID- 6842797 TI - Leads from the MMWR. Third-trimester induced abortions--Georgia. PMID- 6842798 TI - Mercy--for the terminally ill cancer patient! PMID- 6842799 TI - Institutional Review Boards. PMID- 6842800 TI - Long esophagomyotomy for esophageal spasm. PMID- 6842801 TI - Family practice education. PMID- 6842802 TI - Sulindac and renal impairment. PMID- 6842803 TI - A new look at hospital clinical privileges as they apply to radiology. PMID- 6842804 TI - Risk of breast, uterine corpus, and ovarian cancer in women receiving medroxyprogesterone injections. AB - Animal studies have yielded conflicting results on the carcinogenicity of long acting progestins. Since more than 1.5 million women worldwide are currently receiving injections of a contraceptive progestin, depot medroxyprogesterone acetate, this is potentially an important public health problem. We obtained information on the occurrence of breast, uterine, and ovarian cancer among 5,000 black women attending a metropolitan hospital's family planning clinic who had received injections of medroxyprogesterone for contraception (between 1967 and 1976). The women were followed up for four to 13 years after their initial medroxyprogesterone injection. We compared the observed number of cancer cases in these women with the expected number based on annual age-, race-, and sex specific rates derived from National Cancer Institute data. During more than 40,000 woman-years of observation, we found no evidence of an increased risk of developing cancer of the breast, uterine corpus, or ovary in these women. After adjusting for possible underascertainment of cancer because of incomplete follow up, we found the relative risk for medroxyprogesterone users to be 0.7 for breast cancer (95% confidence limits, 0.3 to 1.4), 1.2 (95% confidence limits, 0.1 to 6.7) for cancer of the uterine corpus, and 0.8 (95% confidence limits, 0.1 to 4.6) for ovarian cancer. PMID- 6842805 TI - Association between nutritional status and cognitive functioning in a healthy elderly population. AB - We evaluated the association between nutritional status and cognitive functioning in 260 noninstitutionalized men and women older than 60 years who had no known physical illnesses and were receiving no medications. Nutritional status was evaluated by three-day food records and also by biochemical determination of blood levels of specific nutrients. Cognitive status was evaluated by the Halstead-Reitan Categories Test (a nonverbal test of abstract thinking ability) and by the Wechsler Memory Test. Subjects with low blood levels of vitamins C or B12 scored worse on both tests. Subjects with low levels of riboflavin or folic acid scored worse on the categories test. These differences remained significant after controlling for age, gender, level of income, and amount of education. "Subclinical" malnutrition may play a small role in the depression of cognitive function detectable in some elderly individuals, or depressed cognitive function may result in reduced nutrient intake. PMID- 6842806 TI - Severe, reversible neutropenia during high-dose mebendazole therapy for echinococcosis. AB - Two patients receiving oral high-dose mebendazole therapy for echinococcosis were found to have severe, reversible neutropenia, apparently due to marrow suppression; platelets and RBCs were also reversibly suppressed in one. High blood levels of mebendazole (239 ng/mL) in one patient may have resulted in the neutropenia and several toxic side effects, as well as a striking shrinkage of the patient's pulmonary and liver cysts. Neutropenia with high-dose mebendazole therapy may occur in up to 5% of patients and may be much more common than previously recognized. The WBC count should be monitored frequently during the first several weeks of therapy. Further experience will be needed to determine whether neutropenia is related to mebendazole levels. PMID- 6842807 TI - Thioridazine-induced torsade de pointes. Successful therapy with isoproterenol. AB - Thioridazine (Mellaril) hydrochloride cardiotoxicity is manifested by bradycardia and prolongation of the QT interval. The latter predisposes to atypical ventricular tachycardia (torsade de pointes) when premature ventricular depolarizations occur during the prolonged QT interval. Isoproterenol hydrochloride infusion, which increases the heart rate and shortens the QT interval, is a theoretically advantageous therapeutic modality for use in this situation. This report describes a case of thioridazine-induced torsade de pointes that was successfully managed with isoproterenol infusion after therapy with other agents was unsuccessful. This mode of therapy should be used with caution, but it may be lifesaving in psychiatric or community hospitals where temporary cardiac pacemaker insertion is not performed. PMID- 6842808 TI - Vaginal delivery after cesarean section. Experience in private practice. AB - To test whether vaginal delivery after cesarean section (VDAC) is a safe alternative to repeated section, a retrospective chart review of 2,350 deliveries during a ten-year period in a private practice group committed to VDAC was studied. Eighty-five parturients met six predetermined safety criteria and were permitted a trial of labor. These criteria were (1) prior low-segment transverse uterine incision; (2) vertex presentation; (3) carefully monitored labor with obstetrician present; (4) availability of emergency facilities; (5) no administration of oxytocin; and (6) patients' consent and desire to pursue VDAC. Seventy-six labors (89%) managed expectantly were successful in VDAC. No maternal or fetal morbidity was detected. No uterine ruptures were detected on postpartum examination or at the time of cesarean section. These results support the 1980 report of the National Institute of Child Health and Human Development recommending that labor and VDAC are of low risk to mother and fetus in properly selected cases. PMID- 6842809 TI - Nutrition and cognitive function in the elderly. PMID- 6842810 TI - [Anesthetic management of patients with eclampsia]. PMID- 6842811 TI - [Electrophysiological studies on the analgesic effects of general anesthetics]. PMID- 6842812 TI - [Muscle rigidity caused by succinylcholine in Edwards' syndrome]. PMID- 6842813 TI - [Etiological factors of liver injuries and immunological reactions]. PMID- 6842814 TI - [Experimental ECMO for 23 days in a goat]. PMID- 6842815 TI - [An experimental study on the efficacy of cardiac synchronized ventilation for acute right heart failure after pulmonary artery banding]. PMID- 6842816 TI - [Effects of various antagonists on the pressor effect of norepinephrine]. PMID- 6842817 TI - [Study on the release of vasoactive intestinal polypeptide during hemorrhagic shock]. PMID- 6842818 TI - [Effects of reduced glutathione and methylprednisolone on hepatic energy metabolism in endotoxin treated rats]. PMID- 6842819 TI - [Inotropic interaction between diltiazem and halothane in isolated canine heart muscle]. PMID- 6842820 TI - [Hemodynamic and adrenergic response to surgery under total intravenous anesthesia with alpha xalone/alphadolone]. PMID- 6842821 TI - [A study on the disc sensitivity test for cefsulodin]. AB - Susceptibilities of 101 strains of 34 bacterial species to cefsulodin (CFS) were determined by the 2-fold agar dilution method in parallel with the diameter of inhibition zone by the single-disc method, under the experimental condition established by Kanazawa. The experiments demonstrated significant correlation between MIC by the dilution method and diameter of inhibition zone in each of conventional assay of the over-night (about 16 hours) incubation, delayed assay (about 24 hours incubation), and rapid assay (about 3--4 or 5--6 hours incubation), thus confirming applicability of the single-disc assay for CFS. Analysis of the data obtained by using CFS disc containing 30 micrograms revealed the primary regression equation to be: D (diameter, mm) = 30.0 - 12.1 log MIC (micrograms/ml) in conventional assay, D = 36.3 - 15.6 log MIC (micrograms/ml) in delayed assay, D = 25.2 - 9.0 log MIC (micrograms/ml) in 5--6 hours rapid assay, and D = 20.4 - 6.4 log MIC (micrograms/ml) in 3--4 hours rapid assay, respectively. The range of variations in MICs estimated from the diameters of inhibition zone by the disc test was then calculated in comparison with that in MICs determined by the 2-fold agar dilution assays, as reference for the experimental errors which may be involved in the estimation of MICs of CFS by the single-disc assay. PMID- 6842823 TI - [Safety evaluation of micronomicin. II. Irritation by repeated intravenous injection in dogs]. AB - Micronomicin (MCR) is a new aminoglycoside antibiotic produced by Micromonospora sagamiensis var. nonreducans which was isolated from soil collected at Sagamihara by Nara et al. The purified antibiotic showed a close similarity to gentamicin C complex in physical and chemical properties. The antibacterial activity of MCR is broad-spectrum and almost equal to that of gentamicin C complex. MCR exhibits particularly high activity against Pseudomonas, Proteus, Klebsiella pneumoniae, Serratia, etc. and high activity against some Pseudomonas aeruginosa strains resistant to gentamicin C1a. A study on the irritation by repeated intravenous injection in dogs was carried out for safety evaluation (Doses: 4, 10, 25, 63 mg/kg and 100 mg/kg). Bleeding, edema, vasculitis and perivasculitis were observed at injection sites both in physiological saline-treated controls and MCR treated groups. But irritation attributable to MCR was not observed at any dose. PMID- 6842822 TI - [Safety evaluation of micronomicin. I. Subacute and chronic toxicity in dogs]. AB - Micronomicin (MCR) is a new aminoglycoside antibiotic produced by Micromonospora sagamiensis var. nonreducans which was isolated from soil collected at Sagamihara by Nara et al. The purified antibiotic showed a close similarity to gentamicin C complex in physical and chemical properties. The antibacterial activity of MCR is broad-spectrum and almost equal to that of gentamicin C complex. MCR exhibits particularly high activity against Pseudomonas, Proteus, Klebsiella pneumoniae, Serratia, etc. and high activity against some Pseudomonas aeruginosa strains resistant to gentamicin C1a. Toxicological studies of MCR in dogs were carried out by intravenous injection for safety evaluation. 1. Study on subacute toxicity: Beagle dogs were injected intravenously with MCR at the dose levels of 4, 10, 25, 63 mg/kg and 100 mg/kg for 30 days. 2. Study on chronic toxicity: Beagle dogs were injected intravenously with MCR at the dose levels of 1.6, 4 mg/kg and 10 mg/kg for 180 days. The results of the studies are as follows: 1. In the subacute toxicity study, animals died at the dose level of 100g/kg (3 out of 6 animals). Main changes observed were renal disorders and ataxia which showed a close similarity to those seen during intramuscular toxicity studies in dogs. The renal histological disorders occurred at the dose levels of 10 mg/kg and over, but they were slight at the dose levels of 10 mg/kg and 25 mg/kg. Ataxia was observed at the dose levels of 63 mg/kg and over, but its grade was slight at the dose level of 63 mg/kg. 2. In the chronic toxicity study, animals did not die at any dose. Renal disorders occurred; they were almost similar to those observed in the subacute toxicity study and were slight at the dose level of 10 mg/kg. Ataxia was not observed at any dose. 3. The maximum safety dose was equal to in the subacute toxicity and chronic toxicity study (4 mg/kg). Therefore, cumulative toxicity by intravenous injection seemed very slight. PMID- 6842824 TI - [Safety evaluation of micronomicin. III. Teratogenicity studies in rats]. AB - Micronomicin (MCR) is a new aminoglycoside antibiotic produced by Micromonospora sagamiensis var. nonreducans which was isolated from soil collected at Sagamihara by Nara et al. The purified antibiotic showed a close similarity to gentamicin C complex in physical and chemical properties. The antibacterial activity of MCR is broad-spectrum and almost equal to that of gentamicin C complex. MCR exhibits particularly high activity against Pseudomonas, Proteus, Klebsiella pneumoniae, Serratia, etc. and high activity against some Pseudomonas aeruginosa strains resistant to gentamicin C1a. Teratogenicity studies of MCR in rats were carried out by intravenous injection for safety evaluation (Dose; 25, 50 mg/kg and 75 mg/kg). The results of studies are as follows. 1. Fetal malformation attributable to MCR was not observed at any dose. 2. Suppression of maternal weight gain was observed at the dose levels of 50 mg/kg and over. 3. There was no adverse effect on new borns at any dose. PMID- 6842825 TI - [Effect of intravenous administration of micronomicin on the inner ear of guinea pigs]. AB - The present experiment was made to clarify the effect of intravenous administration of micronomicin (sagamicin, MCR) on the inner ear of guinea pigs (300--350 g). MCR was given to the animals intravenously at dose of 25, 50 mg/kg and 100 mg/kg, respectively for 28 days. Pinna reflex test in frequency range from 20 kHz to 0.5 kHz was performed before, during and after the administration. The temporal bones were removed after intravital perfusion of the inner ears with neutral formation after the end of the administration. Histopathological examination was performed on the serial celloidin sections of the inner ears which had been stained with hematoxylin eosin. The following results were obtained. 1. MCR had a mild corti toxicity, which did not show remarkable dose dependent increase. 2. MCR had more affinity for the vestibular organs than for the organ of corti. The affinity for the vestibular organ increased with increase in dose. 3. MCR showed less increase in corti toxicity in intravenous administration than in intramuscular injection. However, the affinity of MCR for the vestibular organ showed little more increase in the intravenous administration than in the intramuscular injection. PMID- 6842826 TI - [Clinical studies on micronomicin treatment for surgical infections]. AB - The clinical effects of micronomicin (MCR, Sagamicin) treatment for 10 patients with surgical infections were investigated and following results were obtained. 1. Clinical effectiveness Of 10 patients treated with MCR, the results were good in 7 cases, poor in 3 cases. 2. Side effects of MCR No significant side effects were observed in 10 patients treated with MCR. PMID- 6842827 TI - [Pharmacokinetics study on gentamicin intravenous drip infusion in children]. AB - Pharmacokinetics of gentamicin in children after intravenous infusion over 60 minutes were compared with that after intramuscular injection. 1. Mean measured peak serum levels after intravenous infusion of 2.5 mg/kg and intramuscular injection of 2.0 mg/kg were 6.1 micrograms/ml at termination of infusion and 6.5 micrograms/ml at 30 or 60 minutes after injection, respectively. Older children showed higher serum levels. 2. There was no difference in serum half-life between both modes of administration. 3. The AUC after intravenous infusion was slightly larger than that after intramuscular injection. 4. It was suggested that the efficacy and safety of the treatment by intravenous infusion in children are comparable to that by the intramuscular injection, and optimum single dose is 1.5 -2.5 mg/kg. PMID- 6842829 TI - [Clinical studies of cefoxitin in the field of internal medicine]. AB - Ten patients with sepsis and pneumonia complicated by leukemia or lung cancer were treated with cefoxitin (CFX) at daily dose of 6 g. The following results were obtained. 1. Clinical effects of CFX were good in 5 patients, fair in 2 and poor in 3 with effective rate of 50%. 2. Out of 8 patients with sepsis, 5 showed good response to CFX and effective rate was 62.5%. 3. Bacteriological outcomes were eradicated in 1, unchanged in 1, replaced in 2 and unknown in 6 cases. 4. Diarrhea was observed in 1 patient but this was not considered related to CFX therapy. 5. No abnormal laboratory finding due to CFX was observed. 6. It should be considered that 6 g or more of CFX is given in case of severe infections, such as sepsis or pneumonia complicated by serious underlying diseases. PMID- 6842828 TI - [Clinical studies on gentamicin for infectious diseases following intravenous drip infusion]. AB - An antibiotic drug of aminoglycoside group, gentamicin (GM) for parenteral use was used to 14 hospitalized patients; 5 with acute or subacute cholecystitis, 6 with acute peritonitis (4 cases were due to acute appendicitis, a case was torsion of right ovarian cyst and a case was cecal CROHN's disease), 1 with fistula ani and abscess, and 2 with localized peritonitis after gastrectomy due to gastric ulcer. GM in a dose of 60 mg were administered by intravenous drip infusion for 1 to 2 hours, twice a day for 4 to 12 days. To the cases of biliary tract infection, GM was treated for preoperative chemotherapy and to the other cases GM was treated for postoperative chemotherapy. Clinical response was excellent in 7 cases, good in 6 cases, fair in 1 case and poor in none. No adverse effect was observed. The organisms were isolated in 7 cases, 7 were Escherichia coli, 2 were Klebsiella pneumoniae and 3 were Bacteroides fragilis. The MICs for GM were 0.78--1.56 micrograms/ml in 10(8) and 10(6) cells/ml, except B. fragilis. Before the operation of above cases, GM in a dose of 60 mg (a case was 40 mg) were administered by intravenous drip infusion for 1 to 2 hours in 7 cases (3 biliary tract infection, 2 acute peritonitis and 2 gastric ulcer) and 7 cases by intramuscularly. The materials of common duct bile, gall bladder bile, gall bladder wall, the appendix and other tissues, ascites and serum samples were taken during the operation. GM concentration was measured by bioassay method with Bacillus subtilis ATCC 6633 as test organism. GM concentrations in bile and gall bladder wall after intravenous drip infusion were higher than those after intramuscular administration. In the appendicitis with localized peritonitis, GM concentration in the appendix wall with catarrhal appendicitis was 0.90 microgram/g after intramuscular administration. In the cases with diffuse peritonitis and catarrhal appendicitis, GM concentrations in appendixes were 1.18 micrograms/g and 1.37 micrograms/g after intravenous drip infusion. Therefore, it was supposed that GM could be used safety and usefully by intravenous drip infusion than that by intramuscular administration. PMID- 6842831 TI - [Clinical evaluation of cases of aplastic anemia--with special reference to the effect of anabolic steroids]. PMID- 6842832 TI - [Case of pernicious anemia with immunodeficiency, improved after administration of vitamin B12]. PMID- 6842830 TI - [Clinical studies on cefadroxil in the field of pediatrics]. AB - The newly developed cefadroxil (CDX) dry syrup in a mean daily dose of 32.9 mg/kg t.i.d. or q.i.d. was administered to children for a period of 8 days on the average; viz. a total of 64 cases consisting of 39 cases of tonsillitis, 2 of tonsillitis complicated with otitis media, 1 of bronchitis, 1 of pneumonia, 14 of scarlet fever, and 7 of urinary tract infections; and its clinical and bacteriological effects, and adverse reactions were examined, leading to the following results. 1. The clinical effects were "good" or "excellent" in any of 39 cases of tonsillitis, 2 of tonsillitis complicated with otitis media, 1 of pneumonia, 14 of scarlet fever, and 7 of urinary tract infections, and "fair" only in a case of bronchitis, showing the high efficacy of 98.4%. 2. The clinical effects by daily dose were compared only in the great cases of tonsillitis between the 2 daily dose groups of 30 mg/kg or below and 31 to 40 mg/kg, and both groups showed "good" or "excellent" results, but the latter group revealed that the excellent rate was greater by 20.8% than that of the former group. 3. The frequency of daily administration was 3 times or 4 times and the cases of 4 times administration were few in any disease. In comparison of clinical effects between the 3 times group and the 4 times group in the whole cases, no significant difference was observed between both groups but it is desirable to make the 4 times administration in view of the pharmacokinetics. 4. The bacteriological effects could be judged in 15 cases, namely bacteria were eradicated in 14 cases and unchanged in 1 case, showing a good result of the eradication rate as 93.3%. 5. No adverse reaction was observed and the laboratory test values showed eosinophilia in 7 cases (15.9%) and abnormal elevations of GPT in 1 case (4.5%), of GOT and GPT in 2 case (9.1%), of LDH in 1 case (4.8%) and of BUN in 1 case (4.8%), but 4 of the 7 cases with eosinophilia seemed attributable to underlying diseases or objective diseases. From the above it can be said that this preparation is a useful drug in mild bacterial diseases. PMID- 6842834 TI - [Acute kidney failure--pathological study]. PMID- 6842833 TI - [Monoclonal gammopathies associated with silicosis]. PMID- 6842835 TI - [Rhabdomyolysis and acute renal failure]. PMID- 6842836 TI - [Drug-induced acute renal failure]. PMID- 6842837 TI - [DIC, hemolytic uremic syndrome and acute renal failure]. PMID- 6842838 TI - [Acute cortical necrosis]. PMID- 6842839 TI - [Acute renal failure in the surgical field]. PMID- 6842840 TI - [Acute renal failure in emergencies]. PMID- 6842841 TI - [Acute renal failure in the field of obstetrics and gynecology]. PMID- 6842842 TI - [Acute renal failure in urologic field]. PMID- 6842843 TI - [3 cases of acute renal failure in pediatric field]. PMID- 6842845 TI - [Animal models of acute kidney failure--uranyl acetate induced toxic renal failure]. PMID- 6842844 TI - [Acute renal failure in the aged]. PMID- 6842846 TI - [Management of acute kidney failure]. PMID- 6842847 TI - [Ultrasonically guided percutaneous puncture--its history, progress and availability]. PMID- 6842850 TI - [Salivary gland antibodies in Sjogren's disease]. PMID- 6842849 TI - [Humoral antibody in Sjogren's disease]. PMID- 6842848 TI - [Prevention of hypertension--recommendation from WHO]. PMID- 6842851 TI - [Anti-salivary duct antibodies in Sjogren's disease]. PMID- 6842852 TI - [Specific autoantibodies in Sjogren's disease]. PMID- 6842854 TI - [Chronic rheumatoid arthritis associated with Sjogren's disease in sisters]. PMID- 6842853 TI - [Anti-PTH antibody and anti-calcitonin-antibody in Sjogren's syndrome]. PMID- 6842855 TI - [Immunologic abnormalities and classification of Sjogren's syndrome--Mikulicz syndrome and its relationship to sicca syndrome]. PMID- 6842856 TI - [Acute renal failure and systemic circulation]. PMID- 6842858 TI - [Tubuloglomerular feedback]. PMID- 6842857 TI - [Renal circulation dynamics, urine concentration and dilution ability]. PMID- 6842859 TI - [Definition, classification and differential diagnosis of acute kidney failure]. PMID- 6842860 TI - [Electrolyte and mineral metabolism in acute renal failure]. PMID- 6842861 TI - [Acid base equilibrium in acute kidney failure]. PMID- 6842863 TI - [Acute renal failure and gram negative Bacillus infections]. PMID- 6842862 TI - [Acute kidney failure and abnormal hormonal secretion]. PMID- 6842864 TI - [Congestive heart failure and acute renal failure]. PMID- 6842865 TI - [Acute renal failure and diabetes mellitus]. PMID- 6842866 TI - [Acute renal failure and hepatobiliary tract diseases]. PMID- 6842867 TI - [Acute renal failure and hematologic diseases]. PMID- 6842869 TI - [Real-time ultrasonically guided percutaneous transhepatic cholangiography(UGPTC) and percutaneous transhepatic bile drainage(UGPTBD): indication for the first puncture UGPTBD]. PMID- 6842868 TI - [Acute renal failure and malignant tumors]. PMID- 6842870 TI - [Computed tomography of cystic neoplasms of the pancreas]. PMID- 6842871 TI - [Malignant hemangiopericytoma]. PMID- 6842872 TI - [Horseshoe kidney and its complications]. PMID- 6842873 TI - [A case of bilateral extracranial fenestrations of the vertebral arteries]. PMID- 6842874 TI - [Extravasation of contrast media from intracranial aneurysm. Report of a case]. PMID- 6842875 TI - [Radiographic visualization of calcification of the meandering mesenteric artery- a case report]. PMID- 6842876 TI - [Case of the left side inferior vena cava with left renal cell carcinoma]. PMID- 6842877 TI - [Hepatic oil embolism after lymphography in a patient with carcinoma of the uterine cervix]. PMID- 6842878 TI - [Radiotherapy of malignant exophthalmos (report of a case)]. PMID- 6842879 TI - [Computed tomography of limy bile]. PMID- 6842880 TI - [Sialography using the automatic injector: preliminary report]. PMID- 6842881 TI - [Malignant lymphoma invading psoas major muscle]. PMID- 6842882 TI - [Cisternoscintigraphy and cerebrospinal rhinorrhea]. PMID- 6842883 TI - [Radiotherapy and chemotherapy for ovarian cancer]. PMID- 6842884 TI - [Transcatheter arterial embolization of renal disease]. PMID- 6842885 TI - [Development of transcatheter embolization in neuroradiology]. PMID- 6842886 TI - [Expectation on clinical application of nuclear magnetic resonance (NMR)]. PMID- 6842887 TI - [CT scan of bacterial and aseptic meningitis]. PMID- 6842889 TI - [Ultrasonography in the diagnosis of chest diseases]. PMID- 6842888 TI - [Selective thyroid venography--techniques, anatomy and indications]. PMID- 6842890 TI - [Scanning electron microscopic studies on normal gastric mucosa and regenerative mucosa in gastric ulcers]. PMID- 6842891 TI - [Case of acute amebic dysentery with toxic megacolon]. PMID- 6842892 TI - [A constrictive form of ischemic colitis]. PMID- 6842893 TI - [Hyperplastic gastritis in rat stomach mucosa induced by a low dose of MNNG plus bile]. PMID- 6842894 TI - [Release of immunoreactive gastrin (IRG) into the duodenal lumen of the dog]. PMID- 6842895 TI - [Generational change of alkaline phosphatase isozymes from rat transplantable gastric carcinoma tissues induced by N-methyl-N'-nitro-N-nitrosoguanidine]. PMID- 6842896 TI - [Immunohistochemical study of secretory component, IgA and CEA in gastrointestinal lesions]. PMID- 6842898 TI - [Studies on the drug-induced injury and changes of membrane structure in the isolated liver cells]. PMID- 6842900 TI - [Studies on the fine vessels in the healing process of acetic acid ulcer in the rat stomach--scanning electron microscopic studies using plastic vascular models]. PMID- 6842899 TI - [The clinical significance of ultrasonic-guided puncture cholecystography]. PMID- 6842897 TI - [Blood coagulation and fibrinolysis in patients with ulcerative colitis]. PMID- 6842901 TI - Open surgical renal biopsy: its indications and advantages of posterior surgical approach. PMID- 6842903 TI - [Clinical study of 143 patients treated at the kidney center in the Fukuoka University Hospital]. PMID- 6842902 TI - [Case of Imerslund's syndrome (selective vitamin B12 malabsorption with proteinuria) with emphasis mainly on renal histology]. PMID- 6842905 TI - [Clinicopathologic study on IgA nephropathy: clinical and histological features suggestive of progression of the disease]. PMID- 6842904 TI - Electrical threshold levels of nucleus locus coeruleus in normotensive and renovascular hypertensive rats. PMID- 6842906 TI - [Significance of microtubular structures in the diagnosis of the early stage of Systemic Lupus Erythematosus]. PMID- 6842907 TI - A comparative electron microscopic study of antibiotic nephrotoxicity. PMID- 6842909 TI - Comparison of airway responsiveness to exercise and histamine inhalation in asthmatics. AB - In order to investigate the differences between EIA positive and negative subjects, pulmonary function data at rest, atopic tendency and bronchial sensitivity and reactivity were compared. Pulmonary function data revealed no significant difference between two groups except closing volume which was higher in EIA positive patients (p less than 0.01) and also Rrs which was higher in EIA positive patients only in female (p less than 0.05). Incidence of positive skin tests and higher levels of IgE were more frequent in EIA positive, however, IgE was not significantly different. Relationship between % fall of FEV1 after exercise and bronchial sensitivity was examined, however, no correlation was found in two parameters. Bronchial reactivity was not different in two groups. This suggests that EIA positive patients cannot be distinguished from EIA negative by pulmonary function data at rest or by atopic tendency, and also that different mechanisms play a role to produce airway constriction following exercise and inhalation challenge. PMID- 6842908 TI - Physical constitution and smoking habits of patients with idiopathic spontaneous pneumothorax. AB - This is a report on a statistical study comparing the Kaup index and the level of tobacco consumption of patients with idiopathic spontaneous pneumothorax and those of healthy subjects. A statistically significant difference was found between the average Kaup index of the patients with idiopathic spontaneous pneumothorax and that of normal healthy individuals in Japan as published by the Ministry of Health and Welfare. A statistically significant difference was also found in the physical features between 2,433 males with idiopathic pneumothorax and 1,906 healthy males when compared by means of the Kaup index. Again, a statistically significant difference was noted in the level of tobacco consumption between the males with idiopathic pneumothorax and normal males when compared by means of the Brinkmann index. The Kaup index of idiopathic pneumothorax patients was lower than that of healthy subjects, while the level of tobacco consumption of the former was higher. Idiopathic spontaneous pneumothorax is related to thin and tall individuals and the level of tobacco consumption among such patients is higher than among healthy subjects. PMID- 6842910 TI - Two cases of portal-systemic shunts demonstrated by portal venography performed by operative cannulation of ileocolic vein. AB - Two cases of portal-systemic shunt were presented. A 70 year-old cirrhotic female, who was suffered from mental confusion, underwent portal venography which demonstrated a large varicose vein connecting the inferior mesenteric vein with the left renal vein. The mean portal pressure was 15 cm saline. There were no esophagogastric varices. A 47 year-old cirrhotic female, who was admitted for evaluation of liver dysfunction found incidentally, underwent portal venography which revealed a dilated coronary vein connecting to the left renal vein. The portal pressure was 23 cm saline. There was no evidence of esophageal varices. Portal venography was performed through the ileocolic vein in both cases. In general, bleeding varices may develop most commonly in coronary-azygous system and less frequently in the territory of the superior and inferior mesenteric veins. On the contrary, retroperitoneal portal-systemic shunts is likely to cause hepatic encephalopathy rather than to develop bleeding varices. Thus, it is necessary to perform abdominal angiography in patients with hematochezia of unknown etiology or recurrent episodes of hepatic encephalopathy. PMID- 6842911 TI - Combination chemotherapy in retroperitoneal poorly differentiated myxoid liposarcoma: a report of a case. AB - We describe a case of a 47-year-old man with retroperitoneal poorly differentiated myxoid liposarcoma. The retroperitoneal invasion of the sarcoma caused hydroureter-nephrosis, rectal stenosis and also exaggerated steroid induced diabetes mellitus. A remarkable regression was achieved by systemic combination of chemotherapy with prednisolone, cyclophosphamide, vincristine sulfate and actinomycin D. This combination chemotherapy is worth trying if a patient has inoperable liposarcoma. It can also be used to reduce local recurrence rate after surgical or radiation therapy, or both, against liposarcoma. PMID- 6842912 TI - Diaphragmatic flutter with a manifestation of high frequency ventilation. AB - A case of diaphragmatic flutter following status asthmaticus is presented. The initial symptom was tachypnea resembling hyperventilation syndrome. When spontaneous ventilation was completely suppressed for 15 minutes with intravenous administration of pethidine, levels of arterial blood gases were not much deviated from normal limits, because of possible high frequency ventilation. Although the medical therapeutics previously reported in literatures, including diphenylhydantoin, were ineffective in this case, butylophenones provided favourable results despite of some complications. The etiology and management of diaphragmatic flutter are discussed. PMID- 6842913 TI - Symposium on microbial infection and host response. PMID- 6842914 TI - [Experiences with porcine pericardium monocusp ventricular outflow patch (MVOP, Polystan) for reconstruction of right ventricular outflow tract]. PMID- 6842915 TI - [Case of hyperosmolar hyperglycemic nonketotic coma following mitral valve replacement]. PMID- 6842916 TI - [Transesophageal echocardiography for the diagnosis of lung cancer with left atrial involvement]. PMID- 6842919 TI - [Surgical correction of the aneurysm of the main pulmonary artery]. PMID- 6842917 TI - [Clinical investigation of extracorporeal circulation for surgical treatment of descending thoracic aorta]. PMID- 6842920 TI - [Case report of the pulmonary embolism, probably due to SLE]. PMID- 6842921 TI - [Case report of cor triatriatum]. PMID- 6842918 TI - [Bjork-Shiley aortic valvular dehiscence]. PMID- 6842922 TI - [Case report of aneurysm of the mitral valve associated with aortic valve disease]. PMID- 6842923 TI - [Surgical treatment of ruptured aneurysm of sinus of Valsalva into the left ventricle associated with complete A-V block]. PMID- 6842924 TI - [Surgical treatment for mitral regurgitation due to papillary muscle dysfunction following myocardial infarction]. PMID- 6842925 TI - [Surgical treatment of coarctation of the aorta and interrupted aortic arch in infants and children---a new operative technique for repairing hypoplastic aortic arch]. PMID- 6842926 TI - [Diagnosis of tuberculosis]. PMID- 6842927 TI - [A supplementary study on Mycobacterium gadium Casal & Rey Calero 1974]. PMID- 6842928 TI - [Current status of miliary tuberculosis in Japan--analyses of the factors related to the manifestation and death of miliary tuberculosis]. PMID- 6842929 TI - [Tuberculosis in dialysis patients. 7. High susceptibility to lymphnode tuberculosis]. PMID- 6842930 TI - [A clinical study on the chemotherapy for pulmonary tuberculosis in diabetics]. PMID- 6842931 TI - [A study on the family contacts examination of tuberculosis patients. (Sixth report)]. PMID- 6842932 TI - [Echocardiographic signs and differential diagnosis of the infravalvular form of an oblique atrioventricular canal]. AB - Differential diagnosis of tricuspid valve abnormality in patients with infravalvular oblique atrioventricular canal is outlined. Apart from direct echocardiographic evidence of interventricular septal defect (disorder of septo aortal contact localization of both atrioventricular valves through the defect, without the separating interventricular septum), these patients showed signs of tricuspid valve dysfunction, such as increased amplitude and rate of anterior tricuspid cusp opening, pathologic anteriosystolic movement of the cusp, excessive and fragmentary movement of the septal cusp and, in isolated cases, flat-wave cusp fibrillation during ventricular systole, with increased ultimate diastolic diameter of the right ventricle and its outgoing tract. PMID- 6842933 TI - [Study of the neural component of the reaction to temporary myocardial ischemia]. PMID- 6842934 TI - [Arterial embolism of the limbs]. PMID- 6842935 TI - [Results of reconstructive operations in thrombo-obliterating diseases of the blood vessels of the lower limbs in relation to the degree of change in the blood flow and tissue metabolism]. PMID- 6842936 TI - [Diagnosis of myxoma of the right atrium]. PMID- 6842937 TI - [Cardiac hyperfunction in patients with diseases of the aorta and main arteries]. PMID- 6842938 TI - [Ways of improving the therapeutic management of angiosurgical patients in a specialized vascular surgery department]. AB - Many years of experience of the Yaroslavl Interregional Vascular Centre suggests that better therapeutic support at vascular surgery units may be one of approaches to improving current specialized angiosurgical care. Collaboration of angiosurgeons and therapeutists, and drug correction of possible disorders and complications before and after vascular reconstructive surgery is expected to contribute to better outcomes of treatment in patients with acute and chronic pathologic developments in arteries and veins. PMID- 6842939 TI - [Hemosorption in patients with chronic disorders of arterial blood circulation in the lower limbs]. AB - Hemosorption was used in 35 patients with chronically disordered arterial circulation in the lower limbs. Atherosclerotic vascular lesions were noted in all the patients. The study group was composed of patients with diffuse lesions in the lower limbs' arterial bed, where surgical treatment was not indicated because of poor general condition, as well as those after reconstructive vascular surgery performed to prevent thrombosis and prolong operation of the shunts. Clinical parameters, blood lipid composition, rheovasographic, thermometric, thermographic, capillaroscopic, Doppler-ultrasonometric findings, and muscular flow (using local 133Xe clearance technique) were examined in all the patients before, and on days 1, 3, 7, 14 after the hemosorption. A stable short- as well as long-term improvement of regional circulation in lower limbs is noted after hemosorption. It appears to be a new promising method for the treatment of patients with atherosclerotic vascular lesion of lower limbs, where surgical treatment is not indicated, and survivors of vascular surgery for shunt thrombosis prevention. PMID- 6842940 TI - [Comparative characteristics of gas and mechanical endarterectomy based on light and scanning electron microscopy]. AB - A portion of a coronary artery removed at mechanical or gas endarterectomy shows the intima, internal elastic membrane and part of the media. After gas endarterectomy, the vascular "mould" is cone-shaped and pointed, resembling the main arterial trunk with lateral branches, whereas its surface is smooth. After mechanical endarterectomy, the main trunk "mould" may have no lateral branches, while its surface is rough. Electron microscopic scanning shows collagen and elastic fibres of the vascular wall to remain intact following gas endarterectomy, while after mechanical procedure they are torn and "stick out" on the surface, this observation providing anatomical evidence for the advantage of the gas technique over the mechanical one. Following endarterectomy, the vessel retains part of the media, outer elastic membrane and adventitia, whereas the vascular lumen closes due to dystonia of folding vascular wall. PMID- 6842941 TI - [Effectiveness of the modified Linton operation in post-thrombophlebitic syndrome in the light of remote results and medical, social and vocational rehabilitation]. AB - The results of surgical and conservative treatment of 207 patients with the post thrombophlebitic syndrome in pedal veins suggested that modified Linton's operation produced very good long-term effect in late postoperative period. Therefore it can be used as an operation of choice in surgical treatment for this pathology. The efficiency of the operation is improved significantly, if postoperative medical, social and occupational rehabilitation is conducted on a consistent basis. PMID- 6842942 TI - [Use of the microsurgical technics in the treatment of occlusive diseases of the main arteries of the lower limbs]. AB - Microsurgical techniques permit high-quality intervascular anastomosis in small and mid-caliber arterial surgery of lower extremities. This improves immediate outcomes in surgical patients with obliterating atherosclerosis of lower extremities. Microsurgical femoropopliteal autovenous shunting in patients with ischemia of the third or fourth degree (by Fontana) reduced the rate of shunt thrombosis from 37 to 27%. Microsurgical autovenoplasty of the deep femoral artery showed actually no thromboses at follow-up. PMID- 6842943 TI - [Central hemodynamics in patients with arteriosclerosis obliterans of the lower limbs]. AB - Central hemodynamic status was studied using integral body rheography in 93 patients with arterial atherosclerotic occlusions in lower extremities and aorto iliac region. Changes in central hemodynamic parameters were established in 65,6% of the patients, correlating with the severity of aorto-arterial lesion, location of the process and duration of the disease. Improvement of peripheral circulation under the effect of conservative and surgical treatment (lumbar sympathectomy and reconstructive vascular surgery) was accompanied with favourable changes in central hemodynamic parameters in all the patients. PMID- 6842944 TI - [Left-ventricular function before and after aneurysmectomy]. AB - Clinical findings in central hemodynamics of patients with postinfarction aneurysm of the heart are reported. Hemodynamics and myocardial contractility were examined during surgery in 92 patients. Aneurysmectomy was shown to normalize, while still in the surgery, residual volumes of heart cavities and increase significantly myocardial performance. A method for recording hemodynamic information and results of surgical treatment, with blood pressure and flow rate presented as diagrams, is discussed. PMID- 6842945 TI - [Arterial embolism and acute thrombosis in patients with arteriosclerosis and rheumatic heart disease]. AB - The results of diagnosis and treatment of patients with atherosclerosis and rheumatic heart disease are reported (150 cases of embolism and 39 cases of acute thrombosis in the aorta and main arteries of the limbs). The diagnosis was late in 73.3% of the patients, for which reason 22% were admitted with the third stage of the disease. Embolectomy was performed in 111 cases, amputation of a limb without blood flow recovery in 7, and conservative treatment was conducted in 32 cases. Postoperative mortality was 13.7%, and amputation rate 12.5%. Thirteen thrombectomies and 12 reconstructive operations were performed in patients with acute aortofemoral thromboses. Improved diagnosis is expected to reduce postoperative mortality and amputation rates. PMID- 6842946 TI - [Management of iatrogenic injuries of the blood vessels]. AB - A survey of causes and conditions conducive to the development of iatrogenic vascular lesions in 34 patients suggested a classification of the causes in order to specify major trends and methods of their prevention. Specific management strategies are outlined for different kinds of iatrogenic vascular lesions. Timely and adequate reconstructive surgery produces good functional results in cases of severe vascular lesion accompanied with marked regional ischemia. PMID- 6842947 TI - [Mechanisms of regulation of high cardiac output in patients with hypertension (angiocardiographic study)]. AB - To identify mechanism conditioning high cardiac output, an angiocardiographic study was conducted in 39 patients with essential hypertension. Increased stroke and cardiac output was found to be due to increased venous inflow, with inotropic condition of the hypertrophic myocardium being reduced in spite of enhanced general pumping function of the left ventricle. As arterial hypertension tended to stabilize and cardiac output declined, total peripheral resistance assumed the principal responsibility for its regulation, whereas at earlier stages of the disease it shows either normal, or even reduced levels, and venous inflow is the principal factor controlling cardiac and stroke output. PMID- 6842948 TI - [Current state and perspectives of the problem of thromboembolism of the pulmonary artery]. PMID- 6842949 TI - [Transcatheter occlusion of the bronchial and systemic arteries of the lung in patients with tetralogy of Fallot as a method of arresting pulmonary hemorrhage]. AB - Transcatheter endovascular occlusion of systemic arteries, the sources of pulmonary haemorrhages, has advantages over operative means of hemoptysis arrest. It is the only patients with congenital valvular blue-type defects, with markedly developed network of systemic pulmonary arteries. Two case reports are presented where the occlusion of bleeding systemic vessels was successful. Mechanisms of pulmonary haemorrhage development in cases of Fallot's tetrad are discussed. Practical recommendations are made with respect to the identification of vessels causing pulmonary bleeding and transcatheter occlusion thereof. PMID- 6842950 TI - [Hemodynamic indicators, phase structure of the systole of the left and right heart ventricles and the state of pulmonary circulation and microcirculation in patients with hypertension treated with adelphane-esindex]. AB - A total of 58 patients were treated with adelphane-esidrex for hypertension, Stage II. Their general condition improved considerably and arterial blood pressure obviously decreased. The hypotensive effect of the treatment was associated with a considerable fall of high systemic peripheral resistance in most patients, and with reduced systolic and minute blood volume in others. An improvement was noted in the phasic pattern of left and right ventricular systole, pulmonary circulation, external respiratory function and also microcirculation. PMID- 6842951 TI - [Comparative study of various non-invasive methods of recording arterial blood pressure]. PMID- 6842953 TI - [Treatment of auricular fibrillation after correction of rheumatic heart disease under extracorporeal circulation]. AB - Of 372 patients operated on for rheumatic valvular defects under extracorporeal circulation, 221 patients had chronic atrial fibrillation. In 41 patients, the duration of arrhythmia ranged from a few months to 2 years. Sinus rhythm was recovered in 22 patients, using quinidine and electric-impulse treatment, and 19 patients have maintained it continuously for many years. Factors contributing to stable and lasting sinus rhythm are an adequate correction of the defect, inactive rheumatic process, and the duration of atrial fibrillation not exceeding 1-2 years. The optimum time for sinus rhythm recovery is 2-6 months after surgery. Sinus rhythm recovery prior to surgical correction of the defect is not recommended. PMID- 6842954 TI - [Treatment of paroxysmal forms of auricular fibrillation and atrial flutter in a cardiological hospital]. AB - The results of treatment of paroxysmal forms of atrial fibrillation and flutter are analysed in a group of 503 patients with attacks lasting up to 3 weeks. The sinus rhythm was restored in 84.7% of patients, in only 3% of cases was electro impulse therapy resorted to. In alcohol toxic form of atrial fibrillation and flutter potassium chloride was the most effective drug for restoration of the sinus rhythm in 47.1% of cases, and if used with cardiac glucosides in 64.7%. In atrial fibrillation and flutter of other etiology the method of choice was a combination of quinidine with isoptine either by itself, or after saturation of the body with potassium chloride (85% cases of sinus rhythm restoration). PMID- 6842952 TI - [Characteristics of the phase of blood expulsion from the left ventricle in arterial hypertension and aortic valve stenosis]. AB - A study of 96 patients (23 controls, 57 patients with arterial hypertension and 16 with aortal stenosis) has shown the ascending aortal pressure curve to conform to the ascending exponent with different time constants in all cases. The expulsion time constant for middle age (44 +/- 4 years) was 0.063 +/- 0.002 s, with the expulsion time/time constant ratio of 4.01, in normal controls; 0.095 +/ 0.03 s and 2.6, respectively, in hypertensive patients; and 0.170 s and 1.72, respectively, in patients with aortal stenosis. The difference between ventriculographic and estimated left ventricular stroke volumes was not significant (p less than 0.001). Hemodynamic resistance to expulsion was 132 +/- 6 din X s X cm-5 in the controls, and 299 +/- 14 and 305 +/- 28 din X s X cm-5, respectively, in patients with arterial hypertension and aortal stenosis. PMID- 6842955 TI - [Data on repeated studies on the blood lipid levels in evaluating the severity of chronic ischemic heart disease]. AB - During 3 years cholesterol, triglyceride and lipoprotein levels were repeatedly determined in the blood of 125 patients with coronary disease, and the severity of the disease was assessed with bicycle ergometry and coronarography. A relationship has been established between the severity of the disease and its course and the degree of disorders in the lipid metabolism. Group with stable normolipidemia (28%) showed less manifest symptoms of the disease and absence of rapid progression with new coronary accidents. Groups with hyperlipoproteinemia both stable (52.8%) and transient (19.2%) had predominantly severe forms of the disease running unfavourable course. The more frequent with severe and extended, according to angiography atherosclerosis of the coronaries and unfavourable course of disease were associated with hyperlipoproteinemia type II. PMID- 6842956 TI - [Atherogenic changes in lipid metabolism caused by alcohol]. AB - Plasma lipid composition, and plasma and myocardial high-density lipoprotein (HDLP) content were examined in subjects who died of acute ethanol poisoning and in cases of sudden coronary death. Alcohol-induced disorders of lipid metabolism were in many respects similar to lipid metabolic disturbances associated with coronary disease (hypertriglyceridemia, hyperpre-beta- and hyper-beta lipoproteinemia, myocardial lipoidosis). These disorders of lipid metabolism had developed in the presence of increased blood HDLP and cholesterol HDLP, which are known to produce an anti-atherogenic effect. PMID- 6842958 TI - [Diagnostic and prognostic significance of the changes in vectorcardiographic QRS and T waves in ischemic heart disease]. AB - In various clinical forms of coronary disease, vectorcardiographic changes are mostly dependent on the depth and spread of necrotic and dystrophic myocardial changes. In ischemia, T wave only changes its trend, while in small-focus dystrophies and necrosis, it changes both in terms of trend and shape, and in limited myocardial infraction, changes in T shape and trend are combined with those of QRS complex. The more profound and expanded the necrotic changes, the more pronounced are spatial, phasic and morphological changes in QRS and T waves, while the ratio of T and QRS are-as (AT/AQRS) exceeds 60%. Vectorcardiograms showing simultaneous morphological, phasic and spatial changes in QRS and T waves, with DI (dynamic index of electrical activity) exceeding 60% in records from 2 and more leads, indicate marked necrotic myocardial changes and poor prognosis for the outcome of acute myocardial infarction. PMID- 6842957 TI - [Development of atherosclerosis in patients with lung diseases]. PMID- 6842959 TI - Animal model of aluminum-induced osteomalacia: role of chronic renal failure. AB - Both aluminum toxicity and a relative deficiency of parathyroid hormone have been implicated in the development of osteomalacia in dialysis patients. To study the effect of intraperitoneal (IP) aluminum injections on bone histology and parathyroid hormone and to determine if chronic renal failure accentuates aluminum toxicity, rats were divided into five groups: normals (N); low dose aluminum (LDA), 0.1 mg IP aluminum daily; high dose aluminum (HDA), 1.0 mg IP aluminum daily; chronic renal failure (CRF); and chronic renal failure plus high dose aluminum (CRF-HDA). At the conclusion of the study, there were no differences between N and LDA rats. Between the other groups, marked differences were observed. Compared to N rats, the relative osteoid volume (P less than 0.02) and the osteoid seam width (P less than 0.001) were increased in HDA, CRF, and CRF-HDA rats. Percent resorption and osteoclasts/mm2 were increased in CRF rats (P less than 0.02) and decreased in HDA rats (P less than 0.05). Compared to N rats, the amino terminal parathyroid hormone was decreased in HDA rats (P less than 0.02) despite the presence of hypocalcemia. These data suggest that (1) aluminum toxicity produces osteomalacia; (2) a relative parathyroid hormone deficiency may be a contributory factor; (3) chronic renal failure increases the severity of aluminum-induced osteomalacia; and (4) chronic renal failure alone does not result in osteomalacia. PMID- 6842960 TI - Relation of dark cells to the transport of H+/HCO3- and K+ ions: a microperfusion study in the rat submaxillary duct. PMID- 6842961 TI - Morphometric comparison of rabbit cortical connecting tubules and collecting ducts. AB - Connecting tubule (CNT) segments of the rabbit distal nephron were examined by scanning electron microscopy and computer-assisted morphometric analysis of transmission electron micrographs. CNT were very similar to the cortical collecting ducts (CCD) described previously. The epithelium of both segments contains two cell types, both of which can be modeled as simple cuboidal cells, and two distinct systems of extracellular channels. The lateral intercellular channels are comparable to the spaces between simple cuboidal cells but are modified by short projecting microvilli which produce a modest increase in lateral cell surface area. The basal infolded channels are best developed in the connecting tubule cells of CNT and contribute 63% of all channel-associated membranes in CNT. Total membrane areas are similar in CNT and CCD. The two segments differ only in the degree of extracellular channel dilation and the distribution of infolded membrane relative to cell height in the connecting tubule and principal cells. The relatively minor morphometric differences between CNT and CCD do not correlate well with the marked difference in transtubular volume flow induced in the two segments by ADH and an osmotic gradient. PMID- 6842962 TI - Renal vein thrombosis in idiopathic membranous glomerulopathy and nephrotic syndrome: incidence and significance. AB - The point prevalence and clinical significance of renal vein thrombosis (RVT) was evaluated in 27 of 33 consecutive nephrotic patients with idiopathic membranous glomerulopathy. A technique of retrograde venography after the injection of epinephrine into the main renal artery to decrease renal blood flow was used. Two patients had histories compatible with a thromboembolic event, and the excretory urogram was not suggestive of RVT in any patient. RVT was noted in 13 patients; in eight it was bilateral. All patients with RVT received anticoagulant drugs for a minimum of 1 year after the study, and no thromboembolic events occurred in this group. No patient was treated with corticosteroids. Follow-up observation of an average of 2.5 years has not revealed a significant difference in the rate of renal function deterioration or change in degree of proteinuria between patients with and without RVT. Coagulation abnormalities included elevated platelet counts and plasma fibrinogen levels and prolonged reptilase and thrombin times. These were noted in all 14 patients studied, six of whom had RVT. In patients experiencing a nephrotic remission, coagulation abnormalities reverted to normal. RVT is common in idiopathic membranous glomerulopathy with nephrosis and is associated with few clinical markers. Its influence on renal function and proteinuria is of questionable significance. Coagulation abnormalities may be a causative factor of RVT in this setting. PMID- 6842963 TI - Macroscopic hematuria in mesangial IgA nephropathy: correlation with glomerular crescents and renal dysfunction. AB - One hundred and eighty-six renal biopsy specimens from 79 adult patients with mesangial IgA nephropathy were examined and correlated with clinical data at the time of biopsy. Forty patients (group 1) with a history of macroscopic hematuria were compared with 39 patients (group 2) without such a history. Group 1 patients had a higher serum creatinine, 240 +/- 20 mumoles/liter vs. 140 +/- 10 mumoles/liter (P less than 0.01), lower creatinine clearance 69 +/- 36 ml/min vs. 87 +/- 30 ml/min (P less than 0.05), and a higher percentage of patients presenting with serum creatinine greater than 300 mumoles/liter, 22.5% vs. 5.1% (P less than 0.05). Fourteen biopsies were performed in 11 patients during an episode of macroscopic hematuria (group 1A). One hundred percent of these biopsy specimens showed crescents. Ninety-one percent of 11 biopsy specimens from ten patients (group 1B), taken 3 to 27 days following an episode but at a time when urinary red cells were less than 1,000,000/ml, also showed crescent formation. Of 14 biopsy specimens from 13 patients without macroscopic hematuria, but with greater than 1,000,000 red cells/ml in the urine just prior to biopsy (group 2A), 79% had crescents. In conclusion, macroscopic hematuria in adult patients with mesangial IgA nephropathy is associated with a high likelihood of crescents on renal biopsy specimens and worse renal function. Careful quantitative assessment of the urine for renal bleeding may help to better define the activity of disease in these patients. PMID- 6842964 TI - Validation of inulin as a marker for glomerular filtration in preterm babies. PMID- 6842965 TI - Pathophysiology of obstructive nephropathy. PMID- 6842966 TI - Dietary tryptophan supplementation prevents proteinuria in the seven-eighths nephrectomized rat. AB - Surgical reduction of renal mass in the rat leads to proteinuria, hypertension, and progressive renal failure beyond that of the original physical destruction of renal mass. Both hypertension and proteinuria have been implicated in the process of progression of renal failure. The seven/eighths nephrectomized rats fed a diet supplemented with 4% tryptophan (UT) had a urinary albumin excretion rate of 0.055 +/- 0.056 mg/100 g body weight/hr compared to 0.02 +/- 0.029 mg/100 g body weight/hr in control rats, whereas the nephrectomized rats fed a regular diet (UR) excreted 1.12 +/- 0.730 mg/100 g body weight/hr (P less than 0.001). Hypertension was also prevented in the UT group but not in the UR group. Once hypertension and proteinuria were established during maintenance on a regular diet, they were not reversed by subsequent dietary tryptophan supplementation. If dietary tryptophan supplementation is continued, however, the progressive histopathology that develops after seven-eighths nephrectomy is not prevented despite avoidance of proteinuria and hypertension. PMID- 6842968 TI - Aluminum leakage from REDY sorbent cartridge. PMID- 6842967 TI - Red blood cell aggregation in nephrotic syndrome. AB - Red blood cell (RBC) aggregation induced by fibrinogen is a major determinant of the non-Newtonian flow behavior of human blood and has been suggested as a possible contributing factor for thrombogenesis. Given the elevated fibrinogen levels and the high incidence of thrombotic accidents in nephrotic syndrome (NS), a study was designed to assess RBC aggregation in this disease. Three different aggregation assays were used: (1) changes in light transmission through static cell suspensions, aggregation half time (AHT); (2) low gravity centrifugation of blood in nearly vertical tubes, zeta sedimentation ratio (ZSR); (3) direct observation of dilute RBC suspensions, microscopic aggregation index (MAI). The results indicate that RBC aggregation, as measured by AHT and ZSR, is increased significantly in NS patients versus healthy controls (P less than 0.001 for both methods); this increase was not a function of renal insufficiency. The AHT and ZSR data were well correlated with plasma fibrinogen levels (r = 0.75 and 0.84, respectively). No differences were observed with the MAI method, since with this technique the aggregation process reaches an asymptotic plateau for the range of fibrinogen found in NS. Implications of increased RBC aggregation and thus increased blood viscosity and flow disturbances on thrombogenesis are discussed. PMID- 6842969 TI - Hypertension in the elderly. PMID- 6842971 TI - [The breast feeding problem in East Germany--a challenge for the pediatrician]. PMID- 6842970 TI - [Iron requirement and iron intake of children and adolescents in East Germany]. PMID- 6842973 TI - [Studies on breast feeding behavior in the district of Stadtroda]. PMID- 6842972 TI - [Progress in increasing the frequency of breast feeding]. PMID- 6842974 TI - [Treatment control of children with phenylketonuria by fluorimetric phenylalanine determination]. PMID- 6842975 TI - [Thrombosis of the anterior cerebral artery related to primary hyperlipoproteinemia, type IIa in childhood]. PMID- 6842976 TI - [Recommendations on the collection and storage of human milk]. PMID- 6842977 TI - [Comparative evaluation of the methods for treating hemorrhoid patients]. PMID- 6842979 TI - [Microflora of the mucosa of the small and large intestines in external intestinal fistulae]. PMID- 6842978 TI - [Treatment of postoperative external intestinal fistulae]. PMID- 6842980 TI - [Intensive preoperative therapy of patients with tumorous diseases of the colon and rectum and manifestations of intestinal obstruction]. PMID- 6842981 TI - [Morphological and functional changes in the erythrocytes of rectal cancer patients related to intensive telegammatherapy and surgery]. PMID- 6842982 TI - [Prognosis of the course of proctitis after colectomy for nonspecific ulcerative colitis]. PMID- 6842983 TI - [Digestive transport function of the small intestine in the late period after the surgical treatment of duodenal peptic ulcer]. PMID- 6842984 TI - [Evaluation of the immediate and late results of appendectomy]. PMID- 6842985 TI - [Ambulatory cryosurgery of complicated chronic hemorrhoids]. PMID- 6842987 TI - [Rare complications of hernias of the anterior abdominal wall]. PMID- 6842986 TI - [Phonography as an objective method for assessing the peristaltic activity of the intestines]. PMID- 6842988 TI - [Treatment of pararectal fistulae]. PMID- 6842989 TI - [Rare cause of strangulation of the small intestine]. PMID- 6842990 TI - [Treitz's hernia]. PMID- 6842991 TI - [Surgical treatment of multiple intestinal fistulae in a hemophilia patient]. PMID- 6842992 TI - [Meckel's diverticulum in the surgeon's practice]. PMID- 6842993 TI - [Crohn's disease]. PMID- 6842994 TI - [Crohn's disease with esophageal, duodenal and jejunal involvement]. PMID- 6842995 TI - [Volvulus of the cecum combined with an ovarian cyst of large size]. PMID- 6842996 TI - [Case of Peutz-Jeghers syndrome complicated by small intestine invagination]. PMID- 6842997 TI - [Peutz-Jeghers syndrome]. PMID- 6842998 TI - [Immunological status of persons who have been operated on for cancer of the large intestine]. PMID- 6842999 TI - [Pharmacoregulation of intestinal motility in complicated spinal cord injury]. PMID- 6843000 TI - [Method of restoring the inguinal ligament in hernioplasty]. PMID- 6843001 TI - [Method of intubating the small intestine]. PMID- 6843002 TI - [New method of analyzing intestinal motility curves]. PMID- 6843003 TI - [Results of vagotomy in gastroduodenal ulcer]. PMID- 6843004 TI - [Diagnosis and treatment of low duodenal ulcer]. PMID- 6843005 TI - [Reoperation in stomach ulcer]. PMID- 6843006 TI - [Atypical perforations of gastroduodenal ulcers]. PMID- 6843007 TI - [Prognostic value of the atropine test in patients with duodenal ulcer]. PMID- 6843008 TI - [Functional state of the cardiovascular system after vagotomy]. PMID- 6843011 TI - [Results of gastroscopic polypectomy]. PMID- 6843010 TI - [Selection of the surgical method in gastric polyps]. PMID- 6843009 TI - [Diagnosis and treatment of pyloric ulcers]. PMID- 6843012 TI - [Ultrasonic scanning of the abdominal organs and retroperitoneal space in children]. PMID- 6843013 TI - [Large-intestinal esophagoplasty in young children]. PMID- 6843014 TI - [Acute appendicitis in pregnancy]. PMID- 6843015 TI - [Results of the correction of mitral regurgitation by annuloplasty]. PMID- 6843016 TI - [Clinical aspects and treatment of snake bites]. PMID- 6843017 TI - [Surgical tactics in surgical wound dehiscence after resection and extirpation of the stomach]. PMID- 6843018 TI - [Selective proximal vagotomy combined with hyperbaric oxygenation in duodenal ulcer]. PMID- 6843019 TI - [Early relaparotomy in children]. PMID- 6843020 TI - [Peptic lesions of the artificial esophagus]. PMID- 6843021 TI - [Generalized echinococcosis in a child]. PMID- 6843022 TI - [Incarceration of the ileal loop in the foramen of Winslow]. PMID- 6843023 TI - [Ileorectal anastomosis after chemical burn of the large intestine]. PMID- 6843025 TI - [Pathomechanisms of orbital injuries]. PMID- 6843027 TI - [Evaluation of fluorescein angiograms using the multitemporal technic]. AB - If there are differences in the density of black-and-white photographs of the fundus oculi taken at different times, they may be transformed into color differences by means of the multitemporal technique. A multitemporal picture is obtained by additive color mixing of black-and-white photographs transilluminated at the same time with one primary color each. Since, in a serial angiogram, the interrelation between the film density and the passage of the fluorescein concentration in the fundus oculi is known, it is possible to draw conclusions from the multitemporal picture regarding phase differences and changes in the curve shape of the fluorescein concentration. PMID- 6843024 TI - [Combined injuries of the stomach, liver, retroperitoneal segment of the duodenum and the right ureter]. PMID- 6843028 TI - [Angioplastic lymphoid hyperplasia with eosinophilia (Kimura disease)]. PMID- 6843029 TI - [Yersinia uveitis]. AB - A 13 year-old boy was admitted with a unilateral acute fibrinous iritis accompanied by a pauciarticular arthritis which had been preceded by a febrile lower urinary tract infection. The diagnosis of a Yersinia enterocolitica infection was established by significant titers of agglutinating antibodies vs. the serotypes O-I (=0:3). The differential diagnosis of the disease included infections with salmonella, shigella, campylobacter, chlamydiae and metastatic bacterial and mycotic infections as well as rheumatic diseases. Repeated observation of Yersinia enterocolitica in our uveitis patients during the last couple of years suggests that Yersinia enterocolitica is another pathogen causing acute uveitis. The clinical significance of Yersinia enterocolitica infections in ophthalmology will have to be clarified by further specific investigations. PMID- 6843026 TI - [Arterial retinal circulatory disorders: an urgent indication for Doppler sonographic study of the carotid flow system]. AB - Nineteen subjects with retinal strokes of different degrees of severity (amaurosis fugax, occlusion of individual retinal arteries or of the central retinal artery) were examined by continuous-wave Doppler sonography. Evaluation of periorbital Doppler flow and direct examination of the major neck vessels were performed. Twelve subjects presented with homolateral arteriosclerotic lesions at the carotid bifurcation. The ultrasonographic findings were confirmed by carotid arteriography. High-grade stenosis or occlusion of the internal carotid artery were found in approximately 50% of the patients; the remainder turned out to have low-grade stenoses or nonstenosing plaques. These findings emphasize the role of emboli from the major neck arteries in the pathogenesis of retinal and cerebral insults. Hemodynamic effects seem to be of minor significance. Continuous-wave Doppler sonography is a completely non invasive, but nevertheless reliable method for the detection of clinically relevant carotid lesions. Especially patients suffering from retinal insults should be examined by Doppler sonography, since they are at high risk for further cerebral stroke. PMID- 6843030 TI - [Medallion lenses, 500 implantations]. AB - A report is given on the implantation of 500 Medallion lenses, most of which were implanted after intracapsular cataract operation (88%) and were kept under observation for between 3 and 88 months (average 22 months). In 1.2% a severe keratopathy resulted from an operation that was too traumatic, from decentration of the lens or because of postoperative wound rupture. Apart from these events, however, the behavior of the lens was excellent. The track record showed that late complications - particularly those involving the iris and cornea - did not occur in cases in which the operation and postoperative course had been uneventful. Therefore, late complications are unlikely to occur in such eyes. In our opinion the Medallion lens is still an excellent implant although modern posterior chamber lenses might offer certain advantages. PMID- 6843031 TI - [Tetryzoline eyedrops in sympathetic ptosis]. PMID- 6843033 TI - [An electronically guided peristalsis pump with an irrigation and suction cannula for extracapsular cataract extraction]. AB - To improve extracapsular cataract extraction the author's team developed, in collaboration with the Geuder eye instruments company, an electronically controlled aspiration pump and an irrigation aspiration needle. Using this apparatus it is possible, with a deep anterior chamber, to remove the lens cortex completely and easily without damaging the posterior lens capsule. The rate of aspiration and the vacuum have to be adjusted in relation to the aspiration hole in the needle. The method of operating the pump, the aspiration and vacuum values so far determined and the surgical technique are described in detail. PMID- 6843032 TI - [A Y-shaped silicone tube intubation in dacryocystorhinostomy]. PMID- 6843034 TI - [Teaching and learning in ophthalmology]. AB - The acoustic era is being transformed ever more rapidly into the audiovisual era. This development is also having an increasing effect on training methods in medicine. In ophthalmological training especially, "teaching to see" plays a decisive role. Every newcomer to the specialty first has to learn how to "see" correctly, to judge three-dimensional relationships. The dynamic processes in the retinal and choroidal circulation can easily be demonstrated to students and young ophthalmologists by fluorescein angiography and TV fundus photography. This study illustrates the importance of space and time and shows how they can be integrated into ophthalmological training. PMID- 6843035 TI - [Bioavailability of trivalent iron contained in an oral preparation of iron III hydroxide-dextrin complex]. PMID- 6843036 TI - The lectin properties of gluten as the basis of the pathomechanism of gluten sensitive enteropathy. AB - The pathogenesis of gluten-sensitive enteropathy is as yet unknown. According to one theory gluten may act as a lectin with toxic properties for the intestinal cells. We can now confirm this theory by laser nephelometric measurements and demonstrate the oligomannosyl specificity of this lectin-like protein gluten. Furthermore, we demonstrate the highly more intensive binding capacity of gluten for the glycoproteins of the immature crypt cells of the intestinal brush border compared to those from the mature villous zone. It is discussed that gluten sensitive enteropathy is caused by a genetically determined defect-glycosylation of intestinal glycoproteins with the synthesis of more mannosylated glycoproteins. PMID- 6843037 TI - Ambulatory diagnostic evaluation of 389 recurrent renal stone formers. A proposal for clinical classification and investigation. AB - 389 consecutive renal stone formers (275 males, 114 females) were investigated in an out-patient stone clinic. Renal tubular acidosis (RTA) was found in 83 patients (22%). Proximal RTA was twice as common as the distal tubular type. The acidification defects were exclusively of the incomplete form with normal basal blood acidbase status. Main diagnoses besides RTA were primary hyperparathyroidism (3.5%), medullary sponge kidney (3.5%), infection induced stones (3%), urate stones (2%), intestinal disorder (1.5%) and cystinuria (0.5%). The metabolic evaluation was mainly based on 24 h urine sampling on a free diet. In 248 patients (64%) no distinct abnormality was considered to be primarily responsible for stone formation. Clinical and biochemical analysis of these so called idiopathic stone formers disclosed a male preponderance (80%) and, compared to a non-stone-forming control group, a higher urinary calcium excretion, yet with a considerable overlap between the two groups. Hyperuricosuria and hyperoxaluria were rare findings. The conclusion of the study is given as a proposal for clinical classification and ambulatory investigation of renal stone formers. PMID- 6843038 TI - Hypophosphatemia induced by intravenous administration of Saccharated iron oxide. AB - Forty milligrams saccharated iron oxide was given intravenously, daily, to nine iron-deficient patients with moderate to severe anemia. During the 14-42 days of treatment, levels of serum inorganic phosphorus (Pi) decreased significantly and in a stepwise manner (before vs 1 week, P less than 0.005; 1 week vs 2 weeks, P less than 0.01). Seven of the nine patients became hypophosphatemic within 2 weeks and the other two within 4 weeks. In parallel with the decline in serum Pi, the phosphate clearance increased and tubular reabsorption of phosphate decreased. Reversion to normal levels was delayed in patients treated for the longer period. PMID- 6843040 TI - [Accuracy of HDL cholesterol measurements]. AB - The widespread use of different methods for the determination of HDL-cholesterol (in Europe: sodium phosphotungstic acid/MgCl2) in connection with enzymatic procedures (in the USA: heparin/MnCl2 followed by the Liebermann-Burchard method) but common reference values makes it necessary to evaluate not only accuracy, specificity, and precision of the precipitation step but also of the subsequent cholesterol determination. A high ratio of serum vs. concentrated precipitation reagent (10:1 V/V) leads to the formation of variable amounts of delta-3.5 cholestadiene. This substance is not recognized by cholesterol oxidase but leads to an 1.6 times overestimation by the Liebermann-Burchard method. Therefore, errors in HDL-cholesterol determination should be considered and differences up to 30% may occur between HDL-cholesterol values determined by the different techniques (heparin/MnCl2 - Liebermann-Burchard and NaPW/MgCl2-CHOD-PAP). PMID- 6843039 TI - Lipoproteins and lipoprotein metabolism. A dynamic evaluation of the plasma fat transport system. AB - Data now available suggest that a dynamic equilibrium exists in the plasma lipoproteins. Chylomicrons and very low density lipoproteins (VLDL) are primary secretory products of cells and carry triglycerides through the blood stream. As intravascular triglyceride hydrolysis occurs via the action of lipoprotein lipase (LPL), the further metabolism of nontriglyceride constituents of chylomicrons and VLDL can be followed along two interrelated pathways. Along the core pathway, cholesterol ester increasingly becomes a major core lipid with resultant formation of intermediate density (IDL, or remnant particles) and eventually low density (LDL) lipoprotein. Concomitant with reduction of core volume, redundant surface lipids and proteins move along a surface pathway and either form high density (HDL) lipoprotein precursors, or become associated with existing HDL particles. Cholesterol esters are formed via the action of lecithin: cholesterol acyltransferase (LCAT) in HDL. Therefore, action of LPL and LCAT on triglyceride rich lipoproteins and their catabolic products is sufficient and necessary for formation, in plasma, of LDL and HDL. Once formed, all plasma lipoproteins are further remodelled by the activity of exchange and transfer reactions. In humans, a major remodelling occurs through exchange of LDL and HDL cholesterol ester by VLDL (and chylomicrons) triglyceride. The reaction is the main source of cholesterol esters in triglyceride-rich lipoproteins and is responsible for the enrichment of LDL and HDL with triglycerides. When followed by triglyceride lipolysis, this cycle results in limitation of size and cholesterol content of both LDL and HDL. The physiology and pathophysiology of the plasma lipid transport system in humans can therefore be fully appreciated only when the interrelations of all these metabolic reactions is taken into account. PMID- 6843041 TI - [Vascular diseases in 534 Swiss diabetics within the scope of a multinational study]. AB - In Switzerland 278 diabetic men and 256 women in the age group 35 to 54 were examined for the presence of angiopathic lesions, according to a standardized protocol of a multinational study comprising 6,695 diabetics from 14 countries. The diabetics were distributed according to sex, age, and duration of the disease into groups of equal size. Macro-angiopathy, as the sum of coronary heart disease, stroke, and vascular disease of the legs was found in 28% of men and in 29% of women in the Swiss group. The prevalence of myocardial infarction alone was 6.8% in men and 5.5% in women. These rates did not differ from those found in the other national groups. Micro-angiopathy was found in the form of retinopathy in 35% and as nephropathy in 32% of the Swiss diabetics. These rates were not different from those of all groups. Severe retinopathy was found more frequently in Swiss diabetics than in the whole study. Micro-angiopathy was strongly related to duration, hypertension, and type of treatment in all centres. Japanese diabetics showed a higher frequency of micro-angiopathy, although macrovascular disease was found at a low rate. Systolic blood pressure (BP) in the Swiss diabetics did not differ from the results of the whole group. In 14% of the Swiss diabetic men and in 18% of the women, systolic BP was over 160 mmHg. These rates were remarkably higher than in an age- and sex-matched sample of a randomly selected sample of a Swiss population (3.2% in men, 2.4% in women). Cholesterol was high in the Swiss diabetic groups, whereas body mass index was in the intermediate range. Of the Swiss diabetic men 38% smoked regularly. The frequency of coronary heart disease in Swiss men and women was similar. This is different from the lower rate usually found in non-diabetic women. Age, and not duration of the disease was the most important factor relating to macro-angiopathy. The different rates of macro- and microvascular complications in various populations, selected according to the same protocol, suggests that the risk factors for macrovascular disease differ from those of microvascular complications. Race, nutrition, treatment, exercise, and hypertension may further influence the prevalence of angiopathy in diabetics of same sex, age, and duration of the disease. PMID- 6843043 TI - Red cell count dependence of whole blood granulocyte luminescence. AB - To evaluate phagocytosis of granulocyte, chemiluminescence (CL) - measurements were done in whole blood specimen. By this method much less variation (22% versus 84%) could be achieved in the whole blood specimen compared with isolated granulocytes. The quenching of CL by erythrocytes, which is dependent on the quotient erythrocytes/granulocytes, could be significantly reduced by dilution (1:5,000). Optimized reaction conditions were selected (approx. 5 x more sensitive then previous protocols) to evaluate the phagocytic activity of the few remaining granulocytes (approx. 2,000/ml) with routine luminometers. PMID- 6843042 TI - [Immunologic significance of the inflammatory stromal reaction in malignant tumors]. AB - In an investigation of correlation and factor analysis the relations between cell mediated stromalreactions and immunological parameters are checked in 63 patients with malignant tumours. The stromalreaction is determined semi-quantitatively as a cell-mediated infiltration of the tumour by neutrophiles, lymphocytes, plasma cells and macrophages. In regard to immunological parameters circulating immuncomplexes, K-cell-activity, auto-antibodies, B- and T-cells and immunglobulins are determined among others. It is shown that the stromalreaction is to be regarded as a part of an immunological answer of the organism against the tumour. PMID- 6843044 TI - Hypokalemic rhabdomyolysis associated with Bartter's syndrome. AB - Severe potassium deficiency is an uncommon cause of rhabdomyolysis. We recently treated a 45-year-old patient with myalgia, serious generalized weakness, increased serum creatine kinase and myoglobin level as well as excessive hypokalemia. Histological examination of deltoid muscle biopsy showed rhabdomyolysis. After complete recovery of muscle damage by potassium substitution Bartter's syndrome proved to be the cause of initial and persistent hypokalemia. PMID- 6843045 TI - [Oral pancreas function test with FDL in the diagnosis of chronic pancreatitis]. AB - The diagnostic accuracy of a tubeless pancreatic function test--Pancreolauryl (PLT)--was evaluated on 97 patients and healthy controls: we found a pathological result of PLT in 31 (88.6%) of 35 patients with proven chronic pancreatitis and a normal PLT in 30 (90%) of 33 controls with no pancreatic disease. In 29 patients with a defined gastrointestinal disease other than chronic pancreatitis the test result was pathological in 51%. This result points towards a limited specificity of the PLT in this latter group, but shows its usefulness as an indicator for maldigestion accompanying the primary disease. In comparison to firmly established diagnostic means for chronic pancreatitis the PLT result was in accordance with the Secretin-Ceruletide function test in 81.3% with ERCP in 80.9% and with computertomography in 76.4%. PMID- 6843046 TI - Diagnosis of exocrine pancreatic insufficiency from stool fat and weight. AB - Diagnostic workup was performed in 118 patients with a chronic malassimilation syndrome. 45 patients had exocrine pancreatic insufficiency, 23 patients jejunal mucosal atrophy (mainly celiac disease), 36 patients increased enteral deconjugation of bile acids and as shown by the 14C-glycocholate breath test and in 14 patients with chronic diarrhea and steatorrhea the cause could not be determined. Eleven patients with irritable bowel syndrome served as controls. Stool fat and weight were determined in all patients. Classification function coefficient were calculated on the basis of a discriminant analysis, leading to a correct classification in 82.2% of the patients with pancreatic insufficiency, 67.8% in the patients with jejunal mucosal atrophy and 83.3% in the patients with increased enteral deconjugation of bile acids. Calculation of sensitivity, specificity and predictive value in the total group and in two randomized subgroups and the correct diagnosis of exocrine pancreatic insufficiency in 78.5% of the patients of an independent verification group suggest clinical usefulness of this approach mainly in the diagnosis of exocrine pancreatic insufficiency. PMID- 6843048 TI - Apolipoprotein E and cholesterol metabolism. AB - The role of apo-E in mediating lipoprotein interaction with specific receptors has been established. Through the use of selective chemical modification of specific amino acid residues of certain lipoproteins, we have gained insight into the importance of the lysine and arginine residues in this process. This understanding has been expanded by structure-function studies of mutant forms of apo-E. These studies have revealed important information concerning the genetic heterogeneity of the apo-E isoforms, focusing attention on the importance of a specific region of apo-E in the binding process. PMID- 6843049 TI - [Comparative plethymography studies of arterial and venous hemodynamic parameters in the calf and foot in deep venous thrombosis]. AB - In 33 patients with acute deep venous thrombosis of the lower extremity, all verified by phlebography, and in 36 healthy subjects arterial inflow, venous volume and maximum venous outflow were measured by mercury-strain gauge plethysmography. The measurements were performed simultaneously in both legs at the calf and foot level with a cuff pressure of 60 mm Hg for 4 min. In contrast to thrombotic occlusions proximal to the knee and multi-level thromboses, which could be identified by a significantly (p less than 0.001) reduced venous volume and maximum venous outflow (measurement at the calf level), isolated calf vein thromboses could not be detected even by sensing from the foot level or only if all three deep veins of the calf were occluded. The best diagnostic criterion for proximal deep venous thrombosis was the correlation of maximum venous outflow and venous volume (83% right positive), if these parameters were determined from the calf. The results indicate that deep calf vein thrombosis can be detected, even if sensed from the foot, only in cases with cross sectional thrombotic occlusions. PMID- 6843047 TI - Radioimmunoassay of arginine-vasopressin in human plasma: development and clinical application. AB - A sensitive and specific radioimmunoassay for the measurement of arg-vasopressin (AVP) in human plasma is described. Recovery of added AVP from plasma was about 65-70%. An acetone extraction step was necessary to prevent unspecific blank effects. Sensitivity of the assay is 0.5 pg AVP/ml plasma. In normally hydrated subjects AVP-concentration ranged from 0.7 pg/ml to 5.8 pg/ml and showed a good correlation with plasma osmolality. In patients with complete diabetes insipidus (D.i.) AVP-values were below the sensitivity limit of the method and they were subnormal when D.i. was incomplete. There was no increase of AVP-concentration during fluid restriction in patients with complete or incomplete D.i. In subjects with psychogenic polydipsia AVP-values were normal and dehydration produced adequate rises of plasma AVP. In patients with SIADH (Schwartz-Bartter-syndrome) AVP-values were greatly enhanced (greater than 10 pg/ml) when correlated to plasma osmolality (less than 170 mosmol/kg H2O). PMID- 6843050 TI - [Stimulation of limited sperm motility and mucociliary clearance of the lung with theophyllin-ethylendiamin]. AB - The influence of oral aminophylline (Phyllotemp ret., 2 X 225 mg) on the mucociliary clearance of the lung and on sperm motility was examined in 13 patients with asthenospermia vs. placebo because the anatomic structure of the cilia of the sperm cells and of the respiratory epithelium cells is similar. The mucociliary clearance was measured by means of radioactive tagged (99 mTc) monodisperse particles (erythrocytes from the patients). To attain a reproducible deposition pattern, the particles were inhaled during a slow inspiratory vital capacity maneuvre. The i.v. application of aminophylline (6 mg/kg body weight) to four normal subjects increased the mucociliary clearance in three of the four volunteers vs. placebo. The elimination rate of the particles increased under treatment with aminophylline from 29% +/- 12% to 46% +/- 19%, but only in seven of the 13 patients with asthenospermia. Sperm motility increased in all of the patients from 33% +/- 12% to 54% +/- 14%. No correlation was found between the increase in the mucociliary clearance and the sperm motility. The reasons for this difference will be discussed. Theophylline can be recommended for the treatment of male infertility in cases of asthenospermia. PMID- 6843051 TI - Interdigestive motilin secretion and gallstone disease. AB - Plasma motilin concentrations were measured in eight controls and 11 patients with radiolucent gallstones over a period of 3-4 h following an overnight fast. In five of these patients the interdigestive motor complex (IDMC) was studied simultaneously. The results indicate: a) cyclical changes of plasma motilin concentrations (mean cycle duration 110 +/- 9.9 and 102 +/- 8.4 min, means +/- SEM) and a significant correlation between the basal intercyclical motilin concentrations and the age (p less than 0.02) in the controls and the gallstone patients studied, and b) a significant correlation between the maximal motilin increase and the age in the controls (p less than 0.01) but not in the gallstone patients. The results therefore suggest a different behaviour of the interdigestive motilin patterns in controls and gallstone patients. As the motilin cycles were accompanied in 90% with an IDMC in the five patients studied this conclusion might include an abnormal interdigestive motor activity within the intestinal tract in gallstone patients. PMID- 6843053 TI - [Peptic ulcer]. PMID- 6843052 TI - [Primary cardiomyopathy and nonspecific myocarditis (clinical aspects, morphology and immunology)]. PMID- 6843054 TI - [Hemosorption in the clinical picture of internal diseases]. PMID- 6843055 TI - [Diagnostic importance of the ECG monitoring of ischemic heart disease patients during daily life]. PMID- 6843056 TI - [All-Union scientific congresses and conferences--their importance for the further development of medical science and practical medicine]. PMID- 6843057 TI - [Changes in heart and kidney function in renovascular hypertension patients with blood flow restored in the renal arteries by transcutaneous intravascular balloon dilatation]. PMID- 6843058 TI - [The nature of hyperglycemia in diabetes mellitus]. PMID- 6843059 TI - [Afanas'ev-Pfeiffer meningitis (influenza meningitis) in adults]. PMID- 6843062 TI - [Clinical variants of leptospirosis]. PMID- 6843063 TI - [Ischemic insult in typhoid fever]. PMID- 6843060 TI - [Hepatic coma in acute fatty hepatosis]. PMID- 6843061 TI - [Isoenzymes in viral hepatitis A and B patients and their significance in the clinical picture of the diseases]. PMID- 6843064 TI - [Case of Q fever recurrence]. PMID- 6843065 TI - [Free amino acids in the blood of the "Salyut-5" crew members before and after a 21-day space flight (2d expedition)]. AB - This paper presents the measurements of free amino acids in the plasma of the Salyut-5 crewmembers (the second expedition) before and after their 21-day space flight. The measurements were performed in a Hitachi KLA-3B automatic amino acid analyzer. The changes in amino acid metabolism were associated with the chemical composition of the space diet, actual food intake and space flight effects. The conclusion is made that the dietary content of cystine and methionine, as well as phenylalanine, tyrosine, glycine, glutamic acid and serine should be increased. No signs of hepatic or renal dysfunction were detected. It is recommended to control strictly food consumption inflight. PMID- 6843067 TI - [Study of the phase structure of the cardiac cycle during the test with decompression of the lower part of the body in long-term (140-185 days) space flights]. AB - Before and during prolonged space flights changes of systolic time intervals in response to LBNP tests were qualitatively similar and corresponded to the syndrome of myocardial hypodynamics due to insufficient venous return. However, the level of the changes and their contribution to the cardiac cycle were different in flight and on the ground. Greater changes in systolic time intervals seen in flight may be attributed to larger blood shifts to the abdomen and legs. PMID- 6843066 TI - [Nutritional status using chocolate as an emergency diet]. AB - Using the results of studying the body mass, carbohydrate, amino acid, nitrogen and mineral metabolism, as well as the general health status of test subjects who were on a low-caloric diet of 300 g chocolate, it is concluded that, although their condition and nutritional status remained satisfactory, chocolate in the above quantity can hardly be viewed as an ideal emergency food for pilots. The conclusion is based on the metabolic and operational limitations of chocolate. The study was carried out in a temperate climate with water consumption of no more than 11 per day. PMID- 6843068 TI - [Effect of water immersion as a model of weightlessness on lung closing volume]. AB - The effect of 7-day water immersion combined at night with head-down (6 degrees) tilting on the volumes of lung expiratory closing was examined in 6 healthy male test subjects, aged 25-35. During immersion they showed, along with a stable reduction of the lung vital and functional residual capacity (by 4.2 and 14.8%, respectively), an increase in the fraction parameters of the expiratory closing volumes. The increase in the closing volume (up to 40%) (P less than 0.05) was particularly distinct on immersion day 2. Subsequent changes indicated gradual recovery of the closing volumes and a decline in regional nonuniformity of lung ventilation. The time-course variations in the closing volumes may be attributed to an increase in the intrapulmonary blood volume at the early stage of adaptation to immersion and to a decrease in the nonuniformity of the ventilation perfusion ratios. PMID- 6843069 TI - [Physical exertion tolerance after water immersion]. AB - Before and after 24-hour water immersion test subjects performed a submaximal workload on a bicycle ergometer. Changes in their hematocrit, circulating plasma volume and fluid balance were compared with those during immersion. As a result, the test subjects were subdivided into two groups. For one group the workload was very hard; adaptation to immersion was accompanied by significant renal losses of fluid from the intra- and extravascular space. The bicycle ergometry test after immersion demonstrated a decrease of exercise tolerance combined with circulatory disorders. The other group showed a higher exercise tolerance; after immersion exercise tolerance remained high at the expense of the reserves that maintained optimal blood supply to the working muscles. PMID- 6843070 TI - [Hemodynamic indicators in men during constantly increasing overloads]. AB - The effect of acceleration on central hemodynamics was investigated in centrifugation experiments. Also examined was the protective effect of muscle tension, anti-G suit, and of an altered acceleration vector. It was demonstrated that visual disorders were caused by a decrease in cardiac output. The countermeasures diminished the rate with which cardiac output declined due to the higher values of stroke volume that were produced by the anti-G suit and a changed body position. Arbitrary muscle tension ensured the effect only as a result of increased heart rate. PMID- 6843071 TI - [Reaction of rats, formerly subjected to space flight, to immobilization stress]. AB - The study of male Wistar rats flown on the biosatellite Cosmos-1129 showed that 7 10 hours after recovery they developed a distinct stress-reaction of blood cell elements (increased neutrophil and decreased lymphocyte counts) and the thymus (decreased thymocyte count). Despite this, the level of their reaction (as a percentage of the preflight values) to additional immobilization stresses was similar to that of controls. As a result, by the end of immobilization tests deviations from the physiological norm in the flown animals were greater and their reserve capabilities were lower than in the controls. PMID- 6843072 TI - [Formation of organic acids and carbonate content of bone tissue of rats after space flight]. PMID- 6843073 TI - [Effect of long-term hypokinesia on the C-cell system of the thyroid gland]. AB - The state of C-cells of the thyroid gland of Wistar rats during prolonged (30-165 days) hypokinesia was examined. Histo- and morphometric data pointed to a gradual decline in the function of C-cells during hypokinesia and its return to normal after 2-month readaptation. The decline was most distinct by hypokinesia day 90 (significant decrease in the number and size of nuclei, prevalence of small cells with densely packed granules in the cytoplasm). The decline in the function of C cells during hypokinesia may be one of the factors leading to increased calcium elimination from bones. In conclusion, the state of C-cells in animals exposed to weightlessness and hypokinesia is compared. PMID- 6843074 TI - [Complement and heterophil antibody levels in monkeys under conditions of antiorthostatic hypokinesia]. AB - The experiments with sexually immature (about 3 years) primates Macaca mulatta exposed to head-down tilt and clinostatic hypokinesia showed an increase in the complementary activity of serum and a decrease of heterophil antibodies in the first case. It is inferred that an increase in the complement content reflects an adaptive reaction to head-down tilt and a decrease in heterophil antibodies indicates an inhibition of antibody-forming cells (B-lymphocytes). PMID- 6843075 TI - [Activity of oxidative enzymes of the tricarboxylic acid cycle in the liver of rats during hypokinesia]. AB - The activity of oxidative enzymes of the Krebs cycle was examined in white rats during hypokinesia. On hypokinesia day 7 the cytosol activity of NAD-dependent isocitrate dehydrogenase (ICDH) increased and that of malic-enzyme decreased. On hypokinesia days 30 and 45 the activity of succinate dehydrogenase (SDH) and alpha-ketoglutarate dehydrogenase (alpha-KGDH) decreased, that of cytoplasmatic malate dehydrogenases (MDH) slightly increased, and that of NADP ICDH declined. On hypokinesia day 60 the total activity of mitochondrial dehydrogenases reduced due to a low protein content of the mitochondrial fraction, whereas the specific activity either remained unchanged (ICDH, NAD MDH, alpha-KGDH) or increased (SDH, NADP MDH). On recovery day 25 only the activity of mitochondrial NAD-dependent malate and isocitrate dehydrogenases returned to normal. PMID- 6843076 TI - [Urinary excretion of adrenaline and noradrenaline during atmosphere exposure chamber hypoxia]. AB - The effect of altitude chamber hypoxia of different intensity and duration on epinephrine and norepinephrine excretion was investigated. The hypoxia tolerance as a function of catecholamine excretion was also examined. At altitudes 5000 and 6500-7000 m the test subjects were kept for a short time and at 3500-4500 m for 24 hours. The subjects with high hypoxia tolerance showed an increased and those with low tolerance a decreased epinephrine excretion. The epinephrine excretion did not increase with the intensity and duration of the hypoxia effect. Variations in the norepinephrine excretion were insignificant in all tests. PMID- 6843077 TI - [Mathematical models of various exobiological situations]. AB - To analyze quarantine and sterilization requirements of space flights, the possibility of coexistence of terrestrial and aboriginal forms of life was theoretically explored. It was found that if the trophic chain with the terrestrial form acting as a consumer evolves both forms may coexist. Their quantitative relations can be explained by a good number of hypotheses. The study of spatial distribution and diffusion suggests wave-like processes similar to the distribution of autocatalytic reactions in chemical kinetics. PMID- 6843078 TI - [Vitamin metabolism in cosmonauts during pre-flight training]. AB - Measurement of vitamin supply of cosmonauts during their intensive training a month preflight showed moderate deficiency of thiamine, riboflavine, pyridoxine, nicotinamide and ascorbic acid. A regular uptake of the vitamin complex for 2 weeks optimized significantly vitamin metabolism. PMID- 6843080 TI - [Devices for conducting active and passive orthostatic tests under laboratory and field conditions]. PMID- 6843079 TI - [Determination and clinical evaluation of the indicators of work capacity in the flight personnel]. AB - Using submaximal exercises, work capacity of 375 aircraft crewmembers, aged 20 49, was investigated. It declined slightly with age. The factors most frequently causing its decrease in healthy and diseased people were identified and methods of its measurement were refined. It was shown that the work load, chronotropic reserve index and cardiac index may give indirect evidence of the coronary blood flow rate, and the inotropic reserve index of the cardiac contractile function. Determination of work capacity of the flight personnel makes it possible to improve the medical supervision, detect at an early stage cardiovascular abnormalities and to substantiate expertise conclusions. PMID- 6843081 TI - [Effect of long-term hypokinesia on the mineral content of human heel bone]. PMID- 6843082 TI - [Catecholamine content in the isolated hypothalamic nuclei of rats after flight on "Cosmos-1129"]. PMID- 6843084 TI - Cellular outgrowth from isolated glomeruli. Origin and characterization. AB - The incorporation of 3H-thymidine by isolated decapsulated glomeruli from pigs was studied up to 5 days after explantation by light and electron microscopic autoradiography. The visceral epithelial cells (VEC) were the only cell type to be labeled during the first 2.5 days, showing that this tracer can be applied as a specific marker for VEC in decapsulated glomeruli. From the third day, label was incorporated by another cell type, probably mesangial cells. Labeling of endothelial cells could not be observed. Isolated glomeruli were then incubated for 2.5 days with 3H-thymidine in order to label the VEC, and after 5 to 6 days the primary outgrowth of cells appeared. Light and electron microscopic autoradiography performed in situ showed that the majority of cells in the primary outgrowth consisted of labeled cells, thus showing their origin from the VEC. The VEC in culture appeared as very large, irregular cells with a slow proliferation rate. After 9 days of culture another cell type was seen in the outgrowth (type II cells), probably derived from the mesangial cells. This cell grew in multilayers and had a close similarity to smooth muscle cells in culture, with thick bundles of microfilaments in the periphery of the cell and an abundant intercellular matrix. A third cell type (type III) with a regular angulated, "epitheloid" shape was rarely seen in the outgrowths. Because 1 to 2% of the isolated glomeruli were encapsulated, the parietal epithelial cell is suggested as the mother cell for this cell type; this is also thought to be true because the parietal epithelial cell showed 3H-thymidine incorporation in autoradiographs of intact glomeruli. PMID- 6843083 TI - [Effect of acetazolamide on catecholamine excretion in altitude hypoxia (4,5 km)]. PMID- 6843085 TI - Induction and inhibition of outgrowth and development of renal collecting duct epithelium. AB - Renal cortical explants consisting of capsula fibrosa with an adherent thin layer of collecting duct anlagen, S-shaped bodies, and nephrogenic blastema were isolated from newborn New Zealand rabbits and cultured in Dulbecco's Modified Eagle's medium for 24 hours. Within this period of time, the explants formed globular bodies surrounded by an epithelium of differentiated collecting duct cells. The outgrowth of the collecting duct cells and the formation of the epithelium occurred only when serum was added to the cultivation medium. Different types and different concentrations of serum were tested; fetal bovine serum and newborn and adult rabbit sera at concentrations of at least 5% induced the outgrowth and spreading of the cells. The surrounding epithelium did not develop in the absence of serum. The outgrowth of the collecting duct cells in serum-supplemented cultivation media was arrested by inhibitors of protein and glycoprotein synthesis and by cytoskeletonal-blocking agents such as cycloheximide (1 x 10(-6) M), actinomycin C1 (2 micrograms/ml), tunica-mycin (1 microgram/ml), 6-diazo-5-oxo-norleucine (2 x 10(-5) M), vinblastine (5 x 10(-6) M), colchicine (1 x 10(-3) M), and cytochalasin B (2 micrograms/ml). In contrast, inhibitors of DNA synthesis, e.g., cytosine arabinoside (2.5 x 10(-5) M), mitomycin (1 x 10(-6) M), and hydroxyurea (2.5 x 10(-3) M), had no influence on the outgrowth. PMID- 6843087 TI - Diazacholesterol-induced ichthyosis in the hairless mouse. I. Morphologic, histochemical, and lipid biochemical characterization of a new animal model. AB - Several drugs that interfere with sterol metabolism have been associated with hyperkeratosis in man. We found that 20,25-diazacholesterol (30 to 60 mg/kg/day), administered to hairless mice that were otherwise given normal laboratory chow and water ad libitum, consistently produced ichthyosis after 6 to 9 weeks, an effect that was reversible with removal of drug or with coadministration of a high cholesterol diet. Scaling was most pronounced over the tail, but some stratum corneum retention was noted over the entire skin surface. As measured in frozen sections, stratum corneum thickness was three to 10 times thicker in treated animals than in either controls or revertants. Oil red O-stained frozen sections and freeze fracture replicas revealed decreased stratum corneum membrane lipids in the diazacholesterol-treated animals, but this finding was not specific, since a similar deficit was found in control and revertant tail stratum corneum but not in the stratum corneum from other sites. Stratum corneum lipid extracts revealed reduced total free sterols, reduced cholesterol, accumulation of several normally absent sterol precursors, and increased glycosphingolipids on thin-layer chromatography and high pressure liquid chromatography. In summary, we describe a syndrome of drug-induced ichthyosis in hairless mice that parallels the drug-induced syndrome in man. This syndrome is reversible and accompanied by distinctive abnormalities in cutaneous sterol metabolism. The diazacholesterol model may further our understanding of the pathogenesis of human keratinizing disorders and may provide a valuable analogue for testing new forms of therapy, such as retinoids, for scaling dermatoses. PMID- 6843086 TI - Degradation of phagocytosed lysosomes by Kupffer cell lysosomes. AB - Lysosomal membranes are apparently resistant to hydrolytic attack from their own enzymes. Alternatively, degradation occurs but is compensated for by continuous insertion of new membrane components. It may be hypothesized that a mechanism operating exclusively on the luminal side of the lysosomal membrane serves to protect the membrane from being degraded. To evaluate this notion the cytoplasmic side of the lysosomal membrane has been exposed to lysosomal enzymes in vivo. Lysosomes were isolated and subsequently injected into the portal vein of a series of rats. The uptake of the injected organelles by Kupffer cells and their subsequent degradation in lysosomes were monitored by means of electron microscopy. Four minutes after injection lysosomes were seen attached to the surface of the Kupffer cells. After 30 minutes the injected material was present in Kupffer cell phagolysosomes, and signs of degradation of the phagocytosed lysosomes were seen. By 2 hours only a few distinct membranes were left, and by 12 hours the injected lysosomes were no longer recognizable. Instead, the phagolysosomes of Kupffer cells were laden with lipid-like droplets and irregular membranous structures. Acid phosphatase histochemistry and labeling of preexisting Kupffer cell lysosomes with marker particles indicated that the phagosomes engulfing the injected lysosomes acquired hydrolytic enzymes within 30 minutes after their formation. The degradation rate of injected lysosomes was estimated by measuring the decay of radioactivity from a rat liver mitochondrial lysosomal fraction after administration of lysosomes isotopically prelabeled with 14C-leucine and 14C-glycerol. The half-life of the lysosomal membrane proteins varied between 1.5 and 2.0 hours, whereas that of the lipid component was in the range of 2.0 to 3.5 hours. These findings demonstrate that lysosomal membranes are degraded if their outer surface is exposed to lysosomal enzymes. Both the ultrastructural analysis and the isotopic studies indicate that proteins are degraded faster than lipids. Apparently, the cytoplasmic surface of the lysosomes is susceptible to lysosomal hydrolytic attack. PMID- 6843088 TI - Squamous metaplasia of the respiratory tract. Possible pathogenic role in asbestos-associated bronchogenic carcinoma. AB - Asbestos workers who smoke have a substantially greater risk of developing bronchogenic carcinoma than nonsmokers. Squamous metaplasia often replaces the mucociliary epithelium in the respiratory tract of chronic users of cigarettes. As a result, clearance mechanisms are altered. Using both scanning and transmission electron microscopy, we examined the interaction of chrysotile and crocidolite asbestos with the metaplastic mucosa found in the bronchi of cigarette smokers and produced in cultures of hamster trachea by enriched, serum free medium. After deposition on the squamous epithelium, both "long" and "short" fibers were either phagocytosed by, or moved between, the cells of the mucosa. The interaction of asbestos with the mucociliary epithelium differed. Most long fibers were cleared, whereas short fibers were taken up by the mucosa. The apparent increase in uptake of long asbestos fibers by the metaplastic squamous mucosa could contribute to the synergism between this unique mineral and cigarette smoke in the causation of bronchogenic neoplasms. PMID- 6843089 TI - Changes in myocardial cell size and number during the development and reversal of hyperthyroidism in neonatal rats. AB - Increased workload was produced in newborn rats to study myocyte structure during conversion from hyperplastic to hypertrophic growth. Newborn rats were given L thyroxine (T4) for 12 days and killed at that time or 20 days after discontinuing T4 treatment. Myocytes were isolated by a perfusion technique with collagenase. Cellular dimensions were determined with a sonic digitizer. Mean cell volumes were also determined with a Coulter counter for comparison with values obtained with the digitizer. Heart weight to body weight ratios were increased 30% in 12 day-old hyperthyroid rats. Cell length increased 22%, and cell volume increased 31% after 12 days of treatment with T4. The calculated number of ventricular myocytes indicated that T4 inhibited rather than stimulated hyperplastic myocyte growth. Twenty days after discontinuing T4 treatment, heart weight to body weight ratio and mean cell volume of treated animals were similar to control values. Cell length, however, remained significantly increased (14%), and cell width was significantly reduced (8%) after reversal of hyperthyroidism. We conclude that excess T4 inhibits hyperplastic myocyte growth in neonatal rats while stimulating hypertrophy of existing myocytes primarily by increasing cell length. Myocytes remained significantly longer after reversal of hyperthyroidism, indicating that structural changes may persist. PMID- 6843090 TI - A morphologic and biochemical study of the transcriptional changes in rat liver during the acute inflammatory reaction. AB - Transcriptional activity in nuclei isolated from the liver of rats during the acute inflammatory reaction induced by a 24-hour treatment with turpentine was evaluated by biochemical and ultrastructural techniques. This experimental model was chosen because it is known to induce an increase in hepatic synthesis of several plasma proteins called acute phase reactants. Using an in vitro system for estimating the activity of RNA polymerases A and B as an approach to evaluate RNA synthesis, we have shown that the activity of enzyme A (responsible for pre rRNA synthesis) was significantly enhanced, whereas the activity of enzyme B (responsible for giant heterogenous RNA synthesis) remained unchanged in treated rats compared with control rats. At the electron microscopic level, using the Miller technique to spread the nuclear contents, the non-nucleolar transcription units were similar in treated and control rats. In contrast to control rats, more nucleolar transcription units were vizualized in treated rats, although the ribonucleoprotein fibrils were less numerous; in addition, in the latter group 10 to 15 times more aggregates constituted of ribonucleoprotein fibrils and particles were observed, the morphology of which was in agreement with a nucleolar origin. These results suggest that, during the acute inflammatory reaction, there was no overall increase in giant heterogenous RNA synthesis, whereas an increase in rRNA synthesis might be observed. PMID- 6843091 TI - Dimethyl disulphide in the blood of cattle fed on brassicas. PMID- 6843092 TI - Coccidiostat residues in poultry excreta. PMID- 6843093 TI - Changes in the composition and state of unesterified C14-C32 fatty acids during their passage through the ovine digestive tract. PMID- 6843094 TI - A survey of the occurrence of the trichothecene mycotoxin deoxynivalenol (vomitoxin) in UK grown barley and in imported maize by combined gas chromatography-mass spectrometry. PMID- 6843095 TI - Effect of timing and velocity of impact on ventricular myocardial rupture. AB - The effects of impact timing during the cardiac cycle on the sensitivity of the heart to impact-induced rupture was investigated in an open-chest animal model. Direct mechanical impacts were applied to two adjacent sites on the exposed left ventricular surface at the end of systole or diastole. Impacts at 5 m/s and a contact stroke of 5 cm at the end of systole resulted in no cardiac rupture in seven animals, whereas similar impacts at the end of diastole resulted in six cardiac ruptures. Direct impact at 15 m/s and a contact stroke of 2 cm at the end of either systole or diastole resulted in perforationlike cardiac rupture in all attempts. At low-impact velocity the heart was observed in high-speed movie to bounce away from the impact interface during a systolic impact, but deform around the impactor during a diastolic impact. The heart generally remained motionless during the downward impact stroke at high-impact velocity in either a systolic or diastolic impact. The lower ventricular pressure, reduced muscle stiffness, thinner myocardial wall and larger mass of the filled ventricle probably contributed to a greater sensitivity of the heart to rupture in diastole at low impact velocity. However, the same factors had no role at high-impact velocity. PMID- 6843096 TI - Filling of partially collapsed compliant tubes. AB - Filling of a thin-walled, highly compliant tube in a partially collapsed condition is studied. The theory, based on one-dimensional flow, takes account of friction, longitudinal tension, and the highly nonlinear pressure-area law for the tube. Various aspects of filling behavior are revealed by alternative calculations using: (i) the method of characteristics; (ii) numerical integration of the continuity, momentum, and tube-law equations; and (iii) a crude but simple lumped-element capacitance-inertance-resistance model. Varied phenomena appear. At high Reynolds number, these include dispersive wave trains associated with circumferential bending stiffness and longitudinal tension, nonlinear changes of wave form, development of highly asymmetrical wave reflections, and sloshing. At low Reynolds number, the area changes with time in a diffusivelike manner. The experiments exhibited the dispersive phenomena predicted by the theory. PMID- 6843097 TI - Soft tissue attenuation of acoustic emission pulses. AB - The soft tissue attenuation of acoustic emission signals was measured by transmitting pulses through volunteers and measuring the decay of the waveform characteristics of the pulse as a function of the thickness of the interposed tissue. Waveform characteristics of the received signal (signal duration, number of counts, peak amplitude, energy, and rise time) demonstrated an exponential decrease with increasing tissue thickness. The decrease appeared insensitive to the frequency of the pulse within the range of 50 to 600 KHz. PMID- 6843099 TI - Mechanical characterization of membranelike biological tissue. AB - Experimental and analytical methods are presented which enable one to examine the local rheological properties of biological tissues which can be captured as flat sheets between matching pressure manifolds and deformed under experimentally prescribed hydrostatic loading conditions. In spite of the fact that most biological tissues, including arteries, are nonlinearly elastic when considered over wide ranges of strain, it was found that the deformation of swine and canine arterial wall specimens in the physiological range of wall strain can be approximated by an isotropic, linearily elastic membrane model. In view of this, the elastic behavior was characterized approximately by an incremental modulus over the range of 0.45 to 0.65 strain. The incremental modulus in both species was shown to increase by a factor of three along the descending thoracic aorta from the ductus scar to the celiac orifice. PMID- 6843098 TI - Heat and water vapor transport in the human upper airways at hyperbaric conditions. AB - Heat and mass transfer mechanisms have been characterized in physical models of human cadaver airways to simulated depths of 305 m with various gas mixtures. Such characterizations offer a detailed understanding of the effects of environmental pressures, gas composition, and respiratory rates (RMV) on the body cooling capacity of the respiratory airways. Empirical heat transfer relationships in the form -Nu = AReNPr1/3 are derived for the oral and nasal passageways during inhalation and exhalation flows. -Nu, Re, and Pr are the dimensionless Nusselt, Reynolds, and Prandtl numbers, respectively. The Nusselt and Reynolds numbers are based on the diameter and gas flow rate in the trachea and are applicable to Reynolds number values up to 70,000. PMID- 6843101 TI - The effects of contact lens deformation on tear film pressure and thickness during motion of the lens towards the eye. PMID- 6843100 TI - Static analysis of the left ventricle. AB - Static analysis of the left ventricle is developed to estimate the local stresses and deformations that occur during the heart cycle. The left ventricle is represented as a thick hollow tube composed of solid fibers embedded in an inviscid fluid matrix. A finite deformation analysis is developed to estimate the variation of the pressure, fiber tension and fiber extension across the thickness of the left ventricle. Pressure-volume relations are obtained for the diastolic and the systolic peak isovolumetric phases. The fiber stress distribution and pressure variation are estimated as a function of the initial fiber orientation distribution, relative thickness of the ventricle, inner volume of the ventricle and the various tension-extension relations proposed for the fibers of the heart muscle. It is concluded that the diastolic pressure-volume relation is not very sensitive to either the fiber orientation distribution or the thickness of the ventricle. However, the pumping efficiency of the modeled ventricle is shown to increase with increasing thickness of the modeled left ventricle and with increasing contractility of the heart muscle fibers. PMID- 6843102 TI - Rhesus monkey intervertebral disk viscoelastic response to shear stress. AB - A viscoelastic model of the shear response of the Rhesus monkey intervertebral disk, represented by a series chain of four Kelvin units is presented. Two types of investigations are carried out to assess the validity of the model: 1) determination of material properties by comparison with experimental strain creep behavior of the disk; and 2) validation of this viscoelastic model by accurately predicting the experimental results of stress relaxation tests. The use of the series Kelvin units approach provides the first analytical mechanical model capable of predicting the creep and relaxation functions for the intervertebral disk in shear. PMID- 6843103 TI - A programmable limb testing system (and some measurements of intrinsic muscular and reflex-mediated stiffnesses). AB - A new versatile apparatus for investigating the neuromusculoskeletal dynamics of the upper limb, termed the Programmable Limb Testing System (PLTS) has been designed, built, and tested. The planning, construction, and operation of this system are described in this paper. Results are presented from a limited set of experiments, measuring intrinsic muscular and reflex-mediated stiffnesses of the triceps brachii, which exhibit the system's performance and some of its capabilities. PMID- 6843104 TI - Response of an advanced head-neck model to transient loading. PMID- 6843105 TI - Mechanical behavior of fetal dura mater under large axisymmetric inflation. AB - The nonlinear mechanical behavior of fetal dura mater was tested experimentally and compared to two published nonlinear material strain energy functions, the Mooney-Rivlin and the Skalak, Tozeren, Zarda, and Chien (STZC). The STZC constitutive relations best fit the behavior of the dura mater and were used to describe quantitatively its stiffness. Runge-Kutta numerical procedures were used to fit the theoretical data to the experimental results. The material's stiffness was positively correlated with fetal weight (r = 0.67, p less than 0.05). These results are discussed and directions for future research indicated. PMID- 6843107 TI - Acoustic modeling of lung dynamics using bond graphs. AB - Bond graphs are used to model the acoustic behavior of the respiratory system. The model includes the distributed dynamics of the upper airways while the lower passage generations are represented by "lumping" of resistance and compliance effects. The lower airway representation is terminated with ten lung segments. The model is accurate for frequencies as high as 8500 Hz. The model is currently capable of predicting system eigenvalues as a function of system parameters and geometry for a "nonbreathing" lung. Future plans include modifying the model to include lung segment expansion and contraction as well as turbulence generation at airway bifurcations. PMID- 6843106 TI - Determination of the local erosion stress of the canine endothelium using a jet impingement method. PMID- 6843108 TI - A concise sensitivity analysis of the quasi-linear viscoelastic model proposed by Fung. PMID- 6843109 TI - The effect of protein deficiency on growth and response of primary and metastatic hepatoma. AB - Although protein-energy malnutrition is common in the cancer patient, the efficacy of aggressive nutritional therapy is unclear. This study evaluates the effects of protein deficiency on tumor growth, response, and chemotherapy complications in primary and metastatic rat hepatoma. Seventy-two ACI rats (200 250 g) with implanted Morris hepatoma were divided into four groups (N = 18 for each group): 1, regular diet; 2, regular diet plus cyclophosphamide (CPM) (100 mg/kg/ip); 3, protein-free diet; and 4, protein-free diet + CPM. Forty additional rats in similar groups (5-8, ten in each group) underwent intravenous injection of 6 X 10(3) tumor cells to produce pulmonary metastases. Animals were assessed for survival, tumor size, serum albumin, number of pulmonary metastases, and hemorrhagic cystitis at 2 weeks. Survival was 50% in groups 4 and 8, and 100% in the others. Serum albumin was significantly lower in rats on protein free diets (2.59 +/- 0.37 vs 3.35 +/- 0.40 g%, P less than 0.01). Tumor volume was significantly reduced by CPM (26.0 +/- 4.2 cm3 vs 1.2 +/- 0.4 cm3, P less than 0.01). Protein-free diets resulted in lower total body weight, and reduced tumor volume without, but not with CPM (14 +/- 1.6 cm3 P less than 0.05, 1.1 +/- 0.3 cm3, P less than 0.05 vs above controls). CPM reduced the number of pulmonary metastases in regular diet groups (307.2 +/- 108.3 vs 36 +/- 11, P less than 0.01), while protein free diets did not significantly affect metastases, without or with CPM (251.7 +/- 71.4 and 22.3 +/- 12.4, P greater than 0.05 vs controls). Hemorrhagic cystitis was much more common in protein free groups compared to rats on regular diets (55 vs 11%, P less than 0.01). These data indicate that protein deficiency did not affect response to chemotherapy in a primary or metastatic rat hepatoma model. However, protein deficiency results in a significantly increased rate of mortality, weight loss, and hemorrhagic cystitis which may lead to delay or cessation of cancer therapy. PMID- 6843111 TI - Documentation of a venous resistance in the baboon. AB - In the steady state, blood flow out of the heart must be the same as blood flow into the heart. Thus, flow in the cardiovascular system should depend not only on cardiac determinants of flow--pericardial pressure, afterload, heart rate, and contractility--but also on systemic venous determinants of flow as well. We studied the venous determinants of flow in nine baboons. The mean systemic pressure, the upstream driving pressure for venous return, was 10 mm Hg higher than the right atrial pressure. Flow generated by this upstream pressure was modulated by a venous resistance. This resistance acted as if it were interposed between the upstream capacitance vessels and the right atrium. These determinants of venous return in the baboon would be inadequately described by classical concepts of cardiovascular physiology. We suspect that classical concepts would be inadequate in man as well. PMID- 6843110 TI - Protection of thermochemotherapeutic-induced lethal acute hepatic necrosis in the rat by 16,16-dimethyl prostaglandin E2. AB - These studies further evaluate the hepatocytoprotective properties of 16,16 dimethyl prostaglandin E2 (dmPGE2) by assessing its effect on survival, liver function, and hepatic regeneration in a model of in vivo isolated perfusion of the rat liver with high concentrations of cytotoxic drugs and regional hyperthermia. Isolated perfusion with 1.0 g/kg of 5-FU or hyperthermia of 41 degrees C X 10 min resulted in 90-100% mortality in control rats, with extensive, patchy necrosis and infarction on histologic examination, and markedly elevated levels of SGOT and SGPT at 24 hr after perfusion. Pretreatment with dmPGE2 (10 micrograms/kg sc) at 30 min before, and at 6 and 24 hr after hepatic perfusion significantly improved survival to 80% (P less than 0.01) following 5-FU perfusion and to 40% (P less than 0.05) following hyperthermic perfusion. Animals were followed for at least 21 days after perfusion and demonstrated normal liver histology, dmPGE2-treated rats demonstrated significantly lower SGOT and SGPT levels at 24 hr after perfusion. dmPGE2 (2 micrograms/kg sc) given as above improved the length of time of survival but eventual mortality was not significantly improved. Oral administration (50 micrograms/kg po at 30 min before, 6 and 24 hr after perfusion) and posttreatment (10 micrograms/kg sc at 1, 6, and 24 hr after perfusion) had no significant effect on survival. Hepatic regenerative capacity following partial hepatectomy was severely suppressed following isolated hyperthermochemotherapeutic hepatic perfusion. Pretreatment with dmPGE2 (10 micrograms/kg sc) restored the DNA synthetic response in perfused rats to that seen in normal control rats after partial hepatectomy (P less than 0.05 and P less than 0.01). The results from these studies further confirm the role of dmPGE2 as a hepatocytoprotective agent and suggest potential clinical application in situations where there has been deliberate, therapeutic insult to the liver. PMID- 6843113 TI - Enterooxyntin release from isolated perfused canine jejunum. AB - A humoral factor may mediate the intestinal phase of gastric acid secretion. An ex vivo perfused segment of canine jejunum maintained by an oxygenated asanguinous physiologic perfusate was used to test for release of an enterooxyntin (EO) in response to balloon distention at 30 mm Hg for 15 min. Gastric acid secretion in guinea pig fundic mucosa was determined indirectly by a quantitative cytochemical bioassay (CBA) of oxyntic cell hydroxyl ion production (HIP). An increase in the optical density (OD) caused by the cytochemical stain in the oxyntic cells reflects HIP, an index of acid secretion. Basal OD for segments with distention was 16.6 +/- 0.53 and for those without 15.5 +/- 0.68 (NS). Results are expressed as mean change of OD from basal (mean delta OD +/- SEM). (Table-see text) EO caused greater stimulation of HIP than gastrin or histamine. EO was heat stable. Trichloroacetic acid treatment decreased EO activity as did pronase digestion suggesting that EO is composed of one or more peptides. CONCLUSION: EO, an acid secretagogue, is a humoral agent probably composed of one or more peptides and is released by small bowel distention. Mechanical distention of the small bowel may be an important mechanism for the perpetuation of gastric acid secretion. The ex vivo perfused jejunal segment in conjunction with the CBA are ideal tools with which to study mechanisms of release of EO and the mechanism of action of EO on the oxyntic cell. PMID- 6843112 TI - Failure of various agents to decrease oleic acid pulmonary albumin leak. AB - Computerized pulmonary gamma scintigraphy has been shown to be a sensitive technique for the measurement of albumin flux in oleic acid pulmonary microvascular injury. In this technique technetium-99m-tagged human serum albumin is administered intravenously and lung:heart radioactivity ratios are constructed. This ratio remains constant unless there is a net flux of albumin from the vascular space into the lung, when a rising ratio is seen, called the "slope of injury" or SI. Gamma scintigraphy provides a method to rapidly screen the ability of various possible therapeutic agents to reduce the flux of albumin in experimental ARDS. In this study, 0.05 ml/kg oleic acid produced a significant increase in the SI. None of the agents tested (30 mg/kg methylprednisolone, 12.5 mg/kg ibuprofen, 4 mg/kg MK-447, a superoxide radical scavenger, or 140 mg/kg calcium gluconate) were able to alter the scintigraphically measured increased albumin flux produced by 0.05 ml/kg oleic acid. PMID- 6843114 TI - In vitro production of corticosteroid binder IB in the presence of proteolytic inhibitors. AB - The effect of proteolytic inhibitors on the temperature-dependent formation of corticosteroid binder IB in rat kidney cytosol was examined. Antipain increased the apparent binding of [3H]-triamcinolone acetonide in the cytosol. Leupeptin, chymostatin, soya bean trypsin inhibitor and lima bean trypsin inhibitor did not affect total binding, while L-1-tosylamide-2-phenylethyl chloromethyl ketone, N alpha-p-tosyl-L-lysine chloromethyl ketone and phenylmethylsulfonyl fluoride markedly reduced the charcoal resistant steroid binding. However, none of the inhibitors added during tissue homogenization, steroid binding or activation affected the extent of heat-dependent conversion of the [3H]-triamcinolone acetonide-receptor complexes to the IB form, which was characterized by its exclusion from DEAE-Sephadex ion exchanger. In contrast, sodium molybdate (10 mM) effectively inhibits IB formation without inhibiting protease activity of rat kidney cytosol. These observations indicate that the temperature-dependent formation of corticosteroid binder IB in vitro does not involve proteolytic transformation of unbound or steroid-bound cytosolic proteins. Addition of antipain (3 mM) to the cytosol markedly increased the radioactivity in the buffer prewash of DEAE-cellulose columns (apparent IB) only when the inhibitor was added prior to charcoal adsorption. However, a similar peak in the prewash also was obtained with receptor-free cytosol. Antipain had no effect on the rate of dissociation of performed [3H]-triamcinolone-acetonide-receptor complexes nor did it increase the amount of receptor adsorbed to hydroxylapatite. Chromatography on Sephadex G-25 and P-2 columns showed that the increased activity in the charcoal resistant fraction in the presence of antipain is due to unbound steroid. Thus, antipain interferes with the ability of charcoal to remove unbound steroid from the cytosol. PMID- 6843115 TI - The dissociation of testosterone- and 5 alpha-dihydrotestosterone-receptor complexes formed within cultured human genital skin fibroblasts. AB - We have studied the rate and character with which testosterone (T) and 5 alpha dihydrotestosterone (DHT) dissociate from the androgen receptor both within intact cultured genital skin fibroblasts of a subject with 5 alpha-reductase deficiency and after the androgen-receptor complexes have been extracted from the cells. Within the cells, the kinetics of the dissociative process for each hormone was first-order, but T dissociated four times faster than DHT. An Arrhenius plot of the variation of the dissociation rate constants with temperature for T was linear and yielded an activation energy of 28 kcal/mol. This value is identical with the one previously determined for activated DHT receptor complexes. T-receptor complexes extracted from the cells dissociated with complex kinetics: at 37 degrees C the rate constants of the "fast" and "slow" components were 40 and 14 X 10(-3) min-1, respectively. In contrast, DHT receptor complexes extracted from the cells dissociated with first-order kinetics and at a rate identical to that observed within cells, except after exposure to pyridoxal 5'-phosphate (5 mM) or concentration by Amicon (B-15) filtration, when their dissociation kinetics became complex. We interpret these data to mean that, within the cells, both T- and DHT-receptor complexes exist predominantly in the activated state whereas, when extracted from the cells, DHT-receptor complexes remain activated, unless perturbed, while T-receptor complexes become unstable spontaneously, probably by reverting to a preactivated state. PMID- 6843116 TI - Steroid binding to synaptic plasma membrane: differential binding of glucocorticoids and gonadal steroids. AB - The specific binding of [3H]-corticosterone, [3H]-17 beta-estradiol, [3H] testosterone, and [3H]-progesterone to synaptic plasma membrane (SPM) prepared from rat brain has been characterized. The dissociation constant is estimated as on the order of 1 x 10(-7) M for corticosterone and 1 x 10(-8) M for the other three steroids. In a competition experiment, none of the 3H-steroids was displaced by the other steroids at 500-fold excess, indicating the presence of specific binding sites on the membrane for each type of steroid. Moreover, pre incubation of the SPM with phospholipase A2 or phospholipase C totally destroys the membrane binding of corticosterone and testosterone, but the binding of estradiol and progesterone remains intact. Since the SPM prepared from brain tissue is derived from many different neuronal cell types, it is possible that the membrane binding sites for glucocorticoids and for gonadal steroids are present in different neurons. PMID- 6843117 TI - Estrogen receptors and estrogen-inducible progestin receptors in the sexual skin of the monkey. AB - Estrogen-binding macromolecules were identified in sexual skin cytosol and nuclear fractions from female Japanese monkeys (Macaca fuscata fuscata), by sucrose-glycerol gradient analysis and dextran-coated charcoal adsorption technique. Furthermore, using the highly potent synthetic progestin, R5020 (17,21 dimethyl-19-nor-4,9-pregnadiene-3,20-dione; promegestone), progestin-binding macromolecules were detected in sexual skin cytosols from ovariectomized estrogen primed monkeys. Both cytosol components sedimented at the 8S region on sucrose glycerol gradients and had a high affinity for the respective steroids, and competition studies showed a specificity for estrogenic, or progestational compounds. The concentration of cytosol progestin receptors was markedly increased with the elevated level of nuclear estrogen receptors following estrogen priming. The above results demonstrate the existence of cytosol and nuclear estrogen receptor sites, and estrogen-induced progestin receptors in the sexual skin of the female monkeys. PMID- 6843118 TI - Chemical synthesis of glucuronidated metabolites of cortisol. AB - During in vivo metabolism the addition of six atoms of hydrogen to cortisone at the appropriate location and configuration can lead to formation of either 3 alpha,17,20 alpha,21-tetrahydroxy 5 beta-pregnan-11-one (cortolone) or 3 alpha,17,20 beta,21-tetrahydroxy-5 beta-pregnan-11-one (beta-cortolone). Likewise, metabolic reduction of cortisol can lead to formation of either 5 alpha pregnane-3 alpha,11 beta,17,20 alpha,21-pentol (cortol) or the 20 beta isomer (beta-cortol). This paper describes the chemical syntheses of the C-3 beta-D glucosiduronates of cortolone, beta-cortolone, cortol and beta-cortol-conjugates which are normal excretory products of man. The foregoing conjugates are characterized as free acids (or salts), as methyl esters and as polyacetate methyl esters. PMID- 6843120 TI - Potassium intake and aldosterone biosynthesis: the role of cytochrome P-450. AB - K+ Repletion for 48 h of rats previously kept on a low K+ diet for 2 weeks specifically increased the conversion of corticosterone into aldosterone and 18 hydroxycorticosterone by incubated capsular fractions of rat adrenal tissue. This increase in the activity of the final steps of aldosterone biosynthesis was not accompanied by an increase in capsular adrenal mitochondrial cytochrome P-450 concentration. By contrast, an increased corticosterone-induced absorbance change (BI) was consistently found in capsular adrenal mitochondria upon K+ repletion. In addition, a type I-like absorbance change was induced with 18-hydroxy-11 deoxycorticosterone but not with 18-hydroxycorticosterone. Therefore, K+ repletion of K+ depleted rats specifically increased the binding of corticosterone and possibly 18-hydroxy-11-deoxycorticosterone to the 18-methyl oxidase enzyme complex. Whether this increased binding was due to an increase in enzyme protein concentration or due to a better availability of the substrate to the enzyme, could not be decided from these experiments. PMID- 6843121 TI - Determination of occupied cytoplasmic glucocorticoid receptor sites by an exchange assay in rat muscles. AB - We have established an assay to determine total cytoplasmic glucocorticoid receptor sites in heart, vastus and levator-ani-bulbocavernosus muscles from rats. We have tested the exchange of endogenously bound hormone with labeled triamcinolone acetonide by performing long incubation at 0-4 degrees C. This procedure appeared to produce an adequate exchange of exogenously added unlabeled corticosterone in the range of 16 nM (normal unstressed concentration of corticosterone in plasma) with vastus and levator ani-bulbocavernosus muscles. Beyond that level, the displacement of unlabeled corticosterone by labeled triamcinolone acetonide was less efficient. By contrast, in heart and especially in liver cytosols, the exchange was adequate even in the presence of high concentrations of corticosterone (64 and 460 nM respectively). Using the exchange assay conditions (20 h of incubation at 0-4 degrees C with 16 nM of labeled triamcinolone acetonide), we found no significant difference between glucocorticoid receptor levels in intact male and female rats. In both sexes, these glucocorticoid receptor values were not affected by gonadectomy, but increased more than 2-fold after adrenalectomy. No seasonal variations were recorded in intact or adrenalectomized rats. PMID- 6843119 TI - Effects of vitamin B6 nutritional status on the uptake of [3H]-oestradiol into the uterus, liver and hypothalamus of the rat. AB - Rats were depleted of vitamin B6 by treatment with isoniazid, and then maintained on diets providing: no vitamin B6, an adequate amount (1.2 mg/kg diet) or a very large amount (120 mg/kg) for 5 weeks. The uptake of a tracer dose of [3H] oestradiol into the nuclei of liver and uterus was significantly greater in deficient animals than in those receiving an adequate or greater than adequate amount of the vitamin. Similarly the accumulation of oestradiol in the region of the brain corresponding to the hypothalamus, pre-optic area and septum (the major oestradiol-sensitive regions of the central nervous system) was higher in deficient animals than in other groups. There were significant inverse correlations between the uptake of oestradiol into target tissues and vitamin B6 nutritional status as determined by the concentrations of pyridoxal phosphate in plasma and liver. Uteri from deficient animals were significantly smaller than those from animals receiving an adequate or greater amount of vitamin B6, and the induction of uterine peroxidase by oestradiol was impaired. It therefore seems likely that despite the greater net accumulation of steroid in target tissues, vitamin B6 deficiency impairs biological responsiveness to oestrogens. It is suggested that this may be due to a failure of the recycling of oestradiol receptors from the nucleus. PMID- 6843123 TI - Binding of prednisolone to alpha 1-acid glycoprotein. AB - The binding of prednisolone to alpha 1-acid glycoprotein (AGP) was determined in vitro by equilibrium dialysis. The effects of temperature, protein concentration, and drug concentration were evaluated. The binding ratio (bound/free) correlated well with protein concentration (r = 0.958) and percent bound ranged from 2 to 12% over high to low prednisolone concentrations at physiologic AGP concentrations (100 mg/dl). Temperature changes did not perturb binding. The non linear regression estimate of the binding constant (nk) was 4.4 x 10(3) M-1 indicative of both low affinity and low capacity of AGP for prednisolone. Overall, contribution of AGP to the total plasma binding of prednisolone is less than 3% when considered in the competitive protein binding system with transcortin and albumin. Disease induced alterations of AGP concentrations are relatively unimportant regarding plasma protein binding of prednisolone. PMID- 6843124 TI - Algorithmic analysis of estriol time concentration curves as a guide to timing of amniocentesis for fetal lung maturity. AB - Utilizing a computerized algorithm which estimates gestational age (GA) by analyses of third trimester plasma estriol (E3) concentration curves, we predicted L/S ratios at the time of 64 amniocentesis indicated for assessment of fetal maturity. In the identification of immature fetuses, both methodologies concur in 95% of cases if an L/S ratio of less than or equal to 2.3 and projected GA of less than or equal to 36 weeks are accepted as cut-off points. In the identification of mature fetuses there is agreement in only 54% of cases if an L/S ratio of greater than or equal to 2.3 and projected GA of greater than or equal to 37 weeks are accepted as cut-off points. The data show that the E3 algorithm is of value in the postponing of premature and therefore unnecessary amniocenteses for fetal maturity. However the poor correlation between the E3 algorithm, a method previously shown to be accurate in GA prediction, and mature L/S ratios demonstrates the need to utilize more accurate indicators of mature amniotic fluid surfactant activity in future investigations. PMID- 6843122 TI - Progesterone, androstenedione, testosterone, 5 alpha-dihydrotestosterone and androsterone concentrations in specific regions of the human brain. AB - The concentrations of progesterone, androstenedione, testosterone, 5 alpha dihydrotestosterone and androsterone were determined in tissue samples from the human hypothalamus, anterior pituitary, pineal, amygdala and parietal cortex, taken at autopsy from male (n = 4) and female cadavers (n = 4) of various ages. The measurements were performed using radioimmunoassays for the individual steroids after the chromatographic purification of solvent extracts of tissue samples on Lipidex-5000TM. Preliminary qualitative analyses of the chromatographic profiles of various steroids by radioimmunoassay demonstrated the presence of these steroids in various regions of the brain, but an immunoreactive peak corresponding to 17-hydroxyprogesterone was not found. The concentrations (ng/g tissue wet wt.) of all steroids measured were either very low or below the limit of detection in brain tissues taken from male and female infants. In the adult brain, there was no difference in the distribution of steroids between the various regions studied. There was no sex difference in the brain tissue steroid concentrations, with the exception of testosterone which was clearly much higher in brain tissues from men as compared to women. Although testosterone was undetectable in most samples taken from adult women. 5 alpha-dihydrotestosterone could be measured in almost all samples, which suggests that this is the most important androgen in the human brain. When brain tissue steroid levels are compared with serum concentrations, it can be postulated that a state of equilibrium exists between the fraction of serum steroids which are not bound to high-affinity binding proteins and the amount of steroids in brain tissues. PMID- 6843126 TI - Analysis of progesterone receptor in the quail oviduct. Correlation between plasmatic estradiol and cytoplasmic progesterone receptor concentrations. AB - Specific binding sites for [3H]-progesterone are found in the cytosol fraction of the oviduct of castrated, immature and developing quails. The optimal conditions to accurately measure the total cytoplasmic concentration of this progesterone receptor are described. The dissociation constant (KD) at 0 degrees C is 3.6 +/- 0.6 x 10(-9) M (mean +/- SE) for [3H]-P and the concentration of binding sites is 13.4 +/- 2 pmol/mg DNA in immature animals. This binding capacity is not altered even 2 weeks after ovariectomy. During sexual development, although the dissociation constant remains unchanged, the number of binding sites increases to 74.5 +/- 1.6 pmol/mg DNA just before the beginning of the laying cycle. The concentration of cytoplasmic P receptor is under the inductive influence of estradiol. In castrated quails, estradiol 17 beta (E2) perfusion through the portal vein at a rate below or equal to 2 ng/min for 24 hr does not increase plasmatic E2 concentration and consequently does not change [3H]-P binding sites concentration in the oviduct. While E2 perfusion rate exceeds the metabolizing capacity of the liver (6.8 ng/min), both plasmatic E2 level and oviductal P receptor concentration are increased. When E2 is perfused through the jugular vein, plasmatic E2 level increases with the dose of E2 but P receptor concentration only increases when E2 perfusion rate reaches to 2.0 ng/min for 24 h. PMID- 6843125 TI - Effect of phenobarbital on in vitro aromatization of testosterone to estradiol by adult male mice brain. AB - Adult male mice were given phenobarbital (PB) through their food containing 3.5 g/kg for 5 consecutive days. On days 3 and 5 of treatment and 5 days following termination of PB treatment the animals were sacrificed and the in vitro conversion of (1,2-3H)-testosterone to estradiol in the brains was measured. During PB treatment brain aromatization of testosterone was reduced by approximately 50% as compared to the untreated group. Five days after termination of PB administration, brain aromatase activity was as in the control group. Direct addition of PB to brain homogenates (200 micrograms/ml) reduced the conversion of testosterone to estradiol by approximately 30%. These results demonstrate that PB can act directly upon brain tissue to inhibit aromatase activity. It is assumed that this effect of PB is one of the mechanisms by which this drug inhibits testosterone action. PMID- 6843127 TI - Characterization of estrogen, progesterone and glucocorticoid receptors in rabbit mammary glands and their measurement during pregnancy and lactation. AB - Specific cytosolic receptors for estrogen, progesterone and glucocorticoids have been identified in mammary glands of virgin, pregnant and lactating rabbits. Receptors for these three steroids hormones show similar specificity, stability, dissociation, sedimentation characteristics on sucrose gradient and binding constants to steroid hormone receptors which have been characterized in a number of other target tissues. Receptors for estrogen and progesterone are highest at day zero of pregnancy, with values declining by 80-90% during the first week. Estrogen and progesterone receptor levels remain low but measurable throughout pregnancy, with progesterone receptor levels becoming undetectable late in lactation. Glucocorticoid receptors, which are 52.4 +/- 14.5 fmol/mg protein on day 0, decline slightly during the first week of pregnancy and then increase on day 14 to 81.4 +/- 18.9 fmol/mg protein, after which the values decline continuously until parturition. During lactation, values are slightly elevated on day 2 and somewhat lower on day 10. A difference in the receptor binding capacity for estrogens, progesterone and glucocorticoids was observed for mammary glands removed from virgin females (day 0 of pregnancy) which had either accepted or refused the male. Binding capacities were 2.4-, 3.4- and 1.7-fold higher for estrogen, progesterone and glucocorticoid receptors, respectively, in mammary glands of virgins accepting the male than in those females not accepting the male. PMID- 6843128 TI - Cutaneous signs of internal malignancies. AB - The more common paraneoplastic skin changes associated with internal malignancies (acanthosis nigricans, dermatomyositis, secondary ichthyosis) are discussed. The rare glucagonoma syndrome, consisting of alpha cell tumor of the pancreas, migratory necrolytic erythema, and diabetes mellitus, is described. The importance of recognition of these skin lesions may lead to early detection of the underlying cancer with possible cure. PMID- 6843129 TI - Complications of ectopic ureterocele in adult female. PMID- 6843130 TI - Adenocarcinoma of Meckel's diverticulum. AB - The clinicopathologic features of a case of adenocarcinoma arising in Meckel's diverticulum are described and compared with the 21 cases reported in the literature. The prognosis is generally poor. However, the patient in the present case was alive and well 1.5 years after diagnosis, despite the fact that the lesion had perforated at initial presentation. PMID- 6843131 TI - The technique of major amputations for malignant tumors. AB - Major amputations for malignant tumors have declined in incidence due to limb salvage procedures using combinations of modalities. For extensive malignant growths, amputations are still necessary and life-saving operations. Familiarity with the anatomy and technique involved is important. In the following, technical details related to these operations and their variants are provided. PMID- 6843132 TI - Fibrosarcoma associated with intensive chemotherapy for advanced germ cell testicular tumor. PMID- 6843133 TI - Leukonychia striata associated with breast carcinoma. PMID- 6843134 TI - Metastatic malignant melanoma of unknown primary origin: a study of 30 cases. AB - Thirty patients with metastatic malignant melanoma of unknown primary origin treated at Emory University Clinic between 1940 and 1975 are presented. This group represents the 4.4% of all melanomas treated during the same period of time at Emory. Nineteen (63.3%) patients had nodal metastases only, and they were handled by radical lymphadenectomy of the involved area. The remaining 11 patients presented with lung or widespread subcutaneous metastatic disease and treated with biopsy and radiotherapy or chemotherapy. The former group experienced 28.6% five- and ten-year actuarial survival while patients with lung metastases succumbed within four months after diagnosis. Spontaneous regression of a typical melanoma skin lesion has been reported in three patients prior to development of metastatic disease. PMID- 6843135 TI - Determination of catecholamines in rat tissue by precolumn dansylation using micro high-performance liquid chromatography with fluorescence detection. AB - A micro high-performance liquid chromatography (MHPLC)-precolumn dansylation procedure for determination of norepinephrine (NE), epinephrine (E), and dopamine (DO) in various kinds of rat tissue has been developed. After dansylation of the extracted catecholamines to get fluorescent derivatives, they were separated and determined using MHPLC equipment with a fluorimeter. The standard deviation of the method was +/- 8% for NE, +/- 4% for E, and +/- 8% for DO. This relatively simple and rapid procedure for determination of catecholamines provides an efficient and reproducible method. Furthermore, the procedure is readily adaptable to routine pharmacological study of catecholamine metabolism in various kinds of rat tissue. PMID- 6843136 TI - A spectrophotometric method for simultaneous estimation of phenytoin and carbamazepine. AB - A 0.5 ml sample of serum, containing different antiepileptic drugs, singly or in combination, was made alkaline, overlayered with isooctane, and steamed in the presence of KMnO4. The spectra of oxidized products in the organic layer were recorded in the UV range. Oxidized phenobarbitone and primidone show no absorption peak; diazepam a delta-max at 228 nm; phenytoin at 247 nm; and carbamazepine at 247 nm and 372 nm. Consequently, phenobarbitone and diazepam do not interfere in phenytoin quantitation, but carbamazepine does. The contribution of carbamazepine at 247 nm was calculated from the absorption at 372 nm and the ratio of its molar extinction coefficients at the two wave lengths. This was subtracted from the total A247 values to get the actual values due to phenytoin. Thus, a method for simultaneous analysis of carbamazepine and phenytoin in a single sample has been developed. PMID- 6843138 TI - In vivo rat bladder: a new model to screen spasmolytic compounds. AB - A model for in vivo screening of spasmolytic compounds of the rat urinary bladder has been developed. It is physiological, specific, and adaptable. A filling volume of the bladder of 0.6-1 ml proved to be optimal. Agonists such as acetylcholine, KCl and BaCl2 exerted almost identical spasmogenic effects on both the in vivo and the in vitro model (isolated rat bladder strip). Moreover, the antagonistic effects of atropine, N-butylscopolammonium bromide, or flavoxate hydrochloride were directly comparable between the two models. Intravenously administered atropine was shown to be effective immediately; after intragastric application the maximum effect can not be observed until after 9 min. The in vivo rat bladder model presented is proposed to be a suitable method for advanced screening of spasmolytic compounds to include their absorption, biotransformation, and excretion. PMID- 6843139 TI - A rapid and simple assay for the study of thromboxane B2 synthesis by intact human platelets. AB - Conversion of 1-14C-arachidonic acid (AA) to thromboxane B2 (TXB2) by human platelets was studied by using a new, simple technique. Organic solvent extraction was avoided by spotting aliquots of the reaction mixture directly on thin layer chromatography (TLC) plates. In this way it was possible to study the kinetic parameters of the formation of TXB2. Moreover, the rapidity and simplicity of the assay should be particularly suitable when studying the possible relationships between thromboxane synthesis and aggregation function in human platelets, where a large number of determinations is required. PMID- 6843140 TI - Use of an extracorporeal arterio-venous shunt and capillary tubes for frequent micro-blood sampling in rats. AB - Because of the importance of frequent sampling during kinetic analysis, we have developed a method that permits frequent, reliable, and rapid access to the blood stream in rats. The method comprises the establishment of an extracorporeal arterio-venous shunt between femoral blood vessels. Quantitative samples of whole blood and plasma are obtained with capillary micro hematocrit tubes. The small sample volume permits repetitive analysis without major changes in hematocrit. There is good agreement between these measures and ordinary pipetting techniques. Kinetic analysis showed good resolution with close correspondence between actual measurements and the final curve of best fit. This method could be employed advantageously in small conscious animals, when frequent small samples are required by experimental design. PMID- 6843137 TI - Assessing calcium antagonism on vascular smooth muscle: a comparison of three methods. AB - Three methods relying on depolarization-induced contraction of rabbit aortic rings were compared. The effects of hyperosmolarity induced by adding KCl to the bath and of a lowered NaCl concentration due to an exchange of NaCl for KCl were assessed. A dihydropyridine derivative (PY 108-068) and verapamil were used as antagonists. For the first method, 50.3 mM KCl was either added to the bath to reach a final concentration of 55 mM, or KCl was exchanged for NaCl to keep the bath isoosmotic. We found a noncompetitive antagonism and the results obtained from cumulative concentration-response curves appeared to be based on the slow tonic contraction. For the second method, the rings were suspended in a calcium free Krebs-Henseleit (KH) or TRIS bath solution containing also 55 mM of KCl and calcium was added as an agonist. We found a competitive inhibition of the calcium effects. The slope of the Schild Plot was, however, -1.3 for PY 108-068 and -0.5 for verapamil. Very high concentrations of calcium had relaxant effects and thus distorted the results. For the third method, the rings were contracted by KCl and then relaxed by adding the calcium antagonist to the bath. Isoosmotic solution and solution made hyperosmotic with sucrose were also used. Hyperosmolarity by itself contributed to the tension development. In hyperosmolar solution, the calcium antagonists appeared to be less active. Such bath conditions can therefore considerably bias the results. The first and the second method, in combination with experiments using receptor stimulating agents such as noradrenaline, appear to be most suitable for investigating calcium antagonists on blood vessels. PMID- 6843141 TI - Continuous long-term insulin delivery in diabetic rats utilizing implanted osmotic minipumps. AB - Surgically implanted osmotic minipumps were used to continuously deliver insulin to chemically-induced diabetic rats. Serum glucose levels were maintained within normal limits for 7 days in all diabetic rats implanted with the minipumps. Beyond this time period, serum glucose levels could not be adequately controlled in greater than 50% of the diabetic rats. Seven of 20 diabetic rats originally implanted with osmotic minipumps were well controlled throughout the 31-day study period. This study demonstrates that insulin-filled osmotic minipumps provide no advantage over daily insulin injection in the long term control of diabetes. PMID- 6843142 TI - A new method for measuring vascular responsiveness of relatively larger arteries of dogs. AB - A new model of isolated vascular preparation was developed in the dog. Several canine arteries were isolated and suspended in a bath and perfused under a constant flow rate with Ringer-Locke solution. In each experiment, resting perfusion pressure was set at a constant level at 40-60 mm Hg. Drugs were administered in the endothelial side of the artery through a cannulated tubing, and the response was obtained as changes in the perfusion pressure. By inserting the polyethylene cannula into the artery, the space between the luminar wall of the artery and the cannula was decreased enough to obtain a suitable perfusion pressure, while the cannula was filled with the fluid by pumping. Although some other methods have been used to observe contractile responses of the artery, this method might be superior to them because: 1) drugs act only on the luminar wall; 2) vascular responses to drugs, not only constriction, but also dilatation, in nontreated preparations, are readily observed in a relatively larger artery (2-3 mm I.D.); 3) the vascular reactivity is kept in a stable condition over 7-8 hours at 37 degrees C. We used this preparation to examine the contractile responses of the common, internal, external carotid, and femoral arteries to 5 hydroxytryptamine. PMID- 6843143 TI - Repair of tricuspid atresia in 100 patients. AB - One hundred consecutive patients with situs solitus of the atria and tricuspid atresia have undergone surgical repair since 1968. In patients with ventriculoarterial concordance, a nonvalved Dacron conduit or an aortic valve homograft was interposed between the right atrium and right ventricular outlet chamber. In patients with ventriculoarterial discordance, an aortic valve homograft established continuity between the right atrium and pulmonary artery. Among 73 patients with ventriculoarterial concordance, the hospital mortality rate was 11% (eight deaths), and in 27 patients with ventriculoarterial discordance, it was 15% (four deaths). Before 1974, the year of operation was a significant determinant of hospital mortality (p less than 0.001). Thereafter, the hospital mortality declined and is currently 3.7%. In 82 patients with ages ranging from 4 to 16 years, there were six deaths (7.3%) whereas there were six deaths (33.3%) in 18 patients less than 4 or more than 16 years (p less than 0.001). Mode of ventriculoarterial connection and type of repair did not influence significantly the hospital mortality. There were six late deaths due to infection (two), reoperation (two), heart failure (one), and sudden death (one). Regardless of the mode of ventriculoarterial connection, use of a homograft valve produced better results, i.e., more asymptomatic patients (NYHA Class I) (p = 0.0168) and higher postoperative exercise capacity. Postoperative catheterization data and angiocardiographic measurements in patients with ventriculoarterial concordance demonstrated significant advantages with the interposition of a homograft valve between the right atrium and outlet chamber. Of 82 surviving patients, 94% are in NYHA Class I or II. PMID- 6843144 TI - Management of air embolism in blunt and penetrating thoracic trauma. AB - The charts of 61 patients treated from 1970 through 1981 were reviewed to determine the clinical outcome after treatment of air embolism from blunt (15 patients) and penetrating (21 gunshot and 25 stabbing) thoracic injuries. The diagnosis of air embolism was confirmed by the presence of air in the coronary arteries (57%), air aspirated from the heart (30%) or major artery (10%), or Doppler findings (3%). All patients were in shock or cardiac arrest, and in 36% of these patients there were early signs of hemoptysis or unexpected arrest after intubation and positive-pressure ventilation. Successful management included (1) early thoracotomy for diagnosis as well as for specific treatment, (2) hilar cross-clamping for control of bronchovenous communication, (3) maintenance of perfusion pressures with fluids, vasopressors, or aortic cross-clamping, and (4) prompt correction of the embolic source, usually a lung resection. The overall survival rate was 44%, which correlated with the mechanism of injury, with associated nonthoracic injuries, and with the occurrence of arrest in a controlled setting. We conclude that (1) air embolism can insidiously occur even in blunt trauma; (2) suspicion should be high with hemoptysis or unexpected arrest; and (3) successful treatment includes immediate thoracotomy for diagnosis, resuscitation, and prompt control of the bronchovenous communication. PMID- 6843145 TI - The role of the Glenn shunt in patients undergoing the Fontan operation. AB - Twenty-seven patients (3 to 22 years) underwent the Fontan operation. Seventeen had tricuspid atresia and 10 had other complex lesions. Sixteen patients had a Glenn shunt (12 prior to, three simultaneous with, and one following the Fontan operation). One early death (3.7%) occurred in a 4 1/2-year-old child with tricuspid atresia II-C, previous pulmonary artery banding, and a closing ventricular septal defect (80 mm Hg gradient). There were two late deaths (7.4%) from Candida sepsis, after 4 and 6 months, respectively. The 24 patients who survived the Fontan operation had postoperative hospital stays of 6 to 90 days (average 18). Patients with tricuspid atresia and an established Glenn shunt (nine patients, Group I) had postoperative hospital stays of 7 to 19 days (average 9.5), and none had significant pleural or pericardial effusions. Patients with tricuspid atresia without a Glenn shunt (seven patients, Group II) had postoperative hospital stays of 6 to 60 days (average 17.5), with three having significant effusions. Of the patients with other complex lesions, all without an established Glenn shunt, five had significant effusions. Four additional major complications (two tricuspid patch disruptions with ineffective pulmonary blood flow and two complete occlusions of a valved conduit) were encountered in which the Glenn shunt proved lifesaving. We believe that an established Glenn shunt played a major role in attaining minimal postoperative hemodynamic instability, effusions, renal failure, and mortality in our patients. The Glenn shunt should be considered in patients who are less than ideal candidates for the Fontan operation. PMID- 6843146 TI - Late effects on the left upper limb of subclavian flap aortoplasty. AB - The subclavian flap aortoplasty gives excellent short-term and medium-term results when performed on infants with coarctation of the aorta. This study was devised to determine whether there were any detrimental effects to the sacrifice of the left subclavian artery in infancy. Sixteen patients were studied 2 to 9 years post-operatively. Clinical evaluation revealed no major symptoms in the left upper limb. However, in seven children, minor symptoms had been noted by the parents. Anthropometric measurements revealed a shortening of the left upper limb in all patients; when these measurements were compared with those in normal subjects, the shortening was localized to the left upper arm. Four papers which mention the effect on the left arm of ligation of the subclavian artery in childhood during the Blalock-Taussig operation are discussed. It is concluded that the excellent results from the subclavian flap aortoplasty are not compromised by the minor effects of ligating the left subclavian artery in infancy. PMID- 6843147 TI - Blood pressure response to exercise in children following the subclavian flap procedure for coarctation of the aorta. AB - Eight patients who underwent repair of coarctation of the aorta as infants (mean age 4.6 months) by the subclavian flap procedure were evaluated by dynamic exercise. Their mean age at the time of exercise testing was 4.6 years. Resting upper to lower limb systolic blood pressure gradients were similar in the patients and control subjects (mean 17 +/- 12 and 2 +/- 14 mm Hg) (p greater than 0.05). Mean resting systolic blood pressures in the upper limb were 121 +/- 10 mm Hg in the patients and 107 +/- 14 mm Hg in the volunteers (p greater than 0.05). The mean gradient between the upper and lower limbs was 13 +/- 19 mm Hg in the patients on dynamic exercise testing. No patient became pathologically hypertensive in the upper limbs during dynamic exercise. These results indicate that the subclavian flap procedure is an effective form of treatment for the symptomatic infant with coarctation of the aorta and can be expected to result in a low incidence of subclinical residual obstruction or restenosis. PMID- 6843148 TI - Experience with operation for total anomalous pulmonary venous connection in infancy. AB - Twenty patients presenting with total anomalous pulmonary venous connection (TAPVC) in infancy underwent cardiac repair. Four had associated major intracardiac anomalies (complex TAPVC) and 16 had isolated TAPVC. All patients with complex lesions died during or shortly after the operation; they all had pulmonary venous obstruction (PVO). The associated malformations were critical pulmonary stenosis (one case), multiple ventricular septal defects (VSDs) (one case), mitral atresia (one case), and asplenia syndrome with common atrioventricular valve, double-outlet right ventricle, and pulmonary stenosis (one case). Among the patients with isolated lesions there were two surgical deaths, both in infants less than 1 month of age, with severe PVO and subdiaphragmatic drainage. Statistical analysis of these data shows a strongly incremental risk of surgical death due to the presence of associated malformations. Analysis of just isolated TAPVC shows a possible incremental effect due to neonatal age (less than 1 month) and PVO, these two factors being not clearly separated. There have been no late deaths and no late complications among the 14 survivors followed from 7 months to 10 years (mean 44 months). An aggressive surgical approach regardless of the age, degree of pulmonary hypertension, and type of anatomic connection is advised for isolated TAPVC. Some caution is recommended for complex TAPVC, in which a much higher risk is anticipated, particularly when a palliative pulmonary vein-to-left atrium anastomosis is performed. PMID- 6843149 TI - The influence of pulmonary insufficiency on ventricular function following repair of tetralogy of Fallot. Evaluation using radionuclide ventriculography. AB - Long-standing pulmonary insufficiency after repair of tetralogy of Fallot may adversely affect ventricular function. We evaluated 20 patients at a mean of 9 years after repair by radionuclide ventriculography, 24 hour Holter monitoring, and M-mode echocardiography. The mean age at complete repair was 7.1 +/- 2.6 years. Patients were divided into groups as follows: Group I (eight patients), no clinical pulmonary insufficiency; Group II (12 patients), moderate to severe pulmonary insufficiency. Group II was further divided: Group IIa, transannular patch (six patients); Group IIb, no transannular patch (six patients). There was no difference between groups for age at operation, duration of follow-up, right ventricular pressure, or right ventricular-pulmonary arterial gradient. No patient had a residual shunt and all were in New York Heart Association Class I. Serious ventricular dysrhythmias occurred in 38% of Group I patients and 50% of Group II (p = NS). The echocardiographic ratio of right to left ventricular end diastolic dimension was greater in patients with pulmonary insufficiency than in those without pulmonary insufficiency: 0.83 +/- 0.17 versus 0.55 +/- 0.15, p less than 0.01. Right ventricular ejection fraction was 0.39 +/- 0.08 in Group I and 0.27 +/- 0.07 in Group II, p less than 0.01. Left ventricular ejection fraction was 0.64 +/- 0.12 in Group I and 0.53 +/- 0.07 in Group II, p less than 0.02. Radionuclide angiography is a useful means of identifying right ventricular dysfunction following repair of tetralogy of Fallot. The dysfunction appears significantly worse in patients with pulmonary insufficiency. PMID- 6843150 TI - Unusual mitral valve abnormalities complicating surgical repair of endocardial cushion defects. AB - A review of 155 cases of surgically repaired endocardial cushion defects revealed 16 patients (10%) with additional unusual mitral valve abnormalities that complicated the surgical procedure. Eight patients had accessory mitral valve tissue that connected the anterior and posterior leaflets to form a double orifice valve (Group I). In four (50%), the lesion was associated with intermediate atrioventricular canal and small left ventricle; all four died following repair. In the other four, it was associated with ostium primum defect; all survived and are well. A single papillary muscle in the left ventricle was present in six patients (Group II). Two had intermediate atrioventricular canal and both died postoperatively. The other four had complete endocardial cushion defect and three are well following the operation. Perforation of the valve leaflets was present in two patients with ostium primum (Group III). Both patients are well postoperatively. Modification of the surgical technique is required to effect satisfactory repair. The bridge connecting the posterior and anterior leaflets of the mitral valve should be left undisturbed. Otherwise, severe regurgitation may result. In patients with single papillary muscle and complete atrioventricular canal, repair may be accomplished by borrowing from the tricuspid portion of the anterior leaflet, rotating that part posteriorly, and partially closing the cleft. Small perforations of the mitral leaflet do not require closure and do not result in regurgitation. Echocardiographic and angiographic delineation of these abnormalities and thorough intraoperative exploration are important in avoiding pitfalls at the time of repair. PMID- 6843151 TI - Left ventricular aneurysmectomy. Factors influencing postoperative results. AB - One hundred consecutive patients who underwent resection of aneurysms of the left ventricle were reviewed. Eighty-four of these patients had resection or plication of an aneurysm of the anterior left ventricular wall either alone or in combination with coronary artery bypass grafting. In 27 patients who had little or no congestive heart failure, the primary indication for operation was disabling angina pectoris. In them the early mortality was 4% and late mortality, 4%. In nine other patients the primary indication for operation was life threatening ventricular arrhythmias. In this group the early mortality was 56% and late mortality, 0%. Severe congestive heart failure was the primary indication for aneurysmectomy in 48 patients. In these patients the early mortality was 21% and late mortality, 34%. When the primary indication for operation was severe congestive heart failure, overall survival and postoperative results were best in patients in whom the nonaneurysmal left ventricle had good function preoperatively and was supplied by coronary arteries either unobstructed or favorable for bypass grafting; results were poorest in those patients with three-vessel coronary artery disease who had impaired motion of the lateral left ventricular wall and distal lateral wall vessels that were unfavorable for bypass grafting. It is concluded that patients with left ventricular aneurysms form a heterogeneous group in which the prognosis varies markedly. The probability of a good postoperative result can be predicted by careful preoperative analysis of a patient's symptoms, ventricular function, and coronary artery anatomy. PMID- 6843152 TI - Cardiac valve replacement in systemic lupus erythematosus. A review. AB - Three cases of cardiac valve replacement for Libman-Sacks endocarditis and their long-term follow-up are described. From the review of the literature, an additional nine patients who required cardiac valve replacement are studied. Steroids probably increase the incidence of valve incompetence, but most patients presumably die of other associated organ involvement before undergoing a cardiac operation. Operation is indicated because of change in the intensity or character of the murmur, and a new murmur with resultant, resistant congestive cardiac failure. Both the aortic and mitral valves should be explored. Valve reconstruction in these young patients, with the expectation of avoiding prosthetic valve dysfunction and repeat operation, is not possible. Bioprosthetic valve replacement may be preferable, since it eliminates the need for anticoagulation during steroid treatment. Overall mortality was 25%. PMID- 6843153 TI - Relationship between left ventricular morphology and postoperative cardiac function following valve replacement for mitral stenosis. AB - The left ventricular myocardium excised from 14 patients who had mitral stenosis and who underwent mitral valve replacement was examined, and myocardial fibrosis was quantitated in relation to cardiac function. Conventional mitral valve replacement was performed with cold potassium-induced cardioplegia associated with systemic hypothermia (28 degrees C rectal temperature) and topical cooling. All 14 patients had perivascular fibrosis; the amounts ranged from 16% to 54% of the whole tissue excised. The mean left ventricular end-diastolic volume index (LVEDVI) determined by M-mode echocardiography increased significantly (p less than 0.001) from 66.9 +/- 4.6 ml/m2 preoperatively to 79.0 +/- 2.9 ml/m2 postoperatively. The difference between preoperative and postoperative LVEDVIs was significantly correlated (p less than 0.01) to the percentage of myocardial fibrosis (r = 0.72), in that the index increased postoperatively when myocardial fibrosis was more than 35% and decreased when fibrosis was less than 35%. After mitral valve replacement, the mean ejection fraction increased when fibrosis was less than 35% of whole tissue (+0.12 +/- 0.04) and decreased when fibrosis was greater than 35% (-0.02 +/- 0.02, p less than 0.01). No measured preoperative hemodynamic parameters were predictive of prognosis. These data suggest that the degree of myocardial fibrosis is related to left ventricular performance after mitral valve replacement. PMID- 6843154 TI - Exploratory thoracotomy in bronchial carcinoma. AB - Of 2,540 patients with bronchial carcinoma, 1,223 (48.1%) were judged primarily to have inoperable disease. Of the 1,317 (51.9%) patients who seemed operable, 150 (11.4%) proved to have inoperable lesions at thoracotomy. The resectability rate was 45.9%. The difference between the clinical and surgical staging, i.e., the ultimate reason for inoperability, had various causes: inadequate assessment of the available radiologic data, inadequate performance of mediastinoscopy, and pleural or thoracic wall involvement without clinical suspicion preoperatively. Exploratory thoracotomy cannot always be avoided. However, it seems important that physicians check their results with exploratory thoracotomy to improve the quality of the diagnostic procedures in the preoperative work-up. PMID- 6843155 TI - Surgical treatment of endomyocardial fibrosis. AB - Thirty patients with endomyocardial fibrosis were submitted to endocardial decortication and atrioventricular valve replacement between December, 1977, and October, 1981. There were 26 female and four male patients, ranging in age from 14 to 48 years (mean 32). Thirteen patients had biventricular disease, 14 had the right-sided form, and three had endomyocardial fibrosis confined to the left ventricle. All were in Functional Class III or IV (New York Heart Association classification). The hospital mortality was 20% (six cases). Among the survivors (mean follow-up 13 months), 23 of 24 were improved clinically. Postoperative hemodynamic and angiographic studies were performed in 15 patients. Two (6.6%) have definitive atrioventricular heart block. There were five (16.6%) late deaths. Operation for endomyocardial fibrosis should be considered a palliative procedure. Possible limitations include the need for a valve prosthesis, cardiac conduction disturbances secondary to endocardiectomy of the right ventricle, and the possibility of recurrence of the endocardial fibrosis. However, at present, operation seems to be the treatment of choice for this condition because (1) endomyocardial fibrosis is characterized by a grave prognosis and medical therapy is ineffective; (2) endomyocardial fibrosis is a disease in which only the heart is affected, lesions in other organs being the result of passive congestion; (3) systolic performance of the heart is usually only slightly depressed; and (4) the surgical procedure is easily performed, so that the mortality is acceptable. PMID- 6843156 TI - Surgical treatment of the two types of tachycardia caused by Kent bundles with only retrograde function. AB - Accessory pathways of atrioventricular (AV) conduction of the Kent type, with only retrograde conduction, have been implicated in from 25% to 40% of reentry supraventricular tachycardias. In the 22 patients with Kent bundles of this type, the subject of this report, two different kinds of reentry tachycardia were found. Sixteen patients had a narrow QRS reentry paroxysmal tachycardia similar to that found with the usual bidirectional pathway. Their Kent bundles were located in the following areas: posterior septum, two; anterior septum, two; right free wall, one; and left free wall, 11. The pathways had the electrophysiological characteristics of working myocardium. A second and unusual group of six patients had a tachycardia described by Coumel as permanent or incessant junctional reciprocating tachycardia. The pathways were all in the posterior septal area. The electrophysiological characteristics of the Kent bundles were slow conduction with decremental properties similar to the AV node. Operation was successful in correcting both types of tachycardias. His bundle interruption was used as an elective procedure in two and after failure to divide the Kent bundle in two others. Kent bundle interruption was successful in the remaining 18 patients. Some of the electrophysiological aspects of special surgical interest are discussed. PMID- 6843157 TI - Should nutritional status be assessed routinely prior to cardiac operation? AB - One hundred consecutive adult patients undergoing cardiac operations at a single institution were evaluated preoperatively with regard to their nutritional status. Anthropometric, biochemical, and immunologic characteristics were evaluated in addition to cardiac biopsy specimens to determine right atrial glycogen concentration. Although some positive anthropometric, biochemical, and cell-mediated immunity characteristics were observed to have "statistically significant" correlations with morbidity and mortality for the group as a whole, nearly all of the values remained near or at normal limits. Lighter weight men with a smaller arm muscle circumference and lower concentration of total body fat had more complications than their heavier counterparts. Serum transferrin and cell-mediated immunity also formed weakly positive statistical correlations. Anthropometric correlations in women were of no value. Myocardial glycogen concentrations did not correlate with postoperative morbidity and mortality. Because nearly all of the patients had arteriosclerotic heart disease, the series as a whole may have been skewed toward a group with values too close to normal to differentiate them adequately. It is concluded that routine nutritional assessment is of no value in guiding nutritional management for individual patients, although when patients are analyzed as a group, interesting epidemiologic observations can be made. PMID- 6843159 TI - Chylopericardium: new complication of blalock-taussig anastomosis. PMID- 6843158 TI - Enhanced myocardial protection during ischemic arrest. Oxygenation of a crystalloid cardioplegic solution. AB - To determine if, during elective cardiac arrest, the myocardial protection afforded by a cold (4 degrees C) crystalloid potassium cardioplegic solution could be improved by oxygenation of the solution, we placed 16 dogs on cardiopulmonary bypass and subjected their hearts to 4 hours of cold cardioplegic arrest. Group 1 hearts (n = 8) received aerated crystalloid solution perfused through the aortic root every 20 minutes. Group 2 hearts (n = 8) were treated identically except that the crystalloid cardioplegic solution was fully oxygenated. Left ventricular function curves (ejecting heart) were generated before arrest (control) and after 45 minutes of reperfusion. A cardiac output of 1,000 ml/min could be attained in only two hearts of Group 1 after reperfusion, whereas all but one heart of Group 2 had excellent functional preservation. Mean postreperfusion adenosine triphosphate (ATP) levels in Group 1 and Group 2 hearts were 62% and 89% of control, respectively (p less than 0.01). Myocardial water content had increased significantly (p less than 0.002) after reperfusion in Group 1, but not in Group 2. During cardioplegic solution infusion, myocardial oxygen consumption (MVO2) was 1.42 +/- 0.15 ml O2/min/100 gm LV for Group 1 and 6.91 +/- 1.27 ml O2/min/100 gm LV for Group 2 (p less than 0.001). Oxygen consumed per minute of arrest was 0.027 +/- 0.003 ml O2/min/100 gm LV for Group 1 and 0.128 +/- 0.015 ml O2/min/100 gm LV for Group 2 (p less than 0.001). Postreperfusion ultrastructural evaluation of two of the Group 1 hearts revealed severe ischemic damage in contrast to the normal ultrastructural appearance of two of the Group 2 hearts. With careful attention given to maintenance of myocardial hypothermia and cardioplegic delivery methods, the myocardial protection afforded by an oxygenated crystalloid cardioplegic solution exceeds that provided by the aerated control and compares favorably with other methods of myocardial protection during ischemic arrest. PMID- 6843160 TI - Thrombosis associated with a porcine bioprosthesis and ascending aortic graft in a patient with the Marfan syndrome. AB - A fatal thrombosis originating at the junction of an aortic bioprosthetic heart valve and a Dacron aortic graft was observed in a patient with the Marfan syndrome, who had had replacement of the ascending aorta with a valved conduit 29 months previously. This unique complication raises the question of whether patients with such prostheses should be on a program of full anticoagulation. PMID- 6843161 TI - Simple method for treatment of intraoperative hypoxic episodes in patients with tetralogy of Fallot. PMID- 6843163 TI - Thrombectomy of the Bjork-Shiley prosthesis. PMID- 6843162 TI - Acute mitral insufficiency resulting from blunt chest trauma. PMID- 6843164 TI - Surgical treatment of pulmonary hydatidosis. PMID- 6843166 TI - Bone-conducted auditory stimulation in unrestrained, unanesthetized animals. AB - A new method of eliciting auditory responses using bone-conducted stimuli was developed for use in freely-moving unanesthetized animals. In cats and rats piezoelectric materials were either bolted to or embedded within a dental acrylic skull platform. In order to produce acoustic stimulation, click and pip electrical waveforms were used to drive vibrations in the crystalline material. Responses to the crystal-elicited stimuli were compared with responses to air coupled stimuli and were found to be virtually identical. Acoustic masking eliminated the response showing there is no significant contribution made to the responses by other sensory modalities. PMID- 6843165 TI - Arterial repair without coronary relocation for double-outlet right ventricle with subpulmonary ventricular septal defect (Taussig-Bing anomaly) PMID- 6843167 TI - A simple method for fashioning small diameter concentric bipolar electrodes for stimulation of nervous tissues. PMID- 6843168 TI - The use of image analysis for measuring neuritic outgrowth from goldfish regenerating retinal explants. PMID- 6843169 TI - A remotely operated pump for intracerebral micro-injection in the primate. AB - A method is described for making small (2-6 microliters) localized intracerebral drug injections in the conscious monkey. A base plate and guide cannula are initially secured to the skull under general anaesthesia. A mechanical pump containing the drug solution and fitted with an injection needle is located on the base plate assembly. In the conscious animal the pump is triggered magnetically to deliver a predetermined volume into the target brain region. PMID- 6843170 TI - Significance of relative rib cage and abdomen motion in patients with chronic obstructive pulmonary disease. PMID- 6843171 TI - Isolated, perfused fetal rabbit lungs: preparation and flow relationships. PMID- 6843172 TI - Differential diagnosis of lymphedema after indirect lymphography with Iotasul. AB - Indirect lymphography with Iotasul (interdigital, intradermal infusion) was performed in 32 patients with lymphedema. No side effects were observed. Opacification of the peripheral lymph vessels reveals two distinct patterns: 1. No, few, or only very small-calibre lymph vessels ("hypoplasia"): 17 patients (primary lymphedema in 14 cases, secondary in 3). 2. Many large-calibre (dilated) lymph vessels ("hyperplasia"): 15 patients (primary lymphedema in 2 cases, secondary in 13). An occasional finding in "hypoplasia" is drainage of the contrast material in the region of the adventitia of vessels, and a network of extremely fine lymph vessels apparently corresponding to the dermal plexus is sometimes observed. Because it leads to the opacification of barely perceptible lymph vessels in the extreme periphery which were previously inaccessible to radiology, indirect lymphography offers a genuine gain in information and improves the differential diagnosis. When administered correctly, Iotasul invariably enhances the peripheral lymph vessels without making any great demands of the patient or investigator. PMID- 6843174 TI - Aplasia of superficial lymphatic capillaries in hereditary and connatal lymphedema (Milroy's disease). AB - Four patients with hereditary lymphedema present at birth (Milroy's disease) have been studied by fluorescence microlymphography (1, 7). The videomicroscopy technique failed to visualize any lymphatic capillary in the edematous part of their legs. In sporadic primary lymphedema with late manifestation, however, a well developed superficial capillary network is detected (1, 6). Three family members without lymphedema had normal microlymphatics. Milroy's disease, at least in the family presented, is characterized by aplasia or extreme hypoplasia of both lymphatic capillaries and collectors whereas in the usual sporadic form of primary lymphedema aplasia or hypoplasia is confined to the larger trunks. PMID- 6843173 TI - Lymphatic obstruction and lymph node changes--a study of the rabbit popliteal node. AB - Dense cortical lymph node fibrosis is associated with primary lymphedema and proximal obstructive hypoplasia. The fibrosis is not related to the duration of disease nor to episodes of clinical cellulitis. This suggests that the disease may start in the nodes but the effects of obstruction in the adjacent lymph vessel must be elucidated before the assumption is made. The popliteal nodes of 49 rabbits were studied following the ligation of either afferent or efferent lymphatics, and compared with nodes following a sham operation. The efficacy and late effects of ligation were assessed in half the rabbits by cinelymphangiography. In the rest Patent Blue Violet and not Lipoodol was used to minimize any spurious effect on node histology. The rabbits were sacrificed between 6-84 days. Node area was measured on serial x-rays and node volume after removal of the node. Afferent ligation resulted in a significant and permanent decrease in size (p less than 0.005) and lymphocytic congestion; efferent ligation resulted in an increase in size (p less than 0.02) and large lymph spaces. The dense node fibrosis of primary lymphedema was not seen. PMID- 6843175 TI - Pedal microlymphangiography in the experimental animal. PMID- 6843176 TI - Accidental visualization of mesenteric lymph nodes by bipedal lymphography. AB - A case is presented of mesenteric lymph nodes filling accidentally by bipedal lymphography. The radiographs were interpreted erroneously as pathologic; consequently the patient was treated with chemotherapy and radiotherapy. The correct diagnosis was made later by explorative laparotomy. PMID- 6843177 TI - Effects of bradykinin on renal lymph flow and composition. AB - It has been reported that bradykinin causes permeability changes with increased vascular leakage in many peripheral tissues, but not in the renal parenchyma. In the present experiments, the effects of bradykinin on renal hilar lymph flow and concentrations of protein and PAH were studied. The results of these experiments show that the protein permeability of the intrarenal vessels from which lymph is derived is not altered by bradykinin. The data presented does, however, suggest that renal lymph may contain tubular reabsorbate, a component from the glomerulus, or both. In addition, data is presented which suggests that a significant amount of lymph may be formed in the renal medulla during renal vasodilation. PMID- 6843178 TI - Persorption--the way of large sized corpuscle particles via the lymphatic system. PMID- 6843179 TI - A less stressful alternative. PMID- 6843180 TI - Early experience with a universal (DDD) pacing device. AB - To assess the advantages and complications of a new universal (DDD) pacemaker, we studied retrospectively the initial 38 patients who received such a pacing device. This group consisted of 27 men and 11 women whose ages ranged from 23 to 89 years. The pacemaker was the initial one for 32 patients and was the replacement unit for 6. Indications for dual-chamber pacing included a need to maintain atrioventricular synchrony, the previous occurrence of the pacemaker syndrome or the presence of intact ventriculoatrial conduction, and previous success with atrioventricular sequential pacing. Pacemaker-mediated tachycardia developed in six patients during the follow-up period. All six were successfully treated by a change in pacing mode. Eighteen pacemakers remained in the DDD mode, 17 were reprogrammed to the DVI mode, and 3 were reprogrammed to the VVI mode. Seven patients experienced difficulties with loss of capture or undersensing, the most common problem being failure of atrial sensing. This was corrected in four of five patients by noninvasive reprogramming. Pacemaker-mediated tachycardia is a frequent complication that can be avoided by assessing ventriculoatrial conduction before implantation of the pacemaker. Use of the DDD device should be considered in patients in whom atrioventricular synchrony must be maintained or who have previously had the pacemaker syndrome with VVI pacing. PMID- 6843181 TI - Noninvasive radioisotopic technique for detection of platelet deposition in mitral valve prostheses and quantitation of visceral microembolism in dogs. AB - A noninvasive technique has been developed in the dog model for imaging, with a gamma camera, the platelet deposition on Bjork-Shiley mitral valve prostheses early postoperatively. At 25 hours after implantation of the prosthesis and 24 hours after intravenous administration of 400 to 500 microCi of platelets labeled with indium-111, the platelet deposition in the sewing ring and perivalvular cardiac tissue can be clearly delineated in a scintiphotograph. An in vitro technique was also developed for quantitation of visceral microemboli in brain, lungs, kidneys, and other tissues. Biodistribution of the labeled platelets was quantitated, and the tissue/blood radioactivity ratio was determined in 22 dogs in four groups: unoperated normal dogs, sham-operated dogs, prosthesis-implanted dogs, and prosthesis-implanted dogs treated with dipyridamole before and aspirin and dipyridamole immediately after operation. Fifteen to 20% of total platelets were consumed as a consequence of the surgical procedure. On quantitation, we found that platelet deposition on the components of the prostheses was significantly reduced in prosthesis-implanted animals treated with dipyridamole and aspirin when compared with prosthesis-implanted, untreated dogs. All prosthesis-implanted animals considered together had a twofold to fourfold increase in tissue/blood radioactivity ratio in comparison with unoperated and sham-operated animals, an indication that the viscera work as filters and trap platelet microemboli that are presumably produced in the region of the mitral valve prostheses. In the dog model, indium-111-labeled platelets thus provide a sensitive marker for noninvasive imaging of platelet deposition on mechanical mitral valve prostheses, in vitro evaluation of platelet microembolism in viscera, in vitro quantitation of surgical consumption of platelets, and evaluation of platelet-inhibitor drugs. PMID- 6843182 TI - Pindolol--a new beta-adrenergic blocking agent with intrinsic sympathomimetic activity in the management of mild and moderate hypertension. AB - Pindolol, a well-tolerated noncardioselective beta-adrenergic blocking drug, effectively reduced blood pressure in patients with mild to moderate hypertension without causing orthostatic hypotension. In common with other beta-adrenergic blocking agents, pindolol blocked the normal increase in the standing pulse rate. The drug, however, did not decrease the supine pulse rate, a feature that can be interpreted as evidence of the postulated intrinsic sympathomimetic activity of pindolol. PMID- 6843183 TI - Biochemical genetics of catecholamines in humans. AB - Studies of the effects of inheritance on human catecholamine biosynthetic and metabolic enzymes are reviewed. Genetic polymorphisms have been shown to control the level of the biosynthetic enzyme dopamine beta-hydroxylase in serum and the level of the metabolic enzyme catechol-O-methyltransferase in a variety of tissues. Platelet monoamine oxidase, another catecholamine metabolic enzyme, is also under genetic control. These observations help to explain individual differences in response to treatment with catechol drugs and may explain some variations in the function of human catecholamine neurotransmitters. The biochemical genetic approach used to study the enzymes of catecholamine biosynthesis and metabolism could be used to investigate other aspects of adrenergic function and could serve as a model for studies of the effects of inheritance on other human neurotransmitter systems. PMID- 6843184 TI - Irritable bowel syndrome. Role of lactase deficiency. AB - In adults with the irritable bowel syndrome who had no history of milk intolerance, the prevalence of lactase deficiency and the value of lactose restriction were determined. Eighty subjects with the irritable bowel syndrome who were white, non-Jewish, and of northern-western European background were screened for lactase deficiency by means of the hydrogen breath test. Lactase deficiency was found in 5 of the 80 subjects with the irritable bowel syndrome and in 6 of the 100 subjects without intestinal symptoms who were of comparable ethnic background. After exclusion of milk from the diet, three of the five subjects with lactase deficiency and the irritable bowel syndrome had partial to complete relief of symptoms for 3 weeks, and two of these had sustained relief for 1 year (one with complete and one with 75% improvement). Lactase deficiency was found to be a relatively uncommon cause of irritable bowel symptoms among non Jewish whites who are of northern-western European background. PMID- 6843185 TI - The hospice: new wine in old bottles? PMID- 6843186 TI - Late recurrent squamous cell carcinoma of the cervix uteri or vagina after successful initial treatment. PMID- 6843187 TI - Rheumatoid arthritis X: total joint replacement at the hip and knee. PMID- 6843188 TI - The changing role of the health professional in community oncology programs. PMID- 6843189 TI - Colorectal carcinomas have a characteristic ganglioside pattern. AB - The gangliosides in six colorectal and two pancreatic carcinomas were examined. Their concentration in the primary tumour and the metastases was 5-10 fold higher than in normal colon mucosa. This increase involved the simple gangliosides, GM3 and GD3, as well as complex mono- and disialogangliosides. Some complex monosialogangliosides were detected in all the colorectal and pancreatic carcinomas but neither in normal colon mucosa and pancreas nor in kidney and lung carcinomas. PMID- 6843191 TI - Nerve growth-promoting activity in the chick embryo: quantitative aspects. AB - Nerve growth-promoting activity in organ extracts from the chick embryo was titrated using ganglia explanted to a collagen gel. Fibre outgrowth responses evoked in ciliary, sympathetic and spinal ganglia were well correlated. At embryonic day 8, 66% of the activity was localized in the yolk sac, 19% to the chorioallantois and the remaining 15% was widespread in the embryo. At day 18, total activity had increased 27-fold, the carcass now accounting for 90%. In parallel, the embryo extracts also promoted survival and neurite extension in dissociated ganglionic neurons seeded at low density in the gel. It is suggested that the observed effects are due to one active substance widely distributed in the embryo and increasing in amount during development. The substance has a molecular weight of over 10,000 and is distinct from nerve growth factor (NGF). A function of it may be to regulate axonal growth and survival of autonomic and sensory neurons. PMID- 6843190 TI - Tofizopam enhances the action of diazepam against tremor and convulsions. AB - Tofizopam, an anxiolytic 3,4-benzodiazepine, increases the affinity of benzodiazepine receptors for 1,4-benzodiazepines. In this study we investigated whether this increased affinity of the receptors alters the sensitivity of mice to tremor and to convulsions. Convulsions induced by harmane were not affected by tofizopam (50-300 mg/kg), but diazepam (15 mg/kg) increased the ED50 of harmane from 9.9 to 25.1 mg/kg. Tofizopam did not alter the threshold for electroshock induced convulsions, while a dose of 10 mg/kg diazepam protected mice from convulsions. Low doses of tofizopam (12.5-25 mg/kg) sensitized mice to the tremorogenic effect of harmaline. Diazepam inhibited tremor: the ED50 of harmaline increased by 153% after 50 mg/kg of diazepam. In contrast to 1,4 benzodiazepines, tofizopam has no anticonvulsive effect. It sensitises mice to the tremor induced by harmaline. In combination with diazepam, however, tofizopam enhanced the anticonvulsive and antitremorogenic actions of this 1,4 benzodiazepine by 12-65%. This effect probably results from a tofizopam-induced increase in the occupation of benzodiazepine receptors. PMID- 6843192 TI - Introducing a community health center at Mosgiel, New Zealand: effects on use of the hospital accident and emergency (A & E) department. AB - The effects of introducing a community health center on utilization of the accident and emergency (A & E) department of a New Zealand hospital are examined. Use by the recipient community during the 3 years before the health center existed was compared with use over the succeeding 3 years and with that by a nearby city served by traditional forms of primary care. Results from the study did not support the postulated reduction in overall use by the health center population, nor did they confirm a reduction in use during the hours that the health center was open or by those subgroups thought likely to find the new facility a preferred alternative. Furthermore, there appeared to be no change in the behavior of A & E staff toward using the health center as a potential alternative to follow-up care at the hospital. PMID- 6843193 TI - Acceptance of a volunteer first-responder system in rural communities: a field experiment. AB - This article describes a randomized control field experiment that was used to evaluate the impact of an organized volunteer-based emergency first-responder system in 36 rural, medically underserved communities in central Georgia. The system created an information network within communities, which allowed rapid contact with trained resident volunteers when emergencies occurred. The evaluation examined selected environmental variables related to creating an information network and their effect on the general public's willingness to use a first responder for medical emergencies. Measurements of community awareness and attitudes were made using a household telephone survey conducted immediately before project initiation, 3 months and 13 months after implementation. Willingness to use the system was greatest for individual respondents living in communities with less than 800 population and who were participants in the social network of the community. Implications for administrating this type of project through statewide EMS systems are discussed. PMID- 6843194 TI - Medical information management: improving the transfer of research results to presurgical evaluation. AB - We designed a medical information management (MIM) system to 1) identify high risk patients (with cardiopulmonary dysfunction or undergoing major surgery), and 2) augment traditional mechanisms for referring high-risk patients to respiratory specialists. We define MIM as the combination of techniques that solicit, record, transfer, analyze, and distribute patient data according to designated protocols. A randomized trial compared 247 control subjects with 272 surgical patients assisted by information management. Data analysis focused on patients with cardiopulmonary impairment. The results showed that the MIM assisted patients received (1) more preoperative respiratory assessments (83.2 per cent vs. 9.2 per cent) than controls, 2) more preoperative respiratory therapy (37.9 per cent vs. 8.0 per cent) and 3) fewer postoperative respiratory complications (8.4 per cent vs. 16.1 per cent) than controls. These findings suggest that a MIM system can be an effective auxiliary mechanism for improving presurgical care. PMID- 6843195 TI - Identification of low-risk monitor patients within a medical-surgical intensive care unit. AB - We studied the hospital course of 1148 consecutive intensive care unit (ICU) admissions to test the feasibility of identifying patients suitable for early transfer. Based on the type of treatment each admission received during the initial 16 hours in ICU, we divided the patients into active treatment or monitored categories. Which of the 513 monitored admissions received active treatment before discharge was analyzed with a multivariate logistic regression analysis, using variables such as age, sex, indication for admission, and a new severity-of-illness scale. The most important variable in identifying low-risk monitored patients was the severity of illness measure, which performed well in both estimation and validation data sets. Within the 513 monitored admissions, 154 had predicted risks of requiring active intensive therapy of less than 5 per cent. Only five persons actually received such treatment. This approach might assist in reducing the ever-increasing demand for intensive care. PMID- 6843196 TI - A comparison of pharmacists and physicians on the quality of prescribing for ambulatory hypertensive patients. AB - This article discusses a quasi-experimental study of the quality of pharmacists' and physicians' drug prescribing for ambulatory hypertensive patients in a health maintenance organization. The null hypothesis was that there is no difference between pharmacists and physicians as to the quality of drug prescribing for hypertensive patients. Analysis revealed no difference in prescribing between the physician group and the pharmacist group on the scoring for the presence of drug interactions, appropriateness of quantities, dose, and patient directions. The pharmacist prescriber group did significantly better than the physician group, however, on choosing the appropriate drug, prescribing for a "positive effect on the patient's health," and overall appropriateness from combining all the above scales (p less than 0.05). The diastolic pressures of the patients assigned to the pharmacists' group were not significantly different from the physicians' group on pretest, but on posttest the diastolic pressures were slightly lower in the pharmacists' group (p less than 0.10). PMID- 6843197 TI - A randomized trial comparing pharmacists and technicians as dispensers of prescriptions for ambulatory patients. AB - This article describes a study on the impact of utilizing technicians in the dispensing of prescriptions for ambulatory patients. The two hypotheses were 1) there is no difference in error rate for prescriptions dispensed by pharmacists versus technicians, and 2) there is no change in the amount of time pharmacists spend counseling patients after technicians begin dispensing prescriptions. Power analysis indicated that a sample size of 900 prescriptions would need to be randomized into each group to adequately compare error rates. Results showed that there was no significant difference in error rate between pharmacists (5.17 per cent) versus technicians (4.17 per cent), supporting the first null hypothesis. Pharmacists did spend significantly more time counseling patients (p less than 0.001), leading to a rejection of the second null hypothesis. Since the number of staff did not change during the study, it is calculated that, based on annual salary plus fringe benefits, +20,080 in additional pharmacists' time was freed up for patient counseling when technicians were dispensing the prescriptions. PMID- 6843198 TI - Assessing existing technologies: the Manitoba study of common surgical procedures. AB - An overview of the Manitoba study of common surgical procedures is presented. The research is oriented toward describing and explaining the outcomes of nine relatively common procedures, using longitudinal data from the Manitoba Health Services Commission's population registry, medical claims, and physician claims. The research approach recognizes differences among surgical procedures, tailoring the analyses to specific characteristics of a given procedure. At the same time, this article describes the efforts made to achieve economies of scale in organizing the data base and writing the computer programs. The strategy used for assessing surgical risks and benefits is described at some length. Health services utilization before and after surgery is compared across small areas with widely differing surgical rates. Comparisons between surgical and other groups are suggested. The wealth of data permits a number of different types of studies. One study deals with patterns of surgical practice, types of operations performed, and risk characteristics of patients brought to surgery in areas with differing surgical rates. High-risk patients residing in high-rate areas are more likely to be operated upon than their counterparts in low-rate areas. A second study found that hysterectomy is apparently being used in situations where women have high rates of contact with the health care system before surgery; their rates of contact after surgery are almost as high. Ongoing activities in the research project are outlined. PMID- 6843199 TI - Effect of a computerized ambulatory medical record system on the validity of claims data. AB - Relationships were compared between claims data and charts data in a medical practice when a paper chart and manually prepared claims forms were used and after implementation of a computerized medical record system (COSTAR) in which claims data were derived automatically from the medical database. Claims data and chart data resembled each other more closely when the computer system was used, suggesting that claims data derived in this manner may have particular value in health care planning and research. PMID- 6843200 TI - Evaluation of a focused dental utilization review system. AB - It has been suggested that the efficiency of claim-based utilization review systems could be improved by focusing on providers with very high utilization rates. This strategy assumes that 1) high utilizers are more likely to be overutilizers, 2) labeling claims (e.g., "high utilizer") do not bias the review, and 3) the claim review process is sufficiently reliable. These issues were studied in prospective dental utilization review system where dentists submit claims and radiographs to an insurance carrier so that they may obtain treatment authorization. A sample of dentists with very high and moderate utilization rates for amalgams, crowns, and bridges were identified and their pretreatment claims containing these services (N = 553) were collected. Half the services from high and moderate utilizer practices were labeled "high utilizer," and the other half were unlabeled. Seven dental consultants from two large insurance carriers independently assessed the appropriateness of the services (approve or deny) from radiographs. The results indicate that services submitted by dentists with high utilization rates were no more likely to be denied than those with moderate rates, labeling claims did not appear to bias the reviewers, and interconsultant agreement levels for denials seldom exceeded 50 per cent. The study suggests that further development of focused review systems requires a better understanding of the association between utilization rates and overutilization and new methods for improving the reliability of reviewers. PMID- 6843201 TI - Impact of a cost-containment educational program on housestaff ambulatory clinic charges. AB - A cost-containment project was established to determine if a broad educational program that coupled clinical logic with feedback of charges to internal medicine residents in an ambulatory clinic setting could alter behavior. The project was evaluated by comparing charge data from a preintervention comparison year with charge data from the intervention year. Decreases in charges for laboratory procedures occurred in six of the seven diagnostic categories during intervention and were significant (t-test) for four categories. Regression analysis evaluated the influence of the intervention and 12 other variables on charges and demonstrated that the intervention was associated with a mean reduction of lab charges of $ 6.30 (p less than 0.0001) and a mean reduction of total encounter charges of $ 10.36 (p less than 0.01). We conclude that our educational program resulted in a decrease in mean laboratory changes and total charges for ambulatory encounters. PMID- 6843203 TI - Cost control and physicians: an examination of attitudes and behavioral expectations. AB - In 1977, a Committee of the Maine Legislature considered a proposal to include physicians' offices in the Certificate of Need (CON) process. Ultimately, the Committee accepted the Maine Medical Association position and rejected the proposal. A survey was conducted of physicians of Cumberland County, Maine, to determine their attitudes toward the proposal. Questionnaires were sent out concurrently with the legislative debate; 163 were completed (55 per cent). Results indicated that there was not unanimous support of the Maine Medical Association position. Twenty-three per cent of the respondents favored the proposal. The older, more conservative physicians tended to be against the proposal. Behavioral expectations were measured by asking physicians what they would do if the CON proposal was implemented. Nine per cent of the physicians indicated that they would alter their practice in a manner that would have an adverse effect on the availability of care if the CON proposal was implemented. Cross-tabulations revealed that most of those who would alter their practices were close to retirement age. Thus, we can conclude that passage of the proposal would not have had an especially adverse effect upon the availability of care in Maine. PMID- 6843202 TI - The Seattle evaluation of computerized drug profiles: effect on provider activities. AB - We studied whether furnishing care providers with computer-generated summaries of patients' current and past medications would reduce the time they spent on various drug-related tasks during patient visits. An observer used time-sampling methods to measure the amount of provider time spent on each of 10 activities during 166 clinic visits, some with profiles and some without them. Additional data were taken from the medical record on factors that might affect the time spent on various tasks. The results suggest that record reading time was reduced for first encounters between patients and providers in the medical clinics, where prescribing volume was highest; in other situations, no effect of profiles on record reading time was evident. Providers continued to document drug data in their progress notes, whether or not a profile was available, saving no time. Prescription writing required about one third less time when a profile was used than when a traditional prescription blank was used. Both uses of profiles for prescribing and the time saved per prescription also increased sharply with the number of drugs prescribed per visit. PMID- 6843204 TI - Waiting to see the doctor. The impact of organizational structure on medical practice. AB - In this article it is assessed whether or not the scheduling and office visit queues a patient faces depend upon the organizational structure of the physician's practice (i.e., does the physician practice in the fee-for-service system or in a health maintenance organization [HMO], and if in an HMO, in what type of an HMO). Data pooled from two national studies (N = 2448) reveal two major findings. First, although scheduling queues may be predicted from the organizational structure of physicians' practices and other factors, office queues appear to be more of a random phenomenon. Second, a distinct pattern emerges among the effects of the organizational structure of physicians' practices on patient queues, including 1) physicians in solo practice offer their patients the shortest queues, 2) physicians in group model HMOs maximize scheduling queues but minimize waiting room queues, 3) patient queues for physicians practicing in IPAs are no different from those of their counterparts in group-practice fee-for-service settings, and 4) patient queues for salaried physicians practicing in a predominantly salaried environment are among the longest. The implications of these findings are discussed with special reference to extent and future studies of the effects of organizational structure on medical practice. PMID- 6843205 TI - Travel for ambulatory medical care. AB - This article describes travel patterns for ambulatory care based on the 1978 National Health Interview Survey. The county where a physician visit occurs has been compared with the county of patient's residence. Nearly 20 per cent of physician visits occur outside the county of residence, with substantial variation according to metropolitan status and proximity to an SMSA. Visits by nonmetropolitan residents are twice as likely to occur in another county as visits by metropolitan residents. The proportion of visits that occur outside the county of residence increases with decreasing population density, both among metropolitan and nonmetropolitan areas. Travel patterns for the usual source of care are similar to those for primary care physician visits. The results are used to estimate adjusted physician-population ratios by allocating physicians to each county type in proportion to their use by residents. These adjusted ratios exhibit substantially less variation than the unadjusted ratios. PMID- 6843207 TI - [RIA-myoglobin in acute myocardial infarct. Its relation to total CK]. PMID- 6843206 TI - [Viral infections of the central nervous system. Virological study of the cerebrospinal fluid. Etiological and epidemiological aspects]. PMID- 6843208 TI - [Zinc in dialysis patients]. PMID- 6843209 TI - [Comparison between the indices of left ventricular function in patients with ischemic cardiopathy]. PMID- 6843210 TI - [Rediscovery of infectious diseases]. PMID- 6843211 TI - [Myoglobin]. PMID- 6843212 TI - [Mixed cryoglobulinemia with significant central nervous system involvement]. PMID- 6843214 TI - [Kaposi's angiosarcoma associated with bronchopulmonary carcinoma]. PMID- 6843215 TI - [Pontine hemorrhage in a patient addicted to amphetamines]. PMID- 6843216 TI - [Morphea, aortic aneurysm and myxoid degeneration of the mitral and aortic valves]. PMID- 6843217 TI - [Thyroid actinomycosis]. PMID- 6843213 TI - [Treatment of ankylosing spondylarthritis. A new therapeutic alternative]. PMID- 6843218 TI - Symposium on respiratory failure. PMID- 6843220 TI - Respiratory failure, mechanisms of abnormal gas exchange, and oxygen delivery. AB - Patients with respiratory failure may have abnormal gas exchange based on a number of mechanisms. Each of these mechanisms may indicate a different underlying pathology and thus suggest different therapeutic interventions. In addition, the ability to monitor changes in physiologic function can be complicated but is achievable when proper protocols are followed. It should be clear that an adequate understanding of the underlying physiology is crucial to the successful management of these very difficult patients. PMID- 6843221 TI - High-frequency ventilation. PMID- 6843219 TI - Classification of acute respiratory failure. AB - Acute respiratory failure can result from a wide variety of etiologies. Hypoxemia is the hallmark of this condition and is responsible for the major clinical signs and symptoms. The use of arterial blood gas analysis is the cornerstone of diagnosis and is also critical in the subsequent evaluation of the effectiveness of therapy. Treatment must be individualized and coordinated in the setting of an intensive care unit. PMID- 6843222 TI - Acute respiratory failure in obstructive lung disease. PMID- 6843224 TI - [A new approach to eustachian tube function in middle ear disease]. PMID- 6843225 TI - [Hypertension in an suburban area]. PMID- 6843223 TI - Evaluation and management of acute asthma. AB - Successful management of asthma requires an expectant, aggressive approach to asthma attacks as well as a careful management program to maintain remissions. The patient must recognize when he or she needs help, and the physician must be able to assess the severity of deterioration and provide rapid aggressive care. Failures are usually due to patient or physician error, or both. These relate to failures both outside and inside the hospital. Once inside the hospital, failure is mainly the responsibility of the physician. It is clear that deaths in the hospital have been associated with inadequate patient observation and monitoring, and treatment that is less aggressive than required. With appropriate patient and physician education and aggressive management, deaths during acute asthma attacks should be rare. PMID- 6843226 TI - [The importance of evaluating risks of psychosocial maladjustment before implantation for the correction of erectile impotence]. PMID- 6843227 TI - [Changed population trends lead to a new direction of medical care]. PMID- 6843228 TI - [Role of nuclear magnetic resonance among the methods for studying xenobiotic metabolism]. PMID- 6843229 TI - [Chronic nontuberculous meningitis. A general review aprpos of 5 cases]. PMID- 6843230 TI - [Circulating lipids and arterial risk. Retrospective and prospective studies]. PMID- 6843231 TI - [Lipoproteins (generalities, structure, metabolism)]. PMID- 6843232 TI - [The otorhinolaryngologist and craniofacial pain]. PMID- 6843233 TI - [Acoustic inner ear trauma by impedance measurement. Acute acoustic trauma?]. AB - We report on two patients with sudden hearing loss occurring immediately after registration of an acoustically elicited acoustic reflex with pure tones of 500, 1000, 2000, and 4000 cps and 125 dB HL. Aetiology and patho-physiology of this form of acute acoustic trauma are discussed. An obvious destruction of middle ear structures or the membrane of the round and oval window can be excluded. Assuming pre-existing disposition, e.g. distortion of microcirculation in the cochlea, the acoustic stimulus is merely the trigger for the imminent sudden hearing loss. Therefore, we suggest to limit the stimulus power to 105 dB HL. In every case one should keep in mind the possible danger of this examination and perform a benefit risk calculation in every patient. PMID- 6843234 TI - [Rheologic problems of microcirculation and consequences of drug therapy for sudden deafness]. AB - Microcirculation depends on the undisturbed functioning of the vessel walls as well as of the blood cells and plasma. Flow troubles are always highly complex. Viscosity of blood and plasma is of particular clinical interest, and so are the flexibility of red blood cells including the haemoconcentration and the physiology of coagulation. The authors concentrated on the "local hyperviscosity syndrome", which is one of the primary problems in disturbances of microcirculation, as the basis for their treatment of sudden deafness by fibrinolysis with streptokinase. PMID- 6843235 TI - [Pathogenesis of laryngeal cancer in women. A clinical and follow-up study]. AB - Clinical findings and age distribution of 71 female patients with laryngeal cancer seen in the ENT department of the University of Munster between 1961 and 1981 are reported. Of these patients, 26 could be questioned with regard to their habit of smoking and relevant gynaecological biographical data. They were compared with an equal number of patients of the same age not suffering from hormone-dependent diseases. With regard to histology, localisation or TNM staging, no signs of laryngeal cancer in women could be found compared to male patients reported in the literature. From the data gathered by questioning, it is possible to conclude that certain trends are represented, suggesting two pathogenetic types of laryngeal cancer in women: 1. Cancer of a young, non smoking woman, showing signs of virilism. 2. Cancer of an older, smoking woman without signs of virilism. PMID- 6843236 TI - [Giant cell tumour of bone in the cavum tympani and petrous bone]. AB - In the great majority of cases, the giant-cell tumour of bone (synonymous with osteoclastoma of bone) is localised at the end of a long tubular bone. Most of the patients are between 20 and 40 years of age. A case of a grade II giant-cell tumour in a female patient of 32 years of age is reported, which was localised in the middle ear and petrous bone. PMID- 6843238 TI - [Follow-up examinations of patients with isolated fractures of the bony nasal pyramid]. AB - Follow-up examinations in 92 patients with fractures of the bony nasal pyramid showed that repositioning had led to a functionally and cosmetically satisfying result in 38% of all cases only. Groups of patients were identified in which an increased number of therapeutic failures occurred and who, therefore, require exceptionally careful treatment in future. Therefore, --more emphasis must be placed on correct repositioning of the fractured nasal septum, --general anaesthesia permits a more exact correction of the nasal bones, --the nasal skeleton should be stabilized with plaster of Paris in addition to a tamponade, - finally, X-ray pictures in two directions make it easier to recognize the fracture and to control the success of repositioning. PMID- 6843237 TI - [Obliteration of the mastoid cavity with porous tricalcium phosphate ceramic. Results 12 and 18 months after ceramic implantation in the hypotympanon of the pig]. AB - The paper reports on the obliteration of mastoid cavities with resorbable tricalcium phosphate ceramic. As a model, we chose the pneumatic air cell system of the pig's hypotympanon, which resembles the human mastoid. At the time of surgery, the specimens were 10-12 weeks old. In a first group the cells of the hypotympanon were totally removed and the operation cavity was obliterated with adjacent layers of porous tricalcium phosphate ceramic. In a second group of specimens the air cell system was partly removed, leaving the apical part of the hypotympanon intact; the operation cavity was obliterated again with porous tricalcium phosphate ceramic. After 12 and 18 months survival the hypotympanons were removed and prepared for histological investigations. Those ceramic plates, lying close to the bony shell were strongly resolved and replaced by new bone. Other ceramic plates, however, especially those in the center of the implant, showed few signs of resorption and bony remodelling. Inside the ceramic implant there was hardly connective tissue. The space between the still unsolved ceramic plates was filled up with new bony tissue. This bone was partly structured and adjoined directly to the ceramic. The ceramic was integrated into the new bony tissue without any sign of an inflammation. PMID- 6843239 TI - [Long-term results of rhinoplasty in nose injuries in childhood]. AB - In 83 children who were 3 to 15 years of age, long-term results after rhinoplasty are analysed. In 32 cases we observed recurrent septal deviations, 12 children (14.5%) showing signs of significant nasal obstruction. No inhibition of bone growth was seen in 22 cases in connection with additionally performed osteotomies. Both the errors in surgery and the disturbances due to unpredictable growth of septal cartilage are discussed. PMID- 6843241 TI - [Less risky endoscopy of the antrum using a newly developed trocar cartridge]. PMID- 6843240 TI - [Rhinosinusitis polyposa and intolerance to analgesics (aspirin intolerance)]. AB - Although the signs or symptoms of rhinitis, bronchial asthma, urticaria and hypersensitivity to non-steroidal antiphlogistics, antirheumatics and analgesics as well as to some foods, seem to point towards an anaphylactic reaction, this intolerance--known in the U.S.A. as "aspirin intolerance"--is of non-allergic aetiology. In most cases the disease begins in the upper airways. Hence, early diagnosis by the ENT specialist is essential. The medical examinations and case histories of 20 patients suffering from rhinosinusitis complicated by aspirin intolerance, are discussed. PMID- 6843242 TI - [Fluorescein angiography of the tympanic membrane--development of the method and normal findings]. AB - Fluorescence angiography is a new method in the ENT-field, used for determining the vascularization of the tympanic membrane. It enables us to study the kinetics of the blood stream. Our studies on normal drum heads using fluorescein dye, whether applied intravenously or intraarterially, let us assume the external manubrial artery to be the largest and most constant blood supply of the membrane. Shortly afterwards, a network of vessels can be registered, differing according to each quadrant, but showing characteristic patterns, documented in our series of photographs. This technique of fluorescence angiography, successfully used in the diagnosis of vascular disorders of the eye fundus can be applied for scientific and clinical research in the ENT field, as well. Some modifications in that technique were done, using different illuminations and optics. Thus it can be practically applied not only to the tympanic membrane, but also to other areas in the field of ENT which can be visualized using microscopes or endoscopes. PMID- 6843243 TI - [Tympanoplasty with tragus cartilage transplant: "cartilage cover plasty"]. AB - Transplants composed in three layers of tragus cartilage and perichondrium are ideally suited for eardrum transplants. They are easily prepared, well-nourished, stable and withstand retraction tendencies due to negative middle ear pressure. One overlapping perichondrium layer forms, so to speak, the live rail for the eardrum epithelium. To this perichondrium layer the cartilage disk is safely attached. The cartilage disk attached to its outer perichondrium layer--also covered by the perichondrium towards the middle ear--is thus fastened like a circular tape in the eardrum frame similar to the foot plate of the stapes. The eardrum seal is safe; in 87 operations we observed only one case of the edge coming away which was due to the transplant being too small. This type of transplant has proved its worth especially when reconstructing the ossicle chain with column protheses (TORP, PORP). The excellent hearing results may be explained by the optimum transformation of air pressure from the large cartilage via the medium-sized prosthesis screen, which is attached to the surface, to the small foot plate of the stapes. The "tragus" transplant can also be used in case of a Type III interposition of incus. PMID- 6843244 TI - Cuff induced tracheal injury in dogs following prolonged intubation. AB - As the newer high volume low pressure endotracheal tube cuffs have replaced the high pressure cuffs commonly used in the past, there has been a marked decline in the incidence of severe complication due to cuff injury. Studies have shown, however, that the respiratory epithelium of the trachea at the cuff site undergoes squamous metaplasia following prolonged intubation with low pressure cuffs. An experimental model utilizing the canine trachea has been developed to study cuff induced squamous metaplasia and the present study was undertaken to determine the effect of the induced squamous metaplasia on tracheal mucous velocity as well as to determine whether the induced epithelial changes are reversible following removal of the cuffed tube. PMID- 6843245 TI - Carcinoma of the pyriform sinus: analysis of 102 cases. AB - The treatment of 102 patients with squamous cell carcinoma of the pyriform sinus seen at the University of Virginia Medical Center from 1958 through 1977 is reviewed. Eight-seven cases form the basis for this report. Surgery alone, radiation alone and combination of the two were the treatment modalities utilized for the patients in this study. The overall 3 year, no evidence of disease determinate survival was (37%). Recent literature has suggested that preoperative radiation obscures tumor margins with a decrease in survivals as compared to postoperative irradiation. Though the number of patients in both the preoperative (27) and postoperative (7) groups are small, our data suggests similar survivals. In addition, when pathology was examined, no tumor margins were transected in the preoperative irradiation group and only 5/23 patients had margins classified as close. The incidence of postoperative complications was not significantly difference between the combination therapy and surgery only groups. It is concluded that preoperative irradiation does not compromise the resection of adequate tumor margins nor significantly increase postoperative complications. PMID- 6843246 TI - Acute mastoiditis in children: a review of 54 cases. AB - Fifty-four children with acute mastoiditis were managed at the Los Angeles County University of Southern California Medical Center from 1972 through 1982. Our criteria for the diagnosis of acute mastoiditis are acute or subacute otitis media, postauricular swelling and erythema, protrusion of the auricle, and clouding of mastoid air cells on radiographs. Thirty-one (57%) recovered with conservative therapy consisting of early myringotomy and intravenous antibiotic, usually ampicillin. Twenty-three patients were managed surgically. The indication for surgery in each case was the clinical diagnosis of subperiosteal abscess; mastoid radiographs played no part in the decision to operate. Two of the 23 patients managed surgically had only incision and drainage of abscess; simple mastoidectomy was performed on 20 and radical mastoidectomy on one. Etiologic bacteria were cultured in 21 instances, S. pyogenes was cultured in 9, S. pneumoniae was cultured in 6, H. influenzae in 1, enterococci in 1, anaerobes in 2, and M. tuberculosis in 2. PMID- 6843247 TI - Ciliary dyskinesis: the immotile cilia syndrome. AB - In the past 5 years much has been learned about the syndrome of ciliary dyskinesia, commonly referred to as immotile cilia syndrome. This syndrome appears to be a congenital defect in the ultrastructure of the cilia, which results in one of three basic defects; lack of dynein arms, absence of radial spokes, or transposition of microtubules. Three cases are presented with electron micrographs; they illustrate the diverse clinical presentations of this disease entity as well as some of the structural abnormalities. The normal and abnormal anatomy of the cilia is discussed and some explanation is offered as to why these structural abnormalities present with such a variety of clinical expressions. PMID- 6843248 TI - The fate of an ossicular allograft in tympanoplasty. AB - Correction of ossicular defects in tympanoplasty most commonly involves the use of commercially available prostheses or preserved allograft ossicles. Incus autografts and tragal cartilage autografts are also used by many surgeons. Presculptured preserved allograft ossicles have not been used widely, but are used almost exclusively by our clinic. The fate of ossicular grafts has been reported by a number of in investigators with evidence obtained at revision surgery. In this paper we will be able to trace the fate of a presculptured preserved autograft ossicle clinically and pathologically. The unique aspect of this study is the demonstration of the ossicular status in post mortem temporal bone dissection followed by histopathological serial section studies. PMID- 6843249 TI - Cochlear function in chronic otitis media. AB - Otologic symptoms, audiometric data, and operative findings were reviewed in 200 consecutive patients who had surgically treated unilateral chronic otitis media. Bone conduction thresholds were analyzed in relation to extent of perforation, frequency of otorrhea, duration of disease, and extent of pathologic change. Median bone conduction threshold differences between diseased and uninvolved ears were within 5 dB at all frequencies. The mean speech discrimination score between affected and unaffected ears was equal. Patients with prolonged disease and more extensive pathologic alterations were more likely to experience cochlear changes and hence sensorineural hearing loss, though not to the extent others have described. Our findings indicate that chronic otitis media has little effect on cochlear function in the majority of patients. PMID- 6843250 TI - High resolution CT scanning for detection of cholesteatoma and complications in the postoperative ear. AB - Otologists who prefer intact canal wall surgery for removal of cholesteatoma recognize a 12.25% return rate. Revisions often indicated to correct hearing loss are frequently negative for recurrent cholesteatoma. To determine the reliabiity of a noninvasive method of diagnosing recurrent disease and possible complications, 40 patients previously operated on for cholesteatoma using the intact canal wall technique were scanned with a General Electric 8800 scanner. Second procedures were performed on 24 patients and findings compared with preoperative film interpretations. Scans correctly predicted no significant masses in 6 patients and cholesteatoma recurrence in 11; the remaining 6 with diffuse soft tissue changes were incorrectly diagnosed. Focal areas of bone erosion were detectable in 3 cases, indicating active or potential complications. Scans were reliable in detecting cholesteatoma depending upon the pathology. PMID- 6843251 TI - Recurrent alternobaric facial paralysis resulting from scuba diving. AB - Only one detailed case of alternobaric (referring to alternating pressure changes) facial paralysis resulting from scuba diving has been reported in the world literature. This article describes the dive profile and clinical course of a commercial diver who developed facial paralysis after scuba diving on three different occasions. Probable pathophysiologies, identification of the diver at risk, treatment and prophylactic measures are reviewed. Additional cases from the literature due to scuba diving and flying are cited. PMID- 6843253 TI - A model for research on cochlear hypoxia. AB - The vessels emerging from one side of the basilar artery are supplied exclusively by the homolateral vertebral artery. Since blood flow is laminar through the vertebrobasilar system, mixing between two sides does not normally occur. Based on this fact, an experimental model for research on cochlear hypoxia is proposed and described. The animal's own blood flow in the vertebral artery is completely replaced by a stream of poorly oxygenated blood injected retrogradely through the ipsilateral axillary artery. In this way, the territory supplied by the vessels emerging from this side of the basilar artery, including the ear, is rendered hypoxic. The changes in the cochlear action potentials induced by the reduced oxygen supply are recorded by a chronically implanted electrode and analyzed. PMID- 6843252 TI - Serial section reconstruction of the neural poles of hair cells in the human organ of Corti. I. Inner hair cells. AB - Study of the anatomy of the cochlea, and in particular the morphology of synaptic relationships between hair cells and cochlear neurons, is essential for elucidation of the mechanisms of transduction of mechanical acoustic signals into electrical neural events. Because considerable gaps remain in our understanding of the microscopic anatomy of these synapses, particularly in the human, a reconstruction of neural pole of inner hair cells of the human organ of Corti was performed. The data are based on 526 serial sections from the basal turn (10 mm region) and 356 serial sections from the middle turn (26 mm region). This provided complete data on 3 and partial data on 5 inner hair cells. Afferent terminals on inner hair cells were variable in size, ranging 1 to 20 micrometers in diameter. Branching of large fibers to produce multiple terminals innervating from 1 to 3 inner hair cells was common. Each inner hair cell received approximately 6 to 8 different nerve terminals. In addition, each terminal possessed a variable number of synaptic contacts. Junctional membrane specialization consisted of synapses, desmosomes, coated vesicles and arrays of microtubules and membrane cisternae. Specialization at synapses consisted of asymmetrical membrane thickening. At inner hair cells the postsynaptic membrane was thicker than the presynaptic membrane. Eighty-three percent of synapses had presynaptic bodies. Vesiculated efferent terminals synapsed on afferent fibers at the base of inner hair cells, but never directly on the inner hair cell. These anatomical data demonstrate distinct differences between the human and animal inner ear, which are important in the interpretation of neurophysiological data in animals and the formulation of hypotheses that involve assumptions crossing species. PMID- 6843254 TI - Mucin impaction tumor of the paranasal sinuses: a new clinical entity? AB - A variety of uncommon benign lesions occur in the paranasal sinuses and have been reported to masquerade as carcinomas. Nearly all of such cases have been limited to the frontal, sphenoid, and ethmoid sinuses with an isolated report of maxillary sinus involvement. The classic roentgenologic picture is that of bony destruction. Heretofore described destructive lesions of the maxillary sinus include the mucocele, mucous retention cyst, pseudocyst, pyocele and cholesteatoma. This report deals with a previously undescribed entity, the mucin impaction tumor located in a septate maxillary sinus. This inflammatory, non neoplastic tumor-like condition, presents as chronic sinusitis with periorbital edema, malar swelling and tenderness. Radiologic examination reveals total destruction of the bony walls of the nose, of the orbital rim and floor and of the maxillary sinus. The importance of recognizing this lesion lies in its benign nature but destructive capabilities. The destruction may possibly be accounted for by its anatomical origin in the septate sinus. Repeated surgical intervention may also serve to predispose or potentiate development of these lesions. Its resolution after adequate surgical extirpation and its place in the differential diagnosis of antral lesions are worthy of emphasis. PMID- 6843255 TI - Tympanic membrane mobility on otoscopy as an indicator of eustachian function. AB - Three hundred and twelve ears in 156 subjects were assessed. All the subjects were recruit volunteers to the Submarine and Diving branches of the Royal Navy, who were unable to equilibrate their middle ear pressures when exposed to an environment of increased ambient pressure. All these subjects were found to have a deformity of the vomero-ethmoid suture and underwent submucous resection of the nasal septum to correct their Nose-Ear Distress syndrome. Six weeks after operation each recruit was re-assessed otologically; 29 subjects (18.6%) had bilaterally immobile tympanic membranes and 6 subjects (3.9%) had an unilaterally immobile tympanic membrane on performance of Valsalva and Toynbee maneuvers. Nevertheless, 26 subjects (74.3%) were able to equilibrate their middle ear pressures at a depth equivalent to 10 meters of water. Because of this finding it can be stated that immobility of the tympanic membrane on performance of the Valsalva and Toynbee maneuvers does not necessarily denote the presence of eustachian tube dysfunction. PMID- 6843256 TI - Calcifying epithelial odontogenic tumor (Pindborg tumor): an unusual case. AB - A case of the rare calcifying epithelial odontogenic tumor is reported. The tumor was situated high in the left maxillary antrum, bulging into the nasal cavity. The presenting signs were homolateral nasal stenosis and bulging of the lateral nasal wall. The clinical appearances and histological findings are submitted and compared with those in cases described previously. Treatment and prognosis are discussed. From the present case it is apparent that despite its odontogenic nature the tumor may occur so far from the teeth that clinically it may be mistaken for a tumor of the nasal cavity. PMID- 6843257 TI - A new distending laryngoscope for diagnosis and microsurgery of the larynx. AB - A new laryngoscope was developed in order to improve visualization of the larynx and to better adapt the instrument to individual clinical circumstances. As such, the Kleinsasser laryngoscope was divided into two parts, with the width between the two halves changed by adjustment of a screw. The lower part of the instrument can also be moved to provide more space near the larynx. Since the laryngoscope is open laterally, there is more space for the operator, and shorter instruments can be used for endolaryngeal manipulations. The endoscope can be used for intubation as well as for injection. With the new instrument the advantages of the Kleinsasser laryngoscope with the Killian suspension endoscope have been combined. PMID- 6843258 TI - Transient paralysis of the diaphragm following radical neck surgery. AB - We have observed transient diaphragmatic paralysis with high alveolar to arterial oxygen partial pressure difference following radical neck surgery. Patients required supplemental oxygen for maintenance of arterial oxygenation. Patients following radical and neck surgery should be followed with chest roentgenograph to exclude pneumothorax and diaphragmatic paralysis and arterial blood gases in the immediate postoperative period. PMID- 6843259 TI - Treatment of epidermoid and undifferentiated carcinomas from occult primaries presenting in cervical lymph nodes. AB - We treated 83 patients with epidermoid or undifferentiated carcinoma in cervical neck nodes without an obvious primary at our institution between 1964 and 1979. All patients received radiotherapy and 29 patients had radical neck dissection (RND) or total excisional biopsy (TEB) as well. Actuarial survival was 38% at 5 years for the entire group and 25% at 10 years. Fifty-four patients with neck control had significantly better survival (p = .0001) at 5 and 10 years than those whose neck was uncontrolled. Factors associated with improved neck control were initial size of the neck mass and the addition of surgery (RND or TEB). Analysis of failures showed that 50% of patients failed only in the primary or neck and 50% developed distant metastases. Tumor was the major cause of death. We recommend more aggressive treatment with both XRT and neck dissection in patients with large resectable neck masses to prevent regrowth of tumor in the neck. PMID- 6843261 TI - "How I do it"--head and neck and plastic surgery. A targeted problem and its solution. Primary rhytidectomy--complications of the procedure and anesthetic. PMID- 6843260 TI - Ototoxicity of oral neomycin and vancomycin. AB - In contrast to parenteral neomycin, which may result in severe and progressive ototoxicity, oral neomycin has been widely used for 25 years, and its index of safety has been regarded as high. Ototoxicity is viewed as an uncommon complication of oral neomycin most likely to occur in patients with renal failure or gastrointestinal inflammation. Two cases of ototoxicity resulting from oral neomycin are presented. Serial audiometric and neomycin blood level testing are suggested as a means of auditory monitoring in patients receiving the drug. A review of experience with oral vancomycin indicates that this drug has not been shown to cause ototoxicity. PMID- 6843262 TI - "How I do it"--head and neck and plastic surgery. A targeted problem and its solution. Flexible fiberoptics for laryngeal photography. PMID- 6843263 TI - "How I do it"--otology and neurotology. A specific issue and its solution. A new head set for eliciting auditory evoked potentials in the neonate. PMID- 6843264 TI - "How I do it"--otology and neurotology. A specific issue and its solution. Medical management of the chronic draining ear. PMID- 6843265 TI - Effects of laser guided by optic fiber into rat brain on conditioned avoidance response and brain chemistry. AB - Low power lasers were guided by optic fibers into the rat caudate nucleus or frontal cortex, during conditioned avoidance response (CAR) training. The changes in striatal monoamine and amino acid concentrations were subsequently determined. Of six training groups tested, only the experimental group with helium-neon laser radiation to the caudate nucleus exhibited the formation of CAR and an increase of unconditioned leg contractions. The striatal concentrations of dopamine (DA) and norepinephrine (NE) were increased simultaneously in the group. PMID- 6843266 TI - Effects of low-level energy lasers on the healing of full-thickness skin defects. AB - Effects of low-level helium-neon laser radiation were compared on (1) wounds that closed primarily by contraction and (2) the breaking strength of straight-line incisions. Circular full-thickness skin defects in rabbits received dosages of 1.1 J/cm2 during a 30-min exposure every third day, and 2.2 J/cm2 during a 3-min exposure twice daily until wound closure. No significant differences in healing were observed between laser-treated wounds and untreated control wounds. Conversely, rat skin incisions exposed to 2.2 J/cm2 for 3 min twice daily for 14 days demonstrated a 55% increase in breaking strength over control rats (p less than 0.01); 28 days postoperatively, this difference in breaking strength diminished to a nonsignificant 16% increase over the control rats. Increasing the dosage to 4.5 J/cm2 yielded a nonsignificant 17% increase over the control rats 14 days postoperatively. HeNe laser irradiation of wounds increases certain aspects of healing in the early stages, but not to such a degree as to be clinically applicable. More detailed research is indicated to obtain optimal exposure levels necessary to accelerate wound healing significantly. PMID- 6843268 TI - The outpatient-procedure effectiveness of laser treatments in oncology. AB - The outpatient procedure of CO2 laser surgery has been recently integrated into the routine activity of the National Cancer Institute, Milan. Specific operative protocols that are codified for laser outpatient selection after adequate staging by pathology are presented. Specific indications for gynecologic disease (preneoplastic disorders, CIN, VAIN, and VIN), and general-surgery neoplastic disorders (soft tissue sarcomas, lip and oral cavity lesions, breast lesions) are described. Details of the safety procedures, rules of application, laser instrumentation accessories and wattages, both with vaporization and excisional technique, are reported. An overall rate of 30% out of the 4,000 cases treated yearly are selected for laser treatment procedures on the basis of the evaluation of real advantages. The general advantages of laser surgical applications such as reduction of bleeding and postoperative pain, early and late complications; no touch method; and patient acceptability--have been emphasized in the routine outpatient procedures. Reduction of the total costs and of the waiting list for hospitalization by the new procedures are finally considered. PMID- 6843267 TI - Noninvasive assessment of microcirculation of living organs and tissues using laser. AB - For studying microcirculation of intact tissues or organs, a new noninvasive, heat-transient method using laser photoexcitation is described. As a heating source an argon ion laser or R6G dye laser was used via a quartz fiber optic guide. Infrared radiation from heated tissue was detected by a thermography apparatus. After switching the laser irradiation on and off, a thermal transient curve of a model tissue, the skin, was biphasic: a component with a fast time constant and the other with a slow time constant. The temperature increases of both phases following laser irradiation were linear to the applied power from the laser onto the tissue. The temperature rises as a function of the wavelength of irradiated light have shown that the absorption of the light by tissue hemoglobin is a main heat-generation source. Furthermore, the temperature rises as a function of tissue blood volume and flow have shown that the component with a slow time constant is more related to the tissue hemoglobin concentration and tissue blood flow and heat conductivity. Thus, the analysis of heat-transient curves following laser irradiation gives information as to regional tissue blood volume, blood flow, and tissue heat conductivity. PMID- 6843269 TI - [Effect of diet and stress on fat and carbohydrate metabolism after duodenopancreatectomy]. AB - In 6 male patients, who had duodenopancreatectomy, oral fat respectively carbohydrate tolerance tests were performed. Intake of at least 10 g pancreatine did reduce the ensuing steatorrhea. Increased oral intake of carbohydrates led to increased levels of glucose in blood and urine. In addition, the patients were subjected to excessive exercise tests; in the course of these tests hormones, substrates and metabolites of fat and carbohydrate metabolism were measured. The values were compared to corresponding values from 6 type I diabetes patients and 7 normal persons. In the operated group lactate and free glycerol increased because of reduced hepatic glucose neogenesis, catecholamines increased little, and HGH not at all. Capacity for work was reduced in the operated group. Malassimilation and diabetes may be compensated for by drug therapy after duodenopancreatectomy. However, endocrine as well as metabolic derangements do follow duodenopancreatectomy, and ought to be taken into account preoperatively, since they may reduce the benefit of surgery in patients with chronic pancreatitis. PMID- 6843270 TI - [Echinococcosis involvement of the heart]. AB - A case report is given of a 37-year-old patient who had echinococcus infestment the heart. Diagnosis was established after drainage of the pericardium, when cysts of a diameter between 0.5 and 3 cm were evacuated. During this procedure the pericardium and the left ventricle were searched and revised extensively and drug therapy with Mebendazole was instituted. In spite of that a new cyst developed in the pericardium and a big cyst in the abdomen, was found which had practically transformed the whole left lobe of the liver into a cyst. Both lesions were removed surgically. It must be emphasized 1) that a very careful search of all organs liable to harbour echinococcus should be performed in patients who have cardiac involvement of the disease, 2) that chemotherapy will not prevent with necessity the development of fertile elements which could not be removed during surgery and 3) that patients have to be followed through several years in order to evaluate the success of therapy. PMID- 6843271 TI - [Spontaneous bilio-digestive fistula after intraoperative choledochus ligation]. AB - Intraoperative lesions of the extrahepatic bile ducts during cholecystectomy do occur; the incidence is about 0.2 to 0.8%. Lesions of the hepatic duct and the choledochus duct followed by stenosis (usually of the cystic duct confluent) do occur most frequently. Intraoperative ligation of the hepatic duct or the choledochus duct are the most severe sequelae of biliary surgery; the leading symptom is progressive postoperative obstructive jaundice. A bilio-digestive fistula may be formed spontaneously and may masquerade this complication leading to relapsing cholangitis. Pathogenesis, clinical symptoms and therapy of bilio digestive fistula are discussed, after an own case report is given. PMID- 6843272 TI - [Bile peritonitis after inadvertent bladder puncture as a rare complication of percutaneous transhepatic cholangiography with the Chiba needle]. AB - A report is given about a rare complication after percutaneous transhepatic cholangiography: after inadvertent puncture of the gallbladder, bile peritonitis developed. Surgery was done immediately and the gallbladder, which was filled with stones, as well as stones from the choledochus were removed. The literature dealing with complications of percutaneous cholangiography is reviewed. PMID- 6843273 TI - Further results on dapsone-resistant leprosy in Bamako (Mali). PMID- 6843274 TI - Reproducibility of sensory testing and voluntary muscle testing in evaluating the treatment of acute neuritis in leprosy patients. PMID- 6843275 TI - Functional changes of the ulnar nerve in leprosy patients following neurolysis. PMID- 6843276 TI - The moulded double-rocker plaster shoe in the field treatment of plantar ulcer. PMID- 6843277 TI - Leprosy in Zimbabwe. PMID- 6843278 TI - Epidemiologic patterns of leprosy in Vallegrande, Bolivia. PMID- 6843279 TI - Leprosy in 18-month-old children, Bichena District, Gojjam Administration Region, Ethiopia. PMID- 6843280 TI - Domiciliary and field work. PMID- 6843281 TI - Phosphatidylinositol turnover and cellular function. PMID- 6843282 TI - Biochemical mechanisms in the phosphatidylinositol effect. AB - Stimulated labeling of phospholipids from 32Pi is a hallmark of activation of a variety of cell surface receptors. In the case of the central nervous system, the response can reflect muscarinic activation. Recent studies in nerve ending preparations indicate a postsynaptic site of action. Ca2+ is required for the expression of cholinergic stimulation of labeling in nerve ending preparations, but whether it plays a regulatory role is not yet known. While it is inferred that the receptor-ligand interaction leads to increased diacylglycerol availability, its source is not established. In experiments with muscarinic agents and ionophore added to nerve ending preparations, there is a potentiated loss of labeling from prelabeled polyphosphoinositides. It is suggested that phosphodiesteratic cleavage of polyphosphoinositides may be an early consequence of muscarinic receptor activation. PMID- 6843283 TI - Cholecystokinin produces conditioned place-aversions, not place-preferences, in food-deprived rats: evidence against involvement in satiety. AB - The net reinforcing/aversive properties of cholecystokinin (CCK) were measured using a conditioned place-preference paradigm. Both sated and food-deprived rats showed a dose dependent aversion to an environment previously paired with CCK that was correlated with the effects of CCK on feeding. In contrast, all rats showed a conditioned preference for an environment previously paired with food. These results demonstrate the aversive properties of CCK and suggest that the decrease in feeding that follows peripheral administration of CCK results from a CCK-induced malaise. PMID- 6843284 TI - Secretion kinetics of prolactin and growth hormone by mouse anterior pituitaries in long term organ cultures. AB - Long-term organ cultures of mouse anterior pituitaries provides a system for generating an enriched starting material for the purification of prolactin and growth hormone. Culturing 1 anterior pituitary per ml in serum-free medium for 12 days resulted in a total yield of 40.9 micrograms and 6.6 micrograms of prolactin and growth hormone, respectively. This yield represented a 1886% and 18% net increase over the control prolactin and growth hormone content in the unincubated pituitaries. Secondly, culturing of 1-5 anterior pituitaries per ml did not result in a negative feedback autoregulation in the culture system. PMID- 6843285 TI - Dopamine produces vasodilation in specific regions and layers of the rabbit gastrointestinal tract. AB - The effect of intravenous dopamine infusion (25 and 60 micrograms per kg and min consecutively) on blood flow distribution in the splanchnic region of anesthetized rabbits was studied applying the microsphere technique. During infusion of the low dose, blood flow increased most markedly in the stomach, less in the pancreas, jejunum and descending colon, and decreased in the spleen. In the stomach the increase was confined to the mucosa-submucosa. Raising the dose of dopamine resulted in a slight fall of arterial blood pressure, a further increase in blood flow through the mucosa-submucosa of the gastric fundus (+493 % as against control), but not through the other tissues studied. In another series, blood flow through the left gastric artery was measured with an electromagnetic flowmeter. The infusion of dopamine produced a dose-dependent increase in regional blood flow, which was inhibited by the dopamine antagonist bulbocapnine. Furthermore, the control blood flow was transiently decreased, and resistance to flow was increased by bulbocapnine. The results indicate that the dopamine-induced vasodilation in the gastrointestinal tract of the rabbit is largely restricted to the gastric circulation and suggest that specific receptors mediating this vasodilation are located in the mucosa-submucosa. It is hypothesized that endogenous dopamine functions as a vasodilatory tissue hormone in the gastric mucosa of the rabbit. PMID- 6843286 TI - Fatty acid utilization and purine nucleotide binding in brown adipose tissue of genetically obese (ob/ob) mice. AB - The activities of the main enzymes involved in fatty acid utilization i.e. palmitoyl CoA synthetase as well as peroxisomal and mitochondrial beta-oxidation were measured in brown adipose tissue homogenates of lean and ob/ob mice kept at 23 degrees C or acclimated at 4 degrees C. The proton conductance pathway, i.e. the number of purine nucleotide (GDP) binding sites and the percentage of 32,000 polypeptide in brown adipose tissue mitochondria were also measured. In the ob/ob mice at 23 degrees C, the specific activities of the palmitoyl CoA synthetase and of the beta-oxidation as well as the number of GDB binding sites were lower than in the lean mice by 26%, 43% and 37%, respectively. The percentage of 32,000 polypeptide, however, was the same in both groups. In the ob/ob mice at 23 degrees C, the lower homogenate beta-oxidation specific activity was due to the fact that the peroxisomal and mitochondrial specific activities were 44% and 37% lower, respectively. Cold acclimation at 4 degrees C was found to cause an increase of the palmitoyl CoA synthetase specific activity, of the palmitoyl CoA synthetase and peroxisomal beta-oxidation total activities and of the number of GDP binding sites, in both lean and ob/ob mice. Cold acclimation increased the percentage of 32,000 polypeptide in the ob/ob mice only. PMID- 6843288 TI - Naloxone hyperalgesia and stress-induced analgesia in rats. AB - Since past studies concerning the effects of naloxone on nociception have yielded inconclusive findings, the variables of pain test, baseline sensitivity, and stress condition were examined. Within a pure-bred strain of rats, consistent individual differences did not occur. All three measures of pain responsiveness demonstrated hyperalgesic effects of naloxone, but they differed in their capacity to reflect the effects of analgesia produced by continuous or intermittent electrical shock. By some measures, naloxone reversed the stress induced analgesia due to intermittent shock; it did not influence the analgesia produced by continuous stress. The data support a model of pain inhibition involving both opioid and non-opioid systems and suggest that the hyperalgesic effects of naloxone can sometimes give rise to erroneous conclusions concerning apparent naloxone-reversability of putative analgesic procedures. PMID- 6843289 TI - Fasting reduces the response of liver glycogen phosphorylase to physiological levels of epinephrine in rats. AB - The effect of 24 h fasting on the response of rat liver glycogen phosphorylase activity to an i.v. bolus of 2.75, 5.50 or 22.00 nmol kg-1 of epinephrine was studied. Even the lowest dose increased activity of the a form of the enzyme in the liver of anesthetized, fed rats to approximately 70 - 80% of total enzyme activity two minutes after administration. Further increased epinephrine doses failed to potentiate the enzyme response significantly, but shortened the time necessary for attaining the response, and delayed the return of enzyme activity to control values. No activation of phosphorylase was demonstrable after 2.75 nmol kg-1 of the hormone injected to fasted rats, but after increasing the hormone dose to 5.50 nmol kg-1 the enzyme response was the same as in the corresponding fed group at 2 min, and after administering the highest dose both at 1 and 2 min. According to these results, an increased threshold to epinephrine should be added to the already described effects of fasting, i.e. decreased phosphorylase a and total enzyme activity and shortened response to catecholamines. The efficacy of the i.v. bolus of 5.50 nmol kg-1 of epinephrine in increasing plasma epinephrine level to the theoretical value of 27.5 pmol ml-1 was proven by measuring plasma epinephrine which increased during the first minute after hormone administration to 24.5 + 5.9 pmol ml-1, to decrease during an additional minute with a half life of cca 22.2 seconds. PMID- 6843290 TI - Antagonistic effect of urea on oxygenation-linked binding of ATP in an elasmobranch hemoglobin. AB - The O2 affinity of "stripped" (cofactor-free) hemoglobin (Hb) of the elasmobranch, Squalus acanthias is decreased by ATP, the main erythrocytic phosphate cofactor but increased by urea at physiological concentration. When both compounds are present, as in life, urea decreases the ATP sensitivity, indicating that previous Hb oxygenation studies in the absence of urea overestimate the modulator role of phosphate cofactors in sharks. Whereas ATP decreases the O2 association equilibrium constant of the deoxygenated pigment, urea raises those of both the deoxy and the oxygenated states. Possible mechanisms for the urea-protein interactions i.e. binding at carboxy-termini or carbamylation of amino-termini of the protein chains, are discussed. PMID- 6843287 TI - Effect of cyclo(Leu-Gly) on the supersensitivity of dopamine receptors in spontaneously hypertensive rats. AB - Spontaneously hypertensive rats exhibited dopamine receptor supersensitivity as evidenced by a greater hypothermic response to apomorphine in comparison with normotensive Wistar-Kyoto rats. A single injection of cyclo(Leu-Gly) given prior to apomorphine administration did no alter apomorphine induced hypothermia in either the normotensive or the hypertensive rats. Chronic administration of cyclo(Leu-Gly) for 7 days did not affect apomorphine response in normotensive rats, but blocked the exaggerated response to apomorphine in the hypertensive rats. These studies suggest that cyclo(Leu-Gly) interacts with the dopamine receptors and that the central dopamine receptors may play a role in the pathophysiology of hypertension. PMID- 6843291 TI - Stereospecific binding of 3H-dopamine in neostriatal membrane preparations: inhibitory effects of sodium ascorbate. AB - It has been pointed out by several different groups of investigators in the past several years that ascorbic acid was a potent inhibitor of the binding of dopamine (DA) agonists including 3H-DA itself and 3H-ADTN, 3H-apomorphine and 3H norpropylapomorphine to neostriatal membrane preparations. However, the significance of this effect of ascorbic acid has been controversial. For example, it has recently been claimed that the stereospecific binding of DA agonists is facilitated by ascorbic acid and can be measured only in its presence. In the present study in neostriatal membrane preparations in the absence of ascorbic acid, the binding of 3H-DA was very potently inhibited by potent DA agonists (DA, ADTN, apomorphine). Considerably weaker effects were obtained with norepinephrine, isoproterenol, serotonin, catechol and pyrogallol. Stereospecific effects were clearly observed in that the binding of 3H-DA was inhibited to a much greater extent by several biologically active enantiomers than by their less active counterparts. For example, (-)-2-hydroxyapomorphine and (-) norpropylapomorphine were much more potent inhibitors than their corresponding (+) isomers. This binding of 3H-DA was also very strongly inhibited by sodium ascorbate and several other reducing agents. In control experiments in the neostriatal membrane preparation in the absence of ascorbic acid, there was no detectable decomposition of 3H-DA. The data suggest that 3H-DA can, in the absence of sodium ascorbate, bind stereospecifically to a site that has the properties of a DA receptor. Furthermore, sodium ascorbate is a potent inhibitor of this stereospecific binding. PMID- 6843292 TI - Latency to first naloxone-induced jump as a measure of precipitated abstinence intensity in morphine-dependent mice and the interaction of set on this test. AB - A method developed in this laboratory uses latency to time of first jump after injection of naloxone rather than the number of jumps in a specified period or the number of animals jumping as a measure of the degree of morphine physical dependence. For the test, mice are placed in a glass cylinder used as a test chamber, after being injected with the antagonist. During the development of this method it was observed that repeated exposures of dependent mice to both naloxone and the chamber yielded shorter latencies to first jump than did repeated exposures to naloxone alone in animals with the same degree of physical dependence. It appears that learning develops when naloxone injections are given repeatedly and followed by exposure to the test chamber and that this learned behavior is manifested by a reduced latency to first jump which may be confused with increased intensity of the opiate-withdrawal syndrome. PMID- 6843293 TI - Heritable determinants of left-right bias in the rat. AB - The offspring of matings of rats having opposite or same-sided turning biases were tested for turning biases as adults and the degree of similarity to the parents' biases assessed. There were significant and equivalent tendencies for the male offspring to have the same bias as the male parent and the opposite bias as the female parent. Although, overall, female offspring were distributed randomly with respect to the parents' biases, a significant tendency for female offspring to have biases opposite those of the female parent was apparent in litters having more males than females. Based on reports indicating a relationship between the sex ratio of a litter and levels of testosterone in female fetuses, it was suggested that in utero exposure to testosterone reverses the coding of a heritable female influence and induces a tendency for the offspring to have biases opposite those of the female parent. The origins of sidedness in the rat appear to involve a complex interaction between heredity and hormones. PMID- 6843294 TI - The effects of proglumide on cholecystokinin-, bombesin-, and glucagon-induced satiety in the rat. AB - Intraperitoneal (IP) administration of the glutaramic acid derivative proglumide inhibited satiety induced by all IP doses of cholecystokinin octapeptide (CCK-OP) in 3-hour food-deprived intact rats. Proglumide did not influence satiety when administered alone and did not inhibit satiety induced by IP glucagon. While proglumide did not inhibit satiety induced by low doses of IP bombesin, it partially and significantly inhibited the satiety effects produced by high doses of this peptide. Since bombesin is a known secretagogue for CCK in several species, these results indicate that while bombesin and CCK act independently to induce satiety, the effect induced by high doses of bombesin is mediated, in part, by the release of endogenous CCK or a structurally related peptide. Furthermore, these results illustrate that proglumide is a specific antagonist of CCK-induced satiety and is, therefore, a potentially useful tool for investigating the physiologic role of this peptide in the control of food intake. PMID- 6843295 TI - THIP analgesia: cross tolerance with morphine. AB - THIP (4,5,6,7-tetrahydroisoxazolo (5,4-c) pyridone-3-ol), a direct acting GABA receptor agonist, has been shown to have antinociceptive properties. To determine whether tolerance develops to the analgesic response, mice received multiple injections of THIP for up to 21 days after which analgesia was tested using both tail immersion and hot-plate methods. Both tests indicated a significant reduction in the antinociceptive response to THIP, as well as other GABA agonists, beginning between days 3 and 5 of chronic administration. Moreover, these animals demonstrated a decreased analgesic response to morphine, and morphine tolerant animals were also less responsive to THIP. These data indicate that opiates and GABA agonists induce analgesia by acting through separate but related pathways in the central nervous system. PMID- 6843296 TI - Respiratory depression produced by centrally administered taurine in the cat. AB - The effects of taurine (0.8-64.8 mumol) were studied on respiratory activity following intracisternal (cisterna magna) and intracerebroventricular (lateral ventricle) injections in cats anesthetized with alpha-chloralose. Respiratory activity was measured by using a Fleisch pneumotachograph and monitoring tracheal airflow. The flow signal was integrated to obtain tidal volume (VT) and respiratory rate (f) was obtained by counting the number of VT excursions over one minute. Inspiratory (TI), expiratory (TE) and total (TTOT) cycle durations were also determined during this time period. In addition, end-tidal CO2 was continuously monitored. Associated changes in arterial pressure (femoral artery cannula) and heart rate were also determined. After injections into the cisterna magna, taurine caused dose-related decreases in minute ventilation (VE). The maximal decrease in VE was from 495 +/- 59 to 64 +/- 14 ml/min (p less than 0.05), and was due to both decreases in VT (from 27 +/- 3 to 5 +/- 1 ml; p less than 0.05) and f (from 18 +/- 1 to 12 +/- 2 breaths/min; p less than 0.05). TE and TTOT were increased from 2.4 +/- 0.4 to 4.5 +/- 0.6 sec (p less than 0.05) and from 3.7 +/- 0.4 to 6.4 +/- 0.8 sec (p less than 0.05), respectively. Mean inspiratory flow (VT/TI), a measure of inspiratory drive, was decreased from 21 +/- 4 to 4 +/- 2 ml/sec (p less than 0.05). Apnea occurred in 5 of 6 animals after the 64.8 mumol dose. This respiratory depression occurred without any significant change in arterial pressure. After lateral ventricle injections, taurine also caused dose-related, but not as pronounced, decreases in respiratory activity. In addition, taurine caused significant decreases (p less than 0.05) in arterial pressure in doses that decreased VE. Taurine administered intravenously had no significant cardiorespiratory depressant effects. These data indicate that centrally administered taurine produces respiratory depression and, depending on the route of CNS administration, also produces hypotension. PMID- 6843297 TI - A subacute treatment of L-methionine induces an increase in the number of [3H]spiperone binding sites in the striatum of the rat. AB - A subacute treatment, 500 mg/kg I.P. twice daily during 5 days, by L-methionine provoked an increase in the Bmax of [3H]-spiperone binding in the striatum of the rat. This increase was associated to a decrease in membrane microviscosity. However in these conditions no changes were found in the [3H]-DHA, [3H]QNB bindings or in the brain dopamine sensitive adenylate cyclase activity. L methionine treatment reduced the accumulation of Dopa after NSD 1015 and antagonized the decrease in striatal acetylcholine provoked by haloperidol. Thus L-methionine might be a new potential drug for Parkinson's disease treatment. PMID- 6843298 TI - Serotonin mediation of the protective effect of clonidine against pentylenetetrazol-induced seizures in rats. AB - An intraperitoneal injection of 0.5 mg/kg clonidine significantly increased the latency to the first convulsion and reduced tonic seizures and mortality caused by pentylenetetrazol (PTZ), 90 mg/kg, administered subcutaneously to rats. 1 mg/kg clonidine produced similar effects except that tonic seizures were not significantly affected. No effect was observed with 0.01 or 0.1 mg/kg clonidine. Metergoline (1 mg/kg) and methysergide (10 mg/kg), administered intraperitoneally, completely prevented the effect of 0.5 mg/kg clonidine on PTZ induced seizures. An intraperitoneal injection of 5 mg/kg of d-fenfluramine, a releaser of 5HT from nerve terminals, significantly reduced tonic seizures and completely blocked mortality caused by PTZ but did not significantly modify the latency to the first convulsion. The results suggest that serotonin plays an important role in the protective effect of 0.5 mg/kg clonidine against PTZ induced seizures. Possible reasons for the different effects of clonidine on different experimental seizures are discussed. PMID- 6843299 TI - GABA evoked ACH release from isolated guinea pig ileum. AB - To identify the target cells of GABAergic neurons located in the myenteric plexus, the action of gamma-aminobutyric acid (GABA) on the release of acetylcholine (ACh) and on the contractions was studied using the isolated guinea pig ileum. GABA evoked a release of 3H-ACh from the contracting ileum, under conditions of loading with 3H-choline. As both the GABA-evoked release of 3H-ACh and the contractions were inhibited by bicuculline, tetrodotoxin and furosemide, but not by hexamethonium, this release seems to be evoked through GABA receptors which are bicuculline sensitive and associated with the Cl- ion channel. PMID- 6843300 TI - Phospholipid-sensitive calcium-dependent protein kinase and its endogenous substrate proteins in rat pancreatic acinar cells. AB - Phospholipid-sensitive Ca2+-dependent protein kinase and its endogenous substrate proteins were examined in acinar cells from rat pancreas. The enzyme was clearly demonstrable by DEAE-cellulose chromatography of acinar cell extract. At least four endogenous substrate proteins (Mr = 38K, 30K, 22K and 15K) for this Ca2+ activated kinase were found in the acinar cell extract. These substrate proteins were maximally phosphorylated in the combined presence of Ca2+ and phosphatidylserine. Calmodulin was partially effective as a cofactor for phosphorylation of the 38K substrate protein, but ineffective for the other three. A slight Ca2+/phospholipid-dependent phosphorylation of 38K and 30K proteins, but not of 22K and 15K proteins was seen in extract of isolated pancreatic islets. The Ka for Ca2+ for phosphorylation of the endogenous acinar cell proteins was decreased more than ten-fold in the combined presence of phosphatidylserine and unsaturated diacylglycerol. The presence of this Ca2+/phospholipid-dependent protein kinase/protein phosphorylation system provides a potential mechanism of action for Ca2+ as a regulator of exocrine pancreatic function. PMID- 6843302 TI - Metabolism of erucic acid in adipocytes isolated from rat epididymal fat. AB - The metabolism of [14-14C]erucic acid and [U-14C]palmitic acid has been investigated in adipocytes isolated from rat epididymal fat. The rate of acylation of [14C]erucic acid in cellular lipids and oxidation to CO2 and acid soluble activity was ca. 1/3 of the rate with [14C]palmitic acid as substrate. A maximal incorporation of fatty acids in triacylglycerol was found at a fatty acid concentration of 0.8 mM in the medium, both with [14C]erucic acid and [14C]palmitic acid as substrate. Glucose added to the medium increased the esterification and decreased the oxidation of both fatty acids. No significant chain-shortening of [14C]erucic acid to shorter monoenes was identified in the fat cells. Increasing concentrations of unlabeled palmitic acid in the incubation medium markedly inhibited the esterification of [14C]erucic acid, whereas unlabeled erucic acid had little effect on the rate of esterification of [14C]palmitic acid. PMID- 6843303 TI - Phospholipid composition of liver in rats fed high levels of 13-cis retinoic acid. AB - The composition of liver phospholipids was studied in rats fed for 4 weeks diets containing 0, 100 or 300 mg 13-cis retinoic acid per kg diet. There was a significant decrease in phosphatidylcholine content, whereas the levels of phosphatidylethanolamine were slightly increased in liver phospholipids of rats fed 13-cis retinoic acid. The fatty acid composition of total phospholipids, PC, PE, and P1 + PS fractions revealed a general increase in the levels of 18:2 and 20:3 omega 6, whereas the levels of 20:4 omega 6 and C22 fatty acids were reduced in most of the hepatic phospholipids isolated from rats fed 13-cis retinoic acid containing diets. A decrease in the double-bond index of fatty acids was also observed in phospholipids of rats fed 13-cis retinoic acid. The data suggest that high levels of 13-cis retinoic acid may possibly be influencing the activities of microsomal desaturating and chain-elongating enzymes in the liver. PMID- 6843304 TI - Effect of dietary vitamin E on sulfolipid synthesis in rat submandibular salivary gland. AB - The effect of feeding diets containing various levels of vitamin E for 6 months on the in vitro synthesis of sulfolipids in rat submandibular salivary glands (SMG) was elucidated. The incorporation of [35S]sulfate into sulfolipid of SMG from rats on deficient or "normal" vitamin E diets was quite similar, however, the uptake was significantly increased in glands from rats on diets high in vitamin E. Whereas, in many instances, antioxidants can mimic the effect of vitamin E, in the present study, the antioxidant N,N'-diphenyl-p-phenylene diamine (DPPD) was actually found significantly to depress sulfolipid-labeling below that noted in SMG from all other diets. The results suggest that in the synthesis of SMG sulfolipid the action of vitamin E may be more than that of a simple antioxidant. PMID- 6843305 TI - [Energy and weight characteristics of the thermoregulators in the apparatus for artificial circulation]. PMID- 6843301 TI - The influence of chenodeoxycholic acid on cholesterol and bile acid turnover in humans with cholelithiasis. AB - The in vivo dynamics of cholesterol were determined in 8 individuals who were part of a national double-blind study testing the efficacy of chenodeoxycholic acid ingestion on the dissolution of gallstones. Despite the ingestion of this bile acid in amounts in excess of its normal endogenous flux, the conversion of neutral sterol to chenodeoxycholic acid continued. The flux of neutral sterol to endogenous chenodeoxycholate was lower for the patients ingesting bile acid than for one of the patients on placebo, but was similar to that of the other control and similar to previously published chenodeoxycholate flux in patients with cholesterol cholelithiasis. The remaining flux was on the basis of the very efficiently absorbed dietary chenodeoxycholate. The total cholesterol fractional catabolic rate and flux were not appreciably diminished by the administration of either high or low dose chenodeoxycholate to these individuals with cholesterol cholelithiasis. PMID- 6843306 TI - [Precision method of determination of blood oxygen]. PMID- 6843308 TI - [Objectives of medical technology with regard to the technical equipment in Soviet public health]. PMID- 6843307 TI - [Study of the pneumotachograph with the Pito tube]. AB - The pneumotachograph with a velocity head flowmeter and a linearization system has been studied. Theoretical and experimental results have revealed a possibility to design a multilevel pneumotachograph with the Pito tube providing gas output measurements at a wide respiration range while the slight flow resistance and the small dead space being maintained. It also allows for undisturbed data recording. Characteristic properties of a piecewise-linear correction may be used to gain the required accuracy in the presence of a variability of the following parameters: ambient temperature, gas temperature, humidity and density, electromanometer's conversion ratio, baseline drift, spreads in dimensions of breathing tubes, etc. Delta-unit designed for in-line recording the pneumotachograph errors increases markedly an experimental capacity and may be used for calibration testing at plants. PMID- 6843309 TI - [Joint displays for medical and biological data processing on the basis of a microprocessor]. PMID- 6843310 TI - [Thyristor voltage regulator for the radiographic apparatus of the PYM-20 type]. PMID- 6843311 TI - [Study of the dynamics of liquid absorption in biological tissues]. PMID- 6843312 TI - [Dosing of aggressive fluids]. PMID- 6843313 TI - [Methods of color oxidizing of the handles of dental instruments made of aluminum alloy Dlt]. PMID- 6843314 TI - [Device for determination of intermicroelectrode distances]. PMID- 6843315 TI - [Vectorcardiograph with direct ink recording]. PMID- 6843316 TI - [Ultrasonic obstetrical diagnostic equipment LUK 260 and LUD 200]. PMID- 6843317 TI - [Main recommendations for improvement of endocardial electrodes for continuous electric stimulation]. PMID- 6843318 TI - Exercise, health, and aging: a need for more information. AB - Vigorous exercise is currently being encouraged for health maintenance. There is much evidence that a moderate amount of exercise is needed for the maintenance of functional integrity of the cardiovascular system, muscles, bones, and ligaments. There is also fragmentary evidence of a preliminary nature suggesting that regularly performed exercise may protect against and have beneficial effects on coronary artery disease, diabetes, and hypertension. However, the scientific evidence that strenuous exercise has long-term health benefits or slows aging is meager and unconvincing. Even in the case of coronary artery disease, diabetes, and hypertension, the majority of studies have provided either negative or inconclusive results or have resulted in only minor improvements. Taken together, available evidence is inadequate to serve as a basis for recommending regular participation in strenuous exercise for middle-aged and older individuals. This is particularly true because the theories that exercise may accelerate the aging process as a result of increases in metabolic rate and stress hormone production have never been disproved. Therefore, because of the major public health implications of exercise, large-scale, well-controlled studies of the effects of exercise on coronary artery disease, adult onset diabetes, hypertension, and various aspects of the aging process are urgently needed. Important barriers to progress in this area are the current dearth of exercise physiologists interested in research on health maintenance and well trained in human exercise physiology and the lack of an appropriate research funding mechanism for large-scale, interdisciplinary studies of the effects of exercise on chronic disease processes and aging. PMID- 6843319 TI - Delayed-onset muscular soreness and plasma CPK and LDH activities after downhill running. AB - We tested the hypothesis that running down an incline, during which muscles primarily perform eccentric contractions, causes greater delayed-onset muscle soreness and greater increases in plasma enzyme activities than does running on the level, during which muscles perform similar amounts of concentric and eccentric contractions. Subjective sensations of muscular soreness and plasma activities of CPK and LDH were assessed in seven subjects at 0, 24, 48, and 72 h after 45 min of running (one time on the level and a second time down a 10% incline). Following downhill running (57% of VO2max), significant delayed-onset soreness was experienced in gluteal, quadricep, anterior leg, and posterior leg muscles, and plasma CPK (but not LDH) activity was significantly increased (351% at 24 h). In contrast, following level running (78% of VO2max), no statistically significant soreness occurred in any muscle group, and plasma CPK and LDH activities were not elevated. Thus, our results generally support the hypothesis. Secondarily, we investigated whether delayed-onset soreness with downhill running is accompanied by increases in peripheral white blood cell counts suggestive of inflammation. No such association was observed. We suggest that both delayed onset muscular soreness and plasma enzyme activities are affected by structural changes in muscle tissue resulting from eccentric contractions. PMID- 6843320 TI - Effect of strength training upon motoneuron excitability in man. AB - Two healthy females and twelve healthy males, aged 19-24 yr, underwent strength training for periods of 9-21 wk. The muscles trained included extensor digitorum brevis (N = 3), soleus (N = 7), brachioradialis (N = 4), and the hypothenar muscles (N = 3). The effect of training on motoneuron excitability was measured as the degree to which two reflex responses (V1 and V2) were potentiated by voluntary effort. Strength training was found to increase V1 and V2 potentiation by 49.7 and 38.9%, respectively, (P less than 0.01) for pooled muscle comparisons with the exception of the soleus V2 wave, which was rarely seen and excluded from this analysis. There was a positive correlation (r = 0.83, P less than 0.01) between the change in the V1 and V2 potentiation. It was argued that strength training may cause an increased ability to raise motoneuron excitability during voluntary effort. PMID- 6843321 TI - Biomechanical and biochemical synthesis. PMID- 6843322 TI - Effects of lifting rate on elbow torques exerted during arm curl exercises. PMID- 6843323 TI - Heart rate indices of the anaerobic threshold. PMID- 6843324 TI - Heart rate and sweat rate responses associated with exercise-induced hypervolemia. AB - The purpose of this study was to determine the relationships between the plasma volume (PV) expansion accompanying exercise training and the associated changes in heart rate (HR) and sweat rate (SR) during sub-maximal and maximal exercise. Eight male subjects (21 +/- 1 yr) rode a cycle ergometer 2 h/d for 8 consecutive days at 65% maximal oxygen uptake (VO2max). Average HR and SR were measured each day during exercise, and PV (T-1824) was measured prior to, on day 4, and the day following exercise training. The VO2max and maximal HR (HRmax) were measured before and after the 8-d exercise period. Following exercise training, VO2max increased by 8.3% (P less than 0.05), HRmax decreased by 4.1% (P less than 0.05), and PV increased by 430 ml (+ 12.2%, P less than 0.05). During the 2-h ergometer exercise, mean SR increased from 0.83 1 . h-1 on day 1 to 0.97 1 . h-1 on day 8 (P less than 0.05) while mean HR decreased from 169 beats per min (bpm) on day 1 to 148 bpm on day 8 (P less than 0.05). The percent change (% delta) in PV was correlated with % delta SR (r = 0.93, P less than 0.05), % delta HR at 65% VO2max (r = -0.89, P less than 0.05), and % delta HRmax (r = -0.82, P less than 0.05). The data indicated that plasma volume expansion may be necessary for the cardiovascular and thermoregulatory adaptations accompanying chronic exercise. PMID- 6843325 TI - An evaluation of five indices of physical working capacity in children. AB - The purposes of this study were 1) to analyze race, sex, and body surface area (BSA) differences in the mean work to exhaustion index, maximal endurance index, rate-pressure product, maximum power, and physical working capacity index (PWC) of 383 healthy children, ages 5-16 yr, by using an alternative method of statistical analysis than has been used in previous studies of this type; and 2) to determine which index best measures relative physical working capacity in children. As a result of a three-way analysis of variance test, strong interaction effects were found among race, sex, and BSA on all but one of the indices. In general, the results indicated that the differences between males and females and between blacks and whites in physical working capacity were not consistent across all BSA groups. This suggests that normal values for these indices should be separated into race, sex, and BSA groupings. Based on correlation coefficients, it was also found that all the indices except PWC were biased by age and height differences. In addition, PWC was the only working capacity index to discriminate properly among underweight, normal, and overweight children. It was concluded that of the five indices tested, PWC was the best index of relative physical working capacity for use with children. PMID- 6843326 TI - [Dysplasias of the gastric mucosa]. PMID- 6843328 TI - [Comparison between sputum and brush cytology in non-neoplastic lung diseases]. PMID- 6843329 TI - [Current viewpoints on conservative ulcer therapy]. PMID- 6843327 TI - [Post-transfusion hepatitis. Results of a 10-year prospective study on hepatitis after heart operations]. PMID- 6843330 TI - [Progress in the treatment and prevention of urinary calculus disease]. PMID- 6843331 TI - [The value of computer tomography in urologic diagnosis]. PMID- 6843332 TI - [The value of urine cytology in the diagnosis of primary and recurrent urotheliomas]. PMID- 6843333 TI - [Information on the side effects of drug therapy]. PMID- 6843334 TI - [The patient's access to medical records]. PMID- 6843335 TI - [Methods and errors in the diabetic diet]. PMID- 6843336 TI - [Oral antidiabetics]. PMID- 6843337 TI - [Problems of home self care in diabetics]. PMID- 6843338 TI - [Emergency situations in diabetes mellitus]. PMID- 6843339 TI - [Diabetic microangiopathy]. PMID- 6843340 TI - [Macroangiopathy in diabetes mellitus]. PMID- 6843341 TI - [Adenomas and polyps of the large intestine mucosa]. PMID- 6843342 TI - [Cerebral aging and dementia]. PMID- 6843343 TI - [Rehabilitation after lung tumors]. PMID- 6843344 TI - [Migraine, a risk factor for ischemic cerebral stroke]. PMID- 6843345 TI - ["Healing water." Physiology and magic]. PMID- 6843346 TI - [Vasopressin and plasma osmolality determinations in blood donors for testing ADH regulation after blood loss]. PMID- 6843347 TI - [Adrenal cortex cancer in childhood with endocrine activity]. PMID- 6843348 TI - [Limits and possibilities of genetic counseling in general practice]. PMID- 6843349 TI - [Drugs and alcohol--a problem of our youth]. PMID- 6843350 TI - [Pancreatic cancer and pancreatic calcinosis]. PMID- 6843351 TI - [Metabolic and cardiocirculatory changes and driving ability during 90 minutes of simulated automobile driving]. PMID- 6843352 TI - [Behavior of muscle tissue oxygen pressure in patients with severe intermittent claudication after oral administration of benzarone]. PMID- 6843353 TI - [Hemodynamic and coronary effect of various calcium antagonists under rest conditions]. PMID- 6843354 TI - The cutaneous extravascular necrotizing granuloma (Churg-Strauss granuloma) and systemic disease: a review of 27 cases. PMID- 6843355 TI - The triad of gastric epithelioid leiomyosarcoma, pulmonary chondroma, and functioning extra-adrenal paraganglioma: a five-year review. AB - Among 24 patients, 6 had gastric epithelioid leiomyosarcoma, pulmonary chondroma, and functioning extra-adrenal paraganglioma, and the remaining 18 had two of the three tumors. This unusual triad of tumors almost certainly constitutes a specific entity because the coincidental occurrence of the three tumors is improbable, because the tumor multicentricity in the organs or system affected is unusual, because the tumors appeared at an age when neoplasms are uncommon, and because of the predilection of the association for young women. If two of the neoplasms are present, a presumptive diagnosis of the "triad" can be made, particularly if age and sex factors are supportive. Because two components of the "triad" are potentially lethal, it is important that patients less than 35 years of age who have any one of the three tumors be examined periodically in search of the others. PMID- 6843356 TI - Staphylococcus aureus endocarditis: clinical manifestations in addicts and nonaddicts. AB - Data collected from a prospective multicenter study of endocarditis caused by S. aureus were analyzed to contrast the clinical presentation of the disease between a group of 46 intravenous drug addicts and a group of 35 nonaddicts. Two-thirds of the patients in each group were men. The duration of illness before diagnosis was similar (mean, 9.3 days). Intravenous-drug addicts were younger and had less underlying disease (30% versus 80%) than the non-addicts. When first seen, the drug addicts had signs and symptoms of sepsis and pulmonary embolism, but only 40% had pathologic murmurs. Seventy-six percent had evidence of tricuspid valve infection only. Congestive heart failure and neurologic manifestations were uncommon in addicts. Nonaddicts had infection involving predominantly the left side of the heart (14 mitral valves, 8 aortic valves, 4 both aortic and mitral valves) and 80% had underlying medical diseases. Only half of these patients had pathologic murmurs when first examined, but another 30% developed them later. Congestive heart failure, involvement of the central nervous system, and peripheral embolic or septic complications each occurred in over half of the nonaddicts. Eighty percent of these patients had peripheral stigmas of endocarditis. One intravenous drug addict (2%) and seven nonaddicts (20%) died. Six patients required cardiac valve replacement either during or after a course of antibiotics. Outcome was not related to the titer of peak serum bactericidal tests. Endocarditis caused by S. aureus presents as two distinct clinical syndromes depending on the patient population (intravenous drug user or nonaddict) and the location of infection (right-sided or left-sided). The disease is distinguished from endocarditis due to other causes by its acute onset and its fulminant course manifested by a multitude of septic and embolic complications and its ability to cause heart failure. Medical management alone is often successful but in certain subsets of patients, notably those with infection of aortic or multiple valves, early operation may be necessary. PMID- 6843357 TI - Tuberculous spondylitis. A report of six cases and a review of the literature. AB - Tuberculous spondylitis in the United States is a disease of decreasing incidence and, when the incidence is compared to that of developing nations, affects an older population. The thoracic and lumbar spine is most frequently involved, and in advanced disease several vertebrae may be destroyed with resulting significant morbidity and mortality. The usual clinical presentation consists of fever, back pain, and nonspecific systemic symptoms of varying duration. More advanced disease presents with neurological deficits, kyphotic deformities of the spinal column, and paravertebral cold abscesses. Treatment has changed in the past 50 years not only because of the introduction of highly effective anti-tuberculous chemotherapeutic agents, but also because of the development of new surgical approaches. Controlled studies comparing various surgical and more conservative therapeutic regimens have been conducted within the past decade. Despite these new data, controversy remains regarding the indications for surgical treatment, since anti-tuberculous chemotherapy alone is successful in a large proportion of cases. However, in situations where rapid loss of neurologic function is evident or in which progressive deterioration in spinal cord function continues in the face of apparently adequate drug therapy, it appears that anterior surgical decompression of the spinal cord is indicated to prevent irreversible neurologic deficits. Needle biopsy of bone lesions under fluoroscopic or computed tomographic control is essential in the initial evaluation of patients in order to obtain cultural confirmation of tuberculosis. PMID- 6843359 TI - Arginine-induced glucagon secretion in the spontaneously diabetic BB Wistar rat. AB - The spontaneously diabetic BB Wistar rat shows many characteristics analogous to human insulin-dependent diabetes (IDDM). These include inappropriately normal immunoreactive glucagon in the presence of hyperglycemia, absolute hyperglucagonemia with severe ketosis, and hyperresponsiveness to exogenous arginine in vivo. We used an in situ pancreas preparation to further study portal vein glucagon responses to intravenous arginine. In normal rats, magnitude of response was correlated with prestimulation levels. Basal levels were significantly increased in hyperglycemic diabetics compared to controls, but responses to arginine were attenuated in both absolute and relative terms. Comparisons of responses with poor and good prior diabetes control showed no significant differences. Thus, a further anomaly of glucagon secretion has been identified in these rats. PMID- 6843358 TI - Fetal fuels VI. Metabolism of alpha-ketoisocaproic acid in fetal rat brain. AB - The metabolic regulation of alpha-ketoisocaproic acid was studied in fetal brain from rats. Starvation of the mother for days 18-20 did not alter CO2 evolution from alpha-ketoisocaproic acid in fetal brain slices but significantly diminished the incorporation of the branched-chain keto acids into leucine. When fetal brain slices from starved mothers were exposed to graded concentrations of labeled alpha-ketoisocaproic acid (0.05-2.5 mM), over 70% of the labeled products were consistently represented by leucine and less than 30% by CO2. Both beta hydroxybutyrate and pyruvate, alone and in combination, diminished the amount of 14CO2 that evolved from alpha-ketoisocaproic acid-1-14C, but had no effect on the conversion of the keto acid to labeled leucine. It is concluded that exogenous alpha-ketoisocaproic acid is preferentially converted to leucine by fetal brain slices independent of the nutritional state of the mother. During maternal starvation, beta-hydroxybutyrate, by restraining irreversible decarboxylation of alpha-ketoisocaproic acid, could act to salvage the keto acid for conversion to leucine. Thus alpha-ketoisocaproic acid metabolism in the fetal brain may be regulated in part by altered metabolic functions in this structure and in part by changing components in circulating fuel mixtures reaching the fetus from the starved mother. PMID- 6843360 TI - Lipoprotein levels in morbidly obese patients with massive, surgically-induced weight loss. AB - Abnormalities in lipoprotein metabolism are among the risk factors for atherosclerotic cardiovascular disease frequently present in patients with morbid obesity. We have examined the effects of dietary restriction induced by gastric bypass surgery on plasma lipoprotein levels in 22 morbidity obese patients. Operation induced weight loss in all patients. Postoperatively (12 +/- 7 mo), triglycerides decreased from 146.4 +/- 67 (mean +/- S.D. before operation) to 104 +/- 44 mg/dl (p less than 0.01), total cholesterol decreased from 187 +/- 52 to 166 +/- 39 mg/dl (p less than 0.025), LDL cholesterol levels decreased from 119 +/- 42 to 104 +/- 36 mg/dl (p less than 0.038), and HDL cholesterol levels increased from 40.1 +/- 10.1 to 45.2 +/- 9.5 mg/dl (p less than 0.012). HDL cholesterol to LDL cholesterol ratio increased from 0.37 +/- 0.13 to 0.48 +/- 0.21 (p less than 0.01). The results of apo A-1, A-2 and B determinations (n = 12) paralleled the changes in lipoprotein levels. Apo A1/Apo A2 ratio increased suggesting an increase in the concentration of HDL2. We conclude that weight loss following gastric bypass surgery is associated with favorable changes in lipoprotein metabolism which may help prevent or delay the development of atherosclerotic cardiovascular disease. The mechanism responsible for the lipoprotein changes remains to be determined. PMID- 6843361 TI - The effect of training and diet on lipoprotein cholesterol, tissue lipoprotein lipase and hepatic triglyceride lipase in rats. AB - Treadmill training for 1 hr/day for 10 wk did not significantly affect chylomicron, very low density, low density, or high density lipoprotein cholesterol in rats fed either a high carbohydrate (glucose) or high fat (coconut oil) diet. Lipoprotein lipase activity of heart, adipose tissue, and skeletal muscle fibers was also unaffected by training. Carbohydrate feeding, however, when compared to fat feeding significantly lowered all lipoprotein cholesterol values as well as heart and fast-oxidative-glycolytic muscle fiber lipase activity and, conversely, significantly elevated hepatic triglyceride lipase activity. Thus, in the rat, an alteration in the serum lipid profile did not occur as a result of training, but dietary differences did independently influence serum lipid levels and tissue enzyme activity. It is suggested that human studies need to control for the possible independent influence of dietary differences when investigating the effects of training on lipoprotein metabolism. PMID- 6843362 TI - Disparate effects of prazosin and propranolol on lipid metabolism in a rat model. AB - The effects of 14 days of daily intraperitoneal injections of prazosin hydrochloride (3.0 or 0.3 mg/kg) or propranolol (5 mg/kg) on various aspects of the lipid metabolism of normal rats was studied. The results indicate that plasma triglyceride and cholesterol concentrations were lower and the ratio of plasma HDL-cholesterol to total cholesterol concentration higher in prazosin-treated rats compared with propranolol-treated rats. The decline in plasma triglyceride levels in prazosin-treated rats was associated with a commensurate reduction in triglyceride secretion rates. Plasma free fatty acid levels were also lower in prazosin-treated rats, and this change may have contributed to the fall in triglyceride secretion rates. These data demonstrate that the disparate effects of alpha and beta receptor antagonists, previously shown to occur in hypertensive humans, can be duplicated in normal rats. PMID- 6843363 TI - Comparison in man of total body electrical conductivity and lean body mass derived from body density: validation of a new body composition method. AB - This article reports a study in which total body electrical conductivity (TOBEC) measurements and lean body mass (LBM) estimated from hydrostatic weighing in human subjects were compared. The TOBEC method provides a new approach to assessment of human body composition that is based on the principle that the electrical conductivity of lean tissue is far greater than that of fat. In a sample of 32 men and women varying widely in age (20 to 53 years), body weight (45 to 155 kg), and adiposity (9.5 to 53.0% body fat), the TOBEC measurement was found to be extremely reliable (r = 0.999) and to correlate highly with hydrostatically estimated LBM (r = 0.903, P less than 0.0001). When the TOBEC scores were transformed to provide a single variable; namely, the subject's height times the square root of the TOBEC score, a higher correlation with LBM was obtained (r = 0.943). Taking gender into account further enhanced the prediction of LBM from TOBEC (r = 0.951). These observations strongly reinforce the results of a previous investigation in which high correlations were found between TOBEC and both total body potassium and total body water. Accordingly, this new method promises to provide a useful technique for the evaluation of body composition that is at once simple, rapid, objective, and noninvasive. PMID- 6843364 TI - Thermic effects of food and exercise in lean and obese women. AB - The thermogenic responses of ten lean and ten moderately obese women to food, exercise, and food plus exercise were measured using open circuit respirometry for five minutes every half hour for four hours under six conditions: during five minutes of bicycle exercise at a workload of 300 kpm/min with and without eating a 910 kcal mixed meal; cycling at a workload just below the anaerobic threshold with and without food; and at rest with and without food. Over the four-hour period, the thermic effect of food at rest was similar for the lean and obese groups: 50 kcal and 47 kcal, respectively. Eating before exercise increased the exercise metabolic rate by 11% for the lean women and by 4% for the obese women (P less than 0.005). Exercise potentiated the thermic effect of food for the lean women but nor for the obese women: the thermic effect of food was 2.54 times greater during exercise than at rest for the lean group, but only 1.01 times greater for the obese women (P less than 0.005). This reduced response to the combined stimulus of food plus exercise may constitute a subtle metabolic factor associated with obesity. PMID- 6843365 TI - The influence of the thyroid state on energy turnover during tetanic stimulation in the fast-twitch (mixed type) muscle of rats. AB - The effects of thyroid hormones on energy metabolism and force development during tetanic stimulation of fast-twitch skeletal muscle (mixed type) were studied. Hypothyroid, euthyroid, and hyperthyroid (ten days of daily administration of 15 micrograms T3/100 gm body weight) rats showed the same tension-time integral (force x time) under tetanic stimulation. The ATP turnover rate was significantly lower in the hypothyroid group than in the euthyroid and hyperthyroid animals. The ratio difference in the energy/force ratio in the Tx group cannot be ascribed to differences in internal work. Lactate production was diminished in the hypothyroid group; this was probably not the result of a block in glycogenolysis but rather was a reflection of more economic energy expenditure during contraction. After tetanic stimulation, the phosphorylation potential ([ATP]/[ADP]f[Pi]) was decreased most strongly in the hyperthyroid group, mainly because of the higher accumulation of Pi compared with the other groups, which suggests that during the recovery phase the stimulation of oxidative phosphorylation is greater in this group. PMID- 6843366 TI - Severe empyemae caused by yellow motile group E coryneform bacteria. PMID- 6843367 TI - Adherence of Streptococcus mutans to smooth surfaces in the presence of artificial sweeteners. AB - The adherence of Streptococcus mutans to smooth glass surfaces was studied in the presence of the artificial sweeteners, saccharin, acesulfame K and aspartame. The cells were grown aerobically in 2% yeast extract, 1% sucrose medium with artificial sweetener added in concentrations from 0.02 to 20.00 mg/ml. The artificial sweeteners tested reduced overall growth (adherent plus suspended cells), but observed growth was in favour of the adherent cells. As compared to the control optimum adherence was obtained using 2 mg/ml sodium saccharin, 2 to 20 mg/ml acesulfame K and 4 mg/ml aspartame. PMID- 6843368 TI - Pseudo-on-line fast response microvessel dimensions video graphic recorder with electrical signal output. AB - The present article describes a new method of microvessel dimensions measurement in which a writing oscilloscope is used to continuously and graphically record the microvessel video signal from television microscopy at a fast rate of 50 records per second. Dimensions of interest, such as the microvessel red blood cell flux diameter, are then easily marked out manually from the graphic records and a dynamic electrical signal proportional to the dimensions is generated. The signal is then recorded on one channel of a multichannel voltage recorder and is synchronised with other experimental signals which have previously been recorded on-line during the experiment. The result is that the dimension signal appears to have been recorded on-line during the experiment as well. This is desirable for electronic signal correlation and processing. This method is useful when poor experimental conditions, commonly encountered, make automatic recording of microvessel dimension unsatisfactory and manual inspection and processing become necessary. PMID- 6843369 TI - Capillary pressure gradients in cremaster muscle of normotensive and spontaneously hypertensive rats. AB - The purpose of this investigation is to test the hypothesis that capillary pressure gradients are elevated in spontaneously hypertensive rats (SHR) and to determine the mechanism for the elevation. The cremaster muscle was prepared for microscopic examination under chloralose-urethane anesthesia in seven SHR and eight Wistar-Kyoto (WKY) rats 4-6 weeks of age. Capillary hematocrit, diameter, and red cell velocity were measured. Capillary flow induced by a time-varying pressure gradient was treated mathematically. A finite Hankel transformation was applied to the Navier-Stokes equation for capillary vessels. The solution was expressed as a Fourier-Bessel series, and the fluctuation of capillary flow induced by a time-varying pressure gradient was studied. It was shown that if the velocity fluctuation depended only on the pressure gradient, then the velocity fluctuation would be diminished almost instantly after the capillary started to flow. Capillary pressure gradient and shear stress were evaluated according to two different flow models, Newtonian and Casson. The capillary viscosity was obtained from the capillary hematocrit based on the empirical correlation of viscosity vs hematocrit. Calculations based on both flow models indicate that the capillary pressure gradient and shear stress of SHR is higher than in WKY, especially in vessels near 6 microns in diameter. The elevated pressure gradient is due to a combination of reduced capillary density, causing a higher red cell velocity and a tendency toward smaller capillary diameters in the SHR. Capillary hematocrit and viscosity were not elevated in the SHR. PMID- 6843370 TI - Analysis of transcapillary exchange and intraluminal transport in the microocclusion of single capillaries. AB - A theoretical model, appropriate for data interpretation, is presented for the transcapillary fluid exchange and associated intraluminal hydrodynamic and solute transport occurring in the microocclusion of single capillaries. This analysis describes the spatial and temporal behavior of the intraluminal flow. A comparison of the theory with in vivo data suggests good qualitative agreement with that data and, further, the specification of filtration parameters in the model leads to good quantitative agreement regarding the displacement histories of erythrocytes. The model includes both natural and tagged colloidal osmotic influences and can, therefore, be used to represent experiments wherein the concentration of a dyed colloid is measured and related to fluid filtration. The relative merits of measuring colloidal concentration or erythrocyte displacement are discussed within the context of the model. PMID- 6843371 TI - Age-related changes in the gastric submucosal arterioles and gastric acid secretion. AB - The purpose of this study was to determine whether alterations in the reactivity of gastric submucosal arterioles to norepinephrine and changes in acid secretion occur in the same time period in the rat. Experiments were performed on animals 6 weeks and 10, 18, and 25 months of age. Arteriolar diameter was measured by an image splitting in vivo microscopy technique before and after superfusion of the gastric submucosa with graded doses of norepinephrine. Acid secretion was measured in the pylorus-ligated rat. The percentage of arteriolar media stained with periodic acid-Schiff reagent (an age-related change) was determined for each age group. A dose-dependent response to norepinephrine was observed in 6-week and 10-, 18-, and 25-month age groups. Only in the 25-month-old rats were arterioles significantly more responsive to norepinephrine. Acid secretion at 10, 18, and 25 months was significantly less (about one-quarter) than that observed in the 6 week-old animals. Periodic acid-Schiff positive material deposited in the arteriolar media was significantly greater in the 18- and 25-month-old rats than in younger animals. We conclude that by 10 months of age in the rat, acid secretion is markedly reduced. The reactivity of the gastric submucosal arterioles is significantly increased at 25 months, but in the 18-month-old animal, when increased periodic acid-Schiff deposits are clearly evident, the reactivity to norepinephrine is not different from the 6-week-old rat. PMID- 6843372 TI - In vitro and in vivo measurement of red cell velocity with epi- and transillumination. AB - Measurement of red cell velocity with the dual-slit cross-correlation method in glass capillary tubes during transillumination indicates that the measured velocity must be divided by a correction factor of approximately 1.6 to equal the average velocity calculated from a known flow and inner diameter. Whether the same correction factor exists when red cell velocity is measured during epiillumination is questionable. Red cell velocity was measured with the dual slit correlation method nearly simultaneously using epi- (EL) and transillumination (TL) while glass tubes (40-100 microns, i.d.) were pump perfused with whole human blood (hematocrit 39-42%). With TL, the measured velocity is 1.58 +/- 0.07 (SEM) times the calculated average velocity, whereas a factor of 2.04 +/- 0.04 (SEM) was obtained with epiillumination. When intestinal arterioles with approximately the same inner diameters and flow velocities as the glass tubes were used, the ratio of velocities measured with TL to EL was 1.21 +/ 0.02 (SEM) as compared to 1.31 +/- 0.09 (SEM) for glass tubes using TL and EL of the tube at the same pump flow. This similarity of TL to EL velocity ratios for glass tubes and microvessels may be fortuitous or indicate that comparable flow properties and measurement conditions exist for in vitro and in vivo situations. The major finding of the study is, however, that different velocity correction factors exist for EL and TL measurements when the dual-slit correlation method is used to estimate red cell velocities in tubes of an internal diameter of 40-100 microns at normal hematocrits. PMID- 6843373 TI - The effects of cationised ferritin and native ferritin upon the filtration coefficient of single frog capillaries. Evidence that proteins in the endothelial cell coat influence permeability. AB - To investigate whether certain macromolecules reduce capillary permeability by binding to the surface coat of endothelial cells, the effects of cationised ferritin (CF) upon the filtration coefficient (Lp) of individually perfused frog mesenteric capillaries were compared with those of native ferritin (NF). With perfusate CF concentrations between 0.1 g 100 ml-1 and 2.5 g 100 ml-1, Lp was reduced to approximately 30% of its value for the same vessel perfused with protein-free Ringer solution. Electron micrographs of the perfused capillaries revealed that over this range of perfusate concentrations. CF was concentrated uniformly in the endothelial cell coat, occupying 8.5% of its volume. Neither the effect of cationised ferritin upon Lp nor its concentration in the cell coat varied significantly over this range of perfusate concentrations. When perfusate concentration of CF was reduced to 0.01 g 100 ml-1, CF no longer reduced Lp and its concentration in the cell coat fell below 2%. Native ferritin, which is excluded from the cell coat, did not reduce Lp at a perfusate concentration of 0.1 g 100 ml-1. At a concentration of 2.5 g 100 ml-1, NF reduced Lp in a few very permeable vessels (Lp greater than 60 X 10(-3) microns sec-1 cm H2O-1) but had no significant effect on vessels with lower and more normal values of Lp. The effects of CF upon Lp can be described in terms of the Kozeny equation if a major proportion of the hydraulic resistance through the capillary wall is attributed to a fiber protein matrix. PMID- 6843374 TI - Mrs. Apotheosis v Doctor Noches. PMID- 6843375 TI - New MSMS legislation designed to alleviate malpractice situation. PMID- 6843376 TI - Put a miracle in your pocket; carry an organ donor card. PMID- 6843377 TI - The bomb: man's thinking must change. PMID- 6843378 TI - On beyond the CT scanner: Michigan doctors reviewing radiologic trends. PMID- 6843379 TI - Hospice: a rapidly-growing health care delivery segment. PMID- 6843380 TI - Michigan physicians have role to play in lowering state's infant death rate. PMID- 6843381 TI - [Change in the ultrastructure of Bacillus polymyxa cells in the process of sporogenesis]. AB - The fine structure of consecutive modifications was studied in sporulating cells of Bacillus polymyxa 153 growing in a liquid aerated medium. The stages of sporogenesis were found to be similar, in principle, with those in other species of the Bacillus genus, but also had certain peculiarities. In contrast to other bacilli, the nucleoid axial thread was not formed in B. polymyxa cells at the first stage of sporulation. The structure of the of the prospore nucleoid forming the local central zone differed from that of the vegetative cell nucleoid at the second stage. The ultrastructural changes observed when the spore septa was formed indicated that its structure was identical with that of the septa of vegetative division, in contrast to which the cell wall material did not undergo lysis but was preserved at the following stages of sporogenesis. The formation of the spore envelope material could easily be discerned in the cytoplasm of the mother cell. The fine structure of mature spores is described in this paper for B. polymyxa. The outer rigid part of its spore envelope was shown, for the first time, to consist of three layers, the surface one having an ordered fibrillar structure. PMID- 6843382 TI - [Decarboxylase activity and biosynthetic processes in Saccharomyces carlsbergensis exposed to light]. AB - Light at a wavelength from 410 to 520 nm was found to stimulate the activity of decarboxylase, protein biosynthesis and the yield of biomass in Saccharomyces carlsbergensis. Pyruvate decarboxylation yielding a substrate for the di- and tricarboxylic acid cycle is a limiting step in the metabolism of the yeast. Light can activate the process, thus eliminating the substrate deficiency of the cycle and increasing the rate of anabolic processes. PMID- 6843383 TI - [Use of a method of concentrating microorganisms in an electric field in the search for life in Mars]. AB - The paper describes a technique of concentrating microorganisms from filtrates obtained from mixtures of the Martian ground analogs and desert soil using electroretention on polarizable carriers (sterilized cotton wool or gauze). The degree of retention can reach 99.9% at a field intensity of 50 V/cm and a flow rate of 0.5 ml/min. A high concentration of microorganisms in a suspension can be reached when the current is switched off and a small volume of the fresh nutrient medium is passed through the suspension. PMID- 6843384 TI - [Dynamics of populations of microbial antagonists in nonsterile soil]. AB - The interaction between populations was studied with Arthrobacter crystallopoietes and Streptomyces olivocinereus, an actinomycete producing the antibiotic heliomycin active against Gram-positive microorganisms. The two organisms were either cultivated together in a growth medium or the two populations were introduced simultaneously into nonsterile soil at different levels of population density. The antagonism was found in both cases: A. crystallopoietes cells died off when a population of the potential antagonist was added. The density of a population producing the antibiotic had to be sufficiently high for the antagonism to be manifested. The antagonism influenced the dynamics of a population of the antibiotic-sensitive microorganism. The results have confirmed earlier data to the effect that antibiotic synthesis is possible in nonsterile soil. PMID- 6843385 TI - [Relation between cyanide-resistant respiration, effectiveness and rate of growth of Candida valida on ethanol]. AB - The object of this work was to study the correlation between the growth rate of Candida valida and its cyanide-resistant respiration, as well as to investigate the effect of cyanide-resistant oxidase on biomass yield in the course of continuous cultivation of the yeast. The inhibition of cellular respiration by cyanide was shown to be directly correlated with the biomass yield. The intensity of cyanide-resistant respiration depended on the growth rate of the culture, and was lowest at the highest growth rates. It has been concluded that, when cyanide resistant oxidase appears in the yeast cells, it functions simultaneously with the main respiratory chain. Cyanide-resistant respiration can be inhibited under the optimal conditions of the culture growth. PMID- 6843386 TI - [Synthesis of total lipids and waxes by Candida tropicalis with various concentrations of the carbon source]. AB - The object of this work was to study the ability of Candida yeasts to accumulate biomass, lipids and wax in the course of their cultivation in a medium containing different concentrations of n-hexadecane. Its optimal concentration for the above processes was 1 to 2%. At a higher concentration (4 and 8%), the yield of wax and fat decreased, mainly due to inhibition of the culture growth. PMID- 6843387 TI - A programme in undergraduate geriatric education: the Beer Sheva experiment. AB - The Beer Sheva medical school was started in 1974 with the objective of training primary care doctors to meet the health needs of the Negev region of Israel. This paper describes a programme developed at Beer Sheva to prepare students to deal with the health-related problems of the elderly. Students begin their contact with the elderly in their first year (early clinical teaching programme) and continue this exposure in varying degrees during the 6 year curriculum. A preliminary study has shown that there is a trend for students to commence their studies with positive attitudes toward the elderly. The early clinical teaching programme which emphasizes interviewing skills, knowledge about ageing and community services that relate to the aged, reinforces the student's sensitivity to geriatric issues. In order to maintain the student's interest in working with the elderly, it is apparent that it will be necessary to educate both hospital and community-based physicians to provide positive role models for students. PMID- 6843388 TI - Career preference enquiry among Queen's University medical undergraduates and graduates: a follow-up. AB - Questionnaires were distributed in 1979 to fourth-and final-year students and to doctors who graduated in 1977 in the second leg of a longitudinal career preference enquiry at Queen's University medical school. Replies were obtained from 98.5 and 92.3% respectively of the undergraduates and from 74.1% of the graduates. While approximately half fourth-and final-year were consistent with their first preference made two years previously for broad fields of practice, less than a quarter of fourth-and a third of final-year were consistent in their preference of specialty. The proportion of Ulster-born students intending to remain rose by 20%. All 103 graduate respondents were working except two. Almost half either did not intend to continue in their present discipline or were undecided. Forty-five per cent were practising the specialty they had elected as final year students indicating that stability of career choice was greater between final year and SHO grading than between fourth and final year. More respondents in anaesthetics and surgery than in any other specialty were consistent in their choice. Eighty-eight per cent of the Ulster-born respondents were resident here at the time of completing the questionnaire. Sixty per cent intended to practise here ultimately, an increase of 15% on 1977. PMID- 6843389 TI - An experimental assessment carried out in an undergraduate general practice teaching course (OSCE examination). AB - Professional examinations should be fair, comprehensive, objective, and appropriate to the discipline above all. If at the same time they can be made administratively easier, interesting and in themselves a teaching/learning experience, so much the better. General Practice is a difficult subject to examine in the traditional subjective manner, yet unless students and their courses are assessed then the subject loses credibility and respect in the frenetic run-up to Finals. The Objective Structured Clinical Examination seemed a more appropriate examination than any tried so far and an experiment was mounted to instruct the Liverpool University Medical School Department of General Practice Tutors in the technique and to test several station 'formats'. At this first attempt many snags were found, but some interesting lines of enquiry and further study were opened up. No attempt was made to produce an accurate mark for individual students in this test, although all were given an insight into strong and weak areas. The experiment demonstrated that an OSCE in Primary Care or General Practice is possible and can be organized. The examiners can be taught the technique reasonably quickly and need have no previous experience of formal examinations. A working Health Centre can be used. PMID- 6843390 TI - Hand-scoring of multiple choice questions. AB - Although computer marking of MCQ papers is common practice and is popular because of its accuracy, speed and the fact that detailed statistical analysis can be carried out painlessly, there is still a major role for hand-scoring. A computer and computer time are not always immediately available and some form of data capture (optical mark reading or transfer of responses to punched cards) is a necessary preliminary. The use of a computer is an unnecessary extravagance when: (a) the test is a non-critical class or small-group exam (b) the papers are short (thirty questions or less) or (c) the number of candidates is small (ten or less) (d) detailed statistical analysis is unnecessary. One-from-five MCQs can be marked by hand easily and rapidly. Multiple true/false questions are most easily hand-scored using grid response sheets and some form of stencil overlays prepared from the answer key. For multiple true/false questions the +1, -1, 0 marking system is strongly recommended. Candidates' total scores, the mean score and its standard deviation for the whole group, ranked order and histograms of scores can be obtained with little difficulty. Mean scores and standard deviations for questions take more time to calculate, but when these are available simple indices of discrimination and of internal reliability can be estimated with some extra time and trouble, although examiners may not wish to assess the discriminatory ability of every question. Hand-scoring is of greatest value in non-critical tests when candidate scores are needed rapidly and is particularly useful when combined with full feedback discussion of the MCQ paper. PMID- 6843391 TI - Aims of the medical school in relation to motivation: practice, not preaching, creates motivation. PMID- 6843392 TI - Does premedical academic background influence medical graduates' perceptions of their medical school or their subsequent career paths and decisions? AB - A survey of McMaster University's first six medical classes (1972-1977) has shown that neither completion of the science courses that are usually required for admission to other medical schools nor achievement of high grades in premedical studies has an important impact on graduates' perceptions of the medical curriculum or on their evaluation of their preparation for the first year of postgraduate training in comparison to other trainees. No influence of either premedical science background or grade point average was detected on career choices in relation to field of medicine entered, level of specialization, location and type of practice, or on factors influencing these choices. PMID- 6843393 TI - Student characteristics on entry to an innovative medical programme. AB - The interests, attitudes and motivations of two groups of first-year medical undergraduates, one group from an innovative medical school and one group from a more traditional school were compared. Differences were found between the two groups in their reasons for studying medicine, their attitudes to medical education, and the role of the medical profession. The students from the innovative school placed more emphasis on the interpersonal and practical aspects of medicine as well as a sense of responsibility to the community. Reasons for these differences were discussed. PMID- 6843394 TI - Attitudes of medical students to medical ethics in their curriculum. AB - One hundred and one students at different levels of their medical education were surveyed as to their views about inclusion of medical ethics in their curriculum. The results showed that 88% of the students feel that medical ethics has a place in their curriculum, and 84% rated medical ethics to be of High to Critical Importance to good medical care. They tended to read infrequently about medical ethics, which they would like integrated at all levels of the curriculum, particularly the clinical years. The more senior students were less sensitive to ethical issues. The students mentioned only dramatic issues in their accounts of encounters with cases involving ethical issues. It is felt that a wide gap is left in the education of these students if medical ethics is not included in a positive way in their curriculum. PMID- 6843395 TI - Developing a model for clinical and basic science teaching skills. AB - This report describes a model for identifying sets of teaching abilities considered to be effective for medical school teaching staff, based on roles teachers assume and functions they are expected to perform as instructors. The specification of these teaching abilities was the first step in the development of a comprehensive course on Medical Instruction at the Basic Institute of Medical and Agricultural Biology of the State University of Sao Paulo, Botucatu, Brazil, where the senior author is employed. The work was based on the assumption that medical school teachers are expected to assume a variety of teaching roles and that identification and specification of the abilities that define their roles can result in more effective and efficient teaching. PMID- 6843396 TI - The multiple choice tutorial: its use in the reinforcement of fundamentals in medical education. AB - Multiple choice questions (MCQs) were developed on major themes in physiology and delivered in a weekly tutorial to first and second year medical students. The sequence of the MCQs was arranged to follow the usual explanation of tissue function. These multiple choice tutorials (MCTs) were either composed entirely of MCQs or were 50:50 lecture and MCQs. The importance of the MCT was the diversification of questions around the components of the MCQ, hence the MCQs served as the springboard from which different avenues of understanding were able to be investigated. The effectiveness of the MCT was assessed by performance at faculty mid- and end-of-year examinations against a control group of students who received 'conventional' tutorials. This comparison suggests that the MCT may have contributed to improved performance. The multiple choice tutorial is popular and achieves considerable student participation. For the tutor, it represents a consistently reproducible tutorial with an appropriate thrust of emphasis. PMID- 6843397 TI - A new approach to course development in geriatric medicine. AB - A new course in Geriatric Medicine was initially conducted in four District General Hospitals, ten students attending each centre. The course, in the second clinical year, was established in the Department of Geriatric Medicine at Birmingham University by Professor Isaacs. The interview technique described was used from the outset as a means of formative evaluation. Undergraduates were randomly selected from each centre at the end of a course, and the results incorporated into a written report which was corrected by the students and distributed to the tutors. The results proved invaluable in evaluating students needs, attitudes and responses to the course. The interview gave unique information not obtainable from questionnaires, essays or exam questions, and enhanced the students feelings of participation in course development. Overall the information seems reliable and consistent and a valuable tool in curriculum design. The time involved was not excessive and leads us to recommend this approach as one method for continuing curriculum development which involves both the students and the tutors. PMID- 6843398 TI - A model for the study of the long duration pathogenesis of cancer and its relevance to therapy. AB - The problem of comparing human cancer, a disease of long evolution, with experimental models in short life span animals is discussed. It is suggested that malignant tumors are more common in long life span animals because of the requirement of long periods of time for tumor progression. Increased malignancy may result from the ability of tumor cells to change, coupled with the long exposure of the neoplastic cells to the selective forces of the organism and the environment. It is proposed that the dynamic nature of tumors and the time required for changes to be expressed, should be taken into account in the study of the changing biological behavior of tumor cells and their changing responses to therapy. The use of transplantable tumors which increase in malignancy during successive transfers, artificially prolongs the existence of the neoplastic cells in isogeneic hosts, permitting thereby tumor progression. Tumor progression, occurs during a period which is accessible to the therapist. This dynamic process should be of primary interest to cancer researchers and therapists. PMID- 6843399 TI - Role for glucagon as a mineralocorticoid antagonist during the fetal-perinatal period. AB - The progressive decrease in total body water (TBW) and sodium during the fetal perinatal period; the normally noted 5-10 per cent largely water weight loss noted in term infants during the first 3-4 days postnatally; and, the even greater TBW and sodium losses incurred by premature infants during the initial post-natal week may, in part, be secondary to a glucagon-mediated, renal distal tubular hyporesponsiveness to aldosterone. PMID- 6843400 TI - X-ray induced adenomas in rodents. AB - A review of the literature shows that x-ray induced lung adenomas in mice, breast adenomas in rats and thyroid adenomas in rats show the same approximate dependence for number of tumors vs dose. It is hypothesized that these benign tumors are due to cell proliferation. The controls of the G1 stage of the cell cycle have been affected by mutation, such that the time in G1 is very small. In carcinogenesis it is M that is affected. PMID- 6843401 TI - Antibiosis and cancer: clue to cure. AB - Antibiotics are chemical substances produced by living microorganisms which have the capacity to inhibit or kill other microbes of a different class. They were used successfully to revolutionize the treatment of infectious disease several decades ago. It is hypothesized that the concept of antibiosis or microbe antagonism will do the same for the treatment of cancer during the forseeable future. It is predicted that anti-cancer antibiotics, still mostly unidentified in the environment, which can be classified as being Biologic Response Modifiers to enhance the host's natural immune defenses against cancer, will prove to be the chief weapon to win the final battle against invasive cancer. However, to reach that goal the basic laws of immunity, including that of anamnesis, will have to be implemented and not ignored. PMID- 6843402 TI - Failure of methylprednisolone to prevent nonuniform cardiac accelerator nerve discharge associated with coronary occlusion-induced arrhythmia: evidence against prostaglandin modulation of autonomic cardioaccelerator neural discharge in the anesthetized cat. AB - Postganglionic cardiac sympathetic neural discharge in the minute prior to arrhythmia produced by acute occlusion of the left anterior descending coronary artery was nonuniform, i.e., both increases or decreases occurred. It is hypothesized that the nonuniform neural discharge is transmitted to the heart, causing nonuniform changes in excitability and conduction which produce ventricular arrhythmias. Prostaglandins have been shown to exhibit both arrhythmogenic as well as antiarrhythmic actions. Methylprednisolone (30 or 50 mg/kg, i.v., a known inhibitor of prostaglandin synthesis) was given 30 minutes prior to coronary occlusion of the left anterior descending artery. Both doses of methylprednisolone failed to: exert any effect on the mean postganglionic cardiac sympathetic nerve discharge prior to coronary occlusion; eliminate the nonuniform neural discharge associated with occlusion-induced arrhythmia; increase the time to arrhythmia or death; and decrease the number of cats dying after acute coronary occlusion. Thus, it is hypothesized that methylprednisolone failed to prevent the arrhythmogenic actions of prostaglandins. The failure of methylprednisolone to decrease the time to arrhythmia suggests that, in this study, an antiarrhythmic mechanism for prostaglandins does not exist. The failure of methylprednisolone to prevent the occlusion-induced nonuniform cardiac sympathetic discharge suggests that prostaglandin modulation of the autonomic balance on the heart is not due to a direct action on the postganglionic cardiac sympathetic nerve. PMID- 6843403 TI - Interactive modal meaning as the mental basis of syntax. AB - In a previous paper (1), a new computer system for the nonverbal representation of word and sentence meaning was described as the basis for an hypothesis that verbal meaning may occur in the brain in the form of interassociated modal percepts or their neuronal correlates. The discussion was principally on the semantics of the system, but reference was made to a complementary syntactic technique that is also based upon the use of modal codes. (See Table 1 for list of the modalities). In describing here the fundamentals of that syntactic system, it is suggested that, as with modal meaning, the principles of interactive modal syntax might also be usefully applied to the understanding of the cerebral mechanisms of some language processes and their dysfunctions. In particular, the hypothesis is proposed that the mental representation of syntax is fundamentally nonverbal, and that syntax and grammar, far from being different from semantics are based on interassociated modal representations of meaning and use. PMID- 6843404 TI - Autoantigens in an immunological network. AB - An autoantigen network, consisting of all non-lymphoid cells and a subset of peripherally located autoregulatory lymphocytes, is proposed. By equilibrating a web of idiotypic stimulation (helper activity) and antiidiotypic inhibition (suppressor activity) directed at each tissue differentiation antigen, this network quantitatively limits autoantigen expression and thereby regulates the differentiation and growth homeostatic processes these autoantigens mediate. Perturbations of the network's dynamic equilibrium secondary to viral infection, somatic mutation, or interaction with environmental agents would clinically manifest themselves as autoimmune tissue destruction, benign or malignant nonlymphoid neoplasia, and lymphoproliferative disorders. PMID- 6843405 TI - An hypothesis of function for the avian glycogen body: a novel role for glycogen in the central nervous system. AB - Our own and other recent data have led us to hypothesize that the glycogen body, heretofore generally considered to be metabolically inert, may be functionally geared to support the process of myelin formation in the avian central nervous system (CNS). We envision that the abundant glycogen stores in this tissue, unlike those in the liver or in skeletal muscle, can serve as a recyclable substrate for the ultimate production of reducing equivalents that would be available for the synthesis of myelin lipid cholesterol. In addition, it is suggested that such glycogen also may serve as a source of organic acids which might provide alternate substrates to the CNS under conditions of metabolic stress. PMID- 6843406 TI - The interrelationship of factors controlling cardiac output. AB - Our understanding of the mechanics of circulation may be broadened by testing old and new concepts on a new hydraulic model made possible by a unique pump which resulted from the evolution of open heart surgical equipment. Findings in human physiology which have corollaries in the model can be analyzed more easily in the model, with the resulting conclusions transferable with reasonable validity. Factors thought to control cardiac output were tested. The results indicate that there are two separate and distinct sets of control factors, with only one set being operative at a time. It is the set that is potentially limiting cardiac output the most that is the determinant at any time. Past paradoxes in our perception of human circulatory physiology are accommodated by the resulting concept. PMID- 6843407 TI - Localization of 2-deoxyglucose to glial cells. PMID- 6843408 TI - Effect of defibrillation energy on pacing threshold. AB - After an episode of electrical defibrillation, periods of increased pacing threshold may cause lack of pacing in pacemaker patients. This effect is independent of the energy applied during defibrillation, although the data suggest that the most rapid return to prefibrillation pacing thresholds occurs after minimal energy countershocks. PMID- 6843410 TI - Computerized speech recognition for anesthesia recordkeeping. AB - EARS, a computerized speech recognition system, has been developed to simplify data entry for automated anesthesia recordkeeping. As an isolated-word, speaker dependent system, it uses a predefined vocabulary of about 350 words, each of which must first be pronounced by the user to train the computer to his voice. Thereafter, data are entered by spoken words separated by brief pauses and organized into sentences according to a specified syntax. Completed sentences are read back to the user by a speech synthesizer to verify the recognition. Errors can be corrected before they are recorded. Attention to human factors is an important design goal. Performance has not yet been measured, but appears acceptable. PMID- 6843409 TI - Effects of myocardial infarction on catheter defibrillation threshold. AB - Because the automatic implantable defibrillator may be used in patients having ischemic heart disease, it is important to know whether myocardial ischemia changes the threshold for ventricular defibrillation under experimental conditions simulating automatic internal defibrillation. We determined changes in ventricular defibrillation threshold following coronary occlusion, using an electrode catheter designed for use with an automatic implantable defibrillator. Acute myocardial ischemia was produced without thoracotomy in 10 dogs (experimental group) by embolization with a plastic bead injected via a catheter into the left coronary artery. A control group of 4 dogs had only saline injected into the artery. Defibrillation threshold was measured at 15-min intervals from 1 hour before embolization to 2 hours after embolization. In the control group, voltage, current, energy, and impedance were unchanged after injection of saline into the coronary artery, and india ink perfusion revealed no ischemic areas. In the experimental group postembolization threshold current and energy were significantly higher than preembolization values: 0.47 vs 0.40 A/kg and 1.01 vs 0.80 J/kg, respectively (p less than 0.01). The magnitude of the peak change in threshold current after embolization was positively correlated (r = 0.79) with the size of the ischemic zone, determined by weighing unstained areas after india ink perfusion. Defibrillation threshold for a catheter electrode configuration increases for at least 2 hours following onset of acute myocardial ischemia. This finding must be accounted for in the design and use of an automatic implantable defibrillator. PMID- 6843411 TI - Heimlich valve for chest drainage. AB - The Heimlich chest drainage valve was developed so that the process of draining the pleural cavity could be accomplished in a safe, relatively simple, and efficient manner. Replacing the cumbersome underwater drainage bottle system, the Heimlich valve connects to chest tubing and allows fluid and air to pass in one direction only. The valve, which functions in any position, need never be clamped, and regulated suction can be attached to it if necessary. The valve drains into a plastic bag that can be held at any level, allowing the patient undergoing chest drainage to be ambulatory simply by carrying the bag. The construction and function of the valve is easily understood by medical and nursing staffs. It is presterilized, stored in a sterile package, and readily utilized on emergency vehicles and in the operating room. PMID- 6843412 TI - Applicability of personnel management concepts to clinical engineering practice. AB - Personnel management concepts are reviewed for inclusion in clinical engineering basic and continuing education curricula. The management function is evaluated from the aspect of formal and informal leadership, two-way communication, voluntary cooperation, and the direction and discipline of the clinical engineering staff. Prerequisites examined in support of these activities include an effective organizational structure, man-to-job matching, personal needs, and job satisfaction. Steps propounded for stimulating communications between the clinical engineer and his multidisciplinary clients include adjustments to his own role model and to his educational technique so as to accord more with the specific role models of his audience. PMID- 6843413 TI - Managing the problem of aging medical devices. PMID- 6843414 TI - A device to quantify passive resistance to motion of the leg. PMID- 6843415 TI - The cost of laboratory technology: a framework for cost management. AB - Laboratory costs at Vancouver General Hospital have been increasing over the past decade. Of the numerous explanations that have been offered for these increases, one contributing factor is the impact of automation and technology. An aggregate measure of laboratory technology was constructed and the net contribution to cost per acute care admission was estimated. Technology has two counteracting effects: It stimulates demand for tests, thus increasing cost per acute care admission, and it increases productivity, thus reducing costs. Effective management may be able to achieve the cost reductions without incurring an increased demand. PMID- 6843417 TI - Innovations in sterilization technology for instrument processing. AB - The past 5 years have seen the development of specialized devices to package, protect, and sterilize surgical instruments. The sterilization container system is one such innovative approach to operating room instrument processing. When compared with disposable and reusable systems, the sterilization container system was found to have the advantages of lower cost and improved efficiency. PMID- 6843416 TI - Systemic effects of intraoperative autotransfusion. AB - The hematological effects of autotransfusion have not been well characterized. A canine model was used in which a controlled 2000-ml blood loss was effected into the open peritoneum and replaced either by autotransfusion, using one of two devices, or by homologous transfusion. In each group hematological data were collected before, during, and after the operation. None of the parameters measured showed significant differences between the two autotransfused groups. However, intraoperative values for prothrombin time and activated partial thromboplastin time were significantly prolonged in the autotransfused groups compared with the homologous transfusion group. Fibrinogen levels and platelet counts fell significantly from baseline levels in the intraoperative period, but rose above even baseline levels postoperatively. White blood cell counts remained unchanged intraoperatively, but rose significantly and remained elevated at 24 hours and 1 week. No significant differences exist between the effects produced by the two autotransfusion systems. It is clear that prothrombin time and activated partial thromboplastin time are prolonged intraoperatively in the autotransfusion groups, whereas these parameters are unaffected by homologous transfusion. PMID- 6843418 TI - Adverse events with catheters and toxicity testing. PMID- 6843419 TI - Is leptospirosis a "rare" disease? PMID- 6843420 TI - Defining mental health. PMID- 6843421 TI - Chemotherapy for head and neck cancer. PMID- 6843423 TI - Burns from watches. PMID- 6843422 TI - Munchausen's syndrome--a warning for doctors in Australia. PMID- 6843424 TI - Infant death and sheepskin rugs. PMID- 6843425 TI - A modified topical therapy for the treatment of solar keratoses. PMID- 6843426 TI - Hyperparathyroidism in elderly disabled patients. PMID- 6843427 TI - Cellular toxicity of urinary catheters. AB - The cellular compatibility of each of several brands of urinary catheters available on the Australian market was measured by means of cell-culture methods, a rabbit intramuscular implant test, and the traditional mouse systemic toxicity test. Good agreement was obtained between the in-vitro tests and the rabbit implant tests (although the cell-culture tests were simpler, more rapid, more sensitive, and quantitative). The mouse systemic toxicity test was insensitive, and detected no toxic samples. The cell-culture and rabbit-implant test results indicated that some urinary catheters can release substances harmful to mammalian cells. Such substances may contribute to the clinical reactions of urethritis and strictures after urethral catheterization. PMID- 6843428 TI - Human leptospirosis in Victoria. AB - Between May, 1979, and May, 1981, leptospirosis was diagnosed, on the basis of serological and culture findings, in specimens from 208 of 2516 patients with symptoms which suggested leptospirosis or other zoonoses. The most common serological reactions were with serovars hardjo (69%), pomona (29%) and tarassovi (2%). There was a clear association between infection and occupation in 101 farmers, 44 meat workers and 11 meat inspectors. It would seem prudent to consider leptospirosis in the differential diagnosis of pyrexia in patients who have occupational contact with animals, and to institute appropriate serological and culture examinations. PMID- 6843429 TI - The nuclear stethoscope. Serial evaluation of left ventricular function in patients with cardiac disease. PMID- 6843430 TI - Alternative proposals for reform of mental health legislation in Australia. PMID- 6843431 TI - Role of the margidjbu (traditional healer) in western Arnhem Land. AB - Traditional healers are still highly regarded and active in Arnhem Land. Their practices are a logical consequence of the traditional health beliefs of the people. Even though certain health beliefs have changed since contact with the Western health care system, the sociomedical theory of disease is still strongly held by the people, including Aboriginal health workers. PMID- 6843433 TI - Cerebral aneurysms and subarachnoid haemorrhage. PMID- 6843432 TI - Acute phenylbutazone poisoning in a child. AB - Accidental acute intoxication with phenylbutazone in a 2 1/2-year-old child produced an acute picture of coma, convulsions, diarrhoea, and of cholestatic jaundice which evolved over the succeeding 10 days. Transient, unexplained hyperglycaemia occurred during the first few hours of the illness. Recovery was complete within three weeks after the poisoning. Her clinical progress was monitored with the aid of regular estimations of plasma phenylbutazone levels. PMID- 6843435 TI - Sign of the clicking hip. PMID- 6843434 TI - Some aspects of intracranial arteriovenous malformations. PMID- 6843436 TI - Hypersensitivity reactions to tinidazole (Fasigyn) PMID- 6843437 TI - Disappearance of suspected bronchogenic carcinoma. PMID- 6843438 TI - X-radiation during pregnancy. PMID- 6843440 TI - The blood film in meningococcal disease. PMID- 6843439 TI - Level of immunization to diphtheria in Australian communities. PMID- 6843441 TI - Fruit, vegetables and acute respiratory infections. PMID- 6843443 TI - The "warning leak" in spontaneous subarachnoid haemorrhage. AB - A clear history of a warning leak was obtained in 28% of patients with ruptured intracranial aneurysms admitted to a Department of Neurosurgery. The ultimate outcome in these patients was worse than in other patients who were in good condition after initial haemorrhage. There are also cases in which symptoms suggesting a warning leak are found not to be due to haemorrhage, and CT scanning cannot be relied upon to determine accurately whether a warning leak has actually occurred in patients with suggestive symptoms. The frequency and significance of the warning leak should be recognized. Such recognition would improve the outcome after the rupture of an intracranial aneurysm. PMID- 6843442 TI - Survival after free falls of 59 metres into water from the Sydney Harbour Bridge, 1930-1982. AB - Between 1930 and 1982, 92 persons fell from the Sydney Harbour Bridge into the water, 59 metres below. The major problem among survivors was pulmonary trauma, often with severe respiratory failure. The position of impact influenced survival, the feet-first vertical position being the most favourable. Mortality rate from the fall was 85%. Rapid clinical assessment of victims, especially with reference to pulmonary injury, and prompt institution of ventilatory support, where required, may reverse respiratory failure. Intra-abdominal injuries, spinal column or central nervous system involvement and peripheral fractures should all be suspected. PMID- 6843444 TI - Latest developments in contraception. PMID- 6843445 TI - Association of intracranial aneurysm and arteriovenous malformation. AB - In a series of 252 patients (47 with arteriovenous malformation, 205 with aneurysms), two patients had a coexisting intracranial aneurysm and an arteriovenous malformation. In one patient, the aneurysm was proximal to the main feeding arteries of the arteriovenous malformation. In the other patient, there was no anatomical relationship between the two lesions. These findings illustrate different views on the pathogenesis of the rare association of the two conditions. PMID- 6843446 TI - Cervical pregnancy. PMID- 6843447 TI - Multifocal osteomyelitis caused by Mycobacterium chelonei. A therapeutic dilemma. AB - An elderly man developed chronic osteomyelitis in the right tibia and both feet after a penetrating injury to the right knee. Mycobacterium chelonei, a species closely related to M. fortuitum, was cultured from all sites. The selection of antibiotic therapy was difficult. The need for prolonged treatment and possible surgical intervention is highlighted. PMID- 6843449 TI - Patient counselling in medical practice. PMID- 6843448 TI - The falling, rising incidence of invasive cancer of the cervix. PMID- 6843450 TI - Cost containment and equipment maintenance. PMID- 6843451 TI - Exanthem in northwestern Tasmania. PMID- 6843452 TI - Fentanyl in endoscopy of upper GI tract. PMID- 6843453 TI - Not "cured by a verdict". PMID- 6843454 TI - Early gastric cancer. PMID- 6843455 TI - Treatment of Australian-born and immigrant psychiatric disorders. PMID- 6843456 TI - Ethics of infanticide and abortion. PMID- 6843458 TI - Drought and "flu" epidemics. PMID- 6843457 TI - Psychic surgery 'quackery". PMID- 6843459 TI - Use of psychotropic drugs on children. PMID- 6843460 TI - Bra strap headache. PMID- 6843461 TI - Grieving after termination of pregnancy. PMID- 6843462 TI - Standardizing of CSF protein results. PMID- 6843463 TI - Invasive carcinoma of the cervix in Queensland. Change in incidence and mortality, 1959-1980. AB - The treatment of invasive carcinoma of the cervix in Queensland has been centralized at the Queensland Radium institute. From 1959 to 1980 inclusive, 2246 patients with this condition received treatment. Analysis of data from this period reveals significant trends towards a decrease in incidence (P much less than 0.001); a decrease in the incidence of stage 1B disease (P much less than 0.001); a decrease in the incidence of stage 2 disease (P much less than 0.001), which is significantly greater than that in the incidence of stage 1B (P less than 0.01); a decrease in the mortality rate (P much less than 0.001); and a decrease in the incidence within all age groups (P much less than 0.001), excepting an increase in incidence within the 20 to 44 years age group in the years 1974 to 1980 P much less than 0.05). The influence of the introduction of the Papanicolaou smear test is discussed. PMID- 6843464 TI - Personal exercise prescription. Cardiac rehabilitation and preventive medicine. AB - This paper describes a practical programme for the physical and psychological rehabilitation of patients with cardiac disorders. This programme makes possible the prescription of exercise to an accuracy of one metre per minute or two pulse beats per minute. It is inexpensive, portable, requires minimum supervision and has been in use for seven years. The basic principle is to walk or jog in a circle, completing one revolution per minute with the radius of the circle being almost imperceptibly increased as fitness improves. A timing device is incorporated to ensure an absolutely uniform pace for each participant. PMID- 6843465 TI - Diarrhoea associated with Clostridium difficile in a hospital population. AB - The incidence of disease associated with Clostridium difficile was investigated in a general hospital population over a period of six months. In 26 (14.5%) of 179 patients studied, C. difficile was either isolated or faecal cytotoxin was detected. The incidence of other enteropathogenic bacteria, except Aeromonas hydrophila, was low. Faecal cytotoxin was not detected in nine patients (35%), and non-cytotoxigenic strains of C. difficile were isolated from these patients. In seven patients, a selective broth was required to isolate C. difficile, suggesting their presence in low numbers. Although some C. difficile diarrhoeal disease which was not associated with antibiotic therapy was recorded, prior exposure to antibiotic agents still appears to be the major predisposing factor in this population. Faecal cytotoxin detection, sigmoidoscopy, and rectal biopsy were not reliable investigations for disease associated with C. difficile; hence, we advocate increased emphasis on isolation of the causative organism. Routine culturing for C. difficile in a hospital population appears to be warranted. PMID- 6843466 TI - Importance of total colonoscopy in the diagnosis of colonic disorders. AB - The need for colonoscopic examination of the whole colon was determined by evaluating the accuracy of a barium enema X-ray report with particular reference to the right colon. Long colonoscopies were performed on 108 patients. The reports of the barium enema X-ray examination in these patients were compared with the colonoscopy reports. Over all, the barium enema X-ray report was accurate in 47% of cases. The rate of false negative reports was 10% and that of false positive reports 43%. For lesions of the right colon, the barium enema X ray report was accurate in only 32% of cases, with 68% false positive and 15% false negative reports. False positive reports of carcinoma or polyps result mainly from imperfect preparation. Of the eight right colonic lesions missed in the barium enema X-ray examination, five were polyps and one was carcinoma. Long colonoscopy, rather than short colonoscopy, or flexible sigmoidoscopy and barium enema X-ray examination, would be accompanied by the greatest diagnostic accuracy. Air-contrast barium enema X-ray examination and long colonoscopy together offer the best methods of diagnosis of occult lesions in the right colon. PMID- 6843467 TI - Placenta praevia percreta with bladder penetration. PMID- 6843468 TI - Gianotti-Crosti syndrome. Non-parenterally acquired hepatitis B with a distinctive exanthem. AB - A case of Gianotti-Crosti syndrome is reported. This condition is an uncommon form of non-parenterally acquired hepatitis B of children. The distinctive eruption of Gianotti-Crosti syndrome may be the only symptom or sign of associated-hepatitis B. Chronic hepatitis may develop in some patients. PMID- 6843470 TI - Towards health education. A critique of the AMA policy on preventive medicine. PMID- 6843469 TI - Ascarideal perforation of colon. PMID- 6843471 TI - [Alveolar air in the monitoring of occupational exposure to volatile chemical compounds]. PMID- 6843472 TI - Small airways disease after short term occupational asbestos exposure. PMID- 6843473 TI - [Concentrations of cadmium in the blood of smokers and nonsmokers not occupationally exposed to the metal]. PMID- 6843474 TI - Indicators of asbestos exposure in autopsy routine. 1. Lung asbestos bodies and occupation. PMID- 6843475 TI - [Calibration against the standard CECA of the new CNR questionnaire]. PMID- 6843476 TI - [Reading chest radiographs in epidemiologic surveys on pneumoconiosis: a science or art?]. PMID- 6843477 TI - [Indirect measurement of carboxyhemoglobinemia. Evaluations of a simple, rapid method]. PMID- 6843478 TI - [Functional evaluation of a respiratory rehabilitation integrated program]. PMID- 6843479 TI - [Aluminum assay in biological fluids]. PMID- 6843480 TI - [Field application of the critical fusion frequency test in lead exposure in a blind study]. PMID- 6843481 TI - The importance of clothing in death investigation--I. PMID- 6843482 TI - [Chemotherapy of tumors. Pharmacologic bases]. PMID- 6843483 TI - [Bronchitis in children]. PMID- 6843484 TI - The Yorkshire ripper. PMID- 6843485 TI - The work of the Health Service Commissioner. PMID- 6843486 TI - Drugs for psychiatric disorders. PMID- 6843487 TI - Insect venoms. PMID- 6843488 TI - [Initial trial of using a "flying mill" for the comparative study of the flight capabilities of Anopheles pulcherrimus Theobald mosquitoes (Diptera, Culicidae)]. PMID- 6843490 TI - [Characteristics of the biology of Aedes communis Deg. (1776), (Diptera, Culicidae)]. PMID- 6843489 TI - [Maternal influence on the physiology of the progeny in Aedes caspius dorsalis Mg. mosquitoes]. PMID- 6843491 TI - [Sandflies (Diptera, Phlebotominae) of Afghanistan. 2. Distribution by topography]. PMID- 6843492 TI - [DDT resistance of mosquitoes in an Anopheles maculipennis complex in the territory of the Ukrainian SSR]. PMID- 6843493 TI - [Conditions for the mass reproduction of blood-sucking blackflies (Diptera, Simuliidae) and human cases of simulidotoxicosis in the valleys of the Northern Donets River and its tributaries]. PMID- 6843494 TI - [Sites of sheltering and the scattering range of blackflies of the genus Wilhelmia End. (Diptera, Simuliidae) in the Ukrainian steppe]. PMID- 6843495 TI - [Evaluation of bisazir used as a chemosterilant of mosquitoes]. PMID- 6843496 TI - [Repellent properties of Mannich bases and cresol and phenol derivatives for Aedes aegypti L. mosquitoes and the flea Xenopsylla cheopis Roths]. PMID- 6843498 TI - [Comparative effectiveness of 2 types of baits for synanthropic flies in different regions]. PMID- 6843499 TI - [Means of increasing the effectiveness of isolating and assessing the quantity of sexual secretion in the accessory glands of male mosquitoes]. PMID- 6843497 TI - [Action on flea imagoes of bacterial preparations of the thuringiensis-group and their fillers]. PMID- 6843500 TI - [Diphyllobothriasis in Novosibirsk Province. 2. Measures to control infestation in a focus on Lake Ubinskoye]. PMID- 6843501 TI - [Effect of the larval density of Aedes aegypti mosquitoes on their mortality as affected by Bacillus thuringiensis Berl. preparations]. PMID- 6843502 TI - [Local cases of opisthorchiasis in Chernikov Province]. PMID- 6843503 TI - [Quantitative diagnosis of opisthorchiasis and other human helminthiases using a modified Kato method]. PMID- 6843504 TI - [Method of studying the fertility of houseflies using chambers for their individual housing]. PMID- 6843506 TI - A note on the measurement of focal spot sizes utilizing star test patterns at low magnification factors. PMID- 6843505 TI - Temperature rise during photoradiation therapy of malignant tumors. AB - This report discusses the optical and thermal distribution during photoradiation therapy of malignant tumors. Emphasis is put on the therapeutic procedure with the light dose delivered through an inserted optical fiber. Theoretical predictions and experimental results indicate that the temperature rise during the procedure may give rise to hyperthermal cell kill. The report discusses the extent of the regions with hyperthermal bioeffects in terms of tissue parameters as optical absorption and scattering, thermal conductivity, specific heat, blood flow, and optical dose parameters as optical power and exposure time. PMID- 6843507 TI - Thermal energy deposition from a single-loop rf whole-body applicator. AB - Whole-body hyperthermia at moderate temperatures (40.0 +/- 0.5 degrees C) is currently being investigated to assess its effectiveness as an adjuvant to other cancer therapies. At our institution, the whole-body heating is achieved by a combination of hot air circulation and rf inductive heating at 27.1 MHz. This paper reports the results of a study of the thermal energy deposition pattern associated with the rf applicator. The applicator consists of a single loop of nearly elliptical shape with dimensions 20 x 46 cm. The loop is embedded in a mattress and is fed by lead wires entering the side of the mattress. Temperature mapping in a heated gelatin phantom placed just above the rf loop showed maximum heating near the lead wires and a cool region above the center of the loop. Calculations of the magnetically induced and capacitive contributions to the electric field near the applicator indicate that the heating near the lead wires is largely capacitive in nature. This feature of the rf heating is of interest because capacitive fields result in preferential heating of fatty tissues. Further calculations showed that the capacitive heating contribution falls away much more rapidly than the induced field contribution with increasing distance from the plane of the rf loop. PMID- 6843508 TI - Microcomputer supplementation of a liquid scintillation spectrometer. PMID- 6843509 TI - Backscatter of diagnostic x rays from metals. PMID- 6843510 TI - An equation for calculating the contribution to osmotic potential of the separate solutes of water solutions. PMID- 6843511 TI - Exposure uniformity considerations in slit radiography. AB - Slit radiography is a highly efficient means of suppressing scatter. However, when employed with a pulsating x-ray source, a grid line type of artifact results if the movement of the slit is not properly coupled to the periodicity of the source. Taking the exposure of the film to be the convolution of the slit transmittance and the radiation intensity, the conditions for a uniform exposure have been derived for the realistic configuration of a multiple-slit array and a slit transmittance that includes the focal spot and slit geometry. Expressions for the amplitude and spatial frequency of the artifact when the conditions are not met are derived. Methods of suppressing the artifact when its vanishing conditions are not met are also discussed. PMID- 6843512 TI - Coherent scatter in diagnostic radiology. AB - Coherent scatter is often ignored in diagnostic radiology because its cross section is relatively small, and because it is assumed to be indistinguishable from primary radiation. Single-scatter calculations, however, show that coherently scattered photons diverge sufficiently from the primary ray to degrade image contrast, and that they account for a significant fraction of the total scattered energy fluence at the image receptor. Grids and large air gaps are less effective in reducing coherent single scatter than incoherent and multiple scatter. For radiography of the abdomen, coherent first scatter comprises 10% of total scatter and 26% of the primary fluence before a grid, and on the order of 22% and 7.5%, respectively, behind a grid. Coherent first scatter comprises a higher fraction of the total amount of scatter for lower energy examinations such as mammography. PMID- 6843513 TI - Tumor significant dose. PMID- 6843514 TI - Temperature distributions in hyperthermia by electromagnetic induction: a theoretical model for the thorax. AB - Steady-state temperature solutions to the bioheat equation are presented for magnetic induction heating of a thoracic model consisting of a spherical tumor embedded in lung tissue which is layered by muscle and fatty tissue. Analytical solutions are presented for each of the tissue regions along with their numerical evaluations over a range of physical characteristics, including surface cooling effects. A strong dependence of tumor temperature on size and blood perfusion rate is shown to exist and can be used to optimize treatment parameters. Tendencies of the chest muscles and overlaying fatty tissue to overheat, particularly in the case of an obese patient, are discussed along with the alleviating influence of surface cooling. Healthy lung tissue, on the other hand, is shown to be safe from any significant damage in such a heating situation. Transient times required for tumors to achieve thermal equilibrium are computed and shown to depend strongly on tumor size and, to a lesser extent, on blood perfusion rate. Finally, the overall results obtained from the model are compared with available clinical data and are found to be in line with those observations. PMID- 6843515 TI - The use of neutron and gamma ray spectral measurements and calculations to obtain dosimetric information for DT neutrons. AB - Neutron and gamma ray energy spectra were measured using an NE-213 scintillator at depths of 7.2, 15.2, and 22.2 cm in a tissue-equivalent phantom which was uniformly irradiated on one face by deuterium-tritium (DT) neutrons. Coupled neutron-gamma ray multigroup discrete ordinates calculations were performed using semi-infinite slab geometry. These calculations were used to supplement the measured spectra below 1 MeV. Similar calculations were performed to study the perturbation in the phantom due to the detector. The measured and calculated spectra were used to determine the kerma distributions for neutrons and gamma rays at each location. The gamma radiation was determined to contribute more than 10% of the total dose at each depth. The calculated kerma also reveals that a knowledge of the gamma ray spectra below 1 MeV is desirable. PMID- 6843516 TI - Radiation dose enhancement in tumors with iodine. AB - The loading of tissue with iodine can result in the enhancement of the radiation dose absorbed from low-energy x-ray or gamma ray sources. We have explored the potential of this phenomenon for radiation therapy. We have demonstrated the effect of iodine concentration and radiation quality on this dose enhancement in lymphocytes, we have calculated the effect of such enhancement on depth dose distributions in the brain, we have estimated the iodine content in two human brain tumors during computerized tomography (CT) scans, we have studied the dispersion of the iodine contrast media after direct injection into rabbit tumors, and we have demonstrated that the combination of x-ray and contrast media injection is far more effective than either agent alone in causing the regression of mouse tumors. These results suggest that there may be a therapeutic advantage from loading tumors with iodine and treating them with low-energy photons. PMID- 6843518 TI - On the mechanism of hypophosphatemia during acute hyperventilation: evidence for increased muscle glycolysis. PMID- 6843517 TI - Evaluation of optically projected x-ray images from an elastomer-based ionographic system. AB - In ionographic imaging, the ions produced in a high-pressure, high-Z gas are normally collected on an insulating foil. If a deformable dielectric gel is used as a collecting electrode, then the electrostatic image can be visualized by optically projecting the gel deformation onto a screen. In the present work, we have evaluated the imaging performance of such an ionographic system in terms of its sensitivity and resolution capabilities. X-ray images of a sharp lead edge formed on a thin silicone elastomer were optically projected and recorded on x ray films. The edge profiles were obtained at different values of x-ray exposure, elastomer thickness, gas pressure, and collecting voltage across the chamber. These profiles were processed to obtain the sensitivity and resolution of the system at different operating conditions. Images of some test objects are shown using this system in order to demonstrate its clinical potential. PMID- 6843519 TI - Familial hypocalciuric hypercalcemia involving four members of a kindred including a girl with severe neonatal primary hyperparathyroidism. AB - A family with hypercalcemia in four members is reported. The proband, a newborn girl presenting with inadequate sucking due to muscle hypotonia, marked thoracic deformity due to decalcification, hypercalcemia, and hypophosphatemia, suffers from cerebral damage due to hypoxia despite successful total parathyroidectomy of four hyperplastic glands and replacement therapy. Her 31-year-old father showed CCa/Ccr of 0.0094, normal serum Mg, hypercalcemia, hypophosphatemia and normal renal concentrating ability without kidney stone and bone abnormality. Subtotal parathyroidectomy caused only a transient fall of serum Ca. His half sister and her daughter also had symptomless hypercalcemia. Recognition of familial hypocalciuric hypercalcemia is important to avoid unnecessary parathyroid surgery and to respond effectively to severe neonatal primary hyperparathyroidism occasionally seen in such kindred. PMID- 6843520 TI - Intratubular microinjection study of gentamicin transport in the rat. AB - The intratubular microinjection technique was used to determine the absorptive flux of radioactive gentamicin the rat. Microinjection into the early tubule and late proximal tubule resulted in recoveries of proximal 66.6 +/- 3.6% and 80.4 +/ 3.4%, respectively. Recoveries after microinjection into the distal convoluted tubule averaged 101.0 +/- 4.3%. The addition of tobramycin, phospholipase A, spermine or probenecid to the microinjection solution inhibited gentamicin absorption. These studies indicate that an absorptive flux of gentamicin is present in the superficial proximal tubule and at a nephron site or sites between the superficial proximal and distal tubules. Gentamicin absorption is mediated by a phospholipid carrier with specificity for polyamines and other aminoglycosides. The presence of probenecid in the perfusion solution inhibited the tubular absorption of gentamicin. PMID- 6843521 TI - Evidence for operation of the magnification phenomenon in patients with chronic renal insufficiency. AB - It has been proposed that the functional adaptations of surviving nephrons in advancing chronic renal failure (CRF) are not random but characterized by an excretory response which varies inversely with the number of surviving nephrons ('magnification phenomenon'). Because validation of this hypothesis in man is incomplete, we undertook to characterize the excretory response to acute volume expansion in patients with CRF. In normals, water immersion to the neck (NI) results in a redistribution of blood volume with preferential central hypervolemia (CV) in the absence of plasma compositional change. NI was utilized, therefore, to assess the response to acute CV. 13 patients with CRF (GFR = 3-65 ml/min) were studied twice while ingesting a constant diet (60-150 mEq Na/day): during a seated control study (C) and during 4 h of NI. FENa was constant during C. In contrast, during NI, there was a prompt and marked increase in FENa which markedly exceeded that of 29 normal subjects undergoing an identical study. In the CRF group the extent of the augmentation of FENa during immersion varied inversely with GFR (r = -0.54; p less than 0.05). These results provide evidence that the 'magnification phenomenon' subtends renal sodium handling in patients with CRF. PMID- 6843523 TI - Physiologic response to calcium infusion in newborn and adult dogs. AB - The physiologic response to intravenous calcium chloride infusion (12 mueq Ca/min/kg for 1.5 h) was measured in 24 newborn dogs, 4-28 days of age, and in 8 adult dogs for comparison. All adult and 18 of the newborn dogs were thyroparathyroidectomized (TPTX). The other 6 newborn dogs were sham operated as controls. Control puppies had higher plasma calcium, lower plasma phosphate and higher renal phosphate excretion than TPTX puppies indicating effective parathormone function in the newborn. Striking differences in response to calcium infusion between TPTX adults and puppies were reflected by a larger rise in serum calcium and in calcium excretion in adults than in intact or TPTX puppies (p less than 0.01). Moreover, plasma phosphate and renal phosphate excretion rose in the adult and fell in the puppy. 4 TPTX adult dogs and 4 TPTX puppies were volume expanded with saline (33 and 42%, respectively). Compared to the adult, the natriuretic response to expansion in the puppy (fractional sodium excretion, FENa, equaled 2.3%) was significantly (p less than 0.05) less than that of the adult (FENa = 8.5%). The calciuretic response, however, was the same for the adult and newborn (FECa = 12.6 and 10.2%, respectively). These results suggest that in response to calcium infusion, there is a greater deposition of calcium and phosphorus in the bone and other tissues of the newborn animal compared to the adult, accounting for the lower rise in serum calcium, the fall in serum phosphate and the lower renal calcium excretion in the puppy. This response is largely independent of parathyroid hormone or calcitonin. The attenuated natriuretic response and good calciuretric response to saline expansion in the newborn dog are consistent with the hypothesis of a linked proximal tubular calcium and sodium reabsorptive mechanism and an unlinked distal nephron mechanism in the newborn animal. PMID- 6843522 TI - Effect of potassium loading on choline pathways in renal cells. AB - The effect of potassium loading on 14C-choline incorporation into phospholipids, via choline kinase, was measured in young rats after 10 days on a high potassium (1.34 mEq/g) diet, when urinary potassium excretion rose sixfold. Renal choline kinase activity fell by 20%, from 47.3 +/- SEM 2.2 to 37.8 +/- 1.4 pmol 14C choline incorporated into phosphorylcholine/min/mg protein in the potassium loaded rats (p less than 0.005). This inhibition was overcome during 48 h of renal compensatory growth following uninephrectomy. There was a 25% increase in the activity of the enzyme, which was associated with a 24% increase in renal weight in potassium-loaded rats following uninephrectomy. Uninephrectomized rats on a normal diet also showed a 20% increase in both renal choline kinase activity and renal weight compared to sham-operated rats. The effect of potassium loading on 14C-choline incorporation into phospholipids was also studied on renal-derived cells having some of the characteristics of either porcine proximal or canine distal tubule cells. Incubation of either cell type in media with 40 mM potassium for 30 min resulted in a 20-30% decrease in the incorporation of 14C-choline into phospholipids (p less than 0.05). Thus, renal utilization of choline for the incorporation of membrane phospholipids for growth can be partially inhibited by chronic potassium loading in young rats and in cells incubated in vitro with high potassium concentrations. The inhibitory effect of potassium loading on renal phospholipid incorporation can be overcome by the stimulating effect of renal compensatory growth on phospholipid incorporation, resulting in increased growth in the young rat kidney. PMID- 6843524 TI - A working model of the perfect osmometer hypothesis in anuria. AB - This communication contains a model describing osmotic phenomena that result from an osmotic disturbance (gain or loss of non-isotonic solutions from the extracellular compartment), if cells function as perfect osmometers. This model (a) predicts the changes in extracellular water and in solute concentration, if the magnitude of the disturbance is known; (b) computes the amount of a solution of a given osmolality necessary to create a desired change in extracellular water; (c) estimates, by osmometric calculations, initial extracellular and total body water; (d) estimates the 'new' solute that is created by anuria and by dilution of extracellular solute controlled by hormonal feedback. Anuria and extracellular expansion are experimental conditions usually accompanying the osmotic disturbance. The model is, therefore, suitable for precise in vivo studies of osmotic disturbances. PMID- 6843525 TI - [A case of mesomelic dysplasia with unusual characteristics]. PMID- 6843526 TI - [Lymphatic nodular hyperplasia of the colon in childhood]. PMID- 6843527 TI - [Description of a case of microphthalmia-anophthalmia (?) associated with other malformations]. PMID- 6843528 TI - [Long-term results of the treatment of infantile medulloblastoma]. PMID- 6843530 TI - [Psychogenic factors in allergic asthma in children]. PMID- 6843529 TI - [The use of guacetisal in bronchopulmonary pathology in children]. PMID- 6843531 TI - [The clinical score for diagnosis of bronchiolitis in sucklings. Retrospective checking of 133 cases (1974-1981)]. PMID- 6843533 TI - Diagnosis and treatment of thoracic outlet syndrome. PMID- 6843532 TI - [Oculocutaneous albinism and tyrosinuria. Description of a clinical case]. PMID- 6843534 TI - Minnesota Medical Insurance Exchange. PMID- 6843535 TI - Facial injuries in sports. PMID- 6843536 TI - Giant cell arteritis. An additional cause for fever of unknown origin. PMID- 6843537 TI - Isosorbide dinitrate. PMID- 6843538 TI - Dermatophagoides scheremetewskyi and feather pillow dermatitis. PMID- 6843540 TI - Small problems. PMID- 6843539 TI - Child psychiatry in an HMO. A critical review. PMID- 6843541 TI - The professor and the pigeon. Psittacosis in the groves of academe. PMID- 6843542 TI - Campylobacter enteritis. Case report. PMID- 6843543 TI - Risk factors for post-cesarean section endomyometritis. PMID- 6843544 TI - Acute respiratory failure due to atypical pneumonia. Case report. PMID- 6843545 TI - Chronic renal failure and extrapulmonary tuberculosis. Case report. PMID- 6843546 TI - Approach to the patient with recurrent syncope of unknown cause. PMID- 6843548 TI - Organization of the SUC gene family in Saccharomyces. AB - The SUC gene family of yeast (Saccharomyces) includes six structural genes for invertase (SUC1 through SUC5 and SUC7) found at unlinked chromosomal loci. A given yeast strain does not usually carry SUC+ alleles at all six loci; the natural negative alleles are called suc0 alleles. Cloned SUC2 DNA probes were used to investigate the physical structure of the SUC gene family in laboratory strains, commercial wine strains, and different Saccharomyces species. The active SUC+ genes are homologous. The suc0 allele at the SUC2 locus (suc2(0) in some strains is a silent gene or pseudogene. Other SUC loci carrying suc0 alleles appear to lack SUC DNA sequences. These findings imply that SUC genes have transposed to different chromosomal locations in closely related Saccharomyces strains. PMID- 6843547 TI - In vitro methylation of specific regions of the cloned Moloney sarcoma virus genome inhibits its transforming activity. AB - The transforming activity of cloned Moloney sarcoma virus (MSV) proviral DNA was inhibited by in vitro methylation of the DNA at cytosine residues, using HpaII and HhaI methylases before transfection into NIH 3T3 cells. The inhibition of transforming activity due to HpaII methylation was reversed by treatment of the transfected cells with 5-azacytidine, a specific inhibitor of methylation. Analysis of the genomic DNA from the transformed cells which resulted from the transfection of methylated MSV DNA revealed that the integrated MSV proviral DNA was sensitive to HpaII digestion in all cell lines examined, suggesting that loss of methyl groups was necessary for transformation. When cells were infected with Moloney murine leukemia virus at various times after transfection with methylated MSV DNA, the amount of transforming virus produced indicated that the loss of methyl groups occurred within 24 h. Methylation of MSV DNA at HhaI sites was as inhibitory to transforming activity as methylation at HpaII sites. In addition, methylation at both HpaII and HhaI sites did not further reduce the transforming activity of the DNA. These results suggested that; whereas methylation of specific sites on the provirus may not be essential for inhibiting the transforming activity of MSV DNA, methylation of specific regions may be necessary. Thus, by cotransfection of plasmids containing only specific regions of the MSV provirus, it was determined that methylation of the v-mos gene was more inhibitory to transformation than methylation of the viral long terminal repeat. PMID- 6843549 TI - DNA rearrangements and antigenic variation in Trypanosoma equiperdum: multiple expression-linked sites in independent isolates of trypanosomes expressing the same antigen. AB - African trypanosomes resist the immune response of their mammalian hosts by varying the surface glycoprotein which constitutes their antigenic identity. The molecular mechanism of this antigenic variation involves the successive activation of a series of genes which code for different variant surface glycoproteins (VSGs). We have studied the expression of two VSG genes (those of VSG-1 and VSG-28) in Trypanosoma equiperdum, and we report the following findings. (i) The expression of both VSG genes is associated with the duplication and transposition of corresponding basic copy genes. (ii) The duplicated transposed copy appears to be the expressed copy. (iii) Although there are multiple genes which cross-hybridize with the VSG-1 cDNA probe, only one of these appears to be used as a template for the expression-linked copy in four independent BoTat-1 clones. (iv) Analysis of the genomic environments of the expressed VSG-1 genes from each of four independently derived BoTat-1 trypanosome clones revealed that there are at least three different sites into which the expression-linked copy can be inserted. PMID- 6843551 TI - An inhibitor of polyamine synthesis arrests cells at an earlier stage of G1 than does calcium deprivation. AB - Methylglyoxal bis(guanylhydrazone) completely inhibits the induction of thymidine kinase after serum stimulation of quiescent fibroblasts only if added within 3 h after serum, whereas calcium deprivation blocks this induction up to 12 h after serum stimulation. Experiments in which one of these blocks was imposed as the other was released confirmed that cells blocked by methylglyoxal bis(guanylhydrazone) are arrested at an earlier stage in G1 than cells blocked by calcium deprivation. PMID- 6843552 TI - H NMR studies of the Fc region of human IgG1 and IgG3 immunoglobulins: assignment of histidine resonances in the CH3 domain and identification of IgG3 protein carrying G3m(st) allotypes. AB - A 1H NMR study of the Fc region of human IgG1 and IgG3 immunoglobulins is presented. 1H NMR data were collected for the Fc and pFc' fragments obtained from human monoclonal IgG1 and IgG3 and also from rabbit IgG. The C2-H proton signal of His-435 in the CH3 domain of IgG1 was assigned by comparing the spectra of the Fc fragment of IgG1 with that of IgG3 [G3m(g)] where there is a substitution of histidine by arginine at position 435. Chemical shifts and linewidths of the His 435 signal are quite different for the Fc and pFc' fragments. We suggest that His 435 is involved in the interdomain CH2-CH3 contact. Assignments of the C2-H proton signals of His-429 and His-433 in the CH3 domain were made on the basis of our previous 1H NMR results on the human light chain. NMR measurements clearly show that IgG3 Jir, which was isolated from a Japanese patient with cryoglobulinemia, has histidine at position 435 as in the case of IgG1. We also confirmed that IgG3 Jir reacts strongly with protein A. In marked contrast, IgG3 [G3m(g)] does not bind protein A. These results show that binding of protein A to the Fc region is not subclass-specific and the existence of His-435 is a necessary condition for the protein A binding. It has recently been demonstrated that IgG3 proteins carrying G3m(st) allotypes, which are relatively common in Mongoloid populations but quite rare in Caucasians, bind protein A strongly. We confirmed that, as expected, IgG3 Jir carries G3m(st) allotypes. The pH titration curve of His-435 observed for IgG3 Jir is quite different from that for IgG1. This result makes it possible to identify by 1H NMR IgG3 proteins carrying G3m(st) allotypes. In the case of the pFc' fragments, His-435 gives identical titration curves for IgG1 and IgG3 [G3m(st)]. This is consistent with the fact that no serological distinction can be made between the pFc' fragments obtained from these two types of proteins. We suggest that G3m(st)-specific antiserum differentiates IgG1 and IgG3 [G3m(st)] by recognizing the difference in the way in which the CH2 and CH3 domains make contact with each other. PMID- 6843550 TI - Genetic and biochemical distinction among Chinese hamster cell emtA, emtB, and emtC mutants. AB - Genetic and biochemical experiments have enabled us to more clearly distinguish three genetic loci, emtA, emtB, and emtC, all of which can be altered to give rise to resistance to the protein synthesis inhibitor, emetine, in cultured Chinese hamster cells. Genetic experiments have demonstrated that, unlike the emtB locus, neither the emtA locus nor the emtC locus is linked to chromosome 2 in Chinese hamster cells, clearly distinguishing the latter two genes from emtB. emtA mutants can also be distinguished, biochemically, from emtB and emtC mutants based upon different degrees of cross-resistance to another inhibitor of protein synthesis, cryptopleurine. Two-dimensional gel electrophoretic analysis of ribosomal proteins failed to detect any electrophoretic alterations in ribosomal proteins from emtA or emtC mutants that could be correlated with emetine resistance. However, a distinct electrophoretic alteration in ribosomal protein S14 was observed in an emtB mutant. In addition, the parental Chinese hamster peritoneal cell line of an emtC mutant, and the emtC mutant itself, are apparently heterozygous for an electrophoretic alteration in ribosomal protein L9. PMID- 6843553 TI - Affinity analysis of idiotype-positive and idiotype-negative Ars-binding hybridoma proteins and Ars-immune sera. AB - The possibility that idiotype dominance may be associated with increased affinity for hapten was investigated in the murine A/J anti-p-azophenylarsonate (Ars) response. Fluorescence quenching of 14 Ars-binding hybridoma proteins by Ars tyrosine was measured and Ka calculated using computer-assisted curve fitting. There was a 200-fold range in Ka for idiotype-positive hybridoma proteins, with 2 IgM hybridoma proteins being near the median. No clear difference in Ka was apparent between idiotype-positive (Id+) and idiotype-negative (Id-) hybridoma proteins. Ka was measured by fluorescence quenching on affinity-purified anti-Ars antibodies from 6 conventional antisera; there was no difference between Id+ and Id- (idiotype suppressed) sera. The affinities of the hybridoma proteins were correlated with the ratio of binding to Ars36-BSA and Ars10-BSA by direct radioimmunoassay. With this calibration, functional affinities of Ars-immune sera could be determined from relative binding ratios without the need for prior affinity purification. This was done for 18 Ars-immune sera, and again there was no clear difference between Id+ and Id- sera. Studies from this laboratory have identified the amino acid sequence of a hybridoma protein which corresponds to the germ line DNA sequence for the cross-reactive idiotype family. The present study shows that the protein directly encoded by the germ line gene has low affinity for hapten suggesting that somatic diversification operating on the germ line sequence can produce antibodies with increased affinity for hapten within the cross-reactive idiotype family. The present study also suggests that affinity is not the driving force behind idiotype dominance of the Ars-immune response. PMID- 6843555 TI - [Congenital varicella syndrome]. PMID- 6843554 TI - [Screening of newborn infants for hypothyroidism in Berlin (West) 1978-1982]. AB - In July 1978 a neonatal screening program for congenital hypothyroidism was introduced in Berlin (West) covering more than 98% of the neonates born in the city area. Up to July 1982 TSH was determined on the fifth day of life in 74,350 newborns using a radioimmunoassay for TSH determination in dried blood spots. With a cut-off limit at 20 microU/ml, a control examination was necessary in 0.96% of the newborns. 32 infants with congenital hypothyroidism were detected and treated with 1-thyroxine, giving a total incidence of 1 in 2,323 newborns (permanent and transient cases). 63% of all newborns with elevated TSH levels (greater than 20 microU/ml) were born in the obstetric department of the Neukolln Hospital, which uses PVP-Iodine for vaginal disinfection of the mothers during labor and delivery, especially after premature rupture of membranes. Those newborns had only transient TSH-elevations, which were normalized on the tenth day of life. The replacement therapy was started on the average on the ninth day of life. The symptoms present in the newborns with congenital hypothyroidism differed from patient to patient and from the "classical" signs of congenital hypothyroidism described in the literature. All infants detected by the screening program are followed in the outpatient department of the Children's Hospital of the Free University in Berlin and show a normal motor and mental development, except for two infants with other causes for retardation in psychomotor development. PMID- 6843557 TI - [Discussion on otitis media]. PMID- 6843558 TI - [Developing a dose-administration schedule for drug therapy in childhood]. AB - For the application of a target concentration strategy for the assessment of dosage regimens pharmacokinetic parameters and their variances must be known. Since pharmacokinetic parameters like the elimination constant or the volume of distribution undergo considerable changes during the perinatal period until early childhood, the application of standard dosage regimens may lead to serious under- or overtreatment. Based on kinetic data of children from the literature and own studies, it is demonstrated, how changes of the volume of distribution and of the elimination constant influence the optimal dosage regimen. The optimal dosage regimen is evaluated using a special criterion of optimality. PMID- 6843556 TI - [Hemodynamic reactions to intraventricular hemorrhage]. AB - In a 13-year girl with head injury the hemodynamic parameters during 2 episodes of intraventricular hemorrhage were monitored. There were hyperdynamic values for heart rate, Cardiac output, mean arterial and pulmonary artery pressures, systemic vascular and pulmonary vascular resistances. It is likely that centrogenic, sympathico-adrenergic reactions are the cause of pulmonary failure after isolated head injuries. PMID- 6843559 TI - [Pharmacokinetics of drugs from the breast-feeding mother passing into the body of the infant, using theophylline as an example]. AB - In order to find out whether theophylline medication during the lactation period would produce hazards in the suckling infant or not, the following investigations were performed: 1. After oral application of theophylline to 12 nursing mothers the pharmacokinetics of the translactal passage was determined by simultaneous measurements in serum and milk. 2. For predicting the drug uptake by the suckling infant a pharmacokinetic model was designed allowing estimations of drug uptake by the infant on the basis of the kinetics of the translactal passage and the kinetics of the drug in the infant. The following results were obtained: 1. Theophylline passes the blood milk barrier with a certain delay. The time courses of theophylline in the milk thus were depressed when compared to those in the serum. The milk/plasma-quotient varied within a range of 0.6 to 0.89 and was less when maxima of theophylline in plasma were reached. Elimination half-lifes did not differ, but the apparent volume of distribution was greater in milk. This difference showed a good correlation to the divergent areas under the curves for milks and serum concentrations. 2. The kinetic data of the translactal passage of theophylline and the kinetic data of theophylline in infants were fitted into the kinetic model presuming constant dosage intervals as well as constant amounts and intervals of drinking. Theophylline accumulation occurred highly dependent upon the half-life in the infant. This accumulation reached therapeutic levels and even could surpass these when long half-lifes were assumed. For the estimation of drug transfer from breast feeding mothers to their infants via breastmilk, several pharmacokinetic criteria should be considered. PMID- 6843560 TI - [Therapeutic problems with indomethacin in preterm infants with persistent ductus arteriosus]. AB - Inhibition of PGE production in eight preterm infants with persistent ductus arteriosus and respiratory distress syndrome was associated with marked improvement in the respiratory and circulatory function in all of them. However, in six of them this effect was only transient. In the posttreatment period of five and a half days reopening of the ductus arteriosus was frequently associated with increased PGE production and a drop of indomethacin serum levels. Three of these six infants were transferred for surgical ligation and the other three infants were successfully treated with a second course of indomethacin. The margin between closure of the ductus arteriosus and the deterioration of kidney function in preterm infants treated with a presently recommended indomethacin dosage is too narrow. Before an improved therapeutic procedure has been developed indomethacin treatment for the closure of persistent ductus arteriosus should not generally be recommended in preterm infants. PMID- 6843561 TI - [Long-term metabolic control of young diabetics using glycosylated hemoglobin. Total fraction and stable components]. PMID- 6843562 TI - [A 3-component basic diet in the therapy of severe protracted diarrhea]. AB - The protracted diarrhea of young infants with failure to thrive is a clinically defined severe illness. Starting from acute enteritis it will lead to a vicious circle of malnutrition, malabsorption and food intolerance. 17 infants have been treated with a special diet of the three components: 1. oligopeptides (lact albumin enzymatic hydrolysate); 2. long-chain triglycerides; and 3. Maltodextrin 5 (corn hydrolysate). These components are mixed according to the individual clinical state and intestinal tolerance. Trace elements, minerals and vitamins are added. Our diet has proven a great help in reducing and even replacing parenteral nutrition. PMID- 6843563 TI - [Thin layer chromatographic test for the indirect and direct detection of the enzyme defect in histidinemia]. AB - A thin layer chromatographic method for the direct and indirect detection of the enzyme defect in histidineemia is described. Histidin and urocanic acid are analyzed in 0,2-1 mg stratum corneum for specific screening. 5-10 mg skin biopsy material is needed for the direct measurement of the enzyme activity. This simple metabolic test is convenient even in normal hospital laboratories. PMID- 6843564 TI - [Alexithymia. Empirical studies on the diagnosis and therapy of psychosomatic patients]. PMID- 6843565 TI - [Cytochemical detection of nickel in smooth and skeletal muscle]. PMID- 6843567 TI - [Fatal hemorrhage from a leg ulcer caused by varicose veins]. PMID- 6843566 TI - [Morphological evidence of mitochondrial Ca2+ accumulation in the neurohypophysis of rats following stimulation]. PMID- 6843568 TI - [Psychiatric expertise in an action committed during emotional short-circuit]. PMID- 6843570 TI - A comparison of alternative measures of mutagenic potency in the Salmonella (Ames) test. AB - Both the spontaneous and the induced mutation rates in Salmonella tester strains vary among different laboratories, and also within the same laboratory over time. If there is an association between spontaneous and induced mutagenesis, a measure of mutagenic potency that incorporates the background may be more consistent than the simple measure of the induced slope. We have used the statistical procedures recently described by Bernstein et al. (1982), and a large data-base of Salmonella test results to examine the association between spontaneous and induced mutation and to compare several alternative measures of mutagenic potency. A correlation analysis indicated an association between spontaneous and induced mutation for TA98, TA1537 and TA1535; TA1538 was close to being significant. This was observed over a wide range of chemicals. In addition, for TA98, for which we observed the strongest association, we obtained a rough estimate of the relationship between slope and intercept by using least squares to fit K and p in the power curve beta = k alpha p. We then chose 3 simple potency measures: the slope, the ratio of slope to spontaneous background, and the ratio of slope to the square-root of spontaneous background. These corresponded to the range of p's estimated from the least-squares fit procedure. The reproducibility of these measures was compared and no significant differences were found. Though there were some differences in the relative potency ranking of chemicals using the different measures, they were highly correlated. PMID- 6843569 TI - [Unusual stab wounds of the chest]. PMID- 6843571 TI - Implications of an elevated sister-chromatid exchange frequency in rat lymphocytes cultured in the absence of erythrocytes. AB - One important variable in complex culture systems such as whole blood is the interaction of the cell types present. To investigate the effects of erythrocytes (RBCs) and monocytes on the sister-chromatid exchange (SCE) frequency, Ficoll Hypaque-separated Fischer-344 rat leukocytes were added to 1.9 ml of culture medium containing either 4 micrograms phytohemagglutinin or 4-8 micrograms concanavalin A/ml. Bromodeoxyuridine (BrdU;2 microM) was added at 24 h, and the cultures were harvested at 54 or 72 h. SCE frequencies in the mononuclear leukocyte cultures were consistently about 1.5- to 2-fold higher than in the whole-blood cultures. The titration of rat or human RBCs (0.05-2.5 X 10(9)) into purified rat leukocyte cultures reduced the SCE frequency to that of whole-blood cultures. Monocyte depletion decreased the elevated SCE frequency by approximately 50%. Scintillation counting of [14C]BrdU uptake in isolated RBCs revealed that less than 8% of the total amount of BrdU was sequestered. Also, BrdU induced a concentration-dependent increase in SCE in purified leukocytes, but the absolute increase was no greater than in whole-blood lymphocytes. Thus, BrdU had a minor role in the elevated SCE frequency in purified lymphocytes. Neither anti-oxidant enzymes such as catalase and superoxide dismutase nor the hydroxyl radical scavenger, dimethyl sulfoxide, decreased the SCE frequency. Although purified human lymphocytes had a small, but significant increase in SCE compared to whole blood, the magnitude of the dichotomous response between man and rat may represent a fundamental species difference. PMID- 6843574 TI - Regulatory approaches to the control of environmental mutagens and carcinogens. PMID- 6843572 TI - The relationship between sister-chromatid exchange and perturbations in DNA replication in mutant EM9 and normal CHO cells. AB - The majority of the high (12-fold elevated) baseline sister-chromatid exchanges (SCEs) that occur in the CHO mutant line EM9 appear to be a consequence of incorporated BrdUrd, and they arise during replication of DNA containing BrdUrd in a template strand. In normal CHO cells the alkaline elution patterns of DNA newly replicated on a BrdUrd-containing template are significantly altered compared with those seen during the replication on an unsubstituted template. The nascent DNA synthesized on such an altered template is delayed in reaching mature size, possibly because replication forks are temporarily blocked at sites occurring randomly along the template. Transient blockage of replication forks may be a prerequisite for SCE. The delay in replication on BrdUrd-substituted templates was greater in EM9 cells than in parental AA8 cells and was also greater in AA8 cells treated with benzamide, an inhibitor of poly(ADPR) polymerase, than in untreated AA8 cells. Under these conditions, treatment with benzamide also produced a 7-fold increase in SCEs in AA8. An EM9-derived revertant line that has a low baseline SCE frequency showed less delay in replication on BrdUrd-substituted templates than did EM9. However, under conditions where the template strand contained CldUrd, which was shown to produce 4-fold more SCEs than BrdUrd in AA8 cells, the replication delay in AA8 was not any greater in the CldUrd-substituted cells. Thus, other factors besides the delay appear to be involved in the production of SCEs by the template lesions resulting from incorporation of the halogen-substituted pyrimidine molecules. PMID- 6843573 TI - Comparison of kinetics of X-ray-induced cell killing in normal, ataxia telangiectasia and hereditary retinoblastoma fibroblasts. AB - Survival, cumulative labeling indices and chromosomal aberrations were studied in normal, ataxia telangiectasia (AT) and hereditary retinoblastoma fibroblasts after X-irradiation during density-inhibition of growth and immediate release by subculture to low density. The D0 of the survival curves were: normal strains, 150-160 rad; Retinoblastoma strains AG 1880, 95 rad; AG 1978, 40-50 rad (sensitive fraction); AT5BI, 45 rad. Mainly chromosome-type Aberrations were induced in normal and retinoblastoma cells. The frequency of X-ray-induced chromosomal aberrations was much higher in AT5BI cells, and 33-45% were of the chromatid type. Normal and retinoblastoma cells showed a measureable X-ray induced G1 delay before entering S. In addition, a fraction of the cells showed an apparently irreversible G1 block; these cells did not initiate DNA synthesis up to 120 h post-irradiation and subculture. The G1 block was much more marked in retinoblastoma cells; after 400 rad about 70% of retinoblastoma cells did not enter S as compared with only 20% of normal cells. Neither a G1 delay nor a G1 block was observed in AT cells irradiated with up to 400 rad despite their hypersensitivity to cell killing by X-rays and evidence of severe chromosome damage. These results suggest different mechanisms for the X-ray hypersensitivity of AT and retinoblastoma cells. PMID- 6843575 TI - Induction of micronuclei in the mouse. Revised timing of the final stage of erythropoiesis. AB - The early effects of X-rays, vincristine, cyclophosphamide, quinacrine dihydrochloride, cycloheximide, actinomycin D and hydroxyurea on the induction of micronuclei in mouse bone-marrow erythrocytes were studied. A significant increase in the incidence of micronuclei in polychromatic erythrocytes was seen as early as 5 h after a single treatment with vincristine, 6 h after treatment with X-rays and 10 h after treatment with cyclophosphamide. The cell kinetics of the mouse erythropoietic system described by Cole et al. (1981) can be modified to fit these results. According to this revised model, the final mitosis takes place only 5 h before the expulsion of the nucleus. PMID- 6843576 TI - Genotoxicity of cimetidine in primary cultures of rat hepatocytes. AB - The genotoxicity of cimetidine was examined in the hepatocyte primary culture/DNA repair test and by the DNA-damage/alkaline-elution assay. A dose-dependent amount of unscheduled DNA synthesis was elicited by cimetidine, whereas DNA fragmentation occurred only in hepatocytes exposed to the highest (3 mM) concentration of the drug. These findings are in contrast with the negative results previously obtained in long-term and short-term carcinogenesis assays. PMID- 6843578 TI - Inhibition and recovery of DNA synthesis after X-irradiation in radiosensitive mouse-cell mutants. AB - The mouse lymphoma L5178Y cell line and its radiosensitive variants M10 and LX830 were examined for DNA synthesis after X-irradiation. The dose-response curves show that the rates of DNA synthesis immediately after exposure are reduced in a dose-dependent fashion and that the extents of reduction in these 3 cell lines are similar to one another. But a difference was observed in the recovery of DNA synthesis with time of incubation. The recovered levels in M10 and LX830 cells were much higher than those in L5178Y cells at high doses of X-rays. These results are discussed in relation to radioresistant DNA synthesis in ataxia telangiectasia cells. PMID- 6843577 TI - Vegetables inhibit, in vivo, the mutagenicity of nitrite combined with nitrosable compounds. PMID- 6843579 TI - Evaluation of the mutagenic effects of decamethrin: cytogenetic analysis of bone marrow. PMID- 6843580 TI - Effect of ascorbic acid prophylaxis on the frequency of chromosome aberrations in the peripheral lymphocytes of coal-tar workers. AB - The possible anti-mutagenic potential of prophylactically administered ascorbic acid (AA) preparations was studied in a group of 35 coal-tar workers occupationally exposed to PAH and benzene. The effectiveness of AA prophylaxis was assessed by differences in the frequency of chromosome aberrations in peripheral blood lymphocytes of the exposed workers examined before and after a 3 month treatment with AA at the daily doses of 1.0 g for 5 days a week. In the exposed group the cytogenetic analysis of peripheral blood lymphocytes revealed a significant drop in the frequency of aberrant cells (AB.C.) from the initial 5.07% AB.C. (0.0657 B/C, breaks per cell) to 1.77% AB.C. (0.0197 B/C). In a group of matching controls the frequency of AB.C. was 1.50% (0.0170 B/C) and 1.45% (0.0180 B/C), respectively. The study showed that the risk of genetic injury assessed by the frequency of chromosome aberrations in peripheral blood lymphocytes was substantially reduced after AA prophylaxis. PMID- 6843581 TI - Chromosomal aberrations in healthy persons. AB - The frequency of chromosomal aberrations was studied in peripheral blood lymphocytes obtained from 175 healthy individuals of both sexes between 18 and 45 years of age. No aberrations were detected in 113 individuals, but a total of 154 aberrations was found in lymphocytes from 62 persons. The chromosomal aberrations occurred with frequencies between 1 and 6% per cell. These anomalies appeared as 80 chromatid breaks, 62 chromosome fragments and 12 dicentrics, giving an average of 0.88% aberrations per person. This value may be considered as the spontaneous level of aberration frequency in a normal population and may serve as a reference for the evaluation of those occupationally exposed to radiation. PMID- 6843582 TI - Cell kinetics and sister-chromatid-exchange frequency in human lymphocytes. AB - Repeated cultures from 5 healthy donors were set up in 3 tissue-culture media: TC109, TC199 and TC1640. For each donor, 3 blood samples were taken at 1-week intervals, making a total of 5 x 3 x 3 = 45 cultures. Our results show a large variability in the individual SCE base-line frequency. This variability can be partly attributed to the different tissue-culture media or to the donors themselves. Our results, however, stress the importance of the proliferating rate of the culture in determining the SCE frequency. PMID- 6843583 TI - Study of neurotrophism in normal/dystrophic parabiotic mice. AB - The trophic influences of nerve and muscle on one another were studied in normal and dystrophic littermates of C57BL/6J dy2J mice parabiosed at 20 to 23 days after birth. Each parabiont had a soleus muscle cross-reinnervated by a tibial nerve of its partner. Ultrastructural abnormalities of muscle and endplate were quantified and compared 6 to 7 months postoperatively. The dystrophic nerve degenerated despite reinnervation to a normal muscle. The normal muscle did not prevent the dystrophic nerve from degenerating, and the dystrophic nerve induced degenerative changes in the reinnervated normal muscle. Normal nerve did not retard the genetically programmed degeneration of the dystrophic muscle. The dystrophic muscle, however, did not appear to cause normal nerve terminals to degenerate. We conclude that both nerve and muscle cells in dystrophic mice express characteristics of muscular dystrophy. Muscle fibers of a few motor units further suffer from abnormal neurotrophic influence because of the degeneration of the motor neurons. Myotrophic influence on nerve was not observed. PMID- 6843584 TI - Segmental necrosis in tenotomized muscle fibers. PMID- 6843585 TI - Myosin light chains in normal and pathological human skeletal muscles. AB - Thirty-nine human skeletal muscle biopsies from 24 individuals were classified as normal, neuropathic, or myopathic muscle according to classical clinical observations and histopathological properties of the muscles. The content in myosin light chains (LC) of each muscle sample was analyzed by means of a new technique of polyacrylamide gel electrophoresis that gives an improved discrimination, involving isoelectrofocusing of the muscle homogenate for the first dimension and successive migration in a urea-containing gel for the second dimension. Four different LC patterns have been observed in the normal muscles; these four patterns and three different ones have been observed in the pathological muscles. No apparent correlation exists between the myosin LC content and the histochemical fiber typing. It is concluded that the myosin LC are apparently not a useful marker to detect the normality or the pathology of human muscle. PMID- 6843587 TI - Inflammatory infiltration in Fukuyama type congenital muscular dystrophy. PMID- 6843586 TI - High energy phosphate depletion in a model of defective muscle glycolysis. PMID- 6843588 TI - Basement membranes and neuropathy. PMID- 6843589 TI - Kerionlike skin candidiasis on the scalp. PMID- 6843590 TI - Study on equine histoplasmosis "epizootic lymphangitis". PMID- 6843592 TI - Direct microscopy: an adjunct to clinical diagnosis of sloughing corneal ulcers. PMID- 6843593 TI - Comparative analysis of a Trypanosoma brucei gambiense antigen gene family and its potential use in epidemiology of sleeping sickness. PMID- 6843591 TI - Neonatal tinea circinata. PMID- 6843594 TI - Elaboration of mitochondrial function during Trypanosoma brucei differentiation. PMID- 6843595 TI - Higher bioelectric potentials due to decreased chloride absorption in the sweat glands of patients with cystic fibrosis. AB - Patients with cystic fibrosis have characteristic disturbances in the electrolyte composition of their sweat, saliva, and pancreatic secretions. We studied the electrical properties of sweat glands in eight patients with cystic fibrosis and in seven normal volunteers to determine the basis of the well-documented inhibition of sodium absorption in this disease. The average electrical potential across 47 sweat glands in the patients was -66.3 +/- 2.1 mV, as compared with 29.8 +/- 3.2 mV for 39 glands in the normal controls (P less than 0.001). The average sweat-secretion rate in 33 glands from six patients was not significantly different from that in 34 glands from six controls, but average concentrations of sodium, chloride, and potassium were significantly higher in sweat droplets from the patients. Calculated rates of both sodium and chloride reabsorption were lower in sweat glands of patients than of normal controls, but chloride reabsorption was more markedly reduced than sodium reabsorption. We conclude that a decrease in epithelial permeability to chloride may explain the characteristic changes in sweat electrolytes in cystic fibrosis and could be a generalized abnormality in the disease. PMID- 6843596 TI - Who is the primary physician? AB - Several studies have concluded that specialists form a hidden system for primary care delivery. However, these studies assume that a specialist who provides the majority of care is the primary-care physician. Using data for a one-year period from 2752 people enrolled in the Rand Health Insurance Experiment, we examined the validity of this conclusion. We compared the effects of three different definitions of a primary-care physician on identification of the primary-care provider: the physician who delivered the "majority of care" (34 per cent were specialists), the physician designated by the patient to receive the results of a multiphasic-screening examination (12 per cent were specialists), and the physician who treated common problems (9 per cent were specialists). Use of the "majority-of-care" criterion to define primary care overestimated by threefold the contribution specialists make to this activity. Definitions of a primary-care physician must be more specific and should include the tasks frequently associated with primary care, as well as patients' perceptions of the physician who provides their primary care. PMID- 6843597 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 20-1983. Hyperthermia of acute onset in an asplenic man. PMID- 6843598 TI - How reliable are letters? PMID- 6843599 TI - Sounding Boards. Cost containment--imaginary and real. PMID- 6843600 TI - Sounding Boards. Consequences of an oversupply of medical specialists: the case of neurology. PMID- 6843601 TI - Abuse of cimetidine in outpatient practice. PMID- 6843602 TI - Diabetes and bowel habits. PMID- 6843603 TI - Intensity of oral anticoagulation in patients monitored with various thromboplastins. PMID- 6843604 TI - Warfarin resistance caused by broccoli. PMID- 6843606 TI - A medical school curriculum for the 1980s. PMID- 6843605 TI - Whole-blood manganese as an indicator of body manganese. PMID- 6843607 TI - Should letters be reviewed? PMID- 6843608 TI - Shattuck lecture--the increasing supply of physicians, the changing structure of the health-services system, and the future practice of medicine. PMID- 6843609 TI - Human cryptosporidiosis in immunocompetent and immunodeficient persons. Studies of an outbreak and experimental transmission. AB - Infection with cryptosporidium occurred in 12 immunocompetent persons who had direct contact with the feces of infected calves during three unrelated outbreaks of calf cryptosporidiosis. Nine of the twelve subjects had diarrhea and abdominal cramps that lasted 1 to 10 days. Infections were diagnosed and monitored by detection of oocysts in feces, with a modified Sheather's flotation technique and phase-contrast microscopy. Oocysts of cryptosporidium were isolated from calves but not from other animals with which these subjects had been in contact. Oocysts of cryptosporidium were also detected during repeated examinations of feces from two immunodeficient patients with persistent cryptosporidiosis. An apparently identical infection was transmitted to calves and mice, using oocysts from infected calves and human beings. Oocysts from an immunodeficient person also produced infections in kittens, puppies, and goats. This study shows that cryptosporidium may produce a moderate self-limited illness in immunocompetent persons, which contrasts sharply with the prolonged severe diarrhea in immunocompromised patients who contract cryptosporidiosis. Calves with diarrhea should be considered a potential source of human infection, and immunocompromised persons should avoid contact with such animals. PMID- 6843610 TI - Perturbation of sodium-lithium countertransport in red cells. AB - The rate of sodium-lithium countertransport in red cells is thought to be determined by inheritance and to be constant over years in a given person. We have found that the rate is influenced acutely by ultrafiltration and by hemodialysis. In seven patients with endstage renal disease secondary to essential hypertension, the mean rate of sodium-lithium countertransport (+/- S.E.M.) was reduced from 0.18 +/- 0.02 to 0.09 +/- 0.01 mmol per liter of cells per hour (P less than 0.02) by ultrafiltration and from 0.22 +/- 0.03 to 0.12 +/- 0.03 mmol per liter per hour (P less than 0.001) by hemodialysis. When patients' red cells obtained before dialysis were incubated with plasma obtained afterward, the rate of countertransport fell, and when red cells obtained after dialysis were incubated with plasma obtained beforehand, the rate returned to normal. Whereas the rate in red cells from normal subjects was reduced after incubation in post-dialysis plasma from patients, predialysis plasma from the same patients had no such effect. We conclude that the rate of the countertransport system of red cells is dependent on a dialyzable plasma factor. PMID- 6843611 TI - Illness and invulnerability. PMID- 6843612 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological Exercises. Case 21-1983. A 4 9/12-year-old girl with sexual precocity. PMID- 6843613 TI - Emerging zoonoses. PMID- 6843614 TI - A crisis in medical education. The high cost of student financial assistance. PMID- 6843615 TI - Lung-cancer deaths: equality by 2000? PMID- 6843616 TI - Risk factors for infection after hysterectomy. PMID- 6843617 TI - Noninvasive evaluation of heart murmurs in children. PMID- 6843618 TI - Optic neuritis and multiple sclerosis. PMID- 6843619 TI - Correlation of pathological findings with computed tomographic findings after acute carbon monoxide poisoning. PMID- 6843620 TI - Aerosol treatment of bronchoconstriction in children, with or without a tube spacer. AB - To assess whether an extension tube between the aerosol source and the patient improves drug-inhalation therapy in children with acute bronchoconstriction, we treated 20 children under double-blind conditions with placebo or terbutaline delivered by a conventional aerosol or an aerosol with a tube spacer. Both terbutaline treatments resulted in a significant increase in forced expiratory volume in one second, as compared with placebo (P less than 0.001), but treatment with the tube-spacer aerosol produced significantly more improvement than did treatment with the conventional aerosol (P less than 0.01). The number of errors in inhalation technique was reduced when the spacer aerosol was used, and this reduction may account for the greater improvement in the children treated with the spacer. PMID- 6843621 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 22-1983. A 12-year-old boy with renal failure, abdominal pain, and a petechial skin rash. PMID- 6843622 TI - Cimetidine works for gastric ulcer, and more. PMID- 6843623 TI - Estrogen excretion and plasma levels in vegetarian and omnivorous women. PMID- 6843624 TI - Arsenic, chromium, and copper poisoning from burning treated wood. PMID- 6843625 TI - Exacerbation of SLE associated with alfalfa ingestion. PMID- 6843626 TI - Phosphaturic response to parathyroid hormone. PMID- 6843627 TI - More "goggle headache": supraorbital neuralgia. PMID- 6843628 TI - Problems in epidemiologic research. PMID- 6843629 TI - Academic medical centers and HMOs. PMID- 6843630 TI - Can physicians guarantee their treatments? PMID- 6843631 TI - Prediction of awakening after out-of-hospital cardiac arrest. AB - To develop a model that would forecast neurologic recovery after out-of-hospital cardiac arrest, we reviewed charts on 389 consecutive patients who were not awake on admission to the hospital after resuscitation from asystole or ventricular fibrillation. The outcome variable was "awakening," which was defined as having comprehensible speech or the ability to follow commands. Predictor variables that we considered included both preadmission and admission data. Using discriminant analysis, we derived models from a 60 per cent random sample of cases and tested the models on the remaining 40 per cent. We judged that the best model contained four variables from the admission examination: motor response, pupillary light response, spontaneous eye movements, and blood glucose (levels below 300 mg per deciliter predicted awakening). Overall correct classification was 80 per cent in the derivation sample and 77 per cent in the test sample. In a simplified form, the model's predictions of awakening had a sensitivity of 0.92, a specificity of 0.65, a positive predictive value of 0.80, and a negative predictive value of 0.84. This rule should be clinically useful in estimating the neurologic prognosis of patients resuscitated after out-of-hospital cardiac arrest. PMID- 6843632 TI - Protection against cholera in breast-fed children by antibodies in breast milk. AB - We performed a prospective study to examine whether the IgA antibodies against cholera that are present in breast milk protect breast-fed infants and children against colonization with Vibrio cholerae 01 and disease. Among families of patients with cholera, we collected breast milk from mothers who had not had diarrhea in the previous week and monitored them and their breast-fed children for cholera colonization and diarrhea for 10 days. Breast milk was assayed for IgA antibodies to cholera toxin and lipopolysaccharide. Ninety-three mother- child pairs were studied; 30 infants became colonized with V. cholerae 01 and disease developed in 19. There were no differences between the antibody levels in milk fed to children who became colonized and in milk fed to children who did not. However, among the children who became colonized, those who had diarrhea drank breast milk containing significantly lower levels of both kinds of cholera antibodies than were present in the milk consumed by children who had no symptoms. We conclude that breast-milk antibodies against cholera do not appear to protect children from colonization with V. cholerae 01 but do protect against disease in those who are colonized. PMID- 6843634 TI - Lessons from the Darsee affair. PMID- 6843633 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 23-1983. Parkinsonism associated with other neurologic manifestations. PMID- 6843635 TI - Acquired immunodeficiency in Haitians. PMID- 6843636 TI - Carotid bruit and risk of stroke in elective surgery. PMID- 6843638 TI - Chelation therapy for transfusion-dependent adults. PMID- 6843637 TI - Leukemia after treatment of ovarian cancer with alkylating agents. PMID- 6843639 TI - Dilantin and the fragile X syndrome. PMID- 6843640 TI - Physician's role in health promotion. PMID- 6843641 TI - Spanish oil deaths. Toxin is elusive. PMID- 6843642 TI - Data falsification trial: drug testing lab was "shambles". PMID- 6843643 TI - Laboratory safety: bending rules to aid research. PMID- 6843644 TI - Cancer research: support for charity sustained. PMID- 6843645 TI - Human embryo experiments: societies urge a softer line. PMID- 6843647 TI - No need for panic about AIDS. Acquired immune deficiency disease, now frequent among male homosexuals in the United States, is not this century's black death. The most urgent need is to understand what is going on. PMID- 6843646 TI - UK universities. New blood posts make bad blood. PMID- 6843648 TI - Protein kinase, phospholipid and control of growth. PMID- 6843649 TI - Plants that kill snails and prospects for disease control. PMID- 6843650 TI - Melatonin as a seasonal time-cue: a commercial story. PMID- 6843652 TI - Predicted nucleotide-binding properties of p21 protein and its cancer-associated variant. AB - Recently, it has been demonstrated that a single point mutation is responsible for the acquisition of transforming properties by the EJ and T24 human bladder carcinoma gene. The point mutation consists of the conversion of guanine into thymine, which results in the replacement of a glycine by a valine at position 12 of the p21 protein encoded by the EJ and T24 genes. Sequence data of retroviral analogues of the p21 protein also indicate the importance for a glycine residue at position 12 in normal p21. Comparison of the sequence of the 37 N-terminal residues of the normal human p21 protein with the sequence of the dinucleotide binding beta alpha beta unit in a group of structurally related enzymes, suggests that these residues of p21 fold into a very similar unit which is also involved in binding a nucleotide. We present here a three-dimensional model of the p21 beta alpha beta unit which explains directly why glycine at position 12 cannot be replaced by another residue without altering the nucleotide-binding properties of p21. PMID- 6843651 TI - Dispersion of the ras family of transforming genes to four different chromosomes in man. PMID- 6843653 TI - On attributing consciousness to animals. PMID- 6843654 TI - Neuraminidase of influenza virus reveals a flower-like head. PMID- 6843655 TI - A new member of the ras family. PMID- 6843656 TI - Relationships of filaments. PMID- 6843657 TI - Is yellow rain simply bees' natural excreta? PMID- 6843658 TI - Structure of the influenza virus glycoprotein antigen neuraminidase at 2.9 A resolution. AB - The influenza virus neuraminidase glycoprotein is a tetramer with a box-shaped head, 100 X 100 X 60 A, attached to a slender stalk. The three-dimensional structure of neuraminidase heads shows that each monomer is composed of six topologically identical beta-sheets arranged in a propeller formation. The tetrameric enzyme has circular 4-fold symmetry stabilized in part by metal ions bound on the symmetry axis. Sugar residues are attached to four of the five potential glycosylation sequences, and in one case contribute to the interaction between subunits in the tetramer. PMID- 6843659 TI - Inhibition of axonal growth by a monoclonal antibody. AB - Little is known about factors which control the outgrowth of neurites in the central nervous system (CNS) during development, although in vitro studies with neurones from the peripheral nervous system have shown that neurites require an appropriate substrate and specific factors for growth. To investigate the role of cell-surface components in the development of the CNS, we have raised a series of monoclonal antibodies against membrane components of cells from the visual system of the chick embryo. We report here that one of these antibodies, T61/3/12, clearly inhibits axonal outgrowth from chick retinal explants but does not affect axon growth from the peripheral nervous system. PMID- 6843660 TI - Assignment of the gene for human melanoma-associated antigen p97 to chromosome 3. AB - p97 is a 97,000 molecular weight cell-surface glycoprotein, which is present in human melanomas but in only trace amounts in normal adult tissues. Amino acid sequence and iron binding studies have shown that p97 is structurally and functionally related to transferrin. Reports that the genes for the transferrin receptor (TR) and possibly transferrin are located on chromosome 3 prompted us to investigate the chromosomal localization of the p97 gene. Our strategy was to characterize interspecies somatic cell hybrids derived from human fibroblasts or lymphocytes for expression of p97 and presence of human chromosomes. Although fibroblasts and lymphocytes express only small amounts of p97, we were able to type the hybrids for p97 by using monoclonal antibodies in highly sensitive and specific immunoassays. Of 14 hybrids, 6 contained chromosome 3 and expressed p97, and 8 were negative for both. We conclude that the p97 gene, like the transferrin and TR genes, is located on chromosome 3. PMID- 6843661 TI - Mouse skin carcinomas induced in vivo by chemical carcinogens have a transforming Harvey-ras oncogene. AB - Several groups have shown that the malignant phenotype can be transferred to NIH/3T3 fibroblasts by incorporation of DNA isolated from tumour cell lines. These studies have demonstrated that the transforming activity of DNA isolated from human bladder, lung and colon carcinoma cell lines is related to an alteration of the cellular homologues of the ras genes of Harvey or Kirsten murine sarcoma viruses. It is, however, unclear what relevance these observations have to the multi-stage nature of tumorigenesis in vivo, in which several independent events are required in both humans and experimental animals. The activation of a cellular oncogene in a defined experimental system for the progressive induction of solid tumours has not yet been demonstrated. We report here that high molecular weight DNA from transplanted squamous cell carcinomas induced by sequential treatment of mouse skin with initiators and promoters of carcinogenesis causes morphological transformation of NIH/3T3 fibroblasts at high frequency. The transforming properties are due to the transfer of an activated cellular homologue of the Harvey-ras (rasH) oncogene. PMID- 6843662 TI - Mapping of an endogenous retroviral sequence to human chromosome 18. AB - The application of recombinant DNA technologies has allowed the detection of at least three families of moderately repetitive DNA segments in the human genome that are homologous to retroviruses previously isolated from mice and primates. One of these DNA segments has been shown by nucleotide sequence comparisons to be distantly related to both Moloney murine leukaemia virus (MoMuLV) and the endogenous baboon retrovirus and to have the sequence organization characteristic of an integrated retrovirus. Isolation of the homologous locus from chimpanzee DNA indicated that the integration event preceded the evolutionary divergence of chimpanzees and man. Here we have used a panel of rodent x human somatic cell hybrids to assign the chromosomal localization of this segment, called ERV1 (endogenous retrovirus-1), to human chromosome 18 (HSA 18). PMID- 6843663 TI - Structure of trimeric haemerythrin. AB - Several simplifying structural principles have been developed from the considerable data contained in the three-dimensional structures of proteins determined in the past two decades. One of these is based on the observation that particular folding motifs often occur in a variety of structural and functional settings. The compact bundle of four antiparallel alpha-helices, first seen in the structure of myohaemerythrin, is an example. Several non-haemerythrin proteins have since been found to have the same folding pattern, and haemerythrins themselves exist in a wide variety of quaternary arrangements. The unusual ability of the haemerythrin fold to associate as dimers, trimers, tetramers, octamers or higher aggregates provides an opportunity for examining structural diversity in subunit association. We have used X-ray crystallography to study the subunit structure of trimeric haemerythrin from a Siphonosoma species. We report here that the pattern of intersubunit helix-helix interactions differs from the most common mode of association of other helix-bundle proteins. In a novel approach to structure analysis at low resolution, experimental phases for the structure determination were based on anomalous scattering from the iron atoms native to haemerythrin, using the new resolved-anomalous phasing procedure. PMID- 6843664 TI - Success breeds more problems. PMID- 6843665 TI - Muscle crossbridges in disarray. PMID- 6843666 TI - Small-angle X-ray scattering from myosin heads in relaxed and rigor frog skeletal muscles. AB - Low-angle X-ray diffraction patterns from relaxed and non-overlap rigor muscles show a central region of diffuse scattering (disk) which is circularly symmetrical, behaves as solution scattering and comes predominantly from myosin heads. In full-overlap rigor the disk is compressed in the diagonal direction, indicating that the myosin heads have a bent shape and a preferred orientation consistent with a 45 degree angle of attachment to actin. PMID- 6843667 TI - Gene deletions in patients with haemophilia B and anti-factor IX antibodies. AB - Christmas disease, or haemophilia B, is an inherited X-linked haemorrhagic disease which at present occurs in 798 known cases in the United Kingdom, corresponding to a frequency of about 1 in 30,000 males. Patients are deficient in the intrinsic clotting factor IX and are treated by replacement of this protein prepared from pooled plasma obtained from normal individuals. Occasionally treatment is complicated by the appearance of specific anti-factor IX antibodies. It seemed to us that this might be due to the absence of 'self' factor IX causing the immune system to regard the infused normal factor IX as foreign. The absence of all or part of the factor IX gene was an obvious possible reason for this, which we have now tested using our previously isolated gene probe. We have found four patients with gross gene defects. PMID- 6843669 TI - Antics of the elusive trypanosome. PMID- 6843668 TI - True identity of a diffraction pattern attributed to valyl tRNA. PMID- 6843670 TI - Two signals to shape a slime mould. PMID- 6843671 TI - Visual processing in the leech central nervous system. AB - In animals with complex visual systems spatial contrast is enhanced by mutual inhibition between retinal neurones monitoring different fields. By analogy, if animals like leeches and some caterpillars, that have several simple (non-image forming) eyes aimed in different directions, are capable of rudimentary form detection, one might predict mutual antagonism between eyes monitoring different fields. In support of this prediction, I report here a paired interneurone in the central nervous system (CNS) of the leech which is stimulated by eyes on one side of the animal and inhibited by eyes on the other. There are striking parallels between these neurones and other integrating neurones, in particular those processing bilateral auditory input in crickets, suggesting that the visual system of the leech may be representative of a general class of sensory processing systems. PMID- 6843672 TI - A possible morphogen controlling differentiation in Dictyostelium. AB - The complex morphology of a higher organism is generated partly by such developmental processes as cell movement and cohesion but also by a social interaction between cells in small areas of embryonic tissue known as morphogenetic fields. The initially similar cells within such a field organize themselves and differentiate, forming a discrete spatial pattern which is remarkably independent of field size and which can regenerate after some part is removed. Although it is believed that a cell signalling system must underlie this behaviour, the putative signals--or morphogens--have so far proved elusive. Perhaps the simplest known morphogenetic field arises within the multicellular aggregate formed by developing cells of the slime mould Dictyostelium discoideum. As the amorphous aggregate transforms into a cylindrical slug, a simple pattern emerges, with prestalk cells differentiating in the anterior and prespores in the posterior. One great difficulty in identifying any morphogen has been to predict properties that could form the basis of a bioassay. However, in Dictyostelium it is almost essential that the morphogens should dictate to cells their choice of differentiation pathway. We have described previously a crude factor termed DIF which stimulates the differentiation of isolated amoebae into stalk cells. We now show that purified DIF also inhibits spore formation and so switches cells to stalk cell formation. Thus, we believe that DIF is a morphogen which regulates the choice of differentiation pathway of cells in the Dictyostelium slug. PMID- 6843673 TI - Intracellular pH and the control of cell differentiation in Dictyostelium discoideum. AB - During development in the cellular slime mould Dictyostelium discoideum starved amoebae aggregate to form multicellular structures that display a simple antero posterior pattern: prestalk cells occupy the front 20% of the aggregate, and prespore cells occupy the remainder. We have attempted to elucidate the nature of the mechanism regulating the proportions of the two cell types by examining the factors that influence the pathway of differentiation of amoebae in vitro. Amoebae of D. discoideum strain V12 M2 form stalk cells efficiently in appropriate conditions and 'sporogenous' derivatives produce spores as well as stalk cells. Mature spores are formed in a medium containing only cyclic AMP and salts, whereas formation of stalk cells requires, in addition, a low molecular weight hydrophobic factor (DIF). Recent observations have led us to propose that DIF is a morphogen responsible for activating stalk cell differentiation. Here we present evidence that ammonia is a second morphogen, that acts antagonistically to DIF, and that the choice of differentiation pathway is mediated by intracellular pH. PMID- 6843675 TI - [Virus-induced liver diseases in humans. II. Infectious jaundice - viral hepatitis]. PMID- 6843674 TI - [Age dependent changes in organs and the significance for drug therapy]. PMID- 6843676 TI - Patients mount an autoimmune response to their bladder cancer-associated t antigen. PMID- 6843677 TI - Glutathione inhibits the alkylation of liver dna by n-nitrosodimethylamine. PMID- 6843679 TI - Vibrational sensitivity in the pigeon as measured by heart-rate conditioning. PMID- 6843678 TI - Brains burning fat: different forms of energy metabolism in the CNS of insects. PMID- 6843680 TI - [Initial activity and voluntary behavior in animals]. AB - Initiation as a basic property of behavioral activity is functionally analyzed and discussed at the level of voluntary behavior. Fixed action patterns often are not released by stimuli but are generated by the animal itself through brain processes of the Darwinian type. Analogous to mutations, behavioral "subroutines" are brought up by chance and are subjected to selection either by the change in the situation (trial and the elimination of error) or by mental activity suppressing inappropriate behavior even before it is executed. Initiation improves the chance of survival. It is a prerequisite of goal-oriented behavior, an essential constituent of operant conditioning and presumably the first step in the evolution of thought. According to I. Kant a person is free if, by following his own directive, he does what has to be done. This definition meets the two central criteria of initiation: the independence of releasing stimuli and the adaptive value of the behavior generated. PMID- 6843681 TI - [Virus-induced liver diseases in man. III. Chronic hepatitis]. PMID- 6843682 TI - Poly-ADP-ribosylation is not required for excision of a DNA damage. PMID- 6843683 TI - Carcinogenic activity of N-nitrosodiethylamine in snakes. PMID- 6843684 TI - Effects on rats of aqueous extracts of plants used in folk medicine as antihypertensive agents. PMID- 6843685 TI - Establishment and passage of human malignant thyroid tumour xenografts in athymic nude mice. PMID- 6843686 TI - Murine lymphoma cells possess blood group Tn-, T-, N-, M- and S-active substances. PMID- 6843687 TI - Autoradiographic study of rat hearts perfused with 3H-isoprenaline. AB - Bonisch et al. (1974) identified kinetically two extraneuronal compartments into which 3H-isoprenaline distributes in the perfused rat heart: compartment III (characterized by a half time for the efflux of 3H-isoprenaline of about 10 min) had about the same size as compartment IV (half time for efflux: 23 min). These authors suggested that compartment III might be located in the vascular smooth muscle, while compartment IV might be located in myocardial cells. The present study was carried out to validate or refute this suggestion. Rat hearts were perfused for 5, 20 or 60 min with 1 mumol/l 3H-isoprenaline; additional hearts were perfused with 1 mumol/l 3H-isoprenaline for 30 min in the presence of either 20 mumol/l corticosterone or 20 mumol/l corticosterone plus 30 mumol/l cocaine. COMT was inhibited in all experiments (by the presence of 100 mumol/l U-0521). Quantitative autoradiography revealed in all groups that the silver grain density (grains/mm2) was greater over small blood vessels (arterioles and venules) than over myocardial cells. However, total silver grains over myocardial cells greatly exceeded those over small blood vessels (by a factor of 6 to 9). Thus, the suggestion of Bonisch et al. (1974) is untenable. Autoradiographic results obtained with small specimens of ventricular muscle are representative of the whole heart, since "silver grains over total tissue" (per mm2) were highly significantly correlated with the 3H-isoprenaline content of the homogenized hearts (in pmol/g). While corticosterone reduced the accumulation of 3H isoprenaline in myocardial cells, it failed to affect the appearance of silver grains over Purkinje cells. However, cocaine prevented this type of accumulation. Thus, uptake in Purkinje cells appears to resemble neuronal rather than extraneuronal uptake. PMID- 6843689 TI - Enhancement by Ca2+ ions of cholinergic effects on the canine heart in situ. AB - The effects of Ca2+ ions were studied on the canine heart in situ, submitted to vagal influence or not. In addition to heart rate, conduction time was determined separately in atrial muscle, atrioventricular node and His-Purkinje system by means of His bundle potential recording and the effective refractory period (ERP) measured in atrioventricular node, atrial and ventricular muscle according to the extrastimulus method. In the presence of acetylcholine (ACh) released by vagal endings, an increase in plasma calcium concentration from 2.40 to 4.12 mmol/l, acutely induced by the infusion of calcium chloride, elicits the following alterations: slowing down of sinus rate, lengthening of conduction time in atrioventricular node without change of this time in atrial muscle and His Purkinje system, prolongation of atrioventricular node ERP, but notable decrease of atrial muscle ERP and slight decrease of ventricular muscle ERP. These effects are similar to those of ACh:Ca2+ ions probably enhance the responsiveness to ACh. PMID- 6843688 TI - Mode of action of gamma-butyrolactone on the central cholinergic system. AB - Gamma-butylactone (GBL), a drug depressing the central nervous system, produced marked increases in acetylcholine contents in rat brain hemispheric regions (striatum, hippocampus, cortex) and in striatal choline content without modifying choline acetyltransferase or acetylcholinesterase activities. In the hippocampus GBL also strongly decreased the acetylcholine turnover rate and inhibited the high affinity uptake of choline. Its increase in acetylcholine content was prevented by an acute electrolytic lesion of the medial septum but not by a wide array of drug treatments designed to interfere with neurotransmission in various pathways. The results are taken to indicate that GBL directly depresses the cholinergic septal-hippocampal afferents by interrupting impulse flow. In the striatum, too, GBL markedly depressed the acetylcholine synthesis rate but had no effect on the high affinity choline uptake process. Such dissociation of the two phenomena had previously been observed using other drugs and may denote that acetylcholine synthesis in this region is regulated differently from that in the hippocampus. By comparison, gamma-hydroxybutyric acid (GHBA), an active metabolite which shares with GBL the capacity to produce a somnolent state and depress impulse flow in the dopaminergic nigroneostriatal pathway, had no effect on either striatal acetylcholine content or on hippocampal high affinity choline uptake. The results suggest that GBL can be distinguished from GHBA in its neuropharmacological central cholinergic effects. PMID- 6843690 TI - A comparative study of the properties of the catechol-O-methyltransferase inhibitors, U-0521 and tropolone acetamide, in rat perfused heart. PMID- 6843694 TI - [A vomiting neonate]. PMID- 6843693 TI - Inhibition of dopamine synthesis in striatal synaptosomes by lisuride: stereospecific reversal by (-)-sulpiride. AB - Lisuride, an ergot D2 dopamine receptor agonist inhibited dopamine synthesis in striatal synaptosomes concentration-dependently. Significant inhibition was detected at 10(-8) M, and the inhibition by 10(-4) M lisuride was 50%. The inhibitory effect of lisuride was reversed by more than 50% not only by the D1-D2 dopamine receptor blocker haloperidol but also by the D2 dopamine receptor blocker(-)-sulpiride. The effect of sulpiride was stereospecific. Under the same test conditions a similar inhibition of dopamine synthesis by apomorphine was reversed by the neuroleptics almost completely. The results suggest that there are dopamine autoreceptors controlling dopamine synthesis in synaptosomes and these receptors resemble D2 dopamine receptors according to the nomenclature of Kebabian and Calne (1979). PMID- 6843692 TI - The effect of prostaglandin E2 on histamine-stimulated calcium mobilization as a possible explanation for histamine tachyphylaxis in canine tracheal smooth muscle. AB - Isolated strips of canine tracheal smooth muscle rapidly lost their responsiveness to histamine when placed in a zero calcium Krebs buffer. Responsiveness to acetylcholine, however, was not rapidly lost, and following 120 min of incubation in zero calcium buffer with frequent washes, 10% of the contractile response still remained. The kinetics of each loss of response suggest that primarily a loosely bound source of calcium is mobilized by histamine and a more tightly bound source is mobilized by acetylcholine. Consistent with these data were the effects of the calcium antagonist verapamil. In normal calcium Krebs solution, dose-response curves to histamine were markedly reduced by verapamil while acetylcholine responses were relatively unaffected. In calcium depleted tracheal strips, indomethacin potentiated the calcium dose response curve, determined by incremental readdition of calcium in the presence of histamine (10(-4) M), with comparatively little effect on the calcium dose response curve in the presence of acetylcholine (10(-6) M). Also, in indomethacin pretreated tracheal strips, a reduction in the histamine-calcium dose-response curve could be produced by exogenous addition of 2.8 X 10(-9) M and 2.8 X 10(-8) M PGE2. In the acetylcholine-calcium responses there was a significant reduction only at 2.8 X 10(-8) M PGE2. These data suggest that histamine mobilizes primarily a loosely bound, possibly extracellular source of calcium necessary for contraction, and this histamine-stimulated calcium mobilization is sensitive to the effects of PGE2. PMID- 6843695 TI - [Reconstruction of the anterior cruciate ligament]. PMID- 6843691 TI - Interaction between calcium and slow channel blocking drugs on atrial rate. AB - The relationship between extracellular calcium concentration and the chronotropic effect of prenylamine, verapamil and nifedipine was studied in isolated spontaneously beating rat atria. The three slow channel blocking drugs produced a concentration-dependent decrease in atrial rate, though with different relative potencies. The order of potency for decreasing atrial rate, independently of the calcium level (1.0, 3.0, 6.0 or 9.0 mmol/l) was: verapamil greater than nifedipine greater than prenylamine. Increasing calcium from 1.0 to 6.0 and 9.0 mmol/l increased atrial rate from 251 +/- beats . min-1 to 265 +/- 6 beats . min 1 and 285 +/- 9 beats . min-1 (mean +/- 1 standard error) respectively (P less than 0.05). Despite their positive chronotropic effect high calcium levels failed to reverse the negative chronotropic effect of the slow channel blockers. Furthermore, the negative chronotropic effect of both verapamil and nifedipine was enhanced at high calcium levels. Raising calcium from 1.0 to 6.0 mmol/l in the presence of verapamil (1 X 10(-7) mol/l) or nifedipine (3 X 10(-7) mol/l) increased 2-fold the negative chronotropic effect of the calcium channel blockers. In addition, the concentration-effect curves for verapamil and nifedipine shifted to the left by 0.50 +/- 0.14 and 0.50 +/- 0.16 log units, respectively, when calcium increased from 1.0 to 6.0 mmol/l. The data show that increasing calcium may produce positive or negative chronotropic effects depending on whether or not the calcium channels are blocked. This paradoxical effect of calcium ions can be produced either by opposite chronotropic effects on automatic cells or by shifting the pacemaker activity to a group of cells which respond in a different way to an increment of calcium. PMID- 6843696 TI - [Diagnosis of hyper- and hypothyroidism in patients using amiodarone]. PMID- 6843697 TI - [A vesicovaginal fistula, a rare complication of a bladder stone]. PMID- 6843698 TI - [Bone scintigraphy, an expensive affair!]. PMID- 6843699 TI - [A vaginally delivered dicephalus; an obstetrical, pediatric and anatomical report]. PMID- 6843700 TI - [Influenza in the winter of 1982-1983, caused by the A-H3N2 virus]. PMID- 6843701 TI - [Necrotizing enteritis, a forgotten illness]. PMID- 6843702 TI - [ECG monitoring via telephone for the assessment of patients with symptoms suggestive of arrhythmias]. PMID- 6843703 TI - [Follow-up study after surgery of colon or rectum carcinoma]. PMID- 6843704 TI - [The sensitivity, specificity and predictive value of diagnostic tests]. PMID- 6843705 TI - What's wrong with competition? PMID- 6843706 TI - Colostomy--there are alternatives. PMID- 6843707 TI - The Fetal Hydantoin Syndrome: a case report and review. PMID- 6843708 TI - Nebraska SIDS survivors: impressions of the response system. PMID- 6843709 TI - Persistent fetal circulation: current concepts. PMID- 6843710 TI - Intermittent self-catheterization: a revolutionary breakthrough. PMID- 6843711 TI - Diagnosis of deep venous thrombosis by phleborheographic evaluation. PMID- 6843712 TI - Nebraska Tumor Registry. PMID- 6843713 TI - Trauma: life threatening, life changing. PMID- 6843714 TI - Simple isolated fracture of the ulna. PMID- 6843715 TI - The stasis and flow of behavior: toward a theory of goals. PMID- 6843716 TI - Interactionism: a personality model, but not yet a theory. AB - Four basic personality models (trait psychology, psychodynamics, situationism, and interactionism) were summarized. Special emphasis was given to interactional psychology as a model of personality theory and research. This was done in the context of controversial personality issues such as consistency versus specificity, mediating versus reaction variables, and so forth. Dynamic versus mechanistic interaction was discussed, and the role of situations in personality research and theory was presented. The interaction model of personality was described, and empirical support for the model with respect to anxiety was provided. Some suggested methodologies and strategies for examining interactionism were discussed, and directions for future research were indicated. Finally, the limitations of interactionism were presented, and we indicated that while interactionism is a model of personality, it is not yet a coherent personality theory. PMID- 6843717 TI - Toward a response style theory of persons in situations. PMID- 6843718 TI - A socioanalytic theory of personality. PMID- 6843719 TI - A research paradigm for the study of personality and emotions. PMID- 6843720 TI - Natural cell-mediated cytotoxicity in Ehrlich ascites tumor-bearing mice. AB - The level of NCMC (natural cell-mediated cytotoxicity) in the spleen of Ehrlich ascites tumor-bearing mice at every 5 days after i. p. tumor transplantation, and the effect of cell-free ascitic fluid or serum of tumor bearers on natural cytotoxicity in vitro, were assessed. Spleen lymphocytes were used as effectors and 51Cr-labeled YAC1 cells as targets at the effector: target ratio of 200 : 1. In tumor bearers, the NCMC increased in the first days after i. p. inoculation of 1 X 10(6) Ehrlich cells with a maximum peak on day 5. Thereafter, the activity decreased continuously, on day 20 representing about half of normal value. Ascitic fluid and serum of tumor bearing mice significantly depressed the NCMC activity exerted in vitro by spleen lymphocytes of normal mice. PMID- 6843721 TI - Evaluation of the LAI test in patients with benign and malignant breast diseases. AB - Tumor "specific" immune recognition was assayed in 125 patients with various breast diseases including breast cancer of clinical stage I and II, 22 patients with other malignancies and 64 healthy persons employing leukocyte adherence inhibition test (LAI). In the group of breast cancer patients (BC) there were 81% of positive responders (52/65) with a mean nonadherence index (NAI) value 67.4. Sensitization to extract derived from breast cancer was detected in 38.3% (23/60) of patients with benign breast diseases (BBD). The mean NAI value was significantly lower comparing to NAI value of BC patients (34.8 vs. 67.4) but exceeded the upper limit of normal values. The most frequent positive responders of BBD group were found in patients with proliferative mastopathy (11/17). Our study brought further evidence that BC patients and in a lesser degree BBD patients are sensitized to some antigen(s) contained in selected breast tumor extracts. However, high proportion of false positive results in healthy persons (14.1%) and mainly considerable number of positive responders in BBD patients represent a major limitation for clinical diagnostic usefulness of the LAI assay. PMID- 6843722 TI - Haptoglobin types in ovarian tumors. AB - Haptoglobin types were determined in 132 patients with cancer of ovaries and 114 patients with nonmalignant tumors of the ovaries, respectively. In comparison with a normal population significant increase in the frequency of Hp1 gene in the both pathological groups was observed. It was mostly reflected in a lower occurrence of haptoglobin type 2-2. PMID- 6843723 TI - Large granular lymphocytes in blood of healthy donors and patients with tumors. AB - The percentage of large granular lymphocytes (LGL) in the peripheral blood of patients with less advanced tumors (T1 and T2) averaged 2.15 +/- 1.3 as compared with 3.8 +/- 1.5 in patients with more progressive tumors (T3 and T4) and with metastases. The values of LGL remained constant as long as 6 weeks both in the diseased and healthy subjects and were not age- nor sex-related. This observation confirms the usefulness and reliability of the test as one of the markers of the immunologic state since LGL are considered to represent NK cells responsible for resistance to malignant growth. PMID- 6843724 TI - [Psychopathometric procedures: II. Standardized assessment procedures]. PMID- 6843725 TI - [Some theoretical approaches to depersonalization]. PMID- 6843726 TI - [The criteria list as screening instrument for the detection of chronic suicidal tendency]. PMID- 6843727 TI - [Sect affiliation, conformity instinct, limits of anti-authoritarian rearing]. PMID- 6843728 TI - [Preventive neurology]. PMID- 6843729 TI - [Astroglial dystrophy with Rosenthal fibers. On the adult form of Alexander disease and its clinical significance]. PMID- 6843730 TI - [Acute life-threatening polyneuritis]. PMID- 6843731 TI - [Moyamoya syndrome. Case contribution on the disease picture of progressive cerebrovascular occlusion]. PMID- 6843732 TI - [Differential diagnosis of Winiwarter-Buerger thromboangiitis obliterans]. PMID- 6843733 TI - [Myositis ossificans following craniocerebral trauma]. PMID- 6843734 TI - [Expressed emotion and the induction of schizophrenic episodes: review of the literature]. PMID- 6843735 TI - [Basic disorders. A revision with structure-dynamic measures]. PMID- 6843736 TI - [Residual apathy syndrome of the schizophrenic patient. Results of a long-term psychopathologic study]. PMID- 6843738 TI - [Psychotherapy of schizophrenics as a meeting ground for psychoanalysis- existential analysis convergence]. PMID- 6843737 TI - [Family experiences with schizophrenia: possibilities for modification]. PMID- 6843739 TI - Bone marrow disorders in Hodgkin's disease: cyclic pancytopenia coinciding with Pel-Ebstein fever. PMID- 6843740 TI - Effect of naloxone on shock in a patient with fulminant hepatic failure. PMID- 6843741 TI - Coeliac disease and ulcerative colitis; a diagnostic pitfall. PMID- 6843742 TI - Cushing's syndrome due to an adrenal adenoma with paradoxical response to dexamethasone. PMID- 6843743 TI - Association between hydrocarbon exposure and glomerulonephritis. An appraisal of the evidence. PMID- 6843744 TI - Potassium in whole body, skeletal muscle and erythrocytes in chronic renal failure. PMID- 6843745 TI - Psychological effects of exercise training in hemodialysis patients. AB - To assess the psychological effects of exercise training in hemodialysis patients 4 dialysis patients, matched by age, sex, and medical history with 4 controls, received psychological testing before and after a 6-month period of exercise training. The trained patients had a 28% improvement in graded exercise treadmill stress test duration and a 13% improvement in aerobic capacity. This was associated with a significant reduction in anxiety and depression (p less than 0.06), but no measurable change in these moods occurred in the control groups. These results suggest that exercise training may improve psychological functioning in dialysis patients. PMID- 6843746 TI - Effect of dialysate sodium concentration on the appearance of ischemic EKG patterns. AB - This study was undertaken to evaluate the effect of increasing the dialysate sodium concentration on myocardial ischemia assessed by EKGs taken immediately before and after dialysis in 43 hemodialysis patients. An increase in the R wave (V5 + V6) by more than 5 mm was seen in 26 patients with standard sodium dialysate, while only 12 cases showed the same changes after a high sodium dialysis. These was a positive correlation between an increase in R wave amplitude and the weight loss/dry weight ratio of patients only after standard sodium dialysis (r = 0.74, p less than 0.001). Relative high sodium dialysate is beneficial during dialysis and reduce the incidence of myocardial ischemia and unpleasant disequilibrium syndrome. PMID- 6843747 TI - Hepatitis B virus: a possible cause of serositis in hemodialysis patients. AB - An epidemiologic survey in a maintenance hemodialysis population of 300 patients was undertaken to relate the appearance of acute serositis (pericarditis, pleuritis or ascites) to HBsAg antigenemia. A significant number of incidents of serositis occurred in patients acutely or chronically infected with hepatitis B surface antigen (HBsAg) suggesting an etiologic role for the virus in the serositis of uremia. In 2 patients with both end-stage renal disease and chronic HBsAg antigenemia, immunofluorescent studies of serosal tissues showed fluorescent clusters interpreted to be HBs antigen-antibody complexes. It is concluded that an immunologic response to viremia may be one of the causes of serositis in uremia. PMID- 6843748 TI - Renal cysts in pediatric autopsy material. AB - In a series of 6,521 consecutive autopsies of infants and children, renal cysts were found in 136 cases (2%). Of these, 71 were females and 65 males; 103 patients had died in their first month of life. The different types of cystic disease represented were as follows: renal cystic dysplasia 65, cortical cysts in syndromes of multiple malformations 42, polycystic disease 16, simple cortical cysts 7, renal cysts in hereditary syndromes 3, and renal medullary cystic disorders 3. Extrarenal malformations were encountered in 102 of the 136 cases with renal cysts. Gastrointestinal malformations and in particular esophageal atresia very often appeared to be associated with renal disease. Esophageal atresia was found in 29 (21%) cases, 20 in cases with renal cystic dysplasia and 9 in cases with cortical cysts in syndromes of multiple malformations. The possibility of renal cystic disease should therefore be kept in mind in infants with congenital malformation(s), especially those with esophageal atresia. PMID- 6843749 TI - Effects of administration of cationic and native homologous albumin on the kidney. AB - Different doses of anionic and cationic albumin (CA) were administered intravenously to 29 normal unanesthetized female rats. Administration of 20 and 30 mg of CA produced an increase in urinary excretion of endogenous albumin. Urinary CA levels in the urine samples collected during the first 60 min after injection of 30 mg of CA were higher than anionic albumin levels. A marked increase in the number of endocytic vacuoles, large numbers of images suggesting fusion of vacuoles with lysosomes, extrusion of cell elements into the tubular lumen and tubule rupture were observed in the animals injected with CA. These results show that CA may produce changes in proteinuria and in renal structure. PMID- 6843751 TI - Urine osmolarity and the excretion of prostaglandin E2 in man. PMID- 6843750 TI - The effect of phlebotomy on renal function and proteinuria in a patient with congenital cyanotic heart disease. PMID- 6843752 TI - The role of secondary hyperparathyroidism in the anemia of chronic renal failure. PMID- 6843753 TI - Medium-sized peptides in the blood of patients with uremia. AB - We have carried out high performance liquid chromatographic analysis of serum and ultrafiltrate of blood obtained from uremic patients and normal subjects to elucidate the presence of medium-sized peptides unique to uremia. Many fluorescamine-positive substances, excluding amino acids and guanidine compounds, were increased in uremic serum compared with normal serum. At the 0.5-1.0 pmol/ml serum level, several peaks were unique to uremia. The retention time, fluorescamine reactivity, molecular weight distribution and the result of enzymatic digestion revealed that these peaks are peptidic substances. PMID- 6843754 TI - Amino acid administration enhances renal protein metabolism after acute tubular necrosis. AB - The capacity of exogenous amino acids to alter renal protein metabolism was studied during renal regeneration after mercuric chloride-induced acute tubular necrosis in the rat. In regenerating cortical tissue, the free leucine concentration was 17% lower than normal, and was decreased further after glucose infusion. The concentration was raised above normal by amino acid infusion thereby ameliorating the deficit of this amino acid. Synthesis and degradation of rapidly-turning over proteins in renal cortical cells was examined in vitro. Renal protein synthesis in cortical slices was assessed by measurements of tissue leucine specific radioactivity and cycloheximide-inhibitable [14C]leucine incorporation into protein. Protein synthesis in regenerating tissue was 52% higher than normal and was not increased further by glucose infusion. In contrast, amino acid infusion increased the rate 47% above that observed after an isocaloric glucose infusion, thereby demonstrating that amino acid enhancement of protein synthesis is superimposed upon the increased synthetic rate observed during renal regeneration. Renal protein degradation remained at the normal rate after amino acid infusion, but was increased in regenerating tissue and after glucose infusion. These results indicate that infused amino acids act on the kidney to enhance protein synthesis and reduce protein degradation in regenerating renal cells after acute tubular necrosis. PMID- 6843756 TI - Influence of inhibitor of glucose utilization on the blood platelet function. AB - The inhibition of glycolysis by an inhibitor of glucose utilization isolated from urine of the uremic subjects reflects in: (1) decreased platelet aggregation induced by adenosine diphosphate, adrenaline, or collagen, respectively; (2) decreased platelet factor 4 release induced by the same inductors; (3) decreased availability of platelet factor 3, and (4) inhibition of retraction of reptilase clot. It is concluded that the inhibition of glycolysis by 'inhibitor of glucose utilization' contributes to the functional changes of platelets and thus to the alteration of hemostasis in uremic patients. PMID- 6843757 TI - Increased uptake of cholesterol and increased mineral content in the aorta of long-term uremic rabbits. AB - Chronic renal failure was induced in rabbits by cauterization of one kidney and subsequent contralateral nephrectomy. After 3 and 8 months duration of uremia the 24-hour accumulation rate of radioactive cholesterol into the intima-media part of the thoracic aorta was measured. A significant higher uptake rate was found only in the 8 months uremic rabbits. In these rabbits macroscopic changes of the thoracic aorta were noted with dilatation, increased wall thickness and calcifications. In the 3 months uremic rabbits no morphological changes were seen. In the 8 months group of uremic rabbits the aortic concentration of calcium, phosphate and magnesium was 20-fold increased. In the 3 months group of uremic rabbits only the aortic calcium concentration was significantly increased. In none of the groups was the aortic cholesterol concentration increased. In rabbits long-term uremia induced aortic calcifications and an increased uptake rate of labelled plasma cholesterol but no net cholesterol accumulation could be demonstrated. PMID- 6843755 TI - Immunologic patterns in hemodialysis patients with and without HBV infection. AB - 66 patients from 5 dialysis centers were surveyed for the prevalence of HBV markers. Their immune status was evaluated by studying parameters of cellular and humoral immunity. Results showed that all patients had depressed T cell numbers while B cell counts, IgG, IgA, IgM, IgD and C3 levels were normal. However, the group of patients who had persistent HBs antigenemia also had persistence of HBeAg, negative responsiveness to skin testing and high IgE levels. The group with HBsAb had negative reactions for skin testing, and the group with no HBV markers had no further abnormalities. These results suggest that the presence and type of HBV marker influences the immune pattern in the hemodialyzed patient. PMID- 6843759 TI - [Form and measurements of the third ventricle, visual pathway sections and oculomotor nerve]. PMID- 6843758 TI - Hypercalcemia and nephrolithiasis provoked by serum phosphorus reduction in a patient with chronic renal failure and sarcoidosis. AB - A patient with sarcoidosis and chronic renal failure was treated for hyperphosphatemia with aluminum hydroxide. The subsequent fall in serum phosphorus was followed by the development of hypercalcemia and nephrolithiasis. Corticosteroid therapy normalized the serum calcium and halted the progression of the nephrolithiasis, but did not improve renal function. Hyperphosphatemia may have blocked the expression of sarcoid hypercalcemia in the patient. The mechanism is unclear but inhibition of the synthesis or action of 1,25 dihydroxyvitamin D may have been involved. Reduction of serum phosphorus may lead to severe hypercalcemia in some patients with sarcoidosis. PMID- 6843760 TI - [Results of microsurgical lumbar intervertebral disk operation. Preliminary report]. AB - Since the end of 1977 we have introduced the microsurgical discectomy according to the technique of Caspar. The results of 150 consecutive patients have been analysed. The preliminary results of these patients will be presented. The microsurgical and conventional technique were evaluated and compared concerning the size of the operation, complications, recurrent herniations and the outcome. In 84% of our patients a selective monosegmental approach could be performed. A hemilaminectomy was necessary only in 1.3% of the patients. In 96% the discectomy could be restricted to one level. Thus, traumatisation of back musculature and bone resection was markedly less than with the conventional technique. The frequency of complications with the microsurgical technique was significantly lower. The frequency of repeat operation (arachnitis, true repeat herniation) did not differ essentially. Concerning the outcome of operation the results of the microsurgical technique seems to be more favourable. The frequency of bad results did not differ. PMID- 6843761 TI - [Carotid aneurysm with intracerebral hematoma]. AB - The rare intracerebral bleeding type among the aneurysms of the internal carotid artery occurs only in case of certain anatomical relations between the thin walled part of the aneurysm and the cerebrum. Based on our observations, we differentiate between three types which are mainly determined by the intensity of the extravasation: 1. The acute form with decompensated intracerebral haematoma (possibly with ventricular haemorrhage). 2. The subacute form with intracerebral haematoma, the space-occupying growth of which, however, is still compensated for by central mechanisms. 3. The chronic form with small intermittent extravasations resulting in an enlargement of the aneurysm by thrombotic deposition. In intracerebral haematomas originating from cerebrovascular aneurysms, the haematoma will usually result in an aneurysm. The carotid aneurysm is an exception, since the aneurysm will be first, followed by the haematoma. A highly differentiated therapeutic approach must consider the different courses taken by the intracerebral haematomas, as shown in this article. It will have to be decided from case to case which approach is best, e.g. acute intervention or intensive medical attention to severe disease patterns before appropriate operation, or purely symptomatic conservative treatment. PMID- 6843762 TI - [Acute kidney failure: age is not a factor in the prognosis]. AB - The mortality of acute renal failure (ARF) remains distressingly high despite intensive dialysis and remarkable advances in critical care medicine. This lack of survival improvement may be due to an increased frequency of septic ARF and/or the association with multiple organ dysfunction. The role of age, as a factor indicative of a poor prognosis is a matter of controversy. To evaluate this role we have analysed the final outcome of 103 patients with ARF treated between october 1978 and february 1982 by one or more hemodialysis. The average age was 65.1 +/- 14.9 years (mean +/- standard deviation): 64 patients were over 65 years of age (74.7 +/- 10.2), 39 were under this age (47.5 +/- 14.4). Septic causes were found in 64 cases. Sixty eight patients (66%) died during the period of ARF. Mortality was 67% in patients under 65 years of age and 66% in patients over this age (p greater than 0.90). The outcome of septic ARF was independent of age (mortality rate: 79% for patients less than 65 years, 81% for patients greater than 65 years (p greater than 0.90)). The poor prognosis is probably related to multiple organ dysfunction and specially to acute respiratory distress (89% mortality). It can be concluded that patient's age does not worsen the prognosis of ARF. PMID- 6843763 TI - [Advantage of a high-sodium hemodialysis solution: theoretical bases]. AB - In hemodialysis, an excessive oversimplification leads to confuse the transfer direction of a given solute (patient towards dialysate or dialysate towards patient) and the direction of transmembranar concentration gradient. Applied to sodium, this confusion leads to the usual iso- or hypotonic dialysate use, in order to eliminate the patient's sodium overload. We show here how the use of a high sodium dialysate allows the elimination of the sodium overload and makes the free water clearance (approached by the Na-free water clearance) positive, which is the necessary condition to restore an hydro-electrolytic equilibrium near from the normal. That allows a disappearance of hypovolemic symptoms during hemodialysis, a better general condition and a possible increase of water intake between sessions. PMID- 6843764 TI - [Peritonitis during continuous ambulatory peritoneal dialysis. Lavage treatment or not? A prospective study]. AB - A prospective study. To evaluate the advantages of continuous peritoneal lavage in treating peritonitis occurring during continuous ambulatory peritoneal dialysis a prospective study was planned in one Center during a 5 months period. 32 cases of peritonitis divided in two groups were treated according to 2 different protocols, one with continuous peritoneal lavage, the other one with the standard dialysis technique using the bags. Intraperitoneal administration of antibiotics was similar in both groups. Results show no significant advantages in using peritoneal lavage. Continuous lavage should be restricted to cases whose treatment is started late as well as those with purulent dialysate and fungi infections. PMID- 6843765 TI - [Operative technique of lumber disc herniation in conjunction with surgical anatomy]. PMID- 6843766 TI - [Ultrastructure of human oligodendroglioma]. AB - Ten cases of human oligodendroglioma were examined with electron microscope. The materials were specimens derived through surgical operations. Results were as follow. The shape of tumor cells are various, round, oval, polygonal and irregular. The majority of tumor cells have round or ovoid nuclei, some have irregular nuclei or nuclear indentation. Chromatin distributions tend to clump. In the cytoplasm, there are commonly ribosomes, rough surfaced endoplasmic reticulums, mitochondria, microtubules and lysosome. Glial filament is rare or almost absent. Crystalline structures are seen in 3 cases. Cellular junctions, though immature, are seen in 4 cases. Perinuclear halo in the light microscopy was explained to be a fixation artifact in 10% formol. The samples, which were fixed in 2.5% cold glutaraldehyde and post-fixed in 1% osmium tetraoxide, did not show perinclear halo under the light and electron microscope. The specimen, which were fixed in 10% formol, were examined with electron microscope. Plasma membrane of the tumor cell was partly destroyed, intracytoplasmic organelles and matrix were also broken, and the cytoplasm was empty. It is confirmed in this study that empty cytoplasm represents the peculiar perinuclear halo in the light microscopy. PMID- 6843767 TI - [Disappearance of enhancement of brain tumor in contrast CT scan after excessively high dosage of dexamethasone--suggestive indication of steroid administration by CT scan]. PMID- 6843768 TI - [Case of cervical myelopathy due to calcified mass in the cervical yellow ligament]. PMID- 6843769 TI - [Intracranial giant osteochondroma with unusual clinical features]. AB - A case of giant osteochondroma arising from the paramedian skull basis was reported because of unsual clinical features in cranial nerve involvement and pyramidal tract signs, and especially because of sudden death due to intracranial hemorrhage. The patient was a 24-year-old male, who had been followed for over 3 years and 9 months, and received two operations because of bilateral extension of the tumor. During follow-up he had experienced frequent euphoric spells untill mental deterioration became evident. Then he went suddenly into deep coma and intracranial hemorrhage was found with CT scan. Hemorrhage was probably attributed to the marked stretching of cerebral arteries around tumor, although autopsy could not confirm the source of hemorrhage. Neurological characteristics of a giant osteochondroma arising from the skull basis were described in comparison with over skull basis tumor such as chordoma, and special reference was made for CT scan diagnosis. PMID- 6843770 TI - [Metastasizing malignant meningioma: a case report--histopathological observation]. PMID- 6843771 TI - [Computed tomographic metrizamide myelography in Chiari malformation in adult- special reference to the diagnostic values of reconstruction CT]. AB - Three adult patients with a clinical diagnosis of Chiari malformation were examined by computed tomography after intrathecal injection of metrizamide via the lumbar route. In all patients Chiari malformation was demonstrated as a soft tissue oval mass at the level of C1-C2 vertebral body that was intradural and posterior to the medulla and the upper cervical spinal cord. These findings were more accurately visualized in saggital and in frontal reconstructed CTs. In one patient the spinal cord was measurably enlarged at the upper thoracic level. A delayed scan was obtained in another case at 24 hours after the injection and the syrinx was remained opacified whereas the density of cerebrospinal fluid and parenchyma decreased. In the third patient no abnormality of the cord was demonstrated either in CT or myelography. High resolution CT, especially reconstruction-CT appears to be more reliable than myelography and should be the examination of choice in the diagnosis of Chiari malformation. PMID- 6843772 TI - [Meningioma with extracranial multiple metastases--a case report]. AB - A case of meningioma with extracranial multiple metastases is reported in this paper. The patient was a 21 years old woman. The removal of the convexity meningioma and the surrounding intracerebral hematoma in the left occipital region was performed. The histological diagnosis of the tumor was malignant fibroblastic meningioma. The patient was given radiotherapy, 6000 rads in the whole brain. Two years later, the recurrence occurred. The metastasis appeared to the lung and six months later to the liver. There occurred an intraperitoneal bleeding from multiple liver metastases and the patient died in November, 1980. The mode and site of the metastases have been discussed with a review of the literature. PMID- 6843773 TI - [Cotton fiber cerebral emboli following carotid angiography--a case report]. PMID- 6843774 TI - Structural change in muscles of the dystrophic chicken. I. Quantitative indices. AB - The pectoral and posterior latissimus dorsi (PLD) muscles in the dystrophic chicken show many pathological changes. At 7 weeks of age, in a strain of these birds bred for early onset of this inherited disorder, physical weakness is established and these changes can be clearly assessed. Quantitative indices of these progressive changes were obtained by light and electron microscopic analyses; these indices cover fibre hypertrophy, fibre area variation, nuclei distribution, phagocytosis and satellite cell and fibroblast populations. The dystrophic pectoral muscle at 7 weeks is more severely affected than the PLD. In the former, there is an increase of peripheral myonuclei per fibre cross-section of over 200%, a hypertrophy factor nearly 200-fold greater than normal and longitudinal fibre splitting in 11% of the fibres. Many foci of degeneration are also present at this early stage. Although regenerating fibres are uncommon, an increased satellite cell population is observed. These indices provide a basis for assessing the effects of in vivo drug treatments, at the level of muscle structure. PMID- 6843775 TI - Early changes in the rat hippocampus following seizures induced by bicuculline or L-allylglycine: a light and electron microscope study. AB - Status epilepticus was induced in thirteen paralysed and ventilated rats by the injection of either bicuculline or L-allylglycine. After 1-2 h of seizure activity the animals were intracardially perfused with a 2% glutaraldehyde/3% paraformaldehyde solution. Hippocampal blocks from each rat were processed for light and electron microscopy. The effects of L-allylglycine were more severe than those of bicuculline. Changes include perivascular and perineuronal swelling of astrocytic processes, and neuronal alterations which were graded as follows: Grade I (least severe), neuronal cytoplasm appears slightly darker than usual; Grade II, condensed or dark neurons, usually with microvacuoles; and Grade III classical 'ischaemic cell change'--the cytoplasm and karyoplasm is dark and shrunken, with or without microvacuoles. Many of the microvacuoles originate from mitochondria. In a few cases swollen and disrupted mitochondria are also seen is distended basal dendrites of the CA3 and CA1 pyramidal neurons. Dentate granule cells appear unaffected. The hippocampal neuronal alterations induced by seizure activity include those of 'ischaemic cell change'. The pathogenetic factors common to hypoxia/ischaemia and status epilepticus remain to be identified. PMID- 6843776 TI - The effect of ethanol on the cellular composition of the cerebellum. AB - Pregnant Wistar rats were fed on a diet of food pellets and a 10% (v/v) solution of ethanol in water during pregnancy and up to 21 days postnatally. Control groups were given food pellets and water ad libitum. Areal analysis of the cerebellum of neonates showed a significant reduction of 9.7% to 12.4% in three selected lobules of the mid-sagittal vermis. Although there were no significant decreases in the linear frequency and absolute number of Purkinje cells, all three lobules showed a small percentage decrease in the length of Purkinje cell layer. The total number of granule cells was significantly reduced in all three lobules, and the ratio of granule cells to Purkinje cells was reduced by between 8.6% and 13.6%, although not significantly. The pyknotic index in the external granular layer (but not in the internal granular layer) and significantly increased at 21 days, while mitotic activity was unchanged. The extent of the diminution in the cell number of the internal granular layer suggests that besides increased cell death there may be a disturbance of cell proliferation kinetics in the precursor pool of the external granular layer. Although it is known that high blood levels can cause death of Purkinje cells, the moderate alcohol blood levels attained in this study were insufficient to do so. PMID- 6843777 TI - Crystalline aggregates of protein-glycogen complexes (alias 'virus-like particles') in skeletal muscle: report of a case and review of the literature. AB - Crystalline arrays of so-called 'virus-like particles' were found in post-mortem samples of skeletal muscle obtained from an 11-month-old female infant. In a large number of skeletal muscle fibres crystalline inclusions were abundant, variously configurated and positively stained with a cytochemical method for polysaccharides. A battery of enzymatic tests, including some with diastase and alpha-amylase, was, however, entirely noncontributory. A muscle biopsy studied 5 months before death had disclosed no crystalline inclusions of any kind. The literature concerning similar cases of 'virus-like particles', crystalline glycogen aggregates or protein-glycogen complexes in muscle is reviewed. Possible reasons underlying the aggregation of protein-glycogen complexes into crystalline arrays are discussed. PMID- 6843778 TI - Non-anesthetic steroids ameliorate the high pressure neurological syndrome in rats. AB - The hypothesis that non-anaesthetic compounds, structurally related to specific anaesthetics, can protect against the high pressure neurological syndrome was tested. Infusion of two structural analogues of alphaxalone (3 alpha-hydroxy-5 alpha pregnane-11,20 dione) during pressurisation of rats with helium and oxygen gas mixtures (total pressure 80-100 ATA; inspired oxygen partial pressure 0.5 ATA) ameliorated the severe tremors associated with the high pressure neurological syndrome without any shift in tremor frequency (11-14 Hz). The steroid analogues which were selected (delta 16 and 3 beta-hydroxy-alphaxalone) have no known general anaesthetic effects and present an unexpected structural approach to the pharmacology of the syndrome. It may now be possible to investigate, treat or prevent the syndrome by the use of selective drugs without more generalised anaesthetic effects. PMID- 6843779 TI - Angiotensin-induced drinking and the effect of bilateral nephrectomy. AB - The induction of drinking by the intraventricular administration of angiotensin II has been attributed to a specific interaction with receptors in the medial preoptic-anterior hypothalamic border. These studies have been pharmacological in nature, involving exogenous peptide. In experiments reported elsewhere the present authors have shown that nephrectomy resulted in a regionally selective increase in levels of brain angiotensinogen, the putative prohormone of any CNS angiotensin peptides. Nephrectomy also markedly perturbs fluid and ion homeostasis. A study was therefore made of the effect of bilateral nephrectomy on spontaneous and angiotensin-induced drinking behavior. A deficit in spontaneous drinking following nephrectomy was observed, but it was noted that this related directly to diminished food intake. Angiotensin II-induced drinking was markedly potentiated following nephrectomy, indicative of possible up-regulation of angiotensin receptors in selected regions of the rat brain. The results are consistent with a physiological role for angiotensin in regulating fluid intake and volume homeostasis. PMID- 6843780 TI - Actions of morphine and met-enkephalin-amide on nociceptor driven neurones in substantia gelatinosa and deeper dorsal horn. AB - Simultaneous recordings of responses of substantia gelatinosa and deep dorsal horn neurones to thermal noxious cutaneous stimulation were made in spinalized cats anaesthetized with urethane/chloralose. Morphine, whether applied iontophoretically in the substantia gelatinosa (50-200 nA) or injected intravenously (1.0-1.5 mg/kg), enhanced the responses of the substantia gelatinosa cells while depressing those of deep cells. Met-enkephalin-amide (50 200 nA) also had similar reciprocal actions. Naloxone counteracted these effects of the agonists. The results support our previous proposal that the opiates facilitate the activity of a substantia gelatinosa system that controls the responses of deep dorsal horn neurones to pain. PMID- 6843781 TI - Differences in the regulatory adaptation of the 5HT recognition sites labelled by 3H-mianserin or 3H-ketanserin. AB - In crude synaptic membranes prepared from rat brain the sites occupied by 3H spiroperidol that are displaced by microM concentrations of serotonin (5HT) have been termed 5HT2 receptors (Peroutka and Snyder, 1980). Since the 3H-spiroperidol displaced by 5HT is also displaced very effectively (IC50 in the nM range) by ketanserin and mianserin it was suggested that spiroperidol, mianserin and ketanserin are labelling 5HT2 receptors. Data are presented showing that the 3H ketanserin and 3H-mianserin bound to crude synaptic membrane in the presence of a H1 receptor blocker are not labelling the same recognition site. Hence from this standpoint the recognition site marked by 3H-mianserin and 3H-ketanserin is not identical. The possibility that allosteric effects are operative in some of these ligand displacements should be entertained. PMID- 6843783 TI - Ascorbic acid and the binding of DA agonists to neostriatal membrane preparations. AB - A considerable controversy exists over whether ascorbic acid should or should not be used in experiments in which the binding of DA agonists to neostriatal membrane preparations is being determined. Some authors claim that its presence is required. In the present study we have determined that sodium ascorbate was a very potent inhibitor of the specific binding of 3H-DA to a rat neostriatal membrane preparation. Under conditions of these binding experiments, there was no decomposition of the 3H-DA as determined by two separate techniques. These data would seem to suggest that when 3H-DA binding is being measured, ascorbate addition is detrimental. PMID- 6843782 TI - Effects of naloxone and its quarternary analogue on stimulation-induced feeding. AB - Feeding was induced in rats by electrical stimulation in the lateral hypothalamus. Naloxone (0.2 and 1.0 mg/kg) produced a dose-related elevation of the frequency threshold for stimulation-induced feeding while quarternary naloxone (2.0 and 10.0 mg/kg) had no effect. Since quarternary naloxone does not readily penetrate the blood-brain barrier, we conclude that the opiate receptors at which naloxone exerts its anorectic action are located in the brain rather than in potential peripheral tissues such as gastrointestinal tract, pancreas or adrenal medulla. The threshold-elevating effect of naloxone only became marked after rats had engaged in one or two 5-sec bouts of feeding. The effect continued to increase following each subsequent bout of feeding. Naloxone therefore appears to inhibit feeding by interacting with post-ingestive factors. PMID- 6843785 TI - Antagonism of the excitatory effects of 5-hydroxytryptamine on sympathetic preganglionic neurones and neurones activated by visceral afferents. AB - The responses of electrophysiologically identified sympathetic preganglionic neurones (SPGN) and interneurones activated by sympathetic visceral afferents (VA), to iontophoretic application of 5-hydroxytryptamine (serotonin) and serotonin receptor antagonists: methysergide and cinanserin, were tested in the T3 segment of the spinal cord of the cat. Serotonin had a definite and dose dependent excitatory action on sympathetic preganglionic neurones and neurones activated by visceral afferents. This excitatory response to serotonin was characterized by the rapid development of tachyphylaxis. Methysergide antagonized the effects of serotonin in preganglionic neurones and neurones activated by visceral afferents. Cinanserin was less effective than methysergide. Preliminary data on the effect of inhibitors of serotonin uptake: chloroimipramine and fluoxetine are also reported. These findings support the idea that the sympathetic output and the activity of neurones activated by sympathetic viscero afferents is modulated by an excitatory serotoninergic supraspinal input. PMID- 6843784 TI - Anticonvulsant activity of the glial-selective GABA uptake inhibitor, THPO. AB - The intramuscular administration of 4,5,6,7-tetrahydroisoxazolo [4,5-c] pyridin-3 ol (THPO) delayed the onset of isonicotinic acid hydrazide-induced seizures in very young chicks but not in adult mice, the difference being due to the state of development of the blood-brain-barrier which controls access of the drug to the brain tissue. THPO was also effective in preventing seizures induced in epileptic chicks by intermittent photic stimulation. The anticonvulsant action after combined administration of THPO and gabaculine, an inhibitor of GABA-alpha oxoglutarate aminotransferase activity, was no greater than the anticonvulsant action of gabaculine alone. PMID- 6843786 TI - The effect of some decarboxylase inhibitors on striatal tyramines in the mouse. AB - The administration of carbidopa (5-50 mg/kg), a peripheral L-aromatic aminoacid decarboxylase inhibitor, significantly increased striatal tyramines; maximal effects were observed at 2-4 hr after treatment. Benserazide produced similar effects. The drug, NSD 1034, that inhibits both central and peripheral decarboxylase, produced a dose-dependent reduction in striatal p-tyramine; in contrast, concentrations of m-tyramine were increased by the smaller doses (2-20 mg/kg) and reduced by the larger dose (400 mg/kg). The results support the view that the tyramines are formed within the brain by decarboxylation of their parent aminoacids but by different mechanisms. PMID- 6843787 TI - Sex-linked and other genetic factors in the development of tolerance to the anticholinesterase, DFP. AB - Development of tolerance to the effects of the anticholinesterase, di isopropylfluorophosphonate (DFP), on core body temperature, a simple operant drinking response, and an operant fixed ratio lever-press response has been studied in the males and females of the S14 and S15 generations of two lines of rats genetically selected for their differences in sensitivity to DFP. For temperature measurement, males and females of the Flinders-resistant line (R line) developed tolerance quicker than did the males and females of the Flinders sensitive line (S-line). For the operant drinking response, females of both lines were tolerant after the third injection, while resistant males were tolerant only after the seventh injection and sensitive males were not completely tolerant at the conclusion of the experiment. For the operant fixed ratio lever-press responding all groups were tolerant after the second injection. These findings indicate that the development of tolerance to DFP can be influenced by the genetic background, the sex of the organism and the nature of the behaviour being measured, suggesting that several mechanisms may underlie development of tolerance to this agent. PMID- 6843788 TI - Discriminative stimulus properties of a small dose of cocaine. AB - This study characterized the interoceptive discriminative stimulus (IDS) produced by a small dose of cocaine. Rats were trained to use a dose of cocaine of 1.25 mg/kg vs saline as the basis for choosing one of two levers for food reinforcement on a fixed ratio 10 schedule. The discrimination was acquired over approx. 60 training sessions. d-Amphetamine generalized to cocaine with approximately equal potency (ED50's for cocaine and d-amphetamine were 0.07 and 0.06 mg/kg, respectively); 20 mg/kg cocaine and 10 mg/kg methylphenidate also generalized to the cocaine lever. Pentylenetetrazol, 20 mg/kg, did not generalize to the cocaine lever, and diazepam, 10 mg/kg, did not block the 1.25 mg/kg cocaine discrimination. These data indicate that when a small dose of cocaine is used as the basis of discrimination training, the discriminative stimulus that it produces is qualitatively and quantitatively similar to that produced by small doses of amphetamine, is still discriminated with a large dose of cocaine, and is dissimilar to the discriminative stimulus produced by pentylenetetrazol. PMID- 6843789 TI - Metabolism of [3H]dopamine following intracerebroventricular injection in rats pretreated with ethanol or chloral hydrate. AB - The metabolism of [3H]dopamine injected into the lateral cerebroventricles, was studied in rats after treatment with either ethanol or chloral hydrate. The experimental system was designed primarily to detect the possible conversion of dopamine to the tetrahydroisoquinoline derivatives, tetrahydropapaveroline, salsolinol and O-methylsalsolinol. With or without pretreatment with ethanol or chloral hydrate, no conversion of [3H]dopamine to [3H]tetrahydroisoquinolines was detected. The limits of detection per rat brain were: tetrahydropapaveroline less than 1.6 X 10(-14) moles (0.00032% conversion), salsolinol less than 1.6 X 10( 13) moles (0.00032% conversion), and 6- and 7-O-methylsalsolinol less than 3.2 X 10(-14) moles (0.00032% conversion). Two consistent ethanol- or chloral hydrate induced alterations in [3H]dopamine metabolism were noted: (1) small but statistically significant increases in the ratios of reduced to oxidized metabolites resulting from monoamine oxidase action; and (2) decreased relative amounts of N-methylated metabolites. PMID- 6843790 TI - Spinal superfusion of dopamine excites renal sympathetic nerve activity. AB - Chloralose-anesthetized rats, spinalized at C1, were used to investigate the effects of spinal infusion of dopamine on renal sympathetic nerve activity (RSNA). A subarachnoid spinal superfusion technique was used to localize dopamine in the spinal cord while renal sympathetic nerve activity was recorded from the left renal nerve. Dopamine (25-200 pmol) produced dose-dependent increases in renal sympathetic nerve activity (35 +/- 5% - 77 +/- 6%) and mean arterial blood pressure (25 +/- 5 mmHg - 38 +/- 2 mmHg). This increase in renal sympathetic nerve activity was potentiated by pretreatment with disulfiram (0.67 mmol/kg, interscapularly). Superfusion of equivalent doses of norepinephrine (NE) (25-50 pmol) had no effect or (100 pmol NE) inconsistent effect on renal sympathetic nerve activity. Intravenous injection of dopamine (25-200 pmol) produced no changes in renal sympathetic nerve activity and small increases of (5-7 mmHg) in mean blood pressure. Spinally superfused haloperidol (3 nmol) inhibited the dopamine-induced excitation of renal sympathetic nerve activity, but superfused phentolamine (3 nmol) potentiated the response. The magnitude of renal nerve excitation (RNE), elicited by electrical stimulation of points between lamina four and seven and the adjacent white matter of the cervical cord, was reduced to 60% of control by alpha-methyl-p-tyrosine (0.25 mumol, spinally) and was restored to 85% of control by dopamine (25 pmol) but not by NE (25 pmol). However, the magnitude of renal nerve excitation, elicited by stimulation of the same cervical area, was unaffected by pretreatment with disulfiram interscapularly. Therefore, it is concluded that dopamine itself may be an important neurotransmitter of a spinal system modulating renal sympathetic nerve activity. PMID- 6843791 TI - Effects of opiate agonists and antagonists on fluid intake and saccharin choice in the rat. AB - Both naloxone (3 and 10 mg X kg-1) and naltrexone (1-10 mg X kg-1) abolished the preference for a highly palatable 0.05% sodium saccharin solution in rats that had been adapted to a 22 hr water-deprivation schedule. The effect occurred as a result of a selective decrease in the consumption of the saccharin solution, since the intake of water, which was concurrently available in the two-fluid choice test, remained unaffected. When a less preferred saccharin solution was used (0.01%), naltrexone exerted a similar suppressant effect on the sodium preference, whilst naloxone failed to produce significant effects on the intake of saccharin solution or water. The data for the opiate agonists were interpreted in terms of a drug-induced blockade of the natural reward of highly palatable fluids in thirsty rats. In the same choice test, morphine and a stabilised enkephalin analogue, with a selective agonist action at mu-opiate receptors (RX783030), failed to influence the preference for the palatable saccharin solutions. In water-deprived animals, at least, exogenous opiate agonists, active at mu-receptors, did not appear to influence the reward of the palatable solutions. PMID- 6843792 TI - Effects of chronic antenatal and postnatal administration of narcotics on naloxone-induced anorexia in preweanling rats. AB - Previous studies have reported age-related changes in opiate receptors and in their response to narcotics during the process of normal growth of the brain. By inducing alterations in this developmental sequence, the present study attempted to provide correlates of the opiate receptor system with naloxone-induced anorexia. Offspring of mothers treated with morphine (7.5 mg/kg twice daily, s.c.) or saline during pregnancy, and infants from untreated mothers given morphine (5 mg/kg), naltrexone (10 mg/kg) or saline subcutaneously on postnatal days 1-5, were tested at days 10, 12 and 14 for deprivation-induced milk consumption following an acute dose of naloxone (1 or 5 mg/kg, i.p.). Naloxone reduced the food intake of 10- and 12-day old infants chronically treated with morphine postnatally. At age 14, naloxone reduced the food consumed by all the pretreatment groups, and pretreatment with morphine altered the dose-response curves for feeding modulation induced by naloxone. Naloxone had no effect on the food consumed by 10- or 12-day old offspring of mothers treated with morphine or saline, or on those age-groups that received naltrexone chronically or saline pretreatments postnatally. The observed changes occurred in the absence of gross malformations, drug-withdrawal symptoms and differences in activity. These results demonstrate that opiate receptors may participate in feeding. PMID- 6843794 TI - Mediation of nicotine-induced convulsions by central nicotinic receptors of the 'C6' type. AB - The nature of the central receptors mediating the convulsant actions of nicotine has been investigated. Clonic tonic convulsions were seen in mice following intracerebroventricular (i.c.v.) injection of nicotinic agonists. (-)Nicotine was the most potent agonist tested, with a CD50 of 7.9 X 10(-9) mol. (+)Nicotine, cytisine, DMPP and lobeline were 10-100 times less potent than (-)nicotine. Nicotine induced convulsions were antagonized by ganglion blocking drugs administered intraventricularly. Pentolinium was the most potent antagonist, with an ED50 of 4 X 10(-11) mol. The ganglion-blockers also produced convulsions in their own right at doses 80-1000 times the anti-nicotine ED50 dose. 'C10' blockers, such as d-tubocurarine, did not antagonize nicotine-convulsions, but produced convulsions in their own right. alpha-Bungarotoxin had neither convulsant nor anticonvulsant activity at the doses tested. It is concluded that the central receptors mediating this nicotinic effect resemble ganglionic ('C6') receptors, rather than neuromuscular ('C10') receptors. PMID- 6843793 TI - Centrally mediated drug-induced hyperglycemia in mice. AB - In mice, the hyperglycemic response to a stress, such as repeated orbital puncture, evoked a hyperglycemia through activation of the adrenal medulla and consequent release of catecholamines. This hyperglycemia could be blocked by pretreatment of the mice with the ganglionic blocking agent, chlorisondamine. The hyperglycemic response evoked by single doses of serotonin receptor blocking agents, such as cyproheptadine and methysergide, or by dopamine receptor blockings drugs, such as haloperidol or chlorpromazine, could also be blocked by pretreatment with chlorisondamine. Administration of a single dose of the muscarinic agonist, oxotremorine, also resulted in a hyperglycemia that was blocked by chlorisondamine. The results are compatible with the hypothesis that the adrenal medulla is under the control of a central cholinergic pathway with dopaminergic and serotonergic modulating systems. PMID- 6843795 TI - Randomized clinical trials in neurosurgery. AB - Fifty-one randomized trials of neurosurgical topics have been identified. These have been analyzed for content, quality of reporting, and quality of statistical design and analysis. In general, there were major omissions in the reporting of critical portions of the studies, the statistical analysis was highly variable in quality, and the statistical power was low. Few, if any, major neurosurgical questions have been answered by clinical trials. This may reflect the generally low quality of these trials. To improve the quality of such trials, neurosurgeons must seek biostatistical advice in planning and conducting trials and must cooperate in multi-institutional trials to increase statistical power. PMID- 6843796 TI - Spontaneous seeding of medulloblastoma: results of cerebrospinal fluid cytology and arachnoid biopsy from the cisterna magna. AB - Five children with cerebellar medulloblastoma underwent cytological study for neoplastic cells in the cerebrospinal fluid (CSF) from the lateral ventricle and cisterna magna and biopsy of the arachnoid of the cisterna magna before the manipulation of a medulloblastoma. In all cases, seeding of neoplastic cells was present in the CSF or arachnoid of the cisterna magna, whereas the ventricular fluid was negative for neoplastic cells. This study suggests that medulloblastoma seeds spontaneously into the subarachnoid space, thus supporting the need for postoperative whole neuraxis radiation. PMID- 6843797 TI - Compressive neuropathy as a complication of anticoagulant therapy. AB - Three cases of compressive neuropathy after anticoagulant therapy are reported. The first known description of ulnar and radial nerve involvement in this syndrome is provided. A review of the literature along with a discussion of some of the clinical features, the diagnosis, and the management of this entity are presented. PMID- 6843798 TI - Effects of verapamil on acute focal cerebral ischemia. PMID- 6843799 TI - Use of the carbon dioxide laser for acoustic tumor surgery. AB - The carbon dioxide laser has been used clinically in both otorhinolaryngology and neurological surgery for approximately 10 years. Only recently, however, have technical modifications allowed its use with the operating microscope, providing the increased precision and control necessary for intracranial surgery. This paper reports the authors' experience with the carbon dioxide laser in the removal of acoustic tumors, details the surgical technique involved, and describes the advantages that may accompany the use of the laser in the removal of these difficult lesions. PMID- 6843800 TI - Size of intracranial aneurysms. PMID- 6843801 TI - Thoracic disc herniation: operative approaches and results. AB - In a series of 12 cases of thoracic disc herniation operated upon at the University of Pittsburgh, 4 different operative approaches were used. These included laminectomy in 2 early cases, posterolateral extrapleural operation in 5 cases, transthoracic operation in 3 cases, and transpedicular operation in 2 cases. The relative merits of the various approaches are discussed in this paper. The clinical presentation, radiological features, and follow-up data are also presented. Precise preoperative radiological diagnosis was essential in planning the operative strategy. The posterolateral and transpedicular approaches were both satisfactory, but the former had some advantages over the latter. With a mean follow-up period of 5 years, 5 patients were cured, 5 were improved, and 1 was unchanged. One patient was worse due to coexistent amyotrophic lateral sclerosis. PMID- 6843802 TI - Scanning electron microscopic evaluation of variably angled end-to-side microvascular anastomoses. AB - A comparison of right-angled and opposing oblique-angled end-to-side microvascular anastomoses with both patent and occluded recipient vessels was performed in rats. Patency rates after 3 weeks were comparable in all types of anastomoses (average, 92%). However, scanning electron microscopic evaluation revealed a variety of both nonspecific (pits, craters, folds, etc.) and angle dependent (mounds, erosions, bridges, etc.) endothelial alterations. It is concluded that, in proximally patent recipient vessels, the functional integrity of the anastomosis is not related to the grafting angle; however, in proximally occluded recipient vessels, retrograde-directed oblique angles may lead to progressive embarrassment of anastomotic function. PMID- 6843803 TI - Early correction of orbicularis oculi paralysis with an encircling silicone prosthesis. AB - Fifteen patients with paralysis of the 7th and 5th nerves or the 7th nerve alone were treated with an encircling silicone prosthesis. There has been no serious ocular complication observed over the last 3 years. The prosthesis has been removed in 9 of the 15 patients in whom good 7th nerve recovery has occurred. In the remaining 6 patients, the prosthesis is being well tolerated. PMID- 6843804 TI - Spinal arachnoiditis ossificans: case report. PMID- 6843806 TI - Abscess formation within pituitary tumors. AB - Three consecutive cases where abscesses were found within pituitary tumors are presented. In all cases, the diagnosis was made preoperatively and the patients were begun on stress doses of hydrocortisone and antibiotics before surgical drainage of the abscess. All patients recovered with minimal neurological deficits. Review of the literature reveals that the diagnosis is seldom made preoperatively or before autopsy and is associated with high mortality and morbidity. Early suspicion of a pituitary abscess leading to early treatment with antibiotics and operative drainage seem to be important factors in decreasing this high mortality and morbidity. PMID- 6843805 TI - Epidural myxoma causing compression of the cauda equina: a case report. PMID- 6843807 TI - Ewing's sarcoma arising primarily in the spinal epidural space: fifth case report. AB - Ewing's sarcoma is found exceptionally as a primary epidural tumor of the spine. Four cases have been described in the literature. We describe the fifth case: a 10-year-old boy who underwent operation followed by radiotherapy and chemotherapy. For 1 year he then had a complete remission with no local recurrence and his neurological condition was satisfactory, although metastases developed later. Comparison with the cases described previously shows all five to possess interesting features in common. PMID- 6843808 TI - Embolization of a superficial temporal artery to middle cerebral artery bypass: case report. AB - This case history of a man with bilateral carotid artery occlusions presents angiographic documentation of the embolization of a superficial temporal-middle cerebral artery bypass. The embolic source was thrombotic and/or atheromatous debris that had collected in the persistent stump of one of the occluded internal carotid arteries. PMID- 6843809 TI - Subclavian catheterization for the placement of a ventriculovenous shunt. AB - Repeated nonfunction of the distal end of a ventriculoperitoneal shunt led to an unsuccessful attempt to introduce the distal catheter into the vena cava through the jugular vein. Subclavian catheterization utilizing a cardiac pacemaker introducer set proved to be a simple and effective means of establishing a ventriculovenous shunt. PMID- 6843810 TI - A Ponzo-like illusion left and right of fixation: a failed prediction. AB - Ponzo-like figures, with two parallel horizontal test lines superimposed on a pattern of converging background lines suggesting either a floor or a ceiling were presented in a tachistoscope unpredictably left or right of fixation, and the subjects had to compare the test lines as to length. The classical relative overestimation of the line closest to the apex of the background lines was obtained, but it was not stronger in the left visual field, as seemed to be predicted by at least two current generalizations concerning right hemisphere capacities: (a) that the right hemisphere is better at extracting spatial relations; (b) that its processing mode is more "holistic" and less "analytic" than that of the left hemisphere. PMID- 6843811 TI - Left-hand advantage in right-handers for spatial constant error: preliminary evidence in a unimanual ballistic aimed movement. AB - While the superiority of the right hemisphere for the processing of spatial relationships in normal right-handers has been largely accepted, it is surprising that evidence for an advantage of the left "nondominant" hand over the right "dominant" hand in spatial motor tasks is up to now almost totally lacking. We report preliminary evidence that normal right-handers perform open-loop ballistic aimed movements with a smaller constant error when using the left rather than the right hand. In addition, constant error is found to be minimal for movements directed toward the left half-field. PMID- 6843812 TI - Reversed hemispheric organization in a lefthander. AB - For left-handers, cognitive functions are organized in the brain similarly to right-handers or they are more diffusely represented. In this study, we report a left-handed patient with a focal right temporal-parietal lesion who evidenced a lasting Wernicke's aphasia and visual-spatial functioning typical of a right hander with left-hemisphere in involvement. The patient's performance on other tasks (e.g. praxis, singing) as well as observed behavioral changes also resembled those of a right-hander with left-hemisphere compromise. This case suggests that it is possible for cognitive functions to be inversely represented in the two hemispheres. PMID- 6843814 TI - Is cerebral asymmetry of function a dynamic process? Implications for specifying degree of lateral differentiation. AB - It is proposed that the product-moment correlation between a subject's trial-to trial performance and sensory half-field in which a stimulus appears be employed as an index of functional differentiation of the cerebral hemispheres, both when reaction time is the dependent variable and when accuracy is the dependent variable. This proposal is based on a model of hemispheric functioning in which the difference in competencies of the two sides of the brain, rather than being a static and unchanging dimension of an individual subject, is seen to vary from moment to moment, a variability that is just as characteristic of the cerebral hemispheres and their relationship as is the mean level of performance for each side. The relative degrees of asymmetry inferred for different subjects differ for laterality indices based on the static assumption verus correlational indices based on the dynamic assumption. PMID- 6843813 TI - Short-term retention of verbal, visual shape and visuospatial location information in normal and amnesic subjects. AB - Tests of immediate verbal memory span (digit span), immediate memory span for visuospatial location (Corsi block span) and short-term forgetting of words and figures (continuous recognition) were administered to eight alcoholic Korsakoff amnesics, eight alcoholic and eight nonalcoholic control subjects. Korsakoff amnesics had normal immediate memory span for both verbal information and visuospatial location. The performance of control subjects on continuous recognition demonstrated dramatically different patterns of forgetting for words and figures. Amnesics forgot more than control subjects did on both continuous recognition tests, but their patterns of forgetting were equivalent to the patterns of control subjects. PMID- 6843815 TI - Hemispheric asymmetries in motor function: I. Left-hemisphere specialization for memory but not performance. AB - Patients with unilateral brain lesions of vascular origin were administered tests designed to determine if left-hemisphere specialization in manual-sequence tasks involves memory for these sequences, or performance of them, or both. Patients with left-sided lesions were worse than patients with right-sided lesions on two tasks requiring the recall of hand positions. Whereas patients with left-sided lesions showed a trend towards being worse on speeded performance of an already learned manual sequence, in both groups on this task there were a large number of failures to remember the sequence. When memory demands were better controlled by providing a model during the speeded performance task, there were no group differences. It is proposed that there is left-hemisphere specialization for memory but not performance of such motor tasks. PMID- 6843816 TI - Hemispheric asymmetries in motor function: II. Ordering does not contribute to left-hemisphere specialization. AB - Patients with unilateral brain lesions of vascular origin were administered tests designed to determine if the left hemisphere is specialized for the ordering of motor acts. Patients with left- and right-sided lesions responded similarly to manipulations of ordering demands in two motor tasks, one a test of manual sequence learning and the other a test of speeded performance. A detailed analysis of performance on an Ideational Apraxia task indicated that the deficit of patients with left-sided lesions was best characterized as a deficit in generating appropriate acts rather than ordering them. It was concluded that there is no evidence for left-hemisphere specialization for the ordering of motor acts. It was hypothesized that there are two broad stages of motor function: generation of motor "target" acts (which is lateralized to the left hemisphere) and the ordering and execution of these acts (which are not lateralized). PMID- 6843817 TI - Increasing the power of dichotic methods: the fused rhymed words test. AB - A dichotic test made up of monosyllabic rhymed CVC words was modified to minimize stimulus dominance and errors and then administered to 194 dextrals and 175 sinistrals in four different laboratories. The proportion of subjects with left ear advantages in both the right and left-handed groups closely approximated that expected from neurologic data. This dichotic test appears to reflect hemispheric specialization for language function more accurately than previously available tests. Further direct validation studies are needed, however, comparing direction of ear asymmetry and other indices of hemispheric specialization for language on a subject by subject basis. PMID- 6843818 TI - Lateralization of rapid auditory sequences. AB - Subjects were trained to manually respond to the presence of a preassigned target order of a two-element sequence in a dichotic presentation. Reaction times to rapid target sequences presented to the right ear were significantly shorter than left ear reaction times. The speech or nonspeech character of the stimulus was not a significant factor. There were no lateral differences in accuracy of response. The lateral differences in reaction time are interpreted as a greater efficiency of processing by the right ear (and by implication, the left hemisphere) when temporal characteristics of the sequences were similar to temporal values found in speech. PMID- 6843819 TI - The effect of sex, laterality and familial handedness on intellectual abilities. AB - This study assessed the relationship of sex, familial handedness and laterality to the intellectual abilities of 116 right-handed 12-14-yr-old subjects. Verbal scores were predicted by an interaction between familial handedness and the subject's own laterality. A strong right ear advantage for verbal stimuli and a large lateral difference between the ear advantage for verbal and nonverbal stimuli predicted high Verbal Intelligence scores for the strong right hand-eye preference subjects with family histories of dextrality. Conversely, attenuated ear advantage scores for verbal stimuli predicted high Verbal Intelligence scores for the strong right hand-eye familial sinistral subjects. Although the results were less consistent for Performance Intelligence scores, they were significantly and positively related to assessed hand-eye preference, and a significant interaction between familial handedness and the subject's own laterality was observed for the Object Assembly subtest. A strong left ear advantage for nonverbal stimuli predicted high scores for the strong right-preference familial dextral subjects and attenuated ear advantage for nonverbal stimuli predicted high scores for the strong right-preference familial sinistral subjects. PMID- 6843820 TI - Hemispheric specialization for speech in retarded children. AB - Hemispheric asymmetries in retarded and normal children were examined in dichotic tests which followed extensive auditory-discrimination training and which required non-verbal responses to digits or words. Mean right-ear advantages were smaller for the retarded group than for the normal group. However, most retarded children individually showed clear right- or left-ear advantages and absolute ear advantages were similar for the two groups. These data suggest atypical, but not reduced, functional asymmetries for retarded children. PMID- 6843821 TI - Perception of emotional words. AB - Two studies examined the contribution of both hemispheres to the processing of emotional and non-emotional words. These real words and nonsense words were presented to the right and left visual fields simultaneously. Males and females were required to indicate whether or not any of the words were real English ones. The results revealed that emotionally positive and negative words show a RVF superiority (Experiment 1). Both emotional and non-emotional words also showed a RVF advantage (Experiment 2). PMID- 6843822 TI - The connections of cortical somatosensory areas I and II with separate nuclei in the ventroposterior thalamus in the raccoon. AB - The thalamocortical afferents to cortical somatosensory areas I (SI) and II (SII) were investigated in the raccoon using the horseradish peroxidase technique. The purpose of this study was to determine if the cell bodies of origin for thalamocortical afferents to these cortical regions were localized in the same or different nuclei in the ventroposterior region of the thalamus. Horseradish peroxidase was injected into subdivisions of SI or SII and after post-injection survival periods of 12-72 hours the horseradish peroxidase in the tissue was reacted with the chromogens dihydrochlorobenzidine or tetramethylbenzidine in the presence of hydrogen peroxide. The results show that SI and SII receive projections from neurons in separate and distinct nuclei in the ventroposterior thalamus. Following injections into subdivisions of area I, a topographical distribution of retrogradely-labelled cell bodies was observed in the ventrobasal complex. Following injections of horseradish peroxidase into subdivisions of area II, a topographical distribution of labelled cell bodies was observed in the ventroposterior inferior nucleus. No labelled cell bodies were observed in the ventrobasal complex. The thalamocortical connections of somatosensory cortices I and II in raccoon are compared with those in other animals and it is suggested that these two cortical areas may be involved in differential processing of tactile information. PMID- 6843823 TI - The afferent connections of the inferior olivary complex in rats. An anterograde study using autoradiographic and axonal degeneration techniques. PMID- 6843824 TI - Selective retrograde labelling of vestibular efferent neurons with [3H]choline. AB - Following administration of [3H]choline in the lateral semicircular canal of the cat labyrinth, bidirectional axoplasmic transport [3H]choline and its derivatives was shown by radioautography in the vestibular system. Light-microscopic radioautographs exhibited various patterns of radioautographic labelling. First, a diffuse reaction was observed in vestibular nuclei representing anterograde labelled, vestibular nerve endings. Second, a heavy labelling limited to perikarya was detected in efferent vestibular neurons and corresponded to retrograde transport. The anterograde migration of [3H]choline is known to be non selective and is related to synthesis of phospholipids, non-diffusable molecules. In contrast, the retrograde perikaryal labelling seems highly selective and related to the cholinergic specificity of the transmitter. The selectivity of such labelling offers a further possibility of identifying cholinergic neurons and is additional evidence that cholinergic mechanisms are involved in the efferent vestibular control. PMID- 6843826 TI - Characterization and distribution of acetylcholine receptors and acetylcholinesterase during electric organ development in Torpedo marmorata. PMID- 6843827 TI - [Surgical treatment of endocarditis on a valve prosthesis]. PMID- 6843825 TI - Intra-amygdaloid injections of kainic acid: regional metabolic changes and their relation to the pathological alterations. AB - Kainic acid was injected unilaterally in the amygdala of the rat. Following various delays, 2-deoxy-D-[14C]glucose was given intravenously. Autoradiographs of frontal brain sections showed increased glucose uptake in a number of cerebral structures as compared with controls. Most of these structures belong to, or are closely related to, what is traditionally called the 'limbic system'. The structures that show an increased glucose consumption subsequent to kainic acid injections are, with few exceptions, identical to those that are sensitive to the toxic effect that kainic acid exerts on structures distant to the site of injection. The findings are discussed in relation to the hypothesis that the latter effect is secondary to the epileptogenic properties of kainic acid. PMID- 6843829 TI - [Our experience in the use of Gore-tex prostheses in anatomic and extra-anatomic revascularization of the lower limbs]. PMID- 6843828 TI - [The role of surgery in the treatment in infectious endocarditis]. PMID- 6843830 TI - [Diagnostic accomplishments and therapeutic trends in Martorell's ulcer]. PMID- 6843831 TI - [Lumbar sympathectomy. A current measure in surgery of obliterating arteriopathies of the lower limbs]. PMID- 6843832 TI - [Syndrome caused by entrapment of the popliteal artery]. PMID- 6843833 TI - [Malan's syndrome. 3 cases]. PMID- 6843834 TI - [Personal experience in some uses of computerized tomography in cardiovascular pathology]. PMID- 6843835 TI - [Postoperative laparocele of the linea alba. Treatment with posterior imbrication of the aponeuroses]. PMID- 6843836 TI - [Retrospective clinical study of the effectiveness of cimetidine in hemorrhages caused by chronic gastroduodenal peptic lesions]. PMID- 6843837 TI - [Complications of Meckel's diverticulum]. PMID- 6843838 TI - [The role of azygography in the evaluation of the operability of cancer of the thoracic esophagus]. PMID- 6843839 TI - [The role of early endoscopy in bleeding gastroduodenal peptic lesions]. PMID- 6843840 TI - [Reconstruction of the breast after radical mastectomy for cancer. The myocutaneous flap of the latissimus dorsi]. PMID- 6843841 TI - [Super-selective vagotomy with Nissen's fundiplication in the surgery of acid reflux esophagitis]. PMID- 6843842 TI - [The surgical implications of staging in colorectal tumors]. PMID- 6843843 TI - [Critical analysis of magnetic continent colostomy]. PMID- 6843844 TI - [Intra-arterial locoregional chemotherapy with methotrexate and adriamycin associated with radiotherapy in patients with head and neck cancer]. PMID- 6843845 TI - [Lipo-aspiration. A new technic for surgical correction of localized adiposity]. PMID- 6843846 TI - [Current trends in the surgery of idiopathic male varicocele]. PMID- 6843847 TI - [Choledocho-colic fistula after acute pancreatitis]. PMID- 6843848 TI - [Duodeno-cephalopancreatectomy. New trends in the treatment of the pancreatic stump]. PMID- 6843850 TI - [Malignant degeneration of chronic venous ulcer (Marjolin ulcer). Observation of a case]. PMID- 6843849 TI - [Abdominal actinomycosis. Considerations on a case]. PMID- 6843851 TI - [The use of the GIF-P3 Olympus as an operative choledochoscope]. PMID- 6843852 TI - [Stenosing lesions of the esophagus and esophogastric junction. Endoscopic and histo-cytological evaluation]. PMID- 6843853 TI - [The behavior of the HBeAg-anti-HBe system in chronic hepatitis]. PMID- 6843856 TI - [Clinical evaluation of the demonstration of excluded gallbladder by means of serial photoscintigraphy with Rose Bengal I-131]. PMID- 6843854 TI - [Significance of total serum bile acids in the initial and later phases of cirrhosis]. PMID- 6843855 TI - [Epidermoid carcinoma of the colon. Clinical case of double recto-sigmoid basalioma]. PMID- 6843858 TI - [The sham feeding test as a test of the postoperative completeness of the vagotomy]. PMID- 6843859 TI - [Review of cases of ingested foreign bodies in a surgical first-aid department. Anatomo-clinical considerations]. PMID- 6843857 TI - [Radiological diagnosis of biliary ileus]. PMID- 6843860 TI - [Percutaneous biopsy of tumors of the pancreas by aspiration with a thin needle guided by echography under permanent visual control]. PMID- 6843861 TI - [Endoscopic papillotomy in acute pancreatitis of biliary origin]. PMID- 6843863 TI - Experiences with myocutaneous island flaps of the pectoralis major muscle for reconstruction of defects in the bucco-pharyngeal cavity. AB - Defects in the bucco-pharyngeal cavity after tumor resection were closed with pectoralis major myocutaneous island flaps in ten consecutive patients. The skin element consisted of an island which was transposed on a muscular pedicle containing the vascular stalk. The advantages and disadvantages of the method and the results and complications in the treated patients are discussed. When the defects mentioned require pedicled skin flaps, the pectoralis major island flap is preferred. PMID- 6843864 TI - Internal fixation of fractures of the head of the radius. AB - In a group of 25 patients with a displaced fracture of the head of the radius (which otherwise would have been treated by resection) operative reduction and internal fixation were carried out. The results, after a follow-up ranging from six months to over two years after operation, were excellent in 17 (no pain and no restriction of movement) and fair to good in eight patients (no pain and restriction of less than 20 degrees). None of the patients had a bad result. The advantages of this technique, which conserves the length of the radius, are discussed. PMID- 6843862 TI - [Hemobilia after intra-operative hepatic puncture biopsy]. PMID- 6843865 TI - Long-term follow-up of Lord's procedure for haemorrhoids. AB - 86 Patients treated for first or second degree haemorrhoids by Lord's manual dilatation of the anus were followed up for a mean period of 7.2 years. The outcome in the 76 patients traced was satisfactory or good in 76.3%. In only 14.5% was the result unsatisfactory. Lord's anal dilatation is a relatively simple procedure; the results of this study show that it gives good long-lasting results. PMID- 6843867 TI - The Roscoe Graham-Goligher procedure in the treatment of complete rectal prolapse. AB - From April 1972 to December 1980 31 patients underwent repair of a complete rectal prolapse by various techniques. In 17 patients the Roscoe Graham-Goligher procedure was performed and 15 patients were reviewed to assess results. A complete recurrence was found in four patients (27%), two had a mucosal prolapse (13%). Fecal continence improved in four patients (27%). We no longer believe there is a place for this procedure since other rectal fixation techniques are easier to perform and give better results. PMID- 6843868 TI - Treatment of olecranon fractures. PMID- 6843866 TI - Experience with mass screening for lung carcinoma. AB - The 5-year-survival of 128 primary lung cancer patients was studied between 1970 and 1976. In all patients mediastinoscopy was carried out without any mortality or morbidity. Asymptomatic stage I (TNM classification) patients having a squamous cell carcinoma had the best 5 year survival: 46.3% as against 9.5% and 0% of the stage II and III patients. The resectability rate was 58.6% with a perioperative mortality of 7.5%. This suggests the importance of further evaluation of mass screening for lung carcinoma despite the statistical shortcomings of a retrospective study. PMID- 6843869 TI - Cystadenoma of the pancreas. PMID- 6843870 TI - Complete dislocation of the trapezium multangulum majus. PMID- 6843871 TI - Primary and secondary access surgery for haemodialysis with the Brescia-Cimino fistula and the polytetrafluoroethylene (PTFE) graft. PMID- 6843872 TI - [Amenorrhea in drug dependence]. AB - Irregular menstrual cycles are fairly common in drug-addicted patients. The purpose of this research is to stablish the connection between the administration of a narcotic and the onset of amenorrhoea. After a review of the literature and aetiopathogenetic hypotheses regarding ovulatory block, 39 heroin- or morphine addicted patients personally observed during pregnancy are studied. Even relatively low doses of narcotics can impair normal ovarian function and ovulation so there is a risk that menstrual irregularities can arise even when doses are reduced. PMID- 6843873 TI - [Interaction of methimazole and quinones. Spectrophotometric determination of methimazole in blood]. AB - A sensitive method for spectrophotometric determination of methimazole is based on the reaction of this compound with 2,3-dichloro-1,4-naphtoquinone in presence of ammonia. The colour thus formed is stable, reproducible and linear in the range 0,4 to 4 micrograms/ml of methimazole concentration. This method has been employed successfully for estimation of the antithyroid drug in plasma sample with good recovery (75 +/- 2%). The colour is due to formation of a red compound of molecular formula C14H11O2N3S, deduced from elemental analysis and mass spectrum. PMID- 6843875 TI - [Anxiety-generating stress]. AB - After a definition of the condition and a discussion of its physiopathological significance, the need to examine the patient as a whole and provide total therapy is emphasised with reference to both the literature and personal cases. It is concluded: 1) that the mesodiencephalic structures, especially the hypothalamus, are of primary importance in human physiological and pathological processes. The hypothalamus is the real brain of the viscera, the functional bridge between the hypophysis, the limbic structures and the upper cortical centres; 2) that doctors should consider the role of the hypothalamus in the diagnosis and therapy of the total person: a) in evaluating the patient's real emotional and psychological situation; b) in realising that the simple administration of a drug to cure the organic symptom really means only partial treatment of the patient himself. PMID- 6843874 TI - [Prevalence of antibodies against the hepatitis B virus in alcoholic liver diseases]. AB - The prevalence of serum antibody to hepatitis B virus antigen (anti-HBs and anti HBc) were determined in biopsy proven alcoholic liver disease (n = 60), compared with: an age and sex-matched hospital control population (n = 60), HBsAg-negative chronic liver disease (n = 27), renal unit patients (n = 32) and volunteer blood donors (n = 286). All sera were HBsAg negative (RIA). The prevalence of total hepatitis B virus antibody was significantly increased (p less than 0,001) in alcoholic liver disease (71%), as well as in renal unit patients (65%) and non alcoholic liver disease (66%), versus hospital controls (35%) and blood donors (43%). These data suggest that hepatitis B virus infection might be a factor in selecting which alcoholic patients go to develop hepatic damage. PMID- 6843876 TI - [Pneumococcal infections]. AB - Current knowledge of the morphology, biochemistry and function of streptococcus Pneumoniae, the immune response of the host to infection and certain epidemiological aspects of pneumococcus infections is described. Personal experience of acute infections of the lower respiratory ways and meninges is presented and therapeutic problems are discussed. In Italy at least it appears that betalactamine antibiotics are preferable. Brief reference is made to the value and limitations of anti-pneumococcic vaccination. PMID- 6843879 TI - [The surgeon and the tumor patient facing the dilemma: radical surgery and the quality of life]. PMID- 6843878 TI - [Problems related to drug addiction. From medico-social convention in Trieste]. PMID- 6843877 TI - [An unusual case of focal symptomatology, monoparalysis of the abducent nerve and vertebrobasilar ectasia]. AB - Ectasia of the basilar artery is a well-defined form with a complicated clinical symptomatology. Angiography has made it possible to show that its pathogenesis springs from marked changes in the diameter and length of the artery. A case is presented in which the usual array of symptoms was replaced by homonymous diplopia only. It showed that CT can on its own provide information both for diagnosis of the specific lesion, and for assessment of changes in the bone structures, the cerebral parenchima, and the ventricular system. PMID- 6843880 TI - [Acupuncture treatment of painful and dysfunctional syndromes in subjects exposed to severe stress. Psychosomatic interpretation in the light of the dermatoneuromeric theory]. AB - The authors, describe a specimen of subjects from Majano, Friuli, one of the communes that were largely struck by earthquake in 1976 and therefore by its social and cultural consequences which still play an important role in the life of those people. The specimen refers to those patients who spontaneously reported about the setting-up of the symptomatology with reference to the earthquake even when the disease had set up subsequently. Acupunctural points--mostly psychical- have been used. 70% of the subjects have recovered. 30% have markedly improved and recovered after a treatment on local points. A good deal of subjects had been treated with drugs and even acupuncture without successful results. The results are here considered following a psychosomatic view and the dermatoneuromeric theory. PMID- 6843882 TI - [Acupuncture and acetylcholine]. AB - A review of the relationship between electro-acupuncture and acetylcholine is presented. Brain cholinergic mechanisms of areas such as hypothalamus, thalamus, locus coeruleus, caudatus-putamen complex and cortex are surely involved in the production of acupuncture analgesia; the role of peripheral cholinergic mechanisms is still disputed, although confirmed by a certain number of indirect positive results. PMID- 6843881 TI - [Current role of acupuncture in analgesic therapy]. AB - After a brief introduction dealing with the great development of acupuncture in management of various painful conditions in the West today, its increased importance, use and role in acute and chronic pain, benign and intractable pain, are discussed. Recent acquisitions about known and yet unknown neurophysiological parameters (evoked cns potentials, endorphines, action of acupuncture in "regulation" of many functions--so called homeostasis--milieu) in connection with good pain relief properties of acupuncture, are referred. The main methods of acupuncture in pain treatment (acupuncture as reflexotherapy--so called electroacupuncture and the very effective auriculotherapy, in comparison with traditional acupuncture as "regulating" method of homeostasis and others minor methods, with our casuistry and positive results in 724 cases of various pain conditions are stressed. Own conclusions about the positive results and the great significance of physician-patient relations in delicate field of pain therapy are referred. PMID- 6843883 TI - [Epidemiology of urolithiasis in Piedmont. Study of patients dismissed from public hospitals in 1979]. PMID- 6843884 TI - [Serum ferritin in subjects with chronic renal insufficiency undergoing hemodialytic treatment]. PMID- 6843886 TI - [Protocol for reinfusion of ascites: 25 months of experience]. PMID- 6843885 TI - [Radiography of the hands, with a mammographic technic, in the study and supervision of renal osteodystrophy. Patients undergoing periodic hemodialysis]. PMID- 6843887 TI - Spatial dissociation of visual inputs alters the origin of the corpus callosum. AB - The distribution of the origin of corpus callosum neurons was investigated in cats reared with an optically induced strabismus by applying horseradish peroxidase (HRP) to severed callosal axons. These animals demonstrated an enlargement of the region of callosal connectivity compared to normal cats. Bilaterally there was an expanded efferent zone, with callosal cell bodies widely distributed in area 17, extending down the medial bank of the lateral gyrus halfway to the fundus of the splenial sulcus. This suggests that rearing a cat with visual spatial dissociation requires additional communication between the hemispheres in the form of increased callosal connections between cortical regions representing more peripheral portions of the visual field. PMID- 6843888 TI - Cholinergic growth factor from skeletal muscle elevated following denervation. AB - The effect of skeletal muscle extracts upon cholinergic neuron in vitro survival was investigated. All muscle soluble protein extracts elicited survival of neurons above that of neurons alone in culture and were found to be active below a protein concentration of 1.0 mg/ml. However, skeletal muscle which had been previously denervated, was found to contain higher amounts of survival activity than innervated muscle extracts. This elevation of survival activity was greatest within the first 7 days post-denervation, but subsequently declined towards the innervated level. PMID- 6843889 TI - Excitation of single sensory neurones in the rat caudal trigeminal nucleus by iontophoretically applied adenosine 5'-triphosphate. AB - ATP can be released from the peripheral endings of sensory nerves, and thus may be a neurotransmitter of primary afferent fibres [12]. We have found that ATP is excitatory when applied to single sensory neurones in the rat caudal trigeminal nucleus, and this action is consistent with a neurotransmitter role. However, adenosine monophosphate and pyrophosphate, two metabolites of ATP, were respectively found to be inhibitory and excitatory, and thus it remains unclear whether the actions of ATP are direct or are due to actions of its metabolites. PMID- 6843890 TI - Intracellular recordings from two cell types in an in vitro preparation of the salamander olfactory epithelium. AB - Two electrophysiologically distinct cell types were found with intracellular recordings for the first time in an in vitro preparation of the olfactory epithelium of the salamander, Ambystoma tigrinum. Intracellular recordings showed that Type I cells did not discharge action potentials but had high resting membrane potentials (-50 to -104 mV) and relatively low input resistances. Type II cells had resting membrane potentials of -24 to -52 mV, high input resistances, and discharged upon penetration and to depolarizing current steps. The discharge pattern of Type II cells showed the following characteristics: (1) decreased spike latency and increased discharge frequency with increasing current step intensity; (2) relatively slowly adapting spike trains; and (3) varying spike amplitude during repetitive discharges. The superficial location in the epithelium of the Type I cells implies that they may be sustentacular cells with glial-like electrophysiological properties. The Type II cells are presumably olfactory receptor cells, based on the characteristics of their spike discharge to depolarizing current and their intermediate location within the olfactory epithelium. PMID- 6843893 TI - Aspartate and glutamate induced reductions in extracellular free calcium and sodium concentration in area CA1 of 'in vitro' hippocampal slices of rats. AB - Extracellular Ca2+ and Na+ were simultaneously measured with ion selective electrodes in the CA1 pyramidal cell layer of rat hippocampal slices. Repetitive stimulation of the Schaffer collateral/commissural fiber system led to decreases in [Ca2+] omicron and [Na+] omicron (delta Ca, delta Na) by up to 0.5 mM and 13 mM, respectively. Iontophoretic application of glutamate or aspartate caused dose dependent delta Ca of more than 1 mM and delta Na of more than 45 mM. Such ionic alterations were smaller in the presence of GABA or of the Ca2+ antagonists Ni2+ and Mg2+. Ca2+ signals were diminished when evoked in low-Na+ bathing medium and Na+ signals were reduced in Ca2+-free solutions. Thus glutamate- and aspartate dependent decreases in [Na+] omicron and [Ca2+] omicron appear to be caused by 3 different mechanisms: Na+ movement through amino acid-activated ionophores; Ca2+ movement through selective channels, and Ca2+-dependent Na+ movement. PMID- 6843891 TI - The effect of pentylenetetrazol on the levels of dopamine-beta-hydroxylase in the cerebrospinal fluid of rabbits: a dose-dependent relationship. AB - The effect of various doses of pentylenetetrazol (PTZ) on the levels of dopamine beta-hydroxylase (D beta H) and acetylcholinesterase (AChE) in the CSF of rabbits was studied. The drug augments in a dose-dependent manner the D beta H activity but causes only a small and dose-independent increase in AChE. This suggests that PTZ-induced convulsions are associated with an increase in central noradrenergic activity but not by an increase in central cholinergic activity. PMID- 6843892 TI - Electron microscopic identification of superior colliculo-pontine axon terminals. AB - Synaptic boutons emanating from axons of superior colliculus origin were identified by electron microscopy in the neuropil of the basilar pontine nuclei. Such boutons were relatively small (0.6-2.0 microns) and exhibited electron-dense degeneration within a 1-2 day period following electrolytic lesions which involved much of the superior colliculus. Degenerating boutons were observed in synaptic contact with dendritic shafts and spines as well as neuronal somata. The reactive boutons were rapidly engulfed by phagocytic elements and were no longer visible in the neuropil after 6 days of survival. PMID- 6843894 TI - Muscarine-sensitive voltage-dependent potassium current in cultured murine spinal cord neurons. AB - Muscarine produced membrane depolarization and decreased membrane conductance of mouse spinal cord neurons in dissociated cell culture. When the neurons were voltage clamped, muscarine evoked inward currents which increased with membrane depolarization and decreased with membrane hyperpolarization. However, the muscarine-induced inward currents did not invert at large negative potentials, suggesting that muscarine decreased a voltage-dependent potassium current (m current) [2]. Using the voltage-jump current-relaxation technique, m-current was demonstrated in spinal cord neurons and shown to be a muscarine-sensitive potassium current. PMID- 6843895 TI - Evidence for interactions between [3H]glutamate and [3H]kainic acid binding sites in rat striatal membranes. Possible relevance for kainic acid neurotoxicity. AB - In vitro studies have shown that kainic acid (10(-6) M) but not N-methyl-D aspartate (NMDA) in the same concentration reduces the number of striatal [3H]glutamate binding sites and increases their affinity in striatal membranes. In vitro studies also show that L-glutamate (10(-8) M) but not NMDA (10(-6) M) increases the number of [3H]kainic acid binding sites and reduces their affinity in striatal membranes. Ibotenic acid (10(-6) M) can also reduce the affinity of [3H]kainic acid binding sites in striatal membranes. These results give indications for the existence of bidirectional receptor-receptor interactions between two receptors for excitatory amino acids in local striatal circuits. These interactions could partly explain the involvement of glutamate in kainate neurotoxicity. PMID- 6843896 TI - Selective uptake of Lucifer Yellow into different cell populations of the developing chicken retina. AB - Whole chick embryo eyes at different stages of development were incubated in a solution of Lucifer Yellow (LY) and examined in frozen sections. Different cell populations selectively take up the dye during the course of development: from embryonic day 4 - day 8 of incubation (E4-E8) only a subpopulation of neuroepithelial cells are stained, which at E7-E8 are located mainly near the periphery between the prospective ora serrata and the outer edge of the retina. This staining disappears after E8. A second phase starts at E10, with a weak but specific staining of a small population of cells in the outer nuclear layer which becomes less pronounced by E12. Starting around E10.5 a bright staining of cells in the innermost part of the inner nuclear layer can be observed. Their size, shape and location suggest that most of them represent a subclass of amacrine cells (including all 'displaced amacrine cells'). Beginning at E15, the staining pattern becomes more complex. A single cell analysis of the percentage of LY stained cells which are stained either before or after papain-treatment and dissociation of the intact tissue confirms and extends the histological findings. PMID- 6843897 TI - Intrinsic connections in the medial amygdala as revealed by complete deafferentation. AB - Using a newly designed knife, the medial amygdala of rats was completely deafferented to exclude the synapses of the afferents coming from the outside of the medial amygdaloid nucleus (MAN). Semiquantitative analysis by electron microscopy showed that the number of the intact dendritic synapses per unit neuropil area of the MAN of the islands was markedly reduced to about one-third of that of the controls. These intact synapses appeared to be intrinsic or of local origin. In contrast, degenerating synapses, two-thirds of the dendritic synapses in the MAN, were considered as synapses with the fibers from outside the islands. PMID- 6843898 TI - Differential input from the amygdaloid body to the ventromedial hypothalamic nucleus in the rat. AB - Differential amygdaloid afferents to anterior dorsal, anterior ventral, posterior dorsal and posterior ventral subdivisions of the ventromedial hypothalamic nucleus (VMH) were studied by means of retrograde transport of horseradish peroxidase (HRP). Injections of tracer confined to the VMH subdivisions mentioned, and enhancement of tracer uptake and transport were achieved by iontophoretic delivery of an HRP solution containing poly-L-alpha-ornithine. It was shown that the medial, central, basolateral, basomedial, lateroposterior and intercalated nuclei of the amygdala constitute afferent input sources to the ventromedial nucleus in a topographic pattern related to the various subdivisions of the VMH. This topographically organized amygdala-VMH projection is discussed against the background of the functional role that both amygdala and VMH play in the control of feeding, apart from various other autonomous functions that both brain centers are known to be concerned with. PMID- 6843899 TI - Do intracranial and extracranial trigeminal afferents represent divergent axon collaterals? AB - Trigeminal nerves provide the principal afferent pathways for the transmission of intracranial and extracranial head pain. This study, using two retrograde axonal tracers, demonstrated that first division afferents projecting to intracranial and extracranial targets are not commonly axon collaterals of the same neuron. Therefore, divergent axon collaterals probably are not responsible for the phenomenon of referred pain within the first trigeminal division. PMID- 6843900 TI - Development in the frequency selectivity of auditory nerve fibers in the kitten. AB - The modification of tuning properties in the cochlea has been studied by means of tuning curves from auditory nerve fibers in kittens of various ages. Comparison of tuning curves of three characteristic frequencies (CF) shows that the tuning of high CF units tends to approach adult values by the end of the second postnatal week, whereas medium and low CF units have a delayed maturation. Threshold sensitivity, on the other hand, shows a development inverse to that of tuning. The threshold of low CF units tends to reach adult values before that of medium and high CF units. The development of tuning can be related to the structural maturation of the cochlea, where the most differentiated part is located at the base of the first turn and corresponds to the rapid development of high CF units. In the same way, the second and the third turns show a delayed structural development corresponding to a different maturation of tuning for medium and low CF units. PMID- 6843902 TI - Post-stimulus facilitatory and inhibitory effects on respiration induced by chemical and electrical stimulation of thin-fiber muscular afferents in dogs. AB - In anesthetized, vagotomized, paralyzed, and artificially ventilated dogs, respiratory responses to both electrical stimulation of the muscle nerve and chemical stimulation of muscular (polymodal) receptors by means of intra-arterial injection of NaCl solution were studied by recording phrenic nervous discharges. During the period of stimulation both types of stimulation caused intensity dependent facilitation of neural respiratory outputs. After cessation of stimulation, facilitation persisted for a long time (more than 5 min) with a lower intensity stimulation; however, suppression was observed with a higher intensity stimulation. The present results suggest that afferent inputs from the muscular polymodal receptors activate long-acting central mechanisms for enhancement or suppression of respiration. PMID- 6843901 TI - Response of lateral hypothalamic neurons to scrotal and preoptic thermal stimulation in rats. PMID- 6843903 TI - Effects of ion-containing liposomes upon the chemoafferent activity of the rabbit carotid body superfused in vitro. AB - The effects of calcium concentration changes in carotid body cells on the chemoreceptor discharges were studied in vitro on carotid bodies removed from anaesthetized rabbits. Addition of calcium-containing liposomes to the superfusing medium increased the chemoreceptors' discharges. This effect was abolished by hyperoxia or when EGTA-containing liposomes were simultaneously added with the calcium-containing liposomes. A histological control with ferritin enriched liposomes showed that the liposome content was transferred into the cellular elements of the preparation except the nerve endings. Results suggest a relationship between calcium concentration changes in carotid body cells and chemoafferent activity. PMID- 6843904 TI - The effect of sleep deprivation and recovery sleep on plasma corticosterone in the rat. AB - The effect of 24-h sleep deprivation by forced locomotion on plasma corticosterone was investigated in the rat. Corticosterone was slightly elevated after 21.5 h sleep deprivation, but did not differ from controls after a 2.5-h recovery period. An acute 20-min forced locomotion period caused a marked rise in plasma corticosterone. It is concluded that stress is not a major factor contributing to the massive effects of sleep deprivation on sleep parameters. PMID- 6843906 TI - Morphine blocks the increase in acid phosphatase in the substantia gelatinosa during pain. AB - Acid phosphatase activity in the rat substantia gelatinosa has been shown to increase in response to a formalin-induced painful stimulus. In the rat the substantia gelatinosa is the location of the first synapse in the pain pathway. One site of morphine's analgesic effect is at this first synapse. The present study shows that morphine blocks the previously observed increase in acid phosphatase activity during a painful stimulus. Naloxone antagonizes the morphine effect. These results point to a possible functional role of acid phosphatase in the afferent transmission of pain signals. PMID- 6843905 TI - The effects of phencyclidine on glutamic acid decarboxylase activity in several regions of the rat brain. AB - Glutamic acid decarboxylase (GAD) activity in several regions of the rat brain were monitored after administration of phencyclidine. Sub-acute (4 injections over 12 h) treatment decreased cerebellar GAD activity 6 and 12 h after the last dose; recovery was noticed by 24 h. This effect occurred with doses of 5 and 10 mg/kg. GAD activity in other brain regions was not affected by this treatment. Acute and chronic treatments with phencyclidine caused no change in GAD activity in any of the brain regions examined. PMID- 6843907 TI - An aversive naloxone-morphine interaction in rats. PMID- 6843908 TI - 51Cr release cytotoxicity radioimmunoassay to detect immune cytotoxic reactions to rat Schwann cells in vitro. AB - Monolayers of rat Schwann cells incubated with 51Cr were used as targets for a cytotoxicity assay employing rabbit antiserum to galactocerebroside (R anti GalC). Specific 51Cr release was demonstrated which was heat sensitive and complement-dependent. The assay was readily performed, reproducible and quantitative, and should prove useful in assessing anti-Schwann cell cytotoxic activity of experimental and human serum. PMID- 6843910 TI - The dietary treatment of phenylketonuria. PMID- 6843911 TI - Changes in receptor levels in brain during experimental copper deficiency. PMID- 6843909 TI - Antibodies in cerebrospinal fluid to white matter glycoproteins in multiple sclerosis patients. AB - Cerebrospinal fluid (CSF) specimens from 45 patients with multiple sclerosis (MS) and 45 age- and sex-matched controls with other neurological diseases (OND) were tested for antibodies to white matter (WM) membrane glycoprotein (GP) fractions prepared from MS and control WM membranes by lentil lectin chromatography. The binding of the CSF IgG to the 125I-labeled GP fractions was determined by immunoprecipitation using Protein A-Sepharose. CSF from patients with MS bound highly significantly more strongly to the GP fraction prepared from MS WM than did the OND CSF specimens (P less than 0.001). There was no such difference when control GP fraction was used as an antigen. No highly significant differences were observed when 20 paired serum specimens were tested. Electrophoresis of the immunoprecipitates showed that components with molecular weights (MWs) of 157,300, 135,600, 111,100, 93,000, 75,700, 63,300, 50,100, 24,300, 20,300 and 17,000 daltons were precipitated from the MS GP fraction by CSF specimens of both MS and OND groups, whereas components with MWs of 50,100, 24,300, 20,300 and 17,000 daltons were precipitated from the control GP fraction. PMID- 6843912 TI - Food intake, satiety and peptide hormones of the brain-gut axis. PMID- 6843913 TI - Federally supported human nutrition research, training, and education: update for the 1980s. PMID- 6843914 TI - On the formation and measurement of alpha-tocopherolquinone and alpha tocopherolhydroquinone in rat tissues. PMID- 6843915 TI - Radiology rounds. Test yourself: infections of bones and joints. PMID- 6843916 TI - The edematous client: causes, physical assessment and treatment. AB - Fluid movement between the plasma and interstitial compartments is regulated by a balance of forces at the capillary level. Several factors can alter this balance and lead to edema formation. Since the body has no compensatory mechanism to rid the body of excess fluid once edema appears, it is essential for nurse practitioners to accurately assess clients who may be at risk for fluid retention. This article describes the factors responsible for excess fluid accumulation, client assessment and treatment of generalized edema. PMID- 6843917 TI - Evaluating your practice via a nursing model. AB - This article discusses the use of nursing models as an evaluative tool to guide nursing practice in the primary care setting. The functional elements of a model are presented along with guidelines to facilitate selection of a model for your practice. Two case examples are utilized to demonstrate the process of application and evaluation of nursing practice via the Orem Self-Care Model and the Peplau Interpersonal Process Model. PMID- 6843920 TI - Mental health. Bridging psychiatric and primary care. PMID- 6843921 TI - Health management. Levels of intervention for a coexistence model. AB - Conceptualizing health and illness as separate, but coexisting, interacting phenomena provides the basis for delineating levels of intervention and for incorporating intervention strategies for both health and illness. This approach provides a model which directs clinical practice toward an emphasis on both health care and illness care. Nursing providers need to take the lead in recognizing that an equal if not greater emphasis on the health continuum will assist in the delivery of the full range of care necessary to meet both the health and illness care needs of society. PMID- 6843918 TI - Oral health in children: prevention of dental caries. AB - Dental problems are common among children and adolescents in the United States. More than 90 percent of our youth have dental caries, malocclusions, injury to teeth and mouth and gum disease. However, it is possible to maintain oral health and prevent dental problems and, specifically, dental caries, through education and motivation. Nurses working with children and families are more frequently in a position to initiate a program for dental health than are members of the dental profession. We feel that it is essential in light of disease occurrence and current levels of dental caries, for nurses to incorporate oral health maintenance in their care of children in ambulatory and acute care settings. PMID- 6843919 TI - Legal issues. Part 1. Nursing advocacy of patients' rights: myth or reality? PMID- 6843922 TI - Role evolution vs. legislation. PMID- 6843923 TI - Electrocoagulation diathermy for cervical dysplasia and carcinoma in situ: a 15 year survey. AB - The present report assesses 15 years' experience with electrocoagulation diathermy in the treatment of cervical intraepithelial neoplasia (CIN). Selection is based on the ability to visualize the boundaries of the lesion colposcopically. Visualization, together with cytology and target biopsy, should exclude invasive carcinoma. Histologically confirmed CIN of varying severity (almost two thirds were CIN III) was treated by diathermy in 1864 patients. The size of the lesion varied, and at times the lesion extended into the endocervical canal. Cervical intraepithelial neoplasia was eradicated in 97.3% of patients by a single diathermy treatment. Ninety-three percent of all patients under the age of 30 with CIN were treated by this method. Progression to invasive carcinoma after diathermy has not been demonstrated. A single treatment with electrocoagulation diathermy has proved consistently to be the most effective superficial ablative method for primary eradication of CIN whether deep, extensive, or of major severity. PMID- 6843924 TI - Follow-up of patients with tubo-ovarian abscess(es) in association with salpingitis. AB - The medical records of 143 patients hospitalized with a diagnosis of salpingitis over a five-year period were reviewed. Ninety-three patients had salpingitis without clinical evidence of a tubo-ovarian abscess. Seven (7.5%) of these women had surgical treatment; five of the seven were found to have tubo-ovarian abscesses which had not been detected clinically. Eighty-six of 93 (92.5%) patients with a clinical diagnosis of salpingitis and no abscess responded to medical management alone. Fifty patients had salpingitis and clinical evidence of a tubo-ovarian abscess(es); five of these patients had medical management only, 27 had medical treatment followed by surgery, and 18 had surgery initially before receiving antibiotics. There was a significant difference in age but not in parity between patients with evidence of a tubo-ovarian abscess that was managed medically and those who had surgery. There was no significant difference in surgical procedure performed, chronic symptoms, subsequent gynecologic surgery, or subsequent pregnancy among the groups with an abscess. There was a trend toward more surgical complications among women who had delayed surgical intervention for an abscess. Among women with a unilateral tubo-ovarian abscess, those who had a unilateral salpingo-oophorectomy had a higher pregnancy rate than those who received antibiotics alone. In this study, women with a tubo-ovarian abscess in association with salpingitis did not respond well to antibiotic treatment alone. This may be the most reliable way of distinguishing these patients from women with salpingitis alone or salpingitis in association with a tubo-ovarian inflammatory complex, who, as a group, did respond well to medical management alone. PMID- 6843925 TI - Conventional versus laser reanastomosis of rabbit ligated uterine horns. AB - Conventional microsurgical reanastomosis was compared with laser microsurgical reanastomosis of the ligated uterine horn in the rabbit. Fourteen virgin female New Zealand white rabbits had both uterine horns ligated and divided at laparotomy. Four weeks later, seven rabbits had conventional microsurgical reanastomosis of the divided uterine horns after the ligated stumps were excised (group 1). The ligated uterine horns of the other seven animals were incised with a carbon dioxide laser with a power density of 637 to 796 W/cm2 followed by conventional microsurgical reanastomosis using polyglactin (Vicryl) 8-0 sutures (group 2). After six weeks, a laparotomy was performed to determine adhesion formation and uterine horn patency by chromopertubation. Adhesion formation was graded 0 (no adhesions) through 3 (extensive, dense adhesions) for each uterine horn. Only one uterine horn in the control group was not patent. Laser microsurgery produced significantly less adhesion (mean +/- SE, 0.79 +/- 0.24) than conventional microsurgery (2.29 +/- 0.13) (P less than .001). The findings indicate that laser microsurgical tubal reanastomosis produces significantly better results with less adhesion than the conventional microsurgical technique. PMID- 6843926 TI - Effects of clomiphene administration on ovarian function as measured by estradiol and ultrasound. AB - The growth and rupture of the graafian follicle were studied in 23 women during 40 cycles (20 spontaneous, 20 clomiphene-induced) by the estimation of plasma estradiol levels and ultrasound scan. The mean preovulatory estradiol peak level was 415 pg/ml in spontaneous cycles and 626 pg/ml after clomiphene administration when one follicle was present. Ultrasonic examination revealed the presence of more than one developing follicle in one of 20 spontaneous cycles, and in 11 of 20 cycles after clomiphene treatment. The determination of follicle size and number by ultrasound scan during ovulation induction by the routinely used starting dosage of clomiphene has revealed a previously unrecognized incidence of ovarian overstimulation, and may allow the rationalization of ovulation induction regimens. PMID- 6843927 TI - Ectopic pregnancy--a new surgical epidemic. AB - Between March 1972 and September 1981, 154 patients with the diagnosis of ectopic pregnancy were treated at the University of Arizona. A retrospective review of these cases was performed to determine etiologic and demographic factors. Fertility follow-up was obtained in 58 women. Findings are discussed along with the presentation of various thoughts in an attempt to explain this proliferation of a surgical disease. PMID- 6843928 TI - Jogging during pregnancy: an improved outcome? AB - Little information is available concerning the effects of jogging during pregnancy on fetal and maternal outcomes. Through the use of a questionnaire, data were obtained on 67 experienced runners who continued to jog during pregnancy. The women had been running for an average of 3.8 years before the pregnancy, and ran an average of 470 miles during the pregnancy. The average number of miles run decreased as the pregnancy progressed (P less than .05). There was no correlation between the number of miles run during the pregnancy, or in the third trimester alone, and either infant birth weight or gestational age. The incidence of maternal and fetal complications was low. Although there are limitations with questionnaire retrospective studies, these data suggest that jogging during pregnancy by healthy women accustomed to such activity is not harmful to the infant. PMID- 6843929 TI - Fetal surgery for hydrocephalus: successful in utero ventriculoamniotic shunt for Dandy-Walker syndrome. AB - The diagnosis of fetal hydrocephalus based on dilation of the ventricular system presents a broad range of management decisions. The options are presented and a case of Dandy-Walker syndrome managed by fetal ventriculoamniotic shunt placement is presented as an example. Under ultrasonic guidance, a shunt was placed at 30 weeks' gestation by later newborn Dubowitz examination. Delivery was delayed for five weeks, one to two weeks following probable shunt malfunction, after achieving fetal lung maturation. Follow-up six months after definitive neonatal ventricular shunting and three weeks after shunt revision revealed a socially active male infant with a motor development index of 87 and a psychomotor development index of 95. Potential advantages of fetal surgery including achievement of term gestation are presented. Proposed guidelines for determining the benefit of such procedures are also presented. PMID- 6843930 TI - Fetal macrosomia: prediction, risks, proposed management. AB - The outcome of delivery of infants weighing more than 4000 g born during two time periods 15 years apart was studied retrospectively. The increased use of cesarean section and other obstetric advances did not reduce the risk of fetal asphyxia and trauma associated with large fetal size. Maternal factors were identified for risk categorization of fetal macrosomia during pregnancy. Macrosomia was rare at 37 weeks and increasingly common thereafter. Fetal size assessment by ultrasound at 36 to 38 weeks' gestation would permit induction of labor for the macrosomic infant before the size became excessive or would make the accoucheur aware of the dangers that may arise during delivery. PMID- 6843931 TI - Serum gentamicin levels in patients with post-cesarean endomyometritis. AB - Serum gentamicin levels were measured by agar diffusion bioassay in 38 patients undergoing treatment with clindamycin-gentamicin for post-cesarean endomyometritis. Patients received intravenous gentamicin in a dose of 1 mg/kg actual body weight every eight hours. All trough levels were less than 1 microgram/ml. The mean 30-minute postinfusion level was 5.78 +/- 2.43 micrograms/ml (mean +/- SD). The range of postinfusion concentrations was 1 to 12 micrograms/ml. Postinfusion concentrations were less than 5 micrograms/ml in 13 patients, but none of these individuals experienced a clinical failure of antimicrobial therapy. There were no statistically significant differences in mean age, weight, hematocrit, serum creatinine, estimated creatinine clearance, or administered dose in patients with therapeutic gentamicin levels and patients with apparent subtherapeutic levels. The authors conclude that postinfusion gentamicin concentrations fluctuate widely in obstetric patients receiving 1 mg/kg/dose and that apparent subtherapeutic postinfusion levels still may be clinically efficacious, depending upon the antimicrobial susceptibility of the infecting microorganisms. PMID- 6843932 TI - Grade 3 placentation: incidence and neonatal outcome. AB - Although ultrasonically detectable placental changes have been correlated with fetal maturity, the relative incidence of each placental grade at various gestational ages has not been known. During a one-year study period, placental grading was evaluated in 1709 scans performed at 27 weeks' gestation or after. At 40 weeks' gestation or beyond, only about 20% of placentas had extensive calcification (Grannum grade 3). Significant placental calcification was rarely seen before 37 weeks' gestation. Placental grading could not be used to predict postmaturity. The incidence of fetal distress in labor was found to be increased with postmaturity as well as with other pregnancy complications that give rise to premature placental senescence, rather than with grade 3 placentas per se. PMID- 6843933 TI - Intraamniotic injection of ethacridine for second-trimester induction of labor. AB - In the People's Republic of China one of the most widely used methods of second trimester abortion is the intraamniotic injection of ethacridine (Rivanol). Intraamniotic ethacridine produces fetal death, a fall in maternal urinary estriol excretion, and a rise in prostaglandin levels. Although the induction time is longer than that usually seen with prostaglandins, the method is not ordinarily associated with vomiting, cervical injury, or the delivery of a live fetus. In a series of 10,302 cases, the success rate was 96.4% and the incidence of associated complications was low. PMID- 6843934 TI - Delayed vaginal reconstruction in the fibrotic pelvis following radiation or previous reconstruction. AB - Vaginal reconstruction was performed in 14 patients who had developed vaginal stenosis secondary to extensive pelvic fibrosis after pelvic radiation therapy (12 patients) or prior vaginal reconstruction (2 patients). Sixteen procedures were performed using a split-thickness skin graft. All patients had satisfactory vaginal restoration, and 12 patients reported good vaginal function. No fistula developed as a result of the operative procedure, but one patient later developed a rectovaginal fistula resulting from tumor recurrence. Successful vaginal reconstruction can be achieved even years after initial therapy in patients who develop an obliterated vagina from previous radiation or surgery. PMID- 6843935 TI - Induced delivery prior to surgery for ruptured cerebral aneurysm. AB - Labor was induced by amniotomy at 34 weeks' gestation because of preeclampsia in a woman with a recent ruptured cerebral aneurysm prior to corrective neurosurgery. Neither labor nor vaginal delivery caused neurologic injury to the mother. Subsequent neurosurgery was successful and both mother and infant continued to do well several months later. These outcomes support management advised in the literature in circumstances not previously reported. PMID- 6843936 TI - Malfunction of ventriculoperitoneal shunts during pregnancy. AB - Two cases of successful pregnancy in patients with a ventriculoperitoneal shunt are presented. Both patients experienced shunt malfunction early in the third trimester which was apparently related to anatomic changes in the abdomen associated with pregnancy. All symptoms resolved with conservative management. The obstetric and neurologic management of such patients is discussed. PMID- 6843937 TI - Necrotizing fasciitis and progressive bacterial synergistic gangrene of the vulva. AB - Necrotizing fasciitis and progressive bacterial synergistic gangrene are two infrequently reported diseases in the gynecologic literature. The author reports 2 cases highlighting the many similarities and some important differences between these clinical entities. Diabetes mellitus and arteriosclerosis predispose women to both diseases. Aggressive antibacterial and surgical treatment is imperative. PMID- 6843938 TI - Pulmonary lymphangitic carcinomatosis from vaginal carcinoma presenting as congestive heart failure. AB - An unusual presentation of metastatic vaginal carcinoma is reported. A patient with primary squamous cell carcinoma of the vagina presented with symptoms of acute congestive heart failure, and pulmonary lymphangitic spread of the squamous cell carcinoma was found. The use of a Swan-Ganz catheter and the possible efficacy of transbronchia biopsy are discussed. PMID- 6843940 TI - Neonatal mortality statistics. PMID- 6843939 TI - Reduction of fetomaternal bleeding following diagnostic amniocentesis. PMID- 6843941 TI - The health care rebate. Interview by Karen S. Edwards. PMID- 6843942 TI - A medical student looks at Crohn's disease: the mystery and the challenge. PMID- 6843943 TI - Pulmonary fibrosis after prolonged treatment with low-dose cyclophosphamide. A case report. AB - Interstitial pulmonary fibrosis is described in a 26-year-old woman with malignant lymphoma after prolonged intake of cyclophosphamide. Cyclophosphamide was given over a period of 13 years in an oral daily dose of 50-100 mg. Lung biopsy revealed extensive fibrosis with no evidence of malignancy or infection. Cyclophosphamide is considered the most likely cause of pulmonary fibrosis in this patient. PMID- 6843944 TI - Differential agglutination of P388 adriamycin-sensitive and P388 adriamycin resistant leukemia cells. AB - Cell surface modification was studied in a subline of murine leukemia resistant to adriamycin (P388/ADR). Lectin-induced agglutination was used as a probe. Agglutination was studied using two plant lectins, wheat germ agglutinin (WGA) and Ricinus communis agglutinin-I (RCA-I). A 7-fold higher amount of WGA and 14 fold higher amount of RCA-I were required to bring about minimum agglutination of P388/S as compared to P388/ADR. The present studies clearly indicate a change in the plasma membrane of P388/ADR cells. PMID- 6843945 TI - Monoclonal cryoimmunoglobulinemia of IgG4 subclass specificity. AB - Authors demonstrated the prevalence of an unusual cryoimmunoglobulin with IgG4 subclass specificity in the blood of a patient with malignant lymphoproliferative disease. They provide the case history, results of immunochemical studies, and cytological and ultrastructural findings of the bone marrow. PMID- 6843946 TI - Susceptibility to cancer and spontaneous incidence. AB - Susceptibility to cancer implies being easily affected by carcinogen, as well as having an overt spontaneous incidence of cancer. The susceptibility of a population to the development of fatal cancer of a given organ can be represented by a frequency distribution. This distribution depends both upon the genetic susceptibility of the population and upon all environmental carcinogens that have impinged on that population. The method for construction of such a susceptibility distribution has been simplified and applied to experimental data on bone tumor induction with 90Sr in mice, and to bone tumor mortality and prostate cancer mortality in man. The relative susceptibilities of different human organs to the development of fatal tumors can be defined in terms of the spontaneous tumor mortalities. PMID- 6843947 TI - Prognostic significance of changes in serum transcobalamin levels in cancer patients with chemotherapy-induced granulocytopenia. AB - Serum transcobalamin (TC) levels were determined daily in 14 adults suffering from advanced nonhematological malignancies and hospitalized because of chemotherapy-induced leukopenia and fever. Even during the nadir leukocyte count, TCI and TCIII serum levels were normal or only slightly decreased indicating that bone marrow activity was not completely suppressed. A significant increase in serum TCII level was observed in all patients, with peak values occurring an average of 4.5 days from admission at a time when the median leukocyte count was 2,300/mm 3. Full white cell count recovery followed this peak TCII elevation within a mean of 5.5 days in all patients, coinciding with a fall in TCII levels to basal values. The rise in serum TCII level appears to be an early indicator for imminent bone marrow recovery in myelosuppressed patients. PMID- 6843948 TI - A hypothesis concerning the effect of changes in scheduling upon the cardiotoxicity of adriamycin. AB - Evidence is accumulating that the cardiotoxicity of adriamycin is a function of not only total dosage but of scheduling, with those schedules associated with low peak plasma levels of the drug being associated with significant decrease in cardiac toxicity. It is believed that adriamycin enters the cell by passive diffusion, and most cells studied, both normal and neoplastic, have an active excretory mechanism that pumps adriamycin out of the cell. If it is assumed that the myocardium has such a pump then it can be shown pharmacokinetically that those schedules associated with a low peak plasma level can, under certain circumstances, selectively protect the myocardium. PMID- 6843949 TI - Obesity, serum cholesterol, and estrogens in premenopausal women. AB - Creatinine-adjusted levels of estrone, estradiol, and estriol were determined in luteal phase urine specimens of 200 premenopausal women from rural areas of Greece. The relation of each estrogen to height, weight, obesity index, and serum cholesterol was studied by multiple regression, controlling for age, age at menarche, and ovulation status (ovulation, anovulation, undetermined). No consistent relation between any of the somatometric variables and any of the urine estrogens emerged from the statistical analysis, but among older women (30 40 years old) both estrone and estradiol were positively associated with serum cholesterol (p less than 0.05). The data provide no support for the hypothesis that the relationship between body weight and breast cancer risk is mediated through an influence of body weight on estrogen levels--at least in premenopausal women. On the other hand the data on serum cholesterol levels are consonant with the idea that qualitative aspects of nutrition may affect breast cancer risk among older (e.g., postmenopausal) women. PMID- 6843950 TI - Restricted activity of serum blocking factors related to a common tumour antigen in mice. AB - Mice of four different inbred strains (CBA, Balb/c, C57Bl/6 and DBA/2), bearing different transplanted tumours (methylcholanthrene-induced sarcomas, B16 melanoma and P-815 mastocytoma), were tested for cellular immune reactivity to the synthetic encephalitogenic peptide of human myelin basic protein by the leucocyte adherence inhibition (LAI) assay. All exhibited reactivity at about the same optimal concentration of peptide. Normal mice of all strains and pregnant CBA mice were non-reactive. Blocking of LAI was detected with serum obtained 10 or more days after tumour transplantation. Sera from mice bearing different transplanted tumours abrogated the adherence-inhibitory effect of peptide on sensitized syngeneic peritoneal leucocytes. The blocking factors were cross reactive between different tumours only within the same mouse strain, indicating a requirement for genetic compatibility between donors of the reactive cells and the serum blocking factors. PMID- 6843951 TI - [Analysis of the prereplicative period of liver regeneration in young mice. The fate of the hepatocytes in the DNA synthesis phase at the moment of surgery]. AB - In the liver of young mice after partial hepatectomy the hepatocytes which entered S-phase prior to the operation complete DNA synthesis in time and their major part is arrested in G2-phase. During the second half of lag-period (12-24 h after the operation) about half of these cells enters mitosis. Another half of the hepatocytes which were in S-phase during the operation does not proceed to mitosis. The structure of the nuclei of these latter suggests the regression of premitotic preparation: some nuclei return to the initial G0-structure of the normal heterosynthetic hepatocyte (endoreproduction cycle) and others preserve the premitotic structure characteristic of S-phase. A number of morphological features approaches this latter subpopulation to S-nuclei of tumour cells of the mouse hepatoma No. 46. A suggestion is put forward that this subpopulation has lost its capacity for heterosythesis due to operation liver trauma. PMID- 6843952 TI - [Sensitivity of the hematopoietic stem cells of anemic animals to actinomycin D]. AB - It was shown on the model of anemic animals by the method of spleen colonies that non-proliferating CFU-S were resistant against the cytotoxic effect of actinomycin D in concentrations 0.04 to 0.4 micrograms/ml. The entry of CFU-S in proliferation was accompanied by a sharp increase of the sensitivity to the antibiotic in a dose blocking DNA-dependent rRNA synthesis. PMID- 6843953 TI - [Action of heavy metal salts on the development of sea urchin embryos and on protein synthesis by the cells of transplantable mouse tumors]. AB - Zu, Cu, Cd, Pb and Hg salts blocked the cleavage divisions in the sea urchin embryos and, in lesser concentrations, affected gastrulation and induced postgastrulation defects. The early embryo- and cytotoxic effects of Zn salts appear to be based on the inhibition of protein synthesis. Unithiol exerted a protective effect. All salts under study inhibited protein synthesis in the Ehrlich's ascite carcinoma and ascite hepatoma 22a cells; unithiol and other suldhydryl compounds exerted in this case a good protective effect against Cd salts only. PMID- 6843954 TI - [Reactions of energy supply and thermogenesis in the tissues of animals born mature and immature]. AB - In the heart and skeletal muscle homogenates of mature-born neonate and adult guinea pigs succinate is oxidized intensively with a low phosphorylation rate and NAD . H without ADP phosphorylation; both the substrates are oxidized without phosphorylation in the brown fat. In the heart homogenate of immature-born neonate rats succinate is oxidized with a high ADP phosphorylation; in the skeletal muscle homogenate these substrates are oxidized with a low rate and in the brown fat homogenate with a high rate and without ADP phosphorylation. The liver homogenate of all animals in characterized by succinate phosphorylating oxidation and low rate of NAD . H oxidation. These data suggest that in homothermic animals a number of tissues have, besides the phosphorylating, also the non-phosphorylating (uncoupled-oxidizing) respiration system which might be directly related to the provision for the organism's homothermic state. PMID- 6843955 TI - [Acetylcholinesterase distribution in the blastoderm of chick embryos]. AB - The distribution of acetylcholine esterase (AChE; EC 3.1.1.7) was studied cytochemically in the blastoderm of chick embryos (stages 2-5 by Hamburger and Hamilton). The onset of primitive streak formation was accompanied by a sharp increase in the AChE activity in the anterior part of hypoblast. Changes in the AChE distribution during the early embryogenesis correlated fairly well with the movement of the primary hypoblast cells. PMID- 6843956 TI - [Mitotic activity of the embryonic tissues of the clawed toad in the period of gastrulation and neurulation]. AB - The mitotic indices (MI) were measured on serial transverse sections in ecto- and mesoderm of different dorsoventral zones of the X. laevis embryos from the late blastula stage till the end of neurulation. The MI were shown to fall simultaneously in mesoderm of all zones during the transition from middle to late gastrula (stages 12 and 13) and in ectoderm of all zones at the late gastrula stage (12 1/2 and 13) and rise synchronously in the dorsal and lateral ectoderm and lateral mesoderm during neurulation. In the most cases the rise of MI coincided with the periods of active morphogenetic movements of the given area and the fall of MI with the cessation of these movements. PMID- 6843958 TI - Laser treatment is surgery. PMID- 6843957 TI - [Intracellular distribution of NADP-dependent isocitrate dehydrogenase activity in the tissues of chickens in ontogeny]. AB - The distribution of activity of NAD . P-dependent isocitrate dehydrogenase in the chick liver and brain cytoplasm and mitochondria was studied during ontogenesis. A marked increase of its activity was found in both liver fractions during embryogenesis, with the predominance in mitochondria; the major part of its activity during postembryonic development is localized in the cytoplasm. In the brain tissues where this enzyme is less active in both the factions its activity increased to a greater extent in the mitochondria and exceeded markedly that in the cytoplasm. PMID- 6843959 TI - Combined procedure: sub-scleral trabeculectomy with cataract extraction. AB - A sub-scleral trabeculectomy and cataract extraction were performed in 34 eyes of 28 patients. Postoperative visual acuity was 6/6 to 6/12 in 24 eyes. Nine of the remaining 10 eyes had pre-existing glaucomatous neuropathy or chorioretinal maculopathy. Duration of follow-up extended from a minimum of 12 months to a maximum of 68 months. Thirty eyes exhibited satisfactory glaucoma control (88.2%). Twenty-one eyes (61.7%) required no medication postoperatively. There were no significant postoperative complications from the combined procedure. PMID- 6843960 TI - Cataract and corneal opacity are the main causes of blindness in the Samburu tribe of Kenya. AB - An ocular status survey of the Samburu tribe of Kenya was carried out. There were 844 survey members in an age and sex stratified cluster sample. The prevalence of those who were found to have moderate visual loss or worse (less than 20/60 [6/18] in the better eye) was 3.8%. Those blind by USA criteria represented 1.7% of the total population. The two principal causes of blindness, cataract and corneal opacity, are both surgically amenable. A description of the Samburu people, the survey methods, and a summary of the survey findings are included. PMID- 6843962 TI - A new headrest and drape support for ophthalmic surgery. PMID- 6843961 TI - Surgical management of cataract associated with chronic uveitis. AB - Eight eyes in five patients with cataracts associated with chronic uveitis were operated upon with instrumentation designed for vitreous surgery. A clear visual axis with improvement in visual acuity was achieved in all cases. There were no major operative complications. Vitrectomy instrumentation provides improvements over conventional techniques in the management of these difficult surgical cases. PMID- 6843963 TI - Calibrated corneal-scleral section scissors. PMID- 6843964 TI - Tapioca melanoma of the iris: a contribution to the fine structure and its significance. AB - A case of iris malignant melanoma, macroscopically classified as tapioca melanoma, was studied by electron microscopy. The tumor originated in the left eye of a patient, and a specimen was obtained during iridociclectomy. Two main types of cells were found: the differences between them concerned mainly the Golgi complex, mitochondria, RER and free ribosomes. The melanotic bodies, scantly represented, were carefully examined. The ultrastructural findings enabled us to classify these two types of cells as spindle subtype B and epithelioid types. A comparison of ultrastructural features observed in our case with those of other melanomas of the uveal tract and the skin allowed us further to stress the hypothesis of a nevoblastic origin of the tapioca tumor cells. PMID- 6843965 TI - Retinal folding in chicks enhanced by vitamin E deficiency and dietary polyunsaturated fatty acids. AB - Retinal folding appeared in young chicks fed a commercial starter diet. The degree of this folding was increased when diets deficient in vitamin E and enriched with polyunsaturated fatty acids (encephalomalatic diets) were fed. The unique response of the retina and the cerebellum to the encephalomalatic diets is pointed out. PMID- 6843966 TI - [Report of an atypical case of Goldenhar syndrome]. AB - The authors report an atypical case of Goldenhar syndrome characterized by hemifacial and cranial hypoplasia associated with severe microtia and anophthalmia on the right side, antimongoloid palpebral fissures, epibulbar epidermoid, corneal anesthesia and preauricular tags on the left side. The bilateral presence of characteristic features of Goldenhar syndrome is rare and lends support to the possibility that the patient presents an intermediate form of developmental defect of the first branchial arch. The differential diagnosis is discussed. PMID- 6843968 TI - Symposium on special considerations in sports medicine. PMID- 6843967 TI - Red blood cell, serum and tissue magnesium levels in subjects with laryngeal carcinoma. AB - Red blood cell, serum and tissue Mg concentrations in 100 subjects with aged 34 78, with squamous cell carcinoma of the larynx were determined by atomic absorption spectrophotometry. The concentration of this cation in cancerous tissues was found to be about twice as high as in the unchanged homologous tissues of the host. This was accompanied by a systemic deficiency manifesting itself by a decreased Mg concentration in red blood cells, serum and muscles which became more pronounced as the disease advanced, and returned to normal after radical treatment. PMID- 6843969 TI - Development and functions of a regional sports medicine council. The Genesee Valley Sports Medicine Council. PMID- 6843970 TI - Determinants of return to athletic activity. PMID- 6843971 TI - The doctor's bag. PMID- 6843972 TI - Overuse injuries in children's sports: the growth factor. PMID- 6843973 TI - The orthopedist's role in children's sports. PMID- 6843974 TI - Nutrition and the athlete. PMID- 6843975 TI - Rehabilitation of the knee in disorders of the patellofemoral joint: relevant biomechanics. AB - A knowledge of the biomechanics, anatomy, and contact pattern of the patellofemoral joint provides the basis for the selection of a highly individualized program of rehabilitation for those with patellofemoral disease. The program of choice is one that minimizes high impact loading activities and avoids the generation of greater than physiologic contact stress unit loads at articular surfaces. Recommended exercises for rehabilitating the patellofemoral joint include isometrics, terminal extension exercises, swimming, and cycling. PMID- 6843976 TI - Muscle fiber types. Their relationship to athletic training and rehabilitation. PMID- 6843977 TI - Ultrastructural differences in human skeletal muscle fiber types. PMID- 6843978 TI - Warm-up, strength, and power. PMID- 6843979 TI - Types of strength training. AB - Strength gains may be obtained by performing any type of resistance training if voluntary maximal contractions are performed. It is necessary that the advantages and disadvantages of a particular type of strength training are carefully considered before incorporating it into a program. Variables that should be considered include cost of equipment, motor performance increases, amount of strength gains, and range of motion of the strength gains. Further research comparing the different types of strength training is needed. PMID- 6843980 TI - Production and utilization of energy in athletes. PMID- 6843981 TI - [The value of renal scintigraphy in the diagnosis of destructive pathological processes in the renal parenchyma]. PMID- 6843982 TI - [Incidence of cutaneous porphyria in Rotor syndrome]. PMID- 6843983 TI - [Surgical management of aneurysm of the left chamber]. PMID- 6843984 TI - [Glycosylated serum proteins in diabetics]. PMID- 6843985 TI - [The significance of local antibiotic therapy of lower respiratory tract diseases in infancy and childhood]. PMID- 6843986 TI - [Adrenal gland scintigraphy]. PMID- 6843987 TI - [Diagnosis of Budd-Chiari syndrome--in relation to the in vivo detection of a hepatic vein anomaly in a child]. PMID- 6843988 TI - [Cooperation for the prevention of diabetic embryopathy (Appeal to physicians concerned)]. PMID- 6843989 TI - [Retrograde tracheo-laryngofiberoscopy]. PMID- 6843990 TI - [A side-effect of carbamazepine]. PMID- 6843991 TI - [Successfully treated Boerhaave syndrome]. PMID- 6843994 TI - [Immunologic tests in patients with chronic lymphoid leukemia and with non Hodgkin lymphoma]. PMID- 6843992 TI - [The role of the cervical factor in normal ovulation with subfertility]. PMID- 6843993 TI - [Alport syndrome. Results of a survey of 6 Hungarian families]. PMID- 6843996 TI - [Rehabilitation of patients suffering from chronic diseases]. PMID- 6843997 TI - [Traditional social and family structure, surviving traditions and psychiatric disorders in India]. PMID- 6843995 TI - [Hyperthyroidism induced by parquet lacquer poisoning]. PMID- 6843998 TI - [Primary prevention of ischemic heart disease. Possible and indicated management in childhood]. PMID- 6843999 TI - [Incidence of cataract during corticosteroid therapy]. PMID- 6844000 TI - [Hemodynamics in unstable angina pectoris]. PMID- 6844002 TI - [Fibrin adhesive in testicular surgery (animal experiments)]. PMID- 6844003 TI - [Essential athrombia: primary hereditary disorder of thrombocyte aggregation]. PMID- 6844004 TI - [Idiopathic neonatal hyperbilirubinemia associated with significant bacteriuria]. PMID- 6844001 TI - [Appendicitis causing an unusual combination of clinical symptoms]. PMID- 6844005 TI - [Screening of postoperative deep vein thrombosis by the Doppler ultrasonic method]. PMID- 6844006 TI - [Indications and optimal time for closure of the cervix]. PMID- 6844007 TI - [Myocardial infarct in the aged]. PMID- 6844008 TI - [Unusual cases of gonorrhea]. PMID- 6844009 TI - [Breast self examination, its value and difficulties]. PMID- 6844010 TI - [Roentgenologic aspects of disability evaluation]. PMID- 6844012 TI - [Biochemical tests in the study of the function of the soft palate muscle in patients with cleft palate]. PMID- 6844011 TI - [Significance of estradiol-progesterone levels in breast tissue in the management of breast cancer]. PMID- 6844013 TI - [Unrecognized tuberculosis in the autopsy material of the Szeged Institute for Pathology]. PMID- 6844014 TI - [Infrapulmonary effusion]. PMID- 6844015 TI - [Granuloma venereum]. PMID- 6844016 TI - [Pathophysiology and classification of soft tissue damage in fractures]. PMID- 6844017 TI - [Microbiologic and chemotherapeutic aspects of open fractures]. PMID- 6844018 TI - [The problem of open tibial shaft fractures]. PMID- 6844019 TI - [The compartment syndrome]. PMID- 6844020 TI - [Soft tissue lesions in bone fractures]. PMID- 6844021 TI - [Indications and limitations of surgical replantation]. PMID- 6844022 TI - [Postoperative care of fractures with severe soft tissue injuries]. PMID- 6844023 TI - [Previously treated fractures with soft-tissue injuries]. PMID- 6844024 TI - Analgesia for orofacial nociception produced by morphine microinjection into the spinal trigeminal complex. AB - Morphine sulfate (0.75 micrograms) was microinjected into (rat) rostral and caudal trigeminal areas singly and simultaneously, using cannula-electrode combinations. Also, 0.5 micrograms or 1.0 micrograms of morphine was injected into nucleus reticularis paragigantocellularis (PGC). Both single trigeminal nuclear microinjections significantly elevated the latency to a defensive face rub reaction to noxious facial heat, bilaterally. There was no summation effect with the conjoint injection of 1.5 micrograms total to rostral and caudal nuclear areas. The 0.5 micrograms injection in PGC had a significantly larger effect than did the 0.75 microgram trigeminal injections. The caudal but not the rostral trigeminal injections did elevate the threshold for aversive reaction to caudal trigeminal nuclear stimulation of the injected tissue. This finding contrasts with the previously reported fact that as much as 1.0 microgram of morphine in PGC has no effect on this aversive reaction threshold to brain stimulation. PMID- 6844025 TI - Flexion withdrawal reflex as recorded from single human biceps femoris motor neurones. AB - Reflex responses were elicited in the biceps femoris muscle of patients with cervical spinal cord lesions by stimulating the sural nerve and recording from single motor neurones by single fibre EMG technique. The consecutive responses within the surface-recorded early component displayed a latency jitter between 500 and 600 microsec (S.D.), suggesting an oligosynaptic reflex arc. These responses were rarely seen; they were suppressed by increasing the stimulus strength. The surface-recorded late component consisted in the single fibre EMG recordings of repetitive discharges of individual motor neurones. The latency jitter of the earliest of these discharges was about 1440 microsec, and it progressively increased in the later discharges, reflecting increasingly more variable central conduction time. Ischaemia of the leg made some of the late discharges at a latency of about 0.5 sec remarkably stable and reduced their jitter. They may represent responses to the activity of slowly conducting afferent fibres, normally suppressed by inflow along the fast conducting fibres. Stimulation of dorsal columns through epidurally placed electrodes at T1 and T2 levels resulted in a complete suppression of repetitive discharges, outlasting the actual stimulation. TENS and light stroking of the skin below the level of the spinal cord lesion, as well as subthreshold stimuli to the sural nerve, had a similar effect. These results suggest that the late component of the flexion reflex may share some of the neural mechanisms responsible for feeling pain. PMID- 6844027 TI - Sources of variation in analgesic responses in cancer patients with chronic pain receiving morphine. AB - Our objective was to identify and quantify sources of variation in the relief of chronic pain with morphine. Relief scores were extracted from records obtained during controlled trials of analgesics in cancer patients with chronic pain in which intramuscular morphine was the assay standard. Relief data from 715 patients after 565 8-mg and 538 16-mg doses were segregated according to age, race, sex, pre-drug pain intensity, character and site. Middle-aged patients obtained relief after 8 mg comparable to relief obtained by younger patients after 16 mg; oldest patients obtained relief after 8 mg comparable to relief obtained by middle-aged patients after 16 mg. Blacks receiving 8 mg obtained relief comparable to whites receiving 16 mg. Sex-related differences were not significant. Patients with moderate, as compared to severe, pre-drug pain obtained significantly greater relief only after 16 mg. Patients reporting dull pain obtained relief after 8 mg comparable to relief obtained with sharp pain after 16 mg. Patients with abdominal pain obtained relief after 8 mg comparable to relief of pain in the chest or arms after 16 mg. These results provide dose related evidence of variation in relief with morphine in chronic cancer pain and establish particular patient and pain characteristics as variables for which controls should be provided in analgesic assays. PMID- 6844028 TI - Trigger point injections vs. jet injection in the treatment of myofascial pain. AB - Trigger point injections using dilute solutions of local anesthetic agents have proved effective for many patients with myofascial pain. The treatment itself, however, can produce severe pain and may occasionally be associated with complications. It was determined in this study that a local anesthetic solution administered by jet injection in the area of myofascial trigger points was capable of providing short-term pain relief equal to conventional trigger point injections using a hypodermic needle and syringe. The jet injector system produced significantly less pain during treatment than conventional trigger point injections and therefore was preferred by most subjects having the opportunity to compare both forms of treatment. PMID- 6844029 TI - Suppression of primary and secondary antibody responses and inhibition of antigen priming during Babesia microti infections in mice. AB - The antibody response to sheep red blood cells (SRBC) has been measured in C57Bl mice infected with the intra-erythrocytic piroplasm Babesia microti. The primary antibody response is severely reduced or abolished when antigen is administered at the time of maximum parasitaemia. The secondary antibody response of infected mice, which had been primed with SRBC, is reduced but retains the characteristics of a secondary response. Mice injected with SRBC at maximum parasitaemia failed to become primed to that antigen: these mice gave a primary antibody response to a second injection of SRBC given after the infection had become sub-patent. B. microti, therefore, can completely prevent the induction of memory, but only partially inhibit the expression of memory. PMID- 6844026 TI - Behavioral test of tolerance for aversive mechanical stimuli in sympathectomized cats. AB - Cats were studied behaviorally to determine their suitability as an animal model for the post-sympathectomy hyperalgesia reported to occur in humans. For this study a device and methodology were developed which allow humane testing of tolerance for intense mechanical stimulation of the hindlegs. Behavioral tolerance was measured quantitatively before and after unilateral sympathectomy. The results from this preliminary study of 6 cats are remarkably similar to those reported for humans; 1 of the 6 cats showed a decreased tolerance on the sympathectomized side which was delayed in onset and of limited duration. The new methodology appears to provide relatively stable, quantitative measures of tolerance for aversive stimulation, and the cat shows promise as an animal model for post-sympathectomy hyperalgesia. PMID- 6844030 TI - Chemotaxis of human granulocytes toward microfilariae of Onchocerca volvulus. AB - Migration of human peripheral blood granulocytes in response to microfilariae of O. volvulus was demonstrated using modified Boyden chambers. Granulocyte migration was significantly enhanced when microfilariae were preincubated with heat-inactivated immune serum (delta IS), then added to a fresh serum source (P less than 0.025). This effect was not seen when microfilariae were incubated in medium alone, in delta IS alone, in delta IS plus C4-deficient guinea-pig serum, or in fresh serum alone. There was no significant difference between the response of cells from O. volvulus-infected donors and that of cells from normal volunteers. Likewise, there was no significant difference between the migratory response seen toward nodule- versus skin-derived microfilariae. These results suggest that the host inflammatory response to O. volvulus microfilariae is mediated in part by chemotactic factors generated by antibody and complement interaction with the organism and, furthermore, that these factors are product(s) of classical complement pathway activation. PMID- 6844031 TI - [Passage of the microfilaria, Thamugadia ivaschkini, from the intestine into the hemocele of the sand flies of the genus Phlebotomus]. AB - Sand flies of Ph. papatasii and Ph. caucasicus were experimentally infected with Th. ivaschkini. At daily fluctuations of air temperature from 27 to 32 degrees C and relative air humidity from 30 to 60% viable microfilarians migrate into haemocoel within the first 5-6 hours after the blood-sucking of vectors, before the peripheral membrane is completely formed. Most parasites leave the intestine before the formation of a blood clot, within the first 1.5 hour after feeding. The number of larvae overcoming the intestinal barrier (at studied levels of infection) does not depend on the number of devoured microfilarians and is close to 100%. Sand flies of the genus Phlebotomus lack physiological mechanisms limiting the migration of microfilarians from the intestine that causes a high mortality of these vectors at intensive infection. PMID- 6844032 TI - [Glandular nature of the area porosa on the gnathosomes of Ixodes ticks (Ixodidae)]. PMID- 6844033 TI - [Effect of prolonged stay in the organism of the tick Ornithodoros tartakovskyi (Argasidae) on the properties of Yersinia pestis]. PMID- 6844034 TI - [Effect of the repeated infecting feeding with plague microbe on block formation in fleas (Siphonaptera)]. PMID- 6844035 TI - [Problem of tissue adaptation to hypoxia]. PMID- 6844036 TI - [Metabolic aspects of the formation of "shock kidney"]. PMID- 6844037 TI - [Changes in blood rheological properties during extracorporeal circulation]. PMID- 6844038 TI - [Effect of hydrocortisone on lymph circulation and biochemical indices of lymph and blood in anaphylactic shock]. PMID- 6844039 TI - [Heart contractile function and the ultrastructure of the cardiomyocytes during protracted hypokinesia in growing animals]. PMID- 6844040 TI - [Effect of neuropeptides on experimental duodenal ulcer in rats]. PMID- 6844041 TI - [Changes in the electrocardiogram and the phase structure of the cardiac systole in experimental closed chest injury]. PMID- 6844042 TI - [Comparative study of the blood coagulation disorders in unobstructed and thrombosed vascular anastomoses in animals with a splenic autograft]. PMID- 6844043 TI - [Hageman factor indices in arterial and venous blood in severe skeletal trauma]. PMID- 6844044 TI - [Indices of carbohydrate metabolism and lysosomal enzyme activity in the cerebrospinal fluid in the postresuscitation period]. PMID- 6844045 TI - [Thrombocyte aggregation and the antiaggregation activity of the aorta in intact and thymectomized rats]. PMID- 6844046 TI - [Possibilities of using a method of automatic image analysis for studying the state of normal microcirculation and in injury]. PMID- 6844047 TI - [Contact microscopy and interactive television methods in studying the microcirculation in extreme states and their infusion therapy]. PMID- 6844048 TI - [Error analysis of a thermodilution method in determining circulatory minute volume]. PMID- 6844049 TI - The effects of metrizamide on the lung. AB - The pathologic effects of metrizamide on the lung were studied at 24 h and 48 h after its instillation in varying concentrations selectively into the right lungs of a series of immature dogs. Iso-osmolar and slightly hyperosmolar concentrations of metrizamide were found to cause mononuclear interstitial infiltration, focal areas of pneumonia and in some cases alveolar hemorrhage. Control bacterial studies showed that the reaction was aseptic. PMID- 6844050 TI - Adrenal carcinoma and adenoma in children: a review of 17 patients. AB - Seventeen children with adrenocortical neoplasms (13 carcinomas: four adenomas) are reviewed and attention is focused on the value of the newer imaging modalities in the management of these children. All the lesions were functioning tumors. CT is the single most important modality in assessing primary and metastatic disease at diagnosis and during follow-up. In children suspected of having an adrenal lesion, high resolution CT will promptly localize the lesion to an adrenal. Since the only curative treatment is complete surgical removal CT plays an important role in defining the extent of the primary lesion pre operatively. Large carcinomas have an inhomogeneous density on CT and a complex echo pattern on ultrasound reflecting the areas of hemorrhage and necrosis seen macroscopically in these lesions. Smaller lesions have a more homogeneous density on CT but benign and malignant disease could not be differentiated by this modality. Ultrasound is useful in screening the adrenal area in those patients in whom there is a low clinical index of suspicion for an adrenal tumor and also in the post-operative period. PMID- 6844051 TI - A possibly new form of familial bone dysplasia resembling dyschondrosteosis. PMID- 6844052 TI - The metacarpal index of normal Nigerian children. AB - The metacarpal index (MCI) of 500 normal Nigerian children whose ages range from birth to 16 years was determined. The MCI of Nigerian children is higher than that of their Caucasian counterpart, but similar to that of Jamaican children. The adult range of MCI is reached at the relatively low age of 9 years. The index is higher in females than males and the value for the left hand is higher than that for the right hand. PMID- 6844053 TI - Esophageal involvement in eosinophilic gastroenteritis. PMID- 6844054 TI - Nephrocalcinosis demonstrated by ultrasound and CT. PMID- 6844055 TI - Hypertrophic osteoarthropathy in biliary atresia. AB - This case report describes a child with biliary atresia and hypertrophic osteoarthropathy (HO), the second such case report of HO in a child with biliary atresia. Suggested pathogenetic mechanisms are discussed. Surgical intervention in the treatment of biliary atresia has clearly increased survival in affected children. The relationship between surgical intervention, either successful or unsuccessful, and hepatic HO remains speculative. PMID- 6844056 TI - Mesomelic dysplasia with "normal or relatively long fibula", slight micrognathia and brachymetatarsals (IV-V) in a six-year-old girl. PMID- 6844058 TI - Abstracts of the 25th annual meeting of the Society for Pediatric Radiology. New Orleans, Louisiana, 7-9 May 1982. PMID- 6844057 TI - Barium peritonitis. Experience of five pediatric cases. AB - Barium peritonitis secondary to perforation of the gut is an infrequent complication of radiological G-I tract examinations. It is thought to imply a high mortality rate. However, this conception seems to be based on data obtained during the early 1950's. More recent case reports and small series indicate a more favourable prognosis depending on effective antibiotics and successful maintenance of severely ill patients. The scant information concerning the fate of pediatric cases warranted presentation of the experience of 5 patients, who all survived. Our approach to treatment and the suggested use of barium studies, in particular barium enema, in obscure abdominal emergency cases are offered. PMID- 6844059 TI - Paced abdominal breathing and EMG responsivity. AB - 5 subjects participated in a within-subjects design to determine the effect of paced abdominal breathing on EMG levels. After training in thoracic and abdominal breathing, each subject's respiration performance and EMG levels were assessed in both breathing modes via a counterbalanced A-B-A-B reversal design. Reliable effects of respiration training were observed in both breathing modes. No effects were observed on EMG measures. The results were discussed in relation to literature on approaches to respiration training which may target specific arousal indices other than electromyogram activity. The utility of dovetailing complementary treatment techniques such as respiration training and relaxation training which are specific to particular arousal indices was discussed. PMID- 6844060 TI - Tone-taste synesthesia: a replication. PMID- 6844061 TI - Sex differences in neuropsychological performance. PMID- 6844062 TI - Scaling apparent distance in a large open field: some new data. AB - Judged distance in a large open field, scaled by the method of magnitude estimation, is related to physical distance by a power function with an exponent smaller than unity. The exponents obtained with two ranges of distance were not affected by the availability of a standard. The mean exponent for all 80 individual power functions was 0.86, with a standard deviation of 0.11. PMID- 6844063 TI - Relationships of perceptual-motor development to hyperkinesis, educational placement, drug utilization, socioeconomic status, and age. PMID- 6844064 TI - Communication through physical activity for learning disabled children. AB - To measure the extent to which an integrated program of motor and cognitive tasks might enhance the learning disabled children's motor and basic cognitive skills, a treated group of 8 had three 1/2-hr. sessions per week for 6 mo. 8 control subjects continued regular physical education and reading programs with their classroom teacher. All subjects were tested before and after 6 mo. Over-all the treated group showed greater improvement on tests of both motor and cognitive skills than the control group. This study suggests a physical activity program can influence basic cognitive skills as well as motor skills. PMID- 6844066 TI - Patients', medical students', and physicians' perceptions of male and female physicians. PMID- 6844065 TI - Effects of passive physical exercise on peripheral vision in muscular dystrophic children. AB - To investigate the effects of passive exercise of the extremities on peripheral vision of muscular dystrophic children aged 9 to 13 yr. these subjects were either not exercised (control days) for a 6-min. period or were exercised (experimental days) for a 6-min. period after a 5-min. rest. Peripheral vision was recorded after each condition. Analysis of variance with repeated measures on the exercise and no exercise conditions was computed for each measure. 6 min. of passive exercise significantly increased peripheral vision. It was assumed that exercise increased blood flow through the lungs allowing for greater oxygen diffusion in the brain and other facilitory responses which increased effective cerebral activity. Curriculum revisions for such children indicate the importance of activity in facilitating subsequent learning. PMID- 6844067 TI - Feedback influences on the skill of putting. AB - To determine the influence of two forms of visual control techniques and one kinesthetic technique on putting accuracy 27 right-handed female volunteers performed a putting task under one of three testing conditions: eyes on ball, eyes on target, and no vision. Three putting distances of 5, 10, and 15 ft. were employed. The results of a 3 (conditions) x 3 (putting distances) analysis of variance with repeated measures on the second factor indicated that the shorter the putting distance the more accurate the responses. There were no marked differences among the three visual and kinesthetic conditions. Since no differences were found among the visual and kinesthetic putting conditions, it may be argued that the elimination of vision may enhance learning in the early stages of putting skill acquisition. PMID- 6844068 TI - Cognitive tunneling: use of visual information under stress. AB - References to "tunnel vision" under stress are considered to describe a process of attentional, rather than visual, narrowing. The hypothesis of Easterbrook that the range of cue utilization is reduced under stress was tested with a primary task located in the visual periphery. High school volunteers performed a visual discrimination task with choice reaction time (RT) as the dependent variable. A 2 X 3 order of presentation by practice design, with repeated measures on the last factor, was employed. Two levels of stress, high and low, were operationalized by the subject's performing in the presence of an evaluative audience or alone. Pulse rate was employed as a manipulation check on arousal. The results partially supported the hypothesis that a peripherally visual primary task could be attended to under stress without decrement in performance. PMID- 6844069 TI - Perception: a model comprising two modes of consciousness addendum: evidence based on event-related potentials and brain lesions. PMID- 6844070 TI - Associative relationships between pre-sleep sentence stimuli and reports of mental sleep experience. AB - The aim of this experiment was to study some linguistic relationships between pre sleep verbal stimuli and contents of reports of mental experience during sleep. In 4 weekly sessions 16 subjects listened before sleep to a sentence stimulus, which was either semantically acceptable (SEM+) or not (SEM-), and were told to retain it for a recall test after awakening; they were awakened once each night during NREM or REM sleep and asked to report their mental experience during sleep. The relationships between the stimulus and the contents of the reports were classified using Clark's (1970) associative rules. Both pre-sleep sentence stimuli were frequently incorporated into contents of NREM and REM reports, without significant differences between the two types of sleep. The SEM+ sentence led prevalently to incorporations through paradigmatic associative relationships, while the SEM- sentence led to incorporations through both paradigmatic and syntagmatic relationships. It appears that all the features of the lexical constituents of the stimulus may be involved in the processing leading to incorporation. PMID- 6844071 TI - Aftereffect of induced rotation: separation of inducing and static areas, and monocular component. AB - The present investigation shows that the aftereffect of induced rotation is observable when there is a large separation of inducing and static areas; it also has a substantial monocular component. These points are consistent with the possible involvement of lateral inhibition in movement detectors. (a) A recent study shows the importance of a peripheral inducing stimulus, and therefore presumably peripheral movement detectors; other psychophysical evidence shows that such detectors have large receptive fields and inhibitory surrounds. (b) Other effects probably involving lateral inhibition in movement detectors have a large monocular component. PMID- 6844072 TI - Aerobic fitness and emotional arousal: a further response to Zimmerman and Fulton. PMID- 6844073 TI - Rate and distribution of body movements during sleep in humans. AB - Body movements were measured during sleep with a mechanoelectrical transducer in 11 healthy adults. Also measured were the electroencephalogram (EEG), electrooculogram (EOG), and electromyogram (EMG). Each subject slept alone in a quiet room for 21 to 44 consecutive nights. Body movements were classified as minor movements (actogram signal or head leads artifact), major movements (actogram signal plus head leads artifact), or movement time (MT). There was a strong relationship between rate of body movements and sleep stages, with the rate decreasing along the following sequence of stages: W greater than S1 greater than REM greater than S2 greater than S (3 + 4). If the body movements for all nights are pooled per subject, the distribution of body movement rates shows hardly any overlap for the Stages 1, REM, 2, and (3 + 4). The relative frequency of body movements seems to be regulated by a stage-dependent mechanism. The reliability of the body movement rate was determined by computing correlations between pairs of adjacent nights, which resulted in a rtt = .69. When 2 to 9 nights were pooled stepwise according to a split-half procedure, the mean rtt increased and reached values between .80 and .90, which means that body movements are a reliable sleep measure especially if the time base is large enough. PMID- 6844074 TI - Visual imagery and the corpus callosum: a theoretical note. PMID- 6844076 TI - Emotional content of dreams recalled by elderly women. AB - At the end of 6 wk., 37 elderly women turned in 145 dream narratives and accompanying emotions. Approximately two emotions were used to describe each dream; enjoyment, surprise, distress, confusion, interest, and fear accounted for 86% of all dream emotions. The emotions of disgust, anger, shame, and contempt were infrequently reported by these elderly persons. The dreams associated with the retirement life style of the elderly exhibited pleasant as well as unpleasant emotions. PMID- 6844075 TI - Brain laterality: differences in cognitive style or motor function? AB - Two studies were completed to evaluate the role of motor function in the observable brain laterality of normal, familial, dextral males. A right-brain advantage was demonstrated on a figure-matching task and on a sequential-spatial task when subjects responded with a manual key press. A left-brain advantage for the same two tasks was demonstrated when subjects responded by compressing a microswitch embedded in a mouthpiece. The data suggest that both hemispheres of the brain may be capable of processing visuospatial stimuli but do not share the same facility for effecting appropriate motor responses. The results were discussed in terms of lateralized cognitive styles in brain and lateralized control of effector systems. PMID- 6844077 TI - Comparison of static balance in trainable mentally handicapped and nonhandicapped children. AB - While for 31 trainable mentally handicapped children and for 31 nonhandicapped (Mage 91.56 mo.), there were no differences in static balance on left or right legs, total balance time was significantly different between the two groups, confirming prior work which related motor proficiency to intelligence. The normal group showed significant positive correlations among height, weight, age, and measures of static balance but only age was not correlated with balance for the handicapped group. PMID- 6844078 TI - Developing an instrument for eliciting children's description of pain. PMID- 6844079 TI - Manipulation of dominant/non-dominant hand and ipsilateral/contralateral movement as a function of response organization in fourth grade children. AB - The purpose of this study was to measure response organization effects in 30 children in Grade 4. On a reaction time task, subjects were pre-cued as to the forthcoming response, being either an ipsilateral or contralateral response, which hand to use, or on which side the response would be. In each condition, there were varying degrees of response uncertainty and predictability. Analysis indicated that knowing which hand to use played a major role in response organization. However, when the subject was unsure of which hand to use but the other variables were pre-cued, reaction time increased significantly. PMID- 6844080 TI - Misattribution in a fearful situation following different modes of arousal. AB - 52 female college students were exposed to procedures expected to produce some physical or emotional arousal (viewing a sexually-explicit film or riding an exercise bicycle) and were subsequently asked to approach a snake, of which they had previously reported being afraid. Their performance was compared to that of control subjects who had been exposed to non-arousing tasks (viewing a film about sunspots or reading an article about exercise). The prediction that prior arousal would produce misattribution and reduce snake avoidance was not supported. PMID- 6844081 TI - Daylight saving-time changes increase traffic accidents. PMID- 6844082 TI - Age, sex, and body composition as predictors of children's performance on basic motor abilities and health-related fitness items. AB - The purpose of this study was to determine the contribution of age, sex, and body composition to children's motor performances on selected basic motor tasks, balance, speed, agility, power, coordination, and reaction time, and health related fitness items, flexibility, muscle strength and endurance, and cardiovascular functions. 80 subjects were students in Grades 1, 2, 3. Data were submitted to a step-wise multiple linear regression for each criterion variable. Predictor variables were age, sex, and body composition. Age was a significant factor in predicting performance on all variables except muscle strength, endurance, and flexibility. Sex significantly predicted performance for only flexibility and cardiovascular function and body composition for the power and cardiovascular function variables. Beyond the biological potential of each individual are factors that influence his motor development. These factors need early identification to make possible opportunities for each person to reach the full perimeters of motor potential. PMID- 6844083 TI - Job satisfaction of nursing home administrators. PMID- 6844084 TI - Factor analytic study of the Kurtzman Community Dental Health Ideology Scale. PMID- 6844085 TI - Developmental differences in Bender-Gestalt recall of children with learning and behavior problems. AB - To investigate the visual-memory ability of children referred for psychological evaluations of academic and/or behavior problems, 135 children were administered the Bender-Gestalt and then asked to reproduce as many designs from memory as they could. Analysis indicated that the number of designs recalled increased with age and Performance IQ but not Full Scale IQ. Results were discussed in terms of the importance of considering developmental level when evaluating children and the establishment of rough cut-off scores on recall of the Bender-Gestalt designs. PMID- 6844086 TI - "Reverse" Stroop effect in the performance of schizophrenics. AB - The hypothesis was tested that a group of 30 schizophrenic in contrast to a control group of 35 non-schizophrenic patients would demonstrate substantial and significantly more "Reverse" interference in reading incongruent word-color combinations on the Stroop Color-Word Interference Test. Results supported the hypothesis. A "reverse" interference of 19% and of 9% was observed in the groups' performances, respectively. The group performance differences were much larger on both the classical "Stroop" and "Reverse" interference tasks than on corresponding non-interference tasks. But these interactions were not statistically significant. Measures of absolute and proportional performance decrements on the interference tasks showed no correlations between "Stroop" and "Reverse" interference. Issues discussed included impaired selective attention in schizophrenics' performance, the unexpected high "Reverse" effect in control data and the psychodiagnostic applications of reverse interference. PMID- 6844087 TI - Attending to different levels of structure in a visual image. PMID- 6844088 TI - Color segregation and selective attention in a nonsearch task. PMID- 6844089 TI - Uncertainty about spatial frequency, spatial position, or contrast of visual patterns. PMID- 6844090 TI - Magnitude estimation of temporal intervals. PMID- 6844091 TI - An illusion of eccentricity. PMID- 6844092 TI - Temporal order judgment of auditory stimulus offset. PMID- 6844093 TI - The roles of contour and luminance distribution in determining perceived centers within shapes. PMID- 6844094 TI - The effects of temporal waveform upon apparent contrast. PMID- 6844096 TI - Temporal limits to the detection of correlation in transpositionally symmetric dynamic dot textures. PMID- 6844095 TI - The effects of flicker adaptation upon temporal contrast enhancement. PMID- 6844097 TI - Visual transformations underlying apparent movement. PMID- 6844098 TI - Lingual vibrotactile sensation magnitudes: comparison of suprathreshold responses in men and women. PMID- 6844099 TI - Constant errors in the simultaneous matching of angles are not an artifact of the starting point for adjustment. PMID- 6844100 TI - Cyclofusion and stereopsis. PMID- 6844101 TI - Shifts of attention in the identification and discrimination of intensity. PMID- 6844102 TI - QUEST: a Bayesian adaptive psychometric method. PMID- 6844103 TI - Forest before trees? It depends where you look. PMID- 6844104 TI - Lateral masking as a function of spacing. PMID- 6844105 TI - Bidirectional contrast effects in the perception of VC-CV sequences. PMID- 6844106 TI - Vibrotactile temporal summation for threshold and suprathreshold levels of stimulation. PMID- 6844108 TI - Sharp-edged vs. diffuse illusory circles: the effects of varying luminance. PMID- 6844107 TI - Null effects of exposure duration and heterogeneity of difference on the same different disparity in letter matching. PMID- 6844109 TI - Perception of radial distance as a function of magnification and truncation of depicted spatial layout. PMID- 6844110 TI - Taste-taste, odor-odor, and taste-odor mixtures: greater suppression within than between modalities. PMID- 6844111 TI - A model of perceived intersection of two converging line segments. PMID- 6844112 TI - The perception of growth in three dimensions. PMID- 6844113 TI - Subjective contours and apparent depth: a direct test. PMID- 6844114 TI - Legends and myths: a basis for scientific research? PMID- 6844116 TI - The doctor, the patient, and the system: reflections on education for clinical careers. PMID- 6844115 TI - Therapeutic use of spontaneous imagery. PMID- 6844117 TI - The healer-patient/family relationship in Vonda N. McIntyre's "Of Mist, and Grass, and Sand". PMID- 6844118 TI - Interdisciplinary teaching with humanists: reflections of a biological scientist. PMID- 6844119 TI - Homosexuality as a by-product of selection for optimal heterosexual strategies. PMID- 6844120 TI - Doctor-patient relationship. PMID- 6844121 TI - Analysis of creams. IV. Application of high performance liquid chromatography. Part I. AB - The possibilities of applying reversed-phase high performance liquid chromatography to the analysis of o/w emulsion type creams without preceding sample clean-up were investigated. The chromatographic behaviour of cream base components and active compounds in reversed phase systems consisting of methanol water mixtures as the mobile phase and a chemically bonded octadecyl stationary phase, was studied. A number of active compounds and the preservative (sorbic acid) could be determined--often in one chromatographic run--without complications, by simply dissolving the sample in a suitable solvent mixture and injecting an aliquot of the solution into the chromatograph. Separation was achieved by the proper choice of methanol content, pH and ionic strength of the eluent. The compounds were detected by UV absorption. Some of the lipophilic cream base components could easily be determined in the same manner, with methanol as the eluent and with refraction index detection. The developed procedure was applied to the analysis of a number of creams. Some of the results are presented as examples, demonstrating the suitability of the method for quality control purposes. PMID- 6844122 TI - Plasma levels of acetylsalicylic acid and salicylic acid after oral ingestion of plain and buffered acetylsalicylic acid in relation to bleeding time and thrombocyte function. AB - Buffered acetylsalicylic acid (Alka Seltzer, B-ASA) and plain aspirin (P-ASA) tablets were compared as to their effects on bleeding time and platelet function in eight healthy male volunteers. Two doses (500 and 1000 mg) of each preparation were investigated in a cross-over design, each volunteer being his own control in each dose group (n=4). Both preparations disturbed platelet aggregation to the same extent. Bleeding time increased after both preparations, though significantly more after the buffered preparation than after plain acetylsalicylic acid, irrespective of the dosage. The 1000 mg dose prolonged bleeding time significantly more than the 500 mg dose, irrespective of the preparation. Kinetic analysis showed that B-ASA gave higher peak plasma levels of acetylsalicylic acid (ASA) and accordingly salicylic acid peak levels were also higher after the buffered preparation. It is concluded that B-ASA in equi analgesic doses prolongs bleeding time more than the plain preparation. Since it is less agressive on the gastro-intestinal mucosa, its use may be advantageous in situations where acetylsalicylic acid induced loss of platelet aggregation is desired. However, the risk of prolonged bleeding--e.g. after tooth extractions- is probably higher after the buffered preparation. PMID- 6844123 TI - Conductometric determination of methenamine. AB - A method of conductometric titration for determination of methenamine is presented. An aqueous solution of silicotungstic acid is used as titrant. The acid and methenamine form an insoluble compound in which the molar ratio of the acid to methenamine is 1:4. Conductometric curves were obtained, the shapes of which are suitable for accurate and reproducible determination of the end point of titration. The results show reasonable accuracy. Good reproducibility was achieved even when small quantities of methenamine had to be determined. PMID- 6844124 TI - Spasmolytic activity of the flavonoids from Thymus vulgaris. AB - Flavonoids from Thymus vulgaris L. have been studied in vitro for spasmolytic activity on the smooth muscles of the guinea-pig ileum and trachea and of the rat vas deferens. The flavones and thyme extracts inhibit responses to agonists which stimulate specific receptors (acetylcholine, histamine, L-noradrenaline) as well as to agents whose actions are not mediated via specific receptors (BaCl2). Cumulative dose-response curves point to a non-competitive antagonism. Inhibition of Ca2+ contractions on K+ depolarized smooth muscles suggest inhibition of availability of Ca2+ for muscle contraction. pD'2 values were determined to compare the potency of these components to each other and to standard drugs. Flavones induce relaxation of the carbachol contracted tracheal strip without stimulation of the beta 2-receptors, which were blocked by propranolol. PMID- 6844126 TI - Changes in food intake in response to alterations in the ambient temperature: modifications by previous thermal and nutritional experience. AB - 1. The influence of ambient temperature on ad libitum food intake has been investigated in piglets weaned at 2 weeks and kept in the hot (35 degrees C) or the cold (10 degrees C) on a high or low energy intake for 6 weeks. Further, the extent to which food intake was correlated with fasting body temperatures and resting metabolic rate was also examined. 2. The amount of food eaten in a single meal was recorded daily in two series of tests. In Test I, measurements were made both at the normal living temperature and after 2 and 24 h at thermal neutrality (25 degrees C). In Test II, the animals were examined at 25 degrees C over a 4 day period. Resting metabolic rate and body temperatures were also measured, immediately before the measurement of food intake. 3. Food intake was much greater at 10 than at 35 degrees C, but even at thermal neutrality it was significantly higher for those which had been in the cold. This was true for periods of between 2h and 4 days at 25 degrees C. Although food intake was not correlated with skin or core temperatures, there was an indication of a correlation with metabolic rate, particularly at thermal neutrality. 4. The results show that long-term cold exposure has a lasting effect on food intake, even at thermal neutrality, and it is suggested that this may be related to hormonal changes. PMID- 6844127 TI - Determination of myofibrillar diameter by light diffractometry. AB - Distinctive oscillations in the diffraction line intensity were observed when a laser beam was directed at selected spots on single skeletal muscle fibres of frog and normally to the fibres. These intensity oscillations were interpreted as the diffraction from cylindrical myofibrils because they followed the first-order Bessel function. This interpretation allowed a direct determination of the myofibrillar diameter from the first intensity minimum of the zerothorder diffraction line. The hypothesis that the intensity oscillations were related to the myofibrillar diameter was substantiated by further experiments. At fixed sarcomere length the measured myofibrillar diameter increased when the fibre was immersed in hypotonic solution and decreased in hypertonic solution. In another experiment the diameter decreased and the sarcomere volume remained constant when the fibre was stretched passively. Furthermore, there was excellent agreement between the myofibrillar diameters measured by light diffractometry and electron microscopy. PMID- 6844125 TI - Effect of "high ceiling" diuretics on active salt transport in the cortical thick ascending limb of Henle's loop of rabbit kidney. Correlation of chemical structure and inhibitory potency. AB - The group of "high ceiling" diuretics consists of a variety of chemically different potent diuretic and saluretic substances. Appart from a few exemptions direct evidence for an action of these substances in the thick ascending limb of the loop of Henle (TAL) is still lacking. For furosemide, we have reported recently that it inhibits most likely the Na+-2 Cl--K+ cotransport system present in the lumen membrane of the TAL. The present study tests: 1. whether other "high ceiling" diuretics have a similar site and mode of action, and 2. how modifications of the furosemide molecule alter the inhibitory potency. Isolated cortical TAL (cTAL) segments (n = 185) of rabbit kidneys were perfused in vitro. The equivalent short circuit current (Isc = transepithelial PD/transepithelial resistance), as a measure of active salt transport was correlated to the dose of 64 substances. Several diuretics, such as 2-aminomethyl-4-(1,1-dimethyl-ethyl)-6 iodophenol hydrochloride (MK 447), hydrochlorothiazide, muzolimine, etozoline, tizolimide, amiloride, and triamterene were ineffective both from the lumen and basolateral side at concentrations as high as 10(-4) - 10(-3) mol X 1(-1). The phenoxyacetic acids ethacrynic acid, indacrinone (MK 196), and to less an extend tienilic acid were inhibitory active. They differed from furosemide in one or more of the following criteria: delayed onset, incomplete reversibility, stronger action from the bath, different slope of the dose response curve. Similarly, 1 ozolinone acted stronger from the bath. In contrast, the diuretics of the furosemide type and related compounds (bumetanide and piretanide) showed rapid onset and complete reversibility of inhibition. These substances acted stronger from the lumen. The individual positions in the benzyl ring of the diuretics were differently affected by substitutions, leading to parallel shifts in the dose response curves with halfmaximal inhibition at concentrations ranging between 8 X 10(-8) to greater than 10(-4) mol X 1(-1). For these substances the calculated Hill coefficients were close to unity: 0.96 +/- 0.05. We conclude that the so called "high ceiling" or "loop" diuretics consist of at least 3 groups: 1. drugs that do not interfere with the active salt transport in the cTAL segment, 2. drugs that interfere by so far not characterised mechanisms, and 3. drugs of the furosemide type which inhibit the Na+-2 Cl--K+ cotransport system in the lumen membrane of the cTAL segment. PMID- 6844128 TI - Influence of the velocity of changes in end-diastolic volume on the starling mechanism of isolated left ventricles. AB - 1. In this study the relationships between active developed systolic pressure, end-diastolic pressure and different diastolic volumes are studied in Tyrode perfused isolated rabbit left ventricles. Contractions were isovolumic. 2. Rapid diastolic volume changes were imposed on top of different preset basic diastolic volumes. These volume changes are shown to produce systolic and diastolic pressure values that cannot be explained by assuming a single pressure-volume relation during systole and diastole. The changes in pressure are in the same direction but higher than is expected on the basis of the increase or decrease of the ventricular end-diastolic volume alone. 3. The variation of the diastolic pressure-volume relation cannot be explained by assuming variations of the heart's passive elasticity or viscous effects within its wall. During diastole the effect is completely reversible without concomitant systolic effects. No velocity dependent effect of the quick volume change could be observed if the time duration was varied between 10 and 65 ms. The results are in keeping with the hypothesis that active force generating mechanisms may be present during the diastolic pause. 4. The effects observed during systole suggest the possibility of length dependent activation of the myocardial cells. This results in different inotropic conditions of the heart at identical volumes, depending on how these volumes were installed. These volumes may be considered to affect intrinsic properties of the muscle cells on a beat to beat basis. PMID- 6844129 TI - Noninvasive determination of elastic properties and diameter of human limb arteries. AB - A method involving application of a standard cuff on human limbs has been developed making it possible by a single procedure to make a quantitative determination of blood pressure, elastic resistance of "uninfluenced" an mechanically relaxed arterial vessel walls, their bulk modulus and effective inner diameter. The method which is based on the "elasticity reservoir theory" involves recording arterial pressure recordings during periods of gradual compression and evaluation of the pulsatile blood volume increment under the cuff at the on step wise decompression. The reproducibility of the results and the errors involved were estimated by comparing the results with measurements made on a physical model and on human limbs. This paper presents some results of the application of the method to 113 healthy persons and shows the age dependence of the examined parameters in the upper arms and in the lower leg. PMID- 6844130 TI - Ventilatory transients during exercise: peripheral or central control? AB - The fast component of the ventilatory changes that occur at the transition phases of exercise was studied in awake dogs trained to run on a treadmill. Two questions were examined: firstly, is the fast ventilatory component modified by changes in venous return to the lungs, such as those consecutive either to increased work loads or to beta adrenergic blockade?, and secondly, is this component altered by central ventilatory depressants? The results showed that at the onset of exercise, there is no correlation between the instantaneous increment in ventilation and the intensity of exercise, but at the end of the treadmill run, the fall in ventilation is closely linked to the power of the work performed. Ventilatory transients observed either at the start or at the end of exercise remain unaffected by administration of a beta-adrenergic blocking agent. But central depressant effects on ventilation caused by narcotic analgesics or hypnotic drugs altered the breathing pattern of the fast component of exercise induced ventilatory changes. It is concluded that the instantaneous changes in ventilation occurring at the transition phases of exercise are controlled by mechanoreceptor mechanisms, but cerebral control is superimposed on the reflex control in regulating both tidal volume and breathing rate. PMID- 6844132 TI - Factors affecting the metabolism of resting rabbit papillary muscle. AB - The rate of resting heat production of 12 right ventricular rabbit papillary muscles was measured myothermically. Resting heat rate was measured at 4 temperatures (15, 20, 25 and 30 degrees C) in either 45% or 95% O2 while the muscle was passively stretched with various pre-loads. The metabolic substrate was pyruvate (10 mmol X 1(-1)). The mean resting heat rate, averaged across all treatment conditions, was 2.88 mW/g with no significant difference between the two oxygen concentrations. The calculated Q10 of the resting heat rate was surprisingly low--only about 1.4--but is shown to be in general agreement with literature values from whole heart oxygen consumption studies when the time dependent decline is taken into account. Stretching the muscle beyond its rest length increased the rate of resting heat production. This response appeared unrelated to muscle diameter. The results are discussed in terms of the possible diffusion limitation of isolated papillary muscle preparations. PMID- 6844133 TI - Role of the medullary collecting duct in potassium conservation. AB - A capacity for both net potassium absorption and net potassium secretion has been demonstrated in the inner medullary collecting duct. The quantitative importance, however, of the inner medullary collecting duct in the regulation of urinary potassium in potassium deficiency, however has not been established. To assess the contribution of this segment to potassium conservation, microcatherization studies were performed in male Sprague-Dawley rats maintained either on a control diet or on a potassium free diet for 72 h. In control animals approximately 15% of the filtered load of potassium was excreted. Analysis of tubule fluid along the inner medullary collecting duct failed to demonstrate evidence of net potassium movement. Administration of a potassium free diet resulted in a marked reduction in potassium excretion to 0.3% of the filtered load. In contrast to control the inner medullary collecting duct of experimental animals absorbed nearly 90% of the amount of potassium entering this segment, since fractional delivery to the terminal portion of the nephron was about 2%. These data indicate that the inner medullary collecting duct makes a significant contribution to maximal renal conservation of potassium, since previous studies have shown that only 5 to 10% of filtered potassium is present in the late distal tubule of surface nephrons in animals on a low potassium intake. PMID- 6844131 TI - Force generation in experimental tetanus, KCl contracture, and oxygen and glucose deficiency contracture in mammalian myocardium. AB - We studied the amount and time-course of tension recovery after quick releases (0.25 mm) during experimental tetanus, potassium chloride contracture (KCl), hypoxic contracture (H) as well as joint glucose and oxygen deficiency contracture (HG) in left ventricular papillary muscles of rat and right ventricular papillary muscles of cat myocardium. Both in experimental tetanus and KCl contracture, the tension recovery was finished within 200 ms after the release, and was 77% and 60% of initial tension fall, respectively. The Q10 value for the time constant of half of recovery tension was 2.5, and the time constants differed by the same factor between rat and cat myocardium. In H or HG contracture, we never could find any significant tension recovery process during the first 200 ms after a release, neither in late nor in very early stages of contracture tension generation. However, when longer observation periods (90 s) after a release were monitored, a slow tension recovery was observed which was at least 18% of initial tension fall. This data indicates fast, calcium-mediated cross-bridge cycling in experimental tetanus and KCl contracture. In contrast, the very slow tension recovery in H and HG contracture, which is consistent with recent myothermal data, can be interpreted as rigorlike cross-bridges with a very slow cycling rate, a long time of attachment in force-generating position and low energy turnover. PMID- 6844134 TI - Time course of adaptation to low and high NaCl diets in the domestic fowl. Effects on electrolyte excretion and on plasma hormone levels (aldosterone, corticosterone and prolactin). PMID- 6844135 TI - Evidence for electroneutral sodium chloride cotransport in the cortical thick ascending limb of Henle's loop of rabbit kidney. PMID- 6844136 TI - Properties of the lumen membrane of the cortical thick ascending limb of Henle's loop of rabbit kidney. PMID- 6844138 TI - Transport of L-cystine by rat renal brush border membrane vesicles. AB - Brush border membranes were isolated from rat renal cortex by a divalent cation precipitation method. L-35S-cystine uptake into the vesicles was measured by a rapid filtration method. Covalent incorporation of tracer into membrane proteins was observed after prolonged incubations. At short incubation periods (1 min) binding was small and allowed an analysis of transmembrane transport. To guarantee transport of L-cystine, the experiments were performed in the presence of the oxidant diamide. Sodium stimulated L-cystine uptake specifically. A potassium/valinomycin induced inside negative diffusion potential stimulated sodium dependent L-cystine transport. Thus, transport is potential sensitive in the presence of sodium. At low substrate and inhibitor concentrations, L-cystine transport was inhibited by L-lysine, L-ornithine and L-arginine but not by D lysine in the presence and absence of sodium. At higher inhibitor concentration, the neutral amino acids L-phenylalanine and L-leucine also inhibited L-cystine uptake, but only the sodium dependent uptake. These inhibition experiments suggest that L-cystine is transported by the brush border membrane by a transport system for basic amino acids not necessarily requiring sodium. In addition, transport of L-cystine can also proceed via sodium dependent transport pathways for neutral amino acids. In the concentration range tested (up to 0.225 mmoles/l), no saturation of L-cystine transport was observed in the presence and absence of sodium. PMID- 6844137 TI - Properties of the basolateral membrane of the cortical thick ascending limb of Henle's loop of rabbit kidney. A model for secondary active chloride transport. PMID- 6844141 TI - [Isoimmune pancreatitis. Animal experiment study]. PMID- 6844139 TI - Effects of nifedipine on nerve-evoked action potentials and consequent contractions in rat tail artery. AB - The effects of nifedipine on the electrical and mechanical activity recorded from the rat tail artery were examined. Intracellular recordings were obtained from the smooth muscle and vessel diameter monitored during nerve stimulation. Nifedipine (0.1-10 microM) depressed contractions elicited by single and repetitive (2 Hz) stimulation by 32-100% but was ineffective in decreasing the amplitude of the associated action potentials. Concentrations greater than or equal to 10 microM caused a slowly developing membrane depolarization. No change in the amplitude of subthreshold excitatory junction potentials was observed at concentrations of nifedipine less than 50 microM when the membrane depolarization was less than 8 mV. At all concentrations examined nifedipine lowered the stimulus intensity required to initiate an action potential. The amplitude of the nerve-evoked action potential recorded in lowered external Ca2+ (1 mM) was slightly increased (5-10%) by nifedipine. However, nifedipine readily reversed the increased amplitudes of the nerve-evoked action potentials and contractions caused by the addition of 20 mM tetraethylammonium chloride in the tail artery. The action potential recorded in normal solution from the guinea pig vas deferens was selectively abolished by nifedipine. PMID- 6844140 TI - Distribution of capillaries and diffusion distances in guinea pig myocardium. AB - A frequency distribution of distances from random points to the nearest capillary was generated from high-magnification photomicrographs of thin sections of the myocardium of seven guinea pigs. Individual mean capillary densities taken from regions viewed in transverse section ranged from approximately 1800 to 2500 capillaries/mm2. Mean (R) and maximal (R95) diffusion distances measured by the closest individual method ranged from R = 6.6 to 8.7 microns and R95 = 11 to 18 microns. Further mathematical analysis of the frequency distributions of diffusion distances indicated that the capillaries of the myocardium are distributed in an ordered array. PMID- 6844142 TI - Influence of various milk products on the concentration of nitrite and the formation of nitrosodimethylamine in vitro. AB - The influence of various local Estonian milk products on the nitrite concentration and the nitrosation process in vitro was studied. Milk products were found to have a distinct nitrite level decreasing effect, and this effect was dependent upon fat concentration. All milk products with fat levels of 0.6% 3.2% blocked the formation of nitrosodimethylamine (NDMA). Products with a 10% 20% fat content had no effect on NDMA formation, or even increased the nitrosation. The inhibitory effect of milk on the nitrosation process is discussed. The authors recommend the inclusion of low-fat milk products in everyday diet, especially in areas of high nitrite- and nitrate-rich food consumption. PMID- 6844143 TI - Effects of acute and chronic protein deprivation on ornithine decarboxylase levels in rat liver and colon. AB - The effects of protein intake on the levels of total and holo-ornithine decarboxylase (ODC) in colon and liver have been examined in male Sprague-Dawley rats fed varying amounts of casein in a defined purified diet. Pair-feeding was used to eliminate effects of food intake per se. In the colon, both total and holo-ODC activity increased in animals fed a low-protein diet (1% casein). In the liver, on the other hand, both total and holo-ODC activity decreased with protein deprivation. The observed changes in both colon and liver appeared to be maximal within several days after institution of the dietary regimen. Refeeding with a high-protein diet (20% casein) led to a dramatic rise in ODC activity in the liver in animals previously fed a low-protein diet. These results may be important in sorting out the effects of diet on the tumorigenic process. PMID- 6844144 TI - Sodium chloride and cancer of the digestive tract. PMID- 6844145 TI - Nutritional status of African populations predisposed to esophageal cancer. AB - Nutritional status indicators were assessed chemically in blood and urine taken from 625 Transkeians drawn from three age-groups in each of two regions: one with a moderate risk for esophageal cancer and one with a very high risk. Aggregate mean values for protein, albumin, vitamin A, and phosphorus were generally acceptable, but many subjects had inadequate (though not necessarily deficient) values for nicotinic acid (74% of subjects), magnesium (60%), vitamin C (55%), carotene (53%), riboflavin (41%), calcium (35%), and zinc (27%). Groups at highest risk for esophageal cancer had markedly lower serum magnesium and carotene concentrations and mildly depressed hemoglobin and hematocrit values, but such findings are not necessarily associated with esophageal cancer etiology. Possible intestinal malabsorption in the populations at highest risk may be associated with the unusually high fiber and phytate intake of the high-risk populations as well as with exposure to necrotizing mycotoxins. Thus, while protein and energy nutriture seem generally adequate, both the high- and moderate risk populations had high incidences of multiple micronutrient malnutrition. PMID- 6844146 TI - Benign nature of atrial dissociation in pediatric patients. AB - Atrial dissociation is defined electrocardiographically by the presence of an ectopic atrial rhythm depolarizing independently of the basic sinus rhythm, and is characterized by entrance and exit block. Atrial dissociation is most often observed as an ominous sign in adults with severe myocardial dysfunction. We have observed atrial dissociation in 3 pediatric patients, aged 5 to 22 years, who were essentially asymptomatic from this arrhythmia. All 3 patients are well, without therapy for atrial dissociation, during a follow-up period of 1 to 5 years. The benign nature of atrial dissociation in the pediatric patient as compared with the adult is stressed. PMID- 6844147 TI - Thermodilution Qp/Qs: an indicator dilution method. AB - The pulmonary-to-systemic blood flow ratio (Qp/Qs) is critical in the appraisal of the need for surgery in patients with left-to-right shunts. Because of the drawbacks present with conventional Fick, indicator dilution, and radionuclide techniques of Qp/Qs measurement, we sought to determine whether an extension of thermodilution technology could accurately predict Qp/Qs. We studied 30 children with clinically suspected or postoperative atrial or ventricular septal defects. The thermodilution temperature curves from the pulmonary artery were printed on a strip chart recorder after right atrial injection of iced solution. Gamma variate curve fitting and area analysis were used to determine Qp/Qs. The correlation between Fick and thermodilution Qp/Qs values was excellent (r = 0.95). The thermodilution technique was rapid, and did not require either arterial entry, radiation after venous catheter placement, or multiple sampling. PMID- 6844148 TI - Effects of exercise training on aerobic fitness in children after open heart surgery. AB - Graded treadmill tests to maximal exercise were given to 24 children 1 year or more after open-heart surgery and to 26 age- and sex-matched controls, before and after 9 weeks of exercise training to test whether or not they could increase their aerobic fitness levels. The corrected cardiac lesions included tetralogy of Fallot, aortic stenosis, transposition of the great arteries and atrioventricular canal (AVC). Maximal exercise variables measured were heart rate (HR), oxygen consumption (VO2), and workload (stage of exercise and time on treadmill). The results of the pretraining tests indicated that the fitness levels of the 24 patients were significantly less than those of the controls. Of the original groups, 9 controls and 12 patients satisfactorily completed the training (jogging) program. The results of the post-training tests indicated that both the patients and controls significantly improved their fitness levels. Specifically, most subjects improved their maximal workload with little or no increase in maximal HR or VO2. In conclusion, children after open-heart surgery for complex congenital heart disease can further improve their work capacity by a dynamic exercise program. After training, they are able to do more work at a given VO2. PMID- 6844149 TI - Immediate complications and late sequelae of arterial catheterization in children with congenital heart disease. AB - Early vascular complications and late sequelae are reported in relation to 195 left heart catheterizations, 125 performed by brachial arteriotomy (BA), and 70 by percutaneous femoral artery puncture (FAP) with the Seldinger technique. Vascular complications occurred in 25 patients, 11 requiring surgical intervention, which was successful in restoring normal circulation in all. The rate of complications was higher after FAP in children 6 years old or less, while after BA the rate was significantly higher in patients of 2 years or older. In patients under 2 years, brachial artery suture repair resulted in more complications than ligation, but the cases were not randomized. Late follow-up of 101 catheterizations (35 FAP, and 66 BA, of which 38 were ligated and 28 sutured) included clinical evaluation, Doppler pressure measurements, and a comparison of the length and bone development of the catheterized and non-catheterized limbs. All these have indicated an absence of any serious late sequelae in this group 6 months to 9 years (average 4 years) after catheterization. PMID- 6844150 TI - Cerebral arteriovenous malformation in neonates. The role of myocardial ischemia. AB - Ischemic myocardial damage was identified as a complicating feature in the clinical course of 12 newborn infants who died in congestive failure with cerebral arteriovenous malformation. Electrocardiograms of 11 patients showed signs of chamber hypertrophy and T wave and ST segment features of varying degree compatible with ischemia or infarction. Histological evidence of myocardial necrosis or infarction was detected in seven of the ten infants from whom autopsy material was still available. PMID- 6844151 TI - Left ventricular pseudotumor: a two-dimensional echocardiographic sign of aortic insufficiency. AB - A left ventricular, mass-like echocardiographic density (a pseudotumor), present only during diastole and not attached to any intracardiac structure, was present in 77 of 1,820 consecutive 2-dimensional echocardiograms performed with a rotating-head transducer. Evaluation of the patients with a pseudotumor demonstrated that aortic insufficiency of mild to moderate degree was the most commonly associated lesion. Of the 61 patients with aortic insufficiency in our series, 69% had a left ventricular pseudotumor. Of the cases with a pseudotumor and aortic insufficiency, none had severe aortic insufficiency. Of the 1,759 patients without aortic insufficiency, a left ventricular pseudotumor was present in 2%. In our series, the sensitivity of left ventricular pseudotumor for aortic insufficiency was 69% and the specificity was 98%. PMID- 6844152 TI - Velopharyngeal insufficiency in tetralogy of Fallot: a report of four cases. PMID- 6844153 TI - Sudden death in an infant with aberrant origin of the right coronary artery from the left sinus of Valsalva of the aorta: case report and review of the literature. PMID- 6844155 TI - Aortic arch angiography in patients with patent ductus arteriosus: a new technique. PMID- 6844154 TI - Angiographic evidence of absent ductus arteriosus in severe right ventricular outflow obstruction. AB - The angiocardiograms of 5 newborn infants with autopsy and/or surgically-proven congenital absence of the ductus arteriosus (ADA) and right ventricular outflow obstruction (Group A), and of 14 neonates with pulmonary atresia complex and patent ductus arteriosus (Group B) were reviewed. Aortic size was similar in both groups; however, the diameters of the right and left pulmonary arteries were much smaller in Group A than in Group B (right pulmonary artery: 2.6 vs 4.5 mm, P less than 0.005; left pulmonary artery: 2.5 vs 4.3 mm, P less than 0.005). Extensive bronchial collaterals were observed in Group A but not in Group B. Tricuspid aortic valve stenosis was present in 2 patients in Group A but in none in Group B. The diagnosis of ADA may be made in newborn infants with severe right ventricular outflow obstruction if the angiocardiograms reveal hypoplasia of the pulmonary arteries, extensive bronchial collaterals, and nonvisualization of the ductus arteriosus. Other suggestive features include aortic valve stenosis and/or right aortic arch with aberrant left subclavian artery. PMID- 6844156 TI - Nomogram to calculate oxygen consumption index based on age, sex and heart rate. PMID- 6844157 TI - Physiologically advantageous ventricular septal defects. PMID- 6844158 TI - Localization of acid phosphatase activity in testosterone-treated prostatic urethra of human fetuses. AB - Androgens accelerated differentiation of human fetal urethral epithelial cells into secretory prostatic cells in organ culture. These epithelial cells contained supranuclear Golgi complexes in which acid phosphatase enzyme activity could be demonstrated by an electron microscopic histochemical technique. Most of the acid phosphatase activity was localized in lysosomes. Some apical precipitates could also be seen. This apical activity might be in secretory granules. Also, mesenchymal cells contained this enzyme. PMID- 6844159 TI - Combined external radiotherapy and hormonal therapy for localized carcinoma of the prostate. AB - Forty-nine patients with localized carcinoma of the prostate were treated by external radiotherapy together with hormonal manipulation and were followed up to six years. Hormonal manipulation included bilateral orchiectomy and diethylstilbestrol, 3 mg/day. The cumulative five-year survival for the 49 patients was 87.6%, with 11% progression rate to stage D during that period. In 40 patients (81.6%), a decrease in the size of the prostate was noted. In none of the patients was there local recurrence of the tumor during the period of follow up. Transient gastrointestinal and/or urinary symptoms occurred following radiotherapy in 11 patients (22.4%), and in four patients severe cystitis or proctitis appeared. Complications related to hormonal therapy occurred in 11 patients (22.4%). The high survival rates reported herein, together with the low progression rate to stage D during six years of follow-up, may justify the early institution of radiotherapy in combination with hormonal manipulation for patients with localized carcinoma of the prostate. A randomized study with an extended number of patients is underway to further evaluate this mode of therapy. PMID- 6844160 TI - Development of an in vitro clonogenic assay for the R3327 rat prostatic adenocarcinoma permits comparison of the proliferative potential of the R3327, R3327A, and R3327AT tumors. AB - The R3327 class of rat prostate tumors consists of both the androgen-dependent R3327 adenocarcinoma and androgen-independent sublines, the R3327At spindle cell tumor, and the R3327A, a squamous cell carcinoma. We have developed in vitro clonogenic cell assays to measure and compare systematically the proliferative potential of these tumors following various monodispersion techniques. Linear relationships between the number of monodispersed tumor cells cultured at low cell density and the number of colonies formed 10 days later establish these assays as the first quantitative cellular approach to those proliferative subpopulations ultimately responsible for the growth of these tumors. We have chosen the name colony forming cell-prostatic adenocarcinoma (CFC-PA) to refer to the members of the proliferative subpopulation of the R3327 tumor. An ultrastructural comparison of R3327 adenocarcinoma tissue sections with the cells produced during culture provides evidence that the cells of the proliferative subpopulation may be derived from the acinar epithelium of the tumor. PMID- 6844161 TI - Organ culture studies of human prostatic adenocarcinomas. AB - The proliferative responses of human prostatic carcinoma have been evaluated in organ culture using [125I]-iododeoxyuridine ([125I]UdR) to monitor DNA synthesis. The morphological preservation was not influenced by the addition of fetal calf serum or insulin (5 mu gm/ml), transferrin (10 mu gm/ml), and thyrotropin releasing hormone (10(-9) M) to the active medium. Testosterone (4 X 10(-7) M) stimulated [125I]UdR uptake, whereas diethylstilboestrol (4 X 10(-6) M) had no direct effect on uptake. Both estramustine phosphate (4 X 10(-6) M) and oestradiol-17 beta (4 X 10(-6) M) inhibited uptake in a similar manner. Thus while explants of human prostatic carcinoma derived from transurethrally resected specimens can be well maintained in organ culture for a few days, proliferative responses are small and difficult to measure for individual patients. PMID- 6844162 TI - Growth responses of the guinea pig seminal vesicle epithelium and muscle to long term treatment with dihydrotestosterone and/or estradiol benzoate. AB - The three-month treatment regimen with dihydrotestosterone (DHT) and estradiol (E2B) which was capable of producing a supranormal growth of the canine prostate gland equal to that occurring in spontaneous canine benign prostatic hypertrophy, failed to produce similar changes in either the epithelium or smooth muscle of the guinea pig seminal vesicle. The factor limiting the growth response in the seminal vesicle epithelium and muscle of the castrate guinea pig proved to be the lack of a DHT-estradiol benzoate (E2B) synergism, since the growth responses in seminal vesicle tissues to the three-month treatment with DHT alone were similar to that previously recorded for the canine prostate. The lack of a DHT-E2B synergism in the guinea pig seminal vesicle may be responsible for the absence of spontaneous hypertrophy of this organ and other organs such as the human seminal vesicle with advancing age. PMID- 6844163 TI - Thyroid cancer following higher dose radiation therapy. PMID- 6844166 TI - The painful shoulder. A four-article symposium. PMID- 6844165 TI - Acquired immune deficiency syndrome. Implications for the practicing physician. PMID- 6844167 TI - Shoulder arthritis. Distinguishing among the many causes of inflammation. AB - Shoulder inflammation occurs in many rheumatic diseases. It is present in about half of the patients with rheumatoid arthritis but in a higher percentage of patients with less common diseases (eg, amyloid arthropathy, polymyalgia rheumatica). Shoulder arthritis, probably more than arthritis involving any other joint, requires prompt diagnosis and treatment to prevent loss of motion and function. For most patients, antiinflammatory medications, range of motion exercises, and instruction in joint protection constitute adequate treatment. A baseline shoulder roentgenogram is usually recommended. Intraarticular corticosteroid therapy may be a helpful adjunct, provided infection has been excluded. PMID- 6844168 TI - Tendinitis and bursitis of the shoulder. Anatomy and therapy. PMID- 6844164 TI - Proximal airway obstruction presenting as dyspnea. A case of chondrosarcoma of the larynx. AB - A 50-year-old woman presented with a one-year history of dyspnea originally thought to be solely the result of asthma. Physical examination (indirect laryngoscopy) and x-ray study established that proximal airway compromise was present secondary to chondrosarcoma of the larynx. This case illustrates the necessity of considering proximal airway obstruction in differential diagnosis of dyspnea. PMID- 6844169 TI - Two unique shoulder disorders. Adhesive capsulitis and reflex sympathetic dystrophy syndrome. AB - Adhesive capsulitis and reflex sympathetic dystrophy syndrome are unique, but not rare, shoulder disorders that occur most often in persons over 50 who have experienced recent trauma. Although the etiology and nature of the disorders are not fully understood, therapy is often effective when instituted early. Adhesive capsulitis is a self-limited disorder, and patients usually recover in time. Reflex sympathetic dystrophy syndrome, however, can cause serious impairment if not treated promptly. Early mobilization of persons at risk may help reduce the incidence of the disorders. PMID- 6844170 TI - Regression of atherosclerosis in humans. A new frontier? PMID- 6844171 TI - Management of vascular trauma. Approach to injury in various anatomic sites. PMID- 6844172 TI - Bites, rashes, and itches. How to identify and treat them. AB - Skin rashes are commonly seen by the primary care physician. The chief cause of contact dermatitis is the plant genus Toxicodendron, but topical medications such as anesthetics, antibiotics, and preservatives also cause this condition. Commonly seen superficial fungal infections include candidiasis and several types of tinea. Microscopic identification of the organism on a potassium hydroxide (KOH) preparation establishes the definitive diagnosis. In addition to occurring in its usual sites, the herpes simplex virus can cause recurrent disease on glabrous skin areas. A positive Tzanck test establishes a diagnosis of herpesvirus infection. Mosquito, flea, and brown recluse spider bites produce diagnostic physical findings. Scabies infestation produces a distinctive eruption, and the diagnosis is made by isolating the mite or its products. PMID- 6844173 TI - Urinary tract infection in women. New perspectives on office management. AB - Symptomatic urinary tract infection is a common complaint in women. A convenient classification of such infection is bacterial pyelonephritis, bacterial cystitis, and "urethral syndrome," on the basis of symptoms and urine culture colony count. Pyelonephritis can be treated in the office if the patient is not toxic, follow up is possible, and the patient can tolerate oral medication. Treatment commonly is given over a period of two to six weeks. Single-dose therapy is now the preferred treatment for bacterial cystitis, and several agents are effective. When an infectious agent can be identified in urethral syndrome, antibiotic therapy is useful. Patients in whom an agent cannot be identified may be found to have interstitial cystitis. Recurrence can be a matter of relapse but usually results from reinfection. The causes of relapse usually can be approached surgically, while reinfection must be treated with behavior modification and prolonged antibiotic prophylaxis. PMID- 6844174 TI - Food allergy and asthma. PMID- 6844175 TI - Fever without localizing signs in children. Detection and management of occult bacteremia. AB - Occult bacteremia should be of major concern in the child with fever without localizing signs. A number of clinical features and laboratory findings correlate with the risk of bacteremia in such children, and their recognition permits the identification of a group of children at high risk. Treatment of such children with antibiotics on an ambulatory basis appears to significantly lessen the incidence of persistent bacteremia, subsequent meningitis, and other serious localized bacterial infections. PMID- 6844176 TI - The dizzy patient. Symptomatic treatment of vertigo. AB - Vertigo is a distressing symptom, but in the majority of cases it can be treated effectively. Whenever possible, treatment should be directed at the underlying disorder. Usually, however, symptomatic treatment alone or in combination with specific therapy is effective. Symptomatic treatments include antivertiginous medications, vestibular exercises, and surgical therapy. The choice of medications is determined by the known side effects of the drugs and the time course of symptoms. An early vestibular exercise program ensures a more rapid return to normal physical activity. Surgical therapy is reserved for those patients who fail to respond to medical therapy. PMID- 6844177 TI - Food and water acquisition abroad. Guidelines for finding safe sustenance. PMID- 6844178 TI - Ascorbic acid in nephrolithiasis: culprit or cure? PMID- 6844180 TI - The new hepatitis B vaccine. How, when, and why to use it. AB - A hepatitis B vaccine derived from the plasma of carriers of hepatitis B virus has recently become generally available in the United States. Its use is recommended in groups considered to be at high risk of hepatitis B because of their exposure to potentially infectious blood, saliva, or semen. Experience in more than 12,000 patients to date indicates that the vaccine is safe, effective, and free of major side effects. PMID- 6844181 TI - Frontal lobe personality syndromes. Ominous sequelae of head trauma. AB - Head trauma frequently results in frontal lobe dysfunction. This can cause a number of personality changes characterized by disturbances in affect and in regulation of emotions. Behavioral changes and alterations in cognition may occur also and are often accompanied by neurologic signs. The changes are frequently debilitating, and unfortunately in too many cases the lesion and its effects are not reversible and the patient's prognosis for returning to useful and independent life is very poor. A well-planned approach on the part of the physician can aid patient and family in difficult adjustments during rehabilitation and afford the best chance for recovery. PMID- 6844182 TI - Achalasia-like disturbance of oesophageal motility following truncal vagotomy and antrectomy. PMID- 6844179 TI - Syncope in the older patient. Major mechanisms and possible interventions. PMID- 6844183 TI - Acute pulmonary embolism following air travel. PMID- 6844184 TI - Bilateral spontaneous pneumothorax in sarcoidosis. PMID- 6844186 TI - Intrarenal teratoma. PMID- 6844185 TI - Sarcoid-like lymphadenopathy in malignant teratoma. AB - The reported association between sarcoidosis and malignancy has relevance both to the diagnosis of the cause of lymphadenopathy and possibly also to the prognosis of the malignant disease. A case is reported in which mediastinal lymphadenopathy due to non-caseating epithelioid granulomata caused diagnostic difficulty in the staging investigation of a patient with malignant testicular teratoma. PMID- 6844187 TI - An unusual case of Pasteurella multocida septicaemia. PMID- 6844188 TI - Primary hyperparathyroidism unmasked by donor nephrectomy. AB - A patient who was normocalcaemic before donation of a kidney to her son developed hypercalcaemia in the immediate postoperative period, which was subsequently found to be due to a parathyroid adenoma. It is assumed that the hypercalcaemia was unmasked by the reduction in glomerular filtration rate following the nephrectomy. PMID- 6844189 TI - Abnormalities of gut vessels in Turner's syndrome. AB - We describe a 57-year-old patient with Turner's syndrome, iron deficiency anaemia and intestinal vascular abnormalities. Colonoscopy revealed 2 widely dilated, tortuous veins in the terminal ileum and several smaller ectatic veins and haemangioma-like malformations throughout the colon. Laparotomy for herniotomy showed only minimal vascular abnormalities of the serosal surface. Patients with Turner's syndrome and anaemia should be checked for these lesions by endoscopy, and conversely, in patients with such lesions, Turner's syndrome should be considered. PMID- 6844191 TI - Terminal care: evaluation of effects on surviving family of care before and after bereavement. AB - To evaluate the effects on the family of a comprehensive programme of terminal cancer care, 20 close relatives of patients who had died in a Palliative Care Unit (PCU) were compared with a matched group of 20 relatives of patients who had died of cancer in other wards of the same teaching hospital. Interviewed by telephone 1 year and 2 weeks after bereavement, relatives of PCU patients report significantly fewer psychological symptoms and less lasting grief and anger than relatives of patients who had died elsewhere. Factors thought to have contributed to good outcomes were successful relief of pain, awareness by relatives of the coming death of the patient and support given to relatives after bereavement. Two case examples illustrate these findings. PMID- 6844190 TI - Amniotic fluid embolism and disseminated intravascular coagulation complicating hypertonic saline-induced abortion. AB - Amniotic fluid embolism (AFE) associated with disseminated intravascular clotting (DIC) is usually fatal. Such a combination generally occurs at the term of pregnancy or in the immediate postpartum period. A case of AFE with DIC following a hypertonic-saline-induced abortion, is reported. The patient was in the midtrimester with a live fetus. Prompt recognition and treatment of her condition ensured her complete recovery. Such a case has not, to our knowledge, been previously reported. PMID- 6844192 TI - The pharmacokinetics of lysine theophylline, a new soluble theophylline, in human volunteers. AB - A comparative study of the pharmacokinetics of lysine theophylline and aminophylline in normal subjects reveals no significant difference. If lysine theophylline is shown to have the same clinical efficacy as aminophylline, the hypersensitivity reactions associated with the latter could be avoided. PMID- 6844193 TI - Anterior mediastinal haematoma and left haemothorax on well-controlled oral anticoagulant therapy. AB - An anterior mediastinal haematoma and left haemothorax developed in a hypertensive diabetic patient on oral anticoagulant therapy. This occurred in spite of well-controlled anticoagulation and the absence of other evidence of systemic bleeding. Angiography and daily chest X-ray follow-up were not only sufficient to confirm the diagnosis, but also avoided hazardous interventional procedures. PMID- 6844194 TI - Neurofibrosarcoma of the vagus nerve. PMID- 6844196 TI - Epidemiology aspects of endomyocardial fibrosis. AB - Endomyocardial fibrosis (EMF) is a specific clinicopathological entity. It occurs sporadically throughout the world but is endemic in parts of Africa, India and South America. In sporadic cases, blood eosinophilia is a common feature; this is a variable finding in endemic cases. The curious geographical distribution of EMF in the tropics remains unexplained. PMID- 6844195 TI - Pathological aspects of endomyocardial fibrosis. AB - The studies leading up to the unitarian concept suggesting that endomyocardial fibrosis, described in the tropics, and Loffler's endocarditis parietalis fibroplastica (Loffler's endomyocardial disease), described in the temperate zone, belong to the same disease spectrum are detailed. Evidence that the eosinophil is involved in the pathogenesis of endomyocardial diseases, irrespective of the geographical origin, is presented. The findings of a similar abnormality in these cells obtained from patients in the tropical and temperate zones are briefly mentioned. In view of the evidence it is proposed that endomyocardial disease, associated with abnormal eosinophils, hitherto classified under the restrictive type of cardiomyopathy, be removed from this classification and reclassified under 'specific heart muscle disease'. PMID- 6844197 TI - The cardiotoxicity of eosinophils. AB - Although an association between high blood eosinophil counts and endomyocardial disease has been known for nearly a hundred years, the reasons for this were not understood. Brockington, Luzzatto and Osunkoya (1970) suggested that eosinophil leucocytes, in susceptible persons, by some unknown mechanisms, cause endomyocardial damage. Evidence to support this possibility has come from three sources: (1) Clinical studies have shown that very high blood eosinophil counts, from any cause, can be associated with endomyocardial disease, and in some patients it has been possible to show that eosinophilia preceded the onset of heart disease. (2) The development of heart disease has been associated with the presence of degranulated eosinophils in the blood and tissues, including damaged endomyocardium, and raised serum levels of eosinophil granule basic proteins have been found in many of these patients. (3) Low concentrations of eosinophil secretion products (which contain these eosinophil granule basic proteins) have been found to injure isolated heart cells in vitro. Studies with purified eosinophil granule basic proteins have shown that cardiac cell damage is the result of a specific toxic effect of eosinophil cationic protein on the plasma membrane and two enzyme complexes (pyruvate dehydrogenase and 2-oxoglutarate dehydrogenase) involved in mitochondrial respiration. These results support the suggestion that under certain conditions, eosinophils may damage the heart, leading to endomyocardial disease, and they offer new approaches for the early diagnosis and treatment of endomyocardial disease both in temperate and tropical countries. PMID- 6844198 TI - Endomyocardial disease--clinical features. AB - The clinical features of tropical and temperate zone endomyocardial fibrosis (EMF) are the same, allowing for certain regional, environmental and possibly genetic variations. For example, the seasonal incidence in rainy humid areas probably reflects the large and repeated parasitic infestations in tropical EMF, while the absence of tissue eosinophilia in organs other than the heart in tropical EMF may reflect racial and environmental differences between tropical and western geographical areas that have still to be elucidated. That EMF occurs in Europeans who have lived in the tropics is undoubted, but the absence of right ventricular involvement in Europeans in the tropics, but not in temperate climes, is unexplained; perhaps it is a chance finding. It is also apparent that the extreme degrees of right ventricular EMF that are commonly seen in the tropics, with almost complete obliteration of the ventricular cavity are not usually seen in eosinophilic EMF in temperate areas. Involvement of both ventricles and of both atrioventricular valves is, however, common both in the tropics and in temperate climate EMF. PMID- 6844200 TI - Surgical approaches in endomyocardial disease (abstract). PMID- 6844199 TI - Two-dimensional echocardiography in endomyocardial disease. AB - To assess the usefulness of two-dimensional echocardiography in the diagnosis of endomyocardial disease, 7 subjects with this disorder, proved by angiography or necropsy, were studied. Typical echographic findings included apical obliteration of either one or both ventricles by an echogenic mass with preserved systolic inwards motion. Some subjects showed increased specullar echo reflectance at the endocardial border of the obliteration. The combination of apical obliteration, posterior fibrotic thickening of mitral or tricuspid valves, hyperdynamic contraction of noninvolved ventricular walls and large atria constitutes an echographic pattern suggestive of this syndrome. PMID- 6844201 TI - Endomyocardial disease in South America--report on 23 cases in Venezuela. AB - Twenty-three cases of endomyocardial disease (ED) are presented, studied in Venezuela, a tropical country in northern South America. The diagnosis was confirmed in 18 cases by means of pathological studies, and in 5 cases by angiocardiography which showed the characteristic obliterative ventricular lesions. Eosinophilia was present in 35% of the patients. The most frequent clinical feature was heart failure associated with mitral regurgitation. Systemic embolism was the first clinical feature in 5 cases. In 2 cases, ED was associated with autoimmune haemolytic anaemia or vasculitis. Necropsy revealed a predominance of the left-sided (9/16 cases) and biventricular (6/16 cases) types. The pathological lesions were characterised by fibrous thickening of the endocardium at the apex and the ventricular inflow tracts extending to the myocardium and involving the atrioventricular valves. ED is frequently misdiagnosed as rheumatic valvular cardiopathy. The two-dimensional echocardiogram is a very useful procedure for determining the spatial anatomy of ED. The echo findings were closely correlated with ventriculographic and necropsy findings. Even though ED is widely spread around the world, it is most frequently found in tropical and subtropical countries in Africa, Asia and America, such as Venezuela and Brazil. This suggests that there are aetiological factors in these latitudes, about which little is known. PMID- 6844203 TI - A comparison of the clinical and cardiological features of endomyocardial disease in temperate and tropical regions. AB - This study was designed to compare the clinical and cardiological features of endomyocardial disease in temperate and tropical regions. Eleven patients were studied in the U.K., 47 in India and 8 in Brazil. The patients in the U.K. were older, with a male predominance, and they had a systemic illness: the hypereosinophilic syndrome. Half of these patients presented in the early necrotic stage of the disease, and all had biventricular involvement. On the other hand, patients in the tropical countries were younger, with an equal sex incidence, and were from poor, malnourished communities with heavy parasite loads, especially filariasis in India. None presented in the early necrotic stage of the disease and a quarter had isolated right or left ventricular disease. In order to account for these differences between patients in temperate and tropical regions with endomyocardial disease, it was proposed that the nature of the underlying disease and the rate at which endomyocardial lesions develop, determine the clinical features of this disorder. In temperate climates eosinophil granule toxins may produce a rapidly progressive form of the disease in patients with the hypereosinophilic syndrome, whereas the disease may take longer to develop in patients in tropical climates, who have a less marked eosinophilia due to parasitic infections. PMID- 6844202 TI - Endomyocardial fibrosis in Africa. AB - Endomyocardial fibrosis (EMF) is a disease of the rain-forest belt in Africa. There is general agreement as to its pathology in the acute phase, but this is difficult to diagnose clinically. The aetiology is still unknown although there are reports which suggest that eosinophilic endomyocardial disease may be the cause. Further studies are needed to define EMF in its acute stage and find out how chronic EMF evolves. A longitudinal study on young people with eosinophilia and a comparative study of two villages, one in an endemic zone and the other in a zone where EMF is uncommon, will also be helpful in identifying its cause. The most promising form of treatment at present is surgical. PMID- 6844204 TI - Staphylococcal suppurative mesenteric lymphadenitis. AB - Two young adult males presenting with suppurative mesenteric lymphadenitis, caused by coagulase positive staphylococcus, with unusual clinical findings are reported. Pre-operative and operative differential diagnosis and management are discussed. Previous publications are briefly reviewed. The condition is extremely rare in adults and the pathogenesis is not well understood. PMID- 6844205 TI - The relationship between body weight loss during an induced molt and postmolt egg production, egg weight, and shell quality in caged layers. AB - Two trials were conducted to determine the relationship between percent body weight loss (% BWL) during an induced molt and postmolt performance. The molt was induced by fasting and photoperiod manipulation. Four groups with 24, 27, 31, or 35% BWL (Trial 1) or 20, 25, 30, or 35% BWL (Trial 2) were utilized in each trial. Performance was evaluated on the basis of 24 weeks of egg production and determinations of egg weight (EW), specific gravity (SG), and shell weight (SW) conducted during Weeks 8 (Trial 2 only), 18, and 24 following the removal of feed. The 27 and 31% BWL groups of Trial 1 and the 30 and 35% BWL groups of Trial 2 produced significantly more eggs per hen housed than the remaining treatments in their respective trial. Differences in SG and SW at the end of the trial were most pronounced in Trial 1 where the 27 and 21% BWL groups exhibited significantly greater SG and SW at Week 24 than did the 24 or 35% BWL groups. No significant differences occurred for SG at Week 24 of Trial 2, but the 35% BWL group exhibited significantly improved SW when compared to the 25% BWL group with the remaining groups intermediate. The EW was greatest for the 31% BWL and least for the 35% BWL group at 24 weeks in Trial 1 but did not differ in Trial 2. It was concluded that a body weight loss of approximately 27 to 31% produced optimum postmolt performance. PMID- 6844206 TI - Influence of temperature, moisture, and propionic acid on mold growth and toxin production on corn. AB - The influence of temperature and propionic acid on mold growth and toxin production on whole corn with 10, 15, or 20% added water was studied. Levels of propionic acid tested at each moisture level were 0, .025, .05, and .1%. Each flask of corn was inoculated with spores of a citrinin-producing Penicillium spp. and was then incubated for 8 weeks at a constant temperature of 5 C, at 5 C at night and room temperature during the day, or at room temperature both at night and during the day. The corn was then dried, ground, and fed to chicks to determine the presence of citrinin. Regardless of acid level or moisture content, neither mold growth nor toxin production occurred on the corn incubated at 5 C. Both mold growth and toxin production occurred on corn either partially or totally incubated at room temperature but were more prevalent in the latter. Increasing the moisture content resulted in greater mold growth and toxin production, especially on the corn incubated at room temperature. Higher levels of propionic acid were needed to prevent mold growth and toxin production as the moisture content of the corn increased. PMID- 6844207 TI - Northern fowl mite population development on laying hens caged at three colony sizes. AB - Beginning 5 weeks after being experimentally infested with known numbers of northern fowl mites, Ornithonyssus sylviarum (Canestrini and Fanzago), White Leghorn pullets caged alone supported a significantly higher mite population than did pullets housed two and three per cage. During the following 6 weeks, mite populations remained high on the birds caged singly whereas mite populations drastically declined on the birds housed two or three per cage. Eleven weeks after the experiment was initiated, all hens caged alone were infested with northern fowl mites, whereas 22% of the birds housed two per cage and 43% of the birds housed three per cage were free of mites. These data support the hypothesis that social stress in birds influences the development of northern fowl mites (more stress, higher resistance to mites). PMID- 6844208 TI - Effect of increasing dietary energy on hepatic lipogenesis in growing chicks. I. Increasing energy by carbohydrate supplementation. AB - The effect of the increasing the energy content of the diet by supplementation with increasing amounts of carbohydrate on hepatic lipogenesis and the activities of associated enzymes of liver was examined in force-fed growing chicks. Hepatic lipogenesis and the activities of nicotinamide adenine dinucleotide phosphate (NADP-MDH)-malate dehydrogenase (EC 1.1.1.40) and citrate cleavage enzyme (EC 4.1.3.8) in liver were significantly increased as dietary metabolizable energy (ME) increased by supplementation of carbohydrate. Triglyceride content in liver significantly increased as dietary ME increased by supplementation of carbohydrate. The results demonstrated a positive correlation between hepatic fatty acid synthesis and the activities of NADP-malate dehydrogenase and citrate cleavage enzyme in liver. PMID- 6844209 TI - Effect of increasing dietary energy on hepatic lipogenesis in growing chicks. II. Increasing energy by fat or protein supplementation. AB - The effect of increasing the energy content of the diet through supplementation of various levels of fat or protein on hepatic lipogenesis and activities of associated enzymes of liver was examined in force-fed growing chicks. Hepatic lipogenesis was significantly decreased as the dietary metabolizable energy level was increased through supplementation of fat or protein. The activity of nicotinamide adenine dinucleotide phosphate-malate dehydrogenase (NADP-MDH) (EC 1.1.1.40) in liver was higher (P less than .01) in chicks fed diets containing the lowest energy level. The activity of citrate cleavage enzyme (EC 4.1.3.8) in liver was significantly depressed as the dietary metabolizable energy level increased through supplementation of fat, whereas increasing the dietary metabolizable energy level through protein supplementation resulted in a significant increase in citrate cleavage enzyme activity in liver. Nonesterified fatty acid concentration in serum was significantly increased as the dietary metabolizable energy level was increased through supplementation of fat. PMID- 6844210 TI - Calcium metabolism in broiler breeder hens. 1. Calcium status of the digestive tract of broiler breeders throughout a 24-hour period. AB - Dry matter and calcium content of the digestive tract were determined on two groups of broiler breeders during a 24-hr period. The individually caged hens were fed either ad lib or restricted to 122 g of feed during a 4-hr feeding period each day from 0700 to 1100 hr. The hens received artificial light from 0700 to 2300 hr. On Day 14 of the feeding program a total of 100 hens, 10 from each group, were necropsied at selected intervals (0700, 1100, 1900, 2300, 0300 hr), and the contents of the various segments of the digestive tract and feces were collected and analyzed for dry matter and calcium. The calcium analysis also included any endogenous excretions and, therefore, absorption values are apparent. Hens restricted to 122 g feed per day had only 51.7% of the dry matter and 64.2% of the calcium consumed during the 4-hr feeding period remaining in the digestive tract at 1100 hr. By 2300 hr only 20.6% of the feed and 28.1% of the calcium remained. Hens had only approximately 14% (14.2 g) of their total dry matter intake and 16% (.70 g) of the calcium available for absorption from 0300 hr. The ad lib group, with an average intake of 171 g feed per day, had consumed only 26% of their daily feed intake by 1100 hr. Fifty-five percent of the dry matter consumed and 22% of the calcium remained in the digestive tract at 1100 hr. It was concluded that broiler hens restricted to morning feeding do not maintain a constant and equal metering of dry matter or calcium from the crop into the digestive tract throughout a 24-hr period. PMID- 6844211 TI - Calcium metabolism in broiler breeder hens. 2. The influence of the time of feeding on calcium status of the digestive system and eggshell quality in broiler breeders. AB - Experiments were conducted to determine the influence of time of dietary calcium intake on eggshell quality in broiler breeder hens. In Experiment 1, 60 hens were randomly divided among three treatment groups. The control group received 155 g feed (3.1% calcium) per day at 0800 hr whereas the morning- (a.m.) and evening fed (p.m.) treatments received a .42% calcium diet (155 g/bird) and were intubated with 4.2 g calcium at 0800 or 1600 hr, respectively. Egg weight, shell weight, and specific gravity were determined at 3-day intervals for 15 days. In Experiment 2, 150 breeder hens were randomly divided among two treatment groups. They were fed 122 g per hen during a 2.5-hr feeding time at 0700 to 0930 or 1530 to 1800 hr. Eggs were collected for egg weight, shell weight, and specific gravity determinations. At the end of the 5th week, 10 hens from each treatment group were sacrificed at various times throughout a 24-hr period and the contents of each segment of the GI tract and feces were analyzed for moisture, dry matter, and calcium. In Experiment 3, two commercial broiler-breeder houses with 5,000 hens each were used. They were fed 132 g/hen per day at 0530 hr daily with water provided ad lib. The feeding time of one house was moved forward by 2 or 2.5 hr per day until the feeding time was 1600 hr. Eggs were collected for 2 weeks following pretreatment data and values determined for specific gravity. Eggs were also candled at 7 days incubation to determine embryonic mortality and fertility. Hens intubated at 0800 hr with their daily supply of calcium did not maintain shell quality equivalent to controls (Experiment 1). However, hens intubated at 1600 hr had no difficulty maintaining shell quality. Hens fed at 1530 hr had significantly better shell quality during all weeks tested compared to hens fed at 0700 hr (Experiment 2). The p.m.-fed hens had 66.9% more calcium available at 1800 hr (2.07 vs. 1.24 g) compared to a.m.-fed hens. Hens fed at 1600 hr in the commercial houses (Experiment 3) had significantly better eggshell quality (specific gravity) than hens fed at 0530 hr. There was no significant difference in percent embryonic mortality or percent fertility when eggs were candled after 7 days of incubation. It was concluded that p.m.-fed hens had significantly more calcium available during the stages of eggshell calcification. The result was significantly better eggshell quality. PMID- 6844212 TI - Sodium chloride for broiler breeders. AB - Two experiments, each of 224 days duration, were conducted with Cobb broiler breeders, 32 weeks of age, to determine their response to supplemental dietary sodium chloride levels ranging from .12 to .48% in a corn-soybean meal diet. Average hen-day egg production, daily feed intake, feed required per dozen eggs, and egg specific gravity were not significantly influenced by any level of supplemental sodium chloride. Egg weights from hens receiving .36% sodium chloride were significantly heavier than those of birds that consumed .12 and .24% sodium chloride but not those of the .18 and .48% sodium chloride treatments. Egg fertility was significantly depressed by .48% sodium chloride and numerically reduced by .36%. Hatchability of fertile eggs was not found to be affected, but overall hatchability of eggs from .36 and .48% supplemental sodium chloride treatments was significantly lower than that supported by the least sodium chloride level provided, .12%. These data indicate that current National Research Council (1977) sodium requirements for heavy breeders (200 mg/day) may provide at least 23% more sodium than is required (less than or equal to 154 mg/day) and that daily sodium intakes in the range of 320 to 420 mg may reduce fertility in broiler breeders. PMID- 6844213 TI - The interrelationship between methionine, choline, and sulfate in broiler diets. AB - Two experiments were conducted to study the interrelationships between methionine, choline, and inorganic sulfate in a corn-soybean meal diet. The basal diet contained 21% crude protein and 3264 kcal ME/kg and no supplemental methionine, choline, or potassium sulfate. A 2 X 2 X 2 factorial arrangement of treatments was used involving .24% DL-methionine, 1100 mg choline/kg, and .10% potassium sulfate. A total of 384 Cobb, male, feather-sexed chicks were fed the experimental diets for 3 weeks in each experiment. Supplementing the basal diet with potassium sulfate in the presence of choline or methionine resulted in a greater growth response than when either was supplemented alone. A consistent sulfate response occurred when the diet contained supplemental choline and no supplemental methionine. Results indicated that sulfate must be present for choline to spare a maximum amount of methionine. PMID- 6844214 TI - The effect of manganese deficiency upon the ultrastructure of the eggshell. AB - Manganese deficiency in the laying hen results in decreased egg production and eggshell thickness. Eggshells from deficient hens show specific changes in appearance characterized by translucent areas. Examination of these translucent areas with the scanning electron microscope revealed changes in the ultrastructure of the shell. The most prominent feature was large irregular mammillary knobs probably due to the fusion of several mammillary cores during the early phases of eggshell formation. Chemical analysis of the organic matrix of the eggshell showed a decrease in hexosamine and hexuronic acid content consistent with the known role of manganese in polysaccharide synthesis. Studies on the characteristics of the polysaccharide chains isolated from normal eggshells suggested that these polysaccharides were considerably different from those isolated from cartilage proteoglycans. PMID- 6844216 TI - Ahemeral light cycles and protein levels for older laying hens. AB - Variations in light:dark ratios and timing schedules of 26- and 28-hr ahemeral cycles were examined for their effects on shell quality and egg weight. In two experiments utilizing 2578 White Leghorn Laying hens, 16-week long ahemeral treatments were instituted abruptly late in the pullet laying season and again following a forced-molt production cycle. Ahemeral light-dark cycles of 28-hr length resulted in significantly heavier shell and egg weights as compared to 26 hr ahemeral cycles or the control 24-hr cycle. Ahemeral 26-hr cycles did not significantly increase egg weight compared to the 24-hr controls but did increase shell weight. Varying total light in 28-hr cycles from 20 to 10 hr with the light given in either one continuous period or interrupted by two intermediate dark periods and as either 18 or 16 hr of continuous light in the 26-hr cycles did not result in significant differences in shell or egg weight compared to the other treatments of the same cycle length. Rate of lay was lower for the hens given only 10 hr of interrupted light in a 28-hr cycle but was not otherwise affected by light treatment. Dietary protein levels of 15% (as compared to 17%) and 14% (as compared to 16 and 18%) consistently reduced egg weights (P less than .10 or less than .05) and tended to improve shell quality. These experiments further demonstrated the effectiveness of 26- and 28-hr ahemeral light-dark cycles in increasing shell weight as a method of extending the economic laying period of either older pullets or force-molted hens without a sacrifice in the number of eggs produced. PMID- 6844215 TI - Studies on the utilization of leaf protein concentrates as a protein source in poultry nutrition. AB - Spray-dried leaf protein concentrate prepared from Red Clover and alfalfa with low or high saponin content were evaluated by studying their effect on growth and feed efficiency of broiler chicks at the 40% level. Excellent growth and feed efficiency were recorded when 40% of low saponin alfalfa protein concentrate (APC) prepared from fresh alfalfa was incorporated in the diets. Saponin in APC estimated by hemolysis test was an important factor affecting the growth, feed efficiency, and mortality of chicks. Analysis of variance showed no significant (P less than .05) difference in body weight gain between Red Clover protein concentrate and low saponin APC. A significant reduction in body weight gain of both broiler and egg type chicks was observed when 40 parts of wet alfalfa protein concentrate were incorporated in the diets. A combination of 30 parts of wet alfalfa protein concentrate (wet APC) and rice bran in a broiler diet did not adversely affect growth. Supplementation of additional vitamins did not improve gain in body weight when 40 parts of wet APC and rice bran were included in the diet. Supplementation of vitamin E seems to be crucial when higher levels of wet APC and rice bran are included in broiler diets. PMID- 6844217 TI - Development of cultured quail embryos. AB - Japanese quail embryos were cultured by a plastic wrap technique after 2.5 days of normal incubation, and their development was investigated. Mean survival time was 13 days (2.5 days of preincubation plus 10.5 days of experimental culture). Mean morphological stage shown by the cultured embryos was Stage 28 of Zacchei (1961) (corresponding to 11 days of normal incubation) and the maximum stage of development was Stage 31 (corresponding to 14 days of normal incubation). In the latter half of incubation periods, cultured embryos showed retarded development, and their size was smaller than intact control embryos. Because continual observation of embryos is possible, this culture technique would be useful for experimental manipulation of the embryos or studies on lethal genes. PMID- 6844218 TI - Coordination of cecal motility during cecal evacuation. AB - Turkeys were surgically prepared with two strain gauge transducers on each cecum to detect both major and minor contractions at each implant site and to allow appraisal of coordination of contractions within and between ceca at the time of cecal evacuation and at dawn. There were significantly more of both types of contractions and significantly more major than minor contractions immediately before than after evacuation. At dawn the frequency of minor contractions was significantly greater than that of major contractions and there were significantly more contractions immediately after dawn than before dawn. Contractile activity was more often not coordinated than coordinated at anytime both within and between the ceca. When there was coordination within each cecum before evacuation, it was more frequently orad oriented than aborad. Near dawn the occurrence of coordinated contractions within each cecum was not significantly different from the occurrence of no coordination and the latter occurred significantly more frequently than did coordination between the two ceca. PMID- 6844219 TI - Effect of dietary protein source and monensin on performance of chicks. AB - The effects of dietary protein source and monensin on growth performance of chicks fed diets containing 121 or 160 mg/kg monensin were investigated. Crossbred chicks (New Hampshire X Columbian) were fed a corn soybean meal diet (24% crude protein) containing 0, 5.0, or 13.0% animal-source protein supplied by various combinations of fish meal and meat and bone meal. Growth rate and gain/feed ratio were measured from 8 to 22 days posthatching. Growth performance was depressed by both 121 and 160 mg/kg monensin with the depression being greater at 160 mg/kg. The type or level of animal-source protein had no effect on the magnitude of growth depression caused by monensin. Growth performance was improved by addition of fish meal and meat and bone meal to the corn-soybean meal diet. PMID- 6844220 TI - Secretory function of the ductus deferens of male chickens. AB - Juvenile and castrate male chickens with ligated ductus deferens were treated with androgen to determine which regions of the ductus deferens were involved in fluid secretion and to determine the characteristics (pH and protein content) of the secretions. The ductus deferens developed with androgen injection contained a dilute secretion. No significant differences in pH and protein content of the fluid were observed between juvenile and castrate males. Regional ligation of the ductus deferens showed that fluid secretion occurred throughout the length of the tract. PMID- 6844221 TI - Water consumption the first week by egg strain chicks. AB - Water consumption was measured on 12 groups of 75 straight run day-old Leghorn type chicks. For 2 years the consumption was measured on a per day basis for the first week. Control waterers were set up in the floor pens to measure evaporation. Feed consumption averaged 6.9 kg per pen for the week. Average water consumption in liters/1000 chicks/day for the first 7 days was as follows, respectively: 8.5, 8.6, 11.4, 11.9, 13.1, 15.5, 16.4. These values are slightly less than the National Research Council (1977) values and considerably less than other reported values. PMID- 6844222 TI - A self-help group for patients on psychotropic drugs. PMID- 6844223 TI - Brief psychotherapeutic sessions in general practice. PMID- 6844225 TI - Treating detained patients. A role for the GP-arbitrator. PMID- 6844224 TI - How depressive illness presents in Hong Kong. PMID- 6844226 TI - The psychiatric assessment of remanded prisoners. PMID- 6844227 TI - Management of drug dependence. PMID- 6844228 TI - Physical illness in psychiatric patients. PMID- 6844230 TI - The sixth sense of danger. PMID- 6844229 TI - Depression in a rural practice in autumn 1980. PMID- 6844231 TI - Depression: a preventable illness? PMID- 6844232 TI - Warts and all. PMID- 6844233 TI - Psychiatry in 1983. PMID- 6844234 TI - Psycho-social morbidity in general practice. PMID- 6844235 TI - A general practice approach to depression. PMID- 6844236 TI - Psychological impact of stillbirth. PMID- 6844237 TI - The mentally ill doctor. Causes and consequences. PMID- 6844239 TI - Managing alcohol dependence. PMID- 6844240 TI - Psychiatric training for future general practitioners. PMID- 6844238 TI - Psychotropic drug prescribing. PMID- 6844241 TI - Applying the 1959 Mental Health Act. PMID- 6844242 TI - Referrals to clinical psychologists. Do results match expectations? PMID- 6844243 TI - [Destructive cults. Social and health-related sequelae of totalitarian pseudoreligious movements]. PMID- 6844244 TI - [Extremist religious cults and changed consciousness]. PMID- 6844245 TI - [Personality changes in young adults in destructive cults. From the overtaxing idea to hypnotic brain control]. PMID- 6844246 TI - [Early prevention as a principle of modern health education]. PMID- 6844247 TI - [The cult clinic of the Jewish Family Service, Los Angeles. Help for families in need]. PMID- 6844248 TI - [Orders or destructive cults?]. PMID- 6844249 TI - [Cults as a public health problem]. PMID- 6844250 TI - [Status of the knowledge of established neurologists and psychiatric clinics on youth sects (results of a survey)]. PMID- 6844251 TI - [Psychiatric problems in relation to the so-called youth sects]. PMID- 6844252 TI - [Can youth sects cause illness?]. PMID- 6844253 TI - [Psychiatric disorders in members of totalitarian religious communities]. PMID- 6844254 TI - [Destructive cult conversion]. PMID- 6844255 TI - [Causes for the effectiveness of tachiscopic training in writing/reading weakness]. PMID- 6844257 TI - [The sibling constellation and parental support or discipline]. PMID- 6844259 TI - [Employment and education of degree psychologists in institutional child rearing]. PMID- 6844256 TI - [Legasthenia--long-term course of a partial achievement disorder. Trial of a balance based on a longitudinal study]. PMID- 6844258 TI - [Relations between sibling position and intelligence as well as personality in behaviorally conspicuous children]. PMID- 6844261 TI - [Clarity of an individual view of life as a vital and fundamental provision for therapeutic treatment possibilities: A response to Leistikows' "Reciprocal action model . . ."]. PMID- 6844260 TI - [Effect of character structure in school]. PMID- 6844262 TI - Prenatal diagnosis of hemoglobinopathies in twin pregnancies by double simultaneous fetoscopy. AB - A new technique for sampling fetal blood in twin pregnancies using two fetoscopes simultaneously is described. Two fetoscopes were inserted, one after the other, into both amniotic cavities and fetal blood samples were obtained from either the chorionic plate vessels or the umbilical cord insertion area. The observation of the bright tip of the second fetoscope behind the septum using the first fetoscope assured the successful entry of the two fetoscopes into the two different amniotic sacs. This technique was performed on 15 out of 17 patients. In all patients the fetuses were at risk of beta-thalassemia major. Sampling was successful in all cases. Double simultaneous fetoscopy seems to be a safe and accurate technique without technical problems or complications. The simultaneous use of two fetoscopes opens new possibilities in intrauterine fetal surgery and research. PMID- 6844263 TI - Mid-trimester fetal ultrasound: diagnostic dilemmas. AB - Two cases are reported in which an unusual ultrasound finding preceded diagnostic amniocentesis and led to further work-up. In both cases a decision was made to terminate the pregnancy. One fetus in which a neck mass was detected by ultrasound was shown to be normal on post-mortem examination. The second fetus was aborted because of Rh sensitization and had the abnormality seen by ultrasound. However, this lesion, calcified intrahepatic plaques, had no presumed pathological significance. These cases suggest caution in the interpretation of results obtained with the new technologies used for prenatal diagnosis. PMID- 6844265 TI - Prenatal determination of uridine diphosphate galactose-4-epimerase activity. PMID- 6844264 TI - Citrulline in amniotic fluid and the prenatal diagnosis of citrullinemia. PMID- 6844266 TI - Prenatal sonographic diagnosis of meconium peritonitis. PMID- 6844267 TI - Prenatal determination of dihydropteridine reductase in a normal fetus at risk for malignant hyperphenylalaninemia. PMID- 6844268 TI - Prenatal diagnosis, fetal pathology and cytogenetic analysis of a 46,XX/47,XX, + 15 mosaic. AB - Mosaic trisomy 15 was prenatally diagnosed on amniotic fluid cells from two consecutive amniocenteses and was confirmed on cells from five different fetal tissues. The proportion of normal versus trisomic cells was consistently higher in the amniotic cell cultures and--with one exception--in the fetal tissues, while serial subcultures gave different results. The slightly atypical external features and internal malformations of the affected fetus as compared to the only clinical observation from the literature are not unusual enough to allow the delineation of a specific malformation pattern. PMID- 6844269 TI - The hazards of tap water. PMID- 6844270 TI - [Psychosocial structural changes in epilepsy]. PMID- 6844271 TI - [Simultaneous surgical treatment of arterial insufficiency at multiple sites]. PMID- 6844272 TI - [Microbiology of peritonitis]. PMID- 6844273 TI - [Bioavailability of antibiotics in peritonitis]. PMID- 6844274 TI - [Does prevention of bronchial carcinoma fail?]. PMID- 6844275 TI - [Preoperative evaluation and contraindications in surgery of bronchial carcinoma]. PMID- 6844276 TI - [New aspects of surgery of bronchial carcinoma]. PMID- 6844277 TI - [Gram-negative nosocomial infections. Epidemiology, causative agents, clinical aspects, trends]. PMID- 6844278 TI - [3d generation cephalosporins in nosocomial infections]. PMID- 6844279 TI - [Neonatal infections, pathophysiology, microbiology and clinical aspects]. PMID- 6844280 TI - [Meningitis and sepsis in the newborn age: therapy concepts and antibiotic therapy]. PMID- 6844281 TI - [Correlation between morphology and steroid receptors in breast cancer]. PMID- 6844282 TI - [Fetal and infant mortality. Pathologico-anatomic results of a study with individual case analysis]. PMID- 6844283 TI - [Geographic pathology of malignant testicular tumors]. PMID- 6844284 TI - [Bilateral congenital cystic adenomatoid malformation of the lung. Analysis of a case]. PMID- 6844286 TI - Proceedings of the International Symposium on Epidemiology and Prevention of Atherosclerotic Disease. PMID- 6844285 TI - [The erythrocyte adherence test (SRCA test) in preneoplastic urothelial changes in and its prognostic significance]. PMID- 6844287 TI - Controlled experiments in human nutrition: contemporary problems. PMID- 6844288 TI - Diet and serum lipids: controlled studies in the United States. AB - The influence of dietary fat on serum lipids is well established. The general principles of a fat-modified diet--calorie control and the amount and composition of dietary fat--are demonstrated in studies in which nutrient composition was systematically altered. Weight loss, even when caloric deficit involves no other changes in nutrients, reduces serum lipids. With isocaloric diets, the fatty acid composition rather than the amount of fat influences the serum cholesterol concentration. Saturated fatty acids are twice as effective in raising serum cholesterol levels as polyunsaturated fatty acids are in reducing them. The amount of cholesterol in the diet alters the amount in the serum by approximately 5 mg/dl for every 100 mg of change in diets with less than 300 mg/1000 kcal. Cholesterol in excess of this amount has no additional effect. With no dietary cholesterol, serum lipids are unaffected by the fat composition. In the presence of dietary cholesterol, serum lipids are affected by saturated and polyunsaturated fatty acids through an interaction with cholesterol. Polyunsaturates counteract the influence of both saturated fatty acids and cholesterol. The more cholesterol there is in the diet, the more polyunsaturated fatty acids are required to counteract its effect. Both the fatty acid composition of the lipoproteins and lipid metabolism are affected by the fat and cholesterol composition of the diet. PMID- 6844289 TI - Diet and serum lipids--lipoproteins: controlled studies in Europe. AB - Numerous controlled dietary experiments in various U.S. laboratories have demonstrated that fatty acid composition and cholesterol content of the diet influence human serum cholesterol concentration. Work in Ancel Keys's (1) laboratory has shown that the serum cholesterol changes produced by controlled dietary modifications in middle-aged, metabolically normal male subjects in energy balance can be predicted from changes in fatty acid composition and cholesterol content of the diet. The serum cholesterol changes are mostly accounted for by those of low-density lipoprotein cholesterol. The results of some of the European studies are generally comparable to those obtained in Minnesota. Thus, the results in one of the Finnish Hospital studies are in perfect agreement with the prediction of the Keys, Anderson, and Grande equation: good agreement has also been found with the results of a recent experiment by Schlierf et al. in Heidelberg. The effects of dietary cholesterol observed by Dutch workers are also in agreement with our prediction, when cholesterol (egg yolk) was added to a diet rich in polyunsaturated fatty acids, but not when added to a diet rich in saturated fatty acids. PMID- 6844290 TI - The importance of dietary cholesterol in coronary heart disease. PMID- 6844291 TI - Plasma and erythrocyte fatty acids: a methodology for evaluation of hypocholesterolemic dietary interventions. AB - A major source of concern in the management of hypercholesterolemia is the careful evaluation of adherence to dietary prescriptions. Routine analysis of plasma fatty acids to monitor adherence of hyperlipidemic outpatients to diets varied in lipid composition is a major task of our research group. Plasma fatty acid patterns are determined by gas-liquid chromatography 60 days after starting an experimental normocaloric diet with 37% fat calories and a polyunsaturated/saturated (P/S) ratio of 3.4. Where poor adherence is observed, the dietary message is administered more incisively or changed accordingly. It is also possible to identify with certainty diet-resistant hypercholesterolemic individuals, i.e., the true nonresponders, who represent only a minority. The determination of erythrocyte fatty acid patterns represents a useful index of adherence in long-term feeding studies and has been extensively carried out in subsamples of persons examined at the fourth rescreening of a controlled trial of primary prevention of coronary heart disease. Increases in mean erythrocyte linoleic/oleic (L/O) and P/S ratios were observed in persons undergoing collective or individual hypocholesterolemic treatment, mean changes being proportional to the different type of nutritional approach. In our opinion, this methodology is the most reliable technique not only for the identification of the different responses to hypocholesterolemic dietary recommendations but also to monitor fat consumption in population samples. PMID- 6844292 TI - Dietary salt and blood pressure. AB - Research evidence on the role of dietary sodium in the etiology and pathogenesis of hypertension is briefly reviewed. This matter is assuming new importance at present, given new data on the efficacy of normalization of blood pressure for adults with so-called "mild" hypertension (average diastolic 90-104 mm Hg), hence the need for safe nutritional-hygienic alternatives to years-long drug treatment for millions of people with such hypertension. Two trials by the authors deal with some unresolved questions in this area. The first, a preliminary study, involved 21 lacto-ovo-vegetarian high school students living in a boarding school. With decrease in daily Na intake from 216 to 72 meq for the experimental compared with the control group, red blood cell Na concentration was significantly lower in the former; systolic pressure was slightly but not significantly lower. The second trial, the Primary Prevention of Hypertension, involves over 200 hypertension-prone persons aged 30-44, and explores the ability in the experimental group to reduce blood pressure and prevent development of hypertension by safe nutritional-hygienic means (weight reduction, dietary Na decrease, avoidance of excess alcohol, rhythmic exercise). Initial results at 6 months are presented. Trials on the prevention and control of hypertension by nonpharmacologic means, including reduced Na intake, and involving analyses of the inter-relationships among dietary Na, other dietary factors, Na metabolism, and blood pressure in samples from different population strata, are an important present-day research need. PMID- 6844294 TI - Cardiovascular disease epidemiology: lessons for clinical medicine. PMID- 6844293 TI - Evaluation of the hypocholesterolemic effect of vegetable proteins. AB - The hypocholesterolemic effect of dietary vegetable proteins was studied by comparing egg-white protein and fava bean protein concentrate in one normal and seven hypercholesterolemic (six type II A, one II B) persons; five completed the crossover design. To maintain stable body weight, subjects were kept on an isocaloric diet (20% protein, 48% carbohydrate (CH), 32% fat, P/S = 2) for 1 month and then hospitalized for two consecutive 18-day periods while receiving an isocaloric diet of different composition (15% protein, 50% CH, 26% fat, P/S = 2). Women were provided 50 g and men 70 g daily of egg-white or fava bean protein concentrate during the two crossover periods. Hematocrit and fasting plasma or serum were analyzed every 3 days for glucose, insulin, uric acid, creatinine, total and low-density lipoprotein (LDL), very low-density lipoprotein (VLDL), and high-density lipoprotein (HDL) cholesterols, and for total and VLDL triglyceride. Dietary adequacy of both proteins was evaluated by measuring plasma concentration of prealbumin, transferrin, and retinol-binding globulin. Insulin and hematocrit did not show any change, nor did any other biochemical variables show significant differences when results were compared at the end of each crossover period. Compared with baseline, fasting plasma glucose significantly decreased on the fava bean diet. Serum total and LDL cholesterol decreased during both diets but were statistically significant only on the egg-white diet. Serum HDL cholesterol significantly decreased only on the fava bean diet. Serum total and VLDL triglyceride did not show any significant change. Labile plasma protein concentration was significantly reduced only on the fava bean diet. In conclusion, the fava bean diet did not show a significant effect on lowering serum total and LDL cholesterol. Such an effect was mild but significant on the egg-white diet, compared with baseline. PMID- 6844295 TI - Epidemiological observations of old age. AB - Disease prevention in the higher age bracket is a rather new discipline. A necessary prerequisite for any prophylactic interference is a thorough knowledge about prevalence of and incidence change in health condition in various ages and in cohorts followed for a period of time. In the Glostrup Population Studies cohorts aged 50 and 70 years were followed for 10 years. Furthermore, two birth cohorts 14 years apart were investigated at the age of 50 years. From these and other surveys findings included: (a) conservation of muscle strength keeps glucose consumption and insulin production at a normal level even in old age: (b) abstinence from smoking conveys a minimum of respiratory distress and reduction of respiratory parameters by age: (c) food consumption is high in fat (43% of energy) and saturated fat (S/P 3:1) both at ages 40 and 60, with no sex difference. A secular trend pointing toward a change in eating and drinking habits is, however, indicated from the fact that 50-year-old men and women present lower serum cholesterol and higher fasting serum triglyceride levels than do people at the same age deriving from a birth cohort 14 years earlier. PMID- 6844296 TI - Implications of epidemiology for community medicine. AB - Although both epidemiology and community medicine are difficult to define, the relationship between them can be described in practical terms. Examples are given in which cardiovascular epidemiological studies demonstrated the need (a) for improving existing community health care services, (b) for extending them, (c) for transposing them to new settings, (d) for starting preventive measures early in life, and (e) for inducing population-wide changes. However, community medicine has many limitations, calling for a better information base, and also calling for more epidemiological research. PMID- 6844297 TI - Studies in hypertension: implications for clinical medicine. PMID- 6844298 TI - The classic risk factors for coronary heart disease: experience in Europe. AB - This article is based on the follow-up of 9,182 men from 13 cohorts of five European countries (Finland, Greece, Italy, Holland, and Yugoslavia). Its purpose is to explore the associations of known risk factors for coronary heart disease (CHD). A significant positive association was found between age and 10-year mortality from CHD (10-MCHD), between systolic blood pressure (SBP) and 10-MCHD (steeper for the Finns than for men from Mediterranean countries), and between serum cholesterol and 10-MCHD (more pronounced in northern than southern European men). Age-standardized 10-MCHD was found to increase with degree of smoking; the regression slope of this correlation was steeper for men from northern than from southern Europe. Although death from all causes tended to be inversely related to relative body weight, no consistent evidence of a relation between relative body weight or body fatness and CHD was found. Incidence rate of CHD was not consistently related to physical activity characteristics of the groups. Resting pulse rate was an important risk factor for all causes of death in 10 years, but of less consequence for MCHD. Regression slopes were steeper for northern than for southern Europeans. Vital capacity was a significant risk factor for MCHD for Italian but not for Finnish, Greek, or Serbian men. The 10-year adjusted MCHD was correlated with total fat in the diet; the correlation with saturated fatty acids was much more significant. PMID- 6844299 TI - Clinical implications of population-based studies in Europe. AB - The cross-fertilization of epidemiology and clinical medicine is a continuous process. The impressive progress in cardiovascular disease (CVD) epidemiology of the last 30 years was substantially reinforced by large population-based intervention studies in the last decade. As a result, guidelines for prevention are emerging with relatively clear implications for clinical medicine in general. Two such guidelines were recently published by the Royal College of General Practitioners (2, 5). However, the application of these general principles in day to-day doctor-patient interaction is not easy. General health promotion counseling in the family, conscientious case findings, and regular follow-up are the main points of agreement between epidemiologists and progressive clinicians. Preventive treatment with drugs, however, needs to be decided in each case individually. The ever-increasing new epidemiological knowledge, the intimate knowledge of the individual and his family, and the careful balancing of potential benefits and possible side effects of treatment coupled with the art of the clinician are helping physicians to make these difficult decisions correctly. In order to maximally diminish the current need for such difficult decision making, when the patient's risk is already high, generally adopted, sound, and safe health promotion efforts should be pursued by clinicians in their everyday activities. WHO will continue to encourage the accumulation of sound knowledge in prevention of CVD and other chronic diseases. The future calls for comprehensive health promotion policies focused on the individual and on the community, not only in regard to single diseases. PMID- 6844301 TI - The european multifactorial preventive trial of coronary heart disease: four-year experience. AB - The European Multifactorial Preventive Trial of Coronary Heart Disease operates in five centers in Belgium, Italy, Poland, Spain, and Great Britain with a total of 44 pairs of factories employing over 63,000 men aged 40-59. Pairs of factories were randomly allocated to either treatment or control. An entry screening for risk factors was offered to all men in treatment factories and to random samples of men in control factories. Those identified as relatively high-risk in treatment factories (upper 15-20%) were individually treated with advice for cholesterol lowering diet, smoking cessation, regular exercise, weight reduction, and drug control of hypertension, whereas mass education on the same subjects was given to non-high-risk individuals. Random samples of men were reexamined after 2 and 4 years in order to assess risk factor changes, with control groups serving as reference for naturally occurring trends. Changes of main risk factors recorded in different centers varied considerably. Pooled data showed a net reduction of 2.5% random sample (RS) and 5.8% high-risk (HR) for serum cholesterol; of 1.3% (RS) and 2.6% (HR) for systolic blood pressure; of 0.5% (RS) and 0.9% (HR) for body weight; and 8.8% (RS) and 15.2% (HR) for cigarette consumption. The net reduction of coronary risk estimated by the multiple logistic equation was 12% in RS and 17% in HR. PMID- 6844300 TI - Nutrition in coronary heart disease prevention: a program for the 1980s. AB - Within a quarter century the convergence of geographical and prospective epidemiology, clinical research, and laboratory investigation has provided strongly attested theories of coronary heart disease (CHD) etiology. Evidence that application of these theories will reduce CHD incidence is incomplete but adequate to justify their use at clinical and population levels. Additional etiological hypotheses (HDL, hyperinsulinism, personality type) are persuasive but await comparable investigation. Risk-benefit considerations require ongoing scrutiny: current evidence, however, does not give cause for concern that attainable reduction of plasma cholesterol has deleterious effects. To minimize lipoprotein-mediated CHD risk it may be necessary to attain population mean plasma cholesterol levels of less than 200 mg/dl, a target which is probably feasible by dietary modifications directed to lipid, fiber, and energy intake. A substantial obstacle to CHD prevention is the irresponsible rearguard action by small segments of the food industry and the medical profession, permitting inertia on the false grounds that scientific opinion is seriously divided. PMID- 6844302 TI - A randomized primary preventive trial in coronary heart disease: the Oslo study. PMID- 6844303 TI - The multiple risk factor intervention trial in the U.S. A summary of results at four years in special intervention and usual care men. AB - Four-year results of the Multiple Risk Factor Intervention Trial indicate that an integrated approach to lifestyle modification of multiple risk factors is feasible and achieves significant lowering of risk factors compared with a group referred to usual medical care. The greatest changes and differences were in cigarette smoking. The hypertension treatment result met design predictions in the Special Intervention (SI) group. However, at 4 years the difference between groups was less than predicted, primarily due to unanticipated effectiveness of treatment of elevated pressures in the Usual Care (UC) group, reflecting recent secular changes in hypertension detection and control in the U.S. Similarly, the serum cholesterol net fall in the SI compared to UC group was 59% of goal, in part because of an unanticipated reduction in the UC group. The risk factor differences between groups were considerable, even though in some areas short of initial design expectations. The most serious consequence of a less than anticipated difference in risk characteristics between groups is an effective loss of power to detect significant differences in major disease endpoints. A further major benefit from the study has been the demonstration of the ability to have diverse scientific disciplines work effectively together in the long-term preventive management of healthy but high-risk men. PMID- 6844304 TI - The North Karelia project. PMID- 6844306 TI - Physical activity: is it still a risk factor? PMID- 6844305 TI - Diet and atherosclerosis: epidemiologic evidence and public health implications. PMID- 6844307 TI - Lifestyle and risk factor trends, mortality trends, and public health perspectives. PMID- 6844309 TI - Dietary trends in Western Europe. AB - The documentation available on prevailing dietary trends and of relative nutritional status of the various populations in Western Europe, particularly in the European Economic Community (EEC) countries, is not homogenous, somewhat sparse, and often incomplete. It has been possible, however, to tentatively compare and evaluate the main trends of food consumption and to determine the areas and/or population groups potentially at risk for nutritional disorders. Although almost every country has drawn up national nutritional standards or allowances, there is no common agreement on criteria for the dietary typology adequate to maintain health and well-being, while respecting traditional food habits of the different areas. However, while it is evident that quantitative food consumption in Western Europe exceeds average need, marginal situations or qualitative imbalances are often observed. It would first be necessary, therefore, to promote nutritional surveillance programs in order to establish baseline values for the most vulnerable population groups and the relationships between food habits and epidemiology of nutrition related disorders, and subsequently to monitor their evolution over time and with economic changes. PMID- 6844308 TI - International mortality trends and secular changes. AB - The decline in mortality from coronary heart disease (CHD) in several countries, notably the United States, in the 1970s has drawn attention to the need for monitoring secular trends in mortality and morbidity from this disease internationally and to discover the reasons for any upward or downward changes. Mortality trends for CHD in 27 countries are seen to vary widely, being very similar for men and women. It is, however, important to view CHD not in isolation but in terms of total mortality (TM) and other specific causes of death. For a more comprehensive picture, it is also necessary to go back two more decades into the 1950s, requiring the use of a broader diagnostic category "nonrheumatic and hypertensive heart disease" (HD). Using examples from selected countries, it is shown that CHD and HD run generally in parallel, that HD trends often though not always determine TM, and that cancer trends may or may not follow those for HD. Since preventive measures for CHD are likely to be beneficial for the prevention of other diseases as well, the concomitant study of trends for several chronic disorders ought to be rewarding. PMID- 6844310 TI - Changing patterns of coronary heart disease, stroke, and nutrient intake in Japan. AB - During the last 25 years a remarkable change has occurred in the ranking of the causes of death in Japan. In particular, stroke, the leading cause of death in Japan for a long period of time, has been declining from its peak in 1965. Although ischemic heart disease increased about fourfold, it is not yet as prominent as stroke. One reason for these changes may be that the average life span of Japanese men in 1975 was 71.8 years, 12 years longer than in 1950. This trend of mortality rate for stroke compelled attention to changes in dietary habits. This article deals in detail with these Japanese trends. PMID- 6844311 TI - Role of exercise training in secondary prevention of ischemic heart disease. AB - A review of recent studies indicates that: (1) Physiological characteristics, e.g., left ventricular performance and exercise tolerance, are important prognostic determinants; (2) the natural history of acute myocardial infarction includes a significant degree of spontaneous functional improvement during the early recovery phase; (3) short-term programs of physical training are likely to produce significant functional and symptomatic improvement at no cost in terms of excess mortality or morbidity--the mechanisms of improvement are largely peripheral and regulatory; (4) recent scintigraphic studies suggest that prolonged physical training produces improvement in left ventricular function and myocardial perfusion; (5) long-term studies of the effect of physical training on mortality and morbidity have failed to demonstrate conclusively the efficacy of exercise as a single agent, but provide support for the continued use of physical training as a component of multiple interventions. PMID- 6844312 TI - Lipoprotein profile--its value in prediction. AB - The currently popular view that a high concentration of high density (alpha) lipoprotein (HDL) in the blood plasma protects against coronary heart disease is based on publications which compare persons with and without the disease and persons who develop the disease within a few years after the analysis of the plasma. Very little attention has been paid to mortality and the follow-up period has been short. A recent report on civil servants in Israel claims an important inverse relationship between HDL cholesterol and mortality. The HDL values reported, however, differ greatly from all other published values, and the period of follow-up was less than 5 years. In addition, the statistics showing the protective effect of HDL cholesterol depend largely on the ratio of HDL to total cholesterol which really shows that, as is well known, the total cholesterol concentration is a positive risk factor for coronary heart disease. A 25-year follow-up of Minnesota business and professional men aged 50 to 60 at entry who were examined annually through 1978 produced no evidence that either total or coronary mortality was significantly related to the concentration of plasma HDL. The material covers 135 deaths, including 55 from coronary heart disease. The data actually suggest that the probability of death from neoplastic disease is directly related to the concentration of HDL cholesterol in the plasma or at least that there may be a trade-off between coronary heart disease and cancer death in respect to HDL cholesterol. The view that the higher the level of HDL cholesterol the better needs reexamination with attention to mortality during long follow-up. PMID- 6844313 TI - Behavior, stress, and psychosocial traits as risk factors. AB - Although psychosocial factors have long been associated with the pathogenesis of heart disease, the independent relation between these variables and coronary heart disease (CHD) is still controversial. However, when experimental, clinical pathological, and epidemiologic studies are taken together, strong evidence is provided that psychosocial and behavioral factors are important in the development and the provocation of clinical CHD manifestations. Heterogeneity in study results is partially due to methodological problems in defining and measuring behavior, stress, and psychosocial traits in population groups as well as in individuals. The difficulties in separating the role of psychosocial factors from the classic risk factors strengthen the importance and need for these factors to be considered in the design of further clinical and epidemiologic studies, not only to explore their independent predictive value but also to study their role in adherence to preventive advice and in the reversibility of risk. In these respects results are presented from a prospective epidemiologic and from a controlled multifactorial intervention study. PMID- 6844314 TI - Spontaneous changes in risk factors and prediction of coronary heart disease. AB - European cohorts of the Seven Countries Study have been analyzed in order to examine relationships between the observed incidence of coronary heart disease (CHD) in the second 5-year period of the follow-up and the major risk factors and their spontaneous changes in the first 5 years. The analysis, using the Multiple Logistic Function (MLF) model, shows that changes of systolic blood pressure and smoking habits were significant factors associated with CHD incidence, whereas changes of cholesterol and body mass index were not. PMID- 6844316 TI - Nutrition and HDL in children and young adults. AB - Serum samples were collected from 7- and 8-year-old boys in 16 countries with different rates of coronary heart disease (CHD) mortality. Both serum total and high-density lipoprotein (HDL) cholesterols were lower in developing countries than in affluent countries. The mean of the HDL cholesterol/total cholesterol ratio varied within narrow limits: 0.24-0.27 in Asian countries, 0.30-0.36 in Africa, and 0.30-0.37 in the USA and Europe. Thus both total and HDL cholesterol increased under the influence of a more affluent diet. This conclusion is supported by results from controlled trials. Student volunteers received all their food from us for periods of 8 to 16 weeks. Diets were prepared from regular foodstuffs, in such a way that they differed in one nutrient only. Dietary composition was confirmed by double portion analysis. A moderate fat diet with a high P/S ratio was compared with a low-fat, low-PUFA diet and with two high-fat diets having a high or low P/S ratio. Both low-fat and high P/S diets effectively lowered total serum cholesterol. However, HDL was depressed by the low-fat diet in comparison with diets with a higher fat content, whether high or low in polyunsaturates. This difference in HDL persisted for at least 3 months. This suggests that "Western" diets, usually high in fat, elevate both total and HDL cholesterol concentrations in children and young adults. PMID- 6844315 TI - Serum lipid and lipoprotein profiles in childhood. AB - Serum lipids and lipoproteins as well as other factors have been shown to be predictive of future symptomatic coronary heart disease in adult populations. Many epidemiologic data are available on serum lipids in adults in different populations; similar data in children indicate a large geographic variability between different populations and even among individuals of the same population, suggesting that both genetic and environmental factors are determinants of serum lipid concentrations. Serum cholesterol at birth and during childhood is carried predominantly by low-density lipoprotein (LDL) and high-density lipoprotein (HDL) whereas very low-density lipoprotein (VLDL) remains very low during the same period. Longitudinal studies show that serum cholesterol level decreases slightly with age in boys but not in girls; the decreasing trend is most evident between 10 and 14 years of age. LDL cholesterol follows the same trend. A continuous slight increase in serum total and VLDL triglyceride has been shown with age. HDL cholesterol seems to maintain a constant level with only slight variation with age. Moreover, LDL cholesterol has great consistency with future levels. Measurements made in children confirm that high levels of cholesterol may be present at early ages, suggesting the need for follow-up studies in young populations in order to evaluate whether hypercholesterolemia in childhood is predictive of future coronary events. PMID- 6844317 TI - Childhood obesity as a risk factor in adulthood and its prevention. AB - Investigation of the relationship between relative body mass (RBM) of women immediately upon giving birth and birth weight (BW) of newborns showed that variables are positively correlated (r = 0.56, P less than 0.05). Data on distributions of adult RBM and BW show that it is more likely that children with a BW greater than or equal to 4.5 kg will become obese in a later stage of life than those whose BW was less than or equal to 3.2 kg. The regression lines in a group of children indicated a positive correlation between RBM and glycemia (r = 0.30, P less than 0.01), cholesterolemia (r = 0.223, P less than 0.05), and triglyceridemia (r = 0.239, P less than 0.05). After the same duration of dieting, those adults who became obese in early childhood lost as much from their initial body mass and fat as those who became obese in adulthood. A reducing diet produced a decrease in systolic and diastolic blood pressure in both groups, but was significant only in the latter. Therefore, the prevention of obesity and its consequences should begin in the intrauterine stage and be continued through early childhood, adolescence, and adulthood with dietary measures and increased physical activity. PMID- 6844318 TI - Salt and hypertension. AB - The salt hypothesis states that salt is a necessary condition for the genesis of essential hypertension; however, it is not a sufficient condition. Other factors- -primarily genetics--are necessary for the expression of the disease. The arguments in favor of this still controversial subject originate from pathophysiology, evolution, history, pharmacology, experimental and clinical medicine, and epidemiology. Epidemiologic observations favoring the hypothesis mostly relate to comparisons between populations, and much less to comparisons within populations. The arguments against this hypothesis are related mostly to the well known difficulties of proving a within-population relationship of a relatively homogeneously distributed variable to an age-related variable (blood pressure). Mortality data derived from stomach cancer and stroke, compared within and between populations, provide only circumstantial, but nevertheless important, evidence in favor of the salt hypothesis. The strong, consistent, and independent association between stomach cancer and stroke mortality is best explained by the level of salt intake in the population. The observations made in Belgium over the last years are consistent with the salt hypothesis. A decrease in salt intake at the population level correlated with a marked decrease in stroke and stomach cancer mortality, larger than in any other European country, except Finland. PMID- 6844319 TI - The role of dietary polyunsaturated fatty acids and prostaglandins in reducing blood pressure and improving thrombogenic indices. AB - Evidence linking dietary fats to blood pressure and thrombogenic indices is reviewed. Results of dietary studies performed at Beltsville, Maryland, have demonstrated that under controlled dietary conditions, i.e., when total fat intake is maintained at 25% fat calories with a P/S ratio of 1, at either a fixed or free-choice salt intake and where the body weight is maintained relatively constant, blood pressure can be lowered and platelet aggregation indices can be improved in men and women in the 40-60 age group. Results of a pilot epidemiologic study of farmers aged 40-45 in Finland and Italy generally confirm the experimental nutrition studies reported above. A possible explanation of these results based on the conversion of linoleic acid to prostaglandins as well as the physiological actions of prostaglandins is discussed. PMID- 6844320 TI - Diabetes, hyperglycemia, and coronary heart disease. AB - An international collaborative group examined the relation between asymptomatic hyperglycemia and coronary heart disease (CHD). After excluding clinically diagnosed diabetes and treated hypertensives, there were 48,912 men aged 35-64 in the study population. Post-load circulating glucose correlated with age, relative weight, and systolic blood pressure. The prevalence on ECG of S-T/T findings, but not of Q/QS items, was higher in the top quintile of glycemia. For CHD mortality there was no consistent, strong, or independent association with glycemia. In the Whitehall Study (the largest), it appeared that there was a threshold effect, CHD mortality being about twice as high above the 95th percentile of glycemia. Stroke mortality was increased to a similar extent. PMID- 6844322 TI - [Experience of the phthisiological service with the organization of therapeutic and preventive measures in patients with chronic nonspecific lung diseases]. PMID- 6844321 TI - The complementary interaction of epidemiological and experimental animal studies: a key foundation of the preventive effort. AB - This overview will examine the contributions made by animal models of atherosclerosis to our understanding of its pathogenesis and will describe the principles for prevention of this disease process. In addition, some of the recent biochemical and cell biological discoveries, many utilizing animal cells and animal lipoproteins, will be discussed. Further, the increasing knowledge brought to worldwide efforts for the prevention and regression of atherosclerosis by the aforementioned research approaches will be reviewed. The results of some of the most promising animal studies of advanced atherosclerotic plaque regression will be briefly summarized, emphasizing the quantitation of changes. The prospects for verifying some of these findings in quantitative studies of human atherosclerosis will be presented along with some of the obstacles to be overcome. PMID- 6844323 TI - [Influenza vaccination of patients with pulmonary tuberculosis in the tuberculosis dispensary]. PMID- 6844324 TI - [Bronchoscopic diagnosis of adenogenic bronchial tuberculosis in patients with primary tuberculosis]. PMID- 6844325 TI - [Use of radioisotope methods for the evaluation of bronchial patency in patients with pulmonary tuberculosis]. PMID- 6844326 TI - [State of the bronchial system in elderly and aged patients with pulmonary tuberculosis]. PMID- 6844328 TI - [Clinico-radiological characteristics of chronic bronchitis]. PMID- 6844327 TI - [Prevention--basis of antitubercular care of the population]. PMID- 6844329 TI - [Intermittent chemotherapy in adolescents with tuberculosis]. PMID- 6844330 TI - [Efficacy of various methods of drug administration in patients with destructive pulmonary tuberculosis]. PMID- 6844331 TI - [Efficacy of glucocorticoids in the combined treatment of destructive pulmonary tuberculosis]. PMID- 6844332 TI - [Effect of isonicotinoyl hydrazide of phosphonacetic acid on various indices of host nonspecific resistance]. PMID- 6844333 TI - [Metabolism of biogenic amines in patients with active pulmonary tuberculosis complicated by nonspecific endobronchitis]. PMID- 6844334 TI - [Efficacy of controlled ambulatory intermittent chemotherapy in patients with group II and III tuberculosis by dispensary classification]. PMID- 6844335 TI - Growth stimulation of rat colonic cells in organ culture with N-methyl-N'-nitro-N nitrosoguanidine. AB - The effects of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) on rat colonic mucosa were investigated in organ culture. Distal colonic mucosa separated from the muscle layers was cultured on a substrate of human fibrin foam. Exposure of colonic organ cultures to 0.1, 1.0, and 10.0 micrograms MNNG/ml of medium on a multiple discontinuous basis, e.g., every third day for 3 hr, produced significant carcinogen effects. [3H]Thymidine was incorporated throughout crypts and in surface epithelium of carcinogen-treated explants. Outgrowth of epithelioid cells into the fibrin foam matrix was observed in all treated explants 9 days after initial MNNG exposure. Control untreated cultures showed limited outgrowth. After 15 and 21 days in culture, epithelioid outgrowth was still observed in 1.0 microgram MNNG/ml-treated cultures. PMID- 6844336 TI - Differences in vitamin E levels in tissues of the spontaneously hypertensive and Wistar-Kyoto rats. AB - Tissue vitamin E levels were significantly lower in spontaneously hypertensive rats (SHR) than in the normotensive, genetically related Wistar/Kyoto (W/K). This difference was also observed when animals were given identical oral doses of vitamin E. The possible relationship of lower vitamin E tissue levels to lower immune responses in the SHR is discussed. PMID- 6844337 TI - Dimethyl sulfoxide (DMSO) does not affect epidermal wound healing. AB - We studied the effect of 95% DMSO on dermal/epidermal healing and microbiol flora in partial-thickness wounds. Wounds of 0.3 mm were made in the skin of Yorkshire pigs with a keratome and treated daily with either 95% DMSO, water, or they were left untreated. Wounds were excised on Days 2-7 and the dermis was separated from the epidermis. The dermis was assayed for collagen biosynthesis (by measuring the production of [14C]hydroxyproline (HP) and amount of radioactive peptides released after collagenase digestion) and absolute HP (by spectrophotometric analysis). The epidermis was evaluated macroscopically for resurfacing. Aerobic bacteria from unwounded and wounded skin were identified and quantitated. There were no significant differences between treatment groups in HP incorporation or absolute collagen content from Days 2-6 after wounding. HP incorporation in the total protein fractions and in the collagenase digestible fractions were analogous. Collagen biosynthesis was similar in both unwounded, untreated, and unwounded DMSO-treated skin. Epidermal healing did not differ between treatment groups. There were no differences in the number or types of bacteria in wounds between treatment groups. These results indicate that topical DMSO is neither beneficial nor harmful in the healing of superficial wounds. PMID- 6844338 TI - Dietary protein level and skeletal development in the golden Syrian hamster. AB - The hamster was used as a model for investigating the effect of low, moderate, and high protein intake (12, 18, and 36% casein) on bone mineral content. Animals fed the low level of protein between 3 and 8 months of age had a reduction in the weight of all skeletal components measured, with the exception of the diaphyseal portion of the long bones. Diaphyseal weight and calcium remained significantly lower when expressed as a percentage of body weight. However, urinary calcium excretion was not lower than that of animals consuming an adequate protein intake. Ingesting a high protein diet resulted in a significant increase in urinary calcium excretion, and a reduced amount of both mineral and organic material in the diaphyses. We conclude that long-term consumption of a high protein ration led to the development of a mild osteoporotic condition in the hamster which was limited to the diaphyseal portions of the long bones. PMID- 6844340 TI - The amount and distribution of water, dry matter, and sugars in the digestive tract of rats fed xanthan gum. AB - Diets containing a nutritionally adequate, high-maltose nutrient mixture and either 4% xanthan gum or 4% cellulose were fed ad libitum to rats. The feeding of this gum increased the combined weight of the small intestine and its contents by 110%. This effect was partially due to an enlarged intestinal cell mass and to extra dry matter in the contents but chiefly to a 400% increase in intraluminal water. Xanthan feeding enhanced greatly the persistence of sugars beyond the proximal quarter of the small intestine and increased their total recovery in the first three quarters of that organ by 150%. The xanthan-induced increase in intraluminal water in the small intestine was partially due to a slowed absorption of osmotically active substances from the gut. PMID- 6844339 TI - Biochemical changes in rat liver after 18.5 days of spaceflight. AB - The effect of "weightlessness" on liver metabolism was examined using tissue from rats flown in earth orbit for 18.5 days aboard the Soviet Cosmos 936 biosatellite. Changes in the activities of certain carbohydrate and lipid enzymes were noted. Of the 28 hepatic enzyme activities assayed, two, palmitoyl-CoA desaturase and lactate dehydrogenase, increased, whereas five, glycogen phosphorylase, 6-phosphogluconate dehydrogenase, both acyltransferases which act on alpha-glycerolphosphate and diglycerides, and aconitate hydratase decreased. The remaining enzyme activities measured were unchanged. In addition, increased levels of liver glycogen and palmitoleate were noted which probably resulted from the lowered glycogen phosphorylase and increased palmitoyl-CoA desaturase activities, respectively, in those animals that experienced weightlessness. These changes caused by weightlessness were transient since all of the aforementioned alterations returned to normal values when measured in the livers of other rats which had flown in the biosatellite 25 days after recovery. PMID- 6844341 TI - Degeneration of lens and overgrowth of Harderian glands in hamsters neonatally injected with parvovirus MVM-i. AB - Injection of newborn hamsters with 500 plaque-forming units or more of the parvovirus MVM-i, produces an eye defect in a large percentage of the treated animals at maturity. The incidence is directly related to the amount of virus given and is independent of sex, size, or antibody levels to MVM-i. The abnormality is characterized by very small eyes with degenerate lens and adjacent retinal layers, and also by such extensive hypertrophy of the Harderian glands that they may encase the orbit and occlude the eye. On the basis of this latter finding and of previous work by other investigators, we suggest that the glands, whose function is unknown, may act as accessory photoreceptors. PMID- 6844342 TI - Hydrophobic interactions of transcobalamin II (TC II) from mammalian sera. AB - The hydrophobic properties of mammalian transcobalamin IIs (TC II) were studied by chromatography of radioactive cyanocobalamin (CN[57Co]Cbl)-labeled serum on phenyl-Sepharose CL-4B. Mammalian holo TC IIs (CN[57Co]Cbl-TC II) exhibited species variability in their affinity for the hydrophobic matrix in the order: dog greater than mouse greater than human greater than rat greater than rabbit. Phenyl-Sepharose chromatography of the isolated CN[57Co]Cbl-TC II peaks from gel filtration of dog and rat serum showed no hydrophobic change in dog TC II, but an increase in hydrophobicity of rat TC II. Phenyl-Sepharose chromatography of CN[57Co]Cbl-labeled rabbit serum (holo TC II) and the unlabeled serum (apo TC II) showed apo TC II to be more hydrophobic than holo TC II as has been shown for human TC II (Begley et al., Biochem Biophys Res Commun 103:434-441, 1981). Thus mammalian holo TC IIs differ in their hydrophobic properties and apo TC II, in man and rabbit, is more hydrophobic than holo TC II. In addition, isolation of the TC II in some animal sera by gel filtration may result in a TC II that is more hydrophobic than the native molecule. PMID- 6844343 TI - Effect of anesthetic or analgesic drugs on lipogenic and lipolytic adipose tissue activities. AB - The effects of several anesthetic or analgesic agents (halothane, Na thiopental, ketamine, nitrous oxide, xylazine, and procaine) administered in vivo, on swine adipose tissue metabolism were measured. Adipose tissue samples were collected from the subcutaneous depot before and after administration of the anesthetic or analgesic agent. The rate of oxidation of glucose to CO2 and the lipogenic rate, or the basal and stimulated lipolytic rates, were measured on tissue slices incubated in vitro. There were no effects on the oxidation of glucose to CO2 or the incorporation into lipids except by procaine. Procaine depressed (P less than or equal to 0.05) the lipogenic rate (12%) and tended (P less than or equal to 0.1) to depress the oxidative rate (9%). The only observable effect on the lipolytic rates was a tendency (P less than or equal to 0.1) for ketamine to increase the stimulated lipolytic rate. The minimal effects on adipose tissue metabolism reported herein were obtained with short times of compound administration. Several agents (nitrous oxide, procaine, and xylazine) are not recommended because of poor analgesia. PMID- 6844344 TI - Development of a homologous radioimmunoassay for secreted hamster prolactin. AB - A specific and sensitive homologous radioimmunoassay has been developed for secreted hamster prolactin. Hamster serum and pituitary extracts showed parallel dilution-response curves with hamster prolactin. The sensitivity of the assay ranged from 0.5 to 1.0 ng/ml, and the intra- and inter-assay coefficients of variation were 6 and 10%, respectively. Additionally we have demonstrated that the rat prolactin radioimmunoassay kit distributed by the National Institute of Arthritis, Metabolism, and Digestive Diseases is an inadequate method for the measurement of hamster prolactin. PMID- 6844345 TI - Chromosomal aberrations in foreign body tumorigenesis of mice. AB - Sarcomas were induced in 107 male and female isogeneic CBA/H or CBA/H-T6 mice by subcutaneous implantation of double films of unplasticized vinylchloride-acetate copolymer, 15 x 22 x 0.2 mm in size. Tumors were grouped by chromosome number. G banding was performed on chromosomes of (a) 12 sarcomas, (b) 6 specimens of preneoplastic cells derived from foreign body (FB)-reactive tissues at 4, 6, 9, and 16 months postimplantation, and (c) 11 sarcomas which developed from clonal lines of the preneoplastic cells studied. Karyological analyses lead to the following results and conclusions: (1) Various derangements in chromosome number occurred in preneoplastic cells during early FB reaction at the time of, and possibly in causal relation to carcinogenic initiation. (2) Structural abnormalities of specific chromosomes (insertions, translocations, transpositions, etc.) were found as stable cell markers only during late preneoplasia. They may thus contribute to advanced tumor progression. (3) Ploidy deviations of specific chromosomes (secondary to the early derangements in chromosome number) were most frequently seen in chromosomes 1, 6, 7, 13, 15, 18, and 19; however, these latter aberrations were unstable and inconsistent both in vivo and in vitro. PMID- 6844346 TI - Beneficial effect of verapamil in ischemic acute renal failure in the rat. AB - To investigate the possible protective effect of Ca2+ blockers in ischemic acute renal failure (ARF), verapamil, in a dose of 10 micrograms/kg body wt/min was administered for 100 min, starting 15 min before the total occlusion of the left renal artery after right nephrectomy in rats. Mean 24-hr creatinine clearance, blood urea, and serum creatinine levels, 24 hr after declamping, were used as a measure of kidney function. These values which were 135 +/- 1.9 microliter/min, 231 +/- 22 mg%, and 2.25 +/- 0.22 mg%, respectively, in the untreated rats, were found to be significantly different, i.e., 326.3 +/- 33.2 microliter/min, P less than 0.001, 112 +/- 25 mg%, P less than 0.001, and 1.26 +/- 0.28 mg%, P less than 0.01, respectively, in the verapamil-treated animals. Increased 24-hr total urine creatinine, sodium, osmolality, and a lower fractional excretion of sodium were also observed in the verapamil-treated rats with ARF. The combination of propranolol 1 mg/kg body wt/min and verapamil 10 micrograms/kg body wt/min for 100 min had no additive effect on renal function. In another group of ARF rats in which verapamil was started after declamping, no alleviating effect was observed. It is concluded that verapamil, an inhibitor of cellular membrane transport, when given prior to the renal ischemia, offers a partial but significant protection in this model of ischemic ARF. PMID- 6844348 TI - A new technique for hepatic portal sampling in the conscious dog. AB - A technique for implantation of a silastic catheter into the portal vein is described. The central end of the catheter is passed through a puncture hole into a tributary of the portal vein. The peripheral free end, occluded by a rubber membrane, is passed through the abdominal wall and buried under the skin. Once the catheter is in place it can be kept patent for several weeks. Injection of a substance and withdrawal of blood from the portal vein are carried out by percutaneous puncture of the rubber membrane, a virtually painless procedure that can be carried out in fully conscious nonrestrained dogs. PMID- 6844349 TI - Cardiac taurine levels during endotoxemia. AB - Three hours after dogs were given an intravenous injection of Escherichia coli endotoxin significant decreases in cardiac taurine levels were observed in the apex and epicardial regions of the right ventricle and in all regions sampled from the left ventricle. A decrease in taurine was seen in all regions of the heart (including the atria) by 90 min after endotoxin treatment but the results were not statistically significant. Echocardiography and left ventricular cannulation were used in a separate group to confirm that the dose of endotoxin used was adequate to produce depression of cardiac output and force of contraction. PMID- 6844347 TI - Calmodulin antagonist W-7 inhibits aggregation of human platelets induced by platelet activating factor. AB - Experiments were done to test the hypothesis that aggregation of human platelets induced by platelet activating factor (PAF) may be mediated by calmodulin dependent processes. W-7 [N-(6-aminohexyl)-5-chloro-1-naphthalene sulfonamide], a potent calmodulin antagonist, caused dose-dependent inhibition of PAF induced aggregation of human platelets in vitro. The ED50 for W-7 was 51.5 +/- 9.5 microM (mean +/- SEM). This concentration is known to be platelet calmodulin-specific. These data are consistent with the hypothesis. PMID- 6844350 TI - Mitochondrial dysfunction induced by pancreatitis-associated ascitic fluid. AB - Acute hemorrhagic pancreatitis (AHP) involves multiple organ failure probably caused by the toxic factor(s) released in pancreatitis-associated ascitic fluid (PAAF). We found that PAAF interferes with hepatic mitochondrial respiration resulting in severe disturbances in respiratory control (RCR) and ADP/O ratios. Pancreatitis was induced in dogs by retrograde pancreatic duct infusion and the resultant PAAF was centrifuged, filtered, and frozen until used. Two human PAAFs collected from AHP patients were treated in a similar manner. Rat liver mitochondrial oxygen uptake was measured at 30 degrees C before and after addition of ADP and PAAF. Paired control runs were made using pooled heat inactivated dog serum. Tests with nine canine PAAFs showed a mean increase of 120% in state 4 respiration (P less than 0.0001). After exposure to PAAF, addition of ADP to previously coupled mitochondria did not induce state 3 respiration. The human PAAFs both showed significant increases in state 4 respiration (P less than 0.01) and a marked decrease in RCR. Dose-response tests with human and canine PAAFs showed a positive correlation between percentage increase in state 4 respiration and the concentration of PAAF used. These results confirm the presence in PAAF of mitotoxic substance(s) which cause irreversible mitochondrial damage. Inhibition of coupled mitochondrial respiration by PAAF with the resultant fall in ATP may be the causative agent for the tissue and organ damage observed in AHP. PMID- 6844351 TI - Disparate effects of vitamin D treatment upon mitochondrial granulation in proximal and distal renal tubule. AB - The distribution of calcium phosphate granules in mitochondria of proximal and distal renal tubules of nonuremic and uremic children was analyzed by electron microscopy of material obtained by percutaneous kidney biopsy. Although distal tubule had fewer granules/mitochondrion than proximal tubule, uremia induced a significant drop (50%) in both, related to an increase in mitochondria containing O granules and a decrease in mitochondria with 2+ granules. The decrease observed in uremic children was reproduced experimentally by partial nephrectomy in rats. Uremia resulted in a 58% decrease of calcium phosphate granules in rat proximal tubule while a smaller but significant decrease (36%) occurred in distal tubule. Vitamin D deficiency in rats was associated with greatly decreased granulation in proximal tubule (80%) whereas distal tubule was less severely affected (36%). Supplementation of vitamin D to uremic rats restored mitochondrial granulation to normal in proximal tubule in 24 hr, but had no effect in distal tubule since the number of granules/mitochondrion, 0.5 +/- 0.1, remained statistically similar to that of untreated animals. Granulation in both proximal and distal tubule of uremic rats was unaffected by parathyroid hormone administration. Since restoration of granulation occurred only in proximal tubule, the defect in uremia which can be overcome by vitamin D treatment appears localized at the level of the proximal tubular cell membrane, indicating an action of vitamin D on calcium and/or phosphorus translocation into the proximal tubule. PMID- 6844352 TI - Hypercalcemia, excessive bone resorption, and neutrophilia in mice bearing a mammary carcinoma. AB - In an attempt to gain insight into the relationship between bone marrow and bone tissue, studies of bone metabolism and quantitative analysis of bone structure were carried out in mice following a transplantation of a granulocytosis-inducing mammary carcinoma. With the progression of the tumor growth and development of granulocytosis, there was a sharp increase in plasma calcium and urine calcium, both reaching over 200% of control values. Hypercalcemia was associated with a significant increase in urinary hydroxyproline (P less than 0.005), an increase in marrow medullary area (P less than 0.05), and an increase in number of endosteal osteoclasts (P less than 0.005), together indicating that the cause of hypercalcemia was an increase in bone resorption. In parallel with hypercalcemia and hypercalcuria, there was an increase in urinary cyclic AMP excretion. The removal of the tumor normalized both blood neutrophil counts and plasma calcium levels, suggesting that a humoral agent from the tumor tissue, rather than tumor metastasis to bones, may be responsible for the phenomena. These studies documented the association of excessive bone resorption in this animal model of tumor-induced neutrophilia; the model may prove useful for studies of tumor associated hypercalcemia as well as studies of marrow and bone interactions. PMID- 6844353 TI - Induction of rabbit renal mixed-function oxidases by phenobarbital: cell specific ultrastructural changes in the proximal tubule. AB - Administration of phenobarbital (60 mg/kg) daily for 4 days to male rabbits resulted in induction of renal cytochrome P-450 (3.5-fold) and a corresponding increase in ethoxycoumarin-O-deethylase and benzphetamine-N-demethylase activity (17- and 4-fold, respectively). Kidney weight to body weight ratio and renal ethoxyresorufin-O-deethylase were not affected by phenobarbital pretreatment. Numerous focal areas of proliferation of smooth endoplasmic reticulum (SER) were evident in proximal tubule cells from phenobarbital treated rabbits while proximal tubular cells from control rabbits had only small and sparcely located aggregates of SER. Phenobarbital-induced SER proliferation was specifically localized to the S3 segment of the proximal tubule. Proliferation was not observed in S2 cells of the proximal tubule, cells of Henle's loop, distal tubules, or collecting tubules in rabbits pretreated with phenobarbital. These data demonstrate the biochemical heterogeneity of cell types within the proximal tubules of rabbits. Furthermore, induction of mixed-function oxidases specifically in S3 cells of the proximal tubule may be of toxicological significance in the metabolic activation of certain nephrotoxicants. PMID- 6844354 TI - Depressed response of plasma iron and zinc to endotoxin and LEM in STZ-diabetic rat. AB - Laboratory and epidemiological evidence indicate that the enhanced flux of iron and zinc from the plasma to the storage compartments, such as liver, serves as a protective host response to combat infection. Studies were performed to determine the status of this nonspecific immune response in the diabetic animal, since it is commonly held that the diabetic has an increased incidence and susceptibility to infection. Normal rats and rats previously rendered diabetic by streptozotocin (STZ) were injected with either saline or Escherichia coli endotoxin, and plasma levels of zinc, iron, and copper were monitored 8 hr thereafter. Diabetic rats reduced their plasma zinc and iron levels by 35 and 25%, respectively, in response to endotoxin injection whereas control rats had a 70% decrease in zinc and a 46% depression in iron. Insulin administration to the diabetic rats restored the ability to decrease plasma zinc and iron to the same degree as control rats. Plasma copper did not change in any group. Further investigation suggested that the defect in trace metal response occurred after the secretion of leukocytic endogenous mediator (LEM) in the inflammatory response pathway. It is concluded that STZ-diabetic rats have a diminished ability to decrease plasma zinc and iron in response to endotoxin, and that this defect is due to an ineffective response of target tissues to the effects of leukocytic endogenous mediator. Furthermore, it is postulated that the hyperinsulinemia associated with the stress of infection functions to lower plasma zinc and, possibly, iron, thereby allowing the host to better combat infection. PMID- 6844355 TI - Glycosaminoglycan composition of germfree dog lungs. AB - Connective tissue of the lung is fundamentally important to pulmonary function. Exposure to foreign materials such as environmental toxins and microorganisms alters the connective tissue composition of pulmonary structures. In an effort to obtain information on the nature of complex carbohydrates in lungs unexposed to foreign materials, the composition of glycosaminoglycans from germfree dogs was studied. The total glycosaminoglycan concentration in germfree dog lungs was 47% greater than that in conventional dog lungs. Variations in individual glycosaminoglycan concentrations between germfree dog lungs and conventional dog lungs were noted. Heparan sulfate and heparin concentrations were lower in germfree dog lungs than in conventional dog lungs. Heparan sulfate fractions from germfree dog lungs had lower total sulfate content than heparan sulfate fractions from conventional dog lungs. The differences in glycosaminoglycan composition between germfree dog lungs and conventional dog lungs are likely due to exposure of conventional animals to a "normal" microbial flora and other environmental factors. PMID- 6844356 TI - Evidence for photosensitive regulation of prolactin secretion in prepubertal bulls. AB - Changing daily exposure of prepubertal bulls from 8 hr of light: 16 hr of dark (8L:16D) to 16L:8D or 6L:8D:2L:8D increased basal secretion of prolactin 418% 6 weeks later. When daily exposure was changed from 8L:16D (6 weeks) to 6L:14D:2L:2D (6 weeks), basal secretion of prolactin increased only 173%. Among photoperiod exposures, prolactin released into blood after injection of 33 micrograms/100 kg body weight of thyrotropin-releasing hormone paralleled the changes described for basal conditions. There was no repeatable diurnal secretory pattern for secretion of prolactin. The data support the hypothesis that cattle possess a photosensitive rhythm for secretion of prolactin. PMID- 6844357 TI - Dominant susceptibility effect on the murine corneal response to Pseudomonas aeruginosa. AB - Natural host resistance to Pseudomonas aeruginosa corneal infection is regulated by two complementing dominant genes PsCR1 and PsCR2 (RS Berk, MA Leon, LD Hazlett. Infect Immun 26:1221-1223, 1979). In this study we have demonstrated a third dominant gene, which determines susceptibility to P. aeruginosa-induced eye damage. This gene was designated as PsCS. The F1 progeny from matings between the resistant DBA/2J strain and the susceptible strain C57BL/6J and C3H/HeJ displayed the susceptibility phenotype. Backcross and F2 studies using the C3H/HeJ and DBA/2J strains suggested the presence of two linked PsCS loci. PMID- 6844358 TI - Blood and liver concentrations of glutathione, and plasma concentrations of sulfur-containing amino acids in chicks fed deficient, adequate, or excess levels of dietary cysteine. AB - Experiments were conducted with young male chicks to examine the influence of cysteine status on blood and liver glutathione (GSH) concentrations and plasma sulfur amino acids. The equivalence of cystine, cysteine, and GSH as sources of dietary cysteine for the chick was reconfirmed. Whole-blood GSH was unresponsive to dietary cysteine level, but liver GSH increased as dietary cysteine increased from a deficient level to the required level. Excess levels of cysteine (two or four times the chick's requirement) elicited no further increase in hepatic GSH. Plasma cystine concentration increased markedly (i.e., ninefold) and in a linear fashion while plasma cysteine increased only modestly (i.e., twofold) as dietary cysteine level increased. PMID- 6844359 TI - Natriuresis and kaliuresis in saline-expanded, long-term hypophysectomized rats. AB - The ability of unanesthetized, long-term hypophysectomized (HPX) rats to excrete a saline challenge was evaluated. HPX rats were hypophysectomized 1-2 months prior to experiments. Saline was administered either by intragastric gavage or by intravenous infusion. For 3 hr following gastric saline loading, HPX rats excreted significantly less sodium and potassium than did intact rats. When saline was administered intravenously, both intact and HPX rats excreted similar amounts of sodium during 3 hr of continued volume expansion. On the other hand, potassium excretion was again markedly lower in saline expanded HPX rats than in intact rats. Saline expanded HPX rats in both series of studies had lower excretion rates of creatinine and had lower plasma aldosterone and corticosterone concentrations than expanded intact rats. Urine osmolalities were not significantly different between intact and HPX rats, either before or after volume expansion, indicating that there was at least partial recovery of posterior pituitary function in the HPX animals. These results suggest that adequate anterior pituitary function is required for supporting the kaliuresis but not the natriuresis associated with saline expansion. PMID- 6844360 TI - Growth hormone secretion after hypophysial stalk transection in pigs. AB - The level and pattern of growth hormone (GH) secretion were investigated in mature ovariectomized gilts after hypophysial stalk transection and sham operation. A nylon disk was inserted between severed ends of the stalk to prevent vascular regeneration. Blood samples were collected via indwelling jugular catheters at 15-min intervals for 3 hr, 2 days before surgery (Day -2) and 2 days after surgery (Day +2), and at 4-hr intervals from Day +3 to Day +8. Mean overall serum concentrations of GH after hypophysial stalk transection remained similar (P greater than 0.05) to presurgical levels. These mean concentrations also were similar to those in sham-operated and unoperated controls. However, hypophysial stalk transection significantly dampened (P less than 0.05) the episodic secretion of GH and resulted in elevated basal blood concentrations of the hormone as compared with either presurgical levels or those in the two control groups. These results indicate that synthesis and secretion of GH continue in the absence of hypothalamic control in hypophysial stalk-transected gilts. Thus, the hypothalamus is required for regulation of both episodic release and the tonic inhibition of basal secretion of growth hormone in the pig. PMID- 6844361 TI - Clearance concept in salivary drug excretion. Part I: theory. PMID- 6844362 TI - Colorimetric determination of penicillamine in pharmaceutical preparations. PMID- 6844363 TI - [Alcohol in the blood. II. Significance; detection, analysis and determination; absorption, biotransformation, kinetics; estimation; effects]. PMID- 6844364 TI - [Chemistry and therapeutic use of licorice (Glycyrrhiza glabra L.)]. PMID- 6844365 TI - [Microemulsions]. PMID- 6844366 TI - A general practice study of timolol/hydrochlorothiazide/amiloride ('Moducren'), a new therapy for hypertension, and the doctor's influence on management. AB - An open study was carried out in general practice to assess the efficacy and tolerance of a timolol (10 mg)/hydrochlorothiazide (25 mg)/amiloride (2.5 mg) preparation in 558 hypertensive patients previously receiving multi-dose antihypertensive therapy, and to determine whether the results were influenced by the manner in which the doctor conducted this change in therapy. Patients received 1 or, if necessary, 2 tablets once daily over a period of 12 weeks and were randomly allocated on entry to one of two groups. One group was given a full explanation for the change in therapy, the other group was simply told that treatment was to be changed. The results showed that the change in treatment led to a significant reduction in blood pressure in both groups, at a dosage of 1 tablet daily in over half the patients, and the majority (88%) preferred the new form of treatment. Patient acceptance was good and the number of reports of adverse symptoms decreased during the study period. There was no significant difference in any of the results between the two groups. PMID- 6844368 TI - Maintenance therapy of rheumatoid arthritis and of osteoarthrosis with proglumetacin. AB - Maintenance therapy with proglumetacin was studied in an open investigation in 25 patients with classical or definite rheumatoid arthritis and in 34 patients with osteoarthrosis. Proglumetacin (150 mg) was administered twice daily, at meals, and therapy was continued without interruption for 12 months. Patients with rheumatoid arthritis showed a progressive improvement in objective parameters (erythrocyte sedimentation rate, haemoglobin) and in semi-objective parameters (pain, articular tenderness, number of painful joints, morning stiffness, grip strength, Ritchie articular index). Patients with osteoarthrosis also showed a progressive improvement in objective parameters (movement angles of the affected joints) and in subjective parameters (pain, mobility, response to therapy). During the study, 4 patients reported occasional nausea (3 with vomiting), and 3 reported episodes of slight headache. These symptoms did not require interruption of treatment. Haematology, blood chemistry and urinalysis were not adversely affected by the treatment. Five drop-outs were recorded in the rheumatoid arthritis group: 2 because patients failed to report, 2 because of severe relapses which required a radical change in the therapeutic programme and 1 for incorrect enrollment. Fourteen drop-outs were recorded in the osteoarthrosis group: 6 because the patients failed to report, 4 because of orthopaedic surgery and 4 because it was necessary to change the therapeutic programme. No drop-out was due to an intolerance to proglumetacin. It is concluded that proglumetacin appears to have the effectiveness of tolerability features required for a first choice medicament for long-term maintenance treatment of patients with rheumatoid arthritis or with osteoarthrosis. PMID- 6844367 TI - A comparative study of phentermine and diethylpropion in the treatment of obese patients in general practice. AB - A study was carried out in general practice to compare the effectiveness and tolerance of phentermine and diethylpropion in helping patients more than 20% above their desirable weight to lose weight. Patients were allocated at random to receive either one 30 mg capsule of phentermine (50 patients) or one 75 mg tablet of diethylpropion (49 patients) daily over a period of 12 weeks. They were also asked to restrict their calorie intake to 1500 calories per day. The results showed that there was a significantly greater weight loss in patients treated with phentermine which was particularly marked during the last 4 weeks of the study. There were significant reductions in blood pressure and heart rate in the phentermine group and of heart rate in the diethylpropion group. These were almost certainly related to weight loss rather than to a direct effect of drug treatment. Side-effects were generally minor in nature and the incidence and nature of them were comparable in the two groups. PMID- 6844369 TI - Use of a local gentamicin preparation ('Garamycin' Chains) as prophylaxis against infection in major head or neck surgery: a pilot study. AB - A pilot study was carried out in 16 patients undergoing major head or neck surgery to assess the effectiveness of antibiotic prophylaxis against wound infection using a local gentamicin preparation. Chains of 8 beads containing 7.5 mg gentamicin sulphate per bead, the drug being released over a prolonged period, were inserted on both sides of the operative wound before closure and left in place for 48 hours before removal. The results showed that only 3 of the 16 patients developed any clinical or bacteriological evidence of post-operative wound infection over the following 3 days. The chains proved easy to use. Satisfactory wound closure was obtained in all cases and there were no problems in their removal. PMID- 6844370 TI - Side-effects with long-term labetalol: an open study of 251 patients in a single centre. AB - An open study was carried out in 251 hypertensive patients, all but 10 of whom had been treated previously, mainly with beta-blockers or dihydralazine, to collect data primarily on the incidence of side-effects when long-term treatment with labetalol was substituted. Dosage ranged from 100 to 2400 mg per day (mean 654 mg per day) and treatment was continued for between 6 and 18 months (mean 7.8 months) in 229 patients. Labetalol proved to be at least as effective as previous therapy in the majority of patients and, although side-effects were reported in approximately half the study population, most were mild and transient requiring withdrawal in only 10%, within a few days or weeks in 20 patients. Scalp tingling was the most frequent of the side-effects particular to this drug. Postural hypotension and bradycardia was usually not very marked and troubles with micturition or sexual problems did not occur often. There was an improvement in Raynaud's and similar syndromes and arteritis in patients with these symptoms who had previously been receiving beta-blocking agents. PMID- 6844371 TI - Nifedipine in combination therapy for resistant hypertension. AB - Twenty patients with hypertension uncontrolled by existing therapy with two or three antihypertensive agents (a beta-blocker plus a thiazide diuretic in 10 and with the addition of hydralazine or prazosin in the other 10) were studied to assess the effects of additional long-term administration of nifedipine. Eighteen patients received 10 mg nifedipine 3-times daily and 2 received 20 mg twice daily. Patients were followed-up at monthly intervals. The results showed that mean blood pressure levels were reduced at 1 month and adequate control was achieved and maintained in 12 (60%) of the patients. Five of those who continued with the combined treatment remained non-responders and 3 patients had to stop nifedipine because of side-effects (flushing and headaches). Four other patients reported similar side-effects. No changes were evident in weight, pulse rate or the haematological and biochemical parameters studied. PMID- 6844372 TI - Flupenthixol versus haloperidol in acute psychosis. AB - Forty acutely psychotic patients were treated either with flupenthixol drops or haloperidol drops in an open, 28-day controlled study. The flupenthixol group comprised 11 schizophrenic, 8 manic, and 1 paranoid patient and there were 10 schizophrenic, 5 manic, and 5 paranoid patients in the haloperidol group. Mean daily dosage was approximately 112 mg flupenthixol and 18 mg haloperidol. Clinically, both drugs showed an antipsychotic effect. In the schizophrenic patients there was a definite trend towards a more rapid relief of the psychotic symptoms after flupenthixol treatment. In contrast to haloperidol, flupenthixol showed a mood elevating effect and an effect on the negative symptoms, e.g. emotional withdrawal, motor retardation, blunted affect, and disorientation. With both drugs, the most troublesome side-effects were extrapyramidal in nature. Initially, they were more common in the flupenthixol group: later the incidence was similar. PMID- 6844373 TI - Pharmacological basis of arousal and sleep in chickens (Gallus domesticus). PMID- 6844374 TI - New derivatives of methyl-xanthines: effect of thiocaffeine thiotheophylline and 8-phenyltheophylline on lipolysis and on phosphodiesterase activities. AB - The effects of some old and new methylxanthines and 6-thioxanthines, i.e. theophylline (TH), caffeine (CAFF), thiotheophyl line (S-TH), thiocaffeine (S CAFF), 8-phenyltheophylline (8-PT), 3-isobutyl-1-methyl-xanthine (IBMX) were compared at the level of adipose tissue on spontaneous and norepinephrine-induced lipolysis as well as on fat cell phosphodiesterases. These agents stimulated lipolysis. 8-PT was the most potent; thiocaffeine and thiotheophylline the least potent; IBMX and theophylline had intermediate potencies. The order of potency of the same drugs in potentiating norepinephrine-stimulated lipolysis was: IBMX greater than 8-PT greater than S-CAFF greater than greater than S-TH greater than CAFF greater than TH. The rank order of potency to inhibit cAMP phosphodiesterases was: IBMX greater than S-TH and S-CAFF greater than TH much greater than 8-PT (uneffective). Thus (a) thiocaffeine and thiotheophylline were more potent than the parent compound theophylline in inhibiting cAMP-PDE, although their per se stimulating effect on lipolysis was much lower. This indicates that in the thioxanthines the stimulus per se on lipolysis can be dissociated from their effectiveness as inhibitors of PDE. (b) In contrast, 8-PT (a blocker of adenosine receptors) has a potent lipolytic action per se and a potentiating effect on norepinephrine-induced lipolysis, even if deprived of effect on PDE. This indicates that the potentiating power of methylxanthines on norepinephrine-stimulated lipolysis is not strictly dependent on their anti-PDE activities. These results suggest that in adipose tissue (more similar than adipocytes to the in vivo conditions) the anti-adenosine potency of methylxanthines is the prominent factor in stimulating basal lipolysis. Both anti adenosine and anti-PDE activities are involved in modulating hormone-induced lipolysis. PMID- 6844375 TI - Protection from arrhythmias of cultured heart cells by nonsteroidal antiinflammatory drugs. AB - The nonsteroidal antiinflammatory drugs: acetylsalicylic acid, salicylic acid, sulfinpyrazone and indomethacin were tested at 10(-10) - 10(-5) M for their effect on arrhythmias of monolayer cultures of neonatal rat heart myocytes. Arrhythmias produced by reoxygenation were prevented or significantly reduced (p less than or equal to 0.05) by either indomethacin or salicylic acid at 10(-9) M. Acetylsalicylic acid and sulfinpyrazone, while not significantly anti-arrhythmic, produced consistent numerical inhibition of arrhythmias at 10(-9) M. PMID- 6844376 TI - Characterization of stereospecific binding of 3H-(-) sulpiride, a selective antagonist at dopamine-D2 receptors, in rat CNS. AB - Sulpiride endowed with dopamine (DA)-antagonist properties, does not antagonize neostriatal DA-sensitive adenylyl cyclase activity either in vitro or in vivo. Sulpiride however is able to displace radioactive ligands, which label DA receptors, from their specific binding sites. On these bases sulpiride has been proposed as a selective antagonist at dopamine-D2 receptors. We have characterized 3H(-) sulpiride stereospecific binding in various rat brain areas. In particular, 3H(-) sulpiride binding was found to be saturable, stereospecific and maximally enriched in the synaptic membrane fraction prepared from dopaminergic brain areas. Among a variety of compound tested only DA, DA-agonists and DA-antagonists were competitors for 3H(-) sulpiride specific binding sites. The results suggest that 3H(-) sulpiride may be an useful tool for the characterization and localization of dopamine D2-receptors. PMID- 6844377 TI - Experimental studies on the hypolipidemic activity of chloridarol. AB - The efficacy of chloridarol (2-benzofuryl-p-chlorophenyl carbinol) as hypolipidemic agent was evaluated in rats and rabbits. In normolipidemic rats chloridarol, at doses ranging from 50 to 200 mg/kg/day, decreased plasma triglycerides without affecting cholesterolemia and fast- or norepinephrine induced lipolysis. The drug proved effective in reducing fructose-induced hypertriglyceridemia and dietary hypercholesterolemia in rats; in the latter model chloridarol significantly raised both the HDL cholesterol and the HDL/VLDL + LDL cholesterol ratio. In hyperlipidemic rabbits the drug had no effect on plasma cholesterol, but it lowered triglyceridemia. The action of chloridarol on rat liver ultrastructure was also investigated. Treatment for one month induced peroxisome proliferation, less marked, however, than that elicited by clofibrate; after a prolonged chloridarol treatment (9 months), this effect had almost completely disappeared and the ultrastructure of the hepatocytes was close to that of controls. PMID- 6844378 TI - Pharmacopoeias and trends in their development. PMID- 6844379 TI - [Light transmittance and light-protective action of containers for phenylalkylamine solutions. 84: Contributions to problems concerning the use of plastic containers for liquid pharmaceutical preparations; 18: Stability of drugs and preparations]. AB - Using glass as a comparison material, the authors determined spectrophotometrically the light transmittance of plastic containers of different composition and evaluated their ability to protect phenylalkylamine solutions against ultraviolet irradiation. The material best suitable for these solutions is low-density polyethylene coloured with 0.05% of pigment orange G. Brown glass, which meets all requirements as to the protection from light, favours the degradation of phenylalkylamines as it releases heavy metal ions. PMID- 6844380 TI - [Efficacy testing of stabilizing agents in epinephrine model solutions. 19: Stability of drugs and preparations]. AB - The efficiency of 54 stabilizers was tested on epinephrine solutions using a selection-combination method. The addition of only one antioxidant produces but slight improvements in stability. Maximal additive activity is achieved by the combination of two antioxidants. Superadditive effects (which are necessary for considerable prolongation of the time of applicability of aqueous epinephrine solutions) are obtained by the combination of antioxidants of different modes of action and a discolouration-protective agent or a synergist. On this basis, the authors developed an efficient stabilizing procedure for pharmaceutical preparations containing active principles sensitive to oxidation. The relationship between the concentration of the stabilizer and the stabilizing effect is demonstrated by examples. PMID- 6844381 TI - [Drug permeability through artificial lipid membranes. 15: Effect of anions on the transport of buformin in model membranes and isolated, lumen- and vessel perfused small intestine]. PMID- 6844383 TI - [Position of the specialty "organization and economics of drug and pharmacy concerns" in the scientific system, and the scientific, theoretical basis for instruction in this field]. PMID- 6844382 TI - [Changes in the amount of myosin and the rate of myosin biosynthesis in vascular cells in culture]. AB - The relative myosin content of aortic cells of newborn rats was estimated cytophotometrically in the course of cultivation using indirect immunofluorescence staining. It should be shown that the average myosin content of the cell population and the number of cells with high myosin content is greatly enhanced when confluency of the cells is reached and proliferation stops. Following the amount of 14C-labelled leucine incorporated in immunoprecipitated myosin during the same period we found that increasing myosin content of the cells results from an enhanced rate of myosin biosynthesis. PMID- 6844384 TI - [Degree of gratification of needs in the use of drugs]. AB - Studies aiming at determining the degree of satisfaction of needs in drug application are hindered by the fact that a clear-cut differentiation between the portions of drugs and the portions of counselling and of care during the process of satisfaction of needs is very problematic. The satisfaction of needs by prophylactic agents can be deduced from the ratio between the number of diseases for which a group of patients had been treated prophylactically and the number of diseases in an untreated control group. As to therapeutic agents, the decision on the satisfaction of needs depends, due to biological action limits of the pharmacon, on the extent at which the therapeutic accomplishment corresponds to the goal of needs. Goals of needs are defined, and evaluation criteria are established. The goals and the criteria are quantified using rank classifications and scales for grading. A model experiment confirms that it is possible --to evaluate the respective drug from the aspect of therapeutic accomplishment; --to determine the degree of satisfaction of needs by conforming to limiting guide values; and --to compare different drugs as to the satisfaction of needs by them. PMID- 6844385 TI - Synthesis of N3-4-substituted-aryl-N1-(alkyl/aryl-substituted aryl)triazene-N1 oxides as potential anticonvulsant agents. PMID- 6844386 TI - Synthesis of N'-aryl-N3-(substituted)-alpha, alpha'-thio-bis-formamidine dihydrochlorides and their effect on blood sugar level of albino rats. PMID- 6844388 TI - Maternal use of dextroamphetamine and growth of the fetus. AB - Data from a large prospective study were analyzed to determine if taking dextroamphetamine during pregnancy affects fetal growth or fetal/neonatal mortality. 237/42,101 women took the drug to control weight gain. Birth weights were not significantly affected when the drug was discontinued before the 28th week of gestation, but after the 28th week birth weights were 4% lower (144 g) when the drug had been taken in high weight gain gestations (p less than 0.01). The body lengths and head circumferences of neonates were not affected. The perinatal mortality rate was 38/1,000 births for both offspring of drug users and nonusers. PMID- 6844387 TI - Endotoxin and low protein diet induced depression of the rat hepatic drug metabolism. AB - The effects of the combination of low protein diet feeding and endotoxin (E. coli, serotype 026 B6) upon rat hepatic microsomal mixed function oxidase (MFO) enzymes were investigated. Short-term (7 days) feeding of low protein (8%) diet and acute (single dose) exposure to endotoxin resulted in an additive decrease in MFO enzymes. However, chronic (7 days) endotoxin exposure did not depress liver microsomal MFO enzyme activities except for aniline hydroxylase. Long-term (105 days) feeding of the low protein diet and acute endotoxin exposure further decreased aminopyrine N-demethylase and benzo(a)pyrene hydroxylase activities compared to individual treatments. These results suggest that, under these experimental conditions, the two host-related environmental factors interact and potentiate a decrease in rat hepatic microsomal drug metabolizing enzymes. These observations may be of clinical relevance to explain altered drug reactions in patients with gram-negative infections and endotoxemia under the conditions of malnutrition. PMID- 6844390 TI - The role of vasopressin suppression in phencyclidine-induced diuresis. AB - Phencyclidine (PCP; 10 mg/kg, s.c.) produced a marked diuresis which occurred without significant changes in solute excretion. This diuresis occurred predominantly within 2 h of PCP injection, and was blocked by pretreatment with vasopressin. The maximum diuresis corresponded temporally to a significant fall in plasma vasopressin and rise in mean arterial pressure. Thus, PCP-induced diuresis is due, at least in part, to suppression of plasma vasopressin. This suppression is probably related to the rise in blood pressure, though direct effects of PCP on the neurohypophysis cannot be excluded. PMID- 6844389 TI - Changes in enzymes of the cholinergic system and acetylcholine release in the cerebra of aging male Fischer rats. AB - The functional decline of memory in the aging human brain has been partially attributed to defects in cholinergic transmission. Therefore, we have investigated various components of the cholinergic system in cerebra of Fischer 344 male rats, ages 3-33 months. Choline acetyltransferase (ChA), acetylcholinesterase (AChE), and butyrylcholinesterase (BChE) activities were determined in homogenates of the cerebra using specific radiometric assays. For measuring the release of acetylcholine (ACh), cerebral slices were incubated for one hour in Krebs buffer containing 3H-choline chloride to label ACh formed in situ, washed, and transferred to a microbath for superfusion. 3H-ACh released into the superfusate was determined. The levels of ChA in the cerebra of 9- to 27 month-old rats were lower (33%) than those in 3-month-old rats. Only 1% of these rats survive to the age of 33 months. In rats of this age, there was no decrease in ChA levels. AChE decreased while BChE increased with advancing age. The rate of spontaneous release of 3H-ACh decreased gradually by 63% from 3 to 33 months of age. The evoked release of ACh decreased by 50% in 33-month-old rats. Alterations in the levels of ChA, AChE (or BChE) and cholinergic receptors are not large enough to account for losses in cholinergic transmission in the cerebrum. The large decreases in the rates of spontaneous or evoked release of ACh in the aging cerebrum indicates that the functional defect in the cholinergic transmission of the aging cerebrum is possibly due to a defective release mechanism of this transmitter. PMID- 6844391 TI - Eating, drinking and urine output after prolonged cerebroventricular vasopressin infusions in rats. AB - Prior studies suggested that centrally administered single doses of vasopressin (VP) do not affect consummatory behavior or peripheral hydration. To reduce uncertainties related to factors of unknown distribution, concentration and duration, we infused VP (0.5 or 50 ng/h) continuously for 5 h or 5 days into a lateral cerebroventricle of conscious male rats. Eating and drinking behavior, as well as urine volume and sodium and potassium output, were unaffected by these treatments. The results suggest that VP, at sites reached from cerebrospinal fluid, does not alter peripheral hydration of rats. PMID- 6844392 TI - Evaluation of the effects of cephaloridine on urate excretion in the rat. AB - In female Sprague-Dawley rats, the renal clearance of cephaloridine decreased as the plasma concentration of the drug declined from above 10 micrograms/ml to below about 3 micrograms/ml, thus suggesting a saturable tubular reabsorption of cephaloridine similar to that shown previously in man. The effects of cephaloridine (250 mg/kg i.v.) were compared with those shown by a group of rats receiving saline and another group of rats receiving probenecid (250 mg/kg i.v.). Probenecid caused a sustained increase in the urate excretion rate. By contrast, cephaloridine produced a relatively small and transient increase in urate excretion, which may have been caused by its diuretic effect. Thus, it is unlikely that the reabsorption mechanism of urate is the principle mechanism by which cephaloridine is reabsorbed. PMID- 6844393 TI - Application of the concanavalin A precipitation technique in an evaluation of fenofibrate action on cholesterolemia in IIa and IIb hyperlipemic subjects. AB - Total plasma cholesterol and lipoprotein fractions were studied before and after 4 months fenofibrate (Lipanthyl) treatment of 34 hypercholesterolemic adults (16 IIa and 18 IIb), using a concanavalin A precipitation technique. The total plasma cholesterol levels decreased significantly for both IIa and IIb (24 and 18%, respectively, p less than 0.001). Fenofibrate reduced the apoprotein B bound cholesterol in IIa and IIb (29 and 27%, respectively, p less than 0.001). Apoprotein A bound cholesterol increased significantly in IIb (29%, p less than 0.001), but there was no significant increase in IIa (11%). Triglycerides were significantly reduced in both groups. In the light of concanavalin A specificity for apoprotein B and the utility of this technique, it is suggested that the concanavalin A precipitation technique may be applied to hyperlipidemic subjects undergoing treatment with lipid-lowering agents. PMID- 6844395 TI - Influence of different forms of tobacco intake on nicotine elimination in man. AB - In each of three separate experiments mean plasma nicotine t1/2 beta was slightly, but statistically significantly, shorter in habituated compared to naive cigarette smokers. Two of these experiments involved nicotine administration by smoking a cigarette containing a standardized amount of nicotine, whereas in the third experiment nicotine was injected intravenously as a single tracer dose of 14C-nicotine. In contrast to cigarette smokers, naive and habituated snuff dippers had similar mean plasma nicotine t1/2 beta. Habituated pipe smokers tended to have very slightly, but not statistically significantly, shorter plasma nicotine t1/2 beta S than naive pipe smokers. These distinctions are related to special features that characterize each form of tobacco intake. PMID- 6844394 TI - Microsomal metabolism of antipyrine in rats treated with antineoplastic drugs. AB - Pretreatment with antineoplastic drugs for at least 1 week is known to reduce in vivo metabolic clearance of antipyrine in rats tested after 24 h of fasting and restraining. In this study hepatic metabolism of 14C-antipyrine was investigated in 9,000 g supernatants of fed, unrestrained rats pretreated with cyclophosphamide, 5-fluorouracil or methotrexate. Total antipyrine metabolites formed were measured by a radiometric assay. Apparent Vmax and Km values were estimated and transformed to intrinsic (hepatic) clearance and total (body) clearance for comparison with in vivo terms of metabolic rate. Hepatic microsomal metabolism of antipyrine in control rats expressed as intrinsic clearance, 0.12 +/- 0.03 ml (g liver min)-1, and total clearance, 4.8 +/- 1.2 ml (kg body wt min) 1, was not significantly changed after antineoplastic pretreatment, indicating that the previously observed inhibitory action of these drugs on in vivo antipyrine metabolism may be modulated by factors such as fasting and stress. PMID- 6844396 TI - Inhibition of cardiotoxic, nephrotoxic and neurotoxic effects of doxorubicin by ICRF-159. AB - Cardiotoxicity of doxorubicin, 2 mg/kg i.p. twice weekly in rats, was assessed by serial electrocardiography and electron microscopy. The toxic effects were markedly inhibited by ICRF-159, 50 mg/kg p.o. given 1 h before doxorubicin. The development of nephropathy characterized by proteinuria, hyperlipidemia and glomerular and tubular changes was significantly retarded, and the degenerative changes of peripheral nerves were markedly reduced. On the other hand, ICRF-159 enhanced the depressant effects of doxorubicin on bone marrow function. Doxorubicin reduced body weight gain, caused ascites, decrease in heart and thymus weight, and increase in liver and kidney weight. These changes were also inhibited or attenuated by ICRF-159 pretreatment. PMID- 6844397 TI - Absorption and tissue distribution of doxorubicin entrapped in liposomes following intravenous or intraperitoneal administration. AB - Absorption and tissue distribution of free doxorubicin (Dxn) and Dxn entrapped into liposomes have been examined after intravenous (i.v.) or intraperitoneal (i.p.) injection into C57/B1/6 mice. Liposomal encapsulation of Dxn altered its plasma kinetics and tissue distribution. After i.v. administration Dxn in liposomes has a half-life longer than that of free Dxn and it is taken up mostly by tissues rich in reticuloendothelial cells, such as liver and spleen. In the heart and kidney liposomal Dxn reaches a lower concentration than free Dxn. After i.p. injection the tissue distribution of liposomal Dxn is drastically changed. We did not observe the first peak of high concentration in the tissues, the Dxn content in liver and spleen is decreased and its concentration in heart is even more reduced. The results of this study suggest that the route of administration of liposome-entrapped drugs may change both the kinetics of absorption and their tissue distribution and this could result in a different pharmacological effect. PMID- 6844398 TI - Carrier activity of sonicated small liposomes containing melphalan to regional lymph nodes of rats. AB - Tissue distribution following subcutaneous injection of liposomes containing melphalan (MPL) was studied in rats using 14C-MPL and 3H-phosphatidylcholine. Two types of liposomes, prepared by either a brief or a prolonged sonication, were compared. Brief sonication formed large liposomes of various sizes, while liposomes obtained after a prolonged sonication were small and relatively uniform in size (34 nm in mean diameter). Subcutaneous injection of small liposomes produced a strikingly high and sustained concentration of MPL equivalents in regional lymph nodes. In contrast, most liposomes prepared by a brief sonication appeared to remain at the injection site, and there was only a slight increase in the lymph node concentration of MPL equivalents over the plasma level during the 24-hour experiments. PMID- 6844399 TI - Multi-element analysis of the human body using neutron activation. AB - The calibration described is of the Leeds in vivo neutron activation facility for the simultaneous measurement of total body Na, Cl, P, Ca, N and K. The effects of body size and shape have been incorporated into the calibration using a variable anthropomorphic phantom. The main interfering reactions are considered, and the method by which the results are corrected for these interferences described. The accuracy and precision of the technique have been determined. The procedure is suitable for measuring the critically ill since both irradiation and counting are performed with the patient lying supine. For a whole body dose equivalent of 0.5 mSv nitrogen was measured with a coefficient of variation (CV) of 2.2%; potassium was measured in the same counting period with a CV of 1.6%. Using a dose equivalent of 5 mSv sodium (2.2%), chlorine (1.6%) and phosphorus (2.9%) were also determined; for a 10 mSv dose equivalent calcium was measured with a CV of 3%. PMID- 6844400 TI - Normal levels of total body sodium and chlorine by neutron activation analysis. AB - In vivo neutron activation analysis was used to measure total body sodium and chlorine in 18 male and 18 female normal adults. Corrections for body size were developed. Normalisation factors were derived which enable the prediction of the normal levels of sodium and chlorine in a subject. The coefficient of variation of normalised sodium was 5.9% in men and 6.9% in women, and of normalised chlorine 9.3% in men and 5.5% in women. In the range examined (40-70 years) no significant age dependence was observed for either element. Total body sodium was correlated with total body chlorine and total body calcium. Sodium excess, defined as the amount of body sodium in excess of that associated with chlorine, also correlated well with total body calcium. In females there was a mean annual loss of sodium excess of 1.2% after the menopause, similar to the loss of calcium. PMID- 6844401 TI - Effect of tungsten absorption edge filter on diagnostic x-ray spectra, image quality and absorbed dose to the patient. AB - The X-ray spectra from a tungsten-target diagnostic tube were measured with a lithium-drifted silicon detector. Four characteristic X-ray peaks were clearly observed. When a 0.05-0.3 mm thick tungsten absorption edge filter was added to the tube, the number of photons in the spectra above the K-absorption edge decreased dramatically. The effect of the absorption edge filter on image quality and on the absorbed dose were investigated by both measurement and Monte Carlo calculation. The absorbed dose to the patient is reduced without image quality, being degraded. PMID- 6844402 TI - Compliance of articular cartilage and its variation through the thickness. PMID- 6844403 TI - Assessment of a small microwave (2450 MHz) diathermy applicator as suitable for hyperthermia. AB - Temperature profiles and depth data have been measured in three different tissue type phantoms to assess the induced thermal patterns from a modified diathermy applicator with no allowance made for blood flow. Results indicate that tumours up to 50 mm in diameter and 30 mm deep may be therapeutically heated. Increasing the fat thickness has been shown, by these phantom studies, to indicate the need for careful regulation of the surface temperature to reduce large thermal gradients at depth. Field mapping outside the treatment area showed no significant exposure to patient or operator. The applicator is presently being used for a clinical hyperthermia treatment study. PMID- 6844404 TI - A meter for ultraviolet dose and irradiance. AB - A compact, portable, battery-powered meter has been developed to monitor and to integrate ultraviolet irradiance. The meter has been designed to accept signals from either a thermopile or a solid-state (GaAsP) diode detector. A variable scale factor is provided to accommodate a range of different detector sensitivities. The measurable irradiance range is 100 microW cm-2 to 100 mW cm-2 and that of dose is 200 mJ cm-2 to 200 J cm-2. The meter can be operated manually or for a range of preset times. The irradiance, dose and elapsed times are displayed. Outputs from the preamplifier and from the scaling amplifier are available for interfacing the instrument with a computer or chart recorder. The meter has been designed to have an overall measurement uncertainty of the order of 1% in order to ensure that the major error contribution lies with the detecting devices. PMID- 6844405 TI - Measurement of erythrocyte deformability using a stroboscopic recording centrifuge. AB - A stroboscopic recording centrifuge technique is described which can measure deformability of red blood cells in terms of the rate of packing at low g. It can be used to measure several whole blood samples simultaneously, with accurate control of the speed of rotation and recording time. Only 0.05 ml of blood is required per measurement, and no prior treatment or preparation of the sample is necessary. The calibration procedures to allow for variations of the haematocrit and plasma fibrinogen level are explained. PMID- 6844406 TI - The influence of air humidity on gamma-ray calibration and neutron absorbed-dose measurements with different types of A-150 plastic tissue-equivalent ionisation chambers. PMID- 6844408 TI - The use of a laser and interference transmission grating to create dotted lines for positioning radiotherapy patients. PMID- 6844409 TI - Electromagnetic applicators for regional and whole-body hyperthermia. PMID- 6844407 TI - Energy dependence in the spectral factor approach to computed tomography. PMID- 6844410 TI - Are maximal inspiratory breathing exercises or incentive spirometry better than early mobilization after cardiopulmonary bypass? AB - Forty-nine adults who had undergone cardiopulmonary bypass surgery were randomly assigned to one of three exercise programs to determine if either maximal inspiratory breathing exercises or incentive spirometry offered a therapeutic advantage over early mobilization alone. After extubation, the patients started their assigned exercise programs. A physical examination and pulmonary function tests were performed preoperatively, at the start of the exercise program, and 24 and 48 hours after the start of the program. The results showed a significant decrease (approximately 50%) in lung volumes but no airflow obstruction in patients who had coronary artery bypass graft. In those patients who had valve replacement, lung volumes fell, and in addition, mild airflow obstruction occurred. A majority of patients had postoperative pulmonary complications. There were no significant differences among the exercise programs in improving lung volumes and airflow or in preventing postoperative complications. We conclude that maximal inspiratory breathing exercises or incentive spirometry, when used in addition to early mobilization, offers no therapeutic advantage over early mobilization alone after cardiopulmonary bypass surgery. PMID- 6844411 TI - Effect of forearm abduction on the ulnar collateral ligament. AB - Seven fresh cadaveric elbows from one woman and three men were studied to determine if the forearm abduction mobilization commonly used to restore the last 20 degrees of elbow extension produced an increase in the length of the anterior band of the ulnar collateral ligament. Initial ligament length and maximum length during mobilization were measured with a dial caliper and recorded on videocassette. Results indicated no significant difference between ligament lengths at rest and during the mobilization. The mechanism by which the forearm abduction mobilization restores elbow extension remains unknown. PMID- 6844413 TI - Correction of isokinetic and isometric torque recordings for the effects of gravity. A clinical report. PMID- 6844412 TI - Motor control. How posture and movements are governed. AB - This article is a review of the nature of motor control: the abilities and limitations of the body, the principles of doing and learning, how parts of the nervous system interact, and how information is processed to generate the blend of sensory, perceptive, and motor functions that we call motor control. The relation to physical therapy is stressed: PT is regarded as an emerging applied science of motor control, and motor control is regarded as a basic science of physical therapy. PMID- 6844414 TI - Toe splint. Suggestion from the field. PMID- 6844415 TI - Academic tenure: what does it mean? AB - Tenure is an integral aspect of academia. Because tenured faculty give esteem to individual physical therapy programs and to the profession as a whole, understanding the process of attaining tenure is vital to all physical therapy educators. Tenure in universities is described, and the process of attaining tenure is outlined. Criteria for tenure, factors related to transfer of faculty between universities, and considerations for terminating tenured faculty are also discussed. Departmental chairmen have a responsibility to ensure that the faculty members understand the tenure process and are given the opportunity to meet tenure criteria. PMID- 6844416 TI - Priorities in practice. Abstracts. 59th annual conference, June 14-18, 1983, Kansas City, Missouri. PMID- 6844417 TI - Parameter interaction in the perception of French plosives. AB - This investigation takes as its point of departure observations on the production of French fortis versus lenis plosive consonants. In a series of perception tests the role of different parameters in the fortis versus lenis distinction found in production (e.g. duration of the pre-consonantal vowel, the consonantal closure, voicing during the closure and intensity of the consonantal release noise) was investigated. Apart from durational and intensity parameters, vowel quality differences (depending on the fortis versus lenis character of the following consonant) are also shown to play a part in phoneme identification. Furthermore it is shown that in obstruent clusters like /tp, dp/ versus /tg, dg/ not only do phonetic parameters like those mentioned above influence perception, but that also the phonemic identity of /p/ versus /g/ as fortis versus lenis contributes to the hearers' decision about the identity of the first consonant in the cluster. Phonetic as well as contextual factors are shown to interact in a complex manner. Implications of the results for speech perception theory are discussed. PMID- 6844418 TI - Vowel distortion in traumatic dysarthria: a formant study. AB - The frequencies of the first two formants of three German vowels in word context were determined by a formant tracking routine for 8 male subjects with closed head trauma. A centralized formant pattern was found to characterize vowel articulation in traumatic dysarthria. Different degrees of severity could be assessed and the process of recovery was described by the parameter 'formant triangle area'. An interpretation in articulatory terms is given and the results are discussed in the light of articulatory models. PMID- 6844420 TI - Photoproducts of chlorpromazine which cause red blood cell lysis. PMID- 6844419 TI - Synthetic models related to DNA-intercalating molecules. Interactions between 8 alkoxypsoralen and adenine. PMID- 6844421 TI - Nanosecond laser photolysis of rhodopsin and isorhodopsin. PMID- 6844422 TI - Binding of riboflavin to lysozyme promoted by peroxidase-generated triplet acetone. PMID- 6844424 TI - Photosensitization of methyl linoleate oxidation by tryptophan in peptides. PMID- 6844423 TI - Spectral study of the photochemistry of dipyrrole models for bilirubin bound to human serum albumin. PMID- 6844425 TI - Prior exposure of human cells to near UV-radiation gives a decrease in the amount of the unscheduled DNA-synthesis induced by far UV-radiation. PMID- 6844428 TI - Digital radiologic monitoring of renal physiology. PMID- 6844426 TI - Action spectra for inactivation of normal and xeroderma pigmentosum human skin fibroblasts by ultraviolet radiations. PMID- 6844429 TI - Ambulatory monitoring of electrocardiograms - current technology of recording and analysis. PMID- 6844427 TI - An evaluation of nalidixic acid film as a UV-A radiation dosimeter. PMID- 6844430 TI - Clinical applications of bedside hemodynamics monitoring using the Swan-Ganz catheter. PMID- 6844431 TI - Telemetry methods: animal and man. PMID- 6844432 TI - Sensory-specific and motivation-specific satiety for the sight and taste of food and water in man. AB - In normal weight humans it was shown first that the sight of food is pleasant when hungry, and that the pleasantness of the sight of a food which has been eaten to satiety decreases more than the pleasantness of the sight of foods which have not been eaten. Thus the specificity of satiety extends to the visual modality, and this may be an important factor in influencing which foods are selected for ingestion. Second, it was shown that the pleasantness of both the sight and taste of food are modulated in a motivation-specific manner, in that in hungry and thirsty humans the pleasantness of the sight and taste of food but not water is decreased by eating to satiety, and the pleasantness of the sight and taste of water but not food is decreased by drinking water to satiety. Third, it was shown that sensory-specific decreases in the pleasantness of the taste of a particular food produced by its ingestion are associated with only minor changes in the intensity of its taste, which do not account for the changes in pleasantness as shown by an analysis of covariance and by the relation between pleasantness and intensity, so that it is unlikely that sensory adaptation is an important part of the mechanism of sensory-specific satiety. PMID- 6844433 TI - Attenuation of experimental retrograde amnesia through pretraining administration of a dissimilar amnestic agent. AB - Experiment 1 found that pretraining administration of electroconvulsive shock (ECS) attenuated ECS-induced amnesia of one-trial passive avoidance training in rats. Similarly, pretraining injections of cycloheximide (CXM) attenuated the amnestic effects of CXM at training. Experiment 2 demonstrated the ability of pretraining ECS to attenuate CXM-induced amnesia and pretraining CXM to attenuate ECS-induced amnesia. These studies join others in observing comparable behavioral effects of ECS-like amnestic agents and antimetabolite-like amnestic agents despite their different means of primary action. Collectively, these studies support the view that the two families of amnestic agents produce amnesia through a common mechanism. PMID- 6844434 TI - Variety in the flavor of food enhances eating in the rat: a controlled demonstration. AB - The effect of variety in the flavor of food on rats' consumption of a meal was examined in two experiments in which the confounding factors of diet composition and palatability could be ruled out. Experiment 1 showed that rats ate more of a four-course meal when each course was flavored differently than when each course was flavored the same; furthermore, this "variety effect" did not appear to depend upon the rats' prior experience with the flavors. Experiment 2 replicated and extended these findings by showing that the enhancement of eating by variety did not depend critically upon the rat's level of food motivation. The results were discussed in terms of their implications for the etiology and control of obesity, as well as for theories of satiety. It was suggested that the "variety effect" may represent an adaptive mechanism in the control of feeding. PMID- 6844435 TI - Effects of post-weaning environment and apparatus dimension on spontaneous alternation as a function of phenotype in "dwarf" mice. AB - The spontaneous alternations of "dwarf" mice estimated in a Y maze proportioned to the size of control mice demonstrated the necessity of reducing the size of the apparatus for testing the "dwarf" mice. Tested in a maze of reduced dimension, the "dwarf" mice showed a significant deficit in this task but only in a T shaped maze, and not in a Y shaped maze. For one month after weaning, "dwarf" and control mice were reared in either an enriched or an impoverished environment. These rearing conditions did not modify the spontaneous alternation of control mice whether estimated in a T or a Y maze, but they significantly altered the behavior of "dwarf" mice, yet only when evaluated in a T maze: "isolated" "dwarf" mice alternating less than "enriched" "dwarf" mice. It is suggested that this behavioral profile displayed by "dwarf" mice in spontaneous alternation might be explained by a deficit in perceiving, integrating and/or utilizing complex spatial information. PMID- 6844436 TI - Estradiol plus progesterone treatment and precopulatory behavior in ovariectomized female rats. PMID- 6844437 TI - Effects of maternal state on the responsiveness to nest odors of hooded rats. AB - Two experiments were designed to determine if pregnant and lactating rats are differentially attracted to their own bedding at various stages of the reproductive cycle and whether they will discriminate between their own nest materials and those of virgins and other lactating animals. We found that from just before birth until the second week postpartum, rats are attracted to their own bedding but do not differentiate between their own and that of other maternal animals. It is suggested that the responsiveness to nest odors in prepartum pregnant animals is a result of hormonal events prior to parturition. In addition, early maternal activities are thought to be facilitated by changes in responsiveness to olfactory stimuli and also by the presence of an attractant which contributes to nest odors. PMID- 6844439 TI - Dependence of memory of meal time upon circadian biological clock in rats. AB - Water intake was measured in rats under a free feeding schedule and under a meal feeding schedule (food was presented for 3 hours each day from 14:00 to 17:00 hr), both under LD condition. Both schedules allowed animals free access to water. Under the meal feeding schedule, drinking occurred mainly during the food presentation time, but it was also observed during the dark period, when food was not present. After 3 weeks of meal feeding, the rats were transferred to the free feeding schedule. They showed a habit of drinking at the meal time of the previous schedule (meal-feeding-induced drinking) up to 7 days of free feeding. When the rats were made blind in the transition from the meal feeding to the 2nd free feeding, the meal-feeding induced drinking occurred with a progressively increasing delay relative to the clock time, in the same way as seen with the nocturnal drinking. Rats with bilateral lesions of the suprachiasmatic nucleus did not show nocturnal drinking during the meal feeding schedule, and no signs of the meal-feeding-induced drinking were observed after the 2nd free feeding schedule was started. It was concluded that the persistence of the memory of the time of meal feeding in the following free feeding period could be traced with water-drinking as an index and such memory seems to be formed depending on the biological clock which is ascribed to activity of the suprachiasmatic nucleus under LD condition. PMID- 6844438 TI - Plasma catecholamines in fasted and sucrose supplemented rats. AB - Rats were food deprived or given a sucrose supplemented diet for 3 days. Resting plasma catecholamine levels measured remotely from undisturbed rats were not altered by either dietary treatment. However, food deprivation did result in decreases in resting mean arterial blood pressure, heart rate, plasma volume and plasma Na+ concentration. After one minute of intermittent footshock food deprived and sucrose fed rats did not differ from controls with respect to blood pressure, heart rate or plasma catecholamine levels but food deprived rats were less active during footshock and had lower levels of plasma glucose immediately after footshock when compared to controls or sucrose fed rats. Food deprivation and dietary sucrose supplementation have been shown to alter norepinephrine (NE) turnover in specific sympathetic target tissues. Our data indicate that these changes in turnover are not reflected by changes in plasma NE. Therefore, NE turnover rates and plasma NE concentration may not be equivalent indices of sympathetic activity. PMID- 6844440 TI - The relationships between the positive reinforcing and satiating effects of a meal in the rat. PMID- 6844442 TI - Brain growth: interactions of maturation with adrenal steroids. AB - By performing autopsies at two different ages--when fully mature or 80 days later -it was possible to determine whether adrenalectomy-induced brain growth is enduring or transient, due to a temporary acceleration of maturation. Male rats were adrenalectomized or sham-operated at age 25 days. The effects on brain were assessed at either age 65 days or 145 days. Adrenalectomy produced the previously reported hypertrophy as reflected in hindbrain weight, forebrain weight, and linear dimensions. Most importantly, the adrenalectomy-induced brain growth not only continued across the two phases, the rate of divergence between the groups increased with age. The results clearly reject the idea that adrenalectomy merely hastens maturation of the brain. Rather, the effects of adrenalectomy are enduring, progressive, and more dramatic with age. PMID- 6844441 TI - Self-starvation: a problem of overriding the satiety signal? AB - Rats housed in either activity wheels or standard laboratory cages received access to food either ad lib or for one 60-min, two 30-min, or four 15-min periods per day. Imposition of restricted feeding schedules led to reductions in food intake and body weight which were greater for animals with access to activity wheels. Increases in activity reflected the percent of body weight loss, which varied directly with frequency of food access. Subsequent recovery of intake was facilitated by partitioning total feeding time into briefer but more frequent periods. In the most extreme frequency-of-access condition, animals with access to running wheels failed to recover from the reduction of intake incurred by imposition of the restricted feeding schedule, even though their total feeding time was the same as that of animals that did recover. These data indicate that self-starvation is not induced by activity per se but results from a general failure to recover intake which, in turn, results from a failure to override the satiety signal within a meal. PMID- 6844443 TI - High-pressure swivel for infusions into rats. PMID- 6844445 TI - Influence of certain stimulation parameters on the character of the cortical self sustained after-discharge. AB - The ECoG pattern of self-sustained after-discharges (SSADs) evoked by rhythmic electrical stimulation of the cerebral cortex is far from uniform. In acute experiments on male rats the authors studied the significance of the frequency, intensity and length of stimulation for the character of the resultant SSAD. In the first group (11 rats), a stimulation frequency of 8 Hz was used; the stimulation series, which lasted 10 and 20 s, always led to the formation of a SSAD composed of spike-and-wave rhythm right from the outset. Shortening the time of stimulation markedly reduced its effectiveness. In the second group (10 animals), stimulation with 50 Hz frequency often evoked a complex SSAD starting with desynchronization, which was followed by fast spike activity of increasing amplitude and only later by spike-and-wave rhythm or by polyspike-and-wave rhythm. Towards the end, serrated waves--i.e. graphoelements typical of SSADs evoked by electrical stimulation of limbic structures--often appeared in the SSAD. A higher stimulation intensity increased the incidence of this complex SSAD. In this group a minimum duration of stimulation was also essential (series of less than 2 s were not reliably effective). When this second type of SSAD ended, depression of ECoG activity was followed in 27% of the cases by a spontaneous recurrent seizure (RS). The ECoG character of these RS can be very variable. The two types of seizures evoked by slow and fast stimulation differ from each other not only in respect of their ECoG pattern (where the difference is probably due to more pronounced propagation to subcortical structures after faster stimulation), but also as regards the presumed mechanism of their onset. PMID- 6844444 TI - Incidence and development of rhythmic episodic activity in the electroencephalogram of a large rat population under chronic conditions. AB - 689 long-term electroencephalographic recordings from 88 rats with chronically implanted electrodes were evaluated with reference to the onset and development of rhythmic spike episodes of 8-9 Hz frequency characteristic of quiet wakefulness. Episodes occurred in the recordings of 88% of the test animals. Recordings completely devoid of episodes came from selected rats highly sensitive to an acoustic epileptogenic stimulus and from 50% of rats of a Wistar-Velaz barrier breed. These two groups differed from the other animals in respect of their greater aggressiveness and restlessness in the chronic experiment. The episodes were not evoked by the surgical procedure--implantation of a cobalt gelatin pin in the brain--or to the actual implantation of chronic electrodes in the brain. The shortest recorded latent period for the appearance of episodes was one week after the implantation of electrodes and the longest was 6 months. The animals' mean age at the time of the onset of episodes was 3.8 months and the lowest age was 2.5 months (i.e. immediately after implantation of the electrodes). The electrodes were not implanted before the age of 2.5 months. In repeated chronic recordings during the animals' life, both the number and the duration of the episodes increased. In most of the rats, the spike frequency in the episode was 8-9 Hz and was maintained at a stable value characteristic for each rat. Episodic rhythmic activity can thus occur in a state of quiet wakefulness in the electroencephalogram of all the given groups of rats (except highly sensitive animals) from early adulthood up to the age regarded in the rat as senility. The results to date indicate that the main condition for its appearance is the attainment of an optimum state of vigilance--quiet immobile wakefulness. The mechanisms leading to this stage of vigilance display both individual and group differences and are evidently related to the ability to become habituated to the experimental environment. PMID- 6844446 TI - The active avoidance reaction of laboratory rats: differences between experiments carried out in the phase of motor activity and inactivity. AB - The influence of two phases of the circadian cycle (motor activity and motor inactivity) on the rate of acquisition and extinction of an active avoidance reaction was studied in 35-day-old male laboratory rats reared in cages (with limited social contacts), in young reared from the age of 15 days in communities (with the broad social contacts typical of this species) and in adult males reared in cages. A difference was found between the results of experiments carried out in the morning (during the motor inactivity period) and in the early evening (at the outset of the motor activity period) in both young and adult animals. The factor deciding whether acquisition or extinction was influenced depended on the mode of life. In animals reared in cages, inhibition was influenced; extinction was elaborated faster in the evening in adult animals and juvenile young were capable of 100% extinction only in the evening (in the morning only 50%). Community young achieved 100% extinction in both cases. In young rats which lived in a community from the 15th day, acquisition was influenced (it was achieved faster in the evening). The correlation between the rate of acquisition and extinction in cage-bred adult and young rats was negative if the experiments were carried out in the morning and was positive in evening experiments on young animals. In community-bred young it was positive in both cases. PMID- 6844447 TI - Strain differences in avoidance reactions of septal laboratory rats. AB - The effect of a lesion of the dorsal septum on active and passive type of avoidance reactions of adult male Wistar (W) and Long-Evans (LE) rats was studied. The rate of acquisition and extinction of the reaction was studied by 3 different testing methods. The animals were operated on when juvenile (30 days) or adult (90 days). The experiments were always started 50 days after the operation, when the "rage syndrome" was no longer present. In the three different tests we found a single common variable--the strain factor. It was this that determined whether the operation was effective, as well as the direction of deviations and the operation age which led to manifest changes. In W males the lesion did not impair either the acquisition or the extinction of an active avoidance reaction (AAR); the passive avoidance reaction (PAR) was acquired and extinguished more slowly after a lesion in adulthood. The spontaneous passive avoidance reaction (i.e. preference of a small, dark space) was likewise negatively affected by the operation. In intact LE animals the AAR was extinguished more slowly than in intact W males; after a lesion produced in juvenile or adult age extinction was speeded up, so that there were no differences compared either with intact or with septal W animals. Intact LE rats also acquired a PAR more slowly than W rats; a septal lesion led to faster acquisition, irrespective of the age at which the operation was performed, so that the rate for septal LE rats were the same as for intact W animals. The extinction of this reaction took longer after an operation at juvenile age and the rate for these septal LE rats were the same as for those of septal W individuals operated on at 90 days. The spontaneous PAR was qualitatively poorer in intact LE animals than in intact W rats, since only 40% of them preferred the small, dark space. A lesion was followed by improvement, which was especially marked after operation on the 30th day, when all the animals preferred this space, and in a very short time, so that they were equal to intact W males. Correlation of the acquisition and the extinction rate showed that there was imbalance of excitation and inhibition processes in the AAR of the W controls, that they were balanced in the PAR and that the lesion reversed these relationships. Both processes were balanced in the LE control and a septal lesion did not alter the situation. PMID- 6844448 TI - Dilatation of conduit coronary artery induced by high blood flow. AB - The ramus interventricularis ventralis (RIV) of the dog heart was perfused with donor blood from the femoral artery. The inflow and outflow pressure, the blood flow and the diameter of the RIV were recorded. An increase in the blood flow from 11.3 +/- 0.3 to 81.4 +/- 6.2 ml/min induced, in 24.4 +/- 1.7 s a gradual increase in RIV diameter which became stabilized in 90-120 s and amounted to 80.87 +/- 11.68 microns, i.e. to 3.37 +/- 0.70% of the resting diameter. Since the mean pressure at the site where the diameter was recorded was maintained constant, relaxation of RIV smooth muscle has been assumed to have occurred. Dilation could not be evoked after RIV had been dilated by papaverine. Any interference by changes in pressure amplitude accompanying the increase in blood flow was precluded by using non-pulsating perfusion of the RIV. An increase in the non-pulsating blood flow from 12.11 +/- 2.20 to 90.33 +/- 11.30 ml/min likewise--in 19.50 +/- 1.83 s--produced an increase in RIV diameter of 1.8%. Blood flow is being suggested as one factor regulating the tone of the smooth muscle of the major coronary artery. This mechanism is supposed to counteract sympathetic constriction of the major coronary artery. PMID- 6844449 TI - Circadian rhythm of serum and tissue lipids in the rat: the effect of limited access to food. AB - Young male Wistar rats of a conventional breed were kept 4 weeks in a separate room with a light: dark regimen of 12:12 h. Some were fed ad libitum (group C, the control), some were meal-fed from 8.30 to 10.30 a.m. (group A) and the others were meal-fed from 8.30 to 10.30 p.m. (group B). When adapted to the nutritional regimen the animals were decapitated at 3-hour intervals, starting at 8 a.m., and their serum and epididymal tissue non-esterified fatty acid values, their serum and liver triacylglycerol and total cholesterol levels and their serum phospholipid concentration were determined. Limitation of the period for which they had access to food at different times of the day significantly synchronized the circadian oscillations of their serum and tissue lipid levels. The most pronounced differences in the form of the antiphase position of the maxima of the curves in groups A and B, or A and C, were recorded in the oscillations of the serum and white adipose non-esterified fatty acid values, in serum triacylglycerol levels and in liver cholesterol levels. It is reasonable to assume that the synchronizing role of timed meal-feeding will be subject to the influence of seasonal factors. PMID- 6844450 TI - Effects of carbamazepine and diphenylhydantoin on metrazol seizures during ontogenesis in rats. PMID- 6844451 TI - 3,4-dihydro-2, 2-dimethyl-H-1 benzopyran-6-butyric acid. Its preparation from zanthoxylol and its antiinflammatory and related pharmacological properties. PMID- 6844452 TI - Immediate effect of Kuan-xiong aerosol in the treatment of anginal attacks. PMID- 6844453 TI - [Determination of the phototoxic and photomutagenic potency of drug and commercial preparations containing furocoumarin using a Chlamydomonas test system]. PMID- 6844454 TI - Tetramethylpyrazine in the treatment of cardiovascular and cerebrovascular diseases. PMID- 6844455 TI - Clinical trials in psychiatry. PMID- 6844456 TI - Hysterical and obsessional features in patients with Briquet's syndrome (somatization disorder). PMID- 6844457 TI - Extent of depressive symptomatology among patients seeking care in a prepaid group practice. AB - A total of 1921 consecutive adult patients seen in the Departments of Internal Medicine and Obstetrics-Gynaecology at a prepaid group practice completed a self administered depressive symptomatology questionnaire, the Centre for Epidemiologic Studies Depression Scale (CES-D). New health practitioners and physicians, who were not mental health specialists, blindly judged the presence or absence of depressive symptomatology. Twenty-one per cent of the patients suffered from depressive symptoms according to the CES-D, but only 15% of these were judged to be depressed by their physician or new health practitioner. The variables which predict the recognition of depressive symptomatology are discussed. PMID- 6844458 TI - Nosology of atypical depression. AB - A review of the literature on atypical depression indicated three relatively separate usages for the term: anxiety or phobic symptoms additional to depression, reversed functional shift, and non-endogenous depression. A sample of 160 out-patient depressives was rated on a variety of diagnostic systems measuring these concepts. Inter-relationships between groups selected by the three definitions were found to be low. In addition, although there was moderate consistency within different definitions of endogenous depression and of additional anxiety, reversed functional shift symptoms did not correlate well with each other. These findings suggest that atypical depression may be of limited value as a specific diagnosis within non-psychotic depression. PMID- 6844459 TI - Social class and schizophrenia in a Dutch cohort. AB - Recent data from a 2-year follow-up of functional non-affective psychosis, and particularly schizophrenia, favoured social selection rather than social causation theory. Data concerning the cohort were compared with inter- and intra generational mobility in a random Dutch sample. The results indicate that the educational and occupational mobility of patients, relative to their fathers, was greater than expected. Although patients were better educated than the random sample, they fared less well occupationally. An analysis of patterns of occupational mobility before and after the onset of psychosis also showed that social selection played a major role in achieving social status. The outcome of patients' occupational career at follow-up was poor, and only a minority succeeded in obtaining or keeping a regular job. PMID- 6844461 TI - Can a computer take a psychiatric history? AB - A program on an inexpensive microcomputer was designed to elicit personal histories from patients in a general psychiatric ward. Their answers were compared with the information recorded by the responsible psychiatric team. Where answers disagreed with the clinicians' records, the patient was interviewed to investigate the discrepancy. In the computer-elicited case-histories 90% of items were correct; a further 3% of items were considered correct by the patient. Most patients' computer histories revealed several items unknown to the clinicians and of importance in the management of the patient. Most patients (88%) found that the computer interrogation was as easy as a clinical interview. Computer assessment is proposed as a useful technique for the routine assessment of patients to augment the clinician's findings and to allow him to concentrate on the most relevant areas. PMID- 6844460 TI - Why neuroepidemiology? PMID- 6844462 TI - Life events, social interaction and psychiatric symptoms in general practice: a pilot study. AB - Thirty-two adult females who consulted a general practitioner with psychiatric training were assessed by questionnaires on first attendance and at follow-up 6 months later. Major life events and the degree of social support were of importance. Failure to improve was associated with major negative life events; in the absence of such events, improvement seemed likely to occur given a high degree of social support; major positive events appeared to be associated with improvement, regardless of the degree of social interaction. These factors, and the initial and final GHQ scores, are inter-related in a complex manner and it is suggested that these findings merit further investigation on a larger sample of patients. PMID- 6844463 TI - Neuroticism and well-being inventories: measuring traits or states? AB - Inventories designed to measure neuroticism are similar in form and content to inventories used to measure symptoms or subjective well-being. In addition, it is not clear to what extent traits as well as a person's present state explain the variance of such measures. Three inventories--the Neuroticism Scale from Wilde's Amsterdamse Biografische Vragenlijst, Bradburn's Affect Balance Scale and a Symptom Measure--were administered three times in order to study their reliability, stability and relation with psychosocial stress and life events. Major differences between inventories were not found. The results favoured the trait position. PMID- 6844464 TI - Medical students' attitudes to psychiatry. AB - A questionnaire was developed to elicit medical students' attitudes to psychiatry. All 94 second year clinical students at a London teaching hospital completed the instrument before and after an 8-week psychiatric clerkship. Although two-thirds of the sample had mixed feelings about psychiatry initially, by the end of the clerkship the students' general attitude to psychiatry had changed significantly in a favourable direction. Analysis of 18 specific attitudes to psychiatry revealed that the students' first responses showed anticipatory bias and lack of uniformity. Later, however, only two specific attitudes had changed significantly: more students agreed that 'problems presented by psychiatric patients are often particularly interesting and challenging', and more of them disagreed with the statement that 'psychiatric patients, generally speaking, are not easy to like'. The sexes differed on one attitude; more males than females agreed that 'psychiatry is too inexact; it seems to lack a proper scientific basis'. Finally, the proportion of students who considered the possibility of specializing in psychiatry rose from 6 to 17% during the clerkship. The students' reasons for or against such a career are discussed. PMID- 6844465 TI - Common errors in data analysis: the apparent error rate of classification rules. PMID- 6844466 TI - Validity of the General Health Questionnaire in a Yogoslav student population. PMID- 6844467 TI - The patterns of mental disorder in Jewish and non-Jewish admissions to a district general hospital psychiatric unit: is manic-depressive illness a typically Jewish disorder? PMID- 6844468 TI - Immunoglobulin allotypes Gm and Km in chronic schizophrenia: no apparent association. PMID- 6844469 TI - The effect of lithium on renal haemodynamic function. AB - Renal concentrating capacity following 18 hours of fluid deprivation was measured in 75 patients receiving prophylactic lithium therapy, and in 30 affectively ill subjects receiving other drugs. The lithium-treated patients had significantly lower urine osmolality and higher serum osmolality than the control subjects. Older subjects, patients maintained at higher serum lithium levels and those with a history of previous neurotoxicity showed the most impairment. Ten patients with urine osmolalities of less than 700 mOsm/1 following this test were investigated further. Inulin and para-amino hippurate (PAH) clearance rates were determined and the effect of a subpressor challenge of dopamine on these measures was observed. Half of the patients showed some reduction in inulin and PAH clearance, which was greatest in those patients who had been taking lithium for over 10 years. However, all of the patients tested showed the expected increase in renal blood flow and sodium and water excretion in response to dopamine. Six additional patients had clearance estimations made before starting lithium treatment which were repeated after a period of 3-6 months on the drug. No consistent changes in haemodynamics were observed. Lithium clearly reduces renal concentrating capacity, but other measures of renal tubular function were well preserved in patients receiving long-term therapy. Glomerular function may be slightly reduced in patients taking lithium for long periods. The results show that prophylactic lithium treatment does not affect renal cortical function adversely in the majority of patients, but impaired renal concentrating ability is a common accompaniment. PMID- 6844470 TI - Psychological and hormonal factors in the treatment of female sexual dysfunction. AB - Forty-eight couples with a presenting problem of female sexual unresponsiveness were treated in a controlled study using a balanced factorial design. The factors varied in this design were medication (testosterone or placebo), treatment frequency (weekly or monthly sessions), and the number of therapists involved (one female or a male/female pair). All counselling was adapted from that described by Masters & Johnson (1970) and Heiman et al. (1976). Results were assessed before and after a 3-month treatment period, and again 6 months later. Contrary to expectations from earlier work, there was no benefit attributable to testosterone or to the use of two therapists; self-ratings favoured weekly sessions with one therapist. It was concluded that testosterone (at least in the dosage used) is unlikely to have a useful place in the treatment of sexually unresponsive women, but that weekly counselling sessions with a single therapist is a reasonably effective and economic form of sex therapy. Findings from this research suggest the need for a clearer understanding of aetiological and treatment mechanisms. PMID- 6844472 TI - The frontal eye field and attention. PMID- 6844471 TI - Breathlessness and psychiatric morbidity in chronic bronchitis and emphysema: a study of psychotherapeutic management. AB - This paper describes a study of the outcome of psychotherapy with patients disabled by chronic obstructive airways disease giving rise to dyspnoea. Forty three men and 22 women with severe COAD were randomly allocated for 8 weeks to one of three types of psychotherapy or to an untreated control group, and were followed up six months later. The group treated by a medical nurse without training in psychotherapy experienced sustained relief of dyspnoea but tended to undergo less psychodynamic change; psychiatric symptoms were reduced in those receiving supportive, but not analytical, psychotherapy. The psychosomatic mechanisms involved and the implications for medical and nursing practice and for liaison psychotherapy are discussed. PMID- 6844475 TI - Nicotine's role in smoking: an analysis of nicotine regulation. PMID- 6844473 TI - Is follow-up necessary in evaluating psychotherapy? PMID- 6844474 TI - Who suffers more? Sex differences in health risks of the widowed. PMID- 6844476 TI - Notes on effort and achievement-oriented behavior. PMID- 6844477 TI - Reinstating the original principles of Proctor's unified theory for matching-task phenomena: an evaluation of Krueger and Shapiro's reformulation. PMID- 6844478 TI - Geophysical variables and behavior: X. Detecting lunar periodicities: something old, new, borrowed, and true. PMID- 6844479 TI - Dissemination of rumor among retarded residents. PMID- 6844481 TI - Rape as a function of relative sexual frustration. PMID- 6844480 TI - Community adjustment of patients who threaten and attempt suicide. PMID- 6844482 TI - Effects of a fear appeal on arousal, self-reported anxiety, and attitude towards smoking. PMID- 6844483 TI - Impulsiveness and venturesomeness in Canadian children. PMID- 6844484 TI - Impact of OSHA on state and local public employment. PMID- 6844485 TI - Alcohol and multiple drug abuse in accused murderers. PMID- 6844486 TI - Psychological processes associated with premature death in Duchenne muscular dystrophy. PMID- 6844487 TI - Predicting employees' theft in home improvement centers. PMID- 6844488 TI - An inquiry into the possible relationship between GPA and undesirable behavior in residence halls. PMID- 6844489 TI - Development of a self-report measure of depression-proneness. PMID- 6844490 TI - Degree of difficulty in giving up cigarettes. PMID- 6844491 TI - Depression-proneness, low self-esteem, unhappy outlook, and narcissistic vulnerability. PMID- 6844492 TI - Participants' perceptions of ethical issues in research with humans. PMID- 6844493 TI - Correlates of role conflict and role ambiguity among secondary school counselors. PMID- 6844494 TI - Effects of cash deposits on attendance and weight loss in a large-scale clinical program for obesity. PMID- 6844495 TI - Sex and race differences in psychiatric symptomatology in phencyclidine psychosis. PMID- 6844496 TI - Worry and emotionality components of test anxiety in relation to situational and personality determinants. PMID- 6844497 TI - Psychological aging and the cohort of reference. PMID- 6844498 TI - Knowledge of trainees in school psychology about children's legal rights. PMID- 6844499 TI - Attributions of responsibility by simulated jurors: stage of moral reasoning and guilt by association. PMID- 6844500 TI - Psychology of the scientist: XLIX. On becoming a student--again. PMID- 6844501 TI - Modifying impulsive responding in conduct-disordered institutionalized boys. PMID- 6844502 TI - Some comparative personality traits of the mildly retarded. PMID- 6844503 TI - Assessment of anxiety and depression in general and psychiatric nurses. PMID- 6844504 TI - Type A-B behavior and caffeine use in college students. PMID- 6844505 TI - MMPI-168 factor score profiles for major diagnostic groups. PMID- 6844506 TI - Treatment expectancy and therapeutic change in treatment of migraine headache: are they related? PMID- 6844507 TI - Sex-role orientation, stress, and subsequent health status demonstrated by two scoring procedures for Bem's scale. PMID- 6844509 TI - Concurrent validity of the overcontrolled hostility scale for psychotics. PMID- 6844508 TI - Cognitive styles of Caucasian and Native Indian juvenile offenders. PMID- 6844510 TI - The relationship between sexual arousal experience and genital response. PMID- 6844511 TI - Effects of an attention-demanding task on amplitude and habituation of the electrodermal orienting response. PMID- 6844512 TI - Stimulus omission and dishabituation of the skin conductance response. PMID- 6844513 TI - Psychopathy and selective attention during performance of a complex perceptual motor task. PMID- 6844514 TI - Recovery of performance during sleep following sleep deprivation. PMID- 6844515 TI - The effects of directional facial cues on electrodermal conditioning to facial stimuli. PMID- 6844516 TI - Event-related potential correlates of two stages of information processing in physical and semantic discrimination tasks. PMID- 6844517 TI - Skin conductance responses in unmedicated recently admitted schizophrenic patients. PMID- 6844518 TI - An evaluation of trait, state, and reaction aspects of activation processes. PMID- 6844519 TI - Bilateral asymmetry of skin conductance responses during auditory and visual tasks. PMID- 6844520 TI - A consideration of recent criticisms of the T-wave amplitude index of myocardial sympathetic activity. PMID- 6844521 TI - Design and analysis issues and strategies in psychophysiological research. PMID- 6844522 TI - Ambulatory electrodermal monitoring: effects of ambient temperature, general activity, electrolyte media, and length of recording. PMID- 6844523 TI - A device for ambulatory skin conductance monitoring. PMID- 6844524 TI - Opto-electronic belts for recording respiration in psychophysiological experimentation and therapy. PMID- 6844526 TI - The effects of maternal deprivation and of refeeding on the blood pressure of infant rats. AB - Blood pressure regulation was explored in infant rats 12-14 days of age during the 30-40% changes in cardiac rate that accompany nutrient (maternal) deprivation and refeeding at this age. Using specially modified tail cuff and intraarterial cannulation techniques, blood pressure was found to be maintained at stable levels (65-75 mm Hg) throughout these marked changes in pumping rate. The results suggest that adrenergic vasoconstrictor tone is controlled reciprocally with heart rate during a complex cardiovascular response to changes in nutrient levels at this early age. The possible role of such a mechanism in the development of "spontaneous" hypertension is discussed. PMID- 6844525 TI - Evaluation of psychosocial problems of the homebound cancer patient: I. Methodology and problem frequencies. AB - Psychological problem frequencies of very ill, homebound cancer patients were studied using an instrument entitled "Psychosocial Problem Categories for Homebound Cancer Patients." This instrument contains thirteen major categories of problems and fifty individual problems. A total of 570 patient records were obtained from two visiting nurse agencies in two different counties. Records were rated by a pair of trained raters, with level of interrater reliability being r = 0.96. Intervention frequencies by visiting health care professionals were also assessed. Percentages are based on at least one mention of problem or intervention. The five most frequent problem categories included: 1) Somatic side effects, 30% of total problems, of which pain involved 13% of total problems, 2) Patient mood disturbance, 15% of total problems, 3) Equipment problems, 8% of total problems, 4) Family relationship impairment, 7% of total problems, and 5) Cognitive impairment, 6% of total problems. The three most frequent interventions included: 1) Instructor/reinforcement to patient/family, 22% of total interventions, 2) No intervention for problem, 17% of total interventions, and 3) Counseling/emotional support, 17% of total interventions. Because the assessment instrument showed high interrater reliabilities for the two demographically dissimilar patient populations, it may be adaptable to heterogeneous populations. PMID- 6844527 TI - The stressful impact of news of risk for premature heart disease. AB - Efforts at prevention of disease include case-finding of individuals at high risk and offering to these identified people an intervention to reduce their risk. Although the intention of intervention is to reduce risk, the impact of discovering that one is at high risk may also lead to intrusive ideas and feelings that characterize psychological stress response syndromes. The present study examined these issues with a sample of 1,447 men who were advised of their risk for coronary heart disease in the collaborative Multiple Risk Factor Intervention Trial. Comparisons over three yearly data collections between a usual care and special intervention group showed that the special intervention group reported a far greater level of coping and mastery efforts regarding their risk status. This was accompanied by a much smaller tendency to be bothered by intrusive thoughts, but amount of reported upset did not differ. Finally, a small group of men in both groups indicated continuing high levels of upset across the three years. Clinicians are advised to be watchful for these persons for whom mastery of the news appears to be difficult. PMID- 6844528 TI - Type A behavior, self-involvement, and coronary atherosclerosis. AB - Prior to coronary angiography, 150 men were assessed for Type A behavior using the structured interview and two questionnaire measures. The results show no relationship between Type A behavior and extent of coronary artery disease (CAD). A second finding is that the number of self-references (I, me, my) derived from speech in the structured interview correlated positively with the number of previous myocardial infarctions and the extent of CAD; self-references correlated negatively with time on the treadmill and catheterization ejection fraction. Multiple regression analyses show self-references to remain a significant correlate of extent of disease when controlled for age, blood pressure, cholesterol, and Type A behavior. PMID- 6844529 TI - Hostility, CHD incidence, and total mortality: a 25-year follow-up study of 255 physicians. AB - High levels of hostility as assessed by a MMPI scale (Ho) have been found associated with increased levels of arteriographically documented coronary atherosclerosis. In this study we examined the relationship between hostility and subsequent health status in a 25-year follow-up of 255 medical students who completed the MMPI while in medical school. High Ho scores were found to be predictive of both clinical coronary disease incidence and total mortality. PMID- 6844530 TI - Psychologically mediated effect on the delayed hypersensitivity reaction to tuberculin in humans. AB - Recent research with animals has indicated a central nervous system effect on the immune system. This report describes findings of a possible psychologically mediated effect on the delayed hypersensitivity reaction to tuberculin in humans. Seven tuberculin positive subjects evidenced a decreased response to tuberculin (as measured by erythema and induration) when a paradigm similar to behavioral conditioning was followed where the subjects expected their reactions to be negative. PMID- 6844531 TI - [Group psychotherapy with suicidal patients: summary of results reported in the literature]. PMID- 6844533 TI - [Dimensions of the communication experience in the initial interview in family therapy]. PMID- 6844532 TI - [Achievement motivation in myocardial infarct patients]. PMID- 6844534 TI - Irritable bowel syndrome. PMID- 6844535 TI - Aging well. PMID- 6844536 TI - All aging is psychosomatic. PMID- 6844537 TI - Liaison psychiatry and the burn center. PMID- 6844538 TI - Grief, unresolved grief, and depression. PMID- 6844539 TI - School reentry in childhood cancer. PMID- 6844540 TI - Nausea and vomiting in cancer patients: a reply to Chang. PMID- 6844541 TI - On trainers and trainees. PMID- 6844543 TI - Parasitic diseases and man-made lakes in Nigeria. PMID- 6844544 TI - Smoking: how medical students see the doctor's role. PMID- 6844542 TI - Dental health of primary school children in Zaria City, Northern Nigeria. PMID- 6844545 TI - District planning in the restructured N.H.S.--facing up to uncertainty using computer models. PMID- 6844546 TI - The practice and teaching of breast self-examination in Southampton. PMID- 6844547 TI - Combined application of misonidazole and piotron pions on mouse embryos. AB - Mouse embryos on day 8 of gestation were irradiated with negative pions (12.5-100 rad) or 200 kV X-rays (12.5-150 rad). Misonidazole (MISO), a hypoxic cell radiosensitizer, was applied 30 min before exposure. On day 13 the fetuses were examined for lethality, growth retardation and malformation. No significant embryolethal effects were observed after irradiation alone in the dose range of 12.5-100 rad (X-rays or pions). However, MISO alone and in combination with radiation led to high rates of lethality. The frequency of growth retardation was significantly increased at 100 rad and in combined treatments at low radiation doses. MISO and irradiation with 50 rad and more induced complex damages consisting of multiple and severe malformations and growth retardation. The relative biological effectiveness (RBE) for teratogenic effects was 1.6. In conclusion, the combined application of MISO and radiation of different LET revealed a strong enhancing action compared to single treatments. The extent of enhancement depends on both radiation quality and dose. PMID- 6844548 TI - Inhibition and resumption of replicon initiation in X-irradiated mouse L5178Y cells. AB - Cultured mouse L5178Y cells were irradiated at room temperature with various doses of X-rays, and the rate of 3H-thymidine incorporation was followed for 2 1/2h after exposure. The rate of 3H-thymidine incorporation is affected by two factors; inhibition and resumption of replicon initiation, and chain elongation. A simple method has been developed for estimating the amount of thymidine incorporation which is accounted for by DNA chain elongation after irradiation. This then allows an analysis of the inhibition and resumption of replicon initiation caused by X-rays. The method is based on knowledge of the rate of DNA chain elongation and of the distribution of replicon sizes which are determined by fiber autoradiography. The duration of the inhibition of replicon initiation and the initial slope of the curve showing recovery of initiation were obtained by subtracting the DNA synthesis due to chain elongation from the overall rate of 3H-thymidine incorporation. The interval of depressed DNA synthesis increased with increasing dose of X-rays but only gradually at doses higher than 500 rad. The interval did not exceed 60 min even after 5,000 rad. The initial shope of the curve showing recovery of initiation decreased in a dose dependent manner but very slowly at doses higher than 1,000 rad of X-rays. It appears likely that this initial slope correlates with the relative number of replicons initiating synthesis at the beginning of the recovery period. PMID- 6844549 TI - Evidence for existence and compactness of DNA superstructure units in mammalian cells: a microdosimetric approach to radiation-induced DNA release assayed by neutral sucrose gradient sedimentation. PMID- 6844550 TI - Statistical methods in regression and calibration analysis of chromosome aberration data. AB - The method of iteratively reweighted least squares for the regression analysis of Poisson distributed chromosome aberration data is reviewed in the context of other fit procedures used in the cytogenetic literature. As an application of the resulting regression curves methods for calculating confidence intervals on dose from aberration yield are described and compared, and, for the linear quadratic model lambda = beta 0 + beta 1 chi + beta 2 chi 2 a confidence interval for the ratio beta 1/ beta 2 is given. Emphasis is placed on the rationale, interpretation and the limitations of various methods from a statistical point of view. PMID- 6844553 TI - [Multicellular spheroids for use in radiobiological experiments]. AB - Cell spheroids are conglomerates of closely arranged cells with reciprocal effects among them. Spheroids are histologically similar to nodulary tumours. Cells constituting these spheroids are heterogenous in their sensitivity to X rays and fast neutrons. Radiosensitivity of cells in a small spheroid is lower than that of similar cells grown in a monolayer. PMID- 6844551 TI - [Effect of cAMP accumulation activators on the individual stages of genome expression in cells in acute radiation injury. 6. Inhibition of RNA synthesis on a template of isolated chromatin by separate histone fractions from the liver of normal, irradiated and serotonin-protected rats]. AB - Using an acellular system, with isolated chromatin as a template, and E. coli RNA polymerase it was shown that irradiation of rats with a lethal dose (7.76 Gy) caused a progressing, in time, decrease in the inhibitory effect of H1, H2a, H2b, H3 and H4 histones (particularly H2a histone) on RNA synthesis. The administration of serotonin prior to irradiation diminished considerably this effect of radiation. PMID- 6844552 TI - [DNA synthesis in the liver of irradiated and serotonin-protected rats after removal of the cycloheximide block]. AB - The cycloheximide block model was proposed to study the mechanism of action of both radiation and radioprotectors. It was shown that irradiation of proliferating hepatocytes in vivo, at early stages of the prereplicative phase, markedly inhibited DNA synthesis. Serotonin, in its turn, considerably increased DNA synthesis maintaining this increase after subsequent exposure to X-radiation. PMID- 6844554 TI - [Comparative study of the radiosensitivity of normal and regenerating tissues. 1. Interphase cell death and degree of aplasia of regenerating and normal bone marrow and spleen tissues in C57Bl mice]. AB - A comparative study of radiosensitivity of cells of normal and regenerating tissues of bone marrow and spleen has demonstrated that single exposure to X-rays produces a lesser damaging effect on regenerating tissues than on normal ones. The data obtained indicate that the increase in radioresistance of the organism during active regeneration of the haemopoietic organs is due not merely to the increase in the dividing cell pool of these organs but also to qualitative changes in their functional state. PMID- 6844555 TI - [Possible effect of natural background radiation on the development of mammals]. AB - The deceleration of the development of young rats during the postnatal ontogenesis under conditions of a low-background chamber (a 10-fold decrease in the natural radiation background) was detected using the criterion of individual growth of the body weight for 10 days of observation. The administration, to the low-background chamber, of uranium salts which restore the natural background (all other experimental conditions being retained) removed the effect observed. PMID- 6844557 TI - [Role of changes in oxygen concentration during modification of cell reproductive death in vitro. 2. Modification of radiosensitivity during changes in the rate of oxygen consumption by cells]. AB - A study was made of the role of changes in the concentration of oxygen occurring upon modification of radiosensitivity of cells in vitro using temperature (0-37 degrees C), incoupling agents and respiration inhibitors, and also upon stimulation of the oxygen consumption by microsomes. When cells were irradiated in suspension, monolayer, spheroid and roots of plants a change in the rate of the oxygen consumption by cells and a corresponding change in their oxygenation can contribute considerably to a radiomodifying effect. PMID- 6844556 TI - [Dynamics of early postradiation changes in capillary endothelium (quantitative electron microscopic analysis]. AB - Oedema, breakage and fragmentation of plasmolemma and mitochondrial damages developed in rats 1-48 h following total-body X-irradiation (4.5 Gy). These changes were most pronounced 2-6 h after exposure, when they spread over 20-30% of the population, and accompanied by the appearance of wide gaps in the endothelial layer and maximal accretion of free lipids in the endotheliocyte cytoplasm. Changes in the sizes and number of mitochondria were responsible for the tendency toward the increase in their relative total volume which was most pronounced after 12 h. PMID- 6844558 TI - [Seasonal radiosensitivity of rats and dogs]. AB - The data are submitted obtained on 10.5 thousands Wistar rats and 350 mongrel dogs exposed to gamma-radiation (LD40-LD100) in different seasons. The radiosensitivity of both animal species was the highest in autumn (August and September) and the lowest in winter (February and January). The seasonal DMF for rats and dogs with LD16, LD50 and LD84 was 1.24 and 1.31, 1.13 and 1.17 and 1.04 and 1.07, respectively. The curves for seasonal radiosensitivity of dogs with LD84, LD50 and LD16, exhibited a single--phase character throughout a year. For rats, the seasonal radiosensitivity curves with LD84 were single-phase, and the curve with LD50, and particularly LD16, exhibited the second peak of radioresistance in June. The increase in radioresistance of rats and dogs correlated with the increase in number of leukocytes in the peripheral blood of animals. PMID- 6844561 TI - [Effect of alpha particles on bacteriophage T4]. AB - Exponential survival curves were obtained for a dry film culture of bacteriophage T4 Br+ after exposure to both alpha-particles and gamma-quanta. Relative biological effectiveness of alpha-particles was 4.68 with respect to survival. The mutation spectrum after alpha-irradiation slightly differed from that produced by gamma-radiation. PMID- 6844560 TI - [Subcellular distribution of the Ca++-dependent protein regulator in the gray matter of the rat brain in normal conditions and on exposure to roentgen radiation]. AB - It was shown that calmodulin is nonuniformly distributed in subcellular fractions of rat brain gray substance. The largest calmodulin content is found in the synaptosomal-mitochondrial fraction and the lowest, in the microsomal fraction. Different subcellular fractions of rat brain gray substance are characterized by diverse specific activities of calmodulin. Lethal X-radiation doses elicit substantial, oppositely directed, changes in the content and specific activity of calmodulin in different subcellular fractions of rat brain gray substance. PMID- 6844559 TI - [Recovery processes in damage to rats by 252Cf]. AB - The types of recovery processes were demonstrated in experiments on albino rats damaged with 252Cf. The frequency and the degree of manifestation of both pathological and recovery processes were function of radiation dose and time of its formation. The results obtained indicate that changes induced by the incorporation of 252Cf, within a wide range of doses, are compensated incompletely to be manifested later by sklerotic, hyperplastic and neoplastic processes. PMID- 6844563 TI - [Effect of the magnitude of radiation dose on the formation of DNA double-strand breaks]. AB - It was shown that under the effect of sparsely ionizing radiation double-strand DNA breaks in solution were formed more readily at high dose-rates (20 Gy/min) than at low ones (0.03-0.06 Gy/min). Possible mechanisms of the effect observed are discussed. PMID- 6844562 TI - [Comparison of the neutron- and gamma-radiation-induced transformations of 2 deoxy-D-ribose in aqueous solutions]. AB - Effectiveness of neutron radiation (1 MeV) was nearly twice as low as that of electrons and gamma-quanta with regard to the formation of products of radiolysis of 2-deoxy-D-ribose in aqueous solutions. A change in the dose-rate of sparsely ionizing radiation by the order of 5-6, and variation in the concentration of 2 deoxy-D-ribose from 1 to 5 mM did not substantially influence the G products of radiolysis. PMID- 6844564 TI - [Reaction of lymph and blood coagulation systems to gamma radiation at high altitudes]. AB - A study was made of coagulation and cellularity of blood and lymph of thoracic duct of dogs exposed to 2.5 Gy radiation at the altitudes of 760 m and 3200 m above sea level after one-month adaptation. Irrespective of the irradiation conditions coagulation of blood decreased and that of lymph increased. Radiation induced changes in the cellularity of both blood and lymph were less pronounced in conditions of natural hypoxia than at the altitude of 760 m. PMID- 6844566 TI - [Lymphocyte migration in the body in conditions of internal irradiation. 2. Disorders of lymphocyte microenvironmental factors in organs]. AB - At later times after the injection of selenium-75-selenium methionine to CBA mice the inhibition of migration of intravenously injected normal 51Cr lymphocytes to the lymph nodes and liver lasted for a long time. On the contrary, no changes in the normal lymphocyte migration within the animal body were observed after total body gamma-irradiation with the dose of 4 Gy. The data obtained are indicative of the radiation-induced disturbance of the microenvironment factors, which provide migration of lymphocytes within the body, during the long-term exposure to radiation emitted by the incorporated source. PMID- 6844565 TI - [Effect of erythrocyte degradation products on the migration of hematopoietic stem cells in lethally irradiated mice]. AB - In experiments on CBA mice it was shown that erythrocytes administered at the stage of prehemolysis or the stromal fraction of erythrolysate caused an additional increase in the haemopoietic stem cell migration which had been intensified by hemorrhage or hypoxic hypoxia. PMID- 6844568 TI - [Changes in the electric activity of the rat stomach during direct roentgen irradiation]. AB - In experiments on rats inhibition of electric activity of X-irradiated stomach was discovered. The disturbance of the nervous regulation of the exposed stomach was manifested mainly by inhibition of the transmission of exciting stimuli via choline- and serotonin--reactive structures of the vegetative nervous system. The administration of serotonin and phentolamine normalized the stomach activity. PMID- 6844569 TI - [Degree of damage to dogs from a combination of external gamma-radiation and inhalation of submicron 239Pu dioxide evaluated by integral indices]. AB - The possibility of quantitation of the organism affection by the combined effect of external gamma-irradiation (103.2 and 51.6 mC/kg) and succeeding inhalation of different amounts of 239Pu submicron dioxide was shown on 55 mongrel dogs using the following criteria: the rate of extracellular fluid accretion and the body weight loss. PMID- 6844570 TI - [Combined effect of 239Pu and external gamma radiation on pregnant and lactating rats]. AB - Exposure of pregnant and lactating rats to external gamma-radiation (12.9-103.2 mC/kg) caused 239Pu redistribution within their bodies. The increase in the transfer of 239Pu to the progeny was maximum after gamma-irradiation of pregnant rats with the dose of 25.8 mC/kg. The decrease in the intake of 239Pu by the progeny was maximum after gamma-irradiation of lactating rats with the dose of 12.9 mC/kg. With the combined effect of gamma- and alpha-radiation gamma radiation was shown to play the major role in the embryos death. PMID- 6844572 TI - [A test arrangement for quality control of large-format picture-producing systems]. PMID- 6844571 TI - [Measurement of the efficiency features of x-ray diagnosis image converters]. PMID- 6844567 TI - [Patterns of postradiation recovery from the effects of external nonuniform radiation. 7. Relation of postradiation radiosensitivity in rats to the preliminary radiation dose in an oral form of radiation sickness]. AB - Radiosensitivity of rats was studied after double X-irradiation of head first with doses of 5 and 13 Gy, then with 8-21 Gy. PMID- 6844573 TI - [Graduate education in radiology with respect to roentgen diagnosis]. PMID- 6844575 TI - [Mathematical risk analysis of surgical interventions on the lung]. PMID- 6844576 TI - [Improvement of the physico-chemical properties of barium suspensions for the examination of the upper digestive tract]. PMID- 6844574 TI - [Anomalies of the craniocervical passage in a pediatric neuropsychiatric patient load]. PMID- 6844577 TI - [Mathematical model for 131I-hippuran kinetics in the kidney]. PMID- 6844578 TI - [Integration of radiology education into the medical curriculum of East Germany]. PMID- 6844579 TI - [Nuclear medicine studies of lymph flow in transosseous osteosynthesis]. PMID- 6844580 TI - [Genetic radiation burden of children in Halle as a result of x-ray diagnostic measures]. PMID- 6844581 TI - [A skull phantom for roentgen diagnosis]. PMID- 6844582 TI - [Value of roentgen film viewing conditions for the diagnostic quality of chest pictures]. PMID- 6844583 TI - [Goal, tasks and problems of specialist graduate education in radiology]. PMID- 6844584 TI - [Picture viewing conditions in stomatologic roentgen diagnosis]. PMID- 6844587 TI - [Application of Medichrome film]. PMID- 6844585 TI - [Intravenous contrast medium bolus injection in computer tomography with the TuR DZ11 high-pressure injector]. PMID- 6844586 TI - [Recent trends in the therapy of vaginal carcinoma]. AB - The presented paper gives a historic review of the change from the contact therapy to the percutaneous irradiation. The dominating role of radiotherapy compared to surgery is pointed out. With the help of therapeutic planning in Giessen an aimed pendulum irradiation, a high-volume percutaneous irradiation, a modern high-intensity afterloading system (Buchler), and an interstitial therapy are reported. Recently published important cure rates are shown in a table. The 5 year survival rate of 78 patients in Giessen from 1957-1975 was 42.3%. The discussion concentrates on the tolerance dose of the vagina according to the different dose rates and fractionations. PMID- 6844588 TI - [New contrast agents of the ionic group (Rayvist 300 and Rayvist 350)]. AB - Using the newest ionic contrast agents Rayvist 300 and Rayvist 350, investigations were made which factors contribute to the quality of an urogram. The parameters (ml contrast medium/kg, mg iodine/sq. meter, mg iodine/kg, ml contrast medium/m2) were calculated. The results showed that high doses of the contrast agent do not guarantee good quality of urograms. A higher concentrated contrast agent (in this series Rayvist 350) gave better urograms and contrast respectively. High iodine dosage, associated with low concentration did produce worse results. Dose recommendations are given for children. PMID- 6844591 TI - [Excessive soft tissue calcification in scleroderma (Teutschlander syndrome). A case report]. PMID- 6844589 TI - [Excretory urography and miction cystourethrography in childhood]. AB - Excretory urography and voiding cystourethrography constitute the basic examinations of conventional X-ray diagnosis of the urinary tract in children. The procedures have to be adapted to the specific physiologic conditions of childhood. Problems dealing with preparation of the patient, choice and amount of contrast media, sequence of exposures and the different methods of micturition cystography are discussed. PMID- 6844590 TI - [Special features in the roentgen diagnosis of ischiopubic synchondrosis and the femur head in children]. AB - Problems in the diagnosis and differential diagnosis of skeletal changes and abnormalities in children are frequently caused by differences in bone size and shape during maturation, by many normal variations, and finally by many skeletal disease, which mainly occur in childhood. Special difficulties are arising from the differentiation of normal findings and diseases, which need treatment. The problems are demonstrated by example of ischiopubic synchondrosis and femoral head and the most important differential diagnostic considerations are pointed out. PMID- 6844592 TI - [Sonography, urography and angiography in kidney carcinoma. A comparative study]. AB - In a comparative study the validity of angiographic, sonographic and urographic findings for evaluation of 204 renal tumors was investigated. Angiography showed 97% correct results, sonography 96% and urography 93%. Mean tumor size was 8.4 cm. 25% of all tumors caused renal vein occlusion. On the one side there is a striking correlation between tumor growth and vein occlusion, and on the other side between vein occlusion and urographic silent right kidney. 20% of all tumors had metastasized at the time of diagnosis. In 4.5% of all cases we found a left sided symptomatic varicocele of the left side with invasion of the left renal vein by tumor masses. PMID- 6844593 TI - [Radiologic emergency: ulcerative colitis with accompanying abscess]. PMID- 6844594 TI - [Differential diagnosis of pharyngocele]. PMID- 6844595 TI - [Recurring bloody pleural effusion in Boeck's disease? Upper abdominal tumor of obscure origin]. PMID- 6844596 TI - [Sonographic studies of the spleen]. PMID- 6844597 TI - [Sonography of the lower urinary tract]. AB - According to literature and to our experiences sonography should be the first investigation of the lower urinary tract in children, if there is suspicion of obstruction or malformation. In many cases the localisation of obstruction or the diagnosis of malformation can be found. Furthermore by sonographic follow-up studies of ureter obstructions by tumors, by concrements or after surgery, the normal radiographic investigations like urography or retrograde pyelography can be reduced. Sonography is a valuable enrichment for investigations of functional and morphological changes of the urinary bladder, especially for the classification of bladder tumors: whereas the diagnosis of urethral diseases still is found by clinical investigations and conventional radiological procedures. PMID- 6844599 TI - Carotid-ophthalmic artery aneurysm. A report of two cases. PMID- 6844598 TI - [Intraosseous angiography of bone tumours]. AB - Primary bone tumours are comparatively rare lesions. The diagnosis of these bone tumours as well as of tumour-like lesions is supported particularly by radiological investigations on the one hand and by the histological analysis of the tissue on the other. In addition to the traditional methods of radiography, intraosseous vessels can be demonstrated in vivo by the new method of intraosseous angiography. Intraosseous angiography shows the actual size of the tumour which sometimes cannot be seen by normal X-ray-appearance including peripheral angiography. Furthermore by intraosseous angiography valuable informations may be obtained for differential diagnostic considerations. Both, peripheral and intraosseous angiography represent useful radiological methods for supplementary investigation of bone tumours. PMID- 6844600 TI - [Echomorphology of the breast. Comparative sonographic, radiologic, anatomic and histologic studies of breast specimens]. AB - The interpretation of ultrasound mammograms is complicated by the heterogeneous structure of breast tissue. To improve the diagnostic analysis, a method has been developed which enables us to correlate ultrasound images of mastectomized specimens with the cross-sectional anatomy, the computed tomography, the x-ray photographs of the specimen and the histopathologic study of the corresponding gross serial sections. Some echophenomena considering the propagation properties of ultrasound are discussed. Echodense areas correlate well with inhomogeneous structures of the glandular tissue, i.e. the continuous change of microcystically alterated alveoli, dense and looser connective tissue, dilated ducts and small fat lobules. The histomorphologic equivalent to less echogenic lesions is represented by a homogeneous tissue structure, for example the homogeneous fibrosis of glandular tissue or tumourous tissue. Even fatty tissue appears echopoor. Shadowing phenomena are explained by refraction and absorption effects. The topographic comparison of echograms with identical x-ray photographs of specimen slices emphasizes that the sonographic examination of the breast can enhance the radiographic findings and therefore improve the diagnostic accuracy. PMID- 6844602 TI - Colon and rectal carcinoma: spatial distribution and detection. AB - Recent studies have challenged the concept that 50% of colon cancers are detectable by digital examination and two-thirds are within reach of the rigid sigmoidoscope. This is an important consideration because of the potential for failure of an otherwise appropriate screening method when evaluating a patient for carcinoma of the colon. An analysis of 2,298 cases of colorectal carcinoma diagnosed over 20 years showed that the most common sites were the rectum (34%) and sigmoid (25%). Over the 20 years, the incidence of cancer in the cecum increased and that in the rectum decreased. Cecal, ascending, and transverse colon cancers accounted for 34% of lesions - all beyond the range of the flexible sigmoidoscope. The changing site distribution emphasizes the need for an accurate and inexpensive technique to evaluate the entire colon. These data suggest that the barium pneumocolon examination should be included in the screening of high risk patients. PMID- 6844601 TI - Barrett esophagus: reticular pattern of the mucosa. AB - Barrett esophagus is an acquired condition with progressive columnar metaplasia of the esophagus due to chronic reflux esophagitis. The premalignant nature of this entity is well recognized. However, radiologic diagnosis has been limited by the nonspecificity of findings associated with the condition. We recently reviewed 29 cases of pathologically proved Barrett esophagus. Radiologic examinations revealed hiatal hernias, gastroesophageal reflux, esophagitis, and strictures. None of these findings are diagnostic of Barrett esophagus. In seven cases, however, double-contrast radiography also revealed a delicate reticular pattern in the esophagus. In all but one case, there was an adjacent stricture, and this reticular appearance extended distally a short but variable distance from the stricture. To our knowledge, this unusual reticular pattern has not been described previously, and it represents a valuable radiologic sign of Barrett esophagus. The etiology of this finding is uncertain, but correlation with the gross surgical specimen in one case suggests that it results specifically from areas of "villous" metaplasia in Barrett epithelium. This delicate reticular pattern appears to be a specific radiologic criterion for the diagnosis of Barrett esophagus. PMID- 6844603 TI - Biopsy of focal hepatic lesions. Comparison of 18 and 22 gauge needles. AB - One hundred consecutive patients underwent CT-guided percutaneous biopsy of focal non-cystic hepatic lesions using 18 and 22 gauge needles. The overall accuracy rate was 98% for the 18 gauge needle (92 true positives, 6 true negatives, 2 false negatives) and 84% for the 22 gauge needle (79 true positives, 5 true negatives, 4 false negatives, 12 with inadequate cellular material). There were no complications with either needle. The major advantage of the 18 gauge needle was its more consistent retrieval of adequate cellular material. CT with bolus contrast enhancement and rapid-sequence scanning facilitates avoidance of hypervascular lesions and hemangiomas, thereby adding to the safety of the technique. PMID- 6844604 TI - Acute damage to human endothelial cells by brief exposure to contrast media in vitro. AB - Cultured endothelial cells derived from human umbilical cord veins were labeled with Na2 (51Cr)O4 and exposed to pure isoiodinated contrast media or control solutions for 10 minutes to simulate the effects of intravenous injections of contrast media on the human endothelium. Metrizamide, iohexol, iopamidol, meglumine/Ca metrizoate (300 mg I/ml), meglumine/Na diatrizoate, meglumine/Na ioxaglate, and meglumine/Ca metrizoate (200 mg I/ml) were tested. Iso-osmolal mannitol solutions were used to determine the portion of injury that was due to the effects of osmolality. Up to six times more chromium-51 was released from the cultures following exposure to the two hyperosmolal ionic contrast media (meglumine/Na diatrizoate and meglumine/Ca metrizoate) than with exposure to the least toxic agent, iopamidol. The dimer ioxaglate and the three nonionic agents (iohexol, metrizamide, and iopamidol) gave a chromium-51 release rate that was almost equal to or lower than that of 0.9% saline. Follow-up of the washed cultures for 24 hours showed no residual toxic effects. PMID- 6844605 TI - The effect of contrast media on the aortic endothelium of rats. AB - The effect of diatrizoate, ioxitalamate, metrizamide, and ioxaglate on the aortic endothelium of the rat was investigated using transmission electron microscopy and DNA synthesis autoradiography. One milliliter of each contrast medium, containing 300 mg iodine per ml, was injected into the aorta. The types of lesions seen on electron microscopy and the rate of DNA synthesis seen on autoradiography established the degree of endothelial damage that had been produced. Of the four contrast agents tested, ioxaglate produced the least amount of cellular change. PMID- 6844607 TI - Brain parenchymal density measurements by CT in demented subjects and normal controls. AB - Parenchymal density measurements of 14 regions of gray and white matter from each cerebral hemisphere were made from CT scans of 25 subjects who had varying degrees of dementia as measured by a global Clinical Dementia Rating, and also from CT scans of 33 normal control subjects. There were few significant differences between the two groups in the mean density value for each of the regions examined, although several individual psychometric tests did correlate with density changes. Moreover, for six regions in the cerebral cortex, and for one region in the thalamus of each hemisphere, we found no significant correlation between the gray-white matter density difference and dementia. There was, however, a loss of the discriminability between the gray and white matter with an increase in the size of the ventricles. These findings may be attributed to the loss of white matter volume. PMID- 6844606 TI - Neonatal kidneys: sonographic anatomic correlation. AB - The ultrasound appearances of the neonatal and adult kidney contrast dramatically. In the normal kidney of a newborn infant, the echogenicity of the renal cortex equals that of the liver. To determine the morphological reasons for the unique and specific sonographic findings, we performed a quantitative anatomic analysis of the components of the kidney on autopsy specimens from four neonates. Our analysis reveals that the glomeruli occupy proportionally a much greater volume of the renal cortex during the first two months of life (18% as compared with 8.6% in the adult). Other anatomic differences include the greater proportional volume of the cellular component of the glomerular tuft in the neonate, and the location of 20% of the loops of Henle within the neonatal cortex rather than in the medulla. The increased number of anatomical structures, and thus interfaces, undoubtedly accounts for the increased echogenicity. The neonatal kidney often demonstrates prominent and hypoechoic renal pyramids. This may be explained by the larger volume of medulla in the neonatal kidney, which results in a ratio of cortex to medulla of 1.64:1 in the neonate as compared with a ratio of 2.59:1 in the adult. There is also a noted lack of echogenicity in the renal sinus region in neonates. Anatomically this is secondary to the absence of renal sinus adipose tissue in the kidney of the neonate. PMID- 6844608 TI - Computed tomography of the nasopharynx and related spaces. Part I: Anatomy. AB - The normal computed tomographic anatomy of the nasopharynx and pterygopalatine and infratemporal fossae is analyzed. Particular attention is given to the distinction between deglutitional and masticatory muscles. The relations of the palatal muscles to the eustachian tube are described in detail. Those soft-tissue features that, when they deviate from normal, can provide early detection of nasopharyngeal lesions are emphasized. PMID- 6844609 TI - Computed tomographic detection of sinusitis responsible for intracranial and extracranial infections. AB - Computed tomography (CT) is now used extensively for the evaluation of orbital, facial, and intracranial infections. Nine patients are presented to illustrate the importance of detecting underlying and unsuspected sinusitis. Prompt treatment of the sinusitis is essential to minimize the morbidity and mortality associated with complications such as brain abscess, meningitis, orbital cellulitis, and osteomyelitis. A review of the literature documents the persistence of these complications despite the widespread use of antibiotic therapy. Recognition of the underlying sinusitis is now possible with CT if the region of the sinuses is included and bone-window settings are used during the examination of patients with orbital and intracranial infection. PMID- 6844610 TI - Temporal bone disease: a comparison between high resolution computed tomography and pluridirectional tomography. AB - Sixty-five patients with suspected ear disease were examined with CT, and abnormalities were detected in 42 of them; 58 of these patients also had pluridirectional tomographic examinations. Eighteen of the patients in whom abnormalities were detected underwent exploratory surgery. CT was useful in the diagnosis of tympanic membrane swelling, fluid in the middle ear, cholesteatoma, granulation tissue, and adhesions. The superior contrast resolution of CT allowed for the visualization of ossicles when they were surrounded by an inflammatory mass or by blood. In trauma cases, axial images facilitated visualization of longitudinal fractures, which frequently pass through the geniculate ganglion of the facial nerve. CT and pluridirectional tomography were comparable in the demonstration of disease that involved the mastoid air cells, although fluid in air cells was more easily demonstrated by CT. Pluridirectional tomography was superior to CT in the demonstration of bone destruction; CT, however, was more sensitive in the diagnosis of lateral semicircular canal fistula. Based on this analysis, we recommend that these two modalities be used in a complementary fashion to evaluate suspected middle ear disease. PMID- 6844612 TI - Nuclear magnetic resonance imaging of the kidney: renal masses. AB - Fifteen patients with a variety of renal masses were examined by nuclear magnetic resonance (NMR), computed tomography, ultrasound, and intravenous urography. NMR clearly differentiated between simple renal cysts and other renal masses. On spin echo images, the simple renal cyst appeared as a round or slightly oval, homogeneous low-intensity mass with characteristically long T1 and T2 values. The thickness of the cyst wall was not measurable. The cyst had a smooth outer margin and a distinct, sharp interface with normal parenchyma. Hemorrhagic cysts were seen as high-intensity lesions. Renal cell carcinomas displayed a wide range of intensity. The T1 and T2 values of the tumors were always different from those of the surrounding renal parenchyma. Tumor pseudocapsule was identified in four of five patients examined. All carcinomas were accurately staged by NMR and extension of the tumor thrombus into the inferior vena cava was demonstrated. The authors predict that if these preliminary results are confirmed by data from a larger number of patients, NMR will play a significant role in renal imaging. PMID- 6844611 TI - Nuclear magnetic resonance imaging of the infarcted muscle: a rat model. AB - Eleven Sprague-Dawley rats with experimentally produced infarction of the lower extremities were imaged by nuclear magnetic resonance (NMR) immediately after infarction, and 6 and 24 hours later. Contrast between the infarcted and control muscles was noted immediately and continued to increase through 24 hours. These changes corresponded to a significant increase in the water content of the infarcted extremity at 24 hours. These results suggest promise for NMR imaging in the identification of myocardial infarction and should encourage further investigation in this area. PMID- 6844614 TI - Work in progress: potential oral and intravenous paramagnetic NMR contrast agents. AB - The potential use of paramagnetic compounds as nuclear magnetic resonance (NMR) contrast agents was examined in vitro. The T1 relaxation times for serial dilutions of Cu2+, Cr3+, Fe3+, and Mn2+ ions in saline, gadolinium oxalate (a potential oral contrast agent) in suspension, and chromium EDTA (a potential intravenous contrast agent) in solution were determined. The effect on T1 of increasing the concentration of oxygen in solution was also examined. The relative magnitude of the decrease in T1 was, as expected, proportional to both the concentration of the paramagnetic substance and its effective magnetic moment. Thus NMR has the potential to detect differences in tissue oxygenation. By incorporating paramagnetic metal ions into insoluble compounds or stable complexes, toxicity can be dramatically reduced while maintaining a significant paramagnetic effect. Highly insoluble paramagnetic compounds or stable paramagnetic ion complexes can thus be utilized as effective NMR contrast agents with significantly diminished toxicity. PMID- 6844613 TI - Work in progress: nuclear magnetic resonance study of a paramagnetic nitroxide contrast agent for enhancement of renal structures in experimental animals. AB - A piperidinyl nitroxide stable free radical derivative, TES, was tested as an NMR contrast enhancer of renal structures in normal animals and animals with experimentally induced unilateral renal ischemia, renal vascular congestion, and hydronephrosis. Physiologic measurements indicated that TES is rapidly excreted in the urine with a clearance rate equal to the glomerular filtration rate. Because the compound is strongly paramagnetic, it increases the observable NMR intensity within the kidneys and urine in relatively low doses (0.04 to 0.9 g/kg). TES-enhanced spin echo renal images clearly demonstrated the presence of disease and functional abnormalities in diseased kidneys. These abnormalities were either not evident or only indirectly suggested on nonenhanced NMR images. PMID- 6844617 TI - Synovial plicae of the knee on computed tomography. AB - Computed tomography (CT) of the knee was performed in 160 patients following double-contrast arthrography. Seventy-five synovial folds on the medial wall of the knee joint were found, and 63 of these plicae could be considered mediopatellar plicae. In 10 of the 63 cases, long, thick mediopatellar plicae were found, which could lead to a mechanical internal derangement. Twelve synovial folds did not conform to the classic description of a mediopatellar plica. These folds probably represent synovial tissue reaction, since they were most commonly seen in patients who had undergone meniscectomy. PMID- 6844615 TI - Thyroid CT number and its relationship to iodine concentration. AB - Sixty-seven patients with thyroid disease and 24 normal controls were examined with computed tomography (CT). The mean CT number (Hounsfield units +/- SD) in the normal controls (118.1 +/- 12.2) was significantly higher (p less than 0.001) than the mean CT number in patients with diseased thyroids, except for 2 cases of simple goiter (CT numbers 113, 132). The mean CT numbers in the patients with Graves disease (69.5 +/- 17.6) and Hashimoto thyroiditis (61.4 +/- 9.1) were significantly higher than those in patients with adenoma (41.7 +/- 10.6, p less than 0.001), cyst (33.1 +/- 14.8, p less than 0.001), or cancer (48.7 +/- 13.0, p less than 0.01). In 14 patients studied, a significant correlation was observed between thyroid CT numbers and the iodine concentration of the tissue (r = 0.889; p less than 0.001). PMID- 6844619 TI - Ultrasonographic identification of fetal lower extremity epiphyseal ossification centers. AB - The reliability of the sonographic identification of the fetal distal femoral epiphyseal ossification center (DFE) and the proximal tibial epiphyseal ossification center (PTE) in the estimation of gestational age (GA) was assessed in 84 singleton pregnancies. We used the presence of a DFE to indicate a GA greater than or equal to 33 weeks, and this method was 95% sensitive, 95% specific, and accurate overall in 95% of a selected cohort of 61 cases. In the same cohort, the presence of the PTE was highly predictive (accuracy of a positive prediction 95%) of a GA greater than or equal to 35 weeks. Ultrasonographic evaluation of fetal lower extremity epiphyseal ossification centers is a promising technique for the estimation of GA during the last trimester of pregnancy. PMID- 6844616 TI - Contrast enhancement technique for dynamic hepatic computed tomographic scanning. AB - A study comparing precontrast and survey postcontrast dynamic computed tomographic (CT) scanning was performed on 60 patients who had suspected hepatic metastases. An incremental dynamic technique was used during and following a 50-g iodine load administered over two minutes. The survey postcontrast dynamic technique was superior in both sensitivity and contrast differentiation and yielded no known false-negative examinations. No postprocedure renal dysfunction was observed. High-dose contrast-material delivery in conjunction with incremental dynamic CT scanning appears to be the most suitable technique for performing postcontrast hepatic CT examinations. PMID- 6844618 TI - Soft-tissue hemorrhage in hemophiliac patients. Computed tomography and ultrasound study. AB - Fifty-four hemophiliac patients underwent a total of 94 studies using computed tomography (CT), ultrasound, or both. Not only common bleeding sites such as the iliopsoas muscles but also several unusual sites were encountered: these included the iliac bone, bowel wall, mesentery, rectus abdominis muscle, retroperitoneum, bladder wall, and scrotum. Both modalities gave comparable results, and each was helpful in (a) establishing the diagnosis, (b) evaluating the extent of bleeding and its effect on adjacent organs, and (c) demonstrating regression after treatment. PMID- 6844620 TI - The fetal external ear. AB - The ridge pattern of the external ear was evaluated in 50 normal subjects during the second half of pregnancy. Definition was found to progress with gestational age, with a fully defined pattern implying maturity beyond 33 weeks. The external ear was edematous in patients with severe fetal hydrops. Anomalous shape or unusual prominence of the ear was observed antenatally in 4 cases of lethal dwarfism. PMID- 6844621 TI - Duplex ultrasound scanning of the carotid arteries with velocity spectrum analysis. AB - Duplex ultrasound examination of the carotid arteries using high-resolution realtime imaging and pulsed Doppler flow measurements with velocity spectrum analysis was performed on a series of 50 consecutive patients (100 vessels), and findings were compared with findings of conventional carotid arteriography. The criteria for an abnormal duplex examination included: a velocity ratio of 1.5 or more (ratio of the maximum internal carotid artery [ICA] flow velocity to the maximum common carotid artery flow velocity); turbulence, as indicated by an ICA velocity spectral width of 40 cm per second or more; visible plaque that produced an ICA stenosis of 50% or more; a maximum ICA velocity of 100 cm per second or more; and inability to detect ICA flow. A flow-limiting stenosis was defined arteriographically as a 50% or greater stenosis of the diameter of the arterial lumen. The velocity ratio was the best single duplex criterion, with an overall accuracy of 88%. The sensitivity or specificity of the duplex examination was as high as 97%, depending on the number of duplex criteria that were abnormal. PMID- 6844623 TI - Uremic renal cystic disease: value of sonographic screening. AB - A high incidence of bilateral cystic disease occurs in patients who have uremia of chronic renal disease that is being treated by intermittent hemodialysis. Complications of uremic cysts include cyst rupture, cyst hemorrhage, and the development of solid adenomatous or adenocarcinomatous lesions. Obtaining screening sonograms of the native kidneys of patients who have undergone transplantation and of the kidneys of patients who are receiving treatment by hemodialysis may be justified as a baseline for the routine monitoring of these high risk patients. PMID- 6844622 TI - Work in progress: intraoperative abdominal ultrasound. AB - Intraoperative ultrasound examination of the liver, biliary tree, pancreas, and kidney is described. Twenty-three patients were included in the study. In the authors' view the three important indications for operating room sonography of the abdomen are (a) locating biliary, pancreatic, or renal calculi, (b) defining the echostructure and precise location of tumors, and (c) evaluating the spread of tumor. It is concluded that intraoperative ultrasound shortens the length of an operation and increases the safety of the surgical procedure since it is more precise than palpation by the surgeon. PMID- 6844625 TI - Internal mammary lymphoscintigraphy in patients with breast cancer. Correlation with computed tomography and impact on radiation therapy planning. AB - Twenty patients with Stage I or II breast cancer, all of whom had undergone radiation therapy planning, were examined with internal mammary lymphoscintigraphy (IMLS) and computed tomography (CT). Based on the results of IMLS, radiation fields were revised in 12 cases (60%). The mean number of nodes identified by IMLS in each patient was 7.8, which is in agreement with previously published autopsy and scintigraphic data. CT identified 243 possible nodes of normal size, but only 49 of them were within 10 mm of regions shown to be positive on the scintigram. The authors conclude that IMLS is the method of choice for defining parasternal lymphatic drainage and identifying those internal mammary nodes that are normal in both size and function. PMID- 6844624 TI - Acquired renal cystic disease and neoplasia: complications of chronic hemodialysis. AB - Long-term intermittent hemodialysis has resulted in longer life expectancies for patients with end-stage renal disease. These patients are at risk for the development of acquired renal cystic disease and renal neoplasms. We present the following case to provide the radiologist with a better recognition of this clinical problem. PMID- 6844626 TI - Locally recurrent breast carcinoma: the effect of adjuvant chemotherapy on prognosis. AB - A group of 72 patients who had received radiotherapy between 1972 and 1980 for isolated local-regional recurrence of breast cancer was studied; 38 had received adjuvant chemotherapy and 34 had not. The two groups were comparable except for the initial nodal status and median time from mastectomy to recurrence. Outcome was not significantly different for the two groups in terms of response to radiotherapy, incidence of re-recurrence, distant metastases, and three-year survival. The length of the disease-free interval and the response to radiotherapy were the only factors studied that were significantly related to survival. PMID- 6844627 TI - Radiographs obtained during upper gastrointestinal fluoroscopy. Adequacy and comparison to postfluoroscopy images. AB - The usefulness of full-size radiographs obtained with the overhead tube following fluoroscopy was evaluated based on an analysis of 306 biphasic upper gastrointestinal studies that included follow-up postfluoroscopy views. In 32 studies with abnormal findings, the postfluoroscopy images were normal. In one case, the postfluoroscopy images revealed an abnormality not seen on spot views. The confidence levels rose in only 19 cases (6.2%) when postfluoroscopy images were used. In the appropriate setting, routine postfluoroscopy views after an upper gastrointestinal series are of little value. Nonetheless, in a teaching hospital, these images should be obtained when fluoroscopy is performed by junior residents. PMID- 6844628 TI - Optimal visualization of the nasopharyngeal airway. AB - Two sequential nasopharyngeal radiographs (the initial image with the mouth open and the second image with the mouth closed) of 100 randomly selected patients were obtained. Based on this series and a fluoroscopic study of two adult volunteers, the authors conclude that optimal visualization of the nasopharyngeal airway is achieved when the film is exposed during the latter phase of inspiration with the patient's mouth closed. PMID- 6844630 TI - Meniscus formation as a radiographic sign of colonic lesion location. PMID- 6844629 TI - Videofluoroscopy during arthrography of the temporomandibular joint. AB - A dynamic approach to evaluation of the temporomandibular joint is described. By combining videofluoroscopy with arthrography, the authors were able to demonstrate anterior displacement with capture by the condyle, anterior dislocation, perforation of the meniscus, and fibrosis. This technique provides clinical information about the position of the meniscus and its integrity with minimal patient discomfort. PMID- 6844631 TI - Radiation shielding device for fluoroscopy. PMID- 6844634 TI - Radiology of the bile ducts. A symposium on the use of new modalities for diagnosis and treatment. PMID- 6844633 TI - Standard for normal thickness of the thymus gland. PMID- 6844632 TI - Rapid balloon dilatation of the nephrostomy track for nephrostolithotomy. AB - The Olbert balloon catheter can be used to dilate a nephrostomy track from 9 to 30 F (3 to 10 mm) in a single step. Percutaneous nephrostomy, track dilatation, and percutaneous stone extraction can be performed within 40 to 90 minutes. The authors have used this catheter successfully in 10 patients without encountering complications. PMID- 6844636 TI - Progress in experimental tumor research. Workshop on Skin Painting. Arlington, Va., November 3-6, 1981. PMID- 6844635 TI - Computerized cardiovascular imaging. PMID- 6844637 TI - Total exposure of mice to powdered test substances (e.g., shale). PMID- 6844638 TI - Mouse skin application in chemical carcinogenesis. PMID- 6844639 TI - 'Accelerated' skin painting methods for carcinogen evaluation. PMID- 6844640 TI - Looking back on 20 years of, or an experimental protocol on 'mouse skin-painting studies'. PMID- 6844641 TI - Design and logistics of lifetime carcinogenesis bioassay using Syrian hamsters. PMID- 6844642 TI - Intercurrent disease and environmental variables in rodent toxicology studies. PMID- 6844643 TI - Background data and variations in tumor rates of control rats and mice. PMID- 6844644 TI - Background data on tumor incidence in control animals (Syrian hamsters). PMID- 6844645 TI - The use of in vivo carcinogenesis bioassay data in the development of policies aimed at protecting public health. PMID- 6844646 TI - The AMA's position on carcinogenesis bioassays. PMID- 6844647 TI - Skin bioassays in tobacco carcinogenesis. PMID- 6844650 TI - [Fibrin membrane endowed with biological function]. PMID- 6844649 TI - Strain differences and solvent effects in mouse skin carcinogenesis experiments using carcinogens, tumor initiators and promoters. PMID- 6844648 TI - Comparative anatomy and function of skin as related to experimental chemical carcinogenesis. PMID- 6844651 TI - [Relation and transference in Freud's treatments and writings]. PMID- 6844652 TI - [The unwanted pregnancy and its termination--a possibility for unconscious introjection of grief]. PMID- 6844653 TI - [Case report: on visual fantasies in the analysis of an exhibitionist]. PMID- 6844654 TI - [Medical, psychotherapeutic and psychoanalytic discourse]. PMID- 6844655 TI - [Destruction of the therapeutic environment. The dilemma of inpatient psychotherapy of borderline patients]. PMID- 6844656 TI - [Psychoanalysis supervision groups in the university]. PMID- 6844657 TI - [Literature as an attempt at self-liberation. On Jean Paul's "Titan"]. PMID- 6844658 TI - Dexamethasone suppression test combined with total sleep deprivation in depressed patients. AB - The effect of one night's total sleep deprivation (SD) on the dexamethasone suppression test (DST) was studied in groups of endogenously and nonendogenously depressed patients who were diagnosed according to different research classification systems. The DST was normal (less than 5 micrograms/dl) before and after SD in the group of nonendogenously depressed patients. Deterioration, no change or only slight clinical response in single items occurred. In the group of endogenous depressives 8 out of 11 were baseline nonsuppressors (greater than 5 micrograms/dl). After SD a large variability of cortisol nonsuppression was found in this group. Clinical response occurred in the majority of these patients but was more favorable in those who had a trend for normalization of DST. Clinical diagnosis as well as DST seem to have a therapy-predictive value for one night's total SD in patients with affective disorders. PMID- 6844659 TI - The psychiatry of vertebro-basilar insufficiency with the report of a case. AB - Vertebro-basilar insufficiency produces a rich spectrum of psychological and neurological symptoms. Where psychological symptoms dominate the picture, the patient may be presented first to a psychiatrist. The phenomenology of vertebro basilar insufficiency is discussed with special reference to hallucinatory syndromes, memory disturbance, affective disorders, akinetic mutism, 'unusual reports', cortical blindness, agitated delirium, the Capgras syndrome and normal pressure hydrocephalus. Finally, the case of a 61-year-old man illustrating a variety of the neurological and psychological features described in this paper is presented. PMID- 6844660 TI - [Research possibilities on the basis of a routinely implemented psychiatric basic and finding documentation]. PMID- 6844661 TI - U.S. export controls on biotechnology. PMID- 6844662 TI - Meeting of the Large-Scale Review Working Group of the Recombinant DNA Advisory Committee. PMID- 6844663 TI - Purification and characterization of canine intestinal motilin. AB - A 22 amino acid peptide with motilin-like immunoreactivity was purified from acetic acid extracts of small intestinal mucosa from mongrel dogs. Sequential chromatography on carboxymethyl-cellulose, Sephadex G-50, CM cellulose, Biogel P6, and two steps of high-performance liquid chromatography were used for purification. Microsequence analysis of the purified product permitted unambiguous identification of residues 2-22 as -VPIFTHSELQKIREKERNKGQ. The sequence of porcine intestinal motilin is FVPIFTYGELQRMQEKERNKGQ. The amino terminal residue of the canine peptide could not be assigned with certainty since Phe, Lys, and Ser all were identified by analysis of PTH derivatives on the first sequencing cycle. Definite amino acid differences between canine and porcine motilin thus were identified in positions 7, 8, 12, 13 and 14. These differences did not alter immunoreactivity of canine motilin with antibodies specific for the carboxyl-terminal portion of porcine motilin, but probably explain markedly diminished immunoreactivity with antibodies to the amino or mid-portion of porcine motilin. Synthetic Phe1 canine motilin was prepared by a solid phase method. The synthetic peptide had the same pattern of immunoreactivity as natural canine motilin and was biologically active with a potency similar to synthetic porcine motilin for induction of premature activity fronts of the interdigestive motor complex in the small intestine of fasting dogs. PMID- 6844664 TI - Basal hyperchlorhydria and its relation to the plasma concentrations of secretin, vasoactive intestinal polypeptide (VIP) and gastrin during prolonged strain. AB - Twenty young men divided into two groups participated in a five day training course with prolonged and heavy physical exercise, calorie supply deficiency and severe sleep deprivation. Basal acid output (BAO) was measured immediately after the course in seven of ten subjects who were given placebo tablets (placebo group) and in four of ten subjects who had a daily intake of 1 g cimetidine (cimetidine-group) during the course. Median BAO increased 3-fold in the placebo subjects (from 2.7 mmol/h to 8.2 mmol/h) but showed no increase in the cimetidine treated subjects. The median fasting plasma concentrations of secretin increased 2-8-fold during the course. Gastric suction for 1 h or ingestion of cimetidine reduced the plasma concentration of secretin by approx. 50%. Vasoactive intestinal polypeptide (VIP) increased 2-fold and was not influenced by reduction of gastric acid. The placebo group showed a small increase (P less than 0.05) in plasma concentration of gastrin on day two during the course. The study shows a marked hyperchlorhydria which partly explains the fasting hypersecretinemia found during prolonged strain. This strain-induced hyperchlorhydria could be abolished by treatment with the selective H2-receptor antagonist cimetidine. PMID- 6844665 TI - Ontogeny of vasoactive intestinal peptide in the human fetal digestive tract. AB - Immunocytochemistry and radioimmunoassay were used to assess the appearance time and tissue distribution of vasoactive intestinal peptide (VIP) in the digestive tract of the human fetus. By radioimmunoassay, VIP was measurable from 10 weeks of gestation. The peptide was abundantly distributed in the jejuno-ileum and colon, where the tissue peptide concentration rose from 9-14 weeks of gestation (18.4 +/- 4.4 and 22.0 +/- 5.0 pmol/g wet weight, respectively) to 15-21 weeks (83.0 +/- 21.1 and 98.6 +/- 36.4 pmol/g, respectively). Lower concentrations were recorded in pancreas from 9-14 weeks of gestation (4.3 +/- 0.8 pmol/g) to 15-21 weeks (13.9 +/- 3.7 pmol/g). The peptide concentration was 15.6 +/- 1.9 pmol/g in fundus and 25.5 +/- 3.2 pmol/g in antrum from 15 to 21 weeks of gestation. The highest concentration was recorded in duodenum from 15 to 21 weeks of gestation (118.4 +/- 40.8 pmol/g wet weight). Tissue VIP concentration and age were positively correlated in the jejuno-ileum. By immunofluorescence, immunoreactive VIP was localized in nervous fibers in the muscularis externa, in the submucosa and in the lamina propria. Scarce cell bodies were also found in the myenteric plexus. No immunofluorescent endocrine cells were observed. These results suggest: (1) the early appearance of immunoreactive VIP in gut, as early as 10 weeks of gestation; (2) the peptide, localized in nervous structures only, follows the same distribution pattern as that in adults; (3) the development of VIPergic structures is a continuous process, initiated during the 3rd month of pregnancy. PMID- 6844666 TI - Inhibition of pancreatic exocrine secretion and augmentation of the release of gut glucagon-like immunoreactive materials by intraileal administration of bile in the dog. AB - The effect of intraileal instillation of bile, a stimulant of gut glucagon-like immunoreactive materials (gut GLI), on secretin-stimulated pancreatic secretion was examined in anesthetized dogs. Intraileal bile significantly inhibited the flow rate of secretin-stimulated pancreatic secretion. The inhibition of pancreatic secretion was accompanied by an elevation of plasma concentration of gut GLI. Taking the inhibitory effect of glucagon on pancreatic exocrine secretion into consideration, it could be reasonably postulated that gut GLI may be a mediator of bile-induced ileal inhibition of pancreatic exocrine function. PMID- 6844667 TI - Studies on the characterisation of alpha-MSH-like immunoreactivity in rat hypothalamus. PMID- 6844668 TI - [4th national convention of the Nuclear Medicine Section of the Societa Italiana di Radiologia e Medicina Nucleare. Rome, 11-13 February 1982]. PMID- 6844669 TI - [Effect of glucose concentration on spinal anesthesia with bupivacaine 0.5%]. AB - Until recently isobaric agents were relatively seldom employed to produce spinal anaesthesia. Experience with bupivacaine has shown in a prospective study on 60 patients, that complications, especially with high or total spinals, are uncommon with either using hyper- or isobaric agents. Also it has been shown that the height of blockade after using hyperbaric agents can only be crudely controlled by positioning of the patient. 3 ml (15 mg) of 0.5% bupivacaine produces adequate analgesia, and muscle relaxation, rapidly, in the vast majority of patients. The duration of blockade was adequate for longer surgical procedures, and was not affected by varying glucose concentrations in the solutions employed. Also there was no difference in the number of dermatomes blocked. No significant differences could be found between the solutions containing 5 or 8% glucose; however, with the 8% concentration smaller variations were found in regard to the extent of dermatomal blockade. The degree of motor block was identical in all 3 groups. The duration of motor block decreased when using higher concentrations of glucose. It is not clear whether the differing glucose concentrations have an effect on C.S.F. osmolarity, and whether this is clinically relevant. The results show that isobaric spinal anaesthesia is at least as reliable as hyperbaric spinal anaesthesia. PMID- 6844670 TI - [Prospective study on the effect of various preparations of 1% mepivacaine solutions without preservatives]. AB - On 30 volunteers the pain sensitivity and macroscopic changes at the area of intracutaneous injection of 1% mepivacain solutions without adrenalin (and a sodium chloride reference solution) were investigated. It was found that the injection of solutions with only sodium chloride as ingredient were relatively pain sensitive, whereas the injection of preparations which contained also calcium chloride or this alone were much more comfortable. Clinically relevant side effects at the site of injection were not seen for any of the used solutions. PMID- 6844671 TI - [Clinical studies on epidural morphine administration for obstetric analgesia]. PMID- 6844673 TI - [Lumbar spinal and epidural anesthesia for vascular surgery]. AB - From 1979-1981, a total of 355 high risk patients were scheduled for vascular surgery under lumbar spinal or epidural anaesthesia. 201 patients were given spinal anaesthesia and 140 patients continuous epidural anaesthesia. 14 patients had punction failure. The analgesia for vascular surgery on the lower extremities done under spinal anaesthesia was adequate in 193 patients (98%) and insufficient in only 4 patients (2%). Epidural anaesthesia was adequate for 117 patients (96%) and insufficient in 5 (4%). The analgesia for vascular surgery on lower abdomen done under spinal anaesthesia was adequate in 9 patients (64%) and insufficient in 5 patients (36%), epidural anaesthesia, being adequate for 31 patients (65%) and insufficient for 17 patients (35%). Lumbar spinal and epidural anaesthesia are therefore alternative methods to general anaesthesia for high risk patients undergoing vascular surgery, especially on lower extremities. Spinal anaesthesia offers reliable surgical analgesia and good muscle relaxation but it is limited in time. Continuous epidural anaesthesia on the other hand does guarantee unlimited operating time and provides pre- and postoperative pain relief. PMID- 6844672 TI - [Unremovable epidural catheter due to a sling and a knot. A rare complication of epidural anesthesia in obstetrics]. AB - An epidural catheter inserted at the height of L2/3 could not be removed after spontaneous delivery of a healthy boy, manual extraction of the placenta and fixing the episiotomy. X-rays (lumbar spine a-p and lateral) were taken in order to visualize the epidural catheter's site. The catheter could only be recognized on the a-p but not on the lateral film. It was possible to recognize a foreign body in the ultrasonic study. The exact site of the catheter could not be determined. Continuous pulling in various positions (bend over, stretch and lateral position) could not remove the catheter. A consultant neurosurgeon tried also in vain to remove the fixed catheter. In a final trial pulling hard the catheter broke. The indication for operative extraction was given. Finally the catheter fixed in the ligamentum flavum building a loop and a tight knot in the epidural space could be freed up and removed surgically. PMID- 6844675 TI - [Fine-needle puncture aspiration as a diagnostic method in superficial masses. Experience at the Hospital General de Asturias]. PMID- 6844674 TI - [Changes in cholesterol transport by lipoproteins in patients with renal insufficiency]. PMID- 6844677 TI - [Retrospective study of 100 cases of Malta fever. Clinical and therapeutic evaluation related to an established protocol]. PMID- 6844678 TI - [Asterixis in focal lesions of the nervous system]. PMID- 6844676 TI - [Changes in blood levels of delta-ALA dehydratase enzyme activity in experimental thyrotoxicosis]. PMID- 6844679 TI - [Effect of D-L carnitine on the metabolism of plasma lipids, copper and zinc in hemodialysis]. PMID- 6844681 TI - [Hyperventilation syndrome. Apropos of 28 cases]. PMID- 6844682 TI - [Biometeorology. Study of the possible correlations among various meteorological parameters and asthmatic crises]. PMID- 6844680 TI - [Erythrocyte levels of urosynthetase in various types and grades of liver disease]. PMID- 6844683 TI - [Unusual concomitant associations in sepsis]. PMID- 6844684 TI - [Sporadic angioneurotic edema associated with a C1 inhibitor deficiency]. PMID- 6844685 TI - [Current status of porphyria cutanea tarda]. PMID- 6844686 TI - [New treatment for digitalis poisoning]. PMID- 6844687 TI - [Mechanisms of renal lithogenesis. (VIII) Therapeutic response of hyperoxaluric patients after 5 years' treatment]. PMID- 6844688 TI - [Atelectasis caused by lung folding]. AB - An atypical disturbance of ventilation supervening a pleural effusion may occur due to atelectasis by lung folding which is seen radiologically as a round image close to the chest wall with the appearance of a pseudo-tumour. The authors review the mechanisms and the clinical and radiological presentation of this disorder based on 7 cases and a review of the literature. The posterior basal type with adhesions to the chest wall are the most frequent. An intra parenchymatous and a double-form are described. The diagnosis of this benign disorder is radiological. It is based on a characteristic displacement of the vessels and bronchi and associated pleural signs. Recognition of these signs avoids all invasive procedures. PMID- 6844690 TI - Modified nucleosides and cancer. PMID- 6844689 TI - [Mortality from respiratory diseases among agricultural and non-agricultural workers in France from 1970 to 1974]. AB - The mortality due to respiratory disease was studied in France between 1970 and 1974 as well as in seven other countries in the European Economic Community. The French results were presented as an index of mortality by cause of death, enabling a comparison of the mortality in different groups of the population. Data was supplied for 7 diagnostic groups defined according to List A of the International Classification of Diseases. The population studied consisted of men and women between 15 to 64 years, classified according to residence (urban or rural) and profession (agricultural worker or not). In addition the indices of mortality for farmers or agricultural employees were compared to men of the same social class, for the same period. The comparisons between the urban and the rural background revealed an excess mortality for respiratory tuberculosis, lung cancer, bronchitis, emphysema and asthma for those in urban areas. In the rural environment an excess mortality was noted for acute respiratory diseases in both men and women; this was also found comparing agricultural to non-agricultural workers. Lastly, if one compared agricultural and non-agricultural workers of the same social class, deaths due to acute and chronic respiratory infections were higher in the agricultural workers. These results show the relative importance already stressed in other studies, of acute respiratory diseases in agricultural workers. PMID- 6844691 TI - tRNA alterations in cancer. AB - 1. 3H-, 125I-, and 32P-labeling methods were developed for base composition and sequence analysis of minute amounts of nonradioactive nucleic acids containing modified constituents. 2. Base composition analysis showed tRNA from two "liver like" minimal deviation hepatomas, Morris hepatomas 5123D and 7777, to exhibit typical alterations when compared with liver tRNA. Our observations, which were made for different transplant generations of the tumors, indicated a trend toward undermethylation and undermodification of tRNA. 3. Sequence analysis of several cytoplasmic and mitochondrial tRNAs from hepatoma 5123D showed partial lack of m2G and complete lack of Gm and Q. 4. Sequence analysis of mitochondrial tRNAs from hepatoma 5123D indicated several instances of alterations of primary structure, a phenomenon not previously observed for cytoplasmic tRNAs from neoplasms. 5. Biochemical mechanisms underlying these alterations, as well as their functional implications, have yet to be investigated. 6. Modification patterns, but not primary structures, of mitochondrial tRNAs have been highly conserved when compared to prokaryotic and eukaryotic cytoplasmic tRNAs. This implies that (a) post-transcriptional modifications must play a crucial role in tRNA function, and (b) alterations of post-transcriptional modifications in tumor tRNAs have to be regarded as highly significant deviations from the norm. PMID- 6844692 TI - Enzymatic methylation of chicken erythrocyte DNA modified by two carcinogens, 2 (N-acetoxyacetylamino) fluorene and methylnitrosourea. AB - Both DNA-AAF and MNU-alkylated DNA are methylated less than nonmodified DNA by rat brain nuclei cytosine 5-methyltransferase purified either by chromatography on DEAE cellulose or by Dyematrex. The inhibition of methylation is proportional to the modification of the DNA, and DNA having a given percentage of bases modified with MNU is less methylated than DNA modified to the same extent with AAF. Moreover, DNA-AAF irreversibly inhibits the methylation of native DNA, whereas MNU-alkylated DNA does not inhibit the methylation of native DNA. The AAF substituted DNA has a higher affinity for the enzyme than native DNA. However, this is probably not due to the AAF-induced local destabilization of the DNA helix, since heat-denatured DNA shows a lower affinity for the enzyme than double stranded DNA. Addition of DNA-AAF to the enzyme preincubated with native DNA inhibits methylation, but only after a lag period. This agrees with the model in which the methylase walks along the strand to methylate cytosine residues before being detached from the DNA. AAF bound to guanine residues may block the movement of the enzyme along the helix. The in vitro hypomethylation of DNA, caused by carcinogens, could explain the in vivo observations made by several authors and could have significance in gene activity, cellular differentiation, and oncogenesis. PMID- 6844695 TI - Alteration of tRNA modification in eukaryotes: causes and consequences. AB - To evaluate the role of the modified nucleosides in tRNA function, especially their involvement in regulatory mechanisms of development, differentiation, or neoplastic transformation we use the following organisms: eubacteria, the slime mold D. discoideum, the topminnow Xiphophorus, and mice. Ribosylthymine, a common modified nucleoside at position 54 in tRNAs of prokaryotes and the major class of eukaryotic elongator tRNAs, is involved in the binding to the ribosomal A-site and is important for the proper functioning of tRNA during translation. Alterations in the extent of this modification occur early in the development of D. discoideum. The fully methylated species are found on polysomes, actively synthesizing protein. The partially methylated tRNAs accumulate in the nuclei, and might be involved in regulatory mechanisms at the transcriptional level. The Q base, a modified deazaguanine derivative, is present at position 34, the first position of the anticodon of tRNAAsn, tRNATyr, and tRNAHis. Alterations in the extent of this modification occur in corresponding tRNAs during the first minutes after the onset of development in D. discoideum and before final differentiation into spores, indicating that Q is important for developmental processes. Changes in the modification of G34 to Q34 in specific tRNAs of the melanophoric system of the topminnow Xiphophorus further support the view that Q is necessary in differentiation. In plasmacytomas and in Ehrlich ascites tumor cells of mice, the amount of unmodified G34 in corresponding tRNAs is correlated to the growth rate, density, or age of the tumor cells. PMID- 6844693 TI - Ethionine-Induced alterations of tRNA metabolism. PMID- 6844694 TI - Processing of tRNA is accomplished by a high-molecular-weight enzyme complex. AB - An enzyme complex is a multifunctional catalytic unit that efficiently associates substrates with functionally related enzymes. The enzyme complex provides for the cellular regulation of enzymatic activities by physical interaction of the proteins with each other and by prior alteration of one enzyme's substrate by a related enzyme. Such regulatory abilities may go awry in neoplasia. Components of the protein biosynthetic machinery, such as aminoacyl-tRNA synthetases, have been thought to exist freely in the cytoplasm. However, high-molecular-weight enzyme complexes with aminoacyl-tRNA synthetase activities have been found in mammalian cells. We have been the first to report that the mammalian cell enzymes responsible for modification of tRNA occur in enzyme complexes (molecular weight 900000 daltons) associated with aminoacyl-tRNA synthetases and that the activities of these enzymes differ in normal and leukemic cells. Thus the enzymes responsible for the methylation of tRNA occur in enzyme complexes that provide efficient maturation of tRNA and possible regulation of protein synthesis. In FLC cells a unique enzyme complex composed of tRNA-methyltransferase and aminoacyl tRNA synthetase activities has also been shown to contain a specific ribonuclease activity and a cysteine-tRNA sulfurtransferase activity. Sulfurtransferase activity has been characterized and optimized for its tRNA and cysteine substrates and mercaptoethanol and cation cofactors. Abnormal activity of this enzyme during neoplasia could result in improper acylation of tRNA and/or infidelity of coding by tRNA. Specific RNase is important in the sizing of percursor tRNA into mature tRNA. Results showed that this sizing was dependent upon the presence of the enzyme complex and the length of the incubation time. Many of the 20 aminoacyl-tRNA synthetases are also found in the complex. Electron microscopy has verified the subunit nature of the complex, seen previously by density gradient centrifugation and gel filtration. Three subunits, each of 300 000 daltons, comprise a complex approximately 200 A in diameter. PMID- 6844696 TI - New applications of urinary nucleoside markers. AB - In order to extend the usefulness of the quantitation of urinary nucleoside markers, studies were undertaken to explore the adaptability of such determinations for early detection in cancer-prone populations such as asbestos workers. Another study was aimed at exploring the usefulness of therapy in individual patients. During these studies, two heretofore unknown phenomena serendipitously emerged which expand the versatility of the marker determinations: (a) radiation damage in animals and humans causes an excretion of urinary BAIB which from preliminary studies appears to be proportional to the irradiation burden, and (b) lead poisoning in the human also produces BAIB excretion. Some of the practical uses of these determinations are self-evident. Among 13 asbestos workers without clinical symptoms, eight were found to have significant elevations of the marker levels. Nine asbestos workers with diagnosed mesothelioma all excreted two or more markers at high levels. Some of the psi levels were the highest seen. Currently the diagnosis of mesothelioma is difficult and painful, requiring a rib resection; however, an asbestos worker with such elevations--provided small cell carcinoma of the lung is ruled out--can be seriously suspected of having mesothelioma. In a study of the usefulness of the markers in following therapy of trophoblastic disease, these markers were determined in women with incipient invasive hydatidiform mole. After curettage, the nucleoside markers indicated absence of residual disease but the usual marker, HCG, was still markedly elevated. The women were followed up for 2 years and were found to remain symptom-free. Therefore the source of the nucleoside markers is cleared more rapidly than that of HCG. PMID- 6844697 TI - Quantitative high-performance liquid chromatography analysis of modified nucleosides in physiological fluids, tRNA, and DNA. PMID- 6844698 TI - Modified nucleosides in body fluids of tumor-bearing patients. AB - The catabolism of nucleic acids, particularly tRNA, produces a variety of modified nucleosides which are not reutilized by mammalian cells. Investigation of these compounds in body fluids, mainly urine, has recently provided evidence of altered metabolic situations in tumor-bearing patients. The factors involved in the alterations of modified nucleosides formation are connected with altered tRNA-modifying enzymes and/or altered turnover of subpopulations of tRNA. A common pattern in tumor cells or tissues is the presence of isoaccepting tRNA species containing aberrant nucleoside modifications. Several modified nucleosides have been detected and quantitated by HPLC analysis of the urine of normal subjects and cancer patients. Results obtained, in the authors' laboratory, among others, indicate a possible correlation between urinary excretion of these compounds and the course of the disease, with implications for the follow-up of therapeutic treatment. Particular reference should be made to psi, which appears to be a suitable marker for monitoring these subjects. The data from the authors' laboratory also show that the analysis of modified nucleosides in blood may be considered a useful tool in the search for proper markers associated with the cancer status. In this respect psi is suggested as a biochemical indicator for cancer patients. PMID- 6844699 TI - Increasing urinary levels of modified nucleosides and bases during tumor development in mice. AB - Based on the fact that human cancer patients excrete increased amounts of various modified nucleosides and bases in their urine, we investigated whether the same phenomenon takes place in mice bearing experimentally induced tumors. We did indeed find that mice with MCA-induced skin tumors and mice exhibiting leukemia after X-ray irradiation excrete severalfold higher levels of modified nucleosides and bases than do untreated control mice. Comparison of the time course of altered urinary excretion of these RNA catabolites with the appearance of a recognizable tumor after MCA application revealed that the onset of the altered excretion rate of these compounds precedes tumor diagnosis. At present, the time course studies in our mice exposed to a single X-ray dose to induce lymphoblastic leukemia seem to indicate a similar situation. Mice exhibiting preleukemic histological features already excrete increased amounts of various modified nucleosides and bases. Confirmation of our results by analysis of further irradiation-exposed mice in our present detailed time-course studies and of tumors experimentally induced in other organs of mice and other species will be taken as a basis for developing an in vivo test for carcinogenicity. Furthermore, the results could provide a foundation for the setting up of a noninvasive, early screening method for cancer in human beings. PMID- 6844701 TI - Formation and removal of methylated nucleosides in nucleic acids of mammalian cells. PMID- 6844700 TI - Characterization and analysis of oncofetal tRNA and its possible application for cancer diagnosis and therapy. AB - We determined the primary structures of various tumor-specific tRNAs as well as of their normal counterparts by postlabeling RNA-sequencing procedures. The results clearly indicated that tumor-specific tRNAs are mostly formed by undermodification of hypermodified nucleosides located in the anticodon loop: no new tRNA transcripts have so far been found in tumor cells. Among the modified nucleosides affected by tumorigenesis, queuosine and Y base are the most interesting. In various tumor tRNAPhe species, hydroxy Y base located next to the anticodon is undermodified to form hypomodified hydroxy Y base lacking methyl and carboxymethyl groups. This Y base analog should be a good marker for analyzing the state of cancer cells. Queuosine, located in the first position of the anticodon, is partly or completely replaced by guanosine in all tumor cells tested so far. The amount of G-tRNA decreased markedly when the cells differentiated into mature erythroid cells, with concomitant increase of Q-tRNA. This indicates that the presence of G-tRNA is closely related to the state of the cells, not merely to the fast growth rate of tumor cells. The enzyme tRNA-guanine transglycosylase, which is a key enzyme in biosynthesis of queuosine in tRNA (inserting Q base into tRNA by a transglycosylase reaction), is active in both tumor cells and normal cells. Administration of chemically synthesized Q base to tumor-bearing mice resulted in complete conversion of G-tRNA to Q-tRNA in tumor cells, indicating that exogenously added Q base is effectively incorporated into G-tRNA. Various Q base analogs that can be used as substrates for tRNA-guanine transglycosylase were synthesized chemically. These compounds may be used for clinical cancer diagnosis, since they should be incorporated selectively into tRNA in tumor cells. In addition to use as cancer chemotherapeutic reagents, it should be possible to develop new Q base analogs that induce miscoding or blocking of protein synthesis after insertion into G-tRNA. PMID- 6844702 TI - Structural modifications and repair of DNA in neuro-oncogenesis by N-ethyl-N nitrosourea. PMID- 6844703 TI - Role of extent and persistence of DNA modifications in chemical carcinogenesis by aromatic amines. AB - The initial step in tumor formation with aromatic amines is assumed to involve the modification of nucleic acids. Reactive metabolites bind covalently to purine and pyrimidine bases. The extent of formation of DNA adducts and their persistence is therefore expected to correlate with the biological effect. Using [3H]trans-4-amino-stilbene derivatives as model compounds, several parameters have been measured in susceptible and nonsusceptible rat tissues: total initial DNA binding, initial pattern of adducts, persistence of DNA adducts, accumulation of DNA binding after repeated doses, and persistence of DNA adducts after repeated doses. They did not correlate with tissue susceptibility. The tissue burden decreased in the order: liver greater than kidney greater than lung greater than glandular stomach greater than Zymbal gland. The latter tissue is the primary target for tumor formation. Comparison with other aromatic amines shows that aminostilbene derivatives are no exceptions. The role of specific nucleic acid modifications for mutagenic and carcinogenic effects is also difficult to evaluate in these cases. It is therefore emphasized that modulation of secondary steps in the multistage process may largely influence the final outcome. The role of cell proliferation and its stimulation as well as tumor promoting effects are discussed. Aminostilbene derivatives appear to produce primary lesions quite efficiently in rat liver but lack cytotoxic and promoting properties for this tissue. PMID- 6844704 TI - Factor structure consistency in the Bruininks-Oseretsky Test--short form. PMID- 6844705 TI - The Virginia Community Cadre Network: community reintegration of persons with spinal cord injury. PMID- 6844706 TI - The politics of vocational evaluation: a qualitative study. PMID- 6844707 TI - Rehabilitation of unemployable mentally restored persons: the avocational alternative. PMID- 6844708 TI - [Use of reference plasmas for estimating the accuracy of radioimmunological titration measurements]. AB - This article presents a method for estimating the variability of measurements in radio-immunoassays. Repeated assays are carried out on the same plasma used as a reference. The variances of repeatability (or intraassay) and reproducibility are calculated from the values obtained from the reference. These variances are used to calculate the agreement between two or more values obtained from unknown plasma. Analysis of the values of the plasma reference completes information obtained from standard curves. PMID- 6844709 TI - [Gonadal ontogenesis and sex differentiation in the sea bass, Dicentrarchus labrax, under fish-farming conditions]. AB - The histology of the different stages of gonadal development (appearance of PGC, edification of gonad primordium, organization of an undifferentiated gonad, testicular or ovarian development) has been studied in fingerlings and juveniles of sea-bass in fish-culture conditions. Sex differentiation with a caudo-cranial gradient was direct and more in accordance with length than with age. Ovarian and testicular differentiation occurred in fish 11 to 23 months old and from 90 to 187 mm SL. Testis ova were frequently observed. PMID- 6844710 TI - [Technic allowing improvement in the fertility of French Friesian cows in a tropical climate. The effect on plasma progesterone evolution]. PMID- 6844711 TI - [Methodological approach to the circadian pattern of food intake in the growing domestic rabbit]. AB - We graphically recorded the feeding pattern of 9 New Zealand male rabbits during weeks 6, 9, 12, 15 and 18 of age. Feeding was considered as a periodic series of discrete events. We fitted a periodic Poisson process to each particular series. In order to determine if the model was a good representation of the time series, we compared the estimated density curves with non-parametric estimations of density. Approximation of the circadian pattern using the model was better from week 15 on. Before this age, 24-hour feeding activity was generally characterized by two peaks. The parameters of the model--average number of food intakes over a 24-hour period, time of highest feeding activity and scatter index--were easy to interpret. Age variations in circadian feeding pattern were mainly characterized by shortening of scatter and shifting of peak feeding activity from the beginning to the middle of the dark period between weeks 6 and 18. PMID- 6844713 TI - [Total carbohydrates and endogenous glycoproteins in the intestinal contents of the preruminant calf]. PMID- 6844712 TI - The influence of GABA on the synthesis of N-acetylserotonin, melatonin, O-acetyl 5-hydroxytryptophol and O-acetyl-5-methoxytryptophol in the pineal gland of the male Wistar rat. AB - The influence of GABA on the synthesis of N-acetylserotonin, melatonin, O-acetyl 5-hydroxytryptophol and O-acetyl-5-methoxytryptophol has been investigated using different experimental procedures. It was demonstrated that when GABA and an acetyl donor were added to the incubation medium together, a significant increase in synthesis of the N-acetylated products occurred during the night. Moreover there was a large increase in N-acetylserotonin synthesis at 15(00) hrs although none was observed in the control experiments. However, when GABA was added 20 min before the acetyl donor, synthesis of the N-acetylated products was significantly less. The opposite effect was observed for the O-acetylated indoles. These results confirm the proposal by Ebadi et al. (1982) that GABA, like norepinephrine, may be a regulator of melatonin synthesis. As melatonin is implicated in the regulation of reproduction it may be that GABA is equally significant in this regulatory effect. PMID- 6844714 TI - [Glyceride structure of perirenal adipose tissue of rats subjected to a peanut oil regimen]. AB - Weanling male rats were fed a balanced diet containing 15 p. 100 peanut oil by weight. The digestibility and fecal excretion of oil fatty acids were studied for 8 days at the beginning of the diet, which was then continued up to 4 months. At the end of the experiment, perirenal adipose tissues were removed and their triacylglycerols isolated and studied. They were fractionated into 8 fractions according to unsaturation and then analyzed by gas-liquid chromatography (GLC) for fatty acids and triacylglycerols. Each fraction was submitted to pancreatic lipolysis; the mono- and diacylglycerols formed were isolated and their fatty acids analyzed by GLC. The diacylglycerols were further fractionated according to unsaturation and their fatty acid composition analyzed. The triacylglycerol structure of the adipose tissue was determined using mathematical methods previously described. The long-chain saturated fatty acids (from stearic to lignoceric) were poorly absorbed and not incorporated into the fat tissue, whereas oleic acid, the major fatty acid of the oil (54 p. 100), was highly incorporated (57 p. 100) into triacylglycerols. As in the diet oil, unsaturated fatty acids were mainly esterified at the 2-position. Trioleoylglycerol was the major (21 p. 100) triacylglycerol, as in the oil (25 p. 100). Only 14 isomers accounted for more than 1 p. 100 and together represented more than 80 p. 100 of the total. Of the 14 isomers, the first four (10 p. 100 or more) accounted for more than one-half of oil triacylglycerols, namely 56 p. 100. The triacylglycerol structure of studied adipose tissue was very similar to that of the diet peanut oil. PMID- 6844715 TI - [Evolution of postprandial cholesterolemia and triglyceridemia with age in the preruminant calf; the effect of sorbitol ingestion]. AB - From birth to 10 weeks of age, 7 Friesian male calves were fed milk replacers containing 21 p. 100 tallow. The calves were divided into two groups: a control group (4 calves) and a "sorbitol" group (3 calves) receiving sorbitol in the milk replacer (0.6 g/100 g DM). At 2, 3, 5, 7 and 10 weeks of age, plasma concentrations of free cholesterol, cholesterol esters and triglycerides were determined in jugular blood 2 h before the morning meal and 1/2, 2, 3, 5 and 7 h after feeding. No significant variations were observed in the pattern of postprandial estercholesterolemia whatever the age or diet. Average estercholesterolemia was significantly higher (P less than 0.01) at 2-3 weeks of age than at 5, 7 or 10 weeks. Sorbitol supplementation decreased estercholesterolemia significantly (P less than 0.01) when the calves were 2 weeks old, but no effect was observed later. Similar variations in postprandial cholesterolemia were noted for both groups at all ages. Cholesterolemia was significantly higher (P less than 0.05) during the - 2h, + 1/2 hour-period than in the 2-5- hour period and rose significantly at 7 h (P less than 0.05) to the same pre-feeding level. Average cholesterolemia showed the same changes with age as estercholesterolemia in both groups. Changes in postprandial triglyceridemia were similar to those of cholesterolemia in both groups at all the ages studied. The decrease in triglyceridemia (P less than 0.01) 2 h after feeding was probably related to intense lipolysis, and the increase (P less than 0.05) 7 h after feeding was due to the arrival of new feed triglycerides. Triglyceridemia was significantly (P less than 0.05) lower when the calves were 10 weeks old than when they were younger, but no change was observed when sorbitol was added to the diet. PMID- 6844716 TI - Protein secretion by the principal cells of mouse epididymis evidenced by in vitro incorporation of tritiated leucine. AB - The in vitro synthesis and secretion of newly formed proteins were investigated in the principal cells of small pieces of the head and body of mouse epididymis inserted into a modified Rose chamber. Our ultrastructural observations revealed that the cells resumed their normal ultrastructural appearance only after 3 h. Therefore, after preliminary 3-hour culture, the pieces were incubated with tritiated leucine at intervals ranging from 5 min to 6 h. The incorporation of radioactive leucine measured by scintillation counting demonstrated that each of the anatomical segments studied secreted a significant amount of proteins into the culture medium. PMID- 6844717 TI - Postprandial metabolic changes in larval and juvenile carp (Cyprinus carpio). AB - Ammonia-nitrogen excretion and oxygen consumption rates after a meal were followed in carp larvae and juveniles of different sizes, starting from early exogenous feeding and until they had reached about 1 g of body weight. There was an immediate rise in the nitrogen excretion rate after feeding; the amplitude and duration of this increase were affected by body weight (BW) and the amount of nitrogen consumed (NI) and could be described by the equation: 37.61 BW-0.311 NI0.802. Endogenous nitrogen excretion rate and basal metabolic rate were affected by both nutritional status and previous nutritional history. A model used to describe the postprandial nitrogen excretion pattern in young carp fitted well with the experimental data. The different coefficients of the model were affected by body weight. PMID- 6844718 TI - Effect of microflora and lactose on the absorption of calcium, phosphorus and magnesium in the hindgut of the rat. AB - For 4 weeks, 3-month old germfree (GF) and conventional (CV) rats were given a semi-synthetic diet sterilized by irradiation with or without 10% of lactose. During the 5th week, 0.2% of titanium oxide (TiO2) was added to the diet and the rats were killed at regular intervals throughout the light/dark cycle. The patterns of TiO2 and 45Ca excretion were similar, indicating that TiO2 was a good marker of unabsorbed calcium transit. The apparent absorption coefficient of calcium, magnesium and phosphorus was determined in the ileum, caecum, large intestine and faeces by the mineral/TiO2 ratio. The effects of microflora and lactose varied with the mineral and the digestive tract level studied. --In the small intestine, microflora had no effect on the apparent absorption of calcium and magnesium but did have an unfavorable influence on phosphorus absorption. Lactose increased calcium and magnesium absorption, and this increase was similar in GF and CV rats, but lactose had a favorable effect on phosphorus absorption only in CV rats. --In the caecum, microflora had an unfavorable effect on the apparent absorption of calcium and magnesium and a favorable effect on phosphorus absorption. The ingestion of lactose reduced calcium and magnesium absorption in the caecum of GF rats and phosphorus absorption in the caecum of CV animals. --In the colon, mineral absorption was not significant in either CV or GF rats receiving the lactose-free diets. Lactose ingestion caused the absorption of calcium, magnesium and phosphorus to rise significantly only in GF rats. This absorption contributed to the stronger effect of lactose on total calcium and phosphorus absorption in GF rats. PMID- 6844719 TI - [Male sexual behavior induced by testosterone in ovariectomized adult ewes. Effect of the dose and previous sexual experience]. AB - Adult ovariectomized ewes, daily injected with testosterone propionate (2 to 22 mg), showed male-like sexual behaviour, never seen in untreated females, but very similar to that in normal rams. After a few days of latency (3 days minimum), this behaviour gradually appeared and increased in frequency until a plateau was reached. The time-course in which the plateau was reached depended on the androgen dose and on previous experience with male sexual behaviour. Some male like behaviour might have persisted after the end of the treatment. The results have been discussed in terms of possible mechanisms of action on the central nervous system. PMID- 6844720 TI - Thecal vasculature and oocyte maturation during follicular atresia in the sheep and pig. AB - During follicular atresia in the sheep and pig there is a marked reduction in the vasculature of the theca interna underlying the membrana granulosa. In the sheep there is no reduction of thecal blood vessels adjacent to the cumulus which remains viable. By contrast, in the pig the cumulus degenerates during atresia and the underlying thecal vasculature is greatly diminished. However, despite loss of contact between the follicle cells and the oocyte, the germinal vesicle remains intact. PMID- 6844721 TI - Mortality in premature mice at birth and during neonatal development. AB - This paper reports a statistical study of mortality in about 2 500 premature mice at birth and during neonatal development. The premature mice were removed by caesarean section and reanimated for 30 min.; surviving mice as well as newborns delivered vaginally on day 20 of pregnancy (control mice) were raised from birth to day 20 by nursing mothers spontaneously delivered at the same time. The mortality rate in the premature mice and control newborns was estimated immediately after birth by caesarean section and 30 min. after reanimation or parturition, 6 h after birth and at 9 h every day from neonatal days 2 to 20. The caesarean section did not cause mortality. The chances of the survival of premature mice at birth depended on both gestational age and birth weight. Premature mice could not survive if their gestational age was less than 19 days and their birth weight less than 33% of that of newborn mice at term. There was no relationship between mortality and the number of newborns per litter. Two types of mortality were observed in premature mice, mortality at reanimation and breeding mortality. Mortality at reanimation was about 13%; breeding mortality, occurring only during the first 3 neonatal days, was of two types: primary neonatal mortality (10.9%), occurring from the end of reanimation up to 6 h after birth, and secondary neonatal mortality (6.9%) which appeared from days 2 to 3. The role of some factors causing mortality has been discussed. PMID- 6844722 TI - Effect of the relative locations of embryo and corpus luteum on embryo survival in cattle. AB - The objectives were to determine if early in gestation (less than day 30) an embryo in the ipsilateral horn increases the survival rate of an embryo in the contralateral horn and if later in gestation (greater than day 30) the presence of two embryos adversely affects the survival of both embryos in cattle. The experiment involved surgical embryo transfer. Sixty Holstein heifers were assigned to 4 groups: group 1) sham bilateral transfers, group 2) one embryo inserted ipsilateral to CL, group 3) one embryo inserted contralateral to CL, and group 4) one embryo inserted into each horn. Diagnosis of pregnancy and ovarian activity were recorded from day 7 or 8 (surgery) to day 110. Results indicated that the rate of embryo survival early in pregnancy (less than day 30) in heifers with the embryo inserted contralateral to the CL (33%, group 3) was increased (P = 0.05) when an embryo was also inserted into the ipsilateral horn (67%, group 4). The hypothesis that the ipsilateral embryo would have a protective effect on the contralateral embryo was, therefore, supported. This may have been due to the prevention of luteolysis by the ipsilateral embryo. However, when an embryo was present in each horn considerable loss occurred greater than day 30 resulting in a low survival rate by day 110 (27%). The hypothesis that the presence of two embryos would decrease the survival probability of both embryos later in gestation was, therefore, supported. PMID- 6844724 TI - Epilepsy. PMID- 6844723 TI - [Effects of feed restrictions during the growth of sows on their sexual maturity and subsequent reproduction]. AB - Effects on reproduction of feed restriction during different periods of growth were investigated in 76 Large-White gilts given one of 3 treatments between 79 days of age (27.9 kg) and puberty. The control gilts (group 1) were fed ad libitum during the experimental period, and those in group 2 received 12% less feed from 61 kg of liveweight until puberty. The gilts in group 3 received 33% less feed before 61 kg and were then pair-fed with the gilts in group 1. All the gilts were mated at first estrus and received 2.4 kg of feed per day during pregnancy. They were laparotomized at 38 days after mating and slaughtered at 105 days of pregnancy to measure early and late embryonic mortality. Contrary to group 3 (age at puberty: 256 days), no difference was found in age at puberty between group 1 and 2 gilts (232 and 226 days, respectively). Early undernutrition delayed age at first estrus, even when followed by normal feeding after 61 kg of liveweight. The gilts in group 2 had less backfat (backfat depth 24 vs 31 mm) and weighed less at puberty than the others (111 kg vs 124 kg). Severe undernutrition tended to increase early embryonic mortality (21.1, 18.8 and 33% in groups 1, 2 and 3, respectively) but the reverse was observed thereafter so that there was no difference in total embryonic mortality at 105 days of gestation (32.6, 30.6 and 36.5% in groups 1, 2 and 3, respectively). PMID- 6844725 TI - Clinical pharmacokinetics and therapeutic application of antiepileptic drugs. PMID- 6844728 TI - The selection process for surgery of intractable complex partial seizures: surface EEG and depth electrography. PMID- 6844726 TI - Ionic basis for the electrophysiological activity of mammalian neurons. PMID- 6844729 TI - Psychosocial characteristics of epileptic patients. PMID- 6844727 TI - Teratogenicity of anticonvulsant drugs. PMID- 6844731 TI - Effects of indomethacin on renal concentrating capacity in lithium-treated rats. AB - An investigation was carried out to determine whether or not the administration of indomethacin to Li-treated rats would raise PLi2, and whether or not there would be any change in the type or severity of Li-induced renal functional abnormalities. It was found that indomethacin increased PLi, apparently by decreasing CLi. Umax, already reduced by Li, was further impaired by the additional administration of indomethacin. The Li-induced impairment of TcH2O was not worsened by added indomethacin, but a wide variance of the data might have masked any effect. Significant inverse correlations were found between Umax and PLi and between maximum TcH2O and PLi, suggesting that the indomethacin-induced impairment in renal concentrating capacity is attributable to the increased PLi. PMID- 6844732 TI - Interactions between different bile salts in the biliary excretion of the rat. AB - In rats the simultaneous infusion of tauroursodeoxycholate and taurocholate resulted in a longer choleretic condition with higher total bile salt and taurocholate excretion rates as compared to taurocholate infusion alone. A similar but weaker response was observed when taurodehydrocholate was simultaneously infused instead of tauroursodeoxycholate. The taurolithocholate induced cholestasis was most markedly prevented when taurocholate, rather than tauroursodeoxycholate, was simultaneously infused. It was suggested that the effect of tauroursodeoxycholate on the biliary excretion of taurocholate appears to differ from that of taurocholate on taurolithocholate excretion. PMID- 6844733 TI - The effects of Methyl-GAG on a transplantable murine renal cell adenocarcinoma. AB - The effect of Methyl-GAG on a transplantable murine renal cell adenocarcinoma was evaluated. Inoculation of Balb/C mice with 1 X 10(5) renal adenocarcinoma cells under the renal capsule resulted in 100% tumor growth and death of the animal in 29 +/- 5 days. In 66% of the control animals lung metastases was observed. Intraperitoneal injections of Methyl-GAG at dose levels of 200 mg/m2, 150 mg/m2, and 100 mg/m2 administered weekly failed to demonstrate any effect on local growth of the tumor. More than 50% incidence of metastatic development was noted in the treated groups. Methyl-GAG had no apparent effect on primary tumor growth or the retardation of metastatic incidence. PMID- 6844734 TI - Interaction of unconjugated bilirubin with brush border vesicles from proximal tubules of rat kidney. AB - An interaction between non conjugated bilirubin and brush border vesicles was found which does not change the absorbance spectrum of bilirubin, nor protects it against the action of peroxidase. It seems to reach saturation at about 20 min., and appears to be mainly a superficial binding, probably non specific and relatively weak. The bound amount of bilirubin was high and can not be neglected in any interpretation of the reabsorption of the solute by proximal tubules. PMID- 6844735 TI - Muscarinic cholinergic receptors on circulating human lymphocytes: evidence for a particulate binding site. AB - Lymphocytes from thirteen normal volunteers were investigated for their muscarinic cholinergic receptors content. A particular binding site was characterized with 3H-quinuclidinyl benzilate; saturation binding occurred at 80 X 10(-9)M and scatchard analysis provided a dissociation constant of 40 X 10( 9)M. These results showed that there were about 4000 muscarinic receptors on human lymphocyte. Although, it is possible to demonstrate the presence of binding site on a particulate preparation, the significance of such low-affinity receptor is yet unclear. PMID- 6844730 TI - Pathogenesis of behavior change in temporal lobe epilepsy. PMID- 6844736 TI - Modification of digoxin induced arrhythmogenicity in adult rats following atropine administration. AB - Atropine alone in the two lower doses (20mg/kg and 40mg/kg) did not produce any arrhythmias while 80mg/kg of atropine produced arrhythmias in 33% of animals after 31.0 +/- 7.5 min. Only 11% of these rats developed paroxysmal atrial tachycardia. Atropine in lower doses (20,40mg/kg) with digoxin (40mg/kg) decreased the total percent of digoxin induced arrhythmias, delayed their onset, and changed the type of arrhythmias as compared with the digoxin group alone. Atropine given in higher dosage (80mg/kg) with digoxin (40mg/kg) produced arrhythmias in 100% of rats as did digoxin alone, but significantly shortened their onset and modified the types of arrhythmias seen. In conclusion, atropine in varying doses significantly modified digoxin toxicity. PMID- 6844737 TI - Wet-dog body shaking induced by electrical stimulation of hippocampus in the intact and reserpinized rat. AB - Electrical stimulation of the hippocampus evoked body shaking in both control and reserpinized rats. The incidence of shaking induced by hippocampal stimulation was higher in reserpine-treated rats than in control rats. Stimulation of the amygdala, striatum and substantia nigra failed to elicit shaking. Body shaking induced by hippocampal stimulation was inhibited by phentolamine but not by methysergide, atropine and haloperidol. The results indicate that hippocampal stimulation elicits body shaking in which noradrenergic function may be involved. PMID- 6844738 TI - Case reports on deterioration of sleep apnea during therapy with propranolol - preliminary studies. PMID- 6844739 TI - Thiazides III. Evidence of dose proportionality of hydrochlorothiazide 25, 50 and 100 mg tablets. AB - A pilot bioavailability study was carried out where two subjects each were administered a dose of 25, 50 or 100 mg of commercially available hydrochlorothiazide (HCT) tablets. Plasma and urine samples were collected and analyzed by HPLC. A maximum plasma concentration of 50-285 ng/ml was reached in 1 2 hours, and plasma levels declined very rapidly with a half life of about 2-4 hours during first 12 hours period. The AUC was calculated using the trapezodial rule. A linear correlation was seen between the dose administered and amount of drug excreted. PMID- 6844740 TI - Toxicity and biotransformation of acetaminophen in rat hepatocytes (I). Uptake and release. AB - Uptake and conjugation of acetaminophen were studied in isolated rat hepatocytes. Acetaminophen was taken up by the cells and the conjugates formed in the cells were rapidly released from the cells at a constant rate. The kinetic analysis demonstrated that uptake was due to a saturable process as well as a simple diffusion. Decrease in uptake of acetaminophen by metabolic inhibitors suggested that uptake of acetaminophen by hepatocytes might be, at least in part, due to an energy dependent process. PMID- 6844742 TI - Effects of repetitive doses of lithium in fluid-deprived rats. AB - Repetitive daily dosage (2.0 mEq/kg) of LiCl to rats maintained on a restricted fluid intake system resulted in cyclical increases and decreases in volume consumed on about a 10 day interval. At a higher dose (4.0 mEq/kg) a similar treatment led to death of the animals in 10 days. Both doses were associated with polyuria and weight loss. PMID- 6844741 TI - Alleviation of acetylsalicylic acid-induced fetal toxicity by calcium. AB - Alleviation of aspirin-induced fetotoxicity by calcium was investigated in rats. ASA (500 mg/kg s.c.) decreased the plasma Ca level in pregnant rats and that in the feto-placenta units. 0.05 M CaCl2 given to dams as tap water on days 8 through 20 of gestation inhibited ASA-induced hypocalcemic effect in maternal plasma. Tap water of 0.002-0.05 M CaCl2, Ca(OH)2 and Ca-lactate on days 8 through 20 of gestation alleviated malformations elicited by the administration of ASA (500 mg/kg s.c.) on the 11th day of gestation resulting in a decrease in the fetotoxicity in rats. PMID- 6844743 TI - The effects of indomethacin on systemic hemodynamics and blood flow in the conscious dog. AB - Systemic hemodynamics and blood flow were measured in conscious beagle dogs treated with the nonsteroidal antiinflammatory agent indomethacin. Twenty minutes after 2 mg/kg of indomethacin i.v., mean arterial blood pressure increased 5%, but cardiac output fell 24%, due to a decline in heart rate (-10%) and stroke volume (-18%). Small nonsignificant reductions in total bone, coronary, spleen, renal, and brain blood flow paralleled this fall in cardiac output. Larger, statistically significant reductions in arterial perfusion were seen in the skin (-30%), stomach (-47%), and small intestine (-27%). The corresponding 83, 101, and 38% increases in vascular resistance in these tissue beds largely accounted for the 41% increase in total peripheral resistance with indomethacin. Vascular resistance increased slightly in the vehicle control group due to reduced skeletal muscle blood flow seen in both treatment groups. Ovarian and thyroid blood flow also decreased with indomethacin. Indomethacin thus exerts a relatively specific vasoconstriction in the skin and upper gastrointestinal tract of the conscious dog. PMID- 6844744 TI - Reduced drug metabolism in isolated hepatocytes from adjuvant arthritic rats. AB - Viable hepatocytes were isolated from the livers of rats with adjuvant arthritis by the collagenase-perfusion method and measured for activities of drug metabolizing enzymes. These cells produced radioactive metabolites from 14C aminopyrine and 14C-aniline to a much lesser extent than the control hepatocytes that were derived from pair-fed normal rats. On the other hand, 14C-aminopyrine was scarcely metabolized by non-parenchymal cells other than hepatocytes, even when incubated with those from control rats. Although there were no significant differences in cell yield, viability and oxygen consumption, the cellular uptake of indocyanine green was significantly slower in the arthritic hepatocytes than the control hepatocytes. Morphologically, the freshly isolated arthritic hepatocytes demonstrated the disappearance of the microvilli, the appearance of bleb-like protrusions in the plasma membrane and the widespread distribution of the rough endoplasmic reticulum associated with a relatively decreased area of the smooth endoplasmic reticulum in the cytoplasma. Biochemically, these cells showed a significantly higher RNA/DNA ratio and an ability to incorporate 14C leucine into proteins more rapidly, as compared to the control hepatocytes. A possible relationship between the reduction of the drug metabolizing activity and the production of the acute phase proteins in rat hepatocytes after an inflammatory stimulus was discussed. PMID- 6844745 TI - Effect of liposome dose on the elimination of small unilamellar sphingomyelin/cholesterol vesicles from the circulation. AB - The effect of the liposome dose of bovine brain sphingomyelin/cholesterol (2/1; mol/mol) small unilamellar vesicles (mean diameter 187 42A) on the rate of elimination of the vesicles from the circulation of mice was investigated. The results of the study indicated that the relative rate of elimination of the vesicles from the blood depended on the amount of intravenously administered liposomal lipid. The distribution of the liposomes in vivo was followed by monitoring entrapped In-111. In all tissues examined, the uptake of the liposomes was a dose-dependent process. An examination of the dose dependency of the distribution of the administered liposomes in the blood and liver at 23 hours post-injection, and of the kinetics of the elimination of these vesicles from the blood, suggests a hepatic uptake process involving two parallel pathways. One pathway is apparently a capacity-limited Michaelis-Menten process; the other pathway is a linear, non-saturable process. These pathways operate in parallel but respectively dominate at the low end and the high end of the dose range examined. PMID- 6844746 TI - Platelet-activating factor and analogues: comparative studies with human neutrophils and rabbit platelets. AB - Platelet-activating factor and 12 structural analogues stimulated rabbit platelets to aggregate and release [14C]-serotonin. They likewise caused human neutrophils to aggregate, degranulate, and take up [3H]-deoxyglucose. Their respective potencies, which varied by 4-5 orders of magnitude, correlated highly (r greater than or equal to 0.93) in all assays. These compounds also selectively desensitized neutrophils to the degranulating actions of platelet-activating factor but not to C5a or a formylated oligopeptide. Three other analogues with structures quite similar to platelet-activating factor were unable to activate or desensitize the cells. Hence, the structure-activity relations of the analogues in several assays of platelet and neutrophil function were similar and they stimulated neutrophils by a common activation mechanism that differed from those used by C5a or formylated oligopeptides. These data are consistent with the notion that platelet-activating factor activates and desensitizes various target cells through stereospecific receptors. Apparently, these putative receptors on neutrophils and platelets have similar structural specificities for platelet activating factor and its analogues. PMID- 6844747 TI - Synthesis and anticonvulsive activity of a N-propylurea-ninhydrin condensation product in mice. PMID- 6844748 TI - Plasma levels of monocarboxylic short chain fatty acids in patients with diabetes mellitus, liver cirrhosis and thyroidal dysfunction. PMID- 6844749 TI - Absence of pH effect on creatine kinase leakage from mouse skeletal muscle. AB - Skeletal muscle enzyme leakage has been found to be independent of extracellular pH (6.6 - 8.2), changes in ionic strength, osmolarity, and the weight changes that occur during in vitro incubation. This is in contrast to the effect of pH and ionic strength on heart, and no change in heart weight, during incubation in similar media. These observations further emphasize the disparate responses of heart and skeletal muscle to changes in the extracellular environment. PMID- 6844750 TI - The effect of stirring of the luminal solution on the protection of the rat intestinal mucosa during ischemic injury. AB - Segments of rat ileum made ischemic for 15 min by occlusion of their mesenteric vessels were intraluminally perfused at slow and rapid rates with Krebs buffer containing O2, O2 + glucose or nitrogen. Mucosal leucine influx was measured at the end of the ischemic period. O2 and O2 with glucose provided protection against the ischemic injury, particularly when the stirring of the luminal solution was increased. Rapid perfusion in the absence of oxygen or glucose also protected the intestine probably by rinsing the ischemic gut of noxious agents. PMID- 6844751 TI - Differential catecholamine uptake inhibition as a possible mode of action of D amphetamine induced locomotor activity. AB - A determination was made of the roles played by the selective uptake inhibition versus release of dopamine (DA) or norepinephrine (NE) ex vivo in either the striatum or cerebral cortex in mediating d-amphetamine induced locomotor activity (AILA). Desmethylimipramine (DMI) and/or d-amphetamine variously effected the uptake of DA and NE in both regions in terms of the absolute amount of uptake inhibition elicited by each drug separately or by the two drugs administered concomitantly. However, none of the drug treatments produced a selective inhibition of DA or NE uptake in either the striatum or cerebral cortex. On the other hand, a selective inhibition of central DA release by gamma-hydroxybutyrate markedly inhibited AILA. These results suggest that amphetamine induced locomotor activity is not likely mediated by a preferential effect on DA or NE uptake. It is far more probable that AILA is induced by a stimulation of central DA release. PMID- 6844752 TI - Theory of resistive load detection. AB - During normal breathing the brain sets the required muscle pressure to overcome resistance and elastance and presumably monitors the resultant flow (rate of change of volume). The lag in flow compared to the pressure can be described by a phase angle. When a small resistive load is added the resultant flow is delayed further and the phase angle increases. We postulate that if the change in phase angle exceeds a critical phase lag, the added load is detected. Over a wide range of basal resistances, R, the mathematical analysis predicts that detection occurs if the just noticeable added resistance, delta R, is a constant fraction of the basal resistance. Resistive load detection thus obeys the Weber psychophysical law, delta R/R = constant. This is in accord with previous experimental observations. The theory also predicts that delta R/R increases at low basal resistance in accord with recent experimental observations. Further as yet untested predictions of the theory are that breathing frequency and elastance should affect the Weber relationship. PMID- 6844755 TI - Time-dependency and static mechanics of immature airways and saccules. AB - Immature rabbit lungs were inflated, then deflated from the fetal pulmonary fluid (FPF)-filled state. Stereomicroscopic observation and measurement of volume change (delta V) during each pressure step and after 15 and 120 sec at each pressure revealed the following: (1) Only airways inflate from atmospheric pressure (P0) to P25. Significant time-dependency here is due to FPF flow through the narrowest airways, airways dilation and recruitment as functions of tissue and surface forces, and, perhaps, interfacial adsorption of surfactants. (2) Saccular recruitment and distention are the principal transformations from P30 to P35. Time-dependency here is the result of FPF flow and labile bubble production. (3) Time-dependency during deflation from P25 to P10 is due to diminishing influence of inflation processes and to decreasing radii of curvature at air/liquid interfaces as FPF refills the saccular air-spaces. Redistribution of air and hypophase liquid probably also play a role. (4) Deflation from P10 to P0 is determined by FPF flow through the smallest airways, interfacial forces, and recoil of previously distended airways as liquid locks are formed. Some implications are that FPF flow through the smallest airways is a gate to saccular ventilation; time-dependent processes place airspaces at risk to rupture; and different time constants of saccules and airways renders 120 sec pressure steps adequate for evaluation of the latter but not the former. PMID- 6844757 TI - Bulbo-spinal respiratory effects originating from the splanchnic afferents. AB - Phrenic nerve responses to non-hypertensive stimulation of the visceral afferents originating from the pancreatico-duodenal area and running along the greater splanchnic nerve were studied on cats anaesthetized with sodium thiopentone, paralysed with gallamine and vagotomized. In these intact animals, a biphasic response, short activation followed by a long inhibition, was recorded in the phrenic nerve. In animals then spinalized between C1 and C2 this splanchnico phrenic reflex persisted. The latency of the first phase was unchanged, but its amplitude increased. In intact animals, the unitary activity of 16 inspiratory neurons and 10 expiratory neurons was recorded in the part of the medulla oblongata corresponding to the ventral respiratory group. Simultaneously the overall activity of the contralateral phrenic nerve was recorded. The stimulation of splanchnic afferents caused a long inhibition of the bulbar inspiratory neurons and an activation of the expiratory neurons. The latency of the bulbar inhibition was consistently less than the latency of the phrenic inhibition. The fact that this reflex effect persisted in spinal animals with an activation phase of the same latency proves that the bulbar centres and the phrenic motoneurons are independently connected to the splanchnic afferents. The possible functional significance of the reflex is discussed. PMID- 6844756 TI - Effect of breathing route on ventilation and ventilatory drive. AB - Nasal obstruction is associated with abnormal breathing during sleep. To investigate this we measured ventilation and isocapnic hypoxic and rebreathing hypercapnic ventilatory responses in 9 awake normal men, with and without artificial nasal occlusion. Resting breathing frequency was lower (P less than 0.05) with mouth (12.5 +/- 1.0 [SEM]) than with nose (15.1 +/- 1.3 b/min) breathing, due to prolongation (P less than 0.05) of expiratory time with mouth breathing (mouth 3.25 +/- 0.35, nasal breathing 2.41 +/- 0.37 sec). Resting tidal volume was similar for both routes, thus minute ventilation was lower (P less than 0.01) mouth breathing (8.43 +/- 0.44) compared with nose breathing (9.37 +/- 0.47 L/min). Ventilatory responses were greater with mouth than nose breathing both for hypercapnia (mouth 2.29 +/- 0.21, nose 1.58 +/- 0.18 L/min/mm Hg CO2; P less than 0.01) and for hypoxia (mouth 1.08 +/-0.16, nose 0.91 +/- 0.21 L/min/% SaO2; P = 0.10). In 6 subjects measurements were repeated before and after upper airway lignocaine anaesthesia, which abolished the differences in respiratory timing and drive between the breathing routes. It is suggested that there may be upper airway flow receptors which influence respiratory timing. PMID- 6844753 TI - Effect of ambient oxygen on organic phosphate concentrations in erythrocytes of the chick embryo. PMID- 6844754 TI - Comparison of total lung diffusion capacity and the membrane component of diffusion capacity as determined by physiologic and morphometric techniques. AB - Morphometric estimates of diffusion capacity have traditionally been calculated for oxygen (DLO2) while physiologic techniques have been used to determine diffusion capacity for carbon monoxide (DLCO). Morphometric estimates of DLCO and Dm were determined for carbon monoxide so that the results can be directly compared to those obtained using physiologic techniques. Multiple gas rebreathing techniques were used to measure total lung diffusion capacity (DLCO), membrane component of diffusion capacity (Dm) and pulmonary capillary blood volume (Vc) in five anesthetized dogs. After the rebreathing measurements were made, the lungs were inflation fixed with glutaraldehyde and subjected to morphometric analysis. The morphometric estimate of diffusion capacity was three times higher than the physiologic estimate. The major components of diffusion capacity, Dm and theta Vc were found to be of approximately equal size when measured physiologically (Dm = 34 and theta Vc = 27 ml X min-1 X mm Hg-1). In contrast, the morphometric estimate of Dm was about six times higher than the morphometric estimate of theta Vc. The widely different ratios of the two major subcomponents of the total lung diffusion capacity as measured by these two different techniques suggest that the same lung function is not being accurately measured by at least one of these two techniques. Differences in results for DLCO cannot be explained by differences in the physiologic state of the animal at the time the measurement was made. Morphometric analysis predicts that Vc is the major term affecting the value of DLCO whereas the physiologic techniques predict that both Dm and Vc contribute substantially to the value of DLCO. PMID- 6844758 TI - Respiratory responses to stimulation of branchial vagus nerve ganglia of a teleost fish. AB - The effects of electrical stimulation of epibranchial vagus ganglia upon respiration of the carp were investigated. Single shocks evoked fast twitch responses in a number of respiratory muscles with latencies around 18 msec to the beginning and 30-35 msec to the peak of activity. Shocks given during abduction decreased the respiratory cycle duration by shortening abduction and accelerating adduction. Stimuli given throughout most of adduction also shortened the respiratory cycle, accelerating the adduction only. These responses are similar to vagally mediated lung receptor reflexes of mammals. Stimulation with short trains of pulses produced a rapid expansion-contraction movement. This movement resembles in all respects (shape, time in the respiratory cycle, muscle coordination) the intermediate expansion of a normal coughing movement. Continual stimulation at frequencies close to the normal respiratory rate had a synchronising influence upon respiration, speeding up or slowing down its rate. HRP applied to the third vagal ganglion showed that there is a small projection of this ganglion to the nucleus intermedius facialis, although the majority of sensory fibres terminate in the vagal lobe. The nucleus intermedius facialis is already known to connect directly with the respiratory motor centres and thus might provide a pathway for the fast twitch response. A projection was also found to the nucleus ambiguus; in mammals this nucleus plays an important role in the regulation of respiratory movements. PMID- 6844759 TI - Slow to fast shift in inspiratory muscle fibers during heat tachypnea. AB - The firing patterns of single diaphragm fibers and electromyographic moving average (M.A.) of diaphragm and parasternal intercostal muscles (P.I.) were studied in rabbits during control and heat tachypnea at nearly constant tidal volume (VT). During tachypnea the percentage of single diaphragm fibers with relatively high values of peak firing rate (fp) increased. Conversely, fibers with relatively low values of fp at control (likely slow) showed little or no increase of this parameter during tachypnea. These findings, similar to those previously found in P.I., suggest a slow to fast shift in diaphragm fibers during tachypnea. Inspiratory flow at half VT control increased significantly during tachypnea, while the corresponding M.A. of diaphragm did not change. Moreover, during tachypnea mean inspiratory flow increased significantly, while the mean M.A. over inspiratory time did not change either in diaphragm or in P.I. Since during tachypnea the firing rate of most fibers is greater than at control, a lack of increase of M.A. in spite of an increased mechanical power confirms a shift from slow to fast inspiratory muscle fibers under this condition. PMID- 6844760 TI - Comparison of diffusion and perfusion limitations in alveolar gas exchange. PMID- 6844761 TI - Effects of exercise stress on acid-base balance and respiratory function in blood of the teleost Tinca tinca. AB - We measured the effects of severe, short-term exercise stress on the acid-base balance, the O2 transporting properties and the cofactors for O2 binding in the blood of tench, Tinca tinca. Short-term severe exercise resulted in a drastic decrease in arterial blood pH which is attributed to a mixed respiratory and metabolic acidosis. Concomitantly arterial PO2 rose in apparent compensation for the detrimental effects of the acidosis on O2 transport by the blood. PMID- 6844763 TI - Morphometrics of rapidly frozen goose lungs. AB - To understand the structural basis of avian gas exchange better, we made a morphometric study of domestic and Canada goose lungs. The volume of glutaraldehyde-fixed domestic goose lungs (30 cm3/kg body weight) was similar to that determined from silicone casts of Canada goose lungs by Duncker (33 cm3/kg). To examine finer structures, we rapidly froze goose lungs under physiologic conditions, fixed tissue samples by a freeze substitution procedure and analyzed samples with stereological methods. From light micrographs we determined that about 55% of the lung is parabronchi in both species. Volume densities of air capillaries, blood capillaries and tissue and surface:volume ratios of these same structures were determined from electron micrographs. Our measurements agree with those from glutaraldehyde-fixed Canada goose lungs from other laboratories. Gas exchange surface area was largest in the good flier (Canada goose) but both birds had larger surface areas than comparably sized mammals. The harmonic mean blood gas barrier thickness is smaller in both species of birds (0.3 microns) than in mammals. Thus, membrane diffusing capacities for gases should be larger in birds than in mammals. Pulmonary blood capillary transit time, as calculated from blood capillary volume and normal levels of cardiac output, are longer in birds than in mammals and should allow more time for blood-gas equilibrium. Pleats and folds were frequently observed in air and blood capillaries, suggesting that the avian lung may not be as rigid as was previously thought and that capillary volumes and surface areas may change under physiologic conditions. PMID- 6844762 TI - Branchial ion exchange and acid-base regulation after strenuous exercise in rainbow trout (Salmo gairdneri). AB - Specimens of rainbow trout (Salmo gairdneri) were electrically stimulated to exhausting activity in a closed water recirculation system and the changes in dorsal aortic plasma pH, PCO2, PO2, O2 content, [Na+], [Cl-], [K+], [Lactate-] and Ht were measured during a 24 h recovery period. Net transfer of H+, Na+, Cl- and ammonia between fish and environment were determined by measurement of the concentration changes in the recirculating water. Strenuous exercise resulted in a severe lactacidosis which was corrected by transient net transfer of H+ ions to the environmental water within 4 h, about 6-8 h before the lactate was metabolically removed. The net transfer of H+ ions was achieved in part by branchial HCO3-/Cl- ion exchanges, but to a larger extent by branchial exchange of H+ and/or NH4+ against Na+. The excretion of ammonia, which was considerably enhanced during the first 4 h after exercise, was at least partially due to non ionic diffusion across the gill epithelium. The observed elevation in ammonia excretion was probably the result of an exercise-induced increase in nitrogen metabolism rather than of production of ammonia for the purpose of acid-base regulation. PMID- 6844764 TI - Lobar blood flow, blood volume and water content in atelectasis. AB - In nine intact supine anesthetized dogs we measured pulmonary blood flow distribution, lobar hemoglobin content, and lobar wet wt/dry wt during left lower lobe collapse. The animals breathed a mixture of 88% O2/12% N2 and atelectasis was induced by occluding the left lower lobe bronchus. Lobar volume was assessed by measuring lobar N2 concentrations. Using the radioactive microsphere technique, perfusion distribution was measured at lobar volumes of 50% FRC and 18 25% FRC. Hemoglobin content and wet wt/dry wt were measured at the latter volume. At 50% FRC lobar blood flow was unchanged though lobar pressure was negative. At the lower volume lobar blood flow averaged 72% of that at FRC, and lobar hemoglobin content was similar to that of the right lower lobe, indicating that lobar blood volume was unchanged. Wet wt/dry wt was significantly less in collapsed left lower lobes than in control right lower lobes, perhaps indicating that pressure in fluid-exchanging vessels was less than interstitial pressure during atelectasis. PMID- 6844765 TI - Central respiratory drive and recruitment order of phrenic and inspiratory laryngeal motoneurones. AB - Central respiratory drive and recruitment order of phrenic motoneurones and inspiratory laryngeal motoneurones were studied in anaesthetized, paralyzed and artificially ventilated cats. Unitary activities of pairs of motoneurones originating from the same population were recorded on thin filaments. Differences of recruitment during inspiration enabled distinction to be made between early (E) and late (L) recruited motoneurones. 'On-line' cross-correlation analyses were performed on either homogeneous pairs (2E or 2L) or heterogeneous pairs (1E and 1L). In 14/30 pairs of phrenic motoneurones and 26/32 pairs of inspiratory laryngeal motoneurones cross-correlation analysis revealed a bell-shaped increase of probability of firing whose characteristics indicate synchronization by central shared excitatory inputs originating from central respiratory drive. For phrenic motoneurones synchronization appeared mainly in homogeneous pairs (2E:7/11; 2L:5/9) whereas motoneurones of heterogeneous pairs rarely shared the same central respiratory drive (2/10). For inspiratory laryngeal motoneurones, cases of synchronization were equally obtained in homogeneous (2E:8/10; 2L:14/16) and heterogeneous (4/6) pairs. These results suggest that differences of recruitment order during inspiration are related: (i) for phrenic motoneurones, partly to differences of excitability but mainly to a dual central respiratory drive which is assumed to divide the population into two components; (ii) for inspiratory laryngeal motoneurones to differences of excitability since all the motoneurones share the same drive. PMID- 6844766 TI - Comparison of activities of medullary respiratory neurons in eupnea and apneusis. AB - We evaluated patterns of antidromic latencies of medullary respiratory neurons in eupnea and apneusis to define how afferent influences from the pneumotaxic center regulate their activities. Apneusis was reversibly produced by cold block in decerebrate, vagotomized, paralyzed and ventilated cats. Most neurons, which discharged during all of eupneic inspiration or expiration, maintained the same pattern in apneusis. However, those active during only portions of these phases or spanning both changed markedly with alterations in periods of discharge, including tonic patterns or cessations of activity. Such marked changes were observed for activities of all laryngeal expiratory neurons. Upon termination of eupneic discharge, most bulbospinal and laryngeal neurons had transient peaks of latencies, indicating hyperpolarizations; declines from these peak values were greatly reduced in apneusis. Moreover, reflecting depolarizations, latencies of some inspiratory and expiratory neurons declined during eupneic expiration and inspiration, respectively; these declines were much reduced in apneusis. We conclude that the pneumotaxic center influences medullary respiratory neuronal activities not only at end-inspiration, but throughout the entire respiratory cycle. PMID- 6844767 TI - Ventilatory and occlusion-pressure responses to incremental-load exercise. AB - Mouth occlusion pressure (P0.1), minute ventilation (V), and mean inspiratory and expiratory flows were studied in eight normal subjects at rest and during exercise on a cycle ergometer, the load of which was increased in steps of 10 W every minute. All four variables rose curvilinearly as the load was increased from 0 to 200 W. The ratio of P0.1 to mean inspiratory flow, like the ratio P0.1/V, increased with work load in the range 40-200 W, indicating that P0.1 increased considerably faster than mean inspiratory flow and V at rates higher than about 0.7 L X sec-1 and 15 L X min-1, respectively. Evidence is presented that the progressive divergence of the P0.1 and ventilatory responses was a result of raised respiratory impedance consequent to increasing respiratory frequency and resistance, and that, concurrently, the respiratory drive as assessed by P0.1 was enhanced because of an active load-compensating response. In this way, the respiratory drive increased with work load in a self-adjusting fashion, compensating for the impedance-dependent alterations in ventilatory responses. We also conclude that in moderate and heavy exercise P0.1 is a more representative index of the respiratory drive than are V and mean inspiratory flow. PMID- 6844770 TI - [Immediate surgical outcome of a series of 117 cases of adenocarcinoma of the large intestine]. PMID- 6844768 TI - [Diagnosis of ventricular aneurysms by echocardiography]. PMID- 6844769 TI - [Pseudotumoral para-articular calcifications in chronic renal failure]. PMID- 6844771 TI - [Benign intracranial hypertension]. PMID- 6844772 TI - [Endoscopic injection of Teflon in the treatment of urinary stress incontinence in women]. PMID- 6844773 TI - [The HLA group and its importance in the pathology of adults and children. The HLA system]. PMID- 6844774 TI - [Genetics of the HLA system and major histocompatibility complex]. PMID- 6844775 TI - [Association between diseases and the HLA system]. PMID- 6844776 TI - [HLA antigens and transfusion]. PMID- 6844777 TI - [Role of the internist specializing in infectious diseases]. PMID- 6844778 TI - [A case of neurosarcoidosis]. PMID- 6844780 TI - [The Rorschach test in geriatrics]. PMID- 6844779 TI - [Demands of the nursing staff in a hospital milieu]. PMID- 6844781 TI - [Abdominal echography in geriatric practice]. PMID- 6844782 TI - [Stroke and Doppler diagnosis in a geriatric hospital]. PMID- 6844783 TI - [The demands of the patient]. PMID- 6844784 TI - [The work of grief in the hemiplegic patient receiving group psychotherapy]. PMID- 6844785 TI - [The geriatric hospital]. PMID- 6844787 TI - [Center for Continuing Care]. PMID- 6844788 TI - [The geriatrics center and the psycho-geriatric consultation]. PMID- 6844786 TI - [Goals and limits of partial hospitalization in geriatrics. 10 years of day-care hospitals]. PMID- 6844789 TI - [The value of the medical record]. PMID- 6844790 TI - [Demands of the family in geriatrics]. PMID- 6844791 TI - REM-NREM cycle in the cat may be sleep-dependent. AB - The periodicity of the rapid eye movement-nonrapid eye movement (REM-NREM) cycle in real time versus compressed sleep was determined by autocorrelation, computed on the sequence of sleep stages in recordings from spontaneously sleeping cats. The resulting autocorrelation function was correlated to damped cosine waves, and the highest squared correlation coefficient (r2) was taken as indicating the most likely periodicity in the data entered for each animal. The periodicity of REM sleep was stronger (significantly higher r2) in the compressed sleep data than in the real-time data, indicating sleep dependency of the REM-NREM cycle. The REM NREM cycle lengths determined by the autocorrelation technique were not significantly different for the real-time and compressed sleep data. The REM sleep episode interval, defined as the average interval between the start of successive REM sleep episodes, was significantly shorter for real-time sustained sleep than the cycle lengths as determined by the autocorrelation technique. A model is proposed which explains this phenomenon as due to fragmentation of REM sleep within the time periods with high probability for REM sleep. When such fragmentation occurs, the average REM sleep episode interval will not reflect an ultradian REM sleep periodicity. PMID- 6844792 TI - What is the moment of sleep onset for insomniacs? AB - Subjective estimates of sleep latency were compared with three EEG-assessed measures of sleep onset: (a) the traditional one, i.e., the first epoch that is scored as stage 2 sleep; (b) the beginning of the first 15 min of uninterrupted stage 2 sleep; and (c) the beginning of the first 30 min of uninterrupted stage 2 sleep. A total of 56 insomniacs and 10 good sleepers were studied for 3 nights each in the laboratory. The traditional measure of sleep latency agreed best with the subjective estimates of good sleepers. Most insomniacs, however, were best able to estimate their sleep latency when the 15-min criterion was used. We suggest that for most insomniacs the subjective experience of being asleep occurs later in the EEG-defined transition from waking to sleeping than it does for good sleepers. PMID- 6844793 TI - Sleep apnea: relationship to age, sex, and Alzheimer's dementia. AB - The relationship of sleep apnea to age, sex, and Alzheimer's dementia was investigated in 45 elderly subjects and 10 young males, all nonobese, normotensive, nonsmoking, with no sleep complaints and no medical problems other than Alzheimer's disease. Mean apnea/hypopnea index [(AH)I] was significantly greater in elderly males than in young males or elderly females. Mean (AH)I and percentage of subjects with an (AH)I greater than 5 in the Alzheimer groups were not significantly different from age and sex-matched controls. Results were similar when the apnea index was substituted for (AH)I. The data from this preliminary study indicate that healthy, elderly males with no sleep complaints and elderly males with Alzheimer's disease experience a significant, subclinical ventilatory impairment during sleep. Data from the 10 elderly females and 10 young males indicated no such impairment. The physiological significance of this degree of sleep apnea in otherwise healthy elderly males is unclear at present. PMID- 6844795 TI - Postprandial sleepiness: objective documentation via polysomnography. AB - Fifteen normal volunteers were evaluated to assess the effect of a meal on sleep onset latency. The meal was administered in a counterbalanced design on 1 of 2 successive days. Subjects napped 20 min subsequent to the meal (or at the corresponding time on the no-meal day) and 1 h after the initiation of the first nap. Ten subjects completed the Stanford Sleepiness Scale (SSS) on arriving at the laboratory, and just prior to nap 1 and nap 2. Sleep onset latency after the meal was not significantly different from that obtained under the no-meal condition, but was significantly less on nap 1 as compared with nap 2 irrespective of day or meal. SSS did not reveal subjective differences in sleepiness between the initial estimate and the postmeal estimate. Only five subjects showed a decrease in sleep onset latency postprandially (1-11 min). Although group differences in postprandial sleepiness were not documented, the phenomenon was clearly exhibited by certain individuals. Thus, postprandial sleepiness is not an invariable consequence of meal ingestion; rather, it appears to be affected by numerous variables such as hunger, volume of the meal, and meal constituents. PMID- 6844794 TI - REM sleep episodes during the maintenance of wakefulness test in patients with sleep apnea syndrome and patients with narcolepsy. AB - Twelve patients with sleep apnea, 12 narcoleptic patients, and 10 controls were given 20-min opportunities to remain awake while sitting comfortably. Test sessions were administered at 10:00, 12:00, 14:00, 16:00, and 18:00. Apneic and narcoleptic subjects were less capable of maintaining wakefulness than controls. Patients with sleep apnea had an average of 1.4 daytime rapid eye movement (REM) episodes with the peak incidence at 14:00. Narcoleptics also had sleep onset REM periods (mean of 2.7), whereas none of the controls had REM episodes during the daytime testing. Narcoleptic and control groups differed in the probability of REM occurring at each session. There were time-of-day differences in the probability of REM occurring between patient groups. The amount of stage REM the night preceding testing was unrelated to the occurrence of REM episodes during the day in either patient group. In addition, there were notable differences in the frequency of sleep onset REM periods when patients were sitting as opposed to being supine during nap studies. Sleep latency and frequency of REM episodes on the maintenance of wakefulness test were independent of the subject's age. The maintenance of wakefulness test proved unsatisfactory as a diagnostic procedure, but appeared useful as an adjunct procedure in the evaluation of treatment efficacy of hypersomnia. PMID- 6844796 TI - Exercise and sleep: body-heating effects. AB - Eight physically trained subjects underwent three experimental conditions on separate occasions between 1400 and 1800 h. Two conditions acted as controls for a high-intensity exercise (HI) condition of treadmill running at 80% VO2 max for a total of 80 min. The rate of body heating was modelled in a no-exercise passive heating condition (PH), and the total exercise load was replicated in a low intensity condition (LI) at 40% VO2 max for 160 min. LI produced no slow-wave sleep (SWS--stages 3 + 4 sleep) changes, but was the only condition to produce significant increases in sleep length and in non-rapid eye movement (REM) sleep (stages 1 + 2 + 3 + 4), and a significant decrease in sleep onset time. Although HI and PH produced similar SWS increases, these consisted of significant increases in stage 3 sleep for HI and in stage 4 sleep for PH. No REM sleep parameter was affected under any condition. Self-estimates of presleep tiredness produced no significant findings. It was concluded that a high and sustained rate of body heating for 1-2 h, particularly the inherent rapid rates of core temperature increase and of body dehydration, may trigger a SWS response, and that exercise may simply be a vehicle for these effects. PMID- 6844797 TI - Sleep problems in children and their relationship with early disturbances of the waking-sleeping rhythms. PMID- 6844798 TI - Sleep positions in the young adult and their relationship with the subjective quality of sleep. AB - The sleep characteristics and the body positions of eight good and eight poor sleepers were monitored in the laboratory for 2 consecutive nights preceded by 2 adaptation nights. Throughout the nights, sleep positions and sleep motility were monitored with a super-8 camera, and a new scoring method was used. Overall, the findings supported earlier observations regarding sleep positions and sleep motility. Interestingly, poor sleepers spent more time awake and had more awakenings than good sleepers. Consistently, poor sleepers spent more time on their backs with their heads straight. These results suggest that sleep positions constitute an important sleep variable and that they may be related to the quality of sleep. PMID- 6844799 TI - Reevaluation of the phenomena of the first night effect. AB - Thirty subjects, who were between the ages of 24 and 60 years and were free of sleep disorders, were evaluated for impotency by use of polysomnograms recorded over 2 consecutive nights. No statistical differences between the first and second nights' recordings were found in latency to rapid eye movement and stage 4 sleep, sleep efficiency, and movement time with or without awakening. No differences were noted in times spent in different sleep stages, nor between the first 3 h and the second 3 h of sleep across both nights of polysomnography. This confirms previous findings that questioned the efficacy of the first night effect. This study also emphasizes the need to compare sleep disorder patients with matched normal controls. PMID- 6844800 TI - Pilot pharmacokinetic study of brotizolam, a thienodiazepine hypnotic, using electron-capture gas-liquid chromatography. AB - Brotizolam, a thienodiazepine hypnotic, can be reliably and sensitively quantitated in human plasma using gas chromatography with electron-capture detection. After addition of an internal standard, samples are directly extracted into an organic solvent, evaporated, reconstituted, and chromatographed at 290 degrees C on a 1% OV-17 column. Sensitivity limits are 0.25 ng of brotizolam/ml of plasma. Six volunteers ingested single 0.25- and 0.5-mg doses of brotizolam on two occasions, and brotizolam concentrations were measured in plasma samples drawn during 24 h after each dose. Peak concentrations averaged 5.5 and 9.2 ng/ml at the two dose levels, and were always attained within 1.5 h after dosage. Elimination half-life averaged 4.4 h (range 2.6-6.9 h) and was independent of dose. Thus brotizolam is a rapidly absorbed hypnotic drug with a short elimination half-life. PMID- 6844801 TI - Spontaneous electrodermal activity during sleep in man: an intranight study. AB - This study was designed to examine the intranight evolution of spontaneous electrodermal activity (EDA). Eight paid volunteer male students were recorded for 3 complete nights (after a habituation night). The results show that: during the first sleep cycle, EDA is significantly lower than during the rest of the night; rapid eye movement sleep evolves in a particular manner, which emphasizes the specificity of this sleep stage; and there is no internight habituation effect. PMID- 6844802 TI - Group G streptococcal bacteremia: clinical study and review of the literature. AB - Patients with group G streptococcal bactermia represented 10.8% of those with beta-hemolytic streptococcal bacteremia and 0.3% of all those with bacteremia between 1970 and 1980 at Mayo Clinic-affiliated hospitals. The most frequent portal of entry was the skin, usually in cases with preexisting edema due to previous surgical removal, irradiation, or tumor infiltration of lymph nodes, or to chronic venous insufficiency. The majority of these patients had underlying hematologic malignancies or solid tumors. Clinical response to therapy with beta lactam antibiotics was rapid. PMID- 6844803 TI - Salmonella infections of the abdominal aorta. AB - Endovascular infection of the atherosclerotic aorta is a substantial risk in patients older than 50 years of age who have bacteremia due to Salmonella. Until recently, the resultant salmonella aortitis was uniformly fatal. Two patients who were cured are described, and the characteristics of 10 other reported long-term survivors are given. This recent improvement in prognosis may have been related to (1) earlier diagnosis, (2) improved surgical management (axillofemoral bypass graft), and/or (3) increased use of bactericidal antibiotics. A change in bacteriology (fewer infections due to Salmonella cholerae-suis) was also seen in the more recent cases. PMID- 6844804 TI - Infectious diseases update: 1982. Summary of a symposium. PMID- 6844805 TI - Recent developments in the management of anaerobic infections. AB - Anaerobic bacteria are recognized with increasing frequency as etiologic agents in a variety of infectious diseases. The pathogenic significance of these microbes is supported by experimental studies with animals, chemotherapeutic trials, and definition of specific virulence factors by microbial analysis. In vitro sensitivity tests show that many clinically significant anaerobic species are resistant to penicillin; susceptibility to an expanding array of alternative antimicrobial agents is quite variable. Nevertheless, clinical trials suggest that several antibiotic regimens are equally effective. These studies provide guidelines for empiric selection of agents, although in vitro studies or the unique properties of some drugs must be considered in occasional cases. Several commonly accepted tenets held in the past may now be challenged: some abscesses do not require surgical drainage; plasmids conferring resistance to clindamycin in Bacteroides fragilis appear prevalent in some institutions; clindamycin may be the preferred agent for treatment of serious anaerobic pulmonary infections; and metronidazole is the only new agent advocated for anaerobic infections that offers potential advantages over prior agents. PMID- 6844806 TI - Selective primary health care: strategies for control of disease in the developing world. IV. Measles. AB - Measles, a highly contagious viral disease, kills several hundred thousand infants and young children yearly. Essentially all children will become infected; at least 1% of those living in developing countries will die unless protected by immunization. In urban areas, peak incidence occurs in those younger than three years. The youngest and most undernourished children suffer the most severe complications and the highest risk of death. Diarrhea, malnutrition, pneumonia, and blindness associated with vitamin A deficiency are the worst complications. The infection is preventable by the timely administration of a potent vaccine. This endeavor requires a well-managed technical and administrative network that remains difficult to organize in many areas of the world. The vaccine is efficacious and has few adverse effects but must be provided to children during the short interval between loss of transplacentally acquired antibodies and the acquisition of natural infection. The improvements in heat stability of the vaccine increase the likelihood of providing potent vaccine, but a well-managed cold chain remains a prerequisite for any successful immunization program. Health education, improved management skills, publicity, and community support are all important factors for ultimately preventing the morbidity and mortality from this disease. PMID- 6844807 TI - Delayed-type hypersensitivity: probable role in the pathogenesis of dengue hemorrhagic fever/dengue shock syndrome. AB - The hypothesis presented proposes the involvement of a systemic form of a delayed type hypersensitivity reaction in the pathogenesis of dengue hemorrhagic fever/dengue shock syndrome. It envisages the activation of sensitized T lymphocytes during a secondary infection by viral antigen present on the surfaces of mononuclear phagocytic cells. These antigen-activated T cells then release a variety of biologically active chemical mediators (lymphokines), which then produce the symptoms of shock and hemorrhage seen in cases of dengue hemorrhagic fever/dengue shock syndrome. PMID- 6844810 TI - [Diabetic neuropathies]. PMID- 6844808 TI - Selection of antimicrobial agents for treatment of infections of the female genital tract. AB - Evaluation of the treatment of 501 patients with pelvic infections and a review of the literature indicate that prospects for clinical cure without surgical intervention are markedly better in women seen early in the course of infection than in those with well-established infections. Among hospitalized patients with early infections, treatment regimens of less than 10 days duration were successful. Traditional therapies (initial treatment with ampicillin, a first generation cephalosporin, or a combination of penicillin and aminoglycoside, penicillin and tetracycline, or a cephalosporin and an aminoglycoside, followed by clindamycin or chloramphenicol if the patient remained febrile) were compared with new antibiotic regimens (initial treatment with second- or third-generation cephalosporins). Among patients with an infected abortion, the results of treatment with traditional regimens were excellent. In patients with salpingo oophoritis, the immediate cure rates with second- and third-generation cephalosporins were better than those with traditional regimens, but the long term impact of these drugs on fallopian tube patency is not known. In women with postpartum endomyometritis following cesarean section, double-drug therapy with clindamycin and either gentamicin or ampicillin and single-drug therapy with a second- and third-generation cephalosporin were more effective than traditional therapy. PMID- 6844809 TI - [Intracranial metastasis of solid tumors in the adult]. PMID- 6844811 TI - [Visual evoked potentials. Their use in clinical neurology]. PMID- 6844812 TI - [Separation of the cerebral hemispheres]. PMID- 6844814 TI - [Development and normal structures of the kidney]. PMID- 6844813 TI - [How to interpret the electromyogram (in neuromuscular diseases)]. PMID- 6844815 TI - [Presenting signs of renal cancer]. PMID- 6844818 TI - [Nonsurgical treatment of renal cancer]. PMID- 6844817 TI - [Surgery of renal adenocarcinoma]. PMID- 6844816 TI - [Strategy for complementary tests in cancer of the kidney]. PMID- 6844819 TI - [Gram-negative hepatobiliary infections]. PMID- 6844822 TI - [Gram-negative septicemia and state of shock. Clinical study]. PMID- 6844820 TI - [Antibiotic therapy for severe gram-negative infections]. PMID- 6844821 TI - [Severe gram-negative infections. A bacteriologic and epidemiologic reminder]. PMID- 6844823 TI - [Pneumonia caused by Gram-negative bacilli]. PMID- 6844825 TI - [Treatment of tetanus]. PMID- 6844824 TI - [History, definition, classification and symptomatology of the adult respiratory distress syndrome]. PMID- 6844827 TI - [Electrification. Current data and management]. PMID- 6844828 TI - [Pharmacology of morphine and morphinomimetics]. PMID- 6844829 TI - [Morphine antagonists]. PMID- 6844830 TI - [Opiates in cardiology]. PMID- 6844826 TI - [Drowning: current data on treatment]. PMID- 6844831 TI - [Use of morphinomimetics in surgery]. PMID- 6844833 TI - [Fractures of the scaphoid]. PMID- 6844832 TI - [Examination and evaluation of an injuried hand]. PMID- 6844838 TI - [Injuries of the hand and fingers. Medico-legal repercussions]. PMID- 6844836 TI - [Sprains and dislocations of the fingers]. PMID- 6844834 TI - [Fractures of the metacarpus]. PMID- 6844837 TI - [Posttraumatic stiffness of the fingers and its rehabilitation]. PMID- 6844835 TI - [Closed fractures of the phalanges]. PMID- 6844840 TI - Lysosomal enzymes of neutrophils and lymphocytes in aged subjects. AB - The activity and intracellular localization of some main lysosomal enzymes such as: acid phosphatase (AP), beta-glucuronidase (GR) and N-acetyl-beta glucosaminidase (GS) in peripheral blood neutrophils and lymphocytes has been studied in a total group of 141 subjects of both sexes aged 18 to 90 years, divided into two age groups consisting of 81 younger controls aged 18 to 42 years and 60 older subjects aged 66 to 90 years. The most important finding concerning the neutrophil system was the decrease in the aged group of enzyme-positive cells not accompanied by alterations of AP and GR intracellular activity whereas the activity of GS was increased in older subjects. The lymphocytes of aged persons were characterized by lack of normal lysosomal granules and diffusion of AP, GR and GS within the cell cytoplasm. The authors discuss the above changes in the neutrophils and lymphocytes of aged persons within the overall present-day knowledge on ageing of the neutrophilic and lymphocytic series. PMID- 6844839 TI - Investigations upon the incidence of atmospheric fungi in the town of Craiova. AB - The present investigation was suggested by the fact that bronchial asthma (of all types) presents in Craiova and the district of Dolj a relatively increased incidence which may be correlated with certain findings concerning the incidence of atmospheric fungi in the houses and working places of asthmatic subjects. Petri dishes with Czapek medium were exposed monthly in the open air, in 17 houses of asthmatic subjects and in a large bakery unit. The prevalence of various types of fungi was observed on the culture media and a correlation could be made with the seasons. In the houses of asthmatics Penicillium was found to predominate and in certain months of the year Aspergillus as well, which may have a certain etiopathogenic role in bronchial asthma. In certain months Cladosporium and Alternaria also appeared. In the open air the number of colonies was smaller but the incidence was identical. In the bakery unit Penicillium was predominant in 3 out of 5 months, Aspergillus prevailling in all the other months of the year. Cladosporium and Alternaria were also rather frequent. Other fungi sometimes found in relatively large proportions (Mucor, Rhizopus, Verticillium) were not in themselves etiopathogenically involved in bronchial asthma. PMID- 6844841 TI - The effect of working environment contaminated with organic solvents on the activity of acid phosphatase in lymphocytes. AB - In 108 workers occupationally exposed to organic solvents containing benzene, toluene and xylene, the activity of acid phosphatase (AP) was determined in the peripheral blood lymphocytes. A positive correlation was found between the number of lymphocytes exhibiting redistribution of AP from lysosomes into the cytoplasm and the exposure time to the solvents. The cytochemical estimation of the lymphocyte AP activity might practically be used as a screening test for the early detection of the toxic effects of exposure to the above solvents. PMID- 6844842 TI - Defense of peace, defense of human life--a duty of the Romanian physicians. PMID- 6844843 TI - Disappearance of the pulmonary edema on chest films after short time temporary pacing for suddenly developed high degree AV block. PMID- 6844844 TI - Epilepsy induced by systemic penicillin associated with cobalt epileptogenic foci located in the posterior hypothalamus and dorsal hippocampus, respectively. PMID- 6844846 TI - Syntactic and semantic aspects of verb utilization in aphasics. PMID- 6844847 TI - Clinical validity of Eysenck Personality Questionnaire (Junior). PMID- 6844845 TI - Retention of orienting reaction habituation in patients with epileptogenic cerebral tumours. PMID- 6844849 TI - [The indications and results of treatment of children with chronic juvenile arthritis in a specialised centre]. AB - Thirty children were admitted to a specialised centre for rehabilitation for chronic juvenile arthritis. Ten of them stayed for one to three months usually during the school holidays to perfect the physiotherapy essential for the maintenance of a good functional state. Twenty were admitted for longer periods, because of more severe forms of the disease which could not be satisfactorily retrained at home. An overall functional improvement was obtained in the majority of cases; no child was in Steinbrocker's class III or IV on discharge from the centre. The most marked functional progress was observed during the first 6 or 12 months of rehabilitation. Conversely, the radiological lesions progressed in all joints. However, the hip has the potential for definite radiological recovery, seen in 3 out of 10 cases in this small series. The authors believe that, even in severe forms of chronic juvenile arthritis, the possibility of stabilisation does exist and that everything should be done to give these children the best chances of as good a functional improvement as possible. PMID- 6844850 TI - [Stenosis of the lumbar canal: nosologic and semeiologic study. 163 operated cases]. AB - The authors report a retrospective study of 163 cases of degenerative or constitutional stenosis of the lumbar canal. In this series, the most frequent cause was osteoarthrosis and constitutional stenoses were relatively rare. The authors note that this is often a difficult aetiological distinction to make, especially in elderly patients and the anatomical deformities caused by osteoarthrosis lead to stenosis of the canal similar to that seen in constitutional malformations. Sensori-motor claudication is inconstant and was only found in one third of the cases in this series. More often, the lumbar stenosis presents as nerve root pain. It can be distinguished from root disease of disc origin by the frequent absence of Lasegue's sign and of spinal stiffness. When a herniated disc is associated with a stenosis, the clinical picture is altered and can then resemble that of disc sciatica. The diagnosis of stenosis depends on the radiological examination. This series confirms the diagnostic value of the abnormalities seen on standard X-rays, but the severity and the extent of the stenosis can only be assessed by performing tomography, water soluble contrast myelography and C.T. scan. The authors discuss the limitations and degree of reliability of each of these investigations. The extent of the surgical decompression depends on the severity of the symptoms and on the results of this radiological survey. PMID- 6844848 TI - [Bone and phosphoro-calcium metabolism in reflex sympathetic dystrophy]. AB - A combined study organised by the French Society of Rheumatology was devoted to the investigation of bone and phosphoro-calcium metabolism in cases of reflex sympathetic dystrophy. The following observations were made: the usual phosphoro calcium parameters are not altered, apart from a slight elevation of the urinary calcium in multifocal forms of the disease, during the 3rd and 4th months; the level of PTH, studied in 11 patients, was normal in each case; the examination of 8 bone biopsies, one performed in the 7th week and six others performed during the 3rd and 4th months of the disease, showed, initially, invasion of the spongy tissue by oedema, signs of marrow stress and bone stress, with a reduction in the number of osteoblasts, without any marked alteration of bone remodelling. At a later stage, the biopsy shows intense bone remodelling with hyperosteoclastosis and hyperosteoblastosis and the formation of irregular bone tissue which later becomes lamellar. Electron microscopic study of two biopsies revealed signs of acellular demineralisation with normal appearance of the osteoblasts and osteoclasts. PMID- 6844851 TI - [The surgical treatment of lumbar stenosis and its results. A series of 163 operated cases]. AB - 163 patients were operated for degenerative lumbar stenosis (only 10 did not have osteoarthrosis), following the failure of medical treatment. The surgical decompression varied according to the anatomical type of the stenosis: central, lateral or mixed. In 13 p. cent of cases, it was followed by an arthrodesis. There were no deaths. The most frequent complications were: haematoma (6 p. cent), infection (5 p. cent), aggravation of the neurological disturbance (3 cases), breeches in the dura, practically inevitable in very tight stenosis (13 p. cent) and epidural fibrosis (4 re-operations). When there is no sliding prior to the operation, the risk of aggravation or appearance of sliding in cases of spondylolisthesis is somewhat higher (6 cases out of 64). The different symptoms are unequally improved by the decompression: root pain is the best relieved (69 p. cent cure, 20 p. cent improvement) together with intermittent claudication (75 p. cent cure, 14 p. cent improvement) and, to a lesser degree, back pain (48 p. cent cure, 32 p. cent improvement). There is a possibility of recovery even in the severe forms of motor disturbance. PMID- 6844852 TI - [Vitamin A and ankylosing vertebral hyperostosis]. PMID- 6844853 TI - [Isolated hypercalcemia as a sign of sarcoidosis. One case with raised 1,25 dihydroxycalciferol]. PMID- 6844854 TI - [Eosinophilic fasciitis. Description of one case with Sjogrens syndrome and carpal tunnel syndrome]. PMID- 6844855 TI - [Aseptic meningitis and acute renal failure induced by ibuprofen during the treatment of systemic lupus erythematosus]. PMID- 6844856 TI - [Tuberculous multifocal vertebral osteo-condensation with syndesmophytosis. The value of C. T. scan]. PMID- 6844857 TI - The influence of thiol derivatives on synthesis of thyroid hormones in human thyroid cultured cells. AB - The experiments were carried out on 26 lots of thyroid cell cultures treated with sodium sulphate, lithium sulphate, lithium carbonate, cystine, cysteine, and methionine, in 2 doses each, in the presence or absence of iodine in the culture medium. The monolayer culture was used in morphologic, cytochemical and cytoenzymatic studies, and the culture medium was used for assay of thyroglobulin and thyroxin. We found that addition of aminoacids with SH or S--S groups to the culture medium causes stimulation of protein synthesis overstrain on the oxydases system at the expense of dehydrogenases. Stimulation of protein synthesis in the thyroid cell cultures under study is not accompanied by a corresponding hormonal secretory activity, the process of hormonal biosynthesis being inhibited as compared to the control culture. PMID- 6844858 TI - Xeroscintigraphy of thyroid gland in 56 patients submitted to thyroidectomy. AB - The authors present a new method for xeroscintigraphic diagnosis in thyroid pathology. It consists of an exploration method by associating 2 kinds of radiations: X-rays and radioactive isotopes. The graphic peculiarities of these methods in obtaining the radiographic image on the semiconductor plate and its transfer onto special paper (instead of film which contains Ag) condition a very good presentation of bones, trachea, soft tissues in the cervical and cervico endothoracic area. Front and side view cervical xerogram allows a correlation between an altered or enlarged thyroid gland with the organs and tissues in its neighbourhood, the pre- and retrotracheal spaces (intervertebro-tracheal) and others, including thyroid alterations with endothoracic localization. The possibility of recording scintigraphically (by an overlapping method) the state of functionality of the thyroid on a xeroradiogram and not on conventional paper (thyreoxeroscintigraphy) defines thyroid xeroscintigraphy as an important achievement in investigating the thyroid gland, a method of choice in preoperative exploration, producing a concomitant image of morphology, functional status and anatomotopography of the thyroid. PMID- 6844859 TI - Receptivity disorders in gonadal dysgeneses. i. Klinefelter's syndrome. AB - Long-term variation (21-30 days) in the gonadotropic hormones level and testosterone was followed up in Klinefelter's syndrome (chromatine positive). Clinically, the authors followed up the development of the androgen-dependent target tissues before and after administration of 400 mg testosterone/month for 6 months. It was also found a fluctuation in the gonadotropic hormones secretion on a 21-30-day trial which differs from that of the normal adult male. We noticed a great variability of the androgen-dependent structures development in one and the same subject or in different subjects, and a low response to the action of big and prolonged doses of testosterone. The authors interpret these findings as a decrease in the sensitivity of the androgen-dependent target structures (hypothalamus and peripheral tissues) induced genetically and fundamenting the concept of the existence of a receptivity pathology. PMID- 6844860 TI - Psycho-social and therapeutic implications in a late diagnosed intersexuality. PMID- 6844861 TI - Some thoughts on the genetic risks of a possible nuclear war. PMID- 6844862 TI - Laser interferometer for measuring microwave-induced motion in eye lenses in vitro. PMID- 6844863 TI - [Statistical evaluation of the levels of thyroid stimulating hormone, thyroxine and triiodothyronine of the serum in control and obese subjects]. PMID- 6844864 TI - [Suicidal behavior and paranoid conditions]. PMID- 6844865 TI - [An uncommon type of exudative-constrictive pericarditis and problems in its surgical treatment]. PMID- 6844866 TI - Will contralateral white noise interfere with the monaurally click-evoked brainstem response? AB - Monaurally evoked (and ipsilaterally recorded) ABRs to clicks at 70 dB nHL in the presence of contralateral masking by white noise at 60, 70, 80 and 90 dB HL were compared with the corresponding ABRs without contralateral masking. The investigation was performed in 11 normal, young female subjects. There were no differences concerning wave shape and relative amplitudes, except slight changes in one subject. The following latency findings concern group statistics. The latency of wave I did not change significantly with contralateral noise at any one of the four levels. The latency of wave III was significantly prolonged only at the noise level of 90 dB HL. The latency of wave V was significantly increased at the noise levels of 80 and 90 dB HL. The average latency prolongations were on the order of 0.05 ms. The findings suggest the latency increments to be attributable to central masking rather than to acoustic crossover or stapedius reflex elicitation. Contralateral white noise levels below 80 dB HL would not seem to affect the ABR to clicks above 65 dB nHL. PMID- 6844867 TI - Evoked acoustic emissions from the human ear. III. Findings in neonates. AB - Stimulated acoustic emissions were recorded in a consecutive series of 20 full term and otherwise normal neonates with the equipment and method previously used in adults. One ear randomly chosen was tested in each baby, and otoscopy and tympanometry were normal in all ears. A 2 kHz click stimulus was presented with a repetition rate of 10/sec and the recordings were performed at three intensities, i.e. 70, 50 and -20 dBatt (dBatt approximately dB p.e. SPL). The 50 dB recording was repeated for check of reproducibility. A clear and reproducible response could be identified from all ears at 50 dBatt. However, as in the adults, the response pattern differed significantly from one ear to another, both regarding the number of 'echoes', their latencies, response amplitudes, and frequency content. The 'echo' group latencies and amplitudes were within the same range as in normal adults and the amplitude input-output curves exhibited a clear non linearity. The relationship between latency and frequency was just as ambiguous as in the adults. Also, in the neonates, the cross correlation analysis proved to be an efficient method to indicate whether or not a true response was present. The results from this investigation are compared with those described in the literature from other audiological tests and it is concluded that the recording of the stimulated acoustic emissions could be applicable as a screening procedure in newborns. PMID- 6844868 TI - A search for the most suitable imminent components and probe tone frequency in tympanometry. AB - The relative occurrence of bell-shaped and various types of W-shaped susceptance conductance and admittance-phase tympanograms at a probe-tone frequency of 660 Hz was determined from registrations on normal ears. The diagnostic value of the susceptance-conductance versus the admittance-phase representation of tympanograms was studied on pathological middle-ear systems. Using probe-tone frequencies from 510 Hz up to 910 Hz, tympanograms for all four imminent components were recorded on 10 pathological ears and the diagnostic value compared. From the combination of these studies we conclude that the admittance phase approach at a probe tone frequency between 500 and 700 Hz is a good choice. PMID- 6844869 TI - Stapedius reflex test, brainstem audiometry and opto-vestibular tests in diagnosis of acoustic neurinomas. A comparison of test sensitivity in patients with moderate hearing loss. AB - The stapedius reflex test, brainstem audiometry and the opto-vestibular tests for identifying acoustic neurinomas (AN) were evaluated and compared in a study of 21 patients with radiologically or surgically verified AN and a pure tone average not exceeding 60 dB HL. The stapedius reflex test results were interpreted according to the criteria developed at this clinic. The stimuli for the auditory brainstem response (ABR) were 2 kHz haversine waves and 4 kHz square waves. The vestibular examination consisted of a caloric test and the recording of eye tracking and gaze nystagmus. In the cases studied the stapedius reflex test gave 1 false-negative result and ABR none. The ENG gave 3 false-negatives whereas the results of speech discrimination tests were misleading in no fewer than 1/3 of the cases. The results of the different tests were directly correlated but correlation coefficients did not exceed 0.65. Tumours larger than 15-20 mm showed a different test pattern than those below that size: stapedius reflex response, ABR and caloric response were eliminated and all of these patients had abnormal optomotor function. It is suggested that an optimal routine test procedure should consist of a pure tone audiogram, supplemented by ABR or the stapedius reflex test. Opto-vestibular tests may be of value in a preliminary estimation of tumour size. PMID- 6844870 TI - Auditory brainstem response in neonates during the first 48 hours after birth. AB - Auditory brainstem response (ABR) has been recorded in 20 neonates at three different time intervals during the first 48 hours after birth. The first recording was performed about 15 min after delivery, when the babies were in their first period of postnatal reactivity. During this period, we were unable to obtain reliable ABR data. During the second and third ABR test performed 2 and 48 hours after birth the babies revealed gradually better responses. Data from these recordings suggest no significant change in middle ear function during the time interval between 2 and 48 hours after birth. Observations of amplitude ratio wave V/wave I are presented. Finally, reservations regarding the interpretation of the results are discussed. PMID- 6844871 TI - The acoustic reflex threshold in relation to noise-induced hearing loss. AB - In 100 consecutive cases with severe noise-induced hearing loss, pure-tone threshold measurements revealed symmetric hearing losses with maximum shifts at 4000 and 6000 Hz. Acoustic reflex measurements showed that few patients had an elevated pathologic reflex threshold. In contrast, we found a depressed acoustic reflex sensation level (i.e., the difference, in decibels, between pure-tone threshold and acoustic reflex threshold) suggesting a cochlear localization of the injury. Consequently, the probability of retro-cochlear involvement was small, or the cochlear component dominated the retro-cochlear one. The relation between the absence of the acoustic reflex and the degree of hearing loss showed that even at a pure-tone threshold of 80 dB HL, 50% of the ears still had an elicitable acoustic reflex. Statistical analysis yielded a significant correlation between acoustic reflex sensation level and speech discrimination, but no such correlation between acoustic reflex threshold and speech discrimination. We suggest that acoustic reflex sensation level should be a complement to the acoustic reflex threshold in order to distinguish between different localizations of sensorineural hearing losses. PMID- 6844872 TI - Predictive value of directional sensitivity diagrams of hearing aids for word discrimination in noise. AB - In an anechoic room the directional characteristics of 17 different hearing aids were evaluated using KEMAR. Word discrimination scores in the presence of speech like masking noise--a reliable parameter for the performance of a hearing aid- were compared with the directional sensitivity of the hearing aid under study for different signals. The directional characteristics of a hearing aid have the best predictive value for word discrimination scores in the presence of masking noise if this masking noise is used to measure these characteristics. PMID- 6844873 TI - Speechreading performance evaluated by means of TV and real-life presentation. A comparison between a normally hearing, moderately and profoundly hearing-impaired group. AB - The present study investigated speechreading performance as a function of TV versus real-life presentation. List length and type of material was also manipulated as well as degree of hearing handicap: normally hearing subjects, moderately impaired subjects and profoundly hearing-impaired subjects. The results showed that type of group and presentation medium interact. The impaired groups perform worst on 4-item lists with TV presentation, while a real life presentation facilitates performance of those groups relative to the normal group. The groups were, on a post hoc basis, divided into one superior and one inferior subgroup. The results of this analysis showed that this skill factor interacts in several ways with type of medium for presentation and type of material, the 4-item list provoking a larger number of interactions than the longer 7-item lists. Hence, it was concluded that the memory factor imposed by longer lists and the skill factor constitute two basic factors that must be taken into account in the evaluation and training of speechreading performance. PMID- 6844874 TI - Piezoelectric earphones for artefact-free recording of auditory brainstem responses (ABR). PMID- 6844876 TI - Benzylpenicillin penetration into CSF after different routes of administration in rabbits. PMID- 6844875 TI - Cytochemical analysis of human peripheral blood lymphocyte subsets defined by monoclonal antibodies. AB - Human blood lymphocyte subpopulations, revealed by a panel of commercially available monoclonal antibodies by means of a rosetting technique, were submitted to direct cytochemical analysis and were shown to have distinguishing characteristics. T cells reactive with OKT3 antibody (T3+) displayed higher beta glucuronidase and dot-like alpha-naphthyl acetate acid esterase (ANAE) activity than T3- cells. Helper/inducer cells (T4+) were characterized by a high level of dot-like ANAE activity, whereas cytotoxic/suppressor cells (T8+) displayed selective naphthol-ASD-chloroacetate esterase activity. These results provide evidence for association of some cytoplasmic enzyme activities with the expression of membrane differentiation markers defined by monoclonal antibodies. PMID- 6844877 TI - Legionnaires' disease: unusual presentation with pneumothorax. PMID- 6844878 TI - An outbreak of Legionnaires' disease in Sweden: report of sixty-eight cases. AB - From August 27 to September 21, 1979, 58 patients fell ill with Legionnaires' disease (LD) in the town Vasteras, Sweden. All patients had been staying in the town some time during 2 weeks preceding their illness, as had 10 LD patients who fell ill from mid-June to mid-August the same year. Clinically, high fever, headache, dizziness and gastrointestinal symptoms were dominating. Respiratory symptoms were moderate, radiologically verified pneumonia was seen in 59 of 64 patients examined. One patient died. The diagnosis was verified by serology, using the IFL method, in all cases. Legionella pneumophila serogroup 1 was isolated from a closed lung biopsy from 3 patients. Isolates of identical strains were made from the cooling tower on the roof of an indoor shopping centre in Vasteras, visited by 57 of the patients during the incubation period. PMID- 6844882 TI - Multivariate statistics and meaning in the study of psychopathology. AB - A recent article dealing with Schneiderian first-rank symptoms illustrates a frequent occurrence: the use of sophisticated statistical data analysis without clear concepts of either psychopathology or statistics. The purpose of this article is to present some guidelines for the interpretation of multivariate statistics and to increase sensitivity to the importance of integrating underlying clinical concepts with statistical data analysis. PMID- 6844879 TI - Elevated creatine phosphokinase levels associated with influenza A/Texas/1/77 infection. AB - 24 patients admitted to hospital between December 1, 1977 and March 3, 1978 with cultural or serological evidence of influenza A infection were retrospectively analyzed for evidence of elevated creatine phosphokinase (CPK) levels. 14 patients had elevated CPK levels not attributable to usual causes. Muscle biopsies from 2 patients showed focal necrosis and myopathic changes. Influenza A/Texas/1/77 was isolated from the biopsy specimen of 1 patient. Patients with elevated CPK levels tended to have greater per day hospital costs and more complications than patients with normal CPK levels. Elevated CPK levels are relatively common in hospitalized patients with influenza and may be due to influenza virus involvement of skeletal muscle. PMID- 6844881 TI - Septicemia due to Mycoplasma hominis. AB - Mycoplasma hominis was recovered from the blood of 7 patients with various underlying disorders. One patient had a legal abortion, another a Caesarian section, both followed by septicemia. Three patients had genital infections in pregnancy, followed by septicemia and spontaneous abortion. M. hominis was also recovered from cervix and urethra in 2 of these women. High serum antibody levels against M. hominis were demonstrated in 3 women. One female developed septicemia after cancer surgery, one male after heart surgery. In the first 6 patients described the septicemia was of short duration and self-limiting, in the 7th patient it was of long duration and appropriate antimicrobial treatment was required. From this patient M. hominis was also isolated from infected operation wounds. PMID- 6844880 TI - Acute purulent arthritis in children. AB - Acute purulent arthritis (APA) in children is a rare disease. A series comprising 25 children with APA seen in 1960-79 was analysed with regard to clinical problems of diagnosis and treatment. The sex ratio of boys to girls was 2.5:1. The knee joint was most commonly affected (76% of the cases). The other joints affected were the hip (16%), ankle (4%), and elbow (4%), 56% of the patients were 1-2 yr old at the onset of the disease. A bacterial etiology was established in 44% of cases; a positive culture in 36%. Staphylococcus aureus, Haemophilus influenzae, streptococci, and pneumococci were isolated. All but 2 patients received antimicrobial therapy; the duration of therapy averaged 35 days. Seven patients were treated operatively. The usual procedure was arthrotomy, and closed irrigation was performed in 2 cases only. The end result was good in all cases. There were no fatalities. PMID- 6844883 TI - Psychiatric chronicity and diagnosis. AB - The relationship between psychiatric chronicity and schizophrenia in the postacute phase was examined by comparing posthospitalized chronic schizophrenics and chronic nonschizophrenics on symptoms, social functioning, and recidivism. No differences were found between the groups on any of these variables, indicating a general similarity of clinical picture for chronic schizophrenics and chronic nonschizophrenics in the postacute phase. These results were contrasted with two other comparisons made irrespective of diagnosis: (1) Patients with better social functioning were compared to patients performing less well socially; (2) patients living with others were compared with patients living in isolated settings. In both these comparisons, significant differences in the clinical picture were found between the two groups. Thus, living situation and degree of social functioning both appear to have more relevance for the postacute phase than does diagnosis. These results were related to the genetic and outcome literature on chronic psychiatric disorder to advance the view that the diagnosis of chronicity is more crucial for the understanding of severe emotional disorders than the traditional symptom-based DSM-III classification system. PMID- 6844885 TI - Cerebral laterality and psychopathology: a review of dichotic listening studies. AB - Studies using dichotic listening tasks have reported findings suggestive of alterations of cerebral laterality in schizophrenia and affective disorders. In a review of these findings, an effort was made to take into account four factors: (1) type of dichotic listening task; (2) performance level; (3) clinical state of patients at the time of testing; (4) diagnostic subtype of patients. A convergence of evidence indicates that the last two factors are of major importance. Several studies have found a relationship between clinical state and dichotic ear asymmetry. Greater severity of illness in schizophrenic and depressed patients is associated with reduced laterality, and clinical remission is accompanied by a normalization of laterality. While thie relationship appears to hold for both verbal and nonverbal dichotic tasks in depressed patients, that is not the case for schizophrenic patients. Studies have also reported evidence of differences in dichotic ear asymmetry between diagnostic subtypes of schizophrenia (i.e., paranoid vs. nonparanoid patients) and affective disorders (i.e., bipolar vs. unipolar patients). This evidence suggests the existence of homogeneous subgroups with distinctive laterality patterns and clinical characteristics. PMID- 6844886 TI - Smooth pursuit eye movements in psychopathology. AB - Reports of disrupted pursuit eye movements in schizophrenic patients are traced historically. Most of these reports emphasize the specificity for schizophrenia, although such specificity has yet to be demonstrated. There is sufficient evidence to conclude that, in the absence of neurological disease, the stable appearance of tracking dysfunctions is genetically transmitted, although their precise relationship to schizophrenia has yet to be decided. The study of this phenomenon can help elucidate several murky areas of psychopathology, including problems of heterogeneity, the central nervous system processes possibly involved, the study of risk populations, and the nonmotivational aspects of schizophrenia. PMID- 6844884 TI - Eye movement dysfunctions in psychiatric patients: a review. AB - Impairments of smooth pursuit eye movements occur in a high proportion of schizophrenic patients and in a lower but significant percentage of patients with affective psychoses, as well as patients with structural and metabolic disorders of the central nervous system. These findings have been confirmed using a wide range of tracking tasks, recording techniques, and scoring procedures, and therefore cannot be attributed to measurement artifact. The eye movement disruption in schizophrenics does not seem to result from drug treatment or simple inattention. Eye tracking pattern appears to be under genetic control and some impairments may reflect a predisposition to functional psychosis. The smooth pursuit eye movement impairment has been attributed to a central nervous system dysfunction that manifests itself in a disorder of nonvoluntary attention. The study of other oculomotor functions, such as the oculocephalic reflex, optokinetic and vestibular nystagmus, and saccadic eye movements, suggests that the locus of the central nervous system disruption is above the brainstem. PMID- 6844887 TI - Smooth pursuit impairment in schizophrenia--what does it mean? AB - The significance and nature of smooth pursuit impairments in schizophrenia are considered. Studies of potential artifacts show that the phenomenon is not due to medications, age, inattention, or poor motivation. Abnormal pursuit eye movements in schizophrenics consist of intrusive saccades which are present during any visually guided slow eye movements, and in some patients are related to nonvoluntary attention. These results rule out a generalized motor or oculumotor dysfunction, as well as a specific pursuit system dysfunction. The findings are consistent with a cortical dysfunction which results in saccadic disinhibition. Questions are raised for future research. PMID- 6844889 TI - Is eye tracking dysfunction specific to schizophrenia? AB - Based on eye tracking studies in psychiatric patients, normal controls, and first degree relatives of patients, Holzman, Proctor, and Levy et al. (1974) state that eye tracking dysfunction (ETD) is specific to schizophrenia and may be a genetic marker of that disorder. A review of numerous subsequent studies, however, suggests that ETD is not specific to schizophrenia, but is restricted to functional psychosis. Evidence that ETD is a genetic marker of functional psychosis is, as yet, inconclusive. PMID- 6844888 TI - The assessment of smooth tracking dysfunction. AB - The two main techniques for recording eye movements, electro-oculography (EOG) and infrared reflection (IR), are discussed and compared. Methods of quantifying eye movement dysfunction are also reviewed and contrasted. It is concluded that EOG and IR recordings both contain information not present in the other and that both methods will continue to be useful. Similarly, although the root-mean-square (RMS) and the signal-to-noise ratio (S/N) indices are algebraic functions of one another, the function is not linear and one or the other may be more appropriate to a particular application. PMID- 6844890 TI - Abnormal patterns of normal eye movements in schizophrenia. AB - The multilevel control of eye movements for the researcher in the schizophrenic disease process includes the saccadic trajectory, the dual mode tracking system, and schematically directed eye movements in fixation, in scanpaths, and other looking strategies, and in reading. Coordination of eye movements with head movement in gaze and sensory consequences and concomitants of eye movements round out the picture. Recent studies with precise bioengineering instrumentation have defined two abnormal patterns of eye movements--saccadic intrusions and saccadic "smooth" pursuit. Although these signs are not pathognomonic, they raise interesting questions concerning the relationship of these eye movements to the schizophrenic disease process. PMID- 6844891 TI - What is schizophrenia? AB - One of the main questions related to schizophrenia is, naturally enough, what is it? Such a question may seem obvious, naive, impossible, or any combination of these. And certainly it is a bit demanding to expect that anyone could say what schizophrenia is in 1,000 words. On the other hand, we felt that it was worth the effort. We hope that presenting these brief discussions on "what is schizophrenia" by persons who have worked extensively in the field will allow the reader to note areas of overlap and disagreement as well as variations in emphasis. Although no one may yet be able to provide the definitive answer, at least this collection of informed opinions may help clarify the major questions. The essays by John S. Strauss and William T. Carpenter, Jr. are the third in this series. Further collections of these statements will be presented in subsequent issues. Readers' responses and comments are cordially invited. PMID- 6844892 TI - Recovery from schizophrenia: a review of patterns of psychosis. AB - The literature describing symptomatic recovery in schizophrenic psychosis is reviewed. The dimensional and categorical models which have been used in this context are examined separately, and the phenomena of postpsychotic depression and style of recovery are also discussed. A model is then suggested in which the process of recovery is related to five dimensions of psychopathology. Such a model may be of use in efficiently describing the short-term course of psychosis in which symptom patterns or states, having relevance for clinical practice and research, could be defined. PMID- 6844894 TI - [Coincidence of peptic lesions in the upper gastrointestinal tract]. AB - In 3935 patients who underwent upper fiberpanendoscopy in two Zurich hospitals the coincidence of different active peptide lesions has been investigated. There was an association of reflux esophagitis and duodenal ulcer in old age: in patients with reflux esophagitis aged over 60 years, duodenal ulcer was found twice as often as in elderly patients without esophagitis. No association of reflux esophagitis and gastric ulcer or of gastric ulcer and duodenal ulcer was observed. PMID- 6844893 TI - [Malignant mesothelioma and asbestos]. AB - Malignant mesothelioma is a rare neoplasm of rapidly lethal course arising primarily in the pleura and less often in the peritoneum. In the majority of cases the disease is closely related to occupational exposure to asbestos. The latency period, calculated from the first contact with asbestos to the appearance of mesothelioma, is generally in the order of 20 years or more irrespective of the duration of exposure. A causal relationship can be established with certainty only by a careful history and positive tissue analysis for the presence of asbestos. The author's own series of 48 pleural mesotheliomas comprises 39 cases involving occupational exposure to asbestos, 6 others with asbestos demonstrable in pulmonary tissue but no discernible source in the history, and 3 where no relation to asbestos could be established at all. Although a dose-response relation may be assumed for asbestos as for all other carcinogens, the lack of data on asbestos dust concentrations at former places of work rendered determination of the minimal noxious dose difficult or impossible. It also remains unclear whether the various asbestos types, such as chrysotile and amphiboles, differ in pathogenic effect. It is hoped that careful registration and continuing study of mesotheliomas will shed further light on their relationship to asbestos and on the possible hazards of the mineral to the general population. PMID- 6844895 TI - [Morphology of the adrenal gland in primary hyperaldosteronism]. AB - Between 1964 and 1980 25 patients (16 women and 9 men) underwent unilateral adrenalectomy for primary hyperaldosteronism at the Zurich University Hospital Department of Urology. In 17 cases (68%) review of the histological slides revealed adenoma, in 3 cases (12%) so-called idiopathic hyperplasia, and in one patient (4%) adrenal carcinoma. The histological features of these 21 cases were in keeping with the postoperative changes in blood pressure. However, in 4 patients (16%) the alterations of adrenal tissue could not be either correlated with the subsequent clinical course or satisfactorily classified without electron microscopic and biochemical examination. PMID- 6844897 TI - [Peripartum cardiomyopathy]. AB - Peripartum cardiomyopathy is a rare disease of unknown etiology. Its onset is rarely in the last trimester of pregnancy but more often during the first 5 months after delivery. A hemodynamically well documented case from Switzerland with a follow-up period of 6 1/2 years is reported. PMID- 6844898 TI - [Plasmapheresis treatment in multiple myeloma with kidney insufficiency]. AB - Two patients with multiple myeloma and renal insufficiency are described. In both cases free lambda-chains were demonstrated in blood and urine. Plasmapheresis induced a marked reduction of lambda-chains in both patients. In one patient, a 63 year old man, oliguria ceased but renal function remained impaired and required treatment with longterm hemodialysis. The patient died after 6 1/2 months from sudden circulatory failure. In the second patient, a 68 year old woman, renal function was recovered sufficiently to enable hemodialysis to be stopped. Plasmapheresis may efficiently lower the paraprotein concentration in plasma and bring about improvement of renal function, at least in certain cases. However, treatment should be started before the terminal oliguric stage of renal insufficiency has been reached. PMID- 6844896 TI - [Significance of chest pain in ambulatory patients. A prospective evaluation of the anamnesis]. PMID- 6844899 TI - [Hemiplegia following injection of heroin]. AB - Two young drug abusers with nontraumatic hemiplegia have been observed. Onset of symptoms occurred within minutes after intravenous administration of heroin. One case had cerebral infarction and the other cerebral hemorrhage. Hypersensitivity to heroin or an unknown adulterant may play a role. PMID- 6844901 TI - [Psychosocial problems and their management in patients with port-wine stain of the face]. AB - Psychosocial problems and coping in 20 patients with facial naevus flammeus and their families are described. They can be divided into two groups, one of 15 patients in whom coping strategies are regressive, and one of 5 patients in whom they are progressive. In the regressive patients the self-esteem is unstable and social contacts are difficult. The progressive patients are hardly aware of negative reactions from their environment and are scarcely affected in their social contacts. The indication for treatment is discussed. PMID- 6844900 TI - [Neuroradiology in the assessment and treatment of facial hemangiomas]. AB - The introduction of superselective angiography of the branches of the external carotid artery has opened new perspectives in the evaluation and treatment of patients with craniofacial hemangioma. Angiographically craniofacial hemangiomas are classified into three morphologic (arteriovenous, capillary, venous) and two hemodynamic (high-flow and slow-flow) types. Embolization is a measure which serves for reduction of mass, significant decrease of intraoperative hemorrhage and treatment of skin complications such as necrosis, ulcerations, etc. Embolization should be followed by surgical resection of the hemangioma. This report is based on experience with angiographic exploration and embolization of 39 facial hemangiomas. PMID- 6844902 TI - [Problems of intravenous urography in patients with plasmocytoma]. AB - Numerous reports refer to the development of acute renal failure following intravenous urography in patients with multiple myeloma, while other authors consider the risk to be acceptable if abdominal compression and dehydration are avoided and alkalization of urine is carried out. The outcome of 34 intravenous urographies with Conray 70, Conray FL, and Conray 36 has been evaluated in 26 patients with multiple myeloma. No case of acute renal failure was observed. Two patients experienced a mild increase (greater than 0.3 mg/dl) in serum creatinine levels. Mean value of serum creatinine was 1.28 mg/dl prior to and 1.18 mg/dl after urography. In three of four patients with preexisting azotemia serum creatinine levels fell after urography, while in the fourth a mild increase from 2.0 mg/dl to 2.5 mg/dl five days after the examination was observed. Data from the literature in addition to own data are presented. From all the data taken together we conclude that intravenous urography may carry a moderately increased risk of acute renal failure in patients with multiple myeloma. It may be performed if the indication is well established. PMID- 6844903 TI - [Inhalation of beta-stimulators: comparison of the effects of 6 different inhalation devices]. AB - The efficacy of salbutamol inhalations with six different aerosol devices has been evaluated. In four crossover experiments 38 patients with stable asthmatic airway diseases inhaled salbutamol with a pressurized metered-dose inhaler, with a powder inhaler, with two different jet nebulizers, an ultrasonic nebulizer, and an IPPB device. The bronchodilator response was assessed by measurements of FEV1 and specific airway conductance before and after the inhalations. PMID- 6844904 TI - [Thyroglobulin as a tumor marker and thallium scintigraphy for the course control of differentiated thyroid cancer]. AB - The usefulness of measurement of serum thyroglobulin (TG) concentration and whole body 201-thallium scintigraphy for follow-up were evaluated prospectively in 80 patients with differentiated thyroid cancer. All patients had undergone thyroidectomy and 131-iodine ablation. In 74 patients without residual thyroid tissue and a negative whole body thallium and/or iodine scan, the TG concentration in plasma was undetectable. In 5 of the remaining 6 patients, TG was measurable while the patient was receiving T3 therapy and undetectable in one. After 1 and 2 weeks off T3, TG increased in all 6 patients in parallel with TSH. Of 5 patients with abnormal 201Tl scintigraphy, 2 have residual local tissue and 3 distant metastases. Of these cases, 131I scintigraphy detected metastases in only one and local tissue in 2 patients. It is concluded that 1. TG is TSH dependent and increases after withdrawal of T3 replacement therapy. 2. TG measurements under T3 replacement therapy are less sensitive than measurements made after withdrawing T3. 3. 201Tl scintigraphy can replace 131I scintigraphy in follow-up controls. 4. The combination of serum TG and 201Tl scintigraphy seems to be superior to either one alone and can be performed while patient is on replacement therapy. PMID- 6844905 TI - [Cell content of milk in lactating chamois-colored mountain goats]. PMID- 6844906 TI - [Anatomicopathological studies of chronic dietary hypervitaminosis A in the cat]. PMID- 6844907 TI - [Therapeutic application of antibiotics by a feed automat in calves with trimethoprim as model drug]. PMID- 6844908 TI - A window on the sleeping brain. PMID- 6844910 TI - The limits of environmental liability. PMID- 6844909 TI - The role of age in human susceptibility to radiation. PMID- 6844911 TI - An increase of cadmium body burden for this century--an investigation on human tissues. AB - During this century cadmium production, consumption and emissions to the atmospheric, aquatic and terrestrial environment have increased dramatically. Today, as a result of systematic investigations on the concentration of cadmium in human tissues, estimates of body burdens are available from 1968 onward. We have determined the concentrations of cadmium in old pathological--anatomical specimens (61 kidneys, 53 livers) from 1897-1939 (year of death) and found average concentrations of 0.86 micrograms Cd/g renal cortex and of 1.13 micrograms Cd/g liver. In comparison with our studies on modern autopsy material (n = 207) from 1980 the average liver concentration has not altered significantly, while in the renal cortex the concentration of cadmium has increased by a factor of 47 and the body burden by a factor of 4.7. PMID- 6844912 TI - The sorption of copper (II), manganese (II), zinc (II) and arsenic (III) onto human hair, and their desorption. AB - Human hair has been studied in relation to sorption from aqueous solutions of Cu2+, Mn2+, Zn2+ and AsO3-(3). At an equilibrium concentration of 0.3 micrograms ml-1 the sorptions are relatively low for Mn (1.1 micrograms g-1) and As (0.1 microgram g-1), and higher for Zn (10 micrograms g-1) and Cu (35 micrograms g-1). But only in the case of copper is the sorption significant relative to the indigenous levels of the elements in the hair. The greater sorption of Cu2+ may be correlated with better binding to the hair fibre, probably both electrostatically and to the sulphur in the keratin. There appears to be at least three modes of attachment, or three mechanisms of attachment of Cu2+ to the hair. An inter-element effect was observed, where Cu2+ severely inhibits the sorption of Zn2+ and Mn2+. Also the total sorption of Cu2+ is reduced on zinc or manganese treated hair. Some comments are made regarding the results and the problems of exogenous contamination of human hair. PMID- 6844914 TI - Mercury concentrations in canned and fresh fish and its accumulation in a population of Port Moresby residents. AB - Five varieties of canned fish and hair specimens from 243 subjects in Port Moresby have been analysed for organic and total mercury. The mean concentrations of total mercury in the canned fish were 0.45 mg/kg for tuna, 0.21 mg/kg for salmon, 0.17 mg/kg for mackerel, 0.08 mg/kg for sardines and 0.04 mg/kg for pilchard, based on the weight of the fish. The mean hair concentration was 2.1 mg/kg, the standard deviation 1.8 mg/kg and the range 0.15 to 14.4 mg/kg. The total mercury levels in hair were significantly higher for coastal people than for non-coastals. Although this is probably due to the greater fish intake of the coastal people, no significant correlation was found between fish consumption and hair mercury levels. PMID- 6844915 TI - Selenium in environmental and drinking waters of Belgium. AB - The tetravalent and hexavalent selenium content of water samples can be determined by conventional energy-dispersive X-ray fluorescence after different preconcentration steps. Selenium values of nearly three-hundred different environmental and drinking water samples in Belgium are reported. The results are quite low, ranging from the detection limits up to 1 microgram 1-1. The concentration levels are compared to literature data and the speciation is discussed. The contribution of drinking water to the daily intake of selenium in Belgium ranges from less than 0.2 to 5%. PMID- 6844913 TI - DNA damage by PAH and repair in a marine sponge. AB - The sponge Tethya lyncurium from the Northern Adriatic has been used as an experimental species. A method is outlined for preparation of DNA which yields a highly purified DNA with a double-strand (ds) molecular weight of 25 M-dalton between single-strand (ss) breaks, which when properly damaged can be cut opposite to ss-breaks with nuclease S1. The molecular weights of the resulting ds DNA pieces and their distribution has been evaluated by electron microscope photographs. Sponges exposed to benzo[a]pyrene (BaP) in the dark only incorporate BaP-derivatives (BaPD) in small amounts, if any. However, in the presence of light, derivatization to BaP derivatives enables effective coupling to occur, as shown previously (R.K. Zahn et al., 1981). Sponges were exposed to radiolabeled BaP in the presence of light. Coupling of BaPD to the DNA as well as the induction of ss-breaks were measured. Light-mediated coupling is concentration dependent from 0.01-20 ppb BaP with a correlation coefficient of r = 0.84. Under conditions of possible repair, ss-breaks completely disappear from sponge DNA in the course of three weeks while a substantial fraction of the BaP derivatives persists. Double label experiments show that substantial DNA synthesis occurs during this time. Pollution causes a decrease of the molecular weight of unnicked DNA, re-incubation in clean water an increase. A DNA species of 24 M-dalton seems to play a critical role. If its percentage in the DNA population drops below a critical level, recovery is not longer possible. DNA damage by PAH and repair in sponges seems to differ from that of most eucaryotes. PMID- 6844916 TI - Wide world of reports. ABC objections to linkage of aggression to TV violence in NIMH report brings social scientists into contention in novel public skirmish. PMID- 6844917 TI - Invasion by alien genes. PMID- 6844918 TI - Heinz-body hemolytic anemia from the ingestion of crude oil: a primary toxic effect in marine birds. AB - Hemolytic anemia developed in young herring gulls and Atlantic puffins given daily oral doses of a Prudhoe Bay crude oil. Anemia developed 4 to 5 days after the initiation of oil ingestion and was accompanied by Heinz-body formation and a strong regenerative response. The data evince a toxic effect on circulating red blood cells involving an oxidative biochemical mechanism and the first clear evidence of a primary mechanism of toxicity from the ingestion of crude oil by birds. PMID- 6844919 TI - Emory reports on Darsee's fraud. PMID- 6844920 TI - A closer look at the genes of the MHC. PMID- 6844921 TI - Human platelet-derived growth factor (PDGF): amino-terminal amino acid sequence. AB - Human platelet-derived growth factor (PDGF) obtained from outdated human platelets was subjected to amino-terminal amino acid sequence analysis by automated Edman degradation. Despite the apparent presence of limited proteolytic degradation of the protein derived from this method, the sequence analysis reveals two primary peptide sequences and suggests that active PDGF is composed of two, possibly homologous, peptides linked by a disulfide bond or bonds. PMID- 6844922 TI - Cytotoxicity of a perfluorocarbon blood substitute to macrophages in vitro. AB - Murine macrophage and macrophage-depleted splenocyte cultures were incubated under ambient oxygen with a commercially available perfluorocarbon blood substitute. The perfluorocarbon preparation was found to be selectively cytotoxic to macrophages. This finding may be significant in view of the preliminary therapeutic usage of these preparations. In addition, perfluorocarbons may be useful as a means of selectively removing macrophages from tissue and organ cultures. PMID- 6844923 TI - Maternal coordination of the fetal biological clock in utero. AB - Deoxyglucose labeled with carbon-14 was used in studying the utilization of glucose in the suprachiasmatic nuclei of fetal rats. The results showed that an entrainable circadian clock is present in the suprachiasmatic nuclei during fetal development and that the maternal circadian system coordinates the phase of the fetal clock to environmental lighting conditions. PMID- 6844924 TI - Hormonal control of sexual differentiation: changes in electric organ discharge waveform. AB - Males and females of some mormyrid electric fishes generate electrical pulses that differ in waveform and duration. For one such species, testosterone or dihydrotestosterone induces females and immature males to produce the mature male electric organ discharge which is two times the duration of the female or immature discharge. Estradiol has only a weak effect. For a second species where males and females have similar electric organ discharges, testosterone produces no effect. The data suggest that androgens affect the electric organ itself. PMID- 6844925 TI - DNA methylation decreases in aging but not in immortal cells. AB - When normal diploid fibroblasts from mice, hamsters, and humans were grown in culture, the 5-methylcytosine content of their DNA's markedly decreased. The greatest rate of loss of 5-methylcytosine residues was observed in mouse cells, which survived the least number of division. Immortal mouse cell lines had more stable rates of methylation. PMID- 6844926 TI - Neural crest cells contribute to normal aorticopulmonary septation. AB - By analyzing the hearts of quail-chick chimeras, it was found that neural crest cells at the level of occipital somites 1 to 3 migrate to the region of the aorticopulmonary septum. Bilateral removal of this neural crest population prior to migration causes malformation of the aorticopulmonary septum resulting in common arterial outflow channels or transposition of the great vessels. PMID- 6844928 TI - Postnatally induced formation of the corpus callosum in acallosal mice on glia coated cellulose bridges. AB - Developing axons of the corpus callosum of mice are guided across the cerebral midline by a slinglike glial structure that forms transiently between the hemispheres. If the "sling" is cut at precallosal stages, the would-be callosal fibers whirl into paired neuromas adjacent to the longitudinal cerebral fissure. In experiments on such surgically acallosal animals, the aberrant commissural axons maintained a potential to regrow across the hemispheres at prenatal and early postnatal stages if they were presented with a properly aligned, glia covered scaffold spanning the hemispheres. PMID- 6844927 TI - Nucleotide sequence analysis of the T24 human bladder carcinoma oncogene. AB - The nucleotide sequence of the T24 human bladder carcinoma oncogene was determined, and the coding and noncoding sequences of the genome were identified. The amino acid sequence of p21, the translational product of the T24 oncogene, was predicted from the nucleotide sequence of the oncogene. Comparison of this sequence with that of the normal cellular homolog showed that a single point mutation in the coding sequences of the T24 oncogene resulted in the acquisition of transforming properties. Other differences between the T24 oncogene and its normal cellular homolog were found in the 5' noncoding and 3' noncoding sequences, but these differences appear to be due to polymorphism and do not play a significant role in the transformation process. PMID- 6844929 TI - Modifying oculomotor activity in awake subjects increases the amplitude of eye movements during REM sleep. AB - The eye movements of human subjects were experimentally modified while they were awake to determine the effect of waking experience on electroculographic activity during rapid eye movement (REM) sleep. After normal eye movements were monitored under controlled conditions, subjects spent 5 days wearing goggles that contained minification lenses and that curtailed vision to a 5 degree field. The amplitude and frequency of eye movements decreased when subjects were awake and increased during REM sleep; sleep stage durations and distributions were unaffected. Values returned to normal in the first 24 hours of recovery. PMID- 6844930 TI - Erectile mechanisms in man. AB - Increases in penile circumference during sleep-related erections in human subjects closely reflected increases in penile blood flow, and bursts of activity in the bulbocavernosus and ischiocavernosus muscles were temporally related to these increases. The penile arterial system and the perineal muscles appear to have important coordinated roles in human penile erection. Monitoring sleep related erections and penile blood flow holds promise for the study of erectile mechanisms and dysfunction and for screening of drugs. PMID- 6844931 TI - Light and agonists alter pineal N-acetyltransferase induction by vasoactive intestinal polypeptide. AB - Vasoactive intestinal polypeptide stimulated serotonin N-acetyltransferase activity in rat pineal glands in organ culture by a postsynaptic action that was independent of the beta-receptor. The magnitude of stimulation could be altered by environmental lighting conditions and by prior exposure to the agonist. Such up- and down-regulation, well known for catecholaminergic stimulation of this system, is compatible with a possible control of the pineal by vasoactive intestinal polypeptide as well as by catecholamines. PMID- 6844932 TI - Perinatal herpesvirus infections. PMID- 6844933 TI - Gonadal dose reduction in lumbar spine radiography. AB - Different ways to minimize the gonadal dose in lumbar spine radiography have been studied. Two hundred and fifty lumbar spine radiographs were reviewed to assess the clinical need for lateral L5/S1 projection. Modern film/screen combinations and gonadal shielding of externally scattered radiation play a major role in the reduction of the genetic dose. The number of exposures should be minimized. Our results show that two projections, anteroposterior (AP) and lateral, appear to be sufficient in routine radiography of the lumbar spine. PMID- 6844934 TI - Radiology of postnatal skeletal development. VII. The scapula. AB - Twenty-four pairs of scapulae from fetal specimens and 35 pairs of scapulae from postnatal cadavers ranging in age from full-term neonates to 14 years, were studied morphologically and roentgenographically. Air-cartilage interfacing was used to demonstrate both the osseous and cartilaginous contours. When the entire chondro-osseous dimensions, rather than just the osseous dimensions, were measured, the scapula had a height-width ratio ranging from 1.36 to 1.52 (average 1.44) during most of fetal development. The exceptions were three stillborns with camptomelic, thanatophoric, and achondrogenic dwarfism in which the ratio averaged 0.6. At no time during fetal development was the glenoid cavity convex; it always had a concave articular surface. However, the osseous subchrondral countour was often flat or slightly convex. In the postnatal period the height width ratio averaged 1.49. The ratio remained virtually unchanged throughout skeletal growth and maturation. In a patient with unilateral Sprengel's deformity the ratio for the normal side was 1.5, while the abnormal was 1.0. The cartilaginous glenoid cavity was always concave during postnatal development, even in the specimens with major structural deformities, although the subchondral osseous contour was usually flat or convex during the first few years of postnatal development. Ossification of the coracoid process began with the development of a primary center at three to four months. A bipolar physis was present between the primary coracoid center and the primary scapular center until late adolescence. PMID- 6844935 TI - Aggressive fibromatosis. PMID- 6844936 TI - Biomechanics important to interpret radiographs of the hip. AB - Biomechanic principles have important implications to film interpretation. Angulation of the femoral neck results in four different types of forces: compression on the medial side, tension on the lateral side, shear stress in the center, and torque forces at the neck-shaft angle. The body's response to these forces results in recognizable trabecular patterns which respond in a predictable manner to disease states. Surgical intervention in the form of hip replacement or fracture fixation must reflect these engineering considerations. PMID- 6844937 TI - Osteonecrosis of the distal pole of the carpal scaphoid following fracture--a rare complication. PMID- 6844938 TI - Transscaphoid, transcapitate, perilunate fracture dislocation (scaphocapitate syndrome). AB - Five cases of transscaphoid, transcapitate, perilunate fracture dislocation have been presented with a discussion of the radiologic findings, mechanism of injury, and method of treatment. Although a total of only 23 cases have now been reported in the literature, this type of injury is probably not rare as we have seen two cases within a span of six months. It is important to recognize the radiologic features of this fracture dislocation so appropriate therapy may be instituted. PMID- 6844939 TI - Oblique angled view for coracoid fractures. AB - In cases of shoulder injury when clinical signs suggest a possible coracoid fracture, a 20 degree posterior oblique film with 20 degrees of cephalad angulation has been shown to demonstrate coracoid fractures when other views have been inconclusive. PMID- 6844940 TI - Calcific tendinitis of the gluteus maximus tendon (gluteus maximus tendinitis). AB - Seven cases of calcific tendinitis of the gluteus maximus tendon are presented. Awareness of the precise anatomic location of the calcific deposit is essential for the accurate diagnosis of this uncommon site of tendinitis. Clinically, the presenting complaint is that of pain. In some instances, however, the patients are asymptomatic and the calcification is an incidental finding. PMID- 6844942 TI - Case report 220. Osseous sarcoidosis of left 5th digit in a young child with systemic sarcoidosis. PMID- 6844941 TI - The value of angiography in soft tissue leiomyosarcomas of the extremities. AB - The angiographic findings in eight patients with soft tissue leiomyosarcoma of the extremities are presented. All tumours were hypervascular. Vascular compression was seen in four tumours and intravenous tumour growth could be demonstrated in three. These findings are of great value in the planning of surgical treatment. The importance of securing an optimal venous phase of the examination is emphasized. PMID- 6844943 TI - Case report 221. Osteomyelitis of the left femur due to Brucella suis. PMID- 6844944 TI - Case report 222. Sacral and coccygeal supernumerary ribs (pelvic ribs). PMID- 6844945 TI - Case report 224. Giant cell tumor of ossification center of the distal end of the fibula, growing into the metaphysis. PMID- 6844946 TI - Case report 225. Myonecrosis of left leg (stimulating gas) due to gram-negative organisms. PMID- 6844947 TI - Self-concept as a mediating factor in delinquency. PMID- 6844948 TI - Determinants of self-esteem among labeled adolescents. PMID- 6844949 TI - Participation in faecal occult blood screening for colorectal cancer. AB - Chemical faecal occult blood testing has been proposed as a means of screening for colorectal cancer (C.C.) in populations or in identified high-risk groups. The level of public participation is a critical factor in the effectiveness of screening programmes. This study was conducted as a methodological pretest for an intended investigation of factors influencing screening participation. Faecal occult blood screening was offered to 728 employees of a teaching hospital in Sydney, New South Wales and 41% participation was obtained. Both participants and non-participants were questioned on demographic and social background factors, on their experience of C.C. in others, and on their reasons for participating or not participating. Major reasons for participation were: a general feeling of the importance of health checks and screening tests; a belief that it is important to diagnose C.C. early; and the fact that the test was simple and easy to do. Prominent self-acknowledged reasons for non-participation were indifference, procrastination, absence of previous bowel complaints, preference for one's own doctor to do such tests and inconvenience or lack of time. Those more likely to participate were: females; those of Australian or British origin; single, separated or divorced persons; those having two or more dependents and those with personal knowledge of a C.C. patient. PMID- 6844951 TI - Predicting turnover rates among the staff of English and Welsh old people's homes. AB - Staff turnover and wastage are particularly damaging in the personal social services where the establishment of staff-client relationships and a fund of experience are so important for 'successful' service or care. The vulnerability and dependence of the frail elderly in old people's homes make staff turnover and wastage especially problematic. The implications of staff turnover are briefly reviewed in this paper, and used as a basis for a study of the extent of staff turnover in the residential care sector. Using data on the personal characteristics of 8588 staff employed in old people's homes in England and Wales during 1976-1977, we estimated the individual propensities to change jobs and to leave social work-related employment altogether. These propensities were found to be significantly associated with age, sex, length of service, basic education and professional qualifications. PMID- 6844950 TI - Social networks and patterns of help-seeking behaviour. AB - Previous research has suggested that patterns of help-seeking behaviour are influenced by who the sufferer consults when deciding whether to seek medical care or not. This research has been extended to include episodes of illness and injury where more formal contacts are brought into the consultation process. The results show that the perceived urgency with which medical care is required is influenced by who the person has contact with. Some groups such as the police, bystanders and neighbours and friends may be more likely to suggest that the sufferer should seek medical attention than other consultants. This difference was explained in terms of the social, economic, moral and legal pressures associated with these people's positions. PMID- 6844952 TI - The family routines inventory: development and validation. AB - This report builds upon pertinent theoretical considerations regarding the nature and importance of routinization within families and describes the development and validation of a standardized inventory to measure family routines. The Family Routines Inventory (FRI) measures 28 positive, strength-promoting family routines, those observable, repetitive behaviours which involve two or more family members and which occur with predictable regularity in the daily life of a family. The 28 routines were selected from an extensive list of 104 routines obtained through family interviews. Scoring options for the inventory were identified based on their face validity and consistency with the underlying theoretical construct. The inventory was subsequently administered to a diverse group of families for reliability and validity testing. This testing identified an optimal scoring method (frequency score) for the inventory and revealed that the Family Routines Inventory, which measures the extent and importance of routinization within a given family, appears to be a reliable and valid measure of family cohesion, solidarity, order and overall satisfaction with family life. PMID- 6844953 TI - Behavioral science training in family practice residency education: a first evaluation. AB - Although behavioral science training is an essential component of family practice residency education, there have been few evaluations of its effects. In this study, selected behaviors of senior residents and their patients in two different family practice residency programs were compared. One program emphasized behavioral science, the other did not. Residents in the more behaviorally oriented program had more positive attitudes toward both social factors in illness and the importance of a warm physician-patient relationship. In addition, these residents claimed to know more about non-pharmacologic treatments for depression and anxiety and felt more confident in their ability to handle them than their less behaviorally trained counterparts. In regard to patient care, patients of residents in the program which emphasized behavioral science were more likely to receive a psychosocial diagnosis and resident counseling or mental health referral than patients of residents in the program which did not. On a patient satisfaction questionnaire, patients of the two programs differed on only one subscale which concerned convenience of care. Although these early results are encouraging, behavioral science training needs continuing clarification and evaluation of its goals and accomplishments. PMID- 6844954 TI - Acculturation and changes in health among Navajo boarding school students. AB - This paper describes the relationship between cultural background and illness experience among Navajo students during their first year at a reservation boarding school. Sixty Navajo children were enrolled in a 9-month, prospective study in which three descriptors of change in health status were assessed: (a) number of dormitory aide contacts initiated by the child for an illness complaint; (b) number of clinic visits for an illness judged by the aide to require medical attention; and (c) number of psychosocial problems referred to the clinic or to the boarding school administration. Two measures of cultural background were developed to estimate the location of each child along a continuum of acculturation, ranging from a traditional Navajo cultural orientation to full assimilation into modern Anglo-American society. First, the home communities for all children in the study population were ranked by eleven Navajo informants on an equal-interval scale reflecting community differences in cultural identity. Second, a questionnaire assessing acculturative dimensions of family life style was administered to each child by a Navajo assistant. In addition, each student was assigned a score for cultural incongruity, defined as the degree of absolute difference between community and family measures of cultural background. The reliability and validity of each index of acculturation were confirmed using a variety of psychometric approaches. Controlling for the confounding effects of age, sex and family size, a significant positive association was found between the number of clinic visits and the degree of cultural incongruity. Boarding school students from families and communities which conflicted in cultural orientation experienced higher rates of clinic visits for illnesses requiring medical attention. This result is discussed in the context of current understandings of the epidemiological consequences of cultural change. PMID- 6844955 TI - Direct and indirect effects of education on health. AB - In virtually every study by economists considering the determinants of an individual's health, years of schooling has stood out as an important regressor. Yet there is little agreement among economists concerning the mechanisms through which schooling affects health. This study is a first attempt to test for the direct and indirect effects of education on an individual's health. Education is assumed to enhance health directly by, for example, allowing wise use of medical care and indirectly through encouraging healthy habits and caution in the choice of occupation. Evidence from two national surveys indicates that the indirect dominate the direct effects. PMID- 6844956 TI - Young people's knowledge of the cervical smear test. AB - A sample of three hundred and forty-eight 16 and 17-year-old students (120 boys and 228 girls) on a range of vocational courses were asked a number of questions about the cervical smear test in October 1980. 10% of the boys and 27% of the girls selected "smear" as a word they would associate with cancer, but only 3.3% of the boys and 9.2% of the girls mentioned the cervical smear test as a preventive measure. Approximately a quarter of the students considered cervical cancer to be usually curable with early treatment, and the majority considered it to be rarely curable with late treatment. 38% of the boys and 64% of the girls had heard of the cervical smear test and the doctor, clinic, family planning clinic and hospital were suggested as places where the smear is available. 9% of the girls said they had had a smear test. These results were used as a baseline for the designing of suitable teaching material. PMID- 6844957 TI - Diagnosing for administrative purposes: some ethical problems. AB - The performing of medical evaluations which result in the awarding or denial of substantial material benefits to claimants in the absence of therapeutic intent creates a situation in which traditional values of medicine cannot operate and raises many difficult ethical questions. The certifying physician is not accountable for the psychosocial consequences to the claimant of denial or direct gratification of basic needs even if these consequences can be determined. With the loss of therapeutic intent, the physician is more likely to be influenced by personal rather than professional values. Because of the adversary nature of these proceedings, the physician is placed in a classic 'double agent' dilemma which may reverberate his own internal conflicts. Since certification determinations often have 'life-and-death' economic consequences for disadvantaged claimants, the 'ethics of reality' may ultimately transcend all other ethical concerns. Perhaps a first step in clarifying these ethical issues would be to make a clear-cut distinction between diagnosing for administrative purposes and diagnosing for therapeutic purposes. PMID- 6844959 TI - Potential toxicity due to dolomite and bonemeal. AB - Large amounts of dolomite and bonemeal are being consumed, especially by nutrition-conscious persons. The mineral content of commercial samples has been analyzed by different laboratories, and significant amounts of lead, arsenic, mercury, and other potentially toxic metals, which also exist in conventional vitamin-mineral and calcium supplements, were detected. Physicians must consider the possibility of unrecognized self-poisoning from the consumption of such substances, especially in the context of unexplained neurologic, gastrointestinal, cutaneous, and hematologic disorders. The use of dolomite and bonemeal by pregnant women, children with suspected milk allergy, and elderly persons requires careful evaluation. PMID- 6844960 TI - Ciguatera (fish poisoning). PMID- 6844962 TI - Ataxia in Listeria monocytogenes infections of the central nervous system. AB - From 1976 to 1981 Listeria monocytogenes was second only to Neisseria meningitidis as the cause of bacterial infections of the central nervous system in adults at our hospital. None of the patients with Listeria infection was immunosuppressed or had an underlying malignancy. Ataxia was an initial feature in five of the eight patients, and in three of them it persisted beyond their discharge from the hospital. Ataxia was not a feature of the clinical picture of 14 other adult patients with meningococcal and pneumococcal meningitis. Our data indicate that L monocytogenes should be suspected as the etiologic agent in an adult with ataxia and infection of the central nervous system. PMID- 6844961 TI - Practical experience with percutaneous nephrostomy: avoidance of common technical pitfalls. AB - In our 18-month experience with percutaneous nephrostomy (PCN) at Vanderbilt University Hospital and Veterans Administration Hospital (Nashville), a total of 47 PCNs were attempted with a success rate of 96%. The procedure is rapid, offers low morbidity, and has been readily accepted. Some variations of the standard procedure to avoid common technical difficulties include (1) using a combination of real-time ultrasonography and fluoroscopy as a guidance system, (2) maintaining the position of the Chiba needle during the entire procedure, (3) choosing the optimal puncture site, and (4) exercising care in tract dilatation. PMID- 6844963 TI - Extraintestinal infections due to halophilic vibrios. AB - To compare the clinical and epidemiologic features, we reviewed the hospital records and interviewed 18 patients with extraintestinal infections caused by three species of halophilic vibrios. Vibrio vulnificus, the organism most frequently isolated in Virginia during the six-year study period, caused primary septicemia in three patients. Fifteen patients had soft tissue infections, most of which followed injuries that were contaminated by seawater and mostly caused by V vulnificus and V parahaemolyticus. All infections occurred during the warm months of the year, and in most cases were an occupational or recreational hazard of fishing. PMID- 6844958 TI - [Contribution to the kinetics of ethanol absorption and elimination in the presence of hydrocarbons (n-hexane) in the rat]. AB - Increased ethanol blood level follows the administering of ethanol mixed with single hydrocarbons in a similar way as after cannulation of ethanol with benzol Ethanol blood level changes are stipulated by hydrocarbons, reducing benzol compounds are not decisive for increasing influence. Kinetic relations indicate that resorption speed is not influenced substantially. Increased ethanol blood level in rat seems to be caused by restricted elimination. PMID- 6844964 TI - Continent Ileostomy. AB - The continent ileostomy, consisting of a valve and a pouch, makes available an alternative system in which intestinal discharge can be stored and controlled after coloproctectomy. Earlier concerns regarding valve slippage with resulting malfunction have been largely eliminated by recent modifications in the technique of valve construction. A continent ileostomy was provided for 19 patients. In the first five, an antiperistaltic (Kock) valve was constructed and two had dessusception which necessitated reoperation. In the 16 cases in which an isoperistaltic valve was fashioned, there has been no slippage. These improvements, along with the significant enhancement of the quality of life, indicate a need to reexamine the advisability of providing a spout-type ileostomy in those cases favorable to the construction of a continent ileostomy. PMID- 6844965 TI - Gnat sore eyes: seasonal, acute conjunctivitis in a southern state. AB - In late summer 1981, a widespread outbreak of acute bacterial conjunctivitis occurred in southeast Georgia, affecting primarily grade-school children. This outbreak was similar to previously described seasonal conjunctivitis in the South. As suggested in previous studies, the eye gnat, Hippelates pusio, may serve as a mechanical vehicle in the transmission of the suspected causative agent, a possible Haemophilus species. The 1981 Georgia outbreak illustrates that "gnat sore eyes" is not obsolete and apparently can occur unpredictably during warm months in the southern states. Physicians and other health-care workers should be aware of the unique clinical and epidemiologic features of acute seasonal conjunctivitis. PMID- 6844966 TI - Chest pain, dysphagia, and high amplitude esophageal peristalsis: a clinical and manometric study. AB - Recent literature has called attention to an esophageal motor abnormality characterized by high amplitude peristaltic contractions (HAPC). We characterized symptoms, manometric characteristics, and radiographic findings of 19 such patients and compared them to patients with other nonspecific esophageal motor disorders (NEMD). In the HAPC group, mean amplitude was 254 +/- 14 mm Hg, which was significantly higher than that of control subjects (94 +/- 8.9 mm Hg) and of those with other NEMD (116 +/- 10.8 mm Hg). Contractile duration of the HAPC and NEMD groups was 6.9 +/- 0.5 sec and 5.9 +/- 0.4 sec, respectively, both being significantly higher than normal. Results of esophagograms were frequently abnormal in both groups, but there was no specific abnormality separating the two groups. There was a high incidence of chest pain and dysphagia in the HAPC group. These data suggest that HAPC may represent a distinct subgroup of primary esophageal motor disorders. PMID- 6844968 TI - Inoperable stage III carcinoma of the breast. AB - When seen initially, 10% to 29% of patients with breast cancer have locally advanced, nonresectable lesions without evidence of distant metastases. Radiotherapy offers significant palliation for these patients but has little influence on survival. Preoperative chemotherapy can be used to shrink many of these lesions and make them resectable. Adjuvant chemotherapy for patients with histologically positive nodes is now reasonably well established and allows the treatment of the micrometastases that most of these patients have. Removal of the breast can prevent the development of bleeding, ulcerating masses on the chest wall in the later stages of the disease. The removal of the primary tumor may favorably influence the interdependence of primary and metastatic foci. PMID- 6844969 TI - Pseudotumor of the pancreas. AB - A 29-year-old black woman had a peculiar variety of chronic pancreatitis that initially presented as a solid, discrete mass in the head of the pancreas. It mimicked carcinoma and exemplifies the diagnostic and therapeutic dilemma produced by such "pseudotumors" of the pancreas. PMID- 6844967 TI - Midfacial skeletal profile in early and late closure of the hard palate. AB - The midfacial profile (anterior projection of the maxilla) was studied in 57 white children with cleft lip and palate and Veau type III clefts operated upon by one surgeon. These patients were divided into three groups delineated by the time of repair of the hard palate. One group had hard palate repair at 2 years of age, the second group at 3 or 4 years of age, and the third after eruption of the first permanent molar teeth, at about 6 years of age. Lateral cephalograms were obtained and SNA measured. In this study it was the timing of hard palate closure, not the presence or absence of the prosthesis, that was evaluated. There was a statistically significant difference in the midfacial profile (which is dependent on the anterior projection of the maxilla) in those whose hard palate was repaired before and after eruption of the first permanent molar teeth. PMID- 6844970 TI - Anaerobic pyogenic sacroiliitis. PMID- 6844971 TI - Granulocytopenia after intravenous abuse of pentazocine and tripelennamine ("Ts and blues"). PMID- 6844973 TI - Cardiac arrhythmias due to ventricular parasystole in a 12-year-old child. AB - A 12-year-old girl with multifocal premature ventricular contractions had two fixed-coupled ventricular ectopic foci. A third focus with variable coupling interval and a common interectopic interval satisfied criteria for ventricular parasystole, an infrequently recognized arrhythmia pattern in children. PMID- 6844972 TI - Benign intracranial hypertension, monoclonal gammopathy, and superior sagittal sinus thrombosis. AB - We report a case of benign intracranial hypertension associated with monoclonal gammopathy. The course was complicated by superior sagittal sinus thrombosis which we believe to be related to acetazolamide therapy. Response to volume expansion with colloid and crystalloid solutions was dramatic. PMID- 6844975 TI - Crescentic glomerulonephritis complicating idiopathic membranous glomerulonephropathy. AB - We describe the course of a patient with multiple rectal abscesses and progressive renal dysfunction. A renal biopsy demonstrated a membranous glomerulopathy associated with extensive crescent formation. No underlying cause for the glomerulonephritis could be identified and, specifically, the anti-GBM antibody present in other similar cases was not found. There appears to be a subset of patients with membranous glomerulopathy in whom crescents develop with rapid loss of renal function. Anti-GBM antibody is not necessary in the pathogenesis of this lesion. PMID- 6844974 TI - Iron deficiency anemia, thrombocytosis, and cerebrovascular accident. AB - A patient who would otherwise be at low risk for cerebrovascular accident had a right hemiparesis and aphasia. Evaluation revealed iron deficiency anemia secondary to menorrhagia and marked thrombocytosis, which responded to intramuscular and, later, oral iron replacement. Hemiparesis and aphasia resolved after a month. PMID- 6844977 TI - Enteric duplication cyst. AB - We have described a case of cystic duplication of the small bowel in a newborn with a palpable abdominal mass. Roentgenographic studies of this patient failed to show any intrinsic abnormalities of the gastrointestinal or genitourinary tracts. At surgery, a sausage-shaped enteric duplication of the ileum was removed. PMID- 6844976 TI - Ovarian carcinoma metastatic to breast. AB - We have described a case of ovarian carcinoma with bilateral breast involvement. In patients with a previous history of carcinoma who have a breast tumor, metastatic disease must be considered and the histologic features of the tumors compared. Therapy is focused on the primary site, though local treatment may be necessary. The presence of metastatic breast involvement generally indicates widespread metastases, and the prognosis is poor. PMID- 6844978 TI - Listeria monocytogenes endocarditis on a prosthetic heart valve. AB - Listeria monocytogenes endocarditis, an illness with a potentially high mortality developed in a patient with a porcine mitral valve heterograft. After treatment with parenteral ampicillin and streptomycin, blood cultures remained sterile and vegetations noted before treatment cleared. Delay in diagnosis and institution of appropriate antimicrobial therapy may occur because of the diverse morphologic features of L monocytogenes. PMID- 6844979 TI - Anal eroticism: two unusual rectal foreign bodies and their removal. AB - We have described two cases involving unusual rectal foreign bodies and their subsequent removal. Suggestions are included to aid in the removal of colorectal foreign bodies, as well as references to provide for the appropriate management of these cases in the emergency department. Primary care providers need to be aware of the issue of colorectal foreign bodies as a clinical entity and the fact that their occurrence is expected to continue to rise dramatically. Patient education of the dangers inherent in the insertion of objects into the colorectal area should be more prevalent. At the very least, all physicians need to be aware of anal eroticism and the necessity to take a careful medical history. PMID- 6844981 TI - Carbamazepine-induced liver injury. AB - Two patients had carbamazepine-induced liver injury. The clinical, biochemical, and histologic data suggest hepatitis of the idiosyncratic hypersensitivity type with granulomas in one patient; in the other, the liver injury resembles that caused by a hepatotoxin. Both patients showed prompt recovery upon discontinuation of the drug. PMID- 6844980 TI - Severe depersonalization and anxiety associated with indomethacin. PMID- 6844982 TI - Neuroleptic malignant syndrome after haloperidol therapy. AB - A well documented case of neuroleptic malignant syndrome is reported. The patient had unusual, life-threatening complications, consisting of cardiac arrhythmia, followed by cardiac arrest, dysphagia persisting for eight weeks and leading to aspiration pneumonia, seizures, and myoclonus following treatment with haloperidol. An 18-month outpatient follow-up has failed to reveal any residual neurologic or cardiovascular damage. PMID- 6844984 TI - Anorectic agents and the set point theory for regulation of body weight. PMID- 6844985 TI - Intraosseous infusions. PMID- 6844983 TI - Metastatic basal cell carcinoma. PMID- 6844986 TI - [Social and demographic problems of public health in various regions of Siberia]. PMID- 6844987 TI - [Methodology of planning the activities of a satellite municipal hospital]. PMID- 6844988 TI - [Results of the use of an automated system of management at a municipal teaching hospital]. PMID- 6844989 TI - [Organization and administration of dispensarization within the framework of the AMS "Gorzdrav"]. PMID- 6844991 TI - [Organization of the activities of the emergency medical service center]. PMID- 6844990 TI - [Dispensarization of patients with frequent and chronic diseases]. PMID- 6844993 TI - [Organization of socialist competition in medical schools]. PMID- 6844992 TI - [Activities of the permanent committee of health planning councils with regard to public health and social services]. PMID- 6844995 TI - [Graduate training and the moral education of physicians--a single process]. PMID- 6844994 TI - [One can improve the level of knowledge not only at institutes for advanced medical training]. PMID- 6844996 TI - Out of the broom cupboard. PMID- 6844998 TI - Attitudes to education in a paediatric renal unit. PMID- 6844997 TI - Assessing students in FE. PMID- 6844999 TI - A science link with Tulse Hill. PMID- 6845000 TI - Four teenagers take over. PMID- 6845001 TI - Will the Act work. PMID- 6845002 TI - A new deal or dashed hopes? PMID- 6845003 TI - Dyslexia--what's in a name? PMID- 6845004 TI - Coping with disruptive behaviour. PMID- 6845005 TI - [Prospects for abdominal nuclear spin resonance diagnosis]. PMID- 6845007 TI - [Radiologic data systems--problems and solutions]. PMID- 6845008 TI - [A simple procedure for determining the resolving power of x-ray equipment]. PMID- 6845006 TI - [A microcomputer system for documenting ultrasound sections]. PMID- 6845010 TI - [Scintigraphy in the diagnosis of primary bone tumors]. PMID- 6845009 TI - [Roentgenologic and pathologico-anatomic diagnosis of bone tumors]. PMID- 6845012 TI - [Radiologic and clinical aspects of osteodystrophia deformans Paget]. PMID- 6845013 TI - [Roentgen diagnosis of the upper digestive and respiratory tracts]. PMID- 6845011 TI - [Indication for angiography of bone tumors - current status of bone tumor angiography with reference to diagnostic possibilities of computer tomography]. PMID- 6845014 TI - [The diagnosis of gastrointestinal diseases - when roentgen diagnosis, when endoscopy?]. PMID- 6845016 TI - [Present state of therapy of fractures of the clavicle in adults]. PMID- 6845015 TI - [Hypopharynx carcinoma--treatment and results]. PMID- 6845018 TI - [Surgical problems in the treatment of groin pain in athletes]. PMID- 6845017 TI - [Personal experience with the use of the Berg-Fourier EEG analyzer in neurotraumatology]. PMID- 6845021 TI - [Immunologic aspects of operations and anesthesia]. PMID- 6845020 TI - [Diagnosis of pulmonary sarcoidosis using the lung biopsy method]. PMID- 6845019 TI - [Possibilities of computer technics in the administration of traumatology departments]. PMID- 6845022 TI - [Anesthesia in pediatric cardiac surgery]. PMID- 6845023 TI - [Thoracic epidural anesthesia and analgesia]. PMID- 6845024 TI - [Comment on the work of L. Bamabas: Surgical procedures in the stimulated cardiac patient]. PMID- 6845025 TI - [Intravenous administration of Mesocaine in the prevention of complications after tonsillectomy]. PMID- 6845027 TI - [Blunt injuries of the organs in the abdominal cavity and peritoneum]. PMID- 6845026 TI - [Problems in team work in the treatment of multiple injuries]. PMID- 6845028 TI - [Experience in the treatment of Achilles tendon rupture]. PMID- 6845029 TI - [Indications for extirpation of the humeral head after injury]. PMID- 6845030 TI - [Tissue oximetry in experiments]. PMID- 6845032 TI - [The reliability of gammagraphic examinations of the liver in surgical patients]. PMID- 6845033 TI - [Less common complications of pancreatitis]. PMID- 6845031 TI - [Volvulus of the gallbladder]. PMID- 6845035 TI - [Carcinoids of the digestive tract]. PMID- 6845034 TI - [Transvaginal resection of carcinoma of the rectum]. PMID- 6845036 TI - [Second-look operations in colorectal carcinoma]. PMID- 6845037 TI - [Toxic dilatation of the colon in nonspecific colitis]. PMID- 6845038 TI - [Ileus with chronic post-irradiation lesions in the small intestine]. PMID- 6845039 TI - [Diagnosis of postoperative venous thrombosis with the radio-fibrinogen test]. PMID- 6845040 TI - [Contribution to the surgical treatment of congenital arteriovenous fistulas of the lower extremities]. PMID- 6845042 TI - [Comments on indications and preoperative considerations in subcutaneous mastectomy]. PMID- 6845041 TI - [Levels of immunoglobulins in patients after splenectomy]. PMID- 6845043 TI - Plasma lipid and lipoprotein levels in obese black diabetics. PMID- 6845044 TI - lead levels in deciduous teeth of children from selected urban areas in the Cape Peninsula. AB - The lead levels in shed deciduous teeth of children from two selected urban regions in the Cape Peninsula were compared. The average levels in the teeth of children living in the vicinity of two large industrial plants were: whole teeth 20,419 ppm, enamel 10,952 ppm, and dentine 22,733 ppm. The lead levels in teeth from children living in the vicinity of light industries were: whole teeth 16,556 ppm, enamel 2,919 ppm, and dentine 19,926 ppm. These differences were significant at the 1% level (teeth and enamel) and 5% level (dentine). PMID- 6845045 TI - The heart and hypothyroidism. PMID- 6845046 TI - Trichomonas infection in pregnancy--does it affect perinatal outcome? AB - Antenatal patients free of Trichomonas vaginalis vaginal infection were compared with infected patients, half of whom were treated and half left untreated. The treated group was given benzoylmetronidazole 50 ml (2 g metronidazole equivalent) as a single dose. The mode of treatment was found to be very palatable and highly effective. The birth weights and gestational age at delivery were similar in all three groups. PMID- 6845048 TI - Urban Zulu mothers' views on the health and health care of their infants. AB - During a research project aimed at the establishment of developmental norms for Black infants, the lack of information on Black mothers' views on infancy and child-rearing became apparent. A pilot project was therefore undertaken in order to delineate areas for further study. During this pilot project data were obtained on urban Zulu mothers' views on the health and health care of their infants. It appeared that urban Zulu mothers have accepted Western medicine to a certain degree, without having completely relinquished beliefs in traditional health care. We report these views on the health and health care of infants because they seem important not only for those active in community obstetrics and paediatrics, but also for those concerned with the health care facilities provided for urban Blacks. PMID- 6845047 TI - Disease patterns in Transkei and Ciskei. PMID- 6845050 TI - The Tolosa-Hunt syndrome. AB - The Tolosa-Hunt syndrome, or painful ophthalmoplegia, is a rare condition caused by a granulomatous nonspecific process at the level of anterior cavernous sinus, superior orbital fissure and orbital apex. The syndrome is characterized by pain behind, above or around the eye, involvement of the cranial nerves which pass through the cavernous sinus, spontaneous remissions and exacerbations, and a favourable response to steroid therapy. Recognition of this condition is important because administration of steroids may prevent residual damage. PMID- 6845049 TI - Ideal family size in a rural Tswana population. AB - It is a matter of concern that family-planning advice is often given without consideration of the cultural norms which influence the client. A questionnaire was used to discover what 350 rural Tswanas believed the ideal number of children to be; results were tabulated according to age and sex. It appears that older people tend to want more children and, more surprisingly, that men and women agree on the ideal number of children in a family; this is contrary to the traditional impression that Black men want more children than do Black women. Further research among other Black population groups is indicated. PMID- 6845051 TI - The operculum syndrome. A case report. AB - A 48-year-old hypertensive man with signs and symptoms of pseudobulbar paralysis was ultimately found to be suffering from the operculum syndrome. Recognition of this syndrome is important in that: (a) it may be caused by a localized cortical lesion amenable to treatment; (b) some of the symptoms carry a good prognosis as opposed to those in pseudobulbar paralysis; and (c) the operculum syndrome usually has a more favourable prognosis since there is no associated mental impairment or sphincter disturbances. PMID- 6845052 TI - Infections due to Actinobacillus actinomycetemcomitans. A report of 3 cases. AB - Three cases are described which show the typical range of infections which may be caused by Actinobacillus actinomycetemcomitans, namely an actinomycosis-like infection, a prosthetic cardiac valve endocarditis and a post-traumatic soft tissue infection. Cultural studies are detailed, and a short review of the disease-producing potential of this organism and its treatment is presented. PMID- 6845054 TI - Haematoma in the transverse mesocolon secondary to acute pancreatitis. A case report. PMID- 6845053 TI - Congenital broncho-oesophageal fistula. A case report. AB - A case of broncho-oesophageal fistula causing bronchiectasis of the left lung is reported. Oesophagorespiratory fistulas without atresia of the oesophagus often have an insidious clinical course and most commonly present in adulthood. This rare congenital anomaly should be considered as a cause of chronic pulmonary sepsis. The clinical, radiographic and therapeutic features of this lesion are discussed. PMID- 6845056 TI - Malignant cervical polyp. PMID- 6845055 TI - Atlanto-axial subluxation in rheumatoid arthritis. PMID- 6845057 TI - A useful physical sign in the painful hand. PMID- 6845058 TI - Granuloma inguinale (donovanosis) in South Africa. AB - Granuloma inguinale is a chronic specific infection of the genitalia of both sexes. It is endemic in many parts of the world, including the Caribbean, the southern USA, India, New Guinea and tropical and subtropical Africa. Apart from a single patient diagnosed clinically, no cases of the disease have previously been reported in the RSA, and some have thought that it did not occur here. A series of 8 cases diagnosed on the Witwatersrand over the past 21 months is presented, suggesting that the disease is endemic in this country and has until now been overlooked by clinicians and pathologists. PMID- 6845059 TI - Chronic active hepatitis at Baragwanath Hospital. AB - In a retrospective analysis of 35 Black patients with chronic active hepatitis (CAH) admitted to Baragwanath Hospital, Johannesburg, during the period 1972- 1980, four major aetiological categories were found: auto-immune (lupoid, immunological (57%)), drug induced (isoniazid and alpha-methyldopa (17%)), hepatitis B virus-related (14%), and alcohol-related (11%) CAH. Alcohol-related CAH was found in males only. Upper abdominal pain was a presenting feature of alcohol-induced CAH, while jaundice was a common, presenting feature of the other types. Systemic features such as skin rashes (acne, urticaria), bacterial infections and congestive cardiac failure were prominent in the auto-immune type of CAH. The liver was enlarged in the majority of cases. Hepatitis B virus related CAH showed an absence of tissue nonspecific auto-antibodies. Cirrhosis was present in approximately 50% of patients at the time of diagnosis. Despite the facts that isoniazid and alpha-methyldopa are commonly used and hepatitis B infections and alcohol abuse are frequent in this population, CAH remains an uncommon condition in South African Blacks. PMID- 6845060 TI - Prolactin, cortisol and thyroxine levels and the premature infant. AB - The relationship of prolactin, cortisol and thyroxine values in cord and maternal plasma to fetal age and weight and to the incidence of hyaline membrane disease (HMD) was investigated in 80 neonates of whom 40 were born at more than 37 weeks' gestation. Of the 40 born at less than 36 weeks 11 developed HMD. Serum cortisol has been shown to be a differentiating factor for HMD, but cord thyroxine and prolactin levels seem to be related more to age and weight than to the occurrence of HMD. PMID- 6845061 TI - Dagga (cannabis) usage among medical students in Johannesburg. AB - Of 1 020 undergraduate medical students at the University of the Witwatersrand surveyed in 1981 as regards attitudes to and patterns of illicit drug use 868 completed the questionnaire; 32,4% had tried dagga (cannabis) and 16,4% were still using the drug. There was a large increase in the number of students using the drug as they advanced through their studies (6% of the 1st-year class as against 24% of the 5th-year class). The timing of dagga use and previous experimentation with habit-forming drugs are mentioned, and reasons for non experimentation and attitudes towards legalization of dagga are analysed. PMID- 6845062 TI - Rupture of sinus of Valsalva aneurysm into both right atrium and right ventricle. A case report. AB - A young man had a congenital sinus of Valsalva aneurysm originating from the right coronary sinus, complicated by fistulas draining into both right atrium and right ventricle, as well as a congenitally abnormal aortic valve with mild aortic insufficiency. His dramatic clinical presentation, with the sudden appearance of severe biventricular cardiac failure unresponsive to intensive medical therapy, was an important clue to making the correct pre-operative diagnosis. The use of non-invasive techniques, such as phonocardiography and M-mode and two-dimensional echocardiography, is highlighted. Full cardiac catheterization was employed to define the cardiac pathophysiology. This was one of the few cases documented in which a catheter could be passed from the aorta into the right ventricle via the fistula connecting these two chambers. The fistulas were closed and the aortic valve replaced. Postoperative investigations confirmed the success of corrective surgery. As far as we are aware this is the first documented case of successful repair of a congenital sinus of Valsalva aneurysm rupturing into both the right atrium and right ventricle, accompanied by aortic insufficiency. PMID- 6845063 TI - Ischemic heart disease in urban blacks. PMID- 6845064 TI - A true hermaphrodite--an anatomical variation. PMID- 6845065 TI - Oculomotor signs in amitriptyline induced coma. PMID- 6845066 TI - Application of balloon catheters in portal studies. PMID- 6845067 TI - Therapeutic abortion on psychiatric grounds. Part III. Implementing the Abortion and Sterilization Act (1975-1981). AB - This article reviews the experience of the Pregnancy Advisory Service (PAS) of the Department of Psychiatry, Groote Schuur Hospital. Demographic and personal data from the women referred to the PAS during the period 1975-1981 (since the passing of the Abortion and Sterilization Act of 1975) are recorded. Follow-up information from many of the 1251 patients seen over this period confirms the findings of a previous report that in a significant percentage of cases in which a woman was refused legal abortion pregnancy did not proceed to term. For reasons which are not clear there has been a fall in the number of cases seen for assessment. The PAS performs a valuable function in enabling women to examine the circumstances of an unplanned pregnancy and in providing expert counselling. PMID- 6845068 TI - Bolus obstruction by Ascaris lumbricoides. AB - Seventy-three cases of obstruction due to a bolus of Ascaris worms are reviewed. The diagnosis was made on the basis either of a characteristic palpable mass or a characteristic radiographic appearance. In 67 cases conservative treatment was successful. Six patients came to surgery, 5 because of deterioration. There were no deaths. The need for careful reassessment is stressed. PMID- 6845069 TI - Should young adults with sore throat be treated with antibiotics? AB - The diagnosis of streptococcal sore throat on clinical grounds remains a problem. In this study the clinical prediction in a group of young adults corresponded with laboratory findings indicative of a streptococcal (group A or non-A) infection in 23% of cases. The culture of throat swabs was of little value, as the only group A culture-positive patient did not show an antibody response, indicating a carrier state. In 5 cases a streptococcal infection was diagnosed on rising antibody titres only, as culture remained negative. The value of rising antibody titres as a diagnostic tool is also questioned, since they occurred more frequently in the healthy controls than in the sore-throat group. Antibiotic treatment for sore throat was rarely supported by laboratory findings in the young adult population studied. PMID- 6845071 TI - Ventricular septal defect due to blunt chest trauma. A case report. AB - Blunt chest trauma may cause cardiac trauma, this possibility often being overlooked. Various anatomical structures may be affected. A case of ventricular septal defect due to blunt chest trauma is described and the relevant literature is reviewed. PMID- 6845072 TI - Parkinsonism secondary to neurosyphilis. A case report. AB - A case of parkinsonism associated with neurosyphilis, which improved markedly after appropriate treatment, is described. Although neurosyphilis is a rare cause of parkinsonism, it should be considered when parkinsonism appears in the 30-50 year age group, particularly if other anomalous neurological findings are present. Adequate therapy may improve the patient's condition and prevent further progression. PMID- 6845070 TI - A health status and health service utilization study of a peri-urban community in Kwazulu. AB - A community survey was undertaken in a district in Kwazulu, adjacent to Pietermaritzburg. Natal, in order to determine health status and health service utilization patterns at a local level. This low-cost survey was labour-efficient and yielded useful data for the evaluation and planning of local health services. It was found that child health and delivery services were under-utilized while family planning and antenatal care services were comparatively well used. 'Traditional' practitioners' services were used regularly by 51% of the mothers and childminders interviewed. The use of the services of general medical practitioners was less significant. Some 36% of the children under 5 years of age were found to be malnourished, and 29% had conditions requiring medical treatment. The findings of this study indicate that a major discrepancy exists between the local need for health services and utilization of the available services. The introduction of community health workers is proposed as a possible solution. PMID- 6845073 TI - Early referral in cerebral palsy. PMID- 6845074 TI - Toxocariasis. PMID- 6845075 TI - The effect of alcoholism on Parkinson's disease. PMID- 6845076 TI - The fat and the thin--a survey of nutritional status and disease patterns among urbanized Black South Africans. AB - The nutritional status of and disease patterns in 449 healthy and 803 hospitalized urbanized Blacks in Durban were surveyed. While unemployed males were generally less fat than controls, obesity (i.e. weight 40% over that expected) was extremely common among female factory (33%) and female hospital 'domestic' (65%) employees. Undernutrition was significantly more common amont patients and more marked in males, 82% having significantly reduced fat stores. Disease patterns were similar in malnourished male and female patients, with infective and respiratory diseases predominating. However, the pattern was different in overweight male and female patients, non-ischaemic cardiovascular diseases, particularly hypertension, predominating. The most common cause of death in males was respiratory disease, and in females cardiovascular disease. Overall, malnutrition was most common in the subgroup (N = 212) of patients who died. The results confirm the known associations between undernutrition and increased susceptibility to infection and mortality, and also between overnutrition and hypertensive cardiovascular disease. The observation that malnutrition and obesity can coexist within rapidly urbanized communities stresses the need for concurrent education on nutrition. The high incidence of 'hospital malnutrition' observed emphasizes the need for nutritional support in acutely ill patients. PMID- 6845081 TI - Guillain-Barre syndrome in childhood. PMID- 6845083 TI - The university, the medical school and research. PMID- 6845082 TI - Solitary giant-cell pneumatization of the petrous apex. PMID- 6845077 TI - Unexplained spastic paraplegia. AB - Of 330 Black patients admitted to hospital with paraplegia, the causes in 33 remained unexplained after investigation. These patients had features of predominant corticospinal tract degeneration with lesser degrees of sensory loss. This series of patients is similar to some reported previously from South Africa and from other tropical countries. Among several possible causes the most likely is a toxic dietary factor. PMID- 6845078 TI - Pulmonary haemorrhage and nephritis. PMID- 6845079 TI - The restless legs syndrome (Ekbom's syndrome). AB - The restless legs syndrome is a condition of unknown aetiology characterized by nocturnal paraesthesiae in the lower limbs, an irreversible tendency to move the limbs, pain in the distribution of the paraesthesiae, and psychiatric disturbances. The syndrome may occur at any age and in either sex and usually runs a course over many years with spontaneous improvements and exacerbations. An association with iron deficiency has been suggested but in most cases no apparent cause has been found, and treatment at present is symptomatic with analgesics and sedatives. The differential diagnosis includes phenothiazine-induced akathisia and meralgia paraesthetica. PMID- 6845080 TI - Giant complex odontoma of the maxillary antrum. A case report. AB - Complex odontomas are rare benign jaw neoplasms, generally small and asymptomatic. We present an unusual case of a giant complex odontoma which completely filled the maxillary antrum, resulting in elevation of the orbit and facial asymmetry. PMID- 6845086 TI - Syndrome of inappropriate antidiuretic hormone secretion in association with herpes zoster of the chest wall. A case report. AB - The syndrome of inappropriate antidiuretic hormone secretion (SIADH) occurs in a number of diverse medical conditions. We report a case in which SIADH and herpes zoster of the chest wall occurred concurrently. In the absence of other recognized causes we suggest that the two conditions may have been related and speculate on possible mechanisms. PMID- 6845085 TI - Hypocomplementaemia fails to prevent acute-phase stimulation of fibrinogen synthesis. AB - Fibrinogen synthesis rates of normocomplementaemic and hypocomplementaemic rats were measured after turpentine injection using the 14C-carbonate technique and a liver perfusion system. In both groups of animals turpentine administration caused a significant increase (P less than 0,01) in fibrinogen synthesis rates, but no significant difference was observed between the two groups. These results suggest that complement does not play an important role in the genesis of the fibrinogen acute-phase reaction. PMID- 6845087 TI - Maternal obstetric paralysis. A case report. AB - A severe case of puerperal obstetric palsy is presented. Evidence in favour of the Hunerman theory is submitted. Pressure necrosis resulted in a large vesicovaginal fistula. PMID- 6845088 TI - Parkinsonism, gait apraxia and dementia associated with intracranial calcifications. A case report. AB - A 52-year-old Black man with therapy-resistant parkinsonism, gait apraxia and dementia but no endocrine abnormality was found to have extensive intracerebral calcifications which included the basal ganglia. Although most patients with radiological evidence of calcifications in the basal ganglia remain asymptomatic, a small group may present with an extrapyramidal syndrome that is usually progressive, resistant to therapy, and not associated with an endocrine disorder. Plain skull radiography and computed tomography should therefore be performed in patients presenting with a parkinsonian syndrome unresponsive to therapy. PMID- 6845089 TI - Hemichorea-hemiballismus caused by lacunar infarction in the basal ganglia. A case report. AB - Unilateral hemichorea-hemiballismus developed suddenly in a 60-year-old man. Computed tomography revealed a small area of low density in the region of the left anterior limb of the internal capsule and the head of the caudate nucleus which was consistent with a lacunar infarction. Haloperidol gradually abolished the symptoms within 7 days of their onset. No further choreoballistic movements were experienced. This report reveals that ballistic movements may occasionally be caused by lesions lying some distance from the subthalamic nucleus of Luys. PMID- 6845090 TI - Benign recurrent aseptic meningitis (Mollaret's meningitis). A case report. AB - Benign recurrent aseptic meningitis is a rare disorder described by Mollaret in 1944. Since then cases have been reported in the European and American literature, and the first report on a case in South Africa appeared recently. In this article a case seen in Durban is reported and the characteristic manifestations and differential diagnosis are briefly reviewed. PMID- 6845091 TI - Delayed onset of overt porphyria cutanea tarda in a patient on long-term haemodialysis. A case report. AB - After 7 years on haemodialysis, a 37-year-old anephric man developed cutaneous lesions of the hands, arms and face, shown by skin biopsy to be compatible with porphyria cutanea tarda (PCT) (symptomatic porphyria). Elevated levels of plasma uroporphyrin and 7-COOH porphyrin were detected alongside a predominant isocoproporphyrin fraction in the faeces by means of quantitative thin-layer chromatography, confirming the diagnosis of overt PCT. The plasma uroporphyrin did not pass into the dialysate, even after chloroquine therapy. There was no evidence of hereditary PCT, chronic liver disease or iron overload, although the patient had a history of excessive alcohol consumption. The overt PCT developed after 8 months of home dialysis using softened water with high aluminium concentrations and subsided clinically and biochemically when the softened water was replaced by deionized water. PMID- 6845094 TI - Traction induced hypertension in a child. PMID- 6845092 TI - Phenylketonuria in South Africa. PMID- 6845093 TI - Low dietary calcium intake and its role in the pathogenesis of rickets. PMID- 6845084 TI - The Waardenburg syndrome in deaf children in southern Africa. AB - Eighty-nine children with the Waardenburg syndrome were identified during diagnostic surveys of 3006 deaf children attending 19 special schools in southern Africa. Since a hearing deficit is present in only a minority of persons with the Waardenburg syndrome, it can be estimated that there are several thousand individuals with the faulty gene among the local population. The syndrome was encountered in deaf children of White, Black and mixed ancestry but not in Indian scholars. There were marked discrepancies in prevalence in different tribal groups. In several sets of deaf siblings, one individual had the classic syndromic stigmata while the other had apparently undifferentiated perceptive deafness. On this basis it is possible that phenotypic expression of the Waardenburg gene in some persons may be limited to a hearing deficit. Our observations indicate that the sole manifestation of the faulty gene can be irides of a uniform, striking and unusual blue colour, with or without congenital deafness. PMID- 6845095 TI - A comparative evaluation of drug combinations used in the treatment of pulmonary tuberculosis. AB - A retrospective analysis was undertaken of the hospital records of 185 patients admitted for the first time for treatment of pulmonary tuberculosis. The time to sputum conversion was used to evaluate the efficacy of short-course antituberculosis therapy and to determine the effect of including rifampicin (RMP) in various chemotherapeutic combinations. RMP per se was not found to be a significant variable in the drug combinations studied. The combination of RMP and pyrazinamide, however, showed greater efficacy in achieving earlier sputum conversion. The therapeutic advantage of using these two drugs in combination should be more readily appreciated. PMID- 6845096 TI - Comparison of methohexitone and etomidate for general anaesthesia in unpremedicated outpatients. AB - This study compares methohexitone (Brietal; Eli Lilly) and etomidate (Hypnomidate; Janssen) as hypnotic agents for the induction and maintenance of general anaesthesia in outpatients given fentanyl and nitrous oxide for analgesia but no premedication. While both agents provided suitable anaesthesia with a minimal incidence of side-effects, 66% of the patients who received methohexitone were noticeably drowsy 2 hours after the operation, whereas all but 3% of the patients who received etomidate were wide awake. PMID- 6845098 TI - Primary lactose intolerance in Zulu adults. AB - The incidence of lactose intolerance in a sample of 47 Zulu patients from a general medical ward and 14 healthy members of the Zulu population in Durban was investigated. Eighty-nine percent of patients and 93% of control subjects were diagnosed as having lactose intolerance because of failure to increase blood glucose more than 1,1 mmol/l during the 2 hours following 50 g lactose ingestion. Ninety-two per cent of the female and 64% of the male patients complained of symptoms of lactose intolerance, and 61% of the female and 75% of the male patients passed stools with a pH of less than 6. Glucose tolerance (50 g) was normal in 87% of patients and 92% of controls; 2 patients had a diabetic response while 5 patients and 1 control had 'flat' glucose and lactose responses, suggesting delayed absorption. Analysis of nutritional status showed that male patients were significantly more malnourished than female patients, and patients more so than controls. The results indicate that lactose intolerance is a normal observation in the Zulu and that it is primary in origin since there was no association between intolerance, sickness or malnutrition. Practical implications that arise from the study are that milk-based diets should be avoided in refeeding malnourished Zulu patients and that lactose may find a useful place in the treatment of constipation and liver failure in such patients. PMID- 6845097 TI - The phytohaemagglutinin response and lymphocyte subpopulations in young Blacks and Indians with insulin-dependent diabetes mellitus. AB - The lymphocyte transformation response to phytohaemagglutinin (PHA) and the relative numbers of T, B and null lymphocytes were studied in 32 insulin dependent diabetics and 32 healthy matched controls. The mean stimulation index (Sl) of the 18 patients with poorly controlled diabetes mellitus was significantly lower than that of controls. No difference was seen in the mean Sl values of well-controlled diabetics compared with controls. Neither the well controlled group nor the poorly controlled group showed any significant differences in the mean counts of the various lymphocyte subpopulations when compared with controls. PMID- 6845100 TI - Congenital bifurcation of the femur with aplasia of the tibia. A case report. AB - Congenital bifurcation of the femur in association with aplasia of the tibia has been reported in only about 20 cases. One case is reported, the physical findings in this case and in others are described, and the important prognostic features are outlined. Amputation at knee joint level is a common outcome. PMID- 6845099 TI - Gastrin-like immunoreactivity in ulcerative colitis. A case report. PMID- 6845101 TI - Neonatal septicaemia due to a nutritionally deficient streptococcus. A case report. AB - A case of neonatal septicaemia due to a nutritionally deficient streptococcus is described. Unusual features were abdominal distension and excessive nasogastric aspirate with infrequent stools. Recovery followed treatment with intravenous penicillin and gentamicin. Attention is drawn to the possibility of missing such infections unless culture media are supplemented with vitamin B in cases in which staining of the blood culture reveals Gram-positive cocci which fail to grow on standard plates. PMID- 6845102 TI - Extensive thrombosis following central venous catheterization--a relationship to antifibrinolytic therapy? PMID- 6845103 TI - Use of the flexible fibre-optic bronchoscope in the diagnosis of lung carcinoma. AB - Bronchoscopy carried out in 367 patients because of a chest radiograph suggestive of lung carcinoma confirmed this diagnosis in 194 cases and excluded it in 173. The diagnosis of carcinoma was made by fibre-optic bronchoscopy in 141 cases (73%), by examination of biopsy specimens and bronchial brushings in 125, and by visualization and follow-up in 16. Visible tumours accounted for 40% of the malignant lesions and 79% of these were diagnosed on examination of biopsy specimens or brushings, compared with 55% of non-visible tumours. Of the tumours 131 were radiographically peripheral, and 60% of these were diagnosed with the fibre-optic bronchoscope. The diagnostic yield in the 63 proximal tumours was 98%. PMID- 6845104 TI - The antihypertensive effect of indapamide. AB - Fourteen patients with moderately severe essential hypertension were treated for 8 weeks with indapamide 2,5 mg/d. Systolic and diastolic blood pressures fell significantly from the 1st week of treatment; the rapid changes noted thereafter were described mathematically by decreasing power functions of time. Serum potassium and blood glucose values did not change significantly. Indapamide behaves as a power antihypertensive diuretic which appears safe at low doses and can be considered for the first-line treatment of essential hypertension. PMID- 6845105 TI - Lung cancer resectability in urban Blacks. AB - Two hundred and eighty-one patients with carcinoma of the lung were seen over a period of 30 months in our unit. All patients were investigated and staged according to the system of the American Joint Committee for Cancer Staging. Patients with stage I or stage II disease were operated upon, but those with stage III disease or with a pre-operative diagnosis of small cell tumour were not considered for surgery. Of the 281 patients evaluated, 83 (29,5%) underwent thoracotomy and 55 (19,6%) resection. PMID- 6845106 TI - Prolonged inhibition of basal gastric acid secretion by calcitonin in man. AB - This study was performed to investigate the effect of prolonged (6-hour) infusions of salmon calcitonin on basal gastric acid secretion and serum gastrin and calcium levels in 9 normal volunteers. Three tests, during which gastric acid secretion was measured continuously for 8 hours, were performed on each subject. After 1 hour, calcitonin 2,5 or 5,0 micrograms/h or a saline placebo (in random order) was infused intravenously for 6 hours. Calcitonin significantly inhibited basal gastric acid secretion, the effect reaching statistical significance (P less than 0,05) after 90 minutes with the larger dose and after 150 minutes with the smaller dose. Eight of the 9 tests using the larger dose and 6 of the 9 using the smaller dose rendered the subjects achlorhydric. The changes in acid secretion occurred independently of a slight drop in serum calcium levels. No changes in blood gastrin levels occurred. Calcitonin is capable of completely abolishing gastric acid secretion when infused over a long period. PMID- 6845107 TI - Oesophago-antrostomy with and without pyloroplasty - radiological and manometric findings in the chacma baboon. AB - Oesophago-antrostomy with and without pyloroplasty, and with preservation of Latarjet's anterior nerve with an intact pylorus, was studied in chacma baboons. Radiological and manometric studies showed that pyloroplasty is unnecessary after oesophago-antrostomy with an incidental vagotomy and that pyloroplasty in fact interferes with the muscular rhythm of the pyloric sphincteric cylinder. PMID- 6845109 TI - Toxic shock syndrome caused by staphylococcal enterotoxin B. A report of 2 cases in children. AB - Two children with osteomyelitis, staphylococcal septicaemia and toxic shock syndrome (TSS) are reported. Both patients presented with fever, shock, scarlatiniform rash and diffuse mucositis. The multi-organ dysfunction which characterizes this syndrome was apparent in both patients, who had jaundice, functional renal impairment, diffuse myalgia and non-localizing neurological signs. One child developed toxic myocarditis and the other thrombocytopenia. Both showed a significant rise in antibody titre to enterotoxin B produced by the offending staphylococci, suggesting that this toxin was responsible for the TSS. PMID- 6845108 TI - Pain relief in herpes zoster. AB - The severity of pain as a symptom of herpes zoster and post-herpetic neuralgia has seldom been emphasized in the literature. In this report on a series of 113 patients, a treatment which gives immediate relief of pain and prevents post herpetic neuralgia is described. Provided that the steroid solution could be placed accurately in the epidural space adjacent to the affected nerves, the method was 100% successful. Failure to provide relief of pain after the initial effect of the local anaesthetic had worn off was taken as an indication that the epidural injection had been misplaced, and it was repeated. PMID- 6845110 TI - Tuberculous abscess of the liver. A case report. AB - Tuberculous abscess of the liver is rare. A case is reported and the southern African literature briefly reviewed. The clinical similarities to amoebic and pyogenic liver abscesses and primary or secondary neoplasms of the liver are emphasized. Laboratory tests and hepatic scintiscans may not assist in differentiating between these conditions. PMID- 6845111 TI - Restoration of Trichophyton mentagrophytes growth in medium depleted of metals by chelation: importance of iron. AB - The present study examined the requirement of Trichophyton mentagrophytes ATCC 18748 for iron. Nutrient broth depleted of iron by the chelating cation exchange resin Chelex-100 did not support the growth of T. mentagrophytes beyond germ tube formation. The soluble chelate of iron, ferric ammonium citrate, restored the capacity of the chelated medium to support fungal growth in proportion to the amount of iron added. Ferric chloride, which rapidly becomes insoluble at neutral pH, was not effective in the medium. The soluble salts of cobalt, chromium, copper, manganese, nickel, and zinc individually did not replace the requirement for iron. A method for defining the iron requirement based upon utilization of iron from ferric ammonium citrate is described. These data indicate that the growth of T. mentagrophytes ATCC-18748 is iron-dependent, which is consistent with the hypothesis that serum transferrin inhibits dermatophyte growth by the mechanism of iron deprivation. PMID- 6845113 TI - Women contacts of men with gonorrhea: case-finding yields. AB - During a 12-month period intensive case-finding services (interviewing of patients and tracing of contacts) were provided to 255 women contacts of men who had gonorrhea. Approximately three contacts per case were evaluated, and 50% (374 of 739) of the male contacts were infected. If the 255 symptomatic men whose infection led to (and preceded) enrollment in our study population are excluded, 484 contacts remain, of whom 119 (24.6%) were infected. Nearly half (57 of 119) of the infected contacts were asymptomatic. Active public health intervention was frequently necessary to persuade asymptomatic men to seek medical attention. We recommend that case-finding services be offered to women with gonorrhea who initially present as contacts of infected men. PMID- 6845112 TI - The clinical diagnosis of urethral discharge. AB - When a standard method for grading urethral discharge that is based on quantity (profuse, moderate, or scant) and quality (purulent, cloudy, or clear) is used, the optimal performance of the clinical diagnosis of gonorrhea is 73%. This performance (true positives over true plus false positives) is dependent not only on the sensitivity, specificity, and prevalence of gonorrhea but also on the components of that prevalence, i.e., the specific mix of patients who attend a clinical service. Optimal performance, as determined through use of a relative operating characteristics curve, will vary from setting to setting depending upon certain patient variables, such as race and sexual preference. Clinics with full diagnostic service would not employ clinical diagnosis as a screening tool directly, but rather as an epidemiologic device for helping to characterize patient populations at risk. Areas with less developed clinic facilities might apply these observations for clinical decision making in the absence of laboratory support. PMID- 6845115 TI - Computerized tomographic findings in meningovascular syphilis: a case report. AB - Although angiographic findings of arterial narrowing have been detailed in several cases of meningovascular syphilis, very few descriptions of abnormal computerized tomographic (CT) findings have been reported. A case of multiple vascular infarcts detected on CT scan is described; syphilis is proposed as the probable cause of the vascular pathology. PMID- 6845116 TI - Gonococcal urethritis due to fellatio. AB - Of 609 male patients seen for sexually transmitted disease, 94 (15.4%) admitted to having had orogenital intercourse; 30 (5%) had practiced it during their last contact. Ten of the 30 patients admitting to fellatio during their last exposure had gonococcal urethritis. Three of these men practiced fellatio exclusively with prostitutes, and their cases demonstrate the inherent risk of oral-to-genital transfer of sexually transmitted disease. All three patients responded favorably to therapy with ampicillin and probenecid. PMID- 6845114 TI - Etiology of genital ulcerations in Swaziland. AB - The etiology of genital ulcer disease was determined among 155 consecutive new cases in Mbabane, Swaziland. In contrast to genital ulcerations in industrialized countries, chancroid was the most common diagnosis (44% of cases), as established on clinical grounds and by exclusion of other etiologies. Primary syphilis and genital herpes accounted for only 17% and 12% of the cases, respectively. Lymphogranuloma venereum was found in 13% of the patients, and in 15% of cases no diagnosis was made. PMID- 6845117 TI - The titivating penile ring. PMID- 6845119 TI - Financial status of the Social Security Program. AB - This study, originally a background paper for the National Commission on Social Security Reform and published as Appendix J in the Commission's Report, outlines the dimensions of the financing problem the Commission addressed. Prepared by Robert J. Myers, the Commission's Executive Director and a former Deputy Commissioner and Chief Actuary of the Social Security Administration, it discusses, in turn, the operational and funding procedures of the Social Security Trust Funds, the measures developed to determine the financial soundness of the program, and the financial status of each trust fund in the past, at present, and projected for the future. The author shows how program funding was gradually shifted from a modified-reserve to a pay-as-you-go basis and how the balance between income and outgo was disrupted by adverse economic conditions during 1979 81, when prices rose more rapidly than wages and unemployment was substantially higher than anticipated. Using several different economic assumptions, Myers estimates how extensive the deficits of the program could be over the short run (the remainder of the 1980's) and over the long term (the period 1982-2055). PMID- 6845120 TI - Transcutaneous partial oxygen pressure assessment of the ischemic lower limb. AB - As a result of these studies, it can be concluded that the TCpO2 is a reliable indicator of the state of perfusion of the skin in both the healthy and ischemic legs and can be used to predict the healing potential if amputation is performed. The most meaningful reading is obtained at 10 centimeters below knee anteriorly. The critical value is approximately 35 millimeters of mercury, since the pO2 value for below-knee amputations performed upon most patients with a 10 centimeter below knee amputation was less than this, further surgical treatment was required, while all patients with values above this underwent successful amputation. Determination of the 10 centimeter below knee-control site ratio does not appear to provide any further advantage over the absolute 10 centimeter below knee site value. However, the control site measurement should be taken to eliminate central circulatory failure. The technique can be easily undertaken by hospital technicians or regular nursing or junior medical staff. A site reading requires an average of 35 minutes. The capital outlay is well within the capability of an average general hospital, and the running costs are negligible. PMID- 6845122 TI - A review of the importance of acute multidisciplinary treatment following spontaneous rupture of the liver capsule during pregnancy. PMID- 6845121 TI - Acute abdominal pain caused by spontaneous perforation of the urinary bladder. AB - Patients with acute spontaneous bladder perforation have the symptoms and signs of an acute condition of the abdomen which, as a surgical emergency, requires prompt operative treatment. Bladder perforation should be suspected as the cause of this abdominal catastrophe if the history and findings indicate a urinary tract disorder. If the surgeon knows preoperatively that the bladder is perforated, he is able to plan and perform the appropriate surgical procedure with greater dispatch and certainty. The correct preoperative diagnosis should be made more frequently if the primary care physician develops a greater awareness of the possibility of spontaneous bladder perforation as the cause of an acute condition of the abdomen. With earlier diagnosis and earlier surgical treatment, the present reported mortality of 25 per cent for those patients with this condition is likely to be reduced. PMID- 6845118 TI - Urethritis associated with Haemophilus parainfluenzae: a case report. AB - Haemophilus parainfluenzae was isolated from the urethral discharge of a man with urethritis. The patient responded favorably to treatment with amoxicillin. Although the facts suggest that this case of urethritis may have been caused by H. parainfluenzae, a possible etiologic role of other microorganisms is not ruled out. PMID- 6845124 TI - Adjunctive antibiotic lavage in experimental peritonitis. AB - Lethal fecal peritonitis was created in 253 rats. The rats were then randomized to receive injections of saline solution or clindamycin and gentamicin. All rats received a saline solution lavage and were then further divided to receive a lavage with saline solution, gentamicin, clindamycin or cefoxitin. At the end of nine days, all surviving rats were sacrificed and examined for abscesses. All groups receiving clindamycin and gentamicin parenterally as well as those receiving a lavage with gentamicin or cefoxitin had a significantly better survival rate than did the control group. There was no difference in the number of abscesses in any group receiving antibiotics. Therefore, in this study, no benefit was achieved from an antibiotic lavage in rats receiving effective parenteral therapy. PMID- 6845123 TI - Thrombosis prophylaxis using external compression. PMID- 6845125 TI - The use of Marlex mesh in patients with generalized peritonitis and multiple organ system failure. AB - Patients with generalized peritonitis form a rather threatened group, with a high mortality and risk of complications which increases when multiple organ failure develops. In 20 patients with this condition, the laparotomy wound was closed without tension using a Marlex mesh prosthesis, after surgical treatment of the underlying illness and drainage of the abdominal cavity. The mortality was lower than expected, according to data from the literature; also, pulmonary complications, residual abscesses and wound dehiscence occurred less frequently. This method seems to be a valuable contribution to the complex treatment of these patients. PMID- 6845126 TI - Management of traumatic posterior urethral stricture by one stage perineal repair. AB - Ten male patients with posterior urethral strictures secondary to trauma of the pelvis were treated with a one stage perineal repair, consisting of excision of the strictured segment and direct anastomosis between the bulbous urethra and the apex of the prostate. Repair was performed after an interval from trauma ranging from three months to 22 years. The mean followup time was 22 months. Excellent results were observed in eight patients, diffuse distal urethral narrowing in one patient and recurrent stenosis requiring further repair in another patient. Continence and potency were unaffected. This technique is applicable to the majority of posttraumatic posterior urethral strictures, less than 2 centimeters in length, and does not preclude further repair. PMID- 6845127 TI - The value of combined strain gauge plethysmography and radioactive iodine fibrinogen scan of the leg in the diagnosis of deep vein thrombosis. AB - The fallibility of the clinical diagnosis of deep venous thrombosis has led to a variety of noninvasive diagnostic methods, for example, Doppler ultrasound, plethysmography, 125I fibrinogen and radionuclide phlebography. This study was undertaken to analyze the value of combined strain gauge plethysmography and 125I fibrinogen scan of the leg in the diagnosis of deep venous thrombosis. The study was carried out upon 368 patients with suggestive findings of venous thrombosis. Four hundred and fifty strain gauge plethysmograms were reviewed. Venograms were done upon 106 limbs and 125I fibrinogen leg scans, on 136 limbs. Of the 64 limbs with normal strain gauge plethysmograms which had venograms, 58 were normal, five had incompetent perforators and one limb had deep venous thrombosis. Of the 42 legs with abnormal strain gauge plethysmograms which had venograms, 25 had deep venous thrombosis, 15 had incompetent perforators and two were normal. Twenty three of 24 legs having both abnormal strain gauge plethysmograms and leg scans were confirmed to have deep venous thrombosis at venography. Fourteen of 18 legs with abnormal strain gauge plethysmograms but normal scans were found to have incompetent perforators. We conclude, that the strain gauge plethysmogram is a reliable test in excluding deep venous thrombosis and, when combined with the fibrinogen leg scan, is reliable in its diagnosis. PMID- 6845130 TI - Peritoneal lavage in the patient with trauma. PMID- 6845128 TI - Carcinoma of the gallbladder. AB - Results of a retrospective review of 20 consecutive patients with histologically proved carcinoma of the gallbladder encountered during a 15 year period confirm the historically established poor prognosis of the disease. One patient in whom the disease was discovered incidentally and early in its course is alive nine years after diagnosis. The other 19 patients died within eight months of diagnosis, regardless of the extent of the disease or method of treatment. By identifying patients who are at an increased risk, by virtue of such factors as cholelithiasis and advanced age, and scrutinizing all exposed or removed gallbladders for signs of abnormality, carcinoma of the gallbladder may be identified earlier. Then, since carcinoma of the gallbladder develops slowly and spreads along predictable pathways, radical cholecystectomy, including en bloc wedge resection of the gallbladder bed and adjacent nonvital tissue, performed upon patients with localized disease, probably offers the best chance for prolonged survival. PMID- 6845131 TI - Cholecystectomy with and without drainage. PMID- 6845129 TI - Primary aortoduodenal fistula following radiotherapy. AB - Primary aortoduodenal fistula is a rare condition. Common causes include atherosclerosis, leading to formation of an aortic aneurysm (most common); syphilis; carcinoma of the pancreas; trauma; tuberculosis, and myocosis. Presented herein is the recognition and successful treatment of what appears to be the first patient with a primary aortoduodenal fistula following paraaortic radiotherapy. Once suspected, immediate surgical treatment is mandatory. Primary aortic control (closure or resection), along with resection of the diseased intestinal segment, would appear to be the safest and most acceptable treatment. PMID- 6845132 TI - Nerve block in the treatment of finger ischemia. PMID- 6845133 TI - A technique for the positioning of permanent central venous catheters in patients with thrombosis of the superior vena cava. PMID- 6845134 TI - Reducing the recurrence risk of fistula in ano. AB - A method of reducing the risk of recurrence of fistula in ano is described. The technique involves injecting saline solution into the external opening of the tract and identifying the internal opening by the egress of liquid. The procedure has been used in 74 patients over the last two years with a recurrence rate of 1.38 per cent. PMID- 6845135 TI - A new technique for placement of catheters for peritoneal dialysis. AB - We have described a technique for placement of a peritoneal dialysis catheter which involves fixing the end of the catheter to the pelvic wall and creating a peritoneal tunnel near the distal end. This technique prevents malfunction of the catheter due to malposition and rotating superiorly. PMID- 6845136 TI - The size of cerebral aneurysms in relation to repeated rupture. AB - The size of ruptured cerebral aneurysms in 407 cases were studied angiographically in relation to the number of times of rupture. The size of aneurysms was not influenced by the number of clinically documented episodes of bleeding. Patients with long-term clinical courses of untreated ruptured aneurysms had significantly larger aneurysms than in the general patient population. The result indicates that aneurysmal enlargement is not closely related to their rupture when considering aneurysmal growth in general. The mechanism of growth of cerebral aneurysms is discussed. PMID- 6845137 TI - Entrapment neuropathies of the median nerve at and above the elbow. AB - Three surgically verified cases of median nerve entrapment at and above the elbow are reported: one involved a compression of the nerve beneath the Struthers ligament in absence of supracondylar bony spur, and two concerned a compression beneath the lacertus fibrosus bicipitis (aponeurosis musculi bicipitalis brachii). Of the two latter cases, the first entrapment was caused by a hematome and the second the nerve was found to be entrapped between the lactertus and an underlying hypertrophic brachial muscle. The compression mechanisms and clinical and electromyographic findings are presented. PMID- 6845138 TI - Contralateral pontine hemorrhage as a complication of acoustic neurinoma surgery. AB - The authors report the occurrence of a contralateral pontine hemorrhage after an operation for an acoustic neurinoma. A 55-year-old woman was found to have a small pontine hemorrhage opposite to the side of the tumor immediately after the operation. The cause of the hemorrhage is discussed. PMID- 6845139 TI - Extrusion of peritoneal catheter through the mid-lumbar region. An unusual complication of ventriculo-peritoneal shunt. PMID- 6845141 TI - Spinal intradural extraarachnoid metastasis. AB - A case of carcinomatous metastasis at the L2-3 level localized in the intradural extraarachnoid space is presented. The anatomy of the subarachnoid angle where the transition occurs from peripheral nerve to nerve root is reviewed. Anatomic evidence suggests that the spread of the tumor to the potential intradural extraarachnoid space might be via the perineural sheath. PMID- 6845140 TI - Extracranial-intracranial bypass to the proximal posterior cerebral artery and to the proximal middle cerebral artery for multiple occlusive cerebrovascular disease. AB - A 48-year-old man with a multiple occlusive cerebrovascular disease involving both the carotid and the vertebrobasilar systems is reported. Faced with noneffective conservative treatment, a surgical approach was carried out. As the patient had poorly developed posterior communicating arteries, two extracranial intracranial bypasses were performed for both the carotid and the vertebrobasilar circulations; extracranial-intracranial bypasses with interposed saphenous vein grafts between the left external carotid artery and the proximal segment of the left middle cerebral artery, and between the right external carotid artery and the proximal segment of the right posterior cerebral artery. Advantages, precautions, and techniques of this kind of bypass procedure are discussed. PMID- 6845142 TI - Disseminated intravascular coagulation--a complication of 1,3-bis(2-chlorethyl) nitrosourea therapy. PMID- 6845143 TI - Cerebral neuroblastoma in an adult. Case report, pharmacology, and review of the literature. PMID- 6845144 TI - Unusual myelographic pattern in a case with redundant roots of the cauda equina. PMID- 6845145 TI - Bilateral intracavernous carotid aneurysms mimicking a prolactin-secreting pituitary tumor. AB - The triad of hyperprolactinemia, ophthalmoplegia, and radiologic abnormalities of the sell turcica suggest a tumor in the area of the pituitary gland. A new association--bilateral intracavernous carotid aneurysms--is presented. Two elderly women had extraocular muscle palsies and elevated serum prolactin levels of 71 and 32 ng/ml (normal: less than 20 ng/ml). In the former, a high-resolution computed tomography scan made after contrast medium injection was incorrectly interpreted as demonstrating a pituitary tumor; cerebral arteriography revealed bilateral aneurysms. In the other patient, a computed tomography scan after contrast medium injection demonstrated the bilateral aneurysms, and these were confirmed by radionuclide angiography. PMID- 6845146 TI - Fibrosis of the dura mater. A cause of "failed back" syndrome. PMID- 6845148 TI - Excision of a large pineal region hemangiopericytoma (angioblastic meningioma, hemangiopericytoma type). AB - A large hemangiopericytoma was located posterocentrally. The patient presented with headaches and papilledema. Surgical management consisted of total gross excision by a combined right occipital transtentorial and right occipitoparietal transfalcine approach under magnification in three stages over a 6-week period. Removal was aided by dilatation of the right temperooccipital horn ("trapped ventricle") and meningioma-like encapsulation allowed separation of the tumor from the brain and surrounding structures after internal debulking of the tumor. Subsequent peritoneal shunting of the trapped ventricular horn and 5000 rads of radiotherapy were given to the patient. She remains well with an inferior quadrantanopsia on the left side more than 1 year after treatment. Meningiomas of the pineal region, the relationship of meningioma to hemangiopericytoma and malignant mesenchymal tumors (sarcomas) are considered in reference to presumed cells of origin. PMID- 6845149 TI - Suicide, no!--infanticide, yes? PMID- 6845147 TI - Mediastinal hematoma after carotid endarterectomy. PMID- 6845150 TI - How many neurosurgeons? PMID- 6845152 TI - Neurosurgery in Romania. PMID- 6845151 TI - Acute cerebellar hemorrhage with brainstem compression in contrast with benign cerebellar hemorrhage. AB - Twenty six cases of cerebellar hemorrhages were reviewed and analyzed. Two patients were comatose on admission and showed clinical evidence of brainstem compression; they were successfully revived after evacuation of the hematomas. This was in contrast with six other comatose patients who did not have evacuation and subsequently died within 48 hours. The other eight cases of so-called benign cerebellar hemorrhage ran a more benign course and recovered without any operative procedures. It is suggested that prompt diagnosis with computed tomography, even in comatose patients, and immediate removal of the hematoma in this group, might result in a better prognosis with this highly lethal condition. PMID- 6845154 TI - Nontraumatic extracranial aneurysm of the vertebral artery. PMID- 6845153 TI - Posterior fossa epidural hematomas: a review and synthesis. AB - The authors report three patients with posterior fossa epidural hematomas and analyze 80 additional cases in the accessible literature. They occur in the younger age groups with a clear male predominance (3.6 to 1). The loss of consciousness at the time of impact and just before surgical intervention have both proved to be factors indicating a poor prognosis. The clinical symptoms and signs were classified in three general types: increased intracranial pressure, brainstem dysfunction, and cerebellar disturbances. A fracture of the occipital bone was seen in 84.2% of the patients. The source of bleeding often remained undetermined, although a tear of the dural sinuses was a most frequent finding. An associated intracranial lesion was found in 39.7% of the cases, this being another factor indicating a poor prognosis. The overall mortality was 26.5%, while the surgical mortality was only 11.5%. Excellent results were achieved in 65% of the cases. PMID- 6845155 TI - Extraosseous extradural tuberculous granuloma of the spine. PMID- 6845156 TI - Microsurgical anatomy of spinal subarachnoid space. AB - The anatomy of the spinal subarachnoid space is reviewed with special reference to the work of Key and Retzius, the authors' own cadaver dissections, and experience from operative cases. It appears that despite some variations in the spinal arachnoid anatomy, there are many consistent features that can serve to guide the operating neurosurgeon. PMID- 6845157 TI - Radiology of acute subtemporal subdural hematomas. PMID- 6845158 TI - Experience with bucrylate (isobutyl-2-cyanoacrylate) embolization of cerebral arteriovenous malformations during surgery. AB - The clinical experience with five patients selected for embolization of cerebral arteriovenous malformations with bucrylate (isobutyl-2-cyanoacrylate) during surgery is described. Bucrylate embolization was used to obliterate one arteriovenous malformation with a dominant nutrient arterial network, and to facilitate surgical resection in two other cases. The extent of the embolization in one of these cases was limited because of segmental perfusion of the AVM nidus by different nutrient arteries. Histological examination of this arteriovenous malformation, resected 56 days after embolization, suggested bucrylate has minimal histotoxicity. Two arteriovenous malformations were found at operation to be unsuitable for embolization because of technical problems with access and exposure of nutrient arteries, and also because of vagaries in the angiographic data before surgery. In two cases, rapid polymerization of bucrylate resulted in gluing of the injection catheters into the arterial lumen. Two patients experienced transient postoperative neurological deficits after bucrylate embolization. Because of the potential hazards of the technique, direct bucrylate embolization of cerebral arteriovenous malformations should only be considered for those lesions felt unsuitable for direct microsurgical excision, and where facilities exist for recording angiographic data before surgery. PMID- 6845160 TI - Acute chemical meningitis after metrizamide-lumbar myelography. AB - Severe acute meningitis developed after the use of metrizamide for lumbar myelography; cerebrospinal fluid findings included a white blood cell count of 2300, mostly polymorphonuclear cells, glucose level of 8 mg% and protein level of 253%. This apparent chemical meningitis could not be distinguished, either clinically or by cerebrospinal fluid examination, from acute bacterial meningitis. This case emphasizes that severe acute meningeal reactions, while very rare, can occur after the use of metrizamide for myelography. Such patients must be evaluated promptly to rule out bacterial meningitis and should be followed carefully for possible later sequelae. PMID- 6845159 TI - Isotope sinography: technical modifications utilizing computer enhancement and the vertex view. PMID- 6845161 TI - Chronic subdural hematoma after lumbar-subarachnoid analgesia for a cesarean section. PMID- 6845162 TI - Paragangliomas of the spinal canal. AB - Paragangliomas are tumors arising in the paraganglia and rarely occur in the spinal canal. In the literature, 11 such cases have been reported. We present 7 additional cases, 3 of which were epidural in location in contrast to previously described intradural cases. The problems of histological diagnosis of these tumors are discussed. The value of determination of biogenic amines in the tumor tissue or the urine has been pointed out. PMID- 6845164 TI - Nosocomial medicolegal problems. AB - Most incidents resulting in medicolegal claims occur in the hospital setting, partly because of the numerous surgical procedures which take place there, but also because of the complexity of communication and shared responsibility among physicians, house staff, nurses, technicians, and lay employees. Various situations likely to pose medicolegal problems are described, particularly those related to the giving and documenting of medical orders and the delegation of responsibility. Guidelines for avoiding medicolegal problems in the hospital setting, and for handling them should they occur, are given. PMID- 6845163 TI - Solving soft contact lens problems. PMID- 6845165 TI - Ophthalmology manpower: shortfall or windfall? AB - Forecasts of ophthalmology manpower depend on assumptions about future supply and requirements. The two factors that influence supply are the number of residents trained and the attrition of ophthalmologists in practice. The factors that influence requirements are the estimated amount of future ophthalmic services the public will demand and the productivity of ophthalmologists. Previous forecasts have produced widely differing results because of an inadequate data base and varying theoretical assumptions. A conservative approach is to use past ophthalmologist to population ratios as a guide, and to tailor the output of ophthalmologists accordingly. A yearly reduction from 1982 to 1990 between 5% and 10% in the number of residency positions will be necessary to bring supply in line with requirements within the next thirty years. PMID- 6845166 TI - The diagnosis and treatment of midline neck masses in children. AB - Frustration in differentiating before operation among the various causes of midline neck masses stimulated us to review the clinical, operative, and pathologic findings in 176 children hospitalized for a midline cervical lump. The preoperative diagnosis was correct in 61% of these cases, the surgeon's postoperative diagnosis was correct in 83%, and the pathologist's diagnosis was correct in 98%. Only recurrence following prior excision and persistent sinus following drainage of a midline cyst were pathognomonic preoperative indicators of a thyroglossal duct cyst; these findings were present in only 6% of the cases. The age of the child, a history of inflammation or of fluctuation in size, the dimensions of the mass, and the relationship of the mass to the hyoid were useful in differentiating among groups of children with a thyroglossal cyst, an epidermoid cyst, or an enlarged perihyoid lymph node. The duration of the presence of the mass and its movement with swallowing were not helpful. Using the preoperatively recorded historical and physical findings in these children with a known cause for their midline neck mass and applying Bayes' theorem, one can only achieve a correct preoperative diagnosis with an 80% accuracy based on the best available data. Consequently, additional information obtained at surgical exploration is needed to establish a secure diagnosis and to ensure appropriate treatment. PMID- 6845167 TI - Transvenous interruption of the inferior vena cava. AB - Transvenous interruption of the inferior vena cava was successful in 45 of 47 consecutive patients treated during a 41/2-year period. Greenfield filters were used in 40, and Mobin-Uddin umbrellas in 5 others. Technical details of the insertion procedure are of particular importance for successful implantation of the Greenfield device. Follow-up data were available for 34 of 36 surviving patients and autopsy findings for 4 of the 11 who had died. Patency of the vena cava was assessed by radionuclide scan, venography, or autopsy. Of 33 patients with Greenfield filters who were evaluated, only one had an occluded filter, for a patency rate of 97%. One of the three patients with a Mobin-Uddin umbrella had caval thrombosis. Severe postoperative venous stasis was seen in one patient with a Greenfield filter and one with a Mobin-Uddin umbrella. Significant distal migration or angulation of Greenfield filters was observed in six patients and is a theoretical cause for recurrent embolization. The 30-day mortality rate for the patients who had transvenous procedures was 13%, but no deaths were attributed to the procedure itself. There were no clinically evident pulmonary emboli during the follow-up period. In the present study we have documented low operative morbidity and mortality rates as well as complete protection from recurrent pulmonary embolism using transvenous interruption of the inferior vena cava. Although the Greenfield filter is somewhat bulkier and more difficult to insert than the Mobin-Uddin umbrella, it has a clear advantage because of its superior long-term patency. PMID- 6845168 TI - The short-term effects of increasing plasma colloid osmotic pressure in patients with noncardiac pulmonary edema. AB - We infused hyperoncotic albumin (25 or 50 gm of a 50% solution) into patients with noncardiac pulmonary edema (adult respiratory distress syndrome [ARDS]) to evaluate its effect on the transmicrovascular flux from blood to pulmonary edema fluid of two radiotracers--111In-DTPA (mol wt 504) and 125I-human serum albumin (HSA) (mol wt 69,000). Two groups of patients were studied--one with a modest increase in permeability of the pulmonary alveolocapillary membrane to 125I-HSA (group 1) and another with a large increase in permeability to 125I-HSA (group 2). We used furosemide, when necessary, to minimize the effect of albumin infusion to increase the pulmonary microvascular hydrostatic pressure (Pmv), measured clinically as the pulmonary capillary wedge pressure (PCWP). Therapy significantly increased the mean colloid osmotic pressure (COP) in both groups, but not the mean PCWP or calculated Pmv. Albumin had no significant effect on the mean pulmonary transmicrovascular flux of the radiotracers in either group, despite the increase in COP. In individual patients, a change in the Pmv in response to albumin infusion was directly correlated with the change in flux of 111In-DTPA [group 1: delta In-DTPA (%) = 8.66 + 1.4 delta Pmv (%) r = 0.51, P less than 0.02; group 2: delta In-DTPA (%) = -3.43 + 1.6 delta Pmv (%) r = 0.67, P less than 0.01]. A change in the transmicrovascular flux of I-HSA also correlated with a change in the intravascular Starling forces in both groups. We conclude that albumin infusion in patients with ARDS will not augment the pulmonary transmicrovascular flux of low or high molecular-weight solutes when the effect of albumin to increase the Pmv is minimized; nor, however, does an increase in plasma COP significantly reduce the flux of such solutes. PMID- 6845169 TI - Common channel syndrome--diagnosis with endoscopic retrograde cholangiopancreatography and surgical management. AB - Six patients with intermittent bouts of vomiting, fever, abdominal pain, and jaundice beginning in infancy or early childhood were all demonstrated by endoscopic retrograde cholangiopancreatography to have an anomalous junction of the pancreaticobiliary ductal system with the formation of a characteristic long common channel. A varying degree of dilatation of the bile duct also was noted. Resection of choledochus followed by hepaticoduodenostomy was performed with satisfactory results invariably in all cases. The existence of a pathologic entity that might reasonably be designated "common channel syndrome" is discussed with some comments on its relationship with dilatation of the bile duct (choledochal cyst) as well as on the recommendable method of surgical treatment. PMID- 6845170 TI - Effects of bile acid and salicylate on isolated surface and glandular cells of rabbit stomach. AB - Little is known about the response of surface cells and glandular cells of the gastric mucosa to various injurious agents. This study examines the effects of bile acid and salicylate on oxygen consumption and membraneolysis of isolated gastric mucosal surface cells and compares these responses to those of cells constituting the gastric glands. The effects of salicylate and bile acid on oxygen consumption by surface cells are similar to previous observations for intact gastric glands and isolated mitochondria, indicating alterations of oxidative phosphorylation. Salicylate does not appreciably alter lipid release from either surface or glandular cells. However, bile acid causes a profound increase in lipid release from both surface and glandular cells. Salicylate does not alter the number of visibly intact surface or glandular cells, but 1 mM of taurocholic acid decreases the number of surface cells by 45% without altering the glandular cells. In contrast, 5 mM of taurocholic acid completely destroys the surface cells and reduces the number of gastric glandular cells by 51%. These data suggest that surface cells are more susceptible to membraneolytic effects of bile acid than are gastric glandular cells. This may account for the superficial nature of bile acid-induced injury to the gastric mucosa. Although both bile acid and salicylate interfere with oxidative metabolism, this effect alone does not appear to account for cellular destruction. PMID- 6845171 TI - Presidential address: noninvasive testing of vascular disease--fact, fancy, and future. PMID- 6845172 TI - Surgical reconstruction of the vertebral artery. AB - Thirty-five vertebral artery (VA) reconstructions are reviewed. Detailed neurologic, medical, and angiographic information was obtained for all patients. Various reconstructive techniques were used: VA bypass or reimplantation of the VA into subclavian or common carotid sites. Although endarterectomy of severe internal carotid artery lesions in patients with vertebrobasilar insufficiency is often curative, our experience has shown that in patients with normal or minimally diseased internal carotid arteries and severe bilateral VA disease, a single VA repair results in cure in 83% and improvement in an additional 10% of all patients. Simultaneous VA reimplantation in the course of internal carotid endarterectomy is appropriate in selected instances. There were no deaths or central neurologic deficits among the patients in our study. Lymphocele (11%) and partial Horner's syndrome (14%) are the most frequent complications, and some technical considerations to avoid these problems are described. VA reconstruction in carefully selected patients is a successful and safe technique. PMID- 6845173 TI - Computerized multiplanar imaging and lumen area plotting for noninvasive diagnosis of carotid artery disease. AB - Some of the errors associated with pulsed Doppler imaging of the carotid bifurcation relate to the fact that the vessels are usually viewed in only one plane. To reduce these projection errors, a computerized ultrasonic arteriograph (CUA) was developed, which simultaneously produces lateral and anteroposterior images of the carotid bifurcation together with a histogram that depicts the cross-sectional area of the lumen at 1 mm points along the vessel. The area measured from the histogram and that estimated from biplanar arteriograms agreed in 46/57 (81%) of the internal carotid arteries studied by both techniques. The area histogram was positive for 91% of the arteries with arteriographically visible disease and was 79% specific for eliminating the presence of disease. The combined CUA study (histogram plus images) had a sensitivity and specificity of 96% and 80% for detecting any disease, 96% and 92% for evaluating diameter stenoses of 20%, and 89% and 98% or evaluating stenoses of 40%. These preliminary results suggest that the CUA may enhance the accuracy of pulsed Doppler imaging. PMID- 6845174 TI - Cognitive improvement after extracranial reconstruction for the low flow- endangered brain. AB - Twelve patients with multiple occlusive neck vessel lesions were thought to possess low flow-endangered brains. These patients were studied before and after carotid reconstruction with a battery of neuropsychologic tests emphasizing memory and mental agility. A closely matched control group was selected from patients undergoing endarterectomy for hemodynamically insignificant lesions. The patients with low flow-endangered brains showed significantly greater improvements in memory and mental abilities than did the control group. Reconstruction of neck vessels may reverse such global neurologic deficits in carefully selected patients. PMID- 6845175 TI - Isolated iliac artery aneurysms. AB - The records of 50 patients with isolated iliac artery aneurysms seen between January 1970 and January 1982 were reviewed. Forty-seven were men and three were women. Their ages ranged from 41 to 92 years (mean 69.7 years). Aneurysm diameter ranged from 2 to 20 cm (mean 4.7 cm). Seventeen patients had multiple aneurysms. Sixty-two percent of aneurysms were on the right side. Eighty-nine percent were located in the common iliac artery, 10% in the internal iliac artery, and 1% in the external iliac artery. Twelve patients had symptoms; all presented with sudden pain. Rupture occurred in seven patients; only three patients survived. Twenty-four patients had surgical treatment. Aneurysmorrhaphy with graft interposition was the most common procedure. There were no deaths during elective operation. Nineteen patients who did not undergo operation were followed from 0.25 to 11 years (mean 4.9 years). Enlargement occurred in nine patients and rupture in one. We conclude that the natural history of isolated iliac artery aneurysms is similar to that of other atherosclerotic aneurysms. Elective resection and arterial reconstruction are recommended. PMID- 6845176 TI - Limb-threatening potential of arteriosclerotic popliteal artery aneurysms. AB - Eighty-eight popliteal artery aneurysms were diagnosed in 59 men and two women (mean age 67 +/- 10 years). Bilateral aneurysms affected 27 patients (44%). Aneurysm diameter ranged from 1.3 to 12 cm (mean 4 +/- 2.6 cm). Most aneurysms were symptomatic (55%). Dominant symptoms included rest pain (19%), claudication (14%), local pain (13%), and gangrene (9%). The remainder of the aneurysms were asymptomatic (45%). Aneurysm thrombosis occurred in 24% of extremities. Associated aneurysms involved the abdominal aorta (62%), iliac artery (36%), and femoral artery (38%). Aneurysms that caused local pain were larger (6.2 +/- 1.9 cm) than asymptomatic aneurysms (2.9 +/- 2.1 cm, P less than 0.01). Aneurysms smaller than 2 cm were more likely to be asymptomatic than larger aneurysms (P less than 0.05). Operative intervention was undertaken for 56 aneurysms, with aneurysmal exclusion or excision with arterial reconstruction performed most often. Four primary and five secondary major amputations were associated with thrombosed aneurysms, compared to no amputations with asymptomatic aneurysms (P less than 0.01). Thirty-two aneurysms were not treated surgically. Limb loss resulted from ischemic complications which developed in 18% of aneurysms treated without operation. The duration of follow-up for patients who had operation and those who did not averaged 62 months and 25 months, respectively. Operative treatment for all bland popliteal artery aneurysms appears justified if complications leading to major amputation are to be avoided. PMID- 6845177 TI - Arteriomegaly: classification and morbid implications of diffuse aneurysmal disease. AB - Ninety-one patients with arteriomegaly and diffuse aneurysmal disease below the level of the renal arteries have been classified according to the extent and location of aneurysmal change. There exists a high incidence of thrombotic and embolic complications, and treatment entails increased rates of morbidity and mortality when compared to surgical treatment of simple abdominal aneurysms of peripheral artery aneurysms. Complete revascularization at the initial operation would appear to give the best result, but this approach must be tempered by the individual patient risk factors and the urgency of the mode of presentation of the patient. PMID- 6845180 TI - When can revascularization be limited to the isolated popliteal artery? PMID- 6845178 TI - Hemodynamic evaluation of the aortoiliac system based on pharmacologic vasodilatation. AB - Selection of the appropriate vascular reconstructive procedure in patients with multisegment disease requires the differentiation of aortoiliac from femoropopliteal occlusive disease and the detection of subcritical stenoses in the aortoiliac segment. Triplane arteriography and common femoral intra-arterial papaverine injection (30 mg) were done in 43 lower extremities in patients who subsequently had arterial bypass. The percent diameter stenosis was measured on the arteriograms and common femoral intra-arterial pressure was continuously monitored before and after papaverine injection. A resting femoral/brachial pressure index (FBI) was obtained and the percent decrease in this index (% delta FBI) was calculated using the maximum decrease in FBI following injection. Regression analysis revealed a significant correlation between % delta FBI and percent aortoiliac stenosis (r = 0.5446, P less than 0.005). In relation to clinical course, receiver-operator characteristic curve analysis revealed a % delta FBI of greater than or equal to 0.15 to be optimal in the detection of hemodynamically significant aortoiliac stenoses. When compared to clinical course, this % delta FBI was 88% sensitive, 100% specific, and 95% accurate. However, when analyzed with arteriography as the standard (50% stenosis), the same % delta FBI was only 70% sensitive, 100% specific, and 86% accurate. All limbs with a % delta FBI of 0.15 or greater improved following aortoiliac revascularization; 21% of these limbs had a normal preoperative resting FBI. No patient with a % delta FBI lower than 0.15 had improvement following aortoiliac revascularization. All limbs that had infrainguinal bypass had normal FBIs and % delta FBIs before bypass. After operation 90% of these limbs improved. Overall, this technique correctly predicted the clinical course in 95% of the limbs tested. PMID- 6845179 TI - Hemodynamic assessment of venous problems. AB - Objective assessment of venous function based on venous refilling time recorded by photoplethysmography (PPG) was done in 89 patients with postphlebitic syndrome (47), primary varicose veins (29), and after an episode of acute deep vein thrombosis (13). Limbs with symptomatic postphlebitic changes had a shortened venous refilling time of 15.6 +/- 11 seconds (normal greater than 20 seconds). When venographic findings (ascending and descending) in 47 patients with postphlebitic syndrome were analyzed, it was noted that femoral valve incompetence demonstrated by descending venography was a common finding (81%), even in asymptomatic limbs (85%). Venous refilling time bore no relationship to the degree of femoral venous valve reflux. However, if there were associated diseased deep veins with incompetent perforating veins, the venous refilling time was much shorter (14 +/- 4 seconds) than in limbs without calf perforating veins (27 +/- 11.9 seconds, P less than 0.05). A tourniquet was used to impede saphenous flow, and changes in refilling time were recorded in 34 limbs with varicosities of the long saphenous vein. Refilling time normalized after tourniquet application in 31 limbs (14.43 +/- 4.34 to 30.64 +/- 11.9 seconds), and all patients underwent vein stripping. Postoperative recording confirmed the improvement in venous refilling time (29.52 +/- 27.8 seconds, P less than 0.05). Thirteen patients with acute deep vein thrombosis had serial PPG tests during a follow-up period of 27 months (mean 15.8 months). Seven had initial abnormal PPG results and persistently abnormal readings, and all developed postphlebitic changes. Venous refilling time is an useful test to determine the hemodynamic significance of femoral venous valve incompetence and to assess the effect of vein stripping on varicose veins. In acute deep vein thrombosis, follow-up study may help to identify patients at risk for development of postphlebitic changes. PMID- 6845181 TI - Gas bloat syndrome. PMID- 6845182 TI - Adjuvant therapy for melanoma. PMID- 6845183 TI - Use of omentum for liver injuries. PMID- 6845184 TI - Training programs in vascular surgery. PMID- 6845185 TI - [Clinico-morphological changes in the colon in chronic hepatitis and liver cirrhosis]. PMID- 6845186 TI - [Treatment of ascites, non respondive to drug therapy, with an artificial kidney]. PMID- 6845189 TI - [Complex conservative orthopedic treatment of lesions of the shoulder girdle in rheumatoid arthritis]. PMID- 6845188 TI - [Effect of serum from patients with systemic scleroderma on collagen biosynthesis in the fibroblasts before and after administration of antilymphocyte globulin]. PMID- 6845187 TI - [Biochemical aspects of infectious allergic myocarditis]. PMID- 6845190 TI - [Informative value of clinico-immunological indicators in patients with rheumatism]. PMID- 6845192 TI - [Improving the training of a district internist at the medical institute]. PMID- 6845191 TI - [Clinical variants and the morphological picture of the joint syndrome in patients with psoriasis]. PMID- 6845193 TI - [Dynamics of the recurrence of chronic ulcer and the state of the gastric mucosa]. PMID- 6845194 TI - [Diagnostic value of the determination of bile acids in the blood in peptic ulcer]. PMID- 6845195 TI - [Introduction of the results of scientific research into public health]. PMID- 6845196 TI - [Determination of alkaline phosphatase isoenzymes by an original kinetic method in patients with chronic active hepatitis]. PMID- 6845197 TI - [Nonspecific reactive hepatitis with non-conjugated hyperbilirubinemia]. PMID- 6845198 TI - [Pancreatic lesions in alcoholism]. PMID- 6845203 TI - [Differential diagnosis of pancreatitis by the quantitative evaluation of echograms]. PMID- 6845201 TI - [Changes in various functions of the liver and stomach after complex treatment of patients with chronic cholecystitis]. PMID- 6845200 TI - [Peripheral blood and liver function in patients with liver cirrhosis after hemosorption]. PMID- 6845202 TI - [Ultrasonic diagnosis of calculous cholecystitis]. PMID- 6845199 TI - [Intermittent hospitalization of patients with peptic ulcer]. PMID- 6845204 TI - [Diagnostic criteria, diffuseness of fundal and antral gastritis and the correlation between endoscopic and histological signs]. PMID- 6845205 TI - [Local mechanisms of the regulation of the acid-forming and evacuation functions of the stomach in patients with duodenal ulcer]. PMID- 6845206 TI - [Effect of duodenal contents on blood gastrin concentration]. PMID- 6845207 TI - [Characteristics of diagnosis, mechanisms of development and the results of treatment of gastro-esophageal reflux and reflux esophagitis]. PMID- 6845208 TI - [Functional and morphological state of the gastrointestinal tract in chronic circulatory disorders]. PMID- 6845209 TI - [Histomorphological and histochemical characteristics of the colonic mucosa in colonic dyskinesia]. PMID- 6845210 TI - Muscle abnormalities associated with radial aplasia. AB - The purpose of this paper was to report the muscle variations in eleven cases of radial aplasia and to extract information relative to normal and abnormal limb muscle development. The cases all involved other defects ranging from acardia to "thrombocytopenia-absent radius" (TAR) and included several multiple malformations. The muscle patterns did not seem to depend upon the etiology of the radial aplasia but appeared to be more dependent upon late embryonic or early fetal muscular repositioning. PMID- 6845211 TI - Regional variations in guinea pig uterine blood flow during pregnancy: relationship to intrauterine growth of the fetal-placental unit. AB - The relationship between regional variations in uterine blood flow and fetal placental weight/size was examined in guinea pigs possessing three pregnancy sites per horn. Pregnancy sites were localized in either the tubal, middle, or cervical third of the uterus. Throughout pregnancy, the middle uterine pregnancy sites consistently received a lower blood flow rate than did either of the other two uterine zones. The middle zone also possessed the lowest fetal-placental weights and smallest fetuses, based on crown-rump length measurements, of all three zones. Significant correlation coefficients were found to exist between uterine blood flow and placental weight, placental and fetal weights, and fetal weight and crown-rump length. Experimental reduction of uterine blood flow to the tubal pregnancy site effectively induced a retardation of intrauterine fetal placental growth, which was comparable to that found in the middle uterine zones. These data indicate that variations in regional blood flow rates to the guinea pig uterus affect intrauterine growth of the fetal-placental unit. PMID- 6845212 TI - Developmental and cytogenetic effects of potassium dichromate on mouse embryos in vitro. PMID- 6845214 TI - Teratogenicity of triamcinolone acetonide in rats. PMID- 6845213 TI - Supradiaphragmatic accessory lobe of the liver in BB Wistar rats. AB - Supradiaphragmatic accessory livers were observed in two closely related rats in a series of 172 necropsies on BB Wistar rats. The gross and histological appearance of both accessory lobes are described. This abnormality has been reported in only one other inbred strain of rats where it also arose with a very low incidence. As in the previous report, the pattern of occurrence of these accessory lobes suggests a mode of inheritance that is either polygenic or autosomal recessive with low penetrance. PMID- 6845216 TI - Ionic effects on strain differences in hepatic cytosolic glucocorticoid receptor levels in mice. PMID- 6845220 TI - The causes of perinatal death induced by prenatal exposure of rats to the pesticide, mirex. Part I: Pre-parturition observations of the cardiovascular system. AB - Prenatal exposure to mirex, a chlorinated hydrocarbon insecticide, induces a high rate of perinatal death, but only a low incidence of visible abnormalities which could help to account for these deaths. This study is an attempt to determine the cause of these deaths. Pregnant rats were intubated with a moderate dose of mirex, in oil, 6 mg/kg/day, on days 8 1/2-15 1/2 of gestation. Observations, on 78 control and 136 treated fetuses, were made on the morning before parturition was expected. Fetuses were sequentially exposed and electrocardiograms obtained with the fetus attached to the placenta and uterus. ECGs were evaluated for rate of beat, regularity of beat, PR intervals, and other features. Fetuses were examined for edema level and vitality. None of the controls were dead and none had abnormal ECGs. Of the treated group, 14% were dead, 16% had a first-degree heart block, and 2% had a second-degree heart block. Some (6%) had slow, feeble atrial beats only, possibly a third-degree block, and appeared to be dying. The severity of the symptoms was proportional to the degree of visible edema. Most of the fetuses with little or no visible edema had normal ECGs, but the majority of the moderate to severely edematous fetuses (i.e., with a layer of subcutaneous edema across the back of 0.5 mm or more) had abnormal ECGs and/or were either dead or dying. These data show that the effects of mirex on the fetal cardiovascular system are a major factor in inducing prenatal death. PMID- 6845218 TI - Prospective study of suspected associations between certain drugs administered during early pregnancy and congenital malformations. AB - From 1964 to 1976, a cohort study was performed in West Germany to study the possible influence of various factors on pregnancy and child development. Results of the evaluation of 13,643 pregnancies are given with respect to possible teratogenetic effects of antiemetic drugs and sex hormones administered in early pregnancy. There was no evidence of an increased risk of major malformations following the intake of certain antiemetic drugs and progesterone. Also, the use of a hormonal pregnancy test was not significantly associated with an increase of major malformations. PMID- 6845219 TI - The use of early chick embryos in experimental embryology and teratology: improvements in standard procedures. AB - The chick embryo is a convenient experimental system for embryologic and teratologic studies. However, windowing eggs during the first day of incubation, a procedure that is required to expose embryos in ovo, frequently results in dysmorphogenesis. The frequency and severity of the particular anomalies caused by windowing are greater the younger the embryo at the time this procedure is done. At all stages examined, dysraphic defects of the neural tube are the most common anomaly present following windowing. Defects of the neural tube are virtually eliminated if the air space introduced over the embryo by windowing is filled with albumen or saline, and the egg (with its window sealed with tape) rotated 180 degrees, so that the embryo rests subjacent to an undisturbed area of the shell. Subblastodermic injection of saline, a vehicle often used for teratogenic agents, has no adverse effects when eggs are subsequently filled with albumen or saline and rotated. Furthermore, known teratogens (e.g., colchicine, hyaluronidase) injected subblastodermically after windowing are active in eggs that are then filled with albumen or saline and rotated. Finally, the addition of albumen or saline, followed by rotation, may be delayed up to 3 hours without reducing the restorative effects of these two procedures. Our modified procedures for the handling of windowed eggs significantly increase the value of young chick embryos for studies of early developmental events. PMID- 6845217 TI - Another specific effect of prenatal acetazolamide exposure in the mouse. PMID- 6845215 TI - Teratogenicity in vitro of 2-acetylaminofluorene: role of biotransformation in the rat. PMID- 6845221 TI - Complications of pregnancy in mice exposed prenatally to DES. AB - Women exposed prenatally to diethylstilbestrol (DES) develop a variety of reproductive tract anomalies. Most of these anomalies have been replicated in strain CD-1 mice after similar DES exposure. Recently, impaired reproductive performance in DES-exposed women has been reported. To see whether the mouse model also replicates this defect, a study of reproduction was performed. Pregnant CD-1 mice were injected with DES and their female offspring were raised to breeding age. The latter were then exposed continuously to untreated males for a maximum of 4 months. Among 74 mated mice, 34 became pregnant and 11 of these pregnancies ended in abortion or stillbirth. Other anomalies encountered were: two fetuses with compressed heads, one of which seemed blocked from delivery by a vaginal adenocarcinoma; two uterine tumors, one of which was a teratocarcinoma; two teratomas located in uterine lumina; and two uteri containing placentas without embryos. Since the frequency of successful pregnancies in the DES-exposed mice was reduced below control levels to a degree similar to that reported for DES-exposed women, the validity of the mouse model has been confirmed for this characteristic. PMID- 6845222 TI - Regeneration by dissociated adult Hydra cells: a histologic study. AB - Adult Hydra attenuata with vitally stained gastrodermal cells were dissociated into their component cells which were then randomly reaggregated into pellets by low-speed centrifugation. Representative examples of these preparations, which develop into normal adult hydra if left undisturbed, were examined fresh at low magnification and at higher magnification in fixed, stained, and sectioned specimens. The actual pellet stage lasts less than 1 hour because the adult ectodermal and gastrodermal cells rapidly sort themselves into an inner and outer layer and seem to secrete a new mesoglea immediately thereafter. The "embryo" becomes trilaminar and attains a central cavity by extruding a large amount of cellular debris at the end of the first day. At about this same time, new tentacles begin to differentiate from rapidly dividing and undifferentiated interstitial cells. Regulation of tentacle number and position occurs at the end of two days, and the body form is essentially reestablished within 60 hours by further differentiation of the hypostomes and body wall. Complete separation of the preparation into individual polyps does not occur until about 190 hours of development. PMID- 6845223 TI - Effect of vinblastine sulfate on the growth and histologic development of reaggregated Hydra. PMID- 6845225 TI - I like you, doc, and you care about me . . . but a pox on all your waiting games! PMID- 6845224 TI - Relationship of developmental stage to effects of vinblastine on the artificial "embryo" of Hydra. AB - Three milligrams of vinblastine sulfate per liter of culture medium prevented normal development of all reaggregated artificial hydra "embryos" at the 66-hour stage of regeneration. One milligram of vinblastine per liter of medium had no effect on development, and 100 mg did not markedly accelerate the developmental disruption beyond the pace of the 2 mg/liter concentration which was the lowest effective concentration. Treatment with vinblastine through the first few hours of development was sufficient to produce the toxic endpoint at 66 hours of incubation, but effects were delayed in appearance when treatment was initiated later in development. Early development of exposed preparations proceeded normally even in the presence of rather high concentrations of the test substance, and the pellet was resistant to the effects of vinblastine treatment begun after 24 hours of development. From these results, it would appear that interference with cell division is not the primary means by which vinblastine perturbs this developing system. PMID- 6845226 TI - What's new: review of clinical presentations, pathophysiology, and treatment of diabetic neuropathies. PMID- 6845227 TI - Management of the child with diabetes. PMID- 6845228 TI - "Coumarin skin necrosis". PMID- 6845229 TI - Bilateral benign adult cystic ovarian teratomas: case report and review of complications. PMID- 6845230 TI - Why is my child so pale? Evaluation of anemia in children. PMID- 6845231 TI - Physician advertising--legal and ethical considerations. PMID- 6845232 TI - [What walking with a prosthesis involves]. PMID- 6845233 TI - [Postoperative care of the stump and physical retraining of the patient]. PMID- 6845234 TI - [Fitting the first prosthesis in below-knee amputations at the Bellikon Aftercare Center]. PMID- 6845235 TI - [Principles of teaching below-knee amputees to walk including weaning from canes]. PMID- 6845236 TI - [Initial fitting of a prosthesis in above-knee amputations at the Bellikon Aftercare Center]. PMID- 6845237 TI - [Principles of teaching above-knee amputees to walk]. PMID- 6845238 TI - [Significance of conditioning therapy in the rehabilitation of amputees]. PMID- 6845239 TI - [Major amputations in vascular disease. Indication and surgical technique]. PMID- 6845240 TI - [Amputation in geriatric patients]. PMID- 6845241 TI - [Amputation and prosthesis fitting of the upper extremity]. PMID- 6845242 TI - [Prosthetic training of the upper extremities]. PMID- 6845243 TI - [Occupational evaluation and occupational counseling for amputees]. PMID- 6845245 TI - [Smoking and pregnancy]. PMID- 6845244 TI - [Behavior of smokers]. PMID- 6845246 TI - [Repercussions of tobacco consumption on sports performance]. PMID- 6845247 TI - [Effects of smoking from a medico-dental viewpoint]. PMID- 6845248 TI - [Smoking and its effects in otorhinolaryngology]. PMID- 6845249 TI - [Chronic lung diseases in smokers]. PMID- 6845250 TI - [Smoking and gastroenterology]. PMID- 6845251 TI - [Cigarette smoking and coronary heart disease]. PMID- 6845252 TI - [Toxicology of tobacco smoke and smokers' diseases]. PMID- 6845253 TI - [Tobacco smoke and cancer]. PMID- 6845254 TI - [Sociocultural determinants of smoking behaviour and perspectives of primary prevention]. PMID- 6845255 TI - The single-breath carbon monoxide transfer test 25 years on: a reappraisal. 1- Physiological considerations. PMID- 6845256 TI - Preoperative staging of lung cancer: accuracy of computed tomography versus mediastinoscopy. AB - Forty-four patients coming to surgery for carcinoma of the bronchus underwent preoperative staging of the mediastinum by computed tomography (CT scanning) and surgical exploration of the mediastinum by cervical mediastinoscopy or left anterior mediastinotomy or both. Where mediastinal nodes were affected the sensitivity and specificity of computed tomography was inferior to that of mediastinoscopy (57% and 85% versus 71% and 100%). The sensitivity of computed tomography in predicting mediastinal invasion was superior to that of mediastinoscopy (77% v 46%), especially in the case of lower-lobe tumours (67% v 17%). Mediastinoscopy had the considerable advantage of 100% specificity. In the assessment of hilar lymphadenopathy computed tomography had a sensitivity of 38% and a specificity of 64%. In cases where computed tomography showed a normal mediastinum or enlargement of the hilar glands only, mediastinal exploration conferred no additional information and could have been omitted. A computed tomography scan showing mediastinal abnormality is an indication for mediastinoscopy and not a contraindication to surgery. In 23 patients computed tomography showed some abnormality of the mediastinum, confirmed at mediastinoscopy in 12 cases. The remaining 11 patients underwent thoracotomy, resection being carried out in nine. Postsurgical staging showed that six of these tumours were N0 lesions without invasion; in two further N0 cases there was a minor degree of mediastinal invasion which did not prevent resection, and the remaining tumour was N1 without invasion. PMID- 6845257 TI - Intrapleural Corynebacterium parvum for malignant pleural effusions. AB - A pilot study of topical (intrapleural) treatment with Corynebacterium parvum was carried out in 10 patients with malignant pleural effusions complicating primary or secondary neoplasms and necessitating frequent thoracocentesis for symptomatic relief. The method was aspiration of all intrapleural fluid except a small portion left for dilution, and then injection of 7 mg of a preparation of Corynebacterium parvum suspended in 20 ml of normal saline solution. The treatment was repeated in each case as clinical conditions called for further thoracocentesis. In eight of these 10 patients the treatment resulted in prompt reduction of the rate of accumulation of pleural fluid and a striking change of cell sediment composition, with appreciable reduction in or complete disappearance of malignant cells and a rise in lymphocyte and neutrophil polymorph counts. The best responders were patients with primary pleural mesothelioma. Clinical improvement was evident in all responders. PMID- 6845259 TI - Jejunal bypass of the cardia for benign stricture: report of six cases. PMID- 6845258 TI - Surgical treatment of false aneurysm of the left ventricle after myocardial infarction. AB - Rupture of the left ventricle after myocardial infarction results either in sudden death from cardiac tamponade or, when pericardial adhesions are present, in bleeding that is confined to a limited space, which gradually expands as the blood flows through a small communicating orifice under high pressure, forming a false aneurysm. In three such patients a false aneurysm of the left ventricle after myocardial infarction was successfully treated by operation. The interval from the initiating event to the time of surgery averaged 10 months. Two of the patients had pericarditis and all presented at some stage of the illness with tachyarrhythmias and cardiac failure. All the patients survived operation and have improved functionally. Because of the propensity of false aneurysms to rupture, early diagnosis and aggressive surgical treatment are recommended. PMID- 6845260 TI - Intrathoracic fundoplication for reflux stricture associated with short oesophagus. PMID- 6845261 TI - Value of beryllium lymphocyte transformation tests in chronic beryllium disease and in potentially exposed workers. PMID- 6845264 TI - Slope of the dose-response curve: usefulness in assessing bronchial responses to inhaled histamine. AB - The value of determining the slope of the histamine dose-response curve, in addition to the histamine provocation concentration producing a 20% reduction in FEV1 (PC20-FEV1), was assessed by analysis of histamine dose-response curves in 40 patients selected as having a wide range of increased non-specific bronchial responsiveness to inhaled histamine. The histamine dose-response curves were found to be fit the linear curve (dose v response, mean r2 = 0.97) better than the logarithmic curve (log dose v response, mean r2 = 0.93), the difference being significant (p less than 0.001). There was a strong negative correlation between the PC20-Fev1 and the slope (r = -0.98, p much less than 0.001) and a weak negative correlation between the PC20-FEV1 and the log-dose-response slope (r = 0.38, p greater than 0.05). Sixteen normal subjects and 16 asthmatic patients were compared on the basis of histamine dose-response curves measuring fal in sGaw. In this study there was no difference between r2 for the linear determination and for the logarithmic determination (0.91 v 0.90, p less than 0.05). The PC35-sGaw showed a strong negative correlation with the dose-response slope (r = -0.95, p much less than 0.01) and no correlation with the log-dose response slope (r = 0.09, p greater than 0.05). In the two studies there appeared to be little information gained from the determination of either the dose response slope or the log-dose-response slope. The slope and the PC20-FEV1 were equally reproducible, duplicate determinations showing less than a two-fold difference in 14 of 15 paired PC20 measurements and in 13 of 15 paired slope measurements. In summary, the slope of the histamine dose-response curve appears to fit the linear model better than the logarithmic model. It is feasible to calculate it from the results of a standardised histamine inhalation test; determination of either the slope or the log-dose-response slope, however, appears to add little useful information. It is recommended that bronchial provocation test results should be expressed in terms of a threshold concentration such as the PC20-FEV1 or the PC35-sGaw. PMID- 6845262 TI - The single-breath carbon monoxide transfer test 25 years on: a reappraisal. 2- Clinical considerations. PMID- 6845263 TI - Production of lactic acid by respiratory muscles. PMID- 6845265 TI - Thoracoabdominal mechanics during tidal breathing in normal subjects and in emphysema and fibrosing alveolitis. AB - Thoracoabdominal motion and intrathoracic (oesophageal), intra-abdominal (gastric), and transdiaphragmatic pressures were measured during tidal breathing in 20 erect subjects--six normal, seven, with emphysema, and seven with fibrosing alveolitis. In normal subjects all diameters increased synchronously during inspiration and were accompanied by rises in abdominal and transdiaphragmatic pressures. Five patients with fibrosing alveolitis showed a reduction in upper ribcage motion, but normal lower ribcage and abdominal motion; stiff fibrotic lungs may sometimes impair the ability of the diaphragm to expand the upper ribcage and result in proportionally more expansion of the bases. Four emphysematous patients showed increased anteroposterior motion of the ribcage and four showed paradoxical inward motion of the lower ribcage during inspiration. These changes apparently result from increased activity of intercostal and accessory muscles and altered configuration of the diaphragm. The muscles of patients with large, overinflated lungs are at a greater disadvantage than those with small fibrosed lungs. PMID- 6845266 TI - Dermatomyositis and rapidly progressive fibrosing alveolitis. PMID- 6845267 TI - Obliterative bronchiolitis and upper-zone pulmonary consolidation in rheumatoid arthritis. PMID- 6845268 TI - Endobronchial polyp in an asthmatic subject. PMID- 6845270 TI - High molecular weight forms of antithrombin III complexes in blood. AB - A double antibody competition radioimmunoassay was developed that allowed to detect specifically as little as 15 ng antithrombin III (AT III) per ml of the assayed material. In normal plasma examined by this assay, AT III concentration averaged 199 +/- 21 micrograms/ml. Complexes of AT III with thrombin or factor Xa crossreacted with free AT III in 87% and 95%, respectively. Molecular forms of AT III produced in plasma treated with coagulation enzymes, or in serum, were assessed by measuring immunoreactive AT III in fractions obtained by gel filtration chromatography on Sephadex G-200. AT III bound by thrombin in fibrinogen free-plasma ranged in molecular size from 160,000 to above 250,000. Similar aggregation occurred when monomeric complex of purified AT III and thrombin, of 90,000 Mr, was added to plasma. Presence of heparin intensified the degree of aggregation. In factor Xa-treated plasma AT III was converted into components with 160,000 Mr, or less. No complexes below 200,000 Mr were present in serum. They decreased in size to 160,000 Mr after affinity chromatography on heparin-Sepharose. These results indicated that blood represents a unique milieu conducive to aggregation of bound AT III. It appears, however, that AT II complexes present in blood may not only aggregate, but also associate with other serum proteins through unstable binding most likely caused by the enzyme component of the complex. PMID- 6845269 TI - Intralobar pulmonary sequestration in conjunction with bronchial isomerism. PMID- 6845271 TI - Fibrin network structure: modification by platelets. AB - Platelets play a fundamental role in haemostasis and thrombosis. They are known to undergo characteristic changes including release of subcellular material during clotting. The effect of subcellular platelet material on fibrin network structure, however, has not previously been investigated. Using opacity ratio, syneresis, permeation and electron microscopy it was found that subcellular platelet material extracted into NaCl is able to influence fibrin network structure of clots made from purified fibrinogen as well as platelet-poor plasma. Such clots had higher opacity ratio, reduced syneresis and lower permeability than control clots. Further, the responsible platelet material is heat labile and is released from the platelets during their aggregation with several common aggregating agents. Morphometric analysis of transmission electron micrographs has shown that fibrin fibres in plasma clots made in the presence of platelet subcellular material are thinner than those in control clots. In addition, plasma clots made in the presence of platelet extract had a higher resistance to fibrinolytic digestion than control clots. Thus, platelets play a hitherto undescribed role in regulating fibrin network structure. PMID- 6845272 TI - High resolution electrophoretic analysis of human fibrinogen and its crosslinked intermediates. AB - Heterogeneity in human fibrinogen was examined using an improved two-dimensional isoelectric focusing-SDS polyacrylamide gel electrophoretic procedure. Four different preparations of fibrinogen were compared: single donor fibrinogen prepared from plasma by precipitation with ammonium sulfate or by affinity chromatography on fibrin-monomer Sepharose, fraction 1-4 prepared from Cohn fraction I paste, and Kabi grade L. The subunit A alpha, B beta, and gamma chains in all preparations had marked charge heterogeneity. The three chains were clearly separated from each other and a range of isoelectric points for each chain could be assigned. Minor variations in the subunit heterogeneity of the different preparations were found. Intermediates in the transition from fibrinogen to crosslinked fibrin were also examined. A striking increase in the heterogeneity of the beta chain was observed during crosslinking. PMID- 6845273 TI - Increased tissue thromboplastin activity in monocytes of patients with meningococcal infection: related to an unfavourable prognosis. AB - In 16 patients, 13 with meningococcal infection and 3 suspected to have this infection, 8 patients were found to possess significant higher level of tissue thromboplastin activity of their monocytes isolated from the blood at the admission to the hospital than normal. Five of those 8 patients had an extremely high concentration, greater than 60-300 fold increase, and all these patients died. The exposed tissue thromboplastin activity on the surface of the endotoxin stimulated monocytes is probably the direct inducer of disseminated intravascular coagulation (DIC) in meningococcal infection. PMID- 6845274 TI - Relationship between antithrombin III, antiplasmin and plasma lipids in a healthy population. PMID- 6845275 TI - The catalytic activity and physical properties of bovine thrombin in the presence of dimethyl sulfoxide. AB - Dimethyl sulfoxide produces an opposite effect on the esterase and amidase activities of bovine thrombin. The esterase activity is increased by two fold but the amidase activity is decreased to 9% of the initial activity in 20% dimethyl sulfoxide. The stimulation of the esterase activity is due to the change in Vmax rather than Km for the substrate p-Tosyl-L-Arginine methyl ester. The inhibition of the esterase activity of thrombin by NaCl is not affected due to the addition of dimethyl sulfoxide. Ki for NaCl, 0.03 M, is the same for both in the absence and in the presence of 10% dimethyl sulfoxide. The catalytic activity of thrombin is inhibited by heparin. This effect is significantly decreased by dimethyl sulfoxide. The dissociation constant of heparin-thrombin complex, measured in the absence and in the presence of 10% dimethyl sulfoxide are 4 nM and 28 nM respectively. Thermal stability of thrombin, determined by monitoring catalytic activity, is increased in the presence of dimethyl sulfoxide. The enhancement of the fluorescence intensity of thrombin in the presence of dimethyl sulfoxide reflects the contribution of more exposed tryptophanyl residues. The alteration of the conformation of the enzyme structure due to the perturbation of the aqueous medium by dimethyl sulfoxide, has been attributed to these observed effects. PMID- 6845276 TI - Monocyte tissue factor activity in anticoagulant-treated patients. AB - The tissue factor coagulant activity of peripheral blood monocytes was measured in 20 patients on long-term anticoagulant treatment with warfarin and in 21 healthy individuals. Contrary to expectations, tissue factor activity was not reduced in the warfarin-treated group and was, in fact, elevated in several patients. No relationship existed between the daily warfarin dose or the degree of prolongation of the prothrombin time and the monocyte tissue factor activity. These results indicate that monocyte tissue factor activity is not necessarily reduced to below normal levels with warfarin treatment. PMID- 6845277 TI - Enzymatic properties of phospholipid methylation in rabbit platelets. AB - The enzymatic properties of phospholipid methylation in rabbit platelets were examined using S-adenosyl-L-[methyl-3H]methionine as a substrate. pH optimum for the methylation was around 10.5 under Tris-HCl and glycine-NaOH buffer systems. When Tris-HCl buffer was replaced by phosphate buffer, pH optimum shifted to around 8.0 and the methylation was increased approximately threefold, compared with that in the case of Tris-HCl buffer at pH 8.0. The formation of the 3H methylated phospholipids was increased by addition of exogenous phosphatidyl-N monomethylethanolamine or phosphatidyl-N,N-dimethylethanolamine, intermediates of the biosynthesis of phosphatidylcholine from phosphatidylethanolamine. However, the increase in product formations by addition of exogenous intermediates was all but equal under Tris-HCl and phosphate buffer systems at pH 8.0. These results suggest that phosphate ion stimulates the first step of the successive methylation to form phosphatidyl-N-monomethylethanolamine from phosphatidylethanolamine. The methylation in platelets was inhibited to 30% of the basal value with Ca2+ (0.2 mM). However, Ca2+ showed different effects on the methylation in various tissues (activation to 150% of the basal value in the adrenal gland and slight inhibition to 82-88% of corresponding basal values in the liver, lung, kidney and brain). PMID- 6845278 TI - Platelet factor XIII is an active enzyme after solubilization and crossed immunoelectrophoresis. AB - Crossed immunoelectrophoresis of platelets against antiplatelet antibodies has proved to be a valuable tool in the study of platelet proteins (1-8). The advantage of this separation system is that the proteins are separated under nondenaturating conditions and thus to some extent would be expected to maintain their functional properties. Previously, the binding of several proteins to immobilized thrombin (5) and immobilized heparin (9) during crossed immunoelectrophoresis of platelet proteins solubilized in a Triton X-loo containing buffer has been described. Furthermore, it has been demonstrated that fibrinogen is able to bind to immunoprecipitates containing the glycoprotein IIb IIIa-complex (7). These studies indicate that the proteins contained in the immunoprecipitates represent biologically active entities. In the present study we provide direct evidence for this by demonstrating enzymatic activity associated with the immunoprecipitate containing Factor XIII in immunoplates obtained after crossed immunoelectrophoresis of solubilized platelets against anti-platelet antibodies. PMID- 6845280 TI - Quantitative SEM-analysis of adhesive and thrombogenic properties of vascular prostheses. AB - The perfusion technique to measure the relative adhesive and thrombogenic indices of vascular prostheses by a quantitative scanning electron microscopy has been described. To normalize the experiments with different samples of plasma we compared the adhesive and thrombogenic properties of the analyzed prostheses with those of normal and denuded human umbilical vein. The results indicate that adhesive and thrombogenic indices of Dardik, Bakulev and Gore-Tex grafts approximate to those of the non-damaged umbilical vein, while the same indices of Solcograft-P prostheses are considerably higher. The method may be useful for standardizing the properties of new prostheses and bioimplants for cardiovascular surgery. PMID- 6845279 TI - Importance of plasma fibronectin in determining PFP and PRP clot mechanical properties. AB - Plasma fibronectin has been shown to be incorporated into fibrin clots. The serum concentration of fibronectin is 20-50% lower than the plasma concentration (1). Grinnell and Feld, using an indirect immunofluorescence analysis on blood clots prepared on plastic strata, demonstrated that the fibrin-platelet meshwork was covered with a uniform coating of fibronectin (2). Fibronectin binds to fibrin by either non-covalent attachment or covalent crosslinking. The covalent crosslinking of fibronectin to the fibrin alpha-chain is via an epsilon-(gamma glutamyl)lysine linkage, mediated by Factor XIIIa (3). Each fibronectin molecule has two such binding sites. Thus it appears that fibronectin may play a role in blood coagulation. It has been suggested that the mechanical properties of fibrin clots may be enhanced by the presence of fibronectin crosslinking (2). Kamykowski, et al. (4) have shown that the shear modulus of a ligated clot formed from purified fibrinogen can be either increased or decreased if fibronectin is present, depending on the ionic strength and the pH during network formation. Although fibronectin is associated with the network structure in plasma clots, the mechanical role of this fibronectin has not been established. In this study we examine quantitatively the effect of plasma fibronectin on the dynamic rigidity moduli of fibrin clots formed from platelet free plasma (PFP), as well as from platelet rich plasma (PRP). PMID- 6845281 TI - Calcium and fibrin gel structure. AB - Calcium ions (Ca), when present in the gel forming system, were shown to influence liquid permeation of the gels formed, as judged from the Ks-values (permeability coefficients) of the final gels. On increasing Ca concentration, the Ks-values for Fibrin I and Fibrin II gels increase and a maximum is reached at about 10-20 mM for gels formed at ionic strengths between 0.18 and 0.24. For both gels, clotting times (Ct) were shortened on increasing Ca concentration and the shortening was accompanied by increase in Ks. Magnesium also shortened Ct but had no appreciable effect on Ks. The rate of activation of fibrinogen (release of FPA and FPB) was not much affected by Ca, but the activation required for gelation at Ct, decreased with increasing Ca concentration. After the gels were formed, the removal of Ca by EDTA did not change the flow properties. Our results showed that Ca is of importance for formation of the fibrin gel structure, but it may be of minor importance for preservation of the gel structure after its formation. There is a difference between Fibrin I and Fibrin II gels with regard to Ca dependence. The role of calcium in gelation as well as its physiological implications is discussed. PMID- 6845283 TI - Anti-thrombotic effect of very low doses of acetyl salicylic acid in rats. AB - The anti-thrombotic effect of acetyl salicylic acid (ASA) was studied using the following experimental model: a silk thread was inserted in an extracorporeal shunt between the right carotid artery and the opposite jugular vein. A thrombus developed around the thread which was weighed at 10 minutes intervals. ASA inhibits the development of the thrombus at a dose of 3.1 mg/kg. When the dose was increased the anti-thrombotic effect disappeared. These results suggest that ASA may be an effective antithrombotic agent in man if the dosage is based on pharmacological data. PMID- 6845282 TI - Further evaluation of a heparin neutralizer and its effect on factor IX in normal and coumadin-plasma. AB - Heparsorb, a commercial anion exchange resin capable of removing large amounts of heparin from heparinized plasma, has recently been introduced into the clinical diagnostic laboratory as a useful reagent for the evaluation of blood coagulation in heparinized blood and the evaluation of an unexpected prolongation of global coagulation tests. In this paper data are presented which indicate that Heparsorb has little or no effect on the activities of blood coagulation factors in heparinized plasma, except for a modest (22%) reduction in factor IX-activity. Maximal loss of factor IX-activity was observed after incubation of plasma with Heparsorb for 15 min at room temperature. Prolonged storage of plasma before or after incubation with Heparsorb and changes in plasma pH had no appreciable effect on the extent of factor IX-activity loss. Evidence is presented to substantiate earlier findings that factor IX-activity is not removed by Heparsorb from plasma of patients on coumadin therapy, and to indicate that this lack of effect of Heparsorb on factor IX-activity in coumadin plasma is due to reduced affinity of hypocarboxy-IX for the heparin neutralizing resin. PMID- 6845284 TI - Thrombin generation in normal plasma enriched with purified coagulation factors. AB - During the intrinsic coagulation of normal platelet-rich plasma only 11% of the prothrombin is converted to thrombin. Complete conversion of prothrombin to thrombin occurs only via the extrinsic pathway (1). Addition of purified prothrombin to normal plasma to double or triple its concentration, doubled or tripled the amount of the generated thrombin as determined by the thrombin elution assay (1), so that the percentage of the proenzyme which was converted to thrombin remained the same. At the same time the activated partial thromboplastin time (APTT) was prolonged. Proportionality of the amount of the generated thrombin to the amount of prothrombin added and a delay in the appearance of thrombin activity was also observed with the thrombin generation test. Normalization of the APTT was observed when factor IX was added together with prothrombin. Addition of factor IX or X to normal plasma shortened the APTT but did not increase the amount of prothrombin which was converted to thrombin as determined by both the thrombin elution assay and the thrombin generation test. Further experiments indicated that (a) more factor X is activated per mg tissue factor than per mg of activated partial thromboplastin and (b) more thrombin is generated per unit of factor Xa in the presence of tissue factor than in the presence of activated partial thromboplastin. Thus, the two pathways differ not only by the mechanism of factor X activation but also by the extent to which prothrombin is activated by factor Xa. PMID- 6845285 TI - Prophylaxis of postoperative thromboembolism: low dose heparin versus heparin plus dihydroergotamine. PMID- 6845286 TI - Antithrombin III-binding capacity of heparin-sepharose as a function of activation temperature and duration. PMID- 6845288 TI - [Duodenoplasty]. PMID- 6845287 TI - [Surgical treatment of unstable fractures of the thoracolumbar spine by decompression and osteofixation using the Harrington rod]. PMID- 6845289 TI - [Whole gut irrigation as preparation for colonic surgery]. PMID- 6845290 TI - [Echinococcosis. A case of echinococcosis multiocularis cerebri treated with mebendazole]. PMID- 6845291 TI - [Antithrombin deficiency. Diagnosis and treatment]. PMID- 6845292 TI - [Cutaneous Larva migrans. Creeping eruption]. PMID- 6845294 TI - [Differences in utilization of surgical departments and departments of internal medicine]. PMID- 6845293 TI - [Treatment of warts]. PMID- 6845295 TI - [Clinical experiences with clients wanting sex change]. PMID- 6845296 TI - [Acute brachial neuropathy]. PMID- 6845297 TI - [Epidural anesthesia in obstetric patients]. PMID- 6845298 TI - [Epidural anesthesia in labor. A 1-year material]. PMID- 6845300 TI - [Drug therapy of malignant melanoma based on a cell culture test]. PMID- 6845299 TI - [Individualized drug therapy of cancer based on an in vitro test]. PMID- 6845301 TI - [Physical activity immediately before myocardial infarction]. PMID- 6845302 TI - [Rehabilitation courses for heart patients. Practical design, medical and occupational results]. PMID- 6845303 TI - [Survey and treatment of patients with transient ischemic attacks]. PMID- 6845304 TI - [Myelomatosis in Norway during 1970-1979. Evaluation of data from the cancer registry]. PMID- 6845305 TI - [Radiation injury to the small intestine]. PMID- 6845306 TI - [Treatment of hemiplegia]. PMID- 6845308 TI - [Epicrisis. Do the hospital records reach the general practitioners too late, and why?]. PMID- 6845307 TI - [Treatment of herpes zoster]. PMID- 6845309 TI - [Immunological defense factors against viral infections]. PMID- 6845310 TI - [Parasite versus immune system - a fight with uncertain outcome]. PMID- 6845311 TI - [What role does the immune apparatus play in the defense against fungal infections?]. PMID- 6845312 TI - [Immunological disease mechanisms in acute and chronic infections]. PMID- 6845313 TI - [Immunology in glomerulonephritis associated with infections]. PMID- 6845314 TI - [Immunologically mediated extra-valvular disease manifestations in infectious endocarditis]. PMID- 6845315 TI - [What causes nerve damage in leprosy?]. PMID- 6845316 TI - [Microembolization with granulocyte aggregates caused by complement activation. An important pathogenetic mechanism in bacterial septicemia and shock?]. PMID- 6845317 TI - [Diagnostic use of the antistreptolysin O-test (AST) and the antistaphylolysin test (ASTA)]. PMID- 6845318 TI - [Diagnostic use of serological studies in intestinal bacterial diseases and other bacterial infections]. PMID- 6845319 TI - [Serological diagnosis of venereal diseases. I. Syphilis]. PMID- 6845320 TI - [Serological diagnosis of venereal diseases. II. Gonorrhea and lymphogranuloma venereum]. PMID- 6845321 TI - [Skin tests as a diagnostic aid in infectious diseases]. PMID- 6845322 TI - [The practical application of serological diagnosis to some of the most frequent virus infections]. PMID- 6845323 TI - [Toxoplasmosis. Occurrence, diagnosis, treatment]. PMID- 6845324 TI - [Immunological studies in the diagnosis of imported parasitic diseases]. PMID- 6845325 TI - [Indications for the use of normal immunoglobulins and of specific immunoglobulins]. PMID- 6845326 TI - [Granulocyte transfusion in neutropenia and severe infection]. PMID- 6845327 TI - [Pneumococcal vaccine - characteristics and indications]. PMID- 6845328 TI - [Vaccination against meningococcal infection]. PMID- 6845329 TI - [Vaccines against Gram-negative rod-shaped bacteria]. PMID- 6845330 TI - [Parotitis vaccine - another beneficial vaccine?]. PMID- 6845331 TI - [Vaccination against hepatitis B virus - soon a reality also in Norway]. PMID- 6845332 TI - [When will there be vaccines against parasitic diseases?]. PMID- 6845334 TI - [Digestion of carbohydrates in cats]. AB - An introductory study of the literature on the digestion of carbohydrates in cats is followed by a report on personal studies in which three sources of carbohydrates (beet sugar, partially decomposed potato flour and wood cellulose) were used in concentrations of 5, 10 and 15 per cent of dry matter. The passage time was measured and digestibility was determined by the indicator Celite 545. The passage time was slightly higher on each carbohydrate supplementation, and the average digestibility of the flour and cellulose was 95 and 31 per cent respectively. Digestibility was found to be reduced when higher percentages were used in mixing. PMID- 6845333 TI - [Further studies on the practicability of fattening and slaughtering pigs free from Salmonella]. AB - Attempts were made to fatten pigs free from Salmonella on a piggery which was initially contaminated with Salmonella. A specially adapted pig house was thoroughly cleaned and disinfected and efforts were made to keep out birds, insects and rodents during this experiment. Attempts were also made to purchase piglets free from Salmonella. Clean clothes, special footwear and disinfectants were used on entering the pig house. Infection with serotypes of Salmonella similar to those detected immediately prior to the experiment on the ancillary breeding farm occurred in the experimental pig house during the experiment. Other serotypes of Salmonella present on the piggery did not penetrate into the experimental pig house so that it can be concluded that all hygienic barriers functioned adequately after the piglets had been brought in. The experiment showed that the hygienic procedures had a positive effect on economic results, even though efforts to keep out Salmonella had not been completely successful. The pigs were slaughtered in two groups after the fattening period. Group one was slaughtered as usual. The pigs of group two were scalded individually with every care after slaughter and the guts were carefully removed. Examination of the carcases after slaughter showed that 46 per cent of the pigs of group one were contaminated with Salmonella, against 7 per cent of group two. It can be concluded from this finding that slaughtering does not necessarily result in further contamination by the Salmonella organisms present in the intestine but that a careful slaughtering procedure may even reduce the number of Salmonella organisms on the surfaces of the carcases of pigs. PMID- 6845335 TI - [Not from bones only ...]. PMID- 6845336 TI - [Claw amputation above the corona border as a treatment of arthritis of the claw joint, an overview]. PMID- 6845337 TI - [Diabetes insipidus in a filly]. PMID- 6845339 TI - [Nitrofuran poisoning in veal calves]. AB - Prolonged administration of furazolidone to calves may give rise to chronic furazolidone poisoning: retardation of growth, thrombocytopenia and leucopenia, occasionally changing into haemorrhagic diathesis. In acute nitrofuran poisoning neurological signs are observed as a consequence of monoamine oxidase inhibition. Five incidents of acute nitrofuran poisoning on veal calf farms are reported in the present paper, each with a mortality rate varying frm 46.7 per cent ot 70 per cent. Ten times the recommended dose of furazolidone or furadoltone was administered in each case. PMID- 6845338 TI - [Early diagnosis of liver fluke infestation using a serological technic on commercial farms]. PMID- 6845340 TI - [Tricky shadows .....]. PMID- 6845341 TI - [Supply of magnesium in cattle]. AB - The supply of magnesium is determined by the concentration of Mg in the ration, the absorption coefficient of Mg in the fodder and by the feed intake. In lactating cows, the supply of Mg usually will be sufficient when concentrates contain 5 g. or 7 g. of Mg per kilogram during the housing and grazing period respectively. For dry cows fed roughage only a daily supplement of 50 g. of MgO per cow may be required. PMID- 6845342 TI - F.V.E. (Federation of Veterinarians of the E.E.C.). The use of live animals for experimental and industrial purposes. PMID- 6845343 TI - HLA antigens in Alzheimer's disease. PMID- 6845344 TI - Current philosophy of risk management. PMID- 6845345 TI - Medical professional liability. PMID- 6845346 TI - General liability. PMID- 6845347 TI - Directors' and officers' and fiduciary liability. PMID- 6845348 TI - Automobile exposures. PMID- 6845349 TI - Postnatal developmental alterations following prenatal exposure to the herbicide 2,4-dichlorophenyl-p-nitrophenyl ether: a dose response evaluation in the mouse. AB - Although nitrofen, 2,4-dichlorophenyl-p-nitrophenyl ether, is a relatively nontoxic herbicide, prenatal exposure to doses considerably less than the LD50 value for adult rats and mice produces numerous developmental defects that become apparent as the animals mature. In the present study postnatal development was observed following prenatal exposure during Days 7 to 17 of gestation at doses of 0, 6.25, 12.5, 25, 50, 100, 150, and 200 mg/kg/day. These doses did not cause maternal toxicity as indicated by the viability of the dams or maternal weight gain during pregnancy. By 3 days of age all pups in the two highest dose groups were dead and 50% had died in the 100 mg/kg/day dose group. Some of the dead and moribund pups from the 200 mg/kg/day exposure group necropsied at three days of age had cleft palate (15%) or diaphragmatic hernia (6%). In addition, about 22% of the pups at 200 mg/kg/day developed a distended abdomen from gasping and swallowing air. These pups did not suckle and eventually died. Body weights of offspring were reduced at birth in the 150 and 200 mg/kg/day groups and at 3 days of age in the 100 mg/kg/day group. Growth rates were subsequently retarded at 12.5, 25, 50, and 100 mg/kg. The Harderian glands were reduced or absent in 97, 65, and 4% of the mice in the 100, 50, and 25 mg/kg dosage groups, respectively, and the gland weights were reduced at all dosages, including the lowest dose of 6.25 mg/kg/day. Weights of other organs including lung and liver (at 6.25 and above), seminal vesicle (at 12.5 and above), and testes (at 100 mg/kg/day) were also reduced by prenatal nitrofen exposure. In addition, prenatal treatment with nitrofen produced functional deficits of the reproductive system; puberty was delayed in females and litter sizes were reduced at 50 and 100 mg/kg/day. A cross fostering experiment with 100 mg/kg/day of nitrofen demonstrated that the effects noted in the present study were produced solely by prenatal exposure; pups exposed to nitrofen in the milk alone as a consequence of any accumulation of nitrofen in the dam during gestation were unaffected. PMID- 6845350 TI - Retention of lead acetate in weanling and adult rats. PMID- 6845351 TI - Affinity of [14C]nitrosopiperidine and metabolites for mouse epithelial tissues. AB - Male C57BL/6J mice were each administered iv 1.2 mg/kg (6.0 to 7.6 muCi) of [14C]nitrosopiperidine ([14C]NPIP) and frozen by immersion in dry ice/hexane at 0.1, 0.33, 1, 3, 9, and 24 hr after injection. The mice were processed for whole body autoradiography without thawing or the use of any solvents; sagittal sections of the frozen mice were freeze-dried and placed on X-ray film to reveal areas of localization of radioactivity. The autoradiographs revealed intense localization of radioactivity at 6 min in the epithelium of the nose and bronchi, as well as in the liver, kidney, and salivary glands. There is virtually no affinity of [14C]NPIP for melanin. Most of the same localizations persisted from 6 min through 24 hr. At 24 hr the most intense accumulation was in the epithelium of the bronchi, nose, salivary gland ducts, and esophagus as well as the liver and Harder's gland. The results are interpreted to suggest that at least one metabolite of NPIP which localizes in the sites where tumors occur may be similar to a metabolite of NNN. The distribution is consistent with metabolic conversion of [14C]NPIP in liver and epithelium of nose and bronchi with subsequent localization of the metabolite in epithelium of esophagus and salivary gland ducts. PMID- 6845352 TI - Combined effects of propranolol and ethanol on human psychomotor performance. AB - Twelve male subjects were given placebo or 160 mg propranolol, in divided doses, during a 24-hr period before drinking a beverage containing 0 or 50 ml ethanol/70 kg body weight. Tests designed to measure mental and motor performance were administered 75 min after the last dose of propranolol. The tests performed included the wobble board (WB), pursuit meter (PM), delayed auditory feedback (DAF), pegboard (PB), tapping, time estimation (TE), and a modified Cornell medical index (CMI). A mean blood ethanol concentration of 48.0 +/- 9.1 mg/dl and a mean plasma propranolol level of 33.1 +/- 13.1 ng/ml were achieved. Ethanol alone significantly impaired performance in 12 out of 20 tests (p less than 0.05). Propranolol significantly (p less than 0.05) antagonized the decrement in psychomotor performance induced by ethanol on the PM. In all other tests, there was no significant interaction between ethanol and propranolol. Propranolol alone had no significant effect on the psychomotor tests. When the drugs were combined, the subjective symptoms, as measured by the CMI, showed a trend toward being additive. This study suggests that no adverse interaction occurs between therapeutic doses of propranolol and minimum impairment doses of ethanol. PMID- 6845353 TI - Nephrotoxicity of Hexachloro-1:3-butadiene in the rat: the effect of age, sex, and strain. PMID- 6845354 TI - Peroxisome proliferation in primary cultures of rat hepatocytes. AB - Primary cultures of rat hepatocytes were exposed to a range of chemicals known to cause peroxisome proliferation in vivo. Peroxisomal palmitoyl-CoA oxidation and carnitine acetyltransferase (CAT) activity were increased within 12 to 24 hr of adding 0.5 mM clofibrate to the culture medium, reaching about 20 times control levels after 72 hr. Stimulation of CAT activity was dose related over a concentration range of 0.05 to 2 mM clofibrate and 0.02 to 0.2 mM mono-2 ethylhexylphthalate (MEHP). Higher concentrations of MEHP were cytotoxic. The stimulation of CAT activity and palmitoyl-CoA oxidation produced by clofibrate and MEHP was inhibited by cycloheximide. In further studies with clofibrate and a range of other known peroxisome proliferators (nafenopin, tiadenol, BR-931, Wy 14,643, and acetylsalicylic acid), induction of CAT and palmitoyl-CoA oxidation was observed with no increase in activity of another peroxisomal enzyme, D-amino acid oxidase. This differential effect on peroxisomal enzyme activity is typical of that seen in vivo. Furthermore, the relative potencies of the different peroxisome proliferators in vitro agreed well with what is known from studies in vivo. Mitochondrial and microsomal marker enzymes showed little change in activity. Electron microscopy of treated cultures revealed increased numbers of peroxisomes, some of which lacked the characteristic nucleoid. The results indicate that primary cultures of rat hepatocytes provide a rapid, sensitive means of identifying chemicals that cause peroxisome proliferation and a potentially valuable system for studies aimed at clarifying the toxicological significance of this phenomenon. PMID- 6845355 TI - Vitamin K content of liver and feces from vitamin K-deficient and butylated hydroxytoluene (BHT)-treated male rats. AB - Vitamin K content of liver and feces from male rats fed diets containing butylated hydroxytoluene (BHT) was estimated by a chick bioassay method to investigate the mechanism of BHT-induced decreases in the activities of vitamin K dependent clotting factors. The concentration of vitamin K in the liver of rats receiving BHT was reduced as compared to that of control rats. Conversely, the concentration of vitamin K in the feces from rats receiving BHT increased more than that from control rats. The vitamin K deficiency induced by BHT might be due to effects of BHT on absorption and excretion of vitamin K. PMID- 6845356 TI - Interaction between cadmium and zinc, copper, or lead in relation to the collagen and mineral content of embryonic chick bone in tissue culture. PMID- 6845357 TI - The effects of acrolein exposure on pulmonary antibacterial defenses. AB - Inhalation exposure to acrolein induced a dose-dependent impairment of pulmonary antibacterial defenses in mice. Animals exposed to 3 or 6 ppm of acrolein were increasingly less effective in inactivation of aerogenic challenges of 32P labeled Staphylococcus aureus. Acrolein concentrations greater than 6 ppm caused increased sensory irritations, but no additional impairment of lung antibacterial resistance. Influenza A viral pneumonia in mice also suppressed pulmonary bacterial activity. Mice convalescing from moderate viral pneumonia became severely deficient in antibacterial defenses when exposed to acrolein. Whether the viral-induced impairment in pulmonary defense delayed the inactivation or allowed the proliferation of bacteria was dependent upon the dose of acrolein. The present study demonstrated that an underlying infectious disease process compounded the pulmonary toxicity of acrolein such that normally moderate toxicity was elevated to a virtual abolition of antibacterial defense mechanisms. PMID- 6845358 TI - Distribution and metabolism of triamcinolone acetonide in the rat embryomaternal unit during a teratogenically sensitive period. AB - The distribution and metabolism of triamcinolone acetonide (TAC) in the rat embryomaternal unit were investigated during a teratogenically sensitive period. Pregnant rats (Day 12 of gestation) were injected im with 0.125 or 0.5 mg/kg [3H]TAC. Maternal plasma and embryos were collected at selected time points and analyzed by HPLC and liquid scintillation counting. No significant differences in the percentage of total radioactivity representing unchanged TAC, concentration of TAC, or its elimination half-life were detected in either plasma or embryos of the two dose groups. These results provide evidence that the metabolism and distribution of TAC in the rat embryomaternal unit are dose independent over this known teratogenic dose range. To determine whether multiple administration of TAC resulted in any alterations in maternal or embryonal exposure, the same parameters were evaluated following one (Day 12), two (Days 12 and 13), or three (Days 12, 13, and 14) injections of [3H]TAC (0.5 mg/kg, im). The only alterations detected were an increase in the percentage of total radioactivity in maternal plasma representing unchanged TAC at 1 hr following the second or third injection and an increase in the embryonal concentration of TAC at the same time points. PMID- 6845359 TI - Lipid peroxidation: a possible mechanism of cephaloridine-induced nephrotoxicity. AB - Cephaloridine produces renal cortical injury, but the precise mechanism responsible for this nephrotoxicity remains unclear. Recently cephaloridine has been shown to deplete reduced glutathione (GSH) concentration selectively in renal cortex. Cephaloridine nephrotoxicity can be potentiated by diethyl maleate (a GSH depletor), but no glutathione conjugate can be detected. Thus, it was of interest to investigate further the mechanism of depletion of renal cortical GSH by cephaloridine. In the present study, cephaloridine markedly decreased GSH in rat and rabbit renal cortex while concomitantly increasing oxidized glutathione (GSSG). Furthermore, cephaloridine increased lipid peroxidation specifically in renal cortical cells. Conjugated diene formation (an index of lipid peroxidation) was increased in renal cortex but not in the liver shortly following administration of cephaloridine. Removal of selenium and/or vitamin E from the diet, which should enhance lipid peroxidation, potentiated cephaloridine nephrotoxicity and enhanced cephaloridine-induced morphological damage in the kidney. These findings are consistent with a major role of lipid peroxidation in the etiology of cephaloridine nephrotoxicity. PMID- 6845360 TI - Studies on the metabolism and excretion of 1-naphthol, 1-naphthyl-beta-D glucuronide, and 1-naphthyl-beta-D-glucoside in the mouse. AB - Radiolabeled 1-naphthyl-beta-D-glucuronide and 1-naphthyl-beta-D-glucoside were synthesized from 1-[14C]naphthol. The fate of the three compounds in male mice was studied. After a po dose of 45 mg/kg of 1-naphthol, 100 mg/kg of 1-naphthyl glucuronide, and 100 mg/kg of 1-naphthyl glucoside, 95, 93, and 81%, respectively, of the administered dose were eliminated 72 hr after treatment. 1 Naphthyl glucoside was eliminated more slowly than the other two compounds. 1 Naphthol was metabolized predominantly to the sulfate and the glucuronide conjugates, whereas a portion of 1-naphthyl glucoside was eliminated directly or cleaved and then reconjugated to form the sulfate and the glucuronide conjugates. 1-Naphthyl glucuronide was excreted as parent compound and sulfate, indicating hydrolysis and resynthesis. When the glucoside was administered at three doses (10, 50, and 100 mg/kg), it was observed that the lower doses of the glucoside were more readily eliminated in the urine than the higher doses. Larger amounts of the parent compound were found in the excreta at the lower doses than at the higher doses. PMID- 6845361 TI - Percutaneous toxicity and delayed neurotoxicity of organophosphates in the scaleless hen. AB - The acute toxicity of tri-ortho-cresyl phosphate (TOCP) and the development of delayed neurotoxicity were characterized in the scaleless hen, a featherless mutant, and compared to the responses observed in normally feathered birds. Brain acetylcholinesterase (AChE) activity was comparable between scaleless and normal hens, but nonspecific cholinesterase (ChE) activities of brain and plasma were significantly higher in scaleless birds. The acute ID50 of TOCP for plasma ChE activity was 690 mg/kg for scaleless birds and 240 mg/kg for normal ones following sc administration. However, there was no difference in the ID50 for plasma ChE activity between normal and scaleless hens treated sc with the active metabolite of TOCP, 2-(o-cresyl)-4H-1:3:2-benzodioxaphosphoran-2-one, or parathion. The onset of clinical signs of delayed neurotoxicity in scaleless birds was 8 to 14 days after sc or dermal treatment with TOCP and caused typical axonal fragmentation in the sciatic nerve. Plasma creatine phosphokinase activity was significantly increased following the onset of delayed neurotoxicity in both lines of birds. Dermal application of TOCP to a 50-cm2 area on the backs of scaleless hens inhibited plasma ChE activity in a dose-related manner (ID50 = 115 mg/kg), and the lowest dose of TOCP, 114 mg/kg, did not produce delayed neurotoxicity. The results show that the scaleless hen can be used to determine a no-observable effect level for delayed neurotoxicity which regulatory agencies could use to extrapolate a safe level of human dermal exposure to organophosphates that produce delayed neurotoxicity. PMID- 6845363 TI - Induction of hepatic microsomal drug-metabolizing enzymes by sulfur-containing metabolites of chlorinated benzenes in rats. AB - 3,5-Dichlorophenyl methyl sulfide and its oxidized compounds, metabolites of m dichlorobenzene, increased the activity of aniline hydroxylase and aminopyrine N demethylase and the content of cytochromes P-450 and b5 in rat liver microsomes. Hexobarbital sleeping time was reduced by these three compounds. After the administration of the sulfide to rats, 3,5-dichlorophenyl methyl sulfone appeared in blood, liver, and kidneys, and remained detectable in the blood and the tissues between 120 and 240 hr. The sulfone was considered to play a principal role in the induction by these compounds. Other chlorophenyl methyl sulfones also showed similar induction activity. PMID- 6845362 TI - Absorption, distribution, and retention of inhaled selenious acid and selenium metal aerosols in beagle dogs. AB - We studied the distribution and retention of inhaled selenious acid and selenium metal aerosols which were similar in size and chemical form to selenium aerosols that may be produced during fossil fuel combustion. Beagle dogs were given 10 to 61 micrograms Se/kg of body weight by inhalation. Aerosols generated for the inhalation exposures were also collected and instilled into the upper respiratory tracts or stomachs of additional dogs to measure systemic absorption at these sites. Selenium-75, incorporated into the aerosols, was used to determine the Se content in the whole animal, excreta, and individual tissues as a function of time. Virtually all of the inhaled selenious acid aerosol was rapidly absorbed into the blood from the lungs, gastrointestinal tract, and the nasal membranes. Selenium metal aerosols were less rapidly absorbed. Selenium that was absorbed into the blood was translocated to the liver, kidney, spleen, and heart. Selenium 75 in these organs had a biological half-life of 30 to 40 days. Approximately 50% of the deposited Se was eliminated with a biological T1/2 of 1.2 days. Urine was the major route of excretion, accounting for 70 to 80% of the excreted Se. The long-term component of the whole-body retention function for both inhaled aerosols had a half-life of about 34 days and accounted for about 20% of the initial Se dose. The data suggested that although absorption of selenious acid into blood following inhalation was more rapid than absorption of selenium metal, once absorbed the disposition of both compounds was similar. PMID- 6845364 TI - Pulmonary toxicity of inhaled coal liquid aerosols (boiling range 230-450 degrees C). AB - The biological activity of materials produced in the direct liquefaction of coal is being assessed by a variety of test systems. In this study, the pulmonary toxicity of process solvent (PS) from the solvent refined coal-I (SRC-I) process was determined by histamine aerosol challenge tests and pulmonary function and morphologic evaluations. Guinea pigs inhaled aerosols of PS (boiling range, 230 to 450 degrees C) for 6 hr/day, 5 day/week, for up to 12 days in three different experiments. In the first experiment, 8-week-old animals inhaled 0 (controls), 0.15, or 0.60 mg/liter PS aerosols with a mass median aerodynamic diameter (MMAD) of 1.3 micrometer. Exposure to 0.15 mg/liter PS for 12 days resulted in depressed weight gain and marked hypersensitivity to inhaled histamine compared with sham exposed control animals. Four of five animals exposed to 0.6 mg/liter PS died of respiratory failure during exposure. During the second experiment, 14-week-old animals inhaled 0 (controls) or 0.19 mg/liter PS (MMAD, 1.3 microns) for 1, 3, or 12 days. Hypersensitivity to aerosolized histamine occurred only after 12 days exposure to PS aerosols. At that time, morphologic lung evaluations showed mild to moderate pneumonitis and accumulation of exudate in bronchioles of PS-exposed animals. In the third experiment, pulmonary function evaluations were conducted on 4-week-old animals exposed to 0 (controls) or 0.19 mg/liter PS for 8 days. Functional changes measured in these animals (compared to controls) included increased gas trapping at low lung volumes, decreased quasi-static compliance, and decreased diffusion capacity of the lung for carbon monoxide. These studies showed that measurable changes in lung function were produced in guinea pigs after 8 to 12 days exposure to 0.15 or 0.19 mg/liter PS and that exposure to PS affected weight gain only in younger animals (4 and 8 weeks old) but not in 14 week-old animals. PMID- 6845365 TI - Metabolism and disposition of the flame retardant tris(2,3 dibromopropyl)phosphate in the rat. AB - The metabolism and disposition of the flame retardant, tris(2,3 dibromopropyl)phosphate (Tris-BP), were studied after po and iv administration of the 14C-labeled compound to the male rat. Tris-BP was readily absorbed from the gastrointestinal tract and rapidly distributed throughout the body. The distribution and excretion of Tris-BP derived radioactivity were similar after either po or iv administration. The only effects of route of administration on tissue distribution were slightly higher concentrations in liver after po administration and in lung after iv administration. The initial elimination of Tris-BP derived radioactivity in urine, feces, and as CO2 accounted for approximately 50% of the dose in 24 hr. An analysis of Tris-BP derived radioactivity remaining in the tissues one day after administration indicated that most of the radioactivity in all tissues was in the form of various metabolites rather than the parent compound. The terminal clearance of Tris-BP derived radioactivity from most of the tissues studied was best described by a single component exponential decay with a half-life of approximately 2.5 days. Clearance from liver and kidney was somewhat slower having a half-life of approximately 3.8 days. Approximately 33% of the radioactivity excreted in urine and approximately 50% of the radioactivity excreted in bile were identified by cochromatography with synthesized standards on high performance liquid chromatography (HPLC). Six metabolites and a trace of the parent compound were identified in urine and bile by this method. The six metabolites products of dealkylation and dehydrobromination of the parent compound. The metabolites of Tris-BP isolated from urine and bile were also formed in vitro by NADPH-dependent microsomal enzymes from rat liver. The soluble enzymes from liver metabolized Tris-BP to at least three unidentified polar metabolites. PMID- 6845366 TI - Germ cell studies in mice after prolonged exposure to nitrous oxide. AB - Male and female Swiss Webster (SW) mice, age 13 to 14 weeks, were exposed by inhalation for 4 hr per day, 5 days per week, for 14 weeks, to either room air, 0.5% nitrous oxide, 5.0% nitrous oxide, or 50% nitrous oxide. Murine germ cells were examined for evidence of injury after this exposure. A group of male mice were treated with methyl methanesulfonate (MMS) as a positive control for sperm abnormalities while a group of female mice were treated with 3-methylcholanthrene (3-MC) as a positive control for oocyte destruction. There were no significant differences among the four inhalation exposure groups in testes weight, percentage of abnormally shaped sperm, sperm count, or histologic appearance of the testes; the mean percentage (+/- SE) of abnormal sperm ranged from 8.9 +/- 2.4 (5.0% nitrous oxide) to 13.5 +/- 0.5 (50% nitrous oxide) with a concurrent control value of 10.4 +/- 2.3%. In the positive control experiment, 25.2 +/- 4.1% of sperm from mice treated with MMS were abnormal compared with 2.5 +/- 0.3% of sperm from mice treated with saline (p less than 0.001), indicating that sperm of SW mice are sensitive to chemical damage. There was no significant difference between the mean number of oocytes in mice treated with 50% nitrous oxide (33.3 +/- 14.4) and in control mice (29.8 +/- 8.0). In the positive control experiment, mice treated with 3-MC had significantly fewer (p less than 0.001) primordial oocytes, 67.2 +/- 19.5 compared with control mice, 222.4 +/- 21.9, indicating that this strain is sensitive to chemical damage of the ovary. Thus, murine germ cells showed no evidence of toxic effects due to prolonged exposure to nitrous oxide. PMID- 6845367 TI - Theobromine metabolism and pharmacokinetics in pregnant and nonpregnant Sprague Dawley rats. AB - The plasma kinetics of po administered theobromine (TBR) were determined in timed pregnant (P) and nonpregnant (NP) Sprague-Dawley rats at doses of 5, 10, 50, and 100 mg/kg using TBR sodium acetate with 10 microCi [8-14C]TBR as a radioactive tracer. Since plasma radioactivity consisted of greater than 99% TBR and less than 1% metabolites as shown by high-performance liquid chromatographic (HPLC) methods, liquid scintillation counting was used to quantify plasma TBR. No dose dependent kinetics were observed in mean TBR plasma half-life, volume of distribution, systemic clearance, area under the curve-dose normalized, or time to reach maximum plasma concentration in either P or NP rats. The kinetic parameters of P rats were strikingly similar to NP rats at all TBR dosage levels employed. Analysis of urinary metabolites by HPLC and a radioactivity monitoring system after a single po TBR dose of 5 and 100 mg/kg with 10 microCi [8-14C] TBR revealed similar qualitative metabolic patterns in P and NP rats. Compounds identified in the urine were TBR (39 to 62%), 6-amino-5-[N-methylformylamino]-1 methyluracil (20 to 32%), 3-methylxanthine and 7-methylxanthine (8 to 15%), 3,7 dimethyluric acid (5 to 10%), and 7-methyluric acid (5 to 7%). PMID- 6845368 TI - Concentration-dependent behavioral changes in mice following short-term inhalation exposure to various industrial solvents. AB - Mice were exposed during a 4-hr period to various concentrations of 13 aliphatic or aromatic solvents which affect primarily the central nervous system (CNS). The test compounds were benzyl chloride, butyl alcohol, chlorobenzene, cyclohexanone, 1,2-dichloroethylene, diisobutyl ketone, isopropyl acetate, methyl ethyl ketone, styrene, tetrachloroethylene, 1,1,1-trichloroethane, toluene, and ortho-xylene. After exposure, measurements were made to see whether these neurotoxicants would decrease the immobility developed in a "behavioral despair" swimming test. Each chemical was shown to reduce the total duration of immobility measured over a 3 min period in a concentration-related manner. The systematic determination of the atmospheric concentrations responsible for a 50% decrease in immobility (ID50) permitted classification of the solvents in terms of their relative potencies. The possibility of using such experimental data as tentative guidelines for setting safe levels of work exposure to the neurotoxicants was suggested, considering the existence of quantitative relationships between the ID50 values and the current occupational standards. PMID- 6845369 TI - Hepatic phase I and phase II biotransformations in quail and trout: comparison to other species commonly used in toxicity testing. AB - The ability of quail and trout to perform a number of representative phase I and phase II biotransformations was examined. To facilitate interspecies comparisons, metabolism of the same substrates was examined simultaneously under uniform conditions for rat, mouse, rabbit, guinea pig, cat, and dog. Both nonmammalian species can metabolize four representative substrates of phase I mixed-function oxidases and one substrate of epoxide hydrolase, though activity tended to be lower than that of the mammals. Important differences in the conjugative pathways were also noted. Among these differences were the quail's relative deficiency in glutathione conjugation and the trout's low ability to conjugate sulfate compounds. Trout liver UDP-glucuronosyltransferase activity was remarkably high toward testosterone and bilirubin, while quail liver formed glucuronides of naphthol, p-nitrophenol, and digitoxigenin-monodigitoxoside. Also noteworthy was the high N-acetyltransferase activity of both quail and trout toward isoniazid, beta-naphthylamine, and 2-aminofluorene. Differences in substrate specificity for a given enzymatic pathway may be an indication that multiple forms of drug metabolizing systems also occur in these nonmammalian species. Observation of several hundred- or even thousand-fold differences between species in their enzyme activities for certain substrates under uniform conditions re-emphasizes the need for caution in extrapolation of xenobiotic metabolism from one species to another. PMID- 6845370 TI - Tin salts prevent the plasma cell response to metallic tin in Lewis rats. AB - Inoculation of metallic tin powder produced marked proliferation of plasma cells and Russell body cells in draining lymph nodes. Prior, but not concurrent, administration of a soluble tin salt in the drinking water prevented the plasma cell hyperplasia. Various Na, Zn, Ag, and Cu salts were not inhibitory. The inhibitory effect of tin salts was detected as long as 2 months after the pretreatment was stopped. If the plasma cell response to metallic tin were due to an immunologic reaction, then the inhibition by a soluble tin salt may be a form of immunologic tolerance. PMID- 6845371 TI - Malathion percutaneous absorption after repeated administration to man. AB - Prediction of exposure and toxic potential of pesticides such as malathion are routinely based upon acute exposure and single-dose percutaneous absorption determination. What has become obvious with pesticide exposure such as the malathion spraying for the medfly is that chronic daily exposure is the more relevant situation. Our objective was to determine the percutaneous absorption of chronically applied malathion in man and to compare chronic absorption to single dose absorption. The experimental design was to first topically apply [14C]malathion to human male volunteers. This procedure was followed by repeated administration of nonradioactive malathion to the same site of application (ventral forearm). [14C]Malathion was reapplied (Day 8) when urinary excretion of radioactivity from the first application reached minimum detectable levels. The first [14C]malathion absorption was compared to the second [14C]malathion application. The percutaneous absorption from the first [14C]malathion application was 4.48 +/- 1.3% (SD) of the applied dose. The absorption from the second [14C]malathion administration was 3.53 +/- 1.0%, a value not significantly (p greater than 0.05) different from the first application. Therefore, for malathion the single-dose application data are relevant for predicting the toxic potential for longer-term exposure. PMID- 6845373 TI - The uptake and disposition of 1,1-dichloroethylene in rats during inhalation exposure. AB - The uptake, disposition, and respiratory elimination of 1,1-dichloroethylene (1,1 DCE) during inhalation exposure were evaluated to gain insight into the pharmacodynamics of the halocarbon. Anesthetized male Sprague-Dawley rats inhaled 25, 75, 150, or 300 ppm 1,1-DCE for 3 hr from an aluminized Mylar bag through a miniaturized one-way breathing valve inserted into the trachea. Periodic air samples were taken immediately adjacent to the valve from the separate inhaled air and exhaled breath streams concurrently with blood samples from a cannulated femoral vein and analyzed for 1,1-DCE content by gas chromatography. 1,1-DCE was absorbed very rapidly, in that substantial levels were present in the venous blood at the first sampling time (i.e., 2 min). Percentage systemic uptake decreased over time after initiation of exposure until equilibrium was established. Percentage uptake after reaching equilibrium varied inversely with the exposure concentration. 1,1-DCE venous whole-blood levels in animals exposed to 25, 75, and 150 ppm 1,1-DCE increased rapidly to near steady state within approximately 45 min, as did concentrations of 1,1-DCE in the exhaled breath and alveolar air. Calculation of the amount of 1,1-DCE taken up by the body over the course of the 3-hr exposures revealed that cumulative uptake of the inhaled chemical was statistically linear for the 25-, 75-, and 150-ppm exposures. Accumulation plots for 300-ppm exposed animals, however, were best fitted to a cubic curve form. Although trends toward the establishment of equilibrium were initially seen in the 300-ppm exposed animals, levels of 1,1-DCE in the blood and breath rose progressively during the latter hour of the 3-hr exposure period. Thus, despite increased exhalation of 1,1-DCE, these animals could not prevent systemic accumulation of the chemical. PMID- 6845372 TI - Induction of cytochrome P-450 by methylenedioxyphenyl compounds: importance of the methylene carbon. AB - Induction of hepatic microsomal cytochrome P-450 in Dub:ICR male mice treated with phenobarbital, 3-methylcholanthrene, safrole, isosafrole, 5-tert.-butyl-1,3 benzodioxole (BBD), 2-methyl-5-tert.-butyl-1,3-benzodioxole (MBBD), and 2,2 dimethyl-5-tert.-butyl-1,3-benzodiozole (DBBD) was evaluated by measuring the cytochrome P-450 content, Type II:Type 1 binding ratio, ethylisocyanide pH equilibrium point, biphenyl 2- and 4-hydroxylase, ethylmorphine N-demethylase, ethoxyresorufin O-deethylase, and sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Safrole and isosafrole treatment of mice produced a phenobarbital-type induction. BBD, but not MBBD and DBBD, induced cytochrome P 450 and formed a Type III metabolite-cytochrome P-450 complex, in vitro and in vivo. SDS-PAGE revealed that DBBD does induce proteins other than cytochrome P 450. These data suggest that the methylene carbon plays an important role in cytochrome P-450 induction. PMID- 6845374 TI - Chronic toxicity studies of vinyl acetate in Fischer rats. AB - A chronic toxicity test was carried out in groups of 20 male and female F344 rats with vinyl acetate dissolved in drinking water at two concentrations, 2500 and 1000 mg/liter. Treatment lasted for 2 years and did not lead to early death of the animals compared with untreated controls. The incidence of most types of neoplasm was similar in the treated and control groups. However, six females receiving the higher dose of vinyl acetate had adenoma or carcinoma of the thyroid and five had carcinoma of the uterus; the latter were not seen in the controls. PMID- 6845375 TI - Sensitivity of the cat to delayed neurotoxicity induced by O-ethyl O-4 nitrophenyl phenylphosphonothioate. AB - Delayed neurotoxicity was produced in cats following the administration of either a single dermal dose of 22.5 to 225 mg/kg (0.2 to 5.0 times the LD50) or subchronic (90 days) administration of 0.5 to 2.0 mg/kg of technical grade O ethyl O-4-nitrophenyl phenylphosphonothioate (EPN). The study showed three differences from the condition produced in the chicken: difficulty to protect from acute poisoning, slower progression of delayed neurotoxicity, and propensity for improvement. These animals received atropine sulfate and pyridine-2-aldoxime methyl chloride (PAM) to protect them against acute poisoning, but most developed signs of acute cholinergic neurotoxicity, the degree of severity being dose dependent. Also cats given small single doses of EPN showed only leg weakness, while those treated with large doses progressed to severe ataxia and death. In cats treated with subchronic dermal daily doses of EPN, the extent and permanence of injury and progression or improvement of neurologic deficit also depended on the dose size and duration of exposure. Histopathologic changes were present in the most distal portion of the longest tracts in both the central and peripheral nervous system. Ascending tracts were most affected in the cervical spinal cord, while change in the descending tracts was concentrated in the lumbosacral spinal cord. Recovery to a varying degree from delayed neurotoxicity was seen in all surviving cats. The recovery was demonstrated as improvement in clinical signs, increase in body weight, and regeneration of peripheral nerves. PMID- 6845376 TI - Effects of dihydrosafrole on cytochromes P-450 and drug oxidation in hepatic microsomes from control and induced rats. AB - Changes in cytochromes P-450, aminopyrine N-demethylase (APDM), aromatic hydrocarbon (benzo[a]pyrene) hydroxylase (AHH), and type III spectral complex formation were measured in hepatic microsomes of control, phenobarbital (PB)-, and beta-naphthoflavone (beta NF)-induced rats after a single dose of dihydrosafrole (4-n-propyl-1,2-methylenedioxybenzene, DHS). Time profiles of changes in these microsomal parameters were complex and showed that APDM activities and cytochrome P-450 levels decreased immediately after treatment and were associated with concurrent increases in the intensity of the type III methylenedioxyphenyl (MDP) metabolite/cytochrome P-450 spectral complex. In noninduced rats, both APDM activity and cytochrome P-450 levels returned to control levels between 12 and 24 hr after treatment with DHS and subsequently increased above control levels. In PB- and beta NF-induced animals, the inhibitory phases were more prolonged and activity never returned to levels higher than the corresponding controls. AHH activity was increased substantially (two- to three-fold) in all cases after DHS administration. Although displacement of the MDP metabolite/cytochrome P-450 complex with 2-methylbenzimidazole generally led to a marked restoration of cytochrome P-450 levels and partially reversed the inhibition of APDM, it had little or no effect on AHH activities. PMID- 6845377 TI - Effects of dietary protein level on hepatic microsomal mixed-function oxidase systems during aging in two generations of Syrian hamsters. AB - Syrian hamsters were fed one of three levels of lactalbumin (10, 20, or 40%) from 4 weeks of age. Parents (F0 generation) and their offspring (F1 generation) remained for life on the parental diet. Randomly selected hamsters from both generations were killed at 0, 6, 18, 30, and 60 weeks to evaluate hepatic microsomal drug metabolism systems. Microsomal protein content rose with increased dietary protein in both generations of females at 30 and 60 weeks and in both generations of males at 18 weeks. Microsomal protein rose during life, but the timing and magnitude of the increase varied with sex, diet, and generation. Cytochrome P-450 content increased with elevation in dietary protein at most measurement times in females and at all measurement times in F1 generation males. Hepatic aryl hydrocarbon hydroxylase (AHH) and aniline hydroxylase (ANH) activities were influenced by dietary protein, primarily at 6, 18, and 30 weeks, and these values tended to decline between maturity and senescence. AHH generally increased as dietary protein rose, except at 30 weeks, at which time the group fed the medium protein level usually had the highest activity. ANH activity was either elevated in groups fed the 20 or 40% lactalbumin levels or depressed in these groups at 6 and 18 weeks when these values were influenced by dietary protein. The effects depended upon sex and generation. Age effects on hepatic microsomal metabolism in hamsters varied by sex and dietary protein and were somewhat different than those reported for other rodents. PMID- 6845379 TI - Covalent structure of toxins I and II from the scorpion Buthus occitanus tunetanus. AB - The amino acid sequences of neurotoxins I and II, which are active on mammals, purified from the venom of Buthus occitanus tunetanus have been determined using standard methods, including mainly automatic phenylisothiocyanate degradation of S-carboxymethylated derivatives of the two proteins and peptides derived by enzymatic hydrolyses. Both toxins are made of sixty-five amino acid residues cross-linked with four disulfide bridges. For toxin II, the complete covalent structure, including the positions of the four disulfide bridges was determined: the positions are similar to those previously found in toxin II of another scorpion from Africa, Androctonus australis Hector. This finding is in favor of a similar structure for all of the scorpion neurotoxins active on mammals. PMID- 6845378 TI - Effects of aminoglycosides on glomerular permeability, tubular reabsorption, and intracellular catabolism of the cationic low-molecular-weight protein lysozyme. AB - Gentamicin and other aminoglycoside antibiotics in high doses may produce proteinuria and other signs of nephrotoxicity. Proteinuria may result from general renal damage or may reflect alterations in specific steps in the renal handling of proteins. To distinguish between these two possibilities, experiments were designed to quantify the effects of nephrotoxic doses of several aminoglycosides on the renal handling of proteins in the isolated perfused rat kidney with the cationic low-molecular-weight protein lysozyme as a representative protein. Each aminoglycoside was administered ip to male Wistar rats (30 mg/kg/day) for 7 days. Lysozyme and 125I-lysozyme were added to the perfusate to achieve a lysozyme perfusate concentration of about 100 mg/liter. Clearances of inulin and lysozyme, release of tyrosine and trichloroacetic acid soluble radioactive metabolites into the perfusate, and the glomerular sieving coefficient of lysozyme were determined. Scanning and transmission electron microscopy indicated that gentamicin and tobramycin decreased the number and diameter of the endothelial fenestrae of the glomerular capillaries. Concurrently, gentamicin and tobramycin decreased the glomerular sieving coefficient of lysozyme from 0.8 to 0.6 and 0.5, respectively. Netilmicin did not affect the percentage reabsorption of lysozyme whereas gentamicin and tobramycin decreased lysozyme reabsorption from 71.7 to 35.4 and 34.4% of the filtered load, respectively. Lysozyme degradation, estimated by the release of tyrosine into the perfusate during a 150-min perfusion period, was decreased from a control value of 12 mumol/liter to 4.43 and 4.65 mumol/liter in kidneys from rats treated with gentamicin and tobramycin, respectively. This study demonstrates that polycationic aminoglycosides may affect several processes involved in renal handling of lysozyme including glomerular permeability, tubular reabsorption, and intracellular proteolytic degradation. PMID- 6845380 TI - Phospholipase A2 activity of long-chain cardiotoxins in the venom of the banded krait (Bungarus fasciatus). PMID- 6845381 TI - Isolation of a lethal factor from venom of Vespa orientalis (oriental hornet) by affinity chromatography using cross reactive monoclonal antibody. PMID- 6845382 TI - The venom system and venom hyaluronidase of the African honeybee (Apis mellifera adansonii). PMID- 6845383 TI - Occurrence of a ciguatoxin-like substance in the Spanish mackerel (Scomberomorus commersoni). AB - A lipid-soluble toxin, similar to ciguatoxin as isolated by Scheuer et al. (1967), has been found in the flesh of the Spanish mackerel, Scomberomorus commersoni, caught in Queensland. The ciguatoxin-like substance was experimentally characterized by examination of specific biological and chromatographic properties of the lipid-soluble extract from a pooled sample of flesh from Spanish mackerel. Flesh from specimens known to have caused S. commersoni poisoning in humans was confirmed as toxic by cat bioassay. A toxin was extracted from S. commersoni which yielded, on partial purification, a clear, oily substance with an LD50 i.p. to mice of 0.72 mg/kg, and which had chromatographic properties similar to those of classical ciguatoxin. However, the Rf value on thin-layer chromatography plates was lower for S. commersoni toxin than for classical ciguatoxin. This is the first record of a ciguatoxin-like substance experimentally identified in S. commersoni, a pelagic fish that occurs throughout Queensland coastal waters. The majority of toxic S. commersoni are caught between latitudes 24 degrees and 26 degrees S. PMID- 6845384 TI - alpha-Fibrinogenase from Agkistrodon rhodostoma (Malayan pit viper) snake venom. AB - By means of DEAE-Sephadex A-50 column chromatography, Agkistrodon rhodostoma (Malayan pit viper) snake venom was separated into eleven fractions. Fraction II had fibrinogenolytic activity, and when further purified by gel filtration was homogeneous, as judged by sodium dodecylsulfate polyacrylamide gel electrophoresis. It had a single peptide chain with a molecular weight of 25,360 and an isoelectric point greater than 10. The fibrinogenolytic activity was completely destroyed after heating for 30 min at 60 degrees C at pH 5.6, 7.4 or 8.8. This enzyme cleaved specifically the alpha(A) chain of monomeric fibrinogen, without cleaving the beta(B) chain or gamma chain. The specific fibrinogenolytic activity was 51 mg fibrinogen/min per mg protein. This enzyme showed proteolytic activities toward fibrinogen, fibrin and casein, but was devoid of phospholipase A and tosyl-L-arginine methylester esterase activities which are found in the crude venom. The fibrinogenolytic activity was inhibited by EDTA and cysteine, but not by epsilon-aminocaproic acid. PMID- 6845385 TI - Ability of antiserum to myotoxin alpha from prairie rattlesnake (Crotalus viridis viridis) venom to neutralize local myotoxicity and lethal effects of myotoxin alpha and homologous crude venom. PMID- 6845386 TI - Isolation of an anticomplement factor from the venom of the Mojave rattlesnake (Crotalus scutulatus scutulatus). AB - The venom of the Mojave rattlesnake was fractionated by DEAE-Sephadex column chromatography. A venom fraction, F5, inactivated both human and guinea pig complement. Both serum and purified C3 were partially converted to a protein of faster electrophoretic mobility, indicating that F5 had a direct proteolytic effect on C3. This product was capable of passively lysing guinea pig red blood cells. F5 very effectively inactivated the classical pathway, but only partially inactivated the alternative pathway. The venom fraction worked in a dose dependent fashion, was heat labile but not lethal to mice at concentrations as high as 10 micrograms/g mouse weight. Antibodies were produced by immunizing rabbits with F5. The antibodies formed one precipitin line in gels against F5 and also neutralized the complement inactivating activity. The antibodies recognized the venom of the western diamondback rattlesnake, Crotalus atrox, but did not, however, recognize the crude venom of the Mojave rattlesnake. PMID- 6845388 TI - Improvement of Malayan cobra (Naja naja sputatrix) antivenin. AB - A low molecular weight toxic fraction was isolated from venom of the Malayan cobra (Naja naja sputatrix) by Sephadex G-50 gel filtration chromatography. The fraction accounted for almost 100% of the venom lethality. Antisera were prepared by immunizing rabbits with the low molecular weight toxic fraction, the glutaraldehyde-treated low molecular weight toxic fraction and the glutaraldehyde treated, sea snake neurotoxin-enriched low molecular weight toxic fraction, respectively. Only the serum of rabbits immunized with the glutaraldehyde treated, neurotoxin-enriched fraction gave effective protection against high doses of Malayan cobra venom. This antiserum is thus a potent Malayan cobra antivenin. One milliliter of this antiserum was able to neutralize 1.5 mg of Malayan cobra venom. It is thus 4-8 times more potent than the commercially available Malayan cobra antivenins produced by immunizing horses with whole Malayan cobra venom. PMID- 6845387 TI - The effect of Bitis gabonica (Gaboon viper) snake venom on external iliac and mesenteric arterial circulation in the dog. AB - The effects of Gaboon viper (Bitis gabonica) venom on external iliac and mesenteric arterial blood flow and resistance were investigated in eight anaesthetized, close-chest dogs. Venom doses in the range 0.125-0.5 mg/kg produced a profound fall in external iliac and mesenteric arterial resistance, which recovered to control values after 30 min. After a third dose of venom, the mean arterial blood pressure failed to recover and the animals died after a period of severe hypotension. External iliac arterial blood flow rose concomitantly with the fall in external iliac resistance and decreased to a value significantly below control after 30 min. Paradoxically, mesenteric blood flow fell during the period of vasodilation. The results suggest that widespread vasodilation of muscle vascular beds (of which the external iliac circulation is representative) leads to shunting of blood away from the less-dilated mesenteric circulation. Venom-induced peritoneal haemorrhage caused a fall in blood volume and increase in viscosity. These undoubtedly contributed to the severe haemodynamic deterioration of the preparations after the third injection of the venom. PMID- 6845389 TI - Tetanus toxin inhibits the evoked outflow of an inhibitory (GABA) and an excitatory (D-aspartate) amino acid from particulate brain cortex. AB - In order to elucidate the mode of action of tetanus toxin, particles from rat forebrain were preloaded with tritiated GABA or D-aspartate, pre-incubated with tetanus toxin and then depolarized with K+, either in a batch procedure or by superfusion. The toxin depresses, but does not abolish, the evoked outflow of both amino acids in either system. Omission of Ca2+ decreases the outflow in the batch procedure by about 40%. The remaining outflow of either amino acid is insensitive to tetanus toxin, whereas the Ca2+ dependent outflow is completely inhibited. Antitoxin neutralizes the toxin but does not reverse its in vitro effects, once manifest. The toxin effects increase with time and temperature of pre-incubation. Pretreatment of the particles with V. cholerae neuraminidase, which is known to convert the long-chain gangliosides quantitatively into GM1, does not decrease the sensitivity to tetanus toxin. Besides particles from rat brain, those from chicken, but not those from frog brain, are toxin-sensitive when tested for GABA outflow in the batch procedure. Frog brain does not yield the typical ganglioside pattern, and also does not measurably bind 125I-tetanus toxin. The homoexchange diffusion of GABA, but not of D-aspartate, is slightly facilitated by tetanus toxin. We confirmed that tetanus toxin slightly inhibits the uptake of GABA, whereas that of D-aspartate is not measurably influenced. The accumulation, driven by a Na+/K+ gradient, of GABA into membrane vesicles from rat cortex is not affected by tetanus toxin. The present data support the hypothesis that tetanus toxin influences a process involved in the outflow of many transmitters, both excitatory and inhibitory. PMID- 6845390 TI - Acceptance and prevalence of vasectomy in developing countries. PMID- 6845391 TI - Voluntary sterilization in Guatemala: a comparison of men and women. PMID- 6845392 TI - The vasectomy decision-making process. PMID- 6845393 TI - Evaluation of the "condition correction factor" method of estimating theophylline clearance. AB - The predictive ability of the "condition correction factor" method of estimating total body theophylline clearance as proposed by Powell et al. was evaluated in 22 acutely ill hospitalized patients. Actual theophylline clearance was calculated while the patient was on a constant infusion of aminophylline with serum theophylline concentrations obtained at steady-state conditions. Independently, theophylline clearance was estimated for each patient using condition correction factors. The relationship between actual and estimated total body theophylline clearance was evaluated using multiple regression analysis and correlation testing. The data failed to demonstrate any significant positive correlation between actual and estimated theophylline clearance data. Because of this poor correlation, the use of one of the clearance estimation methods incorporating two serum theophylline concentrations obtained early in therapy is preferable, although less convenient. All estimates of clearance must be considered only as guides for individualization of therapy. Serum concentration monitoring and clinical response of the patient must be considered prior to adjustment of dosage. PMID- 6845395 TI - Variations in gentamicin C1, C1a, C2, and C2a content of some preparations of gentamicin sulphate used clinically as determined by high-performance liquid chromatography. PMID- 6845394 TI - Radioimmunoassay for prochlorperazine in human plasma. AB - A new sensitive, specific, and rapid radioimmunoassay procedure for the determination of plasma concentrations of the antiemetic drug prochlorperazine is described. The assay enables the quantitation of 31 pg of the drug in 200 microliters of plasma with a coefficient of variation of approximately 2%. Except for N-desmethylprochlorperazine, the antiserum did not cross-react with the available metabolites tested. Also there was no cross-reactivity with the tricyclic antidepressants and antianxiety agents commonly co-administered with the drug. The method is suitable for single-dose pharmacokinetic and bioavailability studies. It should be adequate for the therapeutic monitoring of the drug in patients. PMID- 6845396 TI - Simultaneous liquid chromatographic determination of chloramphenicol and antiepileptic drugs (phenobarbital, phenytoin, carbamazepine, and primidone) in plasma. AB - A method for the simultaneous analysis of chloramphenicol and four antiepileptic drugs (phenobarbital, phenytoin, carbamazepine, and primidone) in plasma by high performance liquid chromatography (HPLC) is described. The method involves a preliminary extraction of 0.1 ml of plasma with diethyl ether containing phenacetin as an internal standard, chromatography with a reversed-phase column with a methanol-water mobile phase, and detection by measuring ultraviolet absorbance at 210 nm. The method demonstrated sufficient precision, sensitivity, and specificity: the recoveries of the drugs were greater than 95% with the exclusion of primidone (80.3%); the maximum within-day and day-to-day coefficients of variation for all drugs were less than 5%; the lower detection limits were 0.5 microgram/ml or less for all drugs analyzed; and six other antibiotics, phenylethylmalondiamide, carbamazepine-10,11-epoxide, and chloramphenicol esters did not interfere with the analysis. The HPLC method was tested for clinical applicability by analyzing plasma samples from a volunteer who received concurrent single doses of chloramphenicol, phenobarbital, and phenytoin. This method can be used for studying drug interactions between chloramphenicol and antiepileptic drugs and for monitoring the concentrations of these drugs in plasma when administered concurrently, to prevent concentration related side effect(s) of each drug. PMID- 6845397 TI - Effect of secobarbital on theophylline clearance. AB - Increased clearance of theophylline after the administration of secobarbital was observed in a child receiving phenobarbital. Prior to barbiturate treatment, theophylline clearance was 4.78 ml/kg/min. Beginning 10 days after the institution of secobarbital and phenobarbital therapy, a continually increasing amount of theophylline was required to maintain therapeutic serum concentrations. After 29 days of barbiturate administration, theophylline clearance attained a peak value of 16.1 ml/kg/min, an increase of 337% from the prebarbiturate rate. During this time it was necessary to administer theophylline at a dosage four times above that usually recommended. After secobarbital was discontinued, theophylline clearance returned to 4.53 ml/kg/min. The decrease in theophylline clearance occurred while phenobarbital dosage remained stable. It is apparent that changes in secobarbital dosing were subsequently followed by changes in the clearance of theophylline. PMID- 6845398 TI - An improved high-performance liquid chromatographic procedure for monitoring indomethacin in neonates. PMID- 6845399 TI - Intravenous ampicillin pharmacokinetics in the third trimester of pregnancy. AB - The pharmacokinetics of a single dose of intravenous ampicillin were studied in nine patients during their third trimester of pregnancy. Each volunteer was given either 500 mg (5.7-8.8 mg/kg) or 1 g (15.4-21.4 mg/kg) of sodium ampicillin by rapid infusion. Postinfusion plasma concentration-time curves followed biexponential decay in all subjects. Calculated parameters included a mean plasma distribution volume of 177.1 +/- 97.5 ml/kg, tissue or peripheral distribution volume of 246.2 +/- 143.9 ml/kg, elimination half-life of 1.60 +/- 0.51 h, and total body clearance of 4.59 +/- 1.48 ml/min/kg. Dose-dependent disposition was not observed. Gestation-specific drug therapy research during pregnancy is discussed. PMID- 6845400 TI - Pharmacokinetic studies of rifampicin in the elderly. AB - The pharmacokinetics of rifampicin (RMP) and its principal active metabolite desacetylrifampicin (DA-RMP) were studied in six subjects, ranging in age from 78 to 95 years, after single oral doses of 10 mg/kg RMP. The maximal plasma concentrations (Cmax) and the elimination half-lives (t 1/2 beta) of RMP are 8.83 +/- 1.72 mg L-1 and 4.09 +/- 2.59 h, respectively. They are comparable to those reported in young adults. The same applies to the Cmax value (1.93 +/- 0.53 mg L 1) and t 1/2 beta value (4.65 +/- 2.61 h) of DA-RMP. However, the renal clearance of RMP (0.0075 +/- 0.0036 L h-1) and the amounts of RMP (20.7 +/- 9.9 mg) and DA RMP (13.3 +/- 5.6 mg) excreted in the urine during a 24-h period are lower than those reported in young adults. The renal excretion of RMP and DA-RMP, therefore, is reduced in the elderly. But since the drug is also excreted through the liver to such an extent that serum levels are the same as in young adults, for therapeutic purposes the metabolism of RMP may be globally considered as unaltered in elderly patients. PMID- 6845401 TI - Pharmacokinetics of rifampicin and desacetylrifampicin in tuberculous patients after different rates of infusion. AB - Four rates of rifampicin infusion ranging from 3.3 to 15 mg/min in 12 tuberculous patients were studied. Blood samples (n = 10) were drawn during infusion and 8 h later. Urine samples were collected in six fractions during a 24-h period. Rifampicin and desacetylrifampicin were measured by high-pressure liquid chromatography. Results show that the maximum plasma concentrations increase linearly for each dose with the rate of infusion, and that the amounts excreted in the urines are highly dependent on the administered dose. Simulation of plasma concentrations after different dosage regimens shows that a double rate of infusion--20 mg min-1 during 1 h and then 200 mg h-1--allows plasma concentrations to be quickly reached and maintained at a 20 mg L-1 level, far higher than the minimum inhibitory concentrations of most germs. PMID- 6845402 TI - Plasma levels of primidone and its metabolite phenobarbital: effect of age and associated therapy. AB - The effects of age and associated therapy on plasma primidone (PRM) and derived phenobarbital (PB) concentrations, and on plasma concentrations-to-PRM dose ratios (L/D ratio) were evaluated retrospectively from 408 consecutive PRM and derived PB determinations in 238 chronically treated epileptic patients (153 children and adolescents between 5 months and 15 years of age and 85 adults between 16 and 55 years of age). The correlation between PRM administered and both plasma PRM and derived PB levels was significant; the correlation between PRM and PB plasma levels was also significant, but the scatter of values for the linear regressions was such that the relationship had no predictive value. Significant differences in mean plasma PRM and PB L/D ratios were found between patients aged 0-3 years, 4-9 years, 10-15 years, and adults (16-55 years), with higher values in the older groups. The PB/PRM concentration ratios were significantly lower in children than in adolescents and adults. Concomitant treatment with carbamazepine affected PRM disposition and led to increased L/D ratios for PB and decreased L/D ratios for PRM, whereas phenytoin increased the L/D ratios for PB without any significant change in the L/D ratios for PRM. The variability in the results indicates the need for routine monitoring of PRM and derived PB plasma levels, particularly in pediatric populations, in order to tailor the dose to each patient. PMID- 6845403 TI - Plasma protein binding of disopyramide by equilibrium dialysis and ultrafiltration. AB - An ultrafiltration technique, using Ultrafree Anticonvulsant Drug Filters, was compared to equilibrium dialysis for the determination of disopyramide plasma protein binding. Mean total recovery of drug was 92.4% for ultrafiltration compared with 98.4% for equilibrium dialysis. At initial plasma concentrations spanning the therapeutic range (2-8 micrograms/ml), the percentage binding of disopyramide was concentration dependent for both methods (78-38%). Initial experiments with ultrafiltration (1 ml of plasma) indicated a small (0.14%) but variable loss of total plasma protein in the ultrafiltrate (0.1-ml volume). In ultrafiltration, percentage binding of disopyramide was similar at 22 and 37 degrees C, whereas in equilibrium dialysis, binding was significantly (p less than 0.001) greater (1.4-2.7%) at 22 than at 37 degrees C. Percentage binding for plasma (1-ml volume), assessed at ultrafiltrate volumes of approximately 0.1 and 0.25 ml, was found to be significantly (p less than 0.05) different, but in practical terms the mean difference was less than 1% at any of the concentrations studied and was therefore of little consequence. Absolute values for percentage disopyramide bound by ultrafiltration and equilibrium dialysis were very similar, irrespective of the temperature. However, when these values were related in the usual way to the starting plasma drug concentration for ultrafiltration or to the final dialysed plasma concentration, ultrafiltration gave results that were consistently greater than those with equilibrium dialysis. Reasons for these differences and their implications are discussed. PMID- 6845405 TI - Individualizing theophylline therapy: the impact of clinical pharmacokinetics on patient outcomes. AB - We have studied 19 male patients whose theophylline therapy was individualized by a clinical pharmacokinetics service and 34 male patients with empirically derived dosages. All patients were admitted to the medical intensive care unit. Patients in the pharmacokinetics group had fewer adverse reactions (15.7 vs. 50%), shorter intensive care unit stay (6.6 +/- 5.5 vs. 12.4 +/- 16.3 days), shorter hospital stay (15.4 +/- 10 vs. 22.3 +/- 14.1 days), and a shorter period of time to be placed on oral therapy (5.2 +/- 3.1 vs. 8.6 +/- 7.2 days) than the group with empirically derived regimens. The pharmacokinetic method used to individualize theophylline therapy offered an accurate and efficient method of achieving therapeutic concentrations. We conclude that the use of clinical pharmacokinetics to individualize theophylline therapy offers substantial benefits over empirical assessments. PMID- 6845406 TI - Some characteristics of thymus suppression of antibody production in vitro in Xenopus laevis, the South African clawed toad. AB - Organ cultures were used to test whether thymus suppression of antibody production by spleen cells of Xenopus laevis is antigen inducible, antigen specific, or genetically restricted when a thymus-dependent (TD) antigen, horse erythrocytes (HRBC), is injected in vivo. The capacity of mammalian thymus independent (TI) antigens, e.g. TNP-Ficoll (TI-2) and TNP-LPS (TI-1) to induce thymus suppression of the anti-HRBC) response was also tested. Additionally, the susceptibility of TI spleen responses to thymus suppression was studied. Auto- and allogeneic thymus and spleen combinations were compared to spleen cultured alone with respect to hemagglutinin titers secreted into the culture medium. The results suggest that thymus suppression of a TD response in this species is antigen inducible. Moreover, depending on the antigen used either antigen specific or unspecific suppression will be generated. Both can function across allogeneic boundaries. Responses to TI antigens are not subject to thymus suppression. PMID- 6845404 TI - Propranolol, propranolol glucuronide, and naphthoxylactic acid in breast milk and plasma. AB - High-performance liquid chromatographic assays for propranolol and its major metabolites in plasma and breast milk are described. The breast milk/whole plasma ratios of propranolol in three lactating women were in the range of 0.33 to 1.65. The half-life of elimination of propranolol from breast milk was 6.5 +/- 3.4 h (mean +/- SD), which was significantly longer (t = 1.844, df = 4, p less than 0.01) than the half-life of elimination of propranolol from plasma, which was 2.6 +/- 1.2 h (mean +/- SD). The half-life of elimination of the propranolol metabolite naphthoxylactic acid from breast milk was 4.2 +/- 0.9 h (mean +/- SD), which was not significantly different (t = 0.042, df = 4, p greater than 0.05) from the mean half-life of elimination from plasma, which was 4.2 +/- 1.2 h (mean +/- SD). The penetration of propranolol glucuronide into breast milk was slower and to a lesser extent than that of propranolol and naphthoxylactic acid. The maximum dose, calculated from the results presented in this paper, ingested as either propranolol or as propranolol glucuronide in breast milk by the neonate would be less than 0.1% of the maternal dose. PMID- 6845407 TI - Prevention of anaphylactic and histamine shocks by applying early fetal calf blood serum. PMID- 6845408 TI - [The specialty of geriatrics and geriatric education. The origins and functions of a geriatric department in a general hospital]. AB - In 1973 a geriatric ward was set up as part of the general hospital Hoog-Laren (now part of 'Gooi-Noord'). Its function is the examination, observation and medical treatment of elderly patients showing disordered behaviour. In this article we describe the history, goals, organization and methods/activities of this geriatric ward. Experience taught us that disordered behaviour of elderly patients is not a matter of mental illness, but arises in general as result of a disturbance of the somato-psychic-social equilibrium. Before it is possible to start a specific treatment, we try to determine the nature and extent of the disturbance by examining all known aspects of the somato-psychic-social equilibrium in a multidisciplinary manner. Then a therapeutic plan is designed and a recommendation for the future is given. Recently the activities were extended to include policlinical screening of patients. PMID- 6845410 TI - [An older patient with abdominal pain and diarrhea]. PMID- 6845409 TI - [The specialty of geriatrics and geriatric education. Geriatrics and nursing home medicine; differences and similarities]. AB - Modern definitions of geriatric medicine are based upon the central concept of homoiostasis. Starting from this concept, the goals, methods and provisions on behalf of geriatric patients in the Netherlands have been outlined. Likewise some arguments for the identity of the medicine of the nursing home are discussed. It is concluded, that medicine of the nursing home is basically the same as geriatric medicine, although there have grown differences as to the location where it is practiced. Assuming that the magnitude of geriatric problems will increase in the future for both disciplines, concerted action is recommended for geriatric medicine and medicine of the nursing home, specially regarding the proposed educations. PMID- 6845411 TI - [Neuropsychologic aspects of normal pressure hydrocephalus: a case report]. PMID- 6845412 TI - Increased free plasma corticosterone and adrenal hyperactivity associated with graft-versus-host disease. AB - This study profiles adrenal function in 14-day-old neonatal and adult rats with graft-versus-host disease (GVHD). Measurements of adrenal function included total serum corticosterone, the relative percentage of free corticosterone (a measure of biologically active hormone), adrenal cholesterol content, adrenal weights, and adrenal histology. Diseased animals in both age groups displayed a shift from the protein-bound to the free corticosterone fraction, with, surprisingly, no change in total serum corticosterone titers. We discuss the possibility that such a shift toward the biologically active, free-hormone pool results in a physiologic hyperglucocorticoidism that might contribute to the progress of GVHD. Compared with littermate controls, diseased adults had enlarged adrenals. In neonates with GVHD, no adrenal hypertrophy was evident, yet decreased adrenal cholesterol content and associated depletion of adrenal lipid droplets--evidence of adrenal hyperactivity--were identified. The GVHD must be responsible for the observed alterations in adrenal function because treatment of affected animals with alloantiserum directed against donor cells halted the disease and elevated the cholesterol content toward control levels. The possible contribution of adrenal dysfunction to the pathogenesis of secondary manifestations of GVHD is discussed. PMID- 6845413 TI - A Class II monoclonal antibody specific for the RT1.B, rather than the RT1.D, product of the rat major histocompatibility complex. AB - An allospecific monoclonal antibody, 79.7.5., has been shown to be specific for a Class II histocompatibility product of the ACI (RT1.AaBaDa) rat. To further specify the reaction of this antibody to the B or D locus Class II products of RT1, we examined the binding of this antibody to peripheral blood lymphocytes (PBLs) of the WRC rat (haplotype RT1.AnBnDa). Radiolabelled monoclonal antibody 79.7.5. did not bind to PBLs from the WRC rat, but it did bind to PBLs from the WRA rat (RT1.AdBaDa) and the DA (RT1.AaBaDa) rat. These results were confirmed using radiolabelled Staphylococcus protein A in an indirect binding assay. In addition, binding of 79.7.5 could be inhibited by alloantiserum BN anti-BN.1A (DA) (directed against AaBaDa) but not by BN anti WRC (directed against Da). These data demonstrate that monoclonal antibody 79.7.5. reacts with the a allele product of RT1.B rather than RT1.D. This antibody can be used to probe the structures and functional roles of different Class II products of the rat major histocompatibility complex. PMID- 6845414 TI - The molluscicidal properties of Ambrosia maritima L. (compositae). 1. Design for a molluscicide field trial. AB - The composite plant, Ambrosia maritima is toxic to the snail intermediate hosts of schistosomiasis. A field trial was required to confirm this activity. A preliminary survey of irrigation canals and drains was conducted using two snail sampling methods. The results have been used to indicate the minimum number of watercourses which would have to be treated and the number of sampling stations per watercourse required to establish statistical significance in a kill of snails obtained from a molluscicide treatment. PMID- 6845415 TI - Intraperitoneal murine alveolar hydatidosis: relationship between the size of the larval cyst mass, immigrant inflammatory cells, splenomegaly and thymus involution. AB - Both phagocytic and nonphagocytic inflammatory cells infiltrate the peritoneal cavity of mice infected intraperitoneally with Echinococcus multilocularis cysts. A longitudinal study on the kinetics of peritoneal leukocytosis at 3 days, 1, 2, 3, 4, 6, 8, 10 and 14 weeks postinfection revealed that the restrictive and progressive growth phases of the alveolar hydatid cyst correspond sharply with the increasing and decreasing levels of peritoneal cells, respectively. The restrictive phase is characterized by the progressive peritoneal accumulation of lymphocytes, monocytoid cells and eosinophils. Between 6 and 14 weeks p.i., the alveolar cyst increased in weight 30 fold. This phase was associated with peritoneal neutrophilia, splenomegaly, involution of the thymus and a significant decline in the extravasated lymphocytes, monocytoid cells and eosinophils. These results in conjunction with our previous studies indicate that host's hydatid immunosurveillance is compromised as a result of profound immunopathologic disorders during the progressive growth phase of the alveolar cyst. In order to understand the prolonged survival of alveolar cyst, further investigation of inflammatory cell-cyst interactions is indicated. PMID- 6845416 TI - The occurrence of an adverse reaction to chloroquine in Dirofilaria immitis infected dogs. AB - The occurrence of an adverse reaction in Dirofilaria immitis-infected dogs following an intramuscular injection of chloroquine is described. The manifestations of this adverse reaction were characteristic of a neurologic disorder rather than the hypovolemic, shock-like state of the post-DEC adverse reaction previously described in dogs. In 3 of the 12 dogs the adverse reaction was of sufficient severity as to be fatal. Alterations in serum fibrinogen, serum transaminase levels and platelet numbers occurred but the magnitude of changes were not as great as that in the post-DEC adverse reaction. Following the injection of chloroquine the microfilaremia increased to a degree that was greater than the increase following DEC administration in the dog. PMID- 6845417 TI - The fine structure of adult Onchocerca volvulus. III. The cuticle, the interchordal hypodermis and the muscle cells of the female worm. AB - The morphology of the cuticle, the interchordal hypodermis and the muscle cells of three mature but not full-grown worms, one worm less than five years old, two worms at least five years old and seven worms of unknown age are described. The cuticle in the anterior region is very similar to that of the male worm, however, in the midbody region the cuticular structure is more simple. The length of the folds of the surface membrane and the thickness of the coat vary considerably. The outer surface of the hypodermis is increased by lamellae, the inner surface by a labyrinthine system of folds. The structure of the muscle cells is simpler than in the male worm: degenerative alterations are found frequently comprising reduction of the afibrillar portion, separation of the filaments from the septa, disintegration of the filaments, and separation of the plasma from the laminae and finally total disintegration of the cell, leaving the empty laminal coverings behind. PMID- 6845418 TI - Ultrastructural aspects of intraerythrocytic development of a Venezuelan strain of Anaplasma marginale. AB - Blood samples from splenectomized calves infected with a Venezuelan strain of Anaplasma marginale were studied by electron microscope. A. marginale appears to invade erythrocytes by the invagination of the host cell plasma membrane. The parasite reproduces by binary or multiple fission, changing from a rounded to an irregularly polyhedral form during and after division. The mature Anaplasma, within the host red cell modifies the erythrocytes cytoplasma and external membrane producing pores through which the parasite can escape without lysing the host erythrocyte. PMID- 6845419 TI - [Functional activity and metabolism of blood neutrophils exposed to low-intensity microwaves]. AB - A 7 hrs exposure of white rats to power density (PD) of 500, 50 and 10 microW/cm2 for 30 days induced changes in phagocytic ability of blood neutrophils, glycogen content and alkaline phosphatase activity. At PD level of 500 microW/cm2 the depression of absorption and digestion functions of neutrophils as well as the decrease of alkaline phosphatase activity and glycogen content were observed during the whole period of aftereffect (three months after exposure). PD levels of 50 and 10 microW/cm2 caused intensification of phagocytic function and metabolism in neutrophils. By the end of the observation period the mentioned indices did not differ from the initial ones. PMID- 6845420 TI - [Cytogenetic action of the pesticides captan and benomyl in a lymphocyte culture of human peripheral blood in the absence and presence of a system of metabolic activation]. AB - Results of the investigation of mutagenic effects of fungicides captan and benomyl in the culture of human peripheral lymphocytes in vitro with and without metabolic activation showed that captan did not manifest cytogenetic activity in any experimental variants, while benomyl induced colchicine-like and weak clastogenic effect in the concentration 10 micrograms/ml in the presence of microsomal activating mixture only. PMID- 6845421 TI - [Cellular hypertrophy and ultrastructural hyperplasia in the liver parenchyma of mice as a result of acute stress]. PMID- 6845422 TI - [Frequency of sister chromatid exchanges in oncological patients during treatment with cyclophosphane]. AB - The sister chromatid exchange (SCE) level in patients with cancer of lungs before treatment did not differ from the mean number of SCE in healthy donors. In the process of a cyclophosphane treatment the SCE frequency in the patient lymphocyte culture increased with the drug doses of 4 and 5 g. Analysis of the ratio of cells in mitoses I, II and III revealed no differences in the cell cycle rate for groups of healthy donors, patients before the treatment, and treated patients. PMID- 6845423 TI - Effect of breed and age of buck and season of breeding on reproduction. PMID- 6845424 TI - Mineral contents in livestock in eastern Sudan. PMID- 6845425 TI - Livestock production in central Mali. The Macina wool sheep of the Niger inundation zone. AB - This paper gives a brief outline of the supposed origins, the known history and the distribution of the Macina sheep. A physical description of the breed is provided, population demography is discussed and traditional systems of management are described and explained. Productivity is assessed in two ways- from the results of a questionnaire survey of traditional owners and analyses of four years' data on a small flock owned by ILCA and managed as closely as possible on traditional lines. PMID- 6845427 TI - Serological prevalence of bovine brucellosis in El Salvador. PMID- 6845426 TI - Bovine haemoparasitic diseases in Jamaica. PMID- 6845428 TI - Diagnosis of Johne's disease in sheep by counter-immunoelectrophoresis. AB - The use of counter-immunoelectrophoresis (CIEP) in the diagnosis of Johne's disease was investigated in flocks of sheep in Iran and Libya. In 50 sheep with no history of paratuberculosis none had antibodies to Mycobacterium paratuberculosis. Animals vaccinated as neonates were either negative or had reciprocal titres (RT) of less than 4 at 18 months of age unless exposed to infection. Among 105 non-vaccinated adults in an infected flock 91% had antibodies. Twenty-one animals that either died or were slaughtered were autopsied. Eight animals with RT of 8 or above and one with RT of 4 had gross lesions with demonstrable acid-fast organisms. Two animals with RT of 2 had clinical disease while three with RT of 4 and one with RT of 2 had histopathological lesions only. All animals found negative for M. paratuberculosis infection had RT of 2 or below. The critical interpretation of the test is discussed. PMID- 6845429 TI - Abortions in N'Dama cattle due to salmonellosis. AB - An outbreak of diarrhoea, dysentery, abortion and death among N'Dama cattle is reported. Eight animals involved were examined ante- and/or postmortem yielding salmonella belonging to three serotypes, S. visby, S. hadar and S. taksony. The need for further studies to elucidate the problem of salmonella abortion in cattle in Sierra Leone is highlighted. PMID- 6845430 TI - Intake and digestibility of berseem (Medicago sativa) and Sorghum Abu 70 (Sorghum vulgare) forages by Sudan zebu cattle and desert sheep. AB - Two experiments were carried out with Sudan zebu cattle and desert sheep to study the voluntary intake and digestibility of berseem (Medicago sativa) and Abu 70 (Sorghum vulgare) forages when offered ad lib. alone and with supplements of molasses to the cattle and dura grain to the sheep. In both experiments the intake of berseem was significantly higher than Abu 70. Supplementation increased Abu 70 intake and while molasses significantly increased berseem intake by cattle, dura decreased its intake by sheep. On the basis of metabolic body size sheep showed a higher intake of these forages than cattle. There was no significant difference in DM digestibility between berseem and Abu 70 by cattle. Sheep digested berseem significantly better than Abu 70. Molasses and dura significantly increased the digestibility of Abu 70 by cattle and sheep but had no significant effect on the DM digestibility of berseem. PMID- 6845431 TI - Intradermal BCG vaccination complications--analysis of 51 cases. AB - The authors describe 51 cases of local complications due to intradermal BCG vaccination which occurred among 117 533 children between 1974 and 1979, in the city of Niteroi (Rio de Janeiro State). The ages ranged from 0 to 16 years and the lesions observed were abscesses, enlargement of regional lymph nodes, chronic ulceration, and ulceration associated with enlarged lymph nodes. The patients were treated with isoniazid, except 2 who required surgical drainage, with favourable results in all cases. PMID- 6845432 TI - Infection by Mycobacterium haemophilum, a metabolically fastidious acid-fast bacillus. PMID- 6845433 TI - Paediatric laryngeal tuberculosis. PMID- 6845434 TI - Tuberculous axillary lymphadenitis: an unusual presentation. PMID- 6845435 TI - Calcium metabolism during rifampicin and isoniazid therapy. PMID- 6845437 TI - [Chemical acetylation, trypsinolysis and stability of nucleosomes]. AB - Gel electrophoretic analysis of the histone chemical acetylation in the nucleosome core particles with acetic andydride revealed availability of about 14 lysine residues of histone H2A, 15-21 of H2B, 8-11--H3 and 6-9--H4. Moderately lysine-rich histones H2A and H2B were found to be more susceptible to acetylation than arginine-rich H3 and H4. Chemical acetylation enhanced the rate of trypsin digestion in acetylated nucleosomes as evidenced by gel electrophoresis of histone fragments. A more pronounced trypsin digestion was evident at acetylation of only 3-5 histone amino groups per nucleosome. However, even heavily acetylated nucleosomes yielded in familiar trypsin limit digest pattern of histone fragments thus indicating persistence of histone octamer. Nucleosomes which were trace acetylated (up to 3-5 histone amino groups neutralized per nucleosome) and treated with trypsin to remove highly charged terminal histone regions revealed remarkable unfolding and partial dissociation when analyzed by gel electrophoresis. The same trace acetylated nucleosomes did not show such destabilization prior to trypsin digestion. PMID- 6845438 TI - [Isolation and physico-chemical properties of native histone complexes: dimer (H2 H2B), tetramer (H3-H4)2 and octamer (H3-H4-H2A-H2B)2]. AB - The paper is concerned with the isolation of the native histone complexes: dimer (H2A-H2B), tetramer (H3-H4)2 and octamer (H3-H4-H2A-H2B)2 from the calf thymus chromatin under soft conditions (hydroxyl apatite) fractionation with the subsequent gel filtration). Parameters of hydroxyl apatite saturation with chromatin are determined. The complexes obtained are free of DNA and nonhistone proteins. Absorption spectra parameters, quantum efficiencies and fluorescence spectra typical of the corresponding histone oligomers are established. Comparison of free tyrosine fluorescence spectra with histone tyrosyl ones revealed a long-wave shift in the latter. PMID- 6845436 TI - [Mechanism of interaction of pyridoxal-5-phosphate with human serum albumin]. AB - Four and five molecules of pyridoxal-5-phosphate are irreversibly bound to human serum albumin in neutral aqueous or aqueous-spirituous media, respectively. The first step is a reversible formation of the Schiff bases with lysine residues. It is followed by an irreversible interaction of aldimine bond with an imidazole ring of the neighbouring histidine to form cyclic compounds of substituted aldimine type. Cyclic products of the reaction are characterized by absorption spectra with a maximum at 330 nm and fluorescence spectra with a maximum at 400 410 nm in a neutral medium. PMID- 6845439 TI - [Study of the endogenous cyclic nucleotide-dependent phosphorylation of synaptic membrane proteins]. AB - The highest activity of cyclic nucleotide-dependent (cAMP--2 X 10(-5) M, GMP--2 X 10(-4) M) phosphorylation of synaptic membrane proteins in vitro is revealed at equimolar concentrations of ATP and Mg2+ (10(-3)M) and depends on the ratio of the ATP concentration, protein amount in the assay and the period of exposure. At concentrations exceeding 10(-3) M ATP inhibits cyclic nucleotide-dependent phosphorylation. Optimal concentrations of ATR and Mg2+ to provide basal phosphorylation are found to be equal to 10(-2) M. Possible role of cyclic nucleotide-dependent phosphorylation in synaptic transmission is discussed. PMID- 6845440 TI - [Effect of tryptophan excess in a diet on amino acid composition of skin collagen and on an initial stage of protein biosynthesis in rat liver]. AB - Protein deficiency and tryptophane load against its background lead to the acid soluble collagen synthesis in the rat skin. The amino acid composition of the collagen differs from the norm. This is accompanied by changes in the free amino acid pool of blood serum and liver, under tryptophane load the free amino acids pool of the liver increasing twice as high. At the same time protein deficiency increases and tryptophane load decreases the level of tRNA amino acylation with tryptophane in the animal liver. Thus, protein deficiency and tryptophane load against its background cause deep changes in the protein biosynthesis. PMID- 6845441 TI - [Concentrations of carbohydrate components of glycoproteins in rat serum and erythrocyte and leukocyte membranes in hyperthyroidism]. AB - The content of carbohydrate components of glycoproteins in blood serum and erythrocyte and leucocyte membranes was studied as affected of various doses of L thyroxin. It is established that administration of L-thyroxin small doses increases the level of glycoprotein components in blood serum and cells. Administration of median and especially of high doses of the hormone already on the 12th of the experiment lowers sharply the components level in blood serum and increases it in the membranes of erythrocytes and to a less extent in the membranes of leucocytes. By the 24th day of the experiment the total content of carbohydrate components in the membranes decreases (16.3-25.7% below the normal level). A moderate positive correlation is established between the changes in the content of certain components of glycoproteins in the blood serum and cell membranes in rats with hyperthyreosis induced by administration of L-thyroxin small doses. In the rest cases such a regularity is observed only between the indices in the blood cell membranes. PMID- 6845442 TI - [Solubilization of mitochondrial creatine kinase after treatment with lactate and other metabolites]. PMID- 6845443 TI - [Study of the ion transfer in membrane vesicles by ion exchange gel chromatography and ultrafiltration]. AB - A method involving fast ion-exchange gel chromatography and filtration through ultrafilters is suggested for studying ion transport in membrane vesicles from bovine brain gray matter. The method permits separating quantitatively the membrane vesicles from the external radioactive label and studying kinetics of ion transfer. The label transfer is characterized by the presence of fast and slow phases and cannot be described by one exponential curve. PMID- 6845446 TI - [Method of isolation of intact enterocytes from rat duodenal mucosa]. AB - A procedure is suggested for obtaining intact enterocytes from rat duodenum mucosa by the tissue trypsinization in the isotonic Krebs solution (pH 7.9). The maximum yield of certain enterocytes is reached at the enzyme concentration of 0.03%; the incubation time--15 min; 200-250 mg of mucosa produces 3,7 X 10(6)- 4,7 X 10(6) cells. PMID- 6845444 TI - [Estimation of the size of bilayer liposome by optical density and refractive index]. AB - A simple method for estimating a mean particles size in a suspension is suggested on the basis of an empirical correlation of a liposome size found by the optical shift method and on optic properties of the suspension. For liposome size characteristics only two parameters: optical density and refraction index increment are measured. PMID- 6845445 TI - [Isolation of skeletal muscle plasmatic membranes as closed vesicles]. AB - Ultrasonic treatment of skeletal muscle sarcolemma preparations in 0.25 M sucrose, 0.1 M NaCl, 0.001 M tris-HCl-buffer (pH 7.4) induces formation of closed osmotically active vesicles which may be isolated by centrifugation of a sonicated suspension within the sucrose density gradient. The vesicles retain the enzymic activity peculiar to the initial sarcolemma preparations. PMID- 6845447 TI - [Phospholipid composition of human, dog and guinea pig adrenal cortex]. AB - The phospholipid composition was studied in human and dog adrenal cortex and in guinea pig adrenal tissue. The major phospholipids of adrenal cortex were phosphatidylcholine and phosphatidylethanolamine whose ratio in the human, dog and guinea pig tissues was 2.16, 2.01, 1.61, respectively. Phosphatidylinositol, phosphatidylserine, sphingomyelin, diphosphatidylglycerin, lysophosphatidylcholine and lysophosphatidyl-ethanolamine were also found in adrenal cortex. A quantitative phospholipid composition of the human adrenal cortex was close to the dog one. The fatty acid composition of phosphatidylcholine from human and dog adrenal cortex was determined and some differences were shown. PMID- 6845448 TI - [Activation of membrane lipid peroxidation in the liver of young and old rats by thyroxine and actinomycin D]. AB - Thyroxine and actinomycin D evoke activation of enzymatic peroxide oxidation of membrane lipids in the liver mitochondria and microsomes 24 hours after their separate or combined administration to Wistar males rats. In young animals the thyroxine effect is less pronounced than in old ones. Activation of peroxidation of membrane lipids with thyroxine or actinomycin D is not additive. Thyroxine had no essential influence on the glutathione-S-transferase activity of mitochondrial and postmitochondrial fractions of liver homogenates which is higher in old animals. PMID- 6845450 TI - [Effect of exogenous succinate on the contents of tricarboxylic acid cycle metabolites of the liver]. AB - The paper deals with dynamics of tricarboxylic cycle metabolites in the liver after subcutaneous injection of succinate in a dose of 100 mg/kg to guinea pigs. Before the preparation administration the highest level was marked for succinate, malate and citrate. 3 h after the administration the succinate content increased by 57% and 6 h later it returns to the initial level. No essential changes were observed in the content of other tricarboxylic acid cycle metabolites. PMID- 6845449 TI - [Effect of substrates of glycolysis and tricarboxylic acid cycle on the level of oxidative processes in spermatozoa of grass carp and carp]. AB - Endogenic respiration of grass carp and carp spermatozoids is rather low. Oxidation rate of metabolites is different--malate is oxidized more intensively, it is followed by lactate, pyruvate, succinate. Sperm storage lowers the respiration level and oxidation rate of metabolites. PMID- 6845451 TI - [Asthmatic dyspnea caused by chronic constrictive pericarditis]. PMID- 6845452 TI - [Bilateral rupture of the quadriceps]. PMID- 6845454 TI - [Hemoptysis and occupation]. PMID- 6845456 TI - [Pulmonary symptoms, pulmonary function tests, smoking habits and occupational exposure among 40-year old men and women in Glostrup. II. Interrelations]. PMID- 6845455 TI - [Pulmonary symptoms, pulmonary function tests, smoking habits and occupational exposure among 40-year old men and women in Glostrup. I. Distribution and relation to sociodemographic variables]. PMID- 6845453 TI - [Alcoholic liver diseases in young women]. PMID- 6845457 TI - [Stable fracture of the spine treated with a 3-point brace]. PMID- 6845458 TI - [Treatment of fractures of the shaft of the humerus with the Sarmiento bandage]. PMID- 6845459 TI - [Yersinia enterocolitica appendicitis. A follow-up study]. PMID- 6845460 TI - [The coracoclavicular joint]. PMID- 6845461 TI - [Malignant melanoma of the rectum]. PMID- 6845462 TI - [The toxic shock syndrome with unusual recurrence]. PMID- 6845463 TI - [Adenocarcinoma in the corpus uteri. A retrospective study of 150 patients]. PMID- 6845465 TI - [The importance of gastric acid in peptic ulcer]. PMID- 6845464 TI - [Amputation and skin perfusion pressure. Selection of amputation level and measuring technics]. PMID- 6845466 TI - [Erection dysfunction. Evaluation of a screening program for diagnosis with special reference to urodynamic and hormonal factors]. PMID- 6845467 TI - [Cervical interbody spondylodesis. A retrospective study of patients operated on by the Cloward method]. PMID- 6845468 TI - [Blood for clinical chemical analysis with drawn through a central venous catheter]. PMID- 6845469 TI - [Weight reduction with protein powder in general practice]. PMID- 6845470 TI - [Iatrogenic tarsorrhaphy with cyanoacrylate]. PMID- 6845471 TI - [Corneal erosions aggravated by local anesthetic eye-drops]. PMID- 6845472 TI - [Intramuscular injections]. PMID- 6845474 TI - [Bus accidents. II. A detailed study of the mechanisms of injury]. PMID- 6845475 TI - [Injured bus passengers. Occurrence, injuries and causes]. PMID- 6845473 TI - [Bus accidents. I. An epidemiological survey]. PMID- 6845476 TI - [Bus passenger accidents in Fredriksberg]. PMID- 6845477 TI - [Fatal accidents in bus and motor car traffic]. PMID- 6845478 TI - [Ulcerative colitis and Crohn's disease. Prognostic aspects]. PMID- 6845481 TI - [The Pistomat needle biopsy for preoperative breast diagnosis]. PMID- 6845482 TI - [Risk of developing breast cancer in relation to findings at mammography]. PMID- 6845480 TI - [4 simultaneous cases of methanol poisoning caused by home-made plum brandy]. PMID- 6845479 TI - [Choice of drug treatment of alcohol withdrawal symptoms in Denmark]. PMID- 6845483 TI - [Diabur-test 5000. A test strip for semiquantitative determination of urinary glucose from 0 to 5%]. PMID- 6845484 TI - [Cerebral malaria and blackwater fever in Greenland]. PMID- 6845485 TI - [Bilharziasis--a possible diagnosis in Danes]. PMID- 6845486 TI - [Serious side effects of sulfadoxine/pyrimethamine as antimalarials]. PMID- 6845487 TI - [Reactive arthritis associated with Campylobacter jejuni enteritis]. PMID- 6845488 TI - [Subacute chronic meningococcal sepsis]. PMID- 6845489 TI - [Consequences of notification of occupational pulmonary diseases. I. Preventive measures and notification to the Social Security Office, Industrial Injury Insurance]. PMID- 6845490 TI - [Consequences of notification of occupational pulmonary disease. II. Analysis of the cases in the National Social Security Office, Industrial Injury Insurance and the significance of notification for the individual involved]. PMID- 6845491 TI - [Acetylsalicylic acid and renal damage. Evaluation of the role of acetylsalicylic acid in the development of analgesic nephropathy]. PMID- 6845492 TI - [Acetylsalicylic acid and renal function]. PMID- 6845493 TI - [Stillbirth. A retrospective study of 127 cases]. PMID- 6845495 TI - [The compartment syndrome in fractures of the leg]. PMID- 6845496 TI - [Raynaud's phenomenon in the tongue of a patient with sclerodermia]. PMID- 6845494 TI - [The incarcerated hernia]. PMID- 6845498 TI - [The 1983 birth rate. Evaluation of the prognostication of the 1982 birth rate and a 1983 prognostication based upon the number of registered pregnancies in the county of Fredriksborg]. PMID- 6845497 TI - [1943-79 mortality among members of the Danish resistance movement deported to German concentration camps]. PMID- 6845499 TI - [The birth defect registry of the Danish Medical Board]. PMID- 6845500 TI - [Laser surgery in laryngeal diseases]. PMID- 6845501 TI - [Inter-observer agreement in assessing the general condition of patients]. PMID- 6845502 TI - [How physicians assess the general condition of their patients]. PMID- 6845503 TI - [Amaurosis fugax and carotid artery stenosis. A diagnostic imperative?]. PMID- 6845504 TI - [Anemia in the elderly]. PMID- 6845505 TI - [Variability in reaction time in patients with dementia. A pilot study]. PMID- 6845506 TI - [Acute pancreatitis treated with gastric suction or liquid food]. PMID- 6845509 TI - [Wife abuse. A prospective study of violence against women by their consorts]. PMID- 6845508 TI - [What do we know about the occupational solvent syndrome?]. PMID- 6845507 TI - [Not hysteria but mastalgia. Disproving a myth]. PMID- 6845510 TI - [Activity of alcoholic clinics during 1977-81]. PMID- 6845511 TI - [Mutagenic substances in the urine of nurses in an oncological department]. PMID- 6845512 TI - [Fine needle biopsy in the diagnosis of abdominal masses]. PMID- 6845514 TI - [Left-sided necrosis of the colon after reconstruction of the abdominal aorta]. PMID- 6845515 TI - [Choledochal cysts]. PMID- 6845516 TI - [Plasma yield in using the SAG/SAG-M double-bag system]. PMID- 6845518 TI - [Hyperkalemia during bilateral embolectomy in the common iliac arteries]. PMID- 6845517 TI - [Penetrating facial lesion and a foreign body in the retromaxillar space]. PMID- 6845513 TI - [Attempted suicide and hand injuries. Sequelae of wrist slashing]. PMID- 6845519 TI - [Manic-like psychoses and progressive dementia. A possible case of familial leukodystrophy]. PMID- 6845520 TI - [Spontaneous sternoclavicular luxation]. PMID- 6845521 TI - [What do we know about occupational diseases of the central nervous system?]. PMID- 6845522 TI - [Treatment of young patients with borderline psychoses in a therapeutic community]. PMID- 6845524 TI - [Medical education in the 1983 spring semester. Course catalog]. PMID- 6845523 TI - [Cerebral palsy in Eastern Denmark 1965-1974. III. The significance of perinatal factors in congenital spastic cases. Cerebral Palsy Registry of Denmark, no. 9]. PMID- 6845525 TI - [Fixateur externe and minimal osteosynthesis: effect of various mounting technics on the stability of total osteosynthesis]. PMID- 6845526 TI - [Angled 1/3-tubular plate for osteosynthesis of dislocated humeral fractures through the collum anatomicum]. AB - Stable osteosynthesis of dislocated fractures of the head of the humerus by lag screws cannot be granted because the avascular head fragment is small. Alternatively the fixation can be performed by means of an angled 1/3-tubular plate with 8 holes. The plate is inserted similar to the condylar plate after preparing a seat with 3 drills of 2 mm o. The angle-point depends on the diameter of the head fragment. The angle should be approximately 110 degrees. The free part is fixed to the shaft under tension. A successful case of total dislocation for more than one day is demonstrated where no head necrosis occurred. PMID- 6845528 TI - [Therapy of old carpal dislocations and dislocation-fractures and its results]. AB - Carpal fractures and dislocations are rare. Pitfalls in the diagnosis of these injuries are quite common failures. A follow up study in 10 patients with carpal injuries was done. Good results were found in five patients. These had been treated within 2-3 weeks. Another 5 patients had not been operated earlier than 2 17 months after the injury. In these cases the results were poor, because either the lunate must be removed or replaced by a prosthesis or was destroyed by avascular necrosis. The possibilities of early diagnosis and the methods of therapy are discussed. PMID- 6845527 TI - [Analysis of 286 humerus shaft fractures]. PMID- 6845529 TI - [Ender nailing of proximal femoral fractures and its results]. AB - It is reported of 77 patients with fractures of the proximal femur who have been treated with internal fixation using Ender-nails. The average age was 76 years. The mortality rate was 16.9%, the infection rate 2.6%. In 79.2% there were no complications at all. The average hospitalisation period was 35 days. After an average period of 2 1/2 years a follow-up study was possible (24 patients). In 62.5% there was no pain, in 25% patients had light pain in the knee and in 8.3% they felt light pain in the hip. An important disturbance of movements in hip or knee was never to be seen. Only one patient was not able to walk. 58.3% walked without help, 37.5% with the help of a walking stick. In 54.2% there was a rotation failure of the femur, in 25% more than 20 degrees. PMID- 6845531 TI - [Efficiency of a rucksack bandage in the treatment of clavicle fractures]. PMID- 6845530 TI - [Treatment of talus fractures. Control study of 262 treated cases]. AB - It is useful to subdivide talus fractures in central and peripheric ones, as serious complications have to be expected only in the first group. Under 207 central talus fractures the feared talus necrosis has been found after operative treatment as well of collum as of corpus-trochlea fractures in about 21% of the cases, after conservative treatment in 11 respectively 19%, while posttraumatic arthrosis appears in over 50% (talus fractures with side injuries). The isolated central talus fracture has a better prognosis. The earlier the exact anatomical reposition is realized, the better are the results. Open talus fractures are threatened by infection. The so called central talus fractures--open or closed- are surgical emergency cases and so they have to be treated. PMID- 6845532 TI - [Experiences in the treatment of fresh knee ligament injuries]. PMID- 6845533 TI - [Traumatic prolapse of the intervertebral disk--case report]. PMID- 6845534 TI - [Surgical treatment of fresh acromioclavicular luxation with the Bosworth screw]. PMID- 6845536 TI - [Experiences with the treatment of trochanteric femoral fractures with Ender's elastic round nails]. PMID- 6845535 TI - [Results of surgically treated complex ligament injuries of the knee joint]. PMID- 6845538 TI - [Why use Goetze's subcutaneous wire cerclage following tibial fractures? Evaluation of 222 uncomplicated cerclages (almost exclusively) following skiing accidents at a tourist center]. PMID- 6845537 TI - [Comparative morphological, clinical and bacteriological studies in chronic posttraumatic osteomyelitis]. PMID- 6845539 TI - [Experimental studies on adaptive osteosynthesis in the area of the epiphyseal plate]. PMID- 6845540 TI - [Pneumatic reposition splint in cranial extension. An optimal treatment principle for reduction and stabilization in the early treatment of fracture-dislocations of the cervical spine]. PMID- 6845542 TI - [Determination of the vertical position of the patella]. PMID- 6845541 TI - [Necrotic cholecystitis in polytrauma. The gallbladder as a shock organ?]. PMID- 6845543 TI - [Pseudo-arthrosis of the neck of the femur in adults. Pathogenesis, therapy and results]. PMID- 6845544 TI - [Arthrodesis of the knee joint]. PMID- 6845545 TI - [What is meant by stability of osteosynthesis]. PMID- 6845546 TI - [Results of a collective AO follow-up of forearm shaft fractures]. PMID- 6845547 TI - [Olecranon fractures. A retrospective, multicenter therapy study of 175 cases]. PMID- 6845548 TI - [Specific treatment of recurrent dislocation of the shoulder]. PMID- 6845549 TI - [Infected total knee prosthesis. Therapy and results]. PMID- 6845550 TI - [Hypertension in pregnancy: monitoring and management]. PMID- 6845551 TI - [Oral contraceptives: update]. PMID- 6845552 TI - [Lasers: their use in gynecology]. PMID- 6845553 TI - [Fetal growth abnormalities]. PMID- 6845554 TI - [Neural control of respiration. II- Methods of clinical evaluation]. PMID- 6845555 TI - [Pondostatural growth of French Canadian children from birth to 36 months of age]. PMID- 6845556 TI - [Treatment of phobia of medical equipment in a mentally retarded patient with Hodgkin's disease]. PMID- 6845557 TI - [New health problems in children: role of community health centers and departments]. PMID- 6845558 TI - [Diagnosis and treatment of dysplasia and in situ cancer of the cervix neck]. PMID- 6845559 TI - [Education and research problems in clinical neuropsychology in Quebec]. PMID- 6845560 TI - [Functional dysphonia]. PMID- 6845561 TI - [The family physician and infertility problems]. PMID- 6845563 TI - Studies of the persorption of large particles from radio-labelled cation exchangers. AB - Experiments were carried out in pigs to ascertain to what extent the cation exchangers Ujolyt and Campanyl used in the prevention of urinary stones undergo persorption and appear in the urine. We used two preparations of different grain size and detected them by labelling with 35S. A maximum of 0.5% or 5 X 10(-3) of the dose was found as persorbed particles at 51 h, chiefly in the muscles. The number of persorbed particles from the fine-grained preparation was considerably greater than that from the coarse-grained product. The urine contained the smallest proportion of particles, less than 2 X 10(-5) of the dose. In view of these results there is no reason to believe that solid particles persorbed during treatment with ion exchange resins can act as crystallization centres for stone formation, and it is equally unlikely that ion exchangers have to reach the urine before they can exert their effect. PMID- 6845562 TI - High-resolution sonography in experimentally induced scrotal pathology. AB - Benign and malignant extra- and intratesticular lesions were experimentally induced in the testes of Wistar rats so as to evaluate the significance of high resolution ultrasonography for the early detection of intratesticular malignancy. The animals were studied using high-resolution sonography (mean frequency = 8 MHz) over 6 weeks. Walker carcinomas could be induced in the testicle in 50% of the cases; 8 of 17 showed a locally limited growth. Tumors over 2 mm in diameter showed a typical change in the normal sonographic pattern of the testes. The overall sensitivity of high-resolution sonography for intratesticular lesions was 88%, the specificity 91%. The detection of small intratesticular lesions has made high-resolution sonography superior to conventional sonographic techniques and may therefore prove to be of major clinical significance. PMID- 6845564 TI - Separate examinations on core and shell of urinary calculi. AB - Separate core and shell examinations were made on 10,000 urinary stones using a combined crystal-optical X-ray diffractometric method of analysis. 29.5% of these concrements showed differences in qualitative phases between central and peripheral stone parts. All the more frequent stone components were found in core and shell to the same extent. Only weddellite and uric acid dihydrate show a clear preference of the shell. Our method of analysis showed cores to be mostly monomineralic and peripheral stone parts mostly bimineralic. Consequences of this topographic stone analysis for metaphylaxis of urolithiasis are pointed out. PMID- 6845565 TI - Muco-cutaneous ureterostomy: an experimental study for prevention of stomal stenosis using autograft of vaginal vestibular mucosa. AB - To prevent dermal invasion which causes gradual stomal stenosis in cutaneous ureterostomy, transplantation of autologous vaginal vestibular mucosa around the ureteral opening was examined in 9 female dogs. Results of a full-thickness graft to a full-thickness skin bed were hopeful. Though surface keratinization occurred, the thick graft survived well on the abdomen without obvious shrinkage, and the ureteral patency was maintained through the follow-up period with an average of 18 months. This method seemed to be applicable to clinical patients and to dog experiments as a model for separate renal function study. PMID- 6845566 TI - [Specific immunotherapy of prostate carcinoma]. AB - For the first time since the introduction of female sex hormone treatment of carcinoma of the prostate, an entirely new therapeutic approach was tried, i.e., specific immune therapy in the form of chessboard vaccination. With this method, and continuation of hormone therapy, inactivated cancerous cells were injected with neuraminidase intracutaneously into the thigh. Should hormone therapy prove ineffective, a long-term therapeutic effect can be achieved in approximately half of the patients by giving three vaccinations containing 44,400,000 cells. The effectiveness of specific immunotherapy in the form of chessboard vaccinations could be established on the basis of a significant drop in serum phosphatases and carcinoembryonic antigen under therapy, the scintigraphic evidence of remission of osteometastases and not least of all a statistically significant increase in the survival rate during treatment of unconfined metastasizing prostate carcinomas. Even in early stages specific immunotherapy constitutes a new alternative therapeutic method, particularly in the treatment of hormone independent prostate carcinomas and in cases of estrogen intolerance. PMID- 6845567 TI - Long-term observation of young cystinuric patients under ascorbic acid therapy. AB - Long-term results of ascorbic acid monotherapy in four young patients with cystine stone complaints are reported. The therapeutic program is based on the descriptions by Asper and Schmucki, who publicized the method for the first time in 1979. Clinical course observations, renal function checks as well as the excretion of cystine, uric acid and oxalic acid during ascorbic acid therapy of our patient pool will be discussed. Clinical observations made to date indicate that ascorbic acid therapy is a practical, inexpensive prophylaxis for cystine stone patients that is virtually free of side effects. PMID- 6845568 TI - Absence of a complete carcinogenic effect of phenacetin on the quiescent and proliferating urothelium stimulated by partial cystectomy. A 2-year feeding study in rats. AB - It was the object of the present animal experiments to test whether phenacetin (PH) exerts a complete solitary carcinogenic effect on the quiescent and rapidly proliferating urothelium of the lower urinary tract of the rat. In order to stimulate proliferative activity resection of one-third of the urinary bladder was performed which is known to induce intensive reparative regeneration in the stump. PH was administered either continuously with the diet or by gavage in three single doses when proliferative activity was highest. After an experimental period of 2 years 74-83% of the animals receiving PH continuously and 49-52% of the rats after limited gavage feeding had developed uni- and bilateral hyperplasia of the epithelium of the renal papilla. Histologically, the papillary hyperplasia exhibited urothelial differentiation and a typical endophytic growth pattern. It was always associated with healed or, rarely, fresh micronecroses of the subjacent papillary tissue. The urothelial hyperplasia of the renal papilla has to be considered not a true preneoplastic, but rather a reactive proliferative lesion in the sense of a reparative hyperregeneration due to toxic necroses. There was no evidence for a complete solitary carcinogenic action of PH on the urothelium of the entire lower urinary tract. It seems most likely that a metabolite of PH realizes tumor growth only as cocarcinogen with initiation stimulating and/or initiation-promoting effects acting together with other causative factors during multifactorial multistage carcinogenesis. Based upon the experimental findings reported here, the concept of PH as a solitary complete urothelial carcinogen for man should be reassessed. PMID- 6845569 TI - [Torsion of the spleen simulating abdominal tumor in a child]. PMID- 6845570 TI - [Functional state of the liver in obese patients subjected to surgery under halothane and ether anesthesia]. AB - On the basis of an analysis of changes in biochemical indices of the hepatic function in 41 patients operated upon for obesity of the 3d or 4th stage the authors make a conclusion that ether narcosis exerts a less injuring effect on the liver as compared with fluothane and is believed to be preferable. PMID- 6845571 TI - [Characteristic features of systemic hemodynamics during cesarean section under general anesthesia with ketamine]. AB - On the basis of a comparative investigation of the central hemodynamics by the method of integrative rheography of the body in two groups of women during the operation of cesarean section under general anesthesia with ether or ketamin the author makes a conclusion that ketamin is a good drug for anesthesia in urgent surgical situations. PMID- 6845572 TI - [Treatment of massive embolism of the pulmonary artery by a regional infusion of small doses of streptase with heparin]. AB - Good results were obtained in the treatment of 10 patients with massive embolism of the pulmonary artery by regional infusions of small doses of streptase and heparin. The efficiency of the method was dependent on duration of the disease and character of the embolic occlusion of branches of the pulmonary artery, a prolonged activation of the patient's fibrinolysis contributing to lysis of emboli and to recovery of pulmonary blood flow in late follow-up terms. PMID- 6845573 TI - [Effect of directed acute preoperative hemodilution on the indices of systemic hemodynamics in surgical patients]. AB - Indices of the central hemodynamics were studied in 39 patients operated on the organs of the abdominal cavity. It was shown that acute direct hemodilution improved the functional state of the cardio-vascular system of the patient. The authors recommend to maintain the state of hemodilution in the nearest postoperative period. PMID- 6845576 TI - [Transesophageal drainage of the mediastinum in perforating mediastinitis]. AB - The authors describe the method of the aspiration-lavage treatment of perforations of the thoracic portion of the esophagus with a false passage into the mediastinum by a two-lumen tube introduced through the perforation opening with the help of an esophagoslone in combination with transcatheteral feeding. The recovery was reached in all the four patients without a surgical intervention. PMID- 6845574 TI - [Intensive therapy during splenectomy in patients with subleukemic myelosis]. AB - On the basis of analysis of splenectomies in 25 patients in the terminal stage of subleukemic myelosis--myelofibrosis with the aim of prevention and treatment of complications and better endurability of splenectomy the authors have elaborated a complex of measures for intensive therapy such as conducting the operation under protection of donor thrombocytes, limited transfusion of the whole blood, early administration of antibiotics, heparin therapy and disaggregation therapy in postoperative therapy. PMID- 6845575 TI - [Surgery of lung cancer (data from the Moscow Hertzen Research Oncological Institute)]. AB - The authors analyze results of the surgical treatment of pulmonary cancer for 35 years (1947-1981). Operations were fulfilled in 2269 patients, in 1869 of them the operations were radical. The resectability increased from 59,2% (1947-1959) to 92,4% (1973-1981). The postoperative lethality decreased from 15,1% to 7,0%, at the period of 1980-1981 it was 3,7%. The specific weight of preserving operations, lobectomies, resection and plasty of bronchi included, increased from 3,9% to 59,7%. The ways for further improvement of results of the surgical treatment of pulmonary cancer are shown. PMID- 6845580 TI - [Pathogenetic basis of the surgical treatment of pancreatic cysts]. AB - A model of the pancreatic cyst was elaborated in experiments in dogs. The conditions for its appearance were maximally approximated to real conditions of the formation of a cyst in the patient. On its grounds a pathogenetically based method of the surgical treatment of pancreatic cysts in clinic is proposed. PMID- 6845577 TI - [Vagotomy in combined treatment of patients with stomach ulcer complicated by hemorrhage]. AB - The nearest and remote results of using vagotomy in 80 patients with gastric ulcerous hemorrhages are analyzed. The authors recommend this operation in combination with pyloroplasty, suturing or dissection of the ulcer of the stomach. PMID- 6845578 TI - [Endoscopic papillosphincterotomy]. AB - The authors analyze the experience with the employment of the endoscopic papillosphincterotomy in 102 patients with choledocholithiasis and stenosis of the major duodenal papilla, discuss the indications and contraindications to this operation. A comparative assessment of different methods of dissection of the major papilla was made; the effectiveness of the operation, complications and methods for their prevention are analyzed. PMID- 6845579 TI - [Clinico-anatomical basis for the blockade of the round ligament of liver in combined treatment of acute pancreatitis]. AB - Clinico-anatomical studies enabled the authors to substantiate the optimum variant of the novocaine-medicamental blockade of the round ligament of the liver. Its employment in the complex treatment of 45 patients with acute pancreatitis improved the results of conservative therapy. PMID- 6845582 TI - [Liquid crystal thermography in the diagnosis of acute appendicitis, cholecystitis and pancreatitis]. AB - The authors have shown the diagnostic value of the coloured liquid crystal thermography on the basis of a comparative investigation of the data of clinical and thermographic studies, operation findings and histological studies in 223 patients with acute appendicitis, cholecystitis, pancreatitis and other diseases of organs of the abdominal cavity. The method is recommended for wide use in clinical practice. PMID- 6845581 TI - [Novocaine blockade of the root of the small intestine mesentery during the postoperative period]. AB - The authors describe the method of their original continuous novocaine blockade of radix mesenterii of the small intestine through the introduced catheter. Their method improves the course of the postoperative period in patients operated on the abdominal organs. PMID- 6845583 TI - [Role of the architectonic variants of the left colon vessels in the determination of the volume of radical surgery in sigmoid cancer]. AB - The investigation of architectonics of the vessels of the left half of the colon was performed in 52 corpses. The authors think that in carcinoma of the upper third of the sigmoid colon it is necessary to fulfil the left-side hemicolectomy, in injured median and lower thirds a resection of the sigmoid colon may be considered to be radical. Remote results of the operative treatment of 91 patients with carcinoma of the sigmoid colon confirm the authors' recommendations. PMID- 6845584 TI - [Prognosis of the severity of odontogenic osteomyelitis on the basis of plasma concentrations of potassium and sodium ions]. AB - The investigation of the potassium and sodium ion concentration in plasma of 50 patients with acute odontogenous osteomyelitis complicated by phlegmons of the maxillofacial localization has shown the possibility of prognozing the severity of the development of the disease. PMID- 6845585 TI - [Surgical treatment of inflammation of the epithelial coccygeal fistula]. AB - On the basis of results of the treatment of 148 patients the author considers the opening of the abscess on admission of the patient to the hospital to be the method of choice followed (after the subsidence of the inflammation) by a dissection of the epithelial coccygeal passage and the abscess capsule with a continued suture of the wound. PMID- 6845586 TI - [Surgical treatment of chronic gunshot osteomyelitis]. AB - The article summarizes the many-year experimental and clinical investigations concerned with the surgical treatment of chronic gun-shot osteomyelitis. The authors came to a conclusion that a decisive role in obtaining positive outcomes of the operations was played by a careful removal of necrotized and infected tissues from the area of the pathological focus, an effective struggle against the infection in the wound and tight suturing of the wound. The material for filling the remaining bone cavity was of no principal importance. PMID- 6845588 TI - [Treatment of nonpenetrating spleen injuries]. AB - On the basis of the experience with the treatment of 100 patients with the ruptured spleen (in 44 of them the injury was associated with injuries of other organs of the abdominal cavity, skeleton bones or cranio-cerebral traumas) the authors recommend to use organ-preserving operations more often (in 42-46% of the patients). A technique of one of the operations--a compression ("hammering") of the spleen by a peritoneum grafts--is described. PMID- 6845587 TI - [Efficacy of reconstructive resection of the stomach in penetrating peptic ulcer of the anastomosis]. PMID- 6845590 TI - [Diagnosis and surgical treatment of injuries of the major vessels of the extremities]. AB - The authors analyze results of the treatment of 126 patients with injured major blood vessels. In diagnosis the main significance is attached to contrast angiography. The method of short-time shunting is recommended for preventing ischemia. PMID- 6845589 TI - [Treatment of bladder injuries in multiple trauma]. AB - The authors analyze their experience with the treatment of 64 patients with injured urinary bladders in associated traumas. In diagnosis of this pathology great significance is attached to contrast vesicography. Suturing the urinary bladder should be finished by epicystostomy. PMID- 6845591 TI - [Surgical treatment of habitual shoulder dislocation]. AB - The article describes a method of the operative treatment of a habitual shoulder slip which is less traumatic than those used before. Operations were performed in 52 patients. No recurrences were noticed during ten years of observations. PMID- 6845593 TI - [Nonpenetrating liver injuries in combination with cranio-cerebral injuries in children]. AB - On the basis of an analysis of 68 cases the author examines specific features of the clinical course, diagnosis and treatment of a ruptured liver associated with a cranio-cerebral trauma in children. For better diagnosis in difficult cases the author proposes early microlaparotomy with a "feeling" catheter. PMID- 6845592 TI - [Keeled chest]. AB - The authors analyze their observation of 66 patients with pigeon-breast deformity, 42 of them were operated upon. They propose a classification of the pigeon breast deformity on the basis of anatomo-physiological and clinical principles. Techniques for the operative correction of each type are proposed. Good cosmetic and functional results were obtained. PMID- 6845594 TI - [Dysproteinemia and trace element dysbalance in urolithiasis in children]. AB - The investigation of blood microelements by a highly sensitive neutron-activation method has shown an increased level of copper, zinc in the plasma, decreased content of iron, zinc in the plasma, decreased content of iron, manganese in erythrocytes, copper and manganese in the plasma of 75 children with calculous pyelonephritis as compared with healthy children. Besides, dysproteinemia was revealed depending on the activity and duration of the inflammatory process. PMID- 6845595 TI - Assessment of prevalence of clinical babesiosis in cattle in Northern Ireland. AB - Information on the number of clinical cases of bovine babesiosis in Northern Ireland was gathered from three sources: (a) a representative sample of farms; (b) all veterinary practices normally attending cattle; (c) the drug companies which produce babesicide. From (a) an estimate of 4520 clinical cases per year was derived, from (b) 3923 and from (c) 5600. A resultant estimate of at least 4000 cases per year was assumed to be reasonable. The mortality rate overall was 17.4 per cent but ranged from 8.8 per cent to 100 per cent on one farm. A final estimate of 12.5 per cent mortality was assumed resulting in an annual number of 500 deaths. Costs for mortality were estimated for each type of animal involved and figure of pounds 203,500 per year attributed. When the costs of treatment, assessed at pounds 31,000 per annum, unquantified production losses and increased labour costs were added an annual figure of pounds 250,000 per annum was estimated. This cost mainly falls to farmers in the three counties of Armagh, Fermanagh and Tyrone where 84 per cent of clinical cases take place. As a result the farmers in that area have to bear a loss of pounds 212,500 per year because of babesiosis. PMID- 6845596 TI - Urinalysis in canine dirofilariasis with emphasis on proteinuria. PMID- 6845597 TI - Isolation of Clostridium difficile from pigs. PMID- 6845598 TI - Veterinary usage of chloramphenicol. PMID- 6845600 TI - Tattooing of dogs. PMID- 6845599 TI - Drenching milking cows. PMID- 6845601 TI - Change in N battus epidemiology. PMID- 6845604 TI - Vitamin E/selenium deficiency syndrome in pigs. PMID- 6845602 TI - Investigations of a flock heavily infected with maedi-visna virus. AB - Following the discovery that a flock of sheep in England was infected with the virus of maedi-virus, several seropositive sheep were brought to the Central Veterinary Laboratory and kept isolated and under observation for up to three years before being further examined at necropsy. Meanwhile, sheep in the infected flock which died or were culled were examined after death for evidence of the actual disease. At necropsy pulmonary disease was a common (although not always the sole) finding, the lesions being mostly chronic pasteurellosis and pulmonary adenomatosis. One of the 45 carcases examined showed classical lesions of advanced maedi. In four others, early or incipient lesions of maedi were found in otherwise normal lungs, while in three more, maedi was coincidental with the other pulmonary diseases. No clinical evidence to suggest maedi, other than emaciation, was seen in any of the sheep with lesions of the disease. PMID- 6845603 TI - Treatment of nitrate intoxication in a cow. AB - Nitrate poisoning was induced in a cow by giving it 200 g potassium nitrate through a rumen fistula for three to four days in succession. The effect of treatment with methylene blue, ascorbic acid and menadione, administered intravenously in different dosages was assessed by measuring methaemoglobin as a percentage of total haemoglobin and comparing the results with those from the untreated cow. The results obtained indicate that ascorbic acid and menadione are unsuitable for treatment of methaemoglobinaemia in nitrate poisoned cattle, but treatment with methylene blue at 1 mg/kg body weight appears to be adequate. PMID- 6845606 TI - Laboratory transfer of a virus between isolates of Chlamydia psittaci. PMID- 6845605 TI - Ketamine xylazine combination for the immobilisation of Galapagos sea lions and fur seals. PMID- 6845607 TI - COSREEL. PMID- 6845609 TI - Eradication of Mycoplasma bovis infection from a dairy herd in Great Britain. AB - Mycoplasma bovis infection was eradicated from a naturally infected dairy herd in Great Britain by a programme of identification, segregation and culling of infected animals. A series of group and whole milking herd tests was carried out over a period of 15 months, followed by a whole herd nasal swabbing. Cows were also sampled after calving and at drying off and bulk tanks were sampled at weekly intervals during the same period and for a further nine months. Fifty-nine cows were identified as excretors, the majority in group or herd tests, but five after calving and three at drying off. Eight of the original clinical cases were retained in the herd, after repeated negative test results. Bulk tank sampling was found to be extremely useful in detecting infection even down to one cow in a milking herd of 300. The value of milking hygiene and the indications for eradication are also discussed. PMID- 6845608 TI - Possible involvement of leptospires in abortion, stillbirths and neonatal deaths in sheep. AB - Using culture, immunofluorescence and fetal serology, leptospiral infection was demonstrated in aborted, stillborn and weak lambs from nine out of 42 flocks investigated during the 1980 and 1981 lambing seasons. Three serogroups of leptospira, namely the Hebdomadis, Australis and Pomona serogroups, were implicated. PMID- 6845610 TI - Epidemic toxoplasmosis in captive squirrel monkeys (Saimiri sciureus). PMID- 6845611 TI - Premature closure of the lateral distal growth plate of the metatarsus in both hind legs of a calf. PMID- 6845612 TI - Feeding bovine colostrum to newborn lambs. PMID- 6845614 TI - Change in N battus epidemiology. PMID- 6845613 TI - Acute fatal haemorrhagic syndrome in dairy cows. PMID- 6845615 TI - Nodular panniculitis. PMID- 6845616 TI - Demand valve in equine anaesthesia. PMID- 6845617 TI - Evaluation of tail paste as an oestrus detection aid using serial progesterone analysis. AB - Serial progesterone assay of 127 commercial dairy cows over several months identified 363 possible oestrous events. Of these, tail paste correctly identified 81.5 per cent, while the stockmen unaided recorded only 70.2 per cent (national average 55 to 60 per cent). The significance of such a degree of improvement, the factors restricting oestrus detection efficiency and the difficulties in creating the appropriate mental attitude to oestrus detection improvements are discussed. PMID- 6845618 TI - Diseases of farmed fish: non-salmonids including eels and crustacea. AB - All cultured fish are subject to very similar parasitic and bacterial conditions. These disease outbreaks are often stress mediated due to adverse environmental factors. The non-salmonid fishes are affected by a number of specific viral diseases which may vary from mild skin infections to systemic conditions resulting in high mortality. Nutritional diseases may be associated with dietary deficiencies or inclusion of toxic products in artificial feeds. PMID- 6845619 TI - Subsequent fertility following cloprostenol induced luteolysis in the bovine. PMID- 6845620 TI - Liver abnormality in broiler carcases. PMID- 6845621 TI - Bovine mastitis self-assessment test. PMID- 6845622 TI - Breed differences in sheep with respect to the accumulation of copper in the liver. AB - Male lambs of the pure breeds Texel, Flemish milk sheep, and Finnish landrace, and of the crossbreds Texel x Friesian milk sheep, Texel x Finnish landrace, Suffolk x Friesian milk sheep, and Finnish landrace x Ile de France were fed hay and concentrates, the latter differing only in the content of copper. At high (+/ 35 ppm) and at moderately low (+/- 10 ppm) copper levels in the concentrate, breed differences in the accumulation of copper in the liver were studied. Hepatic Cu-levels increased significantly in the case of the high Cu-fed animals, but great differences in the metabolism of excessive amounts of dietary Cu exist between the particular breeds and crossbreds. The Texel breed was most susceptible to an excess of dietary Cu and the Finnish landrace was the least susceptible breed, while the Flemish milk sheep and the crossbreds were intermediate. In blood serum, the enzyme activities of sorbitol dehydrogenase, lactate dehydrogenase, gamma-glutamyl transferase, and glutamic oxaloacetic transaminase were increased to a greater or less extent in the high Cu-fed animals, but the correlation with hepatic Cu-content was poor. For the most susceptible breeds, even a level of 10 ppm Cu in a ration with nearly equal amounts of hay and concentrate is insufficiently low for the prevention of Cu accumulation in the liver. PMID- 6845623 TI - Hip dysplasia in dogs. AB - Inspired by the desire to find an objective selection criterion which might be useful notably in borderline cases of hip dysplasia, 1265 sets of radiographs, taken on 1128 pedigree Rottweilers, have been assessed for 12 particulars of the joints; three subevaluations as well as a final score (FS) have been obtained for each individual involved. The data so obtained from a representative subpopulation have been analysed for their contributions to the 12 assessments leading towards the value of the final score. This article shows that FS, most notably in the borderline cases, is due to a subjective assessment, which disqualifies FS as a selection criterion. In pursuit of this line of thought, it was considered desirable to investigate whether FS could be replaced by some measurable (hence objective) particular assessment, such as the Norberg-Olsson Value (N). In conclusion, we find that N on its own, though objective, fails to meet the requirements. PMID- 6845624 TI - The acetylation-deacetylation equilibrium of sulfadimidine in ruminant calves. AB - Plasma disappearance curves of sulfadimidine (SDM) in calves show at high doses a pattern resembling that of capacity-limited elimination. The half-life of the first part of the elimination phase of SDM when administered at high doses ranged between 6.4 and 11.5 h, while that of the terminal end of the plasma concentration-time curves was similar to that obtained at a low level application, ranging between 2.5 and 6.0 h. The percentage of N4 acetylsulfadimidine (N4-SDM) in plasma was low, viz. 2.2 to 5.8% of the total sulfadimidine concentration measured. The acetylation-deacetylation equilibrium was established within 3 h p.i. The N4-SDM plasma concentration-time curves were parallel to those of SDM beyond 3 h p.i. At high doses (66-235 mg/kg) the percentage of N4-SDM was slightly higher than that found at the low dose level. A small proportion of N4-acetylsulfadimidine, injected as the parent compound, was deacetylated to SDM. The intrinsic elimination half-life of N4-SDM was 0.9 h. It may be concluded that ultra-trace concentrations of N4-SDM, left in edible tissues of ruminants at slaughter, have in case of negative sulfonamide-sensitive bioassays no significance for the public health. PMID- 6845625 TI - Diagnosis of canine hip dysplasia and selection against this trait. AB - N, the Norberg-Olsson value, when regarded as the single predictor of FS in the total research subpopulation, leads to an unacceptably high proportion of misclassifications. These misclassifications are found to be much reduced in number on elimination of all animals suffering from bone deformities (BD) as perceivable on the radiographs. Discriminant analysis, applied to the findings in 915 Rottweilers, yields the combination of a suitable high N with the absence of perceivable bone deformities as a more acceptable predictor for FS, specially applicable in borderline cases. PMID- 6845626 TI - An evaluation of a poison center's effectiveness: a telephone survey. PMID- 6845627 TI - History of food toxicology research in the US Agricultural Research Service. PMID- 6845628 TI - An estimation of the toxicity of non-prescription diet aids from seventy exposure cases. PMID- 6845629 TI - Astragalus bisulcatus--a cause of selenium or locoweed poisoning? AB - Certain plants accumulate selenium at levels that render them toxic. One of the principle groups of selenium-accumulating plants is the selenium-accumulating Astragalus. Reports in early literature suggest that selenium is the only toxin in these plants. Sheep fed Astragalus bisulcatus, a selenium-accumulating plant, had signs similar to those observed in locoweed poisoning, and the microscopic lesions from tissues collected from these sheep were similar to those of locoweed poisoning rather than selenium poisoning. This suggests this group of plants contains toxin compounds in addition to selenium. PMID- 6845630 TI - Central nervous system stimulation from isoniazid therapy. PMID- 6845631 TI - Herbicides: liberators or poisoners of humankind? PMID- 6845632 TI - A report of an outbreak of Salmonella oranienburg in a hybrid mouse colony. AB - Mice in a hybrid breeding colony developed symptoms compatible with a diagnosis of salmonellosis. Salmonella oranienburg was recovered from feces by conventional bacteriological techniques. Active salmonellosis appeared to be precipitated by the stress of pregnancy among breeder female BALB/c mice. Necropsy examination of the BALB/c breeder females revealed diarrhea, roughened hair coats, enlarged spleens, white foci in the liver, and skin abscesses. S. oranienburg was recovered from the spleen, cecum, oropharynx, uterus, and skin abscesses of affected mice. DBA/2N breeder males were asymptomatic and S. oranienburg was recovered from the cecum only. Breeding productivity indices dropped to unacceptable levels in rooms containing infected animals. Relatively normal production was observed among uninfected animals of the same strains in adjacent rooms, thus demonstrating the detrimental effect S. oranienburg had on this breeder colony. PMID- 6845634 TI - Cytotoxic effect of Pasteurella haemolytica on ovine bronchoalveolar macrophages in vitro. AB - Live Pasteurella haemolytica A1 was shown to have a cytotoxic effect on suspensions of sheep bronchoalveolar macrophages. Cytotoxic activity was also demonstrable in bacteria-free supernatants from suspensions containing P. haemolytica. Heat-killed and ultra-violet killed organisms of P. haemolytica and live Staphylococcus aureus were not toxic to sheep BAM. These results suggest that a bacterial cell-free cytotoxin is produced by metabolically active P. haemolytica. Guinea-pig peritoneal macrophages, McCoy and pig kidney epithelial cell suspensions were unaffected by live P. haemolytica and supernatant from P. haemolytica cultures, indicating that the cytotoxin may only affect phagocytic cells of ovine or bovine origin. PMID- 6845633 TI - Enterotoxigenicity, hemagglutination and cell-surface hydrophobicity in Aeromonas hydrophila, A. sobria and A. salmonicida. AB - Thirty-one Aeromonas hydrophila, 13 A. sobria and two A. salmonicida strains of diverse sources were tested for enterotoxigenicity, hemagglutination and cell surface hydrophobicity. Although 93% of the culture supernatant fluids of the Aeromonas strains exhibited cytotoxic effects on Y1 adrenal and Chinese hamster ovary (CHO) cells, typical rounding of Y1 adrenal cells was reproducibly observed before cytotoxicity for 80% of the isolates within 1 h of exposure. Twenty-eight strains were positive for delayed permeability factor (DPF) activity in rabbit skin. Culture filtrates of 16 of 20 strains that were positive both in the Y1 adrenal cell test and for DPF activity elicited fluid accumulation in rabbit ileal loops. The DPF and ileal loop activities were neutralizable by cholera antitoxin. All, except two strains each of A. sobria and A. hydrophila, produced a heat-stable, rapid permeability factor (RPF) detected in rabbit skin. Heat treated culture supernatant fluids of two A. hydrophila and one A. sobria isolate gave positive responses in the infant mouse assay. Nine other strains gave borderline reactions. When A. hydrophila and A. sobria isolates were grown in broth, approximately 90% agglutinated bovine, chicken, human group A and guinea pig erythrocytes in the presence of mannose at 4 degrees C and/or 20 degrees C. The two A. salmonicida isolates produced mannose resistant hemagglutination (MRHA) of these four blood types. Hydrophobic interaction chromatography indicated adhesive potential in 61% A. hydrophila and 100% A. sobria strains expressing weak to strong hydrophobic cell surface properties. The results of these investigations strongly imply that the Aeromonas strains produce a cytotonic enterotoxin immunologically related to cholera toxin. Adhesive characteristics were commonly found in both clinical and routine isolates. PMID- 6845635 TI - Immune response of calves following the inoculation of Mycoplasma dispar and Mycoplasma bovis. AB - A small but significant reduction in the number of Mycoplasma dispar colonising the respiratory tract after intratracheal challenge was observed in gnotobiotic calves previously inoculated subcutaneously three times with formalin-killed organisms and oil adjuvant. Injection of M. dispar by the intramuscular route, with oil adjuvant, and 2 weeks later by the intratracheal route, without adjuvant, failed to induce immunity to subsequent intratracheal challenge. Following the subcutaneous injection of killed M. dispar, the amount of antibody detected by single radial haemolysis (SRH) increased markedly with increasing age in groups of calves with average ages of 16 to 155 days when first injected. Most calves aged less than 40 days failed to produce an antibody response to a single injection of M. dispar. With M. bovis a smaller difference was observed between antibody levels generated in calves of different ages; also, calves less than 40 days old produced a detectable SRH antibody response following a single injection of killed M. bovis. IgG1 and IgG2 antibody to M. dispar and M. bovis were measured by ELISA. IgG1 appeared before IgG2 antibody and this was particularly pronounced in younger calves. Also, for both mycoplasmas IgG2 antibody levels were lower in younger than older calves. The IgG1 response to M. dispar was compared in three groups of calves with average ages of 16, 55 and 155 days and was greatest in the oldest and least in the youngest animals. In contrast, the IgG1 response to M. bovis varied little in calves of different ages. It therefore appears that the immune response of young calves to M. dispar is impaired or defective. PMID- 6845636 TI - Effect of infections with swine fever virus on immune functions. II. Lymphocyte response to mitogens and enumeration of lymphocyte subpopulations. AB - Peripheral blood and spleen lymphocytes from pigs infected with a low-virulent strain of swine fever virus (SFV) were transiently hyporesponsive to the mitogenic action of PHA, PWM and Con A. The mitogenic reactivity of lymphocytes from lymph nodes from such pigs appeared to be enhanced rather than depressed at that time. In addition, hyper-responsiveness of peripheral blood lymphocytes (PBL) to these mitogens occurred in some pigs. PBL from pigs lethally infected with virulent SFV showed a persistent depression of the response to these mitogens, whereas lymphocytes from lymph nodes had a high responding capacity. A lymphocyte response to SFV antigens could not be demonstrated in infected pigs. These SFV infections did not markedly affect the percentage of lymphocytes in the blood and most lymphoid organs rosetting with sheep red blood cells. On the other hand, surface immunoglobulin-bearing lymphocytes were markedly increased in lymph nodes from pigs exposed to virulent SFV. The sum of both lymphocyte subpopulations in the lymph nodes from these pigs often considerably exceeded the 100% value, which strongly suggests the presence of cells bearing both surface immunoglobulin and receptors for dextran-treated sheep red blood cells. Possible correlations between these findings are discussed. The results suggest that infections with SFV induce systemic alterations in the process of lymphocyte recirculation in the pig. PMID- 6845637 TI - Effect of infections with swine fever virus on immune functions. III. Antibody response to lipopolysaccharide and sheep red blood cells. AB - In order to determine the effect of infections with low-virulent swine fever virus (SFV) on antibody responses, pigs were administered lipopolysaccharide (LPS) or sheep red blood cells (SRBC), 2 days after infection. Infected pigs showed an enhanced primary response to LPS late during infection. The secondary response to LPS seemed to be unaffected. Both the primary and secondary antibody response to SRBC appeared to be enhanced rather than depressed in infected pigs. These in vivo findings suggest that pigs infected with low-virulent SFV do not develop a depression of B lymphocyte function. PMID- 6845638 TI - [Clinicoroentgenologic diagnosis of chronic pneumonia in pneumoconioses and dust bronchitis]. PMID- 6845639 TI - [Roentgen pneumopolygraphy of pulmonary respiration in chronic pneumonia]. PMID- 6845640 TI - [Roentgen diagnosis of pulmonary edema in chronic kidney insufficiency]. PMID- 6845641 TI - [Mechanism of left ventricular contraction in arterial hypertension]. PMID- 6845642 TI - [Roentgen diagnosis of the atrioventricular canal with pulmonary artery stenosis]. PMID- 6845643 TI - [Potentialities of computed roentgen diagnosis of spherical formations in the lungs]. PMID- 6845644 TI - [Similarity and differences between lymphogenous metastases of malignant tumors based on lymphographic data]. PMID- 6845645 TI - [Contrast study of penile cavernous bodies (cavernosography) in Peyronie's disease]. PMID- 6845646 TI - [Otitis media in chronic acquired toxoplasmosis]. PMID- 6845647 TI - [Comparison of various radiation collectors for use in mammography]. PMID- 6845648 TI - [Experience in the use of compensating wedge-shaped screens]. PMID- 6845649 TI - [Problem of the so-called "early" and "timely" roentgen diagnosis of peripheral lung cancer]. PMID- 6845650 TI - [Goodpasture's syndrome]. PMID- 6845651 TI - [Case of Goodpasture's syndrome]. PMID- 6845653 TI - [Aneurysm of the azygos vein]. PMID- 6845652 TI - [Case of intrapulmonary hematoma]. PMID- 6845654 TI - [Roentgenologic guidance of ureterolith extraction]. PMID- 6845655 TI - Immunochemical identification of rubella virus hemagglutinin. AB - Purified rubella virus contains three major structural polypeptides whose apparent molecular weights are 62,000, a 47,000-54,000 complex, and 38,000 when analyzed by polyacrylamide gel electrophoresis. Both the 62,000 and 47,000-54,000 dalton polypeptides are glycosylated, but they vary in their relative [3H]glucosamine and [3H]mannose content. Limited-digest peptide maps confirm that each polypeptide is distinct and that the 47,000-54,000 dalton complex is a series of three glycopolypeptides with extensive similarities. Under nonreducing conditions, both the 62,000 dalton glycopolypeptide and the 47,000-54,000 dalton complex exist as monomers and also as disulfide-linked complexes. A complex of 105,000 daltons is a dimer of the 62,000 dalton glycopolypeptide and a second, at 95,000 daltons, is a mixed disulfide-bonded dimer of the 62,000 dalton glycopolypeptide and 47,000-54,000 dalton complex. The 38,000 dalton polypeptide migrated exclusively as a dimer of 78,000 daltons when unreduced. Two monoclonal antibodies which inhibit the hemagglutinin function of the virus were shown to be directed against the 62,000 dalton glycopolypeptide. This glycoprotein is therefore responsible at least in part for the hemagglutinin function of rubella virus. PMID- 6845656 TI - In vitro characterization of an avian reovirus vaccine strain. AB - In vitro studies were performed to characterize the vaccine strain, designated P100, derived from the arthrogenic reovirus isolate, S1133, by cold adaptation. P100 appeared to be temperature sensitive, shown by a marked drop in titer and efficiency of plaquing after incubation at 41 degrees. Studies indicated that genomic double-stranded RNA and protein synthesis were severely restricted at the elevated temperature. Differences in the growth behavior of P100 and S1133 at 37 degrees were also noted. The vaccine strain seemed to be more cell associated than S1133. Three outer coat proteins of P100 grown at 37 degrees displayed mobilities different from those of S1133 by PAGE. It is possible that alterations in these proteins may have some relationship to the growth characteristics observed for the P100 strain. PMID- 6845657 TI - The 1978 revision of the U.S. Standard Certificates. PMID- 6845659 TI - Obese and overweight adults in the United States. PMID- 6845660 TI - Surgical and nonsurgical procedures in short-stay hospitals. PMID- 6845658 TI - Dietary intake and cardiovascular risk factors, Part I. Blood pressure correlates: United States, 1971-75. PMID- 6845661 TI - [Organization of early evacuation of patients with multiple injuries and the seriously ill]. PMID- 6845662 TI - [Reconstructive surgery of defects and deformities of the lower region of the face with Filatov's flap]. PMID- 6845664 TI - [Efficacy of influenza prophylaxis with inactivated vaccines]. PMID- 6845663 TI - [Echographic evaluation of the state of myocardial contraction and hemodynamics in patients with heart defects]. PMID- 6845665 TI - [Hematologic changes during adaptation to the Arctic region]. PMID- 6845667 TI - [Effect of smoking on non-specific resistance of sailors at sea]. PMID- 6845666 TI - [Evaluation of the functional state of the heart muscle during bicycle ergometry tests in Air Force personnel]. PMID- 6845668 TI - [Characteristic features of hemosorption in patients with infectious complications of severe mechanical trauma]. PMID- 6845669 TI - [Gunshot injuries of organs and tissues outside the wound track]. PMID- 6845670 TI - [Microsurgical treatment of penetrating eye injuries]. PMID- 6845671 TI - [Sanitary control for the manufacturing and sales of baked goods]. PMID- 6845672 TI - [Therapeutico-prophylactic measures in an anti-smoking campaign]. PMID- 6845673 TI - [Use of CO 2 laser in treatment of gunshot wounds of the pancreas (experimental study)]. PMID- 6845674 TI - [Autoradiographic study of the effect of wound dressings on wound healing]. PMID- 6845675 TI - [The course of acute pneumonia in young people in a hot climate]. PMID- 6845676 TI - [Recovery of a patient with viral hepatitis complicated by acute liver insufficiency]. PMID- 6845677 TI - [Efficacy of ambulatory care in viral hepatitis]. PMID- 6845678 TI - Distribution of HBsAg subtypes in the world. AB - HBsAg subtyping was performed in 5,337 sera from chronic carriers who originated from 54 different countries of the 5 continents. Nine subtypes were defined: ayw1, ayw2, ayw3, ayw4, ayr, adw2, adw4, adr q- and adr q+. The repartition of these subtypes, according to the country of origin of the carriers, enhances the previous results and supplies new data: ayw1 is prevalent only in Vietnam (51%); ayw2 in Mediterranean countries (73%); ayw3 in Greece and Yugoslavia (54%) along with ayw2 (41%); ayw4 in West Africa (82%) and Central Africa (42%) along with ayw2; ayr was only found in Vietnam (3.4%); adw2 is prevalent in North and Central Europe (70%), East and South Africa (95%), India (55%), along with ayw3 (35%) in northern South American (74%), and in the Antilles (82%); adw4 is widespread in French Polynesia (45%)--with a 100% frequency in the Marquesas archipelago--as well as in Argentina (42%); adr q--was found only in Ocean: French Polynesia (34%) with a 69% frequency in the Australes, New Caledonia (3 out of 3 HBsAg carriers); adr q+ is the prevalent subtype in South-East Asia if we exclude Vietnam (61%). These results show that a precise geographical distribution of HBsAg subtypes needs more than 'four main subtypes' generally used. Enlarging from 4 subtypes to 9 is a requirement for valuable epidemiologic studies, as well as for the specification of anti-HBs antibodies produced by hybrids or induced by synthetic peptide. The geographical distribution of these 9 HBsAg subtypes and the serological relationship between some determinants suggest a genetic recombination of viral DNA. PMID- 6845679 TI - A comparison of the analytical ultracentrifuge and high-performance liquid chromatography for the determination of molecular weight distributions of plasma protein fraction (human). AB - The use of high-performance liquid chromatography (HPLC) with size exclusion column packings is investigated as an alternate assay method to the analytical ultracentrifuge, when assaying for the high molecular weight components of human plasma protein fraction. Results indicate that HPLC is a more accurate and precise method for assaying high molecular weight components in plasma protein fraction, even when present in small amounts. PMID- 6845680 TI - Segregation of proteins and sodium in human plasma upon freezing. AB - The proteins and sodium in human source blood plasma are segregated and concentrated on freezing, particularly in plasma that is frozen slowly in a large container. The temperature and the concentration gradients at the freezing front induce a convection in the liquid phase and thus play the primary role in the segregation of proteins and sodium in the frozen mass. Unidirectional freezing, where the freezing front moves against gravity, minimizes segregation because the density gradient-induced convection is minimized at the solid-liquid interface. Microscopic observation of the freezing front of the plasma indicates that ice crystals are the primary solid formed. Their shape is generally irregular, and they become highly dendritic as the freezing rate increases. Apparently, the liquid phase at the freezing front is trapped between the ice crystals; it then undergoes a complex secondary freezing process at a lower temperature behind the primary freezing front of the ice crystals. PMID- 6845681 TI - What are the critical factors in the production and quality control of frozen plasma intended for direct transfusion or for fractionation to provide medically needed labile coagulation factors? PMID- 6845682 TI - [Current aspects of coordination of research in the field of internal medicine]. PMID- 6845683 TI - [Evaluation of the activity of the hydroxylating monooxygenase system by the excretion of amidopyrine metabolites]. PMID- 6845684 TI - [Various clinical manifestations of typhoid fever]. PMID- 6845685 TI - [Purulent meningoencephalitis and phlegmonous appendicitis in a patient with pseudomonas infection]. PMID- 6845686 TI - [Various cardiodynamic parameters in influenza complicated by pneumonia]. PMID- 6845687 TI - [Principles of treatment of patients with recurrent erysipelas]. PMID- 6845688 TI - [State of microcirculation in patients with peptic ulcer]. PMID- 6845689 TI - [Regeneration in the duodenal mucosa in peptic ulcer treated by selective proximal vagotomy]. PMID- 6845690 TI - [Microcirculation disorders and their correction in patients with acute pancreatitis]. PMID- 6845691 TI - [Differential diagnosis of biliary dyskinesias by means of oral cholecystography]. PMID- 6845692 TI - [Effect of Essentiale on lipid metabolism in patients with chronic kidney failure]. PMID- 6845693 TI - [Functional state of the reticulo-endothelial liver cells in acute pneumonia]. PMID- 6845694 TI - [Effect of adaptogenes on the immunological reactivity of patients with a history of acute pneumonia]. PMID- 6845695 TI - [Use of various methods for the evaluation of bronchial patency in patients with pulmonary tuberculosis]. PMID- 6845696 TI - [Effect of resort therapy on the functional state of the cardiovascular system in patients with digestive tract diseases and with ischemic heart disease]. PMID- 6845697 TI - [Diagnosis of early stages of ischemic heart disease]. PMID- 6845698 TI - [Nature of the general processes of morphogenesis]. PMID- 6845699 TI - [Functional state of the left ventricle in various cardio-vascular diseases]. PMID- 6845700 TI - [Clinical course and prognosis of recurrent myocardial infarction]. PMID- 6845701 TI - [Anatomo-echocardiographic parallels of heart structures]. PMID- 6845702 TI - [The blood kinin system in patients with chronic cor pulmonale]. PMID- 6845703 TI - [Hemosorption detoxication in the combined treatment of hematological patients]. PMID- 6845704 TI - [Changes in the lipid metabolism indices in patients with Hodgkin's disease during incomplete parenteral nutrition]. PMID- 6845705 TI - [Indices of systemic and coronary hemodynamics in patients with borderline hypertension]. PMID- 6845707 TI - [A device for defibrillation]. PMID- 6845706 TI - [Effect of smoking on the indices of hemodynamics and blood oxygen balance in healthy persons]. PMID- 6845708 TI - [Temporal arteritis]. PMID- 6845709 TI - [Use of thyreokomb in the treatment of patients with hypothyroidism]. PMID- 6845710 TI - [Treatment with etimizol of patients with stomach ulcer and chronic gastritis]. PMID- 6845711 TI - [Central and peripheral visual fields in the hypertension syndrome caused by an occlusion at the level of the posterior cranial fossa]. PMID- 6845712 TI - [Role of histamine in the mechanism of vascular reactions in the workers of an open-hearth shop]. PMID- 6845713 TI - [Isolation of monoclonal antibodies to influenza viruses]. AB - Monoclonal antibodies to influenza A/duck/Ukraine/1/63 (H3N8) have been produced. Comparative studies of the antigenic characteristics of hemagglutinin of different influenza virus strains isolated from humans, birds, and water were carried out. A high strain specificity of the antibodies produced was shown. PMID- 6845714 TI - [Experimental slow influenza infection in mice]. AB - In baby mice born to mothers--virus carriers (surviving for various periods after intranasal administration of influenza virus), infectious persisting influenza virus in titres of 10(0.5) to 10(2.5) EID50/0.1 ml was found in the blood, lungs, livers, kidneys, spleens, and brains. Not infrequently, such animals developed a severe pathological process accompanied by growth retardation and characterized by progressive involvement of the hypothalamus, immunocompetent organs, endocrine system and always terminating by the death of the animals. Possible mechanisms of the described slow form of influenza infection are discussed. PMID- 6845715 TI - [pH-dependent hemolytic and neuraminidase activity of remantadine-sensitive and resistant variants of influenza virus]. AB - A comparative study of pH-dependence of hemolytic and neuraminidase activities of four remantadin-sensitive influenza A virus strains CAPV (classical avian plague virus) (H7N7), USSR/090/77 (H1N1), Ann Arbor (H2N2), and Texas (H3N2) and their remantadin-resistant variants was carried out. The original strains were shown to produce hemolysis in a narrow pH range (5.0 and 5.5) and to have maximal neuraminidase activity at the same pH values. In remantadin-resistant variants the optimal pH values for hemolytic and neuraminidase activities were higher by 0.5-1.0 than for the sensitive variants. PMID- 6845716 TI - [Characteristics of the distribution of influenza A and B in various geographical regions of the USSR]. AB - The results of a comparative analysis of laboratory-confirmed cases of influenza A and B recorded annually in October-May from 1977 to 1981 in four towns located in different geographical regions of the country are reported. During this period, influenza A represented by varieties A (H1N1) and A (H3N2) and B were found to have been recorded in all the towns under study. The periods of the maximum number of the laboratory-confirmed cases recorded coincided generally with the periods of increased clinical incidence of ARD. There were instances, however, when during the periods of elevated ARD morbidity the number of laboratory-confirmed cases of influenza increased insignificantly. Peculiar features were found in fluctuations of the incidence of laboratory-confirmed influenza cases in different geographical regions of the country. PMID- 6845717 TI - [Enzyme activity of the neuraminidase from various strains of the influenza A virus]. AB - Some chemical properties of neuraminidase of the mouse-pathogenic strain A/PR/8/34 (H0N1) and the mouse-apathogenic strain A/Krasnodar/101/59 (H2N2) were studied. Neuraminidase of the pathogenic strain was shown to have a lower specific activity, lower resistance and lower sensitivity to the inhibiting effect of CI ions than neuraminidase of the nonpathogenic strain. PMID- 6845718 TI - [Comparative characteristics of influenza C viruses isolated in the USSR and abroad in various years]. PMID- 6845720 TI - [Persistence of the measles antigen in the central nervous system of monkeys infected with clonal variants of the L-16 vaccinal strain of the measles virus]. AB - The time of persistence of measles antigen was studied in Macaca mulatta and green monkeys inoculated intracerebrally with the vaccine L-16 strain of measles virus and its two genetically homologous variants. Two clones differing in their neurovirulence were used. The results of the study showed correlation between the time of the antigen persistence in the central nervous system and the severity of morphological changes. PMID- 6845719 TI - [Effect of the interferon inducer RFf2 on the course of an infection due to the rabies virus in mice]. AB - The data of the study on the influence of an interferon inducer, phage RFf2 RNA, on the course of infection with fixed rabies virus and on the formation of postvaccination immunity are presented. The inoculation of the inducer in a dose of 1 mg/kg was shown to produce interferon in the blood of white mice within 6 hours up to 320 units/ml which decreased by 24 hours to 20-40 units/ml. No protective effect, however, was observed upon intracerebral inoculation of white mice with fixed rabies virus, CVS strain. An increased dose of the inducer resulted in the development of a marked protective effect (50%) particularly after peripheral inoculation of the virus when the latter was administered simultaneously with the inducer. The use of the inducer in combination with various types of rabies vaccines (tissue culture inactivated, sheep brain inactivated, Fermi type vaccines) exerted no influence on the resistance of the animals to subsequent inoculation with the virus or on the formation of postvaccination immunity. At the same time, inoculation of the inducer alone, two weeks before challenge, protected 30% of the animals as compared with 100% mortality in the control group. Further studies on the influence of interferon on the course of the infectious process in rabies and formation of postvaccination immunity are required. PMID- 6845721 TI - [Detection of antibodies to the causative agents of viral infections in multiple sclerosis patients]. AB - Serological examinations of blood sera from patients with multiple sclerosis (MS), their nearest relatives, and subjects of the control groups for antibodies to causative agents of some viral infections demonstrated antihemagglutinins to measles and rubella viruses in 61%-95.5% of the subjects examined in all the groups, to mumps virus in 53% in MS patients, to tick-borne encephalitis virus in 2.2% in the same group, and in 10.5% in the group of patients with other CNS diseases, and none in healthy subjects. Virus-neutralizing antibodies to human acute encephalomyelitis virus (HAEM) in 28% of the cases, frequently in the stage of remission. Specific IgM to measles virus was found in 41% of MS patients, in 15% of their nearest relatives, and in 19.7% of patients with other CNS diseases, but not in healthy subjects. No differences in the rate of antibody findings to herpes simplex virus types 1 and 2 were observed in the groups examined. The rate of detection of virus-neutralizing antibody to HAEM virus was significantly higher in MS patients with the severity of the course of IV-V degree (20%) than of the II-III degree (8.8%). In the period of MS exacerbation the level of specific IgM to measles virus increased (35.6%), and higher titres of antihemagglutinins were observed in patients with longer duration of the disease and higher degree of its severity. PMID- 6845722 TI - [Biological characteristics of lymphoid cell lines producing lymphotropic primate herpesviruses]. AB - Lymphoid cell lines of monkey and human origin were characterized by proliferative activity, electrophoretic mobility, and percentage of colony forming cells. Papio hamadryas cell lines were divided into two types similar to those of humans. One of them includes cell lines of tumor origin with high proliferative activity, decreased electrophoretic mobility, and a high percentage of colony-forming cells. The other type includes lymphoblastic lines of non-tumor origin with low proliferative activity, increased electrophoretic mobility, and low percentage of colony-forming cells. PMID- 6845723 TI - [Analysis of sudden deaths in the early period of myocardial infarction in patients with arterial hypertension]. PMID- 6845724 TI - [Effect of corticotherapy on acid-base equilibrium of the cerebrospinal fluid and arterial blood in intracranial hypertension]. PMID- 6845725 TI - [Self concept in patients with chronic pulmonary tuberculosis]. PMID- 6845726 TI - [A case of large air cyst in the lung]. PMID- 6845727 TI - [Giant stomach ulcer penetrating into the left hepatic lobe and pancreas]. PMID- 6845728 TI - [Congenital cysts of the biliary tract]. PMID- 6845729 TI - [Adenocarcinoma of the duodenojejunal flexure as a cause of megaduodenum]. PMID- 6845730 TI - [Bilateral obturator hernia]. PMID- 6845731 TI - [Ureteral enuresis]. PMID- 6845732 TI - [Case of Milch's syndrome (apophyseolysis ischiadica)]. PMID- 6845733 TI - [Munchausen syndrome]. PMID- 6845734 TI - [Acquired methemoglobinemia in infants]. PMID- 6845735 TI - [Problems of the stone-free gallbladder, a report on 276 cholecystectomies]. AB - Different kinds of disease of the gallbladder without stones are demonstrated. The indication for cholecystectomy is given by anamnesis, radiological findings and the exact exploration of the adjoining organs. There is made a difference between absolute and relative indications. Among 6,311 cholecystectomies there are 276 gallbladders without stones (4.37%). The results of postoperative controls are reported, more than 76% of the patients are absolutely free, 16% are relatively free of complaints. PMID- 6845736 TI - [A successfully treated gall stone ileus in a patient 91 years old. Pathophysiology and clinical aspects]. AB - The - at least to our knowledge - oldest surviving patient with gall stone ileus is reported, pertinent data concerning clinical symptoms, pathogenesis, pathophysiology and therapy discussed. In establishing the diagnosis, the analysis of previous diseases is helpful, a changing clinical course typical, air in the biliary tract upon plain X-ray a proof. Diagnosis means immediate operation, which alone may interrupt a fatal pathophysiologic chain reaction. PMID- 6845737 TI - [Infantile osteoid osteoma of the tibia. Radiologic and computer-tomographic diagnosis and differential diagnosis]. PMID- 6845738 TI - [Experiences with active vaccination against hepatitis B]. PMID- 6845739 TI - Wisconsin physicians' response to child abuse and neglect (CAN) . . . Part I: is it adequate? PMID- 6845740 TI - Adult epiglottitis in a community hospital. PMID- 6845741 TI - Solitary intracranial blastomycotic abscess. PMID- 6845742 TI - On measuring bilirubin in the neonate. PMID- 6845743 TI - Morphological changes in the sex glands of aged and orchidectomized hamsters. AB - Authors deals with a comparative study of the microscopical changes, principally of the sex glands, found in old intact and in old orchidectomized hamsters. They could see that in the Sertoli cells of the testis, and in the epithelial cells of the seminal vesicle and coagulating gland of the aged intact hamsters, a few lipofuscin granules were present. After orchidectomy the amount of lipofuscin granules increased, showing that their age related changes can be increased by orchidectomy. PMID- 6845744 TI - [Diagnosis of gastrointestinal diseases in the aged]. AB - It is a paper that surveys the multivarious diagnostic problems of gastrointestinal diseases in the aged. The particular characteristic of the acutely or chronically sick of advanced years presents itself, above all else, as a change in the organism itself, in a change of personality, and occasionally in the doctor's attitude towards his aged patients becoming different too. Relevant aspects of diagnosis in practice are of particular interest in this work. PMID- 6845745 TI - [Use of anamnestic questionnaires in gastrointestinal diseases in the aged]. AB - The authors relate their experiences in using questionnaires for taking the history of patients with gastroenterological enterological ailments. They have found that the older the patient, the more the results of the questionnaire diverge from those obtained by conventional methods of history-taking. Consequently the authors advise a cautious approach to the use of questionnaires when dealing with elderly patients. PMID- 6845746 TI - [Histomorphometric contribution to W. Beier's exponent of the aging function]. AB - We determined aging changes of the nucleus-cytoplasm-relation in the epithelium of the epiglottis and intestine of human beings and rats. The results were compared with data about the proliferation of connective tissue and the decrease of muscle cells in the wall of the intestine and in the ciliary muscle. We adapted exponential functions to the measured results. For comparing the several equations and the derivable aging velocities, the nucleus-cytoplasm-relation must be transformed into nucleus volume rate of the total cell volume. Similarities in the decrease of the aging speed in the course of life and in the value of the exponent of the aging function by W. Beier (approximately equal to 0,03) were demonstrated. PMID- 6845747 TI - [Endangering the water-electrolyte balance in gastrointestinal diseases in the aged]. AB - In old people the range of operation, as well as the adaptability of the electrolyte and water metabolism, is reduced by the involutive reduction of the renal, pulmonary and endocrinic functions, as well as by a reduced feeling of thirst, a reduction of the buffer mechanisms, and a dwindling amount of body water. The threat to the maintenance of the requisite amount of body-water and to a normal electrolysis, caused by gastro-intestinal illnesses, is discussed from the point of view of geriatrics. Hydro-mineral upsets occurring in gastroenterology are primarily caused either by an inadequate supply, inadequate absorption, or by an extra-ordinary loss of intestinal secretions, as well as by interference with the normal electrolyte and water metabolism due to medical treatment. Situations in which such hydro-mineral disturbances wright occur are indicated and therapeutic measures suggested. We assert and prove that in old people the danger of extreme reduction of body-water and electrolysis frequently presents a greater threat to life than the illness from which it proceeds, and we maintain that a due consideration of this problem can in many cases literally save the life of the old patient. PMID- 6845750 TI - [Some peculiarities of achievement determining personality characteristics in elderly employees. Results of an empirical study]. PMID- 6845748 TI - [Industrial medicine focal points in the preparation for old age]. AB - Occupational medicine takes a certain key position at preparation for an active and healthy old age. Focal points are in this sight: --the active integration of the elder workers into the system of medical investigations of fitness --the dispensary care for elder workers --the shaping of working conditions and claims -health education and --geropsychohygiene. PMID- 6845749 TI - [The rural physician and the complex care of the elderly citizen]. AB - The specialist for general medicine is a key figure in the comprehensive care for the elderly citizen. On him revolves all the extensive basic medical care, and the coordination of all the more far-reaching measures in both the medical and the social fields. He is best able to fulfill these tasks by spending his entire professional life at the same place and actively participating in the social life of the community concerned. PMID- 6845751 TI - [Practical thoracic surgery. 1. Drainage in the thoracic area]. PMID- 6845752 TI - [Early detection of malignant tumors of the gastrointestinal organs]. PMID- 6845753 TI - [HLA complex and diseases: current aspects of diagnosis, prognosis and etiopathogenesis]. PMID- 6845754 TI - [Area index as relevant reference system for objectivation of therapy results in leg ulcer]. PMID- 6845755 TI - [Monstrous sinus pericranii following craniocerebral trauma]. PMID- 6845756 TI - [Report on a controlled study on the principles of general practice]. PMID- 6845757 TI - [Exotic diseases--past and present]. PMID- 6845758 TI - [The problem of neuro-functional impingement in executives]. PMID- 6845759 TI - [Immunogenetic aspects of neuroimmunologic diseases]. PMID- 6845760 TI - [Risk groups and effective x-ray screening frequency of bronchial cancer]. AB - Mortality from bronchial carcinoma has increased in Czechoslovakia since 1950 to the threefold and has amounted to 47.6/100,000 in 1979. Looking for ways to influence this unfavorable development two epidemiological studies were performed with the aim to find hints to increase the efficiency of mass x-ray screenings. In a study in the district of Kolin 18% of 1,081 new cases of bronchial carcinoma were detected by x-ray-examinations of the whole population performed every 3 years and 10% by yearly repeated x-ray examinations of the groups with pulmonary tuberculous and nontuberculous alterations in dispensaire care. The rates of pulmonary resections and of 5 year survival were higher in those cases detected by periodic miniature x-ray examinations than in patients examined by reason of complaints. In an experimental study, done in a risk collective of heavy smokers compared with a randomized control group from 8 selected districts of Czechoslovakia 75% of bronchial cancer incidence was found by screening repeated every half a year. But the resection rate was not as high as a third of these cases. For a screening programme miniature x-ray examinations are recommendable every 1/2 to 1 year for those groups being in dispensaire care because of a higher risk of bronchial carcinoma. PMID- 6845761 TI - [Prospective studies of etiopathogenic factors of bronchial cancer]. PMID- 6845762 TI - [Experimental proteolytic emphysema--review and personal results]. PMID- 6845763 TI - [Frequency of asbestos fibers and asbestos bodies in lung sections]. AB - 100 specimens of lung resections coming from 100 patients operated on in 1980 in the thoracic surgical department were examined without any selection by turn for the presence of asbestos fibres or ferruginous asbestos bodies. Among these patients asbestos fibres were found in 65% and asbestos bodies in 46% of all cases examined. The observations were related to age, residence (town, village), occupation, and underlying diagnosis found with the surgical procedure. It could be recognized by the analysis that also the population of Slovakia is exposed to ubiquitious asbestos. An etiological relation between the frequency of asbestos fibres and the occurrence of malign tumours could not be proved. Such a relation is very complex, the cancerogenic effect of other factors (benzpyrene, smoking) has to be taken into consideration. PMID- 6845764 TI - [Smoking habits of students in the 9th to 11th grades in a regional district]. AB - Among 769 pupils of the 9th to the 12th classes 77% of them had smoked for the first time between the 6th and 16th year of life, being 54% of the boys and 18% of the girls up to the 11th year and 80% and 58% respectively up to the 14th year of life. At the date of the investigation 43% of the pupils smoked and with the same percentage the parents did so. Among the pupils 20% smoked only sometimes, 20% up to 9 cigarettes every day and 3% 10 and more per day. There are sex differences in smoking habits. Boys have their first smoking experience earlier, they would smoke more regularly and more cigarettes with increasing age than girls. But more girls (34%) do smoke already than the mothers (28%). The smoking habit of the pupils is influenced essentially by the smoking habits of the parents, but also by their social position (qualification of the father). The relations between tobacco damage and cancerogenesis are emphasized. Health education for prevention of smoking should be promoted continuously and intensely, at least during school time and it should be referred to the adults, too. PMID- 6845765 TI - Detection of gaseous pollutions in the environment and at work places by means of aerosol detectors. AB - The protection of the free atmosphere and of people at work places requires the development of highly sensitive devices for the assessment of the air-hygiene situation and for the continuous control after measures have been taken. Favourable properties for the solution of such problems are displayed by aerosol detectors, which are suitable for automatic continuous measurements (aerosol ionization gas analyzer AIG) and for applications in gas chromatography (AID-GC). Starting from the principle of measurement the main parameters and properties of both modes of detection for selected pollutions (SO2, NOx, NH3, Ni(CO)4, halocarbons, amines) are given and discussed with consideration of practical experience. PMID- 6845766 TI - [Cooperation between a polyclinic department for lung diseases and tuberculosis and a brine spa in the care of bronchopulmonary diseases]. PMID- 6845767 TI - [Oscillation technic and oscillation mechanics]. PMID- 6845768 TI - [Tuberculosis prevention. Report of a joint IUaT/WHO study group]. PMID- 6845769 TI - Zinc status of Libyan children -- a pilot study. AB - Hair zinc has been investigated in children of North and South Libya. The hair zinc content amounts to 213 +/- 36 micrograms/g in newborns. There is no difference between the values of newborns from North Libya and newborns from South Libya. The hair zinc values decrease during infancy. In toddlers and school children the hair zinc content is 88 +/- 35 micrograms/g, 89 +/- 25 micrograms/g resp. These values are as low as those reported in American children with low height percentiles or nearly as low as those found in dwarfs with poor zinc status from Egypt and Iran. PMID- 6845771 TI - Development of hypertension in spontaneously hypertensive rats fed L-tyrosine supplemented diets. AB - The blood pressure of spontaneously hypertensive rats (SHR) was measured by tail plethysmography. Feeding SHR a diet supplemented with 0.6 g% L-tyrosine, for 15 weeks after weaning, resulted in a slower increase of blood pressure than in rats fed the control diet (no tyrosine added). The blood pressure stabilized, after about 8 weeks, at values lower by about 10 mm Hg than in the control SHR group. Diets with a higher content of free L-tyrosine (1.2 or 2.4 g%) produced no greater hypotensive effects, despite the fact that the plasma level of the amino acid, at the time of blood pressure measurements, was related to the tyrosine content of the diet. In addition, providing 2.4 g% free L-tyrosine to the diet of SHR with established hypertension, produced within a few days a decrease of blood pressure similar to the one recorded in rats fed the tyrosine-supplemented diet during the whole period of development of hypertension. A maximal effect of L tyrosine, in decreasing the blood pressure of SHR, is thus obtained at relatively low concentrations of the amino acid in the diet, and after a short period of consumption. However, this effect is rather small, and rapidly reversed upon removing free L-tyrosine from the diet. PMID- 6845770 TI - Enzymatic and pharmacokinetic studies on the metabolism of branched chain alpha keto acids in the rat. AB - Michaelis-constants and enzyme activities for dehydrogenation and transamination of the three branched chain alpha-keto acids in liver, kidney, skeletal muscle, and brain of rats are reported. After oral load only 11-22% of the keto acids pass the liver unchanged. Blood levels in pharmacokinetic and absorption studies are related to the Michaelis-constants. At the low keto-acid concentrations after oral application, dehydrogenation in the non-hepatic tissues is supposed to prevail over transamination. Data on feed efficiency of branched chain alpha-keto acids reported in the literature support this view. The chance for transamination is better after intravenous administration. The transferability of our data to humans, and various factors influencing the efficiency of branched chain alpha keto acids are discussed in connection with data reported in the literature. PMID- 6845772 TI - Effects of feeding mustard oil diets on the collagen biosynthesis in various tissues of male rats. AB - 30 rats were divided into 3 groups to study the effects of erucic-acid-rich mustard oil (MO) and MO plus fish oil and carnitine (MOFOC) diet as compared to groundnut oil (GNO) diet on the collagen biosynthesis in various tissues. Changes in collagen content and monoamine oxidase (MAO) of hearts, aorta, skeletal muscles, lungs and skin were determined after 24, 60 and 80 days of feeding, respectively. Incorporation of U-14C-proline into collagen of these tissues was also studied. MO diets increased the incorporation of U-14C-proline into total and acid-insoluble collagen in heart, skeletal muscles and lungs but this increase was of lower magnitude in heart and skeletal muscles as compared with MOFOC diet. Total and acid-insoluble collagen contents in all these tissues, except skin, were increased by MO diet and MOFOC diet retarded this increase. Similar trends were observed in the activities of MAO. The results suggest that the MO diet increases both the biosynthesis and maturation of collagen and MOFOC diet retards this trend. The response of various tissues being variable in this respect. PMID- 6845773 TI - [Growth and hematological criteria of rats by different protein and iron supply]. AB - In a two-factorial experiment with growing rats, protein content of diet (5, 25, 45%) and Fe supply (5, 25, 625 mg/kg diet) were changed. Both factors as well as their interactions influenced growth (p less than 0.001). The growth was reduced especially by deficient protein supply but although by inadequate iron supply and in a smaller degree by an excessive protein content of the diet. Hematological values as hemoglobin content, counts and volume of erythrocytes, hematocrit, MCH and MCHC - measured after 35 days of the experiment - were influenced by both factors and their interactions, too (p less than 0.001). Again deficient protein supply and insufficient Fe supply have the marked effects. Referring life weight as well as hematological parameters, the deficient protein supply was - independent of Fe supplementation - the limited factor, whereas in the cause of higher protein content (25, 45%) an insufficient Fe supply has negative effects. PMID- 6845774 TI - [Transesophageal atrial stimulation in hypothyroidism. 1. Studies of cardiac automatism]. AB - Electrophysiologic investigations of the heart with the aid of transoesophageal atrium stimulation (extra-stimulus technique and overdriving stimulation) have been performed in 19 patients with primary hypothyroidism and a normal electrocardiogram in standard linkages. The control group comprised 34 healthy persons. In 68% of patients with hypothyroidism there have been stated a prolonged refraction time of the atrium-ventricular and intraventricular conductivity system while in the case of healthy persons an analogic type of changes has been observed only in 12%. Atrium overdriving stimulation has shown a decrease of the atrium-ventricular conductibility at a frequency below 130/min and in 74% of the patients with hypothyroidism the blocking assumed a shape of Wenckebach's periodic. PMID- 6845775 TI - [Transesophageal atrial stimulation in hypothyroidism. II. Effect of hypothyroidism therapy on cardiac automatism]. AB - Investigations of the heart automatism were carried out in 8 persons with primary hypothyroidism before therapy and after euthyroid status procurement. In order to determine the electrophysiologic parameters there has been applied the transoesophageal atrium extrastimulus technique and the overdriving stimulation. There has been stated a positive effect of the thyroid function compensation upon the atrium refractory period, the atriumventricular conductibility and the refractory time of the total conductivity system. The authors suggest, that investigation, in which transoesophageal atrium stimulation has been applied, may belong to the methods of tracing the effect of hypothyroidism therapy. PMID- 6845776 TI - [Obstruction parameters and pulmonary artery pressure in asthmatics after administration of aminophylline]. AB - In 30 asthmatics after the application of aminophylline the measurement of the pressure of the pulmonary arteries as well as of the parameters of the respiratory function FEV1.0 and Rt was performed. It is proved a significant decrease of pressure in the lesser circulatory system. The reduction of the bronchial obstruction cannot be proved by means of the respiratory impulse test (FEV1.0), but by the determination of the resistance to respiration (Rt). PMID- 6845777 TI - [Diagnostic value of bile acids for determining the activity of chronic hepatitis]. AB - Examinations of 39 patients with histologically ascertained chronic active hepatitis showed that from the behaviour of the bile acids in the C-bile may be concluded to the degree of severity and size of the inflammatory activity of the chronic liver disease. The total unconjugated bile acids were reduced in dependence upon the degree of the biochemical and/or histological activity of chronic hepatitis. The concentrations of the total bile acids decreased the more, the more distinct was the inflammatory activity. The increase of the biochemical and/or histological activity was characterized also by a reduction of the ratio trihydroxy-/dihydroxy-bile acids. From the alteration of the ratio causal relationships between the activity of the chronic hepatitis and the predominance of the chenodesoxycholic acid could be derived. This disease-specific behaviour of the bile acids which had diagnostic value for the demarcation of the stage of the disease of chronic hepatitis was statistically ascertained by the correlation calculation and the factor analysis. PMID- 6845778 TI - [Probe test for the detection of hemoglobinopathies and enzyme defect anemias]. AB - The simplest methods for the diagnosis of thalassaemias are the morphology of erythrocytes, the Hb-F-elution test and the Hb H Heinz bodies test. In order to prove the sickle cell anomaly sickle cell preparation and Hb-S-precipitation test can be performed in every laboratory. By means of the isopropanol precipitation test or the Heinz bodies test can be searched for instable haemoglobins without any laboratory expenditure. On the other hand, haemoglobins with increased oxygen affinity demand a measurement of the oxygen affinity of the erythrocytes. However, simple fluorescence or dye-stuff methods are out our disposal for the most important erythrocytic enzymopenias. PMID- 6845779 TI - [Hepatogenic anemia]. AB - Anaemias with multivariate pathogenesis are frequently observed in chronic liver diseases. Among our patients 44.4 per cent (132 of 297) had an anaemia. The hepatogenic anaemia which appeared most frequently in patients with liver cirrhosis and carcinoma of the liver was in most cases normochromic (75 per cent), at a small proportion hypochromic (17.4 per cent) and rarely hyperchromic (7.6 per cent). Initial phases of an anaemia were more frequently registered by means of the counting of erythrocytes than by means of the determination of haemoglobin, which is to be traced back to the frequently existing volume macrocytosis. Leptomacrocytes, target cells and acanthocytes are observed as further forms of macrocytes in liver diseases. Among the possible individual factors the more frequently appearing latent and more rarely existing manifest haemolysis prevailed in 82 per cent of the examined patients. A hypersplenism, however, was present only in 24 per cent of the patients, vitamin B12 and folic acid deficiency as well as signs of the ineffective erythropoiesis relatively more infrequently occurred. Additional occult haemorrhages or an increase of the plasma volume may lead to an anaemia in latent haemolysis. As to the diagnosis a basis programme and an enlarged programme are reported on. The therapy has to take into consideration the treatment of the basic disease and the deficiency conditions or disturbances established. PMID- 6845780 TI - [Transfusion induced hypersiderosis in aplastic anemia--physiopathology and therapeutic aspects]. AB - Congestive cardiomyopathy and final stage of a liver cirrhosis due to massive overload of iron are often the cause of death in polytransfused patients with aplastic anaemia. With increasing frequency of transfusion the problem of overload of iron becomes more actual. The toxicity of abundant iron is based on various mechanisms of action, which are compiled with the help of literature. Our experiences hitherto made with the intravenous long-term infusion of desferrioxamine are reported. This regimen of therapy is not to be practiced in the long run. PMID- 6845781 TI - [Ulcer disease and duodenogastric reflux]. AB - The intragastric concentrations of lysolecithin and bile acids were determined in 44 chronic peptic ulcer patients and 35 healthy volunteers. Normal reflux values were found in the prepyloric ulcer (Johnson type III) (n = 15) Elevated reflux amounts could be observed in the type I gastric ulcer (n = 15), there was a three to fourfold increase compared to the controls. - Slightly elevated reflux concentrations were found in the duodenal ulcer patients (n = 14), but only under fasting conditions. The increase of reflux concentration in chronic gastric ulcer type I is shown to be in the same range as in acute stress ulcer. Compared to the three-to four times higher reflux concentrations of the resected stomach, the duodenogastric reflux in ulcer disease is very moderate. It's role in ulcerogenesis has to be analyzed further. PMID- 6845782 TI - Gastric ulcer and duodenogastric reflux: causal or casual relationship? PMID- 6845783 TI - [Colitis in the non-functioning rectosigmoid after establishment of an end sigmoid colostomy]. AB - In 11 patients with a sigmoid end colostomy (and one additional patient with an end ileostomy), we examined the endoscopic and microscopic aspects of both the dysfunctioned bowel and the colon proximal to the colostomy. The latter showed in none of the cases signs of inflammation, while in 7 patients a remarkable or even severe colitis (mimicking ulcerative colitis) could be demonstrated endoscopically and/or histologically - irrespective to the duration of the dysfunction (one month up til 11 years). In the four patients with restoration of the intestinal continuity, macroscopic and microscopic findings of the rectal mucosa became normal as soon as two weeks after reoperation. We conclude, that the "dysfunctioned bowel-colitis" is somehow related to the mucosa's contact to the fecal stream. PMID- 6845784 TI - [Plasma concentration and elimination behavior of the cardiac glycoside meproscillarin in patients with liver cirrhosis]. AB - During a one week period patients with liver cirrhosis and a control group were treated with a repeated dosage of the new heart glcoside Meproscillarin. After achieving a steady state in plasma level the same Meproscillarin plasma levels were found among both groups. Compared with the control group no difference was detected in the elimination rate of Meproscillarin in patients with liver cirrhosis, which means a complex disturbed liver function. Nevertheless the greater variance of the Meproscillarin plasma levels in the patients with liver cirrhosis in comparison with the controls means a diminished predictability of the therapeutic success in the cirrhosis group. With this limitation Meproscillarin can be used therapeutically in patients with liver cirrhosis, because a toxic accumulation is not to be expected. PMID- 6845785 TI - The ileocecal (ileocolonic) sphincter. AB - The ileocolonic junctional region exhibits many features considered characteristic of a gastrointestinal sphincter. Thus the junction between large and small bowel is marked in many species by considerable thickening of the circular muscle coat, and physiological studies have revealed properties similar to other sphincteric areas. The region generates a tonic pressure and exhibits responses to distension, nerve stimulation and pharmacological agents clearly different from adjacent ileum and colon. The factors responsible for generating and maintaining tone within this sphincter remain unclear, however. While extrinsic nerves do not appear to play a significant role, importance has been variously attributed to the contributions of intrinsic nerves, myogenic tone and elastic factors. The function of this region in the intact animal has not been extensively investigated or clearly defined. However observations in both animals and man suggest that the ileocolonic sphincter acts in concert with adjacent ileum to store chyme in the distal small bowel and periodically expel it into the colon. Coordinated activity is especially noticeable following food when increased ileal activity combined with relaxation of the sphincter promotes rapid emptying of ileal contents. Clinical and experimental studies indicate that the presence of an intact ileocolonic sphincter may increase survival and reduce morbidity following extensive small bowel resection. By preventing reflux of colonic contents the sphincter may serve to minimize colonization of the small bowel by large bowel bacterial flora. The response of the ileocolonic sphincter to large bowel distension appears highly variable and may depend more on the magnitude of the intracolonic pressure generated rather than on inherited or acquired abnormalities of junctional zone anatomy. PMID- 6845786 TI - [Seasonal increase in gastroduodenal ulcer]. AB - 7084 upper gastrointestinal tract endoscopies in the years 1973 to 1981 revealed 1664 duodenal or gastric ulcers. The number of total ulcer observations in relation to specific months differed between 110 in the 9 June periods and 189 in the 9 October months. A convincing peak was not detected. However, the number of ulcers per month or per season was not distributed evenly, as judged by chi Square analysis. 30% of all ulcer observations occurred in the fall, 24% in the winter, 24% in the spring and 22% in the summer. Our material did not reveal, whether the slight increase in the fall reflected a true rise in the ulcer incidence or whether it had to be attributed to seasonal variations in referrals for endoscopic examinations. Nevertheless the reported data are further evidence for the perennial rather than seasonal nature of gastroduodenal ulcers. PMID- 6845787 TI - [Clinical relevance of the "cockade phenomenon" in abdominal ultrasonic diagnosis]. AB - The ultrasonic diagnosis "cockade sign" in patients with unexplained abdominal complaints was investigated by means of endoscopy and X-ray studies of the gastrointestinal tract. The following final diagnoses were established: gastric cancer in 24 patients (16,2%), colonic carcinoma in 31 patients (21%), intraabdominal tumor without infiltration of the GI-tract in 19 patients (12,8%), inflammatory bowel disease in 35 patients (23,6%). In 39 patients (26,4%) no inflammatory or neoplastic process of the GI-tract could be found. Most of these patients were suffering of a spastic colon. If a tumor of the gastrointestinal tract can be made visible by ultrasonography, this may shorten the diagnostic procedure. However, ultrasonic investigation of the abdomen cannot exclude an abdominal inflammatory or neoplastic process. Therefore, it is only useful as a screening procedure. PMID- 6845788 TI - Changes in gastrointestinal DNA synthesis produced by acute and chronic ethanol consumption in the rat: a biochemical study. AB - The effect of acute and chronic ethanol administration on DNA synthesis in the gastrointestinal tract of the rat was investigated. Acute intragastric ethanol administration (3 g/kg; 50%) decreased significantly in vivo DNA synthesis when measured 1 hour after alcohol application in the stomach and in the upper small intestine, whereas acute intravenous ethanol administration had no significant effect. In contrast, chronic ethanol ingestion resulted in a significant increase of in vivo and in vitro DNA synthesis in the upper gastrointestinal tract. In addition, even a more enhanced stimulation of DNA synthesis after chronic ethanol consumption was found in isolated intestinal cells. These results indicate an inhibition of gastrointestinal cell regeneration directly after the oral application of ethanol. The enhanced cellular regenerativity observed after chronic ethanol consumption may be secondary to the ethanol induced damage of the gastrointestinal tract. PMID- 6845789 TI - [Diagnosis of varicose veins using Doppler ultrasound in the practice]. AB - The unidirectional doppler technique has become indispensible for the modern phlebologic practice. Throughout this instrument, the exact degree of severity of the varicosis (level I-IV) as well as the localisation of perforating veins can be easily determined. Possible circulatory disturbances of arteries may also be detected without difficulty. PMID- 6845790 TI - [Latent sensitization to bee and wasp venoms]. AB - IgE-RAST with bee and wasp venom was performed on 200 persons without any allergic history. Specific IgE antibodies against bee and/or wasp venom were found in 55 persons (27, 5%); in 14 persons of these against bee, in 29 against wasp and in 12 against bee and wasp venom. Specific IgG antibodies were only found in 16, 4% of the silently sensitizated persons. Therefore, the lack of symptoms in the remainder of this group cannot be explained by the presence of blocking IgG antibodies. PMID- 6845791 TI - [Incorporation of L-acetidine-2-carboxylic acid in type I skin collagen. Biochemical and mechanoelastic properties]. AB - In order to elucidate the role of L-acetidine-2-carboxylic acid (L-ac) incorporated into collagen type I of the skin instead of proline, we looked for the mechanoelastic properties of skin. Mice were orally fed with 0, 1% solution of L-ac for 5 weeks, then sacrificed, and type I collagen was extracted. Incorporation of the proline analogue (L-ac) could be shown by two dimensional thinlayer chromatography. The melting point (Tm) of type I collagen was determined by circular dichroism: 36, 5 +/- 1 degrees C for normal collagen, 37 +/- 1 degrees C for L-ac-collagen. This insignificant difference indicates that there was no alteration of the thermal stability of the collagen helix after incorporation of L-ac. Tensile strength was examined on whole strips of skin and worked out at means = 1,00 N/mm, s = 0,20 N/mm, sigma = 0,04 N/mm for normal individuals and means = 0,62 N/mm, s = 0,24 N/mm, sigma = 0,05 N/mm for L-ac-fed animals. The considerable difference could be estimated by the Wilcoxon test (p less than 0,005). As the stability of the collagen helix (shown through melting point determination) has not decreased, the reduced mechanoelastic property of tensile strength seems to be due to intermolecular rather than to intramolecular disturbances of the cross connection of the triple helix. PMID- 6845793 TI - [Critical comment on the Bilobed flap]. PMID- 6845792 TI - [Defibrination in the therapy of leg ulcers in diabetic microangiopathy]. PMID- 6845794 TI - [Psoriasis: the clinical use of "minute therapy" with Cignolin]. AB - The so called "minutes" therapy is a fundamental new method of psoriasis treatment with dithranol (anthralin). Dithranol is applied to the lesions for only 10 to 20 minutes and thereafter washed off thoroughly under a shower. We use an ointment of 0.5 to 3% dithranol with 2% salicylic acid in yellow soft paraffin which is applied with a plastic glove to the lesions. This regimen makes it now possible to offer dithranol routinely for home treatment. The patient should be well informed and must consult the dermatologist weekly. The course of treatment usually starts with 1% dithranol for 10 minutes. Depending on the healing effect and the degree of irritation, the concentration and the contact time is increased step by step. Up to now, 200 patients have been treated, 64 of them as in patients and 136 carrying out the treatment at home. The clearance rate was 77.5% (84% for the in-patients and 74% for the outpatients). The average clearing time for out-patients was 5.5 days longer than for in-patients (31.5 to 26 days). The rate of non-responders in both groups was 10%. The application of corticosteroids or oral retinoids in addition to the "minutes" therapy showed no better therapeutic results. The "minutes" therapy has medical, social and financial advantages. Dithranol is very effective and has no permanent side-effects. Therefore, corticosteroids, retinoids and PUVA can be restricted. Treatment at home enables the patients to enjoy normal family and professional life. Finally, the "minutes" therapy saves large amounts of money in comparison to a hospital stay for several weeks. PMID- 6845795 TI - [Relevance of an iodine allergy to commercial polyvidone-iodine preparations]. AB - Patch testing with Iodine/potassium-iodide (3%) and commercialized povidone (PVP) iodine preparations (Betaisodona-ointment and solution, Polyvidon-Jod-ointment "Braun", Braunol-solution "Braun", Traumasept-ointment, and Traumasept solution- not marketed--, were carried out in 104 patients of the Department of Dermatology of the Municipal Hospital Kassel. In addition, the according ointment and solution-bases were tested. 22 tests were patients with ulcera crurum, 82 patients with infectious skin diseases or skin tumors. 35 out of the 104 patients showed positive reactions to iodine/potassium-iodide. Hyperreactivity to one or more PVP-iodine-ointments was found in 12 patients, to one or more PVP-iodine solutions in 29 patients. If there was no positive reaction to iodine/potassium iodide, PVP-iodine ointments were always tolerated, while PVP-iodine-solutions produced positive reactions in 9 cases even then. Our results show that allergic skin reactions must be expected in 2-9% of all patients using PVP-iodine ointments, and in 12-20% of all patients using PVP-iodine-solutions. If iodine allergy is known the rate of positive reactions to PVP-iodine ointments is 6-25% to the solutions 34-60%. PMID- 6845796 TI - [Keratosis follicularis (avitaminosis A) in acute intermittent hepatic porphyria]. PMID- 6845798 TI - [Comparison of 3 corticoid preparations with the vasoconstriction and erythema test]. AB - The efficacy of a new topic preparation of the corticosteroid Halcinonide containing 5% Urea has been examined and then compared with two commercial preparations of Halcinonide and Betamethasonevalerate respectively. Although these two corticosteroids usually do not belong to the same class of potency, there could not be found any significant difference neither with the vasoconstriction assay nor with the Pyrexal erythema. The influence of the three most important parameters, that are vehicle, occlusion and skin condition, is a subject of discussion. PMID- 6845799 TI - [Surgical interventions on the nail: indications and contraindications]. AB - Nail surgery might be performed for diagnostic and therapeutic reasons. A diagnostic biopsy is indicated for unclear disturbances of nail formation, atypical inflammations, suspicious pigmentations and neoplasias of the nail organ. The following alterations have to be absolutely treated by surgery: solitary pigmented streaks, tumors, ingrowing nails (stage III), panaritium and traumatic injuries of the nail organ. Relative surgical indications are onychogryposis, nail mycoses, discolorations due to chromogenic bacteria and subungual warts, as well as large subungual haematomas, longitudinal split nails and recalcitrant chronic paronychias. However, there are some contraindications for surgical intervention especially for simple avulsions of the nail plate. With malformed nails due to matrix diseases, large scars of the nail bed or ingrowing nails, an extraction of the nail plate does not have any healing effect. Instead repeated nail extractions may cause thickening and overcurvature of the nail. PMID- 6845797 TI - [Standardized recall antigen testing in patients with malignant melanoma, endogenous eczema patients and healthy humans]. AB - By means of a new test kit (Multitest), intracutaneous tests have been performed on several groups of patients in order to evaluate the degree of cellular immunity. This test system affords the simultaneous application of seven quantitatively and qualitatively standardized antigens. In comparison to healthy people, patients suffering from malignant melanoma showed a slightly higher immunity reaction whereas patients with atopic dermatitis revealed a significantly lesser degree of reactivity to the recall-antigens. Chemotherapy with Dacarbazine did not change the amount of reactivity to the Multitest. This paper discusses the advantages of the new test kit as well as the difficulties of recall-antigen testing with regard to the evaluation of cellular immunity. PMID- 6845800 TI - [Effects of tattoo removal and results after salabrasion]. AB - 22 patients have been treated with a three minutes salabrasion, once for repeatedly, on skin areas around 41 tattoos. Following long-term results could be established with tattoos performed by laymen on forearm, upper arm or posterior, a single salabrasion produced perfectly acceptable to good results in the removal of tattoos. As to be expected, repeated salabrasion and additional skin surgery improved the results in removing tattoos. Frequently, single or repeated salabrasion resulted in hypopigmentation of the interfollicular epidermis with a more or less intensive skin-colored to brownish pigmentation of the follicle regions. The general impression of hyperpigmentation only occurred occasionally after single salabrasion and was independent of location. Single or repeated salabrasion resulted in an emphasis of the surface structure and increased wrinkling of the skin in due course, but never in scar formation. PMID- 6845801 TI - [Pedunculate mollusca contagiosa in a patient with endogenous eczema]. PMID- 6845802 TI - [What to do when a physician or one of his assistants injures himself with an instrument used in a patient procedure?]. PMID- 6845803 TI - [Course of rapid hyposensitization with insect venom with special reference to local reaction, as a contribution to risk reduction]. AB - After critical evaluation of literature as well as the results obtained in this department up to now concerning skin tests and therapy with whole body extracts, we changed our mode of treatment of sting allergy to desensitization with pure insect venom. Clinical observations concerning the course of the rapid desensitization led to an accentuation of the local reaction as an important sign of the compatibility of the therapy. On account of local reaction patterns concerning the dosage of the venom, a significant reduction of the rate of side effects could be achieved in this high risk therapy. PMID- 6845804 TI - [Clinical, histological and immunohistochemical study of the early diagnosis of mycosis fungoides]. PMID- 6845805 TI - [Study on the efficacy of a combined treatment of psoriasis with dithranol and UV B (selective ultraviolet-phototherapy)]. AB - Within a clinical study, 12 patients suffering from generalized psoriasis were treated with 0,4% anthralin ointment, unilaterally applicated in combination with UV-B-therapy. Comparing the results, both modes of treatment revealed no considerable difference with regard to erythema, infiltration of the lesions, scaling, itchiness and irritation. The anthralin induced erythema did not show any augmentation by additional use of UV-B-radiation. The clinical improvement of both applications was considered satisfying in 67% of the cases. UV-B-radiation showed no additional therapeutical value if used in combination with anthralin. PMID- 6845806 TI - [Malignant melanoma in lupus (tuberculosis cutis luposa)]. AB - We report on a 72 years old man showing a strikingly fast spreading malignant melanoma developing on a lupus vulgaris which had existed since childhood. The coincidence of both diseases is obviously extremely rare. A pathogenetic relationship between melanoma and lupus vulgaris, such as claimed for carcinoma in lupo, especially after X-ray irradiation, is not inferable. PMID- 6845807 TI - [Behavior of rest and stress ejection fraction in myocardial infarct patients before and after 4 weeks of training. Comparison with a control group]. PMID- 6845808 TI - [Effect of valve type and valve function on chronic intravascular hemolysis after alloprosthetic mitral and aortic valve replacement]. AB - In 1091 patients with isolated Bjork-Shiley, Lillehei-Kaster, Starr-Edwards, and St. Jude Medical mitral and aortic valve replacement, hemolysis parameters were determined (hemoglobin, LDH, haptoglobin, free plasma hemoglobin, reticulocyte count, serum bilirubin, transferrin, urine hemosiderin, schistocyte count). In 1006 of these patients no valve dysfunction was detected, while in 85 patients either paravalvular leakage or a thrombosis of the prosthetic valve was present. Haptoglobin was the most sensitive parameter for detecting even mild intravascular hemolysis, which was present in two-thirds of patients after alloprosthetic heart valve replacement. For quantifying red cell damage LDH was useful. Hemolysis was somewhat higher after Lillehei-Kaster and Starr-Edwards than after Bjork-Shiley or St. Jude Medical implantation. The variance of LDH levels can be explained in a high percentage by correlating them with the hemodynamic findings at rest and exercise, which are indirect parameters of velocity profiles. Hemolysis is higher after aortic than after mitral valve replacement, with the exception of St. Jude valves. In patients with perivalvular leakage or valve thrombosis, red cell damage is more pronounced than in normally functioning prostheses (p less than 0.0005). When the hemolysis characteristics of the individual types of prosthesis are taken into account, the degree of hemolysis is a reliable indicator (p less than 0.05) of the functional integrity of the prosthesis. However, the degree of hemolysis does not correlate with the hemodynamic significance of perivalvular regurgitation. PMID- 6845810 TI - [Ecological aspects of rehabilitation possibilities in nursing homes]. PMID- 6845809 TI - [Microecology of residents and personnel: a behavior mapping study in a home for the aged]. PMID- 6845811 TI - [The need for social services for the elderly in Berlin (West)]. PMID- 6845812 TI - [Changes in opportunities to participate in the transitional period from middle to old age]. PMID- 6845813 TI - [A new concept in nursing homes - demonstrated by a project]. PMID- 6845814 TI - [Quasielastic light scattering of isolated chromatin]. AB - Chromatin undergoes structural changes in dependence on the ionic strength of monovalent cations. At low ionic strength an extended chain of nucleosomes is apparent while with increasing ionic strength more compact structures are formed. Soluble chromatin was prepared from rat liver and fractionated by gel chromatography. Quasielastic light scattering experiments on chromatin were done with monovalent salt concentrations ranging from 3-150 mM. Using this method translational diffusion coefficients have been derived. These appeared to be nearly independent of monovalent salt concentrations, indicating that the hydrodynamic radius of chromatin molecules did not change. On the other hand, sedimentation coefficients were increasing according to an exponential relation. Taken together, both findings reveal a rising of the molar mass with increasing ionic strength. On the contrary, chromatin prepared in physiological salt apparently disintegrates by lowering the ionic strength. Furthermore, it could be demonstrated by earlier small angle X-ray scattering studies that the diameter of the higher order chromatin fiber remained constant at approximately 32 nm even if these structures had been reconstituted from smaller pieces starting at low ionic strength. Thus, isolated chromatin fibers are capable of self-assembling to regular quaternary structures, even if the DNA does not form a continuous strand. PMID- 6845815 TI - Long term cultures of neural retina and pigment epithelium from newborn rabbits. AB - In vitro cultures of neural retina, obtained after dispersion and trypsinization of tissue fragments, were composed of 3 morphologically distinct types of neural cells, as demonstrated by silver impregnation. They resembled ganglion or receptor cells, horizontal or amacrine cells, and bipolar cells of the intact retina. Pigment epithelium was cultured without trypsinization. Both kinds of techniques may prove helpful for long term experiments in neurobiology and neurovirology. PMID- 6845816 TI - Fluorescence patterns of chromatin and cytoplasm by hematoxylin solutions. AB - Treatments of chicken blood and Ehrlich ascites tumor smears with hematoxylin solutions give a fluorescence reaction in chromatin, basophilic cytoplasm and leukocyte granules. In these structures the fluorescence emission increases upon dye aging and prolonged staining times. We present a preliminary spectral analysis suggesting the possibility to employ hematoxylin as a fluorochrome. PMID- 6845817 TI - On the construction of "optimal" phylogenetic trees. PMID- 6845818 TI - Sensitive fluorimetric assay for adenosine deaminase with formycin as substrate; and substrate and inhibitor properties of some pyrazolopyrimidine and related analogues. AB - The nucleoside antibiotic formycin, 7-amino-3-(beta-D-ribofuranosyl)pyrazolo(4,3 d)pyrimidine, a structural analogue of adenosine, is deaminated about 10-fold faster by adenosine deaminase than adenosine itself, and is therefore a superior substrate for both routine assays and kinetic studies with the purified enzyme. The luminescence properties of formycin have been profited from to develop a fluorimetric assay for adenosine deaminase which is considerably more sensitive than the spectrophotometric procedure widely employed with adenosine as substrate. Examples are presented of its application to routine assays of adenosine deaminase levels in cellular extracts, as well as to kinetic studies with the purified enzyme, including the properties of some pyrazolopyrimidine and purine substrates and inhibitors. PMID- 6845820 TI - [Free bone graft with microvascular anastomosis]. PMID- 6845819 TI - Coupling of monomethoxypolyethyleneglycols to proteins via active esters. AB - Two alternative methods for the attachment of monomethoxypolyethyleneglycols (PEG) to proteins are proposed; they are based upon the replacement of the hydroxy terminal function of PEG to carboxylate followed by its activation with dicyclohexylcarbodiimide and N-hydroxysuccinimide. The methods, which give more homogeneous product than that employing trichloro-s-triazine as coupling reagent, may also be used for the modification of essential -SH containing enzymes. The attachment of PEG activated via esters was tested with several model proteins and the influence of the extent of modification i. on the biological activity of various enzymes, ii. on the binding capacity for albumin and iii. on the clearance time in rats using superoxide dismutase as model tracer was evaluated. It was also demonstrated that the extent of PEG attachment varies greatly according to the different proteins used. PMID- 6845821 TI - [Diffusion of various beta lactam antibiotics into infected tissues of the locomotor system in experimental osteomyelitis]. PMID- 6845822 TI - [Thumb reconstruction using a free transplantation of the 2d toe with microvascular anastomosis]. PMID- 6845826 TI - [Follow-up results after lumbar renucleotomy]. AB - This is a report on the results of reoperations of lumbar disc prolapses. Ninety seven operations in ninety-one patients were performed for recurrence of a disc prolapse. The recurrence rate of the cases reviewed was 6.5 per cent. More than 80 per cent of the ninety-one patients who had answered a questionnaire were satisfied with the result of reoperation. About 66 per cent of the patients were able to pursue their former occupation, 20 per cent required vocational rehabilitation, in about 20 per cent of the cases disablement was acknowledged. PMID- 6845824 TI - [The battered child syndrome from the orthopedic point of view]. PMID- 6845823 TI - [The significance of bone spurs at the base of the 2d metacarpal bone in the pathogenesis of joint arthrosis of the base of the thumb]. AB - A causal correlation is proved between an outgrowing osseous spur at the Os metacarpale II and the rhizarthrosis. The midhand bone of the thumb is connected by a ligament with the base of the Os metacarpale II. High tensile stresses elongate the ligament and lead to its partial ossification. The ligament looses its essential function and the thumb subluxates radially. PMID- 6845827 TI - [Ground force in relation to the activity of various leg muscles in the supporting foot phase of human gait]. AB - By means of using biomechanical methods we investigated the relations between muscle activity and ground forces that are produced during walking. Our special attention was directed forwards the touching phase of the foot which was registered via integrated electromyogram (surface electrodes) and force plateform (Kistler). The initial spike of vertical force and its dependence of m. tibialis anterior activity was examined. In addition we observed connections between m. tibialis anterior activity and surface condition of the ground. Further, our results documented a damped movement of the touching fore foot and a steady take over of weight during pressing which was caused by increased tibialis activity. The pressure phase (first part of the vertical force component) was separated in two curves and defined by means of two angles. More data was given for interpretation the activities of m. gastrocnemius, m. peroneus longus and vertical and transversal force components. In further experiments we intend to analyse pathologic conditions. PMID- 6845825 TI - [Indications, methods and results in percutaneous nucleotomy in lumbar disk hernia]. AB - To our knowledge, the method of percutaneous nucleotomy dates back to the first description made by Hijikata in 1975. Compared to the classical hemilaminotomy, the main advantage of this method is that it reduces bone and soft tissue damage in the segment to a minimum. Furthermore, this method avoids disagreeable complications encountered in chemical nucleotomy, for a example, anaphylactic shock, the escape of the nucleolytic agent into the spinal canal, etc. The indication for this method should be avoided in the case of a prolapse within the spinal canal and especially when it is displaced outside the level of the disc. In the period between 1979 and 1981 we carried out percutaneous nucleotomies in 20 patients with a disc herniation mostly combined with a narrow spinal canal or spondylolisthesis. The clinical results from 14 of the 20 patients were described as "very good" or "good". We consider the proportion of patients showing good clinical results to be high, bearing in mind that the indication was not just disc hernia alone but was in most cases associated with other lumbar pathologies. PMID- 6845828 TI - [The functional importance of the iliotibial tract]. PMID- 6845829 TI - [Stresses on the femur following hip joint replacement]. AB - The stresses in femur after joint replacement have been calculated with the finite element method and the results were checked by using strain gauges glued on the surface of the femur and on the prosthetic stem. The influence of stem length and prosthetic collar on the distribution of the stresses have been investigated. The stem length has only a minor effect on the stress distribution if the stem has a texture which allows transfer of tension and shear at the interface endoprosthesis--bone cement. Merely at the tip of the stem changes of the stresses are obvious. The stresses in the bone near the resection plane are distinctly reduced if the prosthesis has a collar. These results have very limited relevance for implants with a smooth stem which does not allow the transfer of tension and shear at the interface endoprosthesis--bone cement. PMID- 6845831 TI - [Results of experimental testing of a screw-in in polyethylene acetabulum in sheep]. AB - In 12 sheep 21 total hip endoprosthesis were implanted, using a polyethylene acetabulum, which was provided with a continuous conique thread for implantation without cement. Out of 14 non luxated hips only 2 acetabula were loosened. After an implantation between 1 week and 18 months the remaining 12 sockets were macroscopically stable and were examined radiologically and histologically. After 3 months of increased osteogenesis a layer of collagenous tissue developed between implant and bone. In the loadbearing area this layer is from 50-80 microns thick and often the ridges of the thread are stabilised by a thin layer of fiber-cartilage, expanding around the implant with longer implantation. Bore holes in the thread are filled with partially lamellous bone after 6 months. Though sometimes a considerable amount of polyethylene wear particles caused by the disadvantageous and small shape of the sheeparthroplasty was observed, none of the examined acetabula showed any signs of loosening. PMID- 6845830 TI - [The role of the alloy-specific elements iron, cobalt, chromium and nickel in aseptic loosening of total hip joint prosthesis]. AB - The cause of aseptic loosening of total hip joint prostheses is still largely unexplained. In addition to mechanical forces, material factors may also be instrumental. In 16 patients with loosened hip prostheses who underwent re operation (8 X Huggler-Weber, 8 X McKee-Farrar), the concentration of the alloy specific elements cobalt, chromium, nickel and iron were determined in 58 tissue samples by means of neutron activation and emission spectrum analysis. An increase in the element concentrations was found in all the tissue samples, and this was unrelated to the time elapsed since implantation. The chromium concentration in particular was significantly elevated in all the tissue samples, in some patients with McKee-Farrar prostheses up to 10,000 times the norm. In view of the known toxicity of cobalt, chromium and nickel in high doses it seems that the presence of unphysiologically high concentrations of these elements in the vicinity of total hip joint prostheses represents an explanation of some of the loosened prostheses. PMID- 6845832 TI - [Hip endoprosthesis shaft fractures - a clinical and technological material study]. AB - This paper begins with a discussion of purely clinical considerations concerning fractures of hip prosthesis shafts, based on findings in 19 cases treated in the University Orthopedic Clinics of Essen and Lubeck. A gradual increase in pain following stress is the principal symptom, although acute pain is not typical. In radiological diagnosis, which is indispensable, the fractures, which are initially often merely hairline cracks, must be looked for. In the patient collective analyzed, the high percentage of implantation defects was striking; this is a factor which increases the risk of fracture because it leads to loosening of the prosthesis. The authors also report on a materials investigation carried out on 18 broken prosthesis shafts. The investigation revealed that in the majority of cases loosening of the prosthesis was the decisive factor leading to the fracture; only in 3 cases was the fracture basically attributable to a fault in the material or in production. PMID- 6845833 TI - [The hazards of knee joint arthrodesis in bilateral gonarthrosis in older patients]. AB - The effects of combined arthrodesis-prosthesis treatment in cases of bilateral osteoarthritis of the knee were studied. Using footprint and film analyses the authors illustrate the fact that the knee joint with the prosthesis is used to support body weight, and not the ankylosed joint. The resulting unsteadiness of gait, impaired quality of life and the limitation of surgical methods of redress on the contralateral knee joint are shown to be consequences of arthrodesis of the knee joint in patients of advanced age. PMID- 6845834 TI - [Endoprosthetic replacement of the metatarsophalangeal joint of the big toe]. AB - The article reports on 20 cases of cup-plasties of the first metatarsophalangeal joint. 13 cups were done without, 7 with bone cement. The early results in both groups were promising. One third of all cases showed failure 2 years postoperatively. Fixation with bone cement leads to markedly better results. In cases of failure it is always possible to bring about a result comparable to resection arthroplasty (Brandes' operation) by removal of loose components. The reaction of cancellous bone under the metal cup can be compared with that of the double cup arthroplasty of the hip. PMID- 6845835 TI - [Hyperostosis of the sterno-clavicular joint - an enthesopathy?]. AB - Erosion of the insertions of tendons and ligaments in bone (i.e. of the enthesis) due to chronic aseptic inflammation causes reparative ossification. With regard to our clinical and radiological findings in ten patients hyperostosis of the sterno-clavicular joint seems to be the late stage of such an enthesopathy. Pain and swelling of the soft tissues and an elevated erythrocyte sedimentation rate are characteristics of this seronegative rheumatic disease. For visualizing the extraarticular changes in the sterno-costo-clavicular region tomography is necessary. Early diagnosis and consequent antiphlogistic therapy should remit pain and help avoid hyperostosis. PMID- 6845836 TI - [Functional anatomical principles for the operative treatment of humeroscapular periarthropathy]. AB - The Periarthropathia humero scapularis (PHS) represents a collective term for all pathological symptoms which come from degenerative alterations of the periarticular tissue at the shoulder. Pathologically anatomic changes appear especially at the supraspinatus tendon, the so-called rotator collar and in the sliding tissue of the long biceps tendon. Abduction entails the compression of the periarticular tissue between the Tuberculum majus humeri, the Acromion and the Ligamentum coracoacromiale. Proceeding on the intraoperative observation that lime focuses and breaches of the rotator collar are predominantly under the Ligamentum coracoacromiale, we have tried to measure the functionally topographical conditions of the space with the aid of 82 corpse specimen in all. Length an width of the Ligamentum coracoacromiale as well as the space between the humerus head and the coracoacromial bow differ individually and show right left-differences. In the case of abduction and inner rotation the space becomes narrower. The supraspinatus sinew usually already runs under the Ligamentum coracoacromiale in the neutral-0-position, especially when abduction and inner rotation are effected. Therefore the resection of this ligament seems to be appropriate as a therapy of recidivating Periarthropathia complaints. PMID- 6845838 TI - [Myocardial infarct--prevention and rehabilitation through physical exercise]. PMID- 6845837 TI - [Physical therapy as prophylaxis. Uses and dangers]. PMID- 6845839 TI - [Prevention of infection by protective vaccination. Active immunization]. PMID- 6845840 TI - [Specific hyposensitization. General references on indications and completion of therapy]. PMID- 6845841 TI - [Preventive measures in childbirth - preparation for delivery]. PMID- 6845842 TI - [Prevention of chronic venous insufficiency]. PMID- 6845844 TI - [Differential diagnosis of the pathologic blood picture (4). Macrocytic anemias]. PMID- 6845843 TI - [Headache and depression]. PMID- 6845845 TI - [Proximal tibial lesions at the ankle in the growth period. Form of injury and treatment principles]. PMID- 6845846 TI - [Emergencies in general medicine (45). Thyrotoxic crisis]. PMID- 6845847 TI - [Endoscopic aspects of gastritis]. PMID- 6845848 TI - [Cholelithiasis in childhood]. PMID- 6845849 TI - [Urachus abnormalities in children]. PMID- 6845850 TI - [Treatment of ovarian cancer]. PMID- 6845851 TI - [Blood platelets. Their Function and inhibition by chemical substances]. PMID- 6845853 TI - [Differential diagnosis of the pathologic blood picture (6). Polycythemia vera and secondary polycythemias]. PMID- 6845852 TI - [Gastroenterology (2). Leading symptom: obstipation]. PMID- 6845854 TI - [Emergencies in general medicine (47). Precipitous labor. Premature membrane rupture--umbilical cord prolapse]. PMID- 6845855 TI - [Compliance. An interdisciplinary medical problem, studied with methods from general medicine in general practice]. PMID- 6845856 TI - [The "therapeutic look." On nonverbal communication between physician and patient]. PMID- 6845857 TI - [Classification of external corticoids]. PMID- 6845858 TI - [Cholelithiasis in autopsy material. Incidence and primary diseases]. PMID- 6845859 TI - [Differential diagnosis of the pathologic blood picture (7). Thrombocytosis]. PMID- 6845860 TI - [Gastroenterology (3). Dysphagias and heartburn]. PMID- 6845861 TI - [Emergencies in general medicine (48). Acute kidney failure]. PMID- 6845862 TI - [Long-term treatment of coronary heart disease with concomitant hypertension. Oxycardin retard in the coronary hypertensive patient]. PMID- 6845863 TI - Leaving a medical service against advice. PMID- 6845864 TI - Endoscopic sphincterotomy to remove gallstones: case reports. PMID- 6845865 TI - Fitness mania: a threat to private practice. PMID- 6845866 TI - [Photochemotherapy (PUVA)--clinico-experimental data and the results of treatment in chronic dermatoses]. PMID- 6845867 TI - [Changes in the ultrastructure of the peripheral blood leukocytes of chronic pyoderma patients]. PMID- 6845869 TI - [Inflammatory diseases of the urogenital organs due to Chlamydia]. PMID- 6845868 TI - [Ultrastructural studies in vitiligo]. PMID- 6845870 TI - [Phenomenon of Treponema pallidum immobilization in the blood serum of rabbits]. PMID- 6845871 TI - [Modeling of the dynamics of syphilis morbidity taking into account the effect of the activities of the public health system]. PMID- 6845872 TI - [Vasculitides of pyococcal origin]. PMID- 6845873 TI - [Effectiveness of detecting syphilis patients in serological surveys]. PMID- 6845874 TI - [Aspects of the interrelation of scleroatrophic lichen, scleroderma and vitiligo]. PMID- 6845875 TI - [Characteristics of scabies in children]. PMID- 6845876 TI - [Effectiveness of using hemosorption in the clinical picture of severe forms of psoriasis]. PMID- 6845877 TI - [Laser reflexotherapy of children with severe forms of neurodermatitis]. PMID- 6845878 TI - [Clinical effectiveness and the incidence of complications of the photochemotherapy of chronic dermatosis patients]. PMID- 6845879 TI - [School health tasks and activities yesterday and today]. AB - In the time between 1882 and 1928 the school doctor was engaged in checking the sensory organs, in controlling infectious diseases and in judging the general state of health of his pupils. Apart from these occupations, health education took an important part. After World War I, goitre prophylaxis was introduced in health services. Between 1928 and World War II we can observe a strong development of medical services for schools. The medical examinations are extended to include kindergarten, high school, and professional schools. Tuberculosis control is expanded. Pupils' insurance is created. From the end of World War II onwards and today there is a further perfection of tuberculosis control through fluorography and BCG inoculation. The peak of preventive medicine is reached with vaccinations for polio and German measles. Because of the radiation load, fluorography has soon got to be abandoned. During the same time psychiatry, psychology, and medical pedagogics are included in the services or developped side by side. Apart from the traditional duties it is sensible for a school doctor to try to coordinate the above mentioned branches of service. PMID- 6845881 TI - [Eye examinations in childhood (a new test for the examination of stereoscopic vision)]. PMID- 6845880 TI - [School medicine: dynamic aspects of a discipline]. AB - School health is evolving according to new knowledge, variations of pathology and epidemiology, scattering of responsabilities as to diagnosis and treatment, progressive coverage of school career, and diverse professional training of the physicians involved. As part of social and preventive medicine does it still correspond to a common denominator? If we pretend so we give the school physician "sensu stricto" a primordial position. But then we ought to formulate new directions inspired by the light of permanent reflexion what youth are expecting from the physician in their situation of students. Today pupil adaptation to school and adaptation of the latter to our young pupils ranks first, with a specific medico-social and pedagogical assistance focused on primary prevention. Therefore collective awareness of school physicians under the auspices of the Swiss Society of Social and Preventive Medicine is welcome. PMID- 6845882 TI - [Compensation modes for part-time school physicians in Switzerland]. PMID- 6845883 TI - [1978/1979: what do adolescents 13 to 20 and their parents think of sex education?]. PMID- 6845885 TI - [The "school physicians" specialist group of the SGSPM (Swiss Society of Social and Preventive Medicine)]. AB - Section of School Health of the Swiss Society for Social- and Preventive Medicine. Since 1981 our group is striving to get in contact with all doctors engaged in school health services. Our aims are: - Increase in the maintenance of contacts with all collegues in school health services (from G.P. to fully employed school physicians). - Exchange of experiences with and post-graduate training for these collegues. - Further development and improvement of primary, secondary and tertiary preventive measures for school children in the whole country. According to an investigation carried out by this group, nearly 1800 doctors are involved in school health. The article also gives some information about future tasks and plans and especially about national meetings on school health subjects, which usually take place parallel to the scientific meeting of the Swiss Society for Social- and Preventive Medicine. The present issue is an extended report of the first section meeting in Basle, June 1982. PMID- 6845884 TI - [Health education as a recent school medicine concern]. PMID- 6845886 TI - Effects of non-steroidal anti-inflammatory drugs on human leucocytes. AB - The action of 4 non steroidal anti-inflammatory drugs (NSAID) on the function of human polymorphonuclear neutrophils (PMN), monocytes and lymphocytes has been investigated and compared to that of prednisolone. Benoxaprofen and diclofenac inhibited the chemotaxis of leucocytes in a dose-dependent fashion in vitro whereas acetylsalicylic acid and indomethacin were inactive or effective on the migration of these cells at high concentrations only. Benoxaprofen did not reduce significantly (variance analysis, p = 0.05) the chemotactic locomotion of PMN or monocytes isolated from volunteers after repeated oral administration of the drug. The other function of the leucocytes investigated, which are essential for the defense of the host, were not suppressed by NSAID at therapeutic concentrations. From these experimental results it was concluded that Nsaid have a differing spectrum of biological activities and can act selectively on functions of leucocytes. However, the relevance of these findings to the effect of drugs on the inflammatory process is still unclear. PMID- 6845888 TI - [Spinal hemangioma in the roentgen picture of the Andersson lesion in ankylosing spondylitis]. AB - The vertebral cavernous hemangioma is described as the number five cause in the etiology of the Andersson lesion (vertebral-discal destruction in ankylosing spondylitis). In one case of a completely stiffened spine, radiographs showed a vertebral hemangioma with a cockade-like appearance instead of the typical coarse striated osseous structure. Histologic necropsy results were those of a cavernous vertebral hemangioma. The immobile rigid spine, that is, the pathologically disturbed function appears to have a strong influence on the form, structure and pathology. PMID- 6845887 TI - [Potential interactions of diclofenac-sodium (Voltaren) with antibiotics]. PMID- 6845889 TI - [Combination of ankylosing spondylitis with dermatomyositis and atypical gout (isolated gout kidney)]. AB - In a 58-year-old man with the clinical and radiological signs of definite ankylosing spondylitis in its final stages, HLA B 27 positive, an onset of dermatomyositis was observed with characteristic clinical, histological, and pathological findings, and with high titers of ANA. It had been discovered years before that a gouty kidney with pyelonephritis accompanied the advanced ankylosing spondylitis. On the basis of these findings a triple association of etiologically different diseases could be diagnosed. After treatment with cortisone, allopurinol, and azathioprine appeared an acute and no longer controllable panmyelophthisis. That a malignant tumor could have caused the dermatomyositis was excluded by autopsy. Diagnostic questions concerning the gouty kidney as well as factors explaining the acute and deadly progress of a panmyelophthisis after the administration of a rather mild immunosuppressive agent are discussed. PMID- 6845890 TI - A study on energy requirement for maintenance and growth in rats with normal or reduced gut flora. PMID- 6845891 TI - Effect of feeding bicarbonate supplemented diet on the retention of calcium in ruminants. PMID- 6845892 TI - Toxicity effects of some legume seed hemagglutinins on some liver enzyme activity. PMID- 6845893 TI - [Growth and feed consumption of carp (Cyprinus carpio L.) with different protein and energy supply. 1. Experimental design, ration composition, digestibility]. PMID- 6845894 TI - [Growth and feed consumption of carp (Cyprinus carpio L.) with different protein and energy supply. 2. Weight gain, feed conversion, protein and energy consumption]. PMID- 6845896 TI - [Appendicovesical fistula]. PMID- 6845895 TI - [Urethroplasty against endoscopic urethrotomy]. AB - From 1970 to 1981 urethroplasty was done in 79 patients and internal urethrotomy under vision was done on 166 urethral strictures from 1977 to 1981. We feel that urethroplasty and internal urethrotomy complete each other. Both of them are successful in some 85% of cases. Direct vision cold knife internal urethrotomy increases the scope of our surgical possibilities in urethral strictures. It should normally be the first treatment. Internal urethrotomy can be performed in all types of urethral strictures. The patients are not severely affected. The advantage of this method is that it can be used at an old age, too. In acute urinary retention as a consequence of urethral stricture internal urethrotomy can also be utilized. It can be done in a second or third procedure. If urethroplasty must be done after internal urethrotomy all surgical possibilities remain. We prefer urethroplasty for long strictures, especially in the membranous urethra, and multiple strictures. PMID- 6845897 TI - [Diagnostic and surgical transurethral ureterorenoscopy. Initial results in 69 patients, testing of the new, rigid compact endoscope of 9.5 charr]. PMID- 6845898 TI - [Occupational accidents in the Aachen bituminous coal mining district- comparative study of the years 1970 and 1980]. PMID- 6845900 TI - [Determination of the size of a district in domestic refuse disposal with reference to stress on the employees]. PMID- 6845901 TI - [Catecholamine excretion in wrappers doing piece-work under increasing effective temperatures--a contribution to the problem of combined stress at the work site]. PMID- 6845899 TI - [Phenol excretion in the adult human in relation to drug use and disease picture]. PMID- 6845902 TI - Phosphate-solubilizing potentiality of the microorganisms capable of utilizing aluminium phosphate as a sole phosphate source. AB - Eight bacteria, each of the genus Bacillus, two actinomycetes, each of the genus Streptomyces, and six fungi, one each of the genus Penicillium and Chaetomium and four of the genus Aspergillus, were isolated on AlPO4-sucrose agar from a typical Indian lateritic soil (Typic Ochragualf). All of them were capable of solubilizing Ca3(PO4)2 to a higher degree than AlPO4. Bacillus subtilis (B-7655), LAB4, Bacillus sp., LAB5, Penicillium sp., LAF2, and Aspergillus spp., LAF3 and LAF4, were solubilizing Ca3(PO4)2 very efficiently, but AlPO4 to a lesser degree. Bacillus spp., LAB1, LAB2, LAB5, LAB6 and LAB7, Chaetomium nigricolor, LAF1, and Aspergillus spp., LAF5 and LAF6, were unable to bring detectable amounts of soluble phosphorus to solution from AlPO4. Except Chaetomium, all the other organisms produced free aliphatic organic acid in detectable amounts. The organic acids produced were oxalic, succinic, citric, and 2-keto gluconic acid. 2-Keto gluconic acid, singly and in combination with succinic or citric acid, accounted for higher solubilization. Amount of free organic acids in the growth medium was not directly correlated with phosphate solubilization. PMID- 6845903 TI - [Cellular structure of propionibacteria during their multiplication]. AB - The aim of the present study was to determine the structure of bacterial cells from Propionibacterium genus as well as their structure during the cellular division. On the basis of the observations made in the electron transmission microscope, in uranyl-acetates-tained preparations of ultra-thin specimens of bacteria, it was stated that propionic bacteria appeared in a shape of short rods, possessing regular profiles of cell walls as opposed to Gram-negative bacteria with a very creased edge line. Besides, it was observed that division of cells had place by formation of septum, most probably preceded by the division of mezosome, which is a signal for creating the divisional wall. In the conducted studies, the following phenomena were started: presence of membraneous structure of mezosomes, which is linked with the chain of circular DNA in bacterial cell, appearance of numerous ribosomes in the regions of tangled threads of nucleic acids, and existence of other undefinite elements. Mezosome present in the cell of propionic bacteria is probably linked with the cell wall at least in two places and on the surface of external cell wall at the site of its linking; it causes the change in electronic density, demonstrated by the undefined holes or scars in cell wall. This finding gives the possibility of distinguishing this genus of Propionibacterium, in the respect of morphology, from other bacteria what, in the opinion of the authors, is a new achievement in the studies on the structure of propionic bacteria. PMID- 6845904 TI - Detection of antibacterial substances in some plant residues and their effect on certain micro-organisms. AB - The effect of dry residues from several plants, belonging to different families on certain microorganisms in vitro and in vivo, was studied. Dry residues of paprica leaves, tomato tops, egg plant leaves, guava leaves, onion peels, garlic tops, wheat straw, sugar cane leaves, cotton leaves, Egyptian clover tops, field bean tops or pea tops were examined for the presence of antibacterial substances, using successive extractions with hexane, ethyl ether, ethanol, and water, respectively, for each plant residue. On culture media, the antibacterial effect, expressed as width of inhibition zones, differed according to the type of plant, type of micro-organism, and extraction medium, used for each plant. Water extract from each of the studied plants showed no effect on any of the studied micro organisms, while the other extracts indicated the presence of antibacterial substances in all the used plants. In most cases, ether extract showed the highest incidence of antimicrobial activities against the majority of test micro organisms. In general, the antibacterial substances seemed to be more inhibitory to Gram-positive bacteria than to Gram-negative ones. Ethyl-ether extract of the residues of most of these plants markedly affected the growth of more than one of the different Rhizobium species when grown on culture medium, as indicated by the presence of wide zones of inhibition. PMID- 6845905 TI - Growth and nitrogen fixation by cultures of Bacillus sp. S 77 g, Pseudomonas sp. S 44 b, and Klebsiella sp. S 145 m, isolated from Egyptian soils. AB - Study of the behaviour of representative aerobic freeliving dinitrogen-fixers, other than azotobacters, with respect to different carbon sources, showed that a broad range of compounds is accessible to them. This group of nitrogen-fixers can assimilate molecular nitrogen as a result of utilization of carbohydrates, alcohols, and organic acid salts. The highest nitrogen-fixation productivity, reaching 20.6-27.3 mg of nitrogen per g of carbon utilized, was observed on medium containing glucose as the carbon and energy source. Supplementary growth factors added to the N-deficient medium in the form of small amounts of yeast extract stimulated their growth and fixation of atmospheric nitrogen. This stimulation is particularly evident in mixed cultures. The nature of the mutual influences of micro-organisms in these cultures remains fairly obscure and further inquiry is necessary to elucidate this problem. A medium containing 1% glucose and Difco yeast extract to produce a bound nitrogen concentration of 10 ppm appeared to be the most favourable for the cultivation and N2-fixation of this group of microorganisms. PMID- 6845906 TI - [Peritoneal drainage following perforation of a gastric or duodenal ulcer]. PMID- 6845907 TI - [Treatment results in surgery of gastroduodenal ulcers]. AB - From 1969 to 1980, 1316 patients underwent surgery for gastric and duodenal ulceration. In 302 cases (23%) the indication was a vital one (158 times [12%] perforation and 144 times [11%] heavy bleeding). 1014 operations (77%) were of selective character: 1159 times partial gastrectomy, 60 times vagotomy and 97 times nonresective emergency procedures. The rate of complications following perforation was 2 1/2 times and after bleeding 3 times higher than after selective operations. The mortality rate after perforation came up to 9.5%, after hemorrhage to 13.2%, but in selective cases only to 0.6%. The total mortality rate came up to 3.0%. Our results demonstrate the fact that surgery for gastric and duodenal ulcer is mainly burdened by mortality following perforation and haemorrhage. PMID- 6845908 TI - [The treatment of acquired anal incontinence]. AB - 11 patients suffering from acquired anal insufficiency underwent a relative simple myoplastic surgical procedure, dealt with in detail. 10 patients of them regained full continence and full working capacity. They also recovered completely from a social point of view. PMID- 6845909 TI - [Surgical aspects of the treatment of malignant thyroid gland tumors]. AB - 95 cases with primary malignant thyroid tumours underwent surgery from 1965 to 1977. In view of the interdisciplinary character of treatment and independent of histological differentiation, total thyroidectomy should be performed. Differentiated carcinomas should be treated by selective dissection of suspected cervical lymph nodes. Surgical intervention of undifferentiated and medullary carcinomas should be followed by unilateral or bilateral neck-dissection. The survival rate is shown to depend on histological stage and extension of the tumour. PMID- 6845911 TI - [Epidemiology of accidents in childhood]. PMID- 6845910 TI - [Simulation of a hypophyseal tumor in carotid-ophthalmic aneurysms]. AB - Case report. A 59 year old woman was thought to suffer from a neoplasm of the hypophysis. This "tumour" was simulated by a giant aneurysm of the infraorbital segment of the left carotid artery. For technical reasons the left carotid artery had not been demonstrated in the angiogram. For final clarification CT as well as bilateral angiography of the carotid arteries will be helpful. PMID- 6845912 TI - [Rupture of the tibial tuberosity in children and adolescents]. AB - The avulsion of the tuberosity of the tibia occurs particularly in male adolescents. Although on the whole being a rare type of injury, it is caused primarily by sports injuries following a sudden contraction of the quadriceps muscle when the knee is bent, especially when jumping. The main symptoms are loss of extensional capacity, local swelling and palpable dislocation. The radiographic differentiation from osteochondrosis of the tibial tuberosity (Osgood-Schlatter) can be difficult, especially if there is a minimal dislocation. Principally, surgical therapy is applied. Depending on the size of the bone - fragment a tension band or fixation with a spongiosal bone screw should be taken into consideration. PMID- 6845913 TI - [Hand burns in children. Personal experiences and follow-up study results]. AB - The analysis of 90 thermal injuries of the hands leads to the following statement: First and second degree burns heal spontaneously by closed wound treatment. Third degree burns demand local surgical treatment, usually according to the principle of delayed early excision and consecutive skin transplantation. Contracted scars have to be corrected early by surgical plastic. Full thickness skin transplants and flap shifting techniques provide satisfactory results. Z plastics tend to recurrent contraction. After-care for preserving the functional results is of great importance for the growing hand. PMID- 6845914 TI - [False diagnosis of acute appendicitis: visceral larva migrans syndrome]. AB - A 8 years old girl suffering from the Larva-migrans-Syndrome (Ascariasis) was operated on the false diagnosis of acute appendicitis. The cardinal symptoms of this disease are chronic eosinophilia, hepatomegaly, affection of the lungs, vague abdominal symptoms, in this case simulating acute appendicitis. Diagnostics, therapy, prognosis and prophylaxis are dealt with in detail. PMID- 6845915 TI - [Pathology and clinical aspects of non-parasitic splenic cysts]. PMID- 6845916 TI - [Biochemical studies of amniotic fluid]. PMID- 6845917 TI - [Results of treatment of functional sterility with clomifen]. AB - Our experiences in the treatment of functional sterility in 482 patients with clomiphene are reported. The dosage of clomiphene was 100 mg per day for 5 days. If treatment was without success after 3 cycles dosage was changed to 150 mg per day for 7 days. The ovulation induction rate detected by basal body temperature was 74.5%. Conceptions were obtained in 35.7%. Pregnancy was terminated by spontaneous abortion in 18.8%. In high weight patients there was the best success rate with clomiphene treatment. PMID- 6845918 TI - [Changes in the automatically analyzed features of fetal heart rate patterns and fetal movements as influenced by atropine sulfate]. AB - The influence of atropine sulphate (0.01 mg/kg body weight of pregnant women i.v.) on several parameters of fetal heart rate was investigated with automatic analysis of FHR. Fetal movements were counted, too. After administration of atropine, there was a first period with an "inverse" effect of atropine in all fetuses: decrease in baseline FHR (5.1%, minimum after 4.5 min) and increase in the amplitude of FHR fluctuation (44.6%). Thereafter, in a second period the "true" atropine effect appeared: increase in baseline FHR (15.5% above the level before atropine maximum after 25.1 min) and decrease in the amplitude of fluctuation (64.5%). In the third period baseline FHR returned to normal values but the amplitude of FHR fluctuation as well as the beat-to-beat irregularity remained small in 12 from 14 fetuses. Fetal movements registered by the mothers decreased significantly in this time. The results demonstrate a dualistic effect of atropine in the fetus. Moreover, the amplitude of FHR fluctuation (amplitude of macrofluctuation) and the beat-to-beat irregularity (microfluctuation) changed in an equal manner and appear to be influenced by similar regulatory processes. The divergence in the reaction of the baseline FHR and the amplitude of fluctuation together with a decrease in fetal movements might be caused by a central nervous effect with a change in the behaviour of the fetus. PMID- 6845919 TI - [Goniometric studies of the human placental barrier in late pregnancy in EPH gestosis]. AB - The structure of normal and toxemic pregnancy (EPH-gestosis) placenta was analysed by goniometric observation. Hitherto the most characteristic symptom of gestotic placenta demonstrable by measurements appeared to be thickening of the placental basallayer consisting of the basal membranes of the capillary endothelium and syncytiotrophoblast. Observations were now made on 20 normal placentas and on 20 ones with full-clinical gestotic symptoms. Specimens prepared by conventional methods were examined with a Philips EM 300 electron microscope, equipped with a goniometer stage. Measurements of the placental basal layer in three goniometer positions: 0 degrees, + 45 degrees, - 45 degrees, were made from negatives of electron micrographs with a final magnification 135,200 x. Data were analysed statistically using Wilcoxon's test. We also used the planimetric statistic method of Casley-Smith and Davy. We found the thickness of the gestotic placental basal layer to be significantly less than in a normal one. Ultrastructural markers of transport through the feto-maternal blood barrier were more evident that in normals. We suppose the increased placental transport and decreased thickness of the placental basal layer could be compensatory reactions to the pathological lesions of gestotic pregnancy. PMID- 6845920 TI - [Detection of secretory immunoglobulin A in cervical secretion and in cervicovaginal irrigation fluids]. AB - Secretory immunoglobulin A (S-IgA) is an essential part of local immune system of female genital tract. Accordingly the estimation of S-IgA in female genital secretions is important for judgement of immunologic problems in female genital tract. The estimation of S-IgA was carried out by means of an antiserum against human secretory component (anti SC) and S-IgA standard. It was used the single radial immunodiffusion according to Mancini and co-workers. Our results refer to changes in the quantity of S-IgA locally produced in the mucous membranes of female genital tract correlated to the menstrual cycle. The essential results are a decrease of S-IgA in midcycle in cervical mucus and vaginal fluids as well as of fertile and sterile patients. PMID- 6845921 TI - [Severe fetal hemorrhage from a vas aberrans after amniotomy within the scope of labor induction]. AB - Case report about a complication of amniotomy to be seen very seldom. An injury of a vas aberrans within the induction of labour was the cause of a fetal bleeding which indicated a cesarean section because of a pathologic cardiotocogramme. The further development of the newborn was undisturbed after primary resuscitation and fractionated blood transfusions. Incidence and meaning of pathologic insertions of the umbilical cord are represented. PMID- 6845923 TI - Isolation and characterization of ortho- and paramyxoviruses from feral birds in Europe. PMID- 6845922 TI - [Reminder: fetal hemorrhage as a complication of intranatal micro-blood sampling]. PMID- 6845924 TI - Potentiation of proliferative responses of bovine peripheral blood lymphocytes to mitogens by pronase. PMID- 6845925 TI - Comparison of seroreactivity of lentogenic, mesogenic and velogenic strains of Newcastle disease virus by enzyme linked immunosorbent and haemagglutination inhibition assays on human sera. PMID- 6845926 TI - [Serum proteins of the deer (Capreolus capreolus, L. 1758). Comparison of support and immunoelectrophoresis in single and continued long term observations]. PMID- 6845927 TI - [Transfer of the bacteriocinogenicity plasmid in mixed staphylococcal populations]. AB - The capacity of the bactericinogenicity plasmid in S. epidermidis strain NI 17 to be transferred to nonbactericinogenic staphylococcal strains in mixed populations was studied. 3 out of 22 studied S. aureus strains and 3 out of 24 studied S. epidermidis strains were found to be capable of receiving the plasmid. No recombinants could be obtained with these recipients, which was seemingly due to the presence of the restriction and modification systems in plasmid DNA. The experiments, where the variants of S. epidermidis strain NI 17, having no plasmid, but resistant to antibiotics as the result of mutation, were used as recipients, revealed that the initial strain contained at least 2 plasmids, one of them controlling resistance to cadmium ions and the other responsible for the synthesis of bactericin. PMID- 6845929 TI - [Stimulation of the multiplication of anaerobes in liver bouillon with sodium nucleinate]. PMID- 6845928 TI - [Dynamics of the ultrastructural changes in opportunistic bacteria in the suppurative wound of an autografted extremity]. AB - The electron-microscopic study of opportunistic bacteria under conditions of a suppurative inflammatory process developing in the autotransplanted extremity in white rats was carried out. The staphylococcal infection of the wound on the autotransplanted extremity in white rats was accompanied by the appearance of a capsule-like formation on the bacterial cell wall, similar to the immunoglobulin covering on the cell wall of bacteria treated with blood serum. The changes of this formation were observed in time course. After the opening and draining of the suppurative focus the contamination of the wound with Gram-negative bacteria occurred. Effective combined methods of treatment were used under experimental and clinical conditions. PMID- 6845930 TI - [Threshold doses of Staphylococcus aureus and the dynamics of leukocyte phagocytic activity in relation to the concentration of the causative agent in the blood]. AB - The study of the phagocytic characteristics of leukocytes at different concentrations of Staphylococcus aureus, carried out in 18 persons, has revealed that the mechanism of phagocytosis cannot be triggered only by the presence of the infective agent in the blood; to trigger this mechanism, the concentration of the infective agent in the blood must reach a definite liminal level (for S. aureus this level is 0.5 X 10(6) microbial bodies per ml). A further rise in the concentration of the infective agent leads to the increase of the efficiency of phagocytosis as indicated by a curve resembling the exponential logarithmic function. When the concentration of S. aureus in the blood exceeds 1 X 10(9) microbial bodies per ml, no essential effect on the increase of phagocytic characteristics is observed. PMID- 6845931 TI - [Evaluation of the toxic action of prophylactic and therapeutic preparations on cell cultures. III. The detection of toxic properties in medical biological preparations by the degree of cell damage in the L132 continuous cell line]. AB - The methods of the quality control of medical biological preparations, including tests on animals, do not ensure the complete absence of toxicity in a final product. The use of the method of "subcultures with the introduced preparation" makes it possible to determine the toxicity of both specific and nonspecific components of vaccines and sera from the number of dead and damaged cells. The toxic action of preparations kills and damages the cells at the site of injection, thus inducing the formation of autoantigens whose effect on the body cannot be predicted. Thus thimerosal, commonly used as preservative, has been found not only to render its primary toxic effect, but also capable of changing the properties of cells. This fact suggests that the use of thimerosal for the preservation of medical biological preparations, especially those intended for children, is inadmissible. PMID- 6845932 TI - [Development and use of instructional programs in the teaching of epidemiology in a therapeutics department]. PMID- 6845933 TI - [Traumatic rupture of the pectoralis major muscle]. PMID- 6845935 TI - [Suggestions for uncemented articular fossae in total hip endoprostheses]. PMID- 6845934 TI - [Total prosthesis of the hip joint in patients over 70 years of age]. PMID- 6845936 TI - [Aging of the joints]. PMID- 6845937 TI - [Static and dynamic disorders of the spine in patients with Perthes disease]. PMID- 6845938 TI - [The growth plate and bone tumors]. PMID- 6845939 TI - [Benign chondroblastoma]. PMID- 6845940 TI - [Spinocellular carcinoma in a scar after scalding]. PMID- 6845941 TI - [Coincidental bone infarction of the lower extremity and coxarthrosis]. PMID- 6845942 TI - [Microsurgical liberation and treatment of partial lesions of the radial nerve]. PMID- 6845943 TI - [Osteopathies of old age]. PMID- 6845944 TI - [Microsurgical autotransplantations in injuries of the radial nerve]. PMID- 6845945 TI - [Osteosynthesis in the hand area using the AO Poldi V kit]. PMID- 6845946 TI - Thromboembolism in cancer patients. PMID- 6845948 TI - Occasional detection of auto-anti-M antibodies in two patients. PMID- 6845947 TI - [Diagnostic bronchoalveolar lavage: technic and significance in pneumology]. PMID- 6845949 TI - [Suprahepatic manometry and transvenous hepatic biopsy: personal experience apropos of 100 cases]. PMID- 6845951 TI - Prolactin release induced by stress and the influence of oestrogen and progesterone treatments, sex and daily rhythm. AB - The effect of sex, ovarian steroids and time of the day on the release of prolactin induced by stress was studied. Albino rats were bled by heart puncture and immediately anaesthetized with ether; 10 min later they were bled again. Ovariectomized, oestrogen-primed rats showed a daily rhythm in the stress (bleeding plus ether) induced prolactin release with maximal concentration of prolactin in the serum at night (01.00 h) and minimum in the morning (09.00 h). IN ovariectomized, oestrogen-treated rats the rise of prolactin in the serum after stress was higher than in the non-treated rats both in the morning and at night. However in the afternoon (17.00 h), when the pre-stress levels of prolactin were high, the response to stress was reversed and prolactin levels declined. A similar effect was seen in the ovariectomized, oestrogen-primed rats 4 h after the injection of progesterone. In these animals the concentration of prolactin in serum was high and declined after stress. However 28 h after injection of progesterone stress failed to induce any change in prolactin release. Progesterone injected into ovariectomized, non-primed rats did not influence the response to stress. In male rats, both intact and castrated, the increase of prolactin concentration in serum after stress was lower than in females and failed to exhibit a circadian rhythm. These results show the importance of the hormonal background and the time of the day in the magnitude of prolactin release induced by stress. PMID- 6845950 TI - Methimazole-induced serum sickness. PMID- 6845952 TI - Serotonin stimulates prolactin secretion in the hypophysectomized adenohypophyseal grafted rat. AB - Normal male, oestrogen (F2) primed male and hypophysectomized adenohypophyseal grafted male rats (HAG rats) were used in the experiments. Serotonin creatinine sulphate was injected as a bolus via an indwelling atrial cannula in the conscious free moving rat. Serotonin caused a dose-dependent increase in plasma prolactin (Prl) in normal (1, 3 and 10 mg/kg serotonin) and E2 primed (1 and 3 mg/kg serotonin) male rats that began immediately after injection and reached a peak within 12-15 min of injection. Oestrogen priming significantly increased the magnitude of the response to serotonin. To analyze the site of action of serotonin in the rat, serotonin (1 mg/kg) was injected into HAG rats. Serotonin increased plasma Prl in this rat preparation, indicating that serotonin acts directly on the ectopic pituitary. PMID- 6845954 TI - Effects of triiodothyronine and nutritional status on nuclear non-histone proteins of the rat liver. AB - In the hepatic nucleus of the rat at least 2 nuclear globulin bands, identified by SDS polyacrylamide gel electrophoresis, are known to be influenced by thyroid hormones. In the present article a quantitation of these bands was obtained by scanning techniques. The effects of T3 were studied in male thyroidectomized (Tx) and intact rats. After sacrifice the hepatic nuclear globulins were prepared according to published methods. In Tx rats substituted with a single dose of 50 micrograms or during one week 2 micrograms T3 the t band decreased from 5.3% to 2.7% of the total nuclear globulin content which represent a complete normalisation. The n band did not show this rapid response to T3 as 2 micrograms given for one week only partially restored this band (Tx 1.4%, Tx + T3 2.2%). However during starvation of intact rats only the n band was slightly influenced by T3 as 2 micrograms of T3 partially prevented the decrease of this band seen in untreated euthyroid starving rats. The increase of the t band in starvation was not affected by T3. IN CONCLUSION: the n and t bands are controlled by several factors, two of which are T3 and nutrition. The control of the t band seems to be dominated by the nutritional status of the animal. T3 seems to keep some activity on the n band, even in starved rats. PMID- 6845953 TI - Oxytocin and renal function in the rat; an investigation of a possible proximal site of action. AB - Direct measurements of proximal tubular fluid reabsorption have been employed to examine the possible renal site of action of oxytocin. In whole kidney studies the natriuresis and chloriuresis, which occurred during the period of oxytocin infusion, did not coincide with the associated diuresis. The latter reached a peak 10-20 min after hormone administration has ceased. The separation in the saliuretic and diuretic responses underlines the apparent independence of these actions of oxytocin on the renal handling of water and electrolytes. The disturbances in renal function were not related to any change in glomerular filtration rate (gfr) and an examination of single nephron function failed to detect any significant effect of oxytocin on proximal tubular reabsorption. The renal actions of oxytocin would therefore appear to emanate from altered tubular rather than glomerular function, though the present study provides no support for a proximal site of action. PMID- 6845955 TI - I.V. Labetalol during coronary artery surgery. AB - The hemodynamic effects of a fixed dose of 10 mg i.v. Labetalol were evaluated in 9 CAD patients during a surgical procedure for myocardial revascularisation. The results show a significant mean decrease in heart rate (HR) (-13%), systolic blood pressure (SBP) (-16%) and rate pressure product (RPP) (-28%). Other hemodynamic parameters were not significantly affected. These results were confirmed by a clinical study where in a series of 110 CAD patients 21 were treated during the surgical procedure with incremental doses of Labetalol to control high systolic blood pressure and tachycardia. Administration of a mean dose of 24.3 mg of Labetalol resulted in a significant decrease of RPP (-38%). No side effects related to Labetalol were encountered. PMID- 6845957 TI - A nomogram for the determination of "virtual shunt" with correction factors for variations in pH, temperature and hemoglobin concentration. AB - Several nomograms are currently in use for determination of virtual shunt from a known FIO2 and PaO2. They are constructed for fixed standard values of pH, T and Hb. In the critically ill however those values often vary widely from the standard values. This may lead to substantial under- or overestimation of the virtual shunt. We therefore calculated correction factors resulting in a more precise value for the virtual shunt. PMID- 6845956 TI - Mucociliary flow in the nose during general and epidural anesthesia. AB - By means of the coloured indicator transport test (phenol red 3% in calcium hydrogen-phosphate), mucociliary function in nose and pharynx was studied in 50 patients who underwent general or ocular surgery and in 10 healthy adult subjects. Patients were anesthetized with halothane, enflurane, NLA, and epidural analgesia. At the end of surgery, mucociliary function was significantly depressed (p less than 0.001) after halothane or enflurane anesthesia, but not after NLA or epidural analgesia. Six hours following enflurane anesthesia we still found a significant depression (p less than 0.001) of mucociliary function. No difference between halothane or enflurane was noted. PMID- 6845958 TI - Pulmonary function and tissue oxygenation studies during anesthetic induction with etomidate. AB - The modifications of pulmonary function and peripheral oxygenation arising during anesthetic induction with Etomidate were studied in 36 unpremedicated patients programmed for elective surgery. The evaluation was carried out through measurement of ventilatory parameters and of the blood gases and oxygen saturation in arterial and mixed venous blood, calculation of the cardiac output, and derivation of data of peripheral oxygenation. A global reduction of the minute volume was observed with a minimal effect on the blood-gas values. The arterial blood oxygenation was reduced during the anesthesia time due to increased alveolo-arterial oxygen gradients and to increased intrapulmonary shunt. The tissular oxygenation data evidenced no significant alterations. PMID- 6845959 TI - Rapid computation of hemodynamic and renal data with a programmable calculator. Part I. PMID- 6845960 TI - Clinical application of a calculator assisted monitoring for the hemodynamic parameters. Part II. AB - This report is a brief clinical discussion about the pathophysiologic changes with four patients in shock. The hemodynamic pattern of each patient has been obtained from directly measured values on monitoring and from parameters calculated by existing formulas on a calculator HP 41C. This hemodynamic pattern has been used to formulate a pathophysiologic patient profile in shock and to have a correct therapeutic approach. PMID- 6845961 TI - Development of the cardiac blood vessels in staged human embryos. AB - Serial paraffin sections (mostly stained with hematoxylin and eosin) of 52 human embryos at stages ranging from 13 to 20 (approximate ovulation age of 5-8 weeks) were examined. The first sign of definitive blood vessels was found to be localized in the apical incisure of the heart of an embryo at stage 14. Blood vessels of this kind closely resembled 'blood islands' in appearance, being composed of primitive erythroblasts surrounded by an outer layer of endothelium. At stage 16, a funnel-like invagination of the endothelium was recognized in the posterior wall of the sinus venosus. This structure was considered to represent one of the cardiac veins (probably the middle cardiac vein). A faint endothelial sprout of the left coronary artery was detected at stage 18, while the right one was observed later, at stage 19. Finally, at stage 20, both of the coronary arteries invariably existed with a covering of mesenchymal cells. PMID- 6845964 TI - An unusual cylindrical body in interstitial cells of rat testis. AB - Testes of 6 rats were processed routinely for electron microscopy and, as an incidental finding, interstitial (Leydig) cells were found to contain bundles of unusual cylindrical bodies or macrotubules. These cytoplasmic structures were found in testes of only 2 of the 6 rats and varied in number from 2 to 346 per cell profile, usually in parallel array but with an irregular orientation in approximately 5% of the cells. The macrotubules were up to 11 microns long, showed a diameter of 130 nm with a wall of 18-20 nm and an inside diameter of about 94 nm. The wall appeared to be formed by two membranes 6-7 nm thick showing a unit membrane structure with a central electron-lucent space of 6 nm. In several instances, the wall membranes appeared corrugated, which may account for the apparent formation of the wall by a spiralling small tubule or tubules of 18 nm diameter. Several macrotubules showed continuity between their wall membranes and elements of endoplasmic reticulum and occasionally two adjacent macrotubules showed continuity at their ends in a U-form. Similar if not identical structures have been described previously in four studies of interstitial cells of the rat renal medulla, in one instance correlated with water-deprivation. They have been considered an alteration in the endoplasmic reticulum. Also, they have been reported in pig uterine glands in pregnancy. They may represent a cellular response to an unrecognized physiopathological state. PMID- 6845962 TI - Source of the colours produced in tissue slices with the MBTH reaction colour sources. PMID- 6845963 TI - Autoradiographic localization of 3H-dihydrotesterone in the reproductive organs of baboons. AB - The uptake and retention of radiolabelled dihydrotestosterone or one of its metabolites by both the male and female reproductive organs were examined in the baboon 2 male and 2 female baboons were injected intravenously with 1 micrograms/kg body weight of 3H-dihydrotestosterone and 2 animals, 1 male and 1 female, were injected with both labelled and 100 micrograms/kg body weight of radio-inert dihydrotestosterone. 1.5 h the injections, the animals were sacrificed and the uterus, cervix, vagina, uterine tube, labia minora, seminal vesicles, prostate, ductus deferens, and prepuce were removed and treated for autoradiography. The stratified squamous epithelia of the cervix, vagina, labia minora and prepuce demonstrated uptake of label in the germinative, but not in the superficial, cell layers. The columnar cells lining the uterine tube and cervical glands, but not the uterine glands, were labelled. In addition, the nuclei of the cells in the luminal epithelium of the prostate and seminal vesicles contained silver grains. The interstitial cells of the seminal vesicles, prostate and ductus deferens, and the smooth muscle of the prostate and ductus deferens, but not the seminal vesicles, demonstrated an uptake of radioactivity. PMID- 6845965 TI - An autoradiographic study of the distribution of fibers from the dorsal motor nucleus of the vagus to the digestive tube of the rat. AB - At the present time, complete agreement on the origin and course of parasympathetic preganglionic fibers to the alimentary canal has not been reached. The purpose of this study was to trace vagal fibers to the abdominal cavity and to follow the distribution of these fibers to the digestive tube. The technique used was to label neurons in the dorsal motor nucleus of the vagus (DMX) with 3H-leucine and then to follow the orthograde transport. 16 albino rats were used in this experiment. The right DMX in one group of rats and the left DMX in the other group was injected with 25 microCi of 3H-leucine in three injections. The injection sites and tissue sections from various areas of the digestive tube were processed for autoradiography. A heavy label was observed in the injection site and it could be traced down the vagus nerve through the thorax into the abdomen. Labelled vagal fibers were found in the parasympathetic ganglia of the stomach, small intestine and colon. PMID- 6845966 TI - [The arterial blood supply of the skin flap of the dorsal foot]. AB - The dorsal foot skin supplied by the arteria dorsalis pedis the dorsal venous arch, the peroneal sensory nerves and the musculus extensor digitorum brevis is a very good myocutaneous flap. The material on which the study was carried out, consisted of 20 feet from standard cadavers, injected with a mixture of terebenthene and minium through the arteria tibialis anterior. The m. extensor digitorum brevis is 6.1 cm long, 1.7 cm wide, 3.9 mm thick. It is mainly supplied by the a. dorsalis pedis and its branches: the a. tarsea dorsalis (constant) and the a. metatarsea dorsalis (12 of 20 specimens). The average diameter of the a. dorsalis pedis at the upper limit of the m. extensor retinaculum was 2.14 mm and this was chosen as the most proximal limit of the dorsalis pedis flap. The a. tarsea dorsalis was present in all the specimens, with a diameter of 0.95 mm at its origin and a length of 35 mm. On average, this artery divided into four branches to the m. dorsalis pedis. The a. metatarsea dorsalis was present in 12 of 20 specimens, with an average diameter of 0.53 mm and a length of 22 mm. On average, this artery divided into three branches to the m. dorsalis pedis. We drew three lines in the proximal, middle and distal third of each flap design and calculated the sum of arterial branch sections with our lines. We think this provides a reasonable indication of the comparative richness of the cutaneous blood supply in the flap. The mean number of cutaneous branches was 10 in the proximal third, 6.7 in the middle third (13 if branches supplying the m. extensor pedis brevis are included) and 5 in the distal third. The myocutaneous dorsalis pedis arterialized flap can be safely used as an island flap to cover the ankle or heel and as a free flap for palm defects. PMID- 6845967 TI - The lymphatic vessels of the lung: morphological study. AB - The authors studied the anatomical structures of the pulmonary lymphatic vessels in the dog and in man using injection techniques and macro- and microangiographic and histological methods. The results show that injection in the basal lobes is easier than in the apical lobes. The dog, an animal with a thin pleura, has a very dense superficial lymphatic network, like man. The superficial and the deep lymphatic vessels are connected through the pleural septa. PMID- 6845968 TI - Bone reactions to tantalum markers. A scanning electron microscopic study. AB - To elucidate intramembranous bone reactions to tantalum bone markers, 0.8-mm tantalum balls were implanted in the craniofacial region of 9 male New Zealand white rabbits. After 1, 2, 4 and 16 weeks the animals were sacrificed for SEM. Implant stability for these intervals was controlled by roentgen stereophotogrammetry. Fibrocytes and deposed fibers were seen to immediately adhere to the ball surface, getting retention in its porosities. A successively increasing bony support was observed to have intimate junctions without intervening fibers or soft tissues. No apparent differences in bone reactions were seen between the neurocranial and splanchnocranial bones. Osseointegration confirmed the inertness of tantalum to bone tissue and strongly confirms its suitability for implantation in bone. PMID- 6845969 TI - Semiquantitative analysis of rabbit knee articular surfaces based on stereomicroscopic examination of the cartilage. AB - A semiquantitative stereomicroscopic method was devised in order to examine rabbit knee articular surfaces. With the aid of a drawing tube mounted on a stereomicroscope, enlarged pictures (magnification of X 14-19) of ink-stained or SEM specimens of joint surfaces were drawn and the structural details classified. The point-counting method or a computer-coupled analyzer was used to analyze the pictures. The data thus obtained underwent statistical evaluation. The method proved to be very useful for the quantitation of experimentally induced changes on cartilage surfaces. PMID- 6845970 TI - Effects of immobilization for 6 weeks on rabbit knee articular surfaces as assessed by the semiquantitative stereomicroscopic method. AB - The effects of a 6-week immobilization period on rabbit knee articular cartilage surfaces were investigated by a new semiquantitative stereomicroscopic method following ink staining and processing for scanning electron microscopy. All surfaces of the immobilized knee joint were affected and displayed significant degenerative alterations. The knee joint contralateral to the immobilized one exhibited slight changes which could be interpreted as a sign of altered loading after immobilization. Articular surfaces of the patella and lateral condyle of the femur proved to be best suited for surface analysis on account of the small size, distinct borders and inherent evenness of the cartilage in non-treated animals. PMID- 6845971 TI - Stereographic reconstruction of human brain CT series. AB - A relatively simple method for the three-dimensional reconstruction of brain contours from a series of CT scans is presented. A procedure is described for storing the structural information obtained from the CT series and for organizing and displaying the data. Furthermore, it is shown how additional features such as standardized artery information taken from an atlas can be superimposed on the spatially reconstructed brain model. It is proposed that three-dimensional representations in the form of computed stereo pairs are quite suitable for morphological documentation of specific neuropsychological issues, such as the localization of aphasic syndromes. PMID- 6845972 TI - The microvasculature of rat salivary glands. A scanning electron microscopic study. AB - The blood vessels together with the parenchymal components of rat salivary glands were studied by scanning electron microscopy (SEM) after removal of stromal connective tissue by acid hydrolysis plus enzymatic digestion. The three dimensional vascular architecture was also studied by SEM of vascular corrosion cats. Each cluster of 4-5 polymorphous acini is connected with the convoluted duct via an intercalated duct. The convoluted duct usually has a sigmoid course and drains to the intralobular striated duct (about 20 microns in diameter); this has a rather straight course before connecting with the interlobular excretory duct. Myoepithelial cells with radiating processes were observed on the stromal surface of the secretory acini. Pericytes with longitudinal and circular processes were also observed surrounding the stromal surface of capillaries. The acini and convoluted ducts are surrounded by plexuses of capillaries derived from terminal arterioles which run along the intralobular duct system. The sinusoidal capillary plexus enveloping the striated duct receives blood from capillaries surrounding the acini and convoluted ducts through portal venules. The interlobular excretory ducts are richly supplied by a subepithelial network of capillaries which receive blood directly from the interlobular artery and drain into the interlobular vein. Thus, the excretory duct circulation is separated from the intralobular circulation. No arterio-venous anastomoses were observed in the gland. However, veno-venous and arterio-arterial anastomoses were often seen along the excretory duct; such anastomoses may participate in controlling the direction of blood flow through the vascular plexus around the excretory duct. The well-developed subepithelial plexus of capillaries observed around this duct is appropriate for its known absorptive/secretory functions. The capillary network around the acini is densest in the parotid gland and sparsest in the sublingual gland. The subepithelial capillary network of the excretory ducts of the submaxillary gland is denser than those of the other two glands which had similar densities. PMID- 6845973 TI - Ultrastructural and cytochemical studies of resorptive and digestive functions of secretory ameloblasts in kitten tooth germs. AB - Ultrastructural and cytochemical studies of kitten secretory ameloblasts were made in order to clarify their functions in the resorption and digestion of extracellular organic materials. The secretory ameloblast had triangular Tomes' processes whose profile was divided into type 1 and type 2 faces. Type 1 face was associated with tubular structures, coated pits, coated vesicles, and irregularly shaped vesicles presumably representing phagosomes. Freeze-fracture replicas clearly showed the presence of large, particle-rich depressions and small depressions on the cell membrane P face in the type 1 face of the Tomes' process. Exocytosis of secretory granules was seldom observed. In both thin sections and replicas, the type 2 face possessed cell membrane microinvaginations. From the supranuclear region to a zone near the Tomes' process, many dense bodies, multivesicular bodies, and vacuoles were present; and many of them showed intense acid phosphatase reactions. Reaction products of acid phosphatase were demonstrated in the Golgi apparatus, GERL, and the lateral cell membrane. These results suggest that kitten secretory ameloblasts resorb and digest extracellular organic materials. PMID- 6845974 TI - Motor and sensory conduction velocities and electromyographic findings in man before and after carbamazepine treatment. PMID- 6845975 TI - Asymmetric function of peripheral nerves in children with cerebral palsy. AB - Nerve conduction velocities (NCVs) in both motor and sensory nerves as well as nerve action potentials (NAPs) of sensory nerves were measured bilaterally in 24 children with cerebral palsy. The NAP amplitude and both sensory and motor NCV were on the average higher on the intact or less affected side. The NCV side difference was still present after the temperature asymmetry of the limbs had been taken into account by calculating the temperature-corrected NCV values, and was statistically significant for motor NCV in N. peroneus and for sensory NCV in N. suralis; this could neither be explained on the basis of spasticity nor by the length difference of the extremities. No correlation of NCV asymmetry with the degree of atrophy seemed to exist. PMID- 6845976 TI - THIP: a single-blind controlled trial in patients with epilepsy. AB - In an early phase-2 study, THIP (4,5,6,7-tetrahydroisoxazolo(5,4-c)pyridin-3-ol) was investigated in a single-blind controlled trial comprising 9 outpatients suffering from epilepsy. THIP was added to the concomitant antiepileptic treatment with increasing doses (15 to 120 mg/day) based on therapeutic effect or side-effects. The blood levels of concomitant therapy were kept constant. No significant difference was established between the number of seizures during treatment with maximal doses of THIP and placebo. A trend was observed for lower seizure frequency during a period on submaximal dose of THIP. PMID- 6845977 TI - Single fibre EMG in 6 cases of botulism. AB - In 6 cases of mild botulinum intoxication, conventional EMG and single fibre EMG (SFEMG) were performed on admission to our ward (about 15 days after ingestion of the toxin) and 4, 8 and 14 weeks after admission. In 4 cases, conventional EMG resulted in abnormal findings; and they normalized 4 weeks later. On the first examination, SFEMG revealed in all cases but one the occurrence of potential pairs with abnormal jitter (above 50 mus). The % of the potential pairs with abnormal jitter ranged in different cases from 17% to 44%. Some of the potential pairs with abnormal jitter showed blockings; the occurrence of blockings was not strictly related to jitter value. Mean jitter value and % of potential pairs with abnormal jitter became progressively reduced with increasing time after intoxication. Nevertheless, in 4 cases slightly abnormal findings were still present after 4 months. The data obtained in the basal condition are in agreement with those reported by others. SFEMG findings relate fairly well to conventional EMG data and clinical status. SFEMG has proved to be a very sensitive method for studying the neuromuscular transmission defect in botulism and in obtaining further information on the course of the syndrome. PMID- 6845978 TI - Vestibular neuronitis; a neurological and neurophysiological evaluation. AB - Neurological and neurophysiological findings were retrospectively reviewed in a group of 50 patients with vestibular neuronitis (VN). The onsets of VN were found to be clustered in the period from August to January. A preceding infection was reported by 36% of the patients. Neurological examinations did not reveal any other relevant signs than a spontaneous nystagmus during the acute phase. The results of routine laboratory tests and cerebrospinal fluid tests were within normal limits. EEG was recorded in 37 patients; 15 patients had a definitely abnormal EEG, with a slowing of the dominant occipital rhythm or more generalized diffuse slowing in 12 cases. 5 patients, 3 of them without slowing of the background activity, had a distinct focal disturbance of intermittent slow activity in the temporal region. In control recordings, an improvement was seen in the slowing of the background activity but not in the focal disturbances. Brainstem auditory evoked responses (BSER) were recorded in 12 patients, 5 of whom had abnormal responses. The seasonal clustering of VN onsets and the association of VN with overt infections further suggest its infectious pathogenesis. The observed EEG and BSER disturbances suggest a subclinical brainstem involvement in some cases of VN. PMID- 6845979 TI - Serum concentration of clonazepam and the therapeutic effect of the drug. AB - The effect of other anticonvulsants (phenytoin, phenobarbitone and primidone) on serum clonazepam concentrations has been studied. Serum clonazepam concentrations were measured in 47 epileptic patients in whom a dose of clonazepam (3 mg or 6 mg) was added to existing therapy. 44 patients were receiving other anticonvulsants; 3 were not receiving any other medication. Patients on low doses of other anticonvulsants showed high clonazepam concentrations. Patients on multiple therapy with high doses of other anticonvulsants showed excessive side effects on clonazepam and low serum clonazepam concentrations. We conclude that other anticonvulsants may reduce serum clonazepam concentrations and therefore that clonazepam is best given alone. PMID- 6845980 TI - Growth of abnormal neurites in atypical Alzheimer's disease. A study with the Golgi method. AB - A cerebral biopsy was performed in a 39-year-old male patient with subacute paraparesis who later developed severe dementia and moderate cerebellar involvement. The histological examination showed a marked neuronal loss, severe neurofibrillary degeneration, and a great number of senile plaques. No PAS positive plaques or amyloid angiopathy could be demonstrated. Golgi's sections showed (a) meshwork of fine dendrites located distally to the soma, (b) thick, coarse dendrites full of synaptic spines in neurons otherwise lacking these structures, and (c) thick dendrites with distal varicosities and filopodium-like processes resembling growth cones. These changes have been interpreted as acquired abnormal receptor sites and represent unique facts of a group of diseases not clearly defined, including atypical Alzheimer's disease and some cases of familiar Alzheimer's disease. PMID- 6845981 TI - Effects of GABA, glycine, and sodium barbiturate on dendritic growth in vitro. AB - Dendritic growth and dendritic arborization of both the large neurons of the cerebral and the cerebellar cortex and the small bipolar neurons were studied in vitro under normal feeding conditions and under the influence of GABA, glycine, and sodium barbiturate. By the end of week 1 the neurons cultured in normal nutrient developed primary dendritic shafts, demonstrating a tendency for bifurcation. By the end of week 2 the neurons appeared as numerous secondary dendritic branches studded with spines. The dendritic development and growth proceeded continuously until week 12 when no further growth and differentiation of the dendritic arborization was noted. Feeding medium enriched with GABA or glycine enhanced dendritic growth and dendritic arborization in vitro. On the contrary, feeding medium contained sodium barbiturate, partially suppressed dendritic growth and dendritic arborization in the neurons of the cerebral and the cerebellar explants. Ultrastructural studies revealed that sodium barbiturate partially suppressed the synapse formation between the neuronal circuits of the cortical explants. PMID- 6845982 TI - An experimental study of the pathogenesis of Grinker's myelinopathy in carbon monoxide intoxication. PMID- 6845984 TI - Element analysis of Lewy and adrenal bodies in Parkinson's disease by electron probe microanalysis. AB - Two possible interpretations of the origin of Lewy bodies and adrenal bodies found in Parkinson's disease are now under discussion: a disorder of (1) catecholamine metabolism or (2) sphingomyelin lipidosis. From the electron probe microanalysis of Lewy bodies and adrenal bodies, we find that the Lewy body contains sulfur, calcium, and phosphorus, and the adrenal body also contains these three elements. Furthermore, a positive correlation was obtained between the X-ray intensity of the sulfur and the diameter of adrenal body. For Lewy bodies, this correlation was not obtained. The results suggest that a common mechanism may exist for the production of Lewy and adrenal bodies, although they differ somewhat in their accumulation of sulfur. It is considered that both structures may originate, in part, from degenerated protein containing sulfur. PMID- 6845983 TI - Regeneration and reinnervation of the dystrophic mouse soleus muscle. A light- and electron-microscopic study. AB - The regeneration and reinnervation of the dystrophic mouse soleus muscle was investigated in response to a double crush-lesion, which causes degeneration of muscle fibres leaving the innervation intact. In normal and dystrophic muscles, injury produced degeneration of muscle fibres, proliferation and fusion of muscle satellite cells, and growth and reinnervation of regenerating fibres. Four, 6 and 21 days after injury, regenerating dystrophic fibres were 50% smaller in cross sectional area than regenerating normal fibres and showed several pathological changes. Nerve terminal morphology was initially unaffected by the crush, and nerve terminals were associated with degenerating muscle fibres 2 days after injury and with regenerating muscle fibres 6-28 days after crushing. In intact muscles dystrophic endplates were longer and showed increased ultraterminal sprouting compared to normal endplates. At 28 days after crushing normal nerve terminal sprouting was significantly increased compared to the contralateral control. The extent of nerve terminal sprouting and endplate length in dystrophic muscles was not affected by the degeneration and subsequent regeneration of the muscle fibres. We conclude that a proportion of dystrophic mouse soleus muscle fibres can regenerate after a crush when the innervation is left intact. PMID- 6845985 TI - Radiographic measurements of the femoral neck anteversion. Comparison of two simplified procedures. AB - A method for in vivo determination of the anteversion of the femoral neck in elderly or disabled patients with restricted hip mobility is described. Comparison is made with a different method for anteversion determination in a material of 20 normal hips and the results are discussed. PMID- 6845987 TI - Vascular complications after total hip arthroplasty. AB - Four cases of vascular complications in connection with total hip replacement are reported and another 25 cases from the literature summarized. Acute intraoperative injuries most often give rise to severe haemorrhage. Delayed injuries with pseudoaneurysm formation or thrombosis give rise to hip pain, distal ischaemia or haemorrhage when a prosthesis is extracted. There is a dominance of female patients and left-sided operations and cases complicated with infections and reoperations. Aetiologic and therapeutic considerations are discussed. PMID- 6845986 TI - Morphological changes in bone following intramedullary implantation of methyl methacrylate. Effects of medullary occlusion: a morphometrical study. AB - Using a computerized, semi-automatic morphometrical system, the morphological effects on diaphyseal rat femur following intramedullary implantation of methyl methacrylate were studied. Furthermore a comparison with the effects of periosteal elevation and removal of the bone marrow by suction was made. The changes in bone morphology were studied with the aid of microangiography, microradiography, fluorescence microscopy and histology. The results showed that there were evident differences between the postoperative course of the three procedures regarding vascular changes in the femoral cortex, bone remodelling and extent and duration of cortical necrosis. Implantation of methyl methacrylate caused greater vascular disturbance than elevation of the periosteum and removal of the bone marrow. PMID- 6845989 TI - Factors associated with early loosening of cemented total hip prostheses. AB - Patient data and radiograms from a series of 237 consecutive total hip replacements were evaluated by means of a computer programme in an attempt to study factors correlated with early loosening. We found that the loosening rate was significantly influenced by several factors. The CAD-prosthesis (Computer Assisted Design, Howmedica) was found to be superior to the Charnley-Muller prosthesis. The viscosity of the cement seemed to be an important factor in that low viscosity was positively correlated to loosening whereas high viscosity showed a negative correlation. Several technical details in the performance of the operations as well as loosening correlated with the surgeon. Males who preoperatively had fairly unrestricted physical activity and high body weight were more prone to early loosening. No correlation was found with the diagnosis, previous hip surgery, age, osteoporosis or cortisone treatment preoperatively. We wish to underline the importance of a thorough technique and suggest that total hip replacement should be performed by specialized surgeons. PMID- 6845990 TI - Trochanter fixation with the Dutchman's hook. AB - For nearly 30 years we have been using a special hook for reattachment of the trochanter. Its use has been evaluated in 80 hip replacements. Non-union was seen in one case. Loss of trochanteric position occurred in 9% of the hips. Trochanteric bursitis was a frequent complication (10%) and six patients had the hooks removed on that account. PMID- 6845991 TI - Teratologic congenital dislocation of the hip. Report of two cases. AB - The incidence of teratologic dislocation of the hip is about 0.04 per thousand. Teratologic CDH is usually described together with other anomalies, such as arthrogryposis. Quite different opinions about the diagnostic criteria are found in the literature; some of these are reviewed in this report. Two cases of teratologic CDH with no other anomalies are also reported. Computer tomography was used to confirm reduction in plaster when conventional radiologic examination gave ambiguous results. PMID- 6845988 TI - Screening and treatment of pulmonary embolism after total hip replacement. AB - The effect of anticoagulative treatment of pulmonary embolism was studied in 63 patients out of 348 operated on with total hip replacement. Screening diagnosis of pulmonary embolism was obtained from 99mTc perfusion scintigraphy in combination with 99mTc-microaerosol ventilation scintigraphy and chest radiogram. The administration of heparin and warfarin was associated with hemorrhagic side effects in 7 per cent. The final outcome of surgery, however, was not interfered with. Fatal pulmonary embolism occurred in one patient (0.3 per cent) in whom the diagnosis had been missed. PMID- 6845992 TI - Blood flow in the juvenile hip in relation to changes of the intraarticular pressure. An experimental investigation in dogs. AB - The blood flow in the hip joint of puppies was studied by means of the microsphere technique. The flow was determined before, during and after intraarticular pressure increase. A venous tamponade of 50 mmHg resulted in a significantly reduced flow in the femoral head and after an arterial tamponade of 150 mmHg the flow almost ceased. The proximal femoral metaphysis, the acetabulum and the hip joint capsule, on the contrary, showed varying degrees of flow increase. It is suggested that the significantly increased blood flow in the hip joint capsule during the intraarticular pressure increase of 50 mmHg and 150 mmHg is caused by an autoregulatory mechanism tending to restore the blood flow in the suffering femoral head. The demonstrated disturbance of the circulation in the juvenile femoral head after venous tamponade supports the theory that synovitis may be the basic mechanism in the production of Calve-Legg-Perthes' disease. PMID- 6845993 TI - Relationship between intraosseous pressures and intra-articular pressure in arthritis of the knee. An experimental study in immature dogs. AB - The influence of chronic synovial inflammation and effusion on the juxta articular bone haemodynamics in the juvenile knee was studied in 12 immature dogs with Carragheenin-induced unilateral arthritis. Using a fluid filled electromanometric pressure recording system simultaneous pressure measurements were taken from the distal femoral metaphysis, juxta-articular epiphyses and knee joint cavity in general anaesthesia followed by intraosseous phlebographies. During resting conditions the intraosseous pressure of the distal femoral epiphysis and the intra-articular pressure was significantly elevated. The phlebographies showed increased accumulation of contrast in arthritic femoral epiphyses with decreased contrast clearance rate. During increasing intra articular pressure an augmented vulnerability of the blood supply of the arthritic femoral epiphyses was demonstrated. The results suggests that joint effusion may play an important role in the bone changes in juvenile degenerative arthritis of the knee. PMID- 6845994 TI - Significance of endogenic factors in the location of fractures of the proximal femur. AB - The significance of endogenic factors in the localization of the fractures of the proximal femur was studied in 373 patients, with 402 fractures. A statistically significant relation was found between muscular disturbances of the affected leg and trochanteric fractures, while the incidence of femoral neck fractures was high in osteoporotic but physically active individuals. PMID- 6845995 TI - Effect of hip dislocation on the blood supply to the femoral head. An experimental study in rabbits. AB - This work consists of a series of experiments which were made in order: a) to examine the possible alterations of blood flow to the reduced femoral heads of rabbits, after inducing a closed dislocation of their hips and b) to determine the influence of the early or late reduction of the dislocated femoral heads on their blood flow. The estimations of blood flow to the normal and reduced femoral heads were made using radioactive microspheres. The findings are as follows: a) The blood flow of the femoral heads of the reduced hips was never interrupted completely. b) The initially decreased femoral head blood flow progressively increased, in association to the time elapsed from the reduction. c) No statistically significant difference was found in the femoral head blood flow between hips reduced in early and those reduced late. d) Pure traumatic dislocation of the hip can only rarely be the cause of aseptic necrosis of the femoral head. PMID- 6845996 TI - Septic sacroiliitis. An analysis of 14 patients. AB - In most joints arthritis is easily diagnosed. This, however, is not the case with infectious sacroiliitis because of the inaccessibility of the sacroiliac joint, due to the anatomic and topographic relations. Fourteen patients with septic sacroiliitis in whom the diagnosis was established between 10 and 90 days after the onset of the disease are reported for a 5-year period. All patients had scintigraphic high uptake and three patients did not show any radiographic changes. PMID- 6845997 TI - In vitro effects of external fixation on intact and osteotomized tibiae. A biomechanical study. AB - In order to study the in vitro mechanical effects of external fixation on intact and osteotomized bone, human and rabbit tibiae were tested in three-point bending in an Instron testing machine. Intact tibiae were loaded in the elastic range before and after application of an external fixation device. In the human specimens the Vidal-Adrey double frame was used, and in the rabbit specimens the external mini-fixation. The bone deformation in the anteroposterior direction was measured with a linear voltage differential transformer. After application of external fixation a median bone elastic stiffness of 110.2 per cent in human tibiae and of 106.1 per cent in rabbit tibiae was found, in relation to the stiffness of intact tibiae without external fixation. The stiffness increase was significant in human specimens, but not significant in rabbit specimens. In osteotomized human tibiae fixed with the Vidal-Adrey double frame a median stiffness of 8.5 per cent of the stiffness of intact bones was found when compression was not applied, compared to 19.9 per cent when compression was applied. In rabbit tibiae a median stiffness of osteotomized bones with external mini-fixation was 8.9 per cent of the stiffness of intact bones. There was a good agreement between the results in rabbit tibiae with the mini-fixation and human tibiae with external fixation without compression. The external mini-fixation thus seems to be a suitable model for the study of bone healing in rabbit tibiae. PMID- 6845999 TI - Amputation for tumor of the upper arm. AB - In a 10-year period 35 patients underwent a proximal amputation of the upper limb because of a malignant tumor. In 27 patients a forequarter amputation was made, in one a humeroscapular disarticulation and in seven an amputation through the humerus. The observed 5-year survival was 23 per cent. Twelve out of 23 patients followed for at least 3 years also survived 3 years. Fifteen living patients were questioned concerning prosthetic use and social and psychologic factors. Only three patients used a functional (mechanical) prosthesis and only five used a cosmetic prosthesis. The other seven patients rejected the use of a prosthesis. Half of the patients had the same occupation postoperatively as preoperatively. Activities of daily living did not constitute any major problem. One of three housekeepers needed daily help. One patient seemed to have suffered obvious psychologic damage. PMID- 6845998 TI - Myonecrotic gas gangrene of the extremities. AB - Twenty-three patients with proven myonecrotic gas gangrene of the extremities caused by Clostridium perfringens bacteria were treated by a combination of surgical measures, benzyl-penicillin and hyperbaric oxygen at three atmospheres. 87 per cent (20/23) of the cases were cured and half of the surviving patients (10) had to be amputated at least one level higher than on admission. No single factor could be established that influenced the course of the infection comparing age under and over 50 years, vascular insufficiency and normal vascular conditions, and toxicity and non-toxicity. Nor did the level of the infection of the limb seem to have any influence. The frequency of death in relation to the described variables could not be established when multi-variance analysis was used. PMID- 6846002 TI - Release surgery in stiffness of the knee. AB - Seven patients have been operated for significantly reduced motion in a knee. A standardized operative technique is described. Excision of scar tissue in the recessus superior, patellofemoral joint and anterior part of the tibiofemoral joint was necessary in all cases. But most important was the release of the retinacula and the sliding mechanism on the medial and lateral side of the joint. The mean gain in motion was 76 degrees. The result was excellent in three patients and good in four. There were no serious complications. PMID- 6846001 TI - Morphologic and morphometric studies of muscle in idiopathic scoliosis. AB - The gluteus maximus and paraspinal muscles in 15 cases of idiopathic scoliosis at the apex of the curve showed myopathic changes and a significant decrease in the type II fibers. Fiber type II atrophy was observed only on the concave side. Ultrastructure of paraspinal and gluteus muscle biopsies showed disruption of myofilaments, Z band streaming and subsarcolemmal accumulation of glycogen, lipid and mitochondria. Quantitative estimation of these subcellular organelles pointed out that a higher glycogen content was significant in both paraspinal as well as the gluteus muscles while a higher mitochondrial content was significant only on the convex side and the gluteus muscle but not the concave side of the apex when compared to normal quadriceps muscle. These findings suggest that idiopathic scoliosis is a diffuse disease process and may be considered a primary muscle disease. PMID- 6846000 TI - Increased incidence of lower limb amputation for arterial occlusive disease. AB - The number of amputations in Malmohus county with just over 500 000 inhabitants had increased from 14 to 161 during the years 1910-79 measured each fifth year comprising totally 724 observations. The number of amputations compared to the age related incidence 1979 had increased four times. Age, diabetes mellitus and sex proportions of ischemic amputees were studied and compared to other Scandinavian reports over the last 30 years. The proportion of diabetic amputees (0.37) and the male proportion (0.54) seemed unchanged, but the proportion of amputees at least 80 years old had increased from about 0.09 to 0.38. PMID- 6846003 TI - Mechanical effects of metal plate fixation. In vitro investigation on intact and osteotomized human and rabbit tibiae. AB - In order to study the in vitro stress-protecting effect on intact bone, and the rigidity of plate fixation on osteotomized bone, human and rabbit tibiae were tested in three-point bending in an Instron testing machine. Intact tibiae were loaded in the elastic range before and after metal plate application. The deformation was measured with a linear voltage differential transformer. In the human specimens a median stiffness increase of 31 per cent was obtained in the plated bone segment after application of a tibial plate (140 x 12 x 4 mm) and of 43.8 per cent after application of a femoral plate (140 x 16 x 5 mm). In the rabbit specimens a median stiffness increase of 31.9 per cent was obtained after application of a thin plate (45 x 5 x 1 mm). In osteotomized human tibiae with tibial plate fixation, a median elastic stiffness of 51.4 per cent of the intact bone was found, compared to 40.4 per cent in osteotomized rabbit tibiae plated with the thin plate. There was good agreement between the results in human tibiae plated with a tibial plate, and rabbit tibiae with the small plate. In previous studies of the stress-protecting effect of internal plate fixation on rabbit tibiae more rigid plates have been used. These plates seem to have been overdimensioned. In further studies in rabbits plates of similar size as the one tested in this study should be applied. PMID- 6846004 TI - Femur lengthening using the Wagner technique. AB - Seventeen femoral lengthenings with an observation period of 1 year or more are reviewed. The mean leg length discrepancy was 6.9 cm, ranging from 3.8 to 14.8 cm. Mean lengthening was 5.8 cm, ranging from 3.6 to 10 cm. Osteosynthesis and bone grafting was done in all cases. Nonunion occurred in one lengthening, and five bones refractured. All failures, however, healed after reosteosynthesis. Transient peroneal paresis occurred in two cases, while in one case knee flexion was reduced to 55 degrees. In spite of minor pin-track drainage, no infections complicated the osteosynthesis. It is concluded that the Wagner procedure is an effective and fairly safe method for leg lengthening. Complications, however, are frequent and great caution is essential. PMID- 6846005 TI - A high incidence of spinal curvature. A study of 100 young female students. AB - A hundred adult female students were clinically examined for scoliosis and other spinal abnormalities. Ninety-nine per cent of them participated voluntarily in X ray examination of the spine. Of the X-rays only 34 per cent were classified into group without spinal curvature. Mild curvature (3-10 degrees) was observed in 51 per cent and a curvature of 11 degrees or more in 15 per cent. The average angle of curvatures was 7.7 degrees. The incidence of 66 per cent of spinal curvatures exceeds what has been observed before. Rotation was observed in spinal X-ray in 86 per cent, but the average of rotation was the same both in spines with curvature or without. In grades of kyphosis and lordosis no difference was observed between the groups with spinal curvature and without. Mild scoliotic curvature and rotation of the spine must be seen as a normal phenomenon at least in females. What makes these curvatures progress during the growth period in idiopathic scoliosis remains to be clarified. PMID- 6846007 TI - Degeneration of the gleno-humeral joint. An anatomical study. AB - One hundred and fifty-one shoulder dissections were performed on 76 cadavera, 41 men and 35 women, with an average age of 68 (range 18-92). Before the age of 60 no degenerative changes were encountered but after 60, degeneration and full thickness ruptures of the rotator cuff, cartilage degeneration and degeneration and ruptures of the long biceps tendon appeared in an increasing frequency with age. A highly significant relationship between cuff degeneration and cartilage degeneration was found. Measurement of the thickness of normal joint cartilage of the caput humeri did not show any changes with time. Gleno-humeral degeneration was encountered bilaterally in 82 per cent and was more frequent in women, and there is little evidence that occupation is of major importance for the development of shoulder joint degeneration. PMID- 6846006 TI - Joint space in normal gleno-humeral radiographs. AB - The gleno-humeral joint space in standard antero-posterior images of 175 normal subjects was measured at three different sites. The average of the three measurements, the integral joint space, was calculated and was found to be between 4 and 5 mm. The value does not change with age, except in women, in whom it increases slightly. A narrow joint space in an elderly patient should not be expected simply because the patient is old. The measuring technique described is useful in population studies. In individual cases a simple measurement with a ruler serves the same purpose. PMID- 6846008 TI - Bristow-Latarjet procedure for recurrent anterior dislocation of the shoulder. A 2-5 year follow-up study on the results of 112 cases. AB - A follow-up study of 111 out of 112 patients operated on for shoulder joint dislocation according to the Bristow-Latarjet procedure during the years 1975 through 1979 in four Swedish hospitals is presented. The average follow-up time was 30 months (range 24-60 months). There were seven cases of significant recurrences (6 per cent). During follow-up, further surgery had been performed on four of these. Another eight patients (7 per cent) had experienced occasional insignificant subluxations. In one case neurolysis of the musculocutaneous nerve was undertaken because of postoperative paresis of elbow flexors. The average limitation of outward rotation as compared with the nonoperated side was 19 degrees in adduction and 21 degrees in abduction. There was a measurable difference in strength between the operated and nonoperated shoulders. The results were considered excellent or good by 101 of the patients (90 per cent), fair by eight and bad by three. Of 12 cases with failed surgery before the Bristow-Latarjet procedure 10 regarded the result as good or excellent. PMID- 6846009 TI - Epidemiology of fractures of the distal forearm in Oslo, Norway. AB - In Oslo in 1979, 1604 fractures were recorded in persons over 20 years of age. Eighty-three per cent were women. In men, the age specific incidence increased only slightly with age. In women, however, the incidence increased in the years around and after menopause, declining again after 75. Even after correcting for falls occurring in winter, the incidence was significantly higher than reported from Sweden and the U.K. PMID- 6846010 TI - Comminuted displaced Colles' fractures. Treatment with intramedullary methylmethacrylate stabilisation. AB - Four women aged 87, 77, 74 and 69 years with severely comminuted, displaced and intraarticular Colles' fractures of the dominant hand, where conservative treatment had failed, were treated by use of intramedullary methylmethacrylate stabilisation in order to retain optimal anatomical position of the fracture. The patients were followed by serial clinical, radiological and 99Technetium scintimetrical examinations for at least 1 year. Normal mobility of the wrist and power of the grip was obtained within 6 weeks postsurgery in all patients. Radiological cortical bone healing occurred within normal time and scintimetrically the fractures was healed within 6 weeks. No secondary displacement of the fractures occurred. It was concluded that this method might be considered in the treatment of certain severely comminuted and unstable Colles' fractures as it seem to offer a quick rehabilitation and so far no late problems. PMID- 6846011 TI - Pressure and nerve lesion in the carpal tunnel. AB - In 16 patients, where the diagnosis carpal tunnel syndrome was electrophysiologically confirmed, the pressure between the median nerve and the carpal ligament was measured peroperatively. At rest the pressure was 18-64 mmHg, mean 31 mmHg. Passive volar and dorsal wrist flexion increased the pressure about three times. Isometric or isotonic maximal contractions of wrist and finger muscles, elicited by tetanic nerve stimulation increased the pressure to three to six times the resting value. These high pressures may be one of the causes of the nerve lesion in the carpal tunnel syndrome. PMID- 6846012 TI - Experimental arthrosis. Early changes in synovial morphology and lysosomal enzyme activities. AB - The Hulth procedure was used to induce osteoarthrosis in a knee-joint in 36 rabbits, whereupon changes in chondral and synovial morphology and lysosomal enzyme activities were studied over a period of 3 months. A significant increase in enzyme activities was observed, which was more pronounced and seemed to occur earlier in the synovial membrane than in the cartilage. The synovial morphological changes were conspicuous in an early stage of the disease process and also seemed to precede the changes in chondral morphology. The results of this study suggest an important role of the synovial membrane in the pathogenesis of osteoarthrosis. PMID- 6846013 TI - Postural control in scoliosis. PMID- 6846014 TI - The tumourigenic and carcinogenic effect of 12-0-tetradecanoylphorbol-13-acetate when applied to the skin of BALB/cA and hairless (hr/hr) mice. AB - One hundred and fourteen BALB/cA and 89 hairless (hr/hr, Oslo strain) mice of both sexes were treated topically once a week on the dorsal skin for about 17 months with 18 nmol 12-0-tetradecanoylphorbol-13-acetate (TPA) in 0.2 ml acetone or with 0.2 ml acetone alone, and observed for up to 24 months. At autopsy all visible lesions and selected areas from the skin, nasal cavities and a number of internal organs were examined microscopically. Only TPA-treated animals developed epidermal tumours, i.e. squamous cell papillomas and carcinomas, which were the only tumours with a higher incidence in TPA-treated animals than in controls. The BALB/cA mice developed more epidermal tumours than the hr/hr mice. Other tumours were: reticuloses, malignant lymphomas, lung adenomas, subcutaneous fibrosarcomas, parenchymal adenomas, hemangiomas and one angiosarcoma of the liver, intestinal adenocarcinomas and one granulosa cell tumour of the ovary. Various degrees of amyloidosis in several organs, and subcapsular fusiform cell hyperplasia in the adrenal glands, occurred in both mouse strains. Kupffer cell proliferation was more prevalent in the hr/hr mice treated with TPA than in the controls. This lesion was absent in the BALB/cA strain. Hence, TPA is a weak skin carcinogen for both BALB/cA and hr/hr mice, and multiple skin applications of the dose of TPA used do not alter the frequency of spontaneous internal tumours in these mouse strains. PMID- 6846015 TI - Progression of myocardial damage following coronary microembolization in dogs. AB - The aim of the present study was to determine whether induction of ischaemic heart failure by micro-embolization leads to only a single episode of myocardial injury or whether it sets up a vicious cycle of progressive myocardial damage. Acute left ventricular (LV) failure was produced in 15 closed-chest anaesthetized dogs by injection of 50 microns plastic microspheres into the left main coronary artery. The dogs showed signs of severely depressed LV function; there was a marked increase in LV end-diastolic pressure and a marked decrease in stroke volume. Myocardial lactate uptake decreased or reversed to production. Six dogs with very high LV end-diastolic pressure died during the subsequent 3 days and autopsy revealed pulmonary edema. The LV function was re-examined in four dogs at 2 and 4 weeks after embolization. Except for a modest elevation of LV end diastolic pressure there were no haemodynamic or metabolic signs of myocardial dysfunction. Gross and light microscopic examination of the heart in dogs 8 hours to 6 weeks following microsphere injections revealed numerous small infarcts or focal areas of granulation or scar tissue throughout the entire left ventricle. At 1 to 6 weeks close to the infarcts there were scattered myocytes with strong eosinophilia and pyknosis or loss of nuclei, interpreted as myocytolysis. In two dogs killed at six weeks after the embolization there were areas of granulation tissue, similar to a recent infarction about 1 week old. Thus, in spite of apparent functional restoration there were morphological signs of repeated and progressive myocardial injury several weeks after coronary embolization. PMID- 6846016 TI - Studies on the rat liver following iron overload. A morphometrical investigation of parenchymal and Kupffer cells. AB - The lysosomal vacuome of parenchymal and Kupffer cells of the liver has been shown to be involved in the storage of iron during iron overload. In order to morphologically quantify alterations in the course of this process a morphometrical analysis of liver cells and subcellular organelles (lysosomes, autophagic vacuoles, and mitochondria) has been performed. The results showed that the Kupffer cells increased in volume density (Vv) as the cells became loaded with iron whereas other cell compartments were unaffected. The volume density of Kupffer cell lysosomes was slightly increased when expressed on "per cell" basis. However, since the volume of the Kupffer cells increased simultaneously, the total volume of the lysosomes in these cells was increased more than 100%. Parenchymal cell lysosomal Vv increased approximately 100% following iron loading. This increase in parenchymal cell lysosomes was most pronounced in periportal cells while centrilobular cells were less affected in this respect. Both Kupffer cell Vv and lysosomal Vv in Kupffer and parenchymal cells were decreased when enhanced mobilization of iron was induced by bleeding. The results agree with the notion that the increase in Vv of the lysosomal vacuome during iron overload is due to the accumulation of iron binding storage proteins. PMID- 6846017 TI - Fetal arterial involvement in Behcet's disease: an electron microscope study. AB - A fetus, 16 weeks old, was removed by hysterotomy from a patient suffering from Behcet's disease. The patient received systemic steroids during pregnancy. Electron microscopy of the fetal thoracic aorta revealed edema of the sub endothelial space and of the luminal part of the tunica media, as well as a pronounced rarefaction and disarrangement of the smooth-muscle cells. Results obtained from two human fetal aortae used as controls suggest that the fetal aortic lesions were caused by the maternal disease and not by the exposure to steroids. PMID- 6846019 TI - Electro-physiological measurements in cultured cellular spheroids. AB - Human Glioma U-118 MG and hamster V-79-379A spheroids were used as models of the nodular structure often seen in poorly vascularized regions of solid tumours. K+, Ca2+ activities and membrane potentials were measured in the spheroids, using microelectrodes. Both stable and peak values were obtained. All values were included in the analysis to allow an accurate estimate of the relative number of electro-physiologically active cells at different depths in the spheroids. The relative number of active cells decreased drastically with depth although most cells in the corresponding regions looked morphologically viable. The amplitude values of potentials and K+ activities showed, however, no significant variations with depth. The Ca2+ activity varied largely between individual cells. The relative number of proliferative cells decreased with depth in the spheroids, in parallel to the decrease in the number of electro-physiologically active cells. The results indicate that the fraction of cells, in poorly vascularized regions, having normal metabolism might be fewer than what can be estimated only on a morphological basis. Thus, the amount of cells with the capacity to contribute to growth might be overestimated when inspecting histological sections. PMID- 6846018 TI - Histopathological grading in soft-tissue tumours. Relation to survival in 261 surgically treated patients. AB - A system for histopathological grading of malignancy in soft-tissue sarcoma is described in detail, and the importance of the grade of tumour in predicting survival is demonstrated in a consecutive series of 261 surgically treated patients with sarcoma of the somatic soft tissue. Mitosis index is the main discriminating criterion. Delay in fixation, for instance in large specimens, may cause an artificially low mitosis index calling for the need of other criteria, too, reflecting grade of malignancy: cellularity, anaplasia, number of pycnotic and/or fragmented nuclei. There is a significant difference in survival between the three grades, 10 years survival with surgical treatment alone is 97%, 57% and 29% for grades 1, 2 and 3 respectively. PMID- 6846020 TI - Ploidy and proliferation patterns in colo-rectal adenocarcinomas related to Dukes' classification and to histopathological differentiation. A flow-cytometric DNA study. AB - The cellular DNA pattern in 66 colo-rectal adenocarcinomas was studied by means of flow-cytometric DNA analysis. The degree of ploidy and the proportion of cells in S-phase were related to the clinical stage according to Dukes' classification and to the histological differentiation. Multiple cell populations were found in about 60 per cent of the tumours but more frequently in advanced clinical stages. According to the DNA index the cell populations were bimodally distributed with one peak in the diploid-peridiploid region and one peak in the tri- to tetraploid region. In the second group there was a higher frequency of more advanced tumours as compared to the first. The proportion of cells in S-phase was higher in pure diploid tumour cell populations of all clinical stages as compared to normal mucosa but lower as compared to peridiploid and aneuploid cell populations with high DNA index. High as well as low S-phase values may occur in all clinical stages, but a significant higher mean value was found for Dukes' C compared to Dukes' B tumours. Distant metastases occur at all DNA indices and with various S phase values. In conclusion, tumours of different clinical stages and histological differentiation may be subdivided according to DNA index, to the existence of single or multiple cell populations and to the proportion of cells in S-phase. The biological significance of this subdivision can only be evaluated by means of clinical follow-up. PMID- 6846021 TI - A comparative study of the pharmacodynamic effects of nimodipine and nifedipine in the isolated spontaneously beating rabbit heart. AB - Myocardial effects of the calcium antagonistic drugs nimodipine and nifedipine were comparatively studied in retrogradely perfused rabbit hearts at stepwise increasing drug concentrations in the perfusion liquid within the range of 1-60 ng ml-1. Pharmacodynamic steady states developed slowly within about 25 min. at each concentration level. Nimodipine produced in comparison with nifedipine a progressive and very marked negative chronotropic effect and caused simultaneously a very pronounced increase in the QT-interval. The potency of nimodipine with regard to these effects were about 10 times that of nifedipine. The PQ-interval was only increased significantly at the two highest concentrations of nimodipine. Both drugs caused a pronounced inhibition of myocardial contractility as judged from the decrease in contraction amplitude and rate of contraction. Myocardial efficiency expressed as the ratio of contraction rate to oxygen consumption decreased progressively and highly significantly with increasing drug concentrations. The relative potency between nimodipine and nifedipine with regard to the negative inotropic effects was only about 1.7. Increasing exposure to nimodipine produced a progressive decrease of the mean coronary flow-rate, whereas nifedipine initially caused an increase followed by a terminal decrease to the initial flow-rate level. PMID- 6846022 TI - Thioamides as false melanin precursors: studies in murine melanomas. AB - Melanotic melanomas show a high rate of melanin synthesis. Foreign substances that are accepted as precursors in the formation of melanin may therefore be useful in the diagnosis and therapy of malignant melanotic melanomas, if labelled with suitable radionuclides. We have earlier reported that 2-thiouracil is incorporated in melanotic melanomas, apparently as a false melanin precursor. In the present study it is shown that methimazole and 5-iodo-2-thiouracil are as well accepted as melanin precursors. 5-Iodo-2-thiouracil is of special interest, since iodine has many clinically useful radioisotopes. The chemical properties that characterize substances which are incorporated as false precursors into melanin are discussed. A free sulfur ligand of the thioamides (2-thiouracil, 5 iodo-2-thiouracil, methimazole and thiourea are all incorporated into melanin) seems to be essential and the link between these substances and the melanin. Uracil (which lacks sulfur) and 2-benzylthiouracil (where the sulfur is blocked with a benzyl group) do not attach to melanin. Our conclusion therefore is that the thioureylene structure is the smallest common molecular fragment of the false melanin precursors. PMID- 6846023 TI - Organ levels of amitriptyline and nortriptyline in fatal amitriptyline poisoning. PMID- 6846024 TI - Central effects of lithium in rats: lithium levels, body weight and water intake. AB - Male rats received LiCl for one week either by continuous intracerebroventricular injection from osmotic minipumps or by oral administration in the diet. Control groups received corresponding treatment with NaCl. The intracerebroventricular lithium treatment produced relatively high lithium levels in brain regions (0.6 2.3 mmol/kg) and negligible lithium levels in plasma (less than 0.1 mmol/l) while the oral treatment produced moderate lithium levels in brain regions as well as in blood (0.5-0.9 mmol/kg and 0.5-0.75 mmol/l, respectively). Body weight loss and enhanced water intake occurred in groups given oral lithium treatment as well as in those given lithium via minipumps. The results suggest that administration of lithium by minipumps may be of use to study central actions of lithium. PMID- 6846025 TI - Application of a primate model for tardive dyskinesia. AB - Persistent signs of oral dyskinesia (tongue protrusion and facial grimacing) had developed as a result of earlier chronic treatment with neuroleptics in a Cebus apella monkey. When this animal was given single doses of any classical neuroleptic, a transient deterioration of dyskinesia occurred, preceded by a temporary abolishment of dyskinesia sometimes with an attack of acute dystonia. Fluphenazine (5-25 micrograms/kg) causes dose-related deteriorations of dyskinesia. Six different drugs were tested on this monkey for their capacity to elicit aggravation of dyskinetic signs: three antihistamines (brompheniramine, promethazine, diphenhydramine) and three dopamine D2 receptor antagonists (sulpiride, tiapride, metoclopramide). High doses of promethazine and diphenhydramine (5 mg/kg) induced a temporary alleviation of dyskinesia, possibly through sedation. All three D2 receptor antagonists precipitated signs of acute dystonia at some dose levels, but out of the test drugs only metoclopramide caused deterioration of dyskinetic symptoms. According to the present results only metoclopramide stands out as a drug with an inherent propensity to cause tardive dyskinesia. PMID- 6846026 TI - Potentiation of hepatotoxicity by ethanol in galactosamine-induced hepatitis in rats: role of propylthiouracil protection. AB - Chronic ingestion of ethanol (5 g/kg/day) for 6 weeks increased the hepatotoxicity of a single injection of D-galactosamine (330 mg/kg) in rats. Plasma transaminases, alkaline phosphatase, gamma glutamyl transpeptidase and sulphobromophthalein retention were consistently high in alcohol-fed rats compared to sucrose-fed controls, 25 hours after galactosamine administration. Liver histology in sucrose-fed rats revealed typical inflammatory changes and cytoplasmic vacuolation without cell necrosis was seen. Propylthiouracil treatment had no beneficial or protective effect in alcohol-fed rats in this animal model of hepatitis. PMID- 6846027 TI - Embryotoxic effects of acrolein, methacrylates, guanidines and resorcinol on three day chicken embryos. AB - Acrolein, four methacrylates, two guanidine compounds and resorcinol were tested for embryotoxicity on three day chicken embryos. The most potent chemical was acrolein, with the ED50 0.05 mumol per egg for the total effect, including deaths and malformations. The substances next in potency were N,N'-di-o-tolyl-guanidine and N,N-diphenylguanidine, with ED50 values 0.17 and 0.20 mumol per egg, respectively. Resorcinol and the methacrylates had ED50 values ranging from 2.4 to 22.0 mumol per egg. Acrolein, diphenylguanidine, tetrahydrofururylmethacrylate and trimethylolpropanetrimethacrylate caused the largest amounts of malformed embryos. PMID- 6846028 TI - The influence of orphenadrine or imipramine on the hypertensive response of physostigmine in the rat. AB - An intravenous infusion of orphenadrine or imipramine to artificially ventilated, urethane anaesthetized rats, completely blocked the physostigmine induced increase in blood pressure and the blood pressure increase induced by electrical stimulation of the posterior hypothalamus; effects mediated via the sympathetic nerve. The noradrenaline induced blood pressure increase was not changed during an infusion with orphenadrine but was markedly depressed during an infusion with imipramine. During an infusion with both orphenadrine or imipramine the pressor response induced by stimulation of the spinal cord were completely blocked in pithed rats. The pattern of the blockade was comparable with the blockade of the pressor response after hypothalamic stimulation. These results show that at least in rats both orphenadrine and imipramine prevents the central stimulatory sympathetic effects on the cardiovascular system by interfering with the sympathetic nervous system. The site of action is discussed. IN CONCLUSION: the present results show that although physostigmine may be helpful in the treatment of central anticholinergic effects caused by overdoses of orphenadrine and imipramine it is of no use for combating the direct toxic effects of both drugs on the cardiovascular system. PMID- 6846029 TI - Metabolism of safrole in the rat. AB - The urinary metabolites of safrole (4-allyl-1,2-methylenedioxybenzene) in the rat were identified using gas chromatographic - mass spectrometric methods. The amounts of the individual metabolites excreted were determined gas chromatographically. Metabolite excretion was 93% in 72 hrs and most of this material (86%) consisted of metabolites formed via demethylenation of the methylenedioxy moiety. The other metabolic routes observed were allylic hydroxylation and the epoxide-diol pathway. PMID- 6846030 TI - Relationship between catalase activity and uptake of elemental mercury by rat brain. AB - Uptake of mercury by brain after intravenous injection of elemental mercury was investigated in the rat. Catalase activity was inhibited by aminotriazole either by intraperitoneal injections affecting catalase in most tissues of the animal or by intraventricular injections affecting catalase in the brain selectively. Uptake of elemental mercury by rat brain was not influenced by intraperitoneal administration of aminotriazole resulting in 50% inhibition of brain catalase. However, when the inhibitor was injected intraventricularly in concentrations to give a 50% inhibition of brain catalase, it was shown that the mercury uptake by the brain was significantly decreased. In the latter case when only brain catalase was inhibited and the supply of elemental mercury to brain was maintained, mercury uptake by brain was proportional to the activity of catalase in brain tissue and to the injected amount of elemental mercury. Contrary to the intraventricular injection of aminotriazole, in animals receiving aminotriazole intraperitoneally prior to elemental mercury injection, we suggest that the lower activity of brain catalase is compensated by an increased supply of elemental mercury caused by the generally lower oxidation rate in the animal. This view is supported by the finding that mercury uptake by liver increased due to aminotriazole intraperitoneally although activity of catalase was depressed. PMID- 6846031 TI - Brain catecholamine metabolism changes and hypothermia in intoxication by anticholinesterase agents. AB - Sublethal doses of physostigmine, paraoxon and soman induce a short-lasting fall in rat core temperature potentiated by alpha-methyl-para-tyrosine (alpha-MT) (early effects). When the own hypothermic effect of the anticholinesterase agent has disappeared (late effects), alpha-MT induces a new decrease in temperature. Parallel biochemical studies of catecholamine levels and turnover were performed in several brain areas. The norepinephrine (NE) turnover is generally increased particularly in the hypothalamus, suggesting that NE hypothalamic changes might be linked to a latent perturbation of thermoregulatory mechanisms. Furthermore, it was shown that soman acts differently from the other drugs by inducing quite important changes in both NE and dopamine levels. PMID- 6846032 TI - Hepatic elimination of femoxetine in pig during intravenous infusion. AB - Hepatic elimination of femoxetine was studied in six anaesthetized pigs during intravenous administration. Femoxetine was given into a jugular vein as a constant infusion of 0.4-7.2 mg/min. in five pigs and as a bolus injection of 383 mg in one pig. The hepatic extraction was high (92-98%) corresponding to earlier findings of 91-99% when femoxetine was infused into the portal vein in pig or given orally to man. The urinary excretion was low, less than 5% of the dose, and the estimated extrahepatic metabolism was not significantly different from zero. PMID- 6846033 TI - Acute memory impairment following electroconvulsive therapy. 1. Effects of electrical stimulus waveform and number of treatments. PMID- 6846034 TI - A study in the relationship between emotional stability, intellectual ability, academic attainment, personal contentment and vocational aspirations. AB - This study investigated the relationship between ability, attainment and emotional stability, as measured by neuroticism, in underachieving, emotionally disturbed children. Forty children participated in four groups (mean age: 12.6, SD: 2.4; mean IQ: 103.3, SD: 13.6). Three experimental groups received different treatments in a therapeutic community, the fourth (control group) comprised children attending remedial units in mainstream education. For group 1 emphasis was on individualized education; for group 2 on psychological treatment and for group 3 on individualized education and psychological treatment combined. Pre- and post-experiment assessments were made on emotional stability, intelligence, reading, spelling and maths quotients, vocational aspirations and contentment with life. All the experimental groups showed significant improvements on all the criteria assessed. Group 3 improved most, P less than 0.001 on all criteria except contentment and vocational aspirations (P less than 0.01). The control group showed a deterioration over the experimental year on all criteria but mostly not at a significant level. PMID- 6846035 TI - Psychiatric study of 69-year-old health examinees in Stockholm. AB - Persons born in 1905 and living in the municipality of Stockholm were, in 1971, invited to a health check-up. The participants in this investigation were 3 years later invited to a follow-up-control. In this, 4,930 persons participated, i.e. approx. 50% of Stockholmers born in 1905, the original target population. In a questionnaire administered in connection with the 1974 health check-up 4% of the men and 7% of the women claimed to have symptoms suggesting a depressive syndrome. These 284 persons were examined psychiatrically, as well as 178 who had claimed the same symptoms 3 years earlier, and 127 who constituted a control group, in all 589 persons. In nearly all cases the depressed mood was judged to be a sign of neurotic condition. Severe untreated depressive states were not observed. In most cases retirement as such seemed not to have had any negative effect on the mental health of the examinees. Fifty-nine subjects stated that their mental problems had begun after the health examination in 1971, i.e. after the age of 65. The majority of subjects with mental disorders had developed their problems much earlier. It would appear that a general health control for elderly people in a major urban area does not reach those pensioners who are most depressed. PMID- 6846036 TI - The bi-seasonal incidence of some suicides. Experience from Finland by marital status, 1961-1976. AB - The seasonal variation in suicides in Finland is examined by marital status using the individual records for all suicides committed in 1961-1976 and periodic regression analysis. Suicides were usually most frequent in spring or summer, but there was an exceptional secondary concentration of suicides in the autumn period among married and widowed females, which makes the monthly pattern bimodal. Suicides among divorced and widowed males aged 15-44 years showed a unimodal variation with the peak in autumn. While an influence from certain social factors might be entertained, the reasons for the seasonal variation in suicides in general and for this anomalous bimodality in particular remain unknown. PMID- 6846037 TI - Patient attitudes towards lithium. AB - Many patients discontinue prophylactic lithium treatment against medical advice. Knowledge of patient attitudes towards lithium treatment may help explain and prevent non-compliant behaviour. One hundred and forty patients given lithium treatment from 2 to 17 years were asked what they found most advantageous about the treatment and what they found most disadvantageous. Seventy-five per cent of the patients experienced freedom from symptoms and the reestablishment of social functions in the family and in work as the main benefit of the treatment. Twenty five per cent perceived no other advantages than possibly the satisfaction of demands from the family or the doctor. Seventy per cent of the patients considered various somatic and non-somatic complaints the main disadvantage of lithium treatment and 30% found no disadvantages at all. Psychological and other non-somatic complaints related to work, training, patient status, and the administration of lithium tablets were almost as frequent as somatic complaints. The advantages and disadvantages perceived by the patients did not necessarily correspond with the physician's perception of good or bad treatment response or the presence of unwanted effects. PMID- 6846038 TI - Studies on biogenic amine metabolizing enzymes (DBH, COMT, MAO) and pathogenesis of affective illness. III. Platelet monoamine oxidase activity in endogenous depression. AB - Platelet MAO activity was determined in blood from 31 healthy persons and 43 persons with endogenous depressive syndrome. It was found that the enzyme activity is significantly higher in women than in men, both in healthy controls and in affective illness groups. Statistically significant lowering of the enzyme activity was found in the group of women with affective illness as compared with healthy women controls (P less than 0.05). Although the latter phenomenon is true of all three diagnostic subgroups of affective disorder (bipolar, unipolar, undifferentiated), it is most pronounced, and statistically significant only in the group of women with an undifferentiated course of disease. A small rise in the enzyme activity was noticed in some patients during remission, as compared with a period of depression, but this was not statistically significant. Analysis of the possible links between MAO activity and the clinical picture, or the severity of depression, revealed no significant correlations. No correlation was found between the level of MAO activity and a family history of psychiatric disturbances in general, and affective disorders in particular--in either women or in men. PMID- 6846039 TI - Acute memory impairment following electroconvulsive therapy. 2. Effects of electrode placement. PMID- 6846040 TI - Prognosis of treated hypochondriasis. A clinical study. AB - Thirty-six patients who had hypochondriacal neurosis for 6 months or longer were treated with individual psychotherapy which focused predominantly on presenting complaints, fears and beliefs. Antianxiety drugs were used at times of anxiety. Sixty-four percent either recovered or improved to the extent that they no longer believed that they had a disease. The improvement was largely maintained on a 2 year follow-up. Good outcome was associated with illnesses of less than 3 years duration, the absence of an additional diagnosis of a personality disorder and there was a nonsignificant trend to belong to a higher social class. Outcome was not associated with age, sex, or severity of initial ratings of anxiety, depression or somatic symptoms. It appears that the prognosis of treated hypochondriacal neurosis is good in a substantial proportion of patients. PMID- 6846041 TI - Evaluation of home care treatment for schizophrenic patients. AB - Twenty-seven patients diagnosed as schizophrenics suffering their first episode of illness and who had not received any prior medical treatment for the present illness, have been treated in their own homes. The treatment was carried out by a visiting nurse, trained in follow-up assessment and counselling. The outcome of this group was compared with a similar group of 27 patients who underwent initial mental hospital admission and subsequent outpatient follow-up. Both groups were followed up for 6 months. The results reveal that the home treatment through a visiting nurse gives a better clinical outcome, better social functioning of the patient and greatly reduces the burden on the patients' families. This treatment modality is also more economical. PMID- 6846042 TI - Studies on biogenic amine metabolizing enzymes (DBH, COMT, MAO) and pathogenesis of affective illness. I. Plasma dopamine-beta-hydroxylase activity in endogenous depression. AB - On the basis of studies carried out with a group of 47 patients with endogenous depressive illness, lower plasma activity of dopamine-beta-hydroxylase (DBH) was found as compared with a control group (31 healthy persons). Lower DBH activity particularly characterized bipolar patients. Lowest DBH activity was found in patients with a family history of psychiatric disorders, in particular, affective illness (in comparison with the control group the difference was statistically significant, P less than 0.05). It was noticed, that in a period of remission or significant improvement the enzymatic activity increases, although in some cases the level of activity is still lower than in the control group. There was a correlation between activity of the enzyme and clinical course of the illness and susceptibility to antidepressive drugs. Most of the observed phenomena are related to male patients. On the basis of these studies and data supplied by corresponding literature, concerning in particular the effects of DBH inhibitors (fusaric acid, disulfiram), the authors consider that changes in DBH activity may play a role in the pathogenesis of depression and that DBH deserves further studies, also of genetic nature. PMID- 6846043 TI - Studies on biogenic amine metabolizing enzymes (DBH, COMT, MAO) and pathogenesis of affective illness. II. Erythrocyte catechol-O-methyltransferase activity in endogenous depression. AB - Erythrocyte COMT activity was determined in 31 healthy persons (16 men, 15 women) and in 34 persons with endogenous depressive syndrome (12 men, 22 women). It was found that enzyme activity is significantly higher in healthy men than in healthy women. In the group of women with endogenous depressive syndrome COMT activity is elevated as compared with the group of healthy women (P less than 0.05). This is true of all forms of affective disease: bipolar, unipolar, and undifferentiated. High COMT activity in women with depression is apparent mainly in patients whose first and second degree relatives revealed psychiatric disturbances, particularly affective disorders. This supports the significance of the sex factor in the genetic transmission of affective disorders, and a possible involvement of COMT activity changes in the pathogenesis of such disorders in women. No correlation was found between the changes in COMT activity and the psychopathological picture of depression or the severity of endogenous depressive syndrome. PMID- 6846044 TI - [Ulcer disease in Yugoslavia and the world. II. Clinical observations]. PMID- 6846045 TI - [Characteristics of weather conditions in a 7-day-period showing a large number of myocardial infarcts in Zagreb]. PMID- 6846046 TI - [Trigeminal nerve syndrome]. PMID- 6846047 TI - [Evaluation of the vitality of the isolated liver and methods of preservation on the basis of pathohistological changes]. PMID- 6846048 TI - Magnesium, calcium and evoked responses in the cat's cerebral cortex. PMID- 6846049 TI - Effect of short-term administration of furosemide and triamterene on sodium, potassium and water content in cardiovascular tissues in normotensive and spontaneously hypertensive rats. PMID- 6846050 TI - Cytological and histological correlation of primary lung cancer: a preliminary study of 106 cases with resectable tumors. AB - In order to increase the accuracy of diagnosis in lung cancer, analysis concerning cytological and histological correlation was attempted. The present study consists of 106 patients, who were seen during the past approximately five years and underwent radical surgery to remove tumors completely; mere biopsy specimens were excluded. These patients were 63 years old on the average, 78 males and 28 females, 29 cases of the hilar type (H) and 77 of the peripheral type (P), and 27 and 76 cases of the clinical stage I in H and P, respectively. Histologically, there were 53 adenocarcinomas (Ad), 38 squamous cell carcinomas (Sq), 4 adenosquamous cell carcinomas (Ad + Sq), 5 large cell carcinomas (LCC), and 6 small cell carcinomas (SCC); among them, 3 Ad and 21 Sq in H, and 50 Ad and 17 Sq in P. The overall positive percentages were 65.5 (H) and 26.0 (P) by combination of spontaneous, airsol-induced and Saccomanno's methods, against 96.6 (H) and 72.8 (P) with inclusion of brushing method. 94.8% of Sq in H and 66.7% of Ad and 70.6% of Sq in P were positive by the brushing. A comparative study of these four methods, performed at least once on the same patient, also confirmed the superiority of brushing. Cyto- and histological agreement was 21/21 (100%) for Sq in H, whereas 30/34 (88.2%) for Ad and 13/15 (86.7%) for Sq in P. In conclusion, cyto- and histological findings in H and P corresponded well, and as far as cytology of peripheral type is concerned, a combined method, especially with brushing, is strongly recommended. PMID- 6846051 TI - Effect of oncogenic nitrosourea on intraocular tumor induction by adenovirus in rats. AB - Interference of oncogenic N-nitrosourea in intraocular tumor induction by human adenovirus type 12 in rats was examined. Transplacental administration of methylnitrosourea to rat embryo reduced significantly the latent period of the intraocular adenovirus tumor in each animal whereas in groups preadministered with ethylnitrosourea the decrease in the latent period showed marked individual variation. Preadministration of N-nitrosourea caused little change in the morphology and incidence of adenovirus tumors. The histological picture of adenovirus induced intraocular tumors which developed in each group of rats was that of retinoblastoma-like tumor identical to the tumor induced by single virus injection. PMID- 6846052 TI - Discriminant analysis of pulmonary function parameters--mild asthmatics versus moderate asthmatics--. AB - Maximal expiratory volume-time and flow-volume (MEVT and MEFV) curves were constructed from the measurements of young male nonsmoking, mild and moderate asthmatic patients (mean age, 29.7 yrs.). Eleven parameters of the pulmonary function tests, two MEVT, six MEFV, and three mean time constant (MTC) parameters, were calculated from the curves. These parameters were used in 15 analyses through the all possible selection procedure (APAP) discriminating between mild and moderate asthmatics. The probability of misclassification was computed with each of the eleven parameters, and all eleven probabilities thus obtained were compared with each other. This procedure showed us that the probability of misclassification ranged from 30.83% to 45.40% and that the most useful parameter was MTC50-25. The probability of misclassification computed using all eleven parameters (total parameter group) was 15.90%. The discriminant analysis indicated that the flow-volume patterns varied according the severity of bronchial asthma, thus, the flow-volume curve was considered to be important in analyzing the severity of bronchial asthma. PMID- 6846055 TI - [Erythrocyte deformability and aging]. PMID- 6846053 TI - Increase in the resistance of stenotic coronary segment by intravenous infusion of isoproterenol. AB - The effects of intravenous infusion of isoproterenol on stenosis resistance were studied in the anesthetized open-chest dog. The circumflex coronary artery (LCx) was isolated near its origin and an electromagnetic flow transducer was placed around the vessel for measuring coronary flow. A polyethylene catheter was inserted into the small branch of LCx for monitoring distal coronary pressure. LCx was constricted with a thick cotton string to a degree of obstruction that eliminated reactive hyperemia following a 20-second coronary occlusion. The coronary resistance across the stenotic segment (RL) was calculated as the pressure gradient across the stenosis divided by coronary flow. Isoproterenol was infused intravenously in a dose to keep the heart rate at a level 25-30% above the control with and without coronary constriction. For maintaining the ascending aortic pressure at the pre-isoproterenol level, the descending thoracic aorta was constricted with a tape. In the absence of coronary constriction, the vascular resistance of large coronary arteries was not affected by isoproterenol with a significant increase in coronary flow. In the presence of coronary stenosis, isoproterenol markedly increased RI regardless of additional aortic constriction. The magnitude of the increase in RL during aortic constriction varied directly with the percent increase in the pressure gradient across the coronary stenosis. Pacing-tachycardia essentially did not affect RL. These results suggest that isoproterenol increased the vascular resistance of the stenotic segment with fixed caliber. PMID- 6846054 TI - Absence of Kupffer cells in carcinogen induced liver hyperplastic nodules: demonstration by intravenous injection of indian ink. AB - Absence of Kupffer cells in rat liver hyperplastic nodules induced by a chemical carcinogen was demonstrated by intravenous injection of indian ink. Hyperplastic nodules appeared 4 weeks after diethylnitrosamine (DEN) was administered, and the nodules continued growing and became eosinophilic hyperplastic nodules after 5 to 6 weeks. After intravenous injection of indian ink, hyperplastic nodules were observed as carbon-free white nodules, which were macroscopically distinguishable from the black surrounding tissue. As observed by light microscopy, Kupffer cells were absent in hyperplastic nodules in contrast to being present in the surrounding tissue. Scanning electron microscopy confirmed these findings and furthermore revealed that the sinusoidal endothelium of hyperplastic nodules had no fenestrae. Injection of indian ink is a useful method for delineation and enucleation of hyperplastic nodules in the study of morphological and chemical changes of nodules. PMID- 6846056 TI - An overview of British urological postgraduate teaching. PMID- 6846057 TI - [Postgraduate medical education]. PMID- 6846058 TI - Reconstructive surgery for dumping: an assessment of the effectiveness of different surgical procedures by use of a physiological test meal. PMID- 6846061 TI - Treating ulcerative colitis - what to choose from the therapeutical supermarket. PMID- 6846059 TI - [Refractory arterial hypertension. Evaluation and therapy]. PMID- 6846060 TI - A case of Kawasaki disease in Portugal. PMID- 6846062 TI - Risk of myocardial infarction in Finnish men in relation to fluoride, magnesium and calcium concentration in drinking water. AB - To study the influence of drinking water composition on the risk of myocardial infarction, the following study was conducted: The cases (C), men 30-64 years of age, had been discharged with a first acute myocardial infarction (AMI) from Kotka Central Hospital. The hospital controls (HC), matched for age and type of community, were selected for each case among surgical patients. Population controls (PC), matched for age and municipality, were drawn for each case from the population register. Subjects submitted a sample of their drinking water and a filled-in questionnaire. After exclusions, a series of 50 C-HC and 50 C-PC pairs was finally constructed. The point estimate of relative risk (RR) for the association between low F (less than or equal to 0.1 ppm) and increased risk of AMI was 3.0 in the C-HC series. In the C-PC comparison, RR was 4.4 RR for low Mg (less than or equal to 1.2 ppm) was 2.0 in the C-HC comparison and 4.7 in the C PC comparison. The results are consistent with the hypothesis that both a low F and a low Mg intake are conducive to atherosclerosis leading to AMI. PMID- 6846063 TI - Studies on high density lipoproteins in fish eye disease. AB - Serum high density lipoproteins (HDL) were isolated by preparative ultracentrifugation from two patients with fish eye disease (FED). Compared to HDL from control subjects the HDL particles of FED were characterized by their abnormally small size and a relative enrichment with polar lipids. No qualitative abnormalities of the HDL apolipoproteins were revealed upon polyacrylamide disc gel electrophoresis or isoelectric focusing. The plasma pool of apolipoprotein A was reduced by 90%. PMID- 6846064 TI - The drug-consuming patient and his drugs. I. The patient. AB - Patient characteristics and pre-hospital drug consumption have been studied in 506 consecutive patients acutely admitted to a department of medicine. Women were older (median 69 years) than men (median 63 years) and weighed less (mean 60 vs. 74 kg). Serum creatinine values were above the normal limits in 110 patients (22%). Forty-eight per cent of men and 26% of women were smokers. Heavy alcohol intake was found in 12% of men and 4% of women. It is concluded that a typical patient group shows much greater variations in age, weight, renal function, smoking and drinking habits--factors all known to influence the results of drug treatment--than is generally taken into account when routine drugs are prescribed. PMID- 6846065 TI - The drug-consuming patient and his drugs. II. The drugs. AB - The drug consumption pattern and patients' knowledge about their drugs have been studied in 506 patients, acutely admitted to hospital. The patients took a mean of 3.2 drugs before hospitalization, the majority of them being used for more than one year. Calculated on all 506 interviewed patients, women took more drugs than men, but among the 406 users there was no significant difference in the number of drugs taken by men or women. The number of drugs increases markedly with age. The drugs most commonly used were digoxin (30% of the patients), nitrazepam (19%), furosemide (18%), potassium (17%) and nitroglycerin (14%). Dosage reduction with advancing age was registered i.a. for digoxin. Judging from the number of adverse drug reactions (ADRs) and subjective side-effects, the dosage reduction should probably have been even greater. Twenty-six patients (5%) were admitted because of an ADR, another 10 (2%) with an ADR. For the majority of drugs (84%) the patients had some understanding of the expected effect, but knowledge about possible side-effects was reported for 26% of the drugs only. PMID- 6846066 TI - Non-traumatic perforation of gastric ulcer in a hiatal hernia to the pericardium. AB - A patient with ulcer in a hiatal hernia with perforation to the pericardial sac is reported. The symptoms and signs of non-traumatic perforation from esophagus or stomach to the pericardium or heart are described on the basis of a brief review of the literature. A prominent feature of our patient was long-standing pain in the left shoulder. We suggest that this symptom may be a warning of threatening pericardial perforation. PMID- 6846068 TI - Selenium therapy of myotonic dystrophy. AB - A patient with myotonic dystrophy (MD) has been treated for two years with selenium and vitamin E. The serum selenium concentration and other relevant variables were continuously studied. The patient showed a marked subjective and objective improvement with increased muscular strength and regression of pathological electromyographic findings. To our knowledge, this is the first report of successful treatment of MD. PMID- 6846067 TI - An unnecessary case of paraffin oil pneumonia. AB - A 64-year-old woman died after 12 years of progressive pulmonary disease which was initially diagnosed as sarcoidosis but later correctly identified as mineral oil pneumonia due to insufflation of paraffin instilled as nasal drops. In view of the potential damaging effect of liquid paraffin on the lungs, the current indications for its use must be strongly questioned. PMID- 6846069 TI - Morphology and biochemistry. PMID- 6846070 TI - Morphology and evolution. PMID- 6846071 TI - Morphology and technology. PMID- 6846072 TI - On the morphology of creative forms and art. PMID- 6846074 TI - Morphology: its place, meaning and prospect. PMID- 6846073 TI - Morphology, its place and meaning. PMID- 6846075 TI - Suprasellar and olfactory meningiomas. Report on a series of 153 personal cases. PMID- 6846076 TI - Intracranial meningiomas in the elderly in the CT scan era. AB - Intracranial meningiomas diagnosed and operated upon in similar five-year periods before and after CT scan are analysed. In the latter period the overall number of meningiomas and the average age of the patients have increased--tumours from 77 to 186, and average age from 50 to 56. All patients but one from the first group were operated on, while only 155 from the second group underwent surgery. Operation was rejected in 31 patients for different reasons. In the pre-CT scan epoch 25% of patients who were operated on were over 60 and 9% were over 65, whereas in the CT scan era these rates have risen to 35 and 21% respectively. Mortality and good recovery rate were the same in both groups up to 65 years of age. After 65, postoperative complications and mortality increased steeply: of the patients over 65 in whom the growth was excised 55% died. The radical surgery of intracranial meningiomas in geriatric patients over 65 still remains a tremendous challenge despite all the advances in operative technique, neuroanesthesia and intensive care. On these grounds, in such patients surgical indications should be carefully evaluated. PMID- 6846077 TI - Surgical treatment of craniofacial deformities. PMID- 6846078 TI - The diagnosis and surgical treatment of intracranial arachnoid cysts. AB - Intracranial arachnoid cysts are becoming a more frequent finding as a result of the increased use of cranial computed tomography. We present 26 patients with such lesions treated surgically at the Mayo Clinic between 1970 and 1980. In children the commonest presenting symptom was cranial enlargement, whereas in adults headaches were most common. On examination, most patients were normal, although focal deficits related to the site of the lesion were not rare. Computed tomography scanning was the definitive study in essentially all the patients. Direct surgical excision was the preferred therapy in most patients. Complications included three subdural hygromas in children, one wound infection, one death from anterior spinal artery thrombosis, and one case of seizures post operatively. PMID- 6846079 TI - Extracerebral non-haemorrhagic expansive complications of intracranial surgery. AB - Extracerebral non-haemorrhagic collections of fluid and air causing significant impairment in the early period after intracranial surgery have received very little attention in the literature. Twenty-five fluid collections have been encountered, of which 17 appeared after intracerebral operations and were often in communication with the ventricular system. After extracerebral explorations supratentorial fluid collections accumulated in the Sylvian fissure or between the brain surface and the falx or tentorium in 5 cases, while a collection of fluid occurred infratentorially in the cerebellopontine angle in three cases. Intracranial air collections have been described more often after craniotomies, particularly after drainage of chronic subdural haematomas, but have not been recognized after intracerebral removal of tumours or in cases where exploration has been performed beyond the limits of the craniotomy in the presence of high intracranial pressure. Improvement after reoperation occurred most promptly in the cases with fluid collections, while additional factors often seem to play a more significant role in the cases with postoperative intracranial air. PMID- 6846080 TI - Unilateral microsurgical approaches to extramedullary spinal tumours. Operative technique and results. AB - The operative technique of limited approaches to extramedullary spinal tumours is described. The results after unilateral approaches are as satisfying as after standard laminectomies. The rationale of attempting an unilateral approach is to avoid damage to the dorsal static structures of the vertebral column. Access given by limited approach and possibilities of enlarging the bony defect depending on the topographical situation of the tumour are discussed in detail. It is emphasized that the dura should be opened only over the tumour in order to avoid protrusion of the cord. PMID- 6846082 TI - CT imaging in lumbar disc disease. The value of multiplanar reconstructions. AB - A CT/T 8800 (General Electric) CT scanner was used to study lumbar disc disease in fifty patients. In seven patients so-called computed tomography metrizamide myelography was performed, whereas in the remaining cases no contrast enhancement was used. Multiplanar reconstructions were done. Irradiation exposure was measured during the investigations and compared with data during conventional myelography. We found that lumbar CT scanning is not a screening method in cases of lumbar disease, but the aimed use gives further information about the underlying process and its differential diagnosis. Multidirectional reconstructions reduce the number of diagnostic errors. This procedure does not increase the radiation exposure dose in comparison with conventional myelography. PMID- 6846081 TI - Differential diagnosis and therapy of herniated thoracic disc. Discussion of six cases. PMID- 6846083 TI - Nerve grafting in compression lesion and neuritis of the radial nerve. Case report. PMID- 6846084 TI - Treatment of hypertension with labetalol in neurosurgical practice. Influence of labetalol on cerebral perfusion pressure in dogs without and with intracranial mass lesions. AB - In neurosurgical patients autoregulation of cerebral perfusion is often lost. Therefore, a sudden increase in blood pressure may lead to an increase in cerebral blood flow and cerebral oedema may follow. The influence of labetalol, a new alpha- and beta-adrenoceptor blocking agent, on intracranial pressure and cerebral perfusion pressure was investigated in dogs without and with mass lesions. During hypotension with labetalol the intracranial pressure remained unchanged and the cerebral perfusion pressure decreased to the same extent as mean arterial pressure (30%). Labetalol seems to be suitable to treat hypertension perioperatively in neurosurgical patients but it is not a suitable drug for induced hypotension. PMID- 6846085 TI - Arterio-venous epidural shunting in epidural bleeding radiological and physiological characteristics. An experimental study in dogs. AB - In order to test the possibility suggested in previous studies that the long bleeding time and the large bleeding volume observed in experimental epidural bleeding can be explained by the development of an arterio-venous shunt, water soluble X-ray contrast was injected into the epidural space in dogs during an epidural bleeding in progress. It was found that the contrast medium left the epidural space through diploic veins in the cranial bone to the neck veins. By draining off epidural blood the arterio-venous shunt counteracts the intracranial pressure tamponade developing in intradural bleeds and thus prolongs bleeding. Perfusion experiments showed the absorption capacity for saline to be about 20 times as large in the epidural space as in the CSF space. While there was no apparent absorption limit for blood in the epidural space the absorption capacity for blood of the subarachnoid space became progressively saturated, leading to a continuously increasing CSF outflow resistance and CSF steady-state pressure. A theory for the formation of epidural haematoma is proposed which in essence implies that the epidural shunt is a major determinant of the clinical outcome of an epidural bleeding. PMID- 6846086 TI - Affective disorders in the elderly: diagnostic and research considerations. AB - Although depressive disorders in the elderly represent a major public health concern by virtue of their high cost in human suffering, disability, and potential suicide, they have not been studied extensively, and specific criteria for diagnostic classification and optimal treatment are lacking. It seems likely that many of the affective syndromes in the elderly like senile melancholia, manic depressive illness, pseudodementia, and masked depression belong to the group of endogenous depressions, and can be identified by a constellation of clinical symptoms (endogenous or endogenomorphic profile), abnormal dexamethasone suppression test (DST) (at least 50%), and positive response to treatment with antidepressant medication. The rest are depressions reactive to psychogenic or sociogenic factors frequently presenting agitation as a dominant symptom, and finally there is a group of organic depressions due to underlying organic brain change, (i.e. senile dementia). It is possible that careful psychometric and psychiatric evaluation based on the symptom pattern, DST, and response to treatment would reveal reliable differences between pseudodementia and mild dementia and distinguish endogenomorphic from non-endogenomorphic depressions, respectively. The validity of such an approach remains to be demonstrated. Biological research in this area has provided valuable findings and should be the aim for the 1980s. PMID- 6846087 TI - Dementia in old age and the need for services. AB - A randomly selected sample of subjects aged 65 years and over was investigated to determine the prevalence of dementia. The sample, which was stratified by age, consisted of 559 subjects living in the community and institutions. It was estimated that 7.7% of those aged 65 years and over suffered from dementia. The disorder affected both sexes equally. There was a marked increase in the prevalence with age so that in those 80 years and over the prevalence rate of dementia was found to be 19%. Those suffering from dementia were significantly more likely to be receiving institutional care than those with normal intellectual function. Those with dementia used significantly more domiciliary services than did those with normal mental function and were more likely to require additional services not already provided. There was a particular need for district nursing supervision, day care and relief admissions. The high prevalence rate of dementia in the elderly, and the high use those suffering from the disorder make of both domiciliary and institutional services, should be appreciated in the planning of services for the elderly. PMID- 6846088 TI - Coronary care in the elderly. AB - Over a five-year period (1974-78), 2947 patients were admitted to the Coronary Care Unit, Victoria Infirmary, Glasgow, and it was confirmed that 1474 of these patients had had a myocardial infarction. Over 70% were of state pensionable age, that is women over the age of 60 years and men over 65 years. No difference was found in the incidence of successful resuscitation from primary ventricular fibrillation following acute myocardial infarction between the under-60-year-old and over-70-year-old age groups. Further, this study did not show any rise in mortality, with age, following acute myocardial infarction. PMID- 6846089 TI - The significance of cardiac arrhythmias in the aged. AB - Twenty-four-hour ambulatory electrocardiography was performed in 25 young and 29 active elderly subjects. Sinus bradycardia and sinus arrhythmia were common in the young but uncommon in the elderly. Ventricular and supraventricular premature beats and brief runs of supraventricular tachycardia were common in the elderly but uncommon in the young. Complex ventricular arrhythmias only occurred in the elderly but brief episodes of nocturnal Wenckebach AV block were quite common in young and old alike. No significant difference in arrhythmia frequency was found between elderly subjects with heart disease and those without heart disease or between elderly subjects without symptoms and those with non-episodic symptoms such as dizziness. None of the arrhythmias in the young or elderly subjects was associated with symptoms. In follow-up at 30 months, only one elderly subject was deceased (from pneumonia) and none had suffered a stroke or heart attack. It is concluded that transient cardiac arrhythmias are commoner in the elderly than in the young. However, their long-term significance remains unknown, but it is likely that they are relatively benign. PMID- 6846090 TI - Digoxin kinetics in the elderly. AB - Digoxin elimination phase kinetics have been studied in 24 hospital in-patients (mean age 79 years), six of whom showed no evidence of digoxin toxicity. The others, with suspected toxicity, have been grouped according to the nature of the drug effects observed. Renal function, digoxin elimination half-life, apparent volume of digoxin distribution, and notional body content of digoxin have been compared between the groups. Apart from two hyperthyroid patients, the volumes of distribution averaged 6.1 1/kg. Toxic patients tended to have lower creatinine clearances, longer digoxin half-lives, and higher body contents of digoxin than the nontoxic, but the highest body contents were found in those with systemic toxicity. Thyrotoxicosis increases the apparent volume of digoxin distribution in the elderly. PMID- 6846091 TI - Reality orientation with elderly patients in the community: an empirical evaluation. AB - There is now good evidence that elderly mentally impaired patients can be re orientated for time, place and person using the technique of reality orientation (RO). To date, all empirical trials demonstrating this have been carried out on elderly institutionalized patients. This technique however might be of greater value to those elderly dementing patients still living with relatives in the community but attending geriatric psychiatry day hospitals, where they could receive RO in a consistent and systematic way. The results of an empirical study of RO with a group of such patients is reported. These showed that day hospital patients could be effectively re-orientated and that concomitant with changes in level of orientation of the patients, there were parallel changes in the patients' behaviour at home, reported stress on relatives and in relatives' mood. PMID- 6846092 TI - Cholecystectomy and colon cancer in the elderly. AB - The incidence of colon cancer is increasing in Sweden. This is partly due to the increase of the older segments of the population. Various risk factors, such as diet, low serum cholesterol and, more recently, cholecystectomy have been found. Earlier studies, particularly regarding cholecystectomy, were carried out on in patients of varying ages. In this longitudinal study, a representative sample of people investigated at the ages of 70 and 75 was analysed with regard to earlier cholecystectomy. Twenty-two per cent of women and 11% of men at the ages of 70 and 75 years were found to have had this operation. A relationship between cholecystectomy and colon cancer was found for women but not for men. The cholecystectomized women had low serum cholesterol values. The female colon cancer cases were related to a high body weight. Cholecystectomized individuals can be regarded as a special group with risk factors for colon cancer. PMID- 6846093 TI - Electrophysiological investigation of peripheral neuromuscular disorders in the elderly. PMID- 6846094 TI - Proprioception and spatial neglect after stroke. AB - Proprioception and neglect were studied in 287 patients surviving up to one week after the onset of their stroke. The presence of proprioceptive loss indicated a more extensive lesion and a larger proportion of these patients had impairment of intellectual function, motor power in the upper and lower limb, and postural function. Proprioceptive loss also had an adverse effect on the level of independence achieved by discharge, final placement, mortality and length of stay in hospital. In 87% of the survivors recovery of proprioception had occurred by eight weeks. Significant neglect was associated with high mortality and poor outcome for functional recovery. PMID- 6846095 TI - Hyponatraemia in the elderly. AB - A study of hyponatraemia in the in-patients of a Geriatric Department during a 10 month period showed that 77 patients (11.3%) had plasma sodium concentrations below 130 mmol/l. Thirty-one patients (4.5%) had severe hyponatraemia of less than 125 mmol/l. Seventy-three per cent of hyponatraemias were iatrogenic caused by diuretic or intravenous fluid therapy. Hydrochlorothiazide/amiloride combination has the greatest tendency to produce hyponatraemia compared to all other diuretics (P less than 0.01). Clinical features attributable to hyponatraemia were present in 61%. Nine patients needed hospital admission solely due to hyponatraemia. The mortality rate for hyponatraemia was twice the overall rate for the unit. PMID- 6846098 TI - [Biosynthesis of glycosaminoglycans by chick retinal pigment epithelium in vitro. II. Studies on labelled samples]. PMID- 6846096 TI - Circadian rhythm of immunoglobulins in aged persons. AB - A circadian rhythm with a high statistical probability was detected for IgA, IgG and IgM in a group of 37 aged subjects. These rhythms have a peak (acrophase) in the early afternoon, around 13h00, with variable confidence interval, which may extend between 8h30 and 17h30. The double amplitude of rhythms is approximately 15% of the mean concentration of antibodies during the day (mesor). No statistical difference was observed in mesor, amplitude or acrophase between males and females or in association with age (below or above 75 years) or in mean concentration of immunoglobulins (inside or outside the adult standard reference value at 8h00). PMID- 6846097 TI - [Effect of topical diclofenac sodium, a non-steroidal anti-inflammatory drug, on various ocular inflammatory models in animals]. PMID- 6846100 TI - [Angioarchitectural studies of canine optic nerve. Report 1: Gelatin injection technique]. PMID- 6846099 TI - [Objective and quantitative evaluation of the cone function by the rapid off response in electroretinogram. 1. Operating curve of the rapid off responses from normal subjects]. PMID- 6846101 TI - [The biometry of each thickness of the human retina, choroid and sclera by using ultrasound and Fourier analysis. High myopia]. PMID- 6846102 TI - [The biometry of each thickness of the human retina, choroid and sclera by using ultrasound and Fourier analysis--at the foveola]. PMID- 6846103 TI - Vitamin E and the heart: possible role as antioxidant. AB - When cardiac muscle becomes hypoxic the cells become oedematous and the fine ultrastructure is altered. Developed tension declines and resting tension increases. The cellular stores of ATP and CP are depleted and the mitochondria exhibit an altered respiration, characterized by a reduced state III respiration and a lowered respiratory control index. Reoxygenation results in a further increase of the hypoxic damage. Using these changes in function as indices of the severity of the damage caused by hypoxia and reoxygenation, we have investigated whether the administration of alfa-tocopherol provides protection. Adult male New Zealand white rabbits were used. The hearts were isolated, Langendorff perfused and then made hypoxic. Alfa-tocopherol acetate was infused directly into the aorta inflow cannula, 20 minutes before the onset of hypoxia and was continued for the remainder of the perfusion. Hypoxia was established by substituting 95% N2 and 5% CO2 + CO2 in the gas mixture. The alfa-tocopherol-treated rabbits hearts were protected in that during hypoxia and particularly during reoxygenation had a lower rate or rise of resting tensions and of ATP and CP depletion. This treatment also maintained mitochondrial function after hypoxia and reoxygenation and it resulted in the preservation of the fine ultrastructure of the myocardium as electronmicroscopic examination of the hearts revealed a marked reduction in oedema, contracture-band formation and mitochondria alterations. PMID- 6846105 TI - Studies on the mechanism of retinoid-induced adhesion of spontaneously transformed mouse fibroblasts. AB - Transformed cells (Balb/c, 3T12-3), induced to increase their adhesion to the substrate by treatment with retinoic acid, display higher incorporation of (2 (3)H)-mannose into both lipids and glycoproteins than untreated controls. Stimulation of (2-(3)H)-mannose incorporation into manno-lipids is evident 8 hr after exposing the cells to retinoic acid, and stimulation of tritiated mannose incorporation into glycoproteins occurs slightly later. SDS-PAGE of (2-(3)H) mannose labelled glycoproteins indicates that both retinoic acid and retinol treatments stimulate the incorporation of the radiolabelled sugar into a glycoprotein with subunit MW 180,000 (Gp 180) and, to a lesser extent, into other glycoproteins. 3H-leucine incorporation into a protein banding at the same position as the 3H-mannose labelled Gp 180 does not appear to be affected by retinoid treatment. A retinoic acid induced increase in the amount of Gp 180 can also be shown by lactoperoxidase catalyzed radioiodination of cultured 3T12 cells, and controlled trypsin digestion experiments indicate that Gp 180 is a component of the cell surface. On the contrary, the increased cell adhesion to the substrate induced by retinoic acid is not accompanied, in this system, by an increase in the amount of fibronectin, as judged by iodination of the cell surface components followed by SDS-PAGE. PMID- 6846104 TI - Colorimetric estimation of vitamin B1 in pharmaceutical preparations. AB - A simple colorimetric method of estimation of thiamine from various pharmaceutical formulations is reported. Thiamine forms a yellow coloured complex with para-aminophenol in ammonia medium. The complex is extracted in chloroform (lambda max. 430 nm). The Beer's law is obeyed from 1.5 to 10 micrograms/ml. PMID- 6846107 TI - Encopresis in children and adolescents. AB - Encopresis is usually secondary to constipation but is sometimes associated with a primary behavioral disorder or a functionally incompetent anal sphincter. Although rare, an underlying organic disorder must be excluded. Encopresis secondary to constipation is treated with mineral oil, with the dosage titrated to individual needs. Adjuncts to therapy include dietary manipulation and stool softeners. PMID- 6846106 TI - Effect of vitamin A deficiency on pulmonary and hepatic protective enzymes in rat. AB - Rats were fed diet with or without vitamin A for 5-6 weeks. Vitamin A deficiency had differential effect on the activities of protective enzymes in lung and liver. Superoxide dismutase activity was reduced significantly in lung, whereas remained unchanged in liver, in vitamin A deficient group. Catalase activity was reduced both in lung and liver by inducing vitamin A deficiency. On the other hand, vitamin A deficiency resulted in significant increase in the activity of glutathione peroxidase in lung and had little effect in liver. NADPH dependent lipid peroxidation, as measured by TBA products, remained unaltered, both in lung and liver in vitamin A deficient animals when compared to control group. These results suggest that vitamin A deficiency does not seem to predispose lung and liver to the injurious effects of oxygen toxicity in vivo. PMID- 6846108 TI - Erysipelas. AB - Erysipelas is a superficial cellulitis that affects the skin and subcutaneous tissues. There is also prominent lymphatic involvement. Group A streptococci are the usual cause of this painful infection, but the responsible organisms cannot always be cultured from the fiery red, edematous, sometimes vesicular rash. A fulminating case developed in the left leg of a man whose veins had been harvested four months earlier for coronary artery bypass surgery. PMID- 6846109 TI - Practical use of therapeutic physical modalities. PMID- 6846110 TI - Anergy and delayed hypersensitivity skin testing. AB - Delayed hypersensitivity skin tests, when properly planned and performed, are both practical and sensitive in determining the status of cell-mediated immunity. They can be diagnostic of specific exposure, such as tuberculosis, or they can rule out anergy. Pitfalls include poor selection of antigens, inappropriate application and poor timing of test interpretation. The transparent tape method is preferred for recording the results. PMID- 6846111 TI - The medical significance of the obstetric history. AB - A carefully obtained obstetric history can provide the family physician with useful clues to his patients' health risks. A previous infant's birth weight and certain congenital malformations may indicate a predisposition to vascular hypertensive or diabetic illness. Additionally, if the family physician knows when his patients are planning pregnancies, he can help reduce exposure to teratogens during early pregnancy by discontinuing medications such as warfarin and phenytoin, by controlling blood glucose levels in diabetics and by counseling against the use of alcohol and tobacco. PMID- 6846112 TI - Aortic dissection. PMID- 6846113 TI - Prevention of ventricular fibrillation by bretylium in a conscious canine model of sudden coronary death. AB - In anesthetized dogs, a silver wire electrode was inserted into the lumen of the circumflex coronary artery (LCX) and myocardial infarction was produced by a temporary 90-minute occlusion of the left anterior descending coronary artery (LAD) followed by reperfusion. Four days later while in the ambulatory state, a 150 microA current was applied to the intimal surface of the LCX of saline (n = 10) and bretylium (n = 10) treated animals. Intimal injury and coronary thrombosis produced ST segment changes at 138 +/- 39 minutes (chi +/- SEM), followed by premature ventricular beats (at 142 +/- 37 minutes), ventricular tachycardia (at 156 +/- 49 minutes), and ventricular fibrillation (at 163 +/- 51 minutes) in 9 of 10 saline-treated animals. In bretylium-treated animals, ST segment changes appeared at 128 +/- 35 minutes, with six animals surviving for 24 hours (p less than 0.03 vs saline). LAD infarction was present in both saline (14.1 +/- 2.3%) and bretylium (15.1 +/- 2.1% of left ventricle) treated animals with only bretylium-treated animals developing LCX infarcts (16.1 +/- 2.1%). Bretylium prevents ventricular fibrillation (VF) resulting from ischemia at a site distant to prior myocardial infarction in the conscious dog and deserves further attention as a potential antifibrillatory agent for prevention of sudden coronary death in man. PMID- 6846116 TI - Effects of direct-current electrical shocks on systolic and diastolic left ventricular function in dogs. AB - Although direct-current (DC) electrical shocks do not significantly alter left ventricular systolic performance, their effects on ventricular diastolic properties and the role of sympathetic stimulation in maintaining postshock contractility are unknown. Accordingly, we studied both diastolic and systolic left ventricular performance in seven open-chest dogs before and after three consecutive 50 joule DC shocks applied directly to the heart. High-fidelity left ventricular pressure and segmental dimensions were recorded as pressure was varied systematically under conditions of beta-adrenergic blockade. The exponential left ventricular end-diastolic pressure-segment length relationship was not significantly altered by electrical shocks. Likewise, pre- and postshock beats matched for loading conditions did not differ in peak positive dP/dt, end systolic segment length, or percentage of segment shortening, although mean normalized shortening rate decreased by approximately 11% (p less than 0.05). However, the time constant (T) for isovolumic pressure fall, an index of the rate of left ventricular relaxation, increased after shocks in all animals (T = 42.2 +/- 5.3 and 51.1 +/- 7.0 msec before and after shock, respectively; (p less than 0.01). We conclude that high-energy electrical shocks applied directly to the heart cause modest slowing of left ventricular relaxation but do not have important effects on left ventricular compliance or on systolic myocardial performance. These data suggest that DC shocks have only minor functional consequences when applied to normal hearts, even when sympathetic compensation is prevented. PMID- 6846115 TI - Reduction of ventricular ectopic beats with oral acebutolol: a double-blind, randomized crossover study. AB - The antiarrhythmic efficacy of oral acebutolol, a new cardioselective beta blocking agent, was assessed in a randomized double-blind, placebo-controlled study. Twenty-five patients with greater than or equal to 30 ventricular ectopic beats (VEB) per hour on three control ambulatory monitorings were studied. Mean VEB reduction from the control period was 35% with placebo and 45% and 50% with the use of acebutolol 200 mg and 400 mg, respectively. Eleven patients had greater than or equal to 70% reduction in VEB with acebutolol and nine of them had greater than or equal to 90 VEB reduction. Among these 11 patients, the mean VEB suppression was 51% after placebo but significantly higher following the two doses of acebutolol at 71% (p less than 0.05) and 86% (p less than 0.01). The mean reduction of paired VEB compared to placebo was 71% (p less than 0.05) and 75% (p less than 0.01) following 200 mg and 400 mg of acebutolol and only 49% after placebo. Complete suppression of paroxysmal ventricular tachycardia was also noted in five patients. Mean PR interval only increased slightly when patients took 400 mg of acebutolol, but there was no significant change in either the QRS or QTc intervals. A significant decrease in heart rate from that during control periods was noted after acebutolol. No significant adverse reactions were noted during the study. Acebutolol appears to be an effective and well-tolerated antiarrhythmic agent in the treatment of VEB and higher grades of ventricular ectopy. PMID- 6846117 TI - Dysrhythmia comparison in apparently healthy males during and after treadmill and acceleration stress testing. AB - Maximal treadmill exercise stress testing and centrifuge +Gz-acceleration stress testing are both known to be dysrhythmogenic. A comparison of the effects of these two stresses on 60 healthy men was performed. The 60 individuals were divided into three groups of 20 each. One group was made up of healthy volunteer members from the United States Air Force School of Aerospace Medicine acceleration stress panel. The other two groups were asymptomatic USAF aircrewmen undergoing aeromedical evaluation for newly discovered dysrhythmias (dysrhythmia group) and for other aeromedical abnormalities (nondysrhythmia group). The effect of these two stresses on the poststress cardiac rate and rhythm were also evaluated by means of 24-hour Holter monitoring. Both stresses were observed to induce dysrhythmias with approximately the same frequency in the two patient groups; but, with the panel members who experienced higher +Gz stress, the centrifuge stress induced more dysrhythmias than did treadmill exercise stress. The stress-induced changes were limited to the period of stress and did not significantly affect cardiac rate or rhythm in the poststress 24-hour period. Certain dysrhythmias were more commonly associated with centrifuge stress. Centrifuge acceleration stress testing apparently is as safe as maximal treadmill exercise testing. For USAF high-performance fighter pilots who are routinely exposed to repeated high sustained +Gz stress during aerial combat, it is imperative to assure that they are not predisposed to +Gz-induced dysrhythmias which could cause sudden inflight incapacitation. Centrifuge stress testing is therefore a valuable tool in the aeromedical evaluation of these aircrewmen. PMID- 6846114 TI - Failure of bretylium to suppress inducible ventricular tachycardia. AB - Five patients with recurrent, life-threatening ventricular arrhythmias were given bretylium tosylate intravenously for a minimum of 4 days. Arrhythmias were not related to acute ischemia in any patient. Four patients had inducible ventricular tachycardia, and one patient had inducible ventricular fibrillation requiring cardioversion while taking no medications. Programmed electrical stimulation was then repeated to assess the ability of bretylium to suppress inducible ventricular tachycardia. Bretylium tosylate, at a mean dose of 2.3 mg intravenously per minute, did not suppress inducible ventricular arrhythmias in any patient. Rapid ventricular tachycardia was induced in all patients, and ventricular fibrillation was induced in one patient. Two patients required external cardioversion to terminate their arrhythmias. Bretylium tosylate, given in relatively large doses chronically, did not suppress inducible ventricular arrhythmias in these five otherwise drug-refractory patients with chronic recurrent ventricular tachycardia. This failure to suppress inducible ventricular arrhythmias cannot be attributed to the initial catecholamine release which occurs in the first hour or two after the drug is administered. PMID- 6846118 TI - Bundle branch block in acute myocardial infarction. AB - The management of patients with acute myocardial infarction complicated by bundle branch block is a significant clinical problem and represents 8% to 13% of patients with acute infarction. This study reviews the records of 606 patients with myocardial infarction admitted to our coronary care unit. Forty-seven (8%) had complete bundle branch block. The risk of developing high-degree AV block in these 47 patients was reviewed. There are no established therapeutic guidelines for patients with pre-existing bundle branch block and left bundle branch block in acute myocardial infarction. We found a high risk of progression in patients with pre-existing bifascicular block in the presence of anterior wall infarction (25%) as well as in patients with left bundle branch block with acute anterior wall infarction (100%). On the basis of our data and careful review of the literature, we recommend prophylactic pacemaker insertion in these high-risk groups. PMID- 6846119 TI - Myocardial infarct extension: prevalence, clinical significance, and problems in diagnosis. AB - To examine the prevalence, clinical significance, and problems in the diagnosis of myocardial infarct (MI) extension, 103 patients with acute MI were studied. Each patient underwent enzymatic infarct sizing in the initial 72 hours and then had quantitative CK-MB (myocardial isoenzyme of serum creatine kinase) analysis at 8-hour intervals over the remaining hospitalization. In addition, daily standard 12-lead ECGs and documentation of prolonged (greater than 15 minutes) resting ischemic chest pain were recorded. MI extension, by CK-MB methods, occurred in 32 (31%) of 103 patients at 5.9 +/- 0.3 days after initial infarction. ECG changes suggesting MI extension occurred in 14 (14%), but only six of these patients had extension by CK-MB. Similarly, recurrent chest pain following initial MI occurred in 28 (27%), but enzymatic extension was evident in only 11 of these patients. MI extension resulted in significantly greater early in-hospital mortality (16%) compared to those patients without MI extension (2.8%, p less than 0.05). Thus MI extension occurs commonly and may explain some early in-hospital deaths post MI. The usual clinical and ECG diagnostic parameters utilized are insensitive indicators of enzymatic MI extension. PMID- 6846120 TI - Evaluation of systolic time intervals in patients with angina pectoris. AB - We have explored the systolic time intervals of 52 patients with angina pectoris at the time of their hospitalization in our wards. Our results are in close agreement with published data, essentially indicating prolongation of the preejection time and shortening of the ejection time. These alterations of systolic times can be interpreted pathophysiologically as as expressing reduced myocardial contractility. The long PEP-short LVET polygraph picture, occurring in the course of chronic ischemic heart disease, reveals the deficit of myocardial contractility at a stage of the disease at which clinical evidence of left ventricular failure is usually not yet detectable. PMID- 6846125 TI - Verapamil improves exercise capacity in chronic atrial fibrillation: double-blind crossover study. AB - Oral verapamil has previously been shown to reduce heart rate at rest and during mild exercise in chronic atrial fibrillation. Its efficacy in improving cardiovascular performance at higher levels of exercise and its safety were investigated in a prospective, randomized, placebo controlled double-blind study preceded by an open label titration phase in 20 digitalized patients with chronic atrial fibrillation. Maximal exercise capacity was improved (from 522 +/- 257 to 806 +/- 348 work units, p less than 0.0005) when tested by a standardized multistage ergometry exercise test. Heart rate was also reduced at rest, at the end of 3 minutes of 300 KPM exercise, and at the point of maximal exercise. Blood pressure and double product were also reduced. Its efficacy and safety may make verapamil the treatment of choice in chronic atrial fibrillation. PMID- 6846124 TI - Radionuclide analysis of ejection time, peak ejection rate, and time to peak ejection rate: response to supine bicycle exercise in normal subjects and in patients with coronary heart disease. AB - Using equilibrium radionuclide angiography, we evaluated the ejection time (ET), peak ejection rate (PER), and time to peak ejection rate (TTp) at test and during supine bicycle exercise in 39 subjects, divided into three groups: group 1 = 13 normal subjects; group 2 = 10 patients with a previous infarction (MI); and group 3 = 16 patients with coronary disease without a previous MI. Normal subjects had greater ejection fractions and PERs than the other two groups at rest or peak exercise (p less than 0.05). PER was no more useful than ejection fraction in identifying cardiac dysfunction at either rest or exercise. The time of its occurrence varied with the group studied, and was slightly but significantly later in systole in groups 2 and 3 when compared to normals (p less than 0.05), though substantial overlap between groups occurred. During exercise, absolute ET shortened in all groups, but actually increased as a function of the R-R interval. The time to peak ejection rate (normalized for the R-R interval) was greater in the noninfarct group (group 3) patients (p less than 0.05) when compared to the group 1 or group 2 individuals at peak exercise. In conclusion, equilibrium radionuclide angiography is a useful technique for the quantification and characterization of events during systole, and is capable of providing information on the timing of events during ejection. Tardokinesis, or the delay of ventricular ejection, is not seen in the response of global indices of left ventricular function to exercise stress. While global early systolic indexes may not detect regional dyssynchrony, their timing during stress may occasionally aid in discerning the presence of cardiac dysfunction. PMID- 6846121 TI - Adverse effects of febrile state on cardiac performance. AB - The hemodynamic characteristics of 36 febrile patients were studied when temperature was greater than 100 degrees F and after resolution of fever (temperature less than or equal to 100 degrees F). The patients were divided into those with bacterial infection (group I, n = 26) and those whose fever was noninfectious in etiology (group II, n = 10). Analysis of patients likely to have coronary artery disease (CAD) (subset A, n = 12) and those unlikely to have CAD (subset B, n = 7) was carried out. To maintain constant preload, pulmonary artery wedge pressure varied by not more than 2 mm Hg in all patients. Resolution of fever was associated with a 23% increase in stroke volume index (SVI) and 37% increase in left ventricular stroke work index (LVSWI) for group I (p less than 0.01). Group II showed a 27% increase in SVI and a 38% increase in LVSWI (p less than 0.05). Both subsets A and B showed significant increases in LVSWI after resolution of fever. We found evidence of decreased left ventricular performance during the febrile state in patients with and without infections. Since all groups and subsets maintained a normal or high cardiac index associated with increased heart rate during the febrile state, the tachycardic response of the febrile patient may serve to maintain cardiac output when myocardial performance is impaired. PMID- 6846122 TI - Extravasated erythrocytes, iron, and fibrin in atherosclerotic plaques of coronary arteries in fatal coronary heart disease and their relation to luminal thrombus: frequency and significance in 57 necropsy patients and in 2958 five mm segments of 224 major epicardial coronary arteries. AB - The presence of extravasated erythrocytes (EE), iron (I), and fibrin (F) within coronary atherosclerotic plaques and their relation to intraluminal coronary thrombus was determined in 2958 five-mm segments of 224 major epicardial coronary arteries in 57 patients with fatal coronary heart disease and in 1290 five-mm segments of 103 coronary arteries in 27 control (c) subjects. Intraplaque EE were present in 10% of the segments (controls [c] = 1%), in 35% of the arteries (c = 5%), and in 84% of the patients (c = 19%); I was present in 4% of the segments (c = less than 1%), in 14% of the arteries (c = 4%), and in 57% of the patients (c = 22%); intraplaque F was present in 2% of the segments (c = less than 1%), in 17% of the arteries (c = 3%), and in 63% of the patients (c = 7%). Intraluminal thrombus, present only in the patients with acute myocardial infarction and in none of the controls, occurred in 3% of the segments, in 8% of the arteries and in 26% of the patients. Intraplaque hemorrhage or EE occurred usually in the absence of intraluminal thrombus and conversely intraluminal thrombus occurred more frequently without than with underlying plaque hemorrhage. The frequency of intraplaque EE, I, and F was proportional to the amount of coronary atherosclerotic plaque present. Intraplaque I and F infrequently were observed in the absence of EE. The significance of extravasated erythrocytes, iron, and fibrin in atherosclerotic plaques remains unclear. PMID- 6846126 TI - Detection of pulmonary venous flow by pulsed Doppler echocardiography in children. AB - Parasternal pulsed Doppler echocardiographic examinations of the left atrium were prospectively performed in 14 pediatric patients, aged 2 weeks to 8 years, in order to characterize the left atrial flow pattern in children. None of the patients had clinical or cardiac catheterization evidence (9 of 14 patients) of either mitral regurgitation, right-to-left shunts at the atrial level, or anomalies of pulmonary venous drainage. In all 14 patients, a systolic-diastolic positive velocity pattern could be recorded within the left atrium. Furthermore, this pattern was more readily detected in those children with left-to-right shunts. We conclude that continuous positive velocity patterns are commonly recorded in the left atria of children and probably represent pulmonary venous return. Demonstration of this signal is contingent on proper orientation of the transducer with respect to pulmonary venous flow. PMID- 6846123 TI - Effects of cardiac rehabilitation after myocardial infarction: changes in coronary risk factors and long-term prognosis. AB - Prognosis during 5 years of follow-up after first myocardial infarction (MI) in a group of men (aged 40 to 55 years) was related to risk factors determined at the time of MI. Progression of coronary artery disease (CAD) was measured by the occurrence of severe angina pectoris, recurrent myocardial infarction, and cardiac death. Only smoking and serum cholesterol level influenced prognosis. It was possible to identify a subgroup (patients smoking less than 20 cigarettes/day and having a cholesterol level of less than 7.0 mmoles/L) with low risk for progression of CAD. A randomly applied 6-week rehabilitation program shortly after MI was associated with a 50% decrease in progressive CAD when compared to the control group. Since only a slight decrease in cholesterol levels was found in the rehabilitation group, a direct effect of the rehabilitation program could thus not be excluded because the second important risk factor, smoking, did not show differences between the two groups. The smoking habits at the time of MI determined the continuation of cigarette smoking and rehabilitation did not influence smoking habits. PMID- 6846129 TI - Osler-Weber-Rendu disease with multiple intrahepatic arteriovenous fistulas. PMID- 6846130 TI - Acute fulminant aortic regurgitation in ankylosing spondylitis. PMID- 6846127 TI - Observations on the relationship between digital heat loss and systemic hemodynamics in patients with heart disease. AB - A concomitant study of finger heat discharge and systemic hemodynamics was undertaken in a series of 19 patients (mean age 54 years) suffering from various forms of heart disease. Finger heat discharge, as measured by calorimetry, was found to correlate significantly with mean circulation time (-0.760), cardiac index (+0.649), systemic vascular resistance (-0.615), stroke work index (+0.649), mean pulmonary artery pressure (-0.596), mean pulmonary capillary wedge pressure (-0.554), stroke index (+0.541), appearance time (-0.502) and mean right atrial pressure (-0.453). There was no significant correlation between finger heat discharge and mean arterial blood pressure, LV dp/dtmax, and heart rate. An effect of heart failure on finger heat discharge was found. When evidence of forward failure and also possibly backward failure was found, mean finger heat discharge was significantly diminished. When both forward and backward failure were present together, mean finger heat discharge fell still further. PMID- 6846128 TI - Transvenous pacing in pediatric patients. PMID- 6846131 TI - Adverse effects of long-term amrinone administration in congestive heart failure. PMID- 6846132 TI - Spontaneous ventricular flutter and fibrillation during quinidine medication. PMID- 6846133 TI - Hemodynamic study of nifedipine administration in hypertensive patients. PMID- 6846134 TI - Disopyramide-induced QT prolongation and ventricular tachyarrhythmias. PMID- 6846135 TI - Mechanisms of lidocaine toxicity. PMID- 6846136 TI - Selective (beta-1) blockade in congestive cardiomyopathy. PMID- 6846137 TI - Long-term antianginal efficacy of sotalol. PMID- 6846138 TI - Arrhythmogenic properties of paradoxical sleep. PMID- 6846139 TI - Dynamic QRS variations in Wolff-Parkinson-White syndrome: electrocardiographic and clinical observations. PMID- 6846140 TI - Angina pectoris without ST-T changes in patients with documented coronary heart disease. PMID- 6846141 TI - An outbreak of acute fever among steam turbine condenser cleaners. AB - Ten of twelve men who participated in the cleaning of an electric power steam turbine condenser clogged with freshwater sponge experienced an acute febrile illness. Two similar outbreaks have been previously described, one of which has been attributed to the Legionnaires' Disease bacterium. Epidemiologic studies of this case showed a syndrome very similar to the two previously reported episodes. However, the exact etiology for this outbreak has not been identified. Environmental sampling was not initiated until after the cleaning was completed. Subsequent testing did not reveal any likely cause for the outbreak. The delayed onset of symptoms and the nature of the illness pointed to an infectious agent. In the absence of any suitable criteria for employee exposure evaluation, it is suggested that crews cleaning condensers under unusually dirty conditions, especially if eye or respiratory symptoms are reported, should be provided with respiratory protection. PMID- 6846142 TI - Exposures to respirable, airborne Penicillium from a contaminated ventilation system: clinical, environmental and epidemiological aspects. AB - Symptoms compatible with hypersensitivity pneumonitis (HP) in two of fourteen employees in a clerical office prompted an investigation of their work environment. Forced-air heater-cooler units which had not been properly maintained were implicated when they were found to be grossly contaminated with predominantly Penicillium molds. Air-sampling for viable, respirable-size particulates in the affected office and an unaffected office in the same building demonstrated a 50- to 80-fold excess in the number of colony-forming-units per cubic meter of air in the affected office. Persistent alveolitis was documented by repeated bronchoalveolar lavage, gallium scan, and other studies in one affected worker whose peripheral lymphocytes underwent blast transformation in response to Penicillium antigens obtained by air-sampling in the work environment. The other affected worker had asthma, presumably exacerbated by exposures to a variety of inhaled environmental irritants and antigens. Despite a documented reduction of airborne fungi to background exposure levels after clean up of the forced-air units, the worker with persistent alveolitis has had occasional recurrences of symptoms consistent with HP. Further research is needed to establish health guidelines for control of occupational and non-occupational exposures to respirable fungal organisms which may contaminate cooling, heating and humidifying systems in these settings. A multidisciplinary method of approach to such research is described. PMID- 6846143 TI - Evaluation of emissions from simulated commercial meat wrapping operations using PVC wrap. AB - Meatwrapper's asthma is an elusive health problem with a suspected relationship to exposure to emissions from polyvinyl chloride (PVC) film cut with a hot wire. A study was conducted to determine how the type of wrap cutter (wire or rod) and its temperature affected the emissions from a simulated occupational wrapping process. The cutting temperatures covered the same range as was measured in Boston retail food stores. A commercial wrapping machine and samples of commercial PVC meat and produce wraps were used. Seventy five percent of the particulate from the hot wire was respirable, and the quantity of emissions was a strong function of the film tension and cutting technique. Particulate emissions did not increase steadily with increasing wire temperature, but plateaued or declined at high temperatures. Particulate emissions from the rod cutter were very low at low temperatures, but exceeded those of the wire at temperatures above 200 degrees C. The particulate was 100% dioctyl adipate (DOA, the plasticizer in the wrap) with wire temperatures below 200 degrees C, and was approximately 80% DOA for temperatures above this. Gaseous HCl was not detected in emissions from a hot wire operated below 150 degrees C, but HCl emissions increased rapidly to a plateau for temperatures above 200 degrees C. Approximately 20% of the HCl produced at temperatures above 200 degrees C was associated with the particulate, which appeared to act as a carrier and transport the HCl through water filled impingers. Field tests are needed to determine if particulate produced in the workplace may also behave as a carrier for HCl. PMID- 6846144 TI - An innovative approach to sampling complex industrial emissions for use in animal toxicity tests: application to iron casting operations. AB - Sampling of complex mixtures of airborne contaminants for chronic animal toxicity tests often involves numerous sampling devices, requires extensive sampling time, and yields forms of collected materials unsuitable for administration to animals. A method is described which used a high volume, wet venturi scrubber for collection of respirable fractions of emissions from iron foundry casting operations. The construction and operation of the sampler are presented along with collection efficiency data and its application to the preparation of large quantities of samples to be administered to animals by intratracheal instillation. PMID- 6846145 TI - Physiological responses to one-handed lift in the horizontal plane by female workers. PMID- 6846146 TI - Formaldehyde in office and commercial environments. AB - The objective of these investigations was to determine a potential cause for occupational discomfort and illness in various nonindustrial situations. Since exposure to commonly used industrial chemicals was nonexistent from a job related situation, the physical environment was the only clue to potential agents. The offices had urea-formaldehyde resin products present as a common factor. Airborne measurements showed presence of formaldehyde in extremely low concentrations and well within the OSHA Standards. Current studies are examining the formaldehyde levels for various nonindustrial exposures reported. PMID- 6846147 TI - Captan exposure in apple orchards. PMID- 6846150 TI - Industrial hygiene career planning. PMID- 6846149 TI - Perceived exertion of physical effort for various manual handling tasks. AB - Ten trained male students between 18 and 28 years of age participated in a study, designed to determine the relationship between perceived exertion and physiological costs of exertion during various manual lifting and lowering tasks. Perceived exertion was defined as one's subjective rating of the intensity of work being performed. Five subjects performed lifting tasks and another five performed lowering tasks. Weight of load lifted or lowered (6.8, 13.6, 20.5 kg), frequency of lift or lower (3, 6, 9 times/min), height of lift or lower (floor to 76 cm, 76 to 127 cm, floor to 127 cm), box width (38, 66 cm), box length (38, 66 cm) and angle of twist of the body (0 degree, 90 degrees) were the independent variables studied. Heart rate, oxygen consumption, and ratings of perceived exertion (RPE) were the response measures. RPE was found almost linearly related to heart rate and oxygen consumption when lifting or lowering loads. For lifting tasks, the coefficient of correlation between RPE and heart rate was 0.673. In the case of lowering tasks, this coefficient was 0.604. When oxygen consumption was considered, the corresponding coefficients for lifting and lowering were 0.734 and 0.619, respectively. The correlation of RPE with the physiological response variables indicates that the severity of manual materials handling tasks in industry can be evaluated quickly and inexpensively by using perceived exertion ratings (RPE). PMID- 6846148 TI - A simple dynamic flow-through exposure system for assessment of biological activity of complex organic mixtures to mammalian cells in vitro. AB - A system for in vitro exposure of lung epithelial cells and Chinese hamster ovary cells maintained at an air-medium interface to volatile organic compounds has been developed. The system has been used for exposure of cells to phenol (vapor pressure at 40 degrees C = 1.6 mm Hg) and to a complex mixture of organic compounds (vapor pressure range at 32 degrees C = 0.17 to 269 mm Hg). A linear relationship was found between vapor generator air flow rate (0.25 to 1.0 L/min at 39 degrees C) and exposure chamber phenol concentration. The relationship between generator air flow rate (0.5 to 1.0 L/min at 39 degrees C) and concentration of the complex mixture in the exposure chamber was also linear. Gas chromatographic analyses of chamber exhaust indicated that a majority of the compounds present in the crude mixture had been volatilized and made available to the cells in the chamber. This exposure system appears suitable for screening of complex mixtures of volatile organic pollutants for biological activity in mammalian cells in culture. PMID- 6846151 TI - A single feed system for maintaining different vapor concentrations in two inhalation chambers. AB - Two different concentrations of the same vapor can be maintained in adjacent dynamic inhalation chambers by using a single feed system which incorporates constant feed air flow rates and efferent tubes of unequal dimensions. For a given set of efferent tubes, the ratio of the air flow rates exiting the feed system and the resultant ratio of chamber concentrations vary as biexponential functions of the net negative pressure applied across the feed system. Depending on efferent tube dimensions and the negative pressure applied across the system, concentration ratios in the two chambers can be varied from 1:1 to 1:10. Three separate 30-day exposures were conducted using the system and observed mean daily vapor concentrations were within 3% of target concentrations. PMID- 6846152 TI - Effects of discontinuing maintenance digoxin therapy in patients with ischemic heart disease and congestive heart failure in sinus rhythm. AB - To evaluate the importance of oral maintenance digoxin therapy in chronic congestive heart failure (CHF), 24 patients in sinus rhythm on maintenance digoxin for documented CHF were studied prospectively on and off the drug. The average duration of therapy was 39 months (range 2 to 180). All 24 patients had documented coronary artery disease (CAD): 22 were in New York Heart Association functional class III and 2 in class II. Twenty-one patients (88%) were receiving diuretic or vasodilator therapy, or both, before digoxin discontinuance. At 1 month off digoxin and with no increase in doses of other medications excepting minor increases in antianginal therapy in 2 patients, no difference was observed in the group as a whole in symptoms, resting heart rate, arterial blood pressure, physical findings, weight, cardiothoracic ratio, radiographic signs of pulmonary congestion, radionuclide left ventricular ejection fraction (LVEF), duration of symptom-limited treadmill exercise (14 patients), or CHF score, compared with evaluation during maintenance digoxin therapy. Similar results were obtained in a subgroup of 9 patients with a resting LVEF less than 0.35 (0.27 +/- 0.02; mean +/ standard error of the mean). Six patients had a decrease and 5 patients an increase in LVEF of greater than or equal to 0.05 units after cessation of digoxin. Off digoxin, the CHF score increased by only 1 point in 2 patients, but also decreased in 2 patients. Thus, in this study population comprised of patients with CAD with documented CHF, most of whom were receiving diuretics or vasodilators, or both, digoxin withdrawal had no adverse clinical or hemodynamic effects. PMID- 6846154 TI - Prognostic and predictive value of exertional hypotension in suspected coronary heart disease. AB - The prognostic and predictive value of exertional hypotension was assessed in 1,241 patients having treadmill maximal exercise testing, coronary arteriography, and follow-up averaging 5.4 years. Medically treated patients with coronary artery disease (CAD) with exertional hypotension had poorer survival than did those without such hypotension; however, maximum systolic pressure during exercise was a more powerful predictor of survival. Patients with exertional hypotension had more extensive CAD and more left ventricular (LV) dysfunction than did patients who had an increase in blood pressure with exertion; these findings probably account for the impaired survival. However, exertional hypotension, was an insensitive indicator of significant left main coronary artery stenosis, 3-vessel disease, or severe resting LV dysfunction. PMID- 6846153 TI - Enhanced detection of proximal right coronary artery stenosis with the additional analysis of right ventricular thallium-201 uptake in stress scintigrams. AB - The value of right ventricular thallium-201 analysis in detecting proximal right coronary artery stenosis in exercise myocardial scintigraphy was analyzed in 52 patients, 27 with and 25 without proximal right coronary artery stenosis. For the detection of proximal right coronary artery stenosis, the sensitivity and specificity of thallium scintigraphic analysis were 59 and 88% for a right ventricular abnormality, 67 and 68% for a left ventricular inferior wall abnormality, and 93 and 56% for an abnormality of either. When both right and left ventricular thallium images were abnormal, all 9 patients had proximal right coronary artery stenoses, and when both were normal, 26 of 28 patients had a normal proximal right coronary artery. The sensitivity and specificity of blood pool scintigraphic variables during exercise (right ventricular ejection fraction and left ventricular inferior wall motion) were not significantly different for detection of proximal right coronary artery stenosis. Thus, the additional analysis of the right ventricle on thallium-201 stress scintigrams can improve the detection of proximal right coronary artery stenosis. When both right ventricular and left ventricular thallium scintigrams are abnormal (or normal), the ability to predict the presence (or absence) of proximal right coronary artery stenosis is very high. PMID- 6846156 TI - Role of myocardial ischemia in the genesis of stress-induced S-T segment elevation in previous anterior myocardial infarction. AB - This study tests the hypothesis that myocardial ischemia is responsible for exercise-induced S-T segment elevation in patients with previous anterior myocardial infarction (MI). Exercise stress testing in conjunction with thallium imaging of the myocardium was performed in 28 patients with previously documented anterior MI. Thallium images were analyzed by computer for the presence of initial uptake defects and evidence of abnormal clearance of the isotope from the myocardium (that is, imaging evidence of ischemia). Total S-T segment elevation (sigma ST) in precordial leads V1 to V6 at rest was subtracted from sigma ST at peak stress in order to quantitate the extent of S-T elevation induced by stress (delta ST). Two groups of patients were identified; 1 with stress-induced S-T elevation (Group I, delta ST greater than or equal to 4.0 mm) and 1 without this abnormality (Group II, delta ST less than 4.0 mm). Evidence of abnormal thallium washout from myocardial scan segments occurred in 12 of 15 Group I patients versus 9 of 13 Group II patients (difference not significant). In addition, abnormal tracer washout from anterolateral or septal scan segments occurred in 5 patients in each group. Likewise, abnormal thallium clearance from inferior or posterior scan segments occurred in 8 of 15 Group I patients versus 7 of 13 Group II patients (difference not significant). The patient with the greatest amount of stress-induced S-T elevation (S-T 11.5 mm) had no evidence of ischemia during the stress test. However, Group I patients did have larger anterolateral plus septal initial thallium uptake defect scores than did those of Group II (10 of 15 with defect score greater than or equal to 350 in Group I versus 1 of 13 in Group II, p less than 0.002). Similarly, resting left ventricular ejection fraction greater than or equal to 30% was present in only 4 of 15 Group I patients versus 13 of 13 in Group II (p less than 0.001). Finally, multiple stepwise linear regression analysis demonstrated that delta ST correlated best with the extent of initial anterolateral plus septal thallium uptake defect score (F = 17.3, p less than 0.001) and to a lesser extent with resting ejection fraction (F = 5.2, p less than 0.05) and change in heart rate from rest to peak stress (F = 8.1, p less than 0.01; corrected multiple correlation coefficient = 0.76, p less than 0.001). Thus, in patients with previous anterior MI (1) exercise-induced myocardial ischemia occurs as often with as without S-T segment elevation, (2) myocardial ischemia is not required for the production of stress-induced S-T segment elevation, and (3) stress-induced S-T elevation primarily reflects the extent of previous anterior wall damage and to a lesser extent an increase in heart rate between rest and peak stress. PMID- 6846155 TI - Relation of segmental wall motion to global left ventricular function in acute myocardial infarction. AB - The relation of left ventricular regional wall motion to global ventricular function was evaluated by radionuclide ventriculography in 127 patients within 18 hours of acute myocardial infarction. No patient had evidence of previous myocardial infarction. The following parameters were measured: (1) wall motion index; (2) percent of abnormally contracting segment; (3) ejection fraction (EF); (4) end-diastolic volume (EDV) and end-systolic volume (ESV); and (5) peak systolic cuff pressure/end-systolic volume ratio (PSP/ESV). The measurements of global function correlated well with wall motion index (r = 0.83, p less than 0.001 for EF; r = -0.69, p less than 0.001 for ESV; and r = 0.061, p less than 0.001 for PSP/ESV), but EDV correlated less well (r = -0.35, p less than 0.001). Multiple linear regression analysis revealed that EF correlated best with wall motion index, and no other parameters of global left ventricular function added significantly to the regression. The correlation of motion in each segment with EF was determined by multiple linear regression analysis. Ejection fraction correlated best with motion in the anterobasal, then in order of correlation, in the apical-septal, inferoapical, anterolateral, and superlateral walls. The relation of EDV, ESV, and degree of percent abnormally contracting segments was as follows: EDV did not increase with a mild regional wall motion abnormality; however, ESV did increase and reduced stroke volume. As percent abnormally contracting segments worsened, enlargement of both EDV and ESV was seen and was associated with further reduction in systolic volume. These data suggest that EF is the best global left ventricular function correlate of the severity of the regional wall motion abnormality, and that abnormal motion in the territory of the left anterior descending coronary best predicts reduction in global left ventricular function. Radionuclide ventriculography is useful in characterizing global and regional left ventricular function in the early hours of acute myocardial infarction. PMID- 6846157 TI - Enzymatic estimation of myocardial infarct size when early creatine kinase values are not available. AB - Estimates of myocardial infarct (MI) size based on plasma creatine kinase (CK) are used widely for prognosis and in the assessment of therapy designed to salvage ischemic myocardium. However, if the initial plasma CK activity is elevated, MI size will be underestimated. To determine the impact of loss of early CK values on estimates of MI size and to develop a procedure to compensate for it, estimates of MI size based on complete and incomplete MB and total CK time-activity curves from 120 patients (experimental group) were compared. Estimates of MI size based on data inclusion intervals beginning at 24, 12, 8, and 4 hours before peak CK were 11, 14, 23, and 47% smaller than values based on complete CK curves, but the correlation was good between complete and incomplete estimates of MI size at any given interval, with r values ranging from 0.91 to 0.98. The derived correction factors were then prospectively applied to a new population (n = 25) with complete CK curves to compensate for purposely omitted early CK values. The corrected estimates of MI size were within 7% of those based on the complete CK curves. Similar results were obtained for transmural and nontransmural and anterior or inferior MI. Thus, if peak plasma CK is known, underestimation of MI size can be compensated for despite the unavailability of early CK values. Since greater than 90% of patients present before plasma CK has reached its peak (24 hours), MI size can be obtained in nearly all patients. Thus, being able to correct for unavailable early CK values makes MI size a more widely applicable endpoint for use in clinical trials and patient management. PMID- 6846158 TI - Cardiokymography during exercise testing: a new device for the detection of coronary artery disease and left ventricular wall motion abnormalities. AB - The cardiokymograph (CKG) is a device that has been shown to reflect left ventricular (LV) wall motion abnormalities. Its accuracy in detecting coronary artery disease (CAD) during treadmill exercise testing was assessed in 204 consecutive patients undergoing coronary arteriography. Of the 188 patients with a technically adequate CKG, 146 (78%) had significant CAD. The sensitivity and specificity were similar for both the exercise electrocardiogram (ECG) (66% and 86%, respectively) and the exercise CKG (73% and 95%, respectively). An abnormal exercise CKG was significantly more common in patients with 3-vessel CAD than in those with 1-vessel disease (97% versus 52%, respectively; p less than 0.001) and in patients with left anterior descending disease than in those without (85% versus 26%, respectively; p less than 0.001). Seventy patients showed both an abnormal exercise ECG and CKG; all had CAD and 86% had multivessel CAD. Forty eight patients demonstrated a normal exercise ECG and CKG; 29% had CAD but only 6% had multivessel CAD. Among 55 patients who had simultaneous exercise radionuclide ventriculography, new septal or apical wall motion abnormalities were found in 79% (23 of 29) of patients with an abnormal CKG compared with 19% (5 of 26) of patients with a normal CKG (p less than 0.001). Thus, the CKG during exercise testing accurately reflects LV wall motion abnormalities and can be used to improve the diagnostic accuracy of exercise testing as an additional marker of myocardial ischemia. PMID- 6846159 TI - Nifedipine tablets for systemic hypertension: a study using continuous ambulatory intraarterial recording. AB - The action of nifedipine tablets was examined in 17 patients with essential hypertension focusing particularly on the profile of blood pressure (BP) reduction over 24 hours resulting from both twice-daily and once-daily therapy (dose range 40 to 120 mg daily). This new formulation of nifedipine has a more prolonged and lower peak plasma level than an equivalent dose of nifedipine capsules. Our patients were fully ambulant and studied by continuous intraarterial recording techniques. BP responses during isometric and dynamic exercise testing were also observed. Within-patient comparisons of consecutive mean hourly systolic and diastolic BP showed a highly significant effect from twice-daily therapy (p less than 0.001) for nearly the entire day. Also, significantly lower BP was maintained during isometric and dynamic exercise. Mean hourly heart rates were not significantly altered. The profile of action of the single morning dose was initially similar, but its efficacy diminished from 6 P.M. to 8 A.M. on the following day. Side effects were not unduly troublesome and did not cause any patient withdrawals. Four patients developed mild ankle edema. Two others had facial flushing. Nifedipine given twice daily in tablet form, therefore, is an effective antihypertensive drug capable of lowering BP consistently over 24 hours in ambulant patients and during formal exercise testing. We suggest that this agent may be useful as initial therapy for systemic hypertension, although the tablets are not as yet widely available. PMID- 6846161 TI - Hemodynamic and myocardial performance characteristics after verapamil use in congestive heart failure. AB - Because of its intrinsic negative inotropic effect, the administration of the recently introduced calcium antagonist, verapamil, is thought to be contraindicated in presence of congestive heart failure (CHF). Yet, as CHF is frequently associated with arrhythmias and angina pectoris, and verapamil possesses potent antiarrhythmic and antianginal properties that could be of great benefit to selected patients with CHF, this study was undertaken to determine whether verapamil can be given to such subjects safely. For this purpose, 14 patients with CHF were studied in the control (preverapamil) state with a combined hemodynamic-cineangiographic approach; the same interventions were repeated during intravenous verapamil administration (0.1 mg/kg bolus, followed by 0.005 mg/kg/min infusion). Verapamil markedly lowered mean aortic pressure (95 +/- 19 to 81 +/- 12 mm Hg, p less than 0.001) and systemic vascular resistance (1,953 +/- 873 to 1,417 +/- 454 dynes s cm-5, p less than 0.01). Simultaneously, indexes of left ventricular (LV) performance substantially improved: the ejection fraction increased from 29 +/- 13 to 37 +/- 17% (p less than 0.01), and mean velocity of circumferential fiber shortening increased from 0.45 +/- 0.18 to 0.64 +/- 0.28 circ/s (p less than 0.001). Cardiac index also increased (from 1.98 +/- 0.49 liters/m2/min before verapamil to 2.24 +/- 0.60 liters/m2/min after verapamil), although this improvement did not become statistically significant. No appreciable changes were noted in the heart rate, LV end-diastolic pressure, or mean pulmonary arterial or pulmonary capillary wedge pressure. Thus, the intrinsic negative inotropic activity of intravenous verapamil in therapeutic doses generally does not represent a serious drawback even in patients with CHF; its potent unloading vasodilatory properties more than compensate for any intrinsic decrease in LV contractility, and can thereby actually improve overall cardiac function. PMID- 6846160 TI - Relation between site of origin of ventricular tachycardia and relative left ventricular myocardial perfusion and wall motion. AB - To assess the relation between the site of origin of ventricular tachycardia (VT) and relative myocardial perfusion and wall motion, 18 patients with a history of recurrent sustained VT underwent cardiac catheterization, invasive electrophysiologic study with endocardial mapping, and resting radionuclide ventriculography. In addition, 6 patients had exercise and redistribution thallium-201 scintigraphy, whereas the remaining 12 patients had resting thallium scans. The site of origin of VT (determined by catheter and intraoperative endocardial mapping) was correlated with relative myocardial perfusion (thallium) and left ventricular (LV) wall motion. All patients had significant (greater than 50% narrowing) coronary artery disease and 16 had LV aneurysms. Twenty sites of origin of VT (28 morphologies) were identified in these 18 patients. Of the 9 patients with multiple VT morphologies, the VT originated at disparate sites in 2 patients. All 18 patients had thallium defects at rest and 3 patients had additional reversible (ischemic) defects on exercise. Of the 20 sites of origin of VT, 16 were at the periphery of the thallium defect, 1 was adjacent to it, and 3 were in the center of it. In the 16 patients with LV aneurysm, there were 18 sites of origin: 15 at the border of the aneurysm, 1 adjacent to it, and 2 within it. The data suggest that in patients with VT and coronary artery disease the site of origin is usually the periphery of a resting thallium defect, and in patients with LV aneurysm the site is the border of the aneurysm. PMID- 6846162 TI - Acute hemodynamic effects of endralazine: a new vasodilator for chronic refractory congestive heart failure. AB - Invasive hemodynamic measurements were made in 10 supine patients with chronic refractory congestive heart failure (CHF) due to ischemic heart disease or cardiomyopathy before and after oral administration of a new arteriolar vasodilator, endralazine. In 9 patients, a 10 mg dose of endralazine produced maximal increases in cardiac and stroke volume indexes of 56 and 41%, respectively, with a 45% reduction in total systemic resistance. After a 5 mg dose of endralazine, cardiac index increased maximally by 38% and stroke volume index by 34%, with a 31% decrease in total systemic resistance. Mean arterial pressure decreased 11 +/- 4 mm Hg (mean +/- standard error of mean) with the 5 mg dose and 17 +/- 5 mm Hg after the 10 mg dose. There were no significant changes in the right atrial, pulmonary arterial, or pulmonary capillary wedge pressures. After administration of a single dose of endralazine, statistically significant hemodynamic changes were observed from 1 to 8 hours with peak responses at 3 to 4 hours. These observations suggest that endralazine has hemodynamic properties similar to those of its structural analog, hydralazine. However, endralazine metabolism is largely independent of the patients' acetylator status, and no cases of systemic lupus erythematosus have been reported after long-term oral administration. These findings suggest that endralazine may be an efficacious drug that is potentially safer than hydralazine in the treatment of chronic CHF. PMID- 6846163 TI - Exercise intolerance in patients with chronic left heart failure: relation to oxygen transport and ventilatory abnormalities. AB - Circulatory, metabolic, and ventilatory responses to maximal and submaximal symptom-limited exercise were studied in 13 patients with chronic stable heart failure. Maximal exercise was sustained 6.5 +/- 0.6 minutes (mean +/- standard error of the mean) and increased minute oxygen consumption (VO2) to 940 +/- 65 ml/min, whereas submaximal exercise was sustained for 15.4 +/- 2.3 minutes and increased VO2 to 825 +/- 49 ml/min (both p less than 0.01 compared with maximal exercise). Both exercise protocols were terminated because of fatigue and both were associated with reduced cardiac output relative to VO2, marked systemic oxygen extraction (80 +/- 2% maximal versus 78 +/- 2% submaximal) and similarly elevated blood lactate concentrations (37 +/- 4 mg/dl maximal versus 36 +/- 4 mg/dl submaximal), suggesting inadequate oxygen delivery to working muscle. Minute ventilation during both types of exercise was also more than twice normal relative to carbon dioxide production. However, during submaximal exercise, dyspnea was noted in only 3 patients despite these ventilatory abnormalities. During maximal exercise, dyspnea was noted in 11 patients but did not force termination of exercise or preclude achievement of marked systemic oxygen extraction and lactate production. These data suggest that patients with chronic stable cardiac failure are limited during both maximal and submaximal exercise primarily by inadequate oxygen transport to working muscle. PMID- 6846164 TI - Pharmacokinetic and pharmacodynamic effects of diltiazem. AB - The pharmacokinetic and pharmacodynamic effects of diltiazem were studied in 8 patients after a short intravenous infusion (20 mg over 10 minutes), a single oral dose (60 or 90 mg), and repeated oral administration (60 or 90 mg every 6 hours for 16 doses). Diltiazem levels decreased in a triexponential manner after intravenous infusion. Terminal half-lives after intravenous, single oral, and repeated oral administration were not significantly different (4.5 +/- 1.3, 3.7 +/- 0.6, and 4.9 +/- 0.4 hours, respectively). The kinetic effects of oral diltiazem were nonlinear. With repeated oral administration, there was accumulation of both diltiazem and its metabolite, deacetyldiltiazem. The diltiazem area under the time versus concentration curve increased by a factor of 2.39 +/- 0.42 (p = 0.00002). Most patients showed a double peaked time versus concentration curve after oral administration, indicating possible enterohepatic recirculation. After intravenous administration, there was a substantial increase in the P-R interval (14.3 +/- 5.4%). Although only small changes in P-R interval were seen with a single oral dose, with chronic administration there was persistent P-R interval prolongation, peaking at 17.3 +/- 5.6% over control. Counterclockwise hysteresis was present in the P-R interval versus plasma diltiazem concentration curve after intravenous administration. Only small changes were seen in heart rate and blood pressure. PMID- 6846165 TI - Prevalence of submitral (anular) calcium and its correlates in a general population-based sample (the Framingham Study). AB - To obtain epidemiologic information on submitral calcium, 2,069 subjects in the original Framingham Study cohort (mean age 70 +/- 7 years) and 3,625 of the offspring of the cohort and their spouses (mean age 44 +/- 10 years) with adequate echocardiograms were evaluated. Submitral calcium was detected in 162 (2.8%) of the 5,694 subjects; greater than 90% of the subjects with such calcium came from the 40% of the study group greater than 59 years of age. Women were more than twice as likely to have such calcium as men. Age in both sexes, systolic blood pressure in men, and obesity in women were significantly and independently associated with submitral calcium. There was a 12-fold excess of atrial fibrillation in subjects with (20 of 162, 12%) compared with those without (53 of 5,532, 1%) submitral calcium. PMID- 6846166 TI - Left ventricular volume and ejection fraction response to exercise in aortic regurgitation. AB - To test the hypothesis that left ventricular (LV) performance in aortic regurgitation (AR) can be more completely characterized by measurement of LV volumes in addition to ejection fraction (EF), 27 asymptomatic patients (Group 1), and 22 symptomatic patients (Group 2), and 10 control subjects were studied at rest and during upright bicycle exercise using the first-pass technique and a multicrystal scintillation camera. LV end-diastolic volume was measured by the area-length method. In the control group end-diastolic volume increased 14%, end systolic volume decreased 22%, and EF increased 22% with exercise. In contrast, in Group 1 patients with AR, end-diastolic volume was elevated at rest and during exercise. The 18% decrease in end-diastolic volume during exercise was significantly different from the control response (p less than 0.01). End systolic volume was also elevated at rest and during exercise, but the 30% decrease during exercise was a response not significantly different from the control. Although mean EF increased 15% in these patients, EF at peak exercise was significantly lower than that in the controls. In Group 2 patients with AR, resting EF was reduced, the EF response to exercise was abnormal, and end diastolic and end-systolic volume responses to exercise were significantly different from those in Group 1: end-diastolic volume did not change and end systolic volume increased. In contrast to the fairly uniform volume responses among all Group 1 patients, there were 2 subgroups based on volume changes within Group 2: 7 of 22 had a decrease in end-diastolic volume and end-systolic volume during exercise and 8 of 22 showed an increase in end-diastolic and end-systolic volume during exercise. In conclusion, LV volumes at rest and exercise give more information about LV functional reserve in symptomatic patients with AR than do EF responses alone, and may be useful in separating symptomatic patients who show a normal end-systolic volume response to exercise from those in whom worsening failure develops during exercise. PMID- 6846167 TI - Comparison of digital intravenous ventriculography with direct left ventriculography for quantitation of left ventricular volumes and ejection fractions. AB - Digital images of the left ventricle obtained at 30 frames/second from continuous fluoroscopy after intravenous injection of contrast medium (digital intravenous ventriculography) were used to estimate left ventricular (LV) volumes and ejection fraction with use of several techniques for identifying the ventriculographic silhouette. The digital technique was compared with direct contrast left ventriculography in 26 patients undergoing diagnostic cardiac catheterization. End-diastolic and end-systolic volumes calculated from digital intravenous and direct left ventriculograms were obtained with use of a standard area-length formula. Both end-diastolic volume (EDV) (r = 0.88, y = 1.06x - 17.1 ml) and end-systolic volume (ESV) (r = 0.89, y = 0.96x + 0.43 ml) determined from digital intravenous ventriculography (mask mode images) correlated closely with those obtained by direct left ventriculography. Combining the EDV and ESV to define the relation between the 2 techniques yielded an even closer correlation (r = 0.96). There was also good correlation between the 2 techniques for measurement of ejection fraction (r = 0.81, standard error of the estimate 6.7%). Measurements from direct left ventriculography were frequently invalidated by ventricular arrhythmias during the time of opacification of the left ventricle; this was rarely the case for digital intravenous ventriculography. It is concluded that area-length estimates of LV volumes and ejection fraction can be accurately obtained from digital processing of fluoroscopic LV images after intravenous injection of contrast medium. PMID- 6846169 TI - Diastolic synchronized retroperfusion versus reperfusion: effects on regional left ventricular function and myocardial blood flow during acute coronary occlusion in dogs. AB - The effects of 170 minutes of diastolic synchronized retroperfusion of the coronary sinus with arterial blood during 180 minutes of coronary artery occlusion on regional myocardial contractility (ultrasonic crystals) and blood flow (microspheres) were investigated in open-chest dogs. These effects were compared with those of 180 minutes of coronary occlusion and those of 170 minutes of anterograde reperfusion after 10 minutes of coronary occlusion in separate groups of dogs. Retroperfusion was able to almost restore transmural blood flow in the moderately ischemic zones and to increase it back to 47% of its preocclusion value in the severely ischemic zones with, in both zones, a favorable redistribution of flow toward the endocardium. Simultaneously, retroperfusion significantly improved segment length shortening in the moderately ischemic zones and significantly reduced the extent of paradoxical bulging in the severely ischemic zones. These partial recoveries in regional contractility and blood flow during retroperfusion were intermediate between those induced by 170 minutes of anterograde reperfusion and those of 180 minutes of coronary artery occlusion. Thus, in the presence of coronary artery occlusion, retroperfusion appears to exert a beneficial effect by improving both regional perfusion and function in the ischemic zones and may be proposed as a medical circulatory support to the jeopardized myocardium. PMID- 6846168 TI - Sustained limitation of myocardial necrosis 24 hours after coronary artery occlusion: verapamil infusion in dogs with small myocardial infarcts. AB - Studies were undertaken to ascertain whether verapamil infusion affords a sustained limitation of myocardial injury in the dog after a 24-hour period of coronary artery occlusion. Regional myocardial ischemia was induced by an embolization procedure which did not involve thoracotomy. Immediately after embolization radioactive microspheres were administered intraventricularly to define any area of myocardial underperfusion (zone at risk of infarction). Verapamil (0.005 mg/kg/min) was then administered and maintained for 24 hours during which time the dogs were allowed to recover from anesthesia. The control group received a corresponding infusion of saline solution. After 24 hours the dogs were killed and transverse myocardial sections (3 mm) were prepared. The resulting area of necrosis was visualized by tetrazolium staining, and risk zones were visualized by autoradiography. In the control heart, 62 +/- 7% of the zone at risk deteriorated to necrotic tissue, whereas in the verapamil-treated group only 18 +/- 4% of the tissue in the zone at risk became necrotic. Verapamil appeared to exert a significant (p less than 0.001) tissue-sparing effect that was sustained for at least 24 hours after the onset of ischemia. PMID- 6846170 TI - Effects of ortho-iodo sodium benzoate on acute myocardial ischemia, hemodynamic function, and infarct size after coronary artery occlusion in dogs. AB - Ortho-iodo sodium benzoate (OISB) decreases the affinity of blood for oxygen, thus enhancing potential tissue oxygen delivery. To test the hypothesis that a change in oxygen affinity would ameliorate regional myocardial ischemic injury resulting from occlusion of the left anterior descending (LAD) coronary artery, experiments were carried out in 55 anesthetized dogs which received an intravenous infusion of OISB. In Protocol I studies (n = 9), preocclusion intravenous infusion of OISB (500 mg/kg) reduced epicardial S-T segment elevation 15 minutes after coronary occlusion, while a similar volume of normal saline solution did not affect this index of ischemic damage. In Protocol II experiments, 34 dogs were randomized to either an OISB or saline group, after which the LAD was ligated, the chest closed, and the animal allowed to recover from anesthesia. Myocardial infarction (MI) size was assessed after the animal died or was killed 8 to 24 hours later, and was found to be 29% smaller in dogs receiving OISB. In 6 dogs, blood P50 (the partial oxygen pressure at which hemoglobin is 50% saturated with oxygen) was increased by OISB infusion, confirming that its administration effected a rightward shift in the oxyhemoglobin dissociation curve. Protocol III studies assessed the effects of OISB on cardiac hemodynamic function and acute myocardial ischemic damage when infusion was begun 15 minutes after LAD occlusion: average epicardial S-T segment elevation was not altered by saline solution, but decreased when OISB was infused during the last 15 minutes of myocardial ischemia. Reductions in heart rate, left ventricular dP/dt, and cardiac output were observed in 7 dogs during OISB infusion, but there were no changes in these measurements during coronary occlusion in 5 dogs receiving a constant infusion of saline solution. There were no changes in regional myocardial blood flow (microsphere technique) to either ischemic or nonischemic zones in either the saline control or OISB treatment groups. Thus, both acute myocardial ischemic injury (assessed by epicardial electrocardiographic mapping) and ultimate MI size are reduced when OISB is infused before experimental coronary artery occlusion. OISB also reduces myocardial ischemic injury when its administration is begun 15 minutes after coronary occlusion, while effecting decreases in heart rate, left ventricular contractility, and cardiac output. PMID- 6846171 TI - Relation of immediate and delayed thallium-201 distribution to localization of iodine-125 antimyosin antibody in acute experimental myocardial infarction. AB - Thallium-201 (TI-201) distribution in acute experimental myocardial infarction (MI) (n = 18) was compared with cardiac-specific antimyosin Fab (AM-Fab) uptake, a specific marker for myocardial necrosis. When antimyosin was injected 4 hours after ligation with TI-201 administered 23 hours 55 minutes later and measurement of myocardial distribution determined 5 minutes after intravenous administration of TI-201, (1) TI-201 distribution closely correlated with microsphere regional blood flow, and (2) an inverse exponential relation to iodine-125 (I-125) AM-Fab uptake was apparent. In another group of 4 animals, TI-201 and AM-Fab were administered intravenously 4 hours after MI, and 36 hours later myocardial distribution was measured. This delayed TI-201 distribution had a close inverse linear correlation with I-125 AM-Fab uptake. This inverse linear relation also was apparent in 28-hour-old MIs in dogs (n = 4) where collateral circulation had been established. TI-201 was administered intravenously at 27 hours after MI, and TI-201 distribution was determined 1 hour later. The present study demonstrated that whereas immediate TI-201 distribution is flow-limited, delayed TI-201 distribution is a marker of cell viability which, due to prolonged circulation time and redistribution, is not flow-limited. PMID- 6846172 TI - Cryosurgery of the fetal ductus arteriosus. AB - The effects of cryosurgical treatment of the fetal ductus arteriosus (DA) on the structure and function of the neonatal DA are assessed for the first time. A cryosurgical probe, cooled with nitrous oxide, was used to freeze the wall of the DA in 5 fetal lambs. Six fetal lambs were used as control animals. After birth, all the cryosurgically treated lambs had a patent DA whereas all the control lambs had a closed DA. Only the cryosurgically treated group had these histologic findings: calcific deposits, necrosis, and focal ganglion cell necrosis in the outer one third to two thirds of the media with a decrease or loss of muscle cells and elastic fibers. This study suggests the feasibility of developing a cryosurgical approach for maintaining patency of the DA. PMID- 6846173 TI - Kent pathways visualized in situ and removed at operation. PMID- 6846175 TI - Progressive pulmonary arterial stenosis. PMID- 6846174 TI - Lipoma of the mitral valve and papillary muscle. PMID- 6846176 TI - Holter versus electrophysiologic studies in the management of malignant ventricular arrhythmias. PMID- 6846178 TI - Sudden death in a marathon runner with origin of right coronary artery from the left sinus of Valsalva. PMID- 6846177 TI - Prolongation of Q-T interval and increased amplitude of the T wave after termination of ventricular tachycardia. PMID- 6846179 TI - Accuracy of 2-dimensional echocardiographic diagnosis of congenitally bicuspid aortic valve: echocardiographic-anatomic correlation in 115 patients. AB - The preoperative 2-dimensional (2-D) echocardiograms of all patients less than 50 years of age in whom the aortic valve had been directly inspected by the surgeon or the pathologist or both were reviewed. From June 1977 to June 1981, 283 patients aged less than or equal to 50 years had aortic valve surgery at the Mayo Clinic: 115 (aged 1 to 50 years [mean 32]) had 2-D examinations preoperatively. The echocardiograms were reviewed blindly, and the aortic valve structure was categorized as bicuspid, tricuspid, or indeterminate. On the basis of combined surgical and pathologic inspection, 50 aortic valves were congenitally bicuspid, 60 were tricuspid, 4 were unicommissural, and 1 was quadricuspid. By 2-D echocardiography, the number of cusps was indeterminate in 29 patients (25%). When these patients were excluded, the sensitivity, specificity, and diagnostic accuracy of 2-D echocardiography for bicuspid aortic valve were 78,96, and 93%, respectively. Thus, with adequate 2-D images, echocardiography is a sensitive and highly specific technique for the diagnosis of bicuspid aortic valve. PMID- 6846180 TI - Classification of the site of ventricular septal defect by 2-dimensional echocardiography. AB - Sixty-three consecutive patients aged 2 months to 27 years with simple ventricular septal defect (VSD) or the syndrome of Fallot's tetralogy were prospectively investigated with 2-dimensional (2-D) echocardiography to assess the accuracy of the method in defining the anatomic site of the VSD. Twenty-two patients were referred for surgery without invasive investigation. The anatomy was confirmed in all patients at operation. Two-dimensional echocardiography was reliable in identifying subaortic, inlet, small, moderate, and large subtricuspid, large subpulmonary, and most large central and apical muscular VSDs. Mistakes were made initially in distinguishing doubly committed subarterial defects from subaortic VSD because of difficulty in imaging the right ventricular outflow in short axis at the aortic root level, small subpulmonary defects obscured by prolapsed aortic cusp tissue, and small apical or outlet muscular VSDs because of difficulty in distinguishing true "dropout" from trabeculations. Other VSDs particularly muscular, were sometimes overlooked after another large VSD had been identified. Thus, identification of the anatomic site of VSDs by 2-D echocardiography is a reliable method that can replace invasive investigation in assessing the uncomplicated VSD before operation. Ventricular septal defects are classified as muscular or subvalvular and subdivided according to the valve to which the defect is related. PMID- 6846181 TI - Results after repair of coarctation of the aorta beyond infancy: a 10 to 28 year follow-up with particular reference to late systemic hypertension. AB - The late outcome in 160 patients aged 1 to 54 years who had surgical repair of coarctation of the aorta was examined 10 to 28 years postoperatively. Twenty years postoperatively the probability of survival of patients discharged from the hospital aged 1 to 19 years at operation was a little less than that of the general population (95% versus 97%). The discrepancy between patients and the general population was more marked in those aged 20 to 39 years and was grossly different when surgical repair was undertaken beyond age 40. There were 19 late deaths (12%), 79% due to cardiovascular disease. Thirteen patients had a poor result because of recoarctation (11 patients) or the development of complications at the site of repair (2 patients). Most patients were hypertensive before operation. The frequency of hypertension decreased markedly in the first few postoperative years. Blood pressure was normal in most patients 5 to 10 years after operation, but when followed up for longer periods the proportion of patients with hypertension increased. Hypertension was more common in patients operated on after 20 years of age than in those aged 5 to 19 years at operation (p = 0.007). The likelihood of being alive without complications and with a normal blood pressure was 69% at 10 years, 55% at 15 years, and 20% at 25 years postoperatively. PMID- 6846182 TI - The valve of the foramen ovale in interatrial right-to-left shunt: echocardiographic cineangiocardiographic and hemodynamic observations. AB - In postpartum persistent right-to-left shunt at the atrial level, the valve of the foramen ovale fails to close. As a thin valve-flap the septum primum is pushed to the left during the phases of right atrial pressure predominance and closes to the septum secundum, when left atrial pressure exceeds right atrial pressure. Thus, it performs a marked movement during the cardiac cycle, reflecting the interatrial pressure-flow dynamics. With use of M-mode echocardiography, this movement pattern was studied in 24 patients: 13 with cyanotic heart disease (age 2 days to 21 years) and 11 newborns with persistent transatrial right-to-left shunt due to noncardiac disease. Cardiac defects were confirmed by cardiac catheterization and cineangiocardiography. Interatrial right to-left shunts were proved by M-mode and 2-dimensional contrast echocardiography. The comparison of the M-mode echocardiographic findings in our patient groups with normal atrial septal movement studied in 20 healthy infants and children revealed considerable differences. The characteristic movement of the valve of the foramen ovale also was compared with results obtained by cineangiography and 2-dimensional echocardiography. Analysis of interatrial blood pressure difference provided a pathophysiologic explanation of the septum primum movement in transatrial right-to-left shunt. PMID- 6846183 TI - Management of adults with congenital bidirectional cardiac shunts, cyanosis, and pulmonary vascular obstruction: successful operative repair in 3 patients. AB - Patients with congenital cardiac shunts in whom marked functional disability, cyanosis and pulmonary arterial hypertension develop have been considered inoperable or at exceedingly high risk. Three adult patients, 2 with atrial septal defect (ASD) and 1 with patent ductus arteriosus (PDA), presented with New York Heart Association class IV symptoms, bidirectional shunting with cyanosis, polycythemia, severe pulmonary hypertension, and increased pulmonary vascular resistance. Pulmonary arterial pressure did not decrease in response to administration of 100% oxygen in any patient, and 2 had lung biopsy results showing advanced pulmonary vascular obstruction. While a right-to-left shunt caused cyanosis in all patients, the net shunt was left to right (Qp/Qs greater than 1) and the resistance ratio (Rp/Rs) less than 0.5. All 3 patients survived operation, became acyanotic with normal hematocrit, and are in functional class I or II a mean of 36 months postoperatively. At repeat cardiac catheterization, pulmonary arterial pressure and resistance had decreased substantially. This high risk group of patients with bidirectional shunts, in whom cyanosis due to pulmonary vascular obstruction and polycythemia develop and who appear to be at very high operative risk, should still be considered for surgical correction if the usual criteria for operability exist: net left-to-right Qp/Qs and Rp/Rs less than 0.50. PMID- 6846185 TI - Symposium on results of the Mustard operation for complete transposition of the great arteries. Introduction. PMID- 6846184 TI - Two-dimensional echocardiographic recognition of the right aortic arch. AB - A mirror-image right aortic arch (RAA) is frequently associated with congenital heart disease. The chest roentgenogram with or without contrast remains the noninvasive diagnostic method of choice. While 2-dimensional (2-D) echocardiography has been used to elucidate the left aortic arch (LAA), detailed description of the technique for RAA has not been reported. This study was pursued to delineate the 2-D echocardiographic approach to the patient with RAA. Twenty-seven patients in this study had LAA (Group A) and 27 had RAA (Group B). The 2-D echocardiographic examinations concentrated on the standard suprasternal long-axis (SSNL), parasternal long and short axes, and the subcostal abdominal short-axis views. When the SSNL failed to demonstrate LAA, an alternate position for RAA was utilized. The SSNL correctly identified the LAA in all Group A patients, but in Group B it located only the ascending aorta. This simulated an interrupted aortic arch anomaly. Transducer realignment to position 2 confirmed RAA in all Group B patients. In the parasternal axes, the left descending aorta was detected posterior to the atrioventricular groove or the left ventricle in every Group A patient but in no Group B patient. The descending aorta was found to the left of the spine on the abdominal short-axis view in both groups. The 2-D echocardiographic technique proposed for RAA is simple, rapid, and definitive. It should be pursued whenever LAA cannot be demonstrated, especially in children suspected of having a congenital heart defect. Anticipation of RAA can expedite chest and cardiovascular surgery. PMID- 6846187 TI - Rest and exercise right and left ventricular function late after the Mustard operation: assessment by radionuclide ventriculography. AB - To evaluate ventricular function late after atrial repair of transposition of the great arteries (TGA), 26 asymptomatic patients had rest and exercise radionuclide ventriculography performed a mean of 9 years (range 5 to 15) after undergoing the Mustard operation. The mean resting right (systemic) ventricular (RV) ejection fraction (EF) was 0.50 +/- 0.10 (+/- 1 standard deviation); the RVEF was less than 0.45 in 8 patients. With exercise the RVEF increased in 9 patients and either failed to increase or decreased in 15 (including all 8 patients with resting values less than 0.45). The weight-adjusted work load performed was a first predictor of RV exercise response (sensitivity 87%, specificity 92%); patients whose RVEF increased did more work. The mean resting left (pulmonary) ventricular (LV) EF was 0.58 +/- 0.09; the LVEF was less than 0.50 in 3 patients. With exercise the LVEF increased in 14 patients and did not increase in 10 (including all 3 with resting values less than 0.50). The presence of complex ventricular arrhythmia documented on Holter monitoring was a first predictor of failure of the LVEF to increase with exercise (sensitivity 84%, specificity 71%). The patient's age, operative age, postoperative interval, residual arterial desaturation, preoperative large ventricular septal defect or pulmonary stenosis, postoperative pulmonary stenosis or superior vena caval obstruction, or performance of a second open-heart procedure was predictive of the rest or exercise EF of either ventricle. PMID- 6846186 TI - Hemodynamic function after the Mustard operation for transposition of the great arteries. AB - Pre- and postoperative cardiac catheterization data and cinenangiocardiograms of 82 patients who survived the Mustard operation for transposition of the great arteries (TGA) were reviewed. The post-operative catheterizations were performed 20 days to 10 years after operation (mean 2.5 years). Forty-six patients (56%) had no or insignificant associated cardiac lesions, whereas 36 (44%) had ventricular septal defect, pulmonary stenosis, or both, and required surgical intervention at the time of the Mustard operation. Postoperatively, 11 patients (13%) had significant systemic venous obstruction. Of the 11 patients, 6 required reoperation, and 2 patients had evidence of restenosis or complete obstruction in the superior vena cava after reoperation. In most patients, superior vena caval obstruction was well tolerated even in the presence of high pressure in the superior vena cava. Pulmonary venous obstruction occurred in 5 patients (6%), 3 of whom had no clinical symptoms despite severe pulmonary venous obstruction, although all had radiographic evidence of pulmonary venous congestion. The incidence of obstruction was drastically reduced after the Mustard operation was modified to include routine enlargement of the pulmonary venous atrium. Tricuspid regurgitation was uncommon (10%), but did occur in patients who had transatrial closure of a ventricular septal defect. Preoperatively, left ventricular outflow obstruction occurred in 38%. In 12 patients an attempt was made to relieve the obstruction at surgery. The 6 patients who had localized obstruction had a good result, but patients with more diffuse narrowing of left ventricular outflow had little or no relief of obstruction. Mild to moderate left ventricular outflow gradients regressed spontaneously in most patients after the Mustard operation. PMID- 6846189 TI - Arrhythmias in transposition of the great arteries after the Mustard operation. AB - Disorders of rhythm or conduction in patients with transposition of the great arteries (TGA) after the Mustard operation have been widely reported. This study provides a systematic evaluation of the electrophysiologic function of 87 survivors of the Mustard operation at a single institution. Surface electrocardiograms were reviewed in all 87 patients, Holter monitoring data in 26 patients, exercise electrocardiograms in 21 patients, and invasive electrophysiologic data in 61 patients. Surface electrocardiograms showed normal sinus rhythm in 52%, sinus node dysfunction in 27%, and atrioventricular block in 16%. Holter monitoring was obtained in an unselected subgroup of 26 patients who had a mean age of 12 years and a mean interval from operation of 9 years. Sinus node dysfunction was found in 58%, atrioventricular block in 27% ventricular ectopy in 50%, supraventricular ectopy in 27%, and no abnormalities in only 8%. Intracardiac electrophysiologic evaluation showed a high frequency of abnormal sinus node recovery times and suboptimal response of the atrioventricular conduction system to rapid atrial pacing. When all modalities used in this study were considered, sinus node dysfunction occurred in 47%, ectopy in 34% and atrioventricular block in 23%. Although only 30% of patients had no evidence of arrhythmia, symptoms of rhythm or conduction disturbances were rare. PMID- 6846188 TI - Exercise studies after the Mustard operation in transposition of the great arteries. AB - Twenty-one postoperative patients with transposition of the great arteries (TGA) underwent graded exercise testing 4 to 15 years (mean 9) after the Mustard operation. No patient had subjective exercise intolerance before testing, although some had symptomatic resting arrhythmias. Correlations were made between cardiac catheterization data and 24-hour ambulatory monitoring. Exercise tolerance was diminished in nearly half of the patients. No statistically significant differences were found in heart rate or blood pressure responses, but maximal oxygen consumption values were lower than the control values (p less than 0.001) in the larger patients. Arrhythmias were present or provoked in most patients during exercise testing. Only 28% remained in normal sinus rhythm during and after exercise. Multifocal premature contractions were the most serious arrhythmias demonstrated. Some long-term survivors of the Mustard operation may have abnormal exercise dynamics, even though they may be asymptomatic and have normal physical activities and endurance. Mean maximal systolic blood pressure, heart rate, oxygen consumption, and maximal treadmill times were consistently in the low-normal range or were statistically lower than normal. PMID- 6846191 TI - Effect of elevating the wrist on the radial pulse in aortic regurgitation: Corrigan revisited. AB - Five patients with severe aortic regurgitation had their intraarterial radial pulse recorded simultaneously with the external radial artery deflection of the other wrist. Recordings were made with the arms horizontal and repeated after elevation of the wrists, until the arms were vertical. Elevating the arm of a patient with aortic regurgitation increased the pulsation recorded over the radial artery, lowered mean intraarterial pressure, and reduced the pulse pressure. The results suggest that elevation increases the compliance of the arterial wall, primarily by moving the artery to a lower position on its pressure volume curve. The same changes occurred in 5 normal subjects but were less pronounced. PMID- 6846190 TI - Early detection of left ventricular dysfunction in chronic aortic regurgitation as assessed by contrast angiography, echocardiography, and rest and exercise scintigraphy. PMID- 6846193 TI - Five coronary ostia: duplicate left anterior descending and right conus coronary arteries. PMID- 6846192 TI - Septal ischemia as a mechanism of complete atrioventricular block: demonstration by thallium scintigraphy. PMID- 6846196 TI - Catheter defibrillation. PMID- 6846195 TI - Discriminant function analysis using thallium-201 scintiscans and exercise stress variables to predict coronary heart disease. PMID- 6846194 TI - Left atrial mass: diagnostic value of transesophageal 2-dimensional echocardiography and indium-111 platelet scintigraphy. PMID- 6846197 TI - Follow-up of patients having either transvenous catheter ablation of the atrioventricular junction or direct surgical His bundle disruption. PMID- 6846198 TI - Comparison of verapamil and nifedipine in chronic stable angina pectoris. PMID- 6846199 TI - Atrioventricular nodal reentry. PMID- 6846200 TI - Ventricular function before and after repair of tetralogy of Fallot. PMID- 6846201 TI - Degeneration of antidromic tachycardia into atrial fibrillation in the Wolff Parkinson-White syndrome. PMID- 6846202 TI - Import of exercise-induced ventricular arrhythmia in malignant ventricular arrhythmia. PMID- 6846203 TI - Polymorphous ventricular tachycardia. PMID- 6846204 TI - How the macrophage regulates its extracellular environment. PMID- 6846205 TI - Sequence of developmental alterations following acute ethanol exposure in mice: craniofacial features of the fetal alcohol syndrome. AB - The typical facial features of the fetal alcohol syndrome (FAS) were induced in C57B1/6J mice with acute maternal ethanol administration at gastrulation stages of embryonic development. These features include microcephaly, microphthalmia, short palpebral fissures, deficiencies of the philtral region, and a long upper lip. Scanning electron microscopy (SEM) analysis of embryos 24 hours following initial ethanol exposure at 7 days 0 hours of gestation revealed an obvious size reduction in the neural plate, which was particularly noticeable in the forebrain region. As expected, deficiencies in neural plate development at these early stages result in abnormal brain and eye formation. SEM analysis of later embryonic stages revealed the development of closely set olfactory placodes with resultant deficiencies in the medial nasal prominences (that area responsible for forming the philtral region of the upper lip, the alveolar ridge contained the upper incisors, and the anterior portion of the hard palate--the primary palate). Cleared skeletal preparations of affected newborns had marked premaxillary bone deficiencies. One of the most prevalent known human teratogens has a major malformation-inducing effect on gastrulating embryos, a developmental stage present in human embryos prior to pregnancy recognition by most women. PMID- 6846206 TI - Ultrastructure of decidualization in the pseudopregnant rat. AB - The ultrastructure of the endometrial stroma in rats bearing deciduomata was examined in detail on day 9 (day of vaginal cornification = day 0) of pseudopregnancy, together with the development of deciduomata from day 4 to day 8. Five major regions were recognizable on day 9. 1) In the basal zone, which contributes to endometrial regeneration following decidualization, stromal cells remained fibrocyte-like and were separated by wide bands of collagen fibrils. Capillaries were fenestrated and large. 2) The capsule surrounding the antimesometrial (region of the) deciduoma was composed of flattened cells, showing mitosis, which appeared to provide a source of appositional growth of the deciduoma. 3) The large, tightly packed, polyploid cells of the antimesometrial deciduoma showed morphological evidence of protein synthesis activity, an absence of smooth endoplasmic reticulum, and surface specializations suggestive of adhesion (adherens junctions), communication (gap junctions), and maintenance of an extensive surface area (lamellar processes). These cells came into very close apposition with capillary endothelial cells, which were seldom fenestrated, lacked any continuous basal lamina, and showed evidence of high metabolic activity. 4) The loosely packed mesometrial deciduoma contained a structurally supportive, "fixed" population of spiny cells and a "free" population of granulated cells and their putative precursors, together with a meshwork of large, sinusoidal capillaries whose endothelium was generally supported by a basal lamina. 5) The peripheral parts of the glycogenic area, which was structurally similar to the mesometrial deciduoma, contained many grossly enlarged intercellular spaces of undetermined function. The stromal cells at day 4, which give rise to all non-vascular elements except the granulated cells mentioned above, were structurally simple and fibrocyte-like. Only two distinct regions, subepithelial and deep, were recognizable. Capillaries at day 4 generally possessed a continuous endothelium, with a complete basal lamina and many pericytes. Between days 5 and 8, the stromal cells showed divergent forms of differentiation according to their position in the endometrium. Ultrastructural differentiation of the vasculature also showed divergence according to position, leading to the various types of capillaries seen at day 9. Regional variation, and high levels of structural organization, characterize the "programmed" decidual response in the pseudopregnant rat. PMID- 6846207 TI - Morphology of taste buds on the gill arches of the mullet Mugil cephalus, and the killifish Fundulus heteroclitus. AB - The morphology of taste buds on the gill arches of two euryhaline teleosts, the mullet Mugil cephalus, and the killifish Fundulus heteroclitus, were investigated using light microscopic and scanning and transmission electron microscopic techniques. On the mullet gill arches, taste buds were limited to the pharyngeal surfaces of the smooth-surfaced gill rakers. On the killifish gill arches, taste buds were located on the pharyngeal surfaces of all gill rakers and on the gill arch itself at the bases of the gill rakers. Despite dramatic differences in gill raker structure between these two species, the taste buds themselves were similar ultrastructurally and closely resembled those described in other fishes. Cells within the taste buds included spindle-shaped dark and light cells and basal cells. Ultrastructural features of both the light and dark cells could support either receptor or transport functions. Tufts of microvilli, including one thick microvillus per light cell and numerous thin microvilli per dark cell, protruded at the apex of each taste bud between the ridged surface epithelial cells. Light cells contained numerous tubular membrane elements some of which appeared to open onto the apical surface of the taste bud. Dark cells contained numerous microtubules and apical, electron-lucent vesicles possibly involved in transport. PMID- 6846208 TI - Ultrastructure of the placenta and fetal membranes of the dog: II. The yolk sac. AB - Yolk sacs from dogs at 40, 50, and 60 days of gestation were examined by electron microscopy. Free ribosomes, mitochondria, and rough endoplasmic reticulum (rER) are more prominent in both endoderm and mesothelium at 40 and 50 days than at 60 days, suggesting a greater synthetic capacity at the earlier stages. Smooth endoplasmic reticulum (sER) and glycogen are also present in greater amounts in the endoderm in the earlier stages. In the mesothelium, however, low amounts of sER and glycogen are consistently present. Certain possibilities relative to the nature of the synthetic activities in these two tissues are discussed. Large amounts of smooth-surfaced vesicles were observed along the basal edges of the 60 day mesothelium; they are indicative of transport processes occurring at this time. As gestation proceeds, in both endoderm and mesothelium, the Golgi complex remains well developed, there are more numerous lysosomelike bodies, and bundles of intermediate filaments either increase or become more diffused. In some endoderm cells at 60 days, large vacuoles and dense glycogen deposits were noted. These observations indicate that degenerative processes are gradually occurring in the endoderm and mesothelium as parturition draws near. Erythropoiesis occurs in the mesenchyme at 40 and 50 days. At 40 days also, segments of endothelium were seen within blood islands, indicating that the endothelial lining of some yolk sac vessels differentiates from cells located in the interior of such islands. PMID- 6846209 TI - The afferent connections of the inferior olivary complex in rats: a study using the retrograde transport of horseradish peroxidase. PMID- 6846210 TI - Morphometric analyses on the muscles of exercise trained and untrained dogs. AB - Nine adult dogs were subjected to an endurance training program consisting of gradually increasing periods of treadmill exercise. Biopsies of vastus lateralis muscles taken prior to an on completion of the training program were used to study the alterations in the capillary network and muscle-fiber nuclei. Combined morphometric and stereological analyses showed that the total length of capillaries (LV) and their total surface area (SV) per unit volume of muscle was significantly increased during training. Changes in the properties of myonuclei following training were also studied. Highly significant increases in the number of nuclei per unit volume of muscle (NV) were found. The increase in the numerical density of muscle-fiber nuclei would seem to indicate that the new nuclei were formed in the muscle during prolonged training. The relative amounts and distribution of heterochromatin and euchromatin were measured in trained and untrained dogs using a simple point-counting and random-transect technique. Their content of the different types of chromatin (volume functions and chromatin patch sizes in micrographs) were found to be altered significantly as a result of the training. The findings were consistent with the view that the amount of euchromatin within nuclei varies according to the degree of cellular activity. PMID- 6846212 TI - Blood lipid distribution of hyperinsulinemic men consuming three levels of fructose. AB - Twelve carbohydrate-sensitive men selected due to their abnormally high insulin responses to a sucrose load and 12 men with normal insulin responses were fed diets containing 0, 7.5, and 15% fructose for 5 wk each in a cross-over design. The diets contained 43% total carbohydrate, 42% fat, and 15% protein. Initial fasting total cholesterol and low-density lipoprotein cholesterol were higher in the hyperinsulinemic men than in the controls. Diastolic blood pressure was not affected by diet, but systolic blood pressure was slightly higher after the men consumed the 0% fructose diet. Free fatty acids were not different. Total plasma cholesterol and low-density lipoprotein cholesterol were higher after the men consumed 7.5 and 15% fructose than when they consumed the 0% fructose diet. Plasma triglyceride increased significantly as fructose in the diets of the hyperinsulinemics increased, but was not affected in the controls. These changes in blood lipids are associated with heart disease. PMID- 6846211 TI - Measurement of total body electrical conductivity: a new method for estimation of body composition. AB - A new method for the estimation of body composition in human subjects is described which entails the measurement of total body electrical conductivity. The method is based on the principle that the electrical conductivity of lean tissue is far greater than that of fat. Comparative studies in 19 adults of widely varying fatness have demonstrated excellent correlations between the total electrical conductivity of the subjects and both their total body water (r = 0.87) and total body potassium (r = 0.86). This noninvasive method, which is safe, simple, rapid, and convenient, should prove useful in the nutritional assessment of individuals and populations. PMID- 6846214 TI - Low blood pressure in vegetarians: the possible role of potassium. AB - Ninety-eight confirmed adult vegetarians were examined against a matched group of nonvegetarians living in the same urban environment in order to evaluate the prevalence of arterial hypertension. The average blood pressure was 126/77 for the vegetarians and 147/88 for the control group (p less than 0.05). Significantly lower blood pressure was found in every decade of age. Only 2% of the vegetarians had hypertension (higher than 160/95) as compared to 26% hypertensives in the nonvegetarians. These differences in blood pressure were maintained also when individuals with the same "relative weight" were compared. Family history of hypertension was similar in both groups. Analysis of factors such as coffee drinking and smoking did not favor reduced blood pressure among the vegetarian group. Sodium and potassium intake were evaluated from their ratios to creatinine in a single urine sample. It was evident that both groups excreted the same amounts of sodium, while potassium excretion was significantly higher in the vegetarians. In view of the increasing evidence that potassium plays an important role in the regulation of blood pressure it is concluded that the protective antihypertensive factor in the vegetarian diet is the presence of high amounts of potassium. PMID- 6846213 TI - Mobilization of triglyceride but not cholesterol or tocopherol from human adipocytes during weight reduction. AB - Adipocyte triglyceride, cholesterol, and tocopherol contents were examined in three human obese subjects, all over 150% of ideal weight, who were placed on weight reduction formula diets for 11, 21, and 25 wk, respectively. Body weight decreased from 77 to 63 kg, 188 to 147 kg, and 147 to 99 kg, respectively. All subjects had normal serum cholesterol and triglyceride levels, and these did not vary greatly during weight reduction. Subcutaneous fat was obtained at frequent intervals by needle aspiration from the buttocks before and during weight reduction. Adipocyte size was measured by osmium tetroxide fixation technique, tissue cholesterol content by GLC, tissue triglyceride content by lipid extraction, and tissue tocopherol by thin-layer chromatography. Initial adipocyte size was 0.54, 1.06, and 0.96 micrograms of lipid per cell, respectively (normal 0.60), and the mean cell size decrease during weight reduction was 40%, all due to triglyceride mobilization. Adipocyte cholesterol and tocopherol content did not change significantly during weight reduction. These data are consistent with the concepts that triglycerides but not cholesterol or tocopherol are mobilized from the fat cell during up to 6 months of weight reduction and that independent mechanisms control the efflux of these adipocyte constituents. PMID- 6846215 TI - Folate status of adult males living in a metabolic unit: possible relationships with iron nutriture. AB - Folate and iron status was monitored at monthly intervals in 40 adult males who were living in a metabolic unit for 2 to 8 months and consuming diets containing 150 to 250 micrograms of folate per day. There were significant (p less than 0.02) declines in hematocrit, serum folate, and serum ferritin. Men who participated in studies for 6 months or more or those with initial serum folate levels more than 10.5 ng/ml and erythrocyte folate levels more than 481 ng/ml also exhibited a highly significant (p less than 0.001) decline in red blood cell folate. Men with erythrocyte folate below 480 ng/ml or serum folate below 10 ng/ml and who participated in the studies for less than 5 months showed little or no change in folate status. The findings may reflect adjustments in body folate to reflect dietary intakes. Also a folate intake of 200 +/- 68 micrograms/day appeared to be adequate for maintenance of folate stores in adult males. A correlation between iron stores and folate status was also observed. However, this relationship may be coincidental. PMID- 6846216 TI - Noncobalamin vitamin B12 analogues in human red cells, liver, and brain. AB - Analogues of vitamin B12 which appear to be noncobalamin corrinoids appear to be present in human red cells, liver, and brain. Their sources, nature, and effects require study, particularly with reference to their positive and/or negative effects on vitamin B12 metabolism. In normal persons, they are concentrated in liver, with only small quantities in red cells and still smaller quantities in brain. Their concentrations in disease states will be of interest, particularly in persons with varying degrees of neurological damage associated with deficiencies in vitamin B12 or analogue metabolism. PMID- 6846217 TI - Wound healing and thymotropic effects of arginine: a pituitary mechanism of action. AB - Supplemental dietary arginine HCl (ARG-HCl) minimizes immediate post-wounding weight loss, accelerates wound healing, and is thymotropic for uninjured and wounded rats. The present experiments were to determine if arginine-pituitary interactions underlie these effects because arginine is a growth hormone secretagogue. Effects of 1% dietary ARG-HCl supplements (0.5% added to a regular commercial rat diet containing 1.8% ARG, 0.5% in drinking water) were studied in (a) hypophysectomized (hypox) rats supplemented with ACTH, L-thyroxine, testosterone propionate, (b) such hypox rats additionally supplemented with bovine growth (hypox + bGH) hormone, (c) intact rats (Int), and (d) intact rats supplemented with growth hormone (Int. bGH). Group (a) hypox rats healed their wounds as rapidly as intact rats (dorsal skin incision breaking strength, accumulation of reparative collagen in sc polyvinyl alcohol sponges). Group (b) hypox, bGH rats showed increased wound breaking strength and accumulation of reparative collagen in the sc sponges to levels significantly greater than those of intact controls; bGH given to intact controls did not affect these indices of wound healing. Supplemental ARG-HCl given intact rats significantly minimized immediate postoperative weight loss, increased wound breaking strength and sponge reparative collagen accumulation, and increased thymic weight. None of these effects of supplemental ARG-HCl were observed in group (a) hypox rats or group (b) hypox + bGH rats. We conclude that an intact hypothalamic-pituitary axis is necessary for these beneficial effects of supplemental ARG-HCl given wounded rats. PMID- 6846218 TI - Effect of dietary protein depletion on nonspecific immune responses and survival in the guinea pig. PMID- 6846219 TI - Comparative lymphatic absorption of sitosterol, stigmasterol, and fucosterol and differential inhibition of cholesterol absorption. AB - Studies have been conducted on the lymphatic absorption of sitosterol (24 alpha ethyl cholesterol), stigmasterol (delta 22, 24 alpha-ethyl cholesterol), and fucosterol (24-ethylidine cholesterol) when administered intragastrically to rats. In addition, the effect of each sterol on absorption of endogenous cholesterol has been assessed by including tracer cholesterol in the administered test emulsion. Analysis of 24-h lymph collections by GLC-mass spectrometry demonstrated that all three sterols were poorly absorbed to the extent of only 3 to 4% of the administered dose of 50 mg. In contrast, cholesterol absorption under similar conditions was about 42% of the administered dose. Administration of either sitosterol or stigmasterol resulted in an equally effective inhibition of cholesterol absorption (54%). Under identical conditions fucosterol had no effect on absorption of luminal cholesterol. The data suggest that the mechanism(s) for intestinal discrimination of sterols for absorption may be independent of the mechanism for interference with efficient cholesterol uptake by the intestine. PMID- 6846220 TI - Length of gestation and nutritional composition of human milk. AB - A comparative analysis of the composition of milk produced during the first 14 days of lactation by mothers who deliver prematurely and those who deliver at term is described and these values are contrasted with the composition of donor milk specimens. Twenty-four-hour milk collections (days 3, 7, and 14 postpartum) were obtained from nine mothers delivered between 37 to 42 wk gestation (term) and from 14 mothers who delivered between 28 to 36 wk gestation (preterm). A single spot milk collection was obtained from nine mothers who were 6 to 10 months postpartum (donor). Term and preterm milk was compared on specific postpartum days using an analysis of covariance controlling for 24-h milk volume. The protein, carbohydrate, fat, and energy content varied in a similar fashion in term and preterm milk over the 14 postpartum days studied. Furthermore, there was no significant difference between the two milk groups on any single postpartum day evaluated in terms of protein, carbohydrate, fat, or energy concentration. The milk volumes were significantly greater from the mothers delivered at term on days 7 and 14 (p less than 0.01) and the protein content of both term and preterm milk was negatively correlated with milk volume (r = -0.6 or more on each day studied). The nutrient and energy composition of spot donor milk was highly variable and frequently quite different from either term or preterm 24-h milk collections. These data indicate that milk from mothers who deliver prematurely does not contain significantly different concentrations of nutrients or energy than milk from mothers delivered at term and suggest that the differences previously noted between the two groups may be related to 24-h milk volume. PMID- 6846221 TI - Growth in "new" vegetarian preschool children using the Jenss-Bayley curve fitting technique. AB - Length and weight measurements obtained on 142 vegetarian and 229 nonvegetarian school children from a normative population were fitted to growth curves using the asymptotic nonlinear regression equation of Jenss and Bayley. All of the children were Caucasian and age ranged from a few weeks to 6 yr. The growth curves obtained for vegetarian children were from 0.5 to 1.0 kg and 1 to 2 cm lower, depending on age, sex, and diet, than were curves for reference populations of nonvegetarian children. Length was affected more than weight. Macrobiotic vegetarian children's curves were more depressed than those of the other vegetarian children, indicating that there was a good deal of heterogeneity in growth within vegetarians which was associated with dietary group characteristics. Measurements of females were more consistently affected than males, and their diets were also more far reaching with respect to animal food avoidances. The analysis of food records available provided evidence that energy intakes of the vegetarians were below recommended levels, whereas protein intakes did not appear to be limiting. PMID- 6846222 TI - Anthropometry of Mexican-American migrant children in northern California. AB - Anthropometric data were obtained from 209 Mexican-American migrant children, aged 0 to 7 yr, in the Sacramento Valley of California. Hematocrit was measured for 170 children. Only 13 children (7.6%) had hematocrits below acceptable levels. Weight-for-age, height-for-age, and weight-for-height growth percentiles approximated the National Center for Health Statistics standards. Only 15% of the children were at or below the 10th percentile of height-for-age, and only 7% were above the 95th percentile of weight-for-height, in contrast to earlier studies of Mexican-American children. The mean percentile of weight-for-height increased significantly with age, while height-for-age decreased. The rate of growth in weight and height accelerated during their summer residence in the US, indicating that the adequate growth status of these children may be related to improved conditions for growth while in the US. PMID- 6846225 TI - The changing pattern of megaloblastic anemia: megaloblastic anemia in Israel. AB - The causes of megaloblastic anemia were studied in a survey of patients admitted to six Israeli hospitals over a period of 15 yr. Among the 203 patients identified, 69% had pernicious anemia, 12% had gastrointestinal disease, 9% had primary nutritional deficiency of whom only 1% were associated with pregnancy, and 7% had selective vitamin B12 malabsorption with albuminuria. Comparison with previously published surveys showed, that in contrast with earlier studies where primary nutritional deficiency was the cause of megaloblastic anemia in about 70% of cases and pernicious anemia in only 20%, in more recent studies the proportion of cases with primary nutritional anemia in general and those associated with pregnancy in particular was much lower. This is most probably the result of improved standards of living and a national program of preventive folate supplementation at maternity clinics. A potential hazard of such preventive programs is the aggravation of neurological complications in patients with undiagnosed vitamin B12 deficiency. Early recognition of pernicious anemia and other forms of selective B12 malabsorption is a new challenge created by the changing pattern of megaloblastic anemias. PMID- 6846224 TI - Serum fatty acids in 8-year-old Finnish boys: correlations with qualitative dietary data and other serum lipids. AB - To survey risk factors in coronary heart disease in Finnish children, fasting serum specimens from 244 healthy 8-yr-old boys were analyzed for the fatty acid composition of cholesterol esters (CE), triglycerides (TG), free fatty acids (FFA), and phospholipids (PL). A qualitative dietary survey was made by asking parents to answer a questionnaire including, among others, a question on the kind of fat usually used on bread by the child. The mean percentages of linoleate (18:2) in serum cholesterol esters, triglycerides, free fatty acids, and phospholipids were 53.1, 13.5, 11.5, and 22.7%, respectively, which represent an international average. The quality of dietary fat had a clear influence on serum fatty acids, eg, the content of 18:2 in CE was 56.8 +/- 3.6% in boys using soft vegetable margarine and 50.5 +/- 3.6% in those using butter. The former had also a marginally lower serum total cholesterol (4.87 +/- 0.86 mmol/l) than the latter (5.08 +/- 0.80 mmol/l). Serum total cholesterol showed significant negative correlations with the percentage of 18:2 in all four lipid fractions, the highest r values being with PL-18:2 (-0.41) and CE-18:2 (-0.24). Accordingly, serum cholesterol was lower in the highest CE-18:2 quartile (4.67 +/- 0.76 mmol/l) compared with the lowest (5.30 +/- 0.70 mmol/l; p less than 0.001). The results indicate that when serum fatty acids are used as indicators of the quality of dietary fat, a negative association between polyunsaturated fat and serum cholesterol may be demonstrable even within a free-living population. PMID- 6846223 TI - Marginal malnutrition in school-aged Colombian boys: functional consequences in maximum exercise. AB - The maximum treadmill oxygen consumption was measured in 1013 boys, 6 to 16 yr of age classified as nutritionally normal, low weight for age and low weight for height in upper socioeconomic urban and lower socioeconomic urban and rural groups. The marginally malnourished children (low weight for age and height) in both lower socioeconomic urban and rural groups had significantly depressed maximum treadmill oxygen consumption (85%) compared to normal boys, associated with smaller body weights. It is suggested that the reduced body size and maximum treadmill oxygen consumption resulting from marginal malnutrition during growth will have a detrimental effect on work capacity and productivity of these children when they become engaged in heavy physical work as adults. There was no statistically significant correlation between blood Hb concentration (approximately 10 to 15 g x dl-1) and aerobic capacity. PMID- 6846227 TI - Forms of vitamin B6 in human milk. AB - A previously developed high performance chromatographic method has been modified slightly and used to determine the forms of vitamin B6 in human milk. The chromatographic traces are free of compounds that would interfere with the two principal forms found, pyridoxal and pyridoxal phosphate. The method is fast and reliable; it yields recoveries of from 90 to 106% for the vitamers and agrees with results obtained on the same samples with the standard microbiological assay. PMID- 6846226 TI - Reproductive histories of low weight girls and women. AB - As shown in 79,000 girls and women participating in four different surveys, low body weight (less than or equal to 47.2 kg) does not prevent the attainment of menarche, conception, or even repeated conceptions. Indeed, low body weight is especially common in early maturing girls and in Puerto Ricans and Mexican Americans. From these data, the concept of a "critical weight" for menarche is difficult to substantiate, although low body weight does have nutritional implications and is the second most important factor in regulating fetal growth. PMID- 6846229 TI - Vegetarianism, ischemic heart disease, and iron. PMID- 6846230 TI - Effects of foods consumed on plasma cholesterol levels. PMID- 6846231 TI - Serum vitamin A levels. PMID- 6846228 TI - Endemic selenium intoxication of humans in China. AB - An endemic disease was discovered in 1961 in parts of the population of Enshi County, Hubei Province of the People's Republic of China. During the years of the highest prevalence, from 1961 to 1964, the morbidity was almost 50% in the 248 inhabitants of the five most heavily affected villages; its cause was determined to be selenium intoxication. The most common sign of the poisoning was loss of hair and nails. In areas of high incidence, lesions of the skin, nervous system, and possibly teeth may have been involved. A case is reported of a middle-aged, female hemiplegic, whose illness and death apparently were related to selenosis. Daily dietary intakes of selenium, estimated after the peak prevalence had subsided, averaged 4.99 (range 3.20 to 6.69) mg and hair and blood selenium levels averaged 32.2 and 3.2 micrograms/ml, respectively. Up to 1000x differences occurred when selenium contents of vegetables, cereals, scalp hair, blood, and urine from the selenosis areas were compared with those from Keshan disease (selenium deficiency) areas. The ultimate environmental source of selenium was a stony coal of very high selenium content (average more than 300 micrograms/g; one sample exceeded 80,000 micrograms/g). Selenium from the coal entered the soil by weathering and was available for uptake by crops because of the traditional use of lime as fertilizer in that region. This particular outbreak of human selenosis was due to a drought that caused failure of the rice crop, forcing the villagers to eat more high-selenium vegetables and maize and fewer protein foods. PMID- 6846232 TI - A model for isotopic sampling and administration in constant infusion experiments: a test with 13C-palmitate. AB - We have proposed and tested a model that demonstrates the importance of the site of isotopic sampling relative to the site of infusion for the constant infusion of labeled palmitate. Palmitate enrichment is significantly increased downstream from the infusion catheter. However, palmitate production is underestimated unless sampling is performed upstream from the catheter. There was no significant difference between upstream sampling from the femoral vein versus the right heart, whereas the downstream arterial sampling gave significantly higher enrichments compared to the femoral vein. We have also discussed the importance of sampling sites for other substrates and the constraints that this model places on the design and interpretation of whole body primed constant infusion experiments using labeled substrates. PMID- 6846234 TI - Vitamin E concentrations in human blood plasma and platelets. AB - Vitamin E (tocopherol), cholesterol, triglyceride, and total lipid concentrations were determined in the plasma of 49 healthy, human, male subjects ranging in age from 24 to 91 yr. Tocopherol concentrations in the blood platelets of these subjects were also determined. alpha and gamma tocopherol accounted for nearly all of the vitamin E compounds in plasma and platelet samples. The mean gamma tocopherol concentration was one-fourth of that of alpha in both plasma and platelets. The alpha and gamma tocopherol concentrations in plasma showed statistically significant positive correlations with total lipid, cholesterol, and triglyceride concentrations. However, the platelet alpha and gamma tocopherol concentrations were not significantly correlated with plasma lipid, cholesterol, or triglyceride concentrations. Thus platelet vitamin E concentrations do not passively reflect plasma lipid changes and are postulated to be better indicators of vitamin E nutritional status than plasma tocopherol concentrations. PMID- 6846233 TI - Nutrition survey in Tabasco, Mexico: nutritional status of preschool children. AB - Nutritional status of 149 preschool children was evaluated using anthropometric, biochemical, and dietary measures. Stool samples were collected from 111 children for analysis of gastrointestinal parasites. Sixty-eight percent of the children were below the 3rd percentile of height-for-age, using Mexican reference data, but only 15% were below the 10th percentile of weight-for-height. The percentage of children with low biochemical values was: Hb, 14% less than 11 g/100 ml; hematocrit, 16% less than 34%; vitamin A, 36% less than 20 micrograms/100 ml; ascorbic acid, 47% less than 0.2 mg/100 ml; and riboflavin, 47% with EGR-AC greater than or equal to 1.35. None of the subjects had levels of serum albumin less than 3.5 g/100 ml. The average dietary intake was less than two-thirds of the Mexican Recommended Dietary Allowances for vitamin A, niacin, iron, calcium, and riboflavin. Energy and protein intake averaged 81 and 99% of the Recommended Dietary Allowances, respectively. Girls had significantly poorer growth and dietary intake than boys. Gastrointestinal parasites were detected in 75% of the stool samples, but no negative relationship between nutritional status and infection with the most common species (Ascaris, Trichuris, and Strongyloides) was found. Children were significantly thinner in the summer when diarrhea was most prevalent. PMID- 6846235 TI - Bioavailability of selenium to Finnish men as assessed by platelet glutathione peroxidase activity and other blood parameters. AB - Three groups of 10 men of low selenium status were given 200 micrograms Se/day as Serich wheat, Se-rich yeast, or sodium selenate for 11 wk. Twenty unsupplemented subjects served as controls. Plasma Se levels increased steadily in the wheat and yeast groups for 11 wk without plateauing, whereas in the selenate group, plasma Se plateaued around 110 ng/ml after 4 wk. Platelet glutathione peroxidase (GSH Px) activities increased rapidly in the wheat and selenate groups for 4 wk and then plateaued. Platelet GSH-Px increased more slowly in the yeast group. Ten weeks after the supplements were discontinued, platelet GSH-Px was higher in the wheat and yeast groups than in the selenate group. Assessment of Se bioavailability requires a short-term platelet GSH-Px measurement to determine immediate availability, a medium-term plasma Se measurement to estimate retention, and a long-term platelet GSH-Px measurement after supplements are discontinued to determine the covertibility of tissue Se stores to biologically active Se. PMID- 6846236 TI - Rate of repair of iron deficiency anemia and blood loss anemia in young and mature rats. AB - The purpose of this study was to evaluate the effect of age on the rate of recovery from iron deficiency and red cell loss anemia in the rat. Iron-deficient diets and exchange transfusions with plasma were used to decrease the hematocrit by about 40% below the control value. The results showed progressively slower reversal of the anemia of red cell loss with increasing age. Hematocrit reached control values after 5, 10, and 14 days, at 50, 100, and 360 days of age, respectively. In contrast, iron-deficiency anemia was reversed at similar rates after intravenous treatment with iron dextran; control hematocrit values were reached after 4 and 5 days in the 50-and 100-day-old rats, respectively. The results indicate that the rate of reversal of the anemia of red cell loss is more age-dependent than the rate of reversal of iron-deficiency anemia in the male rat. PMID- 6846237 TI - Fetal iron balance in the rat. AB - Maternal and fetal iron balance through pregnancy was examined in the rat. The 20th day was selected for detailed study because of the peak iron requirements at that time. The standard diet provided a borderline iron supply to the fetus due to the limited availability of its iron for absorption. When a more available form of iron was used, normal fetal development occurred over a range of dietary iron content from 16 to 2500 mg/kg. At a level of 5 to 8 mg/kg, there was attrition of placental tissues with frequent fetal death and resorption. When the iron-deficient pregnancy was sustained, both maternal and fetal iron deficiency were present. At progressively higher levels of dietary iron, feto-placental iron content was constant despite a progressive increase in maternal iron stores. Fetal iron supply appeared to be determined primarily by plasma iron concentration, and, at normal levels, about 25% of transferrin iron passing through the uterine vasculature, was removed by the intact placentas. Low levels of plasma iron resulted in damage to fetal tissues and reduced the capacity of placental tissues to take up iron. At high levels of plasma iron, plasma iron turnover initially increased 5-fold over basal levels in nonpregnant animals due to increased placental uptake. However, with continued hyperferremia, uptake was regulated so as to maintain fetal iron at a normal level. A comparison of these data with human iron requirements explained the occurrence of both maternal and fetal iron deficiency in the rat, but only maternal iron deficiency in the human. PMID- 6846238 TI - Dietary cholesterol decreases the serum level of zinc: further evidence for the positive relationship between serum zinc and high-density lipoproteins. AB - The previous finding (Am J Clin Nutr 1981;34:2376-81) that the serum level of high-density lipoprotein (HDL) cholesterol is positively correlated with the serum concentration of zinc (r = +0.81; p less than 0.01) led us to evaluate further the zinc-HDL relationship as affected by dietary cholesterol. The two diets, one control diet containing no cholesterol and the other containing 1% cholesterol, were isocalorically formulated with an equal but adequate level of zinc. Cholesterol feeding produced a significant decrease in the serum level of HDL cholesterol at 8th wk of dietary treatment and a significant increase in very low density lipoprotein cholesterol at 4th and 8th wk. At the same intervals of dietary treatment, significant decreases in serum zinc levels were observed in cholesterol-fed rats; no changes were noted in the serum levels of other related elements such as copper, calcium, and magnesium. Linear regression analysis of the 44 pairs of serum HDL and zinc values revealed a significant positive correlation (r = +0.57; p less than 0.01) between the two parameters. The rather selective lowering of serum zinc due to cholesterol feeding and the observation of the positive serum zinc-HDL relationship observed in the present and previous studies warrant further investigation into the role of zinc in cholesterol and high-density lipoprotein metabolism. PMID- 6846240 TI - Nutritional induction of adipose tissue lipoprotein lipase in obese subjects. AB - Other workers have reported increased adipose tissue lipoprotein lipase after a weight loss in obese subjects and have suspected that this enzyme is a primary factor of pathophysiological significance. In order to determine whether this effect was the consequence of refeeding rather than weight loss, six obese females were included in a controlled study. Adipose tissue lipoprotein lipase was measured before weight loss, at the end of 30 days on a diet of 800 kcal/day (mean weight loss 8.7%), and four times during the 8 days after the initiation of refeeding a 1500 kcal/day mixed diet to insure weight stability. Adipose tissue lipoprotein lipase decreased by 77% by the end of the weight loss, and an average 2-fold increase (24.2 +/- 2.7 mean +/- sem versus/11.1 +/- 2.3 mU/10(6) cells, p less than 0.01) was shown as early as 2 days after refeeding. Peak values after refeeding did not surpass predieting values. Changes during restriction and peak postrefeeding values were both positively correlated to baseline values. It can be concluded that the previously shown increase in lipoprotein lipase during weight stability after a weight loss is likely to be a secondary effect of partial refeeding; the individual sensitivity of adipose tissue lipoprotein lipase to nutritional induction could be of critical importance. PMID- 6846239 TI - Further studies of the effect of a high protein diet as meat on calcium metabolism. AB - Previous studies in this Unit have shown that a high protein intake, given as meat, did not induce hypercalciuria, except for the initial and temporary increase in two subjects. In the present investigation the long-term effect of a high meat diet on calcium metabolism was studied for 78 to 132 days in four adult males and the short-term effect for 18 to 30 days in three subjects. Calcium and phosphorus balances and calcium absorption studies, using 47Ca as the tracer, were carried out. During the long-term high meat intake and during the short-term high meat studies, there was no significant change of the urinary or fecal calcium nor of the calcium balance. There was also no significant change of the intestinal absorption of calcium during the high meat intake. These long- and short-term studies have confirmed our previous results that a high protein intake, given as meat, does not lead to hypercalciuria and does not induce calcium loss. PMID- 6846241 TI - Reproducibility of a diet history questionnaire in a case-control study of breast cancer. AB - The reproducibility of a diet history questionnaire was assessed as part of a case-control breast cancer study in Caucasian and Japanese women in Hawaii. The method was designed to estimate the intakes of total and saturated fat, cholesterol, and animal protein during a usual week before symptoms or diagnosis of disease in cases, and during a usual recent week in controls. Except for the time period of reference, the dietary technique was identical for all cases and controls. A subsample of 61 Japanese women (19 cases and 42 controls) and 56 Caucasian women (23 cases and 33 controls) participated in the dietary reinterview conducted within 3 months of the first interview. The mean difference in intake between the two interviews was small and not statistically significant (p greater than 0.05) for all four nutrient items among Japanese cases and controls and Caucasian cases, whereas the mean difference for all four nutrients was substantial and statistically significant (p less than 0.05) among the Caucasian controls. The intraclass correlation and the product-moment correlation were moderately high for all four nutrient items among Japanese cases and controls and Caucasian cases, but not among Caucasian controls. These findings indicate that the diet history method is reasonably reproducible in three of the four groups of studied subjects. Possible reasons for the poor reproducibility among Caucasian controls are discussed. PMID- 6846242 TI - Source of variance in 24-hour dietary recall data: implications for nutrition study design and interpretation. Carbohydrate sources, vitamins, and minerals. AB - Beaton et al (Am J Clin Nutr 1979;32:2546-59) reported on the partitioning of variance in 1-day dietary data for the intake of energy, protein, total carbohydrate, total fat, classes of fatty acids, cholesterol, and alcohol. Using the same food intake data and the expanded National Heart, Lung and Blood Institute food composition data base, these analyses of sources of variance have been expanded to include classes of carbohydrate, vitamin A, vitamin C, thiamin, riboflavin, niacin, calcium, iron, total ash, caffeine, and crude fiber. The analyses relate to observed intakes (replicated six times) of 30 adult males and 30 adult females obtained under a paired Graeco-Latin square design with sequence of interview, interviewer, and day of the week as determinants. Neither sequence nor interviewer made consistent contribution to variance. In females, day of the week had a significant effect for several nutrients. The major partitioning of variance was between interindividual variation (between subjects) and intraindividual variation (within subjects) which included both true day-to-day variation in intake and methodological variation. For all except caffeine, the intraindividual variability of 1-day data was larger than the interindividual variability. For vitamin A, almost all of the variance was associated with day-to day variability. One day data provide a very inadequate estimate of usual intake of individuals. In the design of nutrition studies it is critical that the intended use of dietary data be a major consideration in deciding on methodology. There is no "ideal" dietary method. There may be preferred methods for particular purposes. PMID- 6846244 TI - Tumor recurrence and survival in stage IB cancer of the cervix. AB - Clinical records of 371 women with carcinoma of the cervix, Stage IB, treated in the decade 1969-1979 were reviewed. Cancer recurred in 67 women (18.1%). A group of 171 patients treated by radiation, including 25 who were surgically staged prior to treatment, was compared to 200 patients treated by radical abdominal hysterectomy and pelvic node dissection, including 35 who had postoperative whole pelvis radiation. A multifactorial analysis included time to recurrence, site of recurrence, treatment for recurrence, and survival after recurrence. Pathology review and clinicopathological correlation included tumor configuration, histologic type, size of tumor in greatest dimension, and rate of node metastases in patients undergoing either radical hysterectomy or surgical staging procedures. Lesion size was found to be the most accurate predictor of disease free survival; this was true whether the patient was treated by surgery or radiation and was not significantly affected by the tumor histology. Nodal metastases were associated with increasing size of lesions and predicted high recurrence rates. Node metastasis rates were not affected by the histology of the tumor. PMID- 6846243 TI - The prognostic significance of vascular channel involvement and deep stromal penetration in early cervical carcinoma. AB - Eighty-eight patients with FIGO Stage Ib and IIa squamous cell carcinoma of the cervix underwent radical hysterectomy with pelvic and paraaortic lymphadenectomy. The records and histopathologic material were reviewed to determine the prognostic significance of vascular channel involvement and deep stromal penetration by tumor. Seventy-four patients (84%) were alive and free of disease for more than 2 years and 14 (16%) developed recurrent carcinoma within that time. A positive correlation was found between depth of stromal penetration by tumor and the degree of vascular channel involvement (p less than 0.05). Vascular involvement in itself did not significantly affect nodal status, survival or the rate of recurrence. Depth of penetration was associated with a higher incidence of positive nodes (p less than 0.05). There was a trend towards a lower survival rate and a higher recurrence rate in patients with deep stromal penetration as compared to those with superficial tumors. Microscopic nodal disease increased the rate of recurrence and had an adverse effect on survival. The combination of deep tumor penetration and positive nodes in the same patient was associated with the highest recurrence rate and the lowest survival (p less than 0.05). Nodal status was a more significant prognostic indicator than depth of tumor penetration because patients with deeply penetrating tumors and positive nodes had more than twice the recurrence rate than did patients with deep tumors and negative nodes. Postoperative radiation therapy was beneficial to patients whose tumors demonstrated deep stromal penetration and microscopic metastases to pelvic lymph nodes. PMID- 6846245 TI - Phase II study of maytansine in the treatment of advanced or recurrent adenocarcinoma of the ovary. A Gynecologic Oncology Group study. AB - Twenty-nine patients with advanced or recurrent adenocarcinoma of the ovary no longer responsive to standard treatment measures were given maytansine 1.2 mg/m2 I.V. every 3 weeks. None of the 29 patients demonstrated an objective regression of disease. Eighteen (62%) demonstrated stable disease for 1 or more months, while 11 (38%) developed rapid progression of disease. Adverse effects consisted primarily of leukopenia (7/29), thrombocytopenia (9/29), and nausea and vomiting (14/29). Only one patient developed life-threatening toxicity (platelets less than 25,000 microliters), and no drug-related deaths were observed. Maytansine thus appears inactive in the treatment of adenocarcinoma of the ovary at the dose and schedule tested. PMID- 6846246 TI - Serial tests of carcinoembryonic antigen in patients with breast cancer. AB - Carcinoembryonic antigen (CEA) was performed as part of the follow-up tests in 243 patients who had mastectomy and in 57 patients who had recurrent or metastatic disease. In the former group, 50 patients developed recurrent disease and 48% had elevated CEA levels (greater than 5 ng/ml). Among the 193 patients known to be without recurrence, 12% also had elevated CEA's. Evaluation of 161 CEA tests in 107 patients with known relapse showed that only 8% of those with chest wall recurrences had abnormal CEA's, while 30-81% of those with visceral metastasis had higher levels. If 20 ng/ml of CEA is used as the cut-off point, no patients with chest wall or nodal recurrence had elevated values, while 12-13% of those with bone or lung disease and 29-38% of those with pleura and liver metastasis had higher values. The rate of rise is faster also with visceral metastasis. When the elevated CEA level is greater than 20 ng/ml, and when the metastatic lesion responded to systemic therapy, the rate of fall of CEA levels was similar to the rate of rise prior to treatment, and remained fairly constant for the individual patient. PMID- 6846247 TI - Local-regional treatment of patients with simultaneous local-regional recurrence and distant metastases following mastectomy. AB - High-dose, large volume local-regional irradiation has been shown to be necessary in patients with local-regional recurrence of breast cancer without coexisting distant metastases; however, no studies exist that deal with the dose and volume of local-regional irradiation required for patients with both local-regional recurrence and distant metastases. This report is an analysis of 68 patients who presented with previously untreated local-regional recurrence and coexisting distant metastases. Thirty-five of these patients were treated with local regional irradiation and systemic therapy; the remaining 33 patients received systemic therapy only. An analysis of the dose and volume in the 35 irradiated patients showed that if the irradiation was inadequate (dose less than 4500 rad and volume not large enough to encompass the entire involved site), the incidence of uncontrolled local-regional disease for the duration of life was 79%, similar to the 64% rate of uncontrolled local-regional disease in the 33 patients not receiving local-regional irradiation. On the other hand, if the dose to the recurrence was at least 4500 rad and if the field was large enough to encompass the entire site containing the recurrence, the incidence of uncontrolled local regional disease for the duration of life was only 27%. The present study also suggests that local-regional irradiation may be indicated in patients with asymptomatic as well as symptomatic local-regional disease. In patients with distant metastases and initially asymptomatic local-regional disease, adequate irradiation resulted in a lower incidence of ultimate local-regional symptoms when compared to similar patients who were treated with inadequate or no local regional irradiation. This difference was not quite statistically significant because of the small number of patients in each group. PMID- 6846248 TI - Continuous vindesine infusion in advanced head and neck cancer. AB - Sixteen patients with advanced squamous cell carcinoma of the head and neck were treated with a 48-hour I.V. vindesine infusion. The dosage was 3 mg/m2/48 hours every 2 weeks. Toxicity consisted of leukopenia, paresthesias, and phlebitis. Major objective responses were seen in four patients (one CR, three PR), with a median duration of 4 months. PMID- 6846249 TI - The effective use of combined modality therapy for the treatment of patients with Hodgkin's disease who relapsed following radiotherapy. AB - From 1969 to 1977, 124 patients with advanced staged Hodgkin's disease were entered into a treatment protocol which consisted of three cycles of drugs (nitrogen mustard, vincristine, vinblastine, prednisone, and procarbazine) followed by radiation (1500-2000 rad) to previous sites of known disease. After completion of radiation therapy, two more drug cycles were given. There were 63 newly diagnosed patients with Stage IIIB and IVA or B disease and 61 patients who had relapsed from prior radiotherapy. The median follow-up is now in excess of 5 years. Of the relapsed patients, 86.9% entered a complete remission and 90.6% of these patients have remained in complete remission from 1 to 10 years. In comparison, 81% of the newly diagnosed patients entered a complete remission and 78.4% of these patients continue free of disease from 1 to 11 years. These differences were not statistically significant. The 10-year actuarial disease free survival--79.8% for the 61 relapsed patients compared to 65.6% for the 63 newly diagnosed patients--was not significantly different either. The 10-year actuarial survival for the 40 patients who had relapsed to IIIB and IVA or B was 71.3% and approximated more closely those of newly diagnosed IIIB and IVA or B patients. This drug-radiotherapy protocol is very effective for the treatment of patients who have relapsed from previous radiotherapy. PMID- 6846251 TI - Effect of spirogermanium on V79 Chinese hamster cells. AB - Chinese hamster V79 cells were exposed to spirogermanium (SG), and their mitotic activity, population growth, plating efficiency, viability (dye exclusion), and clonogenicity were assayed. Mitotic frequency of cultures in SG decreased initially with increasing drug concentration and later plateaued at varying levels depending on drug concentration. Cultures continuously exposed to SG showed drug concentration-dependent growth inhibition, with no effect at 0.1-0.2 micrograms/ml and increasing toxicity above 0.5 microgram/ml. Cytolysis was enhanced by the simultaneous presence of amphoterocin B and by exposing cells to SG at 42 degrees C. Hypoxia protected cells from drug-induced lysis. The loss of membrane-intact cells was inversely related with population density at the time of drug exposure. Short exposures (up to 5 hours) at 20 micrograms/ml showed that cell killing was primarily through reduction of dye-excluding cells within a matter of hours and secondarily through loss of proliferative capacity. Prolonged drug contact (24 hours) at lower concentrations (1-5 micrograms/ml) accentuated the effect on clonogenicity. These results suggest that for clinical potency, prolonged drug contact may be beneficial. PMID- 6846250 TI - A phase II study of 6-diazo-5-oxo-L-norleucine (DON, NSC-7365) in advanced large bowel carcinoma. PMID- 6846252 TI - Assessment of the quality of life in long-term survivors after definitive radiotherapy. AB - An interview questionnaire was developed to assess quality of life both in objective and subjective terms in cancer patients. Standardized measures were employed and allowed for comparison with a national baseline. Three hundred thirty-nine patients who were alive without evidence of disease 3 or more years following initial treatment were interviewed. There was no difference in terms of educational level, marital status, or satisfaction with local government, family, job, friends, community, health, recreation, or activities when compared to the age-adjusted national baseline. The patients were more satisfied with region, self, and life as a whole. There was no evidence of a diminished quality of life in these patients. PMID- 6846254 TI - Hypothesis: discontinuous chemotherapy for advanced breast cancer. AB - At present, advanced breast cancer is traditionally managed as if cure were a possibility. In order to preserve the quality of remaining life of such patients and permit the possibility of useful secondary or tertiary therapies, the consideration of discontinuous chemotherapy for recurrent breast malignancy seems warranted. PMID- 6846253 TI - Phase I study of cyclophosphamide (NSC 26271) by 72-hour continuous intravenous infusion. AB - A phase I clinical study of cyclophosphamide administered by 72-hour continuous intravenous infusion was conducted in 13 patients with various types of advanced solid tumors to evaluate the drug's toxicity and efficacy. The initial dosage of 300 mg/m2/day X 3 days repeated at 3-week intervals was progressively increased by 150 mg/m2/day-increments to a maximum dosage of 750 mg/m2/day. The dose limiting toxicities were hematologic and gastrointestinal. Neutropenia was more severe than was thrombocytopenia. The lowest granulocyte count less than 500/mm3 occurred during more than half of the treatment courses at doses of 600 mg/m2 and higher. Severe nausea and vomiting were observed in patients during three of four treatment courses at the 750 mg/m2 dose level. None of the patients had microscopic hematuria or symptoms suggestive of cystitis. Partial response occurred in a patient with parotid cancer metastatic to the lung. Disease stabilization occurred in four patients, while six patients had progression of disease. The recommended starting dosage of cyclophosphamide by continuous intravenous infusion for phase II trials is 600 mg/m2/day X 3 every 3 weeks for patients with good bone marrow reserve. PMID- 6846255 TI - Free erythrocyte protoporphyrin (FEP) I. Normal values for adults and evaluation of the hematofluorometer. AB - Since the early 1970s, measurement of free erythrocyte protoporphyrin (FEP) (by microextraction or by hematofluorometer) has been widely used to screen for lead poisoning and to evaluate microcytic red blood cell (RBC) disorders in children. However, published information on normal values for FEP, performance of the hematofluorometer, and usefulness of FEP in classifying microcytic RBC disorders in adults is scant. In an adult population with normal hematocrit and MCV and normal values for serum ferritin, blood lead level, and serum bilirubin, we obtained normal hematofluorometer FEP levels of less than 30 micrograms/dL for men, and less than 40 micrograms/dL levels for women. We have evaluated a hematofluorometer against a standard microextraction procedure and feel that the hematofluorometer is superior for clinical laboratories if elevated FEPs are confirmed by retesting with washed RBC. In the second part of this paper we demonstrate the usefulness of the FEP in classifying microcytic RBC disorders in adults. PMID- 6846258 TI - Laboratory diagnosis of lupus inhibitors: a comparison of the tissue thromboplastin inhibition procedure with a new platelet neutralization procedure. AB - The introduction of the activated partial thromboplastin time (APTT) as a screening test has resulted in increased recognition of circulating anticoagulants. The most frequently encountered inhibitor is the lupus-type anticoagulant. However, criteria for differentiation of this inhibitor are not well-established. We evaluated the ability of two procedures, tissue thromboplastin inhibition (TTI) and a new platelet neutralization procedure (PNP), to differentiate between various types of coagulation inhibitors. The TTI, widely used for the diagnosis of lupus anticoagulants, proved to be nonspecific. The PNP specifically separated lupus-type inhibitors from Factor VIII, X, and V inhibitors. The PNP may be a useful test for the diagnosis of lupus anticoagulants. PMID- 6846256 TI - Free erythrocyte protoporphyrin (FEP) II. The FEP test is clinically useful in classifying microcytic RBC disorders in adults. AB - Microcytic red blood cells (RBC) are commonly encountered in clinical medicine and are caused by disorders of heme synthesis [usually iron deficiency anemia (IDA) or anemia of chronic disease (ACD)] or disorders of globin synthesis (usually thalassemia syndromes or HbE). Using the clinical history and standard laboratory tests (hematocrit, per cent saturation of transferrin (% sat), serum ferritin, Hb electrophoresis, HBA2, and HbF) we classified 198 adults with microcytic RBC as follows: 48 IDA, 11 probable IDA, 11 iron-deficient erythropoiesis without anemia, 13 ACD, 42 alpha-thalassemia trait, 35 probable alpha-thalassemia trait, 20 beta-thalassemia trait, and 15 unclassified. In addition, we demonstrated that the FEP test reliably (83-90% of the time, depending on FEP methodology) classifies microcytic RBC states into disorders of heme synthesis vs. disorders of globin synthesis. Because of reliability and ease of measurement, we recommend the hematofluorometer FEP as the first step in the clinical laboratory evaluation of microcytic RBC disorders in both adults and children. PMID- 6846260 TI - Peliosis of the spleen. AB - Peliosis of the spleen was found in 10 out of 1,200 cases autopsied from 1977 through 1980 in our laboratory. Eight such cases had no peliosis of the liver. Histologically, it was noticed that the parafollicular areas were the most common sites of the lesions, and this feature seemed to be important for the histologic differentiation of peliosis from simple dilatation of splenic sinuses resulting from passive congestion. The clinical and anatomic features of these cases are described and previously reported cases of peliosis of the spleen are reviewed briefly. PMID- 6846259 TI - Use of anion gap for the quality control of electrolyte analyzers. AB - A simple model for the simulation of patient Na, CO2, Cl, and anion gap was formulated from patient electrolyte data. Analytical error, either random or systematic, was incorporated into the simulation of the electrolyte data and allowed study of the response of anion gap to error. Power functions, plots of probability of error detection vs. size of analytical error, were constructed and indicated a low probability of error detection when single patient specimens with abnormal anion gaps were reanalyzed. These power functions showed that pooling of the anion gap data by averaging consecutive anion gaps resulted in a high probability for detecting systematic error. We recommend, as a useful quality control procedure, averaging at least eight consecutive anion gaps and testing for a significant difference between the average and the established mean gap. PMID- 6846257 TI - Red blood cell morphology in sickle cell anemia as determined by image processing analysis: the relationship to painful crises. AB - Red blood cell morphology was studied in the peripheral blood of adults with sickle cell anemia to determine if changes occur during painful crises. Image processing of the cells with an automated system of red blood cell analysis was used. Four groups of cells were observed: normocytes, macrocytes, target cells, and cells with the shape of irreversibly sickled cells. During asymptomatic periods, the percentages of these cells differed in each individual but were typical for that individual and generally were stable. During crises, macrocytosis occurred and the concentration of irreversibly sickled cells showed greater fluctuation. The macrocytosis most likely reflected a marrow response to increased hemolysis and demonstrated that the increased red blood cell destruction observed during pain crises may be more extensive than previously considered. Changes in the concentration of irreversibly sickled cells during crises were not consistent and could not be used as an indicator of a crisis. Image processing with automated red blood cell analysis allows for accurate assessment of all the morphologic groups of red blood cells in patients with sickle cell anemia and compares well with standard methods for measuring the concentration of irreversibly sickled cells. PMID- 6846262 TI - Evaluation of a colorimetric reagent strip assay for urine specific gravity. AB - N-Multistix SG provides a convenient colorimetric assay for the determination of the specific gravity (sp. gr.) of freshly voided urine. When compared with results obtained by standard hydrometry, the colorimetric assay sp. gr. was observed to decrease by as much as 0.010 units as urine pH increased from 5 to 7. Moderate levels of proteinuria that did not alter hydrometer readings effectively raised the colorimetric sp. gr. by 0.005-0.010 units. The colorimetric assay was almost completely insensitive to clinically encountered concentrations of glucose and urea but responded appropriately to monovalent salts. The magnitude of these observed discrepancies places serious limitations on the value of the colorimetric sp. gr. measurement. PMID- 6846261 TI - Serum enzyme changes during marathon training. AB - Blood enzyme activities that might be suggestive of organ-specific damage were measured over a six-week period in two, male, long-distance runners training for a marathon. Striking changes were observed in the CK and LD isoenzymes. Runner B exhibited a flipped LD1/LD2 isoenzyme ratio that paralleled his persistent MB CK elevation. The hepatic enzyme ALT was transiently elevated in Runner A. These data suggest that increases of cardiac isoenzymes (MB CK and LD1) and the specific hepatic enzyme ALT could lead to an inappropriate laboratory diagnosis of a myocardial infarction or liver disease, respectively, in a healthy runner during intense training for a marathon. PMID- 6846263 TI - Isoelectric focusing for transferrin (TF) subtypes in parentage testing. AB - Transferrin subtyping by isoelectric focusing was performed on a total of 362 paternity cases involving white and black child, mother, and alleged father trios. The probability of exclusion (P) in white and black paternity cases was 0.19 and 0.14, respectively. Reproducibility of TF subtyping and the similarity of observed vs. expected exclusion rates demonstrates that TF subtyping is a valuable tool in the routine test panel. PMID- 6846264 TI - Villous adenoma of the urinary bladder: a morphologic or biologic entity? AB - Villous adenomas in the urinary bladder are rare neoplasms whose malignant potential is unclear. A case of a morphologically benign non-invasive mucin producing papillary neoplasm of the urinary bladder associated with cystitis glandularis is presented. Absence of A tissue isoantigen from the neoplastic and metaplastic cells and the presence of H tissue isoantigen in both neoplastic and metaplastic cells is observed in a patient whose blood type is A, indicating incomplete maturation of surface coat constituents. The histologically benign appearance of this lesion may belie a malignant potential. PMID- 6846266 TI - Predictive value of urine culture. PMID- 6846267 TI - Sodium concentration in the automated measurement of red blood cell volume. PMID- 6846265 TI - Adenosquamous carcinoma of the renal pelvis. AB - A case of adenosquamous carcinoma of the renal pelvis is reported, associated with multiple staghorn calculi, occurring in a 35-year-old woman. A review of the literature revealed only two previously reported cases. It is postulated that chronic irritation from the renal calculi had induced squamous and glandular metaplasia with subsequent adenosquamous neoplasia. PMID- 6846268 TI - Brain-stem auditory evoked potentials and early somatosensory evoked potentials in neurointensively treated comatose children. AB - Forty-three comatose children treated by invasive neurointensive care were examined by brain-stem auditory evoked potentials (BAEPs) and somatosensory evoked potentials (SEPs). The evoked potential (EP) results obtained were reviewed in conjunction with the clinical outcome. As a BAEP criterion, the V-I interpeak latency and, as an SEP criterion, the central conduction time (N20-N14 latency) were measured. A loss of BAEP and SEP components portended a poor prognosis. On the other hand, latency prolongations were seen in a third of patients who made a complete recovery. However, the SEP and BAEP have proved themselves as reliable methods in the judgment of the clinical state and the prognosis of intensively treated children with a hypoxic-ischemic encephalopathy or a head injury. The measurement of both BAEPs and SEPs was a more reliable prognostic aid than either EP measurement alone. PMID- 6846269 TI - Newborn phenylalanine/tyrosine metabolism. Implications for screening for phenylketonuria. AB - Controversy over the sensitivity of newborn screening for phenylketonuria (PKU) has recently led to the specific recommendation that infants discharged within the first 24 hours of life be routinely retested at 1 to 2 weeks of age. To address this controversy, data from cord blood samples, phenylalanine (Phe) tolerance tests at 3 days of age, and sequential plasma Phe determinations in six siblings of known cases of PKU or hyperphenylalaninemia were analyzed, along with data from the literature. These analyses showed that normal and probably heterozygous infants decrease their Phe concentrations with age, while infants with PKU or PKU variants increase their Phe concentrations with age but at varying rates. Predictive equations showed that the sensitivity of the screening test rapidly increases with age, so that the usual critical value of 4 mg/dL is satisfactory for suspecting PKU after 18 hours of age. A critical value of 3 mg/dL would be equally satisfactory at any age, if the Guthrie test were appropriately modified to include a 3-mg/dL standard. PMID- 6846271 TI - Episodic airway obstruction in premature infants. AB - Seventy-six premature infants with clinical apnea, bradycardia, or cyanosis were studied with polygraph recordings of heart rate, nasal thermistor detection of airflow, and impedance pneumography. Pathologic apnea was defined by cessation of breathing for greater than 20 s or less than 20 s with bradycardia (heart rate, less than 100 beats per minute). Apnea was classified as central, obstructive, or mixed. Four hundred thirty-three apnea episodes were demonstrated: 238 (55.0%) were central, 53 (12.2%) showed obstructive apnea, and 142 (32.8%) were mixed. Fifty-two infants (68.5%) demonstrated some degree of obstructive apnea, while 24 infants (31.5%) had central apnea only. Bradycardia did not occur in any patient unless preceded by apnea. In premature infants, a significant percentage of apnea was associated with airway obstruction. PMID- 6846270 TI - Iron, zinc, copper, and manganese in infant formulas. AB - The concentrations of the trace elements iron, zinc, copper, and manganese were determined in 53 regular infant formulas and 41 special infant formulas used for clinical disorders. Several infant formulas had lower concentrations of trace elements than human milk. The ranges of concentrations found in the formulas were as follows: Iron, 0.0 to 57.5 mg/L; copper, 0.01 to 2.14 mg/L; zinc, 0.10 to 13.5 mg/L; and manganese, 0.0 to 7.8 mg/L. In addition to the wide variation in absolute amounts of the trace elements in the formulas, large variations in the ratios of trace elements were found. While the average ratios of zinc/copper, zinc/iron, and iron/manganese in human milk range from 3.3 to 10, 2.5 to 10, and 25 to 100, respectively, they ranged from 0.4 to 74, 0.02 to 40, and 0.04 to 425 in the formulas. These differences in the ratios may be important, as the ratio can affect the absorption of the individual elements. These findings indicate that more attention should be given to the trace element levels in infant formulas. PMID- 6846272 TI - Epidermolysis bullosa--pyloric atresia. An autosomal recessive syndrome. AB - A sister and brother each had epidermolysis bullosa and pyloric atresia at birth. Both died in early infancy of complications related to epidermolysis bullosa. Electron microscopic studies of skin biopsy specimens disclosed findings consistent with a diagnosis of epidermolysis bullosa letalis. The existence of epidermolysis bullosa-pyloric atresia syndrome as a distinct clinical entity with autosomal recessive inheritance is supported by the findings in these patients. PMID- 6846273 TI - Congenital cutis laxa and osteoporosis. AB - A 16-month-old male infant was studied who had a syndrome of cutis laxa and incapacitating osteoporosis. The bones displayed evidence of multiple fractures, with impaction and deformities even in the absence of weight bearing. In addition, the infant had large ears and antimongoloid obliquity of the palpebral fissures. PMID- 6846274 TI - 'Recurrent' erythroblastopenia of childhood. An IgM-mediated RBC aplasia. AB - An anemia of childhood with reticulocytopenia and marrow RBC aplasia was found to be due to immune-mediated erythropoietic suppression. In vitro assays of marrow and peripheral blood erythroid progenitors indicated normal cell numbers that markedly declined when autologous serum or IgM was added to the cultures, but remained unchanged with autologous IgG or with autologous serum depleted of IgM. In contrast to "transient" erythroblastopenia of childhood, this anemia was recurrent, lasted longer, and seemed to be prednisone responsive. PMID- 6846275 TI - Sepsis with coagulase-negative staphylococci in critically ill newborns. AB - Coagulase-negative staphylococci are infrequently recognized as pathogens responsible for life-threatening nosocomial infections in high-risk neonates. To determine the incidence, appearance, and antibiotic sensitivity of infections with these organisms, 416 infants were surveyed. Fifty infants (12%) had blood cultures positive for coagulase-negative Staphylococcus. Fourteen cultures (13 infants; mean birth weight +/- SD, 1.91 +/- 1.13 kg; gestational age +/- SD, 34 +/- 6 weeks) were identified as representing true bacteremia (pure growth of the organism in both bottles of one or more blood cultures exhibiting identical antibiotic sensitivities). Twelve cultures exhibited clinical signs of sepsis, and WBC counts were suggestive of sepsis in seven cases. Thirteen organisms were penicillin resistant, eight were oxacillin resistant, and all were sensitive to vancomycin. Coagulase-negative staphylococci are currently the most common nosocomial pathogens at our hospital. Therapy for suspected coagulase-negative staphylococcal sepsis should include vancomycin hydrochloride. PMID- 6846277 TI - Lupus nephritis in black and Hispanic children. AB - We studied the long-term outcome of lupus nephritis in 23 black and Hispanic children. The follow-up period ranged from two to 16.5 years, with a mean follow up of 5.4 years. The mean age at onset was 10.1 years, which is younger than that described in recent series of children with lupus nephritis. All patients had renal involvement, including four normotensive patients with normal renal function and normal urinary sediment. When children whose disease started before the age of 10 years were compared with patients older at onset, there were no significant differences regarding the type of lesion or duration of therapy, but a higher incidence of renal death (.02 less than P less than .05) was noted in younger children. Overall, 25% of our patients have died of renal causes, and another 25% have been undergoing dialysis, receiving transplants, or in chronic renal failure. The mortality in our series was higher than that reported in other series of children with lupus nephritis in recent years. Age and race may be acting synergistically to produce the higher mortality and morbidity. PMID- 6846279 TI - Angiofollicular lymph node hyperplasia causing a neck mass in nail-patella syndrome. PMID- 6846278 TI - Septo-optic dysplasia and median cleft face syndrome in a patient with isolated growth hormone deficiency and hyperprolactinemia. AB - A pituitary evaluation was carried out in a 12-year-old girl who had early puberty, short stature, optic nerve hypoplasia, and agenesis of the corpus callosum. Her growth hormone (GH) response to insulin-induced hypoglycemia and arginine infusion was blunted. Basal and stimulated levels of prolactin were elevated. The association of GH deficiency and hyperprolactinemia suggests a disruption of the dopaminergic modulation of these hormones. The facial features seen in our patient, such as hypertelorism, V-shaped frontal hairline, and cleft nose and upper lip, are enough to justify the diagnosis of median cleft face (MCF) syndrome. However, the optic nerve hypoplasia and the GH deficiency are characteristics of septo-optic dysplasia, and, to our knowledge, they have never been described in patients with MCF syndrome. Our case fulfills the diagnostic criteria of both, representing a link between both ends of this spectrum. PMID- 6846276 TI - Sustained-release theophylline. Pharmacokinetic and therapeutic comparison of two preparations. AB - The serum theophylline concentration profiles and clinical efficacy of two sustained-release theophylline tablets (Quibron-T/SR and Theo-Dur) were compared in 13 asthmatic children requiring continuous theophylline therapy. Quibron-T/SR and Theo-Dur, administered every 12 hours in the same dose for one week, were evaluated in a multiple-dose randomized crossover study. At the end of each week, serial serum theophylline concentrations were measured and spirometry and body plethysmography were performed. No significant differences between treatments were found in bioavailability, adverse effects, clinical symptom scores, or pulmonary function in spite of the fact that Quibron-T/SR and Theo-Dur produced significantly different serum theophylline concentration profiles as measured by a mean percent of fluctuation in serum theophylline levels of 143 for Quibron T/SR and 65.7 for Theo-Dur. Over the short term of the study the pharmacokinetic differences did not produce significant differences in clinical efficacy. PMID- 6846280 TI - Two cases of tracheal agenesis. PMID- 6846282 TI - Statistical concepts and proper use. PMID- 6846281 TI - Congenital middle ear cholesteatoma. PMID- 6846284 TI - Neonatal fracture and cesarean section. PMID- 6846285 TI - Hyperosmolar formulas in necrotizing enterocolitis. PMID- 6846283 TI - Benzyl alcohol poisoning. PMID- 6846287 TI - Brain death. PMID- 6846286 TI - Intravenous medications administered orally to neonates. PMID- 6846288 TI - Brain death in the pediatric intensive care unit. A clinical definition. AB - The establishment of criteria for brain death is important for decision making in the treatment of critically ill patients. Our experience involving 15 children with coma, apnea, and absent brain-stem reflexes for a period of greater than three days supports previous reports in adults that the diagnosis of brain death can be made by clinical criteria alone. None of these patients survived, and each of the 11 autopsies performed revealed marked liquefactive necrosis in the brain. PMID- 6846289 TI - What physicians know about the prognosis of preterm newborns. AB - A questionnaire assessing physicians' understanding of the prognosis of preterm newborns was sent to every pediatrician, obstetrician, family practitioner, and general practitioner in South Dakota. Fifty-three percent of the total sample completed and returned the questionnaire that covered the mortality, general care, and physical, developmental, and psychosocial morbidity of the preterm newborn. The average physician answered 75% of all items with responses consistent with our interpretation of the medical literature. The physicians did better on items concerning mortality and physical morbidity than on those items related to psychosocial or developmental morbidity. Stepwise multiple regression analysis showed that a physician's years of experience was the most significant predictive variable and was negatively related to his or her overall score. PMID- 6846290 TI - Neonatal jaundice in full-term infants. Role of breast-feeding and other causes. AB - Serum bilirubin determinations were performed on 264 term infants who were consecutively delivered via the vaginal route. Forty-one infants (15.5%) had serum bilirubin concentrations greater than 12 mg/dL. No cause for this was found, initially, in 23 (56%) of these infants. On the third hospital day, the mean (+/- SD) serum bilirubin level was 6.9 +/- 3.6 mg/dL in breast-fed infants and 6.5 +/- 3.2 mg/dL in bottle-fed infants. Of the 23 infants without obvious cause for hyperbilirubinemia, eight (four bottle-fed and four breast-fed infants) had serum bilirubin concentrations greater than 12 mg/dL on the third hospital day, whereas in 15 (14 breast-fed infants and one bottle-fed infant), the elevated serum bilirubin level occurred on day 4 or 5. Breast-feeding does not seem to affect the total serum bilirubin level in the first three days of life but may be associated with an increased incidence of hyperbilirubinemia subsequently. In a normal full-term population, routine investigations do not disclose a cause for hyperbilirubinemia in about half of the patients. PMID- 6846291 TI - The informing interview. Enabling parents to 'hear' and cope with bad news. AB - The diagnosis of a chronic or fatal condition in a child presents a difficult situation for the physician who must inform the parents. It is a situation that can be handled poorly and thus be detrimental to parents "hearing" and coping with this bad news. The successful outcome of an informing interview depends on the characteristics of the informer and circumstances of the interview. PMID- 6846293 TI - Effects of a seat belt law on child restraint use. AB - Automobile passenger fatalities account for almost 25% of all accidental deaths of children aged 1 to 14 years. Given that child automobile restraint devices provide effective protection against serious injury and death, several jurisdictions have adopted some form of child restraint law. In August 1976, Quebec enacted legislation requiring the use of seat belts by all front seat passengers weighing more than 23 kg. Although the law was chiefly aimed at adults, a series of observations extending throughout six years were performed to assess its impact on children. Prelaw rates showed 6.4% restraint use for children aged 0 to 11 years and 14.7% for drivers. In the year after legislation, rates for both drivers and children more than doubled and had increased to 55.5% and 24.5%, respectively, in 1981. The child's age and parent's use of a seat belt were important factors associated with restraint use among children. PMID- 6846292 TI - Child homicide spectrum. AB - Violence toward children is an acknowledged pediatric problem, but physicians may not be aware that it is a leading cause of pediatric mortality. Therefore, I used homicide data for persons younger than 18 years of age to characterize child homicide. There are two broad categories: The first predominates until the victim age of 3 years, is intrafamilial, and is associated with bodily force and poorly defined precipitating events. It might be described as fatal child abuse. The second type predominates after the victim age of 12 years, is extrafamilial, involves guns or knives, occurs during arguments or criminal acts by the offender, and may represent children unsupervised in an adult environment. Homicides that occur in children between 3 and 12 years of age are a mixture of these two types. PMID- 6846295 TI - Indications for flexible fiberoptic bronchoscopy in pediatric patients. AB - Although the availability of flexible fiberoptic bronchoscopy (FFB) has been a major advance in adult pulmonary medicine, the role of FFB in pediatrics has remained less well defined. Therefore, a two-year retrospective study was undertaken to determine the indications for FFB in 95 pediatric patients (mean age, 6.9 years) who underwent 129 FFB procedures. Indications for FFB included stridor (41/129), abnormal chest roentgenogram (38/129), airway evaluation in patients with tracheostomy (13/129), airway obstruction (11/129), hoarseness (9/129), recurrent pneumonia (7/129), chronic cough (4/129), failed extubation (3/129), tracheal injury (2/129), and hemoptysis (1/129). Overall, a specific diagnosis was made in 88% of cases, of which 48% involved a lower airway disorder. A minor complication rate of 2% was observed with no major complications. PMID- 6846294 TI - Acute necrotizing ulcerative gingivitis in children with cancer. AB - We reviewed the findings for 15 immunosuppressed children with cancer who had 18 episodes of acute necrotizing ulcerative gingivitis. Predisposing factors were then assessed for their influence on the course of infection. The nutritional status and oral hygiene of most patients were poor. Eleven of the 18 episodes involved the spontaneous exfoliation of primary or permanent teeth, and 16 of the 18 episodes were complicated by other infections. The infection completely cleared in only two of ten patients who were not in remission and persisted for more than 15 weeks or until death in all of the remaining patients with active disease. By contrast, all six episodes of infection during remission cleared within an average of 4 1/2 weeks. Among the many contributing factors, decreased host resistance, relapse, and neutropenia seemed to have the most negative influence on recovery from this severe form of gingivitis. PMID- 6846296 TI - Crepitations in chests of severely dehydrated infants. PMID- 6846297 TI - Jarisch-Herxheimer reaction in meningococcal meningitis. PMID- 6846298 TI - Vitamin K deficiency and breast-feeding. PMID- 6846299 TI - Submersion accidents and epilepsy. PMID- 6846300 TI - Why do apparently healthy people use antacid tablets? AB - Proprietary antacids represent a multimillion dollar business in this country. Marketing surveys have shown that approximately one-half of American adults have used antacids. Twenty-seven percent of adults take 2 or more doses per month. Seventy-five percent of total antacid consumption is by heavy users, defined as greater than 6 doses per week (less than 5% of adults). We investigated why apparently healthy people are heavy antacid users. Thirty-seven heavy users were evaluated. The median duration of antacid use was 20 years, and most took antacids 2-6 times per day, concentrated through the work week. The primary diagnosis was reflux esophagitis in 31 (84%), peptic ulcer disease in one, and nonulcer dyspepsia in five. Ninety-five percent had symptoms consistent with reflux esophagitis. Thirty-three completed a 1 month double-blind, randomized cross-over trial of antacid tablets (14 mEq neutralizing capacity per tablet) versus placebo. Twenty-nine correctly identified the antacid product (p less than 0.0001). Twenty-three subjects underwent Bernstein tests and endoscopy; 21 had positive Bernstein tests, 13 had definite esophagitis as determined endoscopically. We conclude 1) heavy proprietary antacid tablet use in the adult male is not an expression of functional disease but is due to reflux esophagitis, 2) tablet use can be effective symptomatic treatment, and 3) history is an adequate evaluation for most heavy antacid tablet users. PMID- 6846302 TI - Recurrent ulcers after gastric surgery: endoscopic localization to the gastric mucosa. AB - The traditional teaching has been that ulcers recurring after ulcer surgery occur at, or distal to, the anastomosis of the gastric and intestinal mucosa. These concepts predate the widespread availability of fiberoptic endoscopy. We noted that recurrent ulcers were frequently located in the gastric mucosa proximal to the gastrointestinal anastomosis. We analyzed our cases for the purpose of identifying the location of ulcers that occur after surgery for peptic ulcer disease and to investigate the possible relationship between indication for the original ulcer surgery and the presentation of the recurrent ulcer. Ulcers after peptic ulcer surgery were most frequently located in the gastric mucosa proximal to the intestinal anastomosis. The location of the recurrence was not found to be related to the original diagnosis, to the indication for the operation, or to the presentation of the recurrence. These findings may reflect either a change in the pattern of ulcer recurrence or an altered pattern of recognition related to the routine use of endoscopy. PMID- 6846301 TI - Barrett's metaplasia and dysplasia in postmyotomy achalasia patients. AB - Three patients who were 8 to 30 years status postmyotomy for achalasia were shown to develop Barrett's columnar metaplasia of the esophagus. In one instance, the patient had multiple areas of severe dysplasia to carcinoma in situ. There have been only a few reports in the world literature of Barrett's metaplasia occurring in postmyotomy achalasia patients. Our experience would indicate it may be a more common complication than previously appreciated. Also, a possible causal relationship between surgical intervention, Barrett's epithelium, and adenocarcinoma in achalasia is suggested. PMID- 6846308 TI - Umbilical hernia incarceration: a complication of medical therapy of ascites. AB - Umbilical hernias occur frequently among patients with cirrhosis and ascites. Common complications include incarceration, leakage, and rupture. Two patients experienced umbilical hernia incarceration while undergoing medical therapy of their massive ascites--a complication not previously described. Decompression of ascites apparently causes decreased tension on the umbilical hernia ring with subsequent trapping of the hernia sac contents. Mortality of incarcerated umbilical hernias is significant (3-14%). Patients receiving medical therapy for ascites should be examined carefully for the presence of umbilical hernias and, if present, the hernias should be observed closely during the course of treatment. PMID- 6846303 TI - Regional difference in ambient intraluminal gastric acidity after cimetidine monitored by intragastric pH-metry. AB - Acid secretion was monitored in five duodenal ulcer patients using intragastric glass pH electrodes located in the gastric body and antrum under basal conditions and after the administration of cimetidine. It was shown that differences exist between the body and antral pH in the basal state and in the response to cimetidine. The basal hydrogen ion concentration (mean +/- SEM, mmol/l) in the body, 25.97 +/- 5.03, exceeded that in the antrum, 10.59 +/- 6.44 (p less than 0.05). After cimetidine, the pH rose to 3.5 at both electrodes, this stage being shorter in the antrum (16 min) than body (54 min) (p less than 0.0125). During the next stage the pH rose above 3.5 and the hydrogen ion concentration (mean +/- SEM, mmol/l) was very low in both the body, 0.05 +/- 0.01 (p less than 0.0005 compared to basal) and antrum, 0.08 +/- 0.05 (p less than 0.05 compared to basal). Recovery to basal pH levels occurred more quickly in the body than antrum. Intragastric pH-metry offers a reliable method for studying the mode of action of pharmacological agents on the stomach and contributes information not made available by routine gastric analysis. PMID- 6846305 TI - Bilateral pancreatic pleural effusions: a case report and literature review. AB - The pleuropulmonary complications of pancreatitis are protean. The subject of pancreatic pleural effusions has received avid attention in the recent literature with the demonstration of pancreaticopleural fistulization by endoscopic retrograde cholangiopancreatography. Surgical intervention has been efficacious when nonoperative management has failed. We report the successful nonoperative management of a case of alcohol-related pancreatitis complicated by bilateral pleural effusions, and then review the literature. PMID- 6846304 TI - Cholecystosigmoid fistula. PMID- 6846307 TI - Chlamydia trachomatis in the ascitic fluid of patients with chronic liver disease. AB - Several recent reports suggest that Chlamydia trachomatis causes peritonitis and perihepatitis in young women. We studied nine patients with chronic liver disease and ascites to determine a possible role for C. trachomatis in the bacterial peritonitis of cirrhotic patients. C. trachomatis was isolated and identified from the peritoneal fluid in three of these patients. In these patients, the peritoneal fluid was a transudate that contained fewer than 250 white blood cells/mm3, with fewer than 10% neutrophils, except when a bacterial organism other than C. trachomatis was also present. Two of these patients developed peritonitis that was associated with other bacterial organisms. Unless specific tests for C. trachomatis was performed, its presence will not be detected, and the peritoneal fluid cell count will not suggest bacterial infection. PMID- 6846306 TI - The effect of a synthetic enkephalin analogue on postprandial gastrointestinal and pancreatic hormone secretion. AB - The effect of the synthetic enkephalin analogue Sandoz FK33-824 (DAMME) on gastric emptying and the postprandial secretion of upper gastrointestinal and pancreatic hormones was investigated in six healthy subjects. Gastric emptying was delayed as was the postprandial rise in glucose. There was significant blunting of insulin and gastric inhibitory polypeptide secretion, with complete abolition of the normal postprandial increases in pancreatic polypeptide and motilin. The secretion of gastrin was prolonged. These results demonstrate that pharmacological doses of opiate peptides inhibit gastric emptying and may have direct and indirect effects on gastrointestinal and pancreatic hormone secretion. PMID- 6846309 TI - Granular cell schwannoma of the extrahepatic biliary system. AB - We report the case of a woman who presented with a typical picture of cholelithiasis and choledocholithiasis. A percutaneous transhepatic cholangiogram revealed instead a concentric narrowing of the common bile duct and at operation she was found to have a rare, benign tumor of the extrahepatic biliary tree, a granular cell schwannoma. PMID- 6846310 TI - Multiple infectious esophageal fistulae. AB - Acquired fistulous communication between the respiratory tract and the esophagus in the adult are most often posttraumatic or secondary to malignant disease. Infectious fistulae, although uncommon, have been described secondary to primary esophageal, mediastinal, or pulmonary processes. Because of better mucosal definition, double contrast esophagography may help determine the origin of the communication and therefore aid in the differential diagnosis. In addition, near maximal esophageal distension may demonstrate additional fistulae, which if widely separated, suggest an infectious etiology. To our knowledge, no examples of multiple esophagopulmonary communications have been reported in the English literature. We report two such cases in which the barium study correctly predicted an infectious etiology. PMID- 6846311 TI - Gastroenterology and the law. PMID- 6846312 TI - Alcohol and coronary heart disease in Puerto Rico. AB - The relationship of alcohol consumption, measured in 1965-1968 by the 24-hour recall method, to incident coronary heart disease morbidity at eight years and mortality at 12 years of follow-up was investigated in a cohort of 9150 Puerto Rican males 35-79 years of age. After adjustment for age, cigarettes, exercise, urban/rural status, and income, there was clear evidence of a "U-shaped" relationship between alcohol and total mortality, and also the suggestion of a "J shaped" relationship for angina pectoris, nonfatal myocardial infarction, and nonsudden coronary heart disease death. There was no association of alcohol with sudden cardiac death. The adjusted odds ratio for drinkers versus nondrinkers was 0.6 for angina pectoris (p less than 0.05), 0.7 for nonfatal myocardial infarction (p less than 0.1), and 0.7 for nonsudden coronary heart disease death (p less than 0.05). The inverse association of alcohol consumption to nonsudden coronary heart disease death was found to be dependent on age and income: the adjusted odds ratio for subjects under age 60 (0.4) or over the median income (0.3) strongly favored drinkers, while there was no evidence for a "protective effect" of alcohol consumption in the older and poorer segments of the population. It is concluded that available evidence does not justify the assertion that the inverse association between moderate alcohol intake and coronary heart disease risk is a causal one. PMID- 6846313 TI - Impact of recent changes in diagnostic criteria on the apparent natural history of diabetes mellitus. AB - The effect of changing from the original to the new National Diabetes Data Group diagnostic criteria for diabetes mellitus was to delete 16.5% of the original diabetes incidence cohort described among Rochester, Minnesota, residents in 1945 1969, to shift the clinical spectrum at diagnosis toward more severe disease, to reduce relative survival, and to increase the risk of developing macro- or microvascular complications. The changes in apparent natural history were unexpectedly modest in magnitude, however, and should have little practical effect on comparisons of diabetes prognosis under the two different sets of diagnostic criteria. PMID- 6846314 TI - The impact of selected indices of antihypertensive treatment on all-cause mortality. AB - Two important questions regarding the results of the Hypertension Detection and Follow-up Program are: 1) how much of the difference in mortality between stepped care and referred care can be attributed to treatment for hypertension, and 2) was there a relationship between treatment of hypertension in the program and the risk of subsequent mortality of the participants? Neither of these questions can be answered within the original randomization scheme of the Hypertension Detection and Follow-up Program; however, statistical techniques can address these two questions. Crude analyses of blood pressures of survivors and deaths in each year of follow-up indicate that survivors had lower blood pressure than persons dying during the interval. An analysis using life table regression with time-dependent covariates suggests that well over half of the excess risk in the referred care group can be attributed to differences in factors related to hypertension treatment. Simultaneously testing the coefficients of the time dependent variables (diastolic and systolic pressures, blood pressure goal, and medication status) suggests a highly significant relationship between these variables and the risk of subsequent mortality. PMID- 6846315 TI - Grouping occupations according to carcinogenic potential: occupation clusters from an exposure linkage system. AB - An occupational clustering scheme has been developed from an occupation and exposure linkage system. In this scheme, occupational titles are grouped together hierarchically according to the numbers and degrees of their shared exposures. The use of the clusters obtained from this hierarchy is demonstrated in the analysis of the data from a case-control study of bladder cancer. PMID- 6846316 TI - The use of life tables and survival analysis in testing genetic hypotheses, with an application to Alzheimer's disease. AB - Because of the late onset of some neuropsychiatric disorders suspected to be under genetic influence, such as Alzheimer's disease, standard techniques for testing genetic hypotheses are difficult to apply to clinical data. The statistical aspects of life table methods and survival probability estimators which can be used to test such hypotheses have been neglected in the psychiatric literature. Two techniques of this kind, the Weinberg morbidity table and the Kaplan-Meier product limit estimator, are applied to real and simulated data. As estimators of lifetime incidence these methods yield roughly equivalent results for both types of data, although from a theoretical standpoint the original Weinberg estimator appears to suffer from logical defects. Parametric models may offer more definitive results, particularly when an estimator of segregation ratio is required. The clinical data in this report were gathered by interviewing relatives of Alzheimer's disease patients sampled through a nursing home survey in metropolitan Baltimore, Maryland during 1980. PMID- 6846318 TI - The relationship of hepatitis B surface antigen and antibody to atomic bomb radiation in the Adult Health Study sample, 1975-1977. AB - A frequency of positive hepatitis B surface antigen (HBsAg) and antibody (anti HBs) was determined among 2566 atomic bomb survivors in Hiroshima and Nagasaki, Japan during the two-year period 1975 to 1977. The frequency of positive HBsAg (79% of subjects remained persistently antigen positive) was significantly higher in those exposed to 100 rad or more than in the controls. This difference between exposure groups was more marked among the younger age groups. However, contrary to expectation, there was no difference between the dose groups in the distribution by high vs. low titers among the antigen-positive individuals. There was no difference between the two comparison groups in the occurrence of positive anti-HBs reactions (prevalence of hepatitis B virus). The above findings suggest that immune competence, using the prevalence of positive HBsAg as an index, is depressed in the high dose group, but further study, including follow-up of those with persistent positive HBsAg reactions, is called for. With respect to HBsAg subtypes, adr occurs with higher and adw with lower frequency in Nagasaki than in Hiroshima, corresponding to earlier reports for the Japan archipelago of reverse and complementary distributions of these two subtypes. PMID- 6846317 TI - Effects of interaction, confounding and observational error on attributable risk estimation. AB - The properties of attributable risk are discussed for situations in which there are several risk factors that are possibly interacting or confounded. Conditions are identified when the attributable risk among the exposed is constant, when the marginal attributable risk estimate is valid, and when the public health effects of separate risks are additive. Such conditions reflect, in various ways, the interaction and confounding of the different risk factors involved. For diseases with more than two risk factors, these conditions are sufficient but not necessary; thus it is possible to have additive public health effects of two risk factors even though they are confounded and interactive. In contrast, when there are exactly two binary risk factors, the conditions are sufficient and necessary. It is shown that bias in attributable risk through misclassification of exposure arises primarily through insensitivity errors. Particularly with zero false negative rates and equal false positive rates for cases and controls, the attributable risk estimate is unbiased; however, a larger standard error pertains to the estimate based on misclassified data. PMID- 6846321 TI - Re: "The relation of electronic fetal monitoring patterns to infant outcome measures in a random sample of term size infants born to high risk mothers". PMID- 6846320 TI - Menarcheal age and miscarriage. PMID- 6846319 TI - Telephone household screening and interviewing. PMID- 6846322 TI - Re: "Interaction of alcohol and tobacco in laryngeal cancer". PMID- 6846325 TI - Re: "A survey diagnostic tool for senile dementia". PMID- 6846324 TI - Re: "Rabies in Ethiopia". PMID- 6846326 TI - Interaction of protamine sulfate with thrombin. AB - Protamine sulfate (salmine), a basic protein with a molecular weight of 4,626 +/- 109, is a known antiheparin agent which in the absence of heparin demonstrates an anticoagulant activity. To date, much work has been done to elucidate the interaction of heparin with thrombin and its physiologic inhibitor, Antithrombin III (ATIII). Little is known, however, about the mechanism of anticoagulant action of protamine sulfate and its mode of thrombin inactivation. We provide information about the interaction of protamine sulfate with purified, labeled thrombin and ATIII through binding experiments in which protamine is shown to inhibit the inactivation of thrombin by ATIII. Furthermore, we show in clotting assays that protamine sulfate has an inhibitory effect on thrombin in the conversion of fibrinogen to fibrin, and that this inhibition is concentration dependent, partial, and reversible. PMID- 6846329 TI - Membrane proteins on human megakaryocytes and platelets identified by monoclonal antibodies. AB - We describe five monoclonal antibodies that react with four discrete antigens present on human platelets. Antibodies B2.12 and B59.2 precipitate the glycoprotein IIb-IIIa complex from radiolabeled platelet membrane extracts and inhibit platelet aggregation induced by adenosine diphosphate (ADP), collagen, or epinephrine. The antigen recognized by the two antibodies is present on megakaryocytes but either absent entirely or expressed in small amounts on platelets from Glanzmann's thrombasthenic patients. The antigen recognized by antibody B37.3 is absent from thrombasthenic platelets. Antibody B1.12 reacts with an antigen shared by platelets and 20% of peripheral blood lymphocytes and is a potent inducer of platelet aggregation. Antibody B2.10 reacts specifically with platelets and megakaryocytes but does not affect platelet functions. Thus, these reagents are useful tools in diagnostic and functional studies of both normal and abnormal platelets. PMID- 6846327 TI - Abnormalities of the spleen and liver in patients with hemophilia. AB - Previous studies have demonstrated functional and histologic abnormalities of the liver, and, more recently, splenomegaly in patients with hemophilia. Since these observations usually were derived from hemophiliacs who had received intensive replacement therapy, the question was posed as to whether the frequency of splenic and hepatic abnormalities was secondary to the amount of therapy utilized. In this study, a variety of tests were employed to evaluate spleen and liver size and function to determine if abnormalities in these organs correlated with the intensity of the transfusion program. The study group was comprised of 25 hemophiliacs (mean factor replacement-18,361 U/year; median factor replacement 12,920 U/year). Over 70% of our patients had elevations of aspartate and alanine aminotransferase. Immunoglobulin and complement levels were normal in most subjects. Ninety-six percent had evidence of exposure to hepatitis B virus. Liver spleen imaging suggested significant hepatic abnormalities in most of the patients as evidenced by inhomogeneity of tracer uptake in the liver in 33% and relatively increased colloid uptake in the spleen in 90%. Splenomegaly (palpable spleen or enlargement on liver-spleen imaging) was detected in 40% of our patients, and tended to occur in the more frequently transfused patients. These findings indicate that significant abnormalities of the spleen and liver can occur in hemophiliacs who have received moderate amounts of replacement therapy and that liver-spleen imaging may be a useful method for monitoring the development of hepatic and splenic abnormalities. PMID- 6846323 TI - Breast cancer and spontaneous abortion. PMID- 6846328 TI - Transient erythroblastopenia of childhood: varied pathogenesis. AB - The mechanism of anemia in four patients with transient red cell aplasia of childhood ("erythroblastopenia") was studied at the time of diagnosis by assessing the colony growth of marrow erythroid progenitors in methylcellulose tissue cultures. Marrow from Patient 1 yielded high normal numbers of BFU-E colonies that were completely abolished on addition of autologous serum or IgG. Patient 2 had normal BFU-E growth that markedly declined when autologous serum or IgM was added to the cultures, but growth remained unchanged with added autologous IgG or peripheral blood mononuclear cells (PBMC). Marrow from Patient 3 yielded low CFU-E and BFU-E numbers with standard plating techniques, but colonies strikingly increased when marrow fractions from an albumin density gradient were cultured. PBMC from Patient 3 suppressed control marrow CFU-E and BFU-E, but serum had no effect. Patient 4 had normal CFU-E and BFU-E that increased with autologous serum and remained unchanged with autologous PBMC. We conclude that the red cell aplasia in Patients 1, 2, and 3 was due to suppressed erythropoiesis via IgG, IgM, and cell-mediated inhibition, respectively. In contrast, in Patient 4 no immune mechanism was demonstrated. Whereas transient red cell aplasia has a uniform clinical presentation, there are at least four pathogenetic mechanisms that can be detected in vitro. PMID- 6846330 TI - Migration of human leukocytes from soft agarose droplet: a simplified method for studying chemotaxis and spontaneous migration. AB - Studies of in vitro chemotaxis and spontaneous migration of human leukocytes using the accepted method with the Boyden-chamber-filter are troublesome, because of the need for specially constructed vessels as well as the difficulties caused by the use of membrane filters. We describe a new and simplified method for measuring human leucocyte chemotaxis, which is a modification of the recently described underagarose migration method and which is based upon spontaneous migration of cells from a soft agarose droplet and in response to a chemotactic gradient. We examined suspensions of leukocytes, purified granulocytes, and mononuclear cells from 10 healthy normal adults and from 10 samples of cord blood using E Coli O111B4 endotoxin-activated human serum as attractant. Our results showed that the mean chemotactic indices (C.I.-chemotaxis/migration) for purified granulocytes and for mononuclear cells from normal individuals were 3.0 +/- 1.2 and 2.7 +/- 1.5, respectively. Chemotaxis was significantly reduced when unwashed leukocytes were studied, indicating a detrimental effect of autologous plasma on leukocytic response to a chemotactic stimulus in this system. Cord blood cells showed normal spontaneous migration, but significantly decreased chemotaxis. This preliminary report shows that the technique is simple, rapid, and reproducible, and can detect abnormalities of chemotaxis in both granulocytes and mononuclear cells. PMID- 6846331 TI - Clostridial species in the pathogenesis of necrotizing enterocolitis in patients with neutropenia. AB - The role of gram-negative bacteria in the pathogenesis of necrotizing enterocolitis has been stressed. We describe a 21-year-old woman with chronic neutropenia with cyclic fluctuations who died of necrotizing enterocolitis due to Clostridium septicum. Seven patients with cyclic neutropenia and necrotizing enterocolitis have been described in the literature and in each case in which bacteriologic data were reported, a Clostridial infection was documented. Patients with cyclic neutropenia should be treated with antibiotics effective against Clostridial species when abdominal symptoms complicate neutropenic periods. PMID- 6846332 TI - Peritonitis in continuous ambulatory peritoneal dialysis patients. AB - Peritonitis is the most important complication of continuous ambulatory peritoneal dialysis (CAPD). We reviewed our experience with peritonitis over a 2 1/2-year period. Our patients spent 4% of their total time on dialysis in hospital due to peritonitis. Thirty-eight percent of the episodes of peritonitis were treated without hospitalization. We evaluated the dialysate bag change technique as commonly performed with currently available devices (extension tubing and titanium Luerlock Tenckhoff catheter adapter). The aseptic techniques described for dialysis extension tubing changes appear adequate (with no increased incidence of peritonitis demonstrated shortly after an extension tubing set change). Long-term sterility is maintained at the dialysate bag puncture port and at the orifice of the dialysis catheter adapter (no positive cultures from the bag port and orifice of the titanium adapter). Etiologic diagnosis of uremia was not a risk factor predisposing to peritonitis. The incidence of peritonitis was greater among patients with less formal education and lower income. Out data suggest that patients with less formal education and of lower economic status be carefully evaluated before commencing CAPD. PMID- 6846333 TI - Nontuberculous mycobacterial peritonitis associated with continuous ambulatory peritoneal dialysis. AB - We report two patients undergoing continuous ambulatory peritoneal dialysis (CAPD) in whom peritonitis developed and nontuberculous mycobacteria were isolated from peritoneal fluid. In one, Mycobacterium avium-intracellularis was the only organism isolated. Despite a three-month course of antibiotics to which the organism showed in vitro sensitivity, there was no apparent response. The patient died, and an autopsy showed disseminated mycobacterial disease. In the second case, Mycobacterium fortuitum and diphtheroids were isolated from the peritoneal fluid. Although it was not clear that the mycobacterium was solely responsible for the peritonitis in the second case, the infection failed to resolve with antibiotic therapy appropriate for diphtheroids. This patient also died. Both patients had indolent, chronic infections, although there was granulocyte predominance in the peritoneal fluid. Both had involvement of the catheter exit site. To our knowledge, these are the first reported cases of nontuberculous mycobacterial peritonitis in CAPD patients. We recommend evaluation for mycobacteria, including cultures and stains of dialysate specimens, in all cases of CAPD-associated peritonitis where no organism is identified, or where no improvement is noted after 48 hours of therapy. Repeated cultures for mycobacteria are appropriate for suggestive cases. Since these infections are difficult to treat, it may be prudent to remove the dialysis catheter if they are isolated. PMID- 6846335 TI - The effect of sulfate on serum ionized calcium. AB - Serum sulfate concentrations may reach five to ten times normal in renal failure patients dialyzed on a sorbent cartridge system, and these patients have elevated alkaline phosphatase levels suggesting an increased incidence of renal oseodystrophy. We studied the effect of adding sulfate on ionized calcium (Ca2+) in human serum in vitro and in rat serum in vivo. K2SO4 or Na2SO4:NaCl mixtures were added to aliquots of serum from normal subjects to reproduce the observed biologic range of sulfate concentrations up to 10 mmol. Serum Ca2+ concentration was found to decrease linearly as serum sulfate concentration increased, for each subject. The weighted mean slope estimates of the effect of sulfate on ionized calcium in two experiments were -.0197 and -.0181. Rats were infused through the inferior vena cava with 2 mL of either 200 mmol NaCl (N = 5) or 100 mmol Na2SO4 (N = 6), after ligation of the renal arteries and veins and withdrawal of 2 mL blood for baseline studies. The animals were killed by exsanguination from the aorta after a five-minute equilibration period. In rats administered NaCl, no difference in Ca2+ or sulfate concentration was found between pre- and postinfusion sera. In the Na2SO4 treated rats, however, a significant mean increase of 0.635 mmol (p less than .005) in serum sulfate concentration was associated with a significant mean decrease of -0.062 mmol (p less than .01) in serum Ca2+ concentration. We conclude that the acute in vitro and in vivo addition of sulfate results in a decrease in serum Ca2+ concentration. Thus, hypersulfatemia, which is present chronically in patients on sorbent dialysis systems, may contribute to elevated alkaline phosphatase levels in these patients. PMID- 6846334 TI - Epidemiology of adult polycystic kidney disease, Olmsted County, Minnesota: 1935 1980. AB - Between January 1, 1935 and December 31, 1980, adult polycystic kidney disease (APKD) was diagnosed in 40 residents of Olmsted County, Minnesota, resulting in an age- and sex-adjusted annual incidence rate of 1.38/100,000 person-years. In addition, 16 cases were detected at autopsy, increasing the rate to 2.06. It is estimated that 16 additional cases would have been discovered had all deaths come to autopsy, resulting in a rate of 2.75, or approximately twice the incidence rate of cases diagnosed during life. Because of improvements in medical care and diagnostic techniques, APKD has been diagnosed earlier and more frequently in the recent decades. This, along with therapeutic advances, explains the improvement in kidney and patient survival for the patients diagnosed during 1956-1980, as compared to those diagnosed during 1935-1955. Normotension at diagnosis tended to be associated with better kidney and/or patient survival. Cardiovascular disease was the leading cause of death. PMID- 6846337 TI - Statistical significance. PMID- 6846336 TI - Hypersensitivity reaction on first-time exposure to cuprophan hollow fiber dialyzer. AB - Forty-five patients who have been maintained on hemodialysis using a regenerated cellulose hollow fiber artificial kidney (HFAK) were dialyzed on a cuprophan HFAK for the first time. Three black patients (6.6%), one male and two females, ages 43-61, who had been stable on hemodialysis for 30-88 months developed hypersensitivity reactions. The recommended setup procedure was carefully followed. Within seconds in 1 patient and within 10-16 minutes in the remaining two, respiratory distress, urticaria, pruritus, hypertension/hypotension, and facial edema developed. Dialysis was discontinued immediately. They were treated with oxygen, epinephrine, and diphenhydramine. Two patients received IPPB treatments and one received IV methyl-prednisolone. After allowing 10-15 minutes for stabilization, the dialysis was resumed on a non-cuprophan HFAK. Patients were discharged with no sequelae. The cause of the hypersensitivity reaction is unknown. It could be due to substances used in the sterilization procedure, to the membrane itself, or to substances that leach out of the potting compound or membrane. Hypersensitivity reaction during hemodialysis has been reported to be very severe or even fatal. Personnel delivering direct patient care should be aware of the symptoms and react quickly with proper treatment. Patients suspected to have this reaction should be changed to a dialyzer without a cuprophan membrane. PMID- 6846338 TI - Exposures and mortality among chrysotile asbestos workers. Part I: exposure estimates. AB - A detailed study of plant processes and dust control methods over the period 1930 1975 was conducted in an asbestos textile plant processing chrysotile. Linear statistical models for reconstructing historic dust exposure levels, taking into account textile processes, dust control measures, and job assignments, were developed. Parameters of these statistical models were estimated using 5,952 industrial hygiene sampling measurements covering the period 1930-1975. For most textile operations, exposure levels were significantly reduced by about 1940, when most engineering dust control measures were in place. Results of the exposure estimates indicated "precontrol" exposure levels to range from 3 to 78 fibers/cc with typical levels well above 10 fibers/cc. After textile operations were provided with dust control measures, estimated exposure levels ranged from 3 to 17 fibers/cc and were usually in the range of 5 to 10 fibers/cc. These exposure estimates were combined with an assessment of mortality among workers at this plant to investigate exposure-response relationships. Exposure-response results are presented in the companion manuscript in this volume. PMID- 6846339 TI - Exposures and mortality among chrysotile asbestos workers. Part II: mortality. AB - A retrospective cohort mortality study was conducted among a cohort of 1,261 white males employed one or more months in chrysotile asbestos textile operations and followed between 1940 and 1975. Statistically significant excess mortality was observed for all causes combined (standardized mortality ratio [SMR] = 150), lung cancer (SMR = 135), diseases of the circulatory system (SMR = 125), nonmalignant respiratory diseases (SMR = 294), and accidents (SMR = 134). Using estimated fiber exposure levels in conjunction with detailed worker job histories, exposure-response relationships were investigated. Strong exposure response relationships for lung cancer and asbestos related non-malignant respiratory diseases were observed. Compared with data for chrysotile miners and millers, chrysotile textile workers were found to experience significantly greater lung cancer mortality at lower lifetime cumulative exposure levels. Factors such as differences in airborne fiber characteristics may partially account for the large differences in exposure response between textile workers and miners and millers. PMID- 6846343 TI - Comparison of hospital pharmacies reporting to Monitrend's Northeast Teaching Group. PMID- 6846344 TI - Potential for error using textbook technique for intramuscular administration. PMID- 6846340 TI - Exposure to asbestos: psychological responses of mesothelioma patients. AB - Thirty-eight patients with a diagnosis of malignant mesothelioma participated in a semi-structured interview to evaluate asbestos exposure, acquisition of increased risk information, and retrospective reporting of cognitive and behavioral reactions (particularly smoking behavior) to risk information. Twenty eight patients (74%) had direct occupational contact with asbestos, and six patients (16%) reported indirect nonoccupational exposure to asbestos. Only two (10%) of the directly exposed patients acquired risk information from professional sources prior to diagnosis of mesothelioma. The most frequently reported reaction to learning of increased risk of cancer was a denial of the risk by minimizing personal exposure. Few patients reported being concerned about the information of increased risk. Smoking behavior did not change as a result of risk information, nor was there any increase in visits to physicians. Guidelines for psychosocial management of at-risk groups are recommended. PMID- 6846341 TI - Some immunological studies on coalworkers with and without pneumoconiosis. AB - This work formed part of a series of studies devised to investigate immunological markers which it was considered might reflect individual susceptibility to the development of coalworkers' pneumoconiosis and especially progressive massive fibrosis. Estimations of T and B lymphocytes and white blood cell counts (WBCC) were performed on blood samples from 324 coalworkers grouped according to radiographic category of pneumoconiosis, age, and smoking habits. A subgroup of 43 men was further screened for both humoral anti-lung antibodies (ALA) and direct lymphocyte-mediated cellular cytotoxicity (LMCC) towards human embryonic lung fibroblasts (HEL). In addition 673 serum samples obtained during a previous study of autoimmune factors in coalworkers were screened for humoral antibodies to HEL cells. The only correlation found between category of pneumoconiosis and alterations in WBCC, percentage or absolute numbers of lymphocytes, or the presence of anti-lung antibodies was a decrease in a subgroup of T lymphocytes with increasing severity of pneumoconiosis. The major factor influencing these parameters in this study was the smoking status of the man. Smokers showed increased WBCC and lymphocyte numbers and a higher frequency of ALA and LMCC when compared with nonsmokers. PMID- 6846342 TI - Classical syndromes in occupational medicine: dimethylaminopropionitrile. AB - Dimethylaminopropionitrile, used as a catalyst in the manufacture of polyurethane, was responsible for two epidemics of urinary retention, sexual dysfunction, and peripheral neuropathy in 1978. Most affected workers recovered promptly, but some have had persisting neuropathy, sexual and bladder dysfunction, and CNS symptoms. The mechanism of neurotoxicity appears to be interference with axoplasmic transport. The catalyst that caused the problem was withdrawn from the market after swift governmental action. PMID- 6846347 TI - Inexpensive microcomputer for intravenous admixture service applications. AB - A microcomputer system for maintaining data on intravenous piggyback (IVPB) admixture use and for generating labels for IVPB admixtures is described. The system was developed in a 558-bed hospital where the pharmacy compounds 500-800 i.v. admixtures daily. The objectives were to (1) provide an electronic profile with quick patient-search capabilities, (2) reduce time spent and errors occurring in labeling, (3) decrease duplication and consequent waste of admixtures, and (4) improve collection of drug-use statistics. Software was developed by the pharmacist to achieve these objectives. When a drug order is entered, files are automatically searched for duplication. Every 24 hours, labels for the entire patient profile are printed and statistics are generated on types of drugs used, number of each type of drug, total number of patients on IVPBs, and total number of IVPBs. A user's manual was developed and staff-training sessions were held before the system was implemented. In the first 24 months of operation, most computer downtime was caused by hardware problems. Four man-hours per day were saved in typing time (+7000 annual cost reduction). Waste of approximately six admixtures daily was prevented (+5000 annual savings). Total software development and implementation cost +5000, and hardware cost +4200. The total cost of the system was thus realized during the first year of operation. PMID- 6846345 TI - Job satisfaction among U.S. pharmacists. AB - A review of the literature on job satisfaction that is relevant to pharmacists is presented. Studies conducted in the United States between 1951 and 1982 were evaluated to answer two questions: (1) What is known about the level of job satisfaction among pharmacists? and (2) What factors are related to pharmacists' job satisfaction? Some study populations were selected on the basis of work setting, others on position in the job hierarchy, and others on different criteria. Job satisfaction measures were of two general types, facet-free measures, which assess overall satisfaction, and facet-specific measures, which gauge satisfaction with respect to a specific aspect of the job. Pharmacists in the studies represented a wide variety of work settings and geographic locations. Most of the studies were not comparable because they used instruments unique to a particular study. In some cases, response rates were low and sample sizes were small. Frequently, results were not analyzed statistically for significance. A few studies compared pharmacists with other job populations; the differences were not striking, although pharmacists may be slightly less satisfied with their specific jobs than the general public. Repeatedly, job position and ability utilization appeared related to pharmacists' job satisfaction. Further study of the extent, causes, and consequences of pharmacists' job satisfaction is needed. Research methods should be designed so that results can be analyzed and compared statistically. PMID- 6846346 TI - Evaluation of a cardiopulmonary-resuscitation training manual for pharmacists. AB - The development and evaluation of a training manual for pharmacists participating in cardiopulmonary resuscitation (CPR) efforts at an institution encompassing ambulatory-care, acute-care, and emergency-trauma facilities are described. The manual was developed to familiarize pharmacists who had little or no experience in CPR procedures with the equipment and medications used and the pharmacist's role on the CPR team. To evaluate the effectiveness of the manual, a 29-question multiple-choice test was administered to 35 staff pharmacists who were randomly assigned to study and control groups. Training manuals were issued to members of the study group, who were asked to document time spent studying them. Three weeks after the pretest, the same test was administered to all subjects. There was no control on the number of CPR events attended during the three-week period. The study group spent less than two hours (mean +/- S.D. = 97.5 +/- 34.22 min) using the manual. For the study group, posttest scores were significantly higher than pretest scores. The difference in pretest scores for the study and control groups was not significant, but for the posttest the study group scores were significantly higher. Because use of the manual appeared to improve knowledge of drug therapy and procedures used in CPR, the pharmacy department incorporated it into its orientation procedure. PMID- 6846349 TI - Physician noncompliance with prescription-writing requirements. AB - Prescriptions processed in an outpatient pharmacy department (OPD) were audited retrospectively for physician noncompliance with prescription-writing requirements, and the estimated cost in pharmacist and patient time attributable to the errors made was assessed. During a 14-day period, 7858 prescriptions written by 451 physicians and taken to the OPD of a large teaching hospital were examined. When the patient's name, physician's signature, drug quantity, or directions for use were omitted, patients were asked to return the prescription in person for correction. In a follow-up study, the time spent at the clinic for this purpose was recorded for 50 patients. For another sample of 52 prescriptions corrected by a pharmacist's telephone call to the physician, pharmacist time spent was recorded. Errors were found in 1070 prescriptions. The total number of errors was 1130, for a noncompliance rate of 14.38%. The most frequent errors were ordering of nonformulary drugs and erroneous or unspecified dosage strength. There was no difference in noncompliance among physicians with various levels of training. An average of 25 patients per day were asked to return to the clinic for correction of their prescriptions; more than half did not return to the OPD. For the 50 patients whose return visits were monitored, time spent in the clinic area was 15.0 +/- 9.1 minutes. For the 52 prescriptions corrected by telephone calls to physicians, the pharmacist spent 10.3 +/- 11.0 minutes. Under these study conditions, pharmacists spent 16.3 hours per day correcting prescription errors; if asked to return all unfillable prescriptions, patients would have spent 23.7 hours per day. Pharmacy departments might reduce these time expenditures by conducting periodic reviews of prescription errors and apprising physicians of frequent areas of noncompliance. PMID- 6846348 TI - Diuretic use in an ambulatory elderly population. AB - The nature and extent of diuretic use and the effect of diuretics on clinical laboratory values were studied in a retirement community. Study participants completed health questionnaires and provided information on all prescription and nonprescription medications regularly used. Subjects using diuretics were categorized according to product(s) used; a control group used no diuretics. Results for diuretic users who used potassium supplements were analyzed separately. Data were collected on 2009 women and 1183 men over 65 years old. At least one diuretic drug was used by 40.2% of the women and 29.5% of the men. In most cases, the diuretic was used daily (81.1%) and had been used for longer than two years (72.5%). Approximately one third of the subjects had hypertension. Serum potassium values for users of chlorthalidone and thiazide diuretics showed the greatest difference from the control group, while users of the combination of hydrochlorothiazide and spironolactone showed the greatest difference in serum sodium concentrations. Particularly in furosemide users, uric acid, BUN, and creatinine concentrations were significantly different from control. When serum potassium values of subjects using both diuretics and potassium supplements were analyzed, values were lower in participants using supplements. In many cases, significantly different laboratory values were still within normal limits. Long term diuretic use in this ambulatory elderly population was high and was associated with numerous alterations in biochemical values. PMID- 6846351 TI - Interference of selected second- and third-generation cephalosporins with creatinine determination. AB - The interference of selected second- and third-generation cephalosporins and cephalosporin-like antibiotics with serum and urine creatinine determinations was studied. Single determinations of apparent creatinine concentrations in serum, urine, and water samples were measured by three methods--manual, automated dialysis (SMAC 12/60), and direct kinetic (KDA Analyzer). Various concentrations of each cephalosporin were tested for interference with creatinine determinations. Drugs studied were cefoxitin, cefamandole, cefotaxime, ceftazidime, cefoperazone, ceftizoxime, moxalactam, ceftriaxone, and ceforanide. Cephalosporins demonstrating interference with one or more methods were further tested at concentrations representing the range of clinically achievable serum and urine drug concentrations. Cefoxitin, ceforanide, moxalactam, ceftizoxime, and ceftriaxone demonstrated significant interference in the screening tests. In subsequent testing, interference was shown at clinical concentrations of cefoxitin (all three methods) and ceforanide (manual and KDA methods). Where interference occurred, the degree varied with the assay method and the drug concentration. Recommendations are presented for serum and urine sampling for creatinine determinations in patients receiving cefoxitin and ceforanide. Based on the relationship between test interference and concentrations of these drugs achievable in patients with varying degrees of renal dysfunction, only cefoxitin and ceforanide can be expected to cause significant false elevations in vivo. To minimize interference, blood samples should be drawn at the time of minimum drug concentration. PMID- 6846350 TI - Factors affecting the availability of diazepam stored in plastic bags and administered through intravenous sets. AB - Factors affecting the loss of diazepam from i.v. admixtures to flexible polyvinyl chloride (PVC) bags and to various administration sets were studied. Admixtures containing diazepam and 0.9% sodium chloride injection were stored for up to 550 hours in flexible PVC bags and in glass vials at various temperatures. Diazepam injection containing two different solvents was used. Initial diazepam concentrations in storage studies ranged from 25 to 100 micrograms/ml and pH ranged from 4.2 to 7.5. To determine availability of diazepam after infusion through administration sets, solutions (50 micrograms/ml) from glass containers were run through six different sets at 1 ml/min for seven hours. In storage studies, the difference in composition of the solvent was found to have only a slight effect on the rate and extent of diazepam loss. Diazepam loss was unaffected by pH. For admixtures stored in 1000-ml flexible PVC bags, the fractional loss of diazepam was greater at small volumes. The diazepam concentration of solutions in flexible PVC bags decreased more rapidly during infusion than during storage of the total original volume. The fraction of diazepam remaining in stored solutions was independent of the initial concentration, but the rate and extent of diazepam loss was greater at higher temperatures. Diazepam loss was dependent on length of flexible PVC tubing, and diazepam availability was greater with faster flow rates. In solutions infused through the polyolefin Tridilset, 100% of the diazepam remained. When storage of diazepam admixtures in PVC bags or administration through PVC tubing cannot be avoided, measures to minimize the rate and extent of diazepam loss include decreasing the temperature and the storage time and increasing the surface-area to-volume ratio and the flow rate. Equations are presented for calculating the amount of diazepam delivered. PMID- 6846353 TI - Hospital pharmacy program for reporting adverse drug reactions. PMID- 6846352 TI - Pharmacist liability for suicide by drug overdose. AB - Conditions that affect pharmacist liability for suicide by drug overdose are discussed. Traditionally, courts have refused to find liability on the part of a pharmacist who negligently dispenses medication to a patient who then commits suicide with the medication. The rationale has been that the act of suicide is not reasonably foreseeable to the pharmacist, and therefore it is an independent intervening act that breaks the chain of causation between the pharmacist's negligent act and the death of the patient. This legal precedent was followed in a recent case involving hospital pharmacists in Dallas, Texas. Analysis of the facts in the Dallas case shows that the pharmacists could reasonably have foreseen the patient's suicide, and the court's reliance on precedent might have been misplaced. This case and review exemplifies a pharmacolegal situation in which practitioners cannot strictly rely on reported case law to guide their actions. Pharmacies should develop policies and procedures to prevent patients from accumulating medications with which suicide can be consummated. PMID- 6846354 TI - Developing an adverse drug reaction reporting program. PMID- 6846356 TI - Recorded medication messages for ambulatory patients. PMID- 6846355 TI - Effect of hospitalization on patient use of hypnotics. PMID- 6846357 TI - ASHP guidelines for the use of investigational drugs in institutions. PMID- 6846358 TI - ASHP guidelines for repackaging oral solids and liquids in single unit and unit dose packages. PMID- 6846359 TI - What's best for the patient? PMID- 6846360 TI - Suggestions for improving pharmacy cost-effectiveness research. PMID- 6846361 TI - Theophylline pharmacokinetic monitoring services: another perspective. PMID- 6846363 TI - Medical editors discover clinical pharmacy. PMID- 6846362 TI - Need for attitudinal counseling of patients. PMID- 6846364 TI - Factors affecting the salaries of pharmacy directors in large hospitals. PMID- 6846365 TI - Exposure of hospital workers to airborne antineoplastic agents. AB - Practices for handling antineoplastic drugs were surveyed, and ambient-air sampling for four antineoplastic agents was conducted in outpatient oncology clinics. A questionnaire was administered in 1981 to the nurse or pharmacist in charge of drug preparation at 10 hospital oncology clinics. At three sites, air samples were collected during working hours in medication-preparation rooms and nearby offices. The air-sampling pumps contained filters at breathing-zone height; room air was drawn through each filter for 40 hours. Extracts from the filters were assayed by high-performance liquid chromatography (HPLC) for fluorouracil and cyclophosphamide in seven sets of samples and methotrexate and doxorubicin in five sets of samples. Mass spectrometry (MS) was used to confirm detection of fluorouracil. Total use of each monitored drug was recorded at each site. Nine clinics had no ventilation hood, and drugs were prepared by nurses in eight clinics. Routine use of gloves (three clinics) and masks (one clinic) was uncommon, and wastes were disposed of in uncovered receptacles in four of the clinics. Eating and drinking occurred in seven of the preparation rooms. At the main air-sampling site, fluorouracil (0.12-82.26 ng/cu m) was detected in air during 200 of the 320 hours monitored. Cyclophosphamide (370 ng/cu m) was present during 80 hours. In the two other sites, fluorouracil was detected by HPLC but not confirmed by MS, and no cyclophosphamide was detected. No detectable amounts of methotrexate and doxorubicin were present. Fluorouracil was the most frequently used drug, and cyclophosphamide was second. Results suggest that personnel handling antineoplastic drugs are subject to potential systemic absorption of these agents by inhalation. PMID- 6846366 TI - Procedures for handling antineoplastic injections in comprehensive cancer centers. AB - The procedures for handling injectable antineoplastic drugs in comprehensive cancer centers in the U.S. are summarized. In May 1982, a survey was sent to directors of pharmacy at 27 institutions designated as comprehensive cancer centers. Some questions duplicated a 1979 survey, while others addressed points in recently published guidelines on handling antineoplastic medications. Representatives of 21 institutions responded. These institutions represented 13,638 beds, 1,848 of which were oncology beds. Seventeen institutions had written policies for the preparation of antineoplastics, but only nine had a training program. The pharmacist or pharmacy technician prepared these medications in 12 institutions. Ten institutions prepared antineoplastics in a vertical laminar-flow hood. Gloves and masks were worn by employees in 20 and 13 of the institutions, respectively. Six institutions in some way assessed the health of employees handling antineoplastics. Eleven institutions had written policies on disposal of antineoplastics; 13 institutions disposed of this waste separately. Ten institutions had a training program for administration of antineoplastics. Compared with 1979, the trend is toward increased protection of persons handling injectable antineoplastic agents, but the procedures used at comprehensive cancer centers are not uniform. PMID- 6846367 TI - Effect on drug costs of implementing decentralized drug distribution. AB - The drug costs associated with a centralized drug-distribution system were compared with those of a newly implemented decentralized unit dose and i.v. admixture system in a university teaching hospital. Three months before and three months after implementation and stabilization of the new drug-distribution system, the mean drug cost per patient day was determined for each of 22 nursing stations. Variations in drug use were monitored to eliminate the influence of patient mix or treatment protocol. Data from 2 of the 22 nursing stations were excluded from analysis because of large variations in drug use. Twelve nursing stations demonstrated lower drug costs per patient day with the new drug distribution system. Overall, an 18% reduction in drug costs per patient day was achieved. In this hospital, a decentralized drug-distribution system was associated with lower drug costs than the traditional distribution system. PMID- 6846368 TI - Work-sampling evaluation of an upgraded outpatient pharmacy computer system. AB - The effect of an upgraded outpatient pharmacy computer system on routine dispensing activities was studied. A computer system that previously generated patient bills, prescription labels, and management reports was upgraded to provide patient profiles, allergy and drug-drug interaction monitoring, auxiliary label notification, and prescription prices. Four months after the upgraded system was implemented, dispensing activities were analyzed using a work-sampling technique. The percent of time spent in prescription processing, inventory maintenance, problem solving, or miscellaneous activities was determined. These data were compared with data obtained in a study of the old system. A total of 5897 observations of the upgraded system was compared with 5632 observations in the previous study. There were significantly different changes among the four activity groups for the total staff and for pharmacists, technicians, and the data-entry operator. Under the modified system, pharmacists spent more time in prescription coding and less time on patient counseling. The data-entry operator had less computer-entry time. It could not be stated conclusively that overall efficiency was improved by the new system. PMID- 6846369 TI - Program to disseminate information on new hospital pharmacy practices. AB - A five-year program to stimulate interest in contemporary pharmacy practices and disseminate information to pharmacists and other health professionals in community hospitals throughout the State of Maine is described. Pharmacists from the New England Medical Center in Boston and the Maine Medical Center in Portland conducted a program from 1973 to 1978 that included consultative services, drug information, and continuing-education components. Pharmacy consultants visited about 50% of the hospitals in the state and met with the director of pharmacy, administrator, and director of nursing who received written reports of all findings and suggestions. Most frequently, hospitals requested recommendations on drug-distribution systems, design and use of medical profiles, and design of physician order forms. Surveys at the beginning and at the end of the program indicated that the number of hospitals with unit dose systems and i.v. admixture programs increased during the life of the program; pharmacy staffing levels also increased. The program successfully brought consultative services, drug information, and educational programs to pharmacists and other health professionals in community hospitals in Maine. PMID- 6846371 TI - Stability of allopurinol and of five antineoplastics in suspension. AB - The stability of allopurinol, azathioprine, chlorambucil, melphalan, mercaptopurine, and thioguanine each in an extemporaneously prepared suspension was studied. Tablets of each drug were crushed, mixed with a suspending agent, and brought to a final volume of 10, 15, or 20 ml with a 2:1 mixture of simple syrup and wild cherry syrup. Suspensions were prepared in the following concentrations: allopurinol (20 mg/ml), azathioprine (50 mg/ml), chlorambucil (2 mg/ml), melphalan (2 mg/ml), mercaptopurine (50 mg/ml), and thioguanine (40 mg/ml). Using high-performance liquid chromatography or ultraviolet scans, duplicate assays were performed on each suspension periodically during storage for up to 84 days at ambient room temperature or 5 degrees C. The time required for the suspensions to drop below 90% of labeled strength was used as an indicator of drug stability. Allopurinol and azathioprine were stable for at least 56 days at room temperature and at 5 degrees C. Chlorambucil decomposed rapidly at room temperature but was stable for seven days when stored at 5 degrees C. Melphalan suspensions did not meet the stated criteria for stability even at the time of initial assay. Mercaptopurine and thioguanine were stable for 14 and 84 days, respectively, at room temperature; at 5 degrees C, assay values dropped below those obtained at room temperature. In the suspension formulation tested, allopurinol, azathioprine, mercaptopurine, and thioguanine are stable for at least 14 days at room temperature; chlorambucil suspensions should be refrigerated and discarded after seven days. Melphalan decomposes too rapidly to make this suspension formulation feasible for extemporaneous compounding. PMID- 6846370 TI - Stability of three oral liquid drug products repackaged in unit dose containers. AB - Stability of oral liquid forms of cimetidine hydrochloride, furosemide, and theophylline repackaged in polypropylene oral syringes and glass vials was assessed. Commercial preparations of each product were used; 2-ml quantities were placed in both types of container and stored at 4, 25, 44, 60, and 76 degrees C. Six samples from each container type at each temperature were tested at various times. Stability was defined as no greater than 10% loss of labeled potency. Assay was by high-performance liquid chromatography. All three drugs retained more than 90% of label claim in both types of containers after 180 days at 4 degrees C and 25 degrees C. For cimetidine hydrochloride and furosemide at these temperatures, there was no significant difference in concentration by container type; at the higher storage temperatures, the degradation rate in polypropylene syringes was significantly faster. For theophylline, loss of volume of 10% or greater occurred after 60 days at temperatures greater than 25 degrees C for both container types. Drug loss at higher temperatures was attributed to precipitation of theophylline out of the elixir rather than chemical degradation. Oral liquid cimetidine hydrochloride, furosemide, and theophylline repackaged in either polypropylene oral syringes or glass vials can be stored at 4 degrees C and 25 degrees C for 180 days with less than 10% loss of potency. PMID- 6846373 TI - Effect on dissolution of tablet storage in counting machines. AB - The effects of storage in an automatic counting and dispensing machine on dissolution rates on five drug products with known or suspected bioequivalence problems were studied. Amitriptyline hydrochloride, digoxin, prednisone, hydrochlorothiazide, and tolbutamide tablets exposed and unexposed to automatic counting machines were collected from 10 pharmacies located in various parts of the country. A 60-tablet unexposed sample was taken from a previously unopened container and placed in a tight, light-resistant container. Another 60-tablet sample of the same brand and lot number was collected 30 days after the initial filling of the counting machine or when it had to be refilled, whichever came first. Each sample was tested for dissolution rate and content uniformity. Twenty seven paired samples representing 23 lots from 10 manufacturers were collected. There were no substantial differences in dissolution rate or content uniformity between the exposed and unexposed samples. Average temperatures in the pharmacies during the three-month sampling period ranged from 72 to 79 degrees F. Storage times of the drug product samples in the automatic counting machines varied from 9 to 46 days. The environmental conditions to which these tablets were exposed had no noticeable effect on the dissolution of these formulations. PMID- 6846372 TI - Particulate matter in four reconstituted cephalosporin injections. AB - The amount and size of particulate contamination in three commercially available cephalosporin injections and a new product, anophilized cephalothin sodium injection, were studied. Particles in reconstituted cephalothin sodium (commercially available and anophilized), cephapirin sodium, and cephradine injections were counted using two methods: (1) modified USP membrane-filtration technique and (2) Elzone computerized particle analyzer. The amount of particulate contamination in the ranges of 10-24 and greater than or equal to 25 microns was determined by both methods. In the 10-24-microns range, the cephalothin, cephapirin, and cephradine products had significantly greater particle counts than the anophilized cephalothin product. The greater than or equal to 25-microns particle counts showed that the cephapirin and cephradine products had particle counts greater than the anophilized cephalothin product, while total particle counts showed the same results as the 10-24-microns particle counts. A comparison of counting methods showed that the only significant difference between the number of particulates obtained using the modified USP and Elzone computer methods was with the cephalothin product. Anophilized cephalothin sodium injection has significantly fewer particles in the size ranges studied. No conclusion could be reached as to the more accurate method for counting particles. PMID- 6846374 TI - In vitro effect of cimetidine concentration and pH on guaiac-slide tests. AB - The in vitro effect of cimetidine concentration and pH on two brands of guaiac slide tests was studied. Samples of simulated gastric fluid at pH 1.2, 2.8, and 4.0 were prepared. Cimetidine was added to each of these solutions, and subsequent dilutions of the three samples were made to produce cimetidine concentrations of 10, 5, 2.5, 2.0, 1.5, 1.25, and 0.625 mg/ml. Samples of each pH concentration combination were placed on two test areas of two Hemoccult and two Fe-Cult slides and tested in accordance with manufacturers' instructions. To determine more specifically the effect of pH, seven aliquots of a cimetidine solution of 1.5 mg/ml in distilled water were prepared (initial pH 8.8). Hydrochloric acid was added to six aliquots to adjust the pH to 7.3, 6.5, 4.6, 3.4, 2.6, and 1.5. A sample of each aliquot was applied to two test areas of four Hemoccult and four Fe-Cult slides. In general, at a given concentration, fewer positive results were obtained with samples prepared from the solution lowest in pH. All results were negative at cimetidine concentrations less than 1.5 mg/ml. When the cimetidine concentration was constant at 1.5 mg/ml, pH values greater than 4.6 for Hemoccult and greater than 7.3 for Fe-Cult were associated with positive results. Both tests appeared to become less sensitive to the effect of cimetidine at lower pH values. Positive Hemoccult and Fe-Cult guaiac-slide test reactions occur in vitro at cimetidine concentrations greater than or equal to 1.5 mg/ml. Because it is doubtful that in vivo concentrations of cimetidine in gastric fluid exceed 1.5 mg/ml, the clinical importance of this interaction is probably minor. PMID- 6846375 TI - Recent supreme court antitrust rulings in health care. AB - Three recent U.S. Supreme Court antitrust rulings that influence the health-care delivery system are examined. Historically four defenses protected the health care system from antitrust law. They are the learned-profession exemption, the fact that health-care systems have little effect on interstate commerce, the state-action defense, and the business-of-insurance exemption under the McCarran Ferguson Act. These defenses and Supreme Court cases that have weakened or eliminated them are described. The cases are Arizona v. Maricopa County Medical Society, Union Labor Life Insurance Co. v. Pireno, and Blue Shield of Virginia v. McCready. Health-care providers will be subject to increased antitrust scrutiny as a result of these cases. PMID- 6846376 TI - Relationship of lipid disorders to coronary heart disease. AB - Broad-based population studies have recently provided important new evidence relative to the independent coronary heart disease, stroke, and hypertension risk factors and their interrelationships, "tracking," familial aggregation, and contribution to coronary heart disease morbidity and mortality. Therapeutic studies designed to reduce both total and low-density lipoprotein cholesterol levels in patients with coronary heart disease unequivocally show that morbidity and mortality rates can be sharply reduced by risk-factor intervention. Over the past two decades, there has been a dramatic decrease in the dietary intake of cholesterol and an increase in polyunsaturated fat in the American population, as well as increased adult participation in aerobic exercise programs. Over the same time period, a dramatic decrease in coronary heart disease mortality rates has been recorded in the United States. PMID- 6846377 TI - Hyperlipoproteinemia and atherosclerosis: dietary intervention. AB - Elevated levels of plasma low-density lipoprotein and/or very low-density lipoprotein cholesterol, as seen in hypercholesterolemia and/or hypertriglyceridemia, are primarily caused by a diet high in saturated fat, cholesterol, and calories, and by excessive intake of alcohol. Dietary treatment constitutes the fundamental step in successful management of hyperlipidemia. An appropriately designed diet alleviates the problem to variable degrees, even in patients with primary types of hyperlipoproteinemia. Dietary therapy should be initiated when the serum cholesterol level is above 200 mg/dl in adults, and between 190 to 200 mg/dl in children, and when triglyceride values are consistently greater than 200 mg/dl. Because hyperlipidemia is often familial, due both to genetic influence and eating habits, dietary modification should be made early in life and incorporated as a permanent part of the family's life style. PMID- 6846378 TI - Pharmacologic therapy for the hyperlipidemic patient. AB - Drug therapy should be instituted only after appropriate diet treatment has been started and adequate baseline lipid and lipoprotein values are established. Nicotinic acid is useful in treating most lipoprotein disorders and the cutaneous flushing that develops during the early part of treatment is usually alleviated by aspirin. Cholestyramine and colestipol are nonabsorbable resins whose use is limited to type II hyperlipoproteinemia. Clofibrate is primarily effective in lowering triglyceride levels, but its clinical use has considerably declined following the World Health Organization study results that reported increased morbidity and mortality rates among patients receiving this drug. Based on the finding of increased mortality among a subset of patients participating in the Coronary Drug Project, dextrothyroxine is only recommended for treating patients who do not have clinically evident atherosclerotic heart disease. Probucol lowers total and low-density lipoprotein cholesterol levels, but has the undesirable effect of simultaneously reducing high-density lipoprotein levels. PMID- 6846379 TI - Clinical diagnosis of hyperlipoproteinemia. AB - Specific physical findings are associated with the different phenotypes of hyperlipoproteinemia and may point up the need for further medical work-up to determine whether hyperlipoproteinemia is primary or secondary. The clinical manifestations of severe elevations in plasma lipid levels include xanthomas, which may be tendinous, tuberous, or eruptive. Xanthelasma is a common type of xanthoma that is seen in the creases of the eyelids. Other clinical manifestations of hyperlipoproteinemia include corneal arcus, lipemia retinalis, abdominal pain and pancreatitis. In patients with certain types of xanthoma whose serum cholesterol and triglyceride levels are normal, hyperlipoproteinemia has been diagnosed on the basis of abnormalities in plasma apoproteins and their subfractions. PMID- 6846380 TI - Microbiology problem. PMID- 6846381 TI - Synthetic materials for platelet quality control. AB - At present, the quality control of platelet counting by semi-automated and automated methods does not meet ideal standards. Controls prepared from human or animal platelets have limited stability, and some synthetic platelet controls that are available do not have the size distribution of fresh platelets. The platelet control materials described here are wholly synthetic; however, their particle size distribution is like that of normal human platelets, and the dispersing medium has the viscosity and surface tension of plasma. Two types of products are described. The first type are dilutions of the synthetic platelets which are handled like 3000-fold dilutions of platelet-rich plasma and are intended for direct use on instruments like the Coulter ZBI. The two dilution levels gave counts of about 50,000 and 200,000/microL on the Coulter ZBI and were found to be stable for at least 30 days at - 20C, 4C, and 37C, and at least eight months at 25C. The second type of product is handled like whole blood and is intended for direct use on instruments like the Coulter Model S-Plus. This product gave counts of about 200,000/microL and was found to be stable for at least 120 days at - 20C, 4C, 25C, and 37C. Freezing at - 20C produced some aggregates that dispersed after thawing and standing for several days prior to testing. PMID- 6846382 TI - The serology of the York-Cost-McCoy-Knops red blood cell system. AB - Since 1965, sera from 305 patients who produced alloantibodies against the red blood cell antigens Yka, Csa, McCa, McCc, McCd and Kna have been evaluated by the author. These antibodies were acquired as a result of either transfusion or pregnancy. They reacted only by indirect antiglobulin technique, and were generally unaffected by ficin pretreatment of test cells. The majority reacted poorly in EM-V LISS when 10 minute incubations were used. Cord red blood cells showed normal expression of the antigens. Serologic difficulties were due to relative antigen fragility in vitro of patients' samples, varying expression of antigen strength, relative low antibody avidity, and in 48% of the sera coexistence of additional unrelated alloantibodies. Antigen frequencies for Yka, Csa, McCa and Kna ranged between 90 and 99%, also displaying racial differences. PMID- 6846384 TI - Urine sediment. PMID- 6846383 TI - Normal range of plasma fibrinogen. AB - The automated thrombin time procedure was used to establish the normal range of fibrinogen concentration. Our results indicate a non-Gaussian distribution of this plasma protein and suggest this distribution is both age- and sex-dependent. The 95% confidence interval for the normal range of fibrinogen was 145-348 mg/dl. PMID- 6846385 TI - Quality control in the automated clinical laboratory. PMID- 6846386 TI - Quality control charting in a large automated laboratory. PMID- 6846387 TI - Comparative evaluation of biochemical and microscopic urinalysis. AB - In the present investigation, only one of 244 (0.4%) urines with abnormal microscopic findings would have been missed because of normal biochemical results of pH, protein, glucose, ketones, bilirubin, urobilinogen, hemoglobin, and leukocyte esterase. These biochemical tests detected 106 of 107 (99.1%) urines with significant microscopic findings. Sixty-three (25.8%) of 244 urines tested could have been eliminated from microscopic examination based on the negative results of the biochemical screen. PMID- 6846389 TI - Competitive bidding for laboratory services, supplies, and equipment. AB - A procompetition approach to reducing health care costs has moved from the discussion stage to implementation. The Omnibus Budget and Reconciliation Act of 1981 called for competitive bidding for laboratory services. The Health Care Financing Administration recently awarded a contract to the Center for Health Policy Studies for the development of a competitive bidding system for clinical laboratory services. In 1981 an ASMT Task Force appointed by the Chair of the Government Liaison Committee developed the following White Paper on Competitive Bidding for Laboratory Services, Supplies, and Equipment. The Paper was considered for comment by the 1982 ASMT House of Delegates and adopted by the Board of Directors in October, 1982. This paper provides members of the Society with practical information on using the competitive bidding process in their own work setting. The Chairman of the Task Force was Walter Valliere of Houston, TX, with the final revisions of the Paper being prepared by John P. Smith of Wichita, KS. PMID- 6846388 TI - A continuing education program for rural communities: evaluating cognitive and behavioral change. AB - A total of 133 laboratory workers from 60 institutions participated in a unique continuing education project in North Dakota. Cognitive and behavioral changes of the participants were measured in an attempt to evaluate the effectiveness of the Laboratory Education for North Dakota (LEND) program, which included self instructional programs (SIPs), telelectures, and workshops. The effects of variables such as institutional size, educational level of participants, topic presented, and type of participation were studied. Institutional size had no significant effect on cognitive change (P greater than .05) but had some effect on behavioral change. Educational level was found to significantly affect pretest scores (P less than .05), but was not a major factor in post-test scores. Certain topics presented (i.e., quality assurance and microbiology) resulted in significantly more behavioral changes than other categories. Behavioral changes and degree of cognitive change did not always correspond. Significant correlation was shown between attendance at wet workshops and the number of behavioral changes. PMID- 6846390 TI - Determination of glucose-6-phosphate dehydrogenase levels in red cell preparations. AB - Data are presented which prove that accurate measurement of glucose-6-phosphate dehydrogenase (G6PD) activity in red cells can be affected by the presence of leukocytes and platelets. Measurement of the enzyme in red cell preparations (after buffy coat removal) permits more accurate identification of patients with deficient enzyme activity, especially in the presence of anemia and/or leukocytosis. PMID- 6846391 TI - Hematology problem: plasma cell leukemia in multiple myeloma. PMID- 6846392 TI - Interstitial lung disease in primary biliary cirrhosis. AB - A 51-year-old woman with a 5-1/2 year history of primary biliary cirrhosis (PBC) developed interstitial lung disease (ILD). The initial pulmonary infiltrate consisted of unilateral nodules mimicking neoplastic disease and later progressed to involve both lungs with a diffuse interstitial process. Tissue obtained by open lung biopsy was compatible with lymphoid interstitial pneumonia. The pulmonary infiltrates cleared spontaneously but recurred on two more occasions with subsequent resolution. This pulmonary disease activity appeared unrelated to the chemical activity of the PBC, which progressed to a fatal termination. The association of ILD, especially of a recurrent nature, with PBC is rare. PMID- 6846393 TI - Presumed respiratory syncytial virus pneumonia in three immunocompromised adults. AB - Three cases of presumed respiratory syncytial virus (RSV) pneumonia in immunocompromised adults are described. Two patients had symptoms of cough, fever, and malaise, following completion of a course of combination chemotherapy for the treatment of acute lymphoblastic leukemia. The third patient, a juvenile onset diabetic, developed similar symptoms while hospitalized for severe hyperglycemia. Chest roentgenograms showed lower lobe infiltrates in both leukemic patients and a bilateral non-confluent bronchopneumonia in the diabetic patient. All patients had a marked rise in complement-fixing antibody titres to RSV, suggesting a concurrent infection with the virus. Extensive microbiological investigations failed to reveal any other etiologic agent. Nosocomial infection was considered possible. RSV is not considered a cause of pneumonia in compromised adults. Our three cases suggest that there may be a higher incidence of RSV pneumonia in compromised patients, than previously recognized. PMID- 6846394 TI - Dyssyntonia chronicis (The Syncopated Biological Clock). PMID- 6846396 TI - Origin of a paternal (13q;15q) translocation leading to dup(13q) in two half sibs. AB - We report on two half-sibs, a male and a female with dup(13)(q1405 leads to qter) that resulted from a der(15),t(13;15)(15qter leads to 15q25::13q1405 leads to 13qter), h+, pat. Their manifestations were similar to those with duplication of the distal half 13q. The father was a balanced de novo translocation carrier. Since the der(15) had a long secondary constriction, it was possible to trace the site of the mutation to the germ cell of the patients paternal grandmother who had this distinctive long secondary constriction in one of her normal 15 chromosomes. PMID- 6846395 TI - Brief clinical report: autosomal recessive anophthalmia with multiple congenital abnormalities--type Waardenburg. AB - We report two Brazilian families with children who had anophthalmia and multiple congenital abnormalities and consanguineous parents. Among the five affected children, four had bilateral and one had unilateral anophthalmia. Autosomal recessive inheritance is demonstrated. PMID- 6846397 TI - The branchio-oto-renal (BOR) syndrome: report of bilateral renal agenesis in three sibs. AB - We report a man who had the branchio-oto-renal (BOR) syndrome with crossed renal ectopia. His three children were born with bilateral renal agenesis and the so called Potter syndrome. This case illustrates the potential severity of the renal anomalies in the BOR syndrome and the inadequacy of oligohydramnios and maternal serum alpha-fetoprotein as screening methods for renal agenesis. This case also implies strongly the necessity for meticulous search for renal anomalies in individuals with the BOR syndrome and proper counseling regarding the possibility of lethal bilateral renal agenesis. PMID- 6846398 TI - Familial paracentric inversion of 1p. AB - We report a paracentric inversion of 1p in a boy with mild mental retardation. The chromosome aberration was identified by high resolution chromosome banding, and was also present in his phenotypically normal mother and other relatives. The boy's karyotype was considered to be 46,XY,inv(1) (p31,2p36.22) ISCN (1981). PMID- 6846400 TI - Congenital heart anomalies in the trisomy 18 syndrome, with reference to congenital polyvalvular disease. AB - Congenital polyvalvular disease (CPVD) is seen in trisomy 18 and other aneuploidy syndromes. However, its extent and nature have not been studied. Gross pathologic and histologic aspects of the heart were studied in 15 autopsied cases of trisomy 18. All had CPVD; other congenital defects included membranous ventricular septal defect (87%), patent ductus arteriosus (73%), and high takeoff of the right coronary ostium (80%). With a scoring system, histologic findings of the valves of all trisomy 18 cases were compared with those of 30 normal hearts of comparable age in order to determine the degree of morphologic abnormality. This included the presence of blood cysts, derangement of the spongiosa and fibrosa, vascular degeneration of the spongiosa, and defective elastic fibers. There were distinct differences between the changes seen in CPVD with trisomy 18 syndrome and those seen in the normal individuals. The most severe changes were present in the tricuspid and mitral valves with derangement of the spongiosa and fibrosa and defective elastic fibers. The valve tissue had a similar histologic appearance and structure to that of low birth weight infants (gestational age, 25 weeks). The valvular changes observed therefore are of fetal type and represent errors in tissue differentiation occurring as last as the third trimester. PMID- 6846399 TI - Duplication 8q syndrome due to familial chromosome ins(10;8)(q21;q212q22). AB - We describe a kindred in which an ins(10;8)(q21;q212q22) chromosome rearrangement has been segregating for at least four generations. The risk for balanced carriers to have offspring with duplication of 8q212 leads to 8q22 is about 0.31. Individuals with unbalanced chromosomes are mildly to moderately mentally retarded and have a similar unusual appearance. Other manifestations include highly arched or cleft palate (8/9), micrognathia (6/9), sloped shoulders (4 6/9), convulsions (4/9), camptodactyly (3/9), pectus excavatum (2/9), elbow contractures (1/9), and postaxial polydactyly (1/9). The appearance and habitus resemble the mosaic trisomy 8 syndrome, although other anomalies of mosaic trisomy 8, such as vertebral, patellar, and renal defects, were not demonstrated. PMID- 6846401 TI - Familial agnathia-holoprosencephaly. AB - Two stillborn sisters had characteristics of both agnathia and holoprosencephaly. Familial occurrence implies that agnathia-holoprosencephaly may be determined by a single recessive gene, something to be taken into account when counseling such families. Evidence from human experience and various animal models suggests that agnathia-holoprosencephaly represents a causally heterogeneous single developmental field defect. Anatomical studies of these two stillborn sisters support the view that they shared a developmental field defect which affected structures in the face, cranial cavity, and upper neck. The pathogenesis of these variably expressed defects probably relates to defects in neural crest cells of cranial origin and/or to underlying mesodermal support elements of these cells. PMID- 6846402 TI - Fragile (X) X-linked mental retardation I: relationship between age and intelligence and the frequency of expression of fragil (X)(q28). AB - Members of eight Saskatchewan families with fragile (X) X-linked mental retardation were studied in an attempt to relate frequency to age and intelligence. The mean IQ of 37 affected men was 35 (range 10-66). The mean IQ of 32 carriers was 88 (range 57-119), and the mean IQ of 13 females who remain at risk for being carriers, have no affected sons, and who failed to demonstrate the fra(X) was 100 (range 78-126). We demonstrated a significant inverse relationship between age and frequency of the fra(X) in carriers and in affected males. However, we demonstrated a more highly significant inverse relationship between frequency of the fra(X) and IQ in carriers but to a lesser extent in affected males. Of 32 carriers, only 3 (9.4%) did not demonstrate the fra(X) after addition of 5-fluoro-2'-deoxyuridine (FUdR) to the folic acid and thymidine reduced culture medium. From these data we would recommend that chromosome studies in individuals at risk for fra(X) X-linked mental retardation be carried out at the youngest age and that the addition of FUdR to culture medium is useful in carrier identification. It is clear that, in at least the carriers, a lower expression of the fra(X) is highly significantly correlated to higher intelligence. PMID- 6846403 TI - Panostotic fibrous dysplasia: a congenital disorder of bone with unusual facial appearance, bone fragility, hyperphosphatasemia, and hypophosphatemia. AB - We report a boy with unusual facial appearance, melanotic patches ("coast-of Maine" type), myelofibrosis, recurrent femoral fractures, and widespread fibrous dysplasia of bone. Biochemical findings included raised serum alkaline phosphatase (bone isozyme) and 1,25-(OH)2 vitamin D, and low serum phosphorus levels. Elevated urinary excretion rates of total hydroxyproline, glycylproline, and gamma-carboxyglutamic acid indicated increased turnover of bone matrix. Transiliac bone biopsy showed a dearth of marrow elements, greatly increased bone turnover, and absence of normal trabecular organization. Serial radiographs showed progressive cortical thinning and loss of bony trabeculae. Calcitonin and etidronate treatments had no lasting effect on the progressive bone disease. The term "panostotic fibrous dysplasia" is suggested for this condition. PMID- 6846405 TI - Brief clinical report: two children with de novo del(9p). AB - We describe two patients with characteristic manifestations of the del(9p) syndrome. Among the prominent manifestation are moderate mental retardation, trigonocephaly, flat nasal bridge, anteverted nostrils, long philtrum, square and hyperconvex nails, and apparently long digits. The metacarpophalangeal pattern profiles of the patients showed that the clinical impression of long fingers may be due to relative shortness of the metacarpals rather than to elongation of the phalanges. PMID- 6846404 TI - Clinical and genetic aspects of antithrombin III deficiency. PMID- 6846406 TI - The dup(3)(p25 leads to pter) syndrome: a case with holoprosencephaly. AB - We report a patient with dup(3p) syndrome with holoprosencephaly. This infant is compared with 17 others reported previously with banding studies. In 72% of cases the duplication derived from a mother with a balanced translocation; 78% of affected individuals are males. The most common anomalies are characteristic facial changes, congenital heart defects, and hypoplasia of male genitalia. Holoprosencephaly has not been reported before in the dup(3p) syndrome. PMID- 6846407 TI - Origin of the "associated" anomalies in Kaufman-McKusick syndrome. PMID- 6846408 TI - Fragile X chromosome in normal males. PMID- 6846410 TI - Intrauterine unilateral nephrostomy. PMID- 6846409 TI - Hyperlactacidemia associated with acute ritodrine infusion. AB - The use of beta-mimetic tocolytics has been associated with various metabolic derangements which have been the topic of investigational reports. Lactic acidosis has been reported to follow concomitant steroid administration. The purpose of this investigation was to delineate more clearly hyperlactacidemia in patients receiving various tocolytics with and without concomitant use of steroids in a prospective manner. Twenty patients in premature labor who received ritodrine had markedly increased blood levels of lactate (baseline, 1.0 +/- 0.1 mmol/L [SEM] versus 3.5 +/- 0.3 mmol/L [SEM] after 6 hours' intravenous infusion). In the other treatment groups, ritodrine plus hydrocortisone, hydrocortisone alone, and magnesium sulfate alone, lactate levels failed to change significantly. Clinical relevance and implications for metabolic alterations associated with beta-mimetic tocolysis are discussed. PMID- 6846411 TI - Diameter of cervical internal os after induction of early abortion by laminaria or rigid dilatation. PMID- 6846412 TI - A new etiology for a pelvic mass: cardiac catheterization pelvic hematoma. PMID- 6846413 TI - A method for clearing smoke during laser surgery of the vagina and cervix. PMID- 6846417 TI - Heterotopic pregnancy. PMID- 6846415 TI - The significance of lymphadenectomy in therapy of ovarian carcinoma. PMID- 6846418 TI - What is a retrospective study? PMID- 6846416 TI - Hemodynamic observations in a patient with intrapartum amniotic fluid embolism. PMID- 6846419 TI - Duty to fetus and mother. PMID- 6846414 TI - Does ritodrine cause fever? PMID- 6846420 TI - Femur length measurements with sector scanner. PMID- 6846421 TI - Effect of cholestyramine administration during pregnancy in the rat. AB - The effect of administration of cholestyramine on plasma cholesterol level and hepatic cholesterol and bile acid synthesis was investigated in pregnant and nonpregnant rats. Rates of cholesterol and bile acid synthesis were reduced by pregnancy in both control and cholestyramine-treated rats. Administration of cholestyramine throughout gestation and pregnancy failed either to lower plasma cholesterol level or to increase bile acid synthesis, while cholesterol synthesis was only moderately stimulated. It is suggested that pregnancy-induced alterations in hepatic bile flow and composition in the direction of cholestasis may be responsible for the decreased efficacy of cholestyramine given to the pregnant animal. PMID- 6846422 TI - Intrapartum paracervical block anesthesia with 2-chloroprocaine. AB - Most of the reports of fetal bradycardia and acidosis following paracervical block anesthesia have involved the use of amide-linked anesthetics, such as lidocaine and mepivacaine. The purposes of this study were (1) to determine placental transfer of an ester-linked local anesthetic, 2-chloroprocaine, and its inactive metabolite, 2-chloroaminobenzoic acid (CABA) following paracervical block and (2) to evaluate the clinical use of 2-chloroprocaine for paracervical block anesthesia. Accordingly, 2-chloroprocaine was administered to 16 normal pregnant women in labor at term. Following injection, the levels of 2 chloroprocaine or CABA in maternal and neonatal plasma or urine were quantitated. Multiple clinical parameters, including the presence or absence of fetal bradycardia, were monitored before and after the paracervical block. The pharmacologic data indicated that 2-chloroprocaine is rapidly hydrolyzed. At delivery only trace levels of 2-chloroprocaine were present in 6.3% of the maternal samples and 25% of the cord vein samples. Furthermore, only 0.24% of the total dose of 2-chloroprocaine administered was recovered in neonatal urine as CABA. The clinical data showed no adverse effects on the parturient or neonate. Therefore, the data suggest that paracervical block anesthesia with 2 chloroprocaine may offer safe analgesia during the first stage of labor. Larger clinical studies appear warranted. PMID- 6846423 TI - Effects of maternal alcohol intake and smoking on neonatal electroencephalogram and anthropometric measurements. AB - Anthropometric data and computerized electroencaphalogram analysis during quiet, indeterminate, and active sleep were obtained from infants of mothers of four groups: (1) heavy drinking mothers (greater than 2 ounces of alcohol per day); (2) nondrinking mothers; (3) smoking, nondrinking mothers; (4) nonsmoking, nondrinking mothers. Infants in groups 1 and 2 were matched as closely as possible for postconceptional age, sex, race, and socioeconomic status. Infants in groups 3 and 4 were matched similarly. Infants of alcoholic mothers had a significantly lower birth weight, length, and head circumference than those from the matched control group. Infants of smoking mothers had lower birth weights and lengths than infants of nonsmoking mothers, but head circumference was identical. Hypersynchrony of the electroencephalogram was seen only in "alcoholic" infants, and power spectral density analysis revealed that the average integrated power was significantly increased in quiet, active, and indeterminate sleep. The greatest increase in electroencephalogram power (212%) was seen in active sleep, and this analysis clearly separated 15 of 17 alcohol-exposed infants from the control infants. These data suggest that alcohol has a specific toxic effect on the fetal brain that is not linked with smoking habits. The neonatal electroencephalogram is affected even in the absence of dysmorphology and thus may be the most sensitive indicator of fetal alcohol toxicity. PMID- 6846425 TI - Cardiac output and uteroplacental blood flow in diet-restricted and diet-repleted pregnant rats. AB - Cardiac output and uteroplacental blood flow were measured with 15 mu radioactive microspheres in anesthetized pregnant rats which were fed: (1) ad libitum throughout gestation; (2) a 50% restricted diet from day 5 of gestation; and (3) a 50% restricted diet from days 5 to 13 of gestation and ad libitum from day 14 of gestation. An additional group of nonpregnant rats fed ad libitum was also used. Dietary restriction caused a net maternal weight loss and a 20% reduction in mean fetal weight and mean placental weight by day 21 of gestation. Restricted dams fed ad libitum during the last week of gestation showed a net maternal weight gain, while mean fetal weight, but not placental weight, was near that of the ad libitum--fed controls. In the diet-restricted rats, total cardiac output was reduced 30% relative to controls by days 20 and 21 of gestation, but cardiac output per unit maternal body weight was not significantly different. Dietary restriction decreased both total uterine and placental blood flow by about 65%. Diet repletion late in gestation did not significantly increase total cardiac output or cardiac output per unit body weight. Total uterine and placental blood flows were near those of controls, primarily because of an increased fraction of cardiac output distributed to the uterus. PMID- 6846424 TI - Lack of harmful effects from simulated dives in pregnant sheep. AB - The purpose of the study was to determine if a near-maximum exposure to air at increased atmospheric pressure causes gross fetal malformations, decreased birth weight, or death when administered to pregnant sheep during peak development of the embryo. Twenty-eight timed-pregnant sheep were alternately assigned to a series of 25- or 30-minute exposures at either 4.6 atmospheres absolute or surface pressure between days 12 and 40 of gestation. About day 130 of pregnancy, 11 experimental and eight control fetuses were recovered, weighed, measured, fixed, and examined for defects. No major structural malformations were present. One minor variation, an undescended testis, occurred in a treated fetus. The results indicate that a series of short, marginally tolerated "dives" by pregnant sheep during peak development does not affect fetal health or survival. PMID- 6846426 TI - Basal cell pseudopodia and the degree of maturation of squamous metaplasia of the uterine cervix: a morphometric quantification. AB - Application of morphometry to discrete processes was used to study the stroma epithelial interface in benign proliferative processes of human cervical epithelium. This method with the use of two-dimensional transmission electron micrographs quantifies the number of pseudopodia and other features of the basal cell. The number of pseudopodia per basal cell and other basal cell features in reserve cell hyperplasia, immature squamous metaplasia, intermediate squamous metaplasia, and mature squamous metaplasia of human uterine cervix were measured. The number of pseudopodia per basal cell in reserve cell hyperplasia was 6.77 +/- 1.46 and comparable to that previously observed in advanced cervical intraepithelial neoplasia. The number of pseudopodia per basal cell in the three subtypes of squamous metaplasia ranged from 10.67 to 19.12 and was approximately half that observed in normal control epithelium. The concept of a continuum existing from reserve cell hyperplasia through immature squamous metaplasia to mature squamous metaplasia is supported with the demonstration of increasing numbers of pseudopodia per basal cell with cellular maturation. PMID- 6846427 TI - The pharmacokinetics and metabolism of ethinyl estradiol and its three sulfates in the baboon. AB - Ethinyl estradiol sulfates are major circulating metabolites of ethinyl estradiol (EE2); this is a relationship analogous to that of endogenous estrone and estrone sulfate. Because of the wide use of contraceptives containing EE2, the pharmacokinetics of its sulfate conjugates are of some importance. In previous studies of the intermediate metabolism of ethinyl estrogens we have shown that the baboon is an appropriate animal model. Accordingly, oral and/or intravenous doses of EE2 or each of its three sulfates were administered to castrate female baboons, and plasma levels of EE2 and its sulfates were studied by specific radioimmunoassay or radioisotope counting. After intravenous administration of EE2, the 3-sulfate and the 3,17-disulfate are the major circulating metabolites. After oral dosage administration, the 3-glucuronide and, in some cases, the 3,17 diglucuronide also become important. After intravenous administration, about twice as much of the drug exists in the sulfate as in the free form, as reflected by the areas under the plasma level curves. The bioavailability of orally administered EE2 was about 60%, confirming the presence of a substantial first pass effect. Hydrolysis at the 17-position occurs when EE2-17-sulfate is administered orally but appears not to occur with intravenous administration. EE2 and the three sulfates, given intravenously, exhibited two-compartment open-model kinetics. The elimination phase half-lives of all four compounds were similar, ranging from 8.8 to 11.2 hours. The area under the plasma level curve of EE2 resulting from the intravenous administration of the 3-sulfate was approximately 8% of the total area under the plasma level curve of both EE2 and EE2 sulfates. The ratio of the area under the plasma level curve of sulfates resulting from 3 sulfate administration compared to the other two sulfates was approximately 0.3, reflecting the existence of other metabolic pathways for its disposition. PMID- 6846429 TI - Stage I endometrial adenocarcinoma: treatment results in 835 patients. AB - A 16-year review of 835 patients with Stage I adenocarcinoma of the uterus revealed histologic grade and depth of myometrial invasion to be salient prognostic factors. Sixteen percent of patients developed recurrent disease and despite aggressive treatment, only 10% of these survived. Preoperative or postoperative radium decreased the incidence of vault recurrence. PMID- 6846428 TI - Deaths attributable to tubal sterilization in the United States, 1977 to 1981. AB - In 1979, the Centers for Disease Control began surveillance of deaths attributable to tubal sterilization in order to determine why they occur and what may be done to prevent them. Since that time, 29 such deaths have been identified as occurring in the United States from 1977 through 1981. Of these 29 deaths, 11 followed complications of general anesthesia, seven were due to sepsis, four were due to hemorrhage, three were due to myocardial infarction, and four deaths were related to other causes. Some of these deaths might have been prevented by use of endotracheal intubation for general anesthesia, particularly for laparoscopic sterilization, safer use of unipolar coagulation or use of alternative techniques, careful insertion of the needle and trocar for laparoscopy, and discontinuation of oral contraceptives before sterilization. Further surveillance may help to make tubal sterilization even safer. PMID- 6846432 TI - Creatine kinase activity in human endometrium: relative distribution in isolated glands and stroma. AB - Creatine kinase (CK) activity was measured in human endometrium as a function of the normal menstrual cycle. The specific activity of CK was consistently higher in the secretory endometrium than in the proliferative tissue (proliferative, 0.9 U/mg of protein; secretory, 3.3 U/mg of protein). The relative distribution of CK activity in isolated glands and stromal cells was determined following collagenase digestion of the endometrial specimen according to our previously described procedure. These studies show an enrichment of CK activity in the glands that is greater than fivefold that present in the stromal cells. Electrophoretic mobility of CK activity on cellulose acetate further indicates that the endometrial enzyme is a BB (brain type) isoenzyme. In the rat uterus, CK has been shown to be an estrogen-induced protein. In contrast, the activity of this enzyme may be modulated by progesterone in human endometrium. PMID- 6846431 TI - Evidence of prior pelvic inflammatory disease and its relationship to Chlamydia trachomatis antibody and intrauterine contraceptive device use in infertile women. AB - A total of 204 infertile women attending the Infertility Clinic of the Medical Center Hospital of Vermont were studied for the possible role of Chlamydia trachomatis and intrauterine contraceptive device (IUCD) use as factors related to their infertility. All patients had had at least 1 year of involuntary infertility. All but one woman had negative cultures for C. trachomatis, but a highly significant correlation (p less than 0.001) was evident between evidence of prior pelvic inflammatory disease (PPID) as documented by hysterosalpingograms and/or laparoscopy and the prevalence of chlamydial antibody. Furthermore, a significant (p = 0.01) correlation could be shown between the prevalence of the antibodies and adnexal adhesions. IUCD use could also be shown between the prevalence of the antibodies and adnexal adhesions. IUCD use could also be shown to correlate significantly (p less than 0.001) with PPID, and a detailed statistical analysis indicated that the two factors, antibody to C. trachomatis and a history of IUCD use, were independently related to PPID. Only about one third of the patients with PPID could ever recall having had an illness consistent with PID. Subsequent to the infertility workup, 76 of these women became pregnant and there was a significant (p less than 0.001) correlation between the occurrence of ectopic pregnancy and antibody to C. trachomatis. A significant (p = 0.01) correlation was also noted between a history of IUCD use and subsequent ectopic pregnancy. From these data it appears that antecedent infection with C. trachomatis, as measured by antibody prevalence, and a history of IUCD use are important factors in infertility of tubal origin and are also related to ectopic pregnancy. PMID- 6846430 TI - Prognostic factors in early invasive carcinoma of the uterine cervix. A clinical, histopathologic, and statistical analysis of 343 cases. AB - Three hundred forty-three cases of early invasive carcinoma of the uterine cervix were analyzed. Depth of infiltration and lateral extension of the tumors varied between 0.2 and 9.0 mm and 0.4 and 17.2 mm and were found to be of no prognostic importance. A multivariate statistical analysis revealed several risk factors: an epithelialized portio at diagnosis, suspected or evident tumor invasion in capillary-like spaces, absence of tumor-free margins at conization, and treatment with conization or simple hysterectomy, especially in the presence of the above mentioned factors. Tumors of a large cell keratinizing type were prognostically favorable. Confluent growth was not associated with increased risk of recurrence or death from recurrence. Cervical biopsies proved to be inadequate as diagnostic material. Recurrences were almost always local and developed late. In absence of risk factors conization is sufficient treatment. In the presence of risk factors treatment should be the same as that performed for frankly invasive Stage IB carcinomas. PMID- 6846433 TI - Effective prevention of gestational hypertension in nulliparous women at high risk as identified by the rollover test. AB - The supine pressor (rollover) test was performed on a population of nulliparous patients between 28 and 32 weeks' gestation. Sixteen patients with abnormal test results were treated with increased rest in the left lateral recumbent position. Only one of this group developed gestational hypertension at term (6%), the rest remaining normotensive through delivery. A control group of 16 patients with abnormal test results were left untreated. Three patients of this group (19%) remained normotensive while 13 patients developed hypertensive complications (81%). Of the 13 patients who had hypertensive problems, nine developed preeclampsia and the remaining four had pregnancy-induced hypertension. A significant decrease was noted in the incidence of hypertensive complications in the patients treated with increased rest in the left lateral recumbent position when compared with the incidence in the control group and a composite of untreated patients in other studies. This treatment plan affords an economical approach for treatment of those at high risk for developing gestational hypertension and/or preeclampsia. PMID- 6846434 TI - Cervical cerclage: an aggressive approach to threatened or recurrent pregnancy wastage. AB - Patients at high risk for recurrent pregnancy wastage may not always provide a typical history of cervical incompetence. Seventy-five pregnancies were managed with a cervical cerclage, with tocolytic agents used adjunctively in some. The pregnancies were divided into three groups on the basis of past obstetric history and statistically analyzed with respect to outcome. Patients in categories 1 and 2 showed significant improvement in mean birth weight and maximum gestational age attained with a shift in the ratio of term to premature births after intervention. In category 3, a trend of improvement in mean birth weight and maximum gestational age was seen but fetal salvage was not improved. Maternal morbidity was low with a cerclage-related cesarean section rate of 6.8% and only 8% infectious morbidity. It is concluded that cervical cerclage should be considered in the management of recurrent pregnancy wastage even if the obstetric history is atypical. PMID- 6846436 TI - Disposition of ethanol in human maternal venous blood and amniotic fluid. AB - The disposition of ethanol and acetaldehyde in maternal venous blood and amniotic fluid was studied over 3.5 hours following the ingestion of 0.3 gm/kg of ethanol by six healthy pregnant women at 16 to 18 weeks' gestation. There was a time lag in the appearance of ethanol in amniotic fluid compared with its appearance in maternal venous blood. The maximum maternal venous blood ethanol concentration was twice the maximum amniotic fluid ethanol concentration and occurred at an earlier time. At 3.5 hours, ethanol was present in amniotic fluid, whereas there was virtually no measurable ethanol in maternal venous blood. The rate of ethanol elimination from amniotic fluid was about half the elimination rate from maternal venous blood. Acetaldehyde was present in the maternal venous blood of four subjects, and the maximum acetaldehyde concentration occurred at about the same time as the maximum maternal venous blood ethanol concentration. Acetaldehyde was found in the amniotic fluid of one of these four subjects, and the acetaldehyde concentration was greater in amniotic fluid than in maternal venous blood. It is proposed that the amniotic fluid may act as a reservoir for ethanol following maternal ingestion such that the fetus would be exposed to ethanol for a longer time period than would be predicted by the maternal venous blood ethanol concentration. PMID- 6846437 TI - The nature of structural defects associated with velamentous and marginal insertion of the umbilical cord. AB - Previous studies have documented an increased incidence of structural defects in association with velamentous and marginal insertion of the umbilical cord. Evaluation of 4,677 consecutive placentas at the University of California (San Diego) Medical Center revealed 454 marginal insertions and 72 velamentous insertions. An increased incidence of structural defects was found only in association with a velamentous cord insertion. Delineation of the structural defects according to their developmental pathogenesis revealed that the majority were due to deformation of a normally formed part. These data and the finding of a disproportionate number of twins with a velamentous insertion suggest that competition for space at the implantation site leads to both the velamentous insertion of the cord and the associated structural defects. PMID- 6846438 TI - Intrauterine growth retardation and diabetic pregnancy: two types of fetal malnutrition. AB - Placental transfer of alpha-aminoisobutyric acid and methylglucose was studied near term in normal guinea pigs carrying growth-retarded fetuses and in streptozotocin-treated diabetic guinea pigs. Compared with their normal littermates, growth-retarded fetuses had lower placental weights and a diminished transfer of both nutrient analogues in proportion to the reduction in fetal weight. Fetuses from diabetic animals had normal fetal weight and placental methylglucose transfer but reduced litter size and a 40% reduction in placental alpha-aminoisobutyric acid transfer. These data suggest that intrauterine growth retardation in an otherwise normal pregnancy is associated with a small placenta and a reduced transfer of nutrients. Diabetic pregnancy may represent a different type of fetal malnutrition due to amino acid deprivation. It is speculated that birth weight does not necessarily reflect the degree of fetal malnutrition in diabetic pregnancy since fetal growth may be maintained by glucose and fat deposition. PMID- 6846435 TI - Preliminary evidence of the effect of calcium supplementation on blood pressure in normal pregnant women. AB - In this study the hypothesis that calcium supplementation during pregnancy can modify blood pressure patterns in a population of normal pregnant women was tested. Thirty-six women with normal single pregnancies, between 20 and 35 years of age, in the second trimester of gestation (15 weeks), were randomly assigned to receive 1 gm of calcium per day (n = 11), 2 gm per day (n = 11), or a placebo (n = 14). No differences were observed at the times of admission into the study (baseline) in demographic and clinical variables or in the calcium intake of each group. Baseline blood pressure measures in several positions also were not different. After the initial blood pressure measures (fifteenth week), five follow-up blood pressure measures were obtained. The supplemented groups had significantly lower diastolic blood pressure than the control subjects between the twentieth and twenty-fourth weeks of gestation. Thereafter, an increase in the control group and the group receiving 1 gm of calcium was observed, but levels were similar at term. On the contrary, patients receiving 2 gm of calcium had blood pressure values that remained significantly lower throughout the third trimester. No differences or clear patterns were observed in the blood levels of calcium, magnesium, phosphorus, and proteins between and within groups during gestation. A possible explanation involving parathyroid hormone is attempted. PMID- 6846439 TI - Dietary protein in pregnancy: effect on anthropometric indices of the newborn infant. AB - The urinary urea nitrogen/creatinine nitrogen ratio (UN/CN), an objective index of the level of dietary protein, was measured serially throughout pregnancy in 870 women. The mean UN/CN ratio was calculated for each subject. Subjects were grouped by mean UN/CN ratios. Those in the lowest decile (mean protein intake, 0.7 gm/kg/day) in comparison with those in the highest decile (mean protein intake, 1.5 gm/kg/day) were of lower socioeconomic class, weighed more before pregnancy, and gained less during pregnancy. However, birth weight and other anthropometric indices of the newborn infant were not related to the level of dietary protein during pregnancy. PMID- 6846443 TI - Distribution of major histocompatibility (HLA) antigens in chorionic villi of molar pregnancy. PMID- 6846444 TI - Blood pressure measurements during pregnancy: circadian rhythm? PMID- 6846442 TI - Abruptio placentae associated with cocaine use. PMID- 6846440 TI - Effects of narcotic drugs on fetal behavioral activity: acute methadone exposure. AB - The effects of acute methadone exposure on fetal behavioral activity were investigated in 10 unanesthetized fetal lamb preparations. Fetal behavioral activity was interpreted indirectly from the electrocorticogram (ECoG), electromyogram, electrooculogram, blood pressure, heart rate (FHR), and breathing movements (FBMs) of the fetus. Methadone infusion to the mother (5 micrograms/kg/min) resulted in a suppression of all synchronized ECoG activity, and an increase in FBM, FHR, eye movements, nuchal tone, and body movements. Similar effects were observed when 10% of the dose was given directly to the fetus. These results demonstrate that methadone acts directly om the fetus to suppress both quiet sleep and rapid eye movement sleep and results in a "hyperactive" state that has previously been shown to be associated with a 20% increase in fetal oxygen consumption. PMID- 6846441 TI - Internal and external cervical os dilation with vaginal 15-methyl prostaglandin F2 alpha. PMID- 6846446 TI - Professional liability. PMID- 6846445 TI - The utility of ultrasonically measured umbilical vein diameters in isoimmunized pregnancies. PMID- 6846447 TI - Are separate fetal ultrasound standards necessary for different populations? PMID- 6846448 TI - Fetal bones as intrauterine contraceptive device. PMID- 6846449 TI - "Second-look" procedures in the management of ovarian cancer. PMID- 6846450 TI - Effects of caffeine on the fetal heart. PMID- 6846452 TI - Retinal detachment following late posterior capsulotomy. AB - When we compared the incidence of retinal detachment in 27 eyes after extracapsular cataract surgery and late posterior capsulotomy with the incidence of general aphakic detachment, we found no relationship between the onset of retinal detachment and the numbers, types, or locations of breaks. The interval between cataract extraction and discission had a significant effect on recovery of visual acuity. Final visual acuities of 20/400 or better were attained in 22 of 23 eyes in which discission followed cataract extraction by one year or more but in only one of four eyes in which the procedures were separated by less than one year. Delaying discission for more than 12 months may reduce the extent of retinal detachment and produce the best functional results. Detachments that occurred less than one year after discission were more extensive but achieved better functional results than those that occurred later. PMID- 6846451 TI - YAG laser treatment of cystoid macular edema. AB - Fourteen eyes (some aphakic and some with implanted intraocular lenses) underwent neodymium-YAG laser treatment for cystoid macular edema with vitreous incarceration in the corneoscleral wound. Visual acuity improved in all 14 eyes; ten eyes improved at least three Snellen lines and 12 eyes improved at least two Snellen lines. After follow-up periods of one to nine months, 11 eyes had visual acuities of 20/40 or better (only two had had visual acuities of 20/40 preoperatively and none had had a better visual acuity). An additional eye, which had an intraocular lens implant, was treated prophylactically. Visual acuity in this eye remained stable during a nine-month follow-up period. YAG laser treatment produced no adverse side effects or complications in any of the 15 eyes. PMID- 6846453 TI - Ocular findings in patients with neutrophil dysfunction. AB - Of 32 patients (19 females and 13 males, ranging in age from 2 to 44 years), nine had ocular problems related to neutrophil dysfunction. Four patients had blepharokeratoconjunctivitis and pannus formation. In one of these, severe visual loss secondary to corneal thinning and scarring occurred. Five patients had inactive chorioretinal scars without visual loss. Although some of the other 23 patients had minor ocular abnormalities, we could not demonstrate that they were related to the neutrophil dysfunction. However, none of the control subjects (20 patients with systemic lupus erythematosus and 20 randomly selected eye clinic patients) had lesions resembling those of the patients with neutrophil dysfunction. Fisher's exact test (one-tailed) gave the following values: P less than .03 for keratitis; P less than .01 for chorioretinal scars; and P less than .001 for keratitis and chorioretinal scars. Abnormal neutrophil function probably interferes with the control of normal eyelid flora and predisposes the eye to the development of marginal keratitis. Eyelid hygiene and topical administration of antibiotics and corticosteroids during inflammatory episodes may prevent the progression of corneal vascularization. The chorioretinal scars do not appear to be progressive. PMID- 6846454 TI - Clindamycin in the treatment of toxoplasmic retinochoroiditis. AB - We treated 26 patients with acute toxoplasmic retinochoroiditis with clindamycin between 1974 and 1982. Four patients were treated with clindamycin alone and 17 with clindamycin and prednisolone. Five patients received clindamycin and prednisolone, sulfadiazine, pyrimethamine, or cryocoagulation, or a combination of these. All patients with the acute disease had the characteristic foci and a positive titer on the Sabin-Feldman dye test of at least 1:16. Other causes of retinochoroiditis were excluded. All but two patients, who developed diarrhea after two weeks, received clindamycin for a minimum of three weeks. All patients improved after two weeks of treatment, but two patients with lesions larger than 2 disk diameters required an additional six weeks of treatment to heal completely. During follow-up periods ranging from 18 months to seven years (mean, three years) there have been only two recurrences (7.7%). Complications with clindamycin treatment were limited to gastrointestinal upsets, diarrhea, and skin rash. There were no cases of pseudomembranous colitis, the most serious reported complication of clindamycin use. PMID- 6846455 TI - Laser interferometric prediction of postoperative visual acuity in patients with cataracts. AB - I used the laser interferometer to test 137 eyes to determine whether preoperative interference visual acuity tests could accurately predict postoperative Snellen visual acuities. In 60 patients with immature cataracts and normal maculas the postoperative Snellen visual acuity was predictable within one line in 53 patients and within two lines in seven others. In 29 other patients with cataracts and senile macular scars or macular degeneration without subretinal fluid postoperative Snellen visual acuity was predictable within one line in 26 patients and within two lines in two others. Several easily recognizable clinical conditions make the interferometer test unreliable. Those that produce false-positive responses are serous detachment of the sensory epithelium of the macula, cystoid macular edema, visual fields cut through fixation, amblyopia, macular holes or cysts, geographic atrophy of the pigment epithelium of the macula, and early postoperative retinal detachment. Those that produce false-negative responses are mature cataracts and testing without pupillary dilatation. PMID- 6846458 TI - Obstruction of aqueous outflow by sodium hyaluronate in enucleated human eyes. AB - Instillation of sodium hyaluronate into the anterior chambers of enucleated human eyes caused a 65% decrease in outflow facility (from 0.33 +/- 0.16 microliters/min/mm Hg to 0.08 +/- 0.02 microliters/min/mm Hg). Vigorous anterior chamber irrigation, performed either immediately or three hours after introduction of the sodium hyaluronate, failed to relieve this obstruction. However, irrigation with hyaluronidase restored the facility values to baseline. Tying limbal or corneal 9-0 nylon sutures (for example, in cataract surgery), followed by instillation of sodium hyaluronate into the anterior chamber and subsequent irrigation, produced an overall decrease of 76% in outflow facility (final outflow values were 0.08 +/- 0.03 microliters/min/mm Hg in eyes with corneal wounds and 0.08 +/- 0.04 microliter/min/mm Hg in eyes with limbal wounds). Postoperative intraocular pressure should be monitored closely when sodium hyaluronate is used in cataract surgery. Irrigating the anterior chamber with balanced salt solution after using sodium hyaluronate does not eliminate the possibility of severe postoperative glaucoma. PMID- 6846456 TI - Retinal tears with total vitreous hemorrhage. AB - In ten cases of nontraumatic retinal tears with initial vitreous hemorrhages so dense that all retinal detail was obscured, medical management included hospitalization, sedation, and binocular patching. It took an average of 4.3 days for the vitreous to clear so that the tears could be examined. All the tears were on or anterior to the equator, and all were in the superior quadrants. Surgery was performed promptly once the tears were visible even though much of the retina was still covered with hemorrhage. After total clearing of the vitreous, no additional retinal tears were found in any of the ten cases. Postoperative complications included hemorrhages in three cases, macular pucker in one case, and a paramacular star in one case. PMID- 6846459 TI - Morphologic changes in the lamina cribrosa correlated with neural loss in open angle glaucoma. AB - We divided 25 glaucomatous human eyes into three groups representing mild (Group 1, seven eyes), moderate (Group 2, 11 eyes), and severe (Group 3, six eyes) optic nerve damage, based on visual field testing or remaining number of optic nerve fibers. The optic nerve head of each eye was examined by scanning electron microscopy. Compression of the successive lamina cribrosa sheets was the earliest detected abnormality, occurring in some eyes before the detection of visual field loss. Backward bowing of the entire lamina cribrosa was a later change and involved its upper and lower poles more than the mid-nerve head. The diameter of the scleral opening at the level of Bruch's membrane did not enlarge in these adult glaucomatous eyes. Mechanical compression of the nerve head occurred early enough to be considered a primary pathogenetic event in glaucomatous damage. PMID- 6846457 TI - Intraocular injection of silicone oil for experimental proliferative vitreoretinopathy. AB - We evaluated the effect of intraocular silicone oil as an internal tamponade on an animal model of proliferative vitreoretinopathy. Lensectomy and vitrectomy were performed on two groups of pigmented rabbits. Twenty-five rabbit eyes then had 1,000 centistokes' viscosity silicone oil injected into the vitreous cavity; 20 control eyes received balanced salt solution. Fourteen days later, each eye was injected with homologous fibroblasts (ten eyes with 100,000 cells, 25 eyes with 250,000 cells, and ten eyes with 750,000 cells). All membranes that developed after the cell injections in both experimental and control eyes produced traction retinal detachment. The character of the membranes formed and the timing of the traction retinal detachment were the same for both groups. In an active phase of experimental proliferation, the internal tamponade of silicone oil is insufficient to keep the retina in place. PMID- 6846460 TI - Quantitation of glaucomatous visual field defects with the Mark II Friedmann analyzer. AB - To evaluate the ability of the Friedmann visual field analyzer to determine visual threshold and the depth of visual field defects, we correlated the visual threshold determined kinetically (Goldmann perimeter) with the static threshold (Friedmann analyzer) in various parts of the central field. We found the following: the Friedmann working threshold correlated linearly with the height of the hill of vision represented by the position of the kinetic isopters of the Goldmann perimeter; the static visual threshold (Friedmann) at a particular location, whether normal or abnormal, was linearly related to the kinetic visual threshold (Goldmann) at that location; and the depth of all visual field defects was essentially the same with both instruments. Thus, the Friedmann analyzer accurately quantitated the central visual field in both the normal and abnormal regions, and may be advantageous for following the progress of early glaucomatous defects. For other patients, however, its usefulness may be limited, because defects outside 25 degrees cannot be documented, the visual field examination may be lengthy and inefficient when quantitating large defects of irregular depth, and the maximal quantitation of depth with the Friedmann analyzer is 2.0 log units less than with the Goldmann perimeter near fixation (but there is progressively less difference for defects further from fixation). PMID- 6846461 TI - Chemical blepharitis following drug treatment. PMID- 6846462 TI - Vernal keratoconjunctivitis and keratoconus. PMID- 6846463 TI - Bilateral keratoconus in a patient with gyrate atrophy and hyperornithinemia. PMID- 6846464 TI - Uveitic glaucoma caused by disseminated meningococcemia. PMID- 6846465 TI - Hepatitis B surface antigen in human subretinal fluid. AB - Body fluids containing hepatitis B surface antigen are considered to be potential sources of hepatitis B infection. This antigen has been detected in blood, oral secretions, synovial fluid, urine, feces, bile cerebrospinal fluid, pleural and peritoneal fluid, semen, vaginal secretions, breast milk, and tears. These fluids are probably not equally infectious, however, because the concentration of virus in a particular fluid may be low when compared to that in blood. For instance, in hepatitis B carriers whose tears were positive for hepatitis B surface antigen, the concentration of hepatitis B surface antigen in the tears averaged less than one-fifteenth the average value found in serum. PMID- 6846466 TI - Nephropathic cystinosis: ineffectiveness of cysteamine therapy for ocular changes. AB - The biochemical hallmark of nephropathic cystinosis is the intralysosomal accumulation of free cystine in various organs, including the conjunctiva, cornea, bone marrow, leukocytes, lymph nodes, and internal organs. A patient with the infantile form of nephropathic cystinosis develops several renal tubular malfunctions during the first year of life; these eventually lead to end-stage renal failure and eventual death by the time the patient is 10 years of age. Ocular changes are prominent and may be so typical that an early diagnosis can be achieved by an ophthalmologic examination before the nephropathic signs become evident. PMID- 6846467 TI - A new instrument for removing corneal foreign bodies. PMID- 6846468 TI - Automated fluid-gas exchange. PMID- 6846469 TI - A simple device that maintains the anterior chamber. PMID- 6846470 TI - Instrument for placement of temporary keratoprosthesis during pars plana vitrectomy. PMID- 6846471 TI - Cyclic macular edema. PMID- 6846474 TI - Occupational therapy manpower. PMID- 6846473 TI - Modified strapping of roll sling. PMID- 6846472 TI - Vestibular-proprioceptive functions in 4 year olds: normative and regression analyses. AB - Normative data were obtained for 156 pre-school children's performances on measures of muscle tone, muscle co-contraction, standing balance, prone extension posture, flexion supine posture, asymmetrical tonic neck reflex, and postrotary nystagmus. Regression analysis indicated that these combined variables accounted for only 13.5 percent of the variance of postrotary nystagmus of 145 four year olds. However, if the data are examined only for children exhibiting nystagmus that is lower than 1 standard deviation below the mean, then these variables account for 50 percent of the variance of nystagmus. Prone extension posture, standing balance-eyes closed, and muscle tone account for 37 percent of the variance within this low-nystagmus population. These results are considered in light of the authors' previous studies demonstrating that, in learning-disabled children, vestibular-proprioceptive measures can be used clinically to predict which children will respond to sensory integration therapy with changes in postrotary nystagmus. These changes, according to sensory integration theory, reflect positive responses to therapy. PMID- 6846475 TI - Respite care for community elderly. PMID- 6846476 TI - Student anxiety toward level II fieldwork. AB - The State-Trait Anxiety Inventory (STAI) purports to measure two types of anxiety: state anxiety, fluctuating and transitory; and trait anxiety, a relatively stable proneness to apprehension. As part of a battery of measures comparing a new occupational therapy curriculum with an old curriculum being discontinued, the STAI was administered to separate groups of students from each curriculum completing their programs concurrently. The primary purpose of the anxiety study was to test the hypothesis that students with an early introduction to Level I fieldwork (the new curriculum) would have significantly less state anxiety in anticipation of Level II fieldwork than students with a later introduction to Level I fieldwork (the old curriculum). Statistical analysis failed to support the hypothesis. Also discussed are: the significant reduction in anticipated anxiety when students report for fieldwork, and the validity and reliability of the STAI. PMID- 6846477 TI - Performance difference between hands in children on the motor accuracy test revised. AB - This study was designed to determine the developmental trends in the difference between right-hand and left-hand skill development in children ages 4 to 9 as measured by the Motor Accuracy Test-Revised (MAC-R). There were 120 right handers (60 males, 60 females), with 20 subjects at each age interval, and 68 left handers (36 males, 32 females), with no less than 8 and no more than 20 subjects at each age interval. Performance was analyzed by sex, age, and handedness for the difference scores between the two hands, and the preferred and nonpreferred hand adjusted scores. The difference scores were obtained by subtracting the nonpreferred hand scores from the preferred hand scores. Results showed the mean difference between hands for all children to be 6.7 points with a standard deviation of 4.8. This data suggests that a normative range of difference between right-hand and left-hand skill performance on the MAC-R may be from 2 to 11 points. Left-handed children performed very similarly to right-handed children, supporting the use of right-handed norms for left-handed subjects. No significant differences in sex or handedness were found in the adjusted or difference scores. Comparison of the means and standard deviations of MAC-R normative data with these data showed no consistent significant differences. PMID- 6846478 TI - The effect of wrist immobilization on performance of the Jebsen Hand Function Test. AB - Eighteen normal subjects participated in a study designed to monitor the effect of wrist motion on the time required to complete manual tasks from the Jebsen Hand Function Test. Activities were performed with the wrist free and with the wrist immobilized by a commercially available splint. The results showed a statistically significant increase in time to do the tasks during immobilization when compared to the free condition. There was great variation in patterns of motion between individuals. Treatment implications include individual consideration of position of wrist immobilization for splinting, proper length and fit of splint designed to immobilize, and the importance of practice in tasks following loss of wrist motion. PMID- 6846480 TI - Low profile dynamic splinting of the injured hand. AB - Dynamic splinting is a well-accepted modality in gaining joint motion in the injured hand. Presented is a splinting design system referred to as "low profile" dynamic splinting whereby high outriggers are avoided. A review of the literature reveals that this technique is based on the original design approach used by Dr. Sterling Bunnell. Described are the basic principles of the low profile design system, with illustrations of the system in specific splints and specific construction details. This splinting system is indicated for a stiff hand that has sustained direct trauma. Hands with a muscle imbalance secondary to a central nervous system or peripheral nerve lesion require a different splinting approach, which is not within the scope of this paper. PMID- 6846479 TI - Development of a hand sensitivity test for the hypersensitive hand. AB - An instrument was developed to measure the effects of a desensitization program on hand hypersensitivity. It was standardized with 40 "normal" subjects ages 20 to 40 of both sexes and two ethnic groups. Results showed reliability coefficients ranging from .74 to .82 for the three modalities employed in the test. Analyses of variance of agreement between test and retest scores revealed no significant differences in reliability due to hand used, sex, or ethnicity. It was concluded that the instrument could be used as both a clinical and research tool for the measurement of hand sensitivity. PMID- 6846481 TI - Factors affecting return to work after hand injury. AB - The study of 61 hand-injured subjects suggested that it is more than surgical and technical excellence that facilitates the return-to-work status among the hand injured wage earners. Financial need, level of activities of daily living, and participation in occupational therapy were found to be directly related to return to-work status. Additional findings indicated no difference between the rate of return to work for those whose injuries affected their dominant hand over those who had nondominant hand injuries. The amount of medical care needed and whether it was delivered as an outpatient or an inpatient were not associated with the return to work. The hand-injured subjects' relevant medical history, participation in occupational therapy, capacity in activities of daily living, desire and ability to return to work, and financial support were quantified through chart audit and interview. Occupational development was measured by using the Moorhead Occupational Work History. PMID- 6846483 TI - Effects of induced optical blur on infant visual acuity. PMID- 6846484 TI - Effects of defocus on monkey (Macaca nemestrina) contrast sensitivity: behavioral measurements and predictions. AB - An observer's contrast sensitivity function (CSF) can be affected by degradation of either the optical or neural components of the visual system. In a continuing effort in this laboratory to separate these two components in infant and mature monkeys, we have measured behavioral CSF's with the retinal image defocused by as much as 6 D. With increased defocus, sensitivity decreases much more rapidly at high spatial frequencies than at low frequencies. Furthermore, we find that calculations of retinal image contrast, based upon available optical parameters of the monkey eye, underestimate the amount of optical defocus which still allows pattern detection by our monkeys at high spatial frequencies. Several possible explanations for this apparent conflict are discussed, including optical aberrations present in the primate eye, and the "spurious resolution" of defocused sinusoidal gratings. PMID- 6846482 TI - The effects of exercise on finger extension of CVA patients. AB - The choice of activity to improve finger extension of post-CVA patients is based on untested assumptions and hypotheses. In this study, using electromyography of the extrinsic finger muscles and electrogoniometry of wrist and finger joints, the effects of five types of exercise on the finger extension of post-CVA patients were documented. Results indicated that resisted and rapid exercises recruited high percentages of output of all three muscles. Slow, unresisted extension exercises preferentially recruited the extensor digitorum. No exercise caused significant immediate changes in range of motion (ROM), flexor/extensor balance, time required to open the hand, or level of activity of the extensor digitorum during opening of the hand. Resisted grasp did not limit the patients' ability to extend the fingers. Variability in percent of motor output among the subjects of this study indicates the need to monitor each patient during therapy. PMID- 6846485 TI - Use of light intensity reduction for amblyopia therapy. AB - A form of amblyopia therapy is presented using light intensity reduction which provides a means of increasing the visual acuity in the amblyopic eye while preserving and promoting binocularity. In addition to the rationale and specific instructions for therapy, an illustrative case is presented of a 7-year-old boy with anisometropic amblyopia and eccentric fixation who was treated with light intensity reduction produced by Polaroid filters before his nonamblyopic eye. In this case acuity improved from 6/30 (20/100) to 6/7.8 (20/26), fixation improved from 2 degrees eccentric to unsteady central, and stereopsis increased from no measurable amount to 140 sec as measured by the Randot stereotest. PMID- 6846486 TI - Rotating grid method of measuring vergence limits: the effect of line frequency. AB - When a grid consisting of equally spaced parallel lines is placed in the objective frontoparallel plane and is rotated from an initially vertical orientation about the primary sagittal line, the horizontal distance between the lines increases. When the two eyes fuse specific sections of the grid, this increase in horizontal separation can be used to vary the vergence stimulation. The vergence limits measured by this method were found to be influenced by spatial frequency. Using a selected spectrum of frequencies, it was found that vergence limits decrease nonlinearly with frequency. A range of line frequencies between 1.06 and 4.97 lines/deg is suggested for practical use. The vergence limit determined at one frequency was found to be different from that of the next line frequency for the same subject. The clinical implications of this are discussed. No optimum frequency for stimulating maximum vergence was found. PMID- 6846487 TI - Intersubject difference in corneal edema response to hypoxia. AB - A common clinical observation is that some patients are more prone to the development of corneal edema than others. To test the validity of this observation, 30 subjects each wore an experimental hydrogel lens designed to stress corneal metabolism by reducing oxygen availability and thereby producing measurable amounts of corneal edema. The corneal edema response varied from 20.3 (3.7%) to 55.1 microns (12.2%) after 3 hr of opened-eye lens wear. Mean intrasubject reliability was +/- 3 microns (0.6%). Corneal edema response to the experimental lens was well correlated with corneal edema response to a conventional thin hydrogel lens (r = 0.83). These results support the conclusion that some patients are more prone than others to developing corneal edema and that these patients can be identified by measuring corneal thickness changes after a 3-hr wearing trial with a thick HEMA lens of standard dimensions. PMID- 6846488 TI - Reaction time to spatial frequencies using yellow and luminance-matched neutral goggles. AB - The popularity of yellow goggles for outdoor activities has long been a paradox to visual scientists as previous tests of their effectiveness have failed to show any visual advantage. The achromatic/chromatic theory of color vision suggests a possible solution to the paradox which was tested by measuring reaction times to spatial frequencies of varying contrast. Reaction times were faster with yellow goggles than with luminance-matched neutrals under certain conditions. These conditions included frequencies in the middle of the range of human sensitivity and, specifically, the lower contrasts of these frequencies. The theoretical and practical applications of the results are discussed. PMID- 6846489 TI - A comparison of two techniques of refitting long-term polymethyl methacrylate contact lens wearers. AB - Two techniques for fitting long-term polymethyl methylcrylate (PMMA) lens wearers with a gas-permeable hard lens are compared. These are: complete cessation of all lens wear for the period necessary to achieve stability in the patient's refraction and corneal curvature, and immediate refitting with a Polycon lens. Eleven patients who had worn hard contact lenses for at least 3 years and had wearing times of at least 8 hr per day were refitted with each technique. Refitting with Polycon lenses slowed but did not otherwise inhibit the recuperative changes taking place in the cornea after PMMA lens removal; vision was better and more stable with this group. PMID- 6846490 TI - Variation of the green-red ratio with refractive error. AB - The relationship of refractive error to green-red ratios among color normals was investigated by asking 27 subjects to match a standard yellow with a mixture of red and green primaries using a Nagel anomaloscope. Green-red ratios did not show any regular change with refractive error. Differences in refractive error, natural or induced, among color normal persons did not change the measurements of color vision with the Nagel anomaloscope. PMID- 6846491 TI - Ocular accommodation in human infants. AB - The present longitudinal investigation evaluated the proficiency of the human ocular accommodation system during the 20-week period after birth. Fourteen human infants were tested at specific intervals during the age of 2 through 20 weeks. At each age the refractive state of the eyes during fixation of a vertical striped, high-contrast stimulus pattern presented at viewing distances ranging from 10 to 50 cm was measured by dynamic retinoscopy. The accommodative performance of the infants demonstrated the following: (1) the newborn accommodation system executes reasonably appropriate responses to weak dioptric stimuli; (2) accommodative accuracy generally decreases from 2 through 8 weeks of age; and (3) accommodative accuracy increases beyond 8 weeks of age until adult like levels of proficiency are attained between 16 and 20 weeks. Factors which could affect individual accommodative responses and explanations for the observed developmental pattern of accommodative performance are discussed. PMID- 6846492 TI - Effects of moderate exercise on intraocular pressure. AB - Intraocular pressure measurements were made on human subjects using a noncontact tonometer before and at several time intervals after moderate exercise on a bicycle ergometer. One minute after exercise, intraocular pressures were significantly decreased (by 25%) but gradually returned toward pre-exercise values in 20 to 30 min. The results confirm findings by others that physical exertion results in a transient decrease in intraocular pressures and suggest that the magnitude of the reduction and the time required for recovery are related to the severity of the exertion. PMID- 6846493 TI - Contrast sensitivity in albinotic patients. AB - Vertical and horizontal grating contrast sensitivity functions (CSF) were measured on eight albinotic patients. Several of these patients also had CSF measurements performed through their telescopic aids. For all the patients, the horizontal grating CSF was more sensitive than the vertical grafting CSF. Although there are many pathological problems that could result in this sensitivity difference (high astigmatism, neural modification, etc.), we propose that in this case, the nystagmoid eye movements are the main causative factor. Through the telescopic aid, the CSF resolution acuity and peak sensitivity increased. The increase in resolution was somewhat less than would be predicted based on magnification. The increase in sensitivity is believed to be the result of stimulation of more sensitive peripheral retina. This increase in sensitivity is an added benefit to these patients corrected with low vision aids. PMID- 6846494 TI - A comparative study of tear evaporation rates and water content of soft contact lenses. AB - Tear evaporation rates were measured by resistance hygrometry in a group of five subjects wearing soft contact lenses ranging in initial water content from 38 to 70%. The water content of the lenses before and after wear was measured by a "wet blot weighing" technique using a chemical balance. The placing of all types of soft lenses on the eye disrupts the tear film sufficiently to produce significant increases in evaporation. This increase in tear evaporation was not found to be related to the initial water content of the soft lens. Water lost by dehydration of the lens material made a relatively minor contribution to the increase in evaporation from the eye during lens wear. PMID- 6846495 TI - The bead test: a critical appraisal. AB - An evaluation of the visual acuity levels obtained with the candy bead test (Bock) was performed. White beads (1 mm) were placed on a white felt background under controlled illumination. Ten subjects were required to localize randomly placed beads through increased degrees of induced optical blur. The visual acuity was then measured at the blur level yielding 60% accuracy in localization. The results indicate a range of visual acuity from 6/45 to 6/60 (20/150 to 20/200). These findings are significantly worse than the levels of acuity [6/18 to 6/24 (20/60 to 20/80)] found by other authors. Therefore, our findings raise concerns and indicate caution in the clinical interpretation of the bead test. PMID- 6846496 TI - Construction, specification, and mathematical description of aspheric surfaces. AB - Rotationally symmetrical aspheric surfaces of spectacle lenses are constructed as either "zonal aspherics" or "continuous aspherics." Zonal aspherics consist of annular zones surrounding a central zone with each zone being nominally spherical with progressively lower surface power the farther the zone is from the surface vertex. Aspheric surfaces are often specified by the radial drop in surface power from the center to the edge of the lens (e.g., Welsh Four-drop), but for assessment purposes the surface shape must be specified more precisely. The formulas for the description of continuous aspherics can be manipulated into different forms. Mathematical descriptions are given or developed which will enable theoretical assessment of the performances of all lenses with rotationally symmetrical aspheric surfaces. PMID- 6846497 TI - Comparison of American optical SR-IV refractive data with clinical refractive data on a group of myopic children. AB - Previous studies involving the American Optical SR-III Subjective Refraction System have indicated that refractive data for adults and for populations of mixed age groups compare favorably with conventional refractive data. However, no data concerning children, as a group, have been available. As a part of a 3-year Myopia Control Study being conducted at the University of Houston, 131 myopes between the ages of 6 and 15 years have been refracted by means of both the redesigned SR-IV Programmed Subjective Refractor and conventional clinical procedures. The results indicated that for the majority of subjects, the refractive data obtained by means of the SR-IV differed by no more than 0.25 D from data obtained by conventional procedures. SR-IV and clinical refractive data were also compared for a group of 30 second year optometry students, and agreement for the two methods was found to compare favorably with agreement of clinical refractive data obtained by two or more examiners. PMID- 6846498 TI - Use of a written simulation to evaluate optometric clinical proficiency. AB - A written simulation of an optometric patient examination was designed and administered to 3rd-year optometric students. Test scores from the written simulation were compared with those from a clinical proficiency evaluation and no statistically significant correlations between the scores for the two testing methods was found. The results suggest that the two types of tests measure two different areas of clinical competence: problem-solving and case-analysis skills by the written simulation, and clinical performance skills by the clinical proficiency. This conclusion is supported by the subjective comments of students and faculty to whom the written simulation was administered and indicates that written simulations may be a useful tool in optometric curricula to teach and evaluate problem-solving and case-analysis skills. PMID- 6846499 TI - Saccadic intrusions contributing to reading disability: a case report. AB - Horizontal eye movements were recorded during tracking and reading in a patient with probable neurological involvement who complained of periods of oscillopsia and severe asthenopia, especially during reading. Saccadic intrusions occurred during all tracking tasks. Single and multiple saccadic intrusions found while reading, frequently accompanied periods of visual disturbance, and we attribute part of the reading disability to the presence of such abnormal eye movements. Various therapeutic measures were attempted and achieved some degree of success. PMID- 6846500 TI - Morphologic expression of glandular differentiation in the epidermoid nasal carcinomas induced by phenylglycidyl ether inhalation. AB - Charles River-CD Sprague-Dawley rats in 3 equal groups of 100 males and 100 females each were exposed to 12, 1, and 0 ppm of phenylglycidyl ether vapor for 24 months. Nasal tumors were first detected after 621 days' exposure at 12 ppm with an incidence of 11% in males and 4.4% in females. No nasal tumors were found at 1 ppm in rats exposed for 24 months. The nasal tumors, mostly epidermoid carcinomas, were derived from the respiratory epithelium and nasal glands, both of which revealed squamous metaplasia or dysplasia in the anterior nasal cavity. Most nasal tumors were confined to the anterior nasal cavity and occasionally invaded the dorsonasal bones and posterior nasal cavity. The undifferentiated glandular cells appear to differentiate to neoplastic squamous cells, because the ultrastructure of epidermoid carcinoma revealed traits of glandular cell differentiation in the neoplastic squamous cells. The features of glandular cell differentiation in the neoplastic squamous cells were intercellular or intracellular glandular lumens, secretory vesicles, mucus droplets, and intermediate cells showing both glandular and squamous differentiation. Squamous cells in the well-differentiated epidermoid carcinomas revealed abundant tonofibrils, desmosomes, glycogen particulates, and interdigitated cytoplasmic processes. These markers of squamous-cell differentiation were markedly reduced in the undifferentiated epidermoid carcinomas. The spindle-cell squamous carcinoma showed both squamous and fibroblastic-like differentiations. Some spindle cells had only fibroblastic-like differentiation, suggesting spindle-cell metaplasia of the squamous cells. PMID- 6846501 TI - Immunohistochemical localization of placental-like alkaline phosphatase in testis and germ-cell tumors using monoclonal antibodies. AB - Six monoclonal antibodies raised against the human placental alkaline phosphatase (ALP) recognizing distinct antigenic determinants on the surface of this isozyme were used for immunohistochemical studies of adult and fetal human testes and testicular germ-cell tumors. ALP reacting with all six antibodies was defined as placental, whereas ALP reacting with some but not all antibodies was labeled as placental-like. ALP reacting with one of the monoclonal antibodies that recognizes a determinant common to intestinal and placental ALP was tentatively considered probably intestinal, unless it reacted with any other monoclonal placental specific antibody. Using this approach, the authors have identified placental ALP in 4 of 7 seminomas, 3 of 7 tumors composed in part or fully of embryonal carcinoma, and 1 yolk sac carcinoma. Placental-like ALP was identified in 2 additional seminomas and 4 embryonal carcinoma-containing tumors, whereas 1 seminoma and 1 benign teratoma were devoid of either placental or placental-like ALP. Trophoblastic giant cells in 2 seminomas and 3 teratocarcinomas expressed only the antigenic determinant common to placental and intestinal ALP. The authors thus show that testicular tumor cells may express either placental or placental-like ALP and that in some instances, the tumor isozyme is antigenically different from ALP found on either fetal or adult testicular germ cells. PMID- 6846502 TI - Progressive cytologic changes during the development of delayed feather amelanosis and associated choroidal defects in the DAM chicken line. A vitiligo model. AB - Newly hatched Gallus domesticus chicks of the delayed amelanotic (DAM) line have phenotypically normal down pigmentation. Functioning pigment cells are present in the down plumage, choroid, and retinal pigment epithelium. However, histologic and ultrastructural studies reveal that after hatching regenerating feather melanocytes synthesize melanosomes with abnormal, irregularly shaped surfaces and pigmented extensions. Eventually retraction of melanocytic dendrites and clumping of pigment occurs concomitantly with intracellular compartmentalization of the abnormal melanosomes. Melanocyte degeneration is accompanied by the appearance of mononuclear leukocytes (MNLs) in the pulp of the regenerating feathers. Concurrently, melanocytes cease to migrate into the regenerating feather epithelium, and the result is amelanosis. Changes in choroidal melanocytes are first evident as swelling of cell bodies and associated dendrites. Ultrastructurally, the choroidal melanocytes demonstrate increased cytoplasmic material, melanosomal irregularities, retraction of dendrites, melanosome compartmentalization, and eventual necrosis. Concurrently, MNLs arrive and remove the pigment from the choroid. The authors conclude that a basic melanocyte defect precedes the arrival of immunocytes in the delayed cutaneous and choroidal amelanosis in the genetic DAM vitiligo model of the chicken. PMID- 6846503 TI - Clinical and pathologic features of cyclic hematopoiesis in grey collie dogs. AB - Clinical and pathologic features of cyclic hematopoiesis in 18 grey collie dogs, aged 10 to 113 weeks, were reviewed. The dogs were grouped according to weeks of age: 10-16 (I), 17-21 (II), 30-35 (III), and less than 52 (IV). Clinical illness occurring during each hematopoietic cycle was classified as none, mild, moderate, or severe, based on the neutrophil count, rectal temperature, clinical signs, and use of antimicrobial therapy. The dogs in Groups I, III, and IV had severe infections episodes during one-fourth of all hematopoietic cycles; whereas the dogs in Group II had severe infections during two-thirds of cycles. However, during the cycle prior to death, all groups were similar, each having two-thirds of clinical syndromes classified as severe and one-third as mild. More dogs died during the neutropenic phase of the hematopoietic cycle than during the nonneutropenic phase. Pathologic findings showed distinct patterns in relation to age. Younger dogs showed evidence of acute infectious processes, especially in the lungs, gastrointestinal tract, and kidneys; whereas older dogs had chronic inflammatory changes in those organs. Amyloidosis was a prominent finding in dogs over 30 weeks of age. These findings indicate that predictable age-related changes in tissues of grey collie dogs impair various organ systems and thereby contribute to morbidity and mortality in older dogs. consequently, future clinical and pathologic studies of grey collies should take into consideration the age of the dogs under study. PMID- 6846504 TI - Comparison of aortic intima and inner media in young adult versus aging rats. Stereology in a polarized system. AB - Age-related ultrastructural changes in the intima and inner media of rat thoracic aorta were examined by new morphometric techniques. Young adult male rats, 10 weeks old, were compared with 1-year-old male rats. The most marked changes were found in the sub-endothelium, which increased in thickness more than five-fold. Basement-membrane-like and granular material accounted for the bulk of this thickening. Certain other structures were increased sevenfold or more in subendothelium. These structures and the volume fractions they occupied in 1-year old rats were as follows: banded collagen, 4.3%; mononuclear leukocytes, 4.5%; cystic structures, 3.3%; and fibrillar elastin, 1.0%. Changes were also demonstrated in the fenestrae of and at selected depth levels below the innermost, or alternatively the internal, elastic lamina. Collagen increased strikingly within fenestrae and just below the elastic lamina. This was associated with a 28% increase in the thickness of the elastic lamina and a recession of smooth muscle cytoplasm to a deeper position within the first musculoelastic medial layer. The alterations in subendothelial tissues imply an altered basis for mechanical support for aortic endothelium in aging rats. These results mark the successful application of micro-computer-based stereology to a situation of polarized geometry. PMID- 6846506 TI - Bilateral asymmetry in cone epiphysis of the middle phalanx, fifth finger. AB - The form of epiphyseal-diaphyseal dysostosis in the phalanges of the hand having the appearance of a cone-and-crater (cone-shaped epiphysis) is a common variant in otherwise normal individuals. Dysplasia on the radial margins of the epiphysis and diaphysis, typically resulting in clinodactyly, is another variant and is also common in Down's syndrome. Both variants frequently involve brachymesophalangia. The strong female bias in cone epiphyses and the lack of such bias in dysplasia not involving cones has led to the interpretation of distinct etiologies for the two patterns. A single case displaying brachymesophalangia with cone epiphysis in the middle phalanx of the left fifth finger and brachymesophalangia with clinodactyly in the corresponding bone of the right hand is reported. This is evidence that in certain cases the two patterns of mid-5 dysostosis are manifestations of the same condition. PMID- 6846505 TI - Pulmonary injury induced by phorbol myristate acetate following intravenous administration in rabbits. Acute respiratory distress followed by pulmonary interstitial pneumonitis and pulmonary fibrosis. PMID- 6846507 TI - Failure of linguistic relationships to predict genetic distances between the Waiapi and other tribes of lower Amazonia. AB - Data on blood group, serum protein, erythrocyte enzyme, and histocompatibility antigen (HLA) traits are presented for the Waiapi, a Tupi-speaking tribe of the Brazilian and French Guianas. Intra- and intertribal comparisons have been made between these data, and previously published data from French Guiana, from another Tupi tribe and from other tribes of neighboring areas, and from the continent as a whole. For this purpose, we have modified the usual measure of genetic distance to obtain a value which is independent of the number of loci being considered. The intertribal genetic distances do not correlate with linguistic affinity. Social differences, which may have affected the rate of drift from the continental mean, correlate better with genetic distances. PMID- 6846508 TI - A hominoid humeral fragment from the Pliocene of Kenya. PMID- 6846509 TI - On the assumption of equality of variance-covariance matrices in the sex and racial diagnosis of human skulls. AB - Many papers have been devoted to the assumption of equality of variance covariance matrices (sigma g) with respect to the use of discriminant analysis. Most of them concentrate on the "effect" of inequality on the results, in particular on discriminant functions. In the present paper, the assumption of equality of covariances itself was investigated for measures on human skulls. Data for both sexes were compared, as well as data on several racial groups. A likelihood ratio test was used. It was concluded that the equality of sigma g between the sexes and among subraces was not questioned, whereas the results warrant some caution as to the equality of sigma g among the main racial groups. PMID- 6846510 TI - Cross-sectional geometry of Pecos Pueblo femora and tibiae--a biomechanical investigation: I. Method and general patterns of variation. AB - Variation in long bone cross-sectional geometry can be given a more precise functional interpretation using engineering beam theory. However, difficulties in measurement technique have generally prevented studies of large samples of cross sections in this way. In the present study, an automated system utilizing an electronic digitizer and computer software was used to analyze cross-sectional geometric properties of 11 femoral and tibial locations in 119 individuals from the Pecos Pueblo, New Mexico site. The data generated allow identification of clear differences in geometric properties between different regions of the femur and tibia. These differences appear to be related to specific in-vivo mechanical loadings of the lower limb bones, serving to reduce stress and strain under these loadings. The data are also used to investigate possible differences in loading of the femur and tibia in the Pecos and modern samples, and between humans and a nonhuman primate sample. PMID- 6846511 TI - Cross-sectional geometry of Pecos Pueblo femora and tibiae--a biomechanical investigation: II. Sex, age, side differences. AB - Intra-populational variation in cross-sectional geometric properties of the femur and tibia are investigated in the Pecos Pueblo skeletal sample. Sex differences in geometric parameters suggest that male lower limb bones are more adapted for A P bending, females for M-L bending. Proposed explanations for this finding include sexual dimorphism in pelvic structure and culturally prescribed sex related activities at Pecos. With aging, both males and females undergo endosteal resorption and cortical thinning, greater among females. Both sexes also demonstrate an increase with age in subperiosteal area and second moments of area, supporting results reported in some studies of modern population samples. Sex and site-specific remodeling of the femur and tibia with aging also occur. These localized remodeling changes appear to selectively conserve more compact cortical bone in areas of high mechanical stress. Side differences in cross sectional geometric properties indicate that left lower limb bones are generally larger than right lower limb bones, with asymmetry greater among females. In particular, left femora and tibiae are relatively stronger in A-P bending, again more so in females. PMID- 6846512 TI - Growth of the masseter muscle in rhesus monkeys (Macaca mulatta). AB - The growth of the masseter muscle in eight infant, juvenile, and adolescent female rhesus monkeys (M. mulatta) was examined over a 2.5 year period using serial radiographic cephalometric techniques with the aid of radiopaque muscle markers. The radiopaque markers, which are composed of small pieces of root canal broach inserted into the muscle belly, make it possible to determine longitudinal masseter muscle growth as well as migration of the masseter muscle relative to the mandible. It was found that the masseter muscle increased in length by 64% during the total growth period, most of which occurred between 6 and 18 months of age. Relative to the cranium, the masseter muscle grew markedly inferiorly and only slightly posteriorly. Relative to the mandible, the masseter migrated in a posterior and slightly superior direction, keeping pace with the ramus and condyle as they grew posteriorly and posterosuperiorly throughout the study period. It was concluded that: 1) radiopaque muscle markers are a valuable tool for analysis of muscle growth and alteration of muscle location; 2) the masseter muscle in the rhesus monkey undergoes elongation, probably due to addition of sarcomeres at the fiber-tendon junctions; and 3) posterior migration of the masseter muscle relative to the corpus of the mandible, probably due to the nature of its periosteal attachment, results in a stability of the anteroposterior position of the masseter muscle despite the anterior displacement of the mandible. PMID- 6846514 TI - Adult stature and age at menarche in Zapotec-speaking communities in the Valley of Oaxaca, Mexico, in a secular perspective. AB - Adult stature and the age at menarche among individuals from Zapotec-speaking communities in the Valley of Oaxaca in southern Mexico are considered in a secular perspective. Four sets of observations are utilized: 1) adult stature in males and females from five rural communities; 2) age at menarche in adult women and school girls from a single rural community; 3) earlier studies of adult stature in the Valley of Oaxaca; and 4) estimated stature from long bones excavated in various archaeological sites in the Valley of Oaxaca. There were no significant differences among the five communities for stature; hence, the data were pooled for analysis and comparison. Results of linear regression of stature and stature adjusted for the estimated effects of aging after 30 years of age on year of birth indicate negligible secular changes in either sex. Comparisons with statures from earlier surveys, the earliest dates to 1899, also indicate negligible changes. When adult women are grouped according to age, there are no differences in mean ages at menarche between the older and younger women. Mean age at menarche for the total adult sample is 14.53 +/- 0.08 years, which compares favorably with the probit estimate for school girls, 14.70 +/- 0.32 years. These results thus suggest virtually no secular change in adult size and maturity of the Zapotec-speaking population in the Valley of Oaxaca over the past 80 years. Differences in stature between contemporary populations and estimated statures from long bones from several archaeological sites in Oaxaca are small, and thus suggests little secular change over the past one to two-thousand years. PMID- 6846513 TI - A note on the effect of asymmetry in suture closure in mature human skulls. AB - Studies on suture closure in mature European and East African Bantu skulls revealed marked differences in the degree of suture closure on the left and right side. Asymmetrical closure of sutures may lead to erroneous conclusions being made in ageing skulls if only one-half of the skull is available for examination. Asymmetry in suture closure was rather common in recent skulls, being particularly noticeable in the bregmatic and complicate parts of the coronal suture and in intermediate portions of lambdoid sutures. PMID- 6846515 TI - Principal components for allometric analysis. AB - Logarithmic bivariate regression slopes and logarithmic principal component coefficient ratios are two methods for estimating allometry coefficients corresponding to a in the classic power formula Y = BXa. Both techniques depend on high correlation between variables. Interpretation is logically limited to the variables included in analysis. Principal components analysis depends also on relatively uniform intercorrelations; given this, it serves satisfactorily as a method for summarizing many bivariate combinations. Unmodified major principal component coefficients cannot represent scaling to body weight; rather, they represent scaling to a composite size vector which usually is highly correlated with body size or weight but has an unspecified allometry. Thus, the concepts of proportionality and of isometry must be kept distinct. PMID- 6846516 TI - Changes in maternal postpartum adiposity and infant feeding patterns. AB - The relationship between maternal fatness and infant feeding practices was studied in 46 healthy Caucasian women from parturition to 6 months postpartum. Mothers reported infant feeding practices in diary form throughout the study. Weight, triceps and subscapular skinfolds, and midarm circumference were measured on seven occasions. Upper arm fat area was computed. All women breast fed their infants for at least 5 months, with no nonbreast milk food introduced for at least 2 months. All women had declining or stable postpartum weights. Linear regressions of upper arm fat area on days since parturition were used to ascertain overall direction of change in adiposity for each woman. Declining fat area occurred in 17 cases and was associated with a breast-feeding pattern of short frequent feeds. In the remaining 29 cases, increasing fat area was associated with significantly longer and less frequent feeds. It is hypothesized that these different fat change patterns result from differential activity of adipose tissue lipoprotein lipase, which is itself mediated by serum prolactin concentration. Relevance of these findings for resolution of the controversy surrounding the critical body composition hypothesis and lactation amenorrhea is discussed. PMID- 6846517 TI - Dental indicators of growth disturbance in a series of ancient Lower Nubian populations: changes over time. AB - Previous studies of accentuated striae of Retzius in tooth enamel suggest that early childhood growth disturbance tends to be severe in state-level agricultural societies. The present study investigates the diachronic stability of levels of growth disturbance with a series of Lower Nubian agricultural states broadly similar in terms of mode of subsistence and way of life. The sample consists of 114 first permanent molars from the Meroitic (100 B.C. to 300 A.D.) and X-Group (300 to 600 A.D.) cultures. These teeth were sectioned according to standard histological technique. Data on the frequency and severity of accentuated striae of Retzius were then used to derive estimates of the magnitude of individual growth disturbance. Populations were compared by means of a two-way ANOVA, with growth disturbance as the dependent variable, and age and population as the independent variables. The results show that those dying in childhood experienced significantly higher levels of early childhood growth disturbance than did those surviving to adulthood. The results also show a decline in growth disturbance levels over time. Both X-Group children and X-Group adults experience significantly less early childhood growth disturbance than their Meroitic counterparts. These results suggest an improvement in child health status from Meroitic to X-Group times. Tentative explanatory hypotheses imply an increase in village autonomy, an increase in helminthic disease related to a change in irrigation technology, or direct and indirect effects of consumption of naturally occurring tetracyclines. These hypotheses are not mutually exclusive, and further research is needed before any of them can be tested. PMID- 6846518 TI - Skeletal growth in a medieval population from Sudanese Nubia. PMID- 6846519 TI - Evidence for prehistoric cardiovascular disease of syphilitic origin on the Northern Plains. PMID- 6846520 TI - Humidity as a source of measurement error in osteometrics. AB - A simple experiment was conducted to test the hypothesis that variation in humidity causes expansion of bone and, thereby, affects measurements of dried, preserved skulls. The experiment consisted of subjecting ten macaque skulls to increased humidity for 24 hours. Measurements of nine skull dimensions taken immediately before and after humidification revealed a statistically significant treatment effect of increased skull size with increased humidity. The length of the molar tooth row increased by about 0.1 mm (0.50%) while the greatest length of the skull increased by about 0.9 mm (0.57%). The specimens returned to their original dimensions within 1-2 days after being removed from the humidity chamber. These results confirm the impression gained by the practical experience of measuring museum specimens in different locations and environments. It appears that bony changes associated with humidity differences represent a real, though minor, source of measurement error in osteometrics. PMID- 6846521 TI - Hemolytic action of potassium salts on dog red blood cells. AB - Recent demonstrations of chloride-associated passive potassium movements in red blood cells of humans, ducks, sheep, and toadfish prompted a reinvestigation of potassium permeability in dog red blood cells. Early observations of Davson (J. Physiol. London 101:265-283, 1942) had shown that replacement of chloride by nitrate and thiocyanate caused a greatly increased rate of potassium flux across the dog red cell membrane. This finding seemed at variance with results in other species in which chloride replacement caused a fall in potassium flux. The present data indicate that passive potassium movements in swollen dog red blood cells are chloride dependent and furosemide sensitive, as shown for the cells of other species. Davson's findings were demonstrated to be due to the inclusion of small quantities of calcium in the medium under circumstances that favored calcium entry into the cells, thus opening the calcium-activated potassium channel described by Gardos (Curr. Top. Membr. Transp. 10:217-277, 1978 and Nature London 279:248-250, 1979). Potassium movements through the latter channel were stimulated when chloride was replaced by more permeant anions, such as nitrate and thiocyanate, which also increased the rate of net potassium movements in valinomycin-treated cells. PMID- 6846522 TI - Passive calcium movements in dog red blood cells: anion effects. AB - Calcium influx in dog red blood cells was stimulated by replacing chloride in the medium with nitrate or thiocyanate. These anion effects were due to stimulation of a sodium-dependent calcium pathway, because calcium influx in the presence of nitrate or thiocyanate was 1) inhibited by external sodium, 2) dependent on internal sodium, 3) inhibited by cell shrinkage and low pH, and 4) inhibited by quinidine. All these characteristics had previously been shown to hold for calcium movements in the presence of chloride. Neither nitrate nor thiocyanate caused an irreversible change in calcium transport in the concentrations studied. Calcium-stimulated sodium efflux is stimulated when chloride is replaced by thiocyanate but not by nitrate. Several limiting features of the system are discussed, which preclude a conclusive interpretation of the data. The possibility is considered that the rates of sodium-dependent calcium transport in the presence of chloride, nitrate, and thiocyanate are a function of the conductance of these anions. PMID- 6846523 TI - Volume-responsive sodium movements in dog red blood cells. AB - As dog red blood cells are shrunken in vitro, their sodium permeability increases progressively. Some new features of this volume-responsive transport process are described. Retardation of sodium movements in shrunken cells occurs when chloride is replaced by the more conductive anions: nitrate or thiocyanate. Micromolar concentrations of amiloride or quinidine inhibit the increment of sodium flux associated with a reduction in cell volume. In the presence of a large outwardly directed sodium gradient, dog red blood cells can progressively alkalinize the medium in which they are suspended. This pH change is stimulated by cell shrinkage, reversed by cell swelling, retarded when chloride is replaced by nitrate or thiocyanate, and inhibited by micromolar concentrations of amiloride or quinidine. The similarities between the shrinkage-associated sodium flux and the alkalinization phenomenon suggest that the mechanism responsible for increased sodium permeability in shrunken cells can be made to operate as a sodium-hydrogen exchanger. PMID- 6846524 TI - Sodium gradient-driven transport processes in ATP-depleted renal tubules. AB - The effects of directed Na+ gradients on proximal tubule cell transport processes were examined in suspensions of rabbit renal tubules depleted of ATP. Cells of high-Na+ content were generated by suspending the tubules in high-Na+ media, whereas low-Na+ cells were produced by incubating tubules in Na+-free media. Resuspension of the high-Na+ tubules in Na+-free media caused a fall in cell pH simultaneous with a fall in cell Na+. Resuspending the low-Na+ cells in Na+ replete media led to a rise in cell pH, in parallel with the rise in cell Na+. Removing HCO-3 and CO2 augmented and amiloride inhibited the increase in cell pH generated by the inward Na+ gradient. Low-Na+ tubules exposed to an inwardly directed Na+ gradient also concentrated the sugar analogue alpha-methylglucoside, and this uptake was blocked by phlorizin. These findings demonstrate the suitability of ATP-depleted renal tubules for the study of linked transport processes by providing evidence for the existence of the proximal luminal transport processes, Na+-H+ exchange, and Na+-sugar cotransport in this preparation. PMID- 6846525 TI - Excitation-contraction coupling without Ca2+ action potentials in small intestine. AB - Sensitive mechanical and intracellular electrical recordings showed that phasic contractions occurred in response to electrical slow waves in the absence of Ca2+ action potentials. Drugs that either enhanced or depressed slow waves were used to study the relationship between slow-wave amplitude and the amplitude of the phasic contractions. Acetylcholine (Ach) (10(-8) to 3 X 10(-7) M) increased slow waves and contractions without causing action potentials. When ACh was raised to 10(-6) M, action potentials were elicited and accompanying contractions increased in amplitude by at least a factor of five. The Ca2+ channel blocker, Mn2+ (0.5 mM), decreased slow-wave amplitude and the associated phasic contractions. These data agree with a previous study (12), suggesting that an oscillation in intracellular Ca2+ occurs during each slow-wave cycle. The present study suggests that the increase in intracellular Ca2+ during the slow wave is sufficient to activate the contractile apparatus. PMID- 6846526 TI - Evidence for basolateral membrane potassium conductance in canine tracheal epithelium. AB - The ionic dependence of the basolateral membrane conductance in canine tracheal epithelium was investigated using intracellular microelectrode techniques. Increasing the K+ concentration in the submucosal bathing solution depolarized the electrical potential difference across the basolateral membrane; neither alteration of the submucosal Na+ concentration nor the mucosal K+ concentration had a significant effect on the cellular electrical potential profile. An increase in the K+ concentration in the submucosal bathing solution also decreased the net rate of Cl-secretion. Addition of ouabain (10(-4) M) to the submucosal bathing solution decreased the short-circuit current and depolarized the intracellular voltage without altering transepithelial resistance or the cell membrane resistance ratio, suggesting that basolateral resistance was unchanged. These findings, together with the previous observation that there is no appreciable basolateral Cl- conductance, indicate that a K+ conductance accounts for the predominance of the electrical conductance at the basolateral membrane. The results also indicate that the basolateral membrane K+ conductance plays a critical role in the generation of the negative intracellular voltage that drives Cl- exit across the apical membrane and thus supports Cl- secretion. PMID- 6846527 TI - Phosphagen and metabolite content during contraction in porcine carotid artery. AB - Previous studies (Paul, R. J. Chemical energetics of vascular smooth muscle. In: Handbook of Physiology: The Cardiovascular System. Bethesda, MD: Am. Physiol. Soc., 1980, p. 201-235) have shown that vascular oxygen consumption reaches a steady state at approximately twice the basal rate during maintenance of isometric contraction. The time course of the attainment of a metabolic steady state, the metabolic signal for the observed increase in respiration, and the contribution of endogenous phosphagens to the energetics of isometric contraction are not known with certainty. To this end, the time course of the tissue content of ATP, ADP, AMP, phosphocreatine (PCr), inorganic phosphate (Pi), and lactate were measured during a KCl-induced isometric contraction in porcine carotid artery and compared with values in the basal state. Oxygenated unpoisoned strips were frozen at 0, 0.5, 1, and 15 min of contraction, and tissue extracts were analyzed using analytical isotachophoresis. No statistically significant changes from the basal levels of ATP and PCr were measured. A small but significant increase in ADP was seen at all times. An increase in Pi of 1.25 mumol/g was observed at 0.5 min, which decreased in time. Tissue lactate content increased by 1.79 mumol/g after 1 min of contraction. The calculated range of cellular free ADP (ADPfree), 44-123 microM, may be sufficient to saturate oxidative phosphorylation. This and the apparent lack of change of ADPfree from basal during contraction suggest that it does not play a role in the coordination of metabolism and contractility. From as early as 0.5 min, when less than 40% of peak isometric force is attained, intermediary metabolism provides the total ATP required for contraction. PMID- 6846528 TI - Functional compartmentalization of oxidative and glycolytic metabolism in vascular smooth muscle. AB - The metabolism of vascular smooth muscle is characterized by an unusual component of aerobic glycolysis. Lactate production, even under fully oxygenated conditions, is of similar magnitude to the rate of oxygen consumption when compared on a molar basis. Although the underlying mechanisms are unknown, the ratio of glycolytic to oxidative metabolism has been suggested to be an index of vascular myopathy. Measurements of the rate of O2 consumption (JO2), lactate production (Jlac), and isometric force in porcine coronary arteries were made under conditions known to alter both active force (delta Po) and Na+-K+ transport. As previously reported, JO2 was strongly correlated with delta Po; Jlac, however, was correlated with conditions that alter Na+-K+ transport. Under conditions known to inhibit Na+-K+ transport (10(-5) M ouabain, absence of extracellular K+ or Na+), Jlac was inhibited even though delta Po and JO2 were increased. The coupling of Na+-K+ transport with aerobic glycolysis was not dependent on tonicity or the major anion species, nor was it an effect simply on tissue lactate permeability as indicated by studies of tissue lactate content. Metabolic measurements made at similar levels of delta Po indicate that Jlac is markedly inhibited by ouabain, whereas JO2 shows little effect. Thus the unusual aerobic glycolysis observed in vascular smooth muscle appears to be linked to Na+ K+ transport processes and not to some nonspecific metabolic deficiency. Experiments on both systemic and pulmonary arteries from rat, rabbit, dog, and pig indicate that these results are not limited solely to porcine coronary vessels. PMID- 6846530 TI - Kidney epithelial cell growth is stimulated by lowering extracellular potassium concentration. AB - The factors that induce kidney growth in K+-depleted animals are unknown. To determine if the low extracellular fluid K+ concentration could act as a growth stimulus, cultures of monkey kidney epithelial cells from the BSC-1 line were studied in media with a low-K+ concentration. Growth of confluent cultures was accelerated maximally at a K+ concentration of 3.2 mM, whereas concentrations of 2.9 and 3.5 mM were also stimulatory but to a lesser extent. Because growing renal tissue from K+-depleted rats was previously found to exhibit increased uptake of nutrient molecules, evidence for enhanced uptake was sought in BSC-1 cells after exposure to low-K+ medium. The uptake of 10 different nutrient molecules was enhanced in cells exposed to low-K+ medium for 30 s. These observations indicate that a reduced extracellular K+ concentration per se stimulates proliferation of renal epithelial cells in culture and could be one of the factors that mediate kidney growth in K+-depleted animals. PMID- 6846529 TI - Microfluorometric monitoring of pHi in cultured heart cells: Na+-H+ exchange. AB - Continuous measurement of intracellular pH (pHi) should enhance the likelihood of defining the mechanisms of pHi regulation in actively contracting preparations of cardiac muscle. A filter microfluorometric technique was adapted for use with growth-oriented embryonic chick heart cells to continuously monitor changes in the fluorescence intensity of the pH-sensitive chromophore 6-carboxyfluorescein, generated in situ. Data pertaining to the direction and the rate of pHi changes assisted in thermodynamically characterizing and ascertaining net kinetic parameters of a Na+-H+ exchange mechanism. Imposing an outward Na+ gradient across the cardiac cell membrane rapidly (t 1/2 = 44 s) induced cytosolic acidification, whereas an inward Na+ gradient produced cytosolic alkalinization (t 1/2 = 40 s). Amiloride (10(-3) M) caused the cytoplasm to acidify (t 1/2 = 46 s) and also reversibly blocked the acidification induced by low extracellular Na+. These results are consistent with the presence of a rapid Na+-H+ exchange mechanism in the cardiac cell membrane. Further investigations are required to characterize the involvement of Na+-H+ exchange in pHi regulation and to differentiate the effects of Na+-H+ exchange from other ion gradient-coupled mechanisms, e.g., Na+-Ca2+ exchange. PMID- 6846531 TI - Erythropoietin in liver tissue extracts and in liver perfusates from hypoxic rats. AB - An attempt to evaluate the role of the liver in extrarenal erythropoietin production was made by measuring the content of erythropoietin in homogenates and perfusates from hypoxic rat livers. Extracts from livers from nephric or anephric animals rendered both anemic and hypoxic showed no detectable erythropoietin despite the fact that both plasma and kidney extracts contained large amounts of erythropoietin. This lack of measurable erythropoietin in the liver is not caused by degradation of erythropoietin during the extraction procedure because exogenously added rat erythropoietin was recovered to the same extent from livers or kidney homogenates. More likely, however, it is caused by the fact that extrarenal erythropoietin production accounts for only one-fifth of total erythropoietin production and that the liver mass is about six times that of both kidneys. Consequently, the erythropoietin content of 1 g of liver should be about one-thirtieth of that of 1 g of kidney, an amount that is below the limit of detection of the assay. On the other hand, the 2-h in situ perfusates of livers from similarly stimulated animals contained significant amounts of secreted erythropoietin. It is concluded that the liver participates actively in extrarenal erythropoietin production in the adult rat. However, the small amount expected to be present in tissue homogenates cannot be detected with our current bioassay. PMID- 6846532 TI - Amino acid metabolism in the ovine fetus. AB - Quantitative measurements of the umbilical uptake of a variety of substrates were made in the ovine fetus in both the fed state and after 5 days of maternal fasting. Blood flow was measured in both study periods using the antipyrine method, with the simultaneous measurement of umbilical vein and arterial concentrations of glucose, oxygen, and 25 amino acids in whole blood. Umbilical blood flow and fetal oxygen consumption remained unchanged between the fed and fasted states. Umbilical glucose uptake decreased from a mean of 6.85 to 2.79 mg X kg-1 X min-1 with a concomitant fall in the glucose:oxygen quotient from a mean of 0.70 to 0.31. Whereas the majority of gluconeogenic amino acids decreased in concentration in the maternal circulation during fasting, the branched-chain amino acids, as well as 3-methylhistidine, increased. In contrast the majority of amino acids in the fetal arterial circulation either increased significantly or remained unchanged in concentration. Although the fetal excretion of urea increased by 70% during the period of maternal fasting, the total fetal uptake of nitrogen in the form of free amino acids via the umbilical circulation did not change (1,337 vs. 1,027 mg X kg-1 X day-1). These data suggest that the supply of amino acids from the mother to the fetus does not change dramatically during maternal fasting. Therefore, the fetus must either catabolize amino acids previously destined for fetal tissue synthesis and/or begin catabolizing its own protein stores. PMID- 6846533 TI - Optimal segments: a method for smoothing tracer data to calculate metabolic fluxes. AB - Metabolic fluxes (Ra and Rd) are calculated in the nonsteady state using Steele's equations. These calculations require estimates of the values and rates of change of glucose and specific activity at discrete sampling times. Data smoothing minimizes the effect of measurement error that confounds the Ra and Rd calculations. We compared three smoothing methods: a) moving average, b) polynomial fitting, and c) optimal segments, a new technique that utilizes optimization methods. Experimental designs were simulated: 1) constant infusion of glucagon in depancreatized dogs, and 2) glucose oscillations generated by constant high-level glucose infusion. Measurement error was added to raw data. After smoothing, fluxes were calculated and compared to the "actual" Ra and Rd. Ra calculated from unsmoothed noisy data were in error by an average 39%. Error was reduced by smoothing to: 23%, moving average; 18%, polynomial fitting; 15%, optimal segments. Optimal segments was best for calculating Ra (P less than 0.01) and was better than or equal to other methods for Rd. Distortion in flux patterns was greatest for polynomial fitting (P less than 0.01) and least for optimal segments (P less than 0.001). Optimal segments is the method of choice for smoothing tracer data; it improves calculations of Ra and Rd with minimal distortion. PMID- 6846534 TI - Steroidogenesis by avian ovarian cells: effects of luteinizing hormone and substrate availability. AB - The production of progesterone (P) and estrogen (E) by enzymatically dispersed granulosa and theca cells from chicken preovulatory follicles was examined in 3-h incubations. Accumulation of the P produced by granulosa cells was significantly reduced by the addition of theca cells, whereas E production was increased. The decrease in P accumulation was shown to be due to extensive metabolism of P by theca cells. There were no synergistic effects of luteinizing hormone (LH) and any substrate tested on E production by theca cells. Maturation of granulosa cells was characterized by an increased sensitivity to LH stimulation of P production, but there was no change in pregnenolone conversion to P. Conversely, maturation of theca cells was accompanied by decreased in both sensitivity to LH and the ability to convert substrates to E. The results are discussed in terms of the contribution of each cell type in the production of steroids by chicken follicles during maturation. PMID- 6846535 TI - Effect of endurance training on glucose kinetics during exercise. AB - Control and endurance-trained rats received continuous infusions via jugular catheters of [U-14C]- and [6-3H]glucose under one of three conditions: rest (Re), running at 13.4 m/min (easy exercise, EE), or running at 26.8 m/min (hard exercise, HE). Arterial blood was sampled from carotid catheters. Blood glucose levels were not different between groups at rest (3.88 +/- 0.19 mM) or EE (4.32 +/- 0.35 mM). During HE, trained animals maintained blood glucose better (3.41 +/ 0.34 mM) than did untrained animals (3.03 +/- 0.42 mM). Respiratory exchange ratio (R) increased from rest (0.79 +/- 0.05) to exercise and was significantly lower in trained than in untrained animals during HE (0.87 +/- 0.02 vs. 0.93 +/- 0.03). Glucose turnover (Rt) calculated from [3H]glucose was not different between groups at rest (46.2 +/- 2.7 mumol x kg-1 x min-1). Turnover increased during EE to 91.5 +/- 7.5 vs. 72 +/- 8.5 mumol x kg-1 x min-1 in untrained and trained animals, respectively. During HE, Rt rose to 95.0 +/- 12.6 in trained animals but fell to 78.7 +/- 9.9 mumol x kg-1 x min-1 in untrained animals. The percentage of glucose flux oxidized increased from rest (44.0 +/- 6.8%) to exercise and was significantly lower in trained (73.7 +/- 4.3%) than in untrained animals (95.1 +/- 3.8%) during HE. Metabolic clearance rate increased from 12.5 +/- 0.8 in Re to 29.4 +/- 6.0 ml x min-1 x kg-1 in HE but did not differ between groups. Training improved glucose homeostasis during HE by increasing the glucose flux and by reducing the fraction of the flux lost to oxidation. PMID- 6846536 TI - Incorporation of radioactive phospholipid into subclasses of high-density lipoproteins. AB - The incorporation of orally administered phospholipid into plasma high-density lipoproteins (HDL) was studied in three subjects. Plasma was analyzed by equilibrium density gradient ultracentrifugation, 5, 6, and 8 h after ingestion of 1.1 g [3H-choline, 14C-dilinoleoyl]phosphatidylcholine. At all time points in all subjects, there was a peak of phosphatidylcholine specific activity in fractions of density approximately 1.10-1.13 g/ml, corresponding to the subclass previously designated HDL2a. There was also a more variable, smaller peak of specific activity of phospholipids in HDL2b (1.063-1.100 g/ml) and in fractions of density approximately 1.19 g/ml. In the 1.10-1.13 fraction, 97 and 71%, respectively, of the 3H and 14C radioactivity were in phospholipids. The 3H/14C ratio was similar in phospholipids of HDL subfractions, the d less than 1.07 fraction, and in the administered phospholipid. The results show preferential transfer or exchange or absorbed phosphatidylcholine into specific subclasses of HDL. PMID- 6846537 TI - Water removal and solute additions determining increases in renal medullary osmolality. AB - Osmolality and solute concentrations of the mammalian renal medulla increase and decrease with changing urine osmolality. These changes are brought about by addition or removal of solute or water to or from the renal medullary tissue. In Munich-Wistar rats and Syrian hamsters, males and females, actual amounts of and the various solutes involved in these changes were determined. Kidneys were removed from animals killed in different stages of water diuresis and antidiuresis. The renal medulla was analyzed by a new method that permits determination of water and solutes on the same piece of tissue. Removal of water and addition of urea were the two most important factors in raising inner medullary osmolality. Papillary water content was inversely related to the papillary osmolality and was 50% lower in extreme antidiuresis compared with water diuresis. Rats had higher papillary water content than hamsters. In the outer medulla, water removal was significant in the hamsters but not in the rats. Addition of urea to the papillary tissue exceeded the osmotic equivalent of NaCl by a factor of 2.8 in both rats and hamsters. Females of both species showed greater changes than males in amounts of urea in the inner medulla. PMID- 6846538 TI - Autoregulation of renal blood flow in the rat: effects of growth and uninephrectomy. AB - As a result of normal maturation or after reduction in renal mass, renal blood flow (RBF) progressively increases. However, the effects of renal growth on the relationship of RBF to renal perfusion pressure (RPP) have not been systematically investigated. We examined RBF as a function of RPP in anesthetized young and adult rats that had been subjected to uninephrectomy or sham operation 3-4 wk previously. As a result of normal growth, mean arterial blood pressure increased from 94.1 +/- 2.7 (SE) to 118.9 +/- 4.2 mmHg. The calculated autoregulation factor, in which a value less than 1 indicates the presence of autoregulation, was 0.44 +/- 0.10 over RPP 70-100 mmHg and 1.74 +/- 0.25 over RPP 40-70 mmHg in sham-operated young animals. In adult sham-operated rats, the factor was 0.38 +/- 0.07 over RPP 100-130 mmHg and 1.03 +/- 0.07 over RPP 70-100 mmHg. Uninephrectomy in adults resulted in a 30% rise in RBF over RPP 100-130 mmHg, and there was no change in the autoregulation factor. Uninephrectomy in young rats, however, resulted in a 35% rise in RBF at RPP = 100 mmHg with only a 17% rise at RPP = 70 mmHg, and the autoregulation factor increased to 0.91 +/- 0.10 over this range of RPP. We conclude that the autoregulatory range shifts with increasing blood pressure during normal growth and that autoregulation is "reset" to higher RBF in the uninephrectomized adult rat. Although autoregulation takes place in the young animal, uninephrectomy alters the relationship of RBF to RPP such that autoregulation is impaired. PMID- 6846539 TI - Corticosterone binding sites along the rat nephron. AB - Glucocorticoids influence numerous kidney functions but the precise location of glucocorticoid receptors in the nephron is not known. To identify the renal binding sites of corticosterone, the natural glucocorticoid in the rat, we measured the binding of [3H]corticosterone to discrete nephron segments microdissected from adrenalectomized rats. Highest specific binding capacity at 25 degrees C (expressed as fmol X cm-1 +/- SE) was found in the cortical collecting tubule (9.69 +/- 0.77) followed in decreasing order by the distal convoluted tubule (2.70 +/- 0.49), medullary collecting tubule (2.58 +/- 0.64), proximal convoluted tubule (1.09 +/- 0.10), and pars recta (0.57 +/- 0.08). Binding was lowest in the thick ascending limb of Henle's loop, with comparable values in the medullary (0.27 +/- 0.05) and cortical (0.26 +/- 0.05) portions of this segment. The apparent maximal binding capacity of the cortical collecting tubule for corticosterone exceeded by nearly two orders of magnitude that of aldosterone previously measured by us in this structure, which is in agreement with the observations of other investigators in kidney cytosol. Specific binding of corticosterone can be demonstrated along the entire rat nephron, but binding sites are concentrated in the cortical collecting tubule. This segment appears to be the main target site for corticosterone as it is for aldosterone. PMID- 6846540 TI - Renal response to four hours of biliary obstruction in the dog. AB - Clearance studies were performed in anesthetized dogs before and 4 h after the acute obstruction of the common bile duct (ABDL). ABDL was not associated with any change in systemic hemodynamics or plasma volume. Glomerular filtration rate (GFR) rose by 15.3%, PAH clearance by 13.3%, and renal blood flow by 13% (all values significant at P less than 0.05). Fractional excretion rates of water and sodium rose from 0.29 to 1.1 and from 0.21 to 0.76%, respectively (P less than 0.05). These changes in renal function were associated with a failure of bile excretion rather than distension of the biliary tree or failure of bile to enter the duodenum. They did not depend on intact hepatic nerves, alteration of hepatic perfusion, or the release of gastrointestinal vasoactive peptides. The increment in renal perfusion was maintained for 2-3 days before returning to baseline levels. Several lines of evidence suggested that factors influencing the renal tubule and the renal microcirculation might be separate in nature: e.g., urinary sodium excretion (UNaV) could increase without a change in GFR; if ABDL was relieved, delta UNaV and delta GFR returned to base line with different time courses; and controlling perfusion to the left kidney during ABDL reduced but did not abolish the increase in UNaV. Both effects could be transferred to recipient dogs by cross-perfusion. We have demonstrated, therefore, that 4 h of ABDL may significantly influence renal function through the appearance of humoral factors in the circulation. PMID- 6846542 TI - Alterations in renal cortical phospholipid content induced by gentamicin: time course, specificity, and subcellular localization. AB - Increasing evidence suggests that membrane phospholipids are a major site of interaction between gentamicin and renal tubular cells. To help assess the impact of this interaction on renal tubular cell phospholipid metabolism, renal cortical phospholipid levels were assessed serially during treatment with nephrotoxic doses of gentamicin in the rat. Within 15 h of treatment with a single 100 mg/kg dose of gentamicin, significant increases in phosphatidylinositol and phosphatidic acid occurred, and further increases in these acidic phospholipids were seen 24 h after two and four daily doses. No consistent sustained changes were observed in total phospholipid levels or in levels of other phospholipids. None of these gentamicin treatment regimens was associated with wide-spread tubular cell necrosis in the rat at the intervals studied. In contrast, during models of acute renal failure secondary to HgCl2 and glycerol, increases in phosphatidylinositol and phosphatidic acid were found only after the development of wide-spread tubular cell necrosis. Subcellular fractionation studies showed that the increase in phosphatidylinositol produced by gentamicin involved multiple cell membranes, including mitochondria, brush border membranes, endoplasmic reticulum, and lysosomes, suggesting that the effects of gentamicin on renal cortical acidic phospholipid metabolism are not limited to inhibition of intralysosomal degradative processes but, rather, occur in such fashion as to influence the phospholipid composition of multiple subcellular membranes. PMID- 6846541 TI - Segmental effects of norepinephrine and angiotensin II on isolated renal microvessels. AB - Interlobular arteries and superficial afferent and efferent arterioles were isolated from rabbit kidney, and the effects of intraluminal pressure, norepinephrine (NE), and angiotensin II (ANG II) on lumen diameter were examined. A single microvessel was dissected and one end was cannulated. The other end of the vessel was occluded and lumen diameter was measured at fixed intraluminal pressures. With step increases in intraluminal pressure over the range of 70-180 mmHg, lumen diameters of the interlobular arteries and afferent arterioles remained constant or decreased by up to 11%. In contrast, lumen diameters of efferent arterioles continued to increase as intraluminal pressure was elevated. In all three vessels NE (10(-9) to 10(-5) M) caused a dose-dependent decrease in lumen diameter. However, only the efferent arteriole responded to ANG II (10(-12) to 10(-8) M). The contractile response of the efferent arteriole to NE or ANG II was localized to the first 50-75 micrometers of the vessel as it emerged from the glomerulus. This finding suggests that smooth muscle cells are located only in this portion of the efferent arteriole. It is concluded that at least part of the autoregulation of renal blood flow can be explained by a myogenic mechanism in preglomerular vessels and that ANG II acts primarily on postglomerular segments of the rabbit renal microcirculation. PMID- 6846543 TI - Cell osmotic water permeability of isolated rabbit proximal convoluted tubules. AB - Cell osmotic water permeability, Pcos, of the peritubular aspect of the proximal convoluted tubule (PCT) was measured from the time course of cell volume changes subsequent to the sudden imposition of an osmotic gradient, delta Cio, across the cell membrane of PCT that had been dissected and mounted in a chamber. The possibilities of artifact were minimized. The bath was vigorously stirred, the solutions could be 95% changed within 0.1 s, and small osmotic gradients (10-20 mosM) were used. Thus, the osmotically induced water flow was a linear function of delta Cio and the effect of the 70-microns-thick unstirred layers was negligible. In addition, data were extrapolated to delta Cio = 0. Pcos for PCT was 41.6 (+/- 3.5) X 10(-4) cm3 X s-1 X osM-1 per cm2 of peritubular basal area. The standing gradient osmotic theory for transcellular osmosis is incompatible with this value. Published values for Pcos of PST are 25.1 X 10(-4), and for the transepithelial permeability Peos values are 64 X 10(-4) for PCT and 94 X 10(-4) for PST, in the same units. These results indicate that there is room for paracellular water flow in both nephron segments and that the magnitude of the transcellular and paracellular water flows may vary from one segment of the proximal tubule to another. PMID- 6846544 TI - Ontogeny of cell proliferation and DNA synthesis in rat colon: role of glucocorticoids. AB - This study was undertaken to determine whether the rat colon exhibits ontogenic changes in epithelial cell proliferation and DNA synthesis during growth. DNA synthesis was measured at intervals after birth in four colonic segments by the incorporation rates of [3H]thymidine. The labeled crypt cell index was determined by radioautography. New findings from our study are that 1) in each colonic segment of suckling rats, [3H]thymidine incorporation rate overshot the adult levels (49-119%) with a peak occurring at day 14 postpartum, 2) between days 14 and 20, the incorporation rates declined sharply to adult values and remained thereafter unchanged until adulthood; during the same period, the labeled and mitotic index decreased, respectively, from 52 to 19% and from 3.58 to 1.43%, 3) the decrease in DNA synthesis and in cell proliferation rates was concomitant with an upsurge in plasma total corticosterone initiated on day 14, and 4) treatment of 10-day-old sucklings with physiological doses of hydrocortisone for 4 consecutive days significantly depressed (P less than 0.01) colonic DNA content and DNA synthesis rates to levels about 45-67% of the control values. These data indicate that growth of the colon may be under the control of glucocorticoid secretion at the weaning period. PMID- 6846545 TI - Concentrative uptake of alanine in hepatocytes from fed and fasted rats. AB - The transport of alanine across the liver cell membrane was studied in hepatocytes isolated from fed and 48-h-fasted rats. Aminooxyacetate was used to render alanine nonmetabolizable. The steady-state intracellular-to-extracellular distribution ratio of alanine was maximal at extracellular concentrations below 0.5 mM and was increased from about 10 to about 20 by fasting. This increase was the net effect of a two- to threefold increase in the alanine influx and about a 50% increase in the rate constant of alanine efflux. The results suggest that alanine efflux occurred partly via the transport system mediating Na+-dependent alanine influx and partly by another pathway. The transmembrane Na+ electrochemical gradient remained unchanged by fasting and could apparently account for a maximal distribution ratio of alanine well above 20. In both nutritional states, the simplest kinetic model adequately describing the alanine influx implicated one saturable component besides a passive component. The apparent Vmax of the former was doubled by fasting while the apparent Km was insignificantly decreased. At low extracellular alanine concentrations, the rate of alanine consumption (aminooxyacetate absent) was only 40% of the alanine influx in the fed state but was increased at least fivefold by fasting and thereby balanced with the increased alanine influx. These results suggest a rate limitation at the transport level in the fasted state. PMID- 6846546 TI - Effects of scorpion venom on electrolyte transport by rabbit ileum. AB - Scorpion venom, which depolarizes nerves, was used to obtain further evidence that intramural nerves affect ion transport by the rabbit ileum. Ileal epithelium, stripped of muscularis propria, was mounted in a flux chamber modified to permit electrical field stimulation (EFS) of the tissue. Response of the short-circuit current (Isc) to venom was most rapid on the serosal surface, and the response was eliminated by tetrodotoxin. Isc response was influenced by venom batch number and by factors within the tissue. Venom (10 micrograms/ml) and EFS each caused chloride secretion by reducing mucosal-to-serosal movement and by increasing serosal-to-mucosal movement. Sodium transport and residual ion fluxes did not change. In the presence of venom, EFS caused no further changes in ion transport, but tissues still responded to glucose and to aminophylline. The early peak of Isc was reduced about 40% by atropine, implying that acetylcholine, released by venom, stimulates muscarinic receptors. The blockade of the Isc response to venom with tetrodotoxin is further evidence that venom depolarizes intramural nerves and liberates transmitters that cause chloride secretion. The identity of the other transmitters is not known. PMID- 6846547 TI - Jejunum is more important than terminal ileum for taurocholate absorption in rats. AB - The terminal ileum, with its active transport system, is considered the major site of bile salt absorption. However, earlier studies used bile salt concentrations below physiological levels and may not apply in vivo. Analysis of these studies shows that ileal active transport cannot account for total bile salt recovery. To reevaluate bile salt absorption in rats, we used four preparations and physiological bile salt concentrations. Studies with intestinal sacs showed that, above critical micellar concentration, uptake of taurocholate (TC) was equal in both jejunum and ileum and linear with respect to concentration. A similar pattern was observed in studies of mucosal-to-serosal TC transport using a flux chamber. In vivo studies in anesthetized rats showed approximately 30% of TC absorbed from proximal jejunum and appearing in bile when the bolus had traversed only half the intestine. In unanesthetized fed rats, 60% of TC appeared in bile before the bolus reached distal ileum. Because luminal concentrations of TC are highest proximally, passive absorption by the proximal intestine is mainly responsible for conserving TC within the enterohepatic circulation. Ileal active transport is more efficient at low concentrations and absorbs the TC remaining after proximal absorption. PMID- 6846548 TI - Oxygen consumption by rat liver: effects of taurocholate and sulfobromophthalein transport, glucagon, and cation substitution. AB - The proportion of total hepatic energy utilized for bile formation and transport of taurocholate (TC) and conjugated sulfobromophthalein (cBSP) has not been defined previously. To study this question we have measured changes in oxygen consumption by the isolated perfused rat liver and freshly isolated hepatocytes occurring in response to TC and cBSP administration, cation substitution, and glucagon infusion. The basal rates of bile formation and oxygen consumption varied considerably among different livers, and there was little or no relationship between these two variables. Administration of either TC or cBSP to the perfused liver elicited a marked choleresis but failed to alter steady-state oxygen consumption even at maximal rates of TC or cBSP transport. Similarly, incubation of hepatocytes with TC or cBSP did not alter oxygen consumption. In contrast, inhibition of Na-K-ATPase by removal of sodium and/or potassium from the medium reduced oxygen consumption by perfused rat liver and isolated hepatocytes by 27-37%, and glucagon administration increased oxygen consumption in both systems by 31-40%. These findings indicate that the oxygen requirement for bile formation and even maximal rates of TC and cBSP transport is small compared with that for the metabolic changes induced by glucagon or for hepatic Na-K-ATPase activity. This is in contrast to other epithelial tissues, such as kidney and rectal gland, in which oxygen utilization for transepithelial solute and water transport constitutes a large fraction of both total and Na-K-ATPase dependent oxygen consumption. PMID- 6846550 TI - Ratio of cells and plasma in blood flowing past branches in small plastic channels. AB - Red cell concentrations related to flow were studied by measuring delivered cell fractions from branching channels. A branched channel in a plastic block was cast by pouring setting plastic into a mold containing two 0.18 mm steel wires; one was beveled and touching, at 60 degrees, the side of the other wire, which extended across the mold. The wires were later withdrawn. Two of these flow chambers were perfused (flow of 0.14 ml/min) with human blood or blood diluted with host plasma (anticoagulant ethylenediaminetetra-acetic acid), and the percent cell volume was measured in the collecting tubes. The difference in hematocrit from the two outflow channels was a linear function of the proportional flow in the side branch, and the average slope for 29 experiments was 32.0 +/- 9.7 (SD)% with a negative dependence on inflow hematocrit (correlation coefficient -0.63, P less than 1%). When analyzed as cell flux ratio vs. flow ratio the data show a significant deviation from the line of identity, which is most marked for the lowest values of hematocrit that we studied (approximately equal to 20%). We concluded that if the model branching channels are representative of arteriolar-sized blood vessels, then there is the potential for wide variations in hematocrit in the microcirculation, especially in blood with a low cellular fraction. PMID- 6846549 TI - Gastric mucosal barrier: hydrophobic lining to the lumen of the stomach. AB - The contact angle subtended between a droplet of aqueous fluid and nonwettable surfaces provides a direct estimation of their degree of hydrophobicity. The mean contact angle recorded in dogs at the oxyntic mucosal surface was 85.2 degrees, a value characteristic of acid-resistant substances such as polyethylene. This indicates that the mucosal surface of the stomach has a hydrophobic lining that may be attributed to the surface-active phospholipids known to be present in both the gastric mucosa and juice. Barrier breakers such as bile and aspirin were found virtually to eliminate the hydrophobicity. Hydrophobicity was found to be different in the esophagus, antrum, proximal and distal duodenum, and the colon but consistent with their resistance to acid attack. Endogenous surfactants are discussed for their capability to provide a cohesive and strongly adsorbed protective monolayer--a physical model for the gastric mucosal barrier compatible with the major properties of the gastric lining and many features of ulcerogenesis, including the protection afforded by prostaglandins. PMID- 6846551 TI - Sodium-calcium exchange in dog heart mitochondria: effects of ischemia and verapamil. AB - Na+ - Ca2+ exchange was studied in two preparations of dog heart mitochondria isolated from normal and ischemic muscle following occlusion of the circumflex (CFX) coronary artery with or without prior verapamil infusion. Na+ - Ca2+ exchange in mitochondria isolated using polytron homogenization showed sigmoidal kinetics with phosphate, whereas mitochondria isolated using gentle nagarse treatment showed hyperbolic kinetics and a Vmax 60% greater than the polytron preparation. Nagarse did not alter the sigmoidal kinetics or exchange velocities of the polytron mitochondria observed with phosphate. With acetate, both preparations exhibited hyperbolic kinetics, and the sodium required for half maximum activity was increased. Verapamil inhibited Na+ - Ca2+ exchange in both preparations with phosphate, but not with acetate. Thirty or sixty minutes of acute ischemia following CFX occlusion produced significant epicardial surface S T elevation in the ischemic area and a decrease in myocardial segment shortening. Na+ - Ca2+ exchange of both ischemic preparations was depressed, and the kinetics of the polytron preparation changed to hyperbolic. Pretreatment of the experimental animals with verapamil (0.3 mg/kg) before 60 min of ischemia protected the exchange rates in both preparations, and the sigmoidicity of the polytron mitochondria was retained. PMID- 6846552 TI - Body fluid volumes in prehypertensive spontaneously hypertensive rats. AB - To ascertain the effect of aldosterone on body fluid volumes in neonatal, prehypertensive spontaneously hypertensive rats (SHR), we studied these animals at 12 days using age-matched Wistar-Kyoto (WKY) as normotensive controls. Some pups of each strain were treated with spironolactone (1.5 micrograms/g body wt) on days 10-12. Total body water (TBW, by dessication) and extracellular fluid (ECF, Na2 35SO4 space) volumes were significantly larger in SHR than in WKY, whereas plasma volumes (125I-serum albumin space) were not different. Thus the enlarged ECF was due to preferential expansion of the interstitial fluid (ISF) space. Treatment of SHR with spironolactone reduced TBW and ISF to values not different from untreated WKY and also reduced plasma volume to some extent. These results indicate 1) significant ISF volume expansion occurs in SHR prior to elevation of blood pressure, and 2) the previously observed elevation in plasma aldosterone in SHR at this age probably mediates the volume expansion. PMID- 6846553 TI - Filling and arterial pressures as determinants of RV stroke volume in the sheep fetus. AB - Right ventricular (RV) function was investigated in nine fetal lambs (125-130 days gestation) that were instrumented with pulmonary artery electromagnetic flow sensors and vascular catheters. Control arterial CO2 and O2 tension, pH, and hematocrit values were 46.1 +/- 1.6 (SD) Torr, 20.6 +/- 1.8 Torr, 7.39 +/- 0.02, and 31 +/- 5.3%, respectively. Control values for right ventricular output (247 +/- 75 ml X min-1 X kg-1), stroke volume (SV, 1.5 +/- 0.4 ml X kg-1), right atrial pressure (3.7 +/- 1.2 mmHg), heart rate (166 +/- 18 beats X min-1), and arterial pressure (AP, 43 +/- 4 mmHg) were unchanged by administration of atropine and propranolol. Withdrawal and infusion of fetal blood with or without concomitant infusion of nitroprusside or phenylephrine produced RV function curves at low, normal, and high arterial pressures. All function curves had a steep ascending limb and a plateau. The breakpoint joining the limbs of the control curve was right atrial pressure 3.4 +/- 1.2 mmHg and SV 1.5 +/- 0.4 ml X kg-1. Increased AP shifted the breakpoint downward. Linear regression of SV on AP from 15 to 95 mmHg at right atrial pressure greater than breakpoint was SV = 0.016 ml X kg-1 mmHg-1 X AP + 2.25 ml X kg-1. PMID- 6846554 TI - Left ventricular oxygen consumption and function in hypoxemia in conscious lambs. AB - The effects of hypoxemia on left ventricular myocardial blood flow, myocardial oxygen consumption, and contractile function were studied in 12 conscious newborn lambs 4-24 days after birth. Through a left thoracotomy, we placed fluid-filled catheters in the ascending aorta, coronary sinus, and left atrium. An electromagnetic flow transducer was placed around the ascending aorta, and a solid-state pressure transducer was introduced into the left ventricle. Three to four days later we measured aortic and coronary sinus blood oxygen contents, left ventricular myocardial blood flow, heart rate, aortic and left ventricular blood pressures, ascending aortic blood flow velocity, and the first derivative of left ventricular pressure (dP/dt) and ascending aortic blood flow velocity (dV/dt) during a control period and during 50 and 75% reductions in ascending aortic oxygen content. Myocardial oxygen consumption was calculated. There was no significant change in aortic or coronary sinus blood pH or CO2 tension during the study. Coronary sinus blood oxygen content and the arteriovenous difference of oxygen across the left ventricle decreased as a linear function of the aortic blood oxygen content. Myocardial blood flow increased in proportion to the reduction in aortic blood oxygen content. Myocardial oxygen consumption increased during hypoxemia but not as a function of aortic blood oxygen content. There was no significant change in left ventricular end-diastolic pressure or aortic mean blood pressure. dP/dt and dV/dt doubled during hypoxemia, but the increases did not occur as a function of the aortic blood oxygen content. In conscious, unanesthetized newborn lambs, 50 and 75% reductions of aortic blood oxygen content were associated with significant increases of left ventricular myocardial blood flow, oxygen consumption, and contractile function. PMID- 6846555 TI - Rapid resetting of aortic baroreceptors in vitro. AB - Pressure-response characteristics of arterial baroreceptors (BR) were shown recently to be reset following a 15- to 20-min change in mean arterial pressure (MAP); the curves shifted in the direction of the MAP change. To characterize this rapid BR resetting process more precisely than in vitro studies allow, we utilized an in vitro aortic arch-aortic nerve preparation from Wistar-Kyoto rats. Pressure ramps were used to determine the discharge response curves of single BRs following exposure to precisely controlled conditioning pressures. Rapid resetting occurred in all BRs and followed an exponential time course with a 3- to 5-min time constant. The reset curves were stable for 1 h and were completely reversible. The curves were shifted along the pressure axis in a parallel manner, i.e., pressure threshold (Pth) changed but slope and mean asymptotic discharge were unaltered. In experiments lasting as long as 7 h in which more than two MAP steps were possible, in vitro rapid resetting was a very consistent and reproducible process. Quantitatively, the extent of resetting (delta Pth/delta MAP) averaged 0.33 over an MAP range of 40-160 mmHg. In vitro resetting therefore appears very similar to that observed in vivo, suggesting that the conditioning pressure is the primary, perhaps the sole, determinant of resetting. Resetting occurred at subthreshold MAPs, demonstrating action potentials are not a prerequisite. Efferent neural or hormonal influences are also not required. PMID- 6846556 TI - Hypoxic responses of sympathetic preganglionic neurons in sinoaortic-denervated cats. AB - The relation between arterial O2 tension (PaO2) and the firing rate of sympathetic preganglionic neurons (SPN) was studied in 16 strands of the cervical sympathetic trunk (CST) during graded isocapnic hypoxia in 11 sinoaortic denervated central nervous system (CNS)-intact, anesthetized cats. SPN firing rate was independent of PaO2 from normoxia down to a PaO2 of 40 Torr. Below this PaO2 level three response patterns were observed, i.e., an excitatory response (n = 8), a depressant response (n = 3), and a mixed response consisting of a depression of firing at less severe hypoxic levels and an increase in firing rate at more extreme hypoxic levels (n = 5). Similar response patterns were also observed in four strands of the CST in three unanesthetized, sinoaortic denervated, midcollicular decerebrate preparations. Systemic arterial pressure decreased in all cats as PaO2 decreased. Phrenic nerve activity also decreased in all cats with a course resembling that of the depression of sympathetic firing and disappeared at a PaO2 of 20 Torr. The data suggest that systemic hypoxia in the sinoaortic-denervated, CNS-intact or decerebrate animal activates both excitatory and depressant mechanisms acting on SPNs. PMID- 6846557 TI - Body fluid distribution in the maintenance of DOCA-salt hypertension in rats. AB - Body fluid volumes and their relation to mean arterial pressure and plasma renin activity (PRA) were examined in heminephrectomized rats after 4 wk of treatment with deoxy-corticosterone acetate (DOCA) and placed on one of three levels of salt intake, either high (D-HS), normal (D-NS), or low (D-LS); sham-operated rats, which received heminephrectomy and no DOCA treatment, also received high (S HS), normal (S-NS), or low (S-LS) intakes of salt. Body fluid volumes were measured as the distribution volumes of radioiodinated serum albumin, 35SO4, and tritiated water for plasma volume (PV), extracellular fluid volume (EFV), and total body water (TBW), respectively. Approximately the same degrees of hypertension occurred in the D-HS and D-NS rats, but the D-LS rats were normotensive. PV and EFV were increased only in the D-HS rats, with no prominent changes occurring in the D-NS rats. Intracellular fluid volume (ICF) was not changed in the D-NS rats when compared with the S-NS rats. The ratios of PV/EFV and EFV/TBW in the DOCA-treated groups on high or normal salt were not different from their controls. PRA was greatly suppressed in the D-HS and D-NS rats when compared with all other groups. In another group of D-HS rats, sodium was restricted for 2 wk; in this group the mean arterial pressure fell to control levels without significant changes in PV, but interstitial fluid volume was reduced to normal levels. These results demonstrated that 1) in DOCA-salt hypertensive rats there is expansion of body fluid volumes that are proportionally distributed among the PV, EFV, and ICF; 2) increases in body fluid volumes are not necessary for DOCA to maintain hypertension; 3) a certain minimal amount of dietary sodium is necessary for the development and maintenance of hypertension; and 4) following DOCA treatment the suppression of PRA is not due solely to expansion of body fluid volumes. PMID- 6846558 TI - Force-length relations in cardiac muscle segments. AB - Using a new technique that measures the length of a segment in the central region of isolated papillaries, we have determined the force-segment length relation for ferret papillary muscles at 27 degrees C. The muscles contracted under muscle length isometric (auxotonic) and segment isometric conditions in physiological solutions containing 9.0, 4.5, 2.25, and 1.125 mM Ca2+. Force-segment length relations obtained from auxotonic and segment isometric contractions were identical in a given Ca2+ concentration. Calcium variations, however, changed the position, shape, and segment length intercept of the force-segment length relation. Force, at a given segment length, increased with increasing Ca2+ up to 9.0 mM Ca2+. The force-segment length relation changed shape from linear, in 4.5 mM Ca2+, to concave in 1.125 mM Ca2+. The segment length intercept was found by extrapolation to be 68, 69, and 74% SLmax in 4.5, 2.25, and 1.125 mM Ca2+, respectively. Two passive force corrections were used to calculate the developed force-segment length relations. Assuming passive force to be related primarily to segment length yields curves that change shape with Ca2+ concentration, suggesting length-dependent activation. On the other hand, assuming passive force to be related to muscle length results in curves for different Ca2+ concentrations that are nearly vertically shifted versions of each other, suggesting the influence of internal loads. PMID- 6846559 TI - Myocardial segment velocity at a low load: time, length, and calcium dependence. AB - The length and time dependence of shortening velocity (VL) at a very light load (1 mN) was determined for central segments of ferret papillary muscle at 27 degrees C. A recently developed technique that measures the cross-sectional area of the chosen segment was used to assess segment length. Segment length (SL) or force could be used as a feedback control signal. VL was determined by releasing the muscle to a 1-mN load (less than or equal to 3% maximum force) at various times during a segment isometric twitch. Segment isometric twitches were typically performed at 95-98% SLmax, SLmax being the longest segment length attainable in the preparation. VL, as a function of time and SL, was determined from SL shortening during the load clamp. Muscle responses were sampled, stored, and analyzed with an on-line digital computer. The data indicate that 1) at a given SL, VL declines from 20 to 50% of its peak value by the time of peak force production, 2) VL declines linearly with SL below 90% SLmax in 1.125, 2.25, and 4.5 mM extracellular Ca2+, 3) VL exhibits a dependence on extracellular Ca2+, having peak values at 90% SLmax of 3.32 +/- 0.33, 2.66 +/- 0.17, and 1.89 +/- 0.17 SL/s in 4.5, 2.25, and 1.125 mM extracellular Ca2+, respectively. PMID- 6846560 TI - Actions of adenosine on normal and abnormal impulse initiation in canine ventricle. AB - We studied the role of adenosine in modulating pacemaker activity in normal and infarcted ventricular tissues. We used standard microelectrode techniques to study the effects of adenosine on impulse initiation in Tyrode's superfused normal canine Purkinje fibers (PF), PF obtained from experimentally infarcted hearts, and BaCl2-superfused PF. Adenosine reduced automaticity of normal PF, whereas beta, gamma-methylene ATP did not. In infarcted and in Ba2+-depolarized PF, adenosine had no effect on automaticity or the action potential. We then used intracellular current injection to vary the membrane potentials of normal PF and found adenosine to depress automaticity more at high than at low membrane potentials. The ability of adenosine to counteract the effects of epinephrine on automaticity also was related to membrane potential. We conclude that adenosine depresses normal automaticity but has little effect on abnormal impulse initiation at low membrane potentials. It therefore appears that in the setting of myocardial infarction or ischemia the extent to which adenosine release will modify the function of normal and ectopic pacemakers will be influenced by the membrane potentials of those pacemakers. PMID- 6846561 TI - A microcomputer oximeter for whole blood. AB - A system is described for measuring the percent of oxyhemoglobin in flowing whole blood. The system consists of an Apple II+ computer, a commercially available analog-to-digital converter, a simple electronic circuit to illuminate blood with light at two appropriate wavelengths, and a short program in BASIC. This oximeter is shown to yield a linear measurement of oxyhemoglobin saturation when compared with standard oxygen analyses. Data can be sampled at a sufficiently rapid rate to yield an essentially continuous measurement in typical cardiovascular studies. The system can be implemented by the average investigator from standard electronic components. The oximeter program can be combined into a general purpose data acquisition program, and 15 analog-to-digital channels remain available for gathering other data. PMID- 6846562 TI - An intravascular protein osmometer. AB - Our purpose was to develop an intravascular osmometer for measuring the colloid (i.e., protein) osmotic pressure (COP) of circulating blood. A semipermeable hollow fiber from a Cordis Dow artificial kidney (C-DAK 4000) was attached to polyethylene tubing on one end, filled with saline, and sealed at the other end. This was small enough to be inserted into the vasculature of research animals. Protein osmotic pressure plus hydrostatic pressure was measured by a Statham pressure transducer attached to the hollow fiber. Simultaneously, a second catheter and transducer was used to measure hydrostatic pressure, which was subtracted from the pressure measured from the fiber with an on-line computer. The system was documented by a variety of tests. The colloid osmotic pressure vs. albumin concentration curve determined with the fiber is identical to the curve determined by standard membrane osmometry. The time constant for 2- and 8-cm fibers was 2.6 +/- 0.6 and 1.5 +/- 0.5 (+/- SD) min, respectively. The reflection coefficient (+/- SD) of the fiber for NaCl is 0.042 +/- 0.019 (n = 38); COP measured at varying temperatures (absolute scale) changed linearly as expected from COP = nCRT (i.e., van't Hoff's law). Finally, hollow-fiber osmometers were inserted into femoral veins of dogs and sheep, and blood COP was continuously recorded during osmotic manipulations. In conclusion, we attempted to develop and document a simple method for continuous measurement of intravascular colloid osmotic pressure. PMID- 6846563 TI - A reproducible model of chronic hypoxemia. AB - This report presents our experience with producing a stable chronic hypoxemia preparation in the dog without the disadvantages of prosthetic graft insertion or sacrifice of pulmonary tissue. In 28 adult dogs, the intrapericardial inferior vena cava and the area of junction of the right and left inferior pulmonary veins were exposed through a right thoracotomy. The cava was clamped at the diaphragm and at the right atrium, divided at the atrial clamp, and quickly anastomosed to the inferior pulmonary veins. The mean arterial O2 tension (PaO2) decreased from 83.2 +/- 1.6 mmHg preoperatively in mechanically ventilated (room air) animals to 35.3 +/- 1.5 mmHg postoperatively in awake animals spontaneously breathing room air (P less than 0.001). There was persistent depression of the PaO2 (49.1 +/- 1.8 mmHg) and elevation of the hematocrit (64.8 +/- 2.0%) in six animals tested at 18.5 mo postoperatively. Shunt patency without significant stenosis was confirmed in each animal at autopsy. This method attains predictable and persistent hypoxemia and polycythemia and is simple to perform. It may be useful in studying various aspects of ventricular function and ventricular histological and biochemical changes with chronic cyanosis. PMID- 6846564 TI - Isolated atrial myocytes: adenosine and acetylcholine increase potassium conductance. AB - Adenosine (Ado), like acetylcholine (ACh), hyperpolarizes and shortens the atrial action potential (AP). To elucidate the underlying mechanism of Ado and ACh actions, intracellular APs and membrane currents were measured in calcium tolerant single myocytes isolated from guinea pig atria. Both Ado and ACh hyperpolarize the resting membrane to the potassium equilibrium potential (Ek) and cause a marked abbreviation of the AP. Analysis of membrane currents reveal that Ado and ACh increase the steady-state currents. The Ado- and ACh-induced current reverses polarity at -92 mV, a value that corresponds well with a calculated EK of -90 mV. Thus the Ado- and the ACh-sensitive current can be interpreted as a potassium current. It is suggested that Ado, like ACh, increases the potassium conductance via a common mechanism. PMID- 6846565 TI - Biological similarity: what does Huxley's allometric equation tell us? PMID- 6846566 TI - Role of similarity principles in data extrapolation. AB - This paper addresses the problem of extrapolating from data set gathered on a particular system to problems of more general physiological interest. It asks: what are the limits of the extrapolability of data? Under what circumstances can data derived from a particular system be transformed into data about another, different system? Such questions address the general problem of similarity analysis. A mathematical exploration of the meaning and usefulness of the concept of similarity is presented, and the necessity for a "prototype" is introduced. The discussion shows what we mean by the relationship between natural systems and the purest form of model of such systems, the mathematical model. The value and limitations of Dimensional Analysis are considered. It is concluded that the principle of dimensional homogeneity which underlies Dimensional Analysis is not strong enough to cope effectively with situations involving many phases, as arise in biological studies. Therefore, a more general approach is used. It is shown that the problems associated with data extrapolation are very deep and lead to some of the deepest issues in all of science. The extrapolation of data from animal models to human beings has been a general characteristic of pharmacologic research and, for that matter, biomedical investigations generally. Attention to limitations and dangers of such extrapolations seems overdue. With proper understanding of the essential nature of the extrapolatory action, and modeling relations, models can be validated. PMID- 6846567 TI - Scaling of osmotic regulation in mammals and birds. AB - Allometric equations provide a means of summarizing and relating the components of renal structure and function in water balance and osmotic regulation. These summary equations also serve as base lines for evaluating adaptations to stressful environments and for comparisons of kidney designs and osmotic strategies of ureotelic mammals and uricotelic birds. Many of the functions can be quantitatively related to the M3/4 scaling of metabolic rates. PMID- 6846568 TI - Temperature dependence of the hamster circadian pacemaker. AB - Blind male hamsters were maintained in running-wheel cages in a LD 12:12 light dark cycle. After regular running patterns were established hypothermia was induced by ether anesthesia, wetting of the fur with ethanol, and cooling with ice. The hamsters were kept hypothermic for 3-24 h at colonic temperatures from 10 to 20 degrees C. Following hypothermia the animals were rewarmed and replaced in their home cages. Examination of the locomotor activity records showed phase shifts (delays) in activity onset that were correlated with the temperature and duration of the hypothermia but not with the circadian time at which the hypothermia was administered. The data were interpreted to mean that the circadian pacemaker was running at a reduced rate during the hypothermic bout. Calculation of the Q10 for the rate of the clock during hypothermia produced a range from 1.08 to 1.34 depending on the method of calculation. When compared with earlier data gathered from rats under similar conditions, the hamsters circadian pacemaker appears to be better temperature compensated. PMID- 6846569 TI - Suppression of afferent activity of the hepatic vagus nerve by anomers of D glucose. AB - Afferent discharges were recorded from the nerve filaments dissected from the hepatic branch of the vagus nerve in the guinea pig. Recordings were made in isolated and perfused liver preparations and in vivo to study the effect of alpha and beta anomers of D-glucose on the afferent discharge rate. Infusions of these anomers (30 mg or 50 mg dissolved in 10 ml glucose-free Ringer solution) into the portal vein in perfused liver preparations and intraportal injections of these anomers (50 mg/kg dissolved in 0.2 ml saline) in vivo partially suppressed the afferent activity. However, the effect of suppression by the beta anomer was stronger than that of the alpha anomer. Results indicate the existence of anomeric stereospecificity of D-glucose action to the hepatic "glucose sensors." PMID- 6846571 TI - Physiological conflict in humans: fatigue vs. cold discomfort. AB - Six male human subjects were placed in a situation of physiological conflict, fatigue vs. cold discomfort. Dressed in swim suits and shoes they walked at 3 km X h-1 on a treadmill placed in a climatic chamber. The slope of the treadmill was varied from 0 to 24% and the ambient temperature (Ta) from 25 to 5 degrees C. The subjects could choose Ta when slope was imposed or the converse. They rated pleasure and displeasure of Ta and exercise. Deep body temperature and heart rate were monitored. The results show that the subjects adjusted their behavior to maintain approximatively steady deep body temperature and to limit heart rate below 120 beats X min-1. The physiological compromise was thus correlated to the drive for maximal pleasure-minimal displeasure in the two sensory dimensions fatigue and discomfort. PMID- 6846570 TI - Metabolic responses to fasting and refeeding in lean and genetically obese rats. AB - Injection of norepinephrine (NE) (25 micrograms/100 g body wt) caused a similar rise in metabolic rate in lean and obese (fa/fa) Zucker rats, but 3-day fasting suppressed the response in lean rats and enhanced the rise in obese mutants. Triiodothyronine (T3) injection (10 micrograms/100 g body wt) caused a significantly greater rise in oxygen consumption (Vo2) in obese than lean rats, but the response was attenuated by fasting in all animals. The thermic response to a single meal of either mixed composition, carbohydrate, or protein (40 kJ) was much smaller in obese rats than lean, but the response to the mixed nutrient meal was similar for all rats after a 3-day fast. Refeeding 3-day fasted lean rats with a single carbohydrate meal (40 kJ) caused a rise in plasma T3 levels after 3 h and a delayed increase in metabolic rate 24 h later. Injection of NE instead of refeeding caused a similar delayed rise in metabolic rate. Carbohydrate refeeding had no effect on plasma T3 levels or oxygen consumption in 3-day fasted obese Zuckers, but injection of NE did produce a significant increase in metabolic rate after 24 h. Refeeding 3-day fasted rats with protein (40 kJ) caused a rise in oxygen consumption 24 h later in lean animals but had no effect in obese animals. The data from lean Zucker rats confirm previous findings in Sprague-Dawley rats and suggest that the thermic response to refeeding involves a complex interaction between the sympathetic nervous system and thyroid hormones. Obese Zuckers responded normally to NE and T3, indicating that their reduced thermogenesis after food may be due to insensitivity to nutrient availability or an inability to activate the sympathetic nervous system. PMID- 6846572 TI - Response of single units in the amygdala to stimulation of buffer nerves in cat. AB - Electrical activity of spontaneously active units in the amygdala of 19 chloralose-anesthetized cats was monitored for changes in firing frequency during electrical stimulation of the carotid sinus (CSN) and aortic depressor (ADN) nerves. Stimulation of the CSN altered the firing frequency of 30% (73/241) of the units on both sides of the amygdala. Of these units, 47% were excited and 53% were inhibited. Stimulation of the ADN elicited a change in firing frequency of 20% (50/251) of ipsi- and contralateral units. Of these, 68% were excited and the remainder were inhibited. The average latency for all CSN responses (53 +/- 4.0 ms) was significantly longer than the average latency for ADN responses (35 +/- 3.3 ms). The majority of the responsive units were located in the central and lateral nuclei of the amygdala. Spontaneously firing units responding to both CSN and ADN stimulation were found infrequently (7%, 14/188). These results indicate that the two buffer nerves project to specific regions within the amygdala, but the CSN and the ADN follow separate pathways probably involved in reflex arcs mediating different physiological responses. PMID- 6846573 TI - Aortic and carotid chemoreceptor responses to metabolic acidosis in the cat. AB - The effect of metabolic acidosis on the activity of aortic chemoreceptor afferents and their responses to hypoxia and hypercapnia were investigated in nine cats anesthetized with alpha-chloralose, paralyzed, and artificially ventilated. This effect was compared with that on simultaneously recorded activity of carotid chemoreceptor afferents in three separate cats. The activity of a single or paucifiber preparation of chemoreceptor afferents was recorded at five steady-state levels of arterial O2 tension (PaO2) at a constant arterial CO2 tension (PaCO2) and at three levels of PaCO2 during hyperoxia (PaO2 greater than 400 Torr) before and after slow injection of 1 M lactic acid in the average dose of 2.6 +/- 0.6 mmol X kg-1. On the average, arterial pH decreased from 7.445 +/- 0.046 to 7.222 +/- 0.041 at PaO2 of 98 +/- 5 Torr and PaCO2 of 34 +/- 1 Torr. This decrease in pHa during normoxia increased the aortic chemoreceptor activity from 0.8 +/- 0.2 to 1.4 +/- 0.3 imp X s-1. Metabolic acidosis increased the excitatory effect of hypoxia and hypercapnia. The stimulatory effect of CO2 for the same increase in arterial [H+] was greater than that of metabolic acidosis, indicating a dominant effect of molecular CO2 on aortic chemoreceptors. Simultaneous measurements of carotid and aortic chemoreceptor activities showed that their responses to metabolic acidosis were qualitatively similar. Quantitatively, the response of aortic chemoreceptor afferents was less than that of carotid chemoreceptors. PMID- 6846574 TI - Effects of thyroxine supplementation on metabolic rate and aerobic capacity in a lizard. AB - Effects of thyroxine (T4) on standard and maximal rates of O2 consumption and on citrate synthase activity, an index of mitochondrial oxidative capacity, were examined in the lizard Dipsosaurus dorsalis. Two weeks of daily injections of 200 ng T4/g body mass resulted in significant increases in standard (+60%) and maximal (+15%) rates of O2 consumption. Citrate synthase activity in liver and in red iliofibularis and gastrocnemius muscles was significantly higher than in controls. Correlational analyses indicate that intraspecific differences in standard metabolic rate may be partially attributable to fundamental differences in tissue metabolic capacities and that thyroxine injections lead to a general increase in aerobic capacities. Similar increases in aerobic capacities may occur in response to high thyroid activity during Spring in temperate-zone lizards. The injection protocol used in this study, taken from previous authors, results in suppression of natural thyroid secretory activity and in a 24-h average plasma T4 level of 95 ng/ml compared with 2.5 ng/ml in controls. PMID- 6846575 TI - Ketone-glucose interaction in fed, fasted, and fasted-infected sheep. AB - Ketosis following starvation was suppressed by hindlimb infection in seven fasted sheep. Glucose production determined following the primed constant infusion of [6 3H(N)]glucose was elevated in the fasted-infected animals (9.50 +/- 1.11 mmol X kg-1 X min-1 (mean +/- SE) versus fasted controls (5.56 +/- 2.2). To determine if the ketonemia following sepsis contributed to the increased glucogenesis associated with catabolic disorder, glucose production and arterial substrates were measured before and after infusion of sodium-DL-beta-hydroxybutyrate (beta OHB, 20 mumol X kg-1 X min-1) in fed, fasted, and fasted-infected animals. Following 3 h of beta-OHB infusion in the awake conditioned animals, beta-OHB and acetoacetate blood concentrations more than doubled. With infusion, blood glucose and alanine concentrations decreased in the fed and fasted sheep but not in the fasted-infected group. Glucose production fell significantly from 10.11 +/- 1.33 to 8.44 +/- 1.05 in the fed animals and from 5.05 +/- 0.28 to 4.11 +/- 0.33 in the fasted group. Glucose production was unaffected by beta-OHB infusion in the fasted-infected animals (9.50 +/- 1.83 vs. 9.11 +/- 1.44). The accelerated rate of glucose production in sheep following infection is not a consequence of the hypoketonemic state associated with sepsis. PMID- 6846576 TI - Macronutrient self-selection in three forms of hypothalamic obesity. AB - Adult female rats were adapted to a macronutrient self-selection regimen which allowed them ad libitum access to separate sources of protein, carbohydrate, and fat. The rats were then given either ventromedial hypothalamic (VMH) lesions, paraventricular hypothalamic (PVH) lesions, parasagittal knife cuts through the medial hypothalamus (CUT), or sham lesions and their macronutrient selection was studied for 60 days. Following surgery the VMH, PVH, and CUT rats overate and became obese compared with controls. The hyperphagias of the three groups were similar, although the CUT group gained more weight than did the PVH and VMH groups. All groups overate primarily by increasing their carbohydrate intake. The VMH and CUT groups, in addition, increased their protein intake such that their percent protein intake remain unchanged. The PVH group failed to increase its absolute protein intake and thus decreased its percent protein intake. Except for a transient increase, fat consumption was not affected by the lesions or knife cuts. During the 2nd postoperative mo (static phase) the total caloric intakes and the carbohydrate intakes of the VMH, PVH, and CUT groups returned to near normal levels. Rats with misplaced PVH lesions displayed minimal hyperphagia and failed to outgain controls but yet showed the same altered macronutrient selection pattern as did rats with obesity-inducing PVH lesions. Measurements of resting insulin levels at the end of the experiment revealed hyperinsulinemia in the VMH and CUT groups but normal insulin values in the PVH group. These results demonstrate that VMH lesions, PVH lesions, and medial knife cuts produce similar hyperphagia syndromes associated with carbohydrate-specific overeating, but that they differentially affect protein selection and resting insulin levels. PMID- 6846577 TI - Mitochondrial ammoniagenesis in liver of the channel catfish Ictalurus punctatus. AB - Rates of ammonia formation from six amino acids by hepatocytes and liver mitochondria were compared with the rate of ammonia excretion by individual fish. Glutamine and asparagine are the most ammoniagenic substrates for hepatocytes and glutamine and glutamate, for isolated liver mitochondria. The main site of ammonia release is the mitochondrion. Ammonia is formed mainly via deamidation or transdeamination. Relatively small amounts of aspartate are formed from glutamate and glutamine by the fish liver mitochondria. This apparent "uncoupling" of glutamate transamination may represent an adaptation of carnivorous fish to the utilization of amino acids as a major energy source. More than 90% of the ammonia formed from glutamate and glutamine by isolated mitochondria are elaborated into the medium. Exiting ammonia is accompanied by a proton, but the source of this proton appears not to be the electrogenic proton pump or the carboxylate of exiting glutamic acid. PMID- 6846578 TI - Brain and CSF water and ions during dilutional and isosmotic hyponatremia in the rat. AB - Dilutional (DH) and isosmotic (IH) hyponatremia (plasma [Na+] = 103-109 meq/l) were produced in conscious rats over 3-6 h by intraperitoneal injection of water or mannitol Ringer solution. During DH, CSF [Na+], [Cl-], and osmolality decreased as predicted by passive dilution by the water load. During IH, these variables exhibited little change. Brain water was unchanged during IH despite significant reduction of brain Na+ and Cl- content suggesting that tissue ions lost were replaced by other osmoles. During DH, brain water increased but less than predicted by passive osmotic equilibration. Cell volume increased as predicted by passive swelling while the extracellular volume (Cl space) decreased. Tissue K+ content decreased by a small but significant amount. Tissue Na+ and Cl- decreased by 21 and 28%. This pattern of fluid compartmental and electrolyte changes suggests that brain volume regulation during acute DH occurs via reduction of extracellular volume as cells swell. This may result from bulk flow of extracellular fluid to CSF or from ion and water movement across the blood-brain barrier. PMID- 6846579 TI - alpha-Methyldopa and depression: a clinical study and review of the literature. AB - A review of the literature showed that a high incidence or prevalence of depression in patients being treated with alpha-methyldopa has never been documented. In their study of hypertensive patients in a general medical clinic the authors found that symptoms of depression were no more common in 42 patients treated with alpha-methyldopa than in 38 patients treated with other antihypertensive agents. As with other centrally active agents, alpha-methyldopa appears able to produce many different behavioral symptoms, including mood changes, in predisposed individuals. Because alpha-methyldopa is a DOPA decarboxylase inhibitor but does not consistently affect mood or induce depression, its effects do not support a catecholamine hypothesis of depression. PMID- 6846580 TI - Geriatric emergencies: psychiatric or medical? AB - To determine how the elderly use the emergency room, the authors compared emergency patients 65 years old and older with younger patients in terms of demographics, clinical factors, patterns of emergency room use, and clinicians' responses. They found that, like younger patients, the elderly had scanty social supports but, unlike younger patients, came for care repeatedly with somatic complaints. Despite coexisting medical and psychiatric illnesses, these patients were generally managed by one service without consultation from the other. The authors, who found no differences in physicians' attitudes toward younger and older patients, emphasize the need for a holistic, psychobiologic approach to the care of the elderly emergency patient. PMID- 6846581 TI - Use of a structured diagnostic interview to identify bipolar disorder in adolescent inpatients: frequency and manifestations of the disorder. AB - The authors interviewed 17 adolescent inpatients and their mothers with the Schedule for Affective Disorders and Schizophrenia for School-Aged Children and Adolescents, Epidemiological Version (K-SADS-E), a semistructured interview that generates RDC and DSM-III diagnoses for major affective disorders and nonaffective psychoses and DSM-III diagnoses for dysthymic, cyclothymic, and other selected disorders. Five of the patients (29%) satisfied DSM-III criteria for bipolar disorder or atypical bipolar (bipolar II) disorder, although these diagnoses had not been identified in the hospital charts. These data support previous findings that bipolar disorder occurs moderately frequently in adolescent inpatients, although it is often unrecognized. Moreover, the disorder can be readily identified with structured diagnostic methods. PMID- 6846582 TI - Clinical and psychological assessment of children of bipolar probands. AB - Thirty-one children (age range, 7-14 years) of 18 probands with a bipolar disorder according to Research Diagnostic Criteria were assessed on clinical and psychological measures and compared with 18 matched normal control children. The authors found higher rates of childhood psychopathology in the children of the probands than in the control children. In addition, the experimental group was characterized by 1) a pattern on the WISC-R of higher verbal than performance IQs, 2) higher ratios of color to movement determinants on the Rorschach test, and 3) an overrepresentation of left-handedness. The implications of these findings are briefly discussed. PMID- 6846583 TI - Epidemiology of anorexia nervosa in a defined region of Switzerland. AB - The authors conducted a retrospective study of the incidence of anorexia nervosa in the industrialized canton of Zurich, Switzerland, during three randomly selected sampling periods from 1956 to 1975. The data were derived from case histories from nearly all medical, pediatric, and psychiatric clinics in this region. The incidence of anorexia nervosa increased significantly, from .38/100,000 for 1956-1958 to .55/100,000 for 1963-1965 to 1.12/100,000 for 1973 1975. This increase was not due to the fact that nowadays anorectic patients are hospitalized earlier or that they are hospitalized for less severe illness. PMID- 6846584 TI - The significance of ritual in a church-based healing model. AB - Four major ritual patterns are exhibited in a church-based clinic in Jamaica that represents a model of collaborative clinical care catering to spiritual, psychological, and orthodox medical needs. Three of the ritual patterns correspond to the three sectors of care, with their different beliefs and values, and this creates tension. The fourth pattern has the potential to be a superordinate ritual that could bring the clinic together in a cohesive approach to the task of health care, but this does not occur, as staff and patients remain bound in their unique sociocultural traditions and heritage. PMID- 6846585 TI - Undergraduate education and recruitment into psychiatry. AB - From 1969 to 1979 senior medical students from the University of Colorado School of Medicine entered psychiatric residencies at an average rate of 3.8%. The university gradually instituted a series of changes in its undergraduate psychiatric education program for medical students, and the senior class of 1980 was the first to be exposed to all of the changes. In 1980-1982 7.7% of the seniors went into psychiatric residencies. The authors describe the curriculum changes and speculate that more attention to the quality of medical students' psychiatric education at the undergraduate level enhances recruitment into psychiatric residencies. PMID- 6846586 TI - The future of state hospitals: should there be one? AB - The recognition of the serious problems of state hospitals that dominated public policy in the 1960s has been largely overshadowed in recent years by a preoccupation with the problems of deinstitutionalization. The current backlash against the community movement threatens to legitimize once again the state hospital as an acceptable solution to the problems of the severely mentally ill. The author argues that state hospitals are deficient not simply because they provide an inferior quality of care but because they provide the wrong kind of care for most of their patients. He suggests that most state hospitals be completely replaced by a fundamentally different system. PMID- 6846587 TI - A comparison of delinquent and nondelinquent adolescent psychiatric inpatients. AB - The psychopathology of 29 delinquent and 25 nondelinquent psychiatrically hospitalized adolescent boys was similarly severe. Similar proportions had hallucinations, delusions, learning disabilities, and evidence of neurological impairment, and over half in each group had been diagnosed as being psychotic. Fire-setting, enuresis, and cruelty to animals did not distinguish the two groups. Significantly more of the delinquents had been psychiatrically hospitalized previously, and significantly more of the delinquents had engaged in violently aggressive acts. The household composition of both groups was similar, but more mothers of delinquents than of nondelinquents had been psychiatrically hospitalized. The authors discuss the issue of the treatment of psychiatrically ill violent adolescents. PMID- 6846588 TI - The dexamethasone suppression test in adolescent psychiatric inpatients. AB - The dexamethasone suppression test (DST) was administered to 120 adolescent psychiatric patients at the time of hospitalization, and cortisol levels were measured at 4:00 p.m. and 11:30 p.m. on the day after a 1-mg oral dose of dexamethasone was given. Failure to suppress serum cortisol (i.e., cortisol level less than 5 micrograms/dl) was noted in 25 patients: 7 of 17 patients who met DSM III criteria for major depressive disorder, 7 of 38 patients with dysthymic disorder, 7 of 47 patients with conduct disorder, and 4 of 15 schizophreniform patients. The predictive value of the DST for major depressive disorder was only 28%. Although adolescent patients with abnormal DSTs may eventually develop affective symptoms consistent with a major depressive disorder, the DST did not discriminate between major depression and other psychiatric diagnoses in these hospitalized adolescents. PMID- 6846589 TI - History of incest in girls admitted to a psychiatric hospital. AB - Of 437 adolescent girls admitted to a psychiatric hospital for emotional problems, 61 reported an incestuous involvement. Their mean age at the time of their first experience was 11.9 years. The liaisons occurred as often with fathers as with stepfathers; other, less frequent perpetrators of incest included brothers, brothers-in-law, uncles, a grandfather, an adoptive father, and a half brother. The authors note that the victim of incest is almost always a preadolescent and that the occurrence of incest is probably not accurately reported nationally. PMID- 6846590 TI - Use of joint consultations in inpatient psychiatry. AB - The coexistence of medical and psychiatric problems in psychiatric inpatients often causes compliance difficulties, based on either irrational and distorted fears of medical treatment or more rational concerns that proposed psychiatric treatment could adversely affect a preexisting medical condition. The authors propose the use of joint consultations, in which both the psychiatrist and the other medical specialist meet together with the patient, as a way of ameliorating such distortions and conflicts and thereby improving compliance with both medical and psychiatric treatment. PMID- 6846591 TI - Unexpected clinical features of the Tarasoff decision: the therapeutic alliance and the "duty to warn". AB - The authors present a case report and discuss the clinical effects of the Tarasoff decision on the therapy of a potentially violent patient. They emphasize that the patient's ambivalence toward the intended victim can be used to foster the therapeutic alliance. The therapist's legal duty to the victim and therapeutic duty to the patient, they assert, can then be synergistically applied with an unexpected benefit: the patient's capacity to make choices is enhanced. PMID- 6846592 TI - Behavioral precipitants to civil commitment. AB - The authors examined retrospectively the prehospitalization behavior of 66 voluntary and involuntary psychiatric patients to determine precipitating factors in each person's hospitalization. Involuntary patients had engaged in dangerous acts directed against others more frequently than had voluntary patients. However, very little significant harm was caused by members of either group. PMID- 6846593 TI - Cortisol level response to 1- and 2-mg doses of dexamethasone. AB - Sixteen depressed patients underwent 1- and 2-mg overnight dexamethasone suppression tests in balanced order. Serum cortisol concentrations at all time points were significantly higher after the 1-mg dose. Nine patients were nonsuppressors after the 1-mg dose, and 4 after the 2-mg dose. PMID- 6846595 TI - Near-death experiences and personal values. AB - Near-death experiences reportedly foster value transformations and decrease suicidal ideation. Eighty-nine survivors of near-death experiences judged values related to material and social success as less important than did 175 control subjects. Decathexis of personal failures may account for the reported suicide inhibiting effect. PMID- 6846594 TI - The dexamethasone suppression test in mixed bipolar disorder. AB - The authors administered the dexamethasone suppression test to 10 patients who met DSM-III criteria for bipolar disorder. All 7 patients with bipolar disorder, mixed type, failed to suppress cortisol; however, the 3 patients with bipolar disorder, manic type, were normal suppressors. PMID- 6846596 TI - Preliminary data on the dexamethasone suppression test in children with major depressive disorder. AB - The authors administered the dexamethasone suppression test to 14 children aged 5 12 years who met the Research Diagnostic Criteria and DSM-III criteria for major depressive disorder. The dexamethasone dose used was 20 micrograms/kg; 2 subjects were nonsuppressors. PMID- 6846597 TI - Hypomania after desipramine withdrawal. PMID- 6846598 TI - Psychiatry in a rural general hospital. PMID- 6846600 TI - Errors on "Moonies". PMID- 6846599 TI - Seizure possibly caused by trazodone HCl. PMID- 6846601 TI - The problem of type II error in the "gluten hypothesis". PMID- 6846602 TI - Prostaglandins, depression, and not smoking. PMID- 6846603 TI - DSM III and the genetics of schizophrenia. PMID- 6846604 TI - Psychomotor epilepsy and violence. PMID- 6846605 TI - On writing the consultation. PMID- 6846606 TI - A skeptical view of psychotherapy. PMID- 6846607 TI - Brief versus long hospitalization: other views. PMID- 6846608 TI - Ethical problems of psychiatric practice in CMHCs. PMID- 6846609 TI - A medical student's view of psychiatry. PMID- 6846611 TI - Payment for liaison activities. PMID- 6846610 TI - The role of medical student societies in psychiatric recruitment. PMID- 6846612 TI - Screening for systemic lupus erythematosus. PMID- 6846613 TI - The value of clinical predictions of dangerousness. PMID- 6846614 TI - Opacities and thioridazine. PMID- 6846615 TI - Propranolol, benztropine, fluphenazine decanoate, and delirium. PMID- 6846616 TI - On the nuclear arms race. PMID- 6846617 TI - Affective disorder in the mentally retarded. PMID- 6846618 TI - Female anorgasmia and MAOIs. PMID- 6846620 TI - Alternative theories and treatment for anorexia nervosa. PMID- 6846619 TI - ECT versus behavior modification for self-injurious behavior. PMID- 6846621 TI - Another report of anniversary reactions. PMID- 6846622 TI - Ethics of modality choice. PMID- 6846623 TI - Olfactory reference syndrome and depression. PMID- 6846624 TI - American Psychiatric Association statement on the insanity defense. PMID- 6846625 TI - "Double depression": two-year follow-up. AB - Of 316 patients with a major depressive disorder who were followed for between 6 months and 2 years, 80 (25%) had a preexisting chronic minor depression of at least 2 years' duration. The chronic minor depression reduced the apparent effect of the known predictors of recovery and relapse from the major depressive disorder and predicted a very pernicious course for the chronic depression. Furthermore, the longer the patient continued to suffer from a chronic minor depression after recovering from the major depression, the greater the probability that relapse into another major depression would preempt recovery from the chronic depression. PMID- 6846626 TI - Assessing personality: effects of the depressive state on trait measurement. AB - The influence of the clinically depressed state on personality assessment was evaluated by comparing self-report personality inventories of patients while clinically depressed and at follow-up 1 year later. The authors examined two groups from the National Institute of Mental Health (NIMH)-Clinical Research Branch Collaborative Program on the Psychobiology of Depression: Clinical Studies -patients whose symptoms had completely remitted and those who had not recovered. The clinically depressed state strongly influenced assessment of emotional strength, interpersonal dependency, and extraversion. Assessment of rigidity, level of activity, and dominance did not change after symptomatic recovery. PMID- 6846627 TI - The decline of state mental hospitals as training sites for psychiatric residents. AB - There has been national concern regarding the decreasing number of U.S. medical students entering psychiatric residency training programs in the 1970s at the same time that the Graduate Medical Education National Advisory Committee (GMENAC) report designated psychiatry as one of only three medical specialties with a manpower shortage. The authors document the decline in psychiatric residents in state mental hospitals from 1975 to 1980 and analyze five possible explanations for this absolute and relative decrease. They discuss approaches to altering the situation as well as the emerging role of the state mental hospital in the future training of psychiatric residents. PMID- 6846628 TI - Incest reported by children and adolescents hospitalized for severe psychiatric problems. AB - This study of 65 children and adolescents hospitalized for psychiatric problems revealed a history of incest in 37.5% of the nonpsychotic female subjects. Ten percent of the psychotic girls and about 8% of all the boys had such a history. A comparison of the nonpsychotic girls who had a history of incest and those who had no known history of incest or sexual abuse showed no specific effects of incest. It seems that social and psychological pathology serious enough to warrant hospitalization is not a simple effect of incest itself but is a consequence of severe family disorganization and the resulting ego impairment. PMID- 6846629 TI - Alcoholic patients with secondary depression. AB - This study of alcoholic patients with and without secondary depression showed that the two groups were almost identical in demographic characteristics, early life antisocial problems, quantity and frequency of drinking, and family history of affective disorder. The depressed patients reported slightly more alcoholism in their first-degree male relatives and tended to have more alcohol-related life problems. The only significant difference between the two groups was that the depressed patients were heavier users of drugs other than alcohol. Thus severe depression in alcoholics may be related to a greater intake of drugs in addition to alcohol. PMID- 6846630 TI - Continuing case law development in the right to refuse treatment. PMID- 6846631 TI - Validation of a short Orientation-Memory-Concentration Test of cognitive impairment. AB - A 6-item Orientation-Memory-Concentration Test has been validated as a measure of cognitive impairment. This test predicted the scores on a validated 26-item mental status questionnaire of two patient groups in a skilled nursing home, patients in a health-related facility, and in a senior citizens' center. There was a positive correlation between scores on the 6-item test and plaque counts obtained from the cerebral cortex of 38 subjects at autopsy. This test, which is easily administered by a nonphysician, has been shown to discriminate among mild, moderate, and severe cognitive deficits. PMID- 6846632 TI - Beyond eclecticism. AB - Biopsychosocial eclecticism is incomplete because it does not address the important issues of differential causation and treatment staging. Psychiatric serialism goes beyond eclecticism to consider biological, psychosocial, and existential-moral parameters as equipotential and hierarchical. What this means in practice is that, after forming a treatment alliance, the therapist must always assess the evidence for a biological substrate of disorder and, where feasible, administer the appropriate biological treatments. On a stable biological platform, psychosocial interventions can then be utilized to promote the goals of lieben and arbeiten, and an existential therapy relationship can be forged to promote personal integrity. PMID- 6846633 TI - The APA position statement on the insanity defense. PMID- 6846634 TI - Are patients with chronic pain depressed? AB - Of 100 consecutive patients treated in a program for management of chronic pain, 25 were definitely depressed, 39 were probably depressed, and 36 were not depressed. Comparisons between the definitely depressed and nondepressed groups showed them to have strikingly similar characteristics as well as treatment outcome. Nearly 90% of the definitely depressed patients showed resolution of their depression without use of antidepressant medication. PMID- 6846635 TI - Plasma cortisol secretion and REM period latency in adult endogenous depression. AB - The authors studied the relationship of plasma cortisol secretion and REM period latency in 25 patients with endogenous depression. The 8 patients (32%) with cortisol hypersecretion had a significantly shortened REM period latency in comparison with the 17 with normal cortisol secretion. Furthermore, an extremely short REM latency (20 minutes or less) occurred almost exclusively in those with cortisol hypersecretion. The authors discuss possible neurotransmitter disturbances responsible for these abnormalities and the clinical implications of these findings. PMID- 6846636 TI - Psychiatric components of medical and surgical practice, II: Referral and treatment of psychiatric disorders. AB - In response to a questionnaire regarding the frequency and type of psychiatric disorders among their patients, internists and surgeons in private practice estimated that 21.1% of their patients had psychiatric problems, that 14.6% would benefit from psychiatric treatment, and that they spent an average of 17.3% of their time treating psychiatric problems. They also stated that depression was the most frequent psychiatric disorder among their patients. More than half of the internists indicated they would treat depression, anxiety attacks, psychosomatic disorders, and organic brain disorders, which may be one explanation for the observation that more medical and surgical patients have psychiatric disorders than are referred to a psychiatrist. PMID- 6846637 TI - Identifying alcoholism in treated opiate addicts. AB - The authors evaluated the usefulness of the Michigan Alcoholism Screening Test in detecting alcoholism (as defined by the Research Diagnostic Criteria) in opiate addicts. The test was found to be adequately sensitive and specific in detecting current cases of alcoholism but inadequate for detecting alcoholic opiate addicts whose drinking was currently under control. PMID- 6846638 TI - Psychiatric residency training: relationships and value development. PMID- 6846639 TI - The medical student's perspective of psychiatry residency selection procedures. AB - To determine what factors influence medical students' perception of the application and selection procedures of psychiatric residency programs, the authors sent a questionnaire to 100 medical students interviewed for the residency program at a major psychiatric facility; 43 returned the forms. There was general concordance between the respondents' perception of the institution's selection criteria and their convictions regarding what those criteria ought to be, with the exception that applicants tended to downgrade the dean's letter. Factors important in the residents' evaluation were the warmth, enthusiasm, and interviewing skills of the faculty and residents. They did not object to psychologically probing interviews if the interviews were skillfully conducted. It was important to them that they met the chairman and program director, and if the applicant was a woman, she wanted to have at least one woman interviewer. PMID- 6846640 TI - An extreme case of cocaine dependence and marked improvement with methylphenidate treatment. PMID- 6846641 TI - Choice of antidepressant based on the dexamethasone suppression test. AB - This retrospective analysis of patients with major depressive disorder correlated response to the dexamethasone suppression test (DST) with clinical response to antidepressants. Nonsuppression on the DST predicted good response to noradrenergic drugs; suppression predicted good response to serotonergic drugs. PMID- 6846642 TI - Psychiatric complications of multiple myeloma. AB - Multiple myeloma is an uncommon cancer, but of eight patients with multiple myeloma admitted to a general hospital over 5 months, five had psychiatric illness, and four of the five had delirium. Consulting psychiatrists should be aware of the common occurrence of impaired cognition in patients with multiple myeloma. PMID- 6846643 TI - Hyperprolactinemia and psychiatric illness. PMID- 6846644 TI - Platelet MAO activity and long-term outcome in schizophrenia and schizoaffective disorder. AB - Several years after MAO activity determination, 36 patients with schizophrenia or schizoaffective disorder were contacted for assessment of their outcome. Patients who had had low platelet MAO activity had significantly better social adjustment and fewer schizophrenic symptoms at follow-up. PMID- 6846646 TI - Call to action against drunk/drugged drivers. PMID- 6846645 TI - Complex partial status epilepticus simulating psychogenic unresponsiveness. PMID- 6846647 TI - Lithium treatment of depressed alcoholics: a hypothesis. PMID- 6846648 TI - Two violent adolescents. PMID- 6846649 TI - Behcet's syndrome as a psychiatric disorder. PMID- 6846650 TI - Psychobiological markers in secondary depression. PMID- 6846651 TI - Dexamethasone suppression test in schizophrenia. PMID- 6846652 TI - Support for a modified DST. PMID- 6846653 TI - Depression, borderline disorder, and the DST. PMID- 6846654 TI - Amoxapine-induced akathisia. PMID- 6846655 TI - More on the fallibility of the double-blind. PMID- 6846656 TI - Psychopathology in psychiatric residents. PMID- 6846657 TI - Measuring lithium levels after exercise. PMID- 6846658 TI - Unacknowledged problems with cults. PMID- 6846660 TI - A political system for our future society--a possibility. PMID- 6846659 TI - Commonalities between alexithymia and mental retardation. PMID- 6846661 TI - Effecting change in stepfamilies: a psychodynamic/behavioral group approach. PMID- 6846663 TI - Psychotherapy and the inpatient unit: a unique learning experience. AB - This paper describes the advantages of an inpatient setting for the teaching and learning of psychotherapy. Contributions to this process derive from the continuous and intense expressions of conscious and unconscious dynamics, transferences, and object relationships by the patients, the obligation on residents to therapeutically engage in a relatively exposed way with all the patients under their care, the availability and familiarity of the staff supervisors who participate in assessments and decisions regarding patient management and psychotherapy, and the collaborative work of all the other team members. Conditions of the setting which make this possible are the strong psychodynamic orientation of all the staff, the resident's role as manager and psychotherapist, the staff psychiatrist's role as supervisor and team leader, and the completely open communication among all the treating personnel. PMID- 6846662 TI - Combination of multiple-family therapy with parallel groups. AB - Parallel groups for children, adolescents, and parents have been a usual modality in the Community Guidance Center for over 12 years. This has provided effective therapeutic intervention. However, an inherent difficulty in these groups was discussion with parents about the identified patient's progress. Various methods, on a trial-and-error basis, were attempted. The most successful process, which evolved four years ago, is a multiple-family-therapy session combined with the parallel groups. The multiple-family-therapy group provides an interface for five subsystems [parents and children, also forming families; trainees; staff], opens communication to parents about the child's progress and includes the parent more viably in the treatment process. It provides greater awareness and opportunity for work toward family and individual goals with major focus on communication skills, role modeling for parents and trainees, and realistic goal setting. PMID- 6846664 TI - Preoedipal issues in a postincest daughter. PMID- 6846666 TI - The demographics of American Psychotherapists: a pilot study. AB - Of the professional groups from which data are available, psychiatrists, psychologists and social workers do approximately 30 percent of the total number of hours of self-defined psychotherapy while primary care physicians report doing 10 percent. These figures are not truly representative of the actual percentage of psychotherapy being performed by these groups, since at least three other professions (ministry, psychiatric nursing and the counseling profession) are also significantly involved in the delivery of such services. The expansion of psychotherapeutic practice has been accompanied by an increasing ambiguity in the definition of psychotherapy, to the point that the definition appears solely dependent upon the judgement of the participants. The Commission on Psychiatric Therapies of the American Psychiatric Association is attempting to clarify psychotherapeutic practice in regard to decision trees applied to specific diagnostic categories. In order to lead the way to its utilization by all psychotherapists, two further problems need attention: (1) the demography of American psychotherapists and (2) a definition of the basic elements of psychotherapy. PMID- 6846665 TI - Psychotherapeutic considerations in the management of the suicidal patient. AB - The management of the suicidal patient is complicated by (1) the emotions expressed and the demands made by the patient, (2) the therapist's own responses, and (3) the influence of significant others. The therapist may be required to make himself available and to become personally involved to a greater extent than is usual. The suicidal patient has a tendency to involve himself in symbiotic relationships from which it is difficult for either partner to become detached without generating anxiety in the other. The degree to which the therapist indulges the patient in his dependency needs or encourages him to act responsibly is a matter of fine clinical judgment. The unwillingness of the suicidal individual to entrust himself to others causes him to become ambivalent towards both the therapist and life itself. The hostile, even murderous attitude of family members may require his temporary removal from them and necessitate their involvement in his treatment. PMID- 6846667 TI - Omnipotence, helplessness, and control with the borderline patient. AB - Via transference, borderline patients attempt to actualize dyads that represent fixations at and regressions to the symbiotic phase and the differentiation subphase of separation/individuation. Early awareness of separateness leads to the idealization of the provider as omnipotent and devaluation of the separate self as helpless. Efforts are directed at re-fusion to restore the positive symbiotic self-object via controlling the omnipotent other. This primitive constellation becomes reenacted in the transference with the borderline patients. Clinical examples from long-term psychotherapy with three borderline patients illustrate this constellation and outline the following strategies by which they attempt to reestablish symbiosis manipulatively and maintain fantasies of omnipotence: (1) impulsivity; (2) selection of a dependent object; (3) seduction; (4) overt and covert manipulation (identification with the aggressor); and (5) compliance. These pathological transferences may illuminate reconstructions of early differentiation in borderline infantile development and the impact which this differentiation can have upon subsequent self-systems and object relationships. PMID- 6846669 TI - Bad theater in psychotherapy: the case for therapists' liberation. AB - Freud's admonition to psychoanalysts to be objective in their work, like a mirror or surgeon, was intended to allow them to work in "a pure field." This advice has been excessively adhered to, with the result that many therapists have become unduly unresponsive. A host of petty practices has developed, whereby therapists become preoccupied with such matters as payment of fees, vacations, protecting patients from meeting each other, missed hours, and so on. This has led to stilted and unproductive therapy. Student therapists must be supervised by teachers unencumbered by such attitudes and practices, so that they can do the hard, ordinary work which constitutes psychotherapy. Only in this way will new generations of therapists be liberated from these disabling and artificial constrictions. PMID- 6846668 TI - The patient's relation to time during the final minutes of a psychotherapy session. AB - People must relate to time and the manner in which they relate to time is often a reflection of their object relationships and level of development. A patient's relationship to time throughout a therapy session can be a particular perspective from which object relationships and transference issues can be viewed. The patient's relationship to time during the final minutes of psychotherapy sessions provides a particularly revealing opportunity for observing a patient's desires, affect, and level of functioning. Clinical examples of patients' behaviors during the final minutes of psychotherapy sessions have demonstrated a variety of levels of object relationships. A number of affects have been described in these examples. PMID- 6846670 TI - Black males and psychotherapy: theoretical issues. PMID- 6846671 TI - Psychotherapy for Vietnam veterans with posttraumatic stress disorders. AB - Past psychotherapeutic approaches to posttraumatic stress disorders are discussed with reference to some of the special problems in treating the disorder in Vietnam combat veterans. In some cases therapy oriented specifically to the effects of combat trauma can be helpful even in veterans seen years after combat; in others the symptoms have become so enmeshed in the veteran's life that trauma oriented therapy must be combined with more traditional psychotherapeutic principles. Three cases representing a range of the ways in which posttraumatic stress is experienced are presented and their treatment is discussed. These cases illustrate the importance for effective psychotherapy to be based on an understanding of what the combat experience has meant to the veteran and how such meanings continue to be represented in the individual's postwar life. PMID- 6846672 TI - The valley of the shadow of birth. PMID- 6846673 TI - Four years' experience with home birth by licensed midwives in Arizona. AB - In 1978, Arizona began licensing lay midwives under regulations designed to maintain adequate standards of care for women desiring a home birth. During four years of this program, 3 per cent of home birth clients were hospitalized for complications and another 15 per cent received postnatal outpatient care, primarily for second degree lacerations. Five per cent of the newborns required medical care after delivery; half of these were hospitalized. Complications declined over the period due to increased experience, close supervision, and continuing education. PMID- 6846674 TI - Measurement of the primary care roles of office-based physicians. AB - The Baltimore City Primary Care Study examined the role of the urban office-based physician in the delivery of primary care. During the course of the study, questionnaires were completed by over 90 per cent of licensed physicians in the city, and data were collected from a sample of 16,000 patients. The study developed and assessed three approaches for the measurement of primary care. An empirical method was based upon information regarding the following characteristics of each visit: first contact visit, referral visit, specialized care visit, or principal care visit. A normative method was based on an assessment of the degree to which the practice provided care that was comprehensive, longitudinal, accessible, and family-centered. The third method used physicians' judgments as to the proportion of patients for whom they maintained ongoing responsibility for general medical care. All three methods produced the same categorization of different specialties as providing either primary, intermediate, or specialty care. As a group, primary care physicians included general and family physicians, pediatricians, and general internists. General surgeons and obstetrician/gynecologists have characteristics of both primary care and specialist care. All other physician groups have characteristics of specialists. Any of these methods or a combination of methods can be used to assess the extent to which the practice of a particular physician or group of physicians provides primary care. PMID- 6846675 TI - Premature deaths avoided by the antismoking campaign. AB - The antismoking campaign has encouraged millions of people to quit smoking cigarettes and millions of others not to initiate the habit. Because quitting smoking, or deciding not to start, reduces one's mortality risks relative to the continuing smoker, we estimate that these consumption impacts resulted in the avoidance of more than 200,000 premature smoking-related deaths during 1964-1978. On average, each of these premature deaths averted translates into 23 additional years of life. Furthermore, campaign-related smoking cessation and non-initiation during the 1964-1978 period will result in the avoidance of many more premature deaths in the coming decades. Although these figures suggest that the antismoking campaign has been successful, tens of millions of Americans continue to smoke and the premature deaths avoided constitute only a small fraction of the 4 million deaths attributable to smoking that occurred during the same years. PMID- 6846676 TI - Characteristics of cancer patient referrals to home care: a regional perspective. AB - Records of 609 cancer patients referred in 1979 to home health agencies in rural and urban health service regions in Illinois were abstracted. There was no difference in the overall utilization of home care between the two regions, but significant differences in referral characteristics were found between the two regions with respect to patient's disability level, disease stage, presence of concurrent medical conditions, and living arrangement, and to the source of referral. PMID- 6846677 TI - Weight and sodium reduction for the prevention of hypertension: a comparison of group treatment and individual counseling. AB - Ninety-three overweight adult males with labile blood pressure elevation participated in a 20-week dietary intervention program to achieve a 10 per cent reduction in body weight and a reduction in dietary sodium intake to 70 milliequivalents per day. By random assignment, half were treated with intensive group treatment procedures and half with individual counseling. Written handouts and assignments were identical, as was the schedule of treatment visits. Both techniques produced significant decreases in weight, sodium intake, calorie intake, and blood pressure. Calorie and sodium knowledge also increased significantly with both intervention approaches. The two treatment modalities did not differ in effectiveness. PMID- 6846678 TI - Interpretation of behavioral findings in studies of nutritional supplementation. PMID- 6846679 TI - Effects of WIC on cognitive development. PMID- 6846680 TI - Stress fracture of the ulna in an adolescent tournament tennis player. PMID- 6846681 TI - Biomechanics of the spine in the polevaulter as related to spondylolysis. AB - An athlete was filmed at high speed to anatomically plot the position of the vertebrae during several pole vaults. A computer analysis adapted from a previously described program (Gainor, BJ, et al: The kick: Biomechanics and collision injury. Am J Sports Med 6: 185-193, 1978) was used to quantify the kinematic data. The thoracic and lumbar vertebrae of the polevaulter began in a neutral position but rapidly hyperextended 40 degrees during pole plant. The spine subsequently flexed 130 degrees in 0.65 seconds as the pole uncoiled and the athlete was propelled towards the bar. Angular velocities of the spine reached a maximum of 6 radians/sec during both extension and flexion. More significantly, angular accelerations of 150 radians/sec2 occurred in hyperextension, and 180 radians/sec2 in hyperflexion. Torque about the spine was estimated to be 1,500 inch-pounds during extension and 1,800 inch-pounds during flexion. The maximum kinetic energy in the athlete's body was calculated to be 36,000 inch-pounds. We believe the magnitude of these torques and accelerations predispose the back to injury. These results were correlated with several cases of spondylolysis in competing polevaulters. PMID- 6846682 TI - Jumper's knee. AB - Jumper's knee (patellar or quadriceps tendon tendonitis) is found in a high number of athletes, especially in volleyball and basketball players. Conservative treatment (rest, stretching, physical therapy and antiinflammatory drugs) is usually successful. The athletes often recover completely and resume their sports activity. The purpose of this study is to present the histologic findings and our surgical repair of 18 knees of patients who underwent surgery after failure of conservative treatment. Histologic findings confirm that the so-called "jumper's knee" is a pathology localized at the bone-tendon junction. In all cases the following abnormalities were found: pseudocystic cavities at the borderline between mineralized fibrocartilage and bone, disappearance of the "blue line," increased thickness of the insertional fibrocartilage with myxomatous and hyaline metaplasia, mineralization, and ossification of the fibrocartilage far from the "blue line." Abnormalities of the patellar tendon were observed only in one patient who received local injection of corticosteroids. Eleven of the 18 surgically treated knees obtained a satisfactory result with complete resumption of sports activity. PMID- 6846683 TI - Incidence of soccer injuries and their relation to training and team success. AB - One hundred-eighty players in a male soccer senior division of 12 teams were observed prospectively for 1 year to study the risk of soccer injuries in relation to exposure and to establish the connection between training, injuries, and team success. Totally, more than 100 hours of practice were analyzed. All injuries were examined by the same orthopaedic surgeon. On the average, each team played 36 games and had 95 practice sessions with 66% attendance of selected players. A direct correlation was noted between team success and the amount of training. Teams with more than average training showed a diminishing number of injuries. A high practice-to-game ratio seems to be advantageous. One injury every third game and every ninth practice session was documented. For the individual player the incidence of injury was 7.6/1000 practice hours and 16.9/1000 game hours. The incidence of injury was higher at training camps. Correlation was noted between the design of the training and the incidence of injuries. The duration of warming up seemed adequate, but its content did not appear to be satisfactory from a clinical point of view. Redesign of the warm-up with more emphasis on flexibility and the addition of a cool-down is suggested to reduce injuries. PMID- 6846684 TI - Kinematic and electromyographic patterns of Olympic race walkers. AB - The performance of two Olympic race walkers was studied during free-speed, fast, and race walking. Measurements of the stride and temporal components of gait, as well as the simultaneous displacement patterns of the body segments, and the electromyographic activity of muscles of the trunk and upper and lower limbs were recorded during the three walking speeds. During the testing, the race walkers achieved an average speed of 12.5 km/hr as compared to the 8.7 km/hr average speed achieved by normal men of the same age during fast walking. Race walking was characterized by an increase in cadence and stride length beyond that of normal controls (in a prior study) during fast walking, with stride lengths averaging 125% of stature during race walking, and 115% during normal fast walking. In the two race walkers the amplitudes of most of the movement patterns of the trunk and upper and lower limbs were exaggerated during race walking as compared to normal controls' fast walking. Several mechanisms were used by the race walkers to minimize the vertical excursion of the center of gravity of the body during race walking. All of the muscles monitored in the race walkers showed an increase in the amplitude of electromyographic activity during race walking as compared to fast walking; duration of muscle activity was also usually increased during race walking. Several suggestions for prevention of injuries associated with race walking are made. PMID- 6846685 TI - Valgus extension overload in the pitching elbow. AB - Five baseball pitchers, three college and two professional, with an average age of 24 years, exhibited pain between the acceleration phase and follow-through phase of the pitching motion. This caused the players to be unable to continue at the level of competition necessary to play. A significant osteophyte on the posteromedial aspect of the olecranon process was identified in all pitchers. This caused impingement with the articular wall of the olecranon fossa and often created an area of chondromalacia. The more commonly identified posterior osteophyte was present in all cases. However, if just this posterior osteophyte is removed, the described lesion will be missed, with resultant persistent disability. Surgical excision of the posteromedial osteophyte through a relatively atraumatic posterolateral approach allowed early return of function without morbidity. With an average follow up of 1 year, all of the pitchers returned for one full season at maximum effectiveness. PMID- 6846686 TI - Preliminary report on the Jones, Ellison, Slocum (JES) repair for symptomatic anterior cruciate deficient knees. AB - A modified Jones intraarticular anterior cruciate reconstruction was combined with a distal iliotibial band transfer (Ellison) and a pes anserinus transfer (Slocum) for patients with symptomatic anterior cruciate deficient knees. The procedure was performed on 15 young (average age, 22.5 years) athletes, in a single operation through a long, straight, anterior, midline incision. Preoperatively, all 15 patients (15 knees) had symptomatic instability and all but one had a positive pivot shift. At follow up (averaging 39 month range 24-60 months) 13 (93%) had the pivot shift eliminated and only one, with 36 months followup, had instability on return to sports. Postoperatively, patients were immobilized 3 weeks and then were started on a physical therapy program which ended in return to sports at 1 year. PMID- 6846687 TI - Rupture of the plantar fascia in a middle-aged tennis player. A case report. PMID- 6846688 TI - Superior entrapment of the clavicle. AB - Three degrees of acromioclavicular separation are commonly recognized. A Type III separation with entrapment of the clavicle on the top of the acromion is frequently not recognized while in its acute phase and amenable to closed reduction. The sign of this type of acromioclavicular separation is an apparent Type III in which one cannot manipulate the clavicle. The acute case is treated by local anesthesia, manipulation, and splinting. The chronic case is treated by excision of the outer end of the clavicle. In 1979 we treated three acute and one chronic superior entrapment of the clavicle on the acromion. During this time interval 67 acromioclavicular separations of Grade I, II, and III were treated. This amounted to 6% of our acromioclavicular separations treated during 1979. PMID- 6846689 TI - Bilateral avulsion fracture of the triceps tendon insertion from skiing with osteogenesis imperfecta tarda. A case report. PMID- 6846690 TI - Presidential address. Trouble at the crossroads in the eighties. PMID- 6846691 TI - Micturition neuropharmacology. AB - Applying the basic principles, therapy guides to our hypothetical cases can be constructed. The 60 year old man with postoperative abdominal perineal resection with hypertension and parkinsonism may well need a transurethral resection of the prostate; however, other options include decreasing his anticholinergic-type medications, such as antiparkinsonism medications, changing his hypertensive therapy from beta blockers such as propranolol and metoprolol to alpha blockers such as methyldopa and prazosin. Bethanacol would seldom be helpful alone, but with an alpha blocker could help if not contraindicated by the presence of vascular disease. The second example, a 45 year old woman with stress incontinence, may be assisted with improved storage by an anticholinergic agent, an alpha enhancer, a mucosal enhancer, and if pertinent, switching hypertensive therapy from an alpha blocker to a beta blocker. The last example, a T10 paraplegic with a spastic, hyperreflexic bladder, can have improved storage with anticholinergics, decreased sphincter tone with alpha blockers, as well as decreased sphincter tone with alpha blockers, as well as decreased spasms through suppression of hyperactive spinal cord activity with baclofen. PMID- 6846692 TI - Pancreaticojejunostomy. Report of a 25 year experience. AB - Surgical therapy for 88 patients operated on between 1958 and 1982 has been reviewed. Ninety-three operative procedures were performed including pancreaticojejunostomy in 56, pancreaticocystojejunostomy in 12, pancreaticojejunostomy with resection of less than 10 percent of the pancreas in 16, and pancreaticojejunostomy with resection of more than 50 percent of the pancreas in 9. Operative mortality was 7.5 percent and operative morbidity was 25 percent. Overall, 63 percent of the patients had an excellent or good result in the postoperative follow-up period which averaged 4 years. In the nonalcohol induced pancreatitis group, ductal diameter was a good predictor of postoperative success, whereas in the alcoholic patient population, abstinence from further alcohol intake was a more accurate predictor of the success of pancreatic drainage. PMID- 6846693 TI - Increasing incidence of Crohn's disease. AB - Reports in the literature have shown an increased incidence of Crohn's disease. The incidence in Spokane, Washington, was calculated on the basis of number of first hospitalizations for that diagnosis at all private hospitals within the city. The incidence in 1971 was 5.9 per 100,000 population and increased to 8.8 per 100,000 population in 1981, which is the highest incidence reported in the literature. The number of admissions and operations for Crohn's disease increased threefold in that same time interval. Possible pitfalls of such incidence studies have been discussed. We believe our results indicate a true and continuing increase in the incidence of Crohn's disease. PMID- 6846694 TI - Chronic pancreatitis and congenital strictures of the pancreatic duct. AB - Chronic pancreatitis may occasionally be due to chronic incomplete obstruction of the pancreatic duct. Pancreas divisum is associated with a high incidence of recurrent pancreatitis or pancreatic pain, which may be due to relative stenosis of the accessory papilla through which most of the pancreatic secretions drain. Stenosis of the pancreatic duct at the site of fusion of he ventral and dorsal ducts has been demonstrated in 3 percent of autopsy subjects and in patients studied with ERCP. Two patients with idiopathic chronic pancreatitis presented with dilatation of the pancreatic duct which extended distally from the site of fusion of the embryonic ducts. We postulate that congenital stenosis of the main pancreatic duct may predispose to chronic pancreatitis in the absence of other obvious etiologic factors. PMID- 6846695 TI - Blood flow in the common femoral artery. Evaluation in a vascular laboratory. AB - Accurate knowledge of the hemodynamics of the common femoral artery is a critical part of both the preoperative evaluation of patients with peripheral vascular disease and the postoperative follow-up examination. Interrogation of the iliofemoral system with determinations of palpable pulse status, Doppler analog waveforms, and upper thigh pressure ratios has yielded an overall sensitivity of 91 percent and a specificity of 85 percent in the detection of inflow stenosis. This degree of accuracy (89 percent) allows practical surgical decisions to be based on the results of these noninvasive studies. PMID- 6846696 TI - The middle scalene muscle and its contribution to the thoracic outlet syndrome. AB - The predisposing anatomic alterations or features of thoracic outlet syndrome have been tallied to better define this difficult and inchoate issue. In the last 34 supraclavicular operations involving 33 patients (for a total operative experience of 128 procedures), we have found the anterior insertion of the middle scalene muscle to be present in 48 percent of our patients. This insertion, forward on the first rib, closes an already small interscalene triangle, so that the posteriorly placed brachial plexus is entrapped or irritated by the anterior edge of this muscle, which may be very sharp and firm. In addition, 10 percent of our patients had a middle scalene band intimately associated with the middle scalene muscle, often-times inseparable, for a 58 percent incidence of middle scalene involvement in the thoracic outlet syndrome. With data such as those presented herein, a more simplified operation than the heretofore popular all-out attack on the first rib may well be in the offering. PMID- 6846697 TI - Mason gastric bypass. Long-term follow-up and comparison with other gastric procedures. AB - The Mason gastric bypass as performed over 8 years on 171 patients for the treatment of massive exogenous obesity. The first 26 patients had a large pouch constructed, and poor long-term weight loss occurred. In the last 6 years, 145 patients had a smaller pouch with a 5.5 percent immediate postoperative complications rate. One early death resulted. Late complications and revisions were few. In the last 145 patients there were only 9 who did not maintain a weight loss of greater than 25 percent of their total weight. This group of 145 patients have lost an average of 42 percent of their total weight (121 pounds) and 72 percent of their excess weight. The stapled Alden gastric bypass and horizontal gastroplasties, when compared with the Mason gastric bypass, have similar complications with the potential for poor weight loss after long-term follow-up due to channel enlargement or staple-line leakage. The Mason gastric bypass is an excellent surgical method of weight loss. PMID- 6846698 TI - Screening of carotid arteries by noninvasive duplex scanning. AB - This paper has reported the accuracy of the duplex scanner in diagnosing occlusive disease of the carotid artery. Patients who present with vague neurologic symptoms, syncopal episodes, or asymptomatic carotid bruits are candidates for this type of study to determine the presence of significant stenosis. Other indications include the continuing assessment of known lesions and postoperative results in patients who have had endarterectomies. PMID- 6846699 TI - Percutaneous abdominal abscess drainage. Portland area experience. AB - After reviewing 21 patients who have had percutaneous abdominal abscess drainage, we believe that the procedure should be considered for those abscesses that are unilocular without septations, with safe access being a key variable dictating the use of percutaneous abdominal abscess drainage rather than surgery. A computerized tomographic scan of the abdomen should be employed at some stage of the percutaneous abdominal abscess drainage procedure to facilitate safe access to the abscess and to distinguish a synchronous abscess where present. In addition, we believe that percutaneous abdominal abscess drainage should be considered for postsurgical abscesses only and not those that are spontaneous in nature or where the original abnormality cannot be accurately surmised. With regard to catheter management, frequent irrigation of the catheter must be carried out at least every 4 to 6 hours, with high levels of antibiotics present in the blood before irrigation. This must be done to obviate the most frequent and potentially lethal complication of the procedure, namely sepsis. Percutaneous abdominal abscess drainage, although safe for the most part, is capable of inducing considerable morbidity. Our data suggest that percutaneous abdominal abscess drainage is not as efficacious as previous reports have suggested. Traditional surgical drainage techniques are best utilized for those abscesses that are multiple, highly viscous, inaccessible, spontaneous, or unresponsive to percutaneous abdominal abscess drainage. PMID- 6846700 TI - In situ saphenous vein bypass grafting. Experience in 34 extremities over a 2 year period. AB - Over a 2 year period, 34 limbs were revascularized in 33 patients. The in situ saphenous vein technique was used. Improved instrumentation and patency rates have encouraged the use of this method. Eighteen patients were insulin-dependent diabetics. The indication for operation was limb salvage in 25 limbs (73 percent). No vein was considered too small to use. The origin of 25 of the grafts were femoral and 9, popliteal. The termination of 15 of the grafts were popliteal, 11 tibial or peroneal, and 8 pedal. Of 12 limbs considered to be the most difficult to treat due to diabetes and accompanying poor runoff, 4 had a patent pedal arch. Initial graft patency was achieved in 94 percent of the limbs. Overall graft patency was 73 percent; femoropopliteal patency was 86 percent; and combined femoral, tibial, peroneal, and pedal patency was 64 percent. Learning the in situ bypass technique is tedious. The low thrombogenicity of the graft provides a temptation to extend operative indications. Use of the saphenous vein in situ can result in superior revascularization of the leg. PMID- 6846701 TI - Anterior transpericardial closure of a main bronchus fistula after pneumonectomy. AB - A young woman sustained a penetrating wound to the right anterior chest during a vehicular accident. Septic complications led to emergency pneumonectomy followed by infection of the pleural space and disruption of the right bronchus closure. Her condition improved after creation of a pleural window for dependent drainage and gauze packing of the pleural space. Subsequently, the open bronchial stump was closed utilizing a transpericardial approach through a median sternotomy incision which permitted eventual closure of the pneumonectomy space without thoracoplasty. When the length of the bronchial stump permits its application, the transpericardial approach to postpneumonectomy bronchial fistula closure offers important advantages over conventional transpleural techniques. PMID- 6846702 TI - Reflections of a former chairman and professor emeritus of a department of surgery. PMID- 6846703 TI - Surgical approaches to recurrent choledocholithiasis. Choledochoduodenostomy versus T-tube drainage after choledochotomy. AB - To assess the value of choledochoduodenostomy versus T-tube drainage to manage patients with recurrent choledocholithiasis, a prospective, randomized study was carried out where under strict criteria of selection, 45 patients underwent choledochoduodenostomy after choledochotomy (Group A), and another 45 patients underwent T-tube drainage (Group B). Results revealed that patients in Group A had low early morbidity (8.8 percent), no mortality, and no reoperations due to recurrent choledocholithiasis. In contrast, in Group B patients there was a mortality of 4.4 percent, an early morbidity of 26.6 percent, and a late recurrence and reoperation rate of 20.9 percent. The difference in those elements between patients in Group A and Group B is considered significant (p less than 0.05, p less than 0.001, and p less than 0.0001, mortality and early and late morbidity, respectively). It is recommended that at least for a proportion of patients with recurrent choledocholithiasis who present with clinical and operative findings similar to those in this study, choledochoduodenostomy has to be considered the method of choice. PMID- 6846704 TI - Axilloaxillary bypass for symptomatic stenosis of the subclavian artery. AB - Since the association has been made between stenosis of the subclavian artery and neurologic symptoms, controversy has existed over the preferred surgical procedure for bypass. In addition, concern has been raised regarding the long term patency and effectiveness of this extraanatomic procedure in relieving neurologic symptoms. Twenty-seven patients underwent this operation for posterior cerebral symptoms between 1973 and 1982; 25 were followed for up to 77 months (mean 26 months). Twenty-two patients had complete relief of symptoms, although 3 of them required a subsequent carotid endarterectomy. Two other patients had partial relief, and one patient's symptoms remained unchanged. Upper extremity symptoms, present in nine patients, were relieved by the operation. All grafts remained patent during follow-up. Axilloaxillary bypass is a durable procedure for symptomatic stenosis of the subclavian artery. It is a low-risk procedure and is therefore particularly suited for older patients with associated carotid artery disease. PMID- 6846705 TI - Natural history of ascending thrombosis of the abdominal aorta. AB - During 1980, 30 patients underwent successful operations for ascending thrombosis of the abdominal aorta in its three forms: low (below the inferior mesenteric artery, 11 patients); middle (above the inferior mesenteric artery, 6 patients); and high (at the level of the renal arteries, 13 patients). An angiogram that reveals high ascending thrombosis of the abdominal aorta is paradoxically more favorable than one that reveals middle or low ascending thrombosis of the abdominal aorta. In fact, the patient with a juxtarenal thrombosis has already overcome two of the three phases that constitute the critical moments of potential failure of the collateral circulation. Progressive ascending thrombosis with a poor prognosis and a rapidly downward course can cause acute ischemia with paraplegia of the legs and intestinal infarction. Most patients die suddenly in the emergency or intensive care unit from paraplegia, acute abdomen, or anuria; the latter is due to further progressive thrombosis with obstruction of the orifice of the renal arteries. On the basis of the angiogram only (apart from subjective symptoms), ascending thrombosis of the abdominal aorta constitutes an absolute indication for surgical treatment. PMID- 6846706 TI - Muscle transposition in lesions of the ischemic leg. AB - Ulcerative lesions of the ischemic leg that cannot be revascularized present serious problems. Under carefully defined conditions, a muscle transposition procedure, with or without skin grafting, may be successful. The indications and contraindications, risks, and technical considerations have been presented. Nine patients formed the basis of this study: there was complete healing in six, partial healing in two, and complete treatment failure in one. It has been concluded that this operative approach should be considered in patients with an ulcerated ischemic leg, especially when amputation is being considered. PMID- 6846707 TI - Management of acute ischemia of the upper extremity. AB - Records of 76 patients who presented with ischemia of the upper extremity from 1966 to 1981 were reviewed. Patients were divided into three groups according to cause: Group 1, emboli from the artery; Group 2, ischemia after catheter injury; and Group 3, ischemia due to lesions of the axillary and subclavian arteries. Management varied among the three groups. Long-term anticoagulation therapy was helpful in Group 1 patients in preventing reembolization. Forty percent of patients with catheter-related trauma required angioplasty of some sort in addition to embolectomy. Management of Group 3 patients was most difficult and the results least acceptable (three patients required amputation). Management of this type of ischemia must be individualized; it should vary according to the underlying disorder. PMID- 6846709 TI - Parotoidectomy: points of technique for brief and safe operation. PMID- 6846708 TI - Mucosal proctectomy without reservoir. AB - Mucosal proctectomy with endorectal pull-through allows the removal of all colonic mucosa with preservation of continence. This operation was performed in 19 patients with familial polyposis coli and ulcerative colitis. A temporary loop ileostomy was used to defunctionalize the anastomosis. Intestinal continuity was restored in 17 of the 19 patients. Mean duration of follow-up was 29 months. All patients are continent, and the mean number of bowel movements per 24 hours is 6. Follow-up barium studies revealed a gradual dilatation of the terminal ileum within the rectal cuff which accounts for the decrease in the number of bowel movements. This operation eliminates the risk of carcinoma without compromising sphincter function. PMID- 6846710 TI - Persistent sciatic artery. Clinical aspects and operative management. AB - Abnormal persistent of the embryonic axial blood supply to the leg, the sciatic artery, is a rare but often clinically important condition. The sciatic artery may vary from a small collateral in the upper thigh to a very large vessel that is the leg's sole arterial blood supply. The abnormal artery is prone to aneurysmal dilatation and atherosclerotic occlusion, and different patterns of anatomic development in the sciatic and femoral artery systems pose significant diagnostic and therapeutic problems. Advances in preoperative hemodynamic assessment, arteriography, and vascular surgical technique have improved the results of management of persistent sciatic artery and its complications. The world literature has been reviewed, including one additional case, with emphasis on embryologic development, anatomic variations, and clinical presentation, as well as diagnosis, therapy, and results. PMID- 6846711 TI - [Adenoacanthoma of the endometrium--morphological aspects and clinical data]. PMID- 6846712 TI - [Relative autonomy of steroido- and oogenesis in the human ovarian follicle]. PMID- 6846713 TI - [Ultrastructural study of the process of follicular atresia in human ovaries in disorders of reproductive function]. PMID- 6846714 TI - [Function of the thyrotropic-thyroid system in physiological and pathological climacteric]. PMID- 6846715 TI - [Hysteroscopy in uterine hemorrhage in the climacteric period]. PMID- 6846716 TI - [Indices of thrombocytic hemostasis and the serotonin content of the blood of women in a normal menstrual cycle and in dysfunctional uterine hemorrhage]. PMID- 6846717 TI - [Gonadotropic and sex hormones levels in thyrotoxicosis patients]. PMID- 6846718 TI - [Research on preventing obstetrical and gynecological pathology in women agricultural workers]. PMID- 6846719 TI - [Organization of specialized care for women with menstrual disorders]. PMID- 6846720 TI - [Ovarian function in patients with uterine and vaginal aplasia]. PMID- 6846721 TI - [Nature of the electrical activity of the brain in patients with uterine and vaginal aplasia]. PMID- 6846722 TI - [Immune mechanisms in the occurrence and development of endometriosis]. PMID- 6846723 TI - [Anatomico-histological characteristics of the structure of the human myometrium]. PMID- 6846724 TI - [Use of the tranquilizer mebikar for treating climacteric neuropsychic disorders]. PMID- 6846725 TI - [Differential therapeutic approach in the stages of rehabilitation of patients with tubal sterility]. PMID- 6846726 TI - [Thermographic indices in tuberculosis of the female genitalia]. PMID- 6846727 TI - [Staphylococcus aureus carrier state in obstetrical and surgical hospitals]. PMID- 6846728 TI - [Ultrasonic diagnosis of space-occupying masses in the female genitalia]. PMID- 6846729 TI - Prediction of the development of cerebral palsy from perinatal risk factors. AB - Perinatal data of 29 cerebral palsy (CP) children and 237 control children were analyzed to identify etiological and predictive factors for cerebral palsy. Obstetrical and neonatal factors associated with CP in the low-birth-weight group were sex (male) and place of birth, and in the normal-birth-weight group they were prolonged delivery, meconium staining of the amniotic fluid, an Apgar score of less than 4 at 1 minute, the first respiration occurring only after 3 minutes, and the first cry taking place after 7 minutes. The following neonatal signs and symptoms were strongly associated with CP in the both birth weight groups; convulsion, hypotonia, hypertonia, absence of the Moro reflex, tremor, and apnea. A linear discriminant function was developed from the above neonatal signs and symptoms. The use of three factors, convulsion, hypotonia, and apnea efficiently discriminated between the CP and control children and they would be used as good predictive factors for cerebral palsy. PMID- 6846730 TI - Personality and electroencephalography: significance of epileptiform activity on mass screening electroencephalography. AB - From the mass screening EEG, 31 primary school children and 17 junior high school (Jr-HS) students with paroxysmal discharge were chosen. An equal number of children with disorganized patterns, including a few borderline ones, and with normal patterns were selected from the same classes. School performance and behavior assessments were evaluated based on the school records. Both in primary and Jr-HSs, the order of school performance in these three groups was as follows (shown hereafter--an average score of seven subjects for primary school children; that of 9 for Jr-HS). Firstly, normal EEG group (21.5 +/- 5.53; 30.1 +/- 6.08); secondly, epileptiform EEG group (21.1 +/- 5.09; 27.4 +/- 6.09); lastly, disorganized EEG group (20.8 +/- 5.11; 26.2 +/- 7.32). In behavior assessments, teachers highly evaluated the children with normal EEG both in primary and Jr HSs. On the contrary, those with disorganized EEGs were not as highly evaluated, especially in primary school. PMID- 6846732 TI - An unusual association of tuberous sclerosis and adrenogenital syndrome. PMID- 6846731 TI - Cerebellar hypoplasia, communicating hydrocephalus and mental retardation in two brothers and a maternal uncle. PMID- 6846734 TI - Early infant death in nemaline (rod) myopathy. AB - Congenital 'floppy infant' syndrome with very early death is uncommon. It is here described in a girl. Histopathological examination of a muscle biopsy at the age of 10 days showed rods and infiltration of inflammatory cells. Death occurred at 5 weeks of age. Electron microscopy of the necropsy material showed widened Z disks and rods of Z disk density with a typical transverse periodicity of 18-20 nm. The differential diagnosis between nemaline (rod) myopathy and infantile polymyositis is discussed. Nemaline (rod) myopathy should always be considered in cases of the congenital 'floppy infant' syndrome. PMID- 6846733 TI - Serial changes of cranial computerized tomographic findings in Wilson disease during D-penicillamine therapy. AB - Serial changes of cranial CT findings were studied in three siblings with Wilson disease during the course of D-penicillamine therapy. The older two cases with neurological presentation revealed low density areas in the region of the basal ganglia on the CT scans performed before treatment. Mild cortical atrophy and mild enlargement of the lateral and the third ventricles were also observed. The chelating therapy resulted in a considerable improvement of neurological symptoms and disappearance of Kayser-Fleischer rings. The low density areas of the basal ganglia disappeared. However, cortical atrophy and an enlargement of the ventricles were still present. In an asymptomatic girl, the cranial CT scans remained normal after chelating therapy. The cranial CT scan is considered to be of great use both in diagnosis and observation of the clinical course in Wilson disease, and it is also of prognostic value. PMID- 6846735 TI - Intraventricular and subependymal haemorrhage in infants dying within 10 hours of birth. AB - A group of 103 infants was studied who were appropriate for gestational age (AGA), born at less than 36 weeks gestation, and died within 10 hours of birth. Intraventricular haemorrhage (IVH) had occurred in about one quarter of the extremely small, premature infants (28 weeks) within 5 hours of birth, but was rare in infants greater than 28 weeks gestation. The incidence of subependymal haemorrhage (SEH) was relatively high in babies who died within 5 hours of birth but IVH was more common in those who lived more than 5 hours. There was no relationship between the clinical events studied and the presence of IVH or SEH in the whole group of cases dying within 10 hours of birth, but the babies who died by 5 hours after birth had a high incidence of breech delivery and very low Apgar scores. PMID- 6846736 TI - Humoral and cell-mediated immune responses to dog dander and hair in asthmatic children. AB - Dog dander and hair (DDH) specific IgA and IgG antibodies from serum samples of 202 asthmatic children aged from 4 to 15 years were measured by enzyme-linked immunosorbent assay. The results were compared with clinical history, and with allergy tests (skin prick test, provocation test and RAST) using the same DDH extract. A blood sample for the in vitro lymphocyte stimulation test was obtained from 40 children, and a nasal secretion sample for analysis of the local DDH specific IgA, IgG and IgE antibody levels was collected from 35 of them. In children of dog-keeping families, higher serum levels of DDH-specific antibodies, especially IgE antibodies, were observed if the dog had been in the home already during the first years of the child's life. The serum levels of DDH-specific antibodies, however, did not correlate with the degree of the present exposure to dogs. The serum levels of DDH-specific IgA and IgG antibodies did not correlate with each other, with the levels of specific or total IgE, or with the results of skin prick or provocation test. The serum levels of DDH-specific IgA were highest in children who were subjectively most sensitive to dogs. Nasal levels of DDH specific IgE correlated positively with serum specific IgE levels. The correlation was weaker between nasal and serum titers of specific IgG, and not significant between nasal and serum IgA antibody levels. Specific IgE antibody levels were higher, while specific IgA and IgG antibody levels were lower, in nasal secretion from subjects with nasal symptoms on contact with dogs, when compared with subjects with other complaints (asthma, conjunctival or skin reactions). DDH-specific IgG levels correlated negatively with specific IgE level in the nasal secretion from subjects with a positive provocation test result, while the correlation was positive in subjects with a negative provocation test. The in vitro lymphocyte responses to DDH did not correlate with the results of allergy tests, or with the levels of DDH-specific antibodies in serum or in nasal secretion. PMID- 6846737 TI - Immunoglobulin E and immunoglobulin G4 antibodies to cow's milk in children with cow's milk allergy. AB - The presence of cow's milk specific antibodies of immunoglobulin E and G4 classes were studied in 47 children with a positive clinical history of cow's milk allergy. The children were challenged with cow's milk orally. The clinical diagnosis was verified by immediate reactions in 25 patients while 22 had late reactions or were provocation test negative in spite of the clinical history. There was no relation between levels of cow's milk specific IgG4 antibodies and provocation test results, i.e. neither with immediate or late reactions. Total IgE was elevated above +1 SD for age in 31 of 41 tested patients. Of these, 29 had immediate type reactions to cow's milk, wheat flour and/or egg white, while only two of 10 children with IgE of less than +1 SD had a demonstrable allergy to any of these foods. The sensitivity of the total IgE determinations for the diagnosis of food allergy was 94% and the specificity was 80%. Specific IgE antibodies to cow's milk were demonstrated in 11 of 14 children with immediate reactions and in three of 15 who were provocation test negative or had only late reactions. This means a sensitivity of 79% and a specificity of 80%. At least one of the four patients with specific IgE but negative provocation test results had earlier shown an immediate reaction when challenged with cow's milk, indicating that the specific IgE antibodies were not truly "false" positive reactions but a consequence of previous allergy. Our results confirm an association between elevated total serum IgE and food allergy and an association between positive RAST to cow's milk and positive provocations in young children. We did not find any evidence for specific IgG4 antibodies playing a role in these patients. PMID- 6846738 TI - Effect of topical glucocorticoid treatment on nasal mucosal mast cells in allergic rhinitis. AB - Glucocorticoids were previously considered not to affect the immediate allergic reaction. However, in a nasal allergen challenge, an inhibitory effect on the nasal symptoms induced at the challenge has been shown to occur in patients treated with a recently developed glucocorticoid, budesonide, for 1 week prior to the challenge. This treatment was also found to reduce tissue histamine levels in the nasal mucosa. Mast cells in the mucosa were therefore studied with a view to finding out whether this reduction could be due to a reduction of mast cells. A double-blind study was performed in 14 asymptomatic patients. Nasal biopsies were made before and after 1 week's treatment with either budesonide or placebo. The number of mast cells was counted in two Epon sections after the specimens had undergone specific staining with toluidine blue. No quantitative or qualitative morphological changes in the mast cells were found as a result of treatment. PMID- 6846739 TI - A clinical and immunological study of allergy to hen's egg white. V. Purification and identification of a major allergen (antigen 22) in hen's egg white. AB - Antigen 22 (ag-22) in hen's egg white, previously shown to be one of the major allergens in the egg white, was partially purified by combining biochemical separation techniques and quantitative immunoelectrophoretic methods. The molecular weight of ag-22 was found to be approximately 78,000 using analytical ultracentrifugation and pI was determined to be 6.1, which is appropriate with the values of ovotransferrin. It was concluded that ag-22 is identical with ovotransferrin. The ability of ovotransferrin to react in the human IgE-system was demonstrated in vivo and in vitro, by means of skin prick tests and crossed radioimmunoelectrophoresis. PMID- 6846740 TI - C1 INH concentrate in the therapy of hereditary angioedema. PMID- 6846741 TI - House-dust mites and absolute indoor humidity. AB - The concentration of house-dust mites (Dermatophagoides spp.) was investigated for four seasons in three locations in each of 50 Danish apartments. Simultaneously the absolute humidity was recorded and the previously known correlation between mite counts and indoor humidity was confirmed. It appeared, however, that apartments which had a low absolute indoor humidity in the winter period (due to low household load of water vapour) did not contain noticeable concentrations of house-dust mites in the summer and autumn despite the fact that the indoor absolute humidity in these apartments could be high enough to allow for a high peak-population of mites. Because of this it is suggested that in a temperate climate avoidance measures against house-dust mites should be supplemented at least by a drying out period in the winter, when this process is convenient to perform because of the low outdoor absolute humidity. PMID- 6846743 TI - Allergy to apple, carrot and potato in children with birch pollen allergy. AB - Skin sensitivity to apple, carrot and potato, clinically related to birch pollinosis was investigated. Different skin test techniques using fresh fruit were compared. A simple prick test (SPT) technique with a lancet piercing the apple peel just before pricking the skin was shown to be the most practical and to give reproducible results. The allergenic activity in apple was found to be heat labile and deteriorated during storage at room temperature. Apple, carrot, potato, hazelnut and birch reactivity was transferable in Prausnitz-Kustner test like IgE antibodies. SPT reactivity to fresh material from apple, carrot and potato was investigated in 174 children of whom 128 suffered from pollen allergy. Positive SPT results were obtained almost exclusively in children who were SPT positive to a birch pollen extract. Children who noticed clinical symptoms when eating apple, raw carrot or potato were found to have a significantly larger SPT reaction than children with a negative history. PMID- 6846742 TI - Buckwheat allergy: health food, an inhalation health risk. AB - Thirteen out of 28 persons (14 men and 14 women) employed in a company which imports, prepares and distributes plant products used in spices and as ingredients in so-called health food, had developed work-related symptoms in the form of rhinitis, conjunctivitis, asthma, itch or urticaria. The symptoms occurred in connection with specific work operations, especially in the grinding and packaging of buckwheat. Seven out of 25 examined persons (28%) had at least one positive allergy test (prick test or RAST) against buckwheat. Furthermore, one person had positive RAST against extract from castor-oil bean. The correlation between positive allergy tests and work-related symptoms is significant. Fourteen persons were also patch tested. All were negative except one person who had a positive patch test against nickel. The nickel allergy was diagnosed before this study was done and had no relation to the work. The levels of airborne dust in the breathing zones of the workers when they performed dust forming work were around and below 5 mg/m3. When buckwheat flour was packaged, the airborne dust levels were about 1-2 mg/m3. Thus, exposure to comparatively low levels of buckwheat dust may induce a definite risk of rapidly ensuing allergy. It is also obvious that persons without atopic stigmata, such as an earlier history of allergy or the occurrence of allergic diseases in relatives, risk becoming allergic. A conclusion is that health food could be a danger, when it is inhaled. PMID- 6846744 TI - An automated particle counting immunoassay (PACIA) for determination of blocking antibodies against timothy grass pollen in sera from desensitized allergics. AB - An automated particle counting immunoassay (PACIA) for measurement of blocking antibodies (antigen neutralizing capacity) against timothy grass pollen extract in sera from desensitized allergics is described. Latex particles coated with F(ab')2-anti-timothy are agglutinated by timothy. Serum containing anti-timothy antibodies inhibits the agglutination. Non-agglutinated particles are counted in a modified AutoCounter. Nineteen of 20 sera from timothy allergics who had undergone immunotherapy with purified timothy extract for 30 weeks, showed significant agglutination-inhibition. None of 42 normal human sera gave significant inhibition. The inhibiting antibody could be removed by absorption with protein A and was thus of non-IgE nature, i.e. blocking antibody. The results obtained correlated statistically significantly with those found with a double-antibody method (rS = 0.62, n = 20, t = 3.35, P less than 0.01) and with the cumulated dosage of timothy allergen extract administered to the individual patient (rS = 0.56, n = 20, t = 2.87, P less than 0.02). Between-assay coefficient of variation was from 6.4% to 18.3%. The capacity is 40 samples per hour. The method has also been applied to measurement of blocking antibodies to honey bee and wasp venom. PMID- 6846745 TI - Determination of specific IgG antibody by crossed radioimmunoelectrophoresis. PMID- 6846746 TI - Nasal inhalation as a cause of inefficient pulmonal aerosol inhalation technique in children. AB - In order to evaluate whether children can be taught the efficient use of a pressurized terbutaline aerosol with a tube spacer 71 children were given careful instruction in aerosol inhalation technique according to the manufacturer's instructions. Inhalation technique was assessed as being efficient when a child achieved an increase of more than 19% in FEV1 10 min after taking two puffs of terbutaline (each puff = 0.25 mg). After instruction about 37% of children aged 5 7 years and about 80% of children over 7 years were efficient in inhalation technique. Inhalation through the nose after actuation into the mouth accounted for about 50% of treatment failures, with the problem being more frequent in the younger age group. When this error was corrected about 83% of the children were efficient in the technique. Coordination problems and too rapid inspiration after actuation were also common errors. The findings stress the importance of checking all children's inhalation technique before prescribing inhalation therapy. Careful instruction was not enough. The possibility of nasal inhaling should be borne in mind when looking for causes of treatment failure. PMID- 6846747 TI - Death caused by wasp and bee stings in Denmark 1960-1980. AB - During a 21-year period in Denmark a total of 26 deaths were caused by wasp or bee stings (according to the National Health Service). The deaths might be classified, with some overlapping, as caused by either anaphylactic/anaphylactoid shocks (between 65% and 80%), suffocation after stings in the airways (about 15%) or preexisting diseases, especially arteriosclerotic heart disease (approx. 20%). Characteristically, in most persons with shock reactions unconsciousness and death occurred very shortly after the sting (within 45 min), while the interval between sting and death was longer (30 min to a couple of hours) when death was caused by suffocation. In more than 21 of the 26 cases it seemed reasonable to assume that insect allergy might have contributed to the fatal outcome. Six of these cases had a previous history of abnormal reactions to insect venom, thus only a small group would have benefited from the prophylactic effect of hyposensitisation. There was no known previous history of reactions to insect stings in the other cases, but it is likely that more than six persons had had severe reactions to insect stings on other occasions. Presumably many deaths where insect stings have been involved--through not verified as causal--are classified as inexplicable or accidental, thus the real number of deaths caused by wasp or bee stings could be substantially greater. Consequently hyposensitisation after severe insect sting reactions of verified allergic genesis can still be advised. PMID- 6846749 TI - MMEF or FEV1 in estimating bronchial obstruction in asthmatic children. AB - In this study the maximal mid-expiratory flow (MMEF) was compared with forced expiratory volume in 1 sec (FEV1) by a spirometric investigation of healthy children and children with slight bronchial obstruction. We found that the reproducibility of MMEF was good in both healthy and asthmatic children and that both methods had the same ability to detect abnormality before inhalation of a beta 2-receptor agonist. After such an inhalation the discriminatory power was greater for FEV1 than for MMEF and we therefore prefer FEV1 in estimating bronchial obstruction in children. PMID- 6846748 TI - Reaction to intradermally applied phytohaemagglutinin in asthma patients in relation to corticosteroid therapy. AB - Phytohaemagglutinin (PHA) skin test (diameter of induration 24 h following intradermal injection of 1.0 microgram purified PHA) was carried out on 23 patients with exacerbated atopic asthma and 28 patients with exacerbated non atopic asthma. Preselected adult patients had either not previously been treated with systemic corticosteroids or steroid therapy had been suspended for at least 3 months. Nearly all non-atopic asthma patients and patients with atopic asthma previously treated with corticosteroids showed increased reactions to PHA. Patients with atopic asthma not earlier treated with corticosteroids demonstrated normal responses. None of the asthmatics showed a negative PHA reaction. Administration of single depot doses of corticosteroids produced decreased reactivity to PHA in nearly all patients. These results suggest that neither atopic nor non-atopic asthma is in itself associated with impaired PHA skin reactivity but that changes in this reactivity are largely due to the corticosteroid therapy administered to these patients. In relation to PHA reactivity certain effects of this therapy may persist for as long as 3 months after its cessation. PMID- 6846750 TI - Effects of dietary tryptophan restrictions on clinical symptoms in patients with endogenous asthma. PMID- 6846752 TI - [Preventive measures before a difficult intubation]. AB - Difficult intubations occur frequently. Unfortunately they cannot always be recognized before intubating. This paper describes the most important prophylactical measures which can prevent risks during intubation. These are: examination (morphology, mobilization of the joints, laryngoscopy), optimal positioning of the patient, aspiration prophylaxis, choice and preparation of equipment and drugs, the repeated question of necessity of intubation, the oxygen supply and the attempt to ventilate the patient before giving muscle relaxants. Particularly the last two measures are of great importance in the majority of cases. PMID- 6846751 TI - [Cause of pulmonary disorder following sclerosing therapy]. AB - In order to elucidate pulmonary changes after sclerotherapy of esophageal varices animal experiments were performed. Polidocanol was injected into the submucosa of the distal esophagus and into a branch of the pulmonary artery. The submucous infiltration of the lower esophagus often causes congestive pulmonary alterations near the injection area. The subsequent disturbances of gas exchange as well as the negative inotropic effect of Polidocanol demands therapy in a number of cases. PMID- 6846753 TI - [Muscle biopsy studies in malignant hyperthermia]. AB - Muscle biopsies were carried out in 41 patients with malignant hyperthermia, or supposed at-risk, as well as in some of their relatives. In 20 patients no changes were detected, and in 2 patients only acute rhabdomyolysis was seen (53.7%); in 19 patients (that is 46.3%) myopathic aspects were found in form of minimal changes, but also of syndrome-like tissue alterations (e.g. core disease, muscle dystrophy). These results confirm the existence of a morphologically detectable "subclinical myopathy" in about half of our patients. Four cases apt to demonstrate the variability, and the large morphological spectrum of these "myopathies" within the same family are described. In children, morphological changes are often missing. Carriers of such "subclinical myopathies" are occurring probably more frequently than supposed. Their identification in time is difficult, the only reliable methods being pharmacological fiber contraction tests which can be performed in special laboratories only. A raw screening of patients-at-risk may be, however, achieved by exact anamnestic investigations and preoperative CPK-controls. Individuals suffering from paroxysmal myoglobinuria at any rate have to be considered patients at-risk. PMID- 6846754 TI - [New aspects of cardio-pulmonary resuscitation with particular emphasis on brain protection]. AB - Recent advances in modern technology of resuscitation aim at improving conditions for the survival of the hypoxaemic and ischaemic damaged brain. In this paper we briefly outline the historical development of resuscitation and summarize the new efforts to favourably coordinate the support of respiration and external cardiac compression. Besides the possibility to apply drugs intratracheally is mentioned, and the influence of the technique of CPR and pharmacologic measures for the protection and resuscitation of the brain are considered. PMID- 6846755 TI - [Hemoconcentration caused by excessive intraoperative ascites production in ulcer bleeding]. AB - The estimation of the intraoperative fluid requirements can be particularly difficult in patients with compartmental disturbances, e.g. hepatic cirrhosis. The case history of a 41 year old female with a known history of liver cirrhosis is reported who underwent emergency surgery due to upper gastro-intestinal bleeding. In order to maintain hemodynamic stability preoperative blood loss was replaced with fresh blood. During the operation 4 liters of bank and fresh blood with 5 liters of erythrocyte-free fluids were administered. After operation reliable clinical signs of hypovolemia and a marked increase in hematocrit were noted. The severe hemoconcentration was explained by excessive fluid shifts away from the intravascular compartment since a total amount of 10 liters of ascites was collected for the next 24 hours. This overproduction can be related to portal hypertension, hypoalbuminemia and activation of the renin-angiotensin-aldosterone system. PMID- 6846756 TI - [On-line acquisition of haemodynamic and respiratory data during anaesthesia]. AB - A system is presented which in connection with monitors commonly used affords high resolution control of pulmonary mechanics, respiratory and haemodynamic parameters during surgery. Extent of monitoring as well as choice of the parameters to be monitored is not determined by the system but by the physician concerned. The essential part of the system is a microprocessor in control of all monitors connected, which can store the accumulated data for a 24 hour period. On application in over 200 anaesthetics acceptance by the user was good. Because of the still rather complicated technical procedure use of the system during minor surgery proved to be difficult. PMID- 6846757 TI - [Evaluation of a new apparatus for determining sodium and potassium via ion selective electrodes]. AB - Evaluation of an apparatus for the direct measurement of sodium and potassium by means of ion-selective electrodes yielded very good results. This apparatus is notable for excellent linearity. It possesses a low detection threshold, the lowest identification limit being 4.43 mmol./l. for sodium and 0.21 mmol./l. for potassium. The sensitivity is high, since it is approximately 1.5 mmol./l. for sodium in whole blood and approximately 0.15 mmol./l. for potassium. On checking the accuracy of the instrument, a mean recovery of 100% was seen for both electrolytes. An examination of the precision of the instrument yielded, in serial determinations of sodium, variation coefficients between 0.2 and 0.4%, and in case of potassium, variation coefficients around 1%; even in respect of day-to day precision, all variation coefficients were definitely below 5%. Hence, the overall precision of the apparatus can be rated as good. However, when using whole blood samples anticoagulated with sodium heparinate solution, it is necessary to take the dilution effect into account when arriving at the potassium value. PMID- 6846758 TI - [Filter attachment]. AB - The filter attachment enables rapid and continuous transfusion of stored erythrocytes and of stored whole blood. This attachment is used both with a microfilter and a largepore transfusion device. The filter attachment enables bloodless preparation of the transfusion. The blood volume previously remaining in the microfilter, can now be transfused completely. PMID- 6846759 TI - [A new plastic-bag transfusion set for dilution of erythrocyte concentrates]. AB - A new transfusion set which contains 100 ml of 0.9% sodium chloride solution to resuspend packed red blood cells is described. The advantages of the system are- the technique is simple and hygienic, it contains an optimal quantity of suspension solution, and there is no danger of air embolus occurring. The rheologic properties of the then diluted red cell concentrates are very good, and allow for a mass transfusion. This new system affords the wider use of packed red blood cells, and it will probably contribute to the abolition of the practically obsolete transfusion of whole blood even for surgical patients. PMID- 6846760 TI - [Experiences with the steroid narcotic alfaxalone/alfadolone (Aurantex) in emergency patients in rescue service]. AB - Prehospital emergency patients, especially with polytrauma and/or severe head injury need sedation for intubation and transportation. The use of relaxant drugs is dangerous under these circumstances. The "ideal drug" for this indication should not have any harmful effects on respiration, circulation, intracranial pressure, and should facilitate intubation. Short action without cumulation is desirable to make an early neurological diagnosis possible. Althesin was studied in our rescue service (ambulance and helicopter) in 133 cases (trauma n = 91, neurologic n = 18, cardiologic n = 12, intoxication n = 12), Althesin facilitated intubation in 129 cases, and was generally sufficient for sedation. Negative side effects were not seen provided althesin was correctly used. The necessity of the preceding use of an antihistaminic drug is emphasized. Althesin should not be used in patients suffering from severe cardiac disease because of its possible negative influence on cardiocirculatory function. PMID- 6846761 TI - Quality assurance in anaesthesia. PMID- 6846763 TI - Epidural analgesia and previous Caesarean section. AB - A series in which six cases of ruptured uterus occurred following previous lower segment Caesarean section, out of a total of 222 'trials of scar', is presented, and the literature reviewed in an attempt to clarify the term 'relative contra indication' as applied to this clinical circumstance. The symptoms and signs of ruptured uterus likely to be blocked by an epidural, i.e. maternal tachycardia, scar tenderness and continuous lower abdominal pain, have been shown to be either unreliable (tachycardia and tenderness) or frequently not to occur at all (pain). When pain does occur it is not necessarily masked by an epidural. It is concluded that previous lower segment Caesarean section is not a contraindication to epidural analgesia in a subsequent labour provided certain conditions are fulfilled. PMID- 6846762 TI - Cardiac output and the recumbent position in late pregnancy. AB - Changes in cardiac output were measured by transcutaneous aortovelography in 30 pregnant patients and in 30 control subjects with change of position from the supine. When compared to the supine position, the left and right lateral and left 15 degrees tilt positions caused statistically significant increases in cardiac output, whereas the right 15 degrees tilt position did not. Neither fetal head engagement nor the time spent in each position had significant effects on the changes in cardiac output. It was not possible to identify a subgroup of pregnant patients who were particularly sensitive to changes in posture. PMID- 6846764 TI - Failed intubation in congenital tracheal stenosis. PMID- 6846765 TI - Postnatal paraparesis following epidural analgesia and forceps delivery. PMID- 6846766 TI - Bicornuate uterus and aortocaval compression. AB - A severe case of supine hypotensive syndrome associated with a bicornuate uterus is presented. It is suggested that failure of left lateral tilt to prevent the syndrome was associated with anatomical displacement of the uterus to the right. The importance of trying right lateral tilt, if response to left tilt is poor, is noted. PMID- 6846767 TI - Internal jugular catheterisation in small children. The use of a posterior approach. AB - Internal jugular catheterisation, using a posterior approach, was attempted in 50 infants and children aged from 1 day to 12 years, weighing 1.25 to 30 kg. Thirty five of the patients weighed less than 10 kg. Catheterisation was successful in 49 cases. Initial catheter position was satisfactory in 48 of the 49 cases and satisfactory pressure waveform and flow characteristics were achieved in all 49 cases. There were no complications attributable to the technique. The technique proved reliable and easily learnt and is recommended as a particularly suitable approach to central venous catheterisation in small children. PMID- 6846768 TI - The effect of 50% nitrous oxide in oxygen on lower oesophageal sphincter tone. AB - The effect of 50% nitrous oxide on the lower oesophageal sphincter was studied in eight healthy volunteers. No effect on the sphincter tone was noted in these subjects. The importance of this finding is discussed in relation to the depressant effects of nitrous oxide and other anaesthetic or sedative drugs on the reflex protective mechanisms safeguarding the respiratory tract and lungs from aspiration of acid gastric content and other foreign matter. PMID- 6846769 TI - Anaesthesia for transthoracic electrocoagulation. PMID- 6846770 TI - BOC Boyle M anaesthetic machine-a modification. PMID- 6846772 TI - More trouble with Bier's block. PMID- 6846771 TI - Airway obstruction after surgery in the neck. PMID- 6846773 TI - Anaesthesia for a patient with familial dysautonomia. PMID- 6846774 TI - Scoliosis correction and epidural anaesthesia. PMID- 6846775 TI - An unfortunate incident with etomidate. PMID- 6846776 TI - Postextubation laryngospasm. PMID- 6846779 TI - [Successful alleviation of migraine pain with short ceruletide infusion]. AB - Three patients with refractory migraine attacks were given Ceruletide in short intravenous infusions of 2 ng/kg/min. In all cases a substantial pain decline was achieved, in two cases the pain disappeared completely. It would be an improvement from the pharmacological point of view if migraine could be arrested by a peptide that can be easily regulated, due to its short half-life-time. PMID- 6846778 TI - [Heterogeneity of therapeutically-used human albumin preparations]. AB - 29 human albumin solutions commercially available in Germany were analyzed. Results for total protein vary between 86,25% and 102.40% of the declared value. Values for monomer albumin are between 74.19% and 91.81% of the declared value for total protein (test method: discontinuous polyacrylamide gel electrophoresis). With an sodium content, there are also various differences in quality in missing or wrong declarations of the electrolytes. PMID- 6846780 TI - [Dependence of the inspiratory halothane concentration in a closed system on the level of fresh gas flow]. PMID- 6846777 TI - [Controlled hypotension with metoprolol and sodium nitroprusside]. PMID- 6846781 TI - [High frequency pulsation (HFP) enabling tracheo-broncheal suctioning without interrupting mechanical ventilation]. AB - A new technique of tracheo-broncheal suctioning is presented which enables constant artificial ventilation with high frequency pulsation (HFP), a modification of high frequency ventilation. Beyond that the high frequency pulsation method permits ventilation of the patient with adjusted end-expiratory pressure. This technique prevents the decrease of arterial oxygen pressure which is usually seen in patients who are disconnected for some time from the respirator as well as during the suction procedure and during periods of decreased end-expiratory pressures. PMID- 6846782 TI - [Buprenorphine as a postoperative analgesic following halothane anesthesia. Hemodynamic and respiratory effects]. AB - In 10 healthy patients, buprenorphine was given as the postoperative analgesic (dosage: peripheral venous injection of 5 microgram/kg BW) after traumatological interventions in the lower extremities, which had been performed under barbiturate-induced halothane anaesthesia. The haemodynamic investigations revealed that buprenorphine has only a minor effect on the high pressure system. In the area of the pulmonary circulation, there was a significant increase in mean pulmonary artery pressure from 15.9 mm Hg to 17.8 mm Hg (+12%), as well as an increase in pulmonary vascular resistance by 16.5%. These changes were most marked 30 to 60 min after the administration of buprenorphine. When 2-3 1 O2/min were administered, none of the patients had PaO2 values of less than 100 mm Hg. 60 min after the injection, the PaCO2 value increased from 33.7 mm Hg to a maximum of 43.9 mm Hg. In 3 patients, PaCO2 increased to more than 45 mm Hg. All patients with greater increases of PaCO2 also evidenced greater increases in the pulmonary vascular resistance. Altogether the haemodynamic changes after buprenorphine administration following halothane anesthesia were not very distinct. In individual cases, however, there were greater increases in PaCO2. The cause of this could involve the additive effects of premedication and anaesthesia medication, and possibly the pain level as well. Both the increase in pulmonary artery pressure and the increase in total pulmonary vascular resistance in these patients were due to hypercapnia (von Euler-Liljestrand mechanism). PMID- 6846783 TI - [Metabolism of halothane in rats with CCl4-alcohol-induced liver fibrosis]. AB - Rats treated with carbon tetrachloride (CCl4, twice weekly 0.2 ml/kg p.o.) and a 5% ethanol solution instead of drinking water developed a marked fibrosis and steatosis of the liver within 4 weeks. Fibrosis was evidenced by a 7-fold increase in the hepatic hydroxyproline content and steatosis by a 3-fold increase in the triglyceride content. Exposing these rats to a non-narcotic concentration of halothane (100 ppm) in a closed system the metabolic removal of the anesthetic from the atmosphere of the system was measured. In control rats treated with olive oil and water the elimination half-life for halothane amounted to 0,78 (0,69-0.88) h (confidence limits for p = 0.95). In rats with CCl4-ethanol-induced liver fibrosis and steatosis this elimination half-life was prolonged to 1.24 (1.07-1.41) h indicating an impaired metabolic degradation of halothane in these rats. PMID- 6846784 TI - [Is postoperative respiratory depression associated with tramadol infusion anesthesia?]. PMID- 6846785 TI - [Is the circulatory stimulating effect of dopamine independent of metabolic acidosis?]. PMID- 6846786 TI - [Metabolic consequences of maternal hyperventilation in obstetric anesthesia]. PMID- 6846787 TI - The measurement of the kinetics of lipid phase transitions: a volume-perturbation kinetic calorimeter. AB - A volume-perturbation kinetic calorimeter to be used to study membrane phase transitions in lipid vesicles has been developed. In this instrument, the voltage dependent extension of a stack of piezoelectric crystals is used to force the solution being studied to undergo a small adiabatic bidirectional volume change. This volume change induces a shift in the equilibrium position of the lipid gel to liquid-crystalline transition. The time course of the relaxation to the new equilibrium position is then monitored by observing the induced temperature and pressure changes as a function of time. PMID- 6846788 TI - Recognition by two-dimensional thin-layer chromatography and densitometric quantification of alkali-labile gangliosides from the brain of different animals. AB - A simple method for recognition and quantification of alkali-labile gangliosides is described. The method was worked out using authentic alkali-labile gangliosides in pure form (9-O-Ac-GT1b; 9-O-Ac-GQ 1b; lactone form of GD 1b) and applied to ganglioside mixtures from the brain of mouse, rat, rabbit, pig, and pigeon. The method consists of two-dimensional thin-layer chromatography on silica gel high-performance thin-layer chromatography plates employing the same solvent, chloroform/methanol/0.2% aqueous CaCl2, 50/40/10, for both runs. Prior to the second run the plate is exposed at room temperature for 5 h to ammonia vapors in order to split alkali-labile linkages. At the end of chromatography alkali-stable gangliosides appear lined along a diagonal starting from the origin; the spots corresponding to alkali-labile gangliosides lie out of the diagonal and can be individually detected and quantified on the basis of their sialic acid content. Up to 15 different spots, corresponding to as many alkali labile gangliosides, can be recognized by this procedure. PMID- 6846789 TI - alpha-N-acetyl-beta-endorphin1-26 from the neurointermediary lobe of the rat pituitary: isolation, purification, and characterization by high-performance liquid chromatography. AB - The neurointermediary lobes from 190 rat pituitaries were homogenized in an acidic medium which inhibits peptidase activity and maximizes the solubilization of undamaged peptides. Octadecylsilyl-silica (ODS-silica) was used to extract the supernatant of the tissue homogenate. The ODS-silica eluate, now largely protein and salt free, was subjected to reversed-phase high-performance liquid chromatography (HPLC) employing 0.1% trifluoroacetic as counter ion. The column eluates were monitored for beta-endorphin immunoreactivity. Five immunoreactive components were observed. The most hydrophobic of these was repurified on the same HPLC column using 0.13% heptafluorobutyric acid as counter ion. Characterization of the purified peptide by gel permeation HPLC, amino acid analysis, and tryptic fragmentation indicated that it corresponded in structure to alpha-N-acetyl-beta-endorphin1-26. Amino acid analysis of the native peptide and its trypsin and carboxypeptidase fragments indicated that an alanyl residue occupies position 26. This finding is in contrast to the sequence predicted for the beta-lipotropin/corticotropin precursor by recombinant DNA techniques which suggests that the 26th residue of the beta-endorphin molecule should be valine. PMID- 6846790 TI - A novel method for quantitation of favism-inducing agents in legumes. AB - A new method for the quantitation of the favism-inducing agents in legumes is described. The procedure involves differential extraction of the glucosides vicine and convicine with acetic acid (25%), followed by an enzymatic hydrolysis by beta-glucosidase under anaerobic conditions. Each of the aglycone moieties, isouramil and divicine, anaerobically reduces two molecules of o ferriphenanthroline to o-ferrophenanthroline. This reaction is readily followed spectrophotometrically at 515 nm. Using this procedure, it was found that in various strains of Vicia faba, the level of these two glucosides comprises approximately 0.5% of the wet weight of the seeds. In contrast, these glucosides could not be detected in either green peas or chick peas. PMID- 6846792 TI - Correcting a potential defect in an enzymatic cycle for NADP. AB - An enzymatic cycle for NADP which uses as one of its enzymes glucose-6-phosphate dehydrogenase from Leuconostoc mesenteroides has occasionally caused trouble due to failure to completely heat-kill this enzyme before the indicator step. It was found that a very small increase in pH was the cause of this. It was also found that the other two proteins present in the reagent greatly increase heat inactivation of the enzyme. The inactivation problem is completely overcome by keeping the pH below 7.2. PMID- 6846791 TI - An NADH-coupled assay for femtogram or nanogram quantities of chymotrypsin. AB - Chymotrypsin can be determined with an NADH-coupled assay. Hydrolysis of the substrate benzoyltyrosine ethyl ester is monitored by coupling the liberation of ethanol to the production of NADH and determining the NADH spectrophotometrically or fluorometrically. Nanogram quantities of chymotrypsin can be determined in milliliter volumes. With these microfluorescence methods this assay can be performed in a final volume of less than a nanoliter, allowing determination of femtogram quantities of chymotrypsin, the amount present in an individual zymogen granule. PMID- 6846793 TI - Photochemical action spectra of CO-liganded terminal oxidases using a liquid dye laser. AB - A method of obtaining photochemical action spectra for the relief of CO inhibition of respiration is described. Continuous readout from a membrane covered oxygen electrode of dissolved oxygen in a stirred suspension of microorganisms under CO-oxygen gas mixtures in an open reactor enables measurement of increased respiration on illumination. Advantages presented by the use of a liquid dye laser include high intensity of emission and narrow spectral bandwidth; just two dyes (rhodamine 6G and rhodamine 110) are required to match the alpha-absorption maxima of the CO complexes of all known bacterial and mitochondrial terminal oxidases. PMID- 6846794 TI - Isolation of bovine seminal ribonuclease by affinity chromatography. PMID- 6846796 TI - Determination of malonaldehyde in biological materials by high-pressure liquid chromatography. AB - An HPLC method is described for the determination of malonaldehyde in biological materials. The procedure involves extracting the sample with trichloracetic acid, heating the extract with thiobarbituric acid, separating the thiobarbituric acid malonaldehyde complex on a mu Bondapak C18 column, and measuring the absorbance using a 546-nm interference filter. The method was found to be specific for malonaldehyde in several food and feed samples. Under routine assay conditions, a coefficient of variability of 7.0% was obtained for samples containing 1-2 microgram of malonaldehyde per gram (instrument detection limit 1 ng). This procedure yields lower values for the concentration of malonaldehyde in food samples than the conventional spectrophotometric procedure based on absorbance of the thiobarbituric acid-malonaldehyde complex at 532 nm. PMID- 6846797 TI - A simple method for the quantitation of glycuronic acid-containing glycosaminoglycans with mucopolysaccharidases. AB - A simple method for the quantitative determination of glycuronic acid-containing glycosaminoglycans (UA-GAG) is described. Sample solutions of glycosaminoglycans were digested with chondroitinase AC, chondroitinase C, chondroitinase B, heparitinases, and Streptomyces hyaluronidase, respectively, and the absorbance was read at 232 nm after digestion. The contents of 4-O-sulfated N acetylgalactosaminyl beta (1 leads to 4)D-glucosiduronyl units (Ch-4S), 6-O sulfated N-acetylgalactosaminyl beta (1 leads to 4)D-glucosiduronyl units (Ch-6S) plus N-acetylgalactosaminyl beta (1 leads to 4)D-glucosiduronyl units (Ch-OS), 4 O-sulfated N-acetylgalactosaminyl beta (1 leads to 4)L-idosiduronyl units (D-4S) plus N-acetylgalactosaminyl beta (1 leads to 4)L-idosiduronyl units (D-OS), heparan sulfate, and hyaluronic acid in the sample solutions were calculated from the absorbance with reference to that of the digestion products of known amounts of standard UA-GAG. The analytical data obtained with the mixtures of authentic UA-GAG were in close agreement with the theoretical values. Application of this procedure to the urinary GAG fractions from orthopedic patients gave satisfactory results. PMID- 6846795 TI - Buoyant densities of macromolecules, macromolecular complexes, and cell organelles in Nycodenz gradients. AB - Nycodenz is a new nonionic iodinated density gradient medium which has several advantages over metrizamide. Although, overall, biological samples band at similar densities in Nycodenz and metrizamide gradients, a number of significant differences were found. As compared with metrizamide, not only does Nycodenz appear to interact less with proteins but also the buoyant density of chromatin is less affected by the amount loaded onto the gradient. A high degree of resolution is obtainable using Nycodenz gradients; thus, it is possible to separate density-labeled DNA and to subfractionate subcellular membrane fractions. PMID- 6846799 TI - A rapid assay for DNA repair synthesis using neutral and alkaline sodium iodide gradients. AB - A modification to the method for estimation of repair DNA synthesis in cultured mammalian cells using density labeling which reduces the time and labor involved is described. Centrifugation times are reduced by using high-molecular-weight DNA which is loaded onto the top of a preformed sodium iodide gradient. Cerenkov counting is used to locate the region of the gradient containing light DNA for rebanding and likewise to identify appropriate fractions from alkaline gradients for acid precipitation for scintillation counting. The procedures give results indistinguishable from cesium chloride equilibrium gradients in a shorter time, with less effort, and at a lower cost. PMID- 6846798 TI - A new fluorescent tag for labeling of saccharides. AB - Potential aldehyde groups of N-acetylglucosamine and its di- and tri-saccharides were coupled with 7-amino-4-methylcoumarin (AMC) by reductive amination in the presence of sodium cyanoborohydride. The products were purified by silica gel chromatography. Acid hydrolysis and digestion with glycosidases gave the expected products. One picomole of the sugar-AMC complexes could be detected after thin layer chromatography by fluorescence under uv light. The sensitivity of the detection of the fluorescently labeled carbohydrates is comparable to that of NaB3H4 labeling. PMID- 6846801 TI - Properties of narrow-range ampholytes isolated from wide-range ampholyte preparations. AB - A simple procedure for obtaining useful narrow-pH-range ampholytes from inexpensive laboratory-synthesized ampholytes by preparative isoelectric focusing in Pevikon is described. The narrow-range ampholytes prepared in this way are comparable to commercial ampholyte preparations as judged by conductivity, buffer capacity, pH gradient formation, and resolving power. These inexpensive narrow range ampholytes are particularly well suited to preparative isoelectric focusing applications requiring large quantities of ampholytes. PMID- 6846800 TI - A microapparatus for liquid hydrogen fluoride solvolysis: sugar and amino sugar composition of Erysiphe graminis and Triticum aestivum cell walls. AB - The assembly and use of a simple and safe apparatus for HF solvolysis of microgram amounts of cell walls, polysaccharides, or glycoproteins are described. Using this apparatus the cell wall composition of Erysiphe graminis was compared with that of its wheat host. The HF solvolysis combined with TFA posthydrolysis considerably increased sugar yields compared with TFA hydrolysis alone, due mainly to increased yields of glucose from wheat, and glucosamine from Erysiphe, corresponding to cellulose and chitin, respectively. A potentially useful method for determining amounts of fungal hyphae in plant tissue is also provided. PMID- 6846802 TI - Turbidimetric determination of lysozyme with Micrococcus lysodeikticus cells: reexamination of reaction conditions. AB - Factors affecting the activity of human lysozyme (EC 3.2.1.17) toward cell suspensions of Micrococcus lysodeikticus were reexamined. Effects of substrate concentration, pH, and ionic strength and matrix effects of protein were assessed with special emphasis on the interdependence of various parameters. On the basis of these evaluations, an optimized kinetic turbidimetric method for lysozyme assay was set up. The method was applied for automation with a System Olli 3000 analyzer. The new automated lysozyme assay proved good for routine clinical use in regard to analysis speed, sensitivity, linearity, and reproducibility. Reference values for serum, urinary, and cerebrospinal fluid lysozyme were assessed with the automated method. PMID- 6846803 TI - A method for distinguishing Cu,Zn- and Mn-containing superoxide dismutases. AB - A procedure has been developed to distinguish between the two forms of eukaryotic superoxide dismutases using a common activity assay. Treatment of cellular fractions with 2% sodium dodecyl sulfate at 37 degrees C for 30 min selectively inactivates the mitochondrial, manganese-containing variant without affecting the cytosolic copper, zinc-superoxide dismutase. After removing excess sodium dodecyl sulfate by precipitation with potassium chloride, the supernate is assayed using the xanthine oxidase-cytochrome c method. PMID- 6846804 TI - Separation of unlabeled metabolites of arachidonic acid from their deuterium- and tritium-labeled analogs by argentation high-pressure liquid chromatography. AB - Deuterium- and tritium-labeled analogs of high isotopic purity are required for the analysis of metabolites of arachidonic acid (20:4) by mass spectrometry and radioimmunoassay. We prepared a number of 2H-labeled standards by incubating [5,6,8,9,11,12,14,15-2H]20:4 with soybean lipoxygenase, polymorphonuclear leukocytes, or homogenates of rat spleen or bovine lung. The unlabeled and 2H labeled forms of the following products were completely resolved by argentation high-pressure liquid chromatography: 20:4; 5-hydroxy-6,8,11,14-eicosatetraenoic acid (5h-20:4); 11h-20:4; 12h-20:4; 15h-20:4; 12-hydroxy-5,8,10-heptadecatrienoic acid; leukotriene B4; prostaglandin D2 (PGD2); and PGF2 alpha. The corresponding forms of PGE2 and thromboxane B2 were also separated, but not quite as well as the above compounds. Analysis by mass spectrometry indicated that the amounts of unlabeled material in approx 1:1 mixtures of unlabeled and 2H-labeled products could be reduced to 0.1% or less after two steps of argentation high-performance liquid chromatography. Metabolites of 20:4 labeled with tritium were also separated from their unlabeled counterparts and had retention times longer than those of the corresponding 2H-labeled analogs. PMID- 6846805 TI - An efficient method for the sequence analysis of oligodeoxyribonucleotides. AB - Modifications of the chemical method of DNA sequence analysis that permit rapid and reliable sequence determination of single-stranded oligodeoxyribonucleotides as short as 4 nucleotides in length are reported. The principal changes made were increasing the level of chemical modification and optimizing the conditions for recovery of the chemically modified oligodeoxyribonucleotides. This method includes two approaches to the removal of [gamma-32P]ATP from 32P-labeled oligodeoxyribonucleotides and is especially useful in the determination of the sequence of chemically synthesized oligodeoxyribonucleotides, which are generally between 4 and 20 nucleotides in length. PMID- 6846806 TI - Presence of formaldehyde in biological media and organic solvents: artifactual formation of tetrahydro-beta-carbolines. AB - A gas chromatography-mass spectrometry method is described for the identification and quantitation of 6-hydroxy-1,2,3,4-tetrahydro-beta-carboline (6OHTHBC). During the analysis of 6OHTHBC in human platelets, the artifactual formation of 6OHTHBC was observed and shown to be due to the presence of formaldehyde in both organic solvents and in platelet homogenates. Formaldehyde was facilely removed from the organic solvent via a Pictet-Spengler reaction; however, removal from tissue homogenates was not possible by using conventional aldehyde-trapping agents. The solution of these problems and their consequences for persons attempting to establish the in vivo presence of tetrahydro-beta-carbolines or biochemically study tissue preparations are discussed. PMID- 6846807 TI - A rapid affinity chromatography procedure for the isolation of glucose-6 phosphate dehydrogenase from human erythrocytes. PMID- 6846808 TI - Evidence for a single-chain structure of native human ceruloplasmin using sodium dodecyl sulfate-polyacrylamide-crossed immunoelectrophoresis. AB - A simple method is described for the analysis of proteins by sodium dodecyl sulfate-polyacrylamide gel electrophoresis combined with crossed immunoelectrophoresis. The technique allows the identification of specific proteins and estimation of their molecular weights after the electrophoresis of complex mixtures such as blood plasma. Human ceruloplasmin was estimated to have a molecular weight of 128,000 using this method. Reduction of plasma with 2 mercaptoethanol in the presence of protease inhibitors did not result in dissociation of ceruloplasmin into detectable smaller subunits, suggesting that native ceruloplasmin is composed of a single polypeptide chain. PMID- 6846809 TI - Synthesis and properties of fluorescent derivatives of atractyloside as potential probes of the mitochondrial ADP/ATP carrier protein. AB - The chemical synthesis of fluorescent derivatives of atractyloside (ATR), an inhibitor of the mitochondrial ADP/ATP carrier protein, is described. These derivatives are the following: 6'-O-dansyl ATR, 6'-O-dansyl-aminobutyryl ATR, and 6'-O-naphthoyl ATR. The spectral properties of these analogs were analyzed, and their biological features were compared to those of ATR. The fluorescence emission of the dansyl ATR derivatives was increased in organic solvents and that of naphthoyl ATR was decreased; for both analogs, solubilization in organic solvents resulted in a blue shift of the emission peak. The fluorescent dansyl and naphthoyl ATR derivatives were specifically recognized by the mitochondrial ADP/ATP carrier protein. Because of their spectral properties and their biochemical reactivities, the fluorescent analogs of ATR can be considered as potential probes to investigate the topography of the ADP/ATP carrier in the mitochondrial membrane and to monitor conformational changes of the ADP/ATP carrier protein associated with transport. PMID- 6846811 TI - Novel effective immunoadsorbents based on agarose-polyaldehyde microsphere beads: synthesis and affinity chromatography. AB - Agarose-polyaldehyde microsphere beads were produced by encapsulating polyacrolein microspheres or polyglutaraldehyde microspheres with agarose. Magnetic beads were formed by carrying out the encapsulation procedure in the presence of ferrofluidic particles. Proteins were bound covalently, at physiological pH, to the beads through their aldehyde groups to produce the Schiff base products. The conjugates, beads-proteins, were used successfully in affinity chromatography for specific purification of antibodies. Leaching of the proteins bound to the beads under physiological conditions and eluting conditions was not detected. The agarose-polyaldehyde microsphere beads are suggested as alternatives to the supports currently used in affinity chromatography. PMID- 6846810 TI - Preparation and properties of biologically active radioiodinated parathyroid hormone. AB - A constant-current microelectrolytic radioiodination method was used to label bovine parathyroid hormone (BPTH) with 125I to an overall iodination ratio of 1:1 iodide atoms per PTH molecule. Such iodinated preparations were shown to be fully active in several bioassay systems: in vitro adenylate cyclase activation in rat renal and skeletal membranes, in vitro calcium release from rat calvaria, and the in vivo hypercalcemic response in chickens. Analysis by Sephadex G-15 chromatography after enzymatic digestion showed the radioiodine to be incorporated predominantly as monoiodotyrosine. Bioassay of iodinated preparations from which uniodinated hormone had been removed by isoelectric focusing showed essentially full hormonal activity. Such methods can be used to consistently produce radioiodinated biologically active preparations of BPTH 1-84 with high specific activity (2000 Ci/mmol). PMID- 6846812 TI - Quantitative analysis of 11 alpha-hydroxy-9,15-dioxo-2,3,4,5,20-pentanor-19 carboxyprostanoic acid, the major urinary metabolite of E prostaglandins in man. AB - A system for the assay of the major metabolite of E prostaglandins (PGE-M) in human urine was developed. The metabolite, as the dimethyl ester-bis(O methyloxime)-trimethylsilyl ether derivative, was quantified by gas chromatography-mass spectrometry with selected ion monitoring. The internal standard was the diethyl ester analog. A linear response ratio over the range 10 to 300 ng of injected prostaglandin was demonstrated in calibrations with authentic material. The 20-ml specimens of urine were extracted with Amberlite XAD-2, methylated, chromatographed over octadecasilyl-silica, silicic acid, and Lipidex-5000, and then methoximated, trimethylsilylated, and instrumentally analyzed. The interassay coefficient of variation, for analysis of four identical urine specimens, was 11% and the intraassay coefficient of variation ranged from 1 to 5%. Specificity, accuracy, and precision of the method were verified by recovery of PGE-M from four different 80-ml urine pools. Each pool was divided into four equal portions, and different amounts of PGE-M were added to three. The recovery of authentic, underivatized PGE-M added to urine was 103.2 +/- 3.3% (mean +/- SE, N = 12). The plot of recovered versus added PGE-M followed the equation y = 1.003x + 1.83, with R = 0.9974. PMID- 6846813 TI - Separation of biotin and its analogs by high-performance liquid chromatography: convenient labeling for ultraviolet or fluorimetric detection. PMID- 6846814 TI - Rapid visualization of proteins in isoelectric focusing gels: isolation of brain tubulin subspecies. AB - A method for visualization of unmodified proteins in polyacrylamide isoelectric focusing (IEF) gels is described. The proteins appear as white, translucent bands when disc IEF gels are placed in water. The gel can be scanned with a scanning spectrophotometer, or the protein bands can be excised using a simple apparatus, which is described, and the protein eluted. The method is fast, selective for proteins, sensitive, and quantitative. It has been used to isolate tubulin species separated by as little as 0.5 mm in disc IEF gels. PMID- 6846815 TI - Conversion of a primary amine to a labeled secondary amine by the addition of phenolic group and radioiodination. AB - To preserve the nucleophilicity of amino compounds during conjugative radioiodination, a new method for converting primary amines to phenolic secondary amines was developed. Amino acids were used as model compounds for establishing optimal conditions for the reductive amination. In the first step of the reaction, the aldehyde group of 4-hydroxybenzaldehyde (formylphenol) was reacted reversibly with an amino group to form an imine. The irreversible attachment of formylphenol to the amino group was accomplished by reduction of the imine with sodium cyanoborohydride. The pH optimum for the reaction was 5.0. Higher temperature has favorable effects on the rate and extent of the conjugation. Phenolic derivatives of amino compounds suitable for radioiodination are produced by the reactions described. PMID- 6846816 TI - Chromatographic analysis of sugars in physiological fluids by postcolumn reaction with cuprammonium: a new and highly sensitive method. AB - A new highly sensitive method of high-performance liquid chromatographic analysis has been used to separate mono-, di-, and oligosaccharides present in jejunal aspirates from experimentally perfused animals. The sugars in the column eluant are detected at 280 to 310 nm after reaction with cuprammonium. No reaction coil is required between the column and uv detector because the reaction is virtually instantaneous. This technique is more sensitive than differential refractometry, so that it is possible to detect 2.5 nmol (450 ng) of glucose routinely, compared to a minimum detection limit of 100 nmol (18 micrograms) using a commercial refractive index detector. Using a suitable postcolumn pump, the technique is not sensitive to changes in solvent composition, as with gradient elution, and is applicable to analysis of other cis-cis glycols. PMID- 6846817 TI - Automated analysis of alditols by anion-exchange chromatography with photometric and fluorimetric postcolumn derivatization. AB - Eight alditols were separated in ca. 80 min as their borate complexes by stepwise elution with three borate buffers on a column packed with Hitachi 2633 resin. The alditols in the eluate were derivatized automatically to colored, fluorescent products by applying sequential reactions of periodate oxidation and Hantzsch condensation, and the products were detected either photometrically or fluorimetrically. This automated method allowed simultaneous determination of 20 500 and 20-200 nmol amounts of alditols by photometric and fluorimetric monitorings, respectively. The lower limits of detection were ca. 2 and 0.5 nmol, respectively. The interference by aldoses was slight. Aldoses may be also determined as alditols by direct injection of aqueous solutions to which excess amounts of sodium borohydride have been added. This method was applied with success to urinary alditol assay and to molecular weight determination by end group analysis. PMID- 6846818 TI - An improved gas chromatographic method for measuring glucosamine and muramic acid concentrations. AB - A method of simultaneously measuring glucosamine and muramic acid concentrations in marsh grass litter was developed. Spartina alterniflora samples were preextracted with acetone to remove lipids containing amino sugars and then hydrolyzed in 6 N HCl (100 degrees C, 4.5 h). Amino sugars in the hydrolysates were isolated by ion-exchange chromatography, which gave good recoveries (greater than 90%) and reproducibility (CV less than 5%). Isolated amino sugars were converted to O-methyloxime acetates. beta-Phenylglucose and N-methylglucamine were added as internal standards. Sample derivatives were quantified by capillary column gas chromatography. OV-101 and SE-54 capillary columns completely separated glucosamine and muramic acid from other amino sugars. The detection limit of glucosamine and muramic acid during gas chromatographic analysis was below 30 pmol using splitless-mode injection (SE-54 column). Filamentous fungal and procaryotic biomasses may be estimated simultaneously by using glucosamine and muramic acid biomass conversion factors in conjunction with this method. PMID- 6846819 TI - Guanosine triphosphate cyclohydrolase I assay in human and rat liver using high performance liquid chromatography of neopterin phosphates and guanine nucleotides. AB - D-erythro-7,8-Dihydroneopterin triphosphate (NH2TP) formed from guanosine triphosphate (GTP) by GTP cyclohydrolase I (EC 3.5.4.16) in the presence of EDTA was oxidized to neopterin triphosphate (NTP) by iodine, separated from substrate and other compounds by ion-paired reverse-phase HPLC, and quantitated by fluorometric detection at 365/446 nm. Excess GTP at the end of reaction was controlled by simultaneous detection of guanine nucleotides at 254 nm. The method required only 15 mg of liver tissue for the measurement of GTP cyclohydrolase I and is suitable for activity measurement in liver biopsies. The detection limit was 4 pmol of NTP at a signal to noise ratio of 10:1. The activity of GTP cyclohydrolase I in homogenates of human liver (n = 10) was 45 pmol NH2TP (range 32-60) formed per milligram protein per hour at 37 degrees C. Liver homogenates from Wistar rats (n = 8) formed 47 pmol NH2TP (range 35-61) per milligram protein per hour. PMID- 6846820 TI - A simple cell disrupter designed for small cells with relatively large nuclei. AB - A simple cell disrupter that is particularly suitable for breaking small cells with relatively large nuclei is described. Cells are disrupted by the shearing forces set up as they are pushed by a positive N2 pressure through a 0.8- to 1.5 micrometer stainless-steel filter. The total procedure takes only a few minutes, it is highly reproducible, and the yield is good. The cell homogenate obtained is a good starting source for the isolation of plasma membranes, intracellular organelles, and nuclei. PMID- 6846821 TI - Specific and rapid assay of urinary oxalic acid using high-performance liquid chromatography. AB - A high-performance liquid chromatographic (HPLC) method was developed to determine the levels of oxalic acid in the urine. This acid was extracted from urine with tri-n-butyl phosphate and converted into the fluorescent derivative by esterification with 9-anthryldiazomethane (ADAM). The reaction mixture containing the oxalic acid derivative can be directly chromatographed on HPLC using octadecylsilane reverse-phase column monitoring with a fluorophotometric detector. A linear relationship was observed in the range from 1 to 100 micrograms/ml of standard oxalic acid dissolved in saline. Disease-free Japanese adults excrete 23.8 +/- 9.0 mg (mean +/- SD) of oxalic acid per day. This method should prove valuable for routine measurements of urinary oxalic acid as it is accurate, simple, and specific. PMID- 6846822 TI - A procedure for easy removal of acrylamide gel rods from the casting glass tubes. PMID- 6846823 TI - A novel fluorogenic reagent for thiols: ammonium 7-fluorobenzo-2-oxa-1,3-diazole 4-sulfonate. AB - Ammonium 7-fluorobenzo-2-oxa-1,3-diazole-4-sulfonate (SBD-F) was newly synthesized as a fluorogenic reagent for thiol compounds. Its reactivity to glutathione is superior to its 7-chloro analog, SBD-Cl. The optimal reaction condition was selected at 60 degrees C and pH 9.5 for 1 h. The detection limits for glutathione, coenzyme A, cysteamine, homocysteine, N-acetylcysteine, cysteine, and D-3-mercaptomethylpropanoyl-L-proline (captopril) were 100, 120, 160, 330, 390, 3600, and 150 pmol/ml, respectively. Proline and alanine did not give fluorescence under this condition. PMID- 6846824 TI - Spectrophotometric determination of lantadene A, 22 beta-angeloyloxy-3-oxoolean 12-en-28-oic acid. AB - The formation of a blue chromogen between sodium borohydride-treated lantadene A (22 beta-angeloyloxy-3-oxoolean-12-en-28-oic acid) and acetic anhydride-sulfuric acid (9:1) formed the basis of a spectrophotometric method for its quantitation. The chromogen had a broad absorption maximum (lambda max) at 630-645 nm. The optimum amount of sodium borohydride for lantadene A reduction was 1 mg/mg lantadene A in methanolic solution. The chromogen was stable for 5, 7, and 26 min after reaction at 25, 18, and 0 degree C, respectively. The method is convenient, sensitive, and reproducible. The amount of lantadene A in the leaves of Lantana camara collected in the month of May quantitated by the present method was found to be 13.6 mg/g dry weight of the leaves. PMID- 6846825 TI - A simple, inexpensive, and precise microcell for the exchange dialysis and equilibrium dialysis of small samples. PMID- 6846826 TI - An optical comparator for measuring two-dimensional polyacrylamide gel electrophoresis records using an on-line microcomputer. AB - A comparator which makes it possible to compare two wet gels or photographic negatives or autoradiograms through a flickering light system has been built. The system consists of two special-purpose projectors which combine the images on a digitizing platform. When the lights are switched On and off out of phase, the positions of the common components remain unchanged, whereas those that are spatially displaced appear to jump from side to side and those present in one image but not the other switch on and off. This produces a flickering image in which differences are readily seen. Commercial camera lenses were used to construct the projectors and the overall specifications for the system are given. The coordinates of both the displaced components, as well as the selected standards from the two images, are digitized and entered automatically into an on line microcomputer. By using an iterative procedure for collecting records from several superimposable records of the gel, it is possible to compensate for the lack of total reproducibility over the whole gels. These coordinates are then normalized and superimposed on a master map through a television display using a curser to adjust the coordinates. The whole procedure can be repeated for many gels using a common reference gel in the comparator, and the result is a set of normalized coordinates which can be plotted on a single map to provide a final record of the experiments. PMID- 6846827 TI - Functional integrity of isolated rat hepatocytes prepared by whole liver vs biopsy perfusion. AB - Isolated rat hepatocytes prepared by a newly developed, versatile biopsy perfusion method (HB cells) were compared with hepatocytes prepared by conventional whole liver perfusion (HP cells), immediately after isolation and after 6 h in suspension culture. Thirteen parameters were used to assess the functional integrity of these cells. Both methods produced high yields of metabolically active hepatocytes that were virtually indistinguishable from each other. After 6 h, the average viability of both cell isolates declined approximately 10%, mixed function oxidase activities were decreased approximately 25% at most, and GSH levels were actually increased; other parameters were not significantly changed. The data indicate that HB-cell isolates are at least as viable and metabolically active as HP cells, and, because the biopsy perfusion method can be applied to liver samples from any species, it facilitates comparative studies. PMID- 6846828 TI - Determination of cobalamins in biological material. I. Improvement in the unequal recovery of cobalamins by preincubation with cadmium acetate. AB - Ethanol extraction of 28 specimens of human plasma in the dark showed that the total cobalamin value is increased up to 2 1/2 times by adding 400 micrometers of potassium cyanide. The addition of cyanide significantly changed the substance concentration (fractional content times substance concentration of total cobalamins) for all the cobalamin forms except 5'-deoxyadenosylcobalamin. The ethanol extraction was also studied with 57Co-labeled cobalamin forms. The recovery of [57Co]hydroxo- and [57Co]sulfitocobalamin from both plasma and hemolysate was inadequate. The recovery of [57Co]5'-deoxyadenosylcobalamin was only studied from liver tissue; the extraction recovery of this form was equal to that of 57Co]cyano- and [57Co]methylcobalamin. Preincubation with 0.25 M of cadmium acetate or extraction with 400 micrometers of potassium cyanide almost equalized the recovery of all five cobalamins. It is concluded that (i) the substance concentrations of the individual cobalamins presented hitherto are erroneous, owing to inadequate ethanol extraction of hydroxo- and sulfitocobalamin; (ii) about one-third of the cobalamins in plasma consists of hydroxocobalamin, which is not extractable by the methods used hitherto; (iii) studies of the cobalamin forms in body fluids and tissue cells need to be repeated by methods ensuring equal extraction of all the cobalamins; and (iv) the extraction of the cobalamins must be uniform for determination of the substance concentration of total cobalamins as well as the fractional amounts of all cobalamins. PMID- 6846829 TI - A technique for laser Raman spectroscopic studies of isolated cell populations. AB - A new method has been developed for the study of cell populations by laser Raman spectroscopy. Resonance Raman spectra of a small number of living or fixed tumor cells (ca 5000) treated with the antitumor agent adriamycin have been successfully obtained. This new approach leads to a better understanding of the molecular interactions between drug and biological targets, i.e., nuclear DNA at the cellular level. PMID- 6846830 TI - A versatile cation-exchange procedure of measuring the seven major forms of vitamin B6 in biological samples. AB - A cation-exchange procedure for detecting nanogram quantities of all seven common vitamin B6 metabolites in a variety of biological samples is presented. The procedure uses gradient elution with a single column to effect separation of the seven compounds within 40 to 60 min, depending on the complexity of the sample. Postcolumn addition of buffer and bisulfite ion permits sensitive fluorometric detection of all B6 compounds at the same wavelengths (330 nm activation, 400 nm emission). PMID- 6846831 TI - Single-step, rapid separation of acidic and basic isoenzymes from commercial horseradish peroxidase. AB - A simple and rapid technique for simultaneous separation of the acidic and basic isoenzymes of horseradish peroxidase is described. Upon application of a potential gradient on the electrolyte system composed of Pharmalyte (pH 2.5-5.0) histidine (pI 7.64), and Ampholyte (pH 9-11), the acidic and basic isoenzymes with pI 4.0-8.4 of horseradish peroxidase accumulated at the two interphases generated by this arrangement, with a recovery of 75 +/- 5%. Some advantages, such as rapidity, simplicity, low cost, good yields, and others, of this system over existing ones are outlined. PMID- 6846832 TI - Synthesis of [3H]phlorizin and its binding behavior to renal brush-border membranes. AB - Tetra- and tribromophlorizin have been synthesized under mild brominating conditions. With catalytic debromination in the presence of hydrogen or tritium gas, bromine atoms in the derivatives were completely substituted by hydrogen or tritium. The product was identical to the native phlorizin and was chemically pure. Tritiated phlorizin with extremely high specific radioactivity (45 Ci/mmol) was obtained when hydrogen gas was replaced by tritium gas. While the brominated compounds showed little inhibition of sodium D-glucose co-transport by isolated renal brush-border membranes. [3H]phlorizin had the same binding affinity to the brush-border membranes as native phlorizin and a Ki value of 1.2 microM for the sodium-dependent D-glucose transport. Binding studies performed using a flow dialysis method resulted in 150 pmol of phlorizin-binding sites per milligram of membrane protein. This radioactive phlorizin can be a useful tool for determining D-glucose-(phlorizin) binding sites at a low phlorizin concentration in membranes, in nonvesicle forms such as collapsed membrane vesicles, and in purified protein fractions. PMID- 6846833 TI - Measurement of refolding rate of reduced proteins by high-performance liquid chromatography. PMID- 6846834 TI - Quantitative binding of covalently closed circular DNA to nitrocellulose in NaI. AB - A procedure for quantitatively binding covalently closed circular DNA to nitrocellulose is detailed. The procedure involves making DNA saturated with respect to Nat at 25 degrees C, denaturing the DNA by heating to 80-100 degrees C, then passing the DNA-NaI solution through a nitrocellulose membrane at 50-60 degrees C. Form I DNA remains denatured throughout the loading procedure and is quantitatively deposited on the membrane as denatured DNA. The mechanism of binding DNA to nitrocellulose in NaI appears to be different from the binding promoted by NaCl. PMID- 6846835 TI - Fluorimetric assay of hydrolases at longwave excitation and emission wavelengths with new substrates possessing unique water solubility. AB - A direct and continuous kinetic method for the fluorimetric assay of various hydrolases by using new, highly water-soluble substrates is described. The latter consist of esters of strongly fluorescent 1-hydroxypyren-3,6,8-trisulfonic acid trisodium salt with acetic, butyric, caprylic, and oleic acid. Km and vmax values are given for the hydrolytic activity of porcine liver carboxylic ester hydrolase, wheat germ lipase, candida cylindracea lipase, hog kidney acylase I, and bovine pancreas alpha-chymotrypsin, while others (acetylesterase, trypsin, and cholinesterase) were studied qualitatively. By proper choice of the substrate, a fair selectivity may be achieved. Detection limits as low as 1 microgram enzyme/ml are found in some cases. Advantages of these new substrates over existing ones are briefly discussed. PMID- 6846836 TI - The determination of pterins in biological samples by liquid chromatography/electrochemistry. AB - A method is presented for determining the concentrations of several oxidized pterins in a variety of biological samples. This methodology employs reverse phase "ion-pair" liquid chromatography with electrochemical detection. Detection limits below a picomole have been achieved with responses linear over four orders of magnitude. This methodology was employed to study the excretion pattern of pterins in human urine. The concentration of several pterins in mouse brain and liver samples were also determined. The direct detection of tetrahydrobiopterin was demonstrated. PMID- 6846837 TI - Reverse-phase high-performance liquid chromatography of chemically modified DNA. AB - A reverse-phase high-performance liquid chromatographic method has been developed to determine the sites of reaction and the product distribution of modified salmon sperm DNA. The DNA was reacted with methyl methanesulfonate in neutral solution, and then degraded into deoxyribonucleosides by snake venom phosphodiesterase and alkaline phosphatase. Four products were identified and quantitated: 7-methyldeoxyguanosine (37.1%), 7-methylguanine (7.3%), 3 methyldeoxycytidine (28.8%), and 1-methyldeoxyadenosine (26.8%). This method provides a rapid procedure for analysis of chemically or biochemically modified nucleic acids. PMID- 6846838 TI - Automated bioluminescent assays for NADH, glucose 6-phosphate, primary bile acids, and ATP. AB - An automated flow system for the bioluminescent assay of various metabolites have been developed. The enzymes used in the assays have been coimmobilized onto Sepharose and packed into small flow cells. Assays for NADH, glucose 6-phosphate, and primary bile acids utilize the bacterial NADH:FMN oxidoreductase/luciferase and either glucose-6-phosphate dehydrogenase or 7 alpha-hydroxysteroid dehydrogenase. ATP assays were performed using immobilized firefly luciferase. In general, the lower limit of detection of the metabolites was at the picomole level, and light intensity was proportional to the substrate concentration from several picomoles to several hundred picomoles. The reproducibility was good with coefficient of variations in the range of 2-5%. The carryover was less than 5% and 30 samples per hour could be assayed. The flow cells were reusable for up to 700 consecutive assays. The major factor limiting their continued use was bacterial contamination of the Sepharose. The results obtained for serum primary bile acids using the bioluminescent assay wer in good agreement with independent measurements on the same samples using gas-liquid chromatography. The immobilized firefly luciferase system was successfully used to measure high levels of bacteria in urine specimens. PMID- 6846839 TI - Hypoxanthine and xanthine levels determined by high-performance liquid chromatography in plasma, erythrocyte, and urine samples from healthy subjects: the problem of hypoxanthine level evolution as a function of time. AB - The levels of hypoxanthine and xanthine are determined in plasma, erythrocyte, and urine samples by a reverse-phase high-performance liquid chromatographic (HPLC) method. The hypoxanthine concentration increases in erythrocyte and plasma samples when whole blood is stored at room temperature between sampling and centrifugation. Furthermore, the hypoxanthine concentration increases in erythrocyte samples when they are kept apart at room temperature before analysis, whereas the plasma hypoxanthine level remains constant. This result proves an endogenous formation of hypoxanthine in erythrocytes with time, at room temperature. These studies show the necessity of rigorous conditions for the collection, transport, and treatment of blood samples. In order to achieve accurate results, the blood must be centrifuged immediately after collection. The erythrocyte and plasma samples must be stored frozen until deproteinization and HPLC analysis. Under these conditions, the concentrations of hypoxanthine and xanthine in plasma are 2.5 +/- 1 and 1.4 +/- 0.7 microM, respectively. In erythrocyte samples, hypoxanthine concentration reaches 8.0 +/- 6.2 microM. PMID- 6846840 TI - Determination of hematocrit based on diffusion of an inert molecular probe from agarose gels into whole blood. AB - Whole blood hematocrit was determined by an approach which depends on the diffusion of an inert probe, to which red blood cells are impermeable, from a small agarose gel into a stirred, much larger blood sample. Blood cells influence the diffusion rate of the probe by, on the average, physically blocking a fraction of the gel surface. The blocking effect increases with the hematocrit. Cyanocobalamin (B-12) was found to be a suitable probe because it did not penetrate, bind to, or lyse blood cells and was not bound by plasma solutes. The loss of B-12 from gels in contact with blood was monitored by determination of the absorbance change at 540 nm of gels which had been quickly rinsed. The visible spectrum of B-12 in agarose gels was identical to the spectrum in water. Beer's Law was obeyed in 1-mm thick agarose gels over a concentration range of 0.1-0.8 mM. Based on the results from 48 blood samples covering the hematocrit range 25-69, a least-squares line was generated with a slope, -3.46 X 10(-3) delta A/hematocrit unit, a Y intercept of 0.295, and a correlation coefficient of 0.971. The precision of the technique was +/- 9.7%. The assay was insensitive to mean corpuscular volume and sample volume as long as the latter was 50-fold larger than the gel volume. The diffusion coefficient for B-12 in 1% agarose gels was found to be 1.4 +/- 0.2 X 10(-6) cm2 sec-1. PMID- 6846841 TI - Simultaneous determination of tryptophan and its metabolites in mouse brain by high-performance liquid chromatography with fluorometric detection. AB - A new method for the determination of tryptophan and its metabolites in a single mouse brain using high-performance liquid chromatography (HPLC) with fluorometric detection is described. Tryptophan, serotonin, 5-hydroxyindoleacetic acid, indoleacetic acid, and tryptophol were clearly separated by a C8 reverse-phase column. Tissue preparation is performed only to centrifuge homogenates of brain prior to the injection to HPLC. The sensitivity is in the range from 10 to 15 pg. PMID- 6846842 TI - A system for coupled multiple-column separation of proteins. AB - Purification of proteins is commonly a multiple-step process involving size exclusion, ion exchange, affinity, hydrophobic, and other modes of chromatography. In an effort to circumvent the laborious process of collecting the solutes from each column and reintroducing them onto a second column, a valving system is described that directs the samples eluted from a high performance liquid chromatographic column through a detector with a high-pressure cell into either a second column or into storage loops of a multiloop value. This multiloop value is referred to as a high-pressure fraction collector. After development of the first column is complete, a second solvent can be directed to the second column or high-pressure fraction collector to elute the solutes back through the detector and onto any other column in the system. The process of eluting a sample from a column through a single detector and directing it to the high-pressure fraction collector or any other column in the system may be repeated a number of times. Such valving systems make it possible to chromatograph a single protein component on two or three columns in a short time. PMID- 6846843 TI - A rapid biuret assay for protein of whole fatty tissues. AB - A rapid biuret procedure is described which avoids the turbidity that occurs with protein analysis of intact fatty tissues. Recovery is complete and absorbancy linear with both concentration of the soluble crystalline serum albumin standard and the volume of homogenate of a variety of tissues. This method has been used successfully for the determination of protein concentrations of homogenates of whole rat heart, liver, kidney, brain, lung, and the following muscles: gastrocnemius, interior and exterior obliques, red and white vastus lateralis, and soleus. PMID- 6846844 TI - Purification of sea urchin sperm bindin by DEAE-cellulose chromatography. AB - A procedure for purifying bindin from sperm of the sea urchin Strongylocentrotus purpuratus is presented in detail. The impure bindin, dissolved in 4 M urea, 50 mM sodium phosphate, pH 6.6, is adsorbed to DEAE-cellulose and eluted wit 4 M urea, 650 mM sodium phosphate, pH 6.6. The purified bindin is not contaminated with tubulin or histone HI. A precipitate of this DEAE-purified bindin, made by dialysis into Ca2+-free seawater and natural seawater, is a species-specific agglutinin of unfertilized eggs. This method of obtaining consistently pure preparations of bindin will aid in the analysis of its role in fertilization. PMID- 6846845 TI - A high recovery method for concentrating microgram quantities of protein from large volumes of solution. AB - A method is presented for the recovery of 40-80% of the protein from a 1 microgram/ml solution. The final protein pellet is free of detergent and other ionic compounds and is thus compatible with any denaturing solution. The primary structure of the protein is unaffected by the procedure, making the final pellet an ideal sample for any analytical procedure to determine protein structure. PMID- 6846846 TI - Determination of volatile organic compounds in fish samples by vacuum distillation and fused silica capillary gas chromatography/mass spectrometry. PMID- 6846847 TI - Determination of drugs in blood serum by mass spectrometry/mass spectrometry. PMID- 6846848 TI - Drying procedure for analysis of biological samples by X-ray fluorescence spectrometry. PMID- 6846849 TI - Determination of trace elements in biological materials using a hollow-cathode discharge: comparative study of matrix effects. PMID- 6846850 TI - A critical comparative study of atomic-spectrometric methods (atomic absorption, atomic emission and inductively coupled plasma emission) for determining strontium in biological materials. PMID- 6846851 TI - Determination of lead in blood by flame atomic-fluorescence spectrometry. PMID- 6846852 TI - Determination of lead in whole blood by electrothermal atomic-absorption spectrometry using graphite probe atomisation. PMID- 6846853 TI - Spectrophotometric method for the determination of dobutamine hydrochloride. PMID- 6846854 TI - Determination of noscapine and papaverine in mixtures. PMID- 6846855 TI - Distribution of carotid body type I cells and other periadventitial type I cells in the carotid bifurcation regions of the cat. AB - The bilateral distribution of carotid body type I cells was investigated in five non-pedigree cats by serially sectioning the carotid bifurcation regions. Carotid body type I cells occurred bilaterally in close proximity to the wall of the occipital artery or one of its proximal branches, and less frequently the ascending pharyngeal artery within a division of connective tissue with definable but irregular borders. Caudally, and separate from the principal mass of carotid body type I cells, isolated groups of periadventitial type I cells were found in seven out of ten specimens lying freely in the connective tissues around the occipito-ascending pharyngeal trunk and the origin of the occipital artery immediately rostral to the carotid bifurcation. Periadventitial type I cells were not observed at the level of the carotid bifurcation but on one occasion these cells were noted caudal to the carotid bifurcation lying adjacent to the wall of the rostral end of the common carotid artery. From our data on four specimens, reconstructions were made of the carotid body. The occurrence and significance of the periadventitial type I cells is discussed. PMID- 6846856 TI - Observations on the early development of ascending spinal pathways. Studies using the North American opossum. AB - The development of ascending spinal pathways has been studied in the North American opossum using degeneration methods and the retrograde transport of horseradish peroxidase. Axons from caudal thoracic and/or lumbosacral levels of the spinal cord reach the lateral reticular nucleus, the inferior olivary complex, the reticular formation of the medulla and pons as well as the cerebellum very early in development. Innervation of the nucleus gracilis occurs somewhat later. Spinal axons grow into most of the caudal brain stem areas they occupy in the adult animal, including the nucleus gracilis, before there is convincing evidence that they reach the thalamus. Although spinal axons enter the cerebellum early in development their adult distribution with its characteristic discontinuities appears relatively late. PMID- 6846857 TI - The localization of motoneuron pools innervating wing muscles in the chick. AB - Motoneuron pools supplying principal muscles of the shoulder girdle and wing were localized in the chicks 2-7 days post hatching with the use of retrograde axonic transport of horse radish peroxidase (HRP). HRP was injected into selected muscles and the animals sacrificed after 24 h survival. Labelled motoneuron pools representing individual muscles were found to be clustered in longitudinal columns along the brachial spinal cord segments 13-16. Muscles derived from the dorsal muscle mass were innervated by motoneurons located in the ventro-lateral portion of the horn, while those originating from the ventral muscle mass received innervation from neurons occupying the dorsomedial portion within the ventral horn of the spinal cord. The rostrocaudal extent of the motoneuron pools could be correlated with the proximodistal position of wing muscles. The observed orderly topographical relationships between clusters of motoneurons of the brachial spinal cord and the muscles they innervate will be used as baseline data for experiments where the limb innervation is perturbed. PMID- 6846858 TI - Primary afferent projections to the spinal cord and the dorsal column nuclear complex in the turtle Pseudemys. AB - Primary afferent projections from cervical and lumbar levels were studied in the turtle Pseudemys scripta elegans. Injections of radioactive amino acids, wheat germ agglutinin and horseradish peroxidase were made into the dorsal root ganglia or the spinal cord. Previous reports on the terminal distribution of primary afferents within the ipsilateral segment of entry were confirmed (Kusuma and ten Donkelaar 1979, 1980) and additional dorsal root projections were demonstrated to the contralateral side and to several neighboring spinal segments. The primary afferent projections to the brainstem were essentially restricted to a dorsolateral area that appears to be homologous to the main dorsal column nuclei (n. gracilis and n. cuneatus medialis) in mammals. While exhibiting a similarly extensive rostro-caudal span, the projections originating from lumbar injections terminated more medially, those from cervical injections more laterally. The labeling pattern suggested that terminations are mainly on dorsally extending dendrites. PMID- 6846859 TI - The timing and sequence of events in the development of the human reproductive system during the embryonic period proper. PMID- 6846860 TI - Ultrastructural study of the mouse antimesometrial decidua. AB - The ultrastructure of mouse antimesometrial decidual cells was analyzed during the development of the decidua between days 5 and 8 of pregnancy. The first decidual cells, appearing on the 5th day, are polygonal with rounded nuclei and prominent nucleoli; free ribosomes predominate in the cytoplasm. On the 6th to the 8th days the cytoplasm of these cells is typically that of cells actively engaged in macromolecular synthesis. Large numbers of granular and agranular endoplasmic reticulum cisternae are present in addition to well-developed Golgi complexes, mitochondria and lysosomes. Many bundles of microfilaments and lipid droplets occur during this period. An intense accumulation of autophagosomes and lysosomes with very heterogeneous content was noted on the 7th and especially the 8th days. The presence of these organelles is an indication that involution of this part of the decidua has begun. PMID- 6846861 TI - Afferent projections from the rat longus capitis muscle studied by transganglionic transport of HRP. AB - Using the method of transganglionic transport of horseradish peroxidase (HRP) according to Mesulam (1978), the course and central terminations of the afferents from the longus capitis muscle were studied in the rat. Application of HRP to the cut muscle nerves was followed by heavy labeling of a considerable number of cell bodies of different sizes in the spinal ganglia C2 and C3. The labeled central processes follow two distinct main routes: one to the external cuneate nucleus, which is known to project ipsilaterally to the cerebellum, the other to the central cervical nucleus (CCN) of the spinal cord. The latter nucleus contains dense arborizations and terminals of muscle afferents in close relationship to medium sized cells which project contralaterally to the cerebellum. This could be shown in double labeling experiments with HRP as a tracer for primary afferents and Nuclear yellow for the cerebellar pathway. The labeled area of CCN extends from the fourth cervical segment up to the medulla oblongata where it lies laterally adjacent to the hypoglossal nucleus, though clearly separated from the latter. In the cervical part of CCN, dendrites of neck muscle motoneurons arborize within the area of afferent terminals. Besides the external cuneate and the central cervical nuclei, afferent projections were seen in lamina X, partly in close contact with the central canal, and in more lateral areas of lamina VII. In contrast to results from studies on other neck muscles, no reaction product was observed in dorsal horn laminae I-VI. PMID- 6846862 TI - Quantitative histological study on the thalamic ventro-basal complex of the cat. Numerical aspects of the transfer from medial lemniscal fibers to cortical relay. AB - A quantitative analysis was carried out on the thalamic ventrobasal (VB) complex of the cat. The following numerical and metrical parameters of the neuronal elements (cells and fibers) were determined: 1. Volume of nucleus: 27.38 mm3 2. Total number of neurons: 243,000 3. Total number of fibers of medial lemniscus: 26,000 4. Volume of arborization space of one lemniscal fiber: 2.26 X 10(6) micrometers 3. Numerical data of relay neurons and lemniscal fibers and their relations as basic factors in the estimation of the degree of divergence and convergence of lemniscal input were calculated and compared. It was found that the probable degree of convergence is four-fold (1-4) and of divergence 27-fold (1-27) with regard to the relationship of fibers and cells in the VB. The quantitative data obtained in the VB and our considerations on convergence and divergence were compared with analogous values obtained for the lateral geniculate body LGB. The differences between the two sensory relay nuclei reflect differences in their modes of impulse transmission. PMID- 6846863 TI - Scanning electron microscopy of mouse muscle microvasculature. AB - The surface morphology of the microvasculature from mouse skeletal muscle was studied by scanning electron microscopy. Cell surfaces were exposed by digesting away extracellular collagen and other matrix by a simple HCl treatment. Four distinct subdivisions of the microvasculature (arterioles, precapillary arterioles, capillaries, and venules) were identified based on marked differences in surface features. Arterioles of 20-10 micrometers diameter had a discontinuous, single layer of smooth muscle cells encircling the vessel. These smooth muscle cells had an uneven surface with shallow grooves and depressions that were often oriented parallel to the longitudinal cell body axis. The underlying arteriolar endothelial surface was also rough with long ridges separating shallow furrows that were oriented parallel to the vessel length. As the arteriolar size decreased, the perivascular cell were found further apart, they became smooth surfaced, and were oriented preferentially parallel to the vessel. The endothelium of the precapillary arterioles, as well as, capillaries and venules had smooth surfaces. Venules had a discontinuous layer of flat, smooth surfaced pericytes. Morphologically distinct groups of smooth muscle cells (i.e., precapillary sphincters) were not found. Although pericytes normally associated with capillaries and other vessels were often removed during tissue processing, most cells and their surface feature were generally well preserved. PMID- 6846864 TI - Uterine simple and complex nuclear bodies are separate structural entities. AB - In rat uterine luminal epithelial cells, nuclear bodies occur in the euchromatin in varying numbers in relation to the nuclear concentration of the estrogen receptor (Clark et al., 1978; Padykula et al., 1981, 1982). This functional responsiveness indicates that nuclear bodies may be useful indicators of the degree of cellular estrogenization. Because these filamentous bodies vary in size (200-1200 nm), shape, and composition, quantitative analysis of frequency of their occurrence has been difficult. A fundamental division into 2 categories can be made by the following criteria: 1) simple nuclear bodies (200-500 nm) consisting of a protein mesh of microfilaments, and 2) complex nuclear bodies (200-1200 nm) composed of an outer filamentous protein capsule enclosing a lucent core that may contain granules. Previous quantitative analyses at the electron microscopic level has excluded "simple bodies" because they might actually be ultrathin sections through the filamentous capsule of complex bodies (Le Goascogne and Baulieu, 1977; Clark et al., 1978). To resolve this sampling problem, we have performed serial ultrathin section analysis of nuclear bodies in hyperestrogenized luminal epithelial cells. Ultrastructural evidence presented here demonstrates that simple and complex nuclear bodies are anatomically separate entities. Ultrathin sections through the capsule of complex nuclear bodies will be misidentified as profiles of simple bodies during quantitative analysis. This anatomic distinctness of simple and complex nuclear bodies correlates with their differing responses to estrogenic stimulation and withdrawal (Fitzgerald and Padykula, pp. 131-141, this volume). Thus the existence of these two major categories should be taken into consideration during quantitative analyses. PMID- 6846865 TI - Differing functional responses of simple and complex nuclear bodies in uterine luminal epithelial cells following estrogenic stimuli. PMID- 6846866 TI - A fine structural and cytochemical study of the rhesus monkey yolk sac: endoderm and mesothelium. AB - This study has examined the fine structure and some cytochemical characteristics of the endodermal and mesothelial cells of the rhesus monkey yolk sac between 25 and 66 days of gestation. The endodermal cells were characterized by abundant granular endoplasmic reticulum, some agranular endoplasmic reticulum, a well developed Golgi apparatus, and numerous large mitochondria. During the earlier part of the period studied, endodermal cells had a few acid phosphatase and arylsulfatase-positive lysosomes and moderate numbers of catalase-positive microperoxisomes. During the later stages of development, large granules (believed to be lysosomes) with a heterogeneous content were numerous in the cytoplasm. Mesothelial cells showed fewer development changes. Throughout this period they were usually flattened cells with long microvilli, small mitochondria, and limited amounts of granular endoplasmic reticulum. The mesothelial cells had acid phosphatase reaction product in the Golgi region and occasional large vesicles, but were negative for arylsulfatase and catalase. One specimen was incubated at 37 degrees C in the presence of horseradish peroxidase in order to examine endocytosis. Both the mesothelial cells and endodermal cells internalized the peroxidase into a variety of cytoplasmic vesicles. Based on their cytology, the endodermal cells may function in the synthesis of serum proteins during this period, as has been suggested in other species. They may also be involved in lipid metabolism. The mesothelial cells appeared less synthetically active, but evidence suggested that they may be involved in collagen and extracellular matrix production. The endocytic activity displayed by both cell types may indicate a role in fluid and metabolite transfer across the epithelia. The cytology of both cell types was very similar to that described for human yolk sacs, suggesting that the rhesus monkey may be a useful species in which to study the maturation of yolk sac function. PMID- 6846867 TI - An ultrastructural study of preovulatory apical development in mouse ovarian follicles: effects of indomethacin. AB - The effects of the prostaglandin synthesis inhibitor, indomethacin, on the preovulatory morphology of apical follicle walls have been examined by transmission electron microscopy. Immature mice, superovulated with 5 IU pregnant mare serum (PMS) followed 40 hours later by 80 IU luteinizing hormone (LH) were treated with either 10 mg/kg indomethacin or an equivalent volume of the indomethacin vehicle 10 minutes prior to LH. Follicular apices from both groups were compared at 12 hours post-LH. Indomethacin treatment suppressed many of the morphological changes normally occurring in the apex during preovulatory development. Whereas apices from vehicle-treated animals demonstrated marked deterioration, dissociation, and thinning of tissue, the cell layers of apices from indomethacin-treated animals remained thickened and tightly packed, with limited signs of disruption. The results presented herein are consistent with the idea that prostaglandins are essential mediators of ovulation and suggest that these lipids augment apical rupture by mobilizing granulosa cells and stimulating the loss of connective tissue elements. PMID- 6846868 TI - The behavior of bursal lymphoid follicle-associated cells after treatment with testosterone. AB - Administration of androgens produces damage in lymphoid tissue and in the bursa of Fabricius. After IM administration of 5 mg of testosterone propionate (TP) beginning at hatching and continued during the following 4 days, a significant reduction in the bursal weights is observed. Histologically, an increase in the connective tissue is observed and cystic formations are also found. In all cysts examined, there is continuity of the cystic lumen with the free surface. The follicle-associated epithelial (FAE) cells are on the bottom of the pseudocysts and form a separation between the pseudocystic cavity and the lymphoid tissue which is still further inwards. These cells do not lose their esterase activity, even though they are often flattened. Furthermore, they disappear in the pseudocysts deprived of lymphoid tissue. A new hypothesis is advanced that the FAE cells originate from the mesenchyme with differentiation in the histiocytic line. PMID- 6846869 TI - Simultaneous ultrastructural visualization of acetylcholinesterase activity and tritiated norepinephrine uptake in renal nerves. AB - In this investigation we have combined the methods of ultrastructural demonstration of acetylcholinesterase activity with electron microscopic autoradiography for the demonstration of norepinephrine uptake. The results show electron-dense deposits indicative of acetylcholinesterase activity associated with perivascular axons overlaid by concentrations of silver grains representing exogenous tritiated norepinephrine. Forty-five percent of the intervaricose regions and 19% of the varicosities overlaid by autoradiographic grains showed "moderate" amounts of cholinesterase staining. A greater proportion of autoradiographic grains was observed on the varicosities than in the intervaricose regions; however, the amount of acetylcholinesterase activity was greater in the intervaricose regions than in the varicosities. This investigation provides evidence for the presence of periaxonal acetylcholinesterase staining in adrenergic axons in the rat kidney. PMID- 6846870 TI - The morphology and distribution of Merkel cells in primate gingival mucosa. AB - The morphology and distribution of Merkel cells in primate gingival mucosa have been studied by correlated light and electron microscopic techniques. The gingival mucosa is composed of a stratified squamous epithelium with a dense underlying connective tissue stroma. The epithelium inter-digitates with the underlying connective tissue forming long interconnected rete ridges. Merkel cells and their associated axons are abundant in gingival mucosa where they are located, either individually or in clusters, at the base of epithelial rete ridges. These cells have an identical morphology to Merkel cells described by others in the hard palate, hairy skin, glabrous skin and eyelid. While individual Merkel cells are found throughout the gingival mucosa, Merkel cell clusters are most numerous in the mandibular lingual gingival mucosa. When correlating this finding with data from other investigators, it appears that Merkel cell clusters are located preferentially in the masticatory mucosa in intimate contact with the tongue and thus may function as an important source of somatosensory feedback providing valuable information regarding the position of the tongue in the oral cavity. PMID- 6846871 TI - An electron microscopic analysis of the left phrenic nerve in the rat. AB - In this electron microscopic study, the axonal categories in the left phrenic nerve at its entrance to the diaphragm have been determined. At a level 3 mm rostral to the diaphragm, the left phrenic nerve contains approximately 700 axons: 57% are myelinated and 43% are unmyelinated. The dorsal root ganglion cells give rise to 31% of the myelinated axons and the ventral root contributes 69%. Of the unmyelinated axons, the dorsal root ganglion cell contributes 59%, the cervical sympathetic chain 24%, and 17% course through the ventral roots. These ventral root unmyelinated axons are presumably preganglionic efferents since the proximal stump of the ventral root showed no decrease in unmyelinated axons after ventral rhizotomy. PMID- 6846872 TI - The number and size of axons at the apex of the cat's canine tooth. AB - Using electron microscopy and morphometric analysis the number and size of axons entering the apex of the cat's mandibular canine tooth have been measured. The total number of axons varied from 761 to 1,903 between different animals but the maximum difference between right and left sides of the same animal was 353. From 56 to 79.6% of the axons were nonmyelinated; the difference in proportion between right and left sides never exceeded 6.4%. The mean circumference of myelinated axons ranged from 10.2 to 18.3 micrometers but again the right and left variation was much less and never exceeded 2 micrometers. In one tooth 38.8% of the myelinated axons were larger than 19 micrometers in circumference and thus outside the A delta range. The proportion was much smaller in other teeth but some "large" fibers were always present. Of all the nonmyelinated axons 19.7% showed some degree of axonal exposure to the extracellular space and 1.7% showed ax-oaxonal apposition. A small proportion of nonmyelinated axons showed evidence of apparent degeneration. Comparison of these data with those from studies at more coronal levels suggests that there is considerable branching and narrowing of fibers during their course through the dental pulp and that the degree of axonal exposure and apposition increases considerably. Some of the pulpal fibers are derived from larger axons than are normally associated with pain. The animal to animal variation in the parameters measured is considerable but right and left sides are similar. PMID- 6846873 TI - The striated urogenital sphincter muscle in the female. AB - Striated muscle associated with the female urethra and vagina constitute a continuous mass which appropriately may be called the urogenital sphincter. Though continuous, the muscle may be separated into two parts--one that surrounds the urethra, and the other surrounding the urethra and vagina. The individual muscle fibers are small and are embedded in connective tissue and infiltrated with smooth muscle which obscures the visibility of the muscle to gross dissection. Developmentally the muscle primordium is laid down around the urogenital sinus and urethra early, and foreshadows the anatomical arrangement that is maintained in the adult with little change. The urogenital sphincter muscle extends from the base of the bladder where it lies within the pelvic cavity and continues through the urogenital hiatus of the pelvic diaphragm to expand around the vagina in the perineum. Additional fibers attach to the ischiopubic rami and constitute a compressor of the urethra. As a result there is no superior fascia of the so-called "urogenital diaphragm" which closes off a deep perineal compartment or forms a floor of the urogenital hiatus. PMID- 6846874 TI - A simple method of lung perfusion fixation. AB - A simple perfusion apparatus modified from procedures used and published in renal studies is presented and discussed. The buffer and fixative solutions to be perfused are placed in closed reservoirs under 20 mm of Hg pressure which is provided by a constant inflow of air from an air inflow valve present in any routine laboratory. The pressure is monitored by a sphygmomanometer gauge and adjusted with an air control valve. The perfusate solutions are kept at 37 degrees C. The oncotic-osmotic characteristics of routine buffer and fixative perfusates are presented and discussed. The perfusion technique utilized in a cat model is detailed. The technique does not require sophisticated equipment and yet perfusion conditions can be carefully monitored and controlled. PMID- 6846875 TI - Spectrum of susceptibility to malignant hyperthermia--diagnostic dilemma. AB - Utilizing established in vitro muscle contracture tests, we have identified three diagnostic contracture phenotypes for malignant hyperthermia susceptibility (MHS) among 103 patients. Phenotype H is an unequivocal diagnostic result for MHS, as is the nonsusceptible phenotype N. The third diagnostic group, phenotype K, represents an equivocal diagnostic response. To provide a basis for understanding relationships between contracture phenotypes and MHS, pigs with phenotypes H, K, and N were exposed to a standardized anesthetic protocol for assessing MHS. During the anesthetic challenge, phenotype H pigs developed a more severe form of the MH syndrome than did phenotype K pigs. Comparing phenotype H v K average responses, VO2 increased four- v twofold; lactate increased 13- v 9-fold; and temperature increased 41.7 degrees C v 39.2 degrees C, respectively. These values either had no change or decreased in the phenotype N pigs. Results of this study suggest that a spectrum of MHS exists among the human population. PMID- 6846876 TI - Direct effects of ketamine on isolated canine cerebral and mesenteric arteries. AB - The effects of ketamine on isolated canine cerebral (middle cerebral and basilar) and mesenteric arteries were studied. In arteries contracted with KCl, ketamine in concentrations above 5 X 10(-6)M (cerebral arteries) or 2 X 10(-5)M (mesenteric arteries) caused significant relaxation in a dose-dependent manner. The relaxation was not significantly influenced by aminophylline, aspirin, atropine, or propranolol. In concentrations above 5 X 10(-6)M ketamine attenuated the contractile response to high concentrations of KCl in the middle cerebral arteries, and in concentrations above 5 X 10(-5)M it attenuated the contractile response to high concentrations of KCl in the basilar and mesenteric arteries. The attenuation was greater in cerebral than in mesenteric arteries. The contractile response of cerebral arteries to high concentrations of serotonin was also attenuated by ketamine in concentrations above 5 X 10(-5)M. Ketamine attenuated KCl-induced contraction of cerebral arteries more than it attenuated serotonin-induced contraction. When basilar arteries were exposed to Ca2+-free media and depolarized by KCl, the addition of Ca2+ caused biphasic (transient and sustained) contractions, while in the mesenteric arteries the addition of Ca2+ produced sustained contractions. Ketamine at 5 X 10(-5) and 5 X 10(-4)M attenuated both transient and sustained contractions in basilar arteries, while in mesenteric arteries 5 X 10(-4)M ketamine attenuated only sustained contractions. In both instances, ketamine-induced attenuation was partially reversed by excess Ca2+. It is concluded that ketamine has a direct dilating effect on both cerebral and mesenteric arteries, but the effect is more pronounced in cerebral than in mesenteric arteries. The direct action of ketamine on those arteries may be due in part to interference with transmembrane influx of Ca2+. PMID- 6846877 TI - Intrauterine exposure to halothane increases murine postnatal autotolerance to halothane and reduces brain weight. AB - The effect of halothane on prenatal development was assessed using the appearance of postnatal tolerance to the anesthetic and its effect on brain weight. Eighteen 3-month-old mice were repeatedly tested in a rotating cage for loss of righting reflex during exposure to increasing concentrations of halothane on 15 occasions to determine whether or not tolerance to halothane developed. Of these, nine mice were born to dams exposed for 30 min to 2% halothane on days 14 and 17 of gestation. The other nine mice (controls) were born to dams exposed to 100% oxygen for 30 min at the same stage of pregnancy. There was no significant difference in tolerance to halothane between the groups during the first nine days of repeated exposure to halothane. By the 13th and 15th days, however, mice exposed to halothane in utero became more tolerant to 1% halothane than did controls (P less than 0.025). In addition, the mean total brain weight of six 7 week-old mice exposed to 2% halothane in utero for 30 min on days 14 and 17 of gestation was found to be significantly less than the mean total brain weight of six control mice not exposed to halothane in utero (20.83 +/- 0.27 g and 23.07 +/ 0.51 g, respectively, P less than 0.0025). This difference occurred mainly in the brain stem rather than in the forebrain and cerebellum. PMID- 6846878 TI - Lack of arrhythmogenicity of isoflurane following administration of aminophylline in dogs. AB - Induction of halothane anesthesia after aminophylline administration may cause ventricular arrhythmias. Isoflurane may be as effective a bronchodilator as halothane. This study was designed to determine whether induction of isoflurane anesthesia after intravenous aminophylline is arrhythmogenic in dogs. One group of six dogs was anesthetized with 1.5% isoflurane in the absence of aminophylline. Three additional groups of six dogs were given intravenous aminophylline 10, 25, or 50 mg/kg, respectively, followed 3 min later by 1.5% isoflurane. No arrhythmias occurred after aminophylline and isoflurane at any time in any animal. In contrast to halothane, induction of isoflurane anesthesia after aminophylline is safe and does not cause cardiac arrhythmias. PMID- 6846879 TI - Benefit of elective intensive care admission after certain operations. AB - To determine if patients who have undergone uneventful vascular surgery (VS), nonvascular intracranial surgery (ICS), or anterior cervical laminectomies (ACL) have enough serious postoperative problems to justify routine overnight observation in an intensive care unit (ICU), we recorded every problem and associated therapy administered to 263 such patients within 36 h of ICU admission. The severity of each treated problem was graded from 1 (safe to delay treatment for at least 2 h) to 4 (life-threatening, immediate treatment required). Defining patient benefit from the ICU as treatment for one grade 4 problem or more than one grade 3 problem, 44% of VS patients (N = 177), 14% of ICS patients (N = 73), and none of the ACL patients (N = 13) benefited. We conclude that these percentages justify an overnight ICU stay for all VS patients, especially as the occurrence of serious problems was unpredictable and most serious problems were still being treated 4 h postoperatively. Furthermore, routine ICU admission of all patients in the groups studied would reduce patient costs if only 13 of the 88 patients who benefited were prevented from becoming critically ill. PMID- 6846880 TI - Plasma concentrations of lidocaine associated with cervical, thoracic, and lumbar epidural anesthesia. AB - We measured arterial plasma concentrations of lidocaine by enzyme immunoassay when 10 ml of 2% lidocaine without epinephrine was injected into the cervical, thoracic, or lumbar epidural spaces in 30 patients. There was no difference in the time courses of plasma levels of lidocaine. Peak concentrations were achieved 10 min after injection and were similar regardless of the site of injection. These results indicate the absence of significant differences in the rate of vascular absorption of lidocaine from different parts of the epidural space. PMID- 6846881 TI - Effects of halothane and fentanyl on the rate of CSF production in dogs. AB - Using the open ventriculocisternal perfusion method, the rate of cerebrospinal fluid (CSF) production was examined in dogs anesthetized with either halothane (0.8%) or fentanyl (3.0 micrograms/kg/min for 20 min, then 0.2 micrograms/kg/min, intravenously), and nitrous oxide (60-70%) in oxygen. Halothane decreased the mean rate of CSF production from 0.047 +/- 0.006 ml/min (mean +/- SEM) in controls to 0.033 +/- 0.005 ml/min. This effect persisted throughout 3.0-3.5 h of anesthesia. When the expired concentration of halothane was decreased from 0.8% to less than 0.1%, the mean rate of CSF production returned to control values within 45-50 min. Fentanyl produced no change in the mean rate of CSF production compared to controls. These data suggest that increased CSF volume does not contribute to increased intracranial pressure during prolonged halothane anesthesia. In patients at risk for increased intracranial pressure due to increased CSF volume, either halothane or fentanyl may be preferable to anesthetics that may increase CSF production, e.g., enflurane. PMID- 6846882 TI - Video stethoscope--a simple method for assuring continuous bilateral lung ventilation during anesthesia. AB - Complications of endotracheal intubation and mechanical ventilation are infrequent but important causes of intraoperative morbidity and mortality. We have developed a simple method of monitoring the ventilation of both lungs during general anesthesia and have evaluated this technique in 25 patients undergoing surgery under general anesthesia. A small plastic electrocardiographic electrode casing fitted with a microphone was affixed to the skin overlying each hemithorax in a location where preliminary auscultation showed that breath sounds could be heard. The sounds from each microphone were amplified and displayed on an oscilloscope screen in an X-Y format. The patterns seen on the screen allowed easy identification of right mainstem intubation, esophageal intubation, or proper endotracheal tube placement. This preliminary study suggests that our technique is feasible and provides more information about the position of the endotracheal tube than presently used methods. PMID- 6846883 TI - The adductor pollicis monitor--apparatus and method for the quantitative measurement of the isometric contraction of the adductor pollicis muscle. PMID- 6846884 TI - Esophageal rupture and spinal anesthesia. PMID- 6846885 TI - Electrocautery-induced reprogramming of a pacemaker using a precordial magnet. PMID- 6846886 TI - A new method for massive fluid resuscitation in the trauma patient. PMID- 6846887 TI - Research replication may be subject specific. PMID- 6846889 TI - Percutaneous transtracheal ventilation. PMID- 6846888 TI - Measurement of pseudocholinesterase. PMID- 6846891 TI - Epidural analgesia for patients with chronic neurological disease. PMID- 6846890 TI - Cimetidine and congenital tracheoesophageal fistula. PMID- 6846892 TI - [Myocardial metabolism under ftorotan anesthesia]. PMID- 6846893 TI - [Comparative evaluation of variants of general anesthesia in microsurgical operations on the brachial plexus]. PMID- 6846894 TI - [Use of selective membranes for enriching the air with oxygen in artificial pulmonary ventilation]. PMID- 6846895 TI - [Comparative evaluation of the ftorotan and nitrous oxide content and methods of preventing their contamination of operating room air]. PMID- 6846896 TI - [Treatment of acute circulatory failure]. PMID- 6846897 TI - [General anesthesia in the perfusion period in operations under artificial circulation]. PMID- 6846898 TI - [Effect of hyperbaric oxygenation on the development of centrogenic pulmonary edema]. PMID- 6846899 TI - [Effect of hyperbaric oxygenation on the motility of the small intestine in newborn infants in the postoperative period based on electroenterographic data]. PMID- 6846900 TI - [Effect of hyperbaric oxygenation on the functional and morphological state of the kidneys]. PMID- 6846901 TI - [Use of intra-aortic balloon counterpulsation with toxicologic patients]. PMID- 6846902 TI - [Prognostic importance of various laboratory indices of patients with acute kidney failure]. PMID- 6846903 TI - [Hepatic blood flow after operations on the abdominal organs]. PMID- 6846904 TI - [Effectiveness of frequent stimulation of the left atrium via the esophagus in stopping supraventricular (recurrent) paroxysmal tachycardia]. PMID- 6846905 TI - [Hyperbaric oxygenation in the intensive therapy of severe sodium nitrite poisoning]. PMID- 6846906 TI - [Broncholytic effect of peridural analgesia following chest operations]. PMID- 6846907 TI - [Use of an obturator probe for preventing aspiration complications of anesthesia]. PMID- 6846908 TI - [A dental spreader with a handle]. PMID- 6846909 TI - [Epidural-sacral anesthesia in proctology]. PMID- 6846910 TI - [Preoperative preparation and postoperative therapy of surgical patients with concomitant diseases of the cardiovascular system]. PMID- 6846911 TI - [Rupture of an abdominal aortic aneurysm and simultaneous aorto-caval fistula]. PMID- 6846912 TI - [Treatment of arterial embolism. Evaluation of surgical results in 156 cases]. PMID- 6846913 TI - [A case of uncomplicated, congenital lymphedema. Review of the literature and presentation of a clinical case]. PMID- 6846914 TI - [Exclusion of the superficial venous system in the diagnosis of deep venous thrombosis by Doppler ultrasonics]. PMID- 6846915 TI - [Long-term results of subfascial "escoplage" in the treatment of primary varicose veins of the lower limbs]. PMID- 6846916 TI - [Extra-anatomical revascularization of the lower limbs. III. By-pass through the obturator foramen]. PMID- 6846917 TI - Diagnostic value of thallium-201 myocardial imaging in pulmonary embolism. PMID- 6846918 TI - Descending venography. AB - Patients with chronic venous insufficiency may have a combination of problems. The veins in the lower extremity can be affected by post phlebitic changes, obstruction, venous valvular incompetence or any mixture of these. Correct medical and/or surgical treatment hinges on the accurate assessment of the venous system. Complete studies of the lower extremity should incorporate ascending and descending venography as well as the clinical presentation. The methods described above easily enable one to achieve this accuracy with a minimal of time and discomfort to the patient. The incidence of primary venous valvular incompetence, may be higher than first anticipated and only by performing descending venography will this cause chronic, venous insufficiency to be unmasked. When employed in the appropriate patient, descending venography is an invaluable asset to diagnosis and ultimate treatment. PMID- 6846919 TI - Alternative management of isolated iliac artery aneurysms. AB - Isolated iliac artery aneurysms are uncommon and frequently remain undetected until they reach significant size. Often their first clinical presentation is with rupture of the aneurysm. Direct surgical intervention has been the usual mode of treatment. Successful treatment of iliac aneurysms by alternative approaches in two elderly, debilitated patients is reported. Extra-anatomic bypass and catheter embolization were used in both resulting in a minimal in hospital stay for the patients without morbidity or mortality. PMID- 6846920 TI - Double-blind comparison of acute effects of inhaled albuterol, isoproterenol and placebo on cardiopulmonary function and gas exchange in asthmatic children. AB - Although albuterol aerosol is an effective bronchodilator in adult asthmatics its efficacy and safety are not fully established in asthmatic children. Albuterol (100 and 200 micrograms), isoproterenol (70 and 140 micrograms) and placebo were administered from metered dose aerosol cannisters to 11 asthmatic children (9 to 16 years of age). Our findings indicate that in asthmatic children albuterol aerosol causes bronchodilation for up to six hours and greater bronchodilation than comparable doses of inhaled isoproterenol and does not produce overt effects on the cardiovascular system, significant changes in arterial partial pressure of oxygen or excessive tremor. PMID- 6846921 TI - Value of immunoglobulin E (IgE) in the private practice of allergy. Eight years experience: 1973-1981. AB - In private practice the majority of patients evaluated by allergists are truly atopic. To assess the clinical value of determining the serum level of immunoglobulin E (IgE) in such patients the records of an individual private allergist were reviewed and all new patients were evaluated. Over an eight year period 7,000 new patients were seen and 5,500 measurements of IgE were performed. An elevated serum IgE value was indicative of the atopic state with few false positives. Successful immunotherapy as determined by patient reports, the decreased use of medications and reduced clinical visits was correlated positively with a decrease in serum IgE levels. This was true regardless of the initial value of the IgE. Unsatisfactory results in immunotherapy were often accompanied by an increase in IgE levels. Serial determinations of serum IgE levels over several years of treatment are of value in the evaluation of allergic patients in private practice. PMID- 6846922 TI - Sickle cell disease and bronchial asthma. AB - A six-year-old girl with sickle cell disease and severe asthma was treated for status asthmaticus on several occasions. Sickle cell crises appeared to be precipitated by the asthmatic episodes. The interactions between these two disease processes are discussed and a treatment protocol for the rare patient with both of these diseases is proposed. PMID- 6846923 TI - Anaphylactoid reactions to tolmetin and zomepirac. AB - A 38-year-old male sustained sequential anaphylactoid reactions to tolmetin and zomepirac. This is the first report involving these closely related non-steroidal anti-inflammatory drugs (NSAID) in a single patient. He was historically tolerant of other NSAID and tolerated a graded oral aspirin challenge (up to 625 mg) without reaction. Skin testing with aqueous albumin extracts of tolmetin and zomepirac was negative. These reactions appear to differ from previously described aspirin (NSAID) sensitivity. Physicians should beware of interrupted treatment with either of these preparations. PMID- 6846924 TI - Efficiency of different skin prick testing methods in the diagnosis of allergy to dog. AB - The study of 202 asthmatic children shows that prick testing with standardized dog allergen extract is very useful in the diagnosis of allergy to dog dander. A good correlation was demonstrated with clinical history, RAST and the provocation tests. The use of the histamine control system improves the specificity of the prick test when compared with the simple measuring of the mean wheal diameter. End-point titration of the skin prick reactivity did not further improve the specificity when compared with the histamine control system. PMID- 6846925 TI - A researcher in the policy arena. The case of child labor. PMID- 6846926 TI - Psychology and public policy affecting children, youth, and families. PMID- 6846927 TI - Children and the congress. A time to speak out. PMID- 6846928 TI - The welfare of children and "the new federalism". PMID- 6846929 TI - Translating research into policy for children. The private foundation experience. PMID- 6846930 TI - Infant day care and infant-care leaves. A policy vacuum. PMID- 6846931 TI - Psychology and primary health care for children. PMID- 6846932 TI - Toward "personhood" for adolescents. Autonomy and privacy as values in public policy. PMID- 6846933 TI - What can we learn about pictures from the blind? PMID- 6846934 TI - Parasitic infections as regulators of animal populations. PMID- 6846935 TI - Marginalia. Reflections on the neural crest. PMID- 6846936 TI - Inspiratory and expiratory partitioning of airway resistance during sleep in patients with sleep apnea. AB - Although the sleep apnea hypersomnolence syndrome (SAHS) is now a widely recognized disorder, little is known about the timing and pathogenesis of the abnormal airway mechanics that lead to airway occlusion. In order to characterize the changes in airway resistance and to determine if abnormal airway mechanics are confined to inspiration or expiration in SAHS, we separately determined the inspiratory and expiratory resistances on the 2 breaths preceding occlusive apnea in 7 patients. We observed that 6 subjects experienced a significant increase in expiratory resistance, and 5 subjects had a significant rise in inspiratory resistance from the second to the first breath before apnea. For the group, the median expiratory resistance increased from 11.5 to 18.6 cm H2O/L/s (p less than 0.05), and the median inspiratory resistance increased from 10.5 to 17.5 cm H2O/L/s (p less than 0.05) on the 2 breaths before apnea. We conclude that airway abnormalities occur during both the expiratory and the inspiratory phases of ventilation on breath(s) leading to apnea and, therefore, the loss of airway patency is not solely an inspiratory phenomenon. It is also apparent that patients with SAHS thus experience both inspiratory and expiratory resistive loading prior to apnea. PMID- 6846937 TI - Rapid diagnosis of Legionnaires' disease by latex agglutination. AB - We developed a latex agglutination test to detect antigen(s) of serogroup 1 Legionella pneumophila in urine and evaluated its ability to diagnose legionnaires' disease. Antigen was detected in 46, or 70%, of 66 patients with serogroup 1 legionnaires' disease but in none of 51 patients with various bacteremic infections nor 60 with urinary tract infections. One of 50 patients with other pulmonary infections was antigen-positive, an immunosuppressed patient with Pneumocystis carinii infection. Seven other patients infected with P. carinii were negative. When compared with radioimmunoassay (RIA) and enzyme linked immunosorbent assay (ELISA) using serial dilutions of a single antigen containing urine, latex agglutination was 16-fold less sensitive. However, 82% of RIA- or ELISA-positive specimens were positive by latex agglutination. Latex agglutination is simpler and more rapid than ELISA or RIA, and it should prove valuable in situations where ELISA or RIA are unavailable or unaffordable. PMID- 6846938 TI - Pulmonary disposition of tobramycin. AB - Each antibiotic has a characteristic penetration into respiratory secretions, influenced by serum concentration, protein binding, transport systems, and the presence of infection. Whereas previous studies have used only bronchial secretions and blood, in the present study, blood, bronchial secretions, and bronchoalveolar lavage (BAL) fluid were analyzed for tobramycin levels. In 10 studies in 9 patients, serum levels were significantly related to BAL fluid levels (r = 0.8, p less than 0.01) when both were expressed as a function of creatinine (mean BAL level +/- SD = 144 +/- 124 micrograms/mg creatinine; serum level, 293 +/- 216 micrograms/mg creatinine). The level of drug penetration in BAL fluid, expressed by the slope of the relationship between blood and fluid, was 0.5. The penetration of tobramycin into bronchial secretions ranged from 0 to 1.4 micrograms/ml, the ratio of secretions to serum being 0.2 (r = 0.68; p less than 0.05). It is concluded that the disposition of tobramycin in bronchial secretions and BAL fluid differ. Thus, sampling both fluids offers a more suitable method to study antibiotic pharmacokinetics in bronchi and alveoli. PMID- 6846939 TI - Refractory period after hyperventilation-induced asthma. AB - Nine young asthmatic subjects undertook isocapnic hyperventilation while breathing air under different conditions. Each subject undertook 2 pairs of tests. Pair A consisted of 2 hyperventilation challenges performed while breathing cold (2.8 +/- 1.4 degrees C) dry (2.3 +/- 0.05 mg H2O/L) air. Pair B consisted of an initial warm (38.0 +/- 0.9 degrees C) saturated air challenge followed by a cold dry challenge. Tests were closely matched in terms of ventilation and respiratory heat loss in the cold dry tests. The subjects were rendered refractory by the first cold dry hyperventilation challenge, the fall in forced expiratory volume in one second (FEV1) after hyperventilation in the first test (delta FEV1 = 39 +/- 5%) being significantly greater than that after the second challenge of Pair A (delta FEV1 = 21 +/- 5%, p less than 0.005). In test Pair B, the warm humid hyperventilation challenge neither caused significant asthma (delta FEV1 6 +/- 3%) nor rendered the subjects refractory to the subsequent cold dry test (delta FEV1 38 +/- 4%). Because in a previous study it was shown that exercise while breathing warm humid air could induce a refractory period without itself causing asthma, we conclude that hyperventilation-induced asthma is not the same as exercise-induced asthma in most subjects. PMID- 6846940 TI - The effect of erythromycin on theophylline pharmacokinetics in chronic bronchitis. AB - We examined theophylline pharmacokinetics for changes caused by the addition of erythromycin in patients with chronic bronchitis and obstructive pulmonary disease. Twelve hospitalized patients were randomized in a crossover fashion to receive aminophylline and either erythromycin or placebo. After the eighth dose, plasma was analyzed for theophylline, using the enzyme-mediated immunoassay technique. A 6-h urine collection was analyzed for theophylline metabolites, using high-pressure liquid chromatography. Erythromycin significantly decreased mean theophylline clearance by 22% from 4.9 L/min to 3.87 L/min (p less than 0.05). Mean peak theophylline levels increased 28% from 11.9 micrograms/ml to 15.3 micrograms/ml (p = 0.05). No change in urine theophylline metabolites was found. Patients with chronic bronchitis and obstructive pulmonary disease who begin erythromycin while receiving a preexisting therapeutic theophylline regimen experience a significant elevation of theophylline concentration, which predisposes to theophylline toxicity. For those patients with theophylline levels at the higher end of the therapeutic range (15 to 20 micrograms/ml), we recommend an initial 25% reduction in theophylline dosage when erythromycin is added. Serum theophylline levels should be monitored for further refinement of dosage. PMID- 6846941 TI - Mepacrine but not methylprednisolone decreases acute edematous lung injury after injection of phorbol myristate acetate in rabbits. AB - A good model of the adult respiratory distress syndrome (ARDS) is intravenously injected phorbol myristate acetate (PMA), which causes pulmonary sequestration of neutrophils and a neutrophil-dependent acute edematous lung injury in rabbits. In the present study, pretreatment of rabbits with the antimalarial agent, mepacrine, prevented lung edema after injection of PMA without altering initial accumulations of neutrophils in the lung. Mepacrine also decreased oxygen radical production and degranulation by neutrophils stimulated by PMA in vitro. In contrast, pretreatment with methylprednisolone did not decrease edematous lung injury in rabbits given PMA nor did it inhibit O2 radical production or degranulation by neutrophils treated with PMA in vitro. Our results suggest that agents that modify neutrophil function may be useful in decreasing lung injury after PMA treatment and, perhaps, in treating patients with ARDS. PMID- 6846942 TI - An acute infection model for Mycobacterium intracellulare disease using beige mice: preliminary results. AB - The development of an acute infection model of Mycobacterium intracellulare disease in Beige mice (C57B1/6J-bgJ/bgJ) was investigated. Intravenous injection of 1 x 10(7) viable colony-forming units of M. intracellulare strain 571-8 produced a 1,000-fold increase in the number of mycobacteria recovered from the lungs and spleens after 28 days of infection. More importantly, 40% of the beige mice died from this infection, as was determined from histopathologic sections and bacterial culturing. PMID- 6846943 TI - Respiratory muscle contribution to lactic acidosis in low cardiac output--do the methods limit the conclusions? PMID- 6846945 TI - American Thoracic Society. Medical section of the American Lung Association. Clinical staging of primary lung cancer. PMID- 6846944 TI - Pleural thickening: its significance and relationship to asbestos dust exposure. PMID- 6846946 TI - Pulmonary manpower report. Report and recommendations of the ad hoc Committee on pulmonary manpower, American Thoracic Society, final report, October 1982. PMID- 6846947 TI - Fluid and electrolyte transport across monolayers of alveolar type II cells in vitro. PMID- 6846948 TI - Solute and water transport across epithelia. PMID- 6846949 TI - Fluid balance in the air filled alveolar space. AB - Studies in vitro and in vivo of the alveolar epithelial membrane, which show it can normally be characterized as having a "pore radius" of 0.5 to 1.5 nm, have been presented frequently over 20 years in a number of species (2, 3, 6, 8, 12). The alveolar epithelium appears to share these permeability properties with other epithelia. The changes that can be produced in the solute permeability of the alveolar epithelium by inflation are profound and point to its fragility (table; see text) in experimental situations that are not closely controlled. It is likely that experimental results unable to demonstrate molecular sieving bear the burden of proving that this property has not been altered by the experimental procedure. The inflation changes in epithelial permeability appear restricted to situations in which only a fraction of the lung expands in response to high pressures, such as in the clinical situation of respiratory failure where much of the air space is fluid filled or atelectatic, and large distending pressures are used to ventilate a small fraction of the total alveoli. Inflation-induced permeability changes, particularly to protein, may be important in alveolar water balance or in protein-induced dysfunctions of lung surfactant in such clinical situations. PMID- 6846950 TI - Developmental changes in alveolar epithelial permeability. PMID- 6846951 TI - Ultrastructural features of alveolar epithelial transport. AB - The permeability of the alveolar epithelium is considerably less than the capillary endothelium, although macromolecules can traverse the epithelial lining of alveoli. Knowledge of the contributions of potential surface domains within the epithelial glycocalyx and of the surfactant lining layer to the differences in epithelial and endothelial permeabilities across the air-blood barrier is not secure. Increased numbers of type I vesicles and depletion of type II lamellar bodies characterize the alveolar epithelium after the development of septal edema and alveolar flooding. The thick sides of the alveolar septa are the sites of interstitial fluid accumulation and of increased attentuation along the surface of type I cells in edematous lungs. The development of septal edema and alveolar flooding at 15 degrees C, on the other hand, is not associated with increased vesicles or depletion of lamellar body contents. Thus, these concomitant cellular changes are not primarily associated with formation of alveolar edema but more likely are response to the distension of the septal interstitium and alveoli. The type II cell response could signify an attempt to replenish the surface active phospholipids after alveolar flooding. The vesicular response could represent a cellular defense mechanism against excessive interstitial fluid accumulation by providing a pathway for the return of excess filtrate to the blood (via an expanded endothelial vesicle population) or to the alveolar hypophase layer. The increased vesicle population, on the other hand, could signify an initial cellular pathologic response, with subsequent coalescence of the more closely packed vesicles leading to the formation of cytoplasmic vacuoles and finally to epithelial disruption. PMID- 6846952 TI - Preventive surgery in the female breast. PMID- 6846953 TI - Oculoplethysmography. Evaluation of patients with transient ischemic attacks from internal carotid artery disease. AB - Oculoplethysmography was used to evaluate 66 patients with transient ischemic attacks prior to cerebral angiography. Fifty-eight (87.9%) symptomatic internal carotid arteries had anatomically significant stenosis. Only 69 per cent of these 58 arteries had positive OPG test. Thirty-one per cent of the arteries were well compensated hemodynamically with collaterals and had a false negative test. A negative OPG test does not rule out an anatomically significant internal carotid artery stenosis. PMID- 6846954 TI - The use of shunts in patients undergoing bilateral carotid endarterectomies. Help or hindrance. AB - A retrospective study was undertaken to help assess the influence of shunting or nonshunting in the performance of bilateral, staged carotid endarterectomies. During the years 1969 to 1979, 323 consecutive patients underwent 646 staged, bilateral carotid endarterectomies. The indications included 271 patients (83.5%) with hemispheric and nonhemispheric findings and 52 patients (16.5%) who were asymptomatic. Thirty-six patients had sustained a previous stroke. General endotracheal anesthesia and systemic heparinization were used in all operations. An indwelling shunt was used in 485 (75.1%) endarterectomies whereas 161 operations (24.9%) were done without a shunt, reflecting the surgeons' routine preferences rather than specific criteria of selection. There were 30 (4.6%) neurologic events in 29 patients. Five patients died, representing an operative mortality of 1.5 per cent. Neither carotid occlusion time, interval between operation, nor severity of extracranial occlusive disease correlated significantly with the occurrence of postoperative stroke. An analysis of the neurologic deficits revealed 27 in the shunted group (5.5%) and three in the nonshunted group (1.8%). Results of this study showed that shunting cannot be relied upon to decrease the risk of neurologic deficit and that superior results may be obtained without an indwelling shunt in performing carotid endarterectomy. PMID- 6846955 TI - Carotid endarterectomy. Technical modifications in patients with internal carotid thrombus. PMID- 6846956 TI - Abdominal complications of collagen vascular disease. AB - A retrospective study of 412 consecutive hospital admissions of patients with collagen vascular disease yielded 63 patients who were admitted for abdominal complaints. Of these 63 patients, 11 died during their admission of primary intra abdominal pathology or a complication thereof. A significantly higher incidence of abdominal complications occurred in black women (P less than 0.01). Peritoneal signs invariably were lacking in patients who eventually died. Radiographic documentation of small bowel obstruction or gastroduodenal ulceration in these patients was particularly ominous. Rapid radiologic evaluation and early surgical intervention including diagnostic peritoneal lavage should decrease the mortality rate for these difficult patients. PMID- 6846957 TI - Spontaneous pneumothorax. Special considerations. AB - A review of patients with spontaneous pneumothorax treated at Tripler Army Medical Center (TAMC) between 1977 and 1979 was undertaken to identify areas of strength 1977 and 1979 was undertaken to identify areas of strength and areas of weakness. Fifty patients with a total of 58 pneumothoraces were identified, and their charts were reviewed. Fifty-one pneumothoraces were classified as primary or idiopathic, and seven were secondary to parenchymal disease. Problem areas that were identified included failure to consider catamenial pneumothorax in the differential diagnosis of spontaneous pneumothorax and failure to recognize reexpansion pulmonary edema as a complication of treatment. PMID- 6846958 TI - Subxiphoid pericardiotomy. A safe, accurate, diagnostic and therapeutic approach to pericardial and intrapericardial disease. AB - The records of 36 patients who underwent subxiphoid pericardiotomy were reviewed to determine the safety, accuracy, and utility of the procedure. No deaths were attributed to the operation, and complications were minimal. Most operations were performed under local anesthesia. Findings at operation accurately defined which patients required further surgery and which did not. Although clinical, radiographic, and physical findings are inaccurate in determining the nature and extent of pericardial and intrapericardial pathology, a definitive diagnosis was obtained in all diagnostic procedures. Only one patient needed a second operation, attesting to the effectiveness of subxiphoid drainage as a therapeutic modality. PMID- 6846959 TI - Urinary myelin figures in gentamicin. Treated vs. ischemic kidneys. AB - In view of the demonstrated occurrence of myelin figures in renal tubules and urine following gentamicin administration, we compared urinary excretion of myelin figures in dogs given nephrotoxic doses of gentamicin and in those undergoing clamping of renal arteries. Ten dogs weighing 15 to 20 kg were randomly divided into two experimental groups. Group I consisted of five dogs injected daily with 40 mg/kg body weight of gentamicin intramuscularly. Group II consisted of five dogs that were operated on and had their renal arteries clamped for one to two hours. Baseline studies, including body weight, serum creatinine, and analysis of urine sediment by light microscopy and electron microscopy, were obtained. Daily creatinines were obtained in both groups, and urine sediments were examined for epithelial cells and myelin figures at regular intervals and graded from 0 to 4+. The control serum creatinine levels were normal in all ten dogs, and no myelin figures were observed in the baseline examinations. In Group I, two out of five dogs developed frank renal impairment with creatine levels over 2 mg/dl and subsequently died. These two dogs had 1+ or more myelin figures in the urine sediment early in the treatment, and subsequently, a copious amount of myelin figures (4+) was excreted. The remaining dogs did not develop creatinine elevation greater than 2 mg/dl and showed only trace amounts of myelin figures. In Group II, two out of five dogs developed abnormal creatinine levels on the first postoperative day, but did not show myelin figures in their urine. Two other dogs with normal creatinine levels had trace myelin figures. The study shows that conspicuous urinary excretion of myelin figures occurs in gentamicin induced renal failure in dogs, but myelin figures are absent or slight after renal vascular ischemia of 1 to 2 hours. PMID- 6846960 TI - Kawasaki syndrome. An abdominal crisis. AB - Three new cases of hydrops of the gallbladder associated with mucocutaneous lymph node (Kawasaki) syndrome are presented. The increasing frequency of association of those two entities is emphasized. Ultrasonography is ideal for confirming the diagnosis of gallbladder hydrops and for follow-up. The preferred treatment is medical, and surgical intervention is indicated only for peritonitis and complications of acute acalculus cholecystitis. PMID- 6846961 TI - Primary adenocarcinoma of the appendix. Can preoperative or intraoperative diagnosis be made? AB - Adenocarcinoma of the appendix is a rare entity with a reported incidence of .03 to .08 per cent. A review of all appendectomies performed at St. Joseph Mercy Hospital (a private community hospital) between 1963 and 1979 was undertaken to assess the efficacy of preoperative diagnosis. Six adenocarcinomas were found, consisting of five male patients and one female patient with a mean age of 65 years. Symptoms were present for 24 hours or greater in all cases. A preoperative diagnosis was not made in any patient. Three patients later required a definitive therapeutic procedure, and two patients died from metastatic disease during their initial hospitalization. The literature was reviewed to evaluate methods of preoperative and intraoperative diagnosis of appendical adenocarcinoma. A suspicion of carcinoma of the appendix should be entertained for patients over the age of 50 years who present with signs and symptoms of appendicitis for greater than 24 hours. A barium enema performed preoperatively and especially a frozen section at the time of surgery of any suspicious appendiceal lesions may improve the diagnostic accuracy and survival of patients with this disease entity. If preoperative or intraoperative diagnosis is made, the patient can be better prepared and definitive surgical therapy carried out. This avoids delay in treatment and a second operative procedure. PMID- 6846962 TI - Y-V cardioplasty for recurrent achalasia. AB - Long-term follow-up of patients with achalasia has revealed recurrences many years following an initially successful cardiomyotomy. In three patients with recurrent achalasia, one previously operated on by us and another twice recurrent, we were confronted with an apparently previously complete myotomy at reoperation. We elected to perform a cardioplasty using the Y-V principle employed previously in duodenal stenosis. We added a Belsey type of partial plication. Five-year follow-up with history, esophagram, esophageal function studies, and endoscopy has revealed no recurrence of dysphagia and no symptoms of reflux or esophagitis. PMID- 6846963 TI - Determination of the fraction of G0 cells in cytologic samples by means of simultaneous DNA and nuclear protein analyses. AB - The ratio of protein to amount of DNA in the nucleus was cytophotometrically determined by means of a combined Feulgen-naphthol yellow S staining procedure. Quiescent normal lymphocytes, bronchial epithelial cells and mammary epithelial cells all showed ratios that were significantly lower than in the proliferating counterparts of the different cell types. Hence, combined determinations of DNA and nuclear protein make it possible to determine the fraction of growth-arrested cells (G0 cells) in cytologic preparations. PMID- 6846964 TI - DNA distribution and chromosome number in human cervical carcinoma. AB - The degree of ploidy of 15 human cervical carcinomas was investigated by use of flow cytometry and cytogenetic analysis. All tumors contained aneuploid cell populations. The results showed no correlation between ploidy and the clinical stage of the tumor. A high correlation was found between modal DNA content and modal chromosome number of the aneuploid cell populations, and it is concluded that flow cytometric analyses reflect the occurrence of tumor stemlines. PMID- 6846966 TI - Discrimination of normal and dyskaryotic cells with a new high-resolution system (CIALIS). AB - Measurements on Feulgen-stained nuclei were performed with a new high-resolution system. Squamous intermediate cells and dyskaryotic cells in cervical smears were compared, based on nuclear features: DNA content, area and two features describing nuclear structure. For data evaluation, a histogram and a linear discriminant analysis were used. The discrimination of the two cell types based on the DNA content and nuclear area was possible to a high degree. A classification based only on the two chosen descriptors of chromatin patterns was not possible. PMID- 6846965 TI - DNA flow cytometry of pleural effusions. Comparison with pathology for the diagnosis of malignancy. AB - A study was undertaken to determine the potential value of DNA flow cytometry (FCM) for the diagnosis of malignancy in pleural effusions and to compare its results with those of traditional cytomorphology. Forty-one pleural fluids from 37 patients were evaluated by DNA FCM and routine cytologic techniques. Of the 41 pleural fluids, 29 (70.7%) demonstrated an abnormal DNA content by FCM. Two of the 29 pleural fluids had been originally diagnosed as benign by cytology. Cytologic review of these two cases showed no abnormal cells; therefore, there were no false-negative cases based on cytology. In 12 (29.3%) of the 41 fluids, DNA FCM and cytologic evaluation both indicated benign processes. Our preliminary observations indicate that FCM is an accurate and reliable technique that may be of aid in the diagnosis of malignant effusions. The technique may prove to be of special value in the differential diagnosis of reactive mesothelial cells versus malignant mesothelioma as well as for following patients who receive chemotherapy for malignant pleural effusions. DNA FCM may also complement cytomorphologic diagnoses in other serous, exfoliative or aspiration material. PMID- 6846967 TI - Progress report on experimental use of CYBEST model 2 for practical gynecologic mass screening. Alterations of the specimen rejection threshold and specimen preparation. AB - In order to maintain an acceptable performance of CYBEST model 2 in the field of gynecologic mass screening, the algorithm of rejection for the CYBEST assessment of inadequately oligocellular samples was reviewed, and the mean number of detected cells per square millimeter for passing rejection was raised from two cells to four. The results of field tests obtained after the modification showed a false-positive rate of 28.3% for 9,010 samples as compared with 41.8% for 10,549 samples before the modification while the rejection rate showed a moderate yet acceptable increase after the modification from 4.7% to 7.0%. Some modifications of the specimen preparation routine were also introduced to improve the performance of the system. PMID- 6846968 TI - Curves for modelling chromosome shapes. AB - Representation of chromosome shapes by a single smooth curve forms an important step in a chromosome analysis system. During development of an interactive system for use in plant chromosome studies, the behavior of certain types of curves commonly used in human chromosome analysis systems was found to be unsuitable for modelling plant chromosomes. These chromosomes require modelling by a flexible smooth curve, such as the cubic spline. Preliminary investigation of human chromosomes indicates that some of these must also be modelled by the cubic spline curve. The results of modelling chromosome shapes by several different types of curves are illustrated. PMID- 6846969 TI - Relationship between cell size and weight of the human liver. An automated morphometric study. AB - Using a machine-vision system for the analysis of multicolor multicellular images, an algorithm, consisting of cellular logic operators, was developed for estimating the average cross-sectional area of cells in the liver. A total of 28 three-color histologic images from 22 variable-weight autopsied livers were digitized and processed. The data collected showed a positive correlation, albeit weak, between the weight of the liver and the cell size. This correlation was not visually evident, which demonstrates the utility of machine vision in histopathology. PMID- 6846970 TI - Amiodarone in refractory life-threatening ventricular arrhythmias. AB - Ninety-six patients with life-threatening ventricular arrhythmias refractory to two or more conventional agents were treated with amiodarone and followed for 6 to 40 months (mean, 15 months). Currently, 75 are alive and well. Seven patients died from nonarrhythmic and five from arrhythmic causes. Nonfatal arrhythmias recurred in four patients, one with early and three with late onset. Intolerable side effects occurred in five patients but heart failure was not aggravated by the drug. On 24-hour Holter recordings done before and serially during therapy in 72 patients, amiodarone eliminated episodes of ventricular tachycardia and complex ectopy and reduced total ectopic beat counts by 90% or more in all but 4 patients. In contrast, ventricular tachycardia inducible by programmed electrical stimulation was suppressed in only 50% of patients, but failure of such suppression did not compromise an excellent clinical outcome. Thus, amiodarone is highly effective in the prophylaxis of recurrent refractory life-threatening ventricular arrhythmias. PMID- 6846971 TI - Mortality in patients with implanted automatic defibrillators. AB - Fifty-two patients who survived several arrhythmic cardiac arrests had implantation of an automatic defibrillator along with additional cardiovascular surgery as indicated. The mean follow-up was 14.4 months and the longest was 3 years. In the hospital, the implanted devices identified and reverted 82 episodes of spontaneous and 81 of 99 episodes of induced malignant tachyarrhythmias. There were 62 automatic resuscitations in 17 patients outside the hospital. Twelve patients died; four of the deaths were not witnessed. These deaths represent a 22.9% total and 8.5% sudden-death 1-year mortality rate. Because the expected 1 year mortality in patients without the automatic defibrillator was calculated to be 48%, there was an estimated 52% decrease in anticipated total deaths. The automatic implantable defibrillator can identify and correct potentially lethal ventricular tachyarrhythmias, leading to a substantial increase in 1-year survival in properly selected high-risk patients. PMID- 6846972 TI - Neurologic recovery after out-of-hospital cardiac arrest. AB - A retrospective cohort study of the neurologic sequelae of out-of-hospital cardiac arrest was done using 459 consecutive patients resuscitated and admitted to a teaching hospital over 10 years. Awakening was defined as having comprehensible speech or following commands. One hundred and eighty patients (39%) never awakened and 279 (61%) awakened, 188 without and 91 with persistent neurologic deficits. Fifty-nine patients had cognitive deficits and 32 patients had motor and cognitive deficits. Patients who did not awaken died, with a median survival of 3.5 days. The longer a patient survived without awakening, the smaller the probability of ever awakening and awakening without deficits. Fourteen patients awakening after 4 days had some deficits, and after 14 days six had severe deficits. Neurologic sequelae of cardiac arrest are common and related to awakening. The probability of future awakening and neurologic sequelae for patients not awake at specific times after cardiac arrest can be estimated. PMID- 6846975 TI - The hemolytic-uremic syndrome: recovery after treatment with vincristine. PMID- 6846973 TI - Adult respiratory distress syndrome: risk with common predispositions. AB - A 1-year survey of patients in three hospitals identified 936 patients who had one predisposition and 57 who had several predispositions to the adult respiratory distress syndrome. From the total predisposed population of 993 patients, 68 subsequently developed the syndrome. An additional 20 patients developed the syndrome from causes other than eight identified predispositions, to bring the total of patients studied to 88. A highly significant difference (p less than 0.0001) was found in the incidence rates of the syndrome between patients with one and several predispositions (5.8 versus 24.6 per 100 patients). Within 72 hours of onset of predisposition, 89.5% of patients who developed the syndrome had been intubated and placed on mechanical ventilation. Fifty-seven of the 88 patients (64.8%) with the syndrome died. By the 14th day 90% of deaths had occurred. There were no age- or sex-specific differences in either incidence or mortality rates. Case fatality rates of the syndrome were high in all predisposed groups. PMID- 6846974 TI - Spurious hyperchloremia and decreased anion gap in hyperlipidemia. AB - A patient with overt lipemia presented with hyponatremia, hyperchloremia, and a negative anion gap. The hyperchloremia and negative gap resulted from overestimation of chloride levels due to a light-scattering effect in the colorimetric assay, an effect that was reproducible in vitro. In a prospective study, this effect produced substantial overestimations at even modest degrees of hyperlipemia. This effect expands the differential diagnosis of a decreased gap, adds to the list of technique-dependent artifacts in lipemia, and, if present, must be recognized for a patient's fluid and electrolyte status to be accurately defined. PMID- 6846976 TI - General recommendations on immunization. Recommendation of the Immunization Practices Advisory Committee. AB - This revision of the "General Recommendations on Immunization" updates the 1980 statement. Changes from that statement clarify information on possible interference with the immune response by spacing immunobiologic agents. Recommendations for vaccinating persons with allergies are revised. New sections dealing with many aspects of immunization procedures have been added. PMID- 6846977 TI - NIH conference. Type III hyperlipoproteinemia: diagnosis, molecular defects, pathology, and treatment. AB - Type III hyperlipoproteinemia is characterized by increased plasma levels of triglycerides and cholesterol, palmar-tuberoeruptive xanthoma, and premature cardiovascular disease. Three major classes of molecular defects will predispose patients to develop type III hyperlipoproteinemia: a deficiency in apolipoprotein E, a structural defect in the E apolipoprotein, and a functional defect in the liver receptor system. Most patients with type III hyperlipoproteinemia have a structural defect in apolipoprotein E associated with increased synthesis and decreased catabolism of apolipoprotein E, delayed catabolism of chylomicron remnants, and development of plasma lipoprotein abnormalities characteristic of type III hyperlipoproteinemia. Analysis of cardiovascular disease in patients with type III hyperlipoproteinemia showed extensive coronary and peripheral vascular atherosclerosis indistinguishable from the atherosclerosis of non hyperlipidemic and other dyslipoproteinemic patients. The xanthoma and elevated plasma cholesterol and triglyceride levels in patients with type III hyperlipoproteinemia respond to dietary and drug therapy. PMID- 6846978 TI - When the doctor needs a doctor: special considerations for the physician-patient. AB - The treatment of an ill or impaired physician may present difficulties not typically encountered in other patients. Potential complications arise from the temptation for physicians to diagnose and treat themselves, their tendency to obtain "informal" consultations regarding personal symptoms, their difficult transition from the role of doctor to that of patient, and the inadvertent assumption of a "VIP" status in the hospital. These difficulties may be increased by the denial of illness by the physicians themselves and their families and colleagues. This denial is partially determined by legal, financial, social, professional, and psychological factors. Specific recommendations on caring for an ill physician are presented. PMID- 6846979 TI - Nutrition and hypertension. PMID- 6846980 TI - Analysis of survival in cancer clinical trials. PMID- 6846981 TI - Apheresis and rheumatoid arthritis. PMID- 6846982 TI - Occupational lung disease. PMID- 6846983 TI - The patient-physician contract. PMID- 6846984 TI - The do-not-resuscitate order. PMID- 6846985 TI - Age and mental incompetence. PMID- 6846986 TI - Amiodarone and ventricular tachycardia. PMID- 6846987 TI - Unstable angina pectoris. PMID- 6846988 TI - A selective advantage with mitral valve prolapse. PMID- 6846989 TI - Alcohol and the heart. PMID- 6846990 TI - Nifedipine and erythromelalgia. PMID- 6846991 TI - Naloxone in ethanol intoxication. PMID- 6846992 TI - Naloxone and blood pressure. PMID- 6846993 TI - Cardiovascular effects of cimetidine. PMID- 6846994 TI - Cimetidine and gastric carcinoma. PMID- 6846995 TI - Metoclopramide side effects. PMID- 6846996 TI - Intestinal pseudo-obstruction. PMID- 6846997 TI - A new detail in a complex case. PMID- 6846999 TI - Pumpkin-seed impaction. PMID- 6847000 TI - Penicillamine and progressive systemic sclerosis. PMID- 6846998 TI - Acral erythema and hydroxyurea. PMID- 6847001 TI - HLA-B27 homozygosity in seronegative spondyloarthropathies. PMID- 6847002 TI - Photocopier's phalanx. PMID- 6847003 TI - Pseudohypoparathyroidism, cimetidine, and neurologic toxicity. PMID- 6847004 TI - Imaging of parathyroid adenomas. PMID- 6847005 TI - Nutrition and blood pressure control. Current status of dietary factors and hypertension. PMID- 6847006 TI - Nutrition and blood pressure control. Current status of dietary factors and hypertension. Introduction. PMID- 6847008 TI - Mechanisms contributing to high blood pressure. AB - Essential hypertension, a disease that affects about 60 million Americans, is not a homogeneous clinical entity. The disease is caused by altered regulation of mechanisms that control arterial pressure. Because the manifestations of the abnormally regulated pressure have many factors, the approaches to treatment likewise may be expected to be multifactorial. Hemodynamic, neural and catecholamine, renopressor, renal excretory and volume, hormonal, electrolyte, and depressor mechanisms are discussed. Associated conditions that must be considered include exogenous obesity, hyperuricemia, coronary artery disease, carbohydrate intolerance, and hyperlipidemia. Clearer understanding of the role of each of these factors in essential hypertension should provide a rationale for wise selection of antihypertensive therapy and allow reversal of the very high rates of cardiovascular morbidity and mortality associated with the disease. PMID- 6847007 TI - Hypertension: prevalence, risks, and effect of therapy. AB - The current definitions of hypertension have led to falsely high estimates of its prevalence, inexact assessments of risk, and overly aggressive use of antihypertensive drug therapy. An analysis of available data shows that at least one third of persons found to be hypertensive on initial screening will not have elevated blood pressure subsequently; that persons with mild hypertension (diastolic blood pressure 90 to 104 mm Hg) are not at high risk for cardiovascular disease; and that many patients with mild hypertension should be treated with non-drug therapies unless their diastolic blood pressure remains above 100 mm Hg. PMID- 6847009 TI - Assessment of nutritional correlates of blood pressure. AB - Nutritional factors are thought to contribute to the development of hypertension in susceptible humans. This review categorizes the types of nutrition-related data currently available on the relation between diet and blood pressure and provides guidelines for interpreting and using these data. The nutrition data base and the net effect of specific nutrients on blood pressure are discussed, and examples from the Health and Nutrition Examination Survey are given to compare demographic characteristics of various nutrients with demographic characteristics of hypertension in our society. Criteria for evaluating the strength and relevance of a specific nutrient's influence on blood pressure are presented. A comprehensive, continued assessment of all studies of diet and blood pressure control should assure better understanding of the pathogenesis and treatment of human hypertension. PMID- 6847010 TI - Chronology of the sodium hypothesis and hypertension. AB - The observations that have provided the foundation of the sodium hypothesis of human hypertension are reviewed. Clinical observations made over 125 years ago initiated an investigative effort that has encompassed epidemiologic data, development of salt-related experimental models, and elucidation of theoretical mechanisms that interface Na+ balance with abnormal regulation of peripheral vascular resistance. In spite of the data available, a consensus is lacking on the relevance of applying the link between sodium intake and increased blood pressure in certain hypertensive patients to all persons. PMID- 6847011 TI - Sodium intake and hypertension: a cause for concern. AB - Cardiovascular disease is the leading cause of death worldwide. Hypertension--the leading cause of heart attack, stroke, and kidney failure--occurs in more than 20% of adults in most modern societies. Hypertensive patients have defective sodium metabolism. From childhood throughout adult life most acculturated peoples consume 10 to 20 g of salt daily and have more obesity. Populations with low blood pressure are more active, leaner, and consume a diet low in sodium and high in potassium; however, when members of these groups are exposed to western diets, blood pressure increases with age and hypertension occurs. Drug treatment to control blood pressure prevents deaths. Conservative management, including low sodium, high-potassium diets, restores normal blood pressure in more than half of hypertensive patients. More information on the cause and mechanisms of this condition is needed, but our primary concern is for improved nutrition and drug treatment to prevent hypertension-related cardiovascular deaths. PMID- 6847012 TI - Human essential hypertension: implications of animal studies. AB - Hypertension has been linked to dietary sodium intake in humans. It is possible that 9% to 20% of the population may be genetically susceptible to developing essential hypertension by middle life. The remainder of the population may be genetically resistant to developing essential hypertension. A person genetically resistant to hypertension can ingest as much as 200 meq/d of salt without developing elevated blood pressure. However, in persons genetically susceptible to hypertension, a lifelong restriction of salt intake of less than 60 meq/d in adults may prevent hypertension indefinitely, and subsequent hypertensive complications. The same restriction of salt enhances the effect of most antihypertensive drugs and is the only treatment necessary in some persons with mild or moderate hypertension, especially the elderly. PMID- 6847013 TI - Dietary sodium and essential hypertension: some myths, hopes, and truths. AB - Rigorous sodium deprivation can lower the blood pressure of some patients with essential hypertension (at best, 30% to 50% of patients). In the rest, sodium depletion is ineffective and, in some instances, can raise the blood pressure and cause adverse clinical effects. In normal persons, it is difficult to affect blood pressure even with drastic changes in salt intake; for the blood pressure to rise even slightly, it may be necessary to consume more than 800 meq/d. There is no evidence to indicate that a widely applied, moderate reduction of salt intake could prevent the development of hypertension. The evidence suggesting that such moderate salt intake would significantly lower blood pressure in the patients with sodium-sensitive essential hypertension is weak. Human hypertension comprises a heterogeneous spectrum of abnormal vasoconstriction-volume interactions. Sodium deprivation, like other forms of therapy, should be applied only to those patients in whom its effectiveness has been established. PMID- 6847014 TI - Neural mechanisms of volume regulation. AB - Under steady-state conditions, urinary sodium excretion matches dietary sodium intake. Because extracellular fluid osmolality is tightly regulated, the quantity of sodium in the extracellular fluid determines the volume of this compartment. The left atrial volume receptor mechanism is an example of a neural mechanism of volume regulation. The left atrial mechanoreceptor, which functions as a sensor in the low-pressure vascular system, has a well-defined compliance relating intravascular volume to filling pressure and responds to changes in wall tension by discharging into afferent vagal fibers. These fibers have appropriate central nervous system representation whose related efferent neurohumoral mechanisms regulate thirst, renal excretion of water and sodium, and the redistribution of the extracellular fluid volume. PMID- 6847015 TI - Modification of salt taste. AB - Salt appetite and sodium intake in humans are controlled in part by taste. A distinction can be drawn between salt appetite that occurs when the organism is sodium deficient (in need) and when the organism has sufficient sodium stores (non-need) but continues to ingest salt. Although the latter case is most relevant to human sodium consumption, little is known about its physiologic, developmental, and experiential bases. Recent studies show that changes in dietary sodium consumption are followed by taste changes. Moderate decreases in dietary sodium of 2 months or more are followed by a decrease in the concentration of salt in food judged most pleasant. PMID- 6847016 TI - Dietary potassium and hypertension: epidemiologic data. AB - The strong geographic and social class differences in blood pressure may be related to differences in potassium intake or in the ratio of sodium to potassium intake. "Low salt" populations also have high potassium intake. In Japanese villages, populations with similar salt intake but different blood pressures had different potassium intake. In one study, a significant correlation was found between urinary Na/K ratio and blood pressure. Another study showed a significant negative correlation between potassium excretion and blood pressure. Four studies are available that show that blacks excrete much less potassium than whites. One of these studies also showed, by analyzing duplicate meals, that blacks consumed much less potassium than whites. A high potassium diet tends to be more expensive than a low potassium diet. Potassium intake may be a major factor in the epidemiologic differences of hypertension. PMID- 6847017 TI - Estimates of sodium and potassium intake. AB - Attempts have been made to estimate both the discretionary (consumer-controlled) and nondiscretionary (commercially controlled or naturally occurring) daily intakes of NaC1. These studies suggest that the average American has a total (discretionary plus nondiscretionary) daily intake of NaC1 ranging from 10 to 14.5 g, with about one third occurring naturally in food, one third added during food processing, and one third added by the consumer. Males consume more NaC1 than females and intakes of both sexes decline with age. Sodium chloride ingested with grain and cereal products and meat comprise about 50% of the daily nondiscretionary NaC1 intake. Additional amounts of sodium are ingested daily in drinking water and with drugs, but their contribution is difficult to determine. Total daily nondiscretionary intake of potassium is less well studied and is estimated to be in the range of 4 to 11 g/person. PMID- 6847018 TI - Calcium and magnesium nutrition in human hypertension. AB - Many studies suggest that reduced consumption of calcium or magnesium is associated with an increased risk of developing hypertension and cardiovascular disease. Results of animal studies show that restriction of calcium increases, and supplementation with calcium lowers, the blood pressure of normal and hypertensive rats. Data from the Health and Nutrition Examination Survey I done by the National Center for Health Statistics document the relation between dietary calcium intake and the risk of hypertension in the United States. Hypertensive persons consumed 18% less dietary calcium (hypertensive, 572 +/- 17 mg, versus normotensive, 695 +/- 7 mg; p less than 0.0001). Of the 17 nutrients analyzed, only calcium distinguished hypertensive persons from normotensive persons in all subgroups. Of all nutritional factors assessed, reduced consumption of calcium most consistently distinguishes hypertensive persons from normotensive persons. PMID- 6847019 TI - Calcium, vascular smooth muscle, and calcium entry blockers in hypertension. AB - Increases in vascular tone induced by an increase in cytosol calcium concentration may be important in the development of hypertension, myocardial ischemia, and other cardiovascular disorders. A heterogeneous group of compounds known as calcium entry blockers inhibit smooth muscle contraction induced by physiologic and pharmacologic stimuli by blocking transmembrane transport of calcium through membrane channels. These drugs may reduce blood pressure through effects on the heart, the venous capacitance vessels, the arterial resistance vessels, and the renin-angiotensin system. Although their efficacy in antihypertensive therapy may eventually prove to be nonspecific, their ability to interfere with a basic cellular mechanism for vasoconstriction makes these drugs attractive as potential specific treatment for the abnormal vasomotion in patients with hypertension. PMID- 6847020 TI - Trace elements and blood pressure. AB - Essential trace elements such as zinc, iron, and copper participate in various enzyme reactions directly related to the regulation of blood pressure and indirectly related to generation of oxidative metabolic energy, alterations in blood lipid levels, and alterations in taste acuity. The toxicological action of several heavy metal ions including cadmium, lead, mercury, and thallium can cause hypertension by affecting hormone metabolism, vasoconstriction, and renal tubular function. We conclude, however, that neither deficiencies of essential elements nor the presence of toxic heavy metals are primary causes of hypertension in our population. PMID- 6847021 TI - Dietary fat and blood pressure. AB - Until recently most experimental research linking diet to hypertension was related to dietary salt levels. However, recent evidence suggests that elevations in blood pressure, initially attributed to high salt intake, may be due to other factors in the diet, such as the level and type of fat consumed. Studies in animal models and humans suggest that blood pressure can be lowered during high salt feeding by supplementing the diet with polyunsaturated fatty acids such as linoleic acids. This review outlines key points that delineate the effect and possible interactions of dietary lipids on blood pressure regulation. PMID- 6847022 TI - Dietary protein intake and progressive glomerular sclerosis: the role of capillary hypertension and hyperperfusion in the progression of renal disease. AB - Unrestricted intake of protein-rich foods is accompanied by sustained increases in glomerular capillary pressures and flows. Intrarenal hypertension and hyperperfusion associated with protein intake may eventually cause glomerular sclerosis and account for decreased renal function seen with aging. Further elevation of glomerular capillary pressures and flows contributes to progressive glomerular destruction and eventual loss of renal function when nephron number has been reduced by renal disease. Progressive loss of renal function may be retarded by restriction of protein intake. Protein restriction appears to preserve renal function by limiting intrarenal capillary hypertension and hyperperfusion. PMID- 6847023 TI - Alcohol intake and hypertension. AB - In several studies, persons drinking relatively large amounts of alcohol were found to have higher average blood pressures. The association between alcohol and blood pressure is not explained by adiposity; reported use of salt, coffee, or cigarettes; or by under-reporting of alcohol intake. We examined 12-year follow up data on two matched groups of 850 hypertensive patients each; one group reported an intake of at least three alcoholic drinks per person per day, and the other group, fewer than three per day or none. Except for a lower rate of hospitalization for coronary disease, for which alcohol may be protective, cardiovascular complications leading to hospitalization or death had similar frequency in the two groups. These preliminary findings suggest that presumed alcohol-induced hypertension is as harmful as other forms of hypertension. A method for distinguishing alcohol-induced from non-alcohol-induced hypertension in drinkers is needed. PMID- 6847024 TI - Cardiovascular effects of alcohol. AB - Chronic alcoholism is the commonest cause of cardiomyopathy in the United States. Vascular hypertension and cerebrovascular accidents also occur with greater incidence in chronic alcoholics. Evidence suggests that the fundamental mechanism of injury induced by ethanol is structural and chemical disorganization of membranes, interference with ion transport, and derangement of various biochemical functions that possibly allow calcium to accumulate in the cell. Calcium accumulation in vascular smooth muscle may increase sensitivity to circulating vasopressors, and account for the increased incidence of hypertension in chronic alcoholics. Calcium accumulation may also cause problems in other tissues. The mechanisms for these complications of chronic alcoholism and their clinical relevance are reviewed. PMID- 6847025 TI - Weight and hypertension. AB - Both excess weight and hypertension may contribute independently to increased risk of cardiovascular disease. Weight and blood pressure have been found to be associated in most studies in diverse populations. The increase or decrease of blood pressure with weight gain or loss suggests a causal relation, although the mechanism is uncertain. A correlation between blood pressure and weight can be identified early in life. This correlation coefficient increases to approximately 0.4 in young adults and then begins to decrease at older ages. It is likely that weight interacts with various factors controlling blood pressure at different points over a lifetime. The implications for prognosis or control of blood pressure at different ages may vary as well. Attention to minimizing weight gain at a particular period of life, such as in young adulthood, might have long-term beneficial effects in preventing subsequent hypertension or excess blood pressure increase with aging. PMID- 6847027 TI - Nutritional consequences of reducing sodium intake. AB - An increased awareness of sodium's possible relation to hypertension has resulted in many Americans trying to avoid foods high in sodium without realizing the nutritional risks taken when these foods are eliminated from the diet. A recent study shows that a significant proportion of the population is consuming less than 66% of the recommended dietary allowance for calcium, iron, magnesium, and vitamin B6. Most of the population's daily sodium intake is from foods in the meat, grain, and milk food groups. Foods contributing sodium to the diet also contribute other essential nutrients currently consumed at inadequate levels by many Americans. There is a risk in reducing foods containing sodium from the diet without considering other nutrients. Emphasis should be on eliminating discretionary salt and selecting a balanced diet from the basic five food groups. PMID- 6847028 TI - Diet modification and the development of new food products. AB - The development of new food products to meet the needs of the 20th century American consumer offers a greater challenge to the innovativeness of the food industry scientist than ever before. The sequence of activities that leads to the introduction of a successful new food product into today's highly competitive marketplace has its beginnings and foundation in extensive and ongoing market research. This research elicits and defines the changing consumer needs and wants. The relation of diet to health is but one of many factors that influence food purchase decisions and, thus, the stimulus for developing new food products. In addition, the extent to which existing food products may be modified or new foods developed to meet dietary goals is subject to technologic and regulatory constraints. A commitment to ethical and responsible marketing strategies is essential to the evolution of food products for special dietary needs. Despite these complex restraints, many food products with altered nutrient or ingredient composition are currently available to consumers and others enter the marketplace each year. PMID- 6847026 TI - Exercise and blood pressure: nutritional considerations. AB - Exercise dramatically alters metabolic fuel balance and thus affects nutrient requirements. Because amino acids only serve a minor fuel role in exercise, the effect of work on protein requirements has received little recent attention. However, current research into the regulatory roles of amino acids (notably leucine) on muscle metabolism has led to renewed investigation of the substrate homeostatic functions of amino acids during exercise. These interests, coupled with reassessment of the limitations of recommendations for dietary amino acid intake obtained by the balance method and introduction of new tracer kinetic approaches for estimating nutrient requirements, have raised the possibility that exercise of high intensity or long duration may alter dietary amino acid needs to an extent not previously appreciated. PMID- 6847029 TI - Metabolic consequences of antihypertensive therapy. AB - The availability of pharmacologic agents has contributed to a reduction in the morbidity and mortality of hypertensive cardiovascular disease. However, antihypertensive agents are associated with changes that may adversely affect patients receiving therapy. Nutritional and metabolic consequences of antihypertensive therapy may be associated with enhanced atherosclerosis. The abnormalities in lipid metabolism, carbohydrate tolerance, and changes in the renin-angiotensin-aldosterone axis are reviewed. The mechanisms by which antihypertensive therapy causes these complications are unknown and their exact role in hypertensive cardiovascular disease remains to be elucidated. Appropriate selection of therapeutic agents and dietary manipulations may minimize the metabolic and nutritional consequences of antihypertensive therapy. PMID- 6847030 TI - Nutritional factors and blood pressure control: an assessment. PMID- 6847031 TI - [Supplement No XXV (1981) to Kauffmann-White scheme]. PMID- 6847032 TI - [Extracellular cellulases of "Bacteroides succinogenes"]. AB - The extracellular endo-beta-1.4-glucanase activity of Bacteroides succinogenes S85, grown on filter paper, was poorly stimulated by cysteine, slightly inhibited by cellobiose, but strongly inhibited by ethylthiomercuribenzoate. Active fractions against hydroxy-ethylcellulose and milled filter paper were eluted from a polyacrylamide gel filtration column with an apparent molecular weight of 60,000 daltons. PMID- 6847033 TI - [Evaluation of bactericidal activity of antiseptics on the cutaneous flora of holoxenic hairless mouse]. AB - Holoxenic Hairless mice were used in an experimental model to study the in vivo bactericidal activity of several antiseptics. In these experiments skin was sampled by biopsy; after contact between antiseptic and skin, bactericidal activity was neutralized. The results obtained with several products (polyvinylpyrrolidone iodine, alcoholic iodine, ethanol, chlorhexidin, benzalkonium chloride, mercurothiolic acid, trichlorocarbanilid and hexachlorophen) were quite similar to those obtained on human skin. The differences must be related to the composition of the Hairless mouse skin flora which contains Staphylococcus xylosus, Micrococcus sp. and Streptococcus faecalis, but does not contain Corynebacterium sp. or Propionibacterium sp. PMID- 6847034 TI - Incorporation of thymine, thymidine, adenine and uracil into nucleic acids of Mycobacterium phlei and its phage. AB - Like other prototroph bacteria, Mycobacterium phlei was found to incorporate thymine into its DNA very poorly. As a result of a rapid thymidine-to-thymine conversion, thymidine incorporation also proved to be inefficient. Thymidine incorporation could be somewhat enhanced by pretreatment of the cells with uridine. When radioactive adenine, and particularly uracil, were used as precursors, highly labelled DNA could be obtained from the cells, although the majority of radioactivity was found in the RNA. Uracil was thus found to be the most suitable precursor for labelling phage DNA. On the basis of these findings, uracil is recommended for in vivo labelling of Mycobacterium and mycobacteriophage DNA. PMID- 6847035 TI - Legitimacy of the names of subspecies of Campylobacter fetus proposed by Veron and Chatelain, 1980. AB - Since the publication of the 8th edition of Bergey's Manual of determinative bacteriology, there has been considerable confusion concerning the names of 2 subspecies and the types of the subspecies of Campylobacter fetus (Smith and Taylor, 1919) Sebald and Veron, 1980. Despite the documentation of the names C. fetus subsp. fetus (Smith and Taylor) Veron and Chatelain and C. fetus subsp. venerealis (Florent) Veron and Chatelain, which appear in the "Approved lists of bacterial names", the influence of Smibert's description in the 8th edition of Bergey's Manual continues. To stabilize the nomenclature and to avoid or reject the use of names which may cause error or confusion, this paper will focus on the legitimacy of the 2 subspecific names of C. fetus proposed by Veron and Chatelain. PMID- 6847036 TI - Ewingella americana gen.nov., sp.nov., a new Enterobacteriaceae isolated from clinical specimens. AB - We propose the name Ewingella gen.nov. for a new group in the Enterobacteriaceae. Ewingella is phenotypically distinct from all other groups of Enterobacteriaceae. The members of this genus are lipase- and deoxyribonuclease-negative; Voges Proskauer-positive; lysine-, ornithine- and arginine-decarboxylase-negative; anaerogenic; they produce acid from glucose in the presence (and absence) of iodoacetate, but fail to produce acid from L-arabinose, melibiose, raffinose, D sorbitol or sucrose. DNA-relatedness studies (S1-nuclease method) showed that the 10 Ewingella strains studied form a single DNA-hybridization group which is less than 21% related to other members of the Enterobacteriaceae. This single DNA hybridization group is named Ewingella americana sp. nov. The type strain of E. americana is CDC 1468-78 (= ATCC 33852 = CIP 8194). Although the 10 strains of E. americana were isolated from clinical sources in the United States, the clinical significance of these organisms is not known. PMID- 6847037 TI - In vitro susceptibility of Mycobacterium fortuitum to non-antituberculous antibacterial agents. AB - A study was made of the in vitro susceptibility of 37 strains of Mycobacterium fortuitum to 14 antimicrobial agents using disc diffusion techniques on Mueller Hinton agar plates. Nitro-5-hydroxy-8-quinoleine and pipemidic acid inhibited all strains, while furantoin, mandelamine, metronidazole, nalidixic acid, oxolinic acid and trimethoprim proved to be inactive. In addition, various sulphonamides inhibited 59% of the strains tested. Sulphadiazine inhibited 54.1%, sulphafurazole 64.9%, sulphamethizole 64.9%, sulphametoxypyridazine 62.2% and sulphisoxazole 59.5%. Trimethoprim-sulphamethoxazole was effective against 48.6% of the strains due to its sulph component. The sensitivity to sulphonamides varied in accordance with the origin of the strains, those of human origin being generally much more susceptible than those of non-human origin. PMID- 6847038 TI - [Changes in the activity of antibiotics by fatty acids in bone tissue]. AB - The C14 to C18 fatty acid content of spongious bone was measured by gas-liquid chromatography. Palmitic acid (C16:0), oleic acid (C18:1) and linoleic acid (C18:2) represented 20 to 40% of the total free fatty acid concentration (30 mM/l). Linoleic acid was found to have the greatest bacteriostatic activity against Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa strains. The effect of linoleic acid-gentamicin combination was synergistic against S. aureus. In contrast, both gentamicin and colistin activities were highly antagonized by linoleic and oleic acids against E. coli and P. aeruginosa strains. These different effects of free fatty acids on antibiotic activity could be explained, in part, by a change in permeability of bacterial cells. The clinical implications of these results in bone infections are discussed. PMID- 6847039 TI - [Comparative study of the lipid composition of seven species of "Micromonospora"]. AB - Analysis of the lipids of seven species of Micromonospora showed the constant presence of five phospholipids and three glycolipids. The phospholipids were identified as cardiolipids, phosphatidylethanolamine, phosphatidyl-inositol, mannosides of phosphatidyl-inositol, and possibly lysocardiolipids. The glycolipids were monoglucosyl-diglycerides, diglucosyl-diglycerides (with a small amount of galactosyl-glucosyl-diglycerides) and esters of fatty acids and trehalose. The simultaneous presence of glucosyl-diglycerides and trehalose esters might be specific of the genus Micromonospora. In the seven species studied, a large amount of the total fatty acids (obtained by direct saponification of the cells) consisted of iso and anteiso fatty acids. Three groups could be distinguished, having respectively iso-C15, iso-C16 and n-C17 fatty acids as the main members. A monounsaturated C17 acid has been identified as heptadec-9,10-enoic acid. PMID- 6847040 TI - A mouse model to compare virulence of abortive and intestinal ovine strains of Chlamydia psittaci: influence of the route of inoculation. AB - Strains of Chlamydia psittaci isolated from faeces of a clinically healthy ewe (intestinal strain IB1) and from the foetus of an aborted ewe (abortive strain AB7) were injected into pregnant mice via the intraperitoneal route and into non pregnant mice via the footpad route. In pregnant mice the response to inoculation was followed by recording the performance and viability of infant mice, and in the non-pregnant mice by an enlargement of the spleen and colonization of both the spleen and popliteal lymph node. The intestinal Chlamydia strain was less virulent than the abortive strain, but the actual difference of virulence depends upon the route of inoculation. Thus the intestinal strain was at least 500 times less virulent than the abortive strain and was rapidly ruled out when injected subcutaneously into the footpad, whereas it was even less than 100 times less virulent than the abortive strain, and able to induce death of some infant mice, when given intraperitoneally in pregnant mice. The mouse model of experimental subcutaneous infection via the footpad route could be used to easily test the differences of virulence between different strains of C. psittaci. PMID- 6847041 TI - British Occupational Hygiene Society. Report from the Committee on Asbestos. A study of the health experience in two U.K. asbestos factories. PMID- 6847042 TI - Lead poisoning among Indian silver jewelry makers. PMID- 6847043 TI - Vickers instruments M88 rapid asbestos fibre monitor. PMID- 6847044 TI - Measurement of fibre diameter from SEM images. PMID- 6847045 TI - Remedial measures for wastes containing polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs): destruction, containment or process modification. PMID- 6847046 TI - Urinary N2O as a measure of biologic exposure to nitrous oxide anaesthetic contamination. PMID- 6847047 TI - Pigmented corneal implants: a surgical treatment for iridectomy related optical complications. AB - Initial evaluation in rabbits demonstrates that corneal implants made from prolene and nylon sutures flattened into strips appear promising as a means of covering diplopia or glare-inducing iridectomies. Two-month follow-up studies showed the implants to be well tolerated in the corneal stroma. Results of the studies suggest that black prolene films of 50 to 70 micrometers in thickness, contoured to follow the corneal curvature, would be the ideal configuration for such implants. PMID- 6847048 TI - Diagnosis and treatment of cavernous hemangiomas of the choroid and the retina. PMID- 6847049 TI - Electrophysiologic tests in assessment of senile macular degeneration. AB - Twelve patients with macular disease were studied. Mean age at the beginning stages of the disease was 61.75 years. They were examined by biomicroscopy, fluorescein angiography, and electrophysiological tests (ERG, EOG, VEP). No relevant correlation could be found between the routinely administered and evaluated ERG and EOG tests and the clinical stage of the disease. The VEP proved a more sensitive means of evaluating macular function in our patients. The possibility of the VEP's being of prognostic importance is raised. PMID- 6847050 TI - Bilateral rhegmatogenous retinal detachment associated with unilateral choroidal melanoma. AB - A patient with bilateral rhegmatogenous retinal detachment associated with a unilateral choroidal melanoma is presented. It appears that there is no causative relationship between these two findings in this case. The clinician should be advised that these two phenomena are not as rare as was once thought, and an index of suspicion should be maintained whenever one is evaluating a patient with retinal detachment. PMID- 6847051 TI - Posterior subcapsular cataracts in a patient with hemochromatosis. PMID- 6847052 TI - Familial exudative vitreoretinopathy. AB - Two sisters and a brother with the syndrome of familial exudative vitreoretinopathy are described (FEV). Findings associated with this condition include temporal neovascularization, vitreous hemorrhage, and retinal detachment. Familial exudative vitreoretinopathy is a genetic syndrome with nearly complete penetrance but widely variable expressivity. The differential diagnosis is fairly extensive. This condition is sometimes confused with retrolental fibroplasia, and FEV is probably a more frequently occurring disease than previously thought, because of confusion with RLF. The pathophysiologic mechanism, natural history, and optimal treatment of this disease are matters of debate. With active surgical management, three of the four eyes which presented to us for treatment have visual acuity of 20/30 or better. PMID- 6847053 TI - Intrachoroidal hemorrhage mistaken for malignant melanoma. AB - An 84-year-old man had a choroidal mass in the temporal aspect of his left globe associated with a nonrhegmatogenous retinal detachment of the macula. Because of suspected malignant melanoma of the choroid the eye was enucleated. On histopathologic examination we found that an intrachoroidal hemorrhage, an extremely unusual type of intraocular hemorrhage, accounted for the mass. PMID- 6847054 TI - New instruments and products. Spectacle-mounted telescopic lenses for children. AB - Telescopic aids for children have received little attention in the ophthalmic literature. What has been written is anecdotal and stresses the negative aspects of mobility with spectacle mounted aids. The benefits of a telescopic system that also maintains the patient's mobility are presented in this article. Mounted high in a spectacle carrier lens and with a 10 degrees upward inclination the telescope is "out of the way" while the patient is moving about. However, instant availability is obtained by the patient depressing his chin slightly to align his visual axis with the scope. Forty of 167 legally blind students at the Missouri School for the Blind were fitted with these aids. The objective and subjective results were excellent. Students with albinism and aniridia seem well suited for this type of aid. PMID- 6847055 TI - [Instantaneous measurement of acoustic reflex latency in daily practice. The apparatus. Results]. AB - Increase in acoustic reflex latency (time between stimulus onset and response) provides a highly specific and sensitive sign for early detection of lesions of the first or second auditory neurones. The performance of a new apparatus, including an Amplaid 702 impedance meter with a specially designed numeric oscilloscope, employed systematically for all audiometric examinations (87 subjects) was compared with that of a reference apparatus (Madsen ZO 73 + Elema Schoenander-jet ink recorder). The new apparatus provided a very simple, precise, and rapid method for measuring acoustic reflex latency. The technique has its limits, however, of critical importance being the determination of the acoustic reflex threshold at close to 1 dB (modification of the apparatus), the means for measuring latency, and the use of three criteria for distinguishing retrocochlear lesions from others. The effect of age on latency, variations in the test-retest results according to the type of deafness, and the influence of averaging techniques are discussed. Typical retrocochlear lesions were rare in this series, and the 5 cases observed are described in detail, followed by a discussion of the advantages and inconveniences of systematic as against selective screening. PMID- 6847056 TI - [Equilibration of the upper part of the face in the sequelae of stabilized facial paralysis]. PMID- 6847057 TI - [Osteomas of the sinuses. Approaches and excision technics]. PMID- 6847058 TI - [Intubation or tracheotomy in severe subglottic laryngitis]. AB - A retrospective study to assess safety of nasotracheal intubation for subglottic laryngitis in children was conducted in 44 cases treated in the Intensive Care Unit of Hopital Bretonneau, France between 1971 and 1981. Intubation had been performed in 40 children, and immediate tracheotomy in the other 4. The course of the affection was favorable in 37 (92,5%) of intubated children, secondary tracheotomy being necessary in only 3 cases. A mean duration of 84 hours of intubation was sufficient in 24 children, a total mean duration of 180 hours being required in the 13 other cases. The catheter employed in the 3 tracheotomized children with morbilous laryngitis was too large, and laryngeal stenosis developed in 2 of them. These findings demonstrate that when a catheter of correct size (1/2 size below that indicated by the weight and age of the child) is employed, nasotracheal intubation for severe subglottic laryngitis is a safe procedure. PMID- 6847059 TI - [Postembolization facial paralysis. Apropos of 2 cases]. PMID- 6847060 TI - [Wegener's granulomatosis: an often difficult diagnosis. Apropos of a case with digestive localization but without lung or kidney involvement]. AB - Even if Wegener's disease is a rare condition, it interests many authors. Many recent reports had contributed to a best knowledge of the disease. Nevertheless, it persists a number of questions without yet an answer. In this paper, for example, we present a case of Wegener's granulomatosis, which mimics in the beginning the so-called "lethal midline granuloma", with progressive ulceration of the midfacial tissues and nose. It was highly suspected of being stewart's syndrome--Repeated biopsies gave no evidence of diagnosis. At least, the diagnosis was affirmed only by laparotomy. Pathological findings were typical of Wegener's granulomatosis with lesions interesting the sole digestive tract, lacking the characteristical chest and kidney involvement. The authors insist on the difficulties of the diagnosis, the etiologic considerations, and a better definition and classification of the affection. PMID- 6847061 TI - [Ethmoidal mucocele in a nursing infant. Apropos of 1 case]. AB - Characteristic features of mucoceles of the paranasal sinuses in infants are their extreme rarity, their localization exclusively in the ethmoidal sinuses, and the specific nature of their clinical expression. Partial explanation of these specific features is provided form knowledge of the embryology of the facial sinuses and the various pathogenic theories developed concerning these mucocele lesions. Two out of four cases observed were associated with viscidosis, and a sweat test must be routinely performed in all cases. PMID- 6847062 TI - [Esthesioneuroblastoma. Apropos of a complete case report]. PMID- 6847063 TI - [New surgical approach in chronic gelatinous edema of the vocal cords or pseudomyxoma]. PMID- 6847064 TI - [Correction of defects in the projection of the tip of the nose after surgery]. AB - Dropping of the tip of the nose after surgery is mainly the result of either too extensive resection of the alae or excessive resection of the septum. In the first case, the resulting round or hooked nose can be corrected by an auto or homologous cartilage graft. In the second case, following surgery to obtain functional improvement, the presence of an osteocartilaginous hump can be exploited to support the tip, or a conventional flap can be employed, composed of alar chondromucosal tissue. These remarks are but one particular feature of secondary surgery to the nose, a delicate surgery in full expansion. PMID- 6847065 TI - [Finally an effective treatment of facial hemispasm?]. AB - In the absence of a known or generally admitted etiopathogeneicity, and as a result of failure of medical treatment for facial hemispasm, various surgical procedures have been proposed to alleviate this affection. Two types of operation can be distinguished: muscle resection and facial nerve surgery. The latter includes alcohol injection, combining of the 2nd part of the nerve, neurotomy, or neurectomy of the main or distal portions. However, recurrence is very frequent. Two cases were treated by evulsion of the suborbital nerve with marked success, all the above-mentioned procedures having been employed in one of these cases. Though it is too early to speak of recovery, there was no associated motor deficiency, particularly in the regions of the eye and labial commissure. These findings evoke possible relationships between facial and trigeminal nerves, a peripheral motor stimulus-response process providing an explanation for the hemispasm and its cure after evulsion of the suborbital nerve. PMID- 6847066 TI - [Hemimandibulectomy with immediate reconstruction by iliac bone graft]. PMID- 6847067 TI - [Clinical and anatomopathological course of cancer starting in the vocal cords. Results of treatment]. AB - Histological examination of serial sections from 127 cases of precancerous lesions and 86 cases of early cancer of the vocal cords was conducted. A histological precancerous state was observed: cellular dysplasia. Analysis of progression of cancer of the vocal cords showed 4 different varieties of carcinogenesis: one sudden, one progressive, one by proliferation and one by transformation. Functional conservative surgery of a glottic cancer had been performed in 76.7 p. cent of cases, and cobalt therapy applied in 23.3 p. cent. Recurrence rate was 6.1 p. cent after surgery and 30.0 p. cent after irradiation. Recovery occurred in 75.6 p. cent after surgery and 65.0 p. cent after irradiation. Precancerous lesions were treated by conservative operations and by microsurgery. PMID- 6847068 TI - [Use of tomodensitometry in the evaluation of the extension of certain laryngeal cancers]. AB - Radiopathological examinations were conducted on a frozen laryngeal specimen to determine its characteristics as seen on the CT scan image. Results of CT scan imaging of 37 patients with laryngeal cancer were then compared with results of clinicopathological examination in 20 cases (after fixation and decalcification, the 20 samples were sectioned in axial planes reproducing those of the CT scan as for as possible). The results of computed tomography are conclusive for investigation of tumoral extension to the hyothyo-epiglottic space, and may lead to modification of therapy; they are of marked value for assessment of tumoral extension to the laryngeal cartilages, with the reservation that ossification of these cartilages must be taken into account. Furthermore, they enable assessment of subglottal extension when the respiratory state of the patient or the size of tumor makes it impossible to perform direct laryngoscopy. PMID- 6847069 TI - [Echography and parotid tumors]. AB - Morphological criteria obtained from ultrasonic exploration of 82 parotid tumors were compared with histological findings. Precise determination was possible of the size of the tumor, its cystic or solid nature, and the pre-operative evaluation of its benign or malignant nature. In spite of certain deficiencies, the safety, rapidity of execution, and reliability of ultrasonography make it a complementary investigation of choice for all isolated nodular lesions in the parotid region before surgical exploration, which remains indispensable. PMID- 6847070 TI - [Idiopathic and zoster vestibular neuritis. Course and prognosis]. AB - 112 cases of vestibular neuritis were studied. 77% were relatively pure lesions, whilst in 23% of cases there were more extensive lesions with abnormalities of the saccadic oculomotor system and BERA abnormalities. Spontaneous nystagmus disappeared in 2 to 3 months in general. In 54% of cases there was complete recovery of absolute reflex activity within normal limits on the affected side. There was restoration of normal difference of reflectivity in 22%. In 13% there was normal absolute reflex activity, normal hypovalence and normal directional preponderance. Age appeared to influence the course of directional preponderance and the extent of lesions on the course of hypovalence. Early mobilisation of the patient is of primordial importance. PMID- 6847071 TI - [Current histopathological findings in Meniere's disease]. AB - Controversy exists as to the presence of ruptures of the membranous labyrinth in patients with Meniere's disease, some authors considering the lesions reported to be artefacts only. Confirmation of the existence of healed labyrinthine tears was obtained in all cases of clinically and histopathologically confirmed Meniere's disease studied by means of a protocol involving strict criteria. Lesions were observed mainly in Reissner's membrane and demonstrated three particular aspects. It is suggested that the images described by Out-Pouch in the posterior labyrinth are also the result of healed ruptures. PMID- 6847072 TI - [Adult rhabdomyoma of the larynx. Apropos of a case]. PMID- 6847073 TI - [Problems in the surgical treatment of malignant ethmoidal tumors using a combined endocranial and facial approach]. PMID- 6847074 TI - [Measurement of the latencies of voluntary and corrective ocular saccades. Value in otoneurology]. AB - The delay between the stimulus and the voluntary eye saccade is the only parameter of the saccadic system which can be measured by using standard apparatus. Taking manually the measurements made on records obtained by using minicomputer; the authors show that such manual measurement of latencies is easy and yet sufficiently accurate to be of great clinical value. The latencies of voluntary saccades are normal in peripheral pathology (less than 250 milliseconds). Latencies of voluntary saccades are significantly increased in extrinsic brain stem lesions: tumours (in particular ponto cerebellar tumours), meningitis, head injury; but the velocity of the saccade is normal. This effect goes in parallel with impairement of the smooth pursuit. In intrinsic brain stem lesions (multiple sclerosis, acute brain stem stroke, oculomotor paralysis) latencies are increased bilaterally and above all, there is a significant slowing of the saccade. The role of fatigue increased latencies in some patients of this series. Two populations can be discerned in vestibular neuritis: one normal and one with abnormal smooth pursuit and increased saccadic latencies. PMID- 6847075 TI - [Musculocutaneous flaps in cervicofacial cancerology]. PMID- 6847077 TI - [Interactions between human serum albumin and local anesthetics derived from xylidine]. PMID- 6847076 TI - [Bacterial growth in liquid medium: use of laser nephelometry for the performance of a rapid antibiotic sensitivity test]. PMID- 6847079 TI - [Assay of a radiation-sensitizer, misonidazole, by high-performance liquid chromatography]. PMID- 6847078 TI - [Isolation and confirmation of the structure by 13C-NMR of the main prosapogenin from Ruscus aculeatus L]. PMID- 6847080 TI - [New cyclohexane 3-spirobutenolide acid aminoesters: synthesis and pharmacological approach]. PMID- 6847081 TI - [In vitro interactions between lectins and beta-indoleacetic acid]. PMID- 6847082 TI - [Friedel-Crafts reactions of furanones and furandiones]. PMID- 6847083 TI - Breast reconstruction--selection, timing, and local recurrence. AB - Although reconstruction is now a standard part of the care of breast cancer patients, certain unresolved issues surround local recurrence. A percentage of women can be expected to develop local recurrence after mastectomy, whether or not they have reconstruction. This study provides a baseline for local recurrence in breast reconstruction candidates. Between 1955 and 1975, 1,110 patients underwent modified radical mastectomy at the Cleveland Clinic. This group of patients was analyzed to provide information about local recurrence in breast reconstruction candidates. The data were also analyzed for the effects of timing and nodal status. On the basis of this study, we have concluded that the number of involved axillary lymph nodes alone should not exclude a woman from having reconstruction. We also conclude that there is no oncological justification for imposing a specified waiting time between mastectomy and reconstruction. PMID- 6847084 TI - Silicone-induced human adjuvant disease? AB - Human adjuvant disease is an immunologically mediated disorder manifested by arthritis, arthralgias, skin lesions, malaise, pyrexia, and weight loss. Clinically, it often resembles rheumatoid arthritis and Reiter's syndrome. While scattered cases of adjuvant disease have been reported following injections with silicone fluid of unknown purity, paraffin, and petroleum jelly, no cases of adjuvant disease following silicone gel implant mammaplasty have been reported. We present such a case, discuss the pertinent biology of silicone, and review the literature describing adjuvant disease. PMID- 6847086 TI - Healing of a split flexor tendon graft--an experimental study in chickens. AB - The half-thickness flexor tendon graft proved to be an adequate replacement in experimental tendon defect repair in chickens. The caged birds regained 59% and the free-ranging chickens 75% of normal flexion. The strength of the healing tendons averaged 42% of normal. The donor flexors regained an average of 90% and the grafted portion of the recipient flexors 85% of their original diameter. Birds allowed the freedom of their natural habitat healed better, as shown by greater restoration of tendon diameter, strength, and return of active flexion. In an emergency, in the event of multiple tendon injuries of the hand when other tendon replacement is not possible, the split tendon graft may be usable. PMID- 6847085 TI - Mimetic neurotization from masseter muscle. PMID- 6847087 TI - Subcutaneous-pedicle triangular skin flap for closure of circular defects. PMID- 6847088 TI - Vascularized omentum for facial contour restoration. AB - Our experience with the omental flap for facial soft-tissue augmentation in 7 patients is presented, along with our method of fixation of the graft to prevent gravitational descent. The history of the omental free flap, as well as the previously applied techniques for facial soft-tissue augmentation, is reviewed. It is our conclusion that the omental free flap is a safe, reliable technique. It can be readily molded to exactly conform to the patient's deformity and produces good results both in repose and during facial expression. We believe that gravitational descent of the graft can be prevented by the technique of multiple suture fixation. PMID- 6847089 TI - Palatal grafts for lip reconstruction. AB - Palatal mucosal grafts are used to provide bulk and improve the contour of lip defects. Since the palatal grafts are markedly different in color, they must be placed behind the wet-dry mucosal line so that they cannot be easily seen at conversational distances. The contrast with the red vermilion is too great for this graft to be used as a cosmetic lip substitute, but when the graft is used as a living tissue expander in the posterior position, it improves subtle lip contours. PMID- 6847090 TI - Effects of levator retrodisplacement on conductive hearing loss in the cleft palate patient. AB - The effect of a levator retrodisplacement procedure upon conductive hearing loss in cleft palate patients was evaluated. Forty-two children with cleft palates, operated upon between 1970 and 1975, were included in the study. The results suggest that 73.5% of those in the levator retrodisplacement group achieved normal hearing, compared with 37.5% among those whose palatoplasties did not include levator retrodisplacement. The degree of hearing impairment in patients with levator retrodisplacement was mild (20 to 40 db) in contrast to that in patients without levator retrodisplacement, whose impairment was severe (40 to 60 db). PMID- 6847091 TI - Subciliary incision and skin-muscle eyelid flap for orbital fractures. AB - The lower eyelid skin-muscle flap is now widely used for cosmetic blepharoplasty, primarily because of the ease and speed of dissection it offers. We have used the same technique as a surgical approach in fractures of the orbital floor and rim. In a large clinical series seen over a three and a half-year period, no major complications were noted. This approach provides simple, extremely rapid exposure of the injured area and is an excellent alternative to other approaches to this site. PMID- 6847092 TI - Latissimus dorsi musculocutaneous flap in postthoracotomy patient. PMID- 6847093 TI - Microsurgical replantation of a completely amputated penis. AB - Replantation of a penis with microsurgical repair of vessels and nerves can restore normal genitourinary function. A case is presented of an amputated penis that was ischemic for sixteen hours before being microsurgically revascularized. The patient has at all times appreciated having an intact penis despite the fact that the injury was self-inflicted. Self-mutilation is not considered to be an absolute contraindication to replantation. PMID- 6847094 TI - Angular artery flap for total reconstruction of the lower eyelid. AB - An island flap of the skin and soft tissues of the nasojugal fold and lip can be based on the superior end of the angular artery. This flap, lined with mucous membrane, was a satisfactory means of reconstructing the lower eyelid in a patient with inadequate skin for a cheek flap. A disadvantage was the need to trim the bulkiness of the flap in subsequent stages. PMID- 6847095 TI - Extensor indicis brevis: a rare anatomical variation. AB - We describe a rare anatomical variant, the extensor indicis brevis--a "short" index extensor originating from the ligament over the scaphoid bone. In our patient it presented as a tender mass. The knowledge of such anatomical variations is important in diagnosing dorsal hand masses and in planning tendon transfers. PMID- 6847097 TI - Microsilicone anastomoses. AB - Silicone tubes used for lacrimal system reconstruction have already been tested as temporary microvascular shunts. As a model of the small vessel, the silicone tube is used for initial training in microvascular surgery. It is useful for both teaching and practicing. PMID- 6847096 TI - A system for organizing and storing slides. PMID- 6847099 TI - A further criticism of geometric surgery. PMID- 6847098 TI - Anesthesia for craniofacial osteotomies. AB - Management of major craniofacial deformities requires an interdisciplinary approach. The importance of the role of the anesthesiologist is often not appreciated by those outside that specialty. The experience of almost fifteen years of dealing with these very difficult cases is presented. Anesthetic techniques are discussed in general terms. Intraoperative and postoperative airway problems and solutions are stressed. An effort is made to describe how the anesthesiologist should work with the surgeon to prevent anesthetic emergencies and to ensure optimal patient management. PMID- 6847100 TI - [Critical study of Legg-Calve-Perthes disease. Apropos of a series of 67 cases]. PMID- 6847101 TI - [Peroperative Staphylococcus aureus contamination and functioning of the ventilation in an operating room]. PMID- 6847102 TI - [Value of sulpiride in the prevention and treatment of stress ulcer. Apropos of 3 cases]. PMID- 6847103 TI - [Panorama of lesions of the facial bone structure]. PMID- 6847105 TI - [Surgery of biliary lithiasis in subjects over 75 years of age. Apropos of 139 cases]. PMID- 6847104 TI - [Surgical aspects of radiolesions of the small intestine after total lymphoid irradiation. Apropos of 19 cases]. PMID- 6847106 TI - Vagotomy in the cimetidine era. PMID- 6847107 TI - Treatment of acquired anal incontinence. AB - Outline of the pathophysiological basis of defaecation is given and also classification of anal incontinence. In the operative technique described the defective sphincters are replaced by drawing down the puborectal muscle, i.e. by a displacement of the muscle caudally. This method is simple, physiological, and appears superior to all others. It has been used in 15 patients, in 14 of whom it was completely successful. The lesion had been present in these patients for 1-13 years. Their average age was 40. There is a fundamental distinction between congenital and acquired anal incontinence. The congenital lesions fall within the domain of paediatric surgery, and will not be discussed. PMID- 6847108 TI - Portal pressure following partial to extensive hepatic resection in patients with and without cirrhosis of the liver. AB - In 24 patients with and without cirrhosis of the liver, portal vein pressure was measured prior to and after hepatic resections of various magnitudes. In 6 patients who underwent resection of less than 20% of the liver portal pressure did not change although all patients had associated cirrhosis. On the other hand, a substantial rise in portal pressure was found in 17 of 18 patients who had resection of more than 30% of the liver irrespective of the presence or absence of cirrhosis. No significant difference was observed between the degree of portal pressure rise and the magnitude of hepatic resection. Also, there was no difference in the increase in portal pressure between the patients with and without cirrhosis of the liver. The present study may indicate that splanchnic sequestration associated with acute portal hypertension frequently occurs even in humans after resection of 30% or more of the liver even if the remaining liver is normal and anatomical dissection has been employed. Appropriate intra- and postoperative management is necessary to combat this difficult condition. PMID- 6847109 TI - Carcinoid of the stomach: a case report and review of 100 cases reported in Japan. AB - A case of carcinoid of the stomach is described and a review of 100 patients with carcinoid of the stomach reported in Japan up to 1980 is made. Of the 100 cases, the male to female ratio was 2.54. Typical clinical manifestations of the carcinoid syndrome were quite rare. Metastases to the liver were observed in 76% of cases with tumours larger than 5 cm in diameter. The liver and lymph nodes were common sites of metastases. Carcinoids arising from the anterior wall of the stomach also showed a high incidence of metastasis. As a result of histochemical examinations, it was revealed that the nonreactive cell type was found in 31% of cases, while the argentaffin cell type was found in only 10%. Confirmation of the diagnosis of carcinoid is sometimes difficult. Occasionally, therefore, electron microscopic demonstration of specific secretory granules becomes essential for the final diagnosis. PMID- 6847110 TI - Five-year results of proximal gastric vagotomy. AB - Between February 1972 and December 1976 100 proximal gastric vagotomies (PGV) were performed on duodenal ulcer patients after failure of conservative treatment. The diagnosis was verified by preoperative barium meal and endoscopy and by peroperative examination. There was no operative mortality. Mean duration of postoperative hospital stay was 9.6 days. The percentual distribution in Visick-grading at the 1-year follow-up was 90% in class I + II, and 10% in class III + IV. The corresponding figures at the 5-year follow-up were 82% and 18%. The mean postoperative basal acid output did not change from one to five years. The reduction in pentagastrin stimulated acid output was unchanged at the 1- and 5 year follow-up. Neither did the mean acid output after insulin stimulation change between one and five years postoperatively. The mean concentration of serum gastrin was raised at one year but decreased to normal at the 5-year follow-up. Ten patients (10%) had ulcer recurrence during follow-up. Seven of these were successfully treated by gastric resection and three by antacids and cimetidine. PMID- 6847111 TI - Operated lumbar disc herniation: epidemiological aspects. AB - A total of 1011 operations for lumbar disc herniation were carried out in South West Finland during the period 1975-1979. Of these operations 907 were first and 104 reoperations. Eleven patients had cauda equina symptoms. There were 856 operations performed on patients living in the area served by Turku University Central Hospital, an area with 455 000 inhabitants. Operations on 778 patients (342 women and 436 men, mean age 41.6 years) were first and operations on 78 patients (36 women and 42 men, mean age 42.7 years) were reoperations (9.1%). Nearly 90% of the patients were between 25 and 54 years of age. Neither heavy nor light work was more common among the first operated or reoperated patients than in the population at large. The monthly variation in the number of operations had no statistical significance. The incidence of operation for first lumbar disc herniation varied yearly from 31 to 36 per 10(5) persons living in the Turku University Central Hospital area. PMID- 6847112 TI - Massive foeto-maternal haemorrhage in combination with retarded foetal growth. PMID- 6847113 TI - Modified subtotal mastectomy and free nipple graft in the treatment of severe mammary hypertrophy and ptosis. AB - Subtotal mastectomy using a modified Strombeck formula for planning of the incisions, and occasionally from one to three dermofat flaps, combined with free nipple transplantation, has been applied to seven patients with severe mammary hypertrophy and ptosis. There have been no major complications, the aesthetic result is satisfactory, and the risk for later mammary cancer is minimized. The technique is recommended in severe hypertrophy and/or ptosis to overcome the increased risk of nipple necrosis of the classical reduction plasties. It may also be combined with prosthetic augmentation to substitute a subcutaneous mastectomy in only ptotic breasts. PMID- 6847114 TI - Measurement of serum thyroxine by solid-phase chemiluminescence immunoassay. AB - Descriptions are given of two solid-phase chemiluminescence immunoassays for the measurement of total thyroxine in serum. The antibodies were either attached to small uniform plastic microspheres (method 1) or passively adsorbed to antibody coated tubes (method 2). The labelled antigen was thyroxine-aminobutyl ethyl isoluminol. After the antibody-binding reaction the antibody-bound fraction was washed, sodium hydroxide was added, and the mixture was incubated. Luminescence was initiated by oxidation of the label with microperoxidase/hydrogen peroxide and the signal integrated for 10 seconds. The light yield is inversely proportional to the concentration of thyroxine in the standard or sample. Both methods have similar sensitivity and precision to that obtained by a conventional radioimmunoassay. PMID- 6847115 TI - Radioenzymatic assay of catecholamines: reversal of aluminium inhibition of enzymatic O-methylation by desferrioxamine. AB - Alumina is commonly used for the purification and concentration of catecholamines in biological specimens before analysis. Acid eluates of alumina, found to contain high concentrations of Al3+, interfered with O-methylation but not with N methylation. The chemistry of the catecholamines, supported by kinetic studies, suggest that complex formation between aluminium and the substrate account for the observed inhibition of O-methylation. The addition of desferrioxamine, a metal-chelating agent, to the reaction mixture reversed this inhibition and, by allowing a preliminary alumina extraction, permits the measurement of low concentrations of catecholamines in biological samples. PMID- 6847116 TI - Influence of erythrocytes on direct potentiometric determination of sodium and potassium. AB - We have shown that the sodium concentration in whole blood measured by direct potentiometry is higher than in plasma. The 'erythrocyte-effect', already described by Siggaard Andersen, is most pronounced for instruments equipped with a reference electrode with an open static liquid junction and is thus a general phenomenon. Instruments with a modified liquid junction show less interference. The same phenomenon appears for the determination of the potassium concentration, although the difference between whole blood and plasma, when measured with instruments equipped with a modified liquid junction, can be neglected in practice. PMID- 6847117 TI - A simple, inexpensive quality control material for ortho ELT-8 platelet counts. AB - Dilutions of 1: 600 and 1: 3000 of 1 mum diameter polystyrene latex suspensions are simple, inexpensive materials for quality control of Ortho ELT-8 platelet counts. The coefficient of variation (CV) for a 12-week period at the 350 X 10(9)/l level was 2.2%, comparable with that of a commercial control. The CV at the 70 X 10(9)/l level was 3.5%. PMID- 6847119 TI - Direct progesterone assays. PMID- 6847118 TI - A simple rapid method for determining theophylline in serum by HPLC. PMID- 6847120 TI - Serum iron and total iron-binding capacity determination by flow-injection analysis with atomic absorption detection. AB - The deproteinised sample (150 microliters) is 'injected' into a continuously flowing stream of deionised water which is pumped, via a capillary tube, to the nebuliser of an atomic absorption spectrophotometer. Analytical readout is obtained, in the form of transient peaks, 6 s after sample injection. Before injection traces of haemoglobin are removed from the serum by treatment with trichloroacetic acid-ascorbate solution. This protein precipitant facilitates rapid removal of haemoglobin bound iron without the need for heating. After centrifugation the supernatant solution is introduced into the flowing stream by use of a novel inexpensive 'injector'. Analytical recovery and precision are good, and results compare well with those obtained by a standard AutoAnalyzer procedure. PMID- 6847121 TI - Three families with fast bisalbuminaemia. AB - We describe three cases of familial (SH, AY, and TM) fast-type bisalbuminaemia identified from 300 000 electrophoretic strips screened during the past six years. The immunological antigenicity and chemical composition of the isolated fast and normal albumins were essentially indistinguishable in all three cases. Detailed analyses on one of them (TM) by circular dichroism and fluorescent spectra measurements indicated that there was a marked change in the environment of the single tryptophan residue of the fast albumin, suggesting an alteration in the tertiary structure of the molecule. It is likely that this abnormality of the tertiary structure modulated (perturbed) the distribution of electric charges on the protein surface and thus changed its electrophoretic mobility. PMID- 6847122 TI - Genetic bisalbuminaemia occurring together with myeloma. PMID- 6847123 TI - Development of a filter paper blood spot radioimmunoassay for thyroid stimulating hormone suitable for a regional neonatal screening unit. AB - The radioimmunoassay described measures TSH in dried whole blood spots collected from neonates onto filter paper Guthrie cards. Microgranular cellulose is added to the precipitating reagent at the critical separation stage of the assay to overcome imprecision caused by the presence of the filter paper sample disc in the tube. The method was developed for a regional neonatal screening unit and has been found to be very reliable during ten months' routine use. It was required to be as precise, sensitive, accurate, rapid, simple, and inexpensive as possible and suitable for use with automatic diluting equipment in order to process large numbers of samples. Other methods were examined for their suitability and found not to fulfil one or more of the above criteria. PMID- 6847124 TI - Relative contribution of the mother, the nurse and endogenous synthesis to the taurine content of the newborn and suckling rat. AB - The relative contributions have been determined of taurine derived from the mother in utero, via milk during nursing, and from endogenous biosynthesis to the total taurine content of the rat pup between birth and weaning. At birth, 32% of the taurine in the pup has been biosynthesized, and this proportion rises to 83% by day 20 of life. At birth, 67% has been derived from the mother in utero, and by day 20 this has fallen to 4% of the total. This maternal taurine is lost with a half-life of 16 days. There is wide variation in the turnover from different tissues, the pancreas having a half-life of 7 days, and the brain 50 days. However, the amount of maternal taurine in the brain actually increases by 38% over the first 8 days of life. By day 20, 13% of the taurine content of the pup has been obtained from the milk. Taurine turnover in the suckling pup differs from turnover after weaning in that wholebody turnover from the suckling rat is not slower than exchange between organs. In other words, tissues are not in kinetic equilibrium. After animals are weaned, regardless of the taurine content of the diet, taurine is interchanged between organs faster than it is excreted from the animal. PMID- 6847125 TI - [Effect of short- or medium-chain fatty acids on cholesterol dynamics in the rat]. AB - The effects of a diet consisting of 10% medium-chain triglycerides (C8:0, C10:0) or 10% homogeneous triglycerides of 6- to 14-carbon chain saturated fatty acids on cholesterol turnover processes were studied in rats using the isotope equilibrium method. Cholesterol absorption was not significantly affected by the type of dietary fatty acid ingested. In contrast, lengthening of the fatty acid chain caused a moderate increase in the rates of cholesterol secretion (internal and external) and of transformation into bile acids. Thus, cholesterol synthesis was 80% higher in rats fed trimyristin (25.7 mg/day) than in those receiving tricaproin (14.6 mg/day). This increase seems essentially due to stimulated liver cholesterogenesis, as shown by in vivo incorporation of 14C-acetate. PMID- 6847126 TI - Tolerance of diets deficient or excessive in selenium by Syrian hamsters. AB - Syrian hamsters were fed torula yeast (TY) diets with 8 selenium (Se) supplement levels (0.0-10.0 ppm Se as sodium selenite) or casein (C) diets with 5 supplement levels (0.0-5.0 ppm Se as sodium selenite) for 25 weeks. Whole blood Se, plasma glutathione peroxidase (GSH-Px) activity and erythrocyte GSH-Px activity were measured after 5, 10, 15 and 25 weeks. At 25 weeks hematology was examined and tissue samples analyzed for Se and evaluated for histopathological lesions. While survival was not influenced by dietary Se, food consumption and body weight gain were altered in animals given TY, as those fed 0.0, 0.05 or 10.0 ppm Se consumed less diet. Weight gains at 25 weeks were highest in animals at the 0.1 ppm Se level and reduced in those given unsupplemented TY or 10.0 ppm Se supplements. Hemoglobin, hematocrit and red blood cell counts were reduced in females fed the lowest and highest Se supplements with TY diets. With both C and TY, whole blood Se rose with increasing dietary Se and in the case of TY, Se was elevated with each feeding increment, except between the 0.05 and 0.1 ppm or the 0.25 and 0.5 ppm levels. Plasma GSH-Px increased with rising Se up to 10 ppm, and erythrocyte GSH-Px activity increased up to 5 ppm Se. Erythrocyte GSH-Px values were higher in animals fed C diets. Histopathological observations were normal at all Se levels. Syrian hamsters tolerated dietary Se from 0.05 to 5.0 ppm Se for 25 weeks of observation without detrimental effects. PMID- 6847127 TI - Utilization of dietary urea in rainbow trout. AB - Experiments were conducted to examine the potential utilization of dietary urea by rainbow trout. A control diet and two diets supplemented with 1 and 3% of urea were fed to fish. Postprandial levels of urea and ammonia in blood plasma, and postprandial excretion of these metabolites were followed during 24 h. Apparent digestibility of urea in rainbow trout was very high (greater than 98%). Maximum values of urea levels in plasma were reached 6 h (32.3 +/- 10.2 micrograms/ml) after a meal in the control fish and respectively 6 h (83.4 +/- 18.4 micrograms/ml) and 8 h (250.3 +/- 96.1 micrograms/ml) after a meal in trout fed 1 and 3% urea diets. Peaks of urea excretion rates appeared 7-9 h after meal, coinciding with the highest circulating urea concentration. Total daily urea excretion amounted to 5.53, 10.43 and 33.80 mg urea N/100 mg N intake in trout fed the control, 1 and 3% urea diets, respectively. It is concluded that the dietary urea is readily absorbed in the digestive tract of trout but is totally excreted thus leading to no beneficial effect on nitrogen balance. This excretion of urea also takes place passively without any increase in energy demands. PMID- 6847128 TI - Chemotherapeutic response of tumor derived from human adenovirus 12--induced retinal tumor cell line in syngeneic CDF (F 344) rats. AB - The effect of two anticancer agents, vincristine (VCR) and cyclophosphamide (CTX), on an established cell line (EXP-5) derived from human adenovirus serotype 12 (Ad 12)--induced retinal tumor was studied in vitro and in vivo. VCR at a concentration of 5 and 10 micrograms/ml of culture medium and CTX at 50 and 100 micrograms/ml suppressed growth in vitro. EXP-5 cells were transplanted into the vitreous of 56 inbred CDF (F 344 strain) rats. The implants grew almost exclusively as intravitreous tumors within one month. When the tumor was full grown in the vitreous, VCR and CTX were administered intravenously, singly or in combination, on a schedule based on the protocol CCG-961 for localized unilateral retinoblastoma, Reese-Ellsworth group 5. At a dosage of 0.05 mg/kg, VCR was effective in reducing tumor size; at a dosage of 5 mg/kg, CTX did not reduce tumor size. Combined VCR/CTX therapy induced reduction of about two thirds in tumor size in 2 of 10 treated animals; in all 10 animals, the tumor became morphologically less distinct during the course of treatment although some characteristic features remained. Cytotoxic tumor changes (necrosis, fibrous proliferation, cell transformation, and bizarre giant cells) were observed in all treated animals. This model used the EXP-5 cell line grown in the vitreous, thereby providing a potential tool for evaluating growth and chemotherapeutic responsiveness of retinoblastoma. PMID- 6847129 TI - Karyological analysis of N-methyl-N'-nitro-N-nitrosoguanidine-transformed Syrian hamster cell lines using high resolution G-banding technique. AB - The karyotypes of two Syrian hamster cell lines transformed by N-methyl-N'-nitro N-nitrosoguanidine have been analyzed using high resolution G-banding technique. The change of gene dosage appears to be the main feature of the chromosome aberrations. One of the cell lines (BHLB4) has been passaged in vitro for 68 times and has a pseudodiploid chromosome number of 44. The most common feature of aberrations of this cell line is monosomy of chromosome 15 and in addition trisomy of chromosome 8. The other cell line (HEC5) was newly transformed, having a modal chromosome number of 50. In spite of the occurrence of trisomy of some autosomes, monosomy of chromosome 15 was still evident. No obvious structural changes were found even in G-banded prophase chromosomes. Our observations support the previous report on the monosomy of chromosome 15, as the most common feature of virally- and chemically-transformed Syrian hamster cell lines. PMID- 6847132 TI - Effects of the nucleoside analogues alpha-ara A, beta-ara A and beta-ara C on cell growth and repair of both potentially lethal damage and DNA double strand breaks in mammalian cells in culture. AB - The effects of the DNA polymerase inhibitors a-ara A and beta-ara C have been compared with those of beta-ara A on the endpoints of cell growth, repair of x ray induced potentially lethal damage (PLD) and repair of x-ray induced DNA double strand breaks, a-ara A was found to have no effects on any of the endpoints studied. beta-ara C inhibited cell growth and DNA double strand breaks repair more strongly than beta-ara A but it was less effective in inhibiting repair of PLD. The inhibition of PLD repair by beta-ara C resulted in a diminution of the shoulder width of the x-ray survival curve, a result similar to that previously found for beta-ara A. The effectiveness of beta-ara C was enhanced when cells were treated with the drug in fresh medium rather than under plateau phase conditions. The lower effectiveness of beta-ara C, when compared with beta-ara A in causing expression of PLD, is interpreted in terms of a difference in the ability of the two drugs to cause fixation or misrepair of the DNA double strand breaks during or after treatment with the drugs. PMID- 6847130 TI - Cellular oncogenes, mutations and cancer. AB - The multistep nature of cancer suggested from chemical carcinogenesis studies, epidemiological data and cell culture experiments could be explained by the occurrence of somatic mutations resulting in inappropriate expression of normal cellular sequences which have an intrinsic potential of becoming cancer genes. The discovery that cancer genes could be transferred from one cell to another lends further support that cancer could be due to somatic mutations. Moreover, DNA transfer of cancer genes indicates that at least some of these mutations act dominantly in the transformed cells. The isolation and characterization of human cancer genes has now become a reality. PMID- 6847131 TI - Familial cancer: genetically determined? (review). AB - Many cancers, in both children and adults, cluster in families. Collection and statistical analysis of pedigree data suggest that genetic mechanisms play an important role in most cancer types. This is illustrated in colorectal, breast, lung, ovarian, and childhood cancer. Pedigree data are consistent with the hypothesis that cancer is sometimes inherited in an autosomal dominant Mendelian fashion. These rare hereditary cancers might not be different pathogenetically from those arising sporadically. A two-stage model for carcinogenesis provides a framework for the understanding of both forms of cancer. The establishment of registries for familial cancer would be most helpful for cancer risk determinations, surveillance and management programs, identification of new cancer-prone genotypes and etiological family studies. PMID- 6847133 TI - Chromatin structure: from nuclei to genes (review). AB - Characterization of native nuclei by new unharmful biophysical methods, coupled both with the determination of lower order structures in DNA and isolated chromatin, by a variety of sophisticated physicochemical probes and with the intranuclear DNA distribution monitored in situ by high resolution image analysis, recently, point to a unique organization of chromatin-DNA from the secondary up to the quinternary level. Based on the wide range of experimental findings, hereby reviewed in details, a three-dimensional model for DNA structure is proposed from the nuclear level down to the genes, functional units hereby associated with specific structural repeating units. This "fibrosome" model not only accounts for many of the independent observations on the physical and chemical properties of chromatin-DNA, and on the nuclear scaffold and pores, but also accounts for most recent, yet unexplained, discoveries on eukaryotic gene structure, mapping and coding, suggesting a mechanism by which gene expression and cell function may be controlled. PMID- 6847135 TI - Central pontine myelinolysis following rapid correction of hyponatremia. AB - Central pontine and extrapontine myelinolysis was experimentally produced in dogs by the rapid correction of severe, sustained, vasopressin-induced hyponatremia. Hyponatremia alone or slowly corrected hyponatremia did not produce the disease. Affected dogs showed rigid quadriparesis. The central pons, lateral aspects of the thalamus and adjacent internal capsules, deep layers of cerebral cortex and subjacent white matter, cerebellum, and other regions were symmetrically involved. Myelin and oligodendroglia were affected out of proportion to axons and neurons. Thus, the clinical features, the distribution of the lesions, and their histological features closely resemble the human disease. These experiments document an electrolyte manipulation that can cause permanent neuropathological lesions. Taken with the available clinical data on human patients, the experimental results indicate that human myelinolysis may be due to a rapid increase in serum sodium from previously low levels, and that rapid normalization of severe, sustained hyponatremia should therefore be avoided. PMID- 6847136 TI - Basal forebrain neurons in the dementia of Parkinson disease. AB - Demented patients with Parkinson disease share certain neuropathological and neurochemical features with patients suffering from Alzheimer disease. Recently, loss of cholinergic neurons in the basal forebrain, particularly the nucleus basalis of Meynert, has been implicated in the pathophysiology of Alzheimer disease. The present investigations of 12 patients with Parkinson disease demonstrates that the demented patients with this disease also show a selective loss of cells in the nucleus basalis of Meynert, thus providing an important link between the dementias of Alzheimer disease and Parkinson disease. PMID- 6847137 TI - Studies of human and monkey "epileptic" neocortex in the in vitro slice preparation. AB - The in vitro slice technique was used to study neuronal activity in human cortical tissue removed during neurosurgical procedures for intractable epilepsy and in monkey neocortex rendered epileptogenic by injection of alumina gel. In both cases, biopsies were guided by electrocorticographic signs of epileptiform activity. Intracellular recordings were made from 167 neurons in human tissue and from 73 neurons in monkey tissue samples. There was little spontaneous activity in these biopsies and no indication of spontaneous cellular bursting. Stimulation at the pial surface or in white matter evoked synaptically driven activity that was primarily excitatory. Graded bursts of activity could be elicited from some cells, but no all-or-none paroxysmal depolarization shifts were recorded. Inhibitory postsynaptic potentials were relatively rare. Intracellular injections of dye in a small number of neurons revealed no obvious differences between bursting and nonbursting neurons. These in vitro studies of chronic epileptic cortex have thus far provided few clear insights into the basic mechanisms of epilepsy. PMID- 6847138 TI - Axonal atrophy in sensory nerves of the diabetic BB-Wistar rat: a possible early correlate of human diabetic neuropathy. AB - Clinical, morphological, and biochemical findings reported in the spontaneously diabetic BB-Wistar rat strongly indicate that this animal may be a true model of human insulin-dependent diabetes mellitus. As such, it may provide a valuable model in which to study the neuropathic conditions of diabetes. We examined somatic peripheral nerves at five levels in a longitudinal fashion using quantitative morphological techniques. Myelinated fiber atrophy occurred earlier in sensory nerves than in motor nerves and showed a distal to proximal progression with duration of diabetes. Axon/myelin ratios revealed disproportionate shrinkage of axons evident already after 4 months of diabetes in the sural nerve and only after 8 months in the peroneal nerve. Endoneurial edema could not be demonstrated by morphometric means in diabetic nerves. We conclude that the distal symmetrical polyneuropathy in diabetes can be characterized as a mainly sensory axonopathy of dying-back type. PMID- 6847134 TI - New diagnostic criteria for multiple sclerosis: guidelines for research protocols. PMID- 6847139 TI - Progressive supranuclear palsy: clinical features and response to treatment in 16 patients. AB - Among 415 patients with parkinsonism, 16 (3.9%) had findings of progressive supranuclear palsy (PSP). This report reviews the clinical features and response to drug therapy in those 16 patients. Anticholinergic drugs failed to benefit any of the 5 patients treated, while presynaptic dopaminergic drugs (Sinemet or amantadine) were beneficial in only 5 of 22 patient trials. Alternatively, dopamine agonists (bromocriptine and pergolide) caused improvement in 9 of 14 patient trials despite the fact that all but 1 of these patients had previously failed to respond to presynaptic dopaminergic drugs. Dopamine agonists such as bromocriptine and pergolide may be useful in some patients with PSP. PMID- 6847140 TI - Abnormal unloading reflex in a patient with infarction of the medial lemniscus. AB - The unloading reflex was measured in the intrinsic muscles of the hand. By removing various fractions of the load on the muscles, we determined the size of the electromyographic response as a function of the change in the external force. This technique was applied to both hands of a patient with a pontine lesion who had impaired position sense in the left hand. The response to fractional unloading was significantly smaller in the left hand, an asymmetry not found in control subjects. The results suggest (1) that the unloading reflex is mediated, at least in part, by suprasegmental pathways, and (2) that the fractional unloading technique can reveal abnormalities not found by conventional methods. PMID- 6847141 TI - A dominantly inherited syndrome with continuous motor neuron discharges. AB - A distinct syndrome with continuous motor neuron discharges apparently developed in seven members of a single family, involving both sexes and spanning three generations. Persistent vermiform twitching and episodic stiffness predominantly in lower extremity muscles occurred in early childhood and tended to be less severe in adulthood. In 2 patients the clinical manifestations improved with oral phenytoin and carbamazepine but not with parenteral diazepam. Insertional activity was normal, and continuous, rhythmical, normal-appearing muscle discharges were observed on electromyography. The cerebrospinal fluid levels of homovanillic acid and 5-hydroxyindoleacetic acid were increased in the proband. The disappearance of continuous muscle discharges during spinal anesthesia and the lack of response to diazepam indicated generation of the discharges from the proximal portion of the motor unit. PMID- 6847142 TI - Neuromuscular dysfunction and ultrastructural pathology in children with chronic cholestasis and vitamin E deficiency. AB - The ultrastructural pathology of nerve and muscle and the neurological dysfunction in children with cholestatic liver disease and vitamin E deficiency have not been previously correlated. We studied two children with this syndrome. One child, 11 years of age, had severe hyporeflexia and decreased vibratory sense. Nerve conduction was delayed. The second child, 2 years of age, was neurologically normal. Both children showed ultrastructural evidence of damage to the sural nerve and accumulation of electron-dense deposits in the muscle fibers. Abnormalities of the nerves included disruption of the myelin sheath and separation and degeneration of the inner and outer components of the Schmidt Lanterman incisure. PMID- 6847143 TI - Cerebellar cortex ultrastructure in ataxia-telangiectasia. AB - An ultrastructural study of a biopsy fragment from the cerebellar cortex of a patient with ataxia-telangiectasia was performed. There was a sharp reduction in the number of Purkinje cells and an increase in the number of Golgi epithelial cells. Despite the degeneration of Purkinje cell dendrites, the volumetric density of parallel fiber varicosities and the number of synapses in the molecular layer were only slightly reduced. No qualitative nor quantitative abnormalities were noted in the granular layer. An analysis is made of the severe changes in cerebellar circuitry of this patient and their probable functional implications. PMID- 6847144 TI - Dissociation of early SEP components in unilateral traumatic section of the lower medulla. AB - Spinal and scalp early SEPs were recorded, using a noncephalic reference electrode, in a patient with a traumatic cervicomedullary lesion causing unilateral loss of position sense. Cervical N11 and N13 and scalp-recorded far field P14 SEPs were clearly dissociated following stimulation of the affected side. The findings suggest that the P14 component is generated above the foramen magnum, whereas the cervical N13 has a spinal generator. PMID- 6847145 TI - Cerebral emboli of paradoxical origin. AB - A diagnosis of paradoxical cerebral embolus (PCE) was made in five patients aged 31 to 62 years who sustained eight cerebral ischemic events. No patient had evidence of primary carotid system or left heart disease. A probe-patent foramen ovale was the presumed mechanism in four patients, and an unsuspected congenital atrial septal defect was found in the fifth patient. Clinically apparent pulmonary emboli or venous thrombosis preceded the cerebral event in only one instance. Review of the literature reveals a high mortality with PCE. However, careful clinical search for this lesion may be rewarding: four of our five patients survived. One should consider PCE in any patient with cerebral embolus in whom there is no demonstrable left-sided circulatory source. This principle applies particularly if there is concomitant venous thrombosis, pulmonary embolism, or enhanced potential for venous thrombosis due to, for example, morbid obesity, use of hormonal birth control pills, prolonged bed rest (especially postoperatively), or systemic carcinoma. PMID- 6847146 TI - Removal of sedative-hypnotic antiepileptic drugs from the regimens of patients with intractable epilepsy. AB - Sedative-hypnotic antiepileptic drugs have potentially toxic effects, but their removal is often thought to be difficult and dangerous. We completely withdrew all barbiturates and benzodiazepines from 78 patients with intractable epilepsy (48 inpatients and 30 outpatients). Initially, 19 patients had plasma levels of sedative drugs above the therapeutic range; 28 were taking more than one of these drugs. Dosages of nonsedative antiepileptic drugs were adjusted to provide optimal seizure control. After 6 months of outpatient follow-up, 69 patients remained on a nonsedative regimen: 35 (51%) showed improvement in both drug toxicity and seizure control, 13 (19%) in toxicity alone, 8 (12%) in seizure control alone; 12 (16%) were unchanged, and 1 was worse. Of 9 patients restarted on sedative antiepileptic drugs by their private physicians, 4 had more toxic symptoms than at discharge, 1 had more frequent seizures, 3 were unchanged, and 1, who had had a temporal lobectomy after drug withdrawal, had less frequent seizures. Sedative drugs are not necessary for optimal seizure control, even in intractable epilepsy, and they may be safely withdrawn. PMID- 6847147 TI - Friedreich ataxia and low pyruvate carboxylase activity in liver and fibroblasts. AB - Biochemical studies in liver, muscle, and cultured fibroblasts were carried out in seven patients with Friedreich ataxia. Lowered activity of pyruvate carboxylase was shown in liver and cultured fibroblasts in all instances. PMID- 6847149 TI - Computerized tomography as a diagnostic aid in acute hemorrhagic leukoencephalitis. AB - Computerized tomography (CT) in a pathologically proven case of acute hemorrhagic leukoencephalitis (AHL) showed a mass effect and increased absorption coefficient in the right hemisphere within 18 hours of the onset of neurological symptoms. The changes corresponded to the site of white matter edema, necrosis, and petechial hemorrhages demonstrated postmortem. The early changes of CT reflect the hyperacute nature of AHL and differ from those of herpes simplex encephalitis. PMID- 6847150 TI - Cerebrospinal fluid gamma-aminobutyric acid in spasmodic torticollis. PMID- 6847151 TI - Senile gait: correlation with computed tomographic scans. PMID- 6847148 TI - Normal vitamin E status in spinal muscular atrophy. AB - In an attempt to confirm prior reports of vitamin E deficiency in Werdnig Hoffmann disease, we assessed vitamin E nutritional status in 11 children and 6 adults with spinal muscular atrophy (SMA). Serum vitamin E levels (10.6 +/- 3.3 micrograms/ml for those less than 12 years old, 13.2 +/- 4.5 for those older than 12) and the ratio of serum vitamin E to total serum lipids were normal in all patients. Vitamin E nutritional status appears to be normal in SMA, and vitamin E therapy is not indicated. PMID- 6847152 TI - "Salt and pepper on the face" pain in acute brainstem ischemia. PMID- 6847153 TI - Unilateral straight hair in congenital Horner syndrome due to stellate ganglion tumor. PMID- 6847154 TI - Association of meningiomas with obesity. PMID- 6847155 TI - Sudden deafness in chickenpox: a case report. PMID- 6847156 TI - Major morbidity related to hyperthermia in multiple sclerosis. PMID- 6847157 TI - [Distribution of morphologic traits and ability to taste PTC in Northern Greek populations]. AB - Four qualitative morphological traits (relative finger length, hypertrichosis of external ear, association of the eyebrows, cheek-dimples) and the ability to taste PTC have been studied in a total of 7831 males and females from Thessaloniki and its surroundings. This sample is representative for the population of Northern Greece. The distribution of all these five parameters is showing more or less marked sex differences. The frequencies found in the Greek sample are compared with those reported for other populations. PMID- 6847158 TI - A demographic investigation of the four Albanian communities living in Molise, Italy. AB - In a study of the four Albanian villages of Molise, Italy (Campomarino, Montecilfone, Portocannone and Ururi), demographic data have been obtained through national censuses and direct interviews of 382 subjects. The data demonstrate an increase of the population from 1700 to the middle of the twentieth century. From that time the population decreases in three villages, which now present a considerable degree of ageing. On the contrary, in the fourth village (Campomarino) the population continues to increase during the second half of the twentieth century, and now appears as a relatively young population. Immigration has proved to be somewhat elevated and shows a diminishing trend from the great-grandparents to the propositi. The endogamy decreases passing from the generation of the great-grandparents to that of the parents, and is higher along the paternal ascendence than along the maternal one. The exogamy, on the contrary, increases passing from the generation of the greatgrandparents to that of the parents, demonstrating a rather considerable mixture with the surrounding population. The percentage of Albanian surnames, or those of probable Albanian origin, has also been estimated in the parents of the propositi, and resulted to be higher in Montecilfone and Ururi, in comparison with Campomarino and Portocannone. PMID- 6847159 TI - [Corporeal development of preschool children. Investigations in Szeged (South Hungary)]. AB - 766 boys and 752 girls in the age between 3-6.5 years have been investigated 1981 in Szeged (South Hungary) for body height, body weight and chest circumference. Comparing these children to those of the same age, which have been investigated 1962 in the same town - Szeged -, no statistically significant differences in the anthropometric variables taken into consideration are seen. This means that the secular trend in growth--being present in earlier times--nowadays is no more to be observed in this population. PMID- 6847160 TI - Age changes in kyphosis and lordosis of Jat-Sikh and Bania females of Punjab (India) from 20 to 80 years. AB - The age changes in spinal curvature of the trunk region in females of the two important communities of Punjab Jat-Sikh and Bania have been studied in the present paper. These two communities are traditionally engaged in different types of occupations, the former being agriculturist and the latter being the trading community. The results are based on a cross-sectional data collected on 502 Jat Sikh and 510 Bania females ranging in age from 20 to 80 years. A flexicurve has been used to measure kyphosis and lordosis. The kyphosis has been observed to be influenced by weight and spinal length. Therefore, various indices were examined to test their suitability as estimates of measuring kyphosis due to age only. Linear regression of B/H index on age showed an increase in kyphosis with age from age-group 45-49 to 70+. Lordosis has been found to decrease after age-group 45-49. PMID- 6847161 TI - An odontometric study of molar crown characters of the Bronze Age Harappans. PMID- 6847162 TI - Biosynthesis of vasopressin and oxytocin. PMID- 6847163 TI - Exercise at altitude. PMID- 6847164 TI - Dyspnea and exercise. PMID- 6847165 TI - Specific connections between nerve cells. PMID- 6847166 TI - Hormonal control of apolipoprotein synthesis. PMID- 6847167 TI - Bile acid synthesis. PMID- 6847168 TI - Silver-nylon: a new antimicrobial agent. AB - The potential effectiveness of a silver nylon (SN) fabric as an antimicrobial agent was evaluated in a series of in vitro experiments. The results indicated that silver ions from the SN fabric penetrated 2 mm of agar and killed a challenge of 6.9 X 10(7) Pseudomonas aeruginosa, 4.1 X 10(7) Staphylococcus aureus, and 1.4 X 10(7) Candida albicans organisms per cm2 of SN fabric after 24 h of incubation at 37 degrees C. To determine some of the microbicidal limits of the SN, the distance between the SN fabric and the microbial challenge was increased. Increasing the height of the agar column overlying the SN fabric diminished the inhibitory effect of SN on microbial growth. For each increase in agar height of 2 mm, up to a total height of 8 mm, the effectiveness of SN to inhibit microbial growth decreased by a factor of 10. This distance-related decrease in the microbicidal ability of SN could be overcome by placing the SN fabric in contact with the agar column for 24 to 72 h before microbial challenge. On the basis of these experiments, it appears that SN is an effective antimicrobial agent, although further work must be performed before it is applied clinically. PMID- 6847169 TI - Cefsulodin pharmacokinetics in patients with various degrees of renal function. AB - The pharmacokinetics of cefsulodin were characterized in 19 patients with different degrees of renal function after a single 500-mg, 30-min intravenous infusion. Six subjects had a creatinine clearance (Clcr) of greater than 100 ml min-1 (group I), eight had a Clcr of between 12 and 42 ml min-1 (group II), and five had a Clcr of less than 10 ml min-1 (group III). Nine plasma and four urine samples were collected in the first 36 h. The plasma concentration-time data were fitted to a two-compartment open model. The mean beta-phase half-life was 1.77, 6.37, and 10.12 h in groups I, II, and III, respectively. A significant decline in plasma clearance (Clp) was also noted between the three groups: 136 to 49.6 to 27.2 ml min-1 in groups I, II, and III, respectively. Steady-state volume of distribution was 0.26 liter kg-1, regardless of renal function. The observed linear relationship between Clp and Clcr (Clp = 24.09 + 0.765 Clcr; r = 0.9566) can be utilized to revise dosage schedules for patients with any degree of renal impairment. The nonrenal clearance of cefsulodin was also noted to be significantly lower in groups II and III than in group I. Further investigations will be necessary to elucidate the mechanism(s) responsible for the decrease in the nonrenal clearance of cefsulodin. PMID- 6847170 TI - In vitro antiplaque activity of octenidine dihydrochloride (WIN 41464-2) against preformed plaques of selected oral plaque-forming microorganisms. AB - The antibacterial activity of octenidine dihydrochloride (WIN 41464-2) against intact preformed in vitro plaques of four indigenous oral plaque-forming microorganisms, Streptococcus mutans, Streptococcus sanguis, Actinomyces viscosus, and Actinomyces naeslundii, was studied. Both absolute (plaque bactericidal index) and relative (chlorhexidine coefficient) indices of antiplaque efficacy were established. Octenidine dihydrochloride compared favorably with chlorhexidine digluconate with respect to overall antiplaque potency in this in vitro plaque bactericidal model. These data indicate that prudent selection of treatment concentration and duration and frequency of exposure should provide an effective means to aid in controlling dental caries and Actinomyces-associated disease in vivo. PMID- 6847171 TI - Serotype distribution of penicillin-resistant pneumococci and their susceptibilities to seven antimicrobial agents. AB - A total of 229 clinical isolates of Streptococcus pneumoniae recovered from 225 patients were serotyped and tested for susceptibility to penicillin G, ampicillin, mezlocillin, cefazolin, erythromycin, clindamycin, chloramphenicol, and sulfamethoxazole-trimethoprim. Of all the isolates, 48 (21.0%) showed intermediate resistance and 17 (7.4%) showed resistance to penicillin G. Penicillin-resistant strains had higher minimal inhibitory concentrations of ampicillin, mezlocillin, and cefazolin than did penicillin-susceptible strains. Resistance to erythromycin and clindamycin was rare (1.3 and 0.9%, respectively). Of the isolates, 8.7% were resistant to sulfamethoxazole-trimethoprim, and all were susceptible to chloramphenicol. Penicillin resistance was associated with 13 serotypes. Serotypes 14, 19F, 19A, and 23F were both highly prevalent and frequently penicillin resistant. PMID- 6847172 TI - Inhibition of lysosomal phospholipases by aminoglycoside antibiotics: in vitro comparative studies. AB - Aminoglycoside antibiotics induce an early and characteristic lysosomal phospholipidosis in cultured fibroblasts and in kidney tubular cells. We have recently demonstrated an inhibition of lysosomal phospholipases A1 and A2 by gentamicin and amikacin in vitro. In vivo, gentamicin decreases the activity of phospholipase A1 (Laurent et al., Biochem. Pharmacol. 31:3861-3870, 1982). In the present study, we examined 14 aminoglycosides for in vitro inhibition of phospholipases. To mimic the situation prevailing in lysosomes, the enzymatic activities were assayed with phospholipid vesicles (liposomes) with a composition similar to that of lysosomal phospholipids (phosphatidylcholine, sphingomyelin, phosphatidylinositol, cholesterol; 4:4:3:5.5, molar ratio). We measured the hydrolysis of 1-palmitoyl-2-[1-14C]oleoyl phosphatidylcholine contained in the liposomes by a soluble fraction of highly purified lysosomes isolated from rat liver. Similar IC50S (concentrations causing 50% inhibition of enzymatic activity) were observed for dibekacin, gentamicin (with no major difference between C1, C1a, or C2), netilmicin, tobramycin, and kanamycin B. Sisomicin was slightly more inhibitory. Kanamycin A, N1-(L-4-amino-2-hydroxy-1 oxobutyl)dibekacin, and amikacin showed increasing IC50S. Streptomycin caused the least inhibition. Octa- and tetramethylkanamycin A are much less inhibitory than the parent drug. These results point to the number, the nature, and the respective positions of the cationic groups as essential determinants in causing inhibition of phospholipid breakdown. The binding of three aminoglycosides (gentamicin, amikacin, streptomycin) to the liposomes at pH 5.4 was also measured by gel permeation and was found to be related to the respective inhibitory potency of each drug. Insofar as lysosomal phospholipidosis is an early sign of intoxication by aminoglycosides, these results may serve as a basis for the development or screening of less toxic compounds in this class of antimicrobial agents. PMID- 6847173 TI - Differences in side effects of amantadine hydrochloride and rimantadine hydrochloride relate to differences in pharmacokinetics. AB - In a double-blind, placebo-controlled study, the comparative toxicities and blood concentrations of amantadine hydrochloride and rimantadine hydrochloride were determined. Healthy, working adults ingested either 200 (n = 52) or 300 mg (n = 196) per day in divided doses for 4.5 days. Mean plasma drug concentrations at 4 h after the first dose were lower in rimantadine recipients given 100- (140 versus 300 ng/ml for rimantadine and amantadine, respectively; P less than 10( 5)) or 200-mg doses (310 versus 633 ng/ml; P less than 10(-5)). The plasma drug concentrations after the first dose correlated significantly with total symptom sources for both amantadine and rimantadine, but the plasma levels of toxic and nontoxic subjects overlapped extensively. At 300-mg/day dosage amantadine was associated more often with adverse central nervous system symptoms (33% of amantadine versus 9% of rimantadine recipients; P less than 0.001) and sleep disturbance (39 versus 13%; P less than 0.001), but not gastrointestinal symptoms (19.5 versus 16.0%). However, no differences between the drugs were noted in symptom frequency or scores in volunteers with similar plasma concentrations. Amantadine and rimantadine differ in their pharmacokinetics but not in their potential for side effects at comparable plasma concentrations. PMID- 6847174 TI - Activity of brodimoprim and metioprim alone and in combination with sulfonamides against anaerobic bacteria. AB - The activities of the 2,4-diamino-5-benzylpyrimidines brodimoprim and metioprim against anaerobic bacteria were tested alone and in combination with sulfonamides. Alone they were two to four times more active than trimethoprim, but in combination with sulfonamides, their activity was slightly lower than that of trimethoprim plus sulfamethoxazole. PMID- 6847175 TI - In vitro activity of a group of broad-spectrum cephalosporins and other beta lactam antibiotics against Chlamydia trachomatis. AB - The activities of seven broad spectrum cephalosporins, four other beta-lactam antibiotics, and one monobactam against Chlamydia trachomatis were measured in a cell culture system. The minimal inhibitory concentration of four of the seven cephalosporins was greater than or equal to 128 micrograms/ml; those of the other three were from 16 to 32 micrograms/ml. Of the other agents, only mecillinam had activity against C. trachomatis comparable to that reported for ampicillin (minimal inhibitory concentration, less than or equal to 0.5 micrograms/ml). PMID- 6847176 TI - Comparative activity of amantadine and ribavirin against influenza virus in vitro: possible clinical relevance. AB - The activities of amantadine and ribavirin against influenza A viruses were compared against low-multiplicity (plaque inhibition) and high-multiplicity (protein synthesis inhibition) infections. Our results suggest that the predictive value of in vitro data for the clinic may be improved by consideration of tests against a high-multiplicity infection. PMID- 6847177 TI - R plasmids in Corynebacterium xerosis strains. AB - Plasmids coding for resistance to chloramphenicol, erythromycin, kanamycin, streptomycin, and tetracycline have been found in strains of Corynebacterium xerosis isolated from patients with otitis media. PMID- 6847178 TI - Bacterial populations associated with different regions of the human colon wall. AB - The microorganisms associated with the undiseased human colon wall were examined in material obtained from four sudden-death victims. In traffic accident subjects (aged 45 and 16 years) the anaerobe-aerobe ratio was about 10(4):1 in all areas of the colon examined, whereas in acute heart failure subjects (aged 74 and 46 years) the ratio was as low as 1.2:1. The flora of each individual was distinct and complex. Although the predominant anaerobes isolated were Bacteroides and Fusobacterium spp., which composed over 50% of the flora in some samples, the species isolated (indicated by morphology and glucose fermentation products) varied between individuals. Other major types observed were gram-positive nonsporing rods, including Bifidobacterium spp., and anaerobic cocci (between 8 and 20% of isolates). Clostridia were only isolated in significant numbers from one individual. Scanning electron microscopy showed that most of the organisms were present below the top surface of the mucin layer overlying the mucosa. The use of several different preparative procedures for microscopy showed a complex microbial structure within the mucus, but major variations in the bacterial populations in different areas of the colon were not found. Spiral-shaped organisms up to 60 mum long in the form of double helices were found in two subjects by scanning electron microscopy but were not isolated during the parallel bacteriological investigation. The differences between this and previous studies are discussed in relation to experimental procedures and also in contrast to results with animals that showed a particularly specialized flora associated with the colon wall. PMID- 6847179 TI - Sewage coliphages studied by electron microscopy. AB - Sewage was enriched with 35 Escherichia coli strains, and sediments of enrichment cultures were studied in the electron microscope. They contained up to 10 varieties of morphologically different particles. T-even-type phages predominated in 14 samples. Thirteen phages were enriched, representing the families Myoviridae (seven), Styloviridae (two), Podoviridae (three), and Microviridae (one). Twelve of these corresponded to known enterobacterial phage species, namely, 121, K19, FC3-9, O1, 9266, T2, 16-19, kappa, beta 4, N4, T7, and phi X174. Cubic RNA phages and filamentous phages were not detected. Types 121 and 9266 have previously been observed only in Romania and South Africa. Identification by morphology is usually simple. Our investigative technique is qualitative and will not detect all phages present. Most enrichment strains are polyvalent, and electron microscopy is always required for phage identification. In a general way, electron microscopy seems to be the method of choice for investigation of phage geography and ecology. PMID- 6847180 TI - Microbial fouling of reverse-osmosis membranes used in advanced wastewater treatment technology: chemical, bacteriological, and ultrastructural analyses. AB - Biofouling of reverse-osmosis membranes was investigated at an advanced wastewater treatment facility. Cellulose diacetate membranes operated for approximately 4,000 h became uniformly coated with a mucilaginous fouling layer. The fouling material was approximately 93% water by weight, and nearly 90% of the dehydrated residue was organic in composition. Calcium, phosphorous, sulfur, and chlorine were the major inorganic constituents detected. Protein and carbohydrate represented as much as 30 and 17%, respectively, of the dry weight of the biofilm. Bacteriological plate counts indicated up to 5.6 X 10(6) CFU/cm2 of membrane surface. Accumulation of [3H]glucose in the biofilm and measurement of ATP indicated that the fouling bacteria were metabolically active in situ. The genus Acinetobacter and the Flavobacterium-Moraxella group were the major generic groups associated with the feedwater surface of the membrane, whereas species of the generic groups Acinetobacter, Pseudomonas-Alcaligenes, and Bacillus Lactobacillus predominated on the permeate water surface. Electron microscopy revealed that the biofilm on the feedwater surface of the membrane was 10 to 20 microns thick and was composed of several layers of compacted bacterial cells, many of which were partially or completely autolyzed. The bacteria were firmly attached to the membrane surface by an extensive network of extracellular polymeric fibrils. Polyester (Texlon) support fibers located on the permeate surface of the reverse osmosis membranes were sparsely colonized, suggesting bacterial regrowth in the product water collection system. PMID- 6847181 TI - Prevalence of Campylobacter jejuni in chicken wings. AB - Campylobacter jejuni was found in 82.9% of 94 chicken wing packages analyzed on the day of arrival at supermarkets and in 15.5% of 45 packages obtained from the supermarket shelves a few days later. The number of bacterial cells ranged from 10(2) to 10(3.9) per wing. The prevalence of C. jejuni in the wings varied with the brand, the day of sampling, and the age of the product. PMID- 6847182 TI - Modified method for production and purification of Staphylococcus aureus enterotoxin B. AB - A medium containing 4% bio-trypcase and 1% yeast extract was used for the production of Staphylococcus aureus enterotoxin B. The yield obtained was estimated at 200 micrograms of enterotoxin per ml of S. aureus S-6 culture supernatant. The purification method involves chromatography on Biorex 70 resin, isoelectric focusing, and gel filtration on Sephadex G-100. The purified enterotoxin (isoionic point, pH 8.55) was shown to be homogenous protein with a molecular weight of 29,000 when tested by gel electrophoresis. PMID- 6847183 TI - Occurrence of cyclopiazonic acid in peanuts. AB - Samples of segregation 3 farmer stock peanuts from the 1980 southeastern United States growing season were analyzed for the presence of cyclopiazonic acid and aflatoxins. Cyclopiazonic acid appeared in 21 of 27 loose-shell kernel fractions at a range of 32 to 6,525 mug/kg and in 4 of 21 sound mature kernel fractions at a range of 32 to 130 mug/kg. Aflatoxins were detected in 26 of 27 loose-shell kernel fractions and in 20 of 21 sound mature kernel fractions. Cyclopiazonic acid used at 105 and 210 mug/kg to spike peanut samples was recovered at an average rate of 93.3%, with ranges of 89 to 119 and 166 to 221 mug/kg, respectively. The minimum detection limit on oxalic acid-impregnated silica gel plates was 26 ng. PMID- 6847184 TI - In vitro exposure of adenovirus types 5 and 7 in oropharyngeal secretions to cigarette smoke. AB - Adenovirus types 5 and 7 were suspended in clarified oropharyngeal secretions. After 1 ml of suspension was dispersed in a thin layer over a 25-cm2 surface in a flask, the suspension was exposed at 37 degrees C to eight 25-ml puffs of smoke from one cigarette. A mechanical smoking apparatus was used. Nonfilter cigarettes used had 23 mg of tar and 1.4 mg of nicotine, and filter cigarettes used had 19 mg of tar and 1.2 mg of nicotine. Smoke was flushed from the flask with normal filtered air. At 0, 0.25, and 1 h after exposure to smoke, untreated and smoke treated viruses were titrated with monolayer cultures of human epithelioid (HEp 2) cells. Normal air was in contact with the suspensions between puffs and between smoke treatments and virus titrations. Smoke from filter or nonfilter cigarettes had no effect on the infectivity and replication of adenovirus types 5 and 7. Smoke from four cigarettes administered over a 4-h period caused a 2- to 3 log10 drop in the titers of both viruses. Smoke from four cigarettes was also highly toxic to HEp-2 host cells of the viruses. PMID- 6847185 TI - Ascorbic acid inhibition of Campylobacter jejuni growth. AB - The inhibitory effect of ascorbic acid on Campylobacter jejuni is described. In vitro growth of clinical strains, as measured spectrophotometrically, was inhibited by 0.5 mg of freshly prepared L-ascorbic acid per ml. Alkaline-treated or aged L-ascorbic acid increased inhibition, as did copper; however, L-cysteine, L-cystine, and glutathione prevented inhibition. Biochemical analysis of the medium and cultures indicated that one or more of the oxidation products of L ascorbic acid, e.g., L-dehydroascorbic acid or L-diketogulonic acid, were more effective inhibitors than was reduced L-ascorbic acid. PMID- 6847186 TI - Relative incidence of Alteromonas putrefaciens and Pseudomonas putrefaciens in ground beef. AB - Of 65 H(2)S-producing isolates from seven samples of ground beef, 64 were found to be Alteromonas putrefaciens. Isolates of Pseudomonas putrefaciens were not encountered. The mean guanine-plus-cytosine content of DNAs from 10 of the representative isolates, obtained from thermal denaturation determinations, was 46.5 +/- 1.0 mol%, which is consistent with the designation A. putrefaciens. PMID- 6847187 TI - Nutritional versatility of a starch-utilizing Flavobacterium at low substrate concentrations. AB - A starch-utilizing yellow-pigmented bacterium, isolated from tap water, was tested for the utilization of 64 natural compounds at a concentration of 1 g/liter by measuring colony growth on agar media. Only 12 carbohydrates and glycerol promoted growth. Growth experiments with the organism in pasteurized tap water supplied with mixtures of substrates at concentrations of 1 or 10 micrograms of C of each substrate per liter, followed by separate experiments with a number of carbohydrates at 10 micrograms of C per liter showed that of these 64 natural compounds only sucrose, maltose, raffinose, starch, and glycerol promoted growth at very low concentrations. Also maltotriose, -tetraose, pentaose, -hexaose, and stachyose, which were not included in the mixtures, enhanced growth, and generation times of 3 to 5 h at 10 micrograms of C per liter were observed. The organism, which was tentatively identified as a Flavobacterium species, thus appeared to be highly specialized in the utilization of glycerol and a number of oligo- and polysaccharides at very low concentrations. PMID- 6847189 TI - Occurrence and pathogenicity of Naegleria fowleri in artificially heated waters. AB - The occurrence of pathogenic Naegleria fowleri in thermal discharges, recipient waters, and cooling towers of eight power plants located in western Pennsylvania was investigated for 2 years in conjunction with several environmental measurements. Pathogenic N. fowleri was detected in one cooling tower and in the discharge, receiving waters, or both of five of eight localities. The occurrence of this organism was related to elevated temperatures, but no significant correlation was found for other biological and chemical parameters. Laboratory experiments on the effect of pH on pathogenic N. fowleri documented 100% survival at a range from 2.1 to 8.15. Higher pH reduced or killed the amoebae. No case of human primary amoebic meningoencephalitis occurred during the study. PMID- 6847188 TI - Metabolism of glucose and cellobiose by cellulolytic mesophilic Clostridium sp. strain H10. AB - The metabolism of strain H10, a cellulolytic mesophilic Clostridium sp., was studied on glucose and cellobiose as energy and carbon sources. The main products of fermentation of both sugars were acetate, lactate, and ethanol. At low sugar levels, molar growth yields were better for cellobiose than for glucose. In both cases, an inhibition of growth was observed between 1 and 2 g/liter and a total inhibition after the latter concentration. Inhibition was not the result of low pH due to acid formation; growth under static pH conditions was limited in the same way. On the other hand, acetate and lactate had no inhibitory effect when added at concentrations equal to the final titers. Concomitant with the inhibition of growth was a change in metabolic pathways for sugar concentrations between 1 and 2 g/liter, i.e., the production of lactate was higher. After complete inhibition of growth, an accumulation of carbohydrates which were neither glucose nor cellobiose was observed. PMID- 6847190 TI - Distribution of Vibrio vulnificus and other lactose-fermenting vibrios in the marine environment. AB - During the summer of 1981, 3,887 sucrose-negative vibrios were isolated from seawater, sediment, plankton, and animal samples taken from 80 sites from Miami, Fla., to Portland, Maine. Of these, 4.2% were able to ferment lactose. The lactose-positive strains isolated from the various samples correlated positively with pH and turbidity of the water, vibrios in the sediment and oysters, and total bacterial counts in oysters. Negative correlations were obtained for water salinity. Numerical taxonomy was performed on 95 of the lactose-fermenting environmental isolates and 23 reference strains. Five clusters resulted, with the major cluster containing 33 of the environmental isolates and all of the Vibrio vulnificus reference strains. The 33 isolates, which produced an acid reaction in lactose broth within hours of initial inoculation, represented 20% of all lactose fermenting vibrios studied. These isolates were nearly identical phenotypically to clinical strains of V. vulnificus studied by the Centers for Disease Control, Atlanta, Ga., and by our laboratory, and their identification was confirmed by DNA-DNA hybridization studies. V. vulnificus was isolated from all sample types and from Miami to Cape Cod, Mass., and comparison of the environmental parameters of the eight subsites yielding this species with those of all 80 subsites revealed no significant differences. The majority of the isolates were obtained from animals, with clams providing most (84%) of these. On injection into mice, 82% of the V. vulnificus isolates resulted in death. Members of the remaining four clusters contained strains which differed from V. vulnificus in such phenotypic traits as luminescence and in urease or H(2)S production. None of the other reference cultures, including nine other Vibrio species, were contained in the remaining clusters, and these isolates could not be identified. Most of these were also lethal for mice. Phenotypic differences, potential pathogenicity, and geographic distribution of the five clusters were examined. It is concluded that V. vulnificus is a ubiquitous organism, both geographically and in a variety of environmental sources, although it occurs in relatively low numbers. The public health significance of this organism and of the other unidentified lactose fermenting Vibrio species is discussed. PMID- 6847191 TI - Proteoglycan changes during restoration of transparency in corneal scars. AB - Corneal scars generated in rabbits by penetrating wounds are initially opaque but become transparent within a year. Previous studies have shown that the corneal stroma consists of proteoglycans and collagen fibrils spaced at regular intervals and that the interfibrillar spaces, the presumed location of proteoglycans, are abnormally large in opaque scars. In the present study, the size and glycosaminoglycan composition of the corneal stromal proteoglycans were determined in corneal scars during the restoration of transparency. The results showed that initially opaque scars which contained the large interfibrillar spaces also contained unusually large chondroitin sulfate proteoglycans with glycosaminoglycan side chains of normal size. These opaque scars also lacked the keratan sulfate proteoglycan but did contain hyaluronic acid. In the 1-year-old scars there was a restoration of normal interfibrillar spacing, and a return to corneal stromal proteoglycans of normal size and composition. These correlations suggest that the corneal stromal proteoglycans may play a fundamental role in regulating corneal collagen fibril spacing. PMID- 6847193 TI - Substrate and metal specificity in the enzymic synthesis of cyclic monoterpenes from geranyl and neryl pyrophosphate. AB - A partially purified enzyme (carbocyclase) from the flavedo of Citrus limonum formed alpha-pinene, beta-pinene, limonene, and gamma-terpinene from geranyl pyrophosphate (GPP) and neryl pyrophosphate. The maximum specific activities obtained were 7.0 and 3.6 nmol/min/mg, respectively. Cross-inhibition by the two substrates were observed and the ability to utilize neryl pyrophosphate was almost completely lost with aging. Citronellyl pyrophosphate and dimethylallyl pyrophosphate were the most effective inhibitors of carbocyclase. Isopentenyl pyrophosphate, the monophosphate esters of nerol and geraniol, as well as inorganic pyrophosphate were much less effective inhibitors. The enzyme had an absolute requirement for Mn2+. It could be replaced with about 2% effectiveness by Mg2+ and Co2+. Kinetic studies showed that the observed reaction rate correlates with the calculated concentration of the GPP (Mn2+)2 species. Previous evidence with nonenzymatic reactions and the results presented support the view that the mechanism of carbocyclase may be the intramolecular analog of prenyltransferase. PMID- 6847192 TI - The action of vasopressin and calcium on palmitate metabolism in hepatocytes and isolated mitochondria from rat liver. AB - Vasopressin inhibits fatty acid oxidation and stimulates fatty acid esterification, glycogenolysis, and lactate production in hepatocytes from fed rats. In cells from fasted rats, the effect of the hormone on palmitate oxidation was absent, while gluconeogenesis was stimulated. The inhibitory action of vasopressin on palmitate oxidation was not due to the increased lactate production. Neither was it correlated to glycogen content or stimulation of glycogenolysis, which were restored earlier than the vasopressin effect on palmitate oxidation when previously fasted rats were refed a carbohydrate diet. The level of malonyl-CoA was moderately increased by vasopressin. Isolated mitochondria from rat liver were incubated in the presence of [U-14C]palmitate, ATP, CoA carnitine, glycerophosphate, ethylene glycol bis(beta-aminoethyl ether) N,N'-tetraacetic acid, and varying amounts of calcium. The oxidation of palmitate was inhibited when the concentration of free calcium was increased from about 0.1 to 10 microM. Simultaneously, palmitate esterification was stimulated. This effect of calcium was observed also with mitochondria from fasted rats and with octanoate as well as palmitate as the substrate. Carnitine acylation was not affected by calcium. The possibility that the observed effects of calcium on mitochondrial fatty acid utilization is part of the mechanism of action of vasopressin on hepatocyte fatty acid metabolism is discussed. PMID- 6847194 TI - Peroxisomal and mitochondrial palmitoyl coenzyme A beta-oxidation activities in rat white adipose tissue and their regulation in hypothyroidism. AB - A peroxisomal fraction with catalase and CN- -insensitive palmitoyl CoA beta oxidative activity different from the CN- -sensitive mitochondrial palmitoyl CoA beta-oxidative activity was purified from rat epididymal and perirenal white adipose tissue by differential and sucrose density gradient centrifugations. The degree of purification of this fraction as compared to the nuclei-free and fat free homogenate was 10 and 34 for catalase and palmitoyl CoA beta-oxidative activity, respectively. The finding that it was devoid of urate oxidase activity suggests that white adipose tissue peroxisomes are anucleoid. The contributions of the peroxisomes and of the mitochondria to total beta-oxidative activity in white adipose tissue were 65 and 35%, respectively. Hypothyroidism induced a 2.0- and 2.4-fold decrease of mitochondrial and peroxisomal beta-oxidation specific activities, respectively. These results are discussed in terms of a possible thermogenic role for white adipose tissue peroxisomes. PMID- 6847195 TI - An exploration of the primary specificity site of cathepsin B. AB - Peptidyl diazomethyl ketones inactivate cathepsin B apparently by alkylation of the active center thiol following complex formation as in the case of benzyloxycarbonyl (Cbz)-Phe-AlaCHN2. The phenylalanine contributes considerably to binding in the secondary specificity site. In order to define the topography of the active center region comprising the primary specificity site of beef spleen cathepsin B, a series of peptidyl diazomethyl ketones having the general structure Cbz-Phe-X-CHN2 has now been synthesized. The amino acid, X, has been varied in size to include rather large side chains which might reveal available binding potential or limitations. Some of the reagents, in fact, were not inhibitory even at 10(-4) M. Others, however, that did measurably inactivate cathepsin B provided a range of reactivities that extended over 5 orders of magnitude and correlated with affinity in the reversible phase of inactivation. Some large side chains, for example, that of tryptophan, were very poorly tolerated in this region of the active center, whereas others, such as O-benzyl threonine, provided remarkably active inhibitors. A topographical rationalization of the results is offered. PMID- 6847196 TI - Binding of terbium to apoferritin: a fluorescence study. AB - Luminescence measurements show that apoferritin binds three Tb(III) atoms per subunit in accordance with crystallographic evidence. Fe(II) competes with Tb(III) for at least some of the binding sites. This competition may be the molecular basis for the inhibition of iron incorporation into apoferritin brought about by Tb(III). Ca(II), which is generally replaced by Tb(III) in Ca(II) binding proteins, does not compete with the lanthanide for binding to apoferritin. PMID- 6847197 TI - Glucose-6-phosphate dehydrogenase from Leuconostoc mesenteroides: revised kinetic mechanism and kinetics of ATP inhibition. AB - The kinetic mechanisms of the NAD- and NADP-linked reactions catalyzed by glucose 6-phosphate dehydrogenase from Leuconostoc mesenteroides were examined using product inhibition, dead-end inhibition and alternate substrate experiments. The results are consistent with a steady-state random mechanism for the NAD-linked and an ordered, sequential mechanism with NADP+ binding first for the NADP-linked reaction. Thus, the enzyme can bind NADP+, NAD+, and glucose 6-phosphate, but the enzyme-glucose 6-phosphate complex can react only with NAD+, not with NADP+. This affects the rate equation for the NADP-linked reaction by introducing a term for a dead-end enzyme-glucose 6-phosphate complex. The kinetic mechanisms represent revisions of those proposed previously (C. Olive, M.E. Geroch, and H.R. Levy, 1971, J. Biol. Chem. 246, 2047-2057) and provide a kinetic basis for the regulation of coenzyme utilization of the enzyme by glucose 6-phosphate concentration (H.R. Levy, and G.H. Daouk, 1979, J. Biol. Chem. 254, 4843-4847) and NADPH/NADP+ concentration ratios (H.R. Levy, G.H. Daouk, and M.A. Katopes, 1979, Arch, Biochem. Biophys. 198, 406-413). The kinetic mechanisms were found to be the same at pH 6.2 and pH 7.8. The kinetics of ATP inhibition of the NAD- and NADP-linked reactions were examined at pH 6.2 and pH 7.8. The results are interpreted in terms of ATP addition to binary enzyme-coenzyme and enzyme-glucose 6-phosphate complexes. PMID- 6847198 TI - Purification and properties of transketolase from fresh rat liver. AB - Transketolase has been purified from rat liver. The final product is judged to be homogeneous by the criteria of gel filtration on Sephadex G-200 and Sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis. The estimated Mr's are 139,000 for the native protein and 69,000 for the dissociated subunits. The purified enzyme does not require either Mg2+ or thiamine pyrophosphate for optimum activity. The best C2-donor substrate is D-xylulose 5-phosphate, with Km = 25 microM. D-Fructose 6-phosphate is an active C2-donor, but beta hydroxypyruvate was found to be inactive, even at high concentration. The product of the C2-transfer from D-xylulose 5-phosphate or D-fructose 6-phosphate to D ribose 5-phosphate has been identified as D-sedoheptulose 7-phosphate. Neither D glucose 6-phosphate nor D-arabinose 5-phosphate showed C2-acceptor activity. This enzyme does not appear to be responsible for the formation of octulose 8 phosphates which have been detected in liver extracts. PMID- 6847199 TI - Lateral mobility of the light-harvesting complex in chloroplast membranes controls excitation energy distribution in higher plants. AB - Chloroplast thylakoid protein phosphorylation produces changes in light harvesting properties and in membrane structure as revealed by freeze-fracture electron microscopy. Protein phosphorylation resulted in an increase in the 77 degrees K fluorescence signal at 735 nm relative to that at 685 nm. In addition, a decrease in connectivity between Photosystem II centers (PS II) and a dynamic quenching of the room temperature variable fluorescence was observed upon phosphorylation. Accompanying these fluorescence changes was a 23% decrease in the amount of stacked membranes. Microscopic analyses indicated that 8.0-nm particles fracturing on the P-face moved from the stacked into the unstacked regions upon phosphorylation. The movement of the 8.0-nm particles was accompanied by the appearance of chlorophyll b and 25 to 29 kD polypeptides in isolated stroma lamellae fractions. We conclude that phosphorylation of a population of the light-harvesting chlorophyll a/b protein complexes (LHC) in grana partitions causes the migration of these pigment proteins from the PS II rich appressed membranes into the Photosystem I (PS I) enriched unstacked regions. This increases the absorptive cross section of PS I. In addition, we suggest that the mobile population of LHC functions to interconnect PS II centers in grana partitions; removal of this population of LHC upon phosphorylation limits PS II leads to PS II energy transfer and thereby favors spillover of energy from PS II to PS I. PMID- 6847200 TI - Identification of the mannan-binding protein from rat livers as a hepatocyte protein distinct from the mannan receptor on sinusoidal cells. AB - Cellular distribution in rat livers of the mannan-binding protein, a liver lectin specific for mannose and N-acetylglucosamine was investigated. Estimation of mannan binding activity of isolated cells demonstrated that more than 99% of the mannan binding activity recovered from whole livers was derived from hepatocytes. Intracellular localization of the mannan-binding protein disproved its function as a receptor of endocytosis. A small quantity of mannan binding activity detectable in sinusoidal cells seems to represent a receptor for mannan endocytosis. The receptor resembled the mannan-binding protein in its high affinity for mannan, requirement of Ca2+ for binding, and specificity for mannose and N-acetylglucosamine. However, the receptor was clearly distinct from the mannan-binding protein as indicated by the lack of response to antimannan-binding protein antiserum, by the potent inhibition by L-fucose and by the differences of specificity for various glycoproteins. The results in this study confirm the recent report of Maynard and Baenziger (Maynard, Y., and Baenziger, J. (1982) J. Biol. Chem. 257, 3788-3794) with quantitative data using different methodology and ligands, and provide additional evidence indicating the receptor on sinusoidal cells to be distinct from the hepatic binding protein. A possible role of the mannan-binding protein in the intracellular transport of intermediates of glycoprotein biosynthesis is also discussed. PMID- 6847201 TI - Characterization of lecithin:cholesterol acyltransferase from human plasma: II. Physical properties of the enzyme. AB - The physical properties of purified human plasma lecithin:cholesterol acyltransferase (LCAT) were investigated by techniques including analytical ultracentrifugation, ultraviolet spectroscopy, electrofocusing, and circular dichroism. The partial specific volume of LCAT was determined by sedimentation equilibrium ultracentrifugation experiments in H2O and D2O solutions (0.702 ml/g). The Mr was 67,000 by sodium dodecyl sulfate (SDS)-gel electrophoresis and 60,000 by sedimentation equilibrium ultracentrifugation. The discrepancy between the two sets of data presumably arose from the glycoprotein nature of the enzyme. Studies of the ultraviolet spectrum indicated that LCAT contained 6.5% (w/w) tyrosine which corresponds to approximately 18 tyrosine residues/mol of LCAT (polypeptide Mr 45,000). Spectrophotometric titration of the ionizable phenolic side chains indicated that nearly all the tyrosine residues were buried at neutral pH while they became gradually exposed at higher pH. The apparent pK of this transition was about 12.0 contrasted with 9.8, the apparent pK of ionization of the free tyrosyl groups. PMID- 6847202 TI - Trehalase from the cellular slime mold Dictyostelium discoideum: purification and characterization of the homogeneous enzyme from myxamoebae. AB - Trehalase (alpha-alpha'-trehalose 1-D-glucohydrolase, EC 3.2.1.28) was solubilized from myxamoebae of the cellular slime mold Dictyostelium discoideum by a freeze-thaw cycle and was subsequently purified to homogeneity using the techniques of ethanol fractionation, molecular sieve chromatography, DEAE cellulose ion-exchange chromatography, chromatofocusing, and preparative polyacrylamide disc gel electrophoresis. The 1000-fold purified enzyme had a specific activity of about 104 units/mg, which was accompanied by a net recovery of 5 to 7% of the original activity. The purified enzyme was maximally active at pH 5.5, showed high specificity for trehalose, and exhibited a typical hyperbolic response as a function of trehalose concentration with a Km of 1.2 mM. The enzyme was maximally active at 50 degrees C and had an energy of activation of 12-13 kcal/mol. Thermal stability studies demonstrated that full enzymatic activity was recovered following a 5-min incubation of trehalase at temperatures up to 45-50 degrees C. Analysis of various compounds for inhibitory effects indicated that Tris and urea were slightly effective, reducing enzymatic activity by 28 and 6% at concentrations of 100 and 10 mM, respectively. Of five heavy metals tested, HgCl2 was the most inhibitory, reducing activity by 58% when present at a final concentration of 1.0 mM. Enzymatic activity was not affected by any adenine derivative examined (e.g., ATP, ADP, AMP, cAMP, adenosine, and adenine). The molecular weight of the native enzyme was determined by molecular sieve chromatography, pore gradient electrophoresis, and electrophoresis as a function of acrylamide concentration. All three methods yielded a value of about 10(5) +/- 5 X 10(3). Estimation of the subunit or monomer molecular weight by sodium dodecyl sulfate-gel electrophoresis indicated a value of 95-100 X 10(3). The isoelectric point as determined in 7.5% polyacrylamide gels with pH 3-10 ampholytes was 7.2-7.3. The purified enzyme adsorbed to concanavalin A-Sepharose in the presence of KCl (0.1 M) and was eluted with alpha-methylmannoside, thereby suggesting an association between trehalase and carbohydrate. In agreement with this conclusion was the observation that trehalase could be specifically stained for carbohydrate with the Alcian blue and periodic acid-Schiff's reagents following polyacrylamide disc gel electrophoresis. PMID- 6847203 TI - Effects of thermodynamic nonideality in kinetic studies. AB - Experimental evidence is presented for concentration dependence of the pseudo first-order rate constant describing the rate of inversion of sucrose by 2 M HCl; and also of the increase in maximal velocity for the catalytic reduction of pyruvate by lactate dehydrogenase that results from addition of the inert macromolecular solutes bovine serum albumin, ovalbumin, and Dextran T70. These somewhat unusual and seemingly diverse observations are examined in terms of a theory formulated on the basis of two equilibrium reactions, the first describing complex formation between two reactants, and the second isomerization of that complex to an activated state prior to product formation. This formulation permits consideration of activity coefficient ratios relevant to the equilibria and the expression of these ratios as power series in total solution composition. Quantitative assessment of the experimental results is made possible in these terms by estimating the magnitudes of the constant coefficients of the virial expansions as excluded volumes. It is concluded that the result observed in the sucrose inversion study finds rational explanation in thermodynamic nonideality factors governing the overall equilibrium between the reactants and the activated complex of sucrose and hydronium ion. For the enzyme-catalyzed reaction the same general equation applies but particular attention is given to the simplified form that is relevant to high substrate concentrations, where, in the absence of inert compounds, the conventional maximal velocity is approached. In this region an increase in velocity observed upon addition of an inert macromolecular component may be considered explicitly in terms of excluded volume effects related to a shape change in the isomerization between enzyme-substrate complex and its activated state. PMID- 6847204 TI - The relationship between the osmotic fragility of human erythrocytes and cell age. AB - Erythrocytes in a normal blood sample are hemolyzed over a range of hypotonic salt concentrations. In order to investigate the relationship between the distribution of osmotic fragilities and the distribution of cellular ages, the osmotic fragility has been compared with three indices of cellular age. The activity of glutamic-oxalacetic transaminase (GOT) and the percentage hemoglobin A1C were measured in samples hemolyzed in different hypotonic salt concentrations. The osmotic fragility curve was also obtained for cells of different density separated by centrifugation. These experiments indicate that the fragility distribution is not an accurate reflection of the distribution of cellular ages. The mean fragility for older cells is higher than that of younger cells. However, cellular aging does not produce a gradual increase in osmotic fragility. Instead, it seems to produce changes which can both increase and decrease the fragility, resulting in a broader distribution of fragilities with some of the older cells actually less fragile than the younger ones. PMID- 6847205 TI - Localization of enzymes and alkaloidal metabolites in Papaver latex. AB - In continuing studies on the metabolic activity of Papaver somniferum, latex has been examined for its enzyme and alkaloidal metabolite content. After an initial centrifugation of latex at 1000g, the pellet which contained a heterogeneous population of dense organelles was further resolved on sucrose gradients. Of the enzymes monitored, acid phosphatase and L-3,4-dihydroxyphenylalanine decarboxylase were found to be in the latex 1000g supernatant, whereas catecholase (polyphenolase) was localized in two distinct organelles within the 1000g sediment. The lighter organelles, sedimenting at 30% sucrose, contained a soluble enzyme which was readily released on organelle plasmolysis, whereas the catecholase found within the heavier organelles, sedimenting at 55-60% sucrose, was membrane bound and showed significant activity only in the presence of Triton X-100. These latter organelles also contained the alkaloids, including morphine and thebaine, and were observed to readily accumulate [14CH3]morphine. The alkaloid precursor, dopamine, was localized in the same dense vesicle fraction as the alkaloids. The rate of uptake of [7-14C]dopamine into these fractions at room temperature, however, was markedly lower than that of morphine. Electron microscopic examination of the organelles of various densities revealed that they possessed different morphology. The results are consistent with the concept that both the 1000g and supernatant fractions of the latex are required for alkaloid biosynthesis and that a subpopulation of dense organelles found in the 1000g sediment have at least a function as a storage compartment for both alkaloids and their catecholamine precursor. PMID- 6847206 TI - Vitamin D-mediated alterations in the topography of intestinal brush border proteins: effect of papain on hydrolase release and calcium uptake. AB - The effect of vitamin D status on the topography of intestinal cell membranes was studied in isolated brush borders, as well as their purified membranes, by limited proteolysis. Addition of papain to brush borders isolated from vitamin D3 treated and deficient chicks resulted in a differential solubilization of leucine aminopeptidase, maltase, and sucrase activities (114, 195, and 79%, respectively, of appropriate control levels) but not alkaline phosphatase activity. In comparison, proteolysis of purified membranes exhibited vitamin D3- and 1,25 dihydroxycholecalciferol [1,25(OH)2D3]-dependent differences in release of all four marker hydrolases monitored. Calcium uptake studies revealed that preincubation with papain yielded vesicles with a calcium content that was 125% of corresponding native vesicles, in preparations from vitamin D3-treated, as well as deficient birds. Membrane vesicles prepared from 1,25(OH)2D3-treated chicks initially accumulated calcium to a greater extent than those from rachitic birds, but thereafter exhibited a decline in calcium content to basal levels. Preincubation with papain, however, abolished this loss of calcium. The combined results indicate that vitamin D mediates alterations in brush border protein topography and raise the possibility that this action of the seco-steroid might be involved in calcium absorption. However, if vitamin D-stimulated calcium transport across the brush border is dependent on a protein carrier, the molecular entity is not sensitive to inactivation by papain. PMID- 6847207 TI - Isolation, purification, and characterization of deer mouse (Peromyscus maniculatus bairdii) prolactin. AB - Prolactin (PRL) secreted by Peromyscus maniculatus bairdii anterior pituitaries was purified by gel filtration on Sephadex G-100 and ion-exchange chromatography on DEAE-cellulose. Peromyscus PRL (pmPRL) eluted from Sephadex G-100 with an elution-to-void volume ratio of 1.9 and at a salt concentration of 100 mM NaCl on DEAE-cellulose. Electrophoretic homogeneity of the hormone was demonstrated in several gel systems. On 7 1/2% alkaline polyacrylamide gels, pmPRL migrated with an Rf of 0.65. The molecular weight of pmPRL was estimated at 24,000 to 26,000 by sodium dodecyl sulfate electrophoresis and molecular exclusion chromatography. The amino acid composition of pmPRL was similar to other mammalian PRLs including two tryptophan residues and three disulfide bonds. Leucine was found to be the NH2-terminal residue. Circular dichroism (CD) spectra indicated an alpha-helix content of 55 +/- 5%, a value typical for prolactin molecules. However, in the region of side-chain absorption, the CD spectrum displayed a weak, asymmetric, negative band near 299 nm, with the CD returning to slightly positive values at 292 nm. This CD pattern is not typical of other secreted or stored prolactins. In the pigeon crop-sac assay, pmPRL showed a prolactin-like activity of 21 IU/mg. PMID- 6847208 TI - Oligosaccharides released from glycolipids by trifluoroacetolysis can be analyzed by gas chromatography-mass spectrometry. AB - Carbohydrates are quantitatively released by trifluoroacetolysis of neutral glycosphingolipids that contain 4-sphingenine. During the reaction hydroxyl groups are O-trifluoroacetylated and N-acetyl hexosamines are transamidated to form N-trifluoroacetyl derivatives. Selective removal of O-trifluoroacetyl groups followed by permethylation produces derivatives with properties favorable for analysis by combined gas chromatography/mass spectrometry. Electron impact mass spectra of permethylated N-trifluoroacetylated oligosaccharide alditols are characterized by strong primary and secondary fragments in which a positive charge is localized on the N-trifluoroacetyl hexosamine residue. The method enables rapid separation and identification of components in mixtures of carbohydrate chains from glycosphingolipids containing up to six simple sugars. PMID- 6847210 TI - Topical fluocinonide and tachyphylaxis. PMID- 6847209 TI - Laminin from rat yolk sac tumor: isolation, partial characterization, and comparison with mouse laminin. AB - Laminin was isolated from a rat yolk sac tumor by salt extraction, gel filtration, and affinity chromatography on heparin-Sepharose. The purified laminin gave two polypeptide chains with approximate Mr of 200,000 and 400,000 in sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Its amino acid composition and electron microscopic appearance were similar to those reported earlier for mouse laminin. Carbohydrate analysis revealed 13% carbohydrate consisting of N-acetylglucosamine, galactose, mannose, fucose, sialic acid, and small amounts of N-acetyl galactosamine. The purified rat laminin was immunologically very similar to mouse laminin as recognized by rabbit antibodies but was antigenically distinct when recognized by mouse antibodies. PMID- 6847211 TI - Urolithiasis in lichen planus. PMID- 6847212 TI - Clinical measurement pen. PMID- 6847213 TI - Haber's syndrome or Dowling-Degos disease? PMID- 6847214 TI - Clinical and pathologic cutaneous manifestations of malignant histiocytosis. AB - The clinical and pathologic changes in the skin of five patients with malignant histiocytosis were studied. The clinical signs included papules, nodules, noduloulcers and purpura. The histopathologic changes included exocytosis of inflammatory cells, infiltration of the papillary and reticular dermis with neoplastic histiocytes, and periadnexal and perivascular infiltrates. Phagocytosis of RBCs and nuclear debris by atypical histiocytes was seen in two cases. In one case, the skin lesions were the only initial manifestation of the disease. Skin involvement occurs in about 10% to 15% of all cases of malignant histiocytosis. Hence, it is important to include malignant histiocytosis in the differential diagnosis of patients with such skin lesions, especially when clinical symptoms may be suggestive of this disease. PMID- 6847215 TI - Multivariate risk score for recurrence of cutaneous basal cell carcinomas. AB - Multiple logistic analysis relating prognostic factors to risk of recurrence was performed for 1,417 basal cell carcinomas treated from 1955 to 1969 at New York University. The overall five-year recurrence rates by therapy were as follows: curettage-electrodesiccation, 26.0% (197/758); x-ray therapy, 9.7% (40/412); and surgical excision, 9.3% (23/247). Results for each treatment subgroup indicated that increasing lesion diameter and location of the lesion on various sites of the head, especially the nose, were associated with an increased risk of recurrence, whereas lesion location on the neck, trunk, limbs, or genitalia was associated with a decreased risk of recurrence. Additional significant factors correlated with increased risk were as follows: among patients treated with x irradiation, male sex, and, among those treated by curettage-electrodesiccation, prior therapy and increasing patient age. PMID- 6847216 TI - Phototherapy of pityriasis lichenoides. AB - Eleven patients with chronic pityriasis lichenoides chronica were treated with topically applied bland emollient cream and minimally erthemogenic doses of UV radiation from fluorescent sunlamps. The conditions of all patients cleared completely in an average of 29 treatments, requiring an average UV dose of 388 millijoules/sq cm at clearance. Phototherapy provides a convenient effective outpatient therapy for pityriasis lichenoides chronica. PMID- 6847217 TI - Treatment of pityriasis rosea with UV radiation. AB - Twenty patients with symptomatic and extensive pityriasis rosea were treated with unilateral UV-B phototherapy in a bilateral comparison study. Five consecutive daily erythemogenic exposures resulted in substantially decreased pruritus and extent of disease greater than that on the untreated side in approximately 50% of the patients. Therapy seems to be most beneficial to patients receiving treatment within the first week of the eruption. PMID- 6847218 TI - Incontinentia pigmenti achromians (Ito). AB - Three children had incontinentia pigmenti achromians (IPA). A study of these cases, together with a review of 70 previously documented cases, suggests that this dermatosis is closely related to systematized depigmented nevus and should be categorized as one of the congenital neurocutaneous diseases. There is also a relationship between IPA and incontinentia pigmenti. PMID- 6847219 TI - Heparin-induced cutaneous necrosis unrelated to injection sites. A sign of potentially lethal complications. AB - Skin necrosis is a rare complication of heparin administration that is usually localized to injection sites. A 32-year-old insulin-dependent diabetic patient, receiving intravenous (IV) and low-dose heparin sodium therapy, had cutaneous necrosis in areas distant to the sites of injection. Prior to the onset of cutaneous lesions, thrombocytopenia develop]ed in the patient that may have been heparin induced. Heparin may induce the production of platelet aggregating immunoglobulins that predispose persons who are sensitive to the drug to thrombocytopenia, skin necrosis, and thrombotic events. Obesity, diabetes, and treatment with broad-spectrum antibiotics seem to increase the risk of such complications. Cutaneous necrosis secondary to heparin administration may serve as a warning of the potentially lethal complications of IV use. In patients in whom skin necrosis or thrombocytopenia develops, heparin therapy should be discontinued and anticoagulation with an oral agent should be considered. PMID- 6847220 TI - Progressive vaccinia associated with combined variable immunodeficiency. AB - Progressive vaccinia developed in a previously healthy woman following smallpox vaccination and was successfully treated with vaccinia immune human globulin and methisazone. Immunologic evaluation over the next 4 1/2 years revealed evidence for combined variable immunodeficiency with increased numbers of circulating OKT 8 positive (suppressor-cytotoxic T) cells and the virtual absence of OKT 4 positive (helper-inducer T) cells. PMID- 6847221 TI - Multifocal Merkel's cell tumors associated with a cutaneous dysplasia syndrome. AB - Multifocal Merkel's cell tumors developed in a 24-year-old patient with an unusual cutaneous dysplasia syndrome. The neoplasms behaved in an aggressive fashion, with the development of multiple lymph node metastases. In this case, the dermatologic syndrome had features of both dyshidrotic ectodermal dysplasia and the basal cell nevus syndrome. In addition to Merkel's cell tumors, basal cell carcinomas and actinic elastosis were seen in sun-exposed skin sites. These findings, in conjunction with a known tendency for Merkel's cell tumors to arise in solar-damaged areas, suggest a pathogenetic relationship between these neoplasms and the underlying cutaneous syndrome in this patient. PMID- 6847223 TI - Vascular leiomyoma of the auricle. PMID- 6847222 TI - Amelanotic lentigo maligna melanoma manifesting as a dermatitislike plaque. AB - A 72-year-old man with a previous history of an amelanotic melanoma on his left forearm had an erythematous plaque excised from his right shoulder. Although the clinical impression was a dermatitis, a biopsy specimen revealed an amelanotic lentigo maligna melanoma. To our knowledge, this is the first patient described with an amelanotic lentigo maligna melanoma as a second primary tumor to an apparent previous amelanotic melanoma, manifesting as a dermatitislike plaque. PMID- 6847224 TI - Effects of anticonvulsants on the electroencephalogram. PMID- 6847225 TI - A career in British paediatrics. PMID- 6847226 TI - Congenital lactase deficiency. A clinical study on 16 patients. AB - There are at least 20 rare autosomal recessive disorders that are excessively common in Finland of which congenital lactase deficiency is one. During the last 17 years we have found 16 cases. In each case the mother noted watery diarrhoea, generally after the first feed of breast milk, and at the latest, by age 10 days. The lactose malabsorption was verified at a mean age of 36 (range 3-90) days, by which time the infants were dehydrated and 15 of them weighed less than at birth (mean weight for age was -2.8 SDs). On a lactose-free elimination diet (a group of 6 on Nutramigen and a group of 10 on soy-based formula) the children caught up in growth. One infant in each group showed allergic symptoms. While the infants were being breast fed their faeces contained 20 to 80 g/l lactose. In 24 peroral lactose tolerance tests, the greatest rise in blood glucose concentration was 0.8 mmol/l. Only 2 patients showed abnormal absorption when tested within a week of lactose elimination, and in each absorption tests became normal during the elimination period. Slight to partial villous atrophy of the jejunum was present in 4 early specimens, but in later ones the mean villous height was normal. The mean height of the epithelial cells was reduced and there were fewer intraepithelial lymphocytes in patients. The lactase activities in jejunal biopsy specimens were lower than in most patients with acquired lactase deficiency, with some overlap. The maltase and sucrase activities were normal. PMID- 6847227 TI - Immediate food hypersensitivity reactions on the first known exposure to the food. AB - We report 8 infants with immediate hypersensitivity reactions to foods (milk, egg, or peanut), occurring at the first-known exposure. Each developed symptoms within the first hour, but these generally settled within 2 hours. Sensitisation to the food concerned was demonstrated by positive immediate allergen skin prick tests in every case. Symptoms experienced included irritability, erythematous rash, urticaria, angio-oedema, vomiting, rhinorrhoea, and cough. Five infants were being followed prospectively and 4 were clinically tolerant of the food by age 16 months. The most likely route of sensitisation was via breast milk. None of the infants experienced similar reactions while being breast fed, suggesting that the reaction was dose dependent. As 5 out of a group of 80 infants being followed prospectively developed an immediate reaction at their first known exposure to a food, this appeared to be a not uncommon presentation of food hypersensitivity in infancy. PMID- 6847228 TI - Anorectal manometry results in defecation disorders. AB - Anorectal manometry and suction biopsy were carried out on 47 children with constipation or soiling, or both. Patients were divided into two groups. Group 1 (37 patients): functional faecal retention, group 2 (10 patients): functional faecal soiling without retention. Ganglion cells or normal acetylcholinesterase staining, or both, was demonstrated in all cases. Normal inhibition of internal sphincter could be achieved by rectal distension in all except 2 children with severe constipation. Resting sphincteric pressures, pressure responses, and conscious rectal sensitivity thresholds were similar in groups 1 and 2, but were increased compared with controls. In group 1 alone, the critical volume increased parallel with conscious rectal sensitivity threshold. Since the complete relaxation of internal sphincter occurs before conscious rectal sensation arises in children with soiling without retention, this may be an important factor, at least in some of the soilers. PMID- 6847229 TI - Catecholamine surge and lung function after delivery. AB - Lung function was measured at 30 minutes and again at 2 hours after birth in 12 infants delivered vaginally, in 15 infants delivered by elective caesarean section under general anaesthesia (GA), and in 15 delivered under epidural anesthesia (EDA). Umbilical arterial blood was analysed for pH and for concentrations of catecholamines and cortisol. No important differences in gestational age, birthweight, Apgar scores, or haematocrit were found among the three groups. Tidal volume and minute ventilation measured 30 minutes after birth were lower in infants delivered by caesarean section than in those delivered vaginally and at 2 hours the tidal volume was still lower in the babies delivered by caesarean section than in those delivered vaginally. Dynamic compliance was lower at 30 minutes in the group that had a caesarean section than in the vaginal group, and this difference was significant at two hours. Tidal volume, minute ventilation, and dynamic compliance in the GA and EDA groups did not differ. The catecholamine and cortisol concentrations at birth were higher in the vaginal group than in the group delivered by caesarean section. Two hours after birth there was a significant correlation (r = 0.84) between the catecholamine concentrations of the infants born vaginally and lung compliance. The lower dynamic lung compliance in infants delivered by elective caesarean section might be explained by delayed absorption of liquid in the lung due to lack of catecholamine surge. PMID- 6847230 TI - Phenylalanine and tyrosine levels in newborn screening blood samples. AB - A previously described difference in newborn blood phenylalanine concentrations between those living in urban and non-urban areas in the south west of England has been confirmed and shown to be independent of the type of feed. Several factors including the place of abode, type of feed, birthweight, and the accuracy of the test have been found to affect the measured, phenylalanine concentration in the newborn screening blood spot, and the importance of these results to screening practice is considered. Blood tyrosine also varied with the above factors, but severe, neonatal tyrosinaemia was shown to be a rare problem. PMID- 6847231 TI - Developmental assessment at four years: are there any differences between children who do, or do not, cooperate? AB - Among preschool children failure to cooperate in a developmental assessment is not uncommon, but many reports do not mention this awkward situation. Can such children be ignored? The abilities of 203 children were assessed at age 4 years and 7 1/2 years. At 4 years 37 (18%) did not cooperate fully and an overall developmental score could not, therefore, be calculated. For those sections in which they did achieve a score, the mean values, in all areas of development, were lower than those of complete cooperators and the differences were significant for visuomotor function, language, and comprehension. At 7 1/2 years children in the lower social classes who had been uncooperative at age 4 years had lower scores in all six areas of ability tested than those who had cooperated fully at 4 years. No differences were found for upper class children. Refusal to cooperate may in some cases indicate inability to perform and such children should not be ignored or discarded from follow up analyses. PMID- 6847233 TI - Relation between faecal fat and energy in preterm infants. AB - The energy measured in the faeces correlated highly (r = 0.93) with faecal fat in 111 24-hour stool collections from 37 preterm infants. It is easier to measure faecal energy than faecal fat, and energy measurements provide a better indication of nutrient malabsorption than faecal fat alone. PMID- 6847232 TI - Sex ratio and heterozygote advantage in cystic fibrosis families. AB - The families of aunts and uncles of cystic fibrosis (CF) patients were compared with one another and with controls in order to test claims of increased fertility and sex ratio in families containing the CF allele and to identify the more fertile sex. Uncles' families were found to contain a significant excess of sons, particularly at primiparous births, as well as a significantly increased sex ratio. Reanalysis of published records of CF sibships confirmed the effect of parity on sex ratio. The families of uncles were also exceptional in exceeding the size intended, although their mean size was not raised significantly. It is suggested that these effects could be related to an interaction between CF related, paternally-derived antigens and the maternal immune system. PMID- 6847234 TI - Cryptic mediastinal masses causing airways obstruction. AB - In 3 infants, severe airways obstruction was caused by mediastinal lesions which were not evident on the antero-posterior chest radiograph. Their presence was demonstrated by barium swallow examination. Each infant had thoracotomy carried out urgently. Duplication cysts (without associated cervicodorsal vertebral anomalies) were present in 2 patients and neuroblastoma in the third. PMID- 6847235 TI - Long term indwelling urethral catheterisation for congenital neuropathic bladder. AB - Long term urethral catheterisation remains an important and effective method of achieving dryness and maintaining renal function in children with congenital neuropathic bladders. Those most likely to require an indwelling catheter are girls who are severely disabled because of myelomeningocele. The management of such catheterisation and its consequences, in the light of our experience with a 100 children treated over a 12 year period, is described. PMID- 6847236 TI - Screening for cystic fibrosis. PMID- 6847237 TI - Neonatal systemic candidiasis. PMID- 6847238 TI - Miconazole in systemic candidiasis. PMID- 6847239 TI - Hormonal control of hamster ear sebaceous gland lipogenesis. AB - The sites and hormonal control of lipogenesis in hamster ear sebaceous glands are reported. Sebaceous lipogenesis was determined in ear biopsies by incubation with glucose and tracer concentrations of 14C-acetate in buffer. The 14C-labeled lipids were saponified, extracted, and determined by liquid scintillation counting. Histologically, the ears contained many sebaceous glands. The glands of male animals were much larger and more heavily lipid-stained than glands from females. Lipogenesis was almost entirely confined to the sebaceous glands in the dermal stroma. Lipogenesis was considerably higher in ear biopsies from male hamsters than from female, castrate male, or hypophysectomized male hamsters. In contrast to published data using hypophysectomized rats, where dihydrotestosterone potently and testosterone only weakly increased sebum secretion, both testosterone and dihydrotestosterone potently increased lipogenesis in the ears of hypophysectomized male hamsters. Dihydrotestosterone was somewhat more potent than testosterone in the hamster. Hypophyseal hormones do not appear to be essential for androgen stimulated lipogenesis in the hamster. In female hamsters, 5 alpha-androstane-3 alpha, 17 beta-diol, testosterone, dihydrotestosterone, 4-androstene-3,17-dione, and 5 alpha-androstane-3,17-dione produced dose-dependent increases in lipogenesis. From this and other studies, it is suggested that androgens other than dihydrotestosterone could be physiologically important in man and animals in stimulating lipogenesis in sebaceous glands. PMID- 6847240 TI - Circulating IgA- and IgG-class antigliadin antibodies in dermatitis herpetiformis detected by enzyme-linked immunosorbent assay. AB - A sensitive and technically simple enzyme-linked immunosorbent assay (ELISA) was developed to demonstrate circulating IgA- and IgG-class antibodies to gliadin, a component of wheat gluten. Serum samples from 24 patients with dermatitis herpetiformis (DH), 5 with coeliac disease (CD) and 75 normal controls were analysed. Antigliadin antibodies (AGA) of the IgA class were detected in 71% of DH patients, all of the CD patients and 19% of the controls. IgG-AGA was found in over 90% of DH patients and controls and in all of the CD patients. The mean ELISA values of both IgA- and IgG-class AGA were significantly higher in DH patients than in the controls. The occurrence of circulating IgA-class AGA is compatible with the hypothesis that these antibodies can be deposited in the skin, e.g. as immune complexes, or due to cross-reactivity of gliadin and dermal reticulin. PMID- 6847241 TI - Neutrophil chemotaxis in psoriasis before and after PUVA therapy. AB - Chemokinesis and chemotaxis of neutrophil leucocytes were studied by migration under agarose in 35 patients with psoriasis and compared with 35 healthy controls. Eschericheae coli filtrate and lipopolysaccharide were used as chemo attractants. Of these patients, 14 were tested before and after photochemotherapy. The chemotactic capacities of psoriatic serum before and after PUVA therapy were also investigated. The increase in the chemotactic activity of psoriatic polymorphonuclear leucocytes (PMNs) was not significant and remained unchanged after PUVA therapy. The activated psoriatic serum showed a slight increase in chemotactic activity when compared with normal activated serum. These results do not support an intrinsic abnormality of psoriatic PMNs, and their migration into psoriatic lesions could be chiefly due to the presence of chemotactic factors in involved epidermis. PMID- 6847242 TI - Effects of psoriatic sera on the generation of oxygen intermediates by normal polymorphonuclear leucocytes. AB - The effects of psoriatic sera were investigated on the generation of oxygen intermediates (OIs) by normal polymorphonuclear leucocytes (PMNs). Although increased superoxide generation was noted, a further respiratory burst of the PMns was significantly suppressed. Since superoxide dismutase (SOD) and catalase activities of the sera assayed in the xanthine-xanthine oxidase system were comparable to the controls, it still remains obscure why this dissociation occurs. It is suggested that increased generation of superoxide anion from the PMNs may be another facet of PMN activation which plays an important role in the psoriatic process. PMID- 6847243 TI - Polymorphonuclear and mononuclear leucocyte function in necrobiosis lipoidica and granuloma annulare. AB - Neutrophils and monocytes from patients with necrobiosis lipoidica (NL) and granuloma annulare (GA) were studied in vitro in order to detect functional abnormality. Phagocytosis of latex particles and zymosan-induced release of beta glucuronidase were similar in patients and controls. Plasma from these patients did not enhance or inhibit phagocytosis or enzyme release from normal cells. Our studies suggest that peripheral blood leucocyte function in patients with GA and NL is normal, but this does not exclude a functional abnormality in the lesions. PMID- 6847244 TI - Prostaglandin E1 in normal human skin: methodological evaluation, topographical distribution and data related to sex and age. AB - A methodological evaluation of a radioimmunoassay technique for PGE1 measurement was applied to normal human skin. The detection limit of the assay was 15 pg and recovery (mean +/- SD) was 90 +/- 6%. The mean value of PGE1 (+/- SEM) in nine punch biopsy specimens (4 mm in diameter) from a piece of skin surgically removed from one person was 117 +/- 14 pg/mg dry weight. The individual variation of PGE1 activity in biopsy specimens from the same topographical area in ten persons belonging to the same sex and age group was 33 +/- 4 pg/mg dry weight. The influence has been elucidated of temperature and tissue processing, local anaesthesia, sex, age and topographical distribution on endogenous PGE1 activity. PMID- 6847245 TI - Hematological dyscrasia in teleosts chronically exposed to selenium-laden effluent. PMID- 6847246 TI - Cadmium-induced sterility: possible involvement of the cholinergic system. PMID- 6847247 TI - The disposition of 2,4-dichlorophenoxyacetic acid in rainbow trout. PMID- 6847249 TI - Cytotoxicity of 2,3,7,8-tetrachlorodibenzo-p-dioxin on primary cultures of adult rat hepatocytes. PMID- 6847248 TI - Toxicity, bioconcentration, and metabolism of the herbicide propanil (3',4' dichloropropionanilide) in freshwater fish. PMID- 6847250 TI - Metabolism of 4-chlorophenyl methyl sulfide and its sulfone analog in cattle and sheep. PMID- 6847251 TI - A survey of effects of gaseous and aerosol pollutants on pulmonary function of normal males. AB - A total of 231 normal male human subjects were exposed for 4 hr to air, ozone, nitrogen dioxide, or sulfur dioxide; to sulfuric acid, ammonium bisulfate, ammonium sulfate, or ammonium nitrate aerosols; or to mixtures of these gaseous and aerosol pollutants. Only one concentration of each pollutant was used. This study, therefore, represents a preliminary survey, intended to allow direct comparison of studies to plan future research. During exposure each subject had two 15-min exercise sessions on a treadmill at 4 mph and 10% grade. Environmental conditions were mildly stressful, i.e., temperature = 30 degrees C and relative humidity = 60%. A battery of 19 measurements of pulmonary function was performed just prior to exposure (air control); 2 hr into the exposure, following the first exercise session; 4 hr into the exposure, following the second exercise session; and 24 hr after exposure. Significant differences were noted in specific airway resistance (SRAW), forced vital capacity (FVC), and forced expiratory flow at 50% of FVC (FEF50) and in related measurements in those experimental groups exposed to ozone or to ozone plus aerosols. None of the aerosols alone, nitrogen dioxide or sulfur dioxide alone, or mixtures of nitrogen dioxide or sulfur dioxide with aerosols produced significant effects. A distribution analysis of subject responsivity to ozone gave a normal distribution among subjects not exposed to ozone, and a distribution shifted to the right and skewed to the right among those exposed to ozone alone or in mixture, with no evidence of bimodal distribution of ozone sensitivity. PMID- 6847252 TI - Neurologic evaluation of a population exposed to arsenic in Alaskan well water. AB - One hundred forty-seven persons exposed to arsenic from well water were evaluated by neurologic examination and nerve conduction studies. Total arsenic concentrations in well water ranged from 1 to 4781 micrograms/L and from 6 to 4964 micrograms/L in urine; a calculated index of arsenic ingestion ranged from 1 to 4521 micrograms/day. No dose-response relationship existed between arsenic ingestion and symptoms or physical findings compatible with peripheral neuropathy. Five of six persons with symptoms or physical findings suggestive of sensory neuropathy had normal nerve conduction velocities. Thirteen persons with elevated arsenic ingestion but no signs or symptoms of neuropathy had one or more abnormal nerve conduction velocities. No dose-response relationship, however, existed between arsenic ingestion and nerve conduction velocities. The authors concluded that arsenic ingestion from well water at the concentrations found in this Alaskan community did not result in clinical or subclinical neuropathy. PMID- 6847253 TI - Relation of daily mortality to air pollution: an analysis of 14 London winters, 1958/59-1971/1972. PMID- 6847254 TI - A new relationship between air pollutant inhalation and cancer. AB - Many studies have been conducted to investigate the effects of different air pollutants on health. Our studies have focused on the effects of nitrogen dioxide (NO2), and recently we reported that inhalation of low levels of NO2 can facilitate cancer cell metastasis. The study described herein utilized the same B16 mouse melanoma metastasis model of previous investigations, but under different NO2 exposure conditions. The results provide further evidence that inhalation of ambient level NO2 (0.4 ppm) or polluted urban ambient air play a role in facilitation of blood-borne cancer cell metastasis. In addition, results show different patterns of melanoma cell distribution in the lungs of NO2- and ambient-air exposed animals. They also indicate that extended periods of clean air between NO2 exposures may diminish the severity of the insult in the less sensitive animals. It is our conclusion that the results provide strong support for the need of improved air quality and for reduction of noxious pollutants in urban ambient air. PMID- 6847255 TI - Resolution of pulmonary dysfunction following acute chlorine exposure. AB - Following acute exposure to chlorine gas, 18 asymptomatic subjects were evaluated for early pulmonary dysfunction. Airway obstruction was evident in all exposed individuals immediately after chlorine exposure. The severity, course of the obstructive defect, and clinical picture correlated with the chief complaint on admission. The obstructive abnormalities resolved within 1 wk after exposure to chlorine in 12 subjects whose chief complaint was cough. A slower resolution of the physiologic changes, clinical signs, and symptoms was noted in 6 subjects whose initial chief complaint was dyspnea. In this group, maximum mid-expiratory flow rate (FEF25-75%), and forced expiratory flow after exhaling 50% and 75% of the vital capacity (FEF50% and FEF25%, respectively) were still diminished 2 wk after chlorine exposure. The slow rate of resolution in the dyspnea group is best explained by increased individual susceptibility since a past medical history of smoking or asthma and "wheezing" was more prevalent in this group. PMID- 6847256 TI - Effect of a second metal on cadmium-induced hypertension. AB - One percent salt, 1 ppm cadmium, or 1 ppm cadmium plus 1 ppm lead in drinking water caused similar mild hypertension in rats. The hypertensive effect of salt, given for 4 months beginning at weaning, disappeared when the salt was withdrawn but subsequently returned without further exposure. Rats continuously given 1 ppm cadmium during and after salt exposure were continuously hypertensive, but salt did not increase their hypertension. Rats continuously exposed to cadmium or cadmium plus lead without extra salt remained hypertensive for 20 months. Rats exposed to cadmium or cadmium plus lead for months 4 through 8 remained hypertensive after metal exposure was discontinued; addition of 0.35 ppm selenium corrected the hypertension in cadmium-fed rats but had little effect in the cadmium plus lead exposed rats. PMID- 6847257 TI - Neural control of blood pressure following 1,1,1-trichloroethane inhalation: a role of sympathetic nervous system. AB - The effects of 1,1,1-trichloroethane (1,1,1-TCE) inhalation on arterial blood pressure and renal sympathetic nerve activity were investigated in anesthetized dogs. In acute inhalation experiments, the threshold concentration of 1,1,1-TCE required to produce a decrease in blood pressure was 0.4 to 0.5% in inspired air; moreover, a dose-response relationship between the decrease in blood pressure and 1,1,1-TCE concentration which exceeded the threshold level was observed. In addition, renal nerve activity increased and was associated with a slight decrease in blood pressure following inhalation of relatively low concentrations of 1,1,1-TCE. Following inhalation of relatively high concentrations of 1,1,1 TCE, however, renal nerve activity decreased and was accompanied by a marked decrease in blood pressure. Opposite reactions of renal nerve activity were observed when blood pressure decreased to 70-80 mm Hg following inhalation. It is suggested that systemic hypotension resulting from 1,1,1-TCE inhalation may be controlled by two different reactions of sympathetic nerve activity. PMID- 6847258 TI - Acute polyarticular gout. AB - We report here on 41 male patients with acute polyarticular gout seen in 3 years. Acute polyarticular gout continues to masquerade as other commoner rheumatological disorders such as septic arthritis, rheumatoid arthritis, degenerative joint disease, and even hemiparesis. Almost all of these patients had clues to the diagnosis of acute gout in their medical history. These clues included a past history of intermittent acute gout, prior attacks of polyarticular arthritis, previous hyperuricaemia, and/or obvious tophi. The patients all responded promptly to nonsteroidal anti-inflammatory drugs. We observed serious toxic drug reactions in 8 patients. PMID- 6847259 TI - A controlled study of diet in patients with gout. AB - To determine whether patients with gout have a diet which is distinctive in quality or quantity a careful dietary questionnaire was posed over 7 days to 61 men with gout and 52 control subjects. The average daily intake of most nutrients, including total purine nitrogen, was similar except that the patients with gout drank significantly more alcohol. Beer was the most popular beverage, and 25 (41%) of those with gout consumed more than 60 g alcohol daily (equivalent to 2 . 5 litres of beer). The heavy drinkers had a significantly higher intake of purine nitrogen, half of which was derived from beer. Though the effect of ingested purine on the blood uric acid is difficult to estimate, it probably was sufficient to have a clinical effect, augmenting the hyperuricaemic effect of alcohol itself. PMID- 6847260 TI - Direct activation of neutrophil chemiluminescence by rheumatoid sera and synovial fluid. AB - The majority of paired sera and synovial fluids from 21 patients with rheumatoid arthritis produced a rapid chemiluminescent response when incubated with human neutrophils. Synovial fluid gave considerably higher responses than the paired serum specimen. In contrast little or no response was found with paired sera and joint fluid taken from patients with gout, psoriasis, and osteoarthritis and with sera from healthy donors. A similar chemiluminescent response was observed when neutrophils were preincubated with large aggregates of heated human gammaglobulin (HAGG), which were used as a model of immune complexes. Smaller nonreactive aggregates of gammaglobulin became reactive after preincubation with a purified monoclonal rheumatoid factor (mRF) which had a high avidity for aggregated IgG. The addition of this monoclonal rheumatoid factor also caused enhancement of chemiluminescence by rheumatoid sera. Further evidence suggesting that the active material found in these rheumatoid specimens contained complexed immunoglobulin was obtained by indirect immunofluorescence. Neutrophils developed intracellular immunoglobulin inclusions after preincubation in reactive rheumatoid sera but not with nonreactive or normal sera. However, activation of neutrophil chemiluminescence by rheumatoid specimens did not correlate significantly with levels of rheumatoid factor or immune complexes suggesting that the activating complexes were of a particular type. In conclusion we have shown the direct activation of neutrophil chemiluminescence by rheumatoid sera synovial fluid and suggest that the activation is caused by large IgG-containing immune complexes. It is possible that this activation may have important implications in the immunopathogenesis of the rheumatoid inflammatory process. PMID- 6847261 TI - The ESR in the diagnosis and management of the polymyalgia rheumatica/giant cell arteritis syndrome. AB - A review of 80 patients with the polymyalgia rheumatica/giant cell arteritis (PMR/GCA) syndrome has revealed that the erythrocyte sedimentation rate (ESR) is normal in 22.5% of cases at presentation. Too much reliance on the ESR as a screening test led to delay in diagnosis in 10 patients. Serious complications occurred in 4 patients with a normal or minimally raised ESR. Analysis of follow up data at 4 weeks showed no significant correlation between change in the ESR and change in symptoms, and at subsequent clinical attendances symptoms did not consistently parallel the ESR. Our results cast serious doubts on the use of the ESR as an entirely reliable diagnostic and therapeutic aid in the PMR/GCA syndrome. PMID- 6847262 TI - Hyaluronic acid content of deep and subcutaneous bursae of man. AB - To provide a comparison of the contents of subcutaneous and deep bursae we dissected these structures from unfixed cadavers without apparent joint disease. No free fluid was found within any olecranon or prepatellar bursae (examples of subcutaneous bursae), while viscous fluid was invariably present in the (deep) retrocalcaneal bursae. The hyaluronic acid content of the washings of 5 rectrocalcaneal bursae ranged from 142 to 591 nmol hexosamine (mean = 281 nmol hexosamine). In contrast, the hyaluronic acid content of 4 olecranon bursae was much lower (range 35-72 nmol, mean 53 nmol hexosamine), and hyaluronate was not detected in washings from either of 2 prepatellar bursae. The greater hyaluronate content of the retrocalcaneal bursae did not appear to be due to a greater surface area, since on the basis of calculations made from plaster casts the surface areas of the olecranon and prepatellar bursae were approximately 3 times and 2 times, respectively, greater than that of the retrocalcaneal bursae. The data suggest that, although hyaluronic acid may lubricate deep bursae, other factors may be more important in reducing friction within superficial bursae. PMID- 6847264 TI - Selective renal angiography in Wegener's granulomatosis. AB - Two patients whose illnesses meet the criteria of Wegener's granulomatosis are presented. Selective renal angiography performed in both revealed multiple arterial aneurysms similar to those classically found in polyarteritis nodosa. PMID- 6847263 TI - Cell-mediated immunity to myoglobin in polymyositis. AB - Using the leucocyte migration inhibition (LIF) test we looked for evidence of cell-mediated hypersensitivity against myoglobin in 8 patients with polymyositis (PM) or dermatomyositis (DM). The migration index for PM-DM patients was 47.5 +/- 17%, while in the controls the index was 86 +/- 12% (p less than 0.001). The presence of serum antibodies against myoglobin was also investigated by passive haemagglutination (PH) and counterimmunoelectrophoresis (CIE). By PH the reciprocal titre of antimyoglobin antibodies was 150 +/- 28 in PM-DM compared with 16.2 +/- 15.9 and 8.7 +/- 7.7 in control patients with diseases (p less than 0.01) and negative in normal persons. CIE showed antimyoglobin antibodies in 3 PM DM patients and in none of controls. Cell-mediated immunity against myoglobin may be implicated in the pathogenesis of PM. The pathological significance of antimyoglobin antibodies remains to be determined. PMID- 6847265 TI - Arthritis due to synovial involvement by extramedullary haematopoiesis in myelofibrosis with myeloid metaplasia. AB - A 60-year-old man presented with polyarthralgias, a psoriasiform rash, and severe elbow pain. Peripheral blood smear and bone marrow biopsy established a diagnosis of myelofibrosis with myeloid metaplasia. Biopsy of the skin lesions revealed a nonspecific dermatitis. The clinical presentation was inconsistent with psoriatic arthritis, and there was no evidence for associated gout or collagen-vascular disease. Histological examination of tissue taken at the time of synovectomy indicated elbow arthritis to be due to myeloid metaplasia involving the synovial membrane. PMID- 6847266 TI - Visceral leishmaniasis complicating systemic lupus erythematosus. AB - Active systemic lupus erythematosus in a 32-year-old Chinese woman was successfully controlled by plasmapheresis and steroids. However, occult visceral leishmaniasis was uncovered during therapy and responded to appropriate treatment. PMID- 6847267 TI - Aorto-atrial fistula in rheumatoid arthritis. AB - A patient with severe deforming rheumatoid arthritis presented with a short history of chest pain. The clinical signs were of an unusual diastolic murmur and profound shock unresponsive to therapy. Post-mortem examination disclosed the unexpected finding of a large aorto-atrial fistula. PMID- 6847268 TI - Treatment of the arthropathy of familial hypercholesterolaemia. AB - A 29-year-old woman suffering from the arthropathy of familial hypercholesterolaemia was treated with a fat-modified low-cholesterol diet and colestipol. Symptomatic improvement occurred in association with a moderate reduction in the plasma cholesterol concentration. The pathogenesis of the musculoskeletal features of this disease is reviewed, and the implications of this patient's therapeutic response are explored. PMID- 6847269 TI - Multiple-crystal acute polyarthritis. AB - A patient with acute polyarthritis due to crystal-positive simultaneous gout and pseudogout affecting different joints is described. The case emphasises the importance of aspirating more than one involved joint and carefully searching for crystals in patients with acute arthritis involving 2 or more joints, particular those in whom the diagnosis of multiple crystalline joint disease is considered. PMID- 6847270 TI - Glycosylated haemoglobin in rheumatoid arthritis. PMID- 6847271 TI - Response of extravascular lung water to intraoperative fluids. AB - The effect of Ringer's Lactate (RL) and a colloid containing salt solution Plasmanate (PL) on extravascular lung water (EVLW) during aortic surgery was evaluated in a prospective study of 18 patients. Measured blood loss was replaced with packed red blood cells. In addition to red blood cell replacement, either RL or PL was infused (1) to maintain the cardiac output (CO) equal to or greater than the preoperative value, (2) to maintain the pulmonary capillary wedge pressure (PCWP) plus or minus 2 mmHg of preoperative values, and (3) to keep the urinary output greater than or equal to 30 cc/hr. Cardiac output, EVLW, PCWP, serum colloid osmotic pressure (COP), and intrapulmonary shunt fraction (Qs/Qt) were measured serially. All baseline values were similar between groups. The groups were well matched for age, associated disease, operating time, blood loss, and blood transfusions. During operation, the RL group required two times the rate of infusion of the PL group. Urine flow rates were similar on the day of surgery, but by postoperative days one and two, the PL group had approximately one-half of the urine flow rate compared to the RL group. Cardiac output and Qs/Qt increased in both groups. EVLW did not change after operation in either group, despite marked decrease in COP in the RL group. These data indicate that crystalloid resuscitation to physiologic endpoints does not increase extravascular lung water. Thus, manipulation of COP by PL was unnecessary in these patients. PMID- 6847272 TI - Management of the major coagulopathy with onset during laparotomy. AB - An experience with 31 patients who developed major bleeding diatheses during laparotomy was reviewed. Management of the initial 14 patients was by standard hematologic replacement, completion of all facets of operation, and then closure of the peritoneal cavity, usually with suction drainage; only one patient survived. The subsequent 17 patients had laparotomy terminated as rapidly as possible to avoid additional bleeding. Major vessel injuries were repaired; ends of resected bowel were ligated; and holes in other gastrointestinal segments and the bladder were closed by purse-string sutures. One patient had a ureter ligated. Laparotomy pads (4-17) were then packed within the abdomen to effect tamponade, and the abdomen was closed under tension without drains or stomata. Following correction of the coagulopathy, the abdomen was re-explored at 15 to 69 hours in the 12 survivors. Definitive surgery then was completed: bowel resection and reanastomosis; ureter reimplantation; drains for bile, pancreatic juice, and urine; and stomata for bowel or urine diversion or decompression. Eleven of 17 patients, deemed to have a lethal coagulopathy, survived. This technique of initial abortion of laparotomy, establishment of intra-abdominal pack tamponade, and then completion of the surgical procedure once coagulation has returned to an acceptable level has proven to be lifesaving in previously non-salvageable situations. PMID- 6847273 TI - Total thyroidectomy. A review of 213 patients. AB - During a 10.5-year period ending in June 1982, total thyroidectomy was performed on 213 patients at the Vanderbilt University Medical Center. A nonfunctioning nodule on technetium scan was the primary indication for operation. Twenty-one of 213 patients had undergone previous partial thyroidectomy. The pathologic changes in the excised thyroids were carcinoma (81 patients), thyroiditis (27 patients), multiple benign adenoma (16 patients), thyrotoxicosis (27 patients), multinodular goiter (56 patients), and C-cell hyperplasia (three patients). Three total thyroidectomies were performed in search of a parathyroid adenoma. Fourteen patients had coexistent primary hyperparathyroidism. Excluding 12 patients with medullary carcinoma, 25% of all other patients with carcinoma would have had unrecognized tumor left in the remaining lobe had a total thyroidectomy not been performed. Calcium supplements were required in 59 patients during hospitalization, but only 2.8% of the patients developed permanent hypoparathyroidism. Since the adoption of Thompson's technique of total thyroidectomy, only one of the 128 patients (0.8%) has sustained permanent hypoparathyroidism. Two patients exhibited transient recurrent laryngeal nerve palsies without permanent nerve damage. There were no operative deaths. The low morbidity of total thyroidectomy appears to justify its use in all patients with differentiated thyroid malignancy. With surgeons experienced in this technique, total thyroidectomy should also be considered as the primary treatment for many other patients requiring thyroidectomy. PMID- 6847274 TI - The occurrence of carcinoma of the rectum following ileoproctostomy for familial polyposis. AB - Ileoproctostomy was performed in 32 patients (13 Female and 19 male), with polyposis coli ranging in age from 10 to 54 years. Seven patients (22%) developed cancer of the retained rectum with a median follow-up of 14 years. Two (20%) of ten patients, followed for 10 to 15 years, and three (50%) of six patients, followed for 15 to 20 years, developed rectal cancer. Rectal cancer developed in two of 14 patients who had their ileoproctostomy at 14 cm and in five of 18 patients who had their ileoproctostomy at a higher level, with a median followup of 7 and 11 years, respectively. Rectal cancer developed in two of 15 teenage patients undergoing ileoproctostomy and in nine of 17 patients aged 20 to 54 years. The present average ages of the two groups were 25 and 41 years, and the average age at which rectal cancer appeared was 40 years. Three of the patients who developed rectal cancer had numerous polypectomies over the years, and there was a tendency to develop tubulovillous and villous adenomas with a variable degree of atypia leading to carcinoma. One patient also showed a return to high levels of coprostanol and secondary fecal bile acids. Proctocolectomy, if acceptable, may be the treatment of choice; ileoproctostomy may mean that the patient eventually will undergo a proctectomy. The ileoanal endorectal pull through procedure has a great deal to offer to these patients, and further study is necessary to evaluate this procedure. PMID- 6847275 TI - X-ray calcifications as the only basis for breast biopsy. AB - Two hundred fifty-one consecutive patients were treated between 1964 and 1982 with mammographic calcifications as the only reason for breast biopsy. Patients with either clinical or x-ray findings other than calcifications were excluded. A correlation of the x-ray, pathology, and clinical experience is the basis of this report. Specimen radiography with paraffin section histology (i.e., no frozen section) was performed on all biopsy material. The procedure of specimen radiography that was utilized is described. A team approach involving radiologists, pathologists, and surgeons has been essential both to confirm excision of the calcifications and localize them for pathology study. Carcinoma was found in 45 patients (17%). A retrospective study of the calcifications was also undertaken to determine characteristics that would permit definitive radiographic diagnosis of benign or malignant disease. PMID- 6847276 TI - Gastroesophageal reflux in childhood. The dilemma of surgical success. AB - Successful surgical correction of gastroesophageal reflux has prompted frequent and early referral of children for antireflux surgery. This report describes the results and defines the complications in a series of children treated surgically for gastroesophageal reflux. Methods are suggested to reduce the occurrence of these postoperative complications. In five years (1977-1981), 117 children, 3 weeks to 16 years old, were operated on for gastroesophageal reflux at The Oklahoma Childrens Memorial Hospital. Nissen fundoplication was performed on 111 of them. Patients have been followed for 3 months to five years. At most recent examination, clinical success (remission of symptoms) has been accomplished in 81 of 92 patients (90%). In 86 patients evaluated radiographically, gastroesophageal reflux was absent in 83 and persistent in 3. There were no operative deaths. Twenty-three major complications occurred in 21 patients, 13 of whom required reoperation. These major complications were paraesophageal hiatal hernia (ten patients), small bowel obstruction (eight patients), and wrap malalignment (5 patients). Observations of and reoperation on these children suggests the following necessary steps for avoidance of complications in children: (1) Nissen fundoplication in childhood should be accompanied by an accurate multi-suture crural repair and by suture fixation of the fundal wrap to the crura and to the abdominal surface of the diaphragm; (2) appropriate alignment of the fundal wrap and of the crural repair is best accomplished with a large indwelling esophageal bougie of sufficient size to efface and blanche the esophageal musculature; and (3) appropriate care in avoiding small bowel obstruction mandates meticulous avoidance of trauma to the liver capsule and small bowel serosa. PMID- 6847277 TI - Hepatopedal flow restoration in patients intolerant of total portal diversion. AB - This report describes an experience with operative restoration of hepatopedal portal blood flow in five patients intolerant of total splanchnic shunting. Portal flow was reestablished by takedown of the total shunt and construction of a selective, distal splenorenal shunt, or by isolation and arterialization of the hepatic limb of the shunted portal vein. In two patients, shunt revision was undertaken electively for chronic encephalopathy, which had been unresponsive to low-protein diet, intestinal antibiosis and oral lactulose. Eighteen and 48 months after operation, both patients have had no encephalopathy on an unrestricted protein intake, and work actively as homemakers. Needle liver biopsies showed enhanced mitotic activity in the early postoperative period, suggesting hepatocyte regeneration. In three patients, shunt conversion or arterialization was undertaken in desperate circumstances, characterized by liver failure (bilirubin greater than 10 mg/dl, albumin less than 2.5 g/dl, prothrombin time greater than 16 sec), coma, and respirator dependency. Although the patients showed immediate, marked improvement in mentation, all three died of intraabdominal hemorrhage in the first few postoperative days, in spite of maximum blood product support. Two conclusions can be drawn from this limited experience: (1) at a time of election, restoration of hepatopedal portal flow can be accomplished with considerable benefit in patients with side-to-side portacaval or hemodynamically equivalent shunts, and (2) similar procedures in patients with fulminant liver failure are unlikely to succeed. PMID- 6847278 TI - Percutaneous transhepatic management of complex biliary problems. AB - A series of 27 patients with complex biliary problems secondary to previous biliary operations is presented. The patients are divided into two groups: (1) patients with acute perioperative biliary problems; all had biliary leak with abscess, biliary cutaneous fistula, and/or stricture following cholecystectomy or common duct exploration and (2) patients with chronic postoperative biliary problems; all had previous repair of biliary stricture or injuries with late stricture formation. Early management of all patients included placement of a percutaneous biliary stent. Abscesses were drained operatively, and biliary leaks or fistulas were allowed to close spontaneously. Jaundice and cholangitis were allowed to resolve. Following stabilization, management of stricture, if present, was addressed. Eight acute patients had strictures, of which four were partial and three were dilated percutaneously. Four were complete and required operative repair. All 12 chronic patients had strictures, of which six were partial and successfully managed with percutaneous dilatation. Four patients also had common duct stones which were successfully crushed percutaneously. The authors conclude that percutaneous transhepatic drainage offers significant advantages in the early stabilization and treatment of patients with complex biliary problems, and that partial strictures of the biliary tree may be managed successfully by percutaneous dilatation. PMID- 6847279 TI - The role of surgery in the Zollinger-Ellison syndrome. AB - When the Zollinger-Ellison syndrome was first identified, total gastrectomy was proposed as the most effective treatment for the secretory manifestations of the syndrome. Recently, however, great enthusiasm has developed for medical treatment by means of H2-receptor antagonists. The authors have cared for 27 patients with the Zollinger-Ellison syndrome at The University of Texas Medical Branch in the past 12 years and have been pleased with the results of total gastrectomy, which was performed in 23 of the 27 patients (one patient refused operation and three patients had lesser gastric operations). Twenty-three patients underwent total gastrectomy with Roux-en-Y esophagojejunostomy. There were no operative deaths. Primary tumors were found in 17 patients, seven of whom also had metastatic tumors. No tumors were found in nine patients. Nine patients are dead; the actuarial survival rate for all patients was 75% at 5 years and 52% at 10 years. Eleven of the 27 patients had the multiple endocrine neoplasia I syndrome. Of the 18 survivors, only three have normal serum gastrin levels, and all three had extrapancreatic gastrinomas, one in peripancreatic lymph nodes, one in the liver, and one in a cystic tumor attached to the stomach. Nutritional results were good to excellent, with a mean postoperative weight loss of 14.7% (mean follow-up period was 45 months). The authors conclude that treatment of the hypersecretory problems of the Zollinger-Ellison syndrome by total gastrectomy is safe and dependable. Results compare well with those of long-term medical management, whose success is dependent upon serial favorable responses to a lifetime of repeated challenges. PMID- 6847281 TI - A continent ileostomy device. AB - The feasibility of achieving fecal continence by mechanical occlusion of an end ileostomy is explored. Accordingly, progressive stomal occlusion with an indwelling occluding device was evaluated in four healthy patients with Brooke ileostomies. Pre-occlusion clinical and physiologic tests were done, including fat balance, intestinal transit time, ileal motility and absorption, ileal compliance, ileal radiography, and ileoscopy. Progressive stomal occlusion was then employed until periods of occlusion of 5 to 8 hours were achieved after 10 to 16 weeks. Pre-occlusion tests were then repeated. Patients mastered use of the occluding device rapidly, and the device achieved reliable stomal continence in each patient. Whereas ileal capacity was small initially, intermittent occlusion resulted in a large, capacious ileal reservoir. Fasting ileal motility was increased slightly by stomal occlusion, although intestinal transit during feeding was not altered. Also, ileal absorption of glucose, electrolytes, vitamin B-12, and fat were not changed, and ileal mucosa at the site of occlusion remained intact endoscopically. The authors concluded that chronic intermittent occlusion of a Brooke ileostomy with an indwelling stomal device achieved enteric continence without impairing intestinal function. PMID- 6847280 TI - Comparison of four provocative tests for the diagnosis of gastrinoma. AB - In an attempt to determine the best provocative test for the diagnosis of gastrinoma, ten normal subjects, 13 patients with known gastrinoma, and one patient with presumed gastrinoma were administered four regimens: (1) rapid calcium infusion (2 mg Ca++/kg/min), (2) secretin (2 clinical units (CU)/kg/bolus), (3) long calcium infusion (12 mg Ca++/kg/3 h) and (4) a combination test consisting of a rapid calcium infusion followed immediately by secretin. Blood was drawn for serum gastrin levels before and following infusion of the test agents. The administration of rapid calcium followed by secretin provoked the greatest increases in serum gastrin above basal levels in both normals (29%) and patients (362%). Peak gastrin levels in patients were similar following the long calcium infusion (341%) but were less following the rapid calcium infusion alone (124%) and secretin alone (207%). There were no false positive or false-negative tests with the calcium plus secretin when the criterion for diagnosis was either a 50% increase or a 200 pg/ml increase above the basal gastrin level. The distinct advantages (short test period, low patient morbidity, and relatively great potency) of the calcium plus secretin test make it an attractive alternative to other previously described provocative tests for the diagnosis of gastrinoma. PMID- 6847282 TI - Transduodenal sphincteroplasty and transampullary septectomy for postcholecystectomy pain. AB - Ninety-two patients underwent a transduodenal sphincteroplasty and transampullary septectomy (extended papilloplasty) for chronic, incapacitating upper abdominal pain over an 11-year period. Seventy-nine had a prior cholecystectomy; 42 of 56 patients with reported pathology had documented gallstone disease. Serious morbidity included two moderately severe cases of postoperative pancreatitis and a pulmonary embolus. There were no deaths. Operative findings revealed stenosing papillitis (n = 45), transampullary septitis (n = 40), and papillary dysfunction (n = 7). Histologic examination of septal biopsy specimens revealed inflammation in 34 cases and fibrosis in 19 cases. There were no microscopic abnormalities in 39 biopsy specimens. The results at 1 to 10 years in 83 patients is as follows: good in 36 patients (no pain--43%), fair in 27 patients (occasional pain--33%), and poor in 20 patients (unrelieved by the procedure--24%). Patients with prior sphincteroplasty (12 of 15 with a fair to good result) benefitted the most from the procedure. Those who underwent concomitant cholecystectomy responded poorly. Risk factors for failure include alcoholism, drug addiction, mental illness, and duodenal ulcer disease. The finding of papillary cholesterolosis at operation also was accompanied by a less than optimal result. Transduodenal sphincteroplasty with transampullary septectomy provides long-term benefit to carefully selected patients with chronic abdominal pain after cholecystectomy. PMID- 6847283 TI - Functional indications for bullectomy of giant bulla. AB - Nineteen patients with giant bulla were followed for more than 1 year after bullectomy. They were divided into two groups according to their postoperative symptoms. Group 1 consisted of 16 patients who had no problems in their postoperative clinical course, while Group 2 included 3 patients who complained of severe dyspnea at 5 to 6 years of follow-up. Prior to operation, the forced expiratory volume in 1 sec over vital capacity (FEV1%) was 66.8 +/- in Group 1 and 27.6 +/- 5.4% in Group 2. Differences in preoperative and postoperative FEV1% were statistically significant within Group 1 and between the two groups. Postoperative FEV1% (Y) correlated significantly with preoperative FEV1% (X) (Y = 0.74X + 25.4; r = 0.836; p less than 0.001). Thus, we were able to predict the postoperative FEV1% from the preoperative value. Regional ventilation over volume was computed from the washout curve of xenon 133 after reaching equilibrium with rebreathing in a closed circuit (V/V dynamic). Group 2 had significantly lower regional ventilation over volume in all regions, both before and even after bullectomy, compared with normal subjects or Group 1 patients. Preoperative V/V dynamic was below 0.5 in all regions of Group 2. Furthermore, postoperative V/V dynamic (Y) correlated significantly with preoperative V/V dynamic (X) in the upper region (Y = 0.46X + 0.40; r = 0.638; p less than 0.02) and in the lower region (Y = 0.72X + 0.33; r = 0.869; p less than 0.001). We conclude that functional indications of bullectomy for giant bulla are that FEV1% should be greater than 40%, and that regional V/V dynamic should be greater than 0.5. On the other hand, symptomatic and functional improvement following bullectomy was reduced in patients whose FEV1% was less than 35% in whose V/V dynamic was remarkably disturbed in all regions of the involved hemithorax. PMID- 6847284 TI - Temperature gradients and rewarming time during hypothermic cardiopulmonary bypass with and without pulsatile flow. AB - Pulsatile perfusion during cardiopulmonary bypass (CPB) has been reported to have a number of beneficial effects, including attenuation of hormonal stress responses and improved organ blood flow and function. To determine the effect of pulsatile perfusion on temperature gradients and the time required for cooling and rewarming during CPB, we studied 21 patients scheduled for elective coronary artery operations. The patients were divided into two comparable groups: Group 1 (N = 11) had standard nonpulsatile perfusion, while in Group 2 (N = 10), a pulsatile pump was used. Rectal and esophageal temperatures were monitored, as were deltoid muscle temperatures and upper arm and finger skin temperatures in the same extremity. Ambient temperature, bypass flow and pressure, and bypass time were similar in both groups. Time required to cool to the lowest esophageal temperature was virtually identical for both groups (Group 1, 17 +/- 3 min; Group 2, 17.6 +/- 5 min), as was rewarming time (Group 1, 26.8 +/- 11 min; Group 2, 27.2 +/- 6 min). There were no significant differences in temperature measurements between groups except briefly during rewarming when finger skin temperature rose more rapidly in Group 1 (p less than 0.05). Temperature changes following CPB were the same for both groups, with rectal and esophageal temperatures showing an inverse relationships. These data demonstrate that pulsatile flow does not substantially alter rewarming time or temperature gradients during hypothermic CPB. PMID- 6847285 TI - Prevention and reperfusion injury following cardioplegic arrest by pulsatile flow. AB - To assess the efficacy of pulsatile flow in minimizing reperfusion injury following cardioplegic arrest, 20 dogs supported by cardiopulmonary bypass underwent 60 minutes of hypothermic, hyperkalemic crystalloid cardioplegic arrest. The effects of pulsatile flow (Group 2), initiated during 30 minutes of reperfusion, on myocardial adenosine triphosphate (ATP) and creatine phosphate (CP) stores, coronary blood flow, and myocardial water content were compared with the effects of linear flow reperfusion (Group 1). Myocardial ATP stores were maintained at preischemic levels by this mode of myocardial protection. However, pulsatile flow prevented the significant decline in ATP levels incurred during linear reperfusion. Creatine phosphate stores, although depleted during arrest, were restored equally, regardless of the mode of reperfusion. The decline in ATP stores was associated with no pathological increase in myocardial water content, but was associated with persistent reactive hyperemia. In contrast, after 30 minutes of pulsatile reperfusion, coronary blood flow was significantly decreased compared with preischemic flow. These data indicate that pulsatile reperfusion can prevent the unique decline in ATP levels associated with the restoration of coronary flow after cardioplegic arrest (reperfusion injury), and support its continuing evaluation as an adjunct to adequate intraoperative myocardial protection. PMID- 6847286 TI - Fluorocarbon cardioplegia and myocardial protection. AB - This study compares myocardial protection using nonoxygenated clear cardioplegia with oxygen-carrying solutions of blood (PO2, 100 mm Hg) and fluorocarbon (FC-47 perfluorotributylamine, PO2, 500 mm Hg), all containing 25 mEq/L of potassium chloride. Three groups of dogs, each consisting of 5 animals, were placed on cardiopulmonary bypass, and the aorta of each dog was cross-clamped for 45 minutes. Hemodynamic and biochemical variables were measured at baseline and during recovery. Levels of the myocardial isoenzyme of creatine phosphokinase (CPK-MB) in the coronary sinus were significantly lower in the fluorocarbon cardioplegia group at 15 minutes of aortic cross-clamping (p less than 0.01), while both the fluorocarbon and blood cardioplegia groups demonstrated lower CPK MB levels at 45 minutes (p less than 0.001 and p less than 0.05, respectively), compared with the clear cardioplegia group. The blood and fluorocarbon groups had improved mean aortic blood pressure (p less than 0.02 and p less than 0.05, respectively) and left ventricular pressure. At 45 minutes of reperfusion and recovery, all hemodynamic and enzymatic variables were similar in each group. We conclude that oxygenated solutions better protect the myocardial cell, but that further work is needed to determine the most effective oxygen level for maximum protection with cardioplegia. PMID- 6847287 TI - Diagnosis and treatment of subacute free wall ventricular rupture after infarction. AB - Ventricular rupture is usually a sudden, lethal complication after acute myocardial infarction (MI). Some patients, however, may survive several hours after ventricular rupture, and there is time for surgical repair if the diagnosis is made quickly. In 1980 and 1981, 7 patients underwent operation for ventricular rupture at our institution. Bedside hemodynamic studies with a Swan-Ganz catheter confirmed the diagnosis of pericardial tamponade. Urgent operation with cardiopulmonary bypass was performed. Control of hemorrhage was obtained by covering the ventricular tear and the surrounding infarcted myocardium with a wide Teflon patch. Four patients are alive and well 2, 3, 4, and 10 months after operation. Clinically, free wall ventricular rupture should be suspected when any patient recovering from an acute MI experiences chest pain and cardiovascular collapse. Bedside hemodynamic monitoring will confirm the diagnosis of cardiac tamponade, and urgent operation will save some of these patients. PMID- 6847288 TI - Single aortic clamping for proximal and distal anastomoses in coronary operations: study of myocardial temperatures in nonvented hearts. AB - A prospective analysis of myocardial temperatures (septum, left and right atria, and right ventricle) in coronary operations was carried out in nonvented human hearts during a single period of aortic cross-clamping for construction of all anastomoses, proximal and distal. Also a comparison was made of normothermic versus hypothermic perfusion during cardiopulmonary bypass (CPB). Results indicate that (1) immediately after cross-clampling and infusion of the cardioplegic solution, the septal temperature was identical for hypothermic and normothermic perfusion; (2) at 20 minutes of clamping, however, hypothermic patients had lower septal temperatures than normothermic patients; and (3) at the end of the cross-clamping period, the septal temperature was lower in hypothermic hearts. The left and right atrial and right ventricular temperatures were lower throughout CPB in patients with hypothermic perfusion. It is concluded that if a single period of aortic cross-clamping under cardioplegic arrest is to be used for construction of all anastomoses in nonvented hearts during a coronary operation, core hypothermia is necessary and should be maintained until the aorta is unclamped. The surgeon cannot rely on cold slush and cardioplegia alone to cool the heart while the proximal anastomoses are being performed, since blood from the bronchial (left atrium) and systemic (right atrium) circulations warms the heart. PMID- 6847289 TI - Epicardial corkscrew lead fracture: an underreported cause of pacing failure? AB - Three children with a pacemaker sustained similar lead fractures within a two year period. Each fracture occurred in the corkscrew portion of a Medtronic Model 6917 epicardial lead. All patients were boys. The leads had been in place for 12, 45, and 43 months prior to fracture. None of the patients had sustained major trauma. Fracture of the corkscrew lead has been considered an uncommon complication. However, three lead fractures in the corkscrew area in a population of 60 children followed at this institution indicate that this may be a more common cause of pacemaker-system malfunction than previous data suggest. A plea is made for reporting all pacing failure to the manufacturer. PMID- 6847290 TI - Primary tracheomalacia. AB - Tracheomalacia is a rare congenital malformation of the tracheobronchial cartilages in which the supporting cartilaginous rings permit expiratory collapse of the airway. The condition is usually mild and self-limited. There is a severe variant, however, that is life-threatening and warrants separate categorization. Four children with severe primary tracheomalacia were treated recently. The clinical symptoms, diagnostic findings, and eventual treatment of these patients were highly distinctive and almost identical in all 4, permitting us to make the following observations: (1) primary severe tracheomalacia must be suspected in infants with unexplained respiratory distress manifested by stridor and cyanosis; (2) symptoms are not present at birth but appear insidiously after the first weeks of life, are markedly aggravated by respiratory tract infections, and are made worse by agitation; (3) bronchoscopy is essential for definitive diagnosis and should be employed early in the diagnostic process; (4) tracheostomy is probably essential in most instances; and (5) resolution, although spontaneous, does not occur until after 2 years of age. PMID- 6847291 TI - Surgical treatment of carcinoma of the esophagus and cardiac portion of the stomach in 850 patients. AB - From 1961 to 1978, 850 patients with carcinoma of the esophagus or cardiac portion of the stomach were operated on in the Capital Hospital of the Chinese Academy of Medical Sciences. Eighty-three percent of the patients were men, and about 45% of the patients ranged from 51 through 60 years old. Just over half of the patients were seen when the lesion was at a late stage of development. The thirty-day postoperative mortality among 664 patients with a restricted lesion was 10%. Leakage of the esophagogastric anastomosis was the chief cause of morbidity, and about half of the patients with this condition died. The 5-year survival among these 664 patients with a restricted lesion was 22%. Retrospective review of the literature confirmed the possibility of further increasing resectability, further decreasing mortality, and providing greater long-term survival if early complete resection of the tumor can be carried out. PMID- 6847292 TI - Thymoma following transcervical thymectomy for myasthenia gravis. AB - A superior mediastinal thymoma was found in a patient two years following a transcervical thymectomy for myasthenia gravis. This case report illustrates another potential complication of incomplete thymectomy that may occur with the transcervical approach. PMID- 6847293 TI - Intractable dysphagia following placement of Angelchik prosthesis for reflux esophagitis. AB - In 1979, Angelchik and Cohen [1] reported a series of 46 patients in whom a Silastic prosthesis was used to control gastroesophageal reflux. The initial results were good, and to date, no long-term complications have been noted. We discuss a patient whom severe dysphagia developed following placement of an Angelchik prosthesis. Preoperative evaluation revealed no motor abnormality and no stricture, but there was acute angulation of the gastroesophageal junction. The prosthesis was removed through a left thoracotomy, and a Belsey repair resulted in good relief of symptoms. PMID- 6847294 TI - Unusual complication of porcine heterograft. AB - This paper discusses a complication that is associated with mitral valve replacement utilizing the porcine heterograft and that, to the best of our knowledge, has not been reported previously. Severe mitral insufficiency developed early in 2 patients following mitral valve replacement with a porcine bioprosthesis. Both patients required reoperation. In each patient, it was discovered that one of the cusps of the mitral prosthesis was in the fixed-open position with no evidence of perivalvular leak. The assumption was that failure of the leaflet to close properly had been present from operation. Careful inspection of the valve and assurance that all leaflets close properly should be made at the time of initial valve replacement. PMID- 6847295 TI - Isolated unruptured aneurysm of the left coronary sinus of Valsalva. AB - An isolated unruptured aneurysm of the left coronary sinus of Valsalva was detected incidentally in a patient with a bicuspid aortic valve in whom the left circumflex coronary artery arose from the right coronary artery. With the patient on cardiopulmonary bypass, the mouth of the aneurysm was closed by suturing the reflected posterior cusp of the aortic valve to the aortic root. A Starr-Edwards prosthetic aortic valve was inserted, and an aortocoronary saphenous vein bypass graft maintained good blood flow down the left anterior descending coronary artery. Previous reports of this rare condition and its treatment are discussed. PMID- 6847296 TI - Cervical esophageal anastomosis following cervical esophageal diversion: a new use for an old instrument. AB - Proximal cervical esophageal diversion is occasionally employed in the management of distal esophageal perforation. However, subsequent esophageal reconstruction can pose a formidable surgical challenge. The DeBakey femoral tunneling device has proven helpful in identifying the distal defunctionalized segment of esophagus during certain types of reconstruction. We describe the use of this instrument to reestablish esophageal continuity in two instances. PMID- 6847298 TI - Cardioplegia and pacemakers. PMID- 6847297 TI - A technique for placement of left atrial monitoring line. AB - A technique for placement of a left atrial monitoring line is described. Following repair of a complex congenital heart defect, a long catheter previously advanced from the common femoral vein or the saphenous vein into the right atrium is inserted across the interatrial septum through the parent foramen ovale or through a small incision in the atrial septum at the level of the fossa ovalis. A suture is placed to close the interatrial septum around the catheter. This technique has been used successfully for four years. PMID- 6847299 TI - Vein graft twisting. PMID- 6847300 TI - Cell saver in noncardiac surgery. PMID- 6847301 TI - Annual patterns of human sperm production and semen quality. AB - Mean monthly values for ejaculate volume, sperm density, total sperm count, and percentages of progressively motile, viable, and morphologically normal spermatozoa were calculated from semen analyses performed on the husbands of all couples (excluding cases of azoospermia) referred to an Infertility Service during the years 1975-1979. No significant seasonal variations in any parameter were found. Comparison of the patterns of sperm production with other published studies indicates a tendency for increased sperm production during the late winter and early spring months. PMID- 6847302 TI - Aging and the human zona reticularis. AB - Adrenal androgen levels and excretion increase during adrenarche and puberty. During this time the width of the adrenal zona reticularis has been reported to increase, and this fact is quoted as evidence for the common assumption that the major source of adrenal androgens is the zona reticularis. During human aging there is a marked decrease in adrenal androgen levels and excretion. In the present study, the width of the zona reticularis was studied single blind in multiple sections of the adrenals of 42 victims of sudden death 4 months to 93 years of age to discern a possible correlation between zona reticularis width and the declining adrenal androgen levels and excretion typical of aging. However, no correlation was found, which suggests that direct measurements of adrenal steroid secretion by the individual adrenal zones are necessary for the study of adrenal zonation. PMID- 6847303 TI - Failure of inbreeding to influence pineal-induced gonadal regression in short day exposed hamsters. AB - The rate of testicular degeneration and the drop in plasma testosterone levels were compared in what were referred to as short-term domesticated (STD) and long term domesticated (LTD) Syrian hamsters when they were maintained under short photoperiodic conditions (light:dark cycles of 10:14). STD hamsters were derived from wild stock captured in 1971; LTD animals were derived from the original stock captured in 1930. The rate of testicular degeneration as well as the fall in plasma testosterone levels were similar in both groups of animals. After 26 weeks exposure to short days, the testes and accessory sex organs regenerated to the fully mature state in both the STD and LTD animals; likewise, plasma testosterone levels had returned to normal in both groups. Pineal melatonin levels of STD and LTD female hamsters were compared during both the light phase (2000 and 0800hr) and dark phase (0200 and 0400hr) of the daily light:dark cycle. These animals were kept under photoperiodic conditions of 14:10 with lights on daily from 0600-2000hr. Day- and night-time levels of pineal melatonin were similar in both groups of hamsters. The results indicate that inbreeding does not influence the atrophic response of the reproductive organs of male hamsters to short day exposure or the ability of the pineal gland to produce melatonin. PMID- 6847304 TI - Sialic acid content of human spermatozoa and seminal plasma in relation to sperm counts. AB - Sialic acid levels were determined in spermatozoa and seminal plasma of 47 semen samples divided into two groups according to sperm counts. Group 1, up to 40 x 10(6) sperm/ml seminal fluid and group 2, above 40 x 10(6) sperm/ml seminal fluid. The content of sialic acid in spermatozoa ranged from 4.4-28.1 micrograms/10(8) spermatozoa and from 70-95 mg/100 ml seminal plasma. Sialic acid was significantly higher in sperm and lower in seminal plasma of group 1 as compared to group 2. The lower content of sialic acid in seminal plasma might have a deteriorating effect on structural integrity of sperm. PMID- 6847305 TI - Histochemical studies on genetical control of hormonal enzyme inducibility in the mouse. VI. Effects of short term castration. AB - The regional histology and esterase activity of the mouse epididymis after 24, 48, and 72 hr castration is reported. Differential sensitivity to androgen deprivation among the various epithelial cell types is described, allowing of positive identification of the cell types previously observed to survive long term castration. The possibility of an androgen binding protein, as described in the rat and rabbit, is suggested on morphological grounds. The epididymal body appears to contain a class of highly androgen sensitive cells that degenerate rapidly following castration and a second class that survive from which regeneration occurs on testosterone replacement. PMID- 6847306 TI - Reduced fertilization ability of zona-free hamster ova by spermatozoa from male partners of normal infertile couples. AB - Zona-free hamster ova were used as a penetration test system for human semen obtained from male members of infertile couples. Forty semen samples from normal infertile couples were tested and compared with penetration rates obtained with control semen samples from fertile donors. Normal penetration rates ranged between 20-100%. Out of the 40 tested males, 11 were found to have penetration rates below 10%, two had between 11 and 19%, and in the remaining 27, the rate was above 20%. Three women, whose husbands were found to be in the first group (penetration rate below 10%), conceived after artificial donor insemination within three months of treatment. Thus, the use of the human-hamster ova penetration test should be used as an additional tool in diagnosis of infertility. PMID- 6847307 TI - Acid phosphatases in the mouse testis: activity changes during development. AB - The histology and acid phosphatase activities of the developing testes in the mouse, from 4 days of age until maturity, were analyzed. The specific enzyme activity with p-nitrophenyl phosphate as substrate increased after 3 weeks of age and then reached a plateau. Cobalt and zinc markedly increased the specific activity after the third week. After fractionation the testicular homogenate revealed four acid phosphatases. Enzyme I maintained a high activity during the first 3 weeks but steadily declined thereafter. Enzyme II, present in all age groups, showed a moderate increase after the fourth week. Enzymes III and IV were low and declined further during the first 3 weeks with a subsequent increase. This occurred concomitantly with the appearance of spermatids and mature sperm cells. Changes in enzyme activities seem to reflect the alterations in cellular composition of the testis during the developmental process. Enzymes III and IV were probably associated with spermatids and sperm cells. PMID- 6847308 TI - Histological, histochemical, and ultrastructural aspects of interstitial tissue from the contralateral testis in infertile men with monolateral varicocele. PMID- 6847309 TI - Histochemical study of glycogen and phosphorylase activity on bilateral biopsies of oligospermic men with varicocele. AB - Varicocele is responsible for a high percentage of impairment of spermatogenesis. In contrast to the normal human testis, Sertoli cell glycogen is reduced, while the reaction product of phosphorylase is considerably increased. Even if the mechanism by which varicocele produces deleterious effects on male fertility remains obscure, an anomaly in glycogen metabolism appears to be present bilaterally in impaired spermatogenesis due to the varicocele. PMID- 6847310 TI - Insensitivity of the testis of the musk shrew to DICA. PMID- 6847311 TI - A comparative study on hypotensive and bradycardic effects of some new imidazole derivatives with possible central mechanism of action. AB - Cardiovascular actions of 4(5)-(2,6-dimethylbenzyl)imidazole (MPV-207) and its three alkyl bridge analogues were investigated in urethane-anaesthetized normotensive rats. Intravenous (i.v.) injections of 0.001-0.1 mg/kg of MPV-207 lowered mean arterial pressure (MAP) and heart rate (HR) in a dose-dependent manner. The compound was effective also upon intracerebroventricular (i.c.v.) administration. The hypotensive effect of i.v. injected MPV-207 (5 micrograms/kg) was attenuated by i.c.v. administered yohimbine (100 micrograms/kg), an alpha 2 adrenoceptor antagonist. MPV-295 having an ethano group between the phenyl and imidazole moieties decreased MAP and HR at i.v. doses of 0.03-3 mg/kg, being active also after i.c.v. injection. Extension of the alkyl bridge to the propano group further decreased the hypotensive and bradycardic activity, and the compound having a butano bridge was practically inactive. The results indicate that the extension of the alkyl bridge between the phenyl and imidazole rings reduces the hypotensive and bradycardic activities of the MPV compounds. Furthermore, the hypotensive action of these compounds may be mediated by a central mechanism involving a stimulation of alpha-adrenoceptors. PMID- 6847312 TI - Intravenous infusion of nitroprusside: effects upon cardiovascular dynamics and regional blood flow distribution in conscious dogs. AB - Intravenous infusion of nitroprusside (5 micrograms/kg/min) was carried out in conscious dogs over a 15-min period in order to describe changes in both central and peripheral vascular areas. Dogs were prepared with an electromagnetic flow probe positioned at the root of the aorta, and microspheres (9 microns) were used to measure regional blood flow distribution before and after 15 min of infusion. Controlled hypotension (-15 to -20 mmHg) was maintained throughout the infusion period and this hypotensive state was associated with a significant decrease in stroke volume (-16%), left ventricular power (-25%) and work (-40%) while cardiac index was not significantly affected. Those values were almost back to control levels 5 min following the end of infusion. Regional blood flow studies showed that at the fifteenth min of infusion, nitroprusside induced a significant decrease in blood perfusion to all areas of the myocardium (range -10% to -25%) while their local vascular resistances were not affected significantly. Blood perfusion to liver (hepatic artery), spleen and intestine was also modified significantly (-17%, -12% and -16%, respectively) while their vascular resistances remained close to control values. By the time measurements were made, blood flow to cerebral and renal tissues remained normal while their vascular resistances fell significantly (15% for brain and 20% for kidneys). For each organ studies, blood perfusion was uniform. These results indicate that nitroprusside elicits both central and peripheral hemodynamic changes and that reflex adjustments modify the vasodilator effect of the drug in most vascular beds that we have studied. PMID- 6847313 TI - Influence of acarbose on hyperglycemia induced by various carbohydrates in rats and oral starch tolerance in monkeys. AB - Acarbose, an alpha-glycosidehydrolase inhibitor, reduced hyperglycemia after an oral sucrose or starch load in the rat. The compound showed weaker activity in inhibiting maltose-induced hyperglycemia and no effect on glucose or lactose tolerance in the rat. In the Cebus monkey, the oral starch tolerance curve was significantly inhibited by acarbose at a dose comparable to that showing activity in man. Therefore, the Cebus monkey appears to be a suitable animal model for studying agents which affect starch tolerance in man. PMID- 6847314 TI - Folic acid and the protective action of diphenylhydantoin against maximal electroshock in rats after single doses. AB - Conflicting evidence regarding the antagonistic action of folic acid (FA) on the efficiency of the antiepileptic drug diphenylhydantoin (DPH) led us to study this problem in rats. From the results it is concluded that the enteral absorption of particularly higher doses of DPH is slightly hampered by FA. When the dose of DPH is high enough, this diminished absorption will not manifest itself in impaired protection. On the basis of DPH levels in brain tissue it is concluded that also on brain level there is some antagonistic action of FA on DPH protection. Here too, a sufficiently high level of DPH prevents this antagonistic action from becoming evident. We suggest that only in patients in whom the DPH treatment is marginal, FA treatment may hamper the therapeutic antiepileptic effect. PMID- 6847315 TI - Time course relation between neurotoxic effects of kainic acid on behaviour and brain GABA-levels. Protection by gamma-vinyl GABA. AB - Administration of kainic acid (KA, 11 mg/kg i.p.) to rats produced a syndrome of abnormal behaviour (hyperexcitability, stereotypies, convulsions, aphagia and aggressivity) as well as a reduction in brain GABA levels during the first days after treatment. Pretreatments of rats with gamma-vinyl GABA (900 mg/kg) elevated brain GABA levels and prevented the occurrence of convulsions and aphagia. The findings suggest that KA neurotoxicity is due in part to its disruptive effects on GABA neurotransmission. PMID- 6847316 TI - Plasma, whole blood and red blood cell kinetics of chloroquine after oral and parenteral administration in rabbits. AB - The pharmacokinetics of chloroquine were studied after single oral, intramuscular and intravenous administration of the drug in rabbits. Chloroquine concentration was monitored in plasma, whole blood and red blood cells and the pharmacokinetic parameters were determined from the plasma, whole blood and red blood cell concentration-time data. By whatever route the drug was administered, higher concentrations were reached in red blood cells and whole blood than in plasma, but the concentrations declined at the same rate in the three media thus giving similar half-lives. However, the plasma, or whole blood or red blood cell half lives varied depending upon whether the drug was given orally, intramuscularly or intravenously. With each route of administration the area under the plasma concentration-time curve was less than that for whole blood which was in turn less than that for red blood cells. PMID- 6847317 TI - Spontaneous rhythmicity induced by glucose removal in the guinea-pig tracheal smooth muscle. AB - Guinea-pig tracheal smooth muscle was mechanically quiescent in the normal Krebs Henseleit solution, but rhythmic contraction appeared after removal of glucose from the solution with or without carbachol and was accompanied by a gradual decrease in the resting tension. There was no significant difference in lag time required for appearance of the rhythmicity and % decrease of the tension between glucose removal in the absence and presence of carbachol. Induction of the rhythmicity was limited by hypoxia plus glucose removal, without and with carbachol. The rhythmic contraction produced by glucose removal was low in amplitude and disappeared within one hour, whereas, when a low dose of glucose (0.1-0.2 mM) was periodically applied after glucose removal, the rhythmic contraction was higher in amplitude and continued for over 5 hr. The rhythmicity elicited by glucose removal in combination with an adequate supply of glucose was abolished by addition of glucose (0.22-0.25 mM), ATP (1.8 mM), or pyruvate (0.9 mM), accompanied by restoration of the tension to a certain degree, but not by 3 O-methyl glucoside (11.5 mM). The results suggest that the rhythmicity may be masked in normal metabolic states but unmasked in metabolically deficient states in the guinea-pig tracheal smooth muscle. PMID- 6847318 TI - Effect of pH on the sino-atrial node cells and atrial muscle of dog. AB - Effects of pH (6.0, 6.5, 7.0, 7.4, 8.0, 8.5 and 9.0) on the canine sino-atrial node were studied using isolated right atrial preparations which were obtained from puppies and perfused with oxygenated Tyrode solution through the dorsal right atrial artery (sinus node artery). First, the preparations were perfused by normal solution (pH 7.4), and then by one with a different pH. Low pH perfusate prolonged the cycle length and depressed the atrial contraction. These effects occurred slowly and it took 5-7 min to reach the maximum change. Alkaline solutions caused opposite changes. In both low and high pH solutions, the changes in cycle length were not stronger than those for atrial contraction. The depression in low pH solution or the enhancement in high pH solution became more prominent with the decrease or increase in the pH. As for the configuration of action potential of the sino-atrial node cells, acid solutions caused reduction in the amplitude of action potential and the rate of phase 4 depolarization, and prolonged the duration of action potential. On the other hand, alkaline solutions increased the rate of phase 4 depolarization and amplitude of action potential, and shortened the duration of action potential. We also examined the influence of pH on the effect of norepinephrine on the sino-atrial node. The positive chronotropic and inotropic responses to norepinephrine were maximal in pH 7.4 solution. PMID- 6847319 TI - Cerebellar control of eye movements studied with injection of harmaline in the trained baboon. AB - 1. The alteration of the cortical cerebellar mechanisms resulting from the activation of the olivo-cerebellar pathway by Harmaline (H) administered at doses which were subthreshold for skeletomotor tremor (5 mg/kg, IM) yields, in the trained Baboon (Papio papio), a marked decrease of oculomotor system performance. 2. The mean angular excursion of the spontaneous eye movements produced in the dark over a given period of time is increased by 50%. The increase is basically due to an increase of the number of saccades in the 0-20 degrees amplitude range. 3. The eye movements in response to a slow target displacement are altered as evidenced by a decrease of the smooth pursuit gain, a 60% increase in latency, and by intrusive saccades. The effects are dose dependent so that around 8 mg/kg of H, smooth pursuit is totally suppressed. 4. The saccadic system is also altered, Stepping target tracking shows dysmetria and increase of the amplitude of the fixation eye movements. The velocity-amplitude relationship of the saccades is not modified but the saccadic reaction time is increased by 50%. The observed alterations are in no way similar to the tremor commonly induced by the drug, at skeletal level. In fact, no ocular tremor at 8 to 10 Hz was recorded. 5. In conclusion, administration of H alters considerably the control and the stability of the oculomotor system in a way similar to that resulting from partial or total cerebellectomy. It may thus be possible to use the drug to simulate, in a reversible manner, cerebellar dysfunctions and study the involvement of the cerebellum in oculomotor control. PMID- 6847320 TI - Identification of the motoneurons innervating the stapedius muscle in Gallus gallus: a horseradish peroxidase study. AB - The location of the stapedial motoneurons in Gallus gallus was investigated by means of the retrograde transport of HRP, injected into the stapedius muscle. The labeled neurons are located in both the ventral and dorsal divisions of the VII nerve nucleus, in a lateral and ventral position respectively, facing the superior olivary nucleus. The neurons are distributed in two size classes. The functional implications of these findings are discussed, in relation both to the absence of the acoustic stapedial reflex in birds and to the functional properties of the stapedius muscle. PMID- 6847321 TI - Sympathetic modulation of periodontal mechanoreceptors. AB - The effect of the electrical stimulation of the peripheral stump of the cervical sympathetic nerve, at physiological frequencies, was studied on the activity of mechanoreceptors with sensory field around the teeth, in anaesthetized and paralysed animals. In the 33% of the tested units either an increase of the resting discharge rate or an activation of the receptors occurred. The latency of this response ranged between 0.3 and 6 sec; the maximum discharge frequency, which varied widely in different units, was reached within the subsequent 2 to 4 sec and usually outlasted the duration of the stimulation. The possible mechanisms of this sympathetic effect are discussed on the basis of its latency and pattern and of the following further observations: i) its presence after denervation of carotid sinus and glomus, ii) its dependence on the stimulation of preganglionic sympathetic fibres belonging to the groups S1 and S2, iii) the absence of response in the mechanoreceptor units by the temporary occlusion of the ipsilateral common carotid artery. PMID- 6847322 TI - [Fatal foreign body aspiration in traffic accidents]. PMID- 6847323 TI - [Fatal autoerotic accidents]. PMID- 6847324 TI - [The use of ultrathin isoelectric focusing in the study of traces of blood and secretions]. AB - Four examples of the applicability of ultrathin layer isoelectric focusing in the investigation of bloodstains and stains of body secretions are given: -- differentiation of stains of human and animal blood; -- determination of fetal hemoglobin in bloodstains; -- subtyping of PGM1 isoenzymes in extracts of blood and semen stains; -- Gc typing of bloodstains using an immunofixation technique. For the visualisation of PGM1 subtypes a modified sandwich technique using a celluloseacetate membrane as separator between the focused gel and the visualisation agar is described. PMID- 6847325 TI - [Value of laryngeal injuries as evidence]. AB - Report of two cases: Violations at soft parts of the neck and at larynx pointed to an attack against the throat by strange hand, but local vital reactions showed that the attack had been survived. A 54-year old woman had little excoriations in the skin of the neck, the right great horn of hyoid bone and the left upper process of thyroid cartilage were broken, the fractures were bloodshot. No petechiae in skin and conjunctivitis. Death occurred from a suicidal poisoning of soporifics. The attack against the throat (throttling by hand, conceded by the culprit) had been survived. That was recognizable on a clear cell-reaction in the bleedings within the muscles of the neck. A 87-year old man was found in his rummaged home. Violations of the skin in the face pointed to attacks against mouth and throat; additional maltreatment by gagging and fettering (in the meantime untied) could be supposed. -- Histological examination showed advanced cell-reaction in the wounds, partially even intracellular iron pigment; there was a superposition of old and recent injuries, but even the recent had been survived many hours. The situation of finding the corpse, bleedings inside the iliac muscles, little hemorrhages in the mucosa of the stomach and acetone in blood and urine pointed to a death lately from cold. But complete clearing-up of the case was not yet possible. PMID- 6847326 TI - [Experiences in the postmortem diagnosis of parvovirus enteritis in the dogs]. PMID- 6847327 TI - [Rotavirus infection in children--clinical aspects]. PMID- 6847328 TI - [Pathology and pathogenesis of viral enteritis in animals]. PMID- 6847329 TI - [Rotavirus infections--epidemiological aspects]. PMID- 6847330 TI - [Clarification and control of a virus causing gastroenteritis--common challenge for human and veterinary medicine]. PMID- 6847331 TI - Predicting response to alcohol and drug abuse treatments. Role of psychiatric severity. AB - Male alcoholics (n = 460) and drug addicts (n = 282) were evaluated at six-month follow-up after treatment in six rehabilitation programs. Initial analyses of the unstratified samples showed significant patient improvement, but no evidence of differential effectiveness from different treatments or from "matching" patients to treatments. The two samples were then divided into groups based on the number, duration, and intensity of their psychiatric symptoms at admission, ie, their overall "psychiatric severity." Patients with low psychiatric severity improved in every treatment program. Patients with high psychiatric severity showed virtually no improvement in any treatment. Patients with midrange psychiatric severity (60% of the samples) showed outcome differences from different treatments and especially from specific patient-program matches. These findings support the effectiveness and specificity of different substance abuse treatments, suggest methodologic reasons for the lack of similar findings in previous studies, and demonstrate the importance of psychiatric factors in substance abuse treatment. PMID- 6847332 TI - Psychotherapy for opiate addicts. Does it help? AB - Opiate addicts beginning a new treatment episode on a methadone maintenance program were offered random assignment to drug counseling alone or to counseling plus six months of either supportive-expressive psychotherapy or cognitive behavioral psychotherapy. Sixty percent of patients meeting the study criteria expressed an interest and 60% of these actually became engaged. One hundred ten subjects completed the study intake procedure and kept three or more appointments within the first six weeks of the project. Measures including standardized psychological tests, independent observer ratings, and continuous records of licit and illicit drug use were done at baseline and seven-month follow-up. All three treatment groups showed significant improvement, but patients receiving the additional psychotherapies showed improvement in more areas and to a greater degree than those who received counseling alone, and with less use of medication. More than a third of opiate addicts in our treatment program thus both were interested in professional psychotherapy and apparently benefitted from it. Certain administrative procedures appear necessary to maximize the chances that psychotherapy can be used effectively with drug-addicted patients. PMID- 6847333 TI - Depressive mood in male college students. Father-son interactional patterns. AB - This study was designed to investigate the interrelationship of sets of paternal and adolescent factors in explaining depressive mood in normal male adolescents. Two hundred forty-six male college students and their fathers were administered separate, written questionnaires assessing the personality attributes of both fathers and sons and the socialization practices of the fathers. Results of regression analyses indicated that of three hypothesized models (independent, mediational, interdependent) the mediational model was consistent with the data. Thus, we found that the father's personality attributes and his socialization techniques are related to the son's personality, which, in turn, is related to the son's depressive mood. In addition, certain personality attributes of the son interacted synergistically with those of his father to produce more frequent reports of depressive mood in the son. PMID- 6847334 TI - Carbamazepine and its -10,11-epoxide metabolite in plasma and CSF. Relationship to antidepressant response. AB - Levels of carbamazepine and its -10,11-epoxide metabolite were measured in plasma and CSF of affectively ill patients treated only with carbamazepine for an average of 33 days at an average dosage of 1,055 mg/day. The CSF levels of carbamazepine were 2.06 micrograms/mL (ie, 31% of plasma levels, which equaled 6.55 micrograms/mL); CSF -10,11-epoxide concentrations averaged 0.91 micrograms/mL in 18 subjects (63% of those found in plasma). Carbamazepine levels in plasma or CSF were not related to degree of antidepressant or antimanic response. In contrast, concentrations of the -10,11-epoxide metabolite were correlated with the degree of antidepressant response. This preliminary study suggests the possibility that the -10,11-epoxide metabolite of carbamazepine may be related to the degree of clinical efficacy in affectively ill patients and may thus possess active psychotropic properties in man in addition to its reported anticonvulsant effects in animals. PMID- 6847335 TI - A naturalistic assessment of the motor activity of hyperactive boys. I. Comparison with normal controls. AB - The motor activity of hyperactive and normal boys was studied in 12 age- and classroom-matched pairs. Activity was measured continuously for a one-week period with a portable solid-state monitor. Hyperactives exhibited generally higher levels of motor activity than normal controls regardless of the time of day, including during sleep and on weekends. In a situation-by-situation analysis, hyperactives were most consistently and significantly more active than the controls during structured school activities. Little evidence was found, however, to support the hypothesis that hyperactivity is simply an artifact of the structure and attentional demands of a given setting. Pervasive increases in simple motor behavior are a clear attribute of hyperactive behavior and distinguished hyperactives from controls as well as did a standardized measure of attention. PMID- 6847337 TI - Serbsky and czarist dissidents. PMID- 6847336 TI - A naturalistic assessment of the motor activity of hyperactive boys. II. Stimulant drug effects. AB - Twenty-four-hour motor activity was assessed in a naturalistic setting in 12 hyperactive boys for four weeks (672 consecutive hours). Dextroamphetamine, 15 mg/day, or placebo was administered on alternate weeks, using a double-blind ABAB design. When the boys received dextroamphetamine, motor activity was significantly decreased for about eight hours after drug administration. This decrease was followed by a period of slight but significant increases in activity ("rebound"). Dextroamphetamine decreased activity most strikingly during structured classroom activity; during physical education, however, there was a significant drug-induced increase in motor activity. PMID- 6847338 TI - X-chromosome inactivation and the study of X-linked dominant transmission of bipolar illness. PMID- 6847339 TI - Neglected literature. PMID- 6847340 TI - Use of DSM-III criteria. PMID- 6847341 TI - [Tetronic acids with direct anticoagulant effects]. PMID- 6847342 TI - [Relations between structure and antitumor activity of cis dichloro[bis(oligopeptide-ester)]platinum(II) complexes]. PMID- 6847343 TI - [Detection of sedative-hypnotic active ingredients in hops. 5. Degradation of bitter acids to 2-methyl-3-buten-2-ol, a hop constituent with sedative-hypnotic activity]. PMID- 6847344 TI - Potential antitumor agents, VIII. Allyl, propargyl and cyanomethyl esters of imidazo[2,1-b]thiazole-5-carboxylic acids. PMID- 6847345 TI - [Theoretical investigations of interactions between drugs and models of receptor sites, 3: induced fit interactions of verapamil derivatives]. PMID- 6847346 TI - A comparative study of spondylolisthesis in operations on adolescents and adults. AB - Forty-five patients with spondylolisthesis have been reviewed, all operated with the same surgical procedure: dorso-lateral bilateral fusion. A comparative study was made between two age groups-adolescents (n=22) and adults (n=23). Preoperative symptoms, clinical signs and X-rays of the patients were analysed and compared with postoperative results. The symptoms observed preoperatively differ between these two age groups. In the adolescents, low back pain dominated, whereas sciatic pain did so in the adults. Scoliosis and spina bifida were only found in the younger group, but disc degeneration was, as expected, more often found in the older group. The postoperative results were improved considerably in the younger group and it is suggested that the main cause of the preoperative symptoms in these patients was instability. In the adults, on the other hand, the symptoms seemed to be less due to this instability but rather to other factors, such as disc degeneration and nerve root compression. PMID- 6847347 TI - Posterior cruciate reconstruction using iliotibial band. Preliminary report of a new procedure. AB - In the last 3 years, 11 patients with posterior cruciate injury were treated with the reconstructive procedure utilizing the iliotibial band. The operative technique was found to be easy and simple compared with other methods. Strong reconstruction could be accomplished even in the cases of old injury of more than two years. All 5 patients followed for more than a year considered that the knee that had been reconstructed with the iliotibial band was improved compared with its preoperative status. PMID- 6847348 TI - Animal experiments to examine the histology of fracture healing in osteosynthesis with external fixation and compression. AB - Tibia osteotomies in sheep were stabilized in nail-fixed and wire-fixed external devices with static longitudinal compression. During the 8-week study programme the mechanical situation of the osteotomies was checked via continuous measurements of interfragmentary tension, used as a functional indicator of stabilization. Simultaneously the test animals were marked by polychromatic fluorescent pigments. The histological findings made at the site of osteotomies showed that the temporal and local progress of ossification was influenced by the degree of stability of osteosynthesis. Under stable osteosynthesis conditions primary bone healing occurred analogous to findings in flattened experimental shaft fractures. On grounds of varying stability performance of external pressure osteosynthesis differences in secondary healing of osteotomies were observed due to interfragmentary instability. PMID- 6847349 TI - Recurrent dislocation of the shoulder and the Putti Platt operation. AB - Recurrent dislocation of the shoulder has long been recognized, and more than 100 techniques for repair of the injury are described. This survey describes 113 patients who suffered from recurrent anterior dislocation of the shoulder and were operated upon in accordance with the Putti Platt technique. The most significant preoperative finding was inadequate immobilization after the primary dislocation (62% of the patients). Postoperative recurrence was uncommon (1%) and a relative increased limitation of motion in the postoperative period improved gradually to almost a full range of movement. PMID- 6847350 TI - Failures of total hip arthroplasty and probable incidence of revision surgery in the future. Calculations according to a mathematical model based on a ten years' experience in total hip arthroplasty. PMID- 6847352 TI - Functional myelograhy in spondylolisthesis. AB - Flexion and extension radiographs in myelography in preoperative spondylolisthesis patients were studied. Dural sac motion at the level of the mid vertebral bodies was essentially anterior in extension. At the level of the intervertebral disc, the motion is obstructed by the disc bulging posteriorly in extension. Axial motion is variable and not linearly correlated with spinal column length change. The dural sac undergoes a localized narrowing at the level of the spondylolisthesis. This becomes more prominent during extension. In 21 cases studied completely, no disc herniation was encountered myelographically of surgically. The anterior epidural space is of a greater value at the level of the spondylolisthesis than reported normal values. The change in this space from dorsiflexion to ventral flexion is much less at the level of olisthesis than either the adjacent areas of a comparable adjacent intervertebral level. PMID- 6847351 TI - Reaction to methylmethacrylate in bone metastases treated by surgical curetting and filling with acrylic cement. Histological study of a case. AB - A femur bone metastasis from breast carcinoma was treated by curetting and filling with acrylic cement and osteosynthesis. The histological study of the resected proximal third of the femur five months after surgery shows a thin layer of connective tissue between bone and cement. There are no neoplastic cells in this connective tissue nor in the spongious bone of the proximal femur. Instead the diaphyseal channel is fully invaded with neoplastic cells. Pathogenesis and validity of surgical treatment by the emptying and filling with acrylic cement of bone metastases are discussed. PMID- 6847353 TI - Mechanical properties of bone and skin during recovery after cyclophosphamide administration. AB - The effects of cyclophosphamide were studied 2, 5 and 9 days after terminating a two-week every-second-day intraperitoneal medication in young, male rats. The cytostatic effect was assessed by counting white blood cells (WBC) in arterial blood. WBC counts were reduced by 72% of control values at 2 days and regained normal values at 9 days after an overshooting leucocytosis at 5 days. Compared to control animals, the treated rats had significantly reduced body weights, metaphyseal bending strength and longitudinal growth of the femur at all time intervals observed. The torsional strength of the femur diaphysis and the strength of wounded skin were not affected at 2 days, but significantly reduced at 5 and 9 days. The tensile strength of intact skin was not found to be affected by the drug. From the 5th to the 9th day after ending medication, the curves for control and treated animals were assuming parallel slopes regarding metaphyseal bone strength, longitudinal bone growth and tensile strength of wounds. This may indicate reversion of the drug effects approximately one week after terminating medication. PMID- 6847357 TI - Calculated nerve conduction velocity dependence upon the method of testing. AB - Nerve conduction velocities using the evoked nerve potential can be calculated using six different methods. The latency may be measured to the onset of the negative potential or to the negative peak, using techniques of single or dual stimulation and single or dual recordings. Each method produces a value that is dependent on the method used for latency measurement and velocity calculation. The major factor producing the variability is the measurement of latency to the negative peak of the evoked potential. Awareness of these calculation artifacts is necessary to set standards and compare values. PMID- 6847355 TI - Salvage procedure in failed elbow prosthesis. PMID- 6847356 TI - Carpal tunnel syndrome: median nerve stress test. AB - The purpose of this study was to determine the effect of wrist position on distal sensory and motor latencies of the median nerve. An orthosis was devised to maintain the wrist either in extension or in flexion while measuring these latencies. Fourteen patients with presumptive carpal tunnel syndrome (CTS) and 12 control subjects were evaluated following extension or flexion of the wrist for 5 and 10 minutes. Results showed an increase in distal latencies for both groups; the highest increment was found among CTS patients following 5 minutes of wrist flexion. Since it is not uncommon for patients to present with classical CTS symptoms but without electrodiagnostic findings in support of such diagnosis, it is suggested that such patients be reevaluated after 5 minutes of wrist flexion (median nerve stress) test. PMID- 6847354 TI - Delaying effect of cyclophosphamide on bone fracture healing chemical analyses of rat femora. AB - Hydroxyproline, calcium and inorganic phosphate contents of osteotomised rat femora were compared with those from rats treated with cyclophosphamide. The treatment consisted of 10 mg/kg/body weight injected intraperitoneally daily for 14 days after (group II) and before (group III) operation. The obtained results indicated a reduction in the hydroxyproline content of the callus and a diminution of the calcium and phosphate deposition upon it, thus inhibiting collagen formation and delaying mineralisation, retarding the healing process of the fraction. The degree of inhibition was decreased when the cyclophosphamide treatment discontinued before osteotomy was performed (group III). We would like to draw attention to these results, and suggest that cyclophosphamide treatment should not coincide with the healing of bone fracture. PMID- 6847358 TI - Acetylcholine sensitivity and fibrillation potentials in electrically stimulated crush-denervated rat skeletal muscle. AB - Juxtamuscular electrodes were implanted unilaterally in six groups of adult female Wistar rats to evaluate the effect of chronic electrical stimulation (ES) during denervation and reinnervation of the rat soleus muscle. Two weeks later, the animals underwent bilateral crush-denervation of the sciatic nerve at the sciatic notch. Six additional groups served as normal controls. The soleus muscles in the crush denervated and control groups were stimulated unilaterally with a 4mA, 4msec duration current given at 10Hz continuously 8 hours each day for 5, 10, 15, 20, 25 or 30 days. At the end of each period, the soleus muscles were evaluated for the muscle weights, acetylcholine (ACh) sensitivity and fibrillation potentials (FPs). The normal muscles were unaffected by the stimulation. The denervated-stimulated soleus muscles were heavier at 10 days (p less than 0.05) and had fewer FPs after 5 to 15 days (p less than 0.01) of electrical stimulation than their matched denervated controls. The ACh sensitivity throughout the experimental period and the fibrillatory activity from 20 to 30 days post-crush were similar in the denervated and the denervated stimulated muscles. In conclusion, ES reduced the degree of atrophy and the number of fibrillations of the soleus muscle in the denervation stage. However, it neither enhanced nor impaired the reinnervation of muscle. PMID- 6847359 TI - Median nerve residual latency: normal value and use in diagnosis of carpal tunnel syndrome. AB - If normal variability in nerve conduction velocity (NCV) were eliminated from distal latency measurements, standard deviations of distal latencies should be reduced and normal ranges narrowed. This should be especially useful in diagnosing carpal tunnel syndrome. In this study, the median motor distal latencies, the sensory distal peak latencies, motor NCVs and motor residual latencies were determined in 100 normal subjects. Residual latency was calculated by dividing the distance between the cathode and active electrode by the motor NCV and subtracting the quotient from the motor distal latency. Results showed that the standard deviation and normal range of the residual latency were smaller than those of the motor distal latency or sensory distal latency. Data were also compared by age decade. Residual latencies hold constant into the 9th decade, while motor distal and sensory distal latencies increase with age. Three patients with recent onset of carpal tunnel syndrome are described who had prolonged residual latencies as their only abnormalities. Residual latency determination is particularly attractive because it does not require additional stimulation of the median nerve and the additional discomfort associated with it. PMID- 6847360 TI - Motor and sensory ulnar nerve conduction velocities: effect of elbow position. AB - Ulnar motor and sensory nerve conduction velocities (NCV) were studied bilaterally in 20 able-bodied subjects for below elbow (BE) and across elbow (AE) segments to assess the effect of 4 different elbow positions on NCV (0 degrees, 45 degrees, 90 degrees, and 135 degrees). Although constant skin stimulation marker points were used, the AE segment length became progressively longer with increased elbow flexion. At 0 degrees flexion the AE segment motor NCV was found to be slower, and at 45 degrees it was found faster than the BE NCV. At each subsequent elbow flexion position (90 degrees and 135 degrees) there was an erroneous increase in motor and sensory NCV for the AE segments (p less than 0.01). This increase in AE NCV with elbow flexion was mostly due to stretching of skin over the flexed elbow. The nerve itself was observed in 4 cadaver specimens to slide distally with respect to the above elbow skin marker. Since 45 degrees elbow flexion was the position of least variation in motor NCV for AE and BE segments, this degree of elbow flexion appears to be optimum. From these measurements and from literature review neither short AE segment length (less than 10 cm) nor long AE segment length (greater than 15 cm) is optimum for measurement of AE NCV in the assessment of compressive neuropathy at the elbow. Short segments are subject to increased NCV variation while long segments may not detect pathological slowing of NCV only occurring over a short portion of the nerve. PMID- 6847361 TI - Improvement in heart disease risk factors after gastric bypass. AB - Fasting blood levels of three lipid classes (high-density lipoprotein-cholesterol [HDL-C], total cholesterol, and triglycerides) were measured in morbidly obese patients before, and six and 12 months after, Roux-en-Y gastric bypass. Weight above ideal in 31 women averaged 72 kg, and in 12 men, 78 kg. Excess weight lost after six months was 49.7%. Total cholesterol levels and abnormally high triglyceride levels (183 +/- 106 mg/dL [SD]) decreased and became normal after six months. Low-normal HDL-C levels in 31 women (45 +/- 13 mg/dL) improved by six months to 54 +/- 19 mg/dL; similarly, HDL-C levels in 12 men (38 +/- 9 mg/dL) increased to 57 +/- 17 mg/dL. One of eight diabetic patients remained hyperglycemic; ten of 15 patients who were hypertensive, requiring medication preoperatively, became normotensive by six months. Lipid levels measured again at one year showed little change. Risk factors of coronary heart disease were improved by gastric bypass in these morbidly obese patients, and the changes were clearly established by six months after operation. PMID- 6847362 TI - Comparison of weight loss after gastric exclusion and partitioning. AB - We report follow-up findings after two to almost four years on 100 patients who were described in a previously published prospective randomized series. Horizontally stapled gastric partition (gastroplasty) was compared with gastric exclusion (bypass) using a Roux-en-Y jejunal loop. An additional 142 patients had the identical operative procedures performed during the same time period, but chose their own operation. Both procedures used a small gastric pouch (15 mL) and calibrated 10-mm opening. Weight loss was better after exclusion and has continued to be better. Patients who lose weight well do not regain. There were complications in 8% of the exclusion patients and 12% of the partitioning patients and one death in the exclusion group--0.4% of the total group. Since gastric exclusion is safe and produces significantly better weight loss, we believe it sets the current standard against which all other bariatric surgery must be compared. PMID- 6847363 TI - Endoscopic papillotomy for recurrent common bile duct stones and papillary stenosis. A community hospital experience. AB - Fifty-nine papillotomies were performed, 56 for biliary tract disease and three for papillary stenosis (secondary to carcinoma in two cases). All 56 patients with biliary tract disease had undergone previous cholecystectomies. Fifty-one of them had stones in the common duct, and in 41, all identified stones were removed. Stones were retained in ten patients, four of whom required surgical biliary tract exploration for extraction. Our results indicate that common bile duct stones with diameters 2.5 cm or greater should be approached surgically. Endoscopic papillotomy had an initial success rate of 80% for extraction of common bile duct stones and a late or actual success rate of 92%, confirmed by cholangiography. There were nine complications, including five episodes of bleeding (three requiring surgical intervention for control), giving an overall morbidity rate of 15.2%. The mortality was 3.4%. The procedure is indicated in the treatment of papillary stenosis and stones retained in the common bile duct after cholecystectomy. PMID- 6847364 TI - Straight ileoanal anastomosis v ileal pouch--anal anastomosis after colectomy and mucosal proctectomy. AB - The postoperative results of 50 patients who underwent straight ileoanal anastomosis after total colectomy and mucosal proctectomy were compared with those of 74 patients who underwent ileal pouch--anal anastomosis. No deaths occurred. Of the straight ileoanal anastomoses, 32% failed because of sepsis or diarrhea and necessitated abdominal ileostomy; only 1.3% failed in the pouch-anal group (P less than .05). Stool frequency among patients followed up for three months or more (straight ileoanal, n = 30; pouch-anal, n = 33) was less in the pouch-anal group (mean +/- SEM, 7 +/- 1 stools per 24 hours) than in the straight ileoanal group (11 +/- 1/24 hr, P less than .01). Major nocturnal incontinence was also less in the pouch-anal group than in the straight ileoanal group (0% v 20%), and patient satisfaction was better, as measured on a scale of 1 (very poor functional result) to 10 (excellent result) (pouch-anal score, 9; straight ileoanal score, 6; P less than .02). We concluded that ileal pouch-anal anastomosis resulted in less diarrhea, better continence, and an improved quality of life when compared with straight ileoanal anastomosis. PMID- 6847366 TI - The consultation. PMID- 6847365 TI - Total bile duct obstruction. Prompt diagnosis by hepatobiliary imaging. AB - The value of hepatobiliary imaging for the early diagnosis of total bile duct obstruction is not well known. Four hundred eighteen technetium Tc 99m iprofenin (Pipida) hepatobiliary scans were reviewed, and the anatomic diagnosis was established by postmortem examination, laparotomy, endoscopic retrograde cholangiopancreatography, transhepatic cholangiography, or ultrasound. Sixty cases demonstrated the technetium Tc 99m iprofenin pattern of total bile duct obstruction. Of these, 41 had total bile duct obstruction, 14 had advanced hepatocellular disease, four had massive liver metastasis, and one had portal vein thrombosis. The test was 100% sensitive for the detection of total bile duct obstruction. When the bilirubin level was less than 10 mg/dL, the predictive value was 100%. As the bilirubin level rose to 15 and 20 mg/dL, the predictive value fell to 92% and 88%, respectively. If performed early, hepatobiliary scanning is the preferred test for suspected total bile duct obstruction. PMID- 6847367 TI - Incidental appendectomy in infants and children. Risk v rationale. AB - Between January 1977 and December 1979 (three years), 642 appendectomies were performed at the Childrens Hospital of Los Angeles. Two hundred seventy-two of the appendectomies were performed incidentally at the time of another abdominal operative procedure. Using known incidence of appendicitis, approximately 54 cases of acute appendicitis may have been obviated. In three patients, would infections developed. Twenty-four of the appendices were histologically normal and 30 were abnormal in a clinically insignificant respect. If incidental appendectomy is appropriate in the age group, it is of more benefit to the pediatric patient because of the frequency of appendicitis in patients under 20 years of age. PMID- 6847368 TI - Direct venous surgery for venous valvular insufficiency of the lower extremity. AB - Seven patients had severe deep venous insufficiency and recurrent ulceration in eight lower extremities. All incompetent perforating veins had been previously ligated. All limbs were evaluated by dynamic venous pressure measurements. The venous pressure reduction with exercise was recorded, as well as the recovery time. The most accurate indicator of venous valvular incompetence was a short postexercise recovery time. Abnormal hemodynamic findings were correlated with ascending and descending venographic findings. Based on these anatomic and pathophysiologic abnormalities, patients underwent valvular transposition, superficial femoral vein valvuloplasty, or superficial femoral vein ligation. Immediate postoperative recovery time (mean +/- SEM) was improved to 34.5 +/- 18.3 s from 7.9 +/- 2.9 s preoperatively. Postoperative venography demonstrated patency of all anastomoses and absence of reflux into previously incompetent venous systems. All limbs were symptomatically improved after operation, and no venous thrombosis or pulmonary emboll developed. Persistent ulceration, however, continued in one limb. PMID- 6847369 TI - Effects of hypoxia and hyperoxia on progression of intimal healing. AB - To assess the effect of changes in inspired oxygen concentration on intimal healing, the aorta was stripped by a single passage of an inflated embolectomy catheter in 34 rabbits. Each then was maintained in a controlled-atmosphere cage with a normobaric oxygen concentration of 14%, 21%, or 40% for up to ten days. Although after six months all animals showed nearly normal aortic healing, the progression of healing was considerably different. Hypoxia appears to result in prolonged platelet adherence, exaggerated medial proliferation, and aberrant migration. Hyperoxia appears to allow a more orderly intimalization. An aberrant healing process secondary to tissue hypoxia when combined with exacerbating factors may be important in producing the unfavorable result in vascular surgery. PMID- 6847370 TI - Suture contamination by surface powders on surgical gloves. AB - Recent studies have shown that many glove manufacturers still are using talc as a glove-mold release agent. The removal of talc particles from the patient-contact side of the gloves is difficult and incomplete with the use of recommended washing and wiping procedures. As a result, a shedding hazard exists that may ultimately be related to granulomatous reactions. In our study, shedding was demonstrated to be hazardous because of suture contamination with talc particles. PMID- 6847371 TI - Impact of regionalization. The Orange County experience. AB - Prior to the designation of a trauma system in Orange County, Calif, 73% of the in-hospital non-CNS deaths secondary to motor vehicular trauma were judged by the autopsy method to have been preventable. In June 1980, a regional system of trauma care with designated trauma centers was established in Orange County. We used the autopsy method to evaluate the first year's experience with this new system and compared the results with previous studies in Orange County for 1974, San Francisco County in 1974, and Orange County in 1978-1979. The results indicate a severe reduction in the number of deaths judged preventable. In addition, a more aggressive approach to the traumatized patient was noted as indicated by an increased percentage of patients who received appropriate surgical intervention. PMID- 6847372 TI - Contaminated street heroin. Relationship to clinical infections. AB - Thirty-one samples of street heroin were analyzed bacteriologically and chemically as to their microbial burden and chemical adulterants (fillers). Sixty one percent of the samples were positive for microbial growth. Many species were isolated from the positive samples with Bacillus sp (79%) and Aspergillus sp (10%) predominating. The level of contamination ranged from 1.6 X 10(2) to 3.7 X 10(4) organisms per gram. We obtained cultures from 16 addicts from the Chicago area and 21 from the New Orleans area who had soft-tissue infections related to their habit. Infections in this group of patients were usually polymicrobial; however, there was no correlation between the organisms recovered from street heroin and the addicts' infections. Most drug-related infections appear to be related to the addicts' own oral and dermal microflora. No correlation was observed between the chemical fillers and the bacteria recovered from the heroin. PMID- 6847373 TI - Hyperbilirubinemia of fasting. A case of postoperative jaundice. AB - A patient had substantial jaundice following an uncomplicated appendectomy. After recovery, the hyperbilirubinemia recurred following a 24-hour fast. An analysis to determine the effect of fasting on the bilirubin level in hospitalized patients showed an apparent elevation in the serum unconjugated bilirubin level in the fasting state. PMID- 6847374 TI - Hematobilia from ruptured hepatic artery aneurysm. Report of two cases. AB - Hematobilia secondary to hepatic artery aneurysm must be considered in the differential diagnosis of unexplained gastrointestinal tract hemorrhage. We treated two patients with ruptured hepatic artery aneurysm. One had hepatic artery aneurysm proximal to the gastroduodenal artery; the other had an intrahepatic pseudoaneurysm in the right lobe of the liver. The first patient was treated with obliterative endoaneurysmorrhaphy. The second required ligation of feeding vessels, cholecystectomy, and reconstruction of cholecystoduodenal fistula. PMID- 6847375 TI - Gastric carcinoids and atrophic gastritis. Evidence for an association. AB - An elderly woman with documented pernicious anemia was found to have diffuse involvement of the gastric mucosa, with carcinoid tumors. In reviewing the English-language literature we found 14 additional patients who had atrophic gastritis, pernicious anemia, and gastric carcinoids. This finding suggests that there is a more than coincidental association, although firm clinical and experimental proof is lacking. Nevertheless, appearance of gastrointestinal tract symptoms in patients with pernicious anemia should alert the clinician to the possible presence of gastric carcinoid tumors. PMID- 6847376 TI - Late leakage of saline-filled breast prosthesis. AB - Twenty-four women with breast cancer have had postmastectomy submuscular reconstruction with a valved inflatable prosthetic mammary implant. In four cases (16.6%) spontaneous deflation occurred between seven and 12 months after reconstruction. PMID- 6847377 TI - A technical aid for the difficult embolectomy. AB - Occasionally an embolectomy cannot be performed because of failure of the catheter to pass beyond the embolus. We employ a technique that overcomes this problem when it is due to a holdup of the catheter in a branch orifice or atheromatous recess. PMID- 6847378 TI - Inhalation pharmacokinetics based on gas uptake studies. IV. The endogenous production of volatile compounds. AB - A pharmacokinetic description of production, distribution and metabolism of endogenous volatile compounds is presented. This description uses the "gas uptake model" of a closed recirculated atmosphere in which experimental animals are exposed. As an example, the production rates of acetone, under different conditions of stimulation by xenobiotics, are calculated from published experimental data. The theoretical descriptions may serve as a basis for treating the problem of hydrocarbon exhalation in toxicological experiments with compounds eliciting lipid peroxidation. PMID- 6847379 TI - Quantitative evaluation of ethane and n-pentane as indicators of lipid peroxidation in vivo. AB - The use of exhalation of ethane and n-pentane in experimental animals as parameters of lipid peroxidation led to an examination of pharmacokinetics of both compounds in rats. When rats were exposed, in a closed desiccator jar chamber, to a wide range of ethane concentrations, linear elimination pharmacokinetics were observed. n-Pentane, when concentrations higher than 100 ppm were applied, displayed saturation kinetics. These were formally explained by action of two competing metabolizing pathways or enzymes. Application of preexisting models could describe exhalation of both ethane and n-pentane by untreated control rats. Stimulation of lipid peroxidation by ferrous ions or by carbon tetrachloride resulted in dissimilar quantitative behaviours of ethane and n-pentane. Ethane production rates were enhanced after application of both compounds. Because of relatively slow metabolic eliminations this led to markedly elevated concentrations of ethane in the gas phase of the system. Pentane production rates were simultaneously enhanced. However, difficulties in interpretation arise because of rapid metabolic elimination of n-pentane. Compounds that diminish pentane metabolism are shown to evoke higher pentane concentrations in the system than compounds which only enhance the pentane production rate. Determinations of ethane exhalation should provide a more favourable parameter of lipid peroxidation than exhalation of pentane. PMID- 6847380 TI - The influence of haemoperfusion on white cells, immunoglobulin concentrations and the complement system in the treatment of intoxications. AB - The influence of haemoperfusion on some immunological parameters was investigated in a pilot study involving two groups of three patients each. In columns containing cellulose-coated activated charcoal or polystyrene resin a temporary reduction of the total white cell number, particularly involving the segmented and band neutrophils, was demonstrated. Cellulose-coated activated charcoal and, to a lesser extent, polystyrene resin induced activation of the complement system using C3d as a parameter. An appreciable decrease of immunoglobulin or complement levels could not be demonstrated in either column. PMID- 6847381 TI - Determination of methamphetamine in hair after single and repeated administration to rat. AB - Methamphetamine in hair after p.o. administration to rat was identified and determined by mass fragmentography (MF). Rat hair was washed with HCl/methnanol, methanol and water. The hair was crushed in 0.6 M HCl, suspension was alkalized with Na2CO3, and extracted with chloroform/isopropanol. The extract obtained was purified by column chromatography on aluminium oxide. Concentrated eluate was trifluoroacetylated, and methamphetamine was identified and determined by MF. More than 20 pg of methamphetamine was detectable and less than 1 ng of that was determined by MF. Methamphetamine in hair collected from rat after p.o. administration of 20 mg/kg of the drug was detected and determined up to 8 days after. From hair of rat after 5-days or 14-days repeated administration of 20 mg/kg/day, methamphetamine was detected 25 or 45 days after the last administration, respectively. PMID- 6847382 TI - Methaphenilene, an analogue of the antihistaminic methapyrilene, is a "peroxisome proliferator". PMID- 6847383 TI - The delayed neuropathic effects of nerve agents and some other organophosphorus compounds. PMID- 6847384 TI - Investigation of the mechanism of cadmium toxicity at cellular level. I. A light microscopical study. AB - Chromatin condensation occurs within 15 min to 1 h after the addition of CdCl2 in a concentration of 1 microgram/ml to a liver cell culture and seems to be the first event demonstrable by light microscopy. This chromatin condensation, which precedes membrane leakage, is irreversible and leads to cell death of almost all cells. It does not occur after the administration of equimolecular concentrations of some other bivalent metallic ions. PMID- 6847385 TI - Investigation for the mechanism of cadmium toxicity at cellular level. II. An electron microscopical study. AB - With quantitative techniques at electron microscopical level chromatin condensation and emptying of the interchromatin space have been established in the nuclei of the endothelial cells of small uterine vessels. The nuclear and cytoplasmic changes after cadmium administration show much similarity between endothelial cells of small uterine vessels and cultured liver parenchymal cells. Cytoplasmic changes in both cell types after cadmium administration are suggestive of a disturbance in ribosomal RNA synthesis as the main cause leading to ultimate cell lysis. PMID- 6847386 TI - [Information analysis of neurocytes of various peripheral ganglia, and critical periods of their differentiation]. AB - Calculation of the informatory parameters of entropy and redundancy performed, taking as a base nuclear-cytoplasmic relations of neurocytes in the inferior ganglion of the vagus nerve, in the superior ganglion and in the interorganic ganglia of the respiratory tube, demonstrated certain interconnection of the integral characteristics obtained with some stages of the neuronal morphological differentiation. Periods of an abrupt reduction in the redundant information up to the minimal values which goes in parallel with an increasing entropy on the 2d 4th months of embryogenesis (taking into account heterochronia in the development of various ganglia) are considered as some critical periods in the neuron development when it passes to the stage of growth (the first critical period) and to the stage of maturation (the second critical period). Their existence is regarded in connection with the hierarchical joining of the vascular and neural trophic types of the vegetative ganglia. A supposition is made on a dependence of the specific neuronal differentiation on the epigenetic factors of morphogenesis. PMID- 6847387 TI - [Cholinergic and adrenergic innervation of human intracerebral arteries in ontogenesis]. AB - The intracerebral branches of the anterior, medial and posterior cerebral arteries in the cerebral tissue sections or revealed by means of the preparation method have been studied in cortical parts of the acoustic, optic and motor analyzers at various age periods (from the second half of pregnancy up to 86 years of age). On the intracranial arteries of all the age groups, the adrenergic and cholinergic fibers are revealed in the radial arteries and their large branches. Differences in the maturation rate and in involution of neural conductors have been stated between the cholinergic (revealed by means of reactions for acetylcholinesterase) and adrenergic (reaction with glyoxylic acid) conductors. PMID- 6847388 TI - [Structural characteristics of the hypothalamo-hypophyseal neurosecretory system in the field mouse (Arvicola terrestris)]. AB - The structure of the hypothalamo-hypophysial neurosecretory system (HHNS) has been studied light optically in the Arvicola terrestris that possesses a specific reduction of the concentrating renal function. There are neurosecretory cells (NSC) with cytoplasmic vacuoles in the hypothalamic supraoptic (SON) and paraventricular (PVN) nuclei that secrete antidiuretic hormone. These cells are situated mainly in the caudal part of the nucleus and, evidently, perform an osmoreceptory function. For the hypothalamic nuclei studied, characteristic are single cells with polyploid nuclei, their appearance is supposed to be connected with a necessity to intensity the processes of the neurohormonal synthesis. In the NSC, PVN and partly in the SON axons, as well as in the hypothalamo hypophysial tract fibers and their terminals there is, together with the granular neurosecrete, the one having the form of large homogeneous colloid drops, which are, appearantly, some quickly restorted neurohormonal reserve when certain unfavourable conditions appear. These morphological peculiarities of the HHNS appear to be certain signs of an adaptive mechanism of the osmoregulatory system are species-specific, since the ecological specialization of the animals studied is connected with hyperhydratation conditions. PMID- 6847389 TI - [Morphometric study of the taste buds in rat tongue after colchicine application to the glossopharyngeal nerve]. AB - Colchicine application on the glossopharyngeal nerve produces a decrease in number and size of the taste buds in the foliate papillae of the tongue, in amount of cells in the buds, as well as certain changes in the nuclear area of these cells on the ipsilateral side. Correlation of normal amount of dark, light and intermediate cells (62, 26, 12, correspondingly) changes: the amount of the dark cells decreases, while the relative amount of the intermediate cells increases. An analogous but less pronounced phenomenon is observed on the contralateral side. Similar changes are also observed after the nerve cutting at the same side where colchicine is applied. But these changes develop more quickly. The results obtained demonstrate that every cell type of the taste bud responds specifically to the trophic effect of the nerves, which is realized with the axonal transport participation. PMID- 6847390 TI - [Effect of reduced physical activity on the skeletal muscle]. AB - The musculus masseter has been studied in 12 bioptates of 19-24-year-old men after they have been operated on for correction of true progeny which results in a decreasing functional loading on the masticatory musculature. SDG activity, ratio of myons of various types, cross section area of muscle fibres, content ratio of the connective tissue layers, number of blood capillaries around the myons, relative volume of the submicroscopic structures of the muscle fiber have been estimated. Pronounced pathological disorders in the muscle are absent, it is connected with a gradual change in conditions of functioning and a prolonged time for adaptation. The first type myons ratio increases, comparing to that in the control, the number of the capillaries around the myons decreases, while the amount of the connective tissue grows large. Marked quantitative ultrastructural changes of the energy and contractile-myofibrillar apparatus take place. PMID- 6847391 TI - [Changes in the liver of albino rats after exposure to cold]. AB - The liver in the white rats subjected to the effect of a low temperature for 80 days (23 h every day, 5-7 degrees C) has been studied by means of a complex of morphometric techniques. The investigation is also performed 35 days and 4 months after the exposure to cold has been stopped. In the animals decapitated immediately after the exposure to cold has been stopped, there is a certain decrease in the liver mass, in the size of hepatocytes, drop in the karyometric indices. The latter phenomenon is also observed in the liver of the animals 35 days after the exposure to cold has been stopped. In 4 months, the part of the binuclear hepatocytes and the nuclear size is greater than in the control. PMID- 6847392 TI - [Structuro-functional organization of the fiber network in the human Achilles tendon]. AB - Owing to a complex morphological investigation of the human Achilles tendon, it was possible to distinguish four levels of the structural-functional organization of its fibrous elements and to reveal some regularities of their structure that recur at all the levels. Thus, collagenous molecules, microfibrillae, fibrillae and fibers have a wavy-spiral conformation. This spatial form is stabilized by a complex or a system of transversal connections corresponding to the given level of the organization. In order to maintain integrity (the structural-functional unity) of each level, certain substances of polysaccharide nature take part. Along the course of the long tendinous axis, a re-distribution (branching) of the fibrillar elements is observed at all the levels of the structural-functional organization. PMID- 6847393 TI - [Formation of collagen fibrils in the synovial membrane in rheumatoid arthritis (electron microscope study)]. AB - As demonstrates investigation of the synovial membrane biopsies obtained in patients suffering from rheumatoid arthritis, excessive formation of collagenous fibrillae results from participation, in this process, of activated synoviocytes B, pericytes and fibroblasts capable to intensify secretion and synthesis of tropocollagen. Aggregation of tropocollagen molecules into the collagenous fibrillae occurs in the areas where the inflammation acquires a chronic form where the cellular detritus is accumulated and where immune complexes are deposited. In the places mentioned, together with assembling normal collagenous fibrillae certain pathological fibrillar forms are observed, such as: fibrillae with an increased diameter, fibrillae with a changeable optic density of transversal streakness, those deprived of it, as well as segmentary scrap of fibrillo-formation. It is suggested that disturbance of the tetrary polymerization of the collagenous structures, that occurs at rheumatoid arthritis, prevents the functional-loading rearrangement and reabsorption of excessive fibrillae. Together with phenomena of tropocollagen hypersecretion from activated mesenchymal cells, this results in collagenous hyperfibrillogenesis, in fibrosis of the joints and in their irreversible rigidity. PMID- 6847394 TI - Case of the month No. 64: calcified pleural plaques asbestosis. PMID- 6847395 TI - Endoscopic removal of benign small bowel tumors. PMID- 6847396 TI - Legal liability with genetic conditions. PMID- 6847397 TI - Hyperthermia: its role in modern cancer therapy. University of Arizona experience. PMID- 6847398 TI - [Pathomorphology of recurrent pulmonary edema in myocardial infarction]. AB - Morphological, including electron microscopical, dynamics of multiply recurrent pulmonary edema in myocardial infarction at intervals of 2 to 35 days is presented. The macroscopical picture of the lesion at that resembles croupous pneumonia. Microscopically, release of large disperse proteins and precipitation of fibrin in alveolar lumens, erythrocyte stasis in capillaries, and lipid vacuoles in their lumens are observed. Subsequently, the fibrin exudate in alveolis undergoes organization and carnification. In diffuse lesions this may cause acute respiratory insufficiency. Pathogenesis and morphogenesis of pulmonary changes as well as their importance in tanatogenesis are discussed. The patterns of changes in the lungs in recurrent edema allowed the authors to classify them as a new kind of pathology of intensive therapy caused by prolongation of the terminal condition. PMID- 6847399 TI - [Evaluation of the efficacy of human heart protection during cardioplegia]. AB - Materials from 546 intraoperative incision biopsies from 253 patients were studied in order to assess the effectiveness of myocardium protection during operations on the open heart. No significant ultrastructural, metabolic or functional changes develop in the myocardium upon pinching of the aorta and ischemia for 10 min, therefore myocardium protection is unnecessary. In ischemia for up to 40 min ultrastructural changes in cardiomyocytes are reversible therefore deep hypothermia proved to be sufficient for myocardium protection. When the aorta is pinched for up to 60 min under conditions of cold cardioplegia, ultrastructural changes in cardiomyocytes may be reversible but they depend upon the initial condition of the heart muscle and precise accomplishment of all the requirements of this type of myocardial protection. Cryopharmacological cardioplegia allows one to shut down the heart from the circulation safely for 120 min which has been confirmed by the results of electron microscopic and histochemical studies and the results of clinical examinations of the patients. Incisional intraoperative biopsy allows the judgement of the effectiveness of myocardium protection during asystole due to the pinched aorta, of the initial changes of the myocardium, i. e. the preoperative background, of the subtle features of metabolism and function of the myocardial cell to be made. The open incisional intraoperative biopsy of the myocardium is more informative than the puncture endomyocardial one. PMID- 6847400 TI - [Morphogenesis of nephrocyte dystrophy]. AB - Morphogenesis of dystrophy of nephrocytes was studied by analysis of 106 biopsies of kidneys from patients with glomerulonephritis using light (semi-thin sections) and electron microscopy. The development of one or another kind of nephrocyte dystrophy was shown to be due to the deficiency of certain mechanisms of renal reabsorption and secretion associated with the corresponding membrane-enzyme systems of the cell. Therefore there is no ground to believe in transition of one kind of nephrocyte dystrophy into another as has been assumed until recently. The point is in the combination of various types of dystrophy (hyalino-drop, hydropic, fatty) within the object under study (biopsy), tubule, or even one nephrocyte. The analysis of the data obtained permits some general conclusions to be made with regard to the morphogenesis and the essence of dystrophy. PMID- 6847401 TI - [Hyperplastic changes in the major duodenal papilla in human opisthorchiasis]. AB - Postmortem microscopic examinations and morphometry of the tissue components of the major duodenal papilla in 90 residents of the Tobolsk district who had long time suffered from opisthorchiasis revealed three variants of chronic proliferative papillitis: adenomatous, adenofibroplastic, and sclerosing. They reflect the successive stages of the inflammatory and immunologic reactions of the patients to long-term parasitising of opisthorchiases. Hyperplastic and inflammatory-sclerosing processes in the wall of the papilla ampoule are the main factor in the pathogenesis of diffuse cylindrical cholangiectasia frequently observed in chronic opisthorchiasis. PMID- 6847402 TI - [Mathematical model of the morphogenesis of tumor nodules]. AB - A mathematical model of morphogenesis of tumor nodes has been developed on the basis of the physical theory of elasticity. According to the model, one of the important morphogenetic factors of tumors consists of their internal elastic forces determining the structure of tumor nodes and intermittent phase-wise pattern of their development. The existence of a certain "critical point" in the morphogenesis of nodes (determined by the size of the tumor and its histological structure) was established the passing of which lead to a sharp decrease in the tissue pressure in node centers. The gradient of tissue pressure in tumor nodes is the leading pathogenetic factor of secondary changes and results in the appearance of a typical zonal histotopographic structure of tumors. On the basis of the rate of tumor growth alone, the model allows the intensity of their cell division to be determined and also shows the process of cell proliferation in tumor nodes to be subject to the regularities of Fibonacci number series. PMID- 6847403 TI - [Malignant histiocytosis. Report of a case]. AB - A case of malignant histiocytosis in a man of 32 is described. The diseases had a rapid course, showed marked signs of intoxication, generalized lymphadenopathy, hepatomegaly, jaundice, leukopenia, thrombocytopenia. Specific infiltration with atypic histiocytes with phagocytosis of erythrocytes and their debris, leukocytes, and lipids was found in the lymph nodes, skin, bone marrow, liver, kidneys, heart muscle, and along the lung blood vessels. The final diagnosis of malignant histiocytosis is established by histological examination of the affected tissues (most frequently, lymph nodes). PMID- 6847405 TI - [Morphological diagnosis of Lennert lymphoma]. AB - Two observations of Lennert lymphoma are described. The cytological and histological diagnosis of the disease was established after examination of cervical and axillary lymph nodes on the basis of combination of the following features: multiple tubercle-like aggregates of epithelioid cells and large atypical histiocytes, marked malignant transformation of both large and small lymphoid cells, infiltration of the lymph node capsule and extranodal tissue with atypical lymphocytes and histiocytes, the absence of Berezovsky-Sternberg cells. PMID- 6847404 TI - [Cysts of the body of gastric mucosa glands in a female patient with Peutz Jeghers syndrome and stomach cancer]. AB - A female patient of 18 with Peutz-Jeghers syndrome and gastric cancer was found to have in macroscopically intact areas of gastric mucosa cysts of the body of the gastric mucosa glands (the first observation in the national literature) which were characterized by glandular structures of various sizes lined with clear columnar epithelium with basally located nucleus and with production of the PAS-positive substance. Some of the cysts extend into the gastric lumen, some form polyps. They should be regarded as hamartomas. When the cystic epithelium undergoes malignant transformation, the trend for mucus formation is not lost. PMID- 6847406 TI - [Formulation of the pathological diagnosis]. AB - The authors take part in the discussion concerning the formulation (structure) of pathological diagnosis in pediatric practice, particularly in perinatology. A scheme of formulation of pathological diagnosis which must reflect sections of the "Certificate on Perinatal Death" with due consideration for the new IX revision of International Classification of Diseases is proposed. The authors discuss the justification of the diagnosis of asphyxia and formulation of pathological diagnosis in cases of death of newborn babies due to noninfectious pneumopathies. The rules of formulation of the clinico-anatomical epicrisis is also discussed. PMID- 6847407 TI - [Polyamide film as a cover glass substitute for histological preparations]. AB - A polyamide film is suggested as a substitute for cover slides for covering histological specimens. The film is sufficiently strong, extremely transparent, does not change the color of the specimen or dissolve in xylene and alcohols, and allows a specimen to be examined under immersion. PMID- 6847408 TI - [Colonic and rectal adenomas and carcinomas]. AB - Adenomas of the colon and rectum from 606 patients were examined among which 62.5% were tubular, 28.3% tubularvillous, 9.2% villous forms (according to the WHO classification). In 7 patients carcinoma in situ was found in the area of adenomas, in 10 patients "focal carcinoma" and in 55 patients adenocarcinoma with invasion into the submucous layer of the intestine wall. Three patients had primary multiple carcinoma in adenomatosis of the colon and rectum. The development of cancer was observed predominantly in adenomas with signs of epithelial dysplasia of the II--III degree. Carcinoma in situ and "focal carcinoma" are stages in the establishment of the tumor growth. PMID- 6847409 TI - [Relationship between androgen and estrogen receptors and clinico-morphological characteristics of prostatic cancer]. AB - The paper presents the results of studies on cytoplasmic receptors of androgens (AR) and estrogens (ER) in tumors of 50 patients with prostate carcinoma with respect to age, histological structure and degree of tumor differentiation, and stage of the disease. The study showed the majority of tumors in patients not previously treated with estrogens to contain one or both types of receptors. In prostate carcinoma AR were found more frequently and both receptors were present twice as frequently in elderly as compared to senile patients. In the latter, adenocarcinomas containing only ER were predominant. AR could be detected more frequently in highly differentiated than in poorly differentiated tumors. ER did not correlate with the histological structure and degree of differentiation of the tumor. A negative correlation was observed between the stage of the tumor progression and the presence of AR in prostate carcinoma. AR and ER were seldom found in tumors of the patients treated with estrogens for a long time. Among 13 patients who died from advanced tumor, no AR were found in 12 tumors, both receptors were present in 1 tumor, and ER alone in 5 tumors. PMID- 6847410 TI - [Association of prostatic adenocarcinoma with transitional cell and squamous cell carcinomas of the same organ]. AB - Among 13 cases of transitional cell carcinoma of the prostate there was one case of its combination with clear cell adenocarcinoma of the same organ. Areas with trend to glandular metaplasia were found in transitional cell carcinoma. Also, a very rare case of combination of prostate adenocarcinoma and squamous cell keratinizing microcarcinoma of the excretory duct of the organ is described. In both cases there were foci of dysplastic lesions of both glands of the prostate (atypic hyperplasia) and epithelium of its ducts (squamous cell metaplasia with areas of hyperplasia of basal and parabasal cells). PMID- 6847411 TI - [The nature of so called local sarcoid reaction and its diagnosis]. AB - Local sarcoid reaction was detected in biopsy and surgical materials from 25 patients and 2 autopsies. This reaction develops in different neoplastic and non neoplastic diseases in the area of location of the main lesion and/or in regional lymph nodes. Essentially, local sarcoid reaction is considered to be sarcoidosis in miniature. In the past 22 years the incidence of sarcoid reaction has increased 3.4 times and become important in routine pathology practice. PMID- 6847412 TI - [Hereditary demyelination in mutant quaking mice (breeding and light microscopy)]. AB - Data on breeding of mutant Quaking mice (MQM) and the results of light microscopy and morphometric examination of the central and peripheral nervous systems in them and in control mice varying in ages from 12 days to 4 months are presented. MQM were shown to have a decreased total volume of the white matter due to underdevelopment of myelin because of disturbed function of myelin-forming cells (oligodendrocytes). At the same time oligodendrocytes retain their capacity for proliferation and are normally located interfascicularly in the white matter having the same density of occurrence and the same average volume of the nucleus as in controls, but morphologically they are similar to oligodendroblasts. Another morphological feature of MQM consists of intensive vacuolation of their gray and white matter. However, light microscopy could not determine whether the vacuoles 1 to 9 microns in diameter were located intra- or extracellularly. No pathological changes in neurocytes, astrocytes or capillaries were observed. PMID- 6847413 TI - [Hereditary demyelination in mutant quaking mice (electron microscopy study)]. AB - Light and electron microscopic examinations of the nervous system in autosomal recessive mutant Quaking mice varying in ages from 12 days to 4 months revealed significant dysmyelination in which one of the most important morphological manifestations consisted of formation of "watery" astrocytes. The primary edema of astrocytes extended to other cerebral structures and produced their vacuolation, as a result of which significant disorders in the normal process of myelogenesis were observed, such as a decrease in the total volume of the white matter because of underdevelopment of myelin, disorders of the function of myelin forming cells, oligodendrocytes. Pathological changes were also observed in some neurons and synapses. In contrast to the current opinion, the authors believe dysmyelination to be due not to primary involvement of oligodendrocytes but to edema of astrocytes. This does not rule out the genetic nature of this disease. PMID- 6847414 TI - [Malignant variant of Brenner tumor]. PMID- 6847415 TI - [Peritoneal gliomatosis in ovarian teratoma]. AB - Two observations of gliomatosis of the peritoneum in patients with mature teratomas of the ovaries are described. Growths of neuroglia in the omentum had diffuse and on the peritoneum nodular appearance, the nodes reaching up to 8 cm in diameter. No differences in the structural maturity of neuroglia in primary tumors of the ovaries and in implants were observed. Both patients underwent repeated operations, received multiple courses of chemotherapy and are apparently normal. One of them has been observed for 2 and the other for 5 years after the first visit to the physician. PMID- 6847416 TI - [A rare case of breast metastasis from thyroid cancer in a man]. PMID- 6847417 TI - [Malignant giant cell uterine tumors]. AB - This paper is the first publication of malignant giant cell tumors (MGCT) of the uterus in the Soviet literature. From the analysis of 2 own observations and 2 cases reported in the literature the authors describe the typical macroscopical appearance and histological picture of MGCT of the uterus similar to those of analogous tumors of soft tissues and some organs. The clinical behavior of these tumors depends not so much on histological variant as on the pattern of their growth and degree of differentiation of the tumor tissue. Despite ultrastructural features suggesting their fibrohistiocytic origin of MGCT, their true histogenesis remains obscure. PMID- 6847418 TI - [Rapid diagnosis of early pregnancy by the method of "crushed specimens"]. AB - Urgent diagnosis of uterine pregnancy of short duration by the method of "squashed preparations" is described. The unfixed pieces of tissue were stained with toluidine blue and squashed between two transparent plates. Subsequent microscopy could reveal the outlines of chorion villi. PMID- 6847419 TI - Cerebral vasomotor responsiveness during 100% oxygen inhalation in cerebral ischemia. AB - Cerebral vasoconstrictor responsiveness to 100% oxygen inhalation was measured in 149 subjects, including normal healthy volunteers and those with risk factors for cerebral arteriosclerosis (N = 87). Test results were compared among patients with hemispheric stroke and vertebrobasilar insufficiency (N = 62) with the 133Xe inhalation method. Normal volunteers without risk factors (N = 49), aged 25 to 86 years, showed symmetrical vasoconstriction. Asymptomatic subjects with risk factors (N = 38) and those with vertebrobasilar insufficiency (N = 25) had decreased hemispheric gray matter flow (Fg) values during rest, but vasoconstrictor responsiveness to 100% oxygen inhalation was not significantly reduced. In patients with acute hemispheric infarction, regional vasoconstrictor responsiveness to 100% oxygen inhalation was lost and/or paradoxically reversed; in patients with chronic hemispheric infarction, it was decreased. Testing vasomotor responses during hyperoxia is safe, clinically helpful, and demonstrates impaired vasomotor reactivity in infarcted regions. PMID- 6847420 TI - Cerebral vasomotor responses during oxygen inhalation. Results in normal aging and dementia. AB - Resting-state regional gray matter flow (Fg) values and cerebral vasoconstrictor responses induced by 100% oxygen inhalation were measured with the 133 Xe inhalation method in normal healthy volunteers aged between 15 and 86 years and in patients with senile dementia of Alzheimer's type (SDAT) or multi-infarct dementia (MID). Cross-sectional analysis revealed that there were linear decreases of oxygen responses with advancing age in 84 normal volunteers between the second to ninth decades. Eleven patients with SDAT showed bilateral and symmetrical reductions of resting-state Fg values compared with 22 age-matched normal healthy volunteers. Eight patients with MID showed no significant reduction of mean Fg values compared with normal controls and patients with SDAT. Oxygen vasoconstrictive responses in SDAT were symmetrical and similar to those seen in age-matched controls. Compared with patients with SDAT, patients with MID showed reduced oxygen vasoconstrictive responses that were asymmetrical between hemispheres as well as heterogeneous within hemispheres. Testing cerebral vasoconstrictor responses by 100% oxygen inhalation is helpful for differentiating SDAT from MID. PMID- 6847421 TI - Absence of sleep-related elevation of growth hormone level in patients with stroke. AB - To determine the effect of defined suprahypothalamic lesions on sleep-related growth hormone (GH) secretion, eight patients with hemispheric lesions of vascular origin were studied in a sleep laboratory on two consecutive nights. Despite the normal onset and increased time spent in slow-wave sleep (SWS), the patients failed to show the nocturnal rise in plasma GH concentration that occurred in association with onset of SWS in five age-matched healthy subjects. Arginine hydrochloride infusion in the patients produced a normal GH rise, indicating integrity of the hypothalamic-pituitary axis. Dissociation between SWS and GH secretion in patients with suprahypothalamic damage suggests that cortical subcortical structures are involved in the integration of SWS with nocturnal GH secretion. There is support for the presence of a thalamic regulatory center responsible for the control of GH release during sleep. PMID- 6847422 TI - Compressed spectral array patterns following cardiopulmonary arrest. A preliminary report. AB - Continuous taped EEG recordings were made following resuscitation in 18 survivors of cardiopulmonary arrest. These taped data were processed, using Bickford's method of compressed spectral array, and four distinctive patterns were recognized. These patterns correlated significantly with eventual outcome of these patients, suggesting that processed EEG information can provide important prognostic information for such patients. PMID- 6847423 TI - Recovery function of short-latency components of the human somatosensory evoked potential. AB - Short-latency somatosensory evoked potentials were studied in 14 normal human subjects with the technique of paired stimuli with different interstimulus intervals. Interstimulus intervals were 5, 10, 15, 25, 50, 100, 150, and 200 ms. To obtain the response to the second stimulus of the pair, amplitudes of the second responses (R2) were subtracted from those of the first responses (R1) and recovery curves constructed. Results of this study support previous conclusions that P10 is generated in peripheral nerves (brachial plexus), P14 in medial lemniscus, N19 in sensory radiation, and P23 in sensory cortex. PMID- 6847424 TI - Effects of allopurinol in Duchenne's muscular dystrophy. AB - There is no effective treatment at present for Duchenne's muscular dystrophy (DMD). Recently, clinical improvement and increased muscle strength have been reported after 100 mg of allopurinol was administered daily to 21 boys with DMD in a double-blind crossover study. Its effectiveness was determined by an extensive battery of muscle function, cardiac, and laboratory tests. The ten month study was divided into four periods; (1) one month of baseline observation; (2) three months of therapy to allopurinol and placebo control groups; (3) three months of therapy to crossed over groups; and (4) three months of therapy to all patients. No statistically significant changes between the allopurinol and control periods occurred in the muscle function tests. The earlier report of clinical improvement during allopurinol treatment was not confirmed. PMID- 6847425 TI - Amyotrophic lateral sclerosis. Lack of central chromatolytic response of motor neurocytons corresponding to active axonal degeneration. AB - Ventral spinal roots and anterior horn cells in the lateral nuclear group of the fourth lumbar segment from 21 patients with amyotrophic lateral sclerosis (ALS) and 23 control patients were morphometrically analyzed. The number of large myelinated fibers was remarkably decreased, while small myelinated fibers were well preserved. The population of large myelinated fibers significantly correlated with the population of anterior horn cells. Numerous axonal degenerations were observed in the ventral spinal roots of patients with ALS, even in patients with severe loss of neurons and axons. In spite of this high frequency of active axonal degeneration, the incidence of central chromatolysis of anterior horn cells remained at the control level. PMID- 6847427 TI - Postictal elevation of serum creatine kinase level. AB - Serial serum creatine kinase (CK) level determinations were performed on selected patients for six days following tonic-clonic or focal motor seizures in a prospective study. The time course and magnitude of serum CK elevation was correlated with seizure CK level was observed in all patients. Isoenzyme determinations revealed that CK was derived from skeletal muscle. Our data demonstrate that profound elevations of serum CK level may occur postictally and appear to be related to the intensity of muscular activity. patients with seizures associated with alcohol abuse had the greatest postictal serum CK level increases. PMID- 6847426 TI - Primary position vertical nystagmus and cerebellar ataxia. AB - Hereditary cerebellar ataxia was evaluated clinically and by electro-oculography in three members of a family. There was no clinical evidence of exttra-cerebellar dysfunction although quantitative eye movement analysis did shown internuclear ophthalmoparesis and slow saccadic velocity suggestive of brainstem dysfunction. In addition, oculomotor examination showed primary position vertical nystagmus in all patients. Other findings were in accord with previous reports of cerebellar related oculomotor dysfunction. PMID- 6847428 TI - Peripheral facial palsy with intact taste and tearing caused by intrapontine lesion. AB - Two patients with documented lesions in the floor of the fourth ventricle had unilateral paralysis of the upper and lower facial muscles but normal taste sensation and tearing function. These findings contradict the widely accepted clinical notion that an intraparenchymal lesion of the facial nerve invariably causes loss of gustatory and lacrimal function. PMID- 6847429 TI - Computed tomography in acute cerebral multiple sclerosis. A report of two cases. AB - In two cases of acute cerebral multiple sclerosis, computed tomographic (CT) scans with contrast disclosed several enhanced foci, mainly situated in the periventricular white matter and, in one patient, in the cerebellum. Administration of dexamethasone sodium phosphate in one patient and prednisone with cyclophosphamide in the other was followed by considerable clinical improvement. Successive CT scans with contrast enhancement showed a close correlation between improvement of symptoms and the subsidence of contrast enhanced foci during treatment. Perhaps clinical improvement reflected restoration of the impaired blood-brain barrier. PMID- 6847430 TI - Posttraumatic syringomyelia with paroxysmal episodes of unconsciousness. AB - A 41-year-old man survived 23 years with quadriplegia following a C-5 fracture dislocation. During the last four months of his life he had paroxysmal episodes of unconsciousness. Necropsy disclosed a posttraumatic syrinx. The cyst extended caudally to the midlumbar region and rostrally into the midline of the medulla without communication into the fourth ventricle. Central apnea due to expansion of the cyst in the medullary respiratory centers is postulated as the possible cause of his paroxysmal episodes of unresponsiveness. PMID- 6847431 TI - Benzodiazepines and spasmodic torticollis. PMID- 6847432 TI - Ataxic hemiparesis. PMID- 6847433 TI - Capsular ataxia hemiparesis. PMID- 6847434 TI - Training for metatechnical neurology. PMID- 6847435 TI - Postgraduate training in neurology. Education for what? AB - Among recent graduates of neurology training programs, a majority pursue careers in community practice. Because the scope of community neurologic practice differs from that of referral centers, I suggest five changes in postgraduate neurologic training: (1) instruction in an epidemiologic approach to patient care, (2) greater emphasis on training for ambulatory care, (3) development of departmental links with community hospitals, (4) clarification of the role of neurotechnology outside teaching centers, and (5) recognition of the need to regionalize some neurologic and neurosurgical care. PMID- 6847436 TI - Neuropsychological recovery in head injury. AB - Recovery of neuropsychological functions was studied in a group of adults with mild to severe head injuries. The subjects were first examined when alert and then 12 and 18 months following their first testing. The results support the following conclusions: (1) a broad range of early deficits occur representing the diversity of behavioral performances dependent on the brain; (2) improvement following losses occurs in complex as well as in simple neuropsychological functions; (3) on the basis of information available, conclusions regarding when recovery slows are premature; and most important, (4) the degree of initial deficit is a significant determinant of the subsequent amount of recovery and the residual deficits. PMID- 6847437 TI - Phoria adaptation to prisms. A cerebellar-dependent response. AB - Horizontal prism placement in normal subjects results in an apparent change in phoria by an amount equal in power and opposite in direction to the prisms used. However, the measured phoria gradually returns toward the value preceding the placement of prisms. This is termed phoria adaptation. This response was measured in five normal subjects and five patients with cerebellar deficit. The magnitude of the response was significantly reduced in the patient group. Visual acuities and fusional reserves were comparable in the two groups. The mean age was greater, and the stereoscopic acuity decreased, in the patient group. These factors were unlikely to account for the reduced response in patients. The results suggest that the phoria adaptation response in normal subjects depend on the integrity of the cerebellum. PMID- 6847439 TI - Parainfectious optic neuritis. Report and review following varicella. AB - Severe loss of vision and bilateral optic disc edema occurred in a 10-year-old girl 38 days after the rash of varicella first appeared and subsequent encephalitis developed. Recovery of visual function was nearly complete, but optic atrophy persisted. Parainfectious optic neuritis following other viral infections, with the exception of herpes zoster, has a similar clinical profile: delayed onset, severe visual loss, optic disc edema, bilaterality, good recovery, and residual optic atrophy. Conduction delays in our patient's patterned visual evoked potentials implicated demyelination within the optic nerves. The often favorable recovery, frequency of delayed onset, and bilateral involvement of the optic nerves support an autoimmune process in the pathogenesis of parainfectious optic neuritis. PMID- 6847438 TI - Eye movements in Friedreich's ataxia. AB - Twenty-four patients with well-documented Friedreich's ataxia underwent quantitative oculomotor testing. A consistent pattern of eye movement abnormalities was observed. This pattern included fixation instability, inaccurate saccades with normal peak velocity, impaired smooth pursuit and optokinetic slow phases, decreased vestibulo-ocular reflex gain, and impaired visual-vestibular interaction. This pattern corresponds to the known pathologic changes of Friedreich's ataxia and can be useful in the differential diagnosis of cerebellar atrophy. PMID- 6847440 TI - Juvenile progressive bulbar palsy. Clinical and electrodiagnostic findings. AB - Differentiation of juvenile progressive bulbar palsy from bulbar myasthenia gravis is difficult. Characteristics of both may include ocular involvement, fluctuant course, abnormal fatigability, and normal acetylcholine receptor (AChR) antibody titers. Electrodiagnostic evaluation may demonstrate moment-to-moment variability in motor unit action potential amplitude, fibrillation potentials, and decremental motor evoked responses. Increased jitter with blocking may be the most prominent electrodiagnostic abnormality in either disorder, even in asymptomatic extremity muscles. Complete paralysis of facial muscles with electrical silence on needle electromyography, low-amplitude facial evoked responses without a decrement to repetitive stimulation, increased jitter and fiber density in asymptomatic extremity muscles, and normal AChR antibody levels suggested juvenile progressive bulbar palsy in two patients initially thought to have bulbar myasthenia. Early differentiation of these disorders is important because of therapeutic, genetic, and prognostic implications. PMID- 6847441 TI - Metachromatic leukodystrophy (MLD). XV. Adult MLD with focal lesions by computed tomography. AB - A 31-year-old woman with adult metachromatic leukodystrophy was seen for a progressive dementia. Computed tomographic scans showed four, nearly mirror image, hypoabsorptive areas in cerebral white matter. These symmetric bifrontal and biparietal abnormalities were accompanied by mild ventricular enlargement and by a slight to moderate volume loss throughout the brain. Diffuse white-matter abnormalities of a kind that might otherwise be anticipated in the usual childhood leukodystrophy were not seen. PMID- 6847442 TI - Evoked response studies in patients with adrenoleukodystrophy and heterozygous relatives. AB - Brain-stem auditory evoked responses (BAERs) and somatosensory evoked responses (SERs) were studied in three patients and seven female relatives in three families with adrenoleukodystrophy (ALD). All patients with ALD had abnormal BAERs and SERs, reflecting the central demyelination occurring in ALD. Four of the seven female family members had abnormalities of SERs with or without abnormalities of BAERs, similar to those seen in the patients. We suggest that these abnormalities demonstrate the morphological effects of the ALD gene in the CNS and reflect the physiological alteration in the heterozygous females in families with ALD. PMID- 6847443 TI - Prognostic value of brainstem auditory evoked potentials in neonates. AB - The clinical outcome in 74 children at risk for audiologic or neurologic sequelae of a variety of perinatal insults was correlated with brainstem auditory evoked potentials (BAEPs) in the newborn period. No constant relationship was found between BAEP findings and later hearing status in preterm infants or in infants with severe brain damage. However, persistent patterns of wave I abnormality correctly predicted the presence and type of hearing loss in other infants. Central BAEP abnormalities recorded in preterm infants or in infants who had just suffered anoxia had little predictive value. The abnormalities had greater prognostic value when there was a delay between acute injury and testing. Prognostic errors could be minimized in this population by obtaining repeated recordings at least one month post term and after injury from infants who showed BAEP abnormalities in the neonatal period. PMID- 6847444 TI - Evoked potentials in olivopontocerebellar atrophy. AB - Pattern-reveral visual evoked potentials, far-field and cortical somatosensory evoked potentials, and auditory brainstem potentials were recorded in two patients with olivopontocerebellar atrophy. In one patient, visual evoked potentials exhibited prolonged latency and interocular latency differences in the absence of clinical visual dysfunction. Median and tibial nerve evoked cortical potentials were severely attenuated in the absence of somatosensory deficit or peripheral nerve slowing. The far-field somatosensory potentials, however, were well preserved. All components of the auditory brain-stem potentials had latencies within normal limits. In the other, more severely afflicted, patient, all visual, somatosensory, and auditory evoked potentials were abnormal. PMID- 6847445 TI - Spontaneous regression of a cerebral arteriovenous malformation. Report of a case and review of the literature. AB - A cerebral arteriovenous malformation (AVM) spontaneously and completely disappeared on subsequent angiography. Computed tomography revealed a very similar picture to that of angiographically occult AVM, which was histologically thrombotic. Reviewing the literature, we suggest that in many cases the important factor related to regression of AVM is a previous bleeding episode. PMID- 6847446 TI - Paroxysmal kinesigenic choreoathetosis and abnormal contingent negative variation. A case report. AB - We treated a patient suffering from paroxysmal kinesigenic choreoathetosis (PKC). The etiology and pathophysiologic mechanism of this rare movement disorder are unclear. Like other patients with PKC, our patient experienced attacks more frequently when making anticipated movements. Because anticipation plays an important role in the genesis of the contingent negative variation (CNV), we investigated the CNV in our patient. One of the components of the CNV, the slow negative wave (SNW), repeatedly showed a remarkable enhancement compared with that of controls. After institution of phenytoin sodium therapy, the attacks of PKC subsided and the SNW amplitude came within the range of control values. There may be a relationship between PKC and the abnormal CNV. PMID- 6847447 TI - Visual hallucinations as the earliest symptom of digoxin intoxication. PMID- 6847448 TI - High jugular bulb and high carotid canal first observed as intracranial bruit. PMID- 6847449 TI - An unusual cause of bacterial meningitis in the elderly. Propionibacterium acnes. PMID- 6847450 TI - Effect of anticholinergics on memory in Parkinson's disease. PMID- 6847452 TI - Treatment of cerebral cysticercosis. PMID- 6847453 TI - Benign masturbatory cephalalgia. PMID- 6847454 TI - Transient global amnesia and the law. PMID- 6847451 TI - Neurologic complications of tetanus toxoid. PMID- 6847455 TI - Ethosuximide-induced liver dysfunction. PMID- 6847456 TI - Lumbar puncture and pseudotumor cerebri. PMID- 6847457 TI - Syringobulbia without syringomyelia. PMID- 6847458 TI - beta-Irradiation of choroidal melanoma with 106Ru/106Rh applicators. 16 Years' experience. AB - From 1964 to 1980, 205 patients with choroidal melanoma were treated with 106Ru/106Rh beta-ray applicators (8,000 to 10,000 rad at the summit of the tumor within 14 days). In 132 (64.4%) cases, this treatment was successful. Thirty-six (17.6%) had to be enucleated after irradiation and 37 died, 21 of them of metastases. Of the 132 successfully treated patients, 60 (45.5%) had flat scars and 34 (25.8%) retained a visual acuity of 0.5 to 1.5. Radiogenic late complications with damage to the retinal capillary system were the main causes of visual deterioration, especially in eyes with tumors close to the posterior pole. The survival rate of 85.1% after five years is substantially higher than that for patients who were primarily treated with enucleation. PMID- 6847459 TI - Reactive lymphoid hyperplasia of the uvea. A case with ultrasonographic and computed tomographic studies. PMID- 6847460 TI - Functional visual loss. Follow-up of 42 cases. AB - Forty-two patients with diagnosed functional visual loss were reexamined an average of four years after their initial visit. Twenty-three patients continued to have constricted or spiral visual fields at follow-up. Despite persistent evidence of functional visual defects, few patients were either socially or economically impaired by them. Patients who had other types of visual field loss or loss of visual acuity were more likely to have these signs resolve than were patients with constricted or spiral fields. Concurrent unrelated organic ocular disease was present in 11 patients. In 20 patients, it was not possible to identify psychiatric symptoms either related to the onset of functional eye signs or at follow-up. Treatment did not substantially alter the course. PMID- 6847462 TI - Baring of a circumlinear vessel in glaucoma. AB - We independently examined 144 optic disc stereophotographs. Despite a preliminary learning trial, we were able to agree about the presence of a circumlinear vessel in only 73% of eyes and about baring of a vessel, if present, in only 71% of eyes. Bared vessels were present in 73% of 22 glaucomatous eyes, 41% of 71 ocular hypertensive eyes, and 14% of 51 normal eyes. During several years of follow-up of 44 ocular hypertensive eyes with bared circumlinear vessels, visual field defects developed in only three. We conclude that baring of a circumlinear vessel is a difficult sign for trained observers to detect with certainty and, although present frequently in glaucoma, is of low specificity as a sign or predictor of glaucomatous damage. PMID- 6847461 TI - Orbital inflammation, myositis, and systemic lupus erythematosus. AB - A 39-year-old man with systemic lupus erythematosus (SLE) experienced three episodes of acute orbital inflammation, a primary feature of each being a markedly enlarged extraocular muscle (myositis). The muscles of the upper trunk were concomitantly inflamed, and full-thickness skin and muscle biopsy specimens demonstrated an inflammatory myositis. The case demonstrates that orbital proptosis and extraocular myositis can be features of SLE. PMID- 6847463 TI - Subperiosteal abscess of the orbit. AB - Seven cases of subperiosteal abscess (SPA) of the orbit are reported. Anatomic relationships shared by the orbits, paranasal sinuses, and facial venous system explain the rapid development of SPA after periorbital infection. Computed tomography and echography allow distinction between SPA and other stages of orbital inflammation that are often indiscriminately grouped under the rubric of orbital cellulitis. These techniques suggest that elevated orbital pressure is the primary, and potentially reversible, mechanism of visual impairment produced by SPA. Difficulty in accurately determining the responsible pathogens, relative isolation of the subperiosteal space with regard to antibiotic penetration, and risk of precipitous visual loss require prompt surgical drainage in most cases. PMID- 6847464 TI - Spectral sensitivity of the pseudophakic eye. AB - Spectrophotometric measurements indicated that polymethyl methacrylate intraocular lenses do not mimic the crystalline lens in absorption of shortwave visible light and near-UV light. These wavelengths are particularly effective in producing photochemical damage to the retina. Scotopic spectral sensitivity functions directly confirmed that patients with intraocular lens implants are much more sensitive than normal to these wavelengths (by as much as a factor of 46 at 380 nm). PMID- 6847465 TI - Chemical preparation of the eye in ophthalmic surgery. I. Effect of conjunctival irrigation. AB - We investigated the effect on bacterial flora of conjunctival irrigation as part of the chemical preparation of the eye before surgery. Forty consecutive patients underwent conjunctival irrigation with a saline solution in one randomly selected eye. Aerobic and anaerobic bacterial conjunctival cultures were taken in masked fashion before and after the preparation. In nonirrigated eyes, the colony counts before and after the preparation were virtually identical; the species count increased 23%. In irrigated eyes, the colony count increased 18% and the species count increased 46%. The increase in the species count was significant. Our findings suggest irrigation with a saline solution does not reduce the bacterial flora of the conjunctiva. PMID- 6847466 TI - Chemical preparation of the eye in ophthalmic surgery. II. Effectiveness of mild silver protein solution. AB - Although a mild silver protein solution (Argyrol) has been used for a number of years and is still used by many ophthalmic surgeons, its efficiency as an antibacterial agent on the conjunctiva has not been scientifically evaluated as part of the preoperative chemical preparation of the eye. We studied the effectiveness of a mild silver protein solution on the conjunctival flora of 32 patients in a masked fashion. By bacteriologic analysis, the mild silver protein solution was found to be no more effective in reducing the number of species and colonies in the treated eye than in the untreated eye. While the mild silver protein solution does stain mucus and other debris on the eye to facilitate irrigation, this study did not demonstrate a significant bactericidal effect. PMID- 6847467 TI - A rare choristoma of the optic nerve and chiasm. AB - Two patients with a heretofore undescribed unilateral choristomatous malformation of the intracranial optic nerve and chiasm underwent craniotomy for partial resection of the optic nerve in the belief that the tumor was either a glioma or a meningioma. Visual acuity in the affected eye was reduced to 20/200 in one patient and to finger counting in the other. Chiasmal involvement in the first case was associated with a superotemporal field defect in the opposite eye. Ophthalmoscopy disclosed atrophic nerve heads in both affected eyes. Heteroplastic masses of smooth muscle and adipose tissue replaced most of the resected optic nerve in each case. PMID- 6847468 TI - Fuchs' adenoma affecting the peripheral iris. AB - An elevated, pigmented lesion of the peripheral iris developed in a 73-year-old woman. The lesion was believed to be a malignant melanoma and was excised at the time of routine cataract extraction. Pathologic examination disclosed a Fuchs' adenoma. These lesions are common in the elderly and are almost invariably clinically silent. This case, however, demonstrates that under rare circumstances a Fuchs' adenoma may induce cataractous changes or produce clinical findings that can mimic an iris melanoma. PMID- 6847469 TI - Nitrous oxide cryotherapy for intraepithelial epithelioma of the conjunctiva. AB - Nine patients were treated with the nitrous oxide eyelid cryoprobe for large or recurrent intraepithelial epithelioma of the conjunctiva or cornea. Nitrous oxide cryotherapy is more convenient for ocular cryosurgery than liquid nitrogen therapy and seems to be as effective for intraepithelial epithelioma. Surgical debulking of the lesion is recommended before cryosurgery. An obvious advantage of cryosurgery over surgical modalities for intraepithelial epithelioma is that large areas of tumor as well as surrounding tissues can be treated. This procedure results in a higher cure rate and avoids grafting and symblepharon formation. The complications of light cryosurgery seem to be minor even when the cornea is treated. Heavy cryosurgery may result in severe iritis, posterior synechiae, and corneal scarring. A biopsy-proved diagnosis of intraepithelial epithelioma can be misleading and does not rule out the presence of underlying malignant disease. PMID- 6847470 TI - Metastatic choroidal melanoma. Hepatic binding protein reactivity toward a liver metastasizing clone. AB - A clone of B16 malignant melanoma cells with a preference for metastasis to the liver was isolated and characterized. The parent tumor cells (F1) were injected in the tail vein of C57BL/6 mice, and the resultant liver colonizing cells were isolated and then subcultured for two to three weeks. The cells were then reinjected into the next series of mice. After five such passages, a clone (L4) of melanoma cells was obtained that metastasized almost exclusively to the liver. A hepatic binding protein (HBP) was isolated from rabbit liver that agglutinated neuraminidase-treated F1 and L4 malignant melanoma cells. Different agglutination titers found between the parent and liver-metastasizing clone demonstrated differences in cell-surface properties between the parent tumor and the liver metastasizing clone. These results demonstrate that malignant melanoma cells can be selected for preferential liver metastasis and can be recognized and agglutinated by specific HBPs. Metastasis from human uveal malignant melanoma may occur by similar mechanisms. PMID- 6847472 TI - Histologic characteristics of filtering blebs in glaucomatous eyes. AB - Tissues from six functioning and four failed filtering blebs in glaucomatous eyes examined by light and electron microscopy showed normal epithelium. The response of the subepithelial connective tissue differed in the two groups. Failed blebs had dense collagenous connective tissue in their walls. In functioning blebs, the subepithelial connective tissue was loosely arranged and contained histologically clear spaces. These clear spaces corresponded in size and position to microcystic spaces seen clinically in functioning blebs. The presence of microcystic spaces visible by slit-lamp examination is probably a good sign of bleb function. PMID- 6847471 TI - Metastatic uveal melanoma. Hepatic cell-surface enzymes, isoenzymes, and serum sialic acid levels in early metastatic disease. AB - Serum hepatic cell-surface enzymes, isoenzymes, and sialic acid levels may be useful adjuncts in detecting early metastatic disease and in evaluating the tumor burden of patients with uveal melanoma. Hepatic cell-surface enzyme concentrations were elevated in the serum of ten patients with uveal melanoma and liver metastasis and in five patients with other hepatobiliary disorders and in 75 control patients. Five patients in the metastatic group (50%) had serum gamma glutamyl transpeptidase and 5'-nucleotide phosphodiesterase (5-NPD) bands known to be associated with either primary hepatic carcinoma or carcinoma metastatic to the liver. One patient with uveal melanoma without known metastasis had a positive 5-NPD pattern; metastatic disease was subsequently proved. Higher levels of sialic acid were found in the serum of patients with uveal melanoma and metastatic disease (4 mumole/mL) than in controls (2.4 mumole/mL). PMID- 6847473 TI - A tool and method of preparing razor blade fragments for microsurgery. AB - A different type of cutting tool can be used to prepare fragments of stainless steel razor blades for microsurgery. The tool can be used to cut even flexible, extremely thin, unbreakable razor blades to any size, shape, or tip angle. PMID- 6847474 TI - Vacuum-attached infusion terminal. AB - A vacuum-attached infusion terminal for use in vitrectomy procedures has the advantage of being rapidly positioned in the eye through a 20-gauge pars plana incision. The terminal can be used as a temporary infusion source or throughout an entire vitrectomy procedure. PMID- 6847475 TI - New system of intraocular instruments. I. Guillotine intraocular forceps. AB - A four-instrument system of 20-gauge, rustproof intraocular forceps can be used in conjunction with pars plana vitrectomy to (1) extract intraocular foreign bodies, (2) manipulate intraocular tissue and a dislocated pseudophakos, and (3) obtain biopsy specimens of vitreous gel and abnormal preretinal and epiretinal membranes. The forceps can also be used as an intraocular needleholder for transvitreal suturing of selected giant retinal tear flaps. These instruments are lightweight and sturdy and use a guillotine action and a new barrel-handle design. To facilitate introduction and use through a pars plana approach, the various jaw faces are angled 135 degrees from the long axis. Prototype models have been used successfully in numerous and varied clinical applications. PMID- 6847476 TI - Malignant hyperthermia. PMID- 6847477 TI - Effect of levator veli palatini muscle excision on eustachian tube function. AB - The role of the levator veli palatini (LVP) muscle in eustachian tube (ET) physiology was investigated in five juvenile rhesus monkeys (Macaca mulatta). The baseline ET function and middle ear pressures were documented longitudinally for a period of six months prior to bilateral excision of the LVP muscle, and postoperative ET function and middle ear status were assessed for a period of five months. During the postoperative follow-up period, otitis media with effusion was not observed and middle ear pressure values remained within the normal baseline values. Parameters of ET function as measured by the forced response test did not show any significant differences in comparison with baseline values. These findings provide additional evidence that the operational biomechanics of the ET are independent of the integrity of the LVP muscle, and that the tensor veli palatini is the only paratubal muscle responsible for normal active opening of the ET. PMID- 6847478 TI - Temporal bone fractures. Review of 90 cases. AB - Of 1,300 consecutive head-injured patients admitted to the hospital over a 20 month time period, 118 were found to have skull fractures, of which 22% involved the temporal bone. These figures form part of a larger study of 90 temporal bone fractures treated over a six-year period from 1975 through 1981. The most common cause of a temporal bone fracture was a motor vehicle accident occurring in 40/90 (44%) patients. Pertinent physical findings, occurring alone or in combination, were a hemotympanum, bleeding from the ear canal, tympanic membrane perforation, facial paralysis, and CSF otorrhea. The diagnosis of temporal bone fractures is best made clinically and radiographically. The early care of temporal bone fractures is directed toward the treatment of CSF otorrhea and immediate onset facial paralysis. The delayed care is primarily concerned with hearing rehabilitation. PMID- 6847479 TI - Immunostimulation of patients with head and neck cancer. In vitro and preliminary clinical experiences. AB - The development of malignancy is theorized to be from failure of the immunosurveillance system. Prostaglandins (PGs), synthesized by a mononuclear cell, tumor cell, or both, enhance inhibition of competent cellular immunity. Ten patients with terminal squamous cell carcinoma of the head and neck were treated with indomethacin, and inhibitor of PG synthesis. Two patients had a dramatic response; however, an in vitro assay and a derived-stimulation index did not correlate with the clinical response. A review of the literature and future directions are discussed. PMID- 6847480 TI - Carcinoma of the tongue in persons younger than 30 years of age. AB - Squamous cell carcinoma of the tongue in young people is a rare disease. The usual causal agents associated with this disease in older patients may not be operative in this younger age group or may involve a greatly reduced latency. Failure to perform a biopsy of tongue lesions in young patients often leads to late diagnosis. The prognosis is similar, stage for stage, as for older patients. Thirteen cases of squamous cell carcinoma of the tongue occurred in patients younger than 30 years of age. Their clinical appearance, stage and histologic state, treatment, and survival are discussed. A high index of suspicion leading to early diagnosis and systematic adequate treatment are needed to alter the unfavorable prognosis of this lesion. PMID- 6847481 TI - Carcinoma of the tonsil. A retrospective analysis of prognostic factors. AB - A study was designed to assess clinical and pathologic variables with prognostic value in carcinoma of the tonsil. Seventy-nine cases, diagnosed and treated at the University Hospital of Montevideo, Uruguay, during a 20-year period (1960 through 1979) were studied. Survival of patients according to sex, age, performance status, tumor size (T), nodal status (N), clinical stage, tongue involvement, histologic type, grade of differentiation, and local control with treatment was analyzed with the life-table method and the statistical significance was estimated with the logrank test. Regression methods showed that the combination of T and N factors explained 25% of the prognosis. When local control was included in the equation, the predictive power increased to 52%. Local spread to the base of the tongue and female sex were of marginal significance regarding prognosis. PMID- 6847482 TI - Lymphoma of the nose and paranasal sinuses. AB - The records of 37 patients with lymphoma of the nose and paranasal sinuses in an 18-year period were studied. The symptoms were divided into three categories: (1) local symptoms: obstruction, bleeding, and rhinorrhea; (2) symptoms of invasion of adjacent structures: facial pain and ear fullness; and (3) systemic symptoms: fever, weight loss, and nocturnal sweating. The presence of an intranasal mass was the most common physical finding. Conventional tomography and computed tomography were helpful for diagnosis. Abnormalities were usually disclosed on biopsy specimens from the nose or mouth. As a rule, several sites in the nose and sinuses were involved. An early diagnosis of sinonasal lymphoma and other malignant neoplasms generally allows effective treatment; therefore, the otorhinolaryngologist should be alert for such disease and, if the clinical picture warrants, should add tomography to the diagnostic workup. PMID- 6847483 TI - Wound ballistics of gunshot injuries to the head and neck. AB - It is important for the trauma surgeon to understand the basic principles of terminal gunshot ballistics and the study of the projectile's effect on striking soft tissue. The amount of kinetic energy dissipated to the tissue is directly related to the mass and velocity of the projectile as follows: K = MV2/2. Doubling the velocity quadruples the energy, while doubling the mass only doubles the energy. A temporary tissue cavity is produced as the striking projectile compresses the surrounding tissue; the higher the energy release, the more extensive the inapparent compressive damage. The permanent cavity that remains is the result of extrusion of tissue from the pathway of the projectile. The higher the velocity, the higher the likelihood of extensive damage. If the missile expands or fragments within the tissues, more damage will occur. PMID- 6847485 TI - Transseptal approach for the treatment of pituitary lesions. AB - The transseptal approach is the most logical and adequate technique to reach the sella turcica and adjacent structures. In the era before the use of antibiotic and steroid replacement therapy, Harvey Cushing, MD, and Norman Dott, MD, obtained successful results by using the transseptal approach to resect and decompress pituitary adenomas. Some authors use the maxilla-premaxilla technique followed by a sublabial incision through which they introduce the trans sphenoidal speculum. The endonasal approach is a modification of the sublabial incision, but much of the perpendicular plate of the ethmoid is still removed. Therefore, we have added another modification that consists in removing only a fragment of the perpendicular plate of the ethmoid and vomer anterior to the sphenoid rostrum. We also describe our experience with this technique and analyze our results. PMID- 6847486 TI - Mandibular reconstruction using implantable stabilization plates. AB - The consequences of substantial mandibular loss usually are disturbances in mastication and often in cosmesis. In an attempt to arrive at an easy and reliable technique of reconstructing mandibular defects, a selected group of patients were treated using rigid, implantable reconstruction plates. These were used to provide continuity and stability for the residual mandible with or without the use of graft materials. These have included autogenous fresh, irradiated, or frozen bone, and polytetrafluoroethylene carbon fiber sponge (Proplast). A discussion of the principles and technique of using reconstruction plates is outlined. PMID- 6847484 TI - A safe alternative to endoscopic removal of blunt esophageal foreign bodies. AB - An alternative to the endoscopic removal of blunt esophageal foreign bodies is proposed. A Foley catheter is inserted into the esophagus and its balloon is utilized to extract the foreign body under fluoroscopic control. Experience with over 100 children with blunt esophageal foreign bodies has led us to conclude that the technique is easily performed, safe, and highly cost-effective. To protect the esophagus, care must be taken to ensure that the foreign body has no sharp or ragged edges, that it has been in place less than two weeks, and that there is no underlying esophageal disease. To ensure that no compromise of the airway occurs, several safeguards are employed, including orally inserting and withdrawing the catheter, monitoring the procedure fluoroscopically, and placing the patient in a prone oblique position with the fluoroscopic table steeply inverted. PMID- 6847488 TI - Manual strangulation injuries of the larynx. AB - Laryngeal injuries secondary to manual strangulation are seen more often by the forensic pathologist than by the otolaryngologist. Forces sufficient to cause thyroid and cricoid cartilage fractures are usually sufficient to cause acute asphyxia and death. However, due to the static nature of the compressive forces applied in strangulation, fractures of the cartilaginous framework may occur without obvious mucosal disruption or submucosal hematoma formation. If the victim survives the initial assault and the injuries go unrecognized and untreated, delayed life-threatening airway obstruction of long-term vocal dysfunction may result. Computed tomography seems to be an excellent noninvasive technique to evaluate and verify cartilaginous laryngeal fractures and soft tissue injury. Recognition of the potential for such injuries is the key to management and treatment. PMID- 6847489 TI - Pathologic quiz case 1: papillary carcinoma of the thyroid. PMID- 6847487 TI - Pharyngeal stenosis in Behcet's syndrome. The first reported case. AB - Behcet's syndrome is a very uncommon, chronic multisystem inflammatory disorder that may affect the gastrointestinal tract. Esophageal involvement is rare, and to my knowledge, secondary stenosis of the pharynx has not been previously reported as a complication. A case is described in which dysphagia caused by pharyngeal stenosis was a presenting feature in this condition and obstructive airway symptoms subsequently developed. PMID- 6847490 TI - Pathologic quiz case 2: nasolabial (nasoalveolar) cyst. PMID- 6847492 TI - Adult fluoride therapy for ostosclerosis (otospongiosis) PMID- 6847491 TI - Carcinoma arising in a tracheostomy scar. PMID- 6847493 TI - Children with persistent otitis media. Audiometric and tympanometric findings. AB - Audiometric and tympanometric findings were compared among 129 patients with clinically manifest persistent otitis media (OM) with effusion. Ears with thick effusion (mucoid OM) had significantly larger air-bone gaps and higher prevalence of flat tympanograms than either of the thin effusion types (purulent [POM] or serous OM [SOM]) or ears with no effusion (dry). Ears with thin effusion (POM and SOM) had similar air-bone gaps, thresholds for air and bone conduction, and prevalences of flat and underpressure tympanograms. Ears with no effusion had significantly smaller air-bone gaps, slightly poorer bone conduction thresholds, and lower prevalence of flat tympanograms than ears with effusion (MOM, POM and SOM). Ears with clinically manifest OM and no effusion at tympanocentesis appear to represent patients with a spontaneously resolved episode of OM with thin effusion (POM or SOM) or with ears that evacuated during anesthesia prior to tympanostomy. PMID- 6847494 TI - Passive eustachian tube opening pressure. Its measurement, normal values, and clinical implications. AB - To measure passive eustachian tube opening pressure (PETOP) we have developed a pressure recording instrument that is activated by the sudden fall in output voltage of a sensitive acoustic impedance meter that occurs at the moment of transnasal insufflation of the middle ear. The PETOP was measured in 112 normal subjects aged 2 to 40 years. Normal values rose significantly throughout childhood and stabilized in early adolescence. When sequential insufflations were performed in the same subject, the PETOP fell, even though middle ear pressures had completely returned to baseline values before succeeding measurements were taken. Falls were enhanced by sequential swallowing. Our observations may be explained by the activity of surfactants in the eustachian tube. Measurement of PETOP may provide a more direct means of studying eustachian tube function than that provided by tympanometry alone. PMID- 6847495 TI - Mastoid subperiosteal abscess. AB - Subperiosteal abscess was the indication for surgery in every child with acute mastoiditis who underwent mastoidectomy at our institution since 1972. Nineteen such patients are discussed herein. Positive bacteriologic findings included Streptococcus pyogenes in three patients, Streptococcus pneumoniae in three patients, Mycobacterium tuberculosis in two patients, and enterococcus in the one patient with cholesteatoma. Cultures were more often positive for causative bacteria when taken directly from the abscess before or shortly after beginning antibiotic therapy. PMID- 6847497 TI - Epiglottic dysfunction during deglutition in patients with dysphagia. AB - Among 250 patients with dysphagial complaints, 83 had dysfunction of the epiglottis as revealed by high-speed cineradiography. Nineteen patients had a totally immobile epiglottis and of these 11 had concomitant pharyngeal constrictor paresis. Sixteen of the patients with immobile epiglottis had misdirected swallowing. An absence of the second movement of the epiglottis during deglutition was registered in 53 patients. Thirteen of these had pharyngeal constrictor paresis and 45 had misdirected swallowing. In 11 patients the epiglottis attained an obliquity of 30 degrees to 90 degrees as seen in the anteroposterior projection during its second movement. One of these had a pharyngeal constrictor paresis, while four had misdirected swallowing. The results of this study indicate that epiglottic dysfunction is common among patients with dysphagia and is often accompanied by other functional abnormalities. PMID- 6847496 TI - Bacteria-specific IgE in patients with nasal polyposis. A preliminary report. AB - Sixty-one patients exhibiting chronic nasal polyposis had their conditions evaluated by radioallergosorbent tests to determine the presence of bacteria specific serum IgE. Fifty-nine patients exhibited positive serum IgE to at least one of 11 bacteria tested. There are several implications of the collected data. PMID- 6847499 TI - Myocutaneous flaps for challenging problems in head and neck reconstruction. AB - We treated three cases of recurrent head and neck carcinoma viewed as challenging reconstructive problems because of the extent of the extirpative surgery necessary and the substantial risk of complications that would be associated with previous treatment techniques. In each case, the versatility of myocutaneous flaps is illustrated. In case 1, a double-paddle pectoralis major flap was employed. In case 2, with an exposed infected carotid artery and a failed pectoralis major flap, reconstruction was accomplished by using an ipsilateral trapezius myocutaneous flap. In case 3, for reconstruction of the pharynx with a low esophagostoma, a double-paddle pectoralis major and split-thickness skin graft were used. PMID- 6847498 TI - Vertico-frontolateral laryngectomy (hemilaryngectomy). Indications, technique, and results. AB - The hemilaryngectomy procedure includes the entire hemithyroid cartilage with the extent of the cartilage cut beyond the midline determined by endoscopy and cord cut determined after anterolateral pharyngotomy to minimize or maximize the procedure according to tumor size. Hypopharyngeal or piriform sinus mucosa was used to reconstruct the resected hemilarynx. There were 56 male subjects and one female subject. The mean age was 59 years. All had squamous cell carcinoma. There were 25 T1 lesions. Their 3-, 5-, and 10-year adjusted survival rate was 100%. The average survival in years was 6.6. Five T1 tumors were radiation failures. There were 27 T2 lesions. Their three-year adjusted survival rate was 100%; five year rate, 94.1%; and ten-year rate, 84.7%. The average survival in years was 5.48. There were five T3 lesions. Their 3-, 5-, and 10-year adjusted survival rate was 100%. The average survival in years was 8.4. PMID- 6847501 TI - Neoplastic changes in transposed deltopectoral skin. AB - In a patient who had undergone pharyngeal resection and reconstruction with transposed deltopectoral skin, multiple benign verrucous tumors developed in the neopharynx. These did not resemble the carcinoma for which the original ablative surgery was performed but required extensive resection for restoration of adequate swallowing. Although this complication appears to be rare, the number of patients at risk is sizable, and further examples may be expected in the future. PMID- 6847502 TI - Arachnia propionica (Actinomyces propionicus) as an unusual agent in tympanomastoiditis. AB - The actinomycetes are extremely uncommon causative agents in chronic tympanomastoiditis. Few cases have been reported in the literature, and, before the use of penicillin, the majority of patients died of intracranial extension of their disease. Two patients described in the recent literature could have had their conditions diagnosed preoperatively as cholesterol granuloma. They had intact but immobile or bulging tympanic membranes and histories of intermittent perforations with drainage. The diagnosis was suggested during surgery because of the presence of yellow-green amorphous "sulfur granules" scattered throughout the mastoid. Both patients were well following mastoidectomy and long-term penicillin therapy. The clinical history of a patient with tympanomastoiditis due to Arachnia propionica (Actinomyces propionicus) is discussed. To our knowledge, this is the first case reported of a patient with otic disease due to this strain of the organism. PMID- 6847500 TI - Osteosynthesis of mandibular fractures in the angle region. AB - The region of the angle of the mandible is one of the most frequent sites of fracture in external mandibular trauma. In 14 cases of fracture through the angle region, angled dynamic compression plates inserted through an extraoral route were used to provide rigid internal fixation. This method often obviates the need for intermaxillary fixation and suggests a technically simple technique by which direct and uncompromised healing of angle fractures with good resultant occlusion can be achieved in selected cases. We outline our current technique and the indications and limitations for using angled dynamic compression plates. PMID- 6847503 TI - Cholesteatoma induced by stapedectomy. AB - A case of cholesteatoma induced by stapedectomy is reported. A year after a successful stapedectomy, the wire prosthesis extruded in part through the eardrum. Exploration revealed a cholesteatoma around the prosthesis down to the oval window. The cholesteatoma was removed and the prosthesis replaced. The patient returned for further exploratory surgery 15 months later when the prosthesis extruded again, this time due to necrosis of the distal part of the long process of the incus. There was no return of cholesteatoma. A new prosthesis was crimped on the incudal stump and covered with tragal cartilage and perichondrium. A two-year follow-up was uneventful. PMID- 6847504 TI - Psychogenic aphonia masking mutational falsetto. AB - Aphonia, originally due to laryngeal inflammation, became psychogenic and superimposed on the unstable pitch of adolescent voice change. We presumed that the aphonia was adopted as a means of dealing with peer pressure to maintain a high preadolescent pitch as well. Voice therapy was effective in alleviating both the aphonia and mutational falsetto. Clinicians should be alert to underlying mutational falsetto when confronted with an aphonic or dysphonic adolescent patient with no organic laryngeal pathologic condition. PMID- 6847505 TI - Pneumocephalus from a frontal-ethmoid neurilemoma. AB - A 68-year-old man had memory lapse, character change, and unsteady gait. Skull films disclosed a spontaneous pneumocephalus with air in both ventricles. A dense, bony lesion in the right ethmoid area was thought to be an osteoma, a not infrequent cause of dural erosion. The bony lesion, however, proved to be an osteoid reaction around a primary neurilemoma. Neurilemomas arising in the paranasal sinuses are uncommon tumors and, to the best of our knowledge, this is the first reported case of a patient with a neurilemoma who had pneumocephalus. The lesion was excised through a Lynch approach, and the patient has remained free of tumor for the past two years. PMID- 6847506 TI - Intranasal encephalocele masking as a nasal polyp in an adult patient. AB - Intranasal encephaloceles are rarely seen in adult patients. These lesions may be mistaken for nasal polyps. A 36-year-old woman died after the removal of an intranasal encephalocele during a routine polypectomy. The possibility of an intranasal encephalocele must be considered when examining adult patients with nasal polyps. PMID- 6847507 TI - Congenital atresia of the external auditory canal. PMID- 6847508 TI - Sudden conductive hearing loss caused by finger manipulation in the ear canal. PMID- 6847509 TI - Myositis ossificans of the head and neck. Review of the literature and report of a case. PMID- 6847510 TI - [Comparison of active foreign flow rhinomanometry (oscillation method) and active personal flow rhinomanometry in 17 patients before and after correction of the nasal septum]. AB - The nasal resistance of 17 patients with nasal septum deviation was measured before and after septum correction using two active rhinomanometric methods; the one with external flow (oscillation method), the other with spontaneous flow. Both methods correlated closely (p less than 0.01). The oscillation method proved to be as reliable and sensitive as the spontaneous flow method and less strenuous for the patient. Conventional rhinomanometric methods have failed especially in children because of their great demands on the patient's compliance; thus the oscillation method serves to increase the clinical application of rhinomanometry. PMID- 6847511 TI - Stria vascularis in acoustic trauma. AB - Mechanical energy of noise destroys not only the organ of Corti, Reissner's membrane, and the basilar membrane but also the lateral wall of cochlear duct. The damage is characterized by ruptures running parallel to the attachment of the basilar membrane in the prominentia spiralis or sulcus spiralis externus. The other signs of injury after acoustic overstimulation are blisterlike detachments of the stria vascularis from the spiral ligament. The mechanism of injury is interpreted as the result of interaction of given mechanical properties of exposed tissues and of the kinetic energy of sound in narrow segments of cochlear duct. PMID- 6847512 TI - A comparison of AJC and JJC proposals on TNM classification of maxillary sinus carcinoma. AB - The proposal of the JJC, established in 1977 in an effort to establish a TNM classification of maxillary sinus carcinoma, proved superior to the American Joint Committee for Cancer Staging and End Results Recording (AJC) proposal in terms of reproducibility, well-balanced distribution of cases of T, and prognostication using TNM as the indices, after a nationwide analysis of 474 N0M0 Patients who were among the 541 patients first treated between 1970 and 1973 in 11 leading Japanese medical institutions. The number of patients, with their 5 year cumulative survival rates in parentheses, classified by T1, T2, T3, and T4 were as follows: AJC proposal - 0 (-), 21 (68%), 283 (44%), and 170 (31%); JJC proposal - 6 (83%), 148 (51%), 237 (40%), and 83 (22%). The 283 cases for T3 under the AJC classification are to be redistributed over three JJC T units of T2, T3, and T4, with the respective numbers of cases and 5-year cumulative survival rates of 133 (50%), 128 (41%), and 22 (26%). In a similar manner, the 170 T4 cases under the AJC classification are reclassified into 109 (37%) for T3 and 61 (20%) for T4 under the JJC proposal. The JJC proposal enables closer prognostication than the AJC. PMID- 6847515 TI - [Two-level fenestration]. PMID- 6847513 TI - Prenatal maturation of endocochlear potential and electrolyte composition of inner ear fluids in guinea pigs. AB - The maturation of the endocochlear potential (EP) and the inner ear fluid ionic composition were studied in fetal and neonate guinea pigs. The concentration of sodium and potassium in endolymph and perilymph approximated adult values more than 2 weeks before birth. Endolymph had acquired its specific ionic composition before the onset of cochlear microphonics (52-55 gestation days, results of other authors). Positive EP was recorded starting on day 62 of gestation. The EP rose fast to reach near adult level at birth. It is speculated that the negative EP recorded after the onset of cochlear microphonics was an artifact, probably a result of fetal hypoxia. The significance of the negative EP recorded before the onset of the cochlear microphonics is discussed in relation to the source of the anoxic negative EP in the adult animal. PMID- 6847514 TI - Intrinsic laryngeal muscles in oculocraniosomatic syndrome (OCSS). An autopsy study. AB - In a 36-year-old woman who died due to an atypical subacute necrotizing inclusion body encephalitis with herpes virions, typical clinical symptoms of the oculocraniosomatic syndrome of Kearns and Sayre were substantiated. Her still living daughter suffers from the same disorder. The skeletal muscles taken from various parts of the body of the 36-year-old patient displayed the typical features of a sudanophilic myopathy, including abundant 'ragged-red' fibers and a pleoconial mitochondriosis. For the first time in the literature the intrinsic laryngeal muscles were also found to be significantly involved. Their morphological features are delineated and discussed. PMID- 6847516 TI - Patterns of auditory nerve and brainstem-evoked responses (ABR) in different types of peripheral hearing loss. AB - Auditory brainstem response (ABR) recordings were made in different types of peripheral hearing loss (sensorineural, conductive, and mixed). Scatter diagrams were constructed by plotting different expressions of the hearing loss (audiometric and electrophysiologic) against the obtained wave latencies and for these two sets of variables, correlation coefficients and the parameters of the regression equation were calculated. Consideration is given to the possibility of diagnosing the type of peripheral hearing loss by correlating wave latencies and the electrophysiologic (ABR) threshold. PMID- 6847517 TI - Surface view of strial vessel, prominence vessel, and external sulcus cells as revealed by scanning electron microscopy. AB - The stria vascularis and the spiral prominence in the lateral cochlear wall were observed with scanning electron microscopy (SEM) after dissolving out the epithelial layer and the basement membrane by tryptic digestion and HCl hydrolysis. The external sulcus cells have regularly arranged pegs and a fine basal interdigitation on the cell surface. The strial vessel and the spiral prominence vessel could be visualized well and the characteristic surface view of their periendothelial cells presented. The former has cytoplasmic processes with a fine branching appearance similar to red coral and the latter has bulged popcorn like processes. Their functional significance is discussed. PMID- 6847519 TI - Effect of age on arterial distensibility in Asymptomatic humans. AB - This report describes a noninvasive method by which the volume distensibility of forearm arteries can be calculated from direct measurements of pulse wave velocity. Such measurements are made at a variety of transmural arterial pressures (TMP) accomplished by placing the forearm in a cylinder and changing the pressures within. This technique eliminates arterial blood pressure as a variable, which strongly influences arterial distensibility. We studied 48 asymptomatic men and women, ages 21 to 98 years. There was considerable scatter, but significant positive relationships were demonstrated between increasing arterial distensibility and age at ambient and lower TMPs. This finding can be explained by an age-related reduction in arterial luminal diameter and an increase in arterial wall thickness which reduces arterial wall tension and more than offsets the increased stiffness produced by changes in wall composition. In six subjects, pulse tracings were simultaneously recorded on paper and analog tape. The taped curves were digitized and subjected to Fourier analysis to determine the wave velocity of individual harmonics. The characteristic wave velocity was defined and found comparable to the hand method used in the same beats (regression coefficient = + 0.97). These data indicate that the automatic and manual methods measured the same variable. PMID- 6847518 TI - Recurrent facial palsy. AB - During a 9-year period a total of 447 peripheral facial palsies was seen. Of the 377 cases of acute idiopathic facial palsy (AIFP) for which information was available, 41 (10.9%) were recurrent attacks. The final outcome is known for 346 (92%) of AIFPs. All patients were subjected to an extensive investigation protocol. No prognostic differences were found between primary and recurrent attacks of AIFP and complete recovery occurred just as frequently after recurrent palsies irrespective of whether these were ipsilateral or contralateral to the first attack. The incidence of recurrent AIFP was 2.03/100,000/year. PMID- 6847520 TI - Endothelial regeneration in hypertensive and genetically hypercholesterolemic rats. AB - Endothelial regeneration after a narrow, superficial aortic injury was studied in rats with chronic Goldblatt hypertension, genetic hypercholesterolemia, or a combination of hypertension and genetic hypercholesterolemia. In all groups, endothelial continuity was restored within 24 to 36 hours by a combination of endothelial migration and proliferation. A line of increased endothelial density covering the previous wound was seen through 16 weeks after injury. Intimal thickening after injury did not occur in any of the groups. These results indicate that hypertension and hypercholesterolemia neither delay endothelial regeneration nor cause intimal thickening after a small injury in the rat. PMID- 6847521 TI - Lipoprotein oxidation and lipoprotein-induced cytotoxicity. AB - The results of this study indicate that when human VLDL or LDL is prepared under conditions allowing oxidation, such oxidation renders the molecular complexes highly toxic to human skin fibroblasts growing in culture. The cytotoxicity can be predicted by assaying for the presence of thiobarbituric acid-reacting substances on the lipoprotein. However, malondialdehyde, which reacts with thiobarbituric acid and is known to be injurious to cells, was not cytotoxic in the same experimental system when dissolved in culture medium or covalently bound to non-toxic LDL. The toxic agent(s) on oxidized LDL is(are) located in a lipid extractable moiety. Since lipid peroxides and oxidized sterols can occur in vivo under various pathological conditions, the cytotoxicity of these lipoprotein associated substances observed in vitro may be related to certain manifestations of these conditions. PMID- 6847522 TI - Increased catabolism of native and cyclohexanedione-modified low density lipoprotein in subjects with myeloproliferative diseases. AB - We previously demonstrated reduced levels of low density lipoprotein (LDL) cholesterol in association with increased total fractional catabolic rates (FCR( of LDL apoprotein B (apo B) in individuals with myeloproliferative diseases (MPD). The removal of LDL from plasma and interstitial fluid is mediated via receptor and nonreceptor pathways. We attempted to quantitate LDL catabolism via each of these pathways in subjects with MPD and control subjects. The total FCR of LDL apo B was measured using radiolabeled native LDL. The FCR of radiolabeled cyclohexanedione-modified LDL (CHD-LDL) was used to assess the nonreceptor mediated catabolism of LDL. Total FCR (mean +/- SD) was elevated in MPD vs controls (0.78 +/- 0.32 vs 0.45 +/- 0.11, p less than 0.01). CHD-LDL FCR was also increased in MPD vs controls (0.62 +/- 0.53 vs 0.23 +/- 0.04, p less than 0.01). Studies of the plasma decay of radiolabeled native and CHD-LDL preparations after their injection into cynomolgus monkeys indicated that CHD-LDL preparations from MPD and controls were removed at the same rates in those primates and that all CHD-LDL preparations were catabolized more slowly than the native LDL preparations. Studies in vitro indicated that CHD modification of LDL significantly reduced the rate of degradation of this lipoprotein by a specific high-affinity receptor pathway in normal human monocyte-derived macrophages and cultured human fibroblasts. We conclude that the catabolism of both native and CHD-LDL apo B is increased in subjects with MPD. If CHD-LDL is a valid tracer of nonreceptor-mediated removal of native LDL in individuals with MPD, our results indicate that the reduced LDL cholesterol concentrations demonstrated in these subjects are associated with increased nonreceptor-mediated catabolism of LDL apo B. At this time, both neoplastic cells and activated monocyte-macrophages appear to be likely sites of these abnormalities. PMID- 6847523 TI - Dietary fat saturation and hepatic acylcoenzyme A:cholesterol acyltransferase activity. Effect of n-3 polyunsaturated and long-chain saturated fat. AB - The acylcoenzyme A:cholesterol acyltransferase (ACAT) activity in liver microsomes from rats fed a diet containing 14% menhaden oil (Mp) for 11 days was 117% higher than that in microsomes from rats fed a corresponding diet containing 14% cocoa butter (Ms). There were no differences in the cholesterol and phospholipid contents of Mp and Ms or in the activities of palmitoyl coenzyme A hydrolase and NADPH cytochrome c reductase. NADPH-dependent lipid peroxidation was higher in Mp, whereas glucose 6-phosphatase activity was higher in Ms. These findings indicate that the ACAT response to differences in dietary fat saturation is not due to a nonspecific effect of these diets on microsomal enzymes. When 1% cholesterol was added to the diets, the cholesterol content and ACAT activity of both microsomal preparations increased, but the ACAT activity of Mp remained 60% higher than that of Ms. Addition of cholesterol by incubation of the microsomes with liposomes also increased ACAT activity. At corresponding cholesterol contents, however, the ACAT activity of Mp remained 50% to 70% above that of Ms. There was no difference in the plasma cholesterol concentration in the two groups of rats, indicating that the ACAT effect probably is not due to a difference in the amount of circulating cholesterol available to the liver. Mp contained 40% more polyunsaturated fatty acids and five times more n-3 polyunsaturates than Ms. These findings suggest that the increase in ACAT activity in Mp is due, at least in part, to the difference in the fatty acid composition of the microsomes. PMID- 6847524 TI - Influence of exercise and life-style variables upon high density lipoprotein cholesterol after myocardial infarction. AB - Two groups of postcoronary patients (n = 35 and n = 27) were followed for 1 year. Group 1, recruited 2 to 3 months after infarction, showed a 9% gain of maximum oxygen intake in response to an average of 878 km of walking at speeds increasing to 6.9 km.hr-1. High density lipoprotein (HDL) cholesterol showed a statistically significant, but small, increase over the period of training. If expressed as a ratio to either low density lipoprotein or total cholesterol, the change was correlated with decreases of cigarette consumption, alcohol intake, and body mass, but was unrelated to speed or training distance. Group 2 patients trained an average of 50 to 80 km a week. In this group, HDL cholesterol correlated well with the weekly running distance, declining in those subjects who detrained, and increasing in those who intensified their training. We conclude that the dose of exercise necessary for inducing any substantial increase of HDL cholesterol is about 20 km.wk-1. PMID- 6847525 TI - Evaluation of tensor tympani muscle dominance in the biphasic acoustic reflex. AB - The Acoustic reflex frequently causes a biphasic change in impedance at onset. Understanding the cause of the biphasic response is important for establishing a physiological basis for the clinical measurement of reflex latency. The decrease in impedance at onset may be due to uncoupling of impedance contributed by the cochlea. Subsequent increases in impedance predominantly reflect stapedius muscle activity. The clinical implications of this physiologic model are discussed. PMID- 6847526 TI - Temporal characteristics of the acoustic reflex. AB - Temporal aspects of the acoustic reflex response were estimated for normally hearing subjects, subjects with noise-induced hearing loss and children with sensorineural hearing impairment. Onset latency and rise/fall times of admittance change were measured from the averaged responses (8 presentations) to tone bursts of 250 ms durations and 10 ms rise/fall time. Tone burst frequency was varied from 500 to 4 000 Hz. No differences between groups were observed for onset responses. Compared to the data from normally hearing subjects, the offset responses were slightly longer for subjects with noise-induced hearing loss and were considerably longer for hearing-impaired children. Due to the prolongation seen for noise-exposed subjects, it is difficult to interpret these data in terms of site of lesion. Still, the differences between hearing-impaired children and normal subjects suggest that acoustic reflex offset latency may be a useful screening device. PMID- 6847528 TI - Test-retest reliability of the acoustic stapedius reflex. AB - Acoustic reflex thresholds (ARTs) were determined at 0.5, 1, 2 and 4 kHz in 40 normal ears of college age subjects. Thresholds were redetermined at intervals of 3 min, 15 min and 1 week. Although statistical analysis revealed ARTs at 1 week to differ significantly from previously obtained values, this finding is not clinically significant as the greatest degree of variation was only 3.6 dB SL at 0.5 kHz. Furthermore, significant correlation coefficients at a particular frequency between times were obtained. The finding of a lack of correlation between frequencies serves to alert the audiologist to the potential error inherent to immittance screening programs which utilize reflex testing at one frequency only. The use of tympanometry and pure-tone testing in conjunction with reflexometry may reduce this potential error. PMID- 6847527 TI - Investigation of the frequency specificity of acoustic reflex facilitation. PMID- 6847529 TI - Evaluation of diagnostic audiometric tests. AB - Five diagnostic audiometric procedures - acoustic reflexes, performance-intensity functions for monosyllabic (phonetically balanced) words, Bekesy audiometry, Bekesy comfortable loudness audiometry and suprathreshold adaptation test - were critically evaluated by decision matrix analysis and information theory analysis. The subjects were 20 patients with surgically confirmed eighth nerve disorders and 20 patients with presumed cochlear disorders. Each patient completed all test procedures. In terms of decision matrix analysis, sensitivity (correct identification of eighth nerve site) ranged from 45 to 85%. Specificity (correct rejection of patients with cochlear site) ranged from 70 to 100%. Predictive value ranged from 74 to 100% for positive results and from 62 to 82% for negative results. The efficiency of the five tests ranged from 68 to 78%. In terms of information theory, positive test results increased the probability of eighth nerve disorder in any subject from 50% (a priori) to 74-100%. Negative test results decreased the probability of eighth nerve disorder from 50% to 18-38%. Relative differences among the diagnostic effectiveness of the five individual test procedures were not pronounced. However, the suprathreshold adaptation test (results confined to 500, 1 000 and 2 000 Hz) was less efficient than the other four diagnostic techniques. PMID- 6847530 TI - Influence of pre-voicing duration on dichotic performance. AB - When two speech messages are presented to normal subjects in a dichotic listening task, the stimuli presented to the right ear are generally reported first and more accurately than signals presented to the left ear. Although a normal Italian speaker produces approximately 100 ms of pre-voicing, we found that the maximum dichotic interference (shown by a slightly larger right-ear advantage and fewer double-correct trials) occurred for stimuli with 30-ms pre-voicing. These data indicate that the duration of pre-voicing is important for intelligibility of Italian stop consonants. PMID- 6847531 TI - Dichotic performance of Italian subjects tested with english and Italian stop consonant-vowel stimuli. AB - 15 normal-hearing, right-handed Italian subjects were tested dichotically with Italian and English stop consonant plus vowel combinations (CVs). The stimuli were modified on a computer-based routine so that the pre-voicing of Italian voiced CVs was 30 ms long. In this condition, a significant right-ear advantage and a consistent lag effect were observed with both Italian and English stimuli. In addition, no significant differences between the two types of stimuli (English and Italian) were observed in the dichotic performances (except when using the 90 ms lag, which resulted in a significant difference in performance). PMID- 6847532 TI - Comparison of auditory-evoked potentials and behavioral thresholds in the normal and noise-exposed chinchilla. AB - Auditory sensitivity was tested in three monaural chinchillas using standard techniques and the auditory-evoked potential technique (AEP). Hearing was measured at octave steps from 500 to 8000 Hz before, 1 day after, and 30 days after exposure to a simultaneous combination of 50 impulses (A duration = 30 microseconds) presented at a rate of of 1/min and at 158 dB pe SPL and continuous noise (1 h of 95 dB 2-4 kHz octave band of noise). The two independent assessments of auditory sensitivity showed good agreement and the results support the use of AEP testing in experimental animals. PMID- 6847533 TI - Early detection of hearing loss in infants by auditory nerve and brain stem responses. AB - Auditory-nerve and brain-stem-evoked responses (ABR) have been used alongside standard behavioral hearing tests for the early detection of hearing loss in infants and young children. Two comparisons are presented. The first concerns a group of 65 hearing-impaired children for whom we now have complete pure-tone and speech audiograms. There is a good correlation between the two types of hearing tests in 61 children; the lack of correlation in 4 children is discussed. The second comparison was conducted on neonates. Because ABR testing provides information which is far more accurate than behavioral testing, it is recommended for use in high-risk neonates, especially when mass behavioral screening is not feasible. PMID- 6847535 TI - Lateral differences in susceptibility to noise damage. AB - Usually equal noise exposure is considered to cause symmetrical hearing loss. In studying 1 461 audiometric records of claims for noise-induced hearing loss, it was found that 69 (4.7%) had a well-defined pattern of hearing loss in which only 2 kHz is asymmetrical by 20 dB or more. Audiograms of this type suggest that the cochlea of the worse ear has been damaged more extensively towards the apex. Of the 69 cases with a 2-kHz asymmetry, 82.6% had worse hearing thresholds in the left ear at 2 kHz. In 50% of the 69 cases, the asymmetry could not be accounted for even after the examination of their medical, occupational and nonoccupational histories. It is believed that the asymmetry at 2 kHz is a manifestation of a lateral difference in susceptibility to noise damage and that the left ear is the more susceptible one in the majority of cases. PMID- 6847534 TI - Sound localisation in children with a severe unilateral hearing loss. AB - The ability of 44 children with a severe unilateral sensorineural hearing loss to localise sound in the horizontal plane, has been compared with that of 40 subjects with normal hearing. It was found that the normally hearing group had no difficulty localising sounds in contrast to the majority of hearing-impaired children. None of the children with a hearing loss localised a 500-Hz pure tone as well as the normally hearing group, but 1 was able to localise a low-frequency noise stimulus and 9 a high-pass noise as accurately as those with normal hearing. Covering the pinna in 22 of the hearing-impaired children affected the ability of those who localised the high-pass noise normally more than the remainder of this group. This suggests that better use of pinna information was an important factor in their superior performance. PMID- 6847536 TI - Evaluation of an improved floor pen model for severe coccidiosis. AB - An improved model was evaluated for determining the efficacy of salinomycin (or other anticoccidials) against severe coccidiosis in floor-pen-reared broiler chickens. Broilers were isolated in wire-floored starting batteries until they were 14 days old, then placed in floor pens and exposed to Eimeria spp. from two sources: litter heavily contaminated with three to eight cycles of coccidia infected seeder birds, and feed contaminated with oocysts. This procedure resulted in an average mortality rate of 49.3% due to coccidiosis, and evidence of disease was present in all unmedicated birds examined. High lesion scores, depressed weight gains, and poor feed conversion were also observed. Salinomycin, 60 ppm, was efficacious against various mixed species infections in this model. PMID- 6847537 TI - Immunization of turkey breeder hens against fowl cholera by combined oral and wing-web administration of attenuated (CU) pasteurella multocida. AB - Turkey breeder candidates were exposed to attenuated Pasteurella multocida (Clemson University strain) via both mouth (one or three times) and wing-web stick (one or two times). Significant protection lasting to 25-30 weeks post vaccination was conferred under such immunization programs. The best protection with the fewest adverse effects of vaccination was established when orally vaccinated turkeys were subsequently vaccinated via wing-web at 20 and 25 weeks of age. High doses of attenuated P. multocida via wing-web produced lameness (synovitis and osteomyelitis) and severe wing lesions in growing turkeys. PMID- 6847538 TI - Studies on the pathogenesis of staphylococcal osteomyelitis in chickens. I. Effect of stress on experimentally induced osteomyelitis. AB - A single strain of Staphylococcus aureus was used to study the pathogenesis of osteomyelitis in chickens. The disease was consistently reproduced in 6-week-old broiler chickens when 1 X 10(5) or more organisms were given intravenously. Severe feed restriction, debeaking, and single or multiple injections of corticosteroids delayed the appearance and decreased the severity of lesions due to staphylococcal infection. This increased resistance was associated with increased numbers of circulating heterophils and monocytes. No correlation between the presence of tibial dyschondroplasia and osteomyelitis was found. PMID- 6847539 TI - Studies on the pathogenesis of staphylococcal osteomyelitis in chickens. II. Role of the respiratory tract as a route of infection. AB - Groups of 6-week-old broiler chickens were exposed to Staphylococcus aureus by aerosol, intratracheal or intravenous (control) inoculation. No lesions were produced by aerosol. A single dose of up to 5 X 10(10) organisms given intratracheally failed to produce any lesions. Single or repeated doses of 5 X 10(11) organisms given intratracheally resulted in osteomyelitis in a low proportion of chickens. PMID- 6847540 TI - Quantitation of cardiac gross morphology during the development of FZ-induced cardiomyopathy in turkey poults. AB - Furazolidone (FZ) at a dose of 700 ppm was fed to turkey poults 2-5 weeks posthatch. At 3, 4, and 5 weeks of age, seven poults each were sacrificed from control and FZ-fed groups. A section of ventricular tissue 1 mm thick was excised from the heart distal to the base at a level one-fourth of the distance between the base and apex. Parameters estimated from tracings of each section were area and circumference of both right and left ventricular lumen profile, area and circumference of entire heart profile, area of right ventricular free wall profile, area of left ventricular and septal wall profile, and area of entire heart muscle profile. A major finding was a sequential increase in the area of the ventricular lumina in the FZ-fed poults. Differences between the control and FZ-fed poults were statistically significant for the right lumen profile at 3 and 5 weeks of age and for the left lumen profile at 4 and 5 weeks of age. The area of the heart muscle profile was decreased in FZ-fed poults, but this difference was statistically significant only at 4 weeks of age. Data suggest that the pathogenesis of FZ-induced cardiomyopathy involves a dilation of ventricular lumina resulting in increased intraventricular blood volume and altered ECG patterns. Relationships between gross morphology and ECGs may be seen only in terminal cases of several weeks duration. This explains the inability to correlate ECGs with gross morphologic changes in all poults observed at necropsy. PMID- 6847541 TI - Scanning electron and light microscopy of selected avian strains of Mycoplasma iowae. AB - The morphology of six strains of Mycoplasma iowae was studied at various stages of growth by scanning electron and light microscopy. The six strains, which formerly represented avian mycoplasmal serotypes I, J, K, N, Q, and R, produced filaments and branching filaments, sometimes with centrally or terminally located bulbous swellings. During cell division, the filaments appeared to develop into chains of coccal, coccobacillary, and elongated cells. Mycoplasmas that appeared as chains of cocci under light microscopy were often observed as coccobacillary or fusiform when viewed with scanning electron microscopy. The morphology of single or paired cells of all strains included cocci, rods, coccobacilli, and pleomorphic forms. Fusiform and teardrop-shaped cells with bleb-like structures were also observed. Some cells of all strains deteriorated by the latter growth stages, forming clumps of flattened irregular-shaped cells, sometimes intertwined with fragmented filaments. The formation of filaments, branching filaments, and the other cell morphology indicated that the six strains of M. iowae were similar in morphology and growth characteristics. PMID- 6847543 TI - Characteristics and pathogenicity of two avian reoviruses isolated from chickens with leg problems. AB - Two reoviruses identified as 172 and 176 were isolated from the hock of 2-to-3 week-old broiler breeders exhibiting leg problems. Oral-ocular or intraplantar inoculation of day-old specific-pathogen-free or broiler chickens produced severe mortality (60-100%) within 2 to 6 days. The main lesions observed were tenosynovitis as well as necrosis and congestion of the liver, spleen, kidneys, and bursa of Fabricius. PMID- 6847542 TI - Effect of tiamulin administered by various methods and dosages on turkeys at different ages. AB - Healthy male turkeys not receiving monensin in their feed were treated with tiamulin by various methods and at different ages. Nine cycles of treatments were performed at the ages of 26, 40, 61, 89, 103, 117, 131, 145, and 160 days. Intramuscular of subcutaneous injections of 12.5 mg/kg tiamulin up to 145 days did not result in any signs of toxicity or impair growth rate. Administration at a dose of up to 25 mg/kg, using the drinking-water-deprivation technique, caused no effect in turkeys up to 160 days (marketing age). PMID- 6847545 TI - Foci of cartilage in the lung of broiler chickens. AB - Many small masses of cartilage, degenerating cartilage, and mineralized material were found on histologic examination of the lung of a broiler chicken that had severe tibiotarsal and tarsometatarsal dyschondroplasia. A small survey revealed that occasional masses of similar material could be found in the lungs of many normal broiler chickens. PMID- 6847544 TI - Soluble fractions of Pasteurella multocida: their protective qualities against fowl cholera in turkeys. AB - Soluble fractions of Pasteurella multocida strain P1059 were extracted from a single source by four methods, and their immunogenicity was evaluated by challenge exposure in turkeys. The fractions were extracted by 1) heating in 2.5% NaCl, 2) 0.5M potassium thiocyanate, 3) 1.0M sodium salicylate, and 4) prolonged stirring in formalin solution followed by pelleting (LPS-protein antigen). Eighty percent to 90% of infected turkeys were protected in two trials by vaccination with the saline extract or LPS-protein antigen, whereas less consistent protection was associated with the other two preparations. Endotoxin content was the highest in LPS-protein antigen, followed by KSCN, Na salicylate, and saline extract in that order. The four fractions contained at least one common antigen, which had previously been shown to be a surface-protective antigen. PMID- 6847546 TI - Effect of dietary protein deficiency on the performance of turkeys and chickens. AB - Two field occurrences of protein-deficiency disease were reported in turkeys and chickens. The disease caused unthriftiness, poor growth, and the exhibition of pica in flocks of 15-week-old pedigree large white turkeys, and it resulted in a sharp drop (18%) in egg production in a flock of 60-week-old white leghorn layers. In each case, the disease was cured by replacing the protein-deficient diet with a protein-sufficient one. PMID- 6847547 TI - Laboratory infection of house sparrows (Passer domesticus) with Mycoplasma gallisepticum and Mycoplasma synoviae. AB - House sparrows were infected by aerosol with Mycoplasma gallisepticum (MG) or M. synoviae (MS). MG was reisolated from 5 to 11 sparrows 10 days postinfection, but infection appeared to be temporary. Mycoplasma-free chickens reared in the experimental house became infected with MG during the trial. MS was recovered from only one sparrow. Serological tests were unsatisfactory for diagnosing infected birds. The results suggest that house sparrows may be temporary biological carriers of MG. PMID- 6847549 TI - Flubendazole: safety regarding egg production and reproductive performance of breeder chickens. AB - In a comparative field trial, 5,950 meat breeder chickens were medicated via feed for 7 consecutive days with 60 ppm of the anthelmintic flubendazole. This treatment cured the birds of an infection with Ascaridia galli and Capillaria obsignata. A slight but transitory diarrhea was observed in treated chickens. The applied medication did not unfavorably affect egg production, fertility, or hatchability. PMID- 6847548 TI - Amelioration of pale bird syndrome in chicks by vitamin E and selenium. AB - Vitamin E and/or selenium supplementation of a corn-soybean diet fed to broiler chicks in floor pens ameliorated the effect of an outbreak of pale bird syndrome diagnosed when the chicks were 3 weeks old. Supplementation significantly reduced both mortality and the effects of disease on body weight gain. The added nutrients only partly overcame the effect of the disease on body weight gain when infected chicks were compared with uninfected chicks. PMID- 6847550 TI - Parvovirus-like enteropathy in Missouri turkeys. AB - A viral enteric disease of young turkeys characterized by stunting of affected birds, diarrhea, and increased mortality is described. Eosinophilic intranuclear inclusion bodies were found in the absorptive epithelial cells of the ileum. Electron microscopy of formalin-fixed tissue revealed that the intestinal inclusions contained numerous loosely packed 15-to 20-nm hexagonal particles. The size, shape, and intranuclear location have been used to tentatively identify these particles as parvoviruses. PMID- 6847551 TI - Studies of histocompatibility and immune response of chickens selected for resistance and susceptibility to Marek's disease. AB - Two sets (four lines) of chickens, lines 7 and 6 and lines P and N, the former of each set susceptible and the latter resistant to Marek's disease, were examined for their relative histocompatibility and immunocompetence. Results from the in vivo graft-versus-host response splenomegaly assay, and graft-versus-host chorioallantoic membrane pock formation assay confirmed the within-line, B-locus homozygosity of chickens of lines 7, 6, and N and the heterozygosity of line-P chickens. These assays further confirmed that line-7 and line-6 chickens share identical alleles at the major histocompatibility locus. The capacity of the lines of chickens to elicit specific cell-mediated immune lysis as measured by the release of chromium 51 generally agreed with the in vivo graft-versus-host responses. These data demonstrate that the 51Cr-release assay is a reliable measure of histocompatibility within the avian system. PMID- 6847552 TI - Epizootiology of avian influenza--simultaneous monitoring of sentinel ducks and turkeys in Minnesota. AB - Isolation-reared mallards (Anas platyrhynchos) were placed on ponds in turkey rearing areas in Minnesota, and their cloacae were periodically swabbed to attempt isolating virus from embryonated chicken eggs. Nearby turkeys were sampled by taking cloacal and tracheal swabs as well as blood samples. Hemagglutinating viruses were identified at the National Veterinary Services Laboratory, U.S. Department of Agriculture, Ames, Iowa. During this two-year study, the weekly influenza virus-isolation rate from ducks varied from 0 to 24.4%. A total of 213 influenza viruses were isolated from the ducks. Twenty-six influenza virus subtypes were detected. Ninety-seven flocks of turkeys were diagnosed as having influenza by virus isolation and/or serology. Eight influenza virus subtypes were involved in the turkey outbreaks, and seven of these were also detected in the ducks and/or other avian species. The weekly infection rate of the sentinel ducks correlated directly with observations of wild ducks at the monitoring sites. Influenza virus was isolated from water samples collected near the sentinel duck sites during the study. PMID- 6847553 TI - Neoplasms identified in free-flying birds. AB - Nine neoplasms were identified in carcasses of free-flying wild birds received at the National Wildlife Health Laboratory; gross and microscopic descriptions are reported herein. The prevalence of neoplasia in captive and free-flying birds is discussed, and lesions in the present cases are compared with those previously described in mammals and birds. PMID- 6847554 TI - Neuropsychological functioning after prolonged high altitude exposure in mountaineering. AB - This prospective study examined the possibility of long lasting CNS sequelae of high altitude exposure in mountaineering. An extensive battery of neuropsychological and personality tests was given to 22 subjects before and after Himalayan climbs above 5334 m (17,500 ft). All subjects were at altitude for long periods without supplemental oxygen, but did not suffer other physical insults such as serious injury or food or water deprivation. Although several climbers experienced acute effects of mountain sickness while at altitude, their post-climb evaluations revealed no evidence of lasting cerebral dysfunction or psychological deficit. A few climbers' subjective ratings of mental functioning were worse after their expeditions, but these self-assessments were unsupported by their performances on the objective testing. It was concluded that in healthy people who do not suffer other physical insults as well, acute CNS effects of low oxygen tensions during high altitude climbs are reversible. PMID- 6847556 TI - Flight, flight duty, and rest times: a comparison between the regulations of different countries. AB - Flight time, flight duty limitations, and rest requirements are compared between the regulations from nine different countries. Twelve factors are identified which played a role in formulating restrictions and criteria. Duration of flight duty and crew augmentation are the factors considered by most countries; time of day, night flight, night sleep, and time zones are the factors least considered. Conformity exists in the necessity to prescribe maximum permissible flight or duty times and minimum rest requirements on a daily basis. Agreement was also observed in grading the standards according to more or less fatiguing conditions. Six out of nine regulations define night hours, but fail to agree upon beginning, end, and duration of night. All countries but one limit flying hours on a monthly and yearly basis, although the limits diverge. A brief outline of the German provisions is presented as an example for a compact and practicable regulation. PMID- 6847555 TI - Another function of the inner ear: facilitation of the emetic response to poisons. AB - If a foot were surgically removed and it was observed that walking was then impaired, it could be concluded that the foot is part of the normal mechanism for walking and that one of the physiological functions of the foot is to facilitate walking. In seven dogs, the vestibular apparatus of the inner ear was surgically removed and it was observed that the emetic response to certain poisons was impaired. It was concluded that the inner ear is part of the normal mechanism for vomiting in response to poisons, and that one of the physiological functions of the inner ear is to facilitate the emetic response to poisons. It seems likely that the mechanism, whereby the vestibular apparatus facilitates the emetic response to poisons, is the basis of motion sickness. In essence, motion sickness can be considered the result of activation, by motion, of a mechanism that normally functions to facilitate vomiting in response to poisons. PMID- 6847557 TI - Height, weight, percent body fat, and indices of adiposity for young men and women entering the U.S. Army. AB - The purpose of this investigation was to describe the height (H), weight (W), and percent body fat (%BF) of young men and women (ages 17-35 years) entering the U.S. Army and to determine an index of adiposity that fit criteria described in the literature. H and W were measured with a digital scale and anthropometer, respectively. %BF was calculated from four skinfolds thickness. Men and women were both separated into four age categories. Very little difference in H was found with increasing age. W and %BF increased progressively with age in the males but no increase in either parameter was seen within the three youngest age groups of women. For males, W/H2 was found to be the most appropriate index of adiposity of those studied, having a correlation with %BF of 0.75 and a standard error of estimate of +/- 3.4 %BF. W/H1.5 was the most appropriate index for females, having a correlation with %BF of 0.69 and a standard error of estimate of +/- 3.2 %BF. It was suggested that these indices could be used to replace or supplement the current H-W charts used in the Army. A table for predicting %BF from these indices has been provided. PMID- 6847558 TI - 100% oxygen breathing during acute heat stress: effect on sweat composition. AB - Twelve male Indian Air Force subjects were exposed on two occasions to a simulated hot environment (DB 57 degrees C; WB 35.5 degrees C; RH 25%) for a period of 50 min. On one occasion the subject breathed normal atmospheric air while on the other occasion he breathed 100% oxygen at ambient atmospheric pressure. Arm sweat collected at the end of the two experiments was analysed for Na+, K+, Mg++, C1-, and lactic acid. Arm sweat Mg++ was found to be much higher than that reported in the literature. Hyperoxia during heat stress improved arm sweating and showed significantly lower concentrations of Mg++, Na+, K+, and lactic acid. However, the total loss of these cations and lactic acid through the arm were not found to differ significantly for the two experiments. Based on arm sweat concentration, when the total body loss of these cations was worked out for the two runs, only whole-body Mg++ showed a significantly lesser loss during hyperoxia. The selective retention of Mg++ during the hyperoxic heat run and its association in lowering the heat-induced physiological strain are discussed. PMID- 6847559 TI - Medical standards for experimental human use in acceleration stress research. AB - Acceleration research is necessary to ensure optimum protection for individuals flying high performance fighter aircraft. Human volunteers exposed to high sustained +Gz stress must be carefully screened to assure that no one is at increased risk for G-induced trauma. Rigorous medical standards for qualifying research subjects must be established and followed. Careful documentation of G related symptoms and physiologic disturbances enhances the safety aspects of human experimentation. No severe or life-threatening incidents have occurred. A number of symptoms resulting from +Gz exposure have been documented with loss of consciousness being the most frequently documented symptom. The most frequent medical reason for disqualifying an individual volunteer from participation in the acceleration program was because of irregularities noted on spinal x-rays. The current medical standards and clinical diagnostic testing used to screen volunteer subjects at the USAF School of Aerospace Medicine are reviewed along with the symptoms which have resulted over a three year period of high sustained +Gz stress exposures. PMID- 6847560 TI - The measurement of risk indicators for coronary heart disease in air traffic control officers: a screening study in a healthy population. AB - We describe an attempt to improve the predictive value of the routine annual medical examination of Air Traffic Control Officers by extending its scope. In addition to the four well-recognised coronary heart disease risk indicators--age, smoking habit, family history of coronary heart disease, and systolic blood pressure--we measured plasma fibrinogen, serum total, and high-density lipoprotein cholesterol. Relative risk of coronary heart disease was assessed for each subject using a multiple logistic equation, and then compared with a large matched control. There were no statistical differences between the risk factors in the two groups. The factors measured do not support the view that air traffic control produces an increased risk of coronary heart disease, despite the alleged connection between stress and coronary heart disease. However, the gradient of risk within the air traffic control population should be evaluated in those at highest risk. PMID- 6847561 TI - Comparative study of hematological values of school children of both sexes at Dead Sea level and at Amman. AB - Total red blood cells, hematocrit values, and hemoglobin content of two paired groups of male and two paired groups of female students, aged 10-18 years, at Dead Sea level and at Amman were investigated to find the influence of barometric pressure and ambient temperature on hematological parameters. The tests took place in the winter months of November 1981-February 1982. Each group consisted of 150 subjects. The body weight, and height of these groups of male students ranged between 34.32 kg-63.11 kg, and 142.22 cm-172.36 cm respectively, in Amman; and 30.98 kg-56.55 kg, and 128-181 cm, at Dead Sea level. The same measurements for the groups of female students ranged between 33.60 kg-53.82 kg and 142.92 cm 158.89 cm in Amman, and 32.05 kg-54.60 kg and 141.87 cm-167.09 cm at Dead Sea level. Some of the hematological parameters of these two paired groups such as, body weight and RBC in boys of Amman, and Hb, RBC, PCV and MCHC in girls of Amman were found to be significantly higher than at Dead Sea level, but MCV was significantly higher at Dead Sea level in girls. The mean packed cell volume of male and female students at Amman and Dead Sea level were respectively-42.0, 41.7, 41.6, 40.18%. PMID- 6847562 TI - A statistical analysis of motion sickness incidence data. AB - This paper analyzes motion sickness data that has been obtained from experiments involving the Office of Naval Research motion generator. Based on the analysis, a mixture of two statistical populations has been postulated as an overall model of time to first emesis. Empirical evidence indicates that the subpopulation corresponding to early emesis is Weibull. PMID- 6847563 TI - Decompression sickness: USAF experience 1970-80. AB - During the period 1970-80, there were 58 cases of decompression sickness in one of its forms reported in USAF aircrewmen. These cases occurred in a number of different types of aircraft in which cabin/cockpit depressurization occurred either intentionally (because of operational requirements) or because of mechanical malfunction. The most common manifestation of decompression sickness was bends, although some airmen experienced various degrees of neurological dysfunction. Even though none of the aircraft was lost or damaged due to crew incapacitation, the threat was clearly there. The authors briefly review decompression sickness including prevention, treatment, and aeromedical disposition. PMID- 6847564 TI - Synergistic management: the task of the flight nurse. AB - In general, it is an accepted fact that the task of management is to design and maintain an environment for the effective and efficient performance of individuals working together in groups toward the accomplishment of preselected missions and objectives. The creation of a synergistic environment is considered as one conductive for meeting this goal of management. The barriers to creating such an atmosphere are many, but the benefits of such efforts are greater in terms of creating the climate for superior performance. According to Doctoroff, a synergistic organization is characterized by a sense of internal harmony which enables people to work with a feeling of fulfillment. It enables them to enjoy what they do, cope with change more easily, and expend less energy to achieve meaningful work. The key prerequisites for synergy are trust, effective communication, rapid feedback, and creativity. An analysis of how this concept may be useful to Aerovac Nursing will be explored. Aware of the contributions of support systems, the task of managing a successful client-provider environment rests with the medical crew director--the flight nurse. Establishing trust, controlling for random communication, and facilitating feedback are some of the facets of this task. With this framework in mind, alternatives to traditional methods of management become possible, for "new" ways are being sought to aid those in managerial positions in meeting the challenges of their roles. PMID- 6847565 TI - The controller, aviation medicine and air safety. AB - Aviation medicine has researched many important facts on pilots, but little on direct relationships between controllers, aviation medicine and air safety. The unsuspecting flying public accepts a 'blind faith' in aircraft and pilots, unaware that aircraft are controlled within 'suspect' ATC systems. The deceptive simplicity of controlling air traffic in apparently limitless skies belies the complexity of man-machine ATC systems operated in ever-crowded airspace, sometimes with antiquated equipment and indifferent communications. The indivisible operational controller/pilot team strives to meet similar ICAO medical standards and operate within the limitations of non-standardised recorded air traffic. Despite controllers' intensive stress at air disasters and 'almost' air disasters, air traffic must continually be controlled for air safety; but, countless human lives (and insurance dollars) saved are possibly camouflaged within the smoke screen of ATC. In New Zealand aviation, the Accident Compensation Corporation is statutorily responsible for air-safety, but accident investigators need controllers' expertise. Has a climate of complacency evolved towards air safety such that New Zealand's Erebus and other air disasters could have been avoided? Controllers are that crucial link in aviation with personal medical fitness vital to the air safety of the unsuspecting flying public. Controllers' dedicated aim for complete air safety in ATC shall benefit from greater understanding within aviation medicine and in-depth medical research. PMID- 6847566 TI - Motion sickness: acquisition and retention of adaptation effects compared in three motion environments. AB - A sharp distinction should be made between symptoms of motion-sickness per se and phenomena inferred from the symptomatology, which include rates of acquisition and decay of adaptation effects. Foreknowledge of these "derived phenomena" are valuable if it can be shown that they hold true for virtually any motion environment. Recently, we have developed a sudden-stop vestibulovisual interaction test for measuring susceptibility to motion sickness (1). The test procedure involves four successive assessments that provide not only an index of susceptibility to motion sickness but also the rates of acquisition and decay of adaptation effects. The 14 subjects participating in this test had previously served as subjects in parabolic flight experiments and seven of them had also taken part in the assessment of antimotion-sickness remedies in a slow rotation room. The present report examines whether their rates of acquisition and decay of adaptation to stressful motion represent consistent general features of their responses across motion environments. From these comparisons, it appears that an individual's rates of acquiring and losing adaptation are quite consistent in very different situations. The pattern of results also suggests modifications of the sudden-stop vestibulovisual test that should increase its effectiveness as a motion-sickness screening procedure, both for orbital flight and for terrestrial conditions. PMID- 6847567 TI - Space motion sickness: phenomenology, countermeasures, and mechanisms. AB - A summary of the incidence of Space Motion Sickness (SMS) in 27 Soviet cosmonauts who flew on missions varying from 2-185 d in the Salyut-6/Soyuz vehicle complex is presented. A questionnaire indicated that 88% (24) of the cosmonauts developed some type of "illusionary sensations" while 44% (12) presented some degree of SMS. The SMS countermeasures used in flight included an antihistaminic drug, pneumatic cuffs applied to the thigh region, application of lower body negative pressure, a head cap that restricted head movement while simultaneously providing force stimulus to the cervical antigravity muscles, and finally the use of an insole counterpressure device that added pressure to the sole of the foot. PMID- 6847568 TI - Correction of changes in fluid-electrolyte metabolism in manned space flights. AB - In order to prevent and correct hypohydration and negative electrolyte balance, the effects of exercises, lower body negative pressure (LBNP) and water-salt supplements (WSS) were investigated in more than 100 test subjects during 14-, 49 and 182-d headdown tilt tests (-4 degrees). A combined use of WSS and LBNP during regular exercises led to a distinct water and sodium retention. These changes were mainly determined by the stimulation of the renin-angiotension aldosterone and antidiuretic systems. After these countermeasures were tested in simulation studies, they were used by 12 cosmonauts during the 63- and 185-d space flights. The detailed analysis of the postflight examinations of the crewmembers suggests that these countermeasures may exert a beneficial effect on fluid-electrolyte balance. PMID- 6847570 TI - Cardiac function monitored by impedance cardiography during changing seatback angles and anti-G suit inflation. AB - Impedance cardiography (IC) appears to be a promising noninvasive technique for monitoring small changes in pilot cardiovascular status during conditions simulating flight. Heart rate (HR), stroke volume (SV), cardiac output (CO), ventricular ejection time (VET), and thoracic impedance (Zo) were monitored in ten volunteers for 5 min at each of four seatback angles from vertical: 12 degrees, 30 degrees, 45 degrees, and 60 degrees. Data were also obtained at three seatback angles (12 degrees, 30 degrees, 60 degrees) for 6 min each before, during, and after inflation of the standard USAF anti-G suit to 1.5 psi. Significant differences (p less than 0.05) in HR, SV, CO, VET and Zo were observed among the four positions. Inflation of the standard anti-G suit to 1.5 psi at 1.0 +Gz did not significantly alter HR, SV, or CO; whereas, 1 min of deflation of the anti-G suit significantly altered HR, SV, CO compared to inflation values. The results suggest IC can detect small differences in HR, SV, CO, VET, and Zo within subjects as a function of minor changes in body position. PMID- 6847569 TI - Effects of partial anti-G suit inflation on thoracic volume and breathing pattern. AB - The purpose of this study was to determine the changes in thoracic volume and pattern of breathing during partial anti-G suit (PAGS) inflation by respiratory inductive plethysmography (RIP). Nine normal subjects donned the PAGS, with bladders over legs and thighs, and rested for about 10 min in 60 degrees head-up tilt position. The subjects breathed with closed glottis at functional residual capacity while PAGS was suddenly inflated to 140 mmHg using a calves to thighs sequence. The increase in thoracic volume, as measured from deflection of RIP baseline was 252 ml (S.D. 43 ml), which reflected displacement of blood from the lower extremities into the thorax. On resuming normal breathing, thoracic volume returned to baseline level. Breathing pattern was then monitored for a 15 min baseline period, PAGS was inflated, expiratory reserve volume (ERV) was measured by spirometry, and breathing pattern was monitored another 15 min. ERV decreased 227 ml (+/- 60) after PAGS inflation, which did not differ from the change in thoracic volume expected from displacement of blood into the thorax. Breathing pattern was monitored for another 15 min after PAGS was deflated. No changes took place in minute ventilation, tidal volume, frequency, inspiratory time, fractional inspiratory time, and mean inspiratory flow from deflation to PAGS inflation. Thus, 1) increase in thoracic volume produced by displacement of blood from the calves and thighs is balanced by a decrease in gas volume and, 2) no changes in breathing pattern occur after partial anti-G suit inflation, probably because the pulmonary blood vessels and heart are sufficiently distensible to accept a 250 ml volume increment without leakage of fluid into pulmonary tissues. PMID- 6847571 TI - Combining techniques to enhance protection against high sustained accelerative forces. AB - Five volunteer subjects were tested for acceleration tolerance under eight different experimental conditions representing relaxed and unprotected tolerance and tolerance with all possible combinations of the Anti-G suit, the M-1 maneuver, and supination in a PALE seat. The individual and combined effects of the various acceleration protective techniques were examined as they related to various models for acceleration protection, and the data revealed no statistically significant deviations from a simple additive model. The apparent net additivity was interpreted as resulting from a combination of additive, synergistic, and overlapping mechanisms. PMID- 6847572 TI - Peripheral circular contours inhibit the visual orientation control system. AB - Peripheral visual stimulation with a tilted luminous frame has long been known to influence both body orientation and the apparent tilt of objects. Peripheral visual inputs along with vestibular and somaesthetic components thus constitute a multi-channel perceptual orientation control system. Surrounding the visual induction pattern with a luminous circle reduced the effectiveness of the visual channel to about 23% of maximum, whereas inscribing a circle within the luminous frame was without effect. This finding suggests a simple method for dealing with undesirable visual-vestibular interactions and an explanation for some instances of disorientation. PMID- 6847573 TI - Hemorrhagic tolerance of rats at sea level after acute exposure to high altitude. AB - Exposure of rats to a simulated altitude of 5,000 m for 1 and 3 d caused increases in hematocrit (Hct) and in hemoglobin (Hb) concentration and a decrease in total plasma volume (TPV) in comparison with sea level control animals. Total blood volume (TBV) was decreased after 1 d of exposure to altitude but returned to normal in 3 d of altitude exposure. The sea level hemorrhagic tolerance was measured in all animal groups by determining the bleeding volume which resulted in death following cannulation under anesthesia. This was recorded as a bleeding volume index (BVI), the total volume of blood lost per 100 g of body weight. The mean BVI decreased in 1-d altitude rats, but not in 3-d altitude rats. Changes in mean arterial blood pressure and Hct during bleeding were recorded. The decreased hemorrhagic tolerance was suggested to be due in part to a decreased TBV and to a loss in arterial blood pressure (BP) regulatory capability after severe hemorrhage. The results of the present study for acutely altitude-exposed rats are opposite to those of a previous study for chronically altitude-exposed rats in which BVI, TBV, and the ability for arterial BP regulation were increased. PMID- 6847574 TI - General aviation accident rates and pilot community population size: an examination of rural-urban differences. AB - Most investigations of general aviation accidents involving human factors have emphasized biomedical and psychological concerns, with comparatively few contributions from other disciplines. This study derives from a social science orientation and investigates the relationship between general aviation accident rates and the population size of the involved pilots' communities of residence. After excluding agricultural, air taxi, and commercial helicopter operations, an analysis of 48 Colorado communities reporting at least one 1978 accident-involved pilot revealed a correlation of -0.51 between accident rate per 1,000 pilots and community size. The smallest, and generally most rural, communities produced total and fatal accident rates of respectively 2.55 and 5.36 times greater than those for the largest metropolitan areas. A similar trend characterizes U.S. nationwide general aviation accidents and appears as well for automobile mishaps, thus lending additional support to the present findings. Discriminant analysis of individual-level data for 92 of the accidents revealed that the conventional explanations of airport facilities, terrain, pilot qualifications and exposure, and aircraft complexity failed to exert substantial effects on differences among the categories of accidents grouped by community size. Two alternate explanations are offered which speculate that: 1) the rural-urban accident differential may represent a function of variations in "pilot density," and 2) the observed differences may be attributed to attitudinal differences between rural and urban pilots produced by the former group's exposure to a type of "rural subculture." PMID- 6847575 TI - Hypoxia: USAF experience 1970-1980. AB - During 1970-80, 298 USAF aircrewmen were reported as having experienced in-flight hypoxia. Although none of the incidents resulted in an aircraft accident, the potential was there in that many of the reported symptoms were incapacitating to some degree. Most often, the cause of the hypoxia incident was due to cockpit/cabin depressurization or some other malfunction of the oxygen system. However, it was sometimes due to poor oxygen discipline. The authors emphasize that, with a thorough preflight inspection of the mask, hose, and connections as well as a PRICE check, the risk of in-flight hypoxia would be significantly reduced. PMID- 6847576 TI - The 17th Annual Harry G. Armstrong Lecture. Cannabis: the plant, its drugs, and their effects. AB - Marijuana is not a plant. It is a crude drug made from the Cannabis plant. Many other crude drugs are also made from this plant. Their chemical composition varies with the plant parts used in producing the particular drug. This paper describes the chemical composition of Cannabis, the uses to which these chemicals are put in the manufacture of crude drugs, and the effects of these drugs. PMID- 6847577 TI - Expectations of nursing--shared or divergent? AB - The word interpersonal refers to personal or social relations out of which systems of shared expectations develop. This paper addresses nurses' readiness to meet the challenges of the 80's, from the interpersonal perspective of shared expectations, both among nurses and between nursing and society. The author proposes that nurses' expectations are divergent rather than shared and focuses on historical and current concerns which have led to the divergent expectations. PMID- 6847578 TI - A new method for continuous measuring of respiratory quotient in a computer assisted working heart preparation. AB - A method was developed for continuous monitoring of the respiratory quotient (RQ) and the ratio of O2-consumption to O2-demand (EQ) in an isolated working rat heart preparation. The RQ allows to get informations about substrates actually oxidized in the myocardium. The EQ is a parameter which behaves reciprocally to the ATP/O of the oxidized substrates during steady state and additionally it allows monitoring of a transitory oxygen debt. For registration of RQ the arterio venous O2-difference and the CO2-release are measured. As the CO2-production is very small compared with arterial CO2- and HCO-3 -concentrations when using a bicarbonate buffer for perfusion, a bicarbonate-free perfusion-fluid is used. In a portion of coronary effluent the pH is lowered to shift the CO2/HCO-3 equilibrium to the side of dissolved CO2. Then the pCO2 is measured with a CO2 Nelectrode. Additionally, ventricular pressure, cardiac input and coronary flow are continuously registrated. All data are fed via an AD-converter into an LSI 11 computer. Heart rate, maximum ventricular pressure, dP/dtmax, oxygen demand after Bretschneider's formula, RQ and EQ are calculated. The advantages of the system described are demonstrated with two examples. PMID- 6847579 TI - The effect of Oxfenicine on cardiac carbohydrate metabolism in intact dogs. AB - Measurement of cardiac glucose oxidation (as a percentage of CO2 production) was made using the technique of infusion of 14C-D-glucose, together with measurement of 14CO2 and total CO2 produced by the myocardium. The measurements were made in 16 dogs under chloralose anaesthesia, before and after an i.v. injection of S-4 hydroxyphenylglycine (16.7 mg X kg-1, Oxfenicine: Pfizer). In one group of dogs circulating free-fatty-acid (FFA) levels were raised by infusion of intralipid heparin; in the other, circulating lactate was increased by infusion of 5 MNa lactate (pH 7.0). In the last group of dogs the action of the drug was studied in cardiac denervated dogs. In the dogs with normal circulating substrate levels, Oxfenicine increased the glucose oxidation from 17.3 to 39.9% of total substrate oxidized. This was also the case in those dogs with high circulating FFA (9.0 to 32.3%). However, in dogs with high circulating lactate (over 5.0 mmol X l-1) the oxidation of glucose was relatively unaffected (2.0 to 7.1%). In cardiac denervated dogs, with a known inhibition of glycolysis, Oxfenicine increased glucose oxidation from 4.8 to 23.5%. These results show that Oxfenicine is able to switch the heart from the oxidation of fat to glucose or lactate as fuel. PMID- 6847580 TI - Echographic method for the estimation of cardiac output from mitral-valve area, heart rate, and diastolic-filling period in conditions of mitral stenosis: correlation with cardiac catheterization. AB - An orifice equation for the non-invasive measurement of mitral-valve area is demonstrated. It is shown that by combining this expression with the assumption of mitral-valve area invariance an orifice equation for the non-invasive assessment of cardiac output in conditions of mitral stenosis using simple echographically measureable variables can be developed. This equation is V = (21) 1 R X A X T2, where V = cardiac output in ml, R = heart frequency, A = mitral valve area in cm2 and T = diastolic-filling period in sec X min-1. These results suggest that when mitral-valve area is accurately measured at one point in time, cardiac output may be measured at subsequent times at a clinically useful level from a knowledge of the echographically measurable variables of heart rate and diastolic-filling period. PMID- 6847582 TI - The influence of potassium depletion on cardiac growth response to pressure overload. AB - Previous studies have reported that potassium depletion arrests both body and heart growth, and that aortic ligation can induce myocardial potassium loss. To examine the effects of potassium depletion on the cardiac growth response to an increase in pressure load, we induced severe potassium depletion in rats by dietary means for 3 weeks and then subjected them to aortic ligation. 3 weeks following ligation and after a total of 6 weeks of continued potassium deprivation, the animals were sacrificed. Our results show that after aortic ligation the left ventricular weight in potassium depleted rats significantly increased by an average of 155 mg, a value which was somewhat less than the 208 mg increase observed in normokalemic animals. The presence of focal myocardial necrosis in hypokalemic rats, accordingly, did not appear to prevent the increase in ventricular mass induced by augmented pressure load. Furthermore, despite marked reduction in skeletal muscle potassium content there was no decrease in the myocardial potassium content even after aortic ligation. We conclude that profound dietary potassium depletion for a prolonged period of 6 weeks does not impede the cardiac growth response to an increase in pressure load. PMID- 6847581 TI - The myocardium and its pathological state during the perinatal period and infancy. PMID- 6847583 TI - Contractile performance, mitochondrial function and blood flow distribution in porcine heart with induced coronary collateral circulation. AB - Progressive stenosis of the proximal left anterior descending coronary artery in young pigs was surgically induced over eight weeks and was accompanied by the development of a coronary collateral circulation originating from the right coronary artery. The antero-apical left ventricular myocardium dependent on this induced collateral blood supply became hypokinetic compared with the other regions of the left ventricle in the same hearts, and compared with the same region in different hearts, where the native circulation exists. Regional myocardial mechanics determined as fractional systolic shortening was 12.5 +/- 1.5% in normal regions, 0.7 +/- 2.4% in collateral-dependent myocardium, and in acutely ischemic myocardium was -2.0 +/- 1.3%, indicative of systolic lengthening. The rate of state 3 respiration of isolated mitochondria was depressed by 20% in collateral regions and by 64% in acutely ischemic regions relative to values obtained in mitochondria from respective normal myocardium (300 natoms of oxygen/min/mg mitochondria protein). Regional myocardial blood flow determined by 15 mu radionuclide labelled spheres revealed subendocardial hypoperfusion of 0.34 +/- 0.11 ml/min/g tissue in the collateral-dependent regions compared to 1.06 +/- 0.26 ml/min/g tissue in the normal regions. Transmural ischemia was observed (less than 0.10 ml/min/g tissue) in regions subjected to acute coronary artery ligation. Light microscopy revealed patchy fibrotic lesions predominately associated with the subendocardial half of the collateral dependent myocardial wall. Accordingly, the hypokinesia of collateral dependent myocardium is more likely the result of blood flow abnormalities and loss of contractile elements than from mitochondrial dysfunction. PMID- 6847584 TI - Measurement of left ventricular hemodynamic parameters in closed-chest rats under control and various pathophysiologic conditions. AB - A prototype of a recently developed mikro-tip pressure transducer catheter (3 French) was inserted into the left ventricle of closed-chest rats via the right carotid artery. In thiobutabarbital-sodium anesthesia, heart rate (409 +/- 7 beats/min), left ventricular systolic pressure (LVSP: 142 +/- 4 mm Hg) and the maximal rate of rise of left ventricular pressure (LV dP/dtmax: 6073 +/- 187 mm Hg/sec, mean values +/- SEM, n = 19) were measured. The baroreceptor reflex was intact under these experimental conditions. In closed-chest guinea pigs, all functional parameters determined were lower (heart rate: 271 +/- 11 beats/min; LVSP: 94 +/- 6 mm Hg; LV dP/dtmax: 3248 +/- 295 mm Hg/sec, mean values +/- SEM, n = 9). To test the applicability of the new catheter tip manometer, cardiac hemodynamic parameters were determined in rats under various pathophysiologic conditions: Several periods of asphyxia were followed by progressive depressions in heart rate, LVSP and LV dP/dtmax, and acute as well as chronic stimulation with catecholamines (noradrenaline and isoproterenol) and with triiodothyronine was characterized by a pronounced positive inotropic and chronotropic effect. The technique described has many potential applications in cardiovascular studies on intact small laboratory animals. PMID- 6847585 TI - The effect of chemical damage to the renal medulla on its antihypertensive function. PMID- 6847586 TI - Effects of acute vagally-mediated bradycardia on systemic hemodynamics and coronary blood flow before and after coronary stenosis. AB - The effects of short episodes (1 min) of vagally-mediated bradycardia were studied in 9 anesthetized dogs utilizing vagal stimulation and slow atrial pacing (120 and 80 beats/min) before and after graded coronary constriction of the left anterior descending (LAD) and the left circumflex (CCA). In the presence of 90% LAD stenosis, bradycardia tended to restore both the elevated total LAD coronary vascular resistance (CVR-LAD) and the reduced, total CVR-CCA towards control levels obtained at corresponding slow rates in the absence of coronary stenosis; as a result, LAD coronary flow (F-LAD) was relatively less reduced and the accessory rise of F-CCA disappeared. In the presence of combination of 90% LAD plus 70% CCA stenosis, the effects of bradycardia on total CVR-LAD and F-LAD were similar to those obtained with single 90% LAD stenosis, but the accessory flow through the CCA was abolished resulting in no significant difference of the rate dependent alterations of total CVR-CCA and F-CCA as compared with those observed in the absence of coronary stenosis. In the presence of single or combined coronary stenosis, bradycardia restored the depressed aortic pressure and cardiac output towards control values obtained at comparable slow rates before coronary stenosis. The results support the concept that in the presence of 90% LAD stenosis vagally-mediated bradycardia 1) decreases the tension-time index (myocardial nutritional demand) shifting cardiac performance to less expensive "flow work" and 2) facilitates antegrade flow through the highly stenotic LAD thereby inhibiting accessory flow through the nonstenotic CCA. PMID- 6847588 TI - [Vertebral rotation in scoliosis--a pathologico-anatomic study]. PMID- 6847589 TI - [Pathogenesis and therapy of recurring shoulder dislocation]. PMID- 6847587 TI - Effect of brief periods of paced ventricular tachycardia on coronary blood flow in dogs before and after graded coronary stenosis. AB - The effect of short bouts (1 min) of electrically induced ventricular tachycardias (VT) of increasing rates (160-240/min) was studied in 8 anesthetized dogs before and after graded constrictions of the left anterior descending (LAD) and the circumflex (CCA) coronary arteries. In the absence of coronary stenosis, paroxysmal VT caused a significant decrease in tension-time index (TTI), coronary blood flow (CBF) and coronary vascular resistance (CVR). Single and combined coronary stenosis caused relatively small alterations of the VT-induced depression of the systemic hemodynamics but reversed the effect of paroxysmal VT on the CVR. In the presence of single 90% LAD stenosis, VT resulted in an increase in CVR-LAD and a decrease in F-LAD associated with a fall in CVR-CCA and a rise in F-CCA. Combination of 90% LAD plus 70% CCA stenosis abolished the compensatory fall of CVR-CCA resulting in a pronounced reduction of F-CCA during VT. The results support the concept that in the presence of severe coronary stenosis brief paroxysmal ventricular tachycardias do increase myocardial nutritional demand but rather decrease nutritional supply. PMID- 6847590 TI - [Bruckner's fixation operation in recurring and habitual shoulder dislocation]. PMID- 6847591 TI - [Operative treatment of the post-traumatic condition of the end of the proximal femur]. PMID- 6847592 TI - [Para-spinal anesthesia procedures in orthopedics]. PMID- 6847593 TI - [Occurrence of Campylobacter jejuni in cats]. PMID- 6847594 TI - [Pain and pain control in veterinary medicine]. PMID- 6847595 TI - [Splenectomy in the horse]. PMID- 6847596 TI - [Behavior of blood pressure, heart rate, hematocrit and serum protein concentration during hyperinfusion therapy in chronic obstructive bronchitis]. PMID- 6847597 TI - [Physiopathology of Rhipicephalus evertsi evertsi Neumann, 1897, induced tick paralysis of sheep]. PMID- 6847598 TI - [Occurrence of Campylobacter species in swine. I. Cultural studies of the feces, intestinal contents and gallbladder as well as experimental infections]. PMID- 6847599 TI - [Comparative histometrical and histological studies of skeletal muscles in wild and domestic swine]. PMID- 6847600 TI - [Control of blackflies (Simulidae, Diptera) on cattle in Central Europe. Prerequisites, problems, methods]. PMID- 6847601 TI - Problems of the Keimbahn. New work on mammalian germ cell lineage. PMID- 6847602 TI - Primordial germ cells in mice. PMID- 6847603 TI - Oogenesis in cattle and sheep. PMID- 6847604 TI - Germ cell migration induced and guided by somatic cell interaction. PMID- 6847605 TI - Nomenclature Committee of IUB (NC-IUB) and IUB-IUPAC Joint Commission on Biochemical Nomenclature (JCBN): Newsletter 1983. PMID- 6847606 TI - Heterogeneity of rat goblet-cell mucin before and after reduction. AB - Goblet-cell mucin of rat small intestine was purified from mucosal scrapings by using centrifugation, Sepharose 4B and Sepharose 2B chromatography. The mucin was applied in low concentrations (1 microgram/track) to slab gels containing 0.5% agarose/2% (w/v) polyacrylamide, and bands were detected after electrophoresis by silver stain or by fluorography of 3H-labelled mucin. Before reduction the mucin contained three distinct components: a polymeric species at the top of the gel and two large glycoproteins of higher mobility. After reduction, the polymer disappeared, the two glycoproteins remained unchanged, and two glycopeptide bands of higher mobility appeared. In addition, a non-glycosylated, heavily stained peptide of mol.wt. 118000 was detected. The individual mucin components were partially separated on Sepharose 2B, 0.2M-NaCl/1% sodium dodecyl sulphate being used as eluant. Individual amino acid and carbohydrate analyses suggested that the glycosylated components, despite their differences in size, had identical profiles. The 118000-mol.wt. peptide had a very different amino acid profile, with much less serine, threonine and proline. Glycine and aspartic and glutamic acids comprised 34% of the total amino acids. Thus the 'native' mucin is a heterogeneous structure containing at least two non-covalently associated glycoproteins plus polymeric material. The latter is stabilized by disulphide bonds and consists of several glycopeptides of different size as well as a 'link' peptide of mol.wt. 118000. PMID- 6847607 TI - Relations between high-affinity binding sites for L-tryptophan, diazepam, salicylate and Phenol Red on human serum albumin. AB - Binding of L-tryptophan, diazepam, salicylate and Phenol Red to defatted human serum albumin was studied by ultrafiltration at pH 7.0. All ligands bind to one high-affinity binding site with association constants of the order of 10(4) 10(5)M-1. The number of secondary binding sites was found to vary from zero to five, with association constants about 10(3)M-1. Competitive binding studies with different pairs of the ligands were performed. Binding of both ligands was determined simultaneously. L-Tryptophan and diazepam were found to compete for a common high-affinity binding site on albumin. The following combinations of ligands do not bind competitively to albumin: L-tryptophan-Phenol Red, L tryptophan-salicylate and Phenol Red-salicylate. On the other hand, high-affinity bindings of the three ligands do not take place independently but in such a way that binding of one of the ligands results in a decrease in binding of the other ligands. The decreases in binding are reciprocal and can be accounted for by introducing a coupling constant. The magnitude of the constant is dependent on the ligands being bound. In the present study, the mutual decrease in binding was more pronounced with L-tryptophan-salicylate and Phenol Red-salicylate than with L-tryptophan-Phenol Red. PMID- 6847608 TI - Hydrophobic chromatography of proteins in urea solutions. The separation of apoproteins from a lipoprotein of avian egg yolk. AB - A method is described for the chromatographic separation of mixtures of egg-yolk proteins of low solubility by using a hydrophobic column (phenyl-Sepharose) and eluting with increasing concentrations of aqueous urea at low pH. The resolving power of the method was established by tests on proteins and protein fragments of known sequence. The theoretical basis for the method remains, however, unclear. Factors such as the aggregation of the protein often appeared to be more important than its hydrophobicity in determining the urea concentration needed for elution. The method was applied to the mixture of apoproteins from the low density lipoprotein (density about 0.95 g/ml) of avian egg yolk. For the previously studied apoproteins from egg yolk of the hen (Gallus domesticus), hydrophobic chromatography provided a new and convenient method for isolating the main apoproteins (hen apovitellenins I-VI). For the hitherto unexplored apoproteins from egg yolk of the duck (Anas platyrhynchos) the method has now been used to isolate three new proteins, two of which were not readily separated by methods based on molecular size. The elution pattern obtained with duck egg yolk apoproteins is not the same as that of the hen egg-yolk apoproteins, although we suggest a relationship for the three new apoproteins based on their amino acid compositions and other properties. Possible roles for the apoproteins in avian egg yolk are described. PMID- 6847609 TI - The alpha particulate liver glycogen. A morphometric approach to the kinetics of its synthesis and degradation. AB - Electron micrographs of rat hepatocytes with a glycogen content between 0.36 and 2.55% (w/w) were submitted to morphometrical analysis. From the number and size of glycogen profiles, the distribution of radius and volume of glycogen alpha particles were computed. The 7-fold difference in glycogen content was accompanied by an only 1.8-fold increase in the mean volume of the particles while their number increased by a factor of 4. On the basis of these observations, it is proposed that the population of glycogen particles can be divided in two groups. The first one is made of growing particles, still associated with glycogen synthase; they are the only particles present at low glycogen concentration and their number is limited. Application of a simple mathematical model allows to estimate their number in hepatocytes as 49 X 10(12) particles . ml-1. The second group is made of glycogen particles which have reached their maximal size and the number of which is in principle unlimited. The maximal particle size is estimated to be 0.36 X 10(-15) ml, corresponding to an average molecular weight of 178 X 10(6). The average molecular weight of glycogen, as measured from the actual size of the particles, varied from 89 X 10(6) to 161 X 10(6). PMID- 6847610 TI - The enzyme-activated irreversible inhibition of type-B monoamine oxidase by 3-(4 [(3-chlorophenyl)methoxy]phenyl)-5-[(methylamino) methyl]-2-oxazolidinone methanesulphonate (compound MD 780236) and the enzyme-catalysed oxidation of this compound as competing reactions. AB - 3-(4-[(3-Chlorophenyl)methoxy]phenyl)-5-[(methylamino)methyl]-2- oxazolidinone methanesulphonate (compound MD 780236) is a selective inhibitor of the B-form of monoamine oxidase. Inhibition involves an initial non-covalent interaction between enzyme and inhibitor followed by a time-dependent process resulting in irreversible inhibition. The initial, reversible, phase of inhibition was found to be competitive with respect to phenethylamine and 5-hydroxytryptamine, and a comparison of the Ki values indicated the affinity of the inhibitor for the B form of the enzyme to be some 7-fold greater than its affinity for the A-form. This selectivity was considerably enhanced by preincubation of the enzyme and inhibitor. Time courses showed that complete inhibition was not achieved under conditions where the inhibitor concentration was over 100-fold greater than that of the enzyme. Assay of the activity of monoamine oxidase by determining the release of hydrogen peroxide fluorometrically showed compound MD 780236 to be a substrate for, as well as an inhibitor of, monoamine oxidase, and kinetic analysis revealed that the rate of product formation was some 530-fold greater than that of the process leading to irreversible inhibition of the B-form of the enzyme. PMID- 6847611 TI - An investigation of the properties of ornithine aminotransferase after inactivation by the 'suicide' inhibitor aminohexynoate and use of the compound as a probe of intracellullar protein turnover. AB - Ornithine aminotransferase is shown to bind 1 mol of amino[14C]hexynoate per mol of coenzyme in the 'suicide' inactivation process. At the same time the coenzyme pyridoxal phosphate becomes irreversibly bound to the enzyme protein. Apart from the inactivation, the labelled enzyme is indistinguishable from native ornithine aminotransferase by several separation techniques. Because the rate of degradation of the labelled enzyme is the same as that of the normal enzyme it is concluded that loss of coenzyme does not initiate turnover. Free aminohexynoate is rapidly eliminated from the liver, and 70% of the compound is excreted unchanged in 7.5 h. Inactivated ornithine aminotransferase accounts for 11% of the total labelled liver protein and significant amounts of label are found in aspartate aminotransferase which is also extensively inactivated. The rate of return of enzyme activity is determined and found to be more rapid than expected for a process in which the enzyme is synthesized at a constant rate and degraded in a single, first-order process. PMID- 6847612 TI - A simple assay to study protein-mediated lipid exchange by fluorescence polarization. AB - We investigated the protein-mediated phospholipid transfer between small vesicles by fluorescence polarization measurements with diphenylhexatriene as optical probe. Thermotropic-phase-transition curves were taken after mixing two vesicle preparations of lipids exhibiting different gel-to-liquid phase transitions. From the heights of each phase-transition step we were able to follow the lipid transfer process without separating the two vesicle preparations. PMID- 6847613 TI - Carbohydrate is linked through ethanolamine to the C-terminal amino acid of Trypanosoma brucei variant surface glycoprotein. AB - The C-terminal amino acid of the variant surface glycoprotein from Trypanosoma brucei is glycosylated. For two variant proteins that terminate in an aspartic acid and a serine residue respectively, it was shown that the sugar side chain is linked through ethanolamine to the alpha-carboxy group of the amino acid. PMID- 6847614 TI - An Ehrlich chromogen in collagen cross-links. AB - A well-characterized three-chain peptide [(Col1)2 X T9] from human type III collagen was a rich source of Ehrlich chromogen. The corresponding two-chain peptide [(Col1)2] was not, implying that the Ehrlich chromogen is a trifunctional cross-link. (Col1)2 X T9 also contained pyridinoline, which is not an Ehrlich chromogen. The 7S domain of type IV collagen also contained an Ehrlich chromogen. PMID- 6847615 TI - Ca2+-dependent high-affinity complex formation between calmodulin and melittin. AB - The amphiphatic polypeptide melittin migrates as an equimolar complex with bovine brain calmodulin when monitored by gel disc electrophoresis or gel filtration in the presence of Ca2+, even in 4M-urea. The complex disassociates in the presence of EDTA and urea. The affinity is of the same order as that of calmodulin for its target enzymes, and more than 1000-fold higher than that of calmodulin for basic peptide hormones or hydrophobic drugs. The activation of brain phosphodiesterase by calmodulin is inhibited by melittin. The kinetics of inhibition suggest competition between the enzyme and melittin for calmodulin. The calmodulin melittin interaction may constitute a model for that existing between calmodulin and its target enzymes. PMID- 6847616 TI - Errors in the evaluation of Arrhenius and van't Hoff plots. AB - Errors in the numerical values of activation or normal enthalpies, entropies and free enthalpies calculated from Arrhenius or van't Hoff plots, respectively, are due to the neglect of equidimensionality in equations, or to inappropriate approximations. The logarithmization of dimensioned quantities should be avoided, which demands the use of relative concentrations if a change in mole number occurs in the reaction. The application of the Arrhenius plot to enzymic reactions by using Vmax./ET instead of the rate constant of product formation has meaning only if the reaction follows the simplest Michaelis-Menten mechanism; however, the use of the van't Hoff plot using Km is questionable even in the latter case. PMID- 6847617 TI - Fluorographic detection of radioactivity in polyacrylamide gels with 2,5 diphenyloxazole in acetic acid and its comparison with existing procedures. AB - A fluorographic procedure was optimized which utilized acetic acid as the solvent for 2,5-diphenyloxazole (PPO). This procedure was then compared with existing fluorographic procedures which utilize PPO in dimethyl sulphoxide or sodium salicylate in water, and a commercially available fluorographic solution. En3Hance (New England Nuclear Corp.). A comparison of the four methods revealed that all of the procedures resulted in essentially the same efficiency of radioactivity detection. The acetic acid/PPO procedure was found to have several technical advantages. There is no need to pre-fix proteins in gels, and either agarose or acrylamide gels can be used. The acetic acid/PPO procedure was found to be a simple, sensitive and efficient alternative fluorographic method. PMID- 6847618 TI - Characterization of isoprotein patterns in tissue extracts and isolated samples of metallothioneins by reverse-phase high-pressure liquid chromatography. AB - Reverse-phase high-pressure ('performance') liquid chromatography was used to characterize the isometallothioneins in preparations isolated from tissues of a variety of animals by 'conventional' chromatographic methods. The resolution was such that isoproteins differing by a single serine leads to leucine difference in 61 residues could be easily separated. Yields from the reverse-phase support were typically 60-70% for the isoproteins. Comparisons of isometallothionein patterns after Cd2+-induction in rabbits indicated that total metallothionein concentrations were about 4-fold higher in liver than kidney extracts from the same animal. In the extracts a minimum of four and six isometallothionein peaks were detected in kidney and liver respectively. Under acidic conditions, where the metals are removed from the protein, the chromatographic properties, i.e. hydrophobicities, of the isoproteins from kidney were identical with those of four of those found in liver. Although the same peaks appeared in tissue extracts from individual animals, concentration differences were apparent. Remarkably, no differences were observed between the isoprotein patterns of liver or kidney as a consequence of either Cd2+- or Zn2+-induction. Chromatography of the metal containing forms at neutral pH in Tris buffer indicated that the relative ratios of the complexed metal ions in the isoproteins were found to be effectively identical, not only before and after chromatography, but also within the separated forms from a single tissue source. PMID- 6847619 TI - Active-site-directed inhibition of asparagine N-glycosyltransferases with epoxy peptide derivatives. AB - The hexapeptide Arg-Asn-Gly-epoxyethylglycine-Ala-Val-OMe specifically inactivates membrane-bound N-glycosyltransferases. The specificity is demonstrated by the inability of peptides containing 2,3-epoxypropyl-, allyl- and vinyl-glycine in the epoxyethylglycine position to function as inhibitors. The inhibition is concentration-dependent and follows first-order kinetics, but requires disruption of the membrane vesicles by detergents to achieve accessibility to the transferase. The enzyme can be protected partially against inactivation by the addition of the acceptor peptide Arg-Asn-Gly-Thr-Ala-Val-OMe, pointing to an active-site-directed reaction. Exhaustion of the endogenous pool of glycosyl donor molecules by preincubation of the membrane vesicles with the acceptor peptide before inhibitor application is accompanied by an additional decrease in the inhibition rate. This suggests that inactivation occurs only under conditions where glycosyl transfer is catalysed. A mechanism of inactivation is proposed in which the transferase catalyses its own inactivation by a kind of 'suicide' mechanism. PMID- 6847620 TI - Structural requirements of N-glycosylation of proteins. Studies with proline peptides as conformational probes. AB - Conformational aspects of N-glycosylation have been investigated with a series of proline-containing peptides as molecular probes. The results demonstrate that, depending on the position of the imino acid in the peptide chain, dramatic alterations of glycosylation rates are produced, pointing to a critical contribution of the amino acids framing the 'marker sequence' triplet Asn-Xaa Thr(Ser) on the formation of a potential sugar-attachment site. No glycosyl transfer at all was detectable to those peptides containing a proline residue either in position Xaa or in the next position beyond the threonine of the Asn sequon on the C-terminal side, whereas the hexapeptide Pro-Asn-Gly-Thr-Ala-Val was glycosylated at a high rate. (Emboldened residues denote the 'marker sequence' that is identical in all the peptides; italicized residues distinguish the positions of proline in the various peptides.) Studies with space-filling models reveal that the lack of glycosyl-acceptor capabilities of Ala(Pro)-Asn-Gly Thr-Pro-Val might be directly related to their inability to adopt and/or stabilize a turn or loop conformation which permits the catalytically essential interaction between the hydroxy amino acid and the asparagine residue within the 'marker sequence' [Bause & Legler (1981) Biochem. J. 195, 639-644]. This conclusion is supported by circular-dichroism spectroscopic data, which suggest structure-forming potentials in this type of non-acceptor peptides dominating over those that favour the induction of an appropriate sugar-attachment site in the acceptor peptides. The lack of acceptor properties of Tyr-Asn-Pro-Thr-Ser-Val indicates that even small modifications in the 'recognition' pattern are not tolerated by the N-glycosyltransferases. PMID- 6847621 TI - Characterization of proteins from human synovium and mononuclear leucocytes that induce resorption of cartilage proteoglycan in vitro. AB - Both human synovial tissue in culture and lectin-stimulated mononuclear leucocytes produced a protein that induced proteoglycan resorption in explants of bovine nasal cartilage and human articular cartilage. On gel filtration the protein had Mr 16000-20000 and on isoelectric focusing its pI was 5.2-5.3. The protein corresponded to catabolin, which has previously been identified as a product of cultured porcine synovial tissue and mononuclear leucocytes. The action of partially purified human catabolin was not inhibited by cortisol, although the activity of the leucocyte supernatants from which it had been isolated was inhibited. For this reason it is not possible to be sure that the active factor detected in the bioassay of the crude leucocyte culture supernatants is in fact catabolin. PMID- 6847623 TI - Tandem dye-ligand chromatography and biospecific elution applied to the purification of glucose-6-phosphate dehydrogenase from Leuconostoc mesenteroides. AB - 1. A total of 65 immobilized triazine dyes were screened for their ability to purify the dual-nucleotide-specific glucose-6-phosphate dehydrogenase from Leuconostoc mesenteroides. From this screen a 'negative' (Matrex Gel Purple A) and a 'positive' (Matrex Gel Orange B) adsorbent were found to be the best in terms of overall purification and yield and were therefore combined to give the best purification. 2. Glucose-6-phosphate dehydrogenase from Leuconostoc mesenteroides was purified approx. 56-fold in a two-step tandem chromatographic system using Matrex Gel Purple A followed by Matrex Gel Orange B chromatography to a specific activity of 228 units/mg of protein in a final yield of 73%. 3. A study of the elution characteristics of glucose-6-phosphate dehydrogenase bound to Matrex Gel Orange B by KCl (pulse and gradient) and biospecific eluents (pulse) was carried out. NADP+, NADPH and adenosine 2',5'-bisphosphate were found to be the only effective biospecific eluents. A pulse of 50 microM-NADP+ (1/2 column vol.) was found to give a better purification than a 0-1 M-KCl gradient and therefore was the preferred method of elution. 4. Presaturation of the enzyme with various nucleotides was carried out to determine the effect on the subsequent binding of glucose-6-phosphate dehydrogenase to Matrex Gel Orange B. The results of these and biospecific-elution studies lead us to propose two possible schemes to explain the mechanism of the dye-protein interaction. 5. Reusability, capacity of the adsorbent and effect of varying the ligand concentration were also studied in the purification of glucose-6-phosphate dehydrogenase on Matrex Gel Orange B. PMID- 6847622 TI - Some properties, including the substrate in vivo, of the delta 9-desaturase in Micrococcus cryophilus. AB - The delta 9-desaturase of the psychrophilic bacterium Micrococcus cryophilus is shown to be a membrane-bound enzyme that is probably linked to a cyanide- (and azide-) sensitive respiratory chain with oxygen as the final acceptor. It has a pH optimum of 8.7 and contains an essential thiol group, but has no special ion requirements. The desaturase activity of washed membranes could not be increased by adding supernatant or NADH and NADPH, possibly owing to the endogenous generation of reduced cofactors by the membranes. The substrate for the desaturase is not acyl-CoA and is probably not acyl-acyl-carrier protein. Evidence is presented that the substrate in vivo is saturated phospholipid and a scheme for the possible routes of incorporation of exogenous stearic acid into oleoyl-phospholipid is presented. PMID- 6847624 TI - Oxygen binding by Helix pomatia alpha-haemocyanin studied by X-ray-absorption spectroscopy. AB - The X-ray absorption spectra of haemocyanin from Helix pomatia were obtained by using X-rays from synchrotron radiation. Cu K-edges were recorded at four conditions, namely fully oxygenated, 85% oxygenated, 12% oxygenated and fully deoxygenated. The percentage oxygenation calculated from the edge-shift of the partially oxygenated samples did not agree with the percentage oxygenation as determined by u.v. measurements. Two intermediates in the oxygenation process are presented to explain the observed dissimilarities. PMID- 6847625 TI - The regulatory properties of rabbit muscle pyruvate kinase. The influence of substrate concentrations. AB - The kinetics of rabbit muscle pyruvate kinase were studied in assays at pH 7.4, where the relationships between the initial velocities of the catalysed reaction and the concentrations of substrates ADP, phosphoenolpyruvate and Mg2+ are non hyperbolic. The data were used to test the applicability of the exponential model for a regulatory enzyme, which has been here extended to describe the behaviour of a three-substrate enzyme. It appears that the data can be represented by the model and as a result permit the conclusion that the substrates influence one another's binding by the same type of charge interactions that are evident in the Michaelis-Menten kinetics of the enzyme observed at pH 6.2. Evidence is also presented indicating that MgADP acts as a dead-end inhibitor of the enzyme at pH 7.4. PMID- 6847626 TI - The regulatory properties of rabbit muscle pyruvate kinase. The influence of effector concentrations. AB - The initial velocity of the reaction catalysed by rabbit muscle pyruvate kinase was studied as a function of the concentrations of the modifiers phenylalanine and fructose 1,6-bisphosphate under conditions where the relationships between the initial velocities and the concentrations of substrates are non-hyperbolic. It is shown that these data can be represented by the exponential model for a regulatory enzyme. PMID- 6847628 TI - A soluble NADH dehydrogenase (NADH: ferricyanide oxidoreductase) from Thermus aquaticus strain T351. AB - A soluble NADH dehydrogenase (NADH:ferricyanide oxidoreductase) has been obtained by simple disruption of cells of Thermus aquaticus strain T351, and purified. The enzyme is of low molecular mass, 50 000 Da, and displays many of the properties of the membrane-bound enzyme, including inhibition by both NADH and ferricyanide, and the same Km for ferricyanide. The enzyme contains 0.05 mol of FMN, 0.16 mol of labile sulphur and 2.2 mol of iron per mol of protein. The enzyme is inhibited by NAD and cupferron competitively with ferricyanide, and by ATP (but not ADP) competitively with NADH. The enzyme is particularly thermostable, having a half life at 95 degrees C of 35 min. The effect of temperature on the molar absorption coefficient and the stability of NADH was determined. PMID- 6847627 TI - Studies of the interaction of troponin I with proteins of the I-filament and calmodulin. AB - 1. All lysine residues in native troponin I from rabbit fast-twitch skeletal muscle reacted with methyl acetimidate and ethyl acetimidate. 2. The reactivity of lysine-18 of troponin I to acetimidate was much diminished when the troponin I was complexed in the presence of Ca2+ with troponin C alone or in the whole troponin complex. 3. In the presence of EGTA, lysine-18 of troponin I in the troponin I-troponin C complex was more reactive to acetimidate than it was in the presence of Ca2+. 4. No masking of lysine residues could be detected when troponin I interacted with calmodulin or actin. 5. Sedimentation-equilibrium studies indicated that the complex of troponin I with calmodulin was more readily dissociated in the absence of Ca2+ than was its complex with troponin C under otherwise identical conditions. 6. These studies suggest that the nature of the involvement of the N-terminal region of troponin I is a major difference between its modes of interaction with calmodulin and with troponin C. PMID- 6847629 TI - Binding of platelet factor 4 to heparin oligosaccharides. AB - Heparin fractions of differing Mr (7800-18 800) prepared from commercial heparin by gel filtration and affinity chromatography on immobilized anti-thrombin III had specific activities when determined by anti-Factor Xa and anti-thrombin assays that ranged from 228 to 448 units/mg. The anti-Factor Xa activity of these fractions could be readily and totally neutralized by increasing concentrations of platelet factor 4 (PF4). That these fractions bound to immobilized PF4 was indicated by the complete binding under near physiological conditions of 3H labelled unfractionated commercial heparin. An anti-thrombin III-binding oligosaccharide preparation (containing predominantly eight to ten saccharide units), prepared by degradation of heparin with HNO2 had high (800 units/mg) anti Factor Xa, but negligible anti-thrombin, specific activity. The anti-Factor Xa activity of this material could not be readily neutralized by PF4, and the 3H labelled oligosaccharides did not completely bind to immobilized PF4. A heterogeneous anti-thrombin III-binding preparation containing upwards of 16 saccharides had anti-thrombin specific activity of just less than one-half the anti-Factor Xa specific activity. This material was completely bound to immobilized PF4 and was eluted with similar concentrations of NaCl to those that were required to elute unfractionated heparins from these columns. Furthermore, increasing concentrations of PF4 neutralized the anti-Factor Xa activity of this material in a manner similar to that of unfractionated heparin. It is concluded that heparin oligosaccharides require saccharide units in addition to the anti thrombin III-binding sequence in order to fully interact with PF4. PMID- 6847630 TI - Excretion of laccase by sycamore (Acer pseudoplatanus L.) cells. Purification and properties of the enzyme. AB - A laccase-type polyphenol oxidase is excreted by sycamore cells (Acer pseudoplatanus L.) cells. The enzyme has been purified by classical purification techniques. It is a blue copper protein of Mr 97 000, containing 45% carbohydrate and 0.24% copper. This protein consists of one single unit and the copper content corresponds to four copper atoms per protein molecule. The specific activity of the purified extracellular sycamore-cell laccase measured at pH 6.6 (optimum pH) and in the presence of 20mM-4-methhylcatechol (optimum substrate conditions) corresponded to an oxygen uptake of 32 000 nmol of O2/min per mg of protein. Under these conditions, the catalytic-centre activity of the enzyme reached 100 s 1. The excretion of laccase by sycamore cells is significant, being about 2% of the total protein synthesized by the cells during the exponential phase of growth, and is independent of cell growth. The physiological significance and the problems raised by the passage of this protein across the cytoplasmic membrane are discussed. PMID- 6847631 TI - Isolation and characterization of dermatan sulphate proteoglycan from human uterine cervix. AB - Proteoglycans were extracted from human uterine cervix with 4 M-guanidinium chloride in the presence of proteinase inhibitors. They were purified by density gradient centrifugation in 4 M-guanidinium chloride/CsCl (starting density 1.32 g/ml) followed by DEAE-cellulose and Sepharose chromatography. Only one polydisperse proteoglycan was found. s020,w was 2.1S and the weight-average molecular weight was 73 000 (sedimentation-equilibrium centrifugation) to 110 500 (light-scattering). The core protein was monodisperse, with an apparent molecular weight of 47 000. The proteoglycan contained about 30% protein and probably two or three glycosaminoglycan side chains per molecule. High contents of aspartate, glutamate and leucine were found. The glycan moiety of the proteoglycan was exclusively dermatan sulphate, with a co-polymeric structure with approximately equal quantities of iduronic acid- and glucuronic acid-containing disaccharides. PMID- 6847632 TI - Changes in the 14C-labelling of molecular species of 3-monogalactosyl-1,2 diacylglycerol in leaves of Vicia faba treated with compound San 9785. AB - The effects of the substituted pyridazinone herbicide. San 9785, on the biosynthesis of monogalactosyldiacylglycerol (MGDG) molecular species and on the diacylglycerol precursors were studied. Kinetic experiments with [14C]glucose infiltrated Vicia faba leaf tissue showed that San 9785 inhibited desaturation of MGDG linoleic acid (C18:2) to form linolenic acid (C18:3) and increased the degree of unsaturation of the diacylglycerol molecular species used in MGDG biosynthesis. These results confirmed that the diacylglycerol precursor of MGDG contains highly unsaturated fatty acids, particularly C18:2 and C18:3. The results also indicated that the MGDG 3/3 molecular species (a molecular species of MGDG containing two C18:3 molecules) is derived from MGDG 2/3 (i.e. containing one C18:2 and one C18:3 fatty acid moiety) and, likely, MGDG 2/2 (i.e. containing two C18:2 fatty acid moieties), via sequential fatty acid desaturation in situ. A model for MGDG 3/3 biosynthesis in 'C18:3-plants', incorporating several sites for fatty acid desaturation (in the phospholipid and diacylglycerol precursors, which are not inhibited by San 9785, and in MGDG, which is inhibited by San 9785) is discussed. PMID- 6847633 TI - Electron transfer flavoprotein from pig liver mitochondria. A simple purification and re-evaluation of some of the molecular properties. AB - Electron transfer flavoprotein (ETF) from pig liver mitochondria has been purified to homogeneity by a three-step procedure with approx. 10-fold higher yields than previously reported. The purified ETF exhibits an absorption coefficient for the bound FAD of 13.5 mM-1.cm-1 at 436 nm and an isoelectric point of 6.75. Gel filtration, sodium dodecyl sulphate gel electrophoresis and flavin analysis indicate that pig liver ETF is a dimer, composed of non-identical subunits (Mr 38 000 and 32 000) with only one FAD/dimer. Anaerobic reduction by dithionite produces anionic flavin semiquinone as a stable intermediate and establishes the flavin to be the only redox-active chromophore in ETF. PMID- 6847634 TI - Fluorimetric studies on the dimerization equilibrium of protoporphyrin IX and its haemato derivative. AB - The aggregations of protoporphyrin IX and haematoporphyrin IX in aqueous solutions were studied by fluorimetric techniques. Porphyrin concentrations were limited to 0.001-0.1 microM and 0.01-1 microM for protoporphyrin and haematoporphyrin respectively, where dimerization is the dominant aggregation process. The dimerization equilibrium constants (at 25 degrees C, neutral pH, 50 mM-Tris/HCl buffer) were determined to be 3 X 10(7) M and 4 X 10(5) M for the proto and the haemato derivatives respectively. The fluorescence intensity of a given protoporphyrin solution (within the range indicated above) was markedly decreased by salts in the system, over the salt concentration range 0.1-7 mM at constant ionic strength, in the sequence CaCl2 greater than MgCl2 greater than KCl greater than NaCl. The direction of this effect, fluorescence quenching, suggests that these salts promote an increase in aggregation. The differences in the magnitudes of the effect, among different salt species sharing a common anion, at constant ionic strength, imply that the effect is cation-specific. In contrast, the fluorescence intensity of a given solution of haematoporphyrin (within the range indicated above) was unaffected by these salts, under similar concentrations, nor was it sensitive to the total buffer concentration, or to the type of buffer in the system. PMID- 6847635 TI - High-performance liquid chromatography of coproporphyrin isomers. AB - A reversed-phase system is described for the simultaneous isocratic separation of coproporphyrin I, II, III and IV isomers. The retention behaviour of coproporphyrin I and III is studied in detail. The method is suitable for both analytical and semi-preparative separation. PMID- 6847636 TI - Effect of ferritin-containing fractions with different iron loading on lipid peroxidation. AB - Ferritin-containing fractions with different degrees of iron loading were prepared. All ferritin fractions stimulated the peroxidation of bovine brain phospholipid liposomes, as measured by the formation of thiobarbituric acid reactive material. This stimulation was increased in the presence of ascorbate. Iron salts of equivalent concentration to those of the ferritin fractions were more stimulatory to lipid peroxidation at the higher iron concentrations. None of the fractions inhibited ascorbate-dependent peroxidation in the presence of added iron salts. PMID- 6847637 TI - Exogenous phospholipase enzymes mimic effects of phenylephrine on Ca2+ transport in hepatocytes. AB - Phospholipase C from Clostridium perfringens induced the release of 45Ca2+ from isolated rat hepatocytes incubated at 0.1 mM extracellular Ca2+ with a time course similar to that for the action of phenylephrine. Under the conditions of these experiments, no significant damage to the plasma membrane was detected in the presence of phospholipase C. Little 45Ca2+ release was induced by bee venom phospholipase A2. At 1.3 mM extracellular Ca2+, both phospholipase enzymes stimulated the initial rate of 45Ca2+ exchange. Concentrations of phospholipase C comparable with those that stimulated 45Ca2+ release increased the rates of glucose release and O2 utilization by 70 and 20% respectively. An increase in the rate of O2 utilization but not glucose release was observed after the addition of phospholipase A2 to hepatocytes. The possible role for a cellular phospholipase C in the mechanism by which phenylephrine stimulates glycogenolysis in the liver cell is briefly discussed. PMID- 6847638 TI - The partial characterization of the binding of avidin-biotin complex to rat liver plasma membrane. AB - Rat liver plasma membrane and rat intestinal mucosa plasma membrane were examined for their ability to bind avidin-[3H]biotin complex. Avidin-[3H]biotin complex bound specifically to liver plasma membrane with a Kd of approx. 35 nM and Bmax. of 136 pmol/mg of membrane protein. The receptor on the liver plasma membrane was exposed by Pronase, sensitive to tryptic hydrolysis and insensitive to neuraminidase. The optimum pH of specific binding was less than 6.0. Simple carbohydrates, mannan and ovalbumin did not inhibit specific binding. Periodate treated or alpha-mannosidase-treated avidin was able to inhibit binding of either avidin-[3H]biotin complex or untreated avidin to plasma membrane. [3H]Avidin containing methylated lysine residues did not bind to rat liver plasma membrane. There was no specific binding of the avidin-biotin complex to rat intestinal mucosa plasma membrane. PMID- 6847639 TI - Differences in polyamine availability and insertion into fibronectins released from normal and transformed cells. AB - 1. Fibronectin released from transformed rat kidney cells compared with that released from normal rat kidney cells shows a 50% increase in amino group availability. 2. No such changes were observed in thiol and carboxy group availability or in sialic acid content. 3. The increased amino group availability is not due to a greater polyamine content, which was about 0.04 pmol/mg of protein. 4. Transglutaminase mediated the insertion of spermidine into normal cell fibronectin with linear kinetics. With fibronectin from transformed cells (temperature-sensitive mutant or wild-type), kinetics typical of substrate inhibition were observed. 5. Immunochemical analysis with an anti-polyamine antiserum and an anti-(human fibronectin) antiserum showed that fibronectins from normal and transformed cells react differently. The significance of these results is discussed in the light of changes in the secondary structure between the two fibronectins. PMID- 6847640 TI - A novel technique for rapid determination of energy consumption in platelets. Demonstration of different energy consumption associated with three secretory responses. AB - A novel method has been developed for rapid and quantitative determination of the rate of energy consumption in platelets. In platelets suspended in a cyanide containing medium. ATP resynthesis is abruptly blocked by addition of 2 deoxyglucose and D-glucono-1,5-lactone. We demonstrate that the subsequent changes in the levels of cytoplasmic ATP and ADP reflect the velocity of energy consumption in the platelets immediately before addition of the inhibitors. Despite the arrest in ATP resynthesis the platelets remain responsive to stimulation by thrombin (5 units x ml-1) which triggers the secretion of the contents of dense, alpha- and acid hydrolase granules. Unstimulated platelets were found to consume about 3.5 and 0.5 mumol of ATP equivalents x min-1 x (10(11) cells)-1 at 37 degrees C and 15 degrees C, respectively; the thrombin treated platelets consumed respectively 16 and 2 mumol of ATP equivalents x min-1 x (10(11) cells)-1 at these temperatures. When the velocity of energy consumption was varied by (a) changing the temperature and (b) preincubation with glyco(geno)lytic inhibitors, it was found to be linearly related to the initial rate of secretion from the three types of granules. The precise nature of this relationship differed between the three types of secretion responses and indicated an increasing requirement for metabolic energy for secretion from the three types of granules in the order: dense granule less than alpha-granule less than acid hydrolase granule. The results obtained with changes in temperature were superimposable on those obtained with the glyco(geno)lytic inhibitors for dense granule secretion and alpha-granule secretion, suggesting an apparent coupling between energy consumption and the rate of these secretion responses. The rate of secretion of acid hydrolase was always higher when energy consumption was varied by temperature changes than when glyco(geno)lytic inhibitors were used, probably as a result of metabolic changes prior to induction of secretion. On the basis of these experiments, we calculated an incremental energy consumption during complete secretion of dense, alpha- and acid hydrolase granule contents of 2.5, 4.2 and 6.7 mumol of ATP equivalents x (10(11) platelets)-1, respectively. PMID- 6847642 TI - Isolation of mannose-binding proteins from human and rat liver. AB - A binding assay for the detection of mannose-binding proteins was developed, which uses a ligand of mammalian origin, 125I-labelled bovine pancreatic ribonuclease B. The binding assay was validated by using the recognized mannose binding protein, concanavalin A. Microgram quantities of concanavalin A or mannose-binding proteins could be assayed. A mannose-binding protein was isolated from rat liver by affinity chromatography on mannose-Sepharose 6B. It has a Mr of approx. 900000 under non-dissociating conditions and contains a subunit of approx. 34000 Mr. When ribonuclease B-Sepharose was used as a ligand for affinity chromatography, the predominant mannose-binding material isolated from rat liver had a native Mr of 205000-225000 and consisted largely of a subunit of Mr 70000, which yielded subunits of Mr 28500 and 34000 on reduction. It is suggested that different mannose-binding proteins are isolated by the two affinity chromatography ligands. A mannose-binding protein was also purified from human liver by affinity chromatography on mannose-Sepharose 6B. It has a native Mr of over 1000000 and consists of subunits with Mr 28000 and 30500. Its isolation suggests that mannose-mediated endocytosis or intracellular transport of glycoproteins occurs in human liver. PMID- 6847641 TI - Effect of halothane on metabolism of 5-hydroxytryptamine by rat lungs perfused in situ. AB - The effect of halothane (2-bromo-2-chloro-1,1,1-trifluoroethane) on the uptake of 14C-labelled 5-hydroxytryptamine (5-HT) and its metabolism to 5-hydroxyindol-3 ylacetic acid (5-HIAA) was investigated in rat lungs perfused in situ. The rate of accumulation of 14C-labelled 5-HIAA in the tissue, monitored as an index of 5 HT metabolism, was linear with time, displayed saturation kinetics and remained stable for at least 180 min of perfusion. Exposure of the lungs to halothane (4%) for 60 min reversibly reduced production of 5-HIAA through an increase in the apparent Km for metabolism of the amine from 1.45 to 3.52 microM (P less than 0.001); the anaesthetic had no effect on the Vmax. of the process. The magnitude of the inhibition increased with time of exposure to the anaesthetic. Halothane exposure did not alter the distribution of [3H]sorbitol or [14C]5-HT, pulmonary vascular resistance, levels of ATP or the kinetics of amino acid transport in the tissue. Inhibition of protein synthesis by cycloheximide did not mimic the effect of the anaesthetic. These observations, together with those made in lungs exposed to inhibitors of 5-HT uptake and metabolism, were consistent with a halothane mediated inhibition of 5-HT uptake, which did not appear to involve non-specific changes in membrane permeability. PMID- 6847643 TI - Changes in non-histone nuclear proteins during postnatal myocardial development. AB - Myocardial-cell nuclei isolated from ventricles of rats between 4 days and 15 months of age showed a progressive loss of DNA-synthetic activity in vitro. Correlated with this loss is the differential appearance of three major groups of non-histone nuclear proteins. Group a, with pI5.7-6.5 and Mr 67000, appeared in detectable amounts in rats more than 10 days of age, whereas group b, consisting of proteins with pI6.8-7.2 and Mr 45000, appeared in rats older than 33 days. The third group (group c), with pI6.5-8.5 and Mr 32000-42000, was present throughout postnatal development, but the amount of these proteins appeared to be greater in the 10-day-old rat than in the 15-month-old rat. All groups of these specific proteins were localized within the nucleus and did not reflect cytoplasmic constituents. Furthermore, the amino acid compositions of these polypeptides were also analysed and compared with those of actin and tubulin. PMID- 6847644 TI - Uptake of malate dehydrogenase into mitochondria in vitro. Some characteristics of the process. AB - 1. It was previously shown [Passarella, Marra, Doonan & Quagliariello (1980) Biochem. J. 192, 649-658] that, when mitochondrial malate dehydrogenase from rat liver is incubated with sulphite-loaded mitochondria from the same source, uptake of the enzyme occurs, as judged by a fluorimetric assay of intramitochondrial enzyme activity. Confirmation of sequestration of the enzyme inside the organelles is provided by its proteinase-resistance after uptake. 2. Enzyme uptake into mitochondria is inhibited by enzyme treatment with mersalyl at concentrations that do not affect its catalytic activity. 3. Enzyme uptake is energy-dependent, as shown by inhibition of the process by carbonyl cyanide p trifluoromethoxyphenylhydrazone and by antimycin. ATP and oligomycin, on the other hand, both stimulate the process, but stimulation by ATP is inhibited by oligomycin. These results suggest that uptake depends on maintenance of transmembrane ion gradient rather than direct ATP involvement. 4. Measurements of delta psi by means of the 'redistribution signal' probe safranine suggest no dependence of malate dehydrogenase uptake on membrane potential. 5. Comparison of the effects of the ionophores valinomycin, nonactin, gramicidin and nigericin shows that uptake depends on maintenance of a transmembrane pH gradient. PMID- 6847645 TI - Alteration of hepatic glucocorticoid receptor stability and nuclear binding in vitro by citrate. AB - Citrate greatly stabilized rat hepatic unbound glucocorticoid receptors in cell free conditions at 4 degrees C with optimal effectiveness at 5-15 mM. Control receptors were inactivated at 4 degrees C with a half-life of less than 12 h. However, in the presence of 10 mM-citrate, unbound receptors were almost completely stabilized for 48 h at 4 degrees C. Citrate at a concentration of 1-2 mM yielded half-maximal stabilization. The stabilizing effect of citrate was rather specific, as succinate, alpha-oxoglutarate, oxaloacetate, malate and pyruvate had no apparent stabilizing action. Citrate stabilized receptors over a wide range of H+ concentrations, with complete protection between pH 6.5 and 8.5. In addition, citrate appeared to have a significant effect on glucocorticoid receptor complex activation into a nuclear binding form. Thus 5-10 mM-citrate enhanced nuclear binding, with optimal activation achieved at 10 mM concentration. As analysed by sucrose-density-gradient centrifugation and DEAE cellulose chromatography, no apparent change was observed in the physical characteristics of the glucocorticoid receptor in the presence of citrate. PMID- 6847646 TI - Adenine nucleotide status, phosphoglycerate reduction and photosynthetic phosphorylation in a reconstituted chloroplast system. AB - The concentrations of ADP and ATP were measured during illumination of a reconstituted chloroplast system to which NADP(+), 3-phosphoglycerate and ribose 5-phosphate were successively added. Their effects on photosynthetic oxygen evolution and on the concentrations of ATP and ADP are discussed in terms of the regulation of photosynthetic carbon assimilation. PMID- 6847647 TI - Measurements of the turnover rate of glutamine in normal and acidotic rats. AB - The turnover of glutamine was measured in rats with [1-14C]glutamine. Rates of turnover measured by constant infusion of the label were 130 mumol/h per 100g body wt. in control rats and were not changed in chronic metabolic acidosis. These rates of turnover of whole-body glutamine were about 13-26% of the rate of net glutamine release into the bloodstream, indicating that the bulk of glutamine turnover in vivo is concerned with intracellular processes rather than inter organ fluxes. PMID- 6847648 TI - Inhibition of testosterone biosynthesis by ethanol. Relation to hepatic and testicular acetaldehyde, ketone bodies and cytosolic redox state in rats. AB - In experiments in which liver and testis freeze-stops were performed on pentobarbital-anaesthetized rats, ethanol (1.5 g/kg body wt.) reduced plasma testosterone concentration from 13.1 to 3.2 nmol/litre. 4-Methylpyrazole abolished the ethanol-induced hepatic and testicular increase in the lactate/pyruvate ratio, and the testicular acetaldehyde level, but did not diminish the reduction in plasma testosterone concentration. In testes, but not in liver, ethanol decreased the 3-hydroxybutyrate/acetoacetate ratio, and 4 methylpyrazole did not prevent this effect. In experiments in which freeze-stop was performed after cervical dislocation, ethanol decreased the testis testosterone concentration from 590 to 220 pmol per g wet wt. The effects of ethanol and 4-methylpyrazole on testis acetaldehyde, lactate/pyruvate and 3 hydroxybutyrate/acetoacetate ratios were the same as found during anaesthesia. The NAD+-dependent ethanol oxidation capacity in testis ranged from 0.1 to 0.2 mumol/min per g wet wt. and seemed to be inhibited by 4-methylpyrazole both in vivo and in vitro. In additional experiments, ethanol doses between 0.3 and 0.9 g/kg body wt. did not alter the plasma testosterone concentration in rats treated, or not treated, with cyanamide, which induced elevated acetaldehyde levels in blood and testes. The results suggest that ethanol-induced inhibition of testosterone biosynthesis was not caused by extratesticular redox increases, or by extra- or intra-testicular acetaldehyde per se. The inhibition is accompanied by changes in testicular ketone-body metabolism. PMID- 6847649 TI - The rate of substrate cycling between glucose and glucose 6-phosphate in muscle and fat-body of the hawk moth (Acherontia atropos) at rest and during flight. AB - 1. The rate of substrate cycling between glucose and glucose 6-phosphate was measured in tissues of the hawk moth (Acherontia atropos). 2. The insect was injected with [2-3H,2-14C]glucose, and after periods of time at rest or flying the animal was freeze-clamped. Separation of glucose and hexose monophosphate from the tissues was performed by paper chromatography and t.l.c., and the 3H and 14C radioactivities in these compounds were measured. 3. On the basis of the 3H/14C ratios in these compounds and the measured rate of glycolysis, the rate of cycling was calculated. The rates of cycling were 0.03, 0.10, 0.06 and 3.9 mumol/min per g for fat-body at rest and during flight and for flight muscle at rest and during flight respectively. 4. The marked increase in the cycling rate between glucose and glucose 6-phosphate upon flight contrasts with the finding of Clark, Bloxham, Holland & Lardy [(1973) Biochem. J. 134, 589-597] in the bumble bee, in which this condition inhibited cycling. It is suggested that the increased rate of cycling increases the sensitivity of glucose phosphorylation to changes in the concentrations of effectors of hexokinase should it be necessary to increase the rate of glycolysis in muscle, for example, to increase power output of the flight muscle for increased speed of flight. PMID- 6847650 TI - Inhibition of cardiac proteolysis by colchicine. Selective effects on degradation of protein subclasses. AB - 1. The effect of colchicine (2.5 microM) on cardiac protein turnover was tested with foetal mouse hearts in organ culture. 2. Colchicine had no effect on protein synthesis, but inhibited total protein degradation by 12-18%. Lumicolchicine, which lacks colchicine's ability to disaggregate microtubules, but shares its non specific effects, did not alter protein degradation. 3. The colchicine-induced inhibition of protein degradation was accompanied by significant changes in cardiac lysosomal enzyme activities and distribution. 4. Colchicine inhibited the degradation of organellar proteins, including mitochondrial cytochromes, more than that of cytosolic proteins. 5. Colchicine decreased the rate of myosin degradation and the rate of proteolysis of the total protein pool to a similar extent. Since the regulation of myosin degradation does not involve lysosomes, this suggests that colchicine affects non-lysosomal as well as lysosomal pathways. 6. Release of branched-chain amino acids from colchicine-treated hearts was disproportionately decreased, suggesting that colchicine increased their metabolism. 7. It is concluded that colchicine, via its actions on microtubules, exerts important inhibitory effects on cardiac proteolysis. Colchicine is especially inhibitory to the degradation of organellar proteins, including mitochondrial cytochromes. Its inhibitory effects may be mediated in part via lysosomal mechanisms, but non-lysosomal mechanisms are probably involved as well. PMID- 6847651 TI - The relationship between placental protein synthesis and transfer of amino acids. AB - The relationship between placental protein synthesis and transfer of amino acids from mother to foetus was studied in the guinea pig, by using [U-14C]-lysine, leucine, -glycine, -aspartate and -alpha-aminoisobutyrate. The uptake of label by protein was 12-16% of total label transferred. Cycloheximide inhibited incorporation of all naturally occurring amino acids into protein by 81-96% and transfer by 62-75%; the concentration of label in the free pool was increased for each. These findings were confirmed when specific-radioactivity measurements were made with L-[U-14C]lysine. The transfer of the non-protein amino acid alpha aminoisobutyrate was not significantly decreased by cycloheximide. A model, linking protein synthesis to the generation of a transfer pool of amino acids, is proposed whereby inhibition of protein synthesis decreases the amount of amino acid available for transfer. PMID- 6847652 TI - Coat protein conformation in M13 filaments, I-forms and spheroids. AB - Circular dichroism studies of the filamentous coliphage M13 were carried out to determine conformational changes in the major capsid protein (the B protein) that occur during contraction of the filaments to I-forms and spheroids. The alpha helicity of the B protein is somewhat lower in the I-forms than in filaments and much lower in spheroids. This conformational change may explain the increased detergent and lipid solubility of both I forms and spheroids relative to filaments. PMID- 6847653 TI - Enzyme-induced aziridine formation by isolated hepatocytes. AB - The metabolism of 2-bromoethylaminonaphthoquinone in hepatocytes isolated from rats was studied. This compound was chemically inert in the reaction system used. However, in buffer solution containing isolated hepatocytes, it was gradually converted into aziridinylnaphthoquinone. Under the same reaction conditions, 4 chlorobutylaminonaphthoquinone also gave the cyclization products, pyrrolidinylnaphthoquinone. Cellular GSH decreased in both reactions. PMID- 6847654 TI - Ethanol potentiates the inhibitory effect of D-galactosamine on protein synthesis in isolated hepatocytes. AB - The effect of the combined addition of D-galactosamine and ethanol on hepatic protein synthesis was studied in isolated mouse hepatocytes. 2.5 mM D galactosamine or 40 mM ethanol alone caused slight or no inhibition of amino acid incorporation into proteins. However, a profound inhibition (about 80%) was observed if D-galactosamine of the same dose was added after a preincubation of the cells with 40 mM ethanol and vice versa. It shows that there is a strong mutual potentiation between D-galactosamine and ethanol in the inhibition of protein synthesis. PMID- 6847655 TI - Substrate specificity of an amidating enzyme in porcine pituitary. AB - A series of tripeptides was synthesised and tested as substrates for an amidating enzyme present in porcine pituitary. The rates of conversion of the tripeptides to the corresponding dipeptide amides were determined by ion exchange chromatography of the radio-iodinated peptides. The experiments showed that the amidating enzyme has a mandatory requirement for glycine in position 3 of the tripeptide substrates; peptides containing lysine, glutamic acid, leucine or alanine in the C-terminal position did not undergo reaction. In studies of the substrate requirements at position 2 of the tripeptides, facile reaction took place with neutral amino acids in this position but much slower reactions occurred with basic or acidic residues. With the neutral substrates the enzyme exhibited an optimum pH value of 6.8; with histidine in position 2 the optimum reaction occurred at a higher pH, consistent with a preference shown by the enzyme for an uncharged amino acid in the penultimate position of the peptide substrate. PMID- 6847656 TI - A binding protein for lysosomal enzymes isolated from brain by phosphomannan sepharose chromatography. AB - We have isolated from monkey (Macaca radiata) brain lysosomal fraction by phosphomannan-Sepharose chromatography a protein that binds four different lysosomal enzymes, beta-hexosaminidase, beta-glucuronidase, alpha-L-fucosidase and arylsulfatase. The isolated protein which appeared in an aggregated homogeneous form on gel electrophoresis under non-denaturing conditions at both pH 8.3 and pH 5.0 was found to be heterogeneous on SDS-gel electrophoresis with molecular weights less than 67,000. Binding was partly abolished by periodate treatment or by alkaline phosphatase treatment of the lysosomal enzymes. Binding was completely abolished by pronase digestion of the binding protein. Of the different sugars tested for inhibition of binding, mannose-6-phosphate was most effective followed by mannose and N-acetyl glucosamine while glucose and fucose were ineffective. PMID- 6847658 TI - Guanethidine N-oxide formation as a measure of cellular flavin-containing monooxygenase activity. AB - The usefulness of guanethidine N-oxide formation as a measure of cellular flavin containing monooxygenase activity was assessed using the purified hog liver enzyme, rat liver microsomes and hepatocytes. The apparent Km and Vmax for this reaction in hepatocytes were 0.30 +/- 0.20 mM and 0.81 +/- 0.36 nmole per 10(6) cells min-1 respectively. The Km for the purified enzyme was 0.31 mM and the Vmax was 0.56 nmole per microgram enzyme min-1. 2-Diethylaminoethyl-2,2-diphenyl valerate (SKF-525A) at a concentration of 0.5 mM had no effect on guanethidine N oxide formation by either rat liver microsomes or the purified enzyme. In contrast 2,4-dichloro-6-phenylphenoxyethylamine (DPEA) at the same concentration caused greater than a 100% increase in the microsomal production of guanethidine N-oxide. The tertiary amines imipramine, chloropromazine and methylpyrilene inhibited N-oxide formation by both hepatocytes and the purified enzyme. These data indicate that guanethidine N-oxide formation can be used as a measure of cellular flavin-containing monooxygenase activity. PMID- 6847657 TI - Inhibition of the estrogen-induced synthesis of vitellogenin mRNA in chick liver by tamoxifen. PMID- 6847659 TI - Influence of sodium ions on detergent solubilization of pig brush border D glucose transport system for reconstitution experiments. AB - The D-glucose uptake by liposomes resulting from the association of egg lecithins with solubilized membrane proteins was measured in order to assess their sodium dependent D-glucose transport activity. Membrane proteins were extracted by Triton X-100 solubilization of pig kidney brush border membrane vesicles, which were suspended either in KCl medium or in NaCl medium. When measured by equilibrium isotope exchange procedure in sodium conditions, the D-glucose uptake by sodium detergent extract associated to liposomes occurred with a higher velocity than that obtained with liposomes reconstituted from potassium detergent extract. No differences were observed in the permeability or in the protein content of two types of liposomes. These results are discussed in terms of activation of D-glucose transport system induced by sodium ions before membrane protein solubilization. PMID- 6847660 TI - Mutation induction by cross-links in DNA of Deinococcus radiodurans. AB - Reversion of adenine auxotrophic strains of D. radiodurans by cross-links in DNA was studied. Mutation was induced in a wild-type but not in a mitomycin C sensitive mutant after irradiation with near UV (approximately 365nm) in the presence of 4,5',8-trimethylpsoralen (TMP). To get information on implication of cross-links in the observed mutation, cells containing monoadducts in DNA were exposed to near UV in the absence of TMP. The mutation frequency of the wild-type increased with increasing the cross-links in DNA. These results suggest that structural defects after removal of cross-links in DNA induce mutation in D. radiodurans. PMID- 6847661 TI - Iodide-dependent catalatic activity of thyroid peroxidase and lactoperoxidase. AB - Thyroid peroxidase (TPO) and lactoperoxidase (LPO) display significant catalatic activity at pH 7.0 in the presence of low concentrations of iodide, based both on measurements of H2O2 disappearance and O2 evolution. In the absence of iodide only minor catalatic activity was detected. The stimulatory effect of iodide could not be explained by protection of the enzymes against inactivation by H2O2. A mechanism is suggested involving an enzyme-hypoiodite complex as an intermediate. PMID- 6847662 TI - Occurrence of alpha 2-8 linked polysialosyl units in a neural cell adhesion molecule. AB - A brain cell surface protein (BSP-2) was isolated from mice of different ages by affinity chromatography using a monoclonal antibody. Analysis of glycopeptides obtained after pronase digestion revealed that the embryonal and neonatal forms of the antigen contained an unusually high proportion of sialic acid, which decreased during development. Methylation analysis of native and neuraminidase treated glycopeptides indicated that the sialic acid occurred as alpha 2-8 bound polysialosyl units, similar to those of the recently described developmentally regulated polysialosyl glycopeptides of rat brain. Furthermore, the carbohydrate and amino acid composition, and electrophoretic mobility of BSP-2 antigen correspond to those reported for a neural cell adhesion molecule (N-CAM). PMID- 6847664 TI - Acyltransferase-catalyzed transfer of arachidonic acid to lysophospholipids in rat pancreatic acini. AB - The conversion of 2-lysophospholipids into corresponding phospholipids via acyl CoA acyltransferase was demonstrated in homogenates of rat pancreatic acini. Arachidonic acid was greatly preferred over stearic acid as the acyl donor. Lysophophosphatidylinositol and lysophosphatidylcholine acyltransferases were distributed in subcellular fractions of acinar homogenates with specific activity highest in the fractions known to contain secretory organelles and mitochondria. The distribution of lysophosphatidylinositol acyltransferase paralleled that of a mitochondrial marker (succinate cytochrome C reductase). These findings extend the evidence implicating arachidonate release and reincorporation into phospholipids as a link in the pathway that culminates in pancreatic secretion. PMID- 6847663 TI - Chloroquine stabilizes hepatic glucocorticoid receptors. AB - Chloroquine (an antiarthritic, antimalarial, lysosomotropic amine) was found to significantly stabilize rat unbound hepatic glucocorticoid receptors in vitro for 2 h at 25 degrees C. Chloroquine stabilization was concentration dependent with statistically significant protection at 0.3 mM concentration and optimal effectiveness at approximately 3 mM. KC1 (0.3 M) induced unbound receptor inactivation at low temperature was also markedly reduced in the presence of 3 mM chloroquine. In addition, steroid prebound complexes were significantly stabilized at 4 degrees C and 25 degrees C by 3 mM chloroquine. Unlike molybdate (perhaps the most commonly used glucocorticoid receptor stabilizing reagent), chloroquine did not alter the sedimentation of glucocorticoid-receptor complexes in sucrose-density gradients. These results suggest that chloroquine may have useful application in glucocorticoid receptor quantitation, characterization and purification and may have interesting implications into the biological and pharmacological effects of chloroquine. PMID- 6847665 TI - Chemical modification of spinach ferredoxin with diethylpyrocarbonate: evidence for the essential nature of the histidyl residue. AB - Spinach ferredoxin contains a single ferredoxin which can be chemically modified with diethylpyrocarbonate. By varying the concentration of diethylpyrocarbonate modified ferredoxins could be prepared which had only one or both of the imidazole nitrogens of the histidine modified. A small amount of tyrosine was also modified. Ferredoxin with only one of the imidazole nitrogens modified was fully active in NADP photoreduction by chloroplast membranes. This activity was lost as the second imidazole nitrogen was modified. The results suggest an essential role for the single histidine of ferredoxin. PMID- 6847668 TI - Kinetics of conformational transitions of demetalized Concanavalin A. AB - Demetalized Concanavalin A exists in two conformational states, known as locked (PL) and unlocked (P) [Brown et al., Biochemistry 16, 3883 (1977)]. The equilibrium ratio [PL]/[P] is 0.14 +/- 0.01 at 25 degrees C, pH 6.4 [Brown et al., Biochemistry 21, 465 (1982)]. We now report values of the rate constants for the P in equilibrium; k1 = (33 +/- 4 h)-1 and k-1 = (4.6 +/- 0.6 h)-1 for the P leads to PL and PL leads to P transitions, respectively, at 25 degrees C, pH 6.4. The experiments utilize the fact that saccharide binds to PL [Koenig et al., Biochemistry 17, 4251 (1978)], producing a time-dependent increase in the total concentration of locked forms at equilibrium, and use a new technique for measuring this concentration. PMID- 6847666 TI - The temperature dependence of the MCD spectrum of horseradish peroxidase compound I. AB - The magnetic circular dichroism spectrum of the compound I species of horseradish peroxidase, which contains an iron (IV) porphyrin pi-cation radical complex, has been measured between 273 K and 4.2 K. The spectrum is temperature independent between 273 K and 30 K. However, very strong temperature dependence is observed below 30 K. These data do not appear to fit the temperature dependence expected for the presence of a simple MCD C term, or combination of C terms, but suggest that an increase in the coupling between the S = 1 iron (IV), and the S = 1/2 porphyrin pi-cation radical occurs forming a degenerate ground state. This increase in coupling below 30 K may be the result of a phase change in the protein which in turn affects the electronic structure of the heme group. PMID- 6847667 TI - Identification of gastrin releasing peptide-related substances in guinea pig and rat brain. AB - Rat and guinea pig brain extracts were examined for the occurrence of gastrin releasing peptide (GRP)-like substances by sequence specific radioimmunoassays interfaced with gel filtration and reversed phase high performance liquid chromatography (RP-HPLC). Tryptic digestion of the immunoreactive peptides followed by RP-HPLC was used to further characterize GRP-related peptides in brain. Using these analytical techniques it was found that guinea pig brain extracts contained a peptide with characteristics identical to authentic GRP (27 amino acid residues long). A carboxyterminal fragment with the characteristics of GRP(18-27) as well as a respective aminoterminal fragment with the characteristics of GRP(1-16) were also present in guinea pig brain extracts. The GRP(18-27) seems to correspond to the bombes in related material that has been described previously in mammalian brain extracts. Rat brain extracts also contained a peptide with the characteristics of GRP(18-27). The corresponding aminoterminal fragment, however, behaved differently on RP-HPLC from authentic GRP(1-16) and it was not recognized by antibodies directed to the aminoterminal tridecapeptide fragment of authentic GRP. Similarly the GRP-like peptide from rat brain did not comigrate on RP-HPLC with authentic GRP and was unreactive to antibodies directed toward the aminoterminus of GRP. PMID- 6847669 TI - Inhibition of coenzyme activation of aspartate aminotransferase. AB - Forty compounds were surveyed for their effect on the activation of pig heart apoaspartate aminotransferase by pyridoxamine 5'-phosphate. Most of the nucleotides, sugar phosphates, coenzymes, phospholipid precursors and inorganic oxyanions tested were found to be inhibitory. With few exceptions, the only requirement for a substance to be inhibitory is the presence of a di- or polyanionic moiety analogous to the 5'-phosphate group of the cofactor. In spite of the lack of overall structural similarity to pyridoxamine 5'-phosphate, inorganic pyrophospate and apparently other inhibitors are characterized by dissociation constants comparable in magnitude to that previously reported for the natural cofactor. The physiological significance of the inhibition of coenzyme activation of apoaspartate aminotransferase by these common biological compounds is not known. PMID- 6847670 TI - Spectroscopic evidence for the formation of a transient species during cytochrome P-450scc induced hydroperoxysterol-glycol conversions. AB - Spectroscopic analysis of the interaction of the epimeric 20-hydroperoxy derivatives of cholesterol with bovine adrenocortical cytochrome P-450scc preparations suggested the formation of a transient species. The intermediate was detected at 4 degrees C and characterized by a minimum at 412 nm in the difference spectrum. PMID- 6847671 TI - Isolation and structure of T-kinin. AB - T-kinin, a previously undescribed peptide containing bradykinin, has been isolated following treatment of rat plasma with trypsin (1 mg/ml). The liberated T-kinin, which contracts the rat uterus, was isolated by procedures including OM cellulose, Biogel P-4 and reverse-phase high-performance liquid chromatography. The final material had a single N-terminal isoleucine and was shown by amino acid analysis and sequence determination to have the structure of the undecapeptide Ile-Ser-Arg-Pro-Pro-Gly-Phe-Ser-Pro-Phe-Arg (isoleucyl-seryl-bradykinin). The relationships of the protein from which T-kinin is cleaved (T-kininogen) to other known kininogens is discussed. PMID- 6847672 TI - Sphingomyelin is a possible constituent of binding sites for the tumor promoters phorbol ester, indole alkaloids and polyacetates. AB - Specific binding of 12-0-tetradecanoylphorbol-13-acetate to the epidermal particulate fraction was susceptible to phospholipase A2 and phospholipase C, but was almost resistant to protease and completely resistant to a mixture of several glycosidases. Of vesicles prepared from five phospholipids associated with the epidermal particulate fraction, sphingomyelin vesicles bound 12-0 tetradecanoylphorbol-13-acetate specifically and most effectively. This binding was inhibited by not only phorbol esters but also two other classes of tumor promoters, indole alkaloids and polyacetates. These results suggest that sphingomyelin is involved in the binding sites of tumor promoters to the cell membrane. PMID- 6847673 TI - Purification of mouse liver cytosolic epoxide hydrolase. AB - Cytosolic epoxide hydrolase was purified from male Swiss mouse liver cytosol by passing it sequentially through CM-cellulose, DEAE-cellulose, phenylsepharose, DEAE-cellulose, and hydroxyapatite. The overall yield was ca. 10% with a 180-fold purification, and a final specific activity of 1.5 mumol/min/mg protein as monitored with trans-stilbene oxide. The purified epoxide hydrolase was apparently homogenous as determined by SDS-PAGE and it appears to exist as a dimer in its native form as evidenced by a monomeric molecular weight of 59,000 by SDS-PAGE and a reported native molecular weight of 130,000 by gel filtration. PMID- 6847674 TI - Allosteric interactions among drug binding sites on calmodulin. AB - Felodipine is a fluorescent dihydropyridine Ca2+-antagonist. It binds to calmodulin in a Ca2+-dependent manner, and undergoes a fluorescence increase which allows us to monitor its interaction with calmodulin. Hydrophobic ligands including the calmodulin antagonist, R24571 and Ca2+ antagonists, prenylamine and diltiazem, bind to calmodulin and potentiate felodipine binding by as much as 20 fold. These studies suggest that allosteric interactions occur among different drug binding sites on calmodulin. Our results are discussed in terms of the mechanism of action of calmodulin. PMID- 6847675 TI - Glutathione conjugates of misonidazole. AB - The hydroxylamine derivative of misonidazole reacts with glutathione under physiological conditions to form two isomeric conjugates. Based on physical and chemical properties, the two conjugates have been identified as 1-[2-amino-(4 glutathion-S-yl)-1-imidazolyl]-3-methoxypropanol and 1-[2-amino-(5-glutathion-S yl)-1-imidazolyl]-3-methoxypropanol. The formation of the glutathione conjugates of reduced misonidazole offers a molecular mechanism for the depletion of GSH in mammalian cells after exposure to misonidazole under hypoxic conditions. PMID- 6847676 TI - Affinity chromatography of acyl-CoA utilizing enzymes on Procion Red-agarose. AB - The dye Procion Red HE3B immobilized on agarose and available as Matrex Gel Red A is shown to bind citrate synthase and succinate thiokinase from a number of diverse organisms. Salt-gradient elution removes the enzymes in high yields and with substantial purification. The elution profiles follow a pattern similar to that of the molecular size variations of the enzymes. PMID- 6847677 TI - Differential responsiveness of avian vitellogenin I and vitellogenin II during primary and secondary stimulation with estrogen. AB - Avian vitellogenin consists of two major species, VTG I and VTG II, which show major differences in structure and immunological properties suggesting that VTG I and VTG II are distinct gene products. During primary stimulation with estrogen, VTG I was found to accumulate in plasma much more slowly than VTG II. At 1 day after hormone treatment VTG I was only 1-3% of VTG II, but by day 5 VTG I increased to approximately 25% of VTG II. Measurements of hepatic vitellogenin synthesis confirmed the slower induction and reduced expression of VTG I. A further difference was noted in the amnestic or memory response to secondary estrogen treatment. Measurements of VTG I and VTG II accumulation and synthesis after primary and secondary estrogen treatment showed that the memory response occurs to a much greater extent for VTG I than VTG II. These differences indicate that the inductions of VTG I and VTG II are not tightly coupled. PMID- 6847678 TI - Phenylethanolamine N-methyltransferase: notes on its purification from bovine adrenal medulla and separation from protein carboxymethyltransferase. AB - Standard procedures for the purification of phenylethanolamine N methyltransferase were modified by the addition of an affinity chromatography step utilizing immobilized S-adenosyl-L-homocysteine and by use of preparative isoelectric focusing. Enzyme derived from bovine adrenal medullae was bound to S adenosyl-L-homocysteine agarose, and could be eluted with 0.1 M NaCl. Concentrations of S-adenosyl-L-methionine as high as 10 mM were ineffective in eluting the enzyme. Preparative isoelectric focusing of bovine phenylethanolamine N-methyltransferase showed a single peak with the pI = 4.95. The potential use of immobilized S-adenosyl-L-homocysteine in the differential separation of phenylethanolamine N-methyltransferase from other methyltransferase enzymes is discussed. PMID- 6847679 TI - The reconstitution of higher-order DNA structure after X-irradiation of mammalian cells. AB - X-ray-induced DNA repair in mouse leukemia (L1210) cells was studied by alkaline elution, which measures the amount of DNA strand breakage, coupled with nucleoid sedimentation, which measures DNA compactness. Two phases of X-ray repair were detected. An initial phase was rapid (t1/2 less than 10 min). During this phase most strand breaks were rejoined and some compaction occurred. After a lag of 1-2 hours, a second phase occurred which exhibited very little or no additional ligation but further compaction of the nucleoid DNA. Both the DNA strand rejoining and initial nucleoid compaction of the first phase were inhibited by 3 ABA2 but not by novobiocin, and the second phase was inhibited by novobiocin but not by 3-ABA. The two phases of reconstitution of nucleoid compactness following X-irradiation are thus distinguishable by their time of occurrence and by their sensitivity to inhibitors of DNA-related enzymes. A coordinated process of ligation followed by compaction may be intrinsic to DNA repair following X irradiation. PMID- 6847680 TI - Isolation of laminin from human placental basement membranes: amnion, chorion and chorionic microvessels. AB - Laminin components were solubilized from basement membranes of amnion, chorion and chorionic microvessels of human placenta without prior protease digestion. These structures, after isolation, were initially processed in a sonicator bath containing a solution of Triton X-100, EDTA and 2M NaCl and the laminins extracted sequentially with 0.5M NaCl, 8 M urea, and 8 M urea + 2% 2 mercaptoethanol + 2% SDS. A high molecular weight (appr. 1 x 10(6)) complex containing laminins was purified by gel filtration on a Sepharose CL-2B column. This complex migrated as a single band on gel electrophoresis before reduction but resolved, after reduction, into four major laminin components, laminin A (350,000 M.W.), laminin M (240,000 M.W.) and laminins B1 and B2 (195,000 and 185,000 M.W.). Laminin M is a new molecular species of this protein. PMID- 6847681 TI - Temperate phage induction and filament formation in Vibrio cholerae by furazolidone. AB - Furazolidone a synthetic nitrofuran used in the treatment of cholera, was found to cause prophage induction and filament formation in Vibrio cholerae. Maximum induction of phage beta was obtained at a drug concentration of 0.5 microgram/ml. Neither induction of prophage nor filamentation took place if the drug treatment was carried out in the presence of 2.5 micrograms/ml chloramphenicol, indicating a requirement for de novo protein synthesis. Our results strongly suggest the existence of "SOS" type functions in Vibrio cholerae. PMID- 6847682 TI - CMP-dependent phosphatidylinositol:myo-inositol exchange activity in isolated nerve-endings. AB - Greatly enhanced manganese-dependent phosphatidylinositol:myo-inositol exchange activity was observed when isolated, intact nerve-endings were incubated with the nucleotide, CMP, suggesting that the enzyme, CDP-diglyceride:inositol phosphatidyl transferase, catalyzes this exchange. CMP, at 10 microM, produced as much myo-[2-3H] inositol incorporation into phosphatidylinositol as did 1 mM. This CMP-stimulated exchange activity may reside on the plasma membrane. PMID- 6847683 TI - Cigarette smoking impairs hepatic uptake of high density lipoproteins. AB - The effect of chronic inhalation of cigarette smoke on hepatic uptake of high density lipoproteins (HDL) in White Carneau pigeons was examined. Four treatment groups included: 1) Shelf Control birds fed a chow diet and retained in their cages; 2) Sham pigeons fed a cholesterol-saturated fat diet and exposed to fresh air by a smoking machine; 3) Low nicotine-low carbon monoxide (LoLo) animals also fed the cholesterol diet and exposed to low concentrations of these cigarette smoke products; and 4) High nicotine-high carbon monoxide (HiHi) birds fed the cholesterol diet and subjected to high concentrations of these components. Livers from both smoke exposed groups contained significantly more triglyceride than those from Sham animals while livers from HiHi birds alone had elevated concentrations of protein. Liver slices from LoLo and HiHi pigeons incorporated significantly less HDL 3H free and esterified cholesterol and HDL 14C apoprotein from media during in vitro incubation than livers from Sham birds. Impaired hepatic uptake of HDL suggests a permanent alteration in liver function resulting from chronic exposure to tobacco smoke and may represent one mechanism by which cigarette smoking attenuates HDL's anti-atherogenic properties. PMID- 6847684 TI - Cholesterol and 7-dehydrocholesterol inhibit the in situ degradation of sphingomyelin by cultured human fibroblasts. AB - Feeding cultured human fibroblasts with cholesterol and 7-dehydrocholesterol resulted in a strong decrease of the in situ degradation of sphingomyelin (about 20 and 40 fold reduction for cholesterol and 7-dehydrocholesterol respectively, at 50 micrograms/ml of medium, and for 24 h incubation). Measurement performed on cell homogenates showed a slight decrease of the sphingomyelinase activity (about 75% of controls), whereas the activities of other lysosomal enzymes (beta glucosaminidase, beta galactosidase) were not significantly affected. PMID- 6847685 TI - Fluorescence labeling of cell surface glycoconjugates with Lucifer yellow CH. AB - Lucifer yellow CH, a fluorescent hydrazide, reacted with cell surface glycoconjugates on murine thymocytes oxidized with NaIO4 or galactose oxidase. Surface labeling was monitored by fluorescence microscopy, spectrophotometry and by flow microfluorometry. No labeling was detected in unoxidized cells and fluorescence was reduced by neuraminidase and by trypsin. Lucifer yellow CH derivatives of gangliosides also were prepared and incorporated into the surface membranes of thymocytes. PMID- 6847686 TI - Reversibility of self-phosphorylation of a histidine residue of adrenocortical cyclic nucleotide-independent protein kinase, SPK 380. AB - SPK 380 is a novel cyclic nucleotide-independent protein kinase that self phosphorylates the tau-amino position of the histidine residue(s) residing in its 120,000-dalton subunit and specifically catalyzes the phosphorylation of serine residue(s) of the alpha-subunit of eukaryotic initiation factor 2 [Kuroda, Y. and Sharma, R.K. (1982) Arch. Biochem. Biophys. 217, 588-596]. Herein we demonstrate that this self-phosphorylation reaction is reversible. In the presence of ADP and Mg2+ or Mn2+, the phosphate bound to histidine is transferred from the enzyme to ADP, resulting in the formation of ATP. The rate of reversible reaction is rapid, and maximal value is reached in 30 seconds. The reaction is dependent on ADP concentration and shows a broad pH activity optimum in contrast to the optimal pH of 8 for the forward reaction. PMID- 6847687 TI - Ontogeny of immunoreactive CCK, VIP and secretin in rat brain and gut. AB - Immunoreactive cholecystokinin (iCCK), vasoactive intestinal peptide (iVIP) and secretin (iSEC) were determined in the brain and various gut regions in the developing rat between 3 and 28 days after birth and in the adult. From the different patterns observed with these three peptides, it is concluded that in rat neural tissues, peptide concentrations (iCCK in brain, iVIP in brain and gut) increase continuously until about 4 weeks. Concentrations in mucosal tissues (iSEC in gut) are equal to or higher than adult values 3 days after birth. Gut iCCK (found both in neuronal and mucosal tissues) peaks at about 2 weeks, presumably due to concentrations increasing in the former and decreasing in the latter tissues. PMID- 6847688 TI - Fucosyl-globoside and sialosyl-globoside are new glycolipids isolated from human teratocarcinoma cells. AB - Several novel glycosphingolipids have been isolated from the human teratocarcinoma cell line HT-E (833K). These cells contain two neutral glycolipids which metabolically incorporate radio-labelled fucose. In addition, there are three new gangliosides present, which are all members of the globoside series of glycolipids. One of the fucose containing glycolipids forms globoside when treated with alpha-fucosidase, and one of the gangliosides forms globoside when treated with neuraminidase. On the basis of chromatographic behavior, exoglycosidase treatment and antibody reactivity, the tentative structures of these new glycolipids are: Fuc (alpha 1-?) GalNAc (beta 1-3) Gal (alpha 1-4) Gal (beta 1-4) Glc (beta 1-Cer) and NeuAc (alpha 2-3) GalNAc (beta 1-3) Gal (alpha 1 4) Gal (beta 1-4) Glc (beta 1-Cer) PMID- 6847689 TI - Modification of acetylcholinesterase with the fluorescent thiol reagent S mercuric-N-dansylcysteine. AB - 11s acetylcholinesterase (EC 3.1.1.7) from Torpedo californica electroplax, purified by a combination of affinity and gel chromatography was found to react stoichiometrically with S-mercuric-N-dansylcysteine. Approximately four mols of reagent per mol of enzyme were incorporated when the modification was carried out in 1.0 mM Tris-C1, pH 7.5, either in the presence or absence of 0.1 M NaCl. Prior incubation of the enzyme with 1.0 x 10(-4) M Zn2+ allowed the incorporation of about six mols of reagent per mol of enzyme. Binding of the reagent produced shifts in the emission and excitation wavelength maxima which were similar for all reaction conditions; however the enhancement of fluorescence intensity which accompanied binding of reagent was dependent on the ionic composition of the reaction medium. The modified enzyme remained active towards the active site titrant 7-(dimethylcarbamoyloxy)-N-methylquinolinium and retained its sensitivity towards inactivation by Zn2+. The results suggest that acetylcholinesterase as prepared contains several accessible thiol groups, and that the bound reagent may prove to be a useful probe of ligand-induced conformational changes in acetylcholinesterase. PMID- 6847690 TI - Regulation of the solubilized bovine cerebral cortex muscarinic receptor by GTP and Na+. AB - The muscarinic acetylcholine receptor was solubilized, in a sensitive form for GTP and Na+, from bovine cerebral cortex using a zwitterionic detergent 3-[(3 cholamidopropyl)-dimethylammonio]-1-propane sulfonate. The solubilized muscarinic receptor displayed characteristics as follows: (1) high affinity to nanomolar concentration of Z-[3H]quinuclidinyl benzilate; (2) muscarinic agonists and antagonists had similar inhibitory potencies as on the membrane-bound receptor; (3) without Na+, GTP did not significantly alter the binding affinity of muscarinic agonists and antagonists; (4) GTP in the presence of Na+, selectively decreased the affinity of muscarinic agonists, carbamylcholine and oxotremoline, but not the antagonist binding affinity; (5) Na+ in the absence or presence of GTP, reduced both muscarinic agonist and antagonist affinities. PMID- 6847691 TI - Differentiated inhibition of DNA, RNA and protein synthesis in L1210 cells by 8 methoxypsoralen. AB - The synthesis of DNA, RNA and protein was measured in L1210 cells following treatment with 8-methoxypsoralen in combination with long wavelength ultraviolet irradiation. The results show that the DNA synthesis is strongly inhibited (approximately 95%) at 200 ng/ml reaching a minimum within 2 hours while RNA synthesis is only weakly affected at this concentration (approximately 40% inhibition). At 2 micrograms/ml the RNA synthesis is inhibited approximately 90%. Even at this concentration only a moderate effect is seen on the protein synthesis. These results strongly indicate that the phototoxic action of 8 methoxypsoralen is primarily due to inhibition of DNA synthesis. PMID- 6847692 TI - Indomethacin inhibition of glutathione S-transferases. AB - Indomethacin inhibited rat liver glutathione S-transferases (EC 2.5.1.18). Its inhibition was non-competitive with respect to 3,4-dichloronitrobenzene with an apparent Ki of 5.3 X 10(-5) M and uncompetitive with respect to glutathione with an apparent Ki of 4.0 X 10(-5) M. 4-Chlorobenzoic acid and 5-methoxy-2 methylindole-3-acetic acid, two metabolites of indomethacin, were weak inhibitors of the enzymes. On the other hand, meclofenamic acid was a competitive inhibitor of the enzymes with an apparent Ki of 3.0 X 10(-4) M. Possible significance of these findings in arachidonic acid metabolism is discussed. PMID- 6847693 TI - Handling of in vitro human breast tissue samples: protocol requirements for accurate NMR relaxation measurements. PMID- 6847694 TI - Decreased hepatic microsomal cytochrome P450 due to indomethacin: protective roles of 16,16-dimethylprostaglandin F2 alpha and inducing agents. AB - Indomethacin administration to rats caused a dose-dependent decrease in hepatic microsomal cytochrome P450, aminopyrine N-demethylase, ethoxyresorufin O-de ethylase and benzyloxyresorufin O-debenzylase, accompanied by selective alterations in microsomal sodium dodecylsulphate polyacrylamide gel electrophoretograms. High doses (greater than or equal to 8.5 mg/kg) caused the disappearance of certain of the SDS-PAGE proteins tentatively identified as being different forms of cyt. P450, together with either increases, decreases or no change in some of the non-cyt. P450 proteins in the electrophoretogram. Concomitant administration of 16,16-dimethylprostaglandin F2 alpha gave dose dependent protection against the deleterious effects of indomethacin on the enzymic and electrophoretic parameters of cyt. P450, but did not prevent the changes due to indomethacin in the non-cyt. P450 proteins on the electrophoretogram. In contrast, prior phenobarbitone or 3-methylcholanthrene induction prevented the effects of indomethacin on both cyt. P450 and the other microsomal proteins. Concomitant administration of SKF-525A exacerbated the effects of indomethacin on cyt. P450 and the other proteins. Indomethacin coadministration with 3-methylcholanthrene resulted in the major 3MC-induced putative cyt. P450 apoprotein having a lower mol. wt than usual. Conversely, indomethacin did not prevent the induction by SKF-525A of a different putative cyt. P450 apoprotein, despite causing decreases in cyt. P450 as determined spectrophotometrically and enzymologically. The results indicate that indomethacin rather than one of its metabolites is responsible for the decrease in cyt. P450 and that the mechanisms of protection by prostaglandin and inducing agents are, respectively, different. PMID- 6847695 TI - Structure-activity relationship of ligands of the pyrimidine nucleoside phosphorylases. AB - Eighty-seven pyrimidine base and nucleoside analogs were evaluated as inhibitors of uridine phosphorylase (UrdPase) and thymidine phosphorylase (dThdPase). These findings, together with an extensive literature review, have allowed construction of structure-activity relationships for the binding of ligands to UrdPase and dThdPase and provide a basis for the rational design of new inhibitors of these enzymes. Additionally, 2,6-pyridinediol and 6-benzyl-2-thiouracil have been identified as being potent inhibitors of UrdPase and dThdPase respectively. PMID- 6847696 TI - Effects of cations and temperature on the binding of [3H]spiperone to sheep caudate nucleus. AB - The specific [3H]spiperone binding by sheep caudate nucleus homogenate is increased by divalent cations. The effect of Ca2+ or Mn2+ (5 mM) is temperature dependent, and it is optimal at about 37 degrees, but is relatively low below 15 degrees and above 50 degrees. In the absence of added Ca2+ or Mn2+, the maximal specific [3H]spiperone binding is observed at about 25 degrees, and the cations shift the optimum to about 37 degrees. Under the experimental conditions used, the KD is about 0.6 nM and is not influenced by Ca2+ or Mn2+, or by temperature (25 and 37 degrees). In addition to Ca2+ and Mn2+, Mg2+ and Zn2+ also increase the specific [3H]spiperone binding, but to a smaller extent. At the concentrations of Ca2+, Mn2+, Mg2+ and Zn2+ which produce a maximal increase in the [3H]spiperone binding, the membranes are nearly saturated with the cations which bind about 100 nmoles of Ca2+ or Mg2+/mg of protein, 170 nmoles Zn2+/mg of protein and at least 300 nmoles Mn2+/mg of protein. It is suggested that the cations increase the [3H]spiperone binding by either exposing more binding sites, by preventing denaturation or by increasing the solubility of [3H]spiperone in the membrane phase, or by a combination of these processes. PMID- 6847697 TI - Differences in the structures of monoamine oxidases A and B in rat clonal cell lines. AB - [3H]Pargyline-labeled polypeptides associated with the A and B types of monoamine oxidase (MAO) activity in two rat cell lines were compared by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). [3H]Pargyline was bound to MAO A and B in a crude mitochondrial fraction from rat hepatoma cell line MH1C1 and to MAO A in a mitochondrial fraction from rat glioma line C6. Specific radiolabeling of proteins associated with type A or B activity in the hepatoma samples was achieved by incubation with selective B or A inhibitors, respectively, prior to [3H]pargyline binding. Following [3H]pargyline binding, the samples were solubilized by heating in sodium dodecyl sulfate (SDS) in the presence of a reducing agent. SDS-PAGE of [3H]pargyline bound samples revealed a radiolabeled protein band of apparent molecular weight (mol. wt) 63,000 daltons associated exclusively with MAO A activity and a band of apparent mol. wt 60,000 associated exclusively with MAO B activity. Furthermore, when SDS-solubilized, [3H]pargyline-labeled MAO A and B proteins from these cell lines were subjected to limited proteolysis and one-dimensional peptide mapping in SDS gels, different patterns of [3H]pargyline-labeled peptides were obtained. These findings indicate that the A and B forms of MAO activity are associated with enzyme molecules of different primary covalent structures determined by different gene loci. PMID- 6847698 TI - Increased biliary secretion and loss of hepatic glutathione in rat liver after nifurtimox treatment. AB - Treatment of rats with nifurtimox, a nitrofuran derivative widely used for the treatment of Chagas' disease, induced a time- and dose-dependent depletion of liver glutathione, maximal effects being obtained with 200 mg nifurtimox/kg body weight. Extra release of both oxidized (GSSG) and reduced (GSH) glutathione into bile contributed to this depletion. Glutathione excretion into bile accounted for only part of liver glutathione loss, thus indicating that, in addition to the GSH peroxidase reaction (resulting in GSSG generation), other glutathione-related processes were involved in nifurtimox detoxification. Bile flow, bile salt excretion, liver lipid conjugated diene content, liver glutathione reductase and glutathione peroxidase activities, and serum alanine aminotransferase (ALAT) activity were not affected by the nifurtimox treatment, thus ruling out widespread damage of the liver cell by nifurtimox. Nevertheless, the extra GSH release in the nifurtimox-treated rats may indicate an alteration of the hepatocyte membrane. PMID- 6847699 TI - Chemotherapeutic potential of methionine analogue inhibitors of tumor-derived methionine adenosyltransferases. AB - Two isozymes of ATP:L-methionine S-adenosyltransferase (MAT) were fractionated from rat Novikoff solid hepatoma. Their Km values for L-methionine and/or their inhibition constants for various L-methionine analogues were significantly different from the kinetic constants obtained for three isozymes fractionated from normal rat liver. Ki values for cycloleucine and (+/-)-2 aminobicyclo[2.1.1]hexane-2-carboxylic acid, presented for each tumor and liver isozyme, indicate that (+/-)-2-aminobicyclo[2.1.1]hexane-2-carboxylic acid was the more potent inhibitor. Dixon plots were also used to test a series of amino acid analogues [cycloleucine, 1-aminocyclobutanecarboxylic acid, 1 aminocyclohexanecarboxylic acid, (+/-)-2-aminobicyclo[2.1.1]hexane-2-carboxylic acid, L-2-amino-4-hexynoic acid, (Z)-L-2-amino-5-chloro-trans-4-hexenoic acid, L ethionine, S-n-propyl-DL-homocysteine, S-n-butyl-DL-homocysteine, and seleno-DL ethionine] of methionine for inhibitory potency. Fixed L-methionine concentrations were used to determine the concentration of inhibitor necessary to inhibit the MAT reaction by 50%. Differential inhibitory activities of the amino acid analogues were noted between the tumor and rat liver isozymes thus supporting the suggestion that tumor-derived MAT isozymes may provide an exploitable target for cancer chemotherapy. PMID- 6847701 TI - Formation and disposition of 7-hydroxymethotrexate in rabbits. AB - The metabolism of methotrexate in rabbits was investigated following 6 hr of infusion with [3',5',7-(3)H]methotrexate (50 mg/kg). Methotrexate and its metabolites were analyzed by an enzyme kinetic method, reverse phase high performance liquid chromatography, and scintillation counting of radioactivity. 7 Hydroxymethotrexate was found to be a major metabolite in plasma, urine, bile and various tissues of rabbits. Cumulative production of 7-hydroxymethotrexate during the first 6 hr was 31.8% of the total dose. The peak 7-hydroxymethotrexate concentration in plasma was reached at the end of the infusion, and this concentration was higher than the methotrexate concentration. The plasma clearance of 7-hydroxymethotrexate was biphasic in nature and slower than that of methotrexate. The highest methotrexate concentration was found in kidney after 6 hr. This concentration was found to be 7.2 times greater than that in plasma. A higher ratio of 7-hydroxymethotrexate/methotrexate was found in liver, small intestine, kidney and testis when compared to plasma. Lung and kidney showed significant conversion of methotrexate to 7-hydroxymethotrexate in vitro, as did the liver. PMID- 6847700 TI - Influence of estrogens on peroxidase activity in the Syrian hamster liver, kidney, and renal adenocarcinoma. AB - Only very low levels of peroxidase activity were detected in castrated male hamster kidneys [1.0 +/- 0.8(S.E.) units/g protein], and chronic estrogen administration, either diethylstilbestrol (DES) or 17 beta-estradiol, for 1-5 months did not result in any appreciable increase in this activity. In contrast, hamster liver peroxidase activity was initially 10- to 20-fold higher than kidney levels, and chronic estrogen treatment for similar periods resulted in up to a 9 fold elevation in the activity of this enzyme. Moreover, the level of liver peroxidase activity in both intact and in 5 alpha-dihydrotestosterone-treated castrate hamsters was 2-fold higher than castrate-untreated values. Pure renal carcinoma induced after 9 months of estrogen treatment exhibited peroxidase values similar to those found in hamster livers [124 +/- 27 (S.E.) units/g protein] following estrogen treatment. When administered concomitantly with DES, tamoxifen significantly reduced the elevated levels of liver peroxidase activity observed after 2 months of DES treatment alone. A high affinity (KA = 0.10 X 10(9)M-1) estrogen receptor was found in liver cytosols of DES-treated hamsters which had increased slightly from untreated castrate levels. PMID- 6847702 TI - Uptake and decomposition of chlorambucil by L5178Y lymphoblasts in vitro. AB - The uptake of [14C]chlorambucil by L5178Y lymphoblasts was studied using thin layer chromatography to identify the various radioactive components that enter or leave cells. Theoretical calculations predicted that entry of chlorambucil into cells by simple diffusion would be rapid and essentially complete in 45 sec or less. Uptake of intact chlorambucil was rapid, reaching a cell/medium ratio of approximately 1.5 in less than 15 sec at both 37 degrees and 4 degrees, consistent with a simple diffusion mechanism. In cells treated with [14C]chlorambucil for 60 min, the intracellular level of intact drug decreased with time, and this decay was attributed to hydrolysis and alkylation. The level of intact drug in the medium decreased at a similar rate resulting in a nearly constant cell/medium distribution ratio. Intact chlorambucil in the cells was found to be entirely ethanol- and trichloroacetic acid-soluble. Efflux of intact chlorambucil was very rapid and temperature-insensitive. These findings suggest that chlorambucil efflux, as well as influx, is by a simple diffusion mechanism. A derivative of chlorambucil was found in ethanol solutions of the drug. This derivative, which may be the ethyl ester of the drug, is highly concentrated in cells and may interfere with pharmacological investigations of chlorambucil. PMID- 6847703 TI - Interaction of capsaicinoids with drug-metabolizing systems. Relationship to toxicity. AB - The interaction of capsaicin with microsomal drug-metabolizing systems was assessed to determine the role that bioactivation of capsaicin may play in the induction of hepatotoxicity and neurotoxicity. Capsaicin produced a type I spectral change in rat hepatic microsomes in a high affinity (Ks = 8 microM) concentration-dependent manner and was approximately equipotent with SKF-525A in inhibiting ethylmorphine demethylation. Capsaicin (10 mg/kg, s.c.) inhibited biotransformation in vivo as measured by prolongation of pentobarbital sleep time. Reactive metabolites of capsaicin were studied using [3H]dihydrocapsaicin. [3H]Dihydrocapsaicin bound irreversibly to hepatic microsomal protein after in vitro incubation or in vivo administration. No binding was observed in spinal cord or brain. Although the bioactivation and subsequent covalent binding of capsaicin equivalents may initiate events associated with the hepatotoxicity of capsaicin, it appears that capsaicin-induced neuropathy does not involve covalent interactions with neuroproteins in spinal cord or brain. PMID- 6847704 TI - Effects of a membrane sugar analogue, 6-deoxy-6-fluoro-D-galactose, on the L1210 leukemic cell ectosialyltransferase system. AB - In L1210 leukemia cells, 6-deoxy-6-fluoro-D-galactose specifically inhibited the incorporation of [3H]-D-galactose, while that of other precursors of glycoconjugate biosynthesis, including mannose and glucosamine, was unaffected. The activation of [6-3H]-6-deoxy-6-fluoro-D-galactose to a nucleotide sugar was similar to that found for [3H]-D-galactose. The incorporation of either sugar after 1 hr was visualized by electron microscopic autoradiography to be in the Golgi region. Treatment of L1210 cells with 6-deoxy-6-fluoro-D-galactose in vitro or in vivo resulted in a specific, dose- and time-dependent decrease in the activity of cell surface sialyltransferase (ectosialyltransferase) but not of 5' nucleotidase, a plasma membrane marker enzyme. The decrease in ectosialyltransferase activity appeared to be selective and is suggested to be due to structural modification of the cell surface galactoprotein acceptors for this enzyme. The data indicate that 6-deoxy-6-fluoro-D-galactose is an effective modifier of cellular glycoconjugate in that its incorporation into certain cell surface components results in a modification of plasma membrane structure and function. PMID- 6847705 TI - Inhibition of normal and leukemic lymphocyte proliferation by compound 48/80. PMID- 6847706 TI - Further evidence that vascular serotonin receptors are of the 5HT2 type. PMID- 6847707 TI - alpha 1-acid glycoprotein involvement in high affinity binding of tricyclic antidepressants to human plasma. AB - The binding of the tricyclic antidepressants imipramine (IMI) and desmethylimipramine (DMI) to human plasma and individual proteins was studied by equilibrium dialysis. Both drugs bound extensively to plasma, albumin, and alpha 1-acid glycoprotein, while there was very little binding to the gamma-globulin fraction. The binding of both IMI and DMI to alpha 1-acid glycoprotein was high affinity (association constant K, 9.2 X 10(4)/M and 4.7 X 10(4)/M respectively) and low capacity (number of binding sites, n = 1 for both IMI and DMI), whereas the binding to albumin was low affinity (K for IMI, 2.3 X 10(2)/M and for DMI, 3 X 10(2)/M) and high capacity (n = 7). The binding of IMI to a mixture of human serum albumin and alpha 1-acid glycoprotein revealed two sets of binding sites; a high affinity binding site corresponding to alpha 1-acid glycoprotein and a low affinity binding site corresponding to albumin. The binding affinity and/or number of binding sites for IMI binding to albumin decreased with increasing albumin concentrations. The free fraction in plasma of nineteen normal, male controls was significantly correlated with the concentration of alpha 1-acid glycoprotein (r = 0.601, P less than 0.01), although there was no correlation with albumin or free fatty acid concentrations in plasma. PMID- 6847708 TI - Differential substrate selectivity of murine hepatic cytosolic and microsomal epoxide hydrolases. AB - The initial rates of hydration of sixteen epoxides in the presence of cytosolic and microsomal fractions of mouse liver were determined. 1,2-Disubstituted trans epoxides were found to be excellent, selective substrates for the cytosolic epoxide hydrolase, while 1,2-cis-epoxides were poorly hydrated when one or more substituents was a phenyl moiety. Epoxides of cyclic systems including benzo[alpha]pyrene 4,5-oxide, and two cyclodiene analogs were hydrated almost exclusively by the microsomal epoxide hydrolase while monosubstituted epoxides were hydrated by both systems. Some epoxides which were mediocre substrates proved to be reasonable inhibitors of the cytosolic epoxide hydrolase, indicating that the structural requirements for substrate binding and turnover are different. Some reagents known to interact with sulfhydryl groups, including styrene oxide, proved to be good inhibitors. This work facilitates the design of radiochemical and spectrophotometric assays for both major forms of epoxide hydrolase as well as prediction of potential intrinsic substrates. Also such data may be meaningful in assessing the risk involved in human exposure to epoxidized xenobiotics. PMID- 6847709 TI - Suppression by phospholipase A2 inhibitors of secretion of catecholamines from isolated adrenal medullary cells by suppression of cellular calcium uptake. AB - The involvement of phospholipase A2 in the secretion of catecholamines and cellular uptake of 45Ca2+ was investigated in isolated bovine adrenal medullary cells. In these cells, stimulation of cholinergic receptors by carbamylcholine causes the activation of receptor-linked Ca-channels and influx of Ca2+ is known to trigger the secretory process. Phospholipase A2 inhibitors, such as quinacrine, chloroquine, quinine and p-bromophenacyl bromide, all inhibited the secretion of catecholamines evoked by carbamylcholine in a dose-dependent manner. These phospholipase A2 inhibitors also inhibited the cellular uptake of 45Ca2+ evoked by carbamylcholine with similar dose-response curves to those for inhibition of catecholamine secretion. The inhibition by phospholipase A2 inhibitors was found to be distinct from inhibition by d-tubocurarine which competitively blocks acetylcholine receptors, and from inhibition by diltiazem which acts as a Ca-antagonist at Ca-channels. Phospholipase A2 inhibitors seem to suppress the secretion of catecholamines by interfering with the linkage between acetylcholine receptors and Ca-channels by the membrane effects including the inhibition of endogenous phospholipase A2 activity of the adrenal medullary cells. PMID- 6847711 TI - Anti-inflammatory effect of proteinase inhibitors on carrageenin-induced inflammation in rats. AB - Proteinase inhibitors were evaluated for their anti-inflammatory actions on carrageenin-induced inflammation in rats. The development of granulation tissue and the exudate were markedly suppressed by a single injection of L-1-tosylamide 2-phenylethyl chloromethyl ketone (TPCK) into the carrageenin-air-pouch immediately after carrageenin injection, whereas a single injection of TPCK at 12 or 24 hr after carrageenin injection was less effective or slightly effective respectively. These results suggest that proteinase inhibitors exert their anti inflammatory actions by interfering with the initial inflammatory reactions after carrageenin injection. When the wet weight of granulation tissue and the weight of exudate were measured on day 4 after the simultaneous injection of carrageenin and inhibitors, a single injection of serine- and thiol-proteinase inhibitors including TPCK, leupeptin, antipain, chymostatin and cystamine suppressed the development of granulation tissue, though EDTA and o-phenanthroline, metallo proteinase inhibitors, were also effective at a high dose. Exudate was reduced by treatment with TPCK in a dose-dependent manner, while EDTA and o-phenanthroline were effective only at a high dose. On the other hand, the migration of polymorphonuclear leukocytes into the carrageenin-air-pouch (the inflammatory lesion) was markedly suppressed by TPCK and leupeptin, while a high dose of cystamine and o-phenanthroline was slightly effective, and antipain, chymostatin, pepstatin, elastatinal, EDTA, trans-1-aminomethylcyclohexane 4-carboxylic acid and aprotinin were without effect. PMID- 6847710 TI - Effects of hypophysectomy on acetylcholinesterase and butyrylcholinesterase in the rat. AB - Acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) activities were examined in several tissues of normal and hypophysectomized male and female rats. Significant sex differences in the mean AChE activities of normal rats were observed in the superior cervical ganglion (three times more activity in males) and in serum (50% more activity in females). Sex differences in the BuChE activity of serum and liver were even larger (ten times more activity in females), but the activity of other tissues was similar in both sexes. Hypophysectomy had little effect on the mean activity of AChE but did alter BuChE activity in certain tissues. Most of the effects of hypophysectomy on mean BuChE activity were opposite in direction in the two sexes. For example, in males hypophysectomy caused increases in the BuChE activity of serum (300%) and liver (43%), while in females it caused decreases in both tissues (25 and 30% respectively). In rats of a given group, the AChE activity of each tissue appeared to be regulated independently of the activity in other tissues. By contrast, BuChE activity showed statistically significant correlations in more than half of the tissue-pairs examined in control rats of either sex. These correlations can be considered to reflect a tendency toward body-wide regulation. In female rats, the cross-tissue correlations were largely eliminated by hypophysectomy. This finding indicates that the regulation of BuChE may be strongly affected by hormones under the control of the pituitary gland. However, in male rats, only the correlations involving atria were altered by hypophysectomy. Therefore, the effects of hormones on BuChE are probably both sex and tissue dependent. PMID- 6847712 TI - Benzodiazepine inhibition of nucleoside transport in human erythrocytes. AB - The interaction of several benzodiazepines (BDZs) with the nucleoside transport system of fresh erythrocytes from humans was investigated. The affinities of BDZs for the nucleoside transport system were estimated by measuring BDZ inhibition of (a) the site-specific binding of nitrobenzylthioinosine, a potent and specific inhibitor of nucleoside transport, and (b) the uridine transport processes, zero trans influx, zero-trans efflux, and equilibrium exchange influx. The BDZs inhibited both the inward and outward transport processes, and, for individual agents, inhibition constants (Ki) were similar for the inhibition of each transport process and for the inhibition of the site-specific binding of nitrobenzylthioinosine. The order of potencies of the BDZs in their interactions with the nucleoside transport mechanism (Ro 5-4864 greater than diazepam greater than clonazepam greater than lorazepam greater than flurazepam) is distinct from the potencies of these compounds at BDZ recognition sites. The affinities of the BDZs for the nucleoside transport system, which are about 1000-fold lower than for BDZ recognition sites, suggest that significant inhibition is unlikely to occur with the plasma concentrations (less than 1 microM) that result from usual anxiolytic doses of these agents. PMID- 6847713 TI - Factors affecting solubilized dopamine-sensitive adenylate cyclase. AB - Bovine striatal adenylate cyclase was solubilized with sodium cholate and assayed for its responsiveness to a variety of agents. Magnesium ions (0-20 mM), guanylyl imidodiphosphate (10-50 microM), and striatal lipids were effective in increasing enzyme activity. The adenylate cyclase could be stimulated by dopamine, and neuroleptic drugs inhibited the effect of dopamine (50 microM) with potencies that paralleled their clinical potencies. The IC50 values for spiroperidol, haloperidol and chlorpromazine were 0.2, 3 and 500 nM respectively. PMID- 6847714 TI - N-[2-(o-iodophenoxy)ethyl]cyclopropylamine hydrochloride (LY121768), a potent and selective irreversible inhibitor of type A monoamine oxidase. AB - The effects of N-[2-(o-iodophenoxy)ethyl]cyclopropylamine hydrochloride (LY121768) on types A and B monoamine oxidase (MAO) assayed with radiocarbon labeled serotonin and phenylethylamine, respectively, were studied in vitro and in vivo. Type A MAO from rat brain was inhibited in vitro by LY121768 with an IC50 of 4 x 10(-10) M, whereas 2500 times higher concentrations of LY121768 (IC50 = 1 x 10(-6) M) were required to inhibit type B MAO. The inhibition of type A MAO increased with time of incubation of LY121768 with enzyme prior to substrate addition and persisted after dialysis, indicative of irreversible inhibition. The irreversible inactivation was prevented by harmaline, a reversible, competitive inhibitor of type A MAO, indicating a requirement for catalytic activity of MAO in the time-dependent inactivation by LY121768. In rats, LY121768 selectively inhibited type A MAO in brain and in liver at low doses. The inhibition of type A MAO persisted for several days after a single 10 mg/kg i.p. dose of LY121768 and was associated with a significant increase in brain dopamine, norepinephrine and epinephrine concentrations and a significant decrease in the concentration of the dopamine metabolites, homovanillic acid and 3,4-dihydroxyphenylacetic acid. The inactivation of type A MAO by LY121768 in vivo was prevented by co-administration of harmaline, indicating a similar mechanism for the in vivo inactivation as for the in vitro inactivation of MAO by LY121768. A reasonable inference from these data and from previous literature is that LY121768 acts as a "suicide substrate" for MAO and inactivates the enzyme by formation of a reactive intermediate which binds covalently to the enzyme. The presence of iodine in the LY121768 molecule not only confers high selectivity for type A MAO but offers a site for radionuclide introduction that might be a useful means of labeling type A MAO in vitro or in vivo for various purposes. PMID- 6847715 TI - Photoreactivity of lysergic acid diethylamide and its possible utility as a photoaffinity labeling reagent. AB - Aqueous solutions of lysergic acid diethylamide (LSD) are extremely sensitive to light in the near-ultraviolet region of the spectrum. This rather efficient photoreaction yields a variety of products which have very low affinity for LSD binding sites on plasma membranes from Fasciola hepatica. Since this photoreaction may be elicited by normal white fluorescent lighting in the laboratory, it represents a potential source of error in determining the binding affinity of LSD. Utilizing this photoreactivity advantageously, [3H]LSD was used to photolabel membrane proteins. Covalent binding of [3H]LSD was shown to be a function of the duration of illumination and was inhibited by 5-hydroxytryptamine and nonradioactive LSD. Sodium dodecylsulfate (SDS) polyacrylamide gel electrophoresis of [3H]LSD labeled membranes from F. hepatica showed two proteins which were selectively labeled by the photoreactive [3H]LSD. This method of direct photolabeling with non-derivatized [3H]LSD may allow identification of LSD binding proteins in a variety of systems. PMID- 6847716 TI - Modes of inhibition by acylcarnitines, adriamycin and trifluoperazine of cardiac phospholipid-sensitive calcium-dependent protein kinase. AB - Palmitoylcarnitine, adriamycin, and trifluoperazine competively inhibited, with respect to phosphatidylserine (a phospholipid cofactor), purified cardiac phospholipid-sensitive Ca2+-dependent protein kinase, with apparent Ki values of 3, 49 and 14 microM respectively. These compounds also inhibited the enzyme competitively with respect to Ca2+ (a metal activator), with corresponding apparent Ki values of 0.8, 140 and 9 microM. A synergistic inhibition was observed when palmitoylcarnitine and trifluoperazine were present in combination. A simple addition inhibition on the other hand, was observed for the combination of either palmitoylcarnitine and adriamycin, or trifluoperazine and adriamycin. 1,3-Diolein decreased the inhibitory effect of trifluoperazine by increasing the affinity of the enzyme for phosphatidylserine. The results indicate that the recently identified phospholipid-sensitive species of Ca2+-dependent protein kinase was inhibited by a variety of agents, probably via their abilities to interfere with a hydrophobic interaction between phospholipid and the enzyme, an interaction presumably required to confer upon the enzyme a Ca2+ sensitivity. Because other long-chain fatty acylcarnitines (stearoyl- and linoleoylcarnitine), short-chain fatty acylcarnitines (such as octanoylcarnitine) and palmitoyl CoA, compared to palmitoylcarnitine, were less active as inhibitors, it is further suggested that lipophilicity as well as other structural determinants are crucial for the ability of compounds to regulate the enzyme activity. PMID- 6847717 TI - Inhibition of hepatic drug metabolism in the rat after Corynebacterium parvum treatment. AB - Drug-metabolizing enzyme activities, cytochrome concentration, and protein content of hepatic microsomal preparations from adult, female Sprague-Dawley rats were examined at 1-, 3-, 6-, 10-, 14- and 17-day intervals after administration of a single intravenous injection of Corynebacterium parvum (C. parvum) at a dose of 10 mg/m2. Aniline hydroxylase (AH) activity, aminopyrine demethylase (APD) activity, and cytochrome P-450 concentration were reduced 20-50% on days 3-6 and, thereafter, gradually recovered to control levels by day 17. Cytochrome c reductase activity and cytochrome b5 concentration were reduced significantly (24%) only on day 10. Microsomal protein concentration was unchanged. C. parvum added in vitro had no effect on AH or APD activity. Although livers of treated rats were only slightly (less than 20%) enlarged, gross splenomegaly was apparent, reaching a maximum on day 6. A marked inverse correlation existed between the temporal variation in the size of the spleen and APD activity. In rats killed 6 days after administration of C. parvum at 0.67 to 10.00 mg/m2, a direct relationship was apparent between the adjuvant dose and the magnitude of reduction of APD activity. A similar relationship was apparent between splenomegaly and APD activity. Histopathologic examination of liver sections from treated rats revealed numerous granulomas throughout the parenchyma. The magnitude of enzyme inhibition generally paralleled the severity of the hepatic lesions. PMID- 6847718 TI - N-oxidation of N,N-dimethylaniline in the rabbit and rat lung. AB - We have reported previously that chlorpromazine (CPZ) and imipramine (IMP) are metabolized via N-oxidation by the rat lung, while they are not appreciably metabolized by the rabbit lung. Indeed, marked species differences exist in the pulmonary N-oxidation of these pneumophilic drugs. In the present studies, the isolated, ventilated and perfused lung (IPL) preparations as well as in vitro preparations of the rabbit and rat lungs were used to examine the pulmonary disposition of [14C]-N,N-dimethylaniline (DMA) which has been used frequently as a substrate for N-oxidation. Although the IPLs of both species were active in DMA N-oxidation, the rabbit lung was more active in DMA N-oxidation than the rat lung on the basis of per g lung. The gradual decline in radiolabel concentration in the perfusate was more marked in the rat than in the rabbit IPL. This decline was not due to the drug accumulation in the lung, but to its volatility. There was no dose dependency in the tissue/medium DMA concentration ratios (approximately 1.60), indicating uptake by simple diffusion and low affinity for the lung tissue. In vitro lung preparations showed higher DMA N-oxidase activity in the rabbit than in the rat, regardless of whether whole homogenate, post mitochondrial supernatant fraction or microsomal fraction was used, or how the activities were expressed (per mg protein or per g tissue). These results suggest that, although DMA is not highly concentrated in the lung, it is N-oxidized by the lung and that DMA N-oxidase is different from CPZ or IMP N-oxidase reported previously. PMID- 6847719 TI - Distribution of the acetyl compared with the salicyl moiety of acetylsalicylic acid. Acetylation of macromolecules in organs wherein side-effects are manifest. AB - The distribution in rats of the acetyl group of aspirin has been compared with that of the salicyl moiety with the objective of establishing if: (1) there are differences in their biodisposition which might be important in the development of side- or therapeutic effects of aspirin, and (2) the range of organs and biomolecules therein which are acetylated by aspirin. Using whole-body autoradiography and liquid scintillation counting techniques it was found that the acetyl group of 3H- or 14C-acetyl-labelled aspirin became bound to a wide variety of proteins, glycoproteins and lipids of the glandular and non-glandular region of the stomach, kidney, liver and to a lesser extent bone marrow, i.e. organs in which side-effects are frequently encountered. It is suggested that: (1) the acetylation of biomolecules may be a major factor in the development of side-effects in these organs, and (2) in addition to acetylation of prostaglandin synthetase, the acetylation of enzymes and other biomolecules may have a much wider bearing on the biochemical changes underlying the development of these side effects. Acetylation of the protein/macromolecular components was especially pronounced in inflamed (c.f. control) hindpaws of carrageenan-injected rats. This could be a result of acetylation of the drug-carrier protein, albumin, and other proteins carried into inflamed tissues and this acetylation could have marked consequences for the functions of these proteins. PMID- 6847720 TI - Phospholipid composition of small unilamellar liposomes containing melphalan influences drug action in mice bearing PC6 tumours. PMID- 6847721 TI - An evaluation of the annual meeting of the American Rheumatism Association. Results of a membership survey. AB - Members of the American Rheumatism Association (ARA) were surveyed to determine their views on the content and quality of their annual meeting. Responses were received from 1,208 members. ARA members were generally positive about the major components of the annual meeting program, but there were significant differences in opinion between practitioners and academicians. Practitioners favored a reduction in basic science material and an increase in didactic clinical sessions. Academicians were more likely to feel that recent annual meetings have adequately addressed their educational needs. These findings have implications for the planning of future annual meetings of the ARA. PMID- 6847722 TI - IgG and IgM rheumatoid factors in rheumatoid arthritis. Quantitative response to penicillamine therapy and relationship to disease activity. AB - Penicillamine treatment of patients with rheumatoid arthritis (RA) leads to falling titers of agglutinating IgM rheumatoid factor (RF), but its effect on IgG RF has not been described. Using specific solid phase radioimmunoassays, we have determined serial levels of IgM RF and IgG RF in 18 patients receiving penicillamine for 1 year, and correlated the results with the change in RA activity. Mean IgM RF levels fell to 76 +/- 10% (mean +/- SEM) after 3 months, and 30 +/- 5% of the pretreatment value after 1 year of penicillamine treatment. This decline was greater than that for total IgM (P less than 0.0001), indicating a selective reduction of RF. Patients receiving maintenance doses of 750 mg/day manifested more rapid and greater decreases than did those given 250 mg/day. In contrast, serial mean IgG RF levels did not change significantly, and actually increased in 6 of 18 cases. At onset, there was a significant correlation with erythrocyte sedimentation rate for both IgM RF (r = 0.535, P = 0.05) and IgG RF levels (r = 0.570, P = 0.02). But changes in RF concentration demonstrated no correlation with changes in either erythrocyte sedimentation rate or joint score over the 1-year period, suggesting that circulating IgM RF or IgG RF levels may be unrelated to the degree of RA activity. PMID- 6847723 TI - The prevalence of juvenile arthritis. AB - A secondary analysis of two new large practitioner surveys, one national and one local, showed the prevalence of juvenile arthritis to be between 0.16 and 0.43 cases per 1,000 children. These rates compare quite closely with the majority of reports both in the United States and the world. We believe the prevalence of juvenile arthritis is between 0.2 and 1 case per 1,000 children (13,000--63,000 children), with the best estimate being about 0.5 cases per 1,000 children. Based on the 1980 census data, this latter estimate means there are approximately 32,00 children with juvenile arthritis in the United States. PMID- 6847724 TI - Capillary microscopy in eosinophilic fasciitis. A comparison with systemic sclerosis. AB - Capillary microscopy was performed on 19 patients with eosinophilic fasciitis. These patients were compared with 13 individuals with progressive systemic sclerosis (scleroderma). Capillary patterns were normal in 16 of 19 (84%) eosinophilic fasciitis patients; 3 exhibited either borderline or nonspecific changes, and none showed a definite scleroderma pattern. In contrast, characteristic nailfold capillary changes, consisting of both dilatation and loss of capillaries, were present in 11 of 13 (85%) scleroderma patients; the remaining 2 showed scleroderma-type abnormalities of only 1 finger and were, therefore, classified as borderline. These results suggest that capillary microscopy may help to distinguish these 2 disorders. PMID- 6847725 TI - Neutrophil aggregation induced by sera from patients with active systemic lupus erythematosus. AB - Activated complement components and immune complexes cause neutrophil (PMN) aggregation in vitro and in vivo, as in dialysis-induced neutropenia and adult respiratory distress syndrome. To investigate the possible role of PMN aggregation in systemic lupus erythematosus (SLE), we studied the capacity of 59 sera from 53 patients to induce aggregation of normal PMN in vitro. Neutrophil aggregating activity (NAA) was present in the sera of 26 of 28 patients with active SLE. The mean NAA in this group was significantly greater than that found in 13 patients with inactive SLE, 20 patients with rheumatoid arthritis, and 17 normal controls. In patients with SLE there was a positive correlation between disease severity and the quantitative measure of NAA. NAA did not correlate with serum C3 or C4 nor with the presence or absence of circulating immune complexes. High levels of NAA were particularly characteristic of central nervous system lupus. These data suggest that the formation of intravascular leukoaggregates may contribute to morbidity in SLE. PMID- 6847726 TI - Band keratopathy in MRL/l and MRL/n mice. AB - To define ocular abnormalities in mice with autoimmune disease, we performed biomicroscopic examinations and examined ocular tissue in MRL/l, MRL/n, NZB, NZB/NZW, and Palmerston North mice. Results were compared with MRL/Mp--lpr/lpr, C57BL/6J--lpr/lpr, and normal control strains. Eighty-seven percent of MRL/l and MRL/n mice had typical band keratopathy; this was confirmed by histologic examination. Posterior uveitis was found in 35% of adult MRL/l mice. MRL substrains are potentially important models of ocular disease. PMID- 6847727 TI - Glycosaminoglycan content in skin of the tight-skin mouse. AB - The tight-skin (TSK) mouse has cutaneous changes similar to those found in the skin of patients with progressive systemic sclerosis (PSS). Previous studies have shown that both have common abnormalities in skin thickness, dry weight, and hydroxyproline content. In this study, glycosaminoglycans (GAGs), major components of the ground substance, were quantitated in skins from TSK mice and compared with age-matched normal mice. Biochemical studies included determinations of hexosamines, uronic acids, and total GAGs by cetylpyridinium chloride precipitation. Dry weights and water-fat content of skin biopsy specimens from TSK mice were also compared with those of normal mice. Hexosamine, uronic acid, total GAGs, and dry weight were increased in TSK mouse skin when compared with normal mouse skin. The water-fat content did not differ significantly. These findings were similar to those known to occur in PSS skin, further suggesting that the TSK mouse might serve as an animal model for the skin changes found in PSS patients. PMID- 6847728 TI - The educational impact of a rheumatology elective. AB - We used a newly developed evaluation strategy to compare the performance of 12 medical residents who received ambulatory care rheumatology training and 12 who received inpatient consultative training. There was no significant difference in the cognitive test scores or the patient examination skills of the 2 groups. The ambulatory care residents saw more patients with common rheumatic diseases and performed more joint aspirations and injections. Both groups performed significantly better in all education impact measurements than did a control group of medical residents who received no formal rheumatology elective training. The control group of residents performed no better than did fourth-year medical students who had no formal rheumatology elective training. The study demonstrated that formal rheumatology training is essential if medical residents are to achieve adequate skills in rheumatology. This training can be provided through ambulatory care or inpatient-oriented electives. PMID- 6847729 TI - Radiologic vignette. The "cocktail" digit. PMID- 6847730 TI - Neonatal onset multisystem inflammatory disease. PMID- 6847731 TI - Chronic monocytic arthritis. PMID- 6847732 TI - One thousand private rheumatology patients in Mexico City. PMID- 6847733 TI - The use of dapsone in the treatment of giant cell arteritis and polymyalgia rheumatica. PMID- 6847734 TI - Self-limited esophageal ulcerations in Behcet's syndrome. PMID- 6847735 TI - Gynecomastia associated with low dose methotrexate therapy. PMID- 6847736 TI - Lupus screening questionnaire. PMID- 6847737 TI - "Crystalline DMSO": DMSO2. PMID- 6847739 TI - Ultrasound diagnosis of tophaceous and rheumatoid nodules. PMID- 6847740 TI - The prevalence of speech and language impairments. PMID- 6847738 TI - Role of collagen in polyarthritis questioned. PMID- 6847741 TI - Future directions in audiology. PMID- 6847742 TI - Platelet interaction with high and low density lipoproteins. AB - Gel-filtered platelets (GFP) from normal human subjects bound both low density lipoproteins (LDL) and high density lipoproteins (HDL). This binding was saturable and 125I-labelled lipoprotein uptake was inhibited by plasma. Platelets are also able to degrade lipoproteins but only to a limited extent. LDL appeared to compete with 125I-labelled HDL for platelet uptake, whereas the ability of HDL to displace 125I-LDL was limited. Cyclohexanedione-treated LDL (CHD-LDL), unlike CHD-HDL, did not compete with [125I]LDL for platelet accumulation, suggesting that arginine residues are necessary for LDL but not HDL binding. Addition of HDL or LDL to GFP did not alter platelet aggregation. However, in the presence of thrombin (0.5 U/ml), 1 mg/ml LDL incubated for 1 h at 23 degrees C enhanced platelet aggregation (215% increase) whereas HDL under similar conditions decreased aggregation by 53%. LDL also shortened the time of maximal aggregation whereas HDL had the opposite effect. PMID- 6847743 TI - Effect of partial ileal bypass on plasma clearance and binding of lipoproteins to liver membranes in the rabbit. AB - We studied the effect of partial ileal bypass in the rabbit on the in vivo catabolism of human 125I-labelled low density lipoproteins and on the in vitro binding of human low density lipoproteins and rabbit very low density lipoproteins to hepatic membrane preparations. The in vivo data indicate that partial ileal bypass increases the fractional clearance rate (pools/h) of low density lipoproteins from 0.031 to 0.049 as well as the absolute catabolic rate from 0.495 to 0.605 mg/h. Concomitantly the in vitro binding of both low and very low density lipoproteins to hepatic membranes was increased in membrane preparation from livers of bypassed animals, thus suggesting an increased receptor-mediated uptake of lipoproteins by the liver. This effect may partly explain the hypocholesterolemic activity of partial ileal by-pass. PMID- 6847744 TI - Reendothelialization and maintenance of endothelial integrity in longitudinal denuded tracks in the thoracic aorta of rats. AB - Endothelial repair was studied during, and up to 26 weeks following reendothelialization of longitudinal tracks denuded of endothelium. Deendothelialized tracks were produced on the ventral aspect of the thoracic aortas of rats. A standardized denudation procedure was used in conjunction with continuous intravenous infusion of [3H]thymidine to obtain quantitative evaluations of replication, migration, and cell density. The method of denudation was relatively gentle, selective, and reproducible. Reendothelialization was completed in less than 66 h. During reendothelialization, cell migration and replication proceeded simultaneously until confluence was reached. Following confluence, as migration ceased, cell density returned toward control levels. It continued to rise, associated with continued, though attenuated, nuclear incorporation of [3H]thymidine, until it reached 1 1/2 - 2 1/2 times that of adjacent uninjured control endothelium. The boundaries, or margins, of the tracks were well demarcated as judged by the pattern of labeled cells within and unlabeled cells adjacent to reendothelialized tracks. Widths of deendothelialized and reendotheliazed tracks were similar. Thus, endothelial cells in uninjured regions surrounding denuded tracks were not observed to contribute to reendothelialization by proliferation. During reendothelialization, unlabeled cells were observed within reendothelializing tracks. Thus, some cells migrated relatively long distances (0.3-0.4 mm) before either replicating or sloughing from the luminal surface. Endothelial cell density within reendothelialized tracks remained elevated at 12 and 26 weeks following denudation. At 12 weeks there was little intermingling of cells inside tracks (labeled during reendothelialization) with unlabeled cells in adjacent uninjured areas. At 26 weeks, after a terminal 12-day continuous labeling period in previously unlabeled animals, replication of cells inside tracks was far less than that in adjacent uninjured endothelium. Thus, the newly regenerated cell population in tracks remained synchronously quiescent and physically segregated for long periods of time, despite normally occurring hemodynamic and remodeling factors which might be expected to favor continuous cell turnover and migration. Our findings relating to endothelial cell migration and replication during reendothelialization vary somewhat from those reported using other methods of deendothelialization. PMID- 6847745 TI - Effect of a high carbohydrate diet on the content of apolipoproteins C-II, C-III and E in human plasma high density lipoprotein subfractions. AB - The effect of isocaloric high and low carbohydrate (Carb) diets on the structure and apoprotein composition of plasma high density lipoproteins (HDL) was assessed in four healthy men. The high Carb diet contained 65% calories as Carb and 15% as fat; the low Carb was 15% and 65%, respectively, with protein fixed at 20% of calories in each case. Cholesterol was 400 mg/day and the P/S ratio of the fat was 0.4. Each diet was sequentially consumed for periods of 3 weeks. At the end of each 3-week study period, plasma HDL2 and HDL3 were isolated by zonal ultracentrifugation and their apoprotein and lipid compositions were determined. Compared to the low Carb diet, the high Carb diet was associated with an increase in the size of HDL2 (116.0 +/- 1.8 vs. 109.1 +/- 1.8 A) and in the content (mean weight % +/- SEM) of apoE (2.81 +/- 0.71 vs. 1.79 +/- 0.49, P less than 0.01) and of apoC-II (1.73 +/- 0.09 vs. 1.11 +/- 0.12, P less than 0.01). HDL2 apoC-III content was not significantly different on the two diets (6.49 +/- 0.50 vs. 7.42 +/- 1.21). On the two diets, HDL3 size and HDL3 apoE content were not significantly changed. HDL3 apoC-II and apoC-III, however, were higher on the high Carb diet, P less than 0.05. The ratio (by weight) of HDL2 apoE/HDL2 apoC-II + C-III increased on the high Carb diet compared to the low Carb diet (0.344 +/- 0.058 vs. 0.228 +/- 0.053, P less than 0.01). We suggest that the increased amount of apolipoprotein E in HDL2 may influence its rate of catabolic clearance and may account for the well-known decrease in plasma HDL-cholesterol in subjects on high Carb diets. PMID- 6847746 TI - Effect of positively charged sphingomyelin liposomes on cholesterol metabolism of cells in culture. AB - When cultured human skin fibroblasts were incubated at 37 degrees C with sonically dispersed positively charged sphingomyelin liposomes, sphingomyelin accumulated within the cell. This resulted in stimulation of cholesterol synthesis by increasing 3-hydroxy-3-methylglutaryl Coenzyme A reductase activity. Activation was rapid and was not due to the efflux of cell cholesterol or to cell growth and proliferation. Neither low density lipoprotein cholesterol nor nonlipoprotein cholesterol could suppress the sphingomyelin-induced cholesterol synthesis or activate the acyl-CoA cholesterol acyltransferase, despite an increase in cell cholesterol content. In contrast, the response to 7 ketocholesterol or 26-hydroxycholesterol was not impaired. The effect of sphingomyelin on cholesterol synthesis was temporary and reversible. Twenty-four hours after removal of sphingomyelin, cholesterol synthesis returned to normal and could be suppressed by LDL. Accumulation of sphingomyelin in the cell decreased lysosomal cholesteryl ester hydrolase but had no effect on the microsomal cholesteryl ester hydrolase. These results suggest that accumulation of sphingomyelin in the cell markedly affects cellular cholesterol homeostasis. Resultant accumulation of cholesteryl esters in the presence of extracellular cholesterol could be relevant to atherogenesis. PMID- 6847747 TI - Characterization of the aortic collagens in guinea pigs with chronic vitamin C deficiency. AB - Marginal vitamin C deficiency lasting 19 weeks caused hypercholesterolemia and hypertriglyceridemia in guinea pigs. In the thoracic aorta of deficient animals a moderate decline of type I and an increase of type III collagen was observed. Both types of collagen isolated from deficient aortas proved to be slightly underhydroxylated. PMID- 6847748 TI - Eye injuries caused by S-shaped hooks. PMID- 6847749 TI - Methanol intoxication. PMID- 6847750 TI - Cervical cancer screening programs. PMID- 6847751 TI - Placement or disposal? PMID- 6847752 TI - The status of metformin in Canada. AB - During the 1970s two biguanide drugs, phenformin and metformin, were used to control hyperglycemia. Phenformin was phased out of the Canadian market because it carried an unacceptable risk of causing lactic acidosis, but metformin remains available. All documented cases of lactic acidosis associated with metformin administration, which are rare, have occurred abroad in patients who were taking the drug in spite of having contraindications to its use. The two drugs are metabolized differently, phenformin being deactivated and concentrated in the liver, and metformin being excreted rapidly, unchanged, by the kidneys. In properly selected diabetic patients therapeutic doses of metformin do not raise the blood levels of intermediary metabolites enough to induce ketoacidosis or lactic acidosis. The safety of the drug is supported by the clinical experience over about 56,000 patient-years in Canada. PMID- 6847753 TI - Family practice: I like it. PMID- 6847755 TI - Problems in adequately immunizing international travellers. PMID- 6847754 TI - Uniform requirements for manuscripts submitted to biomedical journals. PMID- 6847756 TI - Toxic effects of benzyl alcohol. PMID- 6847758 TI - Specificity of systems mediating transport of adenosine, 9-beta-d arabinofuranosyl-2-fluoroadenine, and other purine nucleoside analogues in L1210 cells. PMID- 6847757 TI - Unique aspects of the interactions of retroviruses with vertebrate cells: C. P. Rhoads memorial lecture. PMID- 6847759 TI - Serum levels of a human lung tumor-associated antigen using an improved radioimmunoassay. AB - A human lung tumor-associated antigen, previously purified to apparent homogeneity from an extract of a small cell tumor, was radioiodinated with Bolton Hunter reagent for use in a competitive protein-binding radioimmunoassay. A panel of 215 sera was assembled from normal individuals and pretreatment patients with lung cancer, benign lung disease, and nonlung cancers, and lung tumor antigen in each was quantitated using the radioimmunoassay. The mean of normals was 0.92 +/- 0.43 (S.D.) microgram/ml (n = 88), and values greater than 2 standard deviations above the mean (1.78 micrograms/ml) were considered positive. Positive rates in lung cancers of the following histological types were found: adenocarcinoma, 60% (9 of 15); squamous cell, 42% (13 of 31); large cell, 17% (3 of 18); and small cell, 19% (3 of 16). In addition, 13% (3 of 23) of other cancers, 0% (0 of 24) of benign lung disease, and 2% (2 of 88) of normals were positive. Approximately one third of Stage 1 patients in the squamous cell and adenocarcinoma groups were positive while two-thirds of patients with more advanced Stage III disease in these categories showed elevations. PMID- 6847760 TI - Circulating immune complexes and immunoglobulin M-class rheumatoid factor in rats bearing mammary adenocarcinomas which vary in ability to metastasize. AB - In order to explore whether immune complex (IC) formation and immunoglobulin M class rheumatoid factor (RF) synthesis are related to tumor progression, solid phase enzyme immunoassays were used to test for ICs and RF in rats bearing three different syngeneic mammary adenocarcinomas. The mammary adenocarcinoma cell lines used produced either extensive metastasis (13762), metastasis in only a proportion of the animals given injections (R3230AC), or no metastasis (DMBA8). DMBA8 and 13762 tumor-bearing rats developed only low levels of circulating ICs. Of 18 animals bearing R3230AC tumors, four developed palpable lymph node metastasis (macrometastasis), while another five showed evidence of metastasis only upon histological examination (micrometastasis). R3230AC tumor-bearing animals which did not develop metastasis were found to have significantly higher IC levels than those rats with metastasis. Several sera from rats bearing R3230AC tumors were fractionated by molecular sieve chromatography. Most of the ICs in these sera were 7S to 19S in size. Significant RF synthesis occurred only in rats bearing R3230AC tumors and only during terminal tumor growth. These results show that IC formation and RF synthesis varies in animals bearing different mammary adenocarcinomas. PMID- 6847761 TI - DNA damage as a basis for 4'-demethylepipodophyllotoxin-9-(4,6-O-ethylidene-beta D-glucopyranoside) (etoposide) cytotoxicity. AB - The precise mechanism of action of 4'-demethylepipodophyllotoxin-9-(4,6-O ethylidene-beta-D-glucopyranoside) (VP-16), an important chemotherapeutic agent, has yet to be determined. VP-16 has been shown to cause single-strand breaks (SSBs) in DNA, but their relationship to cytotoxicity has not been determined. We have investigated the action of VP-16 using mouse leukemia L1210 cells in culture. By using the alkaline elution technique, we reaffirmed the occurrence of SSBs in DNA over the drug concentration range 1 to 60 microM. We were able to demonstrate additional types of DNA damage in the form of DNA double-strand breaks and DNA-protein cross-links within the same dose range. The number of double-strand breaks formed per SSB was consistent over this dose range and greater than that found after exposure of L1210 cells to gamma-irradiation. DNA SSBs and double-strand breaks were also shown to occur in isolated nuclei, indicating that cytoplasmic components are not required for this drug action. Colony formation by L1210 cells in soft agar decreased over a drug concentration range similar to that which produced DNA damage. The correlation between the effective dose range in the colony-forming assay and the DNA scission experiments supports the hypothesis that DNA breakage is responsible for drug cytotoxicity. The demonstration of strand scission in isolated nuclei may provide an experimental model for elucidating the exact mechanism of action of VP-16. PMID- 6847762 TI - Resistance of tumor-bearing mice to a second tumor challenge. PMID- 6847763 TI - Lung tumorigenic response of strain A mice exposed to hypoxic cell sensitizers alone and in combination with gamma-radiation. AB - The influence of metronidazole, misonidazole, and desmethylmisonidazole on the induction of lung adenomas in the strain A mouse was examined. Two dose levels of the hypoxic cell sensitizers, 0.2 and 0.6 mg/g, were used either alone or in combination with 900 rads of gamma-radiation in a fractionated dose schedule of twice a week for 3 weeks. In the groups of mice which received hypoxic cell sensitizers only, the prevalence and the mean number of lung tumors per mouse were somewhat increased (p less than 0.10) in the group receiving the higher dose (0.6 mg/g) of misonidazole but was not significantly different from results for the control animals in the other two sensitizer groups. The combination of hypoxic cell sensitizer and radiation did not show any significant enhancement of lung tumor response when compared with the group which received radiation only. The dose of radiation used in this study significantly enhanced lung tumor formation in mice when compared with that in the control group. Thus, under the experimental exposure conditions used in this investigation, which were somewhat similar to the exposure conditions occurring in clinical treatment, each of the hypoxic cell sensitizers tested failed to sensitize significantly the mice to the carcinogenic effects of gamma-radiation. PMID- 6847764 TI - Chemical structure and carcinogenicity relationships of some chloroalkene oxides and their parent olefins. AB - Six epoxides of structurally related chloroalkenes were examined for their carcinogenicity by chronic testing in female ICR/Ha Swiss mice, 30/group. Repeated skin application three times weekly or s.c. injection once weekly were used for the life spans of the mice. The epoxides were: cis-1-chloropropene oxide, trans-1-chloropropene oxide, cis-1,3-dichloropropene oxide, trans-1,3 dichloropropene oxide, trichloroethylene oxide (TCEO), and tetrachloroethylene oxide (PCEO). In mouse skin, cis-1-chloropropene oxide, trans-1-chloropropene oxide, cis-1-,3-dichloropropene oxide, and trans-1,3-dichloropropene oxide induced statistically significant incidences of squamous carcinomas of the skin; TCEO did not cause any skin tumors; and PCEO resulted in three mice with benign skin tumors and one with a squamous carcinoma of the skin. Repeated s.c. injection of the four propene oxides induced statistically significant incidences of local tumors, mostly fibrosarcomas. This was not the case with TCEO and PCEO. The data are consistent with the carcinogenicity findings on the parent chloropropenes and suggest that the epoxides function as their activated carcinogenic intermediates. The essentially negative findings with TCEO and PCEO suggest further studies on the carcinogenicity of trichloroethylene and tetrachloroethylene. PMID- 6847765 TI - Inhibition of ultraviolet-B skin carcinogenesis by all-trans-retinoic acid regimens that inhibit ornithine decarboxylase induction. AB - There is a correlation between the ability to induce the polyamine-biosynthetic enzyme ornithine decarboxylase (ODC) and the tumor-promoting ability of various carcinogens in mouse epidermis. Some agents which inhibit skin carcinogenesis also inhibit ODC induction. In this study, all-trans-retinoic acid (RA) regimens that inhibited the induction of epidermal ODC by ultraviolet-B (UVB) were tested for their ability to inhibit UVB skin carcinogenesis. Hairless mice were irradiated once daily with UVB for 20 days, receiving a total dose of UVB (17.1 kJ/sq m). Topical RA was applied immediately (RA, one dose) or applied 0, 1, 2, 3, and 4 hr (RA, five doses) after each irradiance. The mice were maintained for 52 weeks and then sacrificed. Groups treated with RA tended to have fewer mice with tumors, fewer tumors per mouse, smaller tumor diameters, and slower growing tumors than did appropriate irradiated control groups. RA given five times was more effective than was RA given one time at inhibiting UVB skin carcinogenesis. These results show that RA treatments that inhibit epidermal ODC induction may be effective in reducing the carcinogenicity of UVB. PMID- 6847767 TI - Effect of sodium saccharin on urinary bladder epithelial regenerative hyperplasia following freeze ulceration. PMID- 6847766 TI - Effect of plasma and carboxylesterase on the stability, mutagenicity, and DNA cross-linking activity of some direct-acting N-nitroso compounds. AB - The effects of mouse plasma, human plasma, and purified porcine liver carboxylesterase on nitrosourea, nitrosamide, and nitrosocarbamate chemical stability, mutagenicity, and DNA cross-linking activity were compared. These three classes of N-nitroso compounds are chemically similar but displayed different biological activities and were affected differently by plasma and carboxylesterase. Nitrosourea stability as well as mutagenicity and DNA cross linking activity were affected negligibly by esterase or plasma. In contrast, nitrosamide and nitrosocarbamate stability, mutagenicity, and DNA cross-linking activity were rapidly decreased in the presence of plasma or carboxylesterase. For example, chemical half-lives were from 10- to 20-fold shorter for the nitrosamides and nitrosocarbamates in the presence of 5% mouse plasma. Similar decreases were seen for mutagenicity and DNA cross-linking activity. Preliminary studies indicated one active plasma component to be an enzyme, possibly an esterase. Additional factors such as sulfhydryls may also participate. Whereas some nitrosoureas are active antitumor agents, the lack of antitumor activity for analogous nitrosamides and nitrosocarbamates may reside predominantly in their rapid in vivo inactivation. These results may help to account for the high in vitro mutagenicity as compared with the low in vivo activities of nitrosamides and nitrosocarbamates. PMID- 6847768 TI - Tumorigenicity of enantiomers of chrysene 1,2-dihydrodiol and of the diastereomeric bay-region chrysene 1,2-diol-3,4-epoxides on mouse skin and in newborn mice. PMID- 6847769 TI - Viscometric detection of liver DNA fragmentation in rats treated with minimal doses of chemical carcinogens. AB - A new technique, using an oscillating viscometer capable of measuring changes of DNA reduced viscosity (eta red), has been used to detect DNA damage in liver of rats treated with various chemical carcinogens. In denaturing conditions (pH 12.5), the eta red of liver DNA from control rats increased slowly with time, reaching a maximum, (eta red)max, after 10 to 13 hr. Single i.p. doses of N nitrosodimethylamine (0.07 mg/kg), N-nitrosodiethylamine (0.2 mg/kg), N-nitroso-N methylurea (0.5 mg/kg), 1,2-dimethylhydrazine (0.06 mg/kg), procarbazine (1 mg/kg), methyl methanesulfonate (8 mg/kg), and N-diazoacetylglycine amide (3.7 mg/kg) induced a statistically significant reduction of the time (t95) required for eta red to reach its maximal value. A dose-dependent decrease of t95 was observed for dosages markedly lower than those found to be effective in eliciting DNA fragmentation by the use of alkaline elution or alkaline sucrose gradient sedimentation. 2-Acetylaminofluorene (12.5 mg/kg) and 4-nitroquinoline 1-oxide (10 mg/kg) caused a clear-cut increase of (eta red)max. 7,12 Dimethylbenz(a)anthracene (10 mg/kg) markedly prolonged t95. This viscometric assay of in vivo DNA damage allows a reliable assessment of DNA lesions induced by doses of chemical carcinogens sufficiently small not to produce significant alterations in the pharmacokinetic behavior of these compounds. PMID- 6847770 TI - Carcinogenicity of hydroxylated alkylnitrosoureas and of nitrosooxazolidones by mouse skin painting and by gavage in rats. AB - The carcinogenic effectiveness of a number of nitrosoalkylamides related to nitrosoethylurea and nitroso-n-propylurea has been compared by topical application to Swiss mice and by intragastric administration to F344 rats. Nitrosohydroxyethylurea and the related cyclic nitrosamide, nitrosooxazolidone, were as potent as nitrosoethylurea as skin carcinogens, although the latter was a much weaker mutagen to Salmonella. When administered p.o., nitrosooxazolidone induced mainly forestomach tumors in rats, while nitrosohydroxyethylurea was very broadly acting, inducing neoplasms of the lung, forestomach, glandular stomach, colon, duodenum, and bone (osteogenic sarcomas). Nitroso-2-hydroxypropylurea, nitroso-3-hydroxypropylurea, and nitroso-5-methyloxazolidone were all much more potent carcinogens on mouse skin than was nitroso-n-propylurea, nitroso-5 methyloxazolidone being somewhat less effective than the nitrosoureas; the mutagenicity to Salmonella seemed not to be quantitatively related to carcinogenicity. Nitroso-5-methyloxazolidone given p.o. to rats induced mainly forestomach neoplasms and a few neoplasms of the duodenum, whereas similar treatment of rats with nitroso-2-hydroxypropylurea induced a high incidence of neoplasms of the thymus, some of the forestomach, and few at any other site. PMID- 6847771 TI - Alteration of plasma membrane glycopeptides and gangliosides of Chinese hamster cells accompanying development of resistance to daunorubicin and vincristine. PMID- 6847773 TI - Identification and characterization of specific changes induced by retinoic acid in cell surface glycoconjugates of S91 murine melanoma cells. PMID- 6847772 TI - Long-term explant culture of normal mammary epithelium. AB - Mammary epithelium and surrounding stroma have been maintained in an explant system for 1 to 6 months and subsequently xenografted into athymic nude mice. The morphological characteristics of 26 cases of normal human mammary epithelium in long-term explant culture were described, using high-resolution light and electron microscopy. Normal human breast tissue specimens were obtained from immediate autopsy or surgical resection. The explants were cultured in Connaught Medical Research Laboratories Medium 1066 supplemented with serum, insulin, and hydrocortisone. The histotypic features of the mammary epithelium in both the central portion of the explant and the epithelial outgrowth onto the surface of the explant were described. In some cultures, the cells acquired more keratin and formed multicellular blister-like domes. Tissues from eight cases after 1 to 14 weeks in culture were xenografted in athymic nude mice and were maintained up to 924 days. PMID- 6847774 TI - Characterization of microsomal epoxide hydrolase in hyperplastic liver nodules of rats. PMID- 6847775 TI - Assay for initiators and promoters of carcinogenesis based on attachment independent survival of cells in aggregates. AB - A cell line (HRRT) derived from a hereditary renal rat tumor has been used in an assay for initiators and promoters of carcinogenesis based on attachment independent survival in aggregates. Treatment with single noncytotoxic doses of the carcinogens urethan (1 mM), N-methyl-N-nitrosourea (30 microM), and benzo(a)pyrene (0.2 microM) for 1 hr did not affect survival of HRRT cells in the aggregate assay system. However, when carcinogen treatment was followed by exposure of the cells to the potent tumor promoter 12-O-tetradecanoylphorbol-13 acetate (0.16 microM), a considerable increase in survival was observed. With urethan as an initiator, it was found that tumor promoters (12-O tetradecanoylphorbol-13-acetate and phorbol-12, 13-didecanoate) induced a considerable response in the assay system, while nonpromoting phorbol esters (4-O methyl-12-O-tetradecanoylphorbol-13-acetate and 4 alpha-phorbol-12, 13 didecanoate) did not affect the survival. Exposure of HRRT cells to NiSO4 (40 microM) for 3 hr did not influence cell survival in the aggregate form. However, subsequent treatment of the cells with the tumor promoter 12-O tetradecanoylphorbol-13-acetate induced a marked increase in the number of viable cells. Moreover, treatment of HRRT cells with a nontransforming dose of urethan (1 mM) for 1 hr followed by continuous exposure to nickel sulfate (40 microM) also increased cell survival in the aggregate form. These results support the view that nickel sulfate may act as both an initiator and a promoter in mammalian cell transformation. The present data also indicate that the aggregation assay system using the HRRT cell line may be a valuable in vitro screening assay for putative initiators and promoters of carcinogenesis. PMID- 6847776 TI - Quantitative analysis of Roussin red methyl ester in pickled vegetables. AB - In a study of the etiological factors in esophageal cancer, Roussin red methyl ester was isolated and identified in pickled vegetables of Linxian County, North China, where there is a high incidence of esophageal cancer. In this paper, a method is described for quantitative analysis of Roussin red methyl ester in pickled vegetables by gas chromatography-high-resolution mass spectrometry single ion monitoring. The content of Roussin red methyl ester in pickled vegetables from Linxian has been found to be 0.1 to 4.5 mg/kg, and that from Beijing is below 0.005 mg/kg, which is the detection limit of the analytical method used. The marked difference between the contents might be one of the possible reasons for the difference in esophageal cancer incidence between the two regions. PMID- 6847777 TI - Effect of estradiol on human breast cancer cells in culture. AB - Conditions are described for growing and maintaining the estradiol sensitivity of the human breast cancer cell line ZR-75-1 both in monolayer and suspension cultures. Either newborn calf or fetal calf serum can be used in the culture medium, but an effect of estradiol on growth of the cells was only observed reproducibly if the serum was first treated with dextran-charcoal. Sulfatase treatment of the sera prior to dextran-charcoal treatment did not decrease cell growth in the absence of added estradiol, indicating that estrogen sulfates are unlikely to contribute to cell growth in dextran-charcoal-treated sera. In monolayer cultures, estradiol increased both the growth rate and final saturation density of the cells for each individual plating density tested in a dose dependent manner with maximal stimulation occurring between 10(-10) and 10(-8) M estradiol. Estradiol also markedly increased the ability of the cells to grow both in suspension and semisolid Methocel cultures. In suspension, the cells grew as tight balls which clustered together to give small organoid-like structures reaching diameters of 4 mm and composed of an outer shell of living cells containing a central cavity of necrotic cells. In the absence of estradiol in both monolayer and suspension, the cells went through a limited and constant number of divisions and then stopped, such that the final cell number was determined by the initial plating density. In the presence of estradiol, this block was removed such that in monolayer cultures the final cell number was independent of plating density. A major loss of estradiol response was found if the cells were grown for 7 to 14 days in the absence of estradiol. This loss of response appeared to be due to a loss of ability to grow rather than to selective cell death within the population. PMID- 6847778 TI - Early oncofetal antigenic modifications during rat colonic carcinogenesis. AB - M1 antigens, associated with adult rat surface gastric epithelium and which are present in fetal but not adult distal colon, were investigated in this colonic mucosa during carcinogenesis. Fifty Wistar rats were given s.c. injections of 1,2 dimethylhydrazine for 28 weeks. Using an immunohistochemical method, M1 antigens associated with goblet cells were shown to be present after 2 weeks of 1,2 dimethylhydrazine treatment in histologically normal mucosa and then in 78% of mucinous hyperplasia and polypoid-like glands, in 54% of hyposecreting glands, in 58% of dysplasias, Grades 1 and 2, in two of 12 dysplasias, Grade 3, and in five of five transitional mucosas adjacent to carcinoma. The production of sialomucins associated with M1 antigens was often seen in the same histological lesion, although not always associated in the same goblet cells. The number of these histological lesions as well as the production of M1 antigens increased with the number of injections. Thus, these antigenic changes of an oncofetal nature can be regarded as early transformations of goblet cell differentiation in colonic mucosa subjected to chemical carcinogen. PMID- 6847779 TI - Long-term organ culture of normal human bladder. AB - Normal adult human bladder obtained at cystoscopy has been maintained in long term organ culture. Several media were tested for their ability to maintain viability and normal tissue morphology. The optimum medium was Ham's F-12 nutrient mixture, supplemented with 10% fetal calf serum, hydrocortisone (1 microgram/ml), and FeSO4, (0.45 microgram/ml). During the first 28 days in vitro, epithelial damage incurred at biopsy and during preparation of the cultures was repaired, and epithelialization of cut stromal surfaces occurred. A wave of cell proliferation was identified by [3H]thymidine autoradiography, 24-h labeling indices rising to a peak of up to 50% on the cut sides of the cultures between 7 and 21 days and falling to 0 to 5% by 21 to 28 days. The regenerating epithelium showed all the normal features of urothelial cell differentiation when examined by scanning and transmission electron microscopy. From 28 days, histology and scanning and transmission electron microscopy showed the cultured urothelium in most cultures to resemble closely that in the normal bladder in vivo, and in this mature state cultures were maintained for 100 days. Urothelium derived from certain patients, although showing normal surface maturation, developed enlarged intercellular spaces or intraepithelial mucin-containing acini. A study of the cytology of cells shed into the medium at different stages in culture showed that culture viability and epithelial differentiation could be monitored easily in long-term culture by this nondestructive means. PMID- 6847780 TI - Multiple estrogen receptor assays in human breast cancer. AB - A review of assay results from more than 6000 patients revealed 232 patients in whom multiple breast cancer specimens were analyzed for estrogen receptor (ER). All assays were performed in a single laboratory. Specimens were considered estrogen receptor positive (ER+) if the ER level was greater than 10 fmol/mg protein and estrogen receptor negative (ER-) if the ER level was less than 3. ER values between 3 and 10 fmol/mg protein were considered borderline. Simultaneous assays were performed in 58 patients with 3% major discordance (i.e., one assay ER- and one assay ER+). Major discordance for sequential biopsies was 19% (16 of 82) when the initial assay was ER+ and 13% (eight of 63) when the initial assay was ER-. (Apparent change from ER- to ER+ status was observed in five of nine patients with primary tumors less than 2 cm in diameter, suggesting that an inadequate amount of tissue may have been submitted for initial ER analysis.) There was no significant relationship between the time interval between sequential biopsies and the rate of discordance. Marked decreases in ER levels and 78% discordance were seen if rebiopsy was performed within 2 months of tamoxifen treatment. When these tamoxifen cases were excluded from the analysis, neither intervening endocrine therapy nor chemotherapy significantly altered discordance rates. PMID- 6847781 TI - Statistical approach to immunosuppression classification using lymphocyte surface markers and functional assays. AB - We analyzed results of 22 in vitro parameters of immunocompetence in 72 cancer patients and 73 healthy controls. We then applied three statistical methodologies (discriminant analysis, logistic regression analysis, and recursive partitioning) in an effort to select the best predictors of immunosuppression. Using either of two definitions of immunosuppression (deviation by more than 1 standard deviation from the control mean on any assay, or having a diagnosis of advanced cancer), the same variables were selected. The best predictors were percentage of lymphocytes, percentage of suppressor cells, pokeweed mitogen stimulation, percentage of Ia+ cells, and number of helper cells. By all three methods, immunosuppressed and immunocompetent individuals were selected with 95 to 97% accuracy using a decision tree with these five tests as variables. In a cohort of individuals with incomplete data, the three methods still accurately classified the two groups with 70 to 83% accuracy. We conclude that a much smaller battery of tests can be used to identify immunosuppressed individuals for purposes of evaluation of responses to immune modulating agents. PMID- 6847782 TI - Laser photoradiation therapy of cancer. AB - We conducted a trial of photoradiation therapy of cancer at the University of California at Irvine. The basis of this technique is a photochemical reaction between an i.v.-injected material, hematoporphyrin derivative, and red light (wavelength, 630 nm). Hematoporphyrin derivative localized in malignant tissue, resulting in selective destruction of cancer cells upon illumination with red light. One hundred twenty-eight sites of recurrent cancer or premalignant lesions were treated in 37 patients. Of this group, 35 patients had recurrent cancer refractory to conventional therapy, and two had premalignant lesions. Favorable responses were achieved in 67% of the sites treated. The dose of hematoporphyrin derivative used in this study ranged from 2 to 5 mg/kg with the majority of patients receiving 3 mg/kg. Total light dose administered appeared to be the most critical parameter evaluated. Light doses in excess of 20 J/sq cm generally resulted in blistering and necrosis of intact skin, while no appreciable increase in response was observed. Photoradiation therapy has demonstrable efficacy in cancer therapy and avoids much of the morbidity of current conventional techniques. PMID- 6847783 TI - Heterogeneous response and clonal drift of sensitivities of metastatic 13762NF mammary adenocarcinoma clones to gamma-radiation in vitro. PMID- 6847784 TI - Comparison of effects of daily versus hyperfractionated split-course radiation schedules with and without cyclophosphamide on median survival, metastatic dissemination, tumor cure, and growth rates. AB - Daily fractions of 188, 250, 375, 500, and 750 rads were given to rats with hepatoma 3924A so that all groups received the same weekly dose of 1500 rads over a 6-week period, for total doses of 9000 rads when only radiation was given and 4500 rads when combined with cyclophosphamide. No tumors were cured (with two exceptions) with or without three doses of cyclophosphamide (150 mg/kg or 0.9 g/sq m) given 14 days apart. The addition of cyclophosphamide to the daily radiation treatment schedules did not change the time for tumors to reach 8 times the volume at time of treatment but did result in a longer median survival, which was attributed to a reduction of pulmonary metastases. A hyperfractionated radiation schedule using six 250-rad fractions given three times daily every 4 hr for 2 days combined with cyclophosphamide (150 mg/kg) 1 day later and repeated two additional times at 11-day intervals for a total dose of 4500 rads and cyclophosphamide (450 mg/kg) resulted in eradication of six of ten tumors, for a cure rate of 60%. Skin damage, determined by visually scoring the skin, appeared to be fully recovered by Day 126 and remained so until the end of the experiment on Day 384. The three courses of hyperfractionated radiation (total dose, 4500 rads), when given alone, were ineffective in producing tumor regression and cure. Combining cyclophosphamide with hyperfractionated split-course radiation schedules gave a major increase in tumor cure rate as compared with radiation alone at the same (4500 rads) or higher (9000 rads) doses. The major gains in effective utilization of the two modalities is greatly diminished or lost when the radiation is administered as daily fractions. PMID- 6847785 TI - Effects of amiloride on tumor growth and intracellular element content of tumor cells in vivo. AB - The effects of amiloride, a reported inhibitor of serum-stimulated sodium influx, were tested on tumor growth, tumor cell proliferation, and intracellular element content of cancer cells in vivo. We have shown previously that cancer cells have high intranuclear levels of sodium compared to those of their normal counterpart cells and have postulated that such a high level of sodium may be involved in the cancer state. We now report that amiloride, when given in a series of injections, inhibited both H6 hepatoma and DMA/J mammary adenocarcinoma growth in vivo in a dose-dependent fashion and that 3 injections of amiloride at a dose of 1.0 microgram/g body weight into mice bearing H6 hepatomas resulted in a significant decrease in the intranuclear content of sodium but not the content of magnesium, phosphorus, sulfur, chlorine, or potassium as measured by electron probe X-ray microanalysis in the H6 hepatoma cells. Amiloride at dosages as low as 1.0 microgram/g body weight per injection also inhibited tumor cell proliferation as measured by the tritated thymidine autoradiography labeling index. Amiloride caused no changes in the mean profile diameters of metaphase or interphase H6 hepatoma or DMA/J mammary adenocarcinoma cells, suggesting that the action of amiloride on tumor growth was not due to cell volume changes. These data show that amiloride both inhibited tumor growth and decreased the proliferation of the tumor cells in the H6 hepatomas which was correlated with a decreased intranuclear sodium content. PMID- 6847786 TI - Modification of guanine derivatives by reduced 2-nitroimidazoles. AB - Misonidazole, after reduction to the hydroxylamine derivative, was found to react with guanosine in aqueous solution at pH 7. The guanosine product was isolated and was assigned a structure having a new 5-membered ring with a -CHOH-CHOH linkage between the N-1 and N-2 positions of guanine. Removal of the sugar residue from the guanosine product by acid hydrolysis resulted in the corresponding guanine derivative, which was also made by reacting guanine with reduced misonidazole. In aqueous solution at pH 11, the guanine product was quantitatively converted to guanine within 20 min. A number of N-1-substituted 2 nitroimidazoles and 2-nitroimidazole reacted with guanosine in an analogous manner, giving rise to the same product as misonidazole, indicating that the C-4 C-5 fragment from the imidazoles is involved in the modification. Neither misonidazole nor its amine or hydrazo derivatives reacted with guanosine. Reduced misonidazole reacted with N-2-methyl guanosine, whereas with N-1-methyl guanosine a reaction was not detected. The identity of Structure I was confirmed by comparison with an authentic sample of Structure I that was prepared by reacting guanosine with glyoxal. Reactions such as the modification of guanine provide a possible molecular mechanism for the cytotoxic and neurotoxic properties of misonidazole. PMID- 6847787 TI - Initial rate kinetics and evidence for duality of mediated transport of adenosine, related purine nucleosides, and nucleoside analogues in L1210 cells. AB - In studies using a rapid kinetic technique, evidence was derived for multiplicity of systems mediating [3H]adenosine transport in L1210 cells. A variety of approaches were used in discriminating between transport and kinase-mediated phosphorylation. Under these conditions, two systems mediating influx were delineated which exhibited high-affinity [Km = 13.9 +/- 2 (S.E.) microM] or low affinity [Km = 199 +/- 27 microM] for [3H]-adenosine. Both systems exhibited high capacities, but that associated with the low-affinity system (V 37 degrees max = 263 +/- 43 nmol = 99.6 +/- 12 nmol sec/g, dry weight). The relative difference in affinity of these two systems during influx was also reflected in the values for influx Ki obtained with other nucleosides and nucleoside analogues. Influx of [3H]-adenosine by each mediated system was inhibited by 6-(2-hydroxy-5 nitrobenzyl)thioguanosine, a specific transport inhibitor, and by 9-beta-D arabinofuranosylpurine-6(1H)thione which is not phosphorylated in L1210 cells. Influx kinetics were the same in L1210 cells, in adenosine triphosphate-depleted L1210 cells (L1210/ara-C/MMPR) which have substantially reduced ability for [3H]adenosine phosphorylation, and in the presence of 2'-deoxycoformycin, a potent inhibitor of adenosine deaminase. The same multiplicity in mediated influx of [3H]adenosine was shown at 0 degrees when transport became rate limiting to total uptake. The high-affinity system mediating [3H]adenosine influx was also elucidated in L1210 cell plasma membrane vesicles in the presence or absence of 2'-deoxycoformycin. Almost all of the natural nucleosides examined competed less effectively with [3H]adenosine for influx by the high-affinity system than by the low-affinity system. These results are discussed with respect to possible pharmacological implications. PMID- 6847788 TI - Contribution of variable entrance and exit block in protected foci to arrhythmogenesis in isolated ventricular tissues. AB - Automatic foci with membrane potentials in the range characterized by depolarization-induced automaticity exhibit entrance block. The present study demonstrates a role of variable entrance and exit block in arrhythmogenesis. We studied canine interventricular septa with the right bundle branch exposed, isolated false tendons and isolated feline papillary muscle using standard microelectrode techniques. Foci of automaticity were produced either by focal application of electric current or by exposure of the preparations to Tyrode's solution containing 1.5-2.0 mM KCl. Foci induced by mild depolarization exhibited entrance block with exit conduction and were subject to electrotonic modulation. With greater depolarization, varying degrees of exit block developed. Various rhythms, including Wenckebach periodicity, resulted. Delayed emergence of electrotonically accelerated activity led to closely coupled extrasystoles resembling reentrant activity. Exit conduction in some preparations was facilitated by enhanced normal pacemaker activity (membrane potentials -- 70 mV or greater) in tissue peripheral to the focus. Also, when there were two sites of automaticity separated by an area of depressed conduction, intermodulation between the two automatic regions generated complex arrhythmias. Shifts in maximum diastolic potential also changed conduction and led to changes in arrhythmic patterns. In some experiments, focal automaticity was terminated by single stimuli. We conclude that complex and variable behavior of automatic foci may result in activity with characteristics previously attributed to other arrhythmic mechanisms. PMID- 6847789 TI - Kinetics and imaging of indium-11-labeled autologous platelets in experimental myocardial infarction. AB - The kinetics of accumulation and the external imaging patterns of indium-111 labeled platelets infused in a dog model of left anterior descending coronary artery occlusion with reperfusion were studied. The effects of infarct age and regional residual myocardial blood flow upon platelet accumulation were quantified, and the capacity of indium-111 platelets to image the experimental infarction was evaluated qualitatively. The endocardial accumulation of indium 111 platelets occurred primarily in infarct zones with residual blood flow less than 0.6 times normal and was maximal (24.98 +/- 2.76 times normal) in the lowest blood flow zone (less than 0.1 times normal). Indium-111 platelet accumulation in the epicardium occurred in the regions with blood flow less than 0.6 times normal and was maximal (17.83 +/- 1.20 times normal) in the lowest blood flow zone (less than 0.1 times normal). The maximal endocardial and epicardial platelet accumulation occurred 24 hours after reperfusion and was significantly decreased at 48 hours. In vivo cardiac images revealed discrete areas of increased myocardial radioactivity uptake in the anterior wall of dogs 24 hours after reperfusion. All images 48 hours after reperfusion were negative. Thus, in the experimental setting, indium-111 platelets allow quantification of platelet accumulation after myocardial infarction at a tissue level and provide a noninvasive means of in vivo imaging of reperfused infarcted myocardium. PMID- 6847790 TI - Acute myocardial infarct extension into a previously preserved subendocardial region at risk in dogs and patients. AB - In this study we quantitated the region of preserved myocardium between a subendocardial myocardial infarct (SEMI) and the endocardium in dogs and determined whether this preserved zone was within the region at risk and whether infarct extension could occur in this region. We also evaluated whether a similar subendocardial region exists in patients with SEMI. A 40-minute temporary occlusion of the left anterior descending coronary artery (LAD) in eight dogs resulted in a 35 +/- 5% transmural infarct with 8 +/- 1% subendocardial preservation as assessed by point-counting of the histologic specimens. In vivo perfusion of coronary vessels with Microfil showed that this preserved subendocardial zone was within the region at risk. The preserved subendocardial zone had significantly fewer cell layers in the dogs ventilated with room air than in dogs ventilated with 100% oxygen (8 +/- 4 vs 19 +/- 4, p less than 0.001), which suggests that diffusion from the ventricular cavity was the mechanism of cell preservation. In contrast, the inspired oxygen concentration did not influence the size of the SEMI. Reocclusion of the LAD for 24 hours in an additional eight dogs, 1 week after a SEMI had been created by a 40-minute temporary occlusion, resulted in both subendocardial and subepicardial extension involving 5 +/- % and 29 +/- 9%, respectively, of the transmural myocardium at the infarct center. Subendocardial infarct extension of a similar dimension to that in dogs ventilated on 100% oxygen was observed in postmortem material from eight patients with infarct extension. The preserved layers of subendocardium presumably receive sufficient nutrients from the ventricular cavity to maintain the viability of this region during temporary, but not permanent, reduction of blood supply from the coronary arteries. PMID- 6847792 TI - Aneurysmal coronary artery disease. AB - To examine the clinical and historical features and the natural history of aneurysmal coronary disease, we reviewed the registry data of the Coronary Artery Surgery Study (CASS). Nine hundred seventy-eight patients, representing 4.9% of the total registry population, were identified as having aneurysmal disease. No significant differences were noted between aneurysmal and nonaneurysmal coronary disease patients when features such as hypertension, diabetes, lipid abnormalities, family history, cigarette consumption, incidence of documented myocardial infarction, presence and severity of angina, and presence of peripheral vascular disease were examined. In addition, no difference in 5-year medical survival was noted between these two groups. These findings suggest that aneurysmal coronary disease does not represent a distinct clinical entity but is, rather, a variant of coronary atherosclerosis. PMID- 6847791 TI - Total cholesterol and lipoproteins in school children: prediction of coronary heart disease in adult relatives. AB - The distribution of risk factors and the prevalence of coronary heart disease (CHD) were studied in 850 first- and second-degree relatives of 98 healthy index cases selected from 3666 school children surveyed for lipid levels in Rochester, Minnesota. Three groups of families were based on an index child's total plasma cholesterol level: 18 families with a child in less than the fifth percentile (low-cholesterol group), 47 with a child in the fifth to ninety-fifth percentiles (middle-cholesterol group) and 33 with a child in greater than the ninety-fifth percentile (high-cholesterol group). The children's cholesterol levels clustered with those of their relatives; mortality due to CHD before age 65 was increased by 2.5 times in grandfathers of index cases in the high-cholesterol group compared with those of the middle-cholesterol group (p less than 0.016). The prevalence of CHD in all the grandfathers was associated with an index child's total cholesterol, more strongly associated with an index child's low-density lipoprotein cholesterol level and most strongly associated with an index child's high-density lipoprotein cholesterol level as a fraction of total cholesterol. This study establishes that childhood lipid and lipoprotein levels from a single cross-sectional survey identify families at elevated risk for CHD. PMID- 6847793 TI - Effects of afterload reduction on global left ventricular and regional myocardial functions in the isolated canine heart with stenosis of a coronary arterial branch. AB - We examined the effects of graded reduction of afterload on the global left ventricular and regional myocardial functions as well as coronary hemodynamics in hearts with regional ischemia. We used isolated, paced canine hearts that were loaded with a hydraulic system that simulated the aortic input impedance of the dog's arterial tree. The loading conditions could be quantitatively and sequentially changed by the reduction of the systemic vascular resistance of the hydraulic system, while the preload was kept constant using a variable-height reservoir connected to the left atrium. The heart was perfused with arterial blood from a support dog. Mean coronary perfusion pressure was maintained equal to mean aortic pressure (AoP) by a servo-controlled pump. Then, the left circumflex branch was constricted to an approximate 50% flow reduction of the preischemic control condition. The myocardial lengths at ischemic and nonischemic regions were measured with two pairs of ultrasonic crystals. In the hearts without ischemia, cardiac output continued to increase, from 535 +/- 14 to 1181 +/- 74 ml/min (p less than 0.01), as mean AoP decreased fom 111 +/- 4 to 52 +/- 3 mm Hg (p less than 0.01), although mean coronary blood flow decreased by approximately 50%. During regional ischemia, at control pressures, performance of the ischemic region diminished from 0.94 +/- 0.15 to 0.77 +/- 0.15 mm (p less than 0.05). With a small decrease in afterload, from 98 +/- 6 to 86 +/- 3 mm Hg, performance improved slightly as in the normal region. With a larger reduction in afterload, from 86 +/- 3 to 55 +/- 6 mm Hg, performance of the ischemic region decreased from 0.77 +/- 0.15 to 0.61 +/- 0.15 mm (p less than 0.05) while cardiac output increased. Thus, there appears to be a bimodal change in performance: a baseline performance, perfusion pressure-mediated decrease and a second, afterload-modulated change. PMID- 6847794 TI - Left ventricular ejection performance and systolic muscle function in patients with mitral stenosis. PMID- 6847795 TI - Nucleotide degradation and functional impairment during cardioplegia: amelioration by inosine. AB - The degradation of adenine nucleotide levels and impairment of functional recovery associated with exposure to hypothermic (20 degrees C) cardioplegia was studied in 84 isolated working rat hearts. After a 1-hour control period, hearts were exposed to 1 hour of cardioplegia that consisted of increasingly longer periods of cardioplegic solution (CPS) infusion (30 seconds and 10, 30 and 60 minutes), followed by increasingly shorter periods of global ischemia (591/2 minutes and 50, 30 and 0 minutes). Hearts were then reperfused for 1 hour with control perfusate, during which recovery of cardiac output was monitored. Additional hearts were freeze-clamped at various points in the protocols to determine adenine nucleotide levels (ATP, ADP, AMP and their sum TAN). Exposure to increasingly longer periods of CPS perfusion resulted in proportionally greater degradation of nucleotides and poorer recovery of cardiac output. Addition of inosine to the recovery perfusate as well as the CPS further improved nucleotide levels and recovery of cardiac output. These results suggest that washout of nucleotide degradation products in the CPS or reperfusion prevents their salvage for nucleotide resynthesis and impairs functional recovery from cardioplegia. PMID- 6847796 TI - Radionuclide angiographic evaluation of right and left ventricular function during exercise after repair of transposition of the great arteries. Comparison with normal subjects and patients with congenitally corrected transposition. AB - We assessed the incidence, clinical significance and etiology of ventricular dysfunction after intraatrial repair of d-transposition of the great arteries in 11 patients, mean age 9 +/- 3 years, who had had Mustard operations. We compared the results to 15 patients who were considered to have normal ventricular function, two patients who had Rastelli operations and five patients with congenitally corrected transposition. Gated equilibrium radionuclide angiography with supine exercise stress testing was used to assess these children. We found no significant difference between our patient groups in exercise capacity, heart rate, or blood pressure response to exercise. However, we found a high incidence of right ventricular dysfunction in the patient groups, manifested by an abnormal right ventricular ejection fraction response to dysfunction in the patient groups, manifested by an abnormal right ventricular ejection fraction response to exercise in six of 11 patients with a Mustard repair, both patients with a Rastelli repair and all five with congenitally corrected transposition. In addition, the left ventricular response to exercise was abnormal in 10 of 11 patients who had undergone a Mustard repair, both patients with a Rastelli repair, and two of five patients with congenitally corrected transposition. We conclude that biventricular dysfunction is frequently present after intraatrial repair of d-transposition of the great arteries. Despite this dysfunction, no significant decrease in exercise tolerance is found in childhood. PMID- 6847797 TI - Ventricular and pulmonary artery volumes in patients with absent pulmonary valve. Factors affecting the natural course. AB - Right and left ventricular (RV and LV) volumes were determined in 19 patients with absent pulmonary valve syndrome using Simpson's rule and area-length methods. The volume of the proximal right pulmonary artery (RPAV) was calculated at maximal and minimal size using the area-length method. Patient groups included four newborns who responded to medical management (group 1A), seven critically ill newborns who died (group 1B), four infants ages 1-10 months (group 2) and four children ages 2-8 years (group 3). The RV end-diastolic volume in groups 1B and 2 was significantly greater than that in groups 1A and 3. The RV ejection fraction in groups 1B and 2 was significantly less than that in normal patients and groups 1A and 3. Maximal RPAV correlated well with RV stroke volume and end diastolic volume. The maximal RPAV in group 1B was significantly greater than that in groups 1A and 3. Pulmonary arterial compliance was greater than normal in all groups, and the compliance in group 1B was more than two times that in the other groups. We conclude that the increased right pulmonary artery compliance and pulmonary regurgitation in patients with absent pulmonary valve contribute to bronchial obstruction and right-heart failure and are the causes of the high morbidity and mortality in these patients. The management should be directed to the alleviation of bronchial obstruction and right-heart failure. PMID- 6847798 TI - Clinical and echocardiographic features of pulmonary valve endocarditis. AB - We studied the clinical and echocardiographic features of eight patients with infective pulmonary valve endocarditis. In two patients, the vegetation was limited to the pulmonary valve; in the six other patients, infective lesions were also present on the mitral or aortic valves. None of the patients were addicted to narcotics. Seven of the eight patients had underlying congenital heart disease. In six patients the organism responsible for the infective endocarditis was Streptococcus viridans. Two-dimensional echocardiography performed using a wide-angle sector scanner was more useful than M-mode echocardiography for evaluating patients with pulmonary valve endocarditis. PMID- 6847799 TI - Echoventriculography -- a simultaneous analysis of two-dimensional echocardiography and cineventriculography. AB - Two-dimensional echocardiography underestimates left ventricular volume compared with cineventriculography. To exclude the influence of difference in heart rate, blood pressure, respiration phases and any effect of the contrast material on left ventricular function, simultaneous studies of two-dimensional echocardiography and cineventriculography-echoventriculography were performed in 46 patients. Apical two-dimensional echocardiograms in the right anterior oblique (RAO) equivalent view were recorded before and during cineventriculography in the 30 degrees RAO projection. End-diastolic and end-systolic volumes (EDV and ESV) were calculated using a disc method with a semiautomatic computer system. The echo transducer position relative to the left ventricular apex and long axis was analyzed. For EDV determined by two-dimensional echocardiography and cineventriculography, the linear regression equation was y = 0.659x + 0.8, SEE = +/- 26.2 ml, r = 0.907. For ESV, the regression equation was y = 0.571x + 17.8, r = 0.938, SEE = +/- 18.6 ml, and for ejection fraction (EF) it was y = 0.606x + 13.0, r = 0.803, SEE = +/- 9.1%. Injection of contrast material resulted in only a small increase of stroke volume, caused by an increase of EDV as analyzed by echoventriculography. In all but two patients, the transducer position was found to be anterior and superior to the left ventricular anatomic apex, as evaluated by filming the echo transducer position during cineventriculography in 46 patients in the 30 degrees RAO projection and in 15 patients consecutively in the 60 degrees left anterior oblique and 30-40 degrees cranial projections. Thus, tangential cuts of the ventricle resulted in underestimation of diameters, long axis and ventricular volumes. These methodologic problems are exacerbated by slice-thickness artifacts. Furthermore, different outlining of left ventricular contour -- outer border of ventricular trabeculae for cine ventriculography and inner border for two-dimensional echocardiography -- seemed to result in underestimation of volume by echocardiography. PMID- 6847801 TI - Value of two-dimensional echocardiography in detecting tricuspid stenosis. AB - We reviewed the M-mode and two-dimensional echocardiograms of 100 consecutive patients with rheumatic heart disease. All were subsequently studied by cardiac catheterization and angiography. In four patients, cardiac catheterization showed tricuspid stenosis (average mean diastolic gradient 6.2 mm Hg), which was confirmed during cardiac surgery. M-mode echocardiography showed a diminished EF slope in 12 patients (mean 26 mm/sec), including the four patients with tricuspid stenosis. Seven of the eight patients without tricuspid stenosis had significant pulmonary hypertension; the reasons for the diminished EF slope in the other patient could not be identified. Tricuspid stenosis was diagnosed in four patients from two-dimensional echocardiograms on the basis of diastolic doming and restricted leaflet motion of the tricuspid valve. These four patients were the same patients in whom tricuspid stenosis was diagnosed by cardiac catheterization. We conclude that two-dimensional echocardiography is useful in the diagnosis of tricuspid stenosis. PMID- 6847800 TI - Echocardiography in chronic aortic insufficiency. Is valve replacement too late when left ventricular end-systolic dimension reaches 55 mm? AB - To determine whether a ventricular (LV) end-systolic dimension (ESD) greater than or equal to 55 mm and LV left fractional shortening less than 25% are risk factors for aortic valve replacement (AVR) in patients with aortic insufficiency, we analyzed the clinical course and M-mode echocardiograms in 47 consecutive patients who underwent AVR for isolated symptomatic AI. Group 1 patients (n = 27) had a preoperative ESD less than 55 mm (mean 44 mm, range 30-52 mm) and group 2 patients (n = 20) had a preoperative ESD greater than or equal to 55 mm (mean 62 mm, range 55-85 mm). One patient in group 1 and 10 patients in group 2 had left ventricular fractional shortening less than 25%. There were no perioperative or postoperative deaths during an average follow-up of 41 months (range 6-76 months). Five patients had perioperative myocardial infarctions (MIs), three in group 1 and two in group 2. Since myocardial protection with cold potassium cardioplegia was instituted, no patient has suffered a perioperative MI. The average preoperative New York Heart Association functional classification was 2.3 (group 1) and 2.6 (group 2). Postoperatively, it was 1.2 in group 1 and 1.1 in group 2. Thirty-three patients (20 in group 1 and 13 in group 2) had echocardiograms at least 1 year after AVR. Of these, LV-end diastolic dimension decreased fro 67 +/- 6 to 53 +/- 6 mm (mean +/- SD) in group 1 (p less than 0.001) and from 79 +/- 3 to 55 +/- 6 mm in group 2 (p less than 0.001). The LVESD also decreased, but this is difficult to interpret because of frequent postoperative abnormal interventricular septal motion. The LV cross-sectional area, an index of LV mass, decreased in group 1 from 25 +/- 5 to 20 +/- 5 cm2 (p lss than 0.001) and in group 2 from 32 +/- 9 to 20 +/- 5 cm2 (p less than 0.001). Postoperative end-diastolic dimension and cross-sectional area were not significantly different between the two groups. We concluded that in aortic insufficiency, a preoperative ESD greater than or equal to 55 mm does not preclude successful AVR, as judged by long-term survival, symptomatic relief, and normalization of LV dimensions assessed by echocardiography. PMID- 6847802 TI - Echocardiographic detection of infarct-localized asynergy and remote asynergy during acute myocardial infarction: correlation with the extent of angiographic coronary disease. PMID- 6847803 TI - The response to procainamide during electrophysiologic study for sustained ventricular tachyarrhythmias predicts the response to other medications. AB - We evaluated 126 patients with inducible sustained ventricular tachyarrhythmias to assess whether the response to procainamide during electrophysiologic study could predict responses to other conventional antiarrhythmic agents and combinations of agents. Thirty of 42 patients in whom tachycardia was not inducible after the administration of procainamide and 69 of 84 patients in whom ventricular tachycardia was inducible after procainamide underwent serial electrophysiologic studies. Forty-three of 67 antiarrhythmic regimens (64%) tested in the patients in whom ventricular tachycardia could not be induced after procainamide prevented induction of ventricular tachycardia, compared with 10 of 145 regimens (7%) tested in the patients in whom ventricular tachycardia could be induced after procainamide. Sixty of the 69 patients in whom ventricular tachycardia remained inducible after procainamide had ventricular tachycardia induced on all other conventional antiarrhythmic regimens tested. By comparison, of the 30 patients in whom ventricular tachycardia became noninducible after procainamide, 25 had no ventricular tachycardia inducible on at least one other antiarrhythmic regimen tested. Thus, the response to procainamide accurately predicted the response to other conventional antiarrhythmic agents during electrophysiologic study. PMID- 6847804 TI - A mechanism of torsades de pointes in a canine model. AB - A dog model of torsades de pointes (TdP) was developed. Twenty 18-30-kg dogs had cardiopulmonary bypass instituted to maintain stable temperature, perfusion pressure and oxygenation. Quinidine, 30 mg/kg, was then administered and burst ventricular pacing was used to induce arrhythmias. The left anterior descending coronary artery was occluded for 15 minutes and repeat pacing studies were performed. Maps of epicardial activation were made from 27 simultaneously recorded electrograms obtained from 1-mm bipolar electrodes secured to the epicardium with a nylon mesh sock. Arrhythmias in five dogs met criteria for the diagnosis of TdP: All had the characteristic undulating QRS morphology typically associated with TdP, all occurred in the setting of QT prolongation and all ended spontaneously. The epicardial maps demonstrated that each change in QRS morphology was associated with a change in the site of epicardial breakthrough. Those QRS complexes during the transition from one morphology to the next were associated with fusion cycles in which both the old and new sites of epicardial breakthrough were present. In essence, two or more competing activation sequences were vying for control of epicardial depolarization. This conclusion was strengthened by our ability to simulate TdP in the surface ECG and in epicardial maps by simultaneously pacing from two widely separated ventricular sites at slightly different, varying rates. PMID- 6847805 TI - Effects of abrupt changes in cycle length on refractoriness of the His-Purkinje system in man. AB - Abrupt changes in cycle length (CL) occur frequently in the clinical setting of atrial fibrillation. However, the effects of such changes on the His-Purkinje system (HPS) have not previously been considered during aberrant ventricular conduction (VAb). In 12 patients who manifested VAb with atrial premature stimulation (A2) during sinus rhythm, the relative refractory period (RRP) of the HPS was evaluated during a constant atrial CL (method I) and during abrupt changes in the CL (method II), wherein the A2 was coupled to an atrial CL (last A1A1) comparable to method I. This last A1A1 during method II was preceded by a series of constant atrial CLs 100-200 msec longer (method IIA) in 11 of 12 patients, or 109-300 msec shorter (method IIB) in all 12 patients. Although abrupt changes in the atrial CL using method IIA resulted in a longer HH interval (by 0-30 msec; mean 13.2 +/- 9.2 msec) preceding the A2, the RRP-HPS was 5-20 msec shorter (mean 9.3 +/- 5.3 msec) compared with method I in eight patients. The effect of abrupt changes was further evaluated in nine patients using method III, with a constant atrial CL, with a duration equal to the last H1H1 interval of method IIA. The VAb that occurred with method III was not manifested with method IIA in seven of nine patients, and in two patients the RRP-HPS was the same or less. Conversely, method IIB resulted in a shorter HH interval (by 0.110 msec; mean 28.9 +/- 21.1 msec) preceding A2, but in 10 patients, RRP-HPS was 5-40 msec longer (mean 20.7 +/- 10.5 msec) than that of method I and in two, VAb was only manifested using method IIB. Further scanning with method III, derived from the HH interval immediately preceding A2 of method IIB, was performed in seven patients and compared with method IIB. Prolongation in the RRP-HPS was shown using the latter method. The results indicate that abrupt changes in CL influence the functional behavior of the HPS in a manner not anticipated. Such changes may have important implications in determining the occurrence of VAb during atrial fibrillation. PMID- 6847807 TI - Transient entrainment and interruption of the atrioventricular bypass pathway type of paroxysmal atrial tachycardia. A model for understanding and identifying reentrant arrhythmias. PMID- 6847808 TI - Sudden sinus slowing with junctional escape: a common mode of initiation of juvenile supraventricular tachycardia. AB - After noting bradycardia-induced supraventricular tachycardia (SVT) in two successive children with SVT, we analyzed Holter monitor recordings done on 66 children with suspected or proved SVT. Ten children had apparent reentry SVT. The most common mode of initiation (eight of 10 patients) was not premature atrial beats, but sudden sinus pause with a junctional escape beat (JEB), usually fused with the delayed sinus P wave, initiating the tachycardia. Electrophysiologic studies in five children who had this mode of initiation showed evidence of reentry in four, possibly by dual atrioventricular nodal (AVN) pathways. Since sudden sinus pause and JEB are relatively uncommon in adults, the disappearance of this phenomenon with age may be the most significant reason why children often have less tachyarrhythmia as they get older. Both propranolol and digoxin significantly increased the numbers of episodes of SVT in the three patients tested with serial Holter monitoring. PMID- 6847806 TI - Use of alternating current during diagnostic electrophysiologic studies. AB - When conventional programmed electrical stimulation did not yield ventricular arrhythmias suitable for testing implanted automatic defibrillator function and for mapping the location of arrhythmogenic foci, full-wave rectified alternating current (120 Hz) was used for inducing arrhythmias. Application of alternating current resulted in ventricular tachycardias 31 times; in 27 instances, these tachycardias were similar in rate (216 +/- 37 beats/min) and morphology to those previously induced in the same patient by programmed electrical stimulation (191 +/- 30 beats/min). During endocardial mapping, the origin of the tachycardias induced by both methods was found in the same region. Alternating current produced ventricular fibrillation only four times, twice when it was the patient's spontaneous native arrhythmia and twice after apparently effective endocardial resection. No complications of the technique were observed. The use of alternating current was found to be simple, rapid and safe; it may be especially useful in the operating room during antiarrhythmic surgery because it markedly reduces the cardiopulmonary bypass time required for induction and may also be useful for testing the adequacy of endocardial resection. PMID- 6847809 TI - Beneficial effect of intravenous diltiazem in the acute management of paroxysmal supraventricular tachyarrhythmias. AB - We tested the effectiveness and safety of i.v. diltiazem in the management of paroxysmal supraventricular tachyarrhythmias in 39 patients, 21 with organic heart disease and seven in heart failure. Fifteen patients presented with supraventricular tachycardia, 12 with atrial fibrillation and 12 with atrial flutter. End points were conversion to sinus rhythm or slowing of the ventricular rate to 100 beats/min or less. Diltiazem was given as an i.v. bolus of either 150 or 300 micrograms/kg over 2 minutes. A second injection was administered to patients who received the lower dose and failed to reach either end point within 30 minutes. The overall success rate was 82% (32 of 39 patients). Time to end point was 5 minutes or less in 20 patients. Conversion to sinus rhythm occurred in 13 of 15 patients (87%) with supraventricular tachycardia and in two of 12 patients with atrial fibrillation. Treatment side effects included a slow ventricular rate in one patient who had a sick sinus syndrome and hypotension in two patients that rapidly responded to fluid administration. We conclude that i.v. diltiazem is effective and well tolerated and advocate its use in the management of paroxysmal supraventricular tachyarrhythmias. PMID- 6847812 TI - The effects of ribonuclease on rat liver dexamethasone receptor: increased affinity for deoxyribonucleic acid and altered sedimentation profile. AB - The ability of the dexamethasone (9 alpha-fluoro-11 beta, 17,21-trihydroxy-16 alpha-methylpregna-1,4-diene-3,20-dione)-receptor complex to bind to DNA cellulose is stimulated by RNase treatment of the activated receptor. Both RNase A and RNase T1 can induce the stimulation. The enhancement of the DNA binding ability occurs concomitantly with an alteration of the sedimentation profile of the dexamethasone-receptor complex from the 7-8S form to the 3-4S form in low salt sucrose gradients. If RNase treatment occurs in the presence of sodium molybdate, both the increase in DNA binding ability and the alteration in sedimentation profile fail to occur. Treatment of the receptor with high salt suggests that the 3-4S form can reversibly combine with a factor in a salt sensitive association. These experiments indicate that the 7-8S form of the dexamethasone-receptor complex is associated with a RNA molecule(s) that can be removed by RNase treatment or salt dissociation, and that this RNA inhibits the binding of the receptor to DNA. PMID- 6847811 TI - Mechanism of relief of pacing induced angina with oral verapamil: reduced oxygen demand. AB - To evaluate the influence of oral verapamil (80 and 120 mg) on angina threshold, coronary blood flow, myocardial oxygen consumption and left ventricular function, we subjected 13 patients with effort angina and fixed obstructive coronary artery disease to atrial pacing at progressively higher heart rates. After 120 mg of verapamil, the time to onset of angina and the heart rate at the onset of ST segment depression increased by 18% (p less than 0.005) and 10% (p less than 0.001), respectively, without any change in the angina threshold (rate-pressure product at the onset of angina). The rate-pressure product, coronary blood flow and myocardial oxygen consumption were lower at rest and at pre-angina heart rates but not when the angina threshold was reached. Thus, the beneficial effect of verapamil was primarily due to decreased myocardial oxygen demand rather than to increased coronary blood flow. The decreased demand resulted from a lower arterial pressure at each pacing rate. In these patients without heart failure, left ventricular pump function did not deteriorate. This beneficial response was less with 80 mg of oral verapamil. These findings suggest that oral verapamil has a potential role in the management of patients with effort angina due to fixed obstructive coronary artery disease. PMID- 6847810 TI - The electrophysiologic manifestations of abnormal automatic activity arising in depolarized foci. PMID- 6847813 TI - Directional pituitary blood flow: a microcinephotographic study. PMID- 6847815 TI - The influence of donor and recipient age and sex on the quantitative transplantation of monodispersed rat thyroid cells. AB - We have previously reported a technique for the quantitative transplantation of monodispersed rat thyroid cells. In this study, the influence of the age and sexual status of the donor and recipient animals on the transplantation process has been examined using the number of cells required for the growth of 1 or more follicular units in 50% of the transplantation sites (follicular dose 50% or FD50) as the end point. The number of multifollicular clusters per 1000 inoculated cells was also explored. FD50 values in 5-week-old intact male recipients increased as the donor's age increased over the range of 4 weeks to 12 months. FD50 values in 5-week-old thyroidectomized male recipients were similar when donors were 4-8 weeks old, but were increased for cells from 52-week-old donors. The FD50 values of cells from 5-week-old donors was higher in 4-week-old intact recipients than in the 5- or 6-week-old recipients. In male recipients, the FD50 values were lower than in female recipients of 5 and 8 weeks of age. This sex-related effect was reduced by orchiectomy and ovariectomy. Generally, the frequency of multifollicular clusters per 1000 inoculated cells increased as the FD50 decreased. These results are discussed in the light of measurements of thyroidal DNA synthesis and TSH levels reported by others. PMID- 6847814 TI - Hypersensitivity of spontaneously hypertensive rats to heat and ether before the onset of high blood pressure. AB - Hypertension-prone, male, spontaneously hypertensive rats (SHR; n = 60) and normotensive, male, Sprague-Dawley rats (S-D; n = 60) were exposed to the relatively innocuous stimulus of heat and ether when they were 40 days of age, just before the usual onset of high blood pressure in SHR. The animals were decapitated 0, 2, 5, 15, and 60 min postexposure to heat and ether. Blood levels of corticosterone, aldosterone, PRL, GH were measured concomitant with pituitary content of GH and PRL and adrenal content of ascorbic acid and cholesterol. The foregoing constituents were used as an index of pituitary-adrenal responsiveness. Changes in circulating corticosterone, PRL, GH, and especially aldosterone indicated that before the onset of their high blood pressure, SHR are much more responsive to noxious stimuli than normotensive S-D. The pattern of change in the pituitary content of GH and PRL, adrenal ascorbate, and cholesterol were also indicative of SHR hypersensitivity. These findings suggest that adrenal steroidogenesis and the stress response pattern in SHR vs. normotensive rats may be unique. PMID- 6847816 TI - [3h]Dexamethasone binding by rat liver microsomes: effects of age, sex, and adrenal status. PMID- 6847817 TI - Divergent changes in murine pituitary concentration of free alpha- and thyrotropin beta-subunits in hypothyroidism and after thyroxine administration. PMID- 6847818 TI - Neurotensin-like immunoreactivity in a subpopulation of noradrenaline-containing cells of the cat adrenal gland. AB - RIA of cat adrenal tissue extracts revealed a neurotensin-like immunoreactive material concentrated within the medulla of the gland (mean +/- SEM neurotensin concentration, 15.2 +/- 3.6 pmol/g whole gland; 47.9 +/- 18.4 pmol/g microdissected medulla). This immunoreactive material was found to elute in the region of synthetic neurotensin, thus indicating a similarity to the tridecapeptide originally isolated from bovine hypothalamus. Using immunocytochemical procedures at both light and ultrastructural levels, a neurotensin-like immunoreactive material was localized to a subpopulation of noradrenaline-containing cells quite distinct from the previously described enkephalin-immunoreactive chromaffin cells. Correlative ultrastructural observations have identified three morphologically distinct types of chromaffin cells in the medulla, indicating a marked heterogeneity within the noradrenaline cell population. The finding of neurotensin-like immunoreactivity in noradrenaline-containing cells of the cat adrenal medulla provides further evidence in support of the postulated existence of heterogeneous subpopulations of noradrenaline-containing cells and suggests a possible functional interrelationship between neurotensin and catecholamine. PMID- 6847819 TI - Role of vasopressin in blood pressure regulation during adrenal insufficiency. AB - The effect of adrenal insufficiency on the plasma concentrations of two vasoactive hormones, vasopressin and angiotensin II, was studied in conscious dogs. In addition the role of vasopressin in the maintenance of blood pressure during adrenal insufficiency was studied using [1-(beta-mercapto-beta, beta cyclopentamethylenepropionic acid),2-(O-methyl)tyrosine]arginine vasopressin, a specific antagonist of the vasoconstrictor action of vasopressin. Dogs were bilaterally adrenalectomized and maintained on daily cortisol and deoxycorticosterone acetate injections. Withdrawal of steroids for 4 days resulted in a 4-fold increase in plasma vasopressin concentration (P less than 0.05) and a 3-fold increase in plasma angiotensin II concentration (P less than 0.001); mean arterial pressure did not change significantly. Administration of the vasopressin antagonist in adrenalectomized dogs maintained on steroids had no effect on blood pressure. In marked contrast, vasopressin blockade in dogs with adrenal insufficiency decreased mean arterial pressure by 22 +/- 5 mm Hg (P less than 0.001). These results demonstrate the plasma angiotensin II and vasopressin concentrations increase during adrenal insufficiency in conscious dogs, and that vasopressin plays an important role in blood pressure regulation in this hypovolemic state. PMID- 6847820 TI - Noradrenergic regulation of growth hormone secretion in the baboon. AB - We have investigated the effects of iv administered noradrenergic agonists and antagonists on plasma GH concentration in the adolescent baboon, Papio papio, with the aim of defining the relative roles of adrenergic receptor subtypes (alpha 1, alpha 2, beta 1, and beta 2) in the regulation of GH release. Clonidine (0.02 mg/kg) or UK-14,304 (0.02 mg/kg), potent centrally acting alpha 2 noradrenergic agonists, were infused into 24 animals pretreated with either saline, or selective alpha 1 and alpha 2 noradrenergic antagonists. Both agonists potently augment plasma GH, producing peak levels of 30-60 ng/ml 15 min post infusion. These responses can be prevented by the prior infusion of the alpha 2 antagonist, piperoxane (1.0 mg/kg), but not by the alpha 1 antagonist, prazosin (2.0 mg/kg). Log dose response curves of the 2 agonists demonstrate a greater potency for UK-14,304 vs. clonidine on a molar basis. In animals pretreated with monoamine depleting agents (reserpine and alpha-methyl paratyrosine) the plasma GH response to an infusion of clonidine (0.02 mg/kg) is significantly enhanced (P less than 0.001). Beta-Adrenoreceptor antagonism by propranolol (0.02 or 1.0 mg/kg) or the more selective beta 2-adrenoreceptor antagonist, ICI 118,551 (0.02 1.0 mg/kg), results in a rapid and significant (P less than 0.01) increase in plasma GH. The beta 1-antagonist, practolol (0.2-2.0 mg/kg), does not alter plasma GH levels. It is proposed that in the baboon, noradrenaline acts on alpha 2-noradrenergic receptors to stimulate GH release and on beta 2-noradrenergic receptors to inhibit GH release. PMID- 6847821 TI - Hormonal regulation of immunoglobulins in the rat uterus: uterine response to a single estradiol treatment. PMID- 6847822 TI - Anovulatory effect of synthetic analogs of arginine vasotocin in the rat. AB - We synthesized a series of analogs of arginine vasotocin by systematically substituting each residue, and we then evaluated the anovulatory activity of these compounds in the rat, investigating the correlation between molecular structure and anovulatory, pressor, and antidiuretic activities. Substitution of the N-terminus cysteine with 3-mercaptopropanoic acid in arginine vasotocin and arginine vasopressin produced a 3- to 4-fold increase in both anovulatory and antidiuretic activity and only a 10% change in pressor activity. A similar substitution with lysine vasopressin produced no significant change in either anovulatory or antidiuretic potency; however, the pressor activity was reduced by half. Substitution of this cysteine in arginine vasotocin with 2-hydroxy-3 mercaptopropanoic acid produced an analog more potent in anovulatory activity than arginine vasotocin but less potent than [1-(3-mercaptopropanoic acid)] arginine vasotocin. The most potent anovulatory analog synthesized was [1-(3 mercaptopropanoic acid)]-8-ornithine vasotocin, which gave a 10-fold increase in anovulatory activity, a 4-fold reduction in antidiuretic activity, and only a 10% increase in pressor potency when compared with arginine vasotocin. These data suggest that different receptors are involved in the anovulatory and antidiuretic responses, but that the anovulatory and pressor effects may be mediated through similar receptors. Further work is necessary to produce a peptide that possesses specific anovulatory activity. PMID- 6847823 TI - Structure activity relationship of parathyroid hormone: separation of the hypotensive and the hypercalcemic properties. AB - The present study was conducted to show that the hypercalcemic and the vascular relaxing activities of PTH are two separable properties. During the hypotensive action of the synthetic fragment bovine (b) PTH-(1-34), plasma calcium levels were not significantly changed. Mild oxidation with hydrogen peroxide abolished the hypotensive and hypercalcemic actions of bPTH-(1-84). However, the same treatment on bPTH-(1-34) abolished only the hypotensive and not the hypercalcemic action. Analysis of the amino acid composition revealed only the oxidation of the methionines to methionine sulfoxides. The other amino acids remained unchanged. In addition, the analog with methionines replaced by norleucine, [Nle8,Nle18,Tyr34]bPTH-(1-34), was active in all the vascular assays, and these activities were unaffected by hydrogen peroxide treatment of the molecule. Perhaps the methionine sulfoxides in the hydrogen peroxide-treated bPTH-(1-34) affected the changes of the molecule in such a manner that the part of the molecule for the vascular action but not that for the hypercalcemic action was no longer accessible to the receptors of the target organs. The hypotensive pentapeptide, bPTH-(24-28), was not active in the hypercalcemic assay. All these data are consistent with our hypothesis that the vascular relaxing and the hypercalcemic actions of PTH are two separate properties of the molecule. PMID- 6847824 TI - Changes in distribution and androgen production of Leydig cells of two populations during sexual maturation in the rat. PMID- 6847825 TI - Vitamin D-dependent calcium-binding protein in rat brain: biochemical and immunocytochemical characterization. AB - Immunoreactive calcium-binding protein (CaBP) has been characterized in rat brain both biochemically and immunocytochemically. In this study antiserum to chick CaBP was used to characterize this protein and to describe its distribution in neurons and fibers of the rat fore- and midbrain. Immunostaining in neuronal elements was judged specific for this protein by the absence of staining in tissue sections after adsorption of the antiserum with either chick intestinal CaBP or the 28,000-dalton fraction from rat brain, but not with other molecular weight fractions with calcium-binding activity. Immunoreactive CaBP was found to have a widespread distribution throughout the central nervous system, and was present in most but not all major neuronal cell groups and fiber tracts. The protein was limited primarily to neuronal elements and some ependymal cells, and was absent in glia and blood vessels. The proportion of immunoreactivity in neuronal perikarya and fibers varied among nuclei and within a given structure at different rostral-caudal levels. Immunoreactivity was prominent in neocortex, hippocampal formation (primarily in CA1 and granular cells of the dentate gyrus), hypothalamus, and amygdala. These areas are responsible for the regulation of a variety of pituitary hormones, and several bind steroids. Immunoreactive CaBP was also a major constituent of nonlimbic system pathways. The widespread distribution of immunoreactive CaBP in the central nervous system suggests that CaBP and the vitamin D endocrine system may play a significant role in the regulation of mammalian brain function. PMID- 6847826 TI - Inhibition of development of both androgen-dependent and androgen-independent pigment cells in scrotal skin dermis of the rat by antiandrogen treatment during fetal growth. AB - Testosterone controls the melanogenic activity of epidermal melanocytes, but not that of brown dermal pigment cells, in scrotal skin of the adult rat. The effect of prenatal treatment with the antiandrogen flutamide on the development of scrotal skin pigmentation and the male reproductive system was examined. Treatment with flutamide on days 14-20 of gestation resulted in hypospadias, the absence or only rudimentary growth of prostate and seminal vesicles, and the presence of a vagina in male offspring. The scrotal coloration of these animals was lighter than controls, an effect due to the complete absence of dermal pigment cells. There was no effect of prenatal treatment with flutamide on melanin content, morphology, and relative number of epidermal melanocytes. Thus, the administration of antiandrogen during the fetal period of androgen-induced differentiation of secondary genital organs of the male rat prevents development of the androgen-independent dermal pigment cells. It would appear, therefore, that there is a transitory period during development when the dermal pigment cells or other elements in the scrotal dermal environment which regulate their function are under androgen control. PMID- 6847827 TI - The influence of methimazole on thyroglobulin-induced autoimmune thyroiditis in the rat. AB - Experimental autoimmune thyroid disease was induced in August rats by immunization with rat thyroglobulin in complete Freund's adjuvant. Disease severity, assessed by thyroid histology and circulating levels of anti-TG antibody measured by an enzyme immunoassay, was maximal between 30 and 60 days after the initial immunization and thereafter waned. Thyroid function through the duration of the disease, assessed by measurement of serum TSH levels by RIA, remained normal. Once the natural history of the disease was established, groups of rats received methimazole (MMI) with or without T4 in their drinking water, either before or after disease induction. The animals were bled at regular intervals and killed on day 49 for histological grading of their thyroids. MMI alone (group 3) or with T4 (group 4) before disease induction significantly reduced the severity of the disease, although the effect on circulating antibody levels was less marked in the animals in group 4. In animals given MMI alone (group 5) or with T4 (group 6) after establishment of the disease, MMI again significantly reduced the severity of the established disease, although this effect was less marked in the T4 supplemented animals. MMI significantly impaired the induction and reduced the severity of experimental autoimmune thyroid disease in August rats. The ability of MMI to influence the autoimmune process may have important implications for the use of this and other agents that act on the immune system in the management of human autoimmune disease. PMID- 6847828 TI - Glucocorticoid receptors in adult and senescent rat liver. PMID- 6847829 TI - Characteristics of iodothyronine tyrosyl ring deiodination by rat cerebral cortical microsomes. PMID- 6847830 TI - Partial characterization of somatomedin inhibitor in starved rat serum. PMID- 6847831 TI - Similarity of somatomedin inhibitor in sera from starved, hypophysectomized, and diabetic rats: distinction from a heat-stable inhibitor of rat cartilage metabolism. AB - The inhibitory effects of sera from starved, hypophysectomized, and alloxan diabetic rats on basal and somatomedin-stimulated sulfate incorporation into cartilage from hypophysectomized rats were compared. The somatomedin inhibitory activity in serum from diabetic rats behaved like that in serum from starved rats on heating at 60 C. Both were labile in the native sera (pH 8.3-8.4), but activity was conserved to a large extent by lowering the pH to 7.4 and diluting the sera before heating. In all of these sera the peak of the somatomedin inhibitory activity was eluted from a column of Sephacryl S-200 at pH 7.4 just after albumin, and lesser amounts were eluted with albumin and higher molecular weight components. Activity of this type was undetectable in fractions prepared from sera that had been heated at 60 C. These results indicate the similarity of this inhibitor in starved, hypophysectomized, and diabetic rat sera. Certain fractions of both starved and diabetic rat sera, which were eluted from a column of Sephacryl S-200 beyond the total bed volume, contained heat-stable inhibitory activity. In contrast to the effects of the heat-labile inhibitor, these fractions only inhibited basal sulfate incorporation into hypophysectomized rat cartilage under the assay conditions employed. This heat-stable inhibitor was not detected in fractions of hypophysectomized rat serum, and inhibitory concentrations of corticosterone were present in fractions of starved and diabetic rat sera containing the material. The findings suggest that the heat stable inhibitor is corticosterone. PMID- 6847832 TI - Characterization of guinea pig anti-progestin receptor antiserum. AB - Antibody against the progestin receptor was raised in a guinea pig utilizing a partially purified receptor preparation from rabbit uterus. The antibody recognizes the cytosol and nuclear progestin receptor but not glucocorticoid, androgen, or estrogen receptors. In addition, the antibody recognizes the progestin receptor in normal human endometrium as well as that in human breast and endometrial tumor cytosols. Antigen: antibody complex formation between receptor and preimmune or immune serum was judged by shift in sedimentation coefficient on high-salt sucrose gradients, by exclusion from DEAE Affi-Gel Blue columns, and by adsorption with Protein A. PMID- 6847833 TI - Control of renal function by intrarenal angiotensin II. AB - The purpose of this study was to determine if endogenous angiotensin II affects renal function in conscious dogs after sodium restriction. Intrarenal infusion of the angiotensin receptor antagonist saralasin at doses between 0.13 and 2.5 micrograms/kg X min rapidly attenuated pressor responses produced by systemic injections of angiotensin I over a 90-min period. In contrast, intrarenal infusion of the peptide antagonist at 0.07 microgram/ kg X min did not alter the pressor response to injected angiotensin I. Infusion of angiotensin II into the kidney at 0.1 microgram/min reduced urine output by 50% and was totally inhibited by simultaneous infusion of 0.07 micrograms/kg X min saralasin. Intrarenal infusion of saralasin at 0.07 micrograms/kg X min into sodium-restricted conscious dogs increased effective renal plasma flow, glomerular filtration rate, and sodium, potassium and water excretion, whereas urine osmolarity and free water formation were unchanged. These data demonstrate that saralasin can be effectively confined to the renal mass after intrarenal infusion at a dose capable of inhibiting angiotensin action and that endogenous angiotensin plays an important role in maintaining renal function after sodium restriction. PMID- 6847834 TI - Lack of direct effect of dopamine on aldosterone secretion in vivo. AB - Previous work suggests that aldosterone is modulated by dopamine, which exerts an inhibitory effect at the level of the adrenal cortex. This study reports the effect of dopamine on aldosterone secretion in conscious sheep with cervical adrenal transplants in whom endogenous ACTH secretion was suppressed by dexamethasone. In control experiments (n = 7) local adrenal infusions of angiotensin II (AII) (1.6 ng/min for 120 min) increased aldosterone secretion to peak levels (47.8 +/- 6.8 ng/min. mean +/- SEM) at 20 min, after which secretion fell to stable levels (20-28 ng/min) at 60-120 min. On separate days, sheep were restudied (n = 5) during systemic dopamine infusions (4 microgram/kg . min for 90 min), commencing 30 min before AII stimulation. There was no significant difference, either in the pattern or the sensitivity of the aldosterone response to AII, with dopamine infusions. Large intraadrenal infusions of dopamine (10 microgram/min) also failed to alter the aldosterone response to AII. The possibility that aldosterone was already under maximum tonic inhibition by dopamine was studied in four additional experiments using the dopamine blocking drug, metoclopramide. Although the systemic (iv) administration of metoclopramide increased aldosterone in both intact and transplanted sheep, local infusions of metoclopramide (0.5-15 microgram/min intraarterially) had no consistent effect on the aldosterone response to AII, and the addition of dopamine during metoclopramide infusions also had no effect. These results indicate that local (adrenal) dopaminergic mechanisms play little or no part in the regulation of aldosterone secretion in the sheep. The mechanism whereby aldosterone secretion is increased by systemic metoclopramide remains to be explained. PMID- 6847835 TI - Interrelationship of triiodothyronine concentration, metabolism, protein binding, and nuclear occupancy in the induction of malic enzyme by cultured adult rat hepatocytes. PMID- 6847836 TI - Reversible and irreversible inhibition of thyroid peroxidase-catalyzed iodination by thioureylene drugs. AB - The mechanism of reversible and irreversible inhibition of thyroid peroxidase (TPO)-catalyzed iodination by thioureylene drugs was investigated using a model incubation system. The major observations may be summarized as follows. 1) TPO is inactivated by 1-methyl-2-mercaptoimidazole and propylthiouracil even in the presence of a relatively high concentration of iodide. The extent of this inactivation depends on the ratio of iodide to drug. 2) Spectral changes observed on oxidation of the drugs with the peroxidase-iodide system were very similar to those observed when the drugs were oxidized nonenzymatically with I3-. These findings support the view that oxidized iodine is an intermediate in TPO catalyzed oxidation of the drugs. 3) Under conditions where TPO is largely inactivated, inhibition of iodination is complete and irreversible. Drug metabolism, on the other hand, occurs to a limited extent. 4) Under conditions where TPO is only partially inactivated, inhibition of iodination is transient (reversible). In this case, drug metabolism is extensive, and higher oxidation products (sulfate and sulfinic acid) are observed. Inhibition of iodination occurs only during the interval required to reduce the drug concentration to a low level. Thereafter, iodination may occur at a rate close to that observed in the absence of drug. Based on these and other observations, a scheme is presented to explain the mechanism of reversible and irreversible inhibition of iodination. In essence, the type of inhibition depends on the relative rates and extent of TPO inactivation and drug oxidation. These rates, in turn, depend primarily on the iodide to drug concentration ratio. A high ratio favors extensive drug oxidation and reversible inhibition. A low ratio favors TPO inactivation and irreversible inhibition. PMID- 6847837 TI - Differences in de novo cholesterol synthesis between the intact male and female rat. AB - Three different isotopes were used to quantify de novo sterologenesis in intact male and female rats. All three substrates (i.e. [14C]acetate, [14C]octanoate, and [3H]water) were incorporated into nonsaponifiable lipids and cholesterol at significantly greater rates in males than in females. Even with cholesterol feeding, male animals synthesized significantly more cholesterol and nonsaponifiable lipids than females. The primary site of this sex difference in sterologenesis is extrahepatic, extraintestinal tissues (e.g. carcass). In the carcass this sex difference is chiefly due to an enhancement of sterol synthesis in the skin of male rats. Cholesterol synthesis is 73% greater and nonsaponifiable lipid synthesis is 85% greater in the skin of males than in females. Moreover, de novo sterologenesis in skin is hormonally dependent. In castrated females, testosterone treatment results in a 2-fold stimulation of skin sterol synthesis compared to that in animals administered estradiol or oil vehicle alone. In castrated males, estradiol treatment caused a 30% reduction in skin cholesterol and nonsaponifiable lipid synthesis compared to that in animals administered testosterone. The effects of sex steroid hormones on skin are, therefore, probably responsible for mediating the observed sex difference in de novo sterol synthesis. Additionally, this study demonstrates that the administration of estradiol and testosterone in physiological doses to castrated animals has no effect on cholesterol or nonsaponifiable lipid synthesis in liver, intestine, or other nondermal tissues. PMID- 6847838 TI - Pancreatic polypeptide and intestinal migrating motor complex in humans. Effect of pancreaticobiliary secretion. PMID- 6847839 TI - Stressful life events, acid hypersecretion, and ulcer disease. AB - We have evaluated 2 patients with symptomatic gastric disease who dated the onset of their illnesses to stressful events in their lives. In 1 patient, six family members had recently died and our patient feared that he too would die. The other patient was accused of grand theft, was under police surveillance, and had lost his job. Both patients had markedly increased gastric acid secretion rates that decreased to normal after hospitalization and reassurance in the first case and acquittal in the second case. Ulcer symptoms subsided at the same time as the decrease in acid secretion. Although we cannot prove that severe emotional stress in our patients led to acid hypersecretion and ulcer disease, their courses suggest that stressful life events caused increased acid secretion which, in turn, led to ulceration and symptoms. PMID- 6847840 TI - Pentane clearance from inspired air by the rat: dependence on the liver. AB - Pentane, a volatile hydrocarbon, is cleared from inspired air by the rat. We have studied this clearance to learn whether or not it is a function of the liver. Rats were put individually into airtight chambers which contained CO2 absorbent and were connected to an O2 reservoir. Pentane was injected into each chamber and chamber atmosphere was assayed frequently for pentane over 6 h by gas chromatography. Semilog plots of pentane concentration had a rapid distribution phase and a log-linear terminal elimination phase. A chamber clearance value in milliliters at atmosphere cleared per minute per kilogram rat weight was calculated. Nephrectomy had no effect on pentane clearance. Liver injury by thioacetamide (5 mmol/kg) or by CCl4 (75 or 125 microliters/100 g) was associated with a marked decrease in pentane clearance, indicating a major role for the liver in pentane elimination. Treatment of rats with inducers or inhibitors of the hepatic microsomal cytochrome P450 system did not affect their ability to clear pentane. However, administration of ethanol or 4-methyl-pyrazole diminished pentane clearance, suggesting that alcohol dehydrogenase may be involved in pentane metabolism. These findings demonstrate that pentane clearance is a liver function. PMID- 6847841 TI - Hepatic iron uptake in alcoholic liver disease. PMID- 6847842 TI - Diagnosis of Wilson's disease presenting as fulminant hepatic failure. AB - The clinical course, results of standard laboratory tests, parameters of copper metabolism, and hepatic morphology in 9 cases (3 of our own and 6 from the literature) of Wilson's disease presenting as fulminant hepatic failure were compared with the findings in 5 cases of idiopathic fulminant hepatic failure. Patients with Wilson's disease were usually younger, and 7 of the 9 patients had Kayser-Fleischer rings. Patients with idiopathic fulminant hepatic failure had elevated 24-h urinary copper, decreased ceruloplasmin, and low or normal serum copper. Fulminant hepatic failure with Wilson's disease differed from idiopathic fulminant hepatic failure by the following biochemical findings: (a) higher copper levels in serum, urine and liver; (b) less pronounced elevations of transaminase levels; (c) higher concentrations of total bilirubin; and (d) lower hemoglobin values. Serum copper was the most useful biochemical test in diagnosing Wilson's disease before death. At autopsy, only hepatic copper concentrations clearly separated the two groups. Serial serum copper levels (antemortem) and quantitative analysis of hepatic copper (after recovery or postmortem) in patients with fulminant hepatic failure should help to exclude Wilson's disease. PMID- 6847843 TI - Adenocarcinoma of an ileostomy site with skin invasion: a case report. PMID- 6847844 TI - Ischemic colitis complicating sickle cell crisis. AB - Abdominal pain is quite common in sickle cell crisis, although the cause of abdominal pain is seldom determined and remains controversial. We have recently seen an 18-yr-old man with sickle cell disease who developed acute abdominal pain during a crisis. Rebound tenderness on physical exam and "thumbprinting" on barium enema examination suggested possible colon infarction. Histopathologic review of the resected ascending colon demonstrated mucosal necrosis and submucosal edema consistent with ischemic colitis. Hypotheses regarding the cause of abdominal pain in sickle crises are reviewed; the pathophysiology of sickle cell induced vasocclusion and its relation to the development of ischemic colitis in our patient is discussed. PMID- 6847845 TI - Cholestatic jaundice with a normal serum alkaline phosphatase level: another case of hypophosphatasia in an adult. PMID- 6847847 TI - Radiation as a risk factor in the natural history of colorectal cancer. PMID- 6847848 TI - Stress and ulcers-the continuing association. PMID- 6847846 TI - Sucrase-isomaltase regulation by dietary sucrose in the rat. PMID- 6847849 TI - Foodborne transmission of Clostridium difficile. PMID- 6847850 TI - Cimetidine in hypertrophic protein-losing gastropathy (Menetrier's disease) PMID- 6847851 TI - Rapid decrease of secretory IgA serum levels in extrahepatic obstructive jaundice after surgical relief of the bile duct obstruction. PMID- 6847852 TI - Fructose: incomplete intestinal absorption in humans. AB - Fructose is an increasingly important commercial sweetener. However, some patients report abdominal symptoms after ingesting fructose-containing foods. The completeness of fructose absorption by the small intestine was assessed by breath hydrogen analysis in 16 healthy volunteers and incomplete absorption was defined as a peak rise in breath hydrogen of greater than 20 parts per million. Fructose, 50 g as a 10% solution, was incompletely absorbed in 6 of 16 subjects (37.5%). Incomplete absorption was associated with symptoms of cramps or diarrhea, or both in 5 of these 6 individuals. Incomplete absorption was both concentration- and dose-related. Three subjects incompletely absorbed 37.5 g of fructose. In comparison, all 15 subjects who were studied after ingestion of sucrose, 50 g and a 10% solution, completely absorbed this sugar load. Incomplete absorption of fructose should be considered as a possible case of gastrointestinal symptoms. PMID- 6847853 TI - Sorbitol intolerance: an unappreciated cause of functional gastrointestinal complaints. AB - Sorbitol, a polyalcohol sugar, is the sweetener in most "sugar-free" products and may produce an osmotic diarrhea if ingested in large amounts (20-50 g). Whether or not smaller amounts of ingested sorbitol may be associated with other symptoms characteristic of carbohydrate malabsorption has not been determined. Using breath hydrogen analysis, the absorption of 5, 10, and 20 g of sorbitol was studied in 7 healthy volunteers. In a majority of subjects, ingestion of as little as 5 g sorbitol was associated with a significant increase in breath hydrogen concentration. Most subjects experienced mild gastrointestinal distress (gas, bloating) after 10 g and severe symptoms (cramps, diarrhea) after 20 g. These data suggest that the evaluation of patients with "functional" gastrointestinal complaints should include careful inquiry into the use of products containing sorbitol. PMID- 6847854 TI - Radiation-induced cancers of the colon and rectum: assessing the risk. AB - Individuals who have received pelvic irradiation are reported to be at increased risk to develop subsequent malignancies in the large bowel. In order to plan appropriate follow-up for these patients, it is necessary to understand the magnitude of their risk. In this paper we review the literature on colorectal cancer after irradiation and estimate the excess risk based upon available data. Women who are irradiated for gynecologic cancer may have a relative risk for subsequent colorectal cancer of 2.0-3.6 based on best estimates. This risk is calculated independent of any risk imposed by underlying disease. These women are appropriate targets for careful surveillance for colorectal cancer. PMID- 6847855 TI - Evaluation of ileal function using 23-selena-25-homotaurocholate, a-gamma-labeled conjugated bile acid. Initial clinical assessment. AB - 23-Selena-25-homotaurocholate is a synthetic bile acid labeled with a gamma-ray emitting radioisotope 75Se. It is readily measured using external detectors and is thus suitable for whole-body counting. Whole-body retention was measured at 0, 4, and 7 days after oral administration to normal controls and to patients with disease of the small intestine, colon, or ileocecal region. Whole-body retention of less than 25% of the administered radioactivity within 4 days is definitely abnormal, but there was overlap between normal and abnormal groups at this time. At 7 days, whole-body retention less than 12% is abnormal and greater than 19% is normal. Between these limits, values may represent minimal ileal dysfunction not demonstrable by older techniques. Excretion of 23-selena-25-homotaurocholate follows a biexponential curve. The faster component has a half-life similar to that of natural bile acid. It is uncertain whether the slower component represents a hitherto unrecognized slowly turning over pool of bile acid or is a metabolic product of 23-selena-25-homotaurocholate not yet identified in vitro. There is a significant relationship between the whole-body retention of 23-selena 25-homotaurocholate and total fecal and primary bile acids. 23-selena-25 homotaurocholate is simple and acceptable for investigating ileal function. PMID- 6847856 TI - A simple method for determining epithelial cell turnover in small intestine. Studies in young and aging rat gut. AB - Epithelial cell migration in animal gut classically is measured by autoradiography after systemic administration of tritiated thymidine. A migration rate is calculated from observations of the leading edge of villus epithelial cells containing labeled nuclei at varying time periods after tritiated thymidine injection. This method is very accurate, but laborious, time consuming, and costly. A new, simplified method for measuring epithelial cell measurement of [3H] deoxyribonucleic acid specific activity in frozen sections of intestine cryostat-cut from villus tip to crypt base. The leading edge of [3H]deoxyribonucleic acid can be detected reproducibly (coefficient of variation 11.25%). Autoradiographic and chemical methods for determining the leading edge of labeled cells compared favorable (r=0.848). Epithelial cell migration rates in barrier-reared Fisher 344 aging (27 mo) and young control (4-5 mo) rats were compared and no differences were detected in duodenum, jejunum, or ileum. Labeled epithelial cells reached the villus tip sooner in the ileum than in duodenum or jejunum. However, crypt-villus column heights were greater in duodenum and jejunum and the calculated epithelial cell migration rate was faster in upper intestine than in the ileum. Although ileal epithelial cells are shed from the villus sooner than cells in the upper intestine, the rate of cell migration in ileum is slower. PMID- 6847857 TI - Effect of ethanol on jejunal regional blood flow in the rabbit. AB - The effects of intraluminal ethanol perfusion (3.0% and 6.0% vt/vol) on mucosal morphology, water transport, and regional blood flow were examined in in vivo jejunal segments of pentobarbital-anesthetized rabbits. Compared with control segments, ethanol-perfused segments exhibited morphological alterations of the mucosa consisting of subepithelial fluid accumulation (bleb formation), exfoliation of enterocytes, and vascular congestion. The prevalence of epithelial damage was significantly increased in the segments perfused with 6% ethanol. Net water transport was significant (p less than 0.025) depressed in segments perfused with 3.0% and 6.0% wt/vol ethanol. In animals in which the control segment was absorbing water, ethanol led to a depression in net water absorption or to the reversal of absorption to net secretion. In animals in which the control segment exhibited secretion, ethanol led to an enhanced net secretion. Blood flow through the total jejunal wall and through the luminal layer (consisting of mucosa plus submucosa) was significantly (p less than 0.05) increased by the presence of 3.0% and 6.0% wt/vol ethanol in the intestinal lumen. Blood flow in the external layer of the jejunum (consisting of muscularis plus serosa) did not change significantly. It therefore appears that the ethanol induced alterations in jejunal mucosal morphology and water transport are accompanied by a localized mucosal or submucosal hyperemia, or both. However, a direct cause and effect relationship between these remains to be established. PMID- 6847858 TI - Calcium inhibition of inorganic iron absorption in rats. AB - Calcium significantly diminishes the absorption of ferrous and ferric iron in a dose-related manner, whether the test doses of calcium and radioiron are administered orally or introduced into isolated intestinal segments; the effect is maximal in the duodenum and jejunum. Electron microscopic observations and quantitative studies of the mucosal uptake and transfer of iron show that calcium decreases the entry of iron into the microvilli of intestinal epithelial cells. Animals fed a high-calcium, iron-replete diet developed iron depletion; animals consuming high-calcium food of marginal iron content developed mild iron deficiency anemia. Further, more radioiron was absorbed from human milk than either bovine milk or human milk supplemented with calcium. These data suggest that individuals consuming a high-calcium diet contain marginal amounts of iron could develop iron deficiency anemia and may explain why infants who are fed cow's milk have a greater incidence of iron deficiency anemia than those fed human milk. PMID- 6847859 TI - Staff learns how to face TV camera. PMID- 6847860 TI - Natural gas cited as hospitals' main fuel. PMID- 6847861 TI - Damages for wrongful birth, life and death. PMID- 6847862 TI - Hospital economic forecast. PMID- 6847863 TI - Community cancer management. PMID- 6847864 TI - Times of trial. Interview by Emily Friedman. PMID- 6847865 TI - The ways, they are a'changing: both instrument and scientific technologies have had a major impact on the delivery of clinical services. PMID- 6847866 TI - The effect of cortisol, progesterone, and transcortin on phytohemagglutinin stimulated human blood mononuclear cells and their interplay. AB - The effect of transcortin on [3H]thymidine incorporation into phytohemagglutinin stimulated human peripheral blood mononuclear cells and its influence on the well known suppressive effect of cortisol were investigated. Human transcortin by itself had no effect on thymidine incorporation between the concentrations of 0.25-1 X 10(-6) M. When transcortin was added to cortisol, the suppressive effect of cortisol decreased in proportion to the decrease in the protein-unbound cortisol concentration. We also investigated the influence of progesterone on transcortin-bound cortisol. When 0.5 and 1 X 10(-6) M transcortin, which contained 1 and 2 X 10(-7) M cortisol as a transcortin-bound form, were added to 5 X 10(-6) M progesterone, greater suppression of thymidine incorporation was observed that than produced by progesterone alone (86.1% and 81.3 for 0.5 and 1 X 10(-6) M transcortin, respectively). Moreover, when 5 X 10(-7) M transcortin containing the same amount of cortisol was added with 1, 2, and 5 X 10(-6) M progesterone, a greater suppression (92.6%, 74.1%, and 32.4% of control for 1, 2, and 5 x 10(-6) M progesterone) was demonstrated than that caused by progesterone alone (95.1%, 75.8%, and 49.5% of control for the corresponding concentrations of progesterone). This increased suppression was accompanied by an increase in the percentage of protein-unbound cortisol. These results indicate that unbound cortisol, whose concentration increases in the presence of progesterone, may be biologically active. The interaction between progesterone and cortisol may be modulated in part by the transcortin concentration. PMID- 6847867 TI - Somatostatin-like immunoactivity and biological activity is present in a human pheochromocytoma. AB - Somatostatin (SRIF)-like immunoreactivity (SRIF-LI) has previously been demonstrated immunohistochemically in sympathetic nerves and ganglia and in adrenal medullary cells. Studies were therefore performed to determine whether SRIF-LI was present in an adrenal pheochromocytoma. Acetic cid extracts of pheochromocytoma tissue contained high SRIF-LI concentrations (5.52 micrograms/g wet wt). On Sephadex G-75 gel filtration, the major peak of pheochromocytoma SRIF LI coeluted with synthetic SRIF. SRIF-LI of a larger molecular size was also present in the tumor. Pheochromocytoma SRIF-LI coeluted with synthetic SRIF on reverse phase high pressure liquid chromatography. Pheochromocytoma SRIF-LI purified by high pressure liquid chromatography was equipotent to synthetic SRIF in inhibiting (Bu)2cAMP-stimulated GH release by rat pituitary cells in monolayer culture. Serum SRIF-LI was elevated in the patient before surgery and was restored toward normal after removal of the tumor. Serum levels of GH, TSH, and insulin were not obviously different before and after tumor removal. The results indicate that SRIF-LI is produced in excessive quantities by a pheochromocytoma. The immunological, chromatographic, and biological properties of the pheochromocytoma SRIF-LI suggest that it is indistinguishable from synthetic SRIF. This finding extends the list of peptides produced by pheochromocytoma and may provide an additional serum marker for the tumor in man.U PMID- 6847868 TI - Thyroid-stimulating hormone and thyroglobulin levels decrease with chronological age in children and adolescents. AB - TSH, thyroglobulin (Tg), and the free T4 index were determined and related to chronological age in 24 normal boys (aged 7.6-17.6 yr; mean, 12.6 +/- 1.5 yr) and 20 normal girls (aged 7.8-17.0 yr; mean, 12.2 +/- 1.4 yr). There was no significant (P greater than 0.1) difference in mean serum TSH (3.06 +/- 2.07 vs. 2.97 +/- 2.07 microunits/ml) and Tg levels (25.3 +/- 10.0 vs. 28.0 +/- 14.8 ng/ml) or free T4 index (9.6 +/- 1.6 vs. 9.4 +/- 1.3 micrograms/dl) between boys and girls. Serum TSH levels correlated negatively with chronological age (rs = 0.518; r = -0.562; P less than 0.01), as did serum Tg levels (rs = -0.618; r 0.545; P less than 0.01). On the other hand, a positive correlation was found between serum TSH and Tg levels (rs = 0.455; r = 0.421; P less than 0.01). Free T4 index levels did not correlate with chronological age, TSH levels, or Tg levels. We conclude that both serum TSH and Tg levels vary inversely with chronological age in children and adolescents. Also, a direct correlation was noted between serum TSH and Tg levels. These data as well as those from earlier studies may indicate that pituitary secretion of TSH contributes to serum levels of Tg. The decline in TSH with age may be the result of an increased response of the thyroid gland to TSH or a decline in the MCR of T4 with age. PMID- 6847869 TI - On the role of dopamine receptors in the naloxone-induced hormonal changes in man. AB - To assess the role of dopamine receptors in naloxone-induced hormonal changes, the effects of dopamine and metoclopramide on anterior pituitary hormone secretion were studied during the infusion of the opiate blocker in normal men. Naloxone stimulated LH and cortisol secretion in all subjects, whereas FSH, TSH, PRL, and GH did not change. The infusion of dopamine completely suppressed the naloxone-induced LH rise; on the contrary, metoclopramide failed to alter the magnitude of the increments in LH observed during the infusion of the opiate blocker. The cortisol response to naloxone remained unchanged during dopamine and metoclopramide infusion. Metoclopramide stimulated PRL and TSH release during naloxone treatment, whereas dopamine suppressed PRL and TSH secretion. The data do not suggest a participation of dopamine receptors in the naloxone-induced hormonal changes in man and confirm a suppressive effect of dopamine infusion on LH release in humans. PMID- 6847870 TI - Alterations in systolic time intervals in primary hypothyroidism as a consequence of warming. AB - The systolic time intervals (STI) of the preejection period, left ventricular ejection time and their ratio are influenced by thyroid function, the ratio increasing as thyroid secretion diminishes. We have previously shown that the majority of patients with primary hypothyroidism have a subnormal body temperature and that warming such individuals is accompanied by a fall in circulating levels of serum T4, T3, and TSH. On this occasion we studied 24 patients with primary hypothyroidism. Fifteen of these were warmed at rest in bed for 48 h; the remaining 9 control patients were rested for the same period, but not heated. Four euthyroid volunteers were warmed for 24 h, as were a further 5 hypothyroid subjects. Estimations of STI, T4, and T3 were made in all individuals at the beginning and end of the study period. In all warmed hypothyroid patients there was a rise in rectal temperature and a simultaneous increase in the STI. There was a significant fall in serum T4 and T3 levels in those hypothyroid subjects warmed for 48 h, but not in those warmed for 24 h; the latter, however, showed a significant fall in circulating TSH levels. In the 4 warmed euthyroid volunteers there was no significant alteration in STI and there was no change in T4, T3, and TSH levels in the 2 subjects in whom they were measured. Thus, left ventricular function deteriorates with warming in patients with primary hypothyroidism. PMID- 6847871 TI - Occurrence of methionine-enkephalin-Arg6-Gly7-Leu8 with methionine-enkephalin, leucine-enkephalin and methionine-enkephalin-Arg6-Phe7 in human gastric antrum. AB - Recent studies on the nucleotide sequence of cloned DNA complementary to mRNA for preproenkephalin from bovine adrenal medulla and human pheochromocytoma have revealed that this precursor molecule contains four copies of methionine enkephalin (Met-Enk) and one copy each of leucine-enkephalin (Leu-Enk), methionine-enkephalin-Arg6-Gly7-Leu8 (Met-Enk-Arg6-Gly7-Leu8) and methionine enkephalin-Arg6-Phe7 (Met-Enk-Arg6-Phe7). We have demonstrated the existence of Met-Enk-Arg6-Gly7-Leu8 together with Met-Enk, Leu-Enk and Met-Enk-Arg6-Phe7 in human gastric antrum, using high performance liquid chromatography (HPLC) coupled with radioimmunoassays for these opioid peptides. The ratio of molar concentrations of these peptides in human gastric antrum is similar to the ratio of these peptides contained in preproenkephalin. Furthermore, gel filtration studies on Sephadex G-50 showed that most of immunoreactivities of these peptides were eluted at the elution position of each synthetic peptide without any detectable immunoreactivities at high molecular weight positions. These results indicate the presence of Met-Enk-Arg6-Gly7-Leu8 together with Met-Enk, Leu-Enk and Met-Enk-Arg6-Phe7 in human gastric antrum and further suggest that these opioid peptides are derived from the same preproenkephalin as that in the adrenal medulla and that the processing of preproenkephalin is almost complete in the gut. PMID- 6847872 TI - The influence of percutaneous fine needle aspiration on serum thyroglobulin. AB - To determine whether percutaneous needle aspiration of the thyroid affects tests of thyroid function, in particular thyroglobulin (TG), serum TG, T4, free T4 index, T3, and TSH were measured before and after percutaneous needle aspiration biopsy of the thyroid in 25 subjects. Seven control subjects were tested before and after vigorous external manual palpation of the thyroid. Serial measurements were made additionally in 3 subjects undergoing thyroid surgery to assess how quickly serum TG increases after injury. The results were analyzed, and statistically significant differences between paired results were defined if the differences were greater than the maximum interassay variation in 11 consecutive assays. Eleven out of 25 patients had statistically significant elevations of serum TG after aspiration. None of the seven who underwent external manual palpation of the thyroid gland had elevation of serum TG. With three exceptions, there were no significant changes in serum T4, free T4 index, T3, and TSH in either group. Marked elevations in serum TG occurred within 2 min after open manual palpation, diathermy, and excision. The results were analyzed and correlated with factors that might lead to release of TG from the thyroid during needle aspiration. No positive correlation was observed with the apparent degree of trauma, the size of nodule, the TG content, volume or character of aspirate, or the time elapsed from aspiration to withdrawal of the blood sample. Correlation of serum TG elevation with final diagnosis did not show a significant trend; however, the existence of a possible relationship needs further studies. We conclude that serum for TG measurement should be obtained before percutaneous thyroid aspiration biopsy. PMID- 6847873 TI - Identification of thyroxine in human breast milk by gas chromatography-mass spectrometry. AB - In several previous publications it has been reported that human breast milk contains significant amounts of T4. Great differences in concentrations were found by different authors. In all these publications T4 was assayed by RIA, and it seems probable that the varying results obtained are due to varying specificity of the antibodies used in the assay. Definite demonstration of the presence of T4 in breast milk requires a more specific method than RIA. In the present work we have used combined gas chromatography-mass spectrometry. T4 was isolated from human breast milk by combined anion- and cation-exchange chromatography. The purified material was treated with HCl in methanol and trifluoroacetic acid anhydride and was analyzed by single-ion monitoring of the ions at m/e 983, m/e 870, and m/e 799, major ions in the mass spectrum of the N,O bis(trifluoroacetyl) methyl ester of T4. Significant peaks confirmed the presence of T4 in human milk. The estimated concentration was less than 10 ng/ml. Attempts were made to quantitate the T4 by selected ion monitoring of the ions at m/e 870 and m/e 822 after addition of monobromotriiodothyronine as internal standard. According to this latter method, the concentration of T4 in four samples of centrifuged breast milk was less than 4 ng/ml. The possible physiological significance of the finding is discussed. PMID- 6847874 TI - In vivo uptake and subcellular distribution of tritium-labeled estrogens in human endometrium, myometrium, and vagina. PMID- 6847875 TI - The origin of plasma deoxycorticosterone in men and in women during the menstrual cycle. PMID- 6847876 TI - Expression and induction in vitro of macrophage differentiation antigens on murine cell lines. PMID- 6847877 TI - The FcR-mediated endocytosis of model immune complexes by cells from the P338D1 mouse macrophage line. I. Internalization of small, nonaggregating oligomers of IgG. PMID- 6847878 TI - The FcR-mediated endocytosis of model immune complexes by cells from the P388D1 mouse macrophage line. II. The role of ligand-induced self-aggregation in promoting internalization. PMID- 6847879 TI - Development of natural killer cell function in the human fetus. AB - NK cell activity of four human premature infants between 28 and 33 wk of gestation and eleven human fetuses at 9 to 22 wk of gestation was tested against the K-562 cell line in a 4-hr 51Cr-release assay. Cord blood lymphocytes from premature infants expressed well-developed NK capacity, although the level of cytotoxicity was lower than that of full-term newborns or adults. Cells prepared from fetal liver displayed cytotoxicity against K-562 targets in four out of eleven fetuses, whereas cells from fetal bone marrow, spleen, and thymus expressed only marginal or negative anti-K-562 killing. NK cell activity in the fetal liver was observed as early as at 9 wk of gestation. The functional NK capacity of premature infants and fetuses was augmented in vitro by IFN-alpha treatment. Fetal cells without spontaneous NK activity did not develop cytotoxicity against K-562 target cells in the presence of IFN-alpha. The present results corroborate the concept of the intrauterine development of human NK cell activity. PMID- 6847880 TI - Accumulation of guanine-cytosine-enriched low M.W. DNA fragments in lymphocytes of patients with systemic lupus erythematosus. AB - The fate of the newly synthesized DNA in peripheral blood lymphocytes from patients with systemic lupus erythematosus was examined. After lymphocytes were stimulated with the mitogen phytohemagglutinin (PHA), DNA was pulse-labeled with radioactive thymidine and was analyzed by sucrose density gradient centrifugation. Two classes of DNA were identified; the main DNA fraction that migrated to the same position as that of control samples, and low m.w. DNA fragments. The low m.w. DNA fragments were further characterized: i) The amount of low m.w. fragments increased with increasing time of culture after PHA stimulation. ii) The guanine cytosine content was 47% of the total bases at 4 days after PHA stimulation. iii) The base composition was similar to that of DNA fragments isolated from DNA/anti-DNA antibody immune complexes. These results lead us to propose that guanine cytosine-enriched low m.w. DNA fragments accumulate in cells after nuclear DNA is degraded, and that these fragments may serve as a primary source of autoantigen for anti-DNA antibody production. In addition, they may interfere with normal cellular metabolism. PMID- 6847881 TI - Evaluation of homologous and isologous passive Heymann nephritis: influence on endogenous antibody production. PMID- 6847882 TI - Coordinate expression of macrophage procoagulant and fibrinolytic activity in vitro and in vivo. PMID- 6847883 TI - Stable hamster-mouse hybridomas producing IgG and IgM hamster monoclonal antibodies of defined specificity. AB - Specific antibody-secreting hybridomas have been obtained by fusing Syrian or Armenian hamster (Mesocricetus auratus or Cricetulus migratorius) spleen cells with mouse myeloma cells. The hamsters were immunized to mouse cytolytic T lymphocytes. Hybrids were selected either by an indirect binding assay using an 125I-monoclonal antibody (MAb) reactive with hamster kappa-chains or by their ability to block T cell-mediated cytolysis. Three hybridoma clones were obtained that secreted intact IgM-like and IgG-like hamster MAb as shown by SDS-PAGE. The clones were stable as shown by subcloning. Two MAb recognized antigens of wide tissue distribution; the third bound specifically to T lymphocytes, gave strong inhibition of T cell-mediated cytolysis, and immunoprecipitated the Lyt-2,3 molecule. PMID- 6847884 TI - Restriction in IgM expression. IV. Affinity analysis of monoclonal anti phosphorylcholine antibodies. PMID- 6847885 TI - Acrosomal autoantigens of guinea pig sperm. I. The purification of an aspermatogenic protein, AP2. AB - A soluble aspermatogenic autoantigen (AP2) capable of inducing experimental allergic orchitis (EAO) in the guinea pig has been isolated from the soluble acrosomal contents (SAC) released from guinea pig cauda epididymal sperm during the in vitro Ca+2 ionophore A23187-induced acrosome reaction. AP2 purification was achieved by heat inactivation of SAC enzymatic activity, followed by chaotropic solubilization and ultracentrifugation, gel filtration on Sephadex G 50, preparative isoelectric focusing, and SDS-polyacrylamide gel electrophoresis. Approximately 80 micrograms of AP2 was obtained from 1 to 2 x 10(10) cauda epididymal sperm. AP2 has a m.w. of 9500 +/- 1500 as determined by unreduced SDS PAGE and an isoelectric point of 5.52 +/- 0.11. Amino acid analysis of AP2 indicates that it is a protein. AP2 has no detectable hexose or hexosamine as determined by gas liquid chromatographic analysis and is therefore probably not a glycoprotein. Five micrograms of AP2 are capable of inducing severe EAO in 100% of guinea pigs tested, whereas 0.5 to 2.0 micrograms induces mild lesions consisting primarily of aspermatogenesis in 66% of guinea pigs tested. PMID- 6847886 TI - Phagocytosis of mast cell granules by cultured fibroblasts. AB - Cultured rat embryonic skin fibroblasts phagocytosed rat mast cell granules added to the medium or released from co-cultured mast cells by rabbit anti-rat IgE or Compound 48/80. Electron microscopy of fibroblasts incubated with mast cell granules revealed that granules adjacent to the plasmalemma were engulfed by long, thin cytoplasmic processes. Internalization proceeded to fusion of encircling processes and formation of phagosomes. Microtubules and 60 A microfilaments became closely associated with the phagosomal membrane to which small vesicles and cisternae of endoplasmic reticulum fused. The rate of uptake of mast cell granules by fibroblasts was dependent upon temperature and granule concentration. Cytochalasin B inhibited granule uptake whereas colchicine and nocodazole had little effect. Phagocytosis was not influenced by actinomycin D and cycloheximide, was partially inhibited by fluoride, and was markedly inhibited by cyanide, azide, and 2,4-dinitrophenol. Supernatants from fibroblast cultures incubated with mast cell granules for 24 and 48 hr, during which period phagocytosis occurred, contained elevated levels of collagenase and beta hexosaminidase, but normal levels of lactate dehydrogenase and superoxide dismutase. These results support the concept that immediate hypersensitivity reactions are in part terminated by phagocytosis of biologically active discharged mast cell granules by resident connective tissue fibroblasts. Further, it is suggested that a consequence of this process is an alteration in fibroblast behavior, providing a unique link between immediate hypersensitivity reactions and connective tissue responses to inflammation. PMID- 6847887 TI - Changes in intracellular glutathione levels in stimulated and unstimulated lymphocytes in the presence of 2-mercaptoethanol or cysteine. AB - Certain low m.w. thiol compounds can enhance various in vitro lymphocyte mitogenic responses, whereas reagents that react with sulfhydryl groups are potent cell poisons. The possible targets for thiols and thiol reagents could include membrane and cytoplasmic proteins, some of which may regulate lymphocyte proliferation. As a step toward understanding how lymphocyte proliferation is enhanced in the presence of thiols, we studied the appearance of both protein and non-protein sulfhydryl groups in stimulated lymphocytes. To help clarify the role of the cellular targets for thiols, we studied the time course of appearance of both protein and non-protein sulfhydryl groups as lymphocytes proliferate under various conditions. In the presence of an appropriate concentration of the thiol 2-mercaptoethanol (2-ME), there is a substantial rise in the level of intracellular glutathione for lymphocytes stimulated with the mitogen concanavalin A (Con A). Otherwise, the level of intracellular glutathione declines, even for Con A-stimulated cells, but the presence of 2-ME partially prevents this decline. Increasing the amount of cysteine in the medium to a level that enhances cell proliferation leads to effects similar to those obtained with 2-ME. Thus, apparently one effect of various thiol reducing agents is to enhance the production of glutathione in lymphocyte mitogenesis and to protect against the loss of glutathione that occurs in resting or proliferating lymphocytes. PMID- 6847888 TI - Increased expression of C3b receptors on polymorphonuclear leukocytes induced by chemotactic factors and by purification procedures. PMID- 6847889 TI - Lymphocyte function in experimental African trypanosomiasis. V. Role of antibody and the mononuclear phagocyte system in variant-specific immunity. AB - The role of parasite-specific antibody and the mononuclear phagocyte system (MPS) in immunity to the African trypanosomes was examined. For this study C57BL/10SnJ mice were infected with Trypanosoma rhodesiense clone LouTat 1.0. Infected mice were injected with 75Se-labeled LouTat 1.0 trypanosomes, and clearance from the blood upon reexposure was measured throughout the course of infection. Clearance of labeled organisms occurred only on or after day 5, which was the day of natural elimination of LouTat 1.0 from the blood. Clearance was dependent on a functional immune system and correlated with the appearance of antibody to the variant-specific surface antigen (VSSA) of the trypanosomes. The ability to clear trypanosomes was transferred to normal, uninfected mice by immune serum. Both the IgM and IgG fractions of immune serum mediated the clearance, and VSSA-specific IgM fractions were as efficient in clearing LouTat 1.0 as the IgG fractions. Normal levels of complement (C3) were not required for clearance. The liver was the primary organ of clearance, and the ability of the liver to sequester radiolabeled trypanosomes was not impaired in the terminal phase of the disease or by large numbers of circulating trypanosomes present representing different variant antigenic types (VAT). We conclude that in African trypanosomiasis the MPS is not depressed in its ability to clear trypanosomes of the infecting VAT at any time during the course of infection. The observed clearance function requires parasite-specific antibody but normal levels of C3. PMID- 6847890 TI - Genetics of resistance to the African trypanosomes. II. Differences in virulence associated with VSSA expression among clones of Trypanosoma rhodesiense. PMID- 6847891 TI - In vitro immune mechanisms associated with clearance of microfilariae of Dirofilaria immitis. AB - An in vitro system has been developed to elucidate potential immune mechanisms associated with clearance of microfilariae (Mf) from the bloodstream in canine Dirofilaria immitis infection. Granulocytes as well as mononuclear cells adhere to Mf of Dirofilaria immitis in the presence of immune serum. Only granulocytes, however, were capable of killing Mf, whereas PBMC attach to but do not effectively kill Mf. In the presence of granulocytes 1% +/- 1, 10% +/- 2, and 12% +/- 3 of Mf were killed by heated normal (NDS), patent (PS), and occult serum (OS), respectively, after an 18-hr incubation. With the addition of fresh NDS there was an increase in killing to 5% +/- 1 (p less than 0.025) with heat inactivated NDS, to 12% +/- 3 in the presence of PS and to 77% +/- 12 (p less than 0.005) in the presence of OS. On further purification of granulocyte cell populations with metrizamide gradients, neutrophils were found to be the predominant effector cells with 73% +/- 18 killing with neutrophils and 18% +/- 6 with eosinophils (p less than 0.0005). Only with neutrophils was a significant increase in killing of Mf observed when fresh NDS was added to delta OS. Fractionation of OS by gel filtration suggested that IgM was the opsonizing antibody in the occult serum. In addition, immunofluorescent studies showed only IgM bound to the surface on Mf on incubation in OS. The involvement of complement in the fresh serum enhancement of killing was supported by the finding, by immunofluorescence, of surface C3 on Mf after incubation in fresh OS. PMID- 6847892 TI - Biochemical evidence for expression of a semi-allogeneic, H-2 antigen by a murine adenocarcinoma. AB - LT-85 is an alveolegenic adenocarcinoma induced in mutant C3HfB/HeN (C3Hf) mice. This tumor, however, grows preferentially in allogeneic, wild-type C3H/HeN (C3H) mice. The tumor-associated transplantation antigen has been mapped to the K end of the major histocompatibility complex. H-2K antigens were isolated from detergent extracts of LT-85 cells by immunoprecipitation with monoclonal antibody. The tryptic peptides of these antigens were compared, by using high pressure liquid chromatography, with the tryptic peptides of H-2K antigens isolated from syngeneic mutant C3Hf and ancestral wild-type C3H spleen cells. We found that the H-2K antigens of the LT-85 tumor cells were very similar to, but distinct from, those present on syngeneic C3Hf lymphoid cells. We also found, however, that the H-2K antigens of LT-85 tumor cells were clearly different from the H-2K antigens of allogeneic C3H spleen cells. The H-2K antigens of LT-85 cells are therefore foreign to syngeneic C3Hf cells, but do not represent expression by the tumor cells of the allogeneic H-2K antigens expressed by normal C3H cells. Furthermore, the nature of the differences observed between the H-2K antigens of LT-85 cells and C3Hf and C3H spleen cells strongly suggests that the structure of the H-2K molecule of LT-85 cells is identical in some regions to the H-2K molecule of C3Hf cells, and in other regions to the H-2K molecule of C3H cells. PMID- 6847893 TI - Regulation of human lymphocyte-mediated natural killer (NK) cell activity. I. Inhibition in vitro by peripheral blood granulocytes. PMID- 6847894 TI - Quality of life in children treated for brain tumors. Intellectual, emotional, and academic function. AB - Thirty children with primary brain tumors were evaluated for alterations in intellectual, emotional, and academic functions. Nine were studied following surgery (prior to irradiation) and 21 after postoperative irradiation. Twenty four patients (80%) showed no serious disabilities on routine medical and neurological examinations. Nineteen patients (63%) had normal intelligence quotient (IQ) levels. Qualitative disabilities on routine examinations were observed in six children: two of nine tested postoperatively, one of six tested after posterior fossa irradiation, and three of 15 tested after cranial irradiation. Subnormal IQ levels were also noted in two of nine children tested prior to irradiation and one of six after posterior fossa irradiation. Of the 15 studied after cranial irradiation, eight had subnormal IQ scores. Serial postirradiation testing in 10 patients revealed improvement in two, stability in five, and further deterioration in three. Ten children were placed in learning disability settings due to achievement delays or problems with selective attending. Social-emotional evaluations detected excessive tendencies toward psychotic symptomatology. Potential etiological factors, including primary tumor site, extent of irradiation, age, and increased intracranial pressure, are discussed. Preliminary findings suggest a greater than normal risk for late neuropsychological alterations among children with supratentorial tumors and/or cranial irradiation. PMID- 6847895 TI - Experimental craniosynostosis in growing rabbits. The role of the periosteum. AB - Reports on the role of the periosteum in premature sutural synostosis have been contradictory. The present study summarizes a series of six experiments designed to clarify these previously conflicting findings. Twenty-five male New Zealand White rabbits were divided into six experimental groups. In four of the groups, methyl-2-cyanoacrylate was used to glue the frontal and parietal bones together and temporarily immobilize the coronal suture. In the other two groups, the sutures were not immobilized. Polyethylene was used to separate the cyanoacrylate from the periosteum in two of the groups. The experiments were performed at 5 weeks of age, and the animals were killed at either 30, 45, or 180 days postoperatively. Metallic implants were placed in the frontal and parietal bones for monitoring growth and/or sutural immobilization. Sutural fusion was confirmed radiographically or histologically. Based upon the findings it seems that mechanical immobilization of a suture does not induce fusion of that suture in rabbits. Furthermore, it appears that the mere application of methyl-2 cyanoacrylate to the periosteum overlying a suture will consistently cause the formation of a bony bridge in growing rabbits but not in nongrowing animals. The adhesive does not consistently induce synostosis if the periosteum is excised. PMID- 6847896 TI - Delayed cerebral vasospasm is not reversible by aminophylline, nifedipine, or papaverine in a "two-hemorrhage" canine model. AB - Angiographic spasm of cerebral arteries was produced in dogs by successive injections of cisternal blood 48 hours apart. Angiograms were taken before and after each cisternal injection. There was progressively greater angiographic vasospasm of the basilar artery. Intravenous aminophylline, 10 mg/kg/hr, reversed vessel constriction on the 1st and 3rd day after one injection of cisternal blood. On the 5th day after two blood injections (on Day 1 and Day 3), intravenous aminophylline, nifedipine (1 mg/kg), and intra-arterial bolus injection of 2 mg/kg papaverine failed to reverse the constriction. The intractable constriction produced in this model resembles that found in patients. The calcium antagonist, nifedipine, is as ineffective as the more traditional vasodilators in reversing vasospasm in this model. PMID- 6847897 TI - Bilateral aneurysm formation developing from junctional dilatation (infundibulum) of the posterior communicating arteries. Case report. PMID- 6847898 TI - Cerebral dissecting aneurysms in patients with moyamoya disease. Report of two cases. AB - Dissecting intracranial arterial aneurysms were identified in a 16-year-old girl and a 48-year-old man with moyamoya disease. Hemiplegia or tetraplegia rapidly developed. Angiography revealed bilateral stenoses or occlusion of the bifurcation of the internal carotid arteries (ICA's) and an unusual vascular network at the base of the brain. Autopsy confirmed massive hemorrhage from the thalamus and putamen, with intraventricular extension. The intracranial segments of both ICA's were markedly stenotic in both patients, due to eccentric fibroelastic intimal thickening. In one patient, a dissecting aneurysm was identified microscopically, involving the proximal segment of the left anterior cerebral artery. In the other patient, the right middle cerebral artery (MCA) was dissected beneath the internal elastic lamina along the entire length of the horizontal segment of the MCA. Thus, cerebral dissecting aneurysms may be present in patients with moyamoya disease. PMID- 6847899 TI - Ruptured aneurysm of the anterior spinal artery associated with pseudoxanthoma elasticum. Case report. PMID- 6847900 TI - Suppression of cortisol secretion by low-dose dexamethasone testing in Cushing's disease. Case report. PMID- 6847901 TI - Suprasellar germinoma in association with Klinefelter's syndrome. Case report. PMID- 6847902 TI - Lateral sinus pericranii. Case report. PMID- 6847903 TI - Infratentorial approach to the pineal region in the prone position: Concorde position. Technical note. PMID- 6847904 TI - Report of the Research Subcommittee of the Joint Committee on Education of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons. PMID- 6847905 TI - Cerebral arterial constriction after experimental subarachnoid hemorrhage is associated with blood components within the arterial wall. AB - Sequential cisternal blood injections in dogs reproduce some of the morphological and physiological features seen in man after subarachnoid hemorrhage-induced vasospasm. This study reports the morphological features observed in cerebral vessels in areas exposed to subarachnoid blood. Subarachnoid hemorrhage was produced in dogs by two cisternal injections of non-heparinized autologous blood 48 hours apart. Dogs were sacrificed 48 hours after the second injection. Angiographic narrowing of the basilar artery was routinely present 48 hours after the second injection, and there was a good correlation between angiographic vasospasm and a narrowed arterial lumen at postmortem examination. All basilar arteries showed structural changes with electron microscopic examination; these included endothelial cell vacuoles, early smooth-muscle cell necrosis, intimal changes, and adventitial erythrocytes, leukocytes, and mast cells. The finding that accompanied vessel constriction most uniformly was packing of the adventitial cerebrospinal fluid spaces with erythrocytes. Angiographically visible spasm was resistant to vasodilators. These data suggest that infiltration of blood elements into the arterial wall is an important concomitant feature of morphological and angiographic vasospasm. PMID- 6847906 TI - Enzymatic changes in serum and cerebrospinal fluid in neurological injury. PMID- 6847907 TI - Spinal evoked potentials from the motor tracts. AB - There is a need to monitor the motor system, but it has a different blood supply and a different location in the spinal cord from those measured by traditional somatosensory evoked potential monitoring. This paper reports a motor evoked potential monitoring system that uses direct spinal cord stimulation overlying the areas of the motor tract in the cord. In nine cats, evoked potentials were recorded from the dura, which gave a much faster main signal component than the traditional dorsal column evoked potentials, which were also recorded. This 100 m/sec signal was not affected by sectioning of the dorsal columns, which was verified histologically. This mode of monitoring the motor system can be used during surgery. It may also provide a better evaluation of patients after spinal cord trauma. PMID- 6847908 TI - A clinical comparison of subdural screw pressure measurements with ventricular pressure. AB - Simultaneous recordings of intracranial pressure (ICP) from a single-lumen subdural screw and a ventricular catheter were compared in 10 patients with severe head injury. Forty-one percent of the readings corresponded within the same 10 mm Hg ranges, while 13% of the screw pressure measurements were higher and 46% were lower than the associated ventricular catheter measurements. In 10 other patients, also with severe head injury, pressure measurements obtained with the Leeds-type screw were similarly compared with ventricular fluid pressure. Fifty-eight percent of the dual pressure readings corresponded, while 15% of the screw measurements were higher and 27% were lower than the ventricular fluid pressure, within 10-mm Hg ranges. It is concluded that subdural screws may give unreliable results, particularly by underestimating the occurrence of high ICP. PMID- 6847909 TI - The recurrence of intracranial meningiomas after surgical treatment. AB - A study of 114 surgically treated patients with intracranial meningiomas was carried out to evaluate factors influencing recurrence. The data of the initial surgery extended over a 24-year period from January, 1956, to December, 1979. The patients ranged in age from 1 1/2 years to 82 years. Seventy-one (62.3%) were females and 43 (37.7%) were males. The surgical procedure was graded according to Simpson's classification from 1 to 5 (Grade 1 = complete excision, Grade 5 = simple decompression). In this series, 33 procedures (28.9%) were Grade 1, 55 (48.2%) were Grade 2, seven (6.1%) were Grade 3, 18 (15.8%) were Grade 4, and one (0.9%) was Grade 5. There were eight (7%) postoperative deaths. Approximately 60% of the tumors were located in the sphenoid wing (23.7%), convexity (21.1%), and parasagittally (14.9%). Histological diagnosis in 96% of the patients was transitional (42.1%), syncytial (34.2%), and fibroblastic (20.2%) meningiomas. Eight (7%) patients received postoperative radiotherapy. There was evidence of recurrence in 22 patients (19.3%). Twenty-one underwent a second surgical procedure. Using survival analysis, it was determined that 80% of the patients were free of recurrence 5 years after the initial surgery, and approximately 50% showed no recurrence 20 years after the initial surgery. Only the grade of the initial surgery had a statistically significant influence on recurrence. Sex of patients, site and histology of the tumor, and postoperative radiotherapy had no statistically significant influence on recurrence. Angioblastic and malignant meningiomas were rare (only four cases), and recurred relatively quickly. PMID- 6847910 TI - Observer variability in assessing the clinical features of subarachnoid hemorrhage. AB - Clinical assessment of patients with subarachnoid hemorrhage (SAH) is important both in determining management and in predicting outcome. A previous report showed considerable observer inconsistency when patients were graded with either the Hunt and Hess or the Nishioka system. This study evaluates observer variability in assessment of the individual clinical features from which these grading systems are derived. Assessment of the presence or absence of neck stiffness caused least inter-observer variability. Headache caused most variability, due to difficulty in grading its severity. Determination of the severity of a neurological deficit proved more reliable than deciding whether or not a deficit was present. The terms used to describe the level of consciousness in the Hunt and Hess and Nishioka systems were found to be significantly less consistent than the Glasgow Coma Scale. The authors suggest that when patients with SAH are assessed it is necessary to take into account the consistency with which observers can record a clinical feature, as well as its prognostic importance. PMID- 6847911 TI - Peripheral aneurysms of the cerebellar arteries. Review of 16 cases. AB - True congenital peripheral aneurysms of the cerebral arteries are rare and may constitute a special group. The authors report on 16 cases of peripheral aneurysms of the cerebellar arteries; six of them arising from vessels feeding arteriovenous malformations (AVM's). The possible causative role of increased blood flow versus developmental factors in the frequent occurrence in cases of AVM of this otherwise rare type of aneurysm is discussed. In five of the six cases with AVM's (one dural and five parenchymal), the aneurysm rather than the AVM proved to be the source of the hemorrhage. The occurrence of spasm was in inverse proportion to the distance of the aneurysm from the main arteries. The surgical result was good in 11 cases. One patient with associated AVM died, and four patients had residual symptoms. PMID- 6847912 TI - Cerebral and systemic circulatory effects of arterial hypotension induced by adenosine. AB - In six dogs anesthetized with halothane and nitrous oxide, mean arterial pressure (MAP) was lowered to 40 mm Hg for an average of 90 minutes by intravenous infusion of adenosine. The hypotensive effect of the adenosine was potentiated by administering dipyridamole to block its intravascular inactivation. Blood flow to the brain, spinal cord, heart, kidneys, and skeletal muscle was measured six times in each animal using the radioactive microsphere technique. Determinations were made before, during, and 30 minutes after the hypotensive period. During the hypotensive period, MAP was decreased 61% and was related to a proportional decrease in peripheral vascular resistance. Cardiac index decreased 14%. Total cerebral blood flow (CBF) decreased an average of 28% and cerebral vascular resistance decreased 53%. The reduction in CBF was heterogeneous; the cerebral cortex and corpus callosum were most affected and the brain stem least affected. No change occurred in the cerebral metabolic rate of oxygen usage (CMRO2). Left ventricle flow increased 147% and right ventricle flow increased 271%. Blood flow to the kidneys decreased 70%, and to the liver decreased to 6% of control. Jejunum blood flow increased 138% during recovery, while stomach flow varied but showed no statistical change. There was no tachyphylaxis, rebound hypertension, or toxicity associated with the adenosine-induced hypotension. These properties suggest that adenosine may be a useful agent for inducing arterial hypotension in neurosurgical patients. PMID- 6847913 TI - Ultrasound sector scanning for the localization and biopsy of intracerebral lesions. AB - A technique is described for the intraoperative use of ultrasound sector scanning in intracerebral neoplasms (mainly gliomas) for biopsy and for the localization of minor lesions. Altogether, 13 patients underwent sonographic examination: nine had gliomas, one had a meningioma, and three had metastases. Through a trephine hole or a bone flap over the tumor, the ultrasound transducer easily localized the lesion in all cases but one. The striking concordance between the sonogram and the corresponding computerized tomography scan made it easy to take several biopsies from areas where the tumor tissue was suspected to be representative. The results show a close correlation between the biopsy specimen and the specimen obtained at extirpation. In two cases, ultrasonic scanning served as an aid for the surgeon in localizing the tumor prior to removal. PMID- 6847914 TI - Pharmacologically induced profound arterial hypotension in the anesthetized dog. PMID- 6847915 TI - Light and electron microscopic studies of phrenic nerves after long-term electrical stimulation. AB - Light and electron microscopic evaluation were carried out on canine phrenic nerves subjected to long-term electrical stimulation. A total of 34 stimulated and 19 control nerves were studied by light microscopy, and 10 stimulated and five control nerves were evaluated by electron microscopy. Except in a few cases in which a higher current was used, the current used for stimulation was between 1 and 2 mA. The pulse width was 150 microseconds. The typical charge per pulse was 0.22 microC and charge density per pulse 1.125 microC/sq cm of real area. The total number of days of electrical stimulation in individual phrenic nerves ranged from 4 to 374. No morphological changes in the phrenic nerve that could be attributed to the electrical stimulation were observed by light or electron microscopic study. There were, however, two phrenic nerves cuffed with bipolar electrodes which showed focal demyelination at the electrode level, but these changes were caused by factors other than the electrical stimulation. The results of the studies have direct clinical implications to long-term stimulation of phrenic nerves. PMID- 6847916 TI - Response of the diaphragm muscle to electrical stimulation of the phrenic nerve. A histochemical and ultrastructural study. AB - The histological, histochemical, and ultrastructural features of canine diaphragms subjected to pacing by high-frequency electrical stimulation (27 to 33 Hz) of the phrenic nerve are compared with unstimulated diaphragms and with diaphragms subjected to pacing by low-frequency stimulation (11 to 13 Hz). The high-frequency group showed a reduced tidal volume (fatigue) after long-term stimulation, and myopathic changes which included enlarged internal and sarcolemmal nuclei, ring fibers, moth-eaten fibers with irregular histochemical staining, core/targetoid fibers, and smearing and aggregation of Z-band material with electron microscopy. The low-frequency group did not develop a significant degree of fatigue or pathological changes, and showed histochemical evidence of transformation to fast-twitch (type II) fibers. Possible pathogenic mechanisms and their similarity to those in certain human neuromuscular diseases are discussed. The application of the findings resulting from high- and low-frequency stimulation to long-term diaphragm pacing in humans with chronic ventilatory insufficiency is also discussed. PMID- 6847917 TI - The prognostic importance of clinical and histologic features in asymptomatic and symptomatic primary biliary cirrhosis. AB - To determine the life expectancy of patients with primary biliary cirrhosis, we analyzed survival data from 280 patients with either symptomatic (243) or asymptomatic (37) disease. Patients were followed for up to 19 years (mean, 6.9 years). The average length of survival was 11.9 years--nearly twice that reported in other studies. In contrast, over a 12-year period the survival of the asymptomatic patients after diagnosis did not differ from that of a control population matched for age and sex. Jaundice, weight loss, hepatomegaly, splenomegaly, and ascites were each associated with a poor prognosis. Prognosis also correlated with the histologic stages of hepatic fibrosis, cholestasis, and periportal-cell necrosis. A multivariate analysis of clinical features revealed that at the onset of disease, age, hepatomegaly, and elevated levels of serum bilirubin were independent discriminators of a poor prognosis. A histologic finding of fibrosis limited to portal areas improved this discrimination, correlating with prolonged survival. No other factors enchanced the prediction of risk. PMID- 6847918 TI - A medical-school curriculum for the 1980s. PMID- 6847919 TI - Therapy of secondary acute nonlymphocytic leukemia with cytarabine. PMID- 6847920 TI - Physiologic repair of aortic atresia-hypoplastic left heart syndrome. PMID- 6847921 TI - Myocarditis and cardiomyopathy. PMID- 6847922 TI - Primary lymphoma of the nervous system associated with acquired immune-deficiency syndrome. PMID- 6847923 TI - Elevated serum thymosin alpha 1 levels associated with evidence of immune dysregulation in male homosexuals with a history of infectious diseases or Kaposi's sarcoma. PMID- 6847924 TI - Hairy-cell leukemia. PMID- 6847925 TI - Familial hypocalciuric hypocalcemia. PMID- 6847926 TI - Breast-feeding and contraception. PMID- 6847928 TI - Whose is the language barrier? PMID- 6847929 TI - Of veins, IVs, and little rubber balls. PMID- 6847927 TI - Legal abortion in Italy, 1978-1980. PMID- 6847930 TI - Insulin-infusion pumps in type I diabetes. PMID- 6847931 TI - Crohn's disease and psoriasis. PMID- 6847932 TI - Mortality in nosocomial urinary-tract infection. PMID- 6847933 TI - A survey of results with transsphenoidal surgery in Cushing's disease. PMID- 6847935 TI - A challenge to the health-care industry. PMID- 6847934 TI - The phosphaturic response to parathyroid hormone. PMID- 6847936 TI - Investor-owned vs. nonprofit hospitals. PMID- 6847937 TI - Noninvasive tests in the initial evaluation of heart murmurs in children. AB - We prospectively examined the usefulness of electrocardiography, chest radiography, and M-mode echocardiography in discriminating between the presence and absence of heart disease in 280 children older than one month and newly referred for evaluation of a heart murmur. After taking a history and performing a physical examination but before reviewing diagnostic tests, we categorized the children as having "no heart disease" (142), "possible heart disease" (34), or "definite heart disease" (104). Among the children initially thought to have no heart disease, the diagnosis was changed after a review of diagnostic tests in eight--three with mitral-valve prolapse, two with possible cardiomyopathy, and three with no heart disease on follow-up. Among those initially thought to have possible heart disease, the tests changed the diagnosis to definite heart disease in four, of whom only one had heart disease (mitral-valve prolapse) on follow-up. In no case did a review of tests change the diagnosis of definite heart disease. We conclude that the results of diagnostic tests are unlikely to change the clinical diagnosis of no heart disease or definite heart disease, when made by a qualified pediatric cardiologist in children newly referred for evaluation of a heart murmur. PMID- 6847939 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 2-1983. Progressive dyspnea in a 33-year-old woman. PMID- 6847940 TI - The physician's role in health promotion--a survey of primary-care practitioners. PMID- 6847938 TI - An inflammatory pseudotumor of the lung in Q fever pneumonia. PMID- 6847941 TI - Pheochromocytoma and stenosis of the renal artery. AB - Stenosis of the renal artery and pheochromocytoma, although appearing to be singularly rare co-existing entities, have been reported in greater than 25 publications. In an experience of surgically treating more than 500 patients with renal artery stenosis, the author has encountered the dual pathologic condition in four patients. Interestingly, each of these patients represented a different aspect of the coexisting conditions. One instance of compression of the renal artery by a rather large pheochromocytoma of the adrenal gland, one instance of co-existing stenosis of the renal artery and an ipsilateral noncompressing pheochromocytoma, one instance of bilateral renal artery stenosis, probably caused by chronic catecholamine induced arterial spasm, and one instance each of neurofibromatosis, renal artery stenosis and pheochromocytoma comprise the content of this report. The author speculates as to the possible role of chronic catecholamine release and the development of a chronic spasm of the renal artery resulting in morphologic stenosis. PMID- 6847942 TI - Diagnosis of choledocholithiasis. AB - A review of the records of 75 consecutive patients with a discharge diagnosis of choledocholithiasis has been conducted. Clinical assessment as well as laboratory assessment of patients who are suspected of having common duct calculi continues to present significant problems in diagnostic accuracy. More than 90 per cent of the patients who presented with Charcot's triad of pain, fever and jaundice had common duct calculi; however, only one-fourth of the patients in our study with choledocholithiasis had this combination of symptoms. Imaging techniques before operation are associated with a significant incidence of false-negative and false positive findings. Palpation of the common duct and cholangiography at the time of operation remain the most reliable means of detecting choledocholithiasis. PMID- 6847943 TI - Therapeutic groin dissection in malignant melanoma. AB - In a retrospective review of therapeutic dissections of the groin, 22 patients underwent radical groin dissection and seven were alive at five years, whereas 26 patients underwent a superficial groin dissection and two were alive at five years, p less than 0.05. Involvement of the deep nodes is not always equivalent with systemic disease. A radical groin dissection should be used to eradicate the disease locally. The survival rate for the patients following groin dissection correlated significantly with the disease-free interval prior to occurrence of inguinal lymphadenopathy. PMID- 6847944 TI - Irrigation of the peritoneal cavity and local antibiotics in the treatment of peritonitis. AB - Peritonitis was induced in the Sprague-Dawley rats by the implantation of gelatin capsules containing 0.3 milliliter of human fecal suspension into the peritoneal cavity. The rats were then treated with systemic antibiotics or peritoneal irrigation with normal saline solution alone or cephalotin solution, 2,000 micrograms per liter, or both. The results show that peritoneal irrigation with normal saline solution or with cephalotin alone was ineffective, even though the cephalotin concentration used inhibited the growth of all bacterial species isolated during the free stage of peritonitis in vitro. Systemic antibiotics alone as well as in combination with peritoneal irrigation significantly improved the survival rate, p less than or equal to 0.05 and p less than or equal to 0.02, respectively. However, only systemic antibiotics in combination with peritoneal irrigation resulted in a significant cure rate compared with the control group and the group treated with systemic antibiotics alone, p less than or equal to 0.002. There was no increase in the cure or survival rates when antibiotics were added to the peritoneal irrigation fluid. In the second experiment, seven of ten rats treated with systemic antibiotics survived, but only two rats had no intraperitoneal abscesses at autopsy. Intraperitoneal application of antibiotics did not improve these results: six rats survived, and one rat was cured. We conclude that peritoneal irrigation alone is ineffective in the treatment of peritonitis. The addition of peritoneal irrigation to systemic antibiotic therapy, however, resulted in a significantly increased cure rate. The addition of antibiotics to the irrigant does not further improve the results, and local antibiotics are not more effective than systemic antibiotics. We believe that benefit of peritoneal irrigation is due to its mechanical effect. PMID- 6847946 TI - Bedside determination of aminoglycoside therapy in the patient with renal insufficiency. AB - A computer program has been written to assist the clinician in making dosage adjustments for the patient with renal insufficiency. The entire program can be run in less than one minute and requires no previous computer experience. Large memory storage requirements are averted by the introduction of analytic equations to model tabular data. The easy access and friendly alphanumeric capability should make the calculator sufficiently convenient to overcome the physician reluctance noted with earlier programs. Even though the accuracy of these techniques is well established, it should be emphasized that aminoglycoside concentrations can, occasionally, be unpredictable, and therefore, peak and trough levels should be drawn for all patients in this setting. Used in this context, the program described herein should prove to be a useful addition to the physician's armamentarium of clinical software. PMID- 6847945 TI - Effect of cimetidine on intestinal adaptation following massive resection of the small intestine. AB - Gastric acid hypersecretion follows massive resection of the small intestine. Steatorrhea as well as other metabolic imbalances is a challenging management problem associated with massive resection of the small intestine. In the literature, it has been suggested that the empiric use of cimetidine controls gastric acid hypersecretion following massive resection of the small intestine. In this study, an 80 per cent resection of the small intestine was performed upon 12 mongrel dogs. Ileal pH measurements, fecal fat content and serial intestinal biopsies were obtained for morphometric measurements. Steatorrhea was reduced by approximately 40 per cent in the cimetidine treated dogs. Ileal pH measurements declined immediately following intestinal resection. The cimetidine treated dogs demonstrated a return to normal levels within ten days following intestinal resection, p less than 0.05. Intestinal adaptation morphometric parameters revealed an accelerated adaptational response in the cimetidine treated dogs, p less than 0.05. Results of this study colaborates with the empiric and clinical indication for the use of cimetidine in the short gut syndrome clinical situation. In addition, the data suggest an intestinal adaptation accelerated response during the first phase of intestinal adaptation following massive resection of the small intestine in the dog. PMID- 6847947 TI - Postprandial plasma secretin response in patients following gastrectomy. AB - Endogenous secretin release and luminal pH changes after a test meal were investigated in five normal persons and in 22 patients after gastrectomy and various anatomic reconstructions, such as Billroth I and II anastomoses after subtotal gastrectomy and Roux-en-Y and interposed jejunal anastomosis after total gastrectomy. In patients in the Billroth I group, the response of postprandial secretin was good if the duodenal pH was below 4.5 but it was less than that of normal persons. After the Billroth II operation, even when the jejunal pH was below 4.0, the response was much less than that for the Billroth I group. After the complete abolishment of gastric acid secretion by total gastrectomy, no postprandial secretin response was noted in patients with the Roux-en-Y anastomosis. However, a response was seen in patients with interposed jejunal anastomosis, even though it was less than that for those in the Billroth I group and in normal persons. We conclude that the impairment of endogenous secretin release may be an important factor in pancreatic dysfunction after gastrectomy, and we suggest that a Billroth I operation after subtotal gastrectomy and interposed jejunal anastomosis after total gastrectomy are better procedures than the Billroth II or Roux-en-Y anastomoses to obtain endogenous secretin release. PMID- 6847948 TI - Surgical turf or who should do what to whom? PMID- 6847949 TI - Revision of the peritoneovenous valve. PMID- 6847950 TI - A useful technique for the preservation of central venous access in children. PMID- 6847951 TI - Bronchiolitis. What's in the name? PMID- 6847952 TI - Bronchoscopy and bronchography in children. Experience with 110 investigations. AB - The results of 92 bronchoscopic examinations and 18 bronchograms in infants and children performed during a two-year period were reviewed. Of 62 patients with suspected foreign-body aspiration, the diagnosis was confirmed in 36 (58%); of 18 patients mainly suspected of having congenital anomalies, a positive diagnosis was made in 12 (66%); but of nine patients with lobar atelectasis only two had abnormal findings. In three patients a transbronchial biopsy specimen did not provide diagnostic material. Bronchography for suspected localized bronchiectasis was performed in 11 patients and a positive diagnosis was made in seven. In all seven patients suspected of having congenital anomalies, bronchography provided a definitive diagnosis. There was no mortality and morbidity was minimal but three patients died of their primary disease. Nearly 60% of the investigations yielded abnormal results, but many of the normal findings were of equal clinical value. PMID- 6847953 TI - Factors affecting outcome in hypoxic-ischemic encephalopathy in term infants. AB - Forty-nine term infants were prospectively shown to have hypoxic-ischemic encephalopathy (HIE). All infants survived the neonatal period, and all but two infants (seen at 12 months) were followed up to at least 27 months of age. Factors that significantly correlated with outcome included the Sarnat encephalopathy stage and the occurrence of intractable seizures not controlled by phenobarbital sodium alone. There was no association between the one- or five minute Apgar score, the need for early ventilation, the EEG, the occurrence of seizures, and the subsequent outcome. There was no significant difference in outcome for those infants who received dexamethasone sodium phosphate (n = 29) v those who did not receive the drug (n = 20). A review of 97 term infants with HIE from a regional perinatal program during a one-year period (1979), including 35 of the 49 infants in the present study, did show a significant increase in morbidity and mortality for transported infants. PMID- 6847954 TI - Influenza vaccines in children. Comparison of new cetrimonium bromide and standard ether-treated vaccines. AB - We compared a new cetrimonium bromide (CTAB) subunit vaccine with a conventional polysorbate (Tween)-ether split-product vaccine in 63 children and young adults. The vaccines each contained influenza A/Bangkok/79, A/Brazil/78, B/Singapore/79; two doses were given one month apart. Among persons initially seronegative for A/Bangkok/79, the geometric mean antibody titer rose to more than 100 following one dose of vaccine, while those initially seropositive had titers of greater than 200 after one dose of either vaccine. Neither vaccine was able to induce comparable antibody titers to A/Brazil/78 or B/Singapore/79 after one dose in initially seronegative persons. After two doses the titers were greater than 100 for A/Brazil but not for B/Singapore. An A/Bangkok epidemic struck the New York City metropolitan area. The attack rate in the unvaccinated matched sibling control group was 35% (15/43). Only two of the 27 recipients of cetrimonium bromide vaccine and none of the 36 polysorbate-ether vaccines had a fourfold or greater increase in antibody titer during the epidemic. PMID- 6847955 TI - Pneumococcal meningitis in sickle cell disease in childhood. AB - In a population of children with pneumococcal meningitis, 71 had hemoglobin electrophoresis, and 17 of these were found to have homozygous hemoglobin S (24%). These 17 children were compared with 19 similarly infected children who had hemoglobin A and were matched for age and duration of symptoms before treatment. There was no difference in the symptoms or laboratory data, except for the hematocrit value, but patients with fatal disease came to the hospital later than control patients. The mortality and morbidity were similar even though control patients had a wider range of serious sequelae. Although patients with homozygous hemoglobin S were shown to be much more susceptible to pneumococcal meningitis, they were not at an increased risk from its effects. PMID- 6847956 TI - Hypertensive encephalopathy. A cause of neonatal seizures. AB - Hypertensive encephalopathy is rare in newborns. The few reported cases of malignant hypertension in newborns have been secondary to renovascular disease. We studied an infant with hypertensive encephalopathy secondary to isolated coarctation of the aorta. Infants with this condition are generally asymptomatic; to our knowledge, this is the youngest patient to have had neurologic complications secondary to isolated coarctation of the aorta. PMID- 6847957 TI - An approach to the treatment of pseudohypacusis in children. AB - Children will occasionally have hearing loss that is unsubstantiated by results of audiological evaluation and that persists in spite of the audiologist's efforts to obtain valid hearing thresholds. In two cases we used suggestion as an effective means of restoring normal hearing behavior while support was given to help the child deal effectively with the problem underlying the hearing loss. PMID- 6847958 TI - Acquired subglottic stenosis in the very-low-birth-weight infant. AB - In the six-year period from 1975 through 1980, acquired subglottic stenosis was recognized in eight patients during the first year of life who survived intubated mechanical ventilation as newborn infants. Seven of eight cases occurred in infants who weighed less than 1,500 g at birth. This complication was not seen in the first three years of the review, when only nasotracheal intubation was practiced. In the second three years, orotracheal intubation was the predominant practice. Seven infants required tracheostomy and the outcome was poor: none has undergone decannulation and three have died. Recognition of this disorder as a cause of inability to extubate the very-low-birth-weight infant is stressed. PMID- 6847959 TI - Mortality in infants discharged from a neonatal intensive care unit. AB - In a three-year period, 3.8% (43) of 1,123 infants discharged from one neonatal intensive care unit (NICU) subsequently died, the vast majority before 1 year of age. Sudden infant death syndrome was responsible for 28% of the deaths, congenital heart disease for 25% of the deaths, chronic lung disease for 16%, and trauma, infections, and chromosomal disorders each accounted for 5% of the deaths. Postdischarge death rates in the three-year study period remained stable, while infant mortality in the NICU decreased from 26.5% to 16.3%. This study suggests that decreasing mortality among infants treated in NICUs is not necessarily reflected in improved postdischarge death rates and that the vast majority of deaths in these infants are currently not preventable. PMID- 6847960 TI - CSF lactate levels in neonates. Effect of asphyxia, gestational age, and postnatal age. AB - During a six-month period, lactate measurements were performed on all samples of CSF obtained by lumbar puncture from infants of varying gestational ages between birth and 32 days of age. The normal levels of lactate in the CSF of newborns were demonstrated to be higher than those previously reported in older children or adults. A steady decrease in CSF lactate levels was demonstrated as postnatal age increased, so that after the first ten days of life, CSF lactate levels were within the range reported for older children and adults. We could not demonstrate that neonatal asphyxia or gestational age significantly altered these values. PMID- 6847963 TI - Bilateral Bell's palsy. PMID- 6847961 TI - Neonatal pulmonary infarction. A cause of 'cystlike' lucencies on the chest roentgenogram. AB - Perinatal pulmonary infarction is a difficult and infrequently made diagnosis. A male newborn had infarction of most of the right lung secondary to perinatal pulmonary thromboembolism (PTE). Serial chest roentgenograms initially showed opacity of most of the right lung, followed by the appearance of well-defined radiolucencies resembling pneumatoceles associated with mass effect. By the 25th day of life the localized "cystlike" lucencies were no longer evident and the right lung appeared predominantly hyperlucent. Although the presence of underlying disease makes the diagnosis of PTE in the infant and young child difficult, the clinical features and methods of diagnosis of PTE in this age group are similar to those for the adult. The diagnosis of PTE should be considered in the infant with respiratory distress and unusual findings on chest roentgenography. PMID- 6847962 TI - Radiological case of the month: fibrodysplasia ossificans progressiva. PMID- 6847964 TI - Liquid crystal forehead temperature strips. PMID- 6847966 TI - Mucolipidosis IV. PMID- 6847965 TI - Parental estimation of developmental level. PMID- 6847967 TI - Neonatal CSF cytology. PMID- 6847969 TI - Hwa-Byung: a Korean culture-bound syndrome? AB - The author reports three cases of Hwa-Byung, a Korean folk illness ordinarily understood by patients and families to be a physical affliction despite the fact that its manifestations include both physiological and psychological symptoms. In addition, the patient often recognizes interpersonal conflicts and anger as precipitating factors. In the three cases reported, the patients also identified an epigastric mass that was not present on physical examination. Symptoms were accompanied by a fear of impending death that was not easily dispelled by medical reassurance. The author discusses the role of depression in the symptom formation of Hwa-Byung as well as the treatment implications. PMID- 6847970 TI - Aphasia with reported loss of dreaming. AB - Seven patients who had become aphasic as a result of acute vascular lesions reported a loss of dreaming. The authors conclude that the dreaming process is affected when the left hemisphere neural systems related to waking language are impaired. PMID- 6847968 TI - A Latin American perspective on DSM-III. AB - The author examines some of the basic postulates and initial accomplishments of DSM-III from a Latin American vantage point. The phenomenological approach taken by DSM-III has enjoyed a long and prestigious tradition in Latin America. The author cites some of the difficulties posed by the personality disorders section, the exclusion of cultural criteria and psychocultural syndromes, and the practical inapplicability of the axis IV and V specifications for Latin American patients. DSM-III, however, is a challenging stimulus for Latin American and Third World psychiatrists and a real test for the influence and consistency of American psychiatry across the world. PMID- 6847971 TI - Psychologic and behavioral disturbance among epileptic children treated with barbiturate anticonvulsants. AB - From their studies of epileptic children, the authors found that barbiturate anticonvulsants have several unexpected psychologic and behavioral effects. They suggest that clinicians dealing with depression in epileptic patients consider the possibility that barbiturate anticonvulsants may be a contributing factor. PMID- 6847972 TI - Platelet MAO activity in recovered alcoholics after long-term abstinence. AB - The authors measured the platelet monoamine oxidase variables Vmax and Km in recovered alcoholics who had been abstinent for at least 5 years. No significant differences were found between these subjects and age- and sex-matched controls. PMID- 6847973 TI - Akathisia induced by amoxapine. PMID- 6847974 TI - Motivation of surrogate mothers: initial findings. AB - The author presents demographic and motivational data on 125 women who applied to be surrogate mothers. Several complementary motivations were noted: the desires for money, to be pregnant, to "give" a baby, and to resolve internal psychological conflicts. PMID- 6847975 TI - Heritability of schizophrenia. PMID- 6847976 TI - Diagnosis of childhood psychoses. PMID- 6847977 TI - Differential diagnosis in the elderly. PMID- 6847978 TI - Pregnant residents in the 1960s. PMID- 6847979 TI - Further comments on the role of psychiatry. PMID- 6847980 TI - Patients' knowledge of their psychotropic medication. PMID- 6847981 TI - ECT for patients with hypertensive heart disease. PMID- 6847982 TI - Rape and rape-murder: one offender and twelve victims. AB - This study analyzes data pertaining to 12 rapes and rape-murders committed by one male adolescent offender over a 4-year period. All offenses except the first were committed while the offender was under psychiatric and probationary supervision. The use or relinquishment of violence by the offender was found to be dependent on subtle interpersonal factors. The authors stress the importance of the use of crime scene data and interviews of patients who have committed sex crimes, the role of psychological profiles in apprehension of suspects, and the contribution of law enforcement as a data resource. PMID- 6847983 TI - The Center for Epidemiologic Studies Depression Scale: its use in a community sample. AB - The authors gave the Center for Epidemiologic Studies Depression (CES-D) Scale, a self-report depression symptom scale, to 528 subjects drawn from a larger longitudinal community survey. Interviewers also assessed respondents using the Schedule for Affective Disorders and Schizophrenia (SADS), a structured clinical interview; on the basis of the SADS the subjects were then given diagnoses according to the Research Diagnostic Criteria. The results corroborated earlier findings of a modest relationship between self-reported symptoms of depression and the diagnosis of depression. The authors conclude that the CES-D Scale may be useful as an initial or first-stage screening test. PMID- 6847984 TI - Depressive phenomenology in North and South American patients. AB - The authors assessed patients newly admitted to two North American health centers and one South American (Colombian) center according to a standardized protocol, with a structured interview, a symptom checklist, and a depression scale. The patients were suffering from major depressive disorders with endogenous features. There was an impressive similarity in symptoms of depression across cultures, supporting the idea of a universal core depressive syndrome. However, somatization indexes, psychomotor components of depression, and levels of psychopathology differed between U.S. and Colombian samples. The authors offer a general discussion of potential determinants of these cross-cultural differences. PMID- 6847985 TI - Diagnosing schizophrenia in 1980: a survey of U.S. psychiatrists. AB - The authors mailed 1,227 questionnaires to U.S. psychiatrists at the time of the introduction of DSM-III to ascertain their diagnostic approach to schizophrenia; 25% (N = 301) of the questionnaires were returned. Only 4 symptom categories reached a 50% accordance level, and there was little agreement on combinations of signs or symptoms, including that recommended by DSM-III. A cluster analysis showed some overall patterns: younger respondents and those from the Pacific coast tended to diagnose more closely to DSM-III; older respondents gave more individualistic responses. The authors express concern that research separating schizophrenia from other disorders that are far more effectively treated has not had a substantial effect on the diagnostic practices of U.S. psychiatrists. PMID- 6847986 TI - Amish Study, I: Affective disorders among the Amish, 1976-1980. AB - The authors review the goals, methods, sample, and selected epidemiologic findings from a collaborative study of affective disorders among the Amish. This culturally and genetically homogeneous population (N = 12,500) constitutes an excellent research setting for psychiatric epidemiologic and genetic study. Alcoholism, drug abuse, and sociopathy did not complicate the study because they are culturally prohibited. During 1976-1980, 112 active cases of mental illness were identified; 71% received diagnoses of major affective disorder. Equal numbers of men and women received diagnoses of unipolar illness, and slightly more men than women were diagnosed as having bipolar illness. PMID- 6847987 TI - Amish Study, II: Consensus diagnoses and reliability results. AB - Reliability of diagnosis is central to genetic research on mental illness. In the Amish Study of affective disorders, consensus diagnoses were derived by a psychiatric board using the Research Diagnostic Criteria (RDC). To verify the reliability of diagnoses, the authors 1) studied how well board members followed RDC procedures, 2) compared diagnoses based on abstracted medical records with those based on full medical records, 3) compared diagnoses based on the two data sources--abstracted medical records and the Schedule for Affective Disorders and Schizophrenia-Lifetime Version--and 4) studied diagnostic stability to determine validity of diagnosis. The results of these substudies demonstrate a high concordance of diagnosis. PMID- 6847990 TI - The Amish: a naturalistic laboratory for epidemiologic and genetic research. PMID- 6847988 TI - Amish Study, III: the impact of cultural factors on diagnosis of bipolar illness. AB - In the Amish Study of affective disorders, 79% of the 28 active bipolar I patients, diagnosed according to Research DIagnostic Criteria, previously had received hospital record diagnoses of schizophrenia. Both cultural and clinical factors hindered correct diagnosis, and cultural influences particularly complicated the interpretation of the manic symptoms of grandiosity and excessive involvement in activities. Other factors central to misdiagnosis were form of thought (flight of ideas), content of thought (grandiose and religious delusions), paranoid features, and the failure to recognize the presence of a manic syndrome. PMID- 6847989 TI - The price of research neglect. PMID- 6847991 TI - The sex of the psychotherapist. AB - The authors note the recent controversy about whether the sex of the psychotherapist is an important factor in the treatment of patients with certain neurotic and personality disturbances and suggest that much of the confusion is because supportive and insight-oriented psychotherapy are not clearly distinguished. After reviewing the relevant literature they present five clinical vignettes which suggest that the sex of the therapist is immaterial in insight oriented psychotherapy and that attention to defenses, transference, and resistance remains the cornerstone of successful psychotherapy. PMID- 6847992 TI - The dexamethasone suppression test: identification of subtypes of depression. AB - In this study mean 4 p.m. cortisol levels were significantly higher in patients with major depression than in control subjects or in patients with bipolar depression or dysthymic-related disorders. Moreover, the distribution of values differed significantly among groups. Eighteen of 45 patients with major depression had cortisol levels of 10 micrograms/dl or more, compared with 2 of 20 bipolar depressed patients and 0 of 31 controls. Patients with very high cortisol levels (15 micrograms/dl or more) tended to fulfill criteria for major depression with mood-congruent psychosis. The distribution of values in the major depression group also suggested the existence of three major subgroups. The authors discuss the implications of these data. PMID- 6847993 TI - The prevalence of attention deficit disorder, residual type, or minimal brain dysfunction, in a population of male alcoholic patients. AB - The authors assessed the prevalence of attention deficit disorder, residual type, in a population of young adult male alcoholic patients in two residential alcohol treatment programs. They found the prevalence of the disorder in this sample to be 33% and hypothesize that attention deficit disorder in childhood (and adulthood) may be associated with an increased risk for the development of alcoholism. If substantiated, this finding could be of theoretical and therapeutic importance. PMID- 6847994 TI - Alexithymia in medical patients referred to a consultation/liaison service. AB - Seventy-three medically ill patients referred to a consultation/liaison service over a 4-month period were evaluated for alexithymia. Twenty-two (30%) of these patients had alexithymia. Age, race, and marital status were not associated with alexithymia scores. Patients in lower socioeconomic groups and men had significantly higher scores than their counterparts. The idea that alexithymia is prevalent in individuals with a diagnosis of a "psychosomatic disease" was not supported. PMID- 6847995 TI - Can Reagan be indicted for betraying public health? PMID- 6847996 TI - Adverse reproductive outcomes: the occupational health issue of the 1980s. PMID- 6847997 TI - Spontaneous abortions in an industrialized community in Finland. AB - Spontaneous abortions were analyzed in an industrialized Finnish community according to the occupation and workplace of both the women and their husbands. Information about spontaneous abortions and births was obtained from the hospital discharge register, and data about the women and their families were collected from census files. When compared with all women employed outside the home, women who worked at a textile plant (factory A, a clothing manufacturer) had an increased rate of spontaneous abortion (16.7 per cent vs 11.4 per cent). The rate of spontaneous abortions among women employed at factory A differed according to the husband's workplace. The odds ratio for women employed at factor A whose husbands worked at a large metallurgical factory was 3.8, whereas the odds ratio for women whose husbands worked elsewhere was 1.2. Between 1973 and 1976, the rate of spontaneous abortions in this town was consistently lower for the summer period. (May-August) than for the other periods of the year. PMID- 6847998 TI - An evaluation of subsidized rural primary care programs: I. A typology of practice organizations. AB - The design of a comprehensive evaluation of subsidized rural primary care programs on a large national scale is described, Its major purpose is to derive data whose analysis will answer major policy questions about the factors influencing the outcome of the major types of such programs in different communities. This first paper also delineates a typology which was developed of five principal organizational forms of these programs. This classification appears to provide suitable operational definitions of forms of rural practice as a basis for evaluating the differential impact of alternative types of primary care programs. PMID- 6847999 TI - Effects of particulate air pollution on asthmatics. AB - Twenty-four asthmatic subjects in Denver were followed from January through March 1979, a three-month period in which Denver air pollution levels are generally high and variable. Dichotomous, virtual impactor samplers provided daily measurements (micrograms/m3) of inhaled particulate matter (total mass, sulfates, and nitrates) for coarse (2.5--15 micrograms in aerodynamic diameter) and fine fractions (less than 2.5 micrometers). Carbon monoxide, sulfur dioxide, ozone, temperature, and barometric pressure were also measured. Twice daily measurements of each subject's peak expiratory flow rates, use of as-needed aerosolized bronchodilators, and report of airways obstruction symptoms characteristic of asthma were tested for relationships to air pollutants using a random effects model across subjects. During the time actually observed, there were very few days in which high levels of suspended particulates were recorded. Of the environmental variables studied, only fine nitrates were associated with increased symptom reports and increased aerosolized bronchodilator usage. PMID- 6848000 TI - Referrals from an emergency room to primary care practices at an urban hospital. AB - Three hundred ninety-eight patients treated in the emergency room for non-urgent complaints who stated that they had no regular source of primary medical care were referred to one of several medical care centers in the area. Overall, 34 per cent of such patients complied with the referral. Correlates of compliance were: age (very young and very old), patient-perceived health status, medically determined need for follow-up care, and having an appointment made by the emergency room provider. Another group of 500 successfully referred patients became excellent users of the primary care office, complying with requested health maintenance and follow-up visits. However, emergency room utilization by the successfully referred patients did not decrease more than among referred patients who did not enroll in the primary care source. PMID- 6848001 TI - Providing maternal and child health-family planning services to a large rural population: results of the Bohol Project, Philippines. AB - The Bohol Project (1975-1979) sought to improve maternal and child health and to increase the use of family planning among a rural Philippine population of 400,000. Research indicated that maternal and child health (MCH) services did become more available during the Project period and coverage of the priority populations improved. Family planning (FP) use, particularly of less effective methods, increased and fertility declined although some change could have been expected even without the Project. Deaths due to neonatal tetanus were almost eliminated by mortality rates did not decline for a number of reasons, including the fact that services were probably not tailored closely enough to local health problems, especially respiratory diseases. The Project showed that it was possible to increase health and family planning services by using low-cost strategies (such as setting up community drug stores) and by employing paramedical workers, in this case, midwives. Preventive MCH-FP services were not overwhelmed by curative services as had been feared. Perhaps the most significant contributions of the Project were the lessons learned about delivering health and family planning services and conducting evaluation research. In general, if developing countries could maintain well-evaluated field laboratories for working out health and family planning delivery approaches before going nationwide, it is likely that time and money would be saved in the long run. PMID- 6848002 TI - Non-participation in telephone follow-up interviews. AB - The present analysis examined sample attrition in a one-year longitudinal health survey that made use of telephone follow-up interviews (N = 1210). Overall, respondent attrition had little impact on the sociodemographic and health status characteristics of the sample at the final interview. However, certain subgroups were statistically less likely to participate in the follow-up interviews, including younger respondents, the non-employed, people from the lower socioeconomic groups, and those who initially rated their health as fair or poor. Reports of physical illness and disability obtained at the initial interview were unrelated to rates of sample attrition. PMID- 6848004 TI - Validity of a survey question as a measure of visual acuity impairment. AB - Survey questions are frequently used to collect data on the prevalence of vision difficulties. The 1971-1972 Health and Nutrition Examination Survey included both a question about "trouble with your vision even when wearing glasses or contact lenses," and clinical measurement of central distance visual acuity with usual corrective lenses. The question had low sensitivity for impairment of visual acuity, with variation by age and severity of impairment. Sensitivity analyses from other studies are reviewed. (Am J Public Health 1983; 72:93-96.) PMID- 6848003 TI - Cancer mortality patterns around the San Onofre nuclear power plant, 1960-1978. AB - Because of the recent concern over possible health effects associated with nuclear power plants, cancer mortality patterns in Southern California have been examined for time periods before the San Onofre nuclear power plant began commercial operation in 1968 and since then. This is one of America's older plants and is surrounded by major population centers in Orange, Riverside and San Diego Counties. Infant mortality rates and age-adjusted mortality rates for leukemia, lung cancer, all cancer, and all causes have been calculated and compared for Orange, Riverside, and San Diego Counties, for California, and for the United States during 1960-1978. In addition, childhood leukemia death rates and clusters have been examined in detail in the communities within 25 miles of San Onofre. The cancer and total mortality rates near San Onofre have remained essentially identical to the corresponding rates in California and United States from 1960 to 1978. There have been no significant radiation releases to the population surrounding the San Onofre plant and the cancer rates show no patterns which have been influenced by the presence of the plant. Although no radiogenic health effects would be expected, these results do provide a means of assessing overall mortality trends in the population. PMID- 6848005 TI - Physicians' opinions of expanded clinical pharmacy services. AB - A statistical interaction model explaining 27 per cent of the variation in physicians' attitudes toward clinical pharmacy among 180 Alabama physicians is presented. Young primary care physicians who prescribe drugs with a low risk of adverse reactions are the most favorable toward pharmacists practicing clinical tasks. Older solo-practice physicians who lack exposure to clinical pharmacy are the least favorable. The implications for the wider acceptance of clinical pharmacy are discussed in terms of its resources of professional power. (Am J Public Health 1983; 73:96-101.) PMID- 6848006 TI - Isoflurane and enflurane-induced hepatic necrosis in triiodothyronine-pretreated rats. AB - Exposure of triiodothyronine (T3)-pretreated rats to 1.3% isoflurane, 1.8% enflurane, or 1% halothane in 21% oxygen (air) for two hours resulted in hepatic centrilobular necrosis. The incidence of the liver lesion was 28, 24, and 92% after exposure to isoflurane, enflurane, and halothane, respectively. Histopathologic grading indicated that the necrosis was more severe after halothane than after isoflurane or enflurane anesthesia. No lesion was observed in livers prepared from non-anesthetized T3-pretreated rats or in livers prepared from rats which were pretreated with the vehicle for T3 and then anesthetized with either isoflurane, enflurane, or halothane. Hepatic necrosis was not observed in vehicle-treated rats exposed to isoflurane in 12% oxygen or in vehicle-treated rats that were deprived of food for 12 hours prior to exposure to isoflurane under hypoxic conditions. Food restriction to maintain the body weight gain of vehicle-treated rats similar to that of T3-treated rats did not result in hepatotoxicity after exposure to halothane in 21% oxygen. Liver necrosis did not occur in pentobarbital anesthetized (40 mg/kg, intraperitoneally) T3-pretreated rats. These results indicate that isoflurane and enflurane, like halothane, can induce hepatic centrilobular necrosis in T3-pretreated rats. The mechanism for liver toxicity of these volatile anesthetic agents in this model remains to be determined. PMID- 6848007 TI - Migration of pediatric pulmonary artery catheters. PMID- 6848009 TI - A simple system for transtracheal ventilation. PMID- 6848008 TI - A complication following guided nasotracheal intubation. PMID- 6848010 TI - A simpler method of nasogastric tube insertion. PMID- 6848011 TI - The Ts of endotracheal intubation. PMID- 6848012 TI - Tank wrench holder for Ohio Modulus anesthesia machine. PMID- 6848013 TI - Heart rate response to nociceptive stimulation as an index of anesthetic potency for enflurane. PMID- 6848014 TI - Canine whole body and organ system tolerance during 24 hours deep pentobarbital anesthesia. AB - The impact of tolerance on the metabolism of the whole body, skeletal muscle, brain, kidneys, splanchnic region, and heart during prolonged pentobarbital anesthesia was evaluated in 80 dogs. Oxygen consumption (VO2) for each organ system and whole body was calculated from measured blood flow rate and the difference in blood oxygen content between arterial and venous blood during four periods of continuous and unvarying deep pentobarbital anesthesia: 0-3 h, 3-6 h, 12-15 h, and 21-24 h. VO2 increased with time in whole body (12%), gastrocnemius muscle (83%), calculated entire skeletal muscle (15%), brain (27%), kidneys (20%), and splanchnic area (10%); it decreased in the heart (20%). In all studies, the electroencephalogram indicated a constant deep burst-suppression level of 2-6 bursts/min and blood pentobarbital levels ranged from 4.5-6 mg/dl. About one-fifth of the increase in gastrocnemius VO2 could be accounted for by the effect of a continuous infusion of succinylcholine, and about two-thirds of the rise in renal VO2 by increased renal function. The decrease in heart VO2 was associated with increased cardiac output and decreased systemic vascular resistance. The sustained increase in metabolism was significant and otherwise unexplained in whole body, skeletal muscle, and the brain; it occurred after 3 h had continued through 24 h of pentobarbital anesthesia. This was presumably due to tolerance, and was manifested as increased metabolism during steady deep anesthesia with unchanged blood levels of pentobarbital rather than as a greater requirement for pentobarbital. PMID- 6848015 TI - Normalization of cerebral blood flow during prolonged halothane anesthesia. PMID- 6848016 TI - The local metabolic effects of somatosensory stimulation in the central nervous system of rats given pentobarbital or nitrous oxide. AB - General anesthetics are used to eliminate perception of stimuli, yet there have been few studies of the cerebral metabolic effects of stimulation during anesthesia, and of these studies, the results are discrepant. The authors therefore applied the quantitative 2-[14C]deoxyglucose method in a study of the effects of electrical stimulations (5 volts, 0.5 ms, 10 Hz) of a rat's saphenous nerve on glucose utilization in structures of the sensory pathway after administering pentobarbital or nitrous oxide. Under both conditions, stimulation produced a 75 to 108% increase in glucose utilization in the ipsilateral dorsal horn of the spinal cord, and a 9 to 11% increase in only a small fraction of the contralateral somatosensory cortex. No unilateral metabolic effect was seen in the dorsal column nuclei, ventroposterolateral thalamus, periaqueductal gray matter, dorsal raphe nuclei, or the reticular formation. The results of this study show that during peripheral stimulation, little metabolic response is seen in the brain even if the animal is receiving only nitrous oxide (70%), while the dorsal horn of the cord responds dramatically under the same conditions. Moreover, anesthesia with the potent cerebral metabolic depressant pentobarbital does not substantially alter the metabolic responsiveness of the cord or brain to stimulation. Thus, although there are marked differences between the rest in rate of metabolism produced by 70% nitrous oxide and pentobarbital, in terms of their effects on the metabolic response to stimulation, the agents are quite similar. PMID- 6848018 TI - Effects of halothane and enflurane on right ventricular performance in hearts of dogs anesthetized with pentobarbital sodium. AB - The effects of enflurane and halothane on contractile force of the right ventricle were compared using the Walton-Brodie strain gage arch and pulmonary artery catheter data in dogs anesthetized with pentobarbital. Twenty mongrel dogs were studied to determine the effects of the two anesthetics on contractile force during a 30-minute exposure to four approximate multiples of MAC: 0.75, 1.0, 1.25, and 2.0, and during a 2-h exposure to 1.0 MAC of each agent. Both anesthetics caused a dose-dependent reduction in contractile force, cardiac output, and mean arterial blood pressure. Enflurane caused greater depression of all variables at all concentrations tested. After a 30-min exposure to 0.75, 1.0, 1.25, and 2.0 MAC, halothane depressed contractile force 33.9%, 37.9%, 46.1%, and 73.4%, respectively, and enflurane depressed contractile force 48.4%, 53.5%, 66.6%, and 81.3%, respectively. The depression produced by enflurane at 1.0 and 1.25 MAC was significantly greater (P less than 0.05) than the depression produced by halothane at equal MAC. The reduction of cardiac output by enflurane at 1.25 and 2.0 MAC was significantly greater than that observed with halothane (P less than 0.05). The decrease in mean blood pressure produced by enflurane was significantly greater (P less than 0.05) than the decrease produced by halothane at 1.0, 1.25, and 2.0 MAC. No significant differences between groups were found in temperature, arterial PCO2, PO2, pH, or hematocrit levels. No diminution of the differences in effect on contractility between the two agents was observed when the exposure period was lengthened to two hours at 1.0 MAC. PMID- 6848017 TI - Effects of halothane anesthesia compared with fentanyl anesthesia and no anesthesia during coronary ligation in rats. AB - The effects of halothane and fentanyl anesthesia on responses to ligation of a coronary artery in chronically prepared rats were compared with responses in conscious animals. A total of 86 rats were used; 24 were ligated under halothane anesthesia, 18 under fentanyl, and 23 were left conscious. Three other groups (each of seven rats) were identically prepared but not ligated. Non-ligated rats were left conscious or anesthetized with halothane or fentanyl. Ligation was performed with the aid of a permanently implanted snare around the left anterior descending coronary artery. The responses to ligation that were measured were: arrhythmias, blood pressure changes, heart rate changes, ECG changes, mortality rate, occluded zone, and infarcted cardiac tissue mass. It was found that 1% halothane anesthesia starting 30 min before and continuing for 4 h after permanent ligation, had an overall beneficial effect, when compared with controls. Fentanyl (200-1,000 micrograms/kg, iv) had no overall beneficial effect, compared with conscious controls. Halothane reduced arrhythmias and mortality rates, when compared with controls, while fentanyl did not. Halothane produced lower blood pressures, fewer ECG changes, and lower heart rates than those seen in conscious or fentanyl anesthetized rats. The occluded and infarcted zones produced by ligation were not influenced by the two anesthetics. PMID- 6848019 TI - Profound arterial hypotension in dogs: brain electrical activity and organ integrity. AB - To determine whether non-invasive measurement of brain electrical activity can predict ischemic brain damage, we recorded the electroencephalogram (EEG) and somatosensory- (SEP) and auditory- (AEP) evoked potentials before, during, and after trimethaphan-induced profound arterial hypotension in dogs. The authors set out to compare the change in electrical activity with the degree of brain damage, as determined by microscopic examination. Dogs were anesthetized with halothane (1.4 vol % inspired), maintained horizontal (head at the level of the heart), and ventilated mechanically (FIO2 0.50); deviations from normal acid-base status were corrected. Twenty animals received a 1.5-mg/kg intravenous bolus of trimethaphan. Three animals were resistant to the drug. The remaining animals had profound hypotension [mean arterial blood pressure (MABP) at some steady level between 12 and 25 mmHg] for 1 h. Eight of these animals died during or soon after the hypotensive period as a consequence of cardiac arrest (three), intestinal bleeding (three) or unknown causes (two). In all survivors, EEG intensity and the amplitude of the SEP decreased during hypotension; both variables recovered with restoration of MABP. All nine animals surviving hypotension had no apparent neurologic or behavioral deficit nor any histologic evidence of ischemic brain cell injury. We were thus unable to find a MABP threshold for brain with minimal brain injury. Our findings suggest, under the conditions of our experiments, a great margin of tolerance for profound hypotension by the brain in this species. Other organ systems--the heart, gastrointestinal tract, and liver--proved to be more susceptible to ischemic damage. Eight of the nine surviving animals had elevations in serum alanine transaminase (SGPT), aspartate transaminase (SGOT), and alkaline phosphatase. Animals with the greatest increases in these enzymes showed centrilobular hepatocyte degeneration. PMID- 6848020 TI - Anesthetic potencies of isoflurane, halothane, and diethyl ether for various end points of anesthesia. AB - In experiments with rats, the authors compared potency ratios and slopes of dose effect curves of isoflurane, halothane, and diethyl ether for three end points of anesthesia: loss of righting reflex (RR), abolition of purposeful movement (PM) response to painful stimuli, and abolition of heart rate (HR) response to painful stimuli. Determinations of potency were based on the direct measurement of brain concentrations of anesthetics with the use of gas chromatography. It was found that the ratio of the PM ED50 to RR ED50 was 2.41 for isoflurane, 1.74 for halothane, and 1.25 for diethyl ester. They were significantly different for all three agents. Differences between the slopes of the dose-effect curves for RR and PM were significant only with diethyl ether (7 vs. 28). The ratios of HR ED50 to PM ED50 were not significantly different for the studied agents and there were no differences found between the slopes of the dose-effect curves for PM and HR. The results suggest that heart rate response to a noxious stimuli in contrast to the righting reflex is depressed by inhalation anesthetics through a mechanism similar to that underlying the depression of purposeful movement response to a noxious stimuli. Heart rate response to a noxious stimuli might be used as an alternative index for the measurement of anesthetic potency. PMID- 6848021 TI - Right hydrothorax after left external jugular vein catheterization. PMID- 6848022 TI - Acute bupivacaine toxicity as a result of venous leakage under the tourniquet cuff during a Bier block. PMID- 6848024 TI - Myopotential inhibition of unipolar pacemakers: a disease of technologic progress. PMID- 6848023 TI - Disseminated intravascular coagulation following midtrimester abortions. PMID- 6848025 TI - Chronic bronchitis and antibiotics. PMID- 6848026 TI - Alcohol and the heart. PMID- 6848027 TI - Amphetamine cardiomyopathy. PMID- 6848028 TI - Amiodarone and ventricular tachycardia. PMID- 6848029 TI - Cimetidine and hypersensitivity. PMID- 6848030 TI - Familial pancreatic cancer. PMID- 6848031 TI - Raynaud's disease and nifedipine. PMID- 6848032 TI - Cimetidine and eosinophilic fasciitis. PMID- 6848033 TI - Disseminated tuberculosis and the acquired immunodeficiency syndrome. PMID- 6848034 TI - Spondyloarthropathy and hidradenitis suppurativa. PMID- 6848035 TI - Glomerulonephritis and mycoplasma infection. PMID- 6848036 TI - Pneumococcal antigen and pneumococcal infection. PMID- 6848038 TI - Parathyroid surgery in elderly patients. PMID- 6848037 TI - Granulocyte transfusion. PMID- 6848039 TI - Abdominal radiography. PMID- 6848040 TI - Giant cell reparative granuloma of Paget's disease of bone: a unique clinical entity. AB - Giant cell tumor of bone is a rare, but well-recognized complication of Paget's disease of bone. In contrast, giant cell reparative granuloma (a benign tumor of the jaws occurring primarily in young adults) has never been described in association with Paget's disease. Five patients had giant cell lesions complicating Paget's disease. In each instance, the lesion histologically more closely resembled reparative granuloma than true giant cell tumor. The location of these lesions and their sensitivity to irradiation were consistent with reparative granuloma. Unique features included the frequency of polyostotic distribution, the occurrence only in bones affected by Paget's disease, and an apparent familial or geographic clustering of the patients. We also reviewed the histologic findings of three patients from another institution and compared the cases of all eight patients with others we believe were incorrectly diagnosed as having benign giant cell tumors in Paget's disease. We suggest that giant cell reparative granuloma of Paget's disease is a unique clinical entity with specific prognostic and therapeutic implications. PMID- 6848041 TI - Occupationally acquired vibratory angioedema with secondary carpal tunnel syndrome. AB - After several years of occupational exposure to vibration, a man developed episodic vibratory hand swelling, erythema, and pruritus. He subsequently developed symptoms compatible with carpal tunnel syndrome, but his median nerve conduction velocity remained normal. After experimental vibration of the forearm, plasma histamine levels in the ipsilateral antecubital vein rose in association with localized angioedema and slowed median nerve conduction velocity. There was no evidence of other causes of angioedema. Occupational exposure to vibration may predispose to the development of vibratory angioedema, which may predispose to intermittent compression neuropathy. PMID- 6848042 TI - Reversal of hypotension by continuous naloxone infusion in a ventilator-dependent patient. PMID- 6848043 TI - Human blastomycosis after a dog bite. PMID- 6848044 TI - Auricular chondritis as a rheumatologic manifestation of Lucio's phenomenon: clinical improvement after plasmapheresis. PMID- 6848045 TI - Use of the balloon-tipped pulmonary artery catheter in pulmonary disease. AB - Use of the balloon-tipped (Swan-Ganz) pulmonary artery catheter has increased in recent years. The device has three fundamental applications: pressure measurement, flow measurement, and blood sampling. Like any invasive procedure, this catheter should be used only after careful assessment of factors that affect its risk/benefit ratio. There must be a well-defined indication for the procedure. Physicians must be aware of the factors that can influence the validity of the measurements. Familiarity with the technical details of the procedure and with potential complications and how to avoid or manage them is essential to minimize risks and increase the likelihood of obtaining useful information. PMID- 6848046 TI - Syndromes in workers exposed to trimellitic anhydride. A longitudinal clinical and immunologic study. AB - A longitudinal study of workers involved in the manufacture of trimellitic anhydride has been in progress since 1977. Trimellitic anhydride is a low molecular-weight, reactive chemical used in the manufacture of plastics. Initial studies done in 1976 defined three syndromes due to inhalation of trimellitic anhydride: asthma-rhinitis, a late respiratory systemic syndrome, and an irritant response. Also, serologic techniques were developed to measure total antibody and IgE antibody to trimellityl human serum albumin. From 1977 to 1981, 64 workers were assessed. Six workers presented with asthma-rhinitis, high levels of IgE antibody, and skin test reactivity to trimellityl human serum albumin; five workers developed the late respiratory systemic syndrome; and one worker had both immunologic syndromes. These serologic measurements detected or were predictive of an immunologic respiratory illness and were useful in monitoring workers involved in the manufacture of trimellitic anhydride. PMID- 6848047 TI - Extended care in nursing homes: a program for a county teaching medical center. AB - A continuity care program for patients in nursing homes using internal medicine residents in training has been developed in a county teaching hospital. Resident physicians on a paid basis assume primary care responsibility for 1000 patients in 29 private community nursing homes. A faculty internist coordinates the activities of the residents and monitors patient care through an extended care office in the county hospital. The program has produced a significant upgrading of the continuity and quality of care of patients in these nursing homes as well as providing medical residents with geriatric and nursing home experience. The increased sensitivity and concern for the needs of nursing home patients developed by the medical residents seems to continue after they complete their training. PMID- 6848048 TI - Hemipelvectomy for buttock tumors utilizing an anterior myocutaneous flap of quadriceps femoris muscle. AB - Hemipelvectomy utilizing an anterior myocutaneous flap is indicated for aggressive tumors of the buttock and proximal portion of the posterior thigh. A large operative defect created posteriorly by amputation of the lower extremity, hemipelvis, and buttock is covered by a myocutaneous flap of quadriceps femoris muscle and overlying skin and subcutaneous tissue. The superficial femoral artery is preserved to sustain the myocutaneous flap. PMID- 6848049 TI - Small bowel perforation caused by metastatic lung carcinoma. PMID- 6848050 TI - Relationship between vagotomy and/or gastrectomy and the development of cholelithiasis. PMID- 6848051 TI - Resting energy expenditure in morbid obesity. AB - Resting energy expenditure (REE) was measured in 112 morbidly obese adults prior to elective gastric bypass surgery. The patients studied ranged from 157 to 327% of ideal body weight. Standard nutritional assessment indices (serum total protein, albumin, total iron binding capacity, hematocrit, and white blood cell count) were within normal limits. REE was estimated by the Harris-Benedict formula using both current weight and ideal weight. Measured REE was significantly less than expected (p less than 0.01) using current weight and significantly greater than expected (p less than 0.01) when ideal weight was used as the standard. Linear regression analysis between standard indices that reflect resting metabolic rate in normal adults and measured REE in study patients did not demonstrate sufficient correlation to be clinically useful in this patient population. Standard surgical therapy may result in highly variable weight loss in this population if the wide range of resting energy expenditure and the consequential variability in individual caloric deficits is not considered. Standard predictors do not identify those patients likely to be unsuccessful with a given weight loss regimen. PMID- 6848052 TI - Proximal gastric vagotomy: update. AB - Experience with proximal gastric vagotomy at the Mayo Clinic from 1973 to Mayo 1980 is reported. Among 298 patients who had proximal gastric vagotomy for chronic duodenal, pyloric channel, or prepyloric ulcers, a recurrent ulcer rate of 7% was present, with a mean follow-up of 49 months. Three recurrences developed in six patients who had proximal gastric vagotomy for gastric ulceration. In 40 patients, proximal gastric vagotomy was combined with gastrojejunostomy, pyloroplasty, or pyloric dilatation for obstructing ulcers. There was a 15% incidence of reoperation in the gastrojejunostomy group. All nine patients who had proximal gastric vagotomy for active or recent bleeding ulcers were dismissed from the hospital without further hemorrhage, and only one developed a recurrent ulcer. It is concluded that proximal gastric vagotomy remains an acceptable operation for chronic duodenal and pyloric ulcers, but its efficacy in gastric ulcers is unproved. PMID- 6848053 TI - Intra-oral cancer at the Massachusetts General Hospital. Squamous cell carcinoma of the floor of the mouth. AB - A retrospective review of 163 consecutive patients with biopsy-proven, invasive squamous cell carcinoma of the floor of the mouth who underwent inpatient treatment at the Massachusetts General Hospital during the 15-year period from January 1962 through December 1976 is presented. The stage at first presentation, clinical features of the disease, incidence of second primary tumors, analysis of therapeutic modalities, and survival statistics are compared with reports from other large centers. Floor of mouth tumors comprised 28%, (163/592) of oral squamous cell carcinomas seen at the Massachusetts General Hospital during that time period. Seventy-one per cent of floor of mouth tumors were in men and 29% in women; women tended to present earlier in the course of their disease. Thirty seven patients (23%) developed a secondary primary malignancy, and four of these 37 patients developed two second primaries. Distant metastatic disease appeared in 6% of patients with Stage I, II, or III disease and 26% of patients with Stage IV disease. Radiation therapy alone and surgery alone resulted in equivalent long term survival rates for early stage disease. In more advanced stages (III and IV), a combined approach utilizing surgery and radiation therapy obtained superior results for short-term survival than either modality alone. The importance of early diagnosis and treatment and suggestions for development of cooperative protocols in an attempt to improve salvage of patients with this disease is discussed. PMID- 6848055 TI - The Angelchik antireflux prosthesis. Effects on the lower esophageal sphincter of primates. AB - It has been shown that the ACAP causes significant increases in the LES pressure of supine primates which are maximal when properly placed at the EGJ. This effect appears to be due to posterior padding of the EGJ in supine animals and can be reproduced by dowel rods or Maloney dilators. Further studies to evaluate the contribution of this effect to the prevention of acid reflux are underway. PMID- 6848054 TI - Complications of abdominal aortic reconstruction. An analysis of perioperative risk factors in 557 patients. AB - From 1974 through 1978, 557 patients (mean age: 63 years) underwent Dacron graft replacement of the abdominal aorta at the Cleveland Clinic. Postoperative complications occurred in 110 patients (20%), with mortality rates of 5.1% for those having intact aortic aneurysms, 26% for those with ruptured aneurysms, and 2.3% for those with aortoiliac occlusive disease. Myocardial infarction was the most common cause of postoperative death, affecting 3.1% of the entire series, but all 87 patients who had previously required myocardial revascularization survived subsequent aortic procedures (p less than 0.01). As defined in this investigation, temporary renal failure (7.0%) or pulmonary insufficiency (5.9%) were encountered more frequently than were other complications, but each of these was the singular cause of death in only 0.2% of all patients. Several risk factors significantly influenced postoperative mortality, (p less than 0.01), including age over 60 years, suspected coronary artery disease, serum creatinine greater than 2.0 mg/dl, complementary renal artery revascularization, and aneurysm rupture. In addition, intraoperative blood loss had a statistically valid correlation with postoperative mortality (p less than 0.01), myocardial infarction (p less than 0.010, renal failure (p less than 0.001), and pulmonary insufficiency (p less than 0.001). PMID- 6848056 TI - Pancreaticoduodenectomy for benign disease. AB - Ten cases of pancreaticoduodenectomy (PD) performed for benign disease are reported with all patients alive and well at an average of 7.5 years. A review of the English literature reveals that 52 patients have had a PD for benign disease in which a carcinoma had originally been suspected (incidence of 1%) with an overall surgical mortality of 9.6%. Three hundred and thirty-four cases of PD done for complications of pancreatitis have been reported with an overall mortality of 4.8%. On rare occasion, despite extensive preoperative evaluation, a patient will be explored with true uncertainty as to the diagnosis of a periampullary mass. Under these circumstances, it has been considered good surgical judgement to proceed with resection, considering that the lesion may be benign, as opposed to leaving behind an early resectable malignant lesion. Results of this review support this policy only in that if the PD is done for what turns out to be benign disease, the perioperative mortality is low, and an excellent long-term survival can be expected. PMID- 6848058 TI - Restaging laparotomy for Hodgkin's disease. AB - The role of restaging laparotomy (RL) in Hodgkin's Disease (HD) was studied in 39 patients. Four patients had two RL and two patients three RL; 47 RL were performed in the 39 patients. Twenty patients had prior radiotherapy, ten patients chemotherapy, and nine patients radiotherapy and chemotherapy. Twenty of the 39 patients had a prior staging laparotomy at the time of initial HD diagnosis. Four of 13 RL for suspected residual HD at the completion of treatment were positive. Two patients had nodal, one splenic, and one nodal plus ovarian cyst HD. Fifteen of 21 RL for suspected recurrent HD after a five-to-111-month (median = 36 months) disease-free interval were positive. Thirteen patients had nodal, seven splenic, four liver and two bone marrow HD. Five of ten RL to disclose intra-abdominal HD at the time of a peripheral node recurrence were positive. Subsequent treatment was altered in all five positive patients. One of three RL to confirm a clinical complete response disclosed residual HD in intraabdominal lymph nodes. All of the 22 negative RL patients remained clinically free of intra-abdominal disease for a median of 63 months after the procedure. RL is useful in assessing response after treatment of advanced HD. A negative RL is associated with prolonged disease-free survival. PMID- 6848057 TI - Total parathyroidectomy and autotransplantation of parathyroid tissue for renal hyperparathyroidism. A one- to six-year follow-up. AB - From 1975 to 1981 total parathyroidectomy and parathyroid autotransplantation were carried out in 62 patients for renal (secondary) hyperparathyroidism. The paper reports on 46 patients followed for one to six years (mean 2.2 +/- 1.2 years). Forty-one were on chronic hemodialysis, three were predialytic, two had a functioning renal graft. There have been two different groups of indications: one in which hypercalcemia was the main reason for surgery (59%), the other in which severe renal osteopathy (bone pain, radiologic and histologic signs, elevation of alkaline phosphatase, and parathyroid hormone) was observed. Among 45 patients not previously operated on for hyperparathyroidism, five parathyroid glands were removed in three patients, four glands were removed in 36 patients, and three glands were removed in five patients. In one patient previously operated (thyroid surgery), two glands were removed. Tissue was immediately autografted into a forearm muscle. One patient (two glands removed) received a cryopreserved tissue six months after neck exploration. An improvement of bone pain, pruritus, and radiologic signs of renal osteopathy was noted in about 80% of patients. At one to six years no patient was hypercalcemic, in 44 patients the grafted tissue was functioning normally after an average time of 5.8 +/- 1.4 months. One patient is still on low-dose, supplemental therapy for slight hypocalcemia 14 months after autotransplantation. In another patient a part of the grafted tissue was removed for increasing parathyroid hormone levels. Serum concentration of alkaline phosphatase and serum parathyroid hormone decreased after surgery. One- to six year results after total parathyroidectomy and autotransplantation for renal hyperparathyroidism are considered to be extremely satisfactory. PMID- 6848059 TI - Neutropenic colitis and aplastic anemia: a new association. AB - Colitis is a life-threatening complication of aplastic anemia which occurs during periods of profound neutropenia. Four cases of this previously unreported association are described here. A syndrome of fever, watery diarrhea, and generalized abdominal pain and tenderness occurred in close temporal relationship to development of severe neutropenia (less than 50 neutrophils per cu mm). None of the patients had received antibiotics, nor had a history of previous episodes of colitis. Three had cultures positive for colonic organisms during the episodes. In only one instance was the correct diagnosis made without operation. Gross evidence of disease was found in the cecum, the transverse colon, and rectosigmoid in three patients, but the true extent of disease was underestimated. Microscopic examination of the two resected specimens showed extensive mucosal and variable submucosal necrosis with invasion of the colonic wall by bacteria. Acute inflammatory changes were absent. With profound neutropenia, the colon wall lacks resistance to invasion by the resident microflora. The condition is probably best treated without operation. If first recognized at laparotomy, resection should be avoided. PMID- 6848060 TI - The endorectal pull-through for the management of ulcerative colitis in children and adults. AB - Between June 1977 and November 1981, 26 children and adults with ulcerative colitis have undergone a total colectomy, an endorectal dissection of the rectal mucosa, and an ileoanostomy. A combined abdominoperineal approach was used to perform the operation, and the mucosal-submucosal rectal tube was dissected out intact from the abdominal approach. Every patient survived the operation and showed marked clinical improvement presumably due to resection of the diseased colon. Three patients developed intestinal obstruction that was successfully treated with an enterolysis. A rectal cuff abscess and a retroperitoneal abscess were the only other complications. The postoperative stooling pattern of each patient was obtained through detailed interviews. All the patients were continent during the day and at night one month after surgery. Twenty-two patients had a median stool frequency of seven per 24 hours one month after surgery. At one year, the average number of stools was seven per day. Six patients experienced a stool frequency of seven per 24 hours two years after surgery. The results with this series of patients had encouraged the authors to continue to recommend this approach to children and adults with ulcerative colitis, since it offers an alternative lifestyle that is more attractive to certain patients than the presence of an abdominal stoma. PMID- 6848061 TI - Diagnosis of spigelian hernia by computed tomography. PMID- 6848062 TI - An unusual complication of bypassed popliteal aneurysms. AB - The most common treatment of popliteal aneurysms is bypass and in situ ligation of the aneurysm. Two patients treated in this manner continued to have enlargement of their aneurysms, with symptomatic vein and nerve compression in the popliteal space. The aneurysms persisted because of failure to ligate arterial branches arising from the aneurysm itself. These recurrences were treated successfully by ligating the branches from within the aneurysm and obliterating the aneurysmal sac. PMID- 6848063 TI - Surgical resection for isolated cardiac metastases. AB - We performed what we believe to be the second successful resection of metastatic liposarcoma to the heart using cardiopulmonary bypass. Analysis of ten previous resections of cardiac metastases from a variety of tumors from distant primary sites revealed survivals from four months to two years. When patients can tolerate a major operative procedure, resection of solitary cardiac metastases can be successful if the primary tumor is well controlled. Patients with sarcomas and with long disease-free intervals should strongly be considered for aggressive surgical therapy. Computed tomographic scans of the chest were useful in the diagnosis and accurate delineation of the extent of tumor. PMID- 6848064 TI - Cervical dysphagia lusoria from vertebral arterial compression. PMID- 6848065 TI - Foley catheter ballooning: a useful aid in anastomosis with the circular stapling device. PMID- 6848066 TI - Surgeons and the intensive care unit. PMID- 6848067 TI - Evaluation of cystic lesions. PMID- 6848068 TI - Idiopathic hereditary pancreatitis. PMID- 6848069 TI - Gluteal thigh flap in reconstruction of complex pelvic wounds. AB - Nine flaps for reconstructing pelvic wounds were centered on the posterior portion of the thigh over the inferior gluteal artery and posterior cutaneous nerve of the thighs of seven patients. No flap necrosis occurred and all wounds healed (one hematoma and one partial wound separation). Three patients had radiation wounds and three had immediate reconstruction following tumor resection. This flap represents an important advance in pelvic reconstruction and should be considered the flap of choice for this area. Contributions to the procedure from this series include (1) use in vaginal reconstruction, (2) length of flap extended to the popliteal fossa, and (3) use of an air-fluidized bed for postoperative management. PMID- 6848070 TI - Delayed diagnosis of breast cancer as a result of normal mammograms. AB - Review of the effects of a normal mammogram on the treatment of 36 women with palpable breast carcinomas during a two-year period showed that 17 patients had biopsies performed within two months of their normal mammograms and 19 patients had biopsies delayed for three to 24 months. Of the 17 who had biopsies within one month of a normal mammogram, three (17.6%) had extension of disease to axillary nodes. Of 19 patients whose biopsy was delayed, cancer was found in axillary nodes of 11 (57.9%). Normal mammograms should not preclude biopsy of a breast mass. PMID- 6848071 TI - Extended axillopopliteal-axillotibial bypass. Valuable adjunct to limb revascularization. AB - Although axillofemoral bypass is now widely used, little has been reported of its more distal extension. Our experience in 12 patients with axillopopliteal (nine) and axillopopliteal-tibial (APT) (three) bypass form the basis of this report. Indications for these extended bypasses included suppurative groin infections and obliterated common and profunda femoris arteries. These procedures were rapidly performed in poor-risk and often critically ill patients. One patient died of recurrent aortoduodenal hemorrhage three weeks following successful APT bypass. The other 11 patients enjoyed patent grafts for periods ranging from six months to two years, although four of these patients successfully underwent a declotting procedure during this period. The early results of these extended APT grafts have been gratifying. This technique would seem to be especially promising for the management of limb ischemia or for rerouting in patients with infected aortic prosthesis. PMID- 6848072 TI - Rational approach to treatment of hemorrhoids based on a theory of etiology. AB - In a series of 600 patients suffering from hemorrhoidal symptoms, 709 treatment procedures were performed. Only 7% of the patients required hemorrhoidectomy. In the remaining patients, symptoms were relieved by conservative therapy comprising sclerotherapy, band ligation, or cryotherapy of the internal hemorrhoids only. On the basis of this series, the following proposals are made: (1) the concept of hemorrhoidal destruction should be replaced by one of fibrosis, (2) only the internal hemorrhoids need be treated, (3) hemorrhoids need not be treated unless they produce symptoms and then only the symptoms need be treated, (4) only those far-advanced hemorrhoids in which there has been extensive fragmentation of the supportive connective tissue need be treated surgically, and (5) treatment may be chosen according to the stage of the hemorrhoids. PMID- 6848073 TI - Abdominal colectomy for chronic encephalopathy due to portal-systemic shunt. AB - Chronic portal-systemic encephalopathy (CPSE) following portal-systemic shunts may be incapacitating and non-responsive to intensive medical management. Between 1960 and 1980, 12 patients with cirrhosis who were institutionalized with CPSE underwent colonic exclusion. Cirrhosis was due to alcohol in ten patients and to cryptogenic liver disease in two. Nine patients had previously undergone end-to side portacaval shunts and two patients had had mesocaval shunts. One patient had a spontaneous shunt between splenic and renal veins. Ten patients underwent colectomy and ileosigmoidostomy; one had colectomy, ileostomy, and mucous fistula; and one had colonic bypass and ileosigmoidostomy. Four patients died postoperatively. Survivors were clinically improved and able to leave a closed institutional environment. Colectomy may be considered in disabling cases of CPSE unresponsive to medical therapy; it is a final effort at functional rehabilitation. Although mortality is high, improvement in functional status can be expected among survivors of the operation. PMID- 6848074 TI - Fournier's gangrene of the scrotum. A poorly defined syndrome or a misnomer? AB - Fournier's gangrene is defined classically as a fulminant, rapidly spreading infection of the scrotum that also involves the perineum, penis, and abdominal wall. The pathologic findings are described as synergistic gangrene secondary to a polymicrobial flora with a poorly defined portal of entry. In our experience with 12 cases, the portal of entry was well defined and the causative organisms were those typically found in the lower bowel. Portals of entry were perirectal abscesses in five patients, urethral infections in three, and surgical procedures in four patients. All patients required aggressive surgical debridement, broad spectrum antibiotics, and adjunctive measures. The fact that four patients died in spite of aggressive treatment demonstrates the lethal nature of this disease. This study suggests that this syndrome is no longer "idiopathic" but is primarily a necrotizing cellulitis of the perineum with subsequent involvement of the genitalia and surrounding tissues. PMID- 6848075 TI - Biologic behavior of thin malignant melanomas with regressive changes. AB - Thin cutaneous malignant melanomas are defined as lesions measuring less than 0.76 mm in maximal thickness. Eight of the 36 thin lesions that we studied metastasized within two to 120 months. Of the 11 lesions with regressive features, five (45.5%) metastasized. Of 25 lesions without regression, only three (12%) metastasized. Thin melanomas with regressive changes need to be reported as a separate category because of their propensity to metastasize. Conventional prognostic guidelines for treatment of thin melanomas are not applicable to this type of lesion. Clinicians need to be cognizant that regressive changes are serious warning signals when they occur in thin melanomas. PMID- 6848076 TI - Reduced mortality from bleeding pseudocysts and pseudoaneurysms caused by pancreatitis. AB - Exigent hemorrhage from pseudocysts and pseudoaneurysms is the most rapidly lethal complication of pancreatitis. Of eight patients with this unusual entity seen by us, all had acute gastrointestinal hemorrhage; two patients had intraperitoneal bleeding as well. Preoperative visceral arteriograms accurately defined the bleeding lesion and greatly aided in planning operative strategy in six patients. Emergency celiotomy and arterial ligation were accomplished in seven patient, and one patient underwent successful transcatheter arterial embolization. Pancreatic resection was not required in any patient for control of hemorrhage, although gastrectomy was necessary in three cases. One elderly patient died of sepsis five weeks after operation. Our mortality of 12.5% compares favorably with the 37% overall mortality from 123 cases reported in the literature. PMID- 6848077 TI - Abdominal stab wound with omental evisceration. AB - Among 100 patients with omental evisceration due to abdominal stab wounds admitted consecutively to the Los Angeles County-University of Southern California Medical Center, Los Angeles, major intraperitoneal injuries occurred in 69 cases. These injuries involved the small bowel (28), large bowel (15), spleen (three), stomach (ten), liver (14), diaphragm (nine), and pancreas (four). The incidence of major visceral injury coincidental to stab wounds with omental evisceration supports a policy of routine exploratory celiotomy in cases of abdominal stab wounds with omental evisceration. PMID- 6848078 TI - Melanosis coli. Changes in appearance when associated with colonic neoplasia. AB - In 30 cases of colonic neoplasia associated with melanosis coli, proliferating or neoplastic colonic epithelium was notable within the melanotic colons by virtue of a striking absence of pigmentation. Microscopically this characteristic was found to be due to an absence or diminution of pigment-laden macrophages in the lamina propria underlying such lesions. Therefore, the absence of pigment-laden macrophages can be considered a marker for abnormally proliferating epithelium. This characteristic may denote a cellular or humoral change mediated by macrophages in association with neoplastic epithelium. PMID- 6848079 TI - Evaluation and management of vascular injuries of the extremities. AB - We reviewed our experience with 315 extremity injuries in 306 patients for the possibility of accurately evaluating the presence of a potential vascular injury. Indications for surgical exploration based on the clinical finding of a bruit and/or thrill, ischemia, absent, pulse, shock, hemorrhage, neurologic deficit, hematoma, and proximity resulted in a rate of positive surgical exploration results of between 20% and 100%. Angiography was performed in 65 patients; 24 angiograms showed vascular injury and 41 did not. Angiography for proximity alone revealed 12% abnormal finding. Operative morbidity in the surgically explored group was 2%. We developed an algorithm for the treatment of these patients. PMID- 6848080 TI - Oligoclonal IgG in CSF of patients with African Burkitt's lymphoma. AB - Oligoclonal IgG bands were detected in CSF from 12 of 13 patients with African Burkitt's lymphoma (BL) who exhibited neurologic signs or symptoms of CNS involvement. Twenty-three of 26 patients free of neurologic involvement with this tumor were found to lack the oligoclonal IgG bands in their CSF. None of six patients with non-BL included in this study had these bands in their CSF. None of six patients with non-BL included in this study had these bands in their CSF samples. These findings suggest that detection of these bands may be a useful adjunct for determining the presence of African BL that invades the CNS. PMID- 6848081 TI - Developmental changes of glial fibrillary acidic protein in cerebral white matter. AB - Developmental changes were observed in the glial fibrillary acidic protein (GFAP) -positive glia of cerebral white matter (including myelination glia) in the frontal lobes of 38 normal cases. With age, GFAP-positive processes gradually became larger and their location shifted from preponderantly in the deep white matter to mostly in the superficial white matter. This shift in pattern of GFAP positive glia may be related to the parallel changes in perinatal brains in the localization of leukomalacic lesions. However, the shift is a normal developmental phenomenon on which such lesions are superimposed. PMID- 6848082 TI - Bilateral optic neuropathy with remission in young men. Variation on a theme by Leber? AB - Five young men had painless, progressive, bilateral loss of central vision with late optic atrophy. One had a family history of Leber's optic neuropathy. After being functionally blind for four to 21 months, spontaneous improvement began leading to remarkable recovery of vision in all patients. We propose that these are cases of Leber's optic neuropathy in which an unusual capacity for recovery may have been related to a lack of microvascular abnormalities in the fundi. PMID- 6848084 TI - Acute respiratory failure in motor neuron disease. AB - Five patients with sudden deterioration in respiratory function were studied. In three a history of motor neuron disease was known but in two the first evidence of the disease was severe hypoventilation. No other cause for the respiratory difficulty could be detected in any, and all eventually achieved important partial or even complete independence from mechanical support. Severe hypoventilation can be the initial symptom of motor neuron disease, and not all patients with this complication of the disease have the poor prognosis usually expected. PMID- 6848083 TI - Baclofen. Its effect on seizure frequency. AB - Baclofen has been reported to be epileptogenic in man, but many animal studies have demonstrated an anticonvulsant effect. In 12 patients with a history of epilepsy, baclofen was given in the conventional dosage range. In the six patients with anticonvulsant-controlled seizures, none had a seizure during baclofen therapy. In the six patients with uncontrolled epilepsy, two patients had one more seizure per month while receiving baclofen, and a third went from four seizures per month to one per month. Baclofen does not appear to have a deleterious effect in patients with epilepsy. PMID- 6848085 TI - Hearing loss in multiple sclerosis. AB - Hearing loss in an uncommon symptom in multiple sclerosis (MS). In nine patients with MS, seven with unilateral hearing loss and two with bilateral impairment, accompanying symptoms and signs included facial numbness, hemifacial paresis or spasms, ipsilateral limb ataxia, nystagmus, vertigo, tinnitus, and spastic-ataxic gait. Central auditory dysfunction was suggested by audiometric findings and/or by brainstem auditory evoked potentials in all nine patients. Clinical improvement in two was accompanied by return toward normal in the results of audiometric or electrophysiologic studies. Hearing impairment should be sought in patients with MS and appropriate studies pursued. PMID- 6848086 TI - Oculogyric crises and parkinsonism. A case of recent onset. AB - Oculogyric crisis in association with postencephalitic parkinsonism has been reported only following encephalitis lethargica (Economo's disease). Generally, it has been assumed that this phenomenon would fade away with the demise of these postencephalitic patients. Therefore, we report a case of recent onset of persistent oculogyric crisis with parkinsonism in a 35-year-old man following an apparent attack of encephalitis in 1972. PMID- 6848087 TI - HLA antigens in subacute sclerosing panencephalitis. PMID- 6848088 TI - Primary reading epilepsy. AB - In a case of primary reading epilepsy, seizures were consistently triggered by reading, and the associated EEG abnormalities were clearly lateralized to the dominant hemisphere. 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 language functions and not by simple visual or proprioceptive stimuli. PMID- 6848089 TI - Twenty-eight years of benign recurring Mollaret meningitis. PMID- 6848090 TI - Conversion of ischemic to hemorrhagic infarction by anticoagulant administration. Report of two cases with evidence from serial computed tomographic brain scans. AB - Anticoagulant therapy is appropriate for embolic cerebral infarction due to valvular heart disease or cardiac dysrhythmia, as well as for stroke-in evolution. Various incidences of hemorrhagic complications have been cited in patients given anticoagulants after stroke or transient cerebral ischemia. Conversion of ischemic to hemorrhagic infarction has been shown to occur experimentally. We describe two patients in whom this conversion occurred in the absence of hypertension or excessive anticoagulation and was substantiated by serial computed tomographic brain scans. This finding suggests that conversion of ischemic to hemorrhagic infarction may occur even with appropriate and carefully administered anticoagulation therapy. PMID- 6848091 TI - Pure Gerstmann's syndrome from a focal lesion. AB - It is controversial whether a focal lesion can specifically induce Gerstmann's syndrome (dyscalculia, left-right disorientation, finger agnosia, and agraphia). Also, Gerstmann's tetrad has been attributed to other cerebral symptoms, particularly aphasia. We examined a patient who had all four symptoms of Gerstmann's syndrome, without other symptoms or signs, and who had a discrete left parietal lesion. PMID- 6848092 TI - Acute posterior multifocal placoid pigment epitheliopathy and cerebral vasculitis. PMID- 6848093 TI - Neonatal brainstem infarction. A case report with clinicopathologic correlation. PMID- 6848094 TI - Ruptured spinal ependymoma simulating bacterial meningitis. PMID- 6848095 TI - Polyradiculoneuritis secondary to immunization with tetanus and diphtheria toxoids. PMID- 6848096 TI - Intracerebral hemorrhage from an arteriovenous malformation after amphetamine injection. PMID- 6848097 TI - Focal dystonia and lacunar infarction of the basal ganglia: a case report. PMID- 6848098 TI - Prognostic factors for the occurrence of posttraumatic epilepsy. PMID- 6848099 TI - Latency of the acoustic reflex in eighth-nerve tumor. AB - We evaluated acoustic reflex morphologic features in four subjects with confirmed, unilateral acoustic neuroma. All four subjects showed marked reduction in absolute reflex amplitude and alteration in the reflex amplitude-intensity function in the ear with the eighth-nerve disorder. The early, fast-rising component of the normal reflex was also typically absent in the ears with tumor. Interaural latency comparisons were made in three ways. At equal reflex sensation levels and equal reflex sound pressure levels, latency ws substantially delayed in the ear with the eighth-nerve disorder. At equivalent reflex amplitudes, however, latency was equivalent in normal ears and ears with eighth-nerve disorder. Results suggest that delayed onset of the acoustic reflex in subjects with eighth-nerve disorder may reflect amplitude and wave-form morphologic effects rather than a latency prolongation per se. PMID- 6848100 TI - Auditory brainstem responses in infants recovering from bacterial meningitis. Audiologic evaluation. AB - Auditory brainstem response (ABR) was used to assess possible hearing loss in 60 patients recovering from bacterial meningitis. The ABR results were consistent with either unilateral or bilateral hearing loss in 35% of the cases tested. Of these, 15% were conductive-type hearing loss. Twelve percent had sensorineural hearing losses and normal brainstem function. The remaining 8% had elevated ABR thresholds coincident with findings suggestive of neuropathology of the auditory brainstem pathways. A case of reversible sensorineural hearing loss was documented. Various clinical and demographic factors were examined to determine their predictive value with regard to hearing loss. As expected, otitis media occurred significantly with conductive hearing loss. Type of pathogen (Streptococcus pneumoniae) and hospitalization greater than two weeks were significantly correlated with sensorineural hearing loss. As meningitis typically affects young children who are difficult to test with conventional audiometry, ABR provides an effective means of testing hearing in this population. PMID- 6848101 TI - Age-related increase of spontaneous aural cholesteatoma in the Mongolian gerbil. AB - The Mongolian gerbil is the only non-human animal known to spontaneously develop aural cholesteatomas. In this rodent, both the prevalence of spontaneous cholesteatomas and the resultant peripheral auditory evoked potential threshold increases from 6 to 18 months of age. By 24 months, the end of their median life span, other factors begin to affect auditory function. Therefore, the electrocochleographic technique can be efficiently used to nontraumatically trace the development of the cholesteatoma from 6 to 18 months, providing an experimental method for evaluating techniques to prevent or retard the growth of aural cholesteatomas. PMID- 6848102 TI - Hereditary inner-ear abnormalities in animals. Relationships with human abnormalities. AB - A classification scheme for inner-ear abnormalities is defined, based on animals with hereditary inner-ear defects. Three major groups are (1) morphogenetic abnormalities, involving gross structural deformities of the labyrinth; (2) neuroepithelial abnormalities, in which there appears to be a primary organ of Corti defect and Reissner's membrane remains in its normal position; and (3) cochleosaccular abnormalities, showing collapse of Reissner's membranes and restriction of vestibular abnormalities to the saccule. Recent experimental findings in hearing-impaired animal mutants are taken into account. The relevance of the classification of scheme to conditions in humans is discussed. It is suggested that the Mondini and Michel deformities in humans are best considered together in the morphogenetic group. Some cases of inner-ear abnormality in humans might be considered as belonging to the neuroepithelial group. PMID- 6848103 TI - Cardiopulmonary changes secondary to chronic adenotonsillitis. AB - Thirty children with lower respiratory tract infection of varying degrees secondary to chronic tonsillitis and/or enlarged adenoids were studied clinically and roentgenographically. Symptoms and signs of alveolar hypoventilation and signs of cor pulmonale were present in two of them. These symptoms and signs improved markedly after adenoidectomy and tonsillectomy. The relationship of the lung changes to the incidence of cor pulmonale is discussed. The development of recurrent attacks of severe lower respiratory tract infection secondary to diseased tonsils and adenoids is believed to play an important role in the pathogenesis of cor pulmonale in children with upper respiratory tract obstruction due to chronically enlarged tonsils and adenoids. PMID- 6848104 TI - Management of recurrent thyroglossal duct cysts. AB - In a review of 141 patients with thyroglossal duct cysts between 1961 and 1981, 28 patients were found to have surgical treatment for recurrent cysts and sinuses. Recurrent disease following surgical failure results in a high incidence of fistula formation. In the operative treatment of recurrent disease, all patients had a segment of hyoid bone excised. The dissection was extended to include a core of the base of the tongue in 20 of the 28 patients. There have been no surgical failures in this population of patients treated for recurrent thyroglossal duct cysts. We are currently treating patients with recurrent cysts and sinuses with en bloc anterior neck dissections, a modification of the classic Sistrunk procedure. PMID- 6848105 TI - Clinical applications of the rhomboid flap. AB - The Limberg Dufourmentel, and Webster 30 degrees transposition flaps are reviewed. Twenty-two cases are reported. These cases show that preoperative design and attention to placement in relation to skin extensibility is important. However, these cases also demonstrate that placement of incision lines in proper anatomical locations for resulting camouflage and preservation of undue tension is critical to success. PMID- 6848106 TI - Differential diagnosis of nasopharyngeal tumors by computed tomography scanning. AB - While direct visual or even fiberoptic endoscopic examination of the nasopharynx may at times be diagnostic, some limitations are frequently encountered as follows: (1) determination of the extent of submucosal spread, (2) identification of intracranial extensions, (3) in some instances, the differentiation of benign from malignant processes, and (4) the delineation of aggressive inflammatory processes such as Wegener's granulomatosis or mucormycosis. Seventy patients were reviewed to determine what help could be anticipated from computed tomography scanning. Low-density fascial planes are readily identified in the paranasopharyngeal space that provide important clues to the spread and diagnosis of malignant disease or aggressive inflammatory processes. The use of intravenous contrast material for enhancement of intracranial spread of tumors or for identification of the margins of hypervascular lesions can be quite helpful. PMID- 6848107 TI - The quantitative evaluation of hoarseness. AB - As the degree of judged hoarseness increases, the noise component appears to a greater degree and replaces the harmonic structure in the spectrogram. The relationship between these two components has been quantified as the harmonics to noise (H/N) ratio. The computation is straightforward; 50 consecutive pitch periods of a sustained vowel /a/ are averaged; H is the energy of the average waveform, while N is the mean energy of the differences between the individual periods and the average waveform. Therefore, the H/N ratio could be measured in the clinic with the aid of a small, inexpensive computer. This H/N ratio was successfully applied for evaluating the effectiveness of the treatments for hoarseness. Although the H/N ratio does not aid in making a diagnosis of laryngeal abnormality, it would be an important tool for assessing hoarseness. PMID- 6848108 TI - Purulent mediastinal abscess secondary to Ludwig's angina. AB - A case of Ludwig's angina dissected along deep cervical fascial planes into the mediastinum caused a virulent mediastinitis and abscess. Computed tomography precisely delineated the extent of the infection. Incomplete debridement resulted in a residual abscess and persistent systemic sepsis that culminated in the patient's death. Aggressive antibiotic treatment of the orofacial cellulitis along with complete mediastinal drainage are recommended for optimal outcome. PMID- 6848109 TI - The management of gunshot and stab injuries of the trachea. AB - With violence escalating in our society, there has been an increase in the number of gunshot and stab injuries of the trachea. In an effort to determine the natural history and appropriate management of these injuries, a review of the records of patients suffering gunshot or stab injuries of the trachea treated at Ben Taub General Hospital, Houston, between 1975 and 1979 was performed. Seventeen patients were treated, seven with stab wounds and nine with gunshot wounds and one with both; primary repair of the trachea was performed in all injuries and stenosis developed in three patients. The management of tracheal stenosis and complications after repair will be discussed with case histories. PMID- 6848110 TI - Properties of the brain-stem response slow-wave component. AB - A slow-wave component of the brain-stem response recordable to signals at low sensation levels shows some promise for estimating hearing thresholds at low frequencies. This study describes several properties of this slow-wave response (SWR) in 30 normal hearing subjects and examines correlations with psychophysical thresholds. Acoustic signals were tone pips at 0.25, 0.5, 1, 2, and 4 kHz with 3 ms rise-fall times and no plateau. Repetition rate was 40/s. The EEG was filtered at 20 to 1,500 Hz before averaging. Results showed SWR thresholds were on the average about 15 dB higher than behavioral thresholds, however, the range was 0- to 35-dB sensation level. A large decrease in SWR amplitude and a 20-dB increase in threshold could occur in states of deep sleep. The SWR appears to be useful for estimating low-frequency thresholds, but the 35-dB threshold range in normal hearing subjects should be considered when interpreting some SWR results. PMID- 6848111 TI - Tracheotomy tube replacement. PMID- 6848112 TI - Vocal cord carcinoma. PMID- 6848113 TI - Mixed embryonal and alveolar type rhabdomyosarcoma of the sphenoid sinus. PMID- 6848114 TI - Management of megaloblastic anaemia in the very young. PMID- 6848115 TI - Red cell nucleotide levels in patients with thalassaemia, iron deficiency, and renal failure. AB - Red cell nucleotides, predominantly adenine nucleotides, were measured spectrophotometrically in normal individuals and in patients with iron deficiency, beta thalassaemia and renal failure following dialysis or transplantation. There was a significant correlation between the mean red cell haemoglobin (MCH) or the mean cell volume (MCV) and the nucleotide levels in red cells (P less than 0.001). Patients with beta thalassaemia did not have increased nucleotide levels compared to red cells having the same MCH or MCV. Patients with renal failure had significantly increased levels of nucleotides compared to normal individuals, and this level remained high after renal dialysis but returned to normal following renal transplantation. PMID- 6848116 TI - Impaired protein synthesis in erythroblasts enhances their phagocytosis by macrophages. AB - In an attempt to elucidate mechanisms which underly ineffective erythropoiesis, we investigated the effect of impaired macromolecular synthesis in erythroblasts on their phagocytosis by macrophages in vitro. Dimethylsulphoxide-induced murine Friend leukaemia erythroblasts were treated with inhibitors of RNA or protein synthesis and subsequently tested for their interaction with syngeneic mouse peritoneal macrophages in culture. Exposure of the erythroblasts to two reversible inhibitors of protein synthesis, puromycin and cycloheximide, enhanced their association with and phagocytosis by macrophages. The effect was evident after the drugs had caused a partial inhibition of protein synthesis and appeared to be reversible. By contrast, the treatment of erythroblasts with the inhibitor of RNA-synthesis, actinomycin D, which caused a marked depression of RNA but not of protein synthesis, failed to affect the interaction of erythroblats with macrophages. The results are in keeping with previous observations on human bone marrow showing impaired protein synthesis in erythroblasts in some haematological disorders characterized by a marked increase in ineffective erythropoiesis. PMID- 6848118 TI - Recognition of marrow elements by natural killer cells: are NK cells involved in haemopoietic regulation? AB - NK cells from young normal mice are cytolytic in vitro for a virus-induced tumour cell line, YAC-1. Cytotoxicity is inhibited by the addition of unlabelled homologous YAC-1 cells and by regenerating bone marrow cells from the spleens of lethally irradiated, bone-marrow-grafted mice. Quiescent marrow from syngeneic and allogeneic mice produces little or no competition. This suggests that NK cells recognize, and may regulate, marrow progenitor cells. PMID- 6848117 TI - Quantitative cytochemistry of the toxic granulation blood neutrophil. AB - A quantitative cytochemical study has been made, using scanning-integrating microdensitometry, of 1000 toxic granulation blood neutrophils from 20 infected patients, in comparison with 1250 normal blood neutrophils. Myeloid precursor cells in 10 normal marrows were also studied. Normal bone marrow granulocyte maturation was associated with a progressive decrease in azurophilic granule enzymes (myeloperoxidase, beta-glucuronidase, acid phosphatase, chloroacetate esterase), and also Alcian blue staining from acid mucosubstance, but an increase in the specific granule marker lactoferrin. Toxic granulation blood neutrophils showed minor changes in the enzyme content of their azurophilic and specific granules, consistent with cell immaturity, and an increase in acid mucosubstance in azurophilic granules. Abnormal maturation of azurophilic granules, with persistence of acid mucosubstance, is the likely explanation for the intense Romanowsky dye staining of the toxic granulation neutrophil. PMID- 6848119 TI - Aspirin prevents heparin-induced platelet aggregation in vivo. PMID- 6848120 TI - Extreme transient eosinophilia in a healthy infant: eosinophil colonies (CFU-EO) studied in culture. PMID- 6848121 TI - Multiple myeloma: optimal use of salmon calcitonin in the management of myeloma osteoclastic bone disease. PMID- 6848122 TI - Binding of 99Mo to red cell membrane proteins is not affected by reducing agent. PMID- 6848123 TI - Granulocyte function in untreated pernicious anaemia. AB - Neutrophil granulocyte functions were evaluated in nine patients with pernicious anaemia (PA). Membrane potential, oxygen consumption, nitroblue tetrozolium reduction, and phagocytosis and killing of staphylococci were determined prior to the institution of vitamin B12 therapy. There were no significant alterations in these granulocyte functions as compared with normal controls, although in several patients low values were seen. We conclude that in PA the oxidative metabolism and microbicidal functions of granulocytes in general are normal, even in severely anaemic patients. PMID- 6848124 TI - Modifications of granulocyte subpopulations and of their adherence property during filtration leukapheresis in man. AB - Polymorphonuclear leucocytes (PMN) isolated from the peripheral blood of 23 blood donors undergoing filtration leukapheresis were examined with regard to their number, expression of membrane receptors for rabbit IgG or human C3b and their ability to adhere to nylon fibres. All the donors showed an early granulocytopenia followed by a gradual return of PMN into the circulation, but differed in the number of PMN appearing in the rebound phase. Evaluation of rosette forming cells (RFC) and cells adhering to nylon fibres in this phase led to the recognition of two main groups of donors. In one of these groups the number of PMN, RFC and adhering cells remained unchanged compared to the pre apheresis values. The other group showed marked leucocytosis accompanied by a relative increase in the number of non-RFC and non-adhering cells. Possible mechanisms involved in the changes of PMN subpopulations are discussed. PMID- 6848125 TI - Granulocyte-macrophage progenitor cell preservation at 4 degrees C. AB - Eighteen bone marrows collected from patients without haematological diseases and from normal subjects were tested for the effects of 4 d storage at 4 degrees C on CFU-C growth. Results indicate that unfractionated bone marrow cells may be stored at 4 degrees C for 4 d with 97% +/- 8 SEM recovery of the CFU-C evaluated by the agar culture assay. On the other hand, the same preservation procedure on peripheral blood CFU-C of 13 normal subjects yielded only 5% +/- 2 SEM recovery of in vitro growth capacity. The present results have practical implications. They might be exploited to preserve bone marrow CFU-C for transplantation therapy or laboratory investigation. In contrast this single preservation procedure seems not appropriate for preserving blood CFU-C. PMID- 6848126 TI - The effects of surgery on the activity of neutrophil granule proteins. AB - Activities of the neutrophil granule-associated proteins beta-glucuronidase, lysozyme and vitamin B12 binding protein were measured, serially, in the cells and serum of 10 patients undergoing total abdominal hysterectomy. The neutrophil leucocytosis which followed total abdominal hysterectomy was accompanied by a fall in the intraneutrophilic activities of all three granule-associated proteins. Intraneutrophilic lysozyme activity and intraneutrophilic vitamin B12 binding capacity were maximally reduced within 4 h of surgery and fell to 62 +/- 13% (mean +/- SEM) and 63 +/- 9% of their preoperative levels, respectively. This contrasted with the activity of intraneutrophilic beta-glucuronidase which was not maximally reduced until 24 h post-surgery when a fall to 80 +/- 6% of the preoperative level was observed. By the fifth postoperative day activities of the three intraneutrophilic granule proteins were increasing and approaching those observed preoperatively. Serum lysozyme and plasma unsaturated vitamin B12 binding capacity (UBBC) rose steadily following surgery and were significantly elevated by the fifth postoperative day. It is suggested that activation and in vivo degranulation of circulating neutrophils may be responsible for these changes in activity of neutrophil granule proteins following surgery. PMID- 6848127 TI - Idiopathic autoantibody that inhibits fibrin monomer polymerization. AB - A 73-year-old female was found to have prolonged thrombin and reptilase times in the immediate post-operative period. These abnormalities were not corrected by the addition of normal plasma. They were subsequently shown to be due to an IgG immunoglobulin which inhibited fibrin monomer polymerization. The IgG immunoglobulin activity could be neutralized completely by prior incubation with either patient or normal fibrinogen, uncrosslinked fibrin monomers or IgG antisera. No inhibitory effect on thrombin activity, fibrinopeptide A release or on the fibrin cross-linking reaction of factor XIIIa could be detected. Purified patient fibrinogen was functionally normal as demonstrated by normal fibrinogen fibrin polymerization and fibrinopeptide A release. No underlying cause for this phenomenon was found. The presence of the inhibitor was associated with excessive blood loss during the post-operative period. PMID- 6848128 TI - Acquired haemostatic defects in the ill newborn. PMID- 6848129 TI - Cellular cooperation in endothelial cell thromboplastin synthesis. AB - Endothelial cells from human umbilical veins produce a procoagulant identified as thromboplastin (tissue factor, factor III) when stimulated with the phorbol ester 12-0-tetradecanoyl-phorbol-13-acetate (TPA), phytohaemagglutinin (PHA) or endotoxin, Inducible thromboplastin synthesis (i.e. synthesis of the protein component of thromboplastin, apoprotein III) was totally inhibited by cycloheximide and actinomycin D, indicating that de novo protein and RNA syntheses are necessary. Serum enhanced the induced apoprotein synthesis. Of the total thromboplastin activity in homogenates of stimulated endothelial cells, about 50--70% was available on the cell surface for interaction with other coagulation factors, inactivation by trypsin and neutralization with antiserum against apoprotein III. Induced synthesis of thromboplastin in endothelial cells was 2--7-fold enhanced by the presence of several other cell types in optimal ratio 4--10 cells per endothelial cell. Some of these cell types were themselves thromboplstin producers (U-937, U-937-4), some were not inducible (lymphocytes, granulocytes and the lymphoblast lines Daudi and Molt 4). This enhancing effect was also seen with cell-free culture supernatants, but these were generally somewhat less effective than the intact cells. Supernatants derived from cells cultured in the presence of TPA, PHA or endotoxin were in most cases more effective than supernatants from unstimulated cells. PMID- 6848130 TI - 125I fibrinogen turnover in polycythaemia: the effect of phlebotomy. AB - Patients with polycythaemia vera and secondary polycythaemia studied with 125I labelled fibrinogen, had a significantly increased plasma fibrinogen turnover. The abnormalities were greater in polycythaemia vera and correlated with platelet count but not with packed cell volume. In six patients with polycythaemia vera, phlebotomy reduced the packed cell volume to 0.46 or less. Although fibrinogen turnover decreased significantly in all patients, it remained outside the normal range in four cases. The concept of a prothrombotic state is discussed, and also the importance of these observations with respect to various forms of treatment. PMID- 6848131 TI - Angioid streaks in a case of beta thalassaemia major. PMID- 6848132 TI - Effects of experimental hyperlipoproteinaemia on the retina and optic nerve in rhesus monkeys. AB - Hyperlipoproteinaemia resulting from thyroid suppression and long-term ingestion of a high cholesterol diet caused prolonged lipaemia retinalis in 6 rhesus monkeys. No atherosclerotic deposits or other ophthalmoscopically visible changes of the retinal vasculature were detectable. In 2 animals histopathological examination revealed segmental atrophy and gliosis of the optic nerves bearing a resemblance to chronic ischaemic optic neuropathy. One monkey developed ophthalmoscopically visible temporal pallor of the optic discs. Emboli of fat laden cells in blood vessels of the brain in one of these 2 monkeys, and in a penicillated splenic artery in the other animal, were associated with signs of systemic embolic occlusion, suggesting a similar course in the development of optic nerve damage. PMID- 6848133 TI - Prevalence of aphakic retinal detachment. PMID- 6848134 TI - Compliance with treatment of patients with chronic open-angle glaucoma. PMID- 6848135 TI - Computerised evaluation of visual fields. PMID- 6848136 TI - Azelaic acid in the treatment of ocular and adnexal malignant melanoma. PMID- 6848138 TI - An inexpensive method of slit-lamp photography. PMID- 6848137 TI - The Fasanella-Servat operation: a modified simple technique with quantitative approach. PMID- 6848139 TI - Platelet-bound IgM in autoimmune thrombocytopenia. AB - Elevated levels of platelet-bound IgG (PA-IgG) are a feature of autoimmune thrombocytopenia (ATP), but it is well documented that this does not occur in all cases. This has led us to investigate the role of platelet-bound IgM (PA-IgM) in these patients using a quantitative enzyme-linked immunosorbent assay (ELISA). Forty-five determinations of PA-IgM and PA-IgG were done on 24 patients with ATP. Elevated levels of PA-IgM were found in 93.3% of the determinations, while PA-IgG was elevated in only 71.7%. In 64.4% of determinations, both were elevated. Elevated PA-IgM or PA-IgG alone occurred in 28.9% and 6.7% of determinations, respectively. These results show the hitherto unrecognized frequent involvement of PA-IgM in ATP and suggests that a complex interrelationship exists between the two immunoglobulin classes in ATP. Some of the possibilities that might explain this interrelationship are discussed. PMID- 6848140 TI - Generalized hexokinase deficiency in the blood cells of a patient with nonspherocytic hemolytic anemia. AB - In a patient with nonspherocytic hemolytic anemia, a hexokinase deficiency was detected in the red cells (residual activity about 25% of normal) and in blood platelets (20%-35% of normal activity). Although the total hexokinase activity in lymphocytes was normal, the amount of hexokinase type I was decreased to about 50% of normal. However, the deficiency was compensated for by the appearance of type III hexokinase. Compartmentation studies with controlled digitonin-induced cell lysis showed that this type III enzyme was localized in the cytosol, while almost all hexokinase activity in normal lymphocytes is particulate. No abnormal lymphocyte functions could be detected. The patient was homozygous for the defect. The parents and three of five sibs of the patient were apparently heterozygous with residual activities of 50%-67% of normal in their red cells, but did not show any clinical signs of hexokinase deficiency. The variant enzyme had a slightly decreased affinity for MgATP2- and a strongly increased inhibition constant for glucose-1,6-P2. Affinity for glucose, heat stability, and pH optimum were normal. In the electrophoretic pattern of red cell hexokinase, only one subtype of hexokinase I could be detected, while in normal red cells, at least three subtypes are present. In the heterozygous individuals, no enzymatic abnormalities could be detected, except for an aberration in the electropherogram of one sib. PMID- 6848141 TI - Augmentation by platelets of granulocyte aggregation in response to chemotaxins: studies utilizing an improved cell preparation technique. AB - Considerable evidence exists to suggest roles for both platelets and granulocytes (PMNs) in pulmonary injury in shock. While believing that the major contributions of the two cell types are sequential, in vitro observations suggested that direct interactions between granulocytes and platelets might also amplify tissue damage. Using isotonic Percoll density gradients to isolate PMNs, we therefore studied the effect of deliberate platelet contamination on PMN aggregation. PMN aggregation in response to N-formyl-met-leu-phe or activated complement was enhanced by the presence of 1 platelet/PMN, an effect that became maximal at 16 platelets/PMN (p less than 0.01); large mixed aggregates were formed. Lysed, aspirinated, and indomethacin-treated platelets retained their augmentative capacity, as did platelets washed by gel filtration. The effect was not mimicked by the addition of histamine or serotonin to PMN preparations. None of these platelet preparations augmented lysosomal enzyme release. We conclude that platelets augment PMN aggregation, both by forming giant mixed PMN/platelet aggregates and also by producing a labile augmentative substance, the production of which may be independent of thromboxane synthesis. We propose that direct as well as sequential platelet/PMN interactions may be important in tissue injury in shock. PMID- 6848143 TI - Passive participation of fixed platelets in aggregation facilitated by covalently bound fibrinogen. AB - The role of fibrinogen in interplatelet recognition during aggregation was examined by combining two cell types: fresh platelets (in limiting density) activated by thrombin or A23187, and formaldehyde-fixed platelets, bearing cross linked fibrinogen. The fixed platelets did not aggregate by themselves, nor with resting platelets, but were capable of interacting with activated platelets and of participating passively in aggregation. The participation, expressed by enhanced aggregation, was assayed by the conventional turbidometric traces and by cosedimentation of fixed 3H-platelets with aggregates of fresh platelets. Platelet suspensions, prepared without special means to avert spontaneous activation, retained plasma fibrinogen to the extent of 50 micrograms/ml of a suspension containing 10(8) platelets, and the derived fixed platelets participated in aggregation, independently of added fibrinogen. The capability of such fixed platelets to participate in aggregation was sensitive to proteolytic digestion and to massive acetylation. When platelet separation was aided by apyrase or aspirin, PGE1 and gel filtration, the residual plasma fibrinogen was limited to 0.4 micrograms/ml of 10(8) platelet suspension. The derived fixed platelets were incapable of participating in aggregation unless fibrinogen was added prior to fixation. The affixed fibrinogen could not be replaced by soluble fibrinogen or affixed albumin. It is concluded that fibrinogen, which binds to platelets upon activation or is linked to them covalently, is a recognition site for platelet-platelet interaction during aggregation. PMID- 6848142 TI - The membrane potential of human platelets. AB - The membrane potential of the human platelet was investigated using the membrane potential probes 3,3'-dipropyl-2,2'-thiadicarbocyanine iodide and tritiated triphenylmethylphosphonium bromide. The membrane potential in physiologic buffer was estimated to be 52-60 mV inside negative. The membrane was depolarized when extracellular potassium or hydrogen ion concentrations were increased. Changes in extracellular sodium, chloride, or calcium ion concentration had no measurable effect on membrane potential. Elevated extracellular potassium has been shown to increase platelet sensitivity to the aggregating agent, adenosine diphosphate. Our results show that changes in extracellular ion concentrations that depolarize platelets increase platelet sensitivity to aggregating agents. These results suggest that membrane potential changes may play a role in modulating the response of platelets to aggregating agents. PMID- 6848145 TI - Urinary methylmalonic acid excretion. PMID- 6848144 TI - A human granulocyte-specific antigen characterized by use of monoclonal antibodies. AB - Hybridoma cell lines secreting monoclonal antibodies that bind to a surface antigen of human neutrophils have been prepared by fusion of mouse myeloma cells with spleen cells from mice immunized with human neutrophils. Several of the monoclonal antibodies (AHN 1-6) were specific for a neutrophil surface antigen and did not bind lymphocytes, monocytes, red blood cells, platelets, or basophils. All of the granulocyte-specific antibodies immunoprecipitated a polypeptide of 145,000 daltons and an isoelectric point of about 4.5 and other heterogeneous polypeptides of 105,000 daltons. These same components were the major lactoperoxidase-labeled proteins precipitated by hyperimmune mouse serum. The antibodies were further characterized for binding to several human myeloid leukemia cell lines and cells from patients with myeloid or lymphoid leukemia. All antibodies bound the HL-60, ML1, ML2, ML3, K562, and U937 myeloid leukemia cell lines. None of the antibodies bound the RPMI 6410 Raji, RPMI 8226, MOLT 4, or Daudi lymphoid cell lines. All of the hybridoma cell lines (AHN 1-6) produced IgM antibodies that were cytotoxic. PMID- 6848147 TI - Standardization of the laboratory control of oral anticoagulant therapy. PMID- 6848146 TI - Acquired Glanzmann's thrombasthenia. PMID- 6848148 TI - Cell kinetic responses in childhood acute nonlymphocytic leukemia during high dose therapy with cytosine arabinoside. AB - Sequential bone marrow aspirates obtained from 10 children with relapsed acute nonlymphocytic leukemia (ANLL) after a high dose of cytosine arabinoside (Ara-C; 1000 mg/sq m) were analyzed by flow cytophotometry. The drug causing elimination of proliferating cells followed by a synchronous wave of cell recruitment. Among individual patients, considerable variation was observed in the degree of recruitment as well as in the time of appearance of the recruitment maximum (range 17-36 hr). However, both parameters appeared inversely correlated with the proliferative status in the bone marrow before treatment. In 6 other patients, cell kinetic responses were studied during treatment with repeated Ara-C injections scheduled individually according to the expected optima of recruitment. Waves of recruitment could be observed during 4-5 consecutive injections. The results suggest that in childhood ANLL, characteristic and individual cytokinetic responses to treatment with high-dose Ara-C can be monitored during therapy. These observations may allow the development of individual treatment schedules. PMID- 6848149 TI - Costs of orthopedic implants. PMID- 6848150 TI - Evolution of varicose vein therapy. PMID- 6848151 TI - Multiple risk factor intervention trial produces an unexpected result. PMID- 6848152 TI - Nocturnal enuresis. PMID- 6848153 TI - Perspective. Defining family practice: who should do it? PMID- 6848154 TI - The value of demonstration and role of the pharmacist in teaching the correct use of pressurized bronchodilators. AB - The use of an improper technique with metered-dose inhalers decreases the efficacy of the bronchodilators being administered. There is evidently a need for patients to watch a demonstration. Twenty-nine adult asthmatic patients from an allergy clinic were divided into three groups, each receiving a different form of instruction: an information sheet, personal instruction or a videotape presentation. Subsequently each patient was tested for correct use of the inhaler. There was no difference in mean scores for inhalation technique between the groups instructed in person and by videotape, but both were significantly better than the mean score of the group given only an information sheet. There was also no significant change in the scores at a follow-up test in the groups who saw the technique demonstrated. These results indicate the need for and value of the demonstration of proper technique with pressurized inhalers. A pharmacy generated education system using videotape equipment or personal instruction by a pharmacist could readily solve the problem. PMID- 6848155 TI - Cimetidine and portal pressure in chronic liver disease. AB - Portal pressure was determined in 10 patients with chronic liver disease before and after an infusion of cimetidine. The drug had no significant effect on portal hypertension. Suggestions that histamine H2-receptor antagonists, by decreasing portal pressure, may be useful in the management of bleeding from esophageal varices are not supported by these results. PMID- 6848156 TI - Using the laser to treat vulvar condylomata acuminata and intraepidermal neoplasia. AB - The therapeutic effectiveness of the carbon dioxide laser was evaluated in 55 women with condylomata acuminata, particularly of the vulva but also of the urethral meatus and anal region, and in 11 women with multicentric vulvar intraepidermal neoplasia. The rates of persistence and recurrence were 13% and 5% respectively for condylomata and were both 9% for intraepidermal neoplasia. Perioperative and postoperative complications occurred in 6 of the 66 cases (9%) and all were managed on an outpatient basis. Laser beam therapy is recommended as an effective and safe means of treating extensive condylomata and intraepidermal neoplasia of the external urogenital region and anal mucous membrane. PMID- 6848157 TI - Preoperative electrocardiography effect of new abnormalities on clinical decisions. PMID- 6848158 TI - Lightning injury. PMID- 6848160 TI - Thyroid metastasis of clear-cell renal carcinoma. PMID- 6848159 TI - Nutritional rickets in vegetarian children. PMID- 6848161 TI - Increased need for tracheal intubation for croup in relation to bacterial tracheitis. PMID- 6848162 TI - Storage conditions of live measles, mumps and rubella virus vaccines in Montreal. PMID- 6848163 TI - Ethics and the medical student. PMID- 6848164 TI - Dr. Mary Calderone: physicians have a vital role in sex education.. Interview by Evelyne Michaels. PMID- 6848165 TI - An RRSP shopping guide. PMID- 6848166 TI - Drug substitution: remedy or rip-off? PMID- 6848167 TI - Universality of social programs: an impossible ideal? PMID- 6848168 TI - Certificate of clinical training. PMID- 6848169 TI - Evaluating involuntary commitment in Ontario. PMID- 6848170 TI - Effect of hyperglycemia on the thermal response of murine normal and tumor tissues. AB - The effect of an i.p. injection of glucose on the thermal response of murine tissues was studied. Animal tumors were early generation isotransplants of a spontaneous fibrosarcoma, FSa-II. Tumors were transplanted into the foot pad, and hyperthermia was given by immersing the foot into a constant-temperature water bath. The tumor and normal tissue responses were studied by assays of the time required for half the tumors to reach 1000 cu mm from treatment day and of the treatment time required for one-half of the animals to develop a loss of one toe or greater reaction. The glucose administration enhanced tumor response more substantially than normal tissue response. The enhancement was greater for a large tumor than for a small tumor and also greater at 42.0 degrees than at 45.5 degrees. Presumably, the hyperglycemia induced acidosis which eventually enhanced thermal response. Present results suggested that the hyperglycemia is a potential method to specifically enhance tumor response at elevated temperatures. PMID- 6848171 TI - Nitrosourea-induced sister chromatid exchanges and correlation to cell survival in 9L rat brain tumor cells. AB - The ability of various nitrosoureas to induce sister chromatid exchanges (SCEs) in 9L rat brain tumor cells was investigated. Treatment of cells for 1 hr with the alkylating and cross-linking agents 1,3-bis(2-chloroethyl)-1-nitrosourea or chlorozotocin produced concentration-dependent increases in SCEs; elevations above controls were detected at concentrations of 1 microM or more. Above 0.25 mM, the alkylating agent ethylnitrosourea produced a dose-dependent increase in SCEs. Treatment with the carbamoylating agent 1,3-bis(trans-4-hydroxycyclohexyl) 1-nitrosourea did not induce SCEs. The maximum drug concentration at which SCEs are readily scored kills approximately 50% of cells. When accurate cell survival data in this dose range were obtained, a direct correlation between nitrosourea induced cell kill, measured by a colony-forming efficiency assay, and SCE induction was found. Thus, analysis of the levels of SCE production may provide information about the efficacy of antineoplastic drugs. PMID- 6848172 TI - Cytocidal action of the quinone group and its relationship to antitumor activity. AB - Many clinically useful antitumor agents have a quinone group in their structure. A series of model compounds has been studied to determine if the quinone group is involved in the cytotoxic activity of these agents and to investigate the mechanism of this action. Hydrolyzed benzoquinone mustard, which contains a quinone group, produced significant cell kill of L5178Y lymphoblasts, whereas hydrolyzed aniline mustard, which has a similar chemical structure but contains no active functional groups, showed little activity against this cell line. Benzoquinone mustard, which possesses both a quinone moiety and an active alkylating group, was approximately 30,000 times more active against L5178Y cells than was hydrolyzed benzoquinone mustard. It was approximately 600 times more active than aniline mustard, a compound which has the same alkylating group but no quinone function, and 200 times more active than an equimolar combination of aniline mustard and hydrolyzed benzoquinone mustard. The cytotoxic activity of hydrolyzed benzoquinone mustard was inhibited by either superoxide dismutase or catalase, while catalase but not superoxide dismutase inhibited the activity of benzoquinone mustard. Neither enzyme had any effect on the cytocidal action of aniline mustard. These studies suggest that the presence of a quinone group in the chemical structure of a compound can result in significant cell kill by a mechanism that appears to involve free radicals and active oxygen species. In addition, if the compound contains an alkylating group which can bind to DNA, as well as a quinone moiety, the cytocidal activity of the agent appears to be enhanced and is greater than that resulting from an additive effect of the two groups. PMID- 6848173 TI - Pyrazole effects on mutagenicity and toxicity of dimethylnitrosamine in Wistar rats. AB - The correlation between the in vivo toxicity and in vitro mutagenicity of dimethylnitrosamine and the activity of dimethylnitrosamine demethylase I (DMND I) after pyrazole treatment of rats was studied. The biological effects of pyrazole were measured either as toxicity to the rats or as mutations to Salmonella TA 92. A dose-response relationship was observed between DMND I activity and the administered dose of pyrazole. Pyrazole administration increased the toxicity of dimethylnitrosamine when measured as a 50% lethal dose or as a histopathological effect on the liver. Phenobarbital and methylcholanthrene administration did not have any effect on the activity of DMND I or on the number of histidine-revertant colonies when tested using the liquid suspension method in the presence of dimethylnitrosamine and the reduced nicotinamide adenine denucleotide phosphate-generating system. When microsomes from the pyrazole treated animals were used in the mutagenesis assay, there was a linear correlation between DMND I activity and the number of histidine-revertant colonies. It is concluded that pyrazole treatment of animals increases the activity of liver DMND I, the toxicity of dimethylnitrosamine, and the number of mutations. PMID- 6848174 TI - Podophyllotoxin-resistant mutants of Chinese hamster ovary cells: cross resistance studies with various microtubule inhibitors and podophyllotoxin analogues. AB - The cross-resistances of several mutants of Chinese hamster ovary cells which have been obtained after one and two selection steps in the presence of the microtubule inhibitor podophyllotoxin (PodRI and PodRII mutants, respectively) towards various other inhibitors of microtubule assembly (e.g., colchicine, Colcemid, vinblastine, griseofulvin, maytansine, steganacin, nocodazole, and taxol) have been examined. Based upon their specific patterns of cross resistance/sensitivity to various microtubule inhibitors, both the PodRI and PodRII classes of mutants appear to be of more than one kind. Studies on the binding of [3H]podophyllotoxin to cytoplasmic extracts indicate that one of the PodRII mutants which has been shown previously to be affected in a Mr 66,000 to 68,000 microtubule-associated protein shows reduced binding of the drug in comparison to the parental PodS and PodRI cells. The different PodRI and PodRII mutants exhibited proportionally increased cross-resistances to various podophyllotoxin analogues (e.g., deoxypodophyllotoxin, epipodophyllotoxin, beta peltatin, 4'-demethylpodophyllotoxin, alpha-peltatin, podophyllotoxin-beta-D glucoside, beta-peltatin-beta-D-glucoside, picropodophyllotoxin, and podophyllic acid) which possess microtubule-inhibitory activity. However, with the exception of one PodRI class of mutant, none of the mutants exhibited any cross-resistance to 4'-demethylepipodophyllotoxin thenylidine-beta-D-glucoside and 4' demethylepipodophyllotoxin ethylidine-beta-D-glucoside, the 2 podophyllotoxin analogues which lack microtubule-inhibitory activity. The cross-resistance studies with these mutants, which, based upon the biochemical studies and their highly specific patterns of cross-resistance, are presumably affected in microtubules, provide some very novel insights into the mechanisms of action of various microtubule inhibitors. The results presented in this paper also show that the cross-resistance studies with the set of podophyllotoxin-resistant mutants provide a sensitive and highly specific screening procedure for identifying compounds which possess podophyllotoxin-like activity and for investigating the structure-activity relationship among them. The results of structure-activity relationship studies for the various podophyllotoxin analogues examined are discussed. PMID- 6848175 TI - In vitro growth control phenotypes of transformed rodent cells prior to and following tumorigenesis. AB - A number of virus and chemical carcinogen-transformed cell lines were generated in tissue culture and analyzed for growth control phenotypes prior to and following tumorigenesis in appropriate hosts. The cell lines include those of mouse, rat, human, and Syrian hamster, transformed by papovaviruses and adenoviruses (DNA) or murine (RNA) tumor viruses. Cell lines were assayed for: (a) multinucleation or uncontrolled nuclear division (UND+) and uncontrolled DNA synthesis in cytochalasin B (CB) medium; and (b) the continuation of DNA synthesis in media containing reduced (0.5%) amounts of serum. All or nearly all lines of DNA virus transformants exhibited UND+ and high frequencies of DNA synthetic cells in CB medium. Two lines of SV40-transformed hamster cells also showed UND+ following tumorigenesis in weaning hamsters. In addition, DNA virus transformants showed the ability to continue DNA synthesis unabated in low-serum medium. In contrast, the mouse sarcoma virus (MSV)-transformed lines exhibited varying degrees of controlled nuclear division and reduced DNA synthesis in CB medium, both prior to and following tumorigenesis. However, the reduction in DNA synthetic cells was often not as great as that found in untransformed cells. Results similar to the RNA virus transformants were observed with hamster cells transformed by chemical carcinogens. Nearly all of the MSV-transformed lines showed significantly reduced levels of DNA synthesis in low-serum medium as was found in untransformed cells. One cell line, KA31, was followed through three consecutive in vivo tumorigenic passages, but these cells did not acquire UND+ or the ability to continue DNA synthesis in low-serum medium. These results suggest that many MSV- and carcinogen-transformed rodent cells exhibit transformation phenotypes at levels barely above those of normal cells and markedly less than those of DNA virus transformants, and yet they are tumorigenic. PMID- 6848176 TI - Relationship between cellular procoagulant activity and metastatic capacity of B16 mouse melanoma variants. AB - The metastatic process is a complex sequence of steps that may involve coagulation and the presence of fibrin. F1 (low incidence of lung colonization) and F10 (high incidence of lung colonization) variants of the B16 mouse melanoma were used to examine the relationship between the level of cellular procoagulant activity and their metastatic potential. Cell suspensions were prepared from cultures of B16-F1 and B16-F10 cell lines. Aliquots (0.2 ml) containing 50,000 cells were assayed for procoagulant activity in recalcified citrated rat plasma and for metastatic capacity by tail vein injection followed by counting of melanotic lung tumor colonies 17 days later. In one series of experiments, procoagulant activity and metastatic capacity were determined at 1, 2, 3, and 4 days after plating. The data showed an almost parallel decrease in both characteristics as the culture density increased. To examine the correlation between cellular procoagulant activity and the metastatic capacity of the B16 variants in two different series of experiments, regression analysis of the level of procoagulant activity and the number of lung tumor colonies gave correlation coefficients of 0.9 (n = 15) and 0.79 (n = 8). These results suggest that fibrin formation resulting from cellular procoagulant activity may play a role in the metastatic process. PMID- 6848178 TI - Improved therapeutic benefits of doxorubicin by entrapment in anionic liposomes. AB - When used as drug carriers, anionic liposomes can reduce the chronic cardiac toxicity and increase the antileukemic activity of doxorubicin (DXN; Adriamycin). Continuing investigations, reported here, have now established the therapeutic benefits of this mode of drug delivery. Liposome encapsulation caused a prolonged elevation in DXN plasma levels and a 2-fold reduction in the exposure of cardiac tissue to the drug. This reduction, however, was not proportional to the substantial decrease in chronic heart toxicity observed in the earlier study. In vivo studies have demonstrated that the entrapped drug retains its full activity against Sarcoma 180 and significantly increases its action against Lewis lung carcinoma, as measured by reduced tumor volume. The increased antineoplastic activity was again not proportional to the increased association of drug with tumor tissue. The effect of liposome entrapment on the immune-suppressive activity of DXN was also examined to determine if factors other than the direct delivery of drug to tumor tissue might improve the therapeutic response. The suppression of the humoral immune response and peripheral leukocyte counts by free DXN was nearly abolished when the drug was administered in the liposome form. These experiments suggest that the improved therapeutic effect of encapsulation may be the outcome of three different mechanisms: (a) altered disposition into subcellular compartments, which reduces cardiotoxicity; (b) increased plasma drug exposure to tumor cells; and (c) significant reduction in the immune suppressive activity of DXN. PMID- 6848179 TI - Growth of mammalian multicellular tumor spheroids. AB - The in vitro growth of small (0.05 to 3 mm diameter) avascular multicellular tumor spheroids from six rodent and two human tumor lines has been analyzed. Surprisingly, the radial increase of multicellular tumor spheroids is linear with time after a brief initial period of geometric growth. These multicellular tumor spheroids are shown to have a constant thickness of proliferative outer crust and of middle nonproliferative but viable mantle. An analytical model for their growth is developed which explains the growth pattern. This constant crust thickness model leads to a progressively diminishing growth fraction as radius increases and should be applicable to such early growth of micrometastases in vivo. The model also provides a procedure for determining cell cycle time. PMID- 6848177 TI - Cytotoxicity of alkyl-lysophospholipid derivatives and low-alkyl-cleavage enzyme activities in rat brain tumor cells. AB - Alkyl-lysophospholipids (ALP) and related derivatives inhibited the in vitro incorporation of [3H]thymidine into seven different permanent cell lines derived from rat brain tumors. The cytostatic effect of ALP was dependent on dosage and incubation time. Naturally occurring 2-lysophosphatidylcholine did not exhibit cytostatic effects; under these conditions, the incorporation rates of [3H]thymidine were generally more than 100% of the controls. The trypan blue dye exclusion test, which was used to assess severe cell damage, correlated with the extent that [3H]thymidine incorporation was inhibited by ALP. Preincubation of ALP (rac-1-octadecyl-lyso-glycero-3-phosphocholine) for more than 8 min with a tetrahydropteridine-dependent O-alkyl cleavage enzyme preparation from rat liver microsomes destroyed almost all of the cytotoxic properties of ALP when tested at a concentration that previously inhibited tumor growth by more than 50%. [3H]Thymidine incorporation rates were greater than 100% for astrocytoma cells incubated with ALP after exposure to the alkyl cleavage enzyme. Comparison of the microsomal activities of the tetrahydropteridine-dependent alkyl-cleavage enzyme present in astrocytoma 78-FR-G-299 cells and the pleomorphic glioma 78-FR-G 219/S4 cells to that found in normal skin fibroblasts and rat livers revealed a markedly reduced activity in the neoplastic cell lines. Moreover, those tumor cells that were more resistant to ALP cytotoxicity (pleomorphic glioma, 78-FR-G 219/S4) had a 3-fold higher tetrahydropteridine-dependent cleavage activity than a more cytotoxic sensitive line (astrocytoma cells, 78-FR-G-299). Our results indicate that the low-alkyl-cleavage enzyme activities in these neoplastic cells in comparison to normal cells might be a factor in explaining the relatively high cytotoxicity of ALP in tumor cells. PMID- 6848180 TI - Retinoid effects on cell-cell interactions and growth characteristics of normal and carcinogen-treated C3H/1OT1/2 cells. AB - The effects of retinyl acetate and all-trans-retinoic acid on the growth rate, saturation density, and cytoplasmic underlapping of normal and carcinogen initiated C3H/1OT1/2 cells were examined. Retinyl acetate (a) decreased the saturation density by as much as 45%, (b) had no effect on the growth rate, (c) reduced cytoplasmic underlapping of adjacent cells by 55 to 85%, and (d) inhibited neoplastic transformation by methylcholanthrene. The effects were dose dependent and not significantly affected by the serum concentrations over the range of 2.5 to 10%. In contrast, all-trans-retinoic acid (a) decreased the saturation density as effectively as retinyl acetate, but only in medium containing 10% serum; (b) significantly reduced the growth rate of cells at low density, especially at low serum concentrations; (c) had no effect upon cytoplasmic underlapping; and (d) enhanced transformation at nontoxic concentrations in medium containing 5% serum but had no effect in 10% serum. We conclude that the effects of retinoids on the growth rate and saturation density of cells in culture may not be relevant to their inhibition of neoplastic transformation. Rather, we interpret the results of our experiments on cytoplasmic underlapping as an indication that retinoids inhibit transformation by stabilizing and/or enhancing cell surface receptors involved in cell-cell contact-dependent formation of a stable monolayer. PMID- 6848181 TI - Mutagenic responses of thirteen anticancer drugs on mutation induction at multiple genetic loci and on sister chromatid exchanges in Chinese hamster ovary cells. AB - The mutagenic responses of 13 antineoplastic drugs, namely, chlorambucil, busulfan, lomustine, dacarbazine, Adriamycin, daunomycin, bleomycin, VM-26, VP16 213, ellipticine, actinomycin D, mitomycin C, and cis diamminedichloroplatinum(II) have been determined in two different assay systems in Chinese hamster ovary cells which measure mutation induction at multiple genetic loci and the frequencies of sister chromatid exchanges. The five genetic loci whose responses have been measured include those conferring resistance to 6 thioguanine (Thgr or TGr), ouabain, emetine, methylglyoxal bis(guanylhydrazone), and 5,6-dichlororibofuranosylbenzimidazole; of these, only the Thgr marker affects a function (hypoxanthine-guanine phosphoribosyltransferase, hgprt locus) which is not essential for cellular growth. All of these drugs showed a dose dependent increase in mutation frequency at the hgprt locus, but their responses at other genetic loci differed greatly and showed marked specificity for different chemical classes of the drugs. The observed locus-specific differences in response to these drugs suggest that they may differ in terms of their accessibility or affinity to different chromosomal regions. All of these drugs also led to a significant increase in the frequency of sister chromatid exchanges, and a very good correlation was observed between the activity of these drugs in the sister chromatid exchange assay and the mutagenic response of the hgprt locus. Of the drugs which were examined, VM-26, VP16-213, chlorambucil, mitomycin C, and cis-diamminedichloroplatinum(II) showed a particularly strong response in both of these assay systems. In terms of the minimum concentration which gave a mutagenic response, the drugs differed from each other by a factor of about 100,000, with actinomycin D, VM-26, and daunomycin being mutagenic in the range of 3 x 10(-8) to 1 x 10(-7) M, whereas dacarbazine produced a weak mutagenic response only at about 2 x 10(-3) M. PMID- 6848182 TI - Augmentation of carcinogenesis by N-nitrosobis(2-oxopropyl)amine administered during S phase of the cell cycle in regenerating hamster pancreas. AB - Pancreatic acinar cells in various rodent species are capable of undergoing modulation to duct-like structures upon extended exposure to pancreatic carcinogens. Although the majority of malignant pancreatic neoplasms induced in rat and guinea pig are of acinar cell origin, some adenocarcinomas closely resembling those of ductal derivation have been reported. In hamster, on the other hand, carcinoma-induced duct-like modulation of acinar cells is followed exclusively by the development of ductal adenocarcinoma. The present experiments, in which the carcinogen N-nitrosobis(2-oxopropyl)amine (BOP) was administered initially to hamsters during ethionine-induced pancreatic regeneration at a time when the maximum number of acinar cells was in S phase of the cell cycle, were undertaken to ascertain the extent and nature of acinar cell response to such treatment and the pattern of tumorigenesis. BOP was also administered weekly following the cessation of regeneration for periods ranging from 1.5 to 9 weeks to achieve total doses of 120, 90, and 40 mg of BOP per kg. Controls consisted of hamsters with normal nonregenerating pancreas that were treated with BOP on identical schedules to those of the experimental groups. The largest number of carcinomas (12 in 16 animals or 75%) developed in the highest-dose test group as compared to 10 in 26 animals or 38% in its control group. The difference was statistically significant (p less than 0.05). Other groups of hamsters with regenerating and nonregenerating pancreas receiving lower doses of carcinogen had tumor incidences which were not statistically different from one another. These experiments yielded ductal adenocarcinomas exclusively, although it is of interest that the two most common benign lesions encountered in these animals were cystadenomata often lined by zymogen-containing cells and duct-like modulation of acinar cells. Finally, in some of the animals with carcinomas, nests of duct-like structures, some of which appeared to arise from acini, were lined by severely atypical epithelium with numerous mitoses. The increased incidence and exclusive development of ductal adenocarcinoma in animals to whom carcinogen was administered during pancreatic regeneration coupled with the changes noted above are interpreted as presumptive evidence that acini may be involved in the pathogenesis of pancreatic ductal adenocarcinoma in the hamster. PMID- 6848184 TI - Tissue distribution of the tobacco-specific carcinogen 4-(Methylnitrosamino)-1-(3 pyridyl)-1-butanone and its metabolites in F344 rats. AB - The tissue distribution of the tobacco-specific N-nitrosamine, 4 (methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), in the F344 rat was studied by whole-body autoradiography and high-performance liquid chromatography. The results of the wholebody autoradiography experiments indicate that the substance is able to freely cross biological membranes and reach all tissues of the body. A high level of tissue-bound metabolites occurred in the mucosa of the ethmoturbinates, in the lung, and the liver, which are the targets for the carcinogenicity of NNK in F344 rats. However, tissue-bound radioactivity was also present in non-target tissues such as the lateral nasal gland(Steno's gland), the tracheal mucosa, and the mucosa of the nasopharyngeal duct. A high level of unbound radioactivity occurred in the preputial gland, submaxillary and adrenal glands, and the urinary and gastrointestinal systems. High localization of unbound radioactivity was observed in the stomach lumen not only after p.o. but also after i.v. administration of NNK. Analysis of extracts of the stomach contents by high-performance liquid chromatography indicated that, due to their basicity, NNK and its metabolites were trapped in the gastric juice and later reabsorbed from the intestinal tract. Analysis of unbound metabolites in various tissues and in the urine after i.v. or p.o. administration of [carbonyl-14C]NNK indicated metabolism and excretion of products resulting from alpha-carbon hydroxylation, carbonyl reduction, and pyridine N-oxidation of NNK. After p.o. administration of [14CH3]NNK, 47% of the dose was recovered as 14CO2. [carbonyl 14C]NNK, however, was not metabolized to 14CO2. Levels of in vitro metabolism of [14CH3]-NNK to 14CO2 or incorporation of radioactivity into the acid-insoluble material after incubation with [carbonyl-14C]NNK were the highest in the nasal mucosa. Thus, the high activity of NNK-activating enzymes present in the nasal cavity is apparently an important factor in the etiology of NNK-induced neuroepitheliomas. In vitro autoradiography experiments showed that NNK is metabolized in the mucosa of the ethmoturbinates, the lung, and the liver, suggesting that the tumors are induced by metabolites formed locally in the target tissues. In the lung, the labeling was higher in the bronchial tree than in the lung parenchyma. PMID- 6848183 TI - Orthotopic implantation of primary N-[4-(5-Nitro-2-furyl)-2-thiazolyl]formamide induced bladder cancer in bladder submucosa: an animal model for bladder cancer study. AB - Primary bladder tumors induced in Fischer 344 inbred rats by N-[4-(5-nitro-2 furyl)-2-thiazolyl]formamide were transplanted in syngeneic rats by the intravesical, s.c., i.v., and orthotopic routes. Attempts were made to establish bladder cancer cell lines in vitro. No success was achieved in transplantation by either the s.c., i.v., or intravesical routes when primary tumor cells were transplanted as cell suspensions. Cell suspensions of primary tumors also failed to grow in culture. However, orthotopic implantation into the bladder submucosa gave 45% success. Tumor fragments obtained from either the primary tumor or its lung metastases resulted in 10.6 and 36% tumor takes, respectively, when implanted s.c. However, after one orthotopic passage in the bladder submucosa, the tumor cells injected as cell suspension grew s.c. in 14% and orthotopically in 79% of the animals. Tumor fragments obtained from orthotopic tumors and implanted s.c. resulted in 15% tumor takes. After the second orthotopic passage, tumor cells could be grown in cultures and orthotopically in 100% of animals. The technique of orthotopic implantation as well as the usefulness of this tumor model for bladder cancer studies are described. PMID- 6848185 TI - Ultrastructural changes in the mitochondria of intestinal epithelium of rodents treated with methylglyoxal-bis(guanylhydrazone). AB - Ultrastructural studies of rats or mice treated for 24 hr with a toxic dose (100 mg/kg) of methylglyoxal-bis(guanylhydrazone) revealed the presence of damaged mitochondria in the crypt cells of the intestinal epithelium. Mitochondria were severely swollen and electron lucent, and appeared to be similar to those observed previously in a variety of cell types treated in vitro and in vivo with methylglyoxal-bis(guanylhydrazone). Since thymidine incorporation into the intestine was not found to be decreased until after 24 hr, it is concluded that the mitochondrial damage of methylglyoxal-bis(guanylhydrazone) could be responsible for the antiproliferative toxicities of the drug. PMID- 6848187 TI - Selective toxicity of rhodamine 123 in carcinoma cells in vitro. AB - The study of mitochondria in situ has recently been facilitated through the use of rhodamine 123, a mitochondrial-specific fluorescent dye. It has been found to be nontoxic when applied for short periods to a variety of cell types and has thus become an invaluable tool for examining mitochondrial morphology and function in the intact living cell. In this report, however, we demonstrate that with continuous exposure, rhodamine 123 selectively kills carcinoma as compared to normal epithelial cells grown in vitro. At doses of rhodamine 123 which were toxic to carcinoma cells, the conversion of mitochondrial-specific to cytoplasmic nonspecific localization of the drug was observed prior to cell death. At 10 microgram/ml, greater than 50% cell death occurred within 7 days in all nine of the carcinoma cell types and lines of different origin studied, while six of six normal epithelial cell types and lines remained unaffected. Cotreating carcinoma cells with 2-deoxyglucose and rhodamine 123 enhanced the inhibition of growth by rhodamine 123 alone in clonogenic survival assays. The observation of the selective toxicity of rhodamine 123 appears to be unique in view of the absence of selective toxicity reported in vitro for the various antitumor agents currently in clinical use. Preliminary results with rhodamine 123 in animal tumor systems indicate antitumor activity for carcinomas. PMID- 6848188 TI - Definition of antigenic heterogeneity and modulation among human mammary carcinoma cell populations using monoclonal antibodies to tumor-associated antigens. AB - Murine monoclonal antibodies, prepared against human metastatic mammary tumor cells, were used to demonstrate differential expression of several tumor associated antigens (TAAs) among various mammary carcinomas and within a given tumor mass. Using the immunoperoxidase technique on serial sections of 39 human primary mammary carcinomas, a spectrum of antigenic phenotypes of TAAs was observed: 13% of the tumors reacted with all of a panel of four monoclonal antibodies; while 10% of the mammary tumors scored negative with all four antibodies. The remaining 30 tumors could be divided into several additional groups based on their differential reactivity with some, but not all, of the monoclonal antibodies. Furthermore, variation among mammary carcinomas was also observed in the cellular localization of antigens. Antigenic phenotypic diversity of mammary tumor cell populations within a given tumor mass was also observed; this was noted with respect to (a) antigenic expression in one area of a tumor mass and not another and (b) a "patchwork" effect in which antigens were expressed on cells immediately adjacent to cells which scored negative. Antigenic phenotypic diversity was also observed in established mammary tumor cell lines grown in vitro. A differential loss of some cell surface TAAs was observed as a function of continued cell passage; consistent with this finding, MCF-7 mammary tumor cell lines obtained from four sources could be differentiated from each other by their pattern of cell surface TAA expression. Single-cell clones derived from the MCF-7 mammary tumor cell line exhibited at least four distinct antigenic phenotypes; a change in cell surface phenotype of some of the clones was seen during subsequent passage. This definition of phenotypic variation and modulation of TAA expression among, and within, human mammary carcinomas has implications towards both the design and the outcome of studies involving the in situ immunodetection and therapy of breast cancer. PMID- 6848186 TI - Neoplastic transformation of newborn rat oligodendrocytes in culture. AB - We have developed a model to study the neoplastic transformation of rat oligodendrocytes in culture. This procedure utilizes a technique previously developed by McCarthy and de Vellis which allows the preparation of 99% pure astrocyte and oligodendrocyte populations from 1- to 2-day-old rat cerebral cortices. Pregnant rats on the 19th day of gestation were given injections with either ethyl nitrosourea (10 micrograms/g body weight) in phosphate-buffered saline or phosphate-buffered saline, and oligodendrocyte cultures were prepared. Oligodendrocytes appear to be unstable in culture since transformation was observed with cells derived from either pups from pregnant rats either treated with nitrosourea or phosphate-buffered saline. Transformation required 78 to 108 days and 3 to 9 passages, at which time a marked increase in cellular proliferation was observed. The possibility that the transformed cells were derived from a nonoligodendroglial cell was excluded by the following evidence. Light and scanning electron micrographs of the transformed cells revealed cytological features essentially similar to those of primary oligodendroglial cultures. Furthermore, 2 biochemical oligodendroglial markers, the induction of lactate dehydrogenase by N6,O6-dibutyryl cyclic adenosine 3':5'-monophosphate and the presence of 2',3'-cyclic nucleotide 3' phosphohydrolase, were also retained. Conversely, another oligodendroglial marker, the hydrocortisone induction of glycerol phosphate dehydrogenase, was not found in any of the cell lines. These transformed cells grew as tumors when injected intracranially into 21-day-old rats. Histologically, these tumors did not appear as classical oligodendrogliomas, but their oligodendroglial origin was confirmed since the tumor tissue contained 2':3'-cyclic nucleotide 3'-phosphohydrolase activity, and the cells which grew from tumor explant cultures morphologically appeared similar to the parent cell line. The transformed cells were also characterized for in vitro properties which correlate with the expression of tumorigenicity. The transformed cells exhibited anchorage-independent growth and were agglutinated by concanavalin A treatment. Changes in fibrinolytic activity were not an exclusive property of transformed glial cells. This model should now allow us to study various mechanisms involved in the neoplastic transformation of oligodendrocytes. PMID- 6848189 TI - Radiolocalization of human mammary tumors in athymic mice by a monoclonal antibody. AB - Monoclonal antibody B6.2 reacts with a protein found on the surface of primary and metastatic human mammary tumors. B6.2 immunoglobulin G (IgG) was purified, F(ab')2 and Fab' fragments were generated by pepsin digestion, and the IgG and its fragments were radiolabeled with 125I; all were successful in localizing human mammary tumors transplanted into athymic mice, with tumor:tissue ratios increasing over a 4-day period. The 125I-labeled IgG gave tumor:spleen, tumor:liver, and tumor:kidney ratios of greater than 10:1 and tumor:brain and tumor:muscle ratios of 50:1 to 110:1. The F(ab')2 fragment gave higher tumor:tissue ratios than did the IgG, with tumor:liver and tumor:spleen ratios of 15:1 to 20:1. No localization of the labeled B6.2 monoclonal antibody or its fragments was observed in athymic mice bearing a human melanoma or with isotype identical control immunoglobulin or its fragments in athymic mice bearing the mammary tumors. Imaging experiments confirmed the ability of radiolabeled monoclonal antibody B6.2 and its fragments to detect the presence of transplanted human mammary tumor lesions of less than 0.4 cm without the aid of background subtraction manipulations. PMID- 6848190 TI - Monoclonal antibodies to an ectopically expressed alkaline phosphatase in a human malignant cell line. AB - The D98/AH-2 cell line (a subline of HeLa) expresses a form of alkaline phosphatase (ALP) which closely resembles the adult and fetal intestinal forms of ALP. To characterize this ectopic form of ALP, four monoclonal antibodies were raised against D98/AH-2 ALP, and their binding with ALPs from D98/AH-2 cells, placenta, fetal intestine (meconium), adult intestine, and liver was compared using an electrophoretic titration procedure. The ALPs were either untreated or treated with neuraminidase. All four monoclonal antibodies bound desialated D98/AH-2 ALP most strongly. Adult intestinal ALP, which does not contain sialic acid residues, reacted much more strongly than either sialated or desialated fetal intestinal ALP. Two of the four monoclonal antibodies reacted very weakly or not at all with placental ALP, but two others reacted more strongly with placental ALP than with fetal intestinal ALP. None of the antibodies reacted with liver ALP. From these results, it appears that D98/AH-2 ALP may be a modified form of adult intestinal ALP. PMID- 6848191 TI - Carcinogenicity study with technical-grade dichlorodiphenyltrichloroethane and 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene in hamsters. AB - Studies conducted by others have revealed that 1,1-dichloro-2,2-bis(p chlorophenyl)ethylene (DDE), a proximal metabolite of dichlorodiphenyltrichloroethane (DDT), is a strong hepatocellular carcinogen in mice. Since hamsters appear to be resistant to tumor induction by DDT, we wanted to investigate whether DDE has any neoplastic effect in this species. DDE (99% pure) was mixed into the diet at doses of 500 or 1000 ppm and given to groups of male and female Syrian golden hamsters for life. Another group of animals received a diet containing 1000 ppm technical-grade DDT, and a further group served as control. Groups contained a minimum of 40 hamsters per sex. The tested compounds had no effect on the incidence of tumors at all sites, compared to controls. A specific finding in animals exposed to DDE was the appearance of hepatocellular tumors late in life. They were classified as neoplastic nodules, and the incidence was 15% in females and 47% in males of the 500-ppm DDE dose groups and 21% in females and 33% in males of the 1000-ppm DDE dose groups. None of the untreated or DDT-treated animals had these tumors. Eight animals treated with 1000 ppm DDE and four of those treated with DDT had hyperplastic foci of the liver. In addition, adrenocortical adenomas, spontaneous to Syrian golden hamsters, were more frequent in DDE- and DDT-treated animals than in control animals. These results showing that DDE, but not its parental compound, induces liver cell tumors in hamsters emphasize the importance of this metabolite as a proximal carcinogen of DDT. PMID- 6848192 TI - Effect of polycyclic aromatic compounds and phorbol esters on ornithine decarboxylase and aryl hydrocarbon hydroxylase activities in mouse liver. AB - Single i.p. injections of 3-methylcholanthrene (MC; 50 mg/kg) administered to inbred C57BL/6 mice or 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD; 100 micrograms/kg) to DBA/2 mice gave an increase in the hepatic activities of ornithine decarboxylase (ODC) and aryl hydrocarbon hydroxylase (AHH) with peaks occurring by 12 and 48 hr, respectively. A single i.p. dose of the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA; 100 micrograms/kg) enhanced the activity of ODC about 70-fold within 12 hr in C57BL/6 mice and 18-fold within 24 hr in DBA/2 mice without affecting AHH activity markedly. 4-O-Methyl-12-O tetradecanoylphorbol-13-acetate (100 micrograms/kg) raised ODC activity to about 25% of the TPA-treated value in C57BL/6 mice; in DBA/2 mice, TPA and 4-O-methyl 12-O-tetradecanoylphorbol-13-acetate induced ODC activity to roughly the same level. Benzo(e)pyrene (50 mg/kg) failed to affect ODC and AHH activities significantly in either strain. The inducing effect of TPA on ODC activity was potentiated by a simultaneous administration of MC to C57BL/6 mice; combined TPA and TCDD to DBA/2 mice exerted an additive effect on hepatic ODC activity. Difluoromethylornithine administered i.p. effectively inhibited the induction of ODC activity elicited by TPA, MC, or TCDD either alone or in various combinations but did not interfere with AHH induction. These data indicate that different regulatory factors are involved in the ODC induction process elicited by TPA and polycyclic aromatic compounds and that MC and TCDD may induce ODC activity by different mechanisms. The results also confirm our earlier findings in rat skin and cells in culture which suggest that the ODC and AHH induction processes can occur independently of each other. Additionally, there is a strain-related difference in sensitivity with regard to ODC-inducing activity of TPA in the livers of C57BL/6 and DBA/2 mice. PMID- 6848193 TI - Dose-responsive growth inhibition by glucocorticoid and its receptors in mouse teratocarcinoma OTT6050 in vivo. PMID- 6848194 TI - Promotion by verapamil of vincristine responsiveness in tumor cell lines inherently resistant to the drug. AB - Cultured cell lines LL, B16, C26, and C38 established from mouse solid tumors of Lewis lung carcinoma, B16 melanoma, and colon adenocarcinomas 26 and 38, respectively, showed inherently different resistance to vincristine (VCR) in vitro. The inherent resistance to VCR of these cell lines was related to the ability of the cells to accumulate VCR. Verapamil, a calcium antagonist with coronary vasodilator activity, enhanced the cytotoxicity of VCR against these cell lines depending upon their susceptibility to VCR. C26 cells, the most resistant, became the most susceptible to VCR with a nontoxic dose of verapamil. A 12-fold increase in VCR cytotoxicity occurred. Only a 2.5-fold increase in VCR cytotoxicity was observed for B16 cells, the most sensitive cells. VCR cytotoxicity against each cell line reached almost the same level by verapamil (2.2 to 6.6 microM). Thus, the inherent resistance to VCR among the tumor lines was circumvented. Verapamil enhanced the cellular accumulation of VCR. A 3- to 4 fold increase in cellular VCR occurred in C26 cells, while approximately a 2-fold increase was observed for B16 and LL cells. A similar rate of enhancement was observed for both bound and free VCR, indicating that verapamil does not enhance the affinity of VCR to tubulin. Verapamil inhibited the outward transport of VCR from the cells. The most prominent inhibition was observed for C26 cells. Circumvention of inherent resistance of tumor cells to VCR by verapamil could be attained through an enhanced cellular accumulation of VCR in each of the tumor cells. The enhancement of VCR cytotoxicity and circumvention of inherent VCR resistance by verapamil could be explained by the cellular concentration of VCR, and also it might be related to the extent of VCR binding to tubulin in the cell. The chemotherapeutic effect of VCR is significantly enhanced by verapamil in colon adenocarcinoma 26-bearing mice. PMID- 6848195 TI - Carcinogenicity of single doses of N-nitroso-N-methylurea and N-nitroso-N ethylurea in Syrian golden hamsters and the persistence of alkylated purines in the DNA of various tissues. AB - The carcinogenicity of N-nitroso-N-methylurea (NMU) and N-nitroso-N-ethylurea (NEU) has been determined in adult male Syrian golden hamsters following a single i.p. injection or two-thirds of the acute 50% lethal dose, or 30 and 60 mg/kg, respectively. The principal site of action of these agents was the forestomach, squamous cell papillomas of this organ developing in 53 and 61% of the animals receiving the higher doses of NMU and N-nitroso-N-ethylurea, respectively. NMU also induced a low incidence of liver tumors (17%). Very few tumors were seen at other sites. The formation and removal of alkylated purines in DNA was measured in various tissues up to 50 hr after administration of [14C]NMU. Methylation products were detected in all tissues examined, the level in liver being somewhat higher than in other tissues. The removal of 7-methylguanine and 3-methyladenine from DNA occurred at approximately similar rates in all tissues examined, indicating no substantial differences in N-glycosylase activities. Removal of the promutagenic DNA lesion O6-methylguanine varied considerably from tissue to tissue; very little occurred in brain or kidney, while up to 36 and 32% were lost from DNA of intestine and testes, respectively. In the liver, there were relatively small changes in O6-methylguanine levels up to 24 hr; but by 50 hr, 38% had been removed. The persistence of O6-methylguanine relative to 7 methylguanine was highest in the DNA of the brain and intestine and lowest in that of the liver. These results indicate that in this experimental system, the formation and persistence of O6-methylguanine in DNA is insufficient alone to account for the organotropic effect of NMU. PMID- 6848196 TI - Proton-cation translocation in tumor cell mitochondria. AB - The capacity of mitochondria isolated from tumor cells to conserve the transmembrane electrochemical proton gradient set up by respiration has been studied. In a K+ medium, mitochondria from Ehrlich ascites tumor cells exhibit a capacity to conserve aerobic delta microH comparable to that displayed by normal rat liver mitochondria. Mitochondria from Morris hepatoma 3924A show a decreased capacity to store delta microH+, which is principally due to lowering of delta pH. In a Na+ medium, both species of tumor mitochondria show a significant decrease of aerobic delta pH, while delta psi is the same, with respect to rat liver mitochondria. Experiments on passive swelling show that mitochondria from ascites tumor cells have an enhanced permeability to chloride salts of monovalent cations and increased activity of the Na+ (K+)-H+ exchange system of the mitochondrial membrane with respect to normal mitochondria. The enhanced activity of this system in ascites cells is also shown by the characteristics of respiration-linked proton translocation in submitochondrial particles and subsequent anaerobic proton diffusion. It is concluded that the decreased capacity of mitochondria from tumor cells to conserve aerobic delta pH is due to enhanced cyclic flow of Na+ across the membrane. PMID- 6848197 TI - Promotion of spontaneous preneoplastic cells in rat liver as a possible explanation of tumor production by nonmutagenic compounds. AB - Foci of putative preneoplastic cells were detected in the livers of untreated aged Wistar rats of both sexes. The foci exhibited markers similar to those of their counterparts in carcinogen-treated rats such as increased cytoplasmic basophilia, clearness of cytoplasm, or expression of gamma-glutamyltransferase. Rates of DNA synthesis in foci were higher than in normal liver and were further increased by single doses of liver mitogens assumed to promote liver tumor development (phenobarbital, alpha-hexachlorocyclohexane, cyproterone acetate, nafenopin). Thus, cells in the spontaneous foci appear to possess a defect in growth control, rendering them more susceptible to endogenous and exogenous growth stimuli. This defect has been found previously in carcinogen-induced foci and may be used as a marker for putative preneoplastic cells. The spontaneous foci are present at low incidence in 8-month-old rats; at 2 years, all of 50 rats studied possessed foci. These observations suggest that nongenotoxic compounds can produce liver tumors if they promote tumor development from preneoplastic foci. Therefore, long-term bioassay for carcinogenicity will not discriminate between initiating and promoting compounds if preneoplastic lesions develop in control animals. PMID- 6848198 TI - Synthesis of antigens, cross-reactive with bovine serum albumin, by cultured neuroblastoma cells. AB - Antisera to bovine serum albumin (BSA) react with biosynthetic products of the LAN-1 neuroblastoma cell line. This immunological reaction was shown by analysis of immunoprecipitates prepared with anti-BSA and products of this cell line intrinsically labeled by the incorporation of 3H- or 35S-labeled amino acids. Moreover, antibodies in sera from two patients with neuroblastoma precipitate intrinsically labeled macromolecules produced by these tumor cells. Release of antigens cross-reactive with BSA by neuroblastomas may explain, in part, the high levels of antibody to BSA and circulating immune complexes containing hidden or "blocked" antibodies to BSA found in some patients with this tumor. PMID- 6848199 TI - Tumor progression studied by analysis of cellular features of serial ascitic ovarian carcinoma tumors. AB - Seven consecutive ascitic tumors were obtained over a 9-month period from a patient with serous adenocarcinoma of the ovary. The tumor cell populations were analyzed for cellular proliferation (labeling index, agar clonogenicity, and self renewal capacity), for cell differentiation (cell surface expression of carcinoembryonic antigen and histochemical stain for fat accumulation), and for karyotypic changes. Evidence is presented of increased aggressiveness of proliferative features together with a decreasing proportion of cells with differentiated features. Parallel temporal changes were documented in density volume characteristics of the tumor cell population, from small, high-density to large, low-density cells. The only karyotypic change identified over this period was the loss of one X-chromosome and the increased frequency of cells containing double minute bodies. The progressive characteristics described in this human tumor are not, therefore, associated with gross chromosomal changes. The accumulation of double minute chromosome bodies may be associated with a low-dose methotrexate exposure or with the tumor progression. PMID- 6848200 TI - Seasonality in the occurrence of breast cancer. AB - A nationwide study of all 3183 female patients with breast cancer in Israel diagnosed over a 7-year period (1960 to 1966) was conducted. Monthly series analysis showed a clear seasonal pattern in the symptomatology of the disease most pronounced in patients younger than 55 years, in all ethnic groups, mainly confined to cases with a nonlocalized tumor at diagnosis. Peaks occurred during spring, and troughs appeared during autumn. It is suggested that the pattern is of endogenous, probably hormonal nature, although environmental factors cannot be excluded. PMID- 6848201 TI - Pharmacokinetics of the hypoxic radiosensitizers misonidazole and demethylmisonidazole after intraperitoneal administration in humans. AB - The hypoxic radiosensitizers misonidazole or demethylmisonidazole were administered i.p. in a 2-liter volume to 6 patients affected by advanced ovarian carcinoma, and the pharmacokinetic course of the two drugs was studied. The clearance of misonidazole and demethylmisonidazole from the peritoneal fluid was 19.1 and 12.4 ml/min, respectively. At 3 hr after drug administration, both radiosensitizers had peritoneal fluid concentrations more than 8 times larger than in the plasma. The concentration x time exposure in the peritoneal fluid was 3.2 times larger than in plasma for misonidazole and 7.6 times for demethylmisonidazole. The advantage of i.p. delivery compared with systemic delivery decreases with distance from the peritoneal surface, but the advantage may be maintained for up to 1 mm or 100 cell layers. These differences between the two routes of administration provide a rational basis for the expectation that a substantial increase of the therapeutic benefits of misonidazole and demethylmisonidazole in potentiating radiation therapy or chemotherapy can be expected in treating tumors confined to the i.p. space. PMID- 6848202 TI - Clinical pharmacokinetics of 5-methyltetrahydrohomofolate. AB - DL-N5-Methyltetrahydrohomofolate (MTHHF; NSC-139490; N- [(4-[(2-(2-amino 3,4,5,6,7,8-hexahydro-4-oxo-5-methyl-6- pteridinyl)ethyl) amino) benzoyl)] -L glutamate), a new folate antagonist of relatively low toxicity, is active against experimental tumor systems resistant to methotrexate and consequently now in clinical trial. We investigated its clinical pharmacokinetics in six patients; four of them received by rapid i.v. infusion tracer doses of [N5-methyl-14C]MTHHF ranging from 13 to 16 mg/sq m, and 2 received 150 mg/sq m; the total radioactivity dose was 100 to 200 mu Ci/patient. MTHHF was assayed by radiochemical and chromatographic techniques. The elimination of MTHHF from the plasma followed a triexponential pattern, with a harmonic mean initial half-life of 20.1 min, an intermediary half-life of 4.5 hr, and a terminal half-life of 74.6 hr. The apparent volume of distribution was 1.6 liters/kg, suggesting rapid and extensive tissue binding. This, together with the low total clearance of 0.2 ml/kg/min, contributed to the long half-life of this agent. Although 68% of the administered dose was excreted in the urine on the first day, only an additional 1% was excreted on the ensuing 3 days. In the two patients who received the higher dose, very little MTHHF was found in the cerebrospinal fluid. In concentrations ranging from 25 to 500 micrograms/ml, the drug was about 50% bound to plasma protein. MTHHF was not metabolized in humans as also reported in animals. These results suggest that MTHHF is excreted in the bile to certain extent. Moreover, since it tends to localize and persist in the body, to forestall cumulative toxicity, frequent administration of this agent should be undertaken only with caution. PMID- 6848203 TI - Disposition of bisantrene in humans and rabbits: evidence for intravascular deposition of drug as a cause of phlebitis. AB - The investigational antitumor agent bisantrene (9,10-anthracenedicarboxaldehyde bis[(4,5-dihydro-1H-imidazol-2-yl)hydrazone] dihydrochloride) causes frequent local complications of phlebitis and thromboses in patients receiving the drug by peripheral venous infusion. Bisantrene pharmacokinetics was studied in five patients. Plasma elimination was biphasic with t1/2 alpha of 65 min and t1/2 beta of 1142 min; the mean apparent volumes of distribution of the central compartment and peripheral compartments were 185 and 1662 liters/sq m, suggesting extensive uptake, binding, or deposition of drug. Total body clearance was 735 ml/min/sq m, and 11.3% of drug was excreted in urine. One hr after bisantrene (260 mg/sq m) at 1 mg/ml in 5% dextrose was infused into the marginal ear vein of a rabbit, the vein was congested with blood and contained 2.1 mg precipitated bisantrene. After 24 hr, the vein was clotted and contained 1.18 mg precipitated drug. Precipitation of bisantrene appears to be related to the low solubility of the drug at physiological pH. Maximum solubility of bisantrene in human and rabbit serum was 12.7 micrograms/ml. Intravascular precipitation of bisantrene may be responsible for phlebitis and thromboses in humans receiving the drug by i.v. infusion. PMID- 6848204 TI - Prognosis in carcinoma of the urinary bladder based upon tissue blood group abh and Thomsen-Friedenreich antigen status and karyotype of the initial tumor. AB - Several markers of initial bladder carcinomas described recently may be clinically significant predictors of biological behavior of future recurrences. Comparison of the marker systems and assessment of the value of using multiple markers have been difficult, because the various markers have been studied in different patients. In this study, we compared four markers [chromosome mode, marker chromosomes, and expression of the ABH "blood group" antigens and the Thomsen-Friedenreich antigen (using immunoperoxidase or lectin immunoperoxidase methods)] in 39 patients presenting initially with low-stage bladder carcinoma and followed 3 to 11 years or until deep muscle invasion occurred. Each of the markers was significantly related to subsequent recurrences with deep muscle invasion, and each marker system was able to identify those patients with a very low risk of subsequent invasion. For detection of a subpopulation of patients with Grade II carcinomas who were at high risk for development of subsequent invasion, combinations of markers, especially hyperdiploidy and abnormal expression of the Thomsen-Friedenreich antigen, were significantly more effective than any single marker system. PMID- 6848205 TI - Controversies in coronary artery disease. PMID- 6848207 TI - Cardiac dynamics during hemorrhage. PMID- 6848206 TI - Direct effects of cholinergic stimulation on ventricular automaticity in guinea pig myocardium. AB - The purpose of these experiments was to determine whether muscarinic cholinergic agonists exerted a negative chronotropic effect in the absence of endogenous norepinephrine in isolated guinea pig ventricular myocardial strips. The chronotropic response to physostigmine (10(-6) M) in control, reserpine pretreated animals, and in the presence of increased norepinephrine release induced by superfusion of tyramine (10(-5) M), was studied. The control rates in the control, reserpine-pretreated, and tyramine-treated groups were 106 +/- 40, 93 +/- 31, 109 +/- 28/min, respectively. Propranolol (10(-6) M) produced a 23% slowing in rate in control animals and an 8% slowing in reserpine pretreated animals (P less than 0.01), suggesting basal secretion of norepinephrine. Tyramine (10(-5) M) produced a 28% increase in rate in control animals (P less than 0.05) and tyramine (10(-4) M) produced no increase in reserpine-pretreated animals. Physostigmine produced similar negative chronotropic response in control, reserpine-pretreated, and tyramine-treated groups of 45, 49, and 28%, respectively. Physostigmine produced no change in measured Purkinje fiber action potential characteristics, except for a decreased rate of spontaneous diastolic depolarization. Our results demonstrate that physostigmine slows the spontaneous rate in control, reserpine-pretreated and tyramine-treated groups, indicating that muscarinic cholinergic agonists exert a direct negative chronotropic effect at postjunctional cell surface receptors, independent of the presence or level of adrenergic tone. PMID- 6848208 TI - Detection of acute myocardial infarction in closed-chest dogs by analysis of regional two-dimensional echocardiographic gray-level distributions. AB - We hypothesized that acute myocardial infarction could be detected in standard two-dimensional echocardiograms of closed-chest dogs by evaluating regional echo amplitude distributions using computerized image analysis. We tested this hypothesis by performing standard, 2.4 MHz two-dimensional echoes before and 2 days after circumflex coronary occlusion in seven closed-chest dogs. Control and infarcted regions of interest were studied in digitized stop-frame images. Average gray level was calculated for each region of interest, and the shape of the gray-level distribution was analyzed by calculation of skewness and kurtosis and by qualitative features of shape. Average gray level increased significantly from the pre- to postocclusion images in the infarcted regions (16.7 +/- 4.2 vs. 32.4 +/- 4.4 units, P less than 0.01), but not in the control regions (17.4 +/- 4 vs. 22.3 +/- 5.5., P = NS). Average gray level could not distinguish between infarcted and normal regions within the postocclusion images (36 +/- 5.2 vs. 33.6 +/- 5.8, P = NS). Three independent observers qualitatively evaluated histogram shape and correctly identified 7/7 MI regions (100% sensitivity) and 14/20 normal regions (70% specificity). Quantitatively, infarct regions exhibited a significant decrease in kurtosis from pre- to postocclusion images (7.1 +/- 4.0 vs. 5.2 +/- 2.9, P = NS). Within postocclusion images, infarcted regions displayed a significantly lower kurtosis than did normal regions (0.27 +/- .47 vs. 2.5 +/- 1.0, P less than .01). We conclude that acute myocardial infarction may be detected in closed-chest dogs by analyzing regional echo amplitude data from standard two-dimensional echocardiograms. PMID- 6848209 TI - A simulation study of the effects of torso inhomogeneities on electrocardiographic potentials, using realistic heart and torso models. AB - The effects of torso inhomogeneities on electrocardiographic potentials were investigated via computer stimulation, using a 23-dipole heart model placed within a realistically shaped human torso model. The transfer coefficients relating the individual dipoles to the torso surface potentials, as well as the body surface potential maps, the vectorcardiogram, and the 12-lead electrocardiogram resulting due to normal activation of the heart model, were calculated for each of the following torso conditions: homogeneous, homogeneous + skeletal muscle layer, homogeneous + muscle layer + lungs, and homogeneous + muscle layer + lungs + intraventricular blood masses. The effects of each inhomogeneity were deduced by comparing results before and after its inclusion. For individual dipole transfer coefficients we confirm the validity of the "Brody effect," whereby the high conductivity blood masses augment radially oriented dipoles and diminish tangentially oriented ones. With regard to the vectorcardiogram , the electrocardiogram, and the body surface potential maps, the major qualitative effects were an augmentation of the head-to-foot component of the vectorcardiogram due to the lungs, and a smoothening of notches in the electrocardiogram (temporal filtering) and of isopotential contours in the body surface potential maps (spatial filtering) with a consequent loss of information, due to the blood masses, muscle layer, and, to a lesser extent, the lungs. Besides the above qualitative effects of the inhomogeneities, there were also large quantitative effects on the surface potentials, namely, magnitude increases due to the blood masses and magnitude decreases due to the muscle layer, that--if unaccounted for--could compromise the inverse solution of these potentials for the cardiac dipole sources. PMID- 6848210 TI - Morphometry of exercise-induced right ventricular hypertrophy in the rat. AB - In our morphometric study of the effects of exercise on the heart, male Wistar Kyoto rats at 5 weeks of age were subjected daily to a moderate treadmill running program that lasted for 7 weeks. The heart responded to physical conditioning by different magnitudes of tissue growth of the right (22%) and left (7%) ventricular myocardium, the latter change not statistically significant. The increase in right ventricular volume was associated with a 25% enlargement of ventricular area, a 26% average lengthening of the myocytes, and no change in sarcomere length and in ventricular midwall thickness. Exercise produced significant alterations in the quantitative parameters of the microvasculature of the right ventricle, but no appreciable changes in the left ventricle. Right ventricular hypertrophy was characterized by an absolute 44% growth of the endothelial luminal surface brought about through a 16% increase in capillary numerical density, and a 41% augmentation of the total length of the capillary network. Maximum diffusion distance from the capillary wall to the mitochondria of myocytes decreased 10% as a result of capillary proliferation and the lack of lateral expansion of myocyte cross-sectional area. Evaluation of the subcellular constituents of myocytes showed no change in the mitochondria:myofibrils volume ratio, indicating a growth of these components proportional to each other and to the growth of the myocyte population as a whole. It was concluded that, as a result of running exercise, right ventricular growth is analogous to eccentric hypertrophy in which the structural adaptations of the capillary bed can be expected to improve the diffusion and transport of oxygen within the tissue. PMID- 6848212 TI - Peripheral resistance after cardiac output reduction in the barodenervated cat. AB - Studies on the nervous or humoral control of total peripheral resistance are often complicated by concomitant changes in cardiac output. We studied the influence of cardiac output on peripheral resistance in the absence of modulating reflexes. In barodenervated and vagotomized cats, cardiac output was varied by graded inferior caval vein occlusion or by arterial bleeding. Total peripheral resistance was obtained with an analogue device which continuously divided the pressure difference between aorta and caval vein by cardiac output (electromagnetic flowmeter). Cardiac output reduction caused a decrease of peripheral resistance, followed within 2 minutes by a slow increase. Resistance stabilized at preocclusion levels within 5.8 (range 4-9) minutes. The relative changes in resistance and cardiac output were linearly related, when cardiac output was reduced by less than 40%. With larger reductions, the relation became nonlinear, and with a drop of more than 65%, no further change was noticed. These changes in resistance could not be explained by variations in blood viscosity as measured by Hct. They were nonnervous in nature: when all reflexes were abolished by ganglionic blockade, a similar pattern was found. Humoral mechanisms like the vasopressin or the renin-angiotensin system, known to be activated by hypotension, probably played no role, since arterial osmolality remained stable and captopril did not influence the resistance response. The involvement of metabolic autoregulation could not be excluded, but was unlikely because O2 consumption and serum lactate did not change. PMID- 6848211 TI - Mechanism of biphasic contractions in strontium-treated ventricular muscle. AB - Biphasic contractions were produced in dog trabeculae by replacing 90-95% of the calcium in the bathing solution with strontium. These conditions produced prolonged action potentials accompanied by contractions with two distinct phasic components. The early component disappeared slowly when the remaining Ca++ was removed, whereas the late component was eliminated quickly when Sr++ was removed. Manganese ion (0.25 mM) preferentially decreased the late component without changing the action potential, whereas caffeine and ryanodine decreased or eliminated the early component. Ryanodine did not alter the action potential. Isoproterenol rapidly increased the early component and, more slowly and to a lesser degree, increased the late component. The results suggest that the early component is caused by intracellular release of activator cation, probably from the sarcoplasmic reticulum, whereas the late component is the result of Sr++ entry across the sarcolemma, possibly by way of the slow inward current. PMID- 6848213 TI - Dynamic ventricular interaction in the conscious dog. AB - In nine conscious, chronically instrumented dogs, ultrasonic dimension transducers measured left ventricular anterior-posterior and septal-free wall minor axis and major axis diameters. Matched micromanometers measured right and left ventricular transmural and transeptal pressures. Ventricular pressures and volumes were varied by inflation of implanted vena caval and pulmonary artery occluders, and the functional significance of the two types of ventricular interaction, i.e., direct and series, was determined. The left ventricle was represented by a modified ellipsoidal geometry. Left ventricular stroke volume calculated from the dimension data correlated well with that measured directly from ascending aortic electromagnetic flow probes during all interventions (r greater than or equal to 0.96). Partial pulmonary artery occlusion significantly increased right ventricular diastolic and systolic pressures as compared to values obtained during control and venal caval occlusion. During pulmonary artery occlusion, latitudinal septal eccentricity was increased throughout the cardiac cycle compared to control and vena caval occlusion (P less than 0.05), indicating leftward interventricular septal shifting and significant alteration of left ventricular shape. The normalized diastolic pressure-volume curve was shifted to the left with pulmonary artery occlusion compared to control and indicated a decrease in left ventricular chamber compliance. However, when selected cardiac cycles with similar end-diastolic volumes from vena caval and pulmonary artery occlusions were compared, parameters of left ventricular systolic function (stroke volume, percent systolic shortening, peak aortic blood flow, peak left ventricular pressure, and its first derivative) remained relatively constant. These data suggest that mean myocardial fiber length is the major preload determinant of left ventricular systolic function independent of chamber pressure and shape, and that direct ventricular interaction mediated by interventricular septal shifting has minimal effects on systolic myocardial performance in this model. Thus, series ventricular interaction during acute imbalances in biventricular loading, where the output of the right ventricle determines the input of the left, seems to be far more important than direct interaction to the regulation of overall cardiac function. PMID- 6848214 TI - The potential impact of nuclear magnetic resonance imaging on cardiovascular diagnosis. AB - Nuclear magnetic resonance (NMR) is used to generate cross-sectional images of the human body that show excellent anatomic and functional definition. The NMR imaging process involves interactions between electromagnetic fields and the hydrogen nuclei being imaged. These interactions occur on time scales of milliseconds to seconds. Consequently, the motion of these nuclei, for instance, when carried by blood, produces distinct signatures that are used to assess flow in major vessels. Myocardial dyskinesis also produces visible effects. Because of these effects, NMR imaging may be a safe and effective tool in the diagnosis and assessment of cardiovascular disease. PMID- 6848215 TI - Regional blood flow during cardiopulmonary resuscitation in dogs using simultaneous and nonsimultaneous compression and ventilation. AB - We studied regional blood flow (QR) using radiolabeled microspheres and measured hemodynamic variables in 20 anesthetized dogs in normal sinus rhythm and during ventricular fibrillation treated with cardiopulmonary resuscitation (CPR). Nonsimultaneous compression and ventilation CPR (NSCV-CPR) was performed in seven dogs with a pneumatic piston that gave 50 chest compressions/min with an open airway with 10 ventilations at an airway pressure of 33 mm Hg interposed between each fifth and sixth compression. Simultaneous compression and ventilation (SCV CPR) was performed in seven dogs with the piston and in six other dogs with a circumferential pneumatic vest. Both devices gave 30 compressions/min simultaneously with 30 ventilations that elevated airway pressure to 80 mm Hg., The abdomen was bound during SCV-CPR. Regional blood flow (mean +/- SD) to the cerebral hemispheres, cardiac ventricles, and kidneys, expressed as ml/min/100 g tissue, was 3.1 +/- 4.0, 3.4 +/- 3.3 and 1.5 +/- 1.5, respectively, during NSCV CPR; 11.5 +/- 5.9, 4.9 +/- 4.7 and 2.7 +/- 2.7 during SCV-CPR (vest); and 16.2 +/ 7.2, 11.0 +/- 4.0 and 20.1 +/- 20.2 during SCV-CPR (piston) (all p less than 0.05 compared with NSCV-CPR). These results indicate that QR to all organs studied is reduced below normal sinus rhythm levels during CPR for ventricular fibrillation, QR to the brain is proportionately greater than QR to the heart and kidneys, and QR to the brain is greater with both forms of SCV-CPR than with NSCV CPR. PMID- 6848216 TI - Augmentation of cerebral perfusion by simultaneous chest compression and lung inflation with abdominal binding after cardiac arrest in dogs. AB - Recent studies have demonstrated that for the same chest compression force during mechanical cardiopulmonary resuscitation (CPR), the carotid artery-to-jugular vein pressure gradient and carotid blood flow are increased when the phasic rise of intrathoracic pressure is enhanced by abdominal binding and simultaneous ventilation at high airway pressure with each chest compression (SCV). The objective of the present study was to assess whether cerebral blood flow is also enhanced, since it is known that fluctuations in intrathoracic pressure are transmitted to the intracranial space and affect intracranial pressure (ICP). In two series of pentobarbital-anesthetized dogs, one of two CPR techniques was initiated immediately after inducing ventricular fibrillation. Brain blood flow was measured by the radiolabeled microsphere technique immediately before cardiac arrest and at 1 and 3 minutes after commencing CPR. Evidence of adequate mixing of spheres and lack of sedimentation under these low-flow conditions was verified by correlation with brain venous outflow, comparison of the arterial concentration-time profile of spheres and a nonsedimentary marker (thallium-201 in solution), and use of multiple arterial sampling sites. During SCV CPR with abdominal binding, mean carotid artery pressure (60 +/- 3 mm Hg) was higher than that during conventional CPR (25 +/- 2 mm HG). Pulsations of ICP occurred that were in phase with chest compression and greater than jugular venous pressure. Mean ICP was higher during SCV (46 +/- 2 mm Hg) than conventional CPR (20 +/- 2 mm Hg). However, the net brain perfusion pressure gradient (carotid artery pressure - ICP) was greater with SCV (14 +/- 3 mm Hg) than with conventional CPR (5 +/- 0.4 mm Hg). Cerebral blood flow was significantly greater during SCV CPR (32 +/- 7% of prearrest cerebral flow) than during conventional CPR (3 +/- 2%). We conclude that SCV CPR combined with abdominal binding substantially improved brain perfusion by enhancing cerebral perfusion pressure in this experimental model. PMID- 6848217 TI - Outcome in one-vessel coronary artery disease. AB - We analyzed the clinical outcomes in 688 patients with isolated stenosis of one major coronary artery. The survival rate among patients with disease of the right coronary artery (RCA) was higher than that among patients with left anterior descending (LAD) or left circumflex coronary artery (LCA) disease. The survival rate among patients in all three anatomic subgroups exceeded 90% at 5 years. The presence of a lesion proximal to the first septal perforator of the LAD was associated with decreased survival compared with the presence of a more distal lesion. For the entire group of one-vessel disease patients, total ischemic events (death and nonfatal infarction) occurred at similar rates regardless of the anatomic location of the lesion. Left ventricular ejection fraction was the baseline descriptor most strongly associated with survival, and the characteristics of the angina had the strongest relationship with nonfatal myocardial infarction. No differences in survival or total cardiac event rates were found with surgical or nonsurgical therapy. The relief of angina was superior with surgical therapy, although the majority of nonsurgically treated patients had significant relief of angina. The survival rate of patients with one vessel coronary disease is excellent, and the risk of nonfatal infarction is low. Clinical strategies for the care of these patients must consider the long-term clinical course of one-vessel coronary disease. PMID- 6848218 TI - Comparative sensitivity of exercise, cold pressor and ergonovine testing in provoking attacks of variant angina in patients with active disease. AB - Exercise, ergonovine and the cold pressor test have been used to provoke variant angina attacks. The sensitivity of these three tests was compared in 34 hospitalized patients with well documented, active variant angina who had recently undergone coronary arteriography. The three tests were usually performed on three consecutive days, and 28 of the 34 had the three tests within 1 week. Angina was provoked by ergonovine in all 34 patients, by exercise in 17 and by cold pressor test in only five (p less than 0.005). ST elevation developed during the ergonovine test in 32 (94%), during exercise in 10 (29%) and during the cold pressor test in only three (9%). With ergonovine, one patient had only ST depression and one had no ECG changes. During the cold pressor test two patients had pseudonormalization of abnormally negative T waves and 29 had no ECG changes. Exercise induced T-wave pseudonormalization in four patients, ST depression in nine others and no ECG changes in 11. ST elevation was more frequent with ergonovine than with either of the other tests (p less than 0.0001). ST elevation or T-wave pseudonormalization occurred more often with exercise than with cold (p less than 0.05), but both occurred less often than with ergonovine (p less than 0.0001). We conclude that the sensitivity of the ergonovine test is very high in patients with active variant angina and that exercise will provoke angina with ST elevation in about 30% of these cases. In contrast, the sensitivity of the cold pressor test is too low to be of much clinical value in the diagnosis of variant angina. PMID- 6848219 TI - Increased regional myocardial stiffness of the left ventricle during pacing induced angina in man. AB - The left ventricular diastolic pressure-volume relationship shifts upward during angina, but why this happens is not known. To assess regional myocardial stiffness, we studied 12 patients who had coronary artery disease using simultaneous left ventricular micromanometer pressure recording and M-mode echocardiography before and during angina induced by pacing tachycardia. All patients had two- or three-vessel coronary artery disease that involved the posterior left ventricular wall circulation and had positive pacing stress tests, i.e., development of angina and a postpacing rise in left ventricular end diastolic pressure (15 +/- 3 to 31 +/- 6 mm Hg, p less than 0.001). A marked upward shift in the relationship between the diastolic left ventricular pressure and the posterior wall thickness (h) occurred after pacing tachycardia, but the change in left ventricular posterior wall end-diastolic thickness was minimal (8.9 +/- 2.1 to 9.2 +/- 2.1 mm, NS). After pacing, the peak rate of left ventricular posterior wall thinning decreased (82 +/- 37 to 48 +/- 27 mm/sec, p less than 0.005) and the time constant of relaxation derived from the best exponential fit to the isovolumic left ventricular pressure decay increased (49 +/- 5 to 58 +/- 7 msec, p less than 0.001). Diastolic active left ventricular pressure decay, extrapolated from the exponential fit, was subtracted from the measured left ventricular pressure (which is equal in magnitude but opposite in sign to the radial stress at the endocardium) to calculate residual left ventricular pressure (PR) and hence residual stress (sigma R = -PR). A radial stiffness modulus (ER) was determined by the slope of the PR vs log h plots before and after pacing. Over the same range of residual radial stress (sigma R), ER was always higher during pacing-induced angina, indicating increased residual myocardial stiffness. Increased myocardial stiffness in addition to a decreased rate of wall thinning and slow active pressure decay contribute to the upward shift in left ventricular pressure-wall thickness and pressure-volume relationships during pacing-induced angina. PMID- 6848220 TI - Effect of rate on left ventricular volumes and ejection fraction during chronic ventricular pacing. AB - Resting left ventricular (LV) function was evaluated in 22 patients with permanent ventricular pacemakers. LV ejection fraction and volume indexes were determined by gated blood pool scintigraphy at ventricular pacing rates of 50-100 beats/min. In patients with a normal heart size, increases in pacing rates resulted in significant linear decreases in stroke volume index and ejection fraction. However, end-systolic volume index and cardiac index did not change. Patients with cardiomegaly appeared to respond differently. End-diastolic volume index decreased significantly as the pacing rate was increased from 50 to 100 beats/min. Ejection fraction was significantly reduced only at pacing rates of 90 and 100 beats/min. Mean cardiac index was highest at ventricular pacing rates of 70-90 beats/min. Increases in cardiac index, achieved by increasing the pacing rate, were maintained over a 4.3-month follow-up. Patients with underlying sinus rhythm had a 27% increase in cardiac output in association with an increase in ejection fraction from 55% to 62% when sinus rhythm was compared to ventricular pacing at a rate of 60 beats/min. These data suggest that patients with cardiomegaly have a narrow range of optimal pacing rates at rest. PMID- 6848221 TI - Prognosis of patients with acute pulmonary edema and normal ejection fraction after acute myocardial infarction. AB - To assess the prognostic importance of resting left ventricular function in survivors of acute myocardial infarction with pulmonary edema, we retrospectively identified 39 consecutive patients who presented with acute pulmonary edema and myocardial infarction. Sixteen patients had radionuclide ejection fractions 10 +/ 2 days postinfarction of greater than 0.45 (group A, mean 0.55 +/- 0.06), and 23 patients had ejection fractions less than or equal to 0.45 (group B, 0.32 +/- 0.06). There were no significant differences between the two groups for age or sex, but group A patients had a significantly greater incidence of first myocardial infarction predominantly inferior in location. The calculated stroke work index during the acute event was significantly greater in group A than in group B (33.4 +/- 2.4 vs 23.4 +/- 2.0) (p less than 0.05). During a follow-up of 9 +/- 3 months, mortality was not significantly different between the two groups: Four (25%) died in group A and seven (30%) died in group B. In addition, eight patients (50%) in group A were hospitalized for recurrent angina, new myocardial infarction or recurrent pulmonary edema, compared with 11 (48%) in group B (NS). Three deaths in group A were preceded by infarction of the anterior wall of the left ventricle, confirmed at autopsy, and two nonfatal infarctions were anterior by electrocardiography. Four patients in group A had coronary arteriography performed during the follow-up period because of unstable angina, and all had significant (greater than or equal to 70% stenosis) three-vessel disease and two had left main coronary artery disease. Therefore, the predischarge ejection fraction did not predict prognosis for this group of patients. Patients with acute pulmonary edema in the course of myocardial infarction form a high-risk group despite good resting left ventricular function at discharge. They have a significant incidence of recurrent myocardial infarction and death and, because they have good residual left ventricular function, are excellent candidates for surgical intervention. PMID- 6848222 TI - Ventricular septal defect after myocardial infarction: diagnosis by two dimensional contrast echocardiography. AB - Thirteen patients who had ventricular septal defects (VSDs) after myocardial infarction (MI) underwent two-dimensional echocardiography (2-D echo), with confirmation of the VSD by oximetry. Eight of the patients were male and five were female, ages 51-76 years. Five had anterior and eight inferior MIs. Two dimensional echocardiography revealed akinesis or dyskinesis of the interventricular septum (IVS) in all 13 patients. In only six could a defect in the IVS be directly visualized. Two-dimensional echocardiographic left ventricular (LV) wall motion abnormalities correlated with ECG and angiographic site of infarction in all patients. Twelve patients had adequate saline contrast studies. Positive LV contrast (microbubbles entering the left ventricle through the VSD) was seen in 11 patients, and negative right ventricular (RV) contrast (washout of the RV bubbles by LV blood crossing the VSD) in five patients; at least one abnormality was present in every patient. The location of the VSD was determined by visualizing a VSD or by the site of the positive LV or negative RV contrast. Oximetry showed VSD shunts of 1.4:1 to 7:1, with no correlation between the degree of negative RV contrast and shunt size. Surgical or pathologic confirmation of VSD was obtained in 12 patients, with agreement of VSD location by 2-D echo in all. Four of the 11 patients who underwent surgical repair died, and two patients died before surgery could be attempted. We conclude tht 2-D echo is a sensitive, rapid and safe technique for diagnosing VSD after MI. Positive LV contrast, with or without negative RV contrast, is more sensitive in the diagnosis and localization of post-MI VSD than direct echocardiographic visualization of the defect. PMID- 6848223 TI - Two-dimensional echocardiographic diagnosis of left-atrial thrombus in rheumatic heart disease. A clinicopathologic study. AB - Two-dimensional echocardiographic studies were performed in 293 patients with rheumatic heart disease who underwent open-heart mitral valve surgery during an 18-month period. Diagnostic confirmation of a left atrial thrombus was based on direct inspection of the left atrium during surgery and histopathologic examination. Two-dimensional echocardiographic recordings were reviewed. Of the 293 patients, 33 had left atrial thrombi by two-dimensional echocardiographic criteria. This diagnosis was confirmed at surgery and histopathologic study in 30 (specificity 98.8%). A thrombus was not found in three patients. In 21 other patients, left atrial thrombi were present but were not detected by two dimensional echocardiography (sensitivity 58.8%). Ten of these 21 had thrombi in the left atrial cavity. In 11 patients, thrombi were located in the left atrial appendage, all of which were missed by two-dimensional echocardiography. Excluding these 11 left atrial appendage thrombi, the sensitivity of two dimensional echocardiography for detecting left atrial cavity thrombi was 75.0%. PMID- 6848224 TI - Anatomic validation of left ventricular mass estimates from clinical two dimensional echocardiography: initial results. AB - We performed a prospective anatomic validation study to determine the accuracy of left ventricular (LV) mass estimates from clinical two-dimensional echocardiographic (2-D echo) studies. In 21 subjects, antemortem 2-D echo LV mass determinations were compared with anatomic LV weight by postmortem chamber dissection. Major cardiac diagnoses included anatomic LV aneurysm in four, status post aneurysmectomy in one, transmural myocardial infarction in seven, congestive cardiomyopathy in five, rheumatic mitral disease in two, chronic severe mitral or aortic regurgitation in three, amyloid heart in two, and normal heart in three. Marked right-heart dilatation was present in 11 patients and LV thrombus in four. Regression equations derived in vitro for each 2-D echo instrument were used to correct LV mass estimates based on a short-axis, area-length method: uncorrected LV mass = 1.055 x k x 5/6 (AtLt - AcLc) + b, where At = total short-axis LV image area at the high papillary muscle level, Lc = endocardial LV length, k = an instrument-specific regression slope and b = an instrument-specific intercept. LV mass by 2-D echo correlated extremely well with actual LV weight (r = 0.93 slope = 0.85, SEE = 31 g, range 77-454 g). In contrast, M-mode echocardiographic LV mass estimates were less reliable (r = 0.86, SEE = 59 g) in these markedly distorted hearts. These 2-D echo LV mass results compare favorably with reported results from biplane angiography and M-mode echocardiography in more symmetric hearts. Thus, regression-corrected 2-D echo may be the method of choice for determining LV mass in man. PMID- 6848225 TI - Alterations in left ventricular three-dimensional dynamic geometry and systolic function during acute right ventricular hypertension in the conscious dog. AB - Fifteen chronically instrumented, conscious dogs were studied to determine whether, in the intact circulation, mechanical interactions dictated by the anatomic contiguity of the two ventricles significantly alter left ventricular (LV) dynamic geometry and systolic function during acute right ventricular (RV) hypertension. The three-dimensional geometry of the left ventricle was monitored with three pairs of ultrasonic dimension transducers; ventricular pressures were measured with micromanometers. Data collected during pulmonary artery constriction (RV pressure 68 +/- 8/7 +/- 4 mm Hg) were compared with control data collected at matched heart rates (RV pressure 32 +/- 8/4 +/- 4 mm Hg). During pulmonary artery constriction, mean calculated LV end-diastolic volumes decreased from 69.2 +/- 20.0 to 56.2 +/- 21.3 cm3 (p less than or equal to 0.05). Mean systolic stroke volume decreased from 20.6 +/- 5.5 to 14.0 +/- 6.3 cm3 (p less than or equal to 0.05). These changes were entirely accounted for by alterations in the behavior of the LV septal-free wall minor axis and rearrangements in LV equatorial geometry. When the pulmonary artery was constricted, elongation of the septal-free wall axis occurred during isovolumic systole and was accompanied by a reciprocal decrease in anterior-posterior dimension. Most of the decrease in septal-free wall dimension occurred during relaxation and early diastole rather than during ejection. Mean septal-free wall end-diastolic dimension decreased from 5.45 +/- 0.69 to 4.90 +/- 0.75 cm (p less than or equal to 0.05). The mean systolic decrease in septal-free wall dimension fell from 0.36 +/- 0.18 to 0.14 +/- 0.22 cm (p less than or equal to 0.05). The end-diastolic dimensions and systolic shortening of the LV anterior-posterior minor axis and base-apex major axis were not significantly altered by pulmonary artery constriction. These findings suggest that during acute RV hypertension, impairment of LV systolic function and rearrangements in LV dynamic geometry are primarily the result of the anatomic contiguity of the two ventricles. PMID- 6848227 TI - The effect of variations of pulsed Doppler sampling site on calculation of cardiac output: an experimental study in open-chest dogs. AB - We measured aortic flow by two-dimensional Doppler echocardiography in an open chest dog model to examine how variations in Doppler sample volume length and position influence aortic hemodynamic flow calculations. Fourteen dogs underwent right-heart bypass, in which venous return from the venae cavae drained by gravity to a reservoir. A variable-speed roller pump returned the blood to the pulmonary artery, fixing left-sided cardiac input and output. Echo Doppler measurements were performed using a 3.5 MHz transducer placed directly on the aortic arch to determine internal aortic cross-sectional area. The transducer was then directed to image the aortic arch for Doppler velocity measurements and the various sampling sites were investigated. Doppler cardiac output could then be determined for each of the various sample volumes over a range of known roller pump settings. Doppler velocity was analyzed using fast Fourier transform spectral analysis. Mean velocity over the cardiac cycle was obtained by planimetry of the area under the Doppler velocity curve with a minicomputer. Doppler-derived determinations of cardiac output achieved a correlation of r = 0.98-0.99 to values obtained by the roller pump over a range of cardiac outputs from 0.75-5 l/min. The standard error of the estimate was 0.21/min. In this laminar flow model, there was no difference between the predictive accuracy of any of the sampling sites over the range of roller pump flows. Our study shows that Doppler velocity measurements can be used to quantify aortic flow over a clinically useful range and that variations of sample length and position did not produce significant differences in calculated flows. PMID- 6848226 TI - Echocardiographic tissue characterization and range-gated Doppler ultrasound for the diagnosis of pulmonary embolism. AB - We evaluated reflection and absorption indexes of ultrasound as well as Doppler estimates of intrapulmonary blood flow for diagnosing pulmonary embolism. The pulmonary reflection coefficient (PRC), coefficient of tissue attenuation (alpha R) and range-gated blood Doppler signals were studied in 25 patients with pulmonary embolism, 19 with pneumonia, nine with atelectasis, 20 with congestive heart failure, 20 with chronic obstructive lung disease and 10 normal subjects. The PRC was significantly diminished in pulmonary embolism, pneumonia and atelectasis, but was not altered by underlying chronic obstructive lung disease or congestive heart failure. The alpha R in pulmonary embolism was 1.03 +/- 0.04 db/MHz cm, significantly lower than that for pneumonia, 1.48 +/- 0.03 db/MHz cm (p less than 0.001), but not significantly different from that for atelectasis, 0.95 +/- 0.05 db/MHz cm. Doppler signals indicating blood flow in the affected area of lung were present in only two of 25 patients with pulmonary embolism, compared with seven of nine with atelectasis and 17 of 19 with pneumonia. The combined use of PRC, alpha R and blood Doppler signals correctly diagnosed pulmonary embolism in 23 of 25 patients. Thus, ultrasound offers a reliable noninvasive method for diagnosis of pulmonary embolism. PMID- 6848228 TI - The use of Doppler flow velocity measurement to assess the hemodynamic response to vasodilators in patients with heart failure. AB - To determine if the hemodynamic response to vasodilator therapy can be assessed noninvasively by pulsed Doppler velocimetry, we compared the hemodynamic changes after treatment to changes in Doppler aortic blood flow measurements. The relationship between the absolute values and percent changes of invasively measured systemic vascular resistance (SVR) and stroke volume (SV) and Doppler measured peak flow velocity (PFV), left ventricular ejection time (ET) and flow velocity integral (FVI) were evaluated. Measurements were made during 18 drug interventions in 13 patients treated with vasodilator agents for congestive heart failure (CHF). A poor correlation was found between the absolute values of either SVR or SV and the absolute values of each of the three Doppler aortic blood flow indexes studied. In contrast, a good correlation was found between percent changes in aortic PFV and in SVR (r = -0.89), and between percent changes in Doppler aortic FVI and in SV (r = 0.88). The correlation between percent changes in SVR and FVI revealed an r value of -0.65, while the correlation between percent changes in SVR and in ET showed an r value of -0.15. Percent changes in SV and either PFV or ET correlated with r values of 0.75 and 0.70, respectively. We conclude that Doppler aortic blood flow measurement can be used to assess quantitative changes in SVR and SV after vasodilator therapy. These findings suggest that it may be useful for evaluating vasodilator drug therapy in patients with CHF. PMID- 6848229 TI - Origin of the third heart sound. I. Studies in dogs. AB - We studied 13 anesthetized dogs in which a third heart sound (S3) was repeatedly induced by hypoxemia plus fluid overload. A miniature accelerometer with a mass of about 1.1 g was applied at three levels--intact chest wall over cardiac apex, in the pericardium and on the epicardium--to record motion of the structures under observation as well as sound. Intraventricular pressure and sound were monitored using a Millar catheter. Application of two accelerometers simultaneously over the epicardium permitted observation of the chronologic sequence of ventricular wall dynamics in early diastole. The S3 at each level occurred simultaneously with the sudden onset of reduced acceleration, or negative jerk. These dynamic phenomena were maximal at or near the cardiac apex. We conclude that the event that triggers the S3 is a sudden intrinsic limitation of longitudinal expansion of the left ventricular wall. PMID- 6848230 TI - Origin of the third heart sound. II. Studies in human subjects. AB - We report noninvasive and invasive studies designed to clarify the mechanism of the third heart sound (S3) in humans. The noninvasive observations were made using a miniature accelerometer attached to the skin surface at the cardiac apex. In subjects with no S3, the tracings were either flat or showed very low undulations throughout diastole. Those with an S3, however, demonstrated a distinct reduction of acceleration, or negative jerk, of the rapid filling movement at the apex at the time of the sound. The invasive studies in the cardiac catheterization laboratory consisted of frame-by-frame measurements of left ventricular dimensions in the transverse and long axes during early diastole in patients with diastolic overload abnormalities to investigate the temporal sequence of filling in these two principal axes. The maximal long-axis filling rate occurred after the short axis, a finding that helps to resolve a discrepancy noted in the time of maximal short-axis filling and S3 production. These studies support the concept that the S3 is due to a sudden intrinsic limitation of longitudinal expansion of the left ventricular wall during early diastolic filling, resulting in a negative jerk that is transmitted to the skin surface. PMID- 6848231 TI - Physical fitness and blood pressure in school children. AB - We studied the relationship between physical fitness and blood pressure in 228 school children. The data were collected as part of the Loma Linda Child Adolescent Blood Pressure Study. Systolic and diastolic blood pressures were lower in children above average fitness than in children below average fitness among preadolescent and adolescent boys and girls. On multivariate analysis, adjusting for skinfold thickness, an index of lean arm mass, height and age, the relationship between fitness and systolic blood pressure was statistically significant for preadolescent boys and for adolescents of both sexes. The multivariate relationship was not clearly seen for diastolic blood pressure. Multivariate techniques showed that significant correlates of fitness were obesity in preadolescents, age in adolescent boys and height in adolescent girls. Predicted pulse rates for stages 6-10 of a modified Balke treadmill protocol are given in appendix 1 for preadolescent and adolescent boys and girls. PMID- 6848232 TI - The effects of reperfusion and retrograde coronary flow bleeding after coronary occlusion on induced electrical instability in the dog. AB - Reperfusion achieved by streptokinase infusion early after myocardial infarction (MI) is now being performed in patients, but the effect on electrical instability of increasing or decreasing perfusion in the region at risk for MI is unknown. Accordingly, 34 dogs were randomized to control (13 dogs), reperfusion (11 dogs) and retrograde bleeding (10 dogs) groups. All dogs underwent coronary artery occlusion (23 of the left anterior descending and 11 of the circumflex artery). In the control dogs, occlusion was permanent. In the reperfused dogs, the occlusion was released at 2 hours. In the retrograde bleeding dogs, retrograde flow bleeding distal to the occlusive tie was continued for 2 hours after coronary occlusion. Four days later, all dogs underwent a standard right ventricular pacing protocol. Induced arrhythmias were scored; ventricular fibrillation was assigned the highest score, followed by sustained ventricular tachycardia, nonsustained ventricular tachycardia and repetitive ventricular response. Arrhythmias provocable later in diastole were assigned higher scores than those provocable early in diastole. Infarct size was not different in the three groups (35%, 28% and 39% of the area at risk in control, reperfusion and retrograde bleeding groups, respectively). However, the electrical instability index was lower in the reperfusion group than in the other two groups (e.g., electrical instability index A at 200 beats/min: p less than 0.005 for reperfusion vs control; p less than 0.01 for reperfusion vs retrograde bleeding). Retrograde bleeding did not alter the electrical instability index from the control state. These results suggest that despite no significant reduction in infarct size, reperfusion after infarction may reduce electrical instability. PMID- 6848233 TI - Effects of oral verapamil in patients with atrioventricular reentrant tachycardia incorporating an accessory pathway. AB - In 14 patients with atrioventricular reentrant tachycardia incorporating an accessory pathway, electrophysiologic studies were performed before and serially at 0.5--1-hour intervals for 6 hours after the fourth dose of 80 mg of oral verapamil given every 6 hours. Verapamil increased both the longest atrial paced cycle length producing type 1 atrioventricular block and the effective refractory period of the atrioventricular conduction system at all measurements. Before verapamil, sustained tachycardia could be induced in all 14 patients. After verapamil, six patients had induction of echo beats alone at all measurements, and in eight patients nonsustained or sustained tachycardia could be induced, particularly after the fourth hour. Follow-up study with oral verapamil at the same dosage in 13 patients for 7 +/- 5 months (+/- SD) revealed that the six patients with induction of echo beats alone have been free of symptomatic arrhythmia, while six of the remaining eight patients had occasional attacks of sustained tachycardia. Thus, oral verapamil increases atrioventricular nodal refractoriness, with an effect lasting up to 6 hours. Electrophysiologic study performed 5-6 hours after verapamil can be used to predict clinical responses in patients with atrioventricular reentrant tachycardia. PMID- 6848234 TI - Evidence of a reentry circuit in the common type of atrial flutter in man. AB - To investigate the mechanism of atrial flutter (AF) in humans, we studied 13 patients during episodes of spontaneous common AF, with simultaneous multiple atrial endocavitary recordings and atrial programmed stimulation. In all patients, low paraseptal atrial activation preceded high right atrial activation, and the latter preceded mid- or low lateral right atrial activation (recorded in five patients). Programmed atrial stimulation resulted in early reset of the AF cycle, with an unchanged poststimulation AF activation pattern. The poststimulation cycle recorded from an even potential to the site of stimulation was always shorter than the basic flutter cycle length. The poststimulation cycle recorded at the site of stimulation was always equal to or longer than the flutter cycle length. These results strongly favor the existence of a reentry circuit to which the extrastimulus has access. PMID- 6848235 TI - Reevaluation of enhanced atrioventricular nodal conduction: evidence to suggest a continuum of normal atrioventricular nodal physiology. AB - The syndrome of enhanced atrioventricular nodal (AVN) conduction has been defined arbitrarily by: AH interval during normal sinus rhythm (AH-NSR) less than or equal to 60 msec; shortest right atrial pacing cycle length (PCL) maintaining 1:1 AVN conduction (shortest PCL 1:1) less than or equal to 300 msec; and at the shortest PCL 1:1, an increase in the AH interval from AH-NSR (delta AH) less than or equal to 100 msec. We examined the relationship between AH-NSR, shortest PCL 1:1, and delta AH in 160 consecutively studied patients who did not have accessory AV pathways or second-degree AV block to determine whether a distinct subgroup of patients with unusually rapid AVN conduction properties could be identified. The frequency distribution of each of the variables was unimodal and continuous. Cluster analysis, combining the three variables, failed to reveal a distinct subgroup at the lower end of the spectrum. Sixty-six patients (41%) had AH-NSR less than or equal to 60 msec, 36 (23%) shortest PCL 1:1 less than or equal to 300 msec, 76 (48%) delta AH less than or equal to 100 msec, and 17 (11%) all three criteria. The shape of the AH vs atrial PCL curve was independent of shortest PCL 1:1. Neither delta AH nor the terminal slope of the curve for AH vs atrial PCL (measured over the 20-40 msec before Wenckebach block) was related to AH-NSR or shortest PCL 1:1. We conclude that a subgroup cannot be identified by AH-NSR, shortest PCL 1:1, and delta AH, and that enhanced AVN conduction as previously defined represents simply one end of the continuous spectrum of normal AVN physiology. PMID- 6848236 TI - Analysis of interectopic activation patterns during sustained ventricular tachycardia. AB - We analyzed the patterns of interectopic continuous electrical activity recorded within interectopic intervals of sustained ventricular tachycardias. These arrhythmias were induced in dogs that were studied 4 days after left anterior descending coronary artery occlusion. Standard ECG leads and electrograms from the His bundle and left ventricular epicardium, both infarct and normal zone, were recorded. In 19 of 24 dogs with transmural myocardial infarction, one to three ventricular paced beats induced sustained ventricular tachycardia, characterized by continuous electrical activity between the initiating and spontaneous ectopic beat and between successive ectopic beats recorded from the epicardium over the infarct zone but not from the normal epicardium. Continuous activity consisted of discrete potentials that were reproduced in each cardiac cycle, suggesting slow conduction within a reentrant circuit. The interectopic activity was divided into three distinct temporal periods, delineated by potentials occurring at the initial portion, the mid-interectopic portion and terminal portion or exit of the slow conduction segment of the presumed reentrant circuit. In some cases, sustained ventricular tachycardia was induced only if an appropriate initial potential was engaged. Spontaneous termination of the sustained ventricular tachycardia was associated with Wenckebach-like block of conduction in the initial or exit potential. Ventricular pacing caused alteration of the interectopic patterns and resulted in cessation of the arrhythmia. Procainamide produced dose-dependent slowing of the ectopic rate due to depression of conduction in the mid-interectopic portion of the continuous electric activity. Inducibility of the sustained ventricular tachycardia was inhibited by decremental conduction in this compartment of the presumed reentry circuit. The present study uses a preparation showing sustained ventricular tachycardia that is stable and regular. Functional analysis of the various portions of the continuous electrical activity during sustained tachycardias allows further insight into the mechanisms of initiation and termination of sustained ventricular tachycardias. The ability to localize the effect of antiarrhythmic drugs on specific portions of a possible reentrant circuit may provide important correlative data for the analysis and interpretation of detailed epicardial mapping studies. PMID- 6848237 TI - Termination of ventricular tachycardia by single extrastimulation during the ventricular effective refractory period. AB - Termination of ventricular tachycardia by low-energy shocks delivered during the ventricular refractory period has been reported. We describe a case of reproducible termination of multiple episodes of sustained ventricular tachycardia by a low-current extrastimulus delivered during the effective refractory period of the right ventricle, from the distal bipole of a quadripolar electrode catheter. PMID- 6848238 TI - Primary pulmonary artery sarcoma diagnosed noninvasively by two-dimensional echocardiography. AB - A 21-year-old white male was evaluated in our echocardiographic laboratory for presumed mitral valvular bacterial endocarditis. Electrocardiographic, physical, and initial two-dimensional echocardiographic findings suggested a left-to-right shunt at the atrial septal level. However, injection of contrast saline solution failed to demonstrate signs of an atrial septal defect. Continuation of the echocardiographic study led to the diagnosis of an unsuspected primary sarcoma of the pulmonary trunk, which was rapidly confirmed by computerized axial tomography. Therapeutic interventions were undertaken. This case highlights the usefulness of two-dimensional echocardiography. PMID- 6848240 TI - Severe pulmonary hypertension associated with a small ventricular septal defect. AB - A case of progressive pulmonary hypertension in a child with a small ventricular septal defect is presented. Natural history studies have indicated that children with small ventricular septal defects can be followed conservatively. This case represents a contradiction to that rule and suggests that further study must be directed toward defining the etiology of pulmonary hypertension in patients with congenital heart disease. PMID- 6848241 TI - Effect of exercise on labeled blood pool activity. PMID- 6848239 TI - Total disconnection of the right ventricular free wall: surgical treatment of right ventricular tachycardia associated with right ventricular dysplasia. AB - Arrhythmogenic right ventricular dysplasia is a myopathy that affects the right ventricular free wall (RVFW) and gives rise to recurrent reentrant ventricular tachycardia (VT). Because the entire right ventricle is potentially arrhythmogenic, ablating a single site of VT may not eliminate the arrhythmia. We developed an operation to confine any arrhythmic activity arising from the right ventricle to that chamber: total disconnection of the RVFW from the left ventricle. We performed RVFW disconnection in two patients with refractory VT associated with arrhythmogenic right ventricular dysplasia. At least two sites or origin of morphologically distinct VT were identified in the RVFW in each patient. RVFW disconnection was carried out under normothermic cardiopulmonary bypass. An encircling incision was made along the attachment of the RVFW to the aortoventricular unit and the tricuspid annulus; the right coronary artery and its RVFW branches were left intact. Electrical activity of the two chambers became dissociated, and VT arising from the RVFW was confined to that chamber. Postoperatively, there was no clinical evidence of hemodynamic impairment (follow up 4 months and 3 months). Left ventricular function was unchanged and right ventricular flow was maintained by atrial contraction and motion of the septum toward the RVFW during left ventricular systole. One patient had incessant right ventricular tachycardia confined to the RVFW for 3 weeks. We conclude that RVFW disconnection is feasible and applicable to patients with refractory VT originating in the diffusely diseased RVFW. PMID- 6848242 TI - Postural response and baroreceptor abnormalities in chronic CHF. PMID- 6848243 TI - Mechanisms of parasystole. PMID- 6848244 TI - Multivariate analysis of plasma enzyme profiles in severe head injury. AB - We followed the changes in the activities of four enzymes (aldolase, aspartate aminotransferase, creatine kinase, and lactate dehydrogenase) in plasma for four days after head injury. The progression of the changes differs significantly between survivors and nonsurvivors. Stepwise discriminant analysis, involving the four enzymes, allowed us to divide 81 to 92% of head-injured patients (n = 280 selected without conscious bias) correctly into the two groups as early as 72 h after trauma. Most of the patients who were misclassified according to our biochemical criteria had received phenobarbital for sedation. Valuable prognostic information in head injury evaluation may thus be obtained by daily determination of enzymatic activities of these four enzymes. PMID- 6848245 TI - Effect of temperature on the p50 value for human blood. AB - We investigated the effect of temperature (19, 30, 37, and 43 degrees C) on the p50 value for normal human blood at pco2 = 5.72 kPa (43 mmHg), at various pHs (range 7.0 to 7.6) and molar ratios of [2,3-diphosphoglycerate]/[Hb4] (range 0.4 to 2.4). The d(log p50)/d(pH) coefficient varied from 0.39 at 19 degrees C to 0.35 at 43 degrees C. The relationship between log p50 and 1/T (T = degrees Kelvin) was linear under the experimental conditions used, and the d(log p50)/d(1/T) coefficient varied between -2138 at pH 7.0 and -2162 at pH 7.6, independent of the concentration of 2,3-diphosphoglycerate. Assuming that the effect of pco2 on the p50 value is the same at 19, 30, and 43 degrees C as at 37 degrees C, one can use the reported coefficients to calculate the p50 value for normal human blood under conditions of temperature, pH, pco2, and 2,3 diphosphoglycerate concentrations prevailing under physiological and pathological conditions. The p50 value calculated by empirical equations, taking into account the effect of temperature, correlated well with the values for p50 determined experimentally (y = 0.9774x + 0.453; r = 0.998; n = 60), with an SD of 52 Pa (0.39 mmHg). PMID- 6848246 TI - Immunonephelometric determination of apolipoprotein A-1 in hyperlipoproteinemic serum. AB - The intensity of scattered light varies with the size of the scattering particles. Studying the quantitative immunonephelometric determination of apolipoprotein A-1 (apo A-1), we observed that the different particle sizes of lipoproteins must be taken into account in immunonephelometry if apo A-1 is a constituent of the lipoprotein particles. Because interaction between large lipoproteins and immunocomplexes of high-density lipoproteins increases light scattering nonspecifically, false estimations may be obtained in serum with excessive hyperlipoproteinemia. Furthermore, the accessibility of antigenic sites of apo A-1 in intact high-density lipoproteins is limited. Immunonephelometry of apo A-1 in serum necessitates therefore the elimination of various interferents, which we have achieved by a single one-step extraction of lipids in a two-phase liquid system. With n-hexanol/polyfluoro-polychloro-polyethylene, about 90% of the serum lipids are extracted and only apolipoprotein B is precipitated at the interphase. This pretreatment eliminates the interferences caused by excessive hypertriglyceridemia and therefore greatly facilitates the endpoint immunonephelometry of apo A-1 in normal and pathological serum samples. PMID- 6848247 TI - Assay of cerebrospinal fluid protein: a rate biuret method evaluated. AB - We evaluated a rate colorimetric method (Beckman) for measuring total protein in cerebrospinal fluid. The automated instrument we used was Beckman's ASTRA TM. A 100-microL sample of spinal fluid is introduced into the biuret reagent in the reaction cell and the increase in absorbance at 545 nm is monitored for 20.5 s. Solid-state circuits determine the rate of alkaline biuret-protein chelate formation, which is directly proportional to the total protein concentration in the sample. The linear range of measurement is 120 to 7500 mg/L. Day-to-day precision (CV) over the range of 150 to 1200 mg/L ranged from 15.2 to 2.3%. The method was unaffected by radical alteration of the albumin/globulin ratio, but there is a positive interference in the presence of hemoglobin, a suppression in the presence of bilirubin, and no effect by xanthochromia. The method is precise, accurate, rapid, and convenient. The method was compared with the trichloroacetic acid method as performed on the Du Pont aca III, giving a correlation coefficient (r2) of 0.9693. The method is precise, accurate, rapid, and convenient. PMID- 6848248 TI - Statistical comparison of blood glucose as determined by several test-strip procedures and by a hexokinase procedure. AB - We report a new statistical tool for comparing several dry-reagent strip procedures for whole blood glucose, which produce data in both digital and ordinal form, with results by the well-studied hexokinase-glucose-6-phosphate dehydrogenase procedure coupled to NAD+-NADH. Our use of "ordinal comparison unit" allows for a more equitable comparison of such data. These strip procedures produce biases of -2.21 to 1.74 ordinal comparison units over the range of glucose values corresponding to hypoglycemia and hyperglycemia, as compared with results by the hexokinase procedure, but they are essentially equivalent when compared with each other. PMID- 6848250 TI - Further studies on danazol interference in testosterone radioimmunoassays. AB - Investigating the interference of danazol in testosterone radioimmunoassays, we measured serum testosterone concentrations in the serum of women receiving danazol, with three testosterone radioimmunoassay kits. All of these showed positive interference by danazol or its metabolites (or both). Values for testosterone obtained with two of the methods (Diagnostic Products Corp. and Farmos Diagnostica) depended on the volume of serum extracted per assay tube. A detailed column-chromatographic method is presented in which testosterone is resolved from danazol and its metabolites. PMID- 6848249 TI - Evaluation of a colorimetric method for determination of glycosylated hemoglobin. AB - We evaluated a colorimetric assay for glycosylated hemoglobin to determine the effects of several variables --oxalic acid concentration, extraneous glucose, hemoglobin concentration, hydrolysis interval, and 5-hydroxymethylfurfural destruction--and the precision. The interference seen when the blood glucose concentration exceeds 2.0 g/L (11 mmol/L) can be eliminated by washing the erythrocytes with 9 g/L saline. The accuracy of this assay is not influenced by hemoglobin concentrations from 80 to 150 g/L. The background nonspecific color, although substantial, is similar from sample to sample. After a 5-h hydrolysis at 100 degrees C, about 85% of the hexose is released, and the analytical recovery of 5-hydroxymethylfurfural is constant over a wide range of glycosylated hemoglobin concentrations. The 5th to 95th percentile reference interval for a population of 65 nondiabetic individuals was 4.6 to 6.1 mol per 100 mol of total hemoglobin. The range of values for a population of 85 diabetic patients was 6.9 to 20.4 mol per 100 mol. PMID- 6848251 TI - Modified handling of internal catecholamine standards in radioenzymic assays. AB - A departure from a radioenzymic procedure widely used for plasma catecholamine assay is reported, in which we use "mean net standards" instead of individual internal standards. Interlaboratory/intermethod analyses validated use of the modified principle and demonstrated its preferential use over the conventional principle. Also demonstrated is use of the modified procedure for calculating catecholamine concentrations of several plasma samples collected from an exercising man and an acceleration-stressed swine. Benefits already derived from use of the procedure include: (a) quantification of certain plasma samples that could not be satisfactorily quantified by conventional options, (b) an apparent gain in analytical precision in virtually all other analyses, and (c) costs of analysis reduced by about 25%. PMID- 6848252 TI - Simple, reproducible procedure for selective measurement of lipoprotein lipase and hepatic lipase. AB - Existing methods for determining the release of lipoprotein lipase (EC 3.1.1.34) and hepatic lipase (EC 3.1.1.3) into plasma after heparin injection give highly variable results, primarily traceable to errors in the isolation of labeled oleate from the substrate, triolein. Methods involving anion-exchange resin to bind oleate show high variability and have a low yield. Introducing a strong base in the last step of the assay may spuriously increase the counts from oleate, whereas a detergent such as Triton X-100, used to minimize this problem, has a strong quenching effect. We report a simple and rapid method in which we eliminate rather than correct for the sources of variation. The substrate, tri[1 14C]oleoyl-glycerol, is sonicated under strictly standardized conditions with gum arabic, 50 g/L. Incubation is stopped by addition of a benzene/chloroform/methanol mixture and NaOH, 0.2 mol/L. Labeled oleic acid is extracted with hexane after acidification of the alkaline aqueous (upper) phase, so that no alkali is introduced into the scintillation liquid. For lipoprotein lipase measurement, hepatic lipase is inactivated by a specific antiserum, whereas hepatic lipase is measured after lipoprotein lipase is inactivated by NaCl, 1.0 mol/L. The method is efficient and specific, and quenching and chemiluminescence artifacts are avoided. PMID- 6848253 TI - Measurement of nifedipine in plasma by gas--liquid chromatography and electron capture detection. AB - In this method for measuring nifedipine, a calcium-channel inhibitor now widely used in the treatment of cardiovascular disease, the drug is extracted from plasma under basic conditions into toluene, and an aliquot of the extract is injected directly into a gas chromatograph equipped with an OV-101 column and an electron-capture detector. The standard curve is linear between 1 and 100 micrograms/L; the assay measures not only nifedipine, but also a major metabolic product (found only after oral administration of the parent drug) and photodegradation products. The procedure is rapid and adequately sensitive for routine use in clinical monitoring of nifedipine in plasma. PMID- 6848254 TI - Urinary oxalate determination by use of immobilized oxalate oxidase in a continuous-flow system. AB - In this procedure, oxalate oxidase (EC 1.2.3.4) immobilized in a continuous-flow system is used to determine oxalate in urine. The hydrogen peroxide formed from oxalate is detected by use of a color reaction with peroxidase (EC 1.11.1.7), 3 methyl-2-benzothiazoline hydrazine, and N,N-dimethylalanine. However, urine contains an oxalate oxidase inhibitor, which cannot be removed by heating, ion exchange resins, or cellulose columns. This makes it necessary to precipitate the oxalate before assay. The overall assay system is accurate (oxalate recovery, 95.9%), sensitive (less than or equal to 5 mumol/L), precise (within-batch CV less than 1.25%, between-batch CV less than 5%), and relatively rapid (60 samples per working day). The assay system has better accuracy than an established chemical method and a gas-chromatographic method, and is considerably less arduous than and correlates well (r = 0.94) with a modified chemical method. The reference interval for urinary oxalate excretion is 0.16-0.56 mmol per day (n = 97). Only nonphysiological concentrations of ascorbate interfere with the assay, by increasing the oxalate result in the overall assay, presumably by post micturition formation of oxalate from ascorbate in the urine samples. PMID- 6848255 TI - Screening for neonatal Duchenne muscular dystrophy by bioluminescence measurement of creatine kinase in a blood sample spotted on paper. AB - Neonatal screening for Duchenne-type muscular dystrophy is greatly simplified by use of a new bioluminescence procedure for creatine kinase. The blood of newborn myopathic children consistently showed increased activity. The improved method permits the analysis from a dried sample of whole blood spotted on filter paper; it shows high correlation with existing procedures and is highly specific and precise. The use of the improved method in a screening program involving 158 000 newborns is reviewed. We find a prevalence of 1/5929 living eighth-day boys. PMID- 6848256 TI - Clinical and laboratory evaluation of a commercial kit for measurement of serum free thyroxin ("Amerlex Free T4"). AB - Different indexes of thyroid function were determined in conjunction with values obtained with a new commercial radioimmunoassay kit for serum free thyroxin, in 49 apparently healthy subjects, 87 pregnant women, and 142 outpatients attending the thyroid clinic. The results indicate a diagnostic success rate of 88% when free thyroxin was measured instead of estimating the so-called free thyroxin index. Furthermore, in three cases of papillary carcinoma the concentration of free thyroxin was increased, although all the other laboratory tests indicated a euthyroid state. Technically, the method is simple, rapid, and precise, and it would be of most value in the small hospital laboratory lacking the facilities of a comprehensive thyroid-function test service. PMID- 6848257 TI - Improved enzymatic determination of total cholesterol in tissues. AB - In this improved method for rapid enzymatic determination of total cholesterol, the lipid extracts from tissues are dissolved in an equal volume of peroxide-free dioxane/isopropanol (50/50 by vol) solution, and are reacted directly with the aqueous enzymatic reagent, without further treatment. The presence of organic solvents, such as dioxane and isopropanol, does not interfere with enzymatic activity. This simpler procedure eliminates the tedious solubilization of tissue lipid extracts into an aqueous medium. The method is reproducible, and results correlate well with those by a chemical (FeCl3/H2SO4) method. PMID- 6848258 TI - Solid-phase radioimmunoassay for human placental lactogen in serum. AB - We report a solid-phase radioimmunoassay for human placental lactogen, in which antibody-coated polystyrene tubes and polyurethane sponges are used. Incubation time and temperature, ionic strength of buffer, and nonspecific adsorption have been evaluated for optimum conditions required for routine clinical assays. The validity of the assay technique has been ascertained by its specificity, reproducibility, and recovery. The sensitivity of this method is 0.4 ng of placental lactogen per assay tube. PMID- 6848259 TI - Frequency of hypomagnesemia in hypokalemic states. AB - Although both hypokalemia and hypomagnesemia have been linked with life threatening cardiac arrhythmias, published studies disagree regarding the frequency of simultaneously low serum potassium and magnesium concentrations. To investigate the possible associations between the concentrations of these ions in serum, we carried out a retrospective study of all paired magnesium-potassium measurements reported from our laboratory during two separate two-week periods. Of 963 paired measurements in 421 patients, 12% of the samples were hypokalemic and 26% were hypomagnesemic. The frequency of hypomagnesemia was significantly greater in hypokalemic samples (38%) compared with nonhypokalemic samples (25%). The potential clinical importance of this relationship requires further investigation. PMID- 6848260 TI - Revisions of the 1963 semidine HC1 standard method for inorganic phosphorus. PMID- 6848261 TI - Electrophoresis of lactate dehydrogenase isoenzymes. PMID- 6848262 TI - Macro creatine kinase types 1 and 2: clinical significance in neonates and children as compared with adults. AB - We examined the case histories of seven pediatric patients (ages four days to 12 years) whose sera showed significant activities of "macro" creatine kinase (CK; EC 2.7.3.2): two cases of macro CK type 1 (CK-BB isoenzyme bound to IgG) and five cases of macro CK type 2 (polymeric complexes of mitochondrial CK). The diagnoses of the two children with macro CK type 1 were similar to those in 55 adult patients with this form of CK found earlier during screening of a population of 5000. Macro CK type 1 has generally been noted only in older women; this is the first report of it in children. In four of the five cases of macro CK type 2 we found in children, myocardial muscle damage was clinically evident. In contrast, the 26 cases of adults with macro CK type 2 found during the same screening generally had neoplasms, most with metastases to the liver. We suggest that the finding of macro CK type 2 is an indicator of cellular necrosis; in pediatric cases with myocardial damage the associated conditions may be reversible but in adults with malignancies the finding is associated with an extremely poor prognosis. PMID- 6848263 TI - Falsely high serum creatinine concentration associated with severe methanol intoxication. AB - A case of severe methanol intoxication (1300 mg/L) was associated with markedly increased serum creatinine (490 mg/L) despite normal urea values and the absence of any other signs of renal disease. These values declined progressively to normal, and the patient recovered with no visual impairment. Additional laboratory experimentation suggested that the high creatinine value was probably ascribable to some unknown foreign material(s) in the patient's blood that reacted with the alkaline picrate used in the measurement of creatinine. One of the presumed metabolites of methanol, formaldehyde, reacts with creatinine but the product does not react with picrate. We believe that the foreign material was derived from either commercial preparations of methanol or contaminants in the patient's drinking water. PMID- 6848264 TI - Simple quantitation of serum lipid fractions. PMID- 6848265 TI - More on the performance of the IL282 CO-oximeter in the presence of perfluorochemical emulsion, Fluosol-DA. PMID- 6848266 TI - Evaluation of a specific gravity test strip. PMID- 6848267 TI - Watery diarrhea and stool osmolality. PMID- 6848268 TI - Ampicillin interference with test for sulfite oxidase deficiency. PMID- 6848269 TI - More on reliability of reagent-strip urinalyses for glucose. PMID- 6848270 TI - Sodium drift in the Beckman Astra-8. PMID- 6848271 TI - High serum ceruloplasmin activity in pulmonary tuberculosis. PMID- 6848272 TI - Improved sample preparation before liquid-chromatographic determination of probenecid in cerebrospinal fluid. PMID- 6848273 TI - The acetone precipitation step is needed in determining the lecithin/ sphingomyelin (LS) ratio of amniotic fluid. PMID- 6848274 TI - Use of heparinized samples for salicylate determination with the DuPont aca validated. PMID- 6848275 TI - Elimination of interference by atypical CK in CK-MB fractions of column eluates with an immunochemical CK assay. PMID- 6848276 TI - On the calculation of a "reference change" for comparing two consecutive measurements. AB - We describe a statistical method for calculating a "reference change," defined as that difference between two consecutive test results in an individual that is statistically significant in a given proportion of all similar persons. By allowing for variation in within-person variances, this procedure computes a reference change that is more specific (i.e., less prone to false positives) than that obtained directly from the distribution of observed differences between measurements. Moreover, the method may easily be extended to a test for trend in three successive measurements. The method has been applied to semi-annual measurements of serum calcium and alkaline phosphatase in 698 men and women enrolled in a large health-maintenance program. We believe that these ideas may also be usefully applied to successive laboratory tests in carefully defined patient populations--but this introduces special problems, which are discussed briefly. PMID- 6848277 TI - Assessment of the fundamental accuracy of the Jendrassik-Grof total and direct bilirubin assays. AB - Using unconjugated bilirubin (Bu) and authentic human disconjugated bilirubin (dBc) supplemented in low-bilirubin serum pools, we have directly verified for the first time that the Jendrassik-Grof total bilirubin assay modified after Doumas et al. (Clin. Chem. 19: 984-993, 1973) detects Bu and dBc quantitatively, in Bu-equivalent concentrations relative to gravimetric concentration assignment reinforced with quantification by nuclear magnetic resonance (Wu et al., Clin. Chem. 26: 1323-1335, 1980). By contrast, the Jendrassik-Grof direct bilirubin assay (also modified after Doumas) quantifies only 70 +/- 5% of the gravimetrically determined dBc as Bu equivalents. By using Bu and dBc (instead of Bu only, as is routinely done) to calibrate the responses of the total and direct bilirubin assays, the analyses of Bu and dBc become much more quantitative. We mathematically explored the meanings of the conventional terms total, direct, and indirect bilirubins. The clinical and diagnostic implications of our observations are discussed. PMID- 6848278 TI - A diazo-based dry film for determination of total bilirubin in serum. AB - We have prepared a diazo-based dry film for use in determining total serum bilirubin. On a transparent support are a buffered gelatin layer containing a polymeric quaternary amine (the mordant) and a white, reflective spreading layer that contains all of the components necessary for detection of bilirubin. The method is based on the use of dyphylline and Triton X-100 surfactant to dissociate bilirubin from albumin and subsequent reaction of bilirubin with a diazonium salt [4-(N-carboxymethylsulfamyl)benzenediazonium hexafluorophosphate]. In the dry film, unconjugated, mono- and diconjugated, and strongly protein linked (delta) bilirubin all react with the diazonium salt to produce azo dyes having absorption maxima at about 520 nm. With reflection densitometry and appropriate mathematical transformation, readings and bilirubin concentrations are linearly related to 260 mg/L. Results correlate well with those by the Jendrassik-Grof (Doumas modification) method (slope 0.994, intercept 1.1, correlation coefficient 0.993, Sy X x 4.0), and the method is precise (CV = 10.0% at Cav = 4.1 mg/L, 2.7% at Cav = 24.5 mg/L, 1.2% at Cav = 102 mg/L for patients' samples) and relatively free of interferences. PMID- 6848279 TI - Remazol Brilliant Blue as a pre-stain for the immediate visualization of human serum proteins on polyacrylamide gel disc electrophoresis. AB - We describe the pre-staining of proteins in normal human serum with Remazol Brilliant Blue before separation by disc electrophoresis. Critical to reproducibility are: dye concentration of 0.16 mol/L in a Tris-glycine buffer (pH 8.3), use of equal volumes of serum and dye solution, a tagging period of 2 h at room temperature, and electrophoresis of 0.1 mL of the mixture at 2.5 mA/gel for about 2 h. Advantages include speed, quality of resolution, and low background. This method was compared with Amido Black post-electrophoresis staining in 35 sera. Of these, 16 showed identical results with respect to the number of bands. In the other 19, Amido Black showed more bands in the post-transferrin region and, sometimes, in the post-albumin region. The pre-stained gels showed slower electrophoretic mobilities of the components. Protein bands eluted from pre stained gels retained immunological reactivity. PMID- 6848280 TI - Evolutionary changes in acute-phase proteins in alcoholic hepatocellular diseases. AB - We studied the pattern of acute-phase proteins (orosomucoid, C-reactive protein, and haptoglobin) in hepatocellular deficiency due to chronic alcohol consumption, characterized by a decrease in serum transferrin concentration. We found that their patterns could vary independently of hepatocellular deficiency, but depend on the progression of hepatic disease. The most useful protein for discriminating the stage of inflammatory reaction is orosomucoid. In moderate hepatocellular deficiency, acute-phase proteins are increased independently of the decrease in transferrin, whereas in severe hepatocellular deficiency the acute-phase proteins are also decreased. Thus, it is possible to distinguish the two stages of hepatocellular deficiency by following changes in the concentration of orosomucoid. PMID- 6848281 TI - Heterozygote detection in congenital adrenal hyperplasia. AB - Detection of heterozygote carriers for congenital adrenal hyperplasia by use of a modified tetracosactide (a synthetic corticotropin) stimulation test with prior overnight dexamethasone suppression proved to have a diagnostic accuracy of 95%. Discrimination of heterozygotes from normals was best when we used a criterion based on the ratios of 17 alpha-hydroxyprogesterone to cortisol at baseline and at 30 min after intravenous administration of 250 micrograms of tetracosactide. PMID- 6848283 TI - Time-resolved fluoroimmunoassay of human choriogonadotropin. AB - We describe time-resolved fluoroimmunoassay for human choriogonadotropin involving monoclonal antibodies directed against the beta- and alpha-subunits. The latter antibody was labeled with europium, which was measured by counting for 1 s after the immunoreaction was completed. In the solid-phase sandwich assay, both a one-step and two-step procedure were used; the respective measuring ranges were 0.7-135 and 0.7-350 int. units/L, the latter covering a 500-fold dynamic range. The CV within the assay range was between 4 and 8%, depending on the dose. Cross reactivity with lutropin in the one- and two-step procedures was 1.6% and 1.0%, respectively. PMID- 6848282 TI - Multi-enzyme membrane electrodes for determination of creatinine and creatine in serum. AB - An enzyme electrode system for the determination of creatinine and creatine was developed by utilizing three enzymes: creatinine amidohydrolase (CA), creatine amidinohydrolase (Cl), and sarcosine oxidase (SO). These enzymes were co immobilized onto the porous side of a cellulose acetate membrane with asymmetric structure, which has selective permeability to hydrogen peroxide. Two kinds of multi-enzyme electrodes were constructed by combining a polarographic electrode for sensing hydrogen peroxide and an immobilized CA/Cl/SO membrane or Cl/SO membrane for creatinine plus creatine or creatine, respectively. The multi-enzyme electrodes responded linearly up to 100 mg of creatinine and creatine per liter in human serum. Response time was 20 s in the rate method and the detection limit was 1 mg/L. Only 25 microL of serum sample is required. Analytical recoveries, precisions, and correlations with the Jaffe method were excellent, and the multi enzyme electrodes were sufficiently stable to perform more than 500 assays. No loss of activity of immobilized enzymes was observed after nine months of storage at 4 degrees C in air. PMID- 6848284 TI - Measurement of glucose in plasma by a differential pH technique. AB - A new automatic apparatus based on the differential measurement of pH between two solutions has been developed. Two 25-microL (internal volume) glass capillary electrodes are used to measure the results of automated (under microcomputer control) chemical reactions that lead to the liberation or the uptake of hydrogen ions. The sensitivity of the differential pH measurements is better than +/- 0.0001 pH unit, and the change in H+ concentration that can be detected by such an apparatus is 1 mumol/L for plasma and 3 mumol/L for whole blood. The technique has been applied to the measurement of glucose in plasma, giving results in agreement with the specifications of the Food and Drug Administration reference method for quantitative determination of glucose (hexokinase/glucose-6-phosphate dehydrogenase method). PMID- 6848285 TI - Estrone sulfate concentrations in plasma of normal individuals, postmenopausal women with breast cancer, and men with cirrhosis. AB - Estrone sulfate is quantitatively the most important estrogen in plasma. A method for its determination in human plasma is described, and the precision, accuracy, sensitivity, and specificity are defined. Free steroids were extracted from plasma with diethyl ether and steroid sulfates were isolated with use of Vlitos' reagent (methylene blue in dilute H2SO4/Na2SO4 solution). After enzymic hydrolysis, estrone was isolated by chromatography on Celite and measured by radioimmunoassay. The mean concentrations (nmol/L +/- 1 SD) of estrone sulfate were 2.51 +/- 0.90 for plasma from 13 women in follicular phase, 5.33 +/- 1.55 for 17 women in luteal phase, 0.89 +/- 0.60 for 44 postmenopausal women, and 0.96 +/- 0.43 for 24 postmenopausal women with breast cancer. Results for postmenopausal women with or without breast cancer did not differ significantly. For 13 normal men, estrone sulfate concentrations were 2.62 +/- 0.79 nmol/L, and for a group of 19 cirrhotic men the mean value was 1.43 +/- 0.95 nmol/L, significantly lower than normal. PMID- 6848286 TI - Characterization and elimination of a factor in serum that interferes with turbidimetry and nephelometry of lipase. AB - We studied a serum component ("pseudolipase") that interferes with both turbidimetric and nephelometric lipase measurements. Pseudolipase activity in serum was found in the presence of rheumatoid factor and in other disorders of active immune processes. The incidence of this interferent in sera seems to be greater than reported previously. We describe a method for eliminating its effect without affecting pancreatic lipase activity, by precipitating some of the proteins, including IgM, with polyethylene glycol. PMID- 6848287 TI - Prognostic significance of Raynaud's phenomenon in children. PMID- 6848288 TI - An evaluation of breast pumps currently available on the American market. AB - Eight breast pumps commonly seen in clinical practice were measured and ranked for desirability in eight categories: pressure range, pressure control, size and shape of nipple cup, volume accommodation, visual feedback, ease of cleaning, ease of handling, and cost. Three scored relatively high (Egnell, Kaneson, and Loyd-B), three scored low (Gomco, Davol, and Bintner), and two appeared to be frequently ineffective (Evenflo and Ora'lac). PMID- 6848289 TI - Pharmacotherapy for behavior disorders. Typical treatment practices. AB - The parents and teachers of 100 children receiving medications (primarily methylphenidate) for behavior disorders (primarily hyperactivity) were questioned about widely recommended treatment practices. The results showed that (a) in the majority of cases, pediatricians were responsible for supervising drug therapy; (b) most parents were satisfied with their current physician; and (c) approximately one half of the children had three or more office visits per year. However, teachers were rarely asked to use standardized procedures to evaluate drug response, and direct contact between teacher and physician was all but nonexistent. There was a considerable degree of disagreement between parents and teachers concerning drug efficacy, dosage, and the need for medication; and parents appeared to exert a considerable degree of control over treatment-related decisions. In general, drug-free periods were not scheduled on a regular basis, and evidence for an integrated multimodal treatment approach was lacking. The findings suggest that variables other than a clinically determined response to medication are often the salient elements of the treatment-related decision making process. PMID- 6848290 TI - Peripheral venous partial exchange transfusions for neonatal polycythemia. PMID- 6848291 TI - Inoculation of HEp-2 cells for respiratory syncytial virus isolation. PMID- 6848292 TI - Bone and joint complications of Hemophilus influenzae meningitis. AB - Seven patients with a bone or joint complications were identified among 202 cases treated for Hemophilus influenzae meningitis between 1970 and 1980. All patients studied met the minimal diagnostic criteria of pleocytosis of the cerebrospinal fluid (CSF) and CSF culture positive for H. influenzae. The diagnosis of bone or joint complication was based on objective findings of physical examination: swelling, erythema and decreased range of motion, and either an increased number of granulocytes in aspirated joint fluid or radiographic and/or radionuclide scan evidence of bone or joint disease. The only significant difference between the control patients and those with bone or joint complications was duration of fever; in the control group 29 per cent of patients were febrile seven or more days, compared with 100 per cent of complication group. Since a number of those patients who remain febrile beyond the sixth hospital day had presumptive evidence or bone or joint infection, we suggest a bone scan be considered for these patients. PMID- 6848293 TI - Congenital pulmonary lymphangiectasis. A case complicated by chylothorax. AB - A case is reported of an infant with features of Noonan Syndrome and congenital pulmonary lymphangiectasis. Soon after birth, persistent respiratory distress developed, and, at 4 months of ge, a chylothorax was noted. Medium chain triglyceride therapy by the enteral route was tried, but parenteral alimentation and chest-tube drainage were required. Diagnosis of pulmonary lymphangiectasis was confirmed by biopsy. PMID- 6848295 TI - Urinary catecholamine metabolites and effects of clonidine in patients with alcohol amnestic disorder. AB - Seven normotensive patients with alcohol amnestic disorder were treated with 2 micrograms/kg clonidine (C) three times daily for 1 wk. Four patients received 12 micrograms/kg/day during the subsequent week; three developed hypotensive symptoms at this dose and remained on 6 micrograms/kg/day. During a predrug placebo period and after 60 hr on each dose of C, urinary excretion rates of catecholamine metabolites were determined. C, 6 micrograms/kg/day, reduced the ratio of norepinephrine (NE) metabolites (mumol/24 hr) to normetanephrine (NM), vanillylmandelic acid (VMA), and 3-methoxy-4-hydroxyphenyl glycol (MHPG). The excretion of metanephrine (M) was not reduced significantly. The ratio M/NM and M/(VMA + MHPG) increased, indicating Cs effects are primarily noradrenergic. Reduction in NM/(VMA + MHPG) indicates disproportionate lowering of the O methylated metabolite of NE compared to its deaminated metabolites, consistent with C inhibition of NE release. Patients with the highest predrug NM excretion had the greatest decrements with C. The dopamine metabolites 3-methoxytyramine and homovanillic acid were not decreased by C. C-induced reductions in the ratio NM/(VMA + MHPG), an index of NE release, correlated (n = 7) with reductions in supine systolic blood pressure, mean arterial pressure, and salivary flow rate. PMID- 6848294 TI - Urine and plasma propranolol. AB - Eight hypertensive patients who had been followed in an outpatient clinic during long-term therapy with propranolol (40 to 160 mg twice daily) were studied during a 24-hr stay in the ward. The usual oral dose was given and the total and free plasma concentrations were determined during the 24 hr and the urinary excretion of unchanged drug was measured. Average free plasma concentration of propranolol (y free) was calculated from: y free = Excreted propranolol (ng/24 hr)/Creatinine clearance (ml/24 hr). There was a significant relationship between log y free and average free plasma concentration (means free) determined from the directly measured plasma concentration curve: log y free = 0.0743 means free - 0.0466 (r = 0.98, P less than 0.001). In another group of propranolol-treated hypertensive patients there was a significant positive relationship between orosomucoid concentration and reciprocal of the free propranolol fraction in plasma. From this relationship the average total drug concentration (y total) was calculated from y free; there was a significant correlation with directly measured total plasma level: log y total = 0.0038 . means total + 1.0895 (r = 0.91, P less than 0.001). It is suggested that individually determined values of y free below 30 ng/ml and y total below 400 ng/ml (the concentration range studied) can be used to calculate the average mean 24-hr free and total plasma concentrations. PMID- 6848296 TI - Lorcainide disposition kinetics in arrhythmia patients. AB - Lorcainide disposition kinetics were studied after intravenous and oral administration to patients with ventricular arrhythmias. After intravenous doses ranging from 100 to 200 mg, blood samples were drawn and plasma was analyzed for lorcainide concentration by high-pressure liquid chromatography. A three compartment model was used to fit the data. The model-independent calculated values for clearance, steady-state volume of distribution, and terminal half-life were 14.4 +/- 3.28 ml/min/kg, 6.33 +/- 2.23 l/kg, and 7.8 +/- 2.2 hr. After nine doses of oral lorcainide (100 mg every 12 hr) blood samples were drawn and analyzed for lorcainide and its active metabolite, norlorcainide. The lorcainide and norlorcainide half-lifes were 9.6 +/- 2.8 and 26.8 +/- 8.2 hr. Mean steady state level of norlorcainide was 2.2 +/- 0.9 times the level of lorcainide. The data suggest that the clearance of lorcainide decreases with time during long term dosing. PMID- 6848297 TI - Dose-response relationships for spironolactone in combination with a potassium wasting diuretic. AB - The plasma and urine electrolyte responses to repeated doses of spironolactone, 25, 50, and 100 mg, in combination with metolazone, 2.5, 5.0, and 10 mg, were examined in 18 healthy subjects (six at each dose of metolazone). During the period of pharmacologic steady state, there were log linear spironolactone dose response relationships for plasma potassium, sodium, and bicarbonate (P less than 0.001 in each case) with no contraindication to parallelism between the metolazone groups. In the absence of mineralocorticoid challenge, spironolactone dose-urine electrolyte responses could not be demonstrated. However, after fludrocortisone, spironolactone log dose-response trends were linear with respect to natriuresis (P = 0.027), antikaliuresis (P = 0.020), and log 10 Na/K (P = 0.001), which is usually considered the best single index of renal antimineralocorticoid activity, and exhibited parallelism between the metolazone doses. These observations suggest that a convenient bioassay for aldosterone antagonists in normal men may be provided by the electrolyte responses to repeated doses of such drugs in combination with potassium-wasting diuretics. In view of the limitations of other methods, this approach may have particular relevance to the evaluation of potassium-sparing properties. PMID- 6848298 TI - Test dose for predicting high-dose methotrexate infusions. AB - Eighteen evaluable patients were studied to determine whether individual methotrexate (MTX) kinetics, determined by test-dose bolus injection, could be used to predict plasma drug concentrations during and after high-dose infusion. Small nontoxic doses of MTX (10 mg/m2) was given to patients who were followed for 12 to 24 hr and the kinetic data were used to predict subsequent kinetic behavior of moderate- and high-dose methotrexate infusions (150 to 1500 mg/m2 over 12 to 18 hr). After test-dose injection, MTX clearance varied from 36 to 138 ml/min/m2 and decreased with advancing age (r = -0.49, P less than 0.05). MTX clearance varied from 24 to 100 ml/min/m2 after high-doses. Although there was a trend to decreasing clearance with advancing age, this was not as clear as with the test dose (r = -0.42, P greater than 0.05). There was no correlation between MTX clearance and creatinine clearance in this group of patients in whom creatinine clearance varied from 32 to 63 ml/min/m2. When the kinetic parameters derived from the test-dose data were used, accurate predictions could be made of the infusion plateau (r = 0.89, P less than 0.001) and 24-hr (r = 0.92, P less than 0.001) MTX concentrations after high-dose infusions. Our results indicate that test-dose MTX kinetics may serve as a guide to dose modification of MTX infusions in some high-risk patients. PMID- 6848299 TI - Central effects of beta-adrenoceptor antagonists. AB - The central effects of atenolol, a cardioselective beta-adrenoceptor antagonist, were investigated in six healthy men. Two flash-fusion threshold (2FFT), simple reaction time (SRT), digital copying (DCT), symbol-digit modalities (SDMT), and Gibson's spiral maze tests (GSMT) and mood rating scales for tension, alertness, depression, detachment, and anxiety were used. Each subject took 50, 100, 200, and 400 mg atenolol and identical placebo orally in a randomized, double-blind, crossover study and the psychomotor tests were performed at 0, 2, 3, 5, and 8 hr. 2FFT was prolonged at 3 hr after all doses and at 2 and 5 hr with 100, 200, and 400 mg. The maximum effect was achieved with 200 mg and mean 2FFT correlated with mean plasma atenolol concentration. SRTs were prolonged after all doses at between 2 and 5 hr. The DCT and the retest gain of the SDMT were both lower than after placebo at 2 hr with 100, 200, and 400 mg. The time taken to perform the GSMT was not altered by active drug, but the number of errors was lower at 2 hr with 100 and 200 mg. The self-rating mood scales showed a subjective decrease in tension 2 hr after 400 mg. The results show that atenolol exerts central effects in man. PMID- 6848300 TI - Single-dose kinetics and metabolism of carbamazepine-10,11-epoxide. AB - Carbamazepine-(CBZ)-10,11-epoxide (CBZ-E) was found to decompose in gastric juice in vitro. An antacid did not affect the bioavailability of single CBZ doses given to three subjects and was therefore used to neutralize gastric juice when administering CBZ-E. CBZ-E was given orally as a suspension in two single doses ranging from 10 to 200 mg to each of four healthy subjects. Plasma concentrations of CBZ and CBZ-E were determined with high-performance liquid chromatography. Plasma concentrations and urinary excretion of the end metabolite trans-10,11 dihydroxy-10,11-dihydro-CBZ (trans-CBZ-diol) were measured by mass fragmentography. After dosing with CBZ-E, peak plasma concentrations of the parent compound were reached within 2 hr. Urinary recovery of trans-CBZ-diol was 90 +/- 11% (mean +/- SD) of the dose, indicating almost complete absorption. Plasma kinetics of the epoxide fitted an open one-compartment model with elimination half-lifes (t 1/2s) of 6.1 +/- 0.9 hr. Clearance was 89 +/- 25 ml x kg-1 x hr-1. The urinary excretion t 1/2 of the trans-CBZ-diol was 12.4 +/- 0.9 hr, which is longer (P less than 0.001) than the epoxide plasma t 1/2. There was no indication of dose-dependent kinetics of the epoxide. After 200 mg CBZ to the same subjects, plasma CBZ t 1/2 was 26.0 +/- 4.6 hr and clearance was 23.4 +/- 4.6 ml x kg -1 x hr -1. Of the CBZ dose, 20.5 +/- 2.9% was excreted as the trans CBZ-diol, which gives an estimate of the percentage of CBZ that is metabolized by the epoxide-diol pathway in healthy subjects. These observations provide a basis for the administration of CBZ-E in patients to assess its clinical effects. PMID- 6848301 TI - Cefazolin and cephalexin kinetics in continuous ambulatory peritoneal dialysis. AB - We studied single-dose cefazolin (CFZ) and cephalexin (CPX) kinetics in continuous ambulatory peritoneal dialysis (CAPD) patients to establish therapeutic guidelines for two cephalosporins commonly used to treat peritonitis in these patients. CFZ, 10 mg/kg, was given intravenously and intraperitoneally, while CPX, 500 mg, was given orally. CFZ led to serum concentrations of 25 microgram/ml at 24 hr, with a half-life (t 1/2) of 33 hr. CAPD accounted for only 20% of total body clearance. When CFZ was given intraperitoneally, 74% of the dose was absorbed and similar serum concentrations had much the same t 1/2. CPX, on the other hand, had a serum t 1/2 of 8.6 hr and resulted in much lower peritoneal concentrations than CFZ. The kinetic principal of superposition provided a model for the prediction of plasma concentrations after repeated intraperitoneal doses of CFZ. The model predicts that a 10-mg/kg intraperitoneal loading dose, followed by 5-mg/kg doses in each exchange the first day and 2.5 mg/kg doses thereafter, will lead to steady-state plasma concentrations of 50 to 65 microgram/ml. The data suggest that CFZ needs be given only intraperitoneally at doses lower than those in current use. CPX probably adds little to the treatment of peritonitis. PMID- 6848302 TI - Preclinical and clinical evaluation of topical acid products for skin tumors. AB - Distinct differences between topical acid preparations can be detected by simple preclinical and clinical pharmacologic models designed to evaluate potential utility in the treatment of superficial skin tumors. The models distinguish a tissue-dissolving (ulcerating) effect from a tissue-fixation (mummifying) effect, as reflected by a distinct and lasting discoloration of hair in vitro or the skin surface in vivo. Double-blind clinical comparison of the response to different preparations of matched pairs of small superficial skin tumors in 33 subjects demonstrated for greater utility for nitric acid preparations of appropriate strength (6 to 7N), with added oxidizable organic acids, over the mineral acid alone. The nitrate reduction products generated in such preparations markedly speed up discoloration in the models and apparently contribute to the improved clinical utility of the topical treatment by enhancing the speed and intensity of tissue fixation, but not tissue erosion. The architecture of lesions eradicated by such mixtures is generally adequately preserved for histologic diagnosis of the extruded tissue. PMID- 6848303 TI - How a cigarette is smoked determines blood nicotine levels. AB - Indirect evidence suggests that smoking low-tar and nicotine cigarettes does not necessarily reduce exposure to these substances. Puff volume, duration and number, interpuff interval, and volume and duration of inhalation were measured while 11 subjects smoked two or four tobacco cigarettes. Nicotine blood levels and breath CO were measured before and after smoking. The machine-determined nicotine yields of the cigarettes correlated (r = 0.52) with the increase in nicotine blood levels after smoking but, when individual differences in smoking behavior were taken into account along with the nicotine yield, there was a stronger correlation with nicotine blood levels (r = 0.84 to 0.93). PMID- 6848304 TI - Acetaminophen in chronic liver disease. AB - The safety of acetaminophen in therapeutic doses was evaluated in subjects with stable chronic liver disease. Six subjects with chronic liver disease were given 4.0 gm daily for 5 days. Although the mean half-life (t 1/2) acetaminophen was 3.42 hr, there was no evidence of drug cumulation or hepatotoxicity. A double blind, two-period crossover design was also used to evaluate acetaminophen in 20 subjects. Acetaminophen, at a dose of 4.0 gm daily for 13 days, was well tolerated by these subjects with stable chronic liver disease. One subject developed symptoms, which worsened and were associated with deterioration in the results of laboratory studies, while taking acetaminophen. Subsequent challenges with 4.0 gm acetaminophen daily for periods of 10 and 14 days were well tolerated, which indicates that the deterioration was not related to the drug. During this study there were no abnormalities indicative of an adverse reaction to acetaminophen. There is, therefore, no contraindication to the use of acetaminophen in therapeutic doses in the presence of stable chronic liver disease. PMID- 6848305 TI - Therapeutic Intervention Scoring System: update 1983. AB - The Therapeutic Intervention Scoring System (TISS) introduced in 1974 has become a widely accepted method of classifying critically ill patients. In response to requests to update the system because of recent innovations in critical care, some items have been deleted, some have been added, and certain point scores have been adjusted. Explanations of items within the system and guidelines for the user are included. A comparison of the new 1983 system to the old 1974 system in 100 consecutive patients reveals no difference in total point scores. We hope this updated explanation will ease the task of assessing use of intensive care services. PMID- 6848306 TI - Selection criteria for pediatric critical care transport teams. AB - The primary goal of an interhospital critical care transport program is to provide quality medical care during transit as close as possible to that available in the receiving ICU. Critically ill pediatric patients are transported between hospitals by a variety of transport teams. The skills possessed by physicians, nurses, respiratory therapists, and paramedics overlap. To determine the criteria for selection of the team members for these patients, we reviewed the medical records of 115 pediatric patients transported to this facility in 1978 and 1979. Patients were categorized by diagnosis, severity of illness at the time of transport, and the monitoring and life support required during transport. Our data indicate the medical transport team members should have skills required for pediatric critical care diagnosis and management including endotracheal intubation and assisted ventilation; insertion of peripheral, central venous, and arterial catheters; fluid and electrolyte therapy; antibiotic therapy; cardiovascular monitoring; and pharmacological life support. The team members should be chosen based on the particular skills needed for a transport with a goal of providing the patient care required on a consistent basis. PMID- 6848307 TI - Cerebrospinal fluid markers in relation to outcome in patients with global cerebral ischemia. AB - To investigate the possibility of improving the accuracy of prognostication in early hypoxic brain damage, 12 patients with global cerebral ischemia (GCI) due to circulatory arrest outside hospital were followed until death or for 1 yr. Five who survived for more than 2 weeks displayed better values on coma scoring from 16 h-3 days, compared to those who succumbed within 2 weeks. In 2 week survivors, lumbar puncture revealed consistently lower adenylate kinase (AK) activity in cerebrospinal fluid (CSF) at 24 h than in the other patients, whereas glutathione and lactate values overlapped to some degree. The CSF-AK activity at 48--72 h was less correlated to clinical outcome. It is concluded that the results from coma scoring, based upon clinical observation, and from determination of AK activity in CSF at 24 h reinforce each other in discriminative power to predict prognosis in these patients. PMID- 6848308 TI - Comparison of Teflon and polypropylene membranes for transcutaneous oxygen monitoring during anesthesia. AB - Performance of 2 electrodes used for transcutaneous oxygen monitoring, one covered with polypropylene and the other covered by fluorinated ethylene propylene Teflon, was compared in 11 patients during anesthesia. Both electrodes showed good correlation between transcutaneous (PtcO2) and arterial oxygen (PaO2) tension with a correlation coefficient of 0.96 with polypropylene and 0.88 with Teflon electrode. Although the ratio of transcutaneous to arterial tension varied from patient to patient, it was found to be fairly constant in any 1 patient and was not significantly affected by blood carbon dioxide tension. PMID- 6848309 TI - Potentiation of magnesium-induced neuromuscular weakness by gentamicin. AB - A term neonate with hypermagnesemia secondary to maternal administration of MgSO4 for pre-eclampsia had a respiratory arrest after receiving gentamicin im. The neuromuscular tracings and sequential physician exams done before and after administering gentamicin suggest aminoglycosides may potentiate a magnesium induced impairment of neuromuscular transmission and cause muscular weakness in neonates. PMID- 6848310 TI - Patient monitoring and data processing in the ICU. PMID- 6848311 TI - Study of diarrhea in critically ill patients. AB - There has been an impression that diarrhea occurs commonly in seriously ill patients treated in ICUs. In view of the sparsity of published work on the problem, we embarked on a prospective study of all patients admitted to the ICU for more than 48 h over a 12-month period. Three factors were examined in detail: nasogastric feeding, cimetidine administration, and antibiotic treatment. Other factors also were considered, notably the nature of the underlying illness and the spread of a possible infective agent by cross-infection. There was a 41% incidence of diarrhea. A significant increase in the incidence of diarrhea occurred in patients on nasogastric feeding (p less than 0.01) and in those receiving cimetidine (p less than 0.05); there was no increased incidence in those receiving antibiotic therapy. The cytotoxin of Clostridium difficile was specifically looked for in all patients with diarrhea, but was not detected. PMID- 6848312 TI - The effect of smoking on airway permeability. PMID- 6848313 TI - Mitral valve E point-septal separation as an index of left ventricular function with valvular heart disease. AB - Echocardiographic mitral valve E point-septal separation (EPSS) has been found to be a useful hemodynamic index. Prior studies have shown a high negative correlation between EPSS and left ventricular ejection fraction (EF) in selected patients, but the utility of this index with valvular heart disease has not been examined in detail. Cardiac catheterization and M-mode echocardiographic data were retrospectively analyzed from 30 patients with aortic stenosis, 18 patients with chronic aortic regurgitation, and 25 patients with chronic mitral regurgitation. For aortic stenosis patients (including those with coronary artery disease), an excellent correlation (r = -0.89, p less than 0.001) was observed between EPSS and angiographic EF. More modest correlations were noted for patients with aortic regurgitation (r = -0.58, p less than 0.01) and mitral regurgitation (r = -0.63, p less than 0.001). For patients with aortic regurgitation, correlation improved to r = -0.83 by excluding subjects with marked (greater than 4 mm) fluttering of the anterior mitral valve leaflet. For patients with mitral regurgitation, the EPSS-EF correlation improved to r = -0.72 after excluding patients with atrial fibrillation. Compared with other echocardiographic indices of left ventricular function (percent shortening of the minor diameter or echo-derived EF), the EPSS demonstrated an equivalent or superior correlation with angiographic EF for each valvular lesion studied. We conclude that EPSS is a highly reliable index of left ventricular function with aortic stenosis, but its utility in unselected patients with chronic mitral or aortic regurgitation is limited. PMID- 6848314 TI - Large mediastinal hematomas not associated with aortic rupture. Case presentations and surgical approach. AB - Mediastinal hematomas not associated with aortic disruption are thought to be common entities, and it is generally believed that most will spontaneously resolve. However, large mediastinal hematomas can cause fluctuations in cardiorespiratory physiology and can even cause death. Three cases of mediastinal hematomas are presented, as well as their surgical approach. Mediastinal hematomas should be evacuated because of their potential morbidity and mortality. PMID- 6848315 TI - Discordance of exercise thallium testing with coronary arteriography in patients with atypical presentations. AB - Eighty-one patients with diagnostically difficult clinical presentations suggesting coronary disease underwent symptom-limited maximal-exercise treadmill testing (ETT) and exercise radionuclide scanning with thallium-201. Results of these tests were in agreement in only 47 percent of the cases. Either exercise thallium or ETT was positive in 94 percent of patients with disease. Among a population with a disease prevalence of 67 percent, agreement between exercise thallium an ETT predicted disease in 92 percent of instances or excluded disease in 82 percent of instances. Frequent discordance between these two tests in 53 percent of the cases unfortunately limits this usefulness. PMID- 6848316 TI - Respiratory care in small hospitals, nursing and extended care facilities, and in the home. A report of the ACCP section on respiratory care. PMID- 6848317 TI - Superior mediastinal mass. PMID- 6848318 TI - Fatal disseminated aspergillosis in an asthmatic patient treated with corticosteroids. PMID- 6848319 TI - Laryngeal tuberculosis. PMID- 6848320 TI - Mid-systolic sound associated with aortic insufficiency and bisferiens pulse. AB - Systolic ejection clicks, often associated with cardiac disease, can be distinguished from mid-systolic clicks of mitral and tricuspid origin, which are frequently benign. A different mid-systolic sound has been recognized, with timing similar to the mid-systolic clicks, which is associated with aortic insufficiency. This report describes a case in which such a sound was identified prior to aortic valve replacement, and disappeared with surgery, thus adding evidence to previous concepts of the origin of this sound, and its relationship to the hemodynamic abnormality associated with aortic valvular regurgitation. PMID- 6848321 TI - Myxoma of right ventricle presenting as pulmonic stenosis in a neonate. PMID- 6848322 TI - Knotting of intracardiac flow-directed balloon catheter. Simple surgical method of removal. AB - A complete knot occurred in a 7F flow-directed balloon catheter inserted through the right internal jugular vein. The patient was intubated and placed under positive pressure ventilation. After gaining surgical exposure of the venipuncture site, a purse-string of Prolene 4--0 suture was placed around it. The patient was placed in the Trendelenburg position and the knotted catheter withdrawn, while the purse-string suture was immediately tightened avoiding uncontrollable hemorrhage or massive air embolism. PMID- 6848324 TI - Echocardiographic features of traumatic disruption of the aortic valve. AB - The echocardiographic findings are presented of a patient who had evidence of aortic regurgitation one year after blunt trauma to the chest. Combined M-mode and 2-D imaging showed features suggestive of disruption of the posterior aortic leaflet, subsequently confirmed at operation, in the absence of infective endocarditis. Diagnosis of this uncommon cause of aortic regurgitation, heretofore confirmed only by direct visualization, may be made preoperatively by echocardiography. PMID- 6848323 TI - Profound bradycardia following release of cardiac tamponade. Hypothesis for reflex control. AB - A 58-year-old patient with chronic renal failure presented for routine hemodialysis, and was noted to have severe hypotension and findings on examination compatible with cardiac tamponade. The patient had emergency construction of a pericardial window. At the time of surgery, rapid evacuation of the pericardial space resulted in rebound hypertension associated with marked bradycardia. The features of the patient's case were analogous to the cardiovascular and reflex adjustments that normally occur during the Valsalva maneuver. These findings suggest that the cardiovascular changes occurring during the rapid decompression of cardiac tamponade may be reflexly-mediated, and gradually decompression of the pericardial space is therefore recommended to avoid reflex hypertension and bradycardia. PMID- 6848325 TI - Adult respiratory distress syndrome following thrombolytic therapy for pulmonary embolism. AB - Pulmonary edema is rare in patients with pulmonary embolism and to our knowledge has not been described in association with thrombolytic therapy. We describe a patient with massive pulmonary embolism in whom the adult respiratory distress syndrome (ARDS) developed shortly after a course of streptokinase therapy. The possible association between streptokinase therapy or pulmonary embolism and ARDS should be recognized as streptokinase gains wider clinical use. PMID- 6848326 TI - Atropine renaissance. PMID- 6848327 TI - Controlled pressure cuffed endotracheal tubes may not be controlled. PMID- 6848328 TI - Transbronchial biopsy in sarcoidosis. PMID- 6848329 TI - Echocardiographic detection of associated pulmonary and mitral valve prolapse. PMID- 6848330 TI - Nutritional status and lung function in patients with emphysema and chronic bronchitis. AB - This study compared the nutritional status of patients with emphysema and chronic bronchitis and examined the relationship between lung dysfunction and nutritional depletion in patients with emphysema. There was no evidence of nutritional depletion in patients with chronic bronchitis (n = 4). In contrast, patients with emphysema (n = 14) were somatically depleted. They exhibited lower values for percent ideal body weight (%IBW), arm muscle circumference (AMC), and triceps skin fold thickness (TSF) (p less than 0.05) than did patients with chronic bronchitis. The creatinine height index (CHI) was also lower in this group, but the difference was not significant (p = 0.08). In patients with emphysema, there was a good correlation between the degree of airflow obstruction and of somatic depletion (FEV1 vs %IBW, r = 0.699, p less than 0.001). The single-breath diffusing capacity (DCO) also correlated well with %IBW (r = 0.6052, p less than 0.019). These results confirm that patients with emphysema are frequently nutritionally depleted and suggest that nutritional depletion contributes to lung dysfunction in emphysema. PMID- 6848332 TI - Partial and complete maximum expiratory flow-volume curves in asthmatic patients with spontaneous bronchospasm. AB - Bronchodilatation follows a deep inspiration in normal subjects with pharmacologically induced bronchoconstriction. To determine to what extent this occurs in asthmatic patients with spontaneous bronchospasm, we obtained partial (PEFV) and complete (MEFV) maximum expiratory flow volume curves in 20 adults (helium-oxygen responders and nonresponders) and 13 children with asthma. We measured maximum expiratory flow at 25 percent of forced vital capacity from the partial (Vmax - p) and complete (Vmax - c) flow-volume curves and expressed this relationship as the Vmax - p/Vmax - c ratio. Three of the adult subjects and one of the children had a V max-p/V max-c less than 1.0. Following inhalation of nebulized bronchodilators, none of the children or adults had a Vmax - p/Vmax - c ratio less than 1.0. Reasons for Vmax - p to be higher than Vmax - c include bronchoconstriction, decreased lung elastic recoil following a deep inspiration, and time dependence of maximum expiratory flow due to lung inhomogeneity. We conclude that asthmatic patients with spontaneous bronchospasm are only seldom able to obtain bronchodilation following a deep inspiration. PMID- 6848331 TI - Pneumococcal adherence to the buccal epithelial cells of cigarette smokers. AB - Adherence to mucosal surfaces is necessary for bacterial colonization. The in vitro adherence to type 25 Streptococcus pneumoniae to buccal epithelial cells was studied in 15 smokers, 15 nonsmokers, and 21 exsmokers. Background adherence in smokers and nonsmokers was similar, but smokers had a markedly increased pneumococcal adherence compared to nonsmokers (12.3 +/- 6.9 vs 0.7 +/- 0.4). This increase was not related to subject age or duration of cigarette use. Pneumococcal adherence in some exsmokers remained elevated for up to three years after smoking cessation. Incubation of nonsmokers' cells with smoker's saliva resulted in increased pneumococcal adherence to the nonsmokers' cells (1.1 +/- 0.099 to 8.2 +/- 4.4), suggesting mediation of pneumococcal adherence by a noncellular constituent of smokers' saliva. The increased pneumococcal adherence in cigarette smokers may promote oropharyngeal colonization and contribute to the increased risk of respiratory infection in cigarette smokers. PMID- 6848333 TI - The risk factors, incidence, and prognosis of ARDS following septicemia. AB - Adult respiratory distress syndrome (ARDS) is frequently associated with septicemia. However, the incidence, risk factors, and prognosis are poorly defined. Therefore, during a nine-month period, 116 consecutive patients with septicemia were analyzed. ARDS occurred in 21 of 116 (18 percent) of septicemic patients. Shock preceded all cases of ARDS but occurred in only 15 percent of patients without ARDS (p less than 0.001). Thrombocytopenia was more frequent (62 percent vs 16 percent, p less than 0.001). Age, sex, compromised host status, type of septicemia, temperature, and white blood cell count were not significantly different between the two groups. It is concluded that ARDS frequently complicates all forms of septicemia. It is usually preceded by shock and thrombocytopenia and significantly worsens the prognosis. PMID- 6848334 TI - Acute effects of chewable nifedipine on hemodynamic responses to upright exercise in patients with prior myocardial infarction and effort angina. AB - To evaluate the hemodynamic effects of nifedipine on anginal patients during exercise in the upright position, a placebo (P) and 20 mg of nifedipine were administered in a double-blind random sequence to ten patients presenting with exertional angina and a healed myocardial infarction. All patients had previously undergone coronary angiography. The effects of nifedipine in the upright position at rest, at the anginal threshold, and at the maximal level of exercise were studied. Nifedipine decreased systemic vascular resistances in upright position and increased the cardiac index. It reduced the severity of angina and allowed a higher physical work capacity without anginal symptoms. The most important beneficial effect of nifedipine appears to be the reduction in afterload, but an improvement of left ventricular function cannot be ruled out. PMID- 6848335 TI - Diffuse panbronchiolitis. A disease of the transitional zone of the lung. AB - Diffuse panbronchiolitis (DPB) is a disease with chronic inflammation exclusively located in the region of respiratory bronchioles. The pathologic features of the disease are characterized by thickening of the wall of the respiratory bronchiole with infiltration of lymphocytes, plasma cells and histiocytes, and extension of the inflammatory changes toward peribronchiolar tissues. In the advanced stage, secondary ectasia of proximal bronchioli may occur. These changes appear as diffusely disseminated small nodular shadows throughout both lungs on the chest roentgenogram. Obstructive respiratory functional impairment, occasional symptoms of wheezing, and also cough and sputum resemble the feature of emphysema, bronchial asthma, or chronic bronchitis, respectively. In the advanced stage, large amounts of purulent sputum and dilatation of proximal terminal conducting bronchioli resemble bronchiectasis. However, diffuse panbronchiolitis belongs to a distinctly different category from these diseases, and should be distinguished from them, because it may often show rapid progression with fatal outcome. The disease is dominant in males and the onset is unrelated to age. More than 1,000 cases of probable diffuse panbronchiolitis and 82 histologically-confirmed cases have been collected in Japan. PMID- 6848336 TI - Exercise testing in pulmonary sarcoidosis. AB - The variable natural history of sarcoidosis and the toxicity of corticosteroids result in many clinical situations where there is controversy concerning the need for treatment. Progressive incremental testing is an excellent method to identify physiologic mechanisms responsible for exercise limitation. It is therefore ideal to determine if subjective symptoms such as dyspnea are due to cardiac abnormalities, pulmonary abnormalities, or poor physical conditioning. Thirty-one patients with sarcoidosis underwent progressive incremental exercise testing. Four of 14 asymptomatic patients and eight of 17 symptomatic patients demonstrated pulmonary abnormalities which potentially limited exercise tolerance. These consisted of an abnormal respiratory pattern or gas exchange abnormalities, or both. Patients with completely normal routine pulmonary function studies almost always performed normally with exercise. Symptomatic patients with multiple abnormalities on routine pulmonary function studies invariably demonstrated a pulmonary limitation on exercise testing. Patients with one or two abnormalities on routine pulmonary function studies, regardless of the presence or absence of parenchymal infiltrates, required exercise testing to determine if symptoms were due to physiologically significant abnormalities of the respiratory system. The important variables necessary to be measured, arterial desaturation and an abnormal respiratory pattern, can be measured noninvasively with a minimum of equipment. PMID- 6848337 TI - Effects of acebutolol on paroxysmal atrioventricular reentrant tachycardia in patients with manifest or concealed accessory pathways. AB - Electrophysiologic studies before and after administration of 50 mg of intravenous (IV) acebutolol were performed in 20 patients. Four of the 20 had persistent preexcitation, two had intermittent preexcitation, and 14 had a concealed retrogradely conducting accessory pathway (AP). Acebutolol depressed anterograde AP conduction with loss of preexcitation in one patient and increased the effective refractory period of AP in the remaining three; in most, it depressed anterograde normal pathway conduction. The longest atrial paced cycle length producing atrioventricular (AV) nodal block increased from 290 +/- 7 to 39 +/- 6 msec (mean +/- SEM) after acebutolol (p less than 0.01). Acebutolol had no significant effect on retrograde AP conduction. Sustained AV reentrant tachycardia was inducible in all 20 patients before acebutolol and in 19 after acebutolol. The cycle length of tachycardia increased from 323 +/- 8 to 352 +/- 8 msec after acebutolol (p less than 0.01), reflecting an increment of A-H interval from 148 +/- 8 to 174 +/- 9 msec (p less than 0.01). Electrophysiologic studies were reported after 800 mg of oral acebutolol given in four divided doses at six hour intervals in eight patients. The results were comparable to those of IV acebutolol. Thus, acebutolol depresses AV nodal conduction and slows the rate of AV reentrant tachycardia, but is generally ineffective in inhibiting the induction of sustained tachycardia. It occasionally depresses anterograde AP conduction. PMID- 6848338 TI - Two-dimensional echocardiographic recognition of papillary muscle fibrosis in pediatric patients. AB - Two-dimensional echocardiographic examinations were performed in seven infants with anomalous origin of the left coronary artery from the pulmonary artery (ALCA), in one infant with myocardial infarction and left main coronary obstruction, and in eight with critical valvar aortic stenosis (AS). Comparative qualitative echo density assessment demonstrated that each infant had a marked increase in the echo density of one or both left ventricular papillary muscles. The increased echo density was considered to represent fibrosis and scar formation as a result of ischemia and infarction. Pathologic proof of excessive fibrosis of the papillary muscles was obtained in three cases. In an additional case, calcification of the papillary muscle was noted on fluoroscopic examination. The echocardiographic appearance of papillary muscle fibrosis provides a useful indicator of severe subendocardial ischemia in patients with either critical AS or ALCA. PMID- 6848339 TI - [Microorganisms in home-care inhalation devices]. AB - Contamination of inhalation equipment used at home, cleaning procedures, and the occurrence of potentially pathogenic micro-organisms in mouthwash water was studied in 55 patients. Fungi in the oropharyngeal space were found in 58%, Staphylococcus aureus in 29%, Enterobacteriaceae in 47% and Pseudomonas aeruginosa in 11%. Contamination with potentially pathogenic micro-organisms occurred in 64% of inhalation equipment and inhalation solutions. In a total of 151 samples from the equipment Klebsiella was present in 14%, Enterobacter in 10%, Serratia and Acinetobacter in 11% each, Pseudomonas in 5% and Staphylococcus aureus in 4.5%. In three cases the same serotype of Ps. aeruginosa was present in the oropharyngeal cavity and inhalation equipment. In most cases the cleansing of the inhalation equipment had been inadequate. Only 36% of those questioned cleaned the equipment immediately before use, only 4 of 20 stated that they washed their hands before use. Subjective assessment of the value of inhalation treatment was either "very good" or "good" in 80%. PMID- 6848340 TI - [Incidence of varicocele. Results of serial studies on 3 groups of probands]. AB - Varicoceles were encountered in 21.9% of 2752 men at draft and in 16% of 818 sanatorium patients. There was no decreasing incidence in the latter with increasing age. Fathers were encountered almost equally frequently among men with varicoceles as in men without varicoceles. Varicocelectomy seems to be indicated only when further children are wanted, when abnormalities of the spermiogram are present or testicular abnormalities can be detected on palpation. The validity of preventive removal of varicoceles in adults needs to be ascertained in a randomised and prospective study with concomitant registration of pregnancy rate and spermiograms. PMID- 6848341 TI - [Blunt injury to the neck caused by a seat belt. Stenosis of the internal carotid and vertebral arteries]. AB - A 37-year-old woman sustained blunt trauma to the neck from a seat-belt in a car accident, which resulted in marked long-segment narrowing of the internal carotid artery with secondary occlusion of a main branch of the median cerebral artery as well as circumscribed circular stenosis of the right vertebral artery. Serial angiograms documented the course until there was almost complete recanalization of all affected vessels. PMID- 6848342 TI - [Diagnosis of primary amenorrhea]. PMID- 6848343 TI - [Granulocyte transfusion]. PMID- 6848344 TI - [Strangulated papillary calculus: possibility of mechanical lithotripsy]. PMID- 6848345 TI - [Calcified liver metastases in C-cell carcinoma of the thyroid]. PMID- 6848346 TI - [Coronary sclerosis in runners]. PMID- 6848347 TI - [Therapy of prolactinoma with bromocriptine]. PMID- 6848348 TI - [Intrauterine fetal movement. Its significance in the diagnosis of the status of the fetus]. PMID- 6848349 TI - [Hairy cell leukemia. 2d report on the clinical course, morphology and therapy of 27 patients]. AB - The course of hairy cell leukaemia was observed in 27 patients for a maximum of 97 months. Splenectomy had been performed in 17 patients and improved the haematological situation impressively in most cases. Amongst patients with splenectomy ten are alive with 8 to 88 months postoperatively. In five of them disease manifesting as isolated leucocytosis, deterioration of the overall haematological situation or as intraabdominal lymphomatous growth could be treated successfully. Treatment consisted of leucapheresis, low-dose long-term therapy with chlorambucil, administration of doxorubicin (adriamycin) or a combination of cytostatics containing doxorubicin as well as abdominal localized or overall irradiation. PMID- 6848351 TI - [Infections caused by Campylobacter jejuni/coli]. PMID- 6848350 TI - [Cholecystectomy, cholelithiasis and cancer of the large intestine]. AB - In a retrospective post-mortem study the connection between the post cholecystectomy state, cholelithiasis and carcinoma of the large intestine was evaluated in 333 cases and compared with an age and sex matched control group and a group with gastric carcinoma. It was established that cholelithiasis (without cholecystectomy or contracted gallbladder) occurred significantly more frequently (24.9%) in patients with colonic carcinoma than in the control group (15.3%) or the gastric carcinoma group (12.6%) (P less than 0.001). In contrast the rate of cholecystectomy in patients with colonic carcinoma was not significantly increased (6.3%) when compared with both control groups (4.6 and 4.8%). Separate assessment of males and females showed that females had cholecystectomy and contracted gallbladder significantly more frequently (P less than 0.05). These figures suggest that the clinically observed association between cholecystectomy and colonic carcinoma reflects only a - not necessarily causative - connection between gallstone disease and colonic carcinoma. PMID- 6848352 TI - [Chronic vitamin A poisoning]. PMID- 6848353 TI - [Echinococcus cysticus in the spinal canal in spinal cord compression]. PMID- 6848354 TI - [Malignant melanoma caused by fluorescent light at the work place?]. PMID- 6848355 TI - Thyrotropin-mediated induction of thyroidal iodothyronine monodeiodinases in the dog. PMID- 6848356 TI - Antiestrogen-binding sites distinct from the estrogen receptor: subecellular localization, ligand specificity, and distribution in tissues of the rat. PMID- 6848357 TI - Antagonistic effects of progesterone on estradiol-induced synthesis and degradation of uterine glucose-6-phosphate dehydrogenase. PMID- 6848358 TI - Is there a direct correlation between the activities of various lysosomal enzymes and prolactin secretion in the rat anterior pituitary? AB - The degree of endocrine activity by rat pituitary lactotrophs was manipulated and the lysosomal involvement in the release and intracellular degradation of PRL was monitored by concomitant assays of acid phosphatase, beta-glucuronidase, dipeptidyl peptidases I and II, and nonspecific esterases in the anterior lobe. The in vitro release of PRL by cell cultures was inhibited by 0.5 or 1.5 microM bromocriptine during 24 or 72 h of incubation and by 0.75 microM for 4 h. Long term treatment caused a 40% reduction in the total PRL content of cells and media; however, after 4 h of bromocriptine treatment, no reduction in PRL content was found. TRH (10 ng/ml) in medium for 4 h increased PRL release, whereas it produced intracellular hormone depletion. In vitro treatment of anterior lobes of diestrous rats with 1 microM dopamine decreased PRL release by 50%. No changes in lysosomal enzyme activities were observed after the inhibition of release or stimulation of the in vitro secretion of PRL. Haloperidol (2.5 mg/kg BW) caused a 90% increase in serum PRL concentrations in diestrous rats 1 h after sc injection. alpha-Methyl-p-tyrosine (200 mg/kg BW, ip) stimulated in vivo PRL secretion, monitored 1, 4, and 24 h after drug administration. The administration of 100 micrograms/rat bromocriptine for 3 consecutive days, a single dose of 100 micrograms/rat polyestradiol phosphate, and their combination resulted in the expected changes in PRL production in female rats. These in vivo treatments failed to alter lysosomal enzyme activities in the anterior pituitary. These findings suggest that the release, intracellular accumulation, or depletion of PRL occurred without concomitant changes in lysosomal enzyme activity in the anterior pituitary. We suggest that the system of lysosome-dependent hormone degradation may involve more specific enzymes than those monitored to date. PMID- 6848359 TI - Synergistic effects of chymotrypsin and human chorionic gonadotrophin on rat luteal adenylate cyclase. AB - The effects of chymotrypsin on rat luteal adenylate cyclase have been investigated. Maximal stimulation occurred at a concentration of 10 micrograms/ml. This dose of chymotrypsin stimulated basal, GTP-,5'-(beta, gamma imido)triphosphate-, and NaF-stimulated adenylate cyclase activity 2- to 3-fold. hCG-stimulated activities were stimulated 5- to 6-fold by the proteinase and showed a synergistic effect. The proteinase did not alter the hCG response curve, and the effect could not be mimicked by trypsin. Proteolytic activity was required, since chymotrypsinogen and inactivated chymotrypsin were not effective. The presence of chymotrypsin could not restore the hormonal sensitivity of a proteinase inhibitor-inactivated system. The results suggest that chymotrypsin stimulated rat luteal adenylate cyclase activity by two or more mechanisms: 1) a direct action on the catalytic subunit or a closely associated protein, and 2) an action somewhere in the pathway of hormonal stimulation. PMID- 6848360 TI - Estrogenic effects of 5-androstene-3 beta, 17 beta-diol at physiological concentrations and its possible implication in the etiology of breast cancer. PMID- 6848361 TI - Further evidence of adrenergic control of translocation and intracellular levels of estrogen receptors in rat pineal gland. PMID- 6848362 TI - Primary culture of purified Leydig cells isolated from adult rat testes. AB - Methods for isolating highly purified Leydig cells permit the study of acute responses and biochemical properties of Leydig cells independent of other testicular cell types. The present study describes the development of a primary culture system for purified Leydig cells from adult rats in which the cells retain their ability to secrete testosterone for at least 72 h in culture. When Leydig cells were cultured in tissue culture medium 199--0.1% BSA (M199-BSA), basal testosterone secretion declined by 72 h, whereas hCGB-stimulated testosterone secretion was reduced by 48 h. Changing the culture medium twice daily or adding 0.5% fetal calf serum (fcs) enhanced basal and gonadotropin stimulated testosterone secretion at 72 h in culture, although responsiveness to hCG was reduced to 57% of that in freshly isolated cells. Incubation of Leydig cells in the defined culture medium Dulbecco's Modified Eagles-Ham's F-12 (1:1, vol/vol) supplemented with 15 mM Hepes buffer, transferrin, insulin, and epidermal growth factor (DHG:F12 + Hepes + TIE) in either the presence or absence of 0.5% fcs yielded functional Leydig cells for longer intervals in culture. Furthermore, testosterone secretion was greater in DHG:F12 + Hepes + TIE than in M199-BSA at all time intervals tested. In DHG:F12 + Hepes + TIE, basal and gonadotropin-stimulated testosterone production by Leydig cells were maintained for 72 h in culture. Degenerative changes in morphology were apparent in some cells at 72 h, but not at earlier times in culture. This primary culture system for isolated Leydig cells provides a valuable tool to examine the temporally regulated events in Leydig cell function. PMID- 6848363 TI - Nursing induces a biphasic release of prolactin in rhesus monkeys. AB - The effect of nursing on serum PRL levels was studied in four conscious unrestrained rhesus monkeys (20--46 days postpartum) fitted previously with exteriorized cardiac catheters. On the day of an experiment, the infant was transferred to a separate room for 9.5 h. Blood samples for PRL assay were collected from the mother at frequent intervals for 1 h before and 3 h after returning the infant. In all instances, vigorous suckling of the nipple was observed within 10 min of reuniting mother and infant and resulted in an elevation of serum PRL from an initial value of 7.4 +/- 0.5 ng/ml (mean +/- SEM) to a peak at 90 min of 339.7 +/- 56.1 ng/ml. Analysis of secretory patterns from individual animals revealed that PRL release was biphasic. During phase I, which began within 10--50 min of returning the infants and lasted for 20--50 min, serum PRL concentrations increased at an average rate of 0.47 ng/ml . min. This was followed by phase II, lasting 20--40 min, during which serum PRL rose at a 20 fold greater rate (10.57 ng/ml . min) to sustained maximum levels. Whether this unusual pattern of PRL secretion occurs as a consequence of neuroendocrine interactions unique to this species or simply reflects the prolongation and partitioning of a secretory process common to other mammals remains to be determined. PMID- 6848364 TI - Differences in androgen-binding properties of the two molecular forms of androgen receptor in rat ventral prostate cytosol. PMID- 6848365 TI - Dopamine receptors of the monkey anterior pituitary in various endocrine states. AB - The anterior pituitary of adult Macaca fascicularis monkeys was removed when they were killed and the potent dopamine (DA) antagonist [3H]spiperone was used to label DA receptors. Saturation isotherms of [3H]piperone binding indicated a dissociation constant of 0.09 nM and maximal sites of 170 fmol/mg assay protein (n = 2). Competition studies validated the hypothesis that [3H]spiperone labeled DA receptors; the order of potency of 12 compounds was appropriate for a dopaminergic interaction and was similar to the order found in the anterior pituitary of other mammals. A concentration of [3H]spiperone that would label 90% of the specific binding sites (0.76 nM) was used to estimate the total DA receptor activity in the anterior pituitary of individual monkeys. [3H]spiperone binding in pregnant monkeys was greater than the binding in ovariectomized and lactating females or intact males (P less than 0.05 or 0.01). The postpartum lactating group contained more [3H]spiperone binding activity than the cycling group (P less than 0.05). Determination of the serum concentrations of PRL, estradiol, testosterone, progesterone, and dehydroepiandrosterone confirmed the predicted hormonal status of the individual monkeys at the time of sacrifice. Because DA is a PRL inhibitory hormone, it was of interest that the serum PRL concentration was positively correlated with the degree of [3H]spiperone binding (r2 = 0.74). This observation, combined with the known hypertrophy and/or hyperplasia of the mammotroph during pregnancy, supports the hypothesis that the DA receptor is associated with the PRL cell of the anterior pituitary. PMID- 6848366 TI - Variable effects of testosterone on dopamine activity in several microdissected regions in the preoptic area and medial basal hypothalamus. AB - We have observed previously that systemic treatments or local implants of testosterone (T) suppress dopamine (DA) turnover in the preoptic area-anterior hypothalamus of male rats. In the present study, we sought to identify discrete regions innervated by the incertohypothalamic DA system and the tuberoinfundibular DA system which respond to T replacement. Adult male rats were orchidectomized and immediately treated with either empty (controls) or T containing Silastic implants. After 14 days, animals from each group were treated with alpha-methylparatyrosine and killed 0, 45, and 90 min later for analysis of DA turnover in eight microdissected brain regions. The T implants produced an increase in serum T and 5 alpha-dihydrotestosterone and reduced serum LH to concentrations observed in intact male rats without affecting serum PRL levels. Serum levels of T within the physiological range caused a profound decrease in the DA turnover rate in the medical preoptic nuclei and anterior hypothalamic nuclei without influencing DA activity in the periventricular nuclei, the site of perikarya for these DA projections. In contrast, DA turnover in the median eminence was increased 3-fold by T treatment, while DA activity in the arcuate nuclei, the locus of cell bodies of the tuberoinfundibular DA system, was not affected. These studies reveal disparate effects of T on the terminal fields of the two DA systems. While augmentation in the median eminence DA activity may participate in the negative feedback effects of T on gonadotropin secretion, the T-induced suppression of DA turnover in the medial preoptic nuclei and anterior hypothalamic nuclei may well be involved in androgen-dependent aggression and copulatory behavior. PMID- 6848367 TI - Identification of pancreatic polypeptide secretagogues in canine duodenal mucosa. AB - The second phase of pancreatic polypeptide (PP) release after a meal is thought to occur via a vagal-cholinergic-dependent pathway acting in concert with a putative humoral factor of gut origin. To identify this enteric factor(s), extracts of canine duodenal mucosa were evaluated for PP secretagogues using canine pseudoislets in a column-perifusion bioassay system. Two thermostable agents with PP secretagogue activity have been found. The smaller and predominant peptide had an apparent molecular weight slightly larger than insulin and migrated on Sephadex G-50 columns at a distribution coefficient of 0.47 +/- 0.01. This secretagogue consistently elicited 1.3-1.5 times greater PP secretory response when compared to the larger peptide, which migrated at an average distribution coefficient of 0.29 +/- 0.02. Chromatographically similar activities were found in extracts of duodenal venous plasma collected 2 h after a meal. These PP secretagogues are presumed to be unique to the duodenal mucosa since they were not observed in extracts of liver or heart. These results show that the duodenal mucosa contains PP secretagogues larger than those previously demonstrated and further support the notion that a substance of gut origin participates in the mechanism of postprandial PP release. PMID- 6848368 TI - The interaction of estrogen- and antiestrogen-receptor complexes with polynucleotides. AB - As the polynucleotide domain of the estrogen receptor (Re) is a possible site for the modulation of Re activity, the interaction of antiestrogen (4 hydroxytamoxifen and tamoxifen)-receptor complexes (4-OH-Tam-Re and Tam-Re) with polynucleotides (oligodeoxynucleotide-cellulose, DNA-cellulose, and polyribonucleotide-agarose) was investigated and compared with that of the 17 beta-estradiol-receptor complex (E2-Re). E2-Re- and anti-Re-E2-complexes were optimally bound to oligo(dT)-cellulose and poly(U)-agarose at 0.15 M KCl and pH 7.6. Temperature activation of the Re was not required for these selective interactions to occur, but they were inhibited by 10 mM sodium molybdate. OH-Tam Re and E2-Re demonstrated similar selectivity for different deoxynucleotide bases [oligo(dG) greater than oligo(dT) greater than or equal than oligo(dC) greater than oligo(dA) greater than or equal to oligo(dI)] and different ribonucleotide bases [poly(G) = poly(I) greater than poly(U) greater than poly(A) greater than or equal to poly(C)]. Quantitatively, Tam-Re bound significantly less to oligo(dT)-cellulose than did OH-Tam-Re, which did not differ significantly from E2-Re, a result probably related to the dissociation of the lower affinity ligand from the Re/oligo(dT)-cellulose during the assay procedure. Unoccupied Re also bound selectively to these synthetic polynucleotides. It is concluded that: 1) selective binding of Re to synthetic polynucleotides is inhibited by 10 mM sodium molybdate; 2) estradiol is not essential for selective binding to synthetic polynucleotides, since unoccupied Re was only slightly less efficiently bound than E2-Re; and 3) selective binding of Re to synthetic polynucleotides was unaffected by the agonist or antagonist properties of the ligand bound at the steroid-binding site. These data suggest that nonsteroidal antiestrogens are unlikely to exert their antagonist activity by modulating the function of the polynucleotide-binding site of Re. PMID- 6848369 TI - Propranolol decreases serum thyroxine as well as triiodothyronine in rats: a protein-binding effect. PMID- 6848370 TI - Platelet-derived growth factor stimulates bone resorption by monocyte monolayers. AB - Resorption of devitalized bone particles by monocytes grown in culture was stimulated by platelet-derived growth factor (PDGF) in a dose-dependent manner. Bone resorption in response to PDGF was time-dependent with a significant increase over control cultures evident by 72 hours. These data are the first to demonstrate stimulation of bone resorption by PDGF in a specific cell type known to resorb bone in vivo and in vitro. PMID- 6848371 TI - Stimulatory effect of luteinizing hormone upon relaxin secretion by cultured porcine preovulatory granulosa cells. AB - Relaxin, a peptide hormone capable of causing connective tissue alterations, is produced by the corpus luteum and traditionally considered a hormone of pregnancy. We have cultured granulosa cells from preovulatory porcine follicles and have found that these non-pregnancy associated cells secrete relaxin, and that luteinizing hormone, which stimulates ovulation, enhances relaxin secretion by cells from large preovulatory follicles. These results suggest that relaxin secreted prior to ovulation may have a local ovarian effect, perhaps facilitating ovulation. PMID- 6848372 TI - Interactions of microbial populations in cellulose fermentation. AB - Fermentation of cellulose in the rumen occurs through the interactions of many microbial species. The initial degradation of cellulose is caused by cellulase producing organisms. The soluble hydrolysis products are used by both cellulolytic and noncellulolytic organisms to produce acetate, propionate, and butyrate and the important intermediates H2 and succinate. Interactions between species are necessary for the decarboxylation of succinate to propionate. H2 is used by methanogenic bacteria to reduce CO2 to CH4. The removal of H2 by methanogenesis increases the production of acetate from carbohydrates by several important cellulose- and carbohydrate-fermenting microbial species. Monensin and lasalocid appear to alter the overall fermentation by selecting for populations that produce relatively larger amounts of propionate and against populations that produce relatively larger amounts of acetate and H2. Cellulose fermentation in the human large intestine is compared with fermentation in the rumen. PMID- 6848373 TI - Rumen microbial attachment and degradation of plant cell walls. AB - The plant cell wall of forages is a complex entity of cellulose fibers found in a matrix of hemicellulose and pectins. Different microbial types including bacteria, protozoa, and fungi associate with plant cell walls during incubation with rumen fluid. Bacteria, the major degraders of the forage cell wall, often firmly attach to the forage cell wall before digestion. Encapsulated cocci and irregularly shaped or pleomorphic bacteria are the predominant types of bacteria that adhere to and degrade cell walls. Although certain bacterial types adhere to particular forages, no consistent association was found between digestibility and the type of adhering bacteria. Bacteria adhere to the more rigid forage cell walls and adhere, or are close to, the more easily degraded cell walls. Tissues delignified with potassium permanganate or treated with sodium hydroxide (to improve forage digestibility) show a loss of electron denseness. These tissues separate into individual cells, which at times appear as microfibrils in the cell walls. Research is needed on forages of higher fiber content to mitigate the barriers that limit the attack on forage cell walls by rumen microorganisms. PMID- 6848374 TI - Activation and regulation of the first complement component. PMID- 6848375 TI - Regulation of energetics and mechanics by myosin light chain phosphorylation in fast-twitch skeletal muscle. PMID- 6848376 TI - Myosin light chain and membrane protein phosphorylation in various muscles. AB - Phosphorylation of myosin light chain was compared in various muscles. In 32P labeled chicken anterior latissimus dorsi and posterior latissimus dorsi the [32P]phosphate content of the 19,000-dalton and 18,000-dalton light chains, respectively, was 1.8-fold higher in muscles tetanized for 5 or 15 s than in the contralateral resting muscles. Similar results had been previously obtained with frog sartorius and semitendinosus muscles. In addition to the radioactive technique, the extent of light chain phosphorylation was also measured by densitometry after separating the phospho and dephospho forms of the light chain with two-dimensional gel electrophoresis. The extent of light chain phosphorylation in tetanized chicken muscles and caffeine-treated frog muscles was not greater than 50%. The extent of phosphorylation of the 19,000-dalton light chain in hearts from several animals (turtle, rat, frog, chicken, dog, and cat) showed major differences. At the extremes it was 76% in turtle and 10% in chicken. the polymorphism of heart light chain was also demonstrated. Not only myosin light chains but also membrane proteins were detected to be phosphorylated. Some of the membrane proteins exhibited increases in phosphorylation during muscle contraction. PMID- 6848377 TI - Gizzard Ca2+-independent myosin light chain kinase: evidence in favor of the phosphorylation theory. AB - Limited digestion of calmodulin (CaM)-dependent myosin light chain kinase from turkey gizzard with alpha-chymotrypsin in the presence of bound CaM generated an 80,000-dalton kinase fragment that was fully active in the absence of Ca2+. This kinase catalyzed specific Ca2+-independent phosphorylation of the 20,000-dalton light chain of myosin using isolated light chains, intact myosin, and actomyosin. Phosphorylation of myosin in the absence of Ca2+ allowed us to dissociate myosin phosphorylation from other potential Ca2+-dependent regulatory mechanisms, thus permitting an evaluation of the postulated central role of myosin phosphorylation in the regulation of smooth muscle contraction. Ca2+-independent myosin phosphorylation was found to cause loss of Ca2+ sensitivity of 1) actin-activated myosin ATPase activity in a crude actomyosin preparation, and 2) tension development in skinned smooth muscle fibers in the absence of Ca2+. Myosin phosphorylation is, therefore, the key event in actin activation of ATPase activity and initiation of contraction in skinned chicken gizzard fibers. PMID- 6848378 TI - The role of myosin light chain phosphorylation in regulation of the cross-bridge cycle. AB - Ca2+ binding to myofibrillar regulatory sites can produce conformational changes allowing cross-bridge attachment and cycling. Measurements of smooth muscle actomyosin ATPase activity suggested that Ca2+ might act indirectly to mediate cross-bridge attachment by stimulating myosin light chain phosphorylation. However, the predicted obligatory relationship between developed force and myosin phosphorylation was not always observed in living smooth muscle. The observation that myosin phosphorylation was always tightly correlated with average cross bridge cycling rates estimated from isotonic shortening velocities suggested that Ca2+ has two regulatory roles. One action is exerted via a Ca2+-binding protein whose identity is unknown in smooth muscle. This regulatory site acts like other Ca2+-binding regulatory proteins in muscle to permit cross-bridge interaction and to determine active stress. The second regulatory role involves stimulation of myosin light chain kinase and light chain phosphorylation. Increasing the level of phosphorylated cross-bridges increases shortening velocities or rate of force development. We suggest that the dephosphorylated cross-bridges are noncycling or slowly cycling in activated smooth muscle. Smooth muscle may be a particularly favorable experimental preparation for demonstrating a general regulatory role of myosin phosphorylation in modulating the kinetics and energetics of muscle contraction. PMID- 6848379 TI - Coordination of metabolism and contractility in vascular smooth muscle. PMID- 6848381 TI - International workshop on the application of fluorescence photobleaching techniques to problems in cell biology. PMID- 6848380 TI - Coordination of metabolism and contractility by phosphorylation in cardiac, skeletal, and smooth muscle. Introduction. PMID- 6848382 TI - Marine pharmacology: drugs from the sea. Introduction. PMID- 6848384 TI - Aspects of copulatory behavior and peptide control of egg laying in Aplysia. AB - The atrial gland of the marine mollusc Aplysia is associated with the large hermaphroditic duct of the reproductive system and contains several peptides capable of inducing egg laying. The structure and function of these peptides are briefly reviewed. It has been hypothesized that during copulation the atrial gland of the female is stimulated by penile insertion to release its peptides, which in turn initiate events leading to egg deposition. To test this hypothesis we monitored reproductive activity over periods of weeks in individual, paired, and grouped A. brasiliana. It was found that copulation is not a necessary stimulus for egg laying, because individually housed Aplysia lay more eggs than when they are paired and allowed to copulate. Nor is copulation a sufficient stimulus, because the vast majority of copulations are not followed by egg laying. Simultaneous egg laying and female copulatory behavior were often observed with grouped and paired animals, but these events are probably not causally related. It is concluded that although the atrial gland contains at least three peptides that can induce egg laying, stimulation of this gland during copulation does not normally serve to initiate egg laying. PMID- 6848383 TI - Mammalian pharmacology of the fish neuropeptide urotensin I. AB - The urophysis, a neurosecretory organ in fish, contains a number of putative hormones, collectively called urotensins. One of these, urotensin I--a straight chain peptide of 38 amino acids--produces a sustained hypotensive action in all mammalian species examined. In the anesthetized dog, the hypotensive action of native urotensin I is due to specific dilatation of the mesenteric vascular bed, the peptide having no significant actions on other vascular beds. Recent work has established that urotensin I is similar in structure to sauvagine and ovine corticotropin-releasing factor (CRF). Synthetic urotensin I and synthetic sauvagine both share the ability of synthetic ovine CRF to release adrenocorticotropin from cultured pituitary cells. All these synthetic peptides appear to lower blood pressure in the dog by the mechanism established for native urotensin I: selective mesenteric vasodilatation. The selectivity of the mesenteric vascular response suggests that a similar endogenous peptide might be the physiological regulator of gut blood flow. These peptides, or analogs, may also prove to be of value in ischemic bowel disease or anastomotic gastrointestinal surgery, or in reduction of afterload in heart failure. PMID- 6848385 TI - A new hysterographic approach to the evaluation of tubal spasm and spasmolytic agents. PMID- 6848386 TI - Immunoreactive relaxin-like substance in human split ejaculates. AB - Immunoreactive relaxin-like substance concentrations were estimated in whole seminal plasma of normozoospermic patients, in seminal fluid of both fractions of split ejaculates, as well as in the seminal plasma of patients affected by excretory azoospermia of various causes. The relaxin concentration was significantly higher in the first fraction of partitioned ejaculates (P less than 0.001). In cases of azoospermia after vasectomy or after epididymal obstruction, the relaxin levels were similar to the values observed in normozoospermia. Relaxin concentrations, however, were high in cases of congenital agenesis of vasa deferentia and seminal vesicles. Relaxin traced in human male seminal plasma seems thus to have an important extragonadic source, probably localized in the prostate. PMID- 6848387 TI - A mode of action of IUDs. PMID- 6848388 TI - Oil versus aqueous media for hysterosalpingography. PMID- 6848389 TI - Early conception in patients with untreated mild endometriosis. AB - The purpose of this paper is to report the reproductive experience in 31 infertile patients with mild endometriosis who were not treated by surgery or medication. A series of 31 cases of laparoscopically diagnosed mild endometriosis were followed up without therapy for a period of 36 months. Ten patients received artificial insemination by donor (AID) because of male-related infertility; 21 patients had well-timed postcoital tests and monitored ovulation cycles. Life table analysis of conceptions was used for presentation of the pregnancy rate. The group of patients whose husbands were azoospermic had a 90% pregnancy rate within 18 months, with a mean of 3.5 treatment cycles for pregnancy. The nonazoospermic couples had a 47.6% pregnancy rate within 18 months, with a mean of 7.2 monitored cycles for pregnancy. The calculated median delays for the series of patients who conceived were 1.9 cycles. The whole series (n = 31) of patients with mild endometriosis had an 8.3% monthly pregnancy rate within 18 months and a 61.2% cumulative pregnancy rate within 18 months. We have come to the conclusion that mild endometriosis does not interfere with female fertility, and patients with this extent of disease should not be treated for a trial period of at least 18 months as an alternative to more aggressive therapy. PMID- 6848390 TI - The use of the argon laser in the treatment of experimental endometriosis. AB - The argon laser offers several theoretical advantages over excision, electrocautery, or CO2 laser therapy for the treatment of peritoneal implants of endometriosis. Therefore, a study of the feasibility of the argon laser for the treatment of endometriosis was performed using five virgin New Zealand White rabbits. Following 6 days of estrogen administration, each animal underwent laparotomy with excision of the right uterine horn. Sections of endometrium were sutured to several peritoneal surfaces. Approximately 3 weeks later the endometrial implants were photocoagulated with the argon laser (488 nm, 2 W, 2-mm spot size, 3 to 5 seconds). Histologic examination of the sites of laser therapy demonstrated complete ablation of the endometriosis with 0.25-mm damage to the underlying tissue and surrounding tissue. PMID- 6848391 TI - Prolactin in the evaluation of luteal phase in infertility. AB - Hyperprolactinemia was detected in 15 of 130 infertile patients (11.5%) with regular menstrual cycles and no galactorrhea who underwent luteal phase evaluation by basal body temperature (BBT), plasma estradiol (E2), and progesterone (P) determination, and endometrial biopsy (repeated in a later cycle when the first was defective). Luteal phase length and plasma levels of P and E2 were similar in the hyperprolactinemic and normoprolactinemic patients. Moreover, a significantly higher incidence of inadequate luteal phase, histologically documented, was found in the normoprolactinemic group. It is concluded that the usefulness of plasma prolactin (PRL) determination in the evaluation of luteal function in infertility is scanty and that most histologically documented cases of luteal phase defects occur with euprolactinemia. PMID- 6848392 TI - Clomiphene citrate therapy for luteal phase defect. AB - The incidence of luteal phase defects in 366 infertility patients was 12.7%. Life table analysis was used for determination of the conception rate with clomiphene citrate therapy, and with this method, evidence was found for the presence of two subgroups with respect to response. The crude conception rate was 40.9%. In a group of patients with a luteal phase defect and no other infertility factors, those that conceived had a significantly larger mean biopsy delay than those who did not (6.28 days versus 4.32; P less than 0.02). In a group with a histologic delay of 5 days or more, the conception rate was 79%, while the rate was only 8.9% in those with a less severe deficit (P less than 0.001). Theoretic considerations for clomiphene citrate therapy are discussed. PMID- 6848393 TI - Experience with the classification, diagnosis, and therapy of nonejaculatory intercourse. AB - Twenty-one consecutive patients complaining of nonejaculatory intercourse were studied. Fifteen patients had anejaculation of various types, and sex therapy succeeded in 4 of 7 cases. Three patients had retrograde ejaculation that could be corrected by ephedrine sulfate in two cases having a neurologic cause. In one of three patients having nonemission, ejaculation was restored after stopping the drug thioridazine. A juvenile diabetic patient was discovered to have nonemission and not retrograde ejaculation. A classification of the disorders leading to nonejaculatory intercourse based on pathogenetic and clinical data is presented, including anejaculation, retrograde ejaculation, nonemission, and aspermia. PMID- 6848394 TI - Stimulation of the zona-free hamster ova penetration efficiency by human spermatozoa after 17 beta-estradiol treatment. AB - 17 beta-Estradiol (E2) stimulated the zona-free hamster ova penetration by human spermatozoa from both fertile and subfertile men after 5 hours of incubation in vitro. For spermatozoa samples from fertile men, the mean penetration rates increased significantly (P less than 0.05), from 35.6% +/- 3.5% (control) to 60.1% +/- 5.8% (E2 = 50 ng/ ml) and 50.5% +/- 2.6% (E2 = 100 ng/ml), respectively. E2 also increased the mean penetration rates of spermatozoa samples from subfertile men significantly (P less than 0.05), from 10.2% +/- 1.8% (control) to 30.5% +/- 7.2% (E2 = 50 ng/ml) and 33.1% +/- 6.6% (E2 = 100 ng/ml), respectively. These findings indicate that E2 can affect the fertilizing ability of human spermatozoa in vitro. PMID- 6848395 TI - An ultrastructural study of ovarian perifollicular capillaries in the indomethacin-treated rabbit. AB - The perifollicular capillaries of the rabbit ovary were observed by light and electron microscopy following administration of human chorionic gonadotropin (hCG) and indomethacin (IM). Fenestrations and interendothelial gaps were not observed at 4, 10, or 12 hours, at which times carbon particles were confined to capillary lumina. By 24 hours, dilated capillaries were noted among granulosa cells and theca. In the theca, interendothelial gaps permeable to carbon particles were observed. At 48 hours, ribosome-rich, newly developed capillaries were noted. Many collagen fibrils were observed in the tunica albuginea and theca externa in hCG/IM-treated rabbits in contrast to those treated with hCG alone. Ovarian prostaglandins normally produced in response to gonadotropins may be responsible for alterations in perifollicular capillaries and degradation of collagen in the follicle wall, changes considered essential for ovulation. PMID- 6848396 TI - Meiotic chromosomal changes and sterility produced by nitrogen mustard and procarbazine in mice. AB - Treatment and survival of reproductive-age patients with chemotherapy raises the question of possible effects on procreative ability. An attempt has been made to establish an animal model system. The anticancer agents nitrogen mustard and procarbazine caused decreased fertility in mice of both sexes and induced meiotic chromosomal abnormalities, at least in the male. Progeny of treated mice showed similar meiotic chromosomal changes. The possibility of similar effects in human beings receiving chemotherapy must be considered. PMID- 6848397 TI - Immunoreactive neurotensin in the pancreas of genetically obese and diabetic mice. A longitudinal study. AB - Immunoreactive neurotensin (IR-NT) content in 2 N acetic acid extracts of pancreas was measured in genetically diabetic (C57BL/KsJ db/db and ob/ob) and obese (C57BL/6J ob/ob and db/db) mice and normal littermate controls from 5 to 24 wk of age to determine the relationship of any changes to the development of metabolic abnormalities. Pancreatic IR-NT in obese mice showed no consistent change compared with lean littermate controls. In contrast, diabetic mice demonstrated an increase in pancreatic IR-NT that occurred at 6-8 wk of age, and maximal about the time of islet B-cell failure (8-10 wk), and persisted over the study period. Pancreatic IR-NT eluted in two peaks on reverse phase high-pressure liquid chromatography, one of which exhibited a retention time similar to that of synthetic NT. These findings suggest that pancreatic IR-NT concentration is regulated by insulin, with elevated levels occurring in association with insulin deficiency and its metabolic consequences but not with insulin resistance. Taken together with the previous demonstration that NT influences pancreatic islet hormone secretion, the present findings support a possible role of endogenous NT in islet hormone regulation. PMID- 6848398 TI - Lack of glucagon response to hypoglycemia in long-term experimental diabetic rats. AB - Glucagon and catecholamine responses to insulin-induced hypoglycemia were investigated in streptozotocin-diabetic rats at various times after streptozotocin administration and in age-matched control male rats. Diabetic rats had basal glucagon levels higher than those in control rats, while basal epinephrine and norepinephrine levels were essentially identical. As the duration of diabetes increased, the glucagon and epinephrine responses to insulin hypoglycemia decreased. The response of control rats was not correlated with age. Increases in plasma norepinephrine values in response to hypoglycemia were similar in both diabetic and control rats. The data indicate a concurrent impaired response of glucagon and epinephrine release in response to insulin induced hypoglycemia in streptozotocin-diabetic rats as the duration of diabetes prolongs. PMID- 6848399 TI - The effect of continuous subcutaneous insulin infusion on very-low-density lipoprotein triglyceride metabolism in type I diabetes mellitus. PMID- 6848400 TI - No evidence of amyloidosis in type I diabetics treated with continuous subcutaneous insulin infusion. AB - A recent study has demonstrated secondary amyloidosis in dogs treated with continuous intravenous insulin infusion. Since elevated levels of serum amyloid A protein (SAA) and diminished amyloid fibril degrading activity (AFDA) are associated with amyloidosis, we measured SAA and AFDA in ten type I diabetics treated with continuous subcutaneous insulin infusion and in five conventionally treated patients. Only one pump- and one conventionally treated patient had detectable but low SAA levels, comparable with these seen in healthy controls. In patients with secondary amyloidosis the mean SAA level was 24-fold higher than in controls (P less than 0.001). Similarly, in both diabetic groups, AFDA was normal whereas it was reduced by 41% in patients with amyloidosis (P less than 0.001). Furthermore, no local amyloidosis was seen at the infusion site in any of the patients studied. Thus, our data fail to provide any evidence of secondary amyloidosis in patients treated for 3-40 mo with continuous subcutaneous insulin infusion. PMID- 6848401 TI - Diagnostic efficacy of hepatic computed tomography in the detection of body iron overload. AB - To determine whether or not hepatic computed tomography density is an alternative to liver biopsy for the diagnosis of body iron overload, hepatic computed tomography density was determined in healthy controls, patients with idiopathic hemochromatosis, and patients with liver disease. Hepatic computed tomography density was obtained from a single computed tomography slice taken through the liver on a General Electric CT/T 8800 scanner. In 69 controls, hepatic computed tomography density ranged from 11 to 36 units (mean = 30). Given an upper limit of normal of 36 computed tomography units, 4 of 6 untreated patients with idiopathic hemochromatosis had elevated hepatic computed tomography density compared with 0 of 8 patients after venesection (X2 = 7.5, p = 0.01). Hepatic computed tomography density correlated directly with serum ferritin (r = 0.72, p = 0.01). In 58 consecutive patients with clinical or biochemical evidence, or both, of liver disease who underwent liver biopsy for diagnostic purposes, 0 of 52 patients with normal hepatic iron had an elevated hepatic computed tomography density as compared with 4 of 6 patients with excess iron (X2 = 35, p less than 0.001). An elevated hepatic computed tomography density associated with an elevated serum ferritin indicates iron overload; however, a normal hepatic computed tomography density does not exclude iron overload. When computerized tomography is applied to patients with an unexplained elevation of the serum ferritin, it provides a noninvasive alternative to liver biopsy for the detection of excess hepatocellular iron. PMID- 6848402 TI - Clinical and histological events preceding hepatitis B e antigen seroconversion in chronic type B hepatitis. AB - A 60-mo longitudinal study has been undertaken in 99 HBeAg-positive patients with clinicopathologically verified chronic hepatitis. Hepatitis B e antigen clearance occurred in 30 patients at a rate of approximately 17% per year. A phenomenon of abrupt elevation of serum glutamic pyruvic transaminase (greater than 300 IU/L) with histological changes compatible with chronic lobular hepatitis was observed in 13 of 20 patients (65%) preceding spontaneous HBeAg clearance. In contrast, 8 of 10 patients on immunosuppressive or antiviral therapy, or both, had uneventful HBeAg clearance. It was concluded that HBeAg clearance can occur in patients with varying immunologic status. The mechanism responsible for HBeAg clearance awaits further study. PMID- 6848403 TI - Changes in aminolevulinate synthase and aminolevulinate dehydratase activity in cirrhotic liver. AB - Delta-Aminolevulinate synthase and delta-aminolevulinate dehydratase activities were determined in liver biopsy specimens obtained from 12 patients with hepatic cirrhosis. Delta-Aminolevulinate synthase activity was determined by the incorporation of [1,4-14C]succinyl coenzyme A into delta-aminolevulinate. The mean activity of delta-aminolevulinate synthase was significantly higher in cirrhotic liver specimens (mean +/- SE, 193.7 +/- 34.5 picomoles delta aminolevulinate per milligram protein per 30 minutes) than in controls with minimal histologic changes (32.7 +/- 13.6, p less than 0.01). Furthermore, the mean activity of delta-aminolevulinate synthase was higher in micronodular cirrhosis (281.6 +/- 58.8) than in the other types of cirrhosis (131.0 +/- 23.1, p less than 0.05). Levels of indocyanine green retention at 15 min correlated with the activity of hepatic delta-aminolevulinate synthase (p less than 0.05). The mean activity of delta-aminolevulinate dehydratase, in contrast, was significantly lower in cirrhotic liver specimens (9.4 +/- 1.3 nanomoles porphobilinogen per milligram protein per hour) than in controls (22.0 +/- 2.6, p less than 0.05). These results suggest that the extent of liver injury or the degree of portosystemic shunting, or both, influence the rate of hepatic heme biosynthesis. PMID- 6848404 TI - An increased familial frequency of gallstones. AB - Despite the very high prevalence of gallstone disease, studies of familial factors are very few, and asymptomatic family members were not studied. We studied, in a prospective manner, the frequency of gallstones in 171 first-degree relatives of patients with proven gallstones compared with 200 matched controls. All subjects were studied by oral cholecystography, and their height, weight, blood glucose, cholesterol, and other parameters were measured. Gallstones were found in 20.5% of the family group and in 9.0% of the control group. Gallstones were found in 22.8% of the female and 16.7% of the male family members as opposed to 10.3% of the female and 8.0% of the male controls. All these differences were statistically significant. Known risk factors, such as Ashkenazi community group, higher age, and overweight, were more frequent in the control group, as were blood glucose and cholesterol. These findings strengthen the validity of the twofold higher frequency of gallstones found in the family group and are likely to be due to genetic factors. A formal genetic family study of gallstone disease is now indicated, using the ultrasonic method. PMID- 6848405 TI - Alteration of the degree of biliary cholesterol saturation in the hamster and rat by manipulation of the pools of preformed and newly synthesized cholesterol. AB - Our studies compared the effects of changing the availability of newly synthesized and preformed cholesterol by various dietary manipulations on biliary cholesterol secretion in the hamster and rat. In hamsters fed a plain pelleted diet, only 2%-5% of biliary cholesterol was derived directly from newly synthesized sterol. Cholestyramine feeding, through a stimulation of hepatic sterol synthesis, increased this fraction fivefold but did not change total biliary cholesterol output. The relative cholesterol content increased significantly due to a reduction in bile acid and phospholipid output. In contrast, biliary cholesterol output was increased several-fold in hamsters fed a fat-free diet. These animals also manifested a pronounced increase in whole-body sterol synthesis, this being due principally to an increase in hepatic sterol synthesis. Although this resulted in the transport of much more newly synthesized cholesterol directly into bile, this did not account for the disproportionately high rate of biliary cholesterol output. Such excess sterol was derived predominantly from a preformed source. Unlike hamsters, rats fed the fat-free diet manifested a marked reduction in hepatic and whole-body sterol synthesis, bile acid pool size, and bile acid and cholesterol output in bile. These studies demonstrate that when hepatic cholesterol synthesis increases in response to a need for more sterol in the body, a greater proportion of biliary cholesterol is derived directly from newly synthesized sterol, but total biliary cholesterol output is unchanged. In contrast, when more cholesterol is synthesized than is needed to maintain cholesterol balance, biliary cholesterol output may increase. Such excess biliary sterol is derived predominantly from a preformed source rather than from the transport of newly synthesized sterol directly across the canalicular membrane. PMID- 6848407 TI - Individual and combined roles of the pylorus and the antrum in the canine gastric emptying of a liquid and a digestible solid. AB - The gastric emptying of a liquid (5% dextrose) and a digestible solid (liver) were studied in 8 dogs with an intact stomach, after pylorectomy, after antrectomy, and after distal (Billroth I) gastrectomy. Pylorectomy and particularly Billroth I gastrectomy resulted in more rapid gastric emptying of the liquid. With an intact stomach, the digestible solid was broken down predominantly (93.8%) into very small particle size (less than 0.15 mm) before being passed into the duodenum. This ability was largely preserved after both pylorectomy or antrectomy. Billroth I gastrectomy resulted in the small bowel being presented with much larger particles of a digestible solid than if the antrum or the pylorus, or both, were preserved. After excision of both the antrum and the pylorus, 38.2% of the liver emptied in particle size greater than 1 mm as opposed to 2.5% from the intact stomach, 4.9% after pylorectomy, and 6.1% after antrectomy. Thus, both the pylorus and the antrum can control the gastric emptying of both a liquid and a digestible solid. PMID- 6848408 TI - Neuromuscular differentiation of the human pylorus. AB - The mechanical activity of muscle strips from the gastroduodenal junction as obtained at operations was studied. Strips were cut so as to present the activity of the circular muscle layer of the antrum, the duodenum, the intermediate, or the distal pyloric sphincter. All strips increased and maintained a tension with increasing length, but distal sphincter strips did more so than the other types of strips. Phasic contractions were rare in distal sphincter strips, while all intermediate sphincter strips contracted at rates similar to antral strips. Electric field stimulation produced pure contractions in all responsive strips of the antrum and the intermediate sphincter. In most strips from the duodenum and distal sphincter the contraction response occurred during the stimulus, and the relaxation response far outlasted the stimulus. Distal sphincter strips had the larger relaxation responses, and duodenal strips had the larger contraction responses. Relaxation in response to electric stimulation, Ca++ withdrawal, or isoproterenol did not completely abolish the baseline tension of the distal sphincter. At least in its distal segment, muscle from the human pylorus differs from muscle of the antrum and the duodenum by its high baseline tension, its prominent neurogenic relaxation response, and its poor spontaneous contractile activity. PMID- 6848409 TI - Complex pathogenesis of hyperoxaluria after jejunoileal bypass surgery. Oxalogenic substances in diet contribute to urinary oxalate. AB - Balance studies and oxalate loading tests were carried out in order to define the pathogenesis of hyperoxaluria in 8 patients with jejunoileal bypass surgery for severe obesity; two healthy volunteers were also studied. In the bypass patients, urinary oxalate was markedly elevated (118 +/- 43 mg/day, mean +/- SD) when they were on a high oxalate diet (252 mg/day). Hyperabsorption of dietary oxalate was confirmed by the markedly increased urinary recovery of [14C]oxalate given in a test meal. In addition, the oxalate radioactivity was excreted in urine far more slowly than in healthy volunteers, suggesting that the colon was a major site of oxalate absorption. Elevated urinary oxalate excretion persisted, averaging 38 +/ 12 mg/day, despite ingestion of a very low oxalate diet (approximately 6 mg/day), suggesting that the diet contained "oxalogenic" substances other than preformed dietary oxalate which also contributed to dietary oxalate in these patients. Urinary oxalate decreased in 7 of 8 patients, however, when protein rich foods were removed from the diet, suggesting that at least one dietary factor was digestive products of protein or creatinine. These results confirm the current view that in patients with hyperoxaluria secondary to jejunoileal bypass, the majority of urinary oxalate derives from dietary oxalate that is absorbed from the colon. Tissue or bacterial production of oxalate or an oxalate precursor from dietary constituents associated with protein, however, also appears to contribute to urinary oxalate. The results provide an explanation for the reported difficulty of eliminating secondary hyperoxaluria by restriction of dietary oxalate alone. PMID- 6848406 TI - Effect of litholytic bile acids on cholesterol absorption in gallstone patients. AB - We measured intestinal absorption of cholesterol by a plasma isotope ratio method and determined biliary bile acid and lipid composition of fasting gallbladder bile in 5 gallstone patients before therapy and during two randomized treatment periods with chenodeoxycholic or ursodeoxycholic acid (13 mg/kg . day). During chenodeoxycholic acid ingestion, biliary bile acids were composed predominantly (84%) of conjugates of chenodeoxycholic acid. During ursodeoxycholic acid administration, conjugates of ursodeoxycholic acid constituted half the bile acid pool (49%). Fasting gallbladder bile was supersaturated in cholesterol before treatment, but became unsaturated during administration of both chenodeoxycholic and ursodeoxycholic acids. In spite of these marked changes in biliary bile acid and lipid composition, cholesterol absorption was not significantly different before (45.4 +/- 4.3%, mean +/- SEM) or after chenodeoxycholic (42.7 +/- 5.1%) or ursodeoxycholic (46.8 +/- 3.7%) acid ingestion. We conclude that chenodeoxycholic and ursodeoxycholic acids unsaturate bile in cholesterol and dissolve gallstones by a mechanism other than the suppression of intestinal absorption of cholesterol. PMID- 6848410 TI - Pregnancy-related changes in small intestinal myoelectric activity in the rat. AB - To determine if changes in intestinal motility occur during pregnancy, we studied small intestinal myoelectric activity, using monopolar electrodes, in fasted pregnant rats from day 12 to day 18 of the 22-day gestation period. We also studied fasting myoelectric activity in postpartum, nonpregnant, and castrate females. In all rats, the interdigestive myoelectric complex was invariably present with recurring activity fronts appearing at the proximal electrode and moving slowly abroad. Intervals between fronts were similar in all four groups, ranging from 12.61 min to 14.58 min. In pregnant rats, however, there was loss of the periodicity characteristic of activity fronts in the other groups; intervals up to 43 min in length were occasionally noted. Unorganized, randomly occurring spike potentials characterized these intervals. The average coefficient of variation of interval length was significantly (p less than 0.05) greater in pregnant rats (0.401) than in castrate (0.197) and nonpregnant rats (0.248). These studies confirm the presence in rats of pregnancy-related changes in small intestinal myoelectric activity. PMID- 6848411 TI - Origin of slow waves in the canine colon. AB - The objectives of this work were to determine the origin of slow wave activity in the canine colon, to examine the slow wave characteristics in the circular and longitudinal muscle layers, and to examine the roles played by each of these layers in the generation of this activity. Extracellular electrical activity was recorded in vitro from strips of intact muscle wall and from isolated circular and longitudinal muscle using either multiple electrodes applied to one side of the specimen or two electrodes applied simultaneously to opposite sides of the tissue. Intracellular electrical activity was also studied in intact muscle, in isolated circular muscle, and in isolated longitudinal muscle. Slow waves were recorded extracellularly from circular and longitudinal muscle when the two layers formed the intact muscle wall; they were also recorded from isolated circular muscle, but not from isolated longitudinal muscle. Removal of the submucosa from the circular muscle surface abolished slow waves recorded from both isolated circular muscle and the intact specimen. Exposure of the mucosal surface of isolated circular muscle to a hypertonic solution of KCl abolished slow waves, while exposure of the serosal surface to the same concentrations had no effect. Slow waves are not generated in longitudinal muscle. Slow waves in circular muscle are dependent on the integrity of the junction between the submucosa and the innermost circular layer. PMID- 6848412 TI - Location and activity of ulcerative and Crohn's colitis by indium 111 leukocyte scan. A prospective comparison study. AB - A prospective blinded study comparing the indium 111 leukocyte scan to barium enema, colonoscopy, or surgery or a combination of these, was carried out in 15 patients (10 with active ulcerative colitis and 5 with active Crohn's colitis). Correlation of disease location to colonic regions between indium scan and other diagnostic studies was excellent in 11 instances, good in 2, and poor in 3. In 2 of the 3 studies where major disagreement occurred, the comparative barium enema was performed greater than 2 mo after the indium scan. Disease activity, estimated by the intensity of radionuclide uptake, was compared to clinical disease activity assessed by the Crohn's Disease Activity Index for both forms of colitis. The relative degree of inflammation estimated by the indium scan correlated well with the independent clinical assessment (correlation coefficient = 0.81). The indium 111 leukocyte scan appears to be an accurate, noninvasive method for assessing the extent and the severity of the inflammation in patients with acute ulcerative or Crohn's colitis. PMID- 6848413 TI - Chronic camphor ingestion mimicking Reye's syndrome. AB - Camphor is a potentially dangerous drug which nevertheless remains popular as a home remedy. Because of its hepatoneurotoxic effects, camphor toxicity may clinically mimic Reye's syndrome. The differentiation between the two requires histologic examination of liver tissue, further emphasizing the need for a liver biopsy to establish the diagnosis of Reye's syndrome. PMID- 6848414 TI - Biliary cystadenocarcinoma diagnosed by liver biopsy performed under ultrasonographic guidance. AB - A case of a 60-yr-old man with biliary cystadenocarcinoma is reported. By needle biopsy of a cystic lesion performed under ultrasonographic guidance, overt malignant tissue could be obtained successfully. Histologic examination on autopsy material revealed that the tumor arose from preexisting benign liver cysts. The tumor showed a feature of well-differentiated, mucin-producing papillary adenocarcinoma in the primary site while, in the metastatic foci, it produced solid cell clusters with a tendency toward the differentiation into squamous cells. PMID- 6848415 TI - Surveillance/management of an obligate gene carrier: the cancer family syndrome. PMID- 6848416 TI - Chronic type B hepatitis. PMID- 6848417 TI - Progestogens and gallbladder contractility. PMID- 6848418 TI - Can we diagnose amoebiasis? PMID- 6848419 TI - Malignant histocytosis presenting as a fulminant hepatic disease. PMID- 6848420 TI - Endometrial carcinoma--common but curable. PMID- 6848421 TI - Sarcoidosis in older patients--clinical characteristics and course. PMID- 6848422 TI - Control of cancer pain. PMID- 6848423 TI - Meeting the challenge of cancer control: a case in point. PMID- 6848424 TI - Diabetes: geriatric complications. PMID- 6848426 TI - Penicillin allergy--diagnosis and management. PMID- 6848425 TI - Anemia of chronic disease: basic concepts and management. PMID- 6848427 TI - Responding to septic arthritis. PMID- 6848428 TI - Chemical and physical properties of gall stones in South Australia: implications for dissolution treatment. AB - Of 406 consecutive patients with gall-bladder stones, 387 were treated by cholecystectomy and 19 were treated with chenodeoxycholic acid. The gall stones found in 356 of the 387 patients at operation were analysed chemically for cholesterol and calcium, physically for number, size, and mass, and radiologically before cholecystectomy for stone lucency. Gall stones rich in cholesterol (greater than 80% by weight) were present in 75% of patients, while pigment stones (less than 25% cholesterol) were found in 12% of patients. Out of the 406 gall-stone patients, 77 (19%) had functioning gall bladders which contained radiolucent stones 1.5 cm or less in diameter, thereby fulfilling the criteria which are used by most clinicians in selecting patients for dissolution therapy of cholesterol gall stones. The stones of 61 of these patients were available for chemical analysis and 52 (85%) were rich in cholesterol. Using the more stringent criterion for stone size of 1 cm or less in diameter, only 11% of patients had stones suitable for dissolution treatment. Taking into account other factors such as lack of compliance with treatment, obesity, and calcium salts in gall stones, it appears that no more than 10% of gall-stone patients presenting to a general hospital could be successfully treated with chenodeoxycholic acid. PMID- 6848429 TI - Effects of ethanol on the sphincter of Oddi: an endoscopic manometric study. AB - The effects of ethanol, given either intragastrically or intravenously, on the sphincter of Oddi was evaluated by endoscopic manometry. In 12 subjects intragastric ethanol (150 ml of 32%) was given over 10 minutes. In five control subjects saline solution (150 ml of 0.9%) was given intragastrically instead of ethanol. In five other subjects ethanol was infused intravenously (6 ml/kg of 10%) for 36 minutes. Ethanol given intragastrically produced a significant inhibitory effect on sphincter of Oddi pressure. Peak pressure fell from a control value of 75.7 +/- 26.35 mmHg to 39 +/- 15.39 mmHg (p less than 0.001) at 35 minutes. Basal pressure fell from a control value of 30.17 +/- 19.47 mmHg to 11.83 +/- 6.35 mmHg (p less than 0.01) at 35 minutes. Wave height fell from a control value of 41.33 +/- 15.4 mmHg to 27.16 +/- 11.25 mmHg (p less than 0.02) at 35 minutes. No effects on sphincter of Oddi wave frequency were observed. No significant modifications of sphincter motor activity were observed after intragastric saline infusion. Ethanol given intravenously also produced an appreciable inhibitory effect on sphincter of Oddi pressure, without affecting its wave frequency. PMID- 6848430 TI - Effect of sodium taurocholate on gastric secretion in patients with duodenal ulceration. AB - The effect of sodium taurocholate instillation on the stimulated stomachs of patients with duodenal ulceration has been investigated. Instillation into the stomach of sodium taurocholate significantly reduced pentagastrin stimulated volume and outputs of both acid and sodium, with no change in the calculated volume of duodenogastric reflux. These observations are not consistent with the back-diffusion theory, but suggest direct parietal cell inhibition of gastric secretion by sodium taurocholate. PMID- 6848431 TI - Bile salt-induced gastric mucosal damage and histamine receptor antagonists. AB - The effects of both an H1 receptor antagonist and an H2 receptor antagonist on changes in monovalent ion flux induced by topical sodium taurocholate were studied in antrectomised dogs fashioned with a denervated fundic pouch. The magnitude of taurocholate-induced ion flux was unaffected by topical administration of H1 or H2 receptor antagonists Parenteral administration of H1 or H2 receptor antagonist given singly or in combination produced an increase in net luminal Na+ gain before taurocholate administration but failed to reduce the magnitude of taurocholate-induced ion flux. It is concluded that histamine receptors are unlikely to have a role in the induction of mucosal injury by bile salts. PMID- 6848432 TI - Copper chelation therapy in intrahepatic cholestasis of childhood. AB - The effect of copper chelation was studied in a group of children with intrahepatic cholestasis of childhood (IHCC) and increased liver copper levels. Initial therapy was D-penicillamine (10 mg/kg/day), being replaced by triethylenetetramine dihydrochloride (20 mg/kg/day) when side-effects of D penicillamine occurred. Eight children completed two years of copper chelation. Pruritus remained the main symptom and did not improve. Two patients developed D penicillamine side-effects - one patient after nine months (marked anorexia, lassitude) and one other patient after 19 months (thrombocytopenia). Two patients died during the study, in one of these normal hepatic copper concentration was achieved. Hepatic copper concentrations decreased in seven of eight patients from 8.6 (2.7 +/- 16.2) mumol/g to 3.4 (0.6-16.5) mumol/g (median and range (0.05 less than 0.01) and serum aspartate transaminase increased in seven of eight patients (p less than 0.05). Histological assessment of serial liver sections revealed increased fibrosis and cholestasis despite reductions in hepatic copper levels during the study. This study showed that D-penicillamine therapy was associated with significant side-effects, while marked clinical, biochemical, or histological improvement did not follow effective copper chelation therapy in intrahepatic cholestasis of childhood. PMID- 6848433 TI - Factors affecting gall-stone dissolution rate during chenic acid therapy. AB - Gall-stone dissolution rate was measured in 52 patients with radiolucent gall stones in a functioning gall bladder receiving chenic acid 15 mg/kg/day. Percentage reduction in gall-stone area at six months was inversely related to initial gall-stone diameter (n = 52; r = -0.53; p less than 0.001), and to cholesterol saturation index of fasting gall-bladder bile during treatment (n = 28; r = -0.61; p less than 0.001). The duration of treatment required for complete dissolution was directly related to initial gall-stone diameter (r = 0.47; p less than 0.02). We conclude that the rate of gall-stone dissolution depends not only on gall-stone size but also on the degree of unsaturation of gall-bladder bile achieved during chenic acid treatment. PMID- 6848435 TI - Hospital's courtyard transformed into sun-filled lobby. PMID- 6848436 TI - Hospital expenses continue decline in September 1982. PMID- 6848434 TI - Motility of neutrophils and monocytes in Crohn's disease and ulcerative colitis. AB - Random motility and chemotaxis of peripheral blood neutrophils and monocytes from patients with Crohn's disease and ulcerative colitis have been measured using a modified Boyden Chamber filter assay. Increased random motility and chemotaxis of monocytes were found in patients with active ulcerative colitis. Monocyte motility was normal in Crohn's disease and no abnormality of neutrophil motility or chemotaxis was found in either disease. Drug therapy with prednisolone or sulphasalazine received in vivo was found to have no effect on the motility of the washed neutrophils and monocytes in vitro. This work adds to the evidence that monocytes are activated in ulcerative colitis but does not support the hypothesis that Crohn's disease is due to an inherent defect in phagocyte motility. PMID- 6848437 TI - A state of transition. State health officers try to judge cutbacks, growing need, and added responsibilities. PMID- 6848438 TI - On the road recovery. Merrill Lynch predicts a more stable economy by the end of 1983, and less than draconian entitlement cuts. PMID- 6848439 TI - Talking to the board. By opening communication lines with board members, CEOs promote continuity and effective handling of key issues. AB - When asked how he has been able to effectively stay in one job for so long, the man who has been at the head of one of the nation's largest banking organizations for 16 years, Richard Cooley, chairman, Wells-Fargo Bank, said that he "learned very early that board relations was the most important key to his continuity." Cooley said his strategy over the years has been to meet for dinner about once a year with each member of this board to allow the board member to get to know him, to personally hear the issues that the board member considers most important, and to solicit input on proposed management plans. PMID- 6848440 TI - More than a business. Are hospitals forgetting their basic mission? PMID- 6848441 TI - Regionalization pact increases revenue. PMID- 6848442 TI - 1982 third-quarter financial performance. PMID- 6848443 TI - Professional credentials required. PMID- 6848444 TI - Hospital-based alcoholism treatment. PMID- 6848445 TI - Growing legal obligations of physicians to patients. PMID- 6848446 TI - In vitro effects of protease inhibitors on murine natural killer cell activity. AB - To test whether proteolytic events are involved in natural killer (NK) cell mediated lysis of tumour cells, twenty-three different protease inhibitors were added to in vitro assays of natural killer cell reactivity. Of all of the materials tested, only tosyl-L-lysine chloromethyl ketone (TLCK), tosyl-L phenylalanine chloromethyl ketone (TPCK) and benzamidine unequivocally inhibited killing at concentrations approaching those needed to affect appropriate purified proteases. All of the effective inhibitors, and none of the others tested, inhibited binding of effector to target cells. The action of TLCK was focused on both effector and target cells, in that cytolysis was completely inhibited by a 1 hr pretreatment of effectors with 10(-4) M TLCK, and 60% inhibited by a 1 hr treatment of targets only. PMID- 6848448 TI - Membrane sialoglycolipids regulate the activation of alternative complement pathway by liposomes containing trinitrophenylaminocaproyldipalmitoylphosphatidylethaolamine. AB - We found that liposomes associated with trinitrophenylaminocaproyldipalmitoylphosphatidylethanolamine (TNP-Cap-DDPE) activate the alternative complement pathway (ACP) of guinea-pig. The complement activating capacity (CAC) of liposomes with TNP-Cap-DPPE (TNP-Cap-liposomes) was found to be inhibited by the insertion of sialoglycolipids such as GM3 onto the membrane. However, neutral glycolipids tested had no inhibitory effect on the CAC of the TNP-Cap-liposomes. The minimum amount of sialoglycolipids required for the inhibition of the ACP-activating capacity of TNP-Cap-liposomes was 0.01 or less in molar ratio to dimyristoylphosphatidylcholine in the liposomes. Since the insertion of charged amphiphiles did not affect the status of TNP-Cap-liposomes containing glycolipids with respect to their ACP-activating capacity, the surface potential caused by sialoglycolipids was disregarded as being the factor responsible for restriction of the complement-activating effect. For the inhibitory effect to be manifested, it was demonstrated that the presence of GM3 was required on the same liposome membrane as where the TNP-Cap-triggered ACP activation is taking place. Therefore, sialoglycolipids may inhibit ACP activation by reacting directly on certain nascently activated complement proteins. However, insertion of GM3 could not inhibit liposome lysis via the classical complement pathway. Furthermore, the presence of antibody reaction significantly reduced the inhibitory capacity of GM3 indicating that natural antibody may be responsible for discriminating between self and heterologous surfaces, thus cancelling the glycolipid-mediated restriction of ACP activation in the case of heterologous cell surface, bringing about lysis by the cancellation of the glycolipid-mediated restriction of ACP activation on heterologous cell surfaces. PMID- 6848447 TI - The effect of vitamin A depletion on antigen-stimulated trapping of peripheral lymphocytes in local lymph nodes of rats. AB - The effect of vitamin A depletion on antigen-stimulated trapping of peripheral lymphocytes in lymphatic organs was studied in rats. Distribution of [3H]-uridine labelled syngenic peripheral lymphocytes was quantified by assaying radioactive content of brachial and axillary lymph nodes, spleen and liver of normal and vitamin A-depleted F344/Ducrj rats immunized with sheep red blood cells. Localization of labelled cells in the ipsilateral brachial lymph nodes of the normal rats was stimulated by three times upon immunization with sheep erythrocytes as compared with the contralateral nodes. Recruitment of cells in axillary lymph nodes, spleen and liver was not significantly different from non immunized values. The vitamin A-depleted rats exhibited marked deterioration in antigen-stimulated trapping of labelled cells in the draining brachial lymph nodes. These results suggest that this effect of vitamin A depletion is due to derangement of integrity of lymphocyte-trapping mechanism in the draining lymph nodes and not to any change in nature of lymphocytes per se. PMID- 6848449 TI - Specific binding by human polymorphonuclear leucocytes of the immunological mediator 1-O-hexadecyl/octadecyl-2-acetyl-sn-glycero-3-phosphorylcholine. AB - The binding of the platelet-activating factor 1-O-hexadecyl-2-acetyl-sn-glycero-3 phosphorylcholine (AGEPC) by human polymorphonuclear (PMN) leucocytes was complete within 20-30 min and optimal at 37 degrees. Scatchard plot analyses of the total binding of [3H]AGEPC by PMN leucocytes without and with an excess of unlabelled AGEPC revealed two distinct types of binding sites. One type of binding site exhibited a high affinity (KD = 0.11 +/- 0.02 nM, mean +/- SD), was saturable and had a maximal capacity of 5.2 +/- 2.1 x 10(6) (mean +/- SD) molecules of AGEPC per PMN leucocyte. The other binding site demonstrated a substantially lower binding affinity and a greater binding capacity consistent with nonreceptor uptake of AGEPC into cellular structures. The high affinity binding site of PMN leucocytes in suspension was saturated at 196 +/- 90 pmol (mean +/- SD) of AGEPC per ml, while 600 pmol of AGEPC per ml evoked maximal PMN leucocyte chemotaxis in modified Boyden chambers. The specificity of binding of AGEPC by PMN leucocytes was established by the capacity of analogues of AGEPC, but not structurally distinct chemotactic factors, to inhibit the binding of [3H]AGEPC. The high affinity PMN leucocyte binding site for AGEPC was specific for a phospholipid with an alpha-ether linkage and a beta-short chain fatty acid, but the binding site lacked stereospecificity. Similar structural requirements were stereospecificity. Similar structural requirements were observed for the elicitation of PMN leucocyte chemotaxis and the enhancement of the expression of PMN leucocyte C3b receptors by AGEPC. PMID- 6848450 TI - The effect of cimetidine on antibody synthesis in vitro and in vivo. PMID- 6848452 TI - Specific suppression of rat IgE responses with milk from immunized females and with feeds of serum antibody. PMID- 6848451 TI - Human antibody-dependent cellular cytotoxicity and natural killer cytotoxicity to herpes simplex virus-infected autologous and allogeneic cells. AB - Using cultured skin shavings, human cellular cytotoxicity to uninfected and herpes simplex virus (HSV)-infected autologous and allogeneic fibroblasts and Chang liver cells was analysed in a 51Cr release assay. The effector cell requirements and characterization, time kinetics and antibody requirements were similar using each HSV-infected target cell in an antibody-dependent cellular cytotoxicity (ADCC) system. There was lower natural killer cytotoxicity (NKC) to uninfected autologous cells than unrelated cells in an 18 hr assay. NKC to infected autologous and unrelated fibroblasts was similar to that mediated against Chang liver cells. Thus NKC to uninfected fibroblasts correlated with the relationship of effector and target cells while NKC to infected cells correlated with the intrinsic lytic potential of the effector cells. The autologous system offers little advantage in the analysis of ADCC or NKC in normal individuals to virus-infected cells, but is probably crucial for the detection of HLA-restricted T-cell cytotoxicity. The demonstration of autologous anti-viral ADCC and NKC lends further credence to the in vivo importance of the mechanisms. PMID- 6848453 TI - Host protective antibodies and serum immunoglobulin isotypes in mice chronically infected or repeatedly immunized with the nematode parasite Nematospiroides dubius. AB - The nematode parasite Nematospiroides dubius survives to give a chronic primary infection in mice. However, mice subjected to weekly infections of 125 larvae, interspersed by treatment with an anthelmintic to prevent the accumulation of lethal numbers of adult worms in the intestine, develop host-protective antibodies in their serum. The protective effect of these antibodies was demonstrated by passive transfer to naive recipients or to mice already adoptively immunized with immune mesenteric lymph node cells (IMLNC). Sera were first shown to exhibit protective activity during the third and fourth weeks of the multiple immunizing infection, reaching a peak level by week six beyond which there was no further increase in protective activity. This increase was correlated with a ten-fold, concurrent rise in serum IgG1 levels. None of the other immunoglobulin isotypes underwent comparable changes in concentration nor could they be correlated with the pattern of appearance of host-protective antibodies in the sera of donor mice. This suggested that host protective antibodies were of the IgG1 class. CFLP and C57BL10 mice (the latter is a weak responder strain) both had high levels of host-protective antibodies in their serum. However when the sera from NIH mice (a strong responder strain) were compared, they exhibited far less protective activity on passive transfer to recipient mice, although when given together with IMLNC, serum from multiply immunized NIH mice enhanced the protective effect of IMLNC synergistically. When primary infection serum was assayed in this passive/adoptive transfer model, no host-protective antibodies could be demonstrated, even with pools of primary infection serum taken 10 and 17 weeks after infection. These results are discussed with respect to the possible mechanisms by which N. dubius evades the host immune system to give rise to long-lasting primary infections in mice. PMID- 6848454 TI - IgE suppression by maternal IgG. AB - Rats born of egg albumin immunized mothers have a diminished capacity to produce IgE antibody to egg albumin persisting for at least 13-14 weeks after birth. At the same time the primary IgG response to the antigen is usually enhanced. Previous studies indicated that these effects were mediated by factors transferred in maternal milk. The phenomenon can be duplicated by the administration of small quantities of immune serum to rats during the first 3 weeks of life. The active component of immune serum is shown to be specific antibody. Suckling rats acquire egg-albumin-specific IgG from the immune mother via the milk. Their serum level approaches that of the mother by 20 days but declines rapidly after weaning to become undetectable by 6-8 weeks. As maternal influence on the immune responsiveness of the offspring persists for several weeks beyond this time, it is unlikely that the mechanism involves a simple blocking by circulating antibody of the access of antigen to cellular receptors. Alternative mechanisms are briefly discussed. Attention is drawn to the possibility that the suppression of IgE antibody responsiveness by maternal IgG may represent a physiological regulatory process with a role in inhibiting the development of infantile allergies. PMID- 6848456 TI - Isolation of two polypeptides comprising the neutrophil-immobilizing factor of human leucocytes. AB - Human leucocyte lysosomal polypeptides of mol. wt 4000-5000, which constitute the neutrophil-immobolizing factor (NIF), were isolated from the 22,000 g supernate of sonicates of human neutrophils by filtration on Sephadex G-75. The larger (NIF 1) and smaller (NIF-2) of the polypeptides were resolved by filtration on Bio-Gel P6 and purified to homogeneity by sequential reverse-phase high performance liquid chromatography and paper electrophoresis. The results of analyses of amino acid composition indicated that NIF-1 and NIF-2 are distinct polypeptides composed of an apparent total of 41 and 38 amino acids, respectively. Both NIF polypeptides contain one cysteine and one methionine, lack isoleucine, tyrosine and phenylalanine, and are rich in histidine and proline. The sequence of 20 of the amino-terminal amino acids of both NIF polypeptides is identical, but NIF-2 possesses an additional alanine at the amino-terminus. Highly purified NIF-1 and NIF-2 inhibited human neutrophil random migration and chemotaxis to diverse stimuli in a concentration-dependent manner, with 50% inhibition of chemotaxis by 0.31-1 x 10(-8) M NIF-1 and 1-3 x 10(-7) M NIF-2. Neither NIF polypeptide was cytotoxic for neutrophils, altered neutrophil phagocytosis or release of lysosomal enzymes, or inhibited mononuclear leucocyte chemotaxis. The leucocyte and functional specificity of the NIF polypeptides and the quantitites released upon stimulation of the human leucocytes suggest that the transition to a mononuclear leucocyte population in chronic inflammation may be attributable in part to the NIF derived from the leucocyte infiltrates of acute responses. PMID- 6848455 TI - The mediation of tissue eosinophilia in hypersensitivity reactions. IV. Production of delayed eosinophil chemotactic factor-a by peritoneal exudate cells from sensitized guinea-pigs in vitro. AB - An eosinophil chemotactic factor (ECF) was produced in the cell-free culture supernatants (CFS) of peritoneal exudate cells (PEC) from guinea-pigs immunized with dinitrophenyl derivatives of ascaris extract (DNP-As), when stimulated by the antigen in vitro without activation by immune complexes. A 2 or 6 hr pulse of the antigen was sufficient for ECF production, whereas long time incubation (48 hr) was required for the production of a sufficient amount of the factor. Treatment of PEC by cycloheximide resulted in the reduction of ECF production, suggesting that protein synthesis is essential. Its generation appeared carrier specific and the source of the factor is presumed to be lymphocytes, probably T lymphocyte. The factor with a molecular weight of 70,000 shared a common antigenicity with delayed eosinophil chemotactic factor-a (delayed ECF-a), which was isolated from the skin lesions showing delayed tissue eosinophilia in vivo. PMID- 6848457 TI - Age-dependence of hypertensive-normotensive differences in plasma norepinephrine. AB - We compared venous plasma norepinephrine (NE) concentrations in 191 resting, supine patients with essential hypertension and 129 normotensive controls. Among normotensives, plasma NE increased significantly with age, but among hypertensives, no age-related increase occurred, due to relatively high NE values among young hypertensives. When patients and controls less than 40 years old were considered, hypertensives showed significantly higher plasma NE than the controls (317 vs 245 pg/ml, t = 3.15, p less than 0.01); but above the age of 40 years, no significant hypertensive-normotensive difference was obtained. These results, predicted by recent literature reviews, help to resolve the persistent controversy about sympathetic neural activity in essential hypertension, since such activity appears to be abnormal mainly in young patients. The data are consistent with increased sympathetic nervous system activity in the early stages of essential hypertension. PMID- 6848458 TI - Hypothyroidism as a cause of hypertension. AB - To study whether there is an association between hypertension and hypothyroidism, measurements of blood pressure and thyroid function were determined in 477 female patients with chronic thyroiditis. Based on the blood levels of thyroxine (T4) and thyroid stimulating hormone (TSH), 308 patients were considered euthyroid and 169 were hypothyroid [T4 = 2.9 +/- 0.1 micrograms/dl and TSH = 105.8 +/- 6.8 microU/ml (mean +/- SEM)]. Diastolic, but not systolic, blood pressure in hypothyroid patients over 50 years was higher than in euthyroid patients of corresponding age groups. The prevalence of hypertension was higher in hypothyroid patients when hypertension was defined as the systolic and/or diastolic blood pressure above 160/95 mm Hg (14.8% vs 5.5%; p less than 0.01). Correlations between diastolic, but not systolic, blood pressure and either the blood level of triiodothyronine (T3) or T4 was significant (r = - 0.174, p less than 0.01, and r = 0.208, p less than 0.01, respectively) when data from both euthyroid and hypothyroid patients were combined. Adequate thyroid hormone replacement therapy for an average 14.8 months in 14 patients resulted in a normalization of thyroid function and a reduction of blood pressure (p less than 0.01). In four who showed no change in thyroid function due to inadequate replacement therapy, blood pressure remained elevated. These results suggest a close association between hypertension and hypothyroidism. PMID- 6848459 TI - Accuracy of auscultatory blood pressure measurements in hypertensive and obese subjects. AB - In 59 treated or untreated hypertensive subjects and 52 obese subjects (normotensive or hypertensive), intraarterial blood pressure (BP) was compared to simultaneous auscultatory measurements. In the hypertensive group, arm circumference was less than 35 cm compared to over 35 cm in the obese subjects. The occluding cuffs were 12 x 35 cm and 15 x 43 cm respectively. Mean difference between auscultatory and intraarterial systolic BP (SBP) was among the hypertensive -- 8.8 mm Hg (SDDIFF 9.0 mm Hg, range + 13/ - 28) and among the obese - 3.1 mm Hg (SDDIFF 13.8 mm Hg, range + 19/ - 49). Mean difference auscultatory-intraarterial diastolic BP (DBP) Phase V was among the hypertensive patients + 10.8 mm Hg (SDDIFF 6.8 mm Hg, range + 29/ - 8), and among the obese + 5.5 mm Hg (SDDIFF 7.3 mm Hg, range + 20/ - 10). Thus, a 15 x 43 cm cuff used in obese subjects with an arm circumference exceeding 35 cm gave quite as reliable measurements as a 12 x 35 cm cuff used in hypertensive subjects with "normal" dimension of the upper arm (less than 35 cm). It is emphasized that there is a wide scatter in the interindividual differences, and it is argued that a comparison between auscultatory and intraarterial BP should be performed in patients with poorly controlled hypertension. PMID- 6848461 TI - Sympathetic contribution to the cardiac response to stress in hypertension. AB - Studies of cardiac performance in hypertension have often been restricted to cardiac output determinations, although the latter alone are inadequate for that purpose. To define the range of cardiac performance in hypertension, the response of left ventricular filling pressure to increased workload (static exercise) was determined in 39 subjects--eight normotensive (NT) volunteers, seven patients with borderline hypertension (BLH), and 24 essential hypertensives (EH), of age matched groups. A rise of mean pulmonary wedge pressure (PWP) by 5 mm Hg or more during maximum handgrip (HG) was considered "abnormal" for a workload (SBP x HR x 10(-3)) increase of greater than or equal to 25%. All NT subjects and all patients with BLH as well as 16 of the 24 EH (EH-I) showed normal cardiac performance by this definition. In contrast, PWP increased greater than or equal to 5 mm Hg during HG in eight patients with EH (EH-II). The calculated increase in cardiac workload was not significantly different among the four groups (+5, 5.8, 5.4 and 5.5 respectively). Beta blockade (propranolol, 10 mg i.v.) slowed heart rate in all subjects and reduced SBP x HR product in all groups both at rest and during HG. Responses of PWP to HG were widely divergent in the different patients. However, as a group those patients with "impaired cardiac performance" before propranolol (EH-II) had a greater reduction in performance following propranolol than EH-I or NT. This study suggests that adrenergic support of cardiac performance might be important in some hypertensive patients with no evidence of heart failure. PMID- 6848460 TI - Urinary sodium excretion and blood pressure in children: absence of a reproducible association. PMID- 6848462 TI - Dopaminergic control of prolactin and blood pressure. PMID- 6848464 TI - Biochemical and mechanical properties of resistance arteries from normotensive and hypertensive rats. AB - Microchemical techniques were employed to measure the DNA, contractile proteins, and connective tissue protein composition of 150 micrograms samples of mesenteric and cerebral resistance arteries taken from 25-week-old spontaneously hypertensive (SHR) and control Wistar-Kyoto (WKY) rats. The active and passive mechanical properties of intact resistance arteries also were determined. The DNA content of branches of the posterior cerebral and mesenteric arteries (170 micrometers I.D.) were elevated by nearly 30% in the SHR compared to the WKY. The amounts of actin and myosin when normalized to DNA content were unchanged in SHR mesenteric arteries compared to control, whereas these amounts were decreased by 25% and 49%, respectively, in the SHR cerebral arteries vs control. The functional implications of these contractile protein measurements agreed with determinations of active smooth muscle cell stress-generating capabilities, which were found unchanged in the mesenteric arteries and depressed in the SHR cerebral arteries. Neither the absolute amounts and concentrations (relative to tissue mass) of elastin in mesenteric and cerebral arteries, nor the absolute amounts and concentrations of collagen in the mesenteric artery, were changed in the SHR. However, cerebral artery total collagen was elevated by 31% in the SHR, with no change in collagen concentration between the two strains. Under conditions where the smooth muscle cells were fully relaxed, the internal radii of SHR brain and SHR mesenteric arteries were smaller at all pressures with respect to the WKY. However, only the SHR cerebral arteries were actually less distensible than controls. Thus, it is apparent that hypertension-associated changes in the chemical and mechanical properties of the resistance artery wall vary considerably depending upon which vascular bed is examined. The measurements made in this study suggest that these changes are more pronounced in brain arteries. This finding could be of significance regarding the autoregulatory capability of, and blood pressure distribution within, brain vessels of hypertensive animals. PMID- 6848463 TI - The age factor and salt-induced hypertension in the Brattleboro rat. PMID- 6848465 TI - Effects of angiotensin II on the cardiac responses to sympathetic nerve stimulation in dogs. AB - In anesthetized dogs with the left cardiac sympathetic nerves and both vagal nerves intact, angiotensin II (AII) induced a substantial, dose-dependent increase in arterial blood pressure and small increments in cardiac cycle length and ventricular contractile force. In dogs in which the cardiac sympathetic and vagal nerves had been interrupted, AII produced similar increases in blood pressure and larger increases in contractile force, but it decreased the cardiac cycle length. In both groups of dogs, AII augmented substantially the positive inotropic responses to sympathetic nerve stimulation, but it enhanced the positive chronotropic responses only slightly. However, AII did not appreciably prolong the cardiac responses to sympathetic nerve stimulation, nor did it alter significantly the cardiac responses to norepinephrine infusions. Hence, at the dosage levels used, AII probably did not inhibit the neuronal uptake of norepinephrine appreciably nor did it enhance the responsiveness of the cardiac effector sites to norepinephrine. Therefore, the potentiation of the cardiac responses to sympathetic nerve stimulation by AII in these experiments was probably achieved principally by facilitating norepinephrine release from the adrenergic nerve terminals in the heart. PMID- 6848466 TI - Enhanced NE uptake by isolated hypothalamic storage vesicles of hypertensive rats. AB - The in vitro uptake of 3H-NE by storage vesicles from the hypothalamus of age matched spontaneously hypertensive rats (SHR) and Wistar-Kyoto (WKY) rats has been studied using a new reliable procedure for the isolation of biochemically active storage vesicles. In each of 13 paired studies, done in triplicate, storage vesicles of SHR took up more 3H-NE than those of WKY. (The mean difference was 37% more uptake by SHR.) Electron-microscopic examination of normotensive samples showed a concentration of intact synaptic vesicles; whereas SHR subfractions were composed of fragmented membranes that resembled swollen, distorted vesicles. These findings in the brain tissues of SHR parallel our previous results found in SHR peripheral tissues. Taken together, we interpret the results to indicate that the membranes of synaptic vesicles of SHR are altered structurally and biochemically. PMID- 6848467 TI - Insulin reverses hypertension and hypothalamic depression in streptozotocin diabetic rats. AB - Daily subcutaneous injections of lente insulin reduced the hypertension and bradycardia which developed consistently in streptozotocin diabetic rats. Insulin treated rats also became less hyperglycemic, drank less water, and gained weight faster than untreated diabetic controls. Behavioral and tachycardiac effects elicited by electrical stimulation of the ventromedial hypothalamus while the rats were awake were similar, but attendant pressor responses were larger in those that had been treated with insulin. Under subsequent urethane anesthesia, pressor and sympathetic responses to hypothalamic stimulation, as well as pressor responses to tyramine and vasopressin, were augmented in insulin-treated rats. A generalized increase in cardiovascular reactivity caused by insulin seemed unlikely since pressor responses to norepinephrine were unaltered. Enhanced hypothalamic responsiveness was considered due to improvement of diabetic encephalopathy rather than to direct CNS stimulation by insulin because the injected insulin had mostly dissipated by the time pressor responses were recorded. By showing that insulin treatment produced changes opposite to those occurring during induction of diabetes our results suggest that insulin can alleviate cardiovascular and hypothalamic dysfunction in streptozotocin-induced diabetes. PMID- 6848469 TI - "Early" essential hypertension, prevention, intervention. PMID- 6848470 TI - The cardiovascular responses to exercise in children across the blood pressure distribution. The Muscatine study. AB - Children with elevated systolic blood pressure have a wide range of cardiac output. To better understand the mechanisms regulating resting and exercise blood pressure, we investigated the cardiovascular responses to both dynamic and isometric exercise in 264 children who were selected from the low, middle, and upper quintile of the distribution of blood pressure of an entire school population. We sought to identify patterns of response to exercise that correlated with both resting cardiac output and resting blood pressure. During isometric exercise, systolic pressure adjusted for age and body size increased in all groups. The low group's mean pressure remained significantly lower than the high group's pressure throughout the entire exercise period. Body size adjusted group systolic and diastolic blood pressure level differences exist during dynamic exercise. The product of the systolic blood pressure times the heart rate, in the high blood pressure group, was significantly higher throughout dynamic exercise than in the other two groups. Elevated resting resistance is correlated with elevated resistance during isometric exercise and elevated diastolic blood pressure during dynamic exercise. Cardiac index had a significant negative correlation to age (r = -0.58) at all levels of blood pressure. This observation, in children, lends some support to the concept of the evolution from a hyperkinetic circulation in early childhood to a circulation with lower cardiac output and more elevated systemic vascular resistance at an older age. PMID- 6848468 TI - A model of intervention for prevention of early essential hypertension in the 1980s. AB - The onset of essential hypertension early in life is indicated by the high tracking of blood pressure during adolescence; intervention in adults with mild hypertension has been found successful. How, then, can high blood pressure levels in children be modified to prevent early hypertensive cardiovascular disease in adulthood? In an entire biracial town (population 9000) we surveyed 1604 (89%) of all children aged 8--18 years for blood pressure and reexamined those in the upper decile of mean blood pressure (for each race, sex, and height) on three additional occasions. On each examination nine blood pressures were taken by trained observers. All children consistently in the top decile were randomly allocated into either a treatment (n = 50) or comparison (n = 50) group. These two groups and an additional midrange blood pressure comparison group (n = 50) were followed regularly using school facilities including community and school programs. Treatment consisted of 1) dietary guidance; 2) modifications of school lunches and snacks with healthy substitutes; 3) parental involvement; 4) a low dose diuretic and beta-antagonist given by usual standards. All study groups were monitored for blood pressure in a blind manner. In 6 months of observation, blood pressure in the treatment group remained 5 and 3 mm Hg (systolic and diastolic) less than controls (p less than 0.001 and p less than 0.01). An orchestrated community-wide attack on early-stage hypertension is feasible and seems to offer exciting potential for prevention of early hypertensive disease. PMID- 6848471 TI - Baroreflex sensitivity modulates vasodepressor response to nitroprusside. AB - Baroreflex activity is a determinant of the homeostatic response to alteration in blood pressure. We examined the factors that determine the magnitude of the vasodepressor response to sequential incremental intravenous infusions of sodium nitroprusside (NP), 0.05 to 6.4 micrograms/kg/min, in eight male patients with essential hypertension. Each infusion level was of 10 minutes' duration. Change from control values of mean arterial pressure (delta MAP), heart rate (delta HR) and plasma norepinephrine (delta NE) were obtained at the end of each infusion level. Significant correlations were found between delta MAP vs log dose NP, delta HR vs delta MAP and delta NE vs delta MAP for each patient (p less than 0.05). However, the slopes of these relationships varied widely between subjects and were significantly correlated with the control blood pressure of each patient. In addition, the sympathetic responsiveness, as measured by delta NE vs delta MAP, was inversely correlated with the degree of vasodepressor response seen. Thus, the magnitude of the vasodepressor response was determined by two major factors: 1) the predrug blood pressure, possibly reflecting altered vascular geometry with hypertension; 2) the degree of sympathetic response, which probably acts by mediating the degree of reflex alpha-adrenergic-mediated arteriolar vasoconstriction. PMID- 6848472 TI - Renal afferent arteriole in the spontaneously hypertensive rat. AB - We conducted morphometric studies on the afferent arteriole of spontaneous hypertensive rats (SHR) and Wistar-Kyoto (WKY) rats to gain a better understanding of its changes with the development of hypertension. Differences may be related to the SHRs' increased renal vascular resistance. Methacrylate vascular casts were made of the renal vasculature after perfusion fixation with glutaraldehyde. These vascular casts were then examined and measurements made with the scanning electron microscope. Results from this examination of the scanning electron microscope demonstrated a smaller afferent arteriolar diameter in the SHR, compared to the WKY, for both the inner and outer cortical glomeruli. This difference was seen in the 6-week-old SHR, prior to a statistically different blood pressure from the WKY controls, as well as in the 12-week-old hypertensive SHR. However, this afferent diameter difference between rat strains was more pronounced in rats at 12 weeks of age. The tapering of the afferent arteriole (difference between proximal and distal afferent diameters) was greater in the 12-week-old SHR than in the age-matched WKY or 6-week-old SHR. We conclude that the smaller caliber afferent arterioles of the SHR may predispose and play a role in the pathogenesis of the subsequent hypertension. The increased afferent arteriolar tapering seen in the hypertensive SHR relates to the already present increased blood pressure. Wall thickness/radius ratios are not different between rat strains (SHR and WKY) at either 6 or 12 weeks of age. These results suggest increased vascular constriction or hypoplastic vessels as the cause of the smaller caliber vessels in the SHR rather than increased wall thickness. PMID- 6848474 TI - Leukocytes from patients allergic to chromium and nickel examined by the sealed capillary migration technique. AB - Leukocytes from patients allergic to chromium and nickel were studied by a sealed capillary migration test. The migration indices were determined at 2, 5 and 24 h. The chromium-allergic group could be differentiated from the control group at all investigated times, and especially at 2 and 5 h, by using a potassium dichromate concentration of 1.7 x 10(-5) M in the capillaries. The migration indices in the nickel-allergic group could not be used for discrimination from the controls. The highest chromate (1.1 x 10(-4) M) and nickel sulfate (3.8 x 10(-4) M0 concentrations inhibited the migration of leukocytes from both patients and controls, indicating toxic effects. PMID- 6848473 TI - Antibodies to purified protein derivative in different immunoglobulin classes in the diagnosis of tuberculosis in man. AB - The sera of patients with active tuberculosis (TB) and sera from control groups were assayed for IgG, IgA, secretory IgA, IgM and IgE antibody activity to purified protein derivative (PPD) using the enzyme-linked immunosorbent assay. Patients with active TB clearly had higher levels of IgG antibody activity to PPD antigen than did healthy patients who were skin test positive or negative. There was a clear separation between the diseased and healthy groups. Similar, but not as marked increases were seen in IgA and secretory IgA antibody activity in diseased patients. No correlation between the presence of disease and antibody levels were found with IgM, and no IgE antibodies were found. The method presented is a rapid reproducible assay using commercially available materials, and may offer a clinically useful test for the diagnosis of TB. PMID- 6848476 TI - Expression of FcIgG receptors on cultured fetal rat brain cells. Studies on normal, preneoplastic and malignant cells. AB - The expression of FcIgG receptor (FcR) was studied during various stages of growth and subculturing of: (1) fetal rat brain cells (FBC); (2) FBC during in vitro neoplastic transformation after a transplacental pulse of the alkylating carcinogen ethylnitrosurea in vivo, and (3) an established neoplastic brain tumor cell line. Hemadsorption of antibody-coated sheep erythrocytes was used for the detection of FcR-positive cells. Such cells were not detected in cryostat sections of fetal rat brains, but in primary cultures of FBC 1 day after the explantation. FcR-positive cells were present throughout the logarithmic-growth phase. When reaching confluency after 5-7 days in culture. FcR-positive cells could not be detected. In the secondary cultures the occurrence of FcR-positive cells showed a similar variation related to growth: The growth-related receptor was also present on cells growing into arteficial defects in confluent cultures, while the resting cells in the same cultures were FcR-negative. With further subculturing the cells became epithelioid and slowly growing without FcR. Morphologically induced differentiation of such epithelioid cells by 12-O-tetra decanoyl phorbol-13-acetate did not change the FcR expression. We did not detect any change in the receptor expression related to the malignant transformation, and the malignant cell line was FcR-negative. Expression of FcR on FBC undergoing malignant transformation therefore seems to be mainly connected to the mode of growth (log-phase versus confluence). PMID- 6848477 TI - Effects of hydrocortisone and protein synthesis inhibitors on FcIgG receptors on cultured fetal rat brain cells. AB - The in vitro effect of protein synthesis inhibitors on FcIgG receptor (FcR) expression was studied in secondary cultures of fetal rat brain cells (FBC). Hemadsorption of antibody-coated sheep erythrocytes was used for the detection of FcR-positive cells. The addition of actinomycin D 0.5 and 2.5 micrograms/ml or cycloheximide 1.0 and 5.0 micrograms/ml to the growth medium did not change the FcR activity after 4 and 12 h. When the cells were cultured in medium containing hydrocortisone 10(-6) and 10(-7) M for 1, 2 or 3 days, the number of FcR-positive cells increased markedly. Confluent cultures of FBC and FBC undergoing in vitro neoplastic transformation were FcR negative. Hydrocortisone did not induce FcR activity in these cultures. The results indicate that the persistence of FcR on cultured FBC is not dependent on de novo protein synthesis. Hydrocortisone seems to prolong the period of FcR expression in FcR-positive cells. PMID- 6848478 TI - Histopathology of delayed-onset hypersensitivities in contact-sensitive guinea pigs. AB - We have studied the specificity of macroscopic responses and the corresponding cellular infiltrates in Giemsa-stained, glycol methacrylate embedded tissue sections of delayed skin reactions elicited by contact sensitizers, homologous and heterologous hapten-protein conjugates, and tuberculin (PPD) in guinea pigs. The animals were sensitized with contact sensitizers emulsified in Freund's complete adjuvant and tested at 19 days and, after repeated contact testing with homologous sensitizer, at 48 days after sensitization. At both times, all delayed reactions contained numerous mononuclear cells. The reactions elicited by contact sensitizer or hapten-protein conjugate also contained significant numbers of basophils which were lacking in PPD reactions. Contact reactions were highly specific macroscopically and microscopically while reactions elicited by conjugates displayed considerable macroscopic and microscopic cross-reactivity. The greater cross-reactivity of conjugate-elicited reactions compared to contact reactions may reflect differences in mechanism of initiation or mediation of these two reactions. PMID- 6848475 TI - Immunopotentiation of cell-mediated hypersensitivity by Corynebacterium parvum (Propionibacterium acnes). AB - We have investigated the activity of local Corynebacterium parvum (Propionibacterium acnes) as an immunopotentiator of allergic contact dermatitis (ACD) and photo-ACD in rodents. C. parvum given into the sensitization site, but not at a distance, increased the delayed-type hypersensitivity to the chemical allergen. An immunoadjuvant effect could be realized even when C. parvum was given several days after allergen; it was readily obtained in B cell-deficient mice. Cyclophosphamide pretreatment heightened the immunopotentiation seen with local C. parvum. It is unlikely that the specific immunopotentiation by C. parvum is mediated by enhanced macrophage processing of antigen, as proposed by others, since C. parvum immunostimulation occurs just as well 2 days after allergen as on the same day as allergen. We hypothesize that a major mechanism of C. parvum immunopotentiation is the inhibition by stimulated macrophages of the generation of specific T suppressor cells. PMID- 6848479 TI - Perfluorocarbon enhancement of heterologous red cell survival: a reticuloendothelial block effect? AB - The intravascular survival of human erythrocytes transfused to primate animals was prolonged by infusing the recipients with a perfluorocarbon red cell substitute (Fluosol DA). This effect is probably due to transient block of the animals' reticuloendothelial system by the perfluorocarbon emulsion. Perfluorocarbon compounds could be used to study the role of reticuloendothelial function in the immune destruction of red cells. PMID- 6848480 TI - Effects of fibrinogen fragment and proteolytic enzyme on the immune system in mice. AB - The immunomodulating ability of fibrinogen fragment (Hol-DSK) and proteolytic enzyme with fibrinolytic activity from Aspergillus oryzae was analysed in CBA/Ca, C57Bl, C3H/HeJ and NMRI mice. Suppressive effects on the blastogenic response to mitogens were noted. No consistent suppressive effect, but sometimes an enhancing one, was recorded on the antibody responses to protein antigens. Administration of Hol-DSK or proteolytic enzyme shortly after the immunization resulted in a slight inhibition of the development of delayed hypersensitivity to picryl chloride in C57Bl but not in CBA mice. When similar administration was done simultaneously with administration of the challenging antigen of picryl chloride or sheep red blood cells in immunized mice, significant impairment of the delayed type hypersensitivity reaction was noted. The modulating effects by Hol-DSK did not alter the in vitro bacteriocidal effects of peritoneal exudate cells from mice on Escherichia coli. PMID- 6848481 TI - Camphor revisited: involvement of a unique monooxygenase in metabolism of 2-oxo delta 3-4,5,5-trimethylcyclopentenylacetic acid by Pseudomonas putida. AB - Previously, Pseudomonas putida was shown to degrade (+)-camphor, and cleavage of the first ring of the bicyclic structure involved two monooxygenases (a hydroxylase and a ring oxygen-inserting enzyme), a dehydrogenase, and spontaneous cleavage of an unstable oxygenation product (lactone). Cleavage of the second ring was not demonstrated but was assumed also to occur by ring oxygen insertion, since the predicted oxygenation product was extracted from whole-cell incubation systems. Our investigation established that metabolism of the first ring cleavage intermediate, 2-oxo-delta 3-4,5,5-trimethylcyclopentenylacetic acid, occurred through the sequential action of two inducible enzymes, a coenzyme A ester synthetase and an oxygenase. The oxygenase was purified to homogeneity and had a molecular weight of 106,000. This enzyme carried a single molecule of flavin adenine dinucleotide and consisted of two identical subunits. Iron was not present at a significant level. The oxygenase was specific for NADPH as the electron donor and absolutely specific for the coenzyme A ester of 2-oxo-delta 3 4,5,5-trimethylcyclopentenylacetic acid as the substrate. The reaction stoichiometry was compatible with this enzyme being a monooxygenase, and a mass spectral analysis of the methyl ester of the product confirmed the insertion of a single oxygen atom. The enzyme appeared to be analogous to, although distinct from. 2,5-diketocamphane 1,2-monooxygenase in catalyzing a "biological Baeyer Villiger" reaction with the formation of a lactone. Structural analogy suggested that this lactone, like the first, was also unstable and susceptible to spontaneous ring opening, although this was not experimentally established. PMID- 6848483 TI - Ice nucleating activity of Pseudomonas syringae and Erwinia herbicola. AB - Chemical and biological properties of the ice nucleating sites of Pseudomonas syringae, strain C-9, and Erwinia herbicola have been characterized. The ice nucleating activity (INA) for both bacteria was unchanged in buffers ranging from pH 5.0 to 9.2, suggesting that there were no essential groups for which a change in charge in this range was critical. The INA of both bacteria was also unaffected by the addition of metal chelating compounds. Borate compounds and certain lectins markedly inhibited the INA of both types of bacterial cells. Butyl borate was not an inhibitor, but borate, phenyl borate, and m-nitrophenyl borate were, in order, increasingly potent inhibitors. These compounds have a similar order of affinity for cis hydroxyls, particularly for those found on sugars. Lentil lectin and fava bean lectin, which have binding sites for mannose or glucose, inhibited the INA of both bacteria. All other lectins examined had no effect. The inhibition of INA by these two types of reagents indicate that sugar like groups are at or near the ice nucleating site. Sulfhydryl reagents were potent inhibitors of the INA of both bacteria. When treated with N ethylmaleimide, p-hydroxymercuribenzoate, or iodoacetamide, the INA was irreversibly inhibited by 99%. The kinetics of inactivation with N-ethylmaleimide suggested that E. herbicola cells have at least two separate ice nucleating sites, whereas P. syringae cells have possibly four or more separate sites. The effect of infection with a virulent phage (Erh 1) on the INA of E. herbicola was examined. After multiple infection of a bacterial culture the INA was unchanged until 40 to 45 min, which was midway through the 95-min latent period. At that time, the INA activity began falling and 99% of the INA was lost by 55 min after infection, well before any cells had lysed. This decrease in INA before lysis is attributed to phage-induced changes in the cell wall. PMID- 6848482 TI - Effect of transforming DNA on growth and frequency of mutation of Streptococcus pneumoniae. AB - We studied the effect of the presence of homologous transforming DNA on the growth of several transformable strains of Streptococcus pneumoniae and on the frequency of mutation of these strains to various antibiotic resistances. We observed no effect on growth until the strains became competent, when growth was depressed. At the end of the competence period, some strains showed recovery to varying degrees, whereas others showed evidence of cell death. Growth was also depressed by the presence of DNA from Escherichia coli, indicating that recombination was not likely to be the cause of the observed effect. Furthermore, cell death was not caused by the induction of a prophage. Several of the strains showed increased mutation frequencies during the competence period, although treatment with E. coli DNA gave no such effect, indicating that the mutagenesis was due to recombination. We observed no mutagenesis due to UV irradiation of the strains. The possibility that integration of the transforming DNA may produce lesions which induce error-prone repair is discussed. Furthermore, a strain that showed no mutability by transforming DNA, indicating the presence of a more efficient repair system, gave evidence of producing higher amounts of the hex system when competent, and the possible relationship between these properties is discussed. PMID- 6848484 TI - Transport and processing of staphylococcal enterotoxin B. AB - A larger, membrane-bound form of staphylococcal enterotoxin B was shown by in vivo pulse-chase analysis to be the kinetic precursor to extracellular enterotoxin B. Processing of the enterotoxin B precursor molecules can apparently occur either cotranslationally or posttranslationally. Subcellular fractionation of cells revealed that all of the precursor toxin was associated with the membrane fraction. Once processed and released from the membrane, it was transiently associated with the cell wall before being released into the extracellular environment. The cell-wall-associated enterotoxin B was completely resistant to protease treatment and to extraction by high- or low-salt solutions at 0 to 2 degrees C, although it could be easily released from the cell by removal of the cell wall with lysostaphin. These data imply that newly formed enterotoxin B may be temporarily sequestered in specialized regions that require cell wall integrity before being released into the extracellular environment. PMID- 6848485 TI - Contributing carbohydrate catabolic pathways in Cyclobacterium marinus. AB - The primary and secondary pathways of carbohydrate metabolism were determined in a nonfermentative gram-negative ring-forming marine bacterium, Cyclobacterium marinus, by radiorespirometric studies. Whereas glucose is oxidized mainly via the Embden-Meyerhof pathway, gluconate is catabolized mainly via the Entner Doudoroff pathway, both in conjunction with the tricarboxylic acid cycle as a secondary pathway and with some participation of the pentose phosphate pathway. The operation of these contributing catabolic pathways in this unique marine bacterium was substantiated by assaying the activities of the key enzymes specific to each pathway. PMID- 6848486 TI - Nutritional requirements of two flower spiroplasmas and honeybee spiroplasma. AB - A chemically defined medium (CC-494) was used to study the nutritional requirements of three spiroplasmas representing three distinct serogroups: flower spiroplasmas [Spiroplasma floricola and FS (SR-3)] and honeybee spiroplasma [HBS (AS-576)]. Glucose, fructose, and mannose were utilized by all three spiroplasmas. In addition, the honeybee spiroplasma could ferment trehalose, FS (SR-3) could ferment sucrose, and S. floricola could ferment trehalose, sucrose, and raffinose. The three spiroplasmas varied greatly in their requirements of amino acids for growth. S. floricola was the only strain that utilized arginine. HBS (AS-576) required at least one purine and one pyrimidine base (either free base or ribonucleoside) for growth, while both flower spiroplasmas grew with only one base in the medium. Oleic acid, cholesterol, and bovine serum albumin were essential to all three spiroplasmas. Palmitic acid, which was nonessential, promoted growth significantly. PMID- 6848487 TI - Immunochemical analysis of respiratory-chain components of micrococcus luteus (lysodeikticus). AB - Membrane-bound antigens of the respiratory chain of Micrococcus luteus were analyzed by crossed immunoelectrophoresis after growth of the organism in the presence of 59Fe, the flavin adenine dinucleotide-flavin mononucleotide precursor D-[2-14C]riboflavin, or the heme precursor 5-amino-[4-(14)C]levulinic acid. Using zymograms and procedures of selective extraction in conjunction with autoradiography, it was possible to resolve and partially characterize a number of antigens. Succinate dehydrogenase (EC 1.3.99.1) was shown to possess covalently bound flavin and nonheme iron and was possibly present as a complex with cytochrome. Three other dehydrogenases, namely, NADH dehydrogenase, NAD(P)H dehydrogenase (EC 1.6.99.3), and malate dehydrogenase (EC 1.1.1.37), contained flavin in noncovalent linkage, the NAD(P)H dehydrogenase also possessing nonheme iron. Four other discrete antigens (or antigen complexes) containing both iron and heme centers also resolved, as were two minor immunogens possessing iron as the sole detectable prosthetic group. PMID- 6848488 TI - Pleiotropic mutations regulating resistance to glucose repression in Saccharomyces carlsbergensis are allelic to the structural gene for hexokinase B. AB - Previously, we described a mutation glr1-1 in Saccharomyces carlsbergensis which pleiotropically relieves the synthesis of the following enzymes from glucose repression: maltase, galactokinase, alpha-galactosidase, NADH:cytochrome c reductase, and cytochrome c oxidase (C. A. Michels and A. Romanowski, J. Bacteriol, 143:674-679, 1980.) In this report, we demonstrate that glr1-1 and two other alleles, glr1-3 and glr1-16, are also insensitive to the glucose repression of invertase synthesis. Determinations of the levels of hexokinase activity and the rate of glucose transport in these mutants show that both are reduced as compared with the parent strain. Complementation tests and genetic analysis indicate that the glr1 mutations are allelic to HXK2, the structural gene for hexokinase B. The significance of this result is discussed with regard to the mechanism of glucose repression in S. carlsbergensis. PMID- 6848489 TI - Poly(ADP-ribose) metabolism in ultraviolet irradiated human fibroblasts. AB - Exposure of human fibroblasts to 5 J/m2 of UV light resulted in a rapid increase of up to 1500% in the intracellular content of poly(ADP-ribose) and a rapid depletion of its metabolic precursor, NAD. When added just prior to UV treatment, the poly(ADP-ribose) polymerase inhibitor, 3-aminobenzamide, totally blocked both the increase of poly(ADP-ribose) and decrease in NAD for up to 2.5 h. Addition of 3-aminobenzamide at the time of maximal accumulation of poly(ADP-ribose) resulted in a decrease to basal levels with a half-life of approximately 6 min. The rates of accumulation of poly(ADP-ribose) and depletion of NAD were increased in the presence of either 1-beta-arabinofuranosylcytosine or hydroxyurea. Since these agents are known to cause an additional accumulation of DNA strand breaks following UV irradiation, these data provide evidence for a mechanism in which the rate of poly(ADP-ribose) synthesis following DNA damage is regulated in intact cells by the number of DNA strand breaks. Under conditions in which the synthesis of poly(ADP-ribose) was blocked, DNA repair replication induced by UV light was neither stimulated nor inhibited. PMID- 6848490 TI - Excision repair and DNA synthesis with a combination of HeLa DNA polymerase beta and DNase V. AB - The ability of HeLa DNA polymerases to carry out DNA synthesis from incisions made by various endodeoxyribonucleases which recognize or form baseless sites in DNA was examined. DNA polymerase beta carried out limited strand displacement synthesis from 3'-hydroxyl nucleotide termini made by HeLa apurinic/apyrimidinic (AP) endonuclease II at the 5'-side of apurinic sites. Escherichia coli endonuclease III incises at the 3'-side of apurinic sites to produce nicks with 3'-deoxyribose termini which did not efficiently support DNA synthesis with beta polymerase. However, these nicks could be activated to support limited DNA synthesis by HeLa AP endonuclease II, an enzyme which removes the baseless sugar phosphate from the 3'-termini, thus creating a one-nucleotide gap. With dGTP as the only nucleoside triphosphate present, the beta-polymerase catalyzed one nucleotide DNA repair synthesis from those gaps which lacked dGMP. In contrast, HeLa DNA polymerase alpha was unreactive with all of the above incised DNA substrates. Larger patches of DNA synthesis were produced by nick translation from one-nucleotide gaps with HeLa DNA polymerase beta and HeLa DNase V. Moreover, incisions made by E. coli endonuclease III were activated to support DNA synthesis by the DNase V which removed the 3'-deoxyribose termini. HeLa DNase V also stimulated both the rate and extent of DNA synthesis by DNA polymerase beta from AP endonuclease II incisions. In this case the baseless sugar phosphate was removed from the 5'-termini, and nick translational synthesis occurred. Complete DNA excision repair of pyrimidine dimers was achieved with the beta polymerase, DNase V, and DNA ligase from incisions made in UV-irradiated DNA by T4 UV endonuclease and HeLa AP endonuclease II. Such incisions produce a one nucleotide gap containing 3'-hydroxyl nucleotide and 5'-thymine: thymidylate cyclobutane dimer termini. DNase V removes pyrimidine dimers primarily as a dinucleotide and then promotes nick translational DNA synthesis. PMID- 6848491 TI - The mechanism of ether bond formation in O-alkyl lipid synthesis in Ehrlich ascites tumor. Unusual cleavage of the fatty acid moiety of acyl dihydroxyacetone phosphate. AB - We have previously presented evidence for the formation of 1-O-alkyl dihydroxyacetone-P from acyl dihydroxyacetone-P via the initial formation of an intermediate 1-O-acyl endiol of acyl dihydroxyacetone-P. This reaction involves a stereospecific exchange of the pro-R hydrogen of the acyl dihydroxyacetone-P moiety without change in configuration. The fatty acid is replaced by a long chain fatty alcohol which retains the oxygen of the primary carbinol. In the absence of fatty alcohol, water substitutes and the product is dihydroxyacetone-P which has also exchanged the pro-R hydrogen with a hydrogen from the medium. An absolute requirement of the proposed mechanism is that the loss of the fatty acid must proceed via an unusual cleavage of the dihydroxyacetone-P C-1 to oxygen bond instead of the usual cleavage at the fatty acid acyl to oxygen bond. In the present investigation, we have synthesized hexadecanoyl dihydroxyacetone-P containing oxygen-18 exclusively at the dihydroxyacetone-P C-1 oxygen. Using this substrate, we have shown that cleavage of hexadecanoyl dihydroxyacetone-P at the C-1 to oxygen bond is linked to O-alkyl dihydroxyacetone-P synthesis. Inhibition of O-alkyl lipid synthesis by means of magnesium or NADPH inhibited the unusual cleavage. At the same time, we have shown that there was hydrolysis of acyl dihydroxyacetone-P which proceeded by the usual mechanism and which was not related to synthesis of O-alkyl dihydroxyacetone-P. PMID- 6848492 TI - Primary structure of macromomycin, an antitumor antibiotic protein. AB - The antitumor protein macromomycin is a single chain polypeptide of 112 amino acid residues cross-linked by two intramolecular disulfide bonds. The protein was reduced and S-alkylated with 2-mercaptoethanol in 8 M urea followed by treatment with iodoacetic acid. Tryptic digestion of tetra-S-carboxymethyl macromomycin gave four tryptic peptides which were fractionated by gel permeation on Sephadex G-50. The amino acid sequence of the tryptic peptides and the overlap sequences were determined by a combination of automated Edman degradation analysis, gas chromatographic mass spectrometry, and fast atom bombardment mass spectrometry. A comparison of the structures of macromomycin, actinoxanthin, and neocarzinostatin suggests that they belong to a family of related proteins. PMID- 6848493 TI - Arterial neutral cholesteryl esterase. A hormone-sensitive enzyme distinct from lysosomal cholesteryl esterase. AB - We describe here an activable neutral cholesteryl esterase (EC 3.1.1.13) in arteries similar to the hormone-sensitive lipase of adipose tissue and adrenal cortex. Maximum enzyme activity in rabbit aorta was given by cholesteryl ester substrates dispersed as a mixed micelle with phosphatidylcholine and Na taurocholate (molar ratio 1:4:2). A quantitative assay of enzymic activity was obtained with the following component concentrations: 6.0 microM cholesteryl [1 14C]oleate, 23.7 microM phosphatidylcholine, 12.5 microM Na taurocholate, 0.04% serum albumin, and 85 mM K phosphate buffer, pH 7.0. The enzymic activity in aortic homogenates was stimulated 2-fold by addition of 5 microM glucagon or 100 microM dibutyryl cAMP. This activation was Mg-ATP dependent. Addition of 50 micrograms/ml of exogenous protein kinase could reverse the action of protein kinase inhibitor on dibutyryl cAMP activation of the neutral cholesteryl esterase. In addition to activation by cAMP-dependent protein kinase, the enzyme could be distinguished from the more active arterial lysosomal cholesteryl esterase by its pH 7.0 optimum, relative stability to preincubation at elevated temperatures, and exclusive localization in the cell cytosol. Subcellular fractionation of lipid-laden arterial foam cells revealed a significant portion of the neutral cholesteryl esterase bound to cytoplasmic cholesteryl ester-rich lipid droplets. Our results suggest that the breakdown of cytoplasmic cholesteryl ester droplets in arterial cells may be under hormonal regulation. PMID- 6848494 TI - Binding of synthetic oligosaccharides to the hepatic Gal/GalNAc lectin. Dependence on fine structural features. AB - A series of synthetic oligosaccharides, resembling natural N-acetyllactosamine type glycans, were tested for their ability to inhibit the binding of labeled ligand to the mammalian hepatic lectin on rabbit hepatocytes at 2 degrees C. A dramatic hierarchy of inhibitory potency (tetraantennary greater than triantennary much greater than biantennary much greater than monoantennary) could be demonstrated. The range of concentration required for 50% inhibition of labeled ligand binding extended from approximately 1 mM, for the monoantennary oligosaccharides, to approximately 1 nM for triantennary oligosaccharides, even though the absolute Gal concentration increased only 3-fold. It was found that the number of Gal residues/cluster and their branching mode are major determinants of binding affinity of ligands to the hepatic lectin on the surface of hepatocytes. PMID- 6848495 TI - Chemotaxis and the synthesis of specific proteins are inhibited by 3 deazaadenosine and other adenosine analogs in a mouse macrophage cell line. AB - It has been shown earlier that 3-deazaadenosine but not 3-deazaaristeromycin inhibits chemotaxis of RAW264 cells (Aksamit, R.R., Falk, W., and Cantoni, G.L. (1982) J. Biol. Chem. 257, 621-625). We show here in RAW264 cells that (a) the incorporation of the methyl group of methionine into phosphatidylcholine is inhibited approximately 90% by both 3-deazaadenosine and 3-deazaaristeromycin, (b) 3-deazaadenosine but not 3-deazaaristeromycin inhibits the synthesis of specific proteins, and (c) 3'-deoxyadenosine and erythro-9-(2-hydroxy-3-nonyl) adenine in the presence of adenosine and homocysteine inhibit chemotaxis and the synthesis of specific proteins. Inhibition of the synthesis of specific proteins can be observed only after the solubilized cellular proteins are separated by two dimensional polyacrylamide gel electrophoresis, since the adenosine analogs do not significantly affect total protein synthesis. When total protein synthesis is inhibited by incubation of the cells with cycloheximide, puromycin, or actinomycin D, chemotaxis is correspondingly inhibited. The results suggest that the continuous synthesis of one or more cellular proteins is required for chemotaxis by RAW264 cells. PMID- 6848496 TI - Activation of D-beta-hydroxybutyrate apodehydrogenase using molecular species of mixed fatty acyl phospholipids. AB - D-beta-Hydroxybutyrate apodehydrogenase is a lipid-requiring enzyme with a specific requirement of lecithin for enzymatic function. The purified enzyme which is devoid of lipid can be reactivated with lecithin or mixtures of natural phospholipid-containing lecithin. However, it is mitochondrial phospholipid which activates the enzyme optimally and with kinetic parameters similar to that of the native membrane-bound enzyme. Mitochondrial phospholipid consists of three classes of phospholipid (lecithin:phosphatidylethanolamine:diphosphatidylglycerol in a ratio of approximately 2:2:1 by phosphorus); each class consists of a multiplicity of different molecular species due to diversity in the fatty acyl substituents. In this study, we have synthesized defined molecular species of mixed fatty acyl phospholipids to evaluate whether multiplicity of phospholipid molecular species are essential for optimal reactivation. We find that: 1) ternary mixtures of single molecular species of phosphatidylcholine, phosphatidylethanolamine, and phosphatidylpropan-1,3-diol in the liquid crystalline state mimic the optimal reactivation of the enzyme obtained with mitochondrial phospholipids; 2) although some negatively charged phospholipid appears necessary for optimizing the efficiency of activation, diphosphatidylglycerol can be replaced by phosphatidylpropan-1,3-diol, another negatively charged phospholipid; and 3) biphasic Arrhenius plots can be correlated with the liquid crystalline and gel states of the phospholipid. PMID- 6848497 TI - Purification and properties of ornithine decarboxylase from rat liver. AB - Ornithine decarboxylase was purified to homogeneity, as judged by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and polyacrylamide gel electrofocusing, about 710,000-fold with a 35% yield from the liver cytosol of thioacetamide-treated rats. The final specific activity was approximately 24,400 nmol/min/mg of protein. The apparent molecular weight of the enzyme determined by gel filtration analyses on Sephacryl S-200 was 55,000 in the presence of 0.25 M NaCl and 145,000 in its absence. The minimum molecular weight of the enzyme was determined to be 54,000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The isoelectric point of the enzyme was estimated as 5.7 in the presence of 8 M urea. Some catalytic properties of the enzyme were also studied. PMID- 6848498 TI - Purification of an alternate form of the alpha subunit of the glycoprotein hormones from bovine pituitaries and identification of its O-linked oligosaccharide. AB - Extracts of bovine anterior pituitary glands contain significant amounts of material with immunological properties similar to those of the common, alpha, subunit isolated from the pituitary glycoprotein hormones. Purification of this "free alpha-like" material and analysis show it to contain an additional site of glycosylation not present in the alpha subunit isolated from intact glycoprotein hormones. This additional oligosaccharide is O-linked to a threonine residue corresponding to threonine-43 of bovine lutropin-alpha. Carbohydrate analysis shows 1.7 mol of sialic acid, 0.8 mol of galactose and 0.9 mol of galactosamine/mol of oligosaccharide. A similar structure for the free alpha-like material as compared to bovine lutropin-alpha is evident from equal potency in an anti-lutropin-alpha radioimmunoassay, a similar amino acid composition and similar but not identical peptide maps. The free alpha-like material is distinct from lutropin-alpha in that the free alpha-material contains sialic acid and galactose, has a slightly higher apparent molecular weight, an increased negative charge, and will not reassociate with native lutropin-beta. Peptide maps of the tryptic peptides of the free alpha-like material show additional differences (other than the O-linked oligosaccharide) when compared to peptide maps of lutropin-alpha; thus additional modifications are probably present. PMID- 6848499 TI - Kinetics and mechanism of erythrocyte anion exchange. AB - Steady state velocities for the rate of exchange of extracellular dithionite for intracellular sulfate through the red cell inorganic anion transport protein, known as band 3, were measured at increasing trans-sulfate concentrations at constant cis-sulfate concentration in order to directly discriminate between single and double displacement classes of mechanism. A 7-fold increase in trans sulfate concentration resulted in intersecting Lineweaver-Burk plots under iso osmotic conditions. This result argues against a double displacement or ping-pong mechanism. The specificity of the trans-anion effect for band 3 was illustrated by studying reversible 4-acetamido-4'-isothiocyano-2,2'-stilbene disulfonate inhibition of anion exchange. The increase in trans-sulfate increased 4-acetamido 4'-isothiocyano-2,2'-stilbene disulfonate affinity at the outer surface by about 4-fold under conditions where outside anion concentration was constant. A possible two-site ordered sequential mechanism for erythrocyte inorganic anion exchange is briefly discussed. PMID- 6848500 TI - Spontaneous ordering of DNA. Effects of intermolecular interactions on DNA motional dynamics monitored by 13C and 31P nuclear magnetic resonance spectroscopy. AB - Effects of intermolecular DNA interactions on the motional dynamics of defined length (147-, 234-, and 437-nucleotide pair (np)) double-stranded DNA were examined by 13C and 31P nuclear magnetic resonance spectroscopy. At a critical high concentration varying inversely with length, DNA undergoes a spontaneous transition to an ordered, liquid crystalline-like state. Ordering is accompanied by the appearance of distinct opalescence, and an increase in solution viscosity. An apparent standard heat of fusion of -38 kcal/mol of helix (-0.13 kcal/mol of DNA phosphate) and an entropy change of -0.13 entropy units (per mol of helix) were determined from the temperature dependence of the phase transition of 147-np DNA. The average phosphodiester configuration, monitored by Raman spectroscopy, was typical of B-form DNA above and below the phase transition. NMR spectra and relaxation data show that intermolecular interactions are strong at concentrations well below the phase transition and cause stepwise uncoupling of internal motions at specific sites. Motions of the exocyclic C5' carbon, but not other sugar carbons, are frozen in approximately 50% of 147-np DNA molecules at concentrations as low as 6.5 mg/ml. Motions of backbone ring carbons (C3', C4') are frozen in a progressively larger fraction of molecules at concentrations above 46 mg/ml. Rapid C2' motions are unaffected below the critical concentration (193 mg/ml at 32 degrees C), and still occur in the ordered phase. We conclude that rapid internal motions of DNA monitored by NMR consist mostly of coupled, periodic bending deformations and partially uncoupled local motions within the sugar ring. Rapid, extensive C2' motions can occur without strong coupling to other sugar carbon motions. From a comparison of 13C and 31P NMR data, we conclude that 31P NMR at best yields an incomplete representation of DNA dynamics. PMID- 6848501 TI - The histone H1 complements of dividing and nondividing cells of the mouse. AB - In liver, kidney, and lung of the mouse, two of the major H1 subtypes present at 1 week after birth, H1a and H1b, decline to nearly undetectable levels by 8-16 weeks, and a third subtype, H1d, also diminishes. The amounts of two other H1 subtypes, H1e and H1 degrees, increase markedly and that of another, H1c, also increases. The disappearance of H1a is almost complete by the age of 4 weeks, whereas the decline in H1b occurs largely between 4 and 16 weeks, when most cells are nondividing. A decline in H1a was observed also in cultured mouse embryo fibroblasts after they became quiescent. Furthermore, in the quiescent fibroblasts, the synthesis of H1a and H1b was preferentially reduced. In the thymus, newly formed nondividing cells have as much H1a and H1b as the dividing cells from which they are derived, but circulating lymphocytes have less H1a and H1b and more H1e, indicating that molecules of H1a and H1b are removed from chromatin, and H1e deposited, after cell division ceases. H1 degrees, however, is not present in thymocytes or peripheral blood lymphocytes. Our results indicate that 1) there are no tissue-specific H1 subtypes among the somatic tissues examined; 2) H1a and H1b are synthesized in large amounts only in dividing cells, whereas H1c, H1d, and H1e are synthesized in both dividing and nondividing cells; 3) different H1 subtypes are degraded at different rates in nondividing cells; and 4) H1e always, and H1 degrees sometimes, accumulates in nondividing somatic cells. We conclude that alterations of the H1 composition of chromatin are a general feature of nondividing cell formation; that such alterations are made, in large part, after the nondividing cells are formed and are accomplished both by changes in the pattern of synthesis of the various H1 subtypes and by differential loss of subtypes; and that each H1 subtype differs from the others in some or all of the properties that we have examined, supporting the idea that the individual H1 subtypes differ from each other in some of their functions. PMID- 6848502 TI - Developmental changes of hematoside of rat small intestine. Postnatal hydroxylation of fatty acids and sialic acid. AB - The hematoside of rat intestine is analyzed from 1 day to 60 days of age. During the first 3 weeks of life, GM3 (N-acetylneuraminylgalactosylglucosylceramide) contains only nonhydroxylated fatty acids and accounts for 80-90% of the ganglioside sialic acid. Its concentration is maximum at 6 days (315 micrograms of NeuAc/g of intestine) and falls abruptly over the next 2 weeks. It reaches 45 micrograms of NeuAc/g of intestine at 60 days. Between 28 and 60 days, GM3 accounts for 72% of the total intestinal gangliosides. From 21 days on, structural modifications of GM3 are observed. N-Acetylneuraminic acid is replaced progressively by N-glycolylneuraminic acid and nonhydroxylated fatty acids are replaced by alpha-hydroxylated fatty acids. Both changes are interpreted as the result of hydroxylations of GM3 components which are triggered at the time of weaning. These hydroxylations take place chiefly in epithelial cells and to a much lesser extent in nonepithelial residue, as shown by the separate analysis of both compartments of rat intestine at 38 and 60 days. In epithelial cells, the highest percentage of alpha-hydroxylated fatty acids and of N-glycolylneuraminic acid is found at 60 days. In addition, 4 D-hydroxysphinganine is the major base of the GM3 of intestinal cells from birth to adulthood. PMID- 6848504 TI - Coformycin inhibition of platelet AMP deaminase has no effect on thrombin-induced platelet secretion nor on glycolysis or glycogenolysis. AB - Thrombin-stimulated platelet secretion is accompanied by a 30% reduction in the steady state level of cytosolic ATP, a breakdown that proceeds through ADP, AMP, IMP, and inosine to hypoxanthine. The ATP to hypoxanthine conversion could be blocked at the stage of AMP deamination by incubation of platelet-rich plasma for 6 h with 200 microM coformycin, a transition-state analog inhibitor of AMP deaminase. Abolition of AMP deaminase activity had no effect on thrombin-induced secretion from the dense granules, alpha-granules, or acid hydrolases measured in gel-filtered platelets. Coformycin treatment had no effect on thrombin-stimulated lactate production, even when oxidative phosphorylation was blocked by antimycin A, nor on the rate of thrombin-stimulated glycogenolysis. In addition, although it was clear that the adenylate energy charge was maintained by activation of AMP deaminase following thrombin treatment, the adenylate energy charge was also maintained in coformycin-treated platelets, albeit after a short lag, by stimulated ATP production and equilibration through the adenylate kinase reaction. Hydrogen peroxide brings about similar adenylate degradation which could also be inhibited by coformycin. The results indicate that AMP deamination and secretion, although temporally related, are not coupled. The role of AMP deaminase appears to be to maintain the adenylate energy charge in the absence of stimulation of ATP production or to buffer the adenylate charge before ATP production is stimulated. PMID- 6848503 TI - Fluorescence of histones H1. A tyrosinate-like fluorescence emission in Ceratitis capitata H1 at neutral pH values. AB - We have examined the fluorescent properties of histones H1, and of some peptides derived from them, from calf thymus and from the fruit fly Ceratitis capitata. The fluorescent emission spectrum of folded histone H1 from C. capitata at neutral pH is characterized by a maximum at 303 nm and a shoulder at 340 nm. The overall quantum yields of fluorescence do not increase upon folding, although the fluorescence of the single tyrosyl residue of calf H1 is enhanced when the protein folds. As expected, the excitation maximum of calf H1 is shifted to longer wavelengths when the protein folds and its position does not depend upon the wavelength at which the fluorescence is observed. However, Ceratitis H1 exhibits two excitation maxima. The first corresponds to emission at 303 nm and it is slightly redshifted upon protein folding, whereas the second, which corresponds to emission at 340 nm, is displaced from 280 nm in the denatured protein to approximately 285 nm in the folded histone. This suggests that the two tyrosyl residues of the insect histone behave as independent fluorophores. The shoulder at 340 nm does not appear at pH 2, even when the protein is folded. Titration to neutral pH values results in the appearance of the shoulder, the process being characterized by a pK'a approximately equal to 3.7. The fluorescence spectrum of insect histone has been resolved into the contributions of the individual tyrosyl residues and the results suggest that the emission at 340 nm originates in a tyrosinate that may be formed in the excited state by proton transfer to the carboxylate anion of a glutamyl residue. The results obtained from these experiments have also aided in resolving the near-UV circular dichroism spectrum of insect histone (Barbero, J.L., Franco, L., Montero, F., and Moran, F. (1980) Biochemistry 19, 4080-4087) into the individual contributions of the tyrosyl residues. PMID- 6848505 TI - The role of membranes in the mechanism of action of the antineoplastic agent adriamycin. Spin-labeling studies with chronically hypoxic and drug-resistant tumor cells. AB - Electron spin resonance spectroscopy has been employed to analyze the changes in membrane order parameter in Sarcoma 180 cells under conditions in which an alteration in cellular susceptibility to the chemotherapeutic agent adriamycin is demonstrable. Changes in relative membrane fluidity using the paramagnetic probe 5-doxyl stearic acid were found to be associated with two phenomena which result in an altered cellular response to adriamycin: (a) the presence of an oxygen deficient environment and (b) the expression of drug resistance. Under hypoxic conditions, in which the susceptibility to the cytotoxic action of adriamycin is increased, a decrease in bulk membrane order parameter was observed. Upon reoxygenation, the membrane fluidity and enhanced susceptibility to adriamycin reverted to control conditions with the same time course. In the case of drug resistant cells, a progressive decrease in membrane fluidity was also observed which correlated with the degree of resistance to adriamycin. These data suggest that the physical alterations in the membrane reported by the spin label may be functionally linked to biological alterations in sensitivity to adriamycin. PMID- 6848507 TI - Ligand-induced conformational changes in villin, a calcium-controlled actin modulating protein. AB - The physical structure of villin, a Ca2+-modulated regulator protein of actin filament organization, has been studied in the absence and presence of Ca2+ using analytical ultracentrifugation, gel chromatography, ultraviolet difference spectroscopy, and circular dichroism. Villin exhibits an intrinsic sedimentation coefficient, S020, w, of 5.0 s and an apparent Stokes radius, Rs, of 44 A in EGTA containing buffer. In the presence of greater than 20 microM Ca2+, villin shows a S020, w of 4.1 s and Rs of 49 A, indicative of a conformational change in the protein. No significant changes in the partial specific volume (0.73) of villin are observed in the presence of Ca2+, and sedimentation equilibrium studies demonstrates that the effects of Ca2+ are not due to a change in the molecular mass (95,000 daltons). The combined hydrodynamic data suggest that villin is an asymmetric molecule with an axial ratio of 4.5:1, based on a prolate ellipsoid model at 0.5 g/g of hydration, corresponding to a maximum length of 84 A. The presence of Ca2+ changes the shape to a more asymmetric molecule with an axial ratio of 8:1 and a maximum length of 123 A. Since the large proteolytic fragment, villin core, does not exhibit the strong structural change of villin, an important function of the small villin headpiece domain in the observed conformational change of intact villin is suggested. The results indicate new aspects of the function of villin as cross-linker in microvillus core filament bundles and the disintegration of these structures in the presence of calcium. PMID- 6848508 TI - Demonstration of three distinct calcium-binding sites in villin, a modulator of actin assembly. AB - Villin, a Ca2+-modulated F-actin-binding protein (95,000 daltons) present in microvillus core filament bundles, has been shown to contain multiple Ca2+ binding sites. 45Ca Hummel-Dreyer chromatography reveals the presence of two rapidly exchanging Ca2+-binding sites with an apparent dissociation constant, Kd, equal to 4.6 X 10(-6) M. Use of the two proteolytically separable domains of the molecule revealed that one site is located on the 90,000-dalton core (apparent Kd = 3.5 X 10(-6) M) while the second site is provided by the 8,800-dalton headpiece fragment (apparent Kd = 7.4 X 10(-6) M). In addition villin displays a further very slowly exchanging or nonexchangeable high affinity Ca2+-binding site, which is situated in the core domain. Secondary structural predictions and a comparison of the amino acid sequence of headpiece with other known Ca2+-binding proteins indicates one region suggestive of a Ca2+-binding site, although headpiece seems not to exhibit a classical "EF-hand" Ca2+-binding structure. PMID- 6848506 TI - Isolation and characterization of the common intermediate in dichotomous reaction catalyzed by tryptophan side chain oxidase. PMID- 6848509 TI - The dual role of mevalonate in the cell cycle. AB - It is well established that either exogenous or endogenous cholesterol is required for both cell growth and proliferation. This laboratory has recently discovered that, in baby hamster kidney-21 cells, independent of its role as a cholesterol precursor, mevalonic acid plays an essential role in S phase DNA replication. It was later shown that isopentenyl adenine, a known product of mevalonate in prokaryotes and lower eukaryotes, is 100 to 200 times more effective than mevalonate in restoring DNA replication in cells in which mevalonic acid synthesis is blocked with the beta-hydroxy-beta-methylglutaryl-CoA reductase inhibitor, compactin. The present study was designed to determine the relationship in the cell cycle between the known requirement for cholesterol and the newly discovered effect of mevalonic acid and isopentenyl adenine on S phase DNA synthesis. Employing cells arrested by serum depletion, it was shown that the cholesterol requirement is limited to the early and mid-G1 phases, whereas the isopentenyl effect is required at the late G1-S interphase of the cell cycle. The evidence supporting these conclusions involves: first, in serum-arrested cells blocked early in G1 by compactin, only the combination of cholesterol added in early G1 and either mevalonate or isopentenyl adenine in late G1 permitted progression through the G1 and S phase DNA synthesis. Neither isopentenyl adenine added early in G1 nor cholesterol in late G1 was capable of restoring DNA synthesis in this system. Second, in accord with the above formulation, inhibition of cholesterol synthesis with the oxidosqualene cyclase inhibitor, dl 4,4,10 beta-trimethyl-trans-decal-3 beta-ol, affected only the early G1 phase of the cell cycle, but had no late G1 effect on DNA replication. PMID- 6848510 TI - The glucocorticoid receptor in GH1 cells. Evidence from dense amino acid labeling and whole cell studies for an equilibrium model explaining the influence of hormone on the intracellular distribution of receptor. AB - The glucocorticoid receptor in GH1 cells cultured without glucocorticoids and harvested in hypotonic buffer is primarily a cytosolic protein with a sedimentation coefficient of 10 S in low salt gradients. In gradients containing 0.4 M KCl, the receptor sediments at 3.5 S. Following incubation of cells for various times in culture medium containing dense amino acids, discrete peaks of newly synthesized dense receptor and normal density 3.5 S receptor are resolved in salt-containing gradients. The half-life of the 3.5 S receptor is 9.5 h. In contrast, the 10 S receptor gradually becomes more dense as the time of incubation of cells with dense medium increases and discrete normal and dense receptor peaks are not resolved in sucrose gradients. These results suggest that the 10 S receptor is an oligomer and is in a rapidly exchanging equilibrium in intact cells at 37 degrees C with its 3.5 S hormone-binding subunit. When GH1 cells are incubated for 1 h at 37 degrees C with various concentrations of [3H]9 alpha-fluoro-11 beta, 16 alpha, 17 alpha, 21-tetrahydroxypregna-1,4-diene-3,20 dione, 16,17-acetonide ([3H]triamcinolone acetonide), receptor is found both in the cytosol and the nucleus. Sedimentation of the cytosol in low salt gradients reveals that a 4 S receptor form is present along with 10 S receptor. As the concentration of [3H]triamcinolone acetonide is increased, the amounts of both 4 S cytosolic receptor and nuclear receptor increase and the amount of 10 S cytosolic receptor decreases. Following removal of [3H]triamcinolone acetonide from cells, the amounts of both 4 S cytosolic receptor and nuclear receptor decrease and the amount of 10 S cytosolic receptor increases. Density labeling indicates that this increase in 10 S receptor is not due to new receptor synthesis. The 4 S receptor form, but not the 10 S form, binds to purified DNA. Resedimentation studies suggest that the 4 S receptor found in low salt gradients is identical with or derived from the 3.5 S form found in salt-containing gradients. A model for hormone-mediated receptor translocation to the nucleus is proposed in which binding of hormone shifts the equilibrium between the oligomeric 10 S receptor and its 4 S subunit toward the 4 S form. The 4 S form is in equilibrium with 4 S receptor bound to chromatin. The model provides a molecular explanation for many experimental findings concerning glucocorticoid and other steroid receptors. PMID- 6848511 TI - Degradation of choleragen bound to cultured human fibroblasts and mouse neuroblastoma cells. AB - 125I-choleragen bound to human fibroblasts was degraded slowly with a t1/2 of 2-3 days; the radiolabel in bound 125I-choleragen was present in both the A and B subunits. During degradation, radiolabel was lost more rapidly from the 125I-A1 (t1/2 approximately 2 days) than from the 125I-B peptides (t1/2 greater than 5 days). 125I-Choleragen bound to neuroblastoma cells showed a considerably shorter t1/2 for both the 125I-A1 and 125I-B peptides; as with the fibroblasts, radiolabel was lost more rapidly from the 125I-A1 than from the 125I-B peptides. The continued presence of choleragen in the fibroblasts and neuroblastoma cells was associated with a prolonged activation of adenylate cyclase. In addition, fibroblasts, previously exposed to toxin and then washed free of unbound choleragen, only slowly recovered their ability to bind 125I-choleragen with a t1/2 of 7 days. Fibroblasts exposed to choleragen also showed evidence of persistent toxin on the surface based on the ability of the cells to bind antitoxin, antisubunit A or antisubunit B antibodies followed by 3H-protein A. It appears that choleragen remains persistently bound to fibroblasts, is degraded at a slow rate, and may prevent the binding of new toxin molecules to the fibroblast. The relatively slow degradation of toxin by fibroblasts may explain the prolonged activation of adenylate cyclase by toxin. The loss of 125I-toxin binding capacity following incubation with toxin may result from continued presence of toxin subunits on the cell surface. PMID- 6848512 TI - Chiral orientation of prosthetic heme in the cytochrome P-450 active site. AB - The absolute orientation of the prosthetic heme group in the active site of a hemoprotein may influence its substrate selectivity and catalytic properties. The only method available until now to determine the chiral orientation of the heme in a hemoprotein has been high resolution x-ray crystallography. The orientation of the heme in cytochrome P-450, therefore, is unknown because a crystallographic structure is not available for any form of this enzyme. We report here that the absolute configurations of the N-ethylprotoporphyrin IX adducts formed from the prosthetic hemes of cytochrome P-450 and hemoglobin during catalytic turnover of appropriate substrates are identical. The prosthetic heme in the inactivated cytochrome P-450 enzyme, therefore, has exactly the same orientation, relative to the fifth iron ligand, as the heme in hemoglobin. The approach described here can be used to determine the prosthetic heme orientation in other hemoproteins, including other cytochrome P-450 isozymes, for which x-ray structures are not available. PMID- 6848513 TI - Selective changes in microsomal enzymes of triacylglycerol and phosphatidylcholine synthesis in fetal and postnatal rat liver. Induction of microsomal sn-glycerol 3-phosphate and dihydroxyacetonephosphate acyltransferase activities. PMID- 6848514 TI - Isolation and identification of 1 alpha- and 23-hydroxylated metabolites of 25 hydroxy-24-oxovitamin D3 from in vitro incubates of chick kidney homogenates. AB - Five major metabolites (peaks I-V) of 25-hydroxy-24-oxovitamin D3 (25(OH)24-oxo D3) have been isolated in pure form from in vitro incubates containing kidney homogenates of vitamin D-deficient chicks and chicks given 65 nmol of vitamin D3; peaks II, III, and V are from vitamin D-deficient chicks and peaks I, II, and IV are from vitamin D-supplemented birds. The structures of the metabolites were unequivocally identified as 23,25-dihydroxy-24-oxo-vitamin D3 (peak I), 24,25 dihydroxyvitamin D3 (24,25(OH)2D3) (peak II), 1 alpha, 25-dihydroxy-24-oxovitamin D3 (peak III), 23,24,25-trihydroxyvitamin D3 (peak IV), and 1 alpha,24,25 trihydroxyvitamin D3 (peak V) by means of ultraviolet absorption spectrometry, mass spectrometry, and specific chemical reactions. It is concluded that 25(OH)24 oxo-D3 is further hydroxylated at the 1 alpha-position in the kidney of vitamin D deficient chicks and at the 23-position in that of vitamin D-supplemented animals. Formation of 24,25(OH)2D3 from 25(OH)24-oxo-D3 in both vitamin D deficient and -supplemented animals provides evidence for the presence of an enzyme to reduce the 24-oxo group irrespective of the vitamin D status. PMID- 6848515 TI - The presence of a histidine-aspartic acid pair in the active site of 2 hydroxyacid dehydrogenases. X-ray refinement of cytoplasmic malate dehydrogenase. AB - The structure of cytoplasmic malate dehydrogenase has been partially refined by crystallographic least squares methods. Using x-ray phases based on the refined coordinates, analysis of the resultant electron density maps has led to a new model of cytoplasmic malate dehydrogenase and a tentative "x-ray sequence." The two crystallographically independent subunits comprising the dimeric enzyme are nearly identical in structure and are related to each other by roughly 2-fold rotational symmetry. The best fit of the molecular structure of cytoplasmic malate dehydrogenase to that of lactate dehydrogenase has been obtained by least squares methods. The active sites of these two enzymes contain similarly oriented His-Asp pairs linked by a hydrogen bond which may function as a proton relay system during catalysis. This pair could also provide an explanation for the relatively stronger binding by cytoplasmic malate dehydrogenase and lactate dehydrogenase of NADH versus NAD. Similar His-Asp pairs have been observed in the serine proteases, thermolysin, and phospholipase A2, and the His-Asp pair may play a similar functional role in all of these enzymes. PMID- 6848516 TI - Unusual aspects of human thymidylate synthase in mouse cells introduced by DNA mediated gene transfer. AB - Thymidylate synthase-negative mutants of mouse FM3A cells were transformed to thymidine prototrophs by human DNA. The stable transformants had only human thymidylate synthase and segments of human DNA. They grew normally but had unusually high levels of the human enzyme. In two transformants examined, however, neither was the dTTP pool elevated nor the dCTP pool decreased. DNA synthesis in permeabilized cells of a transformant was more efficient than that in the wild type with dATP, dGTP, dCTP, and dUMP as substrates, but this was not so when dUMP was replaced by dTTP. Unlike the mouse enzyme, the human enzyme in the transformants did not co-sediment with DNA polymerase alpha and thymidine kinase in a sucrose gradient, suggesting that the human enzyme is not incorporated into a multienzyme complex for DNA replication. The high levels of the human enzyme in the transformants were suppressed to various degrees by fusion with a wild type mouse line. No active hybrid dimer enzyme was found between the human and mouse enzymes, which each consist of two identical subunits. Thus, the human enzyme in the transformants seems to behave differently from the mouse enzyme and its overproduction seems to be necessary for supporting the normal growth of the transformants. PMID- 6848517 TI - Serine hydroxymethyltransferase. 31P nuclear magnetic resonance study of the enzyme-bound pyridoxal 5'-phosphate. AB - The environment of the phosphate group of pyridoxal-P bound at the active site of cytosolic serine hydroxymethyltransferase has been investigated by 31P NMR spectroscopy. In the holoenzyme, the pyridoxal-P chemical shift is pH-dependent with a pKa of 6.45. The chemical shift of the bound pyridoxal-P is shifted upfield about 0.3 ppm from the signal for free pyridoxal-P. Saturation of the active site with the substrates L-serine, glycine, and tetrahydrofolate does not alter the chemical shift or the pKa of the phosphate group. The addition of these substrates does, however, alter the absorption and circular dichroism spectra of the bound coenzyme, reflecting environmental changes of the pyridine ring Schiff's base system. We conclude from these studies that the phosphate group of the bound coenzyme is exposed to the solvent. The reorientation and conformational changes of the pyridoxal-P ring which take place during the formation of enzyme-substrate complexes do not appear to change the environment of the phosphate moiety of the coenzyme. PMID- 6848518 TI - Structure of Azotobacter vinelandii 7Fe ferredoxin. Amino acid sequence and electron density maps of residues. AB - The complete amino acid sequence of the 7Fe ferredoxin from Azotobacter vinelandii (Av Fd) was determined by repetitive Edman degradation of the whole protein and of peptides derived from CNBr cleavage or chymotrypsin digestion. The sequence was confirmed by the 2A electron density maps for the residues calculated with difference Fourier coefficients. The density maps for all residues are included in the paper. Av Fd has several important differences with the clostridial-type ferredoxins: (i) Av Fd is 106 residues (versus 55-60 for other bacterial ferredoxins); (ii) Av Fd has 9 cysteines, one of which (residue 24) is not homologous with the bacterial ferredoxins; (iii) Av Fd has 2 extra residues between 2 cysteines (residues 11 and 16) homologous to cysteines in the bacterial ferredoxins; and (iv) Av Fd has the unique sequence -Cys-Val-Glu-Val Cys- (residues 16-20) which are two of the ligands of the 3Fe:3S center. These sequence features are compared to the sequences of various ferredoxin groups. Structure predictions for other suspected 7Fe ferredoxins are discussed. PMID- 6848519 TI - Abnormal glycosylation of human fibronectin secreted in the presence of monensin. AB - Detailed studies of the effects of the ionophore monensin upon the glycosylation of secreted fibronectin have been carried out. Human fibroblasts in culture were incubated in 1 microM monensin for several hours, following which radiolabeled glucosamine or mannose was added to the cultures. Parallel incubation and labeling of control cultures were done. Labeled fibronectin was isolated from the culture media by gelatin-Sepharose chromatography, from cell surfaces by urea extraction, and from intracellular locations by cell lysis followed by immunoprecipitation. Detailed comparison of the glycopeptides released from fibronectin by pronase and of the oligosaccharides liberated by hydrazinolysis was carried out, particularly focusing on the secreted fibronectin, using gel filtration, high performance liquid chromatography, and concanavalin A chromatography, in conjunction with the use of endoglycosidase H and specific exoglycosidases. We demonstrate that fibronectin in the medium of monensin treated cultures differs in its glycosylation pattern from the control fibronectin. High mannose oligosaccharides are abundant in the monensin-derived fibronectin, whereas the control protein contains primarily complex oligosaccharides. Monensin apparently does not alter the initial glycosylation of fibronectin since the high mannose oligosaccharides are present on both control and monensin-treated intracellular fibronectin. We suggest, therefore, that monensin, by impairing intracellular translocation through the Golgi region, allows incompletely processed forms of fibronectin to reach the cell surface and to be released into the culture medium. PMID- 6848520 TI - Cell-free translation of frog virus 3 messenger RNAs. Initiation factors from infected cells discriminate between early and late viral mRNAs. AB - Cell-free protein-synthesizing extracts prepared from rabbit reticulocytes, wheat germ, or cultured baby hamster kidney cells efficiently translated frog virus 3 early mRNAs; in contrast, late mRNAs were translated poorly under similar conditions. However, the translational efficiency of the late viral mRNAs was markedly enhanced in cell-free extracts prepared from frog virus 3 (FV 3) infected baby hamster kidney cells and in nuclease-treated rabbit reticulocyte extracts by the addition of a 0.5 M KCl wash from FV 3-infected cell ribosomes; the 0.5 M KCl wash (initiation factors) from uninfected cells had no such effect. Total cytoplasmic RNA from infected cells was fractionated according to size on sucrose gradients and fractions containing different concentrations, and relative proportions of early and late mRNAs were translated in either native or initiation factor-supplemented extracts. Under these conditions, the translation efficiency of early mRNAs was unchanged, while the translation of late mRNAs increased 2-7-fold. Thus, the in vitro discriminatory activity of the 0.5 M wash was not dependent on the complexity of the mRNAs present in the translation mixture. We show also that in native extracts, under conditions of blocked polypeptide chain elongation, early mRNAs are initiated preferentially. However, late as well as early mRNAs are initiated equally well in reticulocyte extracts under similar experimental conditions when supplemented with crude initiation factors from infected cells. These data support the conclusion that the translational enhancement of FV 3 mRNAs in vitro is mediated by a virus-specified or virus-modified initiation factor(s) and likely represents a regulatory mechanism of protein synthesis operative in vivo (Willis, D. B., Goorha, R., Miles, M., and Granoff, A. (1977) J. Virol. 24, 326-342). PMID- 6848521 TI - Induction of chondrocyte vesiculation in vitro. PMID- 6848522 TI - Proteolytic alterations of factor Va bound to platelets. AB - The coagulation protein Factor Va forms the receptor for the serine protease Factor Xa at the platelet surface. This membrane-bound complex of Factor Va and Factor Xa plus calcium constitutes the enzymatic complex prothrombinase, which effects the conversion of prothrombin to the clotting enzyme, thrombin. Studies were undertaken to investigate the proteolytic events accompanying the inactivation of platelet-bound Factor Va by activated protein C as well as the ability of Factor Xa to protect Factor Va from activated protein C inactivation. During the course of these studies, observations were made which indicated that Factor Va was also cleaved by both a platelet-associated protease, as well as Factor Xa. When Factor Va was incubated with washed platelets, electrophoresis and autoradiography of solubilized platelet pellets indicated that three Factor Va peptides were associated with the platelet: component D (Mr = 94,000), component E (Mr = 74,000), and a 90,000-dalton peptide (component D') which appeared with time as the result of a platelet-associated protease cleavage of component D. The Factor Va peptides bound to platelets were proteolytically inactivated by activated protein C, resulting in five peptide products, all of which remained associated with the platelet-membrane surface. Factor Va was protected from activated protein C proteolysis by complex formation with Factor Xa or active site-blocked Factor Xa. However, active Factor Xa cleaved platelet bound Factor Va to peptide products which also remained associated with the platelet. Whereas activated protein C rapidly cleaved components D and D' with secondary cleavages occurring in component E, Factor Xa rapidly cleaved component E with secondary cleavages occurring in components D and D'. The Factor Xa cleaved Factor Va is catalytically functional. To determine whether cleavage was necessary for function, prothrombin conversion reaction mixtures were monitored for thrombin formation and Factor Va cleavage with time in a defined phospholipid vesicle model system. The results indicated that Factor Xa cleavage of Factor Va is not essential for Factor Va activity but may promote its ability to function in the prothrombinase complex. PMID- 6848523 TI - The characterization and submitochondrial localization of delta-aminolevulinic acid synthase and an associated amidase in rat liver mitochondria using an improved assay for both enzymes. PMID- 6848524 TI - Radiation exposure and associated risks to operating-room personnel during use of fluoroscopic guidance for selected orthopaedic surgical procedures. AB - Because of the increased use of fluoroscopic guidance techniques in certain orthopaedic surgical procedures, surgeons and other operating-room personnel who are involved in these procedures are voicing growing concern over possible associated radiation health hazards. Using thin-layer lithium fluoride chips for thermoluminescence dosimetry, we directly measured the radiation exposure encountered by the primary surgeon during seven operative procedures that were done utilizing fluoroscopic guidance techniques. Dosimetry studies were also carried out using a tissue-equivalent phantom model to determine the directions of maximum scatter radiation. These studies indicated that the standard protective apron that is commonly worn during the use of fluoroscopy provides adequate protection to most of the body; however, the surgeon is exposed to significant levels of scatter radiation to the head, neck, and hands, Dosimetry studies showed that positioning the fluoroscopic beam vertically to the fracture site of the supine patient, with the x-ray source posterior to the patient, provided the lowest levels of scatter radiation to the surgeon in the normal working position. PMID- 6848525 TI - Irreducible fracture-dislocation of the distal interphalangeal joint. A case report. PMID- 6848526 TI - Congenital syphilis. A case report. PMID- 6848527 TI - Two-level fracture of the cervical spine in a young child. A case report with operative treatment. PMID- 6848528 TI - Painful sequelae of coxa plana. AB - Thirty-one patients with an average age of twenty-seven years had painful hips as the result of coxa plana in childhood. The pain was severe enough for surgical relief to be considered. Radiographically the lesions could be subdivided into three groups: severe mushroom deformity of the femoral head, 43 per cent; less severe dysplasia of the hip, 27 per cent; and severe osteoarthritis, 30 per cent. Twenty-three hip operations were done on theses patients. Fifteen hips showed radiographic evidence of definitive premature closure of the femoral capital epiphysis. The series is presented to illustrate that coxa plana may be followed by major disability in the hip within the first three decades of life. PMID- 6848529 TI - Diagnosis of vertebral fractures. PMID- 6848530 TI - Supracondylar-intercondylar fractures of the femur treated with a supracondylar plate and lag screw. PMID- 6848531 TI - Carpal tunnel syndrome due to an anomalous distal end of the radius. PMID- 6848532 TI - Anaerobic osteomyelitis. PMID- 6848533 TI - High tibial osteotomy in the treatment of osteoarthritis of the knee. The role of preoperative arthroscopy. AB - Sixty osteoarthritic knees that were evaluated by arthroscopic, radiographic, and clinical (Insall knee-rating scale) examination prior to high tibial valgus osteotomy were re-evaluated radiographically and clinically after a minimum follow-up of two years. After two and three years, the clinical scores of the knees with bicompartmental and tricompartmental osteoarthritis (including exposed subchondral bone in the lateral compartment) were the same as the scores of the knees with unicompartmental disease. The scores of the knees with 5 to 13 degrees of valgus alignment at two years were significantly higher (p less than 0.01) than the scores of the knees with less than 5 degrees of valgus angulation, regardless of the arthroscopy scores. Based on the results after two to three years, the arthroscopic findings prior to osteotomy appeared to have little, if any, predictive value in evaluating patients for this procedure. PMID- 6848534 TI - Operative treatment of spinal deformities in patients with cerebral palsy or mental retardation. An analysis of one hundred and seven cases. PMID- 6848535 TI - Reduction of radiation exposure during radiography for scoliosis. AB - To reduce the radiation exposure received by young scoliosis patients during treatment, six changes in technique were instituted: (1) a posteroanterior projection, (2) specially designed leaded acrylic filters, (3) a high-speed screen-film system, (4) a specially designed cassette-holder and grid, (5) a breast-shield, and (6) additional filtration in the x-ray tube the thyroid, breast, and abdominal areas were made on an Alderson phantom. They revealed an eightfold reduction in abdominal exposure for both the posteroanterior and the lateral radiographys. There was a twentyfold reduction in exposure to the thyroid for the posteroanterior radiography from 100 to less than five milliroentgens and for the lateral radiograph there was a 100-fold reduction from 618 to six milliroentgens. For the breasts there was a sixty-ninefold reduction from 344 to less than five milliroentgens for the posteroanterior radiography and a fifty fivefold reduction from 277 to less than five milliroentgens for the lateral radiograph. These reductions in exposure were obtained without significant loss in the quality of the radiographs and in most instances with an improvement in the over-all quality of the radiograph due to the more uniform exposure. PMID- 6848536 TI - The treatment of femoral fractures by cast-brace application and early ambulation. A prospective review of one hundred and six patients. AB - One hundred and six patients with 108 femoral shaft fractures were treated with a cast-brace. Ninety-eight cast-braces included an abdominal band and hip hinge. At follow-up three femora showed coronal malalignment that exceeded 9 degrees and sixty-nine showed varying degrees of sagittal malalignment (thirty-eight having anterior bowing and thirty-one, posterior bowing). Four patients regained only 100 degrees of knee flexion or less and four others had hyperextension of the knee of more than 10 degrees. Thirty-eight patients showed signs of knee instability but only four of them had symptoms of instability. Four fractures were treated operatively to correct excessive shortening or angulation and another fracture was bone-grafted to promote union. The mean shortening was 10.9 millimeters (standard deviation, 8.8 millimeters). Although the more comminuted of the eighty-five middle-third fractures shortened more than the others, the results of this method of treatment for these comminuted fractures were acceptable. PMID- 6848537 TI - Complications of Ender-pin fixation in basicervical, intertrochanteric, and subtrochanteric fractures of the hip. AB - Two hundred patients with a basicervical, intertrochanteric, or subtrochanteric fracture were treated by Ender-pin fixation during a three-year period. Their median age was 73.5 years and there was a 10 per cent mortality rate. Early partial weight-bearing with some external support was allowed for most patients. Minimum shortening and one non-union occurred. However, there was a substantial incidence of complications. The fixation failed in all basicervical fractures. Distal pin migration of more than two centimeters occurred in 50 per cent of the unstable intertrochanteric fractures. Seventy-six per cent of the forty-two patients who were personally examined at follow-up had pain in the knee and 36 per cent had external malrotation. The incidence of pin migration increased in the more unstable fractures. PMID- 6848539 TI - The contribution of the anterior talofibular ligament to ankle laxity. AB - The motion responses of thirty fresh-frozen cadaver tibiotalar joints were measured for applied anterior-posterior force, inversion-eversion moment, and internal-external rotary torque. The load-motion response curves obtained after sectioning the anterior talofibular ligament were compared with those for intact specimens in three positions of flexion of the ankle. Laxity of the intact ankle was shown to be dependent on flexion position; dorsiflexion was consistently the position of least laxity, reflecting the effects of talar geometry and its articulation with the tibiotalar syndesmosis. Section of the anterior talofibular ligament produced significant increases in laxity for all modes tested. Total anterior-posterior laxity increased by 4.3 millimeters in dorsiflexion, which was the position of maximum change. In contrast, the greatest increases in total inversion-eversion laxity (5.2 degrees) and total internal-external rotation laxity (10.8 degrees) were recorded in plantar flexion. PMID- 6848538 TI - Flexor tendon healing and restoration of the gliding surface. An ultrastructural study in dogs. AB - Healing canine flexor tendons were treated with either total immobilization and were studied by light, scanning, and transmission electron microscopy at ten, twenty-one , and forty-two days. The immobilized tendons healed by ingrowth of connective tissue from the digital sheath and cellular proliferation of the endotenon. The ingrowth of reparative tissue from the digital sheath overwhelmed the epitenon response. At the ultrastructural level, collagen resorption was prominent whereas protein synthesis was limited. This was observed at all study intervals. In contrast, the mobilized tendons healed by proliferation and migration of cells from the epitenon. Ingrowth of reparative tissue from the tendon sheath was notably lacking in this group. The epitenon cells exhibited greater cellular activity and collagen production at each interval compared with cells of the immobilized repairs. PMID- 6848540 TI - Total hip replacement induces injury to remote veins in a canine model. AB - The effects of total hip replacement on the condition of the luminal surface of the jugular and femoral veins and the carotid and femoral arteries were studied in healthy dogs. Four hours after the completion of surgery, most of the blood was removed by whole-body perfusion and the vessels were partially fixed in situ by glutaraldehyde perfusion, harvested, and prepared for scanning electron microscopy. In control dogs (held under anesthesia) the luminal surfaces of the veins (including valves and confluences) and arteries were covered by intact endothelium and were free of adhering blood cells. The arteries from dogs that were operated on were also free of damage. In contrast, the veins from dogs that were operated on showed a series of roughly parallel microtears around 70 to 80 per cent of the confluences of the side branches with the jugular or femoral vein. The basement membrane as well as the endothelial sheet was torn, thereby exposing underlying connective-tissue fibers and smooth muscle cells. The endothelium separated along intercellular junctions. The tears were infiltrated with many leukocytes and platelets and some erythrocytes. Subtle endothelial changes and patchy leukocyte adhesion occurred away from the side branches. The mechanism or mechanisms remain to be elucidated. PMID- 6848541 TI - Drugs and the elderly. Proceedings of a symposium, Toronto, May 4-5, 1981. PMID- 6848542 TI - Drugs and the elderly. Proceedings of a symposium, Toronto, May 4-5, 1981. Keynote address. PMID- 6848543 TI - An introduction to pharmacokinetics. PMID- 6848544 TI - The failing immune system. PMID- 6848545 TI - Determinants of cardiovascular performance: modification due to aging. AB - With advancing age the ability of the cardiovascular system to respond to stress declines. The present discussion examines several mechanisms at both the organismal and cellular level that are known to determine cardiovascular performance, and analyses the current state of knowledge regarding the effect of aging on these processes. The conclusion reached is that aging does not result in a generalized decline in all parameters that regulate cardiovascular function, but rather a few specific functional deficits can be identified. Notably, these include a diminished responsiveness to catecholamines and altered vascular loading of the myocardium during high work load states. PMID- 6848547 TI - Optimal therapy for the geriatric patient: the challenge to clinical pharmacology. AB - The elderly are an increasing proportion of the population. Their median life span should rise to 85 years, although in later life organs of drug distribution and elimination may deteriorate in function and 100 years will remain the general maximum. Progressive containment of chronic diseases will still leave them at lethal risk from acute infectious diseases because of depleted homeostatic reserves of vital systems (cardiovascular, hepatic, immunological and renal). A decline in chronic disease should lengthen the period of well-being and reduce medical needs and perhaps drug needs of older persons. To estimate further therapeutic requirements of the elderly, information is needed on the epidemiology of drug use and rates of efficacy and toxicity in the elderly. Implicit in the data gathering is a true need for systematic post-marketing surveillance (PMS) of drugs with particular respect to drug efficacy and unanticipated adverse or beneficial reactions in this age group. Observational, non-experimental techniques can be devised and should be tested as appropriate methods of establishing the rates of anticipated efficacy and unwanted effects of drugs. The application of such techniques may be one of the only feasible ways to establish utility functions for drugs used in the elderly. PMID- 6848546 TI - Aging and drug disposition--metabolism. AB - The kinetics of drugs are known to change in the elderly. The most unequivocal example is the decrease in renal drug clearance. Yet, few studies have been published on the renal clinically important impairment of drug metabolism occurs in the elderly, and the effect of age per se cannot easily be discerned because a number of other factors that affect drug metabolism change with age (dietary and smoking habits, disease, drug interactions, ect.). In each age group there is a marked interindividual variation in the metabolic clearance of drugs leading to pronounced differences in steady-state plasma concentrations at fixed dosage schedules. For drugs with a narrow therapeutic range it is important to avoid standard doses in slow metabolizers. This phenotype is at risk to develop adverse drug reactions unless the dose is reduced. It may be particularly important to recognize the slow metabolizer phenotype among the elderly, who may have exaggerated drug response due to physiological and pharmacodynamic reasons. PMID- 6848548 TI - Address to the pharmaceutical conference, May 4,5--Montreal, 1981. Aging. PMID- 6848549 TI - Rational therapeutics in the elderly. AB - The potential for altered responsiveness to drugs in elderly patients together with their high frequency of multiple disease states for which drug therapy might be indicated makes it important to define certain basic principles of prescribing for them in order to obtain maximum efficacy with minimum unwanted effects. Many diseases from which the elderly suffer do not require drug treatment and, if it is required, the decision should be made in light of the pharmacokinetic and pharmacodynamic characteristics of the alternatives, the increased potential of certain drugs to produce adverse effects in the elderly and a regular review of the need for continued medication. In order to improve compliance with prescribing instructions, the minimum number of drugs and doses should be prescribed, the size, shape and colour of tablets and capsules should also determine choice, and attention paid to packaging and labelling. The methods by which the patient living at home can manage his/her medication effectively should be carefully considered. PMID- 6848550 TI - Behaviour and adaptation in later life. AB - The implications of three revolutions in current social scientific thinking about behaviour and adaptation in later life are discussed. A demographic revolution is occurring in all countries; the number of older persons is less important than their functional impairments. A knowledge revolution has laid the basis for realistic optimism about modifiability of aging processes. A revolution in expectations about the future of aging is occurring. PMID- 6848551 TI - Aging and heavy drug use: a prescription survey in Manitoba. AB - A random sample of claimants under Manitoba's Pharmacare plan provided information on the drugs prescribed for those individuals who spent more than $50 for drugs in 1978. More women than men were represented among the 412 claimants aged 50 to 64 (58% females), and more drugs were prescribed for women than men (8.38 +/- 3.4 vs. 7.17 +/- .33, mean +/- S.E.M., p less than 0.02). For the 403 claimants aged 65 and older, the sex distribution matched that of the general population (55%), and the difference in number of drugs prescribed was not statistically significant (8.49 +/- .36 vs 7.98 +/- .35). For the claimants aged 65 and older, the five most heavily prescribed drug categories were thiazide-type diuretics (prescribed for 51.6% of older claimants in 1978), benzodiazepines (40.0%), salicylates (26.8%), digoxin (22.6%) and codeine (20.8%). There were few differences in prescription frequencies between younger and older claimants, and these data indicate that drugs prescribed for heavy drug users do not change markedly as a function of age. PMID- 6848552 TI - Drug distribution and renal excretion in the elderly. AB - Drug responsiveness in the elderly often differs from that in younger individuals. A causative factor is often thought to be age-related changes in the quantitative fashion in which the body handles the drug. It is speculated that changes in body size, composition, and tissue perfusion lead to differences in drug distribution. The limited supportive evidence for this is reviewed, along with the practical consequences in drug therapy. More definitive data is presented on the age-related impairment of renal function and its effects on the urinary elimination of drugs and metabolites. Methods are presented to permit rationale dosage regimen modifications for elderly patients with reduced renal function. PMID- 6848553 TI - Hemodynamic sequelae of regression of experimental atherosclerosis. AB - Regression of experimental atherosclerosis is characterized by decreased intimal thickness and luminal enlargement, but intimal fibrosis becomes more dense. We tested the hypothesis that fibrosis of arteries during regression might limit vasodilator capacity and restrict hemodynamic improvement despite luminal improvement. We studied limb, coronary, and cerebral hemodynamics in 11 normal cynomolgus monkeys, 10 monkeys given an atherogenic diet for 20 mo and 8 monkeys given a regression diet for an additional 18 mo. The atherogenic diet induced lesions of moderate severity (50-60% stenosis); owing to characteristic vessel growth during the atherogenic period, luminal size did not decrease correspondingly. Regression monkeys showed typical changes of regression with luminal enlargement but increased fibrosis. The iliac artery was perfused at constant blood flow and maximal vasodilatation was produced with papaverine. Blood flow was measured with microspheres during maximal vasodilatation in the coronary bed (adenosine) and cerebral bed (hypercapnia). In normal monkeys, minimal vascular resistances were 1.95 +/- 0.19 mm Hg/ml/min X 100 g (mean +/- SE) (limb), 0.13 +/- 0.01 (coronary), and 0.44 +/- 0.02 (cerebral). In atherosclerotic monkeys minimal resistance increased (P less than 0.05) 108, 62, and 166% in the limb, coronary, and cerebral beds, respectively. In regression monkeys, minimal resistance increased from values found in atherosclerotic animals in the limb (+22%), decreased inconsistently in the coronary bed (-19%), and decreased significantly in the cerebral bed (-44%, P less than 0.05). Thus morphologic regression was accompanied by significant hemodynamic improvement during maximal dilatation only in cerebral vessels. We conclude that increases in luminal size during regression of atherosclerotic lesions may not be associated with increases in vasodilator capacity, as intimal fibrosis may limit physiologically important hemodynamic improvement. PMID- 6848554 TI - Human eosinophil arylsulfatase B. Structure and activity of the purified tetrameric lysosomal hydrolase. AB - Arylsulfatase B from human eosinophils was purified free of contaminating proteins by gel filtration and sequential affinity chromatography on Affi-Gel Blue and zinc chelate Sepharose. 50 micrograms of the purified enzyme presented as a single stained band on alkaline disc gel electrophoresis. In both goats and rabbits, the purified enzyme elicited monospecific antisera that yielded single precipitation arcs on Ouchterlony analysis with a human eosinophil extract and the purified enzyme; the immunoprecipitation lines fused in a pattern of identity, providing immunochemical evidence for the homogeneity of the purified enzyme. On sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis, a dominant lower molecular weight protein and three other bands with molecular weights approximately two, three, and four times that of the major protein band were resolved. The prominence of the less rapidly migrating protein bands increased relative to the major band if the enzyme was maintained under acidic conditions or was reacted with the cross-linking agent dimethyl suberimidate under alkaline conditions before SDS-polyacrylamide gel electrophoresis, supporting the conclusion that the enzyme consists of four subunits. Two stained bands were present on acid disc gel electrophoresis; they were composed of oligomeric forms of enzyme on analysis by SDS-polyacrylamide gel electrophoresis in a second dimension. A minimum molecular weight of 70,190 was determined from amino acid composition analysis for the tetrameric form of the enzyme. The specific functional activity of the purified arylsulfatase B was concentration and time dependent, compatible with its association or dissociation into subunit forms with differing specific activities. Factors that govern subunit interactions of arylsulfatase B, including local enzyme concentration and pH, provide mechanisms for regulating the enzymatic activity of this lysosomal hydrolase. PMID- 6848555 TI - Role of the 26-hydroxylase in the biosynthesis of bile acids in the normal state and in cerebrotendinous xanthomatosis. An in vivo study. AB - On the basis of different in vitro studies, we have previously suggested that the basic metabolic defect in the rare inherited disease cerebrotendinous xanthomatosis (CTX) is a lack of a hepatic mitochondrial C27-steroid 26 hydroxylase, involved in the normal biosynthesis of bile acids (1980. J. Clin. Invest. 65: 1418-1430; 1981. J. Lipid Res. 22: 191-200; 22: 632-640). In the present work, this hypothesis was tested in vivo. One patient with CTX and two control subjects received intravenously a mixture of [4-14C]7 alpha-hydroxy-4 cholesten-3-one and [6 beta-3H]7 alpha,26-dihydroxy-4-cholesten-3-one, steroids believed to be important precursors of chenodeoxycholic acid. The ratio between 14C and 3H in cholic acid and chenodeoxycholic acid isolated from bile of the CTX patient was approximately 1/40 and 1/60 of those of the control subjects, respectively. Another patient with CTX and one control subject received a mixture of [4-14C]5 beta-cholestane-3 alpha,7 alpha-diol and [1,2-3H]5 beta-cholestane-3 alpha,7 alpha,26-triol, both possible precursors to chenodeoxycholic acid. In this case the 14C/3H ratio in cholic acid and chenodeoxycholic acid from the patient with CTX was 1/10 and 1/15, respectively, compared with that of the control subject. The most likely explanation for these findings is that very little of the 14C-precursors, i.e. without a 26-hydroxyl group, can be converted into cholic acid and chenodeoxycholic acid because of a defect of the 26 hydroxylase step. The results obtained are in accord with our previous findings in vitro. The results further underline the importance of the 26-hydroxylase pathway in the normal biosynthesis of cholic acid and chenodeoxycholic acid in man. PMID- 6848556 TI - Intracellular multiplication of Legionnaires' disease bacteria (Legionella pneumophila) in human monocytes is reversibly inhibited by erythromycin and rifampin. AB - We have previously reported that virulent egg yolk-grown Legionella pneumophila, Philadelphia 1 strain, multiplies intracellularly in human blood monocytes and only intracellularly under tissue culture conditions. In this paper, we have investigated the effect of erythromycin and rifampin on L. pneumophila-monocyte interaction in vitro; erythromycin and rifampin are currently the drugs of choice for the treatment of Legionnaires' disease. The intracellular multiplication of L. pneumophila is inhibited by erythromycin and rifampin, as measured by colony forming units, whether the antibiotics are added just before or just after infection of monocytes with L. pneumophila, or 2 d after infection when L. pneumophila is in the logarithmic phase of growth in monocytes. Intracellular multiplication of L. pneumophila is inhibited by 1.25 microgram/ml but not less than or equal to 0.125 microgram/ml erythromycin and 0.01 microgram/ml but not less than or equal to 0.001 microgram/ml rifampin. These concentrations of antibiotics are comparable to those that inhibit extracellular multiplication of L. pneumophila under cell-free conditions in artificial medium; the minimal inhibitory concentration is 0.37 microgram/ml for erythromycin and 0.002 microgram/ml for rifampin. Multiplication of L. pneumophila in the logarithmic phase of growth in monocytes is inhibited within 1 h of the addition of antibiotics. Intracellular bacteria inhibited from multiplying by antibiotics are not killed. By electron microscopy, the bacteria appear intact within membrane bound vacuoles, studded with ribosomelike structures. L. pneumophila multiplying extracellularly on artificial medium is killed readily by relatively low concentrations of erythromycin and rifampin; the minimal bactericidal concentration is 1 microgram/ml for erythromycin and 0.009 microgram/ml for rifampin. In contrast, L. pneumophila multiplying intracellularly is resistant to killing by these concentrations of erythromycin and rifampin or by concentrations equal to or greater than peak serum levels in humans. Extracellular L. pneumophila in stationary phase is also resistant to killing by erythromycin and rifampin. These findings, taken together with our previous work, indicate that, in vivo, L. pneumophila is resistant to killing by erythromycin and rifampin. Inhibition of L. pneumophila multiplication in monocytes by antibiotics is reversible; when the antibiotics are removed from infected monocyte cultures after 2 d, L. pneumophila resumes multiplication. This study indicates that patients with Legionnaires' disease under treatment with erythromycin and rifampin require host defenses to eliminate L. pneumophila, and that inadequate host defenses may result in relapse after cessation of therapy. PMID- 6848557 TI - Reversal of shortened platelet survival in rats by the antifibrinolytic agent, epsilon aminocaproic acid. AB - Platelet survival in rabbits and rats is shortened by placing indwelling catheters in the aorta; this shortening appears to be at least partly related to the extent of vessel wall injury and platelet interaction with the repeatedly damaged wall. Treatment of rabbit platelets with plasmin and other proteolytic enzymes in vitro shortens their survival when they are returned to the circulation. Because platelets may be exposed to plasmin and other proteolytic enzymes in rabbits and rats with indwelling aortic catheters, we examined the effect of epsilon-aminocaproic acid (EACA) on platelet survival in rats. At a dose of 1 g/kg every 4 h, EACA significantly reduced whole blood fibrinolytic activity and prolonged the shortened platelet survival in rats with indwelling aortic catheters. Mean platelet survival for untreated rats with indwelling aortic catheters was 38.6 +/- 1.9 h, and for rats treated with EACA, 53.8 +/- 3.8 h. Scanning electron microscopy showed that the injured vessel wall of these animals was mainly covered with platelets and fibrin, whereas in control animals that did not receive EACA, the injured surface was mainly covered with platelets and little fibrin was observed. Thus shortened platelet survival during continuous vessel wall injury may result from the local generation of plasmin or the release of proteolytic enzymes at sites where platelets (and possibly leukocytes) interact with the vessel wall. PMID- 6848558 TI - In vitro culture of cells exfoliated in the urine by patients with diabetes mellitus. AB - As an approach to facilitate the understanding of the progression of diabetic renal disease, we assessed the urine of diabetic patients and normal volunteers for the presence of cells that could be cultured in vitro. The results suggest that both normal control subjects and diabetic patients, without clinically detectable microangiopathy, exfoliate few culturable cells into the urine. In contrast, diabetics with documented retinopathy but without nephropathy exfoliate substantially higher numbers of culturable cells (5.2 cells/100 ml urine), whereas diabetics with both retinopathy and advanced nephropathy exfoliate even greater numbers of culturable cells (50.8 cells/100 ml urine). The cells that are exfoliated and culturable can be divided into five distinct cell types based on morphology at the light microscope level. The exfoliated cells proliferate at clonal density after isolation from urine and are epithelial in appearance. These data suggest that the culture of cells from urine might have diagnostic value as an early indicator of diabetic renal disease and provide a convenient, noninvasive new source of human kidney epithelial cells. PMID- 6848559 TI - Effect of carbonic anhydrase inhibition on superficial and deep nephron bicarbonate reabsorption in the rat. AB - The nephron segment responsible for the acetazolamide-insensitive fraction of renal bicarbonate reabsorption has not been clearly delineated. This study compares superficial and deep nephron bicarbonate reabsorption before and after acetazolamide at two dose levels (20 and 50 mg/kg per h) in mutant Munich-Wistar rats employing both cortical and papillary micropuncture and microcalorimetry. Systemic acid-base balance and right whole kidney glomerular filtration rate were similar in all groups examined. The effects of the two doses of acetazolamide were indistinguishable and resulted in a significant increase in whole kidney bicarbonate excretion that compared favorably with the fraction delivered out of the left papillary tip. Acetazolamide inhibited superficial proximal bicarbonate reabsorption by 80.0%, whereas reabsorption up to the deep loop of Henle was decreased by only 52% (P less than 0.001). Bicarbonate reabsorption that was insensitive to acetazolamide occurred in the superficial and deep loop of Henle and between the distal tubule and base collecting duct. Because water reabsorption in these segments could serve to generate transepithelial bicarbonate concentration gradients favorable for reabsorption, we attempted to minimize water abstraction by combined administration of mannitol and acetazolamide. During this condition a significant increase in bicarbonate delivery up to the deep loop of Henle was noted (52 vs. 65%), whereas superficial nephron reabsorption was not altered. Furthermore, an outwardly directed bicarbonate concentration gradient from the deep loop of Henle to vasa recta was demonstrated during acetazolamide (delta tCO2 = 20.9 +/- 3.3 mM), but was abolished during combined mannitol and acetazolamide administration (delta tCO2 = 3.5 +/- 0.9 mM). It is concluded that carbonic anhydrase inhibition results in a disparate effect on nephron bicarbonate reabsorption when juxtamedullary and superficial nephron segments are compared. Our findings suggest that a mechanism for residual bicarbonate reabsorption during acetazolamide administration may be passive reabsorption driven by favorable transepithelial concentration gradients. PMID- 6848560 TI - Species-related innate resistance to Schistosoma mansoni. Role of mononuclear phagocytes in schistosomula killing in vitro. AB - Resistance to infection with the multicellular parasite Schistosoma mansoni has been previously demonstrated to vary among several host species. The current investigation was designed to examine the basis for this species-related resistance in vitro. Adherent peritoneal macrophages or peripheral blood mononuclear cells from several species of host animals were incubated with S. mansoni schistosomula for 18-24 h; parasite viability was then assayed by methylene blue exclusion. Peritoneal exudate macrophages from susceptible species, such as mice (C57Bl/6) and hamsters killed, respectively, 6.6 +/- 2 and 8.0 +/- 2% of incubated schistosomula. In contrast, cells from resistant species: rats, guinea pigs, and rabbits, killed 21 +/- 2.3, 15 +/- 4.6, and 17 +/- 5.5%, respectively. Furthermore, blood monocytes from rabbits resulted in a mean of 25.9 +/- 2.8% dead organisms. Schistosomula killing by mononuclear phagocytes obtained from resistant species (rats or rabbits) was dependent on the cell/parasite ratio. Significant schistosomula mortality resulted from culture supernatants of rat macrophages or rabbit monocytes. Killing by cells from both species was significantly reduced upon addition of L-arginine, while catalase reduced killing only by rat macrophages. We conclude that mononuclear phagocytes may play a key role in species-related innate resistance to schistosomiasis; their in vitro schistosomulicidal activity parallels the known in vivo susceptibility of the donor species. Killing is mediated by lysosomal enzymes (arginase) and by products of oxidative metabolism, the predominant mechanism depends on the specific animal species. PMID- 6848561 TI - Hepatic metabolism of 3 alpha-hydroxy-5 beta-etianic acid (3 alpha-hydroxy-5 beta androstan-17 beta-carboxylic acid) in the adult rat. AB - Normal human meconium has been shown to contain short-chain (C20-C22) bile acids and, recently, these compounds have been identified in sera of patients with cholestasis. This suggests that shortchain bile acids may be secreted in bile. We have examined this point by studying the hepatic metabolism and biliary secretion of one naturally occurring C20 bile acid, 3 alpha-hydroxy-5 beta-etianic acid (3 alpha-hydroxy-5 beta-androstan-17 beta-carboxylic acid). [3-3H]-3 alpha-hydroxy-5 beta-etianic acid was prepared and administered intravenously to rats prepared with an external biliary fistula. 85.5 +/- 1.2% of the administered dose was recovered in bile over 20 h with 71.5 +/- 1.3% appearing in the first hour. 11.9 +/- 1.6% of the dose was estimated to be distributed in body water and 0.6 +/- 0.2% was recovered as organic matter in urine. Total recovery of label was 98.0 +/- 2.6%. Administration of milligram quantities of 3 alpha-hydroxy-5 beta etianic acid produced an increase in bile flow (58.9 +/- 7.1% over basal levels) within 20 min after injection of the steroid. The radiolabeled material in bile was shown by thin-layer chromatography (TLC) to be a polar conjugate which, after beta-glucuronidase hydrolysis, cochromatographed with authentic free 3 alpha hydroxy-5 beta-etianic acid. After purification, and derivatization, the steroid moiety was proven by gas chromatography-mass spectrometry to be identical to 3 alpha-hydroxy-5 beta-etianic acid. Characterization of the conjugate by TLC and by 3 alpha-hydroxysteroid dehydrogenase assay, before and after beta glucuronidase hydrolysis, indicated that the steroid was secreted in bile as the 3-O-beta-glucuronide. It is concluded that 3 alpha-hydroxy-5 beta-etianic acid is cleared from the plasma, conjugated with glucuronic acid, and secreted into bile rapidly and in high concentration. The choleretic properties of this shortchain bile acid contrast with the cholestatic effects of lithocholic acid, its C24 analog. Both the form of conjugation of etianic acid and its effect on bile flow suggest that the shortened side chain of this steroid markedly alters its hepatic metabolism and physiology. PMID- 6848562 TI - Metabolic and cellular alterations underlying the exaggerated renal prostaglandin and thromboxane synthesis in ureter obstruction in rabbits. Inflammatory response involving fibroblasts and mononuclear cells. AB - Unilateral ureter obstruction in rabbits produced profound changes in endogenous and exogenous renal arachidonic acid metabolism. Isolated perfused hydronephrotic kidneys (removed after 3 or 10 d of ureter obstruction) responded to bradykinin stimulation with a markedly enhanced release of prostaglandin E2 and thromboxane A2. Reversal (3 or 10 d) of the ureter obstruction resulted in a reduction in the vasoactive peptide-induced release of prostaglandin E2 and thromboxane A2 from the perfused hydronephrotic kidney. However, postobstruction reversal of prostaglandin production by the agonist-stimulated perfused kidney was not reflected in the cortical microsomal cyclooxygenase activity, which is greatly enhanced during ureter obstruction and does not decrease after removal of the obstruction. Histological analysis of the renal cortex in rabbits with ureteral obstruction revealed a proliferation of fibroblast-like cells and the presence of mononuclear cells; removal of the obstruction did not result in a disappearance of cortical fibroblasts but did result in a decrease of monocytes. The critical involvement of mononuclear cells in the exaggerated arachidonate metabolism that occurs during hydronephrosis was exhibited by the demonstration that: (a) only the perfused hydronephrotic rabbit kidney responded to administration of endotoxin with a sustained release of prostaglandin E2 and thromboxane A2; (b) the contralateral rabbit kidney, which is devoid of mononuclear cells, did not respond to endotoxin; and (c) the hydronephrotic cat kidney, which exhibits a fibroblast proliferation with a low number of mononuclear cells, did not respond to endotoxin. Thus, proliferation of fibroblast-like cells and the presence of mononuclear cells appear to be involved in the exaggerated prostaglandin and thromboxane production underlying hydronephrosis. The increase in microsomal cyclooxygenase activity is apparently most closely correlated with the increased fibroblastic activation and cellularity, whereas mononuclear cells (possibly via monokines) seem to be critical for the markedly enhanced prostaglandin and thromboxane release induced by endotoxin and bradykinin. PMID- 6848564 TI - The American Academy of Allergy and Immunology thirty-ninth annual meeting. Program and abstracts of papers to be presented during scientific sessions March 19-23, 1983. PMID- 6848565 TI - Delayed hypersensitivity skin testing: response rates in a surgical population. AB - The results of this study indicate that skin test responses should be measured at both 24 and 48 hours post-injection and considered reactive or positive if induration of greater than or equal to 5 mm. is noted at either time. The practice of measuring responses at 48 hours only is neither appropriate nor recommended as it may produce a large percentage of false negative results. Erythema without induration was noted in a small percentage of patients. Future studies should evaluate the efficacy of erythema greater than or equal to 15 mm. in the absence of induration as a reactive response to mumps antigen. The validity of data interpretation must ultimately be based on correlations with morbidity and mortality. Streptokinase-streptodornase, mumps, and trichophyton were the three antigens with highest response rates, and this battery detected 94% of the reactive or positive responses to the five-antigen battery. PMID- 6848563 TI - Role for intrarenal mechanisms in the impaired salt excretion of experimental nephrotic syndrome. AB - A unilateral model of puromycin aminonucleoside (PAN)-induced albuminuria was produced in Munich-Wistar rats to examine the mechanisms responsible for renal salt retention. 2 wk after selective perfusion of left kidneys with PAN (n = 8 rats) or isotonic saline (control, n = 7 rats), increases in albumin excretion and decreases in sodium excretion were demonstrated in PAN-perfused but not in nonperfused kidneys of PAN-treated rats although systemic plasma protein concentration remained at control level. Total kidney glomerular filtration rate (GFR) and superficial single nephron (SN) GFR were also reduced selectively in PAN-perfused kidneys, on average by approximately 30%, due primarily to a marked decline in the glomerular capillary ultrafiltration coefficient (Kf), which was also confined to PAN-perfused kidneys. Values for absolute proximal reabsorption (APR) were also selectively depressed in PAN-perfused kidneys, in keeping with a similarly selective decline in peritubular capillary oncotic pressure measured in these kidneys, the latter also a consequence of the fall in Kf. In a separate group of seven PAN-treated rats, however, no differences were detected between PAN-perfused and nonperfused kidneys in the absolute amount of sodium reaching the early (0.77 +/- 0.09 neq/min vs. 0.74 +/- 0.08, P greater than 0.40) and late portions of superficial distal tubules (0.31 +/- 0.02) neq/min vs. 0.32 +/- 0.05, P greater than 0.50), despite the lesser filtered load of sodium in PAN-perfused kidneys. Suppressed sodium reabsorption in both proximal convoluted tubules and short loops of Henle of PAN-perfused kidneys contributed to this equalization of sodium delivery rates to the late distal tubule, as did comparable reabsorption along distal convolutions. In two additional groups of PAN-treated rats, infusion of saralasin (0.3 mg/kg per h, i.v.) led to substantial increases in total kidney GFR and SNGFR in PAN-perfused but not in nonperfused kidneys. Despite these increases in total and SNGFR, urinary sodium excretion by PAN-perfused kidneys remained at a level far below that for nonperfused kidneys, again indicating that the antinatriuresis characterizing the PAN-perfused kidney is due to alterations in sodium handling by the tubules rather than changes in GFR. These results therefore indicate (a) that reductions in Kf and depressed sodium reabsorption by proximal tubules and Henle's loop segments in this model are brought about by intrarenal rather than circulating or systemic factors, and (b) assuming that superficial nephrons are representative of the entire nephron population, renal salt retention in this model is due primarily to intrarenal factor(s) acting beyond the distal convolution. PMID- 6848566 TI - Selenium content of selected foods. PMID- 6848567 TI - Nutrient density of diets in the USDA Nationwide Food Consumption Survey, 1977 1978: I. Impact of socioeconomic status on dietary density. PMID- 6848568 TI - Nutrient density of diets in the USDA Nationwide Food Consumption Survey, 1977 1978: II. Adequacy of nutrient density consumption practices. PMID- 6848570 TI - Metabolic effects of liquid protein. AB - In the first experiment, the liquid protein product (LP) tested would not support growth in rats when fed at the 8% protein level in an otherwise nutritionally adequate diet. The product was composed of an imbalanced mixture of amino acids which could not be used optimally for protein synthesis and which resulted in appetite depression. Total plasma nonessential amino acids increased significantly in the rats receiving LP, while total plasma essential amino acids were not significantly different. In the second experiment, the LP reducing diet caused rapid weight loss. Adequate vitamin-mineral supplementation given to the rats receiving the LP diet apparently prevented heart and plasma electrolyte abnormalities. PMID- 6848571 TI - A computerized dietary order entry system. AB - The Dietary Order Entry System is a computerized system which instantaneously communicates orders/messages from the patient care units to the floor diet offices. The system also produces up-to-date management reports such as diet lists and diet census at pre-determined times and on demand. Dietary and nursing personnel believe it is an extremely beneficial system in terms of both increased accuracy of data and time savings in transmission of information. We believe that improved patient care will result from this improved method of diet ordering. PMID- 6848569 TI - Growth outcome of the very low-birth-weight infant at one year. AB - Growth patterns of weight, length, and OFC complete through 12 months corrected age were determined for 122 VLBW infants who weighed 1,500 gm. or less and were 35 weeks or less gestational age at birth. Significant differences in growth were apparent when infants were grouped according to sex and appropriateness of intrauterine growth. When the mean values of each group were compared, the female AGA infants demonstrated growth at higher percentiles (NCHS term infant norms) for all three growth parameters (weight, length, and OFC). AGA male, SGA male, and SGA female infants all grew similarly, at lower percentiles for weight and length, when compared with the same norms. Growth in OFC was closest to term infant norms in all subgroups of infants. (formula; see text) Appropriateness of weight for length was determined for each of the infants at one year corrected age. The majority of the babies, regardless of subgroup, achieved weights and lengths greater than the 5th percentile and with normal weights for lengths. At 12 months corrected age, 30% remained below the 5th percentile in weight, 21% below the 5th percentile in length, and 14% below the 5th percentile in OFC. Eighteen infants (15%) demonstrated a disproportionately low weight for length (less than the 5th percentile). PMID- 6848572 TI - Automated diet construction for clinical research. AB - Diets used in clinical research must satisfy the nutrient specifications of the individual protocol while simultaneously satisfying the subject's nutrient requirements and preferences. Experience has shown that the use of the computer in the interactive mode greatly reduces the time needed to calculate complex diets. Accuracy is increased as the tedious work of tabulating figures is performed by the computer. Dietary compliance is achieved as foods are of optimal quality and quantity. PMID- 6848573 TI - Coping with dementia: a pilot study. AB - Ten supporters of demented elderly dependents were studied in order to examine their coping behavior in the context of caring for their relatives at home. Coping skills were described with respect to programs, solutions, and cognitive aspects of motivation and stress tolerance. The observations made suggested the hypothesis that tolerance of debility in a demented relative is related not only to the number and type of problems in the dependent but also to the availability and quality of coping skills in the supporter. This hypothesis was explored through the elaboration of a skills training program (Supporter Endurance Training), which was designed and employed to improve and expand the coping skills of a supporter. Supported Endurance Training may prove to be a useful approach to the maintenance of the demented elderly person at home as a possible alternative to institutionalization. PMID- 6848574 TI - Pneumococcal bacteremia in adults: age-dependent differences in presentation and in outcome. AB - In order to evaluate the effect of age on the presentation of and response to acute bacterial infection, the hospital charts of 187 adult patients with community-acquired pneumococcal bacteremia admitted to Bellevue Hospital over a nine-and-a-half year period were reviewed. Compared with younger patients, older patients (aged 65 or older) more frequently had (1) a lower fever in response to the infection, (2) an unclear history of illness, (3) a delay in diagnosis and/or therapy, and (4) a higher risk of dying. On admission, their leukocyte counts and heart rates were similar to those in a group of younger patients, which was composed largely of alcoholic patients and those addicted to intravenous drugs. Response to therapy was also similar in surviving older patients. Lower temperature and an unclear history were features most commonly associated with both delayed diagnosis and higher mortality. When patients with a history of alcohol abuse and those dying shortly after admission (i.e., presenting in a moribund state) were eliminated from the analysis, many of these age-related differences in presentation and outcome became even more evident. PMID- 6848575 TI - Geriatric infectious diseases: an emerging problem. PMID- 6848576 TI - Biologic mechanisms in aging: summary of conference proceedings. PMID- 6848577 TI - Dexamethasone suppression test as a clinical aid in elderly depressed patients. PMID- 6848578 TI - Opportunities for and obstacles to treatments for dementias. PMID- 6848579 TI - Senile dementia of the Alzheimer's type: a costly problem. PMID- 6848580 TI - Red blood cell glucose-6-phosphate dehydrogenase activity in aged humans. AB - The enzyme glucose-6-phosphate dehydrogenase (G6PD) was assayed in the circulating erythrocytes of 38 20-to 30-year-old subjects and 29 80- to 90-year old subjects. The red blood cell G6PD activity of an aged-unbiased erythrocyte population in the young group was found to be significantly higher than in the older group (5.46 +/- 1.06) vs (4.31 +/- 0.99) (P less than 0.001), respectively (mean +/- SD). No significant difference was observed between the mean enzyme values of the male and female subjects in the two age groups. Since the mature red blood cell is devoid of regenerative capabilities, one may propose an explanation for this observation that implicates either an alteration in G6PD synthesis in the erythrocyte precursor cells in aged hosts, and/or the presence of an inhibitory factor that has the effect of decreasing the assayed activity for this enzyme. PMID- 6848581 TI - Determinants of life satisfaction: a note on a race-interaction hypothesis. AB - A "race interaction" hypothesis would suggest that factors important to the life satisfaction of whites may not be important to the life satisfaction of blacks. In this paper we suggest that dummy variable regression with interaction terms allows an assessment of differential effects by race. Using data from 438 white and 219 black elderly respondents, it is shown that most factors influencing life satisfaction of elderly people have similar effects among blacks and whites. Although greater numbers of impairments lead to lower life satisfaction for both races, the negative effect is considerably stronger among black than among white respondents. PMID- 6848582 TI - The life satisfaction index: a methodological and theoretical critique. AB - The Life Satisfaction Index A (LSIA) was examined by factor analytic techniques. The data do not support the original conceptual framework of Neugarten and her colleagues. Although the results indicate a strong need for caution, there is evidence of an alternative interpretation of the LSIA that has a degree of consistency across racial and gender categories. In addition, these findings raise implicit questions about prior research using the LSIA and demonstrate the importance of making comprehensive, critical evaluations of scales with complex theoretical origins. PMID- 6848583 TI - A comparison of various strength of association measures commonly used in gerontological research. AB - An increased usage of measures of strength of association or effect size (ES) has been noted in the gerontological literature. Potential confusion could be generated by the fact that different researchers have reported different measures of ES from study to study. This paper involves a comparison of six ES measures commonly used by gerontological researchers as these measures relate to one another in both the analysis of variance and multiple regression models. Three other issues involving ES measures are discussed: (1) the ES of a contrast; (2) orthogonal and nonorthogonal designs; (3) partial Ess. PMID- 6848584 TI - Differential effects of intermittent feeding and voluntary exercise on body weight and lifespan in adult rats. AB - Male wistar rats were housed in laboratory cages or activity-wheel cages at eight 10.5 or 18 months of age. Part of each cage group continued to be fed ad libitum, whereas the remaining animals were fed every other day. Compared with the ad libitum condition, intermittent feeding decreased body weight and increased lifespan at both ages in both caging conditions. Compared with the caged condition, voluntary exercise in activity wheels reduced body weight only in the 10.5-month-old group fed ad libitum but produced no effect on survival of either age group. The results suggest that intermittent feeding can enhance survival in mature rats even beyond ages at which body weight growth usually ceases, whereas voluntary exercise appears to have an early threshold beyond which increases in longevity are not observed. PMID- 6848585 TI - Age dynamic models of information-processing task latency: a theoretical note. PMID- 6848586 TI - Longitudinal age changes in vigilance over an eighteen year interval. AB - An 18-year longitudinal repeat of the Mackworth Clock vigilance experiment was conducted. Skin potential response latencies (SPRL) and reaction times were taken from 33 men during the vigilance task. The longitudinal change in this study reproduced the earlier cross-sectional relationship. The 51 to 69 year olds showed faster reaction times, the 70 to 88 year olds showed slower reaction times and, the 70 to 88 year olds detected significantly fewer targets than when 18 years younger. It was found that the greater the change noted in this study reflected previously determined cross-sectional SPRL effect. However, the SPRL outcome was equivocated by a time-of-measurement effect. It was concluded that at about age 70 years a noticeable reduction in vigilance performance occurs, and this is accompanied by a reduction in autonomic and central nervous system reactivity. PMID- 6848587 TI - Preparatory interval influences on reaction-time of elderly adults. AB - The influence of regularity of preparatory interval (PI) on simple reaction-time (RT) in elderly persons was studied in a sample of 25 women between 65 and 88 years of age. RTs to regular and variable PIs of 1, 3, 7, 9, and 13 seconds were compared using Steffy's embedded isotemporal blocks method. The advantage of PI regularity was lost at 13 sec, where performance was faster for irregular trials. The RT-PI functions were similar to those found by Botwinick and his associates who used Shakow's paradigm, even though overall RT was slower in this sample. The similarity of results across the two paradigms suggest that the point of RT function crossover is interval dependent and unrelated to response latency in elderly adults. PMID- 6848588 TI - Differences in Brown-Peterson recall as function of age and retention interval. AB - Retention of old (n = 27; M age = 72.4 years) and young (n = 46; age = 20.5 years) adults was compared in a Brown-Peterson task. Participants were instructed to recall letters after either reading digit pairs or summing each pair of digits and reporting the sum as old or even. Old adults recalled a substantially smaller proportion of letters correctly than did the young adults, and the magnitude of the difference between groups was related positively to the length of the retention interval. The main effect of age and the age by retention interval interaction were significant with both serial and free recall scoring criteria. In a multiple regression analysis with letter span, age and interpolated task regressed on Brown-Peterson recall, letter span, and interpolated task accounted for most of the variance in performance. PMID- 6848589 TI - Context utilization in young and old adults. AB - Two experiments examined adult age differences in the spontaneous use of context to study and retrieve information. Young and old adults were presented with a series of homographs (targets) that were paired with two context words which biased a specific meaning of the target. Recognition memory for targets was then tested by presenting them in the same context or removing or varying the context. In general, recognition decreased in both groups as the retrieval context became more dissimilar to the study context, suggesting that both young and old adults utilize context and that congruent study and retrieval information facilitates retrieval. However, it appeared that older primarily encoded general semantic information relating to the association between target and context, whereas younger adults encoded distinctive information about individual targets. Such encoding differences could account for observed age differences in false recognitions for lures in old contexts and correct recognitions for targets in new contexts. PMID- 6848590 TI - Task complexity and problem-solving performance in younger and older adults. AB - In problems resembling the Twenty Questions game, older and younger adults were asked to discover the square or squares the experimenter had in mind from an array of squares. Complexity was varied in three conditions in which problems had 6, 8, or 12 bits of information. Task demands were increased in a fourth condition by imposing a 60-sec time limit. Contrary to a hypothesis drawn from prior results, no evidence was found that older adults select more efficient strategies as task complexity or demands increase. Both age groups maintained the same strategies; the less efficient strategies selected by the older persons were reduced in effectiveness as task complexity increased. PMID- 6848591 TI - Task complexity, problem representation, and problem-solving performance by younger and older adults. AB - To test the hypothesis that increased task difficulty elicits more efficient problem-solving strategies from older adults, younger and older persons were given Twenty Questions tasks with either 64 or 10,000 possible solutions and with the possible solutions either physically present or not. Although younger adults were more efficient than older adults, there was no evidence that task difficulty affected problem solving for either age group. PMID- 6848592 TI - Toward a concept of homelessness among aged men. AB - New York City homeless aged men living on the Bowery and in single-room occupancy hotels were contrasted using Bogue's model of skid row social formation. Because of their commonality of being unattached urban males, it had been assumed that they would exhibit similar characteristics and modes of adaptation. It is shown that homelessness is not a uniform category, nor can these men always be easily distinguished from the general populace. Only sociability criteria differentiated these men as a group from their nonhomeless age peers suggesting the appropriateness of an interactive conceptual framework for homelessness. Regression analysis revealed that three of Bogue's four criteria differentiated between Bowery and single-room occupancy men, with the socioeconomic being the most powerful data set. There were also important differences in the way each group handled their social world. The ability of these men to adapt to other environments is discussed. PMID- 6848593 TI - The health consequences of relocation among the aged in the community. AB - A review of the literature of health consequences of relocation among the aged indicates that there may be substantial differences due to (a) the type of housing environment the individual enters and (b) the degree of voluntarism associated with the move. Recognizing the need for research on this subject among the aged moving within the community at large, this study utilizes longitudinal data from a national sample of older people to examine how moving affects health. Using several measures of health status, the findings indicate that moving adversely affects the health and daily functioning of older people in the community. In addition, the deleterious effects of moving on personal health exist whether the move is voluntary or involuntary. Based on the review of the literature and the findings of this study, it is suggested that the benign effects of older people's moving into senior housing facilities is due to the prevalence of physical and social supports in such settings. PMID- 6848594 TI - Urbanism and life satisfaction among the aged. AB - This study examines the impact of urbanism on the causal mechanisms by which life satisfaction is determined. Although the links between the type of community and life satisfaction have been the foci of many studies, the findings are by no means conclusive. Some have found that the rural elderly express greater satisfaction, others have not. Such a discrepancy may be due to (a) the neglect of other variables, (b) a lack of explicit causal specifications, and (c) the failure to distinguish main effects from interaction effects. In this study a causal model that incorporates urbanism as a polytomous variable and its interaction effects has been proposed. The model was evaluated by using four data sets with sample sizes ranging from 961 to 3,996. Urbanism was found to have indirect main effects as well as interaction effects on life satisfaction. PMID- 6848595 TI - Binding of C4 by IgM. PMID- 6848596 TI - Binding specificities of M-384 and M-870 myeloma proteins. PMID- 6848597 TI - Cell volume and osmotic properties of erythrocytes after complement lysis measured by flow cytometry. AB - The changes of volume distribution curves of erythrocytes during and after lysis by complement or nystatin or in hypotonic buffers were measured by flow cytometry. Biconcave and spheroidal ghosts were observed after complement lysis and spheroidal ghosts were seen only after nystatin and hypotonic lysis. The spheroidal ghosts derived from red cells lysed by complement or nystatin were permeable to sucrose; those from hypotonic lysis were sucrose-impermeable. Spheroidal ghosts after complement lysis remained permeable for sucrose whereas spheroidal ghosts after nystatin lysis resealed after removal of the drug by washing. Biconcave ghosts produced by complement lysis were almost impermeable to sucrose initially and therefore responded to osmotic changes, but they became sucrose-permeable upon prolonged incubation at 37 degrees C. The rate of sucrose equilibration increased as the stability of the biconcave shape diminished with increasing numbers of C5b-9 complexes. At 850 C5b-9 complexes/ghost, the biconcave shape and impermeability for sucrose were completely lost. The results support the hypothesis that complement C5b-9 complexes, in addition to the interaction with the lipid bilayer, may interact with the cytoskeleton of the erythrocyte membrane. PMID- 6848598 TI - Studies on the mechanism of bacterial resistance to complement-mediated killing. III. C5b-9 deposits stably on rough and type 7 S. pneumoniae without causing bacterial killing. AB - Gram-positive cocci resist direct killing by serum. The mechanism of resistance was studied by measuring consumption of terminal complement components from serum and uptake of purified, radiolabeled C7 and C9 on rough and encapsulated type 7 Streptococcus pneumoniae. Extensive consumption of C5, C7, and C9 occurred when 5 X 10(8) rough or type 7 pneumococci were incubated for 1 hr in 10% pooled normal human serum (PNHS). Approximately 10,000 molecules of C7 and C9 bound per organism during the same period of incubation. Twenty to 30% of C7 and C9 was released from rough organisms. Release was not due to autolysis since it occurred with glutaraldehyde-fixed organisms as well as in S. pneumoniae that were rendered resistant to autolysis by growth in ethanolamine. Between 10 and 30% of bound 125IC9 counts were eluted from the rough and type 7 organisms by incubation in 1 M NaCl or 0.01 M EDTA, which suggests that bound C5b-9 was not attached by predominantly ionic interactions. Elution of 44 to 74% of 125IC9 from live and glutaraldehyde-fixed organisms by 1% sodium deoxycholate suggests that hydrophobic bonds are involved in C5b-9 attachment. Trypsin cleaved 67 and 55% of 125IC9 counts from live rough and type 7 S. pneumoniae, respectively which indicates that the bound complex is not protected by the cell wall from proteolytic attack. Serum resistance in S. pneumoniae does not represent a failure to form C5b-9 on the bacterial cell wall but apparently reflects a failure of the bound complex to penetrate the thick peptidoglycan layer. PMID- 6848599 TI - Granulocyte activation by endotoxin. I. Correlation between adherence and other granulocyte functions, and role of endotoxin structure on biologic activity. AB - Reminiscent of high concentrations of formylated chemotactic peptides, another group of bacteria-derived products, the lipopolysaccharides and lipid A, stimulate PMN adherence to petri dishes. Attachment and spreading of PMN is accompanied by intense release of secondary granule constituents and marked stimulation of the hexose monophosphate shunt activity. Dose-response studies with endotoxin preparations of diverse activity show that induction of PMN adherence, enzyme release, and respiratory burst activation are highly correlated, suggesting that this functional triad is mediated by a common mechanism. Hyperadhesiveness inducing concentrations of the chemotactically inert endotoxin lead to marked inhibition of PMN migration without affecting the direction-finding mechanism of the cell toward formylated peptides and C-derived chemotaxin(s). Endotoxin preparations at a lower grade of aggregation are more active, and the polysaccharide chains of the molecule are not essential with respect to PMN stimulation. Under our experimental conditions, endotoxin-induced stimulation of PMN is not inhibited by indomethacin, suggesting independence of cyclooxygenase-derived products. This type of PMN activation may play an important role in endotoxin-mediated tissue damage in vivo. Furthermore, hyperadhesion-induced inhibition of PMN migration to inflammatory sites during endotoxemia might hamper host resistance. PMID- 6848600 TI - C3 cleavage products stimulate release of prostaglandins by human mononuclear phagocytes in vitro. AB - Human monocytes cultured for up to 48 hr in serum-free, chemically defined culture media released low levels of prostaglandin. C3b, C3bi, and C3c stimulated an indomethacin-sensitive, dose-responsive increase in the amount of monocyte prostaglandin released by 18 hr after treatment. Native C3 and C3d, which do not bind to monocyte receptors, failed to stimulate increased prostaglandin release. Lymphocytes, treated and untreated, produced 10(-2) to 10(-3) as much prostaglandin as the monocytes. These data support the concept that monocytes are a significant source of leukocyte prostaglandin. They also introduce an important new biologic function for the C3 fragments C3b, C3bi, and C3c. PMID- 6848601 TI - Maternal-infant transfer of influenza-specific immunity in the mouse. AB - The effects of maternal-infant transfer of influenza-specific antibody on influenza infection in the infant mouse were studied by following mortality, hemagglutination inhibition antibody, virus shedding from the nose and lung, and pathology of the upper and lower airway. By cross-fostering infants, influenza specific antibody was shown to be acquired mainly by breast-feeding. Mice acquiring specific antibody survived lethal influenza infection (p less than 0.001) and had no evidence of influenza pneumonitis. There was variable suppression of nasal virus shedding and tracheal desquamation. Infected infants that initially acquired high levels of serum antibody also showed no evidence for serum antibody 10 wk later. Infant mice surviving initial influenza infection were lethally rechallenged 10 wk later. Rechallenged mice had a higher survival rate when compared to control mice (p less than 0.001) in spite of the absence of anti-influenza antibody and the presence of high lung virus titers in both groups 1 day after rechallenge. Rechallenged mice showed evidence for both significantly lower nasal virus titers (p less than 0.001) and a secondary serum antibody response with associated decline in lung virus titer. These results suggest maternal influenza-specific antibody a) is transferred to the infant mouse; b) is transferred mainly by breast-feeding; c) is life saving and lowers lung virus titers in the infant; and d) suppresses the infant's serum antibody production after challenge without affecting local immunity or the ability to mount a secondary antibody response. PMID- 6848602 TI - Characterization of the lysis of fresh human solid tumors by autologous lymphocytes activated in vitro with phytohemagglutinin. AB - Human peripheral blood lymphocytes (PBL), obtained from patients with a variety of malignancies, when incubated in vitro with phytohemagglutinin (PHA), lysed fresh autologous tumors during a short-term 51Cr-release assay. These PHA activated killer (PAK) cells produced maximum lysis of tumor cells by 4 to 8 hr of co-cultivation. PHA incubation induced the generation of cells lytic for autologous and allogeneic tumors but not autologous or allogeneic PBL. Cold target inhibition studies demonstrated that autologous and allogeneic tumors of various histologic types all shared the determinants recognized by PAK cells. Some adherent cells were necessary for generation of these PAK, but higher numbers were suppressive. Augmentation of tumor cell lysis was seen when adherent cells were partially removed before PHA activation. The PAK effector cell was OKT3+, OKT8+. The precursor cell of the PAK was separated from natural killer (NK) cells on Percoll gradients and was generated from thoracic duct lymphocytes, a population devoid of NK cells. Furthermore, the phenotype of the majority of the precursor cells was OKT3+, OKM1-. Activation by PHA for 2 days was found to be an efficient and convenient method for generating lymphoid cells lytic for fresh autologous human tumor. The biologic and possible therapeutic role of these cells is currently being investigated. PMID- 6848603 TI - 5-halo-6-phenyl pyrimidinones: new molecules with cancer therapeutic potential and interferon-inducing capacity are strong inducers of murine natural killer cells. AB - We tested the effect of three different interferon-(IFN) inducing pyrimidinone molecules with cancer therapeutic potential on natural killer (NK) cells. Peritoneal exudate (PE) cells were selected for these studies because their NK cell cytotoxicity is very low. Augmentation of PE-NK cell cytotoxicity was observed in eight different strains of mice after i.p. administration of 250 mg/kg of each of the pyrimidinones. NK cell induction occurred as early as 6 hr after pyrimidinone administration and peaked 2 to 4 days after treatment; at that time, cytotoxicity was as high as 60 to 90%. Augmentation of NK cell activity was independent of IFN serum levels induced by pyrimidinones and murine H-2 haplotype, and did not exhibit any histocompatibility or species-specific restriction, because it was expressed to syngeneic, allogeneic, and xenogeneic tumor target cells. Characterization studies demonstrated that the cytolytic cells were not macrophages, T cells, or B cells and exhibited NK cell characteristics. NK cell tumor-binding and tumor-killing studies demonstrated that NK cell augmentation was accomplished via both activation and recruitment of NK cells. If one considers NK cells as an important part of tumor immunity (as indicated by murine studies), pyrimidinone molecules may be effective anticancer agents. PMID- 6848605 TI - Physicochemical properties and stability of anthralin in model systems and human skin. AB - The physico-chemical properties and the stability of anthralin, a potent antipsoriatic agent, has been investigated in model systems by optical absorption and fluorescence spectroscopy and by gas chromatography coupled to mass spectrometry. Systematic studies were carried out on anthralin and its oxidation products (1,8-dihydroxyanthraquinone and 1,8-1',8'-tetrahydroxydianthron). Anthralin and 1,8-dihydroxyanthraquinone are shown to readily bind to human serum albumin and not to DNA. Anthralin bound to albumin readily oxidizes, yielding the 1,8-dihydroxyanthraquinone which is fairly stable. These results are correlated with those obtained with intact whole human epidermis and suction blister fluid showing that, in the former case, anthralin binds to protein as suggested by absorption and fluorescence spectroscopies. Gas chromatography-mass spectrometry analysis makes it easy to detect anthralin and 1,8-dihydroxyanthraquinone in suction blister fluid doped with anthralin but not in suction blister obtained after topical application on normal human skin. PMID- 6848604 TI - Enhancement of tumor metastasis and suppression of natural killer cell activity by beta-estradiol treatment. AB - Treatment of mice with 17 beta-estradiol leads to a selective inhibition of natural killer (NK) cell activity as measured by in vitro cytotoxicity against YAC-1 lymphoma and UV-2237 fibrosarcoma target cells. Activation of NK cells by polyinosinic-polycytidylic acid (poly I.C) and Corynebacterium parvum also was impaired in beta-estradiol-treated mice, whereas activation of tumoricidal macrophages was uncompromised. The beta-estradiol-induced suppression of NK cell activity was associated with a higher incidence of experimental and spontaneous pulmonary metastasis of the syngeneic UV-2237 fibrosarcoma and K-1735 and B16 melanoma tumors. Injection of poly I.C or C. parvum before i.v. tumor challenge markedly inhibited the development of lung tumor colonies in normal recipients, but it was less effective in beta-estradiol-treated mice. Adoptive transfer of normal spleen cells enhanced the NK cell activity and increased the resistance of beta-estradiol-treated mice against hematogenous tumor metastasis. Nude mice treated with beta-estradiol also exhibited a low level of NK cell activity and an enhanced susceptibility to metastasis of allogeneic tumor cells. The potential use of this in vivo model for studies of metastasis of human malignant neoplasms is discussed. PMID- 6848606 TI - Glycoprotein composition of psoriatic epidermis in relation to growth control. AB - The composition of isolated [3H]-fucose- and [3H]-glucosamine-labeled glycopeptides from psoriatic lesion, psoriatic uninvolved, regenerating-normal, and normal epidermis (subdivided into basal and differentiated cells) has been analyzed according to molecular weight and affinity to concanavalin A. Basal cells from normal skin have a higher sialic acid content of their "biantennary" fucose-labeled glycoproteins than differentiated cells. Fucose-labeled glycoproteins from regenerating normal skin show an increased molecular weight of their carbohydrate moieties which precedes entrance of the cell into S-phase. In psoriatic uninvolved skin, glycoproteins with more highly branched carbohydrate structures are present in reduced quantity. The previously reported increase in percentage of high-molecular-weight fucose-labeled glycopeptides for psoriatic lesions appears to be specific in that its composition cannot be explained in terms of an increased growth fraction. PMID- 6848607 TI - Basal lamina changes during tissue interactions in hair follicles--an in vitro study of normal dermal papillae and vitamin A-induced glandular morphogenesis. AB - Skin pieces from 14-day fetal mice were cultivated for 1-10 days prior to fixation and sectioning. Subsequently, sections were studied by light and transmission electron microscopy. In a standard medium the lateral hair follicle walls showed progressive maturation of the basal lamina, while the hair matrix, at the time of a known tissue interaction, showed the formation of gaps in the basal lamina, with heterotypic cell contacts through the gaps. In a vitamin-A enriched medium similar changes occurred, not only at the hair matrix, but also at lateral follicle walls, at the sites of, and prior to, budding and glandular morphogenesis. This study shows that the induction of hair matrix by dermal papilla may perhaps be added to the list of normal tissue interactions in which heterotypic cell contacts occur. It also suggests that vitamin-A induced glandular morphogenesis might come about through a mechanism resembling a normal tissue interaction. PMID- 6848608 TI - Involvement of sensory nerve endings in cold and heat urticaria. AB - The involvement of sensory nerve endings in acquired cold and heat urticaria was studied in 8 patients. After repeated topical application of capsaicin, the skin was tested for whealing with cold and heat stimuli. Capsaicin pretreatment prevented the urticarial responses for 4-7 days. Since capsaicin is known to induce selective impairment of the chemosensitive nerve endings, the results suggest that these nerve fibers may play an important role in acquired cold and heat urticaria. The possible mechanisms are discussed. PMID- 6848609 TI - Epidermolysis bullosa dystrophica recessive fibroblasts altered behavior within a collagen matrix. AB - Normal human fibroblasts incorporated into a collagen lattice reduce the size of that lattice over a period of time. Lattice size reduction or lattice contraction is directly related to initial cell number. When equal numbers of fibroblasts derived from patients with epidermolysis bullosa dystrophica recessive, (EBdr), are used, there is delayed lattice contraction. The EBdr fibroblasts have an altered cellular shape, when compared to normal cells, in that the EBdr cells fail to flatten out and elongate, but do attach to collagen fibers like normal fibroblasts. EBdr fibroblasts maintain a rounded shape with numerous filopodia radiating from the cell periphery and such filopodia are attached to the collagen fibers of the lattice. In monolayer tissue culture on glass surfaces, EBdr fibroblasts are three times more likely to grow over neighboring fibroblasts. EBdr cell filopodia structures are attached to the cell surfaces lying beneath them, which demonstrates another condition of altered anchorage attachment of EBdr fibroblasts. PMID- 6848610 TI - Circadian rhythm. PMID- 6848611 TI - Complement (C5)-derived chemotactic activity in serum from patients with pancreatitis. AB - Samples of serum and plasma obtained from eight patients with acute pancreatitis were examined for the presence of complement-derived chemotactic activity for human PMN. Significant chemotactic activity was found in acute phase serum and plasma samples from five patients. The presence of chemotactic activity was associated with reduced levels of CH50 as well as degradation products of C5 (detected by a new method, i.e., radioimmunoelectrophoresis). The chemotactic activity was heat-stable (56 degrees C for 30 min), inhibitable by treatment with antibodies to human C5, and exhibited an apparent molecular weight of 16,000 (determined by chromatography on Sephadex G-75). These properties are identical with those of chemotactic C5-derived peptides (C5a and/or C5a des Arg). Recently, C5-derived peptides have been implicated as being mediators of acute lung injury (i.e., "shock lung") in some clinical situations. It is intriguing to speculate, therefore, that circulating C5-derived chemotactic peptides may play a role in the pathogenesis of the lung injury observed in some patients during the course of acute pancreatitis. PMID- 6848612 TI - Conjugation patterns of endogenous plasma catecholamines in human and rat. A new specific method for analysis of glucuronide-conjugated catecholamines. AB - Plasma free, sulfoconjugated, and glucuronoconjugated CAs were determined radioenzymatically before and after hydrolysis. CA sulfates and glucuronides were hydrolyzed by sulfatase and Ketodase, respectively. Total CA conjugates were deconjugated by acid lyophilization. On the basis of data obtained from systematical studies on these methods, the conjugation patterns of endogenous plasma CA in human and rat have been qualitatively and quantitatively identified. The results show that (1) in human plasma, sulfation is the sole conjugation mode for DA, NE, and E; (2) in rat plasma, sulfation also occurs in DA, NE, and E but the quantities of the sulfates are small, whereas glucuronidation predominates in DA and occurs exclusively in DA but not in NE and E; (3) in both species, conjugation is preferential for DA rather than NE and E. In this study, a new specific method for analysis of glucuronoconjugated CA has been developed. PMID- 6848613 TI - Platelet storage at 22 degrees C for transfusion: interrelationship of platelet density and size, medium pH, and viability after in vivo infusion. AB - Previous studies have suggested that there are two characteristic storage lesions that develop during storage of PC at 22 degrees C with constant agitation in containers constructed from PVC plastic. One occurs only in PC with high platelet count in which there is a fall in pH due to hypoxic conditions within the container. This storage lesion is characterized by an increase in apparent mean volume as determined by Coulter Counter and a change in platelet shape from disc to sphere. The other is observed in PC with low platelet counts; in these, a major pH fall does not occur. Under these conditions, there is a decrease in the apparent mean volume and an increase in the dispersion of the size distribution determined by Coulter Counter. The cause of this storage lesion is uncertain. However, it appears to be more pronounced with some forms of agitation than with others. In the current studies, we have attempted to clarify further the nature of these two storage lesions. We now show that during fall in pH of PC to levels below 6.8, the increase in apparent platelet volume corresponds well with a decrease in platelet density and refractive index, both consistent with cellular swelling due to influx of extracellular fluid. We were previously unable to determine whether this lesion was due to pH fall per se or to the associated hypoxic conditions. In the current study, platelets stored under a nitrogen atmosphere for as long as 7 days show no swelling or shape change when the pH is kept above 6.8, suggesting that the damage is due to pH fall per se. In previous studies of the second storage lesion, which occurs without pH fall, we have found that the increase of the dispersion of the Coulter volume distribution correlates with loss of in vivo viability measured as percent recovery after labelling with chromium-51. In this study, we show that the increase in dispersion results from the presence of a population of abnormally light platelets. Since this light population labels normally with chromium-51, we hypothesize that it contains the cells which fail to circulate after in vivo infusion. In three infusions of thrombocytopenic patients, we support this hypothesis by showing that the abnormal light population does not circulate in vivo and that the dispersion of the apparent volume distribution of the circulating cells is normal. PMID- 6848614 TI - Effect of aspirin on metabolism of acetaminophen and benzidine by renal inner medulla prostaglandin hydroperoxidase. AB - The effect of in vivo and in vitro aspirin treatment on renal inner medullary prostaglandin hydroperoxidase-catalyzed metabolism of acetaminophen and benzidine was examined. Metabolism was assessed by the binding of [3H]acetaminophen and [14C]benzidine to TCA-precipitable material. Microsomes were prepared from control or aspirin-treated rabbits. Aspirin, whether administered in vivo (15 mg/kg i.v.) or added in vitro (2 mM), had no effect on peroxide-initiated metabolism. By contrast, arachidonic acid-initiated metabolism was completely prevented by both in vivo and in vitro aspirin. Salicylate did not inhibit either arachidonic acid- or peroxide-dependent metabolism. The antioxidant glutathione (1 mM) completely inhibited both peroxide- and arachidonic acid-initiated metabolism. Aspirin treatment completely inhibited metabolism of arachidonic acid by medullary microsomes. Thus aspirin does not inhibit the hydroperoxidase component of prostaglandin endoperoxide synthetase, and co-oxidation of acetaminophen and benzidine may proceed in the presence of aspirin. Co-oxidation may be involved in the genesis of the nephrotoxicity of mixed analgesic abuse. PMID- 6848615 TI - Evidence for lipid peroxidation by paraquat in the perfused rat lung. AB - In order to evaluate the effect of paraquat on oxidative radical reactions in the lung, we studied MDA production and chemiluminescence (spontaneous and tBuOOH induced) in the isolated rat lung. After 2 hr of perfusion with 3.0 mM paraquat, MDA content in lung homogenates was 16 +/- 7 nmol/gm dry weight higher than in control lungs (mean +/- S.E., n = 7, p less than 0.05 by paired test); during 30 min of perfusion, malondialdehyde efflux was 33 +/- 15 nmol/gm dry weight higher than in control perfusates (n = 6, p less than 0.05). Spontaneous chemiluminescence was not augmented by 2 hr of perfusion with concentrations of paraquat ranging from 0.75 to 6.0 mM. On the other hand, tBuOOH-induced chemiluminescence was 17% +/- 3 higher immediately after the addition of hydroperoxide and reached a 16% +/- 6 higher plateau for the paraquat-perfused lungs than for control lungs (n = 10, p less than 0.05). Spectral analysis of the light emitted during induced chemiluminescence demonstrated peak intensity between 630 and 730 nm for both control and paraquat-treated lungs. Increased MDA production and increased induced chemiluminescence indicate that perfusion with paraquat enhances lipid peroxidation in the isolated rat lung. PMID- 6848616 TI - Presidential addresses. Academic medical center decompensation: a cardiologist's viewpoint. PMID- 6848617 TI - Decreased glycolipid antigen expression in lymphoma cell variants escaping from anti-glycolipid serotherapy. AB - Mice challenged with L5178Y lymphoma cells expression high levels of the glycolipid asialo GM2 (gangliotriosylceramide) were protected from tumor growth by passive administration of a monoclonal antibody specific for the glycolipid; in a few antibody-treated mice, ascites cells eventually proliferated which contained a reduced chemical quantity of the glycolipid antigen (3). We now report that the cells emerging from antibody-treated mice had abnormal marker chromosomes identical to those in the cells used for challenge, indicating that the emergent cells were progeny of the challenge inoculum. Flow cytometric analysis revealed that asialo GM2 was undetectable on the surface of greater than 95% of the tumor cells from antibody-treated mice, whereas surface display of H-2 determinants was unchanged from that of the cells used for challenge. Tumor cells arising in challenged but untreated mice consisted of a mixture of asialo GM2 positive and -negative cells, indicating the presence of selective pressures in these mice as well. None of the cells taken from tumor bearing mice differed significantly from the challenge cells in their susceptibility to natural killer cell attack, suggesting that resistance to natural killer cell lysis was not responsible for the proliferation of these cells in vivo. When cells derived from an antibody-treated mouse were used to challenge mice, serotherapy with anti asialo GM2 had no effect on mouse survival. These results suggest that serotherapy may complement a host anti-tumor response, from which only asialo GM2 deficient cells can escape. PMID- 6848619 TI - Possible role for C-reactive protein in the human natural killer cell response. AB - Functional NK activity can be removed from human PBL and from phagocyte- and T cell-depleted LGL preparations by treatment with antisera specific for C-reactive protein (CRP) in the presence of complement (C). Pretreatment of NK effector cells with high concentrations of anti-CRP in the absence of C also depletes functional activity. These results indicate that CRP or an antigenically similar molecule is present on a population of NK effector cells. Fluorescent antibody studies in which biotin-avidin amplification was used confirm the presence of surface CRP (S-CRP) on a small percentage of nonphagocytic peripheral blood mononuclear cells. S-CRP readily caps off, which suggest that removal by capping obviates killing by this cell population. This indicates that S-CRP or a molecule that co-caps with S-CRP may be required for successful effector-target cell interaction. The addition of exogenous CRP or CRP-CPS complexes, however, does not alter NK responses. A subpopulation of lymphoid cells responsible for functional NK activity therefore appears to bear surface CRP. PMID- 6848618 TI - Differentiation stages of human natural killer cells in lymphoid tissues from fetal to adult life. AB - Virtually all human granular lymphocytes expressed the HNK-1 differentiation antigen when examined in lymphoid compartments from adults, neonates, and fetuses. The HNK-1+ cells were distinguishable into three subsets having distinct antigenic phenotypes: HNK+T3-M1-, HNK+T3+M1-, and HNK+T3-M1+. Thus, greater than 70% of the HNK-1+ cells from 13-17 wk fetuses (less than 0.2% of nucleated cells) lacked T cell antigens (e.g., T3, T8, T4, and T6) and the M1 myeloid antigen. Morphologically, the HNK+T3-M1- cells consisted of three different types: small granular lymphocytes (less than 10% of HNK-1+ cells), agranular small lymphocytes with a narrow rim of cytoplasm (70-80%), and agranular giant cells (greater than 15 micrometers) with considerable neutrophilic cytoplasm (15%). The purified fetal HNK-1+ cells exhibited a low level of cytotoxicity against K562 target cells. On the other hand, almost all of HNK-1+ cells in neonatal tissues as well as adult bone marrow, lymph node, and thymus, exhibited the HNK+T3+M1- phenotype, contained sparse cytoplasmic granules, and had an intermediate level of NK functional activity. Only adult blood and spleen contained a majority of mature HNK-1+ cells. These cells had an HNK+T3-M1- phenotype, abundant cytoplasmic granules, and maximum NK function. We propose that human NK cells may generate from a separate cell lineage and that they alter their phenotype, morphology, and functional capability during differentiation. PMID- 6848620 TI - Influence of culturing on the survival of major histocompatibility complex compatible and -incompatible thyroid grafts in rats. AB - Culturing Fischer thyroid fragments promotes their survival in major histocompatibility complex (MHC) -incompatible ACI rats but not in MHC- compatible Lewis animals. PMID- 6848621 TI - Lyt-2 glycoprotein is synthesized as a single molecular species. AB - We investigated the possibility that the Lyt-2 molecules made by uncloned mouse T lymphocytes would show variable primary structures like those of immunoglobulins. Newly synthesized Lyt-2/3 complexes were found to include only two major components, both discrete glycoproteins with apparent molecular weights of 31,000 (31 K) and 35,000 (35 K). When products of Lyt-2.1 and Lyt-2.2 thymocytes were compared by two-dimensional nonequilibrium pH gradient electrophoresis and sodium dodecyl sulfate polyacrylamide gel electrophoresis, the isoelectric points of the 35 K molecules were different; thus, the 35 K component was likely to be encoded by the Lyt-2 locus itself. However, the 35 K molecules made by any one genotype were homogeneous in charge as well as in size. The homogeneity was obscured rapidly by post-translational modification. Most strikingly, within 30 min of initial synthesis, these processing events generated the conspicuous array of microheterogeneous products that form the "38 K" component of cell-surface Lyt 2/3. PMID- 6848623 TI - Adolescent health care in family practice. AB - This paper describes the 12,414 health care problems of 3,657 adolescent patients visiting 12 Colorado family practices (4 rural, 3 urban, and 5 residency practices) over a one-year period. All 12 practices utilize the Family Medicine Information System, a selectively automated system for storing and analyzing medical, family, and billing data. Age-sex distribution, visiting patterns, and morbidity are described for patients between 13 and 20 years of age. The 25 most frequent adolescent diagnoses account for 74 percent of visits, and 134 diagnoses account for 95 percent of pediatric visits. Significant sex differences and differences among early, middle, and late adolescent age groups are described. All diagnostic categories are explored in detail, and comparisons are made between urban, rural, and residency practices. PMID- 6848622 TI - Metastatic potential severely altered by changes in tumor cell adhesiveness and cell-surface sialylation. AB - A plastic adherent variant line (ESb-M) of a highly invasive and metastatic murine T cell lymphoma (ESb) was found to have lost its metastatic potential while still being tumorigenic in normal syngeneic hosts. The variant retained most of its ESb-derived antigenic and biochemical characteristics but differed at binding sites for certain lectins with specificity for terminal N acetylgalactosamine residues. Whereas such sites were masked by sialic acid on metastatic ESb cells, they became unmasked on the adherent variant line. Metastatic revertants of ESb-M cells did not express the respective lectin receptor sites because these were again masked by sialic acid. It is suggested that the masking of specific lectin receptors sites on the tumor cell surface is of crucial importance for metastatis. If freely exposed, these sites may change adherence characteristics of the cells possibly not only in vitro (to plastic) but also in vivo. PMID- 6848624 TI - Task and cost analysis of integrated clinical pharmacy services in private family practice centers. AB - Costs and activities required for the provision of integrated clinical pharmacy services were examined in private family medicine centers in rural South Carolina. Work sampling and financial data for a one-year period were merged, yielding an average clinical service cost of $1.65 per center patient visit. Pharmacists in family medicine environments spent almost twice the amount of time in clinical activities as has been shown in studies of their colleagues in chain store environments, and one half as much time in prescription-dispensing activities. A greater proportion of the former's workday was also spent in communication with patients. Costs for prescriptions dispensed in these rural centers combined with the average national net profit per prescription yielded a total cost that was within a few cents of the national average. Hence, costs can be controlled to the extent that maintenance of a competitive prescription pricing policy is possible. Integration of clinical pharmacy services in family practice centers appears to be an economically viable practice model. PMID- 6848625 TI - Emergency department chart auditing in a family practice residency program. AB - A prospective audit of process on 1,200 consecutive patients seen in the emergency department by family practice residents was performed at the Family Practice Residency Program in Gainesville, Florida. The overall quality of care delivered conformed to the standards of "good medical care" as judged by the author in 85.6 percent of cases. Resident errors were detected in the remaining 14.4 percent of cases, and occurred most frequently among physicians in the earlier years of training (P less than .005). Ultimate patient management was changed by the audit in only 1 percent of cases but potentially had an important impact on the care of these patients. Errors of inadequate documentation were common among residents irrespective of their level of training. An ongoing audit of emergency department charts with regular feedback on medical process and recording appears to be useful both as an educational tool and as a method of improving emergency care. PMID- 6848626 TI - Chloride:phosphate ratio with hypercalcemia secondary to thiazide administration. AB - The chloride:phosphate ratio is of only limited value in aiding the clinician in the differential diagnosis of hypercalcemia. The use of thiazide diuretics may cause hypercalcemia with a chloride:phosphate ratio said to be consistent with a diagnosis of primary hyperparathyroidism. Parathormone assay remains the "gold standard" for definitive diagnosis of hyperparathyroidism. PMID- 6848627 TI - Family function and depression. PMID- 6848628 TI - Procompetition legislation: the moral dilemmas of untested assumptions. PMID- 6848629 TI - Practice management training in family practice residencies. AB - Recent surveys have suggested that practice management instruction in family practice residency programs is inadequate. The majority of third-year family practice residents graduating in 1980 felt inadequately trained in nearly all aspects of practice management. Thirty-five percent of these residents noted that their residency programs offered no regularly scheduled time for practice management training. Results of four family practice residency graduate follow-up surveys showed that no fewer than 25 percent and, often, 60 to 80 percent of graduates felt underprepared in most areas of practice management. PMID- 6848630 TI - Motivating lifestyle change. AB - The family physician has enormous opportunities to facilitate healthy lifestyle changes among his patients. It is believed that an unhealthy lifestyle may account for 50 percent of the mortality in the United States. The family physician sees large numbers of well or asymptomatic at-risk patients in the course of practice. In addition, he or she sees other family members and has opportunities to interact with the family unit as a whole. The family, in turn, has powerful molding influences on the individual's health beliefs and actions. If the physician can realize the impact his attitudes and actions have on his families' health, beliefs, and behavior, the multiplication of effects can be considerable. PMID- 6848631 TI - Self-assessment in family practice: childhood cervical lymphadenitis. PMID- 6848632 TI - Medicine in the Mexican Sierra Madre. PMID- 6848634 TI - Evaluation of depression. PMID- 6848633 TI - Etiology of sudden infant death syndrome. PMID- 6848636 TI - Self-monitoring of blood pressure: a pilot study. AB - The purpose of this study was to evaluate the applicability of the sensory detection method (SDM) in patient self-monitoring of blood pressure. The SDM involves the use of a blood pressure cuff alone and represents an easy, simple blood pressure recording method. In a sample of 116 ambulatory patients visiting the Eastern Carolina Family Practice Center, only 59 percent of the patients were able to measure their systolic blood pressure, and 54 percent were able to measure diastolic blood pressure. Of those patients who could sense their blood pressure, no significant mean systolic difference between SDM and indirect method (IDM) was detected. Mean diastolic measurements were significantly different. The correlations between IDM and SDM systolic blood pressures and diastolic blood pressures suggested a moderate relationship. Further analysis suggested that education was positively related to ability to accurately measure blood pressure using SDM. No relationship was detected between obesity, age, sex, or ethnicity and ability to measure blood pressure. PMID- 6848635 TI - Obesity and weight control. PMID- 6848637 TI - Health risks and effects of prenatal exposure to diethylstilbestrol. AB - Patients exposed prenatally to diethylstilbestrol have been shown to have a number of significant health risks that may be considered in the evaluation of this population. Neoplastic lesions of the cervix and vagina have been observed in a few patients. Increased prevalence of squamous intraepithelial neoplasms has been reported by several large clinical centers, and a recent observation of ovarian neoplasms has been reported. The significance of these observations remains to be substantiated. Anatomic deformities of the cervix, vagina, uterus, and fallopian tubes have been associated with increased pregnancy loss or infertility. The epithelial abnormalities of adenosis and cervical erosion essentially hallmark prenatal exposure to diethylstilbestrol. These changes are in themselves not malignant or premalignant and rarely warrant therapy (Figure 1). PMID- 6848638 TI - Indochinese refugee health assessment and treatment. AB - Many Southeast Asian refugees have resettled in the United States. This report reviews data from 426 refugees who underwent comprehensive examination and treatment at the Mayo Clinic. Health problems identified were primarily selected contagious illnesses and stress syndromes with functional complaints. Counseling was necessary in 17 percent of adults for psychosomatic problems or psychiatric disorders. When family-planning issues were applicable and addressed, 80 percent of women chose some method of contraception. The prevalence rate of intestinal parasites was 82 percent, and pathogens necessitated persistent treatment and follow-up. Tuberculosis skin-sensitivity testing was positive in 54 percent; the risk of active disease warrants prophylactic treatment until age 35 years. Hepatitis antigen was positive in 13 percent; precautions should be taken for potentially exposed professionals. Hematologic genetic disorders were very common and accounted for most of the 25 percent incidence of microcytosis. Physicians should become aware of cultural attitudes and treatment acceptance among Indochinese patients and should carefully investigate for infectious diseases. PMID- 6848639 TI - Conversion disorder following termination of pregnancy. AB - A variety of psychologic disorders may present as physical complaints without organic basis. As characterized by Sydenham over 300 years ago, such disorders "mimic all the physical disease to which man is heir." The case here presents the evolution of a conversion disorder (urinary retention) in response to a decision to terminate pregnancy. The predominant disturbance in a conversion disorder is an involuntary loss or alteration in somatic function that is temporally related with an environmental stressor. Conversion, as a defense mechanism, provides primary gain by keeping the conflict from the patient's awareness and secondary gains by generating environmental support and avoidance of undesired activities. Awareness of a patient's current life events, past responses to stress, and support systems is essential in order to recognize and manage this array of physical complaints of functional origin. PMID- 6848640 TI - A multi-institutional study of depression in family practice. AB - Depression among outpatients of three descriptively and geographically dissimilar family practice residency programs was studied. The Beck Depression Inventory, the Popoff Index of Depression, and the Multiscore Depression Inventory (MDI) were compared. Reliabilities of all three instruments were high, as were correlations among the instruments. The only significant differences among the three populations were on the social introversion and sad mood subscales of the MDI. Regression analyses were then performed to compute equivalent scores on the Beck Depression Inventory short form from the MDI and Popoff instruments. This allowed approximate conversion of scores to the four levels of severity of depression described by Beck and Beck. This study provides the first extensive normative data for family practice on these measures, thus providing family physicians with a comparison group appropriate for a family practice rather than a psychiatric population. PMID- 6848641 TI - Intraethnic characteristics and the patient-physician interaction: "cultural blind spot syndrome". AB - Ethnic variation in the beliefs, expectations, and illness behavior of patients has dominated cultural studies of medical care. A widespread supposition, referred to as "cultural blind spot syndrome," assumes that similarities in the ethnic backgrounds of patient and physician invariably enhance clinical communication, thereby resulting in improved outcomes. The author's experience as a Western-trained Chinese physician attending to a wide spectrum of Chinese patients challenged this simplistic assumption. The cultural identity of the Western-trained physician and intraethnic variation among people of a common cultural heritage emerged as two key considerations from this analysis of patient physician interaction. Two cases representing extremes in patient-physician interaction were chosen and analyzed with respect to each of six essential elements of patient-physician interaction. Common ethnicity does not ensure a positive patient-physician interaction. A good match among intraethnic descriptors of patient and physician enhances communication and thereby may improve outcome. However, the match between the patient's explanatory model and expectations of the physician and the physician's actual persona and practice is equally important in determining outcome. PMID- 6848642 TI - Processing of emotional properties of stimuli by depressed and normal subjects. AB - This study investigated whether depressed subjects differ from controls in their ability to appreciate emotional aspects of verbal material, or in their use of emotional qualities of stimuli in learning and remembering. When asked to rate the degree of emotionality of words, depressed subjects did so essentially identically with controls. However, despite apparently similar evaluatory processing, the depressed failed to remember as well as controls. Depressed subjects were more dependent than controls on both high emotionality and high stimulus concreteness for recognition memory, but were less benefited by these properties in free recall. While providing no evidence for deficits specific to emotionality, our results suggest that relatively shallow processing of semantic aspects of stimuli may be an important factor in the memory impairment of depression. PMID- 6848643 TI - Depression, problem recognition, and professional consultation. AB - Data are from a 1979 community sample (n = 1000) of adults in Los Angeles County. The analysis examines how depressive symptoms, measured with the Center for Epidemiologic Studies Depression (CES-D) scale, and a variety of other factors influence problem recognition and use of mental health services. Of those people with a high level of depressive symptoms, nearly one third view themselves as having a nondepressive problem, while another third view themselves as having no personal problem. After controlling for demographic and other factors, depressive symptoms emerge as the most important element enhancing problem recognition; being female and having more education also enhance recognition of depressive problems and enable people to distinguish depressive from other problems. Among those with a high level of depressive symptoms, only one third had consulted a mental health service in the prior year. Factors promoting use of mental health services among those who acknowledge a personal problem include depressive symptoms, prior use of mental health services, use of services by friends and relatives, and discussion with friends and relatives about counseling; no significant effects emerge for sex, age, education, income, or insurance coverage. Data from the untreated show that a self-reliant attitude and some practical barriers prevent people with depressive symptoms from obtaining professional help. PMID- 6848644 TI - Cognitive deficit in schizophrenia. Subvocal mediation, rigidity, and complexity parameters. AB - This study investigated the effects of problem complexity on cognitive performance of 96 schizophrenic and nonpsychiatric inpatients. Subvocal activity (mediation) and three rigidity parameters were examined in relation to performance. The major findings were: a) with increased problem complexity, schizophrenics demonstrated relatively greater difficulty in performance than controls; b) subvocal activity was greater in schizophrenics than controls and was positively related to both the complexity of the problem and the inability to respond correctly; c) motor-cognitive rigidity was higher in schizophrenics and positively correlated with cognitive errors, as well as with the subvocal activity--this was not so in controls, demonstrating the differential role of the rigidity dimension in the two populations. PMID- 6848645 TI - The nonmelancholic depressive syndromes. An alternate approach to classification. PMID- 6848646 TI - Auditory hallucinations and schizophrenia. AB - Forty-five patients with auditory hallucinations were studied. Sixty per cent proved to be excellent hypnotic subjects with multiple personalities. These latter patients received 11 different diagnoses by clinicians, predominantly those related to schizophrenia or an affective illness. Because patients with multiple personalities frequently have hallucinations, delusions, paranoid ideas and bizarre behaviors, they may be misdiagnosed as some form of schizophrenia. PMID- 6848647 TI - Integration of schematic faces and other complex objects in schizophrenia. AB - Twenty-one acute schizophrenic patients and 26 neurotic patients sorted each of six sets of 15 objects into three groups. A set consisted either of schematic faces, nonsense objects, or histoforms, each composed of five independently varying features. For the faces and nonsense objects these features could be integrated into a whole, whereas for the histoforms they could not. The distribution of four of the features was such that a set could be divided into three groups. The fifth feature either remained constant and had no effect on sorting performance or it varied randomly and acted as a distractor. Performance was assessed from the variance in common between the grouping actually present in a set and the grouping produced by the subject. For the control patients faces were sorted much better than histoforms if no distractor was present. However, performance with faces was massively impaired by a distractor while performance with histoforms was not. For the schizophrenic patients faces were not sorted better than histoforms and the effect of distraction was similar for every type of material. The performance of the controls suggest that the gestalt quality of the faces dominated over their constituent details. This enabled more features to be handled at once, thus achieving better sorting with faces than histoforms. However, it also made it more difficult for subjects to ignore a distracting component in the faces. The performance of the schizophrenics suggests that for them the integrated gestalt of the face was not dominant over its components. PMID- 6848648 TI - Testing the escape hypotheses. Alcohol helps users to forget their feelings. AB - Several hypotheses suggest that alcohol is often used to "escape"--to forget unpleasant feelings resulting from personal problems or social stresses. To test alcohol's effects on memory for feelings, 1.1 ml/kg of alcohol (A) or placebo (P) was given in two sessions, 48 hours apart, to 32 subjects divided into four equal drug groups (P-P, P-A, A-P, A-A). The subjects filled out the Profile on Mood States (POMS) after drug ingestion in session 1 while experiencing and learning these emotions. Their memories were tested when they tried to replicate these POMS ratings after drug ingestion in session 2. Alcohol given before memory testing decreased accuracy on each of the six POMS scales, especially Fatigue. However, alcohol did not impair memory for previously learned verbal and pictorial stimuli, and it produced no measurable changes in current feelings. These findings indicate that the impairment of memory for feelings may be a newly discovered specific pharmacological effect of alcohol. PMID- 6848649 TI - Process analysis of two dimensions of the negotiated approach in relation to satisfaction in the initial interview. AB - This study examined relationships between patient and clinician satisfaction ratings and the use of a negotiated approach to the initial psychiatric interview. Two dimensions of the negotiated approach were distinguished- mutuality in making treatment decisions and mutuality in communicating explanatory information. Forty-four patients sampled from a larger pool of 158 patients in a walk-in clinic of a large, urban general hospital participated in the study. At the conclusion of clinical interviews, three kinds of satisfaction ratings were obtained--those of patients' satisfaction, clinicians' perceptions of patients' satisfaction, and clinicians' own satisfaction. Transcripts of patients' audiotaped interviews with these clinicians were independently rated on each of the 10 negotiated approach process measures, comprising five measures of each process dimension. Patient satisfaction was found to be associated with explanatory processes--being given clear and complete explanations concerning the recommended treatment plan, its rationale, and its link to the patient's complaints, and with decision-making processes-stating a request before the start of the disposition phase and having the clinician pursue consensus with the patient on the clinician's recommended treatment plan. None of the negotiation variables was significantly correlated with clinician satisfaction. Moreover, clinicians appeared to be inaccurate in their perception of the sources of patient satisfaction. The study's findings suggest that two sources of strain between the clinician and the patient that may adversely affect the outcomes of their initial interview are the divergence in their value systems concerning initial interview processes and the clinician's misreading of the patient's perspective. PMID- 6848650 TI - Urinary 3-methoxy-4-hydroxyphenethylene glycol in the prediction of pain and depression relief with doxepin: preliminary findings. AB - A group of patients with both depression and chronic pain were treated with doxepin for 4 weeks. Elevated (above median) initial levels of urinary 3-methoxy 4-hydroxyphenethylene glycol (MHPG, a metabolite of central nervous system [CNS] norepinephrine metabolism) were found to be significantly related to final pain relief, but not to improvement in depression. Anxiety, as measured on the Zung Anxiety Scale, was an important covariable, as high anxiety levels were significantly associated with both higher MHPG levels and with pain relief. Possible biochemical and psychophysiological mechanisms associated with the modulation of pain are discussed. PMID- 6848651 TI - Response to dexamethasone suppression and total night sleep deprivation in an affectively disordered Klinefelter patient. AB - A 50-year-old Klinefelter patient acutely developed a psychotic depression which rapidly responded to treatment with amitriptyline. This patient exhibited an early escape from dexamethasone suppression and became hypomanic the morning after total night sleep deprivation. The findings suggest that the use of biological tests to study affective syndromes occurring in Klinefelter patients might yield clues regarding the existence of pathophysiological common denominators of primary and Klinefelter-associated affective disorders. PMID- 6848652 TI - Multiple personality as a borderline state. AB - A case of multiple personality is presented. The primary personality met DSM-III criteria for borderline personality disorder, and displayed several "lower level" borderline defenses as well. The secondary personalities showed other borderline characteristics. Seen as a whole, the patient manifested a more complete spectrum of borderline features than did any of the personalities viewed individually. It is postulated that some patients with multiple personality may be a subset of borderlines, in whom the splitting of self and object representations is so severe that the disparate representations are partitioned and manifested in different "personalities." The importance of preoedipal, as opposed to oedipal, psychopathology suggests that multiple personality may be more properly considered a borderline condition than an hysterical condition. PMID- 6848653 TI - Effects of in vivo hypoxia on acetylcholine synthesis by rat brain synaptosomes. AB - Synaptosomes from normoxic and hypoxic rats were incubated aerobically in the presence and absence of veratridine. In the absence of veratridine, no significant difference was observed between the two types of preparation regarding either ATP/ADP ratio or 14CO2 or [14C]acetylcholine synthesis from D-[U 14C]glucose. However, in the presence of veratridine, significant reductions in the output of 14CO2 and [14C]acetylcholine by synaptosomes from hypoxic rats were apparent. It was concluded that irreversible metabolic lesions occur at the synapse as a result of hypoxia, which are apparent only when the metabolism of the preparation is accelerated to a level comparable with the maximal rate occurring in vivo. The presence of such lesions is further evidenced by the significant reductions in ATP/ADP ratio, 14CO2 output, and [14C]acetylcholine synthesis that occur in synaptosomes from hypoxic rats made anoxic in vitro and permitted to recover. Such decreases are not seen when synaptosomes from normoxic rats are similarly treated. PMID- 6848654 TI - The occurrence of gamma-aminobutyrylcholine in mammalian brain-fact or artefact? AB - gamma-Aminobutyrylcholine (GABAch) has been reported to exist in mammalian brain tissue, but not, as yet, given a specific physiological role in the CNS. In order to investigate further its occurrence and function in the CNS, two new methods have been developed for its isolation and determination at the picomole level. Its isolation has been achieved by ammonium Reineckate precipitation or by cation exchange followed by HPLC determination of the dansyl and o-phthaldialdehyde derivatives. Using these methods, no free endogenous GABAch (less than 80 pmol/g) was found in rat, guinea pig, cat, pig marmoset, or human brain tissue. No evidence was obtained, either in vitro or in vivo, for the incorporation of [14C]gamma-aminobutyric acid into GABACh. GABACh was hydrolysed at a low rate (maximum of 45 nmol/h/g of brain tissue) after incubation with rat, guinea pig, or cat brain minces and homogenates. These results fail to confirm the data of other investigators, and the possible reasons for this are discussed. PMID- 6848655 TI - Studies on the cell-free biosynthesis of CNS membrane proteins. AB - The biosynthesis of CNS membrane proteins was studied in cell-free systems containing membrane-bound polysomes (rough endoplasmic reticulum; RER) or free polysomes from rat forebrain. In previous studies of CNS membrane proteins using two-dimensional gel electrophoretic analysis, five proteins (mol. wt. -pI: 75K, 5.4, 68K 5.6, 61K 5.1, 58K 5.1, and 36K 5.6) were found in cell membrane fractions including preparations enriched in RER, smooth endoplasmic reticulum, and plasma membranes. One of these proteins, 68K 5.6, was also present in cytosol and comigrated with a microtubule-associated protein. In our present study, cell free systems containing RER were found to synthesize the 75K, 5.4, 61K 5.1, and 58K 5.1 proteins. A protein, 34K 5.65, similar (but not identical) to the 36K 5.6 protein was also synthesized. After cell-free synthesis, 75K 5.4 and 58K 5.1 proteins could be purified by concanavalin A affinity chromatography. Of the five common membrane proteins previously identified, only 68K 5.6 protein was synthesized by the free polysome population. The free polysomes were also found to synthesize cyclic AMP binding proteins at 48K and 54K, known from previous studies to be present in both cytosol and plasma membrane fractions in mammalian brain tissue. In conclusion, RER synthesized proteins found exclusively in CNS membrane fractions, whereas free polysomes synthesized those proteins found in both soluble and membrane compartments. PMID- 6848656 TI - Kinetics of transport and phosphorylation of 2-fluoro-2-deoxy-D-glucose in rat brain. AB - The kinetics of transport across the blood-brain barrier and metabolism in brain (hemisphere) of [14C]2-fluoro-2-deoxy-D-glucose (FDG) were compared to that of [3H]2-deoxy-D-glucose (DG) and D-glucose in the pentobarbital-anesthetized adult rat. Saturation kinetics of transport were measured with the brain uptake index (BUI) method. The BUI for FDG was 54.3 +/- 5.6. Nonlinear regression analysis gave a Km of 6.9 +/- 1.2 mM and a Vmax of 1.70 +/- 0.32 mumol/min/g. The Ki for glucose inhibition of FDG transport was 10.7+/-44 mM. The kinetic constants of influx (k1) and efflux (k2) for FDG were calculated from the Km2, Vmax, and glucose concentrations of the hemisphere and plasma (2.3 +/- 0.2 mumol/g and 9.9 +/- 0.4 mM, respectively). The transport coefficient (k1 FDG/k1 glucose)was 1.67 +/- 0.07 and the phosphorylation constant was 0.55 +/- 0.16. The predicted lumped constant for FDG was 0.89, whereas the measured hexose utilization index for FDG was 0.85 +/- 0.16. CONCLUSION: The value for the lumped constant can be predicted on the basis of the known kinetic constants of FDG and glucose transport and metabolism, as well as brain and plasma glucose levels. Knowledge of the lumped constant is crucial in interpreting data obtained from 18FDG analysis of regional glucose utilization in human brain in pathological states. We propose that the lumped constant will rise to a maximum equal to the transport coefficient for FDG under conditions of transport limitation (hypoglycemia) or elevated glycolysis (ischemia, seizures), and will fall to a minimum equal to the phosphorylation coefficient during phosphorylation limitation (extreme hyperglycemia). PMID- 6848657 TI - The protein activator specific for the enzymic hydrolysis of GM2 ganglioside in normal human brain and brains of three types of GM2 gangliosidosis. AB - In order to understand the etiology of Type AB GM2 gangliosidosis, we have purified and characterized the activator protein (GM2 activator) specific for the enzymic hydrolysis of GM ganglioside from normal human brain. The purified activator from human brain moved as one major protein band in various electrophoretic systems. We have also prepared the antiserum against this activator. The levels and the nature of GM2 activator and beta-hexosaminidase A were examined in the brains of five cases of GM2 gangliosidosis-one Type B, two O, and two Type AB. We found that the levels of GM2 activator in both Type B and Type O cases were markedly elevated, and that the two Type AB cases were the results of different causes. One case had a defective beta-hexosaminidase A and an elevated level of GM2 activator. Although this defective beta-hexosaminidase A could hydrolyze synthetic substrates, it was inactive in the cleavage of natural glycosphingolipids in the presence of the GM2 activator. It could, however, hydrolyze asialo-GM2 and GbOse4Cer in the presence of sodium taurodeoxycholate. The other case had normal beta-hexosaminidase A, but had a very low level of GM2 activator when analyzed by in vitro assay, suggesting the deficiency of this activator. By immunoelectrophoresis, this case was found to be completely devoid of the protein that cross-reacts with the antiserum against the GM2 activator. PMID- 6848658 TI - Acetylation of synaptosomal protein: inhibition by veratridine. AB - Incubation of synaptosomes with [3H]acetate results in rapid labeling of protein. Labeling is decreased in the presence of veratridine, and the effect of veratridine is blocked by tetrodotoxin. Most of the radioactivity can be removed by base or acid hydrolysis, and is probably incorporated as acetate; it is this fraction that is affected by the veratridine. The data suggest that veratridine stimulates deacetylation is involved in membrane function. PMID- 6848659 TI - Neuraminidase in calf retinal outer segment membranes. AB - An enzyme catalyzing the hydrolysis of sialic acid (N-acetylneuraminic acid: NeuNAc)-containing glycoconjugates has been found in bovine retinal rod outer segment (ROS) membranes. The enzymatic activity is optimal at pH 4.0 and is stimulated by 0.15% Triton X-100. Total activity was determined by the release of NeuNac from endogenous and exogenous substrates (GD1a). The ROS enzyme preferentially hydrolyses the ROS gangliosides, possibly because they are more accessible than the glycoproteins as substrates for the neuraminidase. Release of NeuNAc from gangliosides leads to important changes in the ganglioside patterns; whereas the amounts of GM1 increased throughout the incubation, the levels of polysialogangliosides GT1b and GD3 diminished owing to their rapid hydrolysis. The finding that gangliosides are hydrolysed more extensively than glycoproteins suggests that endogenous ROS gangliosides may be the principal source of metabolically available sialic acid in ROS. It was also observed that the activity of ROS neuraminidase is not affected by illumination of the membranes. PMID- 6848660 TI - Distinct cellular localization of membrane-bound and soluble forms of catechol-O methyltransferase in brain. AB - The cellular localization of the two forms of catechol-O-methyltransferase (COMT) was investigated by measuring their activities in rat striatum following unilateral stereotaxic injection of kainic acid, which causes degeneration of striatal neurons followed by proliferation of astroglial cells. Membrane-bound COMT activity was decreased in the lesioned striatum, while soluble COMT activity was increased. There was a statistically significant correlation between the ratio of lesioned to control activity for membrane-bond COMT and the neuronal marker enzyme glutamate decarboxylase. Similarly the increase in soluble COMT activity paralleled that of the astroglial marker enzyme, glutamine synthetase. These results indicate that the low-Km membrane-bound catechol-O methyltransferase may be localized predominantly in neurons, whereas the high-Km soluble enzyme is found in glial cells. PMID- 6848661 TI - MAO COMT, and GABA-T activities in primary astroglial cultures. AB - Cultures from cerebral hemispheres of newborn rats contain the enzymes monoamine oxidase (MAO), catechol-O-methyltransferase (COMT), and gamma-aminobutyric acid alpha-ketoglutarate transaminase (GABA-T). The COMT activity was higher in the cultures than in adult rat cerebral hemispheres. The MAO activity was comparable in the cultures and in the rat cerebral hemispheres. The activities of both these enzymes increased with age in the cultures and in the rat brain hemispheres. In the culture the activities were further potentiated by removal of fetal calf serum and addition of 0.1 mM dibutyryl-cyclic AMP (dB-cAMP). GABA-T activity was, however, lower in the cultures than in the adult rat brain hemispheres. The activity increased in brain during postnatal maturation. No changes in the enzyme activity were observed in the cultures, either during growth or after removal of fetal calf serum and addition of dB-cAMP. PMID- 6848662 TI - Effect of chronic hypernatremic dehydration and rapid rehydration on brain carbohydrate, energy, and amino acid metabolism in weanling mice. AB - This is a study of the effects of chronic hypernatremic dehydration and rehydration on carbohydrate, energy, and amino acid metabolism in the brains of weanling mice. Chronic hypernatremic dehydration induced by 4 days of water deprivation and salt loading was associated with severe weight loss (no other observed clinical effects), increased brain Na+ levels, and a decreased brain water content. Changes in the concentrations of brain glucose, glycolytic and citric acid cycle metabolic intermediates, and phosphocreatine were compatible with reduced cerebral metabolic rate. In adaptation to chronic hypernatremia, there was a significant increase in the content of the measured brain amino acids. Rapid rehydration over a 4-h period with 2.5% dextrose in water returned plasma Na+ levels and brain Na+ and water contents to normal. After rehydration, metabolites were altered in a manner consistent with increased fluxes through the glycolytic pathway and citric acid cycle; the brain glycogen content almost tripled. Brain taurine and glutamine levels were not lowered by rehydration, and the total content of the measured amino acids in brain was still significantly higher than in controls. We speculate that these metabolic perturbations may relate to the development of cerebral edema and seizures or coma following rapid rehydration of humans with chronic hypernatremic dehydration. PMID- 6848663 TI - Reversibility of propranolol-induced changes in the biosynthesis of monoacylglycerol, diacylglycerol, triacylglycerol, and phospholipids in the retina. AB - The biosynthesis and metabolism of phospholipids and neutral glycerides were studied in the bovine retina. Radioactive glycerol was used as a precursor. Phentolamine and d- and dl-propranolol were found to produce similar effects on lipid metabolism in the retina. Marked stimulation of phosphatidylinositol (PhI) synthesis and maximal inhibition of phosphatidylcholine (PhC), diacylglycerol (DG), and triacylglycerol (TG) formation were observed within 5 min after exposure to 0.5 mM dl-propranolol. Pulse-chase experiments showed a high turnover rate in DG and a reversibility of the propranolol-induced changes produced during the synthesis of PhC, TG, DG, monoacylglycerol (MG), and phosphatidylserine. All reversals of the drug-induced biosynthetic profiles approached control values 60 min after incubation in drug-free medium. However, complete reversal was not achieved in any of the cases under these conditions. Propranolol appeared to inhibit both the formation of DG from phosphatidic acid and the further metabolism of DG, probably to MG. Phosphatidylethanolamine biosynthesis showed some recovery from this inhibition. Synthesis of PhI was greatly stimulated by preincubation with propranolol and was further enhanced by reincubation in the presence of propranolol. However, this effect was not reversed by reincubation without the drug. The active de novo biosynthesis of retinal phospholipids and glycerides is a very dynamic pathway that may be redirected by amphiphilic drugs. In addition, the partial reversal of modifications induced in the flux of [2 3H]glycerol through the lipids can occur during short-term reincubations of retinas in drug-free medium. PMID- 6848665 TI - Adenosine metabolism in a rat hippocampal slice preparation: incorporation into S adenosylhomocysteine. AB - The incorporation of [14C]adenosine into various metabolites was studied in a hippocampal slice preparation in order to assess the extent of adenosine metabolism via synthesis of S-adenosylhomocysteine, a potent inhibitor of transmethylation reactions. Highest incorporation of 14C occurred into nucleotides, with only a few percent being recovered in inosine + hypoxanthine, S adenosylhomocysteine, and the free adenosine pool. Labeling of S adenosylhomocysteine did not significantly increase with higher concentrations of added adenosine despite greater accumulation of free [14C]adenosine in the tissue. Addition of L-homocysteine significantly increased the labelling of S adenosylhomocysteine. The results indicate that S-adenosylhomocysteine synthesis is a minor pathway of adenosine metabolism in brain tissue under steady-state conditions. Further, changes in adenosine concentration, without a concomitant change in L-homocysteine availability, are unlikely to lead to a significant accumulation of S-adenosylhomocysteine. S-Adenosylhomocysteine is therefore not likely to play a significant role in mediating the biological effects of adenosine in the CNS via inhibition of transmethylations. PMID- 6848664 TI - Effects of CDPcholine and CDPethanolamine on the alterations in rat brain lipid metabolism induced by global ischemia. AB - The fast turnover pool of rat brain lipids was labeled by intracerebral injection of [3H]acetate. Cerebral ischemia for a duration of 5 min after decapitation caused a 2.2-fold increase in radioactivity in the free fatty acids and loss of more than 20% of the radioactivity from choline and ethanolamine glycerophospholipids. An intracerebral injection of 0.6 mumol each of cytidine diphosphocholine (CDPcholine) and cytidine diphosphoethanolamine (CDPethanolamine) prevented the loss of radioactivity from the glycerophospholipids and decreased the amount of radioactivity in the free fatty acids by 59% as compared with control values and 82% as compared with ischemia values. By GLC assays of the mass of the free fatty acids there was a threefold increase of free fatty acids in ischemic brains. Pretreatment of ischemic brains with CDPcholine and CDPethanolamine reduced the levels of unesterified fatty acids to 60% of the control values. Thus, a prior injection of cytidine nucleotides prevented the release of free fatty acids observed in ischemic brains. PMID- 6848666 TI - Regional distribution of catecholamines in nucleus accumbens of the rabbit. AB - The nucleus accumbens is an important telencephalic region, which is the target limbic and mesolimbic pathways. Because of an ongoing physiological study of the effects of dopamine, we wanted to determine regional differences of dopamine and norepinephrine concentrations in the nucleus. As determined by radioenzymatic assays, dopamine levels were not significantly different in the anterior posterior dimension, averaging approximately 187 ng dopamine/mg protein. Substantial amounts of norepinephrine were found throughout the nucleus, but the levels were significantly higher in the caudal portions of the nucleus, being approximately 4.5 times higher than in the anterior portions. PMID- 6848667 TI - 4-Aminobutyraldehyde as a substance convertible in vivo to GABA. AB - [2,3-3H]4-Aminobutyraldehyde ([3H]ABAL) was injected subcutaneously into mice, which were sacrificed at various intervals following injection. [3H] gamma Aminobutyric acid ([3H]GABA) synthesized in vivo from [3H]ABAL was extracted from the brains, separated, and quantitated. The results showed that in the brain, injected [3HABAL was rapidly transformed into [3H]GABA. [3H]ABAL may penetrate the blood--brain barrier into the central nervous system and then be oxidized to [3H]GABA. PMID- 6848668 TI - On the phospholipid metabolism of glial cell primary cultures. II. Metabolism of 1-alkyl-glycerophosphoethanolamine during time course. AB - Primary cultures were prepared from newborn rat brain. After 16-18 days, they consisted mainly of mature and immature astrocytes and oligodendrocytes, as judged by immunohistochemistry. To study the metabolism of ethanolamine glycerophospholipids, the cells were incubated with 1-[1-3H] alkyl-sn-glycero-3 phosphoethanolamine (1-alkyl-GPE), for 1-20 h. Five main products were formed: 1 alkyl-2-acyl-GPE; 1-alkyl-2-acyl-sn-glycero-3-phosphocholine (1-alkyl-2-acyl GPC); 1-alkenyl-2-acyl-GPE (ethanolamine plasmalogen); 1-alkenyl-2-acyl-GPC (choline plasmalogen); and 1-alkyl-glycerol. Acylation of the substrate was the main reaction during the first 3 h of incubation, whereas desaturation to plasmalogen reached a maximum after 12 h. Greater amounts of radioactivity were observed in the phosphatidylcholine fraction after longer incubation times. Only small amounts of choline plasmalogen were observed. The phosphatidylethanolamine fraction consisted of 26.5% diacyl, 27.5% alkyl-acyl-, and 46.0% alkenyl-acyl compounds, whereas the corresponding data for the phosphatidylcholine fraction were 78.5, 16.4, and 5.1%, respectively, after 20 h of incubation. Hydrolysis of the substrate to 1-alkyl-glycerol was a minor reaction. PMID- 6848670 TI - Localization of choline acetyltransferase in laminae of the rat olfactory tubercle. AB - We report the distribution of choline acetyltransferase (ChAT) activity in the laminae of the rat olfactory tubercle. Within its posterior medical portion, the tubercle contains three parallel histological laminae that can be separated by cutting tangential sections from frozen tissue. ChAT was measured in homogenates of consecutive sections (16 micrometers) cut parallel to these laminae. The distribution of ChAT activity, as a function of tubercle depth, showed a broad peak centered at 500 micrometers from the ventral surface of the brain. Enzyme activity measured at this depth (85 pmol acetylcholine formed/microgram protein/h) was 2 1/2 times greater than that measured in the outermost, plexiform, layer. Stereotaxic injections of kainic acid (1 microgram in 1 microliter) made directly into the tubercle were used to eliminate intrinsic neurons. Three days after injection, histological examination revealed the almost total absence of neuronal cell bodies and the proliferation of glial cells. The greatest decreases in ChAT activity (50%) were seen at depths of 300-600 micrometers whereas no loss of activity occurred in the plexiform layer. PMID- 6848669 TI - Glycine uptake by cultured human Y79 retinoblastoma cells: effect of changes in phospholipid fatty acid unsaturation. AB - Glycine uptake was investigated in cultured Y79 retinoblastoma cells containing different degrees of phospholipid fatty acid unsaturation. The modifications were produced by growing the retinoblastoma cells in medium supplemented with various unsaturated fatty acids. Glycine was taken up by the retinoblastoma cells through two kinetically distinguishable process. The high-affinity system is totally dependent upon extracellular Na+ and partially dependent upon Ca2+. Of the glycine taken up by retinoblastoma cells, 85-90% remains as free intracellular glycine and less than 30% is incorporated into cellular protein. When the cells are grown in a medium containing 10% fetal bovine serum as the only source of fatty acids, the phospholipids contained 23% polyunsaturated fatty acids. Under these conditions the high-affinity system has a K'm of 34.2 +/- 3.7 micrometers and a V'max of 91.2 +/- 16.2 pmol min-1 mg protein -1. The low-affinity system has a K'm of 2.7 +/- 0.4 mM and a V'max of 4.1 +/- 0.5 nmol min-1 mg protein-1. When the polyunsaturated fatty acid content of the phospholipids was increased by supplementing the medium with linolenic or docosahexaenoic acids (n-3 polyunsaturates) or linoleic or arachidonic acids (n-6 polyunsaturates), the K'm and V'max of the high-affinity glycine uptake system were increased three- to fourfold. By contrast, supplementing the medium with oleic acid, and n-9 monounsaturate, did not significantly alter the K'm or V'max for glycine uptake. The results with this model system suggest that one of the effects of the high polyunsaturated fatty acid content normally present in neural cell membranes may be a modulation of the high-affinity transport system so that it functions more efficiently in regulating glycine uptake. PMID- 6848671 TI - Increased acetylcholine synthesis and release following presynaptic activity in a sympathetic ganglion. AB - The acetylcholine (ACh) content of sympathetic ganglia increases above its normal level following a period of preganglionic nerve stimulation. In the present experiments, this extra ACh that accumulates following activity was labeled radioactively from [3H]choline and its specific activity was compared with that of ACh subsequently released during preganglionic nerve stimulation. The specific activity released ACh was similar to that of the total tissue ACh, suggesting that the extra ACh mixes fully with endogenous stores. The present experiments also show that transmitter release during neuronal stimulation is necessary for the poststimulation increase in transmitter store, However, the increase was not evident when transmitter release was induced by K+. It is concluded that both transmitter release and impulse invasion of the nerve terminals are necessary for the adaptive phenomenon to manifest itself. The role of choline delivery and choline acetyltransferase activity in generating the poststimulation increase in transmitter store was tested. When choline transport activity measured as choline analogue (homocholine) accumulation increased. ACh synthesis was increased and when transport activity was not increased, neither was ACh synthesis. There was no poststimulation increase in measured choline acetyltransferase activity. PMID- 6848672 TI - Stem cell studies of human malignant brain tumors. Part 1: Development of the stem cell assay and its potential. AB - A stem cell assay for human malignant gliomas has been developed. Cells obtained from tumor biopsies grew into colonies composed of malignant glial cells, as documented by histochemical, immunohistochemical, and immunobiological techniques. Studies suggest that the disaggregated cells are representative of the cells within the solid tumor. Clonogenic cells were obtained from 48 tumors and analyzed for their in vitro sensitivity to graded doses of 1,3-bis(2 chloroethyl)-1-nitrosourea (BCNU). The in vitro anti-tumor activity of BCNU at clinically achievable doses was compared to clinical response to the agent based on changes in computerized tomographic scan, radionuclide brain scan, and neurological examinations. Twenty-two patients received nitrosoureas before or after tumor specimen analysis, and were eligible for in vitro-in situ correlations. Clinical tumor sensitivity to nitrosoureas was predicted by culture results in 42% of all evaluable patients, and clinical resistance was predicted in 100%. The capability of the assay can be appreciated best for the 13 patients not treated with BCNU prior to culture; the in vitro prediction of clinical sensitivity and resistance was 71% and 100%, respectively. Preliminary findings show that clinical tumor resistance to BCNU may result from "intrinsic" cell resistance in some patients and from inadequate delivery of drug to tumor cells in other cases. The potential utility of this method to study the reason(s) for tumor cell resistance to drugs, to screen new chemotherapeutic agents, to individualize patient treatment, and to investigate tumor biology is discussed. PMID- 6848673 TI - Improved treatment of a brain-tumor model. Part 1: Advantages of single- over multiple-dose BCNU schedules. AB - Clonogenic cell and animal survival studies were used to determine the most effective BCNU therapy schedule in the 9L rat brain-tumor model. Survival of tumor cells following a single LD10 dose of BCNU (13.3 mg/kg intraperitoneally) was compared to cell survival after one to four daily 0.5 X LD10 doses. The posttreatment kinetics of surviving clonogenic cells were investigated at various times after BCNU was given in single doses of 0.25 to 1 X LD10 and in two daily doses of 0.5 X LD10. The cell kill was greater, time to reinitiation of cell growth was later, posttreatment rate of clonogenic cell proliferation was slower, and the interval to total repopulation of the clonogenic cell pool was longer with a single LD10 dose as compared to the multiple-dose schedules. Animal survival studies confirmed that a single LD10 dose of BCNU was at least as effective as a cumulative level of up to 1 1/2 times that amount when treatment was administered in smaller doses, regardless of the fractionation schedule. Clinical experience with patients harboring malignant brain tumors has shown that a single BCNU dose of 185 to 200 mg/sq m is tolerated well. Results of these animal experiments suggest that this therapy should have anti-tumor activity at least equivalent to the more commonly employed schedule of 80 mg/sq m/day given for 3 days. Although direct comparison of treatment efficacy using the two schedules is not possible, no adverse clinical effects have been observed with the recently adopted single-dose schedule. Furthermore, the duration of patient hospitalization for chemotherapy has decreased. PMID- 6848674 TI - Arnold-Chiari malformation. Review of 71 cases. AB - The natural history of symptomatic adult Type I Arnold-Chiari malformation (ACM) is variable, and the value of surgery in the management of this disease is difficult to assess. A series of 71 patients in whom a diagnosis of Type I ACM was confirmed at operation is presented, and the progress of the patients following posterior fossa decompression is analyzed. The length of history varied greatly. Pain was the commonest symptom (69% of patients); other symptoms included weakness (56%), numbness (52%), and unsteadiness (40%). The presenting physical signs consisted of a foramen magnum compression syndrome (22%), central cord syndrome (65%), or a cerebellar syndrome (11%). Myelography was performed in 69 patients, and was the most useful investigation. Only 23% of plain radiographs were abnormal. In addition to tonsillar descent, the operative findings included arachnoid adhesions (41%) and syringomyelia (32%). All patients underwent suboccipital craniectomy and C1-3 laminectomy. Respiratory depression was the most frequent postoperative complication (14%), and one patient died from sleep apnea. Early postoperative improvement of both symptoms (82%) and signs (70%) was followed by later relapse in 21% of patients, showing an initial benefit following surgery. None of the patients with a cerebellar syndrome deteriorated, whereas 56% of patients with evidence of foramen magnum compression and 66% of those with a central cord syndrome maintained their initial improvement. The authors conclude that posterior fossa decompression appears to benefit some patients, although a significant proportion might be expected to relapse within 2 to 3 years after operation, depending upon the presenting syndrome. PMID- 6848675 TI - A critical appraisal of "terminal ventriculostomy" for the treatment of syringomyelia. AB - The clinical course of 31 patients who underwent attempted excision of the filum terminale and tip of the conus for syringomyelia is summarized. Of these patients, 17 had had some previous surgical intervention. Eleven patients were continuing to deteriorate at the time of the operation. In three cases, marked postoperative improvement was reported, and objective improvement was thought to result from the conus excision. Eighteen more patients claimed improvement in their preoperative symptoms of loss of pain sensibility, deafness, or reduced motor function, although most of such claims were unverified by objective clinical assessment. Sixteen of the patients who improved have since proceeded to deteriorate. In five of the patients, there was a long-standing improvement of at least subjective phenomena. Thirteen patients were not improved even subjectively and some of these have continued to grow worse. Proof that the greater part of the syrinx was in communication with the conus or filum was difficult to obtain even when the conus was dilated. No correlations have been found to suggest that the operation might be more effective if the central canal was patent at the conus or the filum, nor was there a correlation between a good clinical result and either the age of the patient or the age of the syrinx as judged by the history. The operation did not seem to be more or less beneficial if previous surgery had been performed. The suggestion is made that for syringomyelia with hindbrain abnormalities, other than dense arachnoiditis (particularly if there is evidence of pressure dissociation at the foramen magnum), craniovertebral decompression remains the procedure of choice. In syringomyelia with marked hydrocephalus, drainage by a valved shunt may be the preferred first procedure. If myelotomy is planned it should probably be done where the syrinx is wide, and it is more likely to succeed if the syrinx is drained to a low-pressure area outside the theca, such as the peritoneum or pleura, rather than the subarachnoid space. PMID- 6848677 TI - The role of intracranial hypotension in neonatal intraventricular hemorrhage. AB - Most preterm infants develop transient intracranial hypotension, which reaches its lowest level on the 2nd day of life. This corresponds to the time when most neonatal intraventricular hemorrhage (IVH) occurs. In order to test the hypothesis that intracranial hypotension may have an etiological role in the development of IVH in premature infants, the authors induced intracranial hypotension in the preterm rabbit by the intraperitoneal injection of glycerol. The rabbit model is well suited for this study because this animal is at risk of developing spontaneous germinal matrix and ventricular hemorrhage. Compared to control littermates, the glycerol-treated animals exhibited a greater than 3.5 fold incidence of germinal matrix and intraventricular hemorrhage. PMID- 6848676 TI - Pressure-absorption responses to the infusion of fluid into the spinal cord central canal of kaolin-hydrocephalic cats. AB - The resistance to cerebrospinal fluid (CSF) absorption through the alternative CSF absorption pathway in kaolin-induced hydrocephalic cats was measured by the constant infusion-manometric test. The cerebral ventricles were bypassed, and artificial CSF was infused directly into the central canal of the spinal cord. The infusion rates were increased stepwise from 0.022 to 0.168 ml/min when the capacity to absorb CSF was exceeded. There was an initial increase in resistance which was associated with the emergence of infusion fluid through a slit-like opening in the dorsal columns of the lower lumbar spinal cord. The resistance to flow decreased when the infusion rate was greater than 0.086 ml/min. Fluid accumulated in the spinal subarachnoid space when the ability to absorb was exceeded. The diversion of this fluid caused the pressure in the spinal cord central canal to fall rapidly. The results suggest that the CSF absorption deficit in chronic kaolin-induced hydrocephalic cats is probably caused by the restriction of CSF flow from the central canal through the spinal cord and into the spinal subarachnoid space. As a result of kaolin, the central canal is sufficiently dilated to permit, during infusion, the flow of at least five times as much CSF as the hydrocephalic cats produce. It is not clear whether the overloading of the CSF absorption mechanism is due to the restrictions imposed by the size of the subarachnoid space, or to the structures in this space involved with the return of CSF to the blood. PMID- 6848678 TI - Regional cerebral blood flow in the acute stage of experimentally induced subarachnoid hemorrhage. AB - Subarachnoid hemorrhage (SAH) was induced in 13 adult mongrel cats by a slow injection of fresh autogenous blood into the cisterna magna. Serial determinations of regional cerebral blood flow (rCBF) in the cortex and deep seated areas (internal capsule, thalamus, and caudate nucleus) were made during the following 2 hours, while intracranial pressure (ICP) was maintained at normal values. A decrease in rCBF was observed in all the areas examined. This reduction followed a characteristic triphasic pattern with an initial steep decline immediately after the SAH. The clinical implications of these findings are discussed. PMID- 6848679 TI - Statistical studies on evaluation of mild disturbance of consciousness. Study of a simpler scale for clinical use. AB - In an effort to express the grades of mild disturbance of consciousness (MDOC), or clouding of consciousness, 25 items were selected for application in clinical examination. Factor analysis of the 25 items revealed that MDOC has a two-factor structure; namely, the performance factor (F1) and the verbal factor (F2). This structure was maintained in the sequential examinations. Guttman's scale analysis showed that the scale using the 25 items may be considered to approximate a unidimensional scale. By item selection according to communality, the 25 items could be reduced to 12 items without losing the two-factor structure or the usefulness and reliability of the examination. The principal component analysis (PCA) score, the F1 score, and the F2 score, calculated from the 12 items, were found to be good scales to describe an overall picture and characteristics of the F1 and the F2 of MDOC, respectively. Furthermore, by means of the characteristic curve (ogive) method, it was revealed that MDOC consisted of four clusters of items, the F2 factor (mild), F1 factor (mild), F2 factor (moderate), and F1 factor (moderate), according to the MDOC severity, so that a simpler scale composed of a representative item from each cluster could be constructed which exhibited a high correlation coefficient with the original PCA score. PMID- 6848681 TI - Failure of prophylactically administered phenytoin to prevent late posttraumatic seizures. AB - This randomized double-blind placebo-controlled study was undertaken in a series of 179 patients to determine whether phenytoin administered soon after head injury lessens the incidence of late posttraumatic epilepsy. When delayed hypersensitivity to phenytoin developed, the patient was switched to phenobarbital. The patients were followed for 18 months to detect the occurrence of seizures and to serially measure plasma phenytoin concentrations. There was no significant difference in the percentage of patients having late seizures in the treated and placebo groups (p = 0.75). The time between injury and seizures did not significantly differ between the two groups. The results provide no support for the continued use of phenytoin in the low therapeutic range for prophylaxis against late posttraumatic seizures. It cannot be concluded that higher phenytoin plasma concentrations and higher compliance rates than obtained in this study would not have significantly decreased the occurrence of late posttraumatic epilepsy. The finding that no patient with a phenytoin plasma concentration of 12 microgram/ml or higher had a seizure raises the question of whether phenytoin in blood concentrations in higher therapeutic ranges might lessen the occurrence of posttraumatic epilepsy, and should be studied further. Posttraumatic epilepsy is a major public health problem deserving a large cooperative trial to determine if phenytoin at higher blood levels than obtained in this study, or other currently available or newly developed drugs, can prevent the occurrence of posttraumatic epilepsy. PMID- 6848680 TI - Failure of prophylactically administered phenytoin to prevent early posttraumatic seizures. AB - A randomized double-blind placebo-controlled study was carried out to determine whether phenytoin administered soon after injury lessens the incidence of epilepsy in the 1st week after severe head trauma. In this study, 244 patients were randomized into either a phenytoin or placebo group. The patients in the phenytoin group were administered phenytoin intravenously or intramuscularly within 24 hours of hospital admission. Patients in the placebo group received intravenous or intramuscular diluent. The patients were switched from parenterally administered phenytoin or placebo as soon as oral doses could be tolerated. Over 78% of the phenytoin patients had plasma concentrations of at least 10 micrograms/ml at 1, 3, and 7 days after injury. There was no significant difference in the percentage of patients having early seizures in the treated and placebo groups (p = 0.99). There was no significant difference in the interval from injury to first seizure between the treated and placebo groups (p = 0.41). The early administration of phenytoin did not lessen the occurrence of seizures in the 1st week after head injury. Since the effectiveness of seizure prophylaxis has not been established, the authors suggest that anticonvulsant drugs be administered only after an early seizure has occurred. PMID- 6848683 TI - Sedimentation level in chronic subdural hematoma visible on computerized tomography. AB - A clear interface dividing subdural hematoma into an upper hypodense and a lower hyperdense part was seen on computerized tomography (CT) scan in seven of 140 patients with chronic subdural hematoma. All except one of the seven patients had a definite history of head trauma more than 1 month before they developed acute disturbances of consciousness and pronounced hemiparesis. Consequently, they remained bed-ridden until they underwent drainage of the subdural hematoma. This group was compared to seven chronic subdural hematoma patients with mild clinical manifestations who were selected and intentionally confined to bed for a period before CT examination and craniotomy. The CT scans in this latter group did not show the clear interface in the subdural hematoma seen in the first group. Based on this study, it is hypothesized that this sedimentation level occurred as a result of rebleeding into a chronic hematoma that was sufficiently old to result in its contents being homogenous prior to the rebleed. In cases of rebleeding, a sufficient period of bed confinement in the brow-up position before CT examination allows development of a gravitational sedimentation in the hematoma. This clear level of sedimentation is seen in only a small portion of patients, but this finding may be specific for a significant amount of rebleeding and may herald acute deterioration. PMID- 6848682 TI - Factors affecting coagulation: fibrinolysis in chronic subdural fluid collections. AB - Plasminogen, alpha2-antiplasmin, fibrinogen, fibrin degradation products (FDP's), and hemoglobin were measured in the supernatant fluid of 25 chronic subdural hematomas and five chronic subdural hygromas. The 30 patients underwent pre- and postoperative computerized tomography. The hematomas were characterized by low fibrinogen and high fibrin degradation product concentrations. The hemoglobin content varied directly with the alpha2-antiplasmin, and inversely with the plasminogen. Four patients underwent reoperation for recurrences. The initial fluid from these cases was characterized by relatively high plasminogen and low alpha2-antiplasmin. The hygromas had no hemoglobin, and low fibrinogen, high FDP's, low alpha2-antiplasmin, and variable plasminogen levels. It is possible that those cases having the greatest capacity to produce plasmin (high plasminogen and low alpha2-antiplasmin) can produce more FDP's which in turn causes more rebleeding and an increased risk of reaccumulation of chronic subdural hematomas. PMID- 6848684 TI - Use of free latissimus dorsi musculocutaneous flaps in various neurosurgical disorders. AB - Musculocutaneous (skin-muscle) flaps have been used predominantly by plastic surgeons for a variety of reconstructive purposes. With the advent of microvascular techniques, the area to be reconstructed is no longer limited to the arc of rotation of the vascular pedicle of the muscle. Instead, the muscle and overlying skin that is best suited for the reconstructive procedure may be dissected out as a free flap, with microvascular anastomosis of an arterial supply and venous drainage to locally existing vessels. This report demonstrates the usefulness of musculocutaneous free flaps in the repair of large defects of the scalp, cranium, and dura after trauma or resection of invasive neoplasms. The authors describe the use of a latissimus dorsi free musculocutaneous flap in eight patients who would have required multiple operations to provide coverage by other techniques. There have been no major complications, and adequate repair has been accomplished, even in cases involving exposed brain. PMID- 6848685 TI - Experimental microsurgical embolectomy after middle cerebral artery embolization in the dog. AB - The effects of microsurgical embolectomy were investigated clinicopathophysiologically in 60 dogs after occlusion of the middle cerebral artery (MCA) trunk with a silicone cylinder embolus. One group of animals served as a control (non-embolectomized group), and in the other two groups the embolus was removed 3 or 6 hours after occlusion (3-hour or 6-hour embolectomy group). In the non-embolectomized animals, major neurological deficits with deep cerebral infarction were observed. Regional cerebral blood flow (CBF) in the basal ganglia decreased most prominently. Sensory evoked potentials also declined to about 50% of the control level 3 hours after embolization. In the 3-hour embolectomy group, mild neurological deficits with minimal infarctions were found. One hour after embolectomy, CBF was restored to the original level in all regions, and the sensory evoked potentials surpassed the control level. In the 6-hour embolectomy group, most animals exhibited major neurological deficits and severe brain swelling with hemorrhagic infarction. This study suggests that early microsurgical embolectomy of the MCA trunk restores blood flow in the perforating arteries and prevents deep cerebral infarction. PMID- 6848686 TI - Multiple secreting microadenomas as a possible cause of selective transsphenoidal adenomectomy failure. Case report. AB - Approximately 10% to 20% of patients who undergo selective transsphenoidal removal of secreting microadenomas fail to achieve a cure. One of the possible causes of these failures is multiple adenomas. A case history is presented of two microadenomas within the same gland, and the multiplicity of pituitary adenomas is discussed. PMID- 6848687 TI - Aspergillus infections of the lumbar disc spaces. Report of three cases. AB - Three cases of lumbar vertebral interspace infection due to the Aspergillus fungus are presented. Two patients responded to vigorous surgical therapy in combination with prolonged administration of antifungal agents. The third patient died of complications related to the antibiotic therapy. Possible etiologies of this unusual problem are reviewed in light of the changing spectrum of nosocomial and spontaneously acquired infectious processes. Combined aggressive medical and surgical therapy is discussed with respect to the known difficulties in eradicating deep-seated osseous mycotic infections. PMID- 6848688 TI - Sciatic nerve entrapment. Case report. AB - A case is presented of compression of the sciatic nerve at the back of the thigh. For 3 years after a minor injury, this patient has suffered from pain and paresthesia in the left leg. There were no neurological abnormalities; electromyography was performed twice and showed normal muscular activity. At operation the nerve was found to be rotated and compressed by a tough band of connective tissue. Postoperatively, all discomfort disappeared, and 5 months later the patient remained free of pain. PMID- 6848689 TI - Jefferson fractures in children. Case report. AB - Jefferson fractures in children are exceedingly rare. A case in a 2-year-old is reported, and the other only case in the literature is reprinted. The mechanism of fracture is probably separation of the lateral masses by a force transmitted from the vertex. Because these fractures are not usually associated with neurological deficits, and because of the poor detail obtained with conventional radiography in a child, these fractures may be overlooked. Computerized tomography provides superb definition of this lesion. The preferred mode of treatment is immobilization. PMID- 6848690 TI - Nevus of Ota associated with meningeal melanosis and intracranial melanoma. Case report. AB - A case is reported of a patient in whom an intracranial extracerebral melanoma developed in association with a life-long nevus of Ota. Melanotic pigmentation of the skull, periosteum, and meninges beneath the nevus was found at operation. PMID- 6848691 TI - Acute subdural hematoma and death following lateral cervical spinal puncture. Case report. AB - An acute subdural hematoma dissecting into the posterior cranial fossa and resulting in death is reported. The patient had undergone spinal puncture by the lateral cervical technique prior to development of the hematoma. Autopsy demonstrated that the source of hemorrhage was an anomalous intraspinal vertebral artery. PMID- 6848692 TI - Balloon occlusion of a spontaneous fistula of the posterior inferior cerebellar artery. Case report. AB - A case is reported of a large spontaneous right posterior inferior cerebellar artery fistula in which the patient presented with a right cerebellopontine (CP) angle and right cerebellar syndrome. The patient was successfully treated by balloon occlusion at the fistula site. The location of the arteriovenous fistula, the mass effect of its enlarged draining veins on the cerebellum and CP angle structures, and the simple therapeutic endovascular occlusion with a detachable balloon make this case unique. PMID- 6848693 TI - Traumatic intracranial aneurysm due to arterial injury at surgery. Case report. AB - A case is presented of false intracranial aneurysm of traumatic origin which developed following direct surgical attack on a congenital anterior communicating artery aneurysm. The secondary aneurysm was discovered on the 25th postoperative day and was clipped at a subsequent procedure. The possible pathophysiology is discussed with respect to other direct vessel injuries. PMID- 6848694 TI - The role of neomembranes in formation of hematoma around Silastic dura substitute. Case report. PMID- 6848695 TI - Parkinsonism due to subdural hematoma. Case report. AB - The authors describe the case of a 38-year-old woman who presented with parkinsonian syndrome associated with chronic subdural hematoma. Gradual disappearance of the symptomatology followed removal of the hematoma. Chronic subdural hematoma may in rare instances cause a parkinsonian syndrome, probably by a pressure effect on basal ganglia structures or by altering the function of neurotransmitters. PMID- 6848696 TI - Lipoma of the insula. Case report. AB - The authors present a case of lipoma of the insula. This 20-year-old man with grand mal seizure was diagnosed by computerized tomography, and improved satisfactorily following surgical intervention. PMID- 6848697 TI - Transient global amnesia associated with a single metastasis in the non-dominant hemisphere. Case report. AB - A patient in whom transient global amnesia (TGA) led to the diagnosis of a metastasis of a transition-cell carcinoma of the bladder to the non-dominant hemisphere is described. In previously reported cases of TGA associated with brain tumors, the tumors involved either the dominant or both hemispheres. The etiology of TGA associated with a brain tumor is most likely vascular, as suggested by the sudden development and the transitory character of the event. In contrast to the "common" form of TGA (where both temporal lobes suffer temporary ischemia), in these patients only one side of the limbic system is affected, because a brain tumor has already compromised the other limbic area. Therefore, the dominance of the hemisphere with the tumor is of no consequence, as both hemispheres have been involved. It is concluded that the TGA in these patients is not due to, but is rather associated with, a unilateral brain tumor. PMID- 6848699 TI - Myocardial imaging and metabolic studies with [17-123I]iodoheptadecanoic acid in patients with idiopathic congestive cardiomyopathy. AB - In twenty patients with primary congestive cardiomyopathy (COCM) the patterns of accumulation and washout of the fatty acid analogue [17-123I]iodoheptadecanoic acid (I-123 HA) were studied. In contrast to patients with ischemic heart disease, where reduced I-123 HA accumulation was correlated with stenosis of the main coronary arteries, thus usually involving larger wall segments, the patients with COCM concentrated I-123 HA heterogeneously in small spotty segments throughout the entire left-ventricular myocardium. The regional washout half times varied between 15.1 and 116.2 min. It seems that in patients with severe COCM the elimination half-times are more prolonged than in early stages of the disease. There was no correlation between the regional uptake and the elimination half-times. Sequential myocardial imaging with I-123 HA appears useful for noninvasively diagnosis of COCM. PMID- 6848698 TI - Analysis of cardiac diastolic function: application in coronary artery disease. AB - Separation of systolic and diastolic parameters in gated cardiac blood-pool imaging (RVG) was achieved with the retention of two harmonics in the Fourier series representation of the time-activity curve. Regional and global analysis of left-ventricular peak filling rate (PFR) and time to peak filling (TPF) was performed in 18 control subjects, 20 patients with coronary artery disease (CAD) but with normal RVG (normal regional wall motion and ejection fraction, and 16 CAD patients with abnormal RVG. In regional analysis of CAD patients, the standard deviation of the TPF histogram identified 13/20 (65%) of normal RVG patients and 12/16 (75%) of abnormal RVG patients as abnormal. In global analysis of CAD patients, PFR values identified 10/20 (50%) of normal RVG patients and 11/16 (69%) of abnormal RVG patients as abnormal. Thus, left-ventricular systolic and diastolic parameters can be separately measured with retention of higher order harmonics in the Fourier transform, and regional inhomogeneity of diastolic filling can be detected in CAD patients with normal resting ejection fraction and wall motion. PMID- 6848701 TI - Scintigraphic detection of ventricular aneurysm with thallium-201. AB - We present two patients who exhibited striking abnormalities on stress thallium 201 scintigrams, suggesting ventricular aneurysm before documentation of this diagnosis by contrast ventriculography. The features of the scintigrams included: (a) a large perfusion defect overlying the cavity of the left ventricle, the defect extending to the periphery of the cardiac image and containing fewer counts than the lung background; (b) relatively increased lung background; (c) increased right-ventricular prominence; and (d) abnormal cardiac contour. Although large aneurysms of the left ventricle can usually be diagnosed from history and physical examination, occasionally they can be more subtle in their manifestations. Appearance of a myocardial perfusion image as described above should alert the physician to the possibility of this diagnosis. PMID- 6848700 TI - Distribution of radiolabeled endotoxin with particular reference to the eye: concise communication. AB - A single systemic injection of endotoxin (lipopolysaccharide or LPS) reproducibly induces a cellular infiltrate in the uveal tract of the rat eye within 24 hr. Other organs are not comparably sensitive to systemic endotoxin. One hypothesis to explain this unique sensitivity is that endotoxin is preferentially bound by ocular tissue. We tested this hypothesis by studying the distribution in the rat of intravenously injected endotoxin that had been radiolabeled with Tc-99m or P 32. With either radionuclide the concentration of endotoxin per gram of tissue at a variety of times after injection ranging from 5 min to 3 hr and 45 min, was markedly less in the eye than in liver, kidney, or spleen. A study with radiolabeled albumin indicated that these differences could not be ascribed solely to the organ's blood volume. They demonstrate, therefore, that the eye does not preferentially bind endotoxin, and they are compatible with the hypothesis that endotoxin's ocular effects are indirectly mediated. PMID- 6848702 TI - Imaging of inflammation with indium-111 tropolonate labeled leukocytes. AB - Indium-111 tropolonate has recently been introduced as a new cell-labeling agent. It has the interesting property of labeling cells in plasma with high efficiency, and may therefore promote an improvement in viability of labeled cells. This paper describes our initial experience with In-111 tropolonate as a leukocyte label for abscess imaging. Pure populations of separated granulocytes, as well as crude leukocyte preparations, have been labeled. Of 101 studies performed, 51 were positive (no false positives) and 50 negatives, of which only two were false negatives. Localization in sites of inflammation was prominent and rapid. Of 36 positive studies, 27 were already positive at 40 min following injection and an additional nine at 3 hr. Of the other 15 positive studies, 11 were scanned for the first time at 3 hr, when they were positive. Granulocytes labeled with this agent in plasma showed minimal sequestration in lungs and liver, interpreted as indicating improved viability in comparison with cells displaying prolonged lung sequestration. PMID- 6848703 TI - Tumor-imaging potential of liposomes loaded with In-111-NTA: biodistribution in mice. AB - EMT6 tumors in BALB/c mice have been successfully imaged with small (less than 0.1 mu), unilamellar lipid vesicles (SUVs) loaded with In-111 nitrilotriacetic acid (In-111 NTA). Neutral SUVs prepared from distearoyl phosphatidylcholine (DSPC) and cholesterol (CH) (ratio 2:1) delivered sufficient radioactivity to allow tumor visualization 24 hr after i.v. injection; so did positively and negatively charged SUVs with the ratio 4:1:1 for DSPC:CH:X, were X was stearylamine or dicetyl phosphate. Other SUVs containing a 6-aminomannose or 6 aminomannitol derivative of cholesterol did not cause significant tumor accumulation of In-111 NTA, and tumor images were not readily discernible. The maximum tumor-associated radioactivity, 18.5% of injected dose per gram of tissue, was achieved with neutral SUVs. This level of tumor-associated In-111 was over 4 times that observed when unencapsulated In-111 NTA was injected. Neutral SUVs also gave the lowest specific activities in the liver and spleen (14.6% and 18.8% of dose respectively). PMID- 6848704 TI - A variable angle slant-hole collimator. AB - A variable-angle slant-hole (VASH) collimator was constructed to show the feasibility of using multiple sliding plates to achieve a range of collimator channel inclinations. One hundred and sixty tungsten plates, 0.125 mm thick and 14 cm square, were photoetched to produce 3025 1.5-mm2 holes in each plate, separated by 0.8-mm septa. Along with the collimator holes, registration holes and positioning grooves were also etched. The plates were placed in a holder and stacked to form a collimator 2.0 cm high. The holder permitted the plates to be "sheared" to achieve viewing angles from 0 to 40 degrees from the vertical. Resolution and sensitivity were determined both across and along the shear directions. Resolution of a thin Tc-99m source, 1.24 mm diam and 7 cm long, located 5 cm from the collimator face in air, was 1.1 cm FWHM at 0 degree shear and remained unchanged with increasing slant. The resolution was similar both across and along the shear plane. Sensitivity was determined with a point source placed 7 cm from the collimator face. At 0 degree slant the sensitivity was 169 cps/MBq (6.24 csp/mu Ci). A general all purpose (GAP) collimator had a FWHM of 1 cm for the line source in air at 5 cm, and a sensitivity of 205 cps/MBq (7.58 cps/mu Ci) for the point source at 7 cm. The data suggest that a variable-angle slant-hole collimator can be constructed of laminated plates. PMID- 6848705 TI - Statistics for nuclear medicine. Introduction, descriptive statistics, and graphic displays. PMID- 6848706 TI - An evaluation of the quality of therapeutic studies in perinatal medicine. PMID- 6848707 TI - Quality of growth in premature infants fed their own mothers' milk. AB - With the renewed interest in the feeding of human milk to preterm infants, we have evaluated the partition of energy metabolism and of macronutrient utilization and accretion in growing very low birth weight infants fed their own mother's milk. Fifteen studies combining macronutrient balance, computerized continuous open-circuit indirect calorimetry, and anthropometric measurements were performed in 11 growing, very low birth weight (less than 1.300 gm) preterm infants. The mean milk intake of 172 ml/kg/day provided a gross energy intake of 111 kcal/kg/day. Energy losses in excreta were 11 kcal/kg/day, and the metabolic energy expenditure was 56 kcal/kg/day. The remainder (44 kcal/kg/day) represented the energy stored in the components of new tissue. The infants were gaining weight (15.3 g/kg/day), length (0.98 cm/wk), and head circumference (0.76 cm/wk) at rates approximating intrauterine growth rates. The metabolic energy expenditure was derived from the oxidation (mean +/- SE) of carbohydrate, 9.5 +/- 0.7 gm/kg/day; fat, 1.63 +/- 0.34 gm/kg/day; and protein, 0.68 +/- 0.07 gm/kg/day. The stored energy comprised 2.98 +/- 0.86 gm/kg/day as carbohydrate, 2.25 +/- 0.54 gm/kg/day as fat, and 1.97 +/- 0.1 gm/kg/day as protein. The accretion rates of fat and protein, as well as the composition of the weight gain (fat, 16.6 +/- 4.1%; protein, 13.4 +/- 0.5%), were similar to those reported for the fetus of comparable gestational age. PMID- 6848708 TI - Body water estimates in neonatal polycythemia. AB - To determine whether neonatal polycythemia and its treatment by partial exchange transfusion affect body water estimates, 10 normocythemic and eight polycythemic neonates were studied within 12 hours of birth. Total body water, extracellular water, and plasma volume were estimated immediately prior to and following exchange. Intracellular and interstitial water contents were calculated. There were no significant differences between normocythemic and preexchange polycythemic neonates in mean total body water, extracellular water, interstitial water, and intracellular water contents. In the polycythemic group, exchange did not affect mean total body water, but was associated with decreases in mean extracellular water and mean interstitial water and an increase in mean intracellular water. Mean transcapillary escape rate of T-1824 was not affected by exchange but was quite rapid both before (35 +/- SE 3%/hr) and after the procedure (30 +/- 4.9%/hr). These data suggest that moderate polycythemia in normal term neonates does not affect total and extravascular body water estimates, but that a fluid shift from the extracellular to the intracellular space may accompany the exchange procedure. PMID- 6848709 TI - Breast-feeding, weight loss, and jaundice. PMID- 6848710 TI - Automated method for exchange transfusion: a new modification. PMID- 6848712 TI - Seizures following childhood immunizations. AB - In 1.4% of children who experienced a seizure during the first seven years of life, the seizure followed within two weeks of an immunization procedure. We report 40 postimmunization seizures in 39 children enrolled in the Collaborative Perinatal Project. Ten seizures followed diphtheria-pertussis-tetanus (DPT) immunization, and 10 followed measles immunization. All but one of the seizures were associated with fever, often high. Thirty-seven seizures lasted less than 30 minutes. More than half of the children had a personal or immediate-family history of febrile seizures. One of the children had a right focal seizure lasting six hours after DPT immunization and had a significant speech deficit on long-term follow-up. No child developed epilepsy, and results in all children with brief seizures were normal on neurologic and cognitive examination at 7 years of age. Both in clinical presentation and generally benign outcome, these immunization-related seizures closely resemble febrile seizures, which are common in early childhood. PMID- 6848711 TI - An unusual gastric bezoar in a newborn: polystyrene resin and Candida albicans. PMID- 6848713 TI - Phenylpropanolamine-induced hypertensive seizures. PMID- 6848715 TI - Aspirin and Reye syndrome. PMID- 6848714 TI - Treatment of 242 neonates with dehydrating diarrhea with an oral glucose electrolyte solution. AB - Two hundred thirty-four of 242 neonates (96.7%) with a mean dehydration of 5.1% body weight were rehydrated with a glucose-electrolyte solution given orally in an average time of 7 44 hours. Eight (3.3%) neonates required intravenous fluid therapy. Emesis was not an obstacle for complete oral rehydration. Hypernatremia, hyponatremia, and acidosis present on admission were corrected within a few hours. Oral rehydration is an entirely satisfactory choice for treatment of uncomplicated dehydration in neonates. PMID- 6848716 TI - Association of supernumerary nipples with other anomalies. PMID- 6848717 TI - Methemoglobinemia in infants with enteritis. PMID- 6848718 TI - Hypogammaglobulinemia and elevated sweat chloride values. PMID- 6848719 TI - Association of diabetes mellitus and hemolytic-uremic syndrome. PMID- 6848720 TI - Formula for calculating mean airway pressure. PMID- 6848721 TI - Coagulopathy following brain injury. PMID- 6848722 TI - Hematocrit level of reconstituted blood for exchange transfusion. PMID- 6848723 TI - Glossary of vitamin D metabolites. PMID- 6848725 TI - Ultrasound diagnosis of hypertrophic pyloric stenosis. AB - Thirty infants presenting with vomiting were examined sonographically. In 18 of these patients, a hypoechoic mass medial to the gallbladder and anterior to the right kidney was demonstrated. The mass measured more than 1 cm in diameter in all cases, with an average of 1.7 cm, and was interpreted as representing the hypertrophied muscle mass in pyloric stenosis. Sixteen of these infants had subsequent confirmation of this diagnosis by upper gastrointestinal tract examination and surgery. In two infants, both of whom had a small-diameter mass, the upper gastrointestinal tract study showed an atypical appearing pyloric canal; these two infants were thought to have atypical hypertrophic pyloric stenosis. Of importance technically is operator experience and patience and the use of different patient positions and even real-time imaging for completeness. Potential pitfalls include the fluid-filled duodenal bulb and gastric antrum, which cause a false positive diagnosis, and obscuration of a lesion by overlying bowel gas, which leads to a false negative diagnosis. PMID- 6848724 TI - Preliminary results on the mental development of hypothyroid infants detected by the Quebec Screening Program. AB - A prospective study of the mental development of hypothyroid infants detected by the Quebec Network for Genetic Medicine began in January, 1976. The mean age at initiation of thyroid hormone therapy was 27 days. Forty-five hypothyroid infants and 37 normal control subjects were assessed at age 12 months with the Griffiths mental development test; 77 and 41, respectively, were assessed at age 18 months, and 59 and 40, respectively, at 36 months. There were no statistically significant differences in the various test scores between the two populations at age 12 months, but at age 18 and 36 months the hypothyroid infants had lower scores in hearing-speech performance scales and practical reasoning (36 months) which also decreased their global quotient. The mean scores were still above 100 and only nine were below 85. Further assessment of the influence of early therapy on mental development at age 6 years is needed before definitive statements can be made about the long-term mental development in these subjects. PMID- 6848726 TI - Atrial pacing from the esophagus in the diagnosis and management of tachycardia and palpitations. AB - Recent reports have emphasized the usefulness of programmed electrical stimulation of the heart for predicting the effectiveness of pharmacologic therapy of recurrent tachycardias and for determining the basis of recurrent palpitations. We used programmed electrical stimulation of the atrium from the esophagus to study 12 children (ages 1 to 13 years) with either electrocardiographically documented tachycardia (seven patients) or recurrent palpitations (five patients). Atrial stimulation from the esophagus initiated and terminated tachycardia in all seven patients who had a previously documented tachycardia. In five of these patients tachycardia could not be initiated after therapy with quinidine sulfate, and no recurrences have been noted in 12 to 18 months of follow-up. In two patients tachycardia could be reinitiated despite therapeutic quinidine levels, and tachycardia has recurred despite quinidine therapy. Atrial stimulation from the esophagus initiated tachycardia in four of five patients with a history of palpitations. Electrocardiographic documentation of tachycardia was beneficial, because it provided a basis for determining whether therapy for tachycardia was indicated, and in some instances provided an opportunity for patient education to permit-self termination without medication. PMID- 6848727 TI - Echocardiography reveals a high incidence of bicuspid aortic valve in Turner syndrome. AB - The most common cardiac defect in Turner syndrome has been described previously as coarctation of the aorta. We have evaluated 35 consecutive patients with Turner syndrome by clinical examination and by M-mode and two-dimensional echocardiography. Twelve patients (34%) had isolated, nonstenotic bicuspid aortic valve. A high correlation (82%) existed between the presence of a systolic ejection click and echocardiographic evidence of a bicuspid aortic valve. These data indicate that bicuspid aortic valve may be the most common cardiac anomaly in Turner syndrome. PMID- 6848729 TI - Surgicopathologic staging of neuroblastoma: prognostic significance of regional lymph node metastases. AB - Of 254 children with neuroblastoma treated at St. Jude Children's Research Hospital, 102 (40%) had clinically localized tumors. Using a surgicopathologic staging system, 66 of these 102 children had localized tumor and 36 had tumor dissemination to regional lymph nodes. Survival of these two groups has been markedly different; 57 of 66 (87%) with localized tumor survive, compared with 11 of 35 (33%) with node dissemination, five of whom are less than two years from diagnosis. Our data indicate that the prognosis for children with neuroblastoma metastatic only to regional lymph nodes is no different from that of patients of similar age with widely disseminated tumor. PMID- 6848728 TI - Increased serum opsonic activity and antibody concentration in patients with sickle cell disease after pneumococcal polysaccharide immunization. AB - Opsonic defects have been reported in unimmunized patients with sickle cell disease. We found significant increases (P less than 0.001) in serum opsonic activity, measured by a radiolabeled bacterial uptake assay, and in type 7 pneumococcal polysaccharide antibody concentration in 17 such patients 2 years of age or older after pneumococcal polysaccharide immunization. All 17 patients and six healthy controls achieved a type 7 antibody concentration of more than 300 ng antibody nitrogen per milliliter, believed to be the protective level of antibody in vivo. Six patients with sickle cell disease less than 2 years of age did not have a significant increase in type 7 antibody concentration after immunization. Only three of these six patients achieved a postimmunization type 7 antibody concentration exceeding 300 ng Ab N/ml. Overall, 16 of 23 patients with sickle cell disease (70%) had a twofold or greater increase in type 7 antibody concentration, and 13 of these (81%) had a corresponding increase in opsonic activity (P less than 0.001). Thus most patients who responded to pneumococcal polysaccharide immunization had a concurrent increase in opsonic activity in vitro. PMID- 6848730 TI - Campylobacter colitis in infants. PMID- 6848731 TI - Speech and language deficits in early-treated children with galactosemia. PMID- 6848732 TI - Normal electrolyte and protein content in milk from mothers with cystic fibrosis: an explanation for the initial report of elevated milk sodium concentration. PMID- 6848733 TI - Detection of isolated aldosterone deficiency in the neonate. PMID- 6848734 TI - Neonatal diagnosis of orotic aciduria: an experience with one family. PMID- 6848736 TI - Exophthalmos in hemoglobin SC disease. PMID- 6848735 TI - A screening test for hyperuricosuria. PMID- 6848737 TI - Sinusoidal transcutaneous oxygen pressure pattern in infants with pulmonary atresia. PMID- 6848739 TI - Behavioral effects of clozapine: comparison with thioridazine, chlorpromazine, haloperidol and chlordiazepoxide in squirrel monkeys. AB - The behavioral effects of the antipsychotic drug, clozapine, were compared with those of thioridazine, chlorpromazine, haloperidol and chlordiazepoxide. Behavior of squirrel monkeys was controlled by different consequences of a lever-pressing response (presentation of food, presentation of electric shock or termination of a stimulus associated with electric shock) under different schedules of reinforcement (a fixed-interval schedule or a multiple schedule with alternating fixed-ratio and fixed-interval components). The effects of thioridazine (0.2-24.6 mumol/kg), chlorpromazine (0.03-2.8 mumol/kg) and haloperidol (0.001-0.08 mumol/kg) were largely independent of the type of schedule or the type of consequent event that maintained responding: each drug produced dose-related decreases in responding under all conditions in which they were studied. Clozapine (0.1-9.2 mumol/kg) and chlordiazepoxide (0.9-167.4 mumol/kg) also only decreased responding under most schedule conditions; however, intermediate doses of either drug markedly increased responding maintained by presentation of food under the fixed-interval schedule (whether programmed singly or as a component of the multiple schedule). Only clozapine increased responding maintained by presentation of electric shock under the fixed-interval schedule. Thus, the behavioral effects of clozapine differed qualitatively from those of representative antipsychotic and antianxiety drugs. PMID- 6848738 TI - Macromineral balances in premature infants fed their own mothers' milk or formula. AB - The premature infant's own mother's milk (preterm milk) and modified infant formula (SMA, 67 and 80 kcal/dl) were fed to paired groups of seven infants, all of whom were of very low birth weight (VLBW) (less than 1.3 kg) and were studied during the first month of life. Sodium, potassium, magnesium, calcium, and phosphorus status was compared. The apparent retention of sodium from their mother's milk paralleled intrauterine retention rates and was greater than retention from SMA formula (P less than 0.01) during the first two weeks of life. However, when the formula was supplemented with NaHCO3 to intakes of 2.7 mmol Na/kg/24 hr after week 2, the infants retained adequate amounts of sodium. Potassium retention was similar to intrauterine retention rates in both groups throughout the four postnatal weeks. Magnesium intake, but not retention, was consistently higher in the group fed SMA (P less than 0.01), and intrauterine retention rates were achieved only in the group given formula. Calcium and phosphorus intakes from SMA were also higher (P less than 0.01) than from human milk. However, retention of calcium and phosphorus in both groups did not meet intrauterine retention rates, and hypophosphatemia developed in infants who received their mothers' milk. Growth in length and head circumference in both groups approximated intrauterine growth rates. If it is assumed that body composition of the growing VLBW infants should be similar to the composition of the fetus at corresponding gestational ages, then their nutrient requirements should be based on knowledge of intrauterine nutrient accretion rates. Based on this premise, we conclude that, for the growing VLBW infant, early maternal milk provided for sufficient retention of sodium, chloride, and potassium during the first four postnatal weeks. Neither human preterm milk nor SMA supplied adequate calcium and phosphorus for the growing VLBW infant. PMID- 6848740 TI - Factors influencing the efflux of hepatic glutathione into bile in rats. PMID- 6848741 TI - The effects of photoperiod on the responses of the hamster vas deferens to nerve stimulation. AB - Hamster vas deferens responds to nerve stimulation with a biphasic contraction which is completely blocked by guanethidine and tetrodotoxin. The second component of the contraction is inhibited by phentolamine, whereas the initial component is slightly potentiated by phentolamine. When hamsters are subjected to short photoperiods or castration, the vas deferens becomes supersensitive to nerve stimulation and shows spontaneous mechanical activity. The supersensitivity is not due to increased postsynaptic adrenergic supersensitivity, decreased neuronal uptake of catecholamine, decreased presynaptic feedback by prostaglandin or adrenergic agonist. The supersensitivity is still demonstrable in the presence of 4-aminopyridine, suggesting that the release of transmitter is also not different in animals kept in short photoperiods. The activity of the Na+/K+ pump is increased in vasa deferentia from hamsters kept in short photoperiods and the postsynaptic response to the ATP receptor agonist, diadenosine pentaphosphate, is also enhanced. It is suggested that the supersensitivity induced in the hamster vas deferens by short photoperiod is caused by testosterone withdrawal and is due to increased responsiveness to ATP, which could be acting as a cotransmitter in this tissue. PMID- 6848742 TI - Disposition of caffeine and its metabolites in man. AB - The disposition of caffeine and its metabolites was studied in six healthy subjects by use of sensitive and specific assays. The primary degradation of caffeine in man was found to be N-demethylation and/or ring oxidation to theophylline, paraxanthine, theobromine and 1,3,7-trimethyluric acid. These compounds were further degraded to dimethylated uric acids, monomethylxanthines and monomethyluric acids. About 3 and 6% of the drug was converted to theophylline and theobromine, respectively. The elimination of paraxanthine after its formation did not follow linear kinetics. A large urine recovery of 1 methylxanthine after caffeine administration in comparison with the amount recovered after administration of theophylline suggests an inhibitory effect on the degradation of this metabolite by either caffeine itself or another metabolite of caffeine. Caffeine and its primary metabolites, dimethylxanthines, were extensively reabsorbed in the renal tubule. Their renal clearances were highly urine flow-dependent and their urinary excretion varied with urine output during the study. About 70% of the dose was recovered in the urine. Postulated degradation pathways of caffeine are discussed. PMID- 6848743 TI - Relative potency of dopamine agonists on autoreceptor function in various brain regions of the rat. AB - The effect of six dopamine agonists including apomorphine, epinine, dopamine, piribedil, lergotrile and bromocriptine on the incorporation of [3H]tyrosine into dopamine was studied in slices and synaptosomes prepared from various brain areas containing dopamine terminals including striatum, nucleus accumbens, olfactory tubercle and medial basal hypothalamus. It was observed that all of these drugs were active in causing a decrease in dopamine synthesis in these various brain areas. The catecholamine agonists apomorphine, epinine and dopamine were more potent in inhibiting dopamine synthesis in the mesolimbic structures than in the striatum. On the other hand, apomorphine and epinine were less potent while dopamine was more potent in the medial basal hypothalamus. The ergoline drugs were weak agonists in all structures studied. It is concluded that autoreceptor regulation of dopamine synthesis is more active in the mesolimbic compared with the nigrostriatal dopamine pathway while autoreceptors may be absent in the median eminence. PMID- 6848745 TI - Baroreflex sensitivity as a determinant of responses to hydralazine in dogs. AB - In order to evaluate the relation between hypotension induced by hydralazine and the resultant reflex tachycardia, as well as the role of baroreflex sensitivity in determining the magnitude of these responses, the drug was administered orally at a dose of 1 mg/kg to a group of trained conscious normotensive and renal hypertensive dogs. Responses were assessed by measuring blood pressure and heart rate for 8 hr after dosing and integrating the changes observed over time in order to obtain a mean value. Baroreflex gain was calculated as the ratio of heart rate to blood pressure responses. Hypotension was greater in hypertensives, whereas tachycardia was not different between groups. Gain was therefore smaller in hypertensives, but not uniformly so, a portion of these animals having values within the normotensive range. This high gain group responded with less hypotension and more tachycardia than did the low gain group. Differences in pressure and rate responses to repeated administration of hydralazine between the two groups were minimal. It is suggested that baroreflex gain, an innate individual characteristic, is an important determinant of acute pressure responses to hydralazine in dogs, hypertensive animals having less gain than normotensives and showing increased hypotensive responses. Gain appears not to be as important in determining the chronic effects of the drug. PMID- 6848744 TI - Antihypertensive activity of LY141865, a selective presynaptic dopamine receptor agonist. PMID- 6848746 TI - Covalent binding of metabolites of 4-ipomeanol to rabbit pulmonary and hepatic microsomal proteins and to the enzymes of the pulmonary cytochrome P-450 dependent monooxygenase system. AB - The covalent binding of metabolites of 4-ipomeanol, a potent lung toxin, to proteins in rabbit pulmonary and hepatic microsomal preparations and in purified monooxygenase systems was investigated. The rate of binding was 12-fold greater in pulmonary preparations than in hepatic preparations. Covalent binding in pulmonary microsomal fractions was inhibited 39 to 49% by antibodies to rabbit pulmonary cytochrome P-450II or P-450I and 90% by antibodies to cytochrome P-450 reductase. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and scintillation autoradiography of pulmonary microsomal proteins revealed the presence of heavily labeled bands throughout the molecular weight range (Mr) examined. Two of these bands corresponded in mobility to pulmonary cytochrome P 450I (Mr 52,000) and P-450II (Mr 58,000). In addition, there was a great deal of binding associated with very high molecular weight proteins, probably in the form of cross-linked aggregates which were unable to penetrate the gel matrix. In the absence of cofactor, no binding was observed. Binding was decreased by the addition of the following: antireductase greater than glutathione = NADH (without NADPH) greater than anti-II greater than anti-I. The electrophoretic patterns of the proteins from incubation of [3H]-4-ipomeanol with purified pulmonary P-450 dependent monooxygenase enzymes were also examined. In the complete system, the majority of the binding was associated with high molecular weight species located at the origin and with low molecular weight species that migrated with the tracking dye. In the absence of cofactor, some binding to proteins that corresponded with cytochrome P-450 and P-450 reductase was observed. Protease digestion of incubation mixtures resulted in the migration of all bound material at the dye front. PMID- 6848747 TI - Single-pass removal of [14C]-5-hydroxytryptamine and [3H]norepinephrine by rabbit lung, in vivo: kinetics and sites of removal. AB - Multiple indicator dilution techniques were employed to study the kinetics and sites of removal of [14C]-5-hydroxytryptamine (5-HT) and [3H]norepinephrine (NE) by rabbit lung in vivo. Percentage of single-pass transpulmonary removal of 5-HT decreased from 87 +/- 2 to 73 +/- 3, 49 +/- 7 and 34 +/- 2% when the total dose of administered 5-HT was increased from 8 X 10(-9) to 30, 75 and 150 X 10(-9) mol, respectively. Similarly, percentage of removal of NE decreased from 23 +/- 2 to 18 +/- 2, 1 +/- 2 and 5 +/- 2% when the amount of NE administered was increased from 0.3 X 10(-9) to 10, 50 and 100 X 10(-9) mol, respectively. From these data, kinetic constants of removal were calculated assuming either homogeneous or heterogeneous pulmonary perfusion; values for the apparent Michaelis-Menten constant (Km) averaged 1.1 +/- 0.4 X 10(-6) M (5-HT) and 0.9 +/- 0.3 X 10(-6) M (NE), whereas values for the apparent maximal velocity of removal (Vmax) were 17.4 +/- 2.6 X 10(-9) mol/min/g of lung wet weight (5-Ht) and 4.0 +/- 0.9 X 10(-9) mol/min/g of lung wet weight (NE). Furthermore, increasing the dose of administered 5-HT had little effect on NE removal and, similarly, increasing the dose of NE caused only small reductions in 5-HT extraction, indicating distinct sites of removal of these two amines by rabbit pulmonary endothelium. PMID- 6848748 TI - Tolerance to d-amphetamine and lack of cross-tolerance to other drugs in rats under a multiple schedule of food presentation. AB - Rats were trained under a multiple fixed-ratio 30-response, fixed-interval 5-min schedule of food presentation. Dose-response curves for d-amphetamine, pentobarbital, chlordiazepoxide, ethanol, morphine, phencyclidine and delta 9 tetrahydrocannabinol were determined. At low doses, pentobarbital and chlordiazepoxide produced small increases in response rates, whereas other drugs had no effect. At high doses, all drugs produced decreases in both fixed-ratio and fixed-interval rates of responding. With the exception of ethanol, all drugs produced decreases in fixed-ratio rates at lower doses than those which decreased fixed-interval rates. After the initial dose-response determinations, all animals received a single daily dose of d-amphetamine (10 mg/kg) after the behavioral session for 112 d-amphetamine (10 mg/kg) after the behavioral session for 112 consecutive days. Chronic postsession treatment with d-amphetamine produced a progressive decrease in rate of responding. Dose-response curves for all the drugs were redetermined after 2 weeks of chronic d-amphetamine treatment. During chronic d-amphetamine treatment, there was tolerance to the rate-decreasing effects of d-amphetamine. No cross-tolerance was observed for the other drugs tested. PMID- 6848749 TI - Interactions of phenobarbital with propranolol in the dog. 2. Bioavailability, metabolism and pharmacokinetics. AB - This article describes the effects of chronically administered phenobarbital (180 mg/day p.o.) in dogs on the bioavailability of single 40-mg oral doses of propranolol and on the pharmacokinetics and the patterns of propranolol metabolism in urine after both oral (40 mg) and i.v. (6 mg) doses. Phenobarbital decreased the bioavailability of propranolol from 7.7 to 3.5%. By using a gas chromatography/mass spectrometry technique, the quantitative metabolic pattern of i.v. propranolol was unaltered by phenobarbital, but increases in hydroxylation and induction of new metabolites were observed for oral propranolol after phenobarbital treatment. Chronic phenobarbital treatment led to significant decreases in the half-lives of propranolol after both i.v. and oral doses. Little change was observed in the hepatic blood flow, systemic clearance or intrinsic oral clearance. These data demonstrate the completely nonrestrictive elimination of propranolol. With phenobarbital, both the extent of plasma protein binding and the distribution into erythrocytes change significantly, yet the overall clearance remains unaltered. The half-lives fell in responses to the binding induced reduction in the apparent volume of distribution. PMID- 6848750 TI - Role of protein binding in cocaine-induced hepatic necrosis. AB - The hepatotoxicity of cocaine in the mouse is associated with a significant amount (greater than 2 nmol/mg) of irreversible binding of a cocaine metabolite to hepatic protein. The drug-induced hepatic necrosis correlated with the degree of radiolabeled cocaine binding to hepatic protein and both were shown to be dependent on species high doses of the drug (30-65 mg/kg) and selective channeling of cocaine metabolism by either microsomal induction or esterase inhibition. Subcellular fractionation of hepatic tissue showed that greater than 66% of irreversible binding occurred in the microsomal fraction of the liver. Little (less than 0.2 nmol/mg of protein) binding was observed in other tissue protein of the mouse. Increased binding of radiolabeled material to hepatic protein in phenobarbital-pretreated mice was observed with 3H-benzoyl and 14C methoxy but not with [3H3-C-N]cocaine. It is proposed that cocaine is metabolized by microsomal enzymes to a chemically reactive intermediate that binds to hepatic tissue protein to produce liver damage. The metabolic formation and subsequent hepatic toxicity of the reactive cocaine metabolite is species-dependent and is associated with binding of the intact norcocaine structure to tissue protein. Pretreatments which enhance hepatic microsomal metabolism or inhibit tissue esterase activity increase the amount of protein bound material and lead to production of cocaine hepatotoxicity. PMID- 6848751 TI - Differential-reinforcement-of-low-rate 72-second schedule: selective effects of antidepressant drugs. AB - The effects of antidepressant drugs in rats responding under a differential reinforcement-of-low-rate 72-sec schedule were assessed. Seven clinically used tricyclic antidepressant drugs (imipramine, desipramine, chlorimipramine, protriptyline, nortriptyline, amitriptyline and doxepin), two atypical antidepressants (iprindole and mianserin) and a monoamine oxidase inhibitor (tranylcypromine) dose-dependently reduced response rate and increased reinforcement rate. Nomifensine, an atypical antidepressant which has been reported to have psychomotor stimulant properties and abuse potential, increased response rate and decreased reinforcement rate. Chlorpromazine, an antipsychotic agent, and diphenhydramine, an antihistamine, have been reported to produce effects similar to antidepressants in several behavioral tests, but neither of these drugs mimicked the actions of antidepressants on responding under a differential-reinforcement-of-low-rate 72-sec schedule. Chlorpromazine decreased response rate but did not increase reinforcement rate. Diphenhydramine did not have consistent effects but tended to decrease reinforcement rate. These findings suggest that behavior maintained by the differential-reinforcement-of-low-rate schedule may be selectively affected by antidepressants that have no psychomotor stimulant properties. PMID- 6848752 TI - The social determinants of political change. PMID- 6848753 TI - Predicting performance during clinical years from the new Medical College Admission Test. AB - The results of a predictive validity study of the new Medical College Admission Test (MCAT) using criteria from the clinical years of undergraduate medical education are presented and discussed. The criteria included course grades and faculty ratings of clerks in internal medicine, surgery, obstetrics and gynecology, pediatrics, and psychiatry; scores on a comprehensive test of clinical knowledge (including patient management type examinations); and scores on Part II of the examinations of the National Board of Medical Examiners (NBME). While the validity coefficients of the MCAT with the Part II examinations ranged from .03 to .47, they were higher than those of undergraduate grade-point averages with the same criteria. The implications of the small-to-medium size validity coefficients for admissions are discussed. PMID- 6848754 TI - Baccalaureate preparation for medical school: does type of degree make a difference? AB - Four groups of medical school matriculants (43 with a B.A. degree in social sciences, 68 with a B.A. degree in the humanities, 49 with a B.A. degree in science, and 40 with a B.S. degree in science) were studied. No significant difference was found among the four groups on yearly grade-point averages in medical school or on parts I, II, and III of the examinations of the National Board of Medical Examiners. Those with an undergraduate degree in the humanities considered leaving medical school more frequently than the others. A substantial proportion of medical students with an undergraduate major in the sciences and social sciences reported they would choose the humanities if they were once again high school seniors. Those with a science background were disproportionately more likely than the others to choose residencies in internal medicine and surgery, and those with undergraduate degrees in the humanities and social sciences were more likely to choose psychiatry residencies. PMID- 6848755 TI - The extent of volunteer faculty integration in teaching hospital settings. AB - In a survey conducted by the authors, volunteer faculty members were found to be generally satisfied with their role in medical education, despite their acknowledgement of problems involving respect and responsibility when working with academic colleagues. These problems and the indifference of the volunteers to them are delineated. The structural reasons for simultaneous recognition of an indifference to problems are discussed in relation to the erosion of the utilization and authority of volunteer faculty members. PMID- 6848756 TI - Early outreach: career awareness for health professions. AB - "Early outreach" may be defined as a long-term, talent-development strategy designed to prepare a well qualified pool of disadvantaged and underrepresented minority applicants for entry into health professions schools, particularly medical schools. The concept of early outreach is to prepare, motivate, and educate talented, economically disadvantaged junior high or secondary school students to gain the necessary academic qualifications to make high school graduation, college attendance, and health careers a reality. In this paper the author defines the problem to which early outreach is addressed and discussed the contextual and historical background of the concept. A number of programs at the Health Sciences Center at the University of Illinois at Chicago designed and implemented to provide a model to achieve the concept of early outreach are described. PMID- 6848757 TI - Identifying the content of family medicine for educational purposes: an empirical approach. AB - In this article, the authors present a method to assist in curriculum planning and report an application of the method at one institution. Through interviews of 40 selected subjects, the authors identified 27 content elements appropriate for inclusion in a family medicine curriculum for medical students. These elements were organized into four areas portraying family medicine as "a synthesis of content and process," "a field of inquiry," "a career and peer group," and "a value system." A questionnaire employing the method of pair-comparisons was subsequently completed by 38 of the interview subjects, and on the basis of these responses priorities were assigned to content elements within each area. For three of the four areas, there was statistically significant consensus about the priority orderings. Over three years, the content elements themselves and their priority orderings have proved beneficial to curricular planning at the University of North Carolina School of Medicine. PMID- 6848758 TI - Changes in medical school applicant preparation and admission requirements in the behavioral sciences. PMID- 6848759 TI - Medical school education in hypertension management: a national survey. PMID- 6848760 TI - Effect of residents' use of laboratory tests on hospital costs. PMID- 6848761 TI - Ambulatory care in medical residency: integration of private practitioner's office with traditional sites. PMID- 6848762 TI - Effectiveness of the gynecology teaching associate in teaching pelvic examination skills. PMID- 6848763 TI - A summer program to prepare high school students for careers in the health sciences. PMID- 6848764 TI - Incomes of university-based family medicine faculty. PMID- 6848765 TI - Animals in biomedical and behavioral research. PMID- 6848766 TI - Physician faculty involvement in research. PMID- 6848767 TI - Can an invisible hand palpate the carotid pulse? PMID- 6848768 TI - Course for drug representatives. PMID- 6848769 TI - Ultrastructure of the nonhuman primate vaginal mucosa: epithelial changes during the menstrual cycle and pregnancy. AB - Ultrastructural changes in the vaginal epithelium of the rhesus monkey during the menstrual cycle and pregnancy were studied by scanning and transmission electron microscopy. During the menstrual cycle, the epithelium was keratinized but varied in thickness. Cells of the basal and parabasal layers were polyhedral in shape but as they differentiated they accumulated glycogen and filaments. Cells in the intermediate layers had keratohyaline and membrane-coating granules. Cells in the superficial layers had a thickened cell envelope, abundant keratin filaments, electron-dense intercellular material, and focal tight junctions. The epithelial surface had numerous microridges and numerous adherent bacteria; bacteria were rare on desquamating cells. The epithelium remained keratinized for about the first month of gestation, then underwent "mucification." The cells contained abundant granules and Golgi apparatus. Concomitant with this transformation, bacteria were no longer adherent to the epithelial surface and the surface cells had microvilli instead of microridges. The epithelial changes during pregnancy were roughly associated with the changing pattern of steroid hormone secretion during gestation. PMID- 6848770 TI - Freeze-fracture analysis of phloem structure in plant tissue cultures. I. The sieve element reticulum. AB - During the differentiation of phloem sieve elements, the endoplasmic reticulum undergoes unique modifications to form the sieve element reticulum (SER) which persists in mature, functioning sieve tubes. Cisternae of the SER lack ribosomes and are restricted to the periphery of the sieve element at late stages of development. Some of the SER is seen as single cisternae that are in close contact with the sieve element plasma membrane. Thin sections and freeze-fracture images of sieve elements formed in tissue cultures demonstrate that the SER consists of both single cisternae and regions of stacked cisternae at some stages of maturity. The unstacked regions of the SER are continuous with the cisternae of the stacked regions. In freeze-fracture images the single cisternae adjacent to the plasma membrane are seen to be fenestrated and the openings allow continuity between the plasma membrane and the cell lumen. It is concluded that the interface between the SER and the plasma membrane of the sieve element serves to allow membrane functions such as proton efflux, proton-sucrose cotransport and compensating movements of ions to occur in a microenvironment that is separated from the moving translocation stream in the sieve element lumen. Passage of water and translocated solutes from the plasma membrane or the SER/PM interface to the interior of the cell is enhanced by the openings in the fenestrated regions of the SER. It is suggested tha the SER may also play a role in channeling ATP from mitochondria associated with the SER to the proton-pumping ATPase in the plasma membrane and that the SER may function in the uptake and release of potassium ions in the sieve element. PMID- 6848771 TI - Synthesis and assembly of connecting-piece proteins as revealed by radioautography. AB - The synthesis and assembly of connecting-piece proteins have been studied during spermiogenesis in the rat by electron microscopy and radioautography following intratesticular injection of radiolabeled amino acids [3H]proline and [3H]cystine. Early in spermiogenesis (steps 1-7) the two centrioles that give rise to the connecting piece are essentially unmodified. During the 6.5-day period between steps 8 and 15, the major elements of the connecting piece (striated columns and capitulum) gradually become assembled from an electron dense material that is deposited around the walls of the centrioles; throughout this period, protein molecules containing proline and cystine are synthesized by the step 8-15 spermatids and incorporated into the developing neck region. These proteins subsequently become permanent structural components of the connecting piece. Following completion of the major elements in step 15, few additional proteins are added to the connecting piece during the final steps 16-19 of spermiogenesis. PMID- 6848772 TI - Membrane lipid metabolism in Chlamydomonas reinhardtii 137+ and y-1: II. Cytochemical localization of acyltransferase activities. AB - We have cytochemically localized the acyltransferase activities in the alga Chlamydomonas reinhardtii. Glycerol 3-phosphate (G3P) acyltransferase and lysophosphatidate (LPA) acyltransferase activities were cytochemically assayed utilizing biochemically optimized reaction conditions (Jelsema et al., 1982). The cytochemical assays clearly demonstrate that in the wild-type cells (137+) and the y-1 mutant, both enzymes were present in the photosynthetic membranes, envelope, and pyrenoid tubules of the chloroplast. Activity was also localized to the Golgi apparatus and its associated vesicles. Additionally, LPA acyltransferase activity was found associated with the outer mitochondrial membranes. The cytochemical data from this study confirm the biochemical data obtained using purified chloroplast membranes (Jelsema et al., 1982) and establishes the presence of these glycerolipid-synthesizing enzymes in the photosynthetic membranes of the chloroplast. These findings support the earlier reports of the presence and activity of lipid-synthesizing enzymes in the chloroplast, and also is in agreement with the postulated role of the pyrenoid tubules in the synthesis of the thylakoid membranes. This report differs in that these lipid-synthesizing enzymes have been localized to the chloroplast photosynthetic membranes themselves as well as exhibiting significant levels of activity for both enzymes in the Golgi apparatus. During light-induced chloroplast biogenesis in the yellow mutant of C. reinhardtii (y-1), the photosynthetic membranes appear to be the primary site of acyltransferase activity, suggesting that in situ synthesis of the membrane lipids during this period of rapid membrane formation is the primary mode for the synthesis of the thylakoid lipids. That these intrinsic thylakoid enzyme activities are not exclusively a function of the growth phase of the cell, but are found in mature chloroplast of the 137+ cells as well, further supports the conclusion that the photosynthetic membranes of the chloroplast have the capacity for synthesis of their own membrane lipids. PMID- 6848773 TI - The fine structure of Cymbidium ringspot virus infections in host tissues. III. Role of peroxisomes in the genesis of multivesicular bodies. AB - Ultrastructural studies of Nicotiana clevelandii plants systemically infected with Cymbidium ringspot virus, a member of the tombusvirus group, have shown that a clear-cut relationship exists between perioxisomes and multivesicular bodies (MVB). In infected cells, peroxisomes undergo a progressive vesiculation of the bounding membrane through the possible addition of membranous material by the endoplasmic reticulum and become very plastic. Portions of the ground cytoplasm are engulfed either through the invagination of the limiting membrane or the production of membranous appendages that fold back on the main body. Cytochemical tests have shown MVB to possess catalase and glycolate oxidase activity in the matrix. The vesicles contain RNA, a substantial amount of which is double stranded, as indicated by differential RNase digestion tests in high- and low salt media. The double-stranded RNA may consist of replicative forms or replicative intermediates of the viral nucleic acid. If so, MVB (i.e., modified peroxisomes) may be directly involved in the replication of Cymbidium ringspot virus. PMID- 6848774 TI - Formation of misplaced and reflexive tight junction strands in prostate epithelial cells. AB - Tight junction strands occur at three atypical locations in slices of rat ventral prostate exposed to conditions promoting rapid tight junction assembly: (1) in the basal plasma membranes of the columnar epithelial cells, over 40 microns from the native apical tight junction band (misplaced tight junctions); (2) in the plasma membranes of basal epithelial cells, which never have tight junctions in the native state; and (3) between processes of the same cell (reflexive or autocellular tight junctions) at the basal or lateral portions of the columnar epithelial cell. These findings suggest that tight junction formation is not limited to specific parts of the plasma membrane, even in highly polarized cells such as those in prostate epithelium. Taken together with other new evidence, they also suggest that tight junctions may be very labile. PMID- 6848775 TI - A topographical (SEM) analysis of acellular glomerular mesangial matrix in situ. AB - Normal kidneys from human and New Zealand white rabbits were made acellular by vascular perfusion with detergents. Cortical regions were dissociated from the central renal mass and further minced to 2 mm3 and fixed for TEM and SEM analyses. In an effort to visualize the internal histoarchitecture of glomerular basement membranes (GBM) and associated mesangial matrix (MM), some of the fixed samples were cryofractured prior to preparation for SEM observations. By this technique, the in situ MM exhibits a lacy network of fenestrated plates (septa) that separate and support peripheral glomerular channels. It seems possible that these structures may be intrinsically rigid and that their shape-preserving properties may be transmitted to the entire GBM. The matrix is not restricted to centrolobular zones, but extends throughout the glomerulus via a loose inner (endothelial-mesangial) layer of GBM. This filamentous layer is similar to MM in texture and surface characteristics and is often thrown into folds or trabeculae. In contrast, the outer (epithelial) surface of GBMs is more compact and smoothly contoured. Our SEM and correlative TEM studies indicate that the inner layer is continuous with MM septa distally and extends proximally to the glomerular vascular pole via arteriolar BMs where it reaches the extraglomerular interstitium. This establishes an extracellular morphological pathway from centrolobular zones to the polar cushion. PMID- 6848776 TI - 'Blue' parent, disturbed child: correlation shown. PMID- 6848777 TI - Medical education: prosperitas interrupta. PMID- 6848778 TI - "Bolus" injections of lidocaine. PMID- 6848779 TI - Runner's "high". PMID- 6848781 TI - Pediatric trauma. The No. 1 killer of children. PMID- 6848780 TI - Propranolol infusions after abdominal surgery. PMID- 6848782 TI - Organic brain syndrome. The psychiatric imposter. AB - Rapid differentiation of organic brain syndrome (OBS) from functional psychiatric illness can be difficult when patients come to an emergency department with predominantly psychiatric symptoms. Using four screening criteria-disorientation, abnormal vital signs, clouded consciousness, and patients older than 40 years with no previous psychiatric history-we detected 38 cases of OBS from 1,140 medically cleared patients. Twelve of these patients were subsequently admitted to a medical unit. Despite the presence of striking behavioral aberration, an increased awareness of the clinical manifestations of OBS will enhance the physician's ability to discriminate OBS from other psychiatric illness. PMID- 6848783 TI - Hallux-to-hand transfer during ankle disarticulation for multiple limb anomalies. PMID- 6848784 TI - Basophilic-eosinophilic meningitis in an undifferentiated myeloproliferative disorder. PMID- 6848785 TI - Family Medicine: the need for research. PMID- 6848786 TI - Day-care-associated infection: more than meets the eye. PMID- 6848787 TI - The 'bone within a bone'. PMID- 6848788 TI - Microcytosis. Its significance and evaluation. PMID- 6848789 TI - Arthritis patients get long-term help from total lymphoid irradiation. PMID- 6848790 TI - Stressed whites especially prone to 'trench mouth,' study finds. PMID- 6848791 TI - Blood substitutes: two ways to get there. PMID- 6848792 TI - Choice of blood substitutes in Chicago. PMID- 6848793 TI - The emergent importance of lymphokines. PMID- 6848794 TI - Duty to warn third parties. PMID- 6848795 TI - Dosage of acetaminophen. PMID- 6848796 TI - Absorption of enteric-coated aspirin. PMID- 6848797 TI - Smoking and acute respiratory illness. PMID- 6848798 TI - Risk factors in heatstroke. PMID- 6848799 TI - Management of heatstroke. PMID- 6848800 TI - Mortality from abortion and childbirth. PMID- 6848801 TI - Vaginal function in postmenopausal women. PMID- 6848802 TI - Another family with the Li-Fraumeni cancer syndrome. PMID- 6848803 TI - Women in medicine: two points of view. I. The future of women physicians. PMID- 6848804 TI - Women in medicine: two points of view. II. Medicine and motherhood. PMID- 6848805 TI - Boxers--computed tomography, EEG, and neurological evaluation. AB - During the last three years, 40 ex-boxers were examined to determine the effects of boxing in regard to their neurological status and the computed tomographic (CT) appearance of the brain. Thirty-eight of these patients had a CT scan of the brain, and 24 had a complete neurological examination including an EEG. The results demonstrate a significant relationship between the number of bouts fought and CT changes indicating cerebral atrophy. Positive neurological findings were not significantly correlated with the number of bouts. Electroencephalographic abnormalities were significantly correlated with the number of bouts fought. Computed tomography and EEG of the brain should be considered as part of a regular neurological examination for active boxers and, if possible, before and after each match, to detect not only the effects of acute life-threatening brain trauma such as subdural hematomas and brain hemorrhages, but the more subtle and debilitating long-term changes of cerebral atrophy. PMID- 6848806 TI - Pneumococcal pneumonia in hospitalized patients. Clinical and radiological presentations. AB - The clinical and radiological features of pneumococcal pneumonia were studied in 94 hospitalized patients. Fifty-seven (61%) had a bronchopneumonic pattern on roentgenogram, and 37 (39%), a lobar pattern. Eighty-two (87%) of the patients in both roentgenographic classifications had one or more underlying disease states. There was no difference in the frequency of heart disease, diabetes, chronic pulmonary disease, or malignancy between the two categories. Sputum Gram's stains were also similar in both patterns. Twenty (54%) of the 37 patients with the lobar pattern were bacteremic compared with only five (9%) of the 57 patients with the bronchopneumonic pattern; all five patients with bronchopneumonia and bacteremia had an associated malignancy. Although a lobar pattern is usually emphasized in the diagnosis of pneumococcal pneumonia, this study showed that the majority of patients hospitalized with pneumococcal pneumonia had a roentgenographic bronchopneumonic pattern rather than the classic lobar pattern. Thus, patients with the bronchopneumonic pneumococcal pneumonia pattern may be underdiagnosed. The implications are important both for treatment and for epidemiologic data used in the selection of pneumococcal types for prophylactic vaccines. PMID- 6848807 TI - Polytetrafluoroethylene graft survival in hemodialysis. AB - Expanded polytetrafluoroethylene (PTFE) graft fistulas are widely used as secondary vascular access for patients receiving long-term hemodialysis treatment. Sixty-seven grafts were implanted in 48 patients and followed for 12 to 51 months. Cumulative patency for all grafts at 12 months was 67% +/- 6%, at 24 months 50% +/- 7%, and at 48 months 43% +/- 9%. Graft survival rates were different when considering graft configuration and location. Forearm straight graft survival at 12 months was 35% +/- 13%, upper arm curved grafts 60% +/- 19%, and forearm looped grafts 78% +/- 7%. Complications that decreased graft survival were related to thrombosis (21%), infection (25%), and intimal hyperplasia at the venous anastomosis (34%). After reviewing our experience, we believe that the challenge of secondary vascular access has not been solved by PTFE grafts. This should stimulate the search for better grafts and techniques. PMID- 6848808 TI - Bacterial contamination of arterial lines. A prospective study. AB - One hundred seventeen patients had indwelling arterial illness for hemodynamic monitoring and blood sampling. The duration of catheterization varied from 25 to 439 hours, during which time no components of the system were replaced. In contrast to other reports, our study showed no instance of contamination of transducer dome fluid when the continuous flush device was located just distal to the transducer. The sampling stopcock showed bacterial growth in 16.2% of patients. In the one case in which the arterial catheter tip, stopcock, and patient's blood showed the same organism, culture of the transducer fluid was negative. Our results suggest that elimination of a static inline fluid column and proper aseptic sampling technique limit risk to the patient of transmitted bacterial infection from the fluid in the system. Routine changes of components of the system are not indicated and a substantial cost saving can be achieved. PMID- 6848809 TI - The California experience with the diversion program for impaired physicians. AB - Since January 1980, following a change in California law, impaired physicians have been given the opportunity to be diverted from possible medical board discipline into a statewide treatment program financed by the Board of Medical Quality Assurance. The success of the program has depended on a rapid response mechanism, an individualized treatment program, an ironclad confidentiality, and a multilevel monitoring system. This nondisciplinary approach has made it easier for physicians to encourage their sick colleagues to volunteer for treatment. The experience after 2 1/2 years indicates that impaired physicians are found and treated more quickly when legal restrictions against the physicians' licenses are avoided. Of the 117 physicians currently participating in the California Diversion Program, 109 have been able to continue their practice of medicine while undergoing treatment. PMID- 6848810 TI - Response of thiazide-induced hypokalemia to amiloride. AB - The effects of amiloride hydrochloride on thiazide-induced hypokalemia were evaluated. In metabolic balance studies, amiloride reversed thiazide-induced urinary potassium loss, restored plasma bicarbonate concentration and pH to pretreatment levels, and produced further increases in aldosterone secretion. Effects of long-term administration of hydrochlorothiazide and an amiloride hydrochlorothiazide combination were compared in outpatients who had experienced thiazide-induced hypokalemia while receiving oral potassium supplements. After eight weeks, those given hydrochlorothiazide alone had an average serum potassium level of 3.01 +/- 0.08 mEq/L). Those given the amiloride-hydrochlorothiazide combination had an average serum potassium level of 3.75 +/- 0.008 mEq/L, not significantly different from the control value (3.82 +/- 0.08 mEq/L). Both groups had increased plasma aldosterone concentrations and plasma renin activity. The potassium-conserving effect of amiloride persisted with extended therapy. PMID- 6848811 TI - Efficacy of graded elastic compression in the lower leg. AB - Graded elastic compression stockings on the lower leg were evaluated for their ability to (1) decrease leg volume, (2) decrease circumference, and (3) alleviate discomfort. One hundred three test subjects participated in this study, including 30 normal, asymptomatic control subjects. The conditions of the 73 symptomatic patients were categorized by pain and swelling, varicose veins, venous stasis, lymphedema, and phlebitis, which constituted symptoms in 120 legs. Although total body weight did not change during the week of observation, the volume, circumference, and pain decreased in the symptomatic group. The volume of the stockinged leg decreased in comparison with the nonstockinged control leg in the asymptomatic subjects as well. We conclude that non-custom-made graded elastic stockings with 24 mm Hg of pressure at the ankle are effective in decreasing volume, circumference, and symptoms in the lower leg in patients with minimal problems during a one-week period. PMID- 6848812 TI - Radionuclide cerebral imaging confirming brain death. AB - Cerebral blood flow (CBF) was measured by portable radionuclide cerebral imaging (RCI) and by four-vessel cerebral contrast arteriography in 15 clinically brain dead patients, including six children. Neither technique showed evidence of CBF, although four RCI scans showed sagittal sinus activity. Portable scanning techniques are therefore considered valid determinants of brain death and may be useful in lieu of contrast cerebral arteriography. PMID- 6848813 TI - Emphysematous cholecystitis. A case report. PMID- 6848814 TI - Boxing should be banned in civilized countries. PMID- 6848815 TI - The deadly degrading sport. PMID- 6848816 TI - Brain injury in boxing. Council on Scientific Affairs. PMID- 6848817 TI - Bone cells on microcarrier spheres. PMID- 6848818 TI - Hypnosis gains legitimacy, respect, in diverse clinical specialties. PMID- 6848819 TI - Hypnosis for burn patients: healing body and spirit. PMID- 6848820 TI - Helping the dying to live--through hypnosis. PMID- 6848821 TI - Lentigo maligna melanoma yields to radiotherapy. PMID- 6848822 TI - Gefilte fish does not transmit diphyllobothriasis. PMID- 6848823 TI - Interaction of cimetidine and alcohol. PMID- 6848824 TI - Chronic pneumococcal infection complicating progressive lymphoma. PMID- 6848825 TI - Dog poisons man. PMID- 6848826 TI - Improvement of dementia. PMID- 6848827 TI - Breast feeding. PMID- 6848828 TI - Weight lifting and amenorrhea. PMID- 6848829 TI - Lactic dehydrogenase activity in human pheochromocytoma. AB - Lactic dehydrogenase (LDH), a cytosolic enzyme found in neural and endocrine tissue, was measured in serum and tumor tissue of 15 patients with pheochromocytoma, a neuroendocrine neoplasm. Mean serum total LDH activity was higher in patients with pheochromocytoma than in patients with essential hypertension, normotensive control subjects, or those with various other categories of secondary hypertension. The prominent isoenzyme was LDH type 3. Their pheochromocytoma tissue, as well as normal human adrenal tissue, also contained LDH, maximally type 3; the amount of LDH in tumors far exceeded that in normal adrenal glands, suggesting that the tumor tissue is the source of the excessive serum LDH in these patients. While a large percentage of false-negative results (40%) does not render serum LDH activity a reasonable screening test for pheochromocytoma, and even though the true-positive rate is high (100%), we cannot yet recommend that hypertensive patients with high serum LDH activity undergo investigation for this tumor. PMID- 6848830 TI - Vagal syncope during recurrent pulmonary embolism. AB - The mechanism for syncope during pulmonary embolism is not well understood. We describe two patients with transient sinus bradycardia and atrioventricular (AV) block during syncope from recurrent pulmonary embolism. Consciousness was regained each time the rhythm returned to normal. We believe that the syncope and bradyarrhythmia was caused by a parasympathetic reflex, since simultaneous slowing of the sinus rate with concomitant AV block is a common manifestation of increased vagal tone. Such a reflex is consistent with known cardiac reflexes, may occur frequently, and may be one of the mechanisms for syncope in patients with pulmonary embolism. PMID- 6848831 TI - Hepatic injury possibly induced by verapamil. PMID- 6848832 TI - Renal failure and tubular dysfunction due to zomepirac therapy. PMID- 6848833 TI - Renovascular hypertension: diagnostic problems and therapeutic implications. PMID- 6848834 TI - Chronic anovulation may increase postmenopausal breast cancer risk. PMID- 6848835 TI - Immune complexes initiate RSV pathology. PMID- 6848836 TI - Carbohydrate diet satisfies stomach, scale. PMID- 6848837 TI - CT scanner to become neurosurgical tool. PMID- 6848838 TI - Balking at radiotherapy may signal underlying anxieties. PMID- 6848839 TI - Insomniacs give up stress and medications. PMID- 6848840 TI - Abortion legislation. PMID- 6848841 TI - Irritation from scented toilet tissue. PMID- 6848842 TI - Obsessive video-game users. PMID- 6848843 TI - Oral solutions for fluid and electrolyte replacement. PMID- 6848844 TI - Lipoprotein abnormalities and viral infections. PMID- 6848845 TI - Computed tomographic scan premedication in children. PMID- 6848846 TI - Passive inhalation of marijuana smoke and urinary excretion cannabinoids. PMID- 6848847 TI - How safe should drugs be? PMID- 6848848 TI - Epidemiology of minimal breast cancer. AB - A case-control study conducted within the Breast Cancer Detection Demonstration Project allowed comparison of epidemiologic factors for benign breast diseases (n = 1,404), in situ cancer (n = 199), small (less than or equal to 1 cm) invasive cancer (n = 210), and larger invasive cancer (n = 788). Control subjects consisted of program participants who were not recommended for breast biopsy. Relationships were similar for small and larger invasive tumors, both showing associations with family history of breast cancer, age at first live birth, history of bilateral oophorectomoy, and obesity. In situ cancer was affected by family history and age at first childbirth but not by oophorectomy or obesity. These findings support the notion that "minimal" breast cancer is indeed cancer. In addition, the results suggest that hormonal influences early in life may initiate the carcinogenic process, while those that operate later may enhance the progression from in situ to invasive disease. PMID- 6848849 TI - Profile of women practicing breast self-examination. AB - The monthly practice of breast self-examination (BSE) can result in the early diagnosis of breast cancer. To explore factors that influence women's habits in the practice of BSE, we interviewed 616 women using an interactive computer program. We found that these women were more likely to practice BSE on a frequent basis if they were living with their sexual partner, had been shown how to perform BSE, and were confident in their examination technique. Women with a maternal history of breast disease were also more likely to practice monthly BSE. Unlike past reports that women with formal education beyond high school practice BSE more frequently than less-educated women, our study showed no association between monthly BSE practice and formal education. Contrary to our hypothesis that BSE practice was associated with the practice of other preventive health activities, our study did not demonstrate such a relationship. These findings suggest that demonstrating BSE at the periodic health examination may help increase the number of women practicing BSE on a frequent basis. PMID- 6848850 TI - Dengue fever in the United States. A report of a cluster of imported cases and review of the clinical, epidemiologic, and public health aspects of the disease. AB - In the United States during 1981, fourteen state health departments reported a total of 44 imported cases of dengue fever. Most originated in the Caribbean, where dengue type 4 has reached pandemic proportions. Because the mosquito vector for dengue is abundant throughout the southeast and imported cases continue to occur, the possibility exists for indigenous dengue transmission. We report a cluster of imported dengue type 1 cases in Florida, discuss the clinical, epidemiologic, and public health aspects of the disease, and make recommendations as to how clinicians can assist public health officials in minimizing the risk of indigenous dengue transmission in the United States. PMID- 6848851 TI - Physician's management of the psychological aspects of rape. PMID- 6848852 TI - Pasteurella multocida septicemia. Experience at a cancer hospital. AB - Pasteurella multocida most commonly infects patients with animal contacts. Life threatening systemic disease is distinctly uncommon in otherwise healthy persons and usually occurs in patients with chronic predisposing disease. Two cases of sepsis occurred in a cancer hospital, and we surmise that specific predisposing factors existed in our patients as in prior reported cases of sepsis in patients without cancer. These factors include animal contact, open wounds, and, most important, advanced hepatic disease. PMID- 6848853 TI - Nasal cancer in a worker exposed to formaldehyde. AB - Formaldehyde has not been established as a human carcinogen. Toxicological studies have, however, demonstrated that formaldehyde causes squamous cell carcinoma of the nasal cavity in rats. A case of squamous cell carcinoma of the nasal cavity occurred in a 57-year-old man who had 25 years of occupational exposure to low concentrations of formaldehyde in the textile-finishing industry. PMID- 6848854 TI - Pasteurella multocida infection of a prosthetic vascular graft. PMID- 6848855 TI - More from the pesky Pasteurella. PMID- 6848856 TI - Cosmetic facial surgery. PMID- 6848857 TI - The battle for hospital privileges. I. Access to the judicial forum. PMID- 6848858 TI - Preventing AIDS transmission: should blood donors be screened? PMID- 6848859 TI - In ICU and OR, computers lead the way. PMID- 6848860 TI - Second-trimester abortion. PMID- 6848861 TI - Incidental asymptomatic adrenal mass detected by computed tomographic scan. PMID- 6848862 TI - Phthirus pubis infestation of the lashes. PMID- 6848863 TI - Methemoglobinemia after sulfametoxazole and trimethoprim. PMID- 6848864 TI - Heat and multiple sclerosis. PMID- 6848865 TI - More on turtle headaches. PMID- 6848866 TI - Intracutaneous serial dilution end-point titration. PMID- 6848867 TI - Outpatient intravenous antibiotic therapy. PMID- 6848868 TI - Information, computers, and clinical practice. PMID- 6848869 TI - Demand v need v physician prerogatives in the use of the WBC differential. AB - The clinical use of the WBC differential was investigated before and after it was made available on demand. The results indicate that no consistent policy existed in our hospital for the ordering of a differential. When differentials were made available on demand, the number of differentials did not increase compared with earlier periods. The demand for differentials may have been caused more by the denial of a physician's prerogative to order a differential rather than by its requirement for patient care. PMID- 6848870 TI - Quantitative buffy coat analysis. A new laboratory tool functioning as a screening complete blood cell count. AB - We have developed a system for the quantitative analysis of the buffy coat in centrifuged whole blood samples. This analysis, performed in a modified microhematocrit tube, provides a hematocrit value, total WBC count, platelet count, and a separation of the leukocyte population into granulocytes and nongranulocytes. All results are available within 15 minutes and correlate well with existing methods. The system is expected to provide a rapid means of performing a complete blood cell count in a physician's office. PMID- 6848871 TI - Changing patterns of methaqualone abuse. A survey of 246 fatalities. AB - Of 246 methaqualone-related deaths identified during an 11-year period (1971 through 1981), 76% have occurred since 1977 and 72% have involved fatal trauma. One third of the victims died in vehicular crashes. Sharp increases in methaqualone-related traumatic suicides, nonvehicular accidents, and homicides have occurred since 1978. This report discusses demographic and toxicological findings, particularly in regard to counterfeit methaqualone. The pattern of fatal methaqualone abuse has changed from an overdose phenomenon in the early 1970s to one of traumatic death. Victims frequently have exhibited poor judgment, impulsive behavior, and somnolence while attempting to function in their environment. The socioeconomic impact of recreational methaqualone abuse should be curtailed by appropraite governmental action and restraint in the prescribing of methaqualone. PMID- 6848872 TI - The importance of the WBC count in peritoneal lavage. AB - A subset of ten consecutive patients who had sustained penetrating and blunt abdominal trauma came to the hospital with stable vital signs. None had any clinical evidence of intraperitoneal injury. All patients underwent peritoneal lavage, and surgical exploration was performed on the basis of a 100,000/cu mm in the effluent. Substantial intraperitoneal injury was found in nine of ten patients. We suggest that as a further refinement of peritoneal lavage, in addition to RBC count, the WBC count be measured in the effluent fluid and if it is found to be greater than 500/cu mm, surgical exploration be carried out. PMID- 6848873 TI - Perseverance of laboratory test ordering: a syndrome affecting clinicians. PMID- 6848874 TI - Peritoneal lavage and abdominal trauma. PMID- 6848875 TI - Multivariate analysis. Some guidelines for physicians. AB - "Mystified" best characterizes the feeling of many physicians as they read the results of a multivariate analysis. Much of the mystery disappears when two items are shown: (1) explicit tabulations revealing how each factor selected by the analysis relates to outcome, both singly and jointly with other factors; and (2) alternative models generated by repeating the analysis after removing the most important variables one by one from the list of factors that was initially analyzed. In this way, one can determine which variables are good stand-ins or substitutes for the best variables in the initial analysis. Showing these substitutes may expose exaggerations in benefits attributed to a particular therapy (ie, elective regional node dissection for clinical stage I malignant melanoma). We have applied these guidelines to examples in the literature, particularly studies of malignant melanoma. PMID- 6848876 TI - Radiology of asbestos disease. PMID- 6848877 TI - Breech presentation and parity: the proof of the pelvis. PMID- 6848878 TI - Ten to fifteen year reassessment of the performance characteristics of the Starr Edwards Model 6120 mitral valve prosthesis. PMID- 6848879 TI - Acquired ventricular septal defect. AB - The past 9 years' experience with ventricular septal rupture complicating myocardial infarction has been reviewed. Thirty-six patients were treated surgically, with 10 early deaths (28%) and one late death, for an 8 year actuarial survival rate of 63%. The mortality was highest for those defects which followed inferior infarction, 38% compared with 13% following anterior infarction. The infarction-operation interval also greatly influenced mortality; under 2 weeks, 43%; over 2 weeks, 18%. Concomitant coronary artery bypass grafts (13 patients) or left ventricular aneurysmectomy (14 patients) did not carry an increased mortality. Of 17 patients who presented with cardiogenic shock, eight died (47%). The intra-aortic balloon pump (IABP) was used in 16 patients (44%) and helped greatly in the management of the critically ill. With an estimated 17 acquired septal defects occurring each year in persons under 65 years of age in Wessex, awareness of this complication and of the favorable outcome of operation is essential among those who treat the aftereffects of myocardial infarction. PMID- 6848881 TI - Successful repair of symptomatic cor triatriatum dexter in infancy. AB - Cor triatriatum dexter is a rare cardiac malformation, usually diagnosed incidentally at operation or necropsy. We report the case of a 5-month-old infant, severely symptomatic, who underwent correction of a highly obstructive cor triatriatum dexter, with multiple anomalies of the systemic venous return and a large interatrial communication. This appears to be the first case of successful repair of this anomaly during infancy. PMID- 6848880 TI - Massive hemoptysis. Review of 123 cases. AB - Case histories of 123 patients with massive hemoptysis were reviewed. The causes of hemorrhage were active pulmonary tuberculosis (47), bronchiectasis (37), chronic necrotizing pneumonia (11), lung abscess (six), lung cancer (six), bronchovascular fistula (five), primary pulmonary fungal infection (four), and miscellaneous (seven). Conservative management was used in 66 patients, with 21 deaths (31.8%). Surgical management was used in 34 patients, with six deaths (17.6%). Endobronchial iced saline lavage was used in 23 patients, with one death. All patients treated by lavage stopped bleeding, and further therapy, either surgical (five) or medical (18), was given as appropriate. The early control of tracheobronchial hemorrhage by endoscopic means is an effective though transitory holding procedure. The unpredictability of massive hemoptysis is underscored by eight deaths from sudden, engulfing hemorrhage in seemingly stable patients awaiting endoscopy or operation. PMID- 6848882 TI - Partial reconstruction of right ventricular outflow tract without cardiopulmonary bypass. PMID- 6848883 TI - Rupture of aortic aneurysm into pulmonary artery. PMID- 6848884 TI - Use of a subpulmonary ventricular chamber in the Fontan circulation. AB - In order to study the usefulness of incorporating a subpulmonary ventricular chamber (SPVC) in the Fontan circulation, we compared the hemodynamics of 18 patients who underwent an atriopulmonary connection with those of 17 patients with an atrioventricular connection. Early postoperatively, regardless of whether an SPVC was incorporated or not, the mean pulmonary artery pressure was not higher than the mean right atrial pressure in any of our patients. The stroke work of the right heart was at best zero, and pressure tracings showed an a wave in the pulmonary artery (right atrium-dependent circulation). If an additional gradient was interposed between the right atrium and pulmonary artery, the effective stroke work of the right heart might be negative and the work curve have a negative slope. This can occur irrespective of the use of an SPVC. In the long term, if it grows sufficiently, an SPVC can sometimes provide a right ventricle-dependent pulmonary circulation with a more normal hemodynamic pattern (mean right atrial pressure less than mean pulmonary artery pressure). We concluded that an SPVC should be used in Fontan's circulation, provided that an obstruction-free atrioventricular connection can be established. PMID- 6848885 TI - Double-outlet right ventricle. Surgical results, 1970-1980. AB - Between Jan. 1, 1970, and Jan. 1, 1980, 62 consecutive patients underwent repair of classic double-outlet right ventricle (DORV). Patients with subpulmonic ventricular septal defect (VSD), complete atrioventricular canal, atrioventricular discordance, and univentricular heart were excluded. One hundred six associated defects were present in 54 patients. Forty-six patients had pulmonary stenosis. The 36 male and 26 female patients ranged in age from 8 months to 37 years (median age 9 years). The early mortality was 11% for those with pulmonary stenosis, 25% for those without pulmonary stenosis, and 15% for the entire series. The risk of mortality was related to the age of the patient at operation. Causes of early deaths included low cardiac output (three patients), high residual right ventricular pressure (three patients), anomalous coronary artery injury (one patient), infection (one patient), and hemorrhage (one patient). Eleven late deaths occurred among the 53 operative survivors (21%). Ten (91%) of the late deaths were attributed to arrhythmia. All except one of the long-term survivors are in Functional Class I or II. Although the operative mortality for the repair of DORV continues to decrease, the late mortality is of concern, and the problem of late arrhythmia necessitates further study and analysis. PMID- 6848886 TI - Surgical therapy for congenital aortic valvular stenosis. A 23 year experience. AB - This is a review of 70 consecutive patients (2 to 20 years old) who underwent valvotomy for congenital aortic valvular stenosis from 1958 through 1980. A tricuspid valve was created in 36, a bicuspid valve in 33, and a valve prosthesis was inserted in one, with two operative deaths (2.8%). There were four late deaths, three due to noncardiac causes. Eleven patients required reoperation from 2 to 21 years (mean 11.3 years) after valvotomy, with two deaths. Seven patients underwent valve replacement. One patient died 9 years after a second valvotomy. The overall survival rate including reoperation was 92.6% for 10 years and 86% for 15 years. Of 53 surviving patients free of reoperation, 49 are in New York Heart Association Class I and four are in Class II. One of the patients in Class II is a candidate for reoperation. The other 52 patients are well. Twenty-three have normal stress tests, and only one of 24 studied has a pressure gradient greater than 50 mm Hg. We concluded from this experience that valvotomy effectively and safely relieves left ventricular outflow tract (LVOT) obstruction produced by congenital aortic valvular stenosis. It delays the time when a prosthetic device will be required to relieve LVOT obstruction. PMID- 6848887 TI - Long-term evaluation of pericardial substitutes. AB - The development of postoperative pericardial adhesions increases the risk of cardiac reoperations because of the danger of damaging the heart, great vessels, or grafts. Several pericardial substitutes have been tested in the past in an attempt to facilitate reoperation, with inconclusive results. This study evaluated eight different materials as pericardial substitutes: six synthetic materials and two different preparations of bovine pericardium. In 32 dogs a 10 by 5 cm piece of pericardium was excised through a right thoracotomy and the defect closed with a measured patch. Each material tested was implanted in four dogs that were put to death at 3, 6, 9, and 12 months. At autopsy the development of adhesions and epicardial reaction were graded as none, minimal, moderate, and severe. Histologic studies of the patch, the epicardium, and the suture line were performed. Our results suggest that both types of bovine pericardium were an excellent substitute. Although minimal adhesions developed, these were easily dissected. The underlying anatomy was clearly recognizable because of the lack of epicardial reaction. Silicone rubber-coated polyester fabric was an acceptable material for the prevention of adhesions, but a severe fibrous epicardial reaction impeded the recognition of the coronary arteries. Both silicone-filled and high-porosity polytetrafluoroethylene (PTFE) films reduced adhesions but caused a severe epicardial reaction. The other synthetic materials were considered inferior because of severe epicardial reaction and/or structural deterioration. PMID- 6848888 TI - En bloc resection for neoplasms of the esophagus and cardia. AB - The principles of en bloc resection for carcinoma can be adapted to neoplasms of the esophagus. The techniques of the operation are described. Among the 80 patients undergoing radical resection, there were nine (11%) hospital deaths within 30 days of operation. The actuarial survival rate was 24% at 3 years and 18% at 5 years. There have been no recurrences of cancer more than 3 years after operation. Results have been significantly worse among 12 patients receiving preoperative radiation therapy than in 68 in whom operation was the first treatment (1 year survival rates, 17% versus 60%). There have been no significant differences in results based upon cell type or tumor location, but patients with diseased lymph nodes or full-thickness wall penetration of the tumor had a significantly poorer survival at 2 years than patients without these determinants of prognosis. Radical en bloc resection for carcinoma of the esophagus can be performed with a mortality rate no greater than that from the less extensive standard esophagectomy. A few patients may become long-term survivors after this operation despite unfavorable prognostic factors. The operation provides improved pathological staging as a guide to prognosis and need for subsequent adjuvant therapy. PMID- 6848889 TI - Esophagectomy without thoracotomy: a dangerous operation? PMID- 6848891 TI - Thymectomy in multiple sclerosis. Two preliminary trials. AB - In two preliminary trials, thymectomy was performed on 35 multiple sclerosis (MS) patients, with (Group 1) or without (Group II) azathioprine therapy for 1 year. Formal studies of clinical neurologic status were conducted at yearly intervals after operation. Each group was compared with carefully matched control patients. Group I patients showed significant improvement in total functional groups (Kurtzke scale) and pyramidal functions 1 and 2 years following thymectomy. Other individual functions showed no significant difference. There was a statistical improvement in disability status (Kurtzke) for patients with relapsing-remitting MS 1 and 2 years following thymectomy. This subset also had a significant decrease in MS exacerbations. Group II patients showed none of the favorable trends seen in Group I. Functional groups, disability status scale, and exacerbations were similar to those of the control patients. Several studies indicate azathioprine therapy alone is of questionable benefit in MS. In myasthenia gravis (MG), the full immunosuppressive effect of thymectomy may not be realized for several years. Therefore, it is possible that in Group I patients a dual mechanism of immunosuppression--azathioprine and thymectomy--is yielding a favorable response not yet apparent in the Group II patients having thymectomy alone. If our data still appear favorable after a third follow-up year, a formal pilot study will be undertaken. PMID- 6848890 TI - Total fundoplication gastroplasty. Long-term follow-up in 500 patients. AB - Total fundoplication gastroplasty was designed to combine the low anatomic recurrence rate of gastroplasty with the effectiveness of reflux control obtained by total wrap. The problems requiring evaluation are anatomic recurrence, continued reflux, dysphagia, inability to belch or vomit, and gas bloat, all of which have been described in procedures employing a total wrap. Five hundred consecutive patients were analyzed 6 to 60 months following operation. There were no deaths and a 3.6% incidence of short-term operative morbidity. Follow-up was available clinically in 98.4% (495 patients), radiologically in 89.6% (448), and manometrically in 69.5% (347). Two patients have anatomic recurrence (0.4%) and none has reflux. Excellent results occurred in 93.4% (467), improvement in 5% (25), and poor results in 1.6% (eight). Repeat operation was necessary in 0.4% (two) for recurrence and in 0.8% (four) for severe dysphagia. The other problems were minor dysphagia in 2.2% (11), gastritis in 1.2% (six), late cholelithiasis in 0.4% (two), and continued pain with poor results in 0.4% (two). The length of the gastroplasty tube and the subdiaphragmatic position of the high-pressure zone (HPZ) did not affect the result of the operation. A long tube and unwrapped supradiaphragmatic HPZ was present in 18.8% (94); none had reflux or major dysphagia. Total length of the gastroplasty wrap was 3 to 4 cm in the first 200 and the incidence of major dysphagia was 5% (10). Reducing the length of fundoplication to 1.5 to 2 cm reduced the incidence of dysphagia to 1.7% (five). Other problems of gastritis and difficulty with belching and vomiting occurred in a random fashion. This procedure is effective in reflux control, prevents anatomic recurrence and, if the completed fundoplication is maintained at 1.5 to 2 cm, yields a low incidence of significant dysphagia. PMID- 6848892 TI - Aneurysms of the descending aorta. Surgical experience in 48 patients. AB - Uniformity of opinion does not exist concerning an optimal surgical strategy for descending aortic aneurysms. In order to assess the impact of surgical technique on operative mortality, morbidity, late outcome, we reviewed 48 consecutive patients operated upon from 1976 to 1980. Average age was 61 years, and 37 patients (77%) were men. The average interval of aortic occlusion in the Gott shunt group was 48 minutes, which was significantly longer than that of patients operated upon without shunts (30 minutes). No patient in the Gott shunt group had postoperative paraplegia, but it was noted in two patients (18%) treated without a shunt. Operative deaths in patients with Gott shunts were caused by cardiac (two patients), neurologic (one patient), pulmonary (one patient), and abdominal (two patients) factors. A pulmonary embolus caused the single postoperative death in the "no shunt" group, and another patient died intraoperatively. A group of seven patients were treated by temporary femoral vein--femoral artery bypass because of extensive aneurysmal disease, advanced associated major systemic disorders, or anticipated excessive hemorrhage when the aneurysm was opened. All patients survived free of neurologic sequela, but one developed a reversible intraoperative coagulopathy. This study underscores the safety and usefulness of the femoral vein--femoral artery bypass in treating certain descending thoracic aneurysms and reinforces the importance of several technical guidelines concerning the proper insertion and use of the Gott shunt. These guidelines would have significantly reduced the observed operative morbidity and mortality. PMID- 6848893 TI - Hypernatremia induces hyperlipemia and a fatty liver. AB - Hypernatremic states, often the result of hypothalamic osmoreceptor dysfunction in humans, are sometimes accompanied by hyperlipemia. To investigate whether hypernatremia could cause hyperlipemia we induced hypernatremia in three groups of rats with their respective controls: Group A rats received hypertonic saline alone intragastrically; group B animals were pair-fed and tap water was substituted for hypertonic saline in the treated group; in group C the rats were again fed intragastrically with a liquid diet mixed with hypertonic saline. Rats receiving excess salt had mean serum Na+ concentrations exceeding 159 mmoles/l. While the serum triglyceride values were significantly higher in all hypernatremic rats, hepatic triglyceride content was greater only in group C rats (p less than .01). Serum free fatty acids and ketone bodies were also higher in group C rats (p less than .01) as compared to controls. These data suggest that hypernatremia by itself leads to hyperlipemia and a fatty liver. PMID- 6848894 TI - Increased exercise level and plasma lipoprotein concentrations: a one-year, randomized, controlled study in sedentary, middle-aged men. AB - Eighty-one sedentary but healthy men aged 30-55 participated in a 1 yr randomized study of the effects of exercise on plasma lipoprotein concentrations. Forty eight were assigned to a running program, while 33 remained as sedentary controls (an approximately 3:2 ratio). After 1 yr the running group had become significantly fitter and leaner than the control group. Lipoprotein concentration changes in the runners (vs. controls) uniformly favored reduced risk of coronary heart disease, but were not significant when all 46 participants with complete data were included. However, the 25 men who averaged at least eight miles (12.9 kilometers) per wk of running increased their plasma high-density-lipoprotein (HDL) cholesterol level by 4.4 mg/dl (p = 0.045) and their HDL2 mass level by 33 mg/dl (p = 0.059), vs. controls. Significant correlations were found for distance run per wk vs. change in plasma HDL-cholesterol (r = 0.48), HDL2 (r = 0.41), and low-density-lipoprotein cholesterol (r = -0.31). Changes in percent body fat and in HDL-cholesterol were correlated (r = -0.47) in runners. There appears to be a threshold at about 8 miles per wk above which a 1-yr running program leads to beneficial lipoprotein changes. PMID- 6848895 TI - Increased blood-brain transport of tryptophan after portacaval anastomoses in germ-free rats. AB - Portal-systemic shunting in rats results in altered plasma concentrations of the large neutral amino acids (NAA), and increased blood-brain barrier NAA transport. Bacterial ammonia production in the bowel, especially the colon, is thought to play a major role in the etiology of portal-systemic encephalopathy (PSE). In order to isolate the role of bacteria in PSE, plasma and brain amino acids and ammonia (NH3) were studied in germ-free (GF) rats with portacaval shunts (PCS). Germ-free rats underwent end-to-side portacaval shunt or sham operation under germ-free conditions and were kept in a germ-free isolator under careful bacteriologic control. Similar operations were carried out on conventional animals. Two weeks post-operatively blood-brain transport of the neutral amino acid tryptophan was studied and the animals sacrificed. Plasma NH3 rose after PCS both in GF and in conventional rats. In germ-free and conventional rats with PCS, there was a significant elevation in plasma of the aromatic amino acids and decreased concentrations of the branched-chain amino acids. In the brain, both groups had elevated aromatic amino acids, while the branched-chain amino acids remained normal. The blood-brain transport of tryptophan was elevated in portacaval shunted rats, whether germ-free or conventional. These studies suggest the elevated plasma levels of ammonia and disturbances in plasma and brain amino acids seen after portacaval shunt are not dependent on the presence of gut bacteria. PMID- 6848896 TI - Role of the mitochondrial metabolism of pyruvate on the regulation of ketogenesis in rat hepatocytes. AB - In hepatocytes isolated from fed rats the inhibition of lipogenesis (-80%) by 5 tetradecyloxy-2-furoate (an inhibitor of acetylCoA carboxylase) and alpha-cyano-3 hydroxycinnamate (an inhibitor of pyruvate entry into mitochondria) increases the oxidation of 0.35 mM oleate respectively by 70% and 90%. 5-tetradecyloxy-2 furoate increases ketone body production from oleate only by 30% and has no effect on ketogenesis from octanoate, whereas alpha-cyano-3-hydroxycinnamate mimics the effects of fasting on ketone body production: It increases ketogenesis from 0.35 mM oleate by 90%, from 0.78 mM oleate by 25% and from 1.57 mM butyrate by 37%. alpha-cyano-3-hydroxycinnamate also decreases the activity of tricarboxylic acid cycle and the production of malate and citrate. In hepatocytes from fasted rats, alpha-cyano-3-hydroxycinnamate does not modify ketogenesis from oleate, unless cells are incubated with a mixture of lactate and pyruvate. A lactate and pyruvate mixture decreases ketogenesis from oleate and octanoate and increases citrate and malate production without modifying the uptake of fatty acids. This effect is potentiated by 3-mercaptopicolinate, an inhibitor of phosphoenolpyruvate carboxykinase. The results cannot be interpreted only by the effects of malonylCoA on carnitine acyltransferase. They are discussed with respect to the possible involvement of mitochondrial oxaloacetate concentration in the regulation of ketogenesis. PMID- 6848897 TI - Secretion of pancreatic polypeptide in man in response to beef ingestion is mediated in part by an extravagal cholinergic mechanism. AB - The effect of atropine, a muscarinic cholinergic blocking agent, on the response of plasma pancreatic polypeptide (hPP) to the ingestion of beef was investigated. Six healthy subjects ingested 250 g broiled ground beef on three occasions. After beef ingestion alone, the expected biphasic plasma hPP response was observed. On the two other occasions atropine (intravenous bolus followed by infusion) was begun either at 4 or 60 min after the beginning of beef ingestion so as to coincide with the early (first) and late (second) phases of hPP response to beef ingestion. On both occasions plasma hPP concentrations returned rapidly to baseline. Mean integrated incremental hPP responses in the absence of atropine were 9.1 +/- 3.4 ng min ml-1 for the first phase (0-40 min) and 29.7 +/- 5.7 ng min ml-1 for the second phase (60-180 min); with atropine at 4 min, respective responses were 0.8 +/- 0.9 and -1.0 +/- 1.3 ng min ml,-1 and with atropine at 60 min they were 10.6 +/- 5.0 and 1.3 +/- 1.6 ng min ml.-1 After atropine administration, the half-time of disappearance of hPP from the circulation was 4 6 min, suggesting the complete cessation of stimulated hPP secretion. We conclude that the mechanisms of both the early and late phases of beef meal-stimulated release of hPP involve muscarinic cholinergic-neural transmission. The portion of the second (late) phase response which has been shown to persist after truncal vagotomy must be mediated by a cholinergic mechanism which is extravagal in character. PMID- 6848898 TI - Influence of a palatable, high-fat diet, and exercise training on the high density lipoprotein to total cholesterol ratio in the rat. AB - The influence of a palatable, high-energy diet, and exercise training on the levels of serum total cholesterol (CHOL) and CHOL carried by high-density lipoproteins (HDL CHOL) was investigated. Female rats were fed either a laboratory chow or a diet made of palatable food items containing a high level of fat. The animals receiving the latter were divided into groups fed either ad libitum, or pair-fed, on a calorie basis, with the chow-fed animals. Half of the animals were submitted to a swimming program for 4 wk. Body weight, total and HDL CHOL were measured at the end of the treatments. Exercise-trained rats ingested the same amount of calories as their sedentary counterparts, while the animals fed with high-energy diet ate almost twice as many calories as the chow-fed groups. The sedentary animals fed the palatable diet had higher body weights than the chow-fed animals, and exercise prevented this weight increase. Exercise did not have any significant effect on serum total CHOL, but increased significantly the HDL/total CHOL ratio by 15% in the chow-fed animals. The palatable diet increased total CHOL, and decreased the HDL/total CHOL ratio in sedentary animals, whereas the ratio in their trained counterparts was comparable to that of the sedentary chow-fed group. Exercise can thus prevent both weight gain and a decrease in HDL/total CHOL ratio produced by a palatable, high-energy diet in the female rat. PMID- 6848899 TI - De novo sterologenesis in the intact rat. AB - On the basis mainly of in vitro studies, the liver and, to a lesser degree, the small intestine are widely accepted as the major sites of de novo sterologenesis. Utilizing [3H]water, we have investigated de novo sterologenesis in intact rats. Greater than 80% of labeled nonsaponifiable lipids and more than 70% of the labeled cholesterol were localized to extrahepatic, extraintestinal tissues. Feeding cholesterol markedly suppressed hepatic sterologenesis but had little influence on extrahepatic sites of sterol synthesis. Similarly, partial hepatectomy, which greatly decreased sterol synthesis in the liver, also did not significantly affect the accumulation of labeled sterols in extrahepatic tissues; therefore, the transport of sterols from the liver did not account for a significant portion of labeled sterols in extrahepatic tissues. Cannulation of the thoracic duct demonstrated that transport of newly synthesized intestinal sterols to peripheral tissues also did not account for the large accumulation of labeled sterols in extrahepatic, extraintestinal tissues. The primary extrahepatic, extraintestinal sites of sterologenesis were the skin and remaining carcass. The lung, kidney, spleen, heart, ovary, brain, muscle and adipose tissue made minor contributions to de novo sterol synthesis. Therefore, tissues other than the liver and intestine, especially the skin and remaining carcass, are important sites of de novo sterologenesis in vivo. PMID- 6848900 TI - Parent-offspring and sibling body mass index associations during and after sharing of common household environments: the Princeton School District Family Study. AB - Using the Princeton School Family Study cohort, our specific aim was to determine whether, and to what degree, parent-offspring and sibling associations for measures of body habitus outlast the period of shared common household environment in a single well characterized community. Familial associations of measures in body habitus were assessed in two and three generation kindreds, in parents and their pediatric offspring (less than 20-yr-old), parents and their adult offspring (less than or equal to 20-yr-old), and in pediatric and adult siblings. The cohort included 177 randomly recalled probands and 202 probands from a hyperlipidemic recall group (top decile plasma cholesterol and/or triglyceride). In randomly recalled whites, significant associations of body mass indices in parents and pediatric offspring and in pediatric siblings, and the absence of significant correlations in parents and adult offspring and in adult siblings, emphasize the potency of common household environmental effects relative to within-family similarities for shared body habitus. In whites from the hyperlipidemic recall group, only the mother-pediatric and adult offspring correlations for body mass indices were significant. We speculate that mothers and their offspring from kindreds selected by hyperlipidemic probands are more likely than fathers and their offspring to share eating habits and relative ponderosity, with these communal behaviors outlasting the period of common household environment. Alternatively, and speculatively, in the hyperlipidemic recall group, determinants for ponderosity may be shared more by mothers and their offspring than by fathers and their offspring. Particularly in the random recall group, within-family associations of body mass indices primarily reflect shared common household environments, and probably secondarily, the outcome of genes held in common. PMID- 6848902 TI - Effect of increased substrate availability on fatty acid synthesis in the growth retarded fetus. AB - The purpose of this study was to test the hypothesis that increased substrate (glucose) availability will enhance fatty acid synthesis in the growth retarded rat fetus. At 17 days of gestation, 19 time-dated pregnant rats had one uterine artery ligated, leading to growth retardation (IUGR) in the fetuses located on the uterine horn supplied by the ligated artery. The uterine artery of the opposite uterine horn was left untouched, resulting in appropriately grown fetuses, which served as controls. At 21 days of gestation the animals were infused with either 20% dextrose or 0.9% saline via a maternal jugular vein catheter for 4 hr. Fetal organ fatty acid synthesis was measured by maternal 3H2O injection. In the growth retarded saline infused fetus, specific activity for 3H (representing rate of fatty acid synthesis) was significantly lower in fetal liver, lung and carcass. Dextrose infusion resulted in increased fatty acid synthesis in both control and IUGR fetuses in all tissues cited above. The specific activity in glucose infused IUGR fetal organs equalled that of saline infused control fetuses. The data indicate that maternal glucose infusion resulted in an increased rate of fatty acid synthesis, in IUGR fetuses; consequently, the deficit in fatty acid synthesis in the IUGR fetus (compared to appropriately grown control fetuses) was abolished. PMID- 6848901 TI - Adaptation to hypocaloric feeding: physiologic significance of the fall in serum T3 as measured by the pulse wave arrival time (QKd). AB - We have investigated the physiologic significance of the decline in serum triiodothyronine (T3) occurring during hypocaloric feeding by measurement of changes in cardiovascular function. The QKd interval, the interval between the Q wave of the electrocardiogram and the onset of Korotkoff sounds at diastolic pressure at the brachial artery, is the sum of the preejection period and pulsetransmission time, and has proven to be a sensitive and effective measure of the effect of thyroid hormones on the cardiovascular system. Fifteen euthyroid obese volunteers underwent successive 2 wk periods of hypocaloric feeding (200 400 calories per day) interspersed with periods of at least 2 wk of re-feeding on a weight-maintaining diet (1500 calories). In a later phase subjects received oral supplementation of triiodothyronine (T3) in addition to the diet to prevent the fall in serum T3. In the last study phase, subjects on the diet received supplementation with oral thyroxine (T4), which prevented the fall in serum T3 and resulted in a slight increase in serum T4. During the first 2 wk period of hypocaloric feeding, there was a statistically significant increase in QKd, and a decrease in pulse rate, compatible with a hypothyroid state relative to initial measurements. When oral T3 supplementation was given, the rise in QKd and fall in pulse rate were prevented. Likewise, with oral T4 supplementation, the changes in QKd and pulse were prevented. Thus, the fall in serum T3 occurring during hypocaloric feeding is associated with changes in the cardiovascular system which are qualitatively similar to those observed during hypothyroidism. The present data, taken with other data in the literature, suggest that the decline in serum T3 during hypocaloric feeding may be an adaptive mechanism to conserve energy during caloric deprivation. PMID- 6848903 TI - Cancer chemotherapy. PMID- 6848904 TI - Treatment of hypothermia. PMID- 6848905 TI - The effect of aspirin on lung mucociliary clearance. PMID- 6848906 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 3-1983. A 60-year-old man with progressive confusion, hypernatremia, and abdominal pain. PMID- 6848907 TI - Has one diabetic complication been explained? PMID- 6848908 TI - Precautions recommended in treating patients with AIDS. PMID- 6848909 TI - A new risk of lye ingestion by children. PMID- 6848910 TI - Charcoal for gastrointestinal clearance of drugs. PMID- 6848911 TI - Sclerosis of thyroid cyst with tetracycline. PMID- 6848913 TI - Seizure recurrence after a seizure. PMID- 6848912 TI - Treatment of dystonia with tetrahydrobiopterin. PMID- 6848914 TI - Deficient biotinidase activity in late-onset multiple carboxylase deficiency. PMID- 6848915 TI - Late mortality after surgery for peptic ulcer. PMID- 6848916 TI - Organic voice disorders. PMID- 6848918 TI - Foreign-medical-school graduates object to the visa qualifying examination. PMID- 6848917 TI - Nonrandom cytogenetic abnormalities in Dupuytren's disease. PMID- 6848919 TI - "Human"-cell culture lines not always as advertised. PMID- 6848920 TI - A competitive approach to journal publication. PMID- 6848921 TI - Evaluation of regional and nonregional poison centers. AB - The purpose of this study was to determine whether regional poison centers handle a particular poisoning situation better than nonregional centers do. Informed consent was obtained from 15 regional and 15 nonregional poison centers. A case involving salicylate ingestion by a three-year-old child was presented twice (one day call and one night call) to each center. Those answering the phone at the regional centers asked more information-gathering questions than did those at the nonregional centers (P less than 0.01) and were more proficient in their history taking (P less than 0.01). Nonregional centers did not consider the potentially toxic ingestion (220 mg per kilogram of body weight) important enough to treat or were not willing to handle the poisoning in one third of the calls. The nonregional centers recommended manual stimulation to induce emesis in 30 per cent of the calls, whereas none of the regional centers recommended this treatment. Four calls to the nonregional centers resulted in recommendations of inappropriate emetics--e.g., saltwater, raw eggs, or mustard water. The chance of obtaining incorrect recommendations for poisoning treatment from the nonregional centers was determined to be nine times greater than that from the regional centers. Indications of intention to follow up were twice as frequent among regional as among nonregional centers. These data strongly suggest that regional poison centers provide better and more consistent poison information than do nonregional centers. PMID- 6848922 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 4-1983. A 15-year-old girl with a right ventricular mass. PMID- 6848923 TI - Multiple sclerosis and the Ingelfinger rule. PMID- 6848924 TI - Regional poison-control centers improve patient care. PMID- 6848925 TI - Innocent gallstones. PMID- 6848926 TI - Breathing pattern in asthma. PMID- 6848927 TI - Empyema resuscitans. PMID- 6848928 TI - Cooperative clinical trials and continuing medical education. PMID- 6848929 TI - Addressing patients by their first names. PMID- 6848930 TI - Costs of antimicrobial therapy. PMID- 6848931 TI - Goggle migraine. PMID- 6848932 TI - Growth and biochemical response of preterm infants fed human milk or modified infant formula. AB - My colleagues and I compared the biochemical status and rates of growth of three groups of preterm infants: one group was fed milk obtained early from mothers of preterm infants; one group received milk produced during the mature stage of lactation by mothers of term infants; and one group received a whey-based infant formula. Sixty healthy preterm infants with birth weights of 1600 g or less were randomly assigned to one of the three feedings groups. The 20 infants in each group were followed until they reached a weight of 1800 g. The mean (+/- S.E.M.) number of days required to regain birth weight was similar for infants receiving the formula (10.3 +/- 0.8) and those receiving milk from mothers of preterm infants (11.4 +/- 0.8); both were significantly less than the number (18.8 +/- 1.7) for infants receiving milk from mothers of term infants (P less than 0.001). Subsequent rates of weight gain were greater for the groups receiving formula (27.0 +/- 0.8 g per day) and milk from mothers of preterm infants (23.7 +/- 1.1) than for the group receiving milk from mothers of term infants (15.8 +/- 0.8) (P less than 0.001). Similarly, the average increments in crown-to-heel length and in the head circumference were significantly greater for the groups given formula and milk from mothers of preterm infants (P less than 0.005 and P less than 0.001, respectively). These data indicate that feeding with either milk from mothers of preterm infants or a whey-based infant formula results in more appropriate growth in preterm infants than feeding with milk from mothers of term infants. PMID- 6848933 TI - Excessive obesity in offspring of Pima Indian women with diabetes during pregnancy. AB - We studied the relation in Pima Indians between obesity in children and diabetes during pregnancy in their mothers. Sixty-eight children of 49 women who had had diabetes during pregnancy had a higher prevalence of obesity than 541 children of 134 women who subsequently had diabetes (prediabetics) or than 1326 children of 446 women who remained nondiabetic. At 15 to 19 years of age, 58 per cent of the offspring of diabetics weighed 140 per cent or more of their desirable weight, as compared with 17 per cent of the offspring of nondiabetics and 25 per cent of those of prediabetics (P less than 0.001). Obesity in the offspring was directly related to maternal diabetes, since the association was not substantially confounded by maternal obesity. The findings strongly suggest that the prenatal environment of the offspring of diabetic women results in the development of obesity in childhood and early adulthood. PMID- 6848934 TI - Absence of cytochrome b-245 in chronic granulomatous disease. A multicenter European evaluation of its incidence and relevance. AB - The heme-containing protein cytochrome b-245 has been proposed as a primary component of the microbicidal oxidase system of phagocytes that normally generates superoxide-free radicals but when defective is associated with chronic granulomatous disease. We measured this cytochrome in granulocytes from 27 patients with chronic granulomatous disease and from 64 members of their families. It was undetectable in all 19 of the men in whom the defect appeared to be located on the X chromosome. Female relatives who were heterozygous carriers had reduced concentrations of the cytochrome and variable proportions of cells that were unable to generate superoxide; these two characteristics were closely related (r = 0.93 in the 16 mothers and 0.85 in all 24 carriers, P less than 0.001). In contrast, in all eight patients (seven women) with a probable autosomal recessive inheritance the cytochrome was present but nonfunctional. The properties tested, including midpoint potential, carbon monoxide binding, and organelle distribution, were normal, but the cytochrome did not undergo reduction on cellular stimulation. Thus, absence or malfunction of the cytochrome b-245 may be the causal molecular defect in chronic granulomatous disease, implicating it in the microbicidal oxidase system. PMID- 6848935 TI - Running--an analogue of anorexia? AB - We have explored the apparent similarity between patients with anorexia nervosa and a subgroup of male athletes designated as "obligatory runners." Case examples are provided from interviews with more than 60 marathon and trail runners. Obligatory runners resemble anorexic women in terms of family background; socioeconomic class; and such personality characteristics as inhibition of anger, extraordinarily high self-expectations, tolerance of physical discomfort, denial of potentially serious debility, and a tendency toward depression. Anorexic women and members of their families are often compulsively athletic, and obligatory runners may demonstrate a bizarre preoccupation with food and an unusual emphasis on lean body mass. We speculate that both phenomena could represent a partially successful--albeit dangerous--attempt to establish an identity. These preliminary observations will require further study for validation. PMID- 6848937 TI - Cigarette smoking and ulcerative colitis. PMID- 6848936 TI - Regional citrate anticoagulation for hemodialysis in the patient at high risk for bleeding. PMID- 6848938 TI - Evaluation of right-heart catheterization in the critically ill patient without acute myocardial infarction. PMID- 6848939 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 5-1983. A 72-year-old man with palpable purpura, proteinuria, and microscopic hematuria. PMID- 6848940 TI - Steps toward an understanding of chronic granulomatous disease. PMID- 6848941 TI - Cigarettes, ulcerative colitis, and inferences from uncontrolled data. PMID- 6848942 TI - Hemodynamic monitoring in the critically ill patient. PMID- 6848943 TI - Hypoglycemia during exercise. PMID- 6848944 TI - Should spouses of hepatitis B surface antigen carriers receive hepatitis vaccine? PMID- 6848945 TI - Hepatitis B carriers in the prison population. PMID- 6848946 TI - Oral anticoagulation versus aspirin after myocardial infarction. PMID- 6848947 TI - Risk of bacterial endocarditis in persons with mitral-valve prolapse. PMID- 6848948 TI - Volume expansion and nitroprusside compared with pericardiocentesis in acute cardiac tamponade. PMID- 6848949 TI - 111-indium-labeled platelets in homocystinuria. PMID- 6848950 TI - Antibiotics containing trimethoprim and the fragile X chromosome. PMID- 6848951 TI - Interferon and cimetidine for malignant melanoma. PMID- 6848952 TI - More on Eucharistic problems for patients with celiac disease. PMID- 6848953 TI - Should physicians be paid for their technical failures? PMID- 6848954 TI - Polish physicians under martial law. PMID- 6848955 TI - Hazards of battery ingestion. AB - A 12-year-old boy ingested a mercury battery from a watch as a part of an alleged poisoning attempt by an uncle. The battery apparently ruptured spontaneously in the child's stomach less than 36 hours after ingestion. At surgery one battery terminal was found embedded in gastric mucosa thought to be progressing toward gastric perforation. The unique complications of battery ingestion, such as gastrointestinal perforation and possible mercury poisoning, are reviewed. A strong recommendation for immediate endoscopic or surgical removal of ingested batteries is made. Parental education along with preventive measures by manufacturers such as package warnings, specific labeling of battery contents on each package, and "childproofing" of battery-containing products is stressed. PMID- 6848956 TI - Parent acceptance of routine use of the Carey and McDevitt infant temperament questionnaire. AB - Anticipatory guidance can be more effective in constellations of temperament characteristics that make chiuldren difficult to parent are recognized. The Carey and McDevitt Infant Temperament Questionnaire can be used to screen for such children. Parents of children who were not difficult to parent also found the temperament evaluation useful. A total of 120 questionnaires were completed, and 79 families completed the author's survey. Nearly 90% of parents responding gained a better understanding of their child, 87% thought it changed their approach to parenting. PMID- 6848958 TI - Gasoline sniffing and lead toxicity in Navajo adolescents. AB - During a 6-year period, 23 Navajo adolescents were hospitalized 47 times for presumed lead intoxication secondary to gasoline sniffing. Most patients were male (87%) and sniffed gasoline as a social activity, more frequently in spring and summer. Sixty-five percent of the patients first presented with toxic encephalopathy. Of total episodes, 31% involved asymptomatic lead overload; 31% involved tremor, ataxia, and other neurologic signs; and 38% involved encephalopathy with disorientation and hallucinations. Free erythrocyte protoporphyrin levels were not consistently high, although blood lead levels were all elevated. One death occurred. Approximately 11% of 537 Navajo adolescents said they inhaled gasoline for enjoyment at least occasionally. Among 147 junior high school students, blood lead levels averaged 18 +/- 6 micrograms/dL with no values greater than 40 micrograms/dL. Three of these students had elevated zinc protoporphyrin levels and all three were anemic. No correlation was found between levels of blood lead or zinc protoporphyrin and whether or not the youth reported sniffing gasoline. However, sniffing gasoline was associated with poor school performance and delinquent behavior. Although apparently many Navajo adolescents experiment with gasoline inhalation, only a few engage in this activity frequently enough to develop either asymptomatic or symptomatic lead overload. PMID- 6848959 TI - Malignant hyperthermia in a child with Duchenne muscular dystrophy. PMID- 6848960 TI - Acute urinary retention as presenting symptom of Ascaris lumbricoides infection in children. PMID- 6848957 TI - A comparison study of parental adaptation following a child's death at home or in the hospital. AB - Mothers and fathers of 37 deceased pediatric oncology patients were interviewed 3 to 28 months after their child's death. Twenty-four of these families had participated in a formal Home Care Program for dying children, whereas the remaining 13 families had children who died in the hospital. Parental adaptation following the home care experience appeared to be more favorable than following terminal care and death in the hospital. Specifically, the parents who had cared for their terminally ill child at home displayed more positive adjustment patterns as indexed by their perception of how the child's death had affected their marriage, social reorientation, religious beliefs, and views on the meaning of life and death. Ratings given by parents providing home care indicated a significant reduction in guilt during the home care experience which was maintained at 6 and 12 months following the child's death. In contrast, parents who did not provide home care reported intensified feelings of guilt during their child's terminal hospitalization which were unresolved at one year after the child's death. The results are discussed in terms of the practical and emotional benefits that may be derived from a family's voluntary choice of home care for dying children. PMID- 6848961 TI - Infant respiratory illness and indoor air pollution from a woodburning stove. PMID- 6848962 TI - Children with sinusitis. PMID- 6848963 TI - Is stuttering an illness? PMID- 6848965 TI - Foster care children. PMID- 6848964 TI - Fab fragments in treatment of digoxin ingestion. PMID- 6848966 TI - Carbamazepine-isoniazid interaction. PMID- 6848967 TI - Creatinine excretion. PMID- 6848968 TI - Theophylline-furosemide inactivation? PMID- 6848969 TI - Conjunctivitis-otitis syndrome. PMID- 6848970 TI - Febrile neonates. PMID- 6848971 TI - Asymmetric crying facies: which is the 'right-wrong' side? PMID- 6848972 TI - Help needed on hot water burns. PMID- 6848973 TI - Consultants to schools. PMID- 6848974 TI - Risk factors for necrotizing enterocolitis in infants weighing more than 2,000 grams at birth: a case-control study. AB - A retrospective case-control study of necrotizing enterocolitis (NEC) was conducted among infants weighing greater than 2,000 g at birth. Twenty-three infants met the NEC criteria for inclusion in the study; 12 weighed 2,001 to 2,500 g at birth and 11 weighed greater than 2,500 g at birth. Hypoglycemia occurred in 7/12 (55%) infants weighing 2,001 to 2,500 g and in 4/35 (11%) control subjects (P less than .02). In infants weighing greater than 2,500 g at birth, polycythemia (occurring in 7/12 study infants (58%) and 5/32 (16%) control infants) and respiratory distress (3/11 study infants (27%) and 0 control subjects) were significantly associated with NEC (P less than .02). Larger infants with a history of perinatal stress and/or physiologic immaturity are likely to be at greater risk for NEC than their normal counterparts. PMID- 6848976 TI - Physiologic stress reduction by a local anesthetic during newborn circumcision. AB - To evaluate the effectiveness of the dorsal penile nerve block in reducing the stress of circumcision upon newborns, physiologic measurements in 30 healthy full term infants (including transcutaneous oxygen levels, crying time, heart rate, and respiratory rate) were monitored continuously before, during, and after the operation. Infants receiving the dorsal penile nerve block with lidocaine (1% Xylocaine) (N = 20) experienced significantly less stress, as evidenced by smaller decreases in transcutaneous oxygen pressure levels, less time spent crying, and smaller increases in heart rate, than infants circumcised in an identical manner without anesthetic (N = 10). No complications resulted from injection of the local anesthetic or from the circumcision procedure itself. Inasmuch as dorsal penile nerve block has a low complication rate, is simple to learn, and adds little time or expense to the overall procedure, and if it proves to be as effective clinically as the physiologic data indicate, the dorsal penile nerve block should be considered for every infant undergoing circumcision. PMID- 6848975 TI - A computerized system for continuous physiologic data collection and analysis: initial report on mean arterial blood pressure in very low-birth-weight infants. AB - A system for continuous measurement and analysis of mean arterial blood pressure (MABP) by microcomputer is presented. The system allows prolonged recording and maintenance of fine detail by sequential evaluation and storage of up to 3,600 data points per hour. Fifteen preterm appropriate-for-gestational-age (AGA) infants weighing less than or equal to 1,500 g (very low birth weight) who were free of pulmonary and neurologic disease were monitored continuously from birth to 5 days of age. MABP was recorded via an umbilical arterial catheter with a pressure transducer and module interfaced with the microcomputer. Software was developed to analyze this stored data rapidly. MABP was found to correlate significantly with gestational age from 3 to 15 hours of age (P less than .05). Significant correlation was rare after 20 hours of age. MABP increased as a function of postnatal age in 11 infants. This increase was greater (0.31 to 0.54 mm Hg/h) for the least mature infants (27 to 29 weeks of gestation). The increase for the most mature infants (31 to 32 weeks of gestation) was low (0 to 0.24 mm Hg/h), and in three infants a small negative slope was seen. The steep rise in MABP during the first 40 hours of life in the least mature infants may be due to the perfusion requirements of extrauterine life. These pressures may be at or near the threshold for rupture of immature vascular beds such as are found in the subependymal germinal matrix and thus predispose to intraventricular hemorrhage. PMID- 6848977 TI - Clinical estimation of liver size in newborn infants. AB - Liver size was measured in 100 healthy newborn infants of gestational ages 35 to 44 weeks. A mean liver span of 5.9 +/- 0.8 cm was determined in these infants by measuring the distance between the percussed upper and palpated lower liver borders along the midclavicular line. This value correlated well with measurements derived from percussing both borders (r = .8) and correlated poorly with measurements of liver projection below the costal margin (r = .55). The practice of reporting liver projection below the costal margin as a single indicator of liver size should be discouraged. PMID- 6848978 TI - Oculocardiac reflex in near miss for sudden infant death syndrome infants. AB - To gain insight into the role of the vagus nerve in sudden infant death syndrome (SIDS), 180 infants ranging in age from 1 to 66 weeks were examined with respect to cardiac response to ocular compression. There were 35 near-miss infants, 76 normal siblings of SIDS victims, and 69 normal control infants. Asystoles within the control group ranged from 0.3 to 1.8 seconds. Ten of 35 (28%) near-miss infants and 10/76 (13%) siblings had asystoles greater than 2.0 seconds when first tested. When statistically compared, the near-miss infants were significantly different from both the control infants and the siblings (Kruskal Wallis procedure: P less than .01, and P less than .05, respectively). It is concluded that in the first year of life a significant number of near-miss infants have an exaggerated cardiac response to ocular compression. Furthermore, the presence of prolonged asystoles in certain siblings indicates that vagal hypersensitivity, as manifested by ocular compression, may be, in part, hereditary. PMID- 6848979 TI - Apnea monitoring by acoustic detection of airflow. AB - An acoustic monitor to detect apnea in infants has been developed. Recordings of a signal derived from breath sounds at the nose were made in eight premature infants and compared with observation of the infant and with transthoracic impedance and ECG monitoring. The acoustic monitor detected 26 episodes of apnea lasting 15 seconds or longer which were confirmed by observation and by heart rate slowing of at least 20 beats per minute. Only seven of these episodes were detected by the impedance monitor. The ECG monitor alarmed during the nine spells in which heart rate dropped below 100 beats per minute, 27.5 +/- 9.7 seconds after breath sounds ceased. Inasmuch as the acoustic device detects absent airflow during central or obstructive apnea before bradycardia occurs and is insensitive to body movements, it represents an improved monitoring technique for infants with apnea. PMID- 6848982 TI - Committee on Drugs and Committee on Sports Medicine. Dimethyl sulfoxide (DMSO). PMID- 6848980 TI - Accumulation of aluminum in a nondialyzed uremic child receiving aluminum hydroxide. AB - A child with renal insufficiency was treated with the oral phosphate binder aluminum hydroxide from age 6 to 31 months. The prescribed dose of elemental aluminum varied from 31 to 108 mg/kg/d. Concurrently the patient developed vitamin D-resistant osteomalacia which failed to improve with parathyroidectomy. Encephalopathy with myoclonic seizures, loss of speech, and motor impairment also occurred. Serum and bone aluminum levels were elevated at 334 micrograms/L (normal 7 +/- 3 micrograms/L) and 156 mg/kg (normal 3.3 +/- 2.9 mg/kg), respectively. This case demonstrates that aluminum may accumulate in tissue of children receiving oral aluminum hydroxide. The accumulation of aluminum may have contributed to the vitamin D-resistant osteomalacia and the encephalopathy in this patient. Children receiving aluminum-containing antacids as phosphate binders should be monitored for aluminum accumulation and signs of aluminum intoxication. PMID- 6848983 TI - Inherited deficiency of the third component of complement associated with recurrent pyogenic infections, circulating immune complexes, and vasculitis in a Dutch family. AB - A family is described in which 3/11 children showed a homozygous deficiency of C3, and both parents and six other children had subnormal levels of C3. The three children with selective C3 deficiency suffered repeatedly from bacterial infections, whereas the parents and the other siblings were clinically healthy. During infectious episodes the patients showed a maculopapular skin rash, and at such times immune complexes were present in the serum. Biopsy specimens of the skin lesions showed the picture of leukocytoclastic vasculitis. PMID- 6848981 TI - Evaluation of hypocalcemia with a highly sensitive, homologous radioimmunoassay for the midregion of parathyroid hormone. AB - The diagnosis of hypoparathyroidism by radioimmunoassay of serum parathyroid hormone (PTH) has been hampered by lack of an assay system sensitive enough to allow discrimination between low and normal values. A new assay for human PTH that has improved sensitivity has been developed. It uses an homologous antiserum (against the human hormone) and uses a carboxy-terminal fragment of bovine PTH as tracer to provide an assay monospecific for the midregion of PTH. Immunoreactive PTH (iPTH) was detectable in 25/27 normal children and borderline detectable in the other two. The pediatric normal range was slightly lower than that previously established in adults. Among patients with secondary hyperparathyroidism and normal renal function, iPTH was 3- to 8-fold elevated in those with rickets, and 1.3- to 2.0-fold above normal in those with more acute forms of hypocalcemia. Twelve patients with hypoparathyroidism were studied. iPTH was undetectable in seven with permanent total hypoparathyroidism, and was borderline detectable in five, including four neonates who proved to have transient hypoparathyroidism. In these four patients, iPTH became detectable as the requirements for supplemental calcium decreased. Measurement of iPTH with an adequately sensitive assay may be useful in the diagnosis and management of pediatric hypocalcemia. PMID- 6848984 TI - Floor furnace burns to children. AB - Three children with grid-like second-degree burns of their extremities from contact with floor furnace registers prompted an examination of this thermal hazard. Average temperature of the gratings was 294 degrees F (146 degrees C), with a range of 180 degrees to 375 degrees F (82.2 degrees to 191 degrees C). All of the furnaces tested were positioned at the entrance to bedrooms and had so little clearance that it was impossible to walk around them without contact with their surface. Infants and toddlers are at particular risk: 1 or 2 seconds of exposure would be expected to produce a serious burn. Suggestions for preventing burns from floor furnaces include turning them off when young children are at home; installing barrier gates to prevent children from coming in contact with the registers; and developing a surface coating or replacement grate with less hazardous thermal properties. PMID- 6848986 TI - Severe chest pain due to infectious mononucleosis. AB - Infectious mononucleosis complicated by acute myopericarditis was finally diagnosed in a 17-year-old boy who presented with sore throat and severe left sided chest pain. A mononucleosis spot test and heterophil agglutination test turned strongly positive only on the sixth hospital day. The natural course of infectious mononucleosis complicated by myopericarditis appears to be benign. PMID- 6848985 TI - Psychosocial disturbances during and after pregnancy. AB - The identification of patients at risk for psychologically mediated complications during and after pregnancy should be a part of obstetric care. Psychologic assessment can be incorporated into routine prenatal evaluation. Typically, patients who cope poorly during pregnancy have had previous emotional difficulty. Transient emotional disturbances during the early stages of pregnancy are not unusual. Treatment consists of providing support, education, and opportunity for the patient to ventilate her feelings. These interventions can be provided by the sensitive primary care physician who is willing and able to commit the time, to listen, and to communicate. Drug therapy should usually be avoided. Postpartum blues is common, occurring most often in those who experienced emotional distress during pregnancy and in those with a history of premenstrual tension. Management ideally begins before delivery. Treatment of postpartum depression or psychosis involves use of medication and/or psychotherapy. The effects of medication on breast milk must be considered. PMID- 6848987 TI - Wellness attainable goal or impossible dream? PMID- 6848988 TI - Drug therapy for depression in the elderly. AB - Depression is common in the geriatric population, but recovery rates are gratifying. Safe treatment requires attention to the effects of aging on pharmacokinetics and close monitoring. Antidepressants are the drugs most commonly used; to the standard tricyclic drugs have now been added a tetracyclic and a triazolopyridine. Monoamine oxidase inhibitors and lithium are second choice options; a benzodiazepine is not generally required. Dosages should be lower than conventionally prescribed. Side effects of antidepressant drugs are common, the most important being slowing of cardiac conduction times and the most common being anticholinergic manifestations, such as dry mouth and tachycardia. Some of the more recently introduced antidepressants may have more advantageous side-effect profiles than the older agents. PMID- 6848989 TI - Hypertension. PMID- 6848990 TI - The pickled beets syndrome. Don't just stand there, do something! PMID- 6848991 TI - Potassium in hypertension. AB - Epidemiologic studies in the United States suggest that a low potassium intake may be important in the genesis of hypertension. The higher blood pressure in blacks than in whites in the United States is associated with lower excretion of potassium. This is probably due to less potassium being consumed. The high cost of a high-potassium diet may be the reason for the low potassium consumption. Potassium may reduce blood pressure by increasing sodium excretion, decreasing renin secretion, decreasing sympathetic nerve activity, or directly dilating the arteries. PMID- 6848992 TI - Sleep-related disorders of respiration. PMID- 6848993 TI - Diagnosis of anemia. Clues to greater precision. AB - Typical features on the blood smear suggest the diagnosis in some types of anemia, such as the common microcytic anemias, megaloblastic anemias, and certain hemolytic anemias. Some laboratory tests used in anemia, particularly measurement of serum vitamin B12 and folate levels, may present problems in interpretation, which must be recognized if diagnostic errors are to be avoided. Normocytic anemias that are nonhemolytic, have no obvious cause, and are characterized by marked red cell changes on the blood smear should prompt careful investigation for malignancy or marrow fibrosis. Anemias are often multifactorial, and the diagnosis must be reevaluated after the apparent contributing causes have been treated. A number of "danger signs" in a patient with anemia point to the need for hematologic consultation. PMID- 6848994 TI - Bilateral enterobius vermicularis salpingo-oophoritis. AB - Inflammatory pelvic disease secondary to infection with Enterobius vermicularis is rare in that pinworms are usually asymptomatic inhabitants of the terminal small bowel and cecum. When these parasites do cause symptoms, however, there is a spectrum of gastrointestinal and genitourinary complaints. A case is presented of a woman with bilateral abdominal pain that was found to be due to a combination of parasitic and bacterial (Bacteroides fragilis) infection. The parasitic fallopian tube infection may have predisposed the fallopian tubes to a microbial tuboovarian abscess. PMID- 6848996 TI - Alcoholism in the elderly. PMID- 6848997 TI - Diet center's response to weight-loss article. PMID- 6848998 TI - All melanomas start sometime. What to do before and after. AB - Interest in the prevention and early recognition and treatment of malignant melanoma is increasing because of ongoing education of health care professionals and of the public. The role of primary care physicians in the educational process is essential, for it is they who can shorten the interval between discovery of melanoma and its surgical removal. All melanomas start sometime. The key to cure is early recognition, which requires the physician to always think "melanoma" when examining or excising a pigmented lesion. PMID- 6848995 TI - Continuous subcutaneous insulin infusion systems. A new approach to management of type I diabetes. AB - Although continuous subcutaneous insulin infusion (CSII) is not presently the most feasible method of insulin delivery for most type I diabetic patients, unquestionably it is a major therapeutic advance in recent efforts to normalize blood glucose levels in such patients. In selected, highly motivated patients, CSII therapy has been shown to be safe, effective, and physiologically reasonable. Despite the failure of prolonged CSII therapy to reverse established microangiopathic complications in all cases, normoglycemia produced with CSII may reverse early complications and prevent or minimize their development in patients treated by this method from the onset of hyperglycemia. Understanding of the importance of continuous normoglycemia to the psychologic and physical well-being of type I patients should be greatly advanced by the development and use of CSII systems. PMID- 6848999 TI - Therapeutic heat and cold. A practitioner's guide. AB - Application of heat generally increases metabolic activity, with resulting increase in circulation and exacerbation of inflammation, while cold in most cases has the opposite effect. Choice of treatment method in a given case is based on many factors, including the physical properties (ie, depth of penetration and method of energy delivery) of the modality under consideration and knowledge of the contraindications. A thorough understanding of the physiologic bases for use of thermotherapy and cryotherapy as well as of the various methods for delivery of therapeutic heat and cold will allow the physician to make optimal use of the modalities available. PMID- 6849000 TI - Narcotic maintenance for chronic pain. Medical and legal guidelines. AB - Narcotic maintenance may be needed to relieve chronic pain in ambulatory patients who fail to respond to other pain therapies. Oral, long-acting narcotics are preferred, and nonnarcotic pain therapies can be administered simultaneously to reduce the narcotic dosage. To legally undertake narcotic maintenance, the physician must document the presence of an incurable, painful medical condition. We recommend that the patient give informed consent, since narcotic maintenance may lead to dependence and addiction. When done properly, narcotic maintenance is an appropriate medical-legal procedure that is safe and may provide humanitarian pain relief. PMID- 6849001 TI - Slow virus diseases of the CNS. 1. Subacute sclerosing panencephalitis, progressive rubella panencephalitis, and progressive multifocal leukoencephalopathy. AB - Several slowly progressive diseases of the human CNS are now known to be caused by viruses. Subacute sclerosing panencephalitis (SSPE) is caused by a measles virus that may be sequestered in the cell rather than eradicated; the disease occurs between the ages of 4 and 20. Progressive rubella panencephalitis (PRP) is caused by a rubella virus that persists in the CNS; its onset is about a decade after rubella-virus infection. Progressive multifocal leukoencephalopathy (PML) is caused by a papovavirus that lyses oligodendrocytes; it usually occurs between the ages of 50 and 60. All three disorders are characterized by usually slow mental and motor deterioration; patients with SSPE and PRP also have myoclonic seizures. The pathogenesis of these diseases is not yet understood, and there is no effective treatment. Death occurs within months to years. PMID- 6849002 TI - Patterns of rapid motor responses during postural adjustments when standing in healthy subjects and hemiplegic patients. AB - The purpose of this study was to describe the patterns of postural adjustments during induced body sway in healthy subjects and hemiplegic patients. Electromyograms were taken with surface electrodes from four lower extremity muscles that control ankle, knee, and hip motions. During postural adjustments in 10 healthy subjects, the ankle muscle and the complementary knee muscle contracted in fixed proportion. The first muscle adjustment, acting to stabilize the induced sway, occurred 95 to 118 msec after the onset of the perturbation. The sequence of muscle activation began at the ankle and proceeded proximally. Postural adjustments varied highly in 10 patients with clinically diagnosed right hemiplegia resulting from cerebrovascular accidents. The most frequent abnormalities included 1) synchronous contraction of several or all lower extremity muscles tested, 2) inconsistent patterns of muscle activation throughout each subject's trials, 3) longer, more varied response latencies than with healthy subjects, and 4) distorted sequence of muscle activation. PMID- 6849004 TI - Study of Doppler ultrasonic peripheral vascular assessments performed by physical therapists. AB - The Doppler ultrasound assessment is an effective diagnostic method for determining peripheral vascular status. Because the evaluation currently is not often performed by a physical therapist, the purpose of this study was to provide objective information on the competency of a group of physical therapists who were doing these evaluations. Therapists at a state psychiatric hospital in North Carolina performed a total of 577 Doppler assessments from May 1976 to May 1981. Forty-eight of these evaluations were followed by an invasive peripheral vascular diagnostic technique, either a venogram or an arteriogram. When Doppler results were compared with invasive results, 85 percent of the Doppler evaluations agreed with results obtained using the invasive techniques. There was complete agreement with arterial evaluations, and 81 percent agreement with venous assessments. These results support the contention that Doppler ultrasonic evaluations of peripheral vascular disease can be competently performed by physical therapists trained in the technique. PMID- 6849005 TI - Aging process. Implications for clinical practice. PMID- 6849003 TI - Developmental guidelines for children with myelodysplasia. AB - A new inventory of 166 milestones and developmental tasks was designed and given to parents of 173 children with myelodysplasia to use over a 2 1/2-year period to record their children's development. The inventory included items in the categories of self-help (including independent toileting), personal-social development, and gross motor development. The children were placed in one of four subgroups according to their level of paralysis. For each motor-level group, the percentage of those performing each item at various ages was calculated. The ages of routine performance of selected self-help and personal-social items are reported for 20, 50, and 80 percent achievement for the children for whom the data were known. There was a tendency for the less paralyzed children to learn skills more quickly than their more paralyzed peers. However, the wide age ranges within groups for learning individual skills indicate that factors other than the level of paralysis affect the rate of development, and these factors need to be identified. The data provided represent a reasonable estimate of when children with varying degrees of paralysis can first be expected to perform developmental tasks. The tables can be used to establish learning objectives and programs so that more children with myelodysplasia can learn independence at an earlier age. PMID- 6849006 TI - Shoulder positioning device for patients with hemiplegia. PMID- 6849007 TI - Effect of experience on recovery following CNS lesions. PMID- 6849008 TI - Method to determine the effect of clinical education on production in a health care facility. PMID- 6849011 TI - Congenital band about the pelvis. AB - A fifth case of congenital ring constriction about the pelvis is reported on a 28 year-old pregnant woman. Her pregnancy evolved uneventfully, and she gave birth to a perfectly normal son. The four previous published cases are reviewed in search of potential etiologic factors. PMID- 6849009 TI - The dream fades. PMID- 6849010 TI - Cerebrospinal fluid rhinorrhea following rhinoplasty. AB - Cerebrospinal fluid rhinorrhea, whatever the etiology, is a serious and life threatening problem. We present a case following rhinoplasty. To our knowledge, this specific complication has not been reported, most likely because it has gone unrecognized, since most cerebrospinal fluid leaks cease spontaneously. Surgeons performing rhinoplasty should be aware of this potential complication, how to confirm the diagnosis, and methods for its treatment. PMID- 6849013 TI - Readily available, inexpensive finger tourniquet. PMID- 6849012 TI - Scarlet red allergy. AB - Scarlet red dye, commonly used in clinical situations, is very rarely involved in contact dermatitis. A single report of sensitivity appears in the prior literature. Two cases of scarlet red allergy are presented and documented by patch testing. Discussion is oriented to alert clinicians to the recognition and treatment of this potential complication. PMID- 6849015 TI - Improving the cleft lip nose. PMID- 6849016 TI - Scalp reduction for baldness. PMID- 6849017 TI - The rectus abdominis myocutaneous flap: observations and refinements. PMID- 6849014 TI - Taping technique in chemical face peel. PMID- 6849018 TI - Correction of rectal incontinence. PMID- 6849020 TI - The onlay graft for nasal tip projection. PMID- 6849019 TI - Orbital reconstruction. AB - Twenty patients with severe orbital and orbitomaxillary deformities secondary to oncologic surgery and radiation were studied. Sixteen patients underwent complete reconstruction of the orbit and the periorbital area. The orbital reconstruction was accomplished with autogenous tissue (skin and dermis grafts) that was anchored to the bony orbit. The periorbital area was augmented with customized implants. Most patients now wear a satisfactory prosthesis with or without lightly tinted glasses, giving them an acceptable orbital symmetry. PMID- 6849022 TI - Reconstruction of the burned ear using a temporalis fascial flap. AB - A case report is presented in which a temporalis fascial flap is used to reconstruct a burned ear complicated by full-thickness skin loss with exposed cartilage. The method provides a simple, reliable means for covering exposed auricular cartilage with readily obtainable vascularized tissue. Donor-site morbidity is minimal because the scar lies within the hairline. PMID- 6849021 TI - Reconstruction of the nasal tip using nasalis myocutaneous sliding flaps. AB - An alar island subcutaneous sliding flap is described which, when analyzed, is actually myocutaneous, based on the lower portions of the nasalis muscle. In a series of 47 patients, tip defects 1.25 cm in diameter were reconstructed with a unilateral flap, and defects 2.0 cm in diameter were reconstructed with a bilateral flap. The advantage of the flap lies in aesthetics, which are so important in tip surgery. Not only are the incisions at or parallel with the edges of the lateral crus of the lower lateral cartilage, but also chronic edema and "dog-ears" so common after rotation pedicle flaps are avoided. PMID- 6849023 TI - Technical refinements in mammaplasty. PMID- 6849025 TI - Patients' perceptions of the cosmetic impact of melanoma resection. AB - This study investigated the relationship between primary versus grafted closure for melanoma and the cosmetic impact on the patient of the resulting scar. A total of 176 patients with melanoma completed a multiple-choice questionnaire designed for this study. Two factors were significantly related to negative cosmetic impact: severity of scar indentation (but not scar length) and the extent to which patients were unprepared for the actual size of their scars. Patients whose scars were deeply indented as well as those whose scars were larger than anticipated displayed greatest distress about their appearance. Cosmetic impact was greater for women than for men. These observations suggest that primary closures, rather than closures requiring skin grafts, have important psychological benefits for patients and that physicians can assist postoperative adjustment by giving patients accurate information about the expected appearance of their scars. PMID- 6849026 TI - Glucose metabolism in experimental skin flaps. AB - The metabolism of glucose by rat abdominal skin flaps has been investigated at various times after flap elevation. Biopsies of flap skin taken during the first 3 days after flap elevation and incubated in vitro show a marked increase in glucose consumption and lactate production compared with normal skin. At the same time, flap tissue reserves of glucose and glycogen are lower than those of normal skin. Providing that some circulation persists, the magnitude of the changes in glucose metabolism is proportional to the degree of ischemia experienced by the flap tissue in vivo. In most cases, glucose consumption and lactate production return to normal by the end of the first week after flap elevation. These experiments thus further define a major ischemia-induced shift to anaerobic metabolism (glycolysis) that occurs in skin flaps. PMID- 6849027 TI - Study of carcinogenic effects of in vitro argon laser exposure of fibroblasts. AB - Safety of laser exposure and tissue interaction and possible future carcinogenic effects of laser energy are investigated in this study. Mouse fibroblasts of the BALB/3T3 strain have now become the standard in science for the investigation of carcinogenic effects of a variety of physical and chemical/toxic agents. BALB/3T3 fibroblasts were grown in tissue culture and then exposed to x-ray irradiation and argon laser energy. The cells were then grown nine generations and scored for malignant type III foci in a randomized double-blind manner. Argon laser-treated cell groups were then compared with normal untreated controls and known carcinogenic x-ray controls. The results demonstrated that exposure of mouse fibroblasts in vitro tissue culture to argon laser energy did not produce a statistically significant transformation frequency as compared with that of known carcinogenic agents such as x-ray or untreated controls. PMID- 6849024 TI - Optimal resection margin for cutaneous malignant melanoma. AB - Cutaneous malignant melanoma has traditionally been treated by "wide" local excision with a 5-cm margin of normal skin about the tumor. The rationale of wide excision for melanoma has never been clearly defined, but the procedure is known to be effective in preventing local recurrence. We studied 105 patients who had 109 primary melanomas in 1977 and related margin width of the definitive excision to the presence of satellites, to the subsequent development of local recurrence and in-transit metastases, and to survival. Survival was not dependent on margin width, and there were no incidences of local recurrence. Satellitosis and in transit cutaneous metastasis indicate that a melanoma is capable of local recurrence; these phenomena occurred only in tumors whose thickness (Breslow) was greater than 2.0 mm. These data provide a rationale for wide excision of "thick" melanomas and support more modest local therapy for thin cutaneous melanoma. PMID- 6849029 TI - Entheses and enthesopathy. Anatomical, pathological, and radiological correlation. AB - Entheses are sites of tendon and ligament attachment to bone, and enthesopathy is a disease process occurring at these sites. It may be inflammatory, degenerative, endocrine, metabolic, or traumatic in nature. Common sites of involvement include the pelvis, femoral trochanter, humeral tuberosity, patella, olecranon, and calcaneus as well as portions of the vertebral column. Specific radiographic features, including bone erosion, hyperostosis, fragmentation, and crystal deposition, may allow a precise diagnosis. PMID- 6849028 TI - Scanning electron microscope study of microvenous grafts to artery. AB - The healing of microvenous grafts to femoral arteries in the rabbit has been studied using scanning electron microscopy at intervals ranging from zero time to 5 months. Healing of the grafts followed a similar pattern to that of end-to-end repairs. Postoperative survival of the original endothelium was far superior in the vein than in the artery. Re-endothelialization was completed by 2 weeks. No dilation of the graft or aneurysm formation appeared. A detailed account of the healing vein grafts has been reported and will enable comparison of healing of microvascular heterografts. PMID- 6849030 TI - Internal derangements and arthritis of the temporomandibular joint. AB - Internal derangements of the temporomandibular joint (TMJ) may be a significant factor in the etiology of painful dysfunction of the jaw and associated clinical symptoms. In a two-year prospective investigation, 170 TMJs in 85 patients were studied with plain tomography prior to arthrotomography. Arthritis was detected in 19 patients (22%), predominantly in the second to fourth decade of life, which correlated with internal derangements depicted by arthrotomography, operative findings, and histopathological examination of the condylar surface. The authors suggest that internal derangements related to meniscal dysfunction may be an important factor in the etiology of TMJ arthritis. PMID- 6849031 TI - Soft-tissue desmoid tumors: radiographic bone changes. AB - A retrospective study was done of 132 patients with desmoid fibromatosis (fibrosarcoma grade I desmoid type [FIDT]). Eight patients with tumor in the extremities demonstrated abnormalities in the adjacent bones. Bone erosion and a "frondlike" periosteal reaction were the radiological patterns identified. A local recurrence occurred in 5 of the 8 patients, indicating the locally aggressive behavior of this tumor. PMID- 6849032 TI - Clinical efficiency of nuclear magnetic resonance imaging. AB - Advances in imaging technique have improved the efficiency of clinical nuclear magnetic resonance (NMR) imaging, and will allow total patient examination time that equals or is more favorable than that of x-ray computed tomography (CT). The whole head can be examined with NMR in a 6.5-minute imaging time with a spatial resolution of 1.7 mm. Fifteen sections in the body can be similarly imaged. Quantitative T2 ("spin-spin" relaxation time) information, as well as estimates of T1 ("spin-lattice" relaxation time) can be obtained in this time. Quantitative T1 information requires an additional procedure. PMID- 6849034 TI - Thoracolumbar spine injuries associated with vertical plunges: reappraisal with computed tomography. AB - Eighteen patients who had fallen or jumped, and who had sustained fractures of the thoracolumbar spine, were examined with high-resolution computed tomography (CT). Two distinctive patterns of fracture were demonstrated: compression, or wedge, fractures of the vertebral body were present in seven patients, but they were not associated with permanent neurological deficit; and burst fractures with sagittal cleavage into two fragments occurred in five of 11 patients, and they were associated with permanent neurological deficit. CT provided precise and unique information that aided in clinical decision making for this group of patients. PMID- 6849033 TI - Comparison of computed tomography, lymphography, and phlebography in 200 consecutive patients with regard to retroperitoneal metastases from testicular tumor. AB - Two hundred patients with testicular tumor were examined by computed tomography (CT), lymphography, and phlebography of the inferior vena cava and left renal and testicular veins. Metastases were demonstrated in 71. CT was positive in 66, lymphography in 60, phlebography in 53, and a combination of lymphography and phlebography in 65. CT was particularly helpful in studying the upper retroperitoneal space and defining the extent of tumor. Lymphography was preferable for demonstrating metastases in non-enlarged, contrast-filled nodes. Phlebography was never the only positive examination and is not recommended as a routine procedure, though it may be helpful in planning surgery. The authors suggest that CT be performed first, followed by lymphography in negative or equivocal cases. PMID- 6849035 TI - Normal ventilatory movement of the right hemidiaphragm studied by ultrasonography and pneumotachography. AB - The ventilatory movement of the right dome of the diaphragm was studied over the range of the inspiratory capacity in 50 healthy adults in the supine position using simultaneous ultrasonography and pneumotachography. Regional differences were found in movement of the hemidiaphragm; there was greater movement of the middle and posterior thirds of the diaphragm than of the anterior third. A significant positive correlation was found between body weight and amount of diaphragm movement. An apparently greater degree of movement of the diaphragm was found in males than females; this may be related to weight. About 64% of diaphragm movement has occurred by the time midinspiratory capacity is reached. These data may help to define normal movement and also to differentiate abnormal from normal diaphragm movement. PMID- 6849036 TI - Gray-scale sonographic assessment of pancreatitis in children. AB - A total of 144 gray-scale sonograms were obtained in 110 children to evaluate the pancreas. The entire gland was adequately visualized in just over 86% of cases. The size, contour, echo pattern, and echo intensity were assessed. Either diffuse or focal enlargement of the pancreas was the most consistent finding in the 25 children with pancreatitis. In contrast to previous reports, decreased echo intensity was not a reliable indicator of inflammation. Numerous complications were detected on the 54 sonograms of these 25 patients. These complications included pseudocysts, lesser sac fluid collections, ascites, biliary obstruction, and hemorrhage. It is recommended that ultrasound be the initial imaging procedure in the evaluation of children with suspected pancreatic disease, and that it be used in conjunction with clinical and biochemical data. PMID- 6849038 TI - Sonographic findings of pancreatitis in children. AB - The size and echogenicity of the pancreas was evaluated with real-time and static sonography and correlated in an independent and retrospective manner with amylase values in 17 asymptomatic children, 19 children with acute pancreatitis, and 2 with chronic pancreatitis. A ratio of the greatest anteroposterior dimension of the body of the pancreas relative to the transverse lumbar vertebral body measurement (P/V ratio) greater than 0.3, when associated with a hypoechoic pancreatic parenchyma, was indicative of acute pancreatitis. The predictive value of a positive sonogram was found to be 0.93, whereas the predictive value of a negative sonogram was 0.78. These data indicate that sonography is a useful adjunct to amylase determinations in the detection of pancreatitis in children. PMID- 6849037 TI - Plain radiographic diagnosis of thrombosis of left atrial appendage in mitral valve disease. AB - Conventional posteroanterior chest radiographs of 42 patients with mitral valve disease who had had surgery were analyzed, and particular attention was directed to the presence or absence of the convexity of the left lower midcardiac border (left atrial segment). The flatness or concavity of this segment, despite other evidence of left atrial enlargement, was observed in six (60%) of 10 patients who had left atrial thrombosis, and in three (9%) of 32 patients who did not have thrombosis (false positive diagnosis). Four of the 10 patients who had left atrial thrombosis did not show this finding on the radiographs (false negative diagnosis). One of these four had a thrombus only against the posterior wall of the body of the left atrium. Therefore, the accuracy in the diagnosis of thrombosis of the left atrial appendage was 66.7% (six of nine) for patients who had thrombosis of the appendage. Standard chest radiographs are important in the evaluation of the patient with thrombosis of the left atrial appendage. PMID- 6849039 TI - Sonography of the normal neonatal adrenal gland. AB - Ninety-two consecutive neonates were prospectively evaluated with real-time ultrasound to assess the frequency of adrenal visualization. The right gland was identified in 97% of neonates and the left in 83%. Criteria for normal length and width are presented. The characteristic sonographic appearance of the neonatal adrenal is described and correlated with histologic data. Ultrasound is the examination of choice for evaluating the neonatal adrenal gland. PMID- 6849040 TI - Sonography of portosystemic venous collaterals in portal hypertension. AB - Portosystemic venous collaterals were studied with sonography in 40 patients with known portal hypertension. Eight patients had technically inadequate scans, while 32 had optimal scans. Sixty groups of venous collaterals were identified. At least one collateral pathway was seen in 28 patients, for a sensitivity of 88% for the 32 patients with optimal scans and 70% for the total group. The overall sensitivity for detection of coronary-gastroesophageal collaterals was 80% and 64%, respectively. The small size of the coronary-gastroesophageal varices in early portal hypertension seems to be the most important factor limiting detection in patients suitable for sonography. PMID- 6849041 TI - Ultrasonic assessment of hydronephrosis of pregnancy. AB - Real-time renal ultrasonographic scans were obtained of 204 subjects, comprising 159 pregnant and 45 control subjects. A classification of hydronephrosis based on calyceal diameters was established, and the overall incidence of hydronephrosis was found to be 90% on the right side and 67% on the left side. Calyceal diameters for both kidneys were found to increase gradually throughout pregnancy, the right more rapidly than the left. Neither parity nor a history of urinary tract problems was found to be relevant to the degree of dilatation. PMID- 6849042 TI - Work in progress: intraoperative ultrasonography of the spine. AB - We demonstrate the application of intraoperative real-time ultrasound sector scanning in two patients who had spinal tumors. The scans were obtained through a 4- to 5-cm deep, saline-filled operative field. Ultrasonography imaged the tumors, the relationships of the lesions to the spinal cords, and the normal internal structures of the cords themselves. The technique could prove useful in certain forms of spinal surgery. PMID- 6849043 TI - Work in progress: detection of deep venous thrombosis with 99mTc-sulfur colloid. AB - Scintigrams of the leg were obtained following antecubital venous injection of 99mTc-sulfur colloid (SC) in 25 patients with suspected deep venous thrombosis. Contrast venograms were taken following the scan in all cases. Of 14 patients with confirmed deep venous thrombosis, 11 had positive scans. Of 11 patients with normal venograms, 10 had negative scintigrams. The simplicity of 99mTc-SC venography and its high rate of accuracy (84% in this series) suggest that it may be useful as a relatively noninvasive means of identifying deep venous thrombosis of the leg. PMID- 6849044 TI - Predictive value of an abnormal hepatobiliary scan in patients with severe intercurrent illness. AB - Ten patients had severe intercurrent illness and the gallbladder could not be seen on a hepatobiliary scan. In 4, surgery and pathological examination showed that the gallbladder was normal; 1 had chronic cholecystitis and 5 had acute acalculous cholecystitis. This study indicates that a positive hepatobiliary scan may not be indicative of acute gallbladder disease in the seriously ill patient. PMID- 6849045 TI - Thymus irradiation for myasthenia gravis. AB - Twenty-eight patients with progressive myasthenia gravis without thymoma received treatment of 3000 rads (30 Gy) to the anterior mediastinum, and a followup was conducted for five to 18 years. Twenty-four patients had generalized myasthenia, and four had ocular myasthenia gravis. Twenty patients with generalized myasthenia survived the several month post-treatment period and improved, but four died during that period. The improvement lasted a median of 1.5 years, and older patients had longer remissions than younger patients. The four patients who had ocular myasthenia did not change after treatment. Mediastinal irradiation produces a temporary remission in generalized myasthenia. PMID- 6849046 TI - Comparison and variations of the speed of radiographic film. AB - A study of 50 different batches of film from 20 institutions across Ontario was conducted to measure sensitivities when exposed between intensifying screens and to white light. For films of different types but of the same nominal speed, the x ray exposures required to produce a net optical density of 1.0 varied by a factor of up to 2.5. For films of the same type from different batches, the required exposure varied by +/- 20%. It was found that sensitivity to white light from the commonly used Wejex sensitometer was not always a good indicator of x-ray sensitivity, and therefore should not be used to compare speeds of different films or films from different batches. PMID- 6849047 TI - Anticrossover emulsions evaluated by observer performance tests. AB - Observer performance in the detection of pulmonary nodules and infiltrates was measured using film coated with anticrossover emulsion, a recent innovation in radiographic film that is expected to produce sharper images because of improved resolution. Test radiographs of an anthropomorphic phantom were shown to six experienced observers. Radiographs containing pseudonodule and pseudoinfiltrate images were obtained with the anticrossover film and the same type of film without the anticrossover coating. Test images contained single nodules, single infiltrates, or both; approximately 45% of the test radiographs were normal. Individual receiver operating characteristic (ROC) curves were formed, and sensitivity and specificity values were calculated. The results demonstrated an improvement in observer performance with the anticrossover film as measured by sensitivity and the area under the average ROC curves. PMID- 6849049 TI - A new subcutaneous vascular access device: an experimental evaluation. PMID- 6849051 TI - Sling retraction for proximal placement of percutaneous transhepatic biliary endoprosthesis. PMID- 6849050 TI - Hyaluronidase for the treatment of hematoma at an angiographic puncture site. PMID- 6849052 TI - Removing air bubbles prior to drip infusion cholangiography. PMID- 6849053 TI - Arthrography of total hip replacement. PMID- 6849054 TI - A simple modification of real-time sector sonography to monitor percutaneous nephrostomy. PMID- 6849048 TI - Analysis of the pulmonary circulation using digital intravenous angiography. AB - We evaluated pulmonary transit time in dogs and humans using digital intravenous angiography. Digital data were acquired in both the control state and after isoproterenol was administered to alter the inotropic state. When compared with the control value, transit time was shortened with isoproterenol in both dogs and humans. The inter- and intraobserver variabilities were small (less than 4%), as were the variabilities in data obtained from two sequential injections (less than 5%). Digital analysis of the pulmonary circulation time is a simple technique that requires little image manipulation. This information may be obtained during standard digital cardiac studies, and it can assist in the analysis of cardiopulmonary dynamics. PMID- 6849055 TI - Evaluation of video-printer images as secondary CT images for clinical use. PMID- 6849056 TI - Thallium-201 imaging artifacts not detected by technetium-99m or cobalt-57 quality-control testing. AB - Early stages of hydration in a sodium iodide crystal may cause artifactual "hot" spots on thallium-201 heart images. This phenomenon was observed when a mobile gamma camera was used even though the daily quality-control flood-field views revealed no apparent abnormalities. Nevertheless, hot spots were visible on thallium-201 and xenon-133 flood-field images. With asymmetric photopeak positioning using a technetium-99m source, hot spots were noted in addition to phototube nonuniformities. Subsequently, the camera head was disassembled, the crystal was inspected visually, and the crystal seal was found to be broken. Hydration of the crystal was confirmed by the camera manufacturer. Quality control procedures should test for hydration-induced artifacts on a regular basis. PMID- 6849057 TI - Evaluation of two pediatric cardiac converging collimators. PMID- 6849058 TI - Tantalum-178 count-rate limitations of Anger and multicrystal cameras. PMID- 6849059 TI - A quality assurance protocol for CT scanners. AB - Numerous CT performance-evaluation procedures have been described in the literature, but they are generally unsuitable for routine quality-assurance (QA) testing. This report describes the QA test protocol performed at two institutions. The protocol is comprehensive and practical to perform on a routine basis. Test data demonstrate that clinically significant changes in CT scanner performance do occur, and that this protocol is capable of detecting these changes. PMID- 6849061 TI - Film interpretation session, Radiological Society of North America sixty-eighth scientific assembly and annual meeting, November 1982. Summary of discussion and diagnoses. Case reports. PMID- 6849060 TI - The design of shielding windows using lead glass, lead acrylic, and plate glass. PMID- 6849063 TI - Renal masses considered indeterminate on computed tomography. PMID- 6849062 TI - Work in progress: transverse striations of the esophagus: association with gastroesophageal reflux. AB - Transverse mucosal ridging of the esophagus may be demonstrated on double contrast esophagrams as transverse striations. A case review of 44 patients who had transverse striations was performed to evaluate the significance of the striations with respect to gastroesophageal reflux. Gastroesophageal reflux was significantly more common among patients who had transverse striations than it was in the general population who had been referred for the barium meal. This does not imply that all patients with transverse striations or with reflux at fluoroscopy have esophagitis. However, recognition of transverse striations should prompt careful evaluation for reflux and associated complications in symptomatic patients. PMID- 6849064 TI - Evaluation of the pulmonary hila by CT. PMID- 6849067 TI - Fungal disease of the ureter. PMID- 6849065 TI - Fat necrosis of the breast: characteristic xeromammographic appearance. AB - Eight cases of fat necrosis of the breast were examined by xeromammography and confirmed pathologically. They showed a spectrum of mammographic appearances, from mimicking other benign diseases to suggesting a malignant lesion. Three of the eight cases showed the benign ring-like calcification associated with fat necrosis; this is a higher percentage than reported in previous series. In our experience this radiological presentation of fat necrosis is not infrequent and biopsy of these lesions is not necessary unless other clinical or radiological signs suggest malignancy. PMID- 6849066 TI - Lymphography in the management of urologic tumors. Radiological-pathological correlation. AB - Of 59 patients undergoing lymphography as part of staging for urologic tumor (bladder carcinoma, prostate carcinoma, seminomatous and nonseminomatous testicular tumors), histological material was obtained in 38. Lymphography was shown to have a specificity of 95%, a sensitivity of 81%, and an overall accuracy of 89%. When lymph node regions were considered, the specificity was 99.2%, sensitivity 59%, and overall accuracy 91%. Causes of discrepancies between radiography and histology are evaluated and receiver operating characteristic curves are demonstrated. PMID- 6849068 TI - Paresis following internal iliac artery embolization. AB - Extensive lower limb paresis developed in three patients with terminal cancer following internal iliac (hypogastric) artery embolization. This procedure was carried out for control of hemorrhage in two of the patients and for reduction of the bulk of metastatic tumor in another. The embolic materials used resulted in extensive obliteration of small and large vessels of the posterior and anterior divisions of the internal iliac artery. The paresis is attributed to the resulting ischemia of the sciatic and femoral nerves; previous radiotherapy may also have been a contributing factor. To reduce the incidence of paralysis, identification of the bleeding vessels and selective embolization are recommended. If this cannot be achieved, and the catheter lies in the main stem, it is recommended that the emboli should not be smaller than Gelfoam pledgets (1 X 1 X 10 mm) to preserve the peripheral circulation and lessen the risk of complication. PMID- 6849069 TI - Cryptic vascular malformations involving the brainstem. AB - Six patients with angiographically cryptic vascular malformations involving the brainstem were examined with computed tomography (CT). The clinical and CT findings of cryptic vascular malformations of the brainstem are described and distinguished from those of brainstem glioma and multiple sclerosis. Calcification within a brainstem lesion that displays relatively little mass effect and shows little contrast enhancement, particularly when associated with a long history of waxing and waning brainstem symptoms, should suggest a vascular malformation. PMID- 6849070 TI - Coats' disease: CT-pathologic correlation in two cases. PMID- 6849071 TI - The value of computed tomographic metrizamide myelography in the neuroradiological evaluation of the spine. AB - The diagnostic value of plain film metrizamide myelography (PFMM) was compared with computed tomographic metrizamide myelography (CTMM) in a study of 106 individuals who had undergone high-resolution computed tomographic scanning of the spine. CTMM provided more significant information than PFMM in 42 of 106 cases (40%), but showed no advantage over PFMM in 63 of 106 cases (59%). In 19 of the 42 cases (45%), PFMM was useful in directing the CT analysis to the appropriate region of pathology. In one patient, PFMM revealed a mobile herniated disc that had not been visualized with CTMM. In 30 of 106 cases in which plain CT scans of the spine were also obtained, the addition of intrathecal metrizamide demonstrated additional pathology in ten individuals. In general, CTMM was useful in the delineation of a variety of pathologic entities, especially neoplasms and congenital abnormalities. Low-dose CTMM (3 ml of a 150 ml/mg concentration) was performed as an outpatient procedure and found to be a useful adjunct to plain CT in two patients. A schema for the radiological evaluation of pathology of the spine is presented. PMID- 6849073 TI - Nature of vertex striations on lateral skull radiographs. PMID- 6849072 TI - The need for skull radiography in patients presenting for CT. AB - One thousand patients had both CT of the head and a conventional skull series of radiographs. Radiographic findings were abnormal in 250 patients (25%), but only 64 patients (6.4%) had diagnostically significant abnormalities at radiography that were not detected by CT. If the 163 patients who presented after acute trauma were excluded from the series, only 39 (4.7%) of the remaining patients had radiographically significant abnormal findings that were not seen at CT, and only two (0.2%) of these abnormalities could not be diagnosed by a lateral skull radiograph alone. In only five patients (0.5%) was the management actively changed because an abnormality that was detected at skull radiography was not detected at CT. Thus, in nontrauma patients who have stroke, epilepsy, dementia, or nonspecific symptoms without focal signs, or have recently undergone craniotomy, and who have been referred for CT, skull radiographs are not justified. In the patient with a history and findings that are strongly suggestive of a pathological disorder anywhere other than in the sella turcica, cerebello-pontine angle, and paranasal sinuses, only the lateral skull radiograph should be obtained after CT, and only if CT is equivocal. PMID- 6849074 TI - Detectability of depth information by use of magnification stereoscopic technique in cerebral angiography. AB - Two types of stereoscopic phantoms were constructed to determine the sensitivity of observers in detecting depth information obtained by means of the magnification stereoscopic technique. One of these, a "plus" phantom, contained perpendicular aluminum wires at the top and bottom of steps of various thicknesses; the observer was asked to identify whether one of the wires was on the top, the bottom, or uncertain in location. The fraction of correct responses versus the height of the step was plotted, indicating the detectability of depth. Fourteen of 20 unselected observers (70%) responded consistently and were considered "good" observers. In general, the greater the stereo shift, the greater the fraction of correct responses. A second phantom, a mesh phantom, contained standard and randomly positioned test wires. The observer was asked to identify the depth position of a test wire with respect to the standard wire if they were in the same plane. It was found that observers can discriminate depth differences of one to two millimeters in magnification stereoscopy, and similar performance for magnification stereoscopic cerebral angiograms is expected. PMID- 6849075 TI - A systematic technique for comprehensive evaluation of the temporal bone by computed tomography. AB - A systematic method for comprehensive visualization of the temporal bone structures using thin-section, high-resolution computed tomography (CT) was developed. In relation to the anthropologic baseline (0 degrees), four separate tomographic planes of 0 degrees, 30 degrees, 70 degrees, and 105 degrees were each found to optimize different aspects of temporal bone evaluation with significant reduction in the radiation dose to the lens. Virtually all patients were able to maintain the necessary head positioning that allows for both direct coronal and axial sections. It is concluded that in the majority of cases, thin section, high-resolution CT can replace polytomography, although the examinations may be complementary in the evaluation of certain abnormalities. PMID- 6849078 TI - Reticular mosaic (urticarial) pattern of the colonic mucosa in Yersinia colitis. AB - The colonic mucosa of a patient with Yersinia colitis exhibited a reticular mosaic pattern on an air-contrast barium enema. The authors conclude that Yersinia colitis can be added to the list of colonic lesions producing this characteristic pattern. PMID- 6849077 TI - Coarse areae gastricae in the proximal body and fundus: a sign of gastric hypersecreton. Radiological and endoscopic correlation. AB - The clinical significance of coarse areae gastricae in the proximal body and fundus on the double-contrast radiograph was investigated in 60 patients. Radiographic findings were correlated with endoscopic features and biochemical analysis of gastric juice as well as with the clinical and endoscopic features of 98 controls with a regular mucosal pattern. The patients with the coarse pattern had more gastric secretion than the control group. Ulcers were seen in 65% of patients, particularly in the duodenum (48%); they were more commonly associated with a coarse pattern and closely related to gastric hyperacidity. Coarse areae gastricae in the proximal body and fundus may be a useful radiographic sign in assessment of gastric secretion. PMID- 6849076 TI - Salicylate-induced pulmonary edema. AB - Noncardiogenic pulmonary edema occurs in 35% of salicylate-intoxicated patients who are over 30 years old. Cigarette smoking, chronic salicylate ingestion, a component of metabolic acidosis, and the presence of neurological symptoms on admission are strong risk factors for the subsequent development of pulmonary edema in the appropriate age group. In the absence of these risk factors, salicylate-induced pulmonary edema is rare. The etiology is multifactorial, but it centers around altered vascular permeability in the lungs. PMID- 6849079 TI - Unusual abdominal complications of ventriculo-peritoneal shunts. AB - Placement of ventriculo-peritoneal (VP) shunts is an established procedure for treatment of hydrocephalus. With increasing longevity following successful treatment, complications are becoming more common. The authors reviewed 350 VP shunts in 242 patients and found five uncommon complications relating to the peritoneal end of the catheter: (a) cerebrospinal fluid (CSF) pseudocyst of the lesser sac, (b) subphrenic CSF loculation, (c) bowel perforation and formation of a CSF-enteric fistula, (d) intrathoracic migration of the tip of the shunt, and (e) intractable CSF ascites. PMID- 6849081 TI - Compensatory hypertrophy of bone following surgery on the foot. AB - Compensatory hypertrophy of bone developed in 5 patients following surgery on the foot. The typical finding of diffuse cortical thickening of the entire ray is thought to represent a static compensatory response which occurs when the usual dynamic response of altered weight-bearing is inadequate or overridden. PMID- 6849080 TI - Radiographic and morphological features of cyst formation in idiopathic bone infarction. AB - Cyst formation in an infarcted bone, though rare, can be diagnosed with reasonable confidence when radiographs show an expanding lytic lesion confined by an intact but attenuated cortex. If the cortex is destroyed and a periosteal response or soft-tissue mass is present, malignant transformation should be suspected. PMID- 6849082 TI - Work in progress: percutaneous transhepatic electrocutting of stenoses after hepaticojejunostomy. AB - A new technique for diathermic incision of stenosed biliary-intestinal anastomoses using a papillotome and high-frequency current is described. The method was applied successfully and without complication in three patients. Despite effective cutting in one patient, multiple residual calculi impacted in the intrahepatic bile ducts necessitated later removal of the stones surgically. PMID- 6849083 TI - Grids in mammography. AB - A special soft-tissue grid reduced scattered radiation to the receptor and resulted in improved contrast and visibility of small structures to the degree that increased kVp could be used during screen-film mammography. The reduction in radiation to the skin that is associated with the more penetrating higher kVp technique more than compensated for the Bucky factor of the grid. This technique allowed for better penetration of the base of large, dense breasts without the use of vigorous compression. Results that were obtained with a faster (2X) film are also presented and discussed. PMID- 6849084 TI - A visual concept shapes image perception. AB - Six subjects--three radiologists and three laypersons--were shown a hidden figure picture, a sonogram, a tomogram, and two standard radiographic images while their eye movements were recorded. They were asked to summarize each of the images in one sentence. The distribution of visual attention was found to be related to the assignment of meaning to the image. When the interpretation of the image was correct, visual attention focused on the main subject or radiological abnormality. When the viewers found the images to be ambiguous, visual attention focused on dominant pictorial features such as borders or textured areas. These features were then used to generate a meaningful perception in response to the request for a summary statement. The data are interpreted in terms of a theory that holds that picture perception begins with a parallel global characterization of the scene that uses data from both the retina and memory to form a visual concept. According to this theory, it may be necessary to have seen radiological abnormalities in the past to be able to form an appropriate visual concept for a current abnormality. PMID- 6849085 TI - The abused child: a radiological reappraisal. AB - Radiological findings in 563 abused infants and children who were studied retrospectively emphasize the limitations of diagnostic imaging, specifically radiographic examination of the skeleton. Skeletal trauma was detected in less than one-third of all patients and was uncommon beyond two years of age. Fractures were rarely present without clinical evidence of physical abuse. Radiographic features considered specific for child abuse (epiphyseal metaphyseal, rib fractures) or highly suggestive (occult, multiple/repetitive fractures) were distinctly infrequent and limited to infancy. A more efficacious approach to radiological evaluation based on clinical presentation is offered. PMID- 6849086 TI - Spinal cord size in syringomyelia: change with position on metrizamide myelography. AB - Change in the anteroposterior diameter of the cervical spinal cord was demonstrated on metrizamide myelography in 20 out of 40 cases of cervical syringomyelia. Twelve of these were normal-sized cords, four were small, and four enlarged. Comparable lateral cervical myelograms in the prone and supine positions were sufficient to show size change for normal-sized or small cords. Additional myelograms in the erect and Trendelenburg positions were necessary to show size change in enlarged cervical cords, especially with associated Chiari malformation. A localized change in cord size suggests syringomyelia. If the change in cord size is diffuse, then change less than 10% is not necessarily significant. In undiagnosed myelopathy, metrizamide myelography has the potential to detect unsuspected syringomyelia even when the cord is normal-sized or small. Myelographic study may also be useful as an adjunct to delayed computed tomographic studies. PMID- 6849087 TI - Posttraumatic spinal cord cysts: clinical features and characterization with metrizamide computed tomography. AB - Sixteen patients with posttraumatic spinal cord cysts (PTSCC) were evaluated clinically and studied with metrizamide computed tomography (MCT). These patients presented months to years following a severe spinal cord injury, usually with new or progressively worsening neurological symptoms. The development of the PTSCC was unrelated to the location, type, and severity of injury, or to the time interval from the original injury. MCT showed that these cysts occur most frequently in normal or atrophic cords, they may be multiple, they most frequently are found in the dorsal portion of the cord, and they may vary along their length in width and position within the cord. Knowledge of this radiographic morphology is crucial to the surgical planning. The location of the cysts and the mode of their enlargement are correlated with anatomic features of the spinal cord and changes in cerebrospinal fluid dynamics. Cyst-to-subarachnoid space shunting relieves the majority of symptoms. PMID- 6849088 TI - Nuclear magnetic resonance imaging of the kidney. AB - The role of nuclear magnetic resonance (NMR) imaging of the kidney was analyzed in 18 persons (6 normal volunteers, 3 patients with pelvocaliectasis, 2 with peripelvic cysts, 1 with renal sinus lipomatosis, 3 with renal failure, 1 with glycogen storage disease, and 2 with polycystic kidney disease). Ultrasound and/or computed tomography (CT) studies were available for comparison in every case. In the normal kidney distinct anatomical structures were clearly differentiated by NMR. The best anatomical detail was obtained with spin echo (SE) imaging, using a pulse sequence interval of 1,000 msec and an echo delay time of 28 msec. However, in the evaluation of normal and pathological conditions, all four intensity images (SE 500/28, SE 500/56, SE 1,000/28, and SE 1,000/56) have to be analyzed. No definite advantage was found in using SE imaging with a pulse sequence interval of 1,500 msec. Inversion recovery imaging enhanced the differences between the cortex and medulla, but it had a low signal to-noise level and, therefore, a suboptimal overall resolution. The advantages of NMR compared with CT and ultrasound are discussed, and it is concluded that NMR imaging will prove to be a useful modality in the evaluation of renal disease. PMID- 6849089 TI - Computed tomography in the staging of esophageal carcinoma. AB - The computed tomographic (CT) findings in 52 patients with histologically proved esophageal carcinoma were reviewed. In 30 of these patients, the CT findings were correlated with findings at surgery or autopsy. CT was found to be highly accurate in predicting tumor size and assessing invasion of the tracheobronchial tree and spread to the liver, adrenals, and celiac and left gastric nodes. By quantifying the contact between the tumor and aorta, it was found that the CT appearance correctly predicted the presence or absence of aortic invasion in 24 of 25 cases (five cases were indeterminate). CT was insensitive in detecting metastatic spread to local periesophageal nodes; in these cases the tumor tended to involve the nodes without enlarging them. CT is an accurate method for assessing the spread of esophageal carcinoma. Its use can prevent unnecessary surgery in patients with inoperable tumors. PMID- 6849090 TI - A prospective study of computed tomography and ultrasound in the detection and staging of pelvic masses. AB - Findings from computed tomography (CT) and ultrasound (US) examinations of 74 patients who were clinically thought to have pelvic masses and of 110 patients who had possible recurrence of pelvic tumors were analyzed. There was no significant difference in the ability of the two modalities to identify masses or to predict disease extent. Although both CT and US failed to detect some examples of spread outside of the pelvis, overstaging (apart from two cases of unconfirmed parametrial spread) did not occur with CT and occurred only once with US. The sensitivity was 0.96 for CT and 0.91 for US in the detection of pelvic masses. Both modalities had an accuracy of 0.81 in the detection of recurrent disease. PMID- 6849091 TI - The role of CT in demonstrating perivesical tumor growth in the preoperative staging of carcinoma of the urinary bladder. AB - Carcinoma of the urinary bladder was staged both clinically and by CT in 32 patients before they underwent total cystectomy. Eleven of the patients had perivesical growth demonstrated at histopathological examination of the cystectomy specimen. This was diagnosed by CT in all 11 of these patients before cystectomy, but it was discovered by clinical staging in only four patients prior to cystectomy. Seven patients without histopathologically proved perivesical growth were considered to have perivesical spread as demonstrated by CT findings. Three of these patients had perivesical fibrosis that was misinterpreted as perivesical tumor growth, and in all seven patients the perivesical changes were adjacent to the area of present or previous changes in the bladder wall. CT is a valuable addition to clinical staging because it demonstrates perivesical tumor growth. PMID- 6849092 TI - Abdomino-pelvic computed tomography in the management of ovarian carcinoma. AB - 121 CT scans were obtained in 75 women with ovarian cancer, including 108 scans of the abdomen and pelvis and 13 of the pelvis alone. 70 patients had epithelial carcinoma. In 48 cases, pelvic CT was performed within 3 weeks after surgery, confirming the operative findings in all but 6. In the abdomen, CT identified intrahepatic deposits and minimal ascites not seen at surgery; however, small peritoneal deposits not usually shown by CT were readily found at surgery. CT was superior to clinical examination, detecting unsuspected disease and delineating areas of known disease more accurately. It was also helpful in assessing suitability for repeat laparotomy. In 7 cases, CT demonstrated an operable lesion which had been thought to be inoperable. In 65 cases (59%), CT contributed additional information which was helpful in management, proving it to be an important noninvasive investigation in patients with ovarian carcinoma. PMID- 6849093 TI - Value of computed tomography in interstitial 125I brachytherapy of prostatic carcinoma. AB - Computed tomography (CT) was performed in 20 patients with localized prostatic carcinoma before and after interstitial implantation of 125I seeds. Scans were analyzed to determine prostate volume, seed location, tumor response, and periprostatic tumor spread. CT volumes were an average of 25-30% greater than clinical estimates. In addition, CT demonstrated errors in implantation, including inhomogeneous distribution and extraprostatic seeds, in 17 patients (85%). Serial post-implantation scans showed no change in prostate volume in 12 patients (60%), a decrease in 7 (35%), and an increase in 1 (5%), concurring with clinical assessment of response to therapy. In 2 patients, clinically unsuspected tumor spread was identified on the CT scan. PMID- 6849094 TI - Intraoperative real-time ultrasound in the localization of intracranial neoplasms. AB - Intraoperative ultrasound imaging in the localization of intracranial lesions in eight patients is described. This technique is effective in tumor location, and it can be used throughout surgery to monitor the extent of tumor resection. The ability to locate precisely a deeply situated intracranial lesion intraoperatively can reduce the risk of damage to normal tissue, assist in determining the extent of tumor resection, and reduce the time of surgery. Intraoperative ultrasound holds great promise, but if it is to be used to its fullest extent, further modifications of transducers must be developed. PMID- 6849096 TI - Prospective diagnosis of choledocholithiasis. AB - Choledocholithiasis was detected by ultrasound in 11 of 87 patients (13%) overall, including 11 of 56 patients (20%) who had dilated ducts. Choledocholithiasis occurred with a normal caliber common bile duct in 31 of 87 patients (36%), and choledocholithiasis occurred without stones in the gallbladder in seven of 66 patients (11%). Biliary ultrasound plays a limited role in the exclusion of choledocholithiasis. PMID- 6849095 TI - The occurrence of fluid collections following routine abdominal surgical procedures: sonographic survey in asymptomatic postoperative patients. AB - To investigate the frequency and appearance of reactive effusions following abdominal surgery, a prospective real-time sonographic survey of 80 asymptomatic postoperative patients was conducted. Serial scans on the 4th, 8th, and 12th postoperative days disclosed localized abdominal fluid collections in 19% (15/80), 6% (5/80), and 2.5% (2/80) of cases, respectively. The only collection that enlarged was an abscess. Knowledge of the natural history of reactive postoperative effusions should help the ultrasonographer to detect pathologic fluid collections and abscesses in postsurgical patients. PMID- 6849097 TI - Ultrasonic evaluation of common bile duct stones: prospective comparison with endoscopic retrograde cholangiopancreatography. AB - Ultrasound is the modality of choice for the diagnosis of cholelithiasis and for the evaluation of the intra- and extrahepatic biliary tree in the patient with jaundice, but its role in the diagnosis of choledocholithiasis is less certain. We prospectively examined 90 patients who were to undergo endoscopic retrograde cholangiopancreatography (ERCP) by performing right upper quadrant sonography immediately prior to ERCP. We assessed the size of the intra- and extrahepatic ducts and the presence or absence of calculi. ERCP, which was successfully performed in 77 of 94 attempted examinations, percutaneous transhepatic cholangiography, or surgical follow-up composed the diagnostic standard for comparison. Ultrasound was not accurate in the diagnosis (sensitivity, 25%) or exclusion (value of a negative study, 73%) of choledocholithiasis. Furthermore, in the postcholecystectomy patient population, ultrasound assessment of biliary duct size is not a useful predictor of biliary disease. For symptomatic postcholecystectomy patients, we recommend ERCP as the initial diagnostic modality. PMID- 6849098 TI - Choledocholithiasis and cystic duct obstruction: difficult ultrasonographic diagnosis. AB - Ultrasonography of 53 patients with stones in either the common bile duct (CBD) or the gallbladder neck/cystic duct revealed respective sensitivities of only 30% and 29% for detection of calculi. The data, which were collected over a period of 40 months, were also analyzed with respect to our early experience (first 24 months) versus our later experience (last 16 months). Although there was no improvement in the diagnosis of gallbladder neck/cystic duct calculi (only those in the gallbladder neck could be identified), significant improvement occurred in the diagnosis of choledocholithiasis, with a sensitivity of 15% in the early period and a sensitivity of 55% in the later period. In part this was due to greater dependence upon real-time equipment and more emphasis on the examination of the distal CBD. A limiting factor in the diagnosis of choledocholithiasis was the normal caliber of the duct in 30% of these patients. Despite improved equipment and technique, ultrasonography cannot detect cystic duct obstruction, and the ultrasonographic diagnosis of CBD calculi remains difficult. PMID- 6849099 TI - Ultrasound analysis of solid-appearing abscesses. AB - A retrospective review of 96 abdominal abscesses yielded 11 cases (9%) that were diffusely echogenic on sonograms and that stimulated findings of solid lesions. Sonographic features of these abscesses were analyzed and compared with features of 78 cases of hepatic metastasis. An abscess was considered solid appearing when it contained diffuse internal echoes that were distributed over 90% of the abscess cavity. The visualized internal echoes were of low to medium amplitude, and were generally similar to the normal echogenicity of the parenchymal organs, such as the liver, spleen, or uterus. Distal acoustic enhancement was seen in 91% of the solid abscesses, and it was not seen in hepatic metastases. A distinct echogenic wall was present in 64% of the abscesses (subacute and chronic lesions), but this occurred in less than 4% of metastases. Thin peripheral halos inside or outside of and adjacent to the abscess wall were seen in 36% of abscesses. The peripheral halos seen in metastases were wider and not associated with an echogenic wall. The diagnosis of a diffusely echogenic abscess and differentiation from a neoplasm is possible when the sonographic findings of acoustic enhancement, thin peripheral halo, and echogenic abscess wall are present. PMID- 6849100 TI - Artifacts in iodine-131 renal images due to coincidence summing of technetium-99m photons. AB - Technetium-99m gamma camera images of kidneys produced with an iodine-131 energy window showed "ghosts" over and between the kidneys and between the kidneys and the bladder. The cause was coincidence summing at 281 keV due to a high 99mTc counting rate. In older model cameras careful peaking with a proper energy window reduces this effect; more recently developed cameras with pileup rejection circuits do not have this problem. PMID- 6849101 TI - A simple equivalent tissue-air ratio method for calculating absorbed dose in a heterogeneous medium. AB - Density correction factors for 60Co gamma rays and 8-MV x rays were measured with an ionization chamber in water-equivalent phantoms containing simulated lung or bone inhomogeneities larger or smaller than the beam (beam sizes, 5 x 5 to 30 x 30 cm). Measurements were compared with values calculated from the effective SSD method, the generalized Batho power law method, and a simplified equivalent tissue-air ratio (SETAR) method. The results indicate that the SETAR method gives the best overall agreement with experimental values, while the effective SSD and Batho algorithms are accurate only in certain situations. The SETAR method seems adequate for most clinical applications. PMID- 6849102 TI - Collagen accumulation in irradiated rat lung: modification by D-penicillamine. AB - The collagen antagonist D-penicillamine (10 mg/day, p.o.) significantly ameliorated radiation-induced hydroxyproline (HP) accumulation in the lungs of rats killed 3, 6, 9, or 12 months after a single exposure of 25 Gy of 60Co gamma rays to the right hemithorax. The beneficial effect of penicillamine was observed when HP values were expressed on the basis of wet weight, dry weight, or per whole lung and was not accompanied by significant changes in the size of the soluble (0.5 M citrate, pH 3.6) collagen fraction. This drug regimen had no effect on HP concentration in the shielded left lung and was apparently free of deleterious side effects. PMID- 6849103 TI - Observations on the intraperitoneal distribution of chromic phosphate (32P) suspension for intraperitoneal therapy. AB - Seven patients received intraperitoneal chromic phosphate (32P) suspension in a 3 ml bolus with a saline flush, and another ten patients were given the suspension in a 500-ml infusion of normal saline. During the first six hours after administration, most 32P activity redistributed to the gravity-dependent portion of the peritoneal cavity. From 24 hours up to seven weeks after administration, activity distributions were fixed. Dispersions were heterogeneous in every patient, but the most marked examples of localized activity occurred in patients who had received bolus injections. We concluded that large-volume infusions and frequent changes in patient position for several hours following the infusion, contribute to improved dispersion of 32P suspension. PMID- 6849104 TI - Aluminum-wedge filter for improved arch aortograms. PMID- 6849105 TI - Computed-tomographic-guided minithoracotomy. A preliminary report of a new approach to open lung biopsy. AB - The authors describe a simple computed-tomographic method, using precise surface localization, to locate small subpleural nodules or pulmonary lesions. This permits a guided minithoracotomy for chest lesions which are not visible on plain radiographs or are considered inaccessible by percutaneous or transbronchoscopic biopsy. PMID- 6849106 TI - Rapid, inexpensive real-time directed thoracentesis. AB - A safe, inexpensive, and expedient real-time ultrasound-directed thoracentesis technique that uses a unique closed needle-syringe assembly is described. No pneumothorax has occurred over a four-year period using this technique with 110 patients. PMID- 6849108 TI - Catheters for selective arteriography. Additional configuration alternatives. PMID- 6849107 TI - Real-time ultrasound-guided prostatic biopsy using a new transrectal linear-array probe. PMID- 6849110 TI - Use of through-the-lens light metering in making slides of radiographs. PMID- 6849111 TI - Rapid-process copy-film exposure times. PMID- 6849109 TI - Wrist arthrography. The value of fluoroscopic spot viewing. AB - Wrist arthrography is a valuable procedure for the identification of scapholunate or lunotriquetral ligament tears. The addition of sequential filming during the injection of contrast material permits the arthrographer to determine accurately the specific ligament which is ruptured. PMID- 6849112 TI - Leadership in computer technology. PMID- 6849113 TI - Fishing for a forum on health policy. PMID- 6849114 TI - Spread of AIDS sparks new health concern. PMID- 6849115 TI - Human endometrial adenocarcinoma transplanted into nude mice: growth regulation by estradiol. AB - A model for studying the growth of primary tumors of human endometrium and its regulation by 17 beta-estradiol has been developed in which ovariectomized nude mice are used as recipients. The receptors for sex steroids are maintained during serial transplantation of the tumor in this system. Although the rate of growth of receptor-negative endometrial tumors transplanted into ovariectomized nude mice is unaffected by the sustained presence or absence of estradiol, the growth of receptor-positive tumors is significantly increased by estradiol. Receptor positive tumors treated with estradiol produced elevated concentrations of progesterone receptor. That the progesterone receptor is functional in this tumor is evident from the induction of estradiol 17 beta-dehydrogenase activity upon progestin administration. These findings are consistent with receptor-mediated regulation of growth of endometrial carcinoma. PMID- 6849116 TI - Oxidative bioactivation of S-alkyl phosphorothiolate pesticides: stereospecificity of profenofos insecticide activation. AB - The mouse liver microsomal mixed-function oxidase system converts several phosphorothiolate pesticides with S-ethyl, S-propyl, or S-butyl groups to more potent inhibitors of acetylcholinesterase. This activation is stereospecific for the chiral isomers of O-(4-bromo-2-chlorophenyl) O-ethyl S-propyl phosphorothiolate (profenofos insecticide); the more toxic (-) isomer becomes a 34-fold better inhibitor of acetylcholinesterase in vitro, whereas the less toxic (+) isomer is deactivated by a factor of 2. Prior treatment of the microsomes with piperonyl butoxide or another mixed-function oxidase inhibitor markedly decreases the activation. Piperonyl butoxide also protects against brain acetylcholinesterase inhibition and cholinergic symptoms in chicks resulting from (-)-profenofos administration, thus establishing the importance of the oxidative bioactivation of S-alkyl phosphorothiolate pesticides in vivo. PMID- 6849117 TI - Guanosine triphosphate activation of brain adenylate cyclase: enhancement by long term antidepressant treatment. AB - Activation of adenylate cyclase by a stable guanosine 5'-triphosphate analog was augmented in brain membrane preparations from rats treated on a long-term basis with tricyclic antidepressants or electroconvulsive shock. These treatments may facilitate cyclase activation by promoting the interaction of the regulatory and catalytic subunits of the enzyme. This finding suggests a possible mechanism for the changes in sensitivity to various neurotransmitters seen after antidepressant administration. PMID- 6849118 TI - Parathyroid hormone: effects of the 3-34 fragment in vivo and vitro. AB - The biologically active fragment ofparathyroid hormone, consisting of residues 1 34, and its in vitro antagonist, fragment 3-34, were administered separately or in combination to chronically thyroparathyroidectomized dogs. These fragments were also studied in vitro with dog renal cortical membranes. Fragment 3-34 inhibited the stimulation of adenylate cyclase by fragment 1-34 in vitro, but had no agonist or antagonistic effects on renal phosphate transport in vivo. PMID- 6849120 TI - Effects of tyrosine administration on serum biopterin in normal controls and patients with Parkinson's disease. AB - After administration of tyrosine, total concentration of biopterin, the cofactor for tyrosine hydroxylase, was increased in the striatum, adrenal glands, and serum of rats, and in the serum of humans. Serum biopterin is lower in patients with Parkinson's disease than in normal controls. After oral administration of tyrosine, the increase in serum biopterin concentration was smaller in patients with Parkinson's disease (less than twofold) than in healthy controls (three-to sevenfold). These results suggest that tyrosine may have a regulatory role in biopterin biosynthesis and that patients with Parkinson's disease may have some abnormality in the regulation of biopterin biosynthesis. PMID- 6849121 TI - Role for acetylcholine in mediating effects of light on reproduction. AB - The length of day, or photoperiod, regulates the annual cycle of reproductive activity in the golden hamster. The inhibitory effects of a short-day photoperiod on testicular function were prevented by nighttime, but not daytime, intraventricular injections of carbachol, a cholinergic agonist. Short pulses of light during the night also block short-day induced testicular regression. The findings suggest that acetylcholine may play an important role in the mechanism through which information about the light-dark environment is transferred to the hypothalamic-pituitary-gonadal axis. PMID- 6849123 TI - Vaginal stimulation: an important determinant of maternal bonding in sheep. AB - The immediate induction of the full complement of maternal behavior in nonpregnant ewes primed with estrogen and progesterone has been obtained after 5 minutes of vaginal-cervical stimulation. A similar period of such stimulation given to recently parturient ewes, after the development of selective bonding to their own lambs, reversed their rejection behavior of alien lambs and produced a state of plasticity in maternal behavior, such that ewes receiving vaginal stimulation would accept and adopt alien lambs. These findings implicate vaginal cervical stimulation as playing a role in the onset of maternal behavior. PMID- 6849124 TI - Calcium intake and hypertension. AB - In the article "The 1982 Nobel Prize in Physiology or Medicine" (19 Nov., p. 765), the last full sentence in column 2 on page 765 should have read, "In the 1930's, Raphael Kurzrok and Charles Leib at Columbia University discovered that human seminal plasma contracted uterine smooth muscle." In the first sentence of the last paragraph in column 1 on page 768, "Calloway" should have been "Kellaway." PMID- 6849122 TI - Trypanosomiasis and meat production. PMID- 6849125 TI - On the nature of intelligence. AB - Our concept of intelligence has been heavily influenced by the development of intelligence tests as screening devices in education and personnel selection. An alternative approach is to begin with a theory of the process of cognition and identify those aspects of individual mental performance that should be important on theoretical grounds. Three classes of performance have been identified. These deal with a person's choice of an internal representation for a problem, strategies for manipulating the representation, and abilities to execute elementary information processing steps required by the strategy. PMID- 6849126 TI - Do tumor promoters affect DNA after all? PMID- 6849119 TI - Relation between plasma and cerebrospinal fluid levels of 3-methoxy-4 hydroxyphenylglycol. AB - Concentrations of free 3-methoxy-4-hydroxyphenylglycol in the plasma and cerebrospinal fluid are highly correlated, but concentrations in the cerebrospinal fluid are always higher than those in plasma, even when large amounts of the catecholamine metabolite are derived from a tumor of the adrenal medulla. This is explained by considering the plasma and cerebrospinal fluid as a two-compartment system in which the rate constants for entry into and exit from the cerebrospinal fluid compartment are similar. 3-Methoxy-4-hydroxyphenylglycol that is synthesized, but not catabolized, in the central nervous system maintains cerebrospinal fluid levels at an increment over those in plasma. This increment can be used to provide the best available index of formation of 3-methoxy-4 hydroxyphenylglycol in the central nervous system. PMID- 6849127 TI - Quaternary and quinternary structures of native chromatin DNA in liver nuclei: differential scanning calorimetry. AB - Differential scanning calorimetry of chromatin isolated from rat liver cells revealed three discrete thermal transitions whose temperatures and melting enthalpies depend on ionic strength in the range 0 to 600 millimolar NaCl. Intact nuclei showed a fourth thermal transition at a lower temperature and different melting enthalpies for the other three transitions still present at temperatures similar to those obtained in isolated chromatin. The data are discussed in terms of the tertiary, quaternary, and quinternary structures of chromatin DNA. PMID- 6849128 TI - Uphill sodium transport driven by an inward calcium gradient in heart muscle. AB - Heart cells were loaded with sodium by treatment with toxic doses of acetyl strophanthidin. After this treatment, an increase in extracellular calcium resulted in a transient net outward sodium flux against its electrochemical gradient and in net cellular uptake of calcium. It is concluded that the free energy for the net outward sodium movement was derived from the increased calcium gradient and that these ion movements took place through the sodium-calcium exchange. While in the normal physiological state the sodium-calcium exchange produces calcium extrusion from the cell, these experiments demonstrate its reversibility. PMID- 6849129 TI - Membrane isolation alters the gel to liquid crystal transition of Acholeplasma laidlawii B. AB - The gel to liquid crystal phase transition of membrane lipids of live Acholeplasma laidlawii B was monitored by infrared spectroscopy. It was found that, while isolated membranes are predominantly in the gel phase at the growth temperature, the live cell membranes contain a large liquid crystal phase component. PMID- 6849130 TI - Trypsin inhibition by mouse serum: sexual dimorphism controlled by testosterone. AB - The trypsin inhibiting activity in the serum of male mice is substantially greater than that in females. In five strains of mice and two large groups of interstrain hybrids this difference ranged from 14 (in ICR mice) to 55 percent (in DBA mice). Castration of males significantly decreased the serum trypsin inhibiting activity, whereas the administration of testosterone restored the activity to its original level. Administration of testosterone to female mice increased the activity to a level similar to that in males of the same strain. Because almost all the change in inhibiting activity occurred in the electrophoretic alpha-1 region, alpha-1 region, alpha-1-antitrypsin is probably responsible for this effect. PMID- 6849131 TI - Red/Green color opponency at detection threshold. AB - By means of visual stimnulus without temporal or spatial edges, we have achieved better isolation of chromatic signals at detection threshold than has been reported previously. Under various states of adaptation, the spectral sensitivity of the chromatic mechanism detecting middle- and long-wavelength lights corresponds with that deduced from suprathreshold red/green hue equilibriums. PMID- 6849132 TI - Myasthenic globulin enhances the loss of acetylcholine receptor clusters. AB - Acetylcholine receptors are present in the sarcolemma of cultured skeletal muscle myotubes either as large clusters or in a diffuse distribution. Both the clustered and diffuse acetylcholine receptors are potentially removable from the membrane. Treatment of myotubes with globulin from patients with myasthenia gravis causes the loss of acetylcholine receptor clusters and the concomitant appearance of acetylcholine receptor microaggregates. The rate of acetylcholine receptor cluster loss is greater than the rate of acetylcholine receptor degradation, indicating that acetylcholine receptors are disrupted from clusters to form microaggregates before being removed from the plasma membrane. PMID- 6849134 TI - Ranking carcinogens for regulation. PMID- 6849133 TI - Sex differences in dendritic structure in the preoptic area of the juvenile macaque monkey brain. AB - Quantitative analysis of Golgi-stained neurons in the preoptic area of the brain of prepuberal Macaca fascicularis monkeys indicated structural differences between males and females. Neurons of males had more dendritic bifurcations and a higher frequency of spines. The bifurcation difference appeared in all cell types and was concentrated in the ventrolateral preoptic area. The spine difference was greatest in the central region of the preoptic area. No differences in gross measurements of this brain region were found. These results suggest that sexual dimorphism in the function of the monkey preoptic area may be based on differences in neuronal structure. PMID- 6849135 TI - Ranking carcinogens for regulation. AB - In the issue of 9 August 1968 (p. 541), Science printed the Nobel lecture of Hans A. Bethe on "Energy production in stars." Eddington had at one time hypothesized that stellar energy arises from complete annihilation of matter. The energy to be set free by such a process, if it could occur, would be enough to supply the sun's radiation for 15,000 billion years. In the lecture, this number was erroneously given as 1500 billion years. PMID- 6849136 TI - Running and breathing in mammals. AB - Mechanical constraints appear to require that locomotion and breathing be synchronized in running mammals. Phase locking of limb and respiratory frequency has now been recorded during treadmill running in jackrabbits and during locomotion on solid ground in dogs, horses, and humans. Quadrupedal species normally synchronize the locomotor and respiratory cycles at a constant ratio of 1:1 (strides per breath) in both the trot and gallop. Human runners differ from quadrupeds in that while running they employ several phase-locked patterns (4:1, 3:1, 2:1, 1:1, 5:2, and 3:2), although a 2:1 coupling ratio appears to be favored. Even though the evolution of bipedal gait has reduced the mechanical constraints on respiration in man, thereby permitting greater flexibility in breathing pattern, it has seemingly not eliminated the need for the synchronization of respiration and body motion during sustained running. Flying birds have independently achieved phase-locked locomotor and respiratory cycles. This hints that strict locomotor-respiratory coupling may be a vital factor in the sustained aerobic exercise of endothermic vertebrates, especially those in which the stresses of locomotion tend to deform the thoracic complex. PMID- 6849137 TI - Insulin receptor: evidence that it is a protein kinase. AB - Highly purified preparations of insulin receptor catalyzed the phosphorylation of the 95,000-dalton subunit of the insulin receptor. This subunit of the insulin receptor was also labeled with [alpha-32P]8-azidoadenosine 5'-triphosphate, a photoaffinity label for adenosine triphosphate binding sites. The identity of the 95,000-dalton band was confirmed in both cases by precipitation with a monoclonal antibody to the insulin receptor. These results suggest that the insulin receptor is itself a protein kinase. PMID- 6849138 TI - Quinolinic acid: an endogenous metabolite that produces axon-sparing lesions in rat brain. AB - A current hypothesis links the neuroexcitatory properties of certain acidic amino acids to their ability to cause selective neuronal lesions. Intracerebral injection of the neuroexcitatory tryptophan metabolite, quinolinic acid, has behavioral, neurochemical, and neuropathological consequences reminiscent of those of exogenous excitotoxins, such as kainic and ibotenic acids. Its qualities as a neurotoxic agent suggest that quinolinic acid should be considered as a possible pathogenic factor in neurodegenerative disorders. PMID- 6849139 TI - Missouri's costly dioxin lesson. PMID- 6849140 TI - Is tyrosine the key to growth control? PMID- 6849141 TI - Methyl 4,6-dichloro-4,6-dideoxy-alpha-D-galactopyranoside: an inhibitor of sweet taste responses in gerbils. AB - The sugar methyl 4,6-dichloro-4,6-dideoxy-alpha-D-galactopyranoside (DiCl-gal) is a new type of inhibitor of the gerbil's electrophysiological taste response to sucrose or saccharin. Saturated solutions of this compound alone barely stimulate the gerbil's taste nerve. But, when mixed with sucrose or saccharin, DiCl-gal suppresses the gerbil's taste response to these two sweeteners. In contrast, when mixed with sodium chloride or hydrochloric acid, DiCl-gal does not affect the taste responses to these compounds. However, unlike other inhibitors of sweet taste, the DiCl-gal taste suppression is short-lived and occurs only when the inhibitor is combined with the sweetener. PMID- 6849142 TI - Taste flashes: reaction times, intensity, and quality. AB - Human simple reaction times and magnitude estimates of taste intensity increased as the duration of 500-millimolar sodium chloride or 2-millimolar saccharin sodium pulses lengthened from 100 to 1000 milliseconds. Responses to "What was the taste?" ranged from 94 to 100 percent "sweet" for saccharin and 68 to 83 percent "salty" for salt across all pulse durations when both substances were randomized with water pulses. PMID- 6849143 TI - Nigral transplants reinnervating the dopamine-depleted neostriatum can sustain intracranial self-stimulation. AB - Transplants of embryonic substantia nigra reinnervated the striatum and were able to sustain intracranial self-stimulation in rats with brain lesions induced by 6 hydroxydopamine. Dopaminergic drugs and alterations in current intensity produced typical changes in response rates. Animals with electrodes implanted into cortical grafts or into the denervated striatum failed to exhibit self stimulation. These findings suggest that transplanted dopamine neurons convey specific, temporally organized information axonally to the striatum. PMID- 6849144 TI - Screening for inborn errors of metabolism among mentally retarded patients. Outcome of a surgery at the Witrand Care and Rehabilitation Centre. AB - The prevalence of different types of inborn errors of metabolism among the mentally retarded patients at the Witrand Care and Rehabilitation Centre, were determined by means of a biochemical screening survey. These results are compared with those of other surveys in South Africa and abroad. One important result points to substantial differences in the recorded incidences of metabolic defects between surveys. This observation could partially be due to significant differences between the different studies in terms of methodology employed and sampling procedures. The questions raised in this regard are documented and discussed. PMID- 6849145 TI - Low spinal anaesthesia combined with local anaesthesia for caesarean section--an evaluation. AB - A combination of low spinal anaesthesia using hyperbaric cinchocaine (Nupercaine; Ciba) 0,25% and local anaesthetic abdominal wall infiltration for caesarean section was evaluated for use in peripheral hospitals in the developing world. The technique described is not suitable for this purpose. Further research into this technique is desirable, and recommendations regarding an improved protocol are made. PMID- 6849146 TI - Penalties in multiple-choice and true-false questions. AB - In multiple-choice and true-false (T-F) questions a student expresses his ignorance by leaving questions unanswered, guessing randomly, answering according to some predetermined formula, or, in T-F tests, by marking all those which are unknown as 'true' or all as 'false'. Each of these no-knowledge strategies should, on average, yield the same score. It is shown that partial knowledge is awarded part-marks in multiple-choice question and T-F tests, since the chance of guessing correctly is greater when students possess some knowledge than when they guess randomly. There is a constant relationship between the score obtained by the informed guesser and the minimum, maximum and random-guessing scores, this relationship being independent of the scoring system. Modifications of the scoring system (i.e. of the magnitude of the penalty for incorrect responses) affect only the reward for unanswered questions: in the absence of a penalty the reward for unanswered questions equals the minimum score--a score which is unattainable by random guessing; with a large penalty the reward for unanswered questions approaches the maximum score obtainable. PMID- 6849147 TI - Breast-feeding practices in a Black community. AB - Our study was designed to obtain information about the prevalence of breast feeding among rural and urban Blacks, to determine whether the number of women providing early supplementary feeding has increased over a 4-year period, and to discover groups at particular risk of failure to breast-feed optimally. Women attending child health clinics were interviewed. Over 95% had commenced breast feeding, but only 50% were still doing so after 5--8 weeks. Women uncertain of whether or not to breast-feed and those unsuccessful on a previous occasion are as likely to commence breast-feeding as are other groups, but are likely to introduce early supplementation. Improvements in hospital and clinic practice as regards a greater emphasis on health education, early suckling and the avoidance of supplementary feeding in neonates may have contributed to the slight improvement in breast-feeding practices seen over the 4-year period studied. PMID- 6849148 TI - Surgical excision of lung metastases from squamous carcinoma of the cervix. A report of 2 cases. AB - These 2 case reports serve to emphasize two important points concerning carcinoma of the cervix: (i) blood-borne metastases are now frequently encountered in this disease; and (ii) in selected cases surgical excision of a secondary deposit in the lung is the treatment of choice and may even result in cure. PMID- 6849150 TI - Glycopyrrolate in bladder dysfunction. PMID- 6849151 TI - The rubella immune status of female hospital personnel. PMID- 6849149 TI - Electrocardiographic features suggestive of a left ventricular aneurysm following a high-velocity missile injury. A case report. PMID- 6849152 TI - Holter monitoring--a necessity for the evaluation of palpitations. AB - Eighty-five patients complaining of palpitations were evaluated by means of 24 hour dynamic electrocardiography. A sensitivity of 0,69 and a specificity of 0,90 were calculated. This illustrates the value of Holter monitoring in the assessment of patients complaining of palpitations. PMID- 6849153 TI - Genetic services for patients with severe mental retardation. The South African situation. AB - In South Africa mental retardation is still ill-defined as regards the aetiology and general epidemiology. A systematic diagnostic/genetics programme implemented at various institutions for the mentally retarded within the framework of a comprehensive genetic service is described. The progress made is reported and the contribution of genetic services to the prevention and the management of mental retardation highlighted. PMID- 6849154 TI - Anti-amoebic drugs in rheumatoid arthritis. PMID- 6849156 TI - Peroxide enemas in obstipation. PMID- 6849155 TI - Epidural morphine in the treatment of tetanus. PMID- 6849157 TI - Computed tomogram ring enhancement in multiple sclerosis. PMID- 6849159 TI - The dilemma of the creatine kinase cardiospecific iso-enzyme (CK-MB) in marathon runners. AB - Serum creatine kinase iso-enzyme (CK-MB) levels were measured in 51 marathon runners before and after a 50 km marathon event. Ninety-five per cent of the runners were found to have pathologically elevated values, i.e. CK-MB concentrations were elevated to the range normally considered indicative of myocardial necrosis. Results indicate that a rise in the CK-MB level is common after marathon running. We therefore believe that cardiac enzymes are an unreliable indicator of myocardial infarction in patients who experience chest pain following strenuous muscular exercise. PMID- 6849158 TI - Laboratory evaluation of commercial interferon preparations. AB - The antiviral, antiproliferative and natural killer-cell (NKC) stimulatory activities of four commercial therapeutic interferon preparations were assayed in our laboratory. The antiviral and antiproliferative activities of each preparation were relatively similar, but an unexpectedly high NKC stimulatory activity was found in one of them. In-house determination of antiviral activity and evaluation of the antiproliferative and NKC stimulation potential of interferon preparations are essential before rational clinical trials of this agent are carried out. PMID- 6849160 TI - The effect of disulfiram on the urinary excretion of catecholamine metabolites in alcoholic males. AB - The urinary excretion of vanillylmandelic acid (VMA), homovanillic acid (HVA) and total metanephrines (TMNs) was studied in a group of White male alcoholic patients under three experimental conditions--on admission and prior to treatment, after 7 days of administration of a placebo, and after 9 days of administration of disulfiram 400 mg/d Disulfiram caused a significant decrease in VMA levels compared with the pretreatment (P less than 0,01) and placebo (P less than 0,05) levels. The output of HVA and TMNs was unchanged. It is suggested that disulfiram may produce false-negative results in cases of suspected phaeochromocytoma if VMA levels only are assayed. TMNs would appear to be the measurement of choice in such a situation. PMID- 6849161 TI - The Hospital Information Planning Study at Groote Schuur Hospital, Cape Town. AB - Information is an increasingly important resource in an academic hospital. Effective planning and control of this resource are essential in order to maximize its usefulness. The Hospital Information Planning Study (HIPS) undertaken at Groote Schuur Hospital, and based on the Business Systems Planning (BSP) methodology, is outlined, as are the results of the study. The recommendations arising from the study, which are of considerable significance to the hospital, are mentioned briefly. PMID- 6849162 TI - The role of phosphatidyl-glycerol in the determination of fetal lung maturity. AB - Phosphatidyl-glycerol (PG) and the lecithin/sphingomyelin (L/S) ratio were determined on amniotic fluid from 140 patients to evaluate the role of PG estimation as a functional fetal lung maturity test. PG was absent without associated respiratory distress syndrome (RDS) in 17 cases (12%) and present in 123, 3 of the infants born to these patients developed slight hyaline membrane disease. There were no neonatal deaths. When both PG and the L/S ratio were determined the accuracy of prediction of the RDS improved from 87% to 93%. PG determination should not be used as a substitute for the L/S ratio, but should be used in conjunction with it in high-risk situations. PMID- 6849163 TI - A 3-year cytogenetic survey of 9 661 patients in South Africa. AB - During the period 1 January 1977 - 31 December 1979, 9 661 patients underwent cytogenetic investigation at seven participating laboratories in South Africa. The chromosome data were coded using a standard protocol and the results tabulated, being listed according to the clinical signs which led to referral for investigation. Cytogenetic investigation was most commonly requested for prenatal studies, and 22% of the group's effort was directed towards this. One in 27 amniotic cell specimens was reported to have shown anomalous chromosomes, trisomy 21 being the most frequent abnormality. The majority of postnatal investigations were requested because congenital abnormalities suggested an underlying chromosomal defect. In 42,3% of 2 420 patients a chromosome defect was confirmed. Results of chromosome studies are tabulated by indication for referral and the findings summarized. This collaborative study gives an indication of the nature and frequency of chromosome disorders in South Africa. PMID- 6849165 TI - Problems in the diagnosis of lymphogranuloma venereum. A review of 6 cases. AB - Six cases of lymphogranuloma venereum are described in White South Africans. All initially presented diagnostic problems. This sexually transmitted disease is uncommon in South Africa, and 5 of the 6 patients presented with inguinal lymphadenopathy without a primary lesion. The value of serological tests in the diagnosis of this disease is emphasized. PMID- 6849164 TI - Aneurysm of the splenic artery--a controversial entity. AB - The case of an asymptomatic, calcified, arteriosclerotic, intact splenic artery aneurysm in a 60-year-old woman is presented. The diagnosis was confirmed by selective coeliac arteriography and the aneurysm was successfully resected with preservation of the spleen. PMID- 6849166 TI - Biochemical findings in Bushmen, Whites, rural Vendas and urban Blacks. PMID- 6849167 TI - Beneficial effect of labetalol in hypertensive patients with angina pectoris. AB - Labetalol (Trandate; Allen & Hanbury) was administered to 17 hypertensive patients with angina pectoris, which had persisted despite blood pressure control on treatment including beta-blocking agents. In comparison with placebo, labetalol significantly reduced the frequency and severity of attacks of angina pectoris, without further improvement in control of blood pressure at rest, during isotonic exercise or on performance of the cold pressor test. Labetalol significantly reduced blood pressure levels during isometric exercise but did not reduce the systolic pressure- heart rate product. Labetalol improved the angina without evidence of causing a reduction of cardiac work (and presumably oxygen consumption by the myocardium) in comparison with the other antihypertensive agents used in this study. A possible mechanism whereby labetalol increases myocardial blood supply in hypertensive patients with angina pectoris is by an increase in coronary perfusion due to its vasodilator action. PMID- 6849169 TI - The role of vitamin A in cancer. AB - The differentiation and maintenance of epithelial tissues is a well-known function of vitamin A. The most dramatic expression of this is the antineoplastic effect. This biological activity of vitamin A is reviewed with regard to anticarcinogenesis, the reversal of transformation and a possible role in cancer therapy. A brief account is given of vitamin A absorption and transport in the body and the importance of varying levels of cellular binding proteins in normal and malignant tissues. PMID- 6849168 TI - Prevention of wound sepsis in amputations by peri-operative antibiotic cover with an amoxycillin-clavulanic acid combination. AB - In a series of 44 patients with lower limb ischaemia requiring amputation for major limb sepsis, the performance of a new antibiotic combination with beta lactamase-inhibiting properties, amoxycillin plus clavulanic acid (A-CA) (Augmentin; Beecham), was compared with that of penicillin in the prevention of wound infection. The sepsis rate of 12,9% in the group of patients receiving peri operative A-CA was significantly lower than the 76,9% in the penicillin control group (x2 = 14,48; P less than 0,001). It is concluded that there is a need for peri-operative antibiotic cover in this situation and that A-CA appears to be highly effective. No statistical difference was found as regards development of sepsis in wounds closed primarily or left open while under A-CA cover. PMID- 6849170 TI - The mechanical transmission of hepatitis B virus by the common bedbug (Cimex lectularius L.) in South Africa. AB - Tests for both hepatitis B surface antigen (HBsAg) and hepatitis e antigen (HBeAg) were carried out on wild-caught and laboratory-colonized bedbugs (Cimex lectularius L.), the latter after hepatitis B virus (HBV)-positive blood-meals. Positivity for both antigens was interpreted as an indication of HBV infectivity. Of 22 pools in which were tested 211 bugs collected in the northern Transvaal, 18 were HBsAg-positive and 17 HBeAg-positive, with estimated infection rates of 156,7 and 137,7 per 1000 bugs respectively. Passage of HBV in bugs, allowing an extrinsic incubation period of 57-69 days, resulted in 19 out of 25 bugs being positive for HBsAg after the first passage; only a small number of these were positive for HBeAg. After the second passage all bugs tested were HBsAg-negative, showing that the virus had disappeared. Tests on the salivary glands and carcass of each bug at intervals up to 31 days after an infective meal showed a positivity rate of 98% (HBsAg) and 17% (HBeAg) for carcasses and 20% (HBsAg) and 0% (HBeAg) for salivary glands. Attempts to detect HBV particles in the salivary glands by electron microscopy failed. Bugs were shown to continue to excrete HBsAg in their faeces up to the 42nd day, and both HBsAg and HBeAg together up to the 30th day. HBsAg particles were only detected by electron microscopy in faeces harvested on the 10th day. The results as a whole indicate that no biological multiplication of virus occurs in C. lectularius but that mechanical transmission from insects to man could occur by: (i) contamination of a person when crushing infective bugs; (ii) contamination from infected faeces; and (iii) infection by bite due to regurgitation or interrupted feeding. PMID- 6849171 TI - Complement activity in the cord blood of term neonates with the amniotic fluid infection syndrome. AB - Cord blood samples from 11 term neonates whose placentas showed histological changes typical of the amniotic fluid infection syndrome were analysed in order to determine haemolytic activity of the classic and alternative complement pathways and serum levels of complement proteins and immunoglobulins. Although the mean values of all these parameters were higher in this group than in an age related control group, only classic haemolytic pathway activity was significantly elevated (P less than 0,025). PMID- 6849172 TI - Idiopathic chondrolysis of the hip. A case report. AB - A report of a case of idiopathic chondrolysis of the right hip in a 13-year-old Black girl is presented. Radiographs and microbiological and biochemical investigations excluded all other diseases. Cartilage and synovium were removed at biopsy of the right hip. Macroscopic and histopathological studies showed the typical features of idiopathic chondrolysis. Transmission electron microscopy confirmed the histological findings. Scanning electron microscopy highlighted the irregular pitted and fibrillated surface of the cartilage. Immunofluorescent studies on cartilage and synovium were negative. The possible pathogenesis of the disease is discussed, but the cause still remains unknown. PMID- 6849174 TI - Cervical spine instability in rheumatoid arthritis. PMID- 6849173 TI - The histological appearance of carbon fibre implants and neo-ligament in man. AB - The results of this study indicate that a fibrous ingrowth occurs in man after surgical replacement of a tendon or ligament with carbon fibre. This ingrowth resembles normal tendon or ligament very closely, with parallel orientation of collagen fibres and fibroblasts. A multinucleate foreign-body giant-cell response was seen, but it was not possible to ascertain whether the fragmented carbon lay within or on these cells and other macrophagic components. Numerous intact carbon fibres were still present 2 and 3 years after implantation. PMID- 6849176 TI - Parkinson's disease and thalassalmia in a South African family of Greek origin. PMID- 6849177 TI - Emphysematous pyelonephritis. A report of 2 cases. AB - Two cases of gas formation in the urinary tract are described. Both patients were diabetics. In the first patient the gas was situated in the collecting system while in the second the gas was confined to the perinephric space. The prognosis in the latter situation is especially poor and review of the literature suggests that surgical intervention either by incision and drainage or by nephrectomy is the treatment of choice. PMID- 6849175 TI - Evaluation of an extended pancreatic function test in normal subjects and in patients with chronic pancreatitis. AB - Exocrine pancreatic response was evaluated in patients with varying degrees of pancreatic damage and in control subjects by means of an extended pancreatic function test (PFT). A second injection of secretin and pancreozymin was given after completion of the standard test. The discriminatory value of the standard PFT with regard to bicarbonate and enzyme output was not enhanced by a second bolus dose of hormones. It is concluded that the secretory potential of damaged pancreatic exocrine tissue cannot be exhausted by prolonged stimulation employing repeat bolus stimulation. PMID- 6849178 TI - Extra-uterine pregnancy communicating with the bladder. A case report. PMID- 6849179 TI - Femoropopliteal bypass: the preferred site for distal anastomosis. AB - In many patients undergoing femoropopliteal bypass, an occluded superficial femoral artery may reconstitute at the adductor canal and the popliteal artery will be patent. For these patients, uncertainty exists as to whether the preferred site for the distal anastomosis is an above-knee (AK) or below-knee (BK) bypass graft. Operation is, therefore, often based on personal preference rather than fact. To evaluate this problem, we undertook a 6-year review of the cases of 90 patients who had femoropopliteal bypass to a patent popliteal artery. Seventy AK bypass grafts were performed: 20 with autogenous vein, 25 with Dacron, and 25 with polytetrafluoroethylene (PTFE). Based on the life table analysis method, the late patency rate was 70% for vein, 68% for PTFE, and 64% for Dacron. These results were compared against results in 25 patients who had BK femoropopliteal bypass with autogenous vein, in whom the late patency rate was 65%. There was no statistical difference between these groups (P less than 0.25). An AK femoropopliteal bypass with a prosthesis yielded long-term patency rates that were similar to those of AK or BK vein grafts. When the popliteal artery is patent and the distal anastomosis can be done proximal to the knee joint, a prosthetic graft should be used. A prosthetic graft will reduce operative time, shorten recuperation time, and spare the saphenous vein for use in the coronary or infrapopliteal vessels if the need arises. PMID- 6849180 TI - Prevention of intestinal ischemia following abdominal aortic reconstruction. AB - Prevention of ischemic bowel complications following abdominal aortic reconstruction requires identification of the patient at high risk for developing the complication; on precise, gentle, meticulous operative technique; on knowledge of bowel blood supply; on determining when the IMA must be reconstructed or when it can be safely ligated; and on methods of preserving or preventing damage to bowel blood supply. Patients at greatest risk for developing bowel ischemia following aortic reconstruction include those with a history of visceral angina, those with a patent IMA (40% to 52%), those being treated for ruptured aneurysm, those whose postreconstructive IMA stump mean blood pressures are less than 40 torr, those in whom Doppler flow signals cease following division or occlusion of the IMA, and those who have SMA occlusive disease and arteriographic documentation of IMA to SMA flow in the MMA (Table II). Patients at least risk include those in whom the IMA is already occluded (48% to 60%), those whose postreconstructive IMA stump pressures are more than 40 torr, those in whom Doppler flow signals persist after IMA occlusion, those who have flow in the MMA from the SMA to the IMA (provided this vessel is not injured), and those undergoing aortic reconstruction for aortoiliac occlusive disease. PMID- 6849182 TI - Spinal cord ischemia in surgical procedures with temporary clamping of the abdominal aorta. PMID- 6849181 TI - Renal failure following abdominal aortic reconstruction. AB - Renal failure in aortic surgery is frequently due to the additive effects of multiple subthreshold insults that progressively decrease renal reserve. Prevention of renal failure requires a high index of suspicion concerning the clinical setting in which renal injury may occur. If cardiac hemodynamics and arterial pressure are maintained at optimal levels, especially during periods of maximum hemodynamic stress, ischemic renal injury can be minimized. This requires aggressive monitoring of cardiac hemodynamics using a Swan-Ganz (thermodilution) catheter for measurement of pulmonary artery wedge pressure and cardiac output. Prompt recognition of hemodynamic instability allows rapid intervention to correct the renal ischemia before irreversible renal injury can occur. PMID- 6849183 TI - Abdominal aortic surgery: prevention of lower limb ischemia. AB - Lower limb ischemia represents the most common single threat to the success of operations for abdominal aortic aneurysms. It can occur because of distal embolization from a number of sites or because of thrombosis either at sites of anastamosis or in diseased arteries at or beyond sites of clamping. Preoperative angiographic studies in patients with missing lower extremity pulses aid in planning reconstructive procedures if ischemia occurs in the postoperative period. Systemic heparinization during the stage of interruption of the circulation and specific techniques of dissection, clamping, anastamosis, flushing, and unclamping resulted in an incidence of 0.57% postoperative limb threatening ischemia in a series of 700 abdominal aneurysm operations in which the incidence of lower limb gangrene was 0.28%. PMID- 6849184 TI - Reoperative abdominal arterial surgery--a ten-year experience. AB - The safety and durability of elective reconstructive procedures of the abdominal aorta and its major branches are universally accepted; however, late complications continue to threaten limbs and lives of a minority of patients. The strategy of managing such revascularization failures has received inadequate attention. Between February 1971 and July 1981, 76 patients underwent 83 remedial, transabdominal revascularization procedures because of failed reconstructions. Group I consisted of 34 patients with occlusive complications (0% remedial operative mortality rate); group II, 21 patients with prosthetic sepsis including graft-enteric fistula (14% operative mortality); group III, 11 patients with aneurysmal degeneration (36% operative mortality); and group IV, 10 patients with visceral ischemia (0% operative mortality). The remedial operative mortality rate for the combined groups was 7.9%. Limb preservation was the rule in group I (91%); however, 29% of limbs at risk in group II ultimately required major amputation (15% early, 14% late). All patients in group II without an established graft-enteric fistula were saved; however, three of ten with active hemorrhage died of the sequelae of hypovolemic shock. Progressive arteriosclerotic morbidity and massive intraoperative bleeding accounted for the high mortality rate in group III. Favorable results were obtained in reoperation for recurrent visceral ischemia (renal ischemia in five, mesenteric ischemia in five). On the basis of this experience, an aggressive surgical approach seems justified. First, complete bifemoral revascularization performed at the time of original operation should reduce the need for reoperation. Second, elective, transabdominal remedial arterial surgery can be done with acceptable morbidity and mortality rates. Third, graft-enteric erosions and periprosthetic sepsis must be treated aggressively to avoid life-threatening sepsis and hemorrhage. Finally, anatomic revascularization can be performed successfully after a suitable period following removal of an infected retroperitoneal prosthesis. PMID- 6849185 TI - Ultrastructure of human and transplanted canine veins: effects of different preparation media. AB - Human saphenous veins were studied to determine alterations resulting from preparation by moist gauze wrapping, balanced salt solution immersion, and heparinized whole blood storage at 4 degrees C. Morphologic derangements of endothelial cells, smooth muscle cells, and adventitial tissues were pronounced in the nonblood preparations. In a second study, 20 canine jugular vein segments were interposed into the iliofemoral arterial circulation, with half the grafts prepared in balanced salt solution and half in whole blood. Veins were harvested monthly for 10 months, being subjected to light and electron microscopic examinations. No thromboses or stenoses occurred. Diffuse graft dilatation affected veins three times more often when stored in lactated Ringer's solution than when stored in heparinized blood. Medial thinning, ranging from 20% to 54%, occurred in veins stored in the balanced salt solution. Endothelial regeneration was complete in all grafts within 30 days after implantation. However, medial and adventitial injury to veins prepared in balanced salt solution appeared progressive, with fibrodysplastic tissue replacing smooth muscle cells. Plasmacytosis and neutrophil infiltrates, consistent with chronic active inflammation, often accompanied fibroproliferative changes. Alterations in medial structures, rather than endothelial injury, may have an important influence on the long-term durability of transplanted vein grafts. PMID- 6849186 TI - Autogenous graft replacement of infected prosthetic grafts in the femoral position. AB - Infected prosthetic grafts in the femoral position remain among the most challenging problems in vascular surgery. Over the past 2 years, 11 patients with this critical condition have undergone graft reconstruction with autogenous tissue as described by Ehrenfeld. All infected prosthetic material was removed and replaced by an autogenous graft. The autogenous grafts were constructed with endarterectomized superficial femoral, iliac, and aortic segments as well as portions of saphenous and cephalic veins. This procedure has proven successful, resulting in only one amputation (undertaken with a still functioning autogenous graft) in the series. There was one postoperative death. Six grafts failed in long-term follow-up, due in all cases to inadequate flow because of stenosis of the saphenous vein portion of the autogenous reconstruction. However, the patients were usually free of infection by this time and underwent successful prosthetic reconstruction. PMID- 6849188 TI - Arterial injuries with lower extremity fracture. AB - Review of the records of 41 patients with lower extremity fractures associated with major arterial injuries disclosed that femoral artery injuries were consistently repaired with excellent results and no amputations. Diagnostic delay contributed to an 18% amputation rate following popliteal artery disruption. When arteries distal to the popliteal trifurcation were completely disrupted, a 25% rate of long-term good results was obtained. PMID- 6849189 TI - Employment following peripheral vascular surgery: an increasingly critical issue. AB - As discussion for decreasing social security benefits or increasing the age of retirement ensues, the effectiveness of maintaining patients' employment following vascular surgery becomes extremely important. Two hundred fifty-five major vascular operations were performed from 1977 to 1981 on an employed populace. There was a 64% incidence of return to full employment following a major vascular procedure. The ability to return to work was statistically related to the degree of success of surgery following carotid endarterectomy, aortofemoral bypass for occlusive disease, femoral-distal and femoropopliteal bypass. The ability to work following abdominal aortic aneurysm resection, however, was statistically related to the age of the patient, not the outcome of the operation. Seventy-five percent of patients whose operative indication for aortofemoral and femoropopliteal bypass was claudication returned to work. Only 3% of patients who had been receiving disability benefits for vascular disease prior to vascular reconstruction returned to work. There was no correlation with the success of the operation or the age of the patient. One of the goals involved in performing vascular surgery is to return the patient to full employment. It is encouraging to see that this goal is achieved. PMID- 6849187 TI - The critical manipulable variables of hemispheric low flow during carotid surgery. AB - A significant EEG change, 40% power attentuation in anesthetic-induced fast activity, was documented with a tracing record, compressed spectral analysis, and PSA-1 in this series of 195 patients. Interpretation of the change was simplified by the use of the compressed spectral analysis or PSA-1. Quantification of the change was aided by use of the PSA-1, and the graphic output form of this instrument minimized user error. Also, it provided the needed information to those members of the operative team not skilled in EEG interpretation. No immediate postoperative deficits were missed by the monitoring technique. There were no postoperative deficits upon awakening in the 138 patients without processed EEG change. Shunt placement, depth of anesthesia, and intraoperative blood pressure levels were accurately guided throughout the operative procedure by these monitoring techniques. Accurate documentation of an acute significant change permits prompt treatment for restoration of necessary collateral flow. The monitoring technique described continuously provides information for efficacy of treatment. Attention to blood pressure level, which seems to passively determine cerebral collateral flow during clamping, was a very important clinically manipulable variable. Manipulation of this variable with processed EEG control may prove efficacious not only in patients undergoing carotid procedures but in nonsurgical cases of acute carotid occlusion or middle cerebral stem occlusion. Manipulation of identifiable critical variables has a positive impact on the clinical outcome when continuous monitoring is employed. The detection of hemispheric low flow in 34 patients during the preclamp, clamp, and postclamp periods suggests that shunting will not prevent all low flow deficits. Finally, perfection of surgical therapy for stroke prevention necessitates detection and treatment of hemispheric low flow. PMID- 6849190 TI - Improving predictive value of complementary tests in carotid artery disease. AB - In a prospective study the accuracy of B-mode ultrasound imaging alone was compared with its use in conjunction with bidirectional Doppler ultrasound, carotid phonoangiography, and oculoplethysmography to independently assess contrast arteriograms of carotid arteries studied for presumed extracranial vascular disease. The addition of B-mode real-time imaging improved the accuracy of diagnosis by nearly 10%. PMID- 6849191 TI - External carotid endarterectomy: indications, operative technique, and results. AB - In the presence of chronic internal carotid artery occlusion, the external carotid artery becomes an important source of collateral circulation to the ipsilateral cerebral hemisphere and eye. It not only supplies blood via periorbital collaterals with retrograde flow in the ophthalmic artery, but also may allow emboli to reach the retina or brain. The cul-de-sac or "stump" created by internal carotid artery occlusion may frequently be the source of emboli causing amaurosis fugax or hemispheric transient ischemic episodes. Seven such patients presenting with amaurosis fugax and/or hemispheric transient ischemic episodes were found at operation to have atherosclerotic ulceration or platelet fibrin debris at the carotid bifurcation and the internal carotid artery cul-de sac. These patients were treated by external carotid endarterectomy with excision and closure of the occluded internal carotid artery cul-de-sac to remove a potential source of stasis and platelet fibrin deposition. A preoperative angiogram and intraoperation photograph demonstrating the typical pathologic findings are presented. The surgical technique emphasizing excision and closure of the internal carotid cul-de-sac is illustrated. Six of the seven patients have remained asymptomatic with a 2- to 28-month follow-up. The importance of considering microembolism as a cause of symptoms in some patients without external carotid artery stenosis is stressed. PMID- 6849192 TI - Factors associated with development of foot lesions in the diabetic. AB - A prospective study was undertaken of 80 diabetic patients over the age of 50 years, with the aim of determining which factors were important in the development of foot lesions. It was found that factors associated with diabetic management, including HbAlc levels and frequency of previous admissions to hospital for diabetic control, appeared to play little part in the development of foot lesions. However, both vascular impairment and cigarette smoking were significantly associated with an increased incidence of lesions, while neuropathy was found to occur commonly in control subjects as well as patients with foot lesions. There was also a significant relationship between the level of patient understanding as measured by a questionnaire and the development of foot lesions. The importance of the education of both patients and doctors concerning the significance of diabetic foot lesions is emphasized. PMID- 6849193 TI - Stabilization of ileostomy position with fascia. AB - An ileostomy that maintains its protrusion in a stable manner can be fashioned by the technique of Brooke. However, in a significant number of patients, recession or prolapse of the ileostomy occurs, tending to displace an appliance. A safe and effective technique is described whereby the ileostomy is stabilized without danger. A ribbon of fascia, obtained from the abdominal wall, is passed through the mesentery adjacent to the bowel between vessels, at its point of exit from the peritoneum. It is neither wrapped around the bowel nor sutured to it. The ends of the fascia are securely sutured to the peritoneum and transversalis fascia. This secures the position of the ileostomy without the danger of fistula from suturing the bowel wall. It may be used for recession or prolapse. It may be supplemented by passing additional fascia or suture elsewhere in the mesentery or into other available tissue. PMID- 6849194 TI - Symposium: prevention of complications of abdominal aortic reconstruction. Introduction. PMID- 6849195 TI - Myocardial ischemia. PMID- 6849196 TI - Proceedings of the North American Metronidazole Symposium. Anaerobic infections. Scottsdale, Arizona, October 7-9, 1981. PMID- 6849197 TI - Epidemiology of anaerobic infections. AB - The clinical importance of the anaerobic organisms, especially the toxicogenic Clostridia and some of the nonsporulating anaerobes, has been recognized for some time. Only within the last 20 years, however, owing to improved methodology, have gram-negative anaerobic bacilli, anaerobic cocci, and streptococci been commonly recognized and encountered in clinical infections. Today, anaerobic organisms are common isolates from infections involving intra-abdominal sites, the female genital tract, soft tissue, and oral areas and from major infections involving the lung, brain, and head and neck. Most of these infections are polymicrobial- involving both anaerobic and facultative or aerobic organisms. In some instances, it is difficult to ascertain what role is played by what organisms. No doubt, synergism is present in many cases. Because anaerobes are prevalent normal flora of the body, almost all anaerobic infections are of endogenous origin. Many of these anaerobes are opportunists; given the appropriate set of conditions, they will penetrate tissue and cause infection. Many have been associated with wound infection subsequent to bowel surgery or trauma, tubo-ovarian abscess, perirectal abscess, subphrenic abscess, postabortal sepsis, appendicitis, and many other infectious conditions. This article reviews the distribution of anaerobes in infected hospitalized patients and their relation to infection over a 5-year period. PMID- 6849198 TI - Human pharmacokinetics and toxicity of high-dose metronidazole administered orally and intravenously. AB - This study is part of a clinical program to assess the use of nitroimidazoles as radiosensitizers of hypoxic tumor cells. A total of 37 patients with malignant tumors have been entered into the study to receive oral high-dose metronidazole in conjunction with radiation. Twenty-eight patients with malignant brain tumors received 6 gm/m2 three times a week for 3 weeks (a mean total dose of 5.3 gm/m2). Maximum mean plasma drug concentration of 1 mM was obtained at 4 hours after drug ingestion with a mean half-life of 13 hours. Tissue and cerebrospinal fluid levels of 80% to 90% of the plasma levels were obtained at 4 to 6 hours. A linear relationship between increased drug dose and increased plasma concentration was observed at doses of 2.5 gm/m2 up to 6 gm/m2. Acute gastrointestinal and central nervous system toxicity was the dose-limiting factor (50% and 25%, respectively, at total doses of 5.3 gm/m2). Pharmacokinetic studies of intravenous metronidazole were performed in eight consenting patients. Single doses of 0.5, 1, 1.5, and 2 gm were administered intravenously by zero-order infusion pump. Seven of the eight patients received a second identical dose orally 1 week later and the results were compared. Open two-compartment kinetic characteristics of metronidazole were computed from simultaneous plasma infusion and urine excretion rate equations, by use of a nonlinear least-squares regression analysis program (NONLIN). The mean (+/- SD) for alpha half-life was 1.2 +/- 1.3 hours, and that for the beta half-life was 9.8 +/- 5.9 hours. The absolute oral bioavailability was estimated to approximate 100%. PMID- 6849199 TI - Metronidazole kinetics in dialysis patients. AB - Five volunteers with normal renal function (NOR) and eight patients with renal insufficiency (REN) were given a single dose of 500 mg metronidazole (MET) intravenously over 26 minutes. Serial venous plasma samples were taken at certain intervals for 30 hours. Four of the eight REN patients were also given the drug at the start of hemodialysis and four simultaneous inflow-outflow samples were taken over 4 hours of dialysis. Plasma MET, the acetic acid metabolite (MTAC), and the hydroxymethyl metabolite (MTOH) were determined by high-pressure liquid chromatography assay. Plasma MET over time curves were analyzed with a nonlinear curve-fitting computer program (ASAAM-27) which employed a two-compartment open model. Plasma MET concentrations were similar in the NOR and REN groups. The volumes of distribution for MET--both V1 and Vdss--were similar in the two groups. Moreover, renal insufficiency did not affect the beta half-life (6.5 hours) or the plasma clearance (10.1 L/hr) of MET. Metabolite concentrations peaked at about 12 hours in both groups, but peak MTAC was five times higher in the REN group and peak MTOH twofold higher. Plasma clearance of MET by dialysis averaged 4.0 L/hr at 30 minutes, but thereafter ranged from 2.9 to 4.2 L/hr. Clearance of MTAC ranged from 5.8 to 7.8 L/hr and that of MTOH 2.7 to 5.6 L/hr. We concluded that renal failure does not alter MET disposition but is associated with significant accumulation of the metabolites of MET, possibly requiring a dose reduction. Moreover, an 8-hour hemodialysis eliminates approximately 50% of an administered dose of MET. PMID- 6849200 TI - Biologic activity of metronidazole in plasma and urine of volunteers with normal or impaired renal function. AB - In this study, we have compared a bioassay procedure with high-pressure liquid chromatography (HPLC) for the determination of metronidazole levels in serum and urine. Plasma and urine of volunteers with normal or impaired renal function were obtained at various intervals after a single intravenous dose of 500 mg metronidazole. In plasma of normal volunteers 30 hours after dosing, the bioassay gave results comparable to the total values of the parent compound plus metabolites. In patients with renal failure, the course of the plasma regression curve of metronidazole as measured by the bioassay procedure was intermediate between the values of metronidazole alone and the total values of parent compound plus metabolites. Recovery of metronidazole activity in urine, as determined by this bioassay method, was somewhat less than one half (in normal volunteers) to one quarter (in patients with renal failure) of metronidazole plus metabolites as measured by HPLC. These discrepancies might be explained by the lower antibacterial activity of the hydroxy (congruent to 40%) and acetic acid (congruent to 2%) metabolites as compared with that of the parent compound in the test system used. PMID- 6849201 TI - Mode of action of metronidazole on anaerobic bacteria and protozoa. AB - Metronidazole and related 5-nitroimidazoles are relatively nontoxic. Reduction of their nitro group, however, leads to the production of short-lived cytotoxic intermediates, which finally decompose into nontoxic end products. The toxicity of the intermediates is due to their interaction with deoxyribonucleic acid and possibly with other macromolecules. Metabolic pathways of low redox potential that are linked to ferredoxin or flavodoxin-like electron transport components reduce nitroimidazoles with great efficacy. Such pathways are characteristic of susceptible anaerobic protozoa and bacteria and are absent in nonsusceptible aerobic cells of the host. PMID- 6849202 TI - Antimicrobial prophylaxis in surgery. PMID- 6849203 TI - Metronidazole in the prevention of anaerobic infection. AB - One of the most common complications of appendectomy, or major colorectal surgery and gynecologic surgery, is surgical sepsis. Its incidence may vary from 2% to 4% for normal appendices, up to 20% for hysterectomy, and from 50% to 60% for some colonic operations including gangrenous or perforated appendices. During the last decade, one has become increasingly aware of the importance of non-spore-forming anaerobes as the major cause of serious sepsis associated with these types of operation. Studies carried out at the Luton and Dunstable Hospital, and subsequently at other centers, have shown that metronidazole, a specifically anaerobicidal agent without significant activity against aerobic organisms, is highly effective in preventing postoperative morbidity resulting from anaerobic infections. Moreover, its use has greatly modified the surgical approach in a number of conditions. PMID- 6849205 TI - Double-blind trial of perioperative intravenous metronidazole prophylaxis for abdominal and vaginal hysterectomy. PMID- 6849204 TI - Metronidazole in the prophylaxis of anaerobic infections in gynecologic surgery. AB - A double-blind study was initiated in January 1978 to determine the effectiveness of the prophylactic use of metronidazole, either orally or intravenously, in patients undergoing elective gynecologic surgery. A total of 121 women were evaluated; 42 women received oral metronidazole, 40 women intravenous metronidazole, and 39 women placebo therapy. Evidence of postoperative infection was present in 20% of patients treated with placebo, whereas in the active drug groups the incidence of infection was 12%. Blood levels of metronidazole during the operations had a mean value of 22.2 and 17.9 micrograms/ml for patients receiving intravenous and oral metronidazole, respectively. Preoperative cultures for anaerobic organisms revealed an incidence range of 23% to 45% for the three study groups. The incidence of positive anaerobic cultures declined dramatically by the second postoperative day for patients receiving intravenous and oral metronidazole, In the placebo group, the incidence was not significantly different from that in the preoperative period. This preliminary study revealed that the incidence of postoperative infections subsequent to gynecologic surgery can be reduced significantly through the use of prophylactic metronidazole. PMID- 6849206 TI - Prophylactic antibiotics in elective colon surgery. AB - A double-blind, randomized, prospective study comparing the efficacy of two intravenously administered antibiotics was conducted at Vancouver General Hospital on 98 patients undergoing elective colon surgery. The test drugs, erythromycin gluceptate and metronidazole, were each administered intravenously in 500 mg doses. The first dose was administered with the premedication 1 hour before surgery and the subsequent two doses were administered at 8-hour intervals. All patients received three doses of tobramycin intravenously, 1.5 mg/kg body weight, at the same time as the study drug. Fourteen patients developed wound infections, of which seven were classified as major and seven as minor infections. A major infection was diagnosed when the patient had a fever, required antibiotics, or had a prolonged hospital stay because of the wound infection. Three patients with major infections had received metronidazole and four had received erythromycin. Four patients with minor infections had received metronidazole and three patients had received erythromycin. The two treatment populations were similar with respect to type of surgery, age, gender, weight, and nutritional status. Both drugs were equally well tolerated. The overall wound infection was 14.4%, with no difference between erythromycin and metronidazole. PMID- 6849208 TI - Double-blind comparison of metronidazole plus gentamicin and clindamycin plus gentamicin in intra-abdominal infection. PMID- 6849207 TI - The therapeutic use of metronidazole in anaerobic infection: six years' experience in a London hospital. AB - For the past 6 years at St. Thomas' Hospital, metronidazole has been used to treat proven anaerobic infection at a wide variety of sites and of varying clinical severity. Throughout this period, intravenous, oral, and rectal preparations of the drug have been available. Initial experience was predominantly in abdominal sepsis where excellent therapeutic results were obtained and treated patients included many with mixed aerobic/anaerobic infection in whom metronidazole was used alone. Metronidazole also has been used either alone or in combination, most frequently with amoxicillin, to treat many other anaerobic infections: head and neck, pleuropulmonary, genital tract, bone and joint, skin and soft tissue, and cases of fusobacterial septicemia (necrobacillosis). Although, as in pyogenic infection of any etiology, surgical intervention often is required in anaerobic sepsis, there is little doubt of the useful therapeutic role of metronidazole in these patients. Increasing awareness of the wide clinical spectrum of human anaerobic infections has led to increasing therapeutic dependence on metronidazole with as yet little evidence of bacterial resistance. PMID- 6849210 TI - Metronidazole in the treatment of surgical infections. PMID- 6849209 TI - Prospective, randomized comparison of metronidazole and clindamycin, each with gentamicin, for the treatment of serious intra-abdominal infection. AB - Metronidazole (M) has potent bactericidal activity against anaerobic bacteria. This study was designed to compare its efficacy and safety when combined with gentamicin (M + G) to those of an accepted regimen, clindamycin plus gentamicin (C + G), for the treatment of intra-abdominal infection. Patients were randomly allocated to receive 500 mg of M or 600 to 800 mg of clindamycin (C) each combined with G, 1.5 mg/kg, all administered intravenously every 8 hours. Of 186 patients enrolled, 45 were excluded from analysis (22, M + G). Of the remaining 141 patients, 72 had been allocated to the M + G group. Data refer to M + G and C + G groups, respectively. Infections included abscess in 37 and 30 patients and peritonitis in 30 and 31. Appendicitis was the most common underlying disease, causing intra-abdominal infection in 21 and 22 patients, with diverticulitis occurring next most frequently, seven and 10 patients. Both anaerobic and aerobic bacteria were isolated from abdominal pus in 32 and 27 patients, anaerobes alone in seven and four, and aerobes alone in 24 and 25. In six and seven patients, pus was not cultured. Anaerobic bacteremia occurred in 10/66 and 6/64 patients from whom blood was cultured. Patients were classified as cured, improved, or treatment failures. These ratios were 60:8:4 and 58:8:3. Median trough serum concentrations of M and C were 13.0 and 3.7 micrograms/ml, respectively, and at 15 minutes after infusion, 15 and 10.7 micrograms/ml, respectively. The frequencies of rash, diarrhea, and superinfection were not different in the two treatment groups although abnormal serum tests of liver function occurred more commonly in the C+G group. M+G and C+G are not different in efficacy and acceptability for the therapy of serious intra-abdominal infections in adults. PMID- 6849211 TI - Contribution of intercellular links to ultrasonic absorption of liver tissue. AB - The method discussed aims to characterize the ultrasonic absorption of liver tissues between 3 and 8.75 MHz by the slope of its linear variation with frequency. A transmission measuring device has been used and a data processing system has directly calculated this slope, which is reduced when the strength of intercellular links are lessened by mild treatment with trypsin, although the cells are left intact. This was performed on three batches of Wistar rats and the effect is explained mainly by reduction of the amplitude of relaxation processes dissipating energy in the cells. PMID- 6849212 TI - Sequential changes in erythrocyte volume distribution and microcytosis associated with iron deficiency in kittens. AB - Hemograms, erythrocyte volume distribution curves, serum iron and percent transferrin saturation determinations were done on samples from 50 kittens to characterize feline erythrocytic responses between one and ten weeks of age. At one week of age, all kittens had marked macrocytosis and anisocytosis. Most of the macrocytic cells no longer were present by five weeks. Macrocytes were replaced by erythrocytes of normal volume in 30% of the kittens. At five weeks of age, 70% of the kittens had produced microcytic cells which correlated with significantly lower packed cell volume values (p less than 0.02) and mean corpuscular volume values (p less than 0.001). By seven weeks of age, kittens with microcytosis were producing normocytic erythrocytes. Between two and four weeks of age, kittens with microcytosis had significantly lower serum iron and percent transferrin saturation values (p less than 0.01) compared to kittens without microcytosis. Between five and seven weeks of age, all kittens had very high iron values which were significantly greater than those of healthy adult cats (p less than 0.01). Six kittens with low iron values received an iron dextran injection at two to three weeks of age. At five weeks, these kittens had significantly greater mean corpuscular volumes, packed cell volumes (p less than 0.01) and lower percentage of microcytic cells (p less than 0.001) than littermate controls. These data demonstrate that transient microcytosis and anemia observed in kittens is attributable to iron deficiency. It also was demonstrated that erythrocyte volume distribution curves were more sensitive than the mean corpuscular volume in detecting microcytosis in kittens. PMID- 6849213 TI - Ultimobranchial adenoma of the thyroid gland in a horse. PMID- 6849214 TI - Nontuberculous mycobacterial skin infections in two dogs. PMID- 6849215 TI - Subcutaneous and lymph node granulomas due to Dermatophilus congolensis in a steer. PMID- 6849216 TI - Hair follicle tumors resembling tricholemmomas in six dogs. PMID- 6849217 TI - Lipid deposition in different fiber types of skeletal muscle of periparturient dairy cows. AB - The intracellular deposition of neutral lipid in skeletal muscle of dairy cows before and after calving has been studied in biopsy samples taken from 72 cows in three herds. The amounts of neutral lipid in individual fibers were estimated using Oil red O-stained sections and an average value was calculated for each fiber type within a sample. Intracellular lipid deposition occurred mainly in type 1 fibers and reached its highest level one week after calving. The amount of lipid in muscle at this time showed a high correlation with the amount of lipid in liver and with the rate of lipid mobilization from tissue reserves. PMID- 6849218 TI - Dystrophy of the diaphragmatic muscles in adult Meuse-Rhine-Yssel cattle: electromyographical and histological findings. AB - Electromyographic investigation of diaphragmatic muscles of Meuse-Rhine-Yssel cattle revealed a significant decreased duration of action potentials, while the number of polyphasic potentials was increased in four of seven cows. Histologically, the diaphragmatic muscles in all cows were affected severely, as characterized by variation in size of individual fibers, abundant vacuolar and hyaline degeneration with occasional fragmentation and phagocytosis, fiber splitting, apparent increase in internal nuclei, vesicular nuclei, chains of central nuclei, absence of regeneration, and proliferation of endomysial and perimysial connective tissue. Core-like structures seemed to be a hallmark of the disease. The intercostal muscles in all cows had core-like structures and some variation in fiber size; degenerative lesions did occur, but were less severe than in diaphragmatic muscles. In other skeletal muscles and cardiac muscles, core-like structures were present predominantly, indicating a generalized muscle disorder. No lesions were detected in the peripheral or central nervous systems. The muscular alterations were classified as a progressive muscular dystrophy, with a suspicion of hereditary transmission. This dystrophy may be an important animal model. PMID- 6849219 TI - Congenital intestinal aganglionosis in white foals. AB - A congenital and probably hereditary neurological defect has been identified in the intestinal tract of six foals produced from the breeding of overo (a type of spotting pattern) horses. The foals had white hair and pink skin with the exception of occasional pigmented foci about the muzzle, ventral abdomen, and hindquarters. The foals appeared normal at birth, but within a few hours developed symptoms of colic. At necropsy, the only significant finding was a narrow, pale segment of large intestine. This abnormality either was confined to the small colon and rectum or involved the entire colon and rectum. Microscopically, myenteric and submucosal neuronal plexuses were absent throughout the large intestine and extensive portions of the small intestine. The only other significant finding was the lack of melanin in the skin. PMID- 6849220 TI - Prevalence, lesions, and differential diagnosis of Ollulanus tricuspis infection in cats. AB - Ollulanus tricuspis were found in the stomachs of 26 of 201 cats which were mainly from Washington and Idaho. Twenty-four of the cats were from research or commercial breeding colonies (catteries) and two were pets. Twenty-seven percent of colony cats were infected with O. tricuspis, whereas only 2% of the pet cats were infected. No consistent clinical signs were seen. Histologically there was a significant increase in fibrous connective tissue in the lamina propria and in the number of lymphoid follicles and globule leukocytes in the gastric mucosa of infected cats. Histologic examination revealed no parasites in 13 of the 26 infected cats. The 26 infected cats were identified by examination of stomach washings. An additional 21 cats had larvae of other nematodes in their stomachs. These nematode larvae need to be differentiated from O. tricuspis. PMID- 6849221 TI - Pathology of liver granulomas in turkeys. AB - Liver granulomas from five- and seven-week-old turkeys were studied by light and electron microscopy and by bacterial culture. Granulomas of five-week-old poults were composed of a caseous, necrotic center surrounded by consecutive zones of heterophils, giant cells, macrophages, and finally by lymphocytes. Tissue Gram and modified Dieterle stains demonstrated numerous gram-positive, filamentous bacteria in necrotic centers with radial extension of the bacteria to the zone of giant cells. Electron microscopic examination revealed septate, filamentous bacteria within an electron-dense milieu between heterophils, macrophages, and giant cells. An anaerobic, gram-positive bacillus and a staphylococcus were isolated from most granulomas examined. In broth, the bacillus formed long filaments or chains morphologically similar to those in tissue sections. The bacillus was identified tentatively as Eubacterium tortuosum. The staphylococcus had cultural reactions typical for Staphylococcus epidermidis. Intravenous inoculation of three-week-old poults with a mixture of E. tortuosum and S. epidermidis produced granulomas in liver and spleen and multiple mucosal ulcers in the duodenum and colon. PMID- 6849222 TI - Influence of tachycardia cycle length and antiarrhythmic drugs on pacing termination and acceleration of ventricular tachycardia. AB - We examined the influence of ventricular tachycardia (VT) cycle length and antiarrhythmic drugs on the frequency of VT termination and acceleration by single and double extrastimuli and right ventricular burst pacing. In 57 patients, 89 episodes of sustained VT (32 control, 57 drug) were induced by programmed electrical stimulation. Overall, 60 of 89 (67%) episodes of ventricular tachycardia were terminated by means of programmed electrical stimulation. In patients with relatively slow ventricular tachycardia (VT cycle length greater than or equal to 350 msec) pacing terminated 37 of 44 (84%) episodes but terminated only 24 of 45 (51%) episodes of more rapid VT (VT cycle length less than or equal to 349 msec, p less than 0.005). Pacing successfully terminated VT in nine of 49 (18%) episodes using a single extrastimulus, 22 of 52 (42%) episodes using double extrastimuli, and 40 of 66 (61%) episodes using burst right ventricular pacing. VT acceleration occurred in none of 49 attempts with a single extrastimulus, in eight of 52 (15%) attempts with double extrastimuli, and in 12 of 66 (18%) attempts using burst right ventricular pacing. During therapy, the frequency of either ventricular tachycardia termination or acceleration did not change regardless of the pacing termination method used. However, by prolonging the mean VT cycle length from 311.1 +/- 82.2 msec to 401.9 +/- 103.5 msec (p less than 0.01), drugs increased the overall frequency of VT termination. We conclude that: (1) pacing terminates VT more frequently if the VT cycle length is long and if right ventricular bursts are used, (2) burst right ventricular pacing increases the risk of VT acceleration, and (3) drugs increase the frequency of ventricular tachycardia termination by prolonging VT cycle length but do not affect frequency of VT acceleration. PMID- 6849223 TI - The effects of nifedipine, a calcium antagonist, on platelet function. AB - Platelet function was studied before and 1 hour after ingestion of 20 mg nifedipine, a new calcium antagonist, in 20 patients with coronary heart disease. Platelet counts remained unchanged. Platelet adhesiveness, measured as retention in glass bead columns with Hellem's method for native blood, did not drop significantly eigher when 0.9 or 3.6 ml of blood was used. Platelet aggregation, which is dependent on extracellular calcium, was induced in citrated platelet rich plasma. The mean maximal rate of primary aggregation, initiated with three different concentrations of adenosine diphosphate, was reduced by 20% to 26%. The rate of irreversible collagen-induced aggregation was on average 23% lower after nifedipine. The mean bleeding time was 36 seconds, or 12%, longer after ingestion of the drug. The moderate, but significant reduction of platelet aggregation and prolongation of the bleeding time by nifedipine may be mediated through inhibition of calcium transport across the platelet membrane. PMID- 6849224 TI - Reassessment of the effects of vasodilator drugs in primary pulmonary hypertension: guidelines for determining a pulmonary vasodilator response. PMID- 6849225 TI - Concurrent use of quinidine and disopyramide: evaluation of serum concentrations and electrocardiographic effects. AB - The effects of concurrent disopyramide phosphate and quinidine sulfate therapy were studied in 16 normal healthy adults. No adverse effects serious enough to warrant discontinuation of therapy were observed. There was a small but significant increase in disopyramide serum concentration when concurrent quinidine therapy was given and a small decrease in quinidine serum concentration when disopyramide was added. No significant change in elimination half-life was seen for either drug. Both drugs produced prolongation of the corrected QT interval. This QT prolongation was greater for quinidine than for disopyramide. PMID- 6849226 TI - Nonpharmacologic therapy of hypertension: the independent effects of weight reduction and sodium restriction in overweight borderline hypertensive patients. PMID- 6849228 TI - Esophageal-pericardial fistula presenting as pericarditis. PMID- 6849227 TI - Progression and regression of coronary atherosclerosis: relation to risk factors. PMID- 6849229 TI - Q fever endocarditis of porcine xenograft valves. PMID- 6849230 TI - Effort syncope in aortic stenosis: electrocardiographic correlate of ischemic conduction disturbance. PMID- 6849231 TI - "Reversed" Wenckebach periodicity: a manifestation of concealed reentry in the His-Purkinje system. PMID- 6849232 TI - Alternating unilateral pulmonary edema following pneumothorax in acute myocardial infarction. PMID- 6849233 TI - Chronic epicardial His bundle recordings in awake nonsedated dogs: a new method. AB - Recording cardiac electrical potentials from the region of the bundle of His in the awake, nonsedated animal would allow a more physiologic evaluation of impulse transmission through the specialized atrioventricular conduction system than anesthetized preparations. We present a new technique to localize and record chronic His bundle potentials using standard electronic equipment which obviates the need for intravascular catheters or an atriotomy. Six mature and four immature mongrel dogs underwent a midline thoracotomy. The bundle of His electrogram was recorded from the right atrial epicardium alongside the noncoronary aortic cusp. A flexible tripolar electrode probe with 3 mm interelectrode distance attached to a standard electronic recorder was used to localize the area of greatest His bundle impulse. Silver solder electrodes were sutured to the designated area and the wires were externalized to the back. Electrophysiological measurements were made 1 to 20 weeks later to confirm the accuracy and stability of the His bundle electrogram. These recordings were comparable to the standard internal catheter measurements both before and during atrioventricular impulse interference caused by atrial pacing or pharmacologic intervention. Electrodes sutured to the designated area do not interfere with impulse conduction and allow stable His bundle recordings in all activity ranges in the chronic animal. PMID- 6849234 TI - Laser irradiation of human atherosclerotic obstructive disease: simultaneous visualization and vaporization achieved by a dual fiberoptic catheter. PMID- 6849235 TI - Evaluation of antiarrhythmic efficacy of amiodarone in VT. PMID- 6849236 TI - Mechanisms of junctional tachycardias in the Lown-Ganong-Levine syndrome. PMID- 6849237 TI - Effects of arrhythmia-producing concentrations of digitoxin on mechanical performance of cat myocardium. AB - Digitalis toxicity in vivo generally is recognized by the appearance of cardiac arrhythmias but in vitro by a decline in myocardial performance. To determine whether concentrations of digitoxin producing cardiac arrhythmias in intact animals also produce a decline in myocardial performance directly, three groups of adult cats were studied. One received digitoxin daily until arrhythmias developed (toxic group), the second sufficient digitoxin to produce an inotropic effect without arrhythmias (nontoxic group), and the third was untreated. Peak isometric force and maximal dF/dt of isolated right ventricular papillary muscles were significantly greater in nontoxic muscles (3.9 +/- 0.4 gm/mm2 and 21.3 +/- 1.7 gm/mm2 . sec-1). Values in toxic muscles were similar to untreated ones (2.8 +/- -.6 gm/mm2 and 19.0 +/- 3.2 gm/mm2 . sec-1). Acetylstrophanthidin (2 X 10(-8) M) resulted in an increase in peak force and max dF/dt in nontoxic muscles, whereas myocardial performance changed minimally in untreated muscles and declined in 8 of 10 toxic muscles. We conclude that electrical and mechanical toxicity induced by digitoxin frequently coexist. PMID- 6849239 TI - Ventricular arrhythmias in patients with rest angina: correlation with ST segment changes and extent of coronary atherosclerosis. AB - Major ventricular arrhythmias occurring concurrently with myocardial ischemia are presumed to be the most frequent mechanism for sudden cardiac death. Two hundred eighteen catheterized patients with angina pectoris at rest were reviewed to identify clinical, ECG, and arteriographic features that might correlate with the presence of serious ventricular arrhythmias occurring during episodes of rest pain. Ventricular arrhythmias during episodes of rest pain were significantly more common in patients who manifested transient ST segment elevation in the anterior leads and in patients with marked transient ST segment shifts (greater than 5 mm). Ventricular arrhythmias during episodes of rest pain were not more common in patients with extensive coronary artery disease. PMID- 6849238 TI - Reperfusion arrhythmia: a marker of restoration of antegrade flow during intracoronary thrombolysis for acute myocardial infarction. AB - We studied the effects of coronary recanalization on arrhythmogenesis in patients undergoing intracoronary thrombolysis during the early hours of myocardial infarction. Catheterization, ventriculography, coronary angiography, and intracoronary streptokinase infusion were performed in 22 patients. Twenty-one of 22 had thrombotic total occlusion of the infarct-related transient thrombolysis with reocclusion by the end of the procedure. In 12 of these 17 patients, restoration of antegrade coronary flow was accompanied by transient arrhythmia. In these 12 patients coronary angiography within seconds of onset of arrhythmia showed vessel patency in a previously totally occluded coronary artery. Two additional patients developed arrhythmias during streptokinase infusion but after reperfusion had already been established. Accelerated idioventricular rhythm was most often noted. Sinus bradycardia and atrioventricular block with hypotension occurred during restoration of flow in arteries supplying the inferoposterior left ventricle. These arrhythmias may be useful noninvasive markers of successful reperfusion during thrombolytic therapy in acute myocardial infarction. PMID- 6849240 TI - Acute myocardial infarction: survey of urban and rural hospital mortality. AB - Mortality rates for acute myocardial infarction (AMI) in the province of Manitoba were studied by a retrospective, randomized survey of urban and rural hospital records. Urban hospitals had formal coronary care unit (CCU). Selected rural hospitals lacked CCUs but usually possessed portable monitoring and defibrillation equipment. Twenty-seven percent of 852 cases in the study population died. The mortality rate for unequivocal AMI was 14% to 15% to both urban and rural hospitals. Patients with possible AMI had high mortality rates in both facilities (41% to 45%). Subgroup analysis of the definite AMI population failed to reveal statistically significant differences in urban vs rural mortality, although a consistent trend toward superior performance in urban centers was found. The magnitude of the potential of a rural hospital intervention program to reduce the AMI mortality nevertheless appeared to be small. PMID- 6849241 TI - Amiodarone-induced polymorphous ventricular tachycardia. AB - Five cases of amiodarone-induced polymorphous ventricular tachycardia (torsade de pointes) are presented. All patients had recurrent syncope or dizziness due to polymorphous ventricular tachycardia and in all cases the QT interval was prolonged. In two cases hypokalemia was present at the time the arrhythmia was first recorded, but in both cases polymorphous ventricular tachycardia persisted despite correction of the electrolyte imbalance. Standard treatment for polymorphous ventricular tachycardia (isoproterenol, ventricular pacing, or both) was successful in all patients, however, therapy had to be continued for 5 to 10 days, most probably because of the long elimination half-life of amiodarone. PMID- 6849242 TI - Improving diagnostic accuracy of the exercise test by combining R-wave changes with duration of ST segment depression in a simplified index. AB - To enhance the reliability of the exercise test in diagnosing both overall coronary artery disease and multivessel coronary artery disease, a discriminant function was obtained by means of stepwise linear discriminant analysis. Both electrocardiographic and nonelectrocardiographic factors were used to derive the discriminant function in a retrospective group of 231 patients, 168 of whom had angiographically defined coronary artery disease. The discriminant function converted into a simple exercise index or score was then applied to a retrospective group of 120 patients, 98 of whom had coronary artery disease. This index, combining R-wave changes with duration of ST segment depression and patient's sex, proved highly accurate in diagnosing coronary artery disease in male patients and in diagnosing the absence of coronary artery disease in female patients. When compared to standard ST segment criteria, the sensitivity and predictive value of the exercise index was significantly higher. PMID- 6849243 TI - Ischemia-induced impairment of left ventricular relaxation: relation to reduced diastolic filling rates of the left ventricle. PMID- 6849244 TI - Effects of propranolol on resting and postextrasystolic potentiated left ventricular function in patients with coronary artery disease. AB - The effect of propranolol on global and segmental left ventricular function at rest and after postextrasystolic potentiation was studied in 12 patients with chest pain. Heart rate was controlled with atrial pacing, and left ventricular cineangiograms were performed before and after 0.15 mg/kg of propranolol. During each ventriculogram a premature ventricular stimulus was introduced by means of a programmed stimulator. Propranolol decreased global left ventricular ejection fraction from 64 +/- 4.5 to 58 +/- 4.6 (p less than 0.03). Postextrasystolic potentiated global ejection fraction was not affected by propranolol (78 +/- 3.5 vs 73.6 +/- 3.4; p = NS). The area ejection fraction of the anteroapical region was decreased after propranolol (64 +/- 4.8 vs 52 +/- 6.5; p less than 0.01); however, the postextrasystolic potentiated area ejection fraction was not affected by propranolol (78 +/- 2.6 vs 71 +/- 4.6; p = NS). Frame by frame analysis of the ventriculograms demonstrated that propranolol depressed global and segmental left ventricular function by affecting the second one-third ejection fraction without influencing the first or third one-third ejection fraction. Propranolol has a small depressant effect on global and segmental left ventricular function in patients with coronary artery disease. Postextrasystolic potentiated global and segmental left ventricular function and early systolic ejection phase indices are not altered by propranolol and therefore may be useful in assessing left ventricular function in patients with coronary artery disease who are taking propranolol. PMID- 6849245 TI - Hemodynamic effects of massive peripheral edema. AB - The possibility that noncardiac massive peripheral edema reduces venous distensibility was investigated in eight patients in the supine and 80-degree head-up tilt position before and after diuretic therapy. After clearance of the edema with diuretic therapy, total blood volume (TBV) was not significantly decreased; therefore, in the supine position the significant (2p less than 0.001) decrease of right atrial pressure, stroke volume, cardiac output, and cardiopulmonary blood volume (CBV) by the diuretics was due to an improvement in venous compliance which resulted in peripheral redistribution of CBV since the ratio CBV/TBV was decreased during diuretic therapy (2p less than 0.001). Furthermore, before diuretic therapy, tilt significantly decreased right atrial pressure, stroke volume, cardiac output, CBV, and the ratio CBV/TBV; but after diuretic therapy, the decrease of the same variables during tilt was significantly (2p less than 0.001) greater. These results indicate that marked peripheral edema considerably decreases venous compliance which can be improved with diuretic therapy. PMID- 6849246 TI - M-mode and two-dimensional echocardiographic correlation with findings at catheterization and surgery in patients with mitral stenosis. AB - Thirty-two consecutive patients referred to our institution for evaluation of rheumatic mitral stenosis were studied with M-mode echocardiography (M-mode E), two dimensional echocardiography (2DE), and cardiac catheterization. Twenty-three of these patients underwent mitral valve surgery, 11 requiring mitral valve replacement, and 12 requiring open mitral commissurotomy. Clinical and noninvasive parameters were assessed in order to predict catheterization determined mitral valve areas as calculated by the Gorlin formula, and to predict the choice of operation in patients selected for surgery. For the prediction of valvular area, 2DE planimetry correlated highly (r = 0.89, p less than 0.01) with Gorlin formula results. The presence or absence of pericardial effusion, the anterior-posterior valve leaflet separation (M-mode E), and the left atrium aortic index (2DE) correlated poorly with the degree of mitral stenosis as determined by the Gorlin formula. The most useful predictors of type of mitral surgery were age over 50 years, 2DE valve classification, the presence or absence of calcium at fluoroscopy, and degree of anterior leaflet-septal separation (M mode E). PMID- 6849247 TI - Exercise 2-dimensional echocardiography. Quantitation of left ventricular performance in patients with severe angina pectoris. AB - To assess the feasibility and reproducibility of exercise 2-dimensional (2-D) echocardiography for quantitating left ventricular size and performance, 25 patients with angina pectoris due to severe coronary artery disease and 10 normal subjects were studied before and after the administration of nitroglycerin. In 18 (72%) of the 25 patients, suitable biapical 2-D echocardiograms for quantitative analysis were recorded during upright bicycle exercise. Left ventricular volume (Simpson's rule), ejection fraction (EF), and wall motion score (10 segments graded 0 to 3, normal to dyskinetic) were measured at rest, and at peak exercise (control), 30 minutes later at rest, after nitroglycerin at rest, and at peak exercise. EF increased during control exercise in the normal subjects from 57 +/- 16 to 71 +/- 22% (p less than 0.01), but was unchanged in the patients during exercise before nitroglycerin. In 7 patients (39%), marked increases in EF (greater than 0.05 units) during exercise occurred after nitroglycerin administration. The wall motion score increased significantly in the patients during control exercise, from 2.6 +/- 3.4 to 5.6 +/- 4.5, but was less at maximal exercise after nitroglycerin (3.4 +/- 4.0, p less than 0.001). Intra- and interobserver variability in these measurements was acceptable. Thus, quantitation of left ventricular performance during exercise by biapical 2-D echocardiography can be accomplished in a high proportion of patients with coronary artery disease (CAD) and can be used to assess the effects of therapeutic interventions. PMID- 6849248 TI - Relation between late potentials on the body surface and directly recorded fragmented electrograms in patients with ventricular tachycardia. AB - The relation between low-amplitude, late potentials on the body surface and directly recorded electrograms in 8 patients with and 11 patients without ventricular tachycardia (VT) was studied. Bipolar X,Y,Z leads were signal averaged and filtered with a digital technique. All patients had catheter endocardial left ventricular maps. The VT group had medically intractable VT and an endocardial excision was performed for control of VT. Before bypass, epicardial maps were obtained in the operating room. All studies were performed during normal sinus rhythm. Four patients without VT, each with a previous myocardial infarction, had fragmented endocardial electrograms recorded at 2.0 +/ 1.2 sites. The latest electrogram for each patient ended 87 +/- 8 ms after QRS onset, within the high-amplitude portion of the filtered QRS complex. All patients with VT had fragmented electrograms recorded at 6.1 +/- 3.1 sites/patient. Eighty-eight percent of the fragmented electrograms were endocardial. The latest fragmented electrogram for each patient ended 161 +/- 43 ms after QRS onset, significantly later than the fragmented electrograms from the patients without VT (p = 0.002). Six VT patients had low-amplitude, late potentials at the end of the filtered QRS complex. In these patients, the last 40 ms of the filtered QRS complex contained a higher proportion of fragmented electrograms compared with earlier segments of the QRS complex (68% versus 27%, p less than 0.001). Two patients with VT did not have late potentials. One patient with left bundle branch block had delayed left ventricular epicardial activation which masked the fragmented electrograms. The other had fragmented electrograms of brief duration which ended 80 +/- 12 ms after QRS onset, during the time of normal ventricular activation. It is concluded that the late potential corresponds to delayed, fragmented electrographic activity. Failure to record a late potential may arise from delayed ventricular activation at other sites from bundle branch block or fragmented electrograms of a brief duration. PMID- 6849250 TI - Electrophysiologic studies in atrial fibrillation. Slow conduction of premature impulses: a possible manifestation of the background for reentry. AB - Extrastimulus-induced intraatrial conduction delays were measured in 12 patients with documented episodes of atrial fibrillation (AF) by recording atrial electrograms at the high right atrium, His bundle region, and coronary sinus. Seventeen patients with and without heart disease, but without atrial arrhythmias served as the control group. During baseline-paced atrial rhythms, a conduction delay zone could be delineated, near the atrial effective refractory period, during which all extrastimuli produced conduction delays. When compared at the same paced cycle lengths (500 to 650 ms), the patients with AF had shorter atrial effective refractory periods (mean +/- standard deviation 206 +/- 24.1 versus 233 +/- 28.2 in control patients, p less than 0.02), wider conduction delay zones (79 +/- 21.7 ms versus 52 +/- 21 in control patients, p less than 0.01), and longer conduction delays both to the His bundle region (64 +/- 18.3 ms versus 35 +/- 21.7 in control patients, p less than 0.005) and the coronary sinus (76 +/- 18.9 ms versus 35 +/- 16.1 in control patients, p less than 0.001). Repetitive atrial responses were recorded in 6 patients with AF and in 9 control subjects. Sinus nodal function abnormalities were detected in 6 of the patients with fibrillation. Patients with AF had a higher tendency than control subjects to develop slow intraatrial conduction, as well as shorter effective refractory periods. Since both features would favor reentry, they may be the electrophysiologic manifestations of the abnormalities making these patients prone to atrial reentrant arrhythmias. Repetitive atrial responses were of no predictive value. Sinus nodal dysfunction was frequently found, but was not essential for the occurrence of AF. PMID- 6849249 TI - Clinical spectrum of ventricular tachycardia with left bundle branch morphology. AB - Twenty-nine patients with apparent ventricular tachycardia (VT) of left bundle branch block (LBBB) morphology were evaluated. Tachycardia was associated with an organic basis in 24 of 29 patients: 7 had Mahaim fibers of the nodoventricular type, 7 had arrhythmogenic right ventricular dysplasia, 5 had coronary heart disease, 3 had biventricular cardiomyopathy, and 2 had associated congenital heart disease. In many patients the underlying cardiac disease was not readily apparent. In the patients with a Mahaim fiber, the electrocardiogram taken during sinus rhythm was frequently normal. A reentry tachycardia with anterograde conduction over the nodoventricular fiber could mimic VT as diagnosed by the usual criteria; nodoventricular fibers were, therefore, often unsuspected before electrophysiologic evaluation. In patients with arrhythmogenic right ventricular dysplasia, cineangiography demonstrated abnormalities of the right ventricle, but only minor or no abnormalities of the left ventricle. Clinical and electrocardiographic features were not distinctive. Of the 29 patients, 22 had serious symptoms accompanying the tachyarrhythmia or had required cardioversion. Patients were followed up for an average of 20 months: 4 patients died. Thus, VT exhibiting an LBBB morphology is not uncommon and is frequently associated with organic heart disease, serious symptoms, and significant mortality. Right ventricular angiography and electrophysiologic study may clarify the diagnosis in these patients. PMID- 6849251 TI - Problems in health data analysis: the Maryland permanent pacemaker experience in 1979 and 1980. AB - In a recent report the Maryland statewide health data base, which is derived from "face sheet" data, was used to determine the appropriateness of permanent pacemaker insertion. In the present study the same indications were utilized and both the complete medical records and the face sheet were reviewed for those patients who had been classified as having permanent pacemakers inserted for inappropriate or questionable reasons. In 32 hospitals, 75% of the records were reviewed (610 of 817 patients). Although coded as having received permanent pacemakers, 16% had received temporary pacemakers, battery change, and the like. Diagnoses justifying permanent pacemaker insertion had been omitted in 53% of the face sheet s, and coding errors were found in 39%. Although none of the 610 medical records reviewed had a valid indication for permanent pacemaker insertion listed on the face sheet, complete medical record review demonstrated valid indications in 95%. Inherent difficulties arise in attempting to list rigid indications for permanent pacemaker insertion. The face sheet does not provide adequate data for assessing the appropriateness of permanent pacemaker insertion. PMID- 6849252 TI - Cellular electrophysiologic abnormalities of diseased human ventricular myocardium. AB - Using standard microelectrode techniques, the cellular electrophysiologic features of ventricular myocardium resected from 8 patients with refractory arrhythmias were studied in vitro. Action potentials from damaged myocardium compared with normal myocardium had reduced resting membrane potential, amplitude, and maximal upstroke velocity. Tetrodotoxin, but not verapamil, suppressed 3 action potentials with resting potentials of -60 to -64 mV and Vmax less than 70 V/s. Verapamil, but not tetrodotoxin, suppressed 4 action potentials with resting potentials of -44 to -57 mV and Vmax less than 20 V/s. Unidirectional block, Wenckebach block, and summation occurred in damaged zones. Exit block from and frequency-dependent entrance block into an ectopic focus were noted. Subthreshold responses in the focal area induced by action potentials in the surrounding myocardium and by subthreshold current pulses injected through the recording microelectrode altered the spontaneous discharge rate of the focus, as previously described for modulated parasystole. Pulses early in the spontaneous cycle delayed the next expected discharge, and later pulses accelerated the subsequent discharge. Pulses injected at the singular point completely suppressed automaticity (annihilation). Tetrodotoxin and verapamil suppressed automaticity in some fibers. Single action potentials induced in quiescent fibers triggered and terminated sustained rhythmic activity. These data suggest that depressed fast responses, slow responses, and subthreshold potentials can generate and modulate ectopic activity in damaged human ventricle and that fast- and slow-channel blocking agents and single premature stimuli can terminate such activity. PMID- 6849253 TI - Biphasic nature of propranolol's microelectrophysiologic effects. AB - The microelectrophysiologic effects of d,l-propranolol were observed to be biphasic when a wide range of concentrations was used in canine atrial tissue; therefore, the 2 isomers were used separately to test the hypothesis that the opposite effects of propranolol could be separated by isomeric isolation. Whole atria were detached from dog hearts and 3 by 0.5 cm strips were cut from the atria. Transmembrane action potentials were monitored from the atrial strips mounted in an isolation chamber containing Tyrode's solution. Concentrations of d propranolol, l-propranolol, and the d,l-racemate ranging from 0.03 to 1.0 micrograms/ml were added to the bath and the effects observed for 60 minutes. In lower concentrations d,l-propranolol decreased the effective refractory period and activation time while increasing maximal rise velocity, action potential amplitude, and resting membrane potential. Higher concentrations produced the opposite effects. The l-isomer produced effects very similar to those of the lower concentrations of the racemate, whereas the d-form mimicked those effects of the higher concentrations of the racemic mixture. We conclude that d,l propranolol is capable of exerting 2 opposite electropharmacologic actions, which may be demonstrated by varying the concentration of d,l-propranolol or by separating the isomers. PMID- 6849254 TI - Cryosurgery for cardiac arrhythmias: acute and chronic effects on coronary arteries. AB - The use of cryosurgery near major coronary arteries for the treatment of supraventricular and ventricular tachyarrhythmias has caused concern over the possible deleterious acute and chronic effects of cryothermia on vessel patency and integrity. The present study was designed to examine both the acute and chronic effects of cryothermia on major coronary vessels in an experimental model that simulates clinical conditions. In the acute phase of the study, 10 dogs underwent direct cryothermic exposure of the left anterior descending (LAD) coronary artery while coronary artery flow and regional myocardial blood flow were calculated. Direct cryothermic exposure of the LAD resulted in total cessation of LAD blood flow 20 +/- 4 seconds after institution of cryothermia. Arterial patency returned 29 +/- 8 seconds after termination of cryothermic exposure. In the second phase of this study, 16 dogs had cryolesions applied directly over the LAD at myocardial temperatures of 37 degrees C and during elective cardioplegic arrest at myocardial temperatures of 6 to 12 degrees C. In addition, cryothermia was applied directly to the coronary sinus in these animals. The animals were allowed to live either 48 hours, 2 weeks, or 6 months after the initial procedure, and the cryolesions and underlying vessels were examined histologically. Although coronary arteriography at 6 months showed all coronary arteries to be patent, microscopic examination revealed coronary intimal hyperplasia to be present in the majority of the coronary arteries at the site of the cryolesion, particularly if the cryolesion had been applied during hypothermic, cardioplegic arrest. Cryothermia had no effect on the coronary sinus. This study provides evidence for cryothermia-induced coronary arterial damage that may produce hemodynamically significant coronary artery stenosis and suggests that caution be exercised when it is necessary to create cryolesions in the vicinity of major coronary arteries. PMID- 6849255 TI - Intravascular volume, extracellular fluid volume, and total body water in obese and nonobese hypertensive patients. AB - Intraarterial blood pressure, plasma volume, extracellular and interstitial (IFV) fluid volumes, and total and intracellular (IBV) body water were evaluated in 50 men: 16 obese hypertensive patients, 16 nonobese hypertensive patients, and 18 normal subjects of similar age. In obese hypertensive subjects, the IBW/IFV ratio was significantly increased (p less than 0.01) in comparison with both control subjects and nonobese hypertensive patients. After body weight reduction, blood pressure (p less than 0.01), heart rate (p less than 0.05), and the IBW/IFV ratio (p less than 0.01) significantly decreased. The decrease in the ratio was due to an absolute increase in the interstitial fluid volume, related to a shift of fluid volume from the intracellular to the interstitial space. Thus, obese hypertensive patients have an increased water cell content, causing an altered partition between the intracellular and the interstitial spaces. PMID- 6849257 TI - Compensatory cardiac mechanisms evoked by septal ischemia in dogs. AB - To examine the cardiac responses to selective septal ischemia, the septal artery was occluded intermittently in anesthetized open-chest dogs. Myocardial segment length was recorded continuously by an ultrasonic technique in the interventricular septum and the right and left ventricular free walls. At left ventricular end-diastolic pressure of 3.0 +/- 0.6 mm Hg, occlusion of the septal artery increased left ventricular end-diastolic segment length by 3.9 +/- 0.9% and stroke volume was maintained. After blood volume expansion to a left ventricular end-diastolic pressure of 7.2 +/- 1.4 mm Hg, occlusion of the septal artery did not increase end-diastolic dimensions and stroke volume decreased significantly but by less than 10%. At all levels of blood volume expansion, occlusion of the septal artery did not alter significantly the end-systolic segment length of the free wall of the left ventricle and the dimensions of the free wall of the right ventricle. The distance between the septum and the right ventricular free wall was unchanged in end-diastole and reduced in end-systole after occlusion of the septal artery. These observations indicate paradoxical movement of the ischemic septum. The ischemic septum seems to act as a passive diaphragm pump on the right ventricle without activation of the Frank-Starling mechanism in uninjured areas. In the left ventricle, the Frank-Starling mechanism is fully exploited with unaltered end-systolic dimensions of the uninjured myocardium because of the systolic bulging of the ischemia septum. PMID- 6849256 TI - Failure of dobutamine to increase exercise capacity despite hemodynamic improvement in severe chronic heart failure. AB - The acute hemodynamic and metabolic effects of dobutamine administered during exercise were studied in 8 patients with severe chronic heart failure. Exercise was performed on an upright bicycle ergometer using a graded protocol. During exercise performed without administration of dobutamine, exhaustion occurred after 4.5 +/- 1.2 minutes of exercise. The cardiac index increased from 1.61 +/- 0.25 to 2.67 +/- 0.59 liters/min/m2 (p less than 0.001), the arteriovenous oxygen difference from 7.8 +/- 1.7 to 12.5 +/- 2.4 ml/100 ml (p less than 0.001), and oxygen uptake from 7.9 +/- 3.0 to 41.2 +/- 15.7 mg/100 ml (p less than 0.001). During exercise performed with the administration of dobutamine, the cardiac index was significantly greater than during the control state, 3.23 +/- 0.78 versus 2.67 +/- 0.59 liters/min/m2 (p less than 0.001), while the arteriovenous oxygen difference was significantly lower, 11.2 +/- 2.1 vs 12.5 +/- 2.4 ml/100 ml (p less than 0.01). The arterial lactate level was not significantly changed, 45.3 +/- 17.6 versus 41.2 +/- 15.7 mg/100 ml. Although the dobutamine level tended to increase maximal oxygen uptake compared with the control period of exercise, 9.1 +/- 1.2 versus 8.5 +/- 1.4 ml/kg/min (p less than 0.05), it did not significantly increase exercise capacity, 4.8 +/- 1.5 versus 4.5 +/- 1.2 min. Thus administration of dobutamine in patients with severe chronic heart failure increased the cardiac index during maximal exercise but failed to increase exercise capacity. Since arteriovenous oxygen difference is reduced, dobutamine probably increases blood flow to the nonexercising tissues and not to the actively metabolizing muscles. PMID- 6849259 TI - Can tracking of contrast echocardiographic targets be used to measure intracardiac flow velocities? PMID- 6849260 TI - Cardiac localization of transvascular bioptome using 2-dimensional echocardiography. AB - Two-dimensional (2-D) echocardiography was added to standard fluoroscopic localization of transvascular endomyocardial biopsy in 7 children with heart muscle disease whose ages were 6 months to 18 years. One left ventricular and 11 right ventricular biopsies were carried ot without complications using the fluoroscopic-echocardiographic technique. Two-dimensional echocardiographic monitoring has the advantages of reducing radiation exposure and providing anatomic information about intracardiac structures as well as bioptome localization. Lateral beam spread and reverberation artifacts represent potential problems with 2-D echocardiography, but they did not cause significant difficulties in this study. PMID- 6849258 TI - Mechanisms of spontaneous and induced ventricular arrhythmias in the 24-hour infarcted dog heart. AB - The incidence and types of ventricular arrhythmias were evaluated in 14 dogs, 24 hours after occlusion of the left anterior descending coronary artery. After induction of anesthesia and left thoracotomy, standard electrocardiographic leads and electrograms from the His bundle and the left ventricular endocardium and epicardium (both infarct and normal zones) were recorded. Spontaneous ventricular tachycardia presumably due to abnormal automaticity was consistently observed (average rate 154 +/- 26 beats/min). These arrhythmias were irregular and multiform. In this same group of dogs 3 ventricular paced beats at rates above 300 beats/min induced rapid and uniform reentrant ventricular tachycardias (average rate 345 +/- 17 beats/min) that were difficult to terminate by premature beats or overdrive pacing. During this sustained ventricular tachycardia, continuous electrical activity was recorded from composite electrodes on the epicardial surface overlying the infarcted zone. Such interectopic activity was not observed during the spontaneous, automatic arrhythmias. Two of the 14 dogs showed only ventricular fibrillation in response to the provocative stimuli. These data confirm previous findings that 24 hours after acute myocardial infarction in the dog heart multiform ventricular rhythms can result from enhanced automaticity. In addition, it was found that ventricular tachycardia can be induced in the same dog heart by a standard ventricular pacing procedure. Continuous electrical activity bridging the interectopic intervals only during the latter tachycardia provides strong evidence for the reentrant basis of these induced arrhythmias. These experimental findings are comparable to the 2 different forms of ventricular arrhythmias described clinically, at the same stage of myocardial infarction. The direct myocardial recordings also provide new insights into the phenomenon of entrainment of tachyarrhythmias by overdrive pacing. PMID- 6849261 TI - Validation of the angiographic accuracy of digital left ventriculography. AB - Digital subtraction angiography enhances the contrast to background signal, enabling the performance of angiography with reduced doses of contrast medium. The objectives of the present study were (1) to validate the accuracy of digital left ventriculography for measurement of left ventricular volumes and segmental contraction; and (2) to compare the hemodynamic effects resulting from low-and high-dose intraventricular contrast injections. Twenty-eight patients underwent digital left ventriculography, performed by intraventricular injection of 7 ml of contrast medium diluted in saline solution, followed by conventional cineangiography of the left ventricle performed with 45 ml of undiluted contrast medium. Left ventricular volumes calculated from digital ventriculograms correlated well with volumes calculated from conventional ventriculograms: end diastolic volume (r = 0.97, standard error of estimate [SEE] 23.4 ml; end systolic volume (r = 0.97, SEE 15.4 ml); stroke volume (r = 0.95, SEE 14.7 ml); and ejection fraction (r = 0.97, SEE 3.8%). Segmental left ventricular contraction, measured as percent chordal shortening of hemiaxes, correlated moderately well (r = 0.81, SEE 11.5%). After injection of undiluted contrast medium, left ventricular systolic pressure decreased (133 +/- 31 to 123.5 +/- 27 mm Hg; p less than 0.01) and left ventricular end-diastolic pressure increased (12.0 +/- 7 to 16.9 +/- 10 mm Hg; p less than 0.001). Left ventricular systolic and end-diastolic pressures did not change significantly after injection of diluted contrast medium, and patients had no discomfort. Thus, digital subtraction angiography permits the performance of left ventriculography with markedly reduced doses of contrast medium, obviating the hemodynamic effects resulting from injection of conventional doses of contrast medium. This new approach to left ventriculography provides high resolution ventriculograms for accurate measurement of left ventricular volumes, stroke volume, and ejection fraction. PMID- 6849262 TI - In vivo ultrasonic tissue characterization of human intracardiac masses. AB - Interactions between an ultrasonic signal and cardiac tissue have been used to characterize the histologic state of myocardium in vitro. To assess the utility of in vivo ultrasonic tissue characterization, stochastic analysis was applied to the digitized echocardiographic signals from 15 patients with 2-dimensional echocardiograms suggesting intracardiac masses. Ten subjects with echocardiograms suggesting mural thrombi underwent subsequent surgery or necropsy, which confirmed thrombi in 6 and revealed no thrombi (designated artifact) in 4. Five other patients had intracardiac tumors. The amplitudes within the digitized ultrasonic signals were displayed as histograms, which were described by a parameter k that represented the degree to which each histogram departed from a totally random probability density function. In 5 of 6 thrombi, k = 0, but in all 4 artifacts, k greater than 0. The sixth thrombus had k = 0.5 due to the specular effect of the interface between the thrombus' 2 lobes. All 5 tumors had k greater than 0. Ultrasonic tissue characterization using a stochastic analysis of backscatter can be performed in vivo and helps differentiate thrombus from artifact and tumor in the heart. PMID- 6849263 TI - Implications of increased myocardial isoenzyme level in the presence of normal serum creatine kinase activity. AB - Although increased serum creatine kinase (CK) activity in the presence of an increased level of myocardial-specific isoenzymes (CKMB) has been strongly associated with acute myocardial infarction, the significance of an increased serum CKMB level in the presence of a normal total CK level is uncertain. In 335 consecutive patients suspected of having an acute myocardial infarction and 71 control subjects, peak serum CKMB and CK levels were correlated with the presence of other clinical criteria for acute myocardial infarction: (1) typical chest pain, (2) increased myocardial lactate dehydrogenase (LDH1/LDH2), (3) acute electrocardiographic changes (new or ST-T wave changes with evolution), and (4) an elevated CKMB level on 2 or more determinations or a typical CK curve. No control subject had an increase in CK or CKMB or any of the 4 criteria for myocardial infarction. Of the 176 subjects with normal CK and normal CKMB (Group 1), only 11% had more than a single criterion, and none had more than 2 criteria consistent with myocardial injury. In contrast, of the 83 with elevated CK and CKMB levels (Group 2), 93% had 2 or more and 81% had 3 or more of the 4 criteria. Of the 63 patients with elevated CKMB but a persistently normal CK (Group 3), 65% had 2 or more criteria for acute myocardial infarction and 77% had subendocardial electrocardiographic changes; these patients resembled those with both elevated CK and MB. The phenomenon of elevated CKMB with normal CK occurred in 20% of the patients aged greater than or equal to 70 years but in only 10% of the younger group (p less than 0.01). These findings suggest that elevated CKMB with normal CK likely represents definite myocardial injury, is more likely represents definite myocardial injury, is more common in the elderly, and should be considered part of the spectrum of nontransmural myocardial infarction. PMID- 6849264 TI - Spectrum of global left ventricular responses to supine exercise. Limitation in the use of ejection fraction in identifying patients with coronary artery disease. AB - Left ventricular function was evaluated with rest and supine bicycle exercise multigated blood pool scans in 53 patients who had previously undergone coronary angiography for evaluation of a chest pain syndrome. There were 21 normal patients (less than 25% stenosis in any coronary artery, left ventricular end diastolic pressure less than or equal to 12 mm Hg, and normal left ventriculography) and 32 patients with coronary artery disease (CAD) (greater than 50% narrowing in 1 or more major coronary arteries). Thirty-two (60%) were receiving propranolol at the time of the study. The normal patient group had a significant increase in mean ejection fraction (EF) during exercise (+0.08 +/- 0.09), while the CAD group had no increase (0 +/- 0.11; p less than 0.05). Mean end-systolic volume decreased significantly in the normal group (-5 +/- 8 ml/m2) but demonstrated no significant change in the CAD group (1 +/- 12 ml/m2; p less than 0.05 compared with normal patients). There was no significant change in mean end-diastolic volume in either group. Mean ejection rate, mean peak systolic pressure/end-systolic volume ratio, and mean pulmonary blood volume ratio also differed in the normal versus CAD patients. Despite mean differences, there was considerable overlap in both groups of individual EF responses: 8 of 21 (38%) of the normal group did not have an increase in EF of 0.05 with exercise, while 15 of 32 (47%) of the CAD group did have an increase in EF of 0.05 with exercise. However, the addition of peak systolic pressure/end-systolic volume ratio and pulmonary blood volume (exercise/rest) ratio improved the sensitivity for detecting CAD from 53 to 84% without adversely affecting specificity. Thus, there is a wide spectrum of left ventricular EF responses to supine exercise. In our patient population, EF alone was an insensitive and nonspecific marker of CAD. The addition of other parameters of global left ventricular function, which may be generated using radionuclide angiography, helps distinguish patients with CAD from normal subjects. PMID- 6849265 TI - Left and right ventricular function at rest and during bicycle exercise in the supine and sitting positions in normal subjects and patients with coronary artery disease. Assessment by radionuclide ventriculography. AB - To assess the hemodynamic influence of posture during radionuclide cardiac studies, rest and exercise electrocardiographically gated blood pool cardiac scintigraphy was performed in the supine and sitting positions in 22 normal subjects and in 20 patients with coronary artery disease (CAD). In normal subjects, left ventricular ejection fraction was higher in the sitting position both at rest (67 +/- 6% versus 64 +/- 5%, p less than 0.01) and during exercise (79 +/- 9% versus 76 +/- 6%, p less than 0.05). Left ventricular end-diastolic volume in the sitting position was smaller at rest (by 19 +/- 26%, p less than 0.001), but this variable was similar in both positions during exercise (p greater than 0.05). Left ventricular end-systolic volume was smaller in the sitting position both at rest, by 26 +/- 31 percent, and during exercise, by 14 +/- 20% (p less than 0.001). Left ventricular end-diastolic volume increased from rest to exercise, in the sitting position by 31 +/- 23% (p less than 0.001) and in the supine position by 6 +/- 22% (p greater than 0.05). In patients with CAD, similar left ventricular ejection fractions in both postures were found at rest and during exercise. Left ventricular end-diastolic volume in the sitting posture was smaller at rest by 16 +/- 22% (p less than 0.01) and during exercise by 8 +/- 18% (p less than 0.05). Sitting left ventricular end-systolic volume was smaller by 18 +/- 20% (p less than 0.001) at rest and by 14 +/- 21% (p less than 0.01) during exercise. Left ventricular end-diastolic volume increased from rest to exercise, in the sitting position by 45 +/- 36% (p less than 0.001) and in the supine position by 32 +/- 51% (p less than 0.01). Despite significant hemodynamic differences, the value of rest-exercise radionuclide cardiac studies to detect CAD was similar in the 2 positions. PMID- 6849267 TI - Determinants of variable exercise performance among patients with severe left ventricular dysfunction. AB - The relation between bicycle exercise performance and determinants of central and peripheral cardiovascular function was assessed in 17 patients with class II to III heart failure and in 9 normal subjects. Proportional changes in oxygen consumption (VO2) from rest (R) to maximal exercise (Ex), or Mets, were used as an objective measure of the exercise capacity or functional reserve of the cardiovascular system. Left ventricular ejection fraction (EF) and proportional changes in end-diastolic volume, stroke volume, and cardiac output were determined from appropriate count data by equilibrium radionuclide angiography. Proportional changes in arteriovenous oxygen difference (A-VO2) were derived from the equation Ex/R A-VO2 = Ex/R VO2 divided by Ex/R CO, where CO = count output. Each subject exercised to an anaerobic endpoint. Maximal VO2 was significantly lower in patients than in normal subjects. Because Ex/R A-VO2 was comparable in normal subjects and patients, the lower exercise performance in patients resulted from a reduced count output response. The reduced CO response in patients resulted from failure of the ejection fraction to increase or from an attenuated heart rate response, or both. Exercise performance was variable in both groups. Multivariable analysis in the patient group identified changes in heart rate, count output, and A-VO2 with exercise as important predictors of Mets, but found no relation between Mets and changes in ejection fraction or stroke counts during exercise. Similarly, multiple regression analyses between Mets and determinants of cardiovascular function demonstrated significant correlations with Ex/R heart rate, Ex/R count output, and Ex/R A-VO2 in both groups. In patients, EF at rest ranged from 0.09 to 0.36, but it did not correlate with Mets, nor did changes in ejection fraction, stroke counts, or end-diastolic counts during exercise. The variable exercise performance among patients with severe left ventricular dysfunction was determined predominantly by a variable heart rate and A-VO2 response and not by rest or exercise indexes of left ventricular function. PMID- 6849266 TI - Radionuclide analysis of peak filling rate, filling fraction, and time to peak filling rate. Response to supine bicycle exercise in normal subjects and patients with coronary disease. AB - Using gated equilibrium radionuclide angiography, variables of diastolic filling were analyzed at rest and during supine bicycle exercise in normal subjects (Group 1, n = 18), coronary patients with normal resting ejection fractions (Group 2, n = 26), and coronary patients with reduced resting ejection fractions (Group 3, n = 8). Indexes analyzed were peak filling rate and filling fraction during the first third of diastole. At rest, the peak filling rate was significantly lower in coronary patients than in normal subjects (3.18 +/- 0.82 end-diastolic volume [EDV]/s in Group 1 versus 2.41 +/- 0.66 EDV/s in Group 2, p less than 0.005; and 1.34 +/- 0.26 EDV/s in Group 3, p less than 0.001 versus Group 1). These differences persisted at peak exercise. Coronary patients also had significantly lower filling fractions at rest and during exercise than did normal control subjects. The time from end-systole to peak filling rate was longer at rest in patients in Group 2 (203 +/- 52 ms) than in subjects in Group 1 (172 +/- 50 ms, p less than 0.025). This remained true when the time to peak filling was normalized by the R-R interval. Although the exercise time to peak filling was longer in coronary patients in both Groups 2 and 3 than in Group 1, these differences were not apparent when the interval was normalized by the R-R interval. Thus, abnormalities in peak filling rate and filling fraction exist in patients with coronary disease both at rest and during exercise, but large overlaps exist between normal and coronary patients. Caution is advised in comparing the timing of events during diastole because apparent group differences may be related in part to rest or exercise heart rate. PMID- 6849268 TI - Determinants of ventricular tachycardia in patients with coronary artery disease and ventricular aneurysm. Clinical, hemodynamic, and angiographic factors. AB - Many patients with coronary artery disease (CAD) in whom ventricular tachycardia (VT) develops have transmural scars or frank aneurysms. However, only a minority of patients with ventricular aneurysms go on to develop VT. To determine which factors are associated with the development of VT in patients with aneurysms, we retrospectively reviewed the records of 154 patients with CAD and segments of akinesia or dyskinesia, or both, on left ventriculography. Of the 154 patients, 85 had 24-hour Holter monitoring or 48 consecutive hours of continuous electrocardiographic monitoring in an intensive care unit within 6 months of catheterization. VT occurring at least 10 days after myocardial infarction (MI) or in the chronic phase was recorded in 19 patients (Group I); the remaining 66 patients did not have VT (Group II). The clinical, hemodynamic, and angiographic characteristics of these 2 groups showed no significant difference with respect to age, time from first transmural MI to catheterization, congestive heart failure (CHF), ejection fraction, or presence of dyskinesia. Patients with VT had significantly larger aneurysms and a higher prevalence of septal akinesia or dyskinesia. However, stepwise discriminant analysis revealed septal akinesia or dyskinesia to be the only independently significant variable distinguishing the 2 groups. Thus, septal involvement appears to be a major determinant of VT in patients with CAD and ventricular aneurysm. PMID- 6849269 TI - Electrophysiologic testing in the management of survivors of out-of-hospital cardiac arrest. AB - Forty-five patients survived a cardiac arrest due to ventricular tachycardia (VT) or ventricular fibrillation (VF). Programmed ventricular stimulation was performed with the patients taking no antiarrhythmic medications. Sustained VT was induced in 26 patients (58%) and nonsustained VT in 8 (18%). With treatment aimed at the underlying heart disease (plus empiric antiarrhythmic therapy in 2 patients), the 11 patients who had no inducible VT have had no recurrence of symptomatic VT or cardiac arrest over a follow-up period of 19 +/- 9 months (mean +/- standard deviation). Conventional antiarrhythmic drugs suppressed the induction of VT and were used for chronic treatment in 9 of 34 patients (26%) with inducible VT. Three of these 9 patients had recurrent VT or sudden death, whereas 6 have had no recurrence over follow-up of 20 +/- 7 months. In the 25 of 34 patients in whom the induction of VT was not suppressed by conventional antiarrhythmic drugs, 23 were treated with amiodarone (daily dose 550 +/- 120 mg), and 2 underwent coronary artery bypass grafting with either aneurysmectomy or map-directed endocardial resection. One of the latter 2 patients died suddenly 12 months after surgery. Among the 23 patients treated with amiodarone, 2 had fatal VT or sudden death and 21 (91%) did not, over 18 +/- 14 months of follow up. In survivors of a cardiac arrest, the chief value of electrophysiologic testing is in identifying patients without inducible VT, who appear to have a low risk of recurrent sudden death with treatment directed at the underlying heart disease. Serial electropharmacologic testing with conventional antiarrhythmic drugs is disappointing, with a low incidence of arrhythmia suppression. PMID- 6849270 TI - Quinidine for ventricular arrhythmias: value of electrophysiologic testing. AB - Quinidine was evaluated during serial electrophysiologic testing with programmed ventricular stimulation in 89 patients with life-threatening ventricular arrhythmias. In 30 of the 89 patients, quinidine therapy prevented the initiation of ventricular tachycardia (VT) during programmed ventricular stimulation. In 8 additional patients no single drug tested was effective, and quinidine in combination with either mexiletine (7 patients) or propranolol (1 patient) prevented the initiation of VT during electrophysiologic testing. The mean serum concentrations of quinidine in the patients who responded and those who failed to respond were 2.9 +/- 0.8 and 2.8 +/- 1.1 micrograms/ml, respectively; however, but nonresponders were characterized by more severe congestive heart failure and an increased incidence of digitalis use. During chronic therapy (24 +/- 3 months) with quinidine either alone or in combination with a second antiarrhythmic drug in the 38 patients whose arrhythmia had been suppressed during electrophysiologic testing, 32 (84%) remain symptom-free while 3 have had recurrent arrhythmia and 3 discontinued quinidine because of adverse effects. These data demonstrate that quinidine, when selected on the basis of electrophysiologic testing, provides effective long-term prophylaxis against recurrent ventricular arrhythmia and that approximately 40% of patients tested are likely to respond either to quinidine alone or quinidine in combination with another antiarrhythmic agent. PMID- 6849271 TI - Enhanced parasympathetic tone shortens atrial refractoriness in man. AB - The purpose of this study was to determine the effects of enhanced vagal tone on human right atrial refractoriness in 12 patients. A specially built neck collar connected to a vacuum source was placed around the patient's neck and enhanced vagal tone was produced during neck suction using intracollar negative pressures of 50 to 60 mm Hg. Refractory periods were determined with a catheter electrode positioned in the high right atrium near the sinus node. Induced neck suction increased the spontaneous sinus cycle length from 837 +/- 96 to 1.136 +/- 273 ms (p less than 0.001) and shortened the atrial effective refractory period from 241 +/- 24 to 230 +/- 20 ms (p less than 0.01) and the atrial functional refractory period from 272 +/- 32 to 262 +/- 29 ms (p less than 0.01). In 2 of 2 patients, collar-induced decreases in atrial refractoriness and increases in spontaneous cycle length were prevented after atropine (0.03 mg/kg) was given intravenously. It is concluded that enhanced vagal tone mediated through muscarinic receptors shortens atrial refractory periods in man. PMID- 6849272 TI - Overfeeding with medium-chain triglyceride diet results in diminished deposition of fat. AB - The study was designed to determine whether overfeeding rats with a diet containing medium-chain triglyceride (MCT) as the major fat source (45% of calories) would impede the expected gain in weight and body fat as compared to rats overfed with isocaloric amounts of diet containing long-chain triglyceride (LCT). For 6 wk rats were fed either MCT diet or LCT diet twice daily via a gastrostomy tube. MCT-fed rats gained 20% less weight (P less than 0.001) and possessed fat depots weighing 23% less (p less than 0.001) than LCT)-fed rats. Mean adipocyte size was smaller (p less than 0.005) in MCT- than in LCT-fed rats. Weights of carcass protein and water were similar for both groups as were concentrations of serum insulin and levels of physical activity. The decreased deposition of fat in the MCT-fed rats may have resulted from obligatory oxidation of MCT-derived fatty acids in the liver after being transported there via the portal vein, leaving almost no MCT derivatives for incorporation into body fat. MCT may have potential for dietary prevention of human obesity. PMID- 6849273 TI - Selenium status of vegeterians, nonvegetarians, and hormone-dependent cancer subjects. AB - Human blood selenium (Se) levels have been related to the types of food consumed, bioavailability of Se, and various disease states, including cancer. Some of these interrelationships were investigated in this study in Corvallis, OR (a low soil-Se region) using adult vegetarian and omnivorous subjects, some of whom had hormone-dependent cancer. The study groups were comprised of 48 Seventh-day Adventist vegetarians, 16 Seventh-day Adventist nonvegetarians, 52 non-Seventh day Adventist nonvegetarians, and 16 nonvegetarian hormone-dependent cancer subjects. Fasting blood samples and 3-days dietary intake information were obtained from each subject. Whole blood Se levels, measured fluorimetrically, correlated positively with dietary protein, riboflavin, niacin, and oleic and linoleic acids but not with 11 other nutrients. Due to limited literature values, dietary Se could not be assessed. There was no significant difference in blood Se values between the four groups (which ranged from 0.069 microgram Se/ml for Seventh-day Adventist nonvegetariants to 0.112 +/- 0.050 microgram Se/ml for non Seventh-day Adventists nonvegetarians and nonvegetarian hormone-dependent cancer patients). All values were well below averages reported for other regions of the United States. These data suggest a relationship between blood Se and the consumption of meat, milk, and cereal products, but it is not simply a difference between the vegetarian and nonvegetarian diets. PMID- 6849274 TI - Skeletal muscle function during hypocaloric diets and fasting: a comparison with standard nutritional assessment parameters. AB - Skeletal muscle function and standard nutritional assessment parameters were measured in six obese patients. Base-line measurements were made on a weight maintaining diet, and further measurements after 2 wk of a 400-cal diet, followed by 2 wk of fasting and then after 2 wk of refeeding. The function of the adductor pollicis muscle was assessed by electrical stimulation of the ulnar nerve. The objective parameters of muscle function measured were: 1) force of contraction expressed as a percentage of the maximal force obtained with electrical stimulation at 10, 20, 30, 50, and 100 Hz. 2) Maximal relaxation rate expressed as percentage force loss/10 ms. 3) Endurance expressed as percentage force loss/30 s. Standard nutritional assessment parameters (serum albumin and transferrin, creatinine height index, anthropometry and total body nitrogen and potassium) were also measured. There was a significant increase in the force of contraction at 10 Hz from a base-line of 29.6 +/- 1.0% to 49.0 +/- 2.8% (mean +/- SEM) after 2 wk of a 400-cal diet (p less than 0.01). These was a significant slowing of the maximal relaxation rate from a base-line of 9.8 +/- 0.03% force loss/10 ms to 8.2 +/0 0.3% force loss/10 ms (mean +/- SEM) (p less than 0.01) after 2 wk of a 400-cal diet. After a further 2 wk of fasting these abnormalities in muscle function persisted. There was a significant increase in muscle force loss from a base-line of 3.9 +/- 0.8% force loss/30 s to 13.7 +/- 3.4% force loss/30 s (mean +/- SEM) after fasting (P less than 0.01). After 2 wk of refeeding all aspects of muscle function measured were normal. During the study the standard nutritional assessment parameters did not change significantly. PMID- 6849275 TI - Food intake measurement: problems and approaches. AB - Sources of variance in dietary intake records were measured and compared. Eighteen graduate students recorded self-selected food intakes during a 30-day study. Subjects were divided into two groups and on alternating 5 consecutive day periods, one group weighted all food consumed and recorded it on tape recorders while the other group recorded estimated intake in small notebooks. An average of two, 24-h dietary recalls was also obtained from each subject and compared to previously estimated intake. The major contributions to total variance were within subject and between subject variance. There was no difference in the mean protein and energy intake recorded by weighing when compared to that recorded in household measures, but there was less variability in the records obtained by weighting intake. The 95% confidence limits were calculated both for the group's and an individual's intake for each method, these demonstrated that 1-day dietary record gave a reasonable estimate (within 15%) of the usual intake of the group. However, the 1-day record, regardless of which method used, gave a meaningless estimate of an individual's usual diet. The protein/energy ratios and the coefficient of interindividual variation are also reported. PMID- 6849276 TI - Dietary carbohydrate and second meal glycemic response. PMID- 6849277 TI - The level of plasma cholesterol, a determinant of glucose tolerance. PMID- 6849278 TI - Influence of exercise on food intake in male versus female rodents. PMID- 6849281 TI - The effect of sodium restriction during gestation of offspring brain development in rats. AB - Sodium restrictive diets are today often recommended to women experiencing the normal edema of pregnancy. This study explores some effects of dietary sodium restriction, imposed during pregnancy, on reproductive performance and brain development in resultant offspring. Pregnant Sprague-Dawley rats were fed diets containing either 0.173, 0.067, 0.040, or 0.022% sodium throughout gestation. All other nutrients in the diet were fed at levels in excess of NAS-NRC requirements. At parturition, litters were trimmed to four offspring and mothers fed Purina Rat Chow throughout lactation. Twenty-one days postpartum, offspring were killed and analyses of selected parameters of brain composition made. Rats fed the 0.040 and 0.022% were killed and analyses of selected parameters of brain composition made. Rats fed the 0.040 and 0.022% sodium containing diets during pregnancy consumed less feed, gained less weight, and exhibited altered fluid consumption patterns to rats ingesting the 0.173% sodium control diet. Mothers fed the two diets containing the lowest levels of sodium also had smaller litters, fewer live births, and more stillbirths per litter than control mothers. Birth weights and the number of offspring surviving the lactation period were less in the 0.040 and 0.022% sodium treatment groups. No offspring in the 0.022% sodium diet group survived the lactation period. Brain wet weight, dry weight, cholesterol, protein, and RNA content were decreased in offspring in the 0.040% sodium diet group. PMID- 6849280 TI - Regional differences in hair zinc concentrations: a possible effect of water hardness. AB - Hair Zn, Cu, and Mn concentrations were determined by neutron activation procedures in two groups of healthy, Caucasian children aged 4.5 to 5.5 yr from Halifax, Nova Scotia and Guelph, Ontario and consuming soft water (hardness - 33 ppm) and very hard tap water (hardness = 330 ppm), respectively. Median hair Zn level for the Halifax children (26 males and 26 females) was 140 microgram/g, significantly higher (p less than 0.001) than the Guelph children (median = 82 microgram/g; 25 males and 26 females). No significant differences existed between the two groups for median hair Cu and Mn levels (Halifax hair Cu 12.1 microgram/g. Guelph hair Cu 11.0 microgram/g. Halifax hair Mn 0.17 microgram/g. Guelph hair Mn 0.18 microgram/g). The Halifax children were significantly heavier (p less than 0.001) and slightly taller (p = 0.09) than their Guelph counterparts, although mean daily intakes of energy, protein, Zn, Cu, Mn, and dietary fiber, calculated from 3-day food records were not significantly different in the two groups. The large differences in the hair zinc levels may be due to the high concentration of calcium in the Guelph hard water, which may decrease the absorption of zinc. PMID- 6849279 TI - Evidence of peroxidative damage to the erythrocyte membrane in iron deficiency. AB - The mechanism responsible for reduced red blood cell (RBC) survival in iron deficient infants or animals is unknown. To investigate the possible role of membrane peroxidation in iron-deficiency anemia, we studied RBC membrane lipids and proteins of rats fed iron-deficient (2 ppm Fe) and control (50 ppm Fe) diets between 21 and 41 days of age. Thin-layer chromatography of lipids showed that iron-deficient rats' RBC contained a novel phospholipid (1.9% of the total phospholipid) which moved between phosphatidylserine and phosphatidylethanolamine. Detailed studies showed that this PL is a Shiff's base adduct of phosphatidylserine, phosphatidyl-ethanolamine, and malonyldialdehyde, an end product of lipid peroxidation. Polyacrylamide gel electrophoresis of RBC proteins of iron-deficient rats also showed presence of high molecular protein complexes similar to that formed in in vitro malonyldialdehyde-treated RBC. To examine the role of such membrane cross-linking on in vivo RBC survival, we have studied survival of in vitro malonyldialdehyde-treated RBC in rabbits, 51Cr-T 1/2 of 5 microM malonyldialdehyde-treated RBC, which contained about the same amount of phospholipid/malonyldialdehyde adducts, was reduced to 6 days as compared to 11 days of sham-treated RBC. The in vitro study suggests that peroxidative damage results in significant reduction in RBC T 1/2 and may be analogous to decreased RBC survival in iron-deficient infants and animals. PMID- 6849282 TI - Dietary superoxide dismutase does not affect tissue levels. AB - The effects of dietary supplementation of superoxide dismutase on tissue superoxide dismutase levels were examined in mice. Mice were divided into two groups; the control received a complete purified diet, and the supplemented group received the same diet containing 0.004% superoxide dismutase. There were no differences in the activity of CuZn superoxide dismutase or Mn superoxide dismutase in intestine, liver, kidney, or blood. These data show that oral supplementation of superoxide dismutase does not affect tissue superoxide dismutase activity. PMID- 6849283 TI - Changes in the nutrient composition of human milk during gradual weaning. AB - Six lactating women were recruited at 5 to 7 months postpartum for a study of milk composition during gradual weaning. At recruitment all subjects were exclusively breast-feeding their infants. The subjects were asked to reduce the frequency or duration of breast-feeding episodes by approximately one-third each month for a period of 3 months. Milk was collected before weaning began and at 2 wk intervals for 12 wk. The concentrations of protein and Na were 142 and 220% of base-line values, respectively, at the end of this period. Changes in fat composition were difficult to interpret. A linear trend was observed through wk 10, but values for wk 12 were similar to those obtained before weaning was initiated. The concentration of Fe at wk 12 was 172% of the base-line value. The concentration of Ca did not change and that of Zn fell to 58% of the base-line value at wk 12. The significance of the changes in nutrient concentrations, their relationship to the involution of the mammary gland, and the suitability of milk from this stage of lactation for milk banking are evaluated. PMID- 6849285 TI - Hepatic protein synthesis and secretion after jejunoileal bypass in the rat. AB - The rat was used as an animal model to explore the mechanism responsible for the development of hepatomegaly and hypoproteinemia which commonly occur after jejunoileal bypass. Sprague-Dawley rats. 300 to 350 g, were divided into three groups of 12 animals. Six of the 12 rats per group served as study animals and six as controls. The first six were subjected to 90% jejunoileal bypass and the six controls were sham-operated and pair-fed. In the second group, six animals were subjected to 90% jejunoileal resection and six controls were sham-operated and pair-fed. Six animals in the third group were underfed so that their weights mimicked that of the bypassed animals and six controls were fed ad libitum. After 8 wk the animals were killed. Liver weights, hepatic protein content, and serum protein and triglycerides were determined. Synthesis and secretion of proteins and glycoproteins were measured using incorporation of 14C-leucine and 14C glucosamine, respectively, into hepatic and medium proteins by liver slices. Bypassed animals demonstrated hepatomegaly, decreased serum proteins and triglycerides, and increased hepatic protein content. While both protein and glycoprotein synthesis remained normal, the secretion of these proteins into the medium appeared to be impared. Comparable changes did not occur after jejunoileal resection or after underfeeding. This study suggests that the impairment of glycoprotein and protein secretion may be a contributing factor in the increased liver weight and protein content in conjunction with decreased serum protein observed in the bypassed rat. PMID- 6849287 TI - Data regarding blood drawing sites in patients receiving intravenous fluids. AB - Intravenous fluids were infused into the forearms of 18 volunteers. Baseline hematologic and serum biochemical profiles were obtained from each volunteer prior to starting the IV. After the intravenous fluids had infused for 30 minutes, blood was drawn from the opposite arm, and above and below the IV in the same arm. The intravenous fluids were then stopped, and after waiting two minutes, another blood sample was drawn from the IV needle. The deviation from the baseline value was determined for each analyte by sampling site for each volunteer and the mean deviation was calculated for each analyte from each sample site. Drawing blood from above the infusing IV line resulted in a dilutional effect for most of the analytes. Most analytes were not affected when blood was drawn from the other sites. Serum glucose and phosphorus had mean deviations greater than two standard deviations from the baseline, regardless of where they were drawn. Serum glucose was the only analyte with values higher than the baseline values. We recommend that serum biochemical and hematologic profiles not be drawn above an infusing IV, but should be drawn from the opposite arm or below the IV while it is infusing or out of the IV needle after the intravenous fluids have been stopped for two minutes. PMID- 6849284 TI - Effect of a moderate increase in dietary protein on the retention and excretion of Ca, Cu, Fe, Mg, P, and Zn by adult males. AB - Mineral utilization was studied by metabolic balance techniques in 10 healthy male volunteers fed diets containing 65 and 94 g protein. Both diets contained approximately 650 mg calcium, 1 mg copper, 16 mg iron, 250 mg magnesium 1000 mg phosphorus, and 7 mg zinc. The diet consisted of conventional foods; the additional 29 g protein was egg white protein mixed into a beverage and fed twice per day. Plasma mineral levels were not affected by the increase in dietary protein. When the diet provided 94 g of protein, urinary calcium and zinc were slightly, but significantly, increased by an average of 35 mg (p less than 0.05) and 0.15 mg (p less than 0.001), respectively. Apparent mineral absorption and balance were unchanged by this modest increase in dietary protein. PMID- 6849286 TI - An improved polyacrylamide gel electrophoretic method for demonstration of oligoclonal bands of immunoglobulin G in cerebrospinal fluid. PMID- 6849289 TI - Hepatic capillariasis. AB - The clinico-pathologic features of Capillaria hepatica infection in a 27-year-old Nigerian woman are discussed. This animal parasite has been encountered only rarely in humans. Less than 30 cases of human infection, mostly in children, having been recorded as far as the present authors are aware. This is the first case of hepatic capillariasis reported in West Africa. The pathologic features of this patient is marked by severe hepatic fibrosis, and this is correlated with disordered liver function. The possibility of histopathologic confusion with schistosomiasis mansoni is discussed. PMID- 6849288 TI - Acquired toxoplasmic lymphadenitis with demonstration of the cyst form. AB - Acquired toxoplasmosis usually is diagnosed serologically. Specific histologic criteria allow for the recognition of this disease in lymph node sections. However, Toxoplasma cysts are rarely seen in nodes. The lymph node from a 15-year old male with asymptomatic lymphadenopathy was found to have typical histologic features of toxoplasmic lymphadenitis. Toxoplasma cysts were identified and specific serology was confirmatory. PMID- 6849290 TI - Screening program evaluation. PMID- 6849291 TI - Neural crest cell migration to placenta. PMID- 6849292 TI - Concanavalin A reaction with plasma membrane in human epidermis. PMID- 6849293 TI - Spurious thrombocytosis caused by red blood cell fragmentation. PMID- 6849294 TI - CNS IgG synthesis in multiple sclerosis: choosing the right reference population. PMID- 6849295 TI - A study of optimal reaction conditions for an assay of the human alternative complement pathway. AB - The optimal conditions for performance of a sensitive functional assay for the human alternative complement pathway were studied. The serum dilution causing 50% lysis of rabbit erythrocytes in magnesium EGTA buffer is designated the APH50 titer. Optimal reaction conditions for the assay were pH 7.2, incubation temperature 37 degrees C, incubation time 60 minutes, and magnesium concentration 0.002 M. Lowering the ionic strength of the buffer from 0.150 M to 0.0125 M increased APH50 titers nearly 2.5-fold, but decreased the reproducibility of titers. Significant fluid-phase conversion of C3 at 37 degrees C in low ionic strength buffer was demonstrated by crossed immunoelectrophoresis. Using the optimal reaction conditions, in normal ionic strength buffer the mean APH50 +/- SD for 45 normal adults was 25.3 +/- 5.7 U/mL. Heparin, an inhibitor of the alternative pathway, decreased APH50 by 50% at a concentration of 100 U heparin/mL serum, and totally abolished alternative pathway hemolytic activity at 1,000 U heparin/mL serum, while lowering CH50 titers to a much lesser degree. When increasing doses of zymosan were used for complement activation in vitro, the per cent APH50 depletion at low doses of zymosan was at least twice the per cent depletion of CH50 or antigenic P, B, and C3. A striking dichotomy between nearly complete APH50 depletion and normal or near normal CH50 and hemolytic C4 levels was documented for a human burn patient and for a baboon infused with a lethal dose of Escherichia coli lipopolysaccharide. Therefore, we documented a substantially greater sensitivity of APH50 than of conventional complement determinations for detecting complement consumption by alternative pathway activators. PMID- 6849296 TI - Evaluating the clinical efficacy of laboratory tests. PMID- 6849297 TI - Simultaneous financial evaluation of a complex set of capital budgeting alternatives: a mathematical model. AB - Capital budgeting technics provide for financial evaluation of planned purchases of equipment or other major investments. In capital budgeting, the laboratorian often is faced with a complex set of alternatives, including leasing, installment purchasing, contracting work to another laboratory, and outright purchasing. This paper presents a mathematical model useful for simultaneously evaluating the financial worth of all such alternatives under the same set of assumptions. Armed with the results of financial evaluation and evaluations of quality, turnaround time, and other patient-care factors, the laboratorian can make better decisions regarding the choice of method which, in turn, will affect the productivity of the laboratory. The model is tended for application to mutually exclusive alternatives and includes three useful capital budgeting technics: (1) payback period, (2) net present value, and (3) profitability index. The technics are demonstrated as well as a method of programming the model in financial planning software for solution by microcomputer. PMID- 6849298 TI - Nephrotic syndrome and diffuse mesangial proliferative glomerulonephritis in children. AB - The clinical course, response to therapy, and outcome were analyzed in 25 children with nephrotic syndrome associated with moderate to severe mesangial cell proliferation. The conditions of more than two thirds of the patients (16/23) failed to respond to prednisone therapy, and renal insufficiency or failure developed in 13. Our data suggest an association between response to therapy and degree of mesangial cell proliferation. Persistent nephrotic syndrome was associated with slow deterioration of renal function. PMID- 6849300 TI - Retinoblastoma in Navajo Indian children. AB - Retinoblastoma occurs with an observed incidence of one in 18,000 live births, and 35% to 45% of cases are transmitted genetically in a dominant fashion. A retrospective analysis of Navajo Indian children during the past 15 years disclosed an incidence 21/2 to three times the expected. This observation raises the possibility that silent expression of the gene for retinoblastoma occurs more frequently among the Navajo population compared with the population at large. PMID- 6849299 TI - Primary sclerosing cholangitis associated with immunodeficiency. AB - An infant, first admitted at the age of 5 months with diarrhea (which was adequately treated with formula), was readmitted at the age of 1 year with poor weight gain, steatorrhea, and hepatomegaly. Liver function test results were compatible with cholestatic jaundice, and hepatobiliary scintigraphy visualized dilated bile ducts and evidence of hepatocellular disease. Exploratory laparotomy, liver biopsy, and cholangiography disclosed pathologic and roentgenographic findings of primary sclerosing cholangitis (PSC). The patient proved to be immunodeficient, pointing to the possible pathogenetic role of immunodeficiency in causing PSC in some patients. It is important to look for the disease in immunodeficient children and in patients with ulcerative colitis, and to consider PSC in the differential diagnosis of cholestatic jaundice. PMID- 6849301 TI - Acute respiratory arrest. A complication of malformation of the shunt in children with myelomeningocele and Arnold-Chiari malformation. AB - Three children had hydrocephalus associated with myelomeningocele and the Arnold Chiari malformation. They all experienced neck pain and opisthotonos, followed by the sudden onset of respiratory arrest as a result of the malfunction of a CSF shunt. There were no changes in pupillary response, and each patient remained alert until shortly before the respiratory arrest. Prompt surgical revision of the CSF shunt was carried out, and all three patients recovered. The mechanism of acute respiratory arrest seems to be acute compression of the brainstem as a result of hydrocephalus. The supratentorial pressure is direct on the posterior fossa structures through the enlarged tentorial opening, which is one of the characteristics of the brain in the Arnold-Chiari malformation. Sudden respiratory arrest, a life-threatening complication, is a result of a malfunction of the CSF shunt in children with myelomeningocele and requires prompt surgical decompression. PMID- 6849302 TI - Linear growth patterns in patients with cleft lip or palate or both. AB - Sequential height determinations were made in patients with isolated cleft palate (ICP) and in patients with cleft lip with or without cleft palate (CLP) during an 11-year period. In 31 patients with ICP height percentiles tended to decrease with age. Beyond 8 years of age, none exceeded the 50th percentile, and measurements in eight (26%) of the patients with ICP were consistently below the fifth percentile. In 34 patients with CLP, after 4 years of age height percentiles were bimodular and clearly separable into a short group (65% below the 50th percentile) and a tall group (35% at or above the 70th percentile). The average height of the parents was normal and suggests alteration of the polygenic inheritance of stature in patients with ICP. While the heights of short and tall patients with CLP reflect the mean height of their parents, the distinct bimodular distribution of the heights of patients with CLP was not anticipated. PMID- 6849303 TI - Serum trypsinlike immunoreactivity in cystic fibrosis. An aid in assessing progressive involvement of the pancreas. AB - Serum trypsinlike immunoreactivity (TLI) was measured in 42 children with cystic fibrosis (CF) and related to age and steatorrhea. The mean TLI value in 106 age- and sex-matched control subjects was 22 +/- 7.2 ng/mL. In patients with CF, TLI showed a widespread distribution (range, 0.3 to 214 ng/mL), and an exponential inverse correlation between TLI and age was found. The same trend in the decline in TLI values with increasing age was evident in patients who were followed up. Reduced TLI concentrations were associated with fat malabsorption, but in younger patients with CF, normal or elevated TLI values did not exclude steatorrhea. Elevated serum TLI levels in patients with CF at an early age might reflect pancreatic ductal obstruction. Tendency for TLI to decrease with advancing age and in patients who are followed up can reflect ongoing degenerative destruction within the pancreatic gland. Serum TLI estimation in patients with CF should be used to monitor the progression of pancreatic impairment. PMID- 6849305 TI - Radiological case of the month: ingestion of mercury (quicksilver) from unknown source but without risk. PMID- 6849304 TI - Clonidine poisoning. A complex problem. AB - Clonidine hydrochloride poisoning in children has become more frequent with increasing availability of this drug. We report four cases of accidental clonidine poisoning that demonstrate the various signs and symptoms of clonidine poisoning. The most frequent and significant toxic effects are depression of consciousness, bradycardia, hypotension, and respiratory depression. Ventilatory support must be available if apnea occurs. Bradycardia can be treated with atropine sulfate, epinephrine chloride, dopamine hydrochloride, or tolazoline hydrochloride. Hypotension is treated with intravenous fluids and dopamine, reserving tolazoline for refractory cases. Hypothermia is common but is of minor clinical significance. Paradoxical hypertension should be treated with tolazoline. Clonidine may not be detected in body fluids by routine toxicology screening procedures, so poisoning should be suspected on clinical grounds. PMID- 6849308 TI - Informed consent and circumcision. PMID- 6849306 TI - Oxygen hoods: an unusual cause of neonatal flexion contractures. PMID- 6849307 TI - Epidemic herpes simplex virus infection. PMID- 6849309 TI - Decreased incorporation of 14C-glucosamine relative to 3H-N-acetyl glucosamine in the intestinal mucosa of patients with inflammatory bowel disease. AB - The synthesis of glycoproteins was investigated in intestinal mucosa from patients with inflammatory bowel disease (IBD) and from those with various other conditions. The incorporation into acid-insoluble macromolecules of the amino sugar glucosamine, the first and committed metabolite in the biosynthetic sequence, and its immediate derivative, N-acetyl glucosamine was determined. Tissue was incubated with 1-2 nmol 14C-glucosamine and 3H-N-acetyl glucosamine and the simultaneous incorporation of both isotopes was measured. Bowel tissue from areas microscopically uninvolved in active disease process was examined. Values for the incorporation of both substrates into acid-soluble constituents were similar for both IBD and non-IBD groups, as was also the incorporation of 3H into acid-insoluble constituents. The incorporation of 14C, however, when expressed relative to that of 3H in each individual patient, i.e., 14C/3H, was distinctly different in IBD cases. In 26 non-IBD samples this ratio ranged from 0.04-0.26 with a mean of 0.097 +/- 0.009. In nine cases of Crohn's disease values ranged from 0.013-0.06 with a mean of 0.039 +/- 0.011 (p less than 0.01); in nine cases of ulcerative colitis values were 0.007-0.06 with a mean of 0.031 +/- 0.006 (p less than 0.01). It is concluded that the step involving the N-acetylation of the amino sugar is relatively deficient in patients with IBD and this could reduce the synthesis of the glycoprotein cover which protects the mucosa from damage by bowel contents. PMID- 6849310 TI - Bifid tail of the pancreas: a case presenting as a gastric submucosal tumor. AB - A 49-yr-old male was admitted to our hospital because of epigastric discomfort and a suspected tumor of the stomach on barium meal examination at the Center for Automated Multiphasic Health Test and Services. The tumor shadow of the stomach was initially considered as the "type II" gastric carcinoma according to the Borrmann's classification. Multiple endoscopical and electrocautery cutting biopsies revealed that the tumor occurred in the submucosal layer and was composed of normal pancreatic tissue. A computed tomogram showed a large mass on the pancreatic body which was adjacent to gastric wall. Selective angiography of the celiac trunk revealed that the gastric submucosal lesion was supplied by the transverse pancreatic artery. Endoscopic retrograde pancreatography showed that Wirsung's duct had a divergence in the body of the pancreas and one of the branched ducts headed for the posterior wall of the gastric body. On the basis of these results, a diagnosis was made of the rare pancreatic anomaly, "bifid tail of the pancreas." One of the tails formed the gastric submucosal tumor. This report emphasizes the potential diagnostic value of combined study of endoscopic retrograde pancreatography and computed tomography in determining the presence of pancreatic anomaly. PMID- 6849312 TI - Agenesis of gallbladder with choledocho-colonic fistula. PMID- 6849311 TI - Total obstruction of the ascending colon complicating acute pancreatitis. PMID- 6849313 TI - Computed tomography of the stomach and duodenum: a review. PMID- 6849314 TI - Common bile duct varices: cholangiographic demonstration of a hazardous portosystemic communication. PMID- 6849315 TI - Carcinoma of the intestinal tract in Crohn's disease: results of a survey conducted by the National Foundation for Ileitis and colitis. PMID- 6849316 TI - The GI drug column. Subcommittee on FDA related matters, American College of Gastroenterology. PMID- 6849317 TI - Gastroenterology and the law. PMID- 6849318 TI - Results of Eder-Puestow dilatation in the management of esophageal peptic strictures. AB - Eder-Puestow dilatation of esophageal strictures is a safe procedure. The treatment is followed by symptomatic improvement, but the effect of dilatation on the patients' nutritional state has so far not been reported. We have reviewed 33 patients with benign esophageal stricture with special regard to the effect of dilatation on body weight. A total of 152 dilatations was carried out. All patients had dysphagia, 32 patients had heartburn and 20 had regurgitation. Hiatus hernia was present in 29 patients. Thirteen patients had antireflux surgery; 10 operations were performed before, and four during the dilatation period. One patient required no further dilatations after operation. Dilators greater than 35 FG were passed in 85% of the dilatations. No serious complications occurred. Patients were followed for up to 5 yr (mean follow-up: 27 months). The mean interval between dilatations was 7 months. Body weight was recorded before and one month after dilatation on 78 occasions. There was a significant overall weight increase of 0.78 kg 1 month after dilatation. The mean weight increase was greater after the first dilatation (1.06 kg) than after subsequent ones (0.6 kg). We found that Eder-Puestow dilatation in patients with benign esophageal stricture led to symptomatic improvement and was followed by an increase in body weight. PMID- 6849319 TI - Metastatic endometrial carcinoma to the esophagus. PMID- 6849320 TI - Impact of inter-physician communication on the effectiveness of medical consultations. AB - To evaluate the impact of the inter-physician communication on the effectiveness of consultations, consultations performed by general and subspecialty medical consultation services for one week both early and late in the academic year were prospectively evaluated. Physicians commonly requested consultations to get advice on diagnosis (56 percent), advice on management (37 percent), or assistance in arranging or performing a procedure or test (20 percent). Despite our very liberal definitions, the requesting physician and the consultant completely disagreed on both the reason for the consultation and the principal clinical issue in 22 (14 percent) of 156 consultations. Consultants were twice as likely as the requesting physicians to rate consultations as crucial for management (35 percent versus 18 percent, p = 0.001) because they gave significantly higher ratings when they and the requesting physicians did not agree on the reasons for consultation. Consultations ordered for very specific purposes, such as assistance in arranging or performing a test, were rated significantly higher by the requesting physicians. It was found that breakdowns in communication are not uncommon in the consultation process and may adversely affect patient care, cost effectiveness, and education. PMID- 6849321 TI - Septic shock in a young splenectomized man. PMID- 6849322 TI - Primary hyperparathyroidism masked by hypothyroidism. AB - In a woman with myxedema and normal total and ionized plasma calcium levels, persistent hypercalcemia developed when she was treated with thyroxine. A parathyroid adenoma was subsequently removed, with return of plasma calcium levels to normal. Hypothyroidism may therefore be a further cause of "masked" primary hyperparathyroidism. The mechanism of masking is likely to have been mediated by hypomagnesemia. PMID- 6849323 TI - Sudden unexpected death during ambulatory electrocardiographic monitoring. The Framingham Study. AB - This report documents the clinical and electrocardiographic events of sudden unexpected death in a 52-year-old man without known heart disease during ambulatory electrocardiographic monitoring. This death occurred two and a half hours after detailed noninvasive testing, including treadmill exercise, that was unrevealing. The sequence of S-T change suggesting epicardial injury, multiform ventricular premature depolarizations, and frequent and early cycle ventricular premature depolarizations followed by ventricular tachycardia-flutter fibrillation precipitated by an early cycle ventricular premature depolarization were documented. The delay in cardiopulmonary resuscitation in this witnessed cardiac arrest punctuates the need for widespread dissemination of the skills of cardiopulmonary resuscitation. PMID- 6849325 TI - Strength of conclusion attained from a clinical trial of thrombolysis will depend considerably on interpretation of changes in end-points other than mortality. PMID- 6849324 TI - Metabolic alkalosis due to absorption of "nonabsorbable" antacids. AB - In a patient with end-stage renal disease undergoing long-term maintenance hemodialysis, moderately severe metabolic alkalosis developed in the absence of vomiting or gastric drainage. The cause of the acid-base disorder was exogenous alkali administration, in the form of combined ingestion of "nonabsorbable" antacids (aluminum hydroxide and magnesium hydroxide), neutral phosphate, and a cation-exchange resin (sodium polystyrene sulfonate). In this report, the relevant data of this patient are detailed, and the literature on this well documented, albeit poorly recognized, acid-base derangement is summarized. PMID- 6849326 TI - Relation between variations in the phenotypic expression of an unstable hemoglobin disorder (hemoglobin Zurich) and carboxyhemoglobin levels. AB - Longitudinal studies in a group of 15 asymptomatic subjects with hemoglobin Zurich from two unrelated families indicated marked variation in the clinical and hematologic expression of the hemoglobinopathy, even within the same family. Carbon monoxide bound to normal hemoglobin stabilized the molecule when exposed to a variety of denaturing procedures. The marked increase in the affinity of hemoglobin Zurich for carbon monoxide, approximately 65 times that of normal hemoglobin, led to a study of carboxyhemoglobin levels in smoking and nonsmoking subjects with hemoglobin Zurich and their relation to the phenotypic expression of the hemoglobinopathy. The carboxyhemoglobin content in whole blood from persons with hemoglobin Zurich ranged from 3.9 to 6.7 percent in nine nonsmokers and from 9.8 to 19.7 percent in six smokers. Rates of hemolysis as determined by values for hematocrit, reticulocyte count, and haptoglobin and hemopexin levels were less in smokers than in nonsmokers. Also, rates of Heinz body formation in intact red cells and isopropanol-induced precipitation of the abnormal hemoglobin in hemolysates were less in smokers than in non-smokers. These observations suggest that variability in the phenotypic expression of hemoglobin Zurich is a post-translation event secondary to stabilization of the abnormal hemoglobin by carbon monoxide. PMID- 6849327 TI - Extreme central acidosis from Abbott epinephrine. AB - Investigation into the cause of extreme systemic acidosis during cardiac arrest led to the discovery that a major contributing factor was Abbott 1:10,000 single dose epinephrine, which contained a large unsuspected acid level. Analysis of this product, both in vivo and in vitro, demonstrated that it contained 8.2 times the acid content of a presumably identical product from Bristol Laboratories and also of a presumably identical product from Bristol Laboratories and also 1,850 times the acid content of an identical epinephrine dose made from a Parke-Davis preparation. Abbott epinephrine injected into the central circulation or directly into the heart causes extreme acidemia, which may be potentially lethal by itself when superimposed on pre-existing acidosis as in cardiac arrest. PMID- 6849329 TI - Size and erosive features of the sella turcica in acromegaly as predictors of therapeutic response to supervoltage irradiation. AB - Basal growth hormone levels and the sella turcica of patients with acromegaly were evaluated. Fifty of these patients were followed up, with fasting growth hormone levels determined at several intervals within 10 or more years after supervoltage pituitary irradiation. Prior to therapy, basal growth hormone levels were positively correlated with an estimate of tumor size, as reflected by sella abnormalities. Sella abnormality criteria, developed by Hardy et al., were used as the correlating factor. The percentage of fall in growth hormone levels after radiotherapy was indistinguishable in these patients, regardless of sella grade. However, since the larger, more erosive, tumors were associated with higher pre therapy plasma growth hormone levels, the median growth hormone levels were higher at various intervals after treatment of this group. We suggest that the size and erosive features of the bony sella offer a crude, but possibly useful, predictor of response to supervoltage irradiation in acromegaly. PMID- 6849328 TI - IgA-containing circulating immune complexes in patients with igA nephropathy. AB - The role of circulating immune complexes in the pathogenesis of IgA nephropathy (Berger's disease) is controversial. Previous studies have shown that a minority of these patients have immune complexes, but the methods used have been able to detect only IgG- or IgM-containing circulating immune complexes. Using a sensitive specific Raji cell radioimmunoassay for IgA-containing circulating immune complexes, we have examined serum specimens from 12 patients with IgA nephropathy for the presence of IgA-containing circulating immune complexes. In addition, the Raji cell IgG assay and the 125I-C1q binding assay were used for the detection of IgG- or IgM-containing circulating immune complexes. Purified monoclonal antibodies against human IgA1 and IgA2 were used to determine the subclass of IgA present in renal biopsy specimens from five of these patients. Six of 12 (50 percent) patients had IgA-containing circulating immune complexes, whereas only two of 12 (17 percent) had positive results in the Raji IgG assay and one of 12 (8 percent) in the 125I-C1q binding assay. There was no correlation between serum IgA, C3 C4, or factor B levels and the presence or level of IgA containing circulating immune complexes. None of the three patients with renal failure had circulating immune complexes of any type. Of the seven patents with disease duration of two years or less, five (71 percent) had IgA-containing circulating immune complexes and three (43 percent) had IgG- or IgM-containing complexes. In all five renal biopsy specimens examined for IgA subclass, diffuse heavy, mesangial deposits of IgA1 were seen, whereas IgA2 staining was absent or present in only trace amounts. These findings suggest that IgA1 is the predominant antibody in renal biopsy specimens from patients with IgA nephropathy. The finding of IgA-containing circulating immune complexes in these patients--and their more frequent occurrence in patients with early stages of the disease--suggests that IgA-containing circulating immune complexes may play a role in the pathogenesis of IgA nephropathy. PMID- 6849330 TI - Recurrence of thymic hyperplasia after thymectomy in myasthenia gravis. Its importance as a cause of failure of surgical treatment. AB - Persistence of symptoms in patients with myasthenia gravis who have undergone previous thymectomy has been attributed to thymus remnants. Patients with partial or no recovery were studied 40 +/- 31 months (mean +/- SD) after surgery, which had been carried out by the transcervical approach in 20 and trans-sternal approach in four. Lateral x-ray tomography of the mediastinum after injection of air showed images compatible with residual thymus gland in 18 patients (75 percent). Thirteen of these underwent reoperation by the trans-sternal approach, and thymic tissue was found in 11 (85 percent). After repeated thymectomy, 67 percent of the patients improved clinically. Therefore, it is quite reasonable to infer that incomplete removal of the thymus was responsible, at least partly, for failure of the first procedure. PMID- 6849331 TI - Some considerations for implementing collaborative practice. PMID- 6849332 TI - Isolated angiitis of the central nervous system. Prospective diagnostic and therapeutic experience. AB - Isolated angiitis of the central nervous system is an uncommon clinicopathologic entity characterized by vasculitis restricted to the vessels of the central nervous system without other apparent systemic vasculitis. Experience with the diagnosis, treatment, and follow-up evaluation in four patients with this disease is presented. Early manifestations of disease include severe headaches, altered mental function, and focal neurologic deficits. The pattern of progression from headaches and altered mental status to multifocal neurologic deficits is particularly suggestive of the diagnosis of vasculitis of the central nervous system. Systemic symptoms such as fever, myalgia, arthralgia, and arthritis, which occur frequently in other vasculitic syndromes, are generally not present in patients with isolated angiitis of the central nervous system. No single laboratory study can firmly establish or completely exclude the diagnosis; consequently, tissue diagnosis with biopsy of the brain parenchyma and leptomeninges may be required. In two patients, recurrent disease developed despite treatment with corticosteroids alone. Sustained clinical remission was induced in all four patients with a regimen of daily cyclophosphamide and alternate-day prednisone therapy. Cyclophosphamide and alternate-day prednisone therapy are considered the treatment of choice in severe, progressive, or corticosteroid-resistant isolated angiitis of the central nervous system. PMID- 6849333 TI - Maternal complications of parenteral beta-sympathomimetic therapy for premature labor. PMID- 6849334 TI - Potassium and glucose concentrations without treatment during ritodrine tocolysis. PMID- 6849335 TI - Carotid-dural arteriovenous fistula during use of an oral contraceptive. PMID- 6849336 TI - Spontaneous ileovaginal fistula caused by Crohn's disease: a case report. PMID- 6849337 TI - Atrial fibrillation during hexoprenaline therapy for premature labor. PMID- 6849338 TI - Exacerbation of Cushing's disease during pregnancy. PMID- 6849339 TI - Typhoid fever on an obstetrics-gynecology service. PMID- 6849340 TI - Pregnancy in a patient with tricuspid atresia. PMID- 6849341 TI - Severe consequence of hypertension in pregnancy. PMID- 6849342 TI - Experimental induction of a toxemia-like syndrome in the pregnant beagle. AB - A toxemia-like syndrome was induced in pregnant beagles by intraperitoneal inoculation of concentrates prepared from placentas of patients with preeclampsia eclampsia and hydatidiform mole, which contained an agent, Hydatoxi lualba, that stained in a unique fashion with toluidine blue-O-. The pregnant dogs inoculated with either of these concentrates progressively developed hypertension, eyeground changes consistent with hypertensive retinopathy, proteinuria, disseminated intravascular coagulation, and hepatic dysfunction in addition to intrauterine growth retardation and intrauterine fetal death. Hepatic periportal hemorrhage and glomeruloendotheliosis, lesions usually seen in preeclampsia-eclampsia, were also noted to occur in pregnant beagles inoculated with these concentrates. A significant increased sensitivity to angiotensin II infusion was also noted. The toxemia-like syndrome did not develop in pregnant beagles when inoculated in a similar fashion with concentrates prepared from placentas from normal term pregnancies which were free of Hydatoxi lualba or in nonpregnant beagles inoculated with concentrates containing Hydatoxi lualba. Although the agent was not injected in pure form, the inoculation of concentrates containing Hydatoxi lualba appears to be required for the manifestation of the toxemia-like syndrome. PMID- 6849343 TI - A system to monitor patient care in a perinatal region. PMID- 6849344 TI - Fetoscopic visualization in second-trimester pregnancies. AB - Fetoscopic visualization may be required for the prenatal diagnosis of external fetal malformations which cannot be clearly defined by ultrasound. The synchronous use of real-time ultrasound guidance during the fetoscopic procedure has permitted successful visualization to be achieved in pregnancies of greater than 18 weeks' gestation. The chances of successful visualization and the influence of advancing gestational age have been critically evaluated. Between 18 and 23 weeks', when these techniques were used, advancing gestational age did not appear to exert a significant effect on the chances of successful visualization. Analysis of placental position indicated that an anterior placenta did not significantly affect bloodstaining of the fluid or preclude access to placental vessels for blood sampling. PMID- 6849345 TI - Smoking and the occurrence of congenital malformations and spontaneous abortions: multivariate analysis. AB - A multivariate analysis was carried out with retrospective data on the effects of tobacco smoking on congenital malformations and spontaneous abortions. Congenital malformations were collected from the Finnish Register of Congenital Malformation. Tens of possible confounding variables, including maternal and family characteristics, obstetric history, medicine taking, and diseases during the pregnancy, were taken into consideration. In the final analysis 13 confounders were controlled. The odds ratios for the smoker's child to be born with central nervous system, oral cleft, or musculoskeletal malformations were 1.25, 1.25, and 0.75, respectively. All the differences were statistically nonsignificant. The effect of smoking on spontaneous abortions was analyzed by means of a questionnaire study on hospital personnel. The smokers of over 10 cigarettes per day had more spontaneous abortions than the nonsmokers, but the differences were not significantly statistically. The data were controlled for age, parity, and coffee and alcohol drinking. PMID- 6849346 TI - Phasic blood flow patterns in the superior and inferior venae cavae and umbilical vein of fetal sheep. AB - Measurements of phasic blood flow in the inferior and superior venae cavae and umbilical vein of fetal sheep (gestational age, 121 to 140 days) were made with chronically implanted electromagnetic flow transducers. In the venae cavae blood flow was inversely related to phasic changes in venous and/or intrathoracic pressure. During fetal apnea a forward surge of flow occurred during ventricular systole (systolic surge) and ventricular diastole (diastolic surge). Slower fetal heart rates were associated with a more prominent diastolic surge. Reductions in afterload caused by acetylcholine administration augmented the peak diastolic venous flow. In contrast, increased afterload caused by hypoxia and norepinephrine administration was associated with increased peak systolic flow. During regular fetal breathing movements the phasic flow pattern was determined largely by the respiratory cycle with the effect of the cardiac cycle superimposed. There was minimal venous pulsation in the intra-abdominal umbilical vein, compared with that of the intrathoracic venae cavae of the apneic fetus. Our findings demonstrate that fetal systemic vascular resistance profoundly influences right atrioventricular filling patterns. PMID- 6849347 TI - Effect of delivery method on outcomes in the very low-birth weight breech infant: is the improved survival related to cesarean section or other perinatal care maneuvers? AB - The perinatal mortality rate among very low-birth weight infants has been decreased by 20% during the last 4 years of the 1973 to 1980 period here reported. The concurrent increase in the cesarean section rate from 11.9% to 49.1% during the same time frames has been assumed to be responsible for the improved outcome. The changes were most marked in the extremely low-birth weight group (less than 1,000 gm). The survival rates and cesarean section rates were examined among infants of similar birth weight and gestational age in the vertex presentation, in the same time frames. A similar or greater reduction in mortality rate (from 85% to 45%) was noted in the very low-birth weight vertex infants, whereas the cesarean section rate remained minimally and not significantly increased (14.2% to 22.2%). The interpretation of this finding is by no means clear but must include the hypothesis that the increased cesarean section rate may be incidental and in no way related to the improved outcome. The most statistically significant determinants of outcome remain birth weight and gestational age strata, with no significant difference in outcomes when the extremely low-birth weight group is analyzed separately from the entire very low birth weight group. As yet unidentified perinatal care practices, other than cesarean section, may be more likely to affect outcome in this high-risk group. PMID- 6849348 TI - Intrapartum fetal hypoxia: a study of long-term morbidity. AB - Reported is the second phase of a prospective follow-up study of 37 children who had episodes of intrapartum fetal hypoxia at delivery identified by an acid-base assessment and of a control group of 59 children who had no evidence of intrapartum fetal hypoxia. The newborn infants were normally grown and mature at delivery. Follow-up assessments of motor, cognitive, and language development were made between 1 and 6 years of age. There was no significant difference in the pattern of physical growth and the incidences of motor and cognitive handicap or developmental delay, language developmental delay, and tests of vision and hearing in the children of the hypoxia group and the children of the control group. These findings suggest that acid-base measures of metabolic acidosis can be used as a method of assessment of the mature normally grown fetus during labor without compromising the long-term outcome of the child. PMID- 6849349 TI - Outcome of very low-birth weight infants born at a perinatal center. AB - One hundred six infants with birth weights less than or equal to 1,000 gm were born at a Perinatal Center in 1979 and 1980. Eighty-three (78%) were born to women transferred to the Center because of antenatal problems. The most common obstetric problem was premature labor with or without premature rupture of the membranes. Seventy-two infants (68%) survived. The following perinatal factors were associated with increased survival: increased birth weight and gestational age, intrauterine growth retardation, antenatal steroids, absence of hyaline membrane disease, and absence of seizures or clinical signs of intraventricular hemorrhage. Of the 72 survivors, two were lost to follow-up and one died (sudden infant death syndrome). The most common general health problem was recurrent middle ear infection. Growth was satisfactory. Significant neurological or developmental handicap was found in nine infants (13% of the 69 evaluated). PMID- 6849350 TI - The effect of maternal glucose administration on the specificity of the nonstress test. AB - To determine whether maternal glucose administration can decrease the incidence of false positive nonstress tests, 296 nonstress tests were performed on 235 high risk obstetric patients in a prospective controlled study. Patients were alternately given a 50 gm oral glucose drink or an equal volume of water 30 minutes prior to the commencement of each test. Among "fed" patients (last meal within 2 hour of the nonstress test) whether receiving glucose or water, and "fasted" patients who received glucose, there was no significant difference in the percentage of reactive tests at either 20 minutes (65.2%) or 40 minutes (87.3%) of testing. However, patients fasting and receiving water had a significantly decreased percentage of reactive tests, both at 20 minutes (48.3%, P less than 0.01) and at 40 minutes (76.7%, P less than 0.05). Glucose administered to fasted patients resulted in an increase in the incidence of reactive tests, although this was not statistically significant. Glucose administration had no effect on the nonstress test results when administered to fed patients. PMID- 6849351 TI - Voluntary regionalization and associated trends in perinatal care: the Nova Scotia Reproductive Care Program. AB - The Nova Scotia Reproductive Care Program is a system of voluntary regionalization that involves the 37 hospitals in the province that provide obstetric care to a population of 850,000. Between 1971 and 1980, the perinatal mortality rate in the central tertiary care unit for nonreferred patients fell progressively from 12.5 per 1,000 total births to 5.16. For all cases, including high-risk referrals, this rate has fallen from 12.7 to 7.2. During the same interval, the perinatal mortality rate for the province's seven regional hospitals fell from 18.7 to 12.2, and that for the 28 community hospitals fell from 18.4 to 7.0. Analysis of these reductions by fitted trend lines demonstrates statistical significance. Further analysis demonstrates that, with regionalization of perinatal services, it is possible to reduce the perinatal mortality rate in small community hospitals to levels that approximate those of a sophisticated tertiary care hospital. PMID- 6849352 TI - The outcome of prolonged labor as defined by partography and the use of oxytocin: a descriptive study. AB - A descriptive study of 300 consecutive spontaneous labors in primigravid patients whose pregnancies were of 37 or more weeks' gestation with a singleton fetus in the vertex presentation, showed a cesarean section rate of 13%, a forceps delivery rate of 49%, and a spontaneous delivery rate of 38%. Oxytocin was used in 17% and epidural analgesia was used in 75% of the patients. The median rate for cervical dilatation for those women with spontaneous deliveries was 2 cm/hr (interquartile range = 1.5 to 3.3 cm/hr) and for those delivered with forceps, 1.2 cm/hr (interquartile range = 0.9 to 1.8 cm/hr). When labor was prolonged by 4 hours or more, the cesarean section rate rose to 34%. Oxytocin was used in only 41% of these patients. Of 23 women delivered by cesarean section for dystocia/disproportion, only nine received oxytocin. From the low incidence of low Apgar scores in all labor groups from this series, there would not appear to be a fetal advantage to earlier intervention. Although the suggestion from this study is that oxytocin administration when labor is prolonged by 4 hours will reduce the need for cesarean section, the true value of such an intervention can be tested only by a randomized controlled trial. PMID- 6849353 TI - A comparison of definable traits in women requesting reversal of sterilization and women satisfied with sterilization. AB - More women of reproductive age are being sterilized. Some of these women regret the decision and subsequently request a reversal of sterilization, whereas others do not. This study was undertaken to develop a profile of easily definable traits of 159 women who requested a reversal of sterilization and compare it with that of 160 women who apparently were satisfied with sterilization. Statistically significant differences were found. Remarriage was the most common cause for regret among women in the group which requested reversal of sterilization. Women in this group married younger, completed their family earlier, and were sterilized at a younger age. These women had significantly fewer live children and had undergone more therapeutic abortions (p less than 0.005). PMID- 6849354 TI - Stage IB cervical carcinoma and pregnancy: report of 49 cases. AB - In a study of 49 cases of Stage IB cervical carcinoma associated with pregnancy, the 5-year survival rate was 69.8%, the incidence of tumor-positive pelvic lymph nodes was 25.0%, and the posttreatment serious complication rate was 22.4%. These were significantly different from parameters generated in our center's overall experience with Stage IB cervical carcinoma (p less than 0.001, p less than 0.05, and p less than 0.001). When associated with pregnancy, the 28.8% serious complication rate in patients receiving radiotherapy was significantly higher (p less than 0.025) than the 6.7% rate observed in patients undergoing radical hysterectomy and lymph node dissection. No effect on 5-year survival was observed regarding time of gestation when diagnosis was made, method of delivery, or treatment modality. A subgroup of patients with diagnosis made in the second or third trimester all underwent cesarean section and appeared to have improved survival when radical hysterectomy and lymph node dissection accompanied this procedure as compared to those patients having postpartum radiotherapy. PMID- 6849355 TI - Radical vulvectomy with use of tensor fascia lata myocutaneous flap. PMID- 6849356 TI - Relationship of oral contraceptives and the intrauterine contraceptive devices to the regression of concentrations of the beta subunit of human chorionic gonadotropin and invasive complications after molar pregnancy. AB - One hundred ninety-four patients with pathologically confirmed molar pregnancy and intact uteri were studied prospectively. Group A included 177 patients in whom the beta subunit of human chorionic gonadotropin (hCG-beta) declined to normal (less than 5 mlU/ml) without chemotherapy, whereas group B included 17 patients with invasive complications in the postmolar phase which necessitated the use of chemotherapy. Only women with intact uteri were included in the study. In group A, there were no significant differences in the human chorionic gonadotropin (hCG) positive interval between women who used intrauterine contraceptive devices, barrier and other methods, and those who used oral contraceptives. Differences in the proportions of women in groups A and B who used the oral contraceptives and intrauterine contraceptive devices were not observed. However, the mean dosage of estrogen and the proportion of women who ingested more than 50 micrograms of estrogen were higher in group B. These data suggest that (1) the oral contraceptives with less than 50 micrograms of estrogen and the intrauterine contraceptive devices do not prolong the hCG-beta positive interval nor increase the risk of invasive complications in the postmolar phase which requires the use of chemotherapy; and (2) the dose of estrogen (in formulations that contain more than 50 micrograms) rather than the oral contraceptives per se may influence the risk of these postmolar complications. PMID- 6849357 TI - Diagnosis of lower urinary tract disorders in postmenopausal patients. AB - One hundred patients over age 60 who had lower urinary tract symptoms were evaluated in detail. The five primary diagnoses were urethral syndrome (29%), genuine stress incontinence (21%), unstable bladder (19%), hypoestrogenism (7%), and pelvic relaxation (6%). Among patients with genuine stress incontinence, 95.2% had the symptom of stress incontinence. Of 43 patients with the symptom of stress incontinence, 67.4% had the diagnosis of genuine stress incontinence confirmed on urodynamic testing. Of the patients with an unstable bladder, 88.9% had urgency and/or urge incontinence; but of 40 patients with both of these symptoms, only 40% had the diagnosis of unstable bladder. Sixty-two patients who complained of urinary incontinence had the following primary diagnoses: genuine stress incontinence (36%), unstable bladder (29%), urethral syndrome (21%), and pelvic relaxation (5%). Because of the impossibility of clinically correlating symptom with diagnosis in the individual patient, extensive evaluation of postmenopausal patients to determine the etiology of incontinence is advised prior to surgical intervention. PMID- 6849361 TI - Bilateral injection of contrast medium for dacryocystography. PMID- 6849358 TI - Efficacy of antibiotic therapy in preventing spontaneous pregnancy loss among couples colonized with genital mycoplasmas. AB - Evidence suggests that genital mycoplasmas play a role in spontaneous abortion, prematurity, and perinatal morbidity and mortality rate. Since these organisms are sensitive to antibiotics, three treatment regimens were assessed for efficacy in preventing spontaneous pregnancy loss. The pregnancy loss rate was significantly reduced from 96% to 47.4% among those treated with doxycycline prior to conception and to less than 20% among those treated with erythromycin stearate only during pregnancy or with both regimens. The reduction in pregnancy loss rate was independent of maternal age, the number of previous abortions, gestational age at abortion, or other minor abnormalities. Diagnosis and treatment of mycoplasma infection following a first or later pregnancy loss equally prevented spontaneous loss in the next pregnancy. These observations suggest that appropriate treatment of mycoplasma infection could also prevent recurrent spontaneous abortion syndrome in couples with positive cultures. PMID- 6849359 TI - Serologic evidence of ureaplasma urealyticum infection in women with spontaneous pregnancy loss. AB - Among 71 couples with histories of pregnancy wastage, 84.5% were colonized with Ureaplasma urealyticum and/or Mycoplasma hominis; whereas in couples with successful deliveries the incidence was 25.4%. The distribution of U. urealyticum and M. hominis was comparable in the fertile and infertile populations. Of women with positive cultures, 96% aborted, compared with an expected rate of 19% to 45%. Serologic studies revealed that, at delivery, 42.9% of infants of mothers with pregnancy losses had fourfold elevations in titers above the mothers' level compared with 15% of normal infants. Mothers with pregnancy wastage histories had elevated titers above their infants in 42.9% of cases compared with 10% of normal mothers. Thus, both mothers and fetuses had responded immunologically to the presence of U. urealyticum. When the mean antibody titers in the normal and pregnancy wastage groups were calculated for each ureaplasma serotype, the infants of mothers with pregnancy losses exhibited significantly elevated mean titers to serotypes 6 and 8, while the mothers had elevated mean titers to serotypes 4 and 8. These observations suggest that U. urealyticum causes infection in mothers and fetuses and that certain ureaplasma serotypes may be more pathogenic than others. PMID- 6849360 TI - Effect of maternal ethanol ingestion on fetal breathing movements, gross body movements, and heart rate at 37 to 40 weeks' gestational age. AB - The effect of maternal ingestion of ethanol (0.25 gm/kg) on fetal breathing movements, gross fetal body movements, and fetal heart rate was studied in 11 healthy pregnant women at 37 to 40 weeks' gestation. Fetal breathing movements were almost abolished within 30 minutes of the alcoholic drink and remained significantly decreased for 3 hours. The incidence of gross fetal body movements before or after ethanol was not different from that on the control day, and the fetal heart rate was not changed after maternal ingestion of ethanol. PMID- 6849362 TI - Reverse Collier's sign: pseudoblepharoptosis associated with downgaze paralysis. PMID- 6849364 TI - New visual acuity charts. PMID- 6849365 TI - Globe involvement in sinus histiocytosis. PMID- 6849363 TI - The teardrop appearance of the superior ophthalmic vein on computed tomography. PMID- 6849367 TI - Tuberculous uveitis. PMID- 6849366 TI - Antimicrobial properties of alkyl-2-cyanoacrylate tissue adhesives in vitro. PMID- 6849368 TI - Clinical findings and results of treatment in an outbreak of acute hemorrhagic conjunctivitis in southern Florida. AB - An epidemic of acute hemorrhagic conjunctivitis in Miami, Florida, involved approximately 800 documented cases and more than 2,500 suspected cases. This epidemic was caused by an enterovirus 70 infection affecting primarily young black people residing within a high-risk area. Acute hemorrhagic conjunctivitis is characterized by the rapid onset of swollen eyelids, foreign-body sensation, burning, watery discharge, and, usually, bilateral ocular involvement. Signs include distinctive bulbar conjunctival hemorrhages and a follicular conjunctival reaction with only mild and infrequent corneal involvement. This infection is short in duration, self-limited, and free of significant ocular sequelae. Symptomatic treatment appears to be as effective as various topical medical regimens for relief of symptoms. Secondary bacterial infections (occurring in individuals who used urine as an eyewash) and one case of a transient acute Bell's palsy were the only complications associated with this acute hemorrhagic conjunctivitis epidemic. PMID- 6849369 TI - Pupillary block after intraocular lens implantation. AB - Seventeen patients, ranging in age from 40 to 86 years, developed pupillary block detected one week to three years after intraocular lens implantation. Sixteen of the implants were anterior chamber intraocular lenses and one was a posterior chamber intraocular lens. Despite iris bombe that closed the anterior chamber angle, many cases were asymptomatic and were discovered fortuitously during routine postoperative examinations. Laser iridotomy or iridectomy eliminated the pupillary block in all 17 cases, but permanent synechial closure of a portion of the anterior chamber angle persisted in most cases and sometimes required medication or further surgery. One eye eventually lost all light perception. PMID- 6849370 TI - Iridoschisis associated with glaucoma and bullous keratopathy. AB - Two of six patients (four women and two men ranging in age from 51 to 90 years) with bilateral senile iridoschisis also had secondary unilateral narrow angle or angle-closure glaucoma. All six patients had splitting of the iris stroma inferiorly. Histopathologic studies disclosed marked iris stromal atrophy without evidence of vascular or neural alterations. Vessels were present in the separated anterior stroma. Electron microscopy of iridectomy specimens from three patients and a corneal button from one disclosed scant or absent collagen fibrils in the area of separation. The cornea showed focal loss of endothelial cells, patchy posterior banding (110 nm) of Descemet's membrane, and stromal and epithelial edema. The posterior corneal surface showed degenerated endothelial cells and irregular connective tissue most marked inferiorly; the endothelial cells appeared to be normal. PMID- 6849371 TI - Effect of verapamil on blood pressure and lesions in heart and kidney of rats made hypertensive by deoxycorticosterone (DOC). AB - The effect of verapamil, a calcium antagonist, was studied in rats treated with deoxycorticosterone (DOC). DOC induced hypertensive cardiovascular disease with accompanying gross and microscopic lesions in heart and kidney. Verapamil administered in the drinking fluid (1% sodium chloride) prevented hypertension and significantly ameliorated the incidence and severity of cardiovascular lesions. With exception of the spleen, verapamil did not prevent renal or myocardial hypertrophy in rats treated with DOC in spite of prevention of hypertension. The level of verapamil in the serum of animals consuming verapamil (0.37 +/- 0.16 microgram/ml) was less than that of the DOC-verapamil group (0.89 +/- 0.16 microgram/ml), although the difference was not significant. These results confirm the efficacy of verapamil in reducing blood pressure and in ameliorating vascular lesions. PMID- 6849372 TI - Amyloid of the seminal vesicles. A distinctive and common localized form of senile amyloidosis. AB - Amyloid deposits were found subepithelially in the seminal vesicles of 34 of 209 consecutively studied men. The incidence increased with age and was found in 21% of men over 75 years. This senile seminal vesicle amyloidosis (SSVA) is a localized disorder, and the amyloid substance has unique histochemical and immunochemical properties not shared with any other amyloid described until now. PMID- 6849373 TI - Liver cell proliferation induced by a single dose of lead nitrate. AB - Treatment of male Wistar rats with a single dose of lead nitrate caused a marked enlargement of the liver, which reached its maximum 3 days after the administration of the metal salt. This grossly anatomic effect was accompanied by biochemical changes such as an increase in total protein and DNA content, with a maximum at 3 and 4 days, respectively. A partial regression of liver weight and total DNA and protein content occurred 7 days after lead administration; a significant increase in DNA concentration was found after 1 week, while no variation in protein, when expressed as milligrams per gram liver, was observed in lead-treated rat liver. An increase in DNA synthesis, as monitored by the incorporation of labeled thymidine, was also observed. An enhancement in the specific radioactivity of DNA was evident at 24 hours and appeared maximal at 36 hours after the administration of lead nitrate. The ability of lead to stimulate liver cell proliferation was shown by a significant increase of cells entering mitosis, with a peak at 48 hours. This mitogenic stimulus occurred in parenchymal as well as in nonparenchymal cells, thus showing that this effect was not unique to a particular liver cell populations. No detectable cell necrosis, as monitored by histologic observation, was seen in the liver of lead-treated rats, thus indicating that the cellular proliferation induced by lead is not due to a regenerative response. Only a slight elevation in the levels of serum glutamate pyruvate transaminase (GPT) was observed by biochemical analysis. PMID- 6849375 TI - Effects of changes in serosal chloride on electrical properties of toad urinary bladder. AB - Conventional microelectrode and tracer flux techniques were used to study the effects of reduction in serosal chloride concentration ([Cl]s) on the electrical properties of toad urinary bladder epithelium. Reduction in [Cl]s resulted in a transient change in transepithelial potential (Vms) (and of apical and basolateral membrane potentials) that was inversely dependent on the base-line values of those potentials. In all cases, however, there was a decrease in transepithelial resistance (Rt) that was explained by an increase in the sodium conductance of the apical membrane. In tissues in which the transepithelial potential increased, there was a rise in the active mucosal-to-serosal sodium flux. The increase in conductance was directly related to the increase in short circuit current. The changes in Vms and Rt brought about by reduction in [Cl]s were prevented by agents known to modify sodium transport, including low mucosal sodium concentration, addition of amiloride or amphotericin B to the mucosal solution, or of ouabain to the serosal solution. The results are best explained by a primary effect of chloride reduction on sodium extrusion across the basolateral membrane, with a secondary increase in apical sodium conductance. In addition, the data provide new evidence for the existence of a basolateral chloride conductance pathway. PMID- 6849374 TI - Further characterization of carcinogen-induced hepatocytelike cells in hamster pancreas. AB - Regenerating pancreatic cells of the Syrian hamster treated at the peak of S phase with the pancreatic carcinogen N-nitrosobis(2-oxopropyl)amine (BOP) are converted into stable cells wtih morphologic and functional characteristics that are strikingly similar to those of differentiated hepatocytes. In this article the authors further document their hepatocytelike nature. Seventy-two hours after subtotal hepatectomy, pancreatic hepatocytelike cells responded with an 8-fold increase in labeled nuclei (105.8 +/- 4.04/1000 cells) which had incorporated 3H thymidine and a 5-fold increased mitotic index (3.8 +/- 1.5 mitoses/1000 cells), as compared with similar cells in the pancreas of control animals that had undergone sham operations. Chronic administration of phenobarbital induced a 31 fold increase in the level of aryl hydrocarbon hydroxylase (AHH) in pancreas containing such cells, as compared with normal control pancreases, and caused marked proliferation of smooth endoplasmic reticulum (SER). These cells also showed an enhanced capacity for the accumulation of iron during acute iron excess, as compared with adjacent acinar cells. Collectively, these findings support the view that carcinogen-induced cells in pancreas bear a close functional resemblance to hepatocytes. PMID- 6849376 TI - ATP' sarcoplasmic reticulum, and vascular smooth muscle. PMID- 6849377 TI - Blood oxygen consumption and erythrocyte types in embryonic and postnatal chicken. AB - In an extension of previous work showing that oxygen consumption (MO2) of chick blood cells declines from 5 to 14-15 days incubation age, declines more steeply to hatching, rises abruptly up to 4-6 posthatch days, and declines thereafter, we investigated the succession of embryonic and posthatch erythrocytic types by performing differential erythrocyte (RBC) counts. MO2 of RBC groups separated by density gradients and fractionation into younger and older RBC populations were measured in 1- to 22-day-old posthatch chicks. The embryonic MO2 decline can be attributed to the appearance of erythrocytic types with successively lower metabolism. The MO2 slope change at 14-15 days incubation coincides with the predominance of definitive erythrocytes with oval nuclei over other cell types. The posthatch MO2 rise is due to a temporary invasion of immature RBC, especially postnatal polychromatic erythroblasts. MO2 then decreases as these cells mature. PMID- 6849378 TI - Tissue sites of catabolism of albumin in rabbits. AB - The sites of albumin catabolism were determined in rabbits using [14C]sucrose labeled rabbit albumin. The [14C]sucrose moiety is not degradable and accumulates in tissues degrading the protein. Albumin was labeled with [14C]sucrose, and the monomeric form was selected for injection into rabbits. The validity of the sucrose-labeled albumin as a tracer for native albumin was shown by the similar plasma decay kinetics of 125I-labeled albumin derivatized with sucrose and 131I labeled native albumin and by the similar decay kinetics for the biologically screened and unscreened preparations of [14C]sucrose-albumin. Two days after injection of [14C]sucrose-albumin, tissues were assayed for accumulated 14C labeled degradation products soluble in trichloroacetic acid. All tissues catabolized albumin with no tissue of predominant importance; liver, kidney, and muscle were the largest contributors. Expressed in terms of activity per unit wet weight, adrenal, kidney, spleen, ovary, bone marrow, and liver were the most active. These most active tissues are those with fenestrated or discontinuous capillary beds, suggesting that exposure to high concentrations of albumin is an important determinant of their high rates of albumin degradation. PMID- 6849379 TI - Fatty acid and glucose utilization in isolated, working newborn pig hearts. AB - The effects of exogenous fatty acids on glucose uptake were assessed in isolated, working newborn pig hearts in which great vessel pressures were controlled (mean 55 mmHg) and oxygenated nutrient buffer was recirculated through the heart for 30 or 60 min. When palmitate (1.5 mM) or octanoate (1.0 mM) were added to buffer containing 10 mM glucose and 100 mU insulin/ml, glucose uptake, as measured by 3H2O production from D-[2-3H]glucose, was suppressed to less than one-half that observed when glucose alone was present. Increased tissue levels of glucose 6 phosphate, fructose 6-phosphate, and citrate following perfusion in the presence of exogenous fatty acids were consistent with decreased glycolytic activity due to inhibition of phosphofructokinase. Measurements of carnitine in perfused and unperfused hearts indicated that total carnitine levels in neonatal hearts are similar to those of adult pigs. Increased tissue levels of long-chain acyl carnitine, acetyl carnitine, and citrate in hearts perfused with palmitate and glucose in combination with extensive fatty acid uptake and marked suppression of glycolysis indicated that the newborn pig heart is capable of utilizing fatty acids as a primary energy source. PMID- 6849380 TI - Development of gluconeogenesis in isolated hepatocytes from the rabbit. AB - Gluconeogenesis from 10 mM lactate has been studied in isolated hepatocytes from fetal, newborn, and 70-day-old rabbits. Gluconeogenesis proceeds to a very low rate in fetal rabbit hepatocytes despite substantial activities of all gluconeogenic enzymes including mitochondrial phosphoenolpyruvate carboxykinase. A tenfold increase in the rate of gluconeogenesis occurs in hepatocytes from 1- or 2-day-old fasting or suckling newborn rabbits. The emergence of gluconeogenic capacity in newborn rabbit hepatocytes is triggered by birth itself and not by a chronological factor, and it is primarily controlled by an increase in the activity of cytosolic phosphoenolpyruvate carboxykinase. Moreover, an active fatty acid oxidation is essential to support a high rate of gluconeogenesis in hepatocytes from newborn rabbits. PMID- 6849381 TI - Acute inhibition of PRL and TSH secretion after intraventricular injection of PRL in ovariectomized rats. AB - Prolactin (PRL) is under short-loop inhibitory control via the hypothalamus. However, earlier studies evaluated the effects on PRL secretion of PRL levels elevated for periods of days. In this study we evaluated the acute effects of intraventricular and systemic injection of PRL on the release of a variety of pituitary hormones. Ovariectomized (OVX) rats, bearing implanted third ventricular and jugular cannulas were used. Blood was withdrawn in unanesthetized, freely moving animals before and after intraventricular injection of 0.9% NaCl or 1 or 3 micrograms of bovine (b) or ovine (o) PRL. Prolactin was also administered intravenously in doses of 3 or 6 micrograms. No effect on plasma levels of any of the pituitary hormones occurred after intraventricular or systemic injection of saline. Intraventricular injection of both doses of bPRL or oPRL significantly lowered plasma PRL within 15-30 min. In animals with elevated initial PRL values because of stress or estradiol (E) priming, greater lowering of PRL occurred. Inconsistent reductions in plasma PRL occurred after intravenous injection of oPRL but not bPRL, which elevated PRL values via cross-reaction in the immunoassay. In contrast, only small and inconsistent declines in luteinizing hormone (LH) were seen after intraventricular injection of PRL in either OVX or OVX E-primed rats. Plasma follicle-stimulating hormone (FSH) and growth hormone (GH) were not affected by PRL in any of the experiments; however, a significant lowering of thyrotropin (TSH) occurred in OVX or OVX E-primed rats within 30 min after intravenous injection of 3 micrograms of oPRL, but no change occurred after intravenous PRL. The data indicate that PRL can acutely inhibit PRL and TSH release via a hypothalamic action, whereas release of LH is only slightly inhibited and that of FSH and GH is unaltered. PMID- 6849382 TI - Renal venous outflow and urinary excretion of norepinephrine, epinephrine, and dopamine during graded renal nerve stimulation. AB - The effect of renal nerve stimulation (RNS) on renal venous outflow and urinary excretion of endogenous norepinephrine, epinephrine, and dopamine was examined in anesthetized dogs. In the unstimulated denervated kidney, there was a negative venoarterial concentration difference for all catecholamines. Low-level RNS (LLRNS) caused small changes in renal hemodynamics and renal venous outflow of dopamine and increased norepinephrine outflow by 3.22 +/- 0.95 pmol X min-1 X g-1 (n = 5, P less than 0.05). High-level RNS (HLRNS) reduced renal blood flow by 50% and increased renal venous outflow of norepinephrine and dopamine by 9.58 +/- 0.67 and 0.46 +/- 0.05 pmol X min-1 X g-1, respectively (n = 27, P less than 0.01 for both). Renal uptake of epinephrine was unchanged by HLRNS. The urinary excretion of norepinephrine but not dopamine was increased to a similar degree following RNS at both levels. HLRNS caused a similar increase of the urinary norepinephrine excretion from the contralateral denervated and unstimulated kidney. This could be explained by the increase in arterial norepinephrine (from 0.74 +/- 0.08 to 1.20 +/- 0.14 nM, P less than 0.01) caused by HLRNS as shown by experiments with intravenous infusions of norepinephrine. The alpha-adrenoceptor antagonist phenoxybenzamine counteracted the hemodynamic response to HLRNS and enhanced the renal venous outflow and urinary excretion of norepinephrine and dopamine. Our results indicate that renal nerves release dopamine as well as norepinephrine and that urinary catecholamine excretion is a poor indicator of intrarenal catecholamine release. PMID- 6849383 TI - Interrelated effects of aldosterone and plasma potassium on potassium excretion. AB - The interacting effects of aldosterone and plasma potassium concentration on steady-state renal potassium excretion were studied in two groups of chronically adrenalectomized dogs. In group I (six dogs, 22.9 kg) aldosterone was infused intravenously at 20 micrograms/day while potassium intake was changed in steps of 7-10 days duration from 10 to 30 to 100 meq/day. At the completion of each step, plasma potassium concentration, urinary potassium excretion, and other variables that potentially may affect renal function were measured. In group II (six dogs, 22.2 kg) a similar protocol was followed except that aldosterone was infused at 250 micrograms/day and the potassium intake levels were 30, 100, and 200 meq/day. Plasma potassium concentration and excretion data for the 20 micrograms/day group were: 3.22 +/- 0.26 meq/liter and 5 +/- 1 meq/day, 4.35 +/- 0.08 meq/liter and 21 +/- 2 meq/day, and 5.88 meq/liter and 82 +/- 3 meq/day at the 10, 30, and 100 meq/day intake levels, respectively. For the 250 micrograms/day group the values were: 2.72 +/- 0.18 meq/liter and 28 +/- 7 meq/day, 4.16 +/- 0.14 meq/liter and 71 +/- 8 meq/day, and 4.40 +/- 0.14 meq/liter and 172 +/- 26 meq/day at the 30, 100, and 200 meq/day intake levels. Therefore, the increase in aldosterone infusion rate shifted the relationship between plasma potassium concentration and potassium excretion to the left so that at a given level of plasma potassium a greater amount of potassium was excreted. In the normal range of plasma potassium concentration (4.00-4.40 meq/liter) the increase in aldosterone levels resulted in a four- to eightfold increase in daily potassium excretion. PMID- 6849385 TI - Factors causing natriuresis after hypothalamic injection of a cholinergic drug in rats. AB - We investigated possible mechanisms for the natriuresis seen after injection of the cholinergic drug carbamylcholine chloride (carbachol) into the lateral hypothalamus of conscious rats. In unrestrained rats injection of 1 microgram of carbachol in 1 microliter of 0.15 M NaCl solution through a permanently implanted cannula produced a significant natriuresis and kaliuresis. Injection of vehicle produced no changes. The same animals were then subjected to bilateral renal denervation (n = 13) or sham denervation (n = 13) and injected with the same solutions 1 wk later. Carbachol injection produced a natriuresis (P less than 0.0001) and a kaliuresis (P less than 0.01) in all animals studied. Both responses were of a magnitude similar to the responses seen before denervation. We studied other rats while awake but restrained, which permitted the performance of clearance studies and blood pressure measurements. Injection of carbachol produced diuresis, natriuresis, and kaliuresis in all rats, with no change in p aminohippurate clearance and only transient change in inulin clearance. An increase in blood pressure occurred in some but not all rats. The response in rats with bilaterally denervated kidneys (n = 7) was similar to that of rats with innervated kidneys (n = 5). The natriuresis seen after cholinergic stimulation of the hypothalamus in conscious rats is not primarily mediated by inhibition of renal nerve activity and can be dissociated from changes in blood pressure, glomerular filtration rate, and renal plasma flow. PMID- 6849386 TI - Renal denervation in the rat: analysis of glomerular and proximal tubular function. AB - We examined 1) the potential modifications in both single nephron filtration rate (SNGFR) and the determinants of glomerular ultrafiltration, and 2) the alterations in peritubular capillary (PTC) "physical factors" that may contribute to changes in proximal tubular reabsorption (APR) after acute renal denervation (DNx). Micropuncture measurements were obtained in euvolemic Munich-Wistar rats with DNx or sham operation (sham). The content of norepinephrine in renal tissue homogenates was markedly reduced in DNx kidneys compared with sham kidneys (P less than 0.001). Mean arterial blood pressure, hematocrit, whole kidney GFR, and urinary flow rate were not different between the sham and DNx groups. Absolute urinary sodium excretion was 3 times greater in the DNx than in the sham group (P less than 0.01). SNGFR and its determinants were not statistically different in the two experimental conditions. APR was significantly reduced by approximately 25% in DNx (P less than 0.02). This reduction in APR was not accompanied by significant directional changes in peritubular capillary and renal interstitial pressures and the passive driving forces acting across the PTC-proximal tubular epithelium. These data demonstrate that elimination of renal innervation does not alter SNGFR or its determinants and suggest that the effect of denervation on APR is a primary epithelial event that occurs independent of changes in renal interstitial pressure and peritubular oncotic and hydrostatic pressures. PMID- 6849384 TI - Urate transport via anion exchange in dog renal microvillus membrane vesicles. AB - The transport of urate was evaluated in brush border membrane vesicles isolated from the dog renal cortex. It was previously shown that uphill urate and p aminohippurate (PAH) uptake into these membrane vesicles results from imposing an outwardly directed OH- gradient. In the present study, the OH- gradient stimulated uptake of urate was inhibited by external Cl-. In the absence of OH- gradients, imposing an outwardly directed Cl- gradient induced the transient accumulation of urate against its concentration gradient (overshoot), whereas imposing an inwardly directed Cl- gradient induced the transient uphill efflux of urate (undershoot). The effects of Cl- gradients on urate transport persisted when the diffusion potentials caused by the Cl- gradients were negated by superimposing K+ gradients in the presence of the K+ ionophore valinomycin. The dose-response curves for three different inhibitors were identical for the OH- and Cl- gradient-stimulated modes of urate uptake. The uptake of PAH was also stimulated by imposing an outwardly directed Cl- gradient. The dose-response curves for probenecid inhibition were identical for the OH- and Cl- gradient stimulated modes of PAH uptake. Finally, the existence of a Na+ cotransport pathway for urate or PAH could not be demonstrated. We conclude that the principal mechanism for urate transport in dog renal microvillus membrane vesicles is via an anion exchanger with affinity for urate, PAH, OH-, and Cl-. This anion exchanger may play an important role in mediating organic anion reabsorption and secretion in the proximal tubule. PMID- 6849387 TI - Tubular reabsorptive capacity for magnesium in the dog kidney. AB - Micropuncture studies were performed on 27 thyroparathyroidectomized dogs to determine the segmental reabsorption of magnesium before and after graded magnesium infusion. Overall kidney reabsorption, as determined by the difference between filtered magnesium and urinary excretion, initially increased with elevation of plasma magnesium up to 3.5 meq/liter. Further elevation of plasma magnesium resulted in the appearance in the urine of all additional increments in filtered magnesium. Thus, renal magnesium reabsorption followed a pattern characteristic of a maximal transport rate (Tm). Evaluation of the proximal tubule by micropuncture demonstrated that net reabsorption of magnesium rose proportional to the increase in filtered magnesium and accounted for a constant fractional reabsorption of 14%. In contrast, magnesium reabsorption in Henle's loop initially increased with low delivery rates but peaked and fell with high plasma magnesium concentrations. Little magnesium reabsorption was observed between the distal collection site and final urine. Accordingly, the overall urinary excretion pattern was a summation of the different effects occurring in the proximal tubule and Henle's loop. Thus, renal magnesium reabsorption is not characterized by a Tm process but is a composite of distinct transport properties of the proximal tubule and the loop of Henle. PMID- 6849389 TI - Is there an enteropancreatic circulation of digestive enzyme? PMID- 6849388 TI - Slow rise and diurnal change of blood pressure with saralasin and angiotensin II in rats. AB - Our objectives were to determine whether saralasin, like angiotensin II, raises blood pressure gradually when given by constant infusion and whether either agent alters the diurnal variation of arterial pressure. Eight female Wistar rats were infused intravenously with 5% dextrose for 2 days, then with saralasin at 10 micrograms . kg-1 . min-1 for 4 days, and finally with dextrose for 2 days. Six other rats were infused with angiotensin II (20 ng . kg-1 . min-1) instead of saralasin. Mean arterial pressure (MAP) was recorded continuously. Saralasin and angiotensin II gradually raised MAP in all rats, by 22.0 mmHg on the 4th day of saralasin and by 41.7 mmHg on the 4th day of angiotensin II. Both agents also increased the diurnal variation of blood pressure, MAP increasing 8.3-20.6 mmHg during the night and falling 6.7-19.1 mmHg during the day. Variability of arterial pressure was also increased by saralasin and in an earlier experiment by angiotensin II. We conclude that saralasin has a slow pressor action similar to that of angiotensin II but distinct in its timing both from the rapid agonist action of saralasin and from the acute vasoconstrictor action of angiotensin II. These effects of saralasin may compromise interpretation of experiments in which the drug is given by prolonged infusion to assess the role of angiotensin II. PMID- 6849390 TI - Propagation of the canine migrating myoelectric complex--a mathematical model. PMID- 6849391 TI - Developmental changes in the mechanisms of duodenal calcium transport in the rat. AB - Duodenal calcium transport was resolved into a saturable and a nonsaturable process by means of an in situ ligated loop procedure applied to Wistar rats at 3, 12, 19, 24, 30, 40, 60, 110, and 150 days of age. All postweaning animals were males that had been placed on a 1.5% calcium, 1.5% phosphorus semisynthetic diet. Duodenal calcium-binding protein (CaBP) levels were determined at all ages. The newborn rat had no saturable transport component and no CaBP. Its nonsaturable component was very high. With increasing age the saturable component and CaBP varied biphasically, increasing steeply until the animals were about 35 days old; thereafter, each decreased to low but detectable values. The nonsaturable component, on the other hand, decreased in near-linear fashion in the first 35 days; in animals beyond that age it remained invariant. The difference in age dependence between the saturable and nonsaturable components may be considered to constitute additional evidence for the existence of the two transport processes. CaBP and the saturable transport process were highly correlated, further proof that both are vitamin D dependent. Histological studies have revealed the presence of many vacuoles in the intestinal cells of the very young rats; these vacuoles were absent in rats older than 35 days. It is suggested that these vacuoles may be implicated in a pinocytosislike nonsaturable transport that is superimposed on the nonsaturable, non-vitamin D-dependent calcium transport found in all enterocytes. PMID- 6849393 TI - Myoelectric effects of vasoactive intestinal peptide on rabbit small intestine. AB - Myoelectric recording techniques were used to study the motility of rabbit ileum during infusions of vasoactive intestinal peptide (VIP). VIP was infused intravenously at a rate of 300 pmol X kg-1 X h-1, and peripheral venous blood samples were obtained hourly for VIP assay. VIP was also infused intraluminally at a similar rate, and hourly portal vein blood samples were obtained for VIP assay. Alterations in motility were observed after both intravenous and intraluminal infusions of VIP. These alterations in motility consisted of the migrating action potential complex and repetitive bursts of action potentials. The VIP infusion rate used and the mean peripheral plasma VIP level of 267 +/- 29 pg/ml attained during intravenous VIP infusion were similar to those that induced intestinal secretion in other animal species. Portal venous VIP levels (93 +/- 21 pg/ml) were unchanged during the intraluminal infusion of VIP. These studies show that intravenous infusion of VIP causes alterations in motility of rabbit ileum. These alterations in motility with concomitant secretion of water and electrolytes may contribute to the diarrhea induced by VIP infusion. In addition, intraluminal infusion of VIP also induced alterations in myoelectric activity, which suggested that this peptide has a luminal effect as well as a hormonal effect. PMID- 6849392 TI - Central representation and opioid modulation of gastric mechanoreceptor activity in the rat. AB - The effects of gastric distension on single-unit activity recorded from the dorsal vagal nucleus in the rat medulla have been studied using microelectrodes in anesthetized animals. Out of 97 units studied, 64 responded to gastric distension in one of four characteristic ways. It was possible to modify these gastric distension responses by iontophoretic application of Leu-enkephalin and naloxone. The predominant effect was diminution of the centrally recorded gastric distension response by Leu-enkephalin. These studies show it is possible to modulate the central representation of gastric mechanoreceptor activity by an opioid peptide that is common to both the gut and the brain. It is suggested these studies provide evidence that opiate effects on the gastrointestinal tract are mediated centrally as well as peripherally. PMID- 6849394 TI - Hyperdynamic circulation in portal-hypertensive rat model: a primary factor for maintenance of chronic portal hypertension. AB - Two dissimilar hemodynamic hypotheses, the "backward flow" theory and the "forward flow" theory, have been advanced to define splanchnic hemodynamics in portal hypertension. An animal model with portal hypertension and high-grade portal-systemic shunting, the portal vein-stenotic rat, was studied to determine whether a hemodynamic picture compatible with either theory would develop. Splanchnic and systemic hemodynamics and portal-systemic shunting were measured by radioactive microsphere techniques. The portal-hypertensive rats (portal pressure, 12.8 +/- 0.5 vs. 8.3 +/- 0.4 mmHg) with greater than 95% portal systemic shunting had a 60% increase in portal venous inflow (23.46 +/- 2.54 vs. 14.97 +/- 1.61 ml/min; P less than 0.01) with a concomitant 50% decrease in splanchnic arteriolar resistance (3.86 +/- 0.43 vs. 7.60 +/- 0.80 dyn . s . cm-5 . 10(5); P less than 0.001) compared with control rats. Cardiac index (391 +/- 17 vs. 250 +/- 20 ml . min-1 . kg-1) was elevated 50% (P less than 0.001), and total peripheral resistance (7.1 +/- 0.4 vs. 11.7 +/- 0.8 dyn . s . cm-5 . 10(4)) was decreased 60% (P less than 0.001). The resistance to portal blood flow in portal vein-stenotic rats (4.77 +/- 0.57 dyn . s . cm-5 . 10(4)) was similar to the resistance to portal blood flow in control rats (4.82 +/- 0.43 dyn . s . cm-5 . 10(4)), indicating that the hyperdynamic portal venous inflow, not resistance, provided the main impetus for maintaining the elevated portal venous pressure. The splanchnic hemodynamic observations directly support the forward flow theory of portal hypertension. The relation between splanchnic arteriolar resistance and total peripheral resistance (r = 0.67; P less than 0.01) indicated that the systemic hemodynamic parameters were secondarily altered by the splanchnic hemodynamic changes. This animal model of chronic portal hypertension gave evidence for a generalized splanchnic arteriolar vasodilation occurring in the presence of high-grade portal-systemic shunting. PMID- 6849396 TI - Microelectrode studies of Necturus antral mucosa: electrical potentials and resistances. AB - Intracellular microelectrode techniques were applied to Necturus antral mucosa. Stable intracellular impalements were obtained with 15-50 M omega microelectrodes filled with 3M KCl. It was possible to change rapidly the mucosal bathing solution while maintaining the microelectrode in the cell. With these techniques, we were able to measure the electrical potentials and resistances of the cell membranes and the shunt pathway. The transepithelial potential was -4.9 +/- 1.3 mV, serosal solution reference. Apical cell membrane potential was -43.9 +/- 0.6 mV, cell negative to the mucosal solution. Basolateral cell membrane potential was -48.8 +/- 1.3 mV, cell negative to serosal solution. Transepithelial resistance was 427 +/- 66 omega . cm2. The ratio of apical to basolateral membrane resistances was 3.4 +/- 0.3. The electrical resistances of the transcellular and paracellular pathway were determined by the measurement of the total transepithelial resistance and the ratio of apical to basolateral cell membrane resistances before and after blocking apical membrane sodium permeability with amiloride. The resistances of the apical cell membrane, basolateral cell membrane, and the shunt were 2,203 +/- 585, 1,296 +/- 384, and 604 +/- 81 omega . cm2, respectively (mean +/- SE). Calculations from these measurements indicate that the shunt contribution to transepithelial conductance was approximately 85%. PMID- 6849395 TI - Interaction of enkephalin and caerulein on guinea pig small intestine. AB - This is a report on the effect of caerulein and methionine-enkephalin interaction on mechanical contraction and acetylcholine release in vitro. The ability of enkephalin to relax caerulein-induced contractions and the manner in which the caerulein dose-response curve was shifted in the presence of enkephalin strongly suggest that enkephalin and caerulein are functional antagonists in this system. The failure of enkephalin to alter the action of exogenous acetylcholine implies that such an antagonism is not mediated through a competition with postsynaptic muscarinic receptors on the muscle. Data from acetylcholine-release studies indicate that caerulein stimulation was dose related. As with the mechanical contractions, the release of acetylcholine in response to caerulein was inhibited by enkephalin. However, naloxone was capable of blocking this inhibition and restoring the release to its control level without interfering with caerulein stimulation. These data provide evidence for the modulatory roles of neuronal peptides in the cholinergic control of gut motility. PMID- 6849399 TI - Stability of 8-, 15-, and 26-micron microspheres entrapped in feline myocardium. AB - The stability of 8-, 15-, and 26-micron radioactive microspheres entrapped in ischemic and nonischemic myocardium and possible mechanisms for microsphere loss were investigated. Anesthetized cats were given microspheres prior to left anterior descending coronary artery occlusion (or sham operation) and 8 h later. Eight-micron microspheres, compared with 15-micron spheres, underestimated preocclusion myocardial blood flow in ischemic and nonischemic tissue by 30%. With 26-micron spheres, endocardial-to-epicardial blood flow ratio was 1.28. In nonischemic tissue, no loss of 15- and 26-micron microspheres occurred during 8 h. In ischemic myocardium, however, 15% apparent loss of 15- and 26-micron preocclusion spheres took place. In endocardial ischemic tissue, edema could account for 50% of the 15-micron microsphere loss and almost completely for loss of 26-micron spheres. In epicardial ischemic tissue, microsphere loss was not influenced by edema. We found no hemodynamic variable that could predict the magnitude of microsphere loss. Only weak evidence for migration of 15- and 26 micron microspheres through lymphatic pathways was found. Most likely the spheres migrated through venous pathways to embolize in the lungs. We conclude that 15 micron microspheres provide the most reliable tissue blood flow estimates in normal myocardium, but even for these spheres significant loss occurs during 8 h of ischemia. PMID- 6849397 TI - Neural control of canine small intestinal interdigestive myoelectric complexes. AB - Our aim was to determine the role of the extrinsic and intrinsic nerves in the regulation of the small intestinal interdigestive myoelectric complex (IMC). In five dogs, the extrinsic nerves of the jejunoileum were divided, but the bowel was left in situ with its wall intact. After recovery, IMCs were detected in the duodenum (mean IMC period +/- SE = 188 +/- 19 min), from where most migrated distally into and through the jejunum (84%). In addition, extra IMCs appeared in the jejunum. Thus, the mean period of the IMCs in the jejunum (134 +/- 10 min) was shorter than in the duodenum (P less than 0.05). In contrast, after enteric transection and reanastomosis at the ligament of Treitz and at a site 75 cm distal to the ligament, fewer duodenal IMCs migrated into the jejunum (only 61%). However, extra IMCs still arose in the jejunum, so that the mean period of IMCs in the jejunum (111 +/- 5 min) was now similar to that in the duodenum (128 +/- 4 min, P greater than 0.05). Our data were consistent with the hypothesis that extrinsic nerves regulate the frequency of the small intestinal IMCs, while an intact enteric wall aids in their distal propagation. PMID- 6849398 TI - Autonomic influences on atrioventricular conduction in conscious dogs. AB - Autonomic innervation of the atrioventricular (AV) junction modulates conduction of the cardiac impulse, the sympathetic nerves facilitating and parasympathetic nerves impeding conduction. Experiments assessed the relative importance of parasympathetic vs. sympathetic control by pharmacologic blockade with atropine (0.2 mg/kg) or propranolol (1.0 mg/kg) while pacing the right atrium (100-400 beats/min) in normal, conscious resting dogs and in dogs that had undergone chronic, intrapericardial cardiac denervation. Maximum pacing rate with 1:1 atrioventricular conduction was termed Rmax. Control Rmax at rest was 125.69 +/- 9.49 beats/min and was slightly reduced after propranolol to 118.28 +/- 10.98 (P = 0.043). After atropine, Rmax was significantly increased to 344 beats/min. Propranolol and atropine together resulted in an Rmax of 308 beats/min, which was significantly less than after atropine alone. Rmax in cardiac-denervated dogs was 301 beats/min, which was not significantly different from that following total pharmacologic blockade. In conscious, resting, unsedated dogs, the upper limit of AV nodal conduction is associated with the level of parasympathetic rather than sympathetic tone; during exercise the sympathetics assume greater importance. PMID- 6849400 TI - Transmural distribution of cardiac glucose uptake in rat during physical exercise. AB - The transmural distribution of glucose uptake in the left ventricle of the heart in vivo was studied using the 2-deoxyglucose tracer method under conditions of resting and swimming. Intravenous tracer infusion and aortic blood sampling were performed through chronically implanted catheters. The ventricular glucose uptake of the resting rats averaged 1.5 mumol X min-1 X g protein-1 and was about 60% higher in the subendocardial layers than in the superficial layers (P less than 0.01). During a 20-min swimming period that increased the cardiac work load twofold, the glucose uptake rate was slower (P less than 0.001), about 1.0 mumol X min-1 X g protein-1, and evenly distributed across the left ventricular wall, whereas the reduction in glycogen stores, also evenly distributed through the ventricular wall, was 30 mumol glycosyl units/g protein. Blood lactate concentration increased from 1.8 to 10-13 mM and blood glucose from 6.1 to 12 mM during swimming, but plasma free fatty acid concentration decreased slightly. The inhibition of glucose uptake during swimming was probably caused by the increased use of other oxidizable substrates. PMID- 6849401 TI - Intrarenal blood flow distribution during adenosine-mediated vasoconstriction. AB - Intrarenal infusion of adenosine induces an initial vasoconstriction followed by a subsequent vasodilation. The intrarenal distribution of blood flow in the vasoconstriction phase is unknown. The present study was undertaken to assess the effect of intrarenal infusion of adenosine on intracortical distribution of renal blood flow during both the vasoconstriction and vasodilation phases. Renal blood flow distribution was measured with radiolabeled microspheres in anesthetized sodium-depleted dogs before and during the early vasoconstriction phase and the late vasodilation phase of intrarenal infusion of adenosine. During the vasoconstriction phase, there was a uniform decrease in blood flow in each renal cortical zone. In the late phase of adenosine infusion, there was a significant increase in deep cortical flow without significant changes in superficial cortical flow compared with control. The effects of adenosine were also compared with those exerted by norepinephrine in which decreased blood flow was demonstrated in all zones. We conclude that the vasoconstrictor phase of adenosine infusion is characterized by a uniform reduction of renal blood flow to all cortical zones, whereas the vasodilator phase is characterized by a selective deep cortical vasodilation. PMID- 6849402 TI - Crystal-controlled telemetry system for long-term acquisition of physiological data. AB - A crystal-controlled telemetry system was developed for long-term high reliability recording of blood pressure in unrestrained animals. The miniaturized transducer-transmitter system is powered by two lithium batteries that allow for more than 200 h of continuous recording of blood pressure before battery replacement. The total system has a flat frequency response of 0-25 Hz and a time stability of +/- 1 mmHg/day. Linearity is better than 0.5%. The high degree of dependability of the system permits us to perform continuous, unattended, around the-clock recordings of pressure and heart rate in unrestrained animals. Very high dependability is achieved by the use of a novel piezoresistive blood pressure transducer and by the inherent stability of the crystal-controlled radio frequency oscillator of the transmitter. The receiver is also crystal tuned to the measured transmitter frequency. This transmitter-receiver frequency locking ensures very reliable reception of the telemetered signal. PMID- 6849403 TI - Analysis of coronary collateral structure, function, and ischemic border zones in pigs. AB - The purpose of this study was to compare coronary collateral structure and function in pigs with those in dogs and to analyze the distribution of collateral blood flow across the lateral and transmural border zones in the pig. After acute occlusion of the left anterior descending coronary artery (LAD) in 26 anesthetized open-chest pigs, minimal collateral blood flow was indicated by retrograde flow (0.2 +/- 0.1 ml/min) and microsphere-myocardial blood flow (0.005 +/- 0.001 ml X min-1g-1). Postmortem injection of the distal LAD followed by clearance of the heart demonstrated few tiny collateral structures and negligible collateral filling of other arteries. In contrast to dogs, pigs showed no measurable gradient of collateral blood flow across the transmural border zone, and pigs showed no change in collateral blood flow or its transmural distribution during retrograde drainage of collateral blood flow or elevated left ventricular filling pressures. Pigs showed higher myocardial blood flow in the lateral border than in the center of the ischemic zone. As in the dog, however, this gradient of blood flow across the lateral border zone was accounted for by overlap between occluded LAD branches and unoccluded coronary arterial branches rather than by preferential collateral perfusion of the lateral border of the ischemic zone. We conclude that the pig has a homogeneous distribution of collateral blood flow across the transmural and lateral border zones after acute coronary occlusion but that the minimal collateral circulation limits the usefulness of the pig as a model of ischemic heart disease. PMID- 6849404 TI - Lysophosphatidyl choline potentiates Ca2+ accumulation in rat cardiac myocytes. AB - Lysophosphoglycerides are amphiphilic phospholipids that accumulate in ischemic myocardium and elicit electrophysiological alterations in normoxic Purkinje fibers and ventricular muscle that are analogous to alterations characteristic of ischemic tissue in vivo and that are compatible with altered sarcolemmal permeability to divalent cations. To assess directly the potential influence of lysophosphoglycerides on calcium transport, we characterized changes in the accumulation of 45Ca2+ by cultured cardiac myocytes exposed to selected concentrations of lysophosphatidyl choline (LPC). Perfusion for 10 min with 80 microM LPC augmented the amount of 45Ca2+ in myocytes compared with that in control cells (5.1 +/- 0.7 vs. 2.8 +/- 0.26 nmols Ca2+/mg protein, respectively; P less than 0.005) but did not alter total cell calcium content measured by atomic absorption spectrometry (11.6 +/- 1.0 nmols/mg protein), suggesting equivalent augmentation of bidirectional Ca2+ flux by LPC. In contrast, perfusion for 15 min with 100 microM LPC not only augmented 45Ca2+ accumulation but also increased total cellular Ca2+ content, as the quantity of 45Ca2+ accumulated reached 16.9 +/- 1.4 nmols/mg protein, a value substantially exceeding the normal total Ca2+ content (P less than 0.0025 compared with control cells). In contrast to results observed after only a 5-min exposure to 100 microM LPC, Ca2+ accumulation induced by 15 min of perfusion was not precluded by verapamil (10( 8)M), could not be reversed by perfusion without LPC, and was associated with complete cessation of beating, markedly altered morphology, and substantial depletion of cellular creatine kinase activity. Thus LPC may not only contribute to malignant ventricular dysrhythmias but also may potentiate ischemic injury by facilitating calcium ingress. PMID- 6849405 TI - Myocardial blood flow and function during gradual coronary occlusion in awake dog. AB - The purpose of this study was to correlate dimensions and transmural blood flow in a segment of myocardium supplied by a coronary artery undergoing gradual closure. Nine adult dogs were instrumented with an electromagnetic flow probe, pneumatic occluder, and an ameroid constrictor on the circumflex coronary artery. Ultrasonic crystals were implanted 10 mm from the external surface of the left ventricle in a segment perfused by the circumflex artery. Regional blood flow was determined with 7- to 10-microns radiolabeled microspheres. Data were collected in the awake state at rest before closure began (control), during partial closure, and immediately after total closure. Seven of the nine animals were studied after occlusion during treadmill exercise. During both partial and total closure at rest the rate and extent of systolic shortening as well as the transmural blood flow were unchanged from control. During treadmill exercise mean flow increased. However, flow was redistributed away from the inner two layers causing deterioration in both the rate and extent of shortening of this segment. These data suggest that, although regional myocardial function and flow can be maintained at rest by the immature canine collateral circulation, these parameters are impaired markedly during augmented flow with exercise. PMID- 6849406 TI - Effect of stimulation of ansa subclavia on regional myocardial O2 supply and O2 consumption. AB - Cardiac sympathetic nerve stimulation produces increases in various indices of cardiac work and metabolism. To determine how these increased O2 demands are met, the effects of stimulation of the ansa subclavia on regional arterial and venous O2 saturation, O2 extraction, blood flow, and O2 consumption were determined in the hearts of 16 pentobarbital-anesthetized open-chest dogs. Microspectrophotometric observations of small regional arteries and veins in quick-frozen hearts to determine regional O2 extraction were combined with regional blood flow measurements with radioactive microspheres to determine regional myocardial O2 consumption by the Fick principle. Ansa subclavia stimulation produced significant increases in maximum rate of pressure development, heart rate, and blood pressure. Under control conditions, venous O2 saturation was lower and O2 extraction higher in the subendocardial compared with the subepicardial region of the left ventricle. While sympathetic stimulation did not alter the mean O2 extraction or venous O2 saturation values, there were no longer significant subepicardial vs. subendocardial differences in these parameters. Flow and O2 consumption in these regions increased proportionally during stimulation. The ratio of O2 supply to O2 consumption was not significantly altered by ansa subclavia stimulation, indicating that sympathetic stimulation produced no adverse effect in either region. PMID- 6849409 TI - Peritoneal lymphatic uptake of fibrinogen and erythrocytes in the rat. AB - Intact and thoracic duct-cannulated rats were dialyzed at various intraperitoneal pressures with 5% bovine serum albumin solutions containing 125I-fibrinogen or 51Cr-erythrocytes. Lymphatic transport rates were calculated from the mass of tracer passing into the plasma space as function of tracer concentration in the peritoneal fluid during dialysis periods ranging between 143 and 360 min. Peritoneal protein concentrations were constant over the duration of the experiments. The calculated lymph flow rate was independent of intraperitoneal pressure and in intact rats averaged 2.85 +/- 1.22 microliters/min for uptake of 125I-fibrinogen and 2.60 +/- 1.17 for uptake of 51Cr-erythrocytes. However, the observed fluid loss rates from the peritoneal cavity were sensitive to the intraperitoneal pressure and were 5 to 20 times the calculated lymph flow rate. Mass balance experiments in two rats dialyzed with 125I-fibrinogen indicated that a significant proportion (28%) of tracer leaving the peritoneal cavity is absorbed by the anterior muscle wall of the abdomen and is probably trapped there because of its large molecular weight. Results from 125I-fibrinogen and 51Cr erythrocyte uptake experiments both indicated that only approximately 30% of the total lymphatic drainage of the peritoneal cavity passes through the thoracic duct in rats. PMID- 6849407 TI - Influence of volume changes on osmolality-vasopressin relationships in conscious dogs. AB - The relative importance of plasma osmolality (Posm) and left atrial pressure (LAP) as controllers of plasma vasopressin concentration (PAVP) was investigated in conscious dogs (n = 8). New techniques for the continuous measurement of LAP and computerized data collection permitted monitoring of LAP and mean arterial pressure (MAP) while Posm was suppressed with intravenous distilled water and then elevated with hypertonic NaCl. PAVP was determined by radioimmunoassay. This relationship between Posm and PAVP was determined at low, normal, and high (-0.9 +/- 0.8, 1.8 +/- 0.8, and 7.7 +/- 1.1 cmH2O, respectively) levels of LAP produced by either hemorrhage or autotransfusion of whole blood. MAP was not altered by these maneuvers. The results of these short-term studies have demonstrated a significant modulation of the osmoregulation of PAVP by changes in blood volume as indexed by LAP. Because of this modulation, PAVP is regulated so that contraction or expansion of the blood volume is more expeditiously corrected than would occur if osmoreceptors alone regulated plasma vasopressin. PMID- 6849408 TI - Differential effect of verapamil isomers on sinus node and AV junctional region. AB - The l- and d-isomers of verapamil were selectively perfused into the sinus node artery and atrioventricular (AV) node artery of 48 dogs. Injection of l-verapamil into the sinus node artery during sinus rhythm and into the AV node artery during AV junctional rhythm depresses both sinus rhythm and AV junctional rhythm significantly more than does the d-isomer. l-Verapamil is three to four times more powerful than d-verapamil. Injection of the isomers into the AV node artery during sinus rhythm rapidly impairs AV conduction. Increments in conduction time are measured exclusively at the level of the A-H interval of the His bundle electrogram, and l-verapamil is six times more powerful than d-verapamil. Neither d- nor l-verapamil in concentrations that exert a profound negative chronotropic effect or cause AV block, has any significant effect on transatrial or His bundle conduction. Thus these concentrations of d-verapamil have little or no significant effect on the fast sodium channel, but both verapamil isomers affect the slow channel. The main difference in action between l- and d-verapamil appears to be only quantitative in nature. The sinus node is significantly more sensitive to the negative chronotropic action of verapamil than is the AV junctional pacemaker, and this differential responsiveness appears to be related to the different intrinsic rates of the two pacemakers. During sinus rhythm (either in the presence or absence of atropine) sinus node automaticity is less affected than AV conduction when verapamil is given parenterally. We propose that this greater negative dromotropic effect of verapamil is also in part due to a rate-dependent process, since during sinus rhythm AV junctional cells have to be depolarized at frequencies significantly higher than their intrinsic rates. PMID- 6849410 TI - Impairment and restoration of rat urinary bladder responsiveness following distension. AB - Micturition and bladder responsiveness in vitro were impaired in rats fed isotonic sucrose, afflicted with diabetes mellitus or diabetes insipidus. Their urinary output which was seven times control, initiated micturition responses at volumes three times control. Nerve-induced contractions by bladders from these rats developed substantially less pressure than control. Contractions elicited at 1 Hz by control and impaired bladders were potentiated equally by tetraethylammonium chloride (TEA) (5 mM) or by carbachol (2 X 10(-7) M). Contractions elicited at 20 Hz by normal bladders were not potentiated, those by impaired bladders were. TEA, by increasing transmitter release, and carbachol, by a postjunctional action, substantially reversed bladder dysfunction. Because control and impaired bladders were equally enhanced by TEA, prejunctional and contractile element (CE) activity at 1 Hz were probably unaffected by distension. However, postjunctional sensitivity was probably reduced. Impaired bladders, more compliant than controls, became less compliant after carbachol without elevating resting pressure. Whereas the action of carbachol to enhance bladder responsiveness did not involve tension development, there may have been cholinoceptor facilitation and shortening of CE. PMID- 6849411 TI - Cessation of thermoregulation during REM sleep in the pocket mouse. AB - Electrophysiological sleep patterns, respiration frequency, brain temperature (Tbr), and ear temperature (Tear) were recorded from five pocket mice (Perognathus longimembris) exposed to ambient temperatures (Ta) of 22.5, 27.5, 32.5, and 35.0 degrees C. Thermoregulation was curtailed during rapid-eye movement (REM) sleep, since Tbr declined following REM onsets at Ta's below thermoneutrality and increased at Ta's above thermoneutrality. Tbr subsequently returned to pre-REM levels following the termination of each REM episode. Respiratory frequency was inversely related to Ta but not as strongly during REM sleep as during slow-wave sleep (SWS). These results confirm previous reports of loss of thermoregulatory ability during REM sleep. Mean duration and proportions of wakefulness, SWS, and REM sleep were unaffected by Ta, consistent with earlier findings on ground squirrels, but differing from reports of decreased REM sleep in nonhibernators. Hibernators may have lower peripheral thermosensitivities than nonhibernators, facilitating sleep at low ambient temperatures and during entrance into hibernation. PMID- 6849415 TI - Contribution of statistics to ethics of science. PMID- 6849412 TI - Ventilatory reflexes originated from carotid and extracarotid chemoreceptors in rats. AB - Ventilatory responses to transient stimulation and inhibition of arterial chemoreceptors--by hypoxia and hyperoxia, respectively--were studied in 10 pentobarbitone-anesthetized rats. N2 tests and intravenous injections of NaCN provoked transient increases in tidal volume and respiratory frequency, while O2 tests elicited decreases of these parameters. After bilateral carotid neurotomy, ventilatory responses to N2 and NaCN were still present although reduced in all rats, while ventilatory depression in response to O2 tests was observed in 60% of these rats. Further bilateral sectioning of main vagus, aortic, and superior laryngeal nerves immediately below the nodose ganglia abolished the ventilatory responses to NaCN in only one of the five rats subjected to this procedure, the remaining animals showing moderate hyperventilation in response to large doses of this drug. Mild ventilatory depression in response to hyperoxia, indicative of a persistent peripheral chemosensory drive, was still present in two of these rats. It is concluded that, although the carotid bodies constitute the main source of ventilatory chemoreflexes in rats, other vagally and nonvagally innervated chemoreceptors (presumably thoracic and abdominal) may elicit ventilatory reflexes in this species. PMID- 6849414 TI - Thirst and solute excretion: their effectiveness in osmostatic control of body fluid. AB - The effect of intravenous infusion of hypertonic NaCl at three different rates (series I, 4.0 mmol/min; series II, 8.0 mmol/min; series III, 16.0 mmol/min) on osmotic thirst threshold and postloading restitution of plasma osmolality (Posm) has been determined in dogs. Osmotic thirst threshold increased proportionally to the rate of delivery of the osmotic load. Relative suppression of osmotic thirst at the higher rates of infusion was temporary and largely disappeared within 10 min after the end of hypertonic infusion. During the postloading period excretion of osmotic load and water intake was proportional to the magnitude of the load administered. However, the animals with high osmotic thirst threshold stopped drinking at a higher Posm than those with a low osmotic thirst threshold. In series I and II, Posm decreased during 1 h to a level not significantly different from the preloading value. In each series renal excretion of osmotic load was more important than water intake for restitution of Posm during 1 h. Amount of water ingested during this period was significantly smaller than that theoretically required to restore resting Posm when excretion of osmotic load was not taken into account. However, total amount of water intake and osmotic load excreted during 1 h were together well adjusted to restore preloading Posm. PMID- 6849417 TI - Measurement of extracellular space by total body neutron activation. PMID- 6849413 TI - Diffusion of oxygen in slices of rat brain. AB - A new method for the joint determination in tissue slices of the diffusion coefficient of oxygen (D) and the fluorescence-quenching coefficient (K') of pyrenebutyric acid (PBA) is introduced. Values of D and K' in rat brain at temperatures (Tc) from 20 to 40 degrees C were determined and referred to the values in water. D = DH2O (0.72 - 0.0074 Tc) +/- 0.079 X 10(-5) cm2/s for 80 microns slices. D = DH2O (1.01 - 0.0074 Tc) +/- 0.12 X 10(-5) cm2/s for 160 microns slices. K' = K'H2O (0.72 + 0.025 Tc) +/- 0.56 X 10(-4) mmHg-1. The temperature dependence of both these parameters in tissue is different from their temperature dependence, and comparison with parameter values obtained with other methods leads us to conclude that factors affecting the diffusion of oxygen in tissue are heterogenous rather than homogenous. The variation in the different parameters, D and K', probably exceeds a twofold range. PMID- 6849416 TI - Relationships between maternal hormones and weight of newborn sheep. AB - Intact and ovariectomized mixed-breed sheep were studied in chronic experiments during the last weeks of pregnancy. Measurements were made of the rate of uterine blood flow (ml/min and ml X min-1 X kg-1, combined weight of fetus, uterus, and placenta) and of arterial and uterine venous concentrations of progestagens, estrone, and estradiol. The birth weight of the lamb was directly related to mean maternal concentrations of estrone and estradiol and to the rate of progestagen release by the uterus and its contents (ng X ml-1 X kg-1), calculated by taking the product of the rate of blood flow and the arteriovenous progestagen difference. Ovariectomy altered the relationship between birth weight and progestagen release. Data suggest that rates of progestagen release both by the fetoplacental unit and by the ovary are proportional to the birth weight of the lamb. PMID- 6849419 TI - Control of arterial pressure in aquatic sea snakes. AB - Cardiovascular responses to head-up tilt, acutely graded hemorrhage, and pharmacologic stimulation by principal autonomic drugs were studied in four species of marine snakes, principally Aipysurus laevis (family Hydrophiidae). Arterial pressure varied inversely with tilt angle and blood volume deficit in conscious snakes outside of water, indicating that physiological regulation was poor or lacking. Calculated arterial pressures at head level typically diminished to zero in A. laevis tilted to angles greater than or equal to 30 degrees. Arterial pressure (corrected for external water pressure) did not change when these snakes were tilted in seawater. Changes of arterial pressure induced by tilt, blood loss, or autonomic drugs elicited reflex adjustments in heart activity, but the magnitude of these responses was less than that observed in terrestrial species of snake. It is concluded that baroreflexes are present but comparatively ineffective in sea snakes. Snakes tolerated large losses of blood volume, and extravascular fluids were absorbed into the circulation during hemorrhage; both hemorrhage and estimated hemodilution volumes exceeded 100% of the initial blood volume in Acalyptophis peronii. Thus, in marine snakes major fluid shifts between nonvascular and vascular compartments significantly compensate hypovolemia but, because of minor autonomic adjustments, do not result in a well-regulated arterial pressure. PMID- 6849420 TI - The problem of low-dose radiation toxicity. PMID- 6849418 TI - Effect of forebrain lesions on response to chronic intraventricular angiotensin II. AB - We previously reported that chronic (10 days) intracerebroventricular (ivt) infusion of angiotensin II (ANG II) into conscious rabbits produced a significant rise in mean arterial pressure (MAP), water intake (WI), and urinary sodium excretion (UNaV), and a significant fall in plasma sodium (PNa) and potassium (PK) concentrations. Urinary potassium excretion (UKV) and body fluid volume were not changed significantly. In the present experiments, similar chronic infusions were carried out in intact rabbits and in rabbits with an electrolytic lesion placed in the anteroventral third cerebral ventricle (AV3V) region. Integrity of the AV3V area is essential for normal expression of a variety of acute physiological responses to ANG II injected into the brain. In rabbits with AV3V lesions, chronic ivt infusion of ANG II did not significantly alter MAP, but WI and fractional UNaV increased, and PNa decreased in a manner identical to that of sham-lesioned control rabbits. Plasma and extracellular fluid volumes increased, and body weight and food intake decreased in all rabbits during ANG II infusion, but to a slightly greater extent in the AV3V-lesioned rabbits. We conclude that an intact AV3V region is crucial for the hypertensive effect of chronic ivt fusions of ANG II in the rabbit but is not necessary for most of the fluid and electrolyte alterations associated with such infusions. PMID- 6849421 TI - Sodium retention and salt appetite following deoxycorticosterone in hamsters. AB - Previous research suggests that hamsters 1) fail to retain sodium after mineralocorticoid injections, 2) retain sodium after adrenalectomy equal to controls, and 3) do not develop salt appetite after mineralocorticoid or adrenalectomy. The present studies demonstrate sodium retention, body weight gain, hypernatremia, plasma volume expansion, and reduced fecal sodium excretion after daily injections of deoxycorticosterone acetate (DOCA). Salt appetite appeared after the 3rd and 4th days. Adrenalectomy caused reductions of sodium balance, plasma volume, and food intake, which were reversed by DOCA administration. Mineralocorticoids therefore represent one control of sodium metabolism in hamsters. PMID- 6849423 TI - Homicidally aggressive young children: neuropsychiatric and experiential correlates. AB - Of 55 children admitted to a children's psychiatric service, 21 were homicidally aggressive. Psychiatric symptoms and diagnoses did not distinguish these children from the nonhomicidal children, but the homicidally aggressive children were significantly more likely to 1) have a father who behaved violently, often homicidally, 2) have had a seizure, 3) have attempted suicide, and 4) have a mother who had been hospitalized for a psychiatric disorder. The authors explore explanations for the contribution of these factors to juvenile violence. PMID- 6849424 TI - Suicidal and assaultive behavior in children: classification, measurement, and interrelations. AB - In 102 children aged 6 to 12 years who were in a municipal psychiatric inpatient or outpatient clinic, the authors identified four groups of suicidal and/or assaultive behaviors. Logistic regression analyses showed that neurosis, intellectualization, and low levels of aggression predicted membership in the nonassaultive-nonsuicidal group; intense aggression, parental suicidal behavior, parental assaultive behavior, and compensation predicted it in the assaultive suicidal group; depression, a minimum of aggression, and adjustment disorder predicted it in the suicidal-only group; and intense aggression and absence of depression predicted it in the assaultive-only group. Two clearly distinct types of suicidal children were delineated. PMID- 6849425 TI - Underrecognition of patients' psychosocial distress in a university hospital medical clinic. AB - Seventeen areas of psychosocial distress were evaluated in 87 university hospital internal medicine clinic patients by a self-administered questionnaire and a psychiatric interview. These patients' internists then predicted the patients' distress level in each area. Their predictions correlated significantly with their patients' self-reports of distress-level problems in only 3 of the 17 areas. Even when the internists felt that they had sufficient information to make an accurate prediction, their perceptions were often erroneous, including evaluations of such areas as suicidal ideation and drug use. These data suggest the need for active psychiatric education components in internal medicine training programs. PMID- 6849426 TI - Impact of late-life depression on the social network. AB - The author tested the hypothesis that a major depressive disorder contributes to a decline in social support by studying data from 331 subjects 65 years of age and older who had been selected at random from a larger community group and screened for a major depressive disorder and the availability of social supports. Impaired social support was associated with the presence of a major depressive disorder. Thirty months later, however, the surviving subjects whose social supports had improved were 2.62 times more likely to have been depressed earlier than those whose social supports did not improve. Major depressive disorder was a significant predictor of improvement in social supports at follow-up. PMID- 6849427 TI - The relationship between socioeconomic class and prevalence of schizophrenia, alcoholism, and affective disorders treated by inpatient care in a suburban area. AB - This study relates inpatient-treated prevalence of the three mental illnesses most often requiring inpatient treatment--schizophrenia, alcoholism, and affective disorders--to social class in a suburban area. Rates were developed for the total population, including those living in domiciliary care, for those living in households only, and for first-admission patients living in households. Log-linear models supported the finding that low socioeconomic status was related to a high prevalence of alcoholism and affective disorders. In contrast, socioeconomic status was not related to the prevalence of schizophrenia among those living in households or among first-admission patients living in households. PMID- 6849422 TI - Sex differences in the circadian control of hamster wheel-running activity. AB - The circadian pacemaker that underlies the wheel-running activity of hamsters was studied in males and females. Sex differences were found in the mechanism by which the pacemaker entrains to light-dark cycles and in the timing of activity onset. When exposed to a light-dark cycle with a period of 24.75 h (with 1 h of light/cycle), males show a greater ability to maintain entrainment than do females. This difference in the upper limit of entrainment appears due to a sex difference in the magnitude of light-induced phase shifts. A small difference in free-running period may also contribute to the sex difference in entrainment. Two weeks after castration of adults, the sex difference in entrainment is not affected, indicating that the difference does not depend on circulating gonadal steroids or on estrous cyclicity of the female. However, castration of females at an early age increases their ability to entrain, whereas long-term castration of males seems to reduce entrainment ability. During entrainment to a 24-h light dark cycle (LD 14:10), females were found to begin their daily activity before males and before castrated females. This difference is consistent with a sex difference in the magnitude of light-induced phase shifts and in entrainment of the pacemaker. However, evidence is given that the sex difference in activity onset might also be caused by a sex difference in the relationship of locomotor activity to the pacemaker in intact males and females. PMID- 6849428 TI - The genetics of schizophrenia: a reassessment using modern criteria. AB - The authors present two reasons for reassessing familial transmission of schizophrenia: recent major changes in diagnostic criteria and methodological weaknesses of older studies. Their own study of this subject employed narrowly defined, operational research criteria; prospective proband selection; semistructured family interviews; and blind, independent diagnoses of probands and relatives. For 30 schizophrenic probands they found an age-corrected morbidity risk in first-degree relatives of 1.61%, a figure that would only support familial transmission if the true population prevalence of schizophrenia were .2% or less. The authors conclude that the case for familial transmission of narrowly defined schizophrenia is weak and suggest alternative hypotheses. PMID- 6849431 TI - Foreign medical graduates and board certification: myths and realities. AB - The participation of foreign medical graduates (FMGs) in American medicine is a longstanding phenomenon, yet the documentation of their role has been mainly impressionistic and anecdotal, particularly in psychiatry. Using the results of a survey on Board certification, the authors compared FMGs with U.S. medical graduates (USMGs) on several variables: demographic characteristics, attitudes toward certification, performance, and personal experience with the examination process. They found that FMGs are more similar than dissimilar to USMGs in attitudes, values, and opinions about certification. The authors conclude that the differences are not sufficiently remarkable to warrant some of the prevalent misconceptions about FMGs. PMID- 6849429 TI - Preliminary report on a crosswalk from DSM-III to ICD-9-CM. AB - The wide use of DSM-III by clinicians and researchers in the United States has led to difficulties in reporting to federal agencies, which adhere to a policy supporting the use of ICD-9-CM. To rectify this situation, three federal agencies collaborated to design a translation, or "crosswalk," from DSM-III to ICD-9-CM. The authors discuss some of the differences between the two systems, describe the development of the crosswalk, and make suggestions concerning future nosological and statistical systems. PMID- 6849430 TI - Cross-cultural comparison of British and American psychiatric emergencies. AB - The authors compare patient characteristics in a psychiatric emergency setting in the United States with a similar service in the United Kingdom. They found that despite many significant differences in nonclinical variables, the severity of clinical symptoms did not differentiate between the two groups. In both countries, it was not the degree of psychopathology but the lack of an available support network, an inability to engage the patient in the system, and a history of serious chronic maladjustment that led to the majority of "emergency" visits. The authors conclude that use of an emergency service sensitivity mirrors the gaps in health care delivery. PMID- 6849432 TI - A ten-year follow-up of alcoholic Native Americans in Minnesota. AB - In a 10-year follow-up of 45 alcoholic American Indians, 42 (93%) were located. Seven had been abstinent for 2 or more years, 26 still had drinking problems despite repeated treatment, and 9 had died. The authors hypothesize that the absence of stable employment and a stable marriage or family environment reduced the efficacy of treatment efforts in this population. Those who achieved 2 years of abstinence were characterized by stable employment and/or marriage, as well as by stronger interpersonal relationships and less depression than the others. The recovered subjects provided considerable help to other alcoholic persons in addition to serving as positive role models. PMID- 6849434 TI - Missed seizures and the bilateral-unilateral electroconvulsive therapy controversy. PMID- 6849433 TI - Sexual misconduct by psychiatrists: the ethical and clinical dilemma of confidentiality. AB - Psychiatrists have an ethical obligation to expose colleagues who sexually abuse their patients. However, this obligation often conflicts with the ethical obligation of confidentiality. The principled ethical dilemma is grounded in practical clinical considerations. The author suggests systematic use of consultation as a potential method to address both ethical and clinical responsibilities. PMID- 6849435 TI - Abnormal cortisol suppression in bipolar patients with simultaneous manic and depressive symptoms. AB - The authors studied the cortisol response to 1 mg of dexamethasone in 10 patients who simultaneously manifested manic and depressive symptoms. All patients showed some evidence that normal cortisol suppression was lacking. When 3 patients were randomly retested after recovery, the results suggested the normalization of suppression. PMID- 6849436 TI - Psychiatric aspects of clinical neurology. AB - The author assessed 241 inpatients and outpatients on a neurology service for emotional disorders, using a systematic interviewing technique. DSM-III diagnoses were established in 101 of these patients (41.9%). The author presents a descriptive assessment of the patients' emotional disorders as well as data concerning the connections between neurologic and emotional illness. PMID- 6849438 TI - Life events and early and late onset of bipolar disorder. AB - Forty-six subjects with bipolar disorder and their relatives and friends were interviewed in depth about life events preceding the first and the latest episode of the subject's affective illness. Twenty years of age was the cutting point for dividing the sample into early- and late-onset groups. The late-onset group reported the occurrence of significantly more stressful life events before the first and before the latest episode of affective illness than the early-onset group did. PMID- 6849437 TI - The methylphenidate test for differentiating desipramine-responsive from nortriptyline-responsive depression. AB - Monitoring tricyclic antidepressant concentrations in the plasma of 43 patients with major depressive disorders indicated that some responded to imipramine or desipramine but not to amitriptyline or nortriptyline, or vice versa, even though plasma levels were within therapeutic ranges. Mood elevation by methylphenidate predicted marked improvement from treatment with imipramine or desipramine but not with amitriptyline or nortriptyline. When methylphenidate failed to improve mood, patients responded to amitriptyline or nortriptyline but not to desipramine. These results suggest differential drug responses with different tricyclic antidepressants, the clinical utility of the methylphenidate test, and the heterogeneity of depressions. The authors question the mechanism of action of nortriptyline via blockade of norepinephrine reuptake. PMID- 6849439 TI - Organic psychosis without anemia or spinal cord symptoms in patients with vitamin B12 deficiency. AB - The authors describe two patients with organic psychosis who had vitamin B12 deficiency and no hematologic or spinal cord abnormalities. They review the literature that supports a causal relationship between B12 deficiency and cerebral dysfunction, as measured by the EEG, and consequent organic mental changes. The authors cite evidence that these EEG and organic mental changes are reversible with B12 replacement. They emphasize that psychiatric manifestations may be the first symptoms of vitamin B12 deficiency and thus antedate anemia and spinal cord disease. They recommend consideration of B12 deficiency and serum B12 determinations in all patients with organic mental symptoms. PMID- 6849442 TI - Seclusion and restraint and prediction of violence. AB - The authors studied the use of seclusion and restraint on an inpatient unit in a state psychiatric hospital. Of 69 randomly selected inpatients, 51% experienced seclusion or restraint at least once. More psychotic than nonpsychotic patients required seclusion or restraint. However, neither psychosis/nonpsychosis nor voluntary/involuntary admission status predicted the likelihood of violent threats or actions. Patients experiencing seclusion and restraint showed a nonsignificant trend toward longer mean length of stay in the hospital. The frequency of patient behavior leading to seclusion or restraint appeared to be directly related to the stimulation caused by the presence of many staff members and other patients. PMID- 6849441 TI - Mental patients' knowledge of in-hospital rights. AB - The authors questioned 52 recently admitted patients about formally receiving information regarding patients' rights and about their knowledge of that information. Of the 13 day hospital patients, 12 recalled being given the information, but only 20 of 39 inpatients recalled receiving the information. Most patients, irrespective of their diagnosis or legal status, knew their rights. Surprisingly, comparison with a group of patients who did not receive information on their rights revealed no relationship between receiving this information and knowledge of patients' rights. On the basis of these and other findings, the authors discuss some difficulties with presentation of patients' rights and offer recommendations. PMID- 6849440 TI - Quality review of outpatient psychopharmacological practice with APA Task Force criteria. AB - The authors conducted quality review of outpatient psychopharmacological practice in 180 cases with the screening criteria of the APA Task Force on Psychopharmacological Criteria Development and a subset of 12 criteria involving higher-risk practices. Excessive duration of drug treatment was the most common questionable practice, and no relationship was found between frequency of questionable practices and patients' sex, age, social class, or Global Assessment Scale score. An educational exercise based on the audit resulted in a nonsignificant decrease in the higher-risk practices. PMID- 6849444 TI - Case reports of anorexia nervosa and caffeinism. AB - Many patients with anorexia nervosa drink large quantities of beverages containing caffiene--e.g., coffee and diet cola--which have few calories and suppress the appetite while increasing energy. The author describes the clinical aspects of caffeinism in two such patients. PMID- 6849443 TI - Preliminary report on affective symptoms in the early stages of senile dementia of the Alzheimer type. AB - The authors rated 30 probands with senile dementia of the Alzheimer type and 30 healthy controls for depression at the beginning of a longitudinal study and 1 year later. Significant degrees of depression were not found in either group at either time. PMID- 6849445 TI - Panic disorder in genotypic HLA identical sibling pairs. AB - The authors describe two HLA identical sibling pairs with panic disorder. To their knowledge, this is the first report of histocompatibility testing in patients with anxiety disorders. PMID- 6849447 TI - The dexamethasone suppression test in depressed outpatients and normal control subjects. AB - In contrast to a recently published report by Amsterdam and associates, the authors noted a higher frequency of abnormal dexamethasone suppression test results in 88 outpatients with primary depression (particularly the endogenous subtype) than in 49 normal controls. PMID- 6849446 TI - Desipramine and methylphenidate combination treatment for depression: case report. AB - The authors successfully treated a chronically depressed man with a combination of desipramine and methylphenidate. Methylphenidate did not change his serum desipramine level, and the authors speculate that its ability to potentiate tricyclic responsiveness may be due to its dopaminergic activity. PMID- 6849450 TI - Panic attacks and depression. PMID- 6849448 TI - Case report of carbamazepine-induced reticulocytes. AB - The authors present the case of a woman with bipolar disorder who developed reticulocytosis after two trials of carbamazepine. They urge that blood indices be carefully monitored whenever carbamazepine is used. PMID- 6849449 TI - Antidepressant withdrawal symptoms treated with anticholinergic agents. AB - The authors describe three patients who developed withdrawal symptoms after discontinuation of antidepressants. Their symptoms were successfully treated with atropine. Central cholinergic overdrive is implicated in the genesis of the symptoms. PMID- 6849451 TI - Questioning DST normalization as a guide to tricyclic discontinuation. PMID- 6849452 TI - Interaction of phenelzine and sulfisoxazole. PMID- 6849453 TI - Speech pause time: behavioral correlate of mood. PMID- 6849456 TI - More on ECT and malignant hyperthermia. PMID- 6849454 TI - Cultural variation in affective disorders. PMID- 6849455 TI - More cases of anorgasmia after MAOI treatment. PMID- 6849457 TI - Another interpretation of residents' response to pregnancy. PMID- 6849458 TI - Child psychiatry, present and future. PMID- 6849459 TI - Alternative approach to burned children. PMID- 6849460 TI - Psychiatrists' role in consultation-liaison. PMID- 6849461 TI - Recruitment and qualities of being. PMID- 6849462 TI - Increasing external stimuli to ameliorate hallucinations. PMID- 6849463 TI - Hysteria and gynephobia. PMID- 6849464 TI - Increasing Axis II reliability. PMID- 6849465 TI - Absence of borderline personality disorder in later years. PMID- 6849467 TI - Imipramine for attention deficit disorder. PMID- 6849466 TI - CT scans of patients with borderline personality disorder. PMID- 6849468 TI - Patient education, blood pressure control, and the long run. PMID- 6849469 TI - In support of jogging. PMID- 6849470 TI - Byssinosis: progress in prevention. PMID- 6849471 TI - The contribution of hypertension to mortality in the US: 1968, 1977. AB - The contribution of hypertension to total mortality in the United States in 1968 and 1977 is assessed through multiple cause death rates for all mentions of hypertension and the death certificate prevalence of hypertension. Age-adjusted declines in the hypertension death rates were 32.8 per cent for non-White females, 30.4 per cent for non-White males, 30.3 per cent for White females, and 25.2 per cent for White males. Declines for younger non-Whites were the greatest, about 50 per cent, although their rates were more than twice the White rates in both years. Death certificate prevalence also declined for all four groups with the greatest (16.5 per cent) for non-White males and the least (10.4 per cent) for White males, who only showed declines at older ages. The age trajectory of death certificate prevalence reached a peak at ages 50-69 for non-Whites and ages 60-79 for Whites, with lower prevalence at the most advanced ages. Large declines in the contribution of hypertension to mortality observed in death certificate data are particularly striking in light of the probability that any bias would be toward better detection and reporting over the 10 years. PMID- 6849472 TI - Characteristics of joggers among Japanese men in Hawaii. AB - In a population-based cohort of Japanese American men in Hawaii, the 450 joggers differed from 6,171 nonjoggers in being younger, taller, heavier, and more obese; in having larger vital capacity, higher socioeconomic status, and a higher prevalence of certain electrocardiographic abnormalities; and in being more health conscious as demonstrated by less smoking and a higher frequency of special diets. Blood pressure, serum total cholesterol, hematocrit and high density lipoprotein cholesterol (HDL-C) did not differ significantly between the two groups. Multiple regression analysis showed HDL-C to be inversely related to obesity and cigarettes, and directly related to alcohol consumption but to have no relationship to jogging or age. Temporal analyses suggested that initiation of jogging was followed by a reduction in heart rate, but there was no significant change in other measured parameters. Coronary heart disease (CHD) prevalence was increased in joggers, perhaps because the diagnosis of CHD predisposes to this activity. We conclude that jogging has probably had little impact on the health of this cohort. PMID- 6849473 TI - Five-year blood pressure control and mortality following health education for hypertensive patients. AB - Three health education interventions for urban poor hypertensive patients were introduced sequentially in a randomized factorial design: 1) an exit interview to increase understanding of and compliance with the prescribed regimen; 2) a home visit to encourage a family member to provide support for the patient's regimen; and 3) invitations to small group sessions to increase the patient's confidence and ability to manage his/her problem. Previous evaluation of the initial two year experience demonstrated a positive effect of the educational program on compliance with the medical treatment and blood pressure control. Data accumulated over an additional three years, including mortality analysis, are now presented. The study group consisted of the same cohort of 400 ambulatory hypertensive outpatients in the eight experimental and control groups. The five year analysis shows a continuing positive effect on appointment keeping, weight control, and blood pressure control. All-cause life table mortality rate was 57.3 per cent less for the experimental group compared to the control group (12.9/100 vs 30.2/100, p less than .05), while the hypertension-related mortality rate was 53.2 per cent less (8.9/100 vs 19.0/100, p less than .01). The results from this longitudinal study provide evidence to encourage health practitioners to utilize such educational programs in the long-term management and control of high blood pressure. PMID- 6849474 TI - Impact of legislation raising the legal drinking age in Massachusetts from 18 to 20. AB - On April 16, 1979, Massachusetts raised its legal drinking age from 18 to 20 years. Massachusetts was compared with New York State, exclusive of New York City and Nassau County. New York State retained an 18-year-old drinking age. Random telephone surveys with approximately 1,000 16-19 year olds in each state were undertaken prior to the law's enactment and twice at yearly intervals after the law to assess the law's impact on teenage drinking, driving after drinking, and non-fatal accident involvement. Fatal crash data reported to the US Department of Transportation by each state from April 16, 1976-April 15, 1981 were also analyzed. After the law, although the modes of procuring alcohol changed. No significant changes were observed in Massachusetts relative to New York in the proportion of surveyed teenagers who reported that they drank or in the volume of their consumption. The proportion of teenagers who drove after drinking heavily (six or more drinks at one time) did not decline in Massachusetts relative to New York. However, the frequency that teenagers reported driving after any drinking declined significantly in Massachusetts. Frequency of teenage driving after marijuana use and non-fatal teenage accidents declined at comparable rates in both states. The numbers of teenage nighttime single vehicle fatal accidents declined more in Massachusetts than New York, in the 18-19 year age group. Overall fatal accident trends among 16-19 year olds in the two states were similar. PMID- 6849475 TI - Regionalization of surgical services. AB - Using data from the Studies on Surgical Services for the United States (SOSSUS), the extent of existing surgical care regionalization was examined in a defined area. Specialist surgeons comprised 55 per cent of all physicians who did operations, but performed nearly three-fourths of all operative work. About one third of the most complex operations (CRV greater than or equal to 30), more than one-fifth of medium complexity (CRV = 20-29), and 14 per cent of low complexity (CRV less than 20) were obtained out of county of residence. Nearly one-half of all surgical patients at the university hospital were from other counties; but for those obtaining the most complex operations (CRV greater than or equal to 30), three-fourths of them were from other counties. Thus there was a substantial amount of regionalization of surgical care already existing in this area. PMID- 6849477 TI - The role of community volunteers in health interventions: a hypertension screening and follow-up program. AB - Volunteers from a resident health committee in an apartment complex community carried out door-to-door blood pressure screening of residents. Their results were compared with those from a community where a resident health committee conducted central site screenings and with those of a community where nonresident researchers manned a central screening site. Door-to-door screening by community volunteers was significantly more effective than the two central site screening methods which did not differ from each other. Follow-up measures increased the number of hypertensives who reported seeking treatment by 100 per cent. PMID- 6849476 TI - The establishment of health maintenance organizations: a geographical analysis. AB - Seven characteristics of 243 Standard Metropolitan Statistical Areas (SMSAs) were subjected to discriminant analysis to determine whether they distinguish SMSAs where at least one health maintenance organization (HMO) was organized between 1972 and 1980 from SMSAs where no HMO developed. The discriminant function correctly classifies 77 per cent of the metropolitan areas considered. Presence of a medical school, regional location, and SMSA population were positively related to HMO establishment. Number of Medicare recipients per 1,000 SMSA residents was not associated with HMO development. (Am J Public Health 1983; 73:184-187.) PMID- 6849478 TI - Underrecording of infant homicide in the United States. AB - Homicide rates for infants dropped suddenly between 1967 and 1969. The abrupt nature of this decline suggested the change was artifactual. Investigation suggests that two classification revisions instituted at this time were causes of this decline: changes in related codes set forth in the Eighth Revision of the International Classification of Diseases, Adapted, and revision of the standard certificate of death in 1968. Infant homicides may have been disproportionately underrecorded after 1968. (Am J Public Health 1983; 73:195-197.) PMID- 6849479 TI - Trends in utilization of prenatal cytogenetic diagnosis by New York State residents in 1979 and 1980. AB - It is estimated that 35.3 per cent of pregnant New York State women age 35 or over underwent cytogenetic diagnosis in 1980 as compared to 28.7 per cent in 1979. Rates varied sharply by county. In several small counties far from genetic centers, no 1980 cytogenetic diagnostic studies were reported in women 35 or over while in New York City the rate was 41 per cent. In one county with an active genetic center the rate appears to have plateaued at 30 per cent. PMID- 6849480 TI - Relationship of newborn screening tests for congenital hypothyroidism to subsequent SIDS. PMID- 6849482 TI - Drainage of hepatic, intraabdominal, and mediastinal abscesses guided by computerized axial tomography. Successful alternative to open drainage. AB - Opens surgical drainage of intraabdominal, intrahepatic, and mediastinal abscess is well established. Although this may be the procedure of choice when there are indications for treatment of concurrent intraabdominal and mediastinal surgical disease, with the advent of computerized axial tomography and ultrasonography we have identified a patient population best served by percutaneous catheter drainage. The procedure involves precise localization using ultrasound or CAT scanning, fine needle aspiration for confirmation of diagnosis, and injection of radiopaque contrast medium with fluoroscopic observation to localize the abscess. Catheter placement is usually achieved by a Seldinger technique, although a trochar-cannula method is occasionally required. Our experience with 4 patients, as well as review of the world literature provides a cumulative experience of 252 patients, has led us to believe that this approach is successful 83 percent of the time with a minimal incidence of complications. Percutaneous catheter drainage of intrahepatic, intraabdominal, and mediastinal abscess guided by computerized axial tomography is the treatment of choice in patients who do not have other indications for exploration. PMID- 6849481 TI - Failure rate with gastric partitioning for morbid obesity. AB - One hundred twenty-two morbidly obese patients were selected for gastric partitioning from a multidisciplinary obesity clinic over a 4 year period. Initial early success was not a guarantee against cessation of weight loss or the regaining of lost weight. By emphasizing criteria for success and failure, both from our series and the literature, we showed an alarming increase in the failure rates for this procedure which is predicated on the fact that those lost to follow-up were probably failure patients. Numerous articles in the literature contain inadequate data because they refer to pounds rather than percentage of weight loss, they fail to consider revisions as failures, they do not provide 24 month follow-up data, and they do not take into account the possibility that those lost to follow-up are failure patients. The operation carries mortality and serious morbidity rates of 0 to 3 percent and 4 to 10 percent, respectively, with an average 28 percent weight loss at 24 months and a minimal failure rate of 50 percent. The alarming increase in the number of these procedures being carried out across the continent makes it mandatory for surgeons to accurately collect and register their data until the long-term effects and results are known. Gastric partitioning, although probably not experimental, is still developmental. The widespread use and possibly abuse of these operations may result in discreditation of the surgical approach to morbid obesity which would be unfortunate since it is the only practical method at this time for dealing with the problem. PMID- 6849483 TI - Open packing of the peritoneal cavity in generalized bacterial peritonitis. PMID- 6849485 TI - Diagnosis and treatment of gastric emptying disorders. Clinical usefulness of radionuclide measurements of gastric emptying. AB - We studied 53 patients with severe gastrointestinal symptoms thought to be due to a gastric motility disorder. Sixty-six percent had had a previous operation on the stomach, and 21 percent had insulin-dependent diabetes mellitus. Based on clinical, radiographic, and endoscopic findings, 48 patients were thought to have gastroparesis, 3 were thought to have dumping, and 2 had no diagnosis. Measurement of gastric emptying of solids showed that gastric emptying was normal in 12 patients, rapid in 15 patients, and slow in 26 patients. Further evaluation showed that half of the patients with normal gastric emptying, and one third of those with rapid gastric emptying had other diseases of the gastrointestinal tract that responded well to surgery. Of those patients with dumping, diet modification was effective in 40 percent, and half of those who did not respond to dietary manipulations did well after reoperation. Nineteen patients with delayed gastric emptying were treated with metoclopramide. Sixty percent of those without previous gastric surgery responded, whereas only 25 percent of those with previous gastric surgery had good results. The rate of gastric emptying improved following reoperation in 9 (90 percent) of 10 patients with delayed gastric emptying (4 who had not responded to metoclopramide). Gastric emptying was measured again in 15 patients after treatment. The changes after treatment paralleled the clinical response. These studies indicate that gastroparesis cannot be reliably diagnosed on the basis of clinical findings and standard tests. Gastric emptying studies are essential to diagnose and treat patients thought to have gastric motility disorders, and to evaluate the results of therapy. PMID- 6849484 TI - Improved localization and survival in patients with intraabdominal abscesses. PMID- 6849486 TI - Pyloric and gastric preservation with pancreatoduodenectomy. AB - Pyloric and gastric-preserving pancreatic resection was performed in 35 patients with no mortality. Twenty-seven patients were followed for at least 8 months postoperatively and are reported herein in detail. This variation in the Whipple procedure is associated with a satisfactory weight gain after operation for benign disease, does not produce the usual postgastrectomy digestive symptoms, and so far jejunal or anastomotic ulceration has not been a problem. We believe this variation of the Whipple procedure is the operation of choice for benign disease and for certain types of periampullary malignant growth. PMID- 6849487 TI - Changes in circulating levels of cholecystokinin, gastrin, and pancreatic polypeptide after small bowel resection in dogs. PMID- 6849488 TI - Pathogenesis of early necrotizing enterocolitis in the hypoxic neonatal dog. PMID- 6849489 TI - Preoperative recognition of intestinal strangulation obstruction. Prospective evaluation of diagnostic capability. AB - Early recognition of intestinal strangulation in patients with small bowel obstruction is essential to allow safe nonoperative management of selected patients. We prospectively evaluated preoperative diagnostic parameters as well as the preoperative judgement of the senior attending surgeon for the determination of the presence or absence of intestinal strangulation in 51 consecutive patients who were about to undergo laparotomy for complete mechanical small bowel obstruction. Strangulation was present in 21 (42 percent) of the 51 patients. No preoperative clinical parameter, including the presence of continuous abdominal pain, fever, peritoneal signs, leukocytosis, or acidosis, or a combination thereof proved to be sensitive, specific, and predictive for strangulation. Moreover, the senior surgeon's experienced clinical judgement detected strangulation in only 10 of 21 patients with strangulation preoperatively (sensitivity, 48 percent). Indeed, only 1 of these 10 patients had an early, reversible lesion, whereas 9 had advanced, irreversible infarction. Only 25 of 36 preoperative assessments of simple obstruction proved correct (predictive value of an assessment of no strangulation, 69 percent). Overall, the preoperative assessment was correct in only 35 of the 51 patients (efficiency, 70 percent). These data show that in patients with complete mechanical small bowel obstruction, the preoperative diagnosis of strangulation cannot be made or excluded reliably by any known clinical parameter, combination of parameters, or by experienced clinical judgement. Nonoperative management of complete intestinal obstruction is therefore undertaken at a calculated risk (31 +/- 51 percent in the present series) of delaying definitive treatment of intestinal ischemia. PMID- 6849490 TI - Factors influencing perineal wound healing after proctectomy. AB - The hospital and office records of 86 patients who underwent proctectomy for cancer of inflammatory bowel disease with primary closure of the perineal wound were reviewed. Almost one fourth of all patients suffered a significant perineal wound complication, the majority of which were infections. The incidence of postoperative perineal wound complications was comparable in both groups of patients. Urinary retention occurred in 24 percent of patients who underwent abdominoperineal resection or rectal cancer, and half of these patients required transurethral resection which indicates the need for more thorough preoperative assessment of bladder function, especially in older men. The development of leg ischemia that resulted in amputation in two elderly patients who had preoperative evidence of obstructive peripheral vascular disease suggests that a synchronous two-team abdominoperineal resection with the patient in the modified lithotomy position for a prolonged period should be avoided. One third of all patients were discharged less than 10 days after surgery and two thirds within 2 weeks. Prolonged stays were more frequent in cancer patients and appeared to be related to age rather than to the development of postoperative complications. The perineal wound after abdominoperineal resection for cancer healed more rapidly and more completely than did the wound after proctectomy for inflammatory bowel disease. Fourteen percent of the inflammatory bowel disease patients did not have a healed wound 1 year after surgery. The extent of rectal cancer as determined by Duke's classification played no role in healing of the perineal wound, but women with rectal cancer healed at a slower rate than did men. The location of the exit site for wound catheters and the use of cautery and preoperative steroid therapy appeared too have no effect on the healing of the perineal wound. PMID- 6849491 TI - Presidential address. Surgical gastroenterology: problems and solutions. PMID- 6849493 TI - Effects of resection or bypass of the distal ileum on the lithogenicity of bile. AB - Changes in the composition and lithogenicity of gallbladder bile after resection and bypass of the distal ileum were investigated in the prairie dog. In animals fed a trace cholesterol diet, both ileal resection and ileal bypass increased the cholesterol saturation of bile. In animals fed a cholesterol-enriched diet, the cholesterol saturation was increased by ileal resection but not by ileal bypass. In the animals fed the trace cholesterol diet, both ileal resection and ileal bypass induced the formation of bilirubinate gallstones. PMID- 6849492 TI - Effect of cimetidine on canine gastric mucosal pH and blood flow. AB - The effects of cimetidine inhibition of acid secretion on gastric mucosal blood flow and the intramural pH of gastric mucosa were assessed in a canine model ex vivo. Intravenous infusion of histamine at 1.0 microgram/kg per minute resulted in brisk acid secretion, which was associated with an increase in total gastric and mucosal blood flow and the intramural pH of gastric mucosa. The increased blood flow and mucosal alkalinity may be compensatory mechanisms of the stomach to enhance its tolerance of luminal acid. Cimetidine inhibition of acid secretion was associated with a reduction in mucosal alkalinity and total gastric and mucosal blood flow. These adverse effects of cimetidine on blood flow and mucosal pH, two important factors in the stomach's self-defense against acid injury, may explain the inefficacy of cimetidine in the prevention of stress ulcers. PMID- 6849494 TI - Cavernous hemangiomas of the liver: resect or observe? AB - Surgical decisions regarding cavernous hemangioma of the liver require consideration of the natural history of the lesion. To provide background, we retrospectively evaluated 49 cases of such hemangiomas exceeding 4 cm in diameter. There were 36 female patients (including 4 infants) and 13 males. Their ages ranged from 1 month to 68 years and averaged 44 years. Surgical procedures that ranged from simple excision to hepatic lobectomy were performed on 13 patients. Four had postoperative complications. There were no surgical deaths or any late deaths attributable to hemangioma. The other 36 patients have been observed for up to 15 years (mean 5.5 years) without the need for surgery. None of the patients in this group died, and none has experienced intraperitoneal hemorrhage or intensification of symptoms, although the size of four lesions increased. The benign course should be considered when deciding on management of lesions that are asymptomatic or so large as to pose significant operative risk. PMID- 6849495 TI - Sphincter-splitting approach to the rectum. AB - This is a brief report of experience gained on our service with the sphincter splitting approach to the rectum. The main indications for the approach are emphasized. Sphincter splitting is a new way to resolve surgical problems that have been difficult to solve before. It should be offered to suitable patients who otherwise would have to undergo more extensive operations that carry with them more inherent liabilities. PMID- 6849496 TI - Role of gallbladder mucus in the pathogenesis of cholesterol gallstones. AB - Recent observations indicate that the hepatic secretion of lithogenic bile, gallbladder mucus hypersection, and gallbladder stasis are all critical factors in the pathogenesis of cholesterol gallstones. Using the prairie dog gallstone model, we investigated the interaction of these factors and the sequence in which they develop. The results of this study indicated that (1) gallbladder bile mucus concentration is elevated before cholesterol precipitation and increases progressively with the formation of cholesterol crystals, (2) cystic duct resistance increases in the presence of cholesterol crystals, but not fine, sonicated crystals increase cystic duct resistance. We conclude that these alterations trigger a self-perpetuating cycle of mucus hypersecretion, cholesterol crystallization, and gallbladder stasis which culminates in the formation of cholesterol gallstones. PMID- 6849497 TI - Colonoscopy: an essential monitoring technique after resection of colorectal cancer. AB - A pilot study was undertaken to determine the usefulness of colonoscopy in the postoperative follow-up of patients with colorectal cancer. Of 56 patients, 9 (17 percent) had positive intraluminal examinations, including one recurrent cancer and three large polyps (greater than 1 cm) despite normal barium enema films. Twenty percent had negative colonoscopic findings which ruled out suspicious lesions on roentgenograms. More than one third had alterations in therapy as a result of colonoscopic examination. Colonoscopy is a useful and fruitful diagnostic aid in the follow-up of colon cancer. It should be used early in the postoperative period and added at rational intervals in long-term surveillance. It appears to complement other accepted methods of detecting recurrence. PMID- 6849498 TI - Fecal occult blood screening for colorectal cancer in a Veterans Administration Hospital. PMID- 6849500 TI - Use of isoflurane during resection of pheochromocytoma. PMID- 6849499 TI - Absolute bioavailability of oral and intramuscular diazepam: effects of age and sex. AB - Twenty-two healthy volunteers aged 20-78 years received single 5-mg doses of diazepam by intravenous injection, by mouth in the fasting state, and by a deltoid intramuscular injection. The kinetic profile of diazepam by each route was determined from multiple plasma diazepam concentrations measured 7-14 days after each dose. After intravenous injection, diazepam volume of distribution (Vd) was larger in women than in men, but increased with age regardless of sex. Elimination half-life was longer in elderly than in young men (101 v 32 h, P less than 0.025), partly due to the increased Vd as well as to a significant reduction in total metabolic clearance (0.24 v 0.46 ml/min/kg, P less than 0.05). However, the prolonged half-life in elderly as opposed to young women (99 v 44 h; P less than .01) was due mainly to increased Vd because clearance was not significantly changed (0.29 v 0.35 ml/min/kg). In all subjects, oral diazepam was rapidly absorbed; peak plasma levels were reached an average of 0.9 h after dosage. Absolute bioavailability averaged 94%, indicating essentially complete absorption. Neither age nor sex significantly influenced oral absorption. In all male subjects, and in 8 of 12 women, absorption of diazepam after deltoid intramuscular injection was rapid and essentially complete. However, in three young and one elderly women, absorption was slower and apparently incomplete. Age as such did not significantly influence absorption of intramuscular diazepam. PMID- 6849501 TI - Bronchospasm during pelvic surgery: prostaglandin-kinin pathogenesis? PMID- 6849502 TI - Evaluation of centbucridine as a local anesthetic. PMID- 6849503 TI - Is theophylline, aminophylline, or caffeine (methylxanthines) contraindicated in malignant hyperthermia susceptible patients? PMID- 6849504 TI - Management of a malignant hyperthermia susceptible patient in labor with 2 chloroprocaine epidural anesthesia. PMID- 6849505 TI - Transfusions for Jehovah's Witnesses. PMID- 6849506 TI - Migration of physicians to and from anesthesiology. PMID- 6849507 TI - Parents in the recovery room. PMID- 6849508 TI - Plasma binding of pancuronium: effects of age, sex, and disease. AB - The extent of pancuronium binding in plasma in controversial due to a lack of definitive studies in human plasma. The degree of pancuronium binding in human plasma and the concomitant effects of age, sex, and renal disease on drug binding were determined by equilibrium dialysis using [3H]pancuronium. The free fraction of pancuronium was 93.2 +/- 1.6% in male subjects and 88.9 +/- 2.5% in adult nonpregnant female subjects, indicating that pancuronium is not highly protein bound. The free fraction in newborns and their mothers was 91.0 +/- 1.8% and 89 +/- 1.3%, respectively. There were no significant differences between the plasma binding of pancuronium in men, nonpregnant women (whether on oral contraceptives or not), pregnant women, or neonates. The free fraction of pancuronium was unaltered (90.7 +/- 2.1%) in patients with severe renal disease. We therefore conclude that the binding of pancuronium in human plasma is very low and that age, sex, oral contraceptives, pregnancy, and renal disease do not influence the plasma binding of this drug. PMID- 6849510 TI - The extent of blockade following various techniques of brachial plexus block. AB - The extent of sensory and motor blockades was examined in 195 patients 5 and 20 min after four different techniques of brachial plexus block using 50 ml of 0.5% bupivacaine. The interscalene technique of Winnie (N = 50) resulted in a preferential blockade of the caudad portions of the cervical plexus and the cephalad portions of the brachial plexus. The supraclavicular approach of Kulenkampff (N = 55) and the subclavian perivascular approach of Winnie (N = 56) each resulted in a homogeneous blockade of the nerves of the brachial plexus. The Winnie modification of the axillary approach (N = 34) resulted in a preferential blockade of the caudad nerves of the brachial plexus. With all four techniques, motor blockade developed faster than sensory blockade. The difference in results suggests that the approach to be used should depend primarily upon the site of the operation. The perineural space enclosing the brachial plexus greatly facilitates the spread of a local anesthetic when injected; however, it is usually not filled completely or evenly. PMID- 6849509 TI - Neuromuscular and electrocardiographic responses to verapamil in dogs. AB - Because severe muscular weakness was noted in animals receiving verapamil in doses exceeding those used in humans, we studied the effects of verapamil on neuromuscular function and its correlation with myocardial conduction. The flexor carpi radialis and its nerves were surgically exposed in mechanically ventilated dogs during pentobarbital anesthesia. Indirect and direct electrical stimulation was applied and twitch height recorded following the intravenous administration of verapamil. Twenty animals received one of four dose schedules. The results showed a significant dose-related depression of twitch height to indirect stimulation. Twitch height to direct stimulation was reduced only with the highest dose. The onset of depression of indirect stimulation was temporally associated with onset of A-V conduction delay. However, recovery following indirect stimulation lagged behind recovery of the ECG by 30 min. Recovery times of twitch height following indirect stimulation ranged from 60-208 min and also were dose-related. The qualitative similarity of pancuronium and verapamil on indirect twitch height suggests a similar site of action, i.e., the neuromuscular junction. A presynaptic or postsynaptic effect of verapamil could not be discerned in this study. Verapamil may produce an unrecognized source of weakness in the anesthetized patient either alone or through interaction with anesthetic agents or adjuncts. PMID- 6849511 TI - Calcium gluconate pretreatment for prevention of succinylcholine-induced myalgia. AB - The effects of calcium gluconate pretreatment on succinylcholine-induced postoperative muscle pain and on the changes in serum potassium and calcium levels were studied in 80 patients undergoing elective surgery who were to become ambulatory on the same evening. A test group of 40 patients was given 10 ml of 10% calcium gluconate intravenously immediately before induction of anesthesia with thiopental followed by succinylcholine for tracheal intubation. A control group of 40 patients was given thiopental and succinylcholine without calcium gluconate. Muscle pains were graded according to severity as nil, mild, moderate, and severe. The incidence of postoperative muscle pains was significantly less (5%) in the test group than in the control group (45%). In control patients who subsequently developed muscle pain, serum levels of potassium were significantly increased above preinduction levels 2 min after succinylcholine was administered and serum calcium levels were significantly decreased. In control patients who did not develop postoperative myalgia, there were no significant changes in serum levels of either calcium or potassium. This was also true for patients pretreated with calcium gluconate. Therefore, calcium gluconate pretreatment reduces both the increase in serum potassium and the decrease in serum calcium associated with succinylcholine, and decreases the incidence and severity of postoperative myalgia. PMID- 6849512 TI - Comparison of thiopental and midazolam on the neuromuscular responses to succinylcholine or pancuronium in humans. AB - Midazolam (0.3 mg/kg) was compared to thiopental (4.0 mg/kg) for possible interactions with succinylcholine or pancuronium when used for induction of anesthesia. Neuromuscular function was monitored by recording the force of thumb adduction in response to ulnar nerve stimulation. Following induction of anesthesia with either midazolam (N = 10) or thiopental (N = 10), stable muscle twitch tension was obtained and succinylcholine (1 mg/kg) was given intravenously. The duration of blockade, recovery time, intensity of fasciculations, or adequacy of relaxation for tracheal intubation did not differ between patients receiving midazolam or thiopental. An additional group of patients anesthetized and monitored in the same manner received pancuronium (0.025 mg/kg) in incremental doses until a 99% depression of muscle-twitch tension was obtained. Dose-response curves for pancuronium, duration of blockade, and adequacy of relaxation for tracheal intubation did not differ between patients receiving midazolam (N = 10) or thiopental (N = 10). We conclude that the neuromuscular blockade produced by succinylcholine or pancuronium was no different in patients receiving either midazolam or thiopental for induction of anesthesia. PMID- 6849514 TI - Internal jugular vein catheterization: time required with several techniques under different clinical situations. PMID- 6849513 TI - Fetal anesthetic requirement (MAC) for halothane. AB - We asked whether the anesthetic requirement (MAC) of fetal lambs is lower than that of pregnant ewes. In five pregnant ewes anesthetized with a subarachnoid block, a fetal foot was withdrawn through a hysterotomy. The ewe then breathed 1.5% halothane and a clamp was applied to the fetal foot at 2-min intervals. We concomitantly obtained arterial blood from previously implanted catheters. When fetal movement in response to clamping the foot ceased, halothane was discontinued and the stimulus and sampling continued until the fetus began to move. Anesthesia was again resumed and continued until movement stopped. Anesthesia was then deepened and MAC was determined in the mother (stimulus--ear clamp). The fetal blood concentrations of halothane at MAC were 48 +/- 28 mg/L; they were 133 +/- 5 mg/L in the mother. This difference was highly significant (P less than 0.001). Calculated end-tidal concentrations were 0.33% and 0.69%, respectively. In two animals delivered by cesarean section, MAC increased progressively over the first 12 h of life. Progesterone levels concomitantly decreased. PMID- 6849515 TI - Theophylline administration in children with asthma: optimal pulmonary function and possible tolerance to chronic administration. AB - This study was performed to assess the need of obtaining serum theophylline (T) levels between 10--20 micrograms/ml to achieve maximum reversibility of airway obstruction in chronic childhood asthma. Twenty-seven children with daily asthma (ages 9--16 years mean 11.7) were studied to determine the serum T levels required to obtain optimal pulmonary function tests as measured by FEV1 and FEF25 -75. Two parallel groups were created. Group 1 (13 subjects) received rapid release (RR) anhydrous T. Group 2 (14 subjects) received sustained release (SR) anhydrous T. The groups were identical in age, weight, height and PFT: p = values greater than or equal to .21 (t test for equivalent means). During initial titration maximal PFT's were obtained in Group 1 subjects with mean T level of 7.1 micrograms/ml and in Group 2 subjects with mean T level of 8.5 micrograms/ml. The PFT responses and theophylline dose responses of each group were not significantly different from each other. After two months of continuous high dose (10--20 micrograms/ml) therapy each subject was again titrated for dose response of PFT with serum T levels. PFT's were not significantly different from the acute studies. After continuous high dose theophylline therapy serum T levels needed (mean 11.5 micrograms/ml) to obtain the maximal PFT response were significantly higher than during the initial titration (mean 7.1 to 8.5 micrograms/ml). Maximal PFT's in many asthmatic children do not require serum T greater than or equal to 10 micrograms/ml in an acute dosage. The continuous use of high dose theophylline may lead to tolerance, thus requiring a higher theophylline dose and subsequent serum level to obtain maximal PFT. PMID- 6849519 TI - The clinical diagnosis of ruptured subclavian artery following blunt thoracic trauma. AB - The clinical findings of nine patients who suffered disruption of the subclavian artery following blunt thoracic trauma were reviewed. Seven patients were men, two were women. Their ages ranged from 16 to 43 years. Five patients presented with shock at the time of admission. Five patients incurred a first rib fracture. The radial pulse was present in three patients, absent in three patients, and indeterminant in three patients due to their profound state of shock. Brachial plexus palsy was present in three patients. A palpable supraclavicular hematoma was present in two patients. The chest roentgenograms showed a localized hematoma over the area of the injured subclavian artery in two instances, a widened superior mediastinal shadow in one case, and both findings in another patient. Thus four of the seven patients who survived to undergo chest roentgenograms had films that suggested injury to the arch of the aorta or its branches. Seven patients survived long enough to undergo operative repair; one of these patients died (14%). The following five criteria should alert the physician to the possibility of subclavian arterial injury following blunt thoracic trauma: 1) fractured first rib; 2) diminished or absent radial pulse; 3) palpable supraclavicular hematoma; 4) chest film evidence of hematoma over the area of the subclavian artery or a widened superior mediastinum; and 5) brachial plexus palsy. PMID- 6849516 TI - Bioavailability of sustained-release theophylline granules in apple sauce in pediatric asthmatic patients. AB - To facilitate administration of sustained-release theophylline in pediatric patients fourteen children with asthma were studied using intact capsules versus the granular contents in apple sauce. In a cross-over study during multiple dose intervals the effectiveness of this administration technique was demonstrated for maintaining bioavailability and sustained-release characteristics. PMID- 6849518 TI - Systemic lupus erythematosus activity and IgE. AB - Patients with active systemic lupus erythematosus (SLE) had a higher mean serum level of IgE than patients with SLE in remission. All five patients who had serum obtained during active disease had a drop in their total IgE levels when the disease process was quiescent. Further investigations are needed to settle the question of whether the elevated IgE found during active disease is primary or secondary, a pathogenic factor or an epiphenomenon. PMID- 6849517 TI - Sensitization in a grain handler to the storage mite Lepidoglyphus destructor (Schrank). AB - Allergy to one of the most common Canadian storage mites. Lepidoglyphus destructor, was demonstrated in a grain worker by immediate skin testing and inhalation challenge. The frequency of sensitization to this mite was found to be 12% in 100 asthmatics by skin testing. In 4% of these asthmatics sensitization to another storage mite, Acarus siro, was found, all of whom were also sensitized to L. destructor and the house dust mite, Dermatophagoides farinae. There was a significantly higher proportion of asthmatics sensitive to the storage mites and to fungi who had a history of exposure to grain compared to those who did not. PMID- 6849520 TI - Determination of cerebral cortical blood flow: a thermal technique. AB - A mathematical model for tissue thermodilution was developed to study cerebral cortical perfusion before and after controlled perfusion arrest. Cerebral cortical perfusion rates are readily determined by this method. A thermistor was introduced into the subdural space and secured in direct contact with the frontal cortex in 12 dogs on ketamine and gallamine anesthesia. A 22-gauge angiocath was placed in the right superior thyroid artery and directed into the carotid artery on the same side as the thermistor. The dogs were placed on cardiac bypass using a circuit from the right atrium to the pulmonary artery and a second circuit from the left ventricular apex to the left femoral artery. Arterial pressure, central venous pressure (CVP), intracranial pressure (ICP), and left atrial pressure (LAP) were monitored directly. A heat exchanger was used to maintain a constant blood temperature of 37 C in the output of the left side bypass circuit. Thermal flow curves were generated in the cerebral cortex by injecting 2 to 4 cc of cold saline into the common carotid artery through the injection catheter. Preliminary evaluation of this flow method in comparison to radioactive microspheres indicates that this method can be used in a reliable and reproducible fashion to determine cerebral cortical blood flow. PMID- 6849521 TI - A longitudinal study of residency-trained emergency physicians. AB - An annual survey of emergency medicine (EM) graduate physicians from 31 programs was conducted from 1977 through 1979. Results of the 1979 data are presented. Practice patterns show that 96% of the EM graduates are providing patient care, and almost half are working in the states in which they trained. Of those caring for patients, 38.8% practice in an urban location and only 7% work in rural hospitals. Learning new skills and procedures and retaining skills are major problems faced by physicians in rural locations. Other activities of EM graduates include teaching medical students and residents, administration, research, and community emergency medical services. Data are analyzed with attention to long term commitment to emergency medicine. Implications for manpower needs are suggested. PMID- 6849522 TI - Pentazocine overdose. AB - A patient who ingested 1.5 g pentazocine developed status epilepticus, coma, respiratory depression, acidosis, profound hypotension, and ventricular arrhythmias. Although this patient survived after institution of general supportive measures, she did not respond to usual doses of naloxone. We describe the clinical symptoms and course of recovery of a patient with pentazocine overdose. Our case suggests that pentazocine overdose may require higher doses of naloxone (5 to 20 mg) than are customarily used for narcotic overdoses. PMID- 6849523 TI - Runaway pacemaker. AB - We report a case of a runaway cardiac pacemaker in a hemodynamically unstable patient requiring surgical intervention for correction of the malfunction. The technique for gaining rapid access to the permanent pacemaker and disarming it, and for the utilization of a portable pacemaker generator to establish a normal heart rate is presented. PMID- 6849524 TI - Primary amebic meningoencephalitis diagnosed in the emergency department. AB - Reported is a case of primary amebic meningoencephalitis diagnosed in the emergency department. The patient, a previously healthy teenager, developed Naegleria meningoencephalitis after swimming in a freshwater public pool. The Naegleria caused acute fulminating infection culminating in the death of the patient 36 hours after admission. Results of a spinal tap, together with the history of swimming in warm fresh water, led to the emergency department diagnosis. PMID- 6849526 TI - Perforated cecal carcinoma presenting as thigh emphysema. AB - Gastrointestinal perforation into the retroperitoneum may present as thigh emphysema. In the elderly, abdominal symptoms may be minimal. We report a patient with a perforated cecal carcinoma presenting as right hip pain with thigh emphysema. A diagnosis of perforated intra-abdominal viscus was suspected from the radiographs. The patient initially did well after surgery, which included a hemicolectomy and debridement of necrotic muscle down to the knee. He later succumbed from cardiac arrest following a dyspneic episode. PMID- 6849528 TI - The role of emergency medicine in toxicology. PMID- 6849525 TI - Phenytoin sodium in oxygen-toxicity-induced seizures. AB - A case of cerebral air embolism complicated by oxygen-induced seizures in the hyperbaric environment is presented. Phenytoin sodium (Dilantin) was used during recompression treatment in an attempt to suppress the occurrence of seizure activity. It appeared to inhibit seizure activity, subsequently allowing the patient to be treated with hyperbaric oxygen. PMID- 6849527 TI - Central cord syndrome. PMID- 6849529 TI - Weight lifter's cephalgia treatment questioned. PMID- 6849530 TI - Brachial plexus injury from percutaneous cannulation of the internal jugular vein. PMID- 6849531 TI - Utility of corrected white count in peritoneal lavage. PMID- 6849532 TI - The effect of surgical treatment on the natural history of lung cancer. PMID- 6849533 TI - An evaluation of repeated injections of epinephrine for the initial treatment of acute asthma. AB - We evaluated 4 treatment regimens using single and multiple injections of epinephrine for the initial treatment of acute asthma in children. Twenty-five patients received 2 injections of epinephrine followed by Sus-Phrine (Group EES) given 20 min apart, 25 received Sus-Phrine only (Group S), 24 received Sus-Phrine followed by 2 placebo injections 20 min apart (Group SPP), and 14 received epinephrine only (Group E). Clinical score and pulmonary function were assessed over a 2-h period. The failure rate was similar in Groups EES, S, and SPP (combined failure rate, 17.8%). The failure rate (46%) in Group E was significantly greater (p less than 0.05). The clinical score and pulmonary function was significantly better 5 min after the first injection in Group EES than in Groups S and SPP, but no significant differences were noted thereafter. At 25 min the pulmonary function was similar whether 1 or 2 epinephrine injections were administered. The number of patients exhibiting side effects was significantly greater in the groups receiving epinephrine than in the groups receiving Sus-Phrine only (p less than 0.05). The relapse rates during the 24-h period after the emergency room treatment were similar in Groups EES, S, and SPP (combined relapse rate, 14.3%). We conclude that repeated injections of epinephrine are necessary to sustain bronchodilation but that they do not have a cumulative effect. Furthermore, there is little therapeutic advantage of these repeated injections over a single injection of Sus-Phrine for the initial treatment of acute asthma. PMID- 6849534 TI - Airways responses to inhaled isoproterenol in normal children. PMID- 6849535 TI - Pneumonia and multiple lung abscesses caused by dual infection with Legionella micdadei and Legionella pneumophila. AB - An immunocompromised patient developed pneumonia in which both Legionella micdadei and L. pneumophila, serogroup 6, were isolated from transtracheal aspirates in the absence of any other bacteria. Unusual features included the development of disseminated intravascular coagulation and multiple pulmonary abscesses during treatment with erythromycin, and relapse of the legionellosis after extended therapy with both erythromycin and rifampin, which was heralded by septic shock. Because simultaneous infection with two distinct species of Legionella occurs, concurrent increases in antibody titer to more than one Legionella may, in some instances, reflect multiple infection rather than cross reacting antibody. PMID- 6849536 TI - Respiratory function after paralysis of the right hemidiaphragm. AB - We studied a 45-yr-old man with normal lung function before and 7 wk after right phrenic nerve crush. Total lung capacity, functional residual capacity, and forced vital capacity decreased with residual volume remaining unchanged. Static compliance was also unchanged. Ventilatory response to CO2 (delta Ve/delta PaCO2) was preserved, but P0.1 response to CO2 (delta P0.1/delta PaCO2) increased. Analysis of raw mouth pressure suggested that these responses were the result of a new rapid pattern of inspiratory pressure development. Regional washout was slowed on the side with paralysis, but the normal apex-to-base gradient of regional volumes was preserved. Inhaled 133Xe boluses were distributed away from the side of paralysis, and bolus distribution changed relatively little with increased flow. These results suggested that in compensation for paralysis of a hemidiaphragm, a new pattern of inspiratory muscle recruitment developed, involving more rapid contraction of the remaining muscles of inspiration. PMID- 6849537 TI - Sleep apnea syndrome after poliomyelitis. AB - We present a case of severe breathing abnormality during sleep in a young man who had had poliomyelitis 20 yr before. His sleep disorder led to respiratory failure and cor pulmonale, which were greatly improved by oxygen therapy. A study of this case and those previously described supports the notion that brainstem damage during acute poliomyelitis is important in the later appearance of sleep disordered breathing. In addition, such patients usually have mechanical abnormalities involving the thoracic cage and respiratory muscles. These ventilatory restrictions amplify the pathophysiologic effects of abnormal central nervous system control of breathing during sleep, and we suggest that their presence has a key role in the development of sleep apnea syndrome in these patients. PMID- 6849538 TI - Sleep apnea and nocturnal hypoventilation after western equine encephalitis. AB - That viral encephalitis can produce daytime hypoventilation is well appreciated, but an association of this infection with the development of a prolonged disturbance of breathing during sleep once the ventilatory disorder during wakefulness has resolved, has not been reported. We describe a young male who required assisted mechanical ventilation in association with western equine encephalitis. Normal waking ventilation returned over 3 to 4 wk, but frequent apneas and severe hypoventilation persisted during sleep with a near absence of waking ventilatory response to chemical stimuli. Over 3 months there was considerable improvement in breathing during sleep associated with an increase in both hypoxic and hypercapnic ventilatory responsiveness. PMID- 6849539 TI - The auto-PEEP effect. PMID- 6849540 TI - Progressive and transient hypoxic ventilatory drive tests in healthy subjects. PMID- 6849541 TI - Nifedipine aerosol attenuates airway constriction in dogs with hyperreactive airways. AB - We investigated the ability of a calcium channel blocker nifedipine, given as an aerosol, to attenuate bronchoconstriction induced by citric acid, Ascaris antigen, and methacholine in Basenji-Greyhound dogs. citric acid 10% increased pulmonary resistance (RL) 4.2-fold +/- 1.0 (mean +/- SEM) and 1.7-fold +/- 0.7 in untreated and nifedipine-pretreated dogs (P less than 0.05). Dynamic compliance (Cdyn) fell to 0.58 +/- 0.07 and 0.66 +/- 0.07 of control values in untreated and nifedipine-treated dogs, respectively (p greater than 0.05). Ascaris antigen increased RL 5.1-fold +/- 0.83 and 3-fold +/- 0.48 in untreated and nifedipine treated dogs, respectively (p less than 0.05); Cdyn decreased to 0.33 +/- 0.04 and 0.48 +/- 0.03 in untreated and nifedipine-treated dogs, respectively (p less than 0.05). In 5 dogs challenged with 0.3 mg/ml methacholine, RL increased 6.1 fold +/- 0.7 and 4.4-fold +/- 1.0 in untreated and nifedipine-treated dogs, respectively (p less than 0.05); Cdyn fell to 0.41 +/- 0.-3 and 0.46 +/- 0.07 of control values in untreated and nifedipine-treated dogs (P greater than 0.05). Neither 40% ethanol nor nifedipine-ethanol altered resting RL and Cdyn. We conclude that nifedipine effectively attenuates bronchoconstriction induced by citric acid, Ascaris antigen, and methacholine in dogs with hyperreactive airways. PMID- 6849543 TI - The effects of airway anesthesia on magnitude estimation of added inspiratory resistive and elastic loads. AB - The effects of airway anesthesia on the magnitude estimation of added inspiratory loads were studied in 5 healthy normal subjects. The subjects assessed the magnitude of a given load by means of a handgrip dynamometer; 5 suprathreshold resistive loads. (range, 2.9 to 21.0 cmH2O/L/s) and 7 suprathreshold elastic loads (range, 4.6 to 24.0 cmH2O/L) were used. Anesthesia of the upper and lower airways was obtained by gargling and inhalation of 4% lidocaine solution; the adequacy of airway anesthesia was assessed by the inhalation of 20% citric acid solution. Studies were performed in the control state and during the airway anesthetized state. The relationship between log added load and log handgrip response, represented by the regression coefficient between these two variables, was in accord with the psychophysical power law of Stevens in all the studies. The regression coefficient during the control state of resistive loads (mean = 0.566) and elastic loads (mean = 0.516) did not alter significantly (p greater than 0.05) during the airway anesthetized state. These results indicate that the magnitude estimation of added inspiratory loads is not primarily mediated through receptors in the upper or lower airways. PMID- 6849544 TI - Variation in immunoglobulin levels and circulating immune complexes in sarcoidosis. Correlation with extent of disease and duration of symptoms. AB - Sixty-three patients with clinically definite sarcoidosis confirmed histologically and/or by a positive Kveim test were studied according to the clinical and radiographic extent and known duration of their disease and symptoms. Immunoglobulin levels were not raised among patients with bilateral hilar lymphadenopathy (BHL) alone, but IgG and IgA were raised among patients with pulmonary sarcoidosis, most markedly among patients with long-standing active disease. Serum IgM was found elevated in extrathoracic sarcoidosis. West Indian males had the highest levels of IgG. The presence of circulating immune complexes reacting with conglutinin was strongly associated with a recent symptomatic onset of sarcoidosis; they were more prevalent in patients with BHL and erythema nodosum. In contrast, polyethylene glycol precipitable immunoglobulins were associated with long-standing active disease and with neurologic involvement. PMID- 6849542 TI - Effect of intermittent high dose parenteral corticosteroids on the alveolitis of idiopathic pulmonary fibrosis. AB - Idiopathic pulmonary fibrosis (IPF) is a progressive, fatal disorder in which chronic accumulation of neutrophils within the alveolar structures occurs. These cells with their large stores of preformed mediators likely play a major role in subsequent lung derangement. To evaluate the adjunctive use of intermittent high dose "pulse" corticosteroid therapy as a means of inhibiting neutrophil accumulation in the IPF lung, 5 patients were treated in a single blind random fashion with "high dose" corticosteroids (2 g methylprednisolone given intravenously once a week plus 0.25 mg/kg prednisone given orally daily) and 8 patients were treated with "low dose" corticosteroids only (0.25 mg/kg prednisone given orally daily). All patients had biopsy-proved disease in midcourse, and the 2 groups were matched for clinical and physiologic criteria. To evaluate the effect of these therapies on the quantity of neutrophils in the lungs of these patients, both groups underwent bronchoalveolar lavage and 67Ga scanning at the beginning and end of the 6-month study period; both methods gave an estimate of the intensity of the neutrophil alveolitis in these patients. Low dose corticosteroids had little effect on neutrophil accumulation (% neutrophils in lavage, - 5 +/- 8% change from baseline; 67Ga uptake, + 27 +/- 14% change from baseline), whereas high dose corticosteroids significantly reduced neutrophil accumulation (% neutrophils in lavage, - 46 +/- 8% change from baseline, p less than 0.02 compared with that in the low dose group; 67 Ga uptake, - 23 +/- 11% change from baseline, p less than 0.05 compared with that in the low dose group). In addition, 2 patients in the high dose group were reevaluated 6 months after cessation of the intermittent high dose pulse corticosteroids. Both had marked increases in lavage neutrophils compared with when they were receiving the high dose therapy (10 to 22% and 18 to 52%, respectively). These findings suggest that massive doses of intermittent intravenously administered corticosteroids may help to suppress the neutrophil component of the alveolitis of IPF. PMID- 6849545 TI - Potentiation of butylated hydroxytoluene-induced acute lung damage by oxygen. Cell kinetics and collagen metabolism. AB - Changes in cell proliferation and in collagen synthesis were studied in young adult male BALB/c mice injected intraperitoneally with 400 mg/kg of butylated hydroxytoluene (BHT) in corn oil or corn oil alone and immediately exposed to 70% oxygen or air for 6 days. Mice received [3H]thymidine either as a single injection 90 min before being killed or as a continual infusion via an osmotic minipump. Autoradiography was done 2 to 14 days after BHT injection, and cell kinetic studies were performed. In a similar experiment, mice were injected intraperitoneally with [3H]proline 3 h before being killed, and type l/type III collagen ratio in newly synthesized lung collagen was determined. We found that exposure to 70% oxygen immediately after the administration of BHT initially delayed the epithelial cell proliferation and the decrease in the percentage of newly synthesized type III collagen that occurred after BHT alone. Once the animals were removed from oxygen there was a compensatory burst of cell proliferation and a precipitous drop in the percentage of newly synthesized type III collagen. The proliferating cell population after removal from oxygen was primarily interstitial and not epithelial. When exposure to oxygen was delayed, cell proliferation was similar to that seen after BHT injection alone. PMID- 6849546 TI - Mycobacterium simiae. Clinical features and follow-up of twenty-four patients. AB - The charts of twenty-four patients from whom Mycobacterium simiae was isolated from the sputum were reviewed and the patients seen in follow-up examination when possible. They were divided into 3 groups: 2 patients were felt to have had definite infection with M. simiae, 3 were felt to have had probable infection, and 19 showed no evidence of infection during follow-up for as long as 6 yr. All patients in the study had underlying pulmonary abnormalities. The results of PPD skin tests were negative in patients without evidence of tuberculosis. The patients without evidence of M. simiae infection were found to have had negative initial Acid Fast Bacillus smears, fewer sputum cultures positive for M. simiae, and lighter yields from cultures of M. simiae compared with those in the patients with M. simiae infection. We conclude that M. simiae is a nontuberculous mycobacterium capable of causing progressive granulomatous lung infection, but that it may also be identified as a causal isolate from the sputum of susceptible persons. Antituberculosis chemotherapy should not be employed in this latter group. PMID- 6849547 TI - Endobronchial pH. Relevance of aminoglycoside activity in gram-negative bacillary pneumonia. AB - The in vitro bactericidal activity of certain antimicrobials, especially aminoglycosides, is markedly diminished at an acid pH. In an attempt to correlate this factor with the poor response of gram-negative bacillary pneumonia to aminoglycoside therapy, the endobronchial pH of selected groups of subjects was measured via a bronchoscopically directed pH electrode. The average peripheral, i.e., subsegmental, endobronchial pH of normal persons, patients with chronic lung disease, and patients with pneumonia was 6.58 +/- 0.06, 6.62 +/- 0.10, and 6.61 +/- 0.06, respectively. The average central airway, i.e., major bronchi or tracheal, pH at 6.64 +/- 0.07 did not vary significantly from that of peripheral airways. The presence of pneumonia in individual bronchi was associated with a significantly lower pH than that in noninfected bronchi: 6.48 +/- 0.12 versus 6.69 +/- 0.13 (p less than 0.05). This relatively acid environment appears exaggerated within pneumonic airways and may contribute toward decreasing the effectiveness of aminoglycosides and certain other antimicrobials used in treating lung infection. PMID- 6849548 TI - Small airways in severe panlobular emphysema: mural thickening and premature closure. AB - Histological measurements in cases of severe paniobular and centrilobular emphysema and in normal lungs disclosed a generalized thickening of the walls of small airways in the panlobular group. With mathematical models, this was depicted as a potential basis for airway closure at higher than normal lung volumes and trapping of air. Lungs with mixtures of panlobular and centrilobular emphysema predominate in the general population, and the obstructive component of airways in this setting is likely a net result of multiple lesions. These may be common in varying degrees to both varieties of disease but especially characteristic of one form. Bronchiolar thickening is one such general process. Present findings suggest that this is prone to be linked to emphysema with a panlobular pattern. PMID- 6849549 TI - Weber's law and resistive load detection. AB - The threshold of detection for added resistive loads to breathing (delta R50) was measured in 4 normal subjects at 4 different background resistances (Ro). Under normal conditions (Ro = 2.26 +/- 0.16 (SEM) cm H2O/L/s), the mean delta R50 was 0.53 +/- 0.17 cm H2O/L/s and the Weber fraction (delta R50/Ro) was 0.24 +/- 0.07. When the background resistance was increased, the threshold of detection increased proportionately, so that the Weber fraction did not change significantly. The background resistance was also decreased by having the subject breathe heliox. Although this did not result in a change in delta R50 (0.68 +/- 0.1 cm H2O/L/s), the Weber fraction increased to 0.49 +/- 0.08. These results show that although the Weber fraction is relatively constant over a wide range of background resistances, it rises sharply at low levels of background resistance, a finding that is similar to other sensory modalities. PMID- 6849550 TI - Preexposure to low ozone concentrations does not diminish the pulmonary function response on exposure to higher ozone concentrations. AB - To determine whether persons repeatedly exposed to low ozone concentrations would demonstrate a diminished responsivity, as a result of adaptation or desensitization, when subsequently exposed to a higher ozone concentration, we performed the following study. Respiratory sensitivity (pulmonary function response) to 2 h of exposure to 0.42 or 0.50 ppm ozone (acute exposure) was determined 3 months before or 6 to 8 wk after the study. Twenty-one subjects (8 men, 13 women) were exposed for 2 h or 5 consecutive days to filtered air, 0.20, 0.20, 0.20, and 0.42 to 0.50 ppm ozone, respectively. There were no significant differences between the responses of men and women to ozone. Subjects were divided into a sensitive group (greater than 20% drop in FEV1) and a nonsensitive group (less than 10% drop in FEV1) on the basis of their responses to the acute exposure. Neither the overall group nor the nonsensitive group showed a significant response to 0.20 ppm. Sensitive subjects (n = 9) showed small but significant decreases in FEV1 on exposure to 0.20 ppm. The predominant finding was that the 3 days of preexposure to 0.20 ppm ozone had no effect on the response to 0.42 or 0.50 ppm ozone on the fourth day (when compared with the previous acute exposure to 0.42 or 0.50 ppm). We conclude that subjects repeatedly (3 times) exposed to a low (0.20 ppm) concentration of ozone do not demonstrate a pulmonary function adaptation or desensitization on a subsequent exposure to a higher (0.42 or 0.50 ppm) ozone concentration. PMID- 6849551 TI - The relationship of tar content to decline in pulmonary function in cigarette smokers. AB - The impact of the tar content of cigarettes on pulmonary function was examined in 1,355 men. These men represented 383 current cigarette smokers, 555 former cigarette smokers, and 417 never smokers enrolled in longitudinal study of aging. Current smokers' cigarette exposure was estimated by the number of cigarettes smoked per day and tar content per cigarette. spirometry was performed twice on all subjects at a 5-yr interval. A multiple regression analysis indicated that tar content did not significantly influence baseline levels of forced vital capacity (FVC) or forced expiratory volume in one second (FEV1), after controlling for age, height, and number of cigarettes smoked. Similarly, tar content did not significantly influence follow-up levels of FVC or FEV1, after controlling for age, height, number of cigarettes, and baseline pulmonary function. These data suggest that low tar cigarettes may not protect smokers from an increased rate of decline in pulmonary function. PMID- 6849552 TI - Variability of hypoxic pulmonary vasoconstriction in sheep. Role of prostaglandins. AB - In a minority of conscious sheep, the hypoxic pulmonary vasoconstrictor response is blunted ("nonresponders"). The purpose of this investigation was to determine if this blunted response is related to an increased activity of H2-histamine receptors, beta-adrenergic receptors, or the generation of inhibitory prostaglandins. We measured pulmonary arterial pressure, pulmonary arterial wedge pressure, and pulmonary blood flow for the calculation of pulmonary vascular resistance (PVR) in 5 "nonresponders" and 5 sheep with a typical hypoxic pulmonary vasoconstrictor response ("responders") while breathing room air and 13% O2 (balance, N2). Arterial oxygen tension (PaO2) was also determined as a measure of the severity of hypoxia. During hypoxia, mean PVR increased by 6% (p = NS) in the "nonresponders" (PaO2, 49 +/- 4 mmHg), and by 70% (p less than 0.01) in the "responders" (mean PaO2, 46 +/- 4 mmHg). Metiamide (H2-blocker) and propranolol (beta-adrenergic blocker) pretreatments did not restore the hypoxic pulmonary vascular response in the "nonresponders," whereas pretreatment with indomethacin (prostaglandin synthetase inhibitor) caused mean PVR to increase by 48% (p less than 0.01) during hypoxia, indicating a partial restoration of hypoxic pulmonary vasoconstriction. In the "responders," the hypoxic pulmonary vascular response was not potentiated by indomethacin pretreatment (68% increase in mean PVR). We conclude that some sheep exhibit a blunted hypoxic pulmonary vasoconstrictor response caused by enhanced production of inhibitory prostaglandins. PMID- 6849553 TI - Dynamic insufficiency of lung lymph flow from the right lymph duct in dogs with acute filtration edema. AB - Using 14 anesthetized dogs with lymph flowing through right lymph duct, we observed dynamic insufficiency of lung lymph flow during acute left atrial pressure loading. Net pulmonary microvascular fluid filtration pressure (sigma p) was defined as the difference between pulmonary microvascular pressure (Pmv) and oncotic gradient through the capillaries (pi mv - pi pmv). Pulmonary extravascular water content (PEVW) was well correlated with sigma p in either mild edema or gross edema (PEVW = 0.19 sigma p + 2.15, r = 0.813, 0.001 less than p less than 0.002). Percent increase in lymph flow (% Qlym) was well correlated with both PEVW (% Qlym = 130.8 PEVW - 376.5, r = 0.886, 0.005 less than p less than 0.01) and sigma p (% Qlym = 11.0 sigma p + 34.7, r = 0.853, 0.02 less than p less than 0.05) in mild edema. However, in gross edema compared with mild edema, % Qlym as a function of PEVW or sigma p was significantly low. We concluded that in gross edema with PEVW, over 6 g/g of bloodless dry lung and sigma p over 20 mmHg, lymph flow from right lymph duct becomes dynamically insufficient and can neither transport enough fluid from the pulmonary interstitium nor tracheobronchial trees to relieve the edema process. PMID- 6849555 TI - The effects of protriptyline in sleep-disordered breathing. AB - The effects of therapy with the tricyclic antidepressant protriptyline were studied in 12 patients with hypersomnolence and moderately severe sleep apnea. After treatment there was no significant change in the duration or frequency of sleep-disordered breathing (SDB) during non-REM sleep, but there was an alteration in the breathing pattern characterized by a decrease in the amount of apnea during SDB events. Apnea, as a percent of disordered breathing time, fell from 60.4 +/- 27.2% to 35.5 +/- 26.7% (p less than 0.01) and was accompanied by a reduction in the peak fall in oxygen saturation from 16.2 +/- 6.2% to 9.2 +/- 4.7% (p less than 0.01). During REM sleep there was no change in the pattern, duration, or frequency of SDB, or reduction in the peak fall in oxygen saturation. However, there was a reduction in the amount of Stage REM sleep, thereby reducing the more severe SDB events (p less than 0.01) and further improving nocturnal oxygenation. In 10 of 12 patients, there was subjective improvement in daytime hypersomnolence, which was associated with an increase in median sleep onset time from 3.3 +/- 2.2 to 5.1 +/- 2.1 min (p less than 0.01). Although all patients developed mild side effects from the anticholinergic properties of protriptyline manifested by a dry mouth, 4 patients noted additional side effects including urinary hesitancy, mild constipation, and difficulty in maintaining an erection. One patient developed intolerable constipation that necessitated discontinuation of the drug. We conclude that protriptyline reduced daytime hypersomnolence and altered the pattern of SDB, thus improving gas exchange and oxygenation during sleep. Therefore, in selected patients with moderately severe obstructive sleep apnea, therapy with protriptyline is an alternative to surgical treatment with a tracheostomy. PMID- 6849554 TI - Granulocytes and phorbol myristate acetate increase permeability to albumin of cultured endothelial monolayers and isolated perfused lungs. Role of oxygen radicals and granulocyte adherence. AB - Human granulocytes and phorbol myristate acetate (PMA) increased permeability to albumin of monolayers of cultured endothelial cells grown on micropore filters. Granulocytes from a patient with chronic granulomatous disease and PMA did not increase endothelial permeability to albumin, demonstrating that the increase in permeability is dependent on granulocyte-derived oxygen radicals. When granulocytes were separated from the endothelial cells by a micropore filter, granulocytes and PMA no longer increased endothelial permeability to albumin, demonstrating that PMA-stimulated granulocytes must be closely approximated to endothelial cells to increase endothelial permeability. The relevance of these in vitro findings to an intact microvasculature was confirmed by demonstrating that agents that reduce granulocyte adherence to endothelium reduce edema formed in isolated lungs by granulocytes and PMA, an oxygen radical dependent process. Pretreatment of granulocytes with cytochalasin B or addition of 2% dextran to isolated lung perfusates reduced granulocyte adherence and markedly reduced edema formation in isolated lungs. These studies demonstrate that PMA-stimulated granulocytes must be closely apposed to endothelial cells to increase endothelial permeability through an oxygen-radical-dependent mechanism, and they suggest that reduction of granulocyte adherence may protect against granulocyte-dependent edema. PMID- 6849556 TI - The effects of intravenous infusion of saline on lung density, lung volumes, nitrogen washout, computed tomographic scans, and chest radiographs in humans. AB - In this study we examined the effect of a 15% increase in extracellular fluid volume on lung density, lung volumes, nitrogen washout, chest radiographs and computerized tomographic (CT) scans of the thorax in 5 volunteers. The objective of the study was to determine the sensitivity of these techniques in detecting small changes in lung water. Lung density was measured by a gamma ray Compton scatter technique and with an Ohio nuclear delta 2020 CT scanner. We measured or derived functional residual capacity, residual volume (RV), vital capacity (VC), and total lung capacity by helium dilution. Single-breath nitrogen washout was used to measure closing volume and the slope of phase III nitrogen washout (delta N2). Chest radiographs were taken in the posteroanterior and lateral projections. With the CT scanner we obtained slices 1 cm thick through the bases of the lungs and at 6 and 12 cm up from the bases. All these measurements were made before and 20 to 90 min after the intravenous infusion of 30 ml/kg body weight of warm saline over a period of 20 min. The most striking findings were a 24% increase in delta N2, a 14% increase in RV, and a 4.5% decrease in VC. Chest radiographs and the CT scans showed an increase in the size of the azygos veins. There was no change in Compton scatter density or the CT numbers. These results suggest that (1) tests of small airway function, such as RV and delta N2, are more sensitive than radiographic techniques to small increases in lung water, (2) there is some protection of the lung to increases in extracellular fluid volume. PMID- 6849557 TI - Treatment of eczema herpeticum with acyclovir. AB - Eczema herpeticum is a serious herpes simplex virus infection that may have a fatal outcome. Effective antiviral therapy is therefore imperative. Acyclvoir (9 [2-hydroxyethoxymethyl]-guanine) is a new antiviral agent with high potency and low toxic effect. We treated three cases of eczema herpeticum successfully with acyclovir. PMID- 6849558 TI - Familial atypical multiple mole melanoma syndrome (FAMMM) PMID- 6849559 TI - Psoriasis, glomerulonephritis, and rheumatic fever. PMID- 6849560 TI - Topical steroids and patch tests. PMID- 6849564 TI - Chemotherapy for metastatic basal cell carcinoma. AB - Metastatic basal cell carcinoma is a rare, malignant neoplasm associated with poor survival. A 63-year-old woman had an extensive primary keratinizing basal cell carcinoma of the scalp, with metastases to the regional lymph nodes of the neck. Disease in the primary site and in the regional lymph nodes was controlled by surgery and irradiation. However, skeletal metastases that responded to therapy with three courses of cisplatin and bleomycin sulfate and then to ten courses of cyclophosphamide, methotrexate, and fluorouracil developed. Subsequent progressive metastases failed to respond to a combined cisplatin and cyclophosphamide regimen as well as to etoposide and doxorubicin hydrochloride used as single agents. PMID- 6849561 TI - IgE and IgD concentrations in patients with recurrent aphthous stomatitis. AB - Serum IgE and IgD concentrations were examined in 80 patients with recurrent aphthous stomatitis (RAS), 20 patients with other ulcerative oral disorders, and 39 control subjects. both IgE and IgD concentrations were substantially greater in patients with RAS than in either the other patients with oral disorders or the control subjects. Although the increased IgE concentrations might be related to cell-mediated phenomena in the immunopathogenesis of RAS and the increased IgD concentrations might support the recently postulated role of IgD in immune responses related to the oral cavity, the possibility that the increased IgE and IgD levels are epiphenomena could not be excluded. PMID- 6849563 TI - Quinidine photosensitivity. AB - Two patients with quinidine photosensitivity had an eczematous dermatitis in a photosensitivity distribution on the face, neck, hands, and forearms. Histologically, both patients showed a bandlike dermal lymphohistiocytic infiltrate with overlying vacuolar changes and necrosis in keratinocytes at the dermoepidermal junction. On phototesting, both patients showed marked sensitivity to UV-A radiation. Sensitivity to UV-B was difficult to assess. PMID- 6849562 TI - Solitary small active junctional nevi in juvenile patients. AB - Solitary small very dark and papular pigmented nevi, less than 4 mm, are seen commonly in the second decade of life and have a distinctive histologic pattern. Microscopically these lesions show abundant intraepidermal melanin, included within the keratin layer, and proliferating single melanocytes or nevus cell nests. Prominent nucleoli in the melanocytic cells, occasional mitoses, and the invariable presence of moderate numbers of dermal melanophages and lymphocytes indicated the activity of the pathologic process. The benignity of the lesions in nine patients is supported by a benign course over a one- to three-year evaluation period after limited excisional biopsy procedures. The clinical and pathologic evidence of activity in these nevi suggests yet another possible precursor of malignant melanoma. The B-K mole syndrome and the dysplastic nevi syndrome differ from these cases both clinically and histologically. PMID- 6849565 TI - Extensive verrucosis in primary immunodeficiency diseases. PMID- 6849567 TI - Unusual skin manifestation of brucellosis. PMID- 6849566 TI - Cystic fibrosis manifesting with acrodermatitis enteropathica-like eruption. Association with essential fatty acid and zinc deficiencies. AB - A refractory dermatitis resembling acrodermatitis enteropathica was the manifesting sign in a 5-month-old male infant with cystic fibrosis, preceding pulmonary and gastrointestinal tract symptoms by two months. The eruption was clearly nutritionally responsive. Biochemical evidence was shown for deficiencies of zinc, essential fatty acids, and protein. Altered prostaglandin metabolism was also demonstrated. PMID- 6849568 TI - Congenital onychodysplasia. Report of 11 cases. AB - We have seen 11 cases of congenital onychodysplasia over the past six years. Associated anomalies were present in six patients, most of whom had an anomaly of the hand. Roentgenograms of the affected fingers showed hypoplasia, narrowing at the distal third of the distal phalanx, and bifurcation of the distal phalanx. The etiology of this condition is unknown, but clinical study suggested that ischemia of the finger at a certain period of embryonic life might play an important part in its pathogenesis. PMID- 6849569 TI - Commentary: Darier-White disease. PMID- 6849570 TI - Pathology quiz case 2: Porphyria cutanea tarda. PMID- 6849571 TI - Pathology quiz case 1: Sebaceous adenoma. PMID- 6849572 TI - Auricular chromomycosis. AB - Chromomycosis, a relatively uncommon infection caused by a variety of dematiaceous fungi, eg, Phialophora verrucosa, Fonsecaea pedrosoi, Fonsecaea compacta, Cladosporium carrionii, Rhinocladiella aquaspersa, and Cladophialophora ajelloi, reflects a spectrum of disease ranging from an usually localized cutaneous form to rare visceral involvement. The cutaneous form has been reported to involve almost any site on the body surface. However, the lesions are usually confined to the extremities, face, or buttocks; other parts of the body are rarely affected. We report a case of chromomycosis that involved the auricle. PMID- 6849573 TI - Urethroid cyst. AB - Cysts found on the ventral surface of the penis have been pathogenetically ascribed to defective embryologic closure of the median raphe, to anomalous developmental rests of the periurethral glands of Littre, and to the ectopic development of apocrine cystadenoma in the penile skin. This case reports a previously unrecognized but compelling pathogenesis for at least some ventral penile cysts, namely the anomalous congenital outgrowth of the entodermal urethral lining, giving rise to what is here designated as a urethroid cyst. PMID- 6849575 TI - Ventricular function in surgical patients. PMID- 6849574 TI - Kaposi's sarcoma, chronic ulcerative herpes simplex, and acquired immunodeficiency. AB - Recently, increasing numbers of young homosexual men with a fulminant form of Kaposi's sarcoma have been described. We report herein a case of a young homosexual man with Kaposi's sarcoma, chronic perianal and nasolabial ulcerating herpes simplex infection, oral candidiasis, and immunodeficiency, presumably acquired. PMID- 6849576 TI - Assessment of mitral and tricuspid competence after valvuloplasty. PMID- 6849577 TI - Simplified system for blood cardioplegia. PMID- 6849578 TI - Transvenous pacemaker implantation. PMID- 6849581 TI - Endotracheal cryotherapy in the treatment of refractory airway strictures. AB - In 1977 we reported the successful use of endotracheal cryotherapy in the treatment of experimental tracheal strictures. This technique has now been employed in the treatment of 29 refractory airway lesions in 27 patients ranging in age from 3 months to 42 years. The technique utilizes a nitrous oxide cryoprobe measuring 3 mm in diameter and 43 cm in length. The tip of the probe is applied directly to the stricture through the endoscope and cooled to -80 degrees C for 45 seconds. On removal of the probe, the frozen tissue is resected with biopsy forceps. Cryotherapy has successfully relieved the airway strictures in 20 of the 24 lesions in which treatment was completed. The technique of endotracheal cryotherapy has proved helpful in the management of selected patients with refractory airway strictures. PMID- 6849580 TI - Complete repair of pulmonary atresia with nonconfluent pulmonary arteries. AB - From 1973 through 1979, 16 patients with pulmonary atresia, two normal-sized ventricles, and bilateral but nonconfluent pulmonary arteries underwent complete repair at the Mayo Clinic. Mean age at operation was 9.1 years (standard deviation [SD] 5.2 years). Sources of pulmonary flow were previous surgical shunts, patent ductus arteriosus, and discrete systemic-pulmonary arterial collaterals. The complete surgical repair included interruption of extracardiac shunts, closure of ventricular septal defect (15 patients), closure of atrial septal defect (3 patients), and establishment of right ventricular-pulmonary arterial continuity with a porcine-valved extracardiac conduit anastomosed to a transverse limb (T graft in 12 patients) or to a side-limb (Y graft in 4 patients). There were no operative deaths. Morbidity included reoperation for bleeding in 3 patients and compression of the prosthetic graft by the sternal closure in 1. The mean postrepair ratio of right ventricular peak systolic pressure to left ventricular peak systolic pressure (pRV/pLV) was 0.64 (SD, 0.23). Follow-up ranged from 12 to 72 months (means, 34.6 months; SD, 20.7 months). One patient died 12 months after operation (postrepair pRV/pLV, 1.3). Conduit obstruction has been proved in 4 patients, of whom 3 underwent reoperation for extracardiac conduit obstruction at 46, 47, and 48 months. The remaining 11 patients are alive and free of major symptoms. PMID- 6849579 TI - Reproducible replacement of elongated or ruptured mitral valve chordae. AB - Anatomical rules that make it possible to accurately replace mitral anterior cusp chordae tendineae with tanned xenograft pericardium are defined. Anterior and posterior cusp chordae were replaced with xenograft and autologous pericardium in 11 patients who had ruptured or elongated chordae. The xenograft occasionally became calcified; however, because it did not become elongated or shortened, competence was maintained for up to 3 years. Insufficiency was corrected, and the correction maintained for up to 4 months. Degenerative disease proved easier to treat than rheumatic disease. Two-dimensional echocardiography was a valuable aid in both preoperative planning and postoperative evaluation. PMID- 6849582 TI - Surgical treatment of aneurysms of the descending thoracic aorta: an analysis of 85 patients. AB - We have reviewed our experience with resection of 85 aneurysms of the descending thoracic aorta during a ten-and-one-half year interval ending in June, 1980. There were 39 arteriosclerotic aneurysms, 35 aneurysms associated with chronic aortic dissection, and 11 posttraumatic aneurysms. During repair, a temporary shunt was used in 56 patients (66%), partial (venoarterial) cardiopulmonary bypass (CPB) in 19 patients (22%), and simple aortic cross-clamping in 10 patients (12%). Hospital mortality was 11.8%, and was unrelated to the type of aneurysm or operative method. Spinal cord injury developed in 3 of the 83 patients surviving operation (3.6%), and occurred once with each of the three operative methods. Among the 82 operative survivors without preoperative renal failure, postoperative renal failure requiring hemodialysis occurred in 2 of the 10 patients who had simple aortic cross-clamping (20%), 2 of the 54 who had a shunt (3.7%), and in none of the 18 who underwent partial CPB (p = 0.049). Postoperative renal dysfunction (a rise in the preoperative blood urea nitrogen and creatinine levels of 50% or more) occurred in 27 of the 53 patients (51%) who had preoperative and postoperative determinations. Age, intraoperative hypotension, and the use of simple aortic cross-clamping were significant (p less than 0.05) independent predictors of postoperative renal dysfunction. Intraoperative blood loss and the incidence of reoperation for bleeding did not differ significantly among the three operative methods. We conclude that the aneurysm resection technique and the development of intraoperative hypotension have an important effect on postoperative renal function. Partial CPB may represent the optimal method for preservation of renal function, and may also be the method of choice for elderly patients with preexisting renal dysfunction. PMID- 6849583 TI - Does secondary cardioplegia provide long-term recovery from ischemic injury? AB - Short-term experimental studies have indicated that initial reperfusion with blood cardioplegia may decrease ischemic injury after aortic occlusion; however, no long-term studies have been performed. We evaluated cardioplegic reperfusion in fifteen dogs, divided into three groups of five each. Group I underwent 2 hours of cardiopulmonary bypass at 37 degrees C. Group II underwent 2 hours of cardiopulmonary bypass, including 1 hour of ischemic arrest, at 25 degrees C. Group III was identical to Group II, but the hearts of the animals were initially reperfused with 500 ml of blood cardioplegia at 25 degrees C (K+ = 30 mEq/L). Stroke work index (SWI), left ventricular end-diastolic pressure (LVEDP), dp/dt max and maximal contractile element velocity (Vpm) were measured preoperatively, immediately after operation, 21 days postoperatively, immediately after operation, 21 days postoperatively and 120 days postoperatively. Compliance curves were evaluated using an intraventricular balloon at 120 days. Groups II and III had significant (p less than 0.05) elevations of LVEDP at all three postoperative measurements. The hearts of the Group III animals (cardioplegic reperfusion group) demonstrated significantly (p less than 0.05 to 0.01) better recovery of SWI immediately after operation (62% versus 39%), at 21 days (85% versus 69%), and at 120 days (81% versus 66%) than did those in Group II. However, groups II and III had decreased compliance at 120 days, compared with that of Group I, and also showed both gross and microscopic evidence of subendocardial necrosis and fibrosis. It is concluded that while initial reperfusion with blood cardioplegia appears to provide better preservation of ventricular function early after ischemic cardiac arrest, this technique does not prevent later deterioration of ventricular compliance. Moreover, it produces myocardial fibrosis. PMID- 6849585 TI - Clinical problems in the use of brain-death standards. PMID- 6849586 TI - Pyogenic liver abscess. PMID- 6849584 TI - Surgical treatment of prosthetic valve endocarditis. PMID- 6849590 TI - Poor no more. PMID- 6849588 TI - Aging heart may stay healthy with exercise. PMID- 6849589 TI - Another low-incidence year for reported mumps. PMID- 6849591 TI - Last rights. PMID- 6849587 TI - Reflex control of renal salt and water excretion. AB - The regulation of renal salt and water excretion by the kidneys involves both intrarenal and extrarenal mechanisms. These systems play a pivotal role in the regulation of body fluid volume. An understanding of their operation is important in the treatment of many disease states. The normal operation of these control mechanisms is reviewed. PMID- 6849592 TI - The Kochleffel syndrome. Historical review and manifestation of an old-new clinical entity. PMID- 6849593 TI - Cardiac sarcoidosis. A case with unusual manifestation. AB - A 26-year-old woman was hospitalized with new-onset congestive heart failure. M mode and two-dimensional echocardiography revealed abnormal motion involving the apex and posterolateral wall of the left ventricle. Cardiac catheterization was performed. The left ventriculogram demonstrated apical akinesis and an apical filling defect. The diagnosis of cardiac sarcoidosis was made from an open myocardial biopsy. PMID- 6849595 TI - Osteomyelitis of the clavicle after Swan-Ganz catheterization. AB - Osteomyelitis of the clavicle is an uncommon complication of Swan-Ganz catheterization. The diagnosis should be suspected when the clinical features of fever and sterno-clavicular pain are present. Traditional roentgenograms may be falsely normal early in the disease. Radioactive isotope scanning may be helpful in establishing the diagnosis sooner, followed by tomography or computed tomography to better define the abnormality. Therapy should include long-term parenteral antibiotics and possible surgical removal. PMID- 6849594 TI - Chagas' disease masquerading as coronary artery disease. PMID- 6849597 TI - Pseudotumor cerebri and hypothyroidism. AB - A 38-year-old obese woman with concurrent hypothyroidism and pseudotumor cerebri was monitored with serial thyroid function tests and CSF pressure determinations during levothyroxine sodium replacement therapy. Following normalization of the patient's thyroid status, assessed by both clinical and chemical indexes (serum thyroxine level, 1.5 to 11.0 micrograms/dL; serum thyrotropin level, 128 to 1.5 micro units/mL), intracranial hypertension persisted for more than four months. After weight loss, acetazolamide therapy, and intermittent CSF drainage failed to produce remission, glucocorticoid therapy was associated with prompt, sustained resolution of the pseudotumor cerebri. Contrary to previous reports, this patient's clinical course suggests that thyroid hormone deficiency and pseudotumor cerebri are not causally related. PMID- 6849598 TI - Traumatic aneurysm of the thoracic aorta simulating bronchogenic neoplasms. AB - A 70-year-old man was examined in 1977 because of hoarseness and a central opacification in the left hilus. At that time, the diagnosis of a central bronchogenic carcinoma was made based on roentgenographic findings. The patient's condition was reevaluated five years later, when an examination disclosed a chronic posttraumatic aortic aneurysm. Despite severe chronic obstructive pulmonary disease, the patient was successfully operated on. PMID- 6849596 TI - Serum myoglobin, ionized calcium, and parathyroid function during rhabdomyolysis. AB - The serum ionized calcium, phosphate parathyroid hormone, and myoglobin levels were observed in a patient with idiopathic hypoparathyroidism and rhabdomyolysis. Since calcium levels best correlate inversely with serum myoglobin and lactic dehydrogenase, we suggest that these two enzymes are better markers of the activity of rhabdomyolysis than serum creatine phosphokinase or SGOT. Furthermore, a non-hormonal, nonrenal mechanism is important in the fluxes of serum calcium and phosphate in rhabdomyolysis. PMID- 6849599 TI - Dialysis catheter-induced pericardial tamponade. PMID- 6849601 TI - Paroxysmal nocturnal hemoglobinuria. PMID- 6849602 TI - Origin of the term "internal medicine'. PMID- 6849600 TI - Late generalized tuberculosis and eosinophilia. PMID- 6849603 TI - Fiberoptic bronchoscopy as an outpatient procedure. PMID- 6849604 TI - Isometric exercise testing. Usefulness and limitations. PMID- 6849605 TI - Alcohol and hypertension. PMID- 6849606 TI - Fiberoptic bronchoscopy in outpatient facilities, 1982. PMID- 6849607 TI - Coagulase-negative staphylococcal bacteremia in patients receiving immunosuppressive therapy. AB - From January 1977 to June 1980, coagulase-negative staphylococci caused bacteremia in 22 (17%) of 130 patients receiving immunosuppressive therapy and were the most common cause of all bacteremias. Sixteen (73%) of the 22 patients had granulocytopenia, and eight were isolated in a laminar air-flow room. A Broviac or Hickman central intravenous (IV) catheter was present in 20 (91%) of 22 patients, and soft-tissue inflammation at the catheter exit site was a significant risk factor for bacteremia. Except for debilitating fevers and local mucocutaneous infections, there were no distinguishing clinical features in patients with bacteremia. Most infections responded to cefazolin sodium or vancomycin hydrochloride therapy; catheter removal was necessary in only seven patients. These data show that coagulase-negative staphylococci can be important pathogens in patients receiving immunosuppressive therapy, even when the patients are isolated in a laminar air-flow room, if normal mucocutaneous, host-defence barriers are interrupted by IV catheter-insertion or chemotherapy. PMID- 6849608 TI - Hemophilus endocarditis. Two patients with complications. AB - Two cases of Hemophilus endocarditis were diagnosed in our hospital during a six month period. Although both patients were in good health until the onset of their endocarditis, both had brain emboli and required emergency heart-valve surgery. Falsely low incidences of this disease have been reported, since Hemophilus sp are difficult to isolate. Additionally, these organisms are consistently associated with large vegetations and have a greater than 50% incidence of embolization. It is this higher incidence of embolization that leads us to conclude that prophylactic surgery should be considered in selected patients. PMID- 6849609 TI - Infections associated with subclavian Uldall catheters. AB - During a 12-month period, the use of a subclavian vein Uldall catheter (UC) for hemodialysis or plasmapheresis in 27 patients was studied prospectively. Ten patients had ten UC site infections. Organisms associated with these infections included Staphylococcus epidermidis (five), Staphylococcus aureus (four), Proteus mirabilis (two), and Enterococcus (one). The four S aureus infections occurred 1, 2, 4, and 9 days after UC insertion, whereas the five S epidermidis infections occurred 6, 17, 17, 26, and 97 days after insertion. Five patients had associated bacteremias; in one of these patients, the bacteremia was the major cause of death. The incidence of UC site infection and bacteremia based was higher than the incidence of infection reported with any other type of vascular access for hemodialysis. Further studies are necessary to define whether the UC should be routinely employed for temporary vascular access. PMID- 6849610 TI - Clinical, biochemical, and pathologic features of radiation-associated hyperparathyroidism. AB - The clinical, biochemical, and pathologic findings in 43 patients with primary hyperparathyroidism (HPT) and a history of irradiation to the head or neck were compared with those found in a group of 162 patients with HPT without prior irradiation. There were no differences between the groups with regard to mean age at the time of diagnosis, male to female ratio, serum calcium, phosphorus, and parathyroid hormone concentrations; in the frequency of single parathyroid adenomas v multiglandular disease; or in associated nonthyroidal neoplasms. Asymptomatic HPT was found with greater frequency in the irradiated patients. Almost 80% of the patients with a history of irradiation had concomitant thyroid disease, primarily adenomas and carcinomas, while less than 50% of the patients without a history of irradiation had thyroid disease, mainly colloid nodules, at surgery. PMID- 6849611 TI - CSF lactate in diseases of the CNS. AB - The usefulness of the CSF lactate concentration in the diagnosis of bacterial meningitis was studied in 109 adults and children with a variety of infectious and neurologic diseases. A positive correlation was found between elevated lactate levels and the presence of leukocytes in the CSF. Elevations of the CSF lactate concentration with concomitantly negative Gram's stains and cultures were found in patients with infections at anatomic sites other than the CNS, accidental or neurosurgical head trauma, subarachnoid hemorrhage, and seizures due to alcoholism. When performed routinely on CSF, the positive predictive value was 31%, indicating that a diagnosis other than bacterial meningitis is more likely. We conclude that the CSF lactate concentration does not contribute to the diagnosis in children or adults with suspected meningitis. PMID- 6849612 TI - Pleuropericarditis: an extraintestinal complication of inflammatory bowel disease. Report of three cases and review of literature. AB - We report three cases of pleuropericarditis complicating the clinical course of inflammatory bowel disease. This extraintestinal complication developed in all three patients during the quiescent phase of the disease. One patient had ulcerative colitis, while two patients had Crohn's disease. Aspirin and/or indomethacin were effective in treating two of the three patients, and the third patient required prednisone in addition. Chest symptoms in patients with inflammatory bowel disease should be evaluated to exclude myopericardial-pleural disease. PMID- 6849613 TI - Borderline personality. PMID- 6849614 TI - Rapid cycling. PMID- 6849615 TI - The search for a schizotype. Crossing the border again. AB - We reexamined case records from the Danish Extended Family Study to find so called borderline schizophrenic (B3) persons who were clustered in the biologic relatives of chronic schizophrenic adoptees. A syndrome can be identified in these B3 cases that is distinguishable from borderline personality disorder and other personality disorders. Its discriminating features suggest that current DSM III criteria for schizotypal personality disorder be revised to include new criteria for somatization and social role dysfunction and a shift away from the past emphasis on psychoticlike experiences. Although the methodological limitations in this and other studies that have searched for a schizotype necessitate further research on the criteria for this new category, there is growing evidence to support its validity as a psychiatric diagnosis. PMID- 6849618 TI - Diagnosing borderline conditions in an outpatient setting. AB - Application of the Gunderson-Kolb Diagnostic Interview for Borderline to a population of psychiatric outpatients suggested two complicating factors in diagnosing borderline conditions in an ambulatory setting: the reduced level of borderline symptoms and the confounding presence of recompensated psychotic patients. Overlap between the Gunderson and Kernberg borderline constructs, which is relatively high in the inpatient setting, is diminished in the outpatient setting. Contrary to expectation, distinguishing borderline patients from patients with other personality disorders was not a source of difficulty. PMID- 6849617 TI - Psychiatric disorders in the families of borderline patients. AB - The prevalence of psychiatric disorders was studied among the families of hospitalized borderline patients, defined by Gunderson and Singer's criteria, and compared with the families of schizophrenic and depressed control patients. Among borderline probands, 38.3% have a first-degree relative with depression, 25.5% had one with pathological mood swings, and 23.4% had one with "eccentric or peculiar behavior." There was no significant increase in the prevalence of schizophrenia among the relatives of borderline patients. Depression was more prevalent in the families of schizotypal borderlines compared with unstable or mixed-pattern patients. There were no schizophrenic diagnoses among the impaired relatives of schizotypal borderlines. A relationship is suggested between affective disorder and criteria-defined borderline disorders. PMID- 6849619 TI - A comparison of borderline and nonborderline alcoholic patients. AB - Attempts to document systemically the presence of borderline personality disorder in alcoholic patients were made in 94 alcoholic patients consecutively admitted to an inpatient alcoholism program. Operational diagnoses of borderline or not borderline used Gunderson's semistructured Diagnostic Interview for Borderlines (DIB). With the use of conservative criteria, 12.8% of alcoholic patients could be designated as having borderline disorders. Borderline alcoholics were significantly younger and were more likely to have a history of drug abuse, suicide attempts, and accidents. Diminished satisfaction with self and family life and a greater tendency to experience craving across a variety of situations was reported. PMID- 6849616 TI - The validity of DSM-III borderline personality disorder. A phenomenologic, family history, treatment response, and long-term follow-up study. AB - To test the validity of the DSM-III diagnosis of borderline personality disorder (BPD), we examined the phenomenology, family history, treatment response, and four-to-seven-year long-term outcome of a cohort of 33 patients meeting DSM-III criteria for BPD. We found that (1) BPD could be distinguished readily from DSM III schizophrenia; (2) BPD did not appear to represent "borderline affective disorder," although many patients displayed BPD and major affective disorder concomitantly; and (3) BPD could not be distinguished on any of the indices from histrionic and antisocial personality disorders. PMID- 6849620 TI - Bipolar illness. The sex-polarity effect in affectively ill family members. AB - We examined the sex ratios of unipolar and bipolar affective disorder in 14 studies of bipolar illness. The data are highly consistent in demonstrating that (1) females are more frequently affected than males; (2) among affected females, the ratio of unipolar depression to bipolar illness is about 2:1; whereas (3) among affected males, the ratio of bipolar to unipolar illness is approximately 1:1. This curious discrepancy between the sexes may hold a clue to understanding familial transmission as well as heterogenicity in bipolar illness. PMID- 6849621 TI - Do the mentally retarded suffer from affective illness? AB - Twenty-five published reports were reviewed regarding the occurrence of affective illness, ie, depression and mania, in mentally retarded individuals, using the DSM-III criteria to assess the validity of both diagnoses. Individuals with mental retardation (MR) were found to manifest the full range of affective disorders. Developmentally impaired social functioning and intelligence influence the clinical presentation, but not the development, of affective symptomatology. Affective disorder diagnoses can be made for patients with all levels of MR severity. In individuals with MR of mild and moderate severity, the diagnosis can be made using standard DSM-III criteria. For those with severe and profound MR, a clinically useful diagnosis can be based on changes in behavior and vegetative functioning, as well as family history of affective illness. The psychiatrically symptomatic person with MR should always be evaluated for affective symptomatology and be considered as a candidate for the full range of treatments, including psychotherapy and pharmacotherapy with antidepressants as well as lithium carbonate. PMID- 6849622 TI - Cohort analysis of suicide rates in Australia. AB - Age-specific cohort analysis of Australian suicide rates confirmed recent Canadian and American reports of a substantial increase in suicide rate among young age groups. However, it was unable to replicate fully the previous findings that not only did successive birth cohorts have higher suicide rates, but that at each successive five-year period they had higher suicide rates than preceding cohorts had at that age. The major differences could be explained on the basis of the introduction of legislation that restricted the prescription of sedatives. This suggests that although there may be early and lasting effects on successive birth cohorts contributing to a general increase in cohort-specific suicide rates in the countries examined, such rates also can be influenced by changing environmental factors more immediately related to the suicide itself. PMID- 6849623 TI - Assessing anhedonia in psychiatric patients. AB - In two studies of depressed, manic, schizophrenic, and normal subjects, a scale for measuring the intensity of subjects' pleasureable responses to normally emjoyable situations (the Pleasure Scale) evidenced good internal reliability and moderate agreement with the Chapman Anhedonia Scale and Indexes of depressive symptom severity. Only the depressed patients showed extremely anhedonic responses. Although more than half the depressed patients evidenced pleasure scores in the normal range, about 185 of them seemed more anhedonic than any norma subject. A mixture analysis resolved depressed patient scores into two distinct distributions: a normal-range distribution (88% of depressives) and an extremely anhedonic distribution (12%). The findings provide some support for the existence of a qualitatively distinct subtype of major depression that has been variously defined an "endogenomorphic" or "melancholic." PMID- 6849624 TI - Elements of change and cure in psychoanalysis. AB - Many elements are involved in the process of change and cure in psychoanalysis, some of which are seen as facilitative and others as definitive. I attempted to establish and illustrate the role of the interpersonal interactions between analysand and analyst. As a result of the traditional analytic process, the patient relives at a regressive level some of the unresolved developmental conflicts and crises in the relationship with the analyst. Thus, he has an opportunity to find, through the current experience, a more satisfactory and appropriate developmental resolution of previous psychopathology. PMID- 6849625 TI - Report of the Graduate Medical Education National Advisory Committee and health manpower development. AB - The federally chartered Graduate Medical Education National Advisory Committee projected a shortage of approximately 12,000 general and child psychiatrists by 1990. The committee's methods of analysis and recommendations have been criticized on grounds ranging from the accuracy of its data to the appropriateness of federal involvement in free-market issues. Yet the GMENAC report appears to have contributed to a recent reversal of psychiatric recruitment trends, and psychiatrists should be aware of its further implications for clinical and academic psychiatry. We analyzed the GMENAC process as one element among many that will determine future health care personnel development trends. PMID- 6849626 TI - Rehabilitation research: habit analysis and recommendations. AB - Respondents to a survey by the Association of Academic Physiatrists (AAP) on the research grant application behavior of its members indicated that 41% (45) made no applications during the 6-year period ending December 1980. Of the remainder, 12% (13) were aggressive achievers (eg, earned 54% of the awards), 33% were mild achievers and 14% were unsuccessful applicants. The successful applicants submitted 1 1/2 times more applications than did the unsuccessful ones. Of the awards made, 42% were federally funded. Of articles published in the Archives of Physical Medicine and Rehabilitation by physicians in the years 1978-1980, 76% were federally funded. Study of these data suggest that upgrading of knowledge and skills in the grant application process plus an exposure to new funding sources could increase rehabilitation research productivity. This paper discusses factors influencing success, research initiation and methods of accessing funds available from corporations and foundations. PMID- 6849627 TI - Upper and lower extremity EMG correlations during normal human gait. AB - The purpose of the present study was to determine whether diagonal intersegmental interactions are present during normal human gait. The demonstration of consistently synchronous phasing would indicate the feasibility of utilizing an electromyographic (EMG) signal to control functional electrical stimulation to a paralyzed lower extremity muscle during gait. The EMG activity of several muscles of the upper extremity and of the tibialis anterior (TA) were monitored with surface electrodes in 8 women. Variability in both the frequency of occurrence and duration of EMG activity was found in all muscles of the upper extremity. No single arm muscle common to all subjects was phased similarly to TA. However, 6 subjects demonstrated at least 1 muscle of the upper extremity that was working at the same time as TA. It is postulated that differences in upper limb kinematics may mask the existence of intersegmental interactions during gait. PMID- 6849628 TI - Carpal tunnel syndrome: use of palmar stimulation of sensory fibers. AB - In early or mild carpal tunnel syndrome (CTS), where the segment of median nerve sensory fibers is neurapraxic, stimulation of the nerve distal to the carpal ligament elicits a normal response in comparison to the segment of nerve across the carpal tunnel. In 100 hands of 50 normal adults, palmar stimulation of the median sensory fibers at 7 cm was compared to that at the wrist (14cm). Mean values for latency, amplitude, and duration were obtained, and palm/wrist ratios were calculated. Fifteen patients with CTS and 6 with underlying peripheral neuropathy were studied. This technique is useful for diagnosing early CTS and also for identifying an underlying mild peripheral neuropathy, eg, in diabetes mellitus. PMID- 6849630 TI - Predicting Barthel ADL score at 6 months after an acute stroke. AB - In 83 patients with stroke, multiple regression analysis was used to identify 5 variables, measured at the 1st assessment shortly after stroke, that related to the Barthel ADL score at 6 months. The variables were age, the presence of hemianopia or visual inattention, the presence of urinary incontinence, the motor deficit in the affected arm, and the patient's sitting balance. A 2nd equation, based upon the initial Barthel score with age and hemianopia added, was also developed. The success of the 1st equation in predicting the final Barthel score was about 55%, a rate better than that yielded by the 2nd equation, and also better than that produced by adding the average improvement score to the patient's initial score. PMID- 6849629 TI - Skin breakdown in patients with myelomeningocele. AB - An attempt was made to quantify longitudinal morbidity and identify risk factors associated with high rates of skin breakdown in patients with myelomeningocele. Based on annual evaluations, 227 of 524 patients accounted for 468 positive observations including classic decubiti, abrasions, burns, and ammoniacal dermatitis. Forty-two percent (196) of skin breakdown was attributed to excessive pressure; 57% (267) to other causes; and 1% (5) to unknown causes. Prevalence curve revealed a steady rise from infancy to age 10 years, at which point rates varied between 20-25%. Longitudinal morbidity curves of first skin breakdown showed a tendency of lesions over the perineum or gibbus to appear more frequently in the presence of higher paraplegia (generalized Savage or Mantel Cox, p = 0.05). However, mildly paraplegic and partially insensate patients exhibited relatively higher rates of breakdown over the lower extremities compared to more paraplegic patients. Higher rates of breakdown were associated with other characteristics such as mental retardation, large head size, kyphoscoliosis, and chronic soiling. Data confirm the high prevalence of skin breakdown in patients with myelomeningocele and reflect an overall influence of growth and development. PMID- 6849631 TI - Devices to enable persons with amputation to participate in sports. AB - Participation in physically challenging competitive sports is as important to some persons with amputations as are work and leisure, both of which are ordinarily of a sedentary character. Sports participation contributes not only to physical but also to psychologic well-being. The manner in which a prosthetic clinic team can aid in this aspect of rehabilitation is discussed. Some of the more sophisticated prostheses prescribed to enable participation in sports include above-knee and below-knee water-resistant prostheses for swimmers, an adjustable foot-ankle unit for the proficient swimmer and scuba diver, prostheses and special equipment for skiers, special devices for golfers with upper extremity or lower extremity amputations, and various commercially available terminal devices to enable persons with an upper extremity amputation to bowl, to hold a fishing pole and reel, to play baseball, to hold tools, to fire a pistol, and to swim. PMID- 6849632 TI - Neurogenic bladder: a guide to evaluation and management. AB - The function of voiding, whether normal or abnormal, can be symbolized by a universal formula which is based on the variables of expulsion and retention of urine, timing of urine flow, and emptying of the bladder. A guide for evaluation and management of the neurogenic bladder is derived from the formula by considering the component parts of the variables separately. A minimally invasive method of evaluation and an orderly method of conservative management are described which are based upon the guide. Early application of these principles can reestablish more normal parameters of the variables and thus avoid complications. PMID- 6849633 TI - Partial analysis and purification of polymorphonuclear neutrophil chemotactic inhibitors in serum from anergic patients. AB - An analysis of inhibitory anergic serum and noninhibitory control serum was done to determine the estimated molecular weights (mol wts) of the inhibitors of polymorphonuclear neutrophil (PMN) chemotaxis. Serum from reactive controls with no native inhibitors (PMN chemotaxis, 128.2 +/- 4.4 micrometers) showed marked inhibition (PMN chemotaxis, 54.1 +/- 1.3 micrometers) after threefold concentration through a semipermeable membrane that retained all proteins (mol wts, less than 30,000 daltons). Further concentration of the eluate through a membrane that retained all proteins (mol wts, greater than 1,000 daltons) showed extreme inhibition by this fraction (PMN chemotaxis, 10.1 +/- 1.2 micrometers). Fractionating column chromatography (Sephadex G200) of this concentrate showed most of the mol wt activity at 8,000 daltons. Sephadex G200 chromatography of 12 different inhibitory sera from anergic patients after surgery showed three peaks of PMN chemotaxis (mol wt, greater than 400,000 daltons; mol wt, 250,000 daltons; and mol wt, 130,000 daltons). Three inhibitors with mol wts of 410,000, 38,000, and 8,000 daltons were partially purified using ammonium sulfate fractionation from the serum of a multiple-trauma victim. Fractionation of this same serum through semipermeable membranes as for normal serum again confirmed the presence of a PMN chemotaxis inhibitor (mol wt, 8,000 daltons). Ammonium sulfate fractionation of normal serum identified an inhibitor in the 8,000-dalton range. With surgical stress or major trauma, increases in the concentration of a native inhibitor (mol wt, 8,000 daltons) and possibly a "piggyback" effect on larger circulating serum proteins may led to the detection of PMN chemotaxis inhibition in the anergic sera and the observed variability in the estimated mol wts. PMID- 6849634 TI - Exchange of amino acids by muscle and liver in sepsis. AB - The amino acid "central fractional clearance rate" (CFCR), the ratio of the rate of amino acid entry into the extracellular pool to the size of the pool, is a measure of amino acid uptake and clearance by liver and other visceral tissues. In nine normal postabsorptive persons, the mean CFCR was 5%, compared with 21% in 31 seriously infected patients. For comparative purposes, biopsy specimens of liver and muscle were obtained for incubation. In infected patients, the rate of hepatic incorporation of tyrosine into protein was three times that in noninfected patients and correlated well with the CFCR. There was no significant difference in hepatic tyrosine oxidation. In muscle from infected patients, net protein degradation was six times that in noninfected patients. Incubated tissues from rats behaved similarly. Thus, accelerated transfer of amino acid from muscle to viscera for protein synthesis occurs in humans with sepsis, as it does in animals. The CFCR demonstrated the importance to survival of visceral amino acid uptake; it was 35% in surviving patients, and only 19% in those who died. PMID- 6849635 TI - Relative efficacy and critical interval of antimicrobial agents in experimental infections involving bacteroides fragilis. AB - Activity of seven antimicrobial agents was examined using a mouse model of a subcutaneous infection that involved Bacteroides fragilis. Untreated mice had encapsulated abscesses with approximately 10(10) bacteria. Pharmacokinetic studies showed that all drugs tested penetrated into abscesses to provide mean peak levels that were 17% to 53% of mean peak serum levels. In vivo efficacy v 15 strains was measured by the reduction in counts of viable organisms when treatment was initiated one hour after challenge. This showed that the most active agents, in order of activity, were metronidazole hydrochloride, clindamycin phosphate, moxalactam disodium, and cefoxitin sodium. A delay in treatment of eight to 120 hours after challenge showed a noticeable reduction in activity, except with metronidazole. It is presumed that bacteria within an abscess are in a stationary growth phase, and this has an important influence on in vivo efficacy. PMID- 6849636 TI - Gamma scintigraphic localization of platelets labeled with indium 111 in a focus of infection. AB - To determine if autologous platelets would localize in a focus of infection, a pyogenic abscess was created in the left hind limb of dogs, using previously processed human stool, while an identical surgical procedure without bacterial inoculation was performed on the right hind limb. Autologous platelets labeled with indium 111 (500 microCi) were administered intravenously to five control dogs that had not undergone surgery, to eight dogs two hours following stool inoculation, and to five dogs 24 hours after stool inoculation. A statistically significant scintigraphic increase in tracer activity was apparent within 24 hours in each animal at the site of abscess creation. Tissue samples, obtained at 48 hours after the administration of labeled platelets, revealed a significant increase in percent dose of 111In per gram of infected muscle compared with control muscle. These studies show that platelets localize at the site of bacterial infection. PMID- 6849637 TI - Penetration of eight beta-lactam antibiotics into the peritoneal fluid. A pharmacokinetic investigation. AB - Serial serum and peritoneal fluid samples were taken after intravenous injection of cefuroxime sodium, cefoxitin sodium, cefotaxime sodium, cefoperazone sodium, ceftazidime, moxalactam disodium, mezlocillin sodium, and piperacillin sodium. Time-concentration curves were obtained for both pharmacokinetic compartments. The geometric mean of peritoneal fluid concentrations from eight to ten patients was used to define the time-concentrations curve for each substance. Serum pharmacokinetic values were calculated using an open two-compartment model. The concentrations (Cps) were calculated from peritoneal fluid concentrations by quadratic interpolation. The time for which one fourth of the Cp (Cp1/4) is maintained within the peritoneal cavity varied according to the substance and can be used to estimate dosage intervals. The Cp1/4 was compared with the minimal inhibitory concentrations for 1,344 pathogens encountered in 415 intra-abdominal infections from 31 studies. PMID- 6849638 TI - Fungal sepsis in surgical patients. AB - Records of 65 surgical patients with positive fungal blood cultures were reviewed to address risk, overall mortality, and treatment. Negative urine cultures did not rule out sepsis. Staphylococcus epidermidis sepsis was present in 27 (42%) of the patients. In 70% of whom it occurred before or during fungemia. Increased mortality correlated with the use of multiple antibiotics, antibiotic use for prolonged periods, and with associated bacterial sepsis. Stopping antibiotic therapy did not reduce mortality. Amphotericin B reduced mortality in patients with dissemination, indicating that it is the treatment of choice for disseminated fungemia and that antibiotic therapy should not be discontinued when concomitant bacterial sepsis is present. PMID- 6849639 TI - Determinants of organ malfunction or death in patients with intra-abdominal sepsis. A discriminant analysis. AB - One hundred and six patients found at operation to have intra-abdominal sepsis were prospectively followed up to determine the incidence of organ malfunction and death. These outcomes were correlated with age, preexisting disease, underlying cause of sepsis, shock, nutritional status, and alcoholism. Organ malfunction occurred in 31 patients (29%), 19 (61%) of whom died. Two (3%) of 75 patients without organ malfunction died. Discriminant analysis revealed a significantly increased risk of death in patients with shock at any time, age greater than 65 years, alcoholism, bowel infarction, or malnutrition. A discriminant equation based only on preoperative variables correctly assigned the outcome of death or survival in 97 (92%) of the patients based on probabilities derived from this analysis. At present, this information is primarily of interest for researchers comparing outcomes in groups of patients, but with additional refinements it may become clinically useful for individual patients. PMID- 6849640 TI - Cardiac tamponade and central venous catheters. PMID- 6849641 TI - The role of the penetrating wound in the development of sympathetic ophthalmia experimental observations. AB - Clinical observations have established that sympathetic ophthalmia (SO) develops after a penetrating wound but not subsequent to often more severe intraocular disturbances such as extensive photocoagulation. A feature of the penetrating wound that appears important in the pathogenesis of SO is the access it provides for intraocular antigens to reach regional lymph nodes. The intraocular compartment has no lymphatic drainage and appears to function like a number of alymphatic biologic sites. In an experimental model of SO, subconjunctival injection of retinal S antigen in one eye induced a bilateral sympathetic uveitis, whereas intraocular injection in one eye was ineffective in inducing sympathetic disease. PMID- 6849642 TI - Mode of ion movements into vitreous. Equilibration after vitrectomy. AB - Ion movements into and out of the vitreous space after closed vitrectomy were the same as in open-sky vitrectomy in rabbits. Ion increase or decrease depended primarily on passive penetration, although active transport contributed to increases during the early phase in equilibration. Ions penetrated from the entire area of tissue in contact with the vitreous space; and the posterior wall, comprising the largest area of contact, was an important route. This feature was related to compromise of the blood-retinal barrier following vitrectomy. PMID- 6849643 TI - Topical epinephrine and regional ocular blood flow in aphakic eyes of rabbits. AB - The effects of 4% topical epinephrine bitartrate on regional ocular blood flow were studied in normal, "sham-operated," and aphakic eyes of rabbits. Anterior uveal blood flow decreased in all cases, but reductions in the ciliary processes were less pronounced in aphakic eyes than in sham-operated eyes. Doubling the dose (from 2 to 4 drops) abolished this difference in the ciliary processes, but the increased dose was accompanied by the emergence of a similar (although lesser) effect in the iris. The latter dose additionally decreased retinal blood flow in aphakic eyes compared with the sham-operated eyes. Lens extraction, thus, seems to remove a notable diffusion barrier to topical epinephrine, resulting in both attenuation of its anterior segment effects and in potentiation of a vasoconstrictive response in the posterior pole. PMID- 6849645 TI - Canalicular function during herpetic keratoconjunctivitis in rabbits. AB - Canalicular function during acute herpetic keratoconjunctivitis was investigated in rabbits. Evidence of partial obstruction of the duct was obtained in the infected as compared with the mock-infected eyes. Direct damage of the ductal epithelium by virus could not be demonstrated by histologic and immunofluorescent studies. Our findings suggest that canalicular dysfunction associated with viral infection may result from accompanying inflammatory changes. PMID- 6849644 TI - Ocular penetration of amikacin following intramuscular injection. AB - Amikacin sulfate was given intramuscularly (IM) (7.5 mg/kg) to study its ocular penetration in man. Seventy-three patients with cataracts received a single dose and 35 received two doses given 5 1/2 to 12 hours apart. After a single dose the aqueous humor levels of the antibiotic between two and ten hours ranged from 0.15 to 3.10 mg/L (average and median, 1.0 mg/L). Two doses given 5 1/2 to eight hours apart produced an average level of 3.5 mg/L (range, 0.91 to 8.31 mg/L). When the second dose was given nine to 12 hours after the first, the aqueous humor levels were similar to those found for a single dose. Aqueous humor concentrations of 1.0 mg/L of amikacin would be expected to be bactericidal for most gram-negative bacterial pathogens, whereas levels of 3.5 mg/L would inhibit most strains of Staphylococcus aureus and many strains of Pseudomonas aeruginosa. PMID- 6849646 TI - Echothiophate iodide cataracts in monkeys. Occurrence despite loss of accommodation induced by retrodisplacement of ciliary muscle. AB - Five cynomolgi underwent unilateral 360 degrees ciliary muscle retrodisplacement. Beginning several months later, they received 150 to 210 micrograms of echothiophate iodine topically once daily in both eyes for five months. In all eyes anterior and posterior subcapsular lens opacities developed that were characteristic of those caused by echothiophate. There were no apparent differences in biomicroscopic appearance or time course of the cataracts between eyes with or without retrodisplaced ciliary muscles. Since eyes with retrodisplaced ciliary muscles accommodate only minimally in response to echothiophate, possible mechanical stress on the lens due to sustained, intense accommodation cannot explain echothiophate cataractogenesis. PMID- 6849649 TI - Ocular absorption. PMID- 6849647 TI - Hyaluronate in human aqueous humor. AB - Samples of aqueous humor obtained at cataract operations were analyzed for sodium hyaluronate by a recently developed radioassay. The mean value +/- SD of 47 samples was 1.14 +/- 0.46 micrograms/g. The samples from patients with diabetes and/or glaucoma did not differ substantially from the general distribution. PMID- 6849648 TI - Quantitative assessment of postsurgical breakdown of the blood-aqueous barrier. AB - Breakdown and reestablishment of the blood-aqueous barrier (BAB) following experimental surgical trauma was evaluated by anterior segment slitlamp fluorophotometry. Substantially more fluorescein leakage was caused by 6-mm limbal incisions for at least the first four postoperative days than was produced by 3-mm incisions. Following 3-mm corneal incisions, leakage of fluorescein closely paralleled that of fluorescein-labeled dextran 70 (molecular weight, 70,000) for the first three postoperative days. On the fourth postoperative day, the BAB appeared reestablished to fluorescein-labeled dextran 70 but was still abnormally permeable to fluorescein. Thus, it appears that although fluorescein is the most sensitive technique of demonstrating breakdown of BAB, it may not always be an indicator of large-molecule permeability. PMID- 6849650 TI - Radial keratotomy. PMID- 6849651 TI - Extended-wear soft contact lenses for aphakic correction. AB - Evaluation of an extended-wear perfilcon A soft contact lens (Permalens) in 299 eyes of 244 patients showed that 266 eyes (89%) were successfully fitted and wore the lenses without important complications (mean follow-up, 23 months; range, four to 48 months). Use of the lens in 33 eyes was discontinued because of transient lens-related problems. "Overcorrected" acuity of 6/12 (20/40) or better (with spectacles plus the contact lens) was achieved in all patients who were without vitreous, retinal, or optic nerve disease. Seventy-six percent of patients could wear the lens for longer than one-month intervals, and 30% removed the lens at four- to six-month intervals. There were no cases of infectious corneal ulcers or scarring or permanent visual loss. Our more limited experience with lidofilcon B lenses (Sauflon PW) (24 eyes) and the silicone lenses (Silsoft) (25 eyes) also showed beneficial results. PMID- 6849652 TI - Treatment of contact lenses with papain. Increase in wearing time in keratoconic patients with papillary conjunctivitis. AB - In 15 Keratoconic patients with papillary conjunctivitis associated with wearing rigid polymethylmethacrylate contact lenses, the cleaning of the lenses with enzymatic contact lens cleaner (papain) increased lens wearing time in nine and diminished the symptoms of mucus and itching in 12. In 13 control, lens-wearing keratoconic subjects with papillary conjunctivitis, three had a decrease, four had an increase, and six had no change in lens wearing time and one had a diminution of symptoms. Use of the enzymatic contact lens cleaner did not, however, influence the biomicroscopic appearance of the papillary conjunctivitis. The inclusion of the enzymatic contact lens cleaner in the cleaning regimen offered an adequate improvement in wearing time and tolerance for three of four patients that previously suffered a reduction in wearing time that compromised or precluded their vocational responsibilities. PMID- 6849653 TI - Corneal endothelial cell measurements in megalocornea. AB - A pedigree of megalocornea manifested many of the characteristic features as well as some less common features of the disorder. Endothelial specular microscopy of affected patients disclosed normal endothelial cell densities and morphologic characteristics and increased total endothelial cell populations, suggesting a process of total corneal hyperplasia. In contrast, unpublished data indicate diminished densities in congenital glaucoma, a finding more consistent with corneal distention. We conclude that specular microscopy may be of value in differentiating the two disorders, although larger series are necessary for confirmation. PMID- 6849654 TI - Necrobiotic xanthogranuloma of the eyelid. AB - Necrobiotic xanthogranuloma with paraproteinemia is characterized by multiple nodules or plaques that involve the periorbital area along with other parts of the body. A dysproteinemia due to an IgG paraprotein is associated with the condition; low serum complement, cryoglobulinemia, leukopenia, and hyperlipemia are also sometimes seen. Multiple myeloma is present in some cases. Two cases of necrobiotic xanthogranuloma with IgG monoclonal gammopathy were seen. Both initially had ocular symptoms and in the second case, the ocular manifestations have dominated the clinical picture. Histologically, these granulomas are characterized by collagen necrobiosis and by the presence of many foamy histiocytes and Touton giant cells. Because necrobiotic xanthogranuloma with monoclonal gammopathy frequently has prominent manifestations in the orbital region, may result in dysfunction of the eyelids or extraocular muscles, and is associated with potentially life-threatening systemic conditions, its recognition by the ophthalmologist is important. PMID- 6849657 TI - Sector B-scan ultrasonographic 'hemangiomalike' pattern. AB - Eleven patients with unilateral exophthalmos had sector B-scan ultrasonography. The ultrasonograms were all similar and demonstrated a "hemangiomalike" pattern consisting in a rounded, well-outlined orbital mass with a sharp anterior border, moderate to strong tissue reflectivity, and fair to good sound transmission. Although the postoperative pathologic findings in six cases confirmed the presence of cavernous hemangioma of the orbit, other lesions, such as hemangiopericytoma, lymphangioma, orbital varix, meningioma, and mixed cell tumor, were found to show a similar ultrasonographic pattern. PMID- 6849656 TI - Bilateral bicolored irides with Hirschsprung's disease. A neural crest syndrome. PMID- 6849655 TI - Corneal and conjunctival effects of monobenzone in patients with vitiligo. AB - Monobenzone (the monobenzyl ether of hydroquinone [Benoquin]) is used topically by patients with extensive vitiligo to depigment their remaining normally pigmented skin. A patient who had been applying the drug for one year had an anterior linear deposition of pigment in both corneas. Of 15 additional patients with vitiligo, 11 of whom were using monobenzone, acquired conjunctival melanosis in two patients and pingueculae in three may have been related to monobenzone use. Light and electron microscopy of one corneal epithelial scraping and 12 conjunctival biopsy specimens revealed pleomorphic, single-membrane-limited intracytoplasmic inclusions within the corneal epithelium and within the epithelium, fibrocytes, histiocytes, and vascular endothelium of the conjunctiva. The ultrastructural aspects of these inclusions suggested that they are residual bodies containing lipid and lipofuscin. PMID- 6849658 TI - Primary hereditary oxalosis retinopathy. AB - A female infant had progressive atypical pigmentary retinopathy with type 1 hereditary oxalosis. At the age of 3 months she had a flecked retina type of retinopathy and six months later she exhibited a unique type of atypical pigmentary retinopathy. This latter abnormality was characterized by a dense parafoveal hyperpigmented ring five disc diameters in size, and composed of a confluence of small rings of hyperpigmented retinal pigment epithelium surrounding whitish highly refractile calcium oxalate crystalline deposits. PMID- 6849660 TI - Leishmaniasis affecting the eyelids. AB - Leishman-Donovan bodies were recognized in the smear of a biopsy specimen from an eyelid ulcer. The infecting organisms were identified serologically as Leishmania braziliensis panamensis. The ulcer responded to pentavalent antimony. Ultrastructurally, the organisms had double-unit membranes, beneath which lay a palisade of microtubules. At one end of the organism, there was a rudimentary flagellum; at the other, the nucleus. A kinetoplast basal complex separated the two. PMID- 6849659 TI - Dimensions of the anterior chamber in pigment dispersion syndrome. AB - A recently introduced theory of the mechanism of the pigment dispersion syndrome is that pigment granules are released by mechanical contact between the anterior surface of zonular fibrils and the posterior surface of the pigment epithelium of the iris. A photogrammetric study of the depth of the central and peripheral anterior chamber of the iris was carried out in 37 subjects with the pigment dispersion syndrome. These subjects had deeper anterior chambers, particularly in the midperiphery, than could be accounted for by their age, sex, or refractive error. Excessive depth of the anterior chamber is demonstrated to be a risk factor in the pigment dispersion syndrome. Concavity of the midperipheral iris surface was demonstrated in this group of subjects, confirming previous clinical observations and giving additional support to the mechanical theory of pigment dispersion. PMID- 6849661 TI - Spectral transmission characteristics of intraocular and aphakic contact lenses. AB - Of seven intraocular and 13 aphakic hard contact lenses evaluated for their transmission characteristics to near UV radiation, all intraocular lenses and 12 of 13 hard contact lenses showed high transmission peaks for UV radiation between 300 and 400 nm. PMID- 6849663 TI - Medullary carcinoma of the thyroid. AB - Medullary cancer of the thyroid is rare but of unusual biologic interest. It originates in the thyroid parafollicular or C cells that are of neural crest origin and that secrete calcitonin. Calcitonin measurements, particularly after pentagastrim administration, are useful in detecting the tumor and following its progression. Ninety percent of medullary cancers are sporadic and 10% are familial; the latter may be associated with pheochromocytoma and parathyroid hyperplasia-adenoma. Initial symptoms of both the sporadic and familial varieties include thyroid mass, diarrhea, and less often, flushing. Uninvolved members of kindreds with the disease should be followed up by repeated measurements of calcitonin after pentagastrim and calcium infusion and should be treated when a positive test result is obtained. Therapy involves total thyroidectomy plus node dissection if indicated. In addition, postoperative radiation may reduce the recurrence rate. PMID- 6849662 TI - Effect of elevated intraocular pressure on blood flow. Occurrence in cat optic nerve head studied with iodoantipyrine I 125. AB - Iodoantipyrine was used to record relative blood flow in the retina, choroid, optic nerve head, lamina cribrosa, and postlaminar optic nerve of cats at different levels of intraocular pressure. The IOP could be elevated to within 25 mm Hg of mean femoral arterial pressure, with only a slight effect on blood flow in the retina, choroid, and optic nerve head. At higher IOPs, the blood flow is reduced in the retina, choroid, and optic nerve head, but, in the lamina cribrosa, the blood flow is reduced only with extreme pressure elevation and is not reduced at all in the intraorbital optic nerve. Thus, there is no demonstrated effect of IOP on blood flow preferentially in the normal optic nerve. It is concluded that there is an efficient autoregulation in the optic nerve head and lamina cribrosa so that the IOP over a wide range does not much influence blood flow under normal circumstances. These findings do not rule out a role of ischemia in the pathophysiology of glaucomatous cupping, which may be caused by faulty autoregulation. PMID- 6849664 TI - Laryngeal paraganglioma. Report of two tumors with immunohistochemical and ultrastructural analysis. AB - Paraganglionic tumors of the larynx are uncommon neoplasms and their secretory products have rarely been elucidated. We saw two patients whose laryngeal paragangliomas were examined with an electron microscope and by the use of immunocytochemical techniques. Both tumors manifested positive immunoreactivity against calcitonin and vasoactive intestinal polypeptide. One of the paragangliomas was immunoreactive against carcinoembryonic antigen and pursued a biologically malignant course. Our observations suggest the coexistence of amines and hormonal polypeptides in cells of paraganglionic tumors and demonstrate the multihormonal nature of these tumors. PMID- 6849666 TI - Maxillary sinusitis from Pseudallescheria boydii. Efficacy of surgical therapy. AB - Pseudallescheria boydii is a ubiquitous mold of soil and is a frequent cause of mycetoma in the United States. Involvement of the sinuses is extremely rare. The necessity of medical and/or surgical management is largely unknown but appears to be dependent on variables of host defense mechanisms, as the fungus is relatively avirulent. Chronic maxillary sinusitis secondary to P boydii developed in a noncompromised woman. Evidence of erosion of the bony wall of the orbit was encountered at operation. Successful eradication of this infection was accomplished with surgical drainage alone. PMID- 6849665 TI - Ultrastructure of monomorphic adenoma (ductal type) of the minor salivary glands. AB - A monomorphic adenoma (ductal type) of the palatal minor salivary glands is reported. Ultrastructurally, the predominant tumor cells contained zymogenlike dense secretory granules. There was a continuum from tumor cells with little or no secretory granules to ones with increasing numbers of granules. Except for that, the tumor cells shared many of their fine structural features. Histogenetically, the tumor originated from neoplastic proliferations of "undifferentiated" stem cells corresponding to "end-bud" stage of salivary glands embryogenesis. Under neoplastic influences, such cells underwent further cytodifferentiation and functional maturation along the secretory cell lines. In mature salivary glands, such pluripotential cells reside as "reserve" cells in the intercalated ducts. PMID- 6849667 TI - Pathologic quiz case 1. Fibrous dysplasia of bone and ossifying fibroma. PMID- 6849669 TI - Properties of the brain-stem response slow-wave component. II. Frequency specificity. AB - Frequency specificity of a slow-wave response (SWR) of the brain-stem response (BSR) was measured with a simultaneous masking tuning-curve paradigm. The SWR tuning curves to 250-Hzz tone pips show greatest sensitivity to 350- to 400-Hz maskers. The SWR tuning curves to 500-Hz tone pips are most sensitive to 500- and 600-Hz maskers. Higher-frequency tuning curves show greatest sensitivity when masker frequency is equal to signal frequency. Frequency specificity is preserved to 80-dB sound-pressure level or 55- to 65-dB sensation level. Tone-pip frequencies of 0.5, 1.0, 2.0 and 4.0 kHz appear to be adequate stimuli for eliciting a frequency-specific SWR. The 250-Hzz tone pip does not elicit a frequency-specific SWR and is probably not a useful test frequency under the present recording conditions. PMID- 6849670 TI - Frequency-selective auditory brain-stem response in newborns and infants. AB - The efficacy of the frequency-selective auditory brain-stem response (ABR) in new borns and infants was assessed using an auditory stimulus of a 1-kHz tone pip and compared with the results of click-evoked ABR. In subjects whose responses to conventional behavioral audiometry were obtained at intensities of 40 to 70 dB, the ABR thresholds evoked by 1-kHz tone pips and clicks lay between 5 and 20 dB hearing threshold level (HTL). In subjects who did not respond to conventional behavioral audiometry at the intensity of 70 dB, ABR thresholds in each auditory stimulus were elevated by 35 to 70 dB HTL, and no responses were noted at 80 to 90 dB HTL. These results indicate that frequency-selective ABR can be applied clinically as an objective method of audiometry for newborns and infants. PMID- 6849671 TI - The management of airway involvement in thyroid tumors. AB - I have reviewed 100 consecutive cases of surgically managed thyroid disease. Of those, 35% had evidence of airway involvement. The airway involvement can be classified in the following fashion: compression alone, displacement with compression, displacement without compression, infiltration of the airway with or without compression or displacement, and neurogenic dysfunction of the airway. Definitive management of these cases involved resection of the thyroid gland with decompression of the airway in compressive and/or displacement disease, and en bloc composite resection of the thyroid and involved airway in infiltrative disease. In all cases, with the exception of those involving anaplastic carcinoma, restoration of normal airway function and control of disease was possible. PMID- 6849668 TI - Total glossectomy. A technique of reconstruction eliminating laryngectomy. AB - A series of 15 patients undergoing total glossectomy for advanced carcinoma of the tongue was analyzed with regard to operative management, oral reconstruction, rehabilitation of deglutition and speech, and survival. While patients often underwent elective total laryngectomy to prevent aspiration previously, a method of laryngoplasty has now been devised that permits retention of the larynx with preservation of swallowing and speech. This technique of laryngoplasty may be used for the management of chronic aspiration of any cause. PMID- 6849672 TI - Ectopic parathyroid hormone production by a squamous carcinoma of the tonsil. AB - A patient with recurrent squamous carcinoma of the neck showed hypercalcemia with the immunoreactive parathyroid hormone (PTH) level within the upper limits of normal range, this being inappropriate for the degree of hypercalcemia. An immunoreactive peak of PTH was found in the tumor tissue extract, which appeared on column chromatography to be in the region of elution of pure bovine PTH. The tumor tissue showed positive immunoperoxidase reaction for PTH compared with negative reaction when the patient had normocalcemia. These findings are strong evidence that the tumor produced a PTHlike substance. PMID- 6849673 TI - Parathyroid localization by computed tomographic scanning. AB - Increased accuracy of parathyroid hormone assays has yielded an earlier diagnosis of primary hyperparathyroidism, often in an asymptomatic stage. Non-invasive modalities used to localize parathyroid abnormalities have not been accurate for small adenomas. Although arteriography has been shown to be accurate in detection of adenomas, the invasive nature of the study, as well as possible complications, minimizes its use in preoperative localization of parathyroid abnormalities. The computed tomographic (CT) scan was used preoperatively in eight patients to assess its accuracy in localizing parathyroid abnormalities. The radiographic findings were correlated with surgical and pathologic findings. The conditions of seven patients were correctly diagnosed preoperatively by the CT scan, including that of one patient with diffuse hyperplasia. With the increased accuracy attained by this noninvasive examination, we believe that CT scanning should be a routine part of the preoperative examination of patients with primary hyperparathyroidism. PMID- 6849674 TI - A free vascularized fibular graft in lengthening of the humerus with the Wagner apparatus. Report of a case in a twenty-year old man. PMID- 6849675 TI - Pyogenic and fungal vertebral osteomyelitis with paralysis. AB - A retrospective review of the cases of sixty-one patients with vertebral osteomyelitis revealed that the associated diseases of diabetes mellitus and rheumatoid arthritis as well as increased age and a more cephalad level of infection predisposed to paralysis. For patients with paralysis and a long-term follow-up, the prognosis for isolated nerve-root deficits is good with or without surgery. For patients with spinal cord compression, the results generally are better with anterior decompression and stabilization than with laminectomy. Early treatment should be directed at prevention of intrinsic spinal-cord damage, which is irreversible. PMID- 6849676 TI - Stria terminalis lesions alter the temporal pattern of copulatory behavior in the male golden hamster. AB - The mating behavior of a group of male golden hamsters was observed before and after bilateral electrolytic lesions or knife cuts interrupting the stria terminalis (ST). Whereas males with bilateral lesions of the medial nucleus of the amygdala had previously been observed to stop mating, a majority of hamsters with bilateral ST destruction, whether by electrolytic lesions or knife cuts, continued to display mounts, intromissions, and ejaculations during tests over a two month postoperative period. ST-lesioned males did, however, display a distinctly altered pattern of copulation over the course of postoperative testing, consisting of an increase in mount latency during the first week, an increase in the inter-intromission interval during the second week, and an increase in the number of intromissions preceding ejaculation during the third and subsequent weekly tests. Males with bilateral lesions of the caudal amygdala, which damaged the amygdaloid exit of the ST, displayed alterations in copulatory behavior similar to those seen after bilateral ST destruction at a more rostral level. PMID- 6849677 TI - Afferent pathways to points of self-stimulation in the medial prefrontal cortex of the rat as revealed by the horseradish peroxidase technique. AB - Afferent projections to points of self-stimulation (SS) in the medial prefrontal cortex (MPC) of the rat were studied using the horseradish peroxidase (HRP) technique. Intracranial microinjections of HRP (30%) were delivered at the same stereotaxic points at which the electrodes eliciting SS were located. Retrogradely transported HRP labeled neurons in different thalamic, hypothalamic, mesencephalic and pontine areas. In the thalamus, labeled neurons were found in the dorsomedial, anteromedial, anteroventral, ventral, ventromedial, posteromedial, paratenial, parafascicular nuclei and n. reuniens. Labeled neurons in mesencephalic areas were found in the n. interpeduncularis, ventral tegmental area (AVT) and substantia nigra (SN). In the pons, labeled neurons were found in the locus coeruleus and in the periaqueductal gray. Other nuclei in which labeled neurons were also found were: lateral hypothalamus (LH), periventricular gray and zona incerta (ZI). Theoretically it is possible that all these afferent areas contribute to SS of MPC. This assumption is discussed and criticized in connection with previous literature on SS. It is suggested that only specific areas and their projections are good candidates for the neural mechanisms involved in the reward produced by electrical stimulation of the prefrontal cortex. PMID- 6849678 TI - Multiple unit response in reward areas during operant conditioning reinforced by lateral hypothalamic stimulation in the rat. AB - Neural activities of various brain structures were examined during the acquisition and omission of a behavior. Forty-one rats were used. The positive reinforcer was the stimulation of the lateral hypothalamus, the effectiveness of which had been controlled in advance using the self-stimulation procedure. As original training, head movement during the presentation of an auditory signal was rewarded with the stimulation of the lateral hypothalamus. Following the acquisition of the behavior, omission training was given, during which inhibition of head movement was rewarded. In each session, multiple unit activity for 1 sec prior to the onset of the tone was compared with that during 1 sec tone presentation. In both training sessions, increases in unit activity to the tone, associated with the acquisition of the correct response, were found in the dorsomedial thalamus and the ventral tegmentum. In contrast, the neurons in the prefrontal cortex showed an increased response to the tone only during the omission training. These results suggest that the dorsomedial thalamus and the ventral tegmentum are related to the acquisition of the stimulus-reinforcer contingency, while the prefrontal cortex is related to behavioral inhibition in the omission learning. PMID- 6849679 TI - Hippocampectomy selectively disrupts discrimination reversal conditioning of the rabbit nictitating membrane response. AB - The effects of hippocampal lesions were tested on two-tone discrimination reversal conditioning of the rabbit nictitating membrane response. Results showed that hippocampectomized animals learned the initial two-tone discrimination at rates equivalent to operated control animals and animals with neocortical lesions. During reversal conditioning, however, animals with hippocampal lesions were severely impaired relative to both other groups. Neocortical lesions were without effect on reversal learning. An additional study revealed that the hippocampectomized animals' failure at reversal could not be attributed to a lesion-induced increased resistance to extinction. Results are discussed with respect to several theories of hippocampal function, and with respect to changes in the activity of hippocampal pyramidal neurons which occur during classical conditioning of the nictitating membrane response. PMID- 6849680 TI - Activity of neurons in the anteromedial cortex during rewarding brain stimulation, saccharin consumption and orienting behavior. PMID- 6849681 TI - Activity of basal forebrain neurons in the rat during motivated behaviors. AB - The activity of single neurons in the basal forebrain was recorded in the freely moving rat with moveable fine-wire electrodes. Neural activity was observed while the water-deprived male rat was exposed to three different types of motivating stimuli that elicit locomotion in a running wheel: an estrous female rat; a drinking tube containing water; and grasping and lifting by the experimenter. The neural activity was also observed when the subject was presented with standardized sensory tests and during single pulse stimulation of other brain structures. A majority of the 76 neurons recorded in the forebrain changed their firing rate during orienting and/or locomotion in general (23 neurons) or during behavior related to only one of the specific motivational contexts: the conspecific female (4 neurons); water (7 neurons); or grasp by the experimenter (8 neurons). Whereas the neurons related to orienting and/or locomotion in general were scattered through various brain structures, those neurons related to specific motivational contexts were concentrated in specific areas: the sexually dimorphic nucleus of the medial preoptic area (conspecific female); lateral septum (water); and lateral preoptic area (water and grasp). The present results, although based on relatively few neurons, are consonant with results of research using other techniques. This indicates that analyses at the level of the single neuron promise to be useful for understanding the role of the basal forebrain in motivational systems. PMID- 6849682 TI - Paleostriatal lesions in the pigeon (Columba livia) potentiate classical conditioning: evidence from fixed-interval responding, free operant go-no-go discrimination, and alternation. AB - The paleostriatum augmentatum was the major site of interest for four experiments in which pigeons were given bilateral electrolytic lesions. Experiment 1 investigated the effects of lesions on key pecking for reinforcement on a 1-min fixed-interval schedule. The lesions were found to increase total response rates, but response timing was not disrupted in paleostriatal pigeons. In Experiment 2, naive subjects were given variable-interval baseline training and, in contrast to the results of Experiment 1, paleostriatal lesions did not increase responding. Go-no-go discrimination, which followed baseline training, revealed enhanced positive behavioral contrast in paleostriatal subjects, which was explained in terms of additivity theory, and together, the results of Experiments 1 and 2 suggested potentiated classical conditioning and paleostriatal pigeons. In Experiment 3, naive subjects were given spatial alternation training, and performance was temporarily impaired following paleostriatal lesions. The same paleostriatal subjects showed superior differentiation performance in Experiment 4 with a classical go-no-go alternation procedure (which also suggested potentiated classical conditioning), and it is argued that disruption of (irrelevant) response-produced information may account for paleostriatal superiority. PMID- 6849683 TI - Mediation of the photoperiodic effect on grooming reflexes by glucocorticoid hormones and serotonin. AB - The role of serotonin and glucocorticoid hormones in the mediation of the effect of photoperiod on the size of the receptive field for grooming reflexes was determined in cats with pontile lesions. Nineteen adult male cats with pontile lesions were used to form four groups. One group of cats with pontile lesions was adrenalectomized, another group received 5,7-dihydroxytryptamine injections in the superior colliculi, and the other two groups of cats with pontile lesions were used to provide the baseline response to photoperiod. Then, for all four groups, the receptive fields for the grooming bite, lick, and scratch reflexes were determined under different photoperiods. Both adrenalectomy and 5,7-DHT treatment blocked the effect of photoperiod. After the photoperiodic manipulations, the efficacy of intramuscular injections of hydrocortisone and 5 hydroxytryptophan in abolishing the receptive fields was demonstrated. The data indicate a modulatory effect of serotonergic neurons on the photoperiodic regulation of glucocorticoid hormones. Comparisons of this study with previous photoperiodic studies established that a complex seasonal rhythm exists which is controlled by the annual rhythm in photoperiod. PMID- 6849685 TI - Reactivity of normal and VMH-lesion rats to quinine-adulterated foods: negative evidence for negative finickiness. AB - Much of the evidence for the existence of a negative finickiness component in the ventromedial hypothalamic (VMH) syndrome comes from studies comparing the relative reactivities of VMH and normal rats to quinine adulteration. The present experiments addressed two major questions regarding the response of normal and VMH animals to quinine: (a) Do the anorexic properties of quinine depend on quinine's sensory properties (i.e., its bitter taste) or on its postingestive effects; (b) do VMH rats in fact overrespond to quinine adulteration? These issues were examined by comparing the feeding adjustments to quinine by VMH and normal animals in a sham-feeding situation and under normal feeding circumstances, on animals' initial exposure to this drug. The results were consistent with the view that the sensory properties of quinine alone were sufficient to induce large changes of food intake in both groups. In terms of whether lesion rats were more reactive to the taste of quinine, it is argued that previous research had measured reactivity in two dissimilar ways. The present data were used to illuminate how use of these two procedures for measuring reactivity lead to diametrically opposed conclusions regarding the existence of negative finickiness in the VMH syndrome. It is suggested that when the more appropriate measure of reactivity is adopted and when the confound of body weight differences between normal and VMH animals is eliminated, little evidence exists for a conclusion that VMH rats are more reactive than normals to quinine adulterated foods. PMID- 6849686 TI - Analysis of licking responses in rats: effects of cholecystokinin and bombesin. AB - A detailed analysis of the licking response of rats to milk was made. The effects of cholecystokinin (CCK) and bombesin (BBS) on the consummatory response were compared. The normal licking response pattern was found not to change as the meal progressed; no predictor was found to indicate when the meal would terminate. Licks normally occurred at about six per second, but there were a few licks that occurred at about three per second, with no licking occurring in the intermediate range; thus a distinctive bimodal frequency distribution of the interlick interval was formed. Cholecystokinin was found to reduce the intake of milk and the related licking indexes as expected, but it also induced an unusual licking pattern: The contact duration was shortened, the interlick interval was lengthened, and there was an increase in the proportion of licks with long interlick intervals, the effects that accentuated the bimodality of the distribution of interlick intervals. Bombesin reduced the intake and the related licking indexes as expected; however, it did not induce any unusual licking characteristics as seen with CCK at comparable effective doses. The CCK effect may be mediated partially by a change in the motor aspect of the consummatory response; however, BBS reduced intake by simply decreasing the number of licks and shortening the intake duration. PMID- 6849684 TI - Independent effects of estradiol on water and food intake. AB - Six experiments examined the effects of estradiol on ingestive behaviors of guinea pigs. Estradiol treatment was found to reduce water intake independently of its actions on food intake and body weight. In the first experiment, minimum intake and body weight of intact female guinea pigs coincided with rupture of the vaginal membrane, the estimated time of ovulation. In a second experiment, injections of 3 micrograms of estradiol benzoate per day to ovariectomized females significantly depressed food intake, water intake, and body weight, compared with oil injections. The ratio of water intake per gram of food intake did not change significantly during the estrous cycle or following estradiol injections, results suggesting that the reduced drinking might be a consequence of the reduced feeding. However, reducing food rations to 30% below ad lib levels in Experiment 3 by itself had no significant effect on drinking. In Experiment 4, therefore, ovariectomized females were first placed on a food ration 30% below ad lib levels and then injected daily with either 3 micrograms of estradiol benzoate or oil. Compared with oil injections, these estradiol injections significantly reduced water intake, while food intake did not decline significantly. In these experiments, the reduction in food intake was therefore neither a sufficient nor a necessary condition for the estradiol-induced suppression of water intake. The last two experiments verified that estradiol has independent actions on feeding. The daily water ration was reduced to 30% below ad lib levels in Experiment 5, with no significant effect on food intake. In the sixth experiment, the water ration was first reduced to 30% below ad lib levels, and then the ovariectomized females were injected with either oil or 3 micrograms of estradiol benzoate per day. With this reduced water ration, the estradiol significantly suppressed food intake while producing only minimal and insignificant changes in water intake. These findings established that estradiol can independently influence water intake and food intake in the guinea pig and thereby indicate that estradiol operates through di different mechanisms to produce these two effects. PMID- 6849687 TI - Effects of diet on feeding and body weight regulation during pregnancy and lactation in the golden hamster (Mesocricetus auratus). AB - The hypothesis was tested that the weight loss shown by lactating hamsters constitutes a "regulated" weight loss. The results support the hypothesis: Prefattened overweight hamsters lost more weight from the time of mating to the end of lactation than did unmanipulated controls. However, the weight loss during lactation was reduced by giving hamsters access to a high-fat diet, a result indicating that a portion of the lactational weight loss may also be regulated by the diet provided. When lactating hamsters were given access to a fractionated diet consisting of pure fat, pure carbohydrate, or 45% protein, they increased their proportional intake of both protein and fat but not of carbohydrate. These studies show that hamsters differ from rats in their pattern of energy regulation during pregnancy, lactation, and the postsuckling period. Reasons for these species differences are discussed. PMID- 6849688 TI - Role of the infraorbital nerve in retrieving behavior in lactating rats. AB - Injecting the local lidocaine into the mystacial pads of primiparous rats rendered the snout insensitive to touch and abolished the dams' ability to retrieve. Injecting the drug into the masseter muscles or intraperitoneally did not render the snout anaptic or abolish retrieval, results indicating that the effect of intramystacial lidocaine treatment could not be attributed to systemic toxicity or to the drug's spreading from the mystacial pads to affect the nearby masseter muscles. Cutting the intraorbital nerves produced a temporary retrieval impairment that was indistinguishable from that produced by intramystacial lidocaine injection. Surgical deafferentation did not affect the latency of dams to approach pups that had been displaced from the nest site, which indicates that the retrieval deficit was not due to postoperative debilitation. In addition, infraorbital section did not interfere with the ability to locate and consume a piece of cheese that had been buried in the home cage, which indicates that the operation did not produce anosmia or interfere with the muscles used to grasp pups. Cutting the facial nerves abolished vibrissal movement but did not disrupt retrieval, results indicating that the effect of infraorbital lesions could not be attributed to the loss of vibrissal cues or to nonspecific effects of nerve section. The possibility was tested that infraorbital deafferentation has a profound effect on retrieval because anaptic dams, in their initial attempts at picking up pups, elicit distress vocalizations from their offspring. Dams injected with lidocaine in the mystacial pads failed to retrieve pups that had been anesthetized with a barbiturate to abolish their distress vocalizations. Thus pup-produced vocalizations are not responsible for the retrieval impairment exhibited by anaptic mothers. It is concluded that perioral tactile sensation plays an important role in the ability of lactating rats to retrieve. PMID- 6849689 TI - Can male decorticate rats copulate? AB - Sexually experienced or naive male rats, subjected to neocortex removal or neocortex plus hippocampus removal, were paired with female rats for up to 180 days and compared with control rats with respect to success and latency to impregnate the female. All of the control rats and half of the brain-damaged rats successfully impregnated female rats at least once. Success was not correlated with lesion type or presurgical experience. The brain-damaged rats took longer to impregnate the females than control rats. Since the ablations were extensive, more than 95% of the neocortex in many rats, the study shows that decorticate rats can copulate. Presumably the intact subcortical structures are sufficient for male copulation, but cortical structures in some way facilitate rapid female impregnation. PMID- 6849691 TI - [Correlation between tryptophan, NEFA and albumins in the nephrotic syndrome]. AB - Many connections were considered between bound and free tryptophan and albumins, NEFA and other aminoacids in 18 proofs in ten subjects of paediatric age affected by nephrotic syndrome. A decrease of total tryptophan and a tendency to increase of free tryptophan were showed in our experience. NEFA, at normal concentrations, should not be responsible for this; and this could suggest that the binding sites on albumins for NEFA and tryptophan are different. Besides there is appearance of a positive correlation between albumins and bound tryptophan and a negative correlation between albumins and free tryptophan. These results can suggest that the reduction of the total tryptophan is due to the loss of the fractions bound to albumins, but urinary tryptophan is not increased in our studies. As the albumins get fewer, there is a lost in linked tryptophan and an increase of free tryptophan. A total reduction of other aromatic aminoacids can also explain, through a reduced intestinal absorption, the decrease of the tryptophan in the nephrotic syndrome. PMID- 6849690 TI - Sensitivity to ethanol in inbred mice: genotypic correlations among several behavioral responses. AB - The sensitivity of several inbred strains of mice was assessed for ethanol's effects on activity, body temperature, ataxia, balance, and the righting reflex. Genotypic correlations among the mean responses for the strains were estimated as indexes of pleiotropic influences of genes on drug responses. Three major groups of genetic influence were detected: (a) hypothermic sensitivity to ethanol, (b) activity change (increase after ethanol), and (c) high basal activity. In the first group of variables, strains that had large reductions in body temperature after being given ethanol had high baseline temperatures, pronounced ataxic response to ethanol, and a long-lasting loss of righting reflex. Home cage baseline activity was negatively correlated with body temperature variables. The second group of variables was composed largely of ethanol-induced increases and decreases in activity, which were negatively intercorrelated. Strains with larger increases in activity showed more rapid loss of balance after ethanol. The third group of variables indicated that high levels of basal activity in an open field and in the home cage were determined by the action of common genes. Strains with higher basal activity levels had reduced sensitivity to ambulatory ataxia following ethanol. Thus, there were substantial pleiotropic effects of common genes on several behavioral responses to ethanol in inbred mice. Conversely, the three major groups were not systematically correlated with one another to a major extent. This suggests the influence of three reasonably distinct sets of genes on these responses to ethanol. PMID- 6849692 TI - [Chronobiological study of free thyroid hormones in hypothyroid and hyperthyroid subjects]. AB - Previous reports demonstrate a circadian rhythm of the free thyroid hormones in healthy subjects. In this study we evaluated circadian variation of FT3 and FT4 in hyperthyroid and hypothyroid states. We considered six hyperthyroid patients, six hypothyroid patients and six control subjects. Blood samples were taken two hours apart from a catherterized arm vein. Data were evaluated by Halberg's cosinor analysis. The results show that FT3 and FT4 exhibit a circadian rhythm in healthy subjects, not evident in hyperthyroid and hypothyroid patients. PMID- 6849693 TI - [Experimental observations on the iodination of phenols in the preparation of intermediates of pharmaceutical interest]. AB - A study has been made on the iodination of phenols by elemental iodine in Na2CO3 solution. The results attained by applying the suggested procedure to a number of practical cases have been very encouraging. This method gives rise to the iodine derivatives of aldehydes (2-hydroxy- and 4-hydroxy-3,5-diiodobenzaldehyd), ketones (2-hydroxy-5-iodo-, 2-hydroxy-3,5-diiodo- and 4-hydroxy-3,5-diiodo acetophenone, 4-hydroxy-3,5-diiodo-propiophenone), acids (3,5-diiodo-4 hydroxybenzoic acid, 3-formyl-4-hydroxy-5-iodobenzoic acid), aminoacids (3-iodo- and 3,5-diiodo-tyrosine), esters (methyl ester of 2-hydroxy- and 4-hydroxy-3,5 diiodobenzoic acid, methyl ester of 3-iodo-5-chloro-, 3-iodo-5-bromo- and 3,4,5 triiodosalicylic acid, dimethyl- and diethyl-ester of 4-hydroxy-5-iodo isophthalic acid), amides (2-hydroxy-3,5-diiodobenzamide) and benzoxazole derivatives (2-(2'-hydroxy-3',5'-diiodophenyl)benzoxazole). PMID- 6849694 TI - [Electrocardiographic changes induced by various analogs of radicinin]. AB - The action of some radicinin analogues has been studied on the ECG in the rat. The most active compound is 2,3-dihydro-2, 7-dimethyl-4H,5H-pyrano [4,3-b]pyran 4,5-dione (II) which induced a significant increase of the heart rate (HR) and an evident prolongation of the PR interval, especially at the highest dose. A slight but lasting increase in HR is caused by compound (VII),3-hexanoyl-4-hydroxy-6 methyl-2H-pyran-2-one, while the compound (III), 7,8-dihydro-2,7-dimethyl-4H,5H pyrano-[4,3-b]pyran-4,5-dione caused a small prolongation of the PR time. No significant modifications are caused by the other five compounds tested. PMID- 6849695 TI - [Effects of various radicinin analogs on pulse amplitude and arterial blood pressure]. AB - The action of some radicinin analogues on the pulse amplitude in urethane anesthetized rats has been studied. The compounds used are:2,7-dimethyl-4H,5H pyrano[4,3-b]pyran-4,5-dione (I); 2,3-dihydro-2,7-dimethyl-4H,5H-pyrano[4,3 b]pyran-4,5-dione (II) 7,8-dihydro-2,7-dimethyl-4H,5H-pyrano[4,3-b]pyran-4,5 dione (III) 2,3,7,8-tetrahydro-2,7-dimethyl-4H,5H-pyrano[4,3-b]pyran-4,5 dione(IV); 2,3,7,8,4',8'-hexahydro-2,7-dimethyl-4H,5H-pyrano[4, 3-b]pyran-4,5 dione (V); 3-crotonyl-4-hydroxy-6-methyl-2H-pyran-2-one (VI); 3-hexanoyl-4 hydroxy-6-methyl-2H-pyran-2-one (VII); 3-hexanoyl-5,6-dihydro-4-hydroxy-6-methyl 2H-pyran-2-one (VIII). A clear increase in the pulse has been seen with the compounds (II), (V) and (VII) especially at the lowest doses, while a decrease in the pulse is caused by the compounds (I) and (VIII). The studied substances have no effects on systolic blood pressure in normotensive unanesthetized rats. PMID- 6849696 TI - [Threshold of energy expenditure for maintenance of thermal comfort in working areas]. AB - The Authors test the possibility of improving the microclimatic conditions of some working areas by assessing the threshold energetic expenditure (KCal/hour and KCal/min) in order to maintain the thermic well-being by means of a "thermic comfort" parameter, PMV. For this purpose, we measured PMV on the basis of tg, ts, V, tun, Pa and Clo in 15 working areas. Then, by an iterative mathematical process, we calculated the threshold value of energetic expenditure in accordance with the values of PMV which show conditions of thermic comfort, that is between + 0.5 and - 0.5. In all the working areas observed it is possible to perform works requiring energetic expenditures lower than 200 KCal/h in conditions of thermic comfort; in 50% of the situations we examined even works requiring higher energetic expenditures. PMID- 6849697 TI - Time-dependency of the response to a single vagal stimulus in the rabbit heart. AB - The time-dependency of vagal effects on P-P cycle was studied in rabbits, chosen because of high heart rate, in order to verify the occurrence of this phenomenon already described for animals with lower heart rate. In five rabbits with different resting cardiac cycles, vagal stimuli were delivered randomly. The results indicate that for heart rates higher than 120 beats/min no occurrence of Brown and Eccles' time-dependency was observed. It is evident, however, the different responsiveness of the pacemaker to vagal stimuli delivered at different times of the cardiac cycle. In particular a stimulus given beyond 40-50% of the cardiac cycle does not affect the same but the next cycle. PMID- 6849698 TI - [1st-order response of neurons to angular acceleration controlled by isolated Rana labyrinth]. PMID- 6849699 TI - [Electron microscopic features of neoplastic cells (SGS-3A) cultivated in agar]. AB - The agar suspension culture method was applied to enrich for neoplastic cells in cultures of a cellular strain (SGS-3) derived from Sarcoma Galliera. This method suppresses the growth of normal cells without impairing colony formation by neoplastic cells. The analysis by electron microscopy of colonies of SGS-3A cells cultured in agar medium shows that cytoplasmatic bridges are present in the regions of cell-cell contact. PMID- 6849700 TI - [Early diagnosis of children with brain damage]. PMID- 6849701 TI - [Concepts of borderline children--minor abnormal neurological signs in early infants]. PMID- 6849704 TI - [Diagnostic procedures for hearing disorders in infants]. PMID- 6849703 TI - [Diagnosis of failure to thrive syndrome]. PMID- 6849702 TI - [Screening for chromosome abnormalities, especially for cases with sex chromosomal mosaics]. PMID- 6849707 TI - [Psychogenic diseases in children]. PMID- 6849705 TI - [Abnormal eye movements and cerebral disorders in infants]. PMID- 6849706 TI - [Blood levels of anticonvulsants during hemodialysis]. PMID- 6849708 TI - [Locked-in syndrome with bilateral midbrain infarcts--report of an autopsy]. AB - A case of "Locked-in" syndrome with bilateral midbrain infarcts was reported. A 51-year-old man had a memory disturbance and a change of his personality after head trauma, and then became rapidly "Locked-in" state. He was quadriplegic and bulbar paralytic, but ocular movements were preserved. Left VAG showed the narrowing of the basilar artery and there was a striking anastomosis between the SCA and PICA. Neuropathological findings were as the following; 1) The lateral two third of bilateral cerebral peduncles were extensively infarcted. 2) There were contusion of the left frontal orbital surface and the ischemic infarction of the left frontal white matter. 3) Two small infarcted lesions were found in the ventral pons without involving the pyramidal tracts. 4) Additional findings were retrograde degeneration of the medial nucleus of the left thalamus from the left frontal orbital lesion, and were loss of the Purkinje cells and neurons of pontine nucleus from the infarction of the middle cerebellar peduncle. Tegmentum of the midbrain, pons and medulla were preserved, which was considered to be due to the anastomosis of the SCA and PICA. Bilateral midbrain infarcts are responsible lesions in this case and it seems that "Locked-in" state is not synonymous with the "Ventral pontine syndrome". PMID- 6849710 TI - [Brain serotonin metabolism in experimental cerebral ischemia and the effect of coenzyme Q administration]. AB - Bilateral ligation of common carotid arteries of male Wistar rats was produced during fasting for the periods of 15, 30 and 60 min. Thereafter the animals were killed by decapitation, and the brain was divided into the forebrain (ischemic portion), and the brain stem and the cerebellum (blood flow maintained portions by the vertebrobasilar artery system). The above three portions were subjected to fluorophotometry of serotonin (5-HT) and 5-hydroxindole acetic acid (5-HIAA) according to the method described by Curzon. In the different series of the studies, rats pretreated with coenzyme Q (CoQ) were exposed to bilateral ligation of common carotid arteries for 60 min, and the CoQ effect upon the serotonin metabolism was investigated. The results obtained were as follows; 1. The 5-HT levels in the forebrain progressively reduced starting at 15 min (p less than 0.01), and reached to 80.2% of the control value at 60 min (p less than 0.001), while those of the brain stem and the cerebellum showed no significant changes. 2. The time-course changes of 5-HIAA levels up to 60 min were not remarkable in the forebrain and the cerebellum, while those of brain stem revealed a decreasing tendency. 3. CoQ pretreatment to sham-operated rats disclosed a gross increasing trend of 5-HT and 5-HIAA concentrations in the brain stem. 4. CoQ preadministrated brains, of which bilateral common carotid arteries were ligated for 60 min, showed a statistically significant elevation of the 5-HT in the brain stem (p less than 0.01) and in the cerebellum (p less than 0.05), while the 5 HIAA level of CoQ preadministrated brains was higher only in the brain stem as compared to that of shamoperated rats (p less than 0.05). 5. The above results would lead to the hypothesis that CoQ treatment could activate brain serotonin metabolism in case of cerebral infarct. PMID- 6849709 TI - [Continuous intracranial pressure monitoring in normal pressure hydrocephalus- with special reference to clinical significance of B wave and prognostic criteria for CSF shunting]. AB - The authors investigated the hydrodynamics in normal pressure hydrocephalus (NPH) and suggested surgical indication for identifying cases suitable for shunt operation. 48 patients with presumed NPH who underwent CT scanning, CT cisternography, and continuous monitoring of intracranial pressure for 24 hours were studied for assessing the correlation of incidence of B wave with clinicopathological features of the normal pressure hydrocephalus syndromes. The causes of NPH consisted of idiopathic of primary origin in 24 patients, subarachnoid hemorrhage in 9, head injury in 8, cerebrovascular occlusion in 3, meningitis in 2, intracerebral hematoma in one and craniotomy in one. The incidence of B waves in term of percentage of time with B waves did not correlate with the age of the patients and presence or absence of CT evidence of brain atrophy. There was a good correlation between incidence of B waves and the degree of ventriculomegaly, the presence of periventricular lucency on CT, and the grade of CSF circulation disturbance as evaluated by CT cisternography. The pathogenesis of B waves may be related to increased malabsorption of CSF in the major pathways and episodic pressure response promoting CSF absorption in the lesser pathways. Those patients who exhibit the type IV or type V on CT cisternography and B waves for more than 20% of the time monitored on continuous monitoring of intracranial pressure (ICP) responded to shunting in more than 90%. Patients showing type III-b on CT cisternography and B waves for more than 5% on ICP monitoring benefited from a shunt in about 70%. On the other hand, patients with type III-a on CTC and B waves for less than 5% of the time monitored could not be expected to respond to shunting. Incidence of B waves on continuous ICP monitoring correlated closely with response to CSF shunting. Therefore continuous ICP monitoring, combined with CT cisternography, provide a reliable indication of the potential of a patient with NPH to recover after shunting. PMID- 6849711 TI - [Effects of hypo- or hyperglycemia on brain metabolism in experimental cerebral ischemia]. AB - Glucose, lactate, pyruvate and adenosine triphosphate (ATP) concentrations in the supratentorial brain tissue frozen in situ were measured one hour after bilateral carotid occlusion in spontaneously hypertensive rats, of which blood glucose levels were varied by intraperitoneally injected insulin (hypoglycemia), saline (normoglycemia) and 50% glucose (hyperglycemia). Cerebral glucose concentrations as well as blood glucose levels were significantly increased in hyperglycemic animals, and decreased in hypoglycemic ones. Cerebral lactate, and lactate/pyruvate ratio at one-hour ischemia tended to increase in hyperglycemic animals comparing with those in normoglycemic ones, although cerebral ATP levels were slightly higher in the former. In hypoglycemic animals with one-hour ischemia, cerebral lactate was less increased but ATP was significantly reduced. It has been reported that hyperglycemia has vulnerable effects on brain metabolism of complete cerebral ischemia, presumably due to hyperglycemia-induced lactic acidosis of the brain. In incomplete cerebral ischemia as demonstrated in the present study, however, ATP concentrations remained at slightly higher level, despite tendency to more increase in lactate in hyperglycemic animals, indicating that high blood glucose level might be beneficial, rather than vulnerable, to incomplete cerebral ischemia. On the other hand, hypoglycemia causes more severe impairment of the brain energy metabolism because of an insufficient supply of substrates to the brain. PMID- 6849712 TI - [Lobar cerebral hemorrhage and amyloid angiopathy--a report of 4 autopsy cases]. PMID- 6849713 TI - [Two autopsy cases of malignant pituitary adenoma, with special reference to ultrastructural and cytochemical studies]. PMID- 6849714 TI - Treatment of hypertension in acute stage of myocardial infarction. Haemodynamic effects of labetalol. AB - Labetalol was used to treat systemic hypertension (systolic blood pressure above 150 mmHg) in 11 patients with acute myocardial infarction; its haemodynamic effects and tolerance were studied. Increasing doses of labetalol were infused to lower systolic blood pressure to less than 130 mmHg; the optimal rate was then maintained for one hour (mean rate: 2.3 mg/min). Haemodynamic variables were measured before, during, and after labetalol infusion. Labetalol lowered blood pressure in all patients; this effect was related to a decrease both in total systemic resistance (17.7 to 14 IU) and in cardiac index (3.1 to 2.7 1/min per m2); the stroke index remained unchanged and the heart rate was reduced (94 to 81 beats/min). There was no significant change in the mean pulmonary wedge pressure; it was decreased, however, in the six patients with an initial pressure greater than 15 mmHg. The double product was greatly decreased (16 497 to 8598 mmHg x beats per min), which is favourable in acute myocardial infarction. We conclude that labetalol is a drug of choice to treat hypertension in acute myocardial infarction because it is very effective; its haemodynamic effects are likely to reduce myocardial oxygen requirements and suggest that labetalol administration does not worsen moderate left sided heart failure. The drug, however, may reduce the cardiac output. PMID- 6849715 TI - Plasma vasopressin and blood pressure. Studies in normal subjects and in benign essential hypertension at rest and after postural challenge. AB - Plasma vasopressin levels were compared in three groups comprising normotensive, mildly hypertensive, and more severely hypertensive patients, both under basal conditions and following an 85 degrees head-up tilt, a stimulus known to provoke vasopressin release in man. Vasopressin levels increased two- to fivefold in all subjects after tilt; however, neither the basal levels nor the maximal levels attained at 45 to 60 minutes after tilt differed in the three groups. These data do not support the postulated role for vasopressin in the causation or perpetuation of non-accelerated essential hypertension in man. PMID- 6849717 TI - Myocardial rupture after acute myocardial infarction. Ten year review. AB - Forty-nine patients with myocardial rupture complicating acute myocardial infarction were managed in our coronary care unit from 1972 to 1981: 33 patients with post-infarction ventricular septal defect, 12 patients with isolated rupture of the free wall of the left ventricle, and four patients with papillary muscle rupture. Nine of 19 patients (47%) who underwent surgical repair of a post infarction ventricular septal defect survived. The major determinant of survival was the preoperative haemodynamic status. Ten of 13 patients (77%) who developed cardiogenic shock preoperatively died, while none of the six patients who were not in cardiogenic shock died. Survival was not related to the site or size of infarction, extent of coronary artery disease, or magnitude of the left to right shunt. There were no survivors among the 14 patients with post-infarction ventricular septal defect managed without surgical intervention. Seven of the 12 patients with isolated rupture of the free wall of the left ventricle developed mechanical cardiac arrest and died at the onset of rupture, but five patients developed subacute heart rupture and two of these patients survived after urgent surgical repair. Two of the four patients with papillary muscle rupture underwent mitral valve replacement, but both died in the early postoperative period; both patients who were not operated on died. Early detection and early surgical intervention are essential in the management of myocardial rupture complicating acute myocardial infarction. PMID- 6849716 TI - Selective blockade of retrograde fast pathway by intravenous disopyramide in paroxysmal supraventricular tachycardia mediated by dual atrioventricular nodal pathways. AB - Electrophysiological effects of 2 to 2.5 mg/kg iv disopyramide were studied in 10 patients with dual nodal pathways who used a slow pathway for anterograde and a fast pathway for retrograde conduction during paroxysmal supraventricular tachycardia (mean cycle length 308.5 +/- 37 ms; range 260-370 ms). Disopyramide terminated the tachycardia in six cases by production of ventriculoatrial block in five and by sinus overdrive in one. In the remaining four patients cycle length of the paroxysmal supraventricular tachycardia increased significantly from 270 +/- 8 ms to 377.5 +/- 28 ms. In all 10 patients disopyramide depressed retrograde fast pathway conduction manifest by an increase in mean ventricular paced cycle length producing ventriculoatrial block from less than or equal to 296.5 +/- 25 ms to 358 +/- 60 ms, and increase in retrograde fast pathway effective refractory period from less than or equal to 246 +/- 34 ms to 325 +/- 36 ms; the drug abolished ventriculoatrial conduction in two cases. Anterograde slow pathway and fast pathway conduction properties were unchanged after disopyramide (atrial paced cycle length producing AH block 292 +/- 30 to 306.5 +/ 30 ms; effective refractory period of anterograde fast pathway less than or equal to 274 +/- 56 to 284 +/- 44 ms, before and after the drug, respectively) suggesting that anterograde conduction was not crucial either for sustainment or for failure to initiate paroxysmal supraventricular tachycardia after the drug. Paroxysmal supraventricular tachycardia could not be reinduced in six cases after disopyramide. In the other four the ventricular paced cycle lengths producing ventriculoatrial block (318 +/- 41 ms) and effective refractory period of retrograde fast pathway (320 +/- 28 ms) were shorter than the cycle length of reinduced paroxysmal supraventricular tachycardia (367.5 +/- 35 ms) allowing perpetuation of the tachycardia. We conclude that disopyramide breaks atrioventricular nodal re-entrant tachycardia by specific blockade of the retrograde fast pathway though the effect on anterograde atrioventricular nodal conduction is variable. PMID- 6849722 TI - Confidential enquiry into maternal deaths. PMID- 6849720 TI - Spontaneous closure of ventricular septal defect in a case of double outlet right ventricle. AB - A 5 year old child, previously diagnosed as having tetralogy of Fallot, was admitted to hospital in severe congestive heart failure. The electrocardiogram showed left anterior hemiblock and incomplete right bundle-branch block, neither of which was previously present. The child died in intractable congestive heart failure and the necropsy showed a double outlet right ventricle with complete spontaneous closure of the subaortic ventricular septal defect by fibrous tissue. The possible mechanism involved in the production of this unusual complication of double outlet right ventricle is discussed, together with an explanation for the electrocardiographic changes. PMID- 6849719 TI - Stenosis of pulmonary veins with ventricular septal defect. A cause of premature pulmonary hypertension in infancy. PMID- 6849721 TI - Echocardiographic features of free floating thrombus mimicking right ventricular myxoma. AB - M-mode and cross-sectional echocardiography performed in a patient with acute pulmonary embolism showed a sausage shaped, mobile mass in the right ventricular cavity highly suggestive of a right ventricular myxoma. Emergency thoracotomy 24 hours later showed the right ventricle to be free of tumour but both pulmonary arteries contained embolised venous thrombi, one or more of which were thought to have given rise to the false echocardiographic diagnosis of a right ventricular tumour. PMID- 6849718 TI - Truncus arteriosus. An anatomical-angiographic study. AB - A series of 25 cases of truncus arteriosus communis examined post mortem was studied retrospectively. Fifteen of them had had angiographic studies, enabling anatomo-radiographic correlative analysis to be made. All cases had situs solitus of the atria and concordant connections between atria and ventricles. The three main components of the malformation, present in all 25 cases, were: (a) ventricular septal defect, (b) single semilunar valve, (c) anomalies of the aortopulmonary septum. The ventricular septal defect was always subarterial but its size and its relation to mitral and tricuspid valves were extremely variable. The truncal valve varied greatly also in the number of its cusps and its relation to right and left ventricles. Above valvular level the presence or absence of residual aortopulmonary septum was reflected by the presence or absence of a main pulmonary artery. Additional supratruncal malformations produced variations of the anatomy of the aorta and pulmonary arteries. The angiographic demonstration of all these components was obtained best by selective angiography using special projections. From this study it appears that there is a wide degree of variability in all of the three main components of truncus arteriosus. Such anatomical variations should be identified angiographically in each patient in order to provide enough information before corrective surgery, but they do not alter the basically homogeneous anatomy of the category of truncus arteriosus and therefore do not justify complex classifications. PMID- 6849723 TI - Comparison of the frequency of muscle pain associated with suxamethonium in pre- and post-ovulatory women and in those taking a combined oral contraceptive pill. AB - The frequency of muscle pain following the use of suxamethonium was compared in pre- and post-ovulatory women and in those taking a combined oral contraceptive pill. There were no statistically significant differences between the groups. It is suggested that serum concentrations of progestogen were too low to produce the protection against suxamethonium pains reported in late pregnancy. PMID- 6849725 TI - Cardiac arrhythmias during outpatient dental anaesthesia: comparison of halothane with enflurane. AB - In 75 young female patients undergoing extraction of 3rd molar teeth during halothane or enflurane anaesthesia, the electrocardiogram was recorded on magnetic tape and analysed subsequently for arrhythmias, using a high-speed analyser. Enflurane induced a much lower frequency of arrhythmia during surgery than halothane, but there was otherwise little difference between the two drugs in the quality of anaesthesia or recovery. Many arrhythmias occurred before exposure of the patient to enflurane or halothane; the significance of this is discussed. PMID- 6849724 TI - Comparison of the anaesthetic and haemodynamic effects of chlormethiazole and thiopentone. AB - Two groups of eight women (60-85 yr) undergoing gynaecological operations of 50 to 130 min duration were compared. Anaesthesia was induced with either thiopentone (mean 4.5 mg kg-1) or chlormethiazole (mean 6.0 mg kg-1) and maintained with nitrous oxide and pethidine in combination with the drug used for the induction. The hourly maintenance dose and the plasma concentration determined at equilibrium were greater for chlormethiazole (means 4.7 mg kg-1 h-1 and 27 mumol litre-1) compared with 1.3 mg kg-1 h-1 (P less than 0.01) and 16 mumol litre-1 respectively for thiopentone (P less than 0.02). Impedance cardiography showed that cardiac output was decreased by 30-40% in the thiopentone group (P less than 0.01), whereas no significant change was observed in the chlormethiazole group. Chlormethiazole anaesthesia was followed by a significant increase (P less than 0.02) in stroke volume. No correlations were found between the plasma concentrations and changes in the haemodynamic indices for either of the drugs. PMID- 6849728 TI - Antidepressants do not increase the lethality of ketamine in mice. AB - Swiss-Webster mice were allocated to 35 groups of 20 each, including controls, to evaluate the effect of pretreatment with antidepressant drugs on the LD50 of ketamine i.p. Deaths occurred only in groups given ketamine 400 or 600 mg kg-1. Within these groups, there were no consistent differences among untreated mice and those given one of three daily doses of either a tricyclic (amitriptyline) or monoamine oxidase inhibitor (tranylcypromine) antidepressant in their drinking water for 19 days before the ketamine injections. The ketamine LD50 values for the three major pretreatment groups were: controls 400 mg kg-1; amitriptyline 478 mg kg-1; tranylcypromine 483 mg kg-1. Although non-fatal additive toxicity is not ruled out by these findings, mortality from ketamine was not increased by pretreatment with either type of antidepressant. PMID- 6849727 TI - Influence of urapidil on intracranial pressure and intracranial compliance in dogs. AB - During induced hypotension with urapidil, measurements of intracranial pressure and of the ventricular volume-pressure response (intracranial compliance) were obtained in dogs with and without intracranial hypertension. A bolus of urapidil 50 mg plus an infusion of urapidil 8.2 +/- 1.2 mg min-1 decreased mean arterial pressure by 22 +/- 10% from control in group I (without intracranial hypertension) and by 24 +/- 8% in group II (with intracranial hypertension). In both groups there was no change in intracranial pressure or in intracranial compliance after the administration of urapidil. PMID- 6849729 TI - Anaphylaxis caused by anti-cremophor EL IgG STS antibodies in a case of reaction to althesin. AB - The action of cremophor EL, the solubilizing agent of Althesin in a case of anaphylactic reaction which occurred during the induction of anaesthesia has been demonstrated using the Prausnitz-Kustner (P-K) test 10 weeks later. This test was positive at 2 h, with the heated serum and cremophor, proving the presence of allergic IgG STS antibodies. PMID- 6849726 TI - Interactions of morphine and methotrimeprazine in mouse and man with respect to analgesia, respiration and sedation. AB - Interactions between morphine and methotrimeprazine have been studied in mice and man with respect to analgesia or antinociceptive activity, respiratory effects and sedation. The volunteer study was a double-blind cross-over trial with 10 volunteers. In mice, methotrimeprazine only possessed antinociceptive activity in doses which caused marked sedation. However, small non-sedative doses of methotrimeprazine potentiated the analgesic action of morphine. The volunteer study did not confirm this finding in man. Methotrimeprazine 7.5 mg i.m. caused significant sedation, but did not alter the effects of morphine 5 mg on pain threshold or ventilatory response to carbon dioxide. PMID- 6849730 TI - An unusual complication of extradural catheterization in obstetric anaesthesia. AB - An extradural catheter was inserted at the third lumbar interspace for relief of pain during labour in a 21-year-old gravid patient. Attempts to withdraw the catheter met with resistance and produced severe pain in the distribution of the second left lumbar nerve. Radiography revealed an acutely angled loop of the catheter over the L2-3 nerve root. PMID- 6849731 TI - Rate of entrance of benzodiazepines into the brain determined by eye movement recording. AB - 1 Peak saccadic velocity of horizontal eye movements, saccade duration at 30 degrees of amplitude and saccade reaction time were measured in six drug free male subjects. 2 In two separate experiments, intravenous doses of diazepam (5 mg), lorazepam (2 mg), chlordiazepoxide (25 mg) and placebo were given, and eye movement recordings were made before and at frequent intervals after drug administration. 3 All the benzodiazepines produced a significant impairment of peak saccadic velocity and saccade duration. Only lorazepam significantly affected saccade reaction time. 4 Time to achieve maximum effect was 10 min after diazepam, 29 min after lorazepam and 42 min after chlordiazepoxide. PMID- 6849732 TI - Effect of inhibitors of prostaglandin synthesis on hepatic drug clearance. AB - The effect of inhibition of prostaglandin synthesis on the systemic clearance of indocyanine green and antipyrine was studied in seven subjects. Antipyrine clearance was not altered by indomethacin suggesting that oxidative metabolism was not affected. Both aspirin and indomethacin decreased the clearance of indocyanine green presumably by reducing liver blood flow. These results suggest that an effect of inhibitors of prostaglandin synthesis on hepatic drug clearance is likely to be confined to high clearance drugs when given systemically. PMID- 6849733 TI - Local and systemic effects of pindolol eye drops. AB - Local (reduction of intraocular pressure) and systemic (inhibition of exercise induced tachycardia) effects of 1% and 0.25% pindolol eye drops have been studied in a balanced cross-over double-blind trial in 12 healthy volunteers. Both concentrations produced a comparable reduction in intraocular pressure while the inhibition of exercise tachycardia was significantly less with the lower concentration. PMID- 6849734 TI - Effect of sodium acetyl salicylate on cholesterol saturation of fasting gall bladder bile, with and without chenic acid. AB - The aims of this study were (a) to determine whether sodium acetyl salicylate by itself or in combination with chenodeoxycholic (chenic) acid would decrease the cholesterol saturation index (SI) of fasting gall bladder bile in man; and (b) to confirm prospectively that 8 mg kg-1 day-1 chenic acid given at bedtime together with a low cholesterol diet reduces gall bladder bile SI to a level where consistent gallstone dissolution would be expected. Seven patients were studied on each of the following regimens given in random order for 1 month each: bedtime chenic acid alone 8 mg kg-1 day-1; sodium acetyl salicylate alone 600 mg four times daily; bedtime chenic acid together with sodium acetyl salicylate; no treatment. Gall bladder samples were taken by nasoduodenal intubation at the end of each regimen and SI determined. SI (mean +/- s.e. mean) on low cholesterol diet with no drug treatment was 1.14 +/- 0.06. On bedtime chenic acid 8 mg kg-1 day-1 plus low cholesterol diet it fell to 0.83 +/- 0.03 (P less than 0.05). Sodium acetyl salicylate did not alter gall bladder bile SI. 95% confidence limits for the effect of sodium acetyl salicylate on SI were +0.03 and -0.05. We conclude that (a) sodium acetyl salicylate does not lower SI of gall bladder bile in man; (b) an adequate fall in SI for gallstone dissolution can be achieved with a reduced dose (8 mg kg-1 day-1) of chenic acid given at bedtime with a low cholesterol diet. PMID- 6849735 TI - Secondary metabolism of theophylline biotransformation products in man--route of formation of 1-methyluric acid. AB - The route of formation of 1-methyluric acid (1MU) from theophylline has been investigated by i.v. administration of 1-methylxanthine (1MX) before and after allopurinol treatment and of 1,3-dimethyluric acid (1,3DMU) to healthy male volunteers. 1,3DMU was recovered unchanged in urine and was not demethylated to 1MU. By contrast after administration of 1MX the major part of the dose was recovered as 1MU. After allopurinol this was reversed with most of the 1MX dose being excreted unchanged and only a minor amount as 1MU. The results show that 1MU derived from theophylline is formed by an initial 3-demethylation to 1MX and then a rapid xanthine oxidase mediated 8-oxidation. No 1MU is formed by 3 demethylation of 1,3DMU. PMID- 6849736 TI - Plasma binding of thiopentone in late pregnancy. PMID- 6849737 TI - Diazepam pharmacokinetics after intravenous administration in alcohol withdrawal. PMID- 6849738 TI - Effect of indoramin on human sperm motility. PMID- 6849739 TI - Observations on the mechanism underlying the differences in exercise and isoprenaline tachycardia after cardioselective and non-selective beta adrenoceptor antagonists. AB - 1 Differences in ability to attenuate isoprenaline tachycardia between the cardioselective beta-adrenoceptor antagonist atenolol and the non-selective drug propranolol, when administered in equivalent anti-exercise tachycardia oral doses, were measured in four normal volunteers. 2 Propranolol at all dose comparisons showed a greater potency in antagonism of isoprenaline tachycardia than atenolol; this ranged from 6 at the lowest doses (40 and 50 mg respectively) to 13 at the highest doses (320 and 400 mg respectively). 3 After doses of each drug which produced equal inhibition of exercise tachycardia, isoprenaline induced a greater increase in heart rate and greater decrease in diastolic blood pressure after pre-treatment with atenolol than after propranolol. 4 The contribution of this isoprenaline induced vasodilatation to the reduced tachycardia response, 1 h after 25 mg oral atenolol, was measured in the same four subjects by correction of the hypotension with an intravenous angiotensin infusion. Reversal by angiotensin of the 17 mm Hg average fall in diastolic blood pressure during the sustained isoprenaline infusion did not reduce the tachycardia. 5 The hypotension that results from isoprenaline stimulation of unblocked vasodilator beta 2-adrenoceptors in normal subjects pre-treated with atenolol appears to make a negligible contribution to the tachycardia response and does not explain the different abilities of cardioselective and non-selective beta-adrenoceptor blocking drugs to antagonise isoprenaline tachycardia. Our results are compatible with the presence of beta 2-adrenoceptors in human atria. PMID- 6849740 TI - Cardiovascular effects of alinidine and propranolol alone and in combination with hydralazine in normal man. PMID- 6849741 TI - Cardiovascular effects of indoramin in man--a dose ranging study. PMID- 6849742 TI - Changes in heart rate and forearm blood flow following intravenous boluses of isoprenaline in the presence of practolol and propranolol. AB - 1 Increases in heart rate and forearm blood flow following graded intravenous bolus injections of isoprenaline sulphate, were measured in a double-blind randomised study of six subjects who received either placebo, practolol 50 mg, practolol 200 mg, propranolol 10 mg or propranolol 40 mg. 2 Dose related increases in forearm blood flow were produced by the graded boluses of isoprenaline sulphate. 3 Practolol 50 mg attenuated the heart rate response to isoprenaline but did not significantly affect the changes in forearm blood flow. Practolol 200 mg further attenuated the heart rate responses but also decreased the forearm blood flow responses. 4 Propranolol 10 mg and propranolol 40 mg significantly attenuated both the heart rate and forearm blood flow responses. The effect on forearm blood flow tended to be greater than the effect on heart rate. 5 Practolol 200 mg had the same effect on heart rate responses as propranolol 10 mg but a significantly smaller effect on the forearm blood flow responses. 6 The measurement of forearm blood flow following intravenous bolus injections of isoprenaline provides useful information about the beta 2 adrenoceptor antagonism of propranolol and practolol. However, application of the technique may be limited by the magnitude of the heart rate response and by the short-lived nature of the increase in forearm blood flow. PMID- 6849743 TI - Relationship between myocardial uptake and actions in heart failure of methyldigoxin. AB - 1 Problems have been encountered in recent years in confirming useful benefit to patients with heart failure and sinus rhythm from acute exposure to digitalis glycosides, though effectiveness of these preparations upon cardiac contractile performance is indisputable. Undesired effects such as those upon systemic vascular resistance have been invoked to explain this. 2 Detailed haemodynamic responses have been studied by cardiac catheterisation in nine such patients for 30 min after intravenous methyldigoxin infusion. Myocardial glycoside uptake was simultaneously assessed. 3 Methyldigoxin uptake by the heart was rapid, passing its peak within 20 min, and was followed by substantial elution. 4 A small progressive and significant increase in cardiac output was observed, though left ventricular filling pressures were not significantly reduced after methyldigoxin. Cardiac contractile function as assessed by left ventricular maximum dP/dt, measured in six patients, showed consistent improvement. PMID- 6849744 TI - The effect of digoxin on 86rubidium uptake by erythrocytes from mothers and babies. AB - 1 The uptake of 86rubidium by erythrocytes from mothers and babies has been used as a model system to investigate possible differences in sensitivity to digoxin in the very young. 2 While total 86rubidium uptake was not significantly different between mothers and babies, the digoxin-sensitive proportion was higher in neonatal erythrocytes. Neonatal cells were less sensitive to digoxin, demonstrated by the requirement for a larger amount of digoxin to inhibit 86rubidium uptake and this was accompanied by an increase in numbers of specific erythrocyte binding sites for digoxin. 3 These results provide further evidence in support of the hypothesis of decreased sensitivity to digoxin in the very young. PMID- 6849745 TI - Serum digoxin determination in outpatients--need for standardization. AB - 1 Blood samples were taken from 30 outpatients for serum digoxin analysis before and after 5 min-4 h of rest in the supine position. 2 The digoxin concentration increased significantly during rest and a steady-state concentration was reached after approximately 2 h of rest. 3 The mean increase in serum digoxin after 2 h of rest was 23% with a considerable range, i.e. 0-75% (0-0.6 nmol/l). 4 On the analogy of a previous finding of a decrease in serum digoxin concentration during exercise in healthy subjects ingesting digoxin, the present results suggest that everyday physical activity affects the serum digoxin concentration. Standardized rest in the supine position prior to collecting blood samples from outpatients is therefore necessary for reliable serum digoxin determinations. PMID- 6849746 TI - Acute haemodynamic effects of a new calcium antagonist, nicardipine, in man. A comparison with nifedipine. AB - 1 The acute cardiovascular response to nicardipine was investigated using non invasive techniques in normal subjects. 2 In six subjects, i.v. nicardipine in an increasing dose (0.5-20 mg) was compared with saline, under double-blind conditions. A dose related increase in heart rate and fall in blood pressure were found. Pre-ejection period (PEP) and PEP/left ventricular ejection time (LVET) ratio of the systolic time intervals were shortened in a clearly dose related manner. Total electromechanical systole index (QS2 I) was decreased and LVET index prolonged. 3 In four subjects increasing oral doses (10-40 mg) of nicardipine, administered in a randomized double-blind placebo control design, demonstrated the same pattern, marked changes being found with the 40 mg dose. 4 Comparison with nifedipine in a double-blind-placebo controlled balanced trial in six subjects confirmed that 40 mg nicardipine and 20 mg nifedipine exhibited similar effects. Maximum response was reached between 0.5 and 1.5 h, and changes in some cardiovascular variables were still evident at 3 h. PMID- 6849747 TI - Effect of a 2 week course of oral salbutamol on adrenomedullary function in normal subjects. AB - 1 The adrenal medullary response to intravenous histamine infusions (0.1 and 0.4 micrograms kg-1 min-1 histamine base) was studied in six normal subjects. 2 After a 2 week course of oral salbutamol (8 mg slow release twice daily) plasma adrenaline levels, thought to reflect adrenomedullary function, were unchanged both at rest and in response to histamine infusion. 3 The present study does not support our original hypothesis that salbutamol may be capable of suppressing the adrenal medulla in normal subjects. PMID- 6849750 TI - Protein binding of non-steroidal anti-inflammatory drugs in plasma and synovial fluid of arthritic patients. AB - 1 The protein binding of seven non-steroidal anti-inflammatory drugs (indomethacin, tolmetin, salicylic acid, ibuprofen, flurbiprofen, naproxen and GP53,633) and warfarin was investigated by equilibrium dialysis in simultaneous samples of synovial fluid and plasma from 12 arthritic patients. 2 The protein binding of all drugs studied except warfarin and flurbiprofen was significantly lower in synovial fluid than in plasma. 3 The decreased protein binding of these drugs is likely to explain the lower total drug concentrations found in synovial fluid in comparison to plasma. 4 The lower albumin concentration plays an important role in determination of reduced drug binding in synovial fluid compared to plasma and the fatty acid concentration in synovial fluid may also influence the protein binding of some of these drugs. PMID- 6849749 TI - Effects of therapeutic drugs on lymphocyte transformation. AB - 1 Over 40 non-steroidal drugs, routinely given on a long term therapeutic basis, were tested in lymphocyte transformation cultures at high therapeutic concentrations, or in serum cultures after short term oral drug administration. Lymphocyte transformation was assessed by measuring thymidine and 2-deoxyuridine incorporation into DNA. 2 When added in vitro, salicylate significantly inhibited thymidine (48%, n = 35) and deoxyuridine incorporation (20%, n = 12). Thymidine incorporation was specifically inhibited by phenylbutazone (39%, n = 6) and chlorpropamide (48%, n = 5). Specific inhibition of deoxyuridine incorporation, indicative of impaired lymphocyte folate metabolism, was obtained following the addition of pyrimethamine (51%, n = 3) and to some extent by carbimazole (30%, n = 2). In serum cultures, pyrimethamine inhibited deoxyuridine incorporation (30%, n = 3) and chloroquine inhibited the incorporation of both thymidine (37%, n = 3) and deoxyuridine (46%, n = 3). 3 Most classes of drugs used long term are unlikely to cause any significant clinical effect, by impairing lymphocyte function. Caution may be warranted when high doses of salicylate, phenylbutazone, chloroquine, pyrimethamine, chloropropamide or combinations of these drugs are prescribed. PMID- 6849748 TI - A link between liver microsomal enzyme activity and thyroid hormone metabolism in man. AB - 1 The effect of different combinations of liver microsomal enzyme inducing drugs on thyroidal hormone steady state concentrations was investigated. Three groups of healthy volunteers were given daily either antipyrine 1200 mg together with phenobarbitone 100 mg, antipyrine 1200 mg combined with rifampicin 600 mg or rifampicin 600 mg alone for a period of 14 days. 2 Before and after each treatment the total body clearance of antipyrine, gamma-glutamyl transferase (gamma-GT), 6 beta-OH-cortisol as in vivo parameters of liver microsomal enzyme activity were measured. In addition, thyroxine (T4), free thyroxine (FT4), T3 resin uptake, tri-iodothyronine (T3) reverse T3 (rT3) and TSH were estimated. 3 After rifampicin administration there was a 60% increase in antipyrine clearance while following combinations of antipyrine-phenobarbitone or antipyrine rifampicin an 80% and 128% increase respectively occurred. 4 A marked decrease of T4, FT4 and rT3 was seen in all groups while T3 remained stable in all groups investigated. This effect may be partly due to an increase in extrathyroidal metabolism of T4 as found previously by a kinetic turnover study using 125I-T4. It also depends on the extent of the liver microsomal enzyme inducing capacity rather than on the nature of the drugs used. The striking disparity of liver enzyme induction of T4 and rT3 disposal on the one hand and T3 metabolism on the other is a unique phenomenon whose pathogenesis is not clear at the present time. PMID- 6849751 TI - The interaction of canrenone with oestrogen and progesterone receptors in human uterine cytosol. AB - 1 Canrenone, the major active metabolite of spironolactone, decreased [3H] progesterone binding to isolated uterine cytosolic progesterone receptors. The inhibition was concentration-dependent. 2 Canrenone did not alter [3H]-oestradiol binding to isolated uterine cytosolic oestrogen receptors. 3 Canrenone inhibition of progesterone binding to isolated cytosolic receptors was strictly competitive: Kd (apparent dissociation constant for progesterone binding) was increased in a concentration-dependent manner by canrenone, whereas Bmax (maximal number of progesterone binding sites/mg cytosolic protein) was unaltered. There was marked cooperativity in progesterone binding at high canrenone and low progesterone concentrations. The implication is that canrenone alters the subunit interaction of the receptor protein. 4 Kd for progesterone was 3.2 X 10(-9)M. Ki (the inhibition constant for canrenone with respect to progesterone binding) was 300 X 10(-9)M. Reports in the literature suggest that, following spironolactone administration, canrenone may rise to concentrations sufficiently high to inhibit progesterone binding. This action may contribute to the effect of spironolactone in inducing menstrual disturbances in female patients. PMID- 6849752 TI - Standardised isoprenaline sensitivity tests--a comparison of existent methods. AB - 1 Six healthy subjects (four male, two female, aged 19-24 years) received intravenous boluses of isoprenaline sulphate by two standardised methods of injection (Cleaveland et al., 1972; George et al., 1972). Heart rate changes were analysed by three different methods. 2 The I25 (dose of isoprenaline required to increase the heart rate by 25 beats/min) was not significantly altered by either the method of injection or the method of heart rate measurement. 3 The slope of the heart rate dose response curve was significantly steeper when isoprenaline was injected in a fixed 2 ml volume through a three-way tap, and when the heart rate was measured from the shortest three R-R intervals. 4 However the differences in method of injection and heart rate measurement between the two techniques do not appear to produce major alterations in the results obtained, particularly the I25. PMID- 6849753 TI - Effect of digoxin on the sensitivity to flickering light. AB - 1 The sensitivity to flickering light at various light frequencies (DeLange curve) was determined in 20 controls and 45 patients receiving maintenance doses of digoxin. 2 Flicker thresholds (mean percentage of maximal light modulation +/- s.d.; F 30 Hz) were 7.6 +/- 1.7 in controls and 9.4 +/- 1.7 in patients with optimal plasma digoxin levels (0.5-1.9 ng/ml), but they rose to 15.5 +/- 1.9 at subtoxic levels (2.0-3.0 ng/ml), and to 21.8 +/- 2.6 at toxic levels (above 3.0 ng/ml). 3 Flicker sensitivity was inversely correlated with plasma digoxin levels and returned to baseline values when the administration of digoxin was interrupted. 4 The DeLange curve seems to be a valuable tool to measure the toxic effects of digitalis on the visual system. PMID- 6849754 TI - The effects of diazepam and oxprenolol on short term memory in individuals of high and low state anxiety. AB - 1 The effect of oral doses of diazepam (5 mg) and oxprenolol (80 mg) on short term memory of normal individuals stratified for 'state' anxiety levels has been investigated. 2 Normal student volunteers were stratified into high and low anxiety groups on the basis of responses to the Spielberger 'A-state' scale. Subjects were then randomly administered active drug or placebo and given a form of running memory test performed under a variety of conditions in which variable rate of item presentation and articulatory suppression were used. 3 Diazepam significantly reduced the errors of recall in the running memory test in the high anxiety group and produced a distinct separation of response from the low anxiety group under the test conditions of slow item presentation with articulatory suppression. Oxprenolol had no effect on the short term memory test in either high or low anxiety groups in any experimental test situation. 4 These results are compared to previous work in which generally a deleterious effect of diazepam on short term memory in normal volunteers has been reported. The implications of these findings are further discussed in relationship to possible models of memory function. PMID- 6849755 TI - Effects of naloxone on post-operative pain and steroid-induced analgesia. AB - 1 In a controlled crossover study identical oral surgical procedures were performed on two separate occasions in six patients. 2 Two h after surgery, either 40 mg methylprednisolone (Solu-Medrol) or placebo (saline) was administered intravenously in a double-blind randomized fashion. 3 Five h after surgery, three patients received 4 mg naloxone (Nalonee) while 3. Five h after surgery, three patients received 4 mg naloxone (Nalonee) while three patients received placebo (saline) intravenously, followed by a crossover to alternative injections 1 h thereafter. 4 Several measurements/assessments were recorded for a paired comparison of the post-operative courses. 5 The mean pain assessment (VAS) was reduced by about 50% 45 min after the steroid injection (P = 0.03). 6 Neither increasement of the post-operative pain nor reversal of the steroid-induced analgesia could be demonstrated by injection of 4 mg naloxone. 7 Swelling was reduced by 46% on day 3 after the operation when the steroid was injected as compared to placebo (P = 0.06); on day 6 the reduction averaged 60% (P = 0.04). 8 According to overall assessments after the second operation all patients expressed clear preference for the post-operative course when the steroid was injected. 9 Present and previous results in this model with bilateral oral surgery suggest that short term corticosteroid administration deserves attention as an efficient means which may be of value in reducing pain and excessive inflammation in surgery and traumatology. PMID- 6849756 TI - The influence of a cooked meat meal on creatinine plasma concentration and creatinine clearance. AB - 1 The influence of a meal containing cooked meat (225 g) on creatinine plasma concentration, creatinine urinary excretion and creatinine clearance was determined in six healthy male subjects. 2 The meat meal produced an average 52% increase in creatinine plasma concentration within 1.5 to 3.5 h after ingestion. The 24 h area under the creatinine plasma concentration-time curve increased by about 19%. Urinary creatinine excretion during 24 h increased by an average of 13%. Creatinine clearance was not altered in response to the meal of cooked meat. PMID- 6849757 TI - Optimal sampling times for minimum variance of clearance determination. AB - 1 Clearance of a substance that follows first order kinetics can be determined from multiple plasma concentrations (the standard method) or from only one plasma concentration and an assumed volume of distribution (the simplified method). 2 On the basis of statistical considerations it is shown that the variance of the clearance determined by the standard method has a minimum when the mean sampling time is equal to the reciprocal elimination constant. For the simplified method the variance of the clearance is minimal when the sampling time is equal to the reciprocal elimination constant multiplied by one plus the ratio between the squared coefficients of variation of the concentration and the volume of distribution. 3 The sampling times determined in this way are optimal in the sense that the variance of the clearance estimate will be larger for any alternative choice of the same number of sampling times. In practice, the optimal sampling times can only be determined approximately because the elimination constant is not known exactly. The loss in precision of the clearance estimation arising herefrom will be less if the elimination constant is underestimated than if it is overestimated to the same relative extent. 4 In theory, the simplified method with optimal sampling time will give a more precise clearance determination than the standard method, if the number of optimally spaced sampling times is less than one plus the ratio between the squared coefficients of variation of the concentration and volume of distribution. In studies where each subject serves as his own control and the coefficient of variation of the volume of distribution is relatively small the simplified method will be of higher precision unless the number of samples with the standard method is unusually large. PMID- 6849758 TI - The pharmacokinetics and pharmacodynamics of the diuretic bumetanide in hepatic and renal disease. AB - 1 Bumetanide (1 mg) was given orally and intravenously to a group of patients with chronic renal failure (n = 6) and to another group with cirrhosis of the liver (n = 8). 2 The pharmacokinetics, using a two-compartment model, and the pharmacodynamics of the drug in these patients were compared with those previously obtained for normal subjects. 3 In the renal group serum bumetanide concentrations were higher than for the normal subjects and the terminal half lives were significantly prolonged (P less than 0.001). A decreased whole body clearance was attributable to a low renal clearance of drug, the non-renal clearance being significantly increased (P less than 0.01). 4 For the patients with liver disease, serum bumetanide concentrations were higher than for the renal group, and the terminal half-lives were significantly further prolonged (P less than 0.001). Both non-renal and renal clearances were significantly reduced (P less than 0.001). 5 Absorption rates were not significantly altered in either group and the values of F (bioavailability) were 0.82 and 0.95 for the patients with renal disease and hepatic disease, respectively. 6 A poor pharmacodynamic response and a reduced bumetanide excretion rate were observed for the patients with chronic renal failure, whereas with hepatic disease normal bumetanide excretion rates were observed with an impaired diuretic response. PMID- 6849759 TI - Studies on the pharmacokinetics of chlorambucil and prednimustine in man. AB - 1 Chlorambucil (10 mg) and prednimustine (20 mg), the prednisolone ester of chlorambucil, were administered orally on separate occasions to six patients. 2 Chlorambucil was rapidly absorbed such that the parent compound was observed in the plasma 30 min after administration. 3 A preliminary comparison of chlorambucil levels following oral and intravenous administration, and after repeat oral dosage indicated that chlorambucil was well (greater than 70%) and consistently absorbed. 4 Following prednimustine no parent drug or alkylating metabolites (chlorambucil or phenyl acetic mustard) could be detected in the plasma. 5 In studies with intravenously administered chlorambucil plasma levels of the parent drug were described by a two-compartment open model with first order kinetics. Significant levels of the cytotoxic metabolite phenyl acetic mustard were detected. 6 It is concluded that: a. the bioavailability of orally administered prednimustine is much lower than that of chlorambucil. Thus the use of prednimustine in routine combination therapy is not recommended. b. due to the lower therapeutic index of phenyl acetic mustard in experimental systems, the production of this metabolite in man may be disadvantageous. Thus research aimed at producing chlorambucil analogues, which cannot be metabolised, seems justified. PMID- 6849760 TI - A method to prevent the loss of isoniazid and acetylisoniazid in human plasma. AB - Plasma concentrations of isoniazid and N-acetylisoniazid were measured at varying times after addition of both compounds to plasma (5 micrograms/ml) and storage at several different temperatures (-70 degrees C, -20 degrees C, 4 degrees C and 20 degrees C). The concentration of both compounds declined log-linearly with time and the half-life of decline was shorter with increasing temperature of storage. Both compounds were stable for at least 5 weeks, however, when stored at -70 degrees C. We conclude that this temperature should be used to prevent loss of both compounds during storage and transport of samples. PMID- 6849761 TI - Failure of indomethacin to modify beta-adrenoceptor blockade. PMID- 6849762 TI - The role of naloxone infusions in the treatment of overdoses of long half-life narcotic agonists: application to nor-methadone. AB - This report describes the use of a naloxone infusion at a rate of 300 micrograms/h to provide constant antagonism of the respiratory depressant effects of a near fatal nor-methadone dose in a 2 year old boy. The terminal half-life for nor-methadone was calculated to be 13.5 h. The results indicate that a single dose of a narcotic antagonist with a short half-life (e.g. naloxone) will probably be inadequate to provide long lasting reversal of the effects of overdoses of long half-life narcotic agonists, and that continuous infusion may be the preferable to repeated bolus doses. PMID- 6849763 TI - Specific measurement of 5-aminosalicylic acid and its acetylated metabolite in human bile. PMID- 6849764 TI - Pharmacokinetics of promethazine and its sulphoxide metabolite after intravenous and oral administration to man. AB - Blood concentrations of promethazine and promethazine sulphoxide have been measured following oral and intravenous administration of promethazine to seven healthy male volunteers. Promethazine disposition is characterised by a large volume of distribution (1970 1) and a high blood clearance (1.141 min-1). Less than 1% of the dose is excreted unchanged in the urine, therefore total body clearance is essentially metabolic clearance. In accord with this high clearance the oral availability of promethazine is only 25%. The absorption of promethazine from the gastrointestinal tract exceeds 80% in most subjects. Minimal metabolism by the gastrointestinal mucosa is implicated. Promethazine sulphoxide pharmacokinetics are consistent with a pronounced first pass effect. Although the area under the curve for this metabolite is not route dependent, there is a marked alteration in the shape of the metabolite curve when oral and intravenous data are compared. Evidence is presented to support the hypothesis that S oxidation of promethazine is predominantly an hepatic event. The conclusions of previous investigators with regard to the role of the gut mucosa in S-oxidation of phenothiazines is critically assessed. PMID- 6849765 TI - Effect of age and liver cirrhosis on the pharmacokinetics of nitrazepam. PMID- 6849766 TI - Dose-response study with ibuprofen in rheumatoid arthritis: clinical and pharmacokinetic findings. AB - Clinical response and plasma pharmacokinetics were studied in 20 rheumatoid patients receiving three dosages of ibuprofen. There was a significant response to 1600 mg daily of ibuprofen by all three clinical measurements but increasing the daily dosage to 2400 mg produced no overall increase in response. The AUC increased with increasing daily drug dosages from 800 to 2400 mg daily and the dose normalised AUC fell by 15% over the same dosage range. The fraction of ibuprofen not bound to plasma proteins increased with increasing dosage and may contribute to the fall in the dose normalised AUC. There was a considerably inter individual variation in the AUC. There was no significant correlation between AUC and clinical response as measured by articular index and there was a weakly significant correlation between AUC and clinical response as measured by a visual analogue pain index. Pharmacokinetic variables probably account for only a small part of the inter-individual variation in response of rheumatoid patients treated with increasing dosages of the non-steroidal, anti-inflammatory drug ibuprofen. PMID- 6849767 TI - Antipyrine metabolism in relation to polymorphic oxidations of sparteine and debrisoquine. AB - Thirty-five healthy subjects who had been classified as extensive or poor metabolizers of both sparteine and debrisoquine were given a single oral dose of antipyrine. Saliva concentration of antipyrine and urinary excretion of its three major oxidation metabolites were measured. All the parameters of antipyrine metabolism which were estimated had similar distributions in both the 28 EM and 7 PM genetic phenotypes defined by the metabolism of sparteine and debrisoquine. The clearance of antipyrine by the formation of 4-hydroxy-antipyrine and 3 hydroxy-antipyrine respectively were closely correlated (r = 0.83, P less than 0.001) and both were significantly higher in smokers than in non-smokers. Demethylation of antipyrine also seemed to be influenced by smoking, but not to a statistically significant extent. These findings confirm the influence of the environmental factor of smoking in antipyrine oxidative biotransformations. PMID- 6849768 TI - Characterization of chloroquine plasma protein binding in man. AB - Chloroquine protein binding was determined by equilibrium dialysis of purified plasma proteins and plasma samples from 20 healthy subjects and 14 patients with rheumatoid arthritis. The mean binding was 61 +/- 9% in plasma from healthy subjects (range 46-74%) and 64 +/- 7% in plasma from rheumatoid arthritis patients (range 55-79%). Albumin and alpha 1-acid glycoprotein at physiological concentrations bound chloroquine to an approximately equal extent. Protein binding is unlikely to be an important determinant of chloroquine pharmacokinetics or response. PMID- 6849769 TI - Kinetics of oral trifluoperazine disposition in man. AB - The disposition of trifluoperazine (TFP) was studied in five healthy volunteers following oral administration of a 5 mg tablet. Using a very sensitive GC-MS technique plasma TFP concentrations were measured up until 24 h following drug ingestion. Peak plasma concentrations varied widely (range 0.53-3.09 ng ml-1) and were reached 2.8 +/- 0.5 h following ingestion of the TFP tablet. The apparent terminal elimination half-life of TFP was 12.5 +/- 1.4 h. The area under the plasma concentration-time curve differed widely between subjects (range: 5.9-17.6 ng ml-1 h) suggesting large individual differences in the extent of presystemic TFP elimination. PMID- 6849770 TI - Effects of feeding on the systemic clearance of indocyanine green and propranolol blood concentrations and plasma binding. AB - In six healthy subjects a 250 g steak significantly increased the systemic clearance of indocyanine green. During a steady-state infusion of propranolol there was a rapid decrease (mean 35%) in blood propranolol concentrations within 5 min of feeding and levels were reduced for 30 min before gradually returning towards the pre-feeding. These results suggest that the systemic clearance of high extraction drugs may be increased immediately following food. PMID- 6849771 TI - The debrisoquine hydroxylation test predicts steady-state plasma levels of desipramine. PMID- 6849772 TI - No significant effect of metoclopramide on misonidazole elimination in man. PMID- 6849773 TI - Binding of theophylline in human serum determined by ultrafiltration and equilibrium dialysis. AB - 1 Binding of theophylline (80 mumol/l) was determined in serum from healthy subjects by equilibrium dialysis and by ultrafiltration, using [3H]-theophylline, at 22 degrees C and at different pH-values. pH was regulated by gassing with CO2 or by dialysing the serum against a phosphate buffer before use. 2 Binding of theophylline in serum was 34-38% determined by equilibrium dialysis and 41-45% determined by ultrafiltration at pH 7.4-7.5. The protein concentration in serum decreased by 12-16% during equilibrium dialysis and increased by 20% during ultrafiltration. The intersubject variation in binding was small. 3 Binding of theophylline in serum was pH-dependent with 25-30% bound at pH 7.0 and 58-60% bound at pH 8.1-8.3. Binding was significantly correlated to the fraction of ionized theophylline. 4 The binding of theophylline in normal human serum is about 35-40% at pH 7.4 and 22 degrees C. The difference in binding observed between equilibrium dialysis and ultrafiltration may be explained by the opposite changes in protein concentration during the experiment. 5 Control of pH is necessary to obtain physiologically relevant data on drug binding in serum. PMID- 6849774 TI - Determinants of the plasma protein binding of theophylline in health. AB - 1 The plasma protein binding of theophylline was determined after addition of [14C]-theophylline (15 micrograms/ml) to plasma from 24 healthy drug-free volunteers and equilibrium dialysis for 2 h at 37 degrees C. 2 The percentage of drug unbound was 60.0% +/- 2.2% (s.d.) with very little variation between individuals. The binding ratio of theophylline was not significantly related to the plasma albumin or alpha 1-acid glycoprotein (AAG) concentrations but was significantly, although weakly, negatively related to the logarithm of the non esterified fatty acid concentration (NEFA) (r = 0.443, P less than 0.05). 3 Intravenous administration of heparin (1000 units) caused a significant rise in plasma NEFA concentration and in the percentage of drug unbound in plasma after equilibrium dialysis. 4 In human serum albumin solutions, the binding ratio of theophylline was significantly related to the albumin concentration and at the albumin concentration seen in the 24 normal subjects, the percentage of drug unbound was almost identical. Addition of AAG in physiological concentrations did not enhance theophylline binding but oleic acid, and to a lesser extent palmitic acid, reduced binding significantly. 5 The percentage of theophylline unbound in plasma varied markedly with pH so that at pH7 the percentage unbound was 52% greater than at pH 8. There was no evidence of concentration dependence of binding up to 140 micrograms/ml theophylline. 6 Theophylline appears to bind almost exclusively to albumin and its plasma protein binding varies little in healthy subjects, showing no concentration-dependence over the therapeutic range of concentrations. The binding is affected by pH and by NEFA concentration, however, and these factors may be of greater importance in disease states. Caution should be employed in the use of heparin in studies of plasma protein binding of theophylline. PMID- 6849775 TI - Reproducibility of saliva and plasma theophylline levels following single dose administration of two sustained release preparations. AB - 1 Concomitant saliva and plasma theophylline concentrations were measured in six healthy male volunteers following single dose administration of two sustained release preparations (Nuelin SA and Phyllocontin Continus). 2 Using mean values, a good correlation was obtained between saliva and plasma drug concentrations. Prediction of plasma values using individual saliva was poor and varied widely. The ratio of saliva to plasma concentrations in the same individual, assessed under standardised conditions, was not always reproducible. PMID- 6849777 TI - Contribution of the vagus to the haemodynamic responses following intravenous boluses of isoprenaline. AB - 1 Eight healthy subjects (six male, two female, aged 18-21 years) received graded intravenous bolus injections of isoprenaline sulphate. Heart rate and intra arterial blood pressure were continuously monitored PRE- and POST-atropine (0.04 mg/kg). 2 PRE-atropine, an increase in heart rate of 25 beats/min was produced by 2.15 +/- 0.53 micrograms of isoprenaline and was associated with a fall in mean, systolic and diastolic pressures (18.9 +/- 2.8, 17.7 +/- 3.4 and 20.4 +/- 2.3 mm Hg respectively). 3 POST-atropine, the heart rate dose response curve was shifted to the right so that the dose of isoprenaline which increased heart rate 25 beats/min PRE-atropine, produced a significantly smaller heart rate rise of 20.3 +/- 1.7 beats/min (P less than 0.001). This was associated with a shift of the blood pressure dose-response curves to the left, and larger falls in mean, systolic and diastolic pressures (30.9 +/- 2.8, 31.8 +/- 3.3, 30.1 +/- 3.3 mm Hg respectively; P less than 0.01). 4 It is concluded that there is a significant contribution from a reflex withdrawal of cardiac vagal tone, to the tachycardia produced by a bolus of isoprenaline. PMID- 6849776 TI - Cimetidine inhibits theophylline clearance in patients with chronic obstructive pulmonary disease: a study using stable isotope methodology during multiple oral dose administration. AB - 1 The effect of concurrent cimetidine administration on the disposition of theophylline was investigated in eight male patients (56-78 years) with chronic obstructive pulmonary disease (COPD). 2 The patients, who were taking oral theophylline preparations chronically (384-1020 mg/day), received a [15N], [13C] labelled analogue of theophylline (10 mg i.v.) before and during cimetidine treatment (1200 mg/day p.o.). 3 During cimetidine treatment trough levels of theophylline increased 34% (6.4 +/- 0.8 to 8.6 +/- 1.0 micrograms/ml, P less than 0.05), half-life increased 48% (6.5 +/- 0.6 to 9.6 +/- 0.8 h, P less than 0.001), and total plasma clearance decreased 33% (3.88 +/- 0.46 to 2.59 +/- 0.33 l/h, P less than 0.001), without a significant change in volume of distribution or protein binding. 4 The effect of cimetidine on plasma levels of theophylline was maximal within 72 h. Levels returned to control values within 48 h after its discontinuation. 5 Although there was no correlation with mean plasma concentrations of cimetidine, the change in clearance of theophylline correlated with initial clearance values (r = 0.72). 6 Cimetidine reduced the plasma clearance of theophylline in patients with COPD to an extent similar to that reported in healthy volunteers. PMID- 6849778 TI - Comparison of the effect of pindolol and propranolol on heart rate after acute and chronic administration. AB - 1 The present study compared the effects in healthy volunteers of the acute and chronic administration of placebo, pindolol and propranolol to see if the partial agonist activity of pindolol was reduced by the beta-adrenoceptor blocking activity of pindolol on chronic administration. 2 Five subjects received in random order for 8 days placebo, propranolol 160 mg and pindolol 10 mg; on days 1 and 8 treatments were given twice at 0 and 2 h. Heart rate in supine position and at end of exercise was recorded before dosing and at 2 and 4 h post-dosing on days 1 and 8. 3 Propranolol and pindolol reduced exercise heart rate to the same extent on days 1 and 8. 4 Propranolol reduced supine heart rate more than pindolol on days 1 and 8 but the difference was only significant on day 8. PMID- 6849780 TI - Genetically determined oxidation capacity and the disposition of debrisoquine. AB - 1 The disposition in urine of debrisoquine and its hydroxylated metabolites has been studied in subjects of the 'extensive metabolizer' (EM; n = 5) and 'poor metabolizer' (PM; n = 5) phenotypes. The 4-hydroxylation of debrisoquine by PM subjects following a 10 mg oral dose was capacity-limited and displayed significant dose-dependency over a range of 1-20 mg. In contrast, the EM subjects' ability to perform this metabolic oxidation did not deviate from first order kinetics over a dose range of 10-40 mg. 2 The disposition of debrisoquine in plasma following a 10 mg oral dose has been studied in EM (n = 4) and PM (n = 3) subjects. Whilst PM subjects displayed significantly higher plasma levels of debrisoquine at all time points following 1 h post-dosing, and higher values for areas under the plasma concentration-time curve (EM: 105.6 +/- 7.0 ng ml-1 h; PM: 371.4 +/- 22.4 ng ml-1 h, 2P less than 0.0001), neither debrisoquine plasma half life (EM: 3.0 +/- 0.5 h; PM: 3.3 +/- 0.4 h) nor renal clearance of the drug (EM: 152.8 +/- 30.3 ml min-1; PM: 137 +/- 4.5 ml min-1) displayed significant inter phenotype differences. 3 The results of these investigations show that the phenotyping of individuals for debrisoquine oxidation status by means of a 'metabolic ratio' derived from a single 0-8 h urine sample has a sound kinetic basis. The kinetic differences between the two phenotypes would strongly suggest that the metabolic defect manifested in PM subjects is one of pre-systemic elimination capacity. PMID- 6849779 TI - Prolonged variability in plasma protein binding of disopyramide after acute myocardial infarction. AB - 1 Disopyramide plasma binding was determined in vitro in plasma from 20 patients with acute myocardial infarction (aged 35-79 years) and in 20 age and sex matched healthy subjects. Plasma samples were collected on days 1, 5 and 12 after infarction and when the patient returned to the outpatient clinic. 2 In healthy subjects there was a significant negative correlation between disopyramide free fraction and plasma alpha 1-acid glycoprotein (AAG) concentration. A similar correlation was observed in the patients with myocardial infarction, however this correlation was dependent on time elapsed after infarction. Disopyramide free fraction did not correlate with albumin concentration in either group. 3 Mean plasma AAG concentrations were increased by 63% within 5 days after infarction and had returned to initial levels some months later (73.5 +/- 7.8 days). On each of the four sampling days, a two to four fold individual variability in plasma AAG concentrations was observed. 4 Maximum increases in disopyramide plasma binding were shown on days 5 and 12 after infarction. These increases were dependent on both drug and AAG concentrations. Increases in fraction bound were greater at the higher drug concentrations. Within the usual therapeutic plasma range for disopyramide (2 to 5 mg/l), the mean increases in fraction bound, compared to day 1 data, varied from 22 to 45% respectively. 5 Sequential alteration in AAG concentration after infarction indicates that disopyramide plasma binding may not reach a steady state until some months after infarction. Prediction of the time to achieve this steady state would be difficult due to inter- and intra-patient variability in binding. PMID- 6849782 TI - Disposition of hexobarbitone in healthy man: kinetics of parent drug and metabolites following oral administration. AB - 1 Hexobarbitone plasma kinetics were determined in six healthy volunteers, who received 500 mg hexobarbitone orally. In addition urinary excretion rate and cumulative excretion were measured of its three major metabolites: 3' hydroxyhexobarbitone, 3'-ketohexobarbitone and 1,5-dimethylbarbituric acid. 2 The mean plasma elimination half-life of hexobarbitone was 3.7 +/- 0.9 h (n = 6). Assuming complete absorption, the volume of distribution and the metabolic clearance were 81.3 +/- 20.5 1 and 16.4 +/- 2.9 1/h, respectively. The mean maximal plasma concentration was 7.1 +/- 2.1 micrograms/ml and was reached 1.2 +/ 0.4 h after drug administration. 3 3'-Hydroxyhexobarbitone and 3' ketohexobarbitone, which are products of allylic side-chain oxidation of hexobarbitone, were excreted in 24 h to the extent of 4.7 +/- 1.3 and 32.1 +/- 11.9% of the dose, respectively. In the same period, 1,5-dimethylbarbituric acid, which is the end product of the epoxide-diol pathway, was excreted to 18.0 +/- 7.8% of the dose. The ratio of the sum of 3'-hydroxy- and 3'-ketohexobarbitone vs 1,5-dimethylbarbituric acid excreted varied with time and amounted ultimately in 24 h urine to 2.3 +/- 1.0. 4 The half-lives of 3'-hydroxyhexobarbitone and 1,5 dimethylbarbituric acid, calculated from their renal excretion rate curves, amounted 5.2 +/- 0.9 and 6.6 +/- 1.3 h and were significantly longer than the half-life of hexobarbitone in plasma. The half-life of 3'-ketohexobarbitone was 4.2 +/- 0.8 h. The maximum excretion rate of 1,5-dimethylbarbituric acid was reached at 7.7 +/- 1.0 h after administration of hexobarbitone. 3'-Hydroxy- and 3'-ketohexobarbitone were excreted with a maximal rate at 2.2 +/- 0.8 and 2.8 +/- 0.4 h respectively. PMID- 6849781 TI - An intensive drug monitoring study suggesting possible clinical irrelevance of impaired drug disposition in liver disease. AB - 1 Liver disease can alter the disposition and clinical effects of drugs. However, even though altered drug disposition occurs, there is no clinical evidence relating it to an increased susceptibility to adverse drug reactions (ADRs). 2 An intensive prospective drug monitoring study of 2,582 hospitalized patients was conducted. The adverse drug reactions probability scale (APS) was used to assess ADRs. Only non-mild, definite or probable ADRs (APS greater than or equal to 5) were included. Severity of liver dysfunction was assessed by a composite clinical and laboratory index (CCLI). 3 The frequency of ADRs was higher in 402 patients with cirrhosis (27.4%) than in 661 with renal dysfunction (22.8%) and in 249 with other parenchymatous liver diseases (13.7%) or in 1,270 patients with neither liver diseases nor renal dysfunction (10.9%) (chi 2 3 = 85.53, P less than 0.001). The frequency of ADRs in cirrhotics was highly correlated with the severity of the liver dysfunction measured by CCLI (r = 0.82, P less than 0.001). 4 Drugs predominantly eliminated by liver metabolism were not among those most commonly inducing ADRs or those causing severe reactions in cirrhotics. Thus, frusemide caused the most common and the most severe ADRs, whereas reactions induced by sedatives were uncommon. Drug-induced hepatic encephalopathy was more common in cirrhotics receiving diuretics (13.3%) than in those receiving sedatives (1.8%) (chi 2 y.c. = 5.29, P less than 0.025). Patients with alcoholic liver disease had more drug-induced hepatic encephalopathy (7.7%) than those with non-alcoholic liver disease (1.2%) (chi 2 y.c. = 11.86, P less than 0.001). 5 These results indicate that susceptibility to ADRs is increased only in severe cirrhosis and that the most common and severe ADRs seem more likely related to enhanced pharmacodynamic action than to impaired drug disposition. PMID- 6849783 TI - Labetalol disposition and concentration-effect relationships during pregnancy. AB - 1 Labetalol pharmacokinetics and concentration-effect relationships following intravenous administration have been studied in 10 women during the last trimester of pregnancies complicated by hypertension, in seven of these women postpartum (when normotensive) and in 10 normotensive female volunteers. 2 The clearance and volume of distribution of labetalol were the same in all three groups. Clearance values (1 min-1) were: pregnant, 2.16 (range 1.54-3.14); postpartum 2.35 (1.56-3.85); controls 1.96 (0.98-2.61). Volumes of distribution (1) were: pregnant 274 (250-547); postpartum 407 (248-701); controls 234 (186 415). 3 A linear model relating labetalol concentration to effect successfully described the antihypertensive action of labetalol in the pregnant patients. Supine systolic blood pressure fell by 0.38 (0.14-0.91) mm Hg per ng ml-1 of labetalol and diastolic by 0.36 (0.21-1.14) mm Hg per ng ml-1 of labetalol. In the other two groups labetalol did not lower pressure sufficiently to allow modelling to be performed. 4 We conclude that pregnancy does not alter the clearance or volume of distribution of labetalol. Modelling techniques can be applied successfully to drug induced blood pressure changes during pregnancy. PMID- 6849784 TI - Disposition of chloroquine in man after single intravenous and oral doses. AB - 1 Chloroquine was given in 300 mg single doses as an i.v. infusion, an oral solution and as tablets at intervals of at least 56 days to 11 healthy volunteers. Concentrations of chloroquine and its metabolite desethylchloroquine were measured in plasma, erythrocytes and urine using h.p.l.c. 2 Chloroquine was detectable in all plasma samples up to 23 days and occasionally up to 52 days after dosage. Urinary concentrations were monitored up to 119 days. The disposition pattern was multiexponential reflecting extensive tissue binding of the drug. 3 After i.v. dosing the volume of distribution ranged from 116 to 285 l/kg and the apparent terminal half-life from 146 to 333 h. Total plasma clearance +/- s.d. was 712 +/- 166 ml/min and renal clearance 412 +/- 139 ml/min. The mean estimated urinary recovery of chloroquine was 47%, 42% and 46% after i.v., oral solution and tablets indicating nearly complete bioavailability. The corresponding figures for the metabolite were 7%, 10% and 12%. 4 The disposition of chloroquine in erythrocytes was parallel to that in plasma. The concentrations in erythrocytes were consistently 2 to 5 times higher than in plasma. 5 Subjective side effects like difficulties with swallowing and accommodation, diplopia and fatigue occurred during intravenous infusion and were closely related to plasma concentrations. No effect was seen on the electrocardiogram, mean arterial blood pressure and pulse rate. No adverse reactions were observed after the oral doses. High frequency audiometry did not reveal any significant hearing impairment for the group as a whole. PMID- 6849785 TI - Variations in drug free fraction during alcohol withdrawal. AB - 1 Free fractions of diazepam, propranolol and warfarin were determined in 15 male chronic alcoholics in alcohol withdrawal. 2 On admission the mean free fraction of diazepam was 25% above and propranolol 44% below the limits of normal range, while the mean warfarin free fraction was in high normal range. One week later mean free fraction of diazepam declined by 20% while propranolol and warfarin increased by 24% and 19% respectively (P less than 0.05). 3 Propranolol free fraction and alpha 1-AGP concentrations were highly correlated (linear r = -0.83, P less than 0.001). In contrast the sources of variation in diazepam and warfarin free fraction were more complex and less certain. 4 Statistically significant changes of drug free fractions in serum of chronic alcoholics were observed during alcohol withdrawal. The extent and direction of these changes differed for various classes of drugs and their potential causes appear to be quite different. 5 Clinically important changes in drug effect may be present acutely, within the dosing interval, as a result of altered drug binding. These are more likely when the clinical response is closely related to drug concentration and will occur within the dosing interval due to larger fluctuations in free drug concentration, even though the average free drug concentration will remain unchanged. 6 Total drug level changes will be observed during alcohol withdrawal even in absence of detectable changes of drug metabolism. PMID- 6849786 TI - Paracetamol absorption from Paramax, Panadol and Solpadeine. AB - Plasma paracetamol concentrations were measured after oral administration of three pharmaceutical preparations to four healthy volunteers. The formulations were Paramax (paracetamol with metoclopramide), Solpadeine (paracetamol with codeine and caffeine) and Panadol (paracetamol alone). After Solpadeine, concentrations at 15 min were significantly higher than after Panadol. Absorption of paracetamol from Paramax tablets did not differ significantly from Solpadeine or Panadol. PMID- 6849787 TI - On finding depressed patients for clinical trials. PMID- 6849788 TI - The influence of food intake on the bioavailability of timegadine, a novel non steroidal anti-inflammatory drug. AB - The effects of food ingestion on the absorption of timegadine, a recently synthesised non-steroidal anti-inflammatory drug, was studied in ten healthy volunteers. It was found that food enhanced the absorption of timegadine as shown by increased peak plasma concentrations (Cmax), decreased time taken to achieve these concentrations (tmax), and increased area under the plasma concentration time curve (AUC). PMID- 6849789 TI - The interaction of cimetidine with metoprolol, atenolol, propranolol, pindolol and penbutolol. PMID- 6849790 TI - Chloroquine intoxication. PMID- 6849791 TI - Oral contraceptives and breast cancer: final report of an epidemiological study. AB - During 1968-1980, 1176 women aged 16-50 years with newly diagnosed breast cancer and a like number of matched controls were interviewed at 9 teaching hospitals in London and Oxford and asked about their use of oral contraceptives. The results were reassuring. A few statistically significant differences in oral contraceptive use were found between the breast cancer and control groups, but the data were subdivided in many ways so that some "significant" differences would have been expected through the play of chance alone. Certainly no patterns of risk emerged which would suggest that any of the associations were causal. It must be stressed, however, that the data are still sparse in some important subcategories--for example, only small numbers of both cases and controls had prolonged oral contraceptive use before their first term pregnancy. For this reason, it is important that information on the possible relationship between pill use and breast cancer should continue to be collected. Women who had never used oral contraceptives presented with appreciably more advanced tumours than those who had been using oral contraceptives during the year before detection of cancer, while past users were in an intermediate position. These differences in staging were reflected in the pattern of survival. Possible explanations for these observations include "surveillance bias" among oral contraceptive users leading to earlier diagnosis and a beneficial biological effect of oral contraceptives on tumour growth and spread. Women with breast cancer reported never having used any method of contraception and heavy cigarette smoking (greater than or equal to 15 per day) significantly less often than controls. We could find no obvious explanation for the former observation, but suspect that the latter reflects the unrepresentative smoking habits of our hospital controls rather than a protective effect of smoking against breast cancer. PMID- 6849793 TI - The use of serum deoxythymidine kinase as a prognostic marker, and in the monitoring of patients with non-Hodgkin's lymphoma. AB - A recently developed enzyme assay, utilizing [125I]-iododeoxyuridine as substrate, and capable of detecting normal levels of serum deoxythymidine kinase (s-dTk), was used in an investigation of sera from 155 untreated patients with non-Hodgkin's lymphoma (NHL). The patients were classified at the discovery of disease, both according to spread (stages I-IV according to the Ann Arbor classification) and to tumour histology (the Kiel classification). The results showed a significant correlation between s-dTk level and the extent of disease, as well as to the malignancy; i.e. the more advanced the disease or the more aggressive the tumour, the higher the s-dTk values. Greater than 100-fold increases in s-dTk levels were found in some patients compared to those reported for healthy individuals. A high pretreatment level of s-dTk for patients in stages III-IV correlated with a poor prognosis for the patient in terms of survival. This was consistent even when only patients in stages III-IV with "high grade" malignant lymphomas were included in the analysis. Longitudinal studies of s-dTk levels in 19 NHL patients showed that s-dTk increases with progression of the disease, decreases during successful therapy, and finally increases during relapse. It is concluded that s-dTk could be used both as a prognostic marker and to monitor the effect of therapy in NHL patients. PMID- 6849792 TI - Diet, alcohol, tobacco and risk of cancer of the pancreas: a case-control study. AB - In view of the increased incidence of pancreatic cancer and the possible aetiological role of certain dietary factors, a retrospective epidemiological study was undertaken to investigate the roles of tobacco, alcohol, fat, protein and carbohydrate intakes. Sixty-nine patients with pancreatic adenocarcinoma, and 199 normal subjects were interviewed. Data were obtained on life time drinking, smoking and dietary habits. Conditional logistic regression models were used to analyse the relative risk variations. It was shown that the relative risk of cancer of the pancreas increases with fat and alcohol intakes, does not vary with protein intake, and decreases with carbohydrate intake and duration of alcohol consumption. Alcohol may be not directly involved in the aetiology of cancer of the pancreas: its effect could be due to the contents of some alcoholic beverages. PMID- 6849794 TI - A short-term in vitro test for tumour sensitivity to adriamycin based on flow cytometric DNA analysis. AB - A new method to test the sensitivity of tumour cells to chemotherapy is presented. Tumour cells were incubated in vitro on agar, and drug-induced cell cycle perturbation was monitored by flow cytometric DNA analysis. In the present study the method was applied to monitor the effect of adriamycin on an adriamycin sensitive Ehrlich ascites tumour and two adriamycin-resistant tumours. Adriamycin caused a dose-related accumulation of tumour cells in the G2 + M phase in the sensitive tumour. Drug concentrations greater than or equal to 100-fold higher were required to induce similar changes in the resistant tumours. The dose level causing maximum accumulation in the G2 + M phase is suggested as a parameter for quantifying the sensitivity. The results indicate that the method can be extended to sensitivity testing of human tumours. PMID- 6849795 TI - The mode of action of cis dichloro-bis (isopropylamine) trans dihydroxy platinum IV (CHIP) studied by the analysis of chromosome aberration production. AB - The induction of chromosome damage by the Platinum complex CHIP in Chinese hamster ovary (CHO) cells has been studied, together with the relationship between cell survival and aberration frequency. The type and frequency of chromosome aberrations observed in asynchronous and G1 phase treated cells indicated a similar mode of action to that of bifunctional alkylating agents. A log-linear relationship was observed between the frequency of chromatid aberrations (excluding gaps) and the level of survival after CHIP treatment, with approximately one aberration per cell corresponding to 37% survival. PMID- 6849798 TI - Stability of the glycoproteins from a primary human pancreatic carcinoma during cell culture and in vivo passage in nude mice. PMID- 6849797 TI - Concanavalin A acceptor glycoproteins: a new type of marker for the classification of tumour cells. AB - The Con A acceptor glycoproteins of murine and human tumour cell lines revealed by two-dimensional fingerprinting on polyacrylamide gels fall into two main categories: constant glycoproteins expressed by all cell lines and variable glycoproteins which are only expressed by particular tumour cell lines. Since the number of variable glycoproteins on a typical fingerprint is 50, fingerprints from different cell lines are readily distinguishable. However the variable glycoproteins are not expressed idiosyncratically and cell lines derived from similar classes of tumours express similar patterns of the variable glycoproteins. For example, murine fibrosarcomas express patterns which are virtually identical with one another. Characteristic patterns are also expressed by murine macrophage tumour lines, human carcinomas and human B lymphoblastoid cells. Thus, the variable glycoproteins behave as a set of linked markers which are indicators of the type of normal pre-neoplastic precursor cell from which a tumour is derived and appear to be a new type of marker for tumour cell classification. Antibodies to these glycoproteins could prove useful in tumour localisation and diagnosis. PMID- 6849796 TI - Promotion mechanism of phenobarbital and partial hepatectomy in DENA hepatocarcinogenesis cell kinetics effect. AB - Diethylnitrosamine (DENA, 10 mg kg-1 per day) was fed to rats for 2, 4 and 6 weeks. One week after the cessation of DENA, animals were submitted either to partial hepatectomy or to phenobarbital administration. Partial hepatectomy did not promote neoplastic transformation, except after a 6-week DENA treatment. A minimum of phenobarbital was required to reach a significant promoting effect in DENA carcinogenesis. A too-limited treatment was ineffectual but could be compensated for by prolonged DENA administration. The phenobarbital treatment became unnecessary when neoplastic nodules were present. Phenobarbital continuously given after the carcinogen administration promoted neoplastic transformation even after a subcarcinogenic DENA treatment (2 weeks). It accelerated the pathological evolution and increased the tumour incidence. In these conditions, phenobarbital increased the proliferation advantage of preneoplastic cells over normal cells. In the different experimental modalities, the promoting effect was associated with the induction of chronic cell proliferation, the inhibition of the rapid response to the 2/3 partial hepatectomy and the mitotic circadian rhythm normally present during liver regeneration. It is concluded that the promotion mechanism could consist in disturbing the mitotic control in order to maintain, for a long time, a chronic low level of cell proliferation permitting the selective growth of preneoplastic cells and their subsequent transformation. PMID- 6849799 TI - Exclusion of host cells during spheroid formation from disaggregated solid tumours. PMID- 6849800 TI - Tumour epithelial cellularity and quantitative oestrogen receptor values in primary breast cancer. PMID- 6849801 TI - The association of cytosol oestrogen and progesterone receptors with histological features of breast cancer and early recurrence of disease. AB - Two hundred and eighty-eight primary breast tumours were examined for the presence or absence of oestrogen (REc) and progesterone (RPc) receptors. Analysis has shown a relative interdependence between the steroid receptor status of primary breast cancer and other prognostic variables such as histological grade, lymphocytic infiltration and tumour elastosis. There were significant associations between epithelial cellularity, stromal fibrosis and the value of REc in those tumours in which the receptor was present. Cellularity and fibrosis were unrelated to the presence or absence of oestrogen receptor. By contrast, neither the presence or absence nor the value of RPc could be related to cellularity or fibrosis. The value of REc and RPc analysis as an indicator of prognosis was examined in a sub-group of 175 patients receiving no additional treatment following mastectomy. Overall relapse-free survival (RFS) was no different for those patients with receptors compared to those without them (REc P = 0.11, RPc P = 0.7). There was no difference in RFS of receptor positive and negative tumours when the axillary node status was taken into account. PMID- 6849802 TI - Effect of 17 beta-oestradiol on growth curves and flow cytometric DNA distribution of two human breast carcinomas grown in nude mice. AB - The effect of 17 beta-oestradiol on a "receptor positive" and on a "receptor negative" human breast carcinoma grown in nude mice was studied. Experimental growth data were used to determine the effect on tumour growth. Flow cytometric DNA analysis (FCM) performed on tumour tissue obtained by sequential fine-needle aspirations was used to estimate the effect on the cell cycle. In the receptor positive breast carcinoma, oestradiol induced complete tumour regression and characteristic cell cycle changes. In the receptor-negative breast carcinoma, no changes in tumour growth and cell cycle distribution could be demonstrated following the treatment. The results indicate that the oestradiol-induced cell kill could be explained to some extent by the induction of polyploid cells, which eventually die. Since the cell cycle changes monitored by FCM in the receptor positive breast carcinoma appeared prior to any reduction in the tumour size, the results suggest that FCM may prove a valuable method in the early detection of tumour response to hormone treatment in human breast cancer. PMID- 6849803 TI - Modification of CCNU pharmacokinetics by misonidazole--a major mechanism of chemosensitization in mice. AB - We have investigated the effect of misonidazole (MISO) on the pharmacokinetics of 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) in mice. CCNU and its monohydroxylated metabolites were measured using a high performance liquid chromatography (HPLC) method. In the absence of MISO the plasma disappearance of CCNU was biphasic with a t 1/2 alpha of 2.3 min and a t 1/2 beta of 53 min. The monohydroxylated metabolites of CCNU also followed biphasic clearance kinetics. A large single dose of MISO (0.5 mg g-1), given i.p. 30 min prior to CCNU, prolonged the t 1/2 alpha by a factor of 2.6 but had no effect on t 1/2 beta. In addition, the apparent volume of distribution was decreased by a factor of 1.6. Consequently, the plasma area under the curve (AUC0 - infinity) was increased by a factor of 1.7 for CCNU and by a factor of 2.0 for total nitrosourea (CCNU + monohydroxylated metabolites). The effects of MISO on CCNU kinetics were dependent on MISO dose and plasma concentration and on the interval between MISO and CCNU administration. The concentration of CCNU was measured in 4 tumours: the KHT, RIF-1 and EMT6 mouse tumours, and the HT29 xenograft. For all 4 tumours, 0.5 mg g-1 MISO raised the tumour concentrations of CCNU and total nitrosourea by a considerable amount (2-2.5 times). More detailed studies in the KHT tumour demonstrated that there was a significant lag period before peak tumour CCNU concentrations were reached, and that MISO increased the peak concentrations by a factor of about 2.4. In contrast, there was no such lag period for the plasma and MISO did not increase the plasma peak CCNU concentrations. These data strongly suggest that modification of the pharmacokinetics may be a major contributory factor in the enhancement of CCNU cytotoxicity by large single doses of MISO in vivo. PMID- 6849805 TI - The production of abnormal cells and Reed-Sternberg-like cells from normal lymphocytes. PMID- 6849806 TI - Improving the detection of hepatic metastases by the use of dynamic flow scintigraphy. PMID- 6849807 TI - Direct evidence for the single cell origin of mouse liver cell tumours. PMID- 6849804 TI - Incidence of familial Hodgkin's disease. AB - The family histories of 131 patients with histologically defined Hodgkin's disease (HD) were studied and 2,517 first and second degree relatives and spouses were identified and followed-up. The causes of death in deceased relatives were ascertained from death certificates. The numbers of deaths from selected causes were compared with the numbers that would be expected if the relatives had suffered the same mortality rates as the Scottish national population. A 4-fold increase in deaths due to HD was found among first and second degree relatives of patients with the disease (6 cases observed compared with 1.4 expected). Five of the 6 familial cases were related to index patients with the mixed cellularity form of the disease, the remaining case was the brother of a patient with the lymphocyte-depleted form of the disease. The increased risk was seen among relatives of both young and older patients and there was no consistent intrafamilial similarity in age of onset or time of onset of disease. PMID- 6849809 TI - Staging and grading in breast cancer. PMID- 6849808 TI - The cytoplasmic malate dehydrogenase in neoplastic tissues; presence of a novel isoenzyme? PMID- 6849811 TI - Metabolism of glycosaminoglycans of cultured rat aortic smooth muscle cells altered during subculture. AB - We observed the changes in the metabolism of glycosaminoglycans of cultured smooth muscle cells from the rat aorta during subculture. The primary culture was achieved by the enzymatic dispersion method. The metabolism of glycosaminoglycans in smooth muscle cells was estimated by measuring the incorporation rate of D-[1 14C] glucosamine and [35S] sulphate. Smooth muscle cells were harvested by trypsinization, and glycosaminoglycans were separately extracted and purified from trypsin digest and cells. In the cells of the stationary phase of primary culture, the incorporation of both D-[1-14C] glucosamine and [35S] sulphate into dermatan sulphate was greater than that into heparan sulphate. However, in the trypsin digest, the incorporation of D-[1-14C] glucosamine and [35S] sulphate into dermatan sulphate was less than and equal to that into heparan sulphate. In both the cells and the trypsin digest, the incorporation of D-[1-14C] glucosamine and [35S] sulphate into heparan sulphate decreased and that into dermatan sulphate increased with increase in the number of passages. These results indicate that there is a development of serial modulation in the metabolism of glycosaminoglycans in the cultured smooth muscle cells, in the early passage of subculture and that such should be taken into consideration when analysing the observations. PMID- 6849810 TI - Hormonal and metabolic changes during acute myocardial infarction in normotensive vs hypertensive rats. AB - Male and female, normotensive, Sprague-Dawley (S-D) rats, and spontaneously hypertensive rats (SHR) were subjected to acute and massive myocardial infarction with isoproterenol. Some of the animals were pre-treated (7 days) with the prolactin-lowering drug, bromocryptine. SHR survived in greater numbers than S-D but developed massive congestive heart failure of late onset. The adrenal glands and hearts became greatly hypertrophied in parallel with severely involuted thymus glands. ECG tracings demonstrated intense tachycardia and myocardial ischaemia. Bromocryptine reduction of prolactin (PRL) showed no effect on ECG tracings but reduced triglyceride, free fatty acid, total cholesterol and glucose levels. Isoproterenol caused dynamic increase in glucose, free fatty acids and triglycerides. CPK levels demonstrated greater cardiac damage in S-D vs SHR; greatly elevated SGOT and SGPT levels confirmed the presence of fatty liver in S D and SHR. Myocardial infarction caused marked increase in circulating PRL in females only and sustained increases in aldosterone and corticosterone. SHR survivors had a high incidence of atrial and ventricular thrombi, left ventricular aneurysms, and intense fibroplasia and cartilaginous metaplasia in areas adjacent to damaged myocardium. It is suggested that adrenal steroidogenesis during an acute myocardial infarct favours survival and more complete myocardial repair in females vs males, and preexisting hypertension in SHR is associated with hormonal and metabolic response patterns different from normotensive S-D rats. PMID- 6849812 TI - Prevention of carbon tetrachloride-induced liver necrosis by several amino acids. AB - Aspartic acid, cystine, methionine and tyrosine were protective against carbon tetrachloride (CCl4)-induced liver necrosis 24 h after its administration, when given 30 min before the hepatotoxin. Aspartic acid, cystine and tyrosine were also effective when given as late as 6 h after CCl4. The protective effects of these amino acids, however, were no longer evident when observations of CCl4 induced necrosis were made at 72 h, except for cystine, which retained its protective potential. Protective amino acid administration did not modify the concentration of CCl4 in liver, nor did it decrease the intensity of the covalent binding of CCl4 reactive metabolites to cellular constituents or the CCl4-induced lipid peroxidation. Consequently, protection cannot be attributed to modulation of these parameters. Cystine, tyrosine and aspartic acid significantly lowered body temperature of the CCl4-treated rats, while methionine did not. Combined, these results suggest that the protective effect is not attributable to lowering of body temperature in CCl4-treated animals. Protection probably results from changes in the cell response to injury promoted by amino acid administration. PMID- 6849813 TI - Experimental production of pulmonary granulomas. IV. Eosinophilic granuloma. AB - Pulmonary granulomas induced in rabbits by the endobronchial instillation of mycobacterial chemical fractions were re-examined for eosinophilic infiltration. Delayed type hypersensitivity reactions either of tuberculin type or of wax D type did not induce but rather suppressed eosinophilic infiltration in the inflamed area, although some peptidoglycans which are antigenic for the induction of immediate hypersensitivity and fatty acid fractions were weak stimulators of eosinophilic infiltration. Bacterial endotoxin, LPS, was a potent stimulator. It was found that some long chain fatty acids can cause severe eosinophilic infiltration in the induced granulomas. Arachidonic acid was the most active of those examined, so the activity of its metabolites was tested and PGE2 was found to be most active. As the eosinophilic infiltration was markedly suppressed in animals treated with a cyclooxygenase inhibitor (aspirin), the stimulators of eosinophilic infiltration were not fatty acids themselves but their metabolites, PGE2 and some others. The site of permeation of eosinophils from the circulation was found to be arteriolar in the inflamed lung. The granulomatous lesion with eosinophilic infiltration in rabbits is discussed to shed light on the aetiology of eosinophilic granuloma in the human lung. PMID- 6849814 TI - Characterization of the cytotoxin produced by macrophages in response to dengue virus-induced cytotoxic factor. AB - We have observed earlier that dengue type 2 virus-induced cytotoxic factor (CF) induces macrophages to produce a cytotoxin (CF2) which kills mainly the macrophages, some of the T lymphocytes and has no effect on B-lymphocytes of normal mouse spleen. The findings of the present study show that CF2 is heat labile, trypsin-sensitive and unstable at acid and alkaline pH. It is a low molecular weight product as it is dialysable, non-sedimentable on ultracentrifugation at 103,500 g for 3 h and passes through 0.22 micron Millipore filter. It is adsorbed onto the target normal mouse spleen cells. The properties of CF and CF2 have been compared. PMID- 6849815 TI - Prevention of morphological changes of great arteries in coarctation of the aorta with antihypertensive therapy. AB - The possibility of preventing morphological changes in arterial walls in coarctation of the thoracic aorta with antihypertensive therapy was evaluated in an experimental study on dogs. Seven mongrel dogs weighing 2350-2980 g were operated upon at the age of 2 months. Antihypertensive therapy with a diuretic (hydrocholothiazide 25 mg/day), beta-blocker (propranolol and 80 mg/day) and vasodilatator (prazosin ad 40 mg/day) was started 1 month after the experimental coarctation was produced in the animals. Blood pressure decreased significantly, although not to the level of the control group. Seven months after the coarctation a perfusion fixation was done. Morphometrical light microscopic analysis was performed on the coronary and cerebral arteries. The histochemical findings in the aorta were analysed qualitatively, as was the amount of lipid in the coronary and the middle cerebral arteries. Electron microscopic studies were performed on the coronary artery. The findings were compared to the control and coarctated (non-treated) groups studied earlier (Uhari et al., 1982). Active antihypertensive therapy prevented all the major morphological changes previously reported to occur in coarctation. We suggest that active antihypertensive therapy started immediately after the diagnosis of coarctation might improve the prognosis of the patients with aortic coarctation by preventing morphological changes in the great arteries. PMID- 6849816 TI - Occurrence of disseminated intravascular coagulation in rat BNML leukaemia despite lack of leucocyte procoagulant activity. AB - Signs of disseminated intravascular clotting were observed during the development of BNML myelomonocytic leukaemia in rats, when the peripheral leucocyte count exceeded 20,000/microliters and more than 50% blasts were present in the circulation. BNML cells, harvested from blood and tested in appropriate systems, were found devoid of any procoagulant activity (PCA) even following prolonged in vitro incubation with endotoxin. Thus, it appears that these rat leukaemic cells share the same inability to express PCA which had been previously described in peripheral blood mononuclear cells from normal rats. Conceivably, in this rat model, leucocyte PCA does not represent a major trigger of intravascular coagulation and blood clotting is initiated by other, mainly plasmatic, pathways. PMID- 6849817 TI - Fluid-overload pulmonary oedema in mice: the intercellular junctions of bronchiolar epithelium and arterial endothelium. AB - It has been reported previously that fluid leaks through the intercellular junctions of arterial endothelium and bronchiolar epithelium in fluid-overload pulmonary oedema in mice. In this study, freeze fracture technique was used to see morphological changes in the intercellular junctions at these sites. In arterial endothelium, the intercellular junction consists of a combination of gap junctions and tight junctions. In this experiment, only the tight junctions were disrupted. In bronchiolar epithelium, the tight junction was disrupted. The other sites in the vascular system and respiratory surface did not show any changes in the morphology of intercellular junctions. Thus, this study confirms the previous study and provides some structural correlation for the changes of permeability in fluid-overload pulmonary oedema. PMID- 6849820 TI - A comparison of the phototumorigenic potential of 8-MOP and 5-MOP in hairless albino mice exposed to solar simulated radiation. AB - Hairless albino mice have been treated with topically applied 8-methoxypsoralen and 5-methoxypsoralen at two concentrations and exposed to solar simulated radiation. Both these compounds significantly increased the incidence of cutaneous tumours when compared with controls irradiated after treatment with vehicle. This effect was related to psoralen concentration and at the two concentrations investigated there was no significant difference between the compounds. PMID- 6849818 TI - Inhibition of the expression of pathology in dystrophic mouse leg muscles by immobilization. AB - Normal and dystrophic calf muscles of young mice of the Bar Harbor strain Re 129 were immobilized with the foot in an extended position. Two weeks after treatment the muscles were examined morphologically. Immobilization resulted in the inhibition of fibre necrosis and, consequently, of regeneration. In the contralateral leg these processes progressed unhampered and gave rise to typical dystrophic features. As a result of treatment there was some muscle fibre atrophy. The results clearly indicate that injury of muscle fibres is of a true "myogenic" nature, and that mechanical, i.e. contractive, activity is an important factor inducing damage to the sarcolemma of dystrophic muscle fibres. PMID- 6849822 TI - In vitro growth rates of epidermal cells derived from the skin of psoriatic patients and non-psoriatic controls. AB - The growth of epidermal cells derived from clinically normal skin of psoriatic patients and controls has been studied in culture. Growth rates were measured in secondary cultures established with 5 x 10(4) cells/35 mm plate without feeder layers by determining the plating efficiency, and cell yield and surface area of growth at the end of a 14-day culture period. There was no significant correlation of plating efficiency, cell yield/colony or surface area/colony with the sex or age of the donor in either the normal or psoriatic groups. The morphological development of normal and psoriatic epidermal cell cultures was similar. Comparisons of plating efficiency, cell yield/colony and surface area/colony for the normal and psoriatic groups revealed no significant difference. PMID- 6849821 TI - Stimulation of pigmentation in melanoma cells by trimethylpsoralen in the absence of ultraviolet irradiation. AB - The effects of trimethylpsoralen and 8-methoxypsoralen on the pigmentary characteristics of cultured murine melanoma cells were investigated in the absence of ultraviolet irradiation. Stimulation of pigmentation was assayed by gross examination of centrifuged cell pellets, light microscopy of cells, electron microscopy, a biochemical determination of cell tyrosinase activity, and a chemical determination of cell melanin content. It was found that an adequate concentration (10(-5) M) of trimethylpsoralen for an adequate exposure time stimulated pigmentation in the dark, whereas 8-methoxypsoralen in the same experimental setting did not stimulate pigmentation. PMID- 6849823 TI - Diffusion barriers in skin--a new method of comparison. AB - Using a method which allows the net barrier potential of skin to be expressed in terms of a 'penetration half-life', skin barriers to nandrolone and allyl oestrenol penetration were compared in human, rat and hamster skin. The ranking order in terms of the net barrier was: human = haired rat greater than or equal to hairless rat greater than hairless hamster. Using the same principles, the net barrier effects of the various layers in whole human skin were also compared. The dermis was only slightly less effective than the stratum corneum as a barrier to diffusion. PMID- 6849824 TI - Immune responses of patients with tinea imbricata. AB - Tinea imbricata is a chronic dermatophyte infection caused by Trichophyton concentricum affecting large areas of the skin surface. Spontaneous improvement is unusual and relapse after apparently successful treatment is common. In this study in Papua New Guinea it was found that a high proportion of infected patients had immediate-type hypersensitivity (52%) or negative responses (46%) to intradermal trichophytin. The majority of patients failed to develop delayed-type hypersensitivity on skin testing or as assessed in vitro by leucocyte migration inhibition. However, 78% of patients investigated had antibody to T. concentricum. The relevance of T-lymphocyte hyporeactivity to persistence of the infection is discussed. PMID- 6849819 TI - Therapeutic significance of nocardicin A stimulation of phagocyte function in experimental Pseudomonas aeruginosa infection. AB - Nocardicin A, a monocyclic beta-lactam antibiotic with modest anti-pseudomonal activity in vitro, controlled an otherwise fatal Pseudomonas infection in mice when given in doses which produced blood levels well below the minimum bactericidal concentration. In even smaller doses, it converted the partial protection afforded by modest doses of carbenicillin into full protection. Human polymorphonuclear leucocytes exposed to low concentrations of the drug in vitro and peritoneal macrophages recovered from mice treated with nocardicin A exhibited an unusually specific form of enhanced activity. Chemotaxis and phagocytosis were not affected, but intracellular killing of Ps. aeruginosa was significantly increased. This was shown to be due to an effect on the phagocyte and not to facilitated killing of organisms damaged by extracellular exposure to the antibiotic. It is argued that the effect on phagocyte function is sufficient to contribute materially to the therapeutic effect of nocardicin A. PMID- 6849825 TI - Recent upper respiratory tract infection and pityriasis rosea: a case-control study of 249 matched pairs. AB - A sample of 249 patients was drawn from an original population of 939 patients with pityriasis rosea identified in an earlier population-based study of pityriasis rosea in Rochester, Minnesota. A control was selected for each case, matched for age, sex, and year of diagnosis. Comparison was made with regard to recent immunization, history of atopy, and recent infection. A statistically significant number of patients had experienced recent upper respiratory tract infection (P less than 0.005). The association between recent infection and pityriasis rosea is discussed. PMID- 6849828 TI - Balloon cell melanoma: a case report. PMID- 6849829 TI - Trauma-induced bullae: the presenting feature of systemic amyloidosis associated with plasma cell dyscrasia. PMID- 6849827 TI - Urticarial vasculitis with shock, leukopenia and thrombocytopenia, possibly due to anaphylatoxin release. PMID- 6849826 TI - Hydroxychloroquine versus phlebotomy in the treatment of porphyria cutanea tarda. AB - Hydroxychloroquine and phlebotomy were compared in the treatment of porphyria cutanea tarda (PCT). Thirty patients received hydroxychloroquine (200 mg twice weekly) for 1 year and thirty-one underwent twice-monthly phlebotomies of 400 ml whole blood each, also for 1 year. Clinical signs of disease improved equally in both groups. At the end of the year, urinary porphyrin excretion had significantly improved in twenty-two out of thirty hydroxychloroquine-treated subjects, but in only eight out of the thirty-one patients who received phlebotomy. Liver histology showed significant regression of steatosis and siderosis in both groups compared with the pretrial biopsy, but the activity of liver disease, as judged by the extent of necrosis, inflammation and fibrosis, worsened in twelve hydroxychloroquine and in seven phlebotomy-treated patients. It is concluded that hydroxychloroquine is more effective than phlebotomy in decreasing porphyrin production. However, further work is needed to assess whether long-term hydroxychloroquine treatment favours the progression of the chronic liver disease associated with PCT. PMID- 6849830 TI - The 5q--syndrome: an underdiagnosed form of macrocytic anaemia. AB - Since the description in 1974 of the 5q--syndrome, only 29 cases have been reported. Over a 3 1/2 year period cytogenetic culture of bone marrow submitted from 344 patients being investigated for a blood disorder revealed nine patients with anomalies of chromosome 5. In five of these patients (samples arising from 37 patients being investigated for refractory macrocytic or aplastic anaemia) the 5q-syndrome was diagnosed. The clinical and haematological findings of this syndrome are reviewed and attention is drawn to the importance of reviewing megakaryocytic numbers and morphology in refractory macrocytic anaemia if the diagnosis is to be considered. The diagnosis is compatible with prolonged survival and establishing it prevents repeated and unnecessary investigation. PMID- 6849831 TI - Colchicine ultrasensitivity of lymphocytes in chronic lymphocytic leukaemia. AB - It has been previously reported that, in comparison with normal lymphocytes, the lymphocytes in chronic lymphocytic leukaemia (CLL) are ultrasensitive in culture to the cytocidal action of colchicine. In this report the results of 240 colchicine studies in 87 patients with CLL are presented and analysed in terms of the diagnostic, clinical and haematological significance of colchicine ultrasensitivity (CUS) in CLL. All patients with CLL showed very significantly increased CUS of lymphocytes. The CUS did not vary with clinical and haematological status or time and only very rarely with treatment. There was no correlation between % CUS and subsequent course or survival. The results in CLL and in other forms of lymphocytosis and in non-Hodgkin's lymphoma are compared. It is concluded that the test is of considerable diagnostic value, particularly in identifying low-count and treated CLL and in the exclusion of non-CLL lymphocytosis. It appears to have no prognostic value but may have future application in monitoring treatment which selectively eliminates the abnormal cell population. PMID- 6849832 TI - Fibrinogen Manchester: identification of an abnormal fibrinopeptide A with a C terminal arginine leads to histidine substitution. AB - Purified samples of fibrinogen Manchester, a congenital dysfibrinogenaemia with impaired fibrinopeptide A (FPA) release, were digested with thrombin. Amino acid sequencing of the fibrin showed that FPA had been completely released. High performance liquid chromatographic (HPLC) analysis of the clot supernatant showed the presence of a new peptide eluting ahead of the normal FPA. The amino acid composition and sequence of the new peptide established its identity as a variant of FPA containing histidine in position 16 instead of the usual arginine. The chromatograms from both siblings with the defect demonstrated that they were heterozygous for this clotting defect. PMID- 6849834 TI - Abnormal haemoglobin, thalassaemia and G-6-PD deficiency in Libya. PMID- 6849833 TI - Spectrin-haemoglobin crosslinkages associated with in vitro oxidant hypersensitivity in pathologic and artificially dehydrated red cells. AB - Protein crosslinkages are apparent at 215 000-250 000 daltons in electrophoregrams of membranes from hydrogen peroxide treated erythrocytes (British Journal of Haematology, 48, 435, 1981). Hydrogen peroxide is also capable of inducing crosslinkages of identical molecular weights in stage I and II (red) ghosts and in a mixture of purified spectrin and haemoglobin, but not in white ghosts or in either spectrin or haemoglobin alone. Autoradiographic studies using 14C-methaemoglobin and 32P-spectrin confirm the involvement of spectrin and haemoglobin in this reaction. The alpha chains of both proteins are more reactive than the corresponding beta chains: 3 times more reactive in the case of spectrin and 10 times more reactive in haemoglobin. The reaction is almost totally inhibited by NaCN and partially inhibited by N-ethylmaleimide. Direct addition of malondialdehyde to a spectrin-haemoglobin mixture does not result in protein crosslinkage. Metabolic depletion (40 h), in vivo ageing and sucrose dehydration of fresh, normal cells enhance the reaction considerably, whereas in vitro rehydration of xerocytes normalizes their H2O2 sensitivity. PMID- 6849836 TI - Studies of the efficacy and potential hazards of methylene blue therapy in aniline-induced methaemoglobinaemia. AB - The similarity between poison and antidote was known to the ancient Greeks who used the same word, pharmakon, for both. This paper presents evidence that aniline (the toxin) and methylene blue (ther therapy) are in fact remarkably similar and additive in some of their effects on erythrocytes. Studies were prompted by a case of aniline-induced methaemoglobinaemia in which two injections of methylene blue did not rapidly eliminate cyanosis and were followed by severe, delayed haemolysis. Interactions between aniline and methylene blue were studied in cats which, although showing important differences from man in their haemoglobin and splenic vasculature, represent a useful model. Methylene blue potentiated the oxidative denaturation of haemoglobin by aniline as judged by the size and number of Heinz bodies and their turbidity in haemolysate. It also aggravated and prolonged the fall in erythrocyte reduced glutathione content which occurred at a time of maximum Heinz body production. While methylene blue in judicious dosage will reduce the content of methaemoglobin after aniline exposure, it may not eliminate visible cyanosis. Repeated injections of methylene blue can markedly aggravate subsequent haemolysis without further lowering methaemoglobin content. PMID- 6849835 TI - Haemoglobin H (HbH) disease and severe glutathione peroxidase deficiency: an undescribed association in a mentally retarded child. PMID- 6849837 TI - Serum erythropoietin titres in the anaemia of premature infants. AB - Erythropoietin (EPO) titres in the serum of premature infants were determined by an in vitro method using radioiron incorporation into haem in fetal mouse liver cells in culture. The serum EPO titres in 12 premature infants at birth were significantly lower than those of normal adults. In those premature infants who developed anaemia the serum EPO titres increased significantly by 4-6 weeks after birth, confirming that EPO production increases in premature infants in early days of life. PMID- 6849839 TI - Coexistent myelodysplasia and plasma cell neoplasia. AB - The oncogenic effect of alkylating agents, particularly that of melphalan, has been postulated as the most likely cause of myelodysplastic syndrome (MDS) and acute leukaemia in patients with plasma cell neoplasia. Five patients aged between 69 and 79 years were found to have features of MDS at the time of diagnosis of multiple myeloma. In three of these cases MDS transformed into acute leukaemia. These patients had not received any chemotherapy prior to their presentation. The possible importance of these features is discussed. PMID- 6849838 TI - Anaemia in myelofibrosis: its value in prognosis. AB - Forty-four patients with myelofibrosis were investigated in our hospital in the period 1971-81. Their clinical, laboratory and radioisotope parameters were analysed. The direct correlation between plasma volume and splenic red cell pool has highlighted the role of the spleen in the dilutional anaemia seen in myelofibrosis. 52Fe quantitation enabled us to show that the bone marrow contributes relatively more to effective erythropoiesis than the extramedullary sites. The prognostic value of changes in plasma volume and bone marrow 52Fe activity has been demonstrated. We have shown that the Hb: reticulocyte relationship at diagnosis can be used to recognize probable stages of the disease and provides a useful prognostic determinant. PMID- 6849841 TI - Erythrocyte membrane skeleton abnormalities in hereditary spherocytosis. AB - Erythrocyte ghosts from eight individuals with hereditary spherocytosis have been compared with respect to their protein compositions as judged by SDS gel electrophoresis, their ease of spectrin extractability, and their freeze-etch electron microscopic appearance after incubation in condition designed to promote aggregation of the intramembrane particles. Four of these HS cases were unrelated, while the other four represented two generations from a single family, including a pair of identical twins, one of whom had not undergone splenectomy when this investigation was initiated. Of the four unrelated cases, one showed no departures from normal under the conditions of this investigation, whereas the other three exhibited features which suggested a membrane skeleton lesion. In one of these there was a reduced proportion of spectrin tetramers relative to dimers in 4 degrees C extracts, while the two remaining cases exhibited abnormal intramembrane particle aggregation. The four related cases had almost identical variations from normal. Spectrin was not extractable from their ghost membranes during a mild extraction incubation which removed spectrin from normal control ghosts. However, the intramembrane particle aggregation subsequently induced in these ghosts was of a degree unobtainable in normal ghosts without such spectrin extraction. In addition the ghosts from one twin, the only one of these patients who had not undergone splenectomy at the start of this investigation, showed a reduced amount of band 4.2. However, when this patient's blood was re-tested after splenectomy, this protein was found to be at normal levels. Our results support the view that hereditary spherocytosis is not a single disease, but is rather a term used to describe a variety of different molecular lesions of the erythrocyte membrane skeleton with similar clinical manifestations. PMID- 6849842 TI - Penicillin-G degradation products inhibit in vitro granulopoiesis. AB - 38% of penicillin-G in solution decays at 20 degrees C within 24 h, 50% at 37 degrees C and 66% within 3 h at 56 degrees C. These degraded penicillin-G solutions strongly inhibit growth and maturation of granulocytic stem cells in vitro. Inhibitory concentrations are in the range obtainable with high dose penicillin therapy in vivo. No cytotoxicity of degraded penicillin solutions on bone marrow cells was seen over 24 h. It is suggested that penicillin-G degradation products are responsible for severe granulocytopenia observed after high dose penicillin-G therapy. PMID- 6849843 TI - Circulating granulocyte and macrophage progenitor cells in primary and secondary myelofibrosis. AB - Patients with primary myelofibrosis (PMF) and myelofibrosis secondary to carcinoma (SMF) were compared with regard to circulating granulocyte macrophage progenitor cells (CFU-GM) using in vitro tissue culture techniques. Although increased numbers of CFU-GM had previously been well documented in PMF, few patients with the secondary variety had been studied. Our data indicate that there is an increase in circulating CFU-GM in patients with SMF but it is significantly lower than in those with PMF. It is suggested that in both conditions disruption of the marrow microvascular system results in a release of CFU-GM to the circulation. In PMF stem cell colonization of the spleen with its consequent myeloid metaplasia may be responsible for the additional increase in CFU-GM. The determination of CFU-GM numbers may provide additional data to help to distinguish PMF and SMF in atypical cases where the distinction is unclear. PMID- 6849840 TI - Defective spectrin dimer-dimer association in a family with transfusion dependent homozygous hereditary elliptocytosis. AB - Red cell membrane proteins have been examined in a family in which three children have severe transfusion-dependent homozygous hereditary elliptocytosis. The membranes in all three show a considerable excess of spectrin dimers over tetramers in spectrin extracts. The red cell membranes of their parents with heterozygous hereditary elliptocytosis show a lesser but significant increase in spectrin dimers. Some of the family members also have an alpha-globin gene deletion and haemoglobin D trait. The present results are the first demonstration of a defect of spectrin dimer-dimer association in homozygous elliptocytosis and provide strong support for the concept that this defect is the primary cause of the red cell abnormality in at least some families of hereditary elliptocytosis. PMID- 6849844 TI - Obstetric fistula: one social calamity too many. PMID- 6849845 TI - Epidemiological determinants of vesicovaginal fistulas. AB - Between 1969 and 1980 1443 patients with vesicovaginal fistulas were operated on in Ahmadu Bello University Hospital in Northern Nigeria. They have been studied in relation to their obstetric, social and environmental background. The preventable nature of the lesion was explored particularly with respect to age, parity and obstructed labour, and to traditional practices including 'gishiri cutting', which alone accounts for 13% of all the fistulas. Vesicovaginal fistulas are still a major cause for concern in many developing countries; measures for prevention include universal education and improved status of women in society as well as improved and accessible medical services. PMID- 6849846 TI - Feto-maternal haemorrhage as a cause of fetal morbidity and mortality. AB - Massive feto-maternal haemorrhage is a cause of significant fetal morbidity and mortality, but is often overlooked because screening for fetal erythrocytes in the maternal circulation has not been a routine procedure in stillbirths, fetal distress or neonatal anaemia; there are few recognized clinical symptoms or signs, or histopathological features. This report covers three cases. A screening blood test in the last month of pregnancy could be of value in detecting feto maternal haemorrhage before irreversible damage to the fetus occurs. PMID- 6849847 TI - Plasma copper and zinc concentrations and infertility. AB - Plasma copper concentration was significantly lower in 48 infertile women than in 35 control subjects and somewhat lower in women with secondary rather than primary infertility. Plasma zinc concentration was not appreciably different in infertile and fertile women. Low plasma copper concentration may influence normal human female fertility. PMID- 6849848 TI - Tubal mucosa and ectopic pregnancy. AB - Fallopian tubes containing a gestation are frequently normal on macroscopical and gross histological examination. Scanning electron microscopy and light microscopy studies of tubal biopsies taken from five groups of women showed marked differences in the ciliated surface which was measured planimetrically on photographs. The proportion of ciliated cells was significantly lower in biopsies taken from 25 women with tubal pregnancies compared with that in biopsies from seven women with intrauterine pregnancies at the same gestation. Marked deciliation was also seen in eight women biopsied during tubal surgery sometime subsequent to an ectopic pregnancy and in four women biopsied during tubal surgery who subsequently had a tubal pregnancy when compared with a group of women biopsied during tubal sterilization. PMID- 6849849 TI - Lamicel: a new technique for cervical dilatation before first trimester abortion. AB - Mechanical dilation of the cervix can be both difficult and dangerous and has potentially serious complications. Lamicel, a synthetic hydrophilic polymer, was inserted into the cervix between 2 and 24 h before termination by vacuum aspiration in the first trimester in 48 nulliparae. A control group of 12 nulliparae were not treated with Lamicel. The force needed to dilate the cervix, accurately measured with a specifically designed force-measuring instrument, was found to be significantly reduced in all treated groups. The greatest rate of dilatation occurred within the first 2 h after insertion. PMID- 6849850 TI - Placenta percreta presenting as intra-abdominal antepartum haemorrhage. Case report. PMID- 6849851 TI - Nuclear magnetic resonance imaging of the orbit. PMID- 6849853 TI - Morning glory syndrome with contractile peripapillary staphyloma. PMID- 6849852 TI - Acute morning glory syndrome: report of a case. AB - In 1976 a boy of 12 presented with unilateral morning glory syndrome connected with oedema of the posterior fundus and marked loss vision. The recovery was complete within a few months, with visual acuity improving to 6/4. The other eye could see 6/4 and had a normal fundus throughout. PMID- 6849854 TI - Basal encephalocele and morning glory syndrome. AB - Basal encephaloceles are often associated with other midline anomalies such as hypertelorism, broad nasal root, cleft lip, and cleft palate. Optic disc anomalies such as pallor, dysplasia, optic pit, coLoboma, and megalopapilla have been reported to occur in patients with basal encephalocele We report a case of a child with a sphenoethmoidal encephalocele and morning glory syndrome of the optic nerve. The presence of such optic nerve anomalies with facial midline anomalies should alert the clinician to the possible presence of a basal encephalocele. PMID- 6849855 TI - Glaucoma screening by means of an optic disc grid. PMID- 6849856 TI - An optic disc grid: its evaluation in reproducibility studies on the cup/disc ratio. AB - A grid system is described which may be superimposed upon stereoscopic pairs of optic disc photographs. This grid system allowed reproducible inter- and intraobserver measurements of the cup/disc (C/D) ratio. The surface contour of the optic disc was not clear-cut in approximately 10% of the population studied, which led to a reduction in reproducibility of the measurement made within the group as a whole. As a result it was found that a large increase in the C/D ratio would have to occur for such change to be of statistical significance. Even with an optic grid as a reference system the serial measurements of the C/D ratio are unlikely to be of value in the management of patients with chronic glaucoma. PMID- 6849857 TI - Ocular hypertension and posture. AB - Thirty-seven patients with ocular hypertension (OH) and 29 age matched controls were studied. Intraocular pressure (IOP) measurements were made in the sitting position and, immediately after changing posture, in the lying position. Sixty three (85%) of the OH eyes and all the control eyes showed either stable IOP readings on changing posture of small elevations up to 3 mmHg. Eleven (15%) of the OH eyes showed larger elevations of IOP, between 5 and 9 mmHg when the patients changed to the lying position. We suggest that an IOP measurement in the lying position should be included in the routine evaluation of the patient with ocular hypertension. PMID- 6849858 TI - Acute glaucoma: results of treatment by bilateral simultaneous iridectomy, now without admission to hospital. AB - Medical treatment followed by bilateral simultaneous iridectomy appears to be an effective basis for managing a patient who presents with acute glaucoma. Admission to hospital is seldom necessary. There was minimal evidence that delay in starting treatment caused more sight to be lost, but as the patient's age increased the prognosis for recovery of sight in an affected eye decreased quite significantly. The long-term prognosis for the sight of an individual patient who has had prophylactic iridectomy in the unaffected eye is excellent. PMID- 6849860 TI - Ischaemic optic neuropathy in pulseless disease. PMID- 6849859 TI - Effect of the method of enucleation on the prognosis of choroidal melanoma. AB - The prognosis following treatment of uveal melanomata depends not only on factors such as cell type and degree of mitotic activity, size and location of the tumour, and the age of the patient, but also on the method of enucleation, as surgical manipulation of the neoplasm may potentiate the shedding of malignant cells into the blood stream. One hundred and thirty-one patients treated by different methods of enucleation were reviewed and the mortality patterns assessed. The numbers of deaths over the first 5 years differed significantly between the different groups. A specific method of enucleation used for tumour containing eyes is described and its importance emphasised. PMID- 6849862 TI - Gold as an intraocular foreign body. PMID- 6849861 TI - Slow-release artificial tear inserts in the treatment of dry eyes resulting from the oculomucocutaneous syndrome. AB - Patients with dry eyes resulting from the practolol syndrome present a therapeutic challenge. Very frequent instillation of preservative-free drops are the only therapy in most cases. Using an entirely new agent--a hydrophilic polymer in insert form--we have provided in this open study an alternative therapy which shows some subjective and objective advantages. Few patients experienced problems, and none left the study because of failure of retention of the insert. Some patients preferred the cooling, soothing effects of frequent drops. The problems in mounting a clinical trial of this sort are discussed. PMID- 6849863 TI - Behaviour of the fellow eye in acute angle-closure glaucoma. PMID- 6849864 TI - Bioluminescence emission from the reaction of luciferase-flavin mononucleotide radical with O2-.. AB - The blue neutral luciferase flavin radical has been shown not to be in a catalytically significant equilibrium with species leading to emission of light [Kurfurst, M., Ghisla, S., Presswood, R., & Hastings, J. W. (1982) Eur. J. Biochem. 123, 355-361]. It is shown here that this radical can nevertheless react with O2-. to form a species that is competent in light emission. From its properties, the species formed is deduced to be luciferase-FMNH 4a-hydroperoxide, a key intermediate in the normal luciferase reaction. Although it is concluded that this intermediate can undergo a reversible homolytic dissociation to yield free superoxide and the corresponding luciferase radical, the slowness of these steps precludes a catalytic significance for these pathways in the normal bioluminescent reaction. PMID- 6849865 TI - Species differences in cytochromes P-450 and epoxide hydrolase: comparisons of xenobiotic-induced hepatic microsomal polypeptides in hamsters and rats. AB - Cytochromes P-450 and epoxide hydrolase in hamsters were studied by using two dimensional gel electrophoresis of hepatic microsomes from untreated animals and those treated with phenobarbital, 3-methylcholanthrene, beta-naphthoflavone, trans-stilbene oxide, and pregnenolone-16 alpha-carbonitrile. Coelectrophoresis with corresponding microsomes from rats and in situ peptide mapping were used to identify resolved microsomal polypeptides as cytochromes P-450 or epoxide hydrolase. Two forms of hepatic microsomal epoxide hydrolase were shown to exist in hamsters; these evidenced extensive structural homology with the corresponding enzyme in rats and were induced by the same xenobiotics. At least eight inducible polypeptides in microsomes from hamsters were tentatively identified as cytochromes P-450. Two of these were electrophoretically identical and structurally related with previously characterized forms of the enzyme in rats. Homologues of several major cytochromes P-450 induced by pregnenolone-16 alpha carbonitrile and/or phenobarbital in the rat were apparently not present in the hamster. In most cases, putative forms of inducible cytochrome P-450 in the hamster existed at significant levels in microsomes from untreated animals whereas in rats the levels of most inducible forms of the enzyme were low in control microsomes, being more strictly dependent on xenobiotic pretreatment. In contrast with epoxide hydrolase, the molecular complexity of hepatic cytochrome P 450 seems to be comparable for rats and hamsters, but the structure and control of these hemoproteins appear to have markedly diverged. PMID- 6849867 TI - Limited proteolysis of tubulin: nucleotide stabilizes an active conformation. AB - Limited proteolysis has been used to examine tubulin structure as related to microtubule assembly. Purified tubulin, freed of exchangeable nucleotide, was digested with low concentrations of chymotrypsin (0.01-0.1% w/w to tubulin) and its polymerization behavior investigated. Chymotryptic proteolysis resulted in a loss of assembly activity with apparent first-order inactivation kinetics. The inactivation rates were dependent on both chymotrypsin concentration and incubation temperature. However, these conditions of proteolysis did not significantly affect tubulin's colchicine binding activity. Polyacrylamide NaDodSO4 electrophoresis demonstrated the major cleavage fragments of tubulin to be 34 and 17 kilodaltons. Furthermore, amino-terminal analysis showed methionine for the 17-kilodalton fragment and both glutamate and serine for the 34 kilodalton fragment. Microtubular structures formed from chymotryptic tubulin possessed constrictions and had a frayed appearance in the electron microscope; these polymers were composed of both native tubulin and the 34- and 17-kilodalton fragments, suggesting that the loss of microtubule assembly results from tubulin cleavage and the altered interaction of cleavage fragments with uncleaved tubulin subunits. Interestingly, the readdition of GTP prior to proteolysis significantly protected tubulin's assembly capacity, presumably by stabilizing the fragments in an active conformation as indicated by circular dichroism spectra. PMID- 6849866 TI - Polymerization of the tubulin-colchicine complex: relation to microtubule assembly. AB - The polymerization of purified tubulin-colchicine complex, which results in polymers different from microtubules under microtubule-promoting conditions, has been characterized. It proceeds as a nucleated condensation polymerization, requires Mg2+, and is inhibited by small concentrations of Ca2+. Polymerization requires GTP binding, but GDP is inhibitory. The GTPase activity proceeds, but it is unlinked to polymerization. The thermodynamic characteristics of the growth reaction, namely, the apparent changes of free energy, enthalpy, entropy, heat capacity, and preferential interaction with H+ and Mg2+, are very similar to those of microtubule assembly. It is proposed that the interactions responsible for the two types of polymerization are very similar and that the molecular mechanism of microtubule inhibition by colchicine may consist in a drug-induced distortion of the normal protomer bonding geometry. PMID- 6849868 TI - Affinity labeling of tubulin's exchangeable guanosine 5'-triphosphate binding site. AB - Tubulin requires GTP for maximal rate and extent of polymerization into microtubules. The localization of the guanine nucleotide in the microtubule was examined by preparing affinity probes that would permit tubulin polymerization prior to their covalent coupling to amino acids in tubulin's exchangeable GTP binding site. Two different hydrolyzable GTP analogues with modified ribose moieties, 3'-p-azidobenzoyl)-GTP and the periodate oxidation product of GTP, 2 (guanylformylmethoxy)-3-(triphospho)propanal, were isolated by thin-layer chromatography and high-voltage electrophoresis and identified by ultraviolet and infrared spectroscopy. The analogues bind to the tubulin molecule and promote polymerization. After tubulin polymerization and isolation of microtubules, the [3H]GTP analogues were covalently coupled to tubulin by NaBH4 reduction or UV irradiation. The microtubules possessed about 1 mol of acid-precipitable 3H labeled nucleotide/mol of tubulin dimer. Separation of the subunits showed that the nucleotide analogues were associated with both alpha and beta subunits of tubulin in nearly equal amounts. The binding of analogues to both alpha and beta subunits was saturable and competitive with GTP. Cyanogen bromide cleavage of both alpha and beta subunits showed that the 3H-labeled nucleotide was associated with a single molecular weight species of similar size (approximately 10 000) from each subunit. Two-dimensional electrophoresis of chymotryptic peptides from both (alpha and beta) cyanogen bromide fragments showed that the 3H-labeled nucleotide was associated with a peptide of nearly identical migration properties from both subunits. These results suggest that a similar peptide segment of both alpha- and beta-tubulin has the ability to bind GTP. Furthermore, this peptide was localized to the amino-terminal one-third of the tubulin molecule. PMID- 6849869 TI - Mapping of actin-binding sites on the heavy chain of myosin subfragment 1. AB - When the rigor complex of actin and myosin subfragment 1 (S1) was treated with a zero-length cross-linker, 1-ethyl-3-[3-(dimethylamino)propyl]carbodiimide, covalently linked complexes of actin and S1 heavy chain with apparent molecular weights of 165,000 and 175,000 were generated. Measurements of the molar ratio of actin to S1 heavy chain in the 165K and 175K products showed that they were 1:1 complexes of actin and S1 heavy chain. Chemical cleavages of the cross-linked products followed by peptide mappings revealed that two distinct segments of S1 heavy chain spanning the 18K-20K region and the 27K-35K region from its C terminus participated in cross-linking with actin. Cross-linking of actin to the former site generated the 165K peptide while the latter site was responsible for generating the 175K peptide. PMID- 6849870 TI - Localization of a trifluoperazine binding site on troponin C. AB - Trifluoperazine (TFP) was shown to interact with the cyanogen bromide fragment 9 (CB9) (residues 84-135) of rabbit skeletal troponin C and with a synthetic peptide representing the N-terminal region of CB9. The phenothiazine did not affect the calcium binding property of CB9 as observed by proton magnetic resonance and circular dichroism spectroscopies. The calculated calcium binding constants for CB9 in the presence and absence of trifluoperazine were identical (KCa2+ = 1.3 X 10(5) M-1). Localization of the trifluoperazine binding site was achieved by analyzing the 1H NMR spectrum of CB9 and of a synthetic fragment corresponding to residues 90-104 of CB9. Drug-induced shifting and broadening of the ring protons of phenylalanine residues and the methyl resonances of alanine, leucine, and isoleucine residues suggest that the segment 95-102 is in close proximity to the phenothiazine aromatic region. The neighboring negative side chains in the peptide sequence also suggest that the single positive charge present on the piperazine nitrogens of trifluoperazine may interact with them and sterically block a region of interaction of calmodulin (CaM) and troponin C (TnC) with modulated proteins such as phosphodiesterase. Primary sequence analysis of CaM and troponin C reveals that a homologous hydrophobic region to site 3 is also found in the N-terminal region of site 1 of both calcium binding proteins. Binding of TFP to CB9 occurs both in the presence and absence of calcium since the hydrophobic region in these small fragments is completely accessible to TFP whether calcium is present or not. The dissociation constant of the drug to apoCB9 (8 microM) was obtained by ellipticity measurements at 222 nm and was comparable to the 5 microM value obtained by Levin and Weiss [Levin, R. M., & Weiss, B. (1978) Biochim. Biophys. Acta 540, 197-204] for calcium-saturated rabbit skeletal troponin C. PMID- 6849871 TI - Absence of pyridoxine- (pyridoxamine-) 5'-phosphate oxidase in Morris hepatoma 7777. AB - Morris hepatoma 7777 previously has been shown to have no detectable pyridoxine- (pyridoxamine-) 5'-phosphate oxidase activity [Thanassi, J. W., Nutter, L. M., Meisler, N. T., Commers, P., & Chiu, J.-F. (1981) J. Biol. Chem. 256, 3370-3375]. In order to determine if this enzyme was missing in the hepatoma, we purified rat liver oxidase and raised antibodies to it in rabbits. Final purification of rat liver oxidase for use as an antigen was accomplished by affinity chromatography and gel electrophoresis. The rat liver enzyme is similar to rabbit liver oxidase [Kazarinoff, M. N., & McCormick, D. B. (1975) J. Biol. Chem. 250, 3436-3442] having two noncovalently linked subunits with molecular weights in the range of 25 000-28 000. Evidence indicating that inactive enzyme was simultaneously purified with native enzyme was obtained. The IgG fraction was purified from the serum of a rabbit that had been immunized with rat liver oxidase. This was used in the development of ELISA and immunoblot analyses for the presence of antigenically active pyridoxine- (pyridoxamine-) 5'-phosphate oxidase in cytosolic preparations from normal rat liver and Morris hepatoma 7777. The results indicated that there was no immunologically detectable oxidase protein in the tumor. An alternate pathway of pyridoxal 5'-phosphate synthesis, involving oxidation of pyridoxine to pyridoxal followed by phosphorylation, was ruled out. The implications of these findings with respect to acquisition of nutrients by tumors are discussed. PMID- 6849872 TI - Immobilized metal ion affinity adsorption and immobilized metal ion affinity chromatography of biomaterials. Serum protein affinities for gel-immobilized iron and nickel ions. AB - Immobilized metal ion affinity adsorption (IMA adsorption) is a collective term that is proposed to include all kinds of adsorptions whereby metal atoms or ions immobilized on a polymer cause or dominate the interaction at the sorption sites. IMA chromatography is one of the most powerful methods available to date for protein fractionation although this is not as yet widely recognized. This study deals with the theoretical aspects of IMA adsorption and its practical applications as exemplified by the various results reported here. The synthesis of iminodiacetate-substituted agarose (IDA-agarose) and tris(carboxymethyl)ethylenediamine-agarose (TED-agarose) is described. Many types of metal ions can easily be immobilized on these gel derivatives to form IMA adsorbents. We have not observed any damage to the proteins during the adsorption desorption process. After performance of an experiment, the gels can easily be regenerated and can be loaded with the same or a different metal ion for an ensuing experiment. Specific adsorption is demonstrated for serum proteins on immobilized Ni(II) and Fe(III). Ligand-specific desorption (affinity elution) is also demonstrated by including in the buffer system certain solutes which are similar to or identical with some particular amino acids found in proteins. High concentrations of certain salts that affect the structure of water, such as Na2SO4, promote coordinate covalent bonding of proteins by a mechanism that is apparently similar to that found in hydrophobic interactions. Neutral detergents and aquoorganic solvents may be used. This opens up the possibility for the fractionation of membrane components. The IMA-adsorption method could also be expanded to other areas besides protein fractionation. PMID- 6849873 TI - Fractionation and kinetic properties of rat liver and kidney methionine adenosyltransferase isozymes. AB - Three isozymes of methionine adenosyltransferase (EC 2.5.1.6; MAT-I, -II, and III) exist in normal rat liver and are conveniently purified (MAT-III to homogeneity) by a three-step column chromatography procedure. MAT-I shows Michaelis-Menten kinetics with a Km (L-methionine) of 41 microM and a molecular weight of 208 000 and is slightly inhibited by S-adenosyl-L-methionine (Adomet). MAT-II, which is also the only isozyme found in normal rat kidney, shows negative cooperativity with a Hill coefficient of 0.7. It has a L-methionine concentration required for half-maximal velocity [S0.5(Met)] of 8 microM and a molecular weight of 120 000 and is strongly inhibited by Adomet. MAT-I and -II comprise 15% and 5%, respectively, of total MAT activity in rat liver. The predominant isozyme in rat liver, MAT-III, demonstrates positive cooperativity with a Hill coefficient of 1.8. It has a molecular weight of 97 000 and apparently consists of two subunits of identical molecular weight (47 000). This liver-specific isozyme is strongly activated by both dimethyl sulfoxide and Adomet and has a S0.5(Met) of 215 microM. PMID- 6849874 TI - Affinity labeling of nicotinamide adenine dinucleotide dependent isocitrate dehydrogenase by the 2',3'-dialdehyde derivative of adenosine 5'-diphosphate. Evidence for the formation of an unusual reaction product. PMID- 6849876 TI - Calorimetric and fluorescence characterization of interactions between cytochrome b5 and phosphatidylcholine bilayers. AB - The interactions of cytochrome b5 with dimyristoylphosphatidylcholine and dipalmitoylphosphatidylcholine lipid bilayers have been studied with high sensitivity differential scanning calorimetry and fluorescence spectroscopy. The incorporation of cytochrome b5 into large single lamellar vesicles causes a reduction in the enthalpy change associated with the lipid phase transition. Analysis of the dependence of this enthalpy change on the protein/lipid molar ratio indicates that each cytochrome b5 molecule prevents 14 +/- 1 lipid molecules from participating in the gel to liquid-crystalline transition and that this number is independent of the phospholipid acyl chain length. Resonance energy transfer between the intrinsic tryptophan fluorescence of cytochrome b5 and pyrenedecanoic acid indicates that, in the liquid-crystalline phase, protein and lipid molecules are uniformly distributed within the bilayer plane. In the gel phase, pyrenedecanoic acid partitions into the boundary layer lipid causing a dramatic decrease in the fluorescence intensity of cytochrome b5. The excimer/monomer ratios of pyrenedecanoic acid decrease upon increasing the protein/lipid molar ratio, indicating that the presence of protein molecules within the bilayer slows down the lateral mobility of the lipid probes. The picture that emerges from this set of experiments is that cytochrome b5 perturbs one layer of lipid around the hydrophobic segment of the protein and that this layer is unable to undergo the gel-liquid-crystalline transition, remaining instead in a relatively disordered configuration above and below the transition temperature of the bulk lipid. PMID- 6849875 TI - Chemical modification of L-lactate 2-monooxygenase with fluorodinitrobenzene: evidence for two essential histidine residues. AB - The modification of L-lactate 2-monooxygenase (lactate oxidase) with radioactively labeled fluorodinitrobenzene in 50 mM tris(hydroxymethyl)aminomethane (Tris)-acetate, pH 6.0, resulted in complete inactivation with the incorporation of 1 mol of dinitrophenyl per catalytic site. Analysis of acid hydrolysates using high-pressure liquid chromatography and an amino acid analyzer showed that Nim-(dinitrophenyl)histidine accounted for 95% of the incorporated label. Approximately 50% of the flavin in the modified enzyme was reduced by lactate, formed a sulfite complex, and underwent a photochemical reaction with oxalate. These results suggest that each active site in lactate oxidase contains two essential histidine residues that are modified in a mutually exclusive manner. PMID- 6849877 TI - Chlortetracycline as a probe of membrane-associated calcium and magnesium: interaction with red cell membranes, phospholipids, and proteins monitored by fluorescence and circular dichroism. AB - The fluorescence emission and circular dichroism spectra of chlortetracycline (CTC) have been measured, including the effects of multivalent cations (Ca, Mg, La), of medium polarity, and of interaction with human red cell membranes, lipids, and a variety of proteins. An obligatory role of Ca in the association of CTC with membranes was demonstrated. Binding and kinetic constants for the CTC-Ca chelate interaction with membranes and phospholipids were determined. The results suggest that the CTC-Ca chelate fluorescence is greatly enhanced in the vicinity of membrane phospholipid head groups. The circular dichroism spectra indicate a number of distinct CTC conformations corresponding to chelation of specific cations, to interaction with membranes and phospholipids, and to medium polarity. The high quantum yield CTC-Ca conformation associated with membranes or phospholipids was identified by its characteristic circular dichroism spectrum and is different from the CTC-Ca conformation in nonpolar media (80% methanol). PMID- 6849878 TI - Isolation, characterization, and postsynthetic modifications of tetrahymena high mobility group proteins. AB - We have isolated four major high mobility group (HMG) proteins designated A, B, C, and D, together with ubiquitin from the ciliate protozoan Tetrahymena. These four HMG proteins are integral structural components of macronuclear nucleosomes. The proteins exhibit solubility properties, chromatographic behavior on carboxymethylcellulose, electrophoretic mobilities on various gel systems, and amino acid compositions similar to those of their mammalian counterparts. HMG-A is the largest, most acidic protein of the group and is phosphorylated in vivo at specific serine residues. HMG-B is both phosphorylated at serine residues and ADP ribosylated. HMG-C is not phosphorylated but is ADP ribosylated. HMG-D, the smallest, most basic protein of the group possesses an unusually high content of serine and threonine residues, and it is highly phosphorylated at both serine and threonine positions in the polypeptide chain. PMID- 6849879 TI - Identification of histidine and methionine residues in the active site of the human uterine progesterone receptor with the affinity labels 11 alpha- and 16 alpha-(bromoacetoxy)progesterone. AB - The affinity labels 11 alpha- and 16 alpha-(bromo[2'-3H]acetoxy)progesterone (BAP) react covalently with amino acids present in the progesterone binding site of the human uterine progesterone receptor. Hydrolysis of the affinity labeled receptor followed by separation and analysis of the amino acid products demonstrated the sites of affinity labeling. The 11 alpha-BAP alkylates the 1 position of a histidine residue. The 16 alpha-BAP alkylates the 3-position of histidine, and a methionine residue. Affinity labeling did not occur in the presence of excess progesterone, and under the optimum conditions for affinity labeling of the receptor, heat-denatured receptor, bovine serum albumin, and 20 beta-hydroxysteroid dehydrogenase were not affinity labeled. This is the first report of the identification of specific amino acid residues in the binding site of a steroid hormone receptor. PMID- 6849880 TI - Spectral studies on the calcium binding properties of bovine brain S-100b protein. AB - The effect of Ca2+ binding on the circular dichroism (CD) and 270-MHz proton nuclear magnetic resonance (NMR) spectra of brain-specific S-100b calcium binding protein has been examined at two pH values, 8.5 and 7.5. At pH 8.5, S-100b protein binds two Ca2+ per monomer with Kd values of 6 x 10(-5) and 2 x 10(-4) M, whereas at pH 7.5, the protein binds only one Ca2+ per monomer with a Kd of 2 x 10(-4) M. The presence of K+ inhibits the binding of Ca2+ to the higher affinity site at pH 8.5, and the affinity for calcium is lowered to Kd = 8.5 x 10(-4) M. Mg2+ has no effect on protein conformation. In the absence of Ca2+, S-100b undergoes a conformational change when the protein is titrated from pH 8.6 to 6.0. Addition of Ca2+ perturbed the environment of tyrosine and phenylalanine residues as measured by ultraviolet difference spectroscopy and 1H NMR. CD melt experiments and far-ultraviolet CD studies at alkaline pH and NMR experiments suggest that the protein is more stable in the presence of Ca2+. The single tyrosine residue in the protein ionizes only after the protein is denatured by exposure to high pH. PMID- 6849884 TI - Structural changes in the lens proteins of hereditary cataracts monitored by Raman spectroscopy. AB - Raman spectra have been measured for the lenses from cac-strain mice. These mice possess a hereditary defect and provide lenses at various stages of opacification. The Raman spectra of normal mouse lenses have been obtained also for comparison purposes. The amide I and III bands appear in very similar positions in the Raman spectra of cataractous and normal lenses, suggesting that the peptide backbone of main lens proteins does not undergo a major conformational change upon lens opacification. However, lens opacification causes significant changes in the intensity ratio of the tyrosine doublet near 840 cm-1 and in that of the Raman bands at 881 and 760 cm-1 due to tryptophan residues. These changes could be observed even in the incipient stage of hereditary cataract and became more pronounced with cataract development. These observations indicate that in the course of lens opacification some tyrosine residues undergo a change in their hydrogen-bonding environment and some buried tryptophan residues became exposed. In addition, the present Raman spectroscopic study provides insight into the 2SH leads to S-S conversion in lens proteins. It was found that the conversion proceeded at a faster rate in a hereditary cataractous lens than in a normal lens; however, this difference was fairly small at the early stage of cataract development. Importantly, the 2SH leads to S-S conversion was accelerated after nuclear cataract formation. These observations support the hypothesis that the formation of S-S linkages is not a predominant factor for initiating lens opacification. Probably the formation of S-S linkages plays an important role in stabilizing the protein aggregates which are the cause of lens opacification. The intensity of the SH stretching mode (2579 cm-1) was very weak or absent in the Raman spectrum of a well-developed cataractous lens, suggesting that most sulfhydryl groups form disulfide bonds. Moreover, the fact that this occurs without major conformational changes of peptide backbones implies that most cysteine residues in lens crystallins are accessible to solvent or are clustered closely together. PMID- 6849882 TI - Hemin binding to serum proteins and the catalysis of interprotein transfer. AB - The reaction of hemin (Hm) with human hemopexin (Hx) has been studied in a mixed dimethyl sulfoxide (Me2SO)-water solvent system and in aqueous caffeine solutions. In both media, the kinetics could be described by a single, second order process: (formula - see text) with k = 1.8 X 10(6) M-1 s-1 in 40% Me2SO water [pH 7.4, mu = 0.2 M (NaCl)] and k = 3.9 X 10(7) M-1 s-1 in water [pH 7.4 mu = 0.2 M (NaCl), [caffeine] = 0.025 M]. The reaction shows an ionic strength dependence consistent with a residual 1+ to 2+ charge in the vicinity of the binding region of the protein. The kinetics of the transfer of hemin from albumin to hemopexin (formula - see text) were studied as a function of concentration, ionic strength, pH, and temperature. In experiments conducted at 3 less than or equal to [Alb]0/[Hx]0 less than or equal to 20 where the transfer kinetics are first order, k' = 5 X 10(-3) S-1 at mu = 0.3 M (NaCl), pH 7.1; the reaction is strongly dependent on ionic strength and choice of electrolyte. The addition of imidazole catalyzes this transfer process via a ligand-mediated pathway with k' = 5 X 10(-3) + 21[Im]T2. At [Alb]0/[Hx]0 = 92, the noncatalyzed transfer reaction is second order. From the kinetic analysis of the reaction under these conditions, an estimate is made of the distribution of hemin between the two proteins at concentration levels which are characteristic of serum. The association of hemin and hemopexin is approximately 30 times faster than that of hemin and albumin, a finding consistent with the recycling function of hemopexin during heme transport to the liver parenchymal cells. PMID- 6849881 TI - Rotational freedom of tryptophan residues in proteins and peptides. AB - We studied the rotational motions of tryptophan residues in proteins and peptides by measurement of steady-state fluorescence anisotropies under conditions of oxygen quenching. By fluorescence quenching we can shorten the fluorescence lifetime and thereby decrease the average time for rotational diffusion prior to fluorescence emission. This method allowed measurement of rotational correlation times ranging from 0.03 to 50 ns, when the unquenched fuorescence lifetimes are near 4 ns. A wide range of proteins and peptides were investigated with molecular weights ranging from 200 to 80 000. Many of the chosen substances possessed a single tryptophan residue to minimize the uncertainties arising from a heterogeneous population of fluorophores. In addition, we also studied a number of multi-tryptophan proteins. Proteins were studied at various temperatures, under conditions of self-association, and in the presence of denaturants. A wide variety of rotational correlation times were found. As examples we note that the single tryptophan residue of myelin basic protein was highly mobile relative to overall protein rotation whereas tryptophan residues in human serum albumin, RNase T1, aldolase, and horse liver alcohol dehydrogenase were found to be immobile relative to the protein matrix. These results indicate that one cannot generalize about the extent of segmental mobility of the tryptophan residues in proteins. This physical property of proteins is highly variable between proteins and probably between different regions of the same protein. PMID- 6849883 TI - Lanthanide-induced peptide folding: variations in lanthanide affinity and induced peptide conformation. AB - The present work has demonstrated the utility of the diamagnetic lanthanides lutetium and lanthanum as metal binding probes for a synthetic 13-residue fragment representing calcium binding site 3 of rabbit skeletal troponin C (residues 103-115). The peptide conformation induced by these metals was monitored by the proton magnetic resonance at 270 MHz. The peptide affinity for these rare earths is 50-400 times higher than that for calcium (KLu3+, 1.3 X 10(4) M-1; KLa3+, 1.1 X 10(5) M-1; KCa2+, 3 X 10(2) M-1) which is related to the change in cation charge from 2+ to 3+. The peptide conformation induced by the presence of La3+ generates a different 1H NMR spectrum than the one observed for the lutetium-saturated peptide. Thus, it appears that these metals do not fold the peptide into exactly the same conformation. The resonance shifts observed during the Lu3+ titration are much smaller than those seen in the case of La3+ addition. The fact that lutetium binds less tightly than lanthanum to the peptide may be linked directly or indirectly to the difference in ionic radius between these metals (Lu3+, 0.86 A; La3+, 1.03 A). This may in turn indicate that the peptide primary sequence encodes for some aspects of metal ion specificity. The 1H NMR results also demonstrate that glycine-108 adopts a restricted geometry in the absence of metal such that its two alpha-carbon protons are in different environments which are further affected by the addition of either metal. These observations support the concept that geometric constraints arising from the particular peptide folding pattern near this residue correlate with the highly conserved nature of this site of the EF hand. This position remains occupied by glycine in most EF hand domains with the exception of known distorted calcium binding sites present in intestine calcium binding proteins and S-100. PMID- 6849885 TI - Histone synthesis by lymphocytes in G0 and G1. AB - Peripheral blood lymphocytes are a naturally occurring population of G0 cells which can be activated in vitro to grow and divide. Upon activation with phytohemagglutinin (PHA), they enter G1 and, after a 24-h lag, begin DNA replication (S phase). Using radioisotope labeling and gel electrophoresis of acid-soluble chromatin proteins, we investigated histone synthesis in G0, G1, and S phase cultures of human and pig lymphocytes. In G0 and G1 cultures, which have less than 0.1% S phase cells, all five histones are synthesized and are incorporated into chromatin in equimolar amounts. In G0 lymphocytes histone synthesis accounts for at least 6% of nuclear protein radioactivity, and the rate of synthesis is about 2-3% of that of S phase lymphocytes. In contrast to histone synthesis by S phase cultures, G0 and G1 histone synthesis was completely resistant to treatment with hydroxyurea. PMID- 6849886 TI - Histone H5 can increase the internucleosome spacing in dinucleosomes to nativelike values. AB - Chicken erythrocyte chromatin was assembled with inner histones at about 60% of the ratio found in vivo and subsequently incubated with histone H5 (or H1 + H5) in a solution containing 0.1 M NaCl and poly(glutamic acid). Micrococcal nuclease digestion produced dinucleosomes of 360-390 base pair (bp) DNA content, similar to those from native chromatin and contrasting with the 270-280 bp species found in material incubated without H5. On sucrose gradients a dinucleosome sedimenting at 16 S containing 360 bp DNA was isolated. Removal of H1 + H5 after reconstitution did not change these results; H5 thus can induce rearrangements of nucleosome cores with respect to their neighbors. The results are interpreted as an H5-induced "sliding apart" of histone octamers, complementary to the "sliding together" found in native chromatin after removal of H1 + H5. PMID- 6849887 TI - 6,6-Dimethylpterins: stable quinoid dihydropterin substrate for dihydropteridine reductase and tetrahydropterin cofactor for phenylalanine hydroxylase. AB - The tautomeric structure of the cofactor product of aromatic amino acid hydroxylases, quinoid dihydrobiopterin, is still unknown. Characterization of this molecule, which is also the substrate for dihydropteridine reductase (EC 1.6.99.7), has been hindered by the rapid rearrangement of quinoid dihydropterins to 7,8-dihydropterins. This tautomerization can be prevented by disubstitution at the 6-position. A procedure is presented for the synthesis of 6,6-disubstituted pterins from a vicinal diamine and 2-amino-6-chloro-4(3H)-pyrimidinone. The method is illustrated with the specific synthesis of 6,6-dimethyltetrahydropterin (6,6-Me2PH4). 6,6-Me2PH4 is a cofactor for rat liver phenylalanine hydroxylase (EC 1.14.16.1), with enzyme kinetic parameters similar to those of its positional isomer, 6,7-dimethyltetrahydropterin. The resulting quinoid 6,6 dimethyldihydropterin (q-6,6-Me2PH2) is stable; the half-life in 0.1 M Tris-HCl, pH 7.4, at 27 and 37 degrees C is 4 and 1.25 h, respectively. q-6,6-Me2PH2, produced either by phenylalanine hydroxylase or by chemical oxidation of 6,6 Me2PH4, is a substrate for dihydropteridine reductase, with a Km of 0.4 mM and a maximum velocity double that of the natural isomer of quinoid dihydrobiopterin. In concentrations up to 0.4 mM q-6,6-Me2PH2 is not an inhibitor of phenylalanine hydroxylase, in contrast to 6-methyl-7,8-dihydropterin and 7,8-dihydrobiopterin which inhibit competitively, with Ki's of 0.2 mM and 0.05 mM, respectively. The stability of q-6,6-Me2PH2 has facilitated definitive determination of chemical and physical properties of a quinoid dihydropterin. PMID- 6849889 TI - Reactions of lumiflavin and lumiflavin radicals with .CO2- and alcohol radicals. AB - The kinetics of reaction of oxidized lumiflavin (F0) with the radicals .CO2(-), CH3CHOH, and (CH3)2COH have been investigated at pH 7 and 24 +/- 1 degree C by the pulse radiolysis technique. The radicals have been shown to react with lumiflavin with second-order rate constants of 36 +/- 4, 26 +/- 3, and 20 +/- 3 in units of 10(8) M-1 s-1, respectively. These rate constants are close to the diffusion limit. The main product in each case was the lumiflavin semiquinone radical FH.. By utilization of long pulses (approximately 100 mus), it was shown that the reaction FH. + .AH(alpha) leads to FH- + A(alpha) + H+ [.AH(alpha) = .CO2(-), CH3CHOH, or (CH3)2COH] proceeded for all three types of .AH(alpha) radical with second-order rate constants of 17 (+4,-3), 9 (+5,-3), and 9 (+4,-3), respectively, in the above units. The beta-carbon radical .CH2CH(OH)CH3 added to .FH, forming an alkylated flavin, while the .CH2CH2OH radical appeared to be capable of addition or hydrogen atom donation to .FH. PMID- 6849890 TI - Self base pairing in a complementary deoxydinucleoside monophosphate duplex: crystal and molecular structure of deoxycytidylyl-(3'-5')-deoxyguanosine. AB - The molecular structure of ammonium deoxycytidylyl-(3'-5')-deoxyguanosine, crystallized from aqueous acetone near pH 4, was determined for X-ray diffraction data. The crystals were tetragonal, space group P43212 with a = b = 11.078 (1) A and c = 45.826 (4) A. The structure was solved by tangent expansion of phases based on a derived phosphorus position and refined to R = 0.060 by full matrix least squares. Molecules related by a 2-fold symmetry axis are connected by hydrogen bonds between the bases and form parallel right-handed duplexes. Pairs of cytosines share a proton at N(3) and are joined by three hydrogen bonds: N(4) H...O(2)...H-N(4), and N(3)-H...N(3). Guanines are joined by two hydrogen bonds: N(2)-H...N(3) and N(3)...H-N(2). Base-stacking interactions within the duplex are weak with the cytosine and guanine ring planes inclined at 24 degrees to each other in each monomer. Despite the unusual arrangement of the molecules, the sugar phosphate backbone has the g-g- conformation normally associated with right handed double helical structures. Conformational parameters of the nucleosides are also typical with both sugars C(2')-endo and glycosidic torsion angles 55 degrees for cytidine and 94 degrees for guanosine. The bonding geometry of the bases is influenced by hydrogen bonding and charge-transfer networks in the crystal lattice. The solvent molecules interact with the dimer in three fused circular hydrogen bonding domains with a single disordered ammonium cation per d(CpG) dimer. Parallels with the formation of self base pairs and their implications in molecular biology are discussed. PMID- 6849888 TI - 23,25-Dihydroxy-24-oxovitamin D3: a metabolite of vitamin D3 made in the kidney. AB - Kidney homogenates of rats produced a new metabolite of 25-hydroxyvitamin D3 which has been isolated in pure form after five column chromatographic steps. It was identified as 23,25-dihydroxy-24-oxovitamin D3 by means of ultraviolet and infrared absorption spectrophotometry, mass spectrometry, and proton nuclear magnetic resonance spectrometry. The stereochemistry at the C-23 position is as yet unknown. 25-Hydroxy-24-oxovitamin D3, which also has been isolated in pure form from this system, was found to be the precursor of the new metabolite in vitro. The production of the new metabolite was induced by two different methods: (a) perfusion of the kidneys with 1,25-dihydroxyvitamin D3 contained in the perfusate and (b) injection of 1,25-dihydroxyvitamin D3 in the intact animal. 23,25-Dihydroxy-24-oxovitamin D3 was not biologically active in an assay for intestinal calcium transport and bone calcium mobilization in the vitamin D deficient chick at a dose level of 5.3 nmol. A metabolic pathway is proposed to describe the results; it leads from 25-hydroxyvitamin D3 leads to 24(R),25 dihydroxyvitamin D3 leads to 25-hydroxy-24-oxovitamin D3 leads to 23,25-dihydroxy 24-oxovitamin D3. PMID- 6849891 TI - Spectral properties of cobalt carboxypeptidase A. Interaction of the metal atom with anions. AB - At pH greater than 7 the absorption and magnetic circular dichroic spectra of cobalt carboxypeptidase A are insensitive to anions [Latt, S. A., & Vallee, B. L. (1971) Biochemistry 10, 4263-4270], but at pH less than 6 chloride and other anions perturb them in a manner specific for each anion. Lowering of the pH apparently facilitates the entry of an anion into the metal coordination sphere, suggesting that an acidic group normally stabilizes a metal-coordinated water molecule against displacement. The lack of sensitivity to anions at pHs between 7 and 9--when the enzyme is maximally active--and its evident abolition upon protonation of an active-site group are consistent with this interpretation. Selective modification of cobalt carboxypeptidase at Glu-270 using a carbodiimide affinity reagent generates sensitivity to anions at pH 7 very similar to that of the unmodified enzyme at pH approximately 5. This suggests that the group stabilizing the metal-coordinated water is the catalytically essential carboxylate of Glu-270. These and related results provide evidence for a mechanistically important interaction of Glu-270 with a metal-bound water molecule. PMID- 6849892 TI - Cryokinetic studies of the intermediates in the mechanism of carboxypeptidase A. PMID- 6849893 TI - Structure of apamin in solution: a two-dimensional nuclear magnetic resonance study. AB - A two-dimensional (2-D) Fourier-transform nuclear magnetic resonance (NMR) study of the 18 amino acid neurotoxin apamin isolated from honeybee venom is reported. Combining 2-D J-correlated spectra with 2-D nuclear Overhauser spectra in H2O solution permits essentially complete assignment of the 1H NMR spectrum of apamin at a fixed pH, including a number of spin systems that are reported for the first time. The structural model previously derived by Bystrov et al. [Bystrov, V. F., Okhanov, V. V., Miroshnikov, A. I., & Ovchinnikov, Yu. A. (1980) FEBS Lett. 119, 113-116] from NMR data is shown to be largely correct. The 2-D nuclear Overhauser effect (NOE) spectrum in particular reveals a series of amide-amide NOE's consistent with an alpha-helical core (residues 9-15) in the molecule. NOE's between amide and C alpha protons, followed by amide to amide NOE's, indicate a beta-turn involving residues 3-5 and a nonstandard turn including residues 6-8. We find no evidence for the beta-type structure postulated at the C terminus, however. Instead, it appears that the alpha-helix continues with increasing fraying from residues 16-18. PMID- 6849894 TI - Proton nuclear magnetic resonance assignments and surface accessibility of Tryptophan residues in lysozyme using photochemically induced dynamic nuclear polarization spectroscopy. AB - Tryptophan resonances in the 360-MHz 1H photochemically induced dynamic nuclear polarization spectrum of hen egg white lysozyme are investigated in detail. All resonances of one tryptophan and six of another are identified and assigned to their respective protons. The methods employed, all involving nuclear spin polarization, include the study of cross-relaxation effects and the use of selective radio-frequency irradiation, Gd3+ as a paramagnetic probe, and riboflavin as the chemically induced dynamic nuclear polarization generating dye. From a comparison of the experimental results with the known X-ray structure of lysozyme, second-stage assignments of the two tryptophan residues (Trp-62 and Trp 123) are proposed. A number of other resonances are characterized, among them Trp 63 C(2)H and four indirectly polarized methyl groups. PMID- 6849895 TI - Nuclear magnetic resonance studies of amino acids and proteins. Side-chain mobility of methionine in the crystalline amino acid and in crystalline sperm whale (Physeter catodon) myoglobin. AB - We have obtained deuterium (2H) nuclear magnetic resonance (NMR) spectra and spin lattice relaxation times (T1) of L-[epsilon-2H3]methionine, L-[epsilon 2H3]methionine in a D,L lattice, and [S-methyl-2H3]methionine in the crystalline solid state, as a function of temperature, in addition to obtaining 2H T1 and line-width results as a function of temperature on [epsilon-2H3]methionine labeled sperm whale (Physeter catodon) myoglobins by using the method of magnetic ordering [Rothgeb, T. M., & Oldfield, E. (1981) J. Biol. Chem. 256, 1432-1446]. The results indicate that in the L-amino acid, methyl rotation having an activation energy (delta E) of 8.3 +/- 1 kJ dominates T1 at low temperatures (less than or equal to 10 degrees C), while at higher temperatures an additional large-amplitude side-chain motion occurs which causes changes in the 2H NMR line shape and T1. This motion is inhibited in the D,L lattice, indicating that lattice effects may have a strong effect on the mobility of anhydrous amino acids in the solid state. Further substitution at S delta to form the sulfonium salt [S methyl-2H3]-methionine causes a large increase in delta E, to 15.9 +/- 2 kJ, a value comparable to the 14-16 kJ found in valine and leucine, which contain the structurally similar isopropyl moiety. These results suggest that the very low barriers to methyl rotation in the methionine side chain are due to long C-S bond lengths and the presence of only two substituents on sulfur, while the anomalous high-temperature behavior is due to a lattice-packing effect. 2H T1 results with methionine-labeled myoglobin are complex, reflecting the presence of fast large amplitude side-chain motions, in addition to rapid methyl rotation. Our data indicate that Met-55 and Met-131 are motionally inequivalent in crystalline cyanoferrimyoglobin, in contrast to solution NMR results. We have also recorded 13C cross-polarization "magic-angle" sample-spinning NMR spectra of [epsilon 13C]methionine-labeled crystalline cyanoferrimyoglobin (at 37.7 MHz, corresponding to a magnetic field strength of 3.52 T) and of the same protein in aqueous solution. Cross-polarization transfer rates and proton rotating-frame relaxation time results again indicate that Met-55 and Met-131 are motionally inequivalent in the solid state, and the TCH data indicate that Met-55 is more solidlike. However, we find that 13C chemical shifts in solution and those in the crystalline solid state are in very close agreement, suggesting that the average solution and crystal conformations are the same, in the area of Met-55 and Met 131. PMID- 6849896 TI - Multiple cytochromes P-450 are translated from multiple messenger ribonucleic acids. PMID- 6849898 TI - Modulation of membrane transport by free fatty acids: inhibition of synaptosomal sodium-dependent amino acid uptake. AB - High-affinity, Na+-dependent synaptosomal amino acid uptake systems are strongly stimulated by proteins which are known to bind free fatty acids. The rate of uptake as well as the overall level of accumulation is increased by such proteins as bovine serum albumin, hepatic fatty acid binding protein, beta-lactoglobulin, and fetuin. Such a stimulation is not observed with proteins which do not bind fatty acids. The transport activity of synaptosomal preparations can be directly correlated with the free fatty acid content of the preparation. Thus, incubation with albumin reduces the free fatty acid content of synaptosomal preparations, suggesting that the stimulatory effects of the proteins are related to their removal of inhibitory fatty acids formed by hydrolysis of membrane lipids during incubation. Inhibition of amino acid uptake is seen with most cis-unsaturated long chain fatty acids while saturated and trans-unsaturated fatty acids have relatively little or no effect. Under conditions in which the ionophore gramicidin D causes an increase of 22Na flux into synaptosomes, oleic acid (50 microM) has no effect on the influx. These data are consistent with the hypothesis proposed earlier by us [Rhoads, D. E., Peterson, N. A., & Raghupathy, E. (1982) Biochemistry 21, 4782] that Na+-dependent amino acid transport carrier proteins reside in a relatively fluid lipid domain in the synaptosomal membrane and that the effects of cis-unsaturated fatty acids are mediated by interactions with such domains. PMID- 6849897 TI - Molecular weights of mitochondrial and cytoplasmic aminoacyl-tRNA synthetases of beef liver and their complexes. AB - In eukaryotes, multienzyme complexes containing five to nine aminoacyl-tRNA synthetase activities have frequently been reported. In this study, we report the existence, in bovine liver cytoplasm, of a multienzyme complex containing at least 16 activities which can be disrupted by homogenization to give rise to smaller complexes and noncomplexed synthetases. Determination of the size and component activity of these complexes and of the molecular weights of all 20 free synthetases suggests that the smaller complexes and free activities normally identified arise from the larger complex by well-defined stages during homogenization. We also show that similar, though not identical, complexes are found in bovine liver mitochondria and give the molecular weights of 16 mitochondrial synthetases. PMID- 6849899 TI - Limited proteolysis of the mouse liver glucocorticoid receptor. AB - Activation of the mouse liver glucocorticoid receptor resulted in the generation of a protein of very different characteristics from that found previously in the mouse AtT-20 pituitary tumor cell line [Vedeckis, W. V. (1981) Biochemistry 20, 7237-7245]. Ion-exchange and adsorption chromatography showed that the activated liver receptor was a more basic protein--it eluted earlier from a DEAE-cellulose column, while a later elution was observed upon phosphocellulose and DNA cellulose chromatography. Further experiments showed that this was due to proteolysis of the liver receptor to a smaller form (3.2 S; Rs = 3.9 nm; Mr = 53 000; f/f0 = 1.45) after activation. Mero-receptor (2.4 S; Rs = 2.4 nm; Mr = 24 000; f/f0 = 1.15) was detectable when cytosol was chromatographed on hydroxylapatite or was treated with trypsin. These proteolytic fragments are similar to those obtained for various other steroid hormone receptors. Mixing experiments with liver cytosol showed that the AtT-20 glucocorticoid receptor could also be cleaved to these fragments. Endogenous proteases are apparently in low concentration in this cell line. Finally, activation appears to result in the exposure of the protease-sensitive regions, since sodium molybdate, which prevents receptor activation, also renders the receptor resistant to proteolysis. PMID- 6849900 TI - Subunit dissociation as a possible mechanism of glucocorticoid receptor activation. AB - For the elucidation of the mechanism of steroid hormone receptor activation, the hydrodynamic properties of the unactivated and activated forms of the nonproteolyzed glucocorticoid receptor from the mouse AtT-20 pituitary tumor cell line were determined. The unactivated, molybdate-stabilized receptor has the following properties: sedimentation coefficient = 9 S; Rs = 8.3 nm; Mr = 317 000; f/f0 = 1.70; axial ratio (prolate ellipsoid) = 14. The activated monomeric receptor has a sedimentation coefficient of 3.2 S, a Stokes radius of 6 nm, a molecular weight of 81 000, a frictional ratio of 1.93, and an axial ratio (prolate ellipsoid) of 18. A receptor species of intermediate size was detected when the analysis was performed in buffer containing both 0.3 M KCl and 20mM Na2MoO4. Its characteristics are as follows: sedimentation coefficient = 5 S; Rs = 8.3 nm; Mr = 176 000; f/f0 = 2.06; axial ratio (prolate ellipsoid) = 22. A preliminary study seemed to indicate that this is an activated form of the receptor. On the basis of the molecular weights, it is likely that the unactivated receptor is a tetramer of identical hormone-binding subunits (Mr = 81 000) while the intermediate form is a homodimer. Alternatively, non-hormone binding components (receptor-binding factors) may be involved in forming the multimeric, nonactivated receptor complex. In either case, the dissociation of a multimeric, nonactivated receptor into subunits appears to be a possible mechanism of receptor activation. Finally, the addition of high concentrations of 1-thioglycerol promoted activation. Thus, sulfhydryl groups may be involved in receptor subunit interaction. PMID- 6849901 TI - Effect of liposomal size on the calorimetric behavior of mixed-chain phosphatidylcholine bilayer dispersions. AB - The effect of liposomal size on the endothermic transition profiles of the saturated mixed-chain phosphatidylcholines 1-stearoyl-2-myristoyl-sn-glycero-3 phosphocholine and 1-stearoyl-2-caproyl-sn-glycero-3-phosphocholine has been investigated. Liposomal bilayer dispersions of progressively smaller average diameter were prepared by extrusion of coarse multilamellar preparations of these lipids through polycarbonate membrane filters of decreasing pore size from 3-to 0.2-micrometers diameter. These samples were then investigated by high sensitivity differential scanning calorimetry and negative-strain electron microscopy. It was found that coarse dispersions of the above lipids are composed of liposomes whose average diameter is considerably smaller than that typically associated with multilamellar liposomes of synthetic phosphatidylcholines. This fact, coupled with an analysis of the size dependence of the transition cooperativity, leads to the conclusion that the small size of the liposomes limits the transition cooperativity in coarse dispersions of these mixed-chain phosphatidylcholines. Thus, the broad and highly asymmetric transition profiles that have been observed in previous studies of these phosphatidylcholines are postulated to arise largely from this size dependence, rather than from characteristic packing properties of the phospholipid acyl chains as has been previously suggested. PMID- 6849902 TI - Proton nuclear Overhauser effect study of the structure of a deoxyoligonucleotide duplex in aqueous solution. AB - Nuclear Overhauser enhancements (NOEs) have been observed between some of the nonexchangeable protons of the self-complementary octanucleoside heptaphosphate d(G-G-T-A-T-A-C-C) in conditions under which duplex formation takes place. Comparison of inter- and intraresidue NOEs has made possible the assignment of all the aromatic and 1'- and 2'-ribosyl signals. In particular, and with the exception of the 5' terminal, NOEs of comparable magnitude are observed between H 8 of purines or H-6 of pyrimidines and pairs of anomeric protons. There are the H 1's of the nucleotide containing the relevant aromatic proton and those of the adjacent residue in the 5' direction. Differentially evolving NOEs are also generated between aromatic protons and the C-2' methylene protons on both the same residue and on the neighboring 5' residue. The relative magnitudes of these NOEs are discussed in terms of overall helical geometry and are consistent with a generally accepted B-type DNA model (R. Chandrasekaran and S. Arnott, personal communications). PMID- 6849903 TI - Berberine derivatives as cationic fluorescent probes for the investigation of the energized state of mitochondria. AB - The interaction of rat liver and bovine heart mitochondria with a series of fluorescent, cationic berberine derivatives varying in the length of alkyl chain has been investigated. An increase in the hydrophobicity of the derivative was accompanied by a larger value of the partition coefficient and by binding to a more hydrophobic region of the inner mitochondrial membrane. It was found that berberines could be used as sensitive indicators of processes which take place on the outer surface of the mitochondrial membrane; the greatest (15-fold) increase in fluorescence was obtained with 13-methylberberine in the energized state of mitochondria. The fluorescence increase was due to the increase in fluorescence quantum yield although a small increase in the amount of bound derivative could also be detected upon energization. The fluorescence was linearly dependent on the magnitude of the membrane potential. In parallel with an observed fluorescence enhancement a considerable decrease in rotational mobility was found. We suggest that berberines move in the inner membrane according to the polarity of the membrane potential; consequently, deeper immersion in the less polar region in the energized state brings about a larger fluorescence increase. More hydrophobic derivatives inhibited NAD-linked respiration in rat liver mitochondria but exerted no effect on succinate oxidation up to 10 microM concentration. PMID- 6849904 TI - Characteristics and determinants of osmotic lysis in chromaffin granules. AB - (1) Using isolated bovine chromaffin granules, we demonstrate that osmotic lysis is not a random process and establish the osmotic pressure dependence of osmotic lysis in chromaffin granules, the so-called osmotic fragility curve. (2) We show by measuring the release of constituents of the granule core and correlating these with changes in spectroscopic parameters (turbidity and endogenous catecholamine fluorescence), that the latter can be safely used to measure lysis. (3) Within a particular granule population, noradrenaline granules lyse at higher osmolarities than adrenaline granules, suggesting a higher core osmolarity of the noradrenaline granules. (4) The size distribution of chromaffin granules as a function of lysis was determined by the use of whole mount electron microscopy. It is shown that the mean size of chromaffin granules decreases as a function of lysis. (5) On the basis of theoretical considerations three alternative models of the sequence of osmotic lysis in chromaffin granules are proposed. The experimental results best support a model which postulates that during partial osmotic lysis, granule membranes reseal into smaller vesicles after graded release of contents. The osmotic fragility would represent several cycles of lysis and resealing and would not be a reflection of the distribution of osmotic pressures in the granule population. PMID- 6849905 TI - Interactions in mixed monolayers between distearoyl-L-phosphatidylethanolamine, rod outer segment phosphatidylethanolamine and all-trans retinal. Effect of pH. AB - The interactions in mixed monolayers between distearoyl-L phosphatidylethanolamine, natural phosphatidylethanolamine purified from bovine rod outer segments and all-trans retinal have been studied at the nitrogen/water interface at 21.0 +/- 0.5 degrees C. Seven mixtures of each phospholipid with all trans retinal, covering the whole range of molar fractions, were studied. The monolayers were spread on a 1 X 10(-3) M phosphate buffer subphase at three different pH values, 5.5, 7.1 and 8.2. The results for the two series of mixtures are strikingly different. The surface phase rule shows that all-trans retinal is miscible with the natural phospholipid at the interface. Small, negative deviations with respect to the additivity rule are observed in this case. The excess free energies of mixing were also calculated as a function of concentration for this system at four different surface pressures, 5, 7, 10 and 13 mN X m-1. They are negative for the four surface pressures considered and symmetrical with respect to the mole fraction. On the other hand, when distearoyl L-phosphatidylethanolamine is mixed with all-trans retinal, the components are no longer miscible at the interface. This marked difference in behaviour between the two lipids reflects the importance of hydrophobic interactions in the mixed monolayers of phospholipids with retinals. Furthermore, for the two series of mixtures, the surface pressure isotherms do not show any significant shift when the subphase pH is changed from 5.5 to 8.2. This behaviour raises questions about the formation of a Schiff base between phosphatidylethanolamine and retinal at the interface. It is suggested that, owing to the nature of the disk membranes, such an effect would also be observed in vivo. The possible implications of this are discussed, particularly with respect to questions pertaining to the stability of the retinal chromophore. PMID- 6849907 TI - Protein-mediated intermembrane contact specifically enhances Ca2+-induced fusion of phosphatidate-containing membranes. AB - Ca2+-induced fusion of glycolipid-phospholipid vesicles containing several different anionic phospholipids was investigated, with and without lectin mediated intervesicle contact. In vesicles containing phosphatidylserine, phosphatidylinositol or its mono- or diphosphate as the anionic phospholipid fusion was induced only at 1-10 mM Ca2+ both in the absence and presence of lectin. In contrast, the Ca2+-threshold for fusion of phosphatidate-containing vesicles was reduced to less than or equal to 0.1 mM Ca2+ by lectin-mediated intermembrane contact. PMID- 6849906 TI - Small liposomes are better than large liposomes for specific drug delivery in vitro. AB - We have compared drug transfer into target cells in vitro from liposomes of different sizes. Liposomes of mean diameter 800 A, 2000 A or 4000 A, containing the folate analogue, methotrexate, and the fluorophore, carboxyfluorescein, were covalently coupled to Staphylococcus aureus protein A. Cells of the murine k haplotype were preincubated with an anti-H-2Kk monoclonal antibody. Excess antibody was removed and then cells were incubated with liposomes. The number of cell-bound liposomes was determined by fluorimetry. The drug effect was assayed by the methotrexate-mediated inhibition of radiolabeled deoxyuridine uptake. The drug effect was more important in the case of the 800 A vesicles than for the larger liposomes, despite the fact that the quantity of drug bound to cells was several-fold greater for large liposomes than for small ones. Since fusion is excluded by the non-proportionality of drug binding and drug effect, the predominant manner of liposome entry seems to be endocytosis. At least for these in vitro studies, the endocytosis by target cells of small liposomes seems to be more efficient than that of large liposomes. PMID- 6849908 TI - Studies on the fragmentation of erythrocyte ghost membrane with p chloromercuribenzoate in the micromolar range. AB - The effects of nonsaturating amounts (5-60 nmol/mg membrane protein) of p chloromercuribenzoate on the stability of unsealed erythrocyte ghosts were studied by turbidimetric measurements and direct observation by phase contrast microscopy. The organic mercurial provokes drastic disorganization of the membrane involving vesicle formation by inter- and externalization of the bilayer. These effects are not associated with a release in solution of membrane proteins which was shown in previous studies to occur at higher p chloromercuribenzoate concentration. Attempts have been made to identify the proteins involved in this phenomenon by the use of nonsaturating amounts of radioactively-labelled p-chloromercuribenzoate. Actin and band 3 protein which are the first to be labelled, represent plausible candidates as sensitive targets for the disrupting organic mercurial. Stroma obtained from spherocytes did not show significant differences with normocytes in their stability with regard to p chloromercuribenzoate. Other reagents including N-ethylmaleimide, diamide and DNAase I were also studied. The results suggest strongly that the integrity of the sulfhydryl groups of actin, as well as those of band 3 protein, is essential for the stability of the erythrocyte membrane. PMID- 6849909 TI - Effects of liposome size on the degradation of bovine brain sphingomyelin/cholesterol liposomes in the mouse liver. AB - The relative rates of degradation of the outer lipid bilayer of large multilamellar and small unilamellar bovine brain sphingomyelin/cholesterol (2:1; mol/mol) liposomes in the livers of Balb/c mice were compared. The rate of the release of entrapped In-111 ions from the aqueous reservoir of small unilamellar liposomes or from the outermost aqueous compartment of multilamellar liposomes was used to monitor the rate of degradation of the exterior lipid bilayer surface of these liposomes. The technique of gamma-ray perturbed angular correlation and a method for loading In-111 ions into the outermost aqueous compartment of liposomes were used in this investigation. It was found that in the liver the exterior lipid bilayer of large multilamellar liposomes was degraded more rapidly than the bilayer of small unilamellar liposomes in vivo. In contrast to the situation for small unilamellar liposomes, the degradative process for large multilamellar liposomes in the liver was not maintained under ischemic conditions. Our results suggest that multiple pathways operate in the degradation of liposomes in the liver. The rate of degradation of liposomes in the liver may depend on accessibility of liposomes to degradative sites. PMID- 6849910 TI - The effects of alkali metal ions on active Ca2+ transport in reconstituted ghosts from human red cells. AB - 1. K+, Rb+ or Na+ increase from 30 to 90% the maximum rate of Ca2+ transport from resealed ghosts, leaving unaltered the apparent affinity of the Ca2+ pump for Ca2+. Li+ is ineffective as activator of Ca2+ transport. 2. K+ does not change the temperature dependence of Ca2+ transport. 3. The effects of K+ and Na+ are half-maximal at 4.6 mM and 24 mM, respectively. 4. The site(s) at which K+ or Na+ combine are accessible only from the cytoplasmic surface of the cell membrane. 5. Under conditions in which Na+ activates the Ca2+ pump no Na+ efflux coupled to Ca2+ efflux is apparent. PMID- 6849911 TI - Efflux and exchange of gamma-aminobutyric acid and nipecotic acid catalysed by synaptic plasma membrane vesicles isolated from immature rat brain. AB - The mechanism of gamma-aminobutyric acid translocation in synaptic plasma membrane vesicles from rat brain has been probed by comparing the ion dependency of net efflux with that of exchange. Furthermore the question has been asked if the same mechanism operates for other solutes translocated by this transporter. Dilution-induced efflux of gamma-aminobutyrate from the membrane vesicles is about 3-fold stimulated by externally added gamma-aminobutyrate. Half maximal stimulation is obtained at a gamma-aminobutyrate concentration similar to the Km for gamma-aminobutyrate influx. This stimulation (exchange) is dependent on external sodium but not on external chloride. In contrast to this gamma aminobutyrate influx is absolutely dependent on the simultaneous presence of sodium and chloride ions (Kanner, B.I. (1978) Biochemistry 17, 1207-1211), while efflux is dependent on the presence of these two ions on the inside (Kanner, B.I. and Kifer, L. (1981) Biochemistry 20, 3354-3358). Nigericin stimulates dilution induced efflux of gamma-aminobutyrate from potassium loaded vesicles to a larger extent than external gamma-aminobutyrate. gamma-Aminobutyrate further enhances the nigericin-induced stimulation, provided that the vesicles are not preloaded with chloride. Nipecotic acid is transported with the same features as gamma aminobutyrate and the two solutes behave similar with respect to the ion dependence of net flux and exchange. A model for the translocation cycle is proposed in which at least one of the translocated sodium ions binds to the transporter in its 'outside' conformation after chloride and the solute have bound previously. Conversely, the solute is released from its 'inside' conformation prior to chloride and at least one of the sodium ions. PMID- 6849912 TI - Effects of divalent and trivalent cations on Na+-Ca2+ exchange in cardiac sarcolemmal vesicles. AB - Inhibition of Na+-Ca2+ exchange processes in canine cardiac sarcolemmal vesicles by several divalent and trivalent cations has been investigated. The order of cation effectiveness in inhibiting initial rates of Nai+-induced Ca2+ uptake in the presence of 140 mM Nai+ and 20 microM Cao2+ is La3+ greater than Nd3+ greater than Tm3+ approximately Y3+ greater than Cd2+ much greater than Sr2+ greater than Ba2+ approximately Mn2+ much greater than Mg2+. The effectiveness of the divalent ions is related to their ionic crystal radius as compared with that of Ca2+. No such relationship was observed for the trivalent ions, which appeared instead to be more effective the larger their radius. Very low concentrations of trivalent ions ((1-6).10(-7)M) caused slight stimulation of Ca2+-exchange uptake. The trivalent ions also inhibited passive and Nao+-induced Ca2+ efflux from sarcolemmal vesicles, in the same concentration range as that for inhibiting uptake. The divalent ions, however, stimulated Ca2+ efflux, possibly via divalent cation-Ca2+ exchange. These various results suggest that the divalent and trivalent cations interact differently with the exchange apparatus in the sarcolemma. PMID- 6849914 TI - Kinetic and thermodynamic studies on nitrobenzylthioinosine binding to the nucleoside transporter of Chinese hamster ovary cells. AB - The binding of [G-3H]nitrobenzylthioinosine to intact Chinese hamster ovary cells has been studied kinetically and thermodynamically. The association of nitrobenzylthioinosine with cells is a second-order process which proceeds at 24 degrees C with a rate constant of 2 X 10(7) M-1 X S-1. Dissociation of the complex was characterized as a simple first-order process with rate constant on the order of 7 X 10(-3)S-1. The quotient of these is comparable to the dissociation constant as measured in equilibrium binding studies, 2.2 X 10(-10) M. The temperature dependence of the rate of association indicated an Arrhenius activation energy of 8.4 kcal X mol-1, while that of the equilibrium constant for dissociation indicated a standard enthalpy change of 8.8 kcal X mol-1. The large increase in affinity of nitrobenzylthioinosine as compared to natural nucleosides is attributable to an entropy-driven interaction with the binding site. Thymidine, dipyridamole and papaverine each decrease the apparent dissociation constant for the nitrobenzylthioinosine-cell complex; the latter, inhibitors of nucleoside transport, decrease the rate of dissociation of the complex. PMID- 6849915 TI - Polymorphic phase behaviour of dilinoleoylphosphatidylethanolamine and palmitoyloleoylphosphatidylcholine mixtures. Structural changes between hexagonal, cubic and bilayer phases. AB - The polymorphic phase behaviour of dilinoleoylphosphatidyethanolamine (DLPE) and 1-palmitoyl-2-oleoylphosphatidylcholine (POPC) is investigated by freeze-fracture electron microscopy, X-ray diffraction and 31P-NMR. The structures at 5% or less POPC are predominantly inverted hexagonal (HII), whereas at 15% or more POPC, the structure is mostly bilayer (L), interrupted by defects (lipidic particles). A cubic phase structure is observed in the transition range between H and L phases; the cubic arrangement deteriorates at higher temperatures into an amorphous aggregate of spherical units. Both cubic and amorphous structures contribute to the isotropic 31P resonance, with no preference for PC or PE partitioning in the isotropic motion as observed by high resolution NMR. The existence of the cubic phase seems to depend cirtically on the homogeneity and the degree unsaturation of the phospholipids. PMID- 6849913 TI - Effect of factors of favism on the protein and lipid components of rat erythrocyte membrane. AB - Erythrocytes prepared from riboflavin- and tocopherol-deficient (RT-) and from control rats were used to investigate the mechanism of oxidative hemolysis by the factors of favism. RT- erythrocytes have a defense system against the oxidative stress which is blocked either where regeneration of GSH occurs or the scavenging of the radicals from the membrane is prevented. The oxidative factors used were isouramil, divicine and diamide. When RT- erythrocytes were treated with isouramil, GSH decreased to undetectable levels and was not regenerated. Complete hemolysis occurred, but no oxidation of SH groups of membrane proteins or formation of spectrin polymers was detected. A similar effect was observed with diamide. However, SH groups of membrane proteins were completely oxidized and spectrin polymers were formed. Extensive lipid peroxidation was also detected together with a 30% fall in the arachidonic acid level. Control erythrocytes treated with either isouramil or diamide were not hemolyzed. When treated with isouramil, after a fall in the first few minutes, the GSH level was completely regenerated after 20 min. Incubation with diamide caused extensive oxidation of SH groups of membrane proteins and formation of spectrin polymers. No lipid peroxidation was detected after treatment with isouramil, but the same decrease of arachidonic acid occurred as in RT- erythrocytes. These results support the hypothesis that oxidative hemolysis by the factors of favism is caused by uncontrolled peroxidation of membrane lipids. PMID- 6849918 TI - Studies on the lack of cooperativity in the melting of lipid bilayers. AB - The gel-to-fluid first-order melting transition of lipid bilayers is simulated by the use of a microscopic interaction model which includes a variable number of lipid-chain conformational states. The results suggest that the experimental observation of 'continuous melting' in pure wet lipid bilayers, rather than being ascribed to the presence of impurities, may be explained as a result of kinetically caused metastability of intermediate lipid-chain conformations. PMID- 6849917 TI - Formation of aqueous pores in the human erythrocyte membrane after oxidative cross-linking of spectrin by diamide. AB - Oxidation of erythrocyte membrane SH-groups by diamide and tetrathionate induces cross-linking of spectrin (Haest, C.W.M., Kamp, D., Plasa, G. and Deuticke, B. (1977) Biochim. Biophys. Acta 469, 226-230). This cross-linking was now shown to go along with a concentration- and time-dependent enhancement of membrane permeability for hydrophilic nonelectrolytes and ions. The enhancement is specific for oxidative SH-group modifications, is reversible by reduction of the induced disulfides, can be suppressed by a very brief pre-treatment of the cells with low concentrations of N-ethylmaleimide and is strongly temperature dependent. The pathway of the induced permeability discriminates nonelectrolytes on the basis of molecular size and exhibits a very low activation energy (Ea 3-8 kcal/mol). These findings are reconcilable with the formation of a somewhat inhomogeneous population of aqueous pores with radii probably less than or equal to 0.65 nm. Estimated pore numbers vary with the size of the probe molecule. Assuming a diffusion coefficient as in bulk water within the pore, at least 20 pores per cell have to be postulated; more realistic lower diffusion coefficients increase that number. Alterations of the lipid domain by changes of cholesterol contents and insertion of hexanol or nonionic detergents alter the number or size of the pores. Since aggregation of skeletal and intrinsic membrane proteins also occurs after the SH-oxidation, in parallel to the formation of membrane leaks, one may consider (a) defects in the disturbed bilayer interface, (b) a mismatch between lipid and intrinsic proteins or (c) channels in between aggregated intrinsic proteins as structures forming the pores induced by diamide treatment. PMID- 6849916 TI - Phosphatidylinositol transfer protein from bovine brain. Substrate specificity and membrane binding properties. AB - A recently developed fluorimetric transfer assay (Somerharju, P., Brockerhoff, H. and Wirtz, K.W.A. (1981) Biochim. Biophys. Acta 649, 521-528) has been applied to study the substrate specificity and membrane binding of the phosphatidylinositol transfer protein from bovine brain. The substrate specificity was investigated by measuring the rate of transfer, either directly or indirectly, for a series of phosphatidylinositol analogues which included phosphatidic acid, phosphatidylglycerol as well as three lipids obtained from yeast phosphatidylinositol by partial periodate oxidation and subsequent borohydride reduction. Phosphatidylglycerol and the oxidation products of phosphatidylinositol were transferred at about one tenth of the rate observed for phosphatidylinositol while phosphatidic acid was not transferred. It is concluded that an intact inositol moiety favours the formation of the putative transfer protein-phosphatidylinositol complex. In addition to phosphatidylinositol, the transfer protein also transfers phosphatidylcholine. In order to obtain information on the possible occurrence of two sites of interaction, vesicles consisting of either pure 1-acyl-2-parinaroylphosphatidylinositol or 1-acyl-2 parinaroylphosphatidylcholine were titrated with the protein. Binding of labeled phospholipid to the protein was represented by an increase of lipid fluorescence and found to be much more efficient for phosphatidylinositol than for phosphatidylcholine. This is interpreted to indicate that the protein contains an endogenous phosphatidylinositol molecule which can be easily replaced by exogenous phosphatidylinositol but not by phosphatidylcholine, a lipid with a lower affinity for this protein. Thus the binding sites for the two phospholipids are mutually exclusive, i.e. phosphatidylinositol and phosphatidylcholine cannot be bound to the protein simultaneously. Finally, the effect of acidic phospholipids on the transfer protein activity was studied either by varying the content of phosphatidic acid in the acceptor vesicles or by adding vesicles of pure acidic phospholipids to the normal assay system. The latter vesicles consisted of either phosphatidic acid, phosphatidylglycerol, phosphatidylserine, phosphatidylinositol or cardiolipin. In both instances the transfer protein activity was inhibited, obviously through the enhanced association of the protein with the negatively charged vesicles. These findings strongly suggest that relatively nonspecific ionic forces rather than specific protein-phospholipid headgroup interactions contribute to the association of the phosphatidylinositol transfer protein with membranes. PMID- 6849919 TI - Neutral amino acid transport in Leishmania promastigotes. AB - Neutral amino acid transport was investigated in Leishmania promastigotes. Proline and alanine transport occur against their concentration gradient although there is a very rapid (40% at 30 min) conversion of proline to alanine. Uptake of these amino acids occurs by a sodium-independent route which is completely eliminated by addition of CCCP or KCN. Km values for proline and alanine are 80 microM and 63 microM with Vmax values of 6.4 and 7.2 nmol/min per mg dry weight, respectively. Countertransport of proline, alanine and phenylalanine was measured by loading the cells with a variety of neutral amino acids and proline analogs, followed by CCCP addition. The effect of aminooxyacetic acid, an inhibitor of alanine aminotransferase (EC 2.6.1.2), on proline and alanine countertransport was also examined. The results obtained are consistent with the presence of at least two systems for neutral amino acid transport in Leishmania promastigotes. PMID- 6849920 TI - Potassium permeability and volume control in isolated rat hepatocytes. AB - (1) The occurrence of volume-regulatory responses in isolated rat hepatocytes was investigated. After hypotonic shock, cells were able to shrink back to their normal volume within 15 min. By contrast, after hypertonic shock cells kept their shrunken volume for at least 15 min. (2) Na+-alanine cotransport increases K+ permeability in rat hepatocytes (Kristensen, L.O. (1980) J. Biol. Chem. 255, 5236 5243). It is shown here that this effect is due to cell swelling secondary to alanine accumulation rather than to the Na+-alanine cotransport itself. PMID- 6849921 TI - Bumetanide-sensitive potassium transport and volume regulation in turkey erythrocytes. AB - The bumetanide-sensitive (K+ + Na+ + 2Cl-)-cotransport system in turkey erythrocytes is activated by either of two treatments: addition of epinephrine or an increase in osmolarity. At elevated (20 mM) K+ concentration, cotransport activity induced by epinephrine slowly (within 90 min) declines to background level again. This time-dependent inactivation has been linked to bumetanide sensitive cell swelling. We have compared both the initial rate of cotransport activity and its time dependence after induction by either epinephrine, increased osmolarity or a combination of the two treatments. As a measure of cotransport activity we took the bumetanide-sensitive fraction of 86Rb+ influx. Immediately after activation, several kinetic characteristics of this flux (Vmax; Km towards K+; Ki towards bumetanide; pH profile) were identical in cells activated by either treatment. By contrast, cotransport activated by hypertonicity was significantly more resistant towards subsequent inactivation. We show this to be due to the increase in intracellular ion concentrations brought about by hypertonic cell shrinkage. This tended to reverse the driving force for cotransport, and thereby prevented the bumetanide-sensitive swelling associated with inactivation. Our data support the notion that cell volume plays a key role both in the activation and in the time-dependent inactivation of bumetanide sensitive transport. PMID- 6849923 TI - Major intrinsic polypeptide of lens membrane. Biochemical and immunological characterization of the major cyanogen bromide fragment. AB - A protein of Mr 26000 has been shown to be the major component of eye-lens junctions, which are similar but not identical to the gap junctions of liver and other tissues. Cyanogen bromide cleavage of the Mr 26000 polypeptide from bovine lenses yields a major fragment of Mr 15000 (fragment 1). However, if the junctions are first treated with trypsin or carboxypeptidase Y, cyanogen bromide treatment yields a fragment of reduced molecular weight. Since protease treatment has been shown to cleave residues almost exclusively from the carboxy-terminal end of the Mr 26000 polypeptide, it follows that fragment 1 represents the carboxy-terminal half of this molecule, part of which is exposed to proteolytic attack outside the membrane. This latter result is corroborated by the fact that antisera which recognize both the Mr 26000 polypeptide and fragment 1 fail to do so after preadsorption with intact membranes. In addition, comparative amino acid and partial sequence analyses of the Mr 26000 polypeptide and fragment 1 indicate that fragment 1 is more hydrophilic in character, suggesting that much of the amino-terminal half of the Mr 26000 polypeptide is buried within the lipid bilayer. PMID- 6849924 TI - The effect of neutral and charged micelles on the acid-base dissociation of the local anesthetic tetracaine. AB - The influence of surfactant micelles on the acid-base dissociation of the charged tertiary amino group of the local anesthetic, tetracaine, has been investigated. From measurements of tetracaine fluorescence as a function of bulk pH, apparent pK values of 6.88, 7.58 and 9.92 were found in the presence of cationic, neutral and anionic micelles, respectively, in 10 mM NaCl. These values are considerably displaced with respect to the pK in aqueous solution which is 8.26. Such large shifts can be attributed to the effect of the surface polarity and electrical potential on the dissociation behavior of the anesthetic bound to micelles. It can be expected that the acid-base dissociation of a local anesthetic adsorbed to nerve fibers will also be affected by the properties of the membrane surface. Thus, it is suggested that the influence of the interfacial region on the pK of surface-bound molecules should not be disregarded when estimating the proportion of charged and uncharged forms of local anesthetics interacting with axonal membranes. PMID- 6849922 TI - Kinetics of Lucifer yellow CH efflux in giant mitochondria. AB - The fluorescent dye Lucifer yellow CH was microinjected electrophoretically into giant mitochondria isolated from mice maintained on a diet containing cuprizone. The dye was retained by the mitochondria, indicating that it was contained in a space bounded by a selectively permeable membrane. The labelling was reversible by reversing the polarity of the current. A study of the disappearance of the fluorescence indicates that the permeability of the mitochondrial membrane to the dye (probably the lithium and/or the potassium salts) ranges from 10(-7) to 10( 8) cm/s. PMID- 6849925 TI - Kinetic aspects and mechanism of liposome disintegration in polyoxyethylene lauryl ether and sodium cholate solutions. AB - The disintegration behaviour of liposomes in polyoxyethylene lauryl ether (PLE) and sodium cholate solutions was studied by the turbidity disappearance method. In maximally solubilized systems of liposomes, the molar ratios (phosphatidylcholine/surfactant) were 0.43 and 1.8 for PLE and sodium cholate, respectively. The disintegration process of either unilamellar or multilamellar liposomes followed first-order kinetics. Based on a physical model in which liposomes heterogeneous in size were assumed to disintegrate from the outermost shell one by one, a mathematical expression of the turbidity disappearance rate was introduced and applied to explain the data thus obtained. Model calculations suggested that the number of disintegrated shells would not be so large, even if up to 50% reduction of the initial turbidity was observed. From the dependence of the pseudo-first-order rate constant (kobs) on the surfactant concentration for unilamellar liposomes, it was assumed in general that kobs consists of the contributions of the monomer and micellar fractions: for PLE, both fractions shared in the disintegration, but only the micellar fraction with sodium cholate. Furthermore, in the latter case, kobs depended on the initial liposome concentration. These results are likely to be consistent with the proposed modes of surfactant action classified as type A and type B (Helenius, A. and Simons, K. (1975) Biochim. Biophys. Acta 415, 29-79). PMID- 6849926 TI - Effect of ionic strength on the membrane fluidity of rabbit intestinal brush border membranes. A fluorescence probe study. AB - The effect of ionic strength on the fluidity of rabbit intestinal brush-border membranes has been studied using two fluorescence probes, pyrene and 1-anilino-8 naphthalene sulfonate (ANS). The imposition of a potential gradient on the pyrene probed membrane vesicles (out greater than in) with increasing NaCl concentration in the medium resulted in a marked enhancement of the excimer formation efficiency, accompanied by a decrease in the ratio of fluorescence intensities of the probe at 392 and 375 nm. Fluorescence polarization of the pyrene-membrane complex is independent of temperature in the absence of salts, while it is dependent on temperature from 10 to 47 degrees C in the presence of salts, as shown by the thermal Perrin plots of polarization. It has been demonstrated that there is a linear relationship between the changes in the pyrene excimer formation efficiency in the membranes and of the values of the binding parameters of ANS for the membranes. From these results, it is suggested that the lipid phase of the membranes becomes more fluid by shielding negatively charged groups of the membrane surface and that there is a fairly close correlation between the membrane organization and the membrane surface charge density. PMID- 6849927 TI - Comparative studies of purified and reconstituted monoamine oxidase from bovine liver mitochondria. AB - Monoamine oxidase, a strictly membrane-bound flavoenzyme, has been purified using a modified procedure recently developed. Probably similarly to other preparations known from the literature, the enzyme solubilizes to a clear suspension, which represents large clusters ranging in size from 5 to 50 nm containing appreciable amounts of residual lipids. The purified and reconstituted enzymes are inhibited differently by deoxycholate. In contrast to deoxycholate, Triton X-100 does not inhibit the purified enzyme, but rather disintegrates the lipid-enzyme clusters to the smallest active units. However, removal of the detergent leads to reconglomeration to larger lipid-enzyme aggregates. Using the irreversible destruction of the enzyme by deoxycholate as assay, reconstitution of the enzyme with exogeneous lipids has been studied. All basic enzyme properties, such as stability, maximal activity (V), Michaelis constant (Km), pH- and temperature dependence of the purified and reconstituted systems, are significantly different. PMID- 6849928 TI - Osmotic deformation of red blood cell ghosts induced by carbohydrates. AB - The osmotic response of bovine red blood cell ghosts to a series of sugars is studied by light scattering. The sealed and right-side-out ghosts are prepared by the procedure of Steck and Kant (Steck, T.L. and Kant, J.A. (1974) Methods Enzymol. 31, 172-180), swollen in a hypotonic phosphate-buffered saline solution and their size and shape determined by elastic and quasielastic light scattering. Different carbohydrates are then added to the suspending medium in order to examine the osmotic responses, and the osmotic deformation of ghosts is shown to be spherically symmetric. Having thus established the deformation behavior, we then rank the osmotic activity of a carbohydrate relative to a standard, i.e., raffinose. It is found that the osmotic response of the ghosts to sucrose is about the same as that to raffinose, and the response to the smaller carbohydrates simply follows the number of carbons in various sugars; glucose and fractose are about 1.7 times less effective than raffinose, and pentaerythritol and meso-erythritol are 2.3 times less effective. Glyceraldehyde, which is 3.6 times less effective than raffinose, is the least effective sugar analog among those that we have tested. PMID- 6849929 TI - Requirements for antiribosomal activity of pokeweed antiviral protein. AB - It has been known for some time that pokeweed antiviral protein acts by enzymatically inhibiting protein synthesis on eucaryotic ribosome systems. The site of this action is known to be the ribosome itself. In this paper we show that the pokeweed antiviral protein reaction against ribosomes is a strong function of salt concentrations, where 160 mM K+ and 3 mM Mg2+ retards the reaction, while 20 mM K+ and 2 mM Mg2+ allows maximum reaction rate. It is also shown, however, that an unidentified protein in the postribosomal supernatant solution, together with ATP, allows the ribosome to be attacked even in the presence of high salt. Kinetic analysis of the antiviral protein reaction has been carried out under both sets of conditions, and reveals that the turnover number for the enzyme is about 300-400 mol/mol per min. in each case. The Km for ribosomes is 1 microM in the presence of low salt and 0.2 microM at higher salt in the presence of postribosomal supernatant factors plus ATP. The antiviral protein reaction is also shown to be pH dependent and is controlled by a residue with pKa value of approx. 7.0, apparently a histidine. Stoichiometric reaction of the enzyme with iodoacetamide results in a significant loss of antiribosomal activity. PMID- 6849931 TI - Determination of the kinetic properties of enzymes catalysing coupled reaction sequences. AB - In a coupled system of two enzyme-catalysed reactions the concentration of the final product follows a sigmoidal progress curve. The shape of this curve is dependent on the concentrations and kinetic properties of both enzymes in the system; provided that the activities of the two enzymes are similar, the kinetic properties of both enzymes may be determined simultaneously by analysis of such curves. The value of this approach is substantiated using a model system consisting of pyruvate kinase (EC 2.7.1.40) and lactate dehydrogenase (EC 1.1.1.27). Analysis of the data by a combination of numerical integration and nonlinear regression yielded values for the kinetic parameters which are in excellent agreement with those determined from measurements of steady-state rates. Appropriate experimental designs for this type of progress curve analysis are considered. The analysis is compared with, and is shown to be of much greater generality than, published procedures involving measurements of the early stages of progress curves. PMID- 6849930 TI - Unique acceptors for poly(ADP-ribose) in resting, proliferating and DNA-damaged human lymphocytes. AB - Acceptor proteins for poly(adenosine diphosphoribosyl)ation were determined in resting human lymphocytes, in lymphocytes with N-methyl-N'-nitro-N nitrosoguanidine-induced DNA damage and in lymphocytes stimulated to proliferate by phytohemagglutinin. Kinetic studies showed that the increase in ADP ribosylation which occurred in response to N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) treatment was greater in magnitude but more transient in duration than that which occurred in phytohemagglutinin-stimulated cells. Gel electrophoretic analyses revealed that MNNG treatment and phytohemagglutinin stimulation both caused an increase in ADP-ribosylation of poly(ADP-ribose) polymerase and core histones. In MNNG-treated cells, an increase in ADP-ribosylation of histone H1 was also observed. In contrast, phytohemagglutinin-stimulated cells showed no increase in ADP-ribosylation of histone H1. In MNNG-treated cells there was also ADP-ribosylation of a protein of molecular weight 62 000, while in phytohemagglutinin-stimulated cells there was a marked increase in ADP ribosylation of a protein of molecular weight 96 000. MNNG treatment of phytohemagglutinin-stimulated cells produced a pattern of ADP-ribosylation that appeared to be due to the combined effects of the individual treatments. 3 Aminobenzamide effectively inhibited ADP-ribosylation under all treatment conditions. PMID- 6849932 TI - Improved purification and sulfhydryl analysis of thiosulfate reductase. AB - Thiosulfate reductase purified 900-fold from an extract of baker's yeast by a new procedure consisted of three charge-isomeric species, all with catalytic activity. Amino acid analysis of thiosulfate reductase and titrations with 5,5' dithiobis(2-nitrobenzoate) and iodo[14C]acetate indicated only one cysteine residue per enzyme molecule. Alkylation of this cysteine with either iodoacetate or iodoacetamide did not inactivate the enzyme, indicating that sulfur-sulfur bond cleavage in the thiosulfate substrate does not require an enzymic sulfhydryl group as attacking nucleophile. PMID- 6849933 TI - Multiple isoelectric forms of detergent-solubilized bovine rhodopsin. I. Identity, composition and properties. AB - Isoelectric focusing was performed on crude bovine rhodopsin (a detergent extract of rod outer segments) and on rhodopsin after purification by adsorption chromatography on calcium phosphate-Celite and affinity chromatography on Con A Sepharose. The purified unbleached (native) material resolved into three forms of nearly equal amounts having isoelectric points (pI) of 5.19, 5.58 and 6.14. Each form was stable to refocusing. The composition of the three forms as determined by amino acid analysis, phosphate analysis and polyacrylamide gel electrophoresis was the same as that found for unfocused rhodopsin. Each isoelectric form cross reacted with rabbit antibody to bovine rhodopsin. After photobleaching, one form of opsin was observed, having an isoelectric point of 5.58. While crude rhodopsin showed a single species in the native state (pI of 6.20), multiple forms were revealed after treatment with phospholipase. Purified rhodopsin, after reduction, showed a single major isoelectric point of 6.09 rather than the multiple forms. Exposure of rod outer segments or rhodopsin to antioxidants or rcrude rhodopsin showed a single species in the native state (pI of 6.20), multiple forms were revealed after treatment with phospholipase. Purified rhodopsin, after reduction, showed a single major isoelectric point of 6.09 rather than the multiple forms. Exposure of rod outer segments or rhodopsin to antioxidants or removal of phospholipids led to an alteration in the relative abundance of the multiple isoelectric forms, but not to a change in their isoelectric point. PMID- 6849934 TI - Multiple isoelectric forms of detergent-solubilized bovine rhodopsin. II. Spectral analysis. AB - The absorption and circular dichroic spectra of three stable isoelectric forms of purified rhodopsin (in Emulphogene BC 720) with isoelectric points of 5.19, 5.58 and 6.14 were analysed over the accessible wavelength region of 190-800 nm. It was found from the spectral analysis of the 5.58 and 6.14 forms that the tertiary structure of these isoelectric forms was different, without any change being observed in the secondary structure of these proteins. The difference in structure was removed by denaturation with SDS. Specifically, the aromatic amino acid residues of the 6.14 isoelectric form were suggested to be in a more polar environment as compared to those for the 5.58 isoelectric form. The changes of structure in the microenvironment of retinal in these proteins were minor in comparison to the tertiary changes observed in the proteins. This indicated that the site of charge perturbation is not localized in the retinylidene microenvironment. Furthermore, the spectral features of these isoelectric forms were features common to the spectra of both purified unfocused rhodopsin and crude rhodopsin, suggesting that the isoelectric forms are not a consequence of purification. Spectral analysis of the 5.19 isoelectric form indicated that this form of rhodopsin had an increased tendency to aggregate after focusing. Based on the denaturation properties of these isoelectric forms, it was shown that the 5.19 and 5.58 isoelectric forms had different conformations. It was concluded from this study that preparations of 'purified' rhodopsin are a heterogeneous mixture of stable proteins with different tertiary structures and different isoelectric points. PMID- 6849935 TI - Demonstration of a minor hemoglobin with modified alpha chains and additional modified hemoglobins in normal and diabetic adults. AB - We have attempted to separate various hemoglobins in 10 normal and 11 diabetic persons by Bio-Rex 70 chromatography at 4 degrees C with an exponentially increasing sodium phosphate gradient. Minor hemoglobins, namely AIa1, AIa2, AIb1, AIb2, AIb3, AIc, AId1, AId2 and AId3, have been separated and eluted in that order. Most of these minor hemoglobins were newly observed and could not be detected by the previous chromatographic techniques. On the basis of colorimetric assay protein-bound ketoamine was present in all the minor hemoglobins, which was confirmed by chromatographic separation of hemoglobins after reduction with NaB3H4. All the minor hemoglobins, with the exception of Hb AIa1, HbIa2, and Hb AIb1, showed a 2-fold increase in the diabetic patients. Hb AIc (5.0% in normals; 9.0% in diabetics) and Hb AId3 (1.9% in normals; 3.2% in diabetics) were present in the largest amounts. Both Hb AId3 and Hb Ao showed a decrease in oxygen affinity in the presence of 2,3-diphosphoglycerate, whereas Hb AIc showed no effect. Separation of globin chains by cellulose acetate electrophoresis at pH 8.6 showed that the cathodal mobility of the alpha chains of Hb AId3 was slower than those of Hb Ao. Glycosylation of Hb with [14C]glucose followed by separation of hemoglobins by two Bio-Rex 70 chromatographic methods indicated that the minor Hb formed by glycosylation of the alpha-chain amino-terminus was separated from Hb Ao, while the minor hemoglobins formed by the glycosylation of epsilon-NH2 groups chromatographed with Hb Ao. PMID- 6849936 TI - Possible amino acid repetitive sequences in the proline-rich glycoprotein of human parotid saliva. AB - The amino acid sequence of the proline-rich glycoprotein from human parotid saliva was studied using different preparations: native glycoprotein, tryptic glycopeptides, and their chemically deglycosylated homologous derivatives. The results indicate very similar structural features of the proline-rich glycoprotein and the tryptic glycopeptides and suggest that the peptide backbone of the glycoprotein comprises several repetitive domains containing one carbohydrate-peptide linkage and a proline-rich sequence. These data are in fair agreement with a preceding circular dichroism study (Aubert, J.P., Porchet, N., Boersma, A., Loucheux-Lefevbre, M.H. and Degand, P. (1982) Biochim. Biophys. Acta 704, 361-365). PMID- 6849938 TI - Amino acid sequence of dimeric myoglobin from Cerithidea rhizophorarum. AB - The complete amino acid sequence of the dimeric myoglobin from Cerithidea rhizophorarum, a common gastropodic mollusc on the Japanese coast having an elongated many-whorled shell, has been determined. The monomer is composed of 151 amino acid residues, is acetylated at the amino terminus, and 75 residues out of 151 are homologous with the monomer of myoglobin from the whelk Busycon canaliculatum. Unlike Aplysia myoglobin, which lacks the distal histidine, Cerithidea myoglobin contains three histidines in its monomer, His-66 being assigned to the distal position, and in its oxymyoglobin form its stability properties show a very strong pH dependence. PMID- 6849937 TI - Microcalorimetric determination of binding sites of acetylcholinesterase. AB - Acetylcholinesterase (acetylcholine acetylhydrolase, EC 3.1.1.7), phosphorylated with dichlorvos, showed relatively more reactivity toward the substrate indophenyl acetate than the enzyme that was carbamylated with carbaryl. When the anionic subsite of the phosphorylated or carbamylated enzyme was alkylated with an aziridinium ion, the reaction velocity toward indophenyl acetate increased in the phosphorylated enzyme but not in the carbamylated enzyme. The organophosphate binding site--which appears to be different from that of carbamate or indophenyl acetate, but probably the same as that of acetylcholine -- is apparently alkylated in such a way that the modified (phosphorylated) enzyme is better-fit for the binding (and hydrolysis) of indophenyl acetate. The modified conformation presumably results in the release of the phosphoryl group from the esteratic subsite. PMID- 6849941 TI - Influence of heat treatment on rabbit liver ferritin. AB - Ferritin was purified from rabbit livers either by heat treatment and immunoaffinity chromatography, or by immunoaffinity chromatography alone. The immunoreactivity of ferritin with antibodies raised against heat-treated ferritin was significantly higher for heat-treated preparations than for non-heated preparations. The amount of ferritin protein could be estimated with equal reliability by the assay according to Lowry et al. and by nitrogen determination. Heat treatment favoured the L-subunit-rich ferritin fraction, as measured by densitometric scanning of SDS gradient-pore polyacrylamide gels. Amino acid analysis showed small changes in the amounts of valine, isoleucine and histidine in the heat-treated ferritin, possibly due to selective partial degradation of H subunit-rich forms of ferritin. These results illustrate that heat treatment, which is a commonly used step in most purification procedures, induces partial denaturation of the ferritin molecules. PMID- 6849939 TI - Purification and molecular properties of two cadmium-binding glycoproteins from the hepatopancreas of a whelk, Buccinum tenuissimum. AB - Two cytoplasmic cadmium-binding glycoproteins from the hepatopancreas of a whelk, Buccinum tenuissimum, were purified to homogeneity by Sephadex G-75 gel filtration and two DEAE-Sephadex A-25 chromatographies in the presence of 2 mercaptoethanol. These two cadmium-binding glycoproteins, termed FIIA and FIIB, each showed a single band after electrophoresis on 10% polyacrylamide gel at pH 8.9. The molecular weight of FIIA was estimated as 8000 and that of FIIB as 13000 by SDS-polyacrylamide gel electrophoresis. Based on molecular weights of 6500 and 11900 for the protein moiety of FIIA and FIIB, respectively, the total number of amino acid residues was 52 in the former and 94 in the latter. Three and two cysteine residues in FIIA and FIIB, respectively, were titratable with p chloromercuribenzoate. FIIB also contained two more half-cystine residues. The sugar contents of FIIA and FIIB were about 20.5% and 8.7% by weight, respectively, consisting of galactose, mannose, fucose and amino sugar. The purified glycoproteins FIIA and FIIB contained about 0.6% and 1.0% cadmium by weight, respectively, and both showed strong metal-binding capacity, especially for cadmium, copper and mercury. The apparent cadmium dissociation constants for FIIA and FIIB after treatment with 2-mercaptoethanol were 7.3 X 10(-6) and 9.1 X 10(-7) M, respectively. Cadmium contents at saturation were nearly 6 and 8 gatom per mole for FIIA and FIIB, respectively. PMID- 6849943 TI - Effect of hyperthyroidism on lipogenesis in brown adipose tissue of young rats. AB - Fatty acid synthetic capacity, investigated both in subcellular fractions and in vivo, is very active in brown adipose tissue of room temperature-acclimated rats. In hyperthyroid animals this tissue, analogously to the liver, exhibits an increased activity of acetyl-CoA carboxylase, fatty acid synthetase and microsomal fatty acid chain elongation, this last mechanism remaining unaffected in mitochondria. An enhancement of reducing capacities of a group of cytoplasmic NADP-dependent enzymes has also been observed in brown adipose tissue of hyperthyroid rats, probably due to a greater use of NADPH in lipogenesis under these conditions. An increase in palmitate oxidation and in polyenoic fatty acids was observed in mitochondria of brown adipose tissue from hyperthyroid animals. The latter increase is related to the importance of these compounds in the regulation of membrane fluidity and probably to an increased resistance to cold in the hyperthyroid state. PMID- 6849940 TI - Spectral and oxygen-release kinetic properties of human hemoglobin bound to the cytoplasmic fragment of band 3 protein in solution. AB - Binding of the cytoplasmic fragment of band 3 protein to oxyhemoglobin in solution caused a spectral change in the absorbance of the hemoglobin beta chain at a ratio of one monomer of band 3 protein per alpha beta dimer of hemoglobin. This spectral change was reversed at higher ratios of cytoplasmic fragment to hemoglobin. The unusual dependence on protein concentration was interpreted as indicating the formation of higher aggregates of the complex between hemoglobin and the cytoplasmic fragment of band 3 protein. Oxygen-release kinetic measurements also showed marked changes as a function of the concentration of the cytoplasmic fragment of band 3 protein. The higher ratio mixture had significantly different kinetic properties as compared with the lower ratio one, which in turn was different from oxyhemoglobin in solution. The significance of the formation of aggregates of band 3 protein containing oxyhemoglobin dimers is discussed in context with evidence suggesting that band 3 protein may exist as an equilibrium mixture of tetramers and dimers in the membrane. PMID- 6849942 TI - Evidence that lecithin:cholesterol acyltransferase acts on both high-density and low-density lipoproteins. AB - In incubations of plasma containing lipoproteins at physiological concentrations it has been confirmed that high-density lipoproteins (HDL) are the major initial recipients of the esterified cholesterol formed in the reaction catalysed by lecithin:cholesterol acyltransferase. It has also been confirmed, however, that a small proportion of the esterified cholesterol of lecithin:cholesterol acyltransferase origin is incorporated directly into low-density lipoproteins (LDL), via a pathway that bypasses the HDL. This direct incorporation of esterified cholesterol into LDL is compatible with either of two general models. Model A proposes that lecithin:cholesterol acyltransferase does not interact directly with LDL but rather that it acts only on lipoproteins outside the LDL fraction. According to model A, while most of the esterified cholesterol so formed is incorporated into HDL, a small proportion is transferred directly to LDL. Model B, by contrast, proposes that a direct incorporation of esterified cholesterol into LDL is the result of a direct action of lecithin:cholesterol acyltransferase on the free cholesterol associated with LDL. To differentiate between these two models, experiments have been performed in which incubation mixtures containing LDL, HDL and a source of lecithin:cholesterol acyltransferase were supplemented with free [3H]cholesterol which had previously been incorporated into either LDL or HDL. It was found that, of the esterified [3H]cholesterol which was subsequently formed, the proportion recovered in the LDL fraction was much greater in the incubations to which the free [3H]cholesterol had been added as a component of LDL than in those to which it had been added as a component of HDL. This essentially excluded model A but was consistent with model B. It has been concluded that, while most of the lecithin:cholesterol acyltransferase may interact with particles in the HDL fraction, a small proportion of the enzyme interacts directly with LDL. PMID- 6849946 TI - Lipid metabolism in Chinese hamster V79-R membranes composed of unusual phospholipid molecular species. AB - The relationship between the inhibition of cell growth and the changes in phospholipid metabolism in the presence of erucic acid was studied in Chinese hamster V79-R cells. 1. The addition of erucic acid to the medium inhibited cell growth. The degree of inhibition by erucic acid at a given concentration was dependent on cell density. 2. Exogenous erucic acid was incorporated into cellular phospholipids to form new phospholipid molecular species, which were identified to be the erucoyl/oleoyl, erucoyl/gondoyl and erucoyl/erucoyl species. 3. Synthesis of phosphatidylcholine and phosphatidylethanolamine in endoplasmic reticulum was reduced by erucic acid. Erucic acid had no effect on membrane flow of phospholipids from endoplasmic reticulum to plasma membrane. 4. The specific activity of sn-glycerol-3-phosphate acyltransferase in the membrane fraction from the cells supplemented with erucic acid was lower than that from the control cells. The reduction of phospholipid synthesis was attributed to the decrease in sn-glycerol-3-phosphate acyltransferase activity. PMID- 6849945 TI - Stimulation of microperoxisomal beta-oxidation in rat heart by high-fat diets. AB - 1. Heart microperoxisomal beta-oxidation activity, measured as cyanide insensitive palmitoyl-CoA-dependent NAD+-reduction, was detected in a microperoxisome-enriched fraction from rat myocardium. The effect on this microperoxisomal beta-oxidation of the fatty acid composition of the dietary oils was investigated. 2. Feeding 15% (w/w) high erucic acid rapeseed oil or partially hydrogenated marine oil for 3 weeks increased the microperoxisomal beta-oxidation in the heart 4-5-fold, compared to a soybean oil diet. Increasing amounts (5-30%, w/w) of partially hydrogenated marine oil in the diet led to a 3-fold increase in the microperoxisomal beta-oxidation capacity at 20% or more of this oil in the diet. 3. The activity of the microperoxisomal marker enzyme catalase followed closely the cyanide-insensitive palmitoyl-CoA-dependent NAD+-reduction, except when feeding more than 20% (w/w) partially hydrogenated marine oil where a significant decrease in the catalase activity was observed. 4. In rapeseed oil fed animals the extent of increase of microperoxisomal beta-oxidation was directly correlated to the amount of erucic acid (22:1, n-9 cis) in the diet. 5. Feeding partially hydrogenated rapeseed oil or partially hydrogenated soybean oil resulted in activities of microperoxisomal beta-oxidation significantly lower than in the corresponding unhydrogenated oils. No significant difference could be detected between diets containing hydrogenated or unhydrogenated marine oil. 6. Addition of 5% soybean oil to the essential fatty acid-deficient, partially hydrogenated marine oil diet did not change the effect on the microperoxisomal beta-oxidation activity. 7. Clofibrate feeding increased the heart microperoxisomal beta-oxidation capacity 2.5-fold, as compared to a standard pelleted diet. 8. These findings are discussed in relation to the transient nature of the cardiac lipidosis observed with animals fed on diets rich in C22:1 fatty acids. It is concluded that the heart plays an important part in the adaptation process. PMID- 6849948 TI - Cytochrome b5-dependent delta 9 desaturation of fatty acids in gastric microsomes. AB - Stearyl-CoA was shown to stimulate the reoxidation rate of cytochrome b5 of gastric microsomes and to decrease the reduction rate of trypsin-purified hog liver cytochrome b5 by the NADH-cytochrome b5 reductase of these microsomes. This latter effect was (1) proportional to microsome concentration and to stearyl-CoA concentration with an apparent Km of 3.3 . 10(-6) M and a Vmax of 71 nmol per min and per mg microsomal protein, (2) insensitive to ATP and inhibited by 1.4 mM KCN, (3) mimicked by palmityl-CoA but not by stearic nor palmitic acid. Direct assays carried out using [14C]stearyl- and [14C]palmityl-CoA as substrates showed a production of 0.12 nmol of oleic and palmitoleic acid, respectively, per min per mg of microsomal protein. In the presence of Tb5 antibodies the reaction was inhibited by 40%. These results support the occurrence of cytochrome b5-dependent fatty acid delta 9 desaturation in gastric microsomes. PMID- 6849944 TI - Cholesterol content of red blood cells and low-density lipoproteins in hypertriglyceridemia. AB - The red blood cells and the low-density lipoproteins in hypertriglyceridemia have a lower ratio of unesterified cholesterol to phospholipid than normal. The low density lipoproteins are also smaller and more dense in hypertriglyceridemia, and contain only 45% of the normal unesterified cholesterol mass. The phase behavior of the lipids shows that normal red cells and low-density lipoproteins are close to saturation with cholesterol, whereas in hypertriglyceridemia less cholesterol is present. Because newly secreted triacylglycerol-rich lipoproteins are poor in cholesterol, their excess production and transport in hypertriglyceridemia may prevent maintenance of the normal cholesterol content of blood cells and low density lipoproteins. Partitioning of cholesterol into triacylglycerol-rich lipoproteins is able to account for significant fluxes of unesterified cholesterol in the plasma compartment. PMID- 6849947 TI - Esterification of cholesterol and 25-hydroxycholesterol by rat liver microsomes. AB - The properties of an enzyme in rat liver microsomes was described that catalyzed the formation of 25-hydroxycholesteryl ester in the presence of labeled sterol and oleoyl-CoA. The reaction was similar in several respects to that of cholesteryl ester formation by acyl-CoA: cholesterol acyltransferase. Trypsin pretreatment of microsomes inhibited the esterification of both sterols and a similar dose-dependent inhibition was produced by addition of progesterone and several androgens. Microsomes with an enhanced cholesterol content resulting from in vivo treatment with ethinyl estradiol showed increased esterifying activity towards both cholesterol and 25-hydroxycholesterol. Esterification of endogenous microsomal cholesterol was increased by the addition of 25-hydroxycholesterol, concomitant with 25-hydroxycholesteryl ester formation. To assess the relationship between the association of sterols with membranes and sterol ester formation, microsomes were preincubated with either sterol, reisolated by ultracentrifugation in a density gradient and then analyzed chemically or enzymatically. Cholesterol and 25-hydroxycholesterol both associated with microsomes and the added sterol was subsequently esterified. Maximal esterification was only partially dependent on the amount bound. Progesterone, which inhibited sterol esterification, did not bind to microsomes and no inhibition was observed in reisolated microsomes, indicating that the inhibition produced by progesterone was reversible. PMID- 6849949 TI - Separation, quantitation and distribution of dolichol and dolichyl phosphate in rat and human tissues. AB - Two procedures for quantitative determination of dolichol were studied and these were applied to analyze tissue and subcellular distribution. In the first procedure the dolichols were oxidized with Cr2O3 and reduced with NaB3H4. The radioactivity in the individual dolichols was measured using reversed-phase thin layer chromatography. In the second procedure, dolichols were analyzed by high pressure liquid chromatography. For determination of dolichyl phosphates the lipid extract was subjected to acid and alkaline hydrolysis, and after hydrolysis with acid phosphatase the distribution was determined by high-pressure liquid chromatography. Recovery was monitored by the addition of dolichol D15 and D23 phosphate to the homogenate. Rat spleen had the highest dolichol content (114 micrograms/g) followed by lower content in rat liver and brain. The distribution pattern was similar in all organs, with 18 and 19 isoprene residues as dominating components. Human organs contain considerably higher concentrations of dolichol, with the 19 and 20 isoprene residues as the main components. In rat liver, outer mitochondrial and Golgi membranes, lysosomes and plasma membranes contain considerable amounts of dolichol. A drastic increase in dolichol content was observed in rat liver hyperplastic nodules while human liver cirrhosis and hepatocarcinoma showed a marked decrease in dolichol. In the latter case, the distribution pattern was also changed. Of the total amount of dolichol present in the tissues, 2% was phosphorylated in human liver, 10% in human testis and 18% in rat liver. In rat liver mitochondria and in microsomes 4 and 31%, respectively, of the polyprenols were in activated form. The results demonstrated that dolichyl phosphate and dolichol concentrations were regulated by different mechanisms and that the two forms possessed an independent distribution. PMID- 6849950 TI - Liver lipase and high-density lipoprotein. Lipoprotein changes after incubation of human serum with rat liver lipase. AB - Human sera were incubated with rat liver lipase after inactivation of lecithin:cholesterol acyltransferase, and the changes in serum lipoprotein composition were measured. In the presence of liver lipase serum triacylglycerol and phosphatidylcholine were hydrolyzed. The main changes in the concentrations of these lipids were found in the high-density lipoprotein fraction. Subfractionation of high-density lipoprotein by rate-zonal ultracentrifugation showed a prominent decrease in all constituents of high-density lipoprotein2, a smaller decrease in the 'light' high-density lipoprotein3 and an increase in the 'heavy' high-density lipoprotein3. These data support a concept in which liver lipase is involved in high-density lipoprotein2 phospholipid and triacylglycerol catabolism and suggest that as a result of this action high-density lipoprotein2 is converted into high-density lipoprotein3. PMID- 6849952 TI - Inhibition of enzymic and non-enzymic lipid peroxidation of flounder muscle sarcoplasmic reticulum by pretreatment with phospholipase A2. AB - Sarcoplasmic reticulum, isolated from the muscle of winter flounder (Pseudopleuronectes americanus), was preincubated with phospholipase A2 to determine the effects of enzymic and non-enzymic lipid-peroxidation systems. Eicosapentaenoic acid (20:5) was preferentially released by phospholipase A2, but the percentage of docosahexaenoic acid (22:6) in the free fatty acids was similar to the percentage in membrane total fatty acids. A decrease in the production of both thiobarbituric acid-reactive substances and lipid hydroperoxides was observed in both the enzymic and non-enzymic peroxidation systems upon preincubation with phospholipase A2. Addition of palmitic acid or lysophosphatidylcholine did not inhibit either peroxidation system. Non-enzymic peroxidation was inhibited by the addition of beta-glycerophosphate, but enzymic peroxidation was apparently unaffected. A model is proposed to explain the inhibitory effect of phospholipid hydrolysis on lipid peroxidation in both systems, suggesting that fatty acids are structurally realigned upon hydrolysis, leading to decreased free-radical chain propagation. Additional factors appear to contribute to inhibition of enzymic peroxidation. PMID- 6849951 TI - Slower removal of intestinal apolipoprotein B-48 than of apolipoprotein B-100 in severely hypertriglyceridemic subjects. AB - Apolipoprotein B, the major structural protein of triacylglycerol-rich lipoprotein, occurs in two immunologically distinct forms, termed apolipoproteins B-100 and B-48. In man, the former is associated with triacylglycerol-rich lipoproteins of hepatic origin and the latter with intestinal triacylglycerol rich lipoproteins. We have studied the rates of removal of the two proteins when 125I-labelled triacylglycerol-rich lipoproteins were reinjected into six severely hypertriglyceridemic subjects showing hyperchylomicronemia, and into two normal subjects. The specific radioactivities of apolipoproteins B-100 and B-48 were determined over periods of up to 30 h. In all six hyperlipemic subjects the removal of apolipoprotein B-100 was either significantly faster than that of apolipoprotein B-48 (in four) or similar in the two who cleared triacylglycerol rich lipoproteins very slowly. When triacylglycerol-rich lipoproteins from two hyperlipemic subjects (in whom apolipoprotein B-48 was cleared more slowly) were injected into two normal subjects both B apolipoproteins were cleared at similar rates. Since apolipoprotein B-48 appears to be a marker for remnants of intestinal particles, its slower removal than that of apolipoprotein B-100 in severe hypertriglyceridemia suggests that one metabolic defect associated with the hyperchylomicronemia is defective removal of chylomicron remnants. PMID- 6849953 TI - Structural elucidation by field desorption and electron-impact mass spectrometry of the C-mycosides isolated from Mycobacterium smegmatis. AB - C-mycosides are superficial type-specific glycopeptidolipids of mycobacterial origin. In the present work, we have shown that field desorption mass spectrometry using the cationization method is a useful method for the molecular weight determination of such compounds. Complementary structural information has been obtained by electron-impact mass spectrometry. Combination of both methods has permitted the elucidation of the structure of the C-mycosides of Mycobacterium smegmatis, ATCC 607. This structure is similar to those described elsewhere, but some minor differences are observed in the lipid portion, mainly in the double bond location. PMID- 6849954 TI - The production of liquid crystalline product phases by pancreatic lipase in the absence of bile salts. A freeze-fracture study. AB - The hydrolysis of gum arabic-stabilized trioleylglycerol emulsions by pancreatic lipase was examined by freeze-fracture electron microscopy in the absence of bile salts. A sequence of liquid crystalline product phases was produced during the non-equilibrium conditions of hydrolysis. The morphology of the product phases were pH- and droplet size-dependent. At pH 8.3 the initial product phase was composed of homogeneous spherical vesicles regardless of trioleylglycerol drop size. As the reaction progressed the partially hydrolyzed droplets showed a crystalline 'crust' and a true lamellar phase which was often swollen, giving an isotropic appearance to this phase. Some droplets demonstrated a possible transitory hexagonal phase composed of tubular-lamellar elements in close association with the oil phase. These tubular-lamellar elements graded into a lamellar phase at the aqueous/product interface. A cubic phase was not discernible. At pH 7.0 a single phase was seen which covered the drop surface with an amorphous layered 'crust'. The significance of these phases is discussed in relation to those produced by pure and mixed lipids under equilibrium conditions. PMID- 6849955 TI - Catabolism of fish furan fatty acids to urofuran acids in the rat. AB - A mixture of long-chain furan fatty acids was prepared as methyl esters from testes lipids of Northern pike (Esox lucius). Upon feeding these esters to rats, dicarboxylic acids, which still contained the furan structure, were found in the urine. The first phase of a rapid but incomplete catabolism is beta-oxidation of the proximal chain of the furan fatty acids. It proceeds to a distance of three carbon atoms from the ring. omega-Oxidation of the terminal alkyl chain, followed by alpha-oxidation gives rise to a second alkylcarboxyl chain with five carbon atoms or less. The ring methyl substituents of the precursor acids seem to be more resistant to oxidation than the alkyl substituent with three or five carbon atoms. The urinary catabolites from furan fatty acids in the rat are similar to furan acids found in human urine, but only one of the structures occurs in both sources. PMID- 6849956 TI - A comparison of the surface activities of rat plasma apolipoproteins C-II, C-III 0, C-III-3. AB - Rat apolipoproteins C-II, C-III-0 and C-III-3 give similar surface pressure (pi) molecular area isotherms when spread at the air/water interface. When allowed to adsorb to the clean air/water interface, the intrinsic surface activity of apolipoprotein C-II is somewhat higher than that of apolipoprotein C-III. All three apolipoprotein C molecules can penetrate an egg phosphatidylcholine monolayer spread at the air/water interface causing an increase (delta pi) in surface pressure. Increasing the initial surface pressure (pi i) of the lipid monolayer decreases delta pi, and delta pi = 0 when pi i greater than or equal to 32 +/- 2 mN . m-1 for all three apolipoprotein C proteins. This implies that apolipoproteins C-II, C-III-0 and C-III-3 would adsorb and desorb similarly from the surfaces of lipoprotein particles during metabolism. PMID- 6849958 TI - The rapid incorporation of radioactive fatty acid into triacylglycerols during the in vitro acylation of native lipids of neuronal nuclei. AB - Using neuronal nuclei (N1) and microsomes (P3) isolated from cerebral cortices of 15-day-old rabbits, the incorporation of [14C]oleate was followed in vitro, making use of fatty acid activation factors and endogenous membrane acyl acceptors. Of the lipids of N1, it was triacylglycerol which showed the highest rates of labelling and which represented 71-80% of the total incorporated radioactivity in this fraction. Specific rates of N1 triacylglycerol formation were 63-166 times those of P3 triacylglycerols (based upon membrane phospholipid content). In P3, phospholipids made up 85% of the total microsomal lipid labelling. The incorporation of oleate was dependent upon ATP and coenzyme A, and acyl-CoA synthetase activities were demonstrated in N1 and P3 (specific activity ratio, N1:P3 = 4.5). Using exogenous [14C]oleoyl-CoA, high rates of N1 triacylglycerol labelling were still seen relative to P3, but rates of diacylglycerol and phospholipid labelling were substantially elevated in both fractions in contrast to rates found using [14C]oleate. By increasing levels of endogenous diacylglycerol using preincubations with phospholipase C, a 3-fold increase was seen in specific rates of triacylglycerol formation in both fractions in subsequent assays with [14C]oleate. A 4.5-fold increase in N1 diacylglycerol concentrations was found when N1 was incubated for 10 min in the absence of fatty acid, ATP and coenzyme A. It is concluded that neuronal nuclei have a very active diacylglycerol acyltransferase as well as the ability to generate diacylglycerol substrates. PMID- 6849959 TI - Properties of a non-specific phospholipid-transfer protein purified from rat lung. AB - The present report describes the purification and characterization of a non specific phospholipid-transfer protein from rat lung. The protein is the major phospholipid-transfer protein in lung which transfers phosphatidylcholine. The transfer protein was purified 1200-fold, with a final yield of 3%. The activity of the protein was monitored by measuring the transfer of [14C]phosphatidylcholine from radioactively labeled liposomes to mitochondria. The purified proteins transfers phosphatidylcholine, phosphatidylinositol, phosphatidylserine and phosphatidylethanolamine from radioactively labeled microsomes to either mitochondria or liposomes. The transfer of each phospholipid is proportional to its content in the donor membrane. The protein was purified from a pH 5.1 supernatant preparation by fractionation on DEAE-cellulose, Sephadex G-75 and hydroxyapatite. The molecular weight of the purified protein was estimated as 35 000 by SDS-polyacrylamide gel electrophoresis. The amino acid analysis revealed a high content of glutamic acid (including glutamine) and glycine. The specificity of the purified protein for transfer of phospholipids suggests that it may be the phospholipid-transfer activity which is highly enriched in isolated type II alveolar cells of rat lung. PMID- 6849960 TI - Effect of paraquat on cytochrome P-450-dependent lipid peroxidation in bovine adrenal cortex mitochondria. AB - We have investigated the effect of paraquat (methyl viologen) on lipid peroxidation in bovine adrenal cortex mitochondria. Incubation of a buffered aerobic mixture of mitochondria in the presence of Fe2+ or NADPH resulted in the formation of lipid peroxides whose accumulation could be followed at 532 nm as malondialdehyde. Fe2+ stimulates lipid peroxidation in normal mitochondria and those in which enzymes have been inactivated with heat. In contrast, NADPH has a stimulatory effect only in normal mitochondria, but not in heat-treated mitochondria. These results indicate that NADPH-dependent lipid peroxidation is an enzymatic process. Paraquat strongly inhibits this enzymatic lipid peroxidation, but has no effect on the non-enzymatic Fe2+-dependent process. The chemiluminescence that accompanies the NADPH-dependent lipid peroxidation is also markedly decreased in the presence of paraquat. Superoxide dismutase, which removes superoxide anion efficiently, does not inhibit malondialdehyde production. The mechanism of the inhibition of the lipid peroxidation by paraquat has been examined. Paraquat has no effect on NADPH-2,6-dichlorophenolindophenol reductase and on NADPH-cytochrome c reductase activities in bovine adrenal cortex mitochondria. However, paraquat strongly inhibits the NADPH-dependent reduction of cytochrome P-450. These results suggest that the inhibitory effect of paraquat on NADPH-dependent lipid peroxidation in adrenal cortex mitochondria is due to a decrease in the level of reduced cytochrome P-450 probably by diverting electrons from cytochrome P-450. Cytochrome c, which can compete with P-450 for available electrons from adrenodoxin, like paraquat had an inhibitory effect on NADPH dependent lipid peroxidation. Lipid peroxidation was also strongly inhibited by steroid hydroxylase inhibitors, e.g., amphenone B, aminoglutethimide and metyrapone. PMID- 6849957 TI - Hydrolysis of chylomicron retinyl esters by an acid hydrolase of rat liver. AB - Rat liver homogenate hydrolyzed chylomicron remnant retinyl esters with pH optima 4.5, 6 and 8. The retinyl ester hydrolysis at pH 4.5 was correlated to the acid phosphatase activity in different subcellular fractions, and thus the highest activity was found in highly purified lysosomes. These fractions could also catalyze the reverse reaction, i.e., the esterification of retinol when incubated with excess palmitic acid. Purified rat liver lysosomes hydrolyzed chylomicron retinyl and cholesteryl esters with comparable rates, both being much lower than the hydrolysis of chylomicron triacylglycerols. PMID- 6849961 TI - Modification of positional distribution of fatty acids in phosphatidylinositol of rabbit neutrophils stimulated with formylmethionyl-leucyl-phenylalanine. AB - The effects of formylmethionyl-leucyl-phenylalanine (fMet-Leu-Phe) on the positional distribution of fatty acids in phosphatidylinositol (PI), phosphatidylcholine (PC) and phosphatidylethanolamine (PE) were investigated with rabbit neutrophils. The proportion of arachidonate at the C-2 position of PI was 35.0% in resting neutrophils and declined to 30.8% after 5 min stimulation with the peptide at a concentration of 10(-7) M. In contrast, the profiles of the positional distribution of fatty acids in PC and PE were not affected upon stimulation with fMet-Leu-Phe. The phospholipid composition of rabbit neutrophils was examined at different time intervals following the addition of fMet-Leu-Phe. PI and PC, but no other phospholipids, exhibited significant changes in their quantities. The quantity of PC decreased at 5 min with a concurrent increase in that of lysophosphatidylcholine (lysoPC), suggesting a phospholipase A2 action on PC. The quantity of PI, on the other hand, decreased at 1 min with an accompanying increase in phosphatidic acid when the profile of the positional distribution of fatty acids in PI remained unchanged. No lysophosphatidylinositol (lysoPI) was detected. This indicates the enhancement of the PI cycle in the fMet Leu-Phe-stimulated neutrophils. The augmented PI cycle in response to fMet-Leu Phe was further supported by the finding that [3H]arachidonyl-diacylglycerol and phosphatidic acid accumulated at the expense of [3H]arachidonylPI in rabbit neutrophils prelabelled with [3H]arachidonate. Restoration of the content of PI to the higher than the original level at 5 min after stimulation with fMet-Leu Phe, however, leads to the suggestion that de novo synthesis of PI as well as PI resynthesis along the closed cycle of PI has occurred at 5 min and that this newly synthesized PI, via a de novo pathway with a different pattern of the positional fatty acyl composition, is the cause of the decreased proportion of arachidonate. PMID- 6849962 TI - Phosphatidylcholine and phosphatidylethanolamine metabolism during lens fiber cell formation. AB - Phosphatidylinositol is metabolized with a half-life of about 5 h in lens epithelial cells of 6-day-old embryonic chickens. When these cells differentiate to form lens fiber cells, however, phosphatidylinositol turnover virtually ceases. The present study was undertaken to determine whether there is a similar change in the metabolism of phosphatidylcholine and phosphatidylethanolamine. [32P]Orthophosphate was injected into 6-day-old chicken embryos, and the incorporation of label into phosphatidylcholine and phosphatidylethanolamine was followed for 48 h. The specific activities of the precursors phosphorylcholine and phosphorylethanolamine were also measured during this time. The data were then analysed by means of a simple kinetic model to determine the rate of synthesis and the half-life of each phospholipid. The results showed that phosphatidylcholine is synthesized at a rate of about 1.2 X 10(-20) mol/s per cell in the lens epithelial cells, and 6.4 X 10(-20) mol/s per cell in the fiber cells. Phosphatidylethanolamine is synthesized at approximately 0.9 X 10(-2)) mol/s per cell in the epithelial cells, and 4.0 X 10(-20) mol/s per cell in the fiber cells. Both phospholipids are stable in both the epithelial cells and in the fiber cells, with half-lives of 48 h or greater. Thus, although phosphatidylcholine, phosphatidylethanolamine and phosphatidylinositol all experience an increase in synthesis following lens fiber formation, the previously observed decrease in phosphatidylinositol turnover accompanying differentiation is a specific effect. PMID- 6849970 TI - Unique profile for erythrocyte membrane acetylcholinesterase in hereditary spherocytosis. AB - Acetylcholinesterase of human erythrocytes from healthy donors and from patients with hematological disorders was analysed in a search for differential membrane parameters. Two substrates were used to estimate the exposure of acetylcholinesterase active site in the membrane: phenylacetate, a hydrophobic substrate, to determine total enzyme activity, and acetylcholine, an ionic substrate, to measure the externally reactive enzyme. The sensitivity of acetylcholinesterase to added stearic acid was also analysed. Three categories of the disorders studied were discerned: (a) The erythrocyte acetylcholinesterase profile was indistinguishable from normal control in beta-thalassemia minor and groups of patients with autoimmune hemolytic anemia or congenital dyserythropoietic anemia type II. (b) A marked decline in acetylcholinesterase with both substrates and reduced sensitivity to stearic acid were exhibited by the erythrocytes of paroxysmal nocturnal hemoglobinuria, beta-thalassemia major and other autoimmune hemolytic anemia and congenital dyserythropoietic anemia type II patients. Normal erythrocytes, either aged or pretreated to 50 degrees C, also showed similar characteristics. (c) Hereditary spherocytosis was singly differentiated by an elevated acetylcholinesterase activity with acetylthiocholine and by a vastly diminished sensitivity to stearic acid, while activity with phenylacetate was equal to control. This distinct profile may reflect the unique organization of the erythrocyte membrane in hereditary spherocytosis. PMID- 6849967 TI - Cytosolic cholesterol ester hydrolase from bovine corpus luteum. Its purification, identification, and relationship to hormone-sensitive lipase. AB - The cytosolic cholesterol ester hydrolase from bovine corpus luteum has been purified 760-fold, using isoelectric precipitation and gel filtration chromatography, followed by ion-exchange and adsorption chromatographies in the presence of non-ionic detergent. Further purification was achieved by affinity chromatography on triacylglycerol-containing polyacrylamide-agarose. The partially purified enzyme was inhibited by NaF, HgCl2 and DFP. Incubation with [3H]DFP resulted in specific labelling of a polypeptide of Mr = 84000, the same subunit molecular weight as that of the enzyme from adrenal cortex. This Mr 84000 polypeptide from corpus luteum was phosphorylated by the catalytic subunit of cyclic AMP-dependent protein kinase, phosphorylation causing greater than 2-fold activation of the enzyme. Several properties of the cholesterol ester hydrolase from corpus luteum show striking similarities to those of hormone-sensitive lipase from adipose tissue. This provides further evidence that hormone-sensitive lipase, in addition to its role in adipose tissue lipolysis, has a key role in steroidogenic tissues, namely catalysing the supply of free cholesterol from the cholesterol ester stores. PMID- 6849964 TI - Regulation of fatty acid oxidation in heart muscle. Effects of pyruvate and dichloroacetate. AB - The possibility of a mutual regulation between carbohydrate and fatty acid oxidation was studied in isolated perfused rat hearts. Infusions of pyruvate and/or dichloroacetate were employed to convert fully the pyruvate dehydrogenase complex into its active form during [1-14C]octanoate oxidation, the rate of which was measured by the production of 14CO2. It was found that 5 mM dichloroacetate suppressed the oxidation of 0.1 mM octanoate by 58%, but 10 mM external pyruvate was without effect. Dichloroacetate reduced the tissue malate concentration by 41% and the citrate concentration by 76% at a 0.1 mM octanoate concentration, but had no effect on the metabolite concentrations or fatty acid oxidation rate in perfusions with 1 mM octanoate. Metabolite depletion was probably partly due to inhibition of the carboxylation of pyruvate, as verified by determination of the metabolite labelling kinetics from [1-14C]pyruvate. It is, therefore, possible that the dichloroacetate-induced inhibition of octanoate oxidation could also be partly due to inhibition of tricarboxylic acid cycle secondary to metabolite depletion. Since both dichloroacetate and pyruvate converted pyruvate dehydrogenase to its active form, but only dichloroacetate inhibited fatty acid oxidation, the latter effect could not be due to oxidation of a competing substrate, but instead may result from an inhibition of fatty acid uptake, activation or transport, as also indicated by the observed decrease in the acid soluble acyl-CoA concentration. This interpretation is also supported by the mitochondrial redox effects of dichloroacetate observed during octanoate oxidation in the perfused heart. PMID- 6849968 TI - The final step of aldosterone biosynthesis requires reducing power. It is not a dehydrogenation. AB - A mitochondrial preparation from adult duck adrenal gland was used to study the mechanism (dehydrogenation or other) of the last step of aldosterone biosynthesis (18-oxidation) by incubation of tritiated 18-hydroxycorticosterone. Results show that the role of citric acid cycle metabolites is to provide reducing power. When reducing power is provided by malate, which yields NADH or NADPH directly, the reoxidation of reduced coenzymes in the oxidative phosphorylation chain is not necessary. In the presence of succinate, the oxidative phosphorylation chain is required, but only to provide ATP. Stimulation of the reaction by low concentrations of KCN in the presence of malate shows that the reducing power is not used in the oxidative phosphorylation chain. These data suggest that the reaction is not a dehydrogenation and that the reducing power is used in a pathway competing with the respiratory chain, most probably a hydroxylating pathway, in mitochondria. PMID- 6849969 TI - Metabolism of HDL-cholesteryl ester in the rat, studied with a nonhydrolyzable analog, cholesteryl linoleyl ether. AB - Intralipid was sonicated with [3H]cholesteryl linoleyl ether (a nonhydrolyzable analog of cholesteryl linoleate) and incubated with rat HDL and d greater than 1.21 fraction of rabbit serum at a ratio of 0.012 mg triacylglycerol to 1 mg HDL protein. 25% of [3H]cholesteryl linoleyl ether was transferred to HDL. The labeled HDL was injected into donor rats and was screened for 4 h. [125I]HDL was subjected to the same protocol as the 3H-labeled HDL, including screening. The screened, labeled sera were injected into acceptor rats and the disappearance of radioactivity from the circulation was compared. The t1/2 in the circulation of [125I]HDL was about 10.5 h, while that of [3H]cholesteryl linoleyl ether-HDL was about 8 h. The liver and carcass were the major sites of uptake of [3H]cholesteryl linoleyl ether-HDL and accounted for 29-41% (liver) and 30% (carcass) of the injected label. Maximal recovery of [3H]cholesteryl linoleyl ether in the liver was seen 48 h after injection, and thereafter there was a progressive decline of radioactivity, which reached 7.8% after 28 days. The maximal recovery of [125I]HDL in the liver was about 9%. Pretreatment of the acceptor rats with estradiol for 5 days resulted in a 20% increase in the hepatic uptake of [3H]cholesteryl linoleyl ether-HDL and a 5-fold increase in adrenal uptake. The present findings indicate that in the rat the liver is the major site of uptake of HDL cholesteryl ester and that part of the HDL cholesteryl ester may be cleared from the circulation separately from the protein moiety. On the basis of our previous findings (Stein, Y., Kleinman Y, Halperin, G., and Stein, O. (1983) Biochim. Biophys. Acta 750, 300-305) the loss of the [3H]cholesteryl linoleyl ether from the liver after 14-28 days was interpreted to indicate that the labeled [3H]cholesteryl linoleyl ether had been taken up by hepatocytes. PMID- 6849965 TI - Measurement of lipoprotein lipase and hepatic triacylglycerol lipase in post heparin plasma of the cynomolgus monkey. AB - Conditions for measurement of the lipolytic activities, lipoprotein lipase and hepatic triacylglycerol lipase in cynomolgus monkey postheparin plasma are described. The two activities are separable by heparin-Sepharose chromatography. Goat anti-human hepatic triacylglycerol lipase serum inhibits monkey hepatic triacylglycerol lipase activity and allows direct measurement of lipoprotein lipase in post-heparin plasma. While both human and homologous serum can be used as a source of activator apolipoprotein, homologous serum produces a much greater activation. PMID- 6849966 TI - Immunochemical properties of lipoprotein lipase. Development of an immunoassay applicable to several mammalian species. AB - The reaction of bovine lipoprotein lipase with its antibodies was found to be conformation-dependent. One aspect of this was that most antisera were more reactive with denatured than with native 125I-labeled lipoprotein lipase. Another aspect was that denatured lipase did not compete effectively with native lipase for those antibodies which caused inhibition of the enzyme's activity. This latter observation leads to the conclusion that the inhibiting antibodies recognize conformation-dependent determinants on the native enzyme. Fab fragments prepared from an inhibiting antiserum blocked the binding of the lipase to triacylglycerol/phospholipid droplets. This suggests that the inhibition results from reaction of the antibodies with the enzyme as it exists in solution, either covering the lipid-binding site on the enzyme or making it impossible for the enzyme to go through the conformational transitions necessary for binding to lipid. Most rabbit antisera did not react with rat or mouse lipoprotein lipase, but some sera showed a weak cross-reaction. Antisera raised in hens showed a much stronger cross-reaction, enough to be useful for heterologous immunoassays. An immunoassay for the bovine lipase was developed. For reproducible results it was necessary to have tracer, standard and samples in denatured form. This was accomplished by heating them in SDS, and running the immunoreaction in a Triton X 100-containing medium. PMID- 6849971 TI - Temperature-induced lysis of chromaffin granules provides evidence against the two-pool hypothesis of catecholamine storage. AB - The temperature-dependent release of core constituents from isolated chromaffin granules in isotonic sucrose has been a controversial and puzzling phenomenon that has been interpreted either as selective catecholamine efflux from different catecholamine pools or as temperature-dependent lysis. We have analysed the kinetics, temperature dependence and physical basis of this process. Our results demonstrate that, upon increasing the ambient temperature, chromaffin granules show a shift in their osmotic fragility to higher osmolarities, which is linearly dependent on temperature and leads to measurable lysis in 0.26 M buffered sucrose at temperatures above 12 degrees C. It is possible to demonstrate both protein and dopamine beta-hydroxylase release when lysis as a function of temperature is measured in 0.26 M buffered sucrose. Real time measurements of the lysis kinetics were recorded on cassettes and analysed by a computer program for exponential decay kinetics. It is shown that the temperature-dependent lysis proceeds in two separate phases, the fast one of which is associated with temperature-dependent shift in the osmotic fragility curve. It has no characteristics of any exponential decay kinetics. The slow phase, when followed over several hours, leads to complete lysis of the granules in a sigmoidal time course at 30 degrees C. We conclude from the absence of exponentiality that there is no basis on which to assume the existence of different catecholamine pools. The fast phase of temperature-dependent lysis can be best explained as a simple temperature dependent increase of the granule core solution's osmotic pressure, while the slow phase is probably caused by sucrose permeation into the granules. On the basis of these results, we warn against any efflux experiments measuring the temperature-dependent transmitter release from secretory vesicles with highly concentrated core solutions. PMID- 6849972 TI - Arginase activity of different cells in tissue culture. AB - Arginase activity was measured in ten different cell lines and all of them showed arginase activity. However, the amount of the activity in the cells varied more than 1000-fold. The cell density did not appear to affect the arginase activity much, since cultures of human fibroblasts grown to different cell densities exhibited only small variations in arginase activity. Arginase activity was in general higher than that of ornithine decarboxylase and there was no correlation between the two activities. When human fibroblasts were stimulated to proliferate in serum-free medium by adding certain growth factors the activity of ornithine decarboxylase increased markedly prior to the DNA synthesis, while the arginase activity increased more slowly and to a much smaller degree. Two cell lines, baby hamster kidney and mouse 3T3 cells, had low arginase activity when adapted to grow in serum-free medium, but in spite of this they were able to grow in serum free medium without exogenous ornithine. PMID- 6849963 TI - The effects of polyamines and aminoglycosides on phosphatidylinositol-specific phospholipase C from human amnion. AB - The effects of polyvalent cations (polyamines and aminoglycoside antibiotics) on Ca2+-dependent phosphatidylinositol-specific phospholipase C activity of human amnion tissue were examined. In the presence of 1 mM Ca2+, the hydrolysis of phosphatidylinositol (2 mM) by phospholipase C was increased greatly (240-560% of control) by spermine (0.4 mM), spermidine (1 mM), neomycin (0.1 mM), gentamicin (0.2 mM), kanamycin (0.4 mM) and streptomycin (0.8 mM). Putrescine and cadaverine (0.1-2.0 mM), however, stimulated phospholipase C activity only slightly. The effects of spermidine, spermine and gentamicin on phospholipase C activity were characterized and found to be dependent upon the concentrations of phosphatidylinositol, Ca2+ and the particular polyvalent cation. At low concentrations of phosphatidylinositol and Ca2+ the predominant effect of polyamines and aminoglycosides was to inhibit phospholipase C activity. When the concentrations of phosphatidylinositol and Ca2+ were increased, spermidine, spermine and gentamicin stimulated phospholipase C activity. In the presence of 16 mM Ca2+, however, phospholipase C activity was maximal and was unaffected by either polyamines or aminoglycosides. At all concentrations of Ca2+ examined, the maximal stimulation of phospholipase C activity by a given polyvalent cation occurred at a fixed molar ratio of the particular polyvalent cation to phosphatidylinositol. Polyamines and aminoglycosides appeared to modulate the Ca2+ requirement for phospholipase C activity, but could not substitute completely for Ca2+. The activities of phospholipase A2, diacylglycerol lipase, monoacylglycerol lipase and diacylglycerol kinase in amnion tissue were unaffected by any of the polyvalent cations examined. It is proposed that any in vivo influences (stimulatory or inhibitory) of polyamines and aminoglycosides on amnion phospholipase C activity would depend upon the effective concentrations of Ca2+ and phosphatidylinositol. PMID- 6849975 TI - Influence of folate-binding protein from bovine milk on the absorption of folate in gastrointestinal tract of rat. AB - The absorption of [14C]pteroylglutamic acid (PteGlu) bound to the folate-binding protein of bovine milk was investigated in rat gastrointestinal tract in vivo and in situ. When bound [14C]PteGlu was given to rat intragastrically via oral intubation, a considerable amount of PteGlu was released from folate-binding protein under the acidic conditions in stomach, and it recombined with folate binding protein in jejunum in vivo. Compared with free PteGlu, bound PteGlu was more gradually absorbed in small intestine, but finally the total amount of bound PteGlu absorbed was almost the same as that of free PteGlu. In all experiments in situ, bound PteGlu was only slightly absorbed in jejunum, where free PteGlu was rapidly absorbed under the same conditions. On the other hand, the absorption rates of the two forms of PteGlu were almost similar to each other in ileum. These results suggest that PteGlu bound to folate-binding protein is absorbed by a manner different from that of free PteGlu in rat gastrointestinal tract. PMID- 6849973 TI - A study of lactate dehydrogenase levels and turnover rates during postnatal development in the rat. AB - Specific radioimmunoassays for lactate dehydrogenase A and B subunits have been employed to quantify cellular contents of these proteins more precisely than hitherto possible and to monitor changes during postnatal development. Liver, skeletal muscle, heart muscle and kidney cortex all demonstrated alterations in cellular levels of lactate dehydrogenase subunits over the first 56 days of life, the particular pattern being specific to each tissue. Studies on the turnover of lactate dehydrogenase in vivo and in vitro indicated that the developmental changes in total lactate dehydrogenase content in liver and kidney were regulated at some point(s) during both the biosynthesis and the degradation of the proteins. PMID- 6849974 TI - The glycosaminoglycans of pig colonic wall connective tissue. AB - Colon wall from pig, stripped of most of the mucosal layer to leave material largely composed of muscle, basement membrane, and extracellular matrix, was subjected to procedures for isolation of glycosaminoglycans. A total ethanol precipitate from a papain digest was fractionated by selective ethanol precipitation in the presence of Ca2+. Glycosaminoglycan fractions, freed proteolytically from a high molecular weight glycoprotein component, were further purified by Sepharose CL-6B gel-filtration or DE-52 anion-exchange chromatography. Glycosaminoglycans were identified by chemical composition, 13C NMR spectroscopy and response to chondroitinase and nitrous acid degradations. The content of glycosaminoglycan in the tissue is low (0.05% dry weight) being comprised of dermatan sulphate (38%), heparin (34%), heparan sulphate (18%) and chondroitin sulphates (10%) as a percentage of total glycosaminoglycan content. Hyaluronic acid and keratan sulphate have not been detected. The composition is generally typical of a high muscle content tissue. PMID- 6849976 TI - The role of ligand-ligand interactions in competition by fibrinogen and fibrin degradation products for fibrinogen binding to human platelets. AB - Binding to human platelets of radioiodinated human fibrinogen and fragments X, Y, D, D1 dimer and E was studied to determine the domain of the fibrinogen molecule responsible for binding to the platelet receptor. Although the fragments did not bind, some were able to compete for the binding of fibrinogen to platelets. It was postulated that the fragments bound to fibrinogen and subsequently interfered with its binding to the receptor. Two approaches were developed to test this hypothesis. In the first technique, molecular exclusion on Sephacryl S-200 superfine was utilized to examine the interaction of radiolabeled fragments with fibrinogen. In the second series of studies, fibrinogen-Sepharose was prepared and the binding of degradation products directly determined. A spin dialysis apparatus was employed in each case to achieve rapid separation of bound and free radioligand. These studies demonstrated that fragments D and E bind to fibrinogen. Therefore, the mechanism by which degradation products interfere with fibrinogen binding to the platelet receptor is ligand-ligand interaction rather than binding of the fragments to the receptor. Since none of the radiolabeled degradation products bound to platelets, it appears that receptor recognition requires the intact molecule. PMID- 6849977 TI - Preparation, characterization, biological activity and metabolism of all-trans retinoyl fluoride. AB - All-trans retinoyl fluoride was prepared by treating all-trans retinoic acid with diethylaminosulfurtrifluoride. The crystalline product, which was characterized by melting point, infrared, 1H-NMR, 19F-NMR and elementary analysis, showed lambda max at 382 nm in hexane (epsilon = 4.98 x 10(4) M-1 . cm-1) and at 392 nm in methanol (epsilon = 4.60 x 10(4) M-1 . cm-1). Its biological activity in the rat growth assay, relative to all-trans retinyl acetate, was 22% +/- 10%. Upon oral administration for 5 days to vitamin A-depleted rats, retinoyl fluoride (1020 micrograms) was rapidly metabolized to a polar metabolite fraction and, in the intestine, to an unstable retinol-like metabolite, purportedly 15 fluororetinol. Upon administering intraperitoneally smaller doses (47-94 micrograms) of [11-3H]retinoyl fluoride, which was synthesized from [11 3H]retinoic acid, radioactive retinoic acid was noted in the liver and plasma but not in the intestine. As expected, a radioactive polar fraction appeared in the intestine and liver, but radioactive retinol, retinyl ester and some common oxidation products were not detected. Of the administered radioactivity, 72% was excreted in the urine, and only 4% was found in the feces over a 7-day period. Hydrolysis of the urine gave a radioactive fraction with a polarity similar to that of retinoic acid. Retinoyl fluoride also reacts readily with glycine to yield N-retinoyl glycine. Thus, the biological activity of retinoyl fluoride can be attributed to the formation of retinoic acid, probably by way of N-retinoyl derivatives. A possible pathway for its metabolism is presented. PMID- 6849978 TI - Analytical subcellular fractionation of rat pituitary homogenates with special reference to the subcellular localization and properties of alkaline phosphatases. AB - Alkaline phosphatase activities of the virgin rat anterior pituitary were studied with a highly sensitive fluorometric assay. Tissue whole homogenates were fractionated on sucrose density gradients in a Beaufay automatic zonal rotor and the gradient fractions assayed for alkaline phosphatase, prolactin and various organelle marker enzymes. Alkaline phosphatase was distributed between two peaks on the gradient. The low-density (1.10-1.15 g . cm-3) alkaline phosphatase component co-sedimented with the plasma membrane marker, 5'-nucleotidase, had an apparent Km for 4-methylumbelliferyl phosphate of approx. 59 microM, and was inhibited by levamisole. The high-density (1.20-1.25 g . cm-3) peak was resistant to levamisole-inhibition, had an apparent Km of approx. 30 microM and its distribution was distinct from plasma membrane, Golgi, lysosome, endoplasmic reticulum, mitochondria and prolactin granule markers on the isopycnic gradients. PMID- 6849979 TI - A study of the mechanism of action of pyridoxal isonicotinoyl hydrazone at the cellular level using reticulocytes loaded with non-heme 59Fe. AB - Pyridoxal isonicotinoyl hydrazone (PIH) has recently been identified as a new iron chelating agent with a high degree of iron mobilizing activity in vitro and in vivo which makes this compound a candidate drug in the treatment of iron overload. This study was undertaken to elucidate the mechanism of action of the iron mobilizing activity of PIH at the cellular level. An in vitro system of rabbit reticulocytes with a high level of non-heme 59Fe was used as a model of iron overload. The effects of various biochemical and physiological maneuvers on the mobilization of 59Fe by PIH from the cells were studied. The fate of [14C] PIH in the in vitro system was also studied. Studies were also carried out using a crude mitochondrial fraction. The results indicate three phases in the iron mobilizing activity of PIH: (1) the entry of PIH into erythroid cells seems to be by passive diffusion; (2) chelation occurs mainly from mitochondria and may depend on the availability of iron in a low molecular weight, non-heme pool. Chelation seems to be enhanced by reduction of Fe (III) to Fe (II); (3) the exit of the PIH2-Fe complex is an energy-dependent process. Iron mobilization by PIH is not dependent on (Na+ + K+)-ATPase activity, external ionic composition, or external hydrogen ion concentration. Membrane fluidity does not seem to play a role in PIH-Fe mobilization. The exit of the PIH2-Fe complex is inhibited by anti microtubule agents (vinca alkaloids but not colchicine) suggesting that the PIH2 Fe complex is actively extruded from the cell by a microtubule-dependent event. PMID- 6849980 TI - Potent platelet aggregation inhibitor from Trimeresurus gramineus snake venom. AB - Using DEAE-Sephadex A-50 column chromatography and gel filtration, a potent platelet aggregation inhibitor from Trimeresurus gramineus venom was purified. It was an acidic phospholipase A, rich in aspartic acid, glutamic acid and half cystine, with an isoelectric point of 3.6. At a concentration of 10 micrograms/ml, the purified inhibitor showed a marked inhibitory effect on platelet aggregations induced by adenosine diphosphate, collagen, sodium arachidonate and ionophore A-23187 in rabbit platelet-rich plasma, washed platelet suspension, as well as in thrombin-degranulated platelet suspension. The ID50 of this venom inhibitor was about 2.5-5 micrograms/ml in platelet aggregations induced by all these aggregation inducers. The action of this inhibitor could be partially antagonized by phosphatidylethanolamine. High concentration of Ca2+ (5 mM) did not reverse the inhibitory action even in the presence of ionophore A-23187. The [14C]serotonin release induced by sodium arachidonate and thrombin was unaffected. Malonic dialdehyde formation induced by these aggregation inducers remained unchanged. Basal and prostaglandin E1 stimulated cAMP levels were not altered by this inhibitor. No lactate dehydrogenase was released even at a concentration of 62.5 micrograms/ml. Polylysine-induced platelet agglutination was not affected. beta-Mercaptoethanol inactivated both its phospholipase A enzymatic and platelet inhibitory activities, while p-bromophenacyl bromide only inactivated the former activity. The possibility of acting on a common final step of platelet aggregation, i.e. the intercellular adhesion between the activated platelets, was proposed. PMID- 6849981 TI - A rapid four column purification of 2-deoxy-D-glucoside-2-sulphamate sulphohydrolase from human liver. AB - 2-Deoxy-D-glucoside-2-sulphamate sulphohydrolase was extracted from human liver and purified 40 000-fold by a simple four column procedure. The purification was followed using a specific substrate isolated from an acid hydrolysate of heparin, O-(alpha-2-sulphamino-2-deoxy-D-glucopyranosyl)-(1 leads to 3)-L-[6,3H]idonic acid. Only one form of the enzyme was seen on either ion exchange chromatography or isoelectric focussing, with a pI of 6.8. The apparent Mr of the holoenzyme as determined by gel filtration was 190 000 +/- 20 000. Two other larger Mr protein peaks observed on gel filtration appear to be an inactive dimer of the 190 000 dalton peak and a larger aggregate near the exclusion limit of the column. On polyacrylamide disc gel electrophoresis in sodium dodecyl sulphate, with or without prior reduction, each protein peak from the gel filtration column electrophoresed as a single major band with an apparent Mr corresponding to 55 000 +/- 6000. PMID- 6849982 TI - Structural requirements for microvascular permeability-increasing ability of peptides. Studies on analogues of a fibrinogen pentapeptide fragment. AB - A pentapeptide, Ala-Arg-Pro-Ala-Lys, liberated from fibrinogen during plasmin mediated fibrinolysis, was shown earlier to increase microvascular permeability in rat and human skin. Eighteen new analogues have now been synthesized in addition to the 15 previously prepared and examined for their effect on permeability. The old concept that a tetrapeptide with basic amino acids at both ends and a proline residue adjacent to the N-terminal amino acid is essential for high activity on permeability, has now been challenged. The results obtained with several of the new analogues strengthen this concept. More interestingly, however, the third amino acid, which was found in earlier studies to be less sensitive to exchange, has now been deleted as well as duplicated with only a modest loss of activity of the peptide. The chirality of the C-terminal amino acid, most surprisingly, does not seem to be crucial for peptide activity. Slightly superpotent analogues were obtained on amidation of the C-terminus. In addition, a few naturally occurring peptides, namely tuftsin, substance P, neurotensin and bradykinin, the amino acid sequences of which all exhibit characteristic features of some of our active peptide analogues were investigated in the same test system. Tuftsin displayed a potency equal to that of the pentapeptide. The other three peptides were all highly superpotent in this assay system. PMID- 6849983 TI - The distribution of proteoglycans of high electrophoretic mobility in cartilages from different species and of different ages. AB - The distribution of small proteoglycans of high relative electrophoretic mobility in cartilage of various species and of different ages was studied. Proteoglycans extracted by 4 M guanidinium chloride were purified by ion-exchange chromatography and assessed by gel electrophoresis. Proteoglycans fractionated by equilibrium density gradient centrifugation under 'dissociative' conditions were similarly purified and assessed. A rapid migrating population was found in articular cartilages of young humans, baboons, calves, pigs, rabbits, rats, chickens and in mandibular and vertebral cartilages of dog-fish. It was not detected in unfractionated proteoglycans extracted from fetal rat, pig, calf, baboon and human cartilages. In baboon and human fetal cartilages of advanced gestational age, however, small amounts of the rapid population were present being detected in the low density fractions of dissociative gradients. The rapid migrating population was not found either in unfractionated or in fractionated proteoglycans obtained from articular cartilages of humans aged over 40. It was also absent from human osteoarthritic cartilages but was detected even at advanced age in cartilages covering osteophytes. PMID- 6849984 TI - Mechanisms of lysosomal enzyme secretion by human monocytes. AB - Secretion of lysosomal enzymes by human monocytes in response to various stimuli and the effect of conditioned media from lymphocytes and neutrophils was studied. Monocytes were found to release beta-glucosaminidase in response to NH4Cl and to particles (zymosan, opsonised zymosan, asbestos and latex), but do not respond to some soluble stimuli like formyl-methionyl-leucyl-phenylalanine, phorbol myristate acetate, cytochalasin B, concanavalin A and N-acetylmuramyl-L-alanyl-D isoglutamine. Neutrophil conditioned medium or neutrophil components did not have any effect on secretion. When treated with lymphokines the cells are more responsive, especially to zymosan. Even through there are similarities in the secretory activities of mouse macrophages and human monocytes, there are several differences both in the quantity of the response and in the mechanisms involved. PMID- 6849985 TI - Studies on the inhibitory effect of bacitracin on 125I-labelled insulin internalization in the rat hepatocyte. AB - Previous studies have suggested that transglutaminase has a role in the internalization of some polypeptide hormones and is inhibited by the antibiotic, bacitracin. Bacitracin has been used in insulin-receptor studies to inhibit extracellular degradation of 125I-labelled insulin. The aim of this study was to investigate bacitracin's effect on 125I-labelled insulin-receptor interactions in isolated rat hepatocytes. 1 g/l bacitracin increased cell-associated 125I labelled insulin insulin at 20, 30 and 37 degrees C (P less than 0.001, 0.0005 and 0.0005, respectively). At 5 and 15 degrees C (internalization does not occur), bacitracin did not affect cell-associated 125I-labelled insulin. The bacitracin effect was concentration dependent, increasing to 2 g/l. Scatchard analysis showed that bacitracin did not alter insulin receptor affinity or number. 1 g/l bacitracin abolished the effect of chloroquine. The increased cell associated radioactivity with bacitracin was surface-bound in nature. 0.5 g/l bacitracin decreased 125I-labelled insulin degradation in hepatocyte suspensions (P less than 0.001) and in buffer previously incubated with hepatocytes (P less than 0.0005). More 125I-labelled insulin remained associated with cells during dissociation studies at 37 degrees C when the buffer contained 1 g/l bacitracin. Label that appeared in the buffer after 60 min was significantly more intact in the presence of bacitracin (P less than 0.025). These results suggest that bacitracin retards the internalization of 125I-labelled insulin in isolated rat hepatocytes. PMID- 6849986 TI - Properties of freshly isolated type II alveolar epithelial cells. AB - The biochemical characteristics of type II alveolar epithelial cells dissociated from adult rabbit lung by instillation of low concentrations of an elastase trypsin mixture are reported. Cells studied immediately (within 4 h) after isolation were found to incorporate the radioactively labelled precursors [U 14C]glucose, [methyl-3H]choline and [3H]palmitate into cellular phosphatidylcholine at rates 2-10-fold higher than previously reported for cells not subject to short-term cell culture. Secretion of phosphatidylcholine was stimulated by beta-adrenergic agonists. Measurement of specific activities of enzymes of phospholipid biosynthesis in subcellular fractions of isolated lung cells showed a significant enrichment of acyl coenzyme A-lysophosphatidylcholine acyltransferase, an enzyme believed to be involved in pulmonary surfactant phosphatidylcholine remodeling, in the endoplasmic reticulum of type II cells. These observations support the utility of freshly isolated type II cells as a model system for the study of the functions of the alveolar epithelium. PMID- 6849988 TI - Stimulation of bone resorption in vitro by a non-prostanoid factor released by human monocytes in culture. AB - Cultured human monocytes produce a non-prostanoid factor which stimulates bone resorption in vitro. Production of the factor is not dependent on prostaglandin synthesis, but stimulation of resorption by the factor does involve prostaglandin production by bone. Salmon calcitonin inhibits the stimulatory activity by up to 80%. Production of the factor is not increased by the presence of lymphocytes in the monocyte cultures. Partial purification of the bone-resorbing activity by Ultrogel ACA 54 chromatography shows that it has an apparent molecular weight between 12 000 and 20 000. We suggest that the resorptive activity is due to an interleukin 1-like factor rather than an osteoclast activating factor. PMID- 6849989 TI - [Calculation of stable conformations of anticoagulant fragments of fibrin]. PMID- 6849987 TI - Discrepancies between flow cytometric analysis and [3H]thymidine incorporation in stimulated lymphocytes. AB - The DNA synthesis system of freshly isolated tonsillar lymphocytes and those stimulated by phytohaemagglutinin were compared by different methods. Both cell populations had high DNA polymerase alpha and thymidine kinase activities, as well as a high rate of incorporation of [3H]thymidine into DNA. However, the two cell populations differed when their DNA distributions were compared by flow cytometry. Freshly isolated cells contained many less (6%) cells in S phase than were found in phytohaemagglutinin-stimulated lymphocytes (18%) as detected by flow cytometry. The labelling of different subpopulations of lymphocytes was studied by sorting them electrically with a fluorescence-activated cell sorter. Analysis of the radioactivity of [3H]thymidine pulse-labelled cells, sorted according to their DNA content, showed that cells in the G1 peak of DNA distribution had a significant amount of incorporated [3H]thymidine. Sorting of cells according to their size (i.e., by light scattering) revealed that only large cells were labelled with [3H]thymidine. PMID- 6849990 TI - [Possible role of structural changes in ATP hydrolysis by subfragment-1 and myosin]. AB - Dependence of the rate of ATP hydrolysis with subfragment-I and temperature of SF I, denaturation on the concentration of heavy water in solution was studied. The value of kinetic isotope effect V/Vx linearly increases with the rise of the volume portion of heavy water in solution and at X-1 it equals 1.9. The temperature of protein denaturacticn increases with X rise, the pattern of this relationship looking as an arched curve. The results differ from those earlier obtained on myosin which points to the absence of essential contribution of structural dynamic changes to enzymic hydrolysis of ATP by subfragment-I. PMID- 6849991 TI - [Information properties of biomacromolecule dissipative systems]. PMID- 6849992 TI - [Possible mechanism of membrane fusion]. AB - The stalker mechanism of membrane fusion was considered. Initiation and evolution of monolayer and bilayer bridges-stalks between the membranes were studied. From the expression of elastic energy of the stalk the value of spontaneous curvature of its membrane Ks at which the bridge may appear, was found. It was shown that in terms of the stalker mechanism formation of the stalk of the final radius or complete fusion were possible Ks values for realizing this or that variant were found. The energetic barrier of hydrophobic interaction and the barrier of elastic energy which the membranes had to overcome for stalker formation were found. The experimental data on the fusion of small and large liposomes were analysed. PMID- 6849993 TI - [Effect of shielding as a cause of UV-action spectra shift in mammalian cells]. AB - UV absorption at different wavelengths from 250 to 313 nm was measured in various sites of single SPEV cells in monolayer during the stage of the best cell flattening. At the 260 nm, transmittancy of nuclear regions was less than 50%. The absorption by nucleolar regions was twice as much as by cytoplasmic ones. The influence of self-shielding on the action spectra shape was estimated. It has been shown that the well-known difference between the peaks of the action spectra for mammalian and bacteria cells killing may be the result of the cell self shielding at short wavelengths but not the sequence of the difference in the active chromophore of these cells. PMID- 6849996 TI - [Types of spatial frequency filters in the cat visual cortex]. AB - Three types of receptive fields (RF) were revealed in the studies of mechanisms of spatial-frequency filtration in the cat's visual cortex. The spatial-frequency selectivity of RF of the first type (mainly simple fields) manifests itself in a narrow range of the gratings orientations close to the preferable one, being absent beyond this range. Two other types of RF (mainly complex and hypercomplex ones) are selective to the spatial frequencies at any gratings orientation. At such gratings orientation RF of one type respond with frequency-selective inhibition, RF of another--with frequency-selective excitation. For the majority of RF the two-dimensional spatial-frequency selectivity is realized at short lengths of gratings at which the orientation selectivity of RF is not manifested. A conclusion is drawn that the twodimensional spatial-frequency filters are not Fourier filters. PMID- 6849994 TI - [Identification of native actin in thrombocytes by fluorescence]. PMID- 6849995 TI - [Energy balance of the myocardium and its correction using antiarrhythmics]. AB - Changes in energetic balance (chi) during the transition of myocardium from norm to hypoxia and under antiarrhythmics effect were analysed on a mathematical model of the heart ventricle band. (chi-useful work/consumed energy ratio. Orciprenalin was shown to increase chi in the state close to the norm; quinidine, bretilium, procainamide, propranalol increase chi only under hypoxia; varapamile, as well as lidocain when it improves conduction ought to be effective for each initial (before therapy) state of the myocardium. PMID- 6849998 TI - [Correlation of acoustic characteristics and probable origin of a mouse liver tumor]. PMID- 6849999 TI - [Formation of Ag+2 complexes with collagen]. PMID- 6849997 TI - [Structural differences of spatial-frequency filters in the cat visual cortex]. AB - Sensitivity profiles of receptive fields (RF) of the cat's visual cortex along the width and length of the field were determined. They served as criteria for determining structural differences of the earlier discovered types of spatial frequency filters. It has been shown that RF with spatial-frequency selectivity in a narrow range of orientations close to the preferable one, have the "one dimensional" sensitivity profiles in the same range. For RF showing spatial frequency selectivity along the RF length and width two-dimensional sensitivity profiles along these RF dimensions were revealed. A group of fields was found whose pattern of sensitivity profiles depended on the geometrical properties of images which stipulated the functional changes o RF filtering properties. Possible role of different types of spatial-frequency filters in image processing is discussed. PMID- 6850000 TI - [Estimation of model parameters for the pyruvate kinase reaction from kinetic data]. PMID- 6850001 TI - [Effect of spider Lityphantes paykullianus venom on bilayer lipid membranes]. PMID- 6850002 TI - [Relationship between membrane potential and energetics of mitochondria]. PMID- 6850003 TI - Multiple equilibria and exotic behaviour in excitable membranes. AB - The excitation equation for an excitable membrane dV/dt = F(V) may have multiple equilibria where F(V) = 0, and these may be stable or unstable. We demonstrate multiple equilibria in the Hodgkin-Huxley equations when either -gK or [Ca2+]0 is lowered in the presence of a hyperpolarizing current density. Under these conditions molluscan somata exhibit exotic behaviours -- endogenous paroxysmal depolarising shifts and complex multiple spikes reminiscent of the normal complex activity of some mammalian central neurones. Complex discharge waveforms can be an expression of membrane (differential) properties, rather than electrotonic, geometric (partial differential) behaviour. PMID- 6850004 TI - Slant-tilt: the visual encoding of surface orientation. AB - A specific form for the internal representation of local surface orientation is proposed, which is similar to Gibson's (1950) "amount and direction of slant". Slant amount is usually quantified by the angle sigma between the surface normal and the line of sight (0 degrees less than or equal to sigma less than or equal to 90 degrees). Slant direction corresponds to the direction of the gradient of distance from the viewer to the surface, and may be defined by the image direction tau to which the surface normal would project (0 degrees less than or equal to tau less than or equal to 360 degrees). Since the direction of slant is specified by the tilt of the projected surface normal, it is referred to as surface tilt (Stevens, 1979; Marr, 1982). The two degrees of freedom of orientation are therefore quantified by slant, an angle measured perpendicular to the image plane, and tilt, an angle measured in the image plane. The slant-tilt form provides several computational advantages relative to some other proposals and is consistent with various psychological phenomena. Slant might be encoded by various means, e.g. by the cosine of the angle, by the tangent, or linearly by the angle itself. Experimental results are reported that suggest that slant is encoded by an internal parameter that varies linearly with slant angle, with resolution of roughly one part in 100. Thus we propose that surface orientation is encoded in human vision by two quantities, one varying linearly with slant angle, the other varying linearly with tilt angle. PMID- 6850007 TI - [Legal protection and state registration of scientific discoveries in the USSR. The discoveries of Soviet biologists]. PMID- 6850006 TI - Dynamic behaviour of alpha motoneurone sub-pools subjected to inhomogeneous Renshaw cell inhibition. PMID- 6850005 TI - Selective stabilization of muscle innervation during development: a mathematical model. AB - The biochemical model presented concerns a critical step of the development of skeletal muscle innervation. After invasion of the muscle by exploratory motor axons, several nerve terminals converge from different motoneurons onto each muscle fibre at a single endplate. During the following weeks the redundant innervation disappears: a single nerve ending per muscle fibre becomes stabilized. The model is based on the assumption that the numbers of motoneurons and of muscle fibres remain constant during this evolution and that the selective stabilization of the adult connectivity results from the competition of the active nerve terminals for a postsynaptic retrograde factor mu. At the peak of the multiple innervation, the synthesis of mu by the muscle fiber stops, possibly as a consequence of muscle electrical and/or mechanical activity. The stock of mu becomes limited; a retrograde trans-synaptic diffusion of mu from the muscle to the nerve endings takes place. Within each nerve ending, mu enters into a chemical autocatalytic reaction which results in the production of a presynaptic stabilization factor s. The nerve impulses reaching the nerve terminal initiate this reaction. Any given nerve terminal become stabilized when the concentration of s reaches a threshold value. The mathematical analysis of the model shows that there exists a unique solution which is physically acceptable. Its application and computer simulation predict that only one nerve terminal becomes stabilized per muscle fibre. The model accounts for the experimental observations that the reduction in size of the motor units is not necessarily accompanied by a reduction in the variability of their size. The model also accounts for the acceleration or delay in regression which follows modifications of the chronic activity of the nerve endings and for the variability of the pattern of innervation observed in isogenic organisms. Plausible biochemical hypotheses concerning the factors engaged in the "selective stabilization" of the nerve endings are discussed. PMID- 6850008 TI - ["Thermogradient" unit]. AB - An experimental device--Thermogradient--for studying the behaviour of small animals under various thermal conditions has been described. Constructive circuit of thermoplates and principal circuits of thermoregulator and test thermometer are given. The device provides using of various combinations of temperature gradients and carrying out prolonged experiments with stable regime of heating and cooling of the thermoplates and the automatic registration of the coordinates of a biological subject on the various recorders. The use of the accessory boxes placed on the necessary number of plates with given temperature gradients is possible. PMID- 6850009 TI - Sites of action of light during phototherapy. AB - In order to investigate the main sites of action of phototherapy in the treatment of neonatal jaundice we studied (a) the in vivo and in vitro relationship between the hematocrit and the effectiveness of phototherapy, and (b) the effect of varying the skin area exposed to light. The results show that the hematocrit does not influence in vivo the efficacy of phototherapy, while they confirm that the total skin surface exposed to light is important in determining the effectiveness of light treatment. The authors have also studied the possible action of phototherapy on bilirubin solutions placed into the postmortem brain or the stomach. The results suggest that blue light does not penetrate strongly enough to photomodify the exposed pigment. PMID- 6850010 TI - Evidence that medium-chain fatty acid oxidation can support an active gluconeogenesis in the suckling newborn rat. AB - Long-chain fatty acid oxidation was inhibited in 1-day-old suckling rats by 2 tetradecylglycidic acid. Within 6 h it induced profound hypoketonemia and hypoglycemia together with a decreased rate of gluconeogenesis estimated from [U 14-C]-lactate incorporation into glucose. Medium-chain triglyceride feeding restored, within 3 h, normal blood concentrations of ketones and glucose as well as a high gluconeogenic rate from [U-14-C]-lactate. It is concluded that in the suckling newborn rat 2-tetradecylglycidic acid is effective in inhibiting selectively long-chain fatty acid oxidation and that medium-chain fatty acid oxidation can support an active gluconeogenesis. PMID- 6850012 TI - Developmental changes in fetal adrenal hypertrophy following maternal bilateral and fetal unilateral adrenalectomy at different stages of gestation in the rat. AB - Maternal adrenalectomy on days 14 and 15 of gestation did not alter the fetal adrenal weight 2 days later. The same operation on day 16 caused a significant increase in the adrenal weight with a hypertrophy of the cortical cells. Nevertheless, the operation on days 17 and 18 induced no change in the fetal adrenals. Subsequently on days 19 and 20, the operation resulted in a significant hypertrophy of the fetal adrenals. Fetal unilateral adrenalectomy on day 18 caused, 2 days later, significant hypertrophy of the contralateral adrenal, in contrast with no significant change after maternal adrenalectomy. This is perhaps due to the difference in the amount of fetal plasma corticoids, as evidenced by the previous reports of high concentrations of fetal plasma corticosterone on days 19 and 20. The overall results suggest that the fetal pituitary-adrenal feedback mechanism begins to appear between days 16 and 18 of gestation. PMID- 6850011 TI - Cerebrospinal fluid concentration of biogenic amine metabolites in idiopathic apnea of prematurity. AB - The concentration of homovanillic acid and 3-methoxy-4-hydroxyphenylglycol (MHPG), the major metabolites of dopamine and norepinephrine, respectively, were studied in the cerebrospinal fluid (CSF) of 34 newborn infants. No significant difference was found in the levels of MHPG and homovanillic acid between preterm and term infants. Apneic preterm infants had significantly higher levels of MHPG than nonapneic prematures. Theophylline did not change the levels of these metabolites in CSF. There was a progressive rise of MHPG levels in CSF in preterm infants as their postnatal age increased. We suggest that idiopathic apnea of prematurity is not associated with depletion of catecholamine stores in the central nervous system. Theophylline does not seem to relieve apnea by stimulation of the central adrenergic system. PMID- 6850013 TI - Cardiovascular effects of dopamine in developing swine. AB - Cardiac function and peripheral blood flows were measured before and during single intravenous injections of dopamine (2-25 micrograms/kg) in developing and mature swine anesthetized with pentobarbital. A positive inotropic effect was observed in even the youngest swine. Renal vasoconstriction was observed even after low doses of dopamine in animals younger than 1 month of age, and femoral vasoconstriction in animals younger than 2 weeks of age, unless alpha-adrenergic receptors were blocked by phentolamine. We concluded that the vasodilator responses to dopamine are slower to develop in the renal than in the femoral circulation. PMID- 6850014 TI - Effects of acute preload and afterload stress on myocardial function in newborn and adult sheep. AB - Unanesthetized, chronically instrumented newborn and adult sheep were subjected to acute circulatory preload stress (rapid administration of 30 ml X kg-1 isotonic saline) and afterload stress (intravenous administration of 0.2 mg X kg 1 methoxamine). Variables of circulatory status and myocardial function were monitored continuously during experimental manipulations. Preload stress elevated arterial and venous pressures, reduced the preejection period (PEP) to left ventricular ejection time (LVET) ratio (PEP/LVET), and increased the rate of left ventricular pressure rise (dp/dt) to a comparable extent in newborn and adult subjects. Afterload stress increased arterial and venous pressures to a comparable extent in newborns and adults; the percent changes in PEP (25), LVET (16), PEP/LVET (12) and dp/dt (-21) in newborns were more pronounced than those in adults. PMID- 6850015 TI - Patterns of monoamine oxidase maturation in mouse brain. AB - Monoamine oxidase (MAO) was assayed in mouse brain between the ages of 1 day postpartum and adulthood. Two substrates, 5-hydroxytryptamine (5-HT) and tryptamine, were used and assays were done with and without thermal inactivation at 50 degrees C for 10 min. Relative patterns of MAO maturation were found including one form that decreased with increasing age. PMID- 6850016 TI - Prenatal development of brown adipose tissue in man. A morphometric and biomathematical study. AB - In a series of 110 liveborn infants who died within 24 h of birth, and six 14- to 17-week-old fetuses, the development of perirenal brown fat was studied by morphometric and biomathematical methods. Brown fat was present at the 20th week of age and, taking as index of maturity the population of multilocular adipocytes, its development progressed according to a 3-parametric logistic growth function, with a half-time of 26 weeks and a tendency to asymptotic stabilization by the 35th week. Unilocular adipocytes appeared early and their low percentage (10.9%) remained relatively stable. Brown fat development in 75% of the cases of small-for-dates corresponded to that of infants with matched postconceptional age but appropriate birth weight. Abnormal cases presented whether a persistence of immature patterns or an unusual predominance of unilocular cells. No changes due to lipolysis were detected in any case. PMID- 6850017 TI - Nitrogen metabolism in the sheep fetus. Observations on the liver and placenta. AB - Ammonium ions added in large quantity disappear rapidly from the reservoir of the sheep placenta perfused in situ through the umbilical vessels. Ammonium ions are removed from the reservoir of perfused sheep fetal livers of 108-141 days of conceptual age at a rate of at least 1 mumol/min/g liver. The majority appears as urea. There is little or no change in glutamine concentration. Hepatic carbamoylphosphate synthetase I, ornithine transcarbamylase, argininosuccinate synthetase, argininosuccinase and arginase are present, even at 97 days of conceptual age, in adequate amounts to account for the observed urea production. With the exception of arginase, all levels rise with fetal age. The levels in the maternal liver are comparable with those at 106 days of conceptual age. Arginase is high in the younger fetuses, falls progressively with fetal age and is very low in the mother. It is concluded that (a) the perfused placenta is permeable to ammonia and the placenta may be able to clear ammonia from the fetal circulation at a rate comparable with that of fetal liver; (b) the fetal liver converts ammonia to urea at a rate comparable with the urea production of the fetus; (c) there is virtually no glutamine production by the fetal liver; (d) adequate amounts of the enzymes of urea synthesis are present even in the immature fetal liver to account for the total urea production of the fetus, and (e) the anomalously low arginase level in the maternal liver may conserve maternal arginine, and the high levels in the younger fetuses may be related to fetal polyamine production from maternally derived arginine. PMID- 6850018 TI - Respiratory distress syndrome in the newborn: relationship to serum prolactin, thyroxine, and sex. AB - Prolactin and thyroxine levels were measured by radioimmunoassay in cord blood of 61 premature infants of 26-36 weeks gestation. 30 of the infants subsequently developed respiratory distress syndrome (RDS). The infants who developed RDS had a mean cord prolactin level of 174.5 +/- 24.5 ng/ml and a mean cord thyroxine level of 5.9 +/- 0.4 micrograms/dl. In the 31 healthy infants, the mean cord prolactin and thyroxine levels were significantly higher (226.3 +/- 25.8 ng/ml and 7.1 +/- 0.4 micrograms/dl, respectively). The correlation coefficient between prolactin and thyroxine was r = 0.56 in infants with RDS (p less than 0.0008). Both prolactin and thyroxine correlated with gestational age in the RDS group (r = 0.71 and 0.47, respectively). Discriminant analysis shows that the correlation between prolactin and thyroxine is independent of gestational age (r2 = 0.32, p less than 0.05). There was no correlation between the levels of prolactin and thyroxine in infants without RDS. In the healthy group, the cord prolactin levels were significantly higher (p less than 0.01) in female (335.8 +/- 47.7 ng/ml) than in male infants (209 +/- 17.2 ng/ml). Premature infants who develop RDS have significantly lower thyroxine and prolactin levels in cord blood than infants who remain healthy. PMID- 6850019 TI - Morphological changes in lipid droplets within cells of the duodenal transition zone in suckling rats. AB - This ultrastructural study compares the lipid droplets within epithelial cells at the bases of the duodenal villi in the transition zone between crypts and the lateral portions of the adjacent villi in newborn rats suckled 24 h, 10 days and 15 days and contrasts with cells in similar locations in newborn unsuckled and weaned rats. The mean diameters and numbers of lipid droplets per field decreased when cells from rats at 10 and 15 days of age were compared to those at 24 h of age. The range of sizes also narrowed. There was cell-to-cell variability in number and in opacity of the lipid droplets. Multiple membranous laminae enclosed the droplets. Cells in similar locations in newborn unsuckled and in weaned rats did not contain lipid droplets. It is concluded that the numbers and sizes of the large lipid droplets within cells in the transition zones at the bases of the villi decrease as cells at the same relative locations mature during suckling and as the infant rats mature. PMID- 6850020 TI - Spectral analysis of electroencephalogram during perceptual-motor learning. AB - Spectral analysis of the electroencephalogram was utilized to determine attention demands during learning of a perceptual motor task. Fifteen subjects participated in the task which consisted of 15 trials of the mirror star learning task. EEG was monitored bilaterally from the occipital and parietal lobes during each trial and analyzed for intensity and mean frequency components within five different bandwidths. All subjects rapidly improved performance in terms of both time and error reduction although the former measure appeared to be a better fit of the supradiagonal form of matrix typically found for this type of learning. Mean alpha frequency increased slightly during the task while delta frequency decreased. PMID- 6850021 TI - Sex differences in behaviour pattern and catecholamine and cortisol excretion in 3-6 year old day-care children. AB - Fifteen boys and eleven girls between three and six years of age were examined at a day-care center and at home as regards their catecholamine and cortisol excretion. Behaviour pattern was assessed by the MYTH-scale, which measures the competitiveness, impatience-anger and aggression components of the type A behaviour pattern in children (Matthews and Angulo, 1980). The boys obtained higher type A scores and excreted more adrenaline and noradrenaline than the girls, while cortisol excretion did not differ between the sexes. In view of previous findings, the results suggest that sex differences in catecholamine excretion in children are induced by sex related differences in behaviour. This relationship in childhood could be of relevance for sex differences in catecholamine responses observed in adulthood. In both sexes, adrenaline excretion was significantly elevated at the day-care center compared with the at home levels, indicating that mental arousal was greater at the center. In a separate part of the study, eleven new children were tested while they were adjusting to the day-care situation; it was found that only noradrenaline levels during the first week at the center were significantly elevated. PMID- 6850022 TI - The relationship of sleep and anxiety in anxious subjects. AB - The present study provided polysomnographic corroboration of the frequently reported relationship between anxiety and subjective sleep disturbance. When compared to normals, anxious individuals were found to have significantly less sleep period time, total sleep time, percent stage REM and percent stage 4; shorter latency to stage REM; and greater percent stage 1. Partial correlations (holding depression constant) showed significant positive relationships between anxiety rating and number of awakenings, latency to stage 1, and percent stage 2. A significant negative relationship was found between anxiety and percent stage 4, and a nonsignificant negative trend was found between anxiety and latency to stage REM. Overall there was a tendency toward less sleep and lighter sleep in subjects with anxiety, thus validating subjective reports. The decreased latency to stage REM and its negative relation to anxiety, raised the possibility that this variable may not be specifically indicative of depression. PMID- 6850023 TI - The removal of the eye-movement artifact from the EEG by regression analysis in the frequency domain. AB - A new method to remove the eye-movement artifact from the electro-encephalogram (EEG) is described. It is based on complex regression analysis. Transfer of eye movement activity to EEG can have frequency dependent amplitude and phase characteristics. The proposed method is suitable for handling such transfer because the regression formula is used in the frequency domain. The method is demonstrated with artificial signal-in-noise EOG (electro-oculogram) and EEG series. In the EEG noise an event related potential (ERP) is buried as a constant signal and in the EOG noise a changing EOG response (saccadic eye-movement) is simulated before adding the whole series to the EEG series. Also decreasing levels of transfer from EOG on EEG leads are simulated as the EOG artifact diminishes from the frontal to the occipital area. Because of the possible frequency dependent phase characteristics also a 24 msec time-shift of the EOG is simulated. The complex regression coefficient (P(jw)) of the EOG and EEG series is first calculated and then 'common' regression is removed from the EEG. To do this the estimated P(jw) is tested for significance with the F-statistic and significant EOG activity is subtracted in the frequency domain from the EEG on a single trial base. Then each EEG record is inversely transformed to the time domain. It was found that the complex P(jw)s as used in the subtraction formula, corrects very accurately the influence of the EOG artifact on EEG activity. Finally an application of the method in a real life situation is reported. PMID- 6850024 TI - Drawing and the cerebral hemispheres: bilateral EEG alpha. AB - Bilateral EEG alpha (alpha) was measured during several cognitive tasks in two experiments. EEG alpha was suppressed relative to baseline in both hemispheres during every drawing and writing task. In addition, there were task-related EEG alpha asymmetries. Differences in left-hemisphere, but not right-hemisphere EEG alpha activity, were responsible for EEG alpha asymmetry differences between writing and drawing tasks. There was no difference in bilateral EEG alpha during drawing an upright versus an inverted drawing stimulus; failing to support Edward's (1977, 1979) 'cognitive shift' approach to drawing instruction. PMID- 6850025 TI - Attention-related negative brain potential for speech words and pure tones. PMID- 6850027 TI - Habituation of the orienting reaction in patients with epileptogenic cerebral tumours. AB - A polygraphic study on resistance to habituation of the somatic, autonomic and EEG components of the orienting reaction elicited by a repetitive auditory stimulus was performed in 41 patients with epileptogenic cerebral tumours and in 128 matched subjects in three control groups. The study evidenced a significantly higher resistance to habituation of the orienting reaction in patients with epileptogenic cerebral tumours than in control subjects. The degree of habituation disturbances depended on the tumour site and size as well as on the electro-clinical form and frequency of seizures. PMID- 6850026 TI - Recognition memory and the orienting response: an analysis of the encoding of pictures and words. AB - Three experiments were designed to investigate the role of the orienting response (OR) in the recognition memory for pictures and words. In the first experiment (n = 60), pictures which were shown to have a high frequency of correct recognition in an independent analysis of recognition memory evoked larger initial ORs than words and low recognition frequency pictures. In experiment 2 (n = 56) subjects participated in the recognition memory task and then they received 12 repetitions of a picture or word stimulus which they either recognized or failed to recognize. The magnitude of the initial electrodermal OR was larger for the not recognized than for the recognized stimuli. This finding, which is a stimulus priming effect, was replicated in experiment 3 (n = 40). In experiments 1 and 2, recovery of the OR following a habituation series was induced by a change to the alternate representational form of the stimulus. Differences between the picture word and word-picture transitions were not consistent between experiments. Overall, the experiments indicate that OR magnitude is influenced by the availability of the stimulus memory trace, with increased amplitude determined by less accessible memory traces. PMID- 6850029 TI - The interaction of chemicals during pregnancy: an update. AB - The role of chemical interactions in the genesis of induced embryotoxicity in humans and in experimental animals is a point of current concern and interest. This review summarizes the current knowledge in this field and demonstrates that, under appropriate conditions, the observed results of chemical interactions can be explained, in part, through an understanding of the underlying pharmacokinetic and pharmacodynamic parameters. These define the concentration of the "primary" teratogen at its receptor site in cells and tissues that are particularly sensitive to its embryotoxic action. The interacting "secondary" or "coteratogen" is viewed as an agent that is capable of altering these parameters in a way that is correlated with an observed alteration in the embryotoxic response. A series of recent experiments (diazouracil: 5-fluouracil; hydroxyurea: 5 bromodeoxyuridine; caffeine: 5-bromodeoxyuridine; caffeine: phenytoin) are reported which demonstrate both the validity and the limitations of such an approach and attempt to interpret observations, which are primarily empirical in nature, in pharmacologic terms. PMID- 6850028 TI - Potential factors in carcinogenesis and tumor regression. AB - Known and unknown host factors determine the individual susceptibility to carcinogenic agents. Such factors may interact with either the phase of transformation (initiation) or with the phase of proliferation (promotion). Some of these factors have been recognized as potential determinants of the degree of susceptibility or resistance to cancer. Transformation may be impeded by a low rate of absorption of carcinogenic agents (barrier effect), by the availability of deactivating enzymes operative at several steps of the metabolism of carcinogenic agents, and by a high repair capability of DNA damage. Proliferation of transformed cells may be impeded or prevented by immune defense mechanisms and by maturation factors such as nerve growth factor (NGF), glia maturation factor, fibroblast growth factor, and others. NGF has already been shown to be capable of maturing anaplastic glioma cells (clone F98) and reducing their rate of growth. Rats treated with NGF following implantation of anaplastic glioma cells had a significantly decreased tumor growth rate and increased survival time. NGF administration to pregnant rats preceding exposure to ethylnitrosourea (ENU) (50 mg/kg, 21st day of gestation) or to offspring transplacentally exposed to ENU resulted in reduction of neurinoma development. The importance of NGF as a suppressing agent of neoplastic proliferation and as a prospective tumor therapeutic needs further exploration. PMID- 6850030 TI - An alternative animal model for perinatal carcinogenesis. AB - The differences in developmental biology between marsupials and eutherian animals provide alternative approaches to major problems in perinatal carcinogenesis. The high susceptibility of the neonatal American marsupial, the opossum (Didelphis virginiana), during early postnatal development to oral, chemical induction of dysontogenetic tumors with a close morphologic and biologic resemblance to those in the human suggests that the neonatal marsupial may offer unique opportunities for the study of carcinogenesis during ontogenesis without placental interference and under a maternal influence limited to the constituents of milk and contact with skin secretions. Although there is as yet no experimental data on transplacental tumor induction in the marsupial, several aspects of marsupial gestation, including a primitive yolk sac placenta devoid of implantation and an apparent, partial nutritional autonomy of the developing fetus, imply that the marsupial in utero may, like the marsupial neonate, be more accessible to tumor induction than its eutherian counterpart. The results of preliminary attempts to develop pre- and postnatal life support systems (embryo culture and an artificial marsupium) suggest the feasibility of further reducing maternal influence on the developing marsupial in order to enhance the utility of the model. Currently, the opossum and the marsupial mouse (Sminthopsis macroura) appear to be the marsupials of choice for perinatal carcinogenesis experiments. PMID- 6850031 TI - Partial purification of a chorionic gonadotropin-like protein from bovine cotyledons. AB - The presence of placental gonadotropin activity in early pregnancy was studied in the cow. Cotyledons from the first trimester of gestation were used to isolate a chorionic gonadotropin-like (CG-like) protein by means of ammonium sulfate precipitations (0.17-4.5 M) and gel filtration on Sephadex G-100 and DEAE Sephadex. The CG-like activity was measured by a radioreceptor assay (RRA) specific for human chorionic gonadotropin (hCG). Luteotrophic activity was also assessed in two separate in vitro bioassays using cultures of bovine granulosa and rat Leydig cells. It was found that the 3 M ammonium sulfate precipitate of cotyledon extracts contained a CG-like activity of 179 mIU/mg protein as measured by RRA. The precipitate inhibited 125I-hCG binding in a linear fashion. A ninefold increase in specific activity was achieved by further purification on Sephadex G-100 (800 mIU/mg protein) and Sephadex-DEAE (1600 mIU/mg). In experiments with cell cultures, it was found that 20 micrograms of protein eluted from Sephadex-DEAE (equivalent to 16 mIU of hCG as determined by RRA) added to the culture medium significantly enhanced (P less than 0.05) progesterone production by the granulosa cells and testosterone production by the Leydig cells. We conclude that the bovine placenta contains a chorionic gonadotropin which may serve to maintain the corpus luteum of pregnancy. PMID- 6850034 TI - Pyruvate and lactate levels in oviducts of cycling, pregnant, and pseudopregnant mice. AB - Pyruvate and lactate were measured in oviducts during the first 5 days following ovulation in cycling, pregnant, and pseudopregnant mice, to determine how oviductal metabolism might change to promote the availability of these substrates to the early embryo. The postovulatory peak in ampullar pyruvate was most evident in the 12-h pregnant oviduct, 3.19 mmol . kg-1. This increase at +12 h was related to a decrease in lactate dehydrogenase (LDH) activity, compared to cycling animals, observed at this time. Although cycling animals showed a significant increase in isthmic pyruvate at +3 h, no change in isthmic pyruvate was observed in either mated group through the postovulatory period. Isthmic LDH activity was also unchanged in cycling or mated animals through this period. Ampullar lactate in both mated groups was elevated at 12 to 24 h after ovulation, a pattern similar to that seen in cycling animals. Isthmic lactate levels also increased after ovulation in all groups, but in the pregnant group the lactate remained elevated (25-28 mmol . kg-1) through 72 h, while concentrations in the cycling and pseudopregnant animals, returned to low levels (14-16 mmol . kg-1) by 48 h. The patterns of pyruvate and lactate, especially those in the pregnant animals, seem suited to providing these metabolites at levels near those required for optimal in vitro embryo growth. The +12 h ampullar pyruvate peak noted in mated animals implies a specific response to the mating stimulus. Prolongation of increased isthmic lactate levels only in pregnant animals suggests a response of the oviduct to the viable embryo. PMID- 6850035 TI - Fertilizing ability of cock spermatozoa from the testis epididymis and vas deferens following intramagnal insemination. AB - A reexamination of the fertilizing ability of cock spermatozoa from the testis, epididymis and vas deferens was accomplished through the use of intramagnal insemination. Intramagnal insemination of spermatozoa taken from the testes, epididymides and vas deferentia resulted in fertility levels of 85-90% during the first week and levels of 67-90% the second week after a single insemination. In contrast, vaginal insemination of testicular spermatozoa resulted in a total absence of fertile eggs. Vaginal and intramagnal insemination of ejaculated spermatozoa resulted in fertility levels of 70 and 71%, respectively, during the first week and levels of 42 and 53%, respectively, the second week after a single insemination. There were no significant differences in hatchability of fertile eggs from hens inseminated with semen from different regions of the male tract or by different routes of insemination. PMID- 6850032 TI - Subcellular compartmentalization of the progesterone receptor in cat uteri following the acute administration of progesterone. AB - Cytosol and nuclear progesterone receptors in the cat uterus were measured by Scatchard analysis to determine the relationships between dose of progesterone administered and the time following administration with the content of receptor in these two cellular compartments. Cats were ovariectomized, treated for 7 days with estradiol and then injected via the saphenous vein with progesterone. One uterine horn was removed prior to, and the other uterine horn after the injection of progesterone. The amount of cytosol receptor translocated was found to be dose dependent over the range of 0-200 micrograms of progesterone. A maximum of 40% of the cytosol receptor was depleted even when the amount of progesterone injected was increased. In non-estradiol-primed animals it was also found that approximately 40% of the cytosol receptor was depleted following a progesterone injection. Within 3 h of the injection of 300 micrograms of progesterone, the cytosol and nuclear receptor levels had returned to preinjection values. A second administration of progesterone at 1 or 3 h after the first injection of progesterone caused a partial depletion of the cytosol receptor and an increase in nuclear progesterone receptor concentration. These data suggest that the translocation of cytosol receptor and the appearance of nuclear receptor is dose dependent until approximately 40% of the cytosol receptor is depleted following a single injection of progesterone, that the retention of nuclear receptor after an acute injection of progesterone is of short duration (less than 1 h), and that the replenishment of cytosol receptor is complete within 3 h. PMID- 6850033 TI - Effect of one-second light pulses on testicular function and locomotor activity in the golden hamster. PMID- 6850036 TI - Aging and the regulation of luteinizing hormone in C57BL/6J mice: impaired elevations after ovariectomy and spontaneous elevations at advanced ages. AB - The effects of age on the elevations of plasma luteinizing hormone (LH) after ovariectomy were studied in C57BL/6J mice. In longitudinal studies, mice ovariectomized at 4-6 months and sampled serially reached maximum plasma LH (200 300 ng/ml) after 1 month; these elevations were maintained to at least 15 months of age, when most intact mice have ceased cycling and have persistent vaginal cornification (PVC). In contrast, mice ovariectomized at 15 or 21 months had smaller LH elevations (to 150 ng/ml) 1 or 2 months after ovariectomy, as compared to younger (5- or 11-month-old) cycling mice whose LH was ca. 200 ng/ml 1 month after ovariectomy. The maintenance of LH elevations in chronically ovariectomized mice suggests that the smaller LH elevations in acutely ovariectomized mice of the same age may be an ovary-dependent aging phenomenon. Pilot studies detected no age effects on plasma LH turnover. Intact 20- to 26-month-old mice with leukocytic vaginal smears, low plasma estradiol (E2) and low progesterone had initially elevated plasma LH (ca. 125 ng/ml), if gross pathologic lesions were not present at necropsy. In contrast, old mice with cornified vaginal smears had higher plasma E2 and low (normal) plasma LH. The low plasma progesterone and elevated LH in older mice with leukocytic smears argues against a pseudopregnant status. Old mice of all vaginal smear types with pathologic lesions had low LH. Ovariectomy did not yield further increases of LH in old mice. The spontaneous elevation of plasma LH to ovariectomized levels in old intact mice with leukocytic vaginal smears and reduced plasma E2 implies that C57BL/6J mice eventually undergo ovarian changes analogous to menopause in humans. PMID- 6850037 TI - 17 beta-estradiol maintains normal function of corpora lutea throughout pseudopregnancy in hypophysectomized rabbits. AB - The hypothesis was tested that the action of 17 beta-estradiol is sufficient to ensure normal luteal function in the absence of pituitary hormones. Rabbits were mated to vasectomized males to induce a normal pseudopregnancy and the next day (Day 1) hypophysectomized or sham hypophysectomized. At this time a Silastic capsule containing estradiol was inserted s.c. in all rabbits. In the presence of this implant serum estradiol values in hypophysectomized and sham hypophysectomized animals were not different; the mean concentration for the two groups was 9 pg/ml. Measurements of serum progesterone throughout pseudopregnancy revealed essentially superimposable curves for hypophysectomized, estradiol treated and sham-hypophysectomized, estradiol-treated animals. Further, pseudopregnancy was of normal duration in the two groups, about 17 days. Progesterone secretion was acutely dependent upon estradiol in the hypophysectomized animals, as shown by removal of the Silastic capsule on Day 10; progesterone declined from 18 ng/ml of serum to 10 ng/ml within 12 h, and by 24 h after removal of the implant was 0.5 ng/ml. Twelve-hour incubations of corpora lutea, and measurement of progesterone and 20 alpha-dihydroprogesterone in medium, revealed essentially superimposable rates of production of these steroids for tissues from the hypophysectomized and sham-hypophysectomized animals. We conclude that 17 beta-estradiol satisfies the criteria for the primary luteotropic hormone in this species; further, regression of the corpora lutea is normal and predictable in the presence of estradiol. Beyond the first day following ovulation, the secretion of luteinizing hormone (LH) or other pituitary hormones is not required for a normal course of development, maintenance and regression of the corpora lutea. PMID- 6850039 TI - Histamine H1 receptors and prostaglandin-histamine interactions modulating contractility of rabbit and rat testicular capsules in vitro. AB - The stimulatory effect of histamine on rabbit and rat testicular capsule was blocked by the H1 blocker, diphenhydramine, but not by the H2 blocker, cimetidine, suggesting the presence of H1 histamine receptors in both rabbit and rat testicular capsules. In the rabbit, both anti-prostaglandin F (PGF) and anti prostaglandin E (PGE) effaced spontaneous autorhythmic contractions. They markedly inhibited PGF 2 alpha, PGE1 and histamine-stimulated contractions of the rabbit testicular capsule. In the rat, anti-PGF or anti-PGE had no inhibitory effects on the capsular tone, but they both inhibited the stimulatory effects of histamine. These data suggest that the action of histamine on the rabbit and rat testicular capsules could be due partly to a secondary release of the PG's, PGE2 and PGF2 alpha. PMID- 6850038 TI - Estradiol secretion by theca cells of the domestic hen during the ovulatory cycle. PMID- 6850040 TI - Effect of inhibition of estrogen synthesis during the luteal phase on function of the corpus luteum in rhesus monkeys. AB - It has been hypothesized that estrogen synthesized by the corpus luteum initiates luteal regression during the nonfertile menstrual cycle in primates. To study the role of endogenous estrogens in functional regression of the monkey corpus luteum, we administered the aromatase inhibitor 1,4,6-androstatriene-3,17-dione (ATD) to rhesus monkeys during the luteal phase of the menstrual cycle. Twice daily oral administration of ATD suppressed systemic and intraluteal estrogen levels by 80-90%. The midluteal phase rise in estradiol concentrations that occurs in rhesus monkeys was completely abolished by ATD treatment. Despite suppression of estrogen synthesis during the luteal phase, mean menstrual cycle length and length of the luteal phase were not different than in control monkeys treated with vehicle only. Progesterone levels were lower in the ATD-treated group on the second and third day of treatment, but did not differ from control levels during the remainder of the cycle. These data suggest that elevated estrogen synthesis during the luteal phase of the menstrual cycle is not a prerequisite for spontaneous luteolysis in rhesus monkeys. PMID- 6850041 TI - Pituitary function during the sexual maturation of the male rat: inhibition of prolactin secretion by exogenous dopamine. AB - Experiments were designed to determine if the responsiveness of the anterior pituitary to the prolactin (Prl) inhibiting effects of dopamine were altered during the sexual maturation of the male rat. Initial experiments established that bolus injection of dopamine HCl into cannulated (left carotid) rats pretreated with alpha-methyl-p -tyrosine (MPT) resulted in an appropriate reduction of serum Prl and that the MPT treatment did not significantly alter testosterone or luteinizing hormone (LH). Immature (25-30 days), pubertal (50-55 days), and young adult (75-80 days) rats were studied. One hour after MPT administration a blood sample was collected, followed by administration via the cannula of 2.5, 10, 40 or 160 micrograms dopamine/100 g BW or the 5% glucose vehicle. Additional blood samples were collected 15, 30, 45 and 60 min after dopamine. MPT administration resulted in a significant increase in serum Prl compared to saline-treated controls at all ages; however, the absolute value of these increases varied significantly with age. Subsequent data were calculated in terms of the decrement in serum Prl versus Time O. In immature rats the 160 micrograms dose of dopamine resulted in a significant inhibition of Prl at 15 and 30 min when compared to glucose-treated controls. In pubertal animals, 40 micrograms dopamine was effective in inhibiting Prl at both 15 and 30 min. In young adult rats, 10 micrograms dopamine was effective at 15 and 30 min; 160 micrograms lowered Prl through 45 min. These data suggest that the responsiveness of the pituitary to the Prl inhibiting effects of dopamine increases during the sexual maturation of the male rat. PMID- 6850042 TI - Photoperiodic stimulation of pubertal development in male deer mice: involvement of the circadian system. AB - Pubertal development in prairie deer mice (Peromyscus maniculatus bairdii) is accelerated by exposure of juveniles to a long-day photoperiod, and, conversely, retarded by exposure to short days. The purpose of the present study was to evaluate the possible involvement of the circadian system in the photoperiodic regulation of puberty. Weanling males, previously housed on a short-day light cycle of 6L:18D, were subjected to a "resonance" protocol in which they received one of the following light cycles: 6L:18D, 6L:30D, 6L:42D, 6L:54D, or 16L:8D. Post-weaning exposure to cycles of 16L:8D, 6L:30D, and 6L:54D stimulated reproductive organ growth as measured at 6 weeks of age. Exposure to cycles of 6L:18D and 6L:42D failed to stimulate reproductive development. These data support the hypothesis that young male deer mice use a circadian rhythm of responsiveness to light to measure photoperiodic time and, consequently, regulate pubertal development. PMID- 6850043 TI - Ovarian activity, circulating hormones and sexual behavior in the cat. II. Relationships during pregnancy, parturition, lactation and the postpartum estrus. PMID- 6850044 TI - Spatial and temporal patterns of deoxyribonucleic acid synthesis and mitosis in the endometrial stroma during decidualization in the pseudopregnant rat. AB - A quantitative study was made of the spatial patterns of stromal cell mitosis and DNA synthesis in the endometrium of the pseudopregnant rat before and during decidualization. A colchicine block was used for mitotic counts, and DNA synthesis was studied by [3H] thymidine autoradiography. Observations were also made on the subsequent fates of [3H] thymidine-labeled stromal cells. Before the onset of decidualization, on Days 3 and 4 (vaginal cornification = Day 0), mitosis was largely confined to the subepithelial stroma along the sides and around the antimesometrial pole of the lumen. [3H] thymidine labeling and stromal mitosis following a decidualizing stimulus at noon on Day 4 of pseudopregnancy were first seen close to the uterine lumen, with subsequent spread to deeper layers of the endometrium. At noon on Day 5, mitotic figures were numerous on all sides of the lumen and at all depths in the endometrium. At later stages, mitosis and the development of polyploidy continued in the decidual tissue, but little DNA synthesis or mitosis occurred in the basal zone of the stroma adjacent to the myometrium. In this zone, many cells in animals given [3H] thymidine 18 to 24 h after induction of decidualization remained heavily labeled throughout the growth and regression of deciduomata. Labeled cells derived from the basal zone and outer edge of the decidual capsule were present in the stroma of the regenerated endometrium following the regression of deciduomata. It was concluded that although cells at all depths in the endometrial stroma undergo DNA synthesis and mitosis in the early stages of response to a decidualizing stimulus, their subsequent behavior and fate depend upon their position in the endometrium. PMID- 6850045 TI - Maintenance of ovulatory menstrual cycles in chronically cannulated monkeys: a vest and mobile tether assembly. AB - We report maintenance of apparently normal ovulatory menstrual cycles in cynomolgus monkeys up to 3 months after their placement in a vest and mobile tether assembly, with or without chronic cannulation via a femoral to vena caval catheter. Since menstrual cyclicity and characteristic hormonal profiles of the principal ovarian steroids remained normal in these monkeys, use of the vest and mobile tether apparatus described here permits long-term study of the hypothalamic-pituitary-ovarian axis during chronic cannulation without introducing overt aberrancies as a part of the experimental model. PMID- 6850046 TI - Exposure to diethylstilbestrol during pregnancy permanently alters the ovary and oviduct. AB - To determine the effects of transplacental exposure to diethylstilbestrol (DES) on the ovary and oviduct of the CD-1 mouse, timed pregnant mice were injected subcutaneously with DES (100 micrograms/kg) on Days 9 through 16 of gestation and female offspring sacrificed from 4 weeks to 10 months of age. Following DES exposure, ovarian alterations such as inflammation, a prominent interstitial compartment composed of medullary tubule-like structures, and intra- and para ovarian cysts from mesonephric remnants were observed. In addition, there were oviductal abnormalities including malformation. As reported previously, the oviduct was closely adherent and coiled around the ovary in a similar position to that seen in the fetal mouse. This malformation was termed developmental arrest of the oviduct (DAO) and was a consistent finding in female offspring exposed prenatally to DES (100 micrograms/kg). Increased prevalence of salpingitis and microscopic alterations in the oviduct were also observed. Oviductal epithelium was mostly secretory type with basal vacuoles. In some cases, oviductal epithelium was hyperplastic and formed mucosal folds resembling glands which extended through the muscularis (diverticulosis). The extent of the adenomatous mucosal folds and the degree of extension through the muscularis increased with the age of the animal (100% at 10 months). Some characteristics of this abnormality resembled salpingitis isthmica nodosa, a lesion described in women which is associated with ectopic pregnancies and subfertility. Gross and microscopic changes in the oviduct were more consistent than were the changes among other portions of the reproductive tract of DES-treated mice previously reported. Since subfertility has been described in this mouse model as well as in prenatally DES-exposed women, the data presented in this report may help in evaluation of the reported reduced fertility in exposed patients as well as other infertility patients. PMID- 6850047 TI - Progesterone modulation of specific protein synthesis in the decidualized hamster uterus. AB - Progesterone-dependent synthesis of specific proteins was studied on Days 6, 7 and 8 of pseudopregnancy in the decidualized hamster uterus. Progesterone withdrawal was induced by removal of subcutaneous steroid implants from ovariectomized animals; hamsters retaining the implants served as controls. Eight hours after hormone withdrawal, myometrial and deciduomal tissues were labeled with [35S]methionine during incubation for 1 h in vitro, and proteins were separated by two-dimensional gel electrophoresis followed by autoradiography of the dried gels. Analysis of the two-dimensional gel patterns (maps) revealed both increases and decreases in autoradiographic spot intensity comparing progesterone withdrawn samples to controls, indicating that progesterone both suppressed and stimulated gene expression in the decidualized uterus. Protein synthesis in the deciduoma was more responsive to hormone withdrawal than that in the myometrium; e.g., 45 changes on Day 7 vs. 26 changes, respectively. The sets of proteins in each tissue responding to progesterone withdrawal through changes in synthesis have been termed "domains." The progesterone domains shifted from day to day during decidualization in size and degree of overlap (changes in protein synthesis common to the domain on different days). Although the degree of overlap was similar in cytosol from both tissues, marked differences were apparent in the overlap of responses in the nucleus. Overlap was extensive in the deciduomal nucleus where six protein spots increased intensity following progesterone removal on each day. In contrast, little overlap was seen between the progesterone domains in the myometrial nucleus. These findings emphasize the differences between these two tissues in their responses to progesterone withdrawal, yet five proteins (one cytosolic, four nuclear) responded similarly to hormone removal in both tissues. These studies show that: 1) progesterone domination of the uterus during pseudopregnancy alters synthesis of many proteins in both the deciduoma and myometrium; 2) progesterone effects on specific protein synthesis during decidualization occur in both positive and negative directions; 3) the proteins modulated by progesterone and, by extension, the genes affected by this hormone are predominantly different in the deciduoma and myometrium, and 4) progesterone modulation of specific protein synthesis in the decidualized uterus is time-dependent, such that the domains of response vary daily in composition, size and overlap. PMID- 6850048 TI - Rhodopsin phosphorylation occurs at metarhodopsin II level. AB - Photolyzed rhodopsin was phosphorylated in bovine rod outer segments incubated at -10 degrees C. In the experiment in which urea-treated outer segments and rhodopsin kinase were incubated with ATP in the presence of 30% glycerol, the extent of phosphate incorporation at -10 degrees C was about 30% of that at 37 degrees C. Separation of phosphorylated rhodopsin by isoelectric focusing indicated that a limited number of sites were phosphorylated at -10 degrees C. The partially phosphorylated pigment incorporated more phosphates when the temperatures was raised to 37 degrees C. This was partly due to decreased inhibition of phosphorylation by glycerol at higher temperature. Since the maximum phosphorylation at -10 degrees C (at which metarhodopsin II is stable) occurred at a pH value (6.0) lower than the pKa for metarhodopsin I-metarhodopsin II transition, metarhodopsin II was suggested to be the preferred substrate for rhodopsin kinase at -10 degrees C. Limited proteolysis with thermolysin of rhodopsin phosphorylated at 37 degrees C released peptides containing about 50% of the total phosphate incorporated. In contrast, proteolytic digestion of rhodopsin phosphorylated at -10 degrees C released negligible amounts of phosphate-containing peptides. The results were taken to suggest that the incorporation of phosphates at metarhodopsin II level under the present condition occurred in the residues other than those removed by thermolysin digestion. PMID- 6850049 TI - Behavior of amphipathic helices on analysis via matrix methods, with application to glucagon, secretin, and vasoactive intestinal peptide. PMID- 6850050 TI - Highly mobile charge carriers in hydrated DNA and collagen formed by pulsed ionization. PMID- 6850051 TI - Electrostatic contribution to the stiffness of DNA molecules of finite length. PMID- 6850052 TI - Tyrosine optical activity as a probe of the conformation and interactions of fibronectin. PMID- 6850053 TI - Salt- and sequence-dependence of the secondary structure of DNA in solution by 31P-NMR spectroscopy. PMID- 6850054 TI - High-resolution NMR studies of A- and G-containing oligonucleotides. PMID- 6850055 TI - Centrifugal field relaxation and ionic strength effects on calf thymus DNA gels. PMID- 6850056 TI - An analysis of the sequence dependence of the structure and energy of A- and B DNA models using molecular mechanics. PMID- 6850057 TI - Excluded volume of an intermediate-molecular-weight DNA. A Monte Carlo analysis. PMID- 6850058 TI - Collapse of DNA caused by trivalent cations: pH and ionic specificity effects. PMID- 6850059 TI - Solvent effects on the dynamics of (dG-dC)3. PMID- 6850061 TI - Mutual diffusion of crystallin proteins at finite concentrations: a light scattering study. PMID- 6850060 TI - Translational friction of rigid assemblies of spheres: derivation and application of new hydrodynamic interaction tensors. PMID- 6850062 TI - Temperature-jump kinetics of the dC-G-T-G-A-A-T-T-C-G-C-G double helix containing a G . T base pair and the dC-G-C-A-G-A-A-T-T-C-G-C-G double helix containing an extra adenine. PMID- 6850063 TI - Salt-dependent conformational transitions in the self-complementary deoxydodecanucleotide d(CGCAATTCGCG): evidence for hairpin formation. PMID- 6850064 TI - Analysis of N4-trideuteroacetylsulphamerazine and its metabolites sulphamerazine and N4-acetylsulphamerazine in man by means of high-performance liquid chromatography and mass spectrometry. PMID- 6850065 TI - Development of a gas chromatography mass spectrometry assay for the two eosinophil chemotactic factors of anaphylaxis. AB - Gas chromatography mass spectrometry has been used for over a decade for the determination of the amino acid sequences of fragment peptides derived from larger parent molecules. The majority of these fragments have from four to seven residues and several different methods of derivatization have been devised. Few reports have been published in which similar techniques have been used for the quantification of such peptides, but there is a growing list of small peptides which have been shown to have biological activity in their own right. This report is concerned with the development of a gas chromatographic mass spectrometric assay for the two eosinophil chemotactic peptides, Val-Gly-Ser-Glu and Ala-Gly Ser-Glu, which appear to have a role to play in the course of the inflammatory process in skin disorders. PMID- 6850066 TI - Quantification of ketotifen and its metabolites in human plasma by gas chromatography mass spectrometry. AB - Gas chromatography mass spectrometry with selected ion monitoring has been used to develop a method for the quantification of ketotifen and its demethylated, 10 hydroxy and 10-hydroxy demethylated metabolites in human plasma. The minimum detectable concentrations for ketotifen and its demethylated metabolites were 50 pg ml-1 and 300 pg ml-1 for the 10-hydroxy metabolite. The methodology has been applied in studies of the kinetics of the drug in man, and plasma levels of the unchanged drugs and its metabolites in free and conjugated form are reported. PMID- 6850067 TI - Automated metabolic profiling analysis of urinary steroids by a gas chromatography mass spectrometry data system. AB - A computer system (MSSMET), using methylene unit retention indices for an off line reverse library search analysis of selected ion chromatograms from gas liquid chromatographic mass spectrometric data, has been applied for the qualitative and quantitative determination of daily variations in the excreted levels of urinary steroids of two individuals, using capillary column gas-liquid chromatography. Aliquots of 24 h urine collections and morning spot urine samples were examined. The daily excretion pattern of most of the major steroid metabolites was fairly consistent from day to day (i.e. 3 alpha-hydroxy-5 alpha androstane-17-one, androsterone; 3 alpha-hydroxy-5 beta-androstane-17-one, etiocheolanolone; 3 alpha, 17 alpha, 21-trihydroxy-5 beta-pregnane-11,20-dione, THE; 3 alpha, 11 beta, 17 alpha, 21-tetrahydroxy-5 beta-pregnane-20-one, THF; 3 alpha, 11 beta, 17 alpha, 21-tetrahydroxy-5 alpha-pregnane-20-one; allo-THF; 3 alpha, 17 alpha, 20 alpha, 21-tetrahydroxy-5 beta-pregnane-11-one, cortolone; 3 alpha, 17 alpha, 20 beta, 21-tetrahydroxy-5 beta-pregnane-11-one, beta-cortolone; 5 beta-pregnane-3 alpha, 11 beta,17 alpha,20 alpha,21-pentol, cortol; 5 beta pregnane-3 alpha, 11 beta, 17 alpha, 20 beta, 21-pentol, beta-cortol), while certain other steroid metabolites had a less consistent excretion pattern (3 beta hydroxy-5-androstene-17-one, for example). Advantages and disadvantages of using capillary columns for the automated metabolic profile analysis of urinary steroids by reverse library search of selected mass chromatograms. PMID- 6850069 TI - Selected ion monitoring determination of mono- and bifunctional amines by using phosphorus-containing derivatives. PMID- 6850068 TI - Quantitative gas chromatographic mass spectrometric determination of pinaverium bromide in human serum. AB - A method has been developed for quantitative determination of pinaverium-bromide, a quaternary ammonium derivative with papaverine-like activity, in human serum. The method involves a chloroform extraction of serum spiked with N-(6,6-dimethyl bicyclo[3.1.1]2-heptenyl-ethoxyethyl) perhydro-1,4-oxazine as internal standard. After evaporation of the solvent, and reduction of the residue with Raney-Nickel, the internal standard and the reduced pinaverium-bromide are re-extracted from the reaction mixture with toluene and analysed isothermally on a fused silica column coated with OV-101. Although chemical ionization with methane revealed intense protonated molecular ions for both pinaverium-bromide and the internal standard, selectivity and sensitivity were significantly lower in comparison with electron impact ionization at 70 e V. Therefore, quantification was performed in the electron impact mode by single ion monitoring of the common fragment ion at m/z 100.2. A linear detector response was observed up to 160 ng ml-1. A within run assay precision better than 2% CV (n = 5) was found, and a detection limit of 1 ng pinaverium-bromide ml-1 of serum was attained. PMID- 6850070 TI - Quantitative gas chromatographic mass spectrometric determination of mandelic acid in blood plasma. Comparison of deuterated and homologous internal standards. AB - Quantitative gas chromatography/mass spectrometry/selected ion monitoring of mandelic acid in plasma in the lower micromolar range has been investigated using both the deuterated compound and a homologue, 2-phenyllactic acid, as internal standards. On chromatography of the TMSi-ester ethers, the latter is less stable than the former. The chromatographic isotope effect observed for deuterated mandelic acid does not suggest a carrier function for this compound. Normal plasma levels of mandelic acid are about 0.5 microM. Only a minor portion of phenyramidol is metabolized to mandelic acid. Preliminary in vivo data indicate the presence of a stereoselective transport system for D(-)-mandelic acid in gastrointestinal tract and possibly kidney. PMID- 6850073 TI - Liquid chromatography mass spectrometry of dexamethasone and betamethasone. AB - Chemical ionization mass spectra of dexamethasone and betamethasone have been obtained via liquid chromatography mass spectrometry using a moving belt interface. These results have confirmed a concentration-dependent competition between thermal degradation and vaporization. Caution should be exercised when dealing with molecules subject to thermal instability since sample introduction via the mechanical transport system does not guarantee evaporation without thermal decomposition. PMID- 6850071 TI - Measurement of bile acid kinetics in human serum using stable isotope labeled chenodeoxycholic acid and capillary gas chromatography electron impact mass spectrometry. AB - A non invasive method for measurement of bile acid kinetics in serum using (24 13C)chenodeoxycholic acid has been developed. After oral administration of 50 mg (24-13C)chenodeoxycholic acid, the exponential decay of the 13C atom percent excess was measured in serum using capillary gas chromatography mass spectrometry. This required that isotope ratios were measured with high accuracy and coefficients of variation less than 1% by means of selected ion monitoring and scan averaging. The clinical applicability was tested by repeated determination of pool size, fractional turnover and synthesis rate of chenodeoxycholic acid in one healthy volunteer. This method permitted the determination of pool size, synthesis and conversion of chenodeoxycholic acid into lithocholic acid in man without the use of radioactive tracers and without repeated duodenal intubation. PMID- 6850072 TI - Time-dependent excretion of lithium, sodium, potassium, rubidium, magnesium and strontium in the urine of a multiple sclerosis patient. AB - Field desorption mass spectrometry and stable isotope dilution have been used for direct trace analysis of metals in urine. Samples were collected over 24 h at 2 h intervals from a hospitalized multiple sclerosis patient. Quantitative determinations of Li+, Rb+, Mg2+ and Sr2+ from individual samples have been made and correlated with the amounts of urine excreted as well as with the time of day. The concentrations of Na+ and K+ were determined by flame photometry. The quantities of metals excreted in urine during the course of 24 h were 0.0129 mg for lithium, 4700 mg for sodium, 2100 mg for potassium, 1.4 mg for rubidium, 78.8 mg for magnesium and 0.2356 mg for strontium. The maximal absolute quantities excreted of all metals determined correspond with the largest volume of urine. The highest amounts of potassium, rubidium and strontium were found in urine during the daytime (8.00-20.00), whilst magnesium was excreted increasingly during the night hours (20.00-8.00). The excretion of lithium and sodium is fairly even over the entire 24 h period. It is noteworthy that similarities in the excretion profile and the concentration course are observed between Li+ and Na+ on one hand and between K+ and Rb+ on the other. Moreover, the lower concentration of Rb+ ions in urine of multiple sclerosis patients, in comparison to healthy individuals and clinical controls as reported previously, was confirmed. PMID- 6850074 TI - Identification and quantification of diethylstilbestrol in the urine of cattle by both low and high resolution gas chromatography mass spectrometry. AB - A confirmation method which can be used in regulatory screening programs for diethylstilbestrol in the urine of cattle is presented. trans-Diethylstilbestrol is purified from urine by Sep-Pak extraction and high-performance liquid chromatography and converted into its trimethylsilyl derivative. Identification is based on both accurate mass measurement of the molecular ion of trans diethylstilbestrol trimethylsilyl by gas chromatography high resolution mass spectrometry and determination of the [M + 1] +/[M]+ peak height ratio by selected ion monitoring in low resolution. Specificity is such that on the basis of mass spectrometric data alone, all molecular formulae except those of diethylstilbestrol trimethylsilyl and only one other compound can be excluded. Additional specificity is provided by chromatographic data. The quantification is based on the standard addition method. The average recovery of trans diethylstilbestrol is 76% with a standard deviation of 18% (n = 23). PMID- 6850076 TI - The measurement of 13,14-dihydro-15-keto prostaglandin E2 by combined gas chromatography mass spectrometry. AB - THe main metabolite of prostaglandin E2 (PGE2) 13,14-dihydro-15-keto-PGE2 readily dehydrates and can subsequently form a cyclic derivative. This problem can be overcome by the immediate formation of oximes of the 9 and 15 ketones in aqueous solution followed by subsequent extraction, methylation and t-butyldimethyl silylation of the free hydroxyl groups at 11 and on the oximes. Deuterogenated 13,14-dihydro-15-keto-PGE2 is used as the internal standard and can be stored as the oxime and added with the oximating solution immediately the biological sample is obtained. The sensitivity of the method allows measurement of 2 ng of 13,14 dihydro-15keto-PGE2 in tissue incubates. The intra-batch precision is 11.8% and the inter-batch precision for measurement of 100 ng of metabolite is 8.1%. PMID- 6850075 TI - Characterization and quantification of human plasma lipids from crude lipid extracts by field desorption mass spectrometry. AB - The main classes of human plasma lipids, free fatty acids, cholesterol, cholesterol esters, triglycerides and phosphatidylcholines were identified and quantified from samples of human plasma by field desorption mass spectrometry. A crude lipid extract was prepared from 50 microliters of human plasma and a 1-5% aliquot thereof was subjected directly to field desorption mass spectrometry without any chromatographic separation of the extract constituents. Within the classes of free fatty acids, triglycerides and phosphatidylcholines the fatty acid profile was obtained directly from the mass spectrum and accurate quantification could be achieved by the addition of stable isotope labelled internal standards. PMID- 6850078 TI - 13C nuclear magnetic resonance studies of anaerobic glycolysis in Trypanosoma brucei spp. AB - Anaerobic glycolysis in Trypanosoma brucei spp. has been studied by 13C NMR at 50 and 75.5 MHz. The uptake of [U-13C]glucose by cell suspensions of T. b. brucei was monitored by time-course spectroscopy, and while no anomeric specificity was found, the end-products of glycolysis were confirmed as glycerol and pyruvate together with alanine and dihydroxypropionate. The intermediacy of L-glycerol-3 phosphate was also ascertained. The incorporation of C-1 of [1-13C]glucose and of C-6 of [6-13C]glucose into glycerol and pyruvate in T. b. gambiense was quantified by measurement of the longitudinal relaxation times of the species involved. An incorporation to the extent of 66% of each substrate into equimolar amounts of glycerol and pyruvate indicate that Keq for the triosephosphate isomerase-mediated reaction approaches unity. PMID- 6850077 TI - Initiation of DNA synthesis in the parotid salivary gland of adult mice by a factor isolated from acellular fluid of the Ehrlich ascites carcinoma. AB - The rate of DNA synthesis in the parotid salivary gland of adult mice is very low. We have purified about 5 000-fold a mitogen from the acellular ascitic fluid of the Ehrlich ascites carcinoma which stimulates DNA synthesis in the parotid salivary gland in vivo. This stimulation of DNA synthesis was produced with a protein concentration of this mitogen of 3 micrograms per 25 g of body weight. The purification procedure included ammonium sulfate fractionation and DEAE Sephacel column chromatography. This potent, heat-labile mitogen is presumed to be a protein with a mol.wt. of 3.5 X 10(3) to 1.3 X 10(4). The data indicate that this new factor is quite different from epidermal growth factor and tumor growth factor. Hypophysectomy did not prevent the stimulatory effect of this mitogen on the parotid salivary gland, indicating that the pituitary gland is not involved directly in mediating the mitogenic effect. PMID- 6850079 TI - Early alterations in rat liver chromatin structure after a single dose of diethylnitrosamine. AB - In the chromatin of 24-h regenerating rat livers, derivative melting profiles are characterized by a high proportion of transitions above 90 degrees C. After the injection of diethylnitrosamine there is a rapid shift to lower melting temperatures. This is due to a rearrangement of the chromatin to higher amounts of nucleosomal components but possibly also a consequence of chemical modifications and conformational alterations of the DNA. In the nonregenerating liver essentially the same observations can be made, although reactions proceed significantly slower. These results are in good agreement with the observation that carcinogens are more active in tissues stimulated to rapid proliferation as compared to resting tissues. PMID- 6850080 TI - Theoretical studies on capillary microviscometry of skeletal muscle actin. AB - For improving Ostwald's viscometry, which is time-consuming and requires a relatively large volume of specimen to determine viscosity, we developed a capillary microviscometric method with an appropriate mathematical model, and have compared this method with Ostwald's method. PMID- 6850081 TI - [Ultrastructure of proximal tubular cells of the rat nephron in the period of intense glucose reabsorption]. AB - It has been demonstrated in rat experiment that maximal glucose reabsorption is accompanied by the increased electron density of mitochondrial matrix and the enlargement of the size of microbodies. No vacuoles have been recorded, which is at variance with the concept of the pinocytosis involvement into glucose reabsorption. PMID- 6850082 TI - [Measurement of intrabronchial pressure by catheter]. AB - Some limitations of the measurement of intrabronchial pressure by a catheter have been analyzed on the basis of experimental data obtained on a mechanical model. It has been ascertained that the magnitude of the pressure measured by a catheter may essentially differ from the real one in the bronchi in the absence of a catheter, provided the diameter of the bronchus is more than twice greater than that of the catheter. It is pointed out that catheter introduction even into the bronchi relatively large in diameter may change considerably the position of the equal pressure point, thereby altering the conditions of dynamic contraction of the bronchi. PMID- 6850084 TI - [Use of light scattering to register heat damage to erythrocytes]. AB - A method for the measurement of red cell strength is offered. It is based on red cell destruction under exposure to constant high temperature and recording of the suspension-induced changes in light scattering over time. The method enables the measurement of red cell strength at varying osmotic pressures, in macromolecular solutions, in blood serum as well as the assessment of red cell density, etc. PMID- 6850085 TI - [Membrane damage in brain subcellular structures in terminal states and in the postresuscitation period]. AB - Animal experiments were made to study and compare enzymatic activity of brain tissue mitochondria and microsomes treated and untreated with Tween-80 and Triton X-100. In Mongolian gerbils, the 10-minute brain ischemia induced by bilateral carotid occlusion led to the labilization of the membranes of microsomal fractions, which did not return to normal an hour after resuscitation. The destructive effect of ischemia combined with clinical death from mechanical aspnyxia was similar to that of Triton-X-100. The ten-minute clinical death from ventricular fibrillation due to electroshock in dogs labilized lysosomal membranes. During the first hour after resuscitation and especially during the first 24 hours, the treatment of crude mitochondria with Tween-80 did not activate alkaline phosphatase and plasminogenic activator as compared with the control group. PMID- 6850083 TI - [Method of visually classifying synapses from a multiplicity of attributes]. AB - Seven electron microscopic signs of synapses were recognized and classified visually. Altogether 2250 synapses of the stratum radiatum of the hippocamp of 15 white rats were examined on a statistical basis. Five rats (750 synapses) showed a significant decrease in the magnitudes of two signs of the synapses (the active zone length and the mean sectional area of the terminal) after the elaboration of the conditioned reflex. The concentration of synaptic vesicles adjucent to the active zone rose as compared to that seen in a passive control group (5 rats, 750 synapses). An active control group (5 rats) demonstrated a significant increase in the postsynaptic membrane thickness and sectional area of the terminal occupied by synaptic vesicles. The concentration of vesicles neighboring the active zone was noticeably lowered. PMID- 6850087 TI - [Effect of enkephalins on the reactivity of 2 hippocampal synaptic systems]. AB - The effects of leu- and metenkephalin administration into the perfusion medium on CA-1 and CA-3 pyramidal cell reactivity to electric stimulation of Shaffer collaterals and mossy fibers, respectively, were investigated on mice hippocampal slice preparations. The reactivity changes were measured by amplitude changes in focal potential, which reflected a synchronous pyramidal cell discharge (population spike, PS). Infusion of 10(-6) M leu- or metenkephalin resulted in a rapid and reversible 200-300% increase in the PS amplitude in CA-1 field of the hippocamp, that was blocked by preliminary administration of 10(-5) M naloxone. An increase in the PS amplitude in CA-3 region was observed as a result of the infusion of much higher enkephalin concentrations (10(-4) M) and did not exceed 50%. The data obtained allow the conclusion that enkephalins enhance the reactivity in the two main intrahippocampal synaptic systems but have a more pronounced effect on CA-1 pyramids. PMID- 6850089 TI - [Histofunctional state of mouse ovaries in normal conditions and during hypervitaminosis A]. AB - Morphometry was used to analyze different histofunctional structures of mouse ovaries (follicles of varying maturation grades, yellow and atretic bodies, interstitial tissue) in health and hypervitaminosis A (80 000 IU). It was noticed that in the ovaries of female mice in health, there occurred consistent cyclic processes marked by the changes in the number and size of the morphofunctional structures during different stages of the estrous cycle. In hypervitaminosis A, female mice had no estrous cycle. The ovaries showed the impairment of the growth of the follicles and enhancement of atresia. As a result, the follicles did not reach the final stages of development, which led to the cessation of ovulation and formation of yellow bodies. PMID- 6850086 TI - [Serotonin metabolism in thyrotoxicosis]. AB - Experiments on Wistar rats were made to examine serotonin metabolism in experimental thyrotoxicosis. Correlation analysis demonstrated a direct relationship between the number of detectable serotonin-producing cells and serotonin content in the gastric mucosa at early times of hyperthyroidism and a reverse one at later times. PMID- 6850092 TI - [Rheological properties of erythrocyte suspensions in acute myocardial infarct in the physiological temperature range]. AB - A study was made over time of the relationships between the viscosity of red cell suspensions and temperature [eta (T)] in normal subjects and patients with acute myocardial infarction. In normal subjects, the curves eta (T) have a bend within the temperature range 37-40 degrees C, which apparently reflects the phasic transition. In patients with myocardial infarction, the bend on the curve eta (T) either disappears or is undemonstrable during the acute period within the temperature range indicated. During transition to the subacute period (after 7-10 days), the bend on the curves reappears and then only variation of its pattern follows. The changes seen in the viscosities of red cell suspensions or red cell "shades" in the phasic transition area might be used for defining the stages, the time course, and prognosis of myocardial infarction. PMID- 6850090 TI - [Creatine phosphokinase activity in myocardial sarcoplasmic reticulum membranes in experimental coronary insufficiency]. AB - Experiments on rats with acute coronary blood flow restriction (intravenous injection of vasopressin in a dose of 0.5 units/kg) have shown a decrease in the activity of creatine phosphokinase (CPK) and activation of lipid peroxidation in sarcoplasmic reticulum (SPR) membranes. These changes were attended by structural abnormalities in the membrane apparatus of the SPR, primarily on the part of the lipid composition. Pretreatment (1 h before vasopressin) of the animals with the antioxidant AV-156Na averted the development in the SPR membranes of the changes described. This evidences that the rate of peroxide reactions in the myocardium might determine in many respects the metabolic and structural supply of the cell apparatus. PMID- 6850093 TI - [Complement consumption as criterion of the tolerogenicity of a globulin preparation]. AB - Experiments on mice (296 animals) were made to study the capability of native and deaggregated preparations of human globulin to fix complement as well as the relationship of this indicator to tolerogenic properties of the preparations in question. Ultracentrifuged preparations were discovered to have the decreased capability to activate complement. As anticomplementary properties of the preparations become more demonstrable their tolerogenicity declines. The decreased capability to activate complement can be used as criterion in screening tolerogenic preparations. PMID- 6850091 TI - [Effect of long-term immunization of rabbits of different ages with homologous heart antigen on blood lipid and lipoprotein content]. AB - The data are provided on the content of lipid and lipoproteins in the blood of young and old rabbits during long-term immunization with homologous heart antigen (once a week for 2.5 months). Two weeks after the beginning of the experiment the blood of immunized animals showed cardiac antibodies whose content rose, especially in young animals, in the course of the experiment. The content of immune complexes circulating in the blood also increased, with this increase being more pronounced in old rabbits. During immunization, the blood levels of lipoproteins total cholesterol, and triacylglycerins in old animals increased earlier and more intensely. PMID- 6850088 TI - [Effect of suboptimal temperature of cultivation on the dehydrogenase activity of blood monocytes in normal persons and patients with leprosy]. AB - The activity of succinate, lactate and glucose-6-phosphate dehydrogenases was studied in blood monocytes of 15 healthy donors and 20 patients with lepromatous leprosy. Cytochemical reaction was assessed photometrically. The total extinction in monocytes, relative activity and the dehydrogenase ratio were measured. The data obtained have shown that in healthy donors, the decrease of the culture temperature to 25 degrees C leads to the prevalence of glycolysis and the fall in the activity of the pentose-phosphate shunt. In leprosy patients, the dehydrogenase activity at a culture temperature of 37 degrees C is similar to that in healthy subjects at a temperature of 25 degrees C. Reduction of the monocyte culture temperature in leprosy patients does not cause any significant changes in the dehydrogenase activity of monocytes. PMID- 6850096 TI - [Effect of cytochalasins on the surface topography of neoplastic cells in suspension]. AB - The effect of cytochalasins B or D on the surface topography of mouse neoplastic fibroblasts of L line (detached from glass by trypsin-EDTA solution) or of its LS subline (adapted to the growth in suspension in vitro), as well as on that of Ehrlich's ascites tumor cells was investigated by screening electron microscopy. Incubation of suspended cells with cytochalasin B (2 micrograms/ml) or cytochalasin D (0.2 microgram/ml) for 30-180 min led to the following changes: (I) progressive decrease of the proportion of the cells with a microvillous surface relief and simultaneous increase in the percentage of the cells with a blebbed microrelief; (2) shortening of the microvilli and decrease of their density on the cell surface; (3) appearance of surface areas with a rough folded relief; (4) formation of very large blebs on the LS or L cell surfaces; (5) unusual "polar" distribution of blebs on Ehrlich's tumor and L cells: the blebs were concentrated in one locus on the cell surface. The data show that normal organization of the actin microfilament system in the cell cortex is necessary for formation of the microvilli but not for the blebs. PMID- 6850097 TI - [Cytotoxic effect of methionine-gamma-lyase on neoplastic cells in culture]. AB - The influence of methionine-gamma-lyase from Pseudomonas putida on DNA synthesis by CaOv and L-8 cell lines has been studied. The agent has been demonstrated to inhibit the incorporation of 3H-thymidine into L-8 cell line and to have no effect on CaOv cells. PMID- 6850095 TI - [Coombs-positive reactions in mice during transplantation of syngeneic tumors]. AB - The effect of the growth of syngeneic transplantable tumors on Coombs' positive test in mice was studied. The modification of the hemagglutination test permitting one to minimize the amount of reagents used is described. Tumor transplantation induced Coombs' positive reactions in most recipients. The phenomenon could be observed in 4 murine strains and 6 tumor systems. Sometimes autoimmune reactions occurred before the emergence of palpable tumors. It is concluded that despite the influence of nonspecific factors, the principal cause of autoimmune reactivity is tumor growth. It seems that the appearance of alien "normal" histocompatibility antigens is a characteristic feature of all the tumors; besides, the host response pattern to these antigen is cross-reactive, including autoimmune component. Coombs' positive test may be one of numerous manifestations of such an autoimmune process. PMID- 6850094 TI - [Effect of ultrasound on cellular and humoral immunity factors]. AB - Experiments on CBA mice were performed to explore the changes in the body immunoreactivity induced by low intensity ultrasound. A study was made of the content of lysozyme, properdine, T and B rosette-forming lymphocytes, and complement in the peripheral blood, the histophysiological properties of the lymphoid organs, and the titer of pertussis antibodies. It has been disclosed that ultrasound has a stimulant effect, primarily on the T system immunity, which was confirmed during immunization with B. pertussis vaccine. The stimulant effect has been also supported by histostructural analysis of the lymphoid organs. PMID- 6850098 TI - [Dynamics of postmortem changes in the adrenergic nerve fibers of the cerebral arteries]. AB - The authors studied the changes in the quantity and intensity of adrenergic nerve fiber fluorescence in the rat and human brain arteries every two hours after death at varying temperatures of keeping cadavers (18-20, 10, 4 degrees C). It was established that the differences in the temperatures had an appreciable effect on the duration of complete exposure of nerve fibers as compared with control. No significant reduction in the number of fluorescent conductors was seen for the longest period of time (up to 10 h in rats and up to 8 h in man) at a temperature of 4 degrees C. The relationships are defined between postmortem changes in nerve fiber fluorescence and their number under varying temperatures. PMID- 6850099 TI - [Dynamics of morphological changes in the spinal cord following exposure to non ionizing microwave radiation]. AB - The structure of different portions (cervical, thoracic, lumbar, sacral and coccygeal) of the spinal cord were studied in the experiments on 50 animals with the use of the Nissl, Zimmermann, Cajal and other methods on days 1, 10, 20 and 30 after exposure to non-ionizing microwave radiation (NMI). Single exposure to NMI (wave length 12.6 cm, intensity 400-500 mW/cm2) for one hour (cats) or four hours (dogs) produces a severe distress of glial neurones and cells, which is marked by the appearance of dystrophic processes along the entire spinal cord. The disease progresses, leading to abnormalities of motor and other physiological functions of the body. PMID- 6850100 TI - Large granular lymphocytes: morphological and functional properties. I. Results in normals. AB - Large granular lymphocytes (LGL) represent a morphologically distinct mononuclear cell type. In healthy individuals an average of 12.5 +/- 5.2% of peripheral mononuclear cells exhibit this morphology. Structurally they are characterized by azurophilic granules, light cell density, low surface adherence and expression of Fc-IgG receptors. Functional analyses on LGL suspensions enriched by means of density gradient fractionation and adherence procedures included testing of T cell and monocyte-specific in vitro reactions as well as evaluation of their natural cytotoxicity (NC). Results indicated a close correlation between the percentages of LGL and the capacity to bind and to lyse NC-susceptible tumor targets. In agreement with others we would thus conclude that LGL embrace the majority of NK-effector cells. The morphological definition of LGL provides an additional tool for the clinical evaluation of this cell mediated immune reactivity. PMID- 6850101 TI - Reticulocytopenia in severe autoimmune hemolytic anemia (AIHA) of the warm antibody type. AB - A patient with severe AIHA of the warm antibody type, absence of reticulocytes and red cell hyperplasia of the bone marrow is described. In order to maintain a reasonable hemoglobin level 38 units of washed packed red cells were required within 24 days. The treatment with high doses of steroids showed no permanent beneficial effect. After splenectomy the red cell destruction was immediately reduced and the patient went into a remission. Bone marrow culture studies during the acute phase of the disease and at the time of complete hemato- and immunological remission, i.e. 4 months after splenectomy suggested a circulating autoantibody directed to early erythroid progenitors (BFU-E). The inhibitory activity in the patient's plasma did not influence granulocytic or mixed colony formation (CFU-GEMM). In addition to autoantibodies directed to erythroblasts and erythropoietin involved in the pathogenic mechanisms leading to red cell aplasia type I and II the culture studies suggest an unusual autoantibody that might cause the observed reticulocytopenia and erythropoietic hyperplasia of the bone marrow in AIHA. After the splenectomy the patient recovered, he required no further blood transfusions and his disease has not recurred. PMID- 6850103 TI - The Multiple Personality Syndrome and criminal defense. PMID- 6850102 TI - Congenital dyserythropoietic anemia type I: a freeze-fracture and thin section electron microscopic study. AB - Congenital dyserythropoietic anemia type I was diagnosed in a Japanese patient. Electron microscopic examination of thin sections revealed the features of erythroblasts peculiar to CDA type I; namely "spongy appearance" of nucleus and "internuclear chromatin bridge" etc. However, the widening of nuclear pores, which has been reported as another peculiar feature of CDA type I erythroblasts, were not confirmed. Aberrations of erythroblast nuclear membrane which have not been hitherto noticed were as follows: The nuclear envelopes of erythroblasts frequently lacked heterochromatin application in wide areas where they often showed a marked invagination or evagination. This is associated with the invasion of cytoplasmic organelles into the nuclear territory and occasionally with the extrusion of the nucleolus into the cytoplasm. There were no nuclear pores on the invaginated or the evaginated portions of the nuclear envelope where the perinuclear cistern was compressed to lose the cisternal space, or widened to contain some membrane debris. The findings with thin sectionings were confirmed with freeze-fracturing. Both findings suggest that an aberration may reside in the erythroblast nuclear membrane itself, but not in nuclear pores. PMID- 6850104 TI - The ALI test for insanity: a re-examination. PMID- 6850105 TI - Changes in North Carolina civil commitment statutes: the impact of attorneys. PMID- 6850106 TI - Local variations in the civil commitment process. PMID- 6850108 TI - Medical-legal ramifications of an autoerotic asphyxial death. PMID- 6850107 TI - Family opposition to psychiatric treatment: a medicolegal dilemma. PMID- 6850109 TI - Mania and crime: a study of 100 manic defendants. PMID- 6850112 TI - Enhanced oxygen uptake rates in dragonfly nymphs (Somatochlora cingulata) as an indication of stress from naphthalene. PMID- 6850113 TI - Toxicity of Texan petroleum well brine to the sheepshead minnow (Cyprinodon variegatus), a common estuarine fish. PMID- 6850110 TI - The hostility of the burger court to mental health law reform litigation. PMID- 6850111 TI - Methanogenesis of phenolic compounds by a bacterial consortium from a contaminated aquifier in St. Louis Park, Minnesota. PMID- 6850114 TI - Mercury content in sharks. PMID- 6850115 TI - Total mercury content in yellowfin and bigeye tuna. PMID- 6850116 TI - Cadmium uptake and induction of cadmium-binding protein in the waterflea (Moina macrocopa). PMID- 6850117 TI - Accumulation of seven metals by Crassostrea gigas, Crassostrea margaritacea, Perna perna, and Choromytilus meridionalis. PMID- 6850118 TI - Effect of ascorbic acid on copper-induced oxidative changes in erythrocytes of individuals with a glucose-6-phosphate dehydrogenase deficiency. PMID- 6850119 TI - Chromium and potassium accumulation influenced by body weight in goldfish (Carassius auratus). PMID- 6850120 TI - Use of tetrazolium salts as selective and sensitive reagents for iron in environmental samples. PMID- 6850121 TI - Organochlorine pesticide residues in rice paddies in Malaysia, 1981. PMID- 6850122 TI - Action of sunlight on parathion. PMID- 6850123 TI - Measurement and prediction of chlorsulfuron persistence in soil. PMID- 6850124 TI - Electrophoretic profiles of esterases in starling (Sturnus vulgaris) plasma: an apparent simple genetic variant. PMID- 6850125 TI - Effects of simulated acid precipitation on growth and nodulation of leguminous plants. PMID- 6850126 TI - Fluoride-induced haematological changes in rabbits. PMID- 6850127 TI - In vivo formation of halogenated reaction products following peroral sodium hypochlorite. PMID- 6850128 TI - Detection limits of a biological monitoring system for chemical water pollution based on mussel activity. PMID- 6850129 TI - A simple toxicity apparatus for continuous flow with small volumes: demonstration with mysids and naphthalene. PMID- 6850130 TI - Use of fluorescence spectroscopy for monitoring petroleum hydrocarbon contamination in estuarine and ocean waters. PMID- 6850131 TI - Uptake and elimination of [9(-14)C]phenanthrene in the turkey wing mussel (Arca zebra). PMID- 6850132 TI - Uptake of cadmium, zinc, lead, and copper by earthworms near a zinc-smelting complex: influence of soil pH and organic matter. PMID- 6850133 TI - Ligands binding cadmium, zinc, and copper in a species of New Zealand oyster (Ostrea lutaria). PMID- 6850134 TI - Lead poisoning in cattle: reassessment of the minimum toxic oral dose. PMID- 6850135 TI - Heavy metal concentrations in tissues of Virginia river otters. PMID- 6850136 TI - Organochlorine residues in organisms of two different lagoons of Northwest Mexico. PMID- 6850138 TI - Determination of metaldehyde in workroom air. PMID- 6850139 TI - Evaluation of a mixed-phase column packing for the GC determination of fumigant residues in grains. PMID- 6850137 TI - Changes in nitrogen metabolism in tissues of fish (Sarotherodon mossambicus) exposed to benthiocarb. PMID- 6850140 TI - Effect of hydrazines on substrate utilization by a strain of Enterobacter cloacae. PMID- 6850141 TI - Standardization of lung function testing in infants, children and adolescents. Paediatric Working Group, Cefalu, Palermo, October 4, 1982. Abstracts. PMID- 6850142 TI - The components of the carbon monoxide diffusing capacity in man dependent on alveolar volume. AB - The effect of alveolar volume (VA) on diffusing capacity for carbon monoxide (DL), membrane conductance (Dm) and pulmonary capillary blood volume (Qc) was investigated in 39 normal volunteers to study alveolar membrane expansion and capillary volume recruitment. DL/VA was related to alveolar volume breathing air and 95% oxygen respectively. Both relations appeared to be linear with a negative slope and were used to calculate Dm and Qc as a function of VA. The relation between Dm and VA resulted in: Dm = kVAx, where x characterizes the kind of membrane expansion with increasing alveolar volume, when we assume Dm = kA/delta. In this equation, A is the membrane area and delta the membrane thickness. In 36% of our subjects, x was nearly 0.67, which corresponds to an isotropic expansion of diffusion area with alveolar volume without changes in delta. In 41%, x was between 0.67 and 1. We hypothesized that, in these subjects, either some decrease of delta or some recruitment of alveoli was superimposed on the area increase according to x = 2/3. In recruitment, a proportional increase of diffusion area with alveolar volume is assumed, which means x = 1. Subjects over the age of 50 years (n = 12) showed greater variation in the value of x, which was greater than 1.3 in three and less than 0.6 in a further three. The relation between Qc and VA was best described by a second order polynomial, characterized by a maximum above 50% of VAmax. With lung expansion, either a recruitment of capillaries or a better contact between blood and air could occur up to that maximum. Where Qc was decreasing with further rise of VA, we assumed compression of capillaries by stretching of pulmonary tissue. PMID- 6850144 TI - The physical properties of a jet-nebulizer and their relevance for the histamine provocation test. AB - We have examined the physical properties of eight specimens of a frequently used jet-nebulizer (Wiesbadener Doppelinhalator). For each nebulizer, under various conditions we measured driving pressure, solution output, solute output, particle concentration and size distribution in the aerosol, and the change of solute concentration in the storage vessel. Using histamine acid phosphate solutions in distilled water, there was considerable variability between the nebulizers in solute output (range about a factor 3). Solute output was strongly related to driving pressure (r2 = 0.89), to solution output (r2 = 0.96) and to particle concentration (r2 = 0.87). The particle size distributions of the eight nebulizers were very similar. The volume median aerodynamic diameter (VMAD) of the stable evaporated particles was on average 0.33 micrograms (geometric standard deviation of 1.78), which implies a VMAD of the primary droplets of about 3.2 micrograms. In fifteen subjects with bronchial hyperreactivity, a twofold increase of histamine output of the nebulizer without a change in particle size resulted on average in a twofold decrease of the histamine concentration that caused a 20 per cent fall (PC20) in FEV1. At constant histamine output the administration of dry particles instead of direct nebulization of (partly) saturated droplets into the mouth increased PC20 by a factor 2. This difference could not be explained by a changed deposition in the hypopharynx. There were large interindividual differences in the response to the altered aerosol characteristics. We conclude that the physical properties of the administered aerosols should be carefully controlled since they influence the biological response to inhaled histamine. The solute output of the investigated jet-nebulizer can satisfactorily be validated by weighing, for which an equation is given. In bronchial provocation testing, administration of dry particles is recommended. PMID- 6850145 TI - [Assessment of functional respiratory deficit]. AB - The numerous terms used to describe the physical limitations of a subject to carry out the same level of work as before his illness have brought about an unfortunate confusion. The assessment of respiratory impairment is the responsibility of the doctor, whereas the decision as to whether the patient may resume his previous employment is often that of someone in a legal capacity. Many meetings during the last 20 years have been devoted to the assessment of respiratory impairment. A SEPCR working group recently proposed a classification in 3 categories based on simple functional examinations. The use of this grading system by chest physicians responsible for the assessment of the respiratory impairment will make comparison of data easier. Taking into account other elements of evaluation will give an opportunity of validation of this grading system. An international scale would do away with the disparities of the present evaluation. This scale based solely on simple tests would be one of the elements in the determination of respiratory impairment, and the clinical data must not be forgotten. The radiological aspects are to be treated carefully since they provide only indirect information about the respiratory function. Spirography is not sufficient and a study of respiratory exchanges is needed for an accurate evaluation. Examinations whose results depend neither on the collaboration of the subject nor the predicted values obtained according to the morphology are preferable. For this reason, the examination of blood gases is of utmost importance, despite the criticisms made by some specialists. The cardio respiratory responses during exercise provide a very useful element for assessment. If the physician in charge does not have at his disposal the equipment for maximal exercise tests, he can ask for a short walking test on level ground. The response to this test gives relative approximations, but it can nevertheless be used as a useful complement to results recorded at rest. PMID- 6850146 TI - Effect of oral corticosteroids on mucus clearance by cough and mucociliary transport in stable asthma. AB - Inhaled radioaerosol particles have been used to assess mucus clearance in 12 patients with stable asthma. Patients who coughed frequently showed faster clearance than those who coughed infrequently. Treatment with medium and high dose oral corticosteroids reduced coughing and thereby reliance on mucus transport by cough. Despite this, and despite increased penetration of the particles into the bronchial tree, mean particle clearance was slightly faster after four week treatment (two weeks on 15 mg prednisolone orally each day, plus two weeks on 30 mg). Mean clearance remained, however, markedly slower than in normal subjects. Five patients who were initially sputum producers (mean 1.4 g . h-1) ceased to produce sputum after four week treatment. PMID- 6850147 TI - Bronchial hyperreactivity. Working Group, Cefalu, Palermo, October 4, 1982. Abstracts. PMID- 6850143 TI - Effect of vagal cooling on lung functional residual capacity in rats with pneumonia. AB - We examined the effect of cold vagal block on the functional residual lung capacity (FRC) in control rats and in rats with experimental pneumonia induced by intratracheal administration of the herbicide paraquat. The measurements were performed in a body plethysmograph in anaesthetized and intubated rats. Rats with pneumonia had tachypnoea and increased minute ventilation. Their FRC was 3.6 +/- 0.7 ml in comparison with 2.5 +/- 0.6 ml in controls (mean +/- SD). Cooling the cervical vagi, so that the Hering-Breuer inflation reflex was abolished (approximately 8 degrees C), resulted in a marked decrease of the rate of breathing and an increase of tidal volume in both groups of animals. The value of FRC did not change during vagal cooling (3.7 +/- 0.9 ml in rats with pneumonia, 2.8 +/- 0.8 ml in controls). In rats with model pneumonia, bilateral cervical vagotomy was followed by a normalization of the FRC (2.3 +/- 0.7 ml). In control animals, the FRC did not change after vagotomy (2.5 +/- 0.6 ml). We conclude that increased FRC in rats with paraquat pneumonia depends on intact conduction through thin, slowly conducting vagal fibres. PMID- 6850148 TI - Selection of variables from maximum expiratory flow-volume curves. AB - Various methods are in use for estimating physiological variables from maximum expiratory flow-volume curves, and some of these are recommended by international bodies for use on adults. We have compared eight such methods in 433 adolescents aged 12-16 years. The mean values of expiratory flows, FVC and FEV1 by each method differed less than 6% from those obtained by the method recommended by the ATS, except for MEF25, where differences between methods were substantially larger. The mean within-individual coefficients of variation of FVC and FEV1 did not differ between methods and improved from about 3.1 to 2.6% and 2.7 to 2.3% respectively when using 5 instead of 3 acceptable curves. For expiratory flows, the coefficients of variation ranged between 4.2 and 9.4% and improved slightly but not consistently when using more than 3 acceptable curves. Reproducibilities were systematically poorer when flows were derived from one "best" FVC manoeuvre. It is concluded that taking more than 3 acceptable blows is not cost-effective, even in inexperienced adolescents. An envelope method and maximum composite curve from FVC reproducible within 5% from the largest one are recommended for use with teenagers. PMID- 6850149 TI - [Effects of a helium-oxygen mixture during bronchial provocation tests in asthma patients]. PMID- 6850150 TI - [The pores of Kohn in pulmonary alveoli]. AB - The pores of Kohn are apertures in the alveolar septum, which allow the communication of two adjacent alveoli. Their existence has been most disputed, but was lastly supported in man and adult mammalians by observations from electron microscopy. Located between the meshes of the capillary network, these alveolar apertures are circular or oval, and are bordered by extensions of type I pneumocytes. Type II pneumocytes are often located close to the pores of Kohn. The presence of two near apertures gives a "double-barrelled gun" aspect, frequently observed in the old animal. The specific connections of the pore of Kohn with the septal components, particularly by the myofibroblasts, are analysed. The quantification of the pores of Kohn in various species shows great variations according to the fixation technique, animals age and site of alveoli in the lung and the lobules. The size of these apertures also depends on species, varying from 0.8 to 15 micrograms. Histogenesis of these apertures is still poorly understood and various processes can be evoked. Ventilation, which differs according to the site of the alveoli in the lung, is a determinant factor, proved by the great number of pores of Kohn in the hyperventilated areas. The role of the macrophages (synthesis and excretion of proteases and lipases) is also discussed. The formation of pores of Kohn is linked with renewing and dehiscence of alveolar epithelial cells. The role of alveolar pores in collateral ventilation seems relatively weak in the physiological state, whereas it is certain in lung pathology, contributing to the propagation of bacterial infections in the adult and to changes of local ventilatory conditions in atelectasis and asthmatic bronchoconstriction. The alveolar apertures can explain the specific propagation of some epitheliotropical peripheral cancers (bronchiolo alveolar carcinoma). The pore of Kohn is one of the first signs of parenchymatous senescence of the pulmonary alveolus; its part in the appearance and extension of emphysematous disorders is also discussed. PMID- 6850153 TI - Non-linear growth mechanics--I. Volterra-Hamilton systems. PMID- 6850152 TI - A reinforcement depletion urn problem--II. Application and generalization. PMID- 6850151 TI - Effect of acute hypoxia on lung transvascular filtration in anaesthetized dogs. AB - The pulmonary transvascular filtration changes were investigated in nine anaesthetized open-chest dogs during acute hypoxic exposure. The tracheobronchial pulmonary lymph flow, the lymph and plasma protein concentration, the pulmonary vascular pressures and the cardiac output were measured during three consecutive steady states of about 2 h each: 1) base-line, 2) hypoxia (FIO2 = 0.10), 3) recovery from hypoxia. It was found that pulmonary arterial pressure and lung lymph flow increased in all animals during hypoxia, respectively from (average +/ SD) 19.4 +/- 4.5 to 27.1 +/- 5.6 Torr, and from 27.2 +/- 10.2 to 59.8 +/- 23.8 microliters . min-1; lymph to plasma protein concentration ratio remained unchanged. During recovery, lung lymph flow remained elevated in some animals, while it returned to its initial value in the others. Control experiments with normoxic hyperventilation in five dogs showed no increase in lymph flow. The extravascular water/blood free dry lung ratio was moderately increased in animals that had been made hypoxic (4.64 +/- 0.67) compared to a control group (3.46 +/- 0.36). These results suggest that acute hypoxic exposure causes an increased pulmonary transvascular filtration in anaesthetized dogs. PMID- 6850154 TI - On a simple epidemic model with a heterogeneous infective population. PMID- 6850155 TI - The uniqueness of protein sequences. o-Uniqueness and infrequent peptides. PMID- 6850156 TI - Weber's law and perceptual categories: another teleological view. PMID- 6850157 TI - A note on a more general solution of Eigen's rate equation for selection. PMID- 6850158 TI - Kinetics of deterrence of Gompertzian growth. PMID- 6850159 TI - Numbering binary trees with labeled terminal vertices. PMID- 6850161 TI - Electrostatic potentials in membrane systems. PMID- 6850160 TI - Hematocrit reduction in bifurcations due to plasma skimming. PMID- 6850162 TI - Electric field dependence of phase transitions in bilayer lipid membranes and possible biological implications. PMID- 6850163 TI - Opioid agonist and antagonist behavioural effects of buprenorphine. AB - 1 The agonist and antagonist effects of a range of buprenorphine doses (0.08-20 mg/kg) were studied on the responding of pigeons under a multiple fixed-ratio, fixed-interval schedule of grain presentation. Various doses (0.02-10 mg/kg) of buprenorphine were also tested in pigeons trained to discriminate between injections of 0.05 mg/kg of fentanyl and injections of distilled water. 2 Buprenorphine, over a broad dose range (0.08-5 mg/kg), increased the rates of responding in the fixed-interval component of the multiple schedule and disrupted patterning of responding within the fixed-interval, without affecting fixed-ratio responding even at a dose of 40 mg/kg. The effects of some of the high doses on fixed-interval responding were still evident one and two days after buprenorphine injection. 3 Doses of buprenorphine which produced increases in fixed-interval responding were also effective as antagonists of the behavioural depression produced by 40 mg/kg of morphine, and were discriminated as fentanyl-like by pigeons trained to discriminate between injections of fentanyl and injections of water. 4 These results show that buprenorphine produces marked agonist and antagonist effects over an extremely broad dose range without producing behavioural depressant effects. PMID- 6850164 TI - The role of nicotinic receptors in dog pancreatic exocrine secretion. AB - 1 The effects of pentamethonium, an autonomic ganglion blocker, were studied on the exocrine pancreatic secretion of six conscious dogs given intravenous infusions of urecholine, caerulein or pentagastrin on a background of submaximal doses of secretin. 2 Urecholine-induced protein secretion was not affected but both caerulein- and to a smaller extent, pentagastrin-induced protein secretions were depressed by pentamethonium. 3 These results indicate that intravenous caerulein and pentagastrin, but not urecholine, act at least partially via nicotinic receptors. 4 Volume and bicarbonate output were depressed by pentamethonium when stimulated by intravenous caerulein with a background of secretin, but not when stimulated by pentagastrin on a background of secretin. 5 From these data it is suggested that caerulein and pentagastrin may potentiate secretin-stimulated hydrelatic secretion by different mechanisms. PMID- 6850165 TI - The effect of magnesium deficiency and excess on bovine coronary artery tone and responses to agonists. AB - 1 The hypothesis that magnesium deficiency, linked to the magnesium content of drinking water, induces major tone increases in coronary arteries and enhances their responses to vasoactive agents to an extent sufficient to explain sudden death associated with ischaemic heart disease was examined in an in vitro preparation. 2 The spontaneous tone of cattle coronary arteries was not increased during a 30 min exposure to Mg2+-deficient Krebs until the mineral was omitted entirely from the bathing medium, and even then the observed increase was small. Only in strips maintained under extremely deficient conditions for a prolonged period, namely Mg2+ concentration of 0.2 mM and 0.0 mM for 3 h, was tone substantially greater than in controls in standard (1.2 mM) Mg2+-Krebs. 3 Responses to acetylcholine and to noradrenaline were not increased in Mg2+-free Krebs but those to potassium and to 5-hydroxytryptamine were enlarged over the lower parts of their concentration-response curves. Responses to potassium and to 5-hydroxytryptamine were also examined in Krebs containing very low concentration of Mg2+ (0.4 and 0.2 mM) and only modest increases in contraction size were detected. Increases in the Mg2+ concentration of the Krebs (to 4.8 mM) depressed responses to potassium and 5-hydroxytryptamine. 4 It is concluded that Mg2+ deficiency must be nearly complete (0.4-0.0 mM) to induce even moderate tone increases in coronary vessels, or to sensitize them to agonist responses, and that there is no reason to link marginally subnormal Mg2+ levels, occasionally reported in humans with heart disease, to marked changes in coronary dynamics. PMID- 6850166 TI - Effect of nifedipine on constriction of human tracheal strips in vitro. AB - 1 Autopsy specimens of human trachealis muscle were used to investigate the effect of the calcium channel blocker, nifedipine, on airway smooth muscle constriction. With these tracheal strips, two consecutive cumulative concentration-effect curves to histamine (0.1-100 microM) obtained at a 60 min interval were highly reproducible. 2 We examined the effects of adding nifedipine (2.9 microM) to the incubation medium before the second histamine response. The concentration-effect relationships determined after nifedipine incubation were significantly different from control: the response to 100 microM histamine was reduced by approximately one-half (to 2.53 +/- 0.6 g; P less than 0.025), and the concentration of histamine causing 40% of the maximal control contraction (EC40) increased nearly ten fold (to 36.9 +/- 10.5 microM; P less than 0.02). 3 In two additional tracheal strips submaximally constricted with 10 microM histamine, nifedipine 2.9 microM caused complete relaxation to resting tension or below. 4 These results indicate a direct inhibitory effect of nifedipine on airway smooth muscle constriction and partial dependence of human trachealis muscle on calcium ion fluxes for initiation and maintenance of contraction. In addition, the results suggest a potential mechanism for the inhibitory effects of calcium channel blocking drugs in exercise-induced asthma. PMID- 6850167 TI - Anticonvulsant-like actions of baclofen in the rat hippocampal slice. AB - 1 The effects of baclofen were tested on epileptiform discharge in the rat hippocampal slice. Slices were superfused with bicuculline methiodide (100 microM) and maximal periods of afterdischarge were evoked by stimulating the Schaffer collateral-commissural pathway in area CA1, mossy fibres in area CA3 or perforant path fibres in the fascia dentata or by antidromic stimulation of CA1 pyramidal cells. 2 (-)-Baclofen attenuated the afterdischarge evoked by stimulating all three sets of fibres in areas CA1 and CA3. In each case, a threshold effect was observed at a concentration of 0.25 or 0.5 microM, and complete suppression was usually attained with a concentration of 5 microM. EC50 values ranged between 1 and 2 microM. (-)-Baclofen attenuated hippocampal afterdischarge with 120 times the potency of (+)-baclofen. It did not, however, affect the repetitive firing of dentate granule cells in response to stimulation of perforant path fibres. 3 (-)-Baclofen also reduced the amplitude of the initial population spike evoked by stimulation of Schaffer collateral-commissural fibres, but did not affect the antidromic population spike nor the initial population spike evoked by stimulation of the mossy fibres. 4 Recurrent inhibition in area CA1 was abolished by 1 microM (-)-baclofen. Thus baclofen, unlike many anticonvulsants, does not suppress afterdischarge by potentiating GABAergic inhibition. 5 These results suggest that baclofen attenuates hippocampal afterdischarge by a combination of pre- and postsynaptic mechanisms. PMID- 6850168 TI - Symposium on the teaching of psychiatry. Canada: Queen's University, Kingston, Ontario. AB - The medical school at Queen's University offers a 4-year M.D. degree course. Because the majority of graduating students consistently choose family medicine as a career, it was decided that the overall objective of the undergraduate course should be to provide the students with the skills and knowledge required to deal with the psychiatric disorders commonly found in general medical practice. The teaching of psychiatry is limited to the second, third and fourth medical years, and teachers are clinicians rather than nonpractising experts in particular fields related to medicine. PMID- 6850169 TI - Symposium on the teaching of psychiatry. USA: Michigan State University. Coming to grips with the psychosocial. AB - Problems in psychiatric and psychosocial education arise from the absence of agreement on curricular content, failure to emphasize observable skill development, and the ambivalent views on psychosocial material found in modern medicine. The curriculum for medical students presented here emphasizes an integrated approach to teaching psychiatry and psychosocial material. Great emphasis is placed on interviewing and history-taking as well as on problem solving. Specific courses in development, psychiatry and ageing are prescribed. Preclinical education in psychiatry emphasizes a bio-psychosocial view of mental disorder. PMID- 6850170 TI - Symposium on the teaching of psychiatry. Undergraduate medical students in Denmark. AB - The increasing role of psychiatry in the medical curriculum in Denmark is described. The general schedule of psychiatric teaching to medical students is outlined, emphasizing some of the special features of the Danish tradition. Roughly speaking, six per cent of all curriculum time is devoted to psychiatry. Clinical psychiatry, medical psychology and human sexuality are described separately. Interesting new possibilities for psychiatry in connection with a current curriculum reform, allotting more time to clerkships, elective periods and liaison teaching are pointed out. PMID- 6850171 TI - Symposium on the teaching of psychiatry. England: St George's Hospital Medical School, London. PMID- 6850173 TI - Symposium on the teaching of psychiatry. Scotland: Aberdeen University. PMID- 6850172 TI - Symposium on the teaching of psychiatry. England: University of Manchester. PMID- 6850174 TI - Who's for psychiatry? United Kingdom medical schools and career choice of psychiatry 1961-75. AB - The medical schools of origin were identified in 1229 psychiatrists who qualified in the United Kingdom in the years 1961-75. The group was defined operationally as those who had entered for the preliminary test of the membership examination of the Royal College of Psychiatrists. From 1966-75 only 4 per cent of doctors opted for a career in the specialty. There are wide discrepancies between medical schools in the proportion of their graduates who enter psychiatry. The most likely reasons for this have to do with differences in student selection, the models of psychiatry put forward, the enthusiasm of teachers and the career pull from other specialties, notably general practice. A number of suggestions which might help to improve recruitment to psychiatry are put forward. PMID- 6850175 TI - The development of sex differences in infantile autism. AB - Seventy-five autistic children, 52 males and 23 females, were admitted to the Iowa Autism Programme over a 3-year period. An overall male-female ratio of 2.26:1 was found, but in the patients with IQs less than 50, the ratio was 1.31:1. When IQ and receptive language functioning were considered together, significantly more females than males showed a more deviant form of autism. Autistic females were more seriously affected than autistic males; and more autistic females than males had IQs of less than 50 and evidence of cerebral dysfunction. However, when autistic males and females were closely matched in chronological age and receptive language functioning, the males and females were equally impaired in cognitive and perceptual-motor abilities. The findings suggest that the overall greater degree of morbidity in autistic females was accounted for by a significantly greater proportion of autistic males affected with a mild form of autism, whereas a significantly greater proportion of autistic females were affected with a more deviant form of autism. The findings were linked to the hypothesis of differential genetic loading in males and females. PMID- 6850176 TI - The frequency of psychiatric disorders among patients attending semi-urban and rural general out-patient clinics in Kenya. AB - The prevalence of psychiatric morbidity (PM) was studied among general hospital out-patients in a rural and in a semi-urban area of Kenya. There were no significant differences in the demographic features of psychiatric patients from the two areas, so the results were pooled: this gave a PM prevalence rate of 29 per cent among 388 patients. Anxiety and depression were the most frequent diagnostic categories. Alcoholism was more common in the rural than in the semi urban area. There was no sex difference in the prevalence of PM and possible reasons for this, which is in contrast to western findings, are discussed. Psychiatric symptoms could be readily elicited when present. Patients showing them had been ill longer than non-PM patients. The study suggests that clinic staff not psychiatrically trained should be able to identify and treat psychiatric morbidity, even when it is presented as somatic illness. PMID- 6850178 TI - Abnormal metabolite in alcoholic subjects. PMID- 6850179 TI - Life events precipitating mania. AB - A study of 20 manic patients, with patient and matched control comparisons, showed a two fold increase in life events during the 4 month period before admission to hospital. Life events, independent of affective illness and having significant objective negative impact (i.e. traumatic) were significantly more common. These findings are considered in relation to social relationships, family history of affective illness and the use of psychotropic medication. PMID- 6850177 TI - Hypercalcaemia in a psychogeriatric population. AB - Serum calcium concentration was estimated, via a multichannel analyser, in all patients admitted to a 25 bed psychogeriatric inpatient unit and associated day hospital. Case notes of 629 consecutive admissions over a 42 month period were studied, and the prevalence of hypercalcaemia found to be 0.7 per cent, close to that estimated for the general population. Cases of hypercalcaemia with psychiatric symptoms, undetected medically because of vague and non-specific physical symptoms, do not appear in excess in a psychogeriatric population. PMID- 6850180 TI - The effect of the use of the International Classification of Diseases 9th revision: upon hospital in-patient diagnoses. AB - This study compares the diagnostic terminology used for 592 consecutive discharges from a psychiatric unit before and after teaching psychiatric trainees the use of the ICD-9 classificatory system. The results show a marked increase in specificity of diagnostic labels, with a decrease of diagnoses with the term 'not otherwise specified', and an increase in the diagnoses of organic psychoses, paranoid and hebephrenic schizophrenia and depressive neurosis. The implications of this for training about diagnosis, clinical practice and recording of data for national statistics are discussed. PMID- 6850181 TI - Reducing American diagnosis of schizophrenia: will the DSM III suffice? PMID- 6850183 TI - Phaeochromocytoma with schizophreniform psychosis. PMID- 6850182 TI - The DSM-III concept of organic brain syndrome. AB - The shortcomings of the DSM-II classification of organic brain syndrome are described, including the limitation of the concept to the global brain disorders; the idiosyncratic use of the terms acute and chronic; and the unsatisfactory categories psychotic and nonpsychotic. Organic brain syndrome is defined according to DSM-III and the 10 separate brain syndrome categories are outlined. The diagnostic criteria for each category are listed and the general principles underlying the criteria are described. Finally, the goals of the authors' of DSM III to enhance diagnostic reliability and validity are discussed and the impact of the new nomenclature is assessed. PMID- 6850185 TI - A comparison of depression rating scales. PMID- 6850184 TI - Rate of blinking may predict neuroleptic-induced parkinsonism. PMID- 6850186 TI - Folate, affective morbidity and lithium therapy. PMID- 6850187 TI - Schizophrenia and lateralization of galvanic skin response. PMID- 6850188 TI - Low and high energy ECT. PMID- 6850189 TI - Dangers of reducing lithium. PMID- 6850190 TI - Community screening for mental illness. PMID- 6850191 TI - Are autism and anorexia nervosa related? PMID- 6850192 TI - Foot abscess--a late complication of total knee replacement. PMID- 6850193 TI - Polyarthritis induced by propylthiouracil. PMID- 6850194 TI - Drug companies and rheumatologists. PMID- 6850195 TI - The clinical usefulness of radionuclide scintigraphy in suspected sacro-iliitis: a prospective study. AB - The ability of quantitative sacro-iliac scintigraphy (QSS) to detect sacro-iliac joint (SIJ) disease was compared to that of standard radiographs in a prospective study of 26 patients with low back pain suggestive of spondylitis. Of 52 SIJs studied, QSS was abnormal in 21 (40%) and radiographs positive in 23 (44%) (p = 0.47). QSS was abnormal in only 11 of the 23 (48%) radiographically abnormal SIJs. Conversely, 29 radiographically equivocal or negative SIJs yielded positive scintigraphs in ten (34%). Although QSS in general is no more sensitive than standard radiographs, it may allow detection of radiographically inapparent sacro iliitis in carefully selected patients. PMID- 6850196 TI - Lateral humeral epicondylitis--a study of natural history and the effect of conservative therapy. AB - One hundred and twenty-five patients with lateral humeral epicondylitis treated in a rheumatology clinic were reviewed 1-5 years after presentation. Ten per cent of patients remained symptomatic at discharge, 26% had recurrence of symptoms and many were symptomatic at review. Over 40% of patients had prolonged minor discomfort which affected some activities. Thus tennis elbow is often associated with prolonged disability. This disability is not necessarily recognized by their medical practitioners as frequently patients do not return for further treatment. Ultrasound was not as effective (53% improved) as steroid injection (89% improved), but recurrence was less frequent. PMID- 6850198 TI - Acute knee joint rupture--a report of two unusual cases. AB - An acute rupture of the knee joint is a well recognized and documented condition. The symptoms and signs it produces have been described as the pseudothrombophlebitis syndrome and its importance in the differential diagnosis of calf pain is being increasingly recognized. We report two cases where the symptomatology has been unusual and stress the need for considering this condition in other atypical cases of leg pain which may not strictly conform in presentation to the pseudothrombophlebitis syndrome. PMID- 6850197 TI - Problems for rheumatic patients in opening dispensed drug containers. AB - The ability of 50 rheumatoid arthritis patients with hand involvement and 50 normal control subjects to open a range of reclosable tablet containers and unit dose packs was tested. Child-resistant containers, particularly the clic-loc type, proved the most difficult for patients and control subjects to open. Smaller containers were less easy to open than comparable ones of a larger size. Only 54% patients were able to remove a suppository from its wrapping. Blister packs and conventional screw-capped tablet bottles were easiest to open. Dispensing of drugs for rheumatic patients in child-resistant containers should be limited to those without hand involvement. PMID- 6850201 TI - Trait and state anxiety in male and female cross-country runners. AB - The purpose of this study was to explore the relationships between state/trait anxiety and competitive cross-country performance for males and females. A-trait and A-state pre- and post-competition were monitored in 38 females and 26 males at major meetings. The females' A-trait was correlated with pre-race A-state (p less than .05) which was itself correlated significantly with race performance (p less than .05). A significant post-race A-state reduction occurred only with the better runners. The correlation between A-trait and pre-race A-state was also found in the male athletes (p less than .05) while A-trait significantly correlated with race performance (p less than .05). A-state was significantly reduced post-race, the greatest decrease being observed in the top performers. It is concluded that trait as well as transient dispositions are relevant when psychological determinants of performance are considered. PMID- 6850199 TI - Injuries sustained by runners during a popular marathon. PMID- 6850200 TI - Physiological and anthropometric parameters that describe a rugby union team. AB - The purpose of this study was to describe the anthropometric and physiological parameters that apply to a USA amateur rugby union club team. Fifteen players who were members of the club's first team were evaluated for body composition, muscular strength, power and endurance, flexibility, anaerobic power, anaerobic capacity, and cardio-respiratory function shortly after completion of the regular season. Means for some of the variables measured include: age, 29 yr; height, 180 cm; weight, 84 kg; lean body weight, 74 kg; body fat, 12%, endurance sit-ups, 50/min; vertical jump height, 51 cm; anaerobic power output, 132 m.kg.s-1 (1.32 kw); anaerobic capacity, 2247 m.kp/40s (22.5 kJ); maximum heart rate, 186 beats/min; maximum ventilation, 175 l/min-1; maximum respiratory quotient 1.23; and maximum oxygen uptake, 56.6 ml.kg-1 min-1. In comparison with other rugby players studied these players had higher maximum oxygen uptake values, were similar in endurance sit-up and vertical jump ability, exhibited less upper body strength, and the forwards had lower body fat percentages. They were generally within the range of scores found to describe the aerobic and anaerobic fitness, and body composition of other elite amateur and professional intermittent sport athletes. PMID- 6850202 TI - Physical work capacity and lung function in competitive swimmers. AB - Competitive swimmers require a high aerobic capacity to support the sustained performance of severe exercise. Maximal oxygen uptake values and blood lactate concentrations were measured in ten male and fifteen female swimmers from the Scottish National and Youth Squads 1981-82. Lung function tests were also performed to determine pulmonary efficiency. The results of these studies were compared with other investigations of international competitive swimmers and indicate a high level of fitness among Scottish national swimmers. PMID- 6850203 TI - Maximal anaerobic power in Indian national hockey players. AB - Anaerobic power in relation to field position of 90 Indian hockey players has been studied. These players included 10 goalkeepers, 16 backs, 20 half-backs and 44 forwards. The goalkeepers possess maximum and forwards possess minimum anaerobic power while in vertical velocity, the former are the fastest and the latter are the slowest. In body weight the backs are heaviest followed by half backs, goalkeepers and forwards. Among backs, the lefts are heavier, faster and have more anaerobic power than rights. In half-line players, the centre-half backs are followed by left-half-backs and right-half-backs both in body weight and anaerobic power, while in vertical velocity, the left-half-backs are the fastest and centre-half-backs are the slowest. Among forwards, the centre forwards are heaviest with maximum anaerobic power and are followed by inside forwards and outside-forwards, whereas, in vertical velocity the inside-forwards are fastest followed by centre-forwards and outside-forwards. PMID- 6850204 TI - Effect of physical conditioning on blood lactate disappearance after supramaximal exercise. AB - The purpose of this study was to investigate the effect of physical conditioning on the rate of blood lactate disappearance during recovery from supramaximal exercise. The rate of blood lactate disappearance was determined in 11 female and 4 male subjects before and after a 6-week conditioning programme. Blood samples were taken during the 30 minutes following supramaximal exercise during both passive (resting) and active recoveries. Pre-test active recovery was performed at 25% VO2 max; post-test active recovery was performed at both the same absolute and relative intensities (% VO2 max) as during the pre-test. Eight of the subjects trained 4 days/week for 6 weeks with high-intensity interval bicycle ergometer exercise, and 7 subjects served as controls. The conditioning programme significantly (p less than .05) increased VO2 max by 6.7 ml/kg.min (15%) and work capacity on the cycle ergometer by 2.8 minutes (27%). Physical conditioning did not affect significantly (p less than .05) the rate of blood lactate disappearance measured during passive recovery or during active recovery at the same absolute intensity, but increased significantly (p less than .05) the rate of blood lactate disappearance during active recovery performed at the same relative exercise intensity. The increased disappearance rate following conditioning was attributed to the higher absolute intensity of recovery work performed. PMID- 6850206 TI - Drowning and near drowning. PMID- 6850205 TI - Effects of menstruation and contraceptive pill on the performance of physical education students. AB - Of the 109 specialist female physical education students who answered a detailed questionnaire on menstruation and the contraceptive pill in relation to exercise, 91 (83.5%) reported that they suffered menstrual problems. These included stomach ache, depression, abdominal cramps and backache. Over two-thirds of the students considered that these problems adversely influenced their physical performance. However, whether they had a mainly physiological or psychological effect is not clear. Many of the students with menstrual problems thought that exercise had a beneficial effect and helped alleviate their discomfort. A small number of students reported problems such as amenorrhoea and reduced menses possibly due to excessive training. Just under half the students in the investigation took the contraceptive pill, and though as many students taking the pill complained of menstrual problems as those not taking it, they reported less problems and to a lesser degree. Most students claimed that taking the contraceptive pill had no effect upon their performance. PMID- 6850208 TI - Second injury syndrome. PMID- 6850209 TI - Air embolism in a sports diver. PMID- 6850207 TI - The hydration and electrolyte maintenance properties of an experimental sports drink. AB - Seven highly trained subjects underwent exercise dehydration without fluid replacement (X), resulting in approximately 1.9% and approximately 3.5% body weight (fluid) losses at one and two hours, respectively. Subsequently, subjects underwent two identical exercise trials with isovolumetric fluid replacement of water (W) and an experimental formulation (Q). An anti-dehydration schedule was initiated prior to, and continued throughout the exercise, with W and Q supplied every 15 minutes at 16 degrees C in volumes related to each subject's fluid loss estimate derived from trial X. A rehydration schedule was maintained for two hours of recovery, with total fluid replacement equivalent to the body weight decrement due to fluid losses. In both W and Q trials, selected physiological indices of work performance were maintained closer to homeostatic levels during exercise, with a more rapid return to pre-exercise resting levels during recovery than during that trial X. Furthermore, W and Q were equally effective in preventing plasma volume changes during exercise and restoration to pre-exercise levels during recovery, as well as in preventing plasma osmolality disturbances during exercise and recovery, although minimal plasma electrolyte changes were associated with Q. PMID- 6850210 TI - Paediatric abdominal computed tomography: the technique and use in neuroblastomas and pelvic masses. AB - Paediatric abdominal CT often has to be performed outside a children's hospital. Without careful planning, the examination can be unrewarding and full of snags, and our technique for these conditions is outlined. Some of the problems of whole body CT are discussed and the examination has been found to be of the greatest value in children with extensive retroperitoneal and pelvic masses. In these circumstances it may be used for both diagnosis and treatment follow-up, and the benefits it provides justify any increased radiation to the patient. PMID- 6850211 TI - Repositioning errors in measurement of vertebral attenuation values by computed tomography. AB - Difficulty in repositioning makes a major contribution to reproducibility errors in measurements of bone mineral by computed tomography (CT). The magnitude of measurement variations arising from incremental movements in each of three directions of displacement and two directions of rotation were investigated using two sections of cadaver spines each including three vertebral bodies. Within the range of variation in position readily attainable by currently available scan plane selection techniques, changes in measured attenuation were small. Estimated variations resulting from compounded errors of different movements averaged 8.3 Hounsfield units for a single vertebra and 4.9 Hounsfield units for three adjacent vertebrae. The largest change in measured attenuation which could be attributed with 95% confidence to repositioning error within the quoted limits of scan plane selection was estimated to be approximately 15HU for a single vertebra and 8HU for three adjacent vertebrae. PMID- 6850212 TI - The three-stripe sign of the cocked Crosby capsule: a new radiological sign. PMID- 6850213 TI - Transient hypothyroidism following radioiodine therapy for thyrotoxicosis. AB - A prospective study of thyroid function including serial tracer radioisotope uptake measurements in 55 patients treated with 131I therapy is described. Five patients had an episode of transient hypothyroidism within eight months of treatment: in three of these patients this was due to impaired organification of iodide, with normal iodide trapping by the thyroid (as measured by a twenty minute 123I uptake) being preserved. In contrast, in all patients who developed permanent hypothyroidism, iodide trapping was markedly diminished and did not recover. It is suggested that hypothyroidism due to organification failure following 131I therapy is potentially short-lived; where hypothyroidism is associated with gross impairment of iodide trapping, recovery is unlikely. Early iodine uptake measurements may be of value in selecting those patients whose hypothyroidism is transient and who do not require permanent thyroid hormone replacement. PMID- 6850215 TI - Electron contamination of large cobalt 60 photon beams. AB - Experimental results are presented of the electron contamination of cobalt 60 gamma photon beams from the Mobaltron MS80, over a range of SSD's from 60 cm to 3.5 m. In the absence of an electron filter, the skin dose can exceed the dose at 4 mm depth by up to 1.6 times due to the high level of electron emission from the depleted uranium collimators. 4 mm of perspex effectively removes these electrons, and in the filtered beam, the skin dose cannot exceed the 4 mm dose. The electron contamination of a 6 MV X-ray beam is compared. PMID- 6850214 TI - Tissue-air ratios for cobalt 60 therapy units. AB - Tissue-air ratio (TAR) is the widely used dosimetric parameter for treatment planning in radiation therapy. Comparison of the measured TAR values of 19 60Co therapy units of eight different types was made with the widely used tabulated data of Gupta & Cunningham (1966). The experimental data, and the analysis of the variation in the TAR values caused by individual, unit by unit features, show that discrepancies may be up to +/- 4%. PMID- 6850216 TI - The dielectric properties of normal and tumour mouse tissue between 50 MHz and 10 GHz. AB - Microwaves are currently being investigated as a method of inducing hyperthermia. Values of the relative permittivity and conductivity of mouse muscle and tumour tissues over the frequency range 50 MHz to 10 GHz at a temperature of 37 degrees C are reported. The data were obtained by using an on-line computer-based time domain spectrometer. The tumour tissues were the RIF/1 and KHT fibrosarcomas sited in the hind leg muscle of C3H mice. A significant difference in the relative permittivity between the normal and tumour tissue was shown to exist at frequencies up to 200 MHz. PMID- 6850219 TI - Intra-hepatic gas following embolisation. PMID- 6850217 TI - Stable mediastinal fibrosis demonstrating the aortic "nipple" sign. PMID- 6850218 TI - Ataxia telangiectasia with cancer. An indication for reduced radiotherapy and chemotherapy doses. PMID- 6850220 TI - Reporting the late complication rates of cancer therapy. PMID- 6850221 TI - Radiobiological studies with therapeutic neutron beams generated by p+ leads to degree Be or d+ leads to degree Be. PMID- 6850222 TI - Cytotoxic drugs--radiomimetics? Abstracts. PMID- 6850223 TI - Ultrasonographic appearances of gastric cancer. AB - In 32 patients with known gastric cancer involving different segments of the stomach, an attempt was made to image the tumour by ultrasonography. Identification of the lesion was possible in 31/32 cases. The tumour always appeared as a focal or diffuse thickening of the gastric wall, with irregular outer margins and luminal echoes; in many cases, a "target" pattern was seen. Although ultrasonography cannot be considered a sensitive test in the diagnosis of gastric cancer, knowledge of the possible appearances of tumours in all different portions of the stomach is important, since this method is often used as the first imaging procedure in a large variety of abdominal complaints, and clinically unsuspected gastric carcinomas may be imaged first by it. PMID- 6850224 TI - Clinical indications for optimal use of the radionuclide brain scan. AB - 427 radionuclide brain scans, performed in 1981 at Guy's Hospital Nuclear Medicine Department, were reviewed retrospectively to define clinical circumstances in which the study provided useful information. It was concluded that the radionuclide brain scan was the appropriate first line investigation in patients with known non-cerebral malignancy, in whom the possibility of cerebral metastases exists; and in patients with a low to moderate probability of subdural haematoma. The radionuclide brain scan can provide a valuable alternative to computed tomography studies:--(1) in patients without known underlying disease who develop localising signs; (2) in patients with focal fits; (3) in patients with underlying vascular disease and gradual onset of localising signs; and (4) in patients with suspected inflammatory conditions of the central nervous system. Outside these groups, the radionuclide brain scan rarely provided useful information. PMID- 6850225 TI - A survey of radiation doses to patients in five common diagnostic examinations. PMID- 6850226 TI - Radiation doses to neonates requiring intensive care. AB - Radiological investigations have become accepted as an important part of the range of facilities required to support severely ill newborn babies. Increasing numbers of these very small premature babies now survive although they may undergo a considerable number of diagnostic X-ray examinations within the first few weeks of life. Since the infants are so small, many of the examinations are virtually "whole-body" irradiations and it was thought that the total doses received might be appreciable. A group of such babies admitted to the Neonatal Intensive Care Unit in Sheffield over a six-month period have been studied. X-ray exposure factors used for each examination have been noted and total skin, gonad and bone marrow doses calculated, supplemented by measurements on phantoms. It is concluded that in most cases the doses received are of the same order as those received over the same period from natural background radiation and probably less than those received from prenatal obstetric radiography, so that the additional risks from the diagnostic exposure are small. The highest doses are received in CT scans and barium examinations and it is recommended that the need for these should be carefully considered and requests for such examinations only made by experienced staff. PMID- 6850227 TI - Five years hospital experience with the Amersham caesium 137 manual afterloading system. AB - The Amersham caesium 137 manual afterloading system for treatment of cancer of the uterine cervix and endometrium has been in use at the Royal Free Hospital for more than five years. The system uses permanently loaded flexible source pencils in combination with standard packs of disposable plastic applicators. Both sources and applicators have proved trouble-free in use. The sources are transported in special containers designed and built at the Royal Free Hospital and are inserted and removed on the ward by nursing staff. A set of sources is used in theatre for rectal and bladder dose measurements when the applicators are inserted. Staff radiation doses are low. The system is mainly used to produce pear-shaped dose distributions similar to those of the Manchester system, but simple cylindrical distributions are possible using symmetrically loaded source pencils. PMID- 6850229 TI - Lumbosacral subarachnoid haematoma following lumbar puncture: characteristic myelographic appearances. PMID- 6850228 TI - Dosimetry of radioactive gold grains for the treatment of choroidal melanoma. AB - The dosimetry of small permanent gold grain implants for treating choroidal melanoma has been studied. A means of planning the source configuration required to deliver a desired minimum dose to a tumour has been developed. The interaction of the variable parameters, source activity, number of sources used, geometrical arrangement, and implant diameter, within the physical limitations imposed by the eye and the practical limitations occurring in clinical practice, are discussed. PMID- 6850230 TI - CT scan in subependymomas. PMID- 6850233 TI - Pancreatic cystadenocarcinoma--a diagnostic problem. PMID- 6850231 TI - Leiomyosarcoma of the inferior vena cava. PMID- 6850232 TI - Enemas and myasthenia gravis. PMID- 6850234 TI - The effect of dimethysulphoxide (DMSO) on heat distribution during radiofrequency (RF) capactive heating. PMID- 6850235 TI - Growth sites for experimental tumours: tail vs flank. PMID- 6850236 TI - Aspiration cytology of solid renal tumours. AB - The results of needle aspiration cytology of solid renal lesions in Brighton from 1977 have been reviewed. Thirty-one lesions were aspirated and of the 21 malignant tumours, cytology accurately diagnosed 19 (90%) when sufficient material was sent for analysis. Of the eight avascular solid renal space occupying lesions aspirated, cytology gave a correct differentiation (benign versus malignant) in seven (87%). The results compare favourably with those of other published experience. A modification is suggested to the accepted diagnostic pathway. PMID- 6850237 TI - Idiopathic retroperitoneal fibrosis--the role of autotransplantation. AB - The presentation and management of 12 patients with idiopathic retroperitoneal fibrosis (IRPF) are described. There was a high incidence of venous thromboembolism. External ureteric drainage was associated with complications. A case treated by autotransplantation is described. PMID- 6850238 TI - Percutaneous nephrostomy under guidance of ultrasonography and fluoroscopy using a pigtail catheter. AB - Percutaneous nephrostomy using a pigtail catheter was performed in 37 patients under the guidance of ultrasonography and fluoroscopy. The only failure in 60 attempts was due to a subcapsular haematoma. The catheter appears to be well tolerated and is large enough for good drainage. Ultrasonography has proved to be a valuable part of this technique and has made antegrade pyelography easy. PMID- 6850239 TI - Do intravenous urography and cystoscopy provide important information in otherwise healthy women with recurrent urinary tract infection? AB - An investigation of the influence on therapy of intravenous urography (IVU) and cystoscopy in a prospective study of 93 women with recurrent urinary tract infections is presented. The patients fulfilled the following criteria: a history of recurrent urinary tract infection (at least three episodes a year), a physical and gynaecological examination, determination of plasma creatinine, urine culture, microscopy, and uroflowmetry. It is concluded that IVU seldom reveals abnormalities that influence treatment in otherwise healthy women. On the other hand, uroflowmetry and cystoscopy occasionally yield helpful information. PMID- 6850240 TI - Vesicoureteric reflux in neonates with anorectal anomalies. AB - Thirty-six babies born with an anorectal anomaly were evaluated for vesicoureteric reflux in the neonatal period and the progress of the reflux with age was followed. The overall incidence of reflux was 47%, with higher rates in the more severe types of anomaly. Generally, the reflux was of mild grade and tended to resolve with time, except in the short colon syndrome. Urinary sepsis due to a rectourinary communication may have an important role in the development of reflux. PMID- 6850242 TI - The structure of the bladder neck in male bladder neck obstruction. AB - A light microscope and neurohistochemical study is presented of full thickness biopsies from the bladder neck of 10 middle-aged males with urodynamically proven bladder neck obstruction. Apart from varying degrees of collagen deposition in seven cases, no abnormality was present in the detrusor and pre-prostatic components of the bladder neck muscles or in the distribution of cholinergic nerve fibres. The normal noradrenergic innervation to the pre-prostatic sphincter was absent in all specimens; this may be age-related. PMID- 6850243 TI - Bladder neck incision in the female: a hazardous procedure? AB - Anterior bladder neck incision was carried out in 32 female patients suffering from difficult, mostly incomplete, bladder emptying. All patients underwent a full urodynamic investigation with voiding cystourethrography and endoscopy. Detrusor failure was observed in 20 patients; in the remainder, a mechanical iatrogenic bladder neck obstruction was held responsible for inefficient voiding. Twenty-eight patients (56%) benefited in some degree from the procedure. Six were submitted to a repeat incision and two of them developed severe stress incontinence later on. As the results are far from promising, intermittent self catheterisation may be proposed in some cases as an alternative to bladder neck incision for fear of incontinence. The urodynamic findings and the results of bladder neck incision, which are very different in the two sexes, are analysed. The poorer results in the female are presumably due to the decompensated state of the bladder, mostly responsible for incomplete bladder evacuation. PMID- 6850241 TI - Carcinoma of the urinary bladder in Zambia. A quantitative estimation of Schistosoma haematobium infection. AB - The incidence and intensity of schistosomal infection in 50 African malignant bladders determined by quantitative analysis have been compared with a matched control group of nonmalignant cadaver bladders, and the incidence of radiological calcification in the former has been compared with that of 50 adult urinary bilharziasis patients without associated malignancy. Compared with 45% in the non malignant group, schistosomal infection was present in an overwhelming 94% of the malignant cases. Radiological calcification in the malignant bladders (38%) was slightly more than in patients with urinary bilharziasis (35%). In the majority of the malignant bladders (55.3%) the parasitic infection was noted to be of moderate to low intensity. It has been suggested that the overall severity of schistosomal infection is unlikely to be the sole factor in the pathogenesis of carcinoma of the urinary bladder. PMID- 6850244 TI - Are we using the right irrigation system? AB - The relationships between bladder pressure and irrigant fluid flow rate were tested using two commonly used supply systems and a 27 FG Storz resectoscope. Simple and inexpensive modifications would enable transurethral prostatectomy to be carried out with reduced intravesical pressure and less risk of fluid absorption. With a continuous suction resectoscope, the modified system allows accurate balance of the inflow and outflow of the irrigant fluid. PMID- 6850246 TI - An evaluation of a simple stick test for pyuria. AB - The results of a simple stick test for the detection of urinary leucocyte esterase are compared with the findings from conventional examination of 150 cytoscopic specimens of urine. The test was found to indicate the presence of significant numbers of white cells in urine with accuracy, and its relevance to urological surgery is discussed PMID- 6850245 TI - The composition and origin of the gas produced during urological endoscopic resections. AB - The gas produced from an in vitro model of transurethral resection was found to contain high concentrations of hydrogen and carbon monoxide. Evidence from a further experiment suggests that this gas is formed by the pyrolysis of animal tissue. PMID- 6850247 TI - The Urilos recording nappy system. AB - A technical and clinical evaluation of the Urilos recording nappy system is presented. The recording pads were calibrated to determine the variation between and within batches of 25 pads supplied by the manufacturer. Fifty patients were assessed by this system for periods of 2 to 7 h. The results show that the system is useful in the verification of patient histories, although it is difficult to obtain a quantitative measure of urine loss. PMID- 6850248 TI - Catheter encrustation by struvite. AB - Encrusted catheters from 10 female patients were the source of 26 samples of deposits which were examined by X-ray diffraction. Four different types of catheter were represented. The only detectable compound in all of the samples was ammonium magnesium orthophosphate hexahydrate (NH4MgPO4 . 6H2O), which occurs naturally as the mineral struvite. PMID- 6850249 TI - Prostatic acid phosphatase in serum and bone marrow in patients with prostatic carcinoma. AB - Sixty-two per cent of 61 patients with prostatic carcinoma showed elevated levels of serum acid phosphatase, analysed by radioimmunoassay (RIA). Enzymatically determined serum acid phosphatase was raised in only 38% of the same patients. Bone marrow acid phosphatase determined by RIA was raised in 41%. In untreated metastatic patients with prostatic carcinoma, radioimmunologically determined serum acid phosphatase was elevated in 12 of 13 patients, whereas bone marrow acid phosphatase (RIA) and enzymatically determined serum prostatic acid phosphatase were increased only in about half of the patients. In a control group the upper reference limit of bone marrow acid phosphatase determined by RIA was significantly raised above that obtained by serum analyses. This indicates that nonprostatic acid phosphatases (possibly from bone marrow cells) cross-react with prostatic acid phosphatase in an unpredictable way, even when using a specific radioimmunoassay. In patients with metastatic carcinoma of the prostate, the results of bone marrow acid phosphatase determinations, analysed by RIA, seem to lack diagnostic and/or prognostic information additional to that obtainable by serum acid phosphatase (RIA) analysis. PMID- 6850251 TI - The prognosis of prostatic cancer in the younger man. AB - The effect of age on the prognosis of prostatic cancer is uncertain. Younger patients are commonly assumed to have a worse prognosis. To investigate this impression, survival rates were calculated for two groups of patients with histologically proven prostatic cancer aged under 60 years (46 patients) and 65 to 74 years (193 patients). Age-corrected actuarial survival curves for the two groups were not significantly different when tested by the log rank method. Similar curves constructed for well and poorly differentiated tumours, the presence of metastases and different treatment groups were also not significantly different. The survival of younger patients with prostatic cancer is not significantly worse than that of older patients, nor is it better. PMID- 6850250 TI - Massive prostatic carcinoma in negroes. AB - Three cases of massive carcinoma of the prostate in negroes are presented. Investigation and treatment were carried out along conventional lines. There was a very good response to treatment initially in that all tumours shrank and became impalpable. Two patients died of recurrent carcinoma at 1 and 2 3/4 years respectively. The third has widespread metastases at present controlled by chemotherapy. The possible differences in the behaviour of prostatic carcinoma in negroes are discussed. PMID- 6850252 TI - Accuracy of transcutaneous aspiration biopsy in the definitive assessment of nodal involvement in prostatic carcinoma. AB - The inaccuracy of lymphangiography in predicting nodal involvement and the complications of pelvic lymphadenectomy prompted us to evaluate other methods of staging prostatic cancer. On the basis of the results obtained in 24 patients with carcinoma of the prostate, the authors suggest transcutaneous fluoroscopy guided fine needle aspiration biopsy as a satisfactory alternative to lymphadenectomy. In 95-8% of patients pelvic lymphadenectomy confirmed the cytological findings of transcutaneous aspiration biopsy of pelvic lymph nodes using a "long-bevelled, side-holed" thin needle. It is considered essential to perform aspiration biopsy on most of the pelvic lymph node chains opacified, regardless of lymphographic diagnosis. PMID- 6850253 TI - Nephro-bronchial fistula. PMID- 6850254 TI - Parapelvic cyst in a horseshoe kidney. PMID- 6850255 TI - Renal haemangioma: emergency partial nephrectomy. PMID- 6850256 TI - Acute emphysematous thyroiditis. AB - Acute emphysematous thyroiditis is a severe pyogenic infection of the thyroid gland characterized by the production of gas. Although earlier writers of the pre antibiotic era had referred to 'gangrene of the thyroid with gas formation' (1 3), only 5 cases of gas-forming or emphysematous thyroiditis have been specifically documented. In this report, the sixth case of acute emphysematous thyroiditis is presented and the clinical features of this rare but potentially lethal infection of the thyroid gland are described. The pathogenesis and management of the disease are discussed. PMID- 6850257 TI - Radical surgery following radiotherapy for advanced parotid carcinoma. AB - We have reviewed the surgical treatment of 12 consecutive patients with advanced carcinoma of the parotid gland at this hospital. Ten patients received immediate preoperative radiotherapy to a mean total dose (TD) of 4000 cGy (rad), range 2600 6500 cGy. Two patients with recurrent carcinoma had previously been treated with local radiotherapy (TD 6500 cGy) at 1 year and 2 years respectively prior to referral. A radical parotidectomy with block dissection of the neck was performed on all 12 patients. After a follow-up period ranging from 6 months to 8 years, 6 patients have remained disease free including 3 patients who have died from unrelated causes within this period. Three patients have developed local recurrent disease (interval 9 months-3 years), 3 further patients with residual microscopic disease have been observed postoperatively (follow-up interval 6 months-2 years) without developing overt local recurrence. PMID- 6850258 TI - The influence of ultrasonic Duplex scanning on the management of carotid artery disease. AB - In order to assess the influence of a non-invasive test such as Duplex scanning on the management of patients with suspected carotid artery disease, we reviewed the data on all new referrals (n = 491) during a year. The patients were grouped according to the reason for the referral: 1, patients with focal neurological symptoms lasting less than 24 h (n = 156); 2, patients with focal neurological symptoms lasting longer than 24 h (n = 107); 3, patients with non-focal neurological symptoms (n = 147); 4, patients with asymptomatic bruits (n = 81). For all four groups there was a statistically significant relationship (chi 2; P less than 0 . 005) between the reporting of the presence of a high grade stenosis (more than 50 per cent diameter reduction) and the likelihood that the patient would undergo arteriography. The finding of a high grade stenosis on the arteriogram resulted in a greater number of patients undergoing carotid artery surgery. The results of this study indicate that the report of the non-invasive test influenced the decision-making process in the management of patients with suspected carotid artery disease. PMID- 6850260 TI - Splenectomy and infection in Hodgkin's disease. AB - The incidence of infection in 56 patients with Hodgkin's disease who had undergone staging laparotomy with splenectomy was compared with that of 28 non splenectomized patients with Hodgkin's disease treated concurrently. The results suggest that splenectomy does not result in a major change in the incidence of infection experienced by such patients with stage II or stage III disease. Aggressive therapy may be of greater importance in increasing the susceptibility to infection in Hodgkin's disease. PMID- 6850259 TI - Effects of gastrocystoplasty on serum gastrin levels and gastric acid secretion. AB - Hypersecretion of gastric acid and hypergastrinaemia occur when the antrum of the stomach is transposed as a diverticulum to the colon. Thus, when an antral pouch is transposed to increase bladder capacity or to replace the bladder as a gastrocystoplasty, similar pathophysiological disturbances can be anticipated. However, previous studies in our laboratories in dogs have shown that acid overproduction and stomal ulcerations do not occur. This paper reports the results of gastrocystoplasty in 13 patients followed up from 1 to 6 years. Gastric acid hypersecretion and hypergastrinaemia did not occur. PMID- 6850261 TI - Adult intussusception in the tropics. AB - Thirty-two cases are reported of intussusception occurring in patients over the age of 12 years, diagnosed in Papua New Guinea in the 8 years from March 1973. Malignant disease was found in only 2 patients (6.3 per cent), and in 21 cases (65.5 per cent) no associated pathology was detectable. Benign inflammatory polypi were encountered in 7 patients (22 per cent). A high proportion of primary intussusceptions is characteristic of series reported from tropical countries. Many may be due to the abnormal motility associated with acute diarrhoeal illnesses. Due to the rarity of associated malignancy a policy of conservative operative management is justifiable in a tropical environment. PMID- 6850263 TI - Incisional hernias: when do they occur? AB - Incisional herniation remains a major problem for the general surgeon. Most published studies have followed up patients for 6-12 months after operation. In this study, 363 patients, known not to have an incisional hernia at 1 year, were reviewed between 2.5 and 5.5 years after operation. Twenty-one patients (5.8 per cent) were found to have developed incisional hernias. None of the causal factors previously implicated in the aetiology of incisional herniation (wound infection, male sex, obesity, age, postoperative chest infection or abdominal distension), was found to be associated with the development of these 'late hernias'. PMID- 6850262 TI - The hourly pattern of urine solute and electrolyte excretion following standard surgical trauma. AB - Although urine volume (and, less frequently, concentration) is often measured in the perioperative period, little attempt has been made to separate temporal phases of the intra- and postoperative response to surgery. In 7 patients undergoing standard severe single trauma and managed by a conventional regimen which included intraoperative Hartmann's solution, we have investigated the hourly pattern of urine solute and electrolyte excretion over the first 48 h. Contrary to expectation, in the first 5 h Na+ excretion increases in association with overall solute excretion, and thereafter progressively diminishes. K+ excretion increases 4 h postoperatively and remains elevated for 24 h, after which it returns to normal, even though Na+ excretion remains low. Free water excretion is negative for the first 24 h, though urine osmolality does not suggest a maximal antidiuretic response by the kidney--the highest concentration achieved being just below 800 mosmol/kg. In order to distinguish between the physiological adaptive changes due to starvation and those due to injury, the hourly pattern of urine solute and electrolyte excretion was further investigated in 12 healthy volunteers mimicking postoperative conditions. Apart from the early postoperative period, the hourly pattern of Na+, K+ and osmolar excretion shows no discernible difference from the operated group. These results show that, particularly in relation to Na+, the changes seen in the post-injury patient, even after major uncomplicated surgery, are largely adaptive, and this is especially striking at 24 h after surgery. PMID- 6850264 TI - Safety of contrast enemas in assessing the integrity of large bowel anastomoses. PMID- 6850265 TI - Primary syphilis of the fingers. AB - Six patients were seen with primary syphilitic chancres on their fingers between 1965 and 1980. Of these, two had bipolar chancres on their fingers and genitals resulting from sexual foreplay. Because syphilis is rarely suspected in such cases diagnostic errors are common. PMID- 6850266 TI - Pelvic inflammatory disease associated with Chlamydia trachomatis infection after therapeutic abortion. A prospective study. AB - Chlamydia trachomatis was cultured from the cervix of 70 of 557 (12.6%) patients admitted for therapeutic abortion. Postoperatively, 22 (3.9%) developed acute pelvic inflammatory disease (PID); of these women, 14 (63.6%) had harboured C trachomatis in the cervix before the abortion. Thus of 70 patients with chlamydial infection, 14 (20%) developed PID postoperatively. Of the chlamydia positive patients, six of the 15 (40%) aged less than 20 years and eight of the 53 (15%) patients aged 20-30 years developed PID. Twelve of the 70 women with chlamydial infections showed a significant increase in serum chlamydial IgG antibody titres over a four week period; four of these women developed PID. Neisseria gonorrhoeae was recovered from only four patients, one of whom developed PID after the abortion. Treatment with a single dose of intravenous doxycycline (200 mg) was given before and during surgery to about half of the patients. In our study, this regimen had no protective effect against the development of PID associated with C trachomatis. PMID- 6850267 TI - Lymphogranuloma venereum of the rectum in a homosexual man. Case report. AB - A male homosexual presented initially with bloody diarrhoea and a swelling in the left groin, which was unsuccessfully treated with erythromycin. Examination in hospital showed a rectal mass and an abscess in the left groin. Histological examination of the rectal mass and a positive lymphogranuloma complement fixation test result confirmed the diagnosis of lymphogranuloma venereum. This disease, although rare, should not be forgotten in the differential diagnosis of rectal problems in male homosexuals. PMID- 6850268 TI - Primary endometrial and endocervical granuloma inguinale (donovanosis). Case report. AB - Primary endometrial and endocervical granuloma inguinale (donovanosis) was diagnosed in an 18-year-old Melanesian woman in Papua New Guinea. Granulomatous involvement of the parametrium, salpinges, ovaries, and ureters was associated with ureteric obstruction and bilateral hydronephrosis. Granuloma inguinale of the cervix, labia majora, and anus developed after diagnostic endometrial curettage. Treatment with tetracycline and later chloramphenicol had to be stopped because of poor patient compliance. Hysterectomy was performed, after which the patient made a good recovery. This appears to be the first case of primary endometrial and endocervical granuloma inguinale to be reported. PMID- 6850269 TI - 'Utilization behaviour' and its relation to lesions of the frontal lobes. AB - A new type of behaviour, termed 'utilization behaviour', was observed among patients affected with left or right unilateral, or bilateral, frontal lesions. It is an extension of bilateral manual grasping behaviour (magnetic apraxia). The tactile, visuotactile and visual presentation of objects compels the patients to grasp and use them. This behaviour was obtained with miscellaneous utilitarian objects. For the patients, the presentation of objects implies the order to grasp and use them. It is proposed that the balance between the subject's dependence on and independence from the outside world is disturbed. With frontal lesions, the inhibitory function of the frontal lobes on the parietal lobes is suppressed. The result is a release of the activities of the parietal lobes so that the subject becomes dependent on visual and tactile stimulation from the outside world. Five cases are reported as examples: one anatomoclinical case with bilateral lesions of the frontal lobe. The role of lesions affecting different parts of the frontal lobes is discussed. The neuropathological observations lead to the suggestion that lesions of the orbital surface of the frontal lobe, and perhaps of the head of the caudate nucleus, are responsible for this behaviour. PMID- 6850270 TI - Cognitive deficits in the early stages of Parkinson's disease. AB - Neuropsychological tests known to reveal abnormalities in patients with frontal lobe damage were used to explore cognitive function in 30 mildly disabled, right handed patients with idiopathic Parkinson's disease. None of the patients had received treatment and all had normal CT brain scans. Patients with depression or high ischaemia scores were excluded from the study and similar selection criteria were used for the age-matched controls. No impairment of general intellectual function was found in the patients using the WAIS and New Adult Reading IQ tests and no abnormalities were apparent on cognitive estimates and two-choice Recognition Memory Tests. Patients with Parkinson's disease, however, had significantly greater difficulty in shifting conceptual sets and produced more perseverative errors on both the modified Wisconsin Card Sorting Test and Benton's Word Fluency Test. These subtle cognitive difficulties might underlie the mental inflexibility and rigidity of Parkinson's disease and could be attributed to destruction of the ascending dopaminergic mesocorticolimbic pathway. PMID- 6850272 TI - Selective disturbance of movement vision after bilateral brain damage. AB - A patient who suffered bilateral posterior brain damage exhibited disturbance of movement vision in a rather pure form. The patient had no impression of movement in depth, and could only discriminate between a stationary and a moving target in the periphery of her otherwise intact visual fields. She had some movement vision in the central part of her visual fields, provided that target velocity did not exceed 10 deg/s. Neither did she possess visual movement after effects nor apparent (phi) visual movement. In addition, visually guided eye and finger movements were impaired. In contrast to the disturbance of movement perception in the visual modality, movement perception elicited by acoustic and tactile stimuli was not impaired. On the basis of the localization of the cerebral damage (as judged by CT scanning and neuropsychological testing) it is concluded that the observed disorder in movement vision is due to bilateral cerebral lesions affecting the lateral temporo-occipital cortex and the underlying white matter. The selectivity of the visual disturbance supports the idea that movement vision is a separate visual function depending on neuronal mechanisms beyond the primary visual cortex. PMID- 6850273 TI - Subcortical somatosensory evoked potentials to median nerve stimulation. PMID- 6850271 TI - Astereognosis and dissociated loss of frontal or parietal components of somatosensory evoked potentials in hemispheric lesions. Detailed correlations with clinical signs and computerized tomographic scanning. AB - Detailed clinical sensory and motor signs were correlated case by case with somatosensory evoked potentials (SEP) in 22 selected patients with a single circumscribed hemisphere lesion. The lesions collectively mapped out a variety of cerebral sites from the anterior frontal to the posterior parietal regions. SEPs were averaged from 8 standard scalp sites with an earlobe reference electrode, so that parietal N20-P27-P45 were differentiated from prerolandic P22-N30 SEP components. SEP wave forms to stimulation on the unaffected side served as the patient's own control. A complete parietal lesion produced contralateral hemianaesthesia without upper motor neuron signs and eliminated the parietal N20 P27-P45 while the prerolandic P22-N30 persisted at usual latencies. The neural generators for the N20 and the P22 components are thus distinct. It is also proposed that direct, short latency pathways convey somatosensory inputs to the motor cortex, independently of connections via parietal areas 2 and 5. Enhancement of P22-N30 after chronic parietal lesions suggests collateral reinnervation by residual inputs after partial deafferentiation of prerolandic cortex. Small postcentral lesions produced astereognosis (with preserved tactile and deep sensation) and reduced or eliminated the N20 and P27 SEP components, but did not affect the P22-N30 components. Precentral lesions with severe hemiplegia (but not prefrontal lesions) eliminated the prerolandic P22-N30 SEP components and did not alter the parietal N20-P27-P45 components. The data are pertinent to the understanding of the pathophysiology of somatosensory deficits and for the diagnostic use of SEPs in cerebral lesions. PMID- 6850274 TI - Callosal apraxia. AB - A 43-year-old woman suffered a spontaneous corpus callosum disconnection, resulting in apraxia and apraxic agraphia confined to the left hand. She initially had a functionally total callosal disconnection. With time, the splenium of the corpus callosum became functional, and a computerized tomographic scan performed five months after the onset showed infarction of only the body of the corpus callosum. Concomitant with this improvement in callosal function, the apraxia changed from ideational (loss of the concept of skilled movements) to classic ideomotor apraxia. A temporal analysis of this case provided support for Liepmann's (Liepmann, 1900; Liepmann and Maas, 1970) hypothesis that there is a centre for visuokinaesthetic (space-time) engrams in the left hemisphere of right handed patients that controls skilled motor acts in either hand. This patient's recovery also allowed us a better understanding of the mechanisms underlying various types of apraxia. PMID- 6850275 TI - Lipids of developing brain of twitcher mouse. An authentic murine model of human Krabbe disease. AB - Brains of the newly discovered neurological mutant of the mouse, twitcher, were analysed from birth to the terminal stage of the disease for major tissue constituents and the lipid composition. A genetic deficiency of galactosylceramidase is the underlying cause of this mutant. The affected mice failed to gain body weight after 20 days (30 per cent of normal at 42 days) but the brain weight was much less affected (85 per cent of normal at 42 days). The water content and the four major fractions, chloroform-methanol insoluble residue, chloroform-methanol soluble protein, upper phase solids and total lipid, were essentially unaltered except that the total lipid was reduced slightly towards the terminal stage. Among lipids, only galactolipids, galactosylceramide and sulphatide were abnormal in the twitcher brain. Galactosylceramide was decreased at 37 and 42 days whereas decrease in sulphatide occurred earlier from 25 days, resulting in an increased ratio of galactosylceramide to sulphatide. The analytical abnormalities found in the twitcher brain are qualitatively similar to and quantitatively milder than those in the brain of human patients with globoid cell leukodystrophy (Krabbe disease), of which the twitcher is an enzymatically authentic animal model. The secondary abnormalities observed in brains of human patients as the result of tissue devastation were generally not present in the twitcher brain. Mouse brains contain relatively little myelin. As the pathology in twitcher is greatest in the spinal cord and brainstem (Duchen et al., 1980), the fact that the changes in twitcher brains are quantitatively milder than those of human patients may partly reflect the relative amount of myelin in the two species. While more detailed studies of some specific constituents, such as galactosylsphingosine, and of other tissues, such as the peripheral nervous system and the kidney, will have to be performed, the present results serve as the reference for comparison between the human and murine galactosylceramidase deficiency states and for future experiments with the twitcher mutant, which is an invaluable tool for studies of globoid cell leukodystrophy. PMID- 6850276 TI - Critical perfusion of brain and retina. AB - Four patients with extensive occlusive disease of the extracranial arteries are described. All suffered attacks of visual loss due to transient retinal ischaemia and all developed the haemorrhagic changes of low-flow retinopathy. Resting cerebral blood flow was within normal limits in all patients. The attacks were provoked by falls in systemic blood pressure or, in one patient, by facial heating. The probable mechanism in this last case is thought to be diversion of blood to a dilated external carotid vascular bed. Temporary cerebral and brachial symptoms occurred but no permanent changes developed. Successful surgical reconstruction was achieved in two patients with relief of symptoms. PMID- 6850277 TI - Alexia without agraphia in a composer. AB - A 77-year-old composer had a left occipital lobe haemorrhagic infarct giving a severe reading disturbance with well-preserved writing and without appreciable aphasia. He continued to read music and to compose. His text- and music-reading performance under different conditions suggests that this unusual dissociation was primarily due to four factors. (1) He was unusually talented musically and inferred a great deal about the music he was reading. (2) The symbols of staff music notation are more visually distinctive than the symbols of phonetic language writing systems. (3) In staff music notation, pitch is represented ordinally, and other symbols are also distinguishable by their relative positions and sizes. (4) Music notation can be usefully read by interpreting it acoustically, kinaesthetically or in terms of formal musical concepts; in contrast to written language, it need not be interpreted referentially or in terms of auditory-verbal images. His disorder fits the classic visual-verbal disconnection account of alexia without agraphia and the contemporary view that music involves a family of related but distinct skills probably involving many brain areas in both hemispheres, although different cortical areas make characteristic contributions to different musical behaviours. PMID- 6850278 TI - Selective olfactory deficits in case H.M. AB - A variety of olfactory capacities were evaluated in H.M., a patient with bilateral medial temporal lobe resection. He demonstrated normal performance on a battery of tests of odour detection, discrimination of intensity, and adaptation. In striking contrast, H.M. was unable to discriminate or identify odours in same different discriminations and in matching-to-sample tasks. Although he could name common objects using visual or tactile cues, he could not identify them by smell. These results indicate that the perceptual phenomena of odour detection and discrimination are dissociable by cerebral damage, and that structures in the medial temporal lobe play a critical role in odour discrimination. PMID- 6850279 TI - Visual receptive fields and response properties of neurons in human temporal lobe and visual pathways. AB - Recordings were made from depth electrodes placed in medial temporal and occipital lobes for the localization of seizure foci in patients with medically intractable psychomotor epilepsy. Electrodes were located in the amygdala and at three rostrocaudal levels of the hippocampal formation including the posterior hippocampal gyrus, which lies medial to the portion of the geniculostriate pathway which passes through the temporal lobe. 1. Approximately 10 per cent of single units recorded from microelectrodes chronically implanted in medial temporal sites were visually responsive. Some of the units in the posterior hippocampal gyrus displayed receptive field characteristics similar to those reported in lower primates, including circular or linear shape, monocular or binocular response, variable (1 to 10 deg) receptive field size, retinotopic organization and sustained or transient response. 2. Visually responsive units were also recorded from lateral geniculate nucleus, pulvinar nucleus and occipital cortex, and their basic response form and latencies compared with the short latency visually responsive cells in medial temporal lobe. 3. The heterogeneity of receptive field characteristics in the medial temporal lobe is consistent with the existence of more than one visual input to this region, while their retinotopic relationship differentiates these receptive fields from those of units studied in the inferior temporal lobe of lower primates. 4. Properties of visual pathways in this region are discussed in relation to several types of temporal lobe function and to memory. Recordings from these neurons offer a rare opportunity for comparison of central visual response properties and receptive field characteristics of humans with those reported in animal studies. PMID- 6850280 TI - Blood pressure and vasopressin in progressive autonomic failure. Response to postural stimulation, L-dopa and naloxone. AB - We showed previously that patients with progressive autonomic failure with multiple system atrophy (MSA) failed to excrete a water load while they were standing, suggesting abnormal postural regulation of vasopressin release. The rise of plasma arginine vasopressin (AVP) with upright posture is modulated by central dopamine and opioid receptors. Patients with MSA may have depletion of brain dopamine and opioid peptides. We measured the plasma levels of AVP in patients with MSA and control subjects during postural stimulation by head-up tilt and the inhibition of this rise in AVP by L-DOPA (dopamine precursor) and naloxone (opiate antagonist). Since L-DOPA and naxolone can alleviate hypotension, we also studied the effects of these agents on orthostatic hypotension. Plasma AVP concentration of normal subjects rose progressively over 90 min of head-up tilt and this postural rise in AVP was abolished by L-DOPA and naloxone. Patients with MSA had similar levels of AVP while horizontal. However, they showed a severely blunted postural AVP response since their levels rose to only 10 per cent of the rise in the normal subjects despite the additional stimulus to AVP secretion of considerable postural hypotension. They also showed no inhibition of AVP secretion by L-DOPA or naloxone. Naloxone did not alter the blood pressure of either group. Although L-DOPA did not change the blood pressure of normal subjects, it lowered it in patients with MSA both while they were horizontal and tilted. IN CONCLUSION: (1) the postural stimulation of AVP release is blunted in MSA; (2) this postural rise in AVP is not inhibited by a dopamine agonist or opioid antagonist in MSA suggesting loss of dopaminergic and opioid pathways involved in AVP release; (3) endogenous opioids do not contribute to orthostatic hypotension in MSA; (4) patients with MSA are supersensitive to the hypotensive effects of an acute L-DOPA infusion. PMID- 6850282 TI - Phylogeny through brain traits: objectives and method. PMID- 6850281 TI - Transport of oxygen to the brain in patients with elevated haematocrit values before and after venesection. AB - Cerebral blood flow and oxygen transport to the brain have been studied in 20 patients with primary polycythaemia, before and after venesection. Cerebral blood flow rose by an average of 30 per cent (P less than 0.001) when the mean haematocrit was reduced from 0.537 to 0.444. Whole blood viscosity fell predictably and the correlation coefficient between haematocrit and blood viscosity at a shear rate of 91 s-1 was 0.926 (P less than 0.001). Mean arterial blood pressure, arterial PCO2 and pH were not influenced by venesection. A small but significant overall rise in arterial PO2 was observed but the arterial oxygen content fell with the reduction in haemoglobin concentration. The product of cerebral blood flow and arterial oxygen content rose by an average of 8 per cent (P less than 0.001) and this was considered physiologically significant because the position of the oxygen dissociation curve did not change. The increase in oxygen transport to the brain may serve to protect against ischaemic insult and other mechanisms whereby elevated haemotocrit might predispose to cerebral infarction are briefly discussed. PMID- 6850283 TI - Phylogeny through brain traits: trees generated by neural characters. AB - Phylogenetic trees were computed by the Wagner algorithm from data on up to 15 brain characters scored on 154 specimens of 134 mammalian species. Because the data were not complete on all specimens, only one tree, of 18 taxa, was generated on all 15 features; a tree of 99 species was computed from 10 characters, and trees of 38 species from 10 and 12. The 38-taxon trees were considered best because they preserved most completely the integrity of mammalian orders. All trees consistently separated the subclasses of mammals and suggested that rodents, insectivores, and the tree shrew were most derived on the basis of brain characters. The trees' shapes are sensitive to small alterations in character scorings, largely because of the relatively few characters available and small differences in the number of states among them. PMID- 6850284 TI - Phylogeny through brain traits: the mammalian family tree. AB - Wagner trees based on the analysis of 15 brain characters scored on 154 specimens of 134 mammalian species show consistent patterns of relationship among the taxa, i.e. (1) monotremes are the primitive complement of the group uniting marsupials and placentals; (2) among marsupials, diprotodont Australian forms are more derived; (3) placental mammals divide into two groups of orders, roughly the ferungulates (carnivores, ungulates, and subungulates) and the unguiculates-plus gliroids (chiropterans, dermopterans, lagomorphs, rodents, primates, and insectivores including elephant shrews); (4) edentates sit at the base of or just before the placental dichotomy; (5) the tree shrew and tarsier show the same pattern of distribution of brain traits as some rodents, as do prosimians and New World monkeys. PMID- 6850285 TI - Antidromic conduction in a direct posterior pathway from midbrain to hippocampus. AB - An average field response to electrical stimulation in the hippocampus has been recorded in dorsomedial rat midbrain. The fully developed response is triphasic. Latencies of the three components and their behavior during repetitive stimulation are compatible with the assumption that they are antidromic and originate, respectively, in proximal axons, cell bodies and dendrites. Conduction velocity is estimated to be 5 m/s. Reversal in polarity of the response at different recording points within a distance of 1 mm and abolition by small midbrain lesions confirm location of the active neural elements in that region. Lesions in the white matter of posterior cingulum and in the thalamocortical radiation abolish the response. Latencies of the response recorded in the thalamocortical radiation are in accord with the conclusion that the fibers pass in this location. The findings support results of an earlier study suggesting that visual information is transmitted without a synapse from dorsomedial midbrain to dentate gyrus by a pathway that reaches the cerebral hemisphere in the thalamocortical radiation and enters hippocampus from white matter in the posterior cingulum. A study of visual responses in the medial and dorsal wall of the cerebral hemisphere in lizards may help to evaluate the hypothesis that in these regions are the ancestral homologues for dentate gyrus and cornu ammonis, respectively, in mammalian hippocampus. PMID- 6850286 TI - Androgen and estrogen receptors in adult hamster brain. AB - Both androgen and estrogen receptors are present in the hypothalamus-preoptic area and remaining "brain' regions of gonadectomized adult male and female hamsters. No quantitative or qualitative sex differences are detectable in either receptor system. According to all biochemical criteria tested, both receptors are qualitatively similar to those present in mouse and rat brain. However, there are striking species differences in both the relative concentration and distribution of both androgen and estrogen receptors in hamster brain compared to mouse and rat brain. PMID- 6850287 TI - Serotonin stimulates vasoactive intestinal polypeptide release from rat hypothalamus in vitro. PMID- 6850288 TI - Influences of the limbic system on hypothalamo-neurohypophysial system. AB - (1) Effects of stimulations of various limbic structures (the olfactory bulb, olfactory tubercle, prepyriform cortex, endopyriform nucleus and various parts of amygdaloid nuclei) on the neurosecretory neurons in the supraoptic (SON) and paraventricular nuclei (PVN) of the hypothalamus were studied. All regions stimulated received strong inputs from the olfactory bulb. (2) Out of 195 "identified' neurosecretory neurons tested one-half or more (49-74%, depending on the structures stimulated) were inhibited by stimuli consisting of 1-3 short pulses. The inhibition occurred immediately after the stimulus in approximately one-fifty of all inhibited neurons, in the remaining four-fifths inhibition occurred after more than 20 ms latency. Inhibition of neurosecretory neuron activity lasted for several hundred milliseconds, often followed by clear post inhibitory excitation or rebound. (3) In 23 neurons, a distinct "evoked' response of brief duration occurred with a 30 ms latency following stimulation of the lateral and medical amygdala, olfactory tubercle and prepyriform cortex. In another 17 neurons, a general increase in background activity with a longer latency (50-100 ms) occurred following stimulation of nearly all amygdaloid nuclei, olfactory tubercle and the pyriform cortex: lateral amygdala stimulation caused an excitation of the largest proportion of neurosecretory cells (30%) while none was excited by stimulation of the olfactory bulb and endopyriform cortex, except those occurring as post-inhibitory excitation. (4) There was a convergence of afferent impulses on single neurosecretory cells. A large proportion (42%) of the neurons received inputs from 2 to 4 limbic regions. (5) Neurosecretory cells which were influenced by limbic stimuli were also inhibited by baroreceptor activation and excited by osmotic stimulation. "Unidentified' neurons within SON and PVN and "atypical neurosecretory cells' (those responding to pituitary stalk stimulation with varying latencies) were also affected by the forebrain stimulation; some of these were also affected by an osmotic stimulus. A part of this group may send their axons to the median eminence. PMID- 6850291 TI - Behavioural responses to hypothalamic cooling and heating in the rat. AB - Rats with hypothalamic thermodes had their hypothalamus cooled or warmed for short sessions. In a first series of experiments, rats could bar-press to obtain fanning with cool air. Cooling the hypothalamus did not suppress or inhibit this behaviour although rectal temperature was markedly increased. In a second series of experiments, bar-pressing would warm the water flowing in the thermode. The rats thus self suppressed the cooling of their hypothalamus. This behaviour was absent at 10 degrees C ambient temperature, and increased with increasing ambient temperature up to 35 degrees C. The result of this behaviour was a small hyperthermia in warm and hot environment compared to control when the rats could not self-suppress the cooling of hypothalamus. The results of both experiments suggest that no conscious direct sensation is aroused by hypothalamic cooling. Hypothalamic heating increased the rat's bar-pressing for cool air and decreased the rat's rectal temperature. When pressure on the lever would suppress a warm hypothalamic stimulus rats self-cooled their hypothalamus, especially in warm environments. Such behaviour resulted in an increased somatic hyperthermia due to the warm environment and hypothalamic cooling. These results are compatible with the hypothesis of a direct conscious sensation from a warm hypothalamus. PMID- 6850290 TI - Depth evoked potential and single unit correlates of vertex midlatency auditory evoked responses. AB - The rostral brainstem and thalamus of awake cats were studied for depth correlates of a surface-recorded midlatency auditory evoked potential, wave "A', with a latency range of 17-25 ms. In response to clicks or pure tones, midlatency potentials were recorded from the level of the cuneiform nucleus (14-15 ms latencies) forward through the medial tegmentum to the level of the intralaminar thalamic nuclei centralis lateralis (CL) and center median (CM) (17-19 ms latencies). While this medial projection system to the thalamus involved primarily CL and CM, slightly longer latency responses were also found in nucleus ventralis anterior (VA) and ventralis lateralis (VL). A ventral diencephalic response was characterized by latencies averaging 0.5-1.2 ms less than those from the dorsal thalamic regions. Both surface and depth midlatency potentials showed comparable sensitivity to rate of stimulation. At click rates above 1/s, peak amplitudes diminished, and for rates greater than 10/s, both surface and depth midlatency responses were abolished. This rate sensitivity differs from that of the auditory brainstem responses (ABRs), which are essentially unchanged at rates of 20/s. Whereas ABRs are unaffected by surgical levels of sodium pentobarbital, the surface and depth midlatency potentials are replaced by a deep negativity within minutes following administration of anesthesia. Extracellular recordings of acoustically responsive single units in CL and CM demonstrated latencies comparable to the CL and CM field potential latencies. Both the units and field potentials were similarly rate sensitive. Each auditory unit showed a best frequency response, but none demonstrated somatosensory convergence. Bilateral aspiration of the inferior colliculus did not abolish the midlatency depth or surface responses. Rather, recordings in CL and CM suggested response enhancement over a two week postoperative period. Taken together these data suggest that the midlatency vertex potential, wave "A', reflects a generator system which projects from cuneiform nucleus, through the medial tegmentum to the medial thalamus, particularly to CL and CM. The functional significance of this medial auditory projection system remains to be determined. It could mediate physiological correlates of "state', modulate sensory input or motor output, or it could provide an integrative mechanism for the focusing of auditory attention. PMID- 6850289 TI - The effects of lesions of nucleus rotundus on visual intensity difference thresholds in turtles (Chrysemys picta). AB - Intensity difference thresholds were assessed behaviorally in 7 painted turtles (Chrysemys picta) before and after lesions of nucleus rotundus thalami or control lesions. Three subjects with control lesions and two subjects with slight bilateral damage to nucleus rotundus showed no permanent elevation of threshold postoperatively. In contrast, two subjects with severe damage to nucleus rotundus showed threshold elevations postoperatively and did not recover with further training. The impairment shown by these subjects with damage to nucleus rotundus appeared to be only on the more difficult problems; they performed as they had preoperatively on easy discriminations. PMID- 6850294 TI - An ultrastructural study of serially sectioned Renshaw cells. III. Quantitative distribution of synaptic boutons. AB - The quantitative distribution of synaptic boutons on 17 presumed Renshaw cells has been studied ultrastructurally. All 17 neurons were postsynaptic to axon collateral boutons of intracellularly HRP-stained triceps surae alpha-motoneurons and were located in lamina VII, ventromedially to the main motor nuclei. In each of the presumed Renshaw cells, the values for mean length and mean area of apposition, percentage synaptic covering, and packing density of S-type, F-type, and S + F-type boutons were estimated on the cell body and in two dendritic compartments. The F/S percentage synaptic covering ratio was also calculated. The previously demonstrated differences within the present group of neurons, with respect to the site of axonal origin, were not accompanied by any corresponding differences in the quantitative distribution of synaptic boutons. However, it is suggested that the presumed Renshaw cells may possibly fall into two categories with respect to the F/S percentage synaptic covering ratio. The results are discussed in relation to previous studies on the neuronal architecture and synaptic types on the same presumed Renshaw cells, as well as in relation to earlier observations on the quantitative distribution of boutons on central neurons, particularly spinal alpha-motoneurons. PMID- 6850292 TI - Development of catecholaminergic nerves in the spinal cord of the rat. AB - The development of the noradrenergic and dopaminergic innervations in the spinal cord of rat was studied using fluorescence histochemical and neurochemical methods. From fetal day (FD) 16 to neonatal day (ND) 26, the cord increased in weight by 4-6 mg/day, except for the period between ND 14 and 20, when the increase was 13 mg/day. Norepinephrine was first detectable in the whole cord at ND 18, and then increased rapidly thereafter, peaking at ND 14, then declining at the end of neonatal life to the values found in the young adult spinal cord. The innervation in the intermediolateral cell column of the thoracic cord appeared to be more extensive at ND 14 than in the adult, raising the possibility of the selective destruction of a part of this noradrenergic innervation during later development. The nerve terminals in the ventral horn were first visualized clearly at birth, with a pattern similar to that of the adult. When the fetal locus coeruleus is transplanted into the transected spinal cord of the adult rat, it induces an extensive proliferation of the cut rostral axons in the ventral horn specifically. It is proposed that the transplanted fetal locus coeruleus produces a neurotrophic substance which stimulates the proliferation of the cut rostral axons derived from the locus coeruleus. Dopamine was first detectable in the cord at ND 20. Unlike noradrenergic nerves, dopaminergic nerves developed slowly throughout neonatal life. The adult innervation presumably develops slowly between ND 26 and young adulthood. In the fetus and very young neonate, DA was most concentrated in the thoracic region. Dopamine metabolism in the cord during neonatal life was a fraction of that found in the adult. It is concluded that the spinal dopaminergic and noradrenergic innervations develop with quite different time sequences. The rapid peaking of the noradrenergic innervation of ND 14 may play a significant role in the overall development and functional maturation of the cord. PMID- 6850293 TI - Sprouting of mammalian motor neurones at nodes of Ranvier: the role of the denervated motor endplate. AB - Treatment of the mouse gluteus maximus with the organophosphorus anticholinesterase ecothiopate, 4-aminopyridine and caffeine caused necrosis of the endplate region of the muscle fibres. When these drugs were given 12 h prior to partial denervation of the muscle there was a significant reduction in the amount of nodal sprouting seen 48 h after nerve section. No such reduction was seen if the drugs were given immediately after nerve section. In the former case both innervated and denervated fibres are necrotic; in the latter, only innervated fibres are necrotic. The amount of terminal sprouting was significantly increased in the former group, showing that the drug treatment and necrosis were not directly inhibitory to nerve growth. The reduction of nodal sprouting is therefore likely to be due to necrosis of denervated fibres; this supports the hypothesis that the denervated endplate is the source of a stimulus to nodal sprouting of motoneurones. PMID- 6850298 TI - Audio-motor reflexes in lower lip motor units having different recruitment thresholds. PMID- 6850297 TI - The effect of neonatal testosterone on specific male and female patterns of phosphorylated cytosolic proteins in the rat preoptic-hypothalamus, cortex and amygdala. AB - This study demonstrates that in the rat there are specific patterns of in vitro phosphorylation of cytosolic proteins for the preoptic-hypothalamus, cortex, and amygdala. Furthermore, there are sex-specific patterns for the male and female preoptic-hypothalamus. These sex-specific patterns are controlled by the sex steroid environment of the neonatal rat. If testosterone was removed by neonatal castration of a male, the female pattern of in vitro phosphorylated proteins was found in the adult preoptic-hypothalamus. Conversely, if a neonatal female was androgenized at 2 days by a single injection of testosterone, a male-like pattern was found in the adult preoptic-hypothalamus. Treatment of neonatal females or males did not alter the adult patterns of in vitro protein phosphorylation in the cortex, but such treatments did give rise to anomalous patterns in the amygdala. Thus, as with behavioral and structural characteristics of the preoptic hypothalamus, the spectrum of phosphorylated proteins in this region also seems to be organized by neonatal testosterone. PMID- 6850296 TI - Rat brain cells in primary culture: visualization and measurement of catecholamines. AB - Catecholamines have been visualized and quantified in primary cultures of whole rat brain. Twenty-one-day old cultures treated with glyoxylic acid and viewed under a fluorescence microscope revealed neurons stained specifically with blue green catecholamine fluorescence. Brightly stained multipolar cell bodies were seen, along with stained neurites and varicosities, and there was no staining associated with the non-neuronal portion of the culture. Twenty-one-day-old non neuron-enriched cultures contained 10-20 times less norepinephrine and dopamine than cytosine arabinoside-treated neuron-enriched cultures. The latter cultures contained 10-12 times more norepinephrine than 1-day-old rat brains, demonstrating maturation and differentiation of the cultured neurons. Norepinephrine levels of neuron-enriched cultures were, however, 3 times less than those in 21-day-old rat brains. The cultured neurons had the ability to synthesize catecholamines since levels were decreased with alpha-methyl-p tryosine. On the other hand, the growth medium contained significant amounts of norepinephrine, but did not have the ability to synthesize catecholamines. It may be concluded that the cellular catecholamines are not derived from the medium in any great amounts. This study provides the basis of a system in which to examine catecholaminergic neurotransmission and peptide catecholamine interactions at the cellular level under semi-defined conditions. PMID- 6850299 TI - Organization of stabilizing reflex responses in tibialis anterior muscles following ankle flexion perturbations of standing man. AB - Reflex activity in human ankle muscles in response to 36 deg./s dorsi-flexion rotations of the feet was investigated in subjects standing upright and when leaning back so as to preactivate ankle flexor muscles. Short latency stretch reflex activity in soleus and inhibition in tibialis anterior muscles occurred at 50 ms from ankle rotation onset. Two prominent bursts of tibialis activity followed at 83 and 131 ms. and preceded large stabilizing ankle torques. Head movements commenced 20 ms after foot rotations and acquired accelerations exceeding 100 deg./s2 within 60 ms. It is suggested that the tibialis anterior activity is either a vestibulospinal reflex resulting from the head movement, or a stretch reflex only present during standing, since this activity was not observed when seated subjects received identical foot rotations. PMID- 6850295 TI - Effects of complex or isolated environments on cortical dendrites of middle-aged rats. AB - Female rats were placed into complex (EC) or isolated (IC) environments for 45 days, beginning at 450 days of age. Golgi-Cox stained layer IV stellate and layer III occipital cortical pyramidal neurons were analyzed for numbers and lengths of dendritic branches and the amount and location of dendritic material with respect to the soma. In both cell populations, neurons from EC rats had significantly more dendritic material, with differences occurring throughout the dendritic field. In the stellate population, EC neurons had significantly longer terminating (non-bifurcating) branches, and more second and fifth order branches. In pyramidal cells, EC neurons had significantly more branches at each of orders 2-5 as well as significantly longer terminating branches. This report is the first to describe substantial dendritic alterations subsequent to differential housing in middle-aged rats. These results, taken with previous work, suggest that experience may affect neuronal structure over much of an animal's lifespan. PMID- 6850301 TI - The relationship between the distribution of motor unit mechanical properties and the forces due to recruitment and to rate coding for the generation of muscle force. PMID- 6850300 TI - Relay neurons mediate collateral inhibition of the goldfish Mauthner cell. PMID- 6850302 TI - Synaptic noise-triggered averaging as a technique for investigating the origin of EPSPs. AB - A method to investigate the origin of EPSPs has been introduced and its application to recordings from spinal motoneurons allows an estimate to be made of the proportion of spontaneous EPSPs being of monosynaptic muscle afferent origin. Furthermore its application to the largest muscle stretch evoked EPSPs indicates that they can be of either monosynaptic muscle spindle Ia action or can be interneuronally mediated. PMID- 6850303 TI - Effect of core cooling on short and long latency reflex responses. AB - Subjects were immersed in 10 degrees C water until the rectal temperature dropped to 35 degrees C. Reflexes of wrist flexors were tested before and after cooling with tendon taps and torque motor produced perturbations. Comparison of pre- and post-cooling reflex responses showed that the longer latency reflex (LLR) was delayed in onset more than the short latency monosynaptic reflex (SLR) response. This implies that a portion of the LLR pathway is separate and distinct from the SLR pathway. PMID- 6850305 TI - Peripheral sensory input directs apomorphine-induced circling in rats. PMID- 6850306 TI - Distribution of Met5-enkephalin-Arg6, Phe7 in rat spinal cord. AB - The distribution of Met5-enkephalin-Arg6, Phe7 (YGGFMRF) in rat spinal cord was determined by a specific RIA and compared with that of Met5-enkephalin. The concentration of YGGFMRF on a per mg protein basis was highest in sacral cord and successively decreased in more rostral segments. A similar rostro-caudal distribution was observed for Met5-enkephalin. Regional microdissection revealed the dorsal grey matter to be highest in YGGFMRF content followed by ventral gray, ventral white and dorsal white matter; a similar pattern was observed for Met5 enkephalin. The ratio of Met5-enkephalin: YGGFMRF concentration was 5.4 +/- 0.15 (S.E.M.) on average in all regions measured, indicating a very close quantitative relationship between the two molecules. Our data suggest that YGGFMRF may act as a precursor of or cotransmitter with Met5-enkephalin in spinal cord tissue. PMID- 6850304 TI - Aldosterone blocks the response to corticosterone in the raphe-hippocampal serotonin system. AB - The accumulation of serotonin induced by the monoamino oxidase inhibitor pargyline was used as an index for 5-HT turnover in the dorsal hippocampus and raphe area. A low dose of corticosterone administered s.c. immediately after adrenalectomy significantly increased serotonin turnover in both regions over the subsequent 1 h interval. The same dose of aldosterone was ineffective, but pretreatment with aldosterone blocked the serotonin response to corticosterone in the acutely adrenalectomized rat. [3H]Corticosterone administered to adrenalectomized rats was not retained by cell nuclei of the raphe area in a limited capacity manner as occurred in the hippocampus. Pretreatment with aldosterone blocked the uptake of [3H]corticosterone in hippocampal cell nuclei. It is concluded that corticosterone triggers a serotonin response and that the specificity of the corticosterone action suggests involvement of the steroid receptor system located postsynaptically to the raphe-hippocampal serotonin projection. PMID- 6850307 TI - Met5-enkephalin: potent contraversive rotation after microinjection in rat substantia nigra. AB - This study reports a novel action of Met5-enkephalin in the rat substantia nigra, i.e. potent contraversive rotation that is dose-dependent, site-specific, mimicked by morphine and blocked by naloxone. These results suggest that this pentapeptide may play an important modulatory role in the control of movement in this region of the central nervous system. Alterations in endogenous Met enkephalin levels in the substantia nigra may be a contributive factor in Parkinson's disease, a movement disorder related to neuropathology of the substantia nigra. PMID- 6850308 TI - Intrahypothalamic 5,7-dihydroxytryptamine facilitates feminine sexual behavior and decreases [3H]imipramine binding and 5-HT uptake. AB - 5,7-Dihydroxytryptamine (5,7-DHT) injected into the hypothalamus facilitated feminine sexual behavior in ovariectomized, estrogen-treated female rats beginning 9 days post-lesion. 5,7-DHT treatment was associated with decreased [3H]5-HT but not [3H]NE uptake in the whole hypothalamus and with decreased [3H] imipramine binding in some hypothalamic nuclei. These data provide the first demonstration using chemical lesions that 5-HT neurons may exert tonic inhibition on hormone-mediated feminine sexual behavior. PMID- 6850310 TI - Localizing the corticospinal neurons in neonatal, developing and mature albino rat. AB - Following the administration of horseradish peroxidase (HRP) in the middle or lower cervical cord segments of neonatal (1-10 days), developing (15-20 days) and mature (2-4 months) albino rats, labeled pyramidal neurons were found in layer V of the cerebral cortex. They formed one continuous band of labeled neurons in the frontal and parietal isocortex in neonatal animals. The band began close to the frontal pole and extended distally for about 3600 microns. Mediolaterally the lateral limit of the band was at the dorsal lip of the rhinal sulcus. Neurons in the 'shoulder' region along the medial surface of the cerebral hemisphere were also labeled. As the animals increased in age it became increasingly more difficult to label the pyramidal neurons in the parietal band. The band appeared broken and discontinuous in the parietal region in the 15-day-old rats. In the 20 day-old and mature rats the labeled neurons appeared in two bands, a dorsolateral one and a parietal one, the two being separated by a variable gap of cortex where practically no or very few neurons were labeled. Labeled neurons in the 'shoulder' region were distinctly seen only in the rostral region of the frontal isocortex in older animals. Following the administration of HRP in lumbosacral cord segments, no labeled layer V pyramidal neurons were seen in the 2-day-old rats, but they were seen to form one continuous band in the dorsolateral part of the cerebral cortex in rats aged 5 days postnatally and older. They appeared in a caudo-rostral sequence, with neurons in the caudal part of the cerebral cortex projecting to the more caudal cord segments and those in the frontal part to the more rostral cord segments. Mediolaterally the band was about 2 mm wide. Neurons in the 'shoulder' region were infrequently seen in neonatal and developing animals. PMID- 6850309 TI - The effects of naloxone on the neural control of the urinary bladder of the cat. AB - Naloxone in doses ranging from 0.5 to 512 micrograms/kg i.v., enhanced reflex contractions of the urinary bladder of the cat. At the lowest doses (threshold, 0.5-5 micrograms/kg) the drug increased the frequency of spontaneous bladder contractions. In large doses (10-100 micrograms/kg) the drug produced an initial tonic contraction of bladder lasting 15-40 min followed by a period of high frequency rhythmic activity. Multiunit firing in parasympathetic postganglionic nerves on the surface of the urinary bladder was also enhanced. Bursts of firing which in untreated animals occurred during large bladder contractions occurred continuously during the entire sustained contraction of the bladder following large doses of naloxone. Various evidence indicates that the site of action of naloxone is in the central nervous system. These findings suggest that the parasympathetic reflex pathway to the urinary bladder may be subject to tonic enkephalinergic inhibitory control. PMID- 6850311 TI - Quantitative histological studies on the hypothalamic paraventricular nucleus in rats. II. Number of local and certain afferent nerve terminals. AB - The total number and the numerical ratio of extrinsic and intrinsic (local) innervations of magnocellular neurons in the paraventricular nucleus (mPVN) were determined after surgical isolation of the nucleus in rats. Various lesions and transections of fibers running to the mPVN were performed to determine the number and possible sources of septal, hippocampal and caudal periventricular fibers to the mPVN. The relatively high proportion of possibly intrinsic connections (43%) suggests a local, integrative function of neuronal activity in the PVN. On the average, 57% of the total number of presynaptic boutons have been found to originate from outside the nucleus (extrinsic afferentation). Only 7% of these fibers ascend from caudal through the periventricular area. mPVN afferents originating from the ventral subiculum and from the lateral septal nucleus comprise about 3 and 5% of the extrinsic afferentation, respectively. PMID- 6850312 TI - A difference in the nucleoli of Purkinje cells of the nodular lobe of the hamster cerebellum. AB - Purkinje cells of the hamster cerebellum typically contain a large, single, centrally located nucleolus. Strikingly different are Purkinje cells concentrated in the nodular cortex, which characteristically contain several small, pale staining nucleoli, most of which are peripherally located, in contact with the nuclear envelope. These atypical cells are also smaller, their Nissl bodies stain less intensely, and their nuclear envelopes appear more invaginated. Functional differences are implicit. PMID- 6850313 TI - Group II muscle afferents and low threshold mechanoreceptive skin afferents converging onto interneurons in a common reflex pathway to alpha-motoneurons. PMID- 6850314 TI - Chloral hydrate anesthesia blocks the excitatory response of dorsal raphe neurons to phasic auditory and visual stimuli in cats. PMID- 6850316 TI - Distinct X- and Y-streams in the cat visual cortex revealed by bicuculline application. AB - Responses of striate cortical 'simple' cells to photic stimuli were compared with those of X- and Y-geniculate cells as the simple cells' intra-cortical inhibitory inputs were locally blocked by bicuculline. Blockage was confirmed in 21 simple cells by substantial reductions of their orientation and direction selectivities. All but one of them exhibited either X-like (11) or Y-like (9) responses. This suggests that a given simple cell receives only one type of geniculate input. PMID- 6850315 TI - Localized illumination of the Aplysia and Bulla eye reveals new relationships between retinal layers. AB - The cellular organization of the opisthobranch retina is of interest since the eyes of several of these molluscs express circadian rhythms in optic nerve impulse frequency. In a model for retinal organization proposed by Audesirk, photoreceptors make electrical contacts with higher order cells which generate the compound action potential (CAP) recorded in the optic nerve. However, using micro-illumination on selected retinal regions, we now find that cells near the base of the retina are responsible for light transduction leading to CAPs. Illumination of the distal segments of photoreceptors surrounding the lens generates low-amplitude unitary activity in the optic nerve without CAPs. Furthermore, illumination of this region leads to inhibition of spontaneous CAPs or those generated by illumination of the retinal base. This inhibition is blocked by high magnesium-low calcium solutions and thus we conclude that inhibition and a secretory step comprise at least part of the pathway between the photoreceptor layer and neurons giving rise to the CAP. PMID- 6850317 TI - Inhibitory effect of lithium on neuroleptic and serotonin receptors in rat brain. AB - We investigated the effect of acute and chronic administration of lithium on neuroleptic receptors ([3H]spiroperidol binding sites) and serotonin receptors ([3H]serotonin binding sites) in rat brain. In the limbic-forebrain, both acute and chronic lithium treatment significantly reduced the density (Bmax) of neuroleptic receptors, without affecting the affinity (Kd) of those receptors. However, lithium treatment had no apparent effect on neuroleptic receptors in the caudate-putamen and frontal cortex in either acute or chronic administrations. On the other hand, acute lithium administration markedly decreased the Kd and Bmax of serotonin receptors in the hippocampus, but not in the cerebral cortex; this distinct observation was also found in animals chronically treated with lithium. These results indicate that lithium has an inhibitory effect on neuroleptic receptors in the limbic-forebrain and on serotonin receptors in the hippocampus. Therefore, it is possible to postulate that these effects of lithium in specific brain regions may be related to the therapeutic mechanism of this drug in affective disorders. PMID- 6850318 TI - Suppression of reactive glial proliferation in the denervated dentate gyrus of the rat: effects on the pattern of acetylcholinesterase staining in the molecular layer. PMID- 6850320 TI - Functional correlations between lateral hypothalamic glucose-sensitive neurons and hepatic portal glucose-sensitive units in rat. AB - The effects of glucose injection into the hepatic portal vein on neural activity of the lateral hypothalamic area (LHA) were studied in rats. A majority of identified glucose-sensitive neurons in the LHA were inhibited by portal injection of glucose. This was found to be mediated through the alpha noradrenergic pathways. Most of the glucose-insensitive neurons did not respond to the same procedure. Portal injection of hypertonic saline increased neural activity of some glucose-insensitive neurons but no glucose-sensitive neurons responded. Convergence of hepatic vagal afferent glucose-sensitive units on LHA glucose-sensitive neurons was clarified by this study. PMID- 6850319 TI - Synaptic correlates of associative potentiation/depression: an ultrastructural study in the hippocampus. AB - Brief high-frequency trains delivered to the monosynaptic entorhinal cortical input to the dentate gyrus result in both increases and decreases of synaptic strength as a function of whether a particular afferent is active during conditioning (associative potentiation/depression). The present report concerns the effect of such brief, high-frequency conditioning trains upon the asymmetric synapses of the rat dentate gyrus molecular layer. Only those animals whose responses increased at least 50% following conditioning stimulation were included in the study. Additional animals were used for one-dimensional current source density analyses to localize the activated synaptic region. Double blind scoring procedures were used to classify and quantify electron micrographic data. Asymmetric synapses were scored as a function of their position in the molecular layer, spine head size and shape, and postsynaptic density length. All data were treated as inherently matched comparisons between the conditioned and control sides of each animal. The number of large, concave spine synapses with large postsynaptic densities significantly increases in the central zone of synaptic activation. Bordering this zone are regions with increases in synaptic number following conditioning, primarily due to an increased number of small spine synapses. The increased number of large, concave spine synapses in the central zone is postulated to mediate associative potentiation. The many small spine heads just adjacent to the zone of strongest synaptic activation may reflect synaptic depression evoked at synapses inactive during conditioning. PMID- 6850322 TI - Central connections of the octavolateralis nerves in the pike cichlid, Crenicichla lepidota. AB - The primary projections of the lateral line and eighth (octavolateralis) nerves in the teleost, Crenicichla lepidota, were found to conform to the pattern of projections of these nerves in non-teleost fishes. The lateral line nerves terminate in the dorsal portion of the octavolateralis area of the medulla, the eighth nerve terminates in the ventral portion of this area, and overlap is restricted to nucleus magnocellularis. An anastomotic connection between the posterior lateral line nerve and the eighth nerve, the lateralis branchlet, is composed of posterior lateral line nerve fibers which enter the medulla with the eighth nerve but terminate with lateral line inputs. PMID- 6850321 TI - The identification of specific serotonergic nuclei inhibited by cardiac vagal afferents during acute myocardial ischemia in the rat. AB - Cardio-cardiac autonomic reflexes mediated by the cardiac vagus during acute myocardial infarction play an important role in determining post-infarction hemodynamic function and the susceptibility of the infarcting heart to lethal arrythmias. In an earlier study we had demonstrated that serotonin-containing neurons in the brain participate in the mediation of these reflexes following left coronary artery ligation in the rat. In this study we identify brain serotonin nuclei involved. The accumulation of serotonin was measured in 19 brain nuclei from rats treated with pargyline, a monoamine oxidase inhibitor. The rats were subjected to either left coronary artery ligation or sham operation with or without bilateral cervical vagotomy or lidocaine applied topically only to the left ventricle. Serotonin accumulation was markedly reduced in the nucleus hypothalamicus posterior, nucleus raphe magnus and nuclei-raphe medianus centralis superior in the rats subjected to coronary artery ligation as opposed to sham operation; no other brain regions were affected. The topical application of lidocaine to the left ventricle or vagotomy completely obviated the ligation induced decrease in serotonin turnover. We conclude that there is an inhibition of serotonergic activity in the nucleus hypothalamicus posterior, nucleus raphe magnus and nuclei raphe medianus-centralis superior following left ventricular myocardial infarction in the rat. The afferent signal arises from receptors in the left ventricle and is conducted by the vagus. PMID- 6850325 TI - Cat visual corticopontine cells project to the superior colliculus. PMID- 6850324 TI - Localization of calcitonin binding sites in rat central nervous system: evidence of its neuroactivity. AB - The distribution of calcitonin (CT) binding sites in serial sections of the rat brain and spinal cord has been examined by an 'in vitro' autoradiographic technique using a radioisotope-sensitive sheet film and [125]salmon CT. Autoradiograms of the diencephalic region had the highest grain density throughout the entire hypothalamus, with the exception of the nuclei ventromedialis, posterior and mammillaris, which were not labeled at all. In the brainstem, large amounts of grains were found in the ventrolateral division of the periaqueductal gray, in the locus coeruleus, in the nucleus tractus spinalis nervi trigemini and in the raphe obscurus, pallidus and magnus, while a widespread and lower grain density was observed in the reticular formation. In the spinal cord the labeling was discretely localized in laminae IV, V and VI of the dorsal horn. The observed distribution of CT binding sites is closely related to the neuroendocrine and analgesic effects of exogenous CT and reinforces the concept of a possible neuromodulatory role proposed for the peptide at brain level. PMID- 6850323 TI - A comparison of axonal numbers in dorsal roots following spinal cord hemisection in neonate and adult rats. AB - This study presents myelinated and unmyelinated axon counts from thoracic dorsal roots of rats whose spinal cords were hemisected at birth or at 1 year of age. Axonal numbers from a root on the unoperated side are compared to numbers from the root of the same segment on the operated side of the animal. Counts were made 3 segments cranially and 3 segments caudally from the hemisection. In animals hemisected at birth and sacrificed at 3-8 months, there is a statistically significant increase in unmyelinated axons in roots of the operated as compared to the normal side. We interpret this as sprouting of unmyelinated axons. In animals hemisected at 1 year of age, the statistically significant change was a drop in myelinated axons in roots of the operated side. We interpret this as a loss of myelinated axon cell bodies due to axon section in the dorsal funiculus. Thus axonal sprouting occurs in young rats in our paradigm and a loss of myelinated axons occurs in older animals. We emphasize that different axonal populations respond to hemisection in different ways at different times. PMID- 6850326 TI - The effect of capsaicin application to a peripheral nerve on impulse conduction in functionally identified afferent nerve fibres. AB - Capsaicin applied locally to a coccygeal or saphenous nerve of rats was shown to block impulse conduction in unmyelinated afferent nerve fibres. Shortly after application of capsaicin (1% dissolved in 10% Tween 80 in paraffin oil) conduction of C-fibre--but not A-fibre--compound action potentials across the application site was markedly diminished. No recovery occurred during the period of observation, i.e. up to 2 h afterwards. C-Fibre compound action potentials stimulated and recorded proximal to the application site seemed to be unaffected. Solvent application had no effect. Recording from single units revealed that nociceptive C-fibres responding to strong mechanical and heat stimulation (MH units, polymodal nociceptors) were blocked. In contrast, unmyelinated cold fibres were not affected. The selective block of MH units indicates different membrane properties of unmyelinated MH and cold units not only at the receptive nerve endings, but also at the axons, to which capsaicin was applied. PMID- 6850327 TI - The effect of streptomycin on the neuromuscular junction of the frog. AB - The neuromuscular block produced by streptomycin was studied in the frog sartorius muscle by means of intracellular recording and iontophoretic application of acetylcholine. Decreases of the end-plate potentials (e.p.p.s) and acetylcholine potentials (ACh potentials) were observed following the application of streptomycin. At a concentration of 10(-4) M, the e.p.p. was 36.8 +/- 5.5% (mean +/- S.E.) (n = 12), and the ACh potential was 53.7 +/- 3.8% (n = 12) of the control size. The resting membrane potential and membrane conductance of the muscle fibers were not affected by streptomycin. Streptomycin did not significantly alter the spontaneous prejunctional activity, but the amplitude of the miniature end-plate potentials (m.e.p.p.s) was decreased. After the application of higher concentrations of streptomycin, the quantum content decreased from the control value. It is suggested that the reduction of the e.p.p. amplitude produced by streptomycin is mainly due to a decrease in the sensitivity of the end-plate membrane. In addition, at higher concentrations, streptomycin reduced the amount of transmitter released from the motor nerve in response to a nerve volley. PMID- 6850328 TI - The functional role of the nucleus accumbens in the control of the substantia nigra: electrophysiological investigations in intact and striatum-globus pallidus lesioned rats. AB - The effects of electrical stimulation of the nucleus accumbens on the activity of identified substantia nigra neurons were studied in intact and lesioned rats. The latter had both the caudate-putamen complex and globus pallidus destroyed by electrolytic lesions. In intact rats a total of 42 of 107 neurons (39.2%) responded to stimulation of the nucleus accumbens. Of the 107 neurons 32 (29.8%) were inhibited and 10 (9.4%) were excited. Pure short inhibitions, long latency inhibitions and excitations followed by inhibition were found in both parts of the substantia nigra. Pure long lasting inhibitions were determined on pars compacta cells only. In lesioned animals, in which the coactivation of striatal and/or cortical fibers traversing the accumbens region was avoided, the percentage of responsive neurons decreased to 20% (23/115). The predominant responses recorded in this situation were pure inhibitions of pars compacta cells (14/46) and long latency inhibitions of pars reticulata neurons (7/69). No pure excitation or excitation-inhibition sequence was recorded. In the two sets of experiments 5 cells were activated antidromically from the nucleus accumbens. The results provide electrophysiological evidence for an inhibitory pathway from the nucleus accumbens to the substantia nigra. The low percentage of responsive neurons, the lack of excitatory responses, the paucity of reciprocal connections and the different inhibitory effects on the two populations of nigral neurons demonstrate that the functional role of the nucleus accumbens in controlling the substantia nigra differs from that exerted by the striatum. PMID- 6850329 TI - Immunoreactive thyroid stimulating hormone (TSH)(: association with synaptosomally-rich fractions in the rat hypothalamus. AB - The subcellular compartmentalization of brain thyroid stimulating hormone (TSH) in the hypothalamus of the rat was investigated using differential and discontinuous sucrose density gradient centrifugation. When the mitochondrial fraction (P2) was layered on a discontinuous sucrose density gradient (0.32-1.4 M) and centrifuged for 60 min at 72,000 g, TSH recovered from the gradient was found, by double antibody radioimmunoassay, to be associated preferentially with the synaptosomally-rich layers. The separation was monitored by electron microscopic examination of all fractions obtained throughout the procedure. The addition of a large excess of either [125I]-labeled or unlabeled pituitary TSH at the time of homogenization did not influence the amount of immunoreactive TSH associated with the synaptosome-rich fractions, and both the unlabeled and labeled hormone were recoverable in the final supernatant indicating that the simple addition of peptide to hypothalamic homogenates did not result in any preferential association to any particular subcellular fraction. The apparent association of this brain-based pituitary peptide was not, therefore, an artifact of the homogenization process. It is concluded that an association exists between immunoassayable TSH and brain-based synaptosomes in homogenates of the rodent hypothalamus. PMID- 6850330 TI - Central catecholamine metabolism and hypothalamic self-stimulation behaviour in two inbred strains of mice. AB - These experiments were conducted in order to better understand the role of catecholaminergic neurons in intracranial self-stimulation behaviour (ICSS) elicited from the lateral hypothalamus (LH). Two strains of mice which differ in their ICSS rate and their thresholds were studied. In a first time, we compared the catecholamine (CA) content and activity in various parts of the brain including cell bodies and nerve terminals of the man CA bundle. We used for this determination a high performance liquid chromatographic separation and an electrochemical detection. We observed that the BALB/c strain is distinguished by a higher CA activity than the DBA/2 strain. This correlates with a higher ICSS response rate in the BALB/c strain. The effects of stimulation on CA metabolism were then investigated, the electrodes being implanted specifically either in the dorsal or the ventral part of the LH and the biochemical data obtained analysed separately. Significant enhances of CA turn-over (TO) were noted in nerve terminals as hippocampus, cortex and accumbens. These results provide further evidence for the involvement of dorsal noradrenergic bundle and mesolimbic dopaminergic bundle in LH ICSS. Stimulation in the dorsal part of the LH produced the higher ICSS rate and seemed to induce a large variation of the CA TO. We noted also that the CA metabolism was always more altered in the DBA/2 than in the BALB/c strain, which is surprising in regard to the behaviour and remains unclearly explained. PMID- 6850331 TI - Enhancement of learning four weeks after stimulation of the nucleus locus coeruleus in the rat: differential effects of dorsal noradrenergic bundle lesion and lesion of the locus coeruleus proper. AB - In previous studies we showed that electrical stimulation of the nucleus locus coeruleus produced, four weeks later, a significant improvement in performance in acquisition of food-reinforced operant conditioning. In the two experiments reported here, we tested the role of the dorsal noradrenergic bundle and of the locus coeruleus proper in this long-term effect. Lesioning the dorsal noradrenergic bundle did not have a clear and consistent effect, whereas lesion of the nucleus coeruleus proper suppressed almost totally the beneficial effect of the stimulation. In the first experiment, the dorsal noradrenergic bundle was lesioned by local bilateral injection of 6-hydroxydopamine, 8 days before stimulation of the locus coeruleus. Four weeks after the stimulation, the rats were tested for acquisition of the operant task. Three control groups were used: not lesioned but stimulated, lesioned but not stimulated, and not lesioned/not stimulated. The locus coeruleus stimulation produced the same improvement of performance at the beginning of the acquisition, whether or not the dorsal noradrenergic bundle had been lesioned. However, a significant decrement of performance was observed in lesioned and stimulated rats during the last 40 min of the acquisition. In the second experiment, the locus coeruleus proper was destroyed by bilateral local injection of 6-hydroxydopamine and the locus coeruleus region was stimulated 15 days later. Three control groups were used, as in the first experiment. All the rats were tested 4 weeks later for acquisition of the operant task. The locus coeruleus lesion significantly attenuated the beneficial effect of the stimulation; however, the performance of the lesioned and stimulated rats was still significantly superior to that of the lesioned but not stimulated rats. These results suggest that the noradrenergic locus coeruleus system is involved in the long-term effect, but that the rostral projections passing through the dorsal bundle, in front of the lesion, are not critically involved in the observed effect. PMID- 6850332 TI - Commissural fibers terminate on non-pyramidal neurons in the guinea pig hippocampus -- a combined Golgi/EM degeneration study. AB - The combined Golgi/EM method was applied to guinea pig hippocampi with acute anterograde degeneration of the commissural afferents in order to identify possible synaptic contacts between commissural terminals and non-pyramidal neurons. Degenerating, electron-dense terminals of commissural origin were found in synaptic contact with both perikarya and dendrites of two identified non pyramidal neurons in regio superior, namely a basket cell and a bipolar neuron in stratum oriens. The observed connection may form the morphological basis for the physiologically observed feed-forward inhibition of the pyramidal cells. PMID- 6850335 TI - Light input to crustacean neurosecretory cells. AB - Electrical activity was recorded intracellularly from neurosecretory cells in the crayfish eyestalk identified by lucifer yellow injection. The activity is most commonly enhanced by illumination of retinal fields. Increments in spontaneous activity as well as bursts in otherwise silent cells were the most common type of response. Occasionally light-induced inhibitory responses were recorded. At neuropil level, light pulses result in EPSPs with amplitudes dependent on intensity of light and the previous adaptation to darkness. PMID- 6850334 TI - Immunohistochemical staining of the human forebrain with monoclonal antibody to human choline acetyltransferase. PMID- 6850336 TI - Olfactory receptors respond to blood-borne odorants. PMID- 6850333 TI - Cortico-cortical connections from the visual region of the superior temporal sulcus to frontal eye field in the macaque. PMID- 6850337 TI - Frontal sound source location is represented in the cat cerebellum. PMID- 6850338 TI - Adrenergic stimulation of rat pineal hydroxyindole-O-methyltransferase. PMID- 6850339 TI - Altered visual-evoked potentials in congenitally deaf adults. AB - Visual-evoked potentials recorded from the scalp of congenitally deaf adults were significantly larger over both auditory and visual cortical areas than in normal hearing adults. Over temporal and frontal areas peripheral stimuli presented at long intervals elicited N150 components which were larger in deaf than in hearing subjects. Over occipital and parietal areas peripheral and foveal stimuli elicited larger P230 components in deaf than in hearing subjects. These results imply that early auditory experience influences the organization of the human brain for visual processing. PMID- 6850340 TI - Proportion of unmyelinated axons in the rat inferior alveolar nerve and mandibular molar pulps after neonatal administration of capsaicin. AB - Neonatal rats were given capsaicin subcutaneously. Controls received vehicle only. Six months later the nerve fiber populations in the dorsal root L4, in the inferior alveolar nerve and in mandibular molar pulps were examined by electron microscopy. The proportion of unmyelinated axons was found to be markedly decreased in root and nerve specimens from capsaicin-treated rats. However, the pulpal nerves in tooth specimens from these rats showed no obvious alterations. PMID- 6850341 TI - Cholinergic enhancement of penicillin-induced epileptiform discharges in pyramidal neurons of the guinea pig hippocampus. AB - Acetylcholine (1-20 mM) was applied to guinea pig hippocampal slices bathed in normal and penicillin-containing media. Recordings in the CA 1 pyramidal cell layer in the presence of penicillin showed that acetylcholine caused a prolonged enhancement of the extracellular field potential. Intracellular recordings documented an increase in duration of cell bursting, a decrease in burst afterhyperpolarization, and a membrane depolarization lasting 1-5 min. These results suggest that the actions of acetylcholine to increase membrane excitability interact with penicillin-induced disinhibition to enhance hippocampal epileptogenesis. PMID- 6850342 TI - In vitro motor program for the rostral scratch reflex generated by the turtle spinal cord. PMID- 6850344 TI - Calmodulin infused intracerebroventricularly enhances food intake in the cat. AB - In the fasted cat, calmodulin (CaM) infused into the cerebral ventricle produces an increase in the normal intake of food in a dose-dependent manner. The enhancement of feeding by CaM seems to be functionally specific since the response was: (1) abolished by the simultaneous intraventricular infusion of calcineurin, a specific CaM antagonist; (2) not mimicked by another calcium binding protein, troponin C; and (3) independent of the CaM's lack of effect on body temperature and water intake. This finding opens up the dual possibility that this Ca2+ binding protein may affect receptors other than intracellularly and that CaM is involved in specific functions controlled by the brain. PMID- 6850343 TI - A maturational increase in rat neuromuscular junctional acetylcholine receptors despite disuse or denervation. AB - Junctional acetylcholine receptors (AChR) of rat skeletal muscles were microassayed 4-7 days after denervation or total disuse. The normal growth related increase in AChR number occurred despite denervation or muscle atrophy, but in disused muscles, this increase was less. Thus, at least for short periods, the developmental addition of junctional AChR is independent of muscle fiber size or innervation and partly independent of usage. PMID- 6850345 TI - Dentate granule cells in the rat hippocampal formation have the behavioral characteristics of theta neurons. AB - Recordings were made from the dentate gyrus granule cell layer of freely-moving rats. The neurons recorded from the layer were divisible into 3 classes using a combination of electrophysiological and behavioral criteria; the duration of the extracellularly recorded unfiltered action potential provided the most reliable means of differentiating between cell types. Class I and class II neurons always fired in short duration single action potentials, while class III neurons had broader waveforms and occasionally were observed to fire complex spikes. As the most obvious behavioral correlate of class I and class II neurons was movement of the rat, these cells correspond to the theta cells of Ranck. Class III neurons for which a behavioral correlate was observed had the characteristics of the place cells described by O'Keefe. The neurons of classes I and II comprised 89% (56 of 63) of the total population sampled in the granule cell layer. Most of these neurons (49 of 56) discharged at short latency in response to a stimulus delivered via the perforant pathway; in contrast, none of the class III neurons observed were activated in this way. Horseradish peroxidase or Fast Green dye ejection through glass microelectrodes recording class I cell activity in urethane-anesthetized animals revealed the electrode tip to be in the granule cell layer in 27 of 27 cases. Six single class I neurons were also antidromically activated by a stimulus from an electrode placed in the hippocampal mossy fibers, and collision testing was successful in all cases. It is concluded that the dentate granule cells are theta cells. PMID- 6850346 TI - Genetic control of dopamine and serotonin receptors in brain regions of inbred mice. AB - In this report the genetic determinants of dopamine and serotonin receptors are investigated. We have used two types of radioreceptor binding assays to identify and quantify these neurotransmitter receptors in various brain regions of inbred mice. In the first method dopamine and serotonin sites are quantified using [3H]spiperone in the presence of appropriate blanking agents. These results are compared with those obtained by the use of [3H]domperidone and [3H]mianserin to label D2 and S2 sites, respectively. Both methods yield nearly identical results. Strain differences in D2 sites are found in the striatum, olfactory tubercle and pituitary. The density of dopaminergic sites is uncorrelated in the 3 brain regions in all mouse strains studied, suggesting that genetic determination of receptor density is independently regulated in each region. Similar observations have been made for S2 receptors in the striatum, hypothalamus, olfactory tubercle and frontal cortex. Analysis of D3 and D2 binding sites in recombinant inbred lines suggests that each site may be determined monogenically. PMID- 6850349 TI - Frequency specific effects of stroboscopic rearing in the visual cortex of the rabbit. AB - Rearing animals in stroboscopic illumination deprives those animals of the experience of visual motion. In the rabbit, stroboscopic rearing produces a significant alteration in the response properties of cells in the visual cortex, demonstrating that the rabbit visual system is susceptible to environmental manipulation during early postnatal life. Response properties were determined for single units recorded in the primary visual cortex of 3 groups of rabbits. One group had been reared from birth to 2 months of age at a stroboscopic flash frequency of 8 Hz, a second group was raised at a flash frequency of 4 Hz and a third was reared normally. Compared to normal rabbits, rabbits reared at 8 Hz showed a reduction in the proportion of orientation selective cells which were also direction-selective, and there was an increase in the proportion of cells responsive to stroboscopic flashes. There was no reduction, however, in the overall proportion of orientation-selective cells. This contrasts with the finding for the rabbits raised at a flash frequency of 4 Hz. In addition, cortical cells in the rabbits raised at 8 Hz responded to frequencies of stroboscopic flashes which were significantly higher than the frequencies found for cells in the rabbits raised at 4 Hz. The effects of stroboscopic rearing on the rabbit visual cortex are dependent, therefore, on the flash frequency experienced by the rabbits during development. PMID- 6850347 TI - Antagonists of synaptic and amino acid excitation of neurones in the cat spinal cord. AB - In the spinal cord of the anaesthetized cat microelectrophoretically administered (+/-)-cis-2,3-piperidine dicarboxylate (2,3-PDA), (+/-)-cis-2,5-piperidine dicarboxylate (2,5-PDA), gamma-D-glutamylglycine (gamma DGG), beta-D-aspartyl beta-alanine (beta DAA), (+/-)-2-amino-4-phosphonobutyrate (2-APB), (+/-)-2-amino 5-phosphonovalerate (2-APV) and (+/-)-2-amino-7-phosphonoheptanoate (2-APH) were assessed as antagonists of chemical excitation of dorsal horn interneurones and Renshaw cells by N-methyl-D-aspartate (NMDA), L-aspartate, quisqualate (QUIS), kainate and L-glutamate, and of monosynaptic and polysynaptic excitation by impulses in primary afferent fibres of muscle and cutaneous origin. Whereas polysynaptic excitation of interneurones was readily and reversibly depressed by 2-APV, 2-APH, beta DAA, gamma DGG and 2,3-PDA, all of which also reduced excitation by NMDA (and L-aspartate) more than that by QUIS (and L-glutamate), no selective antagonism of monosynaptic excitation could be demonstrated. In particular, 2,3-PDA, which depressed excitation by kainate to a greater extent than that by either QUIS or NMDA, appeared to have no effect on monosynaptic excitation. The results support the involvement of L-aspartate as the transmitter of some spinal excitatory interneurones, but none of the antagonists tested were considered suitable for assessing the role of L-glutamate as the transmitter of some spinal primary afferent fibres. PMID- 6850351 TI - The effects of early and late monocular deprivation on binocular depth perception in cats. AB - Binocular and monocular depth discrimination thresholds were obtained from cats which had been monocularly deprived either from the time of natural eye opening or else at the age of 4 months. Among normal cats, binocular depth thresholds typically are very much better than monocular thresholds, allowing the inference that normal cats have good stereopsis. For the early-deprived animals in the present study, only those whose deprived eyes were opened by 30 days of age showed any binocular advantage. Deprivation periods lasting to 35 days or older completely eliminated the binocular superiority, with no sign of any recovery. These results provide behavioral evidence that binocular visual mechanisms are extremely susceptible to disruption and, unlike those underlying visual acuity, do not have the potential for recovery. The effect of deprivation imposed later in life was quite different. Three cats, deprived for 1, 2 or 3 months respectively, beginning at the age of 4 months, showed no deficits in binocular depth perception. This latter finding implies the existence of a sensitive period for stereopsis which is over completely by the age of 4 months. PMID- 6850350 TI - Single neuron cultivation of embryonic and perinatal rabbit or rat brains based on plasma clot technique. AB - Isolated neuronal cells dissociated from the brain of embryonic rabbits on the sixteenth day of gestation and of perinatal rats (eighteenth embryonic day, to E18, thirteenth day postnatum, p.n. 13) were selectively cultured using a plasma clot technique. The cells grown were shown to be neurons by means of the neuron specific synaptosomal plasma membrane antibody (SPM). They differentiated at a very high frequency from rounded cells lacking processes into different shapes characteristic for several neuronal cell types. Morphological differences could be distinguished even after 24 h in culture. The neurons differentiated in vitro for up to 11 days, apparently without need of any direct intercellular contact. Cells caught inside the plasma clot were prevented from decreasing in number. This provides the opportunity to culture few neurons even from an extremely small area of a single brain. As an example, different cell types are shown originating from rat cerebella aged E18 to p.n. 13. Their appearance apparently corresponds to the genesis of cerebellar cell types, as is known from the in vivo situation. The high degree of characteristic neuronal differentiation and the prevention of direct intercellular contacts indicate that this culture method may serve as an in vitro assay for genetically fixed properties acquired in vivo. PMID- 6850348 TI - Organization and morphological characteristics of cholinergic neurons: an immunocytochemical study with a monoclonal antibody to choline acetyltransferase. AB - Choline acetyltransferase (ChAT), the acetylcholine (ACh) synthesizing enzyme, has been localized immunocytochemically with a monoclonal antibody in light and electron microscopic preparations of rat central nervous system (CNS). The antibody was an IgG1 subclass immunoglobulin that removed ChAT activity from solution. The specificity of the antibody and immunocytochemical methods has been confirmed by the demonstration of ChAT-positive neurons in a number of well characterized cholinergic systems. For example, ChAT-positive reaction product was present in the cell bodies of spinal and cranial nerve motoneurons, as well as in their axons and terminations as motor end-plates in skeletal muscle. In addition, the somata of preganglionic sympathetic and parasympathetic neurons were ChAT-positive. The specificity of staining was further supported by a lack of reaction product in several groups of neurons thought to use neuroactive substances other than acetylcholine. No specific staining was observed in control specimens. The findings indicated that ChAT had an extensive intraneuronal distribution in many cholinergic neurons, being present in cell bodies, dendrites, axons and axon terminals. ChAT-positive somata were found in the medial septum and diagonal band, the medial habenula, and the basal nucleus of, the forebrain, 3 regions that are sources of cholinergic afferents to the hippocampus, interpeduncular nucleus and cerebral cortex, respectively. In addition, positively stained cell bodies were present within the cerebral cortex. ChAT-positive punctate structures were observed in the ventral horn of the spinal cord, where electron microscopic studies demonstrated that some of these structures were synaptic terminals. Other regions containing numerous ChAT positive puncta included the hippocampus, the interpeduncular nucleus and the cerebral cortex. The light microscopic appearance of these putative cholinergic terminals varied among different brain regions. Large punctate structures related to well-defined post-synaptic elements were characteristic of some regions, such as the ventral horn of the spinal cord, while smaller punctate structures and varicose fibers with a diffuse pattern of organization distinguished other regions, such as the cerebral cortex. PMID- 6850352 TI - Differences between embryos and adults in the plasticity of somatosensory afferents to the axolotl tectum. AB - The plasticity of somatosensory afferents in the adult axolotl tectum was studied in two ways. First, normal adult axolotls were monocularly enucleated, and second, adult animals which had been monocular since embryogenesis had the tectum contralateral to the remaining eye excised. After a survival time of about one year the brains of these animals were studied electrophysiologically and histochemically. In the enucleated adults, the deprived tectum lacked visual activity, and the acetylcholinesterase staining, dense in the superficial neuropil of the normally innervated tectum, was much reduced. Somatosensory units remained deep in the tectal neuropil, as in normally innervated tecta. Serotonergic terminals associated with somatosensory responses were correspondingly largely restricted to the deeper tectal neuropil in these animals. This result is in contrast to that of embryonic enucleation where somatosensory activity and serotonergic terminals are found in the superficial tectal neuropil of the adult. Autoradiographic results from the tectal excision experiments showed that retinal axons in adults regrew to innervate the ipsilateral tectum when deprived of their normal targets. Associated with the ipsilateral innervation both visual units and acetylcholinesterase staining were found in the superficial tectum. In spite of this change in the visual innervation of the tectum, there was little difference in the distribution of somatosensory responses or serotonergic terminals; both remained relatively superficial and appeared to be unaffected by the late ingrowing retinal axons. This result is in contrast to the findings from embryonic transplants to genetically eyeless embryos which, as adults, show somatosensory responses and serotonergic endings restricted to the deeper tectal neuropil. PMID- 6850353 TI - Effects of experimental suppression of active (REM) sleep during early development upon adult brain and behavior in the rat. AB - In order to test the hypothesis that active sleep (AS) is important for the normal development of the central nervous system, 3 different deprivation methods were applied to male Wistar rat pups during the first month of life. Daily injection of clomipramine from 8 to 21 days of age reduced the high level of AS to less than the adult value throughout most of the experimental period. Administration of clonidine from 8 to 21 days of life induced an almost total suppression of AS. Instrumental deprivation, using the 'pendulum' method, led to a significant (but less severe) AS reduction during 2-4 weeks of postnatal age. Open-field behavior testing in adulthood revealed a higher than normal level of ambulation in all 3 experimental groups. Masculine sexual responses were deficient, due to a low level of both mounts and ejaculations, in both clomipramine- and clonidine-treated animals. Neither passive avoidance learning nor dark preference tests revealed any differences between the experimental and control rats. Sleep observations showed that there was an abnormally high incidence of large myoclonic jerks during AS in both clomipramine- and clonidine treated rats. Subsequent measurement of regional brain weights showed a significant reduction in the cerebral cortex and medulla oblongata, as compared with the respective control groups, in both the clomipramine- and the clonidine treated rats. In addition, DNA and protein determination in the affected brain areas showed a proportional reduction in the cortex and in the medulla. These results demonstrate that interference with normal functioning either of AS per se or of specific monoaminergic transmitter systems during early development can produce long-lasting behavioral as well as brain morphological and biochemical abnormalities in later life. PMID- 6850355 TI - Monoclonal antibodies against a differentiated retinal cell population. AB - Two monoclonal antibodies have been isolated which bind preferentially to the plexiform layers of embryonic chick neural retina and to 50-60% of dissociated neural retinal cells in culture as determined by surface binding to cells followed by analysis in a fluorescent activated cell shorter. Each antibody appears to recognize a distinct antigenic determinant on a common cell surface antigen, a protein of approximately 230 kdalton. This antigen increases dramatically in concentration between embryonic days 7 and 11 concomitant with the elaboration of the retinal plexiform layers. The antigen appears first in the central portion of the neural retina and at later times in the periphery, an appearance consistent with the normal pattern of differentiation of the retina. PMID- 6850356 TI - Rat adrenal non-chromaffin cells contain a neurite outgrowth-promoting factor immunologically different from nerve growth factor. PMID- 6850354 TI - Cochlear synaptogenesis in the hypothyroid rat. AB - The effects of congenital hypothyroidism on cochlear synaptogenesis were studied using transmission electron microscopy in 30 propylthiouracil-treated rat pups 1 35 days of age. No difference with controls was observed at the level of the inner hair cells which are known to mature essentially during the prenatal period. On the contrary, hypothyroidism resulted in numerous abnormalities in synaptogenesis at the level of the outer hair cells: abnormal persistence of numerous afferent dendrites and presynaptic specializations, incomplete development of efferent terminals and absence of formation of postsynaptic cisterns. It can be concluded that hypothyroidism results in severe retardation in the postnatal development of the innervation of outer hair cells. PMID- 6850357 TI - Cytoarchitectonic delineation of the ventral lateral thalamic region in the monkey. AB - The cytoarchitecture of the ventral lateral region of the primate thalamus has been appraised in the frontal, parasagittal and horizontal planes. A morphologically distinct region, possessing a sparse and diffuse distribution of large and small neurons is identified. The region includes several nuclei previously separately named by Olszewski. These are nuclei VPLo, VLc, X, VLps, and some cellular extensions into the VLo nucleus. The whole zone is continuous, and it is shown that no clear separation exists between any of the previously identified subnuclei. Connectional grounds are given for suggesting that this region should be considered as a common cerebellar relay nucleus to motor cortex. Morphological criteria for distinguishing the cell-sparse nucleus from adjacent nuclei are given. These cytological criteria provide a basis for the experimental analysis of cortical and subcortical connectivity of the ventral lateral thalamic region. Close attention was paid to the border between the VPLo nucleus and the VPLc nucleus. VPLc is separated from VPLo by a clear border, and no transitional zone can be detected in the parasagittal or horizontal planes. Previous ambiguities in the delineation of the VPLo-VPLc border probably stem from analysis in the frontal plane, in which the border is not clear. PMID- 6850358 TI - Binding of angiotensins to rat brain tissue: structure activity relationship. AB - The binding of 3H-angiotensin II to a synaptosome-enriched fraction of the subcortical part of rat brain was studied. In this fraction specific high affinity binding sites for angiotensin II were demonstrated. The binding sites were saturated at a ligand concentration of 2 X 10(-9) M. Scatchard analysis revealed a single class of binding sites with an apparent maximal binding capacity of 14 fmoles/mg of protein and an equilibrium dissociation constant, KD, of 0.9 X 10(-9) M. The specific binding at the KD concentration amounted to 59% of the total binding and was reversible. The association and dissociation rate constants (k1 and k-1) were 0.0212 nM-1 min-1 and 0.0196 min-1, respectively. Binding was dependent on both incubation time and tissue concentration in the incubation mixture. Angiotensins with biological activity in the brain, i.e., angiotensins I, II, III, and the fragments (3-8) and (4-8) competed with 3H angiotensin II for the binding sites with IC50's of 9 X 10(-8) M, 2 X 10(-9) M, 4 X 10(-9) M, 4 X 10(-7) M and 4 X 10(-6), respectively. In the presence of 1 mM of the converting enzyme inhibitor SQ 14,225 the IC50 for angiotensin I was 2 X 10( 7) M. Competition by the biologically active fragment angiotensin (5-8) could not be demonstrated. The latter peptide, however, was highly metabolized during the incubation under the assay conditions used. The binding potency of the various angiotensins paralleled their dipsogenic and pressor potency. The present data indicate the possible physiological involvement of these binding sites as specific receptors in the actions of angiotensins in the brain. PMID- 6850360 TI - Effect of acute administration of isoproterenol and angiotensin II, separately and in combination, on water intake and blood pressure of rats. AB - The effects of administration of isoproterenol, a beta-adrenergic agonist, and angiotensin II, a peptide, separately and in combination, on water intake and blood pressure of rats were studied. The results of 6 factorially designed studies in which 4 different doses of each compound were administered revealed that water intakes increased directly with the logarithm of increasing doses of each. The effect of simultaneous administration of the 2 compounds on water intake was additive at submaximal doses of each. No interactive effects on water intake were observed when the 2 compounds were administered simultaneously in any study. Reduction in urine output appears to be a more sensitive response to administration of isoproterenol than increase in water intake since it was virtually abolished at a dose (2.5 micrograms/kg SC) that had no effect on water intake. The lowest doses of angiotensin II (25 and 50 micrograms/kg SC) had no significant effect on either water intake or urine output. The effect of simultaneous administration of both compounds on urine output was essentially the same as that accompanying administration of isoproterenol alone. Following administration of angiotensin II (150 micrograms/kg, SC) mean systemic blood pressure of unanesthetized, chronically cannulated rats reached maximal levels within 5 min and returned to pretreatment control level by 60 min. Following administration of isoproterenol (25 micrograms/kg, SC), mean systemic blood pressure decreased within 5 min, was maximally depressed by 30 min and had returned halfway to the pretreatment control level by 60 min. Simultaneous administration of isoproterenol and angiotensin II failed to induce a significant change in blood pressure. These results are of particular interest since they show that neither the pressor effect of angiotensin II nor the depressor effect of isoproterenol is essential for the induction of drinking by these 2 compounds. PMID- 6850359 TI - Effects of morphine on body temperature of squirrel monkeys of various ages. AB - Increased sensitivity to certain drugs is believed to contribute to dysthermia in the elderly. To learn whether the temperature-altering effects of an opiate are increased in aged primates, injections of morphine sulfate (0.5-4 mg/kg) were given SC in randomly assigned order to squirrel monkeys ranging in age from 3.5 to over 17 years. Hyperthermia was the predominant response with no clear relationship to age, although hypothermic and biphasic responses also occurred, most commonly after the highest dose. Lateral cerebral ventricular injections of 0.625 and 1.25 micrograms morphine sulfate evoked hyperthermia in monkeys over 8 years of age but did not affect the temperature of animals less than 5 years old. Doses of 2.5 and 5 micrograms usually elicited hyperthermia regardless of age, but 10 micrograms induced hypothermia in a majority of monkeys. Naloxone was given intraventricularly to several monkeys to limit the degree of hypothermia after high doses of morphine given peripherally or centrally. Thus in these primates, as in other species such as the rat, lower doses of morphine usually evoked hyperthermia, but sufficiently high doses caused body temperature to fall. Unlike the case in the squirrel monkey with diazepam and with endogenous substances such as leukocytic pyrogen and taurine, there was not a strong or consistent relationship between age and morphine-induced temperature changes. PMID- 6850363 TI - A simple inexpensive and reliable nanoliter syringe. PMID- 6850362 TI - Neuropathic changes associated with insulin treatment of diabetic rats: electron microscopic and morphometric analysis. AB - Tibial nerves from control, untreated alloxan diabetic, and 4-week insulin treated alloxan diabetic rats were examined with light microscopy and computerized morphometric analysis of axons. Teased fiber preparations and electron microscopy were utilized to evaluate nerve degeneration. The insulin treatment regimens included daily injections of protamine zinc insulin (PZI), daily injections of ultralente insulin, and continuously delivered insulin through osmotic minipumps. Evaluation of axon:myelin ratios, teased fiber profiles, and electron microscopic cross sections of nerves demonstrated different degrees of neuropathic changes within the treated groups. The control group and untreated diabetic group showed little or no degeneration, while all insulin-treated groups showed evidence of Wallerian degeneration. Among these insulin treated groups, the PZI-treated group showed the greatest number of degenerating profiles while the minipump group showed the least. These data suggest that insulin treatment of alloxan diabetes results in axonal degeneration which closely resembles findings in human diabetic neuropathies. The substantially diminished number of degenerating axons seen in the osmotic minipump insulin-treated rats suggests that continuous delivery of insulin may decrease the neuropathic changes seen with single injection insulin therapy. Since virtually all insulin-dependent diabetic patients receive daily administration of insulin, the possibility that peripheral neuropathies may in part result from the insulin treatment requires more extensive investigation in a variety of animal models to separate the neuropathic effects of diabetes from the neuropathic effects of insulin therapy. PMID- 6850361 TI - Effect of hippocampal lesions produced by intracerebroventricular kainic acid on alcohol drinking in the rat. AB - An alcohol self-selection test was first given to adult male rats of either the Sprague-Dawley or Long-Evans strain in which the concentrations available with water were increased from 3% to 30% over an eight-day period. Subsequently, the animals were anesthetized and, using stereotaxic procedures, a 1.2 or 2.4 nmole dose of kainic acid was infused bilaterally into the cerebral ventricle (ICV) over a 30-sec interval and in a total volume of 10 microliters. When the same alcohol self-selection test was repeated two weeks post-operatively, alcohol intake was significantly suppressed in terms of both g/kg intake per day as well as proportion of alcohol to water selected. Alcohol intake of the control rats infused with the CSF carrier vehicle was unchanged. When a much longer interval of 7-10 min was used to infuse the 2.4 nmole dose of kainic acid ICV, the intake of alcohol of this group also was not significantly changed. Post-mortem histological analysis of forebrain tissue of the kainic acid infused rats confirmed cytological damage to the hippocampus, particularly in cell fields CA3 and CA4, which has been reported previously. Since the hippocampus has been implicated recently in the mechanisms underlying alcohol drinking, our results suggest that a pathological lesion of this limbic-forebrain structure could influence the degree to which alcohol is self-administered in a free-choice situation. PMID- 6850364 TI - A mechanism of carbamazepine-analgesia as shown by bradykinin-induced trigeminal pain. AB - Single neuronal responses induced by micro-application of bradykinin solution to the tooth pulp of the rabbit were recorded in the subnucleus reticularis dorsalis and trigeminal subnucleus caudalis and characterized by intermittent episodes of paroxysmal activities. Carbamazepine, the primary agent for trigeminal neuralgia, suppressed such a paroxysmal response, suggesting that an analgesic action of the drug results from the suppression of synaptic transmission at the subnucleus reticularis dorsalis and trigeminal subnucleus caudalis. PMID- 6850366 TI - [Ontogenesis of speech and its relation to laterality]. PMID- 6850367 TI - [Free amino acids in the sciatic nerve of the dog after ischemia and recirculation]. PMID- 6850365 TI - Immediate prolactin release after pericommissural deafferentation in behaving male rats. AB - Adult male rats received a chronic midline implant of Halasz-type knife placed at the level of the anterior commissure. A chronically implanted heart cannula allowed for sequential blood sampling in unrestrained conditions. Anterior knife rotation of 180 degrees induced a significant increase of plasma prolactin concentration in 30 min. Plasma LH levels remained within control levels. It is suggested that neural projections dorsally entering the preoptic-suprachiasmatic region are significantly involved in the control of prolactin release in male rats. PMID- 6850368 TI - [Changes in the electric activity of myocardial cells of the rat under the influence of hypothalamic stimulation]. PMID- 6850369 TI - [Contribution to the problem of the influence of anesthesia on experimental cough]. PMID- 6850370 TI - [Experimental cough and histamine receptor blockers]. PMID- 6850371 TI - [Breathing pattern during normal respiration and respiratory reflexes in anesthetized cats]. PMID- 6850372 TI - [Changes in coughing in rabbits with experimental pulmonary edema]. PMID- 6850373 TI - [The course of pregnancy after failure of intrauterine contraception]. PMID- 6850375 TI - [Experience with the KTD-X-4 semiautomatic sphygmomanometer]. PMID- 6850374 TI - [Occurrence of vulvovaginitis in childhood caused by yeast microorganisms]. PMID- 6850377 TI - [The significance of measuring the symphysis-fundus distance in the diagnosis of intrauterine fetal retardation]. PMID- 6850376 TI - [Analysis of the occurrence of tick-born encephalitis in Central Slovakia]. PMID- 6850378 TI - [Some health, morphological and functional parameters in young Bratislava gymnasts]. PMID- 6850379 TI - [Problems in indications for abortion in psychiatry]. PMID- 6850380 TI - [Idiopathic cholesterol pneumonia]. PMID- 6850382 TI - Visitors: a smouldering issue for burn unit personnel. AB - Recent acknowledgement by medical care providers of the psychosocial role in health restoration has brought the issue of patient visiting to the forefront. The intense environment characteristic in critical care areas such as burn units has necessitated a carefully balanced 'compromise' between scientifically sound medical care and psychosocially oriented interventions. This is a current area of attention in the development of policy for burn unit operations. However, the 'compromise' seems to have been individually interpreted by professionals. This study investigated visitor policy components involved in shaping the staff visitor-patient constellation. It also probes the consequences of this shaping process. Surveys were mailed to all 174 American burn units listed in the Directory of Burn Care Facilities (January, 1979). Our completed study reflected data reviewing the following characteristics: demographics (that is, age specification and bed distribution, bed allocation); visitor policy determination; visitor policy specifications (that is, who, when, how many); visitor policy, regulation and enforcement; and visitor integration (that is, rooming-in, programme involvement). PMID- 6850381 TI - [The beginnings of otolaryngology at the Comenius University Medical School in Bratislava]. PMID- 6850383 TI - Serum and erythrocyte amino acid pattern: studies on major burn cases. AB - Venous serum amino acids were measured in 13 patients with major burns. Erythrocyte amino acids and plasma cortisol, blood sugar and urine catecholamine were measured in two representative subgroups respectively. After burn injury, serum proline, glycine, valine, isoleucine and arginine were significantly decreased; phenylalanine, cysteine, methionine, leucine, glutamate, alanine, aspartic acid and tyrosine were significantly increased. Histidine and lysine fluctuated. This serum amino acid profile is considered as a specific pattern for major burns. Serum phenylalanine was markedly elevated in the hypermetabolic burn patients, its fluctuation coincided with the burn course and was negatively correlated with serum albumin level (P less than 0.001). These findings suggest that the ratio of phenylalanine tyrosine is a useful clinical parameter for assessing the patient's nutritional condition. Twenty-three simultaneous determinations of both serum and erythrocyte amino acid concentrations show similar changes, suggesting that the serum amino acid profile might reflect the change of total free amino acid pool. After burn injury, plasma cortisol, blood sugar and urine catecholamine were elevated as well as urine urea nitrogen. However, although the first three returned to normal by the end of the second week post burn, urine urea nitrogen remained high. This indicates that there are other factors controlling nitrogen loss in patients with major burns, it is also postulated that, due to the abnormal amino acid pattern revealed after major burns, the constituents of commercially available amino acid solutions should be modified. PMID- 6850386 TI - Diffusion of innovations in burn care: selected findings. AB - Large sums of money are spent to support biomedical research, but relatively little effort is directed toward getting results to the clinical setting. Understanding the process underlying the diffusion of innovations would promote more efficient conversion of new knowledge into practice. This study examines the diffusion of innovations in burn care that were discussed at the United States National Institutes of Health 1978 Consensus Development Conference on Supportive Therapy in Burn Care. The study traces the awareness and use of innovations in burn care, the source and timing of new information to physicians and the ways in which characteristics of both innovations and physicians are related to the diffusion process. The principal basis for the study is a survey in five New England States of physicians who treat burn patients. The data suggested that between 56 and 97 per cent of physicians were aware of eight major advances. Physicians were more aware of high than low consensus treatments and the adoption rate and adoption level were higher for high consensus treatments. The three most important sources of information about the advances were staff conferences, journals and medical school. PMID- 6850385 TI - Effects of early hypnosis on the cardiovascular and renal physiology of burn patients. AB - Sixteen patients with body surface area (BSA) burns of 4 per cent to 83 per cent, with whom single hypnotherapeutic interventions were attempted 5.3 +/- 3.4 h post burn, were compared to 16 matched controls. Ten physiological parameters related to fluid volume and haemodynamics were recorded on the first two post burn days. The only significant difference discovered was elevated urine output 0-48 h postburn in successfully hypnotized patients (P = 0.01). This difference was inversely related (r = -0.94, P = 0.009) to burn size from a 10 per cent BSA burn (3.9 litres/48 h) to a 35 per cent BSA burn (1.6 litres/48 h). A statistically suggestive (P = 0.13) increase in urine output occurred in patients in whom hypnotic trance induction was unsuccessfully attempted. Patients with BSA burn sizes greater than or equal to 50 per cent, who presented with significant physiological stress and hypovolemia, were found not to be susceptible to hypnotic trance induction, and derived no physiological benefit. Attempted hypnotherapeutic intervention per se, with its psychotherapeutic component, may act only to reduce affective or psychological stress and anxiety. This psychological stress reduction apparently facilitates the loss of retained fluid in patients with small burns by a mechanism which is overwhelmed by the physiological stress of a major burn injury. PMID- 6850388 TI - Burn injuries associated with motorcycles. AB - This paper deals with the results of a thirteen-and-a-half year survey of motorcycle accident patients admitted to the burns unit at the Royal Brisbane Hospital. There were 38 patients in the study. Population and analysis of data in three consecutive four-and-a-half year periods shows changing patterns in aetiology, management and morbidity. Cycle design and the use of suitable clothing were identified as reversible aetiological factors. PMID- 6850387 TI - Burn injuries in Lagos. AB - Eighty-nine cases of burns admitted to the Lagos University Teaching Hospital during an 8-year-period (1968-75) have been studied. The age incidence ranged from 1 day to 54 years. Fifty cases (56.2 per cent) occurred in children below the age of 15 years. Thirty-nine (43.8 per cent) were adults, aged 15 years and above. Sixty-three cases (70.8 per cent) were domestic accidents. There was a mortality rate of 13.5 per cent. There was severe morbidity in the surviving cases, the average admission period in 73 cases being 37 days and the average total healing time in 57 cases being 54 days. The most troublesome late complications were contractures, hypertrophic or keloid scars and failure of repigmentation. Gram-negative bacteria accounted for 64 per cent of the incidence of wound sepsis. Health education has an important role to play in the prevention of burn accidents both in the home and in industry. In particular, it is suggested that cooking above floor level and closer supervision of children should reduce the incidence of domestic burns in younger children, while stricter factory inspection, with rigorous enforcement of industrial safety laws, should reduce the incidence of industrial burn accidents in the working adult population. PMID- 6850389 TI - Infection with Acinetobacter in a burns unit. AB - In recent months 17 patients on the Burns Unit at St Lawrence Hospital have been infected with Acinetobacter anitratus. We present 4 patients who have been extremely ill and in whom Acinetobacter was considered to have played a prominent role. We stress the importance of opportunistic infection in burns patients and antibiotic resistance in this organism. PMID- 6850384 TI - Effect of cimetidine, hydrocortisone superoxide dismutase and catalase on the development of oedema after thermal injury. AB - A new hypothesis for the pathophysiological mechanism underlying the development of oedema after a thermal injury has been tested in an experimental burn model. Support was given to the suggestion that oxygen-derived free radicals produced by invading leucocytes which upon activation release the superoxide radical (O2-), may be partly responsible for the increase in microvascular permeability seen after thermal injury. By removal of oxygen-derived free radicals with radical scavengers (superoxide dismutase and catalases) it was possible to reduce significantly the post-burn oedema formation. For comparison, one series of rats was pretreated with hydrocortisone and another with the histamine H2-blocker cimetidine. Hydrocortisone reduced the very early post-burn oedema formation which might partly be due to its membrane-stabilizing influence and partly to a direct effect on the microvasculature, causing a reduction of the vasodilatation observed post-burn. The inhibition of post-burn oedema formation by cimetidine, earlier demonstrated in animal burn models, was confirmed in the present study. The mean arterial blood pressure (MAP) in the cimetidine-treated rats decreased, however, after treatment. It is therefore difficult to determine to what extent the concentration of oedema is attributable to histamine H2-receptor blockade and to what extent to the reduced blood pressure. The influence of MAP on post-burn odema formation was further illustrated in two series of rats anaesthetized with Inactin an Hypnorm/Valium respectively. The results underline the importance of using the same anaesthetic throughout the experimental series. PMID- 6850392 TI - [Perception in symptoms: variations in statements according to different procedures]. PMID- 6850391 TI - [Economic and social consequences of digestive morbidity and of recourse to care]. PMID- 6850393 TI - [Drug consumption and the location of pharmacies in Sherbrooke, Quebec]. PMID- 6850390 TI - Prismatic glasses for the benefit of burned patients. PMID- 6850394 TI - A model for transcellular transport of calcium based on membrane fluidity and movement of calcium carriers within the more fluid microdomains of the plasma membrane. PMID- 6850395 TI - Estimating total body calcium from peripheral bone measurements. AB - In a heterogeneous group of 12 male and 30 female patients, total body calcium (TBCa) was measured by neutron activation analysis, and bone mineral content of the distal femur and six regions of the distal radius and ulna were measured by photon absorptiometry. TBCa was an average of 71 g (9%) lower than normal in the females and 119 g (11%) lower than normal in the males. Of the forearm measurements, those of the radial shaft provided the best estimate of TBCa with a standard error of estimation (SEE) of 88 g (14% of the mean value) for female patients alone, and 113 g (16%) for the whole group. The measurement on the femur provided a better estimate with SEE 80 g (13%) for female patients and 90 g (13%) for the whole group. These SEE are comparable with the variability in TBCa between normal subjects, which has a coefficient of variation of the order of 20% in both sexes. A slightly better estimate of TBCa can be obtained by using a multiple regression equation involving both the femur and radial shaft measurements with a SEE of 74 g (12%) for female patients and 81 g (11%) for the whole group. The correlation between the estimated deficit of TBCa and the estimated deficit of bone mineral from the forearm and the femur has been calculated. PMID- 6850396 TI - Seasonal variation of lumbar spine bone mineral content in normal women. AB - The seasonal influence on lumbar spine bone mineral was evaluated in a prospective study of 26 normal women aged 19-66 years. Bone mineral content of the second, third, and fourth lumbar vertebrae (lumbar BMC) was determined every 3 months during 1 year by using dual-photon (153Gd) absorptiometry. Lumbar BMC was, on an average (mean +/- SE), 0.86 +/- 0.27 arbitrary units or 1.7 +/- 0.5% higher in July to September than in January to March (P less than 0.005), when other sources of variation were eliminated. It is hypothesized that the seasonal variation in lumbar spine bone mineral reflects differences of the mechanical loading on the vertebrae. The interpretation of longitudinal studies of lumbar BMC may be erroneous if the seasonal variations in bone mineral are not considered. PMID- 6850397 TI - Errors in measuring trabecular bone by computed tomography due to marrow and bone composition. AB - The linear attenuation coefficient (mu in cm-1) of trabecular bone was modeled for different conditions of bone and marrow composition in order to assess their influence on computed tomography (CT) quantitation. A large relative change (10% of TBV at 15% TBV) of bone concentration resulted in small changes of mu: 2.3% at 60 keV, 3.4% at 44 keV, 5.2% at 29 keV. Relative changes of trabecular bone volume (TBV) on the order of 3% could be detected in vivo by CT were it not for errors of relocation and for compositional influences on accuracy. The mu (and density) depended critically not only on amounts of bone substance and marrow but on their compositions. Normal variation in the composition of bone substance produced an uncertainty in mu equivalent to 0.5 to 1% TBV. Increases of yellow marrow produced a decrease of mu which could be mistaken for a decrease of bone concentration. The biological variation (90% confidence limit) of marrow composition gives an uncertainty at 15% TBV of about 2.4% TBV at 60 keV, 1.7% at 44 keV, and 1.3% at 29 keV. These correspond to relative uncertainties of 16, 11, and 9% respectively. These factors help explain the large accuracy errors (30%) observed in all studies of trabecular bone where single-energy CT was used. Marrow composition also can affect precision of bone measurement. Systematic shifts of red and yellow marrow could mask biological changes such as those occurring with aging or treatment. PMID- 6850399 TI - Synthetic apatites containing Na, Mg, and CO3 and their comparison with tooth enamel mineral. AB - Apatites containing Na, Mg, and CO3 in amounts occurring in tooth enamel mineral were synthesized by precipitation from aqueous solutions. The X-ray diffraction patterns showed only apatitic reflections, which were somewhat broader than those of enamel. X-ray Guinier photographs resulted in diffuse reflections from which the lattice parameters could not be determined. The infrared (IR) absorption spectrum of the synthetic samples was practically identical with that of tooth enamel. However, after heating the samples for 1/2 h at a temperature between 300 and 600 degrees C, no absorption peak was found at 2340 cm-1 as in the IR spectrum of tooth enamel after heating. PMID- 6850401 TI - Studies on cell lineage of metaphyseal bone in repleted scorbutic guinea pigs. AB - Young weanling guinea piglets were placed on a diet deficient only in vitamin C. When they reached a state of severe scorbutus, they were given vitamin C and the morphological differentiation of various mesenchymal cells in the proximal end of the tibia was followed over 7 days. The altering metaphyseal cellular pattern is recorded descriptively as well as quantitatively. Levels of mesenchymal cells, preosteoblasts, osteoblasts, and osteocytes remained relatively steady for 24 h. However, by 48 h there was a precipitous decline of mesenchymal cells with a concomitant rise in recognizable osteogenic cells; this change continued until the 7th day of repletion. At this time, with the exception of the preosteoblasts, the cellular population had returned to about the level in the control animals. Osteoclastic and endothelial cellular movements fluctuated widely during the period of repletion under examination. These results support the concept of separate lines of differentiation for osteoclasts and osteoblasts in the postnatal animal. Moreover, mesenchymal cells appear to be precursors of osteogenic cells. PMID- 6850403 TI - Metaphyseal pattern: uniqueness of this structure in growing bones originating from cartilaginous anlage. A microradiographic study. AB - Microradiographic examination of metaphyses in long and short tubular growing bones allowed detection of a repetitive, clearly defined pattern of three adjacent zones; the latter are successively formed by the mineralization of cartilaginous longitudinal intercolumnar septa and by the subsequent apposition of other mineralized tissues concurrently with resorption. Consequently, each zone of the metaphysis includes mineralized tissues of various compositions and ages, identifiable by their different mineralization densities. Microradiography of pieces of the growing skeleton in several animal species shows that the same organization is not only present in long and short tubular bones but also in many other such as the pelvis and scapula, cuboid bones like the calcaneum and talus, and cartilaginous bones at the base of the skull. This suggests that there is no difference between the osteogenesis pattern of these bones and tubular ones. The problem of identifying the factors generating such metaphyseal organization is raised. PMID- 6850400 TI - X-ray diffraction studies of the crystallinity of bone mineral in newly synthesized and density fractionated bone. AB - The crystallinity of bone mineral at different stages of maturation has been measured by quantitative X-ray diffraction methods. Crystallinity measurements were made on tibial mid-diaphyses from 17-day embryonic chicks, newly-formed periosteal bone from embryonic chicks, and density-fractionated bone from post hatch chickens from 5 weeks to 2 years of age. For a given animal age and degree of mineralization, crystallinity increases with animal age, indicating that changes in bone mineral occur even after mineralization is complete or nearly complete. PMID- 6850402 TI - Dwarfism in the Alaskan Malamute: ultrastructural features of dwarf growth plate chondrocytes. AB - This study was performed in order to reexamine the ultrastructural morphology of the chondrocytes in the growth plates of dwarf Alaskan Malamutes and to obtain semiquantitative cytochemical data about the proteoglycans. Growth plates from age-matched dwarf and homozygous nonaffected Alaskan Malamutes were processed for routine transmission electron microscopy and also stained with ruthenium red. Chondrocytes in dwarf plates were observed to occur in clumps or cell nests. Within some of these nests, chondrocytes in the upper half of the zone of chondrocyte proliferation had bizarre shapes ranging from V-shaped to whorled or rounded. These chondrocytes contained profiles of markedly dilated rough endoplasmic reticulum (RER). Material within the RER cisternae stained positively with ruthenium red and was partially digestible with testicular hyaluronidase. The material could, therefore, represent either chondroitin sulfate or hyaluronate. The RER in these dwarf chondrocytes was not oriented parallel to the long axis of the cells; instead, it consisted of irregularly dilated cisternae. Granule counts performed on the zone of chondrocyte proliferation revealed a significant decrease in the number of ruthenium red granules in the interterritorial matrix of dwarf chondrocytes when compared to those of the homozygous nonaffected chondrocytes. PMID- 6850398 TI - Basic and clinical evaluation of the measurement of bone resonant frequency. AB - A new computerized apparatus was constructed to measure the resonant frequency of human ulna in vivo with high sensitivity and reproducibility. Experimental studies using aluminum bar and dried human bone revealed the importance of the ulna being positioned parallel to the radius, approximately 90 degree flexion of the elbow joint, and minimal muscle activity in order to demonstrate maximum resonant frequency of ulna. Measurement of bone resonance in monkeys in vivo and after removal of the bone in vitro showed good agreement. Product of F (maximum resonant frequency in Hz) and L (ulnar length in cm), FL, indicating the speed of propagation of sound wave through the ulna, showed a significant positive correlation with bone mineral content/bone width (BM/BW) measured by Norland Cameron apparatus and age-bound decline in both sexes. Patients with osteomalacia and primary hyperparathyroid bone disease tended to have higher FL values than expected from BM/BW. Two-dimensional display of FL and BM/BW thus appears to be useful in distinguishing osteoporosis from osteomalacia better than the use of BM/BW alone. PMID- 6850404 TI - The mineralized ring, a single structure peculiar to long bone growth. AB - Mineralized ring, an elongated tubular structure ensheathing bone metaphysis, is described at successive stages of long bone growth. It is shown that the mineralized ring is characterized by different morphological aspects during its development, corresponding to successive growth stages of one and the same anatomical formation. Its origin is different from periosteal bone and its development is parallel to that of the metaphysis. PMID- 6850405 TI - X-537A ionophore-mediated calcium transport and calcium phosphate formation in Pressman cells. AB - The present study examined precipitate development induced in phosphate solutions by the ionophoric translocation of Ca2+ across a bulk organic solvent barrier. Experiments were conducted at pH 7.4 and 25 or 37 degrees in a three-compartment Pressman cell. The aqueous reaction (0, 2.2 or 22 mM phosphate, 100 mM K+) and donor (1.3 or 13 mM Ca2+, 0.8 mM Mg2+, 100 mM Na+) compartments were separated by a CHCl3 compartment rendered permeable to cations by the addition of the carboxylic ionophore X-537A (2 or 20 mM). The resultant cation movements increased Ca2+, Mg2+, and Na+ concentrations in the reaction compartment at the expense of K+ loss to the donor compartment. The magnitude of the K+ counterflow and the efficiency of the ionophore-mediated Ca2+ in equilibrium 2K+ exchange reaction resulted in appreciable Ca2+ overshoots in the reaction compartment. In the absence of phosphate, Ca2+ increases exceeded donor levels by several-fold. With phosphate present, the Ca2+ flux was sufficient to induced precipitation. Generally, the first solid formed was amorphous. The amorphous precipitate, however, was unstable and converted to an apatite-like crystalline phase. Both carbonate (26 mM) and Mg2+ (0.8 mM) in the reaction solution delayed but did not prevent the conversion. The possible relevance of these findings to matrix vesicle calcification is discussed. PMID- 6850406 TI - A comparison of the effects of strontium chloride and calcium chloride on alveolar bone. PMID- 6850408 TI - XVII European Symposium on Calcified Tissues. 11-14 April 1983, Davos, Switzerland. Abstracts. PMID- 6850407 TI - A comment on "Kinetics of 99mTc-tin-methylene diphosphonate in normal subjects and pathological conditions: a simple index of bone metabolism". PMID- 6850414 TI - The specific capsular polysaccharide of Streptococcus pneumoniae type 20. PMID- 6850409 TI - Primary structures of four novel small ribosomal RNAs from Crithidia fasciculata. AB - We report here the complete primary structures of four novel small RNA species (designated e, f, g, and j) found in the large ribosomal subunit of Crithidia fasciculata, a trypanosomatid protozoan. These RNAs, which are distinct from Crithidia 5S (species h) and 5.8S (species i) rRNAs, do not have counterparts in the more conventional eukaryotic ribosomes characterized to date. The small RNAs are 212 (e), 183 (f), 135-136 (g), and 72-73 (j) nucleotides long, with g and j displaying 5'-terminal heterogeneity. All have unique sequences and all contain 5'-monophosphorylated and 3'-unphosphorylated termini. In their basic structural features, therefore, species e, f, g, and j are indistinguishable from other RNAs (including 5S and 5.8S) that are recognized components of eukaryotic ribosomes, although they are unrelated to 5S or 5.8S rRNA in sequence. Since previous work from this laboratory has ruled out the possibility that these small RNAs are generated by quantitative and highly specific (albeit artifactual) RNase cleavage of large rRNAs during isolation, we conclude that species e, f, g, and j are native components of the Crithidia ribosome. With the exception of e, which appears to contain a single pseudouridine residue, all of these novel RNA species are devoid of modified nucleosides. In connection with primary sequence analysis, we present a simple modification of the standard G-specific chemical sequencing reaction which in our hands yields reproducible and unambiguous results using commercially available dimethyl sulfate. PMID- 6850413 TI - Na+-independent exchange of amino acids in Ehrlich cells. AB - Many hydrophilic amino acids are transported via exchange by the Na+-independent L system in the Ehrlich cells. However, this exchange is measurable only at relative high concentrations of the small hydrophilic amino acids. Whereas leucine saturated this transport system at 0.2 mM, with threonine, serine, or alanine the system was below saturation at 30 mM. All amino acids capable of exchanging showed similar EA values (congruent to 20 X 10(3) cal X mol-1, 1 cal = 4.1868 J) and maximum velocities. Depending on the temperature, the apparent Km values for different amino acids differed by one or two orders of magnitude. These data suggest that for the small hydrophilic amino acids, the relatively slow rate of transport is due to the unfavorable Km values. PMID- 6850411 TI - Purification and characterization of exo-beta-1,3-glucanase from a hatching supernatant of Strongylocentrotus intermedius. AB - Exo-beta-1,3-glucanase from the sea urchin embryos was purified 114-fold from the initial hatching supernatant by the following procedures: (a) gel filtration on Sephadex G-100; (b) hydrophobic chromatography on 4-phenylbutylamine-Sepharose (PBA-Sepharose); (c) two ion-exchange chromatographic steps on DEAE-cellulose; (d) gel filtration on Ultrogel AcA 34; (e) gel filtration on Sephadex G-100. The purified enzyme contained 2.2% carbohydrate and gave a single protein band corresponding to a molecular weight of 136 000 following electrophoresis on sodium dodecyl sulfate (SDS) - urea - polyacrylamide gel. Gel filtration on Ultrogel AcA 34 with a nondenaturing solvent gave a molecular weight of 130 000 +/- 6000. The enzyme displayed an optimum pH at 5.0-5.5 and hydrolysed laminarin and PS(curdlan)-beads at the nonreducing ends, releasing glucose. Although activity of the purified enzyme was not affected by SDS, urea, some divalent ions, and 2-mercaptoethanol, both dithiothreitol and Hg2+ were markedly inhibitory. PMID- 6850412 TI - 2-Fluoro-ATP, a fluorinated ATP analog. 19F nuclear magnetic resonance studies of the 2-fluoro-ADP . myosin subfragment-1 complex. AB - The synthesis of a fluorinated ATP analog, 2-fluoro-ATP (2-flATP), is described. This analog is designed for 19F nuclear magnetic resonance (NMR) studies of large enzymes and proteins which bind adenine nucleotides. 2-flATP is shown to be active as an ATP analog in a number of enzyme systems, and its 19F-NMR properties are determined. Specifically the principal elements of the 19F-NMR chemical shift tensor are shown to be 104, 12, and -116 ppm. The complex between 2-flADP and the myosin subfragment-1 ATPase is studied by 19F NMR, comparing the normal Michaelis complex and 2-flADP "trapped" on subfragment-1. These complexes are shown to be indistinguishable from the standpoint of the environment and mobility of the adenine ring. PMID- 6850410 TI - Rotational mobility associated with the protein moiety of human serum lipoproteins from tryptophan phosphorescence anisotropy measurements. AB - The steady-state phosphorescence anisotropy of human low density (LDL) and very low density (VLDL) serum lipoproteins in a glycerol--buffer solvent has been investigated. By virtue of the long lifetime of the triplet state, depolarization of the emission resulting from slow rotational motions is observed between -90 and -50 degrees C. Despite the number of emitting residues within these complexes, the rotational behavior can be represented within experimental error by a single correlation time. The magnitude and temperature dependence of the rotational correlation times observed for LDL are consistent with overall rotation of essentially spherical rigid particles as the source of the phosphorescence depolarization. Preliminary data for VLDL indicate the presence of internal peptide motions which are more rapid than those of the overall complex. PMID- 6850415 TI - Ontogeny of some enzymes of glycogen metabolism in rabbit fetal heart, lungs, and liver. AB - Optimum conditions were established for the assay of glycogen, glycogen synthase, glycogen phosphorylase, phosphoglucomutase, and glucose-6-phosphatase in rabbit fetal heart, lung, and liver. Using these methods, the pattern of appearance of glycogen and the above four enzymes was established from day 18 of gestation to day 8 after birth. The results indicate that total tissue glycogen reaches maximum levels between days 22 and 24 in the heart, days 24 and 26 in the lung, and days 30 and 31 in the liver. In all three tissues, the rapid rise or depletion of glycogen is coincident with a corresponding increase in glycogen synthase and glycogen phosphorylase activities. However, substantial amounts of glycogen synthase are present both prior to and after the accumulation of glycogen. Similarly, considerable amounts of glycogen phosphorylase are present early in gestation, yet deposition of glycogen occurs. Both the I and D forms of glycogen synthase are present in the three tissues, the major being the physiologically inactive D form. Similarly both the a and b forms of glycogen phosphorylase are present, with the a form (active form) making up about 30-60% of the total phosphorylase activity. Glucose-6-phosphatase was absent in fetal heart and lung throughout the period of gestation investigated. Low levels of this enzyme were detectable in fetal liver near term. The phosphoglucomutase activity increased progressively from day 22 of gestation in all three tissues and continues to increase after birth. The disappearance of fetal lung glycogen occurs between days 27 and 28 at a time when surfactant phospholipids first appear. These findings indicate that the breakdown of glycogen is providing the fetal lung cells with energy necessary for surfactant phospholipid biosynthesis. PMID- 6850417 TI - The variance of linkage disequilibrium between three loci in a finite population. AB - The variance of three-locus linkage disequilibria for an equilibrium infinite alleles model is solved numerically on a computer, using identity coefficients. It is shown that the variance of three-locus linkage disequilibrium created by random drift, although smaller than the variance of two-locus linkage disequilibrium, is of the same order of magnitude. Hence third-order disequilibria are not necessarily good indications of selection. The formula for the variance of linkage disequilibrium is given when there is no recombination between the genes. This model can also be interpreted as intragenic recombination between three sites within a gene. PMID- 6850416 TI - The in vitro inhibition of hepatic ferrochelatase by divalent lead and other soft metal ions. AB - A solubilized protein with ferrochelatase activity has been extracted from hepatic mitochondria of Sprague-Dawley rats. Under anerobic conditions in the presence of sodium ascorbate the ferrochelatase velocity was typically 1.8 nM X min-1 X mg-1. The extract also displayed zinc chelatase activity of 1.2 nM X min 1 X mg-1 without either anerobic conditions or ascorbate. In both cases substrate inhibition occurred for metal ion and deuteroporphyrin, but in the linear range a noncompetitive two-site mechanism was observed. The ferrochelatase activity is inhibited by divalent copper, mercury, and lead ions and the sodium salt of p chloromercuribenzoate and is replaced by zinc chelation activity. This evidence suggests that the metal-binding site includes a thiol group. The inhibition of the site is greatest with Cu2+ and decreases with increasing ionic radius to Pb2+. This observation implies that the binding site is stereochemically adapted to the small Fe2+ ion and to some extent protected from larger, sulfur-binding ions which can inhibit ferrochelatase activity. PMID- 6850418 TI - The maintenance of polymorphisms at two loci in house mouse (Mus musculus) populations. AB - To determine the roles of mutation, migration, and selection in maintaining genetic variability in populations of house mice (Mus musculus), stochastic models based on characteristics of mouse populations inhabiting corn cribs in southwestern Ontario and the t allele were developed. Two sets of models were examined. One involved selection against t/t mice and a migration rate of 0.05 to 0.10 (low migration model) whereas the other involved selection against both t/t and +/t genotypes and a migration rate of 0.33 (high migration model). Both models could account for the t allele frequencies observed in natural populations. Similarly both models explain the frequencies observed at a second polymorphic locus, the Hbb locus which controls the beta chain of the hemoglobin molecule, provided strong selection favoring the Hbb heterozygotes is incorporated. Without such selection pressure rapid extinction of one of the alleles at this locus occurred. A stabilizing force such as selection is considered necessary for the hemoglobin polymorphism observed in the populations under consideration. Evidence supporting the high migration model as the more realistic is also presented. PMID- 6850419 TI - The effects of chlorinated municipal sewage and temperature on the abundance of bacteria in the Sheep River, Alberta. AB - The intersite and temporal differences in the abundance of sessile and planktonic bacteria subjected to a chlorinated municipal sewage discharge and a thermal discharge were investigated in the Sheep River, Alberta, from January through December 1978. Significantly higher densities of both sessile and planktonic cells generally occurred within the chlorinated effluent plume. Higher numbers of sessile bacteria were also found below the thermal discharge, with maximum densities occurring in the late winter-early spring and minimum densities following mountain runoff. The higher numbers of sessile bacteria in the chlorinated plume was attributed to nutrient enrichment. These results indicate that chlorinated sewage effluent has no adverse effects on the abundance of sessile bacteria. PMID- 6850420 TI - Survival in foods of Staphylococcus aureus grown under optimal and stressed conditions and the effect of some food preservatives. AB - Staphylococcus aureus was grown in a rich peptone medium which became alkaline with continued incubation. Cells were grown at 37 degrees C and in the same medium containing 1 M NaCl at 46 degrees C, a temperature at which this organism can grow only when protected by NaCl. Cells of these cultures are hereafter called 37 degrees C-cells and 46 degrees C-cells, respectively. The 37 degrees C cells harvested when the pH was 7.1 to 7.7 had decimal reduction times (D60 value) of 1.8 to 3.1 min in 50 mM pH 7.2 Tris buffer. The D60 value of 46 degrees C-cells tested in the same way, harvested from cultures at pH 6.6 to 7.6, ranged from 5.3 to a maximum of 12.8 min. In milk, green beans, peas, or beef slurry, the D60-value of 46 degrees C-cells was about four times higher than that of 37 degrees C-cells. Length of survival after freeze-drying in skim-milk powder exposed to air was longest for the cells with the highest D-value. In freeze dried peas and media acidified with acetic and lactic acids, 46 degrees C-cells survived longer than 37 degrees C-cells. However, the sensitivity of the two kinds of cells to potassium sorbate, sodium benzoate, and sodium propionate was essentially the same, but the 46 degrees C-cells were more resistant to butylated hydroxyanisole and sodium nitrite. PMID- 6850421 TI - Natural immunity to murine gonococcal bacteremia: roles of complement, leucocytes, and sex. AB - The roles of the serum bactericidal system, inflammatory cells, and sex in resisting gonococcal infection were studied in a murine model of gonococcal bacteremia. The role of serum killing in defense was investigated with complement component 5 deficient (C5-deficient) (B1O.D2/OSN) and normal (B1O.D2/NSN) mice. No significant differences were found between LD50's with either murine serum sensitive or serum-resistant gonococci in those two mouse strains. However, in vitro experiments revealed a heat-stable factor in mouse serum which killed gonococci. Thus it appeared that the C5-deficient mouse is not a good model for the study of the role of C-mediated killing in resistance to gonococcal infection. Mice with Chediak-Higashi disease were used to study the role of phagocytes and natural killer cells. The difference in LD50's between affected mice (C57B1/6J beige J) and controls (C57B1/6J) was significant. The CBA/N mice, which have a B-cell maturation defect, were no more resistant to infection than control mice, which was taken as further evidence that B cells were less important than other leucocytes in innate immunity to gonococcal infection. Finally, male mice were significantly more resistant than female mice to gonococcal bacteremia. Thus, in this study the two most important determinants of resistance to gonococcal infection were inflammatory cells and sex. PMID- 6850422 TI - Scanning electron microscopy of mouse ciliated oviduct and tracheal epithelium infected in vitro with Bordetella pertussis. AB - Infection of mouse tracheal organ culture with Bordetella pertussis resulted in ciliostasis within 36 h. Scanning electron microscopy revealed that B. pertussis attached exclusively to ciliated cells but did not induce expulsion of this cell type at a test interval of 48 h. Mouse oviduct organ culture infected with B. pertussis demonstrated the same strict tropism for ciliated cells as in the tracheal ring system. Only ciliated cells were parasitized, becoming heavily colonized 48 h postinfection. Infected ciliated oviduct cells were not extruded. A fixation method which enhances fine structure was used in the scanning electron microscope studies. Bacterial fimbriae were not observed as the method of attachment of B. pertussis to cilia but fine fibers were seen extending between cilia and bacterial cells. PMID- 6850423 TI - Subcellular location of enzymes involved in leucine dissimilation in Clostridium bifermentans. AB - Conversion of leucine to isovaleric (iV) and isocaproic (iC) acids by cell-free extracts of Clostridium bifermentans was demonstrated using two lysis procedures. Sonication resulted in an extract which had the enzymes to convert leucine to alpha-ketoisocaproic acid (alpha-kiC) and thence iV, but failed to produce iC. Extracts prepared by osmotic lysis, which contained intact membranes, could convert leucine to both iV and iC. The enzyme which converts leucine to alpha-kiC was solubilized during osmotic lysis, whereas the decarboxylase and leucine reductase system remained membrane bound. Osmotic lysis also released at least two small molecular weight, heat-stable, anionic components (3500 greater than molecular weight greater than or equal to 1000), which stimulated decarboxylase activity. PMID- 6850425 TI - Magnetic stimulation of polysaccharide accumulation in cultures of Streptococcus mutans. PMID- 6850424 TI - Investigation of white-rot fungi for the conversion of poplar into a potential feedstuff for ruminants. AB - Five isolates of wood-rotting fungi were compared for their ability to increase the digestibility of poplar shavings. Homogenates of the fungi were inoculated into mixtures of 25 g of shavings and 100 mL of supplementary nutrient solution and incubated at 25 degrees C. The in vitro rumen digestibility of the products increased from 30% at the start of the fermentation to maxima of 72% with Polyporus anceps after 8 weeks, 64% with Ganoderma applanatum and 62% with Phanerochaete chrysosporium after 4 weeks, 61% with Polyporus versicolor after 3 weeks, and 42% with Fomitopsis ulmarius after 4 weeks. Fibre analysis showed a decrease in lignin as digestibility increased. Loss of carbohydrates occurred in all fermentations and continued after lignin loss ceased. Dry matter yield at the time of maximum digestibility ranged from 80 to 94% of the original dry matter. The highest digestibilities attained were similar to those of conventional roughage feeds for ruminants. This shows that this fermentation could form the basis of a practical system for converting poplar into a feedstuff. PMID- 6850427 TI - Ileoanal anastomosis: improving functional results. PMID- 6850426 TI - Effect of incubation atmosphere and temperature on isolation of Campylobacter jejuni from human stools. AB - To determine the optimal conditions for isolation of Campylobacter jejuni from human fecal specimens, we compared incubation atmospheres that contained about 5, 10, and 15% oxygen with the 17% oxygen produced in candle jars and also compared incubation temperatures of 37 and 42 degrees C. At 42 degrees C, C. jejuni was isolated from all 16 specimens; however, colony sizes were larger when plates were incubated in 5 and 10% oxygen than in the other two atmospheres. At 37 degrees C some positive cultures were missed in 15% oxygen and in the candle jar. The largest colony sizes were obtained in 5% oxygen. For each atmospheric condition tested, the colonies were larger at 42 than at 37 degrees C. When incubation is done at 42 degrees C, use of a candle jar is adequate; however, at 37 degrees C candle jars should not be used for isolation of C. jejuni from human feces. PMID- 6850428 TI - The difficulty in assessing the rate of recurrence after proximal gastric vagotomy. PMID- 6850429 TI - Acute necrosis of the gastrointestinal tract: a unified view. PMID- 6850430 TI - A registry for surgery of hepatic metastases. PMID- 6850431 TI - Cricopharyngeal myotomy. PMID- 6850432 TI - Wound measurement. PMID- 6850433 TI - Role of resection in the management of metastases to the liver. AB - The results of 22 hepatic resections for metastatic disease are reviewed. There were no operative deaths and survival was encouraging. Life-table analysis of all 22 patients predicted a 5-year survival of 56.4%, and if 16 patients who had primary colorectal tumours are considered separately, the expected 42-month survival was 42.2%. Patients with a single metastasis generally lived longer, and there was no difference in survival between hepatic metastases resected synchronously or metachronously. The authors recommend an aggressive approach to the treatment of hepatic metastases. PMID- 6850434 TI - Congenital tracheoesophageal fistula without esophageal atresia. AB - Between Jan. 1, 1961 and Dec. 31, 1981, 16 infants (9 boys, 7 girls) with tracheoesophageal fistula without esophageal atresia (H-type fistula) were treated at the Hopital Sainte-Justine and Centre Hospitalier de l'Universite Laval. The mean birth weight was 2.8 kg. Five infants were premature. All presented at first feeding with coughing, choking and cyanosis. Seven had abdominal distension and six had hypersalivation. Mean age at the time of definitive diagnosis was 39.1 days. The diagnosis was confirmed radiologically in all infants, a mean of 1.69 roentgenographic procedures per patient being required. Cervicothoracic (C7 to T2) fistulas were present in 14 and thoracic fistulas in 2 infants. Twelve were operated upon through a cervical and 4 through a thoracic approach. A Fogarty catheter was placed in two fistulas preoperatively. Two patients required gastrostomy. Feeding was started again 3 days postoperatively. One infant died and one had a recurrent fistula. One survivor had 20 episodes of cardiorespiratory arrest. None had dysphagia. The authors consider it imperative that fistulas be visualized before any operative procedure is performed. Catheterization of the fistula with a Fogarty catheter should be attempted preoperatively. It is dangerous to dissect a cervical fistula through a thoracotomy. PMID- 6850435 TI - Segmental infarction of the greater omentum: a cause of acute abdomen in childhood. AB - Segmental infarction of the greater omentum is an unusual cause of acute abdominal pain in children. Over 30 years at the Hospital for Sick Children in Toronto, this entity was encountered nine times. All children complained of right lower quadrant pain. They were tender in that area and were thought to have acute appendicitis. At operation, the appendix was found to be normal in all and an area of infarcted omentum was identified as the cause of the acute illness. Torsion of the infarcted omentum was noted in four cases. Excision of the omentum was curative. PMID- 6850436 TI - Hypoglycemia associated with pediatric surgical procedures. AB - Hypoglycemia, a plasma glucose level below 2.2 mmol/l, was noted perioperatively eight times in association with 61 operative procedures performed on 46 infants. It was most common in children with complications of neonatal necrotizing enterocolitis. It was related to grossly inadequate caloric intake perioperatively and was associated with increased mortality. Because the glucose requirement of the infant brain is high, cerebral damage must be seriously considered in infants with hypoglycemia postoperatively. PMID- 6850437 TI - Treatment of hyperthyroidism in children. AB - Thirty-three children with hyperthyroidism, an uncommon condition in childhood, were treated at the Hopital Ste-Justine in Montreal during the period 1961 to 1974. Of these, 31 underwent medical treatment initially. Fifteen were cured by medical treatment only; the other 18 had to undergo subtotal thyroidectomy. When these two groups were compared the advantage of surgery in the treatment of this disease was clear. There were no major complications postoperatively. Two children became hypothyroid. The mean follow-up was 5 years and 6 months. PMID- 6850438 TI - Atlantoaxial arthrodesis to treat odontoid fractures. AB - The authors reviewed 132 cases of cervical spine fracture over a 10-year period and found 24 cases of fracture of the odontoid process. Using the classification of Anderson and D'Alonzo, they found 20 patients with type II fractures and 4 with type III injuries. Sixteen patients with type II fractures and 1 with type III underwent posterior atlantoaxial fusion by the Gallie method or a modification of it. Immobilization following arthrodesis was by soft cervical ruffs and a four-poster collar. Solid fusion was obtained within 3 to 6 months in 15 of the 16 type II fractures; one patient was lost to follow-up. The one patient with a type III fracture obtained a solid fusion within 3 months. One patient had the fusion revised at 1 month for progressive displacement; otherwise there were no notable complications. It is almost impossible to determine whether the fracture fragments had united but this is not important as long as there is a solid fusion. Whether treatment of acute odontoid fractures, particularly type II, should be operative or nonoperative is controversial, but from this review the authors believe that primary treatment of type II odontoid fractures by posterior atlantoaxial arthrodesis with its low morbidity and high fusion rate is superior to nonoperative treatment. PMID- 6850439 TI - Radial shortening for Kienbock's disease. AB - The subjective and objective results in seven patients with symptomatic Kienbock's disease treated by radial shortening demonstrate that this procedure is simple and effective in the early stages of the disease, when there is no arthrosis, wrist collapse or translation. By decompressing the shear stress imposed on the lunate bone, pain was relieved and function improved in almost all patients. PMID- 6850440 TI - Use and abuse of mammography in the early diagnosis of breast cancer. AB - In the 8 years before 1980, 3958 women were examined in the St. Michael's Hospital breast clinic in Toronto. Of 302 women with breast cancer, 87 (29%) had normal mammograms. Breast cancer was found in 34 after at least one clinical and mammographic examination had given normal results. Of these, 6 (18%) cancers were detected only by mammography while, paradoxically, 23 (68%) were detected only by clinical examination. Normal mammograms are significantly (p less than 0.001) more frequent in young women with breast cancer and in those with small palpable breast cancers. Mammography is most productive when used as a routine study in older women who have clinically normal breasts. All women should start having them around the age of 40 to 45 years. How often they should be repeated is debatable. There is no evidence that they should be repeated annually. Under 35 years of age mammography for any reason is unrewarding. Biopsy of a breast lump that is solid on aspiration should never be delayed because of a normal mammogram. Biopsy of a radiologically suspicious lesion in the breast should never be delayed because the findings on clinical examination are normal. PMID- 6850441 TI - Symposium on the diagnosis and treatment of common cancers. 3. Colorectal carcinoma. AB - Current efforts to reduce the morbidity and mortality of colorectal adenocarcinoma are directed mainly to earlier diagnosis and the development of effective surgical adjuvant treatment. The most generally available screening technique is the identification of fecal occult blood, but numerous false negative and false-positive findings, and the large population at risk, suggest that more effective but time-consuming screening methods, such as endoscopy, should be reserved for high-risk groups. More extensive pelvic and para-aortic lymph-node dissections for rectal adenocarcinoma have not resulted in consistently improved survival rates. Radiotherapy reduces the frequency of pelvic recurrence when given as either preoperative or postoperative adjuvant therapy for rectal cancer but has not yet produced any major improvement in survival. No effective adjuvant chemotherapy for colorectal adenocarcinoma has yet been identified. Primary radiotherapy can control a proportion of rectal carcinomas and may reduce the need for colostomy in some cases. PMID- 6850442 TI - Ureter within a sliding inguinal hernia. AB - Large sliding inguinal hernias may contain a variety of either intraperitoneal or retroperitoneal anatomical structures. A ureter within a sliding inguinal hernia has been reported rarely. The author presents such a case to alert the unwary surgeon of this possibility and to indicate a successful method of treatment. Pyelography is indicated as a routine preoperative diagnostic procedure in morbidly obese patients with large irreducible inguinal hernias, particularly if the patient complains of frequency or other urinary symptoms. The ureter should be carefully dissected with its blood supply from the sliding tissues and laid back in the retroperitoneal space with resection or reimplantation. The hernia may then be repaired by standard methods. The patient described in the report is well and free of symptoms 10 years after the operation. PMID- 6850443 TI - Aortocolic fistula: a rare cause of profuse rectal bleeding. AB - A 62-year-old man with multiple myeloma survived for 19 months following massive hemorrhage from an aortocolic fistula secondary to an aortoiliac aneurysm that was adherent to the sigmoid colon. The literature indicates that early death from multisystem failure is to be expected and that sepsis is an inevitable consequence of aortocolic fistula. However, in this case the patient did not die despite multisystem complications and his eventual death was unrelated to sepsis or graft complications. Reasons for the unexpected outcome are suggested. No survivors have been reported in the literature. PMID- 6850444 TI - Toxic reaction to phenytoin following a viral infection. PMID- 6850445 TI - Hair growth and plaster casts. PMID- 6850446 TI - Breast self-examination. PMID- 6850447 TI - Ribonuclease levels reflect renal function. PMID- 6850448 TI - Clinical immunology: its role in medicine and future in Canada. PMID- 6850449 TI - Humane medicine. PMID- 6850450 TI - Coarctation of the aorta in an elderly man. AB - An active, 74-year-old man with coarctation of the aorta is described. This case is rarely found in patients over the age of 70, and the patient had been in good health. PMID- 6850453 TI - An index of suspicion. PMID- 6850451 TI - Nurse practitioners: stepping into the doctor's domain? PMID- 6850452 TI - Nurse practitioner program: University of Alberta. PMID- 6850454 TI - Carpal tunnel syndrome in pregnancy. PMID- 6850455 TI - Bizarre presentation of abdominal lymphangioma in children. PMID- 6850457 TI - The paradox of family violence. PMID- 6850456 TI - Medical manpower planning. PMID- 6850458 TI - Is professional courtesy dying? PMID- 6850459 TI - Meningococcal meningitis without pleocytosis. PMID- 6850460 TI - Why measure quality of life? PMID- 6850461 TI - Atrial fibrillation and embolism. PMID- 6850463 TI - Artificial cardiac stimulation: a current view of physiologic pacemakers. AB - Artificial pacing of the heart has evolved rapidly over the last 20 years; the physician can now implant "physiologic" pacemakers that preserve the natural order of atrial and ventricular systole. The commonly used pacemakers that pace only the ventricle can induce dizziness, fatigue and syncope and increase congestive heart failure. Physiologic pacemakers can eliminate many of these side effects, but they are more expensive, can be less durable and may induce arrhythmias. Physiologic pacing can provide the greatest benefit and cost effectiveness when the particular functions of the device are matched to the specific needs of the patient. PMID- 6850462 TI - Can we classify "precision guesswork"? PMID- 6850464 TI - Nonspecific and selective stimulation of the immune system in the treatment of carcinoma in humans. AB - The experience of the Toronto General Hospital in the use of nonspecific stimulation of the immune system with bacille Calmette-Guerin (BCG) for the treatment of cancer of the gastrointestinal tract, malignant melanoma and breast cancer is described. The results are presented in terms of survival curves. The use of BCG administered intraperitoneally in a randomized study of patients with gastric, pancreatic and colorectal cancer proved of no benefit. On the other hand, when BCG was given orally in a randomized study of patients with resectable cancer of the colon and in nonrandomized consecutive studies of patients with malignant melanoma and stage IV carcinoma of the breast survival was increased. In a group of patients with advanced gastrointestinal cancer selective stimulation of the immune system with NED 137 produced a significant increase in survival when compared with the survival of historical controls (the patients given BCG intraperitoneally along with 5-fluorouracil for gastrointestinal cancer). The results of these studies suggest the need for a more rational approach in manipulating the immune response that would combine chemotherapy with selective stimulation of the immune system. PMID- 6850465 TI - Multidisciplinary survey of erectile impotence. AB - A study was done of 220 men referred principally by family physicians to a multidisciplinary erectile dysfunction study group to determine the factors causing or contributing to impotence that had persisted for more than 2 months and for which no cause was apparent. The men were aged 21 to 79 (mean 50.3) years, and the duration of impotence was a few months to 15 years (mean 2.65 years). The men were to be assessed from general medical, endocrinologic/metabolic, psychiatric and urogenital viewpoints. The significance of the causal or contributory factors detected was scored by application of defined criteria and a four-point scale. The degree of loss of potency and of libido as well as level of concern were also scored by each specialist. Impotence was complete in 60%, and an associated decline in libido was reported by 38%. The level of concern was high--that is, normal--in 81% and slightly reduced in 9%. Full investigation by all the specialists was precluded by the severity of other conditions in 16 patients, by the return of potency following relief of anxiety/depression or genitourinary tract infection in 16 and for logistic or other reasons in 34. Although the cause of the impotence could be attributed in 186 of the patients, only 154 were fully assessed. Among these patients general medical factors were contributory in 46%, endocrinologic/metabolic factors in 44%, psychogenic factors (primary or secondary) in 60% and urogenital factors in 49%. Multiple contributing factors were identified in 65%, which underscores the importance of a multidisciplinary approach to assessing many cases of impotence. PMID- 6850467 TI - Staphylococcus aureus meningitis: 26 years' experience at Vancouver General Hospital. AB - The records of all patients with Staphylococcus aureus meningitis admitted to Vancouver General Hospital between 1956 and 1981 were reviewed. All the patients had clinical and laboratory features of meningitis, and in all cases S. aureus was isolated from the cerebrospinal fluid. S. aureus was responsible for 21 (3%) of the 710 cases of acute bacterial meningitis. Therapy with cloxacillin or methicillin, or both, with or without other agents, was successful in 14 of the 21 patients. Three of the 14 patients without ventricular shunts died, 2 with fulminating septicemia and 1 with a postoperative brain abscess treated with cloxacillin. Following shunt removal and antibiotic therapy all seven patients with ventricular shunts survived the infection. Shunt removal may therefore be essential in appropriate cases. PMID- 6850466 TI - Site distribution of malignant melanoma. AB - In a continuous series of 300 patients with cutaneous malignant melanoma the site of the primary lesion was recorded, and incidence rates per unit area of skin were calculated. These rates were high for the face, back and upper arm and low for the abdomen, buttocks, forearm and hand for both sexes. Rates for the leg were high for the women but low for the men. Tumours on the back were evenly distributed among the men but occurred less frequently on the lower back among the women. In general, sites that were usually covered by clothing had lower rates than those usually exposed, with the exception of the forearms and hands. No relation was seen between tumour site and age, sex, depth of invasion or month of diagnosis. Superficial spreading and nodular melanomas did not differ in their site distribution. Incidence rates per unit area at different ages were estimated for sites grouped by their degree of usual exposure: while the rates for unexposed sites were low, those for usually or intermittently exposed sites were higher and similar to each other. PMID- 6850469 TI - Oil rig medicine: is 40 hours' training enough? PMID- 6850468 TI - Fulminating necrotizing amebic colitis with perforation: case report and review. AB - A seriously ill patient with diffuse abdominal tenderness of unknown cause is described. The diagnosis proved to be fulminating necrotizing amebic colitis with perforation. This case report serves as a reminder that amebiasis may occur in patients who have not been outside Canada, that it may readily be confused with other types of inflammatory bowel disease, and that particular care should be taken in obtaining a history of exposure. Before inflammatory bowel disease is diagnosed not only should the usual diagnostic tests such as stool examination and mucosal biopsy be done, but also serologic testing for amebiasis should be carried out. PMID- 6850470 TI - Drug therapy and the elderly patient. PMID- 6850471 TI - Family physicians deserting hospitals, says retiring CFPC president. PMID- 6850472 TI - The facts of medical education. PMID- 6850474 TI - Medical illustration: from da Vinci to Telidon. PMID- 6850473 TI - Is the fetus a patient? PMID- 6850475 TI - The wild world of stock options: is it for you? PMID- 6850477 TI - The arms race: cancer in the global village. PMID- 6850476 TI - The nature of nuclear attack. PMID- 6850479 TI - Nuclear war and public health. PMID- 6850478 TI - Casualties in a nuclear war. PMID- 6850480 TI - Psychological aspects of the nuclear arms race. PMID- 6850481 TI - Continuing education for health professionals and administrators: workshops on becoming a critical user of health care research. PMID- 6850484 TI - Stair walking...a few steps to better health. PMID- 6850482 TI - [Evaluation: comparative analysis and the construction of probability models]. PMID- 6850485 TI - Public health and the law. Optometrists, drugs and the law. PMID- 6850483 TI - Analysis of sources contributing to elevated formaldehyde concentrations in the air in a new elementary school. PMID- 6850486 TI - Public health, prevention and the aged. PMID- 6850487 TI - Caloric and nutrient intake of adolescents in the Quebec City region. PMID- 6850491 TI - Fitness and pregnancy: a round table discussion. PMID- 6850488 TI - Relationship between air pollutant levels and hospital admissions in Southern Ontario. PMID- 6850490 TI - Canadian Public Health Association National Physical Activity Week. PMID- 6850489 TI - Report on urea formaldehyde foam insulation. PMID- 6850492 TI - The Canada Fitness Survey. Implications for health research and public health practice. PMID- 6850493 TI - New frontiers in geriatric science: fitness in the "Third Age". PMID- 6850494 TI - The resolution of ambiguities. PMID- 6850495 TI - Teaching some principles of individual psychodynamics through an introductory guide to formulations. AB - One objective of psychiatric education can be to help trainees describe and understand major concerns patients experience in their key relationships, inner conflict and sense of self. A precis of major concepts and principles in this area (usually known as psychodynamics) is presented without the metapsychological framework which makes some of the literature difficult to grasp. This is intended to make learning more efficient and to facilitate the formulation of hypotheses about the presence or absence of specific conflicts, and problems in key relationships. We do not propose that these hypotheses necessarily explain psychopathology but that they (a) supplement formal diagnosis; (b) enrich the clinical data base by providing hypotheses which are testable in part by clinical observation and which can be tested scientifically; (c) provide understanding crucial to psychotherapy. PMID- 6850496 TI - Psychotherapy and pharmacotherapy: the challenge of integration. AB - The use of psychotherapy and pharmacotherapy in combination remains a neglected area of study. In spite of evidence validating the combined treatment psychiatrists often avoid this approach. When combined treatment is employed insufficient attention may be devoted to the important interactive effects. Patients may react to the prescription of medication with a variety of transference feelings such as acceptance, rejection, manipulation and narcissistic injury. Discussion of interpersonal issues precipitated by the use of medication can improve not only the doctor-patient alliance but also the patient's symptomatic experience. The initiation or discontinuation of medications must be carried out with sufficient attention to the patient's realistic concerns and transference distortions. The neglect of a negative transference reaction aroused by the prescription of a medication can result in a resistance to treatment. Case examples and discussion in the article illustrate such phenomena. Psychiatrists need to be aware that their decision to prescribe medication may be influenced by their own unconscious conflicts surrounding the use of medication. They may prescribe or fail to prescribe motivated by their latent fantasies. Attention to the interactive effects of combined therapy is viewed as essential in order to aid patients in the dual goals of symptom alleviation and enrichment of interpersonal experience. PMID- 6850497 TI - Psychiatric disorders associated with atypical facial pain. AB - Atypical facial pain (AFP) patients classically present with a chronic discomfort that is neither anatomic nor dermatomal in distribution. Neuropsychiatric assessment of 68 patients with AFP indicated that 46 (68%) had a specific psychiatric disorder by DSM-III criteria. A wide spectrum of psychiatric disorders was present. The authors emphasize that psychiatric assessment of patients with AFP should be an integral part in early assessments of this disorder, rather than relying on psychiatric opinions after extensive dental and other invasive procedures have been tried in vain and often to the detriment of the patient. Comments on the excellent prognosis in treating the psychiatric syndromes associated with AFP are made. PMID- 6850498 TI - The DSM-III in Canada: a survey. AB - A survey of the membership of the Canadian Psychiatric Association (CPA) was completed for the Scientific Council to discover, first, the reaction of the members to the Diagnostic and Statistical Manual, Third Edition (DSM-III) and second, the support given to the CPA Policy of not endorsing a particular classification system. A total of 26.3% responded. It was noted that 66.6% had studied the DSM-III in detail. Whereas the ICD-9 and DSM-II were the most used systems in the past (28.5% and 25.9% respectively), first choice systems for the future were DSM-III, 42.0% and ICD-9, 16.3%. Furthermore, the DSM-III was recommended to be used as the sole system to various associations, (Statistics Canada, Royal College, Medical Council of Canada and Postgraduate Programs) 45.9% to 51.4%, depending on which association (vs. 8.7% to 13.4% for the ICD-9). Of those responding to the question, 70.8% had a favourable impression of the DSM III and a similar percentage wanted an ICD-10 which would incorporate features of the DSM-III. A survey of directors of postgraduate psychiatric training programs gave similar results. A total of 54.8% of the members supported changing the CPA "non-endorsement" policy. As well, 39.7% voted to maintain the policy and 5.5% did not respond. The survey provides information for the CPA in its consideration of policy about the use of classification systems. Should the policy be changed, and one system endorsed, the DSM-III receives the most support. PMID- 6850499 TI - Psychiatric illness in African students: "brain fag" syndrome revisited. AB - For 20 years, since Prince originally introduced it, the term "brain fag syndrome" has been used to describe a variety of symptoms frequently reported by students in Africa. In this paper the author questions the validity of the use of the term on the basis of clinical evidence afforded by his work and reports in the literature. It is concluded that brain fag syndrome is a misnomer and that more specific diagnostic terms such as anxiety neurosis and depressive neurosis should be used in its place. PMID- 6850500 TI - An open dose finding study of melperone in treatment of agitation and irritability associated with dementia. AB - Seventeen older patients with a diagnosis of Organic Brain Syndrome were placed on a four-week trial of melperone for treatment of behavioural disturbances associated with dementia. Efficacy evaluation of the drug revealed improved ratings of the patients in the areas of agitation/irritability, anxiety, unsociability, and mental alertness. Thirteen of the fourteen patients who completed the trial were rated generally as showing at least minimal improvement while on the drug. There were no serious side effects noted, with drowsiness the most frequent finding. These favourable results are suggestive of the usefulness of this drug, and point to the need for double-blind, comparative studies. PMID- 6850502 TI - [Psychoses and unidentified flying objects]. AB - Some individuals claim to have come into contact and communicated with occupants of flying objects of extraterrestrial origin who often would have entrusted them with "missions" regarding the safeguard of humanity. The authors, who have observed six such subjects, conclude that five of them suffered from a paranoid delusional state often akin to paraphrenia; whereas other analogous cases previously reported have been diagnosed as suffering from paranoid schizophrenia. Their beliefs, inaccessible to criticism and to reasoning, presumably help them to remain outside psychiatric reach. The present article does not take an interest in the physical existence of this phenomenon and does not wish to be reductionistic. It does not claim to express a judgment on the witnesses of such phenomena whose mental health must be evaluated through a rigorous and impartial examination, and not be evaluated in terms of the examiner's preconceptions toward the witnesses' assertions. PMID- 6850506 TI - An unusual intraosseous lesion with fibroblastic, osteoclastic, osteoblastic, aneurysmal and fibromyxoid elements. "Solid" variant of aneurysmal bone cyst. AB - Four examples are reported of an unusual noncystic intraosseous lesion which does not conform to any hitherto recognized entity and which can be mistaken, not only by the general histopathologist but by the osteoarticular pathologist, for a variety of other conditions, including sarcoma and giant-cell tumor. They were in patients aged 5 to 13 years; three in the spine, one in the ethmoid. Local excision, supplemented by low-dose radiotherapy in cases with cord compression, produced a satisfactory outcome in all cases. At presentation the radiologic findings were nonspecific but, following treatment, an eggshell rim of bone developed in those lesions which had been incompletely excised. Histologically, they are characterised by florid fibroblastic or fibrohistiocytic proliferation, osteoblastic differentiation with osteoid production, areas rich in osteoclast type giant cells, aneurysmal sinusoids, and occasional foci of degenerate calcifying fibromyxoid tissue. Because this combination of histologic features can be found in the solid parts of aneurysmal bone cyst and in no other condition, at this centre we have regarded this lesion as a variant of aneurysmal bone cyst devoid of any cystic component. PMID- 6850504 TI - Neurilemomas and salivary gland tumors of the head and neck following childhood irradiation. AB - In a program to contact and examine 4180 individuals with a history of childhood irradiation treatment for enlarged tonsils and adenoids, the authors have discovered 29 neurilemomas, two neurofibromas, and one ganglioneuroma in the 2311 subjects who have been found. Ten of these presented as acoustic neuromas, 21 presented as cervical mass lesions, and one was found in the superior posterior mediastinum. Because of their numbers and their strict localization to the area of treatment, it was concluded that they were radiation-induced. Analysis of the latency of these tumors indicates that they continue to occur for at least 30 years after the radiation exposure. In the same group of individuals, there have been 54 confirmed salivary gland tumors, 40 benign and 14 malignant. These tumors are also continuing to occur many years after the radiation exposure. PMID- 6850503 TI - Psychiatric patients who discharge themselves against medical advice. AB - Hospital treatment staff are constantly faced with the problem of psychiatric patients who discharge themselves against medical advice before their treatment is completed. A total of 50 patients who signed themselves out of the 9th floor service of the Clarke Institute of Psychiatry, over a two year period, were analyzed. When compared with a random sample of patients who remained for the duration of their treatment, the authors found the AMA patients to have the following characteristics: The patient is likely to be a young male, admitted as an emergency, remain in hospital for three days or less and have a diagnosis of personality disorder or schizophrenia. The authors conclude with a number of recommendations to assist in dealing with the problem. PMID- 6850501 TI - Distribution of Leonhard's subtypes of chronic schizophrenia in two cultures. PMID- 6850505 TI - Influence of thyroid substitution therapy and thyroid autoantibodies on the value of serum thyroglobulin in recurring thyroid cancer. AB - The study was performed to evaluate the influence of thyroxine substitution therapy and the presence of thyroglobulin antibodies (TgAb) on the usefulness of serum thyroglobulin (Tg) measurements in the follow-up of patients treated for well differentiated thyroid carcinoma. Seventy-two consecutive patients with differentiated thyroid cancer and eight with medullary carcinoma as well as controls were studied on one or more occasions and blood was drawn for measurement of serum Tg, TgAb, TSH and thyroid hormones. In 23 patients the hormonal substitution was withdrawn and 3-4 weeks later new blood samples and a 131I scintigraphy was performed. Eighteen patients were shown to have recurrence or metastases. Four of these had TgAb, two had normal Tg values, and the remaining 12 had extremely elevated levels. Those with TgAb and normal Tg values all had high Tg levels off thyroxine substitution. The 54 patients without evidence of recurrence had low levels of serum Tg except for one with highly elevated values. Based on the results from this and other studies is concluded that serum Tg is an important adjunct in the follow-up of patients with well differentiated thyroid carcinoma, but certain limiting factors have to be taken into account, i.e., the radicality of surgery, the sufficiency of the substitution, the presence of TgAb and the method for measurement of Tg. PMID- 6850507 TI - Large-cell calcifying sertoli cell tumor of the testis. An ultrastructural, immunocytochemical, and biochemical study. AB - This report describes the ultrastructural and hormonal characteristics of the recently described large-cell calcifying Sertoli cell tumor of the testis, a rare subtype of pure Sertoli cell tumor. The ultrastructural findings showed similarity to normal Sertoli cells, pure Sertoli cell tumors, Sertoli cells in azoospermic human testes, and the Sertoli cell component of Sertoli-Leydig cell tumors. Ultrastructure indicated features common to steroid-producing cells. Testosterone and estradiol were demonstrated in the tumor by immunocytochemical and biochemical methods. PMID- 6850508 TI - Hodgkin's disease, lymphocytic predominance nodular. Increased risk for subsequent non-Hodgkin's lymphomas. AB - Fifty-one cases of Hodgkin's disease, of lymphocytic predominance type, nodular subtype (HDLPN) were singled out from three sources: lymph nodes originally diagnosed as malignant lymphoma, nodes suspected of lymphoma and nodes suspected of toxoplasmosis. Two thirds of the 51 patients were men, and the median age was 42 years. The disease was characteristically unilocular and cervical and axillary nodes were most often involved. Local recurrences were common (in 13 cases). Oncological treatment (irradiation, cytostatics, or both) was given to 20 patients, whereas 31 patients remained untreated as the original histological diagnosis was not malignant. Despite the lack of treatment, the prognosis was good. Relative actuarial survival for the whole material was 93% at five years and 80% at ten years. During follow-up, five patients developed a diffuse large celled non-Hodgkin's lymphoma 4-11 years after the onset of HDLPN. The majority of the subsequent lymphomas cannot be therapy-induced as only one of these patients had previously been treated (irradiated). Transition to other types of Hodgkin's disease was observed only in two cases. It is concluded that HDLPN is a clinicopathological entity with a good prognosis, but that it may sometimes change into a more malignant lymphoma of the Hodgkin's or non-Hodgkin's type. PMID- 6850509 TI - Hydrocele formation in patients with Hodgkin's disease. AB - Hydroceles developed in 12 (7.7%) of 155 consecutive male patients who had Hodgkin's disease treated between 1962 and 1981. Except for one patient who had a hydrocele at diagnosis, all developed this complication during remission, 8 months to 7.5 years after inverted-Y or abdominopelvic 60Co irradiation (3000 3800 rad). Hydroceles were bilateral in five patients and on the right side in seven. No tumor was found in the hydrocele sacs of the ten patients who underwent hydrocelectomy. Lymphatic obstruction was evidenced by lymphatic dilation in the hernia sac in six patients. The authors believe postirradiation fibrosis of the lymphatic pathway was the main cause of hydrocele formation. PMID- 6850510 TI - Meningeal melanocytoma of Meckel's cave associated with ipsilateral Ota's nevus. AB - A case of meningeal melanocytoma of the left Meckel's cave associated with ipsilateral Ota's nevus in a 43-year-old woman, was studied by light and electron microscopy. The cells of the tumor were characterized by the presence of dendritic cytoplasmic processes, melanosomes and premelanosomes; hence, they were deemed as neoplastic melanocytes. Moreover, the tumor was lacking in histologic and ultrastructural features of pigmented meningioma, melanotic Schwannoma and primary meningeal melanoma. The prolonged clinical course was different from primary and metastatic malignant melanomas of the meninges. The best treatment appears to be radical excision, when possible; otherwise, the local or partial enucleation followed by radiation therapy has been found to be the best curative to date. On the whole, meningeal melanocytoma cannot be considered as entirely benign, given its morphologic patterns that resemble those of uveal melanoma, and its potential for recurrence. The association of this tumor with Ota's nevus is referred to as having a common origin from an arrested migration of melanoblasts at different stages. PMID- 6850511 TI - Influence of surgical technique on estrogen and progesterone receptor determinations in breast cancer. AB - The effect of surgical technique on hormone receptor values in breast cancer tissue was examined. One hundred and thirty-one women with breast cancer were divided into three groups: Group I, definitive diagnosis at frozen section and tissue taken for receptor determination; Groups II and III, diagnosis made by aspiration biopsy cytology, with tissue obtained from modified radical mastectomy in Group II and tissue obtained from mastectomy performed separately, prior to axillary lymph node dissection, in Group III. The rates of estrogen and progesterone receptor positivity, and the mean levels of receptor, did not differ significantly among the three groups. Thus tumor tissue from a mastectomy specimen can be reliably used for hormone receptor determinations, if the tumor tissue is kept cold and rapidly frozen for storage. Women whose cancer has been diagnosed by aspiration biopsy cytology need not undergo an additional open biopsy solely to obtain tissue for receptor determinations. PMID- 6850512 TI - Percutaneous biopsy of intrapulmonary mass lesions. Experience with a disposable cutting needle. AB - This study investigated the diagnostic efficacy and safety of a percutaneous core biopsy technique in patients with undiagnosed intrapulmonary mass lesions. Eighty four consecutive biopsies were performed in 81 patients with intrapulmonary mass lesions. Follow-up data permitted a final diagnosis in 79 of these 81 patients, which allowed an assessment of the accuracy of the technique. Fifty-nine of 68 patients with malignant lesions were diagnosed by core biopsy (87% sensitivity) and nine of 11 with benign lesions (82% sensitivity). The complication rate was 21%. Malignant tumor cell-type was predicted correctly from biopsy material in 60% of patients. It is concluded that core biopsy is a safe procedure if restricted to the investigation of intrapulmonary mass lesions, and is effective in the identification of malignant tumors. Its chief advantage over aspiration techniques is that the tissue core obtained permits a specific diagnosis in a high proportion of patients with benign lesions, thus reducing the need in these patients for continued observation or diagnostic thoracotomy. PMID- 6850514 TI - Accuracy of staging in A1 carcinoma of the prostate. AB - The classification of patients with incidental carcinoma of the prostate into focal (Stage A1) or diffuse (Stage A2) subgroups depends primarily on the microscopic findings on tissue removed from transurethral resection (TUR) or open enucleation. However, these procedures sample only a portion of the entire prostate, and some patients staged A1 may have residual diffuse cancer that should properly be classified as Stage A2. This study is a review of 86 patients with Stage A1 cancer of the prostate in whom additional prostatic tissue was available because of repeat transurethral resection or radical prostatectomy. Only six patients (7%) were found to have diffuse cancer in the remaining prostatic tissue. Therefore, it appears that the classification of patients into Stage A1 or Stage A2 is generally accurate when based on the findings from initial TUR alone and that the incidence of understaging in this group is low. Repeat transurethral resection does not appear to contribute significantly to the accuracy of staging. PMID- 6850513 TI - Carcinoma of the esophagus twelve years after curative resection for carcinoma of the esophagus. AB - A patient is presented who developed a second squamous cell carcinoma of the esophagus twelve years after a curative esophagogastrectomy for a similar lesion in the proximal stomach. Factors predisposing to local recurrence at an esophageal anastomosis are reviewed. The long disease-free interval in this patient, however, strongly suggests a metachronous primary tumor rather than local recurrence. PMID- 6850515 TI - A novel method of assessing completeness of tumor registration. AB - A random sampling method of measuring the completeness of registration of cancer patients was tested at a university referral hospital. The target population consisted of all inpatients and nonprivate outpatients with in situ or invasive malignancies. The medical records of a random sample of all hospital records active in the last five years were reviewed to determine their reportability and inclusion in the tumor registry (Method A). Traditional casefinding assessment methods were also employed by conducting a complete review of four commonly used hospital sources for a short time period (Method B). The primary purpose of the study was methodologic; namely, to test the feasibility of Method A and to characterize it relative to the more traditional Method B. The estimated missed case rates using Methods A and B (3% and 5%, respectively) are not directly comparable because not all outpatient information is recorded in the medical record. It is concluded that as a means of completeness assessment, Method A can be feasible, cost effective, and useful in other institutions provided certain conditions are met: (1) an appropriate random sample of the target population can be obtained; (2) all relevant information is available in a unit medical record; (3) the reviewer is fully aware of the reportability criteria. PMID- 6850516 TI - Bladder cancer in Spain. Mortality trends (1955-1975). AB - Studies made of mortality tendencies due to bladder cancer made in various industrialized countries show evidence of an increase with time in death rates. This situation is also seen in Spain with some characteristics which we analyze. An actual increase of 60% in risk of death due to bladder cancer in males was found between 1955 and 1975. A definite tendency in women was not observed. The characteristics of the tendency curves indicate the grave importance that this tumor could eventually have in Spain and the need to adopt a policy of adequate intervention. PMID- 6850517 TI - Cancer and the family physician. AB - The American Cancer Society estimates that several hundred thousand lives could be saved per year if the current knowledge about the early treatment and prevention of cancer could be applied to all of the individuals in this country without new cancer "breakthroughs." The family physician has a unique opportunity, by virtue of his accessibility to a large segment of the patient population, to deliver patient education information as well as perform most of the procedures that are necessary to effect an early diagnosis. The family physician must develop a "preventive attitude" in himself, his office support staff, and the cadre of the consultants frequently used. He must be willing to assume the position of being a leader of the cancer team in all phases, which includes prevention, early diagnosis, definitive diagnosis, initial treatment, adjunctive treatment, reconstruction, continued surveillance for the lifetime of the patient, and finally, supportive care for the terminally ill. Care coordinator and primary communicator are positions he assumes on a continuing basis while acting as the patient advocate within the existing structure of the healthcare system. He must assume the role as financial advisor for the patient and his family with recommendations that are individualized, considering the patient's financial circumstance, age, general physical condition, support mechanisms, community resources available, family attitude, available consultation, and stage of disease. Ideally, we should strive to develop many thousands of cancer centers in individual family physicians, as well as other primary care physicians' offices across the country where correct information about cancer and proper diagnostic and therapeutic procedures can be obtained in that office or through proper consultation, with the alternatives in such procedures clearly provided to the patient and his family. These centers would provide an effective means of reducing morbidity and mortality of cancer within the existing structure of healthcare in this country and, if it were coordinated with episodic care, it could be done in the most effective manner. PMID- 6850518 TI - Trends in cancer mortality and epidemiology. AB - The increase in lung cancer in men has ceased at younger ages and is slowing at older ages. However, in women the increase continues and, by the end of this decade, lung cancer may be the most important cause of cancer deaths in women. The incidence of prostate and breast cancer continues to increase, but mortality is stable, suggesting changes in diagnostic practices. Mortality from stomach cancer and from cancer of the cervix in women continues to fall. Increasingly, it is necessary to recognize the multifactorial causes of cancer, requiring detailed information on lifestyle, occupational, and sometimes residential histories to unravel etiology. Physicians need to understand the requirement for access to patients in order to obtain data for studies. Monitoring unexpected hazards will require linkage, particularly using the National Death Index. Such sources can be used with preservation of confidentiality while increasing knowledge for primary prevention. PMID- 6850519 TI - Hormones, medications, and cancer. AB - Hormones have been shown experimentally to act as cocarcinogens or promoters, i.e., they facilitate the carcinogenic event. In the cases of breast and endometrium, those hormones that facilitate growth may also favor carcinogenesis in the human. There is good epidemiologic evidence that use of estrogens after the menopause increases the incidence of breast and endometrial cancer, the risk increasing with increasing duration of use. Periodic progestin-induced withdrawal will probably mitigate the risk of endometrial cancer after the menopause. Prolactin is the important promoter of mammary cancer in the rat and mouse, but its significance in women is still under study. Intermittently elevated prolactin levels have been noted in some women who subsequently developed breast cancer, but epidemiologic studies of women who have received prolactin-releasing drugs such as reserpine and perphenazine have not disclosed increased risk. Diethylstilbestrol is listed as a carcinogen but any estrogen can induce mammary cancer in the rodent or vaginal adenosis in the neonatal mouse (an experimental model of human vaginal adenocarcinoma). PMID- 6850521 TI - Cancer detection in the periodic physical examination. AB - The periodic physical exam is the ideal time for the primary physician to detect cancer at an early stage. With certain points in mind the physician can rapidly screen for suggestive signs of cancer during the physical examination. Certain procedures, laboratory and x-ray examinations, aid in this detection and should be part of the total examination. PMID- 6850520 TI - Applied cancer prevention in practice. AB - In 1982, more than 125,000 cancer cases in the United States should be preventable. Every physician should advise all patients to eliminate all tobacco use, moderate alcohol use, avoid the use of drugs which are carcinogenic, minimize sun and x-ray exposure, maintain an ideal weight, and follow a "prudent" diet. Secondary prevention efforts would include the American Cancer Society recommendations for the early detection of cancer in asymptomatic persons. Worldwide epidemiologic studies suggest that over 80% of human cancer is due to factors in the environment such as diet, life style, and synthetic chemical contaminants, and perhaps a complex interaction of factors including genetic susceptibility. Current research into the mechanisms of carcinogenesis and in the role of diet in cancer cause, are underway. Chemoprevention of cancer may someday be possible using retinoids, vaccines, and diet alteration. PMID- 6850522 TI - Diagnosis and management of skin cancer. AB - The diagnosis and management of cutaneous cancers, the most common of all malignancies, is well within the province of all physicians. These tumors are highly visible, usually slow growing, have distinctive physical characteristics, and are easily biopsied. Approximately 500,000 cases of basal and squamous cell carcinoma and over 14,000 cases of melanoma are anticipated in the United States this year. Cure rates for the nonmelanoma forms of skin cancer exceed 95%, and the five-year survival rate for clinical Stage I melanoma now exceeds 80%. Visual inspection, a high index of suspicion, and judicious biopsy are all that is necessary for diagnosis. The accurate and timely diagnosis of cancers of the skin should be a rewarding experience for both patient and physician. PMID- 6850525 TI - The role of surgery in the management of gynecologic malignancies. AB - Surgery is the primary treatment modality in a selected group of patients with primary carcinomas of the vulva and cervix. Carcinoma of the endometrium may be treated with both irradiation therapy and surgical excision; whereas carcinoma of the ovary requires surgical excision followed by chemotherapy or irradiation. The new frontier in surgical management for gynecologic malignancies is one of an adjuvant role. Surgery combined with chemotherapy or irradiation, or both, offers a wide range of treatment options with the possibility of improved tumor control rates and decrease in damage to normal tissues. A brief update on the role of surgery in the treatment of gynecologic malignancies is presented. PMID- 6850524 TI - The diagnosis of gynecologic cancer. AB - Malignant tumors of the female reproductive tract may be divided into the accessible and the inaccessible. Cancer of the vulva, cervix, and endometrium fall into the accessible group and they are characterized by knowledge of their precursor lesions and efficient screening or detection methods. Although we have not achieved total surveillance of our adult female population, we can expect to achieve prevention or early diagnosis of these tumors as we educate the public to the possibility of prevention and control. In the case of the inaccessible tumors, such as in ovarian cancer, we are still dependent upon physical examination and its adjuvants, for symptoms are late and no screening measure has been found effective to this date. Research into possible tumor markers, biochemical or immunological, are being investigated for the earlier diagnosis of this disease. Abnormal uterine bleeding requires tissue diagnosis before institution of any treatment. The primary physician's office is the most important site for cancer screening and it is the physician's responsibility to stay abreast of new information available in the oncologic disciplines, since cancer is the second most common cause of death in our country. PMID- 6850526 TI - Clinical trials and the community physician. AB - Further important advances in cancer treatment, and the development of regimens with fewer side-effects, may largely depend upon the subtle manipulations of available agents and comparison of results only possible in large numbers of patients. More than 80% of all cancer patients are treated within their own communities, and the opportunity to increase the overall cure rate significantly above the current estimate of 41% depends upon our ability to conduct clinical trials in these communities. A variety of models have evolved for the integration of the community physician into clinical cancer research. Abundant evidence exists that the quality of clinical research data generated by the community physician is usually not different from that of data generated by university hospitals or Cancer Centers. While the protocol which provides instructions for the clinical trial is often a formidable document, newly developed computer systems permit a highly simplified interaction between the physician or nurse and the office computer terminal. The process of randomization, which is often essential to eliminating bias in studies comparing treatments, has been difficult for community practitioners to accept. A new statistical technique, pre randomization, may solve this problem. Even where patients do not formally enter a clinical trial, the introduction of protocols into a practice provides the benefits of all known technology. Thus, community participation in clinical research is a superb method for delivering optimal patient care. PMID- 6850523 TI - The evaluation of the patient for lung cancer. AB - Cancer of the lung which was almost unknown before 1930 is the most rapidly increasing cancer. It is certainly the cause of most cancer deaths in men. Women are not far behind, and it is said that cancer of the lung in women will surpass breast cancer in the next several years. This article will evaluate the suspect patient who visits his family doctor with one or more of the cardinal signs of cough, hemoptysis, chest pain, or shortness of breath and will establish the diagnosis by x-ray, bronchoscopy, cytology, and tissue biopsy. As the staging is evolved, treatment is dictated, which may take several forms: chemotherapy, radiologic, surgical, or a combination of any of the three. Probably more important is the symptomatic treatment of various side ailments. All of this must be accomplished with conscientious care and concern. PMID- 6850527 TI - Is staging of cancer of value? AB - Complete and accurate classification of all cases of cancer is essential for planning optimal management, estimating prognosis, communicating about individual patients or groups of patients, comparing results of various treatments and evaluating cancer control programs. For most types of cancer, the stage, or the anatomic extent of the cancer, is as important as other characteristics such as the primary site of the tumor, the histologic cell type, and the grade of the malignancy. The TNM system of staging recommended by the American Joint Committee on Cancer and the International Union against Cancer is used throughout the world, and there is convincing evidence of its value in selecting treatment and estimating prognosis. For example, Stage I squamous cell or adenocarcinoma of the lung is almost always amenable to surgical resection and five-year survival rates of about 70% are being reported by many cancer centers. In contrast, stage III lung cancer is usually not resectable and the five-year survival rate of this group is less than 10%. PMID- 6850528 TI - Early and delayed complications of therapy. AB - Coordinated multimodal therapy (surgery, irradiation, and chemotherapy) has markedly improved the survival of children with cancer. The treatments used to achieve these excellent results are often rigorous and have their short- and long term complications. The early secondary effects are well known, but the late ones are only now becoming better understood. They take two major forms: interference with normal function, and oncogenesis. Some will become evident only after the passage of many years, when the child passes from the care of physicians concerned only with children to those caring for adults. It is important to remember that the therapies discussed are successful. It would be folly to withhold an effective regimen for fear of possibly causing a complication 10 or 20 years later. Nonetheless, while all physicians can take pride in the rapid strides being made against childhood cancer, they must also accept responsibility for the cured child and insure that the child will enjoy lasting health as an adult. PMID- 6850529 TI - Detection and diagnosis of colorectal cancer. AB - The option of early detection and diagnosis for the control of colorectal cancer, is discussed. Secondary prevention--the early detection, identification, and removal of premalignant lesions prior to the devastating and often fatal consequences of the disease--is recommended as an approach to symptomatic or asymptomatic patients. This study outlines the risk factors for susceptibility to colorectal cancer and reviews the potential benefits of screening asymptomatic patients by proctosigmoidoscopy and fecal occult blood testing. It is recommended that patients at risk be encouraged to enter the health care system. PMID- 6850531 TI - A systematic approach to the evaluation and management of breast masses. AB - Between 1975 and 1980, 392 patients with a palpable mass or masses were referred for breast evaluation, including risk factor assessment, physical examination, and selective utilization of aspiration cytology and mammography. Three-hundred and thirty-one (85%) were biopsied, with a benign diagnosis in 65% of the patients and cancer in 35%. The 61 patients (15%) who were not biopsied consisted of 32 patients in whom the mass disappeared on follow-up examination, 20 with stabilization on long-term follow-up, and nine with decreased mass size. Most breast masses must be biopsied, but a few can be followed and biopsy avoided. However, a decision not to biopsy requires more precise clinical judgement and experience than a decision to proceed with biopsy. Absolute indications for breast biopsy include a clinically suspicious mass, a mammogram considered malignant or suspicious, aspiration cytologic findings reported as malignant or suspicious, and a persisting, dominant mass, even if clinically benign. PMID- 6850530 TI - Surgery for colorectal carcinoma. AB - An adequate operation for colorectal carcinoma involves removal of the primary tumor and wide excision of the mesentery with its contained regional lymph nodes and lymphovascular pathways. Enker and DeCosse state that radical resection, i.e., total mesenteric lymphadenectomy encompassing the origins of the complete arterial blood supply to an affected bowel segment has proved to be a rewarding operation in terms of survival in cancer patients. In patients with positive lymph nodes, radical resection is associated with twice the five-year survival rate achieved by more limited operations that spare the root of the mesentery. Details of the various surgical approaches to the resection of colorectal cancer are presented. PMID- 6850532 TI - Surgical management of primary breast cancer. AB - The approach to primary operable, or potentially curable breast cancer is a controversial field of oncology and is subject to a number of ongoing clinical experiments in many centers. This report discusses the recommended treatment for patients with this disease who are evaluated at the Breast Service of Memorial Sloan-Kettering Cancer Center. The most widely practiced treatment is modified radical mastectomy, with radical mastectomy reserved for patients having more advanced lesions. Modified radical mastectomy is defined as total mastectomy plus axillary lymph node dissection either with preservation of the pectoralis minor muscle or its removal. The latter allows a more thorough axillary dissection and is preferred for patients with invasive carcinomas. In either case, axillary node sampling is not advocated and will miss a significant percentage of axillary metastases. In patients with negative axillary lymph nodes, who are not candidates for adjuvant systemic therapy, breast reconstruction is possible within a few months of mastectomy. For patients with involved axillary nodes, trials of adjuvant chemotherapy (perhaps with antiestrogen therapy for estrogen receptor positive primary tumors) seem to offer the best hope for improved survival. With available follow-up of such trials to date, there seems little doubt that at a minimum, such treatment prolongs disease-free interval. The role of adjuvant radiation therapy is more controversial, and the difficulty in combining this with chemotherapy is apparent. PMID- 6850533 TI - Glycogen-rich tumor of the oral minor salivary glands. A histochemical and ultrastructural study. AB - A detailed electronmicroscopic study on glycogen-rich tumor is presented. The neoplasm originated from the minor salivary glands on the ventral surface of the tongue. The role of myoepithelial cells in the histogenesis of this lesion is not supported. It is proposed that the tumor arises from "undifferentiated" stem cells analogous to cells in the "end bud" stage of salivary gland morphogenesis. The presence of a large amount of glycogen is secondary to defective carbohydrate metabolism within the tumor cells. PMID- 6850534 TI - Monomorphic adenomas of the parotid glands. Their ultrastructure and histogenesis. AB - Three cases of monomorphic basal cell adenoma of the parotid glands were studied with light microscopy. In one patient, fresh tissue was available for electron microscopic observations. On the basis of ultrastructural findings it was concluded that myoepithelial cells play little, if any, role in the histogenesis of this lesion. The tumor originates from the undifferentiated stem cells analogous to the cells seen at the "end bud" stage of salivary gland morphogenesis prior to their further cytodifferentiation and functional maturation into secretory and myoepithelial cells. In fully developed salivary glands such undifferentiated stem cells reside as "reserve" cells in the intercalated ductal system. PMID- 6850535 TI - Peripheral lymphocyte and eosinophil counts as indicators of prognosis in primary breast cancer. AB - As a part of a major study on the pathophysiologic indices for recurrence of human breast cancer, preoperative eosinophil and lymphocyte counts were determined on 419 and 581 primary breast cancer patients, respectively. Patients with lymphocyte counts less than or equal to 1500/mm3 and/or eosinophil counts of less than 55/mm3 had significantly higher risk of recurrent disease than those patients who had normal or high levels of eosinophils and/or lymphocytes. These findings may indicate that the immunologic activities of eosinophils and lymphocytes enhance the patients' ability to respond against disease. PMID- 6850536 TI - Intracystic papillary carcinoma of the breast. After mastectomy, radiotherapy or excisional biopsy alone. AB - Intracystic papillary carcinoma of the breast (IPC) was distinguished from the more common papillary intraductal carcinoma (DCIS) and infiltrating duct carcinoma with a papillary pattern. IPC was defined as a solitary tumor with a pattern recognizable as carcinoma which is confined to a dilated duct. A series of 41 such cases was collected from three institutions. Twenty-nine patients underwent mastectomy; 11 of them had axillary dissections. None of these patients had metastatic disease in the axillary lymph nodes or recurrence in the follow-up period which averaged five years. Eleven patients did not have mastectomy or radiotherapy. Eight of these patients (followed for an average of ten years) had no recurrence. The only patients who developed invasive carcinoma were those with DCIS as well as IPC in the excisional biopsy. The data suggest that IPC is much more likely to be cured by local treatment than is IPC accompanied by DCIS. PMID- 6850537 TI - Colorectal carcinoma. Evidence for circulating CEA-anti-CEA complexes. AB - Significant increments in measurable plasma CEA were effected by 2.5 M MgCl2 elution from putative circulating CEA-anti-CEA complexes in 11 of 15 patients with disseminated colorectal cancer and in five of ten patients with a high probability of having subclinical disease (Dukes'C category). Following 2.5 M MgCl2 elution, IgG from a patient with a high CEA increment effected a higher specific binding to 125I-CEA than a similar IgG eluate from a patient with a negligible increment in measurable CEA. These data suggest that CEA is autoimmunogenic and may result in circulating CEA-anti-CEA complex formation. The clinical implications of such complexes in the diagnosis and monitoring of patients with colorectal cancer remain to be determined. PMID- 6850538 TI - Acral lentiginous melanoma. A clinicopathologic study of 36 patients. AB - Acral lentiginous melanoma (ALM) is a distinct variant of malignant melanoma with a predilection for the soles, palms, and nail beds. This melanoma has characteristic histologic features, and its biologic behavior is similar to that of nodular melanoma. It occurs predominantly in the sixth, seventh, and eighth decades of life, with a peak incidence in the seventh decade for males and in the sixth decade for females. Diagnosis of ALM during the radial growth phase is often difficult, and it may not be recognized initially, but treatment in this phase offers an excellent prognosis. There is a high incidence of regressive changes and desmoplasia in ALM; these changes, together with the anatomic peculiarities of nail beds, palms, and soles as compared with other skin areas, make it difficult to determine the Clark's level and to measure the depth of invasion. Wide local excision with lymph node dissection is recommended for subungual melanomas measuring more than 1.00 mm and for lesions showing severe regression. Volar melanomas less than 1.00 mm deep and those in the radial growth phase with minimal invasion require only wide local excision. Amputation of digits and lymph node dissection are recommended for subungual melanomas, if the melanomas exhibit the vertical growth phase. If there is only radial growth without regressive changes, wide local excision is adequate. Patients with metastasis to lymph nodes at the time of diagnosis usually have shorter survival times than do those without lymph node involvement (P = 0.027). PMID- 6850539 TI - Hypertension with renal carcinoma. An effect of arterial embolization. AB - A patient presented with mediastinal metastases from renal adenocarcinoma. Palliative therapy included Gelfoam and steel coil embolization of the right renal artery. Six weeks later he was found to have developed severe hypertension. Arteriogram revealed collateral vessels which supplied the tumor; the renal vein renin activity was four times higher on the right than on the left. We suspect that infarction of the kidney was not complete because of collateral arterial supply, and renin-dependent hypertension was the result. Thus, it may be hazardous to embolize large hypernephromas without subsequent nephrectomy. PMID- 6850540 TI - Marjolin's ulcer. The LSU experience. AB - Skin cancers originating in areas of chronic injury (Marjolin's ulcers) are thought to behave in a more aggressive fashion than those due to other causes. The initial surgical treatment, especially the management of the regional lymph nodes, remains controversial. This review of 37 patients with Marjolin's ulcer evaluated the effectiveness of local surgical treatment at our center. Three of 18 patients treated with amputation developed recurrences and died of metastatic disease. Five of 16 patients treated by wide excision developed recurrences, two dying with metastatic disease, the remaining three apparently cured by additional surgery. Only six (17.6%) of the patients treated by "local" modalities, i.e., wide excision or amputation, developed subsequent regional node metastases. Recurrences following local excision tend to be local and can usually be managed by re-excision or amputation. It can be inferred from this study that prophylactic node dissections are not required in most patients with Marjolin's ulcers. PMID- 6850541 TI - Neuroblastoma associated with Beckwith-Wiedemann syndrome. AB - This report describes an infant with Beckwith-Wiedemann Syndrome (BWS) found to have a thoracic neuroblastoma. Infants with BWS are known to have an increased incidence of tumors (10%). We believe this to be the first report of a malignant neural crest tumor in a child with BWS and also the first case occurring in familial BWS. Usually the malignancies associated with the BWS are intraabdominal; however, this malignancy was located in the chest. It is important to detect malignancy in early stages. Therefore, recommendations for screening children with BWS are discussed. PMID- 6850542 TI - Cranial nerve palsies in metastatic breast cancer due to osseous metastasis without intracranial involvement. AB - Between August 1972 and March 1981, ten patients with metastatic breast cancer presented to M.D. Anderson Hospital and Tumor Institute at Houston Medical Breast Clinic with cranial nerve palsies (incidence, 0.13%). Eight of ten patients had extensive metastases at the base of the skull that was causing cranial nerve compression. Two patients had no bone involvement and were suspected to have soft tissue disease, one retro-orbitally and the other at the base of the skull. None of the patients had evidence of intracranial disease. The most frequently affected cranial nerves were V and VII, with 70% and 60% of patients having palsies of these nerves respectively. The estimated median survival of the patients from time of onset of cranial nerve palsy was 20 months; the palsies improved in 50% of patients who received regional therapy. PMID- 6850543 TI - Prolonged venous access for chemotherapy by means of the Hickman catheter. AB - One hundred and six long-term right atrial (Hickman) catheters have been used to establish permanent venous access in 99 patients undergoing prolonged chemotherapy for leukemia and other malignancies at the University of Maryland/Baltimore Cancer Research Center over the 30-month period from November 1978 to May 1981. A uniform technique for insertion, using cannulation of the external or internal jugular vein and atraumatic dissection of the subcutaneous tunnel, has resulted in no episodes of hemorrhage or tunnel infection in the last 55 placements in these high-risk granulocytopenic, thrombocytopenic patients. Twelve catheters have now been in place for over one year, and two catheters have been in place for over two years without apparent ill effects. A low catheter related infection rate is attributed to meticulous adherence to catheter care guidelines, supervised by a single trained and interested nurse. PMID- 6850544 TI - Prognosis of children with soft tissue sarcoma who relapse after achieving a complete response. A report from the Intergroup Rhabdomyosarcoma Study I. AB - Four hundred and twenty-three children with newly-diagnosed soft-tissue sarcoma were treated on the Intergroup Rhabdomyosarcoma Study I from November 1972 through December 1976. After institution of therapy, 341/423 (80.6%) achieved a complete response (no detectable tumor), but 115/341 (33.7%) subsequently relapsed. The types and efficacy of management after relapse were ascertained by questionnaire. Information sufficient for critical analysis was obtained for 98/115 patients (85%). Thirteen of the 98 patients had an isolated local recurrence; the other 85 developed metastases in regional, distant, or multiple sites simultaneously. Patients with distant metastases at diagnosis were most likely to develop recurrence, as were those with sarcoma arising in the perineum anus, retroperitoneum-pelvis, gastrointestinal tract, or extremity. Those with tumor primary in the orbit or genitourinary tract had the lowest recurrence rate, as did those whose tumor histology was nonalveolar. Individualized treatment was given to 90 of the 98 patients after relapse, and a second complete response was achieved in 33 of them (37%). However, only five of the 90 patients (5.5%) are currently tumor-free. The outlook is poor when recurrence develops in patients still receiving chemotherapy; only two of 74 such patients survive, compared to three of 16 who have relapsed after cessation of treatment. Relapse after initial complete response to therapy has a poor prognosis, regardless of site of recurrence. Although effective retrieval therapy can prolong survival, only 2 of 12 patients (17%) with local recurrence and three of 78 patients (4%) with metastatic recurrence remain free of disease. PMID- 6850545 TI - Prospective evaluation of doxorubicin-induced cardiomyopathy resulting from postsurgical adjuvant treatment of patients with soft tissue sarcomas. AB - One hundred and one soft tissue sarcoma patients from an adjuvant chemotherapy study of the Surgery Branch, National Cancer Institute who had received greater than or equal to 430 mg/m2 (range, 430-600 mg/m2) of doxorubicin were followed for evidence of cardiomyopathy. Fourteen patients developed clinical congestive heart failure attributable to doxorubicin. Nine of these fourteen were evaluated by radionuclide angiography (RNA), and all were abnormal with mean ejection fraction both at rest and exercise less than 30%. Sixty-one asymptomatic patients were studied at least once with RNA. In this asymptomatic group, 13 of 61 patients (21%) had abnormal resting left ventricular function. Exercise studies identified an additional 19 abnormal individuals (31%). Overall incidence of cardiomyopathy, as evidenced by RNA, in the asymptomatic group was 52%. By including the fourteen symptomatic patients, the incidence of cardiomyopathy detected either clinically or by RNA in the 75 evaluated patients was 46%. Comparison of patients by age (less than 40 versus greater than 40) revealed a highly significant difference in the incidence of cardiomyopathy (P less than .001). Fourteen of 36 patients (38%) less than or equal to 40 had either clinical or RNA evidence of cardiotoxicity while 32 of 39 (82%) individuals greater than 40 demonstrated cardiomyopathy. No significant difference was seen in those asymptomatic patients in whom RNA was performed less than or equal to 12 months as compared with greater than 12 months after the end of doxorubicin treatment. In the entire group there was no apparent improvement in cardiomyopathy with time, but results suggest that left ventricular function in the group older than 40 years does deteriorate. The cardiac function of patients younger than age 40 appeared to remain stable or possibly improve with time after the completion of treatment. Sex, tumor location, and radiation treatment were not associated with an increased risk of cardiomyopathy. These results emphasize the dangers of full dose doxorubicin therapy. This high incidence of cardiomyopathy became apparent because of our ability to prospectively evaluate a large group of patients with prolonged life expectancy that received adjuvant doxorubicin chemotherapy after surgery. PMID- 6850546 TI - Hodgkin's disease limited to intrathoracic sites. AB - The records of 1470 patients treated for Hodgkin's disease between 1960 and 1980 were reviewed, and sites of initial involvement were scored. Forty-four patients had disease limited to the chest after clinical and/or pathologic staging. Eighteen asymptomatic patients underwent a staging laparotomy and no occult subdiaphragmatic disease was identified. All 44 patients were treated with irradiation (XRT) to involved (IF), mantle (M), subtotal lymphoid (STLI), or total lymphoid (TLI) fields. Eighteen patients were also treated with chemotherapy, consisting of nitrogen mustard, vincristine, and procarbazine, with or without prednisone (MOP(P)), or procarbazine, melphalan, and vinblastine (PAVe). With a median follow-up of 7.5 years the survival at five and ten years was 93% and 89%, respectively, and the freedom from relapse (FFR) at five and ten years was 81% and 78%, respectively. Ten patients relapsed, all in supradiaphragmatic sites (including six relapses within lung parenchyma). Eight had initially received XRT alone, and two had received combined modality treatment. The risk of relapse in the 26 patients treated with XRT alone varied inversely with the volume irradiated: IF, 100% (3/3); M, 45% (3/7); STLI, 17% (2/12); TLI, 0% (0/4) relapsed. Seven of the eight relapsing patients treated with XRT alone were salvaged with subsequent XRT and/or chemotherapy whereas both of the combined modality patients who relapsed, died with progressive disease despite all salvage therapy. PMID- 6850547 TI - Dysmyelopoietic syndromes. A search for prognostic factors in 193 patients. AB - Dysmyelopoietic syndromes cover sideroblastic or nonsideroblastic refractory anemia with or without excess of blasts, subacute or chronic myelomonocytic leukemia. The evolution of 193 patients was studied with regard to the initial hematologic picture. A certain number of variables of prognostic value have then been isolated: excess of marrow blasts (more than 5%); presence of circulating blasts or karyotypic anomalies; reduction in the number of polymorphonuclear leukocytes (less than 1.043 10(9)/l, of monocytes (less than 0.136 10(9)/l), of platelets (less than 140 10(9)/l), of in vitro granulopoietic progenitors (less than 5 per 10(5) nucleated cells plated), of erythrocytic incorporation of 59Fe at day 14 (less than 12%), of hemoglobin level (less than 92 g/l); previous exposure to radiation or chemotherapy; early hemolysis in 51Cr-labeled erythrocytes study; marrow heterogeneity in histology; less than 20% of ringed sideroblasts. The correlation between these variables and adjustments related to the length of survival and the order of magnitude of the critical level of the log-rank test show that the most significant variables in descending order are: excess of marrow blasts, neutropenia, thrombopenia, presence of circulating blasts, the type of erythropoietic insufficiency, and decrease of in vitro growth. PMID- 6850548 TI - Determination of the molecular structure of the bay-region epoxides of benzo(a)pyrene by a force-field calculation. PMID- 6850549 TI - Evidence for the lack of relationship between inhibition of nucleic acid synthesis and cytotoxicity of adriamycin. AB - The ability of adriamycin-sensitive and -resistant Sarcoma 180 cells to incorporate thymidine and uridine into macromolecular material following exposure to this antibiotic was directly compared to the degree of cell survival by measuring in the same population precursor incorporation and cloning efficiency in soft agar after different intensities of drug exposure. The concentration and time dependence of inhibition of these processes by adriamycin wer compared. No correlation between the ability to incorporate radioactive precursors into DNA and RNA and the extent of cell survival was observed except ay very toxic drug concentrations. The results indicate that the extent of inhibition of precursor incorporation into DNA and RNA following drug exposure is not predictive of cell survival. This finding implies that the effect of adriamycin on nucleic acid synthesis is not directly coupled to cytotoxicity. PMID- 6850551 TI - Lipoperoxide levels, glutathione status and glutathione peroxidase activity in liver and tumors of mice bearing the Lewis lung carcinoma. AB - Lipoperoxides, glutathione status and glutathione peroxidase activity have been determined in normal and neoplastic tissues of control and tumor-bearing mice, tissues from both groups being assayed 5, 7, 9, 11, 13 and 15 days after inoculation. The ratio of hepatic reduced: oxidized glutathione increased in tumor-bearing animals as the tumor increased in size. This ratio was 2.5-fold higher at 15 days than at 10 days after tumor inoculation. In both tumor and hepatic tissue the alteration in the ratio was the result of both an increase in reduced glutathione and a decrease in oxidized glutathione levels. In tumor tissue the progressively increasing reduced glutathione content correlated closely with tumor growth. The presence of a tumor did not significantly affect hepatic glutathione peroxidase activity and there was no significant difference between tumor enzyme activity assayed at 2-day intervals between 9 and 15 days after inoculation. The livers of tumor-bearing animals had significantly higher lipoperoxides than control mice, the levels increasing progressively with tumor growth. Tumor lipoperoxides were also high, usually in excess of the hepatic level. The lungs of nontumored littermates, which were compared with the carcinoma as reference tissue, showed no significant change in either glutathione peroxidase activity or lipoperoxide levels when monitored over the same period. PMID- 6850550 TI - Amino acid accumulation in mouse-human parental hybrid cells. AB - Cell membrane function during hybridization was assessed by examining the accumulation of four representative amino acids and a sugar in mouse-human hybrid cells, parental mouse cells and human cells. Qualitatively, accumulation in the hybrids was found to resemble the accumulation in parental mouse more than the human cells. In particular, the steady-state uptake of leucine and glycine in hybrids was similar to that in parental mouse cells and different than that observed in the human cells. The findings suggest that hybrids retain transport properties of mouse rather than human cells. These results are in keeping with our previous observation that the human mouse hybrids conserve most of the mouse chromosomes and the membrane proteins of the hybrids are very likely of mouse parental origin. PMID- 6850553 TI - Association of elongation factor 2 with ribosomes during growth of a murine ascitic tumor. AB - The amount of elongation factor 2 (EF-2) associated with different ribosomal fractions (mono- and polyribosomes) isolated from a methylcholanthrene-induced sarcoma is estimated during tumor growth (exponential and plateau phase of growth). Direct EF-2 quantification is obtained by a modification of the method of the diphtheria toxin-catalyzed transfer of (14C)ADP-ribose from (14C)NAD+ to the enzyme. Data reported show that the amount of EF-2 associated with the monoribosomal fraction changes during tumor growth, and particularly, that this amount increases when the tumor cells enter into the plateau phase. In contrast, the EF-2 content of the polyribosomal fraction does not change during the different phases of tumor growth. Data also show that the amount of EF-2 bound to the monoribosomal fraction isolated from tumor cells is significantly and constantly lower than that of the corresponding fraction isolated from reticulocytes or hepatocytes. Moreover the tumor monoribosomes generated by the polyribosome breakdown induced by the "starvation" procedure did not show significant changes in their EF-2 content with respect to monoribosomes isolated from tumor cells maintained in physiological conditions. Besides, tumor monoribosomes generated by the polyribosome breakdown induced by puromycin or by running-off treatment exhibit a relevant increase of the EF-2 content. In these conditions the amount of EF-2 associated with the monoribosomes is similar to that associated with the monoribosomes of control cells (hepatocytes and reticulocytes). Results are discussed in view of a possible regulative role of the EF-2 enzyme in the ribosomal cycle of eukaryotic cells. PMID- 6850552 TI - Crystallographic studies of the antineoplastic antifolate 2,4-diamino-5-(3',4' dichlorophenyl)-6-methylpyrimidine (DDMP) ethanesulfonate salt. AB - The lipid-soluble diaminopyrimidine, 2,4-diamino-5-(3',4'-dichlorophenyl)-6 methylpyrimidine (DDMP) binds tightly to dihydrofolate reductase and has antineoplastic activity in man and several animal systems. The x-ray crystal structure of this antifolate, as the ethanesulfonate salt, was studied to investigate the conformational aspects of its binding specificity. The molecular conformation shows the dichlorophenyl ring nearly perpendicular (phi = 110 degrees) to the pyrimidine ring which is coplanar with its 2,4,6-substituents. the protonated N1 atom of the pyrimidine ring forms a hydrogen bond to an ethanesulfonate oxygen, as do both N2 and one of N4 hydrogens. The other N4 hydrogen participates in an inversion related base-pair type of hydrogen bond with N3 of a neighboring molecule, similar to patterns observed in other diaminopyrimidine antifolates. PMID- 6850554 TI - C-band pattern in lymphocytes of patients with soft tissue sarcomas. AB - The pattern of heteromorphisms in the C-band-positive constitutive heterochromatin of human chromosomes No. 1, 9, and 16 was studied in peripheral lymphocytes of 45 patients with soft tissue sarcomas and 78 control individuals. The parameters of the heterochromatic regions analyzed were relative size, symmetry-asymmetry within homologous pairs, and incidence of inversions. No consistent differences were found in these parameters between controls and sarcoma patients. PMID- 6850555 TI - Trisomy of chromosome 6.15 is not necessary for proliferation of AKR(Rb6.15)1Ald lymphoma cells. AB - By utilizing a unique AKR(Rb6.15)Ald (AKRb) mouse line we have been able to determine the incidence and frequency of cells with and without abnormalities of chromosome number (specifically trisomy 6.15) in spontaneous and transplanted lymphoma. The transplanted lymphoma cells were easily distinguished from the normal cells of AKR/J recipients by the presence in diploid cells of 2 metacentric and 36 acrocentric chromosomes. The majority of the cells from 17 normal control AKRb mice were diploid and trisomy 6.15 (3 metacentric and 36 acrocentric chromosomes) was not seen. In 73% of the 59 AKRb mice with spontaneous lymphoma, the majority of cells were diploid. In 54% of the mice none of the cells had trisomy 6.15, and in 22% of these mice a majority (greater than 50%) of cells had trisomy 6.15. In order to determine which of the cells from AKRb mice with spontaneous lymphoma were malignant, they were transplanted into normal young AKR/J recipient mice, and when lymphoma developed in recipients, their cells were analyzed. The majority of first passage lymphoma cells from 30 recipient mice were donor-type and the majority of these donor cells were diploid. Ten (17%) of these recipients had a majority of cells with trisomy 6.15. In order to further determine whether or not trisomic lymphoma cells had a different proliferative rate than diploid lymphoma cells, eight first passage recipient mice were used to start sequential passage lines. In two diploid lines and four trisomic lines, the same relative frequency of the trisomy was maintained in the sequential passages. However, in two trisomic lines, the frequency of lymphoma cells with three metacentric chromosomes diminished after passage. These studies suggest that aneuploidy is not necessary for proliferation of lymphoma and that diploid cells are a major part of the malignant cell population. PMID- 6850556 TI - Chromosome 6 in malignant melanoma. AB - Cytogenetic analysis of malignant melanoma (MM) cells from a number of cases revealed the frequent involvement of chromosome 6 in structural aberrations. The relevance of these findings to certain aspects of MM is briefly discussed. PMID- 6850558 TI - 8;21 chromosome translocation in eosinophilic leukemia. PMID- 6850557 TI - Chromosome 6q involvement in human malignant melanoma. AB - Chromosome banding analysis was performed on five cases of human malignant melanoma. Results demonstrated a variety of chromosome alterations, including deletion or translocation of chromosome 6q, in four of five cases. A comparison of our results with previously published studies suggests that chromosome 6q may represent a specific site of chromosome aberration in malignant melanoma. PMID- 6850559 TI - Effects of dietary fat on age-dependent sensitivity to mammary carcinogenesis. AB - Two groups of female Fischer rats were fed either a high-fat, low-carbohydrate (HF) diet or a low-fat, high-carbohydrate (LF) diet throughout the experiments, beginning from weaning. Each group of rats was divided into 4 subgroups and given an i.v. dose (50 mg/kg body wt.) of N-methyl-nitrosourea (NMU) at 35, 50, 90 or 130 days of age, respectively. Mammary tumor yield showed an age-dependent response in both groups. Although mammary tumor incidence decreased in rats as their age increased, irrespective of whether they were fed a high- or low-fat diet, the tumor incidence was significantly higher in rats fed the high-fat diet at any age. Thus, the combined effect of dietary fat and age-dependent sensitivity on mammary carcinogenesis caused more than a 4-fold difference in mammary tumor incidence rates between the 2 groups of rats. PMID- 6850561 TI - Selenium levels in blood and plasma, and glutathione peroxidase activity in blood of breast cancer patients during adjuvant treatment with cyclophosphamide, methotrexate and 5-fluorouracil. AB - Glutathione peroxidase activity in whole blood and selenium levels in whole blood and plasma from breast cancer patients, were measured during combination chemotherapy with cyclophosphamide, methotrexate and 5-fluorouracil. No significant change in either glutathione peroxidase activity or selenium levels was observed. Comparison with matched controls showed no significant differences for either parameter. PMID- 6850560 TI - Long term dose response study of N-[4-(5-nitro-2-furyl)-2-thiazolyl] formamide induced urinary bladder carcinogenesis. AB - The effect of dose was evaluated for the bladder carcinogenicity of N-[4-(5-nitro 2-furyl)-2-thiazolyl] formamide (FANFT). The chemical was fed to male weanling F344 rats for 30 weeks followed by 74 weeks of control diet. The incidences of bladder carcinoma were 100, 100, 87, 0, 0 and 0% for doses of 0.2, 0.1, 0.05, 0.01, 0.005 and 0.001%, respectively. There was an inverse relationship between dose and latency period. There was no increased incidence of tumors of other tissues. PMID- 6850562 TI - A morphologic and kinetic basis for the more invasive character of N-methyl-N' nitro-N-nitrosoguanidine induced duodenal tumors following pyloroplasty. AB - Pyloroplasty increased the invasiveness of duodenal tumors in Wistar rats receiving N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) for 12 weeks (83 mg/l in drinking water) (Arch. Surg., 117, 768-771). To assess morphologic and kinetic alterations, analyses of tritiated thymidine (3HTdR) pulse-labeled fundic, antral and duodenal mucosa were carried out. The normal appearance of MNNG-treated antral and duodenal mucosa was characterized by the appearance of elongated hyperactive columns exhibiting elevated levels of DNA synthesis. Pyloroplasty in carcinogen-treated rats induced both a 3-fold enhancement in the number of these elongated columns and an elevation in the number of proliferating cells within them (P less than 0.001). In the MNNG and pyloroplasty treated duodenal mucosa 26% of columns contained over 130 cells/column rather than an average of 100 cells in normal appearing MNNG-treated mucosa. DNA synthesis was increased by 23% within these hyperactive glands (11.3 proliferative cells/column vs. 9.4/column in normal appearing mucosa). Pyloroplasty creates both an increase of gastric bile reflux and an increase of the gastric evacuation rate, conditions which influence cell proliferation. Such alterations in antro-pyloro-duodenal physiology contribute to the increased cellular activity observed, promote malignant transformation and foster the expression of invasiveness. PMID- 6850563 TI - Malignant Clara cell line derived from ethylnitrosourea-induced murine lung adenomas. AB - Lung adenoma induced in Swiss-Webster mice by transplacental exposure to ethylnitrosourea were minced, cultured and carried as cell lines for up to 2 years. The evolution of cell lines was followed every 3 months by ability to grow in nude mice and by morphological and ultrastructural examination of the tumors. Four cell lines, each originating from a single cell inoculum, were cloned. One of these produced mainly papillary tumors in nude mice and ultrastructurally had the morphology of Clara cells. PMID- 6850564 TI - Tumor induction by a single subcutaneous injection of 1-butyl-1-nitrosourea or 1 butylurea in newborn mice. AB - A subcutaneous injection of 1-butyl-1-nitrosourea (BNU) at the maximum tolerated dose (333 mg/kg body wt.) to newborn CDF1 mice induced adenocarcinoma and adenoma of the lung, adenoma of the liver, thymic or non-thymic lymphoma and neurinoma of the acusticus nerve; the total incidence of tumors was statistically significant as compared with that of control. However, in the 1-butylurea (BU) mice, one adenoma of the lung was induced in a male mouse; the total incidence of tumor was comparable to that of control. PMID- 6850565 TI - Effects of supplemental zinc on melanoma metastasis in mice. AB - The influence of a single intraperitoneal injection of zinc (0.5, 1.5 and 4.5 mg/kg) on the metastasis and subsequent growth of radiolabelled melanoma cells was examined in mice receiving tumor cells s.c. or i.v. 24 h following zinc treatment. Parenteral zinc resulted in increased tumor cell survival in the liver, spleen and lungs of zinc-treated mice 1 day post-injection, while 21-day cell survival was enhanced in the spleens of s.c. injected, zinc-treated mice. Regardless of zinc exposure, relative numbers of s.c. injected tumor cells decreased with time in the lungs and spleen, while increasing in the liver and kidneys. A single dose of zinc can modify the organ distribution and viability of metastatic tumor cells in mice. PMID- 6850566 TI - Effect of Konjac mannan on 1,2-dimethylhydrazine-induced intestinal carcinogenesis in Fischer 344 rats. AB - The effect of Konjac mannan (KM) on 1,2-dimethylhydrazine (DMH-induced intestinal carcinogenesis was studied in male F344 rats. Rats were fed a diet containing 5% KM at 5 weeks of age. At 6 weeks of age, all animals were given a weekly intraperitoneal injection of 20 mg DMH/kg body wt for 13 weeks and autopsied 13 weeks after the last injection of DMH. The weight gain was lower in rats fed the KM diet than in rats fed the control diet throughout the experiment (P less than 0.05). The incidence of DMH-induced colon tumors was lower in animals fed the KM diet compared to animals fed the control diet (P less than 0.05). The number of colon adenocarcinoma per animal was also lower in animals fed the KM than in animals fed the control diet (P less than 0.05). However, the incidence of tumors of the small intestine did not significantly differ between the groups fed the KM and control diets. The present study demonstrated that colon tumorigenesis induced by DMH in F344 rat was inhibited by maintaining the KM diet. PMID- 6850567 TI - Tumour-initiating activities of dihydrodiols of dibenz[a,c]anthracene. AB - The tumor-initiating activities of dibenz[a,c]anthracene (DBA) and of the related trans-1,2-, 3,4- and 10,11-dihydrodiols have been examined on mouse skin subsequently promoted with 12-O-tetradecanoyl-phorbol-13-acetate (TPA). The 1,2- and 10,11-dihydrodiols were active and were more active than equivalent doses of either the parent hydrocarbon or the 3,4-dihydrodiol. The data are discussed in relation to possible mechanisms that may be involved in the metabolic activation of DBA. PMID- 6850568 TI - Inhibition of 12-O-tetradecanoylphorbol-13-acetate-induced induction in Epstein Barr virus early antigen in Raji cells. AB - Retinol, 5 flavonoids, 3 steroids and 7 sweetening agents were studied for their effects on 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced early antigen (EA) of Epstein-Barr virus (EBV) in Raji cells. Concomitant treatment of Raji cells with TPA and retinol showed inhibition of EA induction. Among flavonoids, quercetin resulted in effective inhibition of EA induction by TPA and alpha naphthoflavone showed the weakly inhibitory effect. None of the other flavonoids such as rutin, catechin and beta-naphthoflavone affected the induction of EBV-EA by TPA. beta-Estradiol obviously inhibited EBV-EA induction by TPA, but hydrocortisone did not show any inhibitory effect on it. Glycyrrhetinic acid, steviol, phyllodulcin and perrillartine also showed the remarkable inhibition of EBV-EA induction. On the other hand, glycyrrhizin and stevioside, glycosides of glycyrrhetinic acid and steviol, did not inhibit the induction of EBV-EA by TPA. Some of the inhibitors reported here may be effective on the inhibition of the in vivo tumor promotion by TPA. PMID- 6850569 TI - The lack of initiating and/or promoting activity of sodium malondialdehyde on SENCAR mouse skin. AB - Malondialdehyde (MDA), a lipid peroxidation product, has been implicated in carcinogenesis, in part for its reported mutagenic activity. It was of interest therefore, to determine its activity as either a complete carcinogen, a tumor initiator, or a tumor promoter. Using the SENCAR mouse skin model, pure sodium MDA (NaMDA) was found to lack activity in any of these categories. Furthermore, NaMDA was determined to be negative in the Chinese hamster V-79 metabolic cooperation assay for promoters. PMID- 6850571 TI - Antitumor activity of some diorganotin and tin(IV) complexes of Schiff bases. AB - Some new di-n-butyltin and tin(IV) complexes of the type Bu2SnL, Bu2SnL2 and SnL2 (where L = anions of Schiff bases derived from S-substituted dithiocarbazates and fluoro-aniline) have been prepared and screened for their antitumor activity in P 388 Lymphocyte Leukaemia system. These complexes do not show any toxicity at low dose levels and display T/C values in the range 94-124. Di-n-butyltin complex derived from salicylaldehyde-S-methyl dithiocarbazate has been found to be the most active in this series. PMID- 6850572 TI - Excretion of mutagens in human urine after passive smoking. AB - Eight non-smokers were experimentally exposed to cigarette smoke by staying in a poorly ventilated room together with heavy smokers for 6 h. Air samples were taken and the extract appeared to contain mutagenic substances. This is in accordance with the presence of carcinogens in tobacco smoke. Inhalation of the contaminated air by the passive-smokers resulted in an increase in the urinary excretion of products mutagenic in the Salmonella/microsome assay. This observation suggests that there is a causality in the association between increased cancer risk and passive-smoking, as was found by other investigators. PMID- 6850570 TI - Agglutination assay of bladder cells by Concanavalin A proved the high susceptibility of analbuminemic rats to bladder carcinogens. AB - The susceptibility of analbuminemic rats, a mutant strain of Sprague-Dawley rats, to bladder carcinogens was examined by testing the agglutinability of isolated bladder epithelial cells by Concanavalin A (Con A). One-week treatment with 0.001% N-butyl-N-(4-hydroxybutyl)nitrosamine (BHBN) in the drinking water or 0.01% N-(4-(5-nitro-2-furyl)-2-thiazolyl)-formamide (FANFT), 0.01% and 0.1% 4 aminobiphenyl, 0.1% 4-nitrobiphenyl, 0.1% benzidine, 0.1% 2-napthylamine or 5% sodium saccharin in the diet clearly induced high agglutinability of bladder cells of male analbuminemic rats but not Sprague-Dawley rats. These results suggest that male analbuminemic rats are very susceptible to bladder carcinogens in general and therefore will be very useful in screening tests for bladder carcinogens. PMID- 6850574 TI - Effects of route of administration and dose on the carcinogenicity of N nitrosodiethanolamine in the Syrian golden hamster. AB - N-Nitrosodiethanolamine was assayed for carcinogenicity in Syrian golden hamsters by s.c. injection, topical application, and oral cavity swabbing. Three groups of 30 hamsters each received 27 weekly s.c. injections of either 500, 170, or 58 mg of N-nitrosodiethanolamine per kg in 0.9% NaCl solution. In the group treated with 500 mg/kg, 19 of 30 animals developed nasal cavity tumors, 7 of 30 had tracheal tumors, and 2 of 30 had tumors of the larynx. Among the animals treated with 170 mg/kg, 7 of 29 presented with nasal cavity tumors and 4 of 29 presented with tracheal tumors. In the group treated with 58 mg/kg, only two tracheal tumors were observed. Acetone solutions of N-nitrosodiethanolamine were applied to the shaved backs of three groups of 30 hamsters, each three times weekly for 36 weeks, at doses of 25, 8, or 2.5 mg; the total doses were the same as in the groups treated by s.c. injection. At the 25-mg dose level, 5 of 30 animals developed nasal cavity tumors and 4 of 30 animals had tumors of the trachea. No skin tumors were observed. The incidence of respiratory tract tumors in the groups treated with 8 or 2.5 mg was not significant compared to controls. The oral cavities of 40 hamsters were swabbed three times weekly for 45 weeks with 20 mg of N-nitrosodiethanolamine; the total dose was the same as the highest doses given by s.c. or topical administration. Seventeen of 38 hamsters had nasal cavity tumors, 6 of 38 developed tracheal tumors, and 1 of 38 presented with a tumor of the larynx. No tumors were observed in the oral cavity. The results of this study demonstrate that N-nitrosodiethanolamine is organospecific for the Syrian golden hamster nasal cavity and trachea and that it induces tumors in these sites at doses lower than previously reported. PMID- 6850575 TI - The nitrosating agent in mice exposed to nitrogen dioxide: improved extraction method and localization in the skin. AB - We reported previously that mice exposed to atmospheric NO2 contained a nitrosating agent (NSA) that reacted with morpholine in aqueous methanol homogenates of the mice to give N-nitrosomorpholine. We have now found that N nitrosomorpholine was also produced by reacting morpholine with ether extracts of aqueous homogenates prepared from NO2-exposed mice. After exposure to NO2 for 4 hr, mice contained NSA (5.0 nmol/g tissue, corrected to 50 ppm NO2 and assuming that 1 mol NSA yields 1 mol N-nitrosomorpholine). This is 3.6 times the concentration observed by our previous method. Some NSA (0.6 nmol/g tissue) was also detected in untreated mice. The NSA in ether extracts was nonvolatile and stable on storage at -15 degrees or for short periods in the presence of water at pH 1 to 10, but it was decomposed by a pH 1 solution of nitrite scavengers. It reacted to similar extents with three different secondary amines. Eighty-eight % of the NSA occurred in the skin, one-third of which was in the hair. The high skin concentration occurred when the bodies but not the heads of mice were exposed to NO2, indicating that the major exposure route was the skin. The NSA might consist of alpha-nitro or other activated nitrite esters derived from unsaturated lipids. PMID- 6850577 TI - Correlation of in vitro clonogenic assay data with in vivo growth delays and cell cycle changes of a human melanoma xenograft. AB - We have reported previously that, in a human melanoma xenograft line, plating efficiency and drug sensitivity in vitro were enhanced under hypoxic conditions. In the present study, we show that the in vitro chemosensitivity data using clonogenic assays at 5% oxygen also correlate better with the drug-induced in vivo growth delay. Tumors implanted in bilaterally symmetrical locations grew at different rates, and response to chemotherapy was also variable. Cell cycle changes in the xenograft, as monitored by flow cytometry, suggest that major changes in cell cycle traverse occur when a drug is active in vitro and also causes in vivo growth delay. These studies indicate the usefulness of the nude mouse human xenografts to study correlations between soft agar clonogenic assays, in vivo growth delay, and cell cycle traverse in response to chemotherapeutic manipulation. PMID- 6850573 TI - Effect of simultaneous administration of clofibrate with diethylnitrosamine on hepatic tumorigenesis in the rat. AB - Effect of clofibrate administered simultaneously with diethylnitrosamine (DEN) on hepatocarcinogenesis in F344 male rats was investigated. DEN was given in drinking water at a concentration of 40 ppm for 5 weeks. Rats were fed the diet containing clofibrate at concentrations of 0.1% and 0.25% during DEN-treatment. All rats were killed 25 weeks after the beginning of DEN-treatment, and hepatic tumors over 1 mm in diameter were counted. Hepatic tumors in the rats given clofibrate at both concentrations were twice as many as those in rats given DEN alone. The significant increase in number of hepatic tumors was observed mainly in the tumors under 10 mm in diameter. Thus, the enhancing effect of clofibrate on hepatocarcinogenesis was evident even when fed simultaneously with the carcinogen, in contrast with phenobarbital (PB). PMID- 6850576 TI - Inhibition by 2(3)-tert-butyl-4-hydroxyanisole and other antioxidants of epidermal ornithine decarboxylase activity induced by 12-O-tetradecanoylphorbol 13-acetate. AB - The relationship between reactive oxygen and/or free radical species and tumor promotion was evaluated by investigating the inhibitory effects of 2(3)-tert butyl-4-hydroxyanisole (BHA) and other antioxidants on the induction of ornithine decarboxylase (ODC) activity in mouse epidermis by a tumor promoter, 12-O tetradecanoylphorbol-13-acetate (TPA). Mice maintained on a diet containing 0.75% BHA for 8 days showed a 50% reduction in maximal ODC induction following treatment with TPA when compared to mice fed a control diet. Topical application of BHA (55 mumol) 30 min prior to TPA treatment (17 nmol) elicited an 80% inhibition of promoter-induced ODC activity. BHA was ineffective as an inhibitor when administered either 16 hr before or 2 hr after the promoter. The inhibition by BHA was dose dependent with a dose producing a 50% inhibition of ODC induction of 6 mumol. A structure-activity study with BHA analogues (2-tert-butyl-4 hydroxyanisole, 3-tert-butyl-4-hydroxyanisole, 2-tert-butyl-1,4 dimethoxybenzene,tert-butylhydroquinone, 4-hydroxyanisole, p-hydroquinone, phenol, and 2-tert-butyl-phenol) showed that hydroxyl and tert-butyl substituents were important determinants of inhibitory activity. A spectrum of other antioxidants were also tested. Butylated hydroxytoluene was nearly equipotent to BHA; alpha-tocopherol, propyl gallate, and disulfiram were all less potent, and L ascorbate was inactive. None of the antioxidants affected basal ODC activity in non-TPA-treated mice. Collectively, these results demonstrate an early and direct inhibition of TPA-induced ODC activity by lipophilic phenolic antioxidants and suggest a role for reactive oxygen and/or free radical species in tumor promotion. PMID- 6850580 TI - Comparison of mutagenicity and induction of sister chromatid exchange in Chinese hamster cells exposed to hematoporphyrin derivative photoradiation, ionizing radiation, or ultraviolet radiation. AB - Cell culture studies have been performed to compare the mutagenic potential and the induction of sister chromatid exchanges for hematoporphyrin derivative photoradiation, ionizing radiation, and UV radiation. The mutation frequency in Chinese hamster ovary cells at the hypoxanthine-guanine phosphoribosyltransferase locus was measured using resistance to 6-thioguanine. Phenotypic expression time prior to mutation selection was also examined. Treatment with either X-rays or UV was effective in producing mutants resistant to 6-thioguanine, but treatment with hematoporphyrin derivative photoradiation (at comparable toxicity levels) did not induce any mutagenic activity above background levels. The hematoporphyrin derivative incubation and photosensitization conditions used in this study did induce sister chromatid exchanges at frequencies comparable to those induced by X rays but at lower frequencies than for UV treatments. PMID- 6850578 TI - Host cathepsin D response to tumor in the normal and pepstatin-treated mouse. AB - In view of the postulated role of cathepsin D in cachexia, investigations have been pursued on the host tissue response of cathepsin D activity in DBA/2 mice inoculated with 5 X 10(5) L1210 tumor cells. The results confirmed previous investigators' findings of the increase in cathepsin D activity (specific activity) in liver and muscle of tumor bearers. In addition, it was found that this increase was a general response of the host since heart, kidney, lung, and spleen cathepsin D specific activity were also enhanced in tumor bearers. These increases ranged from an average of 10% for spleen to 100% for gastrocnemius muscle. This effect was age related in heart and kidney. As a working hypothesis, we propose the concept that tumor bearers release protease-enhancing factor(s) which trigger increase or enhancement of cathepsin D activity in host tissues by yet unknown mechanisms. Pepstatin (60 mg/kg), a known inhibitor of cathepsin D in vitro, was shown to provide long-lasting inhibition (3 to 6 days) of cathepsin D in vivo in non-tumor bearers particularly in spleen, liver, kidney, lung, and heart. Evidence is provided from assays of cell fractions that this inhibition takes place at or in the lysosome. The duration of the effectiveness of pepstatin was altered in tumor bearers in that cathepsin D activity of heart, lung, and spleen had returned to near normal values in 48 hr following pepstatin injection. However, in muscle, liver, and kidney, significant inhibition (90%) still persisted in tumor bearers as it did in non-tumor bearers. Pepstatin or related antiproteases may prove useful as "anticachexia" agents by decreasing proteolysis in muscle and other tissues. PMID- 6850579 TI - Influence of thyroidectomy and prolactin suppression on the growth of N nitrosomethylurea-induced rat mammary carcinomas. AB - Mammary carcinomas were induced in female Sprague-Dawley rats with N nitrosomethylurea. Thyroidectomy increased the serum prolactin and reduced serum growth hormone levels of 17 rats without affecting tumor growth. Pergolide mesylate, 80 micrograms twice daily for 7 days, suppressed the serum prolactin of another 17 animals; seven of 17 tumors continued to grow, four became static, and six (35%) underwent partial regression. Treatment with pergolide mesylate plus thyroidectomy reduced both serum prolactin and growth hormone in all of 14 rats, caused regression of ten of the 14 tumors (71%), while two became static, and two continued to grow. Five of the ten regressions were complete. Only the combined thyroidectomy-pergolide treatment group showed a significant difference in posttreatment surface area compared with the controls (p less than 0.001). Ovine growth hormone, 40 micrograms/hr delivered by s.c. osmotic minipumps for 7 days, stimulated regrowth of six of seven tumors undergoing regression in response to thyroidectomy plus pergolide; the other one became static. Thyroxine, 2 micrograms/100 g body weight, stimulated regrowth of the tumors in another six thyroidectomized rats despite continued suppression of prolactin by pergolide. Thus, regression of N-nitrosomethylurea-induced mammary tumors produced by thyroidectomy plus pergolide is due to the combined suppression of circulating growth hormone and prolactin. PMID- 6850581 TI - Metabolism of 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane (DDT), 1,1-dichloro 2,2-bis(p-chlorophenyl)ethane, and 1-chloro-2,2-bis(p-chlorophenyl)ethene in the hamster. AB - The urinary metabolites of 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane (DDT), 1,1-dichloro-2,2-bis(p-chlorophenyl)ethane (DDD), and 1-chloro-2,2-bis(p chlorophenyl)ethene in female hamsters are reported. The principal metabolite of both DDT and DDD is 2,2-bis(p-chlorophenyl) acetic acid. DDT- and DDD-treated animals also excreted small amounts of DDD, 1-chloro-2,2-bis(p chlorophenyl)ethene, 1,1-dichloro-2,2-bis-(p-chlorophenyl)ethene, 2-hydroxy-2,2 bis(p-chlorophenyl)acetic acid, and 2,2-bis(p-chlorophenyl)ethanol. 1-Chloro-2,2 bis(p-chlorophenyl)ethene is metabolized to afford significant amounts of 2,2 bis(p-chlorophenyl)acetic acid, 2,2-bis(p-chlorophenyl)-ethanol, 2-hydroxy-2,2 bis(p-chlorophenyl)acetic acid, 2,2-bis-(p-chlorophenyl)acetaldehyde, and 1,1 bis(p-chlorophenyl) ethan-1,2-diol. These results indicate that the metabolic disposition of DDT in the hamster, a species refractory to DDT tumorigenicity, is very similar to that observed previously in the mouse, a species sensitive to DDT tumorigenicity. The one exception is that the hamster is not nearly as efficient as the mouse in converting DDT to 1,1-dichloro-2,2-bis(p-chlorophenyl)ethene, a metabolite that is tumorigenic in both species. PMID- 6850582 TI - Comparative cytotoxicity of bisantrene, mitoxantrone, ametantrone, dihydroxyanthracenedione, dihydroxyanthracenedione diacetate, and doxorubicin on human cells in vitro. AB - The cytotoxic efficacies of several substituted anthraquinones, ametantrone, dihydroxyanthracenedione, dihydroxyanthracenedione diacetate, mitoxantrone, bisantrene, and doxorubicin, were evaluated on an established human colon adenocarcinoma cell line by the method of inhibition of colony formation. The concentration-dependent survival curve following treatment for 1 hr was biphasic exponential for all agents. At concentrations below 1 microgram/ml, mitoxantrone was about twice as active as both hydroxyl-substituted anthracenediones and doxorubicin, about 14 times more efficacious than ametantrone, and about 22 times more powerful than bisantrene. At higher concentrations, these differences in efficacy became even more pronounced. Treatment in stationary phase decreased the lethal efficacy of doxorubicin but not that of the other agents. No recovery of potentially lethal or sublethal damage was noted for any agent, but for anthracenedione derivatives, there was a small but statistically significant increase in cell kill during fractionated exposure. Continuous treatment with mitoxantrone or bisantrene resulted in marked degrees of cell killing, reaching 99.95 and 99.5%, respectively, after 24 hr. For doxorubicin, cell kill efficacy declined after 4 hr. Mitoxantrone was 10-fold more active on cells in G2 phase than on those in mid- to late-S phase. Sensitivity in G1 phase was intermediate. Thus, mitoxantrone appears as the most active compound while bisantrene and ametantrone are the least active agents. The cytotoxic efficacy of bisantrene increases during prolonged continuous exposure, while that of mitoxantrone increases in fractionated administration. These characteristics could be exploited in clinical strategies designed to improve the performance of these agents. PMID- 6850583 TI - In vitro growth inhibition of human malignant melanoma cells by glucocorticoids. AB - The human malignant melanoma cell line, NEL, was found to contain glucocorticoid receptors. When the binding data were analyzed according to the method of Scatchard, results indicated a ligand binding capacity of 247 fmol/mg protein and a Kd of 1 X 10(-9) M. Additional studies show that the continuous incubation of NEL cells with triamcinolone acetonide (TA) for 72 hr results in a 30% inhibition in cell growth. To ascertain the mechanism by which glucocorticoids inhibit the growth of NEL cells, uptake and incorporation studies were carried out using various 3H precursors. Results indicate that, after 4 hr of TA treatment, a modest inhibition in [3H]thymidine uptake was observed, while stimulation of [3H]thymidine incorporation was noted at all steroid concentrations tested. However, cells incubated for 18 hr with TA (concentration, greater than or equal to 10(-8) M) showed a 30% decrease in the amount of [3H]thymidine incorporated into DNA. TA had no effect on [3H]leucine or [3H]glucose uptake after 4 hr of treatment but did inhibit [3H]glucose (42%) uptake after 18 hr of treatment. A slight stimulation (9%) in [3H]leucine incorporation was observed at this time point. When NEL cells were incubated with TA and the antiglucocorticoid, progesterone, the inhibition in [3H]thymidine incorporation was negated. These findings indicate that glucocorticoids exert some influence on the growth of human melanoma cells, and this effect is mediated through the glucocorticoid receptor. PMID- 6850584 TI - Cytotoxic effects of daunomycin-fatty acid complexes on rat hepatoma cells. AB - The anthracycline antibiotic drug daunomycin has been coupled to fatty acids through formation of a peptide bond with the amino group of its lyxose residue. The arachidonic (C20:4) and docosahexaenoic (C22:6) acid derivatives showed potent in vitro and in vivo cytotoxic activity against rat hepatoma cells producing alpha-fetoprotein. With the exception of the acetate derivative, the complexes with saturated fatty acids showed no activity. The in vivo toxicity of the free daunomycin is markedly diminished when present in the form of these derivatives. The antitumor activities of the polyene fatty acid complexes appear to depend upon the high degree of affinity of alpha-fetoprotein for these acids. These results strongly suggest the use of daunomycin or other cytotoxic drug:polyene fatty acid complexes in the therapy of human tumors producing alpha fetoprotein. PMID- 6850585 TI - Kinetics of thermotolerance decay in Chinese hamster ovary cells. AB - The kinetics of thermotolerance decay and cell proliferation was determined following initial heat treatments of 10 or 30 min at 44 degrees in Chinese hamster ovary cells. Thermotolerance was more pronounced following the longer initial heat treatment, but maximal tolerance developed by 10 hr in both cases. After its maximal development, tolerance decayed in an exponential manner. The half-times of tolerance decay were 11 or 16 hr following 10- or 30-min pretreatments. Thermotolerance was apparent in the progeny of heated cells for 4 to 5 postheat cell generations. PMID- 6850586 TI - Mechanism of diethylstilbestrol carcinogenicity as studied with the fluorinated analogue E-3',3",5',5"-tetrafluorodiethylstilbestrol. AB - E-3',3",5',5"-Tetrafluorodiethylstilbestrol (TF-DES), a structural analogue of diethylstilbestrol synthesized as a possible noncarcinogenic estrogen, was found to induce renal clear-cell carcinoma in Syrian hamster. The tumor induction frequency of TF-DES was the same as that of diethylstilbestrol, although the induction period was longer (approximately 9 months) than that of diethylstilbestrol (approximately 6 months). TF-DES was estrogenic and was found to support in vivo growth of estrogen-dependent H-301 cells, a cell line derived from the primary estrogen-induced and -dependent renal clear-cell carcinoma of male Syrian hamster. These data established the ability of TF-DES not only to induce tumors but also to promote estrogen-dependent tumor growth after the initiation process. Oxidation of TF-DES to TF-DES quinone was catalyzed by horseradish peroxidase. The structure of this metabolic intermediate was confirmed by comparison with synthesized TF-DES quinone. This intermediate was very unstable (half-life in methanol, 24 min; half-life in water, 4 min) and rearranged to Z,Z-3',3",5',5"-tetrafluorodienestrol. Based on the experiments with the fluorinated derivative, it is postulated that stilbestrol estrogens induce tumors via metabolic oxidation to quinone intermediates, which then may interact with DNA or other cellular targets. PMID- 6850587 TI - Effects of the DNA strand-cleaving antitumor agent, streptonigrin, on ataxia telangiectasia cells. AB - Cells from patients with ataxia telangiectasia (A-T) were shown to be more sensitive to streptonigrin than were cells from normal individuals. A linear dose dependent cell survival was observed for both normal and A-T cells exposed to streptonigrin (up to 1.5 ng/ml) for 3-hr, with the A-T cells being about twice as sensitive as were the normal cells (Do approximately 0.25 ng compared with Do approximately 0.5 ng). The extreme toxicity of streptonigrin is also seen in the response of DNA synthesis which is inhibited sharply in both A-T and normal cells using doses of up to 125 ng/ml, although the effect was less pronounced in A-T cells. A greater amount of time was needed for recovery of DNA synthesis in normal cells compared with that of A-T cells. Finally, chromosomes from both A-T lymphocytes and fibroblasts show about a doubling of breakage rate following exposure to streptonigrin. The increased sensitivity of A-T cells to streptonigrin appears to be fairly comparable to the sensitivity to ionizing radiation, bleomycin, or neocarzinostatin and provides further evidence that perhaps A-T cells are deficient in some form of DNA strand repair. PMID- 6850589 TI - Cell surface-mediated cytotoxicity of polymer-bound Adriamycin against drug resistant hepatocytes. AB - Growth inhibition properties of Adriamycin-coupled polyglutaraldehyde microspheres have been assessed using a highly resistant rat liver cell line, RLC. Covalent attachment of Adriamycin to microspheres increased the cytostatic activity of the drug 1000-fold for this cell line as measured by 50% inhibitory concentration determinations. The effects of Adriamycin-polymer complexes were investigated and compared to free drug, using trypan blue dye exclusion and 51Cr release as indicators of cell viability. When carcinogen-altered drug-resistant rat hepatocytes were tested at an Adriamycin concentration of 10(-6) M, the polymer-bound drug killed 32% of the cells, while the free drug had no detectable cytotoxic effect. However, with normal rat hepatocytes at the same drug concentration, the Adriamycin-coupled microspheres were shown to be less toxic than free drug at 24 hr. It was demonstrated that greater than 99.5% of the drug remains covalently coupled to the microspheres throughout the experiments. Scanning electron micrographs are presented for both cell types, which demonstrate the effects of free and bound Adriamycin on the ultrastructure of the cell surface. The cells lose their microvilli, exhibit numerous blebs, and develop holes and pits in the surface. Transmission electron microscopy demonstrates that less than 1% of the microspheres is internalized by either cell type. Multiple interactions of the drug-polymer complexes with the cell surface are presented as the most probable explanation for the results. PMID- 6850590 TI - Human ovarian carcinoma cells maintained on extracellular matrix versus plastic. AB - The ability of culture dishes coated with an extracellular matrix (ECM) to act as a suitable substrate for human ovarian carcinoma cells in vitro has been examined. The plating efficiency on ECM was 30 to 80% (dispersed tumor cells from solid tumor tissue and effusions) with active proliferation of tumor cells being observed. Within a few min, ovarian carcinoma cells seeded on an ECM were noted to attach firmly and assume a flattened morphology. In addition, ovarian carcinoma cells maintained on ECM-coated dishes could be released easily via trypsinization or with a cell scraper. This is in marked contradistinction to tumor cells seeded onto plastic dishes without an ECM. Invasion through the ECM by tumor cells from solid tumor tissue was occasionally noted. Nonmalignant cells were removed from dispersed tumor cell preparations by preplating on plastic culture dishes without an ECM. The malignant origin of the tumor cells was confirmed by morphological, histochemical, and cytogenetic criteria. This culture system represents a significant improvement over current methods for routinely culturing human ovarian carcinoma cells. Such a model may be utilized for screening anticancer drugs for their ability to inhibit proliferation of human ovarian carcinoma cells from individual patients. This system also may be useful for elucidating mechanisms of ovarian tumor cell attachment and invasion in the process of metastasis. PMID- 6850588 TI - Comparison of sulfation of glycosaminoglycans and glycopeptides from control and virus-transformed baby hamster kidney cells. AB - Sulfation of glycosaminoglycans and glycopeptides was compared in baby hamster kidney (BHK) cells and the polyoma virus transformants (PY-BHK). Cells were incubated with [3H]glucosamine and [35S]sulfate, and the labeled glycosaminoglycans and glycopeptides were isolated by digesting the cell membrane fraction with pronase followed by gel filtration. Each type of glycosaminoglycan in the void volume fraction (Fraction I) and in the included fraction (Fraction II) was determined by sequential enzymatic digestions. The residue was regarded as being glycopeptides. Of the total 3H radioactivities of glycosaminoglycans in Fraction I from BHK cells, 51% were in dermatan sulfate, 23% were in heparan sulfate, 17% were in chondroitin 4- and 6-sulfates, and 9% were in hyaluronate. PY-BHK cells acquired significantly larger amounts of 3H radioactivities in sulfated glycosaminoglycans than did BHK cells on the basis of cell number. On the basis of protein content, there was no such difference due to higher protein content of PY-BHK cells. The degree of sulfation of the glycosaminoglycans, estimated from the ratio of 35S to 3H and by disaccharide analysis, was significantly lower in PY-BHK cells than in BHK cells. Considerable amounts of 35S radioactivities assigned to sulfated glycopeptides were found in Fraction II from both BHK and PY-BHK cells. PMID- 6850591 TI - Azathioprine induction of lymphomas and squamous cell carcinomas in rats. AB - The carcinogenicity of azathioprine was evaluated in weaning female noninbred Sprague-Dawley rats by feeding it in the diet. Due to toxicity, the dose had to be changed during the course of the experiments and ranged from 0.015 to 0.04% of the diet by weight. In the first experiment, the estimated maximal cumulative consumption of azathioprine was 1.5 g/rat. Of the 14 rats evaluated, six developed thymic lymphomas, and four developed squamous cell carcinomas of the ear duct. When the experiment was repeated with a slightly lower daily consumption but with a cumulative total dose of 2.2 g/rat, there were seven of 19 rats with thymic lymphoma and two rats with ear duct carcinoma. These data support the hypothesis that azathioprine is a carcinogen. PMID- 6850592 TI - Glycoproteins as differentiation markers in human malignant melanoma and melanocytes. AB - Human malignant melanoma cell lines have been divided into three broad groups on the basis of morphology, pigmentation, tyrosinase levels, the 2-dimensional electrophoretic patterns of their [3H]glucosamine-labeled glycoproteins and the presence or absence of an extracellular matrix of fibronectin. The most pigmented cell lines were characterized by the synthesis of a novel glycoprotein with a molecular weight of 75,000 and the absence of a fibronectin matrix. As cultured skin melanocytes also had these characteristics, this group of melanomas appears to be the most differentiated. Melanoma cell lines in the amelanotic group were characterized by the synthesis of high levels of HLA-DR antigen and by the production of an extracellular fibronectin matrix. PMID- 6850594 TI - Receptor status and subsequent sensitivity of subclones of MCF-7 human breast cancer cells surviving exposure to diethylstilbestrol. AB - The estrogen receptor (ER)-positive human breast cancer cell line MCF-7 was incubated continuously in the presence of pharmacological concentrations of diethylstilbestrol (DES) in an attempt to correlate receptor status with DES sensitivity. It was consistently observed that cytotoxicity occurred at DES concentrations greater than 5 X 10(-6)M; however, a small percentage of cells, both from the wild-type MCF-7 line and from subclones derived in soft agar from single MCF-7 cells, survived, with altered morphology, up to 4 months of continuous exposure to DES concentrations ranging from 5 X 10(-6) to 1 X 10(-4)M. Characterization of seven regenerated surviving cell populations suggested that they remained ER positive; no evidence could be found for a block in the pathway of hormonal activation, as determined by progesterone receptor induction, to explain the ability of these cells to survive DES. Three regenerated cell populations were reexposed to DES. Two remained as sensitive to growth inhibition as untreated parent cells from which they were derived; however, one of these, designated MCF-7(35-1), was found to have autonomously high progesterone receptor (463 +/- 94 fmol/mg of cytosol; Kd = 1.8 +/- 0.2 X 10(-9)M) which was not significantly stimulated by the addition of 1 X 10(-8)M 17beta-estradiol for 72 hr. The third population, designated MCF-7(35-3), which survived initial exposure to 5 X 10(-5)M DES for 109 days and which remained ER positive (27 +/- 3 fmol/mg of cytosol; Kd = 0.8 +/- 0.2 X 10(-10)M) and progesterone receptor inducible, demonstrated significantly decreased sensitivity (p = 0.025) on reexposure to DES; conversely, significantly increased sensitivity (p less than 0.03) to the antiestrogen tamoxifen was observed. The mechanisms by which some MCF-7 cells survive prolonged exposure to DES are not certain; the data suggest that there is no clear relationship between ER status and sensitivity to DES and that there is no way of predicting the ultimate status of cells surviving DES treatment. PMID- 6850593 TI - Rapid method for preparation of nuclei from a mucin-producing solid tumor. AB - Nuclei were prepared from the human colon mucin-producing tumor GW-39. The method described involves incubation in beta-mercaptoethanol under mild conditions and results in the preparation of nuclei free of the mucin web that initially enmeshes them. A sensitive colorimetric immunoassay was used to confirm that nuclei prepared in this fashion were generally free of contaminating mucin. This method is mild, rapid, and should be applicable to other mucin-producing tumors. PMID- 6850595 TI - Influence of intestinal bacteria, sex of the animal, and position of the nitro group on the hepatic genotoxicity of nitrotoluene isomers in vivo. AB - The nitrotoluenes failed to induce unscheduled DNA synthesis in in vitro cultures of rat hepatocytes. Because intestinal bacteria are known to be involved in the metabolic activation of other nitroaromatic compounds, the genotoxicity of the nitrotoluenes was evaluated using an in vivo-in vitro hepatocyte DNA repair assay. 2-Nitrotoluene (2NT), 3-nitrotoluene, or 4-nitrotoluene was administered by gavage to male F344 rats. At selected times after treatment, primary hepatocyte cultures were prepared and incubated with [3H]thymidine, and unscheduled DNA synthesis was assessed by quantitative autoradiography. Corn oil controls ranged from -6 to -3 net grains/nucleus (NG). Only 2NT at 12 hr after treatment induced DNA repair (200 mg/kg: 15.4 NG). Twenty-four hr following treatment with 2NT, a 50-fold increase in the number of hepatocytes in S phase was observed and indicated that 2NT induces cell division in addition to DNA repair. To examine the influence of intestinal bacteria on the hepatic genotoxicity of 2NT, germ-free rats and germ-free rats inoculated with Charles River Altered Schaedler Flora were gavaged with 2NT. The cecal bacterial status was confirmed at sacrifice. 2NT did not induce DNA repair in germ-free animals (200 mg/kg: -3.8 NG), whereas DNA repair was induced in Charles River Altered Schaedler Flora-associated animals (200 mg/kg: 5.4 NG). When F344 females with conventional intestinal microflora were gavaged with 2NT and primary hepatocyte cultures were prepared, no unscheduled DNA synthesis was observed (200 mg/kg: 2.6 NG). Male and female F344 rats were shown to have similar populations of intestinal bacteria. These results demonstrate that the mononitrotoluenes display marked isomeric differences in their genotoxic potential, indicate the obligatory role of intestinal bacteria in the metabolic activation of 2NT, and show that the genotoxic potential of 2NT is dependent upon the sex of the animal under study. PMID- 6850598 TI - Isolation and analysis of melanoma cell mutants resistant to the antiproliferative action of retinoic acid. AB - Retinoic acid inhibits both the anchorage-dependent and the anchorage-independent growth of the murine melanoma S91-C-2 cells. To explore the mechanism of these effects, several mutant cell clones resistant to retinoic acid-induced growth inhibition have been derived from the S91-C-2 cells by exposing them to the mutagen ethyl methane sulfonate and plating in soft agarose in the presence of 1 microM beta-all-trans-retinoic acid. Under such conditions, the nonmutagenized S91-C-2 cells failed to grow; however, 2 X 10(-6) of the mutagenized cells did form colonies. These colonies were isolated, expanded in culture, and recloned in agarose containing retinoic acid. Five cell clones that retained their drug resistant phenotype after repeated subculture for 3 months, in the absence of retinoic acid, were characterized further. They were found to be 3- to greater than 1000-fold and 100- to greater than 100-fold resistant to retinoic acid induced inhibition of anchorage-independent and anchorage-dependent growth relative to the wild-type C-2 cells, respectively. The rate of uptake of [3H] retinoic acid by the resistant cell clones was similar to that of the sensitive C 2 cells, indicating that resistance is not the result of reduced uptake. Analysis of cytoplasmic retinoic acid-binding protein revealed that it is present in the most resistant clones in amounts that are similar to or even greater than those found in the sensitive S91-C-2 cells. These results indicate that resistance is not the result of the absence of the binding protein. The retinoic acid-resistant mutants exhibited cross-resistance to related retinoids such as 13-cis-retinoic acid and all-trans-retinol as well as to the arotinoid p-[(E)-2-(5,6,7,8 tetrahydro-5,5,8,8-tetramethyl-2-naphthyl) propenyl]benzoic acid suggesting that they all share a similar mechanism of action. These resistant mutants may provide a useful system for further studies of the molecular processes through which retinoic acid exerts its antiproliferative effects. PMID- 6850596 TI - Therapy of a murine sarcoma using syngeneic monoclonal antibody. AB - Syngeneic monoclonal antibodies (MoAb) to Moloney sarcoma cells (MSC) were produced by fusion of spleen cells from MSC regressor mice to myeloma SP2/0. MoAb 244-19A, an immunoglobulin G2b, bound to MSC cells and did not bind to two other sarcomas (K-BALB and Ha2), a carcinoma (Line 1), a fibroblast (A31) or a fibroblast infected with C-type virus (A31-Moloney leukemia virus). In contrast, MoAb 271-1A bound to the MSC and Ha2 sarcoma and line 1 carcinoma as well as to the normal and infected fibroblast cultures. Antibodies were tested for therapeutic effect using three schedules of antibody injection. Injection i.p. of ascites fluid containing 244-19A MoAb given on Days-1, 0, and +1 relative to tumor cell injection increased life span significantly over that of control animals given injections (P3, immunoglobulin G, or MoAb 271-1A) and produced some seven of 19, one of five, and one of five long-term survivors in three separate experiments. Antibody given to animals with established tumors (4 days after implantation) also prolonged life span significantly and produced three of nine long-term survivors. Antibody given to animals with very large tumor burdens (10 days after implantation) did not prolong life span significantly. Optimal dose, schedule, and mechanism studies concerning this therapy are in progress. PMID- 6850597 TI - Protection of normal tissues with 2-aminoethylisothiouronium during local pelvic radiation in monkeys. AB - Intestinal and bladder injury are the main limiting factors to radiation therapy in patients with pelvic neoplasms. 2-Amino-ethylisothiouronium (AET) is a radiation-protective agent when given systemically but absorbs poorly from the intestines. Accordingly, it was explored for the local protection of the bowel and bladder during radiation to the pelvis. Radiation localized to the pelvis in various high fractionated doses and various schedules was applied to pairs of stumptailed monkeys (Macaca arctoides): one was always a control; and the other was treated with AET. AET was applied to the bladder through a catheter and to the rectum with a cotton tampon during the time of radiation. After radiation, AET was removed by repeated washings. Control animals developed hemorrhage, diarrhea, and emaciation and died at various times after completion of the radiation course; biopsy of rectal mucosa showed severe radiation damage. AET treated animals had only occult blood in the stools and suffered slight weight loss; rectal biopsies showed normal tissues 2 weeks after radiation. PMID- 6850599 TI - Neodymium-yttrium aluminium garnet laser destruction of nonsensitized and hematoporphyrin derivative-sensitized tumors. AB - The injection of hematoporphyrin derivative (5 mg/kg i.v.) followed 24 hr later by a neodymium-yttrium aluminium garnet laser irradiation shows the destruction of CX1 tumors grafted on nude mice. This acidophilic necrosis occurred with a significantly increased frequency in tumors treated by hematoporphyrin derivative injection and irradiated with the neodymium-yttrium aluminium garnet laser as compared with noninjected but irradiated tumors or with injected tumors irradiated with sunlight. On the basis of our data, it seems difficult to maintain the hypothesis of singlet oxygen production as the only mechanism of the phenomenon. Further studies will be necessary to explain the necrosis that we observed. PMID- 6850600 TI - Isolation and characterization of subclones of L1210 murine leukemia with different sensitivities to various cytotoxic agents. AB - Two subclones of L1210 murine leukemia (L1210-46.1 and L1210-56.3) were isolated in the absence of selective agents. Subclone 56.3 appeared to be more sensitive than was subclone 46.1 to treatment with dexamethasone, 1-beta-D-arabinofuranosyl cytosine, vincristine, and X-irradiation. No differences between the parent cells and the two subclones could be observed in population-doubling time, cloning efficiency, number of chromosomes, and tumorigenic potential in DBA/2 mice. The subclones did not differ in the per cell number of glucocorticoid receptor sites. Animal experiments revealed an increase in life span of 65% in mice inoculated with cells from subclone 46.1 and of 130% of mice with subclone 56.3 after treatment with 1-beta-D-arabinofuranosylcytosine. The present results indicate that the L1210 wild-type murine leukemia cells contained stable subpopulations with a different but collateral sensitivity to various cytotoxic treatments. It is postulated that differences in drug sensitivity between cells are partly determined by cellular properties which are independent of the mechanism of action of any specific treatment. PMID- 6850601 TI - Elimination of O6-ethylguanine from the DNA of brain, liver, and other rat tissues exposed to ethylnitrosourea at different stages of prenatal development. AB - The magnitude of the neurooncogenic effect of N-ethyl-N-nitrosourea (EtNU) in the BD IX rat is strongly dependent on the developmental stage of the nervous system at the time of carcinogen exposure, with a maximum during late prenatal and early postnatal development. Both with increasing postnatal age and in the direction of early embryonic development (prior to Postnatal Day 15), the yield of neuroectodermal tumors in the brain and peripheral nervous system declines sharply. Using a competitive radioimmunoassay for O6-ethyldeoxyguanosine (O6 EtdGuo), we have ascertained that the initial degree of DNA ethylation in BD IX rat tissues (including brain) is independent of the developmental stage at the time of transplacental (i.v.) exposure to a constant single dose of EtNU over a time range from Prenatal Day 11 to a postnatal age of 102 days. O6-EtdGuo is highly persistent in the DNA of peri- and postnatal rat brain but enzymatically removed from the DNA of other tissues, notably liver. The present analyses by radioimmunoassay indicate that O6-EtdGuo is equally persistent in the DNA of prenatal BD IX rats exposed to EtNU (50 micrograms/g body weight) on the 11th, 13th, or 16th day of gestation but removed enzymatically from other prenatal tissues. The rate of removal from the DNA of liver (Prenatal Day 16) is higher than the corresponding rate in 10-day-old (postnatal) BD IX rats. On Prenatal Day 11 to 12 (when a neurooncogenic effect first became apparent after transplacental exposure of BD IX rats to EtNU; S. Ivankovic and H. Druckrey, Z. Krebsforsch., 71: 320-360, 1968), the number of cells per brain is approximately 2 X 10(5). When a limited number of experimental animals are used, and regardless of the incapacity of neural precursor cells to remove O6-EtdGuo from their DNA, this target population size may be incompatible with the manifestation of a rare event such as malignant transformation. PMID- 6850602 TI - Circumvention of vincristine and Adriamycin resistance in vitro and in vivo by calcium influx blockers. AB - Calcium influx blockers, diltiazem, nicardipine, nifedipine, niludipine, and nimodipine, which possess coronary vasodilator activity, greatly enhanced the cytotoxicity of vincristine (VCR) in tumor cells and especially in VCR-resistant sublines of P388 leukemia (P388/VCR) and human K562 myelogenous leukemia. The extent of enhancement was different among the drugs, and up to a 50- to 70-fold increase in VCR cytotoxicity occurred in P388/VCR cells with nontoxic or marginally toxic concentrations of diltiazem and nicardipine. A 50- to 100-fold enhancement occurred in VCR-resistant human K562 myelogenous leukemia cells with diltiazem, nicardipine, niludipine, and nimodipine. VCR resistance of these cell lines was circumvented completely by these blockers. Calcium influx blockers also enhanced the cytotoxicity of Adriamycin in P388 leukemia cells and especially in its Adriamycin-resistant subline. The extent of enhancement, however, was lower than that which occurred in VCR-resistant tumor lines with VCR. An approximately 10- to 30-fold increase in Adriamycin cytotoxicity occurred in P388 Adriamycin resistant subline cells with diltiazem, nicardipine, niludipine, and nimodipine. Although VCR alone at 10 to 200 micrograms/kg did not confer a significant therapeutic effect in P388/VCR-bearing mice, calcium influx blockers in doses of 30 to 125 mg/kg administered daily for 10 days with VCR enhanced the chemotherapeutic effect of VCR in P388/VCR-bearing mice. A maximum of approximately a 40 to 50% increase in life span occurred with diltiazem, nicardipine, niludipine, and nimodipine. The calcium influx blockers also enhanced the therapeutic effect of Adriamycin in P388 Adriamycin-resistant subline-bearing mice, although the extent of enhancement was smaller than that observed with VCR in P388/VCR-bearing mice. PMID- 6850603 TI - Increased resistance to chlorambucil in cultured cells with a high concentration of cytoplasmic metallothionein. AB - Cultured cells with elevated levels of cytoplasmic metallothionein (MT), a small molecular-weight protein extremely rich in cysteine, showed resistance against the alkylating drug chlorambucil. One human epithelial line (HE) and one mouse fibroblast line (Cl 1D) were used, as well as substrains of both cell lines (HE100 and Cl 1D100). The substrains contain large amounts of MT. Dose-survival curves obtained from cloning studies with the murine cells after exposure to chlorambucil for 1 hr revealed that Cl 1D100 was approximately 3-fold more resistant than were Cl 1D cells (D0 = 32.9 and 11.6 micrograms/ml, respectively); this difference was highly significant (p less than 0.001; t test). In growth rate studies, both MT-containing strains showed resistance against chlorambucil over the total dose range of 0.5 to 100 micrograms/ml compared to the parent strains. After 4 days treatment with 25 micrograms/ml, the growth inhibition of Cl 1D was 67%, but only 13% in Cl 1D100. For HE and HE100, 50 micrograms/ml gave growth inhibitions of 83 and 65%, respectively. Following 1- and 24-hr incubations of cells with [14C]chlorambucil and subsequent ultracentrifugation and gel filtration of the cytosols, about 20 to 40% of the 14C-derived radioactivity coeluted with the MT from the resistant strains. The results indicate that intracellular MT sequesters chlorambucil or its toxic metabolites and that the protein thus contributes to the resistance against this drug. PMID- 6850604 TI - Susceptibility of germ-free rats to the hepatotoxic effects of dimethylnitrosamine or dimethylamine plus sodium nitrite administered orally. AB - The influence of intestinal microflora on the hepatotoxic effects of dimethylnitrosamine (DMN) or dimethylamine (DMA) plus NaNO2 was studied by comparing the degree of liver necrosis and the levels of serum alanine aminotransferase (GPT) and aspartate aminotransferase (GOT) in germ-free and conventional male Wistar rats (320 to 340 g). In one experiment, both germ-free and conventional rats were intubated with DMN in respective doses of 8, 9, and 10 mg/kg of body weight, while in another experiment, both groups were intubated with DMA (1500 mg/kg) plus NaNO2 (100 mg/kg). In both experiments, 48 hr after intubation, there was a marked difference in the degree of liver necrosis and the levels of serum GPT and GOT between the groups. In particular, a dose of 8 mg of DMN or 1500 mg of DMA plus 100 mg of NaNO2 produced severe liver necrosis in the majority of germ-free rats, while the same dose did not produce any detectable liver necrosis in the majority of conventional rats. At a dose of 8 mg, serum GPT and GOT levels were raised to 22 and 15 times normal values, respectively, in germ-free rats, but only to about twice the normal values for both levels in conventional rats. At the combination dose of DMA plus NaNO2, the levels of serum GPT and GOT were raised to 40 and 30 times normal values, respectively, in germ free rats, while both levels remained almost normal in conventional rats. Thus, the results indicated that the liver of the germ-free state was far more susceptible to the acute toxic effects of DMN as well as DMA plus NaNO2 administration at a certain dose range than was the liver of the conventional state, suggesting the influence of the absence of microflora. PMID- 6850605 TI - Phospholipid-sensitive Ca2+-dependent protein phosphorylation system in various types of leukemic cells from human patients and in human leukemic cell lines HL60 and K562, and its inhibition by alkyl-lysophospholipid. AB - Phospholipid-sensitive Ca2+-dependent protein kinase (PL-Ca-PK), its endogenous substrate proteins, and regulation of the enzyme system by an antitumor agent alkyl-lysophospholipid were investigated in various types of leukemic cells (chronic myelocytic, acute myelocytic, and acute monocytic) from patients and in two cultured human leukemic cell lines (HL60 and K562). Exceedingly high levels of PL-Ca-PK, largely localized in the particulate fraction, were found in all types and lines of leukemic cells; much lower levels of cyclic adenosine 3':5' monophosphate-dependent protein kinase and cyclic guanosine 3':5'-monophosphate dependent protein kinase were also found. Although numerous and similar endogenous substrates for PL-Ca-PK were found in all cell types and lines examined, substrates specific for certain leukemic cells appeared to be present. Substrate proteins for calmodulin-sensitive Ca2+-dependent protein kinase, cyclic adenosine 3':5'-monophosphate-dependent protein kinase, and cyclic guanosine 3':5'-monophosphate-dependent protein kinase, in comparison, were much fewer or undetected. The PL-Ca-PK activity and the phosphatidylserine-Ca2+-stimulated phosphorylation of endogenous proteins from leukemic cells were inhibited by alkyl-lysophospholipid, which acted as a competitive inhibitor of the phospholipid cofactor of the enzyme. The findings suggested that the PL-Ca-PK system is a predominant protein phosphorylation system in leukemic cells and that this enzyme system may represent a site of cytotoxic action of alkyl lysophospholipid. PMID- 6850606 TI - Salted fish and inhalants as risk factors for nasopharyngeal carcinoma in Malaysian Chinese. AB - We conducted a case-control study of nasopharyngeal carcinoma among Malaysian Chinese to test inhalants, salted fish consumption, and use of tobacco, alcohol, and nasal ointments as risk factors for the disease. Interviews with 100 cases and 100 controls indicated that salted fish consumption during childhood was a significant risk factor (relative risk, 3.0; p = 0.04); childhood daily consumption of this food item compared to nonconsumption carried a relative risk of 17.4 [95% confidence interval = (2.7, 111.1)]. Occupational exposure to smokes (relative risk, 6.0; p = 0.006) and to dusts (relative risk, 4.0; p less than 0.001) was also significantly associated with nasopharyngeal carcinoma. The two risk factors (consumption of salted fish and exposure to smoke and/or dust) were independent of each other. There was no association between nasopharyngeal carcinoma and tobacco, alcohol, or nasal ointments. PMID- 6850607 TI - Urinary excretion of modified nucleosides in patients with malignant mesothelioma. AB - Transfer RNA is the most complex biomacromolecule in both structure and function. The complexity of its structure is caused by a large variety of enzymes which add modifying groups to the four bases after the primary synthesis. The most abundant of these enzymes are the transfer RNA methylases, which add methyl groups at various positions in the macromolecule. These methylating enzymes were found to be, without exception, aberrantly hyperactive in every malignant tumor examined. In turn, every malignant tumor contains a few transfer RNAs that are different in structure from the transfer RNAs in the normal tissue. Again, there is no exception. These are the first qualitatively different biochemical components of every malignant cell, not more or less but different transfer RNAs. The late Alexander Gutman observed that cancer patients excrete in their urine elevated levels of certain methylated bases. From the structure of these bases and our knowledge of their method of synthesis, it became apparent that most of them come from the breakdown of transfer RNA. Their elevation in the urine stems from an extraordinarily high rate of turnover of transfer RNAs in tumor tissue. Highly sophisticated, sensitive methods of analysis were developed for the determination of the modified nucleosides in the urine of cancer patients. When related to the creatinine level of the urine, some of the modified nucleosides and products derived from them were elevated in a large variety of tumors. Perhaps more importantly, it was found that these elevated levels return to normal after effective chemotherapy. Thus, these markers may also be useful in monitoring the effectiveness of therapy. We report here initial studies on the detection of cancer in asbestos workers and possible premalignant conditions in workers with asbestosis. PMID- 6850608 TI - Nonrandom chromosome abnormalities in lymphoma. AB - G-banded chromosomes were studied from involved lymph nodes or other tumor masses in 94 patients with malignant lymphoma. Clonal chromosome abnormalities were identified in 91 patients including all 81 B-lymphomas but only 6 of 9 T lymphomas. Many recurring chromosome abnormalities were found. Most common numerical alterations involved gains of chromosomes 12 (19% of patients), 18 (13%), 7 (12%), and 21 (10%). Structural abnormalities, which were more frequent than numerical alterations, most commonly involved chromosome regions 14q (71% of patients), 18q (36%), 6q (31%), 1p (24%), and 8q (19%). Seven recurring translocations were identified, and all except one involved 14q32. The most frequent were t(14;18)(q32;q21) in 22 patients, t(8;14)(q24;q32) in 9 patients, and t(1;14)(q42;q32) in 3 patients. Deletions most frequently involved the long arm of chromosome 6 at band q21 (11 patients) or q23 (7 patients). The common recurring chromosome abnormalities were correlated with histology (International Working Formulation for Clinical Usage) and immunological phenotype. Four abnormalities were significantly associated with specific histologies. Eighteen (82%) patients with t(14;18)(q32;q21) were follicular. Similarly, 82% of patients with del(6)(q21) were large cell lymphomas. Lymphomas with trisomy 7 were either diffuse large cell or follicular, while patients with t(8;14)(q24;q32) were either diffuse large cell or small noncleaved cell. A significant association with immunological phenotype was seen for t(14;18) only. All patients were either B- or complement lymphomas, and the heavy chain(s) was more commonly gamma and less frequently delta mu than among the total B-lymphoma population. We conclude that essentially all lymphomas have cytogenetic abnormalities; further study is required to determine their significance. Particularly, it will be of interest to see if oncogenes are found in the regions of these chromosome abnormalities. PMID- 6850609 TI - Progesterone and estrogen receptors as prognostic variables in breast cancer. AB - Estrogen receptor (ER) and progesterone receptor (PR) levels have been measured in 374 tumors from patients with primary breast cancer and compared with axillary nodal status and other patient variables to determine their relationship to prognosis. Nodal status reliably predicted disease-free interval and overall survival, and both ER and PR status predicted overall survival both individually and within node-positive and node-negative subgroups. PR but not ER status was also able to predict disease-free survival both overall and in the node-positive subgroup. When the two receptor measurements were used in combination, a group of receptor-negative, (ER- and PR-negative), node-negative patients were identified with a significantly worse survival than that for an ER- and PR-positive group of node-positive patients. It is apparent that receptor status provides useful prognostic information in patients with early breast cancer and that ER and PR assays used in combination identify a subgroup of node-negative patients with poor prognosis who are likely to benefit from adjuvant therapy following mastectomy. PMID- 6850610 TI - Prognostic index for clinical Stage I cutaneous malignant melanoma. AB - Thirteen variables were evaluated for their significance in predicting the survival of 148 patients in a retrospective study with clinical Stage I cutaneous malignant melanoma. The variables studied were histological type, tumor thickness, level of invasion, mitotic activity, pigmentation type, existence of ulceration, presence of lymphocytic infiltration, cell type, sex and age of the patient, site of melanoma, and wide local excision preceded or not by contact radiotherapy and associated or not with lymphadenectomy. When these variables were individualized, only seven were significantly related to survival: histological type; tumor thickness; level of invasion; mitotic activity; pigmentation type; existence of ulceration; and sex of the patient. Multivariate analysis based on Breslow's version of the Cox proportional-hazards model was performed on a group of 110 patients. This analysis demonstrated that 5 of the original 13 variables (i.e., mitotic activity, tumor thickness, sex, lymphadenectomy, and site of primary melanoma) could be used to develop a prognostic model. A Gompertz distribution which provided for an appropriate smoothing of the Breslow model estimates was used to derive a simple prognostic index and to predict the survival of individual patients. Fifty-four patients in a prospective study were subsequently evaluated with the Gompertz model in order to test the prognostic accuracy of the model for the five variables. PMID- 6850611 TI - Eosinophil infiltration of human colonic carcinomas as a prognostic indicator. AB - In experiments with suspensions of cells from colonic carcinomas, we noted that some colonic carcinomas contain large numbers of eosinophils. We therefore carried out a prospective study with 67 almost consecutive colonic carcinomas in our medical center after optimal fixation and staining for the demonstration of eosinophils. Infiltration of the primary tumor by eosinophils was found to have marked prognostic significance. The proportion (4 of 17 or 23.5%) of carcinomas with more than 30 eosinophils/sq mm that had metastases was significantly less (p = 0.01) than the proportion (31 of 50 or 62.0%) of carcinomas with less than 30 eosinophils/sq mm that had metastases. At 18 months, following the resection of tumor in patients without metastases, all of the patients (9 of 9) with greater than 30 eosinophils/sq mm were alive in contrast to 73.7% (11 of 15) of the patients with less than 30 eosinophils/sq mm. The number of survivors at 18 months for the total population without regard to metastases was significantly greater (p = 0.028) for those with greater than 30 eosinophils/sq mm than for those with less than 30 eosinophils/sq mm. We conclude that the quantitative assessment of eosinophils is one of the most important aspects of the microscopic evaluation of this common human tumor. PMID- 6850612 TI - Randomly controlled study of chemotherapy versus chemoimmunotherapy in postoperative gastric cancer patients. AB - From September 1979 through March 1981, a total of 302 patients with gastric cancer and undergoing gastrectomy at the Department of Surgery at Chiba University Hospital and its 14 affiliated hospitals was studied for clinical effectiveness of immunotherapy with Nocardia rubra cell wall skeleton. The patients were stratified by gross stage of cancer and degree of operative curability. They were then assigned randomly to either chemotherapy group or chemotherapy plus immunotherapy group. Immunotherapy used was intradermal injection of 400 micrograms of N. rubra cell wall skeleton which was given weekly for the first month and monthly thereafter. After the specimen was examined microscopically, the patients were classified by histological stage of cancer and radicality of surgical intervention into curative or noncurative groups. The patients were surveyed for survival period in December 1981. The postoperative survival rate was compared in patients of histologically curative or noncurative resection cases between the two treatment groups. No statistical difference was detected between the groups in age, sex, or operative procedures that might influence the patient's survival. As a result, statistical intergroup difference in survival rates was not seen in patients of the curative group, probably due to a short observation period. However, the intergroup difference in survival rates was statistically significant in patients of the noncurative group (p less than 0.01). These results indicate the adjunctive effect of N. rubra cell wall skeleton as an immunotherapeutic agent in patients undergoing gastrectomy for gastric cancer. PMID- 6850613 TI - Reflections on diet, nutrition, and cancer. PMID- 6850614 TI - Effect of hyperglycemia on thermochemotherapy of a spontaneous murine fibrosarcoma. AB - The effect of hyperglycemia on the cytotoxic effect of a chemotherapeutic agent was studied at elevated temperature. The seventh generation of a spontaneous C3Hf/Sed mouse fibrosarcoma, FSa-II, was transplanted into the footpads of the same strain of mice. Hyperthermia was given by immersing animal feet into a water bath where 41.5 +/- 0.1 degrees (range) was maintained by a constant temperature circulator. Cyclophosphamide (CY), an alkylating agent, was selected as a test agent. Single i.p. doses of glucose and of CY were given 60 and 30 min before the initiation of hyperthermia. Tumor response was assayed by determining the median tumor growth time (time required for one-half of the treated tumors to reach 1000 cu mm), and the dose-response curve was obtained. Hyperthermia enhanced tumor response to CY. The enhancement was greater when a glucose dose of 10 mg/g was administered before CY and heat treatments. The enhancement ratio, calculated as a ratio of the tumor growth time following CY (200 mg/kg) with heat or with glucose and heat to that following CY alone, was 1.31 or 2.86, respectively. Glucose given at ambient temperature did not enhance the effect of CY. A dose response curve obtained for a glucose dose with fixed CY (200 mg/kg) and heat (90 min at 41.5 degrees) doses demonstrated that a significant enhancement was obtained following a glucose dose as low as 2 mg/g, suggesting that the glucose enhancement could be safely achieved for human cancer treatment. PMID- 6850615 TI - Generation of phenotypic diversity in the B16 mouse melanoma relative to spontaneous metastasis. AB - Serial s.c. transplantation of the B16 melanoma in syngeneic mice for nearly 30 monthly generations effected gradual changes in the incidence of spontaneous pulmonary metastasis. Cell lines derived from s.c. tumors and from secondary tumor growths in the lungs were comparably variable in metastatic predilection and also differed in ability to produce tumor colonies in the lungs following i.v. injection of cultured cells. Some lines metastasized to the lungs from s.c. tumors and also colonized the lungs; others were metastatic but noncolonizing, colonizing and nonmetastatic, or nonmetastatic and noncolonizing ("null"). Metastatic and colonizing activities of all cell lines except the most potent colonizers were unstable in culture and during s.c. growth. Over 150 clones and subclones were obtained from B16 melanoma cell lines, and four distinct categories were defined on the basis of dissemination-related phenotypic characteristics: slow-growing null (Ns); rapid-growing null; metastatic; and colonizing. No single cell belonged to more than one category at the same time, but interconversions occurred rapidly and consistently during growth in vitro and in vivo. Progenitor Ns cells generated metastatic cells in culture and in tumors and became rapid-growing null cells and colonizers solely within tumors. Metastatic activity was transient, with cells reverting back to an Ns phenotype in culture and s.c. or converting to rapid-growing null cells and colonizers in vivo. Only potent colonizers were stable, an apparent end result of phenotypic diversification, but formation or proliferation of these cells within tumors was somehow regulated. Comparable heterogeneity was generated within lung metastases, except that reversion of metastatic cells to Ns cells and regeneration of metastatic activity were not demonstrated; the result was a progressive loss of metastatic cells within developing metastases. PMID- 6850616 TI - Metabolism of acrylonitrile by isolated rat hepatocytes. AB - Several of the pathways of metabolism of the suspected carcinogen acrylonitrile (AN) were identified previously in this laboratory with the use of subcellular fractions and purified enzymes (Guengerich, F.P., Geiger, L.E., Hogy, L.L., and Wright, P.L., Cancer Res., 41: 4925-4933, 1981). In order to establish the relative contributions of the various pathways leading to activated and detoxicated products, we examined AN metabolism in isolated Fischer 344 rat hepatocytes as a model. Reduced glutathione (GSH) was depleted, and cell viability was lost in an AN concentration-dependent manner. The major GSH adduct formed at all AN concentrations was identified as S-(2-cyanoethyl)GSH using thin layer and high-performance liquid chromatography. Acid hydrolysis and amino acid analysis of labeled hepatocellular, protein revealed S-(2-carboxyethyl)-cysteine as the major adduct formed, indicating direct alkylation of cysteinyl residues by AN. 2-Cyanoethylene oxide accumulated in the hepatocyte incubations but did not appear to contribute extensively to alkylation of GSH or protein. Cyanide, resulting from hydrolysis of 2-cyanoethylene oxide, appeared to be completely converted to thiocyanate, which was identified by gel exclusion chromatography and mass spectrometry of the methyl derivative. The concentration of thiocyanate formed was directly proportional to the concentration of AN used. Cyanide does not appear to play a role in AN-mediated cell death. Alkylation of hepatocellular DNA and RNA and extracellular DNA was not observed to an extent greater than one base in 3.5 X 10(5). The relative rates of the various pathways were compared, and more than 97% of the metabolites can be accounted for by the described reactions. These results are of use in evaluating the contribution of the various pathways and modes of binding of AN to toxicity and carcinogenicity in liver and extrahepatic target tissues. PMID- 6850617 TI - Chemotherapy and radiation therapy of human medulloblastoma in athymic nude mice. AB - The human medulloblastoma cell line TE-671 was grown s.c. and intracranially in athymic nude mice. Tumor-bearing animals treated with chemotherapeutic agents or radiation were compared to untreated tumor-bearing controls. Tumors growing s.c. were sensitive to cyclophosphamide and vincristine with growth delays in duplicate trials of 15.8/16.5 and 12.9/15.0 days, respectively. These tumors were minimally responsive to the 2,5-bis(1-aziridinyl-3,6-dioxodiethyl ester of 1,4 cyclohexadiene-1,4-dicarbamic acid (NSC 182986) and cis-diamminedichloroplatinum II and unresponsive to methotrexate, 2,4-diamino-6-(2,5-dimethoxybenzyl)-5 methylpyrido(2,3-d)pyrimidine (NSC 351521), 1,3-bis(2-chloroethyl)-1-nitrosourea (NSC 409962), and procarbazine. Radiation therapy with 2500 or 1500 rads as a single fraction produced a marked response, with growth delays of 39.5 and 21.1 days, respectively. Cyclophosphamide produced a significant (p less than 0.0005) increase in the median survival of mice with intracranial tumors. Vincristine produced a minimal increase in the median survival while no response was seen to the 2,5-bis(1-aziridinyl-3,6-dioxodiethyl ester of (1,4-cyclohexadiene-1,4 dicarbamic acid at the dose level and schedule tested. This model system will allow further analysis of the therapeutic sensitivity of human medulloblastoma to other agents or combined-modality regimens. PMID- 6850619 TI - Some advantages of curing mice bearing a large subcutaneous MOPC-315 tumor with a low dose rather than a high dose of cyclophosphamide. AB - Mice bearing a large s.c. MOPC-315 tumor can be cured by a dose of cyclophosphamide (CY) ranging from 15 to 200 mg/kg. However, the low (15 mg/kg) and the high (200 mg/kg) doses mediate tumor eradication via different mechanisms. Tumor eradication by the low dose of drug requires the cooperation of the toxic effect of the drug and T-cell-dependent antitumor immunity. On the other hand, tumor eradication by the high dose of drug does not require the participation of antitumor immunity but depends primarily on the tumoricidal activity of the drug. Spleen cells from tumor-bearing mice treated with the low dose of CY exhibit an augmented antitumor immune potential, whereas spleen cells from tumor-bearing mice treated with the high dose of CY exhibit suppressed antitumor immune potential. More importantly, tumor-bearing mice treated with the low dose of drug are able to reject a challenge with 300 times the minimal lethal tumor dose given 1, 6, or 31 days after CY therapy, whereas mice treated with the high dose of drug are unable to reject such a challenge given within the same time intervals after CY therapy. Moreover, when mice bearing a large tumor are treated with the high dose of CY and subsequently challenged again with tumor cells to establish a Day 4 nonpalpable tumor, this tumor is less responsive to cure by combined chemoimmunotherapy than is a Day 4 nonpalpable tumor established in normal mice. Thus, although the high dose of CY can cure most mice bearing a large-size MOPC-315 tumor, it not only does not result in antitumor immunity, but it actually reduces the effectiveness of chemoimmunotherapy for a second tumor challenge. In contrast, mice cured with the low dose of CY exhibit long-lasting potent antitumor immunity. PMID- 6850618 TI - Characterization and quantitation of antiestrogen binding sites in estrogen receptor-positive and -negative human breast cancer cell lines. PMID- 6850620 TI - Role of the acetylation polymorphism in determining susceptibility of cultured rabbit hepatocytes to DNA damage by aromatic amines. AB - In humans and rabbits, differences in the rate of N-acetylation of aromatic amines are under polymorphic genetic control. Individuals are classified as either rapid or slow acetylators. In the current study, the relationship between acetylator phenotype and susceptibility to the genotoxicities of benzidine, 4 aminobiphenyl, 4,4'-methylenebis-2-chloroaniline, and 2-naphthylamine was investigated. Cultured hepatocytes isolated from rapid and slow acetylator rabbits were exposed to a dose range of the aromatic amines, and genotoxicity was determined by the autoradiographic measurement of DNA repair synthesis. Hepatocytes from rapid acetylator rabbits were more susceptible to the genotoxic effect of benzidine than were cells from slow acetylators. 4-Aminobiphenyl and 4,4'-methylenebis-2-chloroaniline were both weakly genotoxic, but no clear correlation was seen with acetylator phenotype. No genotoxicity was observed with 2-naphthylamine. These results thus demonstrate that differences in acetylation rates can affect the genotoxicity of benzidine. This study provides further evidence for the role of the genetically determined acetylator polymorphism in determining susceptibility to the effects of certain aromatic amine carcinogens. Since the acetylator polymorphism is a human trait, a similar susceptibility may be displayed in humans. PMID- 6850621 TI - Effect of hyperthermia on the survival of normal human peripheral blood mononuclear cells. AB - Human peripheral blood mononuclear cells from normal healthy volunteers were exposed to elevated temperatures of 41-43 degrees for up to 6 hr. Thereafter, the cells were stimulated with phytohemagglutinin in vitro in order to measure indirectly the surviving fraction. DNA replication in heated cells in response to phytohemagglutinin was found to be a sensitive indicator of thermal injury. Exposure to even 40 degrees for 2 hr lowered thymidine incorporation at early time points after phytohemagglutinin stimulation, but the cells were able to recover from thermal injury after exposure for up to 4 hr at 42 degrees. At 43 degrees, exposure for even 1 to 2 hr caused irreversible damage. The changes in thymidine incorporation were not due to changes in endogenous nucleotide pools since parallel changes were observed in DNA polymerase activity. Thus, the heat sensitivity of normal human lymphocytes could be a limiting factor for use of hyperthermia as an adjunct to radiotherapy and chemotherapy of human cancer. PMID- 6850622 TI - Influence of heat on the intracellular uptake and radiosensitization of 2 nitroimidazole hypoxic cell sensitizers in vitro. AB - The effect of elevated temperature (44 degrees) on the intracellular uptake of the 2-nitroimidazole hypoxic cell radiosensitizer, misonidazole (MIS), and analogues more hydrophilic than MIS was studied in Chinese hamster ovary cells. It was found that the intracellular uptake of these compounds which enter cells by restricted passive diffusion can be enhanced approximately 4-fold when incubated at 44 degrees compared to the uptake at 37 degrees. Peak intracellular uptake (expressed as the ratio of intracellular concentration to extracellular concentration) following incubation of cells in 2 mM MIS was 100% at 44 degrees but only 25% at 37 degrees. Furthermore, a short-term nonlethal heat pulse (44 degrees for 15 min) with MIS present caused a 2-fold enhancement in uptake which was sustained for an additional 45 min at 37 degrees. This same nonlethal heat pulse was found to induce a similar enhancement in uptake even when MIS was added at subsequent time intervals at 37 degrees. The heat pulse induced a time-related enhancement of uptake at 37 degrees which increased for 1 hr and persisted for at least 6 hr. Finally, in vitro radiosensitization studies of hypoxic Chinese hamster ovary cells showed that the nonlethal heat pulse of 44 degrees for 15 min could greatly enhance the sensitization by low concentrations (0.5 mM) of MIS added after heating due to increased intracellular concentrations of the drug. MIS (0.5 mM) alone achieved a radiosensitization enhancement ratio of 1.29 (compared to irradiated hypoxic cells alone), while the addition of the short term heat pulse, which had only a minor effect itself, achieved an enhancement ratio of 1.78. PMID- 6850623 TI - A fast and convenient method for determining estrogen receptor using rabbit uterus as a standard. AB - A fast and convenient method is described for the determination of estrogen receptors (ERs). This method involves the use of rabbit uterus as a standard. ER content of the rabbit uterus powder was determined using the conventional methods, i.e., Scatchard plot and sucrose density gradient methods. The rabbit uterus cytosol was serially diluted to give a range of protein concentrations from 1 to 0.062 mg/ml. A standard curve was thus generated with the corresponding ER concentrations, and this curve was used for the determination of ERs in breast tumors. The method involved incubating the standards with 125I-estradiol and subsequent removal of the free radiolabeled estradiol using dextran-coated charcoal. A parallel sample was also incubated with diethylstilbestrol. A standard curve was obtained between the 125I-estradiol percentage of binding and the corresponding ER concentration. Tumor cytosols were also treated in a similar manner, and the receptor content was determined from the standard curve. Excellent correlation was obtained between this method and other conventional methods. This method is simpler and less time consuming, and up to ten tumors can be analyzed at one time. It is especially useful when limited amounts of tumor tissue are available, as a concentration of only 1 mg of protein per ml is required. PMID- 6850624 TI - Comparison of in vitro methods for assessing cytotoxic activity against two pancreatic adenocarcinoma cell lines. AB - Several models of pancreatic adenocarcinoma are now available for experimental evaluation of newer chemotherapeutic agents. The present study represents an attempt to develop a rapid in vitro screening technique that would allow prediction of cytotoxic activity (or lack thereof) as reliably as the clonogenic or colony formation assay. To this end, seven drugs (cisplatin, dactinomycin, doxorubicin, 5-fluorouracil, menogarol, mitoxantrone, and streptozocin) were tested against two pancreatic adenocarcinoma cell lines using a standard colony formation assay and a 24-hr microcytotoxicity assay. The cell lines tested were PANC-1, of human poorly differentiated pancreatic adenocarcinoma origin, and WD PaCa, of hamster well-differentiated pancreatic adenocarcinoma origin. The dose survival curves and resulting determinations of drug dose (microgram/ml/1-hr exposure) at which there is a 50% inhibition of survival as compared to controls were compared for the two cell lines by each assay system. Lack of correlation of the two assays and considerable interdrug and inter-cell line variation were found. In addition, the microcytotoxicity assay was felt to underestimate the in vitro drug sensitivity of PANC-1 to three drugs (dactinomycin, doxorubicin, and mitoxantrone) and of WD PaCa to two drugs (5-fluorouracil and mitoxantrone). Despite the possible utility of the microcytotoxicity assay with other experimental models, the colony formation assay technique appears to provide the most reliable in vitro assessment of antineoplastic activity for pancreatic adenocarcinoma cell lines and should continue to be the standard to which other assay systems are compared. PMID- 6850625 TI - Monoclonal antibodies to human melanoma-associated antigens: an amplified enzyme linked immunosorbent assay for the detection of antigen, antibody, and immune complexes. AB - An amplified, indirect biotin-avidin micro-enzyme-linked immunosorbent assay was developed for the measurement of human melanoma-associated antigens, either free or circulating with associated immunoglobulin in patient sera. Parameters and specificity of detection were assessed using monoclonal antibody to human melanoma-associated antigens. The main advantages of the assay are its flexibility, through the use of indirect detection and a variety of formats, and its sensitivity, with a lower limit of antibody detection at 100 pg/well and a lower limit of soluble antigen detection at 10 pg/well. The assay was applied to cell surface antigen detection with monoclonal antibody 9.2.27 to a melanoma associated antigen against a panel of glutaraldehyde-fixed cells, and gave similar binding specificity as assessed by a previous 125I-Protein A assay. Utilizing a unique "sandwich" format, aMr 100,000 melanoma-carcinoma-associated antigen was quantitated in melanoma patient sera and found highly elevated in Stage IV disease. The same sandwich format was also used to detect and determine the class of human immunoglobulin associated with circulating Mr 100,000 human melanoma-associated antigens in normal donor sera. Thus, the sensitivity and flexibility of this enzyme-linked immunosorbent assay system make it particularly suitable for numerous applications in the study of monoclonal antibody-defined tumor-associated antigens. PMID- 6850626 TI - Effects of ultraviolet-visible irradiation in the presence of melanin isolated from human black or red hair upon Ehrlich ascites carcinoma cells. AB - The present study is an attempt to investigate the possibility that ultraviolet irradiation in the presence of pheomelanin may be more harmful to cells than the irradiation in the presence of eumelanin. The effects of UV-visible irradiation upon Ehrlich ascites carcinoma cells in the presence of the melanin isolated from human black hair (eumelanin) or from red hair (pheomelanin) were investigated. Irradiation of these cells was found to produce cell lysis, as observed by leakage of 51Cr from labeled cells and intracellular lactic dehydrogenase from the cells and decrease in cell viability demonstrated by the trypan blue exclusion test. The three parameters were quantitatively parallel to one another under various experimental conditions, namely different periods of irradiation and irradiation in the presence of different concentrations of melanin. The above effects were more pronounced when the irradiation was carried out in the presence of melanin from red hair than in the presence of black-hair melanin. In the absence of either melanin, the irradiation did not produce any significant effect in cell viability or cell lysis. Irradiation of the cells in the presence of red hair melanin also decreased the transplantability of these cells. These observations clearly show that irradiation of cells in the presence of pheomelanin could produce cytotoxic effects. The present experimental design may have application in the development of in vitro models for the study of UV radiation-induced cutaneous carcinogenesis. The reactions of pheomelanin may be related to the susceptibility of "Celtic" skin to UV radiation-induced skin damage and carcinogenesis. PMID- 6850627 TI - Mechanism of sensitization of Chinese hamster ovary cells to melphalan by hypoxic treatment with misonidazole. PMID- 6850628 TI - Use of uridine rescue to enhance the antitumor selectivity of 5-fluorouracil. AB - We examined the ability of uridine to increase the therapeutic index of 5 fluorouracil (FUra) against C57BL/6 X DBA/2 F1 mice bearing a Day 1 B16 melanoma or L1210 leukemia. FUra (400, 600, or 800 mg/kg, i.p.) followed in 24 hr by a 5 day s.c. infusion with uridine (5 g/kg/day, s.c.) was compared with the maximum tolerated dose of FUra (200 mg/kg, i.p.) plus a 5-day infusion with 0.9% NaCl solution. High-dose FUra plus delayed infusion with uridine was more effective than FUra (200 mg/kg) in inhibiting the growth of the B16 melanoma. High-dose FUra plus uridine rescue was, however, no more effective than FUra (200 mg/kg) in increasing the survival times of mice bearing the L1210 leukemia. To see if uridine rescue from FUra toxicity correlated with effects against a sensitive normal tissue, bone marrow nucleated cellularity of normal, non-tumor-bearing mice was monitored after drug treatment. In mice treated with FUra (200 mg/kg) followed in 24 hr by a 5-day infusion with either uridine (5 g/kg/day) or 0.9% NaCl solution, there was not as great a decrease in cellularity at the nadir with uridine, and, in addition, uridine accelerated recovery as compared to 0.9% NaCl solution. Furthermore, uridine (5 g/kg/day), but not thymidine (dThd) (5 g/kg/day) or 2'-deoxyuridine (dUrd) (5 g/kg/day), had a sparing effect on the depression in bone marrow nucleated cellularity seen at the nadir on Day 4 after Fura (200 mg/kg). The specificity of uridine to rescue mice from the lethal toxicity of the related fluorinated pyrimidines, 5-fluorouridine and 5-fluoro-2' deoxyuridine, was also examined. Mice were treated with 5-fluorouridine (250 mg/kg, i.p.) followed in 24 hr by a 5-day infusion with uridine (1, 5, or 10 g/kg/day), dThd (1, 5, or 10 g/kg/day), or dUrd (1 or 5 g/kg/day). Uridine (1, 5, or 10 g/kg/day) rescued mice from the lethal toxicity of 5-fluorouridine, whereas dThd or dUrd was ineffective. Similarly, a 5-day infusion with uridine, but not dThd or dUrd, rescued mice from the lethal toxicity of 5-fluoro-2'-deoxyuridine (1800 mg/kg, i.p.). PMID- 6850631 TI - Effects of combination estrogen:cyclophosphamide treatment on the growth of the MXT transplantable mammary tumor in the mouse. AB - The present studies were done to determine if the growth-promoting properties of estrogen on the MXT transplantable mammary tumor in the mouse would enhance the cytotoxicity of cyclophosphamide. Mice bearing these tumors had beeswax pellets implanted which contained 17 beta-estradiol (0.01 to 1.0 mg/pellet) and/or injected twice weekly with cyclophosphamide (10 to 40 mg/kg body weight in sesame oil) for 4 to 7 weeks. During this time, tumor size [(L + W)/2] and body weights were monitored every 7 to 14 days. The results show that administration of estradiol (0.01 to 1.0 mg/pellet) by implant slightly stimulated tumor growth, and in no case was tumor regression observed in response to the steroid. Likewise, cyclophosphamide treatment alone (10 to 20 mg/kg) failed to inhibit the tumor; however, combined administration of estradiol plus cyclophosphamide (10 to 40 mg/kg) resulted in significant inhibition of tumor growth. This response was time and dose dependent. These results show that while neither compound alone inhibited tumor growth, estradiol and cyclophosphamide are synergistic and completely block the growth of this transplantable mammary tumor in the mouse. The mechanism for this antagonism of mammary tumor growth remains to be resolved; however, we speculate that estradiol stimulates cellular hypertrophy and hyperplasia in these tumors, and under these conditions the cytotoxic effectiveness of cyclophosphamide is enhanced. PMID- 6850629 TI - Systemic lidocaine enhancement of hyperthermia-induced tumor regression in transplantable murine tumor models. AB - Previously, we reported that local lidocaine infusion of a CA 755 mammary adenocarcinoma growing in C57BL X DBA/2 F1 mice, when combined with local heating for 1 hr in a 43.5 degrees water bath, significantly increased survival and inhibited tumor growth more than heating alone. Because of its clinical implications, systemic lidocaine was tested in the above model system and in a murine fibrosarcoma tumor model. An equivalent supraadditive, tumor-inhibitory effect of heat and lidocaine was obtained with both systemically and intratumor administered lidocaine. The serum levels of lidocaine necessary to achieve tumor regression were within the therapeutic range for the control of arrhythmia in humans. Several treatment schedules, varying the mode of drug delivery, were evaluated. The effects of treatment on tumor growth characteristics were analyzed using an extension of the Cox survival model. PMID- 6850630 TI - Role of lipid transfer proteins in the abnormal lipid content of Morris hepatoma mitochondria and microsomes. AB - The level of nonspecific lipid transfer protein in three Morris hepatomas of varying degrees of differentiation has been found to be less than 10% of the level in either host or control livers, whereas phosphatidylcholine transfer activity is slightly reduced for hepatomas compared to host livers (20 to 40%), though nearly the same as levels present in livers of non-tumor-bearing rats. Two major differences have been observed in the lipid compositions of tumor mitochondrial and microsomal membranes compared to those of normal membranes. For all three hepatomas, the cholesterol content of mitochondria is markedly elevated, and the phospholipid content of microsomes is reduced (per mg of protein). As a consequence of the above alterations, the cholesterol: phospholipid ratio of both the microsomal and mitochondrial membranes of these tumors is increased, and the extent of this increase correlates well with the degree of differentiation of the hepatomas. If an important physiological role of lipid transfer proteins is to transfer newly synthesized lipids from microsomes to other cellular organelles, one would expect a 10-fold decline of nonspecific lipid transfer protein activity in hepatomas to result in phospholipid and cholesterol accumulation in microsomes and depletion in mitochondria. The observed decline of phospholipid in microsomes and accumulation of cholesterol in mitochondria from hepatomas suggest that this is not an important function of the nonspecific lipid transfer protein. Finally, preliminary studies of the possibility that the elevated cholesterol: phospholipid levels in hepatoma membranes affect the activities of enzymes of these membranes are reported. PMID- 6850632 TI - Effects of four retinoids in N-nitrosobis(2-oxopropyl)amine-treated hamsters. AB - Four synthetic retinoids were evaluated with regard to chemo-prevention of pancreatic carcinomas in carcinogen-treated hamsters. Syrian golden hamsters were given two injections of N-nitrosobis(2-oxopropyl)amine (20 mg/kg) and then were fed retinoid-supplemented diets for 1 year. The incidence of pancreatic carcinomas was lower in six of eight retinoid-fed groups than in the control group, although the differences were not statistically significant. The lowest incidence was observed in groups fed N-(4-pivaloyloxyphenyl)retinamide and N-(2 hydroxypropyl)retinamide. Testicular atrophy with decreased spermatogenesis was noted in males fed N-(2-hydroxypropyl)retinamide, N-(3-hydroxypropyl)retinamide, and N-(2,3-dihydroxypropyl)retinamide. PMID- 6850634 TI - Thermal survival characteristics of cell subpopulations isolated from a heterogeneous human colon tumor. AB - Responses of a heterogeneous human colon adenocarcinoma model tumor system to in vitro hyperthermic treatment at various temperatures have been studied. This model tumor system consists of an original tumor line (DLD-1) obtained from surgical biopsy, and two derivative subpopulations termed clones A and D. These 3 tumor cell populations differ in many properties, including karyotype and DNA content, production of specific antigens, and sensitivities to other cytotoxic agents such as chemotherapeutic drugs and X-irradiation. In these experiments, exponentially growing tumor cells were exposed to hyperthermia (42.2, 42.5, 43.0, 44.0, or 45.0 degrees) for graded time periods. A single-hit, multitarget equation was used to express the dependence of survival on time at a given temperature, and values for extrapolation numbers, quasi-threshold time (min), and T0 (mean lethal time; min) were obtained for the initial regions of survival. At the lower temperatures of 42.2 and 42.5 degrees, biphasic survival curves were obtained for all three tumor lines and, as a consequence, a second mean lethal time (T0,f) was also determined for the final thermal-resistant portion of the survival curves. Using the T0 values as an index of relative resistance, values at 42.2 and 42.5 degrees indicated that, in this temperature region, the parent (DLD-1) line was the most sensitive, the clone A line showed intermediate sensitivity, and the clone D line was the most resistant. In the thermally resistant portion of the survival curve, T0 values indicated that the clone A subpopulation was the most sensitive, the DLD-1 line showed intermediate sensitivity, and the clone D tumor subpopulation remained the most resistant. At the higher temperatures of 43, 44, and 45 degrees, in which thermotolerance is not observed during heat treatment, values for T0 indicated the parent (DLD-1) tumor line was still the most sensitive tumor line, and the clone A and clone D lines showed approximately equal resistance. These data indicate that significant differences may exist among subpopulations of heterogeneous tumors in their survival responses to hyperthermia. PMID- 6850633 TI - Weak promotion of C3H/10T1/2 cell transformation by repeated treatments with formaldehyde. AB - C3H/10T 1/2 cells were treated with N-methyl-N'-nitro-N-nitrosoguanidine and then repeatedly exposed to formaldehyde (0.1 to 2.0 micrograms/ml). Exposure of N methyl-N'-nitro-N-nitrosoguanidine-initiated cultures to formaldehyde concentrations of 0.5 or 1.0 micrograms/ml in a variety of treatment regimens resulted in focus formation in up to 9% of the treated dishes. Transformed foci were observed in 2% or less of the cultures treated with N-methyl-N'-nitro-N nitrosoguanidine or formaldehyde alone. Formaldehyde thus appears to be only a weak tumor promoter for C3H/10T 1/2 cell transformation. PMID- 6850635 TI - Direct and indirect clastogenic activity of anthracenedione in Chinese hamster ovary cells. AB - The purpose of this study was to characterize the clastogenic activity of 1,4 dihydroxy-5,8-bis [[(2-[(2-hydroxyethyl)amino] ethyl)amino]]-9, 10 anthracenedione (NSC 301739), an antitumor compound now under clinical investigation. Chromosome damage in Chinese hamster ovary cells in G2 phase was assayed directly by the technique of premature chromosome condensation, and this damage was compared with the aberration levels determined when the G2 cells attained metaphase. 1,4-Dihydroxy-5,8-bis [[(2-[(2 hydroxyethyl)amino]ethyl)amino]]-9, 10-anthracenedione was observed to slow the progression of cells to mitosis and induce chromatid gaps, breaks, and exchanges directly in interphase cells. The frequency of gaps, breaks, and complete exchanges observed at metaphase were similar to those observed in G2 prematurely condensed chromosomes; however, the frequency of incomplete exchanges was increased in mitotic preparations. The additional exchanges appeared to result from chromosome stickiness occurring during chromosome condensation for metaphase. The chromosome attachments were strong and resulted in persistent chromosome bridges during anaphase. These results suggest that 1,4-dihydroxy-5,8 bis[[(2-[(2-hydroxyethyl)amino]ethyl)amino]]-9, 10-anthracenedione induces chromosome damage through both direct and indirect mechanisms. PMID- 6850636 TI - Stimulation of increased capillary endothelial cell motility by chondrosarcoma cell-derived factors. AB - The ability of chondrosarcoma cell-derived preparations to stimulate an increase in the motility of bovine capillary endothelial (BCE) cells was quantitated using a phagokinetic track assay which measures the area of tracks produced by BCE cells after ingestion of gold particles. Chondrosarcoma preparations stimulated a 2-fold increase in the mean track area produced by BCE cells in an 18-hr incubation period. The motility-stimulating activity of chondrosarcoma was purified about 120-fold. The most highly purified fractions had molecular weights between 16,000 and 20,000 and stimulated a 2-fold increase in BCE cell motility at concentrations of 10 to 20 ng/ml. PMID- 6850637 TI - Clonal chromosome changes in stimulated lymphocytes of untreated human B-cell leukemias. AB - The chromosome constitution of peripheral blood lymphocytes from nine cases of B cell chronic lymphocytic leukemia and one case of B-cell prolymphocytic leukemia were studied at diagnosis following stimulation by B- and T-cell activators. Chromosome analysis with banding techniques revealed an extra chromosome 12 (trisomy 12) in 4 B-cell chronic lymphocytic leukemia cases and complicated abnormalities, i.e., trisomy 12, 6q-, 14q+, and a translocation between chromosomes 6 and 12, [t(6; 12)] in the prolymphocytic leukemia case. These findings suggest that trisomy 12 is a prototypic change in B-cell leukemia, particularly in B-cell chronic lymphocytic leukemia. Based on sister chromatid exchange studies of unstimulated lymphocytes, it appears that some leukemia cells with a normal karyotype not only divide but also proliferate in vitro. PMID- 6850638 TI - Organ-specific promoting effect of phenobarbital and saccharin in induction of thyroid, liver, and urinary bladder tumors in rats after initiation with N nitrosomethylurea. AB - Tumor-promoting effects of phenobarbital (PB) and sodium saccharin (SS) were tested in rats pretreated with N-nitrosomethylurea (NMU) with special reference to the site of their action. Male F344 rats were initially given injections of NMU (20 mg/kg i.p.) twice a week for 4 weeks, then given basal diet containing 0.05% PB or 5% SS for the next 32 weeks, and then killed. Appropriate control studies were also done. Histological examination of whole organs of the rats showed that PB promoted thyroid carcinogenesis whereas SS did not. A significant increase in the incidences of total tumors as well as papillary adenocarcinoma of the thyroid was observed in the group given PB after NMU (p less than 0.001). The incidence of papillary adenoma with or without papillary adenocarcinomas was also high in the NMU-PB-treated group. The organ-specific promoting effect of PB in the induction of preneoplastic lesions, as demonstrated by development of gamma glutamyl transpeptidase-positive foci in the liver and of SS in papillary or nodular hyperplasia in the urinary bladder, as reported previously, was also confirmed. The incidences of papillomas in the forestomach were similar in groups treated with NMU-PB, NMU-SS, or NMU alone. The results indicate that PB is a tumor promoter in the liver and thyroid and that SS is a tumor promoter in the urinary bladder of rats. PMID- 6850639 TI - O6-Methylguanine removal by competent and incompetent human lymphoblastoid lines from the same male individual. AB - Two cell lines, one proficient (Mex+) and one deficient (Mex-) in the ability to remove O6-methylguanine, have been isolated by Epstein-Barr virus-mediated transformation of a single blood sample obtained from a normal human male. Extracts of untreated cells differ in their O6-methylguanine transferase (methyl acceptor protein) activity. Although both lines arise from the same individual, they show great difference in their sensitivities to the toxic action of N-methyl N'-nitro-N-nitrosoguanidine. Chromosome counts of the strains reveal a modal number of 46 for both. Neither X-inactivation nor a gross abnormality in chromosome number can be the cause of the difference between the two lines. PMID- 6850640 TI - Regional measurements of blood flow in experimental RG-2 rat gliomas. AB - Regional measurements of blood flow (F) were performed in transplanted intracerebral RG-2 rat gliomas using [14C]iodoantipyrine, Kety-Schmidt blood flow equations, and quantitative autoradiography. Twenty-nine intracranial tumors in ten rats were analyzed by location; 18 intraparenchymal, seven meningeal, two third-ventricular, and two fourth-ventricular tumors were studied. For all tumors, averaged mean F was 91 +/- 33 (S.D.) ml/hg/min. In all but one tumor, mean F was intermediate between normal cortex and corpus callosum values. There was moderate regional variation: averaged mean F was lower in tumor center (78 +/ 47 ml/hg/min) than in tumor periphery (93 +/- 30 ml/hg/min). Within individual tumors, F showed moderate variation which correlated to some extent with histological features; a regional F of less than 10 ml/hg/min was observed in only one tumor within an area of necrosis. F in regions of brain immediately surrounding the tumor was higher than in tumor periphery. Blood flow to RG-2 tumors seems unlikely to limit drug delivery any more than to normal brain, and the consistent levels from tumor to tumor and within individual tumors make the RG-2 model an excellent one with which to study drug delivery in experimental brain tumors. PMID- 6850641 TI - Regional measurements of blood-to-tissue transport in experimental RG-2 rat gliomas. AB - Regional measurements of blood-to-tissue transport were performed in transplanted RG-2 rat gliomas using [alpha- 14C]aminoisobutyric acid (AIB), quantitative autoradiography, and equations to express a unidirectional transfer constant. Thirty-eight intracranial tumors in ten rats were analyzed according to location; 23 intraparenchymal tumors, eight meningeal tumors, six fourth-ventricular tumors, and one third-ventricular tumor were studied. Except for the small third ventricular tumor, the transfer constant (K) for AIB was similar in all groups and ranged from 0.031 to 0.038 ml/g/min. Within individual tumors, regional variation of K was also small, although some local variation could be correlated with histological features. The K for AIB decreased in brain around tumor and, at a distance of 300 microns from tumor edge, had returned to values similar to those of normal cortex (0.002 ml/g/min). An average extraction fraction (E) of 0.09 was calculated for AIB in the RG-2 tumors. The low E suggests that delivery of water-soluble chemotherapeutic drugs to RG-2 tumors should be limited more by capillary permeability or surface area than by blood flow. RG-2 is an ideal experimental tumor with which to test drug delivery and the methods that attempt to increase drug delivery in brain tumors. PMID- 6850642 TI - Effect of size on portal circulation of hepatic nodules from carcinogen-treated rats. AB - The portal circulation of diethylnitrosamine-initiated nodules (0.5 to 7 mm in diameter) was studied in rat livers perfused exclusively via the portal vein. Microlight guides were placed on normal and nodular tissue on the capsular surface of the liver to measure pyridine nucleotide fluorescence (366 leads to 450 nm). When oxygen tension of the inflow perfusate was lowered, fluorescence in both normal tissue and small nodules (less than 2 mm in diameter) increased sharply due to the reduction of pyridine nucleotides, indicating previous normoxia. In contrast, similar manipulations did not increase fluorescence in nodules greater than 2 mm in diameter, demonstrating that nicotinamide adenine dinucleotide was reduced maximally previously; i.e., the nodules were anoxic. Direct measurements of nodule oxygen concentrations with a miniature oxygen electrode confirmed these results. 7-Hydroxycoumarin or fluorescein could be detected with micro-light guides in normal tissue and nodules less than 2 mm in diameter but not in nodules greater than 2 mm in diameter. Furthermore, fluorescent microscopy indicated an absence of fluorescein in nodules greater than 2 mm in diameter. Therefore, with four independent optical and polarographic techniques, we have demonstrated reduced portal circulation in nodules greater than 2 mm in diameter; however, smaller nodules could not be differentiated from normal tissue. PMID- 6850644 TI - Treatment of mouse mammary tumors using combined hyperthermia and ischemia. AB - To investigate ischemic potentiation of thermal cell killing, mammary carcinomas transplanted to the legs or tails of C3H mice were treated with hyperthermia using rubber-lined compression cuffs. During treatment, warm water was circulated through the cuffs under pressure so that blood flow to the contained tumor bearing limbs was interrupted. Ninety min at 41.5, 42.0, or 42.5 degrees and pressures between 60 and 135 mm Hg destroyed about 50% of tumors but damaged the normal tissues. Damage increased with the degree of compression. Intermittent pressure application was therefore adopted (five 18-min periods at 80 to 90 mm Hg alternating with four periods of 5 min at zero pressure). This favored the normal tissues, a high cure rate being maintained (73%) with damage to normal tissue virtually eliminated. The most satisfactory explanation of these results is a selective heat sensitivity, augmented by ischemia, on the part of tumor blood vessels. The success of intermittent treatment is then attributable to progressive impairment of the blood supply to the tumors, preventing the heat dissipation and relief of conditions such as acidity and nutrient deficiency which would otherwise result from periodic restoration of the circulation. PMID- 6850643 TI - Characterization of a differentiated cat melanoma cell line. AB - We have established several long-term cultures of a naturally occurring metastatic melanoma of a domestic cat. The cells are fully differentiated as indicated by the Fontana-Masson staining of the melanin in the perinuclear region and by electron microscopy of the cytoplasmic melanosomes in various stages of development. The melanoma cells do not produce virus particles or the major core proteins (i.e., protein with a molecular weight of 30,000) of the feline leukemia virus or the endogenous cat virus RD-114. Retrovirus is also not induced when melanoma cultures are treated with 5-iodo-2'-deoxyuridine or bromodeoxyuridine and cocultivated with susceptible cells. Treatment of cells with N6,O2'-dibutyryl cyclic adenosine 3' :5'-monophosphate or theophyllin, however, accentuates melanin production and increases the number of pigmented cells. The cultured cells develop melanotic tumors in s.c. inoculated newborn cats and athymic nude mice. As far as we can ascertain, this is the first report of a spontaneous malignant melanoma of a cat which provides an important resource for studying cell differentiation in vitro. PMID- 6850646 TI - Paradoxical effects associated with supranormal urinary testosterone excretion in premenopausal women with breast cancer: increased risk of postmastectomy recurrence and higher remission rate after ovariectomy. AB - Urinary testosterone excretion was measured in 18 normal premenopausal women, 80 women studied shortly after mastectomy for primary operable breast cancer, and 93 women with either metastatic breast cancer (77) or primary inoperable breast cancer (16) who were to be ovariectomized. Forty-two of the 93 were restudied after the ovariectomy. The control women showed a normal distribution of testosterone excretion, up to 12 micrograms daily; the postmastectomy patients showed a bimodal distribution, with 14 patients (17.5%) having values above 12 micrograms (up to 39 micrograms) daily. In the metastatic group, 24 of 77 patients (31.1%) had urinary testosterone excretion greater than 12 micrograms daily (up to 77 micrograms). The difference in percentage of high excretors was significant (p less than 0.02). Of the patients treated by ovariectomy, 27 had supranormal testosterone excretion preoperatively, and 16 of these (59.2%) had remissions; 66 had normal excretion preoperatively, and 21 of these (31.8%) had remissions. The difference was significant (p less than 0.02). Urinary testosterone excretion was restudied postoperatively in 42 of the 93 ovariectomized patients. Values were normal preoperatively in 31, and these were unchanged postoperatively. Values were supranormal preoperatively in 11; all of these fell significantly after ovariectomy, to normal in 8 cases. These findings appear to confirm the ovarian source of the excessive urinary testosterone. The following conclusions were drawn. There is a subgroup of premenopausal women with primary operable breast cancer who have supranormal urinary testosterone excretion; the incidence of this abnormality in women with recurrent metastatic disease after mastectomy is nearly twice as high. It can be calculated that the finding of supranormal urinary testosterone shortly after mastectomy represents virtually a 100% risk of recurrence, in contrast to a recurrence rate of about 38% in women with normal testosterone excretion. Patients with supranormal testosterone excretion prior to therapeutic ovariectomy have nearly twice as high a remission rate as do those with normal testosterone excretion. PMID- 6850645 TI - Multivariate analysis of prognostic variables in patients with metastatic testicular cancer. AB - A majority of patients with metastatic testicular cancer achieve a complete remission as a result of current treatment programs. However, patients who fail to achieve a complete remission have a very poor prognosis, and nearly all die of their disease. A multivariate logistic regression analysis of several clinical variables associated with prognosis was performed using data from 171 patients treated for metastatic testicular cancer at Memorial Hospital between September 1975 and February 1981. A mathematical model was identified which correctly predicted 94% of complete remissions and 83% of all outcomes. The variables achieving statistical significance were the logarithm of the serum values of lactate dehydrogenase (p less than 0.001) and human chorionic gonadotropin (p less than 0.001) and the total number of sites of metastasis (p less than 0.001). The model was tested against 49 patients with metastatic testicular cancer treated at the University of Minnesota Hospitals, and it correctly predicted 86% of complete remissions and 84% of all outcomes. In a highly curable disease such as testicular cancer, mathematical modeling may enable the clinical investigator to anticipate those patients who are least likely to do well. Alternate treatment strategies would be appropriate for such patients. PMID- 6850648 TI - Plasma pharmacokinetics of adriamycin and adriamycinol: implications for the design of in vitro experiments and treatment protocols. AB - The plasma pharmacokinetics of Adriamycin and adriamycinol following a 15-min infusion of 75 mg/sq m of Adriamycin were studied in ten patients previously untreated with Adriamycin. The disappearance kinetics of Adriamycin could adequately be described by a biexponential equation with an initial half-life of 8-min and a terminal half-life of 30 hr. The major drug exposure (area under the concentration-time curve) occurs during the terminal phase where drug concentrations are generally less than 10(-7) M (0.05 micrograms/ml). An improvement in the high-performance liquid chromatography sensitivity facilitated the determination of the terminal phase. The plasma kinetics of adriamycinol, the major and only known active metabolite of Adriamycin, show a rapid initial increase in plasma concentration followed by a slow decline which parallels that of Adriamycin during the terminal phase. The relative drug exposure of adriamycinol to Adriamycin was approximately 50%. The relationship between the measured plasma drug levels and free drug available for distribution into tissues was studied by comparing the plasma binding characteristics of Adriamycin and adriamycinol. A constant 20 to 25% of the total plasma concentrations of both Adriamycin and adriamycinol was freely diffusible over the whole range of observed concentrations, 20 nM to 2 microM. Thus, the free drug exposure (area under the concentration-time curve) of tumor and host tissues in vivo can be determined from these plasma measurements, since the free drug exposures in plasma and in extracellular fluid are equivalent. These results can also serve as a guide for the design of clinically relevant in vitro studies of Adriamycin and adriamycinol. The pharmacokinetic parameters determined in this study have been used to simulate plasma concentration-time courses for a variety of Adriamycin treatment schedules. Alternatives are suggested which reduce peak plasma Adriamycin concentration while antitumor area under the concentration-time curve is maintained. PMID- 6850647 TI - Pharmacokinetics of N4-behenoyl-1-beta-D-arabinofuranosylcytosine in patients with acute leukemia. AB - N4-Behenoyl-1-beta-D-arabinofuranosylcytosine (BHAC), a lipophilic and deaminase resistant derivative of 1-beta-D-arabinofuranosylcytosine (ara-C), was studied pharmacologically in patients with acute leukemia. The concentrations of BHAC, ara-C, and 1-beta-D-arabinofuranosyluracil were measured by high-performance liquid chromatography, bioassay, and gas chromatography-mass spectrometry-mass fragmentography, respectively. The data of plasma BHAC concentrations were analyzed by a MULTI computer program. In seven patients given BHAC (200 mg/body weight; 2.97 to 4.26 mg/kg) i.v. for 90 min, the plasma disappearance curve of BHAC was biphasic with a mean initial half-life of 0.37 hr and a mean second half life of 5.27 hr. The apparent volume of the central compartment and the apparent volume of distribution were 0.047 and 0.316 liter/kg, respectively; the systemic clearance was 0.051 liter/hr/kg. BHAC concentrations in erythrocytes were significantly higher (p less than 0.01) than those in plasma at 4 to 22.5 hr after infusion, suggesting that the erythrocytes may act as a reservoir for the drug. The plasma 1-beta-D-arabinofuranosyluracil level increased to 603 ng/ml at 4 hr after infusion, and it was over 129 ng/ml for at least 22.5 hr after infusion. Plasma ara-C levels, which could be detected in only 2 of 11 patients examined, were maintained (over 0.08 micrograms/ml) for 8 hr after infusion. Urinary BHAC excretion was less than 0.2 micrograms/ml of the sensitivity limit in all samples. Prolonged urinary ara-C excretion was detected, but it was only 0.5% of the administered BHAC for 24 hr. At 12 hr after a 200-mg infusion of BHAC, BHAC level in bone marrow fluid was significantly higher (p less than 0.01) than that in plasma. In spite of the lipophilic nature of the agent, the BHAC concentration in cerebrospinal fluid was less than 0.2 micrograms/ml in 8 of 9 patients without meningeal involvement. These findings were thought to indicate a restricted and prolonged BHAC distribution including plasma, blood cells, and bone marrow fluids, which may be of importance in the administration of BHAC in the chemotherapy of hematological cancers. PMID- 6850649 TI - Patterned distribution of metastases from malignant melanoma in humans. AB - Malignant melanoma has an unpredictable clinical course in terms of metastatic behavior, and further understanding might lead to improved therapeutic intervention with immune agents or antagonists. To determine whether metastases show patterns or are randomly distributed, we analyzed the distributions of metastases in the 56 patients with metastatic malignant melanoma, subjected to complete autopsy at The Johns Hopkins Hospital, using parametric statistics and cluster analysis. Variables examined included age, race, sex, location of primary tumor, length of survival, mode of therapy, histology of tumor, location of metastases, and extent of tumor infiltration at each metastatic site. The results indicate that the distributions of metastases from malignant melanoma are patterned such that significant positive correlations (p less than 0.05 or better) were observed among various tissues and organs. We identified several aggregations with respect to the distributions of metastases: (a) central nervous system; (b) mesodermal; (c) endocrine; (d) reticuloendothelial; and (e) foregut. Organs and tissues comprising each aggregation were interrelated by their similar developmental origins or functions. A very highly significant negative correlation between central nervous system and hepatic metastases (p less than 0.001) was also demonstrated by cluster analysis. We concluded that the distributions of metastases from malignant melanoma are not random; the patterns of metastases may be related to the embryological derivation of tissues involved. PMID- 6850651 TI - Meige syndrome: relief on high-dose anticholinergic therapy. AB - A patient with Meige syndrome associated with spasmodic torticollis was treated with benztropine mesylate (Cogentin) at doses of 12-16 mg daily. Marked suppression of both oromandibular dystonia and the torticollis was obtained. Mild impairment of recent memory was the major side effect. Peripheral anticholinergic side effects were controlled by the concomitant administration of ambenonium chloride (Mytelase) 15 mg daily. PMID- 6850650 TI - In vivo drug sensitivity assay of clonogenic human melanoma cells and correlation with treatment outcome. AB - In vitro tests of tumor cell drug sensitivity have been suggested as a means of selecting more appropriate clinical strategies against human cancer and improving preclinical drug development. The lack of biotransformation in these in vitro assays precludes the meaningful assessment of several major chemotherapeutic agents, including dacarbazine and cyclophosphamide. In vivo drug exposure of tumor cells in agar diffusion chambers placed in mice offers a possible solution to problems of drug biotransformation and pharmacokinetics. We have prospectively used this system as an assay for sensitivity of clonogenic human melanoma cells. Tumor cells were tested fresh, cryopreserved, and/or cultured in vitro before or after clinical use of dacarbazine, semustine, and mitolactol in 41 patient-drug combinations in which a clinical correlation could be made. Tumor cell drug sensitivity in the assay using fresh or cryopreserved tumor cells was highly correlated with clinical response and resistance with clinical nonresponse. Cultured melanoma cells exhibited enhanced plating efficiency in comparison to both fresh and cryopreserved cells of the same tumor. Cultured cells also showed increased drug sensitivity which did not correlate with drug sensitivity of the same fresh or cryopreserved tumor or with clinical response. Tumor cell drug sensitivity assays carried out in vivo provide a possible basis for preclinical evaluation of drugs which are unsuitable for in vitro testing. PMID- 6850652 TI - Hypermetabolism of phenytoin as a cause of treatment failure. AB - Hypermetabolism of phenytoin is not frequently recognized as a cause of treatment failure. We report the case of a 37-year-old male in whom detailed pharmacokinetic investigation revealed that hypermetabolism, rather than lack of compliance or poor absorption, was responsible for low plasma levels of phenytoin. An increase of his daily dose of phenytoin to 800 mg resulted in adequate plasma levels and good seizure control. Additional studies with two model drugs metabolized by the liver--aminopyrine and antipyrine--showed that he was also a fast metabolizer for these substrates, suggesting a nonspecific induction of hepatic drug metabolizing enzymes. Low plasma phenytoin levels should not be systematically ascribed to lack of compliance, and increased phenytoin metabolism should be considered as an occasional cause of treatment failure. PMID- 6850653 TI - Cardiac evaluation of mitoxantrone. AB - Mitoxantrone is a synthetic anthraquinone that was developed through the doxorubicin analog program in hopes of retaining anticancer activity with less cardiotoxicity. This study evaluated 18 patients receiving mitoxantrone with serial noninvasive tests of left ventricular function and with endomyocardial biopsy. The echocardiograms and systolic time intervals demonstrated a trend to deterioration that did not achieve statistical significance. However, the nuclear angiographic ejection fraction significantly decreased from 61% +/- 6% (means +/- SD) at baseline to 58% +/- 5% (P less than 0.05) after 48 mg/m2 of mitoxantrone. The endomyocardial biopsies revealed tubular swelling, degeneration of mitochondria, minimal chromatin clumping, and myofibrillar lysis. This study has revealed mild but definite impairment of cardiac function and mild changes of myocardial morphology during mitoxantrone therapy. Although mitoxantrone is an effective chemotherapeutic agent, a direct comparison of mitoxantrone with doxorubicin is necessary to compare relative therapeutic to cardiotoxic ratios. PMID- 6850654 TI - High-dose cytarabine in acute leukemia: toxicity and pharmacokinetics. AB - High-dose cytarabine (HDARA-C) at doses ranging from 1000 to 3000 mg/m2 administered as 30-min iv infusions was used in 12 patients with acute leukemia. HDARA-C toxicity was marked by nausea, vomiting, and somnolence; fever occurred in one patient. Myelosuppression was brief and reversible; the wbc count nadir occurred between Days 10 and 15 after treatment. In this study of a limited number of patients, no reliable conclusions could be drawn about antileukemic activity. However, (a) HDARA-C appeared to be a well-tolerated regimen in acute myeloblastic leukemia in complete remission; (b) a clear improvement was obtained in a patient with central nervous system leukemia; and (c) a sharp but transient decrease in peripheral blast cell counts was seen in two patients with acute myeloblastic leukemia. Cytarabine distribution was bi- or tri-compartmental; plasma final half-life was greater than 4 hrs in six patients. Pharmacokinetic parameters were not correlated with serum deoxycytidine deaminase activity. HDARA C crosses the blood-brain barrier and may be useful in the prophylaxis against and treatment of central nervous system leukemia. PMID- 6850657 TI - Phase II study of maytansine in advanced sarcomas. PMID- 6850655 TI - Phase II trial of mitoxantrone in refractory acute leukemia. AB - Mitoxantrone was administered to 41 adults with refractory acute leukemia. The initial dose employed was 4 mg/m2/day X 5 days. Eventually a starting dose of 10 mg/m2/day X 5 days was used, with some patients receiving a subsequent course at 12 mg/m2/day X 5 days. Three patients had a complete response, one a partial response, and one hematologic improvement. Although antileukemia effect was more frequent at the higher doses, so was death following treatment. PMID- 6850656 TI - Phase II study of etoposide in the treatment of esophageal carcinoma. PMID- 6850658 TI - Megestrol acetate flare. PMID- 6850659 TI - Use of dimethyl sulfoxide in limiting tissue damage caused by extravasation of doxorubicin. PMID- 6850660 TI - Influence of pentagastrin administration on survival of mice with L1210 leukemia. PMID- 6850661 TI - Vesicant activity of chemotherapeutic agents. PMID- 6850662 TI - Phase I trial of mitoxantrone by 24-hour continuous infusion. AB - Mitoxantrone (DAD) is a new agent which intercalates into DNA. Preclinical studies have demonstrated activity equal to or greater than that of doxorubicin in all tumor systems tested. In this phase I clinical trial, the schedule of drug administration consisted of a 24-hour continuous iv infusion repeated at 21-day intervals. Twenty-nine patients received a total of 66 courses over a dose range of 4-15 mg/m2. The dose-limiting toxic effect was leukopenia, with a wbc count nadir on Day 12 and resolution prior to Day 21. Other toxic effects were thrombocytopenia, mild phlebitis, and blue discoloration of veins. Objective tumor responses were seen in a patient with adenocarcinoma of the breast and in another patient with clear cell carcinoma of the vagina. An additional six patients with acute leukemia were treated at a dose of 12 mg/m2; a decrease in peripheral blast count was observed in four of these six patients. The toxicity of DAD by 24-hour iv infusion was similar to that previously reported for iv bolus administration. We recommend phase II evaluation of DAD at a dose of 12 mg/m2 by single iv injection at 21-day intervals. Patients with acute leukemia should be evaluated at higher dose levels. PMID- 6850663 TI - Attenuation of dermal toxicity of doxorubicin by liposome encapsulation. AB - The severe tissue damage which occurs when doxorubicin (Dxn) is extravasated during infusion has been attenuated by encapsulating the drug in anionic liposomes. Mice were injected intradermally with either 0.05 or 0.10 mg of Dxn in the free or liposome-entrapped form. At both dose levels, the animals receiving free drug developed dermal lesions at a higher frequency and of a greater severity than did those animals receiving Dxn-liposomes. Determination of tissue associated fluorescence indicated that free Dxn was removed from the area of the dermal injection more rapidly than was the liposome-entrapped drug. The data suggest that the dermal toxicity of Dxn may be determined more by its mode of disposition than by the absolute amount of drug in tissue. Similar observation was made earlier for the Dxn-induced chronic cardiotoxicity. PMID- 6850664 TI - Phase II trial of alpha (human leukocyte) interferon administered daily in adenocarcinoma of the colon/rectum. AB - Nineteen patients with metastatic adenocarcinoma of the colon or rectum were treated with alpha (human leukocyte) interferon (alpha IFN). Patients received 3 X 10(6) IU/day of interferon im 5 days/week. Eighteen patients are evaluable for response and toxicity. There were no objective responses. All evaluable patients demonstrated progression of disease during therapy. Toxicity consisted primarily of mild granulocytopenia, thrombocytopenia, fatigue, weakness, and fever. This trial demonstrates that while alpha IFN can be administered safely as scheduled, this regimen has no activity against adenocarcinoma of the colon/rectum. PMID- 6850666 TI - Phase II trial of aziridinylbenzoquinone (AZQ) in patients with refractory lymphoma. PMID- 6850665 TI - Failure of DMSO and vitamin E to prevent doxorubicin skin ulceration in the mouse. AB - Doxorubicin (DOX)-induced skin ulceration in rats and pigs has been reported to be reduced when treated with topical DMSO and/or vitamin E. In the present study using a mouse model, neither intradermal nor topical DMSO with or without vitamin E, administered up to 7 days, reduced intradermal DOX-induced skin ulceration. Intradermal DMSO with or without vitamin E caused skin ulceration and significantly increased DOX-induced ulcerations. Topical DMSO-containing solutions were not toxic to mouse skin. To test for a systemic effect of topical DMSO, two groups of mice received an additional 0.05-mg intradermal injection of DOX above a DMSO-treated lesion. There was no apparent effect of topical DMSO with or without vitamin E on this proximal but untreated DOX lesion. The results suggest either a major difference in DOX ulceration characteristics between rats and pigs on the one hand and mice on the other hand or a lack of significant efficacy for DMSO and vitamin E as DOX extravasation antidotes. PMID- 6850667 TI - Phase II trial of etoposide in adenocarcinomas of the upper gastrointestinal tract. PMID- 6850669 TI - Comparison of 5-FU and doxorubicin in the treatment of carcinoma of the bladder. PMID- 6850668 TI - PCNU in advanced adenocarcinoma of the ovary: a phase II study. PMID- 6850670 TI - Two-dimensional, 1H-n.m.r. study of peracetylated, reduced derivatives of three oligosaccharides isolated from human milk. PMID- 6850671 TI - An automated Elson-Morgan assay for 2-amino-2-deoxy-hexoses, with increased sensitivity. AB - The Elson-Morgan assay for 2-amino-2-deoxyhexoses, despite its many modifications, can still give variable results because of slight variations in reaction conditions. An automated method is reported which uses microgram samples and provides greater sensitivity than hitherto possible. The use of sodium orthophosphate and optimisation of the concentrations of the reagents provide conditions that are more stable, and results that are more reliable, than any previously reported. PMID- 6850672 TI - Synthesis of a hexasaccharide unit of a complex type of glycan chain of a glycoprotein. PMID- 6850674 TI - Structural studies of the capsular polysaccharide from Streptococcus pneumoniae type 12A. PMID- 6850673 TI - Structural studies on an antitumor polysaccharide from Microellobosporia grisea. AB - The structure of the antitumor polysaccharide from the actinomycete Microellobosporia grisea has been investigated. By methylation and periodate oxidation studies, the polysaccharide was shown to consist of (nonreducing) D mannosyl groups, (1 leads to 4)-linked D-glucosyl residues, and 3,6-branched, (1 leads to 4)-linked D-glucosyl residues in the approximate molar ratios of 2:1:1. Periodate oxidation of the polysaccharide, followed by borohydride reduction and mild hydrolysis with acid yielded glycerol, erythritol, 2-O-beta-D-glucopyranosyl D-erythritol, and 5-O-beta-D-glucopyranosyl-2,4-bis(hydroxymethyl)-1,3-dioxane, which were isolated in the molar ratios of 2.0:0.14:0.74:0.35. Partial hydrolysis of the polysaccharide gave alpha-D-Manp-(1 leads to 6)-D-Glcp, beta-D-Glcp-(1 leads to 4)-D-Glcp, alpha-D-Manp-(1 leads to 3)-D-Glcp, and beta-D-Glcp-(1 leads to 4)-[alpha-D-Manp-(1 leads to 3)-]-D-Glcp. From these results, it is proposed that the polysaccharide is mainly composed of tetrasaccharide repeating-units having the following structure. (formula: see text) PMID- 6850675 TI - Structural investigations on the core oligosaccharide of Aeromonas hydrophila (Chemotype II) lipopolysaccharide. PMID- 6850676 TI - Synthesis of a hexasaccharide that forms part of an alveolar glycoprotein. PMID- 6850677 TI - Murine submandibular mucin (MSM): a mucin carrying N-and O-glycosylically bound carbohydrate-chains. PMID- 6850680 TI - Characterization of a new oligosaccharide containing myo-inositol found in pregnancy urine. PMID- 6850679 TI - Structural studies of the carbohydrate component of a human, parotid-saliva, proline-rich glycoprotein. AB - The carbohydrate chains of the human, parotid-saliva, proline-rich glycoprotein were released as oligosaccharides by hydrazinolysis and were fractionated by high pressure-liquid chromatography. Four oligosaccharides were characterized. On the basis of compositional analysis, sequential enzymic degradation, and methylation data, the carbohydrate moiety of the glycoprotein was found to be a complex-type oligosaccharide containing a tri-D-mannosyl-di-N-acetylchitobiose core with two and three lactosamine branches, and an L-fucosyl group linked to O-6 of the asparagine-linked 2-acetamido-2-deoxy-D-glucose residue. In addition, several L fucosyl groups, linked at O-6 of the penultimate D-galactose residues, are present in variable proportions. The biological significance of these results is discussed. PMID- 6850678 TI - Structure of intestinal-mucus glycoprotein from human post-mortem or surgical tissue: inferences from correlation analyses of sugar and sulfate composition of individual mucins. AB - The carbohydrate composition of 14 human, small-intestine mucins, obtained at surgery or post-mortem, varied greatly from specimen to specimen with respect to individual sugars and average chain-length (ratio of total carbohydrate to N acetylgalactosamine). Three monosaccharides, galactose, N-acetylglucosamine, and fucose gave good correlations with each other, and to total carbohydrate content, when expressed as a ratio to the chain-terminal N-acetylgalactosamine residue. In contrast, sialic acid gave a good correlation only with N-acetylgalactosamine. In eight specimens the molar sulfate to N-acetylgalactosamine ratios gave good correlation with the ratios of galactose to N-acetylgalactosamine, N acetylglucosamine to N-acetylgalactosamine, and total carbohydrate to N acetylgalactosamine. These results indicate that the intraspecies variability of intestinal-mucin carbohydrates arises from the interdependent addition of galactose, N-acetylglucosamine, fucose, and sulfate residues. Partial correlation analysis indicated that proportions of N-acetylglucosamine and fucose were correlated only through a mutual dependence on galactose, suggesting that the key elongating-factors involve the addition of galactose residues. The number of sialic acid residues per oligosaccharide chain remained relatively unchanged from mucin to mucin, and this, coupled with the close correlation between the proportions of sialic acid and N-acetylgalactosamine, suggests that almost all sialic acid residues are bound to the core N-acetylgalactosamine residues in intestinal mucin. High fucose-to-sialic acid and high sulfate-to-sialic acid ratios reported in some disease states are explained as the consequence of chain elongation. PMID- 6850681 TI - Exaggerated respiratory variation in left ventricular ejection time during lax pericardial effusion. AB - In 20 consecutive patients with echocardiographic pericardial effusions and no pulsus paradoxus or other signs of cardiac embarrassment the left ventricular ejection time fell (delta LVET) during inspiration by 18.3 +/- 2.47 (SE) ms, greatly exceeding mean inspiratory delta LVET in normal subjects (7.0 ms). Median and mode delta LVET were each 15.0 ms, with delta LVET less than 10 ms and more than 25 ms in only 1 patient each. With a single exception, the magnitude of the abnormal delta LVET was least in patients with minimal to small effusions. Ejection time indices were normal during expiration and low during inspiration, indicating diminished stroke volume during inspiration only. Thus, even without clinical and echocardiographic signs of cardiac compression, the presence of pericardial fluid clearly exaggerated respiratory effects on left ventricular function but not to the degree characteristic of overtly compressing (tamponading) fluid. The consistent exaggeration of delta LVET during even small pericardial effusions is thus of physiologic interest and may be of diagnostic value. PMID- 6850682 TI - Exercise-induced S-T segment elevation in variant angina. AB - 3 patients with co-existing effort angina and Prinzmetal's variant angina are described, who had also 'atypical' manifestations of variant angina, i.e. chest pain and S-T segment elevation also during treadmill exercise testing. Because of these unusual manifestations the proper diagnosis was delayed and the patients continued with inappropriate therapy (propranolol and only low-dose nitrates). After the correct diagnosis of variant angina with 'atypical' manifestations was made, application of high-dose nitrates and nifedipine resulted in complete relief of symptoms. Repeat treadmill testing during this therapy did not provoke attacks of chest pain with S-T elevation. PMID- 6850683 TI - Calcified left ventricular aneurysm in a 6-year-old boy. Case report. AB - The case of a calcified left ventricular aneurysm in a 6-year-old asymptomatic boy is presented. The anomaly was discovered on a routine chest X-ray. The etiology of this condition is discussed. A review of the literature reveals that this is a rare occurrence in children and that the origin is often unknown. Selective left coronary arteriography showed no arterial anomalies but early filling of the right coronary veins, apparently through small AV fistulas. This might have caused some peripheral myocardial underperfusion, followed by myocardial infarction and aneurysm formation. Aneurysmectomy was carried out uneventfully. PMID- 6850684 TI - Cardiac tamponade in Dressler's syndrome. Case report. AB - A case of Dressler's syndrome with cardiac tamponade is presented. 19 days after an acute lateral myocardial infarction, the patient, 46 years old, was admitted the second time with a characteristic clinical picture of cardiac tamponade. The patient did not receive at any time during his admission an anticoagulant treatment. The clinical diagnosis was supported by fluoroscopic and echocardiographic findings. A pericardiocentesis performed immediately revealed a hemorrhagic pericardial fluid. After withdrawal of 60 ml, the patient's clinical condition improved dramatically and this improvement continued further under treatment with corticosteroids. At the best of our knowledge this is the second case in the literature of Dressler's syndrome with cardiac tamponade and hemorrhagic fluid in a patient not treated with anticoagulants. PMID- 6850685 TI - Possible female preponderance in prenylamine-induced 'torsade de pointes' tachycardia. Short communication. AB - Episodes of ventricular tachycardia of the 'torsade de pointes' (VTTP) types provoked by prenylamine were observed in 7 patients: 5 females and 2 males. They all received prenylamine in a dose of 120-180 mg daily for anginal pains. Syncope or syncopal equivalents occurred in all 7 patients. Q-T intervals ranged from 0.52 to 0.64 s. Review of the literature revealed 11 patients with prenylamine induced VTTP, of whom 8 were females. The female preponderance (72.2%), hitherto not commented upon in the literature, is highlighted. Prenylamine-indiced VTTP may appear late after initiation of therapy, consequently clinical and ECG long term follow-up is mandatory. The drug should promptly be discontinued in symptomatic patients, and particularly in females showing prolonged Q-T. PMID- 6850686 TI - Exercise capacity before and after cardiac valve surgery. AB - Exercise stress testing and right-heart catheterization were carried out in 131 patients before and 6 months after cardiac valve surgery. The exercise capacity increased only a little in patients with mitral or double-valve surgery. In contrast, most patients with an aortic valve replacement had good exercise performance after surgery. Corresponding to the reduced exercise capacity most of the patients also had disturbed hemodynamics after surgery, with an elevated mean pulmonary artery pressure at rest, that raised inappropriately during exercise, and a diminished cardiac output at rest, that failed to increase during exercise, in relation to oxygen uptake. PMID- 6850687 TI - Cardiovascular reactivity to ergometric exercise in mild hypertension. AB - Cardiovascular reactivity to ergometric exercise was studied on work loads of 60, 80 and 100 W in 16 young and middle-aged males with mild hypertension and 17 normotensive subjects of the same age. The middle-aged hypertensive group showed a stronger rise in systolic blood pressure to a 100-watt work load than the matched normotensive group. Cardiovascular reactivity was not different with work loads of 60 and 80 W, and young hypertensives and normotensives had the same reactions. Thus cardiovascular reactivity to exercise is dependent on both blood pressure and age. PMID- 6850690 TI - Heart rhythm disorders. 4th Upper Rhine Cardiologists Symposium, Freiburg i. Br., 8 May 1982. PMID- 6850689 TI - [Pathophysiology of cardiac arrhythmias]. PMID- 6850688 TI - Valsalva maneuver in the assessment of baroreflex responsiveness in borderline hypertensives. AB - Baroreceptor function was assessed by (1) the reflex response during Valsalva maneuver, (2) phenylephrine injection, and (3) increase in neck tissue pressure by a neck-chamber in 15 borderline hypertensives (B) and in 15 age-matched normotensives (N). B responded to the fall in blood pressure, occurring in phase II of Valsalva maneuver, with an increase in blood pressure and a decrease in the R-R interval of comparable extent to those observed in normals. On the contrary, in phase IV B showed a depressed heart rate reflex response whether evaluated by the slope of the regression line obtained by plotting the R-R interval versus the systolic blood pressure (slope: B = 6.1 +/- 3.3; N = 35.6 +/- 7, p less than 0.005) or by the change in R-R interval (delta R-R interval: B = 67.5 +/- 37 ms; N = 319 +/- 55 ms, p less than 0.005). On the other hand, both phenylephrine injection and neck-chamber procedure showed an impaired baroreflex responsiveness in B. A linear positive correlation was found between the individual values of the slopes obtained during phase IV of Valsalva maneuver and after phenylephrine injection both in N (r = 0.944, p less than 0.001) and in B (r = 0.84, p less than 0.001). Finally, a linear positive correlation was found between the individual values of the slopes obtained by the phenylephrine technique and the corresponding maximum percent change in R-R interval during phase IV of the Valsalva maneuver both in normals and in hypertensives. In conclusion, overshoot bradycardia during Valsalva maneuver seems to show enough specificity in the evaluation of baroreflex responsiveness to be employed in epidemiological studies in this area. PMID- 6850691 TI - [Electrophysiological studies on the specific effects of new anti-arrhythmia agents]. PMID- 6850694 TI - [Endoatrial mapping. Its application to the study of normal and pathologic atrial depolarization]. PMID- 6850692 TI - [Low-dose amiodarone therapy in the treatment of therapy-refractory complex ventricular arrhythmias]. PMID- 6850693 TI - [Arrhythmogenic anti-arrhythmia agents]. PMID- 6850695 TI - [Differential diagnosis of tachycardia arrhythmias]. PMID- 6850696 TI - [Holter recording in syncope and lipothymia]. PMID- 6850697 TI - [Recording of arrhythmia in patients with coronary heart disease]. PMID- 6850698 TI - [Value of the intervention test in assessing cardiac arrhythmias]. PMID- 6850699 TI - [Electrophysiological study for identifying patients at risk for arrhythmia and to determine therapy]. PMID- 6850701 TI - [Prognostic value of arrhythmias in coronary disease]. PMID- 6850700 TI - [Incidence and course of persistent arrhythmias after acute myocardial infarct]. PMID- 6850702 TI - High-grade ventricular ectopic activity and 5-year survival in patients with chronic heart disease and in healthy subjects. PMID- 6850703 TI - [Proximal and distal AV conduction disorders]. PMID- 6850704 TI - Interobserver and intermethod variation in evaluation of regional wall motion of the left ventricle. AB - To determine the variation in the repeated evaluation of quantitative regional wall motion of the left ventricle (LV) from right anterior oblique (RAO) silhouettes, an intra- and inter-observer test was performed in 17 patients without wall motion abnormalities, using nine different methods of regional wall motion (RWM) analysis. The results were: 1. Around the cardiac apex and near the valve plane there are regions where the subjective contour delineation yields regional mean discrepancies up to 4-5 mm (2-3 mm, respectively, near the valves); while in the other regions the mean discrepancies are usually smaller than 1 mm. 2. Absolute regional contour discrepancies, calculated in mm, show only small differences in the various methods, applied for RWM analysis. 3. If these discrepancies instead are calculated as relative changes (in relative percent) of hemiaxial or segmental shortening or area diminution, the method applied is of great significance, since the length of the axes can vary considerably from method to method. 4. From all methods applied for RWM analysis, that of Mathes [10] (radial method) had the smallest average discrepancy. These results suggest, that the LV silhouette may be best defined in the anterior and inferior wall area, while in other regions subjective impressions of contour tracing may produce a considerable variation, which can be further enhanced by the method applied for RWM analysis. Methods that employ relatively large axes of as similar as possible length are therefore preferred. PMID- 6850705 TI - Noninvasive detection of intracardiac tumors by ultrasound and computed tomography. AB - Nine patients presenting with intracardiac masses were examined by ultrasound (US) and computed tomography (CT). Of these, 6 patients with atrial myxomas were diagnosed primarily by US, with the movement of the pedunculated tumors well visualized by this technique. The myxomas and the three solid tumors were demonstrated by CT as contrast defects following the intravenous administration of contrast medium. Two solid intraventricular tumors, however, were overlooked by US. In the detection of solid tumors CT is considered superior to US, owing to its better geometric resolution. Generally solid tumors require heart catheterization to obtain information about the blood supply. Visualization of atrial myxomas by CT and US, in contrast, should be followed by immediate operation without additional invasive procedures. PMID- 6850706 TI - Subselective magnification angiography of experimental pneumonia. AB - An experiment was designed to determine whether or not acute pneumococcal pneumonia in dogs is associated with intravascular thrombosis, or with angiographic features distinguishable from pulmonary embolism. In dogs with normal baseline chest radiographs and perfusion scans, pneumonia was produced by transbronchial instillation of type III pneumococcus. After 2 days, perfusion scans demonstrated discrete appropriate defects. In vivo magnification pulmonary arteriography, postmortem pulmonary arteriography, and histologic examination disclosed no evidence of thrombi. PMID- 6850707 TI - Spontaneous obliteration of pancreaticoduodenal artery aneurysm after retroperitoneal hemorrhage. AB - We present a rare case of aneurysm of the pancreaticoduodenal artery that bled into the region of the head of the pancreas. Computed tomography (CT) demonstrated the presence and extent of the resultant mass (hematoma) but the angiographic examination allowed a specific diagnosis via visualization of the aneurysm. Unlike previously reported cases, the patient was treated conservatively. Follow-up arteriogram and CT showed spontaneous closure of the pancreaticoduodenal artery and aneurysm and complete resolution of the mass in the pancreatic head. These findings suggest that in some cases a conservative approach to a bleeding pancreaticoduodenal artery aneurysm may be indicated. PMID- 6850708 TI - Transcatheter wiring of abdominal aortic aneurysm. AB - A new technique of transcatheter wiring of unresectable aortic aneurysm is described that provides simultaneous transcatheter occlusion of both common iliac arteries followed by axillofemoral bypass. The spring coil used for aortic aneurysm wiring was of our own making. The outer portion of a movable core stainless steel guidewire was bent in a coil shape and introduced into the aneurysm through a 7 French Teflon catheter via the right femoral artery. The same catheter was also used for coil embolus occlusion of both iliac arteries. PMID- 6850709 TI - Bowel infarction: complication of ethanol ablation of a renal tumor. PMID- 6850710 TI - Angiographic demonstration of arterial puncture by external fixation devices: two cases presenting with delayed hemorrhage. PMID- 6850711 TI - Selective digital venous hypertension: a rare complication of hemodialysis arteriovenous fistula. AB - We report and document angiographically a case of selective venous hypertension, masquerading as an infection, which involved the three middle digits of the right hand in a patient with an access arteriovenous (AV) fistula. This complication arose following hemodialysis and was resolved after resection of the right radial artery at the site of AV fistula and re-anastomosis. PMID- 6850712 TI - Relationship of radionuclide indexes of cardiac function during interventions: volume loading, afterload stress, exercise, and pacing. AB - We compared three radionuclide indexes of cardiac function: (1) the ejection fraction (EF), (2) the mean ejection rate (ER), and (3) the mean velocity of circumferential fiber shortening (MVCF) during volume loading, phenylephrine hydrochloride stress, exercise, and atrial pacing. All behaved in a similar (linear) fashion, allowing appropriate hemodynamic conclusions to be drawn using either index. During atrial pacing, the ejection fraction declined, when velocity indexes increased--suggesting that the ejection fraction may not be a suitable index to characterize alterations in inotropic state during rapid alterations in heart rate, particular in the absence of angina pectoris. This may result from the reductions in cardiac volume for the duration of pacing, where the velocity index is preserved. In most circumstances excluding atrial pacing, ejection fraction during interventions is an adequate index of the change of myocardial contractile state. Overall, radionuclide angiography is an excellent technique to characterize acute hemodynamic interventions, with ejection fraction, in general, the simplest and most reliable of cardiac indexes during stress interventions. PMID- 6850713 TI - Effect of heel-raising exercise upon collateral resistance in patients with occlusion of the superficial femoral artery. AB - Invasive blood pressure measurements were performed in the common femoral- and popliteal artery of six limbs with occlusion of the superficial femoral artery during upright exercise (heel raising) and intraarterial alpha-receptor blockade. Femoral blood flow was obtained by an indicator dilution method injecting 131 RISA into the femoral artery and sampling from the popliteal artery. Exercise increased femoral blood flow from an average of 184 (SE +/- 27) cm3 . min-1 at rest to 531 (SE +/- 61) cm3 . min-1 during a 40 degrees head up tilt. Intraarterially induced alpha-receptor blockade caused a further increase in blood flow to 685 (SE +/- 86) cm3 . min-1 during exercise. Changes in collateral arterial resistance was calculated relative to the supine resting value. During exercise a decrease of 24% (SE +/- 13) was observed. After alpha-receptor blockade and exercise collateral resistance decreased by 46% (SE +/- 12). The results indicate that the passive head-up tilt induced a constriction of the collateral arteries which is abolished by heel raising exercise (ie standing on tip toe). It seems, however, that during these circumstances there still remains some alpha-receptor mediated constriction of the collateral arteries which is blocked by intraarterially injected alpha-receptor blocking agents. PMID- 6850715 TI - The vasculature of the carotid body. AB - A histological and electron microscopical study was carried out on the vasculature of the carotid bodies in seven subjects coming to necropsy. None of these had suffered from chronic hypoxaemia or systemic hypertension during life and none had hypertrophy of the right or left ventricle. The vasculature of the carotid bodies showed three distinct components. There was a proximal portion, comprising elastic interlobular arteries, which had a wall in which elastic tissue predominated and in which many nerve fibrils could be demonstrated. This is considered to be baroreceptor in nature. There was an intermediate portion comprising muscular intralobular arterioles which are believed to be capable of controlling the level of blood supply to the parenchyma of the carotid bodies. Finally there are glomic capillaries surrounded by elongated pericytes and sustentacular cells. One or other of these elongated cells is thought to be responsible for the carotid body hyperplasia which is associated with systemic hypertension and states of chronic hypoxaemia. PMID- 6850714 TI - The B-aminopropionitrile-fed turkey: a model for detecting potential drug action on arterial tissue. AB - Broad-breasted white male turkeys develop hypertension, tachycardia and aortic arteriosclerosis spontaneously by approximately 5 weeks of age. When fed B aminopropionitrile (BAPN), aortic tensile strengths are lowered, and a high percentage of the turkeys die from aortic dissecting aneurysms. There are essentially no deaths from aneurysms when either dl-propranolol or reserpine is fed in concert with BAPN; practolol and soltalol partially protect the BAPN-fed turkey from lethal aneurysms while hydralazine and phenelzine sulphate potentiate mortality from aneurysms. Dl-propranolol decreases and reserpine increases dP/dtmax and both drugs lower arterial pressure and heart rate when fed with BAPN. Such diets also decrease the ultrastructural disarray of collagenous and elastic fibres in the media of the abdominal aorta that occurs from the feeding of BAPN and thereby raise aortic tensile strength. Sotalol and practolol when fed to BAPN-fed turkeys lower blood pressure and dP/dtmax, but neither drug affects aortic tensile strength and both counteract the deleterious effect of BAPN on the ultrastructure of collagenous and elastic fibres to a minor degree. Phenelzine sulphate does not affect arterial pressure while hydralazine reduces arterial pressure; both drugs decrease aortic tensile strength and increase the ultrastructural disruption of aortic elastin and collagen in the BAPN turkey. The results suggest that dl-propranolol, reserpine, phenelzine sulphate, and hydralazine have an action on aortic tissue and indicate the usefulness of the BAPN-fed turkey as a model for identifying potential drug effects on aortic elastin and collagen. PMID- 6850716 TI - Verapamil, propranolol, and hydralazine protect against the acute cardiac depression induced by adriamycin. AB - The apex ejecting isolated rat heart perfused with media containing 3 X 10(-5) mol . litre-1 adriamycin for 40 min demonstrated the following changes in contraction patterns: (a) a ten-fold increase in end-diastolic pressure; (b) a 45% decrease in developed pressure; (c) a 17% decrease in coronary flow; (d) a 27% increase in time to peak pressure; (e) a 26% increase in time for pressure to fall 50% during relaxation; and (f) a 65% decrease in maximum (+) and (-) dP/dt. In rats pretreated 1 h before death, verapamil, propranolol, and hydralazine significantly attenuated the cardiac depression produced by adriamycin. The combinations of verapamil and hydralazine, or propranolol and hydralazine were especially efficacious. Particularly striking was the protection afforded against an increase in diastolic pressure. Digoxin pretreatment afforded no protection. It is postulated that the acute depressive effects of adriamycin may be related to calcium overload. PMID- 6850717 TI - Severity of canine myocardial infarcts in relation to indices of oxygen demand: preservation of myocardial creatine kinase activity by vagal stimulation and propranolol. AB - The left anterior descending coronary artery was ligated in 58 open-chest anaesthetised dogs; 23 were controls, 15 were given intravenous propranolol 1 mg . kg-1 before and at 6 h intervals after coronary ligation, nine had bilateral cervical vagal nerve stimulation (VS) before and for 4 to 6 h after coronary ligation, and 11 had both VS and propranolol. None of the 20 dogs undergoing VS developed ventricular fibrillation within the first hour after coronary ligation compared to nine of the remaining 38 (P less than 0.05). Compared to controls, myocardial creatine kinase (CK) depletion in the epicardial layer of the infarct centre measured 24 h after coronary ligation was significantly less in the groups treated separately with vagal nerve stimulation and propranolol. Myocardial blood flow (MBF) measured at 15 min after coronary ligation was reduced to the normal myocardium by the interventions, but was unchanged at the infarct centre. Severely ischaemic myocardium (MBF less than or equal to 20% of normal) was better protected by the interventions than was moderately ischaemic myocardium. At 15 min after coronary ligation, the heart rate--blood pressure product (RPP) was reduced compared with controls by propranolol (18% reduction, P less than 0.05), reduced more by vagal stimulation (by 37%, P less than 0.001) and still more by vagal stimulation with propranolol (by 43%, P less than 0.001). Preservation of CK in myocardium with MBF less than or equal to 20% of normal was improved by VS and propranolol given separately roughly in proportion to reduction in RPP, but further reduction in RPP by VS and propranolol together did not improve CK levels further. We conclude that there may be an optimum level of indices of oxygen demand for preservation of very ischaemic myocardium in experimental infarction. PMID- 6850718 TI - Overview of rheumatology: 1983. PMID- 6850719 TI - Efficacy and tolerability of hydralazine, in conventional and slow-release preparations, during long-term treatment of primary hypertension. AB - In 23 patients with primary hypertension, the efficacy and tolerability of slow release hydralazine administered once daily were compared with those of conventional hydralazine given two to four times a day. All patients were treated concomitantly with beta-blockers, diuretics, or both. Blood pressure control achieved with multiple doses of conventional hydralazine was maintained with slow release hydralazine, with no discrepancy between once- and twice-daily administration, when the same daily dose of hydralazine was given. A differentiated method of assessing tolerability demonstrated no differences between the hydralazine formulations and dose regimens in the incidence of side effects. This finding indicates that larger single doses than are normally given with hydralazine can be given with slow-release hydralazine without increased risk of side effects. PMID- 6850720 TI - Absorption and antiarrhythmic efficacy of sustained-release mexiletine. AB - Absorption of the antiarrhythmic agent mexiletine from conventional capsules (200 mg) and two sustained-release formulations (360 and 432 mg) was studied in four healthy volunteer subjects, and use of the 360-mg preparation was studied in nine patients who had been using conventional capsules. In the four volunteers, acute dosage with the 432-mg preparation produced a markedly lower peak mexiletine concentration and fewer side effects than did two 200-mg capsules. Chronic dosing in two volunteers, which indicated that the 360-mg preparation produced fewer side effects and lower predose and peak plasma mexiletine concentrations than did the 432-mg preparation, suggested the use of equivalent doses of the 360-mg preparation in the nine patients who had been using 100-, 200-, or 250-mg preparations. The arrhythmia control produced by the slow-release preparation, as measured by 24-hour ECGs, was comparable to that produced by the conventional forms of mexiletine; gastrointestinal side effects were less marked when patients took the slow-release preparation, despite higher mean predose plasma mexiletine concentrations associated with use of the 360-mg preparation. Reduced frequency of daily dosage as well as patient acceptance are clinical advantages of the slow release preparation. PMID- 6850721 TI - Cyclacillin in the treatment of acute sinus infections and exacerbations of chronic infections. AB - Cyclacillin was used to treat 40 patients with bacterial sinus infections, either acute or exacerbations of chronic infections. The drug was administered orally in a dosage of 500 mg every six hours for ten days, although three patients required extended treatment. More than 70% of the patients had remission of symptoms in six days, and all but the aforementioned three had remission in ten days or less. More than 90% of the patients had a moderate to good response; only two patients had a poor response. The only side effects were gastrointestinal disorders, which disappeared with administration of antacids. No side effects were noted in 72.5% of patients. Cyclacillin proved to be an effective and well-tolerated antibiotic for infections of the paranasal cavities. PMID- 6850722 TI - Comparison of guanadrel and guanethidine efficacy and side effects. AB - Eighteen patients with essential hypertension uncontrolled by hydrochlorothiazide alone were randomly assigned to receive additional therapy with either guanadrel sulfate or guanethidine sulfate. The frequencies of morning orthostatic faintness, other orthostatic faintness, and diarrhea were twice as high in eight patients treated with guanethidine as in ten patients treated with guanadrel in a six-month comparison. The two drugs reduced blood pressure about equally well. In light of the efficacy without severe side effects, guanadrel may be an agent for step II therapy of hypertension. PMID- 6850723 TI - Betamethasone dipropionate and salicylic acid lotion for nonscalp dermatoses. AB - A multicentric open study was conducted to evaluate the efficacy and safety of betamethasone dipropionate and salicylic acid lotion in 86 patients with psoriasis or other steroid-responsive dermatoses of nonscalp body areas. Medication was applied to affected areas for 14 to 31 days. Patients were evaluated weekly. Within 14 to 21 days of therapy, there were favorable results in 68/86 (79%) patients. A complete clearing or marked improvement of signs and symptoms was achieved in 78/86 (91%) patients; improvement occurred in 7/86 (8%). Treatment failed in one (1%) patient. Three transient adverse reactions were reported. PMID- 6850724 TI - [C-reactive protein in acute coronary syndromes. Dynamics of development and contribution to differential diagnosis]. PMID- 6850726 TI - [Observations on the incidence of myocardial infarct with regard to the external environment]. PMID- 6850725 TI - [Cardiac involvement in thyrotoxicosis and aging. Sphygmographic study]. PMID- 6850727 TI - [Gluconate heart scan in 5 patients with lupus erythematosus]. PMID- 6850728 TI - [Characteristics of the mutual physician-patient relationship under the conditions of the scientific-technical revolution]. PMID- 6850729 TI - [A suggestion for a simplified method of intermittent and hydrostatic compression in the prevention of venous thrombosis]. PMID- 6850730 TI - [Radionuclide venography. A new method of studying the venous system]. PMID- 6850731 TI - [Differences in the ergometric values in school children before and after short term stays in the country]. PMID- 6850732 TI - [The SQUID magnetometric technic]. PMID- 6850733 TI - [Metyrapone in the therapy of vitiligo]. PMID- 6850734 TI - [Antibiotics Policy]. PMID- 6850735 TI - [Levels of 4 hormonal steroids in plasma and saliva and the clinical significance of their determination]. PMID- 6850737 TI - [The effect of glucocorticoids on experimental brain edema and edema of the optic nerve papilla]. PMID- 6850736 TI - [Changes in triiodothyronine and the reactivity of monodeiodase in patients with myocardial infarct]. PMID- 6850740 TI - [Aspects of future development in the communication of scientific medical information]. PMID- 6850738 TI - [Picibanil (OK 432)]. PMID- 6850739 TI - [Socialist international division of labor in the area of scientific medical information]. PMID- 6850741 TI - [Experience in the use of problem solving teaching methods in the training of medical students]. PMID- 6850742 TI - [Essential phospholipids in the treatment of liver cirrhosis]. PMID- 6850743 TI - [The effect of passive smoking on the young person with a history of respiratory tract disease]. PMID- 6850744 TI - [The Institute of Hematology and Blood Transfusion in Sofia and the Bulgarian Transfusion Service]. PMID- 6850746 TI - The fine structure of the gill epithelium of a fresh-water flea, Daphnia magna (Crustacea: Phyllopoda) and changes associated with acclimation to various salinities. I. Normal fine structure. AB - Two kinds of epithelial cells, dark and light types, are alternately arranged in the gill of Daphnia magna. The dark cell has numerous mitochondria and an elaborate tubular system containing two kinds of cytoplasmic tubules, small about 70 nm in diameter, and large about 130 nm in diameter. The former occur in bundles and seem to be smooth-surfaced endoplasmic reticulum. The latter, lined with a ridged surface coat and frequently open at the lateral and basal cell membrane, are regarded as extensions of the cell membrane. The atypical cell membrane of the dark cell is modified by repeated subunits of a cytoplasmic coat on the inner leaflet of the unit membrane. The light cell exhibits a high degree of basal infoldings of the cell membrane, which represent a magnification of the surface area of the cell. Large mitochondria between the infoldings often come into intimate association with the infolded cell membrane to form a regular array of parallel mitochondria interposed with the double cell membranes. The results suggest that at least the dark epithelial cells play an important role in the osmoregulation of this animal. PMID- 6850745 TI - Response of prolactin cells to environmental calcium in the eel (Anguilla anguilla L.). AB - Prolactin (PRL) cell activity was investigated in eels kept in fresh water (FW), deionized water (DW) supplemented or not with Ca (2 mM), in Ca-enriched FW (10 mM), in normal (Ca 3.4 mM) or Ca-free 1/3 sea water (SW), and in SW (Ca 10.2 mM) or Ca-free SW (Ca 0.15 mM). Light-microscopic studies, including measurement of the nuclear area and cell height, showed that PRL cell activity, reduced in DW, is not affected by Ca supplementation. Activity is reduced in Ca-enriched FW, in 1/3 SW and in SW, conditions inducing an increase in the plasma sodium level. The lack of calcium in saline environments partly suppresses the nuclear atrophy occurring in SW. There is no significant correlation between external or total plasma calcium concentration and PRL cell activity. In artificial Ca-free SW, eels show a rapid increase in plasma osmolarity and sodium levels; there is a significant negative correlation between these two plasma values and the nuclear area or cell height of PRL cells. As in some other teleosts, plasma osmolarity and plasma sodium seem to play a more important role than external or internal calcium in controlling PRL secretion. This correlation is not apparent in eels kept in SW, having unstimulated PRL cells but active calcium-sensitive (Ca-s) cells in the pars intermedia. PMID- 6850747 TI - Ultrastructure of the endometrial blood vessels during implantation of the rat blastocyst. AB - The ultrastructure of the blood vessels of the endometrium was analysed during implantation of the blastocyst in rats, at the time of appearance of the Pontamine Blue Reaction. Vessels from implantation sites and from interimplantation sites were compared. In vessels from implantation sites the endothelial cells showed fenestrations covered by diaphragms. In addition, small interruptions (gaps) between the endothelial cells were observed. These features were present in vessels larger than 5 micrometers in diameter and more than 100 micrometers away from the uterine epithelium, both in the mesometrial and antimesometrial wall of the endometrium. Vessels from interimplantation sites displayed neither fenestrations nor interruptions. The endothelial cells of the implantation sites displayed morphological signs of metabolic activation. These consisted of increased numbers of polyribosomes, well developed Golgi complexes and prominent nucleoli. The fenestrations and gaps in the vessel wall were interpreted as constituting the morphological basis for the increase in vascular permeability and the consequent edema which characterize the Pontamine Blue Reaction. PMID- 6850749 TI - The effect of a MAO inhibitor on reserpine-induced secretion of catecholamines from the adrenal medulla of the rose-ringed parakeet. AB - The effect of MAO inhibitor on reserpine-induced release of catecholamines from the adrenal medulla of the rose-ringed parakeet was investigated in this biochemical, histochemical, and ultrastructural study. The MAO inhibitor provided some blockade of epinephrine secretion and was ineffective in blocking norepinephrine secretion. Differences between birds and mammals were noted, suggesting that different mechanisms of catecholamine release may be operating in the two classes. PMID- 6850750 TI - Synaptic organization of the indoleamine-accumulating neurons in the cyprinid retina. AB - The distribution and synaptic connections of the indoleamine-accumulating neurons in the retinae of the goldfish and carp were studied by means of fluorescence and electron microscopy. The indoleamine-accumulating neurons were visualized after intravitreal injection and uptake of the indoleamine 5,6-dihydroxytryptamine. This labeling procedure produced a characteristic yellow fluorescence of the indoleamine-accumulating neurons and also characteristic ultrastructural changes in these cells. To avoid interference from the dopaminergic neurons of the retina, their processes were either removed by prior treatment with 5 hydroxydopamine or prevented from taking up 5,6-dihydroxytryptamine by the simultaneous injection of the catecholamine alpha-methyl-noradrenaline. Fluorescence-microscopic studies confirmed earlier reports that the indoleamine accumulating perikarya and processes are distributed similar to those of amacrine cells. The indoleamine-accumulating processes ramify in three bands in the inner plexiform layer, the outermost one being the densest. Electron-microscopic investigations showed the indoleamine-accumulating neurons to have synapses of the conventional type, similar to amacrine cells. Their main synaptic contacts are with other amacrine cells, but synapses with bipolar cell terminals are also present. Both the distribution of the indoleamine-accumulating processes and their synaptic arrangement in the cyprinid retina differ from those found in mammalian retinae investigated previously. PMID- 6850748 TI - Differentiation and transdifferentiation of adrenal chromaffin cells of the guinea pig. III. Transplants under the kidney capsule. AB - Histochemical, ultrastructural and biochemical studies (quantitative determinations of catecholamines (CA) and phenylethanolamine N-methyltransferase (PNMT) activity) were carried out on autologous transplants of adult guinea-pig adrenal medulla under the kidney capsule, in order to investigate the specific influences of a virtually nerve-free environment in comparison to those mediated by a densely innervated one such as in the iris (cf. Unsicker et al. 1981). Three weeks after transplantation chromaffin cells survived well, most cells maintaining their morphological identity in terms of adrenaline (A) storage, although biochemically measured A and PNMT had dramatically decreased. Chromaffin cells in transplants extended neurite-like processes in an identical fashion as seen in transplants to the anterior chamber of the eye and in culture. Chromaffin cells were frequently connected by synaptoid contacts, but did not receive cholinergic synapses as observed in transplants to the iris. It may be concluded that the growth factor(s) eliciting neurite outgrowth from transplanted chromaffin cells are rather ubiquitously present, independent of whether the transplantation site is sparsely or richly innervated. PMID- 6850751 TI - Synapses of the inner plexiform layer in the retina of cyprinid fish. AB - Two types of synapses are known to occur in the inner plexiform layer of the vertebrate retina. The typical ribbon synapse has two postsynaptic elements, whereas the conventional synapse displays only one. Ribbon synapses are characteristic of bipolar cells, and the conventional synapses are seen in amacrine and interplexiform cells. Two varieties of conventional synapses with one postsynaptic element are described in the present study. One has the well known presynaptic cluster of synaptic vesicles, whereas the other has several clusters surrounding dense globules. Furthermore, there are conventional synapses with two postsynaptic elements, called branched conventional synapses. They are most numerous in the middle of the inner plexiform layer and are characterized by a presynaptic aggregation of synaptic vesicles usually clustering around a dense globule. The neuronal processes with branched conventional synapses also have conventional synapses with one postsynaptic element and are therefore thought to be amacrine cell processes. PMID- 6850752 TI - Molecular charge as a determinant of macromolecule permeability across the fetal capillary endothelium of the guinea-pig placenta. AB - The effect of molecular charge on the permeability to macromolecules of the fetal capillary endothelium of the guinea-pig placenta has been investigated. In a series of experiments for horseradish peroxidase (HRP) isoenzymes with different isoelectric points were perfused through the fetal circulations of guinea-pig placentae, which were then prepared for ultracytochemical localization of peroxidase activity. It was found that the two anionic HRP tracers did not penetrate the endothelial cell layer of the fetal capillaries. By contrast, both cationic HRP tracers did penetrate; reaction product was found in the subendothelial space underlying the endothelial cell layer. The route of transendothelial penetration was via the lateral intercellular spaces (LIS) between endothelial cells. In further experiments cationic and anionic ferritins were perfused. Cationic ferritins were found apparently bound in clusters to the luminal surface of the endothelial cell layer in the luminal ends of the LIS whereas very few anionic ferritin molecules were present. We conclude that molecular charge is an important determinant of macromolecule permeability through the fetal capillary endothelium of the guinea-pig placenta and may be related to the presence of anionic sites on the luminal plasma membrane of the endothelial cells. PMID- 6850753 TI - The aminergic system in the brain of Blennius incognitus (Bath 1968) (Teleostei, Perciformes). AB - In the brain of Blennius incognitus the distribution of biogenic amines was investigated by means of formaldehyde-induced fluorescence (FIF). The telencephalon of Blennius is devoid of fluorescent perikarya. Fluorescent telencephalic fibers and terminals contain either dopamine (DA), noradrenaline (NA), or an indolamine. Two diencephalic nuclei display fluorescent perikarya, the nucleus recessus lateralis and the nucleus recessus posterioris; both nuclear regions contain DA. Only occasionally single green-fluorescent perikarya are found within the ependymal lining of the caudal portion of the recessus lateralis. Four fluorescent nuclei, two catecholamine-containing nuclei and one indolamine-containing nucleus, are present in the tegmentum of the midbrain and in the medulla oblongata. Three of these nuclei, N1 and N3, consist of large, green-fluorescent neurons, which apparently contain NA. N2, located medial to the nucleus isthmi, is formed by several clusters of small neurons, which show a yellow indolamine fluorescence. Caudal to the calamus scriptorius another green fluorescent nucleus (N4) is visible. PMID- 6850754 TI - Ultrastructural and immunocytochemical investigation of ecdysteroid secretion by the prothoracic gland of the waxmoth Galleria mellonella. AB - The formation and secretion of ecdysteroid by the prothoracic gland cells of Galleria mellonella (Insecta, Lepidoptera) were investigated electron microscopically and immunocytochemically. The moulting hormone ecdysone becomes first evident in vesicles and tubules of the smooth endoplasmic reticulum (SER). The SER forms secretory granules in which ecdysone was shown immunocytochemically. The Golgi apparatus seems not to be directly involved in ecdysone secretion. The secretory granules are released from the cells by exocytosis. PMID- 6850755 TI - Endogenous control of spinule formation in horizontal cells of the teleost retina. AB - The process of horizontal cells invaginating teleost cone pedicles are studded with small finger-like projections which are present only in the light-adapted state. The aim of this study was to investigate whether the formation and degradation of these so-called spinules, which are thought to function as feed back synapses onto the cones, is endogenously controlled. Three types of experiment were carried out involving fish entrained to a 12 h light/dark cycle: 1) The number of spinules was determined in goldfish at various times during exposure to either constant darkness (36 h) or constant light (57 h). 2) The time course of spinule formation and degradation in goldfish was investigated following exposure to light or darkness at various times during the light/dark cycle. 3) The time course of flash-induced spinule formation in tench following dark adaptation at noon was compared to that following dark adaptation at midnight. The results of these experiments show that spinule formation and degradation are partially under endogenous control but that they need light and full expression. This endogenous rhythm is reflected in the time courses of spinule formation and breakdown during different phases of the light/dark cycle. PMID- 6850756 TI - Capacity of fertilized ova from mature and middle-aged rats to undergo preimplantation development in vitro. AB - The ability of ova collected from mated middle-aged rats (9-10 months of age) to undergo preimplantation development in vitro was compared to that of younger controls (3-4 months of age). The majority of ova from young rats underwent at least one cleavage division for every 24 h of the 96 h culture period. Seventy two percent reached the morula/blastocyst stage at the termination of the culture. Aged ova had a reduced capacity to undergo preimplantation development in vitro with the number of fragmented and/or degenerated ova increasing after each day in culture. At the end of the culture period, 81.6% of the ova had degenerated. It is concluded that middle-aged rats ovulate defective ova and that these defective ova account, in part, for the preimplantation losses that characterize middle-aged rats. PMID- 6850757 TI - GABA or sodium-bromide-induced plasticity of neurites of mouse neuroblastoma cells in culture. A quantitative study. AB - Differentiated C1300 mouse neuroblastoma cells were treated with 10(-4)-10(6) M gamma-aminobutyric acid (GABA) and/or sodium bromide (NaBr) for 2 days and then fixed. Quantitative studies revealed an increase in the length and branching of the processes, as well as an increase in the number of cells when compared to the controls. It is suggested that the above changes contribute to the augmentation of specialized contacts between cells and processes as well as the further maturation of the primitive stages of synaptogenesis as discussed. PMID- 6850759 TI - Structure of the tail fin in teleosts. AB - A morphologic study of the structure of the tail fin in eight species of teleosts was performed by aid of the Picrosirius-polarization method, which is a specific histochemical method for the detection of collagen in tissue sections. This structure is composed mainly of skeletal elements, the fin rays, covered by skin. Fin rays are bound to each other and to the surrounding tissues by a series of collagenous ligaments forming a complex, highly pliable and resistant structure. Although the general structural pattern of tail fins was consistent in all species studied, the comparative aspects reported in this paper show that variations in the form and size of their components are responsible for the morphologic diversities which are closely related to specific functional adaptations. Morphometric data on the number and size of actinotrichia in normal adult specimens are presented. PMID- 6850758 TI - The demonstration of close nerve-Purkinje fibre contacts in false tendons of sheep heart. AB - An observation of intimate nerve-Purkinje fibre associations in false tendons of sheep heart is reported. Nerve bundles were observed in deep clefts of Purkinje fibres, in channels running between coupled Purkinje cells and embedded within Purkinje cells, as well as in the outer connective tissue sheath. Most nerve terminals in these areas were filled with small clear vesicles and a few large dense-cored vesicles. Only a few axons with many small dense-cored vesicles were observed. Intimate associations (separation, 60 to 90 nm) between the Purkinje cell and nerve varicosity were observed in the deep clefts. Similar close appositions were also present where nerves were embedded in Purkinje cells. In these cases the Purkinje cell enclosing the nerve bundle formed intercellular junctions with its own sarcolemma. Elaborate sarcolemmal folds with multi vesicular bodies were also frequently observed near nerve bundles and varicosities. The identity of the transmitter is unknown although the nerves forming intimate associations with Purkinje cells have a morphology typical of cholinergic nerves. PMID- 6850761 TI - Binding of cationized and native ferritin to cellular structures of the electric organ of Torpedo marmorata. AB - The distribution of polycationic and polyanionic binding sites in the electric organ of Torpedo marmorata was investigated by incubation of tissue with native (NF) ferritin. 1) Collagen fibrils from the electric organ carry rosettes of polyanionic sites on their surface with a periodicity of 60 nm, corresponding to the pattern of crossbanding in collagen fibrils. The CF-binding sites are abut 30 nm in size and project 20 nm beyond the surface of the fibril. 2) As revealed by incubation of tissue homogenates, CF heavily stains the intraperiod line of the axonal myelin and also tubular structures in the axonal cytoplasm. 3) Neither the extracellular aspects of the pre- nor the postsynaptic membrane became labeled with either NF or CF. After incubation of tissue homogenates. labeling of the electron-dense material of the cytoplasmic aspect of the postsynaptic membrane was observed with NF and, in particular, with CF. The ventral basal lamina of the electroplaque cell revealed uniform labeling with NF. In contrast, CF-binding sites were distributed in the lamina densa of the basal lamina as a lattice of discrete binding sites, approximately 45 nm in diameter. The presence of polyanionic sites in the basal lamina, which also proceeds through the synaptic cleft, suggests the existence of a diffusion barrier for the released neurotransmitter acetylcholine. It is proposed that this facilitates hydrolysis of acetylcholine in the synaptic cleft and recirculation of the products of hydrolysis to the axon terminal. PMID- 6850760 TI - Reinnervation of the denervated adult spinal cord of rats by intraspinal transplants of embryonic brain stem neurons. AB - Previous studies have revealed a remarkable capacity of intracerebral grafts of embryonic brain tissue to establish extensive axonal connections with denervated areas in the brains of adult rats. In the present study we have explored the possibilities of using grafts in the spinal cord to substitute for the loss of noradrenergic brain-stem inputs to the severed spinal cord. Intraspinal grafts of embryonic pontine noradrenergic neurons were made into the lower thoracic region of adult rats. Three different surgical techniques were tested: (i) grafting to a small central cavity in the spinal-cord grey matter; (ii) grafting to a small subpial cavity involving removal of the dorsolateral third of the spinal-cord matter; (iii) grafting to the gap between the rostral and caudal stumps of the spinal cord after a nearly complete subpial transection. The results indicate that direct contact with the vessel-rich pia is essential for good survival of the grafts. Provided that the pia was left intact, the scarring around the grafts was minimal and the grafts fused well with both the grey and white matter of the cord. In the subpially transected cord, a brain-stem graft taken from a young embryonic donor fused well with both the rostral and the caudal stumps of the severed cord and thus restored tissue continuity across the gap. Large numbers of catecholamine (CA)-containing and non-monoaminergic cells were present in the transplants after 3-6 months. CA fluorescence histochemistry in combination with injections of fluorescent retrograde tracers revealed that both noradrenergic and non-monoaminergic neurons in the grafts had grown to reinnervate large segments of the host spinal cord. In those cases where the transplant had fused well with the cord, abundant CA-fluorescent axons could be traced across the graft-cord junction. They course along the grey and white matter of the host cord to reestablish a new CA terminal plexus in the grey matter as far as 12 mm from the graft. PMID- 6850763 TI - Effects of denervation on 3H-fucose incorporation by odontoblasts in the mouse incisor. AB - The present study was designed to determine the effects of denervation on glycoprotein synthesis in the predentinal matrix of the mouse incisor. The inferior alveolar nerve (IAN), superior cervical ganglion (SCG) or both (IAN + SCG) were unilaterally resected in adult mice with the contralateral side remaining intact as a control. Fourteen days after surgery and 4 h prior to killing, 0.2 mCi of 3H-fucose was injected intravenously and mandibles were processed for standard histological and autoradiographic techniques. Silver halide grains were counted over the predentin matrix for 2000 micrometers per tooth. The results showed that the IAN and SCG resection affected 3H-fucose incorporation into the predentinal matrix; however, the highest absolute mean grain counts occurred after IAN + SCG resection. SCG resection increased the amount of 3H-fucose incorporated into the predentinal matrix by 48%, that of IAN by 24% and that of IAN + SCG by 14% as compared to contralateral controls. These data indicate a regulatory role for the nervous system and a possible interaction of neural components in the control of glycoprotein synthesis by odontoblasts in the mouse incisor. PMID- 6850762 TI - Epithelial cell production and mucosal morphology in colonic obstruction. AB - The purpose of this study was to determine the temporal course of changes in epithelial cell production and mucosal morphology following ligation of the rat's ascending colon. Control animals were sham ligated with a loose tie of suture, and ligated and control rats were pair red after surgery. Between the 12th and 24th postoperative h, crypt mitotic and [3H] thymidine labelling indices in the obstructed colon increased to a level of 75% greater than values obtained from unoperated rats. This response was accompanied by gains in the proportion of crypt cells engaged in the division cycle. By 72 h, the numbers of cells per total crypt length and crypt circumference were increased by 40 and 47%, respectively. In addition, morphometrical measurements revealed that crypt cell size in the obstructed colon was significantly greater than control value at 72 h. Colonic ligation had relatively minor effects on cell production and villus and crypt cell number in the terminal ileum. Contrasted with the obstructed bowel, proliferative indices distal to the ligature and in the ileum and colon of control rats diminished rapidly after surgery. Thus, limitation of the hyperproliferative response to the intestine immediately proximal to the ligature strongly suggests that the proliferative stimulus in colonic obstruction is local in action. PMID- 6850765 TI - Aminergic innervation of the blood vessels of Octopus vulgaris. AB - Evidence is presented from fluorescence histochemistry studies that blood vessels in the viscera of octopus vulgaris are innervated by nerve fibres containing catecholamines. This, with other evidence, suggests that cephalopods, like vertebrates, may be capable of regulating their peripheral vasculature by central neural control. PMID- 6850764 TI - Glomerular ultrastructure of the trout, Salmo gairdneri. Glomerular capillary epithelium and the effects of environmental salinity. AB - The epithelial ultrastructure of the glomerulus of fresh- and sea-water adapted rainbow trout, Salmo gairdneri was examined by scanning and transmission electron microscopy after in vivo-perfusion fixation. Adaptation to seawater for a period of up to 9 weeks was not associated with a change in glomerular size, although after one year in seawater both glomeruli and their capsules were significantly smaller than the glomeruli of freshwater adapted fish. In freshwater adapted trout the epithelial ultrastructure conformed to the general vertebrate pattern, with rounded podocytes, well-defined primary processes and interdigitating pedicels. Adaptation to seawater was associated with a marked increase in the frequency of cytoplasmic microprojections. In many glomeruli there was a flattening of the podocytes, broadening of the primary processes, and areas of closely-packed pedicels were common. These observations are discussed in the light of previous studies on the mammalian kidney and the changes of single nephron function known to be associated with adaptation of trout to increased environmental salinities. PMID- 6850766 TI - Topographical distribution of the gonadotrophs, mammotrophs, somatotrophs and thyrotrophs in the pituitary gland of the baboon (Papio cynocephalus). AB - The identification and regionalization of four pituitary parenchymal cell types, gonadotrophs, mammotrophs, somatotrophs and thyrotrophs, were studied in the baboon (Papio cynocephalus) hypophysis using immunocytochemistry. The gonadotrophs were homogeneously distributed throughout the entire pars distalis. Both mammotrophs and somatotrophs predominate at the superior and inferior poles of the organ. The medial and anteromedial regions are populated by mammotrophs and thyrotrophs, while the lateral and posterior portions of the pars distalis contain large numbers of somatotrophs. PMID- 6850768 TI - Caste-specific maturation of the endocrine system in the female honey bee larva. AB - The endocrine system of female honey bee larvae has been studied through postembryonic development with histological and autoradiographic techniques. During larval development, brain and retrocerebral complex proceed from immature cells to an active endocrine system. Caste-specific retardation occurs in the worker during this process. In the developing queen, the differentiation of the neurosecretory cells (NSC) and the outgrowth of their axons occurs from the second instar onward and is nearly completed in the fourth, whereas in the worker larva these processes are delayed by more than one instar. In the queen, RNA synthesis starts in the NSC at the end of the third instar and in the worker at the fifth instar. Stainable neurosecretory material is present only in fifth instar queen larvae. The queen's corpora cardiaca become active at the end of the fourth, those of the worker in the fifth instar. In the corpora allata (CA), nuclei undergo several phases of endomitosis. These phases of polyploidization end at the beginning (queen) or at the end (worker) of the fifth instar respectively. CA volume in the queen is twice that of a worker at its height at the end of larval development. these data demonstrate a caste-specific maturation of the endocrine organs which results in differences in hormone titres. PMID- 6850767 TI - Projection of statocyst sensory neurons associated with crescent hairs in the crayfish Procambarus clarkii girard. AB - The central projection of statocyst sensory neurons associated with the crescent hairs of the crayfish Procambarus clarkii was investigated. Cobalt fills of statocyst nerves revealed that they entered the brain as the two discrete fiber bundles and terminated in different portions of the brain. One terminates in the ipsilateral half of the brain and the other in the contralateral half. The later was further subdivided into two discrete components. The relationship between the location of statocyst receptors in the different regions of the crescent and their central projection pattern was investigated by the extracellular cobalt marking method. The results showed that the two fiber bundles, which projected to the ipsilateral and contralateral halves of the brain respectively, originated from different regions of the crescent. Ipsilaterally projecting neurons had their origin mainly in the posterior hairs of the sensory crescent whereas contralaterally projecting ones in the anterior hairs of the sensory crescent. PMID- 6850770 TI - Central innervation of the pineal organ of the Mongolian gerbil. A histochemical and lesion study. AB - Nerve fibers connecting the brain with the pineal gland of the Mongolian gerbil (central pinealopetal fibers) were investigated by means of light and electron microscopy. Several myelinated fibers penetrate from the brain into the deep pineal gland, extend further into the pineal stalk and continue to the superficial portion of the pineal gland. In the centripetal direction these fibers were traced to the stria medullaris and to the habenular nuclei, where they turned laterad and then occupied a position immediately ventral to the optic tract. As shown in electron micrographs, lesions of the habenular area led to degeneration of myelinated fibers and nerve boutons in the deep pineal gland, the pineal stalk and the superficial pineal gland. Only boutons containing clear transmitter vesicles (devoid of a dense core) were observed to degenerate after the habenular lesions. On the other hand, removal of the superior cervical ganglia resulted in degeneration of boutons containing small (40 to 60 nm in diameter) dense-core vesicles. Several of the nerve fibers that penetrate into the deep pineal directly from the brain (central fibers) exhibited a positive reaction for acetylcholinesterase (AChE). AChE-positive perikarya were located in the projections of the stria medullaris, the lateral portions of the deep pineal, the area of the posterior commissure, and the periventricular gray of the mesencephalon. Such perikarya were found neither in the pineal stalk nor in the superficial pineal gland. These results present anatomical evidence that the pineal organ of the Mongolian gerbil receives multiple nervous inputs mediated by peripheral autonomic (i.e., sympathetic) nerve fibers, on the one hand, and by central fibers, on the other. PMID- 6850769 TI - Vacuoles in macrophages and reticular cells of regional lymph nodes of the rat after injection of large doses of steroids. AB - The ultrastructure of macrophages and reticular cells of regional lymph nodes of the rat after administration of large doses of cortisone acetate, estrone, progesterone, and cholesterol in aqueous suspensions was investigated. A large number of vacuoles, most of which were surrounded by unit membrane, and lipid droplets not surrounded by unit membrane were observed in the cytoplasm of both macrophages and reticular cells. They were not seen in these cells of control animals and in experimental animals that had received smaller doses of these steroid hormones. After cholesterol injection, many lipid droplets were observed in the cytoplasm of macrophages. These observations suggest that steroids injected in suspension accumulate in macrophages and reticular cells of the regional lymph nodes. Electron-dense material was often present in vacuoles of macrophages but not in those of reticular cells. PMID- 6850771 TI - Structural studies on lymphomyeloid tissues of the dogfish, Scyliorhinus canicula L. AB - The structure and ultrastructure of the lymphomyeloid epigonal and Leydig organs of the dogfish Scyliorhinus canicula L. were investigated. The tissues produce leucocytes, mainly granulocytic cells, but also some lymphocytes and plasma cells. Lymphocytes sometimes form nodule-like aggregations, especially in the epigonal organ. Granulocytes are probably stored within the lymphomyeloid tissues and enter the circulation on maturation. They may also release biologically active substances into the blood. PMID- 6850772 TI - Ultrastructure of sensory receptors on the labium of the rice brown planthopper. AB - The ultrastructure of the sensory receptors located on the labium of the rice brown planthopper is described; possible functions of individual receptors are suggested on morphological grounds. Uniporous chemosensilla which may or may not possess a mechanoreceptive dendrite, domed multiporous chemosensilla, and mechanoreceptive pegs are present on the flattened labial tip. Mechanoreceptive pegs are distributed over the labium. The fine structure of a multilobed sensillum located on either side of the labium is also described. PMID- 6850774 TI - The compound eye of Leptodora kindtii (Cladocera). An adaptation to planktonic life. AB - Each of the approximately 500 ommatidia in the compound eye of the cladoceran crustacean Leptodora kindtii has a crystalline cone consisting of five cells. Five retinula cells are also present, one of which contributes to the distal 1-2 micrometer of the rhabdom only; the other four retinula cells from a continuous rhabdom. Throughout the rhabdom its cross section displays two separate halves with the axis of the microvilli in one half perpendicular to that in the other (orthogonal pattern). Interferometric analysis of the refractive index of the crystalline cone revealed an inhomogeneous system with one distal and one proximal gradient. The gradient system was found to exclude rays entering from adjacent facets, thus maintaining the optical isolation. Consequently, these optics replace distal screening pigment, which is absent in the eye. The long and unscreened crystalline cones give rise to an almost transparent eye in conformity with the overall transparency of this plank-tonic animal. The morphological characteristics of the eye of this species deviate from other cladoceran eyes, but the optical design closely resembles that of some pelagic marine amphipod crustaceans. PMID- 6850773 TI - The hypothalamus of Lacerta sicula R. II. A Golgi study of the preoptic area. AB - An analysis of the preoptic area of the lizard, Lacerta sicula R., with the use of the Golgi method revealed that: 1) in principle, the dendritic pattern of its neurons is relatively simple; 2) the supraoptic nucleus contains large- to medium sized bipolar or multipolar neurons together with small, usually multipolar nerve cells; 3) the preoptic periventricular gray and the paraventricular nucleus exhibit a varied neuronal typology, including large multipolar or bipolar elements, abundant CSF-contacting neurons and some tufted elements; and 4) the lateral regions display some conspicuous multipolar neurons. PMID- 6850775 TI - Coxal organs of Lithobius forficatus (Myriapoda, Chilopoda). Fine-structural investigation with special reference to the transport epithelium. AB - In Lithobius forficatus each of the coxae of the four posterior trunk segments bear a pore field with several coxal pores. The surrounding single-layered epithelium is composed of four different cell types: the main epithelial cells having a fine-structural organization of transport cells with deep apical and basal folds of the cell surfaces and plasmalemma-mitochondrial complexes, junctional cells, exocrine glands, and the wall cells of the pore channel. The entire epithelium is separated from the hemolymph by an inner cellular sheath. It is assumed that the coxal organs participate in fluid uptake. PMID- 6850777 TI - Ontogeny of the photoreceptors in the embryonic retina of the viviparous guppy, Poecilia reticulata P. (Teleostei). An electron-microscopical study. AB - Ultrastructural analyses of retinal development in the guppy embryo show that at midgestation all types of photoreceptors are differentiated in the fundus, and at birth differentiation extends over the whole retina. Formation of discs of outer segments is more rapid in rods than in cones. Double cones differentiate simultaneously with long single cones and are formed by the adhesion of two primordial inner segments; short single cones develop last. Wherever cones are differentiated, they are arranged in an adult-type square mosaic. The rods in the embryo, as opposed to the adult, are likewise regularly arranged within the mosaic unit. These results are at variance with the generally held opinion that adult teleosts which possess duplex retinae have larvae with pure cone retinae, and that rods, double cones and mosaics appear in late larval life or only at metamorphosis. In the double cones of the guppy embryo subsurface cisternae develop along the adjoining primordial inner segments. Additionally, regularly distributed subsurface cisternae are formed in the regions of intimate contact of long single cones with double cones and rods. We suggest that the early development of rods and double cones, and a square-mosaic with regular distribution of rods and subsurface cisternae, provide the newly born with a fully functional optical apparatus, especially suited to perception of movements. This is necessary for its survival against predatory, especially maternal, attacks. PMID- 6850776 TI - Ultrastructural study of the hypophysial neural lobe of newborn rats in tissue culture. AB - Neural lobes of newborn rats were cultured for two weeks after transection of the infundibulum. The pituicytes display phagocytic capacity, as do mature pituicytes in vivo, and eventually eliminate degenerating neurosecretory axons. A peculiar glycogen accumulation exists at the time of advanced phagocytosis of axonal elements. Cultured pituicytes are similar to immature pituicytes in vivo. The numerous processes form a network with comparatively wide intercellular spaces, and an intercellular canalicular system appears. the cells are interconnected by gap- and desmosome type-junctions. PMID- 6850778 TI - A quantitative analysis of spermatogenesis in the trout, Salmo trutta fario. AB - The pattern of spermatogenesis was studied during an annual reprodutive cycle in adult male brown trout. The part of the testicular volume occupied by the nuclei of germ cells and of Sertoli cells, the lobular lumen and the extra-lobular space were measured. The number of germ cells was estimated by the total volume occupied by each cell divided by the individual volume of each cell. The permanent number of spermatogonia A (spermatogonia isolated or in groups of 2) was about 50 million. Each GA cell produced several spermatogenetic waves during the same reprodutive cycle. Sperm production was about 25 X 10(9)/g of testis/year, or about 6.8 X 10(7)/g of body weight/year. Males stocked separately from females, thus presumably not releasing spermatozoa, were killed in December, January and February. Since these fish contained the same amount of spermatozoa it appears that the process of spermiation initiated in December did not continue in January and February. During this period, some spermatozoa were phagocytized by macrophages (spermatophages) in the lobular lumen and by Sertoli cells. PMID- 6850779 TI - Demonstration of fluid-phase endocytosis in epithelial cells of the male reproductive system by means of horseradish peroxidase-colloidal gold complex. AB - The occurrence of fluid-phase endocytosis in Sertoli cells as well as epithelial cells of the rete testis and ductuli efferentes was demonstrated by use of horseradish peroxidase combined with colloidal gold (HRP-G) as a tracer. The characteristic electron dense spherical colloidal gold particles facilitate the localization of the HRP-G complex in pinocytotic vesicles, multivesicular bodies, and lysosomes of these epithelial cells. With this method, which does not require the use of diaminobenzidine, a clear distinction can be made between peroxidases from endogenous and exogenous origins. PMID- 6850780 TI - An ultrastructural morphometric study of the papillary muscle of the right ventricle of the cat. AB - The papillary muscle of the cat heart's right ventricle has not been studied previously with quantitative ultrastructural techniques despite its wide use for functional studies. This tissue was perfusion-fixed, processed for electron microscopy, and morphometric techniques were used to assess the ultrastructural characteristics of the papillary muscle as well as the working myocardial cells. The results of this study were that 73.5% of the papillary muscle was composed of muscle cells, 9.7% of blood vessels, and the remainder of interstitial connective tissue. In the muscle cell the volume fraction of mitochondria was 17.3%, that of myofibrils was 49.8%, and that of the nucleus was 2.0%. The mitochondria to myofibrils ratio was 0.36 and the surface to volume ratio was 0.309. In a quantitative ultrastructural comparison of perfusion and immersion fixed tissue it was found that significant differences in the volume density of the blood vessel lumen existed between the two groups. In addition, there were significant differences in the volume fraction of mitochondria and nucleus between perfusion fixed and immersion-fixed muscle cells. A concurrent significant decrease between the two groups was also found for the ratio of mitochondria to myofibrils. The perfusion-fixed tissue can be considered to provide only normal baseline data for the papillary muscle of the right ventricle. These data are important as they can be used in future structure-function studies on normal and pathological heart tissue. PMID- 6850781 TI - The presence of two populations of sensory-type cells in the pineal organ of the five-bearded rockling, Ciliata mustela L. (Teleostei). AB - The pineal organ of the five-bearded rockling, Ciliata mustela L., was examined by means of electron microscopy. Two categories of sensory cells are described: 1) Sensory cells 1 (or photoreceptor cells sensu stricto) showing the characteristic ultrastructure of photoreceptor cells with a well-developed receptor pole (outer segment) and a transmitter pole (ribbon-type synapse in the basal pedicle contacting dendritic processes), and a segmental organization of organelles. 2) Sensory cells 2 (or photoneuroendocrine cells) displaying no particular segmentation. The ultrastructure of the receptor pole (outer segment) is variable in shape (with either long or short disks) and in the number of disks; some outer segments are simple cilia of the 9 + 0 type. This second cell category is rich in smooth endoplasmic reticulum, beta-particles of glycogen, dense inclusions of variable size and content, and dense-core vesicles 130 nm in diameter. These cells have an extended contact area with the perivascular space. The functional significance of both cell categories is discussed in terms of the known physiological responses of the pineal organ. A possible confusion in identification of interstitial cells and neuroendocrine cells in some teleost species is discussed. PMID- 6850782 TI - Local interneurons associated with the mushroom bodies and the central body in the brain of Acheta domesticus. AB - Within the central part of the brain in male crickets (Acheta domesticus) 150 local interneurons were recorded intracellularly and consequently stained with either Lucifer Yellow CH or cobaltous sulphide. The shapes of the injected cells were reconstructed from serial sections and drawn to scale using known brain regions as landmarks. Several types of neurons were encountered, which differ in their topographical relationships to the mushroom bodies and the central body. Extensive branching was often found in the calyces or the lobes of the mushroom bodies, within the lateral protocerebral neuropil and in the columns of the central body. These neurons connect different parts of the brain with the neuronal assemblies of the mushroom bodies and the central body, structures, which are considered to participate in the control of complex behavior. The role of the mushroom body with respect to its connectivity to other brain areas and various feedback loops is discussed. PMID- 6850783 TI - Ultrastructural evidence of variation in the number of secretory granules within the granulosa cells of the sheep corpus luteum. AB - The granulosa luteal cells of the sheep corpus luteum secrete their hormonal products by exocytosis of granules. Electron micrographs of randomly selected granulosa cells from nine corpora lutea at day 10 of the oestrous cycle were examined to obtain the cellular density of these granules. From the area of the cell, calculated using an x-y digitiser, and the number of granules observed, the number of intracellular secretory granules per microns 3 of luteal cell cytoplasm was calculated. There was a large variation in the number of granules per cell within the same corpus luteum and between corpora lutea taken at the same stage of the cycle. The number of intracellular granules in nine corpora lutea varied from 2.12 +/- 1.05 granules per microns 3 (mean, SD, n = 30) cells to 0.36 +/- 0.18 granules per microns 3 (mean, SD, n = 26). These morphological data suggest that the variation in granule synthesis in individual cells may contribute to the variation in hormone content of corpora lutea at the same stage of the cycle, and the episodic release of hormone into the plasma. PMID- 6850785 TI - Permeability of the blood-brain barrier in the median eminence during the perinatal period in rats. AB - An electron microscopic study has been carried out in order to examine the permeability of the blood-brain barrier in the median eminence of perinatal rats. After several minutes, intravascularly injected electron-dense tracers (lanthanum nitrate; horseradish peroxidase, 40000 MW1, ferritin, 500000 MW) pass the capillary wall, the perivascular space, and become incorporated into neurosecretory axons and basal processes of tanycytes both in fetuses and young rats. In the case of immature capillaries, the materials diffuse freely through the endothelial cells, and to a lesser extent are transferred via occasional plasmalemmal vesicles and fenestrae. As the maturation of capillaries proceeds, their permeability via plasmalemmal vesicles and fenestrae increases considerably due to a gradual rise of the number of these structures. The plasmalemmata of the differentiated endothelial cells become impermeable to all of the tracers. Only ionic lanthanum appears to penetrate through transendothelial channels and intercellular junctions between adjacent endothelial cells. PMID- 6850784 TI - Quinacrine-induced degeneration of non-adrenergic, non-cholinergic autonomic nerves in the rat anococcygeus muscle. AB - The morphological changes induced in the autonomic nerves of the rat anococcygeus muscle after the injection of quinacrine (QC, 100 or 200 mg/kg) were examined by electron microscopy in order to clarify the nature of QC-binding nerves seen at the fluorescence-microscopic level. A correspondence between granular QC fluorescence and many lysosomal dense bodies is observed both in the cytoplasm of muscle cells and in non-adrenergic, non-cholinergic (NANC) axons during the first few days following injection. A number of brilliantly fluorescent fibres is observed 1 week after injection. At the ultrastructural level, these fibres seem to correlate with NANC axons which are crowded with many dense bodies and large granular vesicles. Notably, some lysosomal dense bodies contain many large granular vesicles. The effects of QC injection on the ultrastructure of adrenergic axons have also been observed, but are not so marked as in the NANC axons. The administration of QC did not cause complete degeneration of the NANC nerves, though degenerating axons were sometimes observed. The present data indicate that most, if not all, QC-binding nerves observed at the fluorescence microscopic level correspond to NANC nerves at the electron-microscopic level. Furthermore, NANC axons appear to contain a considerable amount of ATP concentrated in the large granular vesicles. PMID- 6850787 TI - Preliminary observations of satellite cells in undamaged fibres of the rat soleus muscle assaulted by a snake-venom toxin. AB - Satellite cells were studied in the undamaged part of the rat soleus muscle rendered partially necrotic by a subcutaneous injection of notexin, the myotoxic toxin purified from the venom of the Australian snake Notechis scutatus scutatus. Nuclei of satellite cells were twice as numerous as in the controls, with a decreasing gradient in the number of satellite cells with distance from the necrotic area. The cells were in an activated state with an increased cytoplasmic volume and prominent organelles. Occasionally, mitosis of some satellite cells was observed. Between the satellite cell and the muscle fibre, an unusually wide space was frequently seen, within which a "new" basal lamina was often visible. It is suggested that the role of the satellite cells of undamaged muscle fibres in the regeneration of necrotic muscle is worthy of more detailed investigation. PMID- 6850786 TI - Ultrastructure and morphometric analysis of preimplantation mouse embryos. AB - During cleavage, both qualitative and quantitative morphologic characters of mouse ova change. Up to the 8-cell stage, the volume density of mitochondria remains nearly the same although it increases during early and late blastocyst stages. While a rise of the volume fraction of granular endoplasmic reticulum is noticed during cleavage, the volume density of agranular endoplasmic reticulum diminishes gradually from the 1-cell stage onwards. An increase in the volume fraction of autophagic vacuoles is found, the maximum being reached in early blastocysts. The volume fraction of crystalloid inclusions slightly increases after the 4-cell stage, but this increase is statistically insignificant. The volume density of filamentous material (plaques) conspicuously decreases in all studied embryos from the beginning of cleavage. Starting with the 2-cell stage, the volume fraction of lipid droplets remains practically unchanged. No differences in volume densities of the Golgi apparatus, multivesicular and residual bodies, and large cytoplasmic vesicles with medium electron-dense content are found between the respective cleavage stages. PMID- 6850788 TI - Isoenzyme studies of whole muscle grafts and movement of muscle precursor cells. AB - Isoenzymes of glucose-6-phosphate isomerase (GPI: E.C. 5.3.1.9) were used as markers to determine the origin of cells which give rise to new muscle formed in allografts of whole intact muscle. GPI isoenzymes were also employed to see whether host precursor cells, which have been shown to contribute to muscle formation in grafts of minced muscle, can be derived from muscle lying adjacent to grafts. Excellent muscle regeneration was found in allografts of extensor digitorum longus (EDL) muscle examined after 58 days: 12 of 16 grafts contained 80% or more new muscle. Isoenzyme analysis showed that most, and in 2 instances all, new muscle was derived from implanted donor cells; however, there was strong evidence that in 5 grafts some, or all, new muscle must have resulted from host cells moving into the graft. Although hybrid isoenzyme was not detected this was attributed to factors associated with host tolerance which appear to interfere with fusion between host and donor myoblasts. Isografts of minced muscle were placed next to whole EDL muscle allografts to see if cells from allografts moved into adjacent regenerating tissue. Unfortunately, muscle regeneration in minced isografts was poor; only 3 contained 50% or more new muscle and most contained large amounts of fibrous connective tissue. Only a single isoenzyme band was detected in 11 isografts, but in five instances, the presence of a second band showed that cells from EDL allografts were also present. As no hybrid isoenzyme was detected, it is not known whether these cells which had moved into the regenerating minced grafts were muscle precursors, fibroblasts or some other cell types. PMID- 6850789 TI - Regional difference in effect of filipin in plasma membranes of epithelial cells and surrounding free cells in the choroid plexus. AB - Epithelial cells and surrounding free cells in the choroid plexus were examined cytochemically using filipin to clarify the distribution pattern of cholesterol within plasma membranes. The apical and basal membranes of the choroid epithelial cell are less susceptible to filipin than the lateral epithelial membrane and plasma membranes of adjacent mesenchymal cells such as macrophages and fibroblasts. Apical and basal domains of the epithelial membranes, which are relatively resistant to action of filipin, appear to have a slightly lower cholesterol content. We suggest that the apical and basal membranes may possess a unique membrane fluidity or stability that differs from that of the lateral epithelial, macrophage or fibroblast membranes. PMID- 6850790 TI - Fine structure of the horny teeth of the lamprey, Entosphenus japonicus. AB - The fine structure of the horny teeth of the lamprey, Entosphenus japonicus, was examined by light- and electron-microscopy. Most of the horny teeth consisted of two horny and two nonhorny layers. The primary horny layer was well keratinized, and the cells were closely packed and intensely interdigitated, being joined together by many modified desmosomes. The plasma membrane of the horny cell, unlike the membranes of other vertebrates, was not thickened. The intercellular spaces were filled with electron-dense material. Microridges were seen on the free surface. Structures resembling microridges were found on the underside of the primary horny layer. The secondary horny layer displayed various stages of keratinization. The keratinization started at the apex and developed toward the base. In the early stage of keratinization, the superficial cells became cylindrical and were arranged in a row forming a dome-shaped line. Their nuclei were situated in the basal part of the cells. The appearance of the nonhorny layers varied according to the degree of keratinization of the horny layers beneath them. The nonhorny cells were joined together by many desmosomes and possessed many tonofilament bundles. The replacement and keratinization of the horny teeth are discussed in the light of these results. PMID- 6850791 TI - The ultrastructural basis of the permeability of arterial endothelium to horseradish peroxidase. Freeze-fracture and tracer studies of rat thoracic aorta and basilar artery. AB - The thoracic aorta and basilar artery, in which the incidence of atherosclerosis is known to be different, were examined to elucidate the correlation between the structure of the intercellular cleft junction between adjacent endothelial cells and its permeability to HRP. Tannic acid or HRP in the vessel lumen passed through the intercellular clefts of the thoracic aorta into the subendothelial space, whereas in the basilar artery they were unable to penetrate beyond the tight junction of the intercellular clefts. Freeze-fracture replicas revealed that the tight junctions of the thoracic aorta consisted of one to two junctional strands in most areas of the cleaved planes, with discontinuities in some places, whereas those of the basilar artery consisted of a continuous belt-like meshwork of six anastomosing junctional strands on average. These observations confirm that the structure of endothelial junctions in arteries has a close correlation with the permeability of the intercellular clefts to HRP. PMID- 6850792 TI - An isthmo-optic system in a bony fish. AB - This investigation reveals the existence of an isthmo-optic system in a bony fish for the first time. Two cell aggregates of the isthmic region project bilaterally to each eye in Polypterus. The crossed connections are significantly more developed than the uncrossed ones. These findings provide further evidence for the presence of bilaterally projecting isthmo-optic systems in early stages of vertebrate evolution. Furthermore, they suggest that a loss of one or all of these connections during evolutionary or ontogenetic development reflects a parcellation process as proposed by the parcellation theory. PMID- 6850793 TI - Freeze-fracture study of the turtle lung. 1. Intercellular junctions in the air blood barrier of Pseudemys scripta. AB - The air-blood barrier in the lung of the turtle Pseudemys scripta was studied by means of freeze-fracture replicas in an attempt to give a detailed account on the structural organization of the intercellular junctions. Between the pneumocytes, zonulae occludentes containing 4-19 strands in the apico-basal direction are present; they are considered to be physiologically very tight. In the endothelium, fasciae occludentes, i.e., discontinuous occluding junctions can be found, composed of up to 4 strands. These junctions are regarded to be very leaky. The findings are discussed in relation to recent physiological results, suggesting that in comparison with 'dry' mammalian lungs, the turtle lung is a rather wet lung based on its much larger transcapillary fluid filtration into the interstitium. In addition, small maculae communicantes are demonstrated between the pneumocytes; they possibly serve for metabolic coupling. PMID- 6850794 TI - Immunohistochemical demonstration of serotonin-containing nerve fibers in the inferior olivary complex of the rat, cat and monkey. AB - By the use of a modified peroxidase-antiperoxidase immunohistochemical method, the distribution of serotonin-containing nerve fibers was studied in the inferior olivary complex of the rat, cat and monkey. The entire inferior olivary complex of all three species contained serotonin fibers, and species-related differences in the distribution of serotonin fibers were observed. In the rat, the overall density of serotonin fibers was sparser than that in the other two species; the highest concentration of varicose serotonergic fibers was noted in the lateral portion of the dorsal accessory olive. In the cat, the densest distribution of serotonin fibers occurred in the caudal portion of the medial accessory olive, the dorsomedial cell column and the lateral portion of the dorsal accessory olive, where intervaricose segments of serotonin-immunoreactive fibers were not so distinct. In the monkey, the caudal medial accessory olive, the lateral portion of the dorsal accessory olive and the dorsal as well as the lateral lamella of the principal olive showed a maximum density of serotonin fibers. Apart from the influence of afferent serotonergic projections to the cerebellum, serotonergic neurons of the brainstem are considered to affect Purkinje cells via neurons of the inferior olivary complex projecting to the cerebellum particularly in the cat and monkey. PMID- 6850795 TI - X-ray microanalysis of the filter chamber of the cicada, Cyclochila australasiae Don. A water-shunting epithelial complex. AB - X-ray microanalysis of frozen-hydrated specimens of the cicada filter chamber shows that there are concentration changes in K+ and Cl- in the various compartments of the filter chamber from feeding to non-feeding states. These changes are consistent with an osmotic transfer of water between the anterior midgut and the posterior midgut and Malpighian tubules. K+ and Cl- account for a large proportion of the osmotically active solutes in these compartments, and it is suggested that the osmotic gradients are generated by secretion of K+ and Cl- into the posterior midgut and Malpighian tubule lumina. Analysis of freeze substituted sections of filter chamber supports the analysis of frozen-hydrated specimens and indicates that Na+ may also be secreted into the posterior midgut and the Malpighian tubules. The system functions as a water-shunting complex. PMID- 6850796 TI - Effect of K+ and Na+ on calcium-dependent electron-dense particles in the monoaminergic synaptic vesicles of rat pineal nerves fixed in Ca2+-containing solutions. AB - The effect of K+ and Na+ on the Ca2+ binding site in the dense core of monoaminergic vesicles of pineal nerves was investigated in the rat. Rat pineal glands, bisected immediately after decapitation, were incubated at room temperature in solutions containing high K+ or high Na+ in the presence or absence of Ca2+. Fixation was performed in glutaraldehyde-osmium tetroxide in collidine buffer, with and without CaCl2. It was confirmed that, after fixation in Ca2+-containing solutions, an electron-dense particle, located in the vesicle core, which can be considered a calcium deposit, appears within the synaptic vesicles. It was observed that this Ca2+ deposit may be modified by incubation in a high K+ or high Na+ milieu before fixation in Ca2+ containing solutions. When the incubation was carried out with high K+ and high Ca2+ simultaneously, Ca2+ deposits were considerably increased. With K+ alone, no Ca2+ deposits were apparent, as when electrical stimulation is applied before fixation. This effect was not observed when the incubation was done in high Na+. Consecutive incubations in high K+ and high Na+, respectively, restored the capability of the vesicle cores to bind Ca2+. Prolonged incubation in high Na+ before fixation increased Ca2+ deposits within the vesicles. These findings are in line with data on the effect of these ions upon the storage and release of biogenic amines and suggest that these ions modify the capability of synaptic vesicles to bind Ca2+. PMID- 6850797 TI - Phagosome-lysosome interactions related to erythrophagocytosis in Kupffer cells of fetal rat liver. AB - Kupffer cells of fetal rat liver were examined by ultrastructural cytochemical methods to reveal acid phosphatase (AcPase) activity in lysosomes. Elongated cisternae, 940-1150 A in width containing AcPase reaction product, were identified in these cells. These cisternae were sometimes in continuity with phagosomes containing engulfed erythrocytes. Observations suggest that such cisternae may partly encircle these phagosomes. The relationships of these cisternae to GERL (Golgi Endoplasmic Reticulum Lysosomes) is discussed. PMID- 6850799 TI - Influence of melatonin on the process of protein and/or peptide secretion in the pineal gland of the rat and hamster. An in vitro study. AB - The hypothesis that melatonin (aMT) is implicated in the regulation of the secretory process involved in the synthesis and release of protein/peptide "hormones" of the pineal organ has been tested in the present study by the use of an in vitro system in two mammalian species. In these species the secretory process studied is characterized by either large (hamster) or very small (rat) numbers of granular vesicles. In both species, aMT clearly participates in the regulation of the process of protein/peptide secretion. However, the effect of aMT varies with the presence of noradrenaline (NA) in the medium and is not identical in both species. Melatonin, in the absence of NA, induces the formation of granular vesicles by the Golgi apparatus in pinealocytes of the rat but not in those of the hamster, while in the presence of NA, aMT provokes a decrease in the number of these vesicles in both species. The present experiments show (i) that the pineal is one of the target organs for aMT, and (ii) that aMT is implicated in the control of protein/peptide secretion in the pineal organ. PMID- 6850798 TI - Afferent connections of the optic tectum in the piranha (Serrasalmus nattereri). AB - Injections of horseradish peroxidase into the optic tectum of the piranha resulted in retrograde transport to the following structures bilaterally: the central telencephalic nucleus, four hypothalamic nuclei, the caudal part of the dorsomedial optic nucleus, the ventral nucleus of the torus semicircularis, the torus longitudinalis, the perilemniscal nuclei, the reticular formation, and a tentatively identified locus coeruleus. In addition, labeled cells were found unilaterally in the contralateral tectum and in the medial octavolateralis nucleus, the ipsilateral thalamic portion of the dorsomedial optic nucleus, the corpus geniculatum laterale ipsum, the pretectal nucleus, the nucleus corticalis, the dorsal nucleus of the torus semicircularis, and the nucleus isthmi. Efferent projections of the optic tectum appeared identical to those reported in Holocentrus (Ebbesson and Vanegas 1976). PMID- 6850800 TI - Synaptic development and microtubule organization. AB - Using techniques for enhanced microtubular preservation (albumin pretreatment of Gray) occipital and pyriform cortices of rats were studied by electron microscopy at various stages of development. A close structural relationship was seen between microtubules (mts), focal membrane densities, synaptic vesicles, and presynaptic dense projections (pre-dps) during maturation. Mts were seen in the neonates to be focused onto the inner surface of immature axonic profiles merging or sometimes fragmenting there. Focal densities occur at these attachment sites and thereafter synaptic vesicles clothe the mts and abut onto these presumed primordial pre-dps. Thus, mts may contribute to the initial formation of pre-dps as well as their maintenance in the adult and may act to channel the first synaptic vesicles to the site of eventual synaptic contact and transmitter release. PMID- 6850802 TI - Regional surface changes during the development of the telencephalic choroid plexus in the chick. A scanning-electron microscopic study. AB - The surface morphology of the developing chick telencephalic choroid plexus (TCP) was examined by scanning electron and light microscopy. A blunt evagination develops rostro-cranially to the foramen of Monro on the medial telencephalic septum. The pseudostratified TCP epithelium differs in its surface morphology from that of the surrounding ependyma. Subsequently the TCP becomes elongated and branches. On the 9th embryonic day (ED) the pseudostratified epithelium progressively becomes high columnar epithelium in a distal to proximal direction along the branches of the TCP. The apical poles of the high columnar epithelial cells protrude into the ventricular lumen. Later, additional branches sprout at the base of the TCP, which then resembles a tree with a bush growing at its roots. Before the time of hatching, the high columnar epithelium changes to low columnar epithelium again in a distal to proximal direction. The surface of the TCP becomes flatter, in the process of which the number of cilia per unit surface area is reduced. On the developing TCP the epiplexus cells vary in shape, depending upon their functional state. It is proposed that not only the morphological but also the functional differentiation of the TCP proceeds in a distal to proximal direction along the branches of the choroid plexus. The surface differentiation of the TCP has a more regular character than that of the diencephalic CP (DCP), described previously, which seems to be influenced in its development by other anatomical structures. PMID- 6850801 TI - Pituitary folliculo-stellate cells immunostained with S-100 protein antiserum in postnatal, castrated and thyroidectomized rats. AB - Pituitary folliculo-stellate cells and associated cells were studied immunohistochemically throughout the life of male and female rats. The marginal layer cells of the pars distalis and intermedia as well as the folliculo-stellate cells were immunostained with anti-S 100 protein serum. The immunostained folliculo-stellate cells in one section were identified as themselves by their ultrastructural properties on the adjacent section. Corticotrophs, thyrotrophs and prolactin cells, characterized by the stellate shape, were not immunostained with anti-S 100 protein serum. Reactivity for S-100 protein appeared on postnatal Day 6 in the marginal layer cells of the pars intermedia, and appeared on Day 10 in those cells of the pars distalis. No immunostained folliculo-stellate cells appeared before Day 6, but a few of them appeared on Day 10. Thereafter they increased in number, having more intense immunostaining with advancing age. In castrated rats, the immunostained folliculo-stellate cells appeared quite numerously, with branched cytoplasmic processes surrounding the gonadotrophs. In the thyroidectomized rats, however, folliculo-stellate cells lacked ramified cytoplasmic processes, and their topographic affinity for thyrotrophs was negligible. PMID- 6850803 TI - Freeze-fracture observations of ovulated hamster oocytes with their cumulus cells. AB - Mature unfertilized oocytes in the cumulus oophorus were examined using the freeze-fracture technique. The P face of the oocyte plasma membrane (oolemma) has randomly distributed intramembranous particles (IMPs) with an average diameter of about 10 nm. No marked difference is found between the intermicrovillous and microvillous regions of the oocyte with respect to the size and distribution of IMPs. The E face of the oolemma has fewer IMPs than the P face. The intermicrovillous region is slightly elevated in some places because of close contact with underlying cortical granules. The oolemma of this elevated region and the membrane of the cortical granule have IMPs which are considerably smaller than those in the remaining areas of the oolemma. The IMP density of the P face of the cortical granule membrane is much lower than that of the E face, possibly indicating a membrane specialization required for fusion of the cortical granule membrane with the overlying oolemma at the time of exocytosis. Cytoplasmic lamellae appear as parallel bands of particles in freeze-fractured specimens. No gap junctions are found between the oocyte and cumulus cells, but residual gap junctions are seen among clustered cumulus cells. PMID- 6850804 TI - Ultrastructural studies on sporogony of Babesia microti in salivary gland cells of the tick Ixodes dammini. AB - Tick larvae were permitted to feed on infected hamsters and then allowed to molt. Nymphs were examined just prior to feeding on uninfected hamsters or at timed intervals thereafter. Invasion of the salivary gland by B. microti occurs before feeding of the nymph begins, and development of the parasite is further stimulated by feeding. The sporoblast forms a massive multinucleated meshwork which ramifies throughout the large host cell. No separation of the meshwork into multiple subdivisions, termed "cytomeres" by other workers, has been detected. Instead the specialized organelles characteristic of sporozoites, namely micronemes, rhoptries, and segments of double membrane appear in the meshwork itself and gradually become organized into sporozoite anlagen which protrude from its surface. At the same time the meshwork shortens and thickens giving rise to large compact undifferentiated bodies whose surface is also studded with sporozoite anlagen. Sporozoites thus originate either from the meshwork or from the undifferentiated bodies. In either case large lobate nuclei send projections into the anlagen as they protrude from the surface of the sporoblast. In a final step the mature sporozoites arise by simultaneous nuclear and cytoplasmic divisions. There is no separate stage of schizogony and the process is one of true budding. PMID- 6850805 TI - Morphometry of the small intestinal enterocytes of the fasted rat and the effects of colchicine. AB - The function of the microtubules that are present in the villus enterocytes of the mammalian small intestine is virtually unknown. In order to advance our knowledge about enterocyte microtubules, a quantitative ultrastructural comparison was carried out on enterocytes from rats injected intraperitoneally with colchicine (0.5 mg/100 g body weight) in saline and from rats injected with saline alone. Our morphometric and stereologic study demonstrates that colchicine treatment results in 1) an absolute decrease in microtubules, 2) a reduction in microvilli, essentially in length, 3) an increased thickness of the terminal web, 4) an increase in total lysosomal volume, apparently by an increased number of smaller lysosomes, and 5) a decrease in the number of Golgi lamellae. These results along with those from other studies suggest to us that enterocyte microtubules are involved in the biogenesis of microvillus plasma membrane. Our morphometric data from the saline-treated rats essentially agree with comparable data from other studies. However, comparison with comparable data from hamster enterocytes demonstrates species differences. PMID- 6850806 TI - Ultrastructural aspects of rapid-frozen, deep-etched and rotary-shadowed synaptosomes. AB - Isolated synaptic terminals were rapid-frozen with a liquid-propane jet, deep etched, and rotary-shadowed replicas produced. The replicas show a three dimensional view of the cytoplasmic components. Intraterminal mitochondria display a rough inner membrane with numerous stalked globular particles. Microfilaments connect the diverse organelles of the nerve terminal. The main cytoplasmic structure is a tubular membrane system, probably formed by the smooth endoplasmic reticulum (SER). Rapid-frozen synaptosomes reveal sparse profiles of synaptic vesicles in contrast to the current structural features shown by the techniques employing cryoprotectants and/or fixatives. The structural lability of these SER-profiles seems to be very high, to the extent that varying morphological features are observed in the same replica. It is proposed that the synaptic vesicles originate from cisternae of the SER, and that the synaptic vesicles and the SER are in close structural and functional relation. The morphological relationship of both structures to the cell membrane still remains unclear. PMID- 6850807 TI - Correlating the initiation of virus replication with a specific pupal developmental phase of an ichneumonid parasitoid. AB - The morphogenesis of virus particles associated with the calyx region of the lateral oviduct of the ichneumonid parasitoid Campoletis sonorensis is initiated during a specific phase of pupal development. The extent of body pigmentation proved to be the most reliable visual marker for correlation of induction of virus replication with particular phases of pupal development. Parasitoids removed from their pupal cases at 15 and 16 days after egg deposition were categorized into one of four developmental groups based on the degree of pigmentation. Viruses were not evident in the calyx cells of pupae representing the initial developmental stage, however, in all subsequent stages the concentration of particles gradually increased as development progressed. Observations of freeze-fractured tissue support previous suppositions that the viruses bud through the nuclear envelope following synthesis de novo within the nucleus. PMID- 6850808 TI - Structural organization of the normal and anoxic heart of Scyllium stellare. AB - The general and ultrastructural organization of the heart of the elasmobranch, Scyllium stellare, was studied in normal and in anoxic animals. The rich coronary supply was revealed three-dimensionally by the use of corrosion casts, showing a thebesian system of coronary arterioles and capillaries in the thin, outer compact layer as well as in the predominant, inner spongy layer of trabeculae. Only the sinus venosus received a neuronal input of large bundles of granule containing axons terminating at fenestrated regions of the endocardium and suggesting a neurohormonal function. A simple, tubular sarcoplasmic reticulum with flattened junctional cisternae was present in myocardial cells of 1-5 microns diameter, which contained one or two bundles of myofibrils. The latter were closely apposed to the inner aspect of the plasmalemma. Mitochondria were located centrally in the cells, which were joined by unfolded desmosomes involving Z-band material. Long periods of anoxia were tolerated without loss of heart function, but at the expense of cytoplasmic glycogen. Lipid granules were abundant in all layers and chambers, notably in animals prepared in the summer. The lipid granules displayed a marked increased in electron density when the heart was incubated in a buffered oxalate solution prior to fixation. A glycogen sparing effect of the lipids during anoxia was observed. PMID- 6850810 TI - Changes in the organization and ultrastructure of smooth muscle cells in the stomach of the gastric brooding frog, Rheobatrachus silus, during brooding. AB - The young of the aquatic Australian frog, Rheobatrachus silus (Leptodactylidae) develop from eggs to juvenile frogs in the mother's stomach. During brooding the stomach expands greatly and becomes very thin walled. Transmission electron microscopy showed that the distension of the stomach was accompanied by a severe disruption of the smooth muscle layers. Many of the smooth muscle cells seemed to be highly contracted and resembled smooth muscle cells contracted in the absence of an intact connective tissue matrix. Eight days after the birth of the juveniles through the mouth of the female, the stomach muscle cells had returned to a normal appearance. It is suggested that during gastric incubation of the young, smooth muscle cells become at least partially dissociated from their surrounding connective tissue matrix, allowing maximal distension of the stomach wall. PMID- 6850809 TI - Distribution of interchromatin granules in nuclear matrices obtained from nuclei exhibiting different degree of chromatin condensation. AB - Female Wistar rats were injected intraperitoneally with thioacetamide or Ledakrin (1-nitro-9/3'-dimethylpropyloamine/acridine . 2 HCl) to provoke chromatin decondensation or condensation, respectively. Liver nuclei of each experimental group were used to isolate nuclear matrices. The results provide evidence that interchromatin granules are components of the nuclear matrix obtained by the procedure used in these experiments. They also reveal that the general ultrastructural pattern of the nuclear matrix is related to the degree of chromatin condensation in the nuclei used for its isolation. The distribution of interchromatin granules characteristic for the source nuclei is maintained in the nuclear matrices. PMID- 6850811 TI - Motility, cell shape, and locomotion of neutrophil granulocytes. AB - Activation of the motile apparatus by chemokinetic factors cannot be reliably assessed in cells that are attached to a solid substratum because motility can be totally abolished by excessive adhesion. It is however, necessary to quantify the activation of the motile apparatus in order to analyze and understand chemokinetic responses. It was the purpose of the present work to establish morphological criteria that can be used to quantify motility in nonadherent (floating) neutrophils and to predict the locomotor response under conditions of limited adhesion. The proportion of neutrophils performing crawling-like movements (polarized cells) in suspension correlates very closely with stimulated locomotion at low to optimal concentration of f-Met-Leu-Phe, ie, under conditions of limited adhesion. Reduced locomotion at supraoptimal concentrations of f-Met Leu-Phe has also morphological correlates. The major feature is the decrease in the proportion of neutrophils performing crawling-like movements and the corresponding appearance of cells that are motile but not polarized in suspension and that do not locomote on the substratum. Concentration-dependent changes in neutrophil length and in the proportion of polarized neutrophils with and without tail were also observed. The locomotor potential of neutrophils under conditions of limited contact with the substratum can be predicted on the basis of their motile behavior, in particular the proportion of cells showing crawling-like movements, in suspension. In combination with measurements of adhesion the procedure should permit a more complete analysis of the regulation of chemokinetic responses. PMID- 6850813 TI - Invited review: bacterial flagellar sheaths: structures in search of a function. AB - Although bacterial flagellar sheaths were observed over 30 years ago, they may still be characterized as structures in search of a function. In addition to true sheaths, bacterial flagella may possess other adornments that cause an increase in the organelle's cross-sectional diameter. These "complex flagella" are sharply differentiated from sheathed flagella. Immunological and chemical distinctions have been found between flagellar sheaths, flagellar cores, and LPS layers inferred to be the sheath sensu stricto. Although complex flagella may serve as specific receptors for flagellotropic phages or in allowing for more efficient swimming in viscous environments, similar functions have not yet been attributed to true sheaths. It is postulated that flagellar sheaths may allow for specific interaction between a bacterium and a surface. In addition, there is a problem as to the relationship between a rapidly rotating flagellum and the sheath. PMID- 6850812 TI - Nocodazole pretreatment in anaphase selectively reduces anaphase B in PtK1 cells. AB - During early anaphase PtK1 cells were briefly treated with the rapidly reversible microtubule (MT) poison nocodazole. This treatment abruptly stopped chromosome motion and effected a large decrease in spindle birefringence. On removal of the drug, chromosome to pole motion (anaphase A) returned, though at a lesser rate but not extent than untreated cells. In most cases elongation of the pole-pole distance (anaphase B) also occurred, at both a rate and to an extent less than in untreated cells. During the recovery period following drug arrest spindle birefringence did not return to pretreatment levels. Electron microscopic analysis of nocodazole arrested, or arrested and released, cells revealed extensive disassembly of the nonkinetochore class of MTs (nkMTs), particularly evident in the astral region. Microtubules seen in the interzone region were largely fragments of midbody precursors. Kinetochore MTs (kMTs) appeared to be unaffected by the brief drug treatment chosen for these experiments. Analysis of MT profiles seen in transverse sections of the interzone region indicated in treated and released cells approximately 60% fewer MTs. This may suggest that chromosome motion during anaphase is not dependent on interactions between kMTs and nkMTs and separation of the spindle poles can occur in the presence of disrupted interzonal MTs. PMID- 6850815 TI - The erythematous-maculo-papular eruption in acute trypanosomiasis report of a case. PMID- 6850816 TI - The frequency of mental disorders in the outpatients of two Nyanza hospitals. PMID- 6850814 TI - Human bilharziasis in a peri-urban area in Zimbabwe with special reference to its relationship to malnutrition in school children. PMID- 6850817 TI - "PEDLIZ: unwarranted restriction of prescribing freedom, or rational cost effective measure? PMID- 6850818 TI - Cluster headache--clinical findings in 180 patients. AB - Anamnestic data and clinical features were accurately investigated in 180 patients with cluster headache; 161 were episodic sufferers and 19 were chronic. A significantly high familial incidence of coronary heart disease was found. The patients' medical history revealed a significantly high incidence of peptic ulcer disease and head injury with brain concussion. It is stressed that the side on which head injury took place is very frequently the same side on which cluster headache is located, although the latency between the two events appears to be a long one. The study of timing of cluster periods suggests, for some patients, a constant, typical temporal pattern not necessarily related to seasons or the months of of the year. Cluster attacks frequently occur during certain periods of the day (onset being most frequent between 1 and 3 p.m.). Cluster headache cannot be considered as a nocturnal headache. PMID- 6850819 TI - Histamine release from leucocytes in migraine. AB - The spontaneous histamine release (SHR) from leucocytes in migraine patients during symptom-free periods has been investigated, and also the influence of migraine sufferer serum on histamine release (HR) from blood donor leucocytes. The leucocytes were isolated according to the Day method and histamine assay was made by the Shore spectrofluorometric method modified by Bergendorff and Uvas (1). SHR in the 17 female migraine patients was significantly higher (39.7% +/- 13.1%) than in 8 controls (25.4% +/- 4.2%). Migraine serum increased HR from blood donor leucocytes by 14.6% +/- 20.2% compared with the SHR of these cells. PMID- 6850820 TI - Low plasma testosterone levels in cluster headache. AB - Serum levels of various hormones have been estimated in cluster headache and non cluster headache controls. Cluster headache patients were studied prior to, during, and after attack. During the cluster phase, plasma testosterone levels were low, whereas levels were within the reference limits. Normal values were also found in control patients with non-cluster headache. It is suggested that a decrease of plasma testosterone levels in episodic cluster headache should be viewed in context with disordered REM sleep in cluster headache. PMID- 6850821 TI - Chronic paroxysmal hemicrania. VIII. The sweating pattern. AB - Evaporimeter measurements of forehead sweating during attack were carried out in six female patients with chronic paroxysmal hemicrania. The patients served as their own controls. Increased sweating on the symptomatic side was found in two patients, both when compared to the non-symptomatic side during attack and when compared with the symptomatic side outside attack. The remaining four patients, two of whom had only weak attacks at the time of study, showed sweat values within the control range. In one patient, attacks could be precipitated by head flexion and by pressure against certain circumscribed points in the neck ("mechanical" precipitation of attacks). These attacks were also associated with increased sweating on the symptomatic side. Increased forehead sweating does not seem to be a sine qua non in CPH. PMID- 6850822 TI - So-called "tension headache"--the response to a 5-HT uptake inhibitor: femoxetine. AB - Sixteen patients with a headache resembling the so-called "tension headache" and a clear response to doxepin (demonstrated in a previous work) were given femoxetine, 400 mg p.d., and placebo in a cross-over, double-blind fashion. Only single blindness was kept in the last third of the study. Placebo and femoxetine tablets were each given for four weeks. Whereas there was a daily or practically daily occurring headache untreated, placebo was associated with a headache frequency of 92%. The corresponding figures for doxepin and femoxetine were 27% and 41%, respectively. Femoxetine led to transitory nausea and gastrointestinal discomfort, but in contrast to doxepin, no weight gain and only slight, if any, sedation. Most patients preferred femoxetine to doxepin. Femoxetine, an antidepressant phenylpiperidine derivative with predominant serotonin re-uptake inhibition (little effect on noradrenaline), thus seems to counteract so-called "tension headache". PMID- 6850824 TI - Percutaneous intra-aortic balloon pumping: new problems and dilemmas. PMID- 6850825 TI - The minimum error in estimating coronary luminal cross-sectional area from cineangiographic diameter measurements. AB - A formal analysis of the error associated with the use of radiographic diameter measurements in estimating the luminal area of an elliptically-shaped coronary cross-section was performed. When two views are available, the maximum potential error was found to decrease rapidly as the angle between the views increased to 90 degrees, but this error was small (less than 25%) for orthogonal views only for mild degrees of ellipticity (major/minor axis ratio less than 2). Since, for each successive doubling of the number of radiographic views, a stepwise reduction in the potential error by an approximate factor of only one-half was found, a large number of views is required to eliminate the potential error associated with diameter assessment of highly elliptical lumena. PMID- 6850827 TI - Unsuspected vascular disease: a potential limitation to the use of the intra aortic balloon. AB - Since vascular tortuosity of stenosis may preclude placement of the intra-aortic balloon, 63 consecutive patients (37 men) having routine Judkins' cardiac catheterization had an aortogram prior to withdrawal of the last catheter. No patient had a history of claudication, palpable aneurysms, pulse deficit, or bruit. No complications occurred. Significant peripheral vascular disease was found in ten patients: three had aortic, one had iliac, and six had femoral stenosis or tortuosity. All were men. The age of patients with peripheral vascular disease was 61.4 +/- 7.7 years, while those without were 56.9 +/- 9.3 years (P = NS). No difficulty was encountered entering the femoral artery in any patient; there was difficulty advancing the catheter in five of ten (50%) patients with peripheral vascular disease and in three of 54 (6%) patients without (P less than 0.002). Fifteen patients without peripheral vascular disease had normal coronary arteries, while none with peripheral vascular disease was normal. In patients with coronary disease, the number of vessels involved was the same in both groups. Peripheral vascular disease that might preclude placement of the intra-aortic balloon occurs in 14% of patients undergoing cardiac catheterization and 18% of patients with coronary artery disease. Aortography may be safely performed and should be considered during routine cardiac catheterization in patients who may require intra-aortic balloon placement. PMID- 6850826 TI - Regional sequential motion in the normal left ventricle: nonuniform apical motion. AB - Timing of the onset and sequence of systolic regional wall motion was examined in the digitized left ventricular cineangiograms of 13 patients with angiographically normal coronary arteries and left ventricular function. Distance -time curves for anterior and inferior wall segments, the aortic valve plane, and apex point were compared to the volume--time curve in each ventricle. No significant differences were found in the onset of motion for the wall segments or for descent of the aortic valve where the sequence of motion was generally uniform. At the apex point, however, the onset of motion was significantly delayed. In addition, reduced velocity of motion in the first half of systole was followed by high velocity motion in the latter half. This apparent nonuniform apical motion may be explained by a geometric relationship of normally contracting myocardial wall fibers adjacent to a thin apical point which has relatively little or no contractile motion of its own. PMID- 6850828 TI - Significance of precordial ST-segment depression in acute transmural inferior infarction: coronary angiographic findings. AB - Coronary arteriographic findings in patients with acute transmural inferior infarction were studied from 57 patients (51 men and 6 women). Their ages ranged from 28 to 72 years with a mean of 50 years. Twenty-six patients (Group A) had minimal (less than 0.1 mV) or no precordial ST-segment depression. Thirty-one patients (Group B) had precordial ST-segment depression of 0.1 mV or more. The two groups showed consistent differences in frequency of the left anterior descending artery (LAD) stenosis, multivessel disease, mean peak plasma creatinine phosphokinase (CPK, IU/L), and mean ejection fraction. For Group A vs B, these differences were: LAD stenosis, 31% vs 68%, multivessel disease, 35% vs 81%, mean peak plasma CPK, 1283 versus 1904, and mean ejection fraction, 60.5% vs 45.3%. The incidence of abnormal anterolateral and posterobasal wall motion in Group B was more (p less than 0.01 and p less than 0.05 respectively) than in Group A. All patients in Group B who had precordial ST-segment depression of 0.3 mV or greater, had LAD stenosis. There was no relation between the duration of ST segment depression and the presence of LAD stenosis. Also, there was no correlation between the presence of collateral circulation and the development of ST-segment depression. The Group B patients tended to have more complications in the acute phase and in the follow up period (p less than 0.05) than did those in Group A. It is concluded that precordial ST-segment depression in acute inferior wall infarction is probably related to anterior injury due to LAD stenosis and these patients were shown to have more severe coronary artery disease, more depression of their ejection fractions, and more myocardial damage than patients without this finding. The earliest recorded ECG is most valuable in identifying the high risk patients. The presence of LAD stenosis in patients with inferior wall infarction who have precordial ST-segment depression of 0.3 mV or more are likely. PMID- 6850829 TI - Aneurysm of the interatrial septum occurring as an isolated anomaly. AB - We report a case of aneurysm of the atrial septum occurring as an isolated abnormality in a patient with atypical chest pain. Apical two-dimensional echocardiography demonstrated phasic bulging of the fossa ovalis region of the atrial septum into the right atrium. Biplane cineangiography confirmed the presence of a large septal aneurysm in an otherwise normal heart. The incidence, pathogenesis, and complications of this unusual anomaly are briefly discussed. PMID- 6850830 TI - Subclavian artery to pulmonary circulation fistulas. PMID- 6850831 TI - Primary pulmonary hypertension: M-mode and two-dimensional echocardiographic findings. AB - In two young men subsequently found to have primary pulmonary hypertension, echocardiographic findings suggested an atrial septal defect. Additionally, contrast echocardiography demonstrated right-to-left shunting at the atrial level. Cardiac catheterization demonstrated severe pulmonary hypertension with patent foramen ovale. Thus, primary pulmonary hypertension may result in findings similar to atrial septal defect on echocardiography, particularly if a foramen ovale is present. PMID- 6850835 TI - A complication from 7 French catheter. PMID- 6850833 TI - A catheterization technique for reproduction of a human atherosclerotic lumen within the dog coronary artery in vivo. AB - Reproduction of a human atherosclerotic lumen within the arterial lumen of an intact animal would facilitate angiographic and hemodynamic studies of stenoses. Accordingly, a male silicone rubber cast of a human atherosclerotic lumen was obtained from a cadaver artery, and a thin-walled replicate arterial phantom was constructed from the cast by use of a rapidly polymerizing liquid plastic. The casting properties of both materials were such that the topography of the arterial lumen was duplicated precisely in the phantom with 20 x microscopic detail preserved. The phantom was coated with a banzalkonium-heparin solution and introduced over a guidewire into an epicardial segment of a coronary lumen of the dog. Similarly, a larger phantom was placed within the dog femoral artery either directly via an arteriotomy or indirectly via a catheterization technique. Since the plastic material used to make a phantom had the same radiographic density of tissue, the angiographic appearance of an intra-arterial phantom was that of a human stenosis. PMID- 6850832 TI - Fracture of a polyurethane cardiac catheter in the aortic arch: a complication related to polymer aging. AB - An undated Cordis Ducor polyurethane coronary catheter fractured and separated in the aortic arch during a cardiac catheterization, and was removed with an intravascular retriever. The recovered specimen appeared brittle, prompting an investigation of the effects of aging on the tensile strength of 91 polyurethane catheters manufactured by Cordis and the United States Catheter and Instrument Company (USCI). Cordis catheters have stable tensile strength for five years from manufacture, but then deteriorate substantially by seven years, particularly at the bond between the catheter tip and the stainless steel-reinforced catheter body. The deterioration is associated with the microscopic appearance of deep cracks in the catheter lumen wall. USCI catheters showed a modest but significant loss of tensile strength by three years after manufacture at the catheter bond. It would seem prudent to place a three-year expiration date on USCI polyurethane catheters, similar to those already on Cordis catheters. PMID- 6850838 TI - Endogenous nuclease activity in chick embryo lens cells. AB - The temporal and spatial sequence of nuclear disappearance during the terminal differentiation of lens fiber cells could be due to an impairment of the DNA repair pathways or to the appearance of an active DNA degradation process. The results presented here favor the second hypothesis. A single-stranded DNA nuclease activity and a double-stranded DNA nuclease activity have been found in chick embryo fiber cells. Moreover, there is a good correspondence between the variations of the nuclease activity and the stages of differentiation of the different samples analyzed. PMID- 6850837 TI - The accumulation of the maternal pool of histone H1A during oogenesis in Xenopus laevis. AB - The accumulation of the maternal pool of histone H1A in Xenopus laevis oocytes was measured by the use of a semi-quantitative immunoradiographic method. This method implies the size-fractionation of total basic protein extracts from oocytes on a polyacrylamide gel, blotting of the proteins to diazotized paper and detection of histone proteins on the blots with the aid of antibodies to histone H1A and of [125I]protein A. It is shown that the maternal H1A pool that is present in fully-grown oocytes is accumulated very early in oogenesis, mainly in early vitellogenic oocytes. Stage III oocytes (Dumont, 1972) already contain approximately 80% of the final amount of H1A that is found in mature oocytes. The minimum amount of histone H1A estimated to be present in mature oocytes is 8-10 ng. PMID- 6850836 TI - Desferrioxamine inhibits induced erythroid differentiation of human leukemic K 562 cells. AB - The iron chelator desferrioxamine reversibly inhibits heme accumulation and globin synthesis in human leukemic K-562 cells induced to express erythroid genes by butyric acid. These results suggest that iron metabolism can modulate globin gene expression. In addition we describe experimental conditions (6.25 micrograms/ml desferrioxamine) which do not suppress transcription of globin genes and translation of globin mRNA but prevent heme synthesis. Therefore expression of globin genes in butyric acid induced K-562 cells does not require accumulation of heme molecules. Human leukemic K-562 cells cultured with different inducers and treated with desferrioxamine should be used as a useful model system to further analyse the relationship between expression of erythroid genes, iron metabolism and heme accumulation. PMID- 6850839 TI - The organisation of fruiting body formation in Dictyostelium minutum. AB - The process of culmination was investigated in three strains of the species Dictyostelium minutum. After aggregates have been formed a pulsatile signalling mechanism arises; the centre of signal emission becomes the apex of the developing fruiting structure. In the late aggregate, all cells differentiate into prespore cells. Cells that have reached the apex of the culminating cells mass redifferentiate into stalk cells. In two of the three D. minutum strains, interruption of regular stalk formation, more or less random formation of stalk cells and the synthesis of stalk supporting material from cell debris often takes place. The formation of multiple apices on aggregates and early fruiting structures is characteristic for these two strains. Within the species D. minutum, the exhibition of a marked pulsatile signalling mechanism is correlated with a capacity to form a regularly shaped stalk and to organize relatively large cell masses. The possible function of pulsatile signalling in the culmination process is discussed. PMID- 6850841 TI - Macrophage-mediated cytostatic activity blocks lymphoblast cell cycle progression independently in both G1 phase and S phase. AB - Recent work has shown that macrophage-mediated cytostatic activity inhibits cell cycle traverse in G1 and/or S phase of the cell cycle without affecting late S, G2, or M phases. The present report is directed at distinguishing between such cytostatic effects on G1 phase or S phase using the accumulation of DNA polymerase alpha as a marker of G1 to S phase transition. Quiescent lymphocytes stimulated with concanavalin A undergo a semisynchronous progression from G0 to G1 to S phase with a dramatic increase in DNA polymerase alpha activity between 20 and 30 hr after stimulation. This increase in enzyme activity was inhibited, as was the accumulation of DNA, when such cells were cocultured with activated murine peritoneal macrophages during this time interval. However, if mitogen stimulated lymphocytes were enriched for S-phase cells by centrifugal elutriation and cocultured with activated macrophages for 4-6 hr, DNA synthesis was inhibited but the already elevated DNA-polymerase activity was unaffected. Similar results were obtained when a virally transformed lymphoma cell line was substituted as the target cell in this assay. These results show that both G1 and S phase of the cycle are inhibited and suggest that inhibition of progression through the different phases may be accomplished by at least two distinct mechanisms. PMID- 6850840 TI - The suppression of myogenic functions in heterokaryons formed by fusing chick myocytes to diploid rat fibroblasts. AB - Heterokaryons were formed by fusing differentiated chick skeletal myocytes to fibroblasts derived from skin, lung or heart cultures. The heterokaryons were analyzed for the synthesis of skeletal myosin light chains, acetylcholine receptor, total CPK activity and the ability to spontaneously fuse to form myotubes. Whereas all of the above myogenic functions were expressed in control heterokaryons formed between myocytes and myoblasts, all were extinguished in the crosses between myocytes and fibroblasts. These results confirm that the suppression of myogenic functions previously observed in cell hybrids involving fibroblastoid tumor cells also occurs in heterokaryons isolated using biochemical inhibitors between diploid fibroblasts and chick skeletal myocytes. PMID- 6850842 TI - The interaction of cells persistently infected with canine distemper virus with antiviral antibody and complement. AB - Cells persistently infected with canine distemper virus can be lysed by antibody and complement. This reaction is dependent upon the alternative complement pathway. In the absence of antiviral antibody, the virus-infected cells will activate the alternative complement pathway, although this will not produce cell lysis. PMID- 6850843 TI - Induction of macrophage-mediated cytolysis of neoplastic cells by mycoplasmas. AB - Unexpected cytolysis was encountered when nonactivated murine peritoneal macrophages were cultured with [3H]TdR-prelabeled syngeneic or allogeneic tumor cells at a 10:1 ratio. The level of specific cytolysis reached 70% within 48 hr of cocultivation. Similar killing was observed whether the macrophages were derived from untreated, thioglycollate-treated, or germ-free mice. Cytolytic activity was also demonstrated when bone marrow-derived or peritoneal macrophages from 9- and 5-day in vitro cultures, respectively, were employed rather than freshly harvested peritoneal macrophages. Thus, the macrophage-mediated killing was neither the result of in vivo preactivation nor a consequence of the presence of lymphocytes in the assay. Moreover, macrophages derived from different strains caused similar effects. Our study revealed that the neoplastic target cell cultures susceptible to cytolysis by nonactivated macrophages were contaminated with mycoplasma. A mycoplasma was isolated from the supernatant of a culture of the A9HT fibrosarcoma line, identified as Mycoplasma orale, and cultivated. Addition of viable mycoplasma from that isolate to mixed cultures of thioglycollate-elicited macrophages and [3H]TdR-prelabeled mycoplasma-free target cells resulted in specific cytolysis of transformed A9 cells, but not of normal mouse fibroblasts. The level of macrophage-dependent cytolysis correlated with the number of viable mycoplasma cells added and was higher than that attained by activation with LPS at optimal concentration. Similar specific cytolysis was observed with heat-killed mycoplasmas. Our results demonstrate that mycoplasmas may cause selective macrophage-mediated cytolysis of neoplastic but not of normal target cells, perhaps via activation of the macrophages. It is suggested that undetected infection of experimental systems by mycoplasmas may account for some reports on lysis of neoplastic cells by nonactivated macrophages. PMID- 6850844 TI - Susceptibility of inbred mice to Leishmania tropica infection: correlation of susceptibility with in vitro defective macrophage microbicidal activities. AB - Eleven mouse strains were inoculated in footpads with amastigotes of Leishmania tropica and observed for 12 weeks. Liver and spleen impression smears from infected mice were examined for the presence of intracellular parasites. Four strains (BALB/cJ, C57L/J, NZW/N, and P/J) failed to heal the subcutaneous lesion and showed evidence of systemic infection; the remaining seven strains (A/J, C3H/HeJ, C3H/HeN, C3HeB/FeJ, C57BL/6J, C57BL/10J, and C57BL/10ScN) were each resistant to infection and resolved their lesions by Week 10. Macrophages from the four susceptible strains could not be activated to kill L. tropica amastigotes by treatment with soluble lymphocyte products in vitro. In contrast, macrophages from all seven resistant strains responded to lymphokine treatment and eliminated 80-90% of intracellular parasites. These results suggest that in vitro macrophage microbicidal activities predict the course of systemic leishmanial disease. PMID- 6850846 TI - Natural killing and antibody-dependent cellular cytotoxicity: characterization of effector cells by E-rosetting and monoclonal antibodies. AB - Recent investigations have indicated that the OKM1 hybridoma monoclonal antibody reactive with cells of the myelomonocytic series identifies a subpopulation of human peripheral blood mononuclear cells (PBMNC) which mediate natural and antibody-dependent cellular cytotoxicity (ADCC). However, it was not clear whether this OKM1+ group was heterogeneous with regard to cytotoxic function or the presence of receptors for sheep erythrocytes. Thus, the purpose of the present study was to further define the phenotype of the ADCC effector cell and natural killer (NK) cell using a combination of reactivity with hybridoma antibodies and separation of subsets by sheep erythrocyte rosette (E+) formation. Furthermore, the phenotypes of the NK population were assessed directly by performing two-color immunofluorescent staining on tumor cell conjugates. These studies led to the following conclusions: (1) that NK activity is mediated by both E+ OKM1+ and E- OKM1+ cells; the E+ OKT3+ cell possessed essentially no ADCC or NK activity; (2) that E+ OKM1+ cells mediated more NK activity on a per cell basis than E- OKM1+ cells; this was verified by separating OKM1+ cells on a cell sorter into E+ and E- with the OKT11 monoclonal antibody (anti-E-receptor antibody); (3) that E+ OKM1+ cells mediated both ADCC and NK activity; (4) that the phenotypes of PBMNC forming tumor cell conjugates were (a) OKM1+ (both E receptor positive and negative) and (b) OKM1- E-receptor positive. PMID- 6850845 TI - The migration of lymphocytes across specialized vascular endothelium. VI. The migratory behaviour of thoracic duct lymphocytes retransferred from the lymph nodes, spleen, blood, or lymph of a primary recipient. AB - Thoracic duct lymphocytes labelled with 51Cr were injected into a primary recipient and then were transferred for a second time from the lymph nodes (cervical and/or mesenteric), spleen, lymph, or blood into a series of final recipients. Measurement of the organ distribution of labelled lymphocytes in the final recipients enabled three main conclusions to be drawn. (1) Lymphocytes that had localized in the spleen, mesenteric lymph nodes (LN), or cervical LN of the first recipient showed no tendency to return in increased numbers to the same organ in the final recipient. (2) Lymphocytes that had recently entered the spleen or LN were temporarily impaired in their ability to reenter LN. This capacity was recharged when the cells returned to the lymph and the blood. (3) Lymphocytes that had been passaged from blood to lymph and collected for up to 4 hr at room temperature entered the LN of a recipient much faster than did nonpassaged thoracic duct lymphocytes collected overnight at 0 degree C. Supplementary experiments indicated that the different migratory behavior of thoracic duct lymphocytes under these two circumstances was mainly a consequence of their handling in vitro during the collecting and the labelling procedures. This functional impairment was not associated with a diminished ability to enter the spleen and bone marrow or to survive in recipients for up to 24 hr. PMID- 6850847 TI - Specific TPA-induced protein phosphorylations in cultured myotubes. PMID- 6850848 TI - Intercellular coupling during maturation of the rat seminiferous epithelium. PMID- 6850849 TI - The organization of the vitelline envelope in the lizard Tarentola mauritanica. PMID- 6850850 TI - Intercellular communications during early development of Paracentrotus lividus. PMID- 6850851 TI - Filipin labelling of lipid droplets in lactating rat mammary gland. PMID- 6850853 TI - The nucleus negatively controls the synthesis of mitochondrial proteins in the sea urchin egg. AB - Enucleation of Paracentrotus lividus eggs, followed by parthenogenetic activation induces a sharp increase in the synthesis of mitochondrial proteins as shown by electrofluorography after in vivo labeling with radioactive amino acids. These results further substantiate the hypothesis that the cell nucleus negatively controls mitochondrial replication in the sea urchin egg. PMID- 6850852 TI - Time-related increase of nucleolar size and villus cell number during DMH carcinogenesis in the rat duodenal epithelium. PMID- 6850854 TI - Retinol increases synthesis and secretion of Sertoli cell mannose-containing glycoproteins. AB - Sertoli cell isolated from prepuberal rats were cultured in a chemically defined medium in the presence or in the absence or retinol. In the two experimental conditions the incorporation of 3H-mannose into cellular glycoproteins was measured. The results obtained demonstrated a 3 fold increase of mannose incorporation into cellular glycoproteins after retinol addition without any qualitative variation of their electrophoretic profile. Sertoli cell secretory activity increased of approximately 50% after retinol administration; the electrophoretic analysis showed that two of the secretory products were selectively enhanced by the vitamin addition. PMID- 6850856 TI - Binary dividing cells of Chlorella. PMID- 6850860 TI - Activated macrophages: inductors of endocard lesions in murine malaria. PMID- 6850855 TI - Structural defects in DNA from primary hepatocyte cultures. AB - Structural analysis of DNA from primary hepatocytes has been made by chromatography on benzoylated-DEAE-cellulose. DNA was labelled in vivo by incorporation of 3H-TdR after partial hepatectomy 2 weeks prior to animals being used to establish hepatocyte cultures. Structural change in DNA associated with the transition to primary culture was assessed by comparison of data with that obtained when DNA was isolated from the intact organ immediately after death. In terms of this comparison, DNA from primary hepatocytes was bound more extensively to benzoylated-DEAE-cellulose in the presence of 1.0 M NaCl. Thus 32% of primary hepatocyte DNA was recovered in the formamide-eluted fraction after chromatography, a result which regions. This proportion of formamide-eluted DNA in primary hepatocytes could not be further reduced by extensive shearing and could not be affected by manipulation of the isolation procedure. Analysis of DNA isolated from hepatocyte cell lines revealed structural characteristics similar to DNA isolated from intact liver. The data imply that extensive structural damage to DNA is a consequence of the primary status of the hepatocytes examined. PMID- 6850858 TI - Effects of dipyridamole (Persantin R) on morphology and motility of mouse embryo cells. AB - DPD inactivates the edges of cultured mouse embryo cells. Pseudopodal activity is inhibited and spreading is reduced. Concomitantly, the growth rate of the cells is reduced. The interference reflection image shows very large close contacts under DPD treated cells. The translocation speed of the cells is unaffected. DPD penetrates into the cytoplasm, but less or not into the nucleus. PMID- 6850857 TI - Enhanced 5-hydroxytryptamine sensitivity of morphologically differentiated neuroblastoma cells. AB - The addition of 2% (vol./vol.) dimethyl sulfoxide to replated confluent cultures of NIE-115 neuroblastoma cells abolishes cell-proliferation and induces extensive neurite formation. The morphologically differentiated cells exhibit higher resting membrane potential and higher input resistance. In addition the differentiated cells also express an increased sensitivity to 5 hydroxytryptamine. PMID- 6850861 TI - Electron microscopy of bone formed by syngeneic transplanted calvarial osteoblasts. PMID- 6850859 TI - Responses of mouse cell lines transformed by various means to histidinol/cytosine arabinoside treatment. AB - The responses of the phenotypically-normal BALB/c 3T3 mouse cell line A31 and three of its transformed derivatives, BP-A31 (a benzo(a)pyrene transformant), M A31 and SV-A31 (Moloney murine sarcomavirus and SV-40 virus transformants, respectively) to L-histidinol and to L-histidinol/cytosine arabinoside (AraC) combinations were investigated. As observed in comparable studies with other normal cell lines, prior treatment of the A31 parental line with L-histidinol led to significant protection from AraC-mediated toxicity. However, in contrast to previous analyses of a number of other transformed cell lines which showed enhanced AraC-mediated toxicity upon prior exposure to L-histidinol, the three types of A31 transformants were afforded varying degrees of protection from AraC when treated with histidinol. These findings support the concept that transformed, tumorigenic cells may retain certain growth properties of their nontumorigenic parental cells. PMID- 6850862 TI - Birbeck granules involved in endocytosis of ferritin-anti-ferritin complexes in thymic interdigitating cells. PMID- 6850863 TI - Human fibroblasts X mouse cell hybrids, containing a human 11/X translocation, do not express human fibronectin. AB - Using a monoclonal antibody specific for human fibronectin (FN), we screened hybrid clones derived from the fusion of FN+ human fibroblasts, carrying a 11/X translocation, and FN-, HPRT- mouse cells for the production of this glycoprotein. Since no hybrid clone retaining the human der 11 chromosome was found to produce any human fibronectin, the segment of chromosome 11 included in the rearranged chromosome (11qter leads to 11p13) probably does not carry the structural locus for fibronectin. PMID- 6850865 TI - Synergism of endogenous inhibitors, exogenous cytostatic agents and hormones in arrest of proliferation. AB - The synergism between endogenous regulators of proliferation (protors), alkylating agents and hormones in vitro was studied. The effects were monitored by the incorporation of 3H-TdR into human and rat short term bone marrow cultures and by the formation of mouse granulocyte-macrophage colonies in semisolid agar capillaries. An additive and/or slight potentiating synergism was demonstrated between different types of inhibitory protors (GI-3S2, GI-3S3 and GI-3B), between GI-3 and hydrocortisone, and between GI-3 and the alkylating agents (adriamycin, dianhydrogalactitol) examined. The results offer a real possibility of strengthening the inhibition of neoplastic proliferation without increasing cytotoxicity of the drugs used. PMID- 6850864 TI - Purification and partial characterization of ring-shaped miniparticles. AB - Small ring-shaped miniparticles, found in the nucleus nucleolus and cytoplasm of a variety of normal and malignant cells, have been purified by a procedure involving differential and gradient centrifugation, hydroxylapatite chromatography and preparative electrophoresis. They are multisubunit proteins comprised of at least six polypeptide chains of Mr 20,000-30,000 Daltons (by one D SDS-PAGE which present a series of 20-30 spots on two-D IEF/SDS gels. They can be reversibly dissociated in EDTA containing buffers. They are not membrane associated and contain no carbohydrate. They have an S20,W of 21S on sucrose gradients. They are immunologically similar in several human cell lines. PMID- 6850866 TI - Characterization of pinocytic vesicles from CHO cells: resolution of pinosomes from lysosomes by analytical centrifugation. AB - Pinocytic vesicles (pinosomes) and lysosomes from suspension cultured, Chinese hamster ovary (CHO-S) cells have been resolved as two non-overlapping organelle populations by analytical centrifugation in Percoll gradients. Pinosomes were labeled with either horseradish peroxidase (HRP), a fluid phase content marker, or by radioiodination by pinocytosed lactoperoxidase (LPO). CHO-S cell lysosomes followed by three different marker enzymes and electron microscopy behaved as a single, dense organelle population. Pinosomes were partially resolved from plasma membrane, a less dense organelle population. PMID- 6850867 TI - Skin fibroblasts from humans predisposed to colon cancer are not abnormally sensitive to DNA damaging agents. AB - We report here that skin fibroblasts from individuals with hereditary adenomatosis of the colon and rectum (ACR), an autosomal dominant trait, were not abnormally sensitive to x-rays, UV-light or MNNG. ACR cells were also competent in restoring x-rays and UV-light induced damage of SV40 T-antigen expression following infection of these cells by the irradiated virus. We concluded, therefore, that sensitivity to x-rays, UV-light and MNNG can not be used to identify gene-carriers dominantly predisposed to colon cancer. PMID- 6850868 TI - Influence of Sertoli cell products upon the in vitro survival of isolated spermatocytes and spermatids. AB - We have investigated the effect of Sertoli cell products upon the in vitro survival of isolated pachytene spermatocytes and round spermatids using co cultures without contact between the somatic and germ cells. 3H-leucine incorporation was measured in such conditions at different culture times and compared with that of isolated germ cells incubated in presence of different energetic substrates. Dependence upon pyruvate and Sertoli cell products with respect to lactate is shown and discussed for both cell types; differences in pyruvate requirement are reported between meiotic and haploid cells. PMID- 6850871 TI - [The binding of drugs to proteins. I. General significance for drug kinetics]. PMID- 6850869 TI - Myofibroblast-like cells in non-pathological bovine endometrial caruncle. AB - The fine structure of the fibroblastic cells of the normal bovine endometrial caruncle was described. These cells appeared different when compared with the classical fibroblasts encountered throughout the rest of the stromal endometrium. They possess some features similar to those of myofibroblasts reported in various pathological states, to those of epithelioid fibroblasts and to those of cultured fibroblasts. However, they appeared distinct by a few other aspects. We described here the ultrastructure of these particular fibroblastic cells, as they appeared in the caruncle in vivo and under physiological conditions. PMID- 6850870 TI - [Detection limits in the photometric determination of salicylates with ferric nitrate in serum]. PMID- 6850872 TI - [Nodular lymphatic hyperplasia of the small intestine associated with hypogammaglobulinemia and amyloidosis]. PMID- 6850873 TI - [12th May hepatology symposium. Karlovy Vary, 4-6 May 1982]. PMID- 6850874 TI - [Smoking habits in patients with nonspecific intestinal inflammation]. PMID- 6850875 TI - [Longitudinal study of rat intake in a student canteen]. PMID- 6850876 TI - [The effect of calcium chloride on the ulcerogenic effects of phenylbutazone and reserpine in relation to the calcium content of the stomach wall in rats of various ages]. PMID- 6850878 TI - [Anatomy of the embryonic umbilicus (a study using scanning electron microscopy)]. PMID- 6850879 TI - [Suggestion for a new classification of pregnancy with cardiac and vascular defects]. PMID- 6850877 TI - [Use of testosterone determination in amniotic fluid for prenatal sex determination]. PMID- 6850880 TI - [Care of benign lesions of the uterine cervix using the KG-80 cryocauterization apparatus]. PMID- 6850882 TI - [The rooming-in system from the viewpoint of the pediatrician]. PMID- 6850881 TI - [Early postnatal sterilization]. PMID- 6850883 TI - [Nitroimidazole trichomonacidal preparations in the treatment of anaerobic pelvic infections]. PMID- 6850884 TI - [Menstrual tampons--potential risk factor in toxic shock]. PMID- 6850885 TI - [A closing word on the successful discussion on "What shall we do with a diagnosed precancerous condition?"]. PMID- 6850889 TI - [Long-term study of the incidence of the birth of premature fetuses in Czechoslovakia]. PMID- 6850887 TI - [Effectiveness of inviting women for periodic preventive examinations using a computer]. PMID- 6850888 TI - [For requesting adoption there is not always "plenty of time"]. PMID- 6850891 TI - [The role of anaerobes in severe pelvic infections]. PMID- 6850890 TI - [Prenatal treatment of fetal hypotrophy using long-term glucose infusions. IX. Neurologic development of children up to 18 months of age]. PMID- 6850886 TI - [Rooming-in--legal aspects]. PMID- 6850892 TI - [Results of urodynamic examination of various degrees of urinary stress incontinence in women]. PMID- 6850894 TI - [Choice of anesthesia in microsurgery of the larynx with complicating cardiovascular diseases]. PMID- 6850893 TI - [Motor feedback mechanisms in stuttering attacks]. PMID- 6850896 TI - [Problems of frontobasal injuries]. PMID- 6850895 TI - [A suggestion for methodical instructions for admission for periodic examinations of workers at risk from noise]. PMID- 6850898 TI - [Thermal effects of ultrasound on the human hypophysis in experiments]. PMID- 6850897 TI - [Topography of the glandular tissue of the pharynx and larynx and its relation to clinical problems]. PMID- 6850900 TI - [Biochemical aspects of the postnatal adaptation of newborn infants]. PMID- 6850901 TI - [Collagen diseases in children and adolescents]. PMID- 6850899 TI - [Central auditory analyzer in occupational hearing loss caused by noise]. PMID- 6850902 TI - [Determination of blood glucose levels of newborn infants of diabetic mothers]. PMID- 6850904 TI - [Experience with measuring the level of serum theophylline in infants and toddlers]. PMID- 6850903 TI - [Comparison of the clinical reactivity and immunological effectiveness of adsorbed and non-adsorbed sub-unit influenza vaccine]. PMID- 6850905 TI - [Salmonella gastroenteritis in children less than a year old]. PMID- 6850906 TI - [Fractures of the skull in infants and small children]. PMID- 6850907 TI - [Fibromatosis of the larynx in childhood]. PMID- 6850908 TI - [Congenital hypochloremic alkalosis. A case report]. PMID- 6850909 TI - [Inappropriate antidiuretic hormone secretion syndrome in an infant with an acute respiratory disease]. PMID- 6850910 TI - [Bone maturation in premature children in the early stages of development]. PMID- 6850911 TI - [Morbidity of school children in Most]. PMID- 6850912 TI - [Findings in computerized tomography of the brain in perinatal hypoxia]. PMID- 6850913 TI - [Study of blood glucose levels in newborn infants]. PMID- 6850914 TI - [Further development of children with a low birth weight after 6 years of age]. PMID- 6850916 TI - [Volvulus of the appendix]. PMID- 6850915 TI - [Problems of thelarche praecox]. PMID- 6850917 TI - [Modern classification and nomenclature of viruses]. PMID- 6850918 TI - [Advances in pediatric surgery and realization of the results of research activity in practice during the past 10 years]. PMID- 6850919 TI - [Mortality of children from 1 to 14 years of age from injuries in Czechoslovakia from 1950 to 1980]. PMID- 6850920 TI - [Radiographic problems of post-traumatic aneurysms of the aorta and its branches]. PMID- 6850921 TI - [Diagnostic and therapeutic punctures of renal cysts]. PMID- 6850922 TI - [The position of computer tomography and lymphography in the diagnosis of diseases of the pelvic and abdominal lymph nodes]. PMID- 6850923 TI - [Bilateral hypoplasia and occlusion of the internal carotid artery of non arteriosclerotic origin]. PMID- 6850924 TI - [Osteoblastoma]. PMID- 6850925 TI - Incorporation of radioactivity from labeled Di-(2-ethylhexyl)phthalate into DNA of rat liver in vivo. AB - Di-(2-ethylhexyl)phthalate (DEHP), when fed at high levels in the diet for two years, is reportedly an hepatocarcinogen to rats and mice. Radioactivity from ethylhexyl-labeled, but not from phthalate-labeled, [14C]-DEHP is associated with highly purified DNA from the livers of treated rats and this radioactivity is not accounted for by assumptions of adsorption, intercalation, attachment to RNA or histones, an impurity in the labeled DEHP, or artifactual binding during sample workup. Spontaneous binding of radioactivity to DNA from either ethylhexyl labeled DEHP or its total urinary metabolites could not be detected. Although rat liver slices generated all of the known metabolites of DEHP in vitro, no binding to DNA occurred. Administration of dual 3H/14C-labeled DEHP to rats yielded liver DNA whose 3H/14C ratio was inconsistent with the attachment of any reasonable multi-carbon fragment from the ethylhexyl portion to the DNA. The observation that roughly 100 times as high a percentage of the 14C administered was found in urea as in total DNA suggests that the 14C entered DNA through carbamyl phosphate, a precursor of both urea and pyrimidine bases. If this is the case, the association of C-1 from the ethylhexyl portion of DEHP with DNA may not involve alteration of the DNA or genetic damage. PMID- 6850926 TI - Biochemical assessment of the bioreactivity of intratracheally administered polyvinyl chloride dust in rat lung. PMID- 6850927 TI - DNA breakage by methyl methanesulfonate and its repair in brain and liver cells cultured from fetal rat and mouse. AB - DNA strand breakage and repair following methyl methanesulfonate (MMS) treatment of primary cell cultures from 14-day fetal Sprague-Dawley rat brain and liver and 12-day fetal C57BL/6 mouse brain and liver, were studied using alkaline sucrose density gradient analysis. Cells were incubated with MMS (7 mM or 14 mM) for 20 min and harvested for alkaline sucrose gradients 40 min or 24 h later. The extent of initial damage in fetal rat and fetal mouse cells was comparable. Fetal mouse brain and liver and rat liver showed nearly complete repair 24 h after treatment. However, fetal rat brain cells showed comparatively little repair after 24 h. The possible significance of a repair deficit in cultured rat fetal brain cells and the striking neurogenic organotropism of transplacentally administered direct acting alkylating agents in the rat is discussed. PMID- 6850928 TI - The effects of N-methyl-N'-nitro-N-nitrosoguanidine on KB cells. I. Growth inhibition and cell killing in relation to inhibition of macromolecular synthesis. AB - Cytotoxic effects of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) on KB cells were analyzed taking into account cell killing and growth inhibition. Attempts to correlate these effects with macromolecular synthesis inhibition were monitored. At low doses (1 X 10(-6) at 1 X 10(-5) M), MNNG acting for 1 h only inhibited cell proliferation in a dose dependent manner and specifically inhibited DNA synthesis. At intermediate doses (1.6 X 10(-5) at 3.2 X 10(-5) M), treatment resulted in detachment and death of the cells during a 20-h post-incubation period. This effect was related to a dose-dependent inhibition of RNA and protein synthesis. At high doses (greater than 3.2 X 10(-5) M) MNNG treatment resulted in cell killing which was distinct from that produced by lower doses, since the cells did not detach from the glass. At these high doses strong inhibition of RNA and protein synthesis was observed early. When cells prelabelled with radioactive uridine or amino acids were treated with MNNG, the release of labelling into the culture medium increased, especially with uridine prelabelled cells. This increase was very high with the intermediate doses of the drug, but more modest with the strong doses. Furthermore, with the moderate doses, cell size showed greater reduction compared to the control than with the high doses. Thus, cell size reduction and loss of cellular material varied parallel to cell detachment. We hypothesize that moderate doses of MNNG may induce cellular degradation, whereas high doses may prevent it. The significance of this finding is discussed. PMID- 6850929 TI - A new efficient method for conversion of corticosteroid 17 alpha,21-cyclic ortho esters to 17 alpha-acyloxy-21-chloro-21-deoxy derivatives. PMID- 6850930 TI - Sparsomycin analogs. II. Synthesis and biological activities of 5-carboxy-6 methyluracil derivatives. PMID- 6850932 TI - New chromogenic substrates for the assay of esterases--acetates and butyrates of phenolic naphthylazo compounds with sulfonic acid group. PMID- 6850933 TI - Evaluation of corticosterone secretion-inducing activities of ginsenosides and their prosapogenins and sapogenins. PMID- 6850934 TI - Purification and properties of glutathione peroxidase from human liver. PMID- 6850931 TI - Studies on quantitative structure-activity relationships. V. QSAR investigations of rifamycin B amides and hydrazides by utilization of the substituent entropy constant sigma s degrees. PMID- 6850935 TI - Transformation of hemoglobin by various peroxides in vitro. PMID- 6850936 TI - Sorbitol pathway in lenses of normal and diabetic rabbits. PMID- 6850938 TI - Hydralazine-phenobarbital interactions in rats. II. Disposition of hydralazine and its acid-labile conjugates, and liver drug-metabolizing enzyme activities in normotensive and spontaneously hypertensive rats. PMID- 6850939 TI - Preparation and evaluation of gelatin microcapsules of sulfonamides. PMID- 6850937 TI - Influence of fatty acid composition on the properties and polymorphic transition of fatty suppository bases. PMID- 6850941 TI - Biopharmaceutical evaluation of gelatin microcapsules of several oral antibiotics. PMID- 6850942 TI - Effect of simultaneous administration of drugs on absorption and excretion. XV. Effect of probenecid on plasma protein binding of sulfadimethoxine in rabbits: the role of N4-acetylsulfadimethoxine, the major metabolite of sulfadimethoxine. PMID- 6850940 TI - Biopharmaceutical evaluation of gelatin microcapsules of sulfonamides. PMID- 6850943 TI - Magnetic guidance of Ferro-colloid-entrapped emulsion for site-specific drug delivery. PMID- 6850944 TI - Enhancement of oral bioavailability of spironolactone by beta- and gamma cyclodextrin complexations. PMID- 6850945 TI - Studies on the absorption, distribution, excretion and metabolism of ginseng saponins. II. The absorption, distribution and excretion of ginsenoside Rg1 in the rat. PMID- 6850946 TI - Interaction of 3',4'-dideoxykanamycin B with a lysosomal enzyme, N-acetyl-beta-D glucosaminidase. PMID- 6850947 TI - The analysis of fatty acid binding to protein using a modified equilibrium dialysis method: detailed analysis of chromophore-fatty acid-protein interactions. AB - In this paper we extend our previous analysis of fatty acid-chromophore-protein interactions using a modified equilibrium dialysis method described previously. A more rigorous mathematical treatment is combined with a micro-dialysis method using a maximum volume of dialyzate of between 250 microliters and 400 microliters to examine the suitability of different chromophores (mepacrine, quinine, chloroquine, chlorpromazine, methylene blue, rhodamine 6G, 6 carboxyfluorescein) for studying the binding of fatty acid to protein. The macro- and micro-methods of dialysis are compared, and the binding of fatty acid to bovine serum albumin and beta-lactoglobulin discussed as examples of the method. Problems associated with propagated errors in the measurements and obtaining the number of binding sites and the binding constants from curve-fitting are also considered. PMID- 6850948 TI - Raman spectroscopic and X-ray diffraction studies of the effect of temperature and Ca2+ on phosphatidylethanolamine dispersions. AB - Raman spectroscopy and X-ray diffraction are used to study the effect of heat and Ca2+ on dimyristoylphosphatidylethanolamine dispersions. Unlike phosphatidylcholine dispersions, dimyristoylphosphatidylethanolamine bilayers (at pH 8) require heating above Tm in order for hydration to occur and apparently bind Ca2+ at very low levels. These results are related to models for membrane fusion. PMID- 6850949 TI - Association of cholesterol with lysophosphatidylcholine. AB - With equimolar cholesterol, lysophosphatidylcholine (lysoPC) or 1-ether-2 deoxylyso-phosphatidylcholine (etherdeoxylysoPC) form unilamellar vesicles of identical dimensions. 13C-NMR spectra of such vesicles are interpreted on the premise that suppression of a signal by broadening (i.e. decrease of T*2 relaxation time) indicates a decrease of motion of the carbon atom relative to its surroundings. The signals for sn-glycerol C-1 and C-2 are completely suppressed in the lysoPC-cholesterol vesicles. In contrast, in the vesicles containing etherdeoxylysoPC, all three glycerol carbon signals make their appearance, with the T*2 of C-2 approaching the T*2 in the monomolecularly dissolved lysolipid. This result argues for lipid-lipid complexing in the "hydrogen belts' of the lysoPC-cholesterol bilayer, specifically, for hydrogen bonding involving the hydroxyl and carbonyl groups of lysoPC and the hydroxyl of cholesterol. PMID- 6850950 TI - Electrostatically induced change of the conformational order of charged lipid membranes. PMID- 6850951 TI - [Malignant lymphoma or Burkitt's tumor. Apropos of 2 cases]. AB - Two cases of Burkitt's tumor treated in the Pediatric Hospital, Owendo, Libreville are discussed. The tumors were of the maxillofacial type, and remission by chemotherapy was obtained for a period of between 6 to 8 months. After this length of time, and in spite of spectacular local results, metastases developed and led to a fatal outcome. Cyclophosphamide chemotherapy is effective locally, but does not prevent recurrence. PMID- 6850952 TI - [The place of surgery in the treatment of neuroblastoma]. AB - From 1957 to 1980, 170 neuroblastoma were surgically approached: 3 cervical, 11 thoracic, 147 abdominal, 5 pelvic. The surgical data gathered from this large series leads us to assess that there are great differences between lateral and median neuroblastoma. Lateral ones can be surgically removed without major risk. Median ones arising from sympathetic nerves which depend on the aorta or on the visceral arteries (coeliac or mesenteric) cannot be removed totally without life threatening risk. These data do not agree with Evans and d'Angio staging. Indeed, stage I and II are only observed in neuroblastomas developed on the lateral nerves of the sympathetic chain and can be removed. Stage III tumors can also be removed surgically when arising from a lateral site, even if they cross the median line. On the contrary all median perivascular neuroblastomas are to be staged III: total removal is not possible and the surgical risk is too high when compared with efficiency of chemotherapy. A special type, the distal perivascular neuroblastoma, is pointed out (5 cases). It is very important to precise exactly the initial localization of neuroblastoma, whatever be their metastatic extension. The new technics of investigation (C.T., ultrasonography, but also plain film and front and lateral views of intravenous pyelogram) allow to define precisely the median or lateral site of the tumor and also to choose between a non-surgical (median) or a surgical (lateral) treatment. This distinction seems in correlation with the two different ways of pathway of the embryonic neuroblast cells. PMID- 6850955 TI - [One-stage correction of posterior hypospadias using a transverse pediculed flap (Duckett's operation). Apropos of 50 cases]. PMID- 6850953 TI - [Mesocaval H shunt using an external iliac graft in the treatment of portal hypertension in children]. AB - The authors reported four cases of mesocaval interposition shunt in children with autogenous vein graft. In three cases, external iliac vein was used as the graft because its appropriate size in diameter and length; for local reasons, jugular graft was used in last case. Post-operative controls by angiography in all patients except the one recent case showed a patent anastomosis; esophago gastric endoscopy three month post operatively in the last case showed regression of varices. External iliac vein is convenient to this shunt. Edema of the lower limb is minimal and well tolerated. The control of hypersplenism and esophogastric varices is progressive with time. PMID- 6850954 TI - [Enlarged substitutive colocystoplasty for congenital neurological bladder in children. Apropos of 8 cases]. AB - The encouraging success of replacement of the detrusor for contracted bladder due to a tuberculosis or other causes prompted an attempt to reconstruct bladder in a patient with neuropathic bladder. Colocystoplasty has been used by the authors in a total of 12 children with neurogenic bladder: 8 with a sufficient follow-up (6 months to 10 years). Technical data are given with some details. The sclerosed detrusor inducing elevated bladder pressure must be resected and the sigmoid is anastomosed to the trigone of the bladder. The sigmoid conduit is extraperitonized. The new colonic bladder give ample and supply cystern allowing protection of ureters and kidneys. The incontinence is not modified. Simultaneously with colocystoplasty the patient must be managed by self catheterization or by urinary artificial sphincter or by a continent cystostomy. The initial results are very encouraging. PMID- 6850957 TI - [Intra-uterine urologic surgery in the lamb. Development of an experimental protocol]. PMID- 6850956 TI - [Treatment of anterior hypospadias. Place of balanoplasty]. AB - Authors report their experience of the treatment of anterior hypospadias which represent more than 71% of these cases operated all along the eight past years. The different aspects of these malformation are emphasized. For the majority of these cases the correction of the malformation may be obtained by a simple balanoplasty which gives the gland a normal form and height though directing the meatus forward; the redundant foreskin is excised and the penile skin torsion is corrected aligning the median raphe; a deficit of the ventral skin case be filled in with preputial flaps. This technic was used in fifty of the reported cases with very good results both functionally and cosmetically. This procedure is comparable to the technic described by J.W. Duckett and called Magpi for meatal advancement and glanduloplasty incorporated. The results reported here corroborate the good results already published. PMID- 6850958 TI - [Separation of pygopagous Siamese twins]. AB - The successful separation of pygopagous twins is described. The sacrum formed a common canal since S 1 to coccyx with two medullary cords side to side and diastematomyelia with, at this level, two dural sacks. In each baby there was small atrophy in one lower limb. There were two opposite vulvovaginal ducts and two recto-perineal fistules. PMID- 6850959 TI - [Congenital tracheoesophageal fistulas without esophageal atresia]. AB - Between 1961 and 1982 sixteen patients with tracheo-oesophageal fistulae without oesophageal atresia (H type fistula) were treated at Hopital Ste-Justine and Centre Hospitalier de l'Universite Laval. Nine patients were male and seven female, with a mean birth weight of 2.8 kg. Five were premature. All presented at first feeding with coughing, choking and cyanosis. Seven had abdominal distension and six had hypersalivation. Mean age at time of definitive diagnosis was 39.1 days. The diagnosis was confirmed radiologically in all patients, a mean of 1.69 cine-radiographic procedures per patient being required. Cervical region (C7 - T2) fistulas were present in 14 and thoracic in 2 patients. Twelve patients were operated via a cervical approach and four via a thoracic approach. A Fogarty catheter was in place in 2 fistulae pre-op. Two patients required gastrostomy. Refeeding was started 3 days post-operatively. One died and one had fistula recurrence. Fifteen patients survived. One survivor had multiple episodes of cardio-respiratory arrest. None had major swallowing difficulties. We consider it imperative that fistulae be visualized before surgical intervention. Catheterization of the fistula utilizing a Fogarty catheter should be attempted prior to surgery. It is dangerous to dissect a cervical fistula via a thoracotomy. PMID- 6850960 TI - [Physiologic surgery for anomalies of the cardio-hiatal region]. AB - In 11 years (1971-1981) 1.040 cases of anomalies of the cardio-hiatal sector have been controlled in the Children's Hospital of the Social Security of Barcelona, 101 patients were operated. Surgical indication was based on the following facts: size of the hernia, poor clinical evolution with postural treatment, or infants of more than 2 years who also presented a high gastric acidity or a clearly pathological pHmetry, or, lastly, a social cause. We have used a much more physiological technique than that of Nissen, based on the obtention of a large segment of the abdominal esophagus on which changes of pressure existing in the abdominal and thoracic cavities can act, clearly registered in manometric studies effected before and after operation. The few complications observed in this large series of operated children speak clearly in favour of its necessary diffusion and utilization. PMID- 6850961 TI - [Surgical treatment of gastroesophageal reflux by partial posterior fundoplication. Apropos of 33 cases]. PMID- 6850962 TI - [Peptic esophagitis fistulated into the left atrium with food emboli in a 13-year old child]. PMID- 6850963 TI - [Risk of recurrent laryngeal nerve palsy in surgery of esophageal atresia]. AB - From the last 100 cases of esophageal atresia treated since october 1975, the authors emphasised the incidence of left or right recurrent laryngeal nerve palsy. This incidence is about 20%. Most often, an unilateral palsy is asymptomatic, but in a few cases many complications have been reported. Therefore it is necessary to insist on the surgical and anatomic factors which could increase the risk of a nervous injury and the technics to prevent it. PMID- 6850964 TI - [Barotraumatic rupture of the thoracic esophagus in children. Apropos of a case]. AB - Presenting symptoms in an 8-year-old child, subjected to high pressure in the upper respiratory and digestive tracts following bursting of a truck inner tube, were initially only pleuropulmonary in nature. A secondary diagnosis of rupture of the thoracic esophagus was established by radiological follow-through examination using a water soluble medium. The presence of an esophagopleural fistula led to repair of the esophageal tear on the 5th day. Operation involved wide mediastinal and thoracic drainage, protection of the esophageal suture by a minimal pharyngostomy, and the performance of an evacuation gastrostomy and an alimentation jejunostomy. Bipolar esophageal exclusion can be avoided by the use of this technique. When confronted with closed thoracic injuries due to high pressures exerted on the upper respiratory and digestive tracts, radiological examination of the esophagus employing water-soluble media should be conducted, therefore, to enable early diagnosis of any esophageal rupture. Furthermore, from the therapeutic point of view, even after secondary discovery of an esophageal tear, suturing is not contraindicated by the direct approach as long as protection is provided by minimal pharyngostomy and a gastrostomy, this avoiding the need for bipolar exclusion. PMID- 6850965 TI - [Abdomino-pericardial hernia as a result of an anomaly of the septum transversum. Apropos of a case in a newborn infant]. AB - This is a case report of a peritoneo-pericardial diaphragmatic hernia revealed by a respiratory distress in a newborn infant. Radiography and angiocardiography allowed preoperative diagnostic and the patient was operated upon successfully on two days of age. Anatomic finding was a defect of the central tendon of the diaphragm with a hernial sac. This anomaly is rare and probably results from a misdevelopment of the septum transversum. PMID- 6850966 TI - [Value of neuroleptoanalgesia in preventing recurrence of fetal shunts during treatment of diaphragmatic hernias]. AB - A leptanalgesia (Chlorpromazine-morphine) was used in the treatment of postero lateral diaphragmatic hernia in six neonates. The treatment which was begun immediately after the arrival of the child and continued during and after surgery seemed to contribute to the favorable outcome observed in five of the babies. In spite of the empirical nature of their argument, the authors suggest the possible mechanism of action of the treatment. However they recognize that its effectiveness can only be assessed after careful hemodynamic studies. PMID- 6850968 TI - [Wound infection in pediatric surgery]. AB - During the five-year period 1977-1982, 97 (3,37%) out of 2,898 pediatric surgical wounds became infected, 23 out of 2,140 (1,07%) corresponded to "clean" wounds, 18/475 (3,8%) belonged to the "clean-contaminated", 14/91 (15,4%) to the "contaminated" and 42/192 (21,8%) to the "dirty" groups. These rates were somewhat lower than those found in similar studies carried out in adults. The bacteriologic studies revealed that the source of infection of "clean" wounds was exogenous and almost exclusively due to --Staphylococci, whereas that of most of the remaining wounds was the patient's own enteric flora, with aerobic and anaerobic bacteria and very constant presence of E. coli and B. fragilis. Our antibiotic policies were guided by this evidence. In spite of the lack of mortality related to this minor complication, the risk and uncomfort incurred by the patients aside with the higher cost of hospital stay justify every effort to prevent this complication. PMID- 6850969 TI - [Giant congenital paravertebral arteriovenous fistulas in children]. AB - Six cases of giant congenital paravertebral arteriovenous fistula in children are presented. In one case the fistula was jugulocarotid, in another case between the vertebral artery and jugular vein. Two were cases of fistulae in the lower thoracic region, and the last two were subclavian fistulae, one of which caused the death of the neonate. The principal embryologic and clinical features of these anomalies are described, and the choice between treatment by surgery or embolization discussed in the light of the new materials available for the latter procedure. PMID- 6850972 TI - The development of a test of overarm throwing: an application of generalizability theory. AB - Although much effort has been directed toward an understanding of sequential progressions between and within motor skills, little evidence is available to indicate that teachers have incorporated this material into instructional practice. The fact that pupil progress has been evaluated primarily through movement achievement (distance, velocity), rather than through movement content (analysis of form), has been postulated as a reason for this non-use. It was thus the purpose of this study to develop a reliable, objective and practical method of measuring one particular manipulative skill--that of overarm throwing. As such, previously developed sequential progressions were analyzed and modified to produce a measure which did not require the use of a camera. A system of rating throwing performance was adopted which allows for separate rating of the three components: "foot placement", "body rotation", and "arm action". Each component depicts five hierarchically arranged levels, or "steps", and performance is rated on a scale ranging from 1-5. The throwing test was administered to 78 subjects by three trained observers. Reliability analyses, through the use of generalizability theory, showed high objectivity (r's of approximately .90) and good day-to-day reliability (r's of .75 to .93) for most testing conditions. It was concluded that this test is a reliable, valid and practical test for the analysis of overarm throwing in children. PMID- 6850973 TI - Changes in the centre of mass and moment of inertia of a headform induced by a hockey helmet and face shield. AB - A study of the hockey helmet and face shield as potential contributors to cervical spinal cord trauma (burst vertebral fractures and cord injury) was undertaken. The main concern was whether the alteration in the location of the c of m or in the mass moment of inertia (Icm) of a player's head, induced by a helmet and face shield, would predispose him to a hyperflexion neck posture. The c of m and Icm of a bare Hodgson-WSU humanoid headform (H) were first determined and then the same measures were made with a helmet (H + h) and with a helmet and face shield (H+h+f). Of the nine different helmet and face shields evaluated none caused the c of m to move more than 6mm from that of H. Measurements made on minor hockey players aged 8 to 15 years indicated that the proportion of maximum isometric neck strength required to hold the head in the typical skating posture while wearing a helmet and face shield ranged from 8% to 12%. It seems unlikely that this would predispose to the hyperflexion neck posture. The Icm of H+h increased by 68% and of H+h+f by 89% from that of H and when translated to a pivot point on the neck (C7-T1) the change in I was 30% for H+h and 41% for H+h+f. The effect on the neck of such an increase in I could lead to strain on the neck ligaments and musculature but would not account for a burst fracture of a vertebrae. Thus, in and of themselves, the helmet and face shield do not appreciably alter the dynamics of the neck thereby predisposing the wearer to increased neck injury risk. PMID- 6850971 TI - [Value of herniography in the therapeutic management of inguinal hernias in young girls. Apropos of 148 cases]. AB - The authors report a study on 148 female children demonstrating clinical evidence for inguinal hernias. The diagnosis was evaluated using Ducharme-Bensoussan's procedure for herniography hernia was documented in 143 cases, so which 44% revealed genital tract content. Eight cases produces unrelated pathological findings, especially crural hernia, nephro-uropathy diaphragmatic hernia. However, the main interest of the procedure is in evaluating the controlateral inguinal canal. Whereas three infants presented with bilateral symptoms, bilateral hernia was proven in 66 cases (46,2%) by herniography. In this way, the procedure is a sure way to ensure that hernia is really unilateral and to prevent any controlateral recur in the coming months. PMID- 6850967 TI - [Arguments against routine surgery for acute intestinal intussusception. Apropos of 220 cases]. AB - 220 children with intussusception were treated at Rouen Children's Hospital between 1969 and 1981. The patients are separated in four groups according to the treatment: --primary operation without barium enema, --operation after failure of the barium enema, --surgical control after reduction by barium enema, --barium enema alone. This study shows that in the third group, the operation did not demonstrate neither any "lead-point", nor any intestinal damage requiring resection. A "lead-point" or an intestinal lesion have been found only in intussusceptions which had not been reduced by barium enema. Thus, one can conclude that a surgical control is useless when the barium enema is successful. The technique of the enema is described. PMID- 6850970 TI - [Pyogenic sacroiliac arthritis in children. Analysis and commentary apropos of 7 cases]. AB - Seven cases of pyogenic arthritis of the sacro-iliac joint in children were observed between 1968 and 1981. Their analysis is discussed with the conclusions of the too much rare publications in the recent literature. Taking in to account the anatomic particularities the necessity of very precise roentgenographic technics in order to assess the sacro-iliac joint, especially in children because of incomplete ossification, the authors replace this pathology into the osteomyelitis in children. From the clinical aspects of the disease, with its typically localized pain, and its acute clinical and biological septicemic syndrome, the authors attempt to demonstrate that the classical idea of a delayed diagnosis, is not absolute. Even in this particular localization, an early "up to date" diagnosis is possible allowing rapid treatment with efficient antibiotherapy directed towards the responsible germ after their isolation (especially staphylococcus aureus). Indubitable progress has been gained with systematic radio-nuclide bone scanning in emergency. PMID- 6850974 TI - Influence of exercise on body sway in the standing rifle shooting position. AB - Standing stability was measured in 16 male subjects during standing at rest, and aiming an air rifle at both rest and after an exercise bout simulating cross country ski racing. Subjects consisted of a control group with no previous shooting experience, groups of rookie and established biathletes, and experienced position rifle shooters. Anteriposterior and lateral positions of the subject's centre of pressure were determined by a force platform, sampled at 30 Hz over a 60 second period. Horizontal movement was calculated digitally from the anteriposterior and lateral position data. Body sway was greater (p less than 0.05) during aiming at rest than while standing at rest, and also greater during aiming after exercise than at rest. Body sway was significantly smaller (p less than 0.05) in the position shooters compared to subjects with 4 months or less of shooting training. The contribution of anteriposterior movement to body sway while standing at rest was approximately twice that of lateral movement. Greater increases in lateral movement with aiming and after exercise lead to similar contributions by both components of body sway. PMID- 6850975 TI - Relationship of selected variables to performance in women's basketball. AB - Twenty women were measured on physiological, anthropometric, motor fitness and skill related variables in order to provide a current profile of elite female basketball players. Performance of each subject was evaluated firstly to determine the relationship between performance and selected variables and secondly to determine which variables best discriminated between the top and lower ranked performers. The profile of the elite female player had changed considerably subsequent to rule changes. The better basketball players exhibited a superior aerobic power and anaerobic capacity, were more accurate shooters and possessed less body fat. The factors which best discriminated between high and low performers were accuracy shooting, percent fat and VO2max. These variables could be used in a test battery to assist in the selection and development of potential basketball players. PMID- 6850976 TI - The bicycle ergometer for muscle power testing. AB - The force-velocity relationship implies that the faster a contracting muscle is permitted to shorten, the weaker it becomes or the slower a contracting muscle is permitted to shorten, the stronger it becomes until it reaches maximal isometric tension. The relationship is hyperbolic for a denervated muscle but is inverse and linear for functionally innervated muscle groups. When the force of contraction is multiplied by the velocity of contraction, a power production curve is obtained. The purposes of the study were to examine the force-velocity relationship on a standard bicycle ergometer, to deduce a power-velocity curve, to compare the results of young men and women and to see if the measures were reproducible. Fifty-eight young men and women volunteered for the study. Testing consisted of pedalling as quickly as possible for five seconds at resistance settings from 2 to 7-kg. In order to evaluate the reproducibility of the scores, retesting was done one hour later. It was shown that the relationship between the resistance settings and the number of revolutions completed by the male and female subjects was inverse and linear. The higher the resistance setting was, the larger was the difference in the scores of the young men and women. When a power curve was derived for each group, a peak power was only identified in the female subjects and this was encountered at a 5-kg resistance setting. The scores obtained at a resistance setting of 5 and 7 kg for female and male subjects respectively showed the best reproducibility. The bicycle ergometer may not be used as an alternative but as a complementary tool to an isokinetic dynamometer. PMID- 6850977 TI - Speed reliability of cassette and tape players. AB - The playback speed of tape players directly affects the accuracy of some fitness tests. New and used portable cassette (n = 28) and tape (n = 16) players were generally found accurate (playback speed error less than 2% tolerance limit). The apparatus showed almost no speed variation over four consecutive trials. Four portable cassette players were also checked three times over ten days without any appreciable change in speed. Four cassette players (14%) were, however, found inaccurate making it necessary to possess a rapid method of checking speed accuracy. Similar or better results were found for open reel tape recorders. PMID- 6850978 TI - Error in estimating % fat. PMID- 6850979 TI - [One method of trans-cultural validation of psychological questionnaires: implications for sports psychology]. PMID- 6850981 TI - Synthesis of potential proximate and ultimate carcinogenic metabolites of 3 methylcholanthrene. PMID- 6850980 TI - Dibenz[a,h]anthracene-induced subcutaneous tumors in mice. Strain sensitivity and the role of carcinogen metabolism. AB - Four inbred strains of mice (C3H/HeJ, C57BL/6J, AKR/J, and DBA/2J) were injected s.c. with 150 micrograms of dibenz[a,h]anthracene and followed for 9 months. Strains C3H/HeJ and C57BL/6J were most susceptible to dibenz[a,h]anthracene induced carcinogenesis with 80% and 53% incidence of tumors, respectively. Strains AKR/J and DBA/2J were much less sensitive with only one tumor observed out of a total of 60 treated mice. Dibenz[a,h]anthracene was shown to induce hepatic aryl hydrocarbon hydroxylase activity in the two sensitive strains, C3H/HeJ and C57BL/6J, but not in the two resistant strains, AKR/J and DBA/2J. When 3-methylcholanthrene-treated liver microsomes from the four strains were studied for dibenz[a,h]anthracene metabolism in vitro, the two sensitive strains not only demonstrated a 3- to 4-fold greater overall rate of metabolism than the two resistant strains, but also showed a quantitative shift with a greater percentage of the total metabolites being the 3,4-diol of dibenz[a,h]anthracene. This diol is the presumed precursor to the apparent ultimate carcinogen, dibenz[a,h]anthracene 3,4-diol-1,2-epoxide. PMID- 6850983 TI - Inhibitory effects of carbon tetrachloride on dimethylnitrosamine metabolism and DNA alkylation. AB - The effect of CCl4 pretreatment (dose range from 0.5 to 2.0 ml/kg body weight) on the pathways of dimethylnitrosamine (DMN) metabolism was investigated. The oxidative-N-demethylation by the enzymes, DMN-demethylase I and II operating at low (4 mM) and high (200 mM) substrate concentration, respectively, was greatly reduced in a dose-dependent manner. In addition, the generation of an electrophilic intermediate capable of methylating DNA, specifically at the N-7 and O-6 positions of guanine, was completely inhibited by CCl4 (0.5 ml/kg body weight) pretreatment. When indole feeding (1% in the diet for 8 days prior to CCl4 administration) was employed as a means to enhance DMN-demethylase activities, it was found that the reduction of DMN-demethylase activities was more pronounced in these rats than in the controls. In agreement with earlier findings, 7-methylguanine and O6-methylguanine were not detectable in the CCl4 pretreated group. These results suggest that CCl4 exerts a strong inhibitory action on hepatic DMN metabolism, in particular on the pathway leading to alkylation of DNA guanine. This phenomenon may explain the protective role of CCl4 against DMN-induced hepatotoxicity and perhaps, carcinogenicity, believed to be closely associated with the abnormal modifications of DNA. PMID- 6850982 TI - Sequential observations on the appearance of neoplastic lesions in the liver and kidney after treatment with N-ethyl-N-hydroxyethylnitrosamine followed by partial hepatectomy and unilateral nephrectomy. AB - Sequential observations were carried out on the induction of preneoplastic lesions in the liver and the kidney. Rats were initially given N-ethyl-N hydroxyethylnitrosamine (EHEN) in their drinking water (0.1%) for 3 days (Group 1), 1 week (Group 2) or 2 weeks (Group 3) or tap water (Group 4). Rats in Groups 1-3 were subjected to partial hepatectomy and unilateral nephrectomy (right side) 2 weeks after the end of EHEN treatment. Rats from these groups were killed in week 10, 20, 30 and 40 of the experiment. In the liver, the effect of EHEN in the induction of gamma-glutamyltranspeptidase (gamma-GT) positive foci and hyperplastic nodules (HN) was clearly dependent on the length of treatment. The preneoplastic lesions increased with the lapse of observation time. Changes measured as number of gamma-GT positive foci were 10-40 times greater than those measured as HN, especially among the small size range. Values for changes in Group 1 given 0.1% EHEN for 3 days were very low, indicating that this dose is close to the threshold. Two rats with hepatocellular carcinoma in Group 3 given EHEN for 2 weeks survived until week 40. In the kidney, tubular epithelial proliferations composed of cells with slightly basophilic cytoplasm and slightly atypical nuclei were tentatively named atypical cell foci (ACF). EHEN induced ACF, renal cell adenomas and renal cell carcinomas. The increase in the induction of ACF was dependent on the length of observation period but not on the length of treatment. Even though control rats (not treated with EHEN) also had ACF, their quantitative values were far less than the groups given EHEN and killed at week 40, indicating that a large number of ACF were induced by EHEN. Therefore, EHEN is good for experimental induction of preneoplastic lesions in the liver and kidney of rats. The experimental schedule for Groups 1 and 2 could be used as a shortterm screening test for promoters and the schedule for Group 3 as an assay for inhibitors. PMID- 6850984 TI - Evaluation of DNA damage by the alkaline elution technique in liver, kidneys and lungs of rats and hamsters treated with N-nitrosodialkylamines. AB - Induction of single-strand breaks in the DNA of three organs of BD-VI rats and Syrian golden hamsters was examined 4 h after a single i.p. dose of N nitrosodimethylamine (DMN) or N-nitrosodiethylamine (DEN). Damage was monitored in vivo by the alkaline elution method, in which DNA is dosed fluorometrically. DNA damage was induced by DMN in the liver and kidneys of rats and in the liver and lungs of hamsters, and by DEN in rat and hamster liver. High doses of the hepatocarcinogen and hepatotoxic compound carbon tetrachloride, did not induce DNA damage in rat liver. A correspondence between DNA fragmentation (our study) and tumour induction (reported in the literature) was found in the following organs: rat and hamster liver (DMN, DEN), rat kidney (DMN), rat lung (DMN, DEN), hamster kidney (DMN, DEN). In contrast, no such correlation was observed in rat kidney and hamster lung following DEN-treatment and in hamster lung following DMN treatment. Thus, the in vivo alkaline elution assay would appear to be most useful for detecting DNA damage by chemicals that are activated metabolically in the liver and that bind to hepatic DNA. PMID- 6850985 TI - A minimal dose of N-methyl-N-nitrosourea carcinogenic to heterotopically transplanted rat urinary bladder. AB - The present investigation was conducted to determine a single dose of the carcinogen N-methyl-N-nitrosourea (MNU) which remains subcarcinogenic in a heterotopically transplanted rat urinary bladder with a communicating reservoir (HTB) either in a urine-free or urine-existing environment. A single dose of MNU, either 0.1 mg or 0.025 mg, was instilled directly into the HTB, and was followed by weekly instillation of normal rat urine or 2.1% NaCl solution (equiosmolar to the urine) for up to 52 weeks. Bladder tumors observed were divided into 2 categories depending upon their location. Those arising at the hyperplastic foci which were induced by mechanical irritation by the connector tip were referred to as inflammatory polyp (IP)-related tumors and those arising in the region free from the IP changes were referred to as IP-unrelated tumors. The results indicated that both carcinogen levels fail to induce IP-related or IP-unrelated tumors in the urine-free environment. In the presence of urine, however, the high MNU dose (0.1 mg) was tumorigenic at both IP-related and IP-unrelated sites, whereas, the low MNU dose exhibited tumorigenicity only at the IP-related site. Physical irritation by the connector enhanced MNU-initiated tumorigenesis at the connector tip only in the presence of urine in bladder lumen. Physical irritation per se induced tumors at the connector tip even without prior carcinogen treatment provided urine was present in the HTBs. PMID- 6850987 TI - A biochemical defect in the repair of alkylated DNA in cells from an immunodeficient patient (46BR). AB - The fibroblast cell strain 46BR, derived from an immunodeficient individual, is hypersensitive to the lethal effects of a variety of DNA-damaging agents, this effect being particularly marked for monofunctional methylating agents. After u.v. irradiation 46BR cells show normal unscheduled DNA synthesis, daughter strand repair, and recovery of DNA and RNA synthesis. The inhibition of DNA replicative synthesis by u.v. is slightly less than that of normal cells. After gamma-irradiation the rejoining of strand breaks is normal as are the kinetics of replicative DNA synthesis. Following treatment with dimethylsulphate, replicative DNA synthesis is affected in a similar way to normal cells, unscheduled DNA synthesis may be increased relative to normal cells, but more strand breaks persist in 46BR than in normal cells. In addition 46BR cells are hypersensitive to the toxic effects of 3-aminobenzamide, an inhibitor of ADP-ribosyl transferase. This enzyme is involved in the ligation step of repair of alkylation damage. A hypothesis is presented suggesting that 46BR may be defective in DNA ligase I. PMID- 6850986 TI - Effect of dietary cholesterol on azoxymethane-induced colon carcinogenesis in rats. AB - The effect of dietary cholesterol on azoxymethane (AOM)-induced colon carcinogenesis was evaluated with two different sets of experiments. Starting at 6 weeks of age, male Donryu rats were divided into four groups, and fed either control chow or one supplemented with 1% cholesterol, and with or without AOM (11 weekly s.c. injections at a dosage of 7.4 mg/kg body weight). The rats were sacrificed at 20 weeks after (first experiment) and at 15 weeks after (second experiment) the last injection of AOM. The AOM-treated groups in both experiments developed tumors in the colon and small intestine, whereas no tumors were seen in the AOM-untreated groups. An interesting observation was that cholesterol feeding significantly increased the number of colon tumors/rat and the number of animals with distant metastases to several organs. Tumor growth and invasiveness were also enhanced, but not significantly. Both bile acids and neutral sterols in the feces were markedly increased in the rats fed the 1% cholesterol supplement (2-3 fold and 5-6 fold, respectively). According to these results, it might be postulated that dietary cholesterol revealed potent promoting effects on AOM induced colon carcinogenesis through the mechanism of increasing excretion of bile acids and neutral sterols in the gut. PMID- 6850988 TI - U.v. induces long-lived DNA breaks in Cockayne's syndrome and cells from an immunodeficient individual (46BR): defects and disturbance in post incision steps of excision repair. AB - In normal cells exposed to low u.v. doses the several enzymic steps of the excision repair process are closely coupled with the result that DNA gaps are transient and present at such low frequency that it is very difficult to detect them. Cells from a u.v.-sensitive human genetic disorder, Cockayne's Syndrome (CS) and from an immunodeficient individual 46BR, have been examined with respect to their incision capacity after u.v. in the presence and absence of inhibitors of DNA synthesis. We have measured the initial rates of DNA break accumulation in the presence of hydroxyurea and 1-beta-D arabinofuranosylcytosine and find that in both these groups the rate is only slightly lower than in normal cells. However, there is a marked difference between u.v. sensitive cells and normal in the accumulation of long-lived DNA breaks in the absence of inhibitors. While in normal cells practically no breaks could be detected, the u.v. sensitive cells accumulated significant numbers of DNA breaks within 15 min of incubation; 46BR cells showed almost the same level of DNA breaks without the inhibitors as with them. In CS break accumulation can be detected in the absence of inhibitors for only a short time after irradiation (approximately 30 min), but less so when deoxyribonucleosides are provided. The spontaneous break accumulation is related to the time elapsed since proteolytic detachment of the cells from monolayer; 24 h after replating CS breaks no longer accumulate in response to u.v. 46BR cells, on the other hand, accumulate breaks even 1 day after replating and express unligated gaps 2 h after irradiation with a relatively low u.v. dose such as 4 Jm 2. Provision of DNA precursors does not greatly reduce break accumulation. The extremely slow rate of gap sealing in 46BR cells is consistent with the hypothesis that a ligase defect is expressed in these cells. In the absence of inhibitors break accumulation in CS cells often fluctuates between experiments for unaccounted reasons; though 11961 fluctuates less than other CS strains this phenotypic trait helps to confirm its assignation as a Cockayne Syndrome. Spontaneous conditional break accumulation is not restricted to CS cells; fibroblasts from a normal individual also express similar behaviour though their ability to seal repair sites is considerably greater. PMID- 6850989 TI - Phosphorylation of cytochrome-P-450-dependent monooxygenase components. AB - Most chemical carcinogens require activation by polysubstrate monooxygenase. The phosphorylation of essential components of this cytochrome P-450 monooxygenase system, isolated from rabbit liver microsomes, cytochrome P-450 (LM2) and cytochrome reductase, was tested using two different protein kinases. One of the kinases, a cyclic AMP-independent phosvitin kinase (kinase P), was inactive in all systems tested. However, the catalytic subunit of a cyclic AMP-dependent protein kinase (kinase C) catalyzed phosphoryl group transfer to both proteins, but to different extents. Cytochrome P-450 was phosphorylated when added as sole component and also when in the presence of P-450 reductase and phosphatidylcholine. In contrast, the weak phosphorylation of P-450 reductase was reduced considerably in a complete reconstituted system containing P-450 and phosphatidylcholine. The inclusion of kinase P did not alter these results which excludes the possibility that these kinases participate in a sequential phosphorylation mechanism. The monooxygenase constituents themselves were without kinase activity. When hepatic microsomes were isolated in presence of the phosphatase inhibitor sodium fluoride no significant change in monooxygenase (7 ethoxycoumarin O-deethylation) activity was observed, whilst after preincubation with either acid or alkaline phosphatase a significant reduction in monooxygenase activity was measured. Thus, cytochrome P-450 (LM2) is phosphorylatable by protein kinase C and the catalytic activity of polysubstrate monooxygenase decreases after preincubation of microsomes with phosphatases. PMID- 6850990 TI - Characterization of drug-metabolizing systems in hyperplastic nodules from the livers of rats receiving 2-acetylaminofluorene in their diet. AB - A number of drug-metabolizing systems were measured in hyperplastic noduli from the livers of rats receiving 2-acetyl-aminofluorene in their diet and compared with corresponding activities in control liver. The level of microsomal cytochrome P-450 is reduced 54% in the nodular tissue, while 5 activities catalyzed by the cytochrome P-450 system (i.e., aminopyrine N-demethylase, benzo[a]pyrene monooxygenase, ethoxyresorufin O-deethylase, ethoxycoumarin O deethylase, and 2-acetylaminofluorene N-hydroxylase) are all present at levels corresponding to 5-44% of the control levels. The pattern of 2 acetylaminofluorene metabolites formed by nodule microsomes also differs from the pattern observed with control microsomes. Microsomal epoxide hydrolase is increased 415%, cytosolic glutathione S-transferases 203-576%, microsomal UDP glucuronyltransferase activity about 200%, and cytosolic DT-diaphorase 1210% in the nodules. The same changes are seen in nodules of different sizes and in individual nodules of the same size. Finally, of all of these changes only the full increase in epoxide hydrolase can be seen after 1-3 weeks of exposure to 2 acetylaminofluorene. PMID- 6850991 TI - Phenotypic instability in focal and nodular lesions induced in a short term system in the rat liver. AB - A comparative morphologic, morphometric and enzyme histochemical investigation of lesions induced by short-term application of N-nitrosomorpholine (NNM) and subsequent so-called 'selection pressure' was carried out in order to assess the characteristics of the numbers of induced putative preneoplastic populations and to cast light on reversibility associated with this model. The glycogen storage foci, mixed cell foci and neoplastic nodules observed after 'selection pressure' were in principle similar to those seen after stop experiments, although alterations in morphology and enzyme phenotype of individual cells were usually far more pronounced after short-term induction. It was established that 75% of the lesions were no longer visible 11 weeks after withdrawal of induction stimuli and that a large proportion of these remaining demonstrated heterogeneity in morphological and histochemical markers indicative of reversion to normal phenotype. After a further 10 weeks a slight increase in number of foci associated with decrease in size and enhanced homogeneity in phenotypic markers was established. The behaviour of foci and nodules undergoing reversion was considered with respect to changes in basophilia and glycogen storage and activity of the enzymes glucose-6-phosphate dehydrogenase, glucose-6-phosphatase, glyceraldehyde 3-phosphate dehydrogenase, glycogen phosphorylase and synthase, acid phosphatase and gamma-glutamyl transpeptidase and correlated with location of altered cellular populations within the liver functional acinus. PMID- 6850992 TI - Sister chromatid exchanges in Chinese hamster V79 cells treated with the trivalent chromium compounds chromic chloride and chromic oxide. AB - The induction of sister chromatid exchanges (SCEs) in Chinese hamster V79 cells exposed to soluble CrCl3 and insoluble Cr2O3, compounds of trivalent chromium (Cr3+), was determined. Their ability to induce SCEs was compared with those of three hexavalent chromium (Cr6+) compounds: K2CrO4, Na2CrO4 and Na2Cr2O7. Both the delay in progression through the cell cycle induced by Cr3+ compounds and the SCE frequencies in the delayed cells were also evaluated. The exposure for 28 h to CrCl3 and Cr2O3 at concentrations of 9.7-39 micrograms and of 34-136 micrograms of Cr3+ per ml, respectively, induced a statistically significant (p less than 0.001) dose-dependent increase in SCEs up to 1.9-fold (CrCl3) and 4 fold (Cr2O3) over control levels. Compared with the effective concentrations of Cr6+ compounds, which produced up to 4-fold increase of SCEs, inducing concentrations of CrCl3 and Cr2O3 were 300- and 1000-fold higher in terms of chromium. By prolongation of treatment time up to 48 h, a progressive dose- and time-related enhancement in SCE frequencies induced by Cr3+ compounds in delayed cells was observed. Lower concentrations of Cr2O3, without effect after 28 h of treatment, induced an increase of SCEs by prolongation of exposure time. PMID- 6850993 TI - Enhancement by testosterone of dimethylnitrosamine carcinogenesis in lung, liver and kidney of inbred NZR/Gd female rats. AB - The effect of androgenic treatments on single dose dimethylnitrosamine (DMN) carcinogenesis was studied in 60 female NZR/Gd inbred rats, 25 of which were intact and received DMN 20 mg/kg i.p. in one dose after 48 h starvation, while 35 received DMN combined with testosterone injections every 4 weeks beginning 15 days before or after DMN, and in 29 rats combined also with ovariectomy. Sixteen female rats underwent ovariectomy and received testosterone every 4 weeks with no DMN. There were also 107 untreated intact contemporaneous control female rats. A single dose of DMN induced alveologenic lung (16%), hepatocellular (24%) and kidney epithelial (44%) tumours in intact rats, and the incidences of lethal tumours at these sites were significantly enhanced by androgenic treatments following the carcinogen, most markedly in the kidney. Androgenic treatment given before DMN injection had no significant effect on kidney or liver tumour incidences, but the carcinogenic response in lung was still strongly enhanced. PMID- 6850994 TI - The effect of disulfiram on the carcinogenicity of N-butyl-N-(3 carboxypropyl)nitrosamine in the rat. AB - N-Butyl-N-(3-carboxypropyl)nitrosamine (BCPN) is a proximate carcinogenic metabolite of the bladder specific carcinogen N-butyl-N-(4 hydroxybutyl)nitrosamine (BHBN). The objective of this study was to determine if disulfiram would inhibit the induction of bladder cancer in rats given BCPN, as reported for BHBN (Cancer Res., 39, 3040, 1979). Two groups of 30 male Wistar rats were given 1.5 mM BCPN (0.028%) in the drinking water for 12 weeks. The total dose of BCPN/rat was 5 mmol (0.95 g). During administration of the BCPN, one group of rats was fed a diet containing 0.5% disulfiram, while the other group was maintained on control diet. At the end of 12 weeks, the animals were maintained on control diet without BCPN for an additional 18 weeks, at which time the animals were sacrificed. It was found that 0.5% disulfiram significantly reduced the incidence of bladder cancer, decreasing from 30/30 (100%) in the group receiving BCPN alone to 3/30 (10%) in the group fed the disulfiram diet. The inhibition of BHBN-induced bladder cancer by disulfiram, previously reported, was also confirmed in these experiments. PMID- 6850995 TI - The effect of enzyme induction on the stereoselective metabolism of optically pure (-)1R,2R- and (+)1S,2S-dihydroxy-1,2-dihydrobenz-[a]anthracenes to vicinal 1,2-dihydrodiol 3,4-epoxides by rat liver microsomes. AB - The optically pure (-) and (+)trans-1,2-dihydroxy-1,2-dihydrobenz[a]anthracenes (BA trans-1,2-dihydrodiol) were obtained through the resolution of their diastereomeric di(-)menthoxyacetates by normal-phase h.p.l.c., followed with base catalyzed hydrolysis. The (-)-BA trans-1,2-dihydrobiol has been determined to have 1R,2R absolute stereochemistry by exciton chirality method. Each of the enantiomeric and racemic BA trans-1,2-dihydrodiol was incubated with liver microsomes from untreated, phenobarbital (PB)-, and 3-methylcholanthrene (MC) treated male Sprague-Dawley rats. The racemic and enantiomeric BA trans-1,2 dihydrodiols were each metabolized to two 1,2,3,4-tetrahydroxy-1,2,3,4 tetrahydrobenz[a]anthracenes (BA 1,2,3,4-tetrol) derived from the hydrolysis of BA trans-1,2-dihydrodiol anti-3,4-epoxide (the 3,4-epoxy oxygen is trans to the 1 hydroxyl group) and syn-3,4-epoxide (the 3,4-epoxy oxygen is cis to the 1 hydroxyl group), respectively. All the BA 1,2,3,4-tetrols were identified by comparing the reversed-phase h.p.l.c. retention times of tetrols and their vicinal acetonides with the hydrolysis products of the chemically synthesized BA trans-1,2-dihydrodiol anti-3,4-epoxide, BA trans-1,2-dihydrodiol syn-3,4-epoxide, BA trans-3,4-dihydrobiol anti-1,2-epoxide, and BA trans-3,4-dihydrodiol syn-1,2 epoxide, respectively, by their modes of forming vicinal acetonides, and by ultraviolet absorption and mass spectral analyses. From the metabolism of (-)-BA trans-1,2-dihydrodiol, a BA trans-1,2-dihydrodiol anti-3,4-epoxide was the major product formed by liver microsomes from MC-treated rats whereas a BA trans-1,2 dihydrodiol syn-3,4-epoxide was the major product formed by liver microsomes from either untreated or PB-treated rats. In contrast, BA trans-1,2-dihydrodiol syn 3,4-epoxide was the major product formed from the metabolism of (+)-BA trans-1,2 dihydrodiol by all three rat liver microsomal preparations. Liver microsomes from PB-treated rats were found to catalyze the metabolism of both the racemic and the enantiomeric BA trans-1,2-dihydrodiols at a rate higher than those by liver microsomes from untreated and MC-treated rats. All BA 1,2,3,4-tetrol metabolites were found to be optically active by circular dichroism spectral analysis. The results indicate that the 'bay-region' BA trans-1,2-dihydrodiol is metabolized by rat liver microsomes predominantly at the vicinal 3,4-double bond and that each enantiomeric BA trans-1,2-dihydrodiol is metabolized to a pair of diastereomeric BA trans-1,2-dihydrodiol 3,4-epoxides with varying degrees of stereoselectivity depending on the constitutive forms of cytochrome P-450 in the rat liver microsomal preparations. PMID- 6850996 TI - Inhibition of 2-acetylaminofluorene oxidations by monoclonal antibodies specific to 3-methylcholanthrene-induced rat liver cytochrome P450. AB - The inhibitory effects of ten monoclonal antibodies specific for methylcholanthrene (MC)-induced P450 were determined on both C- and N hydroxylations of 2-acetylaminofluorene (AAF) by liver microsomes from rats pretreated with MC, phenobarbital as well as untreated animals. The inhibitory effects of these antibodies were also determined on AAF hydroxylations by purified rat liver MC-P450. The inhibition patterns of AAF hydroxylations with both microsomes and the purified P450 indicate that the formation of 7-OH-, 5-OH , 3-OH-, 1-OH- and N-OH-AAF was catalyzed by the same unique isoenzyme or at least isoenzymes of common antigenic determinants. PMID- 6850997 TI - 'Flitting' in nursery school children. PMID- 6850998 TI - Child rearing in poor urban Jamaica. AB - Child rearing practices and attitudes were investigated using a questionnaire, among 75 families with 31--60-month-old children in poor suburban Kingston. A pattern emerged of many social contacts, outdoor activities and authoritarian discipline. While teaching and preparation for school were highly regarded, there was little conscious effort to foster cognitive and language development through play. Child rearing appears to reflect the influences of an African heritage, Western urbanization and poverty. Items from the questionnaire were used to devise an index of stimulation. Developmental assessments (DQs) were performed on a subgroup of 45 children. The results correlated positively with the index of stimulation. PMID- 6851000 TI - Asymmetry of gait in normal children demonstrated by polarized light goniometry. AB - Polarized light goniometry recordings were obtained from 46 neurologically normal children aged 4--15 years. Asymmetry in terms of thigh and knee angle differences between right and left legs was common in children aged less than 10 years but uncommon in children aged more than 10 years. This asymmetry was predominantly in the direction of more flexion on the right side. The tendency for goniometric asymmetry to mirror asymmetry on clinical examination was slight and did not reach statistical significance. It is suggested that angular asymmetry during gait which occurs in some children under 10 years of age may be related to unequal rates of maturation of the two hemispheres. Other minor neurological asymmetries, neuro-anatomical asymmetries nd postural asymmetries which may be found in normal children are discussed. PMID- 6850999 TI - A household study of the pattern of utilization of mother and child health services in rural Greece and variation by socioeconomic status. PMID- 6851001 TI - Alterations of fibronectin and reticuloendothelial phagocytic function during adaptation to experimental shock. AB - Fibronectin is a large molecular weight glycoprotein that participates in opsonization as well as in adhesive structural tissue support. The effect of repetitive low grade traumatic shock on circulating fibronectin, opsonic activity, and RES phagocytic function was studied in rats during the process of adaptation to trauma. Enhanced hepatic Kupffer cell phagocytic activity was observed in rats that were resistant to trauma. During the adaptation process, serum fibronectin levels, as measured by immunoassay, were altered markedly and manifested a pattern of acute deficiency early post-trauma followed by rebound and sustained elevation of fibronectin greatly in excess of control levels. At the time adaptation to trauma was achieved, the circulating fibronectin was within the normal range. In an in vitro system, livers from adapted rats exhibited increased phagocytic ability. The data suggest that Kupffer cell activation occurs during the development of adaptation to trauma and that increased hepatic RE activity accounts for the overall increase in RES clearance seen in the trauma-adapted animals. Since repetitive low grade trauma, which can lead to adaptation, will cause immunoreactive opsonic fibronectin levels to become substantially higher than normal throughout much of the duration of the adaptation protocol, it is possible that this excessive circulating fibronectin represents a means by which local conditioning of blood vessels to trauma may be achieved. Most likely, this would be due to incorporation of the circulating fibronectin into the insoluble tissue fibronectin pool, which has been recently shown to take place. The findings suggest that RES function and fibronectin may be factors influencing trauma tolerance. PMID- 6851002 TI - Neutrophil migratory activity in severe hemorrhagic shock. AB - Sepsis continues to be a major cause of patient death following hemorrhagic shock. To explain this increased susceptibility to infection on a cellular level, neutrophil function was studied in nine adult baboons subjected to severe hemorrhage. Neutrophil migratory activity was found to be significantly decreased immediately after hemorrhage (P less than 0.05 vs control) and continued to decline throughout the experiment. After an initial small decline, neutrophil adherence increased to significant levels after 4 h of hypotension (P less than 0.05 vs control). The present data support the hypothesis that increased susceptibility to infection after sustained hemorrhage is a result of impaired neutrophil function. PMID- 6851003 TI - Interaction of oxygen free radicals and cardiac sarcoplasmic reticulum: proposed role in the pathogenesis of endotoxin shock. AB - An initial event in gram-negative bacteremia is activation of the complement cascade with production of C5a. C5a, in turn, acts as a chemotactic stimulus for leukocytic aggregation and, in conjunction with bacterial products, stimulates the release of oxygen free radicals from leukocytes. We have hypothesized that these oxygen free radicals (.O2-, superoxide anion; .OH, hydroxyl radical; H2O2, hydrogen peroxide) contribute to the characteristic myocardial dysfunction of endotoxin shock, Isolated canine cardiac sarcoplasmic reticulum (SR) was used as a subcellular determinant of mechanical function. SR was incubated for 20 min at 37 degrees C in the presence of phorbol myristate acetate activated leukocytes (A L) and calcium uptake and Ca2+-adenosine triphosphatase (ATPase) activities were measured. Activated leukocytes significantly depressed SR Ca2+ uptake rates (C = 1.12 +/- 0.05 mumol CA2+/mg-min; A-L = 0.73 +/- 0.05). The addition of catalase (CAT; 10 micrograms/ml) or superoxide dismutase (SOD: 10 micrograms/ml) plus CAT reversed the inhibition of SR Ca2+ uptake. SOD further depressed SR Ca2+ uptake (+SOD = 0.55 +/0 0.04 mumol Ca2+/mg-min). Mannitol had no effect. SR ATPase activity was inhibited with A-L (C = 1.41 +/- 0.04 mumol Pi/mg-min; A-L = 0.84 +/ 0.09). Neither mannitol, nor SOD nor CAT alone had any effect on the depression of SR ATPase activity. SOD plus CAT reversed the ATPase depression induced by A L. It is concluded that phorbol myristate acetate activated leukocytes via free radical-mediated mechanisms can directly affect function and activity of the excitation-contraction coupling system of cardiac muscle. Free radical scavengers identified hydrogen peroxide as a major mediator of depressed Ca2+ uptake rates. In conjunction with the superoxide anion, hydrogen peroxide contributes to the depressed ATPase activity. PMID- 6851004 TI - Role of hydrostatic and oncotic pressures in renal sodium reabsorption. AB - Physical factors, and renal interstitial hydrostatic pressure in particular, have an important effect on sodium excretion by the kidney. Changes in hydrostatic and oncotic pressures in the peritubular microcirculation may have effects on proximal tubule reabsorption under some, but not all, circumstances. In regard to control of sodium excretion, the loop of Henle may be a particularly important segment which is sensitive to transepithelial hydrostatic pressure changes. There is little evidence to support an effect of physical factors on sodium reabsorption by the distal tubule. The collecting tubule may be another pressure sensitive site; however, changes in sodium reabsorption by deep nephrons in the kidney may account for changes that have been attributed to the collecting duct. Changes in intrarenal pressure may be an important link in the regulation of sodium excretion, particularly in pathological circumstances, such as the exaggerated natriuresis of hypertension and the sodium retention seen in congestive heart failure. PMID- 6851005 TI - Contractions of canine vascular smooth muscle cells caused by ouabain are due to release of norepinephrine from adrenergic nerve endings. AB - Experiments were performed to determine whether the contractions of isolated canine blood vessels caused by ouabain are due solely to the release of endogenous norepinephrine. The response of segments of splenic arteries and veins and strips of splenic capsules to ouabain were compared before and after surgical sympathectomy. Successful denervation was demonstrated by absence of a contractile response to electrical stimulation, supersensitivity to exogenous norepinephrine, an extremely low content of endogenous norepinephrine, reduced accumulation of 3H-norepinephrine, and inability of electrical stimulation and tyramine to augment the overflow of 3H-norepinephrine. Ouabain augmented the overflow of 3H-norepinephrine from control but not from denervated splenic capsule. It caused contraction of control but not of denervated splenic arteries, veins, and capsules. Studies were also conducted in the same tissues and in segments of mesenteric and femoral arteries and of circular and longitudinal segments of the portal mesenteric vein before and after chemical sympathectomy with 6-hydroxydopamine. In these tissues, the contractile responses to electrical stimulation but not exogenous norepinephrine and prostaglandin F2 alpha were abolished. In the control tissues, ouabain caused strong contractions, whereas, in the denervated tissues, only a weak or no response to the glycoside occurred. The study demonstrates that, in isolated canine blood vessels, ouabain causes contraction of smooth muscle cells by virtue of its ability to release norepinephrine from the sympathetic nerves. PMID- 6851006 TI - Attenuation of the negative chronotropic effect of myelinated fibers by nonmyelinated fibers in the vagus nerve of the rabbit. AB - In the adult rabbit, both myelinated and nonmyelinated efferent fibers travel from the cervical vagus nerve to the sinoauricular node. The myelinated fibers convey the negative chronotropic effect. The influence of the nonmyelinated fibers was studied. Stimulation (4/sec) of the myelinated fibers, while the compound action potential was monitored continuously, caused a slowing of the heart rate. Subsequent activation of the non-myelinated fibers attenuated this negative chronotropic effect. Stimulation of adrenergic fibers was excluded, based on data from histochemical studies and the effects of blockade of beta- and muscarinic receptors. The lengthening of the RR interval during activation of the myelinated fibers alone was about 3.5 times larger than during activation of all fiber groups. When the conduction of the myelinated fibers was blocked (anodal block), activation of the nonmyelinated fibers did not show any effect on heart rate. It was concluded that the negative chronotropic effect is conducted via small myelinated fibers and that the nonmyelinated fibers modulate the effect of these cardiomotor fibers, without having an effect on heart rate on their own. This modulation is effected either via a presynaptic mechanism on preganglionic fibers or via an interaction with postganglionic neurons. The nonmyelinated fibers constitute a novel peripheral system to modulate heart rate. PMID- 6851009 TI - On the mechanism of lysophosphatidylcholine-induced depolarization of cat ventricular myocardium. AB - Lysophosphatidylcholine, a putative biochemical mediator of ischemia-induced arrhythmias, reduces the resting potential of ventricular muscle. To elucidate possible mechanisms of lysophosphatidylcholine-induced depolarization, we investigated the effects of lysophosphatidylcholine on the electrophysiological properties of cat ventricular muscle, using potassium ion-selective electrodes and conventional microelectrode, current-, and voltage-clamp techniques. Lysophosphatidylcholine (50 microM) decreased the sensitivity of the resting potential to changes in extracellular potassium concentration. Hyperpolarization of lysophosphatidylcholine-depolarized fibers by current-clamp methods failed to reveal two stable levels of resting potential. Depolarizing concentrations of lysophosphatidylcholine did not reduce the potassium equilibrium potential, as determined from the reversal potential of the time-dependent potassium current and measurements of intracellular potassium activity using potassium ion selective electrodes. Lysophosphatidylcholine induced a depolarizing shift of the reversal potential for steady state current, and did not induce the formation of a negative slope region in the steady state current-voltage or background current voltage relationships. Lysophosphatidylcholine induced an inward shift and linearization of the background current-voltage relationship negative to -30 mV, and the lysophosphatidylcholine-sensitive component of the background current was an inward rectifier with a reversal potential approximately equal to the potassium equilibrium potential. Lysophosphatidylcholine also reduced the amplitudes of the time-dependent potassium current, slow inward current, and the potassium accumulation and depletion currents. These results indicate that lysophosphatidylcholine-induced depolarization is due, in part, to reduced potassium conductance at voltages near the normal resting potential, and that lysophosphatidylcholine may act as a nonspecific depressant of membrane channels. PMID- 6851007 TI - Effects of sympathetic stimulation and changes in arterial pressure on segmental resistance of cerebral vessels in rabbits and cats. AB - The purpose of this study was to determine directly segmental cerebral vascular resistance during sympathetic stimulation and changes in arterial pressure. We measured pressure in pial arteries in anesthetized rabbits and cats with a servo null pressure-measuring device. Cerebral blood flow was measured with microspheres. Using these measurements we calculated large artery resistance and small vessel resistance. Under control conditions, large artery resistance accounted for approximately 40% of total cerebral vascular resistance. Sympathetic stimulation increased large artery resistance and reduced pial artery pressure. Cerebral blood flow and total cerebral vascular resistance did not change significantly. To examine constrictor responses of small cerebral vessels, we raised cerebral perfusion pressure by obstructing the descending aorta. During increases in arterial pressure from 70 to 110 mm Hg, large artery resistance tended to increase and small vessel resistance increased significantly. We conclude that, although sympathetic stimulation has little effect on total cerebral vascular resistance under normal conditions, it has important effects on segmental vascular resistance and cerebral microvascular pressure, and that sympathetic stimulation and increases in systemic arterial pressure within the physiological range have markedly different effects on segmental resistance; i.e., sympathetic stimulation produces constriction only in large arteries, and increases in systemic arterial pressure within the physiological range produce constriction primarily in small vessels. PMID- 6851008 TI - Evidence for a local sympathetic venoarteriolar "reflex" in the dog hindleg. AB - The study was performed in order to determine whether a local sympathetic venoarteriolar "reflex" is present in the dog hindleg. Femoral artery blood flow was measured by an electromagnetic flowmeter probe, and blood flow in the thigh muscle and subcutaneous tissue distally in the paw was measured by the local 133Xe washout technique. Twenty experiments were carried out in seven dogs unilaterally sympathectomized 2-4 weeks previously. Resting vascular tone did not differ in the sympathectomized and nonsympathectomized legs. In the control leg, venous pressure elevation caused a decrease in femoral blood flow of 49% corresponding to an increase in vascular resistance of 58%. In muscle and subcutaneous tissue vascular resistance increased by 81% and 35%, respectively. In the denervated leg, venous stasis caused no change in total vascular resistance. In muscle the vascular resistance increased by only 24%. In subcutaneous tissue, vascular resistance decreased by 12%. The effect of acute lumbar sympathectomy was studied in another group of seven dogs. Operation caused an immediate decrease in vascular resistance of 40%. The increase in vascular resistance during venous stasis in the total leg, as well as in muscle and subcutaneous tissue, was not affected. However, acute lumbar sympathectomy combined with injection of phenoxybenzamine into the femoral artery almost abolished the vasoconstriction induced by venous stasis. In muscle, the increase in vascular resistance was still present, but considerably attenuated. In subcutaneous tissue, the normal response was completely blocked. Finally, local suction induced vasoconstriction in an adjoining area not subjected to changes in vascular transmural pressure, an effect that could be blocked by local neural blockade at the site of suction. The results strongly suggest that a local sympathetic veno-arteriolar (axon) "reflex" is present in muscle and subcutaneous tissue in the dog hindleg. PMID- 6851010 TI - Increased arterial pressure variability after arterial baroreceptor denervation in fetal lambs. AB - Baroreceptor reflexes can be demonstrated during fetal life, but whether baroreceptors normally regulate fetal arterial pressure is unknown. This problem was addressed directly by measuring arterial pressure and analyzing its variation in eight unanesthetized fetal lambs throughout the last third of gestation, and comparing these data with similar measurements made in seven fetal lambs with denervated arterial baroreceptors. Measurements were made at 5-minute intervals over 24 hours in a total of thirty-three experiments. The coefficient of variation of mean arterial pressure (standard deviation of mean arterial pressure/mean value of mean arterial pressure) expressed as a percentage was used as an index of blood pressure variability. Coefficients averaged 7.0% in intact lambs and 12.1% in barodenervated lambs (P less than 0.001), signifying considerably increased variability of mean arterial pressure after barodenervation. Mean arterial pressure averaged over 24 hours was not different between the two groups prior to 120 days (0.8) of gestation. Between 120 days and term, mean pressure was significantly greater in the denervated fetuses (65 cm H2O) than in the sham-operated controls (60 cm H2O, P less than 0.025). These data demonstrate that a baroreceptor-blood pressure reflex functions during late gestational development in lambs and signify an important role of arterial baroreceptors in regulating fetal arterial pressure. Failure to regulate arterial pressure in the barodenervated fetus could result in significant alterations in placental perfusion and exchange, and in the regional delivery of oxygen and substrates to developing organs in these animals. PMID- 6851011 TI - Baroreflex control of the circulation in chronically instrumented fetal lambs. AB - The role of the arterial baroreceptors in regulating the fetal circulation was studied in 18 chronically instrumented fetal lambs, 120-136 days gestation. The results were compared to those obtained in three sinoaortic denervated adult sheep. Nine fetuses underwent sinoaortic denervation and nine fetuses served as sham-operated controls. Two to 3 days after surgery, heart rate and blood pressure were recorded continuously and analyzed over 1-hour periods. In the denervated fetuses, marked fluctuations of the arterial pressure and heart rate were observed. Frequency distribution curves for mean arterial pressure and heart rate showed broader and flatter curves in the denervated fetuses. The average mean arterial pressure and heart rate were not significantly different between the two groups. However, the standard deviation as an index of variability of the mean arterial pressure increased from 2.7 +/- 0.9 (mean +/- standard deviation) in the control group to 6.5 +/- 2.4 in the denervated fetuses, and the standard deviation of the heart rate increased from 10.6 +/- 2.1 to 21.5 +/- 5.7. In the adult sheep, mean arterial pressure and heart rate increased on the 1st day after denervation and returned to near control values on the 3rd day. The variability of the mean arterial pressure increased, but that of the heart rate did not change. Fetal cardiac output and its distribution were measured by the radionuclide-labeled microsphere technique. Combined ventricular output was not statistically different between the groups, but the blood flow to the fetal body was 27% higher in the denervated fetuses. The calculated fetal body vascular resistance was 31% lower in the denervated lambs. This study indicates that the arterial baroreceptors are important in regulating variability of the arterial pressure and heart rate in fetal life, and also may have a significant role in maintaining the normal peripheral vascular resistance. PMID- 6851013 TI - Determination of coronary collateral flow by a load line analysis. PMID- 6851012 TI - Attenuation of arterial baroreflex control of heart rate by left ventricular receptor stimulation in the conscious dog. AB - The purpose of this investigation was to determine whether left ventricular receptor stimulation attenuates the arterial baroreflex control of heart rate in the conscious dog and to determine the role of cardiac efferent sympathetic and parasympathetic pathways in any interaction observed. Mean arterial blood pressure-heart rate function curves, which characterized arterial baroreflex control of heart rate, were constructed before (control) and during an infusion of veratrine into the left circumflex coronary artery. Peak sensitivity, the maximum absolute slope along the mean arterial blood pressure-heart rate curve, and heart rate range (maximum minus minimum heart rate) were reduced during intracoronary infusion of veratrine. The mean arterial blood pressure-heart rate relationship also was shifted to a lower pressure during intracoronary infusion of veratrine. In order to study the role of cardiac efferents in this interaction, we constructed mean arterial blood-pressure-heart rate curves during cholinergic blockade, cholinergic blockade plus intracoronary infusion of veratrine, beta 1-adrenergic blockade, and beta 1-adrenergic blockade plus intracoronary infusion of veratrine. The addition of intracoronary infusion of veratrine during cholinergic blockade produced a shift of the mean arterial blood pressure-heart rate curve down the ordinate axis (heart rate) and to a lower pressure; however, peak sensitivity and heart rate range remained unchanged. The addition of intracoronary infusion of veratrine during beta 1-adrenergic blockade resulted in reductions in peak sensitivity and heart rate range. These data indicate that left ventricular receptor stimulation attenuates arterial baroreflex control of heart rate and that the reduction of sensitivity and heart rate range is mediated by parasympathetic motoneurons common to both reflex arcs. On the other hand, resetting to a lower operational set point may be mediated by cardiac sympathetic motoneurons common to both reflex arcs. PMID- 6851014 TI - Invasive cardiac electrophysiologic testing: the current state of the art. PMID- 6851015 TI - Effect of 12 months of intense exercise training on stroke volume in patients with coronary artery disease. AB - The purpose of this study was to determine whether 12 months of intense endurance exercise training can induce an increase in left ventricular stroke volume and in stroke work during exercise in patients with coronary artery disease. Eleven male patients were studied. With training, mean maximal oxygen uptake capacity (Vo2max) increased 39%, from 1.85 +/- 0.36 to 2.57 +/- 0.43 l/min. Stroke volume during upright exercise that required 35-65% of Vo2max was 18% higher after training. At the same percentage of Vo2max, mean blood pressure was the same before and after training; as a result, left ventricular stroke work (mean blood pressure X stroke volume) increased 18% (p less than 0.01). These findings suggest that in patients with coronary artery disease, prolonged, intense training induces an increase in stroke volume, and this is a result of cardiac rather than peripheral adaptations. PMID- 6851016 TI - Value of two-dimensional echocardiography in endomyocardial disease with and without eosinophilia. A clinical and pathologic study. AB - Ten patients (six women and four men) with endomyocardial disease, four with and six without hypereosinophilia, were studied by two-dimensional echocardiography (2-D echo). Eight had biventricular congestive heart failure and two had atypical chest pain with ischemic electrocardiographic changes. The patients were 15-50 years old (mean 40 years) and duration of illness was 2-9 years (mean 4.4 years). Nine had cardiac catheterization and three pathologic examination. Characteristic 2-D echo findings included apical obliteration of one or both ventricles by echogenic material suggestive of fibrosis or thrombosis; bright, specular echoes at the cavity surface of the apical obliteration suggesting patchy calcification; preserved left apical systolic inward motion, which differed significantly from the dyskinetic motion of thrombotic apical obliteration of ischemic or Chagasic origin (p less than 0.001); involvement of the papillary muscles and posterior atrioventricular valve; preserved ventricular contractile function in most patients; and the combination of normal-to-small ventricles with large atria. None of 14 subjects with secondary hypereosinophilia followed for 15.4 months developed similar 2-D echo findings. We conclude that both forms of endomyocardial disease had a 2-D echo pattern useful for noninvasive recognition and differentiation from patients who have valvular heart disease, constrictive pericarditis and cardiomyopathies of other origins. PMID- 6851017 TI - Quantitation of regional cardiac function by two-dimensional echocardiography. I. Patterns of contraction in the normal left ventricle. AB - Regional differences in wall motion and wall thickening were quantitated in the normal left ventricle using two-dimensional echocardiography (2-D echo). Using a computer-aided system, the left ventricle was subdivided in a standardized manner into 40 segments of five 2-D echo short-axis cross sections from the mitral valve level to the low left ventricle or apex. Measurements of sectional and segmental cavity areas, muscle areas and endocardial as well as epicardial perimeters, allowed assessment of contractile function using such indexes as endocardial systolic fractional area change (FAC), wall thickening (WTh), and circumferential fiber shortening (shortening). In 50 normal anesthetized, closed-chest dogs (including 10 studies in the conscious state) and in 32 normal humans, left ventricular contractile function increased significantly from base to apex. Thus, in anesthetized dogs, sectional FAC, WTh and shortening increased from left ventricular base to apex as follows: 39.4 +/- 5.1% to 61.6 +/- 7.2%, 20.5 +/- 6.6% to 46.7 +/- 11.5% and 22.7 +/- 3.4% to 35.4 +/- 5.9%, respectively. Similar trends were noted in conscious dogs. In man, sectional FAC, WTh and shortening also increased from the mitral valve to the low left ventricular level: 38.8 +/- 3.3% to 60.7 +/- 4.5%, 23.9 +/- 5.6% to 28.9 +/- 7.6% and 21.4 +/- 5.0% to 30.6 +/- 5.6%, respectively. Detailed segmental analysis in individual cross sections also revealed regional differences in contraction. Generally, contraction was most vigorous in posterior regions of the left ventricle. The septal regions exhibited lowest contraction at the base, but also the greatest increase from base to apex, both in the canine and human. Lateral regions did not show significant changes along the length of the left ventricle. Diastolic wall thickness also varied. We conclude that contraction in the normal left ventricle cannot be assumed to be uniform or symmetrical. These normal regional differences in function should be taken into account when evaluating altered physiologic states and in studying effects of therapeutic interventions. PMID- 6851018 TI - In vivo assessment of left ventricular wall and chamber dynamics during transient myocardial ischemia using prospectively ECG-gated computerized transmission tomography. AB - Seven dogs were evaluated with prospective ECG-gated computerized transmission tomography (CTT) to analyze left ventricular (LV) wall thickness and cross sectional chamber area after acute occlusion of the left anterior descending coronary artery (LAD). ECG-gated CTT scanning during i.v. administration of contrast material was performed over the mid-left ventricle at rest, after acute occlusion of the LAD and 30 minutes after release. The extent of systolic wall thickening (EWTh) of the anterior (potentially ischemic) segment was 39.8 +/- 8.8% (SEM) in the control state and -26.0 +/- 4.7% during LAD occlusion (p less than 0.01). The nonischemic septum demonstrated a compensatory increase in EWTh, from 28.6 +/- 3.5% to 46.4 +/- 6.1% during LAD occlusion (p less than 0.05). The end-diastolic LV luminal area (LVA) increased from 17.4 +/- 0.8 cm2 in the control state to 21.0 +/- 1.1 cm2 during LAD occlusion (p less than 0.01). End systolic LVA also increased, from 11.0 +/- 0.9 to 15.2 +/- 1.1 cm2 (p less than 0.01). In addition, the percent change in LVA from end-diastole to end-systole declined from 37.4 +/- 3.8% during control to 28.0 +/- 2.6% during LAD occlusion (p less than 0.02). In conclusion, gated CTT demonstrates that the alterations in acute ischemia are characterized by changes in regional wall thickening dynamics, consisting of wall thinning during systole in the jeopardized segment and compensatory increase in the extent of systolic thickening in the normal segment, and changes in global LV function, consisting of an increase in the LVA and a decrease in the percent change of LVA during systole. Gated CTT may be useful for monitoring regional and global effects of ischemia when subjects can be studied in the supine position and with respiration suspended for 45 seconds. PMID- 6851019 TI - A new ECG classification system for myocardial infarction based on receiver operating characteristic curve analysis and information theory. AB - An optimized three-lead ECG hierarchial decision-tree type of classification system for myocardial infarction is presented. For selection of the best threshold values for each criterion and the best association of features, we developed a procedure based on "receiver operating characteristic" (ROC) curve data analysis and information theory. Optimization was obtained through maximization of information content of the criteria. The classifier is based on nine measurements that can be easily obtained by hand (QX duration, Q/R Y amplitude, R Y amplitude, Q/R Y duration, Q Z amplitude, QRS and T axes in the horizontal plane, Q Z duration and R Z amplitude) and achieved a satisfactory performance in an independent group of patients (true-positive ratio 0.853, false positive ratio 0.105, average information content 0.308 bits). PMID- 6851020 TI - Electrocardiographic and hemodynamic changes in experimental right ventricular infarction. AB - To investigate the electrocardiographic and hemodynamic changes in isolated right ventricular infarction, 0.25 ml or 0.5 ml of metallic mercury was injected into the right coronary artery of 14 closed-chest dogs. At autopsy, at least 60% of the right ventricle was necrotic in every dog. Hemodynamic observations were made in 11 and electrocardiographic mapping was performed in all 14 dogs. Right atrial pressure rose in 10 and left atrial pressure in nine of the 11 dogs; early right atrial pressure did not exceed left atrial pressure, but late right atrial pressure was greater in four dogs. Although cardiac output and blood pressure fell significantly, circulation was maintained. Twelve of 14 dogs had transient ST-segment elevation in the right precordial leads, and 12 developed right bundle branch block. Abnormal Q waves or R waves of 1 mm or less appeared in the right precordial leads in 13 of the 14 dogs. Since right bundle branch block and abnormal Q waves in the right precordial leads have not been recognized as useful signs in human right ventricular infarction, further investigations are warranted to determine their value in clinical applications. PMID- 6851021 TI - Right ventricular infarction: role of the moderator band artery in determining infarct size. AB - We studied 19 patients with proximal right coronary artery occlusions associated with acute myocardial infarcts less than 30 days old. Right ventricular infarct size, determined as a percentage of right ventricular surface area, ranged from 0% to 29%. Correlation of 24 variables measuring infarct size, chamber size and coronary artery disease failed to demonstrate a significant correlation with the extent of right ventricular infarction. However, estimates of the degree of obstruction to potential collateral flow into the right coronary arterial system from the left anterior descending coronary artery, especially through the moderator band artery, showed a significant positive correlation with infarct size (p less than 0.02). Among the five patients with massive (greater than 25%) right ventricular infarction, four had significant (greater than 75%) obstruction of the left anterior descending system, resulting in potentially impaired collateral blood flow; the other patient had normal coronary arteries and embolic occlusion of the proximal right coronary artery with contraction band necrosis. The study suggests that collateral flow to the right ventricular myocardium, especially through the moderator band artery, protects against massive infarction in the presence of proximal right coronary artery occlusion. PMID- 6851023 TI - Indomethacin-induced scar thinning after experimental myocardial infarction. AB - We investigated the effect of indomethacin, a widely used nonsteroidal antiinflammatory drug, on the healing of myocardial infarction (MI). Experimental MI was produced in anesthetized, open-chest dogs by occluding the left anterior descending coronary artery. Ten dogs received indomethacin, 10 mg/kg i.v., and 11 received saline, 15 minutes and 3 hours after occlusion. After 6 weeks, the dogs were killed and their hearts were subjected to morphologic and biochemical analysis. The average thickness of the transmural scar and the noninfarcted left ventricular wall was measured at multiple sites in formalin-fixed left ventricular slices and the ratio of the thickness of the transmural scar to the noninfarcted wall determined. The average thickness of the noninfarcted wall was 8.80 +/- 0.19 mm (mean +/- SEM) in the control group and 8.44 +/- 0.26 mm in the indomethacin group (NS). The scar thickness was 7.24 +/- 0.64 mm in the control group and 3.56 +/- 0.40 mm in the indomethacin group (p less than 0.001). The ratio of scar to noninfarcted wall thickness was 0.83 +/- 0.07 in the control group and 0.43 +/- 0.04 in the indomethacin group (p less than 0.001). Scars in treated dogs did not differ from controls either by light microscopic histologic analysis or by analysis of hydroxyproline content per unit weight. We conclude that indomethacin results in marked scar thinning when given early after experimental MI. PMID- 6851022 TI - Serum creatine kinase MM isoenzyme sub-bands after acute myocardial infarction in man. AB - Using an isoelectric-focusing (IEF) method developed to quantitate MM isoenzyme creatine kinase (CK) sub-band activity, we identified a reproducible time-varying pattern of these sub-bands in the serum of eight patients with acute myocardial infarction (MI). Our observations are consistent with the view that MM3-CK (the M2-CK dimer, the pure gene product) is converted intravascularly to MM2-CK, and then to MM1-CK (the M1-CK dimer, the pure postsynthetic sub-band). The MM3-CK reaches a peak first, 16 hours after infarction, followed by MM2-CK, and then by MM1-CK. The MM3-CK is the dominant sub-band in normal myocardium; there is much less MM2-CK and virtually no MM1-CK. The MM3-CK sub-band peak may indicate the time at which enzyme ceases to be released from the injured myocardium. The ratio MM3-CK:MM1-CK rises within 6 hours after onset of chest pain from a baseline of 0.38 and peaks 10 hours after MI. The peak ratio was between 1.1 and 4.2, and the value correlated with the time when total CK activity peaked after MI. The 10 fold change in the MM3:MM1 ratio after MI, as well as the early period at which this ratio peaks (10 hours), makes this an earlier and more sensitive indicator of enzyme release. PMID- 6851024 TI - Evaluation of high-energy phosphate metabolism during cardioplegic arrest and reperfusion: a phosphorus-31 nuclear magnetic resonance study. AB - Hypothermic potassium cardioplegia is now commonly used to protect the myocardium during surgically induced ischemia. Because the potassium-related membrane depolarization has been shown to increase calcium influx, we undertook this study to define the effects of varying the calcium content in hyperkalemic perfusates and the effects of using magnesium instead of or in addition to potassium as the arresting agent on the ability of hearts to recover normal function after ischemic arrest. We subjected isolated perfused working rat hearts to 60 minutes of cardioplegic arrest followed by 30 minutes of reperfusion, and measured high energy phosphate levels every 2 1/2 minutes by phosphorus-31 nuclear magnetic resonance spectroscopy. These data were correlated with postischemic recovery of function. Our results show that potassium cardioplegia may be harmful when the calcium concentration is greater than 1 mM. The kalemic injury is significantly reduced when the calcium content is lowered to 0.25 mM and the greatest extent of preservation is provided by a calcium-poor perfusate (0.25 mM) containing 13 mM magnesium. The beneficial effects of magnesium are not enhanced by subsequent addition of potassium. Close correlations were found between all observed metabolic changes during arrest and the degree of recovery of contractile performance after reperfusion. We conclude that the ability of the myocardium to maintain or resynthesize high-energy phosphate after cardioplegic arrest may be an important determinant of postischemic mechanical performance. These results show that phosphorus-31 nuclear magnetic resonance spectroscopy is a valuable method for evaluating interventions to reduce the severity of ischemic damage. PMID- 6851026 TI - Influence of age on wall thickness, cavity dimensions and myocardial contractility of the left ventricle in simple transposition of the great arteries. AB - This study was carried out to establish a reference table of echocardiographic values for the left ventricle of simple d-transposition of the great arteries (d TGA) and to determine at what age left ventricular dimensions in these patients become different from those of a normal population. Fifty-three patients with d TGA and normal pulmonary pressure and 395 normal children ages 1 day to 10 years were studied by M-mode echocardiography. Results show that in d-TGA, left ventricular systolic and diastolic internal diameters are normal at birth. After 1 month, however, both diameters were below normal and despite a progressive increase with age, the mean values were always below normal. The mean posterior wall thickness of patients with d-TGA was also normal at birth but did not increase with age (2.3 mm in diastole and 4.3 mm in systole) and became significantly thinner than normal at 10 months of age in diastole and 7 months in systole. Septal thickness of patients with d-TGA did not differ from that of the control group. The shortening fraction and mean velocity of circumferential fiber shortening were significantly greater in d-TGA at all ages. Left ventricular measurements related to age are presented and should be of help in interpreting M mode echocardiograms of patients with d-TGA. PMID- 6851025 TI - Chest wall velocity and the second heart sound. An improved sensor of S2 splitting. AB - We report a new method of detection of the timing of the aortic and pulmonary valve closure that depends not on the registration of audible vibrations, but rather, on subtle but distinct movements of the chest wall, which are external manifestations of these events. We studied these phenomena in six open-chest dogs and in 69 human subjects. The dog studies show that the two distinct inward movements detected by a motion sensor applied to the epicardium in the vicinity of the right ventricular outflow tract correlate with the timing of the incisural notches of the pressure signals from the great vessels. In humans, these movements are transmitted to the skin surface and can be detected noninvasively. In 48 of the 69 human subjects (70%), these spikes provided a significantly better indication of the timing of semilunar valve closure than did the conventional phonocardiogram. PMID- 6851027 TI - Evaluation and surgical treatment of pulmonary atresia and intact ventricular septum in infancy. AB - The initial surgical approach to the infant with pulmonary atresia and intact ventricular (PA-IVS) is to establish an adequate source of pulmonary blood flow and, when possible, relieve right ventricular (RV) outflow obstruction. The selection of patients for pulmonary valvotomy, alone or in combination with a systemic-pulmonary arterial shunt, depends on the presence of an RV outflow tract and the adequacy of the RV chamber. To evaluate the size of the RV cavity in PA IVS, an RV index (RVI) was developed using biplane angiographic measurements of the sum of the tricuspid valve annulus and the RV inflow and the RV outflow tracts. The RVI was normalized by relating it to the aortic diameter (Ao) at the diaphragm (RVI/Ao). The RVI/Ao was 13.5 +/- 1.4 in 20 control subjects and only 7.3 +/- 2.6 in 26 PA-IVS patients (p less than 0.001), and was within the normal range in only two of the 26. Since 1976, pulmonary valvotomy plus a Blalock Taussig shunt has been performed in 10 infants, with one death. Serial cardiac catheterizations in five of nine survivors demonstrated substantial RV growth in all, with the RVI/Ao increasing from an average of 8.0 to 12.5. In contrast, patients who underwent a shunt alone had no change in RV cavity size. We conclude that pulmonary valvotomy may be performed successfully in most PA-IVS patients, but usually must be combined with a systemic-pulmonary shunt. In a small minority of patients, a normal RV cavity, as evidenced by an RVI/Ao greater than or equal to 11, appears to be sufficient to sustain adequate pulmonary blood flow after valvotomy alone. The RVI/Ao ratio is a simple method of quantitatively evaluating RV cavity size and is helpful in planning the initial surgical approach for these infants. PMID- 6851029 TI - Effect of nitroprusside on hydraulic vascular loads on the right and left ventricle of patients with heart failure. AB - We studied the effect of nitroprusside on the hydraulic vascular load of the right and left ventricle in seven patients with severe left ventricular failure. At doses of 0.25-0.75 micrograms/kg/min, stroke volume increased progressively from 40.1 to 48.6 ml and left ventricular end-diastolic pressure decreased from 24.5 to 11.2 mm Hg. Accompanying this improvement in left ventricular performance were dose-related decreases in mean ventricular pressures, pulmonic and systemic resistances and the lower-frequency components of input impedance moduli. Characteristic impedance and both total and oscillatory external power were decreased in the pulmonic, but not the aortic, vasculature. In this class of patients, right ventricular unloading is a striking and direct effect of nitroprusside and may account, in part, for improved left ventricular performance through ventricular interdependence. PMID- 6851028 TI - Plasma norepinephrine concentration and plasma dopamine-beta-hydroxylase activity in patients with congestive heart failure. AB - The relationship between plasma norepinephrine (NE), epinephrine (E) and dopamine beta-hydroxylase activity (DBH) was studied in 90 cardiac patients (New York Heart Association [NYHA] classes I-IV), 85 healthy control subjects and 18 competitive skiers. The cardiac patients in NYHA classes III and IV had significantly higher NE (p less than 0.001) and lower DBH (p less than 0.001) levels than the controls, whereas the skiers had significantly lower NE (p less than 0.001) and higher DBH (p less than 0.05) levels than the controls. Seven cardiac patients in whom successful cardiac surgery was performed had decreased NE (p less than 0.001) and increased DBH (p less than 0.02), as well as significantly improved NYHA cardiac status (p less than 0.001). These findings demonstrate an inverse relationship between NE and DBH in a population of athletes, normal subjects and cardiac patients; the same inverse relationship holds for these patients when sequential studies are done after a change in cardiac status. PMID- 6851030 TI - Clinical pharmacokinetics and efficacy of amiodarone for refractory tachyarrhythmias. AB - Using a high-pressure liquid chromatographic assay, we measured serum amiodarone concentrations serially in 122 patients treated with amiodarone for 1.5-53 months (mean 9.3 months) for control of refractory symptomatic atrial or symptomatic and life-threatening ventricular tachyarrhythmias. The atrial tachyarrhythmias were successfully controlled in 45 of 54 patients (83%) during a mean follow-up of 10.0 months. In the ventricular tachyarrhythmia group, which included 22 survivors of sudden cardiac death, 38 of 50 patients (76%) responded to amiodarone during a mean follow-up of 10.9 months. Although the mean serum amiodarone concentration did not differ between responders and nonresponders, eight responders relapsed when their serum concentration fell below 1.0 mg/l. Side effects resulted in withdrawal of amiodarone in only 10 of 122 patients (9%) despite a 30% overall incidence of side effects. Central nervous system and gastrointestinal side effects became more frequent with serum concentrations greater than 2.5 mg/l, although only central nervous system side effects achieved statistical significance. Absorption and disposition kinetics of a single oral 800-mg dose of amiodarone were studied in eight patients. Serum values were measured for 24 hours in five patients during maintenance therapy, and elimination kinetics after long-term therapy were evaluated in three patients. The tissue concentration of amiodarone was determined in two patients who died during long-term amiodarone therapy and an attempt was made in 14 patients to correlate serum concentrations with daily dosages during maintenance therapy. The pharmacokinetics of oral amiodarone support the practice of using high loading dosages until arrhythmia suppression or apparent steady state is achieved (usually 2-4 weeks), followed by low-dose maintenance therapy (200-600 mg once a day) for treatment of symptomatic atrial and ventricular tachyarrhythmias. PMID- 6851032 TI - Acceleration of sinus rhythm during slow-rate atrial pacing. AB - We evaluated the effects of slow-rate atrial pacing on impulse formation of the sinus node in 13 isolated rabbit right atria using the microelectrode technique. After the spread of activation was mapped to determine true sinoatrial conduction time (SACT) (38 +/- 16 msec [+/- SD]), the atrium was paced for eight beats at constant intervals slightly shorter than spontaneous cycle length in steps of 10 msec. In all preparations, slow-rate atrial pacing failed to capture the pacemaker center, but shortened action potential duration because of electrotonic interaction between atrium and sinus node. The resulting acceleration of impulse formation of dominant fibers ceased instantaneously when atrial pacing was terminated. Estimation of SACT by constant pacing 5 beats/min faster than sinus rhythm seriously underestimated the true values (p less than 0.05), because sinus node acceleration prevented capture of dominant pacemaker fibers in 10 of 13 preparations. At pacing rates 10 beats/min faster than sinus rhythm, capture did not occur in eight of 13 experiments; at pacing rates 20 beats/min faster, the pacemaker center was captured in all preparations. This study describes sinus node acceleration as a consistent and hitherto unknown finding during slow-rate stimulation of the atrium. This phenomenon accounts for the failure of the constant atrial pacing technique to determine SACT accurately in man. PMID- 6851031 TI - Characteristics and possible mechanism of ventricular arrhythmia dependent on the dispersion of action potential durations. AB - The arrhythmogenic role of increased dispersion of repolarization (dispersion) was studied in 23 open-chest dogs using six simultaneously recorded monophasic action potentials (MAPs) from the ventricular surface and programmed ventricular premature stimulation (VPS). Increased dispersion was induced by generalized hypothermia (29 degrees C) and regional warm blood (38-43 degrees C) perfusion through a coronary artery branch. Hypothermia and regional warm blood perfusion increased maximum dispersion from 13 +/- 10 to 111 +/- 16 msec (p less than 0.001), predominantly because of the increased MAP duration difference (10 +/- 15 vs 97 +/- 16 msec, p less than 0.001). The maximal difference between activation times was not significantly changed, but the QRS duration increased from 47 +/- 6 to 52 +/- 7 msec (p less than 0.01). Ventricular arrhythmia did not occur spontaneously but was induced by a single VPS in all 23 dogs during hypothermia and regional warm blood perfusion when dispersion reached a critical magnitude. The critical magnitude of dispersion required to induce ventricular arrhythmia was documented in 16 dogs by stepwise increments or decrements of dispersion. In four dogs, an increase in atrial pacing rate of 24 beats/min prevented induction of ventricular arrhythmia by decreasing dispersion from a critical magnitude of 103 +/- 5 msec to a nonarrhythmogenic value of 86 +/- 9 msec (p less than 0.05). In six dogs, we compared the stimulation site-dependent effects of VPS applied in the region with short and long MAPs. In all dogs, ventricular arrhythmia was inducible only by VPS from the region with a short MAP. Premature impulses from this region propagated more slowly than those from the region with a long MAP. Our results show that the large dispersion of repolarization facilitates the development of a conduction delay necessary to induce sustained arrhythmia by an early premature stimulus applied at the site with a short MAP. PMID- 6851033 TI - Complete atrioventricular block in patients with atrioventricular discordance. AB - Although patients with atrioventricular (AV) discordance (corrected transposition) have abnormal conduction pathways and may spontaneously develop high-grade AV block, no quantitative assessment of the risk of this happening is available. We reviewed the data on 107 patients with AV discordance ages 2-76 years (mean 22 years) at follow-up. Eighty-two patients (77%) had a ventricular septal defect, 57 (53%) had pulmonary stenosis, 35 (34%) had tricuspid insufficiency and 24 (23%) had dextrocardia. Twenty-three patients (22%) had complete AV block. This condition was present in four patients at birth and developed in 19 patients at ages 4 months to 53 years (mean 18.1 years). Nine of these patients had permanent pacemaker implantation, four at the onset of complete block and five an average of 11 years later. Nine patients have AV block but no pacemaker. One patient died suddenly. Detailed data analysis showed that with increasing follow-up the risk of natural onset AV block continued at a rate of approximately 2% per year after diagnosis. The presence of an intact ventricular septum made AV block more likely. We conclude that patients with AV discordance are at risk of developing complete AV block throughout their lives. With increasing age, this risk is approximately constant and is probably not significantly increased by corrective or palliative surgery if acute surgical AV block does not occur. Pacemaker implantation is not necessary in some children with spontaneous AV block. PMID- 6851034 TI - Functional characteristics of sinoatrial and subsidiary pacemaker activity in the canine right atrium. AB - A canine in vitro right atrial preparation was developed to study the functional characteristics of subsidiary atrial pacemaker (SAP) activity and to compare them with those of sinoatrial node (SAN) activity. Extracellular bipolar electrodes were used to estimate the site of earliest activation and monitor spontaneous rate. Ligation of the SAN artery at the midportion of the sulcus terminalis suppressed SAN activity and usually (73.5%) elicited SAP activity in a well defined region of the inferior atrium. SAP activity in this region required a "threshold" concentration of norepinephrine (10(-8) M) in the Tyrode's perfusate. In response to all concentrations of norepinephrine tested, SAN activity attained a greater maximum spontaneous rate than SAP activity. Cholinergic stimulation with acetylcholine or eserine elicited a greater negative chronotropic response from SAP than SAN activity. Overdrive pacing suppressed SAP activity to a significantly greater extent than SAN activity. We conclude that this in vitro preparation can be useful for studying the pharmacology and electrophysiology of subsidiary atrial pacemakers that emerge after suppression of SAN activity. In contrast to SAN activity, SAP activity requires norepinephrine and is more sensitive than SAN activity to acetylcholine and overdrive pacing. Consequently, after loss of SAN function, autonomic modulation of SAP activity may result in atrial dysrhythmias and prolonged periods of overdrive suppression. PMID- 6851035 TI - Aha committee report. Diet in the healthy child. PMID- 6851036 TI - Effects of propranolol on blood lipids and lipoproteins in myocardial infarction. AB - The effects of propranolol on lipids and lipoproteins were investigated in survivors of a recent myocardial infarction who were enrolled in the double-blind Beta-Blocker Heart Attack Trial. Nonfasting serum samples were obtained in more than 2800 patients assigned randomly to either propranolol or placebo. The propranolol-treated group had high-density lipoprotein cholesterol levels 3-4 mg/dl less and triglyceride concentrations 30-40 mg/dl higher than the placebo group. These effects occurred in men and women in all age categories. PMID- 6851037 TI - Reduction in infarct size, arrhythmias and chest pain by early intravenous beta blockade in suspected acute myocardial infarction. AB - Four hundred seventy-seven patients suspected of having had acute myocardial infarction within less than 12 hours were randomized to receive i.v. atenolol followed by oral treatment for 10 days or to a control group. In patients with ECG changes indicative of infarction at entry, i.v. atenolol significantly reduced enzyme release by one-third and enhanced R-wave preservation. In patients without such ECG changes, treatment significantly prevented the development of infarction in a proportion of patients. There was also a significant reduction in R-on-T ectopics, repetitive ventricular arrhythmias and supraventricular arrhythmias. Treated patients had significantly greater pain relief and required fewer opiate analgesics. Significantly fewer atenolol-treated patients died by 10 days (the treatment period), had nonfatal cardiac arrests, developed heart failure, or suffered reinfarction. PMID- 6851038 TI - Augmentation of regional coronary blood flow by intra-aortic balloon counterpulsation in patients with unstable angina. AB - Intra-aortic balloon counterpulsation is capable of reducing afterload in patients with unstable angina. Whether it is also capable of augmenting coronary blood flow to poststenotic myocardium is controversial. We studied seven patients receiving maximal drug therapy and requiring balloon pumping for unstable angina as balloon volume and assist ratio were altered. All patients had greater than 90% stenosis of the proximal left anterior descending coronary artery. With maximal augmentation (40 cc balloon volume, 1:1 assist ratio) great cardiac vein flow, representing the efflux from the left anterior descending coronary artery bed, rose from a baseline of 52 +/- 20 to 67 +/- 25 ml/min (mean +/- SD, p = .004) and mean aortic diastolic pressure increased from 77 +/- 13 to 99 +/- 33 mm Hg (p = .004). Increased great cardiac vein flow correlated with increased mean aortic diastolic pressure across changes in balloon volumes (off, 20 cc, 30 cc, and 40 cc) and changes in assist ratio (off, 1:4, 1:2, and 1:1) (p = .02). However, the intermediate balloon volumes produced great cardiac vein flows at an intermediate level between full assist and no assist (p less than .05), whereas the intermediate assist ratios did not augment flow. Thus balloon pumping increased flow to a bed fed by collateral vessels or critical stenoses; this increased flow correlated with increased aortic diastolic pressure, indicating probable loss of autoregulatory ability. PMID- 6851039 TI - Mechanisms of angina relief after nifedipine: a hemodynamic and myocardial metabolic study. AB - To elucidate the mechanisms of action of nifedipine in angina pectoris, 14 patients were studied before and after sublingual administration of 10 mg nifedipine. Systemic and coronary hemodynamic and myocardial metabolic measurements were taken at rest and during pacing. At the pacing rate that induced pain in the control situation, no patient experienced angina after nifedipine administration. Lactate production during control turned into extraction after nifedipine administration (p less than .05), and the double product was reduced (p less than .001). Systemic and coronary vascular resistance were reduced by 26% (p less than .001) and 19% (p less than .005), respectively. Systolic blood pressure fell from 160 +/- 29 to 127 +/- 25 mm Hg (p less than .001) and diastolic from 100 +/- 14 to 79 +/- 11 mm Hg (p less than .001). Pulmonary artery diastolic blood pressure fell from 14 +/- 4 to 10 +/- 3 mm Hg (p less than .01). When the pacing rate was further increased after nifedipine administration until pain developed, the double product and the degree of lactate production were the same as during pain before nifedipine was administered. The pacing rate was 131 +/- 12 compared with 119 +/- 13 during control (p less than .001). Both the systolic and diastolic blood pressures were still significantly reduced compared with control pacing values, 131 +/- 26 mm Hg (p less than .01) and 84 +/- 13 mm Hg (p less than .01), respectively. Our data demonstrate that the antianginal efficiency can be partly explained by afterload reduction, which decreases myocardial oxygen consumption. The data also suggest additional mechanisms, possibly an increase in collateral flow, direct dilatation of stenotic parts of epicardial arteries, or a decrease in myocardial back pressure secondary to reduced left ventricular filling pressure. PMID- 6851040 TI - Sustained improvement in left ventricular function and mortality by intracoronary streptokinase administration during evolving myocardial infarction. AB - One hundred eighty-eight patients with acute myocardial infarction were studied prospectively from August 1980 to September 1982. One hundred thirty-six of these patients were entered into a intracoronary streptokinase study after informed consent was obtained. The remaining 52 patients, who either met exclusion criteria for the study or refused to participate, served as a control group and were treated as those in the study group except that they did not undergo emergency cardiac catheterization. Left ventricular function was determined in both groups by gated radionuclide ejection fraction (EF) on admission to the hospital, at discharge, and 6 months after discharge. With successful reperfusion up to 18 hr after onset of chest pain, mean left ventricular function in the study group improved (EF 39 +/- 13% on admission and 46 +/- 12% at discharge; p less than .001). Mean EF in control patients and those not achieving reperfusion did not change from admission to discharge. Mean EF at 6 month follow-up was not significantly different than at discharge in the study group or the control group. Total cardiac mortality in the control group was 19% compared with 10% in the study group (p = .06, NS). When patients admitted in pulmonary edema or shock (Killip class III or IV) were excluded from both groups, total cardiac mortality in the study group was significantly lower (4%) compared with in the control group (12.5%, p less than .05. The administration of intracoronary streptokinase during evolving myocardial infarction up to 18 hr after onset of chest pain may result in decreased mortality and sustained improvement in left ventricular function. PMID- 6851042 TI - Left ventricular pressure-volume relations shift to the left after long-term loss of pericardial restraint. AB - The short-term effect of pericardiectomy is to shift the in vivo left ventricular (LV) pressure-volume curve to the right. We studied nine weight-matched pairs of male guinea pigs 28 to 39 days (mean 35) after complete pericardiectomy or sham thoracotomy to determine the long-term effects of pericardiectomy on LV pressure volume relations. Hemodynamic and in vitro LV pressure-volume data were collected in matched pairs on the same day, 2 to 3 hr after catheter placement and recovery from anesthesia. Cardiac output was measured by the microsphere reference sample method. Postsurgical weight gain was similar in both groups: 823 +/- 6 (mean +/- SD) to 925 +/- 6 g in the pericardiectomy group and 829 +/- 7 to 927 +/- 7 g in the sham thoracotomy group. We found no difference in LV weight: 1.555 +/- 0.145 g in the pericardiectomy group vs 1.564 +/- 0.148 g in the sham thoracotomy group, nor any difference in heart rate, mean arterial, right atrial, or left ventricular end-diastolic pressures, cardiac outputs, or stroke volumes (p = NS). LV pressure-volume relations, however, were shifted to the left in the pericardiectomy group (p less than .005). At 10 mm Hg, LV volume in the pericardiectomy group (0.85 +/- 0.22 cc) was less than that in the sham thoracotomy group (1.02 +/- 0.15 cc; p less than .025). The LV stress-elastic modulus relationship was not different between groups (p greater than .30). One month after pericardiectomy, LV pressure-volume relations in vitro were shifted to the left without a change in LV weight, LV elastic modulus, or hemodynamics. We speculate that this shift compensates for the lack of pericardial restraint and returns LV volume and hemodynamics to normal in vivo. PMID- 6851043 TI - Pulmonary edema formation with myocardial infarction and left atrial hypertension: intravascular and extravascular pulmonary fluid volumes. AB - The response of pulmonary blood volume (PBV) and extravascular lung water (EVLW) was examined by indicator-dilution techniques in 14 "open chest" dogs, seven that underwent coronary occlusion (group 2) and seven that served as controls (group 1). Data were obtained in a control stage (control stage 1) 45 min after coronary ligation (control stage 2), and 90 min after the left atrial pressure had been increased to approximately 35 mm Hg with a left atrial balloon. In group 2 animals, EVLW increased after coronary ligation without a marked change in left atrial pressure (6.9 +/- 0.4 to 8.2 +/- 0.5 ml/kg mean +/- SD; p less than .05) and increased to 20.1 +/- 1.4 ml/kg after the production of left atrial hypertension (p less than .005 vs control and vs coronary ligation). In the control dogs, EVLW was unchanged 45 min after the initial data had been collected (7.1 +/- 0.7 to 7.0 +/- 0.8 ml/kg). After the production of left atrial hypertension in these dogs, EVLW rose (14.8 +/- 1.2 ml/kg; p less than .005 vs control stage 1 and control stage 2, p less than .01 vs group 2 dogs). PBV did not change significantly with ligation and increased similarly in both groups during left atrial hypertension. We conclude that coronary ligation can increase EVLW, independent of microvascular hydrostatic pressure. During the production of left atrial hypertension there was greater transcapillary fluid flux in group 2 dogs at matched levels of left atrial pressure elevation. This may be due to an alteration in the permeability of the pulmonary capillary membrane during myocardial infarction and provides a partial explanation for the occasional disparity between left heart dynamics and the chest radiograph in acute myocardial infarction. PMID- 6851041 TI - Short- and long-term efficacy of high-dose oral diltiazem for angina due to coronary artery disease: a placebo-controlled, randomized, double-blind crossover study. AB - The effects of oral diltiazem (360 mg/day) on exercise tolerance, left ventricular performance, and plasma lactate and catecholamine levels were studied in 13 patients with atherosclerotic coronary artery disease in a placebo controlled, randomized, double-blind protocol. Exercise duration to the onset of ischemic ST segment depression, time to angina pectoris, and time to peak exercise improved by 120, 174, and 144 sec, respectively (p less than .0001). Left ventricular ejection fraction, as determined by radionuclide angiography, increased in patients at rest from 52 +/- 11% (mean +/- SD) during placebo therapy to 58 +/- 11% during diltiazem therapy (p less than .001); at peak exercise ejection fraction increased from 44 +/- 11% during placebo treatment to 52 +/- 15% during diltiazem therapy (p less than .01). The mean plasma norepinephrine level in patients at rest increased from 498 +/- 221 pg/ml during placebo treatment to 667 +/- 272 pg/ml during diltiazem therapy (p less than .05). Resting standing blood pressure and supine and standing diastolic blood pressures decreased significantly with diltiazem. In all 10 patients followed over a long term, oral diltiazem caused persistent improvement in exercise performance at 12 to 20 weeks, without evidence of placebo effects. Thus, diltiazem is highly effective in divided doses of 360 mg/day for the therapy of chronic angina pectoris due to coronary artery disease. PMID- 6851044 TI - Sustained regional dysfunction produced by prolonged coronary stenosis: gradual recovery after reperfusion. AB - Prolonged nontransmural ischemia was produced and the early and late effects of reperfusion were studied in 10 conscious dogs instrumented over the long term. Five hours of partial circumflex coronary artery stenosis was produced with a hydraulic occluder, followed by gradual release over 20 min, with measurements of left ventricular pressure, regional myocardial function (systolic wall thickening by sonomicrometry), coronary blood flow velocity (pulsed Doppler), and myocardial blood flow (microspheres). During coronary stenosis the occluder was adjusted frequently to maintain a reduction of systolic wall thickening to 50% to 75% of control (average 62.6% of control). Myocardial blood flow in the ischemic area at 4 hr of partial coronary stenosis was reduced in the inner layers of the myocardium (subendocardium, from 0.81 +/- 0.18 at control to 0.36 +/- 0.08 SD, p less than .01; midwall, from 0.77 +/- 0.20 to 0.46 +/- 0.07 ml/min/g, p less than .01), accompanied by significant ST segment elevation on the subendocardial electrogram (0.83 +/- 0.96 to 4.58 +/- 4.10 mV; p less than .05) and decreased left ventricular dP/dt (3503 +/- 462 to 2991 +/- 339 mm Hg/sec; p less than .01). Within a few minutes after complete release of partial coronary stenosis, ST segments returned to control and myocardial blood flow of the inner layers was increased (subendocardium, 1.37 +/- 0.39, p less than .01; midwall, 0.97 +/- 0.28, p less than .05), but systolic wall thickening and left ventricular dP/dt were significantly depressed and remained reduced at 24, 48, and 72 hr when myocardial blood flow was normal. By seven days, systolic wall thickening and left ventricular dP/dt had returned to control (94.1 +/- 7.0% of control, 3353 +/ 605 mm Hg/sec, respectively; NS). Histologic changes caused by ischemia constituted only 2.7% (average) of the tissue between the crystals in the ischemic wall, but ischemic damage in the posterior papillary muscle, which did not contain crystals, was 31.9%. Thus, regional myocardial dysfunction reduced by nontransmural ischemia for 5 hr persisted for at least 3 days, with only slight damage to the left ventricular free wall but considerable infarction of the posterior papillary muscle. Full recovery of regional and global contractile function of the free wall then occurred within a period of 1 week. PMID- 6851045 TI - Mitral valve prolapse in short-term experimental coronary occlusion: a possible mechanism of ischemic mitral regurgitation. AB - Experimental coronary occlusions were carried out in 12 closed-chest dogs to investigate the functional anatomic characteristics of the mitral valve complex during acute myocardial ischemia. Two-dimensional echocardiography was used to assess left ventricular function, the mitral valve complex, and left atrial size. Presence of mitral regurgitation was assessed by left ventricular contrast echocardiography. Thirty-seven coronary occlusions of up to 10 min in duration were carried out in proximal or distal locations in the left anterior descending and the left circumflex coronary arteries. Mitral regurgitation, which was mild in severity as judged by a small rise in pulmonary artery wedge pressures, was observed in 15 of 37 brief coronary occlusion experiments. Mitral valve prolapse was noted in all 15 experiments, as well as in four additional studies in which mitral regurgitation was not seen. The development of experimental mitral valve prolapse was explained by measurements that demonstrated a relative displacement of the papillary muscle tips toward the mitral orifice. We conclude that mitral valve prolapse is a common sequela of short-term coronary occlusion and is often associated with mild mitral regurgitation. Relative displacement of ischemic papillary muscles toward the mitral orifice appears to be a likely mechanism of acute ischemic mitral valve prolapse. PMID- 6851046 TI - Evidence that ischemic cell death begins in the subendocardium independent of variations in collateral flow or wall tension. AB - Irreversible ischemic injury occurs after coronary artery occlusion in vivo, first in the subendocardium and progressing toward the subepicardium over time, presumably due to transmural variations in collateral flow or wall tension. In this study, 10 left ventricular globally ischemic slabs were created that were free of wall tension and collateral flow. The onset and completion of ischemic contracture were identified by means of a new tissue compressibility gauge designed for these studies. Transmural samples were obtained at 15 min intervals for determination of high-energy nucleotide levels and for ultrastructural analysis. The results show that there is a statistically significant gradient of ATP depletion, with the subendocardium consistently showing accelerated energy utilization compared with the subepicardium (p less than .05). Ultrastructural evidence of irreversible injury first appeared in the subendocardium at the onset of ischemic contracture and occurred when ATP levels declined to less than 1 mumol/g wet weight. In summary, these data show that during total ischemia in vitro, cell death begins in the subendocardium at the onset of ischemic contracture and progresses toward the subepicardium over time. These changes occurred independent of variations in collateral flow or wall tension. The results suggest that the increased risk of the subendocardium to ischemic injury previously noted in vivo may occur not only because of variations in collateral flow and wall tension, but may also be secondary to an increased metabolic rate of the subendocardium resulting in faster ATP use during the period of ischemia. PMID- 6851047 TI - Canine left ventricular mass estimation by two-dimensional echocardiography. AB - This study was designed to develop a two-dimensional echocardiographic method of measuring the mass of the left ventricle. The general formula for an ellipse was used to derive an algorithm that described the shell volume of concentric truncated ellipsoids. In 10 canine left ventricular two-dimensional echocardiograms, this algorithm accurately predicted postmortem left ventricular mass (r = .98, SEE +/- 6 g) and was independent of cardiac cycle phase (systole vs diastole, r = .92). PMID- 6851048 TI - Quantitative texture analysis in two-dimensional echocardiography: application to the diagnosis of experimental myocardial contusion. AB - We postulated that the analysis of regional image texture in two-dimensional (2D) echocardiograms would be an accurate method to differentiate normal from abnormal myocardial structure. We tested this hypothesis with quantitative texture measures to study the regional, spatial distribution of echo amplitudes in 2D echocardiograms performed before and immediately after blunt left chest trauma was induced in six anesthetized dogs. After trauma the contused region of myocardium appeared brighter and exhibited an altered myocardial texture. By use of a set quantitative texture measures, we found no significant differences in pretrauma images when normal regions were compared with regions to be contused. Also, we found no difference when we compared the normal regions in each animal in pretrauma vs posttrauma images. Twelve measures, however, differentiated normal from contused regions within the posttrauma images (p values ranged from .0057 to .0001 by multivariate analysis of variance). These texture measures were capable of differentiating normal from abnormal tissue only when texture along the azimuthal (lateral) direction was calculated. We conclude that regions of myocardial contusion exhibit visibly altered local echo-amplitude patterns (altered image texture) and that these image texture alterations may be quantified with digital image analysis techniques. These findings suggest that quantitative texture calculations may be a useful approach to ultrasound tissue characterization. PMID- 6851049 TI - Optimal resources for implantable cardiac pacemakers. AB - In this document, the 1974 Inter-Society Commission for Heart Disease Resources (ICHD) report, Implantable Cardiac Pacemakers, has been revised and updated to emphasize the increased complexity of present-day pacing, to propose realistic guidelines for various aspects of pacing practice, and to identify the resources needed for delivery of this important mode of health care. The first section of the report describes the several types of pacemakers currently available, how they function, and how and to what purpose they may be modified through noninvasive programming. Recommendations are given for a modified and updated version of the widely accepted ICHD code for identification of pacing modes. The emphasis of the second section of the report is on physical and personnel resources. Matters considered in some depth include the training and qualification of the various medical, technical, and paramedical specialists involved in an implantation procedure; requirements for, and methods of achieving, short- and long-term surveillance of pacemaker patients; and the role of the hospital, the manufacturers, and the FDA in this new era of complex dual chamber, multiprogrammable pacemakers. PMID- 6851050 TI - Atrioventricular sequential pacing: differential effect on retrograde conduction related to level of impulse collision. AB - Patients with DDD pacemakers who have intact retrograde conduction are known to be at risk of developing ventricular and "endless loop" tachycardia. To address this problem, a pacing protocol was designed in which V2A2 conduction was assessed in 16 patients during ventricular pacing alone (standard method) and during paced atrioventricular (AV) sequential drive (AV sequential method); the results were then compared. In eight of 16 patients who had intact retrograde conduction with both methods (group 1), the V2A2 intervals were significantly shorter (by 60 to 340 msec) with the AV sequential method. In the remaining eight patients, who demonstrated V2A2 block with the standard method, no V2A2 block occurred with the AV sequential method. In this study, two sets of AV intervals were programmed to produce collision of the two impulses (atrial and ventricular), either in the AV node or the His-Purkinje system (HPS). The site of V2A2 facilitation was related to the site of impulse collision. These results can be explained by earlier excitation by the atrial impulse (of AV node and/or HPS) during AV sequential pacing. However, in some cases it was evident that antegrade propagation of the atrial impulse was responsible for subsequent facilitation. The data suggest that assessment of retrograde conduction in candidates for DDD pacemakers can be made most accurately by the AV sequential method. PMID- 6851051 TI - Secular trends in ischemic heart disease mortality: regional variation. AB - We compared secular trends in ischemic heart disease (IHD) mortality in four southeastern states (North Carolina, Georgia, South Carolina, and Virginia) with those in three selected other states (California, New York, and Utah). Mortality data were obtained from U.S. vital statistics and population information from the U.S. Census Bureau. Age-adjusted IHD mortality increased until 1968 in the southeastern states and then declined and declines were greatest in the nonwhite female population. In contrast, IHD mortality in all groups in California and in the female population in New York and Utah began to decline in the early 1950s, with accelerated declines since 1968. In all states the decline in rates in nonwhite populations have been greatest in the younger age groups. This has not been true in the white populations. Declining IHD mortality correlated moderately well with the decline in death from all cardiovascular disease and from all causes, but not with the declining cerebrovascular disease mortality. Respiratory cancer mortality increased in similar proportions in California and South Carolina, two states with dissimilar IHD trends. These findings suggest that improved control of hypertension and changing patterns of cigarette smoking may not be responsible for the recent decline in IHD mortality. PMID- 6851052 TI - Persistent sinus nodal electrograms during abnormally prolonged postpacing atrial pauses in sick sinus syndrome in humans: sinoatrial block vs overdrive suppression. AB - A transvenous electrode catheter technique was used for direct recording of bipolar sinus node electrograms during postpacing atrial pauses. Multiple repetitive local sinus node electrograms during atrial quiescence validate sinus node electrograms. Such atrial pauses with sinus node electrograms are due to sinoatrial block; atrial pauses without sinus node electrograms are due to overdrive suppression or improper recording. Eight consecutive patients were prospectively selected on the basis of a corrected sinus node recovery time greater than 1500 msec during diagnostic electrophysiologic evaluation. Six patients had atrial pauses with sinus node electrograms; three patterns of sinus node electrograms during atrial pauses were observed. We conclude that (1) sinus node electrogram recording is of value in understanding the mechanism underlying postpacing atrial pauses; (2) atrial pauses are usually (6/8) caused by sinoatrial block; (3) three patterns of sinus node electrograms are observed, thus making indirect interpretation unreliable. PMID- 6851053 TI - Detection of aortic porcine valve dysfunction by maximum entropy spectral analysis. AB - A high-resolution method of spectral analysis, of the class generally called "maximum entropy method," was used in a study of aortic porcine valve closing sounds in 37 patients (ages 19 to 76). Spectra from 27 normal xenografts, implanted from 2 weeks to 61 months previously, were characterized by a dominant frequency peak, F1, at 89 +/- 15 Hz (mean +/- SD), with a lower amplitude peak, F2, at 154 +/- 25 Hz. Eight of nine patients with aortic porcine valve dysfunction were proved surgically to have leaflet degeneration or infection and had either F1 (139 +/- 54 Hz) and/or F2 (195 +/- 74 Hz) significantly higher than normal (p less than .001). In two patients with paravalvar leak but no leaflet abnormality, F1 and F2 were in the normal range. Estimation of F1 and F2 was highly reproducible and was unaffected by duration of implant up to 5 years. Spectral analysis of aortic porcine valve closing sounds by the maximum entropy method may be useful for detection of intrinsic xenograft dysfunction. PMID- 6851054 TI - Effects of aging on changing arterial compliance and left ventricular load in a northern Chinese urban community. AB - Pulse wave velocity (PWV) was measured by means of transcutaneous Doppler techniques in the aorta, right arm, and right leg of 480 normal subjects of both sexes in urban Beijing, China (age range 3 to 89 years, mean age 41 +/- 20.8 SD); supine blood pressure was recorded in the brachial artery of each subject with standard sphygmomanometric procedures. Serum cholesterol was determined in a subgroup of 79 subjects (age 17 to 85 years, mean 47 +/- 26 SD). PWV (y in cm/sec) was found to vary with age (x, years) at each of the three locations according to the following regression equations: aorta, y = 9.2x + 615, r = .673 (p less than .001); right arm, y = 4.8x + 998, r = .453 (p less than .001); right leg, y = 5.6x + 791, r = .630 (p less than .001). Systolic, diastolic, mean, and pulse pressures were found to increase with age. PWV also increased with mean supine blood pressure but was not related to serum cholesterol (average 4.49 +/- 0.11 [SEM], mmol/l). Compared with that of Western populations, serum cholesterol tended to be lower at all age groups, systolic pressure higher at ages over 35 years, and PWV higher at all ages. Because change in PWV is directly related to change in arterial compliance, these results indicate that aging and not concomitant atherosclerosis (known to be rare in Asian populations) is the dominant factor associated with reduced arterial compliance and increased left ventricular load in these subjects. PMID- 6851055 TI - Dynamics of left ventricular filling at rest and during exercise. AB - Left ventricular filling dynamics were examined at rest and during supine bicycle exercise in 33 patients at cardiac catheterization; 23 had coronary artery disease (ischemia group), five with prior infarction had an akinetic area at rest (scar group), and five had minimal cardiovascular disease (control). Peak filling rate and mean filling rate during the first half and second half of diastole were assessed by biplane angiography. Simultaneous micromanometer pressures were used to compute the time constant of isovolumic pressure decay (T). Peak filling rate and mean filling rate during the first half of diastole increased with exercise in all groups (from 615 to 1050 and 358 to 681 ml/sec in controls and comparably in the scar group and from 697 to 1035 and 347 to 768 ml/sec in the ischemia group). However, T was greater (reduced rate of pressure decay) with exercise in the ischemia group (38 vs 26 msec in controls; p less than .05). Changes in the atrial driving pressure for filling appeared to counterbalance the difference in T. Mean filling rate during the second half of diastole increased with exercise in controls and in the scar group but only modestly in the ischemia group (from 202 to 349 ml/sec). The reduction in late diastolic filling during exercise induced ischemia was associated with increased filling in early diastole, with a middiastolic volume increase from 160 to 186 ml and an upward shift in the diastolic pressure-volume relation. Thus left ventricular filling is not impaired at rest in patients with coronary artery disease who have normal ejection fractions. Furthermore, the augmentation of early filling induced by exercise is not blunted but is maintained during ischemia, apparently at the expense of elevated left atrial pressure. However, late filling is restricted with ischemia by an increase in impedance. PMID- 6851056 TI - Interventricular septal configuration as a predictor of right ventricular systolic hypertension in children: a cross-sectional echocardiographic study. AB - Abnormal interventricular septal position and motion have been noted in patients with right ventricular pressure overload. The quantitative relationship between this alteration in septal configuration and the severity of right ventricular systolic hypertension has not been previously reported. We used cross-sectional echocardiography to assess the radius of septal curvature at end-diastole, midsystole, and end-systole in 20 normal children and 29 children (ages 2 weeks to 20 years) undergoing cardiac catheterization for a variety of congenital cardiac disorders. The measured septal radius of curvature (r) was normalized by the ideal radius (ri) for the left ventricular cavity area and then expressed as normalized septal curvature [l/(r/ri)]. A slight leftward shift and flattening of the interventricular septum occurred in the course of normal systolic contraction (mean +/- SEM normalized curvature at end-diastole 0.92 +/- 0.03 and at end systole 0.85 +/- 0.02; p less than .05). Marked exaggeration of this configurational change occurred in patients with right ventricular systolic hypertension (right ventricular systolic pressure greater than 50% systemic pressure), with progressive loss of curvature from end-diastole (0.45 +/- 0.05) to end-systole (0.19 +/- 0.06). Normalized septal curvature correlated well with relative right ventricular systolic pressure at all three sampling periods, with the best correlation at end-systole (r = .86). End-systolic flattening of the interventricular septum thus proved to be a sensitive marker for right ventricular systolic hypertension. PMID- 6851057 TI - Amiodarone: clinical efficacy and toxicity in 96 patients with recurrent, drug refractory arrhythmias. AB - Ninety-six patients with recurrent, drug-refractory tachyarrhythmias were treated with amiodarone for 8.0 +/- 7.5 months (range 1 day to 27 months): 77 for recurrent ventricular tachycardia or ventricular fibrillation (VT/VF), two for complex ventricular ectopy, and 17 for supraventricular tachyarrhythmias. The actuarial incidence of successful amiodarone therapy was 52 +/- 7% at 12 months and 28 +/- 9% at 24 months for patients with VT/VF. Neither patient with complex ventricular ectopy was successfully treated. Among the patients with supraventricular tachyarrhythmias, 64.7% were successfully treated for 7.7 +/- 7.6 months (range 1 to 22 months). Amiodarone toxicity occurred in 66 of 91 patients (72.5%) treated for more than 1 week. Fourteen patients had therapy limiting toxicity. Of these 14, six had pulmonary toxicity, four had arrhythmia exacerbation, one had hepatitis, one had renal toxicity, one had rash, and one had erythema nodosum. The actuarial incidence of therapy-limiting side effects was 27 +/- 7% at 15 months. We conclude that amiodarone is useful in the treatment of refractory tachyarrhythmias but that the rate of efficacy in VT/VF is lower and the incidence of significant toxicity is higher than has been generally appreciated. PMID- 6851059 TI - Power calculations for the Style-30 (Sheets design) and other intraocular lenses. PMID- 6851058 TI - The length of hospitalization after acute myocardial infarction determined by risk calculation. AB - The feasibility of the use of a Cox model for risk assessment of individualized hospital discharge after myocardial infarction was evaluated. First, a previously developed prognostic index computed at the fifth day after admission was tested on a new population of 1140 patients. It was confirmed that after 5 days half of the patients (52%) could be discharged with low risk. Second, a new competing risk variant of the Cox model that updates prognosis according to the occurrence of complications was developed that describes the risk of death, cardiac arrest, and cardiogenic shock within 44 days after hospital admission. With a risk of one of these events being below 2% during a 14 day period after proposed discharge, 453 patients of 966 survivors (47%) could be discharged after only 5 days. A longer stay (of up to 30 days) was proposed for 338 patients (35%) to achieve the same level of risk. The savings in hospitalization days would be 15%. These results were confirmed in a new sample of 197 patients from the same institution who were discharged according to the proposed system. Of the 169 day 5 survivors, 67% were discharged on days 6 through 15 and this resulted in only two unexpected deaths and a 20% savings in hospitalization days. We conclude that individually determined discharge time is feasible without increased risk of death of severe complications after early discharge. PMID- 6851060 TI - Changes in corneal curvature with long-term PMMA contact lens wear. PMID- 6851062 TI - Meibomian keratoconjunctivitis: oculo-dermal correlates. PMID- 6851063 TI - Effect of contact lens wear on the mitoses of corneal epithelial cells: preliminary report. PMID- 6851061 TI - Findings on follow-up of corneal warpage patients. PMID- 6851064 TI - Bausch & Lomb "O" lenses for extended wear. PMID- 6851065 TI - Hydrophilic contact lenses in aphakia: experience with geriatric patients intolerant to spectacle lens correction. PMID- 6851066 TI - Electrophysiologic studies on the effect of contact lenses on central nervous system activity. PMID- 6851067 TI - Stability of hydrogel intracorneal implants in non-human primates. PMID- 6851068 TI - Protection of the corneal endothelium during IOL surgery: a symposium. PMID- 6851069 TI - Budgerigar fancier's lung. The persistence of budgerigar precipitins and the recovery of lung function after cessation of avian exposure. AB - Forty-eight budgerigar fanciers have been studied and twenty-five (52%) of these lost their serum budgerigar precipitins after cessation of avian exposure. Twenty (80%) subjects lost their precipitins within 2 years. The lung function was assessed serially in seventeen patients with allergic alveolitis and correlated with the persistence of their serum precipitins. There was no difference in the lung function at presentation or in the incidence of complete recovery between the ten subjects, whose precipitins persisted for longer than 2 years, and the seven individuals in whom the precipitins had disappeared within this time. These observations suggest that budgerigar precipitins do not have a major role to play in the continuing pathogenesis of allergic alveolitis. PMID- 6851070 TI - The late bronchus-obstructive response to bronchial challenge with pigeon faeces and its correlation with precipitating antibodies (IgG) in the serum of patients having long-term contact with pigeons. AB - From a total of 160 patients with allergic bronchial asthma or chronic asthmatic bronchitis, eighteen (11.3%) patients reported being regularly exposed to pigeons. In these eighteen patients, bronchial provocation tests with pigeon faeces were performed and the precipitating antibodies (IgG) in their serum against pigeon faeces and serum were estimated. Of the eighteen patients, seven (39%) demonstrated a 'late bronchus-obstructive response' to pigeon faeces. Three patients developed only an 'isolated late response' and in the other four patients the late response occurred as a part of the 'dual response'. In the seven patients with the positive late bronchial response, the precipitating antibodies in their serum to pigeon faeces were positive in five (71%) and to pigeon serum in two (28%) of them. The late skin responses to pigeon faeces were positive in five (71%) patients, the blood eosinophilia increased in six (86%) of them, a slight pyrexia occurred in two (28%) and general malaise symptoms appeared in six (86%) of them. None of these patients developed changes on the chest X-ray during the late response. The remaining eleven patients did not develop any bronchial response to pigeon faeces challenge, although in six (55%) of them the late skin responses were positive, and two (18%) had precipitating antibodies in the serum to pigeon faeces and one (9%) to pigeon serum. It is concluded that positive precipitating antibodies in the serum to pigeon faeces and serum are important parameters for detection of pigeon breeder's disease in exposed individuals, however confirmation of this diagnosis should be provided by the bronchial provocation tests. PMID- 6851071 TI - Site of airflow obstruction in immediate and late reactions to bronchial challenge with Dermatophagoides pteronyssinus. AB - The density dependence of maximum flow in ten atopic asthmatics was assessed by response to breathing a helium-oxygen mixture. They were then subjected to bronchial challenge by Dermatophagoides pteronyssinus and density dependence re assessed during early and late bronchial reactions. There was considerable individual variation in the density dependence before challenge and in the change in density dependence during induced bronchospasm. However, for any given individual the results were similar during early and late reactions. This suggests that the major site of airflow obstruction may vary from one asthmatic to another but that when antigen challenge is followed by a dual early and late reaction the site of obstruction is similar at each stage. PMID- 6851072 TI - Lymphocyte transformation studies in suspected hypersensitivity to trimethoprim sulphamethoxazole. AB - In a group of patients with suspected and probable adverse skin reactions to trimethoprim-sulphamethoxazole, the lymphocyte transformation test (LTT) was positive in approximately 60% of subjects tested. Levels of stimulation in the majority of cases were low, probably reflecting either use of inappropriate stimulatory forms of the drug or lack of marked reactivity. Since there appeared to be a correlation between peak stimulatory index and duration of the rash, the latter explanation appeared more likely. PMID- 6851074 TI - Persistent nausea and food aversions in pregnancy. A possible association with cow's milk allergy in infants. AB - In a retrospective study the mothers of twenty-one children with well-defined cow's milk allergy and an equal number of matched controls were asked about their health and diet in pregnancy and the pattern of feeding of their children in infancy. Corroborative evidence was obtained from the medical notes. Nausea in pregnancy was found to be more persistent and atopic disease more common among the mothers of the milk allergic children; in this group food aversions during pregnancy were also more common particularly to dairy produce. The milk-allergic infants had been breast-fed for longer and had cow's milk introduced into feeds later than the control group. It is suggested that nausea in pregnancy may be a physiological response to foetal sensitization by dietary antigens such as cow's milk protein, due to impaired placental permeability in atopic pregnant women. A larger prospective study is indicated to substantiate this hypothesis. PMID- 6851073 TI - Serum dopamine beta-hydroxylase and free fatty acids in exercise-induced asthma. AB - Serum dopamine beta-hydroxylase activity, which is thought to reflect noradrenaline secretion, and free fatty acid level were measured in twenty atopic asthmatic children, of whom ten had exercise-induced asthma (EIA), after exercise on the treadmill. There was a significant decrease in the level of serum dopamine beta-hydroxylase activity in the asthmatics who developed EIA and this closely accompanied the onset of airflow obstruction. There was no change in the free fatty acid levels. In contrast, the asthmatics, who did not have EIA showed a significant rise in the levels of dopamine beta-hydroxylase activity and free fatty acids after the same exercise task. Our results suggest that the atopic children studied, who developed EIA, may have had an impaired noradrenaline response to exercise. It is further suggested that this impaired noradrenaline secretion may facilitate mediator release and contribute to the airflow obstruction in EIA. PMID- 6851077 TI - Evaluation of the PaT Stat Kinetic UV Test set for the determination of phenylalanine and tyrosine in serum or plasma. AB - We have evaluated the PaT Stat Kinetic UV Test Kit for the simultaneous determination of phenylalanine (Phe) and tyrosine (Tyr) in plasma or serum. The Phe and Tyr concentrations measured with the kit show a coefficient of variation of about 15% for both within- and between-day determinations. The assays for both Phe and Tyr are linear to concentrations of at least 18 mg/dL without predilution of the specimen. Concentration differences of as little as 0.5 mg/dL are distinguishable. No significant interference was found from either phenylpyruvate or phenyllactate at levels up to 0.5 mM, nor from bilirubin, haemoglobin, or triglycerides at levels well above those generally found in clinical specimens. A comparative study of 70 clinical specimens, using the kit method and an amino acid analyzer (AAA) showed a linear relationship. Least-squares analysis of the data yielded the following parameters (AAA as reference): slope = 0.93 to 1.00, intercept = 0.04 to 0.21, correlation coefficient = 0.97 to 0.98. We conclude that the kit is suitable for the determination of Phe and Tyr in plasma or serum and can enable any laboratory equipped with a recording UV-spectrophotometer to assay these two amino acids for the dietary management of PKU. PMID- 6851076 TI - Hyaline ascospores as a cause of the epidemic of asthma deaths in the 1960s. PMID- 6851075 TI - Seasonal variations of total histamine in patients with seasonal allergic rhinitis. AB - Seasonal variations of total blood histamine were examined in twenty patients with seasonal allergic rhinitis (Japanese cedar pollinosis). In blood specimens taken in the pollen season of 1978, the symptom-free season of 1978, and the pollen season of 1979, the mean values of blood histamine were 61.6, 50.0 and 84.2 ng/ml respectively. The differences in blood histamine levels between the pollen season of 1978 and the symptom-free season of 1978 and between the symptom free season of 1978 and the pollen season of 1979 were statistically significant. In the symptom-free season of 1978, the blood histamine levels of twenty normal subjects were also examined; the mean value was 58.2 ng/ml. The blood histamine levels of the patients in the symptom-free season were not statistically different from those of the normal subjects. PMID- 6851078 TI - Measurement of human skeletal muscle acetylcholine receptor antibodies using monkey receptors. AB - Human skeletal muscle acetylcholine receptor (AChR) antibodies were assayed by a double immunoprecipitation technique using 125I-alpha-bungarotoxin as the label. Monkey AChRs were found to be superior to those from diabetic humans for analytical and practical reasons. The analytical sensitivity is 0.05 nmol alpha bungarotoxin/L serum. The between-run and within-run precision (1 c.v.) of the assay are 13% and 3%, respectively. The normal range is 0-0.2 nmol alpha bungarotoxin/L. There was no correlation between the antibody concentration and the clinical severity of myasthenia gravis. The clinical sensitivity and specificity of the assay for generalized myasthenia gravis are 79% and 96%, and for ocular myasthenia gravis 29% and 96%, respectively. PMID- 6851079 TI - Evaluation of a chromatographic method for globin chain biosynthesis in thalassemia. AB - We report our experience with a column chromatographic procedure for separating 3H-leucine-labelled alpha and beta globin. In non-thalassemic subjects the alpha: beta biosynthesis ratio was 1.04 +/- 0.10 S.D. An abnormal ratio was useful in defining thalassemia variants. The technique, although labour intensive, is not difficult and is recommended for any hospital laboratory acting as a reference centre for the diagnosis of hemoglobinopathies. PMID- 6851082 TI - Breath ethyl alcohol concentration and analysis in the presence of chronic obstructive pulmonary disease. AB - We have made continuous measurements of exhaled ethanol concentration vs volume during slow expiration in subjects with plasma ethanol concentrations up to 700 mg/L. Subjects included individuals with normal pulmonary function and those with severe chronic obstructive pulmonary disease (COPD). In addition to the measurements of breath ethanol made using a flame ionization detector, paired measurements were also made of plasma ethanol and breath ethanol using a Model 900A Breathalyser. In normal subjects, the breath ethanol concentration was found to increase continuously during expiration until the very end of the expiration when a decline in concentration was noted. In the presence of COPD the ethanol concentration/volume tracing was essentially flat during the middle portion of expiration, but many subjects showed a decrease in concentration at the end of the expiration. One subject showed a sharp rise in breath concentration at the end of expiration. The results suggest that fluctuations in the ethanol concentration are caused by variation in the ventilation/perfusion ratio of regions of the lung supplying the expirate, and that breath with ethanol in equilibrium with the plasma is not routinely obtained, especially at the end of a maximal expiration. Thus, exhaled air at the end of maximal expiration does not always provide the best, or a close, indication of the plasma (or blood) ethanol concentration. The peak breath ethanol concentrations found were, as an equivalent plasma concentration, = -25 + 0.924 X plasma ethanol, mg/L. The Breathalyser readings = -45 + 0.898 X plasma ethanol, mg/L, with a mean difference of -81 mg/L. PMID- 6851080 TI - The high performance liquid chromatographic measurement of chloramphenicol and its succinate esters in serum. PMID- 6851081 TI - A comparison of dye binding methods for albumin determination: the effects of abnormal sera, reaction times, acute phase reactants and albumin standards. AB - Four bromcresol green methods were evaluated, three of which were used with a reaction time of 15 seconds. An immunonephelometric assay and a bromcresol purple method were used as comparison methods. The bromcresol purple method agreed well with the more specific immunonephelometric procedure. Forty-seven human sera, thirty with low albumin concentrations and seventeen with high albumin concentrations were used in each assessment. The best bromcresol green methods were those using low dye and surfactant (Brij-35) concentrations and the shortest possible reaction times. Except in one bromcresol green method with a long reaction time of 10 minutes, there was no significant difference in values overall between sera having a low albumin concentration with either raised or normal acute phase reactants. Comparable results were obtained using standards of human and bovine albumin preparations in bromcresol green methods but not in the bromcresol purple method. PMID- 6851083 TI - Is there a role for routine estimations of plasma magnesium? AB - The inclusion of magnesium in a blood chemistry profile has resulted in the detection of potentially significant abnormalities in 2.7% of specimens analyzed. Hypomagnesaemia occurs most often in patients treated with intravenous fluids or diuretics, and hypermagnesaemia in patients with renal failure. Hypomagnesaemia is often associated with abnormalities of potassium or calcium metabolism. Inclusion of magnesium in a routine blood chemistry profile is not clinically justified. PMID- 6851084 TI - Changes in serum myoglobin, total creatine kinase, lactate dehydrogenase and creatine kinase MB levels in runners. AB - A comparison was made between pre- and post-run serum levels of total creatine kinase (CK), CK-MB isoenzyme, lactate dehydrogenase (LD) and myoglobin (MG) levels in 84 runners in each of three groups; male 5-10 mile run; female 5-10 mile run; and male 15-55 mile run. Levels of CK-MB and MG were quantified using radioimmunoassay, while total CK and LD were measured using spectrophotometric procedures. Post-run levels of all four markers were significantly higher than the pre-run levels (p less than 0.001). Although levels of enzymes and MG correlated with the sex and distance run, the post-run changes did not correlate with age nor with the smoking status of the runners. Elevation of these markers as a result of vigorous exercise in the absence of myocardial infarction requires cautious interpretation of serum enzyme changes in runners. PMID- 6851085 TI - Effect of ingested lead on concentration of blood and tissue lead in rabbits. AB - The accumulation of lead (Pb) and erythrocyte protoporphyrin (EP) in blood was studied in 11 rabbits. The rabbits were given a daily dose of 50 mg Pb as lead nitrate, dissolved in 100 mL of drinking water. Blood samples were drawn once a week from the ear lobes and assayed for Pb and EP. The Pb concentration increased sharply during the administration of Pb while the EP concentration rose slowly. When Pb was withdrawn its concentration fell immediately, whereas the EP concentration started decreasing only after two weeks and the decrease was slower. At the end of the experiment the rabbits were sacrificed and the Pb content of a number of organs determined. The largest accumulation of Pb was in bone, followed by kidney, liver, lung, spleen, brain and heart. The concentration of Pb in brain and heart was much lower than in the excretory organs - spleen, kidney and liver. PMID- 6851087 TI - 125I-labeled radioimmunoassay kits for progesterone evaluated for use in an vitro fertilization program. AB - We have evaluated two commercially available 125I radioimmunoassay kits (Diagnostic Products Corp., DPC; and Radioassay Systems Laboratories, RSL) for measurement of serum or plasma progesterone, to determine their suitability for use in in vitro fertilization programs. Both kits were suitably rapid for program requirements. Results by both were linear with concentration up to 60 nmol/L, and both had acceptable lower detection limits of 0.3 nmol/L. Kit-determined progesterone concentrations (y) for 100 patients' samples correlated well with results by our existing 3H radioimmunoassay method (y = 1.11x + 0.2, r = 0.965 for the DPC kit; y = 1.01x + 1.4, r = 0.974 for the RSL kit). Mean analytical recovery for the RSL kit was 116%, that for the DPC kit, 202%. Within-batch precision, expressed as the mean CV for three concentrations of progesterone, was 6.5% for the RSL kit, and 16.4% for the DPC kit; between-day CV was 8.1% for the RSL kit, 17.7% for the DPC kit. We conclude that the RSL kit provides a rapid, precise, and accurate assay for serum progesterone, suitable for use in a fertilization program, but do not recommend the DPC kit for either this purpose or the more general purpose of tracking menstrual cycles. PMID- 6851086 TI - Measurement of true salicylate concentrations in serum from patients with Reye's syndrome. AB - Patients with Reye's syndrome who have been given aspirin are said to maintain higher-than-anticipated salicylate concentrations in blood, for longer than expected. We explored whether this could be attributed to spurious results from nonsalicylate compounds in the Trinder reaction for salicylates. All of 63 organic acids and amines examined that form colored complexes with Trinder's reagent had detectable absorbance at 540 nm at 0.2 g/L, including some endogenous compounds known to be increased in Reye's syndrome patients and many others endogenous in humans. By subjecting deproteinized sera to thin-layer chromatography and eluting the salicylate fraction before complexing it with ferric ion, true salicylate can be measured quantitatively and differentiated from interfering compounds. In addition, when we examined the effect of salicylate on palmitate binding to serum proteins, we found that salicylate concentrations of 0.2 g/L displaced [16-14C]palmitate binding to protein more in Reye's syndrome patients than in Reye's syndrome survivors or children with influenza. This suggests the presence of atypical binding characteristics for salicylate and palmitate in the acute disorder but not in survivors or children with influenza. PMID- 6851088 TI - Interpretation of cerebrospinal fluid protein assays in various neurologic diseases. AB - Albumin and immunoglobulin G (IgG) were determined in cerebrospinal fluid (CSF) and serum, and the CSF/serum albumin Index (CSF X 10(3)/serum albumin concentration ratio) and IgG Index [(CSF/serum IgG)/(CSF/serum albumin)] were calculated. Data for these indices and oligoclonal banding are described in 23 cases of multiple sclerosis (MS), 19 of systemic lupus erythematosus (SLE), eight of sarcoidosis, 48 cases of miscellaneous disease, and 25 control patients with nonspecific complaints. Of the MS, SLE, and sarcoidosis patient groups, 8.5%, 26%, and 12.5% showed an abnormally high CSF/serum albumin Index; 87%, 16%, and 0% an increased IgG Index; and 87.5%, 42% and 0% showed positive oligoclonal banding. IgG Index and oligoclonal banding results for MS patients differed significantly from the sarcoidosis (p less than .001) and SLE (p less than .05) groups. When the CSF/serum albumin Index is considered also, the control and sarcoidosis patient results differ significantly from the MS group (p less than .001 and p less than .01). A strong correlation between the IgG Index and oligoclonal banding is implicated. PMID- 6851089 TI - Pseudocholinesterase/high-density lipoprotein cholesterol ratio in serum of normal persons and of hyperlipoproteinemics. AB - The proposed complementary risk factor, pseudocholinesterase/high-density lipoprotein cholesterol ratio, was significantly higher in patients with type IIb and IV hyperlipoproteinemias then in controls. In contrast, the established risk factor, total cholesterol/high-density lipoprotein cholesterol ratio, was significantly higher in patients with type IIa and IV hyperlipoproteinemias. Discriminant analysis indicated that prediction of risk for coronary heart disease on the basis of lipoprotein phenotypes can be improved by about 20% when both the above factors are assessed concurrently. On the basis of earlier studies in humans and animals, we also suggest that the proposed risk factor may provide a better understanding of events leading to enhanced risk for coronary heart disease as a consequence of nutrition and of abnormal metabolism of lipids and lipoproteins. PMID- 6851090 TI - Reflectance digital matrix photometry. AB - We have designed and constructed a digital matrix photometer for quantitative measurement of reflected light of small chromophoric areas or colored spots. The areas are divided conceptually into small subunits in which the reflected light is measured. This is done through stepwise scanning with a photodiode array. The sum of the individual reflectance measurements is related to the total amount of an analyte in the spot. We have found that this technique makes possible accurate and precise quantitation of light-absorbing substances in small areas of different sizes, shapes, and internal irregularity measuring as little as 1 mm across. PMID- 6851091 TI - Beta-carotene determined in serum by liquid chromatography with an internal standard. AB - We describe a procedure for quantitative determination of beta-carotene in human serum. The 0.1-mL serum sample is precipitated with ethanol containing the internal standard, dimethyl-beta-carotene, then extracted with hexane. This extract is injected onto a reversed-phase, "high-performance" liquid chromatography column, and the carotenes are resolved and eluted with an acetonitrile/methylene chloride isocratic solvent system. They are quantified from the peak-height ratios of their absorbance at 450 nm. About 14 min is required for each chromatogram. The procedure has excellent precision and is appropriate for routine use in analysis of large numbers of samples. The method should be particularly useful for clinical studies on the relationship of serum beta-carotene and cancer incidence in human populations. PMID- 6851093 TI - Serum LD-1 activity in suspected acute myocardial infarction. AB - We have studied the diagnostic value of measuring lactate dehydrogenase (LD) isoenzyme 1 in serum of 331 cases of suspected acute myocardial infarction (AMI). At a discriminatory level of 200 U/L (Scandinavian Committee on Enzymes, recommended method for the determination of LD) LD 1 verified the diagnosis in 96% of the AMI cases and excluded it in 96% of the not-AMI cases when samples were drawn 24-72 h after onset of pain. The correlation between 24-h S-LD-1 and 16-h S-CK B activities was 0.94 in the AMI cases. We found that quantitation of serum LD-1 is diagnostically more reliable than the serum LD-1/LD ratio. PMID- 6851094 TI - Stability of estrogen- and progesterone-receptor concentrations in human uterus tissue. AB - Homogeneous control specimens for estrogen receptor (ER) and progesterone receptor (PR) assays were prepared from freshly collected human uterus. After removal of the connective tissue, the specimen was washed with isotonic saline, cut into small pieces, quickly frozen in liquid nitrogen, and stored at -70 degrees C until analyzed. Cytosol prepared from this specimen was lyophilized and stored at -70 degrees C. A single step of reconstitution, with glycerol (100 mL/L) in water, is sufficient to prepare a control. Two specimens prepared this way were found to be reasonably stable for 20 months (first specimen, mean +/- SD: ER = 22.1 +/- 2.9 fmol/mg, PR = 136.5 +/- 26.9 fmol/mg; second specimen: ER = 107.2 +/- 11.7 fmol/mg, PR = 922 +/- 71.6 fmol/mg). Another specimen, prepared similarly but not frozen in liquid nitrogen soon after collection, was less stable; its ER and PR concentrations deteriorated faster. PMID- 6851092 TI - Immunoquantification of total apolipoprotein B in serum by nephelometry: influence of lipase treatment and detergents. AB - The immunoquantification of total apolipoprotein B in human serum has been evaluated by rate and equilibrium nephelometry. The presence of triglyceride-rich lipoproteins spoiled all immunochemical assays and yielded too-high values for apolipoprotein B. The use of detergents improved the results substantially, but results were inaccurate at high triglyceride concentrations. Of many detergents investigated, only Thesit, Kryo Ebo, and Apovax were useful, decreasing the light scatter signals almost linearly with increasing detergent concentrations. The regression lines, however, were not parallel among the different apo B-containing lipoproteins. Incubating sera or apo B-containing lipoproteins with bovine milk lipoprotein lipase or bacterial triacylglycerol lipase, at concentrations of 100 kU/L, hydrolyzed all of the triglycerides and most of the phosphatidylcholine within 18 h at 37 degrees C Lipase-pretreatment of samples gave optimal correlation between apo B values as determined by nephelometry with those obtained gravimetrically. We also assessed the influence of sample storage, freezing, and thawing on the nephelometric apo B assays. PMID- 6851095 TI - Enzyme inactivation in serum before determination of total bile acids. AB - Endogenous NADH-generating enzymes must be inactivated before total serum bile acids can be measured accurately by the direct enzymic method. To do this, we pretreat the sera with NaOH, in a final concentration of 0.1 mol/L. Consequently, lactate dehydrogenase activity at least as high as 30 000 U/L is destroyed, obviating blank determinations. Values for bile acid in serum, so obtained, agree with values obtained after pretreatment with heat, an alkali-methanol solution, or sodium pyruvate, but our pretreatment has the advantages of ease, speed, economy, and negligible blank values. PMID- 6851096 TI - Reagent for the enzymatic determination of serum total cholesterol with improved lipolytic efficiency. AB - We describe a sensitive method for quantifying the extent of cholesterol ester cleavage during enzymatic assay of total cholesterol in serum. Lipids are extracted from the assay mixture with chloroform/methanol (1/1 by vol), concentrated, then quantified by "high-performance" thin-layer chromatography. Although with conventional enzymatic reagents for determination of serum total cholesterol the hydrolysis of the cholesterol esters may be incomplete, a new enzymatic cholesterol reagent (Monotest Cholesterol, High Performance, Boehringer Mannheim) gives virtually complete cholesterol ester cleavage (i.e., greater than or equal to 99.5%). Use of this reagent with its improved lipolytic efficiency yields results for serum total cholesterol that are identical to those measured with a candidate reference procedure involving alkaline cholesterol ester saponification. PMID- 6851097 TI - Glycosylated hemoglobin measured by affinity chromatography: micro-sample collection and room-temperature storage. AB - Under proper conditions, whole blood can be stored at room temperature for as long as 21 days before measurement of glycosylated hemoglobin by affinity chromatography. Whole blood (anticoagulated with EDTA or heparin) was placed in capillary tubes, which were then sealed at both ends and stored at room temperature. Just before assay, whole blood was rinsed from the tubes and diluted 10-fold with water. Samples of each patient's blood were assayed as whole-blood hemolysates by affinity chromatography after zero, seven, 14, and 21 days of storage. Values for glycosylated hemoglobin did not change over 21 days of storage and values for each storage day correlated well (r = 0.97, p less than .0001) with hemoglobin A1C measured in fresh erythrocyte hemolysates by "high performance" liquid ion-exchange chromatography. PMID- 6851098 TI - Liquid-chromatographic study of fluorescent materials in uremic fluids. AB - Using reversed-phase "high-performance" liquid chromatography with fluorescence detection, we separated and identified some naturally fluorescent compounds in uremic serum and hemodialysate from patients with chronic renal disease. Several of the naturally fluorescent compounds were identified as indole derivatives by co-chromatography with authentic standards. In one specific case, the identity was confirmed by an enzymic peak-shift method. Compounds identified included indican, kynurenic acid, tryptophan, and 5-hydroxy-indole-3-acetic acid. Comparison of normal and uremic serum showed that the fluorescent materials are present in significantly greater concentrations in samples from uremic patients. PMID- 6851099 TI - Liquid-chromatographic determination of nadolol in plasma. AB - We describe a liquid-chromatographic procedure for determining nadolol in plasma. After an analog of nadolol is added as internal standard, the plasma sample is passed through a disposable BondElut C18 column. After several column washes, nadolol and the internal standard are eluted with methanol, and the eluate is evaporated and reconstituted with the mobile phase (acetonitrile/water, perchloric acid, and tetramethylammonium hydroxide). An aliquot of the extract is chromatographed on a non-silica resin-base reversed-phase column. The peaks are detected by fluorescence (lambda ex = 265 nm and lambda em = 305). Drug and internal standard are well resolved, and only a few extraneous peaks appear. The standard curve ranges from 10 to 400 micrograms/L. We are using this procedure to determine steady-state concentrations of nadolol in patients receiving various dosages of nadolol along with other types of antihypertensive drugs. PMID- 6851100 TI - Improved determination of aluminum in serum by electrothermal atomic absorption spectrophotometry. AB - This method for determining aluminum in human serum involves electrothermal atomic absorption spectrophotometry. A longer drying time allows less pre dilution of the sample, and the method also includes a flush cycle after atomization. Standard-addition methodology is used to eliminate matrix effects and the need for a standard curve. We used this method on serum from 50 normal persons and from 34 patients with chronic renal failure who were on long-term intermittent hemodialysis. The mean normal serum aluminum concentration was 6.1 micrograms/L (CV 2.7%), and values for the patients ranged from 13 to 475 micrograms/L. PMID- 6851101 TI - Evaluation of a direct potentiometric method for sodium and potassium used in the Du Pont aca. AB - We evaluated an accessory that enables the Du Pont aca discrete analyzer to measure Na+ and K+ by direct potentiometry (aca/ISE). Na+ and K+ gave linear responses in both the blood and urine modes, with no carryover. No interfering species were identified in the blood mode. Intra-assay and interassay precision for Na+ and K+ were more than adequate and analytical recoveries comparable to those with flame photometry were found for plasma. The Na+ and K+ values for plasma were comparable with those obtained by use of another direct potentiometric analyzer (the Orion SS-30), but slightly higher than flame photometric values. Samples from patients with hyperlipemia and multiple myeloma gave clinically relevant values with the aca/ISE, but the flame photometric values were artefactually low. Whole blood could not be accurately analyzed. The aca/ISE is a precise, easy-to-use instrument, which gives values for plasma similar to those obtained with direct potentiometric analyzers. For analysis of urine, certain precautions are necessary. PMID- 6851102 TI - Reversed-phase liquid-chromatographic simultaneous analysis for thiopental and pentobarbital in serum. AB - We describe a reversed-phase liquid-chromatographic assay suitable for therapeutic monitoring of thiopental and pentobarbital simultaneously in human serum. The drugs are extracted from serum at pH 6.6 into n-butyl chloride containing thiamylal and barbital as the respective internal standards. The compounds are back-extracted into dilute sodium hydroxide, an aliquot of which is submitted to chromatography. The lowest measurable concentrations are 1.0 mg/L for thiopental and 2.0 mg/L for pentobarbital. The standard curve is linear from 0 to 100 mg/L for both. Between-run CVs are: at 25 mg/L, 4.1% (thiopental) and 3.2% (pentobarbital); at 50 mg/L, 2.8% (thiopental) and 3.4% (pentobarbital). Data on patients receiving thiopental and pentobarbital illustrate use of the method. PMID- 6851103 TI - Liquid-chromatographic determination of aminoglutethimide in plasma. AB - A simple, rapid "high-performance" liquid-chromatographic procedure is presented for the determination of aminoglutethimide in plasma. After precipitation of the protein with acetonitrile, an aliquot of the supernate is injected directly onto a radially compressed, reversed-phase column. The aminoglutethimide is isocratically eluted with a mobile phase of acetonitrile/water/tert-butyl ammonium phosphate. The method is both accurate and precise and has been in routine use in our laboratory for more than 12 months. PMID- 6851104 TI - Interference from renal dialysis patients' specimens in a direct method for serum iron. AB - In a direct-measuring, sample-blank procedure for serum iron we obtained spuriously high results for renal hemodialysis patients. These spurious results were found to be the result of protein precipitating out of solution owing to anticoagulation of these patients with heparin during hemodialysis. Two methods are described for circumventing this interference: adjusting the pH of the buffer and adding sodium dodecyl sulfate (lauryl sulfate). We prefer the latter procedure for reasons which are discussed, and optimized conditions are described for it. The effects on results by this latter method of bilirubin, hemolysis, and turbidity are described. The method is also evaluated for precision and accuracy, and it is recommended for routine use. A significant "protein effect" (due to viscosity) is noted, which has implications for calibration of the American Monitor KDA instrument. PMID- 6851105 TI - Three commercial methods for serum ferritin compared and the high-dose "hook effect" eliminated. AB - We evaluated four commercial kits for measuring serum ferritin, based on three techniques: immunoradiometric assay, radioimmunoassay, and enzyme immunoassay. The kits evaluated were those manufactured by Abbott Laboratories, Clinical Assays, Corning Medical, and Ramco. Two of the immunoradiometric kits showed satisfactory results with respect to sensitivity and precision; they should be useful in diagnosing individuals with uncomplicated iron-deficiency anemia. One of the immunoradiometric assay kits, however, showed a high-dose "hook effect," beginning at 10 mg of ferritin per liter. We modified this kit to eliminate this effect, at least to ferritin concentrations of 33 mg/L. (We observed a ferritin value as high as 47 mg/L in one patient.) Results with all these kits did not inter-compare well for ferritin concentrations greater than 300 micrograms/L, a finding that casts further doubt on the controversial use of serum ferritin measurement in cases of iron overload. PMID- 6851106 TI - Effects of whole blood storage on results for glycosylated hemoglobin as measured by ion-exchange chromatography, affinity chromatography, and colorimetry. AB - After storage of whole blood at either 4 or 20 degrees C, results for glycosylated hemoglobin by ion-exchange chromatography ("high-performance" liquid and mini-column chromatography), thiobarbituric acid colorimetry, and affinity chromatography were compared. At 4 degrees C, all methods gave acceptable results for samples stored for as long as a week. At 20 degrees C, the colorimetric and affinity methods also showed sample stability for a week or more. The ion exchange methods were associated with a marked increase in values for glycosylated hemoglobin after a few days of storage. Evidently, care in details of sample collection and handling is especially important for ion-exchange methods, and the colorimetric and affinity methods have advantages over ion exchange in situations where long delays between sample collection and assay are unavoidable. PMID- 6851107 TI - Boehringer immunoinhibition procedure for creatine kinase-MB evaluated and compared with column ion-exchange chromatography. AB - In determination of creatine kinase isoenzyme MB (CK-MB), the Boehringer immunoinhibition method gives a high and variable blank activity as compared with column-chromatography. Thus a correction must be applied. Furthermore, a second correction of 1% of total creatine kinase activity is necessary to compensate for nonspecific creatine phosphate-dependent activity. As a consequence, two immunoinhibition determinations--one for CK-MB and one for blank activity--and a determination of total creatine kinase are required. Use of the manufacturer's diagnostic criteria, on the basis of which suspected myocardial infarction is confirmed or eliminated, leads to a high frequency of false-negative conclusions. PMID- 6851110 TI - Abstracts of meeting papers: 35th national meeting of the American Association for Clinical Chemistry. July 24-29, 1983, New York, New York. PMID- 6851108 TI - Automated particle-counting immunoassay of C-reactive protein and its application to serum, cord serum, and cerebrospinal fluid samples. AB - The assay for C-reactive protein has been fully automated as a particle-counting immunoassay. For cerebrospinal fluid, cord serum, and adults' serum its range of sensitivity extends from 1 microgram/L to 300 mg/L, with a minimal sample dilution of twofold and a maximal dilution of 50-fold being required. This range is so broad because free antibodies are added to the reaction medium. However, we have used Fab fragments rather than whole antibody to avoid too steep a standard curve and a decrease of agglutination at high concentrations of antigen. For 99 consecutive cord sera examined, the concentrations of C-reactive protein ranged from 7 micrograms/L to 1.750 mg/L. The geometric mean was 50 micrograms/L and the upper normal limit (geometric mean +/- 2 SD of the log values) was established at 525 micrograms/L. PMID- 6851111 TI - Bilirubin interferes in the aca determination of Mg2+ in serum. PMID- 6851109 TI - New statistical approach in biochemical method-comparison studies by using Westlake's procedure, and its application to continuous-flow, centrifugal analysis, and multilayer film analysis techniques. AB - In this paper, we present an application of Westlake's method (Biometrics 32:741, 1976) in method-comparison studies in clinical chemistry. The techniques under study are continuous flow (CF), centrifugal analysis (CA), and multilayer film analysis (the Kodak Ektachem procedure KE). The experimental data are for plasma calcium and serum uric acid. It results from a particular regression procedure proposed by York (Can J Phys 44:1079, 1966) that the usual regression comparison technique (joint testing procedure) is irrelevant because it rejects the identity hypothesis for the three methods, whereas fixing a tolerable upper limit deviation, delta, between two methods would lead to the conclusion that, in 95% of cases, CF and KE results are equivalent for plasma calcium (delta less than or equal to 45 mumol/L) and CF is roughly equivalent to the other two methods for serum uric acid (delta less than or equal to 27 mumol/L). PMID- 6851112 TI - Cloxacillin interference with screening tests for Bence Jones proteins. PMID- 6851113 TI - Sodium drift in the Beckman ASTRA: a response. PMID- 6851114 TI - Urine urea nitrogen as measured in the Beckman Astra-8. PMID- 6851115 TI - Evaluation of a kit to measure HDL cholesterol (HDL-C) in serum. PMID- 6851117 TI - A potential problem on comparison of plasma with serum for zinc content. PMID- 6851116 TI - Cefoxitin interference with urinary 17-hydroxycorticosteroid determination. PMID- 6851118 TI - Determination of total urinary and cerebrospinal fluid protein with a new precipitant-dye method. PMID- 6851119 TI - Measurement of serum calcium by use of a rapid kit procedure. PMID- 6851120 TI - Automated sequential urea and glucose assay in one cuvet. PMID- 6851121 TI - Kits for measurement of free thyroxin. PMID- 6851122 TI - Enzymatic assay for methotrexate with a centrifugal analyzer (Cobas-Bio) PMID- 6851124 TI - "Alpha" and "beta" errors. PMID- 6851123 TI - Aluminum, barium, silicon, and strontium in amniotic fluid by emission spectrometry. PMID- 6851125 TI - Chloride interference with use of an iodide-selective electrode for urinary I. PMID- 6851126 TI - Fetal alcohol syndrome and lactic acidosis. PMID- 6851128 TI - Marked post-operative increase in serum aspartate aminotransferase activity. PMID- 6851127 TI - Glucose method comparison criticized. PMID- 6851129 TI - Is there an enzymatic reversibility of nonenzymatic glyosylation of hemoglobin? PMID- 6851131 TI - The histopathology of viral hepatitis and its sequelae. PMID- 6851130 TI - Triamterene interferes in urinary catecholamine analyses. PMID- 6851132 TI - Hepatitis in hospitals. PMID- 6851133 TI - Horizontal transmission of hepatitis viruses. PMID- 6851135 TI - Aspects of viral hepatitis in infancy and childhood. PMID- 6851136 TI - Prophylaxis of hepatitis B infection. AB - The prophylaxis of hepatitis B by interrupting transmission of the virus, by passive and active immunisation is discussed with particular relation to problems arising in obstetrics. Better information about the incidence of the infection and the clinical disease is urgently required to provide a rational basis for optimal use of the vaccines which will soon become available. PMID- 6851137 TI - Stereospecificity of phenylalanine plasma kinetics and hydroxylation in man following oral application of a stable isotope-labelled pseudo-racemic mixture of L- and D-phenylalanine. AB - L-[15N]Phenylalanine and D-[2H5]phenylalanine have been administered orally to two healthy adult volunteers as a pseudo-racemic mixture at a dose of 25 mg/kg each. After oral application, the plasma kinetics of phenylalanine and tyrosine have been followed by the combined use of high pressure liquid chromatography and field desorption mass spectrometry. Additional incubation with D-amino acid oxidase was used to determine the enantiomeric composition of the differently labelled species of phenylalanine and tyrosine. D-Phenylalanine plasma levels show a faster rise to higher maximum values compared to L-phenylalanine (D/L ratio at maximum 3.19, 3.26). L-Phenylalanine is efficiently hydroxylated to L tyrosine. In contrast, conversion of D-phenylalanine to the L-form with subsequent hydroxylation to L-tyrosine was observed. From the plasma kinetics it is estimated that about 1/3 of the applied dose of 25 mg/kg of D-phenylalanine is converted to the L-isomer. Of the administered dose of L-phenylalanine only very small amounts are excreted into urine as such (0.25%, 0.8%), whereas a substantial amount of the D-phenylalanine dose is found in urine (27.4%, 38.0%). PMID- 6851134 TI - Vertical transmission of hepatitis B. PMID- 6851138 TI - Homogeneous enzyme immunoassay of estriol in picogram amounts. AB - A homogeneous enzyme immunoassay for estriol has been described using estriol glucose-6-phosphate dehydrogenase (E3G6PD) as enzyme conjugate. Antisera for estriol were raised by immunising rabbits with two different immunogens, estriol 6-(O-carboxymethyl oxime) bovine serum albumin (E36CMOBSA) and estriol-3 carboxymethyl ether bovine serum albumin (E33CMEBSA). A new method for preparation of estriol 3-O-carboxymethyl ether in high yield (90%) has also been described. Addition of anti-estriol antibodies to E3-G6PD conjugate resulted in inhibition of enzyme activity. In the presence of free estriol, the antibody induced inhibition of enzyme activity was reduced in a concentration dependent manner. The use of the heterologous combination between immunogen and enzyme conjugate, i.e. using anti-E33CMEBSA and E36CMOG6PD improves the sensitivity at the expense of specificity, the cross-reaction with other estrogenic hormone being 10-15%. PMID- 6851143 TI - Influence of sex, age, and smoking habits on the urinary excretion of D-glucaric acid. AB - Reference values for urinary D-glucaric acid and the influence of sex, age and smoking habits were evaluated with a low-pH enzymatic method. D-Glucaric acid measured on spot urine samples from 573 healthy subjects gave mean concentrations (mumol/1) and D-glucaric acid/creatinine ratios (mmol/mol creatinine) of 56.1 (+/ 22.9) and 3.05 (+/- 0.99) for males and 53.3 (+/- 20.9) and 3.35 (+/- 0.95) for females. No difference between morning and evening was observed for urinary D glucaric acid/1 values, but D-glucaric acid/creatinine was higher in the evening samples for both sexes. There was a negative correlation between D-glucaric acid/1 values and age in males but not in females: the decrease of D-glucaric acid concentration was, however, quantitatively very small. Smoking produced a significant increase in D-glucaric acid concentration and in the D-glucaric acid/creatinine ratio for males and also partially for females. PMID- 6851141 TI - Comparison of ASAT, CK, CK-MB, and LD for the estimation of acute myocardial infarct size in man. AB - The purpose of this study was to set up a simple and reliable procedure for estimating acute myocardial infarct (AMI) size by measuring serum enzymes in a few daily blood samples. Peak enzyme values and estimated infarct size from one, two, or three daily samples of aspartate aminotransferase (ASAT), creatine kinase (CK), CK-MB, and lactate dehydrogenase (LD) were compared with the extent of myocardial necrosis measured at autopsy in 22 patients who died from AMI. The correlation between the extent of the necrosis measured and peak serum enzymes from one daily blood sample was highest for CK-MB (r = 0.78) and LD (r = 0.73) compared to CK (r = 0.68) and ASAT (r = 0.67). To obtain a significant correlation, however, two patients had to be excluded from the ASAT and LD analyses. No significant improvement was obtained by more frequent blood sampling. Estimation of infarct size did not improve the correlation significantly for any enzyme, although the coefficient of correlation for CK-MB increased slightly (r = 0.83). Serum CK-MB determination provides a semiquantitative estimate of infarct size, but the other enzymes may give erroneous estimates owing to lesser cardiospecificity. PMID- 6851142 TI - Low-pH method for the enzymatic assay of D-glucaric acid in urine. AB - The enzymatic methods for measuring D-glucaric acid in urine are based on the conversion of D-glucaric acid into its 1,4-lactone and measurement of inhibition of 1,4-lactone against beta-glucuronidase at pH 5.0. All the enzymatic methods described suffer from the disadvantage of a procedure that is complicated and inherently inaccurate, because the nature of glucaric acid/1,4-lactone equilibrium has not been properly considered in the development of such methods. After elucidating the factors influencing glucaric acid/1,4 lactone equilibrium in more detail, a low-pH enzymatic method has been developed in which the 1,4 lactone is formed in the urine sample by acid boiling at pH 3.8 and assayed at the same pH using beta-glucuronidase from Limpets. This procedure allows the acid/lactone equilibrium to remain stable during both the lactonization step and the enzymatic assay. The coefficient of variation for the proposed method (within run and between-day precision) was from 4.2 to 8.7. The analytical recovery varied from 92-108%. PMID- 6851140 TI - Preparation and metabolism of 125I-sulfobromophthalein. AB - Metabolism of 125I-sulfobromophthalein (BSP) prepared by the chloramine-T method was studied in rats. 125I-BSP is removed rapidly from the circulation. However, as compared to BSP, its plasma clearance and biliary excretion are delayed, and its accumulation in the liver is prolonged. Although BSP and 125I-BSP show similar binding to albumin in serum, their binding properties to liver cytosolic proteins and to the liver cell plasma membrane organic anion binding protein (OABP) differ. In contrast to the X-, Y- and Z-protein binding of BSP, 125I-BSP binds predominantly to a high molecular weight protein and only a small proportion of 125I-BSP binds to OABP. PMID- 6851139 TI - Characterization of hyperlipidemia in two patients with analbuminemia. AB - The results of plasma lipid and lipoprotein analysis in two related patients, brother (R.U.) and sister (R.R.) with analbuminemia, and three first-degree relatives (parents and sister) are reported. Both patients showed a remarkable increase in cholesterol and phospholipid levels, and there was a corresponding increase in serum apo B and apo A-I. This hyperlipidemia is due to a selective increase in LDL and HDL concentrations. R.U. showed an increase in both HDL2- and HDL3-cholesterol, R.R. only in HDL3-cholesterol. VLDL concentration was reduced in R.U. and normal in R.R. The plasma lipoprotein electrophoretic pattern did not correspond to any of the phenotypes in Fredrickson's classification. Composition of the different lipoprotein fractions was normal in the patients and family members. Serum FFA level in R.R. was very low. An increase in the plasma protein fractions, particularly the transport fractions, was confirmed in both patients. The possible pathophysiology of the hypercholesterolemia in these patients is discussed. Unlike other reported cases, clinical signs of atherosclerotic complications were absent. PMID- 6851144 TI - Met-enkephalin level in the cerebrospinal fluid of schizophrenic patients. AB - The level of met-enkephalin in the cerebrospinal fluid of 18 schizophrenic and 18 non-mental patients were determined by radioimmunoassay. The concentration of this peptide in the schizophrenic patients ranged from 12 to 39 ng/l with a mean of 22.2 ng/l. The mean and range of the non-mental patients were 28 ng/l and 16 to 41 ng/l, respectively. The difference between the mean enkephalin level of the two groups was statistically significant by the t-test. However, this difference must be interpreted with caution since the data obtained from the non-mental patients cannot be regarded as normal. No significant correlation was observed between the severity of schizophrenic symptoms and cerebrospinal fluid met enkephalin level. PMID- 6851146 TI - Ultrathin-layer isoelectric focusing separation of apoprotein C of human very low density lipoproteins. PMID- 6851145 TI - Effects of storage on serum apolipoprotein polymorphs using the Iso-Dalt technique. PMID- 6851147 TI - A single reagent method for determination of total and conjugated bilirubin with a centrifugal analyser. PMID- 6851148 TI - Instability of C-peptide reactivity in plasma and serum stored at -20 degrees C. PMID- 6851149 TI - Preservation of human erythrocytes for sodium-dependent lithium efflux rate measurements. AB - Measurement of red blood cell ion transport levels have become increasingly important as biological markers in psychiatric research. A major drawback to large-scale collaborative studies of red blood cell lithium transport rates has been the requirements of fresh cells and a transport research laboratory for performance of the assays. We have developed a method for the preservation of human red blood cells for up to five days with retention of lithium efflux characteristics. This method should find wide-scale application in collaborative studies of this marker in major affective disorders, in genetic studies of families living in diverse geographic locales, and in collaborative studies utilizing a centralized transport assay laboratory. PMID- 6851150 TI - Equilibrium density gradient analysis of erythrocytes from normal humans and patients with Duchenne muscular dystrophy. AB - Human red blood cells were fractionated by centrifugation in a continuous Ficoll/Triosil density gradient and the density distribution was determined by scanning the gradient in situ. Variation of some of the conditions used showed that erythrocyte mean cell density is very sensitive to the type of anticoagulant and washing system employed. A population study of mean cell density showed no significant difference between males and females and no correlation with age. Patients with Duchenne muscular dystrophy showed no significant difference from normals in mean cell density but an almost sevenfold increase in the variance. This may explain the disparate findings of different workers. PMID- 6851153 TI - A white blood cell control of long-term stability. PMID- 6851155 TI - A thin layer chromatographic technique for screening for sialuria. PMID- 6851154 TI - An improved method for measuring intracellular electrolytes in erythrocytes and the effects of cold storage. PMID- 6851152 TI - Elevation of lactate dehydrogenase isoenzyme-1 due to adenocarcinoma of the ovary. PMID- 6851151 TI - A 125I-radiolabelled probe for vinblastine and vindesine radioimmunoassays: applications to measurements of vindesine plasma levels in man after intravenous injections and long-term infusions. AB - The transformation of vinblastine into a reactive acid azide was used for the preparation of a vindesine-glycyl-tyrosine conjugate. This conjugate was radiolabelled [125I] and used as a tracer for the radioimmunoassay of vinblastine and vindesine with antisera developed by the Eli Lilly Research Laboratories and by ourselves. Its higher specific activity as compared to tritiated vinblastine significantly increases the sensitivity of the assay (0.05 microgram/1 as compared to 0.6 microgram/1). It was then possible to monitor vindesine plasma levels for more than 60 h after intravenous bolus injection and to evaluate the elimination rates more accurately. When plasma levels were also measurable using tritiated vinblastine a satisfactory agreement was observed with determinations performed with radioiodinated vindesine-glycyl-tyrosine. Furthermore, the use of a gamma-emitting probe simplifies the radioimmunoassay procedure and accordingly increases its reproducibility. A few examples of vindesine level measurements in human plasma collected after bolus intravenous injection and during long-term infusion are given. PMID- 6851156 TI - Biotin dependent carboxylase activities in normal human and multicarboxylase deficient patient fibroblasts: relationship to the biotin content of the culture medium. AB - Three mitochondrial carboxylase activities can be depleted in skin fibroblasts from patients with the neonatal form of multiple carboxylase deficiency when the biotin content of the culture medium is lowered to 25 nmol/l. On the other hand this depletion can be achieved in control fibroblasts or in fibroblasts from patients with the late onset form of the deficiency when avidin (50 U/l) is added to the culture medium. The kinetics of the carboxylase activity decrease are nevertheless identical for control and for both types of fibroblasts. After depletion, control and late onset form fibroblasts recover their carboxylase activities at the same rate, whereas fibroblasts with the neonatal form of deficiency need longer times or higher concentrations of biotin to restore their carboxylase activities. These results are consistent with previous hypotheses concerning the origin of both forms of the deficiency. In addition, this technique provides a convenient access to human apocarboxylases, i.e. substrates for in vitro holocarboxylase synthetase investigation. PMID- 6851157 TI - Volatile halocarbons in tap water as a problem in haemodialysis therapy. AB - The concentrations of volatile halocarbons in the tap water of Turku and of Turku University Central Hospital are quite high and are reduced but not eliminated during water treatment at the hospital. Before haemodialysis is started, only trichloromethane is found in the blood of the patients. Two hours later dichlorobromomethane and dibromochloromethane could also be found. These substances are absorbed, and possibly accumulate, in the body or are metabolised and excreted because all their concentrations are lower at the end of dialysis therapy. Therefore, maximum levels for volatile halocarbons in drinking water should be sufficiently low to prevent these substances being detected in body fluids and special care should be taken with hospital water. PMID- 6851158 TI - Thyroid hormones in the sudden infant death syndrome (SIDS). AB - Results are presented of serum total T4, T3, and TSH measurements on 92 patients. There are 34 infants exhibiting the sudden infant death syndrome, 36 in control group 1, who are matched both for age of infant and for duration of storage of specimen, and 22 post-mortem sera from non-SIDS deaths. There is no significant difference between the groups for total T4 measurements, but there is a highly significant elevation of both total serum T3 and TSH in the SIDS group compared with control group 1. It is suggested that the TSH elevation may be due to a post mortem effect, but the T3 results appear to confirm and extend the recent publication of Chacon et al [1]. Evidence of one case of a near-SID that subsequently died is presented, demonstrating that disturbances of thyroid function tests occurred in this patient before death. PMID- 6851159 TI - Two different modes of enzymatic changes in serum with progression of Duchenne muscular dystrophy. AB - Nineteen serum enzymes from patients with Duchenne muscular dystrophy and asthma, and normal subjects were studied. These enzymes include aminopeptidases, cathepsin C, angiotensin-converting enzyme, serine proteinase, sulphatase, phosphatase, esterases and ribonuclease. The enzymatic changes in dystrophic patients were related to two parameters: severity of the disease as judged from symptomatology, and duration of the disease. Most of the enzyme levels tested were increased in milder cases, but they tended to decrease with severity of the disease. On the other hand, there was a group of enzymes showing just opposite tendencies: serine proteinase, cathepsin C and ribonuclease. Even when viewed from the relationship to duration of the disease, the above mentioned grouping of enzymes was generally valid. Most of the enzyme levels, including those routinely applied as clinical parameters, tended to decrease, logarithmically, with an increase in duration of the disease. On the contrary, some others, including serine proteinase, cathepsin C and ribonuclease, tended to increase toward their control levels. Such tendencies were not found in the patients with asthma. The discrepancy between the above two groups of enzymes may have some implications for the process of protein degradation in dystrophic patients. PMID- 6851160 TI - Activities of sulfatases for the degradation of acidic glycosaminoglycans in cultured skin fibroblasts from two siblings with multiple sulfatase deficiency. AB - Cultured skin fibroblasts from two siblings with multiple sulfatase deficiency (MSD) were assayed for the activities of sulfatases known to degrade acidic glycosaminoglycans (AGAG). There were iduronate sulfatase, arylsulfatase B, heparan sulfate (HS) sulfatase, N-acetylgalactosamine-6-sulfate sulfatase, HS derived N-acetylglucosamine-6-sulfate sulfatase, and two keratan sulfate (KS) derived N-acetylglucosamine-6-sulfate sulfatases. The activities of sulfatases required for the degradation of HS were reduced to a greater extent than those for the degradation of dermatan sulfate (DS), and those of sulfatases associated with basic defect of Morquio disease type A were moderately decreased or normal. On the other hand, urinary excretion of AGAG in both patients was increased about 10-fold compared to controls, and especially, the excretion of HS and DS was increased about 150-fold and 50-fold, respectively. Keratan sulfate was not detected. The results suggest that in patients with MSD the degradation of HS might be affected to a greater extent than that of DS. PMID- 6851162 TI - One step isolation of human lysozyme using exclusion chromatography based on isoelectric point. PMID- 6851163 TI - Determination of lysozyme in tears by immunoturbidimetric and optimised kinetic bacteriolytic methods. PMID- 6851161 TI - Serum creatine kinase and CK-MB isoenzyme responses to acute and prolonged swimming in trained athletes. AB - Six highly-trained male swimmers completed a maximum work capacity tethered swim and a 1-h continuous tethered swim at approximately 70% VO2max in order to evaluate total serum creatine kinase and CK-MB isoenzyme changes. Venous blood obtained before, 5 min post-, 6 h post-, and 24 h post-exercise was analyzed for total serum CK (kinetic UV method, normal = less than 100 U/l) and CK-MB isoenzyme (quantitative electrophoretic technique, normal = less than 5 U/l). VO2max averaged 4.59 +/- 0.28 l/min, with a mean total work time of 24.5 min to achieve maximum capacity. Mean resting total CK was 100.5 +/- 15.8 U/l. Compared to rest, neither swim bout produced a significant (p greater than 0.05) elevation in mean total creatine kinase. No CK-MB isoenzyme was observed in any post exercise blood sample. Swimming, performed by highly-trained swimmers at high levels of intensity or for prolonged durations, may not impose sufficient degrees of trauma producing muscular stress. Therefore, the structural integrity of the cell membrane is maintained and the loss of intracellular creatine kinase to the bloodstream prevented. PMID- 6851164 TI - Improved separation procedure for urinary di- and polyamines by means of thin layer chromatography. PMID- 6851165 TI - Improved recoveries in the extraction of steroids from neonatal urine. PMID- 6851166 TI - Measurement of silicon in biological fluids in man using flameless furnace atomic absorption spectrophotometry. PMID- 6851167 TI - Urinary alpha-L-fucosidase in cystic fibrosis. AB - The binding of the urinary lysosomal enzyme alpha-L-fucosidase to free- and Sepharose 4B-bound concanavalin A has been compared in cystic fibrosis (CF) patients and normal controls. The concentration of methyl-alpha-D-mannoside necessary to prevent 50% of total alpha-L-fucosidase activity to bind to free and bound concanavalin A (Ki, 50%) was similar for CF (0.68 +/- 0.20 and 1.3 +/- 0.3 mmol/l, respectively) and normal controls (0.53 +/- 0.18 and 1.9 +/- 0.5 mmol/l, respectively). The CF and normal urinary alpha-L-fucosidase also showed similar pH optima (4.8), Km, app (0.071 and 0.074 mmol/l, respectively) and thermodenaturation curves at 44 degrees C (t1/2 = 108 min). We report that the kinetic and the concanavalin A-binding affinity of alpha-L-fucosidase are similar from urine of cystic fibrosis patients and controls. PMID- 6851169 TI - Analysis of total urinary catecholamines by liquid chromatography: methodology, routine experience and clinical interpretations of results. AB - A simple routine method is described for simultaneous assay of total urinary adrenaline, noradrenaline and dopamine. The catecholamines are pre-purified on a small ion-exchange column, separated by reversed phase ion-pair liquid chromatography, and are quantitated by electrochemical detection. The method was routinely applied to 422 urines. Elevated values were found in four urine specimens obtained from patients with histologically proven phaeochromocytomas. Virtually no interference by endogenous or exogenous compounds was found. Values for urinary catecholamines determined by fluorimetric analysis agreed with those obtained by high pressure liquid chromatography with electrochemical detection. Within-day CVs for the compounds ranged from 5.2-11.9%, between-day CVs from 3.3 6.6%. The normal range (95% confidence level) was 20-230 micrograms/24 h for noradrenaline and 1-35 micrograms/24 h for adrenaline. PMID- 6851171 TI - Endocytosis and intracellular protein degradation in cystic fibrosis fibroblasts. AB - Normal rates of pinocytosis of [3H]sucrose were measured in cystic fibrosis fibroblasts, and were not affected by the addition of cystic fibrosis serum. Bulk protein degradation (a significant proportion of which occurs intralysosomally following autophagy) and its regulation by growth state was apparently identical in normal and cystic fibrosis cultures. PMID- 6851168 TI - Serum prealbumin, transferrin and immunoglobulins in fatty liver, alcoholic cirrhosis and primary biliary cirrhosis. AB - The serum concentrations of prealbumin, transferrin and immunoglobulins, as well as their concentration ratios, were determined in patients with fatty liver, alcoholic cirrhosis and primary biliary cirrhosis to evaluate the usefulness of these measurements in the differentiation between these diseases, and in the evaluation of the severity of the liver injury. Alcoholic cirrhosis was characterized by high IgA/prealbumin and IgG/prealbumin ratios, whereas in fatty liver these ratios remained normal or close to normal. The IgG concentration and the ratio of IgG/prealbumin were markedly higher in advanced than in early alcoholic cirrhosis, IgG/prealbumin being the most sensitive indicator. None of the assays reflected the degree of fatty degeneration. In primary biliary cirrhosis the mean IgG concentration was 93% higher than in alcoholic cirrhosis. One of ten patients with primary biliary cirrhosis had a normal IgM level, whereas 2 of 10 patients with alcoholic cirrhosis had a value above normal (greater than 2.9 g/l). IgM alone did not differentiate between alcoholic and primary biliary cirrhosis, while the ratio of IgA/IgM seems useful: a value over 2.0 was found in all patients with alcoholic cirrhosis but in none of those with primary biliary cirrhosis. PMID- 6851172 TI - Assessment of liver function using fasting bile salt concentrations in psoriasis prior to and during methotrexate therapy. AB - To determine if fasting bile salt concentrations are an accurate indicator of pre existing and methotrexate-induced liver disease in patients with psoriasis, the plasma concentrations of conjugated cholate, chenodeoxycholate and sulpholithocholate were measured in 18 patients being assessed for methotrexate therapy and 21 receiving long-term therapy. The results were compared with other liver function tests and liver histology. The liver function tests were a poor indicator of occult liver disease and, whilst fasting bile salts appeared more sensitive, they were still unreliable and inadequate for the clinical assessment of the hepatopathy associated with psoriasis. The reasons for these discrepancies are discussed. PMID- 6851173 TI - A direct kinetic fluorimetric method for the enzymic determination of lactate in plasma. PMID- 6851170 TI - Plasma malonaldehyde levels during myocardial infarction. PMID- 6851174 TI - A new chromatographic method for separation of plasma 17 alpha hydroxyprogesterone. PMID- 6851176 TI - Reduction of oxalogenesis in a rapid gas chromatographic procedure for the analysis of oxalate ion in urine. PMID- 6851175 TI - The stability of MM-creatine kinase activity in human fetal plasma--a pitfall in the prenatal diagnosis of Duchenne muscular dystrophy. PMID- 6851177 TI - A new sensitive assay for measuring volatile sulphur compounds in human breath by Tenax trapping and gas chromatography and its application in liver cirrhosis. AB - A new analytical technique is described for measuring volatile sulphur compounds in human breath. The sulphur compounds were trapped and concentrated onto Tenax GC and then assayed by gas chromatography, using a specific sulphur detector. The detection limit amounts to about 0.2 ng/l (0.1 ppb). Among the sulphur volatiles, dimethylsulphide and methanethiol were quantitatively analysed in 100 ml of breath of 20 normal subjects and 35 cirrhotic patients. Dimethylsulphide in the breath of cirrhotics (113.4 +/- 31.9 ng/l, mean +/- SEM) was significantly elevated (p less than 0.05) compared with normals (21.1 +/- 1.7 ng/l). The concentration of methanethiol in the breath of normals and of most cirrhotics was less than 1 ng/l. In only five cirrhotics could methanethiol be detected in 100 ml of breath (3-23 ng/l). Dimethyldisulphide and hydrogen sulphide were not present in detectable amounts in the breath of normals. In cirrhotics, dimethyldisulphide was detected in a few cases. Ethanethiol was absent in the breath of both normals and cirrhotics. PMID- 6851180 TI - Unreliability of enzymatic cholesterol analyses for the determination of electrophoretically separated lipoproteins: selective loss of HDL cholesterol. PMID- 6851178 TI - Albumin I.M.V.S.: a variant detected by a Bromcresol Green dye binding method. AB - A unique variant of human albumin was discovered in a family following routine multiple biochemical analysis. Their sera demonstrated increased Bromcresol Green (BCG) dye binding under certain reaction conditions (excess amounts of the detergent Pegosperse in the presence of Merthiolate). This effect was also seen with a structurally similar dye, Bromcresol Purple (BCP). The variant sera also showed an altered pattern of BCG dye binding (in the presence of Merthiolate and excess Pegosperse) compared to normal sera when the temperature or the pH of the dye reagent was changed. Decreased binding of the dye 2-(4' hydroxybenzeneazo)benzoic acid (HABA) was also noted. Similar findings were observed in six other patients over a period of 21 months. Column chromatography of the variant sera on a DEAE-Sepharose column separated the albumin into two fractions, one showing normal dye binding properties, the other showing the more extreme pattern of dye binding seen for the whole variant serum. PMID- 6851182 TI - Interference of heparin in carcinoembryonic antigen radioimmunoassays. AB - A false Roche carcinoembryonic antigen (CEA) activity could be detected in all commercial and noncommercial heparin preparations we examined. The possibility of 'due to contamination' has been ruled out. Using the Roche procedure, heparin solutions, in the absence of CEA, gave positive CEA activity; on the other hand, no CEA activity was detected in solutions containing only heparin when the Abbott Kit was used. When heparin was present in specimens containing CEA, the Abbott Kit underestimated the CEA activity, whereas the Roche Kit gave false elevated values. However, the negative effect of heparin could be reduced by heat treatment in the presence of plasma proteins. PMID- 6851179 TI - Assay of blood and tissue aldehydes by HPLC analysis of their 2,4 dinitrophenylhydrazine adducts. AB - A new method for the assay of blood and tissue acetaldehyde is described. Samples are reacted with a methanolic solution of 2,4-dinitrophenylhydrazine (DNP) and the DNP-aldehyde adducts extracted into CHCl3. DNP-[14C]formaldehyde is added as internal standard. The CHCl3 extracts are washed with HCl and H2O and purified by aluminium oxide chromatography. The eluate is dried down, re-dissolved in methanol and subjected to quantitative analysis by HPLC. The acetaldehyde adduct was identified by co-chromatography with the authentic derivative and by mass spectrometry. Recoveries of added acetaldehyde were 85% and addition of 20 mmol ethanol to the sample gave no apparent increment in acetaldehyde content. This technique is suitable for assessment of acetaldehyde levels in clinical and experimental studies of ethanol metabolism. PMID- 6851181 TI - The measurement of propionyl-CoA carboxylase and pyruvate carboxylase activity in hair roots: its use in the diagnosis of inherited biotin-dependent enzyme deficiencies. AB - Two mitochondrial biotin-dependent enzymes, propionyl-CoA carboxylase and pyruvate carboxylase, are measurable in hair roots. A third biotin-dependent enzyme, beta-methylcrotonyl-CoA carboxylase, was barely detectable in hair roots. The diagnosis of isolated propionyl-CoA carboxylase deficiency was confirmed in hair roots of a known affected patient. This method should be a rapid and accurate method for the diagnoses of the various carboxylase deficiencies, particularly isolated pyruvate carboxylase deficiency in individuals with lactic acidosis, as well as for the assessment of biotin responsiveness in these patients. PMID- 6851184 TI - The development of a rapid ELISA for IgE utilizing commercially available reagents. AB - An enzyme-linked immunosorbent assay (ELISA) for human immunoglobin E (IgE) has been developed. To coat the polystyrene tubes (the solid phase) an antibody concentration of 6 mg/l in sodium carbonate buffer, pH 9.8, at 37 degrees C for 24 h was found superior to other conditions. The maximum amount of globulin adsorbed to the polystyrene surface was estimated to be 2.7 mg X m-2. This is consistent with a monolayer being adsorbed. While some of the anti-IgE molecules are inactivated during adsorption, the remaining molecules, once adsorbed, appear to retain activity for extended periods, and the coated tubes were stable for several weeks. Kinetic studies of the association of analyte, of antibody-enzyme conjugate and enzymic catalysis were used for the optimisation of the assay and allowed us to reduce assay time to 6 h. The association of analyte to the coated tube and the association of anti-IgE-peroxidase conjugate to bound IgE, in the present design, had T1/2 of approximately 0.5 h. Equilibrium is not obtained. The dissociation of analyte, surprisingly, was nearly undetectable. At least one of the two antibodies employed in the sandwich assay, preferably the anti-IgE peroxidase conjugate, should be free of non-specific antibodies in order to eliminate non-specific reactions. The influence of serum matrix was eliminated by diluting serum samples and standards 1:21 in buffer. For the assay of very low concentrations (i.e. less than 10 kIU/l) standards produced in IgE-free serum are required to compensate the influence of matrix. Comparison with a commercial kit (Hoechst-Behringwerke, Frankfurt/Main, FRG) showed good agreement. All reagents are commercially available and the assay is well suited for routine use. PMID- 6851183 TI - Investigation of the heterogeneity of the MM isozyme of creatine kinase. AB - MM creatine kinase (MM CK) from human skeletal muscle was resolved into 21 subspecies by isoelectric focusing. Rabbit and bovine MM CK's were also shown to have patterns of 21 bands. These results are compatible with the presence of six different M subunit forms in skeletal muscle, which by random association into dimers, could produce 21 different subspecies of creatine kinase. Two-dimensional isoelectric focusing of human MM CK yielded a diagonal pattern, indicating that the various enzyme subspecies were not induced by ampholyte-protein interaction. Heat inactivated serum appeared to stabilize various CK subspecies and also produced one further anodally migrating MM CK form. Fresh serum had combined inhibitory and stabilizing effects on the MM CK subforms, and allowed for the identification of four anodally migrating CK subspecies not present in tissue extract. These findings are of critical importance because of the widespread use of CK isoenzymes in serum for diagnostic purposes. PMID- 6851185 TI - A stable human platelet-white blood cell control for the Coulter Model S-Plus II. AB - The preparation and evaluation of a human platelet-white blood cell control of at least 5 months' stability, as measured in the Coulter Counter Model S-Plus II, is described. In some preparations minor departures from log normal platelet (PLT) distributions were found, impeding the generation of values for mean PLT volume (MPV) and PLT distribution width (PDW). In many cases, however, excellent linearity for PLT and white blood cell (WBC) counts and low coefficients of variation for PLT and WBC counts and PDW were found. Some possible factors causing the large coefficient of variation found for MPV values are mentioned. PMID- 6851187 TI - Microfiche data reduction for the EEG laboratory. AB - A convenient, low cost microfiche system for the random access, storage and retrieval of EEG data is described. Some of the more important advantages of microfilm in an EEG laboratory are: enormous data reductions; reduced operating costs; simplified records handling; improved communications between electroencephalographers; and access to an expanding number of inexpensive publications and reference materials. PMID- 6851186 TI - The low-voltage electroencephalogram. PMID- 6851191 TI - Effect of bromocriptin therapy on the electroencephalogram in chronic hepatic encephalopathy. PMID- 6851188 TI - The prognostic value of EEG in neonatal meningitis. AB - EEG recordings were made polygraphically in 29 newborn infants with meningitis. Visual and auditory evoked potentials, and CT scans were also obtained in some of them. The neonatal findings of these examinations were well correlated with the clinical outcome. Background EEG activity was a good prognostic tool but could not indicate the type of complications, although persistent abnormality correlated with severe brain damage or development of complications. The polygraphically recorded EEG was of great value to diagnose the apneic seizures often encountered in neonatal meningitis. PMID- 6851189 TI - Photic driving and psychogeriatric diagnosis. PMID- 6851190 TI - A quantitative study of the electroencephalographic response to levodopa treatment in parkinsonian patients. AB - A quantitative EEG study was done in order to confirm previous impressions that there is a significant EEG response to levodopa in parkinsonian patients, and in order to trace the existence of dopaminergic mechanisms in the generation of the human EEG. EEGs of twenty-five parkinsonian patients were recorded both before and during levodopa treatment, two to four weeks apart, when levodopa doses reached maintenance levels of 3-5g/d. Derivations from F7-T3, F8-T4, T5-O1, and T6-O2 were recorded and digitally processed into power density spectra. These spectra were analyzed for levodopa effects in a full factorial repeated measures multiple analysis of variance (MANOVA). A significant effect of levodopa treatment on the EEG was found, and localized to the left occipital lobe. This effect manifested as an increase in power in all the EEG frequency bands. These findings are compatible with multiband synchronization of the EEG generating processes, attributable to dopaminergic mechanisms. PMID- 6851192 TI - Sleep studies in the subject's home. AB - Because the ambient environment affects sleep duration and sequence, sleep in the subject's home may be more valid than in a laboratory. Telephone polysomnogram transmission (TPSM) and portable electromagnetic tape recordings offer recordings in the subject's bedroom. Ten subjects were recorded in the laboratory and at home by TPSM and portable recording. Overall sleep patterns were similar with all three techniques, but sleep and REM latency were much shorter and REM duration much longer, and time awake after sleep onset was longer with laboratory recordings. These data show that sleep patterns in the home differ from recordings in the laboratory. Portable recordings provide the additional benefit of monitoring daytime cycles. TPSM affords seven or eight channels for more precise recording and sleep staging. PMID- 6851193 TI - Testosterone and delta 4-androstenedione in the saliva of patients with Klinefelter's syndrome. AB - This study compares salivary and total plasma levels of testosterone and androstenedione in healthy controls and chromatin positive patients with Klinefelter's syndrome. The mean plasma testosterone level in fifteen Klinefelter patients was significantly lower than in ten control subjects, but the mean androstenedione levels were similar. Saliva of the normal men and patients with Klinefelter's syndrome did not differ significantly in binding potency for testosterone or androstenedione. The mean salivary testosterone level in the Klinefelter patients was significantly lower than in the controls but again salivary androstenedione levels were similar. Although testosterone as well as androstenedione showed a fair correlation between the salivary and plasma concentrations, preliminary data suggested that salivary testosterone levels better characterize the clinical state of androgenicity than do plasma levels. When salivary testosterone and androstenedione were expressed as a percentage of total steroid levels in plasma, the ratios for both steroids were similar in Klinefelter patients and healthy controls and closely approximated to the reported percentages of free steroid levels in plasma. The absolute salivary testosterone concentrations also were almost identical to the reported free plasma hormone levels. Together the data provide indirect evidence that in Klinefelter patients testosterone and androstenedione binding in plasma and saliva does not differ from that in normal men, and measurement of salivary steroids, by reflecting their free hormone concentration in plasma, may be useful in evaluating endocrine function in both health and disease. PMID- 6851194 TI - Reciprocal pattern of the TSH and PRL responses to dopamine receptor blockade in women with physiological or pathological hyperprolactinaemia. AB - The TSH and PRL responses to administration of the two dopamine (DA) receptor antagonists sulpiride and domperidone, were studied in fifteen normoprolactinaemic subjects, twenty-two post-partum women and sixteen subjects with presumptive evidence of (six subjects) or surgically confirmed (ten subjects) prolactinomas. Sulpiride (100 mg i.m.) or domperidone (10 mg i.v.) elicited a slight increase in basal TSH levels in both normoprolactinaemic and post-partum women, but induced a clear-cut TSH rise in subjects with a tumour. Conversely, sulpiride and domperidone strikingly stimulated PRL secretion in normoprolactinaemic and post-partum women, but only slightly enhanced base-line PRL levels in women with prolactinomas. The reason for the reciprocal pattern of TSH and PRL responsiveness to DA receptor blockade of post-partum women and subjects with prolactinomas is presently obscure. Since baseline PRL levels in the two hyperprolactinaemic states overlapped widely, it would appear that hyperprolactinaemia per se is not responsible for such behaviour. PMID- 6851195 TI - The renin-angiotensin system and total body sodium and potassium in hypertensive women taking oestrogen-progestagen oral contraceptives. AB - Measurements of total body sodium and potassium, and of components of the renin angiotensin-aldosterone system, were made in a group of women who developed hypertension while taking oestrogen-progestagen oral contraceptives. The results were compared with similar measurements made in age-matched women with essential hypertension. Total body sodium and potassium were normal in both groups. Plasma renin-substrate was significantly elevated in the women taking oral contraceptives, while concentrations of active renin were similar and normal in both groups. Thus plasma angiotensin II was significantly elevated in the pill users; overall the product of renin and renin substrate concentrations correlated significantly with angiotensin II. The rise in plasma angiotensin II in conjunction with normal total body sodium could therefore contribute to the increase in blood pressure induced by oestrogen-progestagen oral contraceptives. PMID- 6851196 TI - Naloxone inhibits exercise-induced release of PRL and GH in athletes. AB - Opiate peptides stimulate the release of GH and PRL, and such changes have also been reported following physical exercise. To investigate opiate involvement in the exercise-induced release of these hormones, eight professional athletes were exercised to 80% of their maximal heart rate on a bicycle ergometer. This exercise alone induced an increase in circulating mean GH (basal to maximal level, 3.1 +/- 0.9 ng/ml-27.3 +/- 5.9 ng/ml) and mean PRL level (6.1 +/- 1.1 ng/ml-19.5 +/- 1.9 ng/ml). Infusion of naloxone (0.3 mg/min) antagonized these responses in mean serum GH (5.6 +/- 1.0 ng/ml to 8.6 +/- 1.1 ng/ml) and PRL levels (6.4 +/- 1.1 ng/ml-8.1 +/- 1.2 ng/ml), which were both significantly less than during the control infusions (P less than 0.01). It is suggested that certain forms of stress stimulate the release of PRL and GH via endogenous opiate peptides. PMID- 6851197 TI - Corticosteroid myopathy: a clinical and pathological study. AB - In six patients with Cushing's syndrome and three with steroid myopathy, the clinical, functional, biochemical and structural characteristics of myopathy are described. Proximal muscle weakness occurred in all the patients, preferentially affected the lower limbs and was accompanied by muscle wasting in all but one patient. Force measurements confirmed quadriceps weakness in every patient. Vastus lateralis muscle biopsies showed light microscopic abnormalities in two of three patients with steroid myopathy and one of five patients with Cushing's syndrome. Type II fibre atrophy was the commonest abnormality. Reduced type II mean fibre areas occurred in all the patients with steroid myopathy and were common in Cushing's syndrome patients. Type I mean fibre areas were also reduced in two of the former group and one of the latter group and two further patients in this group had areas at the lower end of the normal range. Abnormalities in electron microscopy, mitochondrial function tests and chemical content of skeletal muscle were frequent and are described and discussed. A plasma creatine kinase activity (CK) at the lower end of the normal range, a myopathic electromyogram (EMG) and a raised 24-h urinary 3-methylhistidine/creatinine ratio on a creatine free diet were other characteristic findings in both groups of patients. PMID- 6851198 TI - Relationship between intralymphocytic sodium content and pressor response to mental arithmetic and static exercise in essential hypertension. AB - The relationship between intralymphocytic sodium content (ILSC) and blood pressure (BP) was assessed in a group of 18 untreated patients with essential hypertension. BP was recorded with an automatic device at rest and during mental arithmetic and handgrip. When BP was recorded in the presence of the physician patients with very high ILSC values showed significantly higher values than patients with moderately high ILSC values. This difference was no longer detectable when BP was recorded in a quiet room the patients being alone. ILSC and diastolic BP at rest were significantly related (r=0.80) only when the physician was present. The percent increase in diastolic BP induced by stimulation tests was significantly related to ILSC values (r=0.91). These data suggest that pressor response to adrenergic stimulation in patients with essential hypertension is related to intracellular sodium content. PMID- 6851199 TI - Prolactin, dopaminergic mechanisms and hypertension. PMID- 6851200 TI - Increased systemic vascular responsiveness to catecholamines in spontaneously hypertensive rats. AB - Systemic vascular responsiveness to i.v. bolus injections of norepinephrine and tyramine was evaluated in adult male spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY). Changes in total peripheral resistance (TPR) were used as an index of vascular response. Dose-response curves were plotted with 1n-dose on the x-axis and percent of maximum change in TPR on the y axis, and the following indices of responsiveness were used: slope, 1nED50, 1nx intercept, and maximum response. Measurements were made before and after ganglionic blockade with pentolinium (5 mg/kg, i.v.). Cardiac output for TPR calculations was obtained from an implanted flow probe on the ascending aorta. The slopes and maximum responses to norepinephrine and tyramine were greater in SHR v. WKY, P less than .05, before and after pentolinium treatment. There were no significant differences in 1nED50 or 1nx-intercept between WKY and SHR for tyramine and norepinephrine prior to pentolinium. After pentolinium 1nED50 and 1nx-intercept were similar for SHR and WKY for norepinephrine, but were greater in SHR for tyramine. The results demonstrate an increased systemic vascular responsiveness to catecholamines in adult SHR, with no evidence of increased systemic vascular sensitivity. These findings are consistent with the concept of increased systemic vascular responsiveness to catecholamines in adult SHR secondary to structural changes in blood vessels. PMID- 6851202 TI - [Interaction of thyroid hormones and catecholamines in peripheral tissues]. PMID- 6851201 TI - The effects of nicergoline on spontaneously hypertensive rats and their offspring. AB - Six consanguine monogamous SHR couples (G1) were treated from 5 weeks of age on with an alpha blocker, nicergoline, 0.1 mg/kg/day i.p.. Male rats were treated without interruption; treatment was withheld in female rats from delivery to weaning. They were compare to six similar SHR couples who were only daily i.p. injected with the same volume of solvent in the same conditions as controls, as well as with naive (untreated) rats. Second (G2) and third (G3) generation rats (untreated) were studied. In G1 rats, systolic blood pressure (SBP), heart rate, heart weight/body weight ratio and bulbar noradrenaline content were decreased (compared to control or naive rats), while plasma renin activity (PRA) and hypothalamic noradrenaline content were not changed. In G2 rats, SBP and PRA were decreased, all other parameters being unchanged. No parameter was changed in G3 rats. This appears to be the first report of a preventive effect of antenatal treatment on the development of hypertension in SHR. PMID- 6851203 TI - [A case of glucocorticoid and partial mineralocorticoid deficiency]. PMID- 6851205 TI - [Radioimmunoassay for TSH with the CIS kit: its clinical application]. PMID- 6851204 TI - [Clinical significance of human placental lactogen (hPL)]. PMID- 6851206 TI - [Studies on free thyroxine measurement with radioimmunoassay kit--evaluation of LiquiSol free T4 kit]. PMID- 6851207 TI - The fibreoptic bronchoscope in the diagnosis and investigation of laryngeal disorders. PMID- 6851208 TI - Squamous papillomas of the larynx in adults. A review of 63 cases. AB - Sixty-three cases of squamous papillomas of the larynx occurring in adults are presented. Twelve cases started as juvenile papillomas and continued into adult life. Twice as many males as females were in the series. The papillomas were always present on the true vocal cords at presentation, although other parts of the larynx were involved to a variable extent. The symptom of hoarseness gave a good indication as to the state of the larynx during treatment. Malignancy did not develop in patients with papillomas which fulfilled the histological criteria. Papillomas are clusters of thin, cylindrical projections of squamous epithelial covered mucosa with second and even third order branching. Biopsies in 5 cases show papillomatosis of respiratory epithelium, a process which is here described in the larynx for the first time. The prognosis as regards recurrence for 20 patients with solitary lesions was good, for 38 patients with multiple lesions reasonable, but for 5 patients with extensive florid lesions was exceptionally poor. PMID- 6851209 TI - The normal cochlea; how does it work? PMID- 6851210 TI - The airway resistance of the naso-frontal duct during and after acute frontal sinusitis. A long term follow-up of 49 trephined frontal sinuses. AB - A new pressure flow method for function tests and calculation of the airway resistance in the naso-frontal duct is presented. With this pressure flow technique the function and airway resistance of the naso-frontal duct was tested in 49 patients who were trephined for acute frontal sinusitis. The tests were performed during the primary healing period (0-16 days) and in a long term study 2, 6 and 12 months after operation. The patients were also checked radiologically and clinically. A prolonged healing period (more than 6 days) corresponded significantly to a high incidence of recurrent disease. With this method it is possible to define groups where recurrences might be expected because of impaired function of the naso-frontal duct. PMID- 6851213 TI - A linkage study of the HLA region using C-band heteromorphisms. AB - A linkage study was performed to establish the map distance from the HLA region to the centromere on 6p. In this study, seven families were investigated for the segregation of their HLA types and a polymorphic C-band marker on chromosome 6. Four out of 29 children were found to be recombinants. A map distance of 14 cM was determined. Ninety-five percent confidence limits for the recombination frequency were established (0.012 less than or equal to theta less than or equal to 0.263). PMID- 6851211 TI - Malignant neoplasms of the nose and paranasal sinuses. A survey of cases treated in a regional centre. AB - A review of 250 patients with malignant disease of the nose and paranasal sinuses treated over a 20 year period is presented. Treatment could be divided broadly into three groups consisting of subradical surgery plus radiotherapy; a drainage procedure plus radiotherapy and radiotherapy alone. Three and 5 year survival rates are presented for each mode of treatment for tumours originating in four anatomical sites. In tumours of the maxillary antrum the 5 year survival was significantly higher in patients who underwent a partial maxillectomy or palatal fenestration before radiotherapy. In the other anatomical sites the survival rates were not significantly different. Although this is an uncontrolled retrospective review, it does add further data to that already published on this uncommon but difficult management problem. PMID- 6851212 TI - Oestrogen and progesterone receptors: physiological and pathological considerations. PMID- 6851214 TI - Karyotype 47,XXY,18p--in a newborn child with holoprosencephaly. AB - This may be the first reported case of a 47,XXY,18p--("Klinefelter-de Grouchy I syndrome"), in a post-term male neonate. The child had a dysmorphic facies, a small nose with a single orifice, cranial malformations and an alobar holoprosencephaly. These symptoms corresponded with the known phenotypic variants of the simple 18p--anomaly. The karyotypes of both parents were normal. PMID- 6851215 TI - Partial trisomy 2q. AB - An infant with unusual facies and anomalies of brain, heart, and kidney was found to have a simple duplication of the distal long arm of chromosome 2. The clinical features of this case refine the phenotypic spectrum of partial trisomy 2q; prior cases had more complicated chromosomal rearrangements. PMID- 6851217 TI - Chronic granulomatous disease carrier geno-dermatosis (CGDCGD). AB - A persistent eruption in light-exposed areas in two related carriers of X-linked chronic granulomatous disease is described. This eruption appears to be a separate entity, rather than a variant of cutaneous lupus erythematosus or Jessner's disease. Recognition may enable detection of carrier females prior to the birth of an affected son, so that genetic counselling and antenatal diagnosis can be instituted. PMID- 6851216 TI - HLA and disease: haplotype sharing in multiplex families. AB - Recently it has been argued that the distribution of shared haplotypes in multiplex sibships for HLA-associated diseases may be an indicator of the disorder's underlying mode of transmission. Specifically, it has been suggested that the presence of multiple disease susceptibility genes and/or loci may be inferred when an inverse relationship between the amount of haplotype sharing and the number of affected sibs is observed in families where neither parent is affected. This claim is evaluated using extensive computer simulations. It is shown that a variety of haplotype sharing patterns are possible, even for the simplest models, and that for a large segment of the parameter space the actual distribution of shared haplotypes is opposite to that predicted. Accordingly, the inference that more than one locus is involved in the etiology of an HLA associated non-Mendelian disease, if based only on the distribution of shared haplotypes in multiplex sibships, is unjustified. PMID- 6851218 TI - Silent microcephaly: a distinct autosomal dominant trait. AB - Thirteen patients from three unrelated families were found to have microcephaly, without any neurological or dysmorphic manifestations. Autosomal dominant inheritance is concluded since the trait was transmitted directly in all three families, including one male-to-male instance. The recognition of this uncomplicated form of microcephaly as a Mendelian trait further extends its etiological heterogeneity. PMID- 6851221 TI - Translocations in Prader-Willi syndrome. AB - The Prader-Willi Syndrome (PWS) has frequently been associated with chromosomal anomalies involving the region 15q11-q12. The first case of this syndrome associated with a de novo translocation involving chromosomes 11 and 15 is reported. The breakpoints were identified as 11q25 and 15q11 or q12[45, XX,t(11;15)(q25;q11-12)], resulting in the deletion of 15pter leads to 15q11-q12. Previously reported cases of PWS associated with translocations are reviewed in relation to the "deletion hypothesis." PMID- 6851220 TI - Cytogenetics of recurrent abortions. AB - G-banded chromosome complements were analysed from both partners of 150 couples who had had two or more spontaneous abortions. Two women and four men were found to be balanced translocation carriers, as follows: 46,XX,t(2;10), 46,XX,t(6;11), 46,XY,t(6;10), 45,XY,t(13;14), 45,XY,t(13;14), 45,XY,t(14;21). Another woman had an abnormal karotype 46,XX/47,XXX and a man had a pericentric inversion of chromosome 1; six other men and two women had pericentric inversions of chromosome 9. PMID- 6851219 TI - Family resemblance for fasting blood glucose in a population of Japanese Americans. AB - The pattern of inheritance of fasting blood glucose was examined in a Japanese cohort of 500 nuclear families living in Hawaii. A principal component of glucose was defined to improve the ranking of diabetics and individuals receiving treatment (medication and/or diet) for hyperglycemia, thereby allowing as well as possible for inability to determine untreated levels in patients. Results from path and segregation analysis show that family resemblance for glucose is low in this population. The additive variation can be explained by a cultural model of inheritance without introducing intergenerational differences, a maternal paternal effect, or even genetic parameters. Heritability is approximately 0.125. Complex segregation analysis provides no convincing evidence for a major gene, with preliminary support based upon leptokurtic outliers in five families disappearing on further analysis by partial truncation. A claim by other workers of a major recessive gene for hyperglycemia may be due to their failure to allow for treatment, skewness, and multifactorial heritability. In future, the search for major loci acting on liability to hyperglycemia should use multiple determinations of fasting glucose or be addressed to more primary and repeatable variables than fasting blood glucose. PMID- 6851223 TI - The fragile X chromosome in a large Indian kindred. AB - A large Indian kindred in which the fragile X chromosome is segregating has been investigated in Cape Town. Eight male hemizygotes and four female heterozygotes were mentally retarded. There is suggestive evidence that one deceased male of reportedly normal intelligence may have been a hemizygote. The existence of the fragile X syndrome in a number of different ethnic groups supports the contention that the gene controlling the phenotype and the fragile site are the same, or at least overlap. PMID- 6851222 TI - The wrinkly skin syndrome: a report of two siblings from Saudi Arabia. AB - A brother and sister born to a Saudi couple showed aging appearance, wrinkled skin over the hands and feet, inelastic skin, prominent veins over the hands, and other musculoskeletal and connective tissue manifestations. Both children were small for their age and had congenital dislocation of the hips. The paper describes the main manifestations and compares them with the previously described two families. PMID- 6851225 TI - Reflections on muscular dystrophy in a Sudanese kindred. AB - An extended kindred in the Sudan, where a severe muscular dystrophy has been interpreted as of autosomal recessive inheritance, has been further analysed. The within-sibship ratio, the autosomal and X-linked inbreeding coefficients, and the creatine kinase levels suggest a possible alternative interpretation: X-linked muscular dystrophy with failure of clinical expression in some males. PMID- 6851224 TI - Tandem duplication of chromosome 14 (q24 leads to q32) in male newborn with congenital malformations. AB - A tandem duplication of 14q24 leads to q32, estimated by G- and R-banding, was found in a male newborn with growth retardation and congenital malformations. His clinical picture is compared with that of three patients from the literature with partial trisomy for a similar segment of 14q due to a parental reciprocal translocation or a de novo translocation. PMID- 6851227 TI - Reproductive drive and genetic counselling. PMID- 6851226 TI - Fetal mortality in oral cleft families: data from Indiana and Montreal. AB - Analysis of 418 sibships of oral cleft probands from Indiana, and 288 sibships from Montreal indicate that the incidence of fetal mortality is significantly greater in sibships of probands with cleft lip and cleft palate (CLP) as compared to that in sibships of probands with cleft lip (CL) alone. These findings support a multifactorial-two-threshold concept, according to which a lower level of liability results in clefting whereas a higher level of liability causes fetal deaths. They add confirmatory evidence in support of the authors' earlier work, utilizing data from two different sources. PMID- 6851230 TI - Autosomal dominant inheritance of conductive deafness due to stapedial anomalies, external ear malformations and congenital facial palsy. AB - Three siblings of Indian stock had profound bilateral conductive deafness with variable malformations of the external ears, stapedial abnormalities and facial paralysis. Their mother was similarly affected and inheritance of this private syndrome is evidently autosomal dominant. Some improvement of auditory function was obtained by surgical intervention in the middle ear. PMID- 6851228 TI - A lethal neonatal variant of carbamoyl-phosphate synthetase deficiency in combination with an intermediate activity of L-ornithine: 2-oxoglutarate amino transferase. AB - Shortly after birth, a newborn girl developed anorexia, hypotonia, apneic attacks and seizures. After 61 h the child died in coma. Biochemically, a highly elevated blood ammonia level was found together with an increased plasma level of the amino acids mainly involved in ammonia detoxication. Enzyme studies in post mortem liver tissue material revealed a deficiency of carbamoyl-phosphate synthetase (0.9% of the mean value in controls) in combination with an intermediate activity of L-ornithine: 2-oxoglutarate aminotransferase (40% of the mean value in controls). PMID- 6851231 TI - Two different structural abnormalities of chromosome 13 in offspring of chromosomally normal parents with two fragile sites. AB - Two siblings were found with different structural abnormalities involving their maternally inherited chromosome 13. The proband exhibited a ring 13 and a small fragment: 46,XX,r(13) (p11q34), +f, while her clinically normal brother carried a dicentric Robertsonian translocation: 45,XY,dic(13;15) (p11;p11). Both parents had normal karyotypes in peripheral blood and skin fibroblasts. The structural abnormalities of chromosome 13 may be due to an unstable gonadal 13;15 translocation in the mother. In addition, two autosomal fragile sites were segregating in this family. The mother had a fragile (16) (q22) which was inherited by the proband. The father and paternal grandmother possessed a fragile (12)(q13) which was not inherited by either child. The expression of both fragile sites was dependent on culture conditions. PMID- 6851229 TI - Biochemical abnormalities in connective tissue of osteodysplasty of Melnick Needles and dyssegmental dwarfism. AB - Biochemical findings in the connective tissue of two rare genetic skeletal dysplasias are reported. Osteodysplasty of Melnick-Needles showed an increased content of collagen; its increased synthesis may be the expression of the sclerosing process. In the neonatally lethal dyssegmental dwarfism, abnormal gel electrophoretic patterns of collagen peptides were found. These point to a deficiency in alpha 1-chains which may be the cause of an increase in cross linking with a change in cleavage and extractibility of collagen. PMID- 6851232 TI - An azoospermic male with presumably balanced reciprocal translocation. PMID- 6851233 TI - Assessment of skin surface by scanning densitometry of macrophotographs. PMID- 6851235 TI - Lipoid proteinosis: variations in the histochemical characteristics. PMID- 6851234 TI - Hair and nail growth: an investigation of the role of left- and right-handedness. PMID- 6851236 TI - Investigation of the pharmacokinetics of clobetasol propionate and clobetasone butyrate after a single application of ointment. PMID- 6851237 TI - Myxoid cysts of the finger: treatment by liquid nitrogen spray cryosurgery. PMID- 6851238 TI - Hand-Schuller-Christian disease with secondary cutaneous involvement. PMID- 6851239 TI - Vulval schistosomiasis. PMID- 6851240 TI - Macular amyloidosis, presenting as periocular hyperpigmentation. PMID- 6851243 TI - UVR for uraemic pruritus. PMID- 6851241 TI - Sarcoidal tissue reaction--another complication of ear piercing. PMID- 6851242 TI - Morphoea, sclerotic panatrophy and disseminated granuloma annulare. PMID- 6851244 TI - Thalidomide and the management of lupus erythematosus. PMID- 6851245 TI - The relation of clinical disease to antibody titre, proliferative response and neurophysiology in murine experimental autoimmune myasthenia gravis. AB - Murine myasthenia is a relatively faithful model of the human disease. We studied anti-AChR antibody titres, lymphocyte proliferative response to AChR, characteristic electromyographic (EMG) abnormalities and muscle strength at weekly intervals after immunization of C57B16J mice with Torpedo AChR. The boosting immunization at 1 month after the primary immunization resulted in a progressive increase of anti-AChR IgG antibodies, but caused a marked drop in the proliferative response. Although characteristic EMG abnormalities occurred in nearly all immunized mice, clinical disease appeared very late or not at all. These data parallel findings in human myasthenia. PMID- 6851247 TI - Do food antigens play a role in the pathogenesis of some cases of human glomerulonephritis? AB - Circulating immune complexes after a test meal were measured with three methods (PEG precipitation, Clq-ELISA and the indirect granulocyte phagocytosis test) in 10 controls, two symptomless persons with selective IgA deficiency and 14 patients with various types of glomerulonephritis, of which two patients (with idiopathic membranous glomerulopathy and local focal glomerulonephritis) also had selective IgA deficiency. The PEG and Clq-ELISA test did not show significant differences between the groups. In the two symptomless persons with selective IgA deficiency and in the patient with local focal glomerulonephritis and selective IgA deficiency the indirect granulocyte phagocytosis test (IGFT) showed a reproducible increase in IgG, IgM and complement containing immune complexes. In the last patient multiple food antigens were probably responsible for this phenomenon, a rapid amelioration of kidney function could be induced three times by giving an antigen free diet. PMID- 6851248 TI - Cross-reactivity of IgA antibodies between renal mesangial areas and nuclei of tonsillar cells in patients with IgA nephropathy. AB - A study on autoradiographical analysis of antigenic sites in patients with IgA nephropathy is described. Renal biopsy specimens were obtained from patients with IgA nephropathy. These specimens were treated with citrate buffer (pH 3.2) and the 'eluate' was neutralized by sodium hydroxide. The 'eluate' was labelled with 125iodine by the chloramine-T method. 125I-labelled eluate was then applied to the tonsillar cells obtained from the same and other patients with IgA nephropathy as well as to those with other glomerular diseases. The tonsillar cells were dipped into the emulsion (NBT-2) and then examined with a light microscope. It was demonstrated that the antibodies eluted from renal tissues of patients with IgA nephropathy specificially bound with the nuclear regions of tonsillar cells. The binding of eluted antibodies and tonsillar cells was completely inhibited by the addition of anti-human IgA antisera, but not inhibited by human IgA myeloma proteins. The eluted antibodies bound with tonsillar cells from the same patients, but only 10% of them bound with the tonsillar cells obtained from other patients with IgA nephropathy. It is concluded that IgA antibodies deposited in glomeruli specifically bind with tonsillar cells obtained from patients with IgA nephropathy and these antibodies show some heterogeneity among those patients. PMID- 6851246 TI - Regulation of the immune response in experimental models of autoimmune disorders: resistance of (NZB X NZW)F1 mice to tolerance induction in vivo. AB - Studies were carried out to test whether tolerance to alloantigens and to heterologous proteins could be induced in (NZB X NZW)F1 (B/W) female mice, compared with females of various other mouse strains, including BALB/c, C3H/eb, C57Bl/Ka and (BALB/c X C57Bl/6)F1. Untreated BALB/c and B/W mice were resistant to tolerance induction by deaggregated BSA, while all other strains were susceptible, as indicated by their lack of response to antigen challenge. Tolerance induction to BSA was further potentiated in all mouse strains including BALB/c with the exception of B/W, following prior conditioning of the mice with total lymphoid irradiation (TLI). Similarly, specific and permanent tolerance to H-2 incompatible alloantigens was successfully induced in TLI conditioned BALB/c, C3H/eb, (BALB/c X C57Bl/6)F1 injected with bone marrow cells, however, B/W mice were resistant. Stable chimeras could be established in TLI treated B/W mice only across a semi-allogeneic combination (BALB/c--greater than B/W). No graft vs host disease (GVHD) was observed in any of the chimeras including B/W mice. We conclude that B/W mice are resistant to tolerance induction to heterologous proteins and alloantigens, even after TLI conditioning. We postulate that this phenomenon is a function of both the intrinsic properties of the haemopoietic stem cells, including their differentiated progeny, as well as characteristics of their cellular microenvironment. PMID- 6851249 TI - Factors affecting IgA related hyperviscosity. AB - Sera from 14 patients with an IgA M-component, six of whom had myelomatosis and eight with benign monoclonal gammopathy (BMG) were analysed. All six sera from patients with high IgA (greater than 40 g/l) and total protein (greater than 100 g/l) concentrations were hyperviscous (HV). Four of these six patients also had hyperviscosity syndrome (HVS). There was no correlation between the quantity of IgA dimers or polymers and the presentation of HV and HVS. The binding between IgA and albumin and alpha 1-anti-trypsin was not covalent. Differences in the microenvironment of S-S bonds or of aromatic amino acids between isolated monoclonal monomeric and dimeric IgA were demonstrated with circular dichroism. Besides that, differences in hydrophobicity (exposure of aromatic amino acids) between IgA from normal serum and monomeric and dimeric IgA from a myeloma serum were revealed using hydrophobic interaction chromatography. The significance of hydrophobic interactions involving IgA and the influence of such forces on the circulation of the molecules are discussed. PMID- 6851250 TI - Changes in serum IgD in cigarette smokers. AB - Serum IgD levels in 83 healthy adults were measured by a radioimmunoassay technique and analysed according to each subject's smoking habit. The IgD geometric mean in cigarette smokers was twice as high as in non-smokers (408.6 vs 202.0 micrograms/dl). Serum IgD levels of 1,000 micrograms/dl or greater were noted in 22% of smokers but in none of the rare smokers or non-smokers. In the smokers group, the highest mean IgD level was found in those who did not actively inhale the smoke (762.6 micrograms/dl), followed by that in moderate smokers (563.8 micrograms/dl), and was lowest in heavy smokers who inhaled the smoke (283.0 micrograms/dl). The number of years a person smoked did not appear to have a significant effect on IgD levels. In ex-smokers, the mean IgD level (199.8 micrograms/dl) was similar to that in non-smokers, suggesting reversibility of the IgD changes following cessation of smoking. It seems prudent that the smoking habit should be taken into consideration in the interpretation of serum IgD levels. PMID- 6851252 TI - Phagocytic activity of polymorphonuclear leucocytes in patients with IgA nephropathy. AB - The phagocytic activity of polymorphonuclear leucocytes (PMN) in 57 patients with IgA nephropathy was investigated using Immunobeads. Depressed activity was detected in 41 patients (72%). A significant correlation existed between the ingestive function of neutrophils and glomerular histological abnormalities, such as the degree of mesangial proliferation. In addition, 25 patients with IgA nephropathy were studied to detect the presence of immunological inclusions in the PMN by a direct immunofluorescent technique (anti-IgG, IgA, IgM and C3). Intracytoplasmic inclusions containing IgA were frequently detected in the PMN, and a negative correlation was found between the percentage of IgA-positive PMN and the phagocytic activity of neutrophils in patients with IgA nephropathy. These results suggest that the activity of neutrophils represents one of the important factors in the pathogenesis of IgA nephropathy and that mesangial IgA deposition is partly caused by decreased clearance activity of PMN. PMID- 6851251 TI - Relationship between megadose vitamin supplementation and immunological function in a healthy elderly population. AB - We studied the immunological effects of 'megadose' vitamin or mineral supplementation by comparing the immunological functions of healthy elderly subjects taking large amounts of specific nutrients to similar subjects not on supplements. There was a non-significant trend for those subjects taking megadoses of vitamin C to have increased cell-mediated immune responses as measured in vivo by skin test reactivity but not by in vitro mitogen responses. In addition, subjects taking megadoses of vitamin E or any of several B vitamins (B1, B2, B6, folate and niacin) had lower absolute circulating lymphocyte counts than did the rest of the population. The relative lack of effect of megadose vitamins on immunological function in this population compared to reports of short term trials of mega nutrients raises the possibility that some of the previously reported immuno-enhancing properties of megadose vitamins may be due to a non-specific adjuvant effect that disappears with time. PMID- 6851253 TI - Thyroid status in patients with chronic renal failure. AB - Serum thyroid hormone concentrations have been measured in 21 patients with chronic renal failure, treated conservatively and compared with values from 19 control subjects. Many patients had serum total T3 and T4 concentrations below the reference ranges. The concentrations of free T4 and free T3 and the free thyroxine index were significantly lower in patients with abnormal total concentrations of the thyroid hormones than in the controls. Both the free and the total concentrations of T4 correlated inversely with the degree of renal failure. The concentration of thyroxine binding globulin (TBG), fell within the reference range in each of the patients, but was significantly lower in the patient group when compared with the controls. These TBG concentrations, however, were not sufficiently decreased to explain the low total thyroid hormone concentrations found in the patients. The affinity of TBG for T4 and T3 in the patient and control groups was not significantly different. The TSH response to TRH was diminished in many of the patients, but the measurement of other pituitary hormones indicated that pituitary function was normal in these patients. The possible mechanisms responsible for the changes observed in thyroid and pituitary hormones are discussed. PMID- 6851255 TI - Cognitive function and regular dialysis treatment. AB - The purpose of this investigation was to assess the intellectual function of patients on regular dialysis treatment by using neuropsychological tests such as the Wechsler Adult Intelligence Scale (WAIS) and the Wechsler Memory Scale (WMS). Studies were performed on 54 patients; 21 patients were retested after at least 12 months. We found no relationship between the neuropsychological scores and the blood levels of small molecules, the hemoglobin concentrations, the serum aluminium levels, and the levels of formal education. We found, however, an impairment of neuropsychological performance, mainly for memory function, related to the duration of dialysis and, possibly, to parathormone levels. We conclude that standard hemodialysis strategies are not able to prevent the development of intellectual impairment in uremic patients and that the WMS could be used as a sensitive objective measure of the comparative adequacy of various long-term dialysis treatments. PMID- 6851256 TI - Plasma kinetics of small molecules during and after hemofiltration: decrease in hemofiltration efficiency related to increase in ultrafiltration rate. AB - The influence of delay in mass transfer on the real efficiency of hemofiltration sessions (HF) was studied in 7 patients during HF at a moderate ultrafiltration rate (UF rate = 100 ml/min) and at a high UF rate (UF rate = 200 ml/min). Real efficiency was expressed as "effective clearance" (KE) and compared to plasma clearance (KP); KE/KP was calculated from the kinetics of small molecules during HF and stabilized rebound post HF. Rebound in urea and uric acid plasma levels stabilized by 90 min post HF; increase in the UF rate from 100 to 200 ml/min was responsible for a decrease in KE/KP of 4% for urea and 11% for uric acid. Plasma creatinine and phosphorus levels had not stabilized by 90 min post HF, and it was thus impossible to calculate effective clearance; on the other hand, the magnitude of the rebound phenomenon for these two molecules was considerably greater than for uric acid. The magnitude of the post HF rebound for creatinine and phosphorus might be associated with delayed diffusion from a bound form in the intracellular space. PMID- 6851254 TI - Clinical implications of uremic middle molecules in regular hemodialysis patients. AB - Sixty-five regular hemodialysis patients, maintained on stable dialysis schedules for at least one month, were investigated to assess the relationship between uremic morbidity and the accumulation of individual middle molecule fractions (MM). Pre-dialysis plasma levels of MM were determined by the use of gel chromatography followed by ion exchange gradient elution chromatography. Thirty three symptom-free patients were compared with 32 patients who exhibited uremic symptoms or complications (overhydration, the depletion syndrome, chronic or recurrent infection, isolated episodes of infection and pericarditis). The plasma concentrations of urea and creatinine were no higher in the symptomatic groups than in the controls. On the other hand, all the symptomatic groups showed higher levels of fraction 7 c in plasma than the controls. In addition, overhydration and chronic or recurrent infection were associated with high plasma levels of 7 f and 7 b respectively. Six patients with depletion syndrome, three of whom had progressive peripheral neuropathy, had significantly elevated plasma concentrations of MM including not only fraction 7 c but also fractions 7 b and 7 d. At the time of acute infections, plasma levels of 7 c were considerably higher than when the same patients were free from symptoms. Despite the association between uremic morbidity and the accumulation of MM, there is a great overlap between asymptomatic controls and "sick" uremic patients with regard to plasma levels of MM. PMID- 6851257 TI - Effect of plasma protein binding, volume of distribution and molecular weight on the fraction of drugs eliminated by hemodialysis. AB - The correlation between plasma protein binding, the volume of distribution, molecular weight, and percentage removed by hemodialysis was investigated in 89 drugs using information available in the literature. The correlation was significantly linear between dialyzability and plasma protein binding, as well as with the reciprocal volume of distribution. This is in agreement with the theoretical deduction of dialyzability from diffusion and convection kinetics. Multiple linear regression analysis revealed that only 27% of the variance in dialyzability could be explained by plasma protein binding (17%), the volume of distribution (6%), and the molecular weight (4%) of the drugs. Therefore, the dialyzability of drugs can not be predicted reliably. PMID- 6851258 TI - Acute renal failure and tubular necrosis associated with hematuria due to glomerulonephritis. AB - A 16 year old male with a history of recurrent synpharyngitic macroscopic hematuria presented with severe loin pain, macroscopic hematuria and oliguric acute renal failure. Although renal biopsy showed mesangial IgA nephropathy with focal and segmental proliferation with crescents, the extent of glomerular involvement could not explain the severe functional disturbance. Intratubular obstruction and tubular necrosis secondary to the presence of severe glomerular bleeding provide a better explanation. Although renal failure resolved spontaneously, the long-term effects of episodes of this type on structure and function is unknown. PMID- 6851259 TI - Nephrotic range pseudoproteinuria in a tolmetin-treated patient. AB - False-positive proteinuria by acid precipitation testing in tolmetin-treated patients has been noted on routine urinalysis screening. However, the magnitude of such false positivity has not been previously reported. We present a patient with systemic lupus erythematosus who presented with nephrotic range pseudoproteinuria using an acid precipitation method of testing. This misleading laboratory result and alternative methods of testing for proteinuria in tolmetin treated patients are discussed. PMID- 6851260 TI - Protein-reduced diet in diabetic renal failure. AB - The effect of treatment with a protein-reduced diet (20-30 g/day) and essential amino acids was studied in 21 patients with diabetes mellitus and renal failure. The mean treatment time was 5.0 (0.5-14) months. Most patients experienced considerable amelioration of their uremic symptoms and the mean serum value was reduced by 50% of the initial value during treatment. Residual renal function continued to decrease during treatment. Vigorous treatment of fluid retention and hypertension was a prerequisite for a successful course and may also have decreased the rate of progression towards dialysis. Compliance with the diet was not different from that found in non-diabetic uremic patients. Satisfactory control of blood glucose levels was obtained with no or only minor adjustments of the insulin dosage. It is concluded that dietary therapy should be considered in diabetic patients with renal failure for treatment of uremic symptoms. PMID- 6851261 TI - Intravenous methylprednisolone pulse therapy in essential mixed cryoglobulinemia nephropathy. AB - In 15 patients with essential mixed cryoglobulinemia, 24 exacerbations of renal disease, characterized by an increase in plasma creatinine (13 episodes) and/or proteinuria (18 episodes), were treated by 3 intravenous pulses of methylprednisolone (1 g each), followed by oral prednisone (0.5 mg/kg/day). Plasma creatinine levels fell within a week (P less than 0.025), while a significant decrease in urinary protein excretion was observed only after one month (P less than 0.05). After therapy, plasma creatinine levels remained stable in 8/10 patients for 3 to 60 months. These beneficial results suggest that MP pulses may be useful in the treatment of cryoglobulinemic nephropathy. PMID- 6851263 TI - Red cell survival and red cell enzymes in patients on continuous peritoneal dialysis (CAPD). AB - In 11 patients on CAPD with persisting anemia the survival of red cells labelled with 51Cr, red cell mass and the levels of several enzymes within red cells were measured. 51Cr red cell survival was shortened in 9/11 (mean +/- SD:20.0 +/- 4.9 days) and correlated with red cell mass, i.e. with the degree of anemia (r = 0.79, P less than 0.01). Determinations of the levels of enzymes of the hexose monophosphate shunt and the glycolytic pathway revealed no obvious defects in red cell metabolism. The level of hexokinase (HK) was normal whereas the activities of glucose-6-phosphate dehydrogenase (G-6-PD), 6-phosphogluconate dehydrogenase (6-PGD), glutathione reductase (GR) and pyruvate kinase (PK) as well as reduced glutathione (GSH) were increased significantly. CAPD did not eliminate the hemolytic component of anemia in the majority of these patients. PMID- 6851264 TI - Congenital nephrotic syndrome: clinico-pathological heterogeneity and prenatal diagnosis. AB - During the last five years, we have observed four families in which siblings were affected with the congenital nephrotic syndrome (CN). Clinically, all patients, with one exception, could barely be differentiated from classical examples of CN of the Finnish Type (CNF). Morphologically, however, each family showed a different type of CN, although the appearance in siblings was identical. This morphological heterogeneity, makes it likely that CN in a population outside Finland is the result of an unknown number of autosomal recessive mutations at different gene loci. In an attempt to diagnose CN prenatally by means of measurements of the concentration of alpha-fetoprotein in amniotic fluid, we found two false normal results, one in a patient with histologically confirmed CNF, another in a patient with CN, histologically non Finnish Type. Thus the results of prenatal diagnostic procedures for these disorders have to be reevaluated. PMID- 6851262 TI - Renal function following cardiopulmonary bypass surgery in children: a randomized comparison of the effects of gentamicin and cloxacillin with cephalothin. AB - Renal function was studied in 36 children who were randomly allocated to receive either gentamicin and cloxacillin or cephalothin as prophylactic antibiotic cover for complex cardiopulmonary bypass surgery. Both groups of children developed a similar degree of impairment of glomerular function with significant elevations in plasma creatinine concentrations and urine albumin excretion compared to preoperative levels which tended to resolve by the 5th postoperative day. The urine excretion of N-acetyl-glucosaminidase increased in both groups postoperatively but remained significantly elevated only in those children who had received gentamicin. These findings suggest that whilst gentamicin exerts a demonstrable nephrotoxic effect on the proximal renal tubules it does not contribute significantly to either the incidence or severity of postoperative renal glomerular impairment. PMID- 6851265 TI - Plasma calcitonin concentration in patients treated with chronic dialysis: differences between hemodialysis and CAPD. AB - We have determined plasma calcitonin levels in 72 chronic dialysis patients and investigated their possible correlations with other parameters of calcium and phosphorus metabolism, including plasma levels of calcium, phosphorus, alkaline phosphatase and parathormone, as well as with the duration of treatment. Forty one of the patients were being treated with hemodialysis (HD) and thirty-one with continuous ambulatory peritoneal dialysis (CAPD). Increased calcitonin levels were detected in 83% of the HD patients and in 79% of the CAPD group. In the former there was a positive correlation between the levels of calcitonin and the calcium, corrected calcium, alkaline phosphatase and parathormone levels and with the duration of treatment, whereas in the latter the calcitonin levels only correlated with the serum calcium. The patients receiving CAPD also showed significantly lower calcium and calcitonin levels than the HD patients. Our conclusion is that, apart from accumulation due to renal failure, the main factor determining the calcitonin level is the blood calcium level, and that the observed increase might play a role in the physiological protection of bone against the action of parathyroid hormone. PMID- 6851267 TI - Flucloxacillin nephritis. PMID- 6851266 TI - The influence of indomethacin on renal acidification in normal subjects and in patients with sickle cell anemia. AB - Patients with sickle cell nephropathy have been shown to have a distal type of incomplete renal tubular acidosis. We evaluated renal tubular acidification before and after indomethacin administration because prostaglandins have been shown to inhibit the transepithelial potential difference in the collecting tubule and since we previously found indirect evidence of increased prostaglandin synthesis in patients with sickle cell nephropathy. Indomethacin did not change urine pH in the sickle cell anemia (SCA) patients or in the control subjects. It induced, however, an increase in titratable acid excretion particularly in the SCA patients. Ammonium excretion decreased after indomethacin in the SCA patients while it did not change significantly in the control subjects. In the SCA patients, net acid excretion did not rise after indomethacin. In contrast there was an increase in net acid excretion after indomethacin administration in the control subjects. We conclude from our study that the inability of patients with SCA to lower urine pH to a normal extent after ammonium chloride loading is not improved by indomethacin. The decrease in ammonium excretion after indomethacin administration in SCA might be due to an effect of the prostaglandin synthesis inhibitor indomethacin on ammoniagenesis. PMID- 6851268 TI - Acute renal failure and IgA nephropathy. PMID- 6851269 TI - Perianeurysmal fibrosis and bilateral ureteric obstruction. PMID- 6851270 TI - Acute effects of alcohol on left ventricular dynamics during isometric exercise in normal subjects. AB - The aim of this study was to assess whether drinking social amounts of alcohol impairs myocardial contractility in normal humans. To that end, 17 healthy volunteers performed isometric handgrip exercise before and 60 minutes after an intake of 1 g/kg body weight of ethanol within 60 minutes. Left ventricular M mode echocardiogram, systolic time intervals, and sphygmomanometric arterial blood pressure were recorded before and at the end of 4-min handgrip at 30% of maximum voluntary contraction. The blood ethanol concentration (mean +/- SD) was 24.4 +/- 2.0 mmol/liter. At rest, ethanol increased heart rate (p less than 0.05), and decreased left ventricular end-diastolic diameter (p less than 0.05), end-systolic diameter (p less than 0.01), and circumferential systolic wall stress (p less than 0.05). The indices of left ventricular performance were unchanged except for the maximum circumferential fiber shortening velocity which was increased after ethanol (p less than 0.001). The cardiac response to isometric exercise was similar before and after ethanol except that the handgrip induced rise in systolic wall stress was smaller postingestion (p less than 0.05). This study does not support the view that drinking small to moderate amounts of alcohol brings about myocardial depression in normal humans. Although preload, afterload, and heart rate were altered by ethanol at rest, myocardial contractility was not impaired even during the afterload stress imposed by isometric exercise. PMID- 6851271 TI - Submitral atheromatous lesions in monkey and man. AB - Posterior submitral recess (PSMR) calcification is a common autopsy finding in elderly people, but its pathogenesis is undetermined. In this communication we show that, in part at least, the PSMR changes at autopsy are atheroma-like with lipid around the sclerosis and calcific deposits. These changes in the PSMR showed a statistically significant correlation with the presence of hypertension and with an autopsy finding of severe coronary atherosclerosis. We showed, for the first time, that similar fibrosis and lipid deposition in the PSMR can be produced in high-fat, high-cholesterol fed macaque monkeys (Macaca arctoides) with or without concomitant experimentally produced hypertension. It is concluded that changes in the PSMR in monkeys and man are strongly related to atherosclerosis and hypertension. PMID- 6851272 TI - The cardiovascular response at rest and during exercise in hypothyroid subjects to thyroxine substitution. AB - Rapid and intense thyroxine substitution can lead to heart failure and myocardial infarction in hypothyroid patients. We have analyzed the normalization of the circulatory system in hypothyroid subjects on a gradual thyroxine substitution. Fourteen hypothyroid patients were studied repeatedly with an orthostatic test and a standardized symptom-limited exercise test during substitution. ST and T abnormalities were observed in 51 and 33%, respectively, before substitution. Many of these changes were normalized upon substitution at a dose level of 0.15 mg/d thyroxine. The pulse reaction to standing was enhanced early during substitution. The capacity to perform work, on the other hand, responded more slowly to thyroxine substitution, and was significantly increased only after six months of full substitution. This difference in the time course of recovery may be of clinical importance when substituting patients with hypothyroidism and ischemic heart disease. PMID- 6851273 TI - Effect of metoprolol on cardiac and pulmonary function in chronic obstructive pulmonary disease. AB - We evaluated the effects of oral metoprolol, 200 mg daily, on cardiac and pulmonary function in 6 patients with chronic reversible airways obstruction and no cardiac dysfunction. The patients were clinically stable. In all patients, baseline forced expiratory volume in 1 second (FEV1) was less than 60% predicted, and increased at least 15% after isoproterenol inhalation. Resting control first pass right and left ventricular radionuclide ejection fractions were normal or only slightly depressed. Compared to placebo, metoprolol did not significantly affect FEV1 or forced vital capacity. Metoprolol did not significantly alter left or right ventricular ejection fraction, measured by first pass radionuclide technique. On patient experienced increased dyspnea on metoprolol, which was not accompanied by changes in clinical exam, spirometry, or ejection fraction. We conclude that metoprolol may be safely administered to a subset of stable patients with chronic reactive airways disease. PMID- 6851275 TI - Unusual cardiovascular manifestations in a case of pheochromocytoma. AB - A case of proven pheochromocytoma is reported of a patient who presented with attacks of apparent hypotension, pulmonary edema, and myocardial injury with typical ECG and enzyme change. In spite of unmeasurably low peripheral blood pressure recordings during the attack, central aortic pressure was well above 240/140 mmHg. A clinical shocklike state was in effect due to severe arterial vasoconstriction. The pulmonary artery pressure was 48/26 mmHg during attacks, wedge pressure was 26 mmHg, and cardiac index 1.8 liters/min/m2. The coronary angiogram showed abnormal pooling of dye in the myocardial capillary network. It is concluded that: (1) Apparent hypotensive episodes in pheochromocytoma may be misleading and central arterial measurements may be needed to demonstrate the hypertensive crisis. (2) The abnormal coronary angiogram in our patient may be due to myocardial necrosis and damage to the intact arteriolar and microvascular system of the myocardium. PMID- 6851274 TI - Flecainide-induced aggravation of ventricular tachycardia. AB - Flecainide acetate is a new class I antiarrhythmic agent which slows atrial, A-V nodal and ventricular conduction velocity, and prolongs refractoriness of these structures (Borchard et al., 1982; Hodess et al., 1979). Recent studies with oral flecainide therapy suggested its high potential for suppression of ventricular tachycardia in humans (Anderson et al., 1981; Duff et al., 1981; Hodges et al., 1982). Its favorable pharmacokinetics with an average plasma half-time of about 20 hours allows in most patients twice daily dosing (Duff et al., 1981). Usually, the drug seemed to be well tolerated and side-effects, such as blurred vision, could be resolved with smaller but still effective doses (Duff et al., 1981). Actually, the ideal antiarrhythmic agent which represents a high degree of effectiveness, a low level of toxicity, a wide therapeutic range, and a prolonged antiarrhythmic action does not exist (Dreifus and Ogawa, 1977). In this report we describe a patient with flecainide-induced aggravation of ventricular tachycardia necessitating resuscitation because of severe hemodynamic deterioration. PMID- 6851277 TI - The pathology of hypertension in a tropical environment. AB - Hypertension is very common in blacks and occurs at a younger age than in whites. It behaves in an explosive manner with death occurring frequently from cerebral hemorrhage, uremia or congestive heart failure. Pathologically the majority have essential hypertension. The development of hypertension is related to urbanization and Westernization, as the incidence in rural blacks is low. Despite the high incidence of hypertension, myocardial infarction remains infrequent. PMID- 6851276 TI - Fully automated ambulatory blood pressure in the diagnosis and therapy of hypertension. AB - Technical characteristics of a fully automatic apparatus for ambulatory semicontinuous blood pressure monitoring are described. Initially, we ascertained the reliability and the fidelity in the reproduction of studied events (blood pressure, heart rate, ECG). Good results were obtained, even in comparison with other methods (blood pressure semiautomatic or invasive monitoring). We then studied the results of the research on 200 hypertensive subjects. The easy applicability of this method allowed us to demonstrate blood pressure variability over a 24-h patient period. We now can evaluate the factors contributing to blood pressure variability and the alterations contributing to the meaning of circadian rhythm. We are now able to comment on the prevalent incidence of organic or neurogenic components in single hypertensive states, the possible coexistence of asymptomatic coronary heart disease, and on the choice and efficacy of hypotensive drugs. PMID- 6851278 TI - Cardiogoniometry. AB - Cardiogoniometry is a new method to test heart function. It consists of a simple computerized vectorcardiography with a system of leads derived for the construction of three orthogonal projections. With the aid of these three dimensional projections the cardiogoniometer, a microprocessor system, measures and computes the maximal vectors of depolarization (QRS) and repolarization (T). It also fixes the orientation of these two spatial vectors by projection on two planes (frontal and oblique sagittal) and determines the solid angle phi between them. Every third heart beat these five parameters and the preceding beat interval are printed out. In this way, a series of measurements is obtained in which only little disturbances of the signals of cardiac de- and repolarization occur. In patients with latent coronary insufficiency an abnormal position of the T vector can be detected long before the standard ECG shows a pathological pattern. Cardiogoniometry can be performed in the consulting room or at the bedside. It is noninvasive, painless, and free of risk. The value and limits of this new method are to be tested in comparison with the ECG and invasive methods in cardiology laboratories. PMID- 6851279 TI - Cardiogoniometry: a new noninvasive method for detection of ischemic heart disease. AB - Cardiogoniometry is a new vectorcardiographic method. The vector-loops are constructed from three orthogonal ECG leads and registered on-line by a microprocessor. The angle between the maximal QRS and T vectors, as well as the spatial orientation of these vectors are very constant in healthy individuals. Deviations of these vectors and angles are sensitive indicators for changes in repolarization occurring, for instance, during coronary insufficiency. The changes in these variables were evaluated in 50 patients with suspected coronary artery disease and correlated with angiographic findings. Cardiogoniometry showed a sensitivity of 79% and a specificity of 82%, which is comparable to exercise testing. In contrast to the latter cardiogoniometry can be performed at rest, is free of risk, and therefore also suitable for elderly patients. PMID- 6851281 TI - Penetration of netilmicin into heart valves, subcutaneous and muscular tissue of patients undergoing heart surgery. AB - In 57 patients undergoing heart surgery concentrations of netilmicin in plasma, heart valves, muscle, and subcutaneous tissue were determined after a 5 min intravenous bolus injection of 1.5 mg/kg body weight. Within 8 h netilmicin serum concentration declined from 3 micrograms/ml to 1 microgram/ml. In heart valves the concentrations during heart surgery were high enough to inhibit most staphylococci, Klebisiella, Enterobacter and Escherichia coli strains. No different serum and tissue concentrations in patients with and without extracorporal circulation could be found. PMID- 6851280 TI - Heparin effect on plasma fibrinogen in the thrombophilic syndrome. AB - The effects of heparin were studied in a group of 42 patients with preinfarction angina (PA) and acute myocardial infarction (AMI) whose plasma fibrinogen was increased. Plasma fibrinogen was measured by the turbidimetric method in timol turbidimetric units. Statistically significant results proved that heparin reduces the plasma fibrinogen progressively over a treatment period of 6 weeks. During the first three weeks a dose of 1 cc (50 mg or 5000 IU) was given by intravenous injection at 6-h intervals, this was followed by a dose of 2 cc (100 mg or 10,000 IU) given by subcutaneous injection at 12-h intervals for a further three weeks. Hyperfibrinogenemia is perhaps one of the most important factors in the thrombophilic syndrome, and at the same time it is one of the fundamental physiopathological alterations observed in AMI and PA. Because heparin reduces hyperfibrinogenemia it has a beneficial effect in these diseases. PMID- 6851282 TI - Serial M-mode echocardiographic mapping in myocardial infarction: a quantitative evaluation of left ventricular wall motion abnormalities. PMID- 6851284 TI - Four-year-old boy with small right lung? . . . or . . . large left lung? PMID- 6851283 TI - Noninvasive recognition of the parchment right ventricle (Uhl's anomaly arrhythmogenic right ventricular dysplasia) syndrome. AB - The case of a 53-year-old man with right heart failure, selective enlargement of the right-sided cardiac chambers, and recurrent sustained ventricular tachycardia is presented. Echocardiographic, radionuclide ventriculographic, and angiographic studies were typical of the right ventricular abnormalities in Uhl's anomaly; electrocardiographic and electrophysiologic findings were those of arrhythmogenic right ventricular dysplasia. Features of this unusual cause of cardiac failure and ventricular arrhythmias in the adult are reviewed, and compared to previous reports of both Uhl's anomaly and arrhythmogenic right ventricular dysplasia. We postulate that these two syndromes are manifestations of a single, presumably congenital, pathophysiologic process--the "parchment right ventricle" syndrome. PMID- 6851285 TI - Cystic fibrosis. Clinical manifestations in older patients. PMID- 6851286 TI - Optical physics with emphasis on endoscopes. PMID- 6851287 TI - Hysteroscopy as an aid to diagnosis in female infertility. PMID- 6851290 TI - Pharmacokinetic considerations in the maternal-placental-fetal unit. PMID- 6851293 TI - Anesthesia and surgery during early pregnancy and fetal outcome. PMID- 6851292 TI - Alcohol consumption and cigarette smoking: effect on pregnancy. PMID- 6851291 TI - Reproductive hazards of the workplace and the home. PMID- 6851289 TI - Fetoscopy. PMID- 6851288 TI - Hysteroscopic sterilization: silicone elastic plugs. PMID- 6851294 TI - The value of animal teratogenicity testing for predicting human risk. PMID- 6851295 TI - Counseling pregnant women exposed to potentially harmful agents during pregnancy. PMID- 6851296 TI - The effects of embryonic and fetal exposure to X-ray, microwaves, and ultrasound. PMID- 6851297 TI - Iniencephaly: a neuropathologic study. AB - Five cases of iniencephaly are reviewed. Numerous central nervous system malformations were found at all levels, including microencephaly, polymicrogyria, heterotopic glial tissue in the leptomeninges, atresia of the ventricular system, marked disorganization of the brain stem, vermian agenesis, large cerebellar cyst, and disorganization of the spinal cord tissue. The cerebellum was normal in one case. Numerous skeletal anomalies were found as well as marked retroflexion of the craniocervical junction. We concluded that cerebral anomalies, although severe, are not specific for iniencephaly. Cerebellar anomalies, on the other hand, were considered to share some morphologic features between Dandy-Walker and Arnold-Chiari, i.e., Chiari type II and Chiari type III, malformations. PMID- 6851298 TI - Malignant lymphoma presenting with neoplastic angioendotheliosis of the central nervous system. AB - In this paper we report a case of malignant lymphoma with neoplastic angioendotheliosis in the brain. A 44-year-old man with transient episodes of deafness, hypersomnia, and anorexia over a 5-month period acutely deteriorated. He presented with low grade fever, dementia, frontal lobe signs, general hyperreflexia, muscle weakness of the extremities, and ataxia. He did not have hepatosplenomegaly, lymph node swelling, or skin eruptions. On the 15th day after admission to the hospital he developed convulsions and died. Post-mortem examination revealed multiple infarcts in the central nervous system, especially in the bilateral cerebral white matter and basal ganglia, where mononuclear tumor cells were widespread within the lumens of small blood vessels, accompanied by lymphocytic infiltration and degenerative and occulsive changes of the vessels. Intravascularly in many visceral organs and in the adrenal glands, both intra- and extravascularly, proliferation of tumor cells was observed. Furthermore, a small nest of malignant lymphoma of diffuse mixed cell type was found in a para aortic lymph node, and the lymphoma cells were identical to tumor cells observed in the brain and other organs. PMID- 6851299 TI - Burkitt's lymphoma--a correlated light and electron microscopic study on the malignancy in the CSF. AB - In a sporadic case of primary maxillar Burkitt's lymphoma and secondary spinal epidural dissemination, the massive malignancy in the CSF was investigated by light and electron microscopy. At both levels the CSF tumor cells were strikingly similar, with the undifferentiated lymphoblasts that characterize Burkitt's lymphoma in tissue. However, the starry-sky appearance in the CSF was produced more often by degenerating malignant cells than by histiocytes as classically described in tissue with Burkitt's lymphoma. PMID- 6851300 TI - Perinatal diagnosis of myotubular (centronuclear) myopathy: a case report. AB - This is a case report of a male infant who was hypotonic at birth, failed to maintain his respiratory effort, and despite ventilation died at 27 days of age. Infrequent fetal movements were noted and the possibility of a neuromuscular disorder was suggested antenatally. Electromyography in the neonatal period was indicative of a neurogenic disorder, but muscle biopsy at 16 days of age showed the characteristic histologic appearance of myotubular (centronuclear) myopathy. There was no family history of muscle disease, and the mother has subsequently given birth to a normal male child. The relationship of the present case to other reports of severe congenital myotubular myopathy is discussed. PMID- 6851302 TI - Combined acute necrotic myelopathy (ANM) and cerebellar degeneration associated with malignant disease. AB - Clinicopathologic findings are reported in the case of an unusual combined degeneration of the cerebellum and spinal cord associated with bronchial carcinoma. Clinical features were sudden sensory onset, rapid and complete flaccid paraplegia with ascending course, sphincter paralysis, rapid impairment of general condition, and high protein content in CSF without inflammatory cell reaction. The neuropathologic findings included massive transverse necrosis at the thoracic level and degeneration of the ascending and descending tracts. The necrotic areas involved mostly white matter without any vascular topography. There was no inflammation or specific vascular alteration. In the cerebellum widespread cortical atrophy was observed. There were no metastases in the cord, meninges, vertebral column, or nerve roots. The simultaneous occurrence of two distinct types of nervous tissue alterations reflects the pathomechanisms effective in CNS reactions to extraneuronal malignancy. PMID- 6851303 TI - Precocious puberty in a 3-year-old girl associated with a parasellar ganglionic hamartoma. AB - Precocious puberty due to disorders of the nervous system is uncommon and may arise from neoplastic lesions situated in the pineal gland, hypothalamus, tuber cinereum, and midbrain. Most of these neoplasms maintain connections with or are attached to the central nervous system. Rarely, however, tumors lying free within the meninges may be associated with precocious puberty. A patient with this rare form of precocity who was found to have a parasellar ganglionic hamartoma is described in this report. Her post-operative course was marked by a reversal in her sexual precocity and a subsequent arrest in her accelerated growth rate. PMID- 6851301 TI - Muscle in chronic uremia--a histochemical and morphometric study of human quadriceps muscle biopsies. AB - This report describes qualitative and quantitative studies performed on ten muscle biopsies from chronic uremic patients on renal dialysis at light and electron microscopic (EM) levels. The muscle biopsies showed myopathic changes (variation in fiber size, central nuclei, and fiber splitting). Histochemical studies showed type II fiber atrophy and lipid deposits. The ultrastructural study showed disruption of myofibrillary architecture and subsarcolemmal deposits of glycogen, mitochondria, and lipids. Quantitative estimations of the subcellular organelles revealed a statistically significant increase in lipid and glycogen contents of the muscle. The myopathic changes, type II atrophy, and lipid and glycogen deposits in chronic uremic patients raise the question of the effects of uremia and/or chronic dialysis on muscle metabolism. PMID- 6851304 TI - Initial results from a programme of breast self-examination. AB - As part of a national study of early detection of breast cancer, 28663 women aged between 45 and 64 have been invited to attend a teaching programme on the method of self-examination with the advice to practise it regularly. This paper reports the early results of the Nottingham study on 14905 who have attended. To date there have been 717 self-referrals. One hundred and thirty-nine of these had a significant abnormality on either clinical examination or mammography and eight biopsies have been performed. Cancer was detected in 43 women. This is a detection rate of 2.9 cancers per 1000 educated. Mean tumour size was 2.3 cm (0.5 6.0 cm) and 56% were lymph node negative. PMID- 6851305 TI - Primary treatment of breast cancer in elderly women with Tamoxifen. AB - One hundred and sixty-one female patients, over the age of 70, with breast cancer were treated by Tamoxifen alone in a pilot phase II study. 61% showed objective regression of the disease and in 27% there was complete remission. The treatment was well tolerated and the survival rate compared favourably to that following conventional methods of treatment. An accurate assessment of the method awaits a randomized clinical trial. PMID- 6851306 TI - Fibreoptic bronchoscopy in the diagnosis of bronchial cancer: comparison of washings, brushings and biopsies in central and peripheral tumours. AB - Fibreoptic bronchoscopic cytodiagnosis by washings and brushings and histodiagnosis by forceps biopsy were studied in 484 Chinese patients with bronchial carcinoma. When the tumour was bronchoscopically visible, the yields of the three procedures were: washings 76%, brushings 74% and biopsy 82%, giving a total yield of 94%. For peripheral bronchoscopically non-visible tumour, the yields were 52%, 52% and 61% respectively, making a total yield of 86%. Bronchial washings and brushings were important complementary procedures to biopsy and provided the exclusive diagnosis in 12% of the central and 25% of the peripheral tumours. The cytologic cell typing accuracy is 92% for epidermoid carcinoma, 87% for small cell carcinoma, 83% for adenocarcinoma and only 38% for large cell carcinoma. The accuracy of cell-typing of the two bronchial cytodiagnostic methods was comparable in central tumours, but higher with brushings in peripheral tumours. PMID- 6851307 TI - The effect of 5-fluorouracil on DNA synthesis in the rat liver undergoing compensatory hyperplasia after partial hepatectomy. AB - An investigation has been made into the effects of 5-fluorouracil (5FU) on DNA synthesis after partial hepatectomy. Animals underwent in vivo isolated liver perfusion with 5-fluorouracil followed by partial hepatectomy or Sham hepatectomy. Controls consisted of animals whose liver was perfused with 0.9% saline. Liver weight and DNA synthesis were recorded at various times following 5 fluorouracil perfusion and partial hepatectomy and control procedures. The results have shown that perfusion with large concentrations of the cytotoxic agent (5 FU) can be performed without apparent serious side effects on liver weight and with only minimal delay in liver cell proliferation. PMID- 6851308 TI - A case of Masson's vegetant, intravascular haemangioendothelioma presenting in a large neck vein. AB - Masson's vegetant intravascular haemangioendothelioma is a rare, benign, intravascular tumour. It is often associated with a pre-existing vascular process such as a pyogenic granuloma or a haemangioma. The clinical diagnosis is usually that of a vascular lesion or of a cyst. This is the first report of such a lesion presenting in a large neck vein. It is important to recognize the existence of this tumour as it is invariably benign, and local excision is curative. PMID- 6851309 TI - Plasmacytoma of the thyroid gland. AB - Solitary plasmacytoma of the thyroid is very rare. Thus far, only 12 cases have been reported in literature. This report describes the clinical and histological features of two additional cases. One patient developed bone metastases 1 month after diagnosis and died 17 months later. The second patient is alive with no evidence of disease, 19 months after diagnosis. At the present time there are insufficient data to assess the prognosis in any single case. PMID- 6851311 TI - Anticancer activity in urea. PMID- 6851310 TI - Malignant pericardial effusion managed with Vinblastine. AB - A 69-year old man with a known bronchial carcinoma developed a malignant pericardial effusion, and signs of subacute tamponade. Single agent chemotherapy with intravenous Vinblastine resulted in complete resolution of the effusion without untoward side effects. PMID- 6851312 TI - Ring UPM total hip arthroplasty. AB - It is apparent that failure at the cement-bone interface is an increasing problem with total hip arthroplasty. This failure may be difficult or impossible to rectify. The risk of infection at the cement-bone interface and the difficulty of revisional surgery in the cemented articulation appear to justify fully an attempt to develop a reliable, uncemented total hip prosthesis. During the period from 1980 to 1982, 471 uncemented metal-on-plastic total hip arthroplasties have been performed. The results were compared with those for earlier metal-on-metal articulations and a comparable group of cemented metal-on-plastic joints. The short-term results for this procedure appear better than those obtained with the uncemented metal-on-metal articulation and comparable with those of the cemented joint, while retaining the relative freedom from complications of the uncemented articulation. The implant relies on the axial location of the pelvic component, and it is designed to be revised with ease, should revision prove necessary. PMID- 6851313 TI - Bony ingrowth fixation of newly designed acetabular components in a canine model. AB - Implantation of a newly designed acetabular component with a porous coating has resulted in superior fixation when compared with acrylic cementation in the short term. Experiments in dogs demonstrate rapid ingrowth within the porous layers, resulting in rigid fixation of the acetabular components despite defects in the prepared bony bed. Acute infection prevents bony ingrowth and causes loosening. The absence of any foreign-body response to the titanium fiber mesh components suggests that this is a biocompatible metal. The fixation has been excellent; progressive or delayed loosening is not encountered once successful ingrowth is achieved. Progressive radiolucent zones generally do not appear in the short term but when visible soon after surgery, may consolidate and disappear. Ingrowth fixation of acetabular components appears to offer an attractive alternative to the use of acrylic cement and may even be feasible in patients with periarticular bony abnormalities. PMID- 6851314 TI - Urinary cobalt levels in patients with porous Austin-Moore prostheses. AB - Austin-Moore prostheses with a porous surface have been used recently to improve stabilization in total joint arthroplasty. However, these prostheses expose tissue directly to greater metallic surface area than previous nonporous designs. Cobalt levels were measured in the urine of patients who had received porous and nonporous prostheses, to assess any increased risk of metal toxicity posed by the porous design. Although a higher mean urinary cobalt concentration was found for patients with porous prostheses, the absolute levels were comparable with those of patients with nonporous prostheses. The prostheses with a porous surface appear to pose no significant added risk of metal toxicity as compared with the nonporous design. PMID- 6851315 TI - Charnley low-friction arthroplasty in patients with psoriasis. AB - A retrospective study of 38 patients with established psoriasis treated by 55 Charnley low-friction arthroplasties showed a superficial infection rate of 9.1% and a deep infection rate of 5.5%. All of the operations were carried out in the Charnley clean-air enclosure, without prophylactic antibiotic therapy. The incidence of postoperative sepsis in psoriatic patients was significantly higher than in patients with osteoarthritis (p less than 0.001) and rheumatoid arthritis (p less than 0.05). Hence, prophylactic antibiotic therapy appears beneficial in psoriatic patients. PMID- 6851316 TI - Long-term follow-up study of a distal iliotibial band transfer (DIT) for anterolateral knee instability. AB - In a prospective study 60 consecutive patients underwent a distal iliotibial band transfer for anterolateral rotatory instability. A knee function score was obtained prior to operation and 17 and 40 months after operation. The maximum score possible was 100 points. Patients with scores greater than 77 were rated as good/excellent. The mean preoperative score was 59.3 points. At 17 months the score was 88.0, a significant improvement, and at 40 months it had dropped significantly, to 73.1. The decrease in score was due mainly to increasing symptoms of instability and pain. At the 17-month follow-up examination, 80% of the patients were stable, but at 40 months only 42% remained stable. The initial results were encouraging, but at 40 months the distal iliotibial band transfer did not function satisfactorily. The best results were obtained in patients in whom symptoms of instability were initially moderate. PMID- 6851317 TI - Angular and torsional deformities of the lower limbs in children. AB - Angular and torsional malalignments of the lower extremity in children are common problems for which parents seek orthopedic advice. Calcaneal valgus of the foot, internal tibial torsion, genu varus, genu valgus, and femoral anteversion are normally observed in infants and usually are corrected with growth. The majority of angular deformities are physiologic; however, it is important to distinguish those requiring further evaluation and treatment. Accurate examination and knowledge of the natural history of rotational and angular deformities allow accurate assessment of the child and sound advice to the parents. There is a trend away from the use of shoe modifications, Denis-Browne-type bars, and twister cables in treating these deformities. Surgical treatment is occasionally required, but the prerequisites in each case should be carefully observed. PMID- 6851320 TI - Lower extremity electromyographic analysis of running gait. AB - Onset of firing for the quadriceps, hamstrings, and gastroc soleus groups during running, both on a treadmill and over ground, was determined in seven normal adult male subjects. Surface and wire electrode data were collected simultaneously from 959 individual gait cycles. The mean velocity over ground was 274 +/- 38 m/minute, with a mean cadence of 171 +/- 14 steps/minute. The treadmill was set at 107 m/minute (4 miles/hour), and the subjects' mean cadence was 147 +/- 11 steps/minute. Over ground, the mean swing/stance ratio was 70/30 +/- 3%, and that for the treadmill was 60/40 +/- 6%. Like muscle groups on the right and left showed a mean difference in onset of muscle activity of 1.3% (+/- 4.6%) when measured during a minimum of ten cycles per subject for each test condition. The average difference in time of onset between the surface and wire electrodes was 2% (SD +/- 4.9%) on the treadmill and 1.5% (SD +/- 3.7%) for over ground running. These differences are not statistically significant. Surface and wire electrode data have been determined to be equivalent only for regional synergistic muscle groups and should not be extrapolated to compare functions of individual muscles within those groups. PMID- 6851318 TI - Osteonecrosis-like syndrome of the medial tibial plateau. AB - Thirty-six patients with an osteonecrosis-like lesion of the proximal tibia presented due to the sudden onset of pain along the medial side of the knee and marked tenderness over the medial tibial plateau. Initially, the roentgenograms were within normal limits or showed mild degenerative joint changes. All patients had positive radionuclide bone scans; the lateral view clearly demonstrated the lesion within the tibia. The symptoms remained severe for six to 12 weeks, after which they gradually resolved. Most patients were asymptomatic after nine to 12 months. Differentiating this entity from a torn meniscus or pes anserinus bursitis is difficult without obtaining a bone scan. As more bone scans are obtained, this may prove to be a common entity; recognition of the condition may prevent unnecessary surgery. PMID- 6851319 TI - Lisfranc's fracture-dislocations: etiology, radiology, and results of treatment. A review of 20 cases. AB - Tarsometatarsal fracture-dislocation is an uncommon but severe lesion. Since this diagnosis is over-looked in about 20% of cases, accurate radiographic examination is imperative. In the presence of suggestive clinical signs and negative standard roentgenograms, stress-films in eversion-pronation and inversion-supination are obtained under general anaesthesia. A review of 20 cases shows that plaster cast immobilization without reduction is unsatisfactory, often resulting in Sudeck's atrophy and subsequent painful degenerative arthritis. Secondary fusion may be necessary to relieve symptoms. The treatment of choice is anatomic reduction and transfixation with Kirschner wires. The major complication is arterial damage with necrosis of the forefoot. Amputation may be necessary. PMID- 6851321 TI - Foramen magnum and upper cervical cord tumors. Diagnostic problems. AB - Five of six patients with foramen magnum and upper cervical cord tumors were inadequately treated owing to erroneous diagnoses. The time course from the onset of the disease to surgery ranged from six to 96 months (average, 37.3 months). Occipitalgia and neck stiffness are often of diagnostic importance, and foramen magnum and upper cervical cord tumors should be considered when these conditions are accompanied by upper motor neuron disturbance and/or sensory disturbance. Myelography, with careful examination up to the foramen magnum, is essential to establishing a diagnosis. CT scanning and vertebral angiography are also indispensable prior to surgery, as they offer important information as to tumor size and the distribution of nutritive arteries to the tumor. PMID- 6851323 TI - Primary dislocation of the shoulder. Factors affecting the two-year prognosis. AB - Two hundred fifty-five patients with 257 primary dislocations of the shoulder were followed up for two years +/- 15 days in a multicenter study in Sweden. In patients 22 years of age or younger, there was a 47% recurrence rate. The corresponding figures for patients 23-29 and 30-40 years of age were 28% and 13%, respectively. The greatest risk for recurrence was in patients 17-19 years of age, 53% of whom had at least one recurrence. Such factors as sex, type of trauma, or physical activities did not enter into the prognosis. Spontaneously appearing dislocations were found most often in patients 22 years of age or younger--14% as compared with 1% in patients 30-40 years of age. The incidence of bilateral dislocations was greatest in patients 23-29 years of age. PMID- 6851322 TI - Ectopic calcification as a late sequela of compartment syndrome. Report of two cases. AB - Ectopic calcification occurred in two patients as a late sequela of compartment syndrome. The clinical and roentgenographic appearance are sufficiently typical that the diagnosis should be made without difficulty. Leaving the wound open after incision and drainage of these lesions may lead to secondary infection. Closing the wound after decompression over suction drainage or needle decompression are treatment alternatives that may lead to more satisfactory results. PMID- 6851325 TI - Forearm fractures in the head-injured adult. AB - Forty-seven of 661 head-injured adults sustained 50 forearm fractures. Eight extremities exhibited elbow flexion contractures greater than 55 degrees. Traumatic heterotopic ossification at the elbow developed in ten (20%) extremities: four with Monteggia fractures, two with olecranon fractures, and four with no known trauma. Only two of 18 (11%) extremities treated by plaster immobilization achieved good or excellent results, while 17 of 32 (53%) extremities treated by open reduction and internal fixation achieved good or excellent results. Union of fractures of one or both bones occurred at the same rate as for the normal population. There were no nonunions or deep infections, and there was only one delayed union. Calcification occurred in the interosseous membrane in 12 extremities (24%). In nine forearms (18%) a complete synostosis developed. One isolated radial fracture treated by open reduction and internal fixation and one isolated ulnar fracture treated by plaster incurred a synostosis. Seven of 21 (33%) fractures of both bones developed synostosis. Five of 16 (31%) fractures of both bones treated by open reduction and internal fixation developed a synostosis. These observations corroborate reports demonstrating that head injury predisposes to heterotopic ossification in forearm fractures. PMID- 6851326 TI - Eosinophilic granuloma of the growing epiphysis. A case report and review of the literature. AB - A six-year follow-up study of an eosinophilic granuloma of bone occurring in the growing epiphysis of a five-year-old boy is reported. This is the seventh such case reported in the literature. Eosinophilic granuloma of bone occurring in the epiphysis can extend into the metaphysis by destroying the growth plate. PMID- 6851324 TI - Volar dislocation of the metacarpophalangeal joint. Pathologic anatomy and report of two cases. AB - Of two cases of volar metacarpophalangeal joint dislocation, the thumb was affected in one. This is the first case of its kind reported in the English language literature. Patients with this injury are older than patients with the more common dorsal dislocation. The mechanism of injury seems to be direct trauma to the dorsum of the hand with the metacarpophalangeal joint acutely flexed. The pathologic anatomy may be a combination of a dorsal capsular tear, a tear of one or both collateral ligaments, and a tear of the volar plate with interposition in the joint. Attempt at closed reduction, even if a pin is used percutaneously to transfix the joint, almost invariably will lead to recurrence of the deformity. The recommended treatment for such very rare injuries is open reduction through dorsal, or both dorsal and volar, approaches; removal of the incarcerated volar plate from the joint; and repair of all torn ligaments. PMID- 6851327 TI - Musculoskeletal infection with nongonococcal neisseria species not associated with meningitis. AB - Five patients with type III musculoskeletal infection from nongonococcal Neisseria species were examined during a 13-month period. The initial clinical diagnosis was incorrect in all cases. Synovial fluid analysis and Gram's stain were not helpful, and the correct diagnosis was made only after culture reports were available. The patients responded well to antibiotic treatment, but two patients with underlying rheumatoid arthritis required surgical debridement. All patients were asymptomatic, with resolution of their infection at follow-up evaluation. An early correct diagnosis is mandatory and Neisseria infection should be considered in patients with pre-existing joint disease. PMID- 6851328 TI - The incidence of thromboembolic disease. AB - The incidence of thromboembolism was determined by a survey of 7986 orthopedic patients who had 5966 operations at a university hospital during a three-year period. Patients were analyzed to determine thromboembolic risks with respect to the orthopedic diagnosis to assist in providing the patient with informed consent and to identify patients who need prophylactic anticoagulation therapy. The patient population was divided into three risk classes: Class 1, low-risk patients, including children, all upper-extremity patients, and adult non surgical ambulatory rehabilitation patients; Class 2, medium-risk patients, including all adult lower-extremity patients and patients with spine problems and no history of thromboembolic disease; Class 3, high-risk patients, including all patients with a previous history of thromboembolic disease or venous stasis disease. Class 1 patients require no prophylactic anticoagulation, Class 2 patients should be treated with dextran or aspirin, and Class 3 patients should be treated with warfarin. The calculated mortality for Class 2 patients, excluding hip problems, is 0.26%; mortality for acute spinal cord injuries is 2.9% and for hip surgery 2.2%. PMID- 6851329 TI - Patellar pain and incongruence. I: Measurements of incongruence. AB - In 150 normal asymptomatic knees, the average Q angle was 15 degrees. The patellar length was equal to the patellar ligament length, and the average congruence angle was -8 degrees. In 53 knees with recurrent subluxation, the patella was high-riding (TP, 1.23), the sulcus angle was shallow (147 degrees), and the average congruence angle was +16 degrees. In 53 knees with "chondromalacia," the Q angle was increased (20 degrees), and the average congruence angle was -2 degrees. PMID- 6851330 TI - Patellar pain and incongruence. II: Clinical application. AB - Proximal realignment was performed in 75 knees due to patellar pain or instability. With a follow-up period of from two to ten years, the result was excellent or good in 68 knees (91%) and fair or poor in seven knees (9%). Postoperative Merchant views were obtained in 57 knees. In the 52 knees rated good and excellent, the average congruence angle was -11 degrees. Five knees were rated fair or poor, with an average congruence angle of 0 degree. Clinical results seemed to correlate more with correction of patellar congruence than with the severity of chondromalacia found at operation. PMID- 6851332 TI - Tibial osteotomy for the varus osteoarthritic knee. AB - High tibial osteotomy is a reliable method for relieving pain in the varus osteoarthritic knee. In a review of 139 osteotomies, excellent and good results were noted in 64% of the knees after a follow-up period of at least ten years. The ideal candidate for this operation has Grade I or II osteoarthritis; less than 10 degrees of varus deformity, as measured by a single leg standing roentgenogram; no lateral subluxation; and no instability. The lateral closed wedge osteotomy without internal fixation is the preferred technique, and correction beyond the normal anatomic position, to 5 degrees of valgus, is advised. Protected weight-bearing after the second postoperative day is allowed. Complications have been infrequent and minor. Forty-seven knees were managed in this manner, and 88% had an excellent or good result at a four-year follow-up evaluation. In the majority of the well corrected knees, the alignment did not change with time, and the osteoarthritis did not progress. No failures in this series were attributable to the associated patellofemoral osteoarthritis; the reaction of the patellofemoral joint to osteotomy is obscure. PMID- 6851331 TI - Unicompartmental knee arthroplasty for single compartment disease. Clinical experience with an average four-year follow-up study. AB - Unicompartmental knee arthroplasty using the Marmor modular knee prosthesis or, later, the Richards Modular II prosthesis in a series of 72 knees (60 patients) is reviewed, with an average follow-up period of four years (minimum, 2 years). Pain relief was rated as excellent in 90% of the knees. The average range of motion was improved after operation. No deep infections were encountered. Only one knee in the series has required further surgery, for patellofemoral disease. PMID- 6851334 TI - Correlation of prosthetic femoral head size and/or design with longevity of total hip arthroplasty. AB - Sixty-seven Mueller and 84 Charnley total hip arthroplasties were followed up for a minimum of seven years; pain, radiographic radiolucency, and prosthetic component loosening were evaluated. The patients who had Mueller total hip prostheses had significantly more pain at five (p less than 0.021) and seven years (p less than 0.001). No statistical differences were found between the two prosthetic groups in regard to incomplete or complete radiolucency or loosening of the femoral component, or incomplete or complete nonprogressive radiolucency of the acetabular component. The Mueller acetabular cup was loose in 15%, as compared with 4% for the Charnley group (p less than 0.032). A survival analysis at five and seven years revealed that the success rate for Charnley total hip arthroplasties was 94% and 86%, respectively, as compared with 87% and 70%, respectively, for Mueller total hip arthroplasties (p less than 0.003). This difference possibly is due to the large Mueller femoral head; if so, resurfaced hips would also experience earlier acetabular loosening. PMID- 6851333 TI - A canine cementless total hip prosthesis model. AB - To evaluate a porous fiber titanium composite as a fixation method, total hip arthroplasty was performed in 13 large male mongrel dogs. In seven both acetabular and femoral composites were fixed with a porous titanium fiber composite, and in the other six the acetabulum was fixed with acrylic cement. The animals were killed one, three, and six months following implantation. At autopsy all components were fixed by bony ingrowth. There was progressive remodeling of the ingrown bone and of the bone trabeculae surrounding the prosthesis in the three- and six-month animals, with gradual thickening and development of haversian structures. Cortical osteoporosis, which did not appear to be progressive, was detected in both the one- and six-month specimens. PMID- 6851335 TI - One day versus seven days of preventive antibiotic therapy in orthopedic surgery. AB - Three hundred fifty-eight patients undergoing total hip arthroplasty, total knee arthroplasty, and hip fracture repair were given preventive antibiotics 20 minutes before surgery; administration of antibiotics was continued for either 24 hours or seven days. The 24-hour group (186 operations) had three (1.6%) deep wound infections. The difference in infection rates between groups was not significant. PMID- 6851336 TI - Relation of mineralization defects in collagen matrices to noncollagenous protein components. Identification of a molecular defect in dentinogenesis imperfecta. AB - Hydroxyapatite crystal deposition and stabilization within the collagen matrix of bone and dentin have been linked to the presence of noncollagenous proteins (NCP). Dentinogenesis imperfecta (DI), a genetic disorder of dentin mineralization, is being studied as a model for the analysis of mineralization mechanisms. A comparative study of the NCP in normal human dentin and dentinogenesis imperfecta Type II (hereditary opalescent dentin) dentin has been performed. The proteins of each tissue were extracted and separated using a variety of techniques. The calcium-binding, highly phosphorylated protein phosphophoryn was one of the principal NCP in normal human teeth dentin, whereas there was no evidence for the presence of such a component in the DI teeth. These data imply that dentin phosphophoryn may be related in function to the mineralization process. A similar calcium-binding protein defect should be sought in the various types of osteogenesis imperfecta. PMID- 6851337 TI - Primary calcification in remodeling haversian systems following tibial fracture in rats. AB - Electron micrographs of fracture callus obtained ten days after injury show typical primary matrix vesicle mineralization. In remodeling haversian canals distant from the fracture sites, matrix vesicles and calcifying nodules were observed. The occurrence of these elements was also found to control unfractured tibiae with intramedullary nails but not normal bone. These observations suggest that during haversian remodeling, mineralization after osseous or marrow tissue damage is associated with matrix vesicles. PMID- 6851338 TI - Estimation of mechanical properties of the distal radius from bone mineral content and cortical width. AB - Bone mineral content (BMC) was determined by photon absorptiometry and cortical width (CW) by radiographic morphometry at two levels in 17 radii obtained postmortem from women ranging in age from 39 to 95 years. One level was the region in which Colles' fracture occurs (lower level) and the other about 6 cm from the styloid tip (upper level). Principal compressive strain at a 600-N load, fracture load, compliance, and work/unit length to fracture were measured in longitudinal compression tests. In general, BMC provides more precise estimates of mechanical properties than CW. The correlation coefficient between fracture load and BMC at the lower level was +0.83 (less than 0.001). Between work/unit length to fracture and BMC the coefficient was +0.81 (p less than 0.001). PMID- 6851339 TI - The effect of continuous passive motion on the clearance of a hemarthrosis from a synovial joint. An experimental investigation in the rabbit. PMID- 6851340 TI - Porous polysulfone coatings for fixation of femoral stems by bony ingrowth. AB - Sixteen porous polysulfone-coated canine femoral stems were inserted into 14 dogs. Coatings were approximately 40% porous, with an average pore size of 125 or 250 microns. Bone was formed within at least about 30% of the surface pores of the implants. The tissue ingrowths filling the pores included marrow and fibrous tissue. Correlated roentgenographic and histologic observations revealed a trabecular "lamina dura" at the coating-bone interface and relatively dense trabeculae distal to the stem tip. These observations support the concept of coating femoral prostheses with porous material for cement-free stabilization. PMID- 6851341 TI - Powder metal-made orthopedic implants with porous surface for fixation by tissue ingrowth. AB - Powder metal-made orthopedic implants with a porous coating provide an effective means for implant fixation by tissue ingrowth. Additionally, the use of metal alloy powders for forming porous surfaces offers the advantage of uniform coatings on complex part shapes. With proper processing, implants with strong, porous surface layers and good substrate mechanical properties can be formed. The in vivo tests have demonstrated the need for initial implant stability to achieve bony ingrowth. Animal studies indicate an optimum pore size range of 50-400 mu, and human hip prostheses with pores in this range appear to function well. A porous surface integrated with a compatible implant design avoids undesirable bone remodeling with these types of implants. PMID- 6851343 TI - The madreporic cementless total hip arthroplasty. New experimental data and a seven-year clinical follow-up study. AB - During the period from February 1975 to January 1, 1982, 1509 cementless total hip arthroplasties were performed employing madreporic prostheses. A previous study (1979) introducing this type of rough-surfaced implant and discussing the main requirements for a biologic cementless anchoring included new experimental data about the acetabular component, the threaded ring, indications, complications, and clinical results. A full assessment of the madreporic prosthesis must await ten-year follow-up data, but in view of the good results to date and the increasing incidence of failure with cemented prostheses, surgical cement may be unnecessary for many hip arthroplasties. PMID- 6851342 TI - Hip arthroplasty with a Moore prosthesis with porous coating. A five-year study. AB - The five-year clinical experience with Moore hip prostheses with a porous coating has been encouraging. The results have been equivalent to those of a simultaneous experience using cemented prostheses. The patient population chosen for hip arthroplasty using prostheses with a porous coating was a group at high risk for failure with cemented prostheses. The mean Harris hip ratings for the 26 patients have improved rather than deteriorated with time. Based on current knowledge, it is the author's opinion that the implants in these 26 patients were firmly fixed by a combination of fibrous and bony tissue ingrowth. The presence of radiopaque lines in one-third of the patients at a two-year follow-up examination indicates that micromotion often was present. Close inspection of the three- and four-year follow-up roentgenograms reveals that the tissue ingrowth seems to have provided implant fixation sufficiently uniform to prevent the roentgenographic signs of localized high-stress concentration so frequently seen with smooth-stem Moore prostheses of the same design. The tissue ingrowth also has produced stress transfers sufficiently uniform to provide roentgenographic signs of healthy bone modeling. With four-year follow-up roentgenograms now available in ten patients, there has been no roentgenographic evidence of bone resorption due to femoral stress shielding by the relatively high-modulus implant with a porous surface. PMID- 6851344 TI - Bony ingrowth fixation of the acetabular component in canine hip joint arthroplasty. AB - Five mature dogs were studied five to eight months after insertion of a newly designed acetabular component that eliminates the use of bone cement in total hip arthroplasty (THA). The component was hemispheric, with a layer of porous metal on its outside surface. It initially was fixed to the innominate bone by screws passed through projections from the edge of the metal substrate. When the dogs were killed five or eight months after implantation, all components were fixed rigidly to the bone. Bony ingrowth covered an average of 53% of the porous surface of the implant, penetrating three layers of balls. PMID- 6851345 TI - Cementless fixation of "isoelastic" hip endoprostheses manufactured from plastic materials. AB - Nine years of clinical experience with an "isoelastic" shaft prosthesis manufactured using polyacetal resin reveal that for the transmission of forces from the pelvis through the femoral head and neck into the femoral shaft, some rigidity of the proximal part of the prosthesis is necessary. The object is to eliminate micromovements, which lead to bone resorption and implant loosening. However, elasticity greater than that present in metallic implants prevents stress concentrations and disuse stress protection atrophy of the bone. Greater elasticity of the prosthesis, which can be achieved by plastic materials, makes possible a more even, harmonious distribution of the forces transmitted from the implant to the bone and vice versa. A more elastic implant can also act as a better shock absorber than a rigid one. The results in 627 cementless polyethylene cups after a maximum observation period of 5.5 years reveal good incorporation and no aseptic loosening. Especially favorable results occurred in 61 cases by replacing loosened cemented cups with bone grafts and cementless polyethylene cups. On the femoral shaft side too high an elasticity in the proximal part of the prosthesis led to bone resorption and loosening with the first model of the prosthesis. By reinforcing the proximal part of the femoral component, much better results were obtained. The isoelastic femoral shaft, however, is in an early stage of experimentation. PMID- 6851347 TI - Preliminary experience with a total knee prosthesis with porous coating used without cement. AB - Preliminary results of implanting a total knee prosthesis with a porous coating without cement in 41 patients (46 knees) followed up for four to 25 months have shown no clinical interface failures. Radiographs show that intimate contact between bone and prosthesis is maintained for as long as two years. Instrumentation is particularly critical to cementless application but also important to all total knee arthroplasties. Prosthetic design may also be critical for cementless operations. An anatomic, minimally constrained resurfacing design has been shown to be successful in the short term and justifies continuation of clinical investigation of cementless total knee arthroplasty. PMID- 6851346 TI - Cementless fixation of prosthetic components in total arthroplasty of the knee and hip. AB - An appropriately designed implant can be fixed without cement to accurately prepared bone surfaces so as to give results comparable with those of cemented fixation in the short term. The unchanging appearance of the roentgenograms suggests that these results may be maintained in the long term. If these conclusions are valid, polymethylmethacrylate (PMMA) may be thought of as an optional alternative in joint arthroplasty. Thus, theoretically, inert materials, e.g., carbon, can be directly interfaced with the skeleton. Since the authors have achieved interlock with viable bone without relying on bony ingrowth, these materials need not be porous. It is strongly suspected (but as yet unsupported by data) that adequate fixation can be obtained without relying even on the authors' relatively unsophisticated finned peg, provided that (1) the overall shape of the implant achieves interlock on the gross scale, with acceptably low shear stresses at the interface; and (2) the surgical technique achieves a correctly positioned implant applied to accurately cut bone surfaces. However, if for any reason accurate bone cuts can not be achieved, the authors advocate use of PMMA as a valuable fixation agent. PMID- 6851349 TI - [Diffuse demyelinating myelitis, an autopsy case]. PMID- 6851348 TI - [A case of adult type sialidosis with partial beta-galactosidase deficiency without myoclonus]. PMID- 6851350 TI - [Lipids and fatty acids in the fractions of mitochondria and sarcoplasmic reticulum from dystrophic chicken]. PMID- 6851352 TI - [Disturbance of micturition in Shy-Drager syndrome]. PMID- 6851353 TI - [A case of Niemann-Pick disease type C with narcolepsy syndrome]. PMID- 6851351 TI - [A simple form of adult onset familial sudanophilic leukodystrophy manifesting pyramidal tract involvement and presenile dementia]. PMID- 6851355 TI - [Two cases of mixed connective tissue disease (MCTD) with trigeminal sensory neuropathy]. PMID- 6851354 TI - [An autopsy case of Gerstmann-Straussler-Scheinker's disease (spinocerebellar ataxia with dementia and plaque-like deposits)]. PMID- 6851356 TI - Radionuclide brain scans in hospitalized psychiatric patients. AB - Radionuclide brain scans were obtained routinely on 100 consecutive patients admitted to the inpatient psychiatric service. Ninety-nine of these scans were unequivocally normal. One showed unilateral decreased flow in the carotid distribution, but this was not confirmed arteriographically nor did this result in any change in therapy. The authors conclude that there is no justification for the use of the radionuclide brain scan as a screening procedure for patients presenting with psychiatric symptoms. PMID- 6851357 TI - Low iodine diet in I-131 ablation of thyroid remnants. AB - A low-iodine diet was developed for used in decreasing iodine intake and excretion in patients undergoing evaluation with radioactive I-131 for ablation of thyroid remnants as treatment for thyroid cancer. It has been demonstrated to effectively lower iodine excretion to less than 25% of basal values. Preliminary calculations suggest that such iodine depletion may be potentially useful in increasing the radiation dose per mCi of administered activity in I-131 ablative therapy. PMID- 6851358 TI - Evidence of left ventricular aneurysm by thallium-201 myocardial scintigraphy. AB - TI-201 myocardial scintigrams from 100 patients were reviewed for evidence of left ventricular aneurysms without prior knowledge of the clinical or angiographic data. Scintigraphic evidence of left ventricular aneurysms was considered present when TI-201 myocardial activity extended outward from the expected left ventricular contour in a region adjacent to an area of resting scintigraphic hypoperfusion. Scintigraphic findings suggestive of left ventricular aneurysm were detected in four patients, of whom three had angiographic evidence of left ventricular aneurysm. In the fourth patient, a dilated, akinetic left ventricular apex was present but an angiographic diagnosis of left ventricular aneurysm was not made. In three additional patients with angiographic evidence of left ventricular aneurysm, scintigraphic criteria for left ventricular aneurysm were absent. Although ungated TI-201 myocardial scintigraphy is an insensitive technique for the detection of left ventricular aneurysm, a characteristic scintigraphic pattern should suggest that a left ventricular aneurysm is present. PMID- 6851359 TI - Demonstration of a biliary-bronchial fistula using Tc-99m p-butyl IDA imaging. PMID- 6851360 TI - Bone imaging in osteoblastoma. PMID- 6851361 TI - The qualitative I-131 Hippuran renogram. A potential problem. AB - The I-131 Hippuran renogram time activity curve is usually generated by assigning computer assisted regions of interest over each kidney. Qualitative whole kidney renogram curves can be misleading when there is a nonobstructed but dilated collecting system or asymmetrical excretion of the tracer from the renal collecting system. This problem can be minimized by generating an additional renogram curve from a region of interest assigned over each renal cortex. PMID- 6851362 TI - Left ventricular thrombus. Detection by ECG synchronized cineangiography. AB - The detection of a left ventricular mural thrombus, a potentially fatal complication of various heart diseases, is often missed by current radiographic techniques. The findings on ECG synchronized radionuclide cineangiography in a patient with a large thrombus in the left ventricular cavity, confirmed by echocardiography and angiography are reported. This suggests a role for radionuclide cineangiography in the detection of left ventricular mural thrombus. PMID- 6851363 TI - Clinical utilization of perfusion lung scans in the diagnosis of pulmonary emboli. AB - To study the utilization of perfusion lung scans, the records of 116 consecutive patients who had "pulmonary embolus" (PE) as a discharge diagnosis were reviewed. The PE group was identical to the control group in the percent of male patients and of white patients. However, the PE group was older (60.4 versus 47.5 years), had a higher percentage of smokers (53.1 versus 34), and had a higher proportion of obese individuals (39.6 versus 25) than controls. Mortality was significantly greater in the PE patients (9.5% versus 1%) as was the length of hospital stay (21 versus 9 days). The PE group had more chest x-rays than did controls (6.1 versus 1.8) and had a higher percentage of lung scans (95.7 versus 5). While 95.7% of the patients diagnosed as having PE were studied by perfusion lung scans, 4.3% had none. Further, 18.1% had only one lung scan. Of 111 patients with perfusion lung scans, 3.6% were discharged with a diagnosis of PE despite a negative study. While clinical acceptance of perfusion lung scans is high, some patients diagnosed as having pulmonary emboli did not have a scan but underwent other diagnostic tests, while a small group of others were assigned the diagnosis despite a negative lung scan. This points to the need for better communication with referring clinicians. PMID- 6851364 TI - Reversible ischemia of the femoral head. PMID- 6851365 TI - Ewing's sarcoma seen as a "cold" lesion on bone scans. PMID- 6851366 TI - Pseudocysts of the pancreas mimicking space-occupying lesions on liver scan. PMID- 6851367 TI - Thallium stress test in a patient with dextrocardia. PMID- 6851368 TI - False-positive liver scan due to a posterior sulcus tumor. PMID- 6851369 TI - Abstracts of papers and exhibits presented at the Society of Nuclear Medicine, 28th Annual Southwestern Chapter meeting. Oklahoma City, Oklahoma, March 18-20, 1983. PMID- 6851371 TI - Induction of salicyluric acid formation in rheumatoid arthritis patients treated with salicylates. AB - Average steady-state serum salicylate concentrations and salicyluric acid (SU) formation rates were measured in 4 subjects with rheumatoid arthritis. After a salicylate washout period (1 month), the mean observed maximum formation rate of SU was determined by collecting frequent urine samples after a single oral dose of salicylate (35 mg/kg). The patients were then commenced on appropriate high dose salicylate therapy. Two and 5 weeks later, the mean observed maximum rates of SU formation were re-determined along with the average steady-state serum salicylate concentrations. Mean observed maximum SU excretion rates increased significantly between the single-dose study (0.96 +/- 0.22 mg/kg/h) and the last dose of the high dose therapy at 2 weeks (1.65 +/- 0.30 mg/kg/h; p less than 0.01); however, there was no further increase at week 5. Similar increases in the theoretical maximum rate of SU formation (Vmax) were observed between the single dose study and after 2 weeks of high dose salicylate therapy. Average steady state serum salicylate concentrations showed no decline between weeks 2 and 5. High dose salicylate therapy leads to acceleration of the rate of SU formation in patients with rheumatoid arthritis and this occurs largely during the first 2 weeks of therapy. PMID- 6851372 TI - Pharmacokinetics of phenylethylmalonamide (PEMA) after oral and intravenous administration. AB - The pharmacokinetics of phenylethylmalonamide (PEMA), one of the major metabolites of the antiepileptic drug primidone, have been studied in 6 healthy volunteers after administration of single 500mg intravenous and oral doses. Following intravenous administration, after a very short distributive phase (t1/2 = 0.23-0.53h), the decline of the log-PEMA concentration with respect to time appeared linear. The pharmacokinetic parameters, calculated according to a 1 compartment open model, showed the following values (mean +/- SD): terminal half life, 15.7 +/- 3.4h; apparent volume of distribution, 0.69 +/- 0.10 L/kg; total serum clearance, 31.3 +/- 6.6 ml/h/kg. After oral administration, peak serum concentrations occurred at 0.5 to 4 hours and the oral bioavailability was 86.4 to 95.9%. PMID- 6851370 TI - Clinical pharmacokinetics of dothiepin. Single-dose kinetics in patients and prediction of steady-state concentrations. AB - The pharmacokinetics of dothiepin were evaluated in 9 depressed patients following a single oral dose of 75 mg. Blood and plasma concentrations of dothiepin and 2 major metabolites, northiaden and dothiepin S-oxide, were measured by gas chromatography/mass fragmentography. The mean (+/-SD) peak plasma concentrations of dothiepin were 49 +/- 27 micrograms/L at 3 +/- 1.2h. Mean (+/ SD) estimates of other parameters were as follows: absorption half-life 1.1 +/- 1.1h; distribution half-life 2.2 +/- 0.8 h; elimination half-life 25 +/- 7h; apparent volume of distribution 70 +/- 62 L/kg; and oral clearance 2.1 +/- 1.6 L/kg/h. The mean (+/-SD) peak plasma concentration of dothiepin S-oxide was 125 +/- 43 micrograms/L at 3.5 +/- 1.3h with an elimination half-life of 22 +/- 12 h. The mean peak plasma concentration of northiaden was 6 +/- 3 micrograms/L at 4.5 +/- 1.1h, with an elimination half-life of 31 +/- 12 h. No significant differences were found in pharmacokinetic parameters compared with a previous study in 7 healthy volunteers. When data for the patients and healthy volunteers were combined (n = 16), pharmacokinetic parameters were not found to be affected by age. However, a significant difference was found between males and females for the elimination half-lives of dothiepin and northiaden, and for the apparent volume of distribution of dothiepin. The 24-hour blood/plasma concentrations of dothiepin and dothiepin S-oxide accurately predicted the steady-state concentrations obtained following 4 weeks' treatment with dothiepin 150 mg nocte. PMID- 6851373 TI - Central nervous system manifestations of sarcoidosis in children. Case report and review. PMID- 6851374 TI - Prevalence of lymphadenopathy of the head and neck in infants and children. AB - This study demonstrates the widespread prevalence of "normal" adenopathy in children; i.e., not associated with infectious adenitis or serious system illness. The knowledge of this distribution is helpful in determining when adenopathy may be pathologic. Occipital and postauricular adenopathy is a common nonspecific finding in infancy; but, over the age of 2 years, it is sufficiently rare that it can be a useful diagnostic finding. Cervical and submandibular nodes are rare in infants under 12 months but are common in older children. Supraclavicular nodes are probably pathologic at any age. PMID- 6851376 TI - Teaching well child care. AB - Despite recommendations that the emphasis of the well child visit be on behavior and development, some studies indicate that pediatricians continue to spend a relatively small percentage of each well baby visit on these subjects. One factor contributing to the discrepancy between current recommendations and practice may be the way we teach residents to perform this task. In this study, we investigated and evaluated current methods for teaching well child care. Our data indicate that the content of well child care is being taught, but that problems with teaching setting, methods and frequency of supervision, and lack of formal evaluation may be among the factors which contribute to our continued inability to change the focus of well child visits. PMID- 6851377 TI - Hair zinc levels in infants. PMID- 6851375 TI - Trends in medication treatment of hyperactive school children. Results of six biannual surveys. AB - In biannual school surveys from 1971 through 1981, it was found that the rate of medication treatment of hyperactive students increased two- to threefold over the decade. This increase applied similarly to parochial, public elementary, and public middle/junior high school students. Other findings over the decade include the following: methylphenidate use increased from 40 per cent to 91 per cent of all the medication prescribed for hyperactivity, administration of medication for hyperactivity in the school increased from 61 per cent to 87 per cent of the total, and the number treated with medication prescribed by the family doctor decreased from 98 per cent to 59 per cent. Noteworthy findings in 1981 were as follows: 19 per cent of public elementary school students in special education classes were treated with medication for hyperactivity; hyperactive students in middle/junior high school had received medication treatment for an average of five to six years; the most common school period of medication use was grades one through four; entrance into first grade and secondary school corresponded to an increased use of medication for hyperactivity; and female, relative to male, students were treated with medication for hyperactivity less often than would be expected in teacher surveys of classroom hyperactivity, a finding particularly striking in middle/junior high school. PMID- 6851378 TI - Oral zinc therapy in Indian childhood cirrhosis. PMID- 6851379 TI - Congenital ventral hernia associated with infantile idiopathic scoliosis. PMID- 6851380 TI - Successful treatment of supraventricular tachycardia with metoprolol, a cardioselective beta blocker. AB - Paroxysmal supraventricular tachycardia is a common problem in infancy and childhood. Past treatment has included digitalis and nonselective beta blockers (propranolol). We describe a new mode of therapy with a cardioselective beta blocker (metoprolol) that may be of use in patients resistant to standard therapy. PMID- 6851381 TI - Symposium on innovative planning of perinatal centers. PMID- 6851382 TI - The University of Utah Perinatal Center. An innovative design. PMID- 6851383 TI - Evolution of nursery design and function. The Memphis story. AB - The total design of a neonatal special care unit is fundamentally determined by patient load, essential staff, fiscal wherewithal, and available space. Given a commitment to this type of care, the least controllable of these factors are patient load and essential personnel. Suggestions for the design of these units can be made only in terms of effective function of personnel and optimal care of infants. The encapsulated account of our evolution is intended to present the rationale of our decisions. A straight-forward unembelished description of these physical facilities would not be meaningful without continuous reference to the staff and the infants that bring a facility to life. PMID- 6851384 TI - A new obstetric unit. E. H. Crump Women's Hospital and Perinatal Center, Memphis, Tennessee. AB - Planning or renovation of a labor and delivery area is a major undertaking. It is often necessarily done in dynamic condition--changing facilities, numbers of deliveries, residents, students. Input from the large number of disciplines that provide care for mothers and babies should be sought in the early planning stages. Visiting other hospitals to see their facilities firsthand and to discuss the good and bad points of the facility is money well spent. A recent publication regarding design of perinatal facilities has much useful information. Early consultation with an architect who has designed several labor and delivery suites may help to prevent difficulties in the later phases of design. Imagination, forethought, perseverance, and a positive attitude will contribute to the success of this very difficult task. PMID- 6851386 TI - Renovations of an obstetrics suite: Regional Center for Tertiary Perinatal Care of Presbyterian Hospital in the City of New York. PMID- 6851387 TI - Equipment costs. The neonatal intensive care unit and the modern obstetric unit. AB - In summary, the cost of equipment depends on a plethora of factors. In purchasing equipment, while cost is a major consideration, it should not be the sole determinant. Other major concerns include prepurchase evaluation opportunity, repair capabilities, breakdown frequency, capability for emergency repair, self monitoring systems built into equipment, personnel education on the use of the equipment, other services offered by the company, trade-in capability, reliability of the company, and restrictions established by the Hospital's Standardization committee. The Emergency Care Research Institute is considered to be the "consumer's guide" for sophisticated hospital equipment and issues a publication called Health Devices, which reviews the results of their findings. Also the Medical Device Register is a single source of information on medical equipment and suppliers. PMID- 6851385 TI - Neonatal intensive care unit renovation. The New York Hospital--Cornell Medical Center 1975-1976. AB - The renovation of the neonatal intensive care unit at The New York Hospital has served to test several new ideas about the design of intensive care facilities for infants. Our experience has supported our original feelings that smaller rooms rather than large open spaces offer significant advantages to both staff and families of patients. The radial arrangement of beds around a central supply module has concentrated our available floor space immediately around the patient's bed while providing convenient access to virtually all supplies used in infant care with a minimum of labor devoted to stock maintenance. The anticipation of our relationships with supportive services such as radiology and biochemistry has allowed us to integrate these functions smoothly into the design of the unit in such a way that service and patient care are generally improved as a result of this advance planning. In short, the design has proved conceptually sound but shares flaws that many units before ours have recognized. You cannot have too much storage space or too much floor space. In general, this design has vindicated our original concept that facility design should offer unique solutions to individual problems. It is difficult to generalize about what will and what will not work in a particular setting. But, in general, careful consideration and good planning are excellent investments in the future success of a design for a new ICU or a facility renovation. PMID- 6851388 TI - Neonatal intensive care unit. Basic equipment needs for neonatal monitoring. PMID- 6851389 TI - Use of computers in the newborn intensive care unit. PMID- 6851390 TI - Intracranial monitoring. Its role and application in neonatal intensive care. PMID- 6851391 TI - Electronic monitoring of the fetus. PMID- 6851392 TI - Ultrasound uses in obstetrics. AB - Diagnostic ultrasound, particularly real-time, has significantly altered the management protocols for many obstetric problems. Often a clinical situation arises quickly where essential diagnostic information is needed as soon as possible in order to make a rational management decision. Thus, the need for a real-time ultrasound unit has become essential for the perinatal unit. With current rapid technical advancement, one should carefully determine the essential and desired elements of the apparatus and shop around. When planning a perinatal unit, planners should consider the layout of a diagnostic suite, a place for ultrasound scanning, and aminiocentesis procedures and consider both a free standing and fixed ultrasound units. PMID- 6851393 TI - Planning a perinatal center. From vision to reality. PMID- 6851394 TI - The typical perinatal center. An overview of perinatal health services in the United States. PMID- 6851396 TI - The nurseries at Medical Center Hospital in San Antonio. A means to a new beginning. PMID- 6851395 TI - Labor-delivery-recovery room. Planning the delivery suite for current need. PMID- 6851398 TI - The perinatal unit at the University of Illinois Hospital at Chicago. PMID- 6851397 TI - Planning and design of the obstetrics unit at Medical Center Hospital in San Antonio. PMID- 6851399 TI - Principles of building a perinatal center. PMID- 6851400 TI - The Phoenix Perinatal Center. PMID- 6851401 TI - New drug development during and after a period of regulatory change: clinical research activity of major United States pharmaceutical firms, 1958 to 1979. AB - The 1962 drug amendments fundamentally changed the way in which U.S. pharmaceutical firms could test new drugs in man and receive New Drug Application (NDA) approval. Although it is well known that the amendments and associated events caused a profound decline in the annual number of new drugs receiving NDA approval, the amendments' effects on clinical research into new chemical entities (NCEs) have not been investigated because data were unavailable. To study this we requested drug development information dating back to 1958 from most major United States-owned pharmaceutical firms and obtained complete responses from nine. The results showed that the introduction rate of NCEs into human testing dropped sharply in the early 1960s and declined substantially thereafter. The number of NCEs entering human testing fell from a mean of 89 a year in 1958-1962, to 35 a year in 1963-1972 (a reduction of 61%), and to 17 a year in the last 5 years of the survey, 1975-1979--an overall reduction of 81%. The number of NDA approvals received by these firms fell sharply by 49% in the early 1960s and more slowly for 10 years thereafter, from the mid-1960s to the mid-1970s. In the case of self originated NCEs, the size of this later fall was 71%. Causes of these changes in NCE flow include the amendments and the events that prompted them; changes in scientific philosophy, standards, and state of the art; and economic factors. PMID- 6851402 TI - Hemodynamics and leg muscle metabolism at rest and during exercise in young healthy men after prenalterol. AB - In eight young healthy men the effects of short-term treatment with prenalterol, a new beta-adrenergic agonist, on peripheral hemodynamics and leg muscle metabolism were studied at rest and during exercise at a moderate and a heavy workload. At rest prenalterol treatment significantly increased pulmonary oxygen uptake, heart rate, rate pressure product, and leg blood flow and decreased leg arteriovenous oxygen content difference. During exercise fewer hemodynamic effects of prenalterol were observed. At the moderate workload there was a slight increase in heart rate, but at the heavy workload heart rate fell. Prenalterol raised the arterial concentrations of free fatty acids and glycerol at rest by 70% and 40%, but during exercise these alterations were not present. The plasma levels of epinephrine and dopamine in subjects at rest decreased significantly during influence of prenalterol, but these differences were also abolished during exercise. The leg exchange of metabolites and the concentrations of endogenous muscle metabolites were not influenced by prenalterol, although the lactate concentrations in muscle tended to be lower at rest and during exercise. The results at rest demonstrate that prenalterol in this situation acts predominantly as a stimulator of beta 1-adrenoceptors. During heavy exercise, however, when the endogenous sympathetic tone is high, the beta-stimulating effects are no longer overt and instead reduced heart rate indicates a blocking effect on beta adrenoceptors. The hemodynamic and metabolic results are concordant with the hypothesis that prenalterol acts as a partial beta-receptor agonist. PMID- 6851403 TI - Blood pressure and plasma norepinephrine concentrations after endogenous norepinephrine release by tyramine. AB - To determine whether small changes in sympathetic activity would cause detectable changes in plasma norepinephrine (NE) levels, and whether the effects of endogenously released and exogenous NE differ, we injected tyramine infusions and l-norepinephrine (l-NE), into six healthy subjects, and the changes in blood pressure (BP) and plasma NE were related. The mean increase in systolic BP was approximately 17 mm Hg with both infusions; diastolic BP increased with l-NE but did not rise significantly with tyramine. Heart rate fell more with l-NE than with tyramine infusions. The maximum increase in plasma NE levels was more than 500% during l-NE infusions but less than 200% with tyramine. There was no correlation between plasma NE and absolute levels of systolic BP when individual data were plotted for tyramine infusions, whereas mean group changes in systolic BP correlated strongly with mean group plasma NE, both during tyramine and l-NE infusions. The slope of the relationship was much steeper for tyramine than for l NE. We conclude that the use of plasma NE to measure small differences in sympathetic activity among individuals is limited by interindividual variability, whereas changes in sympathetic activity within groups are more likely to be detected. PMID- 6851404 TI - Digitoxin kinetics and renal excretion in children. AB - Digitoxin kinetics were investigated in 11 children, three girls and eight boys, with a mean age of 7.1 yr (5.9 to 9.2). Five children received digitoxin, 17.5 to 20 micrograms/kg IV, and six other children received 20 micrograms/kg as an oral solution. Digitoxin was given as a single dose 24 to 48 hr after cardiac surgery, and patients were monitored in an intensive care unit for 24 hr. Serum and urine digitoxin concentrations were determined by radioimmunoassay. Children had larger apparent volumes of distribution (1 l/kg) than adults (0.57 l/kg). Mean serum elimination t 1/2 was 6.4 days in children (3 to 11.2) and 8.2 days in adults (5.9 to 11.3). Total body clearance was much greater in children (0.085 ml X min 1 X kg-1) than in adults (0.036 ml X min-1 X kg-1). This was because of an increase in metabolic clearance, although there was no difference in renal clearance in children and adults. Absolute oral bioavailability, measured by comparing serum AUCs after intravenous and oral doses, was complete. Peak serum concentrations of 23 to 50 ng/ml developed 90 to 120 min after the oral dose. A single digitalization dose of 20 micrograms/kg was well tolerated and did not induce arrhythmias. PMID- 6851406 TI - Mianserin kinetics in depressed patients. AB - We studied mianserin kinetics after a single (60 mg) dose in eight inpatients suffering from depression. There was a considerable interpatient variability in plasma levels. Mean peak plasma levels (+/- SEM) were 114 +/- 26 ng/ml and were reached between 1 and 3 hr. The decline of mianserin levels in plasma was biphasic. The mean elimination t 1/2 was 21.6 +/- 3.1 hr and ranged from 10.7 to 40.8 hr. The estimated first-pass loss ranged from 26% to 48% (mean, 37%) and was lower than that reported for tertiary amine tricyclic antidepressants. The mean apparent volume of distribution (15.7 +/- 2.2 l/kg; 9.7 to 28.8 l/kg) was in the range of that for imipramine but somewhat lower than for maprotiline. Apparent total body clearance ranged from 0.33 to 0.81 l/hr/kg (mean +/- SEM, 0.52 +/- 0.05 l/hr/kg) and was of the order of that after maprotiline. Our results indicate that mianserin kinetics are in most respects similar to those of tertiary amine tricyclic antidepressants (e.g., imipramine) and the tetracyclic maprotiline. PMID- 6851405 TI - Isosorbide dinitrate kinetics and dynamics after intravenous, sublingual, and percutaneous dosing in angina. AB - Isosorbide dinitrate (ISDN) kinetics and dynamics were examined after various routes of administration for angina. Given intravenously, ISDN kinetics were apparently linear over the range of infusion rate (0.083 and 0.133 mg/min) and duration (15 min and 1 and 2 hr) studied. Mean +/- SD systemic clearance of ISDN was 3.4 +/- 1.4 l/min and volume of distribution (VdSS or Vdarea) about 100 l. These data are consistent with the presence of extensive extrahepatic metabolism. In six patients, sublingual ISDN (5 mg) was also given and mean bioavailability of 59% (19% to 93%) for this route was determined. For this group, sublingual absorption of intact ISDN was incomplete and variable. The presence of a longer disappearance t 1/2 after sublingual dosing suggested that the input process may be rate limiting. After percutaneous application of a topical formulation (100 mg over an area of 400 cm2), steady-state plasma concentrations at about 7 ng/ml were maintained from 6 to 24 hr. The bioavailability of the topical application was estimated at 30%. At the doses given, intravenous ISDN had no apparent effect on heart rate but induced significant reduction in standing systolic blood pressure. The effect vs the ISDN concentration profile was described by a hysteresis loop, indicating that changes in blood pressure response lag behind changes in plasma ISDN concentration. After intravenous dosing, peak plasma ISDN concentration and peak effect (maximum change in standing systolic blood pressure). At the doses used, both sublingual and percutaneous ISDN induced less distinct circulatory changes than the intravenous infusion. PMID- 6851407 TI - Tricyclic antidepressants and supine, standing, and exercise plasma norepinephrine levels. AB - Fourteen depressed patients were treated for 1 to 8 wk (4.1 +/- 0.6, mean +/- SEM) with imipramine, doxepin, or amitriptyline to study the effects of tricyclic antidepressants (TCAs) on sympathetic nervous system (SNS) function. Eight had chronic but medically stable cardiac disease and six were medically healthy. Supine plasma norepinephrine (NE) and epinephrine (EPI) levels, mean arterial blood pressure (MAP), and heart rate were measured at rest, after standing, and during graded, supine maximal bicycle exercise. Eight nondepressed patients with cardiac disease were studied without drug intervention as controls. There were no baseline differences in any of these measures among the medically healthy depressed subjects, the depressed cardiac patients, and the eight nondepressed patients matched for cardiac disease. After TCAs, NE was increased by 51 +/- 6% of basal values and heart rate rose, but EPI and MAP were unchanged. The supine to 10-min standing increment in NE increased from 309 +/- 51 pg/ml at baseline to 406 +/- 55 pg/ml during TCA treatment. These findings are compatible with an increase in SNS outflow after TCAs. PMID- 6851408 TI - Caffeine metabolism and coffee-attributed sleep disturbances. AB - In six healthy subjects with a history of caffeine-induced wakefulness caffeine kinetics were compared to with those in six subjects not affected by caffeine. The data indicated that the former have a longer plasma t 1/2 (mean 7.4 and 4.2 hr) and slower plasma clearance (mean 1.2 and 1.7 ml . min-1 . kg-1) of caffeine. Plasma caffeine concentration at midnight, 8 hr after afternoon coffee, is higher in those with caffeine-attributed insomnia. Those reporting "coffee wakefulness" also tend to drink less coffee. We conclude that the rate of caffeine metabolism is a determinant of individual variation in the effect of drinking coffee on sleep. PMID- 6851410 TI - Gallamine disposition in open-heart surgery involving cardiopulmonary bypass. AB - Kinetics of gallamine, a neuromuscular blocker, were investigated in 22 adult patients undergoing surgery involving cardiopulmonary bypass (CPB). Approximately 60 min before CPB, 11 patients received 480 mg gallamine IV; the other 11 patients received an initial dose of 240 mg IV, followed by another 240 mg through the pump priming fluid at the start of CPB. In 14 of our patients, the time course of gallamine concentrations in the plasma before, during, and after CPB was similar to that in normal surgical patients, indicating little or no effect of cardiac disease or CPB. In the remaining patients, perturbations were not observed before CPB, but with its onset there were varying changes, typically, rises in gallamine concentration ranging from an alteration during the period of CPB only or during the elimination phase, to an alteration at all times after starting CPB. Although the mechanism for this rise in gallamine plasma concentrations during and after CPB is not known, computer simulations suggest that it is due to a contraction in blood volume or decreased tissue perfusion during the period of extracorporeal circulation. Gallamine disposition differed only moderately in our patients from that in control patients. Therefore, from a kinetic viewpoint, provided that renal function is not impaired, gallamine is not contraindicated in CPB surgery. PMID- 6851411 TI - Effects of cigarette smoking and oral nicotine on hand tremor. AB - The effect of nicotine on hand tremor was assessed by measuring the current induced in a coil by a magnet attached to the finger. Experiment 1 assessed the amplitude of tremor induced by smoking two cigarettes in a group of 33 subjects drawn from two age groups. Smoking increased tremor significantly. Age, sex, and anxiety levels had no effect. Experiment 2 assessed the effect of smoking on tremor frequency. Analog recordings of tremor in 10 subjects were processed to yield the total power in 20 1-Hz bands from 1 to 20 Hz. The log amplitude showed a strong linear relationship to the log frequency, but this relationship was not affected by smoking. Smoking also had no effect on peak frequency in the frequency spectrum. Experiment 3 confirmed that the effects of smoking on tremor were attributable to nicotine. Twelve subjects were tested before and after smoking a cigarette and before and after chewing gum containing 4 mg nicotine. The two conditions induced comparable increases in tremor. A 2-mg nicotine preparation tested in eight subjects had no effect on tremor. Tremor may be a useful index of the central activity of nicotine and may help illuminate its mechanism of action. PMID- 6851409 TI - Placental transfer and maternal midazolam kinetics. AB - Midazolam was given in a single 15-mg oral dose as a sedative the evening before elective cesarean section. Twelve hours later, levels of this new benzodiazepine were measureable in the fetomaternal entity in only one of 13 cases. After 15 mg midazolam orally or 0.05 mg/kg midazolam intramuscularly 15 to 60 min before elective cesarean section, there was evident transfer of drug into the placenta, but transfer took place more slowly than with diazepam. On the basis of kinetics derived from maternal serum concentrations after oral, intramuscular, or intravenous dosing, midazolam appears to have a rapid onset and short duration of action, which was also evident from subjective assessments by the patients. There was wide interindividual variation in the gastrointestinal absorption of midazolam in full-term pregnant women. Clinically, midazolam nevertheless seemed to be very useful for nocturnal sedation before elective cesarean section; it ensures a mean duration of sleep of about 6 hr and there are virtually no detectable levels of drug in the fetomaternal entity the next morning. PMID- 6851412 TI - Cigarette smoking and subjective response in alcoholics: effects of pentobarbital. AB - The effects of oral pentobarbital on cigarette smoking and subjective response were determined in five adult men with histories of alcoholism and cigarette smoking habits. Subjects resided in a residential research unit for the 6-wk study and were individually tested 5 days a wk in rooms that were equipped for automatic monitoring of cigarette-smoking behavior. Each subject was tested with placebo, one dose level of ethanol (either 89 or 134 gm absolute ethanol), and each of three pentobarbital doses (200 to 900 mg), in at least four randomized block sequences. Ethanol induced increases in puffs and other smoking measures in all subjects. Pentobarbital increased smoking in two subjects, whereas it did not induce change or suppress smoking in the other subjects. Both pentobarbital and ethanol increased scores on scales of the Addiction Research Center Inventory and other self-report measures. The results indicate that the effects of pentobarbital on smoking differ from those of ethanol, and that the effects of both drugs on smoking may depend on previous experience of the subject in the use of those drugs. PMID- 6851413 TI - Diflunisal disposition and hypouricemic response in osteoarthritis. AB - The disposition of diflunisal was studied at daily doses of 250, 500, 750, 1000 mg/day in 24 male patients (mean age 65 yr and mean creatinine clearance 72 ml/min). Each dose was given for 14 days and diflunisal apparent oral clearance and serum urate was measured on the last day of each dosing regimen. There was a dose-dependent decrease in mean diflunisal apparent oral clearance with dose from 628 ml/hr at 250 mg/day to 426 ml/hr at 1000 mg/day, with most of the decrease occurring at the lower doses and becoming less pronounced at doses of 750 and 1000 mg/day. There was a strong positive correlation between diflunisal apparent oral clearance and creatinine clearance. Diflunisal induced a hypouricemic effect at all doses, but the responses at doses of 750 and 1000 mg/day did not differ. PMID- 6851414 TI - Effect of probenecid on dyphylline elimination. AB - Dyphylline is a methylxanthine bronchodilator with such a short a biologic t 1/2 that development of practical dosing regimens has been difficult. Because its rapid renal elimination suggests active secretion, the effect of 1 gm probenecid on single-dose elimination kinetics of dyphylline was determined. Twelve subjects (six male, six female) participated in a crossover design. Subjects were their own controls and received dyphylline, 20 mg/kg orally, alone and after probenecid. The dyphylline t 1/2 increased from 2.57 +/- 0.45 to 4.88 +/- 1.2 hr, whereas the elimination rate constant decreased from 0.276 +/- 0.056 to 0.150 +/- 0.037 hr-1 after probenecid. There was no significant change in the dyphylline apparent volume of distribution. Dyphylline total body clearance fell from 173 +/ 20 to 95 +/- 12 ml/kg . hr. The combined use of these drugs may lead to a practical dyphylline dosage schedule in aminophylline-hypersensitive patients or those incapacitated by theophylline gastrointestinal side effects. PMID- 6851415 TI - Treatment of noninsulin-dependent diabetes mellitus with enzyme inducers. AB - Although treated adequately with antidiabetic drugs, diet, exercise, and education, patients with noninsulin-dependent diabetes mellitus (NIDDM) may develop resistance to treatment. In NIDDM hepatic microsomal enzyme activity is reduced and since postreceptional glucose metabolism is influenced by these enzymes, we treated the subjects with enzyme-inducing drugs. These inducers (phenobarbital and medroxyprogesterone acetate) when added as adjuvant therapy to sulfonyl urea regimen, reduced blood glucose and plasma insulin, and increased microsomal enzyme activity (as indicated by increased antipyrine metabolism). A trial with placebo did not alter serum glucose levels. Body weight fell and serum aminotransferase levels were normalized. These changes were reflected by reduction of liver fat content (determined by light microscopy), by increased surface density of smooth endoplasmic reticulum, and by repairation of the plasma cell membrane of hepatocytes, as seen in electron micrographs. Activation of postreceptional events in hepatocytes may thus be a new approach in the treatment of therapy-resistant type II diabetes. PMID- 6851416 TI - Some aspects of the arterial response to venous occlusion in man. AB - 1. Plethysmographic blood flow records made after venous occlusion of the forearm showed a biphasic response which was first vasodilator and then vasoconstrictor. 2. The myogenic nature of the vascoconstrictor phase was confirmed in eight subjects after total autonomic blockade with atropine, propranolol, phentolamine and guanethidine. 3. Forearm venous blood demonstrated a rise in hydrogen ion concentration and a fall in oxygen tension during venous occlusion, which may contribute to the vasodilatation phase. PMID- 6851417 TI - Effects of haemorrhage in rats lacking vasopressin (Brattleboro strain): influence of naloxone. AB - 1. The effects of naloxone on blood pressure recovery after either rapid arterial haemorrhage or prolonged venous haemorrhage were studied in rats lacking vasopressin (Brattleboro strain) and in control (Long Evans) rats. 2. To produce similar reductions in blood pressure, less blood had to be taken from the Brattleboro rats than from the Long Evans rats. 3. After rapid arterial haemorrhage in the absence of naloxone, blood pressure recovery was slower in Brattleboro rats than in Long Evans rats. Naloxone did not affect the response to rapid arterial haemorrhage in Long Evans rats, but improved blood pressure recovery in Brattleboro rats; despite this improvement, the Brattleboro rats remained hypotensive at a time when the Long Evans rats were normotensive. These findings suggest that both the absence of vasopressin and a depressor action of beta-endorphins may contribute to the poor ability of Brattleboro rats to cope with rapid haemorrhage. 4. After prolonged venous haemorrhage in the absence of naloxone, there was no difference between the recovery of blood pressure in Brattleboro rats and Long Evans rats. Naloxone improved blood pressure recovery to a similar extent in both strains of rat. These findings suggest that the absence of vasopressin does not impair blood pressure recovery after prolonged haemorrhage. PMID- 6851419 TI - Depressive effect of coughing on spinal monosynaptic reflexes in conscious man. AB - 1. The relationship between coughing and spinal monosynaptic reflexes (SMR) in extensors and flexors was investigated in eight healthy subjects by using the Hoffmann technique. Coughing exerted major depression (81% in extensor and 83% in flexor SMR). This depressant effect began simultaneously with the first cough and lasted through the coughing phase. Complete recovery to initial values occurred an average of 40 s thereafter. 2. In comparison, mental tasks induced only a slight decrease in SMR amplitude. In contrast, the Mueller and Valsalva manoeuvres induced facilitation. 3. During coughing, large variations in extensor amplitudes were observed that were coupled with the ventilatory cycle. Slight facilitation was observed during inspiration, but expiration induced pronounced depression, occurring 0.20 s after the beginning of the expiratory period. Experiments performed during baseline breathing failed to show any change throughout inspiratory or expiratory phases. 4. Chemical stimulation of irritant receptors (inhalation of citric acid) produced no specific modification of extensor responses compared with the effect of placebo inhalation (distilled water). 5. These data suggest that coughing exerts a major depressant effect on motor activity via a loop that possibly includes cardiopulmonary receptors and inhibitory supraspinal descending pathways. PMID- 6851418 TI - Effect of atrial extract on renal function in the rat. AB - 1. The effects of myocardial extracts on renal function were studied in the rat. Infusion of rat atrial extract but not of ventricular extract resulted in a significant natriuresis in both pentobarbitone anaesthetized and unanaesthetized rats that were either deprived of food and water (for 18 h before the experiment) or were expanded with isotonic sodium chloride solution (1.5% body weight/h) during the experiment. 2. The increase in sodium excretion was three to four times greater in both groups of volume-expanded rats than in the two groups of food- and water-deprived rats. 3. Glomerular filtration rate and renal blood flow were not affected by atrial extract, indicating that the atrial natriuretic factor (ANF) directly inhibited sodium reabsorption at the tubular level. 4. Distal tubular blockade with a combination of frusemide and amiloride was employed to differentiate between proximal and distal tubular sites of action of ANF. Infusion of atrial extract into saline-expanded, distally blocked rats resulted in a transient increase in both the glomerular filtration rate and sodium excretion; fractional sodium excretion was unaffected by atrial extract in these experiments. 5. We conclude that (a) the renal response to ANF is not affected by pentobarbitone anaesthesia, (b) the renal response to ANF is dependent on the state of the extracellular fluid volume of the animal and (c) that ANF inhibits sodium reabsorption in the distal nephron. PMID- 6851420 TI - Sex-steroid enzymes, aromatase and 5 alpha-reductase in the pancreas: a comparison of normal adult, foetal and malignant tissue. AB - 1. Following the finding of high levels of oestrogen receptor proteins in pancreatic carcinoma tissue, two enzymes involved in sex-steroid biosynthetic pathways, aromatase and 5 alpha-reductase, have been measured. 2. Activities of aromatase, which converts testosterone into oestradiol, comparable with those found in pre-menopausal uterus (P less than 0.5) were found in all seven samples of pancreatic carcinoma tissue, and in a pooled sample of foetal pancreas. Measurable but significantly lower activities (P less than 0.001) of aromatase were found in seven specimens of normal pancreas. 3. 5 alpha-Reductase activity, which converts testosterone into the more potent androgen 5 alpha dihydrotestosterone, was found in malignant pancreatic tissue at approximately half the level found in prostatic tissue (P less than 0.01) and at almost twice the levels found in either normal adult or pooled foetal pancreatic tissue (P less than 0.01). 4. These findings suggest that sex steroids are involved in foetal and adult pancreatic physiology. 5. Since these enzyme pathways are present in pancreatic carcinoma at greater levels than those in normal adult pancreas, it is possible that agents known to interfere with steroid metabolism could be of value in the treatment of this tumour. PMID- 6851422 TI - Effects of acute blood volume expansion on vascular resistance and reactivity in anaesthetized dogs. PMID- 6851421 TI - Changes in the binding of radioactive conjugated bile salts to serum proteins in cholestatic jaundice. AB - 1. A micro-partition centrifugal ultrafiltration technique has been used to monitor the percentage of [14C]glycocholate, [3H]glycochenodeoxycholate and [3H]glycochenodeoxycholate-3-sulphate bound to serum proteins of patients with cholestatic liver disease. 2. In comparison with normal individuals the percentage of binding of [14C]glycocholate and, to a lesser extent, of [3H]glycochenodeoxycholate and [3H]glycochenodeoxycholate-3-sulphate was reduced. 3. The binding of [14C]glycocholate was inversely related to the serum bile salt and bilirubin concentrations. In contrast, the binding of [3H]glycochenodeoxycholate and [3H]glycochenodeoxycholate-3-sulphate were not altered by the severity of the cholestasis. 4. Studies in vitro indicated that the reduction in the binding of [14C]glycocholate in cholestatic liver disease was not due to high concentrations of bile salts, unconjugated bilirubin or fatty acids. PMID- 6851423 TI - Effects of hydralazine versus propranolol on blood velocity patterns in patients with carotid stenosis. AB - 1. Since endothelial damage due to flow disturbances is of postulated significance in the pathogenesis of atherosclerosis, this study examined the effects of antihypertensive drugs on carotid flow patterns in patients with known carotid stenosis. A Doppler Echoflow unit was used to display arterial velocities in red (normal range), yellow (increased velocity) and blue (abnormally increased velocity thought to represent turbulence and other departures from laminar flow). 2. Twenty patients were studied before drug, then during intravenous administration of hydralazine, 6-12 mg, and propranolol, 2-5 mg, over 10-15 min each, with return to baseline between drugs. 3. After hydralazine, the occurrence of abnormal high velocity flow patterns increased in 17 of 20 patients; there was no change in three patients. Propranolol reduced the occurrence of abnormal high velocity flow patterns in 19 of 20 patients (P less than 0.00001; chi-square). 4. These effects of antihypertensive drugs on arterial velocity patterns may be important in the selection of antihypertensive drugs to prevent or minimize the progression of atherosclerosis. PMID- 6851424 TI - The electrophoretic mobilities of minerals determined by laser Doppler velocimetry and their relationship with the biological effects of dusts towards macrophages. AB - The role of surface charge in the pathogenicity of mineral dusts has been little studied, partly due to the time consuming nature of such determinations using conventional microelectrophoresis apparatus. In this work the use of laser Doppler velocimetry proved to be a rapid method of determining the electrophoretic mobility of mineral dusts. Ceramic ball milling of fibrous minerals, whilst dramatically reducing the cytotoxicity of the dusts towards macrophages, had only a small effect on electrophoretic mobility. It is concluded that some other factor, possibly fibre morphology, is important for observed biological effects. The coating of quartz and kaolinite with poly-2-vinyl pyridine-N-oxide dramatically lowered their cytotoxicity towards macrophages. The dusts' electrophoretic mobilities were also lowered. The significance of these findings is discussed. PMID- 6851425 TI - The measurement accuracy required for acceptable estimation of steady and non steady rates of appearance and disappearance from the inaccessible compartment of an open, two-compartment system. AB - A two-compartment system for measuring non-steady state turnover rates was examined by computer simulation. Tracee appears de novo in a compartment to which the experimenter has no access, and from which material is irreversibly lost. In the steady state, Monte Carlo analysis showed that the compartment sizes and fluxes could be determined by tracer experiments with reasonable accuracy. In contrast, under non-steady state conditions, the results proved extremely sensitive to observational uncertainties. Given perfectly accurate input data, simulation showed that the calculated turnover rates agreed closely with the true answer, although not perfectly because of the necessity for interpolation. Contaminating the input data with a single erroneous observation of either tracee or tracer concentration produced large, spurious oscillations in the calculated turnover rates, the duration of which was inversely proportional to the frequency with which the infused compartment was sampled. Contaminating the input data with observational noise of a magnitude likely in practice so degraded the results that they became almost unusable. It is concluded that non-steady state measurements are feasible using this model, but that rapid sampling and random uncertainties smaller than 1% (coefficient of variation) are desirable in the measurement of tracer and tracee concentration. PMID- 6851426 TI - The physics of arteriole blood flow. I. General theory. AB - A continuum physics theory of arteriole blood flow is presented based on the observed behaviour of blood using high-speed photography. The theory highlights the importance of time scales as well as length scales in constructing a physical theory of blood flow. Arteriole flow viewed at 8000 frames s-1 reveals a highly complicated cellular motion; however the same flow viewed at the same spatial magnification by the human sensor, the eye, reveals only a pinkish column of fluid. The eye 'smoothes out' the microscopic cellular behaviour. This principle is used in the continuum theory, where averages are taken over space and time, to explain how the observed collisions of the erythrocytes with themselves, plasma molecules and the arteriole wall determine blood, mass-averaged velocity profiles and mass flow rates. A new dimensionless similarity parameter arises from the continuum mixture. Its magnitude provides a measure of the relative importance of the viscous drag of a constituent and the frictional force experienced by one constituent due to the presence of another constituent in the mixture during arteriole blood flow. (The second paper in a series.) PMID- 6851428 TI - An accurate method of measuring medical humidifier output. AB - A low-cost capacitance hygrometer capable of measuring steady-state and some transient changes in the output of medical humidifiers is introduced and evaluated. The method of operation is presented in detail, as is a comparison with the widely used gravimetric standard. The hygrometer produces results within 7% of those given by the gravimetric method when using units of percentage relative humidity (which give the widest discrepancies). This is shown to be an acceptable figure for the proposed application. Problems encountered when converting units of humidity are discussed in detail and methods of conversion explained. PMID- 6851429 TI - Estimation of mean transit times from semiquantitative indices derived from standard renograms. PMID- 6851427 TI - The physics of arteriole blood flow II. Comparison with experiment. AB - The results of paper I, General theory, are used to explain, using a continuum physics approximation, some of the experimentally observed phenomena which appear in the literature. The magnitude of the new dimensionless similarity parameter which arises from the mixture theory indicates that the internal frictional force acting on the plasma due to the presence of the erythrocytes (with an equal and opposite force acting on the erythrocytes due to the plasma) dominates the internal plasma viscous force. It is this feature that produces the observed slower flow rate of blood compared with water for a given pressure gradient. Quantitative predictions, which agree with experiment, of the cell-free layer, feed, dynamic and discharge haematocrits for cylindrical pipe flow are obtained. The observed decrease in apparent blood viscosity with decrease in cylinder diameter is also predicted. Finally an explanation is presented for the experimental observation of an off-centre peak in the tube radial viscosity profile. PMID- 6851431 TI - Effect of EMG onset variation on average motor potentials. PMID- 6851430 TI - In vivo nitrogen analysis using 241Am-Be neutrons--a feasibility study for a mobile facility. PMID- 6851432 TI - A critique of the breath-by-breath radioabsorptiometric assay of stable xenon in expired air. PMID- 6851434 TI - Positive direct antiglobulin test in normal individuals. II. AB - Investigations into the IgG sub-types and number of molecules of IgG present on the red cells of 22 apparently normal healthy blood donors with positive direct antiglobulin tests are described. In all cases, the sub-type was IgG1 or IgG4, and none had more than 1000 mol of IgG per red cell. It is suggested that sequestration of IgG-coated cells only occurs when the number of IgG1 mol per cell reaches a certain level. PMID- 6851433 TI - Haemolytic-uraemic syndrome and T-activation of red blood cells. PMID- 6851435 TI - Plasma and erythrocyte lipids in sickle cell anaemia. AB - The content and composition of plasma and erythrocyte lipids from individuals having sickle cell anaemia has been determined. The plasma contains a significantly reduced content of both cholesterol and phospholipid while the ratio of cholesteryl ester to total cholesterol, the distribution of phospholipid classes, triglyceride concentration and the fatty acid content were similar to normal values. However, the free glycerol content of the plasma was eight-fold higher than normal. Erythrocyte lipids contain an elevated level of cholesterol and control levels of phospholipid content, phospholipid distribution and fatty acid content. The plasma was separated by ultracentrifugation into VLDL (density less than 1.006), LDL (1.006 less than d less than 1.063) and HDL (1.063 less than d less than 1.21). Significant decreases in cholesterol and phospholipid were observed in LDL and HDL. PMID- 6851436 TI - Some influences on the ESR and the fibrinogen level in healthy subjects. AB - In healthy subjects the ESR is higher in women than in men, and in both sexes a rise with age occurs. It is well established that pathological elevation of the ESR may be due to elevation of the fibrinogen level. The present study has shown that in normal subjects the ESR correlates not only inversely with the haemoglobin level but also directly with the fibrinogen level. These two factors together explain the difference in ESR between men and women, and the major part of the age-related increase in the ESR. Fibrinogen levels were found to be significantly higher in male smokers than male non-smokers, and in women were inversely correlated with alcohol consumption; despite this the ESR did not differ in smokers and non-smokers, nor was it related to alcohol intake. Oral contraceptive intake influenced neither the fibrinogen level nor the ESR. The correlation of ESR and fibrinogen concentration in healthy subjects suggests that physiological variation in the ESR is determined by the fibrinogen concentration as well as the haemoglobin level. PMID- 6851438 TI - Lymphopenia in histiocytic medullary reticulosis. AB - A survey of the Western literature of histiocytic medullary reticulosis (malignant histiocytosis) provided 104 case reports with sufficient data from which the presence or absence of an absolute lymphopenia could be ascertained. Of these, 46 (44%) were lymphopenic at presentation or within the subsequent 10 days. A survey of a series of publications containing detailed peripheral leucocyte counts recorded in patients with diseases that, like HMR, may present with, or develop, pancytopenia showed that the incidence of lymphopenia ranged from 14% (Hodgkin's: stages I & II) to 46% (acute myelofibrosis; systemic lupus erythematosus; angio-immunoblastic lymphadenopathy). It was concluded a that HMR should be added to the list of accepted causes of lymphopenia, b that lymphopenia, as an aid to the diagnosis of HMR, will be of limited value, c that when the peripheral leucocyte count of a patient is recorded in a case report, it should be accompanied by a full differential count. PMID- 6851437 TI - Monitoring heparin therapy--a role for the chromogenic assay. AB - Heparin therapy was evaluated by simultaneous determinations of the activated partial thromboplastin time (APTT), and plasma heparin levels by chromogenic assay. These tests showed good correlation (r = 0.73) in patients on heparin alone. However, in the presence of concurrent warfarin administration, r fell to 0.37, reflecting an additional warfarin effect upon the APTT. Furthermore, the studies confirmed the increased heparin requirement in patients with pulmonary embolization. PMID- 6851439 TI - Five-day storage of platelet concentrates. I. In-vitro studies. AB - Platelet concentrates have been prepared in standard PVC (PL-146) packs and polyolefin (PL-732) packs. Comparison of pH and hypotonic stress of the platelet concentrates has shown that significantly improved values are obtained after storage of the concentrates at 22 C in PL-732 packs for 5 days than after storage for 3 days in PL-146 packs. There was no significant difference under conditions of the test between vertical and horizontal agitation of the concentrates. Since both pH and hypotonic stress recovery have shown a relationship to post transfusion recovery and viability, evidence is presented to support the 5-day storage period of concentrates prepared and stored in PL-732 packs. PMID- 6851440 TI - Testing of calibration and quality control material used with automatic blood counting apparatus: application of the protocol devised by the British Committee for Standardization in Haematology. PMID- 6851442 TI - Three-year evaluation of a commercial quality control reagent for cell counting and sizing. PMID- 6851441 TI - Platelet associated IgG and immune thrombocytopenia in lymphoproliferative and autoimmune disorders. AB - Thrombocytopenia is frequently encountered in patients with lymphoproliferative disorders (LPD) and systemic erythromatosus (SLE) and to a lesser extent in association with other diseases such as rheumatoid arthritis (RA), pernicious anaemia (PA) and autoimmune haemolytic anaemia (AIHA). This report attempts to document the incidence of thrombocytopenia in these disorders, other than that overtly due to malignant infiltration or marrow suppression by drugs and to demonstrate, that in a significant proportion antibody mediated immune destruction of platelets can be confirmed by positive platelet antibody tests. Platelet associated IgG (PAIgG) was measured in all patients by a quantitative enzyme linked assay. Platelet antibodies were found in 11 of 24 (46%) thrombocytopenic patients with LPD, 10 of 16 (62%) patients with SLE and thrombocytopenia, and in all patients with RA and PA who had low platelet counts at the time of study. In addition, elevated PAIgG levels were found in the following non-thrombocytopenic patients: 9 of 43 (21%) patients with LPD, 2 of 12 (17%) with SLE, 2 of 12 (17%) with AIHA, 2 of 39 (5%) with PA and 5 of 61 (8%) patients with RA. The nature and the role of raised PAIgG levels in diseases other than autoimmune thrombocytopenia is controversial. Our reasons for interpreting these as true platelet autoantibodies in this selected group of disorders and the clinical implications of our results are discussed. PMID- 6851443 TI - [Multifactor treatment of depression]. PMID- 6851444 TI - [Effect of antibiotics on blood culture and serodiagnosis in typhoid fever]. PMID- 6851445 TI - [Efficacy of atenolol in moderate-to-mild essential hypertension and in ischemic cardiopathy. Evaluation with the bicycle ergometer]. PMID- 6851446 TI - [Therapy of adrenal cortex insufficiency]. PMID- 6851447 TI - [Effect of lisuride in the "on-off" phenomena due to L-dopa]. PMID- 6851449 TI - [Blood concentrations of morphine after peridural administration]. PMID- 6851448 TI - [Serum digoxin levels and echocardiographic indices of myocardial contractility in acute ischemic heart disease]. PMID- 6851451 TI - [Personal experience with kanendomycin in the treatment of various infectious bronchopulmonary diseases]. PMID- 6851450 TI - [Viral hepatitis B vaccine]. PMID- 6851454 TI - [Clinical evaluation of the effectiveness of a sulfoglycopeptide (sulglicotide) in the therapy of non-ulcerous inflammatory gastroduodenal pathology]. PMID- 6851453 TI - [Evaluation of the effects of tiapride in therapy of heroin withdrawal crises]. PMID- 6851452 TI - [Drug therapy combined with intensive pressotherapy in the treatment of lymphedema of the limbs]. PMID- 6851455 TI - [Recurrent nodal tachycardia secondary to slow ventricular tachycardia caused by a parasystolic focus localized in an anomalous pathway: description of a case]. PMID- 6851457 TI - Resistance of the pulmonary circulation. PMID- 6851456 TI - [Nutritional, behavioral and endocrine-metabolic evaluation in obesity. Suggested clinical chart]. PMID- 6851458 TI - Peripheral oxygen uptake and delivery in health and disease. AB - Peripheral O2 uptake is mandated to subserve the energy requirements of tissue and organ systems in an obligatory aerobe such as the human. In addition to this basic need, local O2 demand may also be increased by more general bodily conditions such as fever, increased catecholamine levels, or alkalosis. Blood flow, which brings O2 to the periphery, is closely regulated at the local level to meet O2 demand except where other functional requirements, such as filtering by the kidney, may intervene. In addition to regulation of total flow at the tissue level, the distribution of flow at the microcirculatory level is another important regulatory feature because it determines the capillary surface area available to extract O2. Dominant vasoconstrictor tone is modulated at the local level by a metabolically linked substance such as adenosine or possibly by a direct effect of PO2 on the microvasculature. The precapillary vessels that control distribution are more sensitive to local hypoxia than are the resistance vessels so that blood flow redistribution is a first-line defense. The total blood flow response is made more sensitive by activity of beta-adrenergic vasodilator receptors which are active in this counterpoised system of local blood flow control. Disruption of the microvasculature, such as by microembolization, makes O2 uptake more dependent upon O2 supply than is normally the case. This event is accompanied by a loss of autoregulatory ability. In view of the myriad potential effectors on microvascular smooth muscle, the true wonder is that blood flow and O2 delivery generally are so strongly meshed with O2 uptake at every level of functional organization in the body. It would hardly be surprising, then, if disruption in one part of the system, such as the pulmonary circulation, had a counterpart in the peripheral circulation. This was alluded to in the possible association of O2 supply dependency in the periphery and severe ventilation-perfusion abnormality in the lung during ARDS. It reminds us that deranged processes that are revealed by relatively routine measurements may not be restricted to a single target organ. PMID- 6851459 TI - The influence of cardiovascular function on gas exchange. AB - Alterations in cardiovascular function may play a major role in determining pulmonary gas exchange and thus significantly influence the gas composition of the arterial blood. The influence of the cardiovascular system may be exerted through changes in the PvO2 or by directly altering the distribution of ventilation and blood flow in the lung. Although this relationship is difficult to clinically assess, it must always be considered when interpreting changes in the arterial blood gases of patients with cardiopulmonary dysfunction. PMID- 6851460 TI - Pulmonary mechanics and artificial support of the arrested circulation. PMID- 6851461 TI - Symposium on cardiovascular-pulmonary interaction in normal and diseased lungs. PMID- 6851462 TI - Health implications of vegetarian diets. PMID- 6851464 TI - Clinical, tissue, and biochemical signs of zinc deficiency. PMID- 6851463 TI - Patterns of alcohol abuse and the role of diet in alcoholic liver disease. PMID- 6851465 TI - Obesity in pregnancy. PMID- 6851466 TI - Use of vitamin E for prevention and treatment of spinocerebellar disorders. AB - Evidence has accumulated that vitamin E is essential for normal neurological function. It is a fat-soluble vitamin, and, therefore, deficiency states are most likely to occur in patients with fat malabsorption. If such patients have low serum vitamin E concentrations, it is important to initiate appropriate vitamin E therapy with the aim of restoring and maintaining normal serum vitamin E concentrations and preventing long-term neurological disability. This is likely to become a more frequent problem with the increasing survival of patients with chronic fat malabsorptive states. As a corollary, it would also seem reasonable to measure serum vitamin E concentrations in all patients with spinocerebellar disorders, whatever the supposed cause. PMID- 6851467 TI - Understanding food-drug interactions. PMID- 6851468 TI - Anaerobic pulmonary infections. PMID- 6851469 TI - Current concepts of Staphylococcus aureus infection with emphasis on treatment. PMID- 6851470 TI - Early detection of breast cancer. PMID- 6851471 TI - Fungal infections of the lung. PMID- 6851472 TI - Short course chemotherapy for tuberculosis: treatment of choice? PMID- 6851473 TI - Toxoplasmosis: an ophthalmologic viewpoint. PMID- 6851474 TI - Effect of elevated temperature on the intracellular degradation of different collagen types. AB - The intracellular degradation of newly synthesized collagen of types I, II and IV was studied under cell culture conditions at normal and elevated body temperatures. The degradation of type I procollagen was studied in both human skin and chicken tendon fibroblasts, type II procollagen in chicken sternal chondrocytes and type IV procollagen in a human tumor cell line (HT-1080). To avoid the effect of the different temperatures on isotope penetration and protein synthesis, the cells were pulsed at 37 degrees C. The degradation of the newly synthesized procollagen was then followed during the chase period at 37 degrees C and at different temperatures slightly above the melting temperature of type I procollagen. Degradation was clearly increased in the human skin fibroblasts when the temperature was raised to 41 degrees C, whereas the result in the chicken tendon fibroblasts at 43 degrees C was not as dramatic. The extent of degradation in chicken chondrocytes was resistant to changes in temperature, whereas that in the HT-1080 cells was clearly increased when the incubation temperature was raised to 43 degrees C. PMID- 6851476 TI - Identification of collagen chains as a function of cyanogen bromide peptide patterns using gel permeation high-performance liquid chromatography. AB - A gel permeation high-performance liquid chromatography system utilizing commercially-available silica-based gels has been developed for evaluation of the cyanogen bromide cleavage products derived from collagen a chains. The high efficiency and precision of the system permits unequivocal identification of various chains by inspection of the peptide elution pattern following a single run requiring 40 minutes. The system is sufficiently sensitive to permit analyses to be performed with as little 1.0 microgram of sample, although the columns utilized may accommodate samples as large as 1.0 mg making the system useful for preparative purposes as well. PMID- 6851477 TI - Type II collagen from lathyritic rat chondrosarcoma: preparation and in vitro fibril formation. AB - Intact type II collagen monomer was isolated in 10-20% yield from lathyritic rat chondrosarcoma and purified to homogeneity. On warming in neutral solution, the collagen formed a mixture of D-periodic native fibrils and thin filaments with no apparent structure. There were characteristic lag and growth phases in the turbidity profile. cooling dispersed or dissolved the fibrils leaving thin filaments. The fibrils were very wide, up to 2.0 micrometers compared to the 10 to 40 nm fibrils present in situ. They had the appearance of stiff tactoids compared to the very long and flexible fibrils obtained from type I collagen under similar conditions. Type II collagen also required higher temperatures and concentrations than type I to form fibrils. The continued presence of thin filaments when type II fibril formation was complete suggests either that filaments are in slow equilibrium with fibrils or that they may not be intermediates but rather a separate product. PMID- 6851478 TI - Retrospective identification as influenza virus of a hemagglutinating agent isolated from turkeys in Israel in 1973. PMID- 6851475 TI - Histomorphological basis of articular cartilage destruction in rheumatoid arthritis. PMID- 6851480 TI - Regulation of porcine heart and skeletal muscle AMP-deaminase by adenylate energy charge. AB - 1. Cytosol from pig skeletal muscle, but not heart, contains an inhibitor of AMP deaminase (AMP-D, EC 3.5.4.6) which reduces AMP-D activity 8-fold. 2. Heart and skeletal muscle AMP-D have been purified to apparent homogeneity by cellulose phosphate and DEAE-Sephacel chromatography. 3. AMP-D from skeletal muscle is inhibited more severely than the heart enzyme by an increase in adenylate energy charge to levels exceeding 0.4. Nevertheless both enzymes seem to be regulated by the energy charge, which contrasts with reports for rabbit heart AMP-D. PMID- 6851479 TI - Prevalence of influenza viruses A-H1N1 and A-H3N2 in swine in the Netherlands. AB - In the period December 1979-May 1980 a respiratory disease spread rapidly through pig herds in The Netherlands. Surveillance of 12 pig farms resulted in isolation of 22 influenza A-Swine-H1N1 (Hsw1N1) strains from 9 pig herds. The morbidity rate was high but the mortality rate was nil. Retardation in growth was observed. Sera collected from affected pig herds showed a fourfold increase in haemagglutination inhibition (HI) titre against A-Swine-H1N1 virus. Sera collected on five farms showed a geometric mean HI titre against the A-H3N2 virus above 100. A significant HI titre increase against this virus was found in sera collected on three farms. These findings indicated a recent infection by this virus. A-H3N2 virus was not isolated. The Dutch Swine-1980 isolates showed in the cross-HI test a distant antigenic relationship with the classical A/Swine/Iowa/30 (H1N1) virus and one-sided close antigenic relationship with A/New Jersey/76 (H1N1) virus. HI antibody to A/Swine/Nederland/80 (H1N1) virus was found in 4, 0, and 44%, to A/New Jersey/76 (H1N1) virus in 0.5, 0.4, and 42%, and to A/Swine/Iowa/30 (H1N1) virus in 0.5, 1, and 30% of pig sera collected in 1976, 1977, and 1980, respectively. HI antibody to A/Hong Kong/68 (H3N2) virus was detected in 36, 56, and 68%, and to A/Victoria/75 (H3N2) virus in 38, 73, and 68% of these sera, respectively. The results of this study indicate that pigs in The Netherlands, like those in North America, Southeast Asia, Japan, and Western Europe harbour A-Swine-H1N1 and A-H3N2 influenza viruses and are thus potential reservoirs for future human pandemics. PMID- 6851482 TI - Cytosolic malate dehydrogenase in muscle extracts of Toxocara canis. AB - 1. Malate dehydrogenase (L-malic acid:NAD+ oxydoreductase, EC 1.1.1.37) was partially purified from muscle extracts of Toxocara canis by means of gel chromatography in Sephadex G-150 and affinity chromatography in Sepharose-4B-Blue dextran. 2. The purified enzyme was very active in reducing oxalacetate and less active in oxidizing L-malate. It was inhibited by excess oxalacetate but not by L malate. 3. The kinetic parameters of the enzyme were obtained and these included: pH and temperature optima and apparent Michaelis constants for the substrates. 4. The results suggest that the enzyme from Toxocara canis behaves like the enzyme of the model helminth Ascaris lumbricoides. PMID- 6851481 TI - The profile of the glycolytic system and the metabolic activity of chicken erythrocytes. PMID- 6851484 TI - Methemoglobin reductase activity in phylogenetically diverse piscine species. PMID- 6851487 TI - A guide to the analysis of growth curve data with special reference to SAS. AB - The analysis of data variously termed growth curve data, repeated measurements data, or profile data is discussed. Typically, one has measurements taken at several points in time for each experimental unit. Usually there are also treatments randomized to these experimental units according to a suitably chosen design. The conditions under which the "split-plot-in-time" analysis is valid are given and the Geisser-Greenhouse approximation is discussed when it is not valid. Often, however, a low degree polynomial can be fitted to the profile of measurements for each experimental unit, thereby reducing the dimension of the profile considerably. An exact multivariate analysis can then be performed on the regression coefficients. This removes many of the objections usually raised against multivariate techniques. All of this is easily implemented on the statistical analysis system (SAS) and sample programs are given. PMID- 6851483 TI - Changes in acid phosphatase activity during sporulation of Eimeria tenella oocysts. AB - Extracts of sporulated oocysts of Eimeria tenella have acid phosphatase activity which can be separated into Peak I (basic form) and Peak II (acidic form) on a DEAE-Sepharose Column. 2. Sporulation markedly effects the behavior of Peak I acid phosphatase (basic form) through the DEAE-Sepharose Column. 3. The Km value of Peak I decreases during sporulation. 4. The data obtained suggest that during sporulation the basic form of acid phosphatase (Peak I) undergoes marked degradation and transformation indicating that acid phosphatases may play an important role in the metabolism of E. tenella. PMID- 6851485 TI - Differences in the fatty acid composition of atrial and ventricular phospholipids of rat heart following standard and lipid-supplemented diets. AB - 1. The major saturated fatty acids of the phospholipids of rat heart atria and ventricles are similar and are not greatly altered by supplementing the diet with widely different types of lipid. 2. There are important differences in the relative proportions of the major unsaturated fatty acids of the phospholipids of these anatomically and functionally distinct regions of the heart. 3. The proportions of linoleic (C18:2, eta-6) and docosahexaenoic (C22:6, eta-3) acid are significantly higher in the ventricles than in the atria; the proportions of oleic (C18:1, eta-9) arachidonic (C20:4, eta-6) and docosatetraenoic acids (22:4, eta-6) are higher in atria. 4. The differences in unsaturated fatty acid profiles persist even after twelve months of feeding lipid supplements of sunflower seed oil (SSO) or sheep kidney (perirenal) fat (SKF). 5. However, the ratios of arachidonic to docosahexaenoic acid in both tissues are changed by decreasing the intake of linoleic acid, which apparently favours the conversion of dietary linolenic (C18:3, eta-3) to docosahexaenoic acid. The level of docosahexaenoic acid is greater in the ventricles than in the atria, and greatest when the animals were fed SKF diet. 6. The physiological and pharmacological differences in ventricles and atria may arise from differences as fundamental as the phospholipid fatty acid composition of cardiac membranes. PMID- 6851486 TI - Effect of experimental anaemia on red cell GSH and enzyme activities in guinea pig and rabbit. AB - 1. The effect of experimental anaemia on red cell GSH and enzyme activities of GSH-Px, GSSG-R and G6PD was investigated in guinea-pig and rabbit. 2. The anaemia was induced by injection of PHH in guinea-pig and rabbit and also by bleeding in guinea-pig. 3. Red cell GSH increased from 115.5 to 141.8 mg/dl RBC in the guinea pig and from 108.5 to 133.5 mg/dl RBC in the rabbit during anaemia. 4. There were significant rises in the level of all the three enzymes activities in both the species of animals. However, the changes in rabbit were more pronounced than in the guinea-pig. PMID- 6851488 TI - Stratified trend and homogeneity analyses of proportions and life table data. AB - Tests for linear trend and homogeneity among proportions and analogous time adjusted tests for life table data are programmed for stratified data. For proportions, the maximum likelihood estimator of the common logistic slope and its approximate standard error is given. This parameter is related to the relative risk for the factor under test. The model is a simpler and more relevant subcase of the general linear multiple logistic model. Tests of fit include a chi square test of departure from trend for both types of data, and, for proportions, a test for the equality of slopes among groups of strata. The program is particularly useful for large prospective studies in epidemiology, but may also prove helpful for case-control studies, clinical trials, and combining animal studies. Several optional analyses are included. The program generalizes most aspects of a previously published program by Thomas, Breslow, and Gart (Trend and homogeneity analyses of proportions and life table data. Comp. Biomed. Res. 10, 373 (1977)). A FORTRAN card deck with documentation is available upon request. PMID- 6851492 TI - Gamma camera MTF measurements using an image chain analysis approach. PMID- 6851491 TI - The fitting of growth curves using constrained splines. PMID- 6851490 TI - A FORTRAN program for stratified analysis of data from case-control studies. AB - Stratification of study subjects by one or more covariates is a commonly accepted method for dealing with confounding and effect modification in epidemiologic case control studies. A flexible FORTRAN program is described which facilitates simultaneous stratification by several covariates and which produces summary odds ratio estimates and chi-square statistics by the Mantel-Haenszel method. It also facilitates detection of effect modification by each covariate considered individually. Straightforward means are provided for the user to modify input data before analysis or to exclude certain subjects from analysis, simulating such capabilities in larger statistical packages. PMID- 6851489 TI - Determination of myosin light chain phosphorylation using astronomical image analysis programs on autoradiographs of electrophoretic gels. AB - Computer image analysis programs developed by astronomers for celestial photometry were used for the analysis of autoradiographs of electrophoretic slab gels. Oxytocin-stimulated myosin light chain phosphorylation in mammary myoepithelial cells was studied by incubating cells with [32P]orthophosphate followed by oxytocin addition, polyacrylamide gel electrophoresis of cellular protein, and autoradiography of electrophoretic slab gels. After scanning and digitization of autoradiographs, [32P]phosphate incorporation into the myosin light chain was measured by the determination of radiation flux recorded on the X ray film. Within seconds after oxytocin addition, the myosin light chain was fully phosphorylated. The large library of astronomical computer programs has applications for the quantitative analysis of both one- and two-dimensional electrophoretic gels. PMID- 6851493 TI - Development of a radioimmunoassay data analysis pack (RIADAP) in level II basic for microcomputers. AB - A simple program written in Microsoft BASIC for the analysis of radioimmunoassay data is presented. The program was designed for use by unexperienced operators on a TRS-80 Model III microcomputer. Standard curve data are fitted by linear regression after a logit response/loge dose transformation. Standard errors of individual observations are computed, and confidence intervals are obtained for a critical t of 0.1. Standard observations are eliminated when they lie outside the confidence interval from the calculated response on the fitted curve, and this is accomplished until no datum can be eliminated or until the coefficient of determination reaches an operator defined value. The program then prints the regression parameters and the retained standard values. Unknown sample data can then be entered, and the values are computed relative to the final regression parameters of the standard curve. The values can be modified by operator defined correction/dilution factors. The mean value of the slope for 28 assays is -0.99, while the predicted theoretical slope with a loge transformation is -1. This program finds its greatest use in research laboratories where a number of different RIA are performed and where it is of value to have some control over the computation process. PMID- 6851494 TI - An on-line data acquisition system for radiation therapy: external photon and electron beams. AB - An on-line data acquisition system for external beam treatment planning has been developed. The hardware consists of a Tektronix 4054 Computer, an SHM Nuclear 3-D scanning water phantom, interfaces for 16 channels of ADC and 32 channels of digital I/O, and two detector probes for measuring dose distribution and monitoring fluctuations in machine output. The program to control the movement of the scanning probe and to collect data is written in BASIC. Results of the measurements are plotted in real time on the Tektronix screen. The beam data format consists of a set of percentage depth doses along the central axis and five sets of off-axis ratios at five different depths. In the electron mode, when ionization chambers are used, data points are averages of two measurements, one with positive bias and the other with negative bias. The beam data are stored on disk which can be accessed by the Capintec treatment planning system. PMID- 6851495 TI - Computer simulations of learning in neural systems. AB - Recent experiments have shown that, in some cases, strengths of synaptic ties are being modified in learning. However, it is not known what the rules that control those modifications are, especially what determines which synapses will be modified and which will remain unchanged during a learning episode. Two postulated rules that may solve that problem are introduced. To check their effectiveness, the rules are tested in many computer models that simulate learning in neural systems. The simulations demonstrate that, theoretically, the two postulated rules are effective in organizing the synaptic changes. If they are found to also exist in biological systems, these postulated rules may be an important element in the learning process. PMID- 6851496 TI - Diffusion and convection in a branching tube. AB - Transport by diffusion and convection is described in a branching tube using a stochastic formulation in a multiple pattern network. The concentration curves are compared with the solutions of the classical one-dimensional transport equation for each branch, coupled with a constraint condition at the branch point. A very good agreement is found for a large domain of variation of the parameters compatible with the lung anatomy. The present analysis gives a sound basis to the multibranch point models of the lung. PMID- 6851497 TI - On-line analysis of neuromuscular bioelectric potentials. AB - A computer system is presented which provides for on-line data capture and analysis of evoked end-plate potentials and action potentials, and on-line data capture with off-line analysis of spontaneously occurring miniature end-plate potentials at the end-plate region of the neuromuscular junction. Sampling of evoked waveforms begins after an adjustable delay following the stimulus. Spontaneously occurring waveforms are captured by 'freezing' the contents of a circular buffer. The software provides MENU selectable support functions including storage and retrieval of data and calculated parameters, analog and digital display of waveforms, data calibration and gain modification, data editing, file management, and hardcopy output. Calculated parameters of the waveform are optionally placed in a data base file by the analysis programs. The data base may be used for editing, arithmetic operations, and subsetting of variables as well as statistical analysis and plotting of any selected variables. PMID- 6851498 TI - Computed tomography of malignant tumors of the osseous pelvis. AB - The medical records, conventional radiographs, bone scans and pelvic CT scans obtained in 50 consecutive patients with malignant lesions involving the osseous pelvis were retrospectively reviewed. In 21 patients with primary bone tumors or with osseous involvement from adjacent pelvic neoplasms, CT provided additional information, in 17 patients (80%) which had direct bearing in the clinical management. CT was less useful in 29 patients with bony metastases. Although more information was obtained, this was of clinical significance in only 12 patients. PMID- 6851499 TI - Diagnosis of inferior vena cava anomalies by computerized tomography. PMID- 6851500 TI - Interhemispheric subdural hematoma from ruptured aneurysm. PMID- 6851501 TI - The computerized tomographic appearance of patchy liver congestion due to irradiation. PMID- 6851502 TI - Computed tomographic demonstration of idiopathic familial basal ganglia calcification. AB - This report describes our experience with CT scanning in a patient with idiopathic familial basal ganglia calcifications. The clinical symptoms were characterized by late onset of progressive mental deterioration, seizures, involuntary movements and speech disorder. An extensive deep cerebral calcification was clearly visualized with CT as was midbrain and cerebellar calcification. Our communication is the first which documents CT profile of this rare disorder. PMID- 6851504 TI - Child psychiatry: taking stock. PMID- 6851505 TI - Multiaxial classification in psychiatry. PMID- 6851503 TI - Computed tomography in the evaluation of severe facial trauma. AB - Computed tomography (CT) is a simple, rapid, and safe method of evaluating patients with severe facial trauma. It has its greatest value in defining the extent of soft tissue damage as well as in assessing the skeletal disruption. In a group of 32 patients with severe facial trauma, CT outlined the degree of soft tissue and skeletal fracture. In 13 of these patients who also underwent conventional pleuri-directional tomography CT was determined to be just as effective in identifying all fractures. CT was also shown to be useful for follow up evaluation of patients with previous severe facial trauma. PMID- 6851506 TI - Allergic disorders in depressive patients. PMID- 6851507 TI - A logical analysis of disease concepts. PMID- 6851508 TI - Thought disorder and depression in psychiatric patients. PMID- 6851509 TI - Cognitive impairment scales derived from verbal samples. PMID- 6851512 TI - Admission decisions in the psychiatric emergency room. PMID- 6851511 TI - Suicide attempts in treated opiate addicts. PMID- 6851513 TI - Psychiatric perspectives on psychotherapy. PMID- 6851510 TI - Chronic anxiety and social adjustment. PMID- 6851514 TI - Depressives syndromes in a primary care setting: evaluation, classification, and outcome. PMID- 6851516 TI - Migration and manic-depressive illness. PMID- 6851515 TI - Some issues in research on the epidemiology of demoralization. PMID- 6851517 TI - Lithium and affective disorder in the elderly. PMID- 6851519 TI - Obsessive compulsive disorder. PMID- 6851518 TI - Medication use and mortality. PMID- 6851521 TI - Copper--a rare sensitizer. AB - To determine the incidence of patch test reactions to copper, 2% copper sulphate was included in our routine patch test series. The allergic potential of copper sulphate was evaluated by the guinea pig maximization test method (GPMT). 13 of the 1190 eczema patients showed reactions (1.1%), but they were considered non relevant. 3 series of GPMT demonstrated that copper sulphate was a grade I allergen. A critical review of the literature disclosed that several reports on cases of allergic contact dermatitis to copper must be regarded as uncertain or non-relevant. 4 cases were considered relevant and another 20 cases probably relevant. It is suggested that a test reaction to copper sulphate should be verified by a serial dilution test (SDT). Furthermore, the sensitivity of patients to other metals should be stated, so that one can be aware that false positive reactions from metal impurities, especially nickel, in the copper salt used for testing may occur. PMID- 6851520 TI - Biochemical and clinical studies in a case of contact urticaria to potato. AB - Contact urticaria to potato was confirmed by skin testing in a 26-year-old male with atopic dermatitis, birch-pollen rhinoconjunctivitis and a history of immediate finger itching upon handling raw potato. The potato peel was non reactive. The urticarial reactivity to potato could be transferred by the patient's serum in a Prausnitz-Kustner test, indicating an immunological etiology. Electrophoretic and chromatographic examination of extracts from homogenized potatoes (unexposed to synthetic fertilizers and insecticides) revealed allergenic activity in a heat-labile macromolecular fraction with a mass of 20-30 kdalton migrating towards the anode during agarose gel electrophoresis at pH 8.6 with a mobility similar to that of human alpha 1-antitrypsin. The technique used for preliminary fractionation of the allergenic activity in a potato extract, similar to crossed immunoelectrophoresis, appears to be a simple and widely applicable technique for the characterization of proteins with this biological activity. A partially purified fraction with allergenic activity, seemingly more stable than the activity in crude homogenates, was obtained by gel filtration and preparative agarose gel electrophoresis. When an antihistamine was also injected, the urticarial reaction to the protein fraction was less pronounced. Pretreatment of the skin with compound 48/80, a histamine releaser, blocked the reaction. Histamine thus seems to be the major vasoactive substance mediating the contact urticarial response to potato antigen in this patient. PMID- 6851522 TI - Nickel in tap water. AB - Nickel analyses of tap water from several sources in Copenhagen gave up to 490 X 10(-6) g X 1(-1) in the first 250 ml portions. Hot water gave higher values than cold water. After flushing for 5 min, low values were found. Considerable variation from time to time and from tap to tap was found. Drinking of only the first portion in the morning might have an influence on nickel hand eczema. PMID- 6851523 TI - Contact urticaria from horse saliva. PMID- 6851524 TI - Unusual cutaneous reaction after a gold chloride patch test. PMID- 6851525 TI - The sensitizing potential of neopentyl methacrylate in the guinea pig. PMID- 6851526 TI - Sensitization to cis-3-hexenyl salicylate. PMID- 6851527 TI - Drug induced cicatrisation of the conjunctiva. PMID- 6851528 TI - Type I reaction to chloramine. PMID- 6851529 TI - Contact dermatitis from chlorhexidine. PMID- 6851530 TI - Patch tests to metals in childhood. PMID- 6851531 TI - Allergic contact dermatitis to the fragrance material lilial. PMID- 6851532 TI - Dissolving of copper by synthetic sweat. PMID- 6851533 TI - Chloracetamide--a hidden contact allergen. PMID- 6851534 TI - Allergy to carbimazole. PMID- 6851535 TI - Contact urticaria from phosphorus sesquisulphide. PMID- 6851536 TI - Contact dermatitis from ketoprofen. PMID- 6851537 TI - Contact urticaria to fruit and birch sensitivity. PMID- 6851538 TI - Photosensitization by amantadine (Symmetrel). PMID- 6851539 TI - Contact dermatitis from nifuratel. PMID- 6851540 TI - Patch tests with allergens related to cosmetics. PMID- 6851541 TI - Shampoo dermatitis due to cocobetaine and sodium lauryl ether sulphate. PMID- 6851542 TI - Contact urticaria to diethyltoluamide. PMID- 6851543 TI - Guinea pig maximization test: Podophyllum lignans. AB - The guinea pig maximization test was used to study the sensitizing potential of Podophyllum lignans; 0.5% of each drug in propylene glycol was used for induction and 0.01%, 0.05%, 0.1% and 0.5% preparations for topical challenge. The 0.1% and 0.5% preparations caused non-allergic toxic reactions associated with the cutaneous destructive influence of these drugs; allergic responses did not occur. PMID- 6851544 TI - Lanolin allergy: crisis or comedy. AB - Lanolin has been applied to human skin from at least Egyptian times. Its virtues as an emollient and vehicle for cosmetics and drugs have been extolled for centuries. 50 years ago, a fly was found in the ointment--the first case of lanolin allergy was reported (1). Since then lanolin has achieved considerable notoriety as a contact sensitizer. Dozens of articles in the dermatologic literature emphasize the high frequency of lanolin allergy. European dermatologists seem to have become especially sensitized to lanolin allergy. Medical students learn early on, that medicaments in lanolin bases are hazardous. Every novice knows that lanolin is a sensitizer! The nadir of lanolin's fall from grace has been reached in advertisements of topical drugs which emphasize the absence of lanolin in the vehicle. These denouncements by dermatologists have not slowed down the demand for lanolin. About 2 billion pounds of finished cosmetics contain lanolin or its derivatives. It is impossible to reconcile this expanding market with the apprehensions of skin doctors. It is my intention to review the history of lanolin allergy, to present experimental data on its contact sensitizing potential and to put the risk of lanolin allergy in perspective. PMID- 6851545 TI - Mycotic aneurysm of the abdominal aorta: successful management of Campylobacter fetus aortitis. PMID- 6851546 TI - Anterior approach to resurfacing arthroplasty of the hip: a preliminary experience. PMID- 6851547 TI - Percutaneous endoscopic gastrostomy. Report of two cases and a review of the literature. PMID- 6851548 TI - The Dalkon Shield debate. PMID- 6851549 TI - Prevention of bacterial endocarditis. PMID- 6851551 TI - Computer technology and continuing medical education: a scenario for the future. PMID- 6851552 TI - Update on acquired immune deficiency syndrome (AIDS) among patients with hemophilia A. PMID- 6851553 TI - Incidence of pelvic inflammatory disease in clinical trials with Cu-7 (intrauterine copper contraceptive): a statistical analysis. AB - Pelvic inflammatory disease (PID) was recorded for 365 of 10,760 women using the Cu-7 for up to 48 months during clinical investigations in the United States. This involved a total exposure of 242,169 woman-months, or some 20,000 woman years. The overall incidence of PID was 18 cases/1000 woman-years. Incidence was inversely related to age and to duration of use. It was statistically significantly greater in parous subjects than in nulliparous, after stratifying for age. The estimated rates in this study do not differ markedly from those in most other prospective investigations. PMID- 6851550 TI - Fraud and negligence in science. PMID- 6851554 TI - Pharmacokinetics of oral contraceptive steroids after morning or evening administration. AB - An oral contraceptive containing ethynyloestradiol and norethisterone was administered to six women in the morning and in the evening using a cross-over design. Serum levels of ethynyloestradiol and norethisterone were measured at various times after administration. There was no significant difference in a number of pharmacokinetic parameters between the two times of administration, suggesting that morning or evening administration of the contraceptive are equally effective. PMID- 6851555 TI - Pituitary, ovarian and endometrial effects of progesterone released prematurely during the proliferative phase. AB - The pituitary, ovarian and endometrial effects of premature exposure to progesterone during the proliferative phase were investigated in 18 normally menstruating women. Daily blood samples were drawn during a control cycle and an endometrial biopsy was obtained on cycle day 6 (in 9 subjects) and on cycle day 11 (in 9 subjects), respectively. Daily blood samples were drawn again throughout a treatment cycle, in which a vaginal delivery system releasing progesterone at a constant rate of 1.4 mg/24 h was inserted and left in situ for 96 hours during cycle days 2-6 (9 subjects) and cycle days 7-11 (9 subjects), respectively. On the 6th and 11th cycle day, respectively, the devices were removed and another biopsy specimen was obtained. In all blood samples the levels of immunoreactive lutropin (LH), estradiol (E2), 17-hydroxyprogesterone (17-HO-P), progesterone (P) and 20 alpha-dihydroprogesterone (20 alpha-HO-P) were estimated by radioimmunoassay. Insertion of the devices resulted in a rapid, approximately six fold increase (from 0.5 to 3.0 nmol/l) in P levels and an approximately three fold (from 0.5-0.6 to 1.5-2.0 nmol/l) increase in 20 alpha-HO-P levels. A high degree of correlation was found between P and 20 alpha-HO-P levels. No major changes were observed in the profiles and levels of the other hormonal indices studied. However, premature exposure to small amounts of P during cycle days 2-6 resulted in a significant decrease in the ratio of the E2 to LH peaks and exposure during cycle days 7-11 gave rise to a significant increase in the ratio of the length of follicular to luteal phases. Progesterone released during the early proliferative phase (days 2-6) exerted little, if any, effect on the appearance of the endometrium. However, the same dose of P released during the late proliferative phase (days 7-11) significantly diminished the number of glandular mitoses, the height of the glandular epithelium, reduced pseudostratification and the number of plasmolemmal vesicles, but did not induce any subnuclear vacuolation, predecidual reaction or leucocytic infiltration. It is suggested that systematic studies involving the exposure to progestogens in normally menstruating women during cycle days 7 to 11 will provide a reliable and practical method for the comparative assessment of the potency profile of individual progestogens in women. PMID- 6851557 TI - The zoapatle II--botanical and ecological determinants. AB - A collection of Montanoa (Cerv) specimens was conducted throughout Mexico. Twenty one specimens were classified, some of them grown in the greenhouse and transplanted in an agricultural experimental field station in the Valley of Mexico. In vitro uterotonic potency was assayed and the results expressed as equivalents of oxytocine, by using estrogenized guinea pig uterine strips. A great variation of uterotonic potency was observed among the wild plants. A clear decrease and uniformity of uterotonic potency was found in plants grown in the experimental field. The study points out the importance of ecological variations in expression of the plant's biological activity. PMID- 6851556 TI - The abortifacient effect of synthetic androstane derivatives in the baboon. AB - Synthetic androstane derivatives have been tested for their ability to induce abortion during early pregnancy in primates. Two compounds were studied following intramuscular (IM) and oral treatment in fourteen baboons. A five-day treatment regimen was started at approximately day 20 of pregnancy in 12 baboons, with treatment delayed until after day 40 in two baboons. All seven baboons treated IM with either compound aborted following intramuscular treatment, although three required a second treatment series beginning on approximately day 40 of pregnancy. Two of five baboons treated orally aborted following the single treatment series initiated around day 20 of pregnancy. The two baboons treated only after day 40 continued to term and delivered healthy infants. These compounds are therefore effective at terminating pregnancy when given around the time of the missed menstrual period. Further studies are necessary to determine optimal dose and treatment schedule. PMID- 6851558 TI - The zoapatle III--biological and uterotonic properties of aqueous plant extract. AB - Differences in uterotonic activity were observed between zoapatle Montanoa (Cerv.), plants growing in their natural habitat and plants growing in an experimental agricultural plot. Details of an in vitro analogic model for assaying uterotonic potency in guinea pig strips is described. Important species differences on the uterine response to zoapatle aqueous crude extract were noticed in rats, hamsters, guinea pigs, cats and Rhesus monkeys. The need for proper biological evaluation of chemical substances already isolated from zoapatle specimens, is mentioned, and the advantages of working with zoapatle specimens grown under controlled ecological conditions are pointed out. PMID- 6851559 TI - The zoapatle IV--toxicological and clinical studies. AB - The zoapatle aqueous crude extract has been used in Mexico for the last 5 centuries for the induction of labor, treatment of post-partum bleeding problems, and as a menses inducer. Today, it is sold in street markets, and its long documented history of use by humans could be taken as indirect evidence of a lack of toxicity. Rigorous pharmacological and clinical studies described here, fully confirm the empirical observations. PMID- 6851561 TI - Predictive value of serum ferritin in anemia development after insertion of T Cu 220 intrauterine device. AB - A one-year follow-up study in 30 healthy women was undertaken to study serum ferritin as well as other hematological parameters prior, six and twelve months after insertion of an intrauterine device, T Cu 220. Women were allocated into one of two groups according to the baseline ferritin serum levels; Group I abnormal ferritin and Group II normal ferritin levels. Other hematological parameters were normal and no iron supplement was given throughout the study. A direct relationship between low ferritin serum values (Group I), and anemia development was found. Seven out of 15 developed anemia, whereas only 2 out of 15 had anemia at twelve months in Group II with normal ferritin values. The overall data suggested that measurement of serum ferritin levels could be a useful tool to anticipate anemia development in women with intrauterine devices. PMID- 6851560 TI - The zoapatle V--the effect of kauradienoic acid upon uterine contractility. AB - Kauradienoic acid was obtained from the hexanic extract of M. tomentosa (Cerv) leaves by chromatographic separation. This substance influenced the in vitro contractility of the rat, dog and guinea pig uterine strips. It also induced strong contractions of the guinea pig uterus in vivo when administered intravenously, without changes on arterial blood pressure. The effects produced by the plant infusion, the hexanic extract and pure species were compared. The hexanic of other utero-active compounds in M. tomentosa in addition to those already described is discussed. PMID- 6851562 TI - The effects of three different regimens of oral contraceptives and three different intrauterine devices on the levels of hemoglobin, serum iron and iron binding capacity in anemic women. AB - The effects on hemoglobin, iron and iron binding capacity (IBC) in 150 moderately anemic women of 1) a 21-day low-dose combined pill, 2) the same low-dose combined pill for 21 days, followed by 7 days of an iron-containing pill, 3) the same low dose combined pill administered for 63 consecutive days, followed by 7 days of no pill intake, 4) Lippes IUD, 5) TCu 220C and 6) Progestasert were studied. The three pill regimens were associated with an increase in hemoglobin and serum iron after 12 months. However, the iron pill and 63-day schedule groups produced an increase in hemoglobin and iron at the 6th month ans a diminution of IBC at 12 months. The Lippes and TCu 220C groups did not show any change in hemoglobin, iron or iron binding capacity after 12 months. The Progestasert group showed an increase in hemoglobin and iron levels at 6 and 12 months, and a diminution of IBC at 12 months. The pill and Progestasert have advantages as contraceptives in anemic women. PMID- 6851564 TI - Pre-operative cervical dilatation in termination of first trimester pregnancies using 16, 16-dimethyl-trans-delta 2 PGE1 methyl ester vaginal pessaries. AB - The effect of a prostaglandin E1 analogue on the cervix prior to termination of first trimester pregnancy was studied in a double-blind placebo-controlled trial with 70 primigravid and 125 multigravid patients in the Hong Kong University Gynaecological Unit. One mg of 16, 16-dimethyl-trans-delta 2-prostaglandin E1 methyl ester (ONO 802) in the form of vaginal pessary was inserted 3 hours before vacuum aspiration. The cervical dilatation in patients receiving ONO 802 pessaries was significantly greater than that in patients who received no treatment or placebo pessaries but the difference in dilatation between patients who received no treatment or placebo was not significant. The blood loss during operation in patients receiving ONO 802 pessaries was also significantly less than that in patients receiving placebo pessaries. The side effects due to ONO 802 pessaries were mild and infrequent. PMID- 6851563 TI - Evaluation of a rapid method for determination of total urinary estrogens in morning samples from normally menstruating women. AB - Total urinary estrogens (TUE) in morning urine samples delivered during seven days around midcycle from 14 normally menstruating women were analyzed and the results were compared with those obtained by radioimmunoassay of serum estradiol 17 beta (E2) and LH. The Spinnbarkeit of the cervical mucus was also determined daily and ovulation was confirmed by RIA of serum progesterone. Significant correlations (p less than 0.01) between day of peak levels of serum E2 and the day with the highest TUE value were obtained. Peak values for Spinnbarkeit, estradiol, TUE and LH were on the average obtained on cycle day 13.1 (10-17), 13.3 (10-16), 13.9 (11-18) and 14.1 (11-17), respectively, and the mean cycle length was 27.9 (24-32) days. The difference in mean peak day for estradiol and TUE, estradiol and Spinnbarkeit, estradiol and LH was significant in each comparison (p less than 0.01). Assays of TUE in morning samples as compared to analysis of TUE in 24 h urine portions were compared during 48 h in 10 women. The day with the highest TUE excretion was found to be the same in 7 women irrespective of the type of urinary sample analyzed. Analysis of urinary creatinine did not improve the TUE results. Levels of TUE in normally cycling females (n = 14); in women taking contraceptive steroids (n = 10), in menopausal women (n = 10) and in normal men (n = 10) agreed with those previously reported. It is concluded that the TUE determination by RIA may be helpful as a rapid method for everyday clinical use. PMID- 6851565 TI - Somatic tissue responses of male rhesus monkeys treated with a contraceptive steroid formulation. AB - Rhesus monkeys (Macaca mulatta) were treated with testosterone (100 micrograms/kg/day) plus estradiol (0.5 micrograms/kg/day) via subcutaneous polydimethylsiloxane (PDS; Silastic) implants for thirteen months. This steroid regimen inhibited dramatically spermatogenesis. Gross and histopathological examination of the musculoskeletal, circulatory, endocrine (excluding the testis), central nervous, gastrointestinal and respiratory systems failed to uncover any untoward effects of the long-term exposure due to the contraceptive formulation. Similarly, no remarkable effects were observed in the ionic, chemical and formed elements of blood or secondary sex structures. Failure to detect secondary complications attributed to the steroid treatment offers further justification for evaluating a contraceptive strategy based on administering naturally occurring steroids at sustained rates approximating those at which they are produced endogenously in the human male. PMID- 6851570 TI - Interaction between phenytoin and norethisterone in the rhesus monkey. AB - The effects of phenytoin treatment on plasma concentrations of norethisterone (NET) was studied in 7 healthy female rhesus monkeys. Before phenytoin treatment was started each monkey received an oral dose of 0.5 mg NET and 2 weeks later the same dose was given intravenously. On both occasions, plasma concentrations of NET were measured at frequent intervals during 24 hours. The monkeys were given phenytoin daily orally for more than 4 weeks. The absorption of phenytoin was confirmed by plasma determinations of phenytoin. While still on phenytoin treatment, the monkeys were again given 0.5 mg NET orally and 2 weeks later i.v. and blood sampling was repeated. During phenytoin treatment, plasma NET concentrations were always below those found before treatment. Both at iv and oral administration, the areas under the plasma concentration vs time curve (AUC) were reduced to 55% of the pretreatment AUCs. No difference in plasma half-life was found during phenytoin treatment. The results of this study may suggest that women on antiepileptic treatment with phenytoin should be given an oral contraceptive with a comparatively high dose of the steroids to provide contraceptive efficacy. PMID- 6851568 TI - Interaction between ethanol and contraceptive steroids on clotting activity in the rat. AB - Female rats were given either ethinyl estradiol or norethindrone in conjunction with water or 5% ethanol. Hematological parameters measured included the prothrombin time (PT), partial thromboplastin time (APTT), fibrinogen (FIB), factors II, V, VII, VIII, X, and XII activity; plus the platelet count (PLT) and hematocrit (HCT). The data indicates that norethindrone together with water produces the greatest number of changes in clotting activity. PMID- 6851567 TI - Lack of an effect of gossypol on the epididymis of the rat. PMID- 6851569 TI - Subcellular distribution of estradiol and estrone in human endometrium and myometrium during the menstrual cycle. PMID- 6851566 TI - Contraceptive efficacy of testosterone-estradiol implants in male rhesus monkeys. AB - Rhesus monkeys (Macaca mulatta) were treated with testosterone (100 micrograms/kg/day) plus estradiol (0.5 micrograms/kg/day) via subcutaneous polydimethylsiloxane (PDS, Silastic) implants. This treatment caused a striking reversible sterility. No pregnancies were observed in females bred to the steroid treated males. In contrast, there was no difference in pregnancy rate of females bred to control and steroid-treated monkeys for 14 weeks, beginning 17 weeks after removal of the steroid-filled implants. PMID- 6851572 TI - Blood pressure and proteinuria in adolescents. AB - The study was conducted in two groups of factory apprentices including boys aged 15 to 17 years. The first group consisted of a randomly selected 10% sample of 231 apprentices of the total number of 2,300 boys. The second group included 77 boys with casually found proteinuria. In both groups, the distribution of blood pressure and of the body mass and changes in these indices were followed up over a period of two years. The boys with proteinuria had a significantly higher systolic and diastolic blood pressure and a lower body mass index. Their systolic and diastolic blood pressure was rising more steeply in regression to the body mass. The casual finding of asymptomatic proteinuria in juveniles always calls for a long-term follow-up. It signalizes, inter alia, also the presence of a factor raising blood pressure probably independently of body height and body mass. PMID- 6851571 TI - Pulmonary precapillary hypertension in mitral valve disease. AB - Pulmonary hypertension in mitral stenosis is caused by a blockade of the mitral orifice. The haemodynamic examinations of 302 patients with mitral stenosis (MS) revealed that the increase in pulmonary vascular resistance significantly depended on the degree of stenosis. This increase is of functional and of anatomic origin; the acetylcholine infusion test makes possible to differentiate both these causal components. In mitral defects, the blood flow distribution in the lungs is altered, too. During exercise, pulmonary vascular resistance increases mainly in patients with elevated left intraatrial pressure. The pulmonary vascular bed, whose distensibility in mitral disease is diminished, is able to resist higher intravascular pressures without increasing its capacity. PMID- 6851573 TI - Topography and blood supply of atrioventricular node of the human heart. AB - Characteristic features of the topography and blood supply of the atrioventricular (A-V) node were studied on 80 autopsy heart specimens of adults deceased of other than cardiovascular disease. The authors used injection methods, angioroentgenography, macro- and microscopy. They refined nodal projection and established relationships between its location and the fossa ovalis, coronary sinus orifice, the base of the septal leaflet of the tricuspid valve and cardiac parameters. New information was obtained on the structural variability of the main source of A-V node nutrition - the arteria septi fibrosi, the pathways of A-V node blood supply, and the interrelationship between various types of cardiac blood supply and nodal artery variants. This information should be taken into consideration in cardiac surgery and analyses of electrocardiographic and coronarographic findings. PMID- 6851574 TI - Solar activity and myocardial infarction. AB - The correlation between the incidence of myocardial infarction, sudden cardiac death, the solar activity and geomagnetism in the period 1969-1976 was studied, basing on Wroclaw hospitals material registered according to WHO standards; sudden death was assumed when a person died within 24 hours after the onset of the disease. The highest number of infarctions and sudden deaths was detected for 1975, which coincided with the lowest solar activity, and the lowest one for the years 1969-1970 coinciding with the highest solar activity. Such an inverse, statistically significant correlation was not found to exist between the studied biological phenomena and geomagnetism. PMID- 6851576 TI - Comment on "Statistical inference from clinical trials: choosing the right P value". PMID- 6851575 TI - Referential plane of the equivalent dipole of the heart in an orthogonal ECG of healthy adolescents at postural changes. AB - The authors studied the relation of the position of the equivalent dipole at changes in the position of the examined person to the magnitude of amplitudes of potentials registered from the chest surface at the 4th and 5th intercostal spaces (ICS). The investigated group consisted of 77 healthy boys and male adolescents aged 8.5 to 21.1 years, who were selected on the basis of a special questionnaire. The results showed that the influence of the body position on the location of the electric centre of the heart at ventricular depolarization is insignificant. The amplitudes of the QRST complex in the X and Z leads significantly decreased after the electrodes had been shifted from the plane of the 5th to the 4th ICS, in all postural situations. For clinical practice, it is possible to accept in Frank' lead system the referential plane of the 5th ICS also in recumbent patients. This conclusion applies also to the antiorthostatic position (-45 degrees head down). PMID- 6851577 TI - Discussion on early stopping. PMID- 6851578 TI - Rejoinder: statistical inference from trials with sequential stopping rules. PMID- 6851579 TI - Sequential stopping rules and sequentially adjusted P values: does one require the other? AB - During the course of a clinical trial it is normally necessary to conduct periodic reviews of the data in order to determine whether the trial should be terminated. Since these reviews affect the probability of the final outcome, many statisticians recommend that the P values quoted for a clinical trial be sequentially adjusted to account for the possibility of premature termination. In this article it is argued that the sequentially adjusted P value is an inappropriate measure of the strength of evidence justified by a clinical trial. This is because the size of sequentially adjusted P values will vary according to actions that might have been taken if the trial had gone differently than it in fact did. Although such contingencies will effect the frequency of occurrence of certain events in hypothetical sequence of trial replications, it is hard to see why decisions that would have been made in response to outcomes that did not occur should have any bearing on the strength of evidence that can be attributed to the results that were actually observed. The credibility merited by a clinical trial depends not only on the implausibility of the observed results under the null hypothesis, but also on factors such as the medical plausibility of hypothesis well supported by the data, and the extent to which observed results have been predicted in advance. It is argued that publishing these factors along with fixed sample P values is the best way to indicate the degree of certainty that should be attributed to the conclusions of a clinical trial. PMID- 6851580 TI - Further comment on "Statistical inference from clinical trials: choosing the right P value". PMID- 6851581 TI - An ethics committee to aid in implementing a randomized clinical trial. AB - Individuals who care for children are sometimes reluctant to participate in experimental research because of concern about withholding a potentially helpful intervention from some of their patients and their impressions about the effects of the treatment being studied. These concerns may conflict with investigators' interests in obtaining subjects for protocols. This report describes the use of an external review committee to assess the appropriateness of enrolling patients in a randomized clinical trial. The committee served as a mechanism for assessing the validity of physicians' concerns about randomization of a given patient and for reconciling clinicians' differences about enrollment. It appears to have helped implement randomization by affording a procedure to ensure patients' rights and quality of care. It is offered as a technique for resolving the practical dilemmas of those conducting clinical research while at the same time respecting the rights of patients. PMID- 6851583 TI - Winds of change in clinical trials--from Daniel to Charlie Brown. PMID- 6851582 TI - Comparing survival of responders and nonresponders after treatment: a potential source of confusion in interpreting cancer clinical trials. AB - The comparison of survival distributions between patients who respond to therapy and those who do not can present methodologic and interpretational difficulties. Since assignment of patients to the responder or nonresponder groups is not random, statistical procedures that test the equality of survival distributions only demonstrate association between response and survival, not cause and effect. This association may have no relevance to the efficacy of treatment. The assignment of patients to response categories also represents a methodologic problem. Variability in the definition of a nonresponder and the handling of early deaths can both lead to varying conclusions concerning survival. In spite of these problems, statistical comparisons of survival distributions of responders and nonresponders are reported in approximately 20% of phase II and phase III clinical trials. Descriptive statistics may be more useful than inferential statistics in this situation. PMID- 6851585 TI - Familial sinistrality and sex differences in cognitive abilities. AB - The performance of right-handed males and females, with and without a family history of sinistrality (FS+ and FS-, respectively) were examined for three cognitive abilities: spatial ability, verbal fluency, and perceptual speed. FS+ subjects, especially females, showed performance decrements in spatial ability. Also, FS+ subjects, especially males, showed performance decrements in perceptual speed, with no differences being observed in verbal fluency. PMID- 6851586 TI - Lexical decision time as a function of visual field and stimulus probability. AB - Two experiments were performed to study lexical decision time to word and non word Hebrew trigrams as a function of stimulus probability, visual hemifield and responding hand. The results indicate that lexical decision time to words is shorter than to non-words. In addition, although decision time to words is significantly shorter with right hemifield stimulation than with left hemifield stimulation, decision time to non-words is the same whether they are presented to the right or left hemifield. Decision time to non-words decreases almost linearly as stimulus probability increases from 0.25 to 0.75, whereas decision time to words decreases in a concave manner apparently approaching an asymptote at a stimulus probability of 0.75. Responding hand is not significant as a main effect or in any interaction with any other variable. The data are discussed in terms of several models of hemispheric linguistic superiority. PMID- 6851584 TI - ["Sub-angular" alexis and associated neuropsychologic signs: clinical and tomodensitometric study]. AB - A clinical case of alexia without agraphia is reported. The computerized tomography (CT) showed a left sub-cortical parieto-occipital hemorrhage. The cortical lesion probably involved the posterior part of the angular gyrus but spared the medial occipital cortex. There was no evidence of a corpus callosum lesion. The clinical findings associated with the alexia and the localisation of the haematoma could be compared to the case reported by Greenblatt as a "subangular alexia" and considered as a disconnection of the left angular gyrus from right angular gyrus and both left and right occipital areas. The semiological aspects of the present case have been found to consistently differ from the classical forms of alexia usually described. Some common features with phonological alexia have been observed. PMID- 6851587 TI - A note on the interpretation of data derived from neuropsychological tests. PMID- 6851588 TI - Developmental deep dyslexia? AB - A detailed analysis was made of the errors of a developmental dyslexic who is now 18 years of age. It was found that her error pattern was very similar to that observed in a particular form of acquired dyslexia, i.e. deep dyslexia. She made semantic, visual, derivational and function word substitution errors, and was almost completely unable to read non-words. Although the possibility of brain damage cannot be completely ruled out, her case remains an unusual one as her reading disorder is a certain extent developmental in nature in that she has never achieved fluent reading. PMID- 6851589 TI - Hemispheric asymmetry for face recognition: cognitive style and the "crossover" effect. AB - Photographs of faces were serially presented for central viewing, while Ss made either "social" or "physical" judgments about each face. Subsequent tachistoscopic recognition of laterally displaced targets displayed a pattern of contrasting visual field superiorities for faces seen under the two conditions. This "crossover" pattern occurred in opposite directions for reaction time and for accuracy. Field dependent and field independent Ss displayed the crossover equally, but crossovers by field independent Ss showed a consistent direction within each dependent measure, whereas those by field dependent Ss were equally divided between the two directions. Choices of encoding strategy by field independent Ss appear to be more strongly task-determined than those by field dependent Ss, but the relation between the encoding manipulation, presumed encoding strategy differences, and specific visual field advantage remains unknown. PMID- 6851590 TI - The contribution of the right hemisphere to the organization of paragraphs. AB - Patients with unilateral right-hemisphere lesions performed significantly worse than normal controls in arranging the mixed-up sentences of stories. This impairment was not restricted to paragraphs conveying primarily spatial information, but occurred on other types of paragraphs as well. Nonspecific deficits of brain injury were ruled out as possible alternative explanations for the patients' difficulty on the task. The organization of language at the paragraph level may depend on right-hemisphere functioning. PMID- 6851592 TI - Individual differences in mode of processing in visual asymmetry tasks. AB - Three experiments were carried out to investigate whether individual differences in the perceptual factors of Closure speed (Cs) and Closure flexibility (Cf) are related to patterns of visual asymmetry. It was predicted that high-Cs subjects would demonstrate a relatively greater readiness for wholistic processing, whereas high-Cf subjects would show a relatively greater readiness for analytic processing. Subjects were administered a battery of perceptual tests. On the basis of their factor scores, forty subjects were assigned to one of four groups: low-Cs, high-Cs, low-Cf and high-Cf. Each subject participated in three tachistoscopic tasks: one verbal recall task and two binary classification tasks with visuo-spatial material. From previous studies, these tasks appeared to foster either analytic or configurational processing. The results indicated that the interaction between individual differences in proficiency in wholistic and analytic processing and task characteristics may be of great importance in the way in which the left and right hemispheres are involved in the processing of visual stimuli. PMID- 6851593 TI - Left hemispheric advantage for a visuopatial-dichaptic matching task. AB - Twenty right handed, female subjects performed a visuospatial-dichaptic matching task which required them to view a single shape for a brief period of time while palpating two shapes, one in each hand. There was an identification and reaction time advantage for right hand responses, which allowed the inference of a left hemispheric advantage for this particular matching task. These results are discussed in reference to factors that may modify the typical right hemispheric superiority for the processing of spatial information, i.e., motor feedback, concurrent memory load, and the differential use of spatial cues. PMID- 6851591 TI - Hemispheric specialization in nonverbal communication. AB - Subjects sustaining right hemisphere damage were impaired in the ability to evaluate emotional situations presented through nonverbal means, particularly through facial expressions. Left brain damage, even of considerable extent, led to significantly milder deficits. In agreement with these findings, a study in split-brain patients showed the isolated right hemisphere to be competent in evaluating facial expressions but less sensitive to body movements, while the left hemisphere showed the opposite pattern. PMID- 6851594 TI - Analysis of sequential letter matching tasks utilising lateralised tachistoscopic presentation. AB - Four experiments are reported in which sequential matches were demanded for double letter stimuli, the first stimulus pair was presented in central vision and the second in the left or right field. The responses were analysed according to the type of classification required (physical or nominal identify, or different). The results indicated that there were alterations in laterality patterns between retention intervals of 50 msec. and 990 msec. despite evidence for a prolonged and stable form of visual memory. These findings were incompatible with a model of the letter matching task which maps "name" codes to the left hemisphere and "visual" codes to the right. PMID- 6851596 TI - Inappropriate ADH secretion in tetanus. AB - Of 99 patients with adult tetanus, 7 developed the clinical and biochemical features of the syndrome of inappropriate antidiuretic hormone secretion (SIADH). The diagnosis for these 7 patients was severe tetanus (dysphagia with frequent severe spasms); 5/7 patients had evidence of autonomic overactivity (tachycardia, sweating, cardiovascular lability, and hypersalivation). They all responded favorably to fluid restriction, SIADH was self-limited and resolved as the disease regressed. PMID- 6851595 TI - Hemispheric interaction in visual field asymmetry. AB - A survey of previous literature suggests that asymmetries obtained in visual field recognition are larger when stimuli are presented bilaterally than when presented unilaterally. Three experiments confirm the existence of the effect, eliminate a number of published hypotheses used to explain it, and support a mechanism of hemispheric interaction in processing information. Both theoretical and methodological implications are discussed. PMID- 6851597 TI - Effectiveness of the neonatal transport team. AB - This study was performed to determine the effectiveness of a hospital-based transport team in lowering mortality in newborns. The medical records of 603 outborn infants weighing from 500 to 2500 g and having primary respiratory disorders were reviewed. The infants were admitted to 1 of 3 regional neonatal centers between January 1, 1977 and September 30, 1980. The 2 centers without transport teams admitted 304 outborn infants, of whom 62 (20%) expired by 120 h of age. The center with a transport team admitted 184 team-transported infants and 115 nonteam-transported infants, of whom 38 (13%) expired by 120 h of age. Outborn infants admitted to the hospitals without a neonatal transport team had a 60% (p less than 0.01) greater mortality compared to those admitted to the hospital with a transport team. At the onset of intensive care, the babies transported to the nonteam hospitals had a greater incidence of hypothermia and acidosis which may be related to their increased mortality. We conclude that hospitals without the services of a neonatal transport team may have significantly more deaths among low birth weight infants with respiratory disease than comparable hospitals with neonatal transport teams. PMID- 6851598 TI - Postural variations in pulmonary resistance, dynamic compliance, and esophageal pressure in neonates. AB - In order to determine effect of posture and to assess the reliability of the esophageal balloon method for measuring esophageal pressure changes (delta Pes) under clinical conditions, lung mechanics were measured in 13 term and preterm babies in each of 3 postures: supine, right, and left lateral. The pulmonary resistance (Rp) was significantly lower and the dynamic compliance (Cdyn) higher in the right lateral than in the supine position. Judged by the occlusion test, delta Pes was recorded accurately in each posture. The mean end-expiratory esophageal balloon pressure (PesEE) was higher in preterm infants and in the supine posture. It is concluded that the (right) lateral posture is mechanically less demanding than the supine posture and that delta Pes can be measured accurately in the supine posture. Absolute values of PesEE have no physiologic meaning and should not be used for patient management or for the calculation of lung mechanics. PMID- 6851600 TI - Risk factors predicting laryngeal injury in intubated neonates. AB - We evaluated 95 extubated neonates to determine if certain risk factors could predict the development of laryngeal injury. Risk factors were recorded prospectively during the intubation period and correlated with laryngeal injury determined by laryngoscopy after extubation. Duration of intubation greater than or equal to 7 days and 3 or more intubations significantly predicted injury. PMID- 6851601 TI - Postcardiopulmonary resuscitation pulmonary edema. AB - Although severe pulmonary edema is encountered occasionally in patients needing CPR, there has been no definitive description on the mortality and morbidity of pulmonary edema after CPR. The author experienced severe pulmonary edema after standard CPR in 20 of 71 patients who suffered sudden, unexpected cardiac arrest and regained heart function by CPR. The varied onset of pulmonary edema, which may have developed when massive pink frothy secretions exited from the endotracheal tube, ranged from a few minutes to 45 min after the re-establishment of heart beat. These 20 patients showed a significantly higher P(A-a)O2, insignificant lower plasma protein concentrations, and high plasma osmolarities as compared with those who did not develop pulmonary edema. Only 2 patients with pulmonary edema survived. During CPR, many factors could cause pulmonary edema, including external cardiac massage (ECM), administration or release of catecholamines, hypoxia, acidosis, overhydration, etc. This study indicates that patients who need CPR have a high likelihood of developing pulmonary edema. PMID- 6851599 TI - The effect of head position on intracranial pressure in the neonate. AB - Elevation and maintenance of the head in an elevated, midline position reduces cerebral venous and intracranial pressure (ICP) in adult neurosurgical patients. To determine the possible effect of head position on ICP in the neonate, we studied 26 neonates less than 2500 g at birth and less than or equal to 10 days of age. ICP was measured in each of 4 different head positions: head turned to the right and bed horizontal (R-0 degrees); head turned to the right and head of the bed elevated 30 degrees (R-30 degrees); head in the midline and bed horizontal (M-0 degrees); and head in the midline and head of the bed elevated 30 degrees (M-30 degrees). ICP results were as follows: R-0 degrees, 10.0 +/- 1.2 (mean +/- SEM), cm H2O; R-30 degrees, 8.6 +/- 1.3 cm H2O; M-0 degrees, 6.9 +/- 1.2 cm H2O, and M-30 degrees, 5.3 +/- 1.0 cm H2O. ICP was significantly lower in the M-0 degrees and M-30 degrees positions when compared to either R-0 degrees and R-30 degrees. When the effect of elevating the head of the bed 30 degrees was evaluated for infants whose ICP was greater than or equal to 7 cm H2O in the R-0 degrees and M-0 degrees positions, it was noted that there was a significant drop in ICP in the elevated positions. These data suggest that head position influences ICP significantly in the neonate probably due to venous congestion caused when the neck is turned, and hydrostatic pressure changes when the head of the bed is elevated. ICP fluctuations due to changes in head position may be deleterious to the infant at risk for intracranial hemorrhage (ICH) or cerebral edema. PMID- 6851602 TI - Long-term management of diaphragmatic paralysis complicating prosthetic valve replacement. AB - The exact incidence of diaphragmatic paralysis complicating secondary heart procedures is not known. The postoperative period can be complicated by difficulty in weaning from mechanical ventilation and misinterpretation of the clinical signs of respiratory muscle fatigue for congestive heart failure and acute bronchospasm. We present 3 patients, all of whom had right diaphragmatic paralysis and recurrent respiratory failure after a second mitral valve replacement. Long-term management with night-time ventilation in 2 patients resulted in no further episodes of respiratory failure and physical rehabilitation with exercise tolerance significantly greater than the preoperative state. PMID- 6851603 TI - The relation of conjunctival PO2 to capillary bed PO2. AB - A polarographic oxygen sensor in contact with the palpebral conjunctiva makes a measurement of oxygen tension related to that in the underlying capillary bed but not equal to it. A mathematical analysis based on the equation describing oxygen diffusion in an oxygen-consuming tissue indicates that the measured oxygen tension will be 5-10 torr below that in the capillary bed. PMID- 6851604 TI - Dose of thiopental, pentobarbital, and phenytoin for maximal therapeutic effects in cerebral ischemic anoxia. AB - Recent interest in pharmacotherapy for various cerebral insults with potentially dangerous drugs, such as barbiturate anesthetics, has created a need to determine the lowest or optimal dose resulting in maximal therapeutic effects. Our earlier studies suggested that whole brain free fatty acid (FFA) accumulation during complete global ischemia reflects the evolution of brain damage. Various drugs effective in ameliorating ischemic brain injury were also effective in attenuating FFA accumulation. The degree of attenuation by a given drug at various doses may indicate the optimal dose. We studied the attenuation of whole brain FFAs (i.e., 20:4, 18:0, 18:1, and 16:0) by 15-120 mg/kg of thiopental or pentobarbital, or 50-300 mg/kg of phenytoin or ketamine intraperitoneal (IP), during 10-min decapitation ischemia in rats. Plasma and brain drug levels were measured except ketamine. Maximal attenuation of FFAs occurred at pentobarbital, thiopental, and phenytoin doses of 15, 30, and 150 mg/kg IP reducing total FFA by 18, 22, and 31%, respectively. These results indicate that maximal therapeutic effects are obtained at subanesthetic doses of barbiturates and at the anticonvulsant dose of phenytoin. PMID- 6851605 TI - Thermodilution cardiac output measurements by injection in pulmonary artery vs CVP catheter. AB - Thermodilution cardiac output (CO) measurements are compared after liquid injection in the pulmonary artery (PA) catheter and CVP catheter. No significant differences were found. When the proximal lumen opening of the PA catheter is clogged, CO measurements can still be obtained after injection in the CVP catheter. PMID- 6851606 TI - Continuous drug infusions in children: a table for simplifying calculations. PMID- 6851607 TI - NIH consensus Development Conference on critical care medicine. PMID- 6851608 TI - Long-term barbiturate infusion to reduce intracranial pressure. AB - We report two cases of children, 7 and 14 yr old, in whom prolonged infusion of thiopental sodium (TS) was used to control intracranial hypertension previously unresponsive to conventional therapy. Intracranial hypertension followed removal of a large tumor in 1 case, and trauma in the other. TS was administered at a rate of up to 7 mg/kg . h for 8 days in 1 patient, and up to 12 mg/kg . h for 10 days in the other. Both children regained consciousness and made significant recovery of neurological function. The advantage and the side-effects of the prolonged use of TS for intracranial hypertension are discussed. PMID- 6851609 TI - Effects of methylprednisolone on P50. PMID- 6851611 TI - Evaluation of congenital hip dysplasia and tibial torsion by computed tomography. AB - We have performed over 200 examinations in children with congenital dislocation of the hip during a 3-year period. From this experience, we conclude that computed tomography is useful in the evaluation of: (a) concentricity of closed reduction; (b) obstacles to closed reduction, such as infolding of the capsule, secondary to a tight iliopsoas tendon; (c) femoral torsion; (d) intraarticular obstacles contributing to persistent subluxation, such as (1) hypertrophy of the pulvinar, (2) intraarticular soft-tissue interposition, and (3) iatrogenic obstacles, such as metallic pins penetrating into the joint space; and (e) acetabular configuration, specifically (1) anterior or posterior lip of the acetabulum, (2) capacity of the acetabulum, and (3) acetabular torsion. PMID- 6851610 TI - Technical consideration of synchronized chest tube occlusion in bronchopleural fistula. PMID- 6851614 TI - On the necessity of in-house computed tomography in children's hospitals. PMID- 6851612 TI - Aggressive fibromatosis in childhood. Computed tomographic findings in three patients. AB - Three children with aggressive fibromatosis are presented and the value of computed tomography in defining the extent of the lesions and for follow-up and treatment planning is discussed. Aggressive fibromatosis is a nonmetastasizing fibrous lesion with a propensity for local invasion and recurrence after surgery. The lesions usually have a poorly defined margin on computed tomography and the attenuation coefficient is less than that of muscle with poor enhancement following intravenous administration of contrast material. PMID- 6851613 TI - Computed tomography and lymphogram correlation in children with Hodgkin's disease. AB - In 17 children with Hodgkin's disease, abdominal computed tomography (CT) and bipedal lymphangiography findings were correlated in an attempt to assess the accuracy of CT in excluding the presence of retroperitoneal and pelvic lymphadenopathy. There was excellent correlation in 14 (82%) patients. In 13 of these, both studies were negative; in one, enlarged nodes were noted in the pelvis on both studies, which otherwise revealed no abnormality in the remainder of the abdomen. In one other patient, CT revealed lymphadenopathy high in the abdomen and these nodes were not filled with contrast medium at lymphangiography. Lymphangiography revealed pelvic lymphadenopathy in 2 (12%) patients in whom the CT scan was initially interpreted as normal. If strict attention is paid to adequate opacification of the bowel and retroperitoneal vasculature, CT is an accurate modality for excluding retroperitoneal and pelvic lymphadenopathy, particularly in older children. PMID- 6851616 TI - Posttraumatic hemorrhage into the gallbladder. PMID- 6851615 TI - Role of computed tomography and ultrasound in neonatal brain imaging. AB - Neonatal brain imaging has had a tremendous impact on neonatal care with the introduction of computed tomography and ultrasound to noninvasive study of the neonatal brain. Improved obstetrical and neonatal care have saved many premature infants, resulting in an increased incidence of central nervous system hemorrhagic and hypoxic brain damage in those very-low-birthweight infants who are at greatest risk for intracranial hemorrhage. The evaluation of the neonatal brain can best be done by an understanding of the relative merits of computed tomography and ultrasound as imaging techniques. This report demonstrates the ability of each modality in specific lesions and recommends a basic approach to neonatal care based on the most likely lesion. PMID- 6851617 TI - National culture vs professional culture: a comparative study of psychiatric educators in two countries. AB - A survey of the literature in medicine and in comparative education finds virtually no reports of systematic studies of professional education across national boundaries. This paper describes the use of the Priority Sort of Educational Objectives in Mental Health with samples of psychiatric and psychiatric nurse educators in the United States and South Korea. The data suggests a somewhat different pattern of cultural influences in professional education priorities between these disciplines in the two countries. The relative impact of the culture of a profession and of national culture are examined through the data generated on these populations of educators in two culturally dissimilar countries. Despite these differences of culture there has been a great impact of professional education from one country to the other. The resulting data suggest a stronger impact of professional culture with one profession, psychiatry, and a greater impact of national culture with the psychiatric nurse educators. PMID- 6851618 TI - The logic of noncompliance: management of epilepsy from the patient's point of view. AB - Studies of patient compliance with medical regimens reveal that one-quarter to one-half of patients act at variance with their physician's suggestions. Using anthropological methods of long-term participant observation, seven epileptic patients were intensively studied for ten months in a variety of social contexts, including visits to health resources. Their conceptions of proper management of epilepsy were elicited, and their communication of these conceptions to providers of health care was observed. Although most of these patients were noncompliant, no single pattern of noncompliance encompassed their behavior as a group, and some of them had more than one drug consumption strategy. Furthermore, some patients were found to be noncompliant with biomedical regimens, yet actively and consistently pursuing alternative regimens. A range of such alternative therapies were identified both for low-income and middle-income patients. These case histories suggest that patients actively assess the quality of care given by their providers of health care. From the patient's point of view, biomedical strategies form one facet of many coping mechanisms in the management of epilepsy. PMID- 6851620 TI - Urine specific gravity measurements: comparison of a new reagent strip method with existing methodologies, as applied to the water concentration/dilution tests. AB - A study was carried out to compare a new, unique chemical strip test for the measurement of urine specific gravity with the traditional methods of hydrometry and refractometry, during water concentration/dilution tests in 12 normal subjects. The pattern of specific gravity results during these serial measurements was virtually identical for the strip and for the comparative methods. Comparison of the strip results with those obtained by both hydrometry and refractometry produced acceptable linear regression data. In addition, a close relationship was demonstrated between the strip specific gravity and urine osmolality. The findings show that the strip method is an acceptable alternative to traditional methods as an indicator of urine concentration. PMID- 6851619 TI - The use of nonprescribed treatments by hemodialysis patients. AB - In an attempt to examine the extent to which a specific chronically ill population might be engaged in self care through the use of nonprescribed treatments, 230 adult hemodialysis patients in Hawaii were interviewed. Information about the use of various treatment methods was correlated with sociodemographic characteristics, and the chi-square test of significance was applied to selective findings. Within this multiethnic patient population, 74% indicated they had tried one or more nonprescribed treatments for their kidney failure, and the majority of individuals judged their efforts to be effective. Ethnicity was not a significant determinant in the tendency to use nonprescribed treatments, although it influenced the selection of specific methods. Other sociodemographic characteristics were also found to be of minimal value as predictors of this type of help seeking behavior. The illness experience itself overrides many of the sociocultural factors in this study. PMID- 6851621 TI - Pharmacokinetics and pharmacodynamics of drug delivery. AB - The complex pharmacokinetics that promote transit of a drug from ingestion to elimination are characterized by variability. The rate and degree to which a drug undergoes absorption, distribution, biotransformation and excretion are a result of both endogenous and exogenous factors, some of which can be predicted, many of which cannot. One of the greatest problems associated with conventional drug formulations has been the dose-related appearance of side-effects that often accompany the initial surge of drug release. Drugs with short half-lives or narrow therapeutic ratios may alternately produce over-medication and under medication in a patient. Innovations in drug form design have resulted in a new precision-release formulation that permits zero-order steady state drug release. Sodium indomethacin trihydrate ('Osmosin') is the first drug to be contained within this new precision-release formulation which approaches the objective of delivering drugs at a therapeutically optimal rate. PMID- 6851622 TI - Evolution and design of 'rate controlled' osmotic forms. AB - A new type of therapeutic system, the precision release osmotic form, has recently been developed. This new dosage form has been referred to in other publications as the gastro-intestinal therapeutic system (GITS). Its action is based on the principles of osmosis as a means of delivering precise amounts of drug over prolonged periods of time. The precision release form has evolved from a prototype design through a simplification and miniaturization process into the elementary osmotic pump, a simple, elegant delivery form that permits controlled drug release by osmosis. Sodium indomethacin trihydrate is the first drug to be incorporated into this precision release form ('Osmosin'). Comparisons with conventional drug forms have shown 'Osmosin' to produce more sustained and constant drug release profiles, thus aiming to improve the therapeutic applicability of a drug through a reduction in dose-related side-effects and allowing once-daily dosing. PMID- 6851623 TI - The evolution of precision drug delivery. AB - Controlled-release formulations can enhance a drug's efficacy, safety, and duration of activity by regulating the rate and extent of drug release. 'Osmosin' (sodium indomethacin trihydrate) incorporates a newly developed osmotic system for oral administration. It is designed to release precisely a solution of drug at a predetermined rate into the gastro-intestinal lumen. Drug dissolution is programmed by the form itself and is independent of gastro-intestinal variables such as pH and motility. In vitro testing of this oral precision-release dosage form has been paralleled by a high degree of in vivo predictability. Certain drugs are better candidates for oral precision-release systems than others. Indomethacin is particularly well suited for incorporation into such a system. Comparisons with conventional drug forms have shown 'Osmosin' to produce more sustained and constant drug release profiles. PMID- 6851624 TI - Innovations in drug delivery systems. AB - The history of pharmaceuticals has reflected a concern with the development of new chemical entities. Only recently has the importance of dosage form design been recognized as a vital component of effective therapy. Not only has the time and expense involved in the research of the new molecules escalated dramatically, but it has been discovered that many of these products might be improved through incorporation in rate-controlled dosage forms. Conventional formulations have provided vehicles with which to introduce agents into the body. New therapeutic systems offer great versatility since they permit localized treatment of specific tissues, sophisticated methods of animal experimentation, and controlled-release methods for systemic delivery. These new dosage forms are diverse, precise, and adaptable in many therapeutic situations. A membrane-controlled gastro-intestinal therapeutic (GIT) system resembling a conventional tablet in external appearance has recently been developed. This system is designed for the constant, controlled release over a period of 10 to 12 hours of drug in solution and uses osmotic activity as the source of energy. The GIT system, as used for 'Osmosin' (sodium indomethacin trihydrate), differs from conventional sustained-release and other controlled-release dosage forms in that the rate of release is not dependent upon pH to release the medication and is designed, therefore, to overcome the problems associated with unpredictable release patterns. PMID- 6851625 TI - Biopharmaceutical evaluation of 'Osmosin'. AB - 'Osmosin' is an osmotically-controlled oral drug delivery system which presents a saturated solution of sodium indomethacin trihydrate (105.4 mg), equivalent to 85 mg indomethacin, to the gastro-intestinal tract at a constant rate of 7 mg per hour, with a release time of 10 to 12 hours. Drug delivery is not influenced by pH or gastro-intestinal motility. The bioavailability and functionality of 'Osmosin' have been studied after single-dose and after repeated administrations in man. Its performance was compared to that after intravenous administration and various capsule regimens of indomethacin. In both studies, comparable urinary excretion and renal clearance for all oral regimens indicated that like amounts of drug were available for absorption from 'Osmosin' and 'Indocid' capsules. This comparability was verified by the fact that indomethacin is 85% bioavailable from 'Osmosin' compared to intravenous or oral regimens (75 mg given as one dose of 3 X 25 mg capsules or 25 mg 3-times). Drug is absorbed at a constant rate for about 4 hours after 'Osmosin' administration. Indomethacin plasma profiles on an 'Osmosin' 12-hourly regimen were different from typical indomethacin capsule regimens (25 mg at 0, 4, 8 hours; 75 mg at 12 hours or 50 mg at 0, 4 and 14 hours daily). Indomethacin plasma levels from 'Osmosin' were more uniform and sustained, demonstrating more even distribution of drug with time. The constant rate delivery of sodium indomethacin trihydrate to the gastro-intestinal tract from 'Osmosin' controls the rate of drug absorption, prolongs the effective half life of drug in plasma, does not inhibit the efficiency of absorption, but does significantly decrease the extremes in plasma level fluctuation noted with conventional dosage forms. PMID- 6851626 TI - Nutrition and drugs. PMID- 6851628 TI - Use of topical fluoride by patients receiving cancer therapy. PMID- 6851627 TI - Lipid-lowering drugs and low-fat diets. PMID- 6851630 TI - Small intestinal obstruction secondary to intraabdominal abscesses. PMID- 6851629 TI - Resection of tumors of the chest wall. PMID- 6851631 TI - Construction of a competent phonatory neoglottis using cervical skin flaps. PMID- 6851633 TI - Genital candidiasis. PMID- 6851632 TI - Gastric carcinoma after peptic ulcer surgery. PMID- 6851634 TI - Alopecia. II. Trichotillomania (trichotillohabitus). PMID- 6851635 TI - Pigmented purpuric lichenoid dermatitis of Gougerot-Blum mimicking Kaposi's sarcoma. AB - A case of pigmented purpuric lichenoid dermatitis of Gougerot-Blum is presented and the pertinent literature is reviewed. This case is unusual in that the lesions were unilateral and very limited in extent. The patient presented with a localized pigmented purpuric eruption of plaques on the dorsum of one foot which mimicked Kaposi's sarcoma. However, a biopsy confirmed the diagnosis of pigmented purpuric lichenoid dermatitis of Gougerot-Blum. PMID- 6851636 TI - Metastatic breast cancer in the eyelid. AB - Atypical cutaneous lesions in women following cancer of the breast should be biopsied to rule out the possibility of metastasis to distant cutaneous sites. An unusual location should not change the logical approach to diagnosis. PMID- 6851637 TI - Diseases of Hawaii. PMID- 6851638 TI - Criteria for the diagnosis of staphylococcal scalded skin syndrome in adults. AB - The diagnosis of staphylococcal scalded skin syndrome is usually made upon the bases of characteristic skin lesions and the isolation of toxin-producing staphylococci. However, these criteria are not always reliable. An adult patient with characteristic skin lesions was colonized with phage group 2 staphylococci. The patient was subsequently found to have a drug-induced toxic epidermal necrolysis. The criteria necessary for the diagnosis of staphylococcal scalded skin syndrome are reviewed. PMID- 6851639 TI - Steatocystoma multiplex. AB - A family with a four-generation history of steatocystoma multiplex is presented. The subject described had unusually large tumors on his scalp and forehead which were successfully excised and closed with skin grafts. PMID- 6851640 TI - Lipoatrophia semicircularis associated with an osseous cyst. AB - A 15-year-old woman developed an atrophic band on the anterior aspect of her left thigh. A homolateral tibial cyst had been diagnosed five years earlier. To the best of our knowledge, the association of lipoatrophia semicircularis and osseous cysts has, up to now, been unknown. PMID- 6851642 TI - Herpes zoster presenting as soft abdominal mass with obstipation. PMID- 6851646 TI - Biopsy methods for melanoma. PMID- 6851641 TI - Penile tourniquet syndrome. AB - A 2 1/2-year-old boy was examined because of swelling of the penis of six weeks' duration. Several strands of hair wrapped around the penis and buried under the epithelium were found to cause a constriction. The penile tourniquet syndrome should be suspected whenever the penis is swollen, especially in children, even if a foreign body is not visible. PMID- 6851643 TI - Granuloma gluteale infantum. PMID- 6851644 TI - Yellow nail syndrome. PMID- 6851647 TI - Lupus erythematosus arising in striae distensae. AB - A 21-year-old man with systemic lupus erythematosus presented with a prominent inflammatory dermatitis confined primarily to steroid-induced striae. To the best of our knowledge, this cutaneous manifestation of lupus erythematosus has not been previously reported. Koebner's phenomenon is suspected to be the underlying mechanism. PMID- 6851645 TI - Letterer-Siwe disease with nail involvement. PMID- 6851649 TI - Thyroid carcinoma presenting as a solitary skin metastasis. PMID- 6851648 TI - Penile premalignant fibroepithelioma of Pinkus. AB - A 63-year-old man with a premalignant fibroepithelioma of Pinkus on the base of his penis is presented. Penile premalignant fibroepitheliomas have not, to the best of our knowledge, been previously described. Because fibroepithelioma of Pinkus is a morphological variant of a basal cell epithelioma, we believe that clinically benign fibroma-like lesions appearing on the penis should be biopsied to rule out the presence of this premalignant lesion. PMID- 6851650 TI - Syphilis: a cause of fever of unknown origin. AB - A homosexual man presented with a persistent high fever and a pruritic maculopapular eruption. All symptoms abated following penicillin treatment. Physicians should be aware that syphilis may present as a fever of unknown origin. PMID- 6851651 TI - Disciform erythrasma. AB - A case of disciform erythrasma is presented. This unusual manifestation of a common cutaneous infection may mimic other dermatologic disorders, including lichen sclerosus et atrophicus and plaque-type parapsoriasis. The condition is characterized by an atrophic appearing surface, located in nonintertriginous areas. Appropriate diagnostic procedures easily differentiate disciform erythrasma. These include Wood's light examination, potassium hydroxide preparation, and skin scrapings or tissue sections stained with Gram stain, periodic acid-Schiff, Giemsa, or methylene blue. PMID- 6851654 TI - Umbilical metastasis as the presenting sign of pancreatic adenocarcinoma. PMID- 6851652 TI - Injectable collagen: a clinical overview. AB - Injectable bovine collagen is extremely effective in the correction of contour defects of the skin due to scarring and age-induced rhytides and folds. The rate of adverse reactions is low. Of 5,109 patients treated in clinical trials, 1.3 percent experienced temporary local inflammation at the site of injection. Techniques of injection and proper patient selection are presented. Repeat implantations at intervals of six to twenty-four months are often required to maintain full correction of cutaneous contour defects. PMID- 6851653 TI - A retrospective study of 375 patients with genital herpes simplex infections seen between 1973 and 1980. AB - A retrospective survey was performed to study the clinical course of 375 patients with genital herpes simplex infections seen between 1973 and 1980. Genital herpes simplex is increasingly being recognized as a disease of the affluent middle class. Recurrences in this study were most frequently associated with emotional stress (85.9 percent) and by coital friction (66 percent). The enormous psychological burden of this disease resulted in 42 percent of the patients withdrawing from sexual encounters. The study suggests a relatively low index of communicability (25.3 percent) to sexual partners even though neither topical nor systemically administered therapeutic agents seemed to significantly influence the course of disease. When curves were constructed based on patients' statements as to when they experienced a period of protracted remission from disease, 50 percent of those with genital herpes simplex were found to be essentially free of frequently recurring episodes within seven years after the onset of disease. PMID- 6851655 TI - Comparison of amcinonide ointment 0.1 percent twice daily and fluocinonide ointment 0.05 percent three times daily in the treatment of psoriasis. AB - Thirty-nine patients with psoriasis were treated either with amcinonide ointment 0.1 percent twice a day or with fluocinonide ointment 0.05 percent three times a day in a two-week, randomized, parallel-group, double-blind study. The severities of the skin lesions at baseline and at weekly intervals and the overall improvement at weekly intervals were evaluated by the investigator and the patient. The skin lesions improved significantly (p less than or equal to 0.01) over their condition at baseline, with good overall improvement attained by both treatment groups within one week. Both treatments were well tolerated. Amcinonide ointment 0.1 percent applied twice a day was found to be as effective and acceptable to patients as was fluocinonide ointment 0.05 percent applied three times a day in the treatment of psoriasis. PMID- 6851656 TI - Variation between homologues and sister chromatids in individual karyotypes. AB - Chromatid absolute length and density profile from electron micrograph images of human group A chromosomes were studied in an attempt to identify significant individual karyotypic variation. The variation within sister chromatids can be utilized as an internal standard to establish a limit of variability for the purpose of demonstrating differences between homologues. Homologous chromosomes were found to differ with respect to absolute length and density profile. PMID- 6851657 TI - Annular structures in erythrocyte membranes of various animal species as revealed by electron microscopy. AB - Electron microscopic examination of negatively stained erythrocyte membranes revealed the presence of annular structures having an overall diameter of 33 nm and a ring-thickness of 9 nm. Each annular structure appeared to be composed of eleven globular subunits. The structures were most conspicuous in human erythrocyte membranes which showed, on the average, 160 per membrane. Appreciably smaller numbers of what appeared to be the same structures were seen in erythrocyte membranes derived from rhesus monkey, cat, guinea pig, rabbit, horse, dog and chicken. None at all could be found in erythrocyte membranes from sheep, deer, goat and ox. The size and shape of these structures readily distinguishes them from ring-like entities whose formation is induced by treatment of membranes with a variety of haemolytic agents. PMID- 6851660 TI - A rapid cell culture technique for assessing the toxicity of detergent-based products in vitro as a possible screen for eye irritancy in vivo. AB - It is generally accepted that the Draize rabbit eye irritation test has several disadvantages and inadequacies when used as an indicator for potential irritancy of detergent-based commercial products. In the search for a possible in vitro screen, it was decided to use mouse LS cells in suspension, taking 50% cell death (CD50) after exposure to the product for 4 h as the endpoint. This result for eleven samples was compared with rabbit eye irritation data ranked on an arbitrary classification of mild, moderate and severe. All samples with a CD50 less than 0.5 mg ml-1 were severe eye irritants while, with one exception, all those with a CD50 greater than 1.0 mg ml-1 were mild irritants. Samples between these two cytotoxicity levels were, in general, moderately irritant to the rabbit eye. It would appear that the present in vitro test is a possible screen for the irritancy of detergent-based products. PMID- 6851658 TI - Cytogenetic effect of chlordiazepoxide on the bone marrow cells of Swiss mice in vivo. AB - Chromosomal preparations were examined for structural and numerical abnormalities induced by chlordiazepoxide (CDZ) in mice which received either a single oral dose (20 mg/kg) or multiple doses (10, 20, 40 and 80 mg/kg) for time-response and dose-response studies, respectively. The sampling was done at different post treatment hours. The structural aberrations recorded were mostly of the chromatid type. CDZ induced a significant increase in chromosomal aberration frequencies at all sampling hours with a peak at 32 h post-treatment. In dose-response studies all the dose groups showed a significant increase over controls but the effect was maximum at the lowest dose level. PMID- 6851659 TI - Fibronectin-like properties in antigen B from the cysticercus of Taenia solium. AB - The most prominent antigen of the cysticercus of Taenia solium in the serology of human cysticercosis, antigen B, is capable of agglutinating red blood cells of different species, of aligning in vitro cell growth of transformed mouse fibroblasts, and of strongly binding to pig, rat and human collagen. Scatchard analysis of the adsorption isotherms indicates quite avid heterogeneous binding of antigen B to rat collagen (K's = 10(3), 10(5)). These remarkable biological activities of antigen B, resembling those of fibronectins, allow for some speculation concerning its role in the host-parasite relationship (i.e. organizing vicinal host components to improve the parasite's lodging niche; the 'smoke screen' effect for the host's immune response; Clq inhibition), and expand fibronectin-like properties to molecules from Phyla other than vertebrates. PMID- 6851661 TI - Stimulatory protein kinase modulator, the cation-binding protein and megamodulin 2 preparation of cation complexes, occurrence of dissociated forms, interaction with basic protein, and probable modes of action. PMID- 6851662 TI - Changes in expressions of red blood cell antigens following gamma irradiation of chicken embryos. AB - Red blood cells (RBC) from chicken embryos receiving 450 R of gamma-irradiation on the 6th day of incubation displayed various differences from controls with respect to agglutination properties in the presence of antibodies for three blood group antigens as assayed over a period extending from 12 days of incubation to after hatching. An alloantigen (B21), which normally can be detected prior to 10 days of incubation, showed increased agglutinability following radiation exposure at 6 days. Likewise, an 'embryonic' blood cell antigen, which normally would decrease rapidly after 12 days of incubation, persisted in the blood of irradiated embryos. On the other hand, an alloantigen (B19), which normally appears only after 10 days of incubation, was severely depressed in cases where the embryos received 450 R of gamma-irradiation. The authors propose that in the first two instances gene activation (or induction) for the respective RBC antigens had been accomplished prior to radiation exposure, whereas in the last instance induction had not been accomplished prior to the radiation insult and the gamma-rays had strongly interfered with this process. PMID- 6851663 TI - Effects of environmental lead poisoning on the breast muscle of the Canada goose: an ultrastructural study. AB - Canada geese (Branta canadensis) showing symptoms of lead poisoning were collected from their natural habitat, and their pectoralis muscle was examined for ultrastructural changes. Both the red and white fibre types showed pathological changes. In some red fibres, there were prominent accumulations of glycogen granules, occasionally membrane-bound, at certain spots, and of lipid droplets. Glycogen and lipid were also located within mitochondria. When lipid droplets were sparse in a certain fibre, occurrence of fused mitochondria often with distorted cristae, was observed. Swollen mitochondria with disrupted cristae and dense intramitochondrial inclusions were present. Lysosomes and areas of mitochondrial degeneration were also seen. Dilatation of the terminal cisternae of the sacroplasmic reticulum and of the T-system was also observed in the red fibres. In the white fibres, enormous accumulations of glycogen granules were present and the cristae of mitochondria were often disrupted. In some white fibres the triads and Z-lines were in a state of severe disarray. The nuclei in both the fibre types appeared to be normal and did not contain the typical intranuclear inclusion bodies present in kidney and liver cells of lead poisoned animals and humans. It is suggested that, in the goose, lead has a diabetogenic effect, which in the breast muscle, is manifested in the large accumulations of glycogen and the disruption of glycolytic metabolism. Lead poisoning also affects mitochondrial structure and function leading to adverse effects on oxidative metabolism in the muscle. PMID- 6851664 TI - Toxicity of some charged lipids used in liposome preparations. AB - The inhibition of 3H-thymidine incorporation into DNA of L1210 cells in culture by liposomes was used as an index of liposome toxicity. Inhibition of 3H thymidine incorporation appeared to be dose dependent for some lipid compositions tested. The commonly used neutral lipids, phosphatidylcholine and cholesterol did not appear to inhibit 3H-thymidine incorporation. Phosphatidic acid, an adjunct for preparing anionic liposomes, appeared to be non-toxic compared to phosphatidylserine and dicetylphosphate (alternative adjuncts for preparing anionic liposomes). Stearylamine, a synthetic lipid which continued to dominate the preparation of cationic liposome was the most toxic of the lipids tested. PMID- 6851665 TI - A physical (electromagnetic) model of differentiation. 1. Basic considerations. AB - There are a number of biological phenomena and events that cannot yet be adequately described, such as cell growth and differentiation, which may be controlled by physical factors. Frohlich (1980) has discussed the principles of dissipative structures as applied to electromagnetic interactions in relation to basic couplings in biological systems. Recently, increasing evidence of photon storage and ultraweak photon emission from living systems, particularly from DNA, has suggested the concept of an electromagnetic model of differentiation, based on the known quantum optical properties of nucleic acids. This model has the advantage over all ideas so far published, that it is (1) simple; (2) universally applicable to events in living matter, because it is consistent with both the quantum mechanical and the thermodynamic properties on the one hand, and the known biological and biochemical data and phenomena at the other hand; (3) it not only describes the phenomena and events in terms of pure mathematical parameters, but it can also explain them; and (4) it escapes the difficulty of finding basic control mechanisms, which themselves do not need a regulator, ad infinitum. PMID- 6851666 TI - On the types of chromosomal aberrations induced by 8-methoxypsoralen. AB - When activated by near-ultraviolet light, 8-methoxypsoralen can react with pyrimidine bases to produce mono-adducts in DNA. Upon further irradiation these mono-adducts can be converted to interstrand crosslinks, but if the re irradiation is carried out in the absence of unbound 8-methoxypsoralen, no new mono-adducts can be formed. The effects of re-irradiation are, therefore, a consequence of the conversion of mono-adducts into crosslinks. Here we report the types of chromosomal aberrations produced by re-irradiation and, hence, by DNA crosslinks. Our results demonstrate that crosslinks induce a wide variety of chromosomal aberrations in the first division after treatment. In addition, crosslinks are shown to induce new aberrations in second-division cells, a result which shows that the crosslink or some lesion derived from it survives at least one round of DNA replication. PMID- 6851667 TI - A temperature sensitive mutant of a Chinese hamster cell line exhibiting high chromosomal breakage. AB - A temperature sensitive mutant exhibiting a very high level of chromosomal aberrations has been isolated from the Chinese hamster cell line E36. The chromosome aberrations, which include chromosome and chromatid breaks, multiradial configurations, dicentrics, and pulverizations, start to appear 1 h after a shift in temperature from 34 degrees C to 40.5 degrees C. The rate of sister chromatid exchange is not increased in this mutant. Analysis of somatic cell hybrids indicates that the mutation in this temperature sensitive mutant is dominant. PMID- 6851670 TI - Chromosomal homologies and phylogenetic relationships of the vespertilionid bat genera Euderma, Idionycteris, and Plecotus. PMID- 6851671 TI - A presumptive new hylobatid subgenus with 38 chromosomes. PMID- 6851668 TI - Comparative gene mapping of the owl monkey, Aotus, with karyotypes V (2n = 46) and VI (2n = 49, 50). AB - Biochemical analysis of cytogenetically defined rodent--owl monkey hybrid cell lines segregating owl monkey chromosomes allowed the assignment of 14 structural gene markers to seven owl monkey karyotype V (K-V, 2n = 46) chromosomes. Comparative study of assigned gene loci to chromosomes of owl monkey karyotype V (K-V, 2n = 46) and karyotype VI (K-VI, 2n = 49/50) provides the first evidence supporting some of the previously proposed mechanics of chromosomal rearrangements responsible for the great karyotypic diversity in owl monkeys. In addition, chromosome homologies deduced from gene loci of Aotus and other primates are compared here to determine the conservation or modification of chromosome morphology in the course of primate evolution. The data demonstrate the usefulness of gene mapping as an alternative to banding patterns for obtaining evidence on chromosome evolution. PMID- 6851669 TI - Molecular cytogenetics of the equidae. II. purification and cytological localization of a (G + C)-rich satellite DNA from Equus hemionus onager and cross species hybridization to E. asinus chromosomes. AB - A (G + C)-rich satellite DNA component (p = 1.716 g/ml) has been fractionated from the total DNA of the Iranian subspecies of the Asiatic wild ass, Equus hemionus onager, by successive dactinomycin-CsCl and netropsin sulfate-CsCl isopycnic gradients. Complementary 3H-RNA (cRNA) transcribed from the satellite DNA hybridized predominantly to the centromeric and telomeric constitutive heterochromatic regions of onager chromosomes. These studies have suggested that satellite DNA's with similar sequences are present in the centromeric, as well as telomeric, heterochromatic regions of some onager chromosomes. The centromeric region of the fusion metacentric t(23;24) of the onager is deficient in sequences homologous to the onager 1.716 g/ml satellite DNA, indicating a loss of satellite DNA during fusion or an amplification of the satellite DNA in the centromeric regions of the acrocentric chromosomes 23 and 24 subsequent to fission. Sequences complementary to onager 1.716 g/ml satellite DNA show extensive hybridization to the constitutive heterochromatin of the feral donkey (E. asinus) karyotype, consistent with a view of conservation and amplification of similar or identical sequences in the two species. PMID- 6851672 TI - High-resolution banding by treating cells with acridine orange before fixation. PMID- 6851673 TI - DNA replication and sister chromatid exchange in 9qh+. AB - The frequency of sister chromatid exchanges (SCE's) in the euchromatin and heterochromatin of a human 9qh + chromosome was determined using the BrdU-Giemsa technique. The 9qh + region contained fewer exchanges than the euchromatin, and there was an excess number of exchanges at the junction of the euchromatin and heterochromatin of the long arm. BrdU incorporation and differential staining of sister chromatids showed that the heterochromatic region of the 9 was always the last region to replicate and was among the last areas of the whole human chromosome complement to complete replication. PMID- 6851675 TI - Synaptonemal complexes and the chromosome complement of domestic fowl, Gallus domesticus. AB - Synaptonemal complexes (SC's) were compared to their chromosomes by transmission electron microscopy (TEM) of whole-mount spreads from 42 male chickens. Individual macrochromosomal SC's were first identified in heterokaryotypes and later by their centromere index. For all nine macrochromosomes (eight autosomes and the Z sex chromosome), the relative length (rl) of each SC corresponded to that of its mitotic and meiotic chromosome, and the centromere position along each SC corresponded to that of its mitotic chromosome. An idiogram was constructed which included the 30 microchromosomes. The idiogram revealed a graded series of SC lengths with a 30-fold difference between the longest and the shortest SC. Microchromosomal SC's comprised 35% of the genome length. PMID- 6851674 TI - The chromosomes of Muntiacus feae. AB - The karyotype of a female Muntiacus feae is described. It comprises 13 chromosomes, three submetacentrics, and ten acrocentrics. Chromosome 1 is the sex chromosome. This individual was heterozygous for a Robertsonian translocation between chromosomes 2 and 7. PMID- 6851677 TI - Meiosis and spermiogenesis in a freshwater teleost fish, Channa punctatus (Bloch): an estimation of their duration by autoradiographic method. PMID- 6851676 TI - Non-random human chromosome distribution in human-mouse myeloma somatic cell hybrids. AB - The process of human chromosome segregation in human myeloma x mouse myeloma cell hybrids was investigated. The human myeloma cells were derived from two different patients. Fifty-eight independent hybrid lines were obtained. A representative number of cells from each line were karyotyped and isozyme markers for a number of the chromosomes retained were analyzed. Statistical analyses were performed on 113 cells from five different cell lines showing the largest complement of human chromosomes. A log-linear models approach to the statistical analysis was used to predict the expected chromosome segregation under a variety of assumptions concerning the dependency relationship between the pattern of loss and the specific chromosomes both within and between cell lines. Human chromosome segregation occurring after the hybrids were grown continuously in suspension for several months was also studied. Results indicated a statistically significant dependency among patterns of loss of specific chromosomes, with certain chromosomes preferentially retained and others lost more often than expected under the assumption of randomness of segregation. PMID- 6851678 TI - Hereditary coproporphyria and variegate porphyria in Denmark. PMID- 6851681 TI - A correlation study between acute toxicological data in animals and threshold limit values. PMID- 6851680 TI - Serum ferritin in healthy Danes: relation to marrow haemosiderin iron stores. PMID- 6851679 TI - Familial myoglobinuria. A study of muscle and kidney pathophysiology in three brothers. PMID- 6851682 TI - Effect of intra-arterial administration of acetaldehyde on pig pancreas. PMID- 6851683 TI - The ACCP Council on Critical Care. PMID- 6851684 TI - Bronchoscopy for endoscopically visible carcinoma of the lung. PMID- 6851685 TI - Educating tomorrow's chest physician. An international challenge. PMID- 6851686 TI - Increased prevalence of HLA-Aw19 and of the phenogroup Aw19,B18 in advanced silicosis. AB - The frequencies of HLA antigens in 27 patients with silicosis were compared with those of referents matched for exposure to silica dust, age, and sex, and having no roentgenographic signs of silicosis. A group of 900 blood donors served as an additional reference group. The prevalence of HLA-Aw19 was higher in the silicosis patients (29.6 percent) than in the silica-exposed referents (3.7 percent; p = 0.02). In turn, the frequency of Aw19 in the unexposed population consisting of blood donors (19.6 percent) was higher than that of silica-exposed referents (p = 0.04). Accepting that the prevalences of HLA antigens in the blood donors fairly well describe those of the silica-exposed population, the highest risk of developing advanced fibrosis was associated with the phenotypic combination Aw19,B18 (observed-expected ratio = 17.05; p less than 0.01). The results suggest that HLA-Aw19 and the haplotype Aw19,B18 are, at least in Finnish population, associated with a progression into advanced silicotic fibrosis. PMID- 6851687 TI - Exercise testing early after myocardial infarction. AB - A consecutive series of 179 survivors of acute myocardial infarction had a symptom-limited 12-lead electrocardiographic treadmill exercise test, coronary angiographic studies, and left ventriculograms six to eight weeks after infarction. The exercise-induced ST-segment responses were correlated with the presence of multivessel disease, the presence of advanced left ventricular wall motion abnormalities (LVWMA), and ejection fraction. Each type of ST-segment response in patients after infarction has its own specific predictive value. ST segment depression indicated multivessel disease. ST-segment elevation indicated advanced LVWMA and low ejection fraction. Concomitant ST-segment depression and ST-segment elevation indicated both multivessel disease and advanced LVWMA. PMID- 6851688 TI - The accuracy and response characteristics of a simplified ear oximeter. AB - We evaluated the accuracy and speed of response of a newly available, lightweight, and relatively inexpensive ear oximeter (Biox II oximeter). The instrument was compared with another oximeter (Hewlett-Packard 47201A) under conditions of both steadily maintained and progressively increasing hypoxia induced in normal subjects by rebreathing. The new oximeter (Biox II), which can be operated in either a "normal" or "fast" response mode, as selected by a switch on the front panel, was evaluated in its "normal" mode during steady-state hypoxic conditions and in both "normal" and "fast" modes during progressive hypoxic conditions. The other oximeter (HP 47201A) was operated in its factory preset "normal" mode for all measurements. During steady-state hypoxia the relationship between oximetric arterial oxygen saturation (SaO2) readings (y) and spectrophotometrically measured SaO2 in samples of arterial blood (x) when SaO2 exceeded 65 percent was as follows: for the new oximeter (Biox), y = 0.95x + 3.25 (r = 0.96); and for the other oximeter (HP 47201A), y = 1.03x - 2.31 (r = 0.94). Neither of these relationships differed significantly from the line of identity. During trials of progressive isocapnic hypoxia induced acutely in ten normal subjects, SaO2 was measured continuously by both oximeters. With the new oximeter (Biox) operated in the "normal" mode, the relationship between values for SaO2 from it (y) and the other oximeter (Hewlett-Packard) (x) was y = 0.85x + 12.91 (r = 0.93). When the new oximeter (Biox) was switched to its "fast" response mode, the relationship more closely approximated the line of identity such that y = 1.05x - 5.95 (r = 0.98). The response of the new oximeter (Biox II) to an in vitro step change in saturation followed a complex nonexponential function characterized by small initial changes in output signal with the greatest changes in output occurring during the latter portion of the response period. The 50 percent response times of the new oximeter (Biox II) were 5.65 seconds and 2.86 seconds in the "normal" and "fast" modes, respectively, by contrast to the 50 percent response time of 2.87 seconds for the other oximeter (H-P 47201A). We conclude that the new oximeter (Biox II) demonstrated accuracy comparable to a more complex and expensive oximeter and had response characteristics that may be useful in clinical and laboratory settings. PMID- 6851690 TI - Elastin fibers in the sputum of patients with necrotizing pneumonia. AB - We have observed five patients for whom the presence of fibers of elastin in potassium hydroxide (KOH) preparations of sputum represented the first evidence of necrotizing pulmonary disease. In four cases, the discovery of elastin fibers in sputum provided additional evidence supporting initiation or modification of antibiotic therapy. Necrotizing disease was confirmed in all cases by autopsy or by the development of cavitation on chest x-ray film. Cytochemical staining, electron microscopy, and elastase digestion all suggest that the refractile fibers seen on KOH wet mount of sputum are elastin. The test, first described in 1846, is simple to perform, requires little experience to read, and may be a valuable adjunct to the chest roentgenogram in the diagnosis of pulmonary parenchymal destruction. PMID- 6851691 TI - Rapid increase of the incidence of lung disease due to Mycobacterium kansasii in Japan. AB - Until 1977, the incidence of lung disease due to Mycobacterium kansasii in Japan was as low as 0.11 or fewer per 10(5) people per year. It began to increase from 1978, reaching 0.33 per 10(5) people per year in 1981. In contrast, the incidence of lung disease due to the M avium-M intracellulare complex was 1.22 to 1.69 per 10(5) people per year from 1977 to 1981. In 1977, the fraction of the disease due to M kansasii in all atypical mycobacterioses was 6.9 percent, while in 1981 it increased to 19.5 percent. Concurrent with this increase, the disease spread all over west Japan, although until 1977 the disease had been restricted almost entirely to Tokyo and its environs. This change of the epidemiologic state of atypical mycobacteriosis seems to be related to the decrease of the incidence of lung tuberculosis. PMID- 6851693 TI - Intra-aortic balloon counterpulsation in an experimental model of myocardial infarction. AB - The efficacy of intra-aortic balloon counterpulsation for heart failure during acute myocardial infarction has been controversial, and early intervention has been suggested as crucial. We have examined this type of therapy in the intact anesthetized dog during complete occlusion of the proximal left anterior descending coronary artery with a balloon-tipped catheter. Group 1 (n = 8) represented untreated animals undergoing four hours of ischemia. Group 2 (n = 7) consisted of animals undergoing counterpulsation with an intra-aortic balloon after 15 minutes of ischemia. Initially, stroke volume and the mean rate of left ventricular fiber shortening were similarly diminished in both groups, while filling pressure rose proportionately. After four hours, the mean rate of fiber shortening, stroke volume, and left ventricular filling pressure rose to a greater extent in untreated compared to treated animals (p less than 0.01). The degree of swelling in ischemic tissue and the number of sites with ST-segment elevation and their sums were comparable in the two groups. Thus, intra-aortic counterpulsation applied early in the course of ischemia can improve global left ventricular dysfunction without affecting the extent of myocardial injury. PMID- 6851692 TI - Cardiogenic shock. AB - The definition, pathophysiology, and diagnosis of cardiogenic shock are presented. Its management is detailed, including specific forms of therapy for the various subgroups of patients in whom cardiogenic shock is an integral part. The choice of patients for and results of circulatory support using the intra aortic balloon pump followed by early cardiac surgery are presented. The importance of treating hypovolemia, when present, and recognizing cardiogenic shock, a result of right ventricular infarction, is stressed. Early and late prognoses are given. Although the prognosis still remains grave, early aggressive therapy along the lines outlined often succeeds in reducing a mortality rate that otherwise is unacceptably high. PMID- 6851694 TI - Roentgenogram of the month. Bronchial obstruction due to a calcified mass. PMID- 6851689 TI - Radiation-related chronic heart disease. AB - Three cases of radiation-related chronic heart disease are reported. All three patients had been treated for Hodgkin's disease with a mantle technique six to ten years earlier. Ten years after radiation treatment, a 34-year-old woman had dyspnea during exercise. Her heart was enlarged, and an ECG showed a RBBB. An echocardiogram showed pericardial effusion. Right-sided catheterization revealed an infundibular stenosis. A 31-year-old man had chest pain nine years after radiation. An ECG showed complete RBBB and an exercise stress test signs of ischemia; a coronary angiogram showed three proximal stenoses; and an echocardiogram revealed pericardial effusion. A 12-year-old boy had angina pectoris six years after radiation; one year later, he suffered an acute posterior infarction. Two weeks later he died suddenly. An autopsy showed a severe fibrotic and calcified narrowing of the proximal part of the left main coronary artery. Regardless of the patient's age, radiation-related cardiac complications must be kept in mind. Echocardiograms and, in cases of chest pain, exercise stress tests should be a part of routine postradiation follow-up. PMID- 6851695 TI - Electrocardiogram of the month. Noninvasive diagnosis of dual AV nodal pathways with inability to participate in reentrant tachycardia. PMID- 6851697 TI - Aortico-right ventricular shunt following aortic valve replacement. AB - A 58-year-old man developed cardiac decompensation following aortic valve replacement as a result of an aortico-right ventricular fistula. Serial hemodynamic and electrocardiographic changes are presented. Attention is drawn to this rare complication as a cause of hemodynamic deterioration following aortic valve surgery. PMID- 6851699 TI - Contralateral effusions secondary to subclavian venous catheters. Report of two cases. AB - Two cases of contralateral pleural effusions due to indwelling central venous catheters are presented. Radiographic contrast studies were performed to elucidate diagnosis and to define the mechanism of this complication; mediastinal leakage was documented in one case. PMID- 6851698 TI - Necrotizing fasciitis as a complication of tube thoracostomy. AB - Necrotizing fasciitis is a serious, rapidly progressive infection of subcutaneous tissue and fascia, most often related to trauma or surgery. We report a case of necrotizing fasciitis which occurred as a complication of tube thoracostomy. Physicians performing tube thoracostomy should be aware of this potential complication, since definitive treatment requires not only antibiotic therapy, but also surgical debridement. PMID- 6851701 TI - A combined atrial/ventricular lead for permanent dual-chamber cardiac pacing applications. AB - A new urethane insulated dual unipolar atrial/ventricular transvenous lead has been developed to facilitate implantation of permanent dual-chamber cardiac pacing systems in man. The atrial portion of the lead has tines and is designed to retain a permanent J configuration, while the coaxially situated ventricular lead is freely and independently adjustable and incorporates a ring tip electrode with four urethane tines. Our initial experience with the dual lead in one patient is reported herein and suggests that combined atrial/ventricular pacing leads are feasible and may obviate need for implantation of two separate pacing electrodes in patients being considered for permanent dual-chamber pacing. PMID- 6851702 TI - A new treatment modality for pneumoperitoneum associated with mechanical ventilation. PMID- 6851700 TI - Rupture of the left main-stem bronchus with a polyvinylchloride double-lumen tube. AB - Double-lumen tubes have proved to be a useful adjunct in thoracic surgery. Their use has become quite commonplace, particularly since the introduction of the softer polyvinylchloride (PVC) tubes, which are technically easier to use and may carry less risk for serious complications. Any such tube, however, can cause life threatening complications. We present a case with such a complication related to the use of a PVC double-lumen tube and make recommendations regarding the use of these tubes to minimize the risk of serious intraoperative complications. PMID- 6851696 TI - Echocardiographic demonstration of right atrial rupture in a patient with right sided cardiac tumor. AB - Two-dimensional echocardiographic evaluation of a young man with recent drainage of a hemorrhagic pericardial effusion revealed persistent fluid and a massive tumor involving the right atrium, tricuspid valve, and right ventricle. Echocardiographic demonstration of right atrial wall rupture was confirmed at surgery; pathologic analysis showed a spindle cell sarcoma. PMID- 6851704 TI - ARDS after local lidocaine administration. PMID- 6851706 TI - Weight loss in chronic obstructive lung disease. PMID- 6851705 TI - Noncardiac pulmonary edema. PMID- 6851703 TI - Sudden respiratory arrest from asthma. PMID- 6851708 TI - Recurrent spontaneous pneumomediastinum. The first reported case. PMID- 6851707 TI - The effect of ultrasonically nebulized distilled water on lung epithelial permeability. PMID- 6851709 TI - Needle in a haystack. PMID- 6851710 TI - A rapid, sensitive method for estrogen receptor analysis of cells from malignant pleural effusions in recurrent breast cancer. PMID- 6851712 TI - Infant crying and stability in the mother-infant relationship: a systems analysis. AB - Mother-infant interaction was studied using a general systems theory framework. 20 mother-infant pairs were observed in their home for a 7-hour period when the infants were 2, 3, 4, and 5 weeks of age. A measurement procedure was devised to assess, for each pair, the consistency over weeks in their allocation of time to 4 interactional contexts that make up the day: feeding, changing or bathing, social attention, and baby alone. The measure was called an Interactional Stability Score. Construct validity for this measure was investigated based on our hypothesis that high interactional stability would be strongly linked to low levels of crying during social attention. This hypothesis was confirmed. The results are interpreted within a general systems theory perspective--namely, that this measure of interactional stability is an empirical indicator of the degree of equilibrium within the relationship, at the level of patterning of interactional contexts. High stability scores represent consistency in allocation of time to the 4 contexts over weeks and not a rigidity in sequencing of these contexts, and thus appeared to reflect a dynamic process of mutual constraints on the behaviors of both partners. PMID- 6851713 TI - The emergence of spatial perspective taking: an information-processing alternative to egocentrism. AB - 120 children between ages 4 and 8 were administered a set of 4 visual perspective taking tasks similar to ones employed in previous investigations. It was hypothesized that children's competence with the tasks would be a function of the number and type of spatial relationships embedded in the stimulus displays. 2 kinds of spatial relationships were described: (1) internal relationships--those between objects within a display; and (2) external relationships--those between the display and a frame of reference. Of the 4 task types, type A tasks necessitated awareness of possible variations in external relations, types B and C tasks required both awareness and computation of changes in those external relationships, and type D tasks required simultaneous coordination of internal and external spatial relationships. It was predicted that the tasks would sequence in terms of difficulty level as A less than B, B = C, and C less than D. Analysis of variance results on the obtained data revealed a good fit with the hypothesized predictions. The findings were discussed in terms of an information processing analysis of children's performance on perspective-taking tasks. PMID- 6851711 TI - Interaction between Six-month-old peers. AB - 12 pairs of previously unacquainted 6-month-old infants were observed in both the presence and absence of toys. Interactive episodes that began when an infant touched the peer or a toy held by the peer were examined. The infants' immediate reactions to these events, which provoke conflict between toddlers, were neutral or positive. Furthermore, the patterns of occurrence of these behaviors indicated social influence over time: the outcome of 1 episode influenced the initiation of the next, and, when toys were present, 1 infant's tendencies to touch the peer and the peer's toys could be predicted from his or her partner's corresponding tendencies. The conclusion from previous research that in the absence of toys infants explore other infants needs further consideration: the frequency of peer contact when toys were absent was not reliably predicted by an infant's tendency to play with toys when they were present. It appears that the increase in peer contact that occurs in the absence of toys is mediated by corresponding increases in individual infants' gestural activity, which increases the likelihood of contact; however, gestural activity does not predict the initiation of contact when toys are present and does not predict an infant's tendency to reciprocate the peer's overture in either trial. PMID- 6851714 TI - Attentional inertia at four and seven months? AB - Anderson showed that, for TV watchers as young as 12 months, the probability of maintaining a look increases as the look progresses. Based on this finding, he hypothesized a previously unreported process, "attentional inertia," that he considered the conceptual obverse of habituation. Since the existence of such a process would profoundly affect theories of infant attention, the present research tested for evidence of attentional inertia in babies younger than 12 months. Data from 1 group of 7-month-olds and 3 groups of 4-month-olds who participated in previous studies were reexamined here. The main analysis involved the conditional probability of a look surpassing t sec given that the look had already surpassed t -- 3 sec. The conditional probabilities varied as a function of time similarly for the 4 groups: the first 6 sec but subsequently increased (supposedly evidence of attentional inertia). The increase, however, was attributable to 1 of 2 computational artifacts that were understandable in terms of habituation. Thus, no evidence of attentional inertia was found in these infants. PMID- 6851715 TI - Infants' cross-modal transfer from solid objects to their graphic representations. AB - 12-month-old infants were familiarized either tactually or visually with objects and then tested for visual recognition memory using either (1) the familiar and a novel object, (2) colored pictures of the objects, or (3) outline drawings of them. In Study 1, infants showed recognition memory on all 3 visual intramodal problems but showed cross-modal transfer only when objects were used as test stimuli. With increased familiarization times in Study 2, transfer from tactually presented samples to both pictorial displays was achieved, indicating that after feeling an object the infants were able to recognize it visually solely on the basis of its contour. With reduced familiarization times in Study 3, there was no evidence for transfer from visually presented samples to the 2 pictorial displays, replicating the pattern of results observed cross-modally in Study 1 and suggesting that, at least in certain respects, cross-modal and intramodal perception follow similar principles. PMID- 6851716 TI - Perception of numerical invariance in neonates. AB - 40 healthy, normal newborn infants were evaluated with reference to their ability to discriminate among visual stimulus arrays consisting of 2 versus 3 or 4 versus 6 black dots. Infants made this discrimination within a habituation/dishabituation paradigm for the small number sets (2 to 3 and 3 to 2) but not for the larger sets (4 to 6 and 6 to 4). We argue that this suggests the ability to abstract numerical invariance from small-set visual arrays and may be evidence for complex information processing during the first week of life. PMID- 6851717 TI - Newborn infants imitate adult facial gestures. AB - Newborn infants ranging in age from 0.7 to 71 hours old were tested for their ability to imitate 2 adult facial gestures: mouth opening and tongue protrusion. Each subject acted as his or her own control in a repeated-measures design counterbalanced for order of stimulus presentation. The subjects were tested in low illumination using infrared-sensitive video equipment. The videotaped records were scored by an observer who was uninformed about the gesture shown to the infants. Both frequency and duration of neonatal mouth openings and tongue protrusions were tallied. The results showed that newborn infants can imitate both adult displays. 3 possible mechanisms underlying this early imitative behavior are suggested: instrumental or associative learning, innate releasing mechanisms, and active intermodal matching. It is argued that the data favor the third account. PMID- 6851718 TI - Developmental differences in encoding length series. AB - Children ages 6-13 and college students had to remember length relationships for 3 pairs of sticks. In one task, 4 sticks (A, B, C, D) were used and the training pairs were interlinked, i.e., A greater than B, B greater than C, C greater than D. In another task, 6 sticks were used to form 3 unrelated pairs, i.e., A greater than B, C greater than D, E greater than F. For 6-7-year-olds interlinked pairs were much more difficult to retain than unrelated pairs, whereas the opposite held true for college students. As a check on the stability of this finding, the linguistic form of questions and the number of different lengths of sticks were varied, but the same results were obtained. It is suggested that the previously observed difficulty that children encounter in learning length series in comparison to adults is not only due to a lack of motivation or attention or memory limitation but also to a difference in approach to the task. PMID- 6851719 TI - Word magic revisited: monolingual and bilingual children's understanding of the word-object relationship. AB - We examined the claims that preschool children regard an object's name as being inseparable from its intrinsic properties and that bilingual children relinquish this notion earlier than monolingual children. 12 monolingual and 12 bilingual children of equivalent SES, nonverbal intelligence, talkativeness, and willingness to consider counterfactual situations were asked whether various objects could be renamed and then asked to identify objects by nonsense names and names for other objects. Virtually all the children performed the renaming tasks without error, and the monolinguals and bilinguals were equally likely to assent to renaming objects. However, monolinguals were more likely to mention an object's properties when justifying an answer, whereas bilinguals were more likely to mention the social context of the renaming act. These findings suggest that neither bilingual nor monolingual children are necessarily subject to "word magic"; rather, monolinguals have learned that an object can have more than 1 name by virtue of its various attributes, whereas bilingual children have learned, in addition, that an object can have more than 1 name by virtue of the different social contexts in which its name is used. PMID- 6851720 TI - [Association between hepatitis B surface antigenemia and HLA histocompatibility phenotypes]. AB - To test whether HLA histocompatibility phenotypes might be associated with circulating hepatitis B surface antigen (HBsAg), we performed chi-square test with Yate's correction and Fisher's exact test on findings in 315 normal healthy hospital staffs with known HLA types and HBsAg status. A significant relation between locus A of HLA types and HBs antigenemia was demonstrated, with negative association suggested between A1, AW23, A26, A29, +AW30 +AW31 and AW32 types and HBs antigenemia. Another significant relation between locus B of HLA types and HBs antigenemia was shown, with negative association suggested between B7, B8, BW21, BW44 and BW49 and HBs antigenemia. There was no significant relation between locus C of HLA type and HBs antigenemia, but type CW4 was revealed to have a relative risk of 2.11. Therefore, previous suggestion that both susceptability and resistance to hepatitis B virus infection may be in part genetically determined and previous observation of population differences in HBsAg prevalences could be interpreted by these findings. PMID- 6851721 TI - Immunologic study on nasopharyngeal carcinoma patients: correlation of in vivo and in vitro reactivity to phytohemagglutinin. AB - The skin response to 5 micrograms of purified phytohemagglutinin (PHA) was studied in 125 subjects, including 32 normal controls, 31 patients with head and neck cancer other than nasopharyngeal carcinoma (NPC), and 62 NPC patients. In vitro lymphocyte transformation to PHA (M form) was tested simultaneously to examine its correlation to the PHA skin test. A positive reaction of skin test was observed 24 hours after injection in 29 (90.6%) of 32 normal controls, 16 (51.6%) of 31 patients with head and neck cancer other than NPC, and 51 (82.3%) of 62 NPC patients respectively. Histological examination of the area of erythema revealed the same as those found in the delayed hypersensitivity with perivascular mononuclear cell infiltration. The PHA skin test was repeated 3 times over a period of 9 weeks in 10 normal controls, and no significant change in their skin reactivity was detected. In vitro reactivity to PHA-M was hyporesponsive in NPC patients than in normal controls in three measurements i.e. net counts of incorporated tritiated thymidine, stimulation index, or differences of square roots of counts between the well with PHA and without PHA. Net counts proved to be the most sensitive criterion to differentiate the lymphocyte response to PHA between NPC and normal controls. It is suggested that the general hyporesponsiveness to PHA stimulation in NPC is due to intrinsic T-cell dysfunction. The suboptimal dose of PHA for lymphocyte transformation in NPC was 2.5 microliters per 1.5 X 10(5) cells. Quantitatively, the correlation between in vivo and in vitro reactivity to PHA was not found in normal controls, yet it proved to have a good correlation in some NPC patients--in stage III r = 0.63, p greater than 0.05; in stage IV r = 0.71, p less than 0.01; in stage V r = 0.95, p less than 0.001. Qualitatively (delta cpm greater than or equal to 20,000; erythema greater than or equal to 20 mm), a correlation was found between in vivo and in vitro reactivity to PHA in 27 (84.4%) of 32 normal controls (p less than 0.001), and 39 (62.9%) of 62 NPC patients (p less than 0.01). It is concluded that if in vitro testing of PHA stimulation can not be done, the PHA skin test can be used as an alternative to screen the T-cell functions of NPC patients. PMID- 6851722 TI - [Percutaneous transhepatic electroincision of stenosed biliodigestive anastomoses]. AB - Percutaneous transhepatic electroincision is a new method for the treatment of stenoses after hepatico-jejunostomy. Using the percutaneous transhepatic approach the stenosis is cut with the aid of a papillotome by applying high frequency current. In all 5 patients treated the anastomis was patent. In one case multiple calculi in the intrahepatic bile ducts necessitated operative stone removal later on. In view of the problems of surgical correction percutaneous electroincision offers an attractive alternative to operation. PMID- 6851724 TI - [Rectal cancer--functional results following sphincter-preserving surgery]. PMID- 6851725 TI - [Incidence and significance of accessory adrenal tissue in the inguinal region in childhood]. PMID- 6851727 TI - [Volvulus of the cecum]. PMID- 6851726 TI - [Acute inflammatory breast cancer and surgery with non-closure of wounds]. AB - Six women with acute inflammatory breast cancer were operated between 1967 and 1978 with non-closure of the incision. The mean survival rate was 6.4 years. One patient is still alive after 13 years. This paper discusses possible improvements in the procedure. - The non-closure of the surgical incision should ensure drainage of the lymph which is considered to be the carrier of cancer cells. Non closure should prevent cancer resorption, it also ensures that the size of the incision is sufficient. Even large incisions heal well. The inflammatory processes of the breast cancer have stimulated this surgical procedure which has been practised in 54 patients (59 times). The tables demonstrate portion and process of severe cases. Since every cancer, particularly cancer of large size, can turn into inflammation, an extended indication for the "non-closure" technique appears worth considering. Especially for the acute inflammatory cases early detection and immediate treatment is mandatory, as well as "non-touch technique". PMID- 6851723 TI - [The risk of hemorrhaging in the prevention of thromboembolism in general surgery: comparison of low-dose heparin and heparin-dihydergot 2500]. AB - In a prospective randomized double-blind study, the risk of heparin-induced intra or postoperative hemorrhage in prophylaxis of thromboembolism was studied. 500 general surgical patients were divided into 2 groups; group A receiving a reduced portion of heparin (2 X 2500 IU) in combination with 0.5 mg dihydroergotamine (DHE) was compared to group B with conventional low dose heparin regimen (2 X 5000 IU) with regard to postoperative wound hematomas and reoperation for hematoma. After prophylaxis with heparin dihydroergotamine 2500 wound hematoma and reoperation for hematoma are shown to be reduced in a significant way (p = 0.03). PMID- 6851728 TI - [Surgical closure of persistent perineal residual cavities by interposition of the gracilis muscle]. PMID- 6851729 TI - [Comments on the article by L. Ulatowski et al.: Mechanical esophago-jejunostomy: modern trend or progress?]. PMID- 6851730 TI - [Comments on the article by B. Fleischer and D. Borm: Surgical treatment of bronchial carcinoma in the aged]. PMID- 6851732 TI - [Heterotopic pancreatic tissue in the duodenum with a clinical picture of malignant pancreas head tumor]. PMID- 6851731 TI - [Cystic dysplasia of the pancreas in Lindau's disease]. PMID- 6851734 TI - [The question of burden of proof in the non-establishment of the simplest diagnostic and laboratory findings]. PMID- 6851733 TI - [Injuries of the deep veins in varicose vein surgery]. PMID- 6851735 TI - [Surgical treatment of adrenal diseases]. PMID- 6851736 TI - [Surgical treatment of adrenal diseases]. PMID- 6851737 TI - [Combined disease picture of an autonomous thyroid adenoma with acute and chronic thyroiditis]. AB - This is a case report of a 20 year old woman suffering from a single toxic hot nodule of the thyroid gland. Following inflammation of the neck a cystic nodule with a thick fibrotic capsule was resected. Histology revealed a follicular adenoma with central necrosis surrounded by chronic fibrosing thyroiditis with intima proliferation of the blood vessels similar to Riedels thyroiditis. PMID- 6851738 TI - [Accidental finding: the small, differentiated thyroid carcinoma. Report of 46 thyroid carcinomas of up to 15 mm diameter]. AB - Review of 190 cases of thyroid carcinoma between 1974 and 1981 showed an increasing rate of small papillary carcinoma. The study included 46 tumors which did not exceed 15 mm in diameter. Most of these lesions (3/4) were discovered incidentally at thyroid operations of various types. In spite of the early stage of carcinoma 6 tumors were already associated with cervical nodal metastasis, cases showed multiple lesions within the thyroid gland, homolateral and bilateral. With respect to these cases total thyroidectomy and subsequent radium therapy are generally suggested. PMID- 6851740 TI - [Clinical research in surgery--an example of gastroenterology surgery]. PMID- 6851741 TI - [Methodological forms of clinical studies in surgery: indication and evaluation]. PMID- 6851742 TI - [Retrospective clinical studies as the basis for choice of therapy in differentiated thyroid carcinoma]. PMID- 6851739 TI - [Percutaneous intramedullary bore-wire fixation of typical localized radial fractures in danger of dislocation]. AB - During the years 1973 through 1981 127 of altogether 1156 patients with fractures of the distal end of the radius (representing 11%) were treated with a percutaneous intramedullary pin fixation at the surgical clinic, Grevenbroich. The technique was used in the treatment of transverse, oblique or marginal fractures with dorsal displacement (Colles' type) or palmar displacement (Smith's type) of the distal fragment. A follow-up examination of 120 patients revealed excellent results in 36.7%, good results in 53.3%, fair results in 9.2% and poor results in 0.8%. Of seven epiphyseal fractures of the distal and of the radius five had an excellent and two a good result. The total results were analysed regarding to the age and sex of the patients and the fracture types I-VIII of Frykman's classification and were compared with indication, technique, complications and results of different methods of operative fixation. The advantages of percutaneous intramedullary pin fixation are simple practicability, minimal injuries of soft tissues, low expenditure of personnel and equipment and avoidance of secondary repositions. PMID- 6851743 TI - [Vascular surgery--chronic vascular occlusive disease of the lower extremity: a main point of surgical research]. PMID- 6851744 TI - [Reflections on follow-up studies of hip and knee prostheses]. PMID- 6851745 TI - [Assessment of conservative and surgical treatment of bone fractures--the upper extremity]. PMID- 6851746 TI - [Assessment of conservative and surgical treatment of bone fractures--the lower extremity]. PMID- 6851747 TI - [Assessment of conservative and surgical treatment of bone fractures--the pelvis and spinal column]. PMID- 6851748 TI - [Assessment of conservative and surgical treatment of bone fractures during the age of growth]. PMID- 6851749 TI - [Therapeutic breast-preserving measures in operable breast carcinoma]. AB - Simple mastectomy with axillary clearance represents the standard therapy in operable breast cancer. In many cases no additional complex therapeutic measures have to be taken. For small tumors without clinical suspicion of lymphnode involvement in the axilla a combination of tumorectomy and axillary clearance followed by high voltage radiotherapy allows the conservation of a nearly normal breast. The survival figures available today show no difference between amputation and conservative treatment. An absolute condition for successful conservative treatment and follow-up is a consequent and continuous collaboration between the involved disciplines. If this is not the case, mastectomy with eventual later reconstruction has to be preferred. PMID- 6851751 TI - [Treatment of the polytraumatized patient in a hospital with basic care]. AB - Severe traumatized patients with multiple injuries (polytrauma degree III according to Schweiberer [11]) can be treated also in a peripheral communal hospital, if some personal and technical suppositions are guaranteed. Preclinical treatment by an emergency doctor (surgeon or anaesthesist) on the accident place should as well be possible as the admission of the patient and diagnosis and treatment in all functional important fields by experienced personal for 24 hours daily. The therapeutic principle must be the stabilization of the patient after emergency operations making survival possible in a treatment schedule, planned by the surgeon and the anaesthesist in a cooperating team. Definitive treatment and rehabilitation can be performed in a special clinic or center, if necessary. The problems observed in a peripheral communal hospital in treatment of multiple injured patients are demonstrated in a series of 49 consecutive cases of polytrauma degree III. PMID- 6851750 TI - [Treatment of the polytraumatized patient in a clinic]. AB - 433 patients (mean age 33.3 years) with multiple injuries were treated from 1978 to 8/1982. Classification of the injuries was done according the S(skeleton)A(abdomen)T(thorax)scheme. The overall mortality was 18%. The cause of death were CNS-injuries in 50% of the patients. Besides CNS-injuries single and multiple organ failure were limiting the prognosis. In all cases of organ failure the lung was affected. Two patterns of multiple organ failure were found. Significant factors were shock, massive blood transfusions and abdominal trauma- but as well as errors in the treatment. Still improvement of the survival rate of the polytraumatised patients must be achieved in the future. Besides aggressive shock therapy and prevention of posttraumatic pulmonary insufficiency through earliest respiratory support we emphasize a strict strategy of treatment priorities. Based upon an intensive training especially in trauma care the surgeon will be able to recognize complications earlier and thus increase the chance of survival of the polytraumatised patient. PMID- 6851753 TI - [Internal intestinal splinting with a soluble tube for the prevention of recurrent adhesion ileus]. AB - An absorbable, non-toxic, easy gliding, cross-linked gelatine tube has been developed to prevent and to treat chronical adhesion ileus. The tube is patterned upon the interior intestinal splinting with long tubes. By doing a small enterotomy it was possible to splint the whole intestine in pigs or endangered parts within a few minutes. The flexible gelatine tube does not kink and is melting off from the surface. It prevents the intestine from kinking and does not cause any lesions even on previously damaged intestinal walls. Possible complications seen by insertion and extraction of conventional tubes were not observed. PMID- 6851752 TI - [Infection prevention in elective large intestine surgery. Results of a prospective randomized comparative study]. AB - In a prospective randomized trial clinical results of orthograde bowel lavage alone (group I) versus combined bowel lavage and parenteral antibiotic prophylaxis with 4 gm Cefoxitin (group II) in two separate dosages (perioperative short-term-prophylaxis) are compared with regard to the reduction of septic complications after colorectal surgery. Septic wound complications were 11/27 = 41% in group I and 2/30 = 7% in group II. The rate of anastomotic leakages was significantly different in the two groups (5/27 in group I, 0 in group II). The monetary costs for given antibiotics and the duration of hospitalization were less in group II. Orthograde bowel lavage alone proved to be of no effect in reducing the rate of septic complications when used without antibiotic perioperative short-term-prophylaxis and therefore cannot be recommended to be used solely. PMID- 6851754 TI - [Complications and late results following surgical treatment of Echinococcus granulosus]. AB - The case histories of 110 patients with hydatid disease were evaluated for localisation of the cysts, operative treatment and postoperative complications. Pericystectomy and hydatectomy were the most frequently performed operative procedures. 1 of 37 patients, who were followed up, showed a relapse (2.7%). If consideration is taken of the postoperative complications, hydatectomy is a suitable operative procedure for hydatid disease in comparison with pericystectomy. PMID- 6851755 TI - [Iatrogenic false aneurysm of the radial artery with atypical superficial course]. PMID- 6851756 TI - [Problems in cesarean section]. PMID- 6851757 TI - [The role of cesarean section in breech delivery]. PMID- 6851758 TI - [Cesarean section for pregnancy complicated with severe cardiac disease]. PMID- 6851760 TI - [The rising cesarean section rate -- its causes and perinatal influence on mother and neonate]. PMID- 6851759 TI - [Some aspects of the indications for cesarean section: report of 862 cases]. PMID- 6851762 TI - [A study on the indications for cesarean section]. PMID- 6851761 TI - [The effect of premature rupture of membranes on perinatal infants: clinical analysis of 100 cases]. PMID- 6851764 TI - Circadian rhythms in subjective alertness and core body temperature. PMID- 6851765 TI - Chronobiologic serial sections of several orders. AB - The chronobiologic serial section is described. Its applicability to the analysis of nonequidistant data is emphasized. Its ability to detect and quantify multiple components is discussed and exemplified on simulated series with various amounts of additive Gaussian noise. This least-squares method is discussed in the context of a number of complementary procedures such as complex demodulation and linear nonlinear least-squares rhythmometry. PMID- 6851763 TI - Prolactin and breast skin temperature rhythms in postmenopausal women with primary breast cancer. AB - Plasma prolactin and cortisol were determined and breast skin temperatures measured in 8 postmenopausal diurnally active-nocturnally resting women, 7 with primary breast cancer and 1 with benign breast disease. In all subjects, prolactin peaked during the early morning hours. Cortisol and oral temperature served as internal physiological markers of anticipated rhythmicity in adrenocortical function and metabolism. In all patients studied, the tumour site had an increased mesor (midline-estimating statistic of rhythm) and reduced amplitude of the circadian breast skin temperature rhythm when compared to a similar site on the contralateral breast. Thermal asymmetry was also observed between left and right breasts. A cancer, if in the left breast, may reinforce lower amplitude and perhaps a higher mesor (associated with the healthy left breast in these particular patients), whereas if it is located in the right breast, it tends to nullify inter-mammary differences in mesor and amplitude. Screening for breast cancer appears to require subjects being monitored on at least two occasions before thermal abnormalities due to tumour or preneoplasia become discernible. PMID- 6851768 TI - [Cpd method and its applications to non-parametric statistical tests (1)]. PMID- 6851767 TI - [Food poisoning caused by Bacillus faecalis alcaligenes]. PMID- 6851766 TI - [The use of mercuric oxide and titaniummercury alloy in a fluorescent lamp plant]. PMID- 6851769 TI - [Evaluation of wet technic dust control in an asbestos textile factory]. PMID- 6851771 TI - [Survey and control malaria in eight counties of Guizhou Province]. PMID- 6851770 TI - [Poisoning with a kind of Bitter Edible Gourd]. PMID- 6851774 TI - [The relation between the physiological age and the seasonal prevalence of Culex fatigans in Guangzhou]. PMID- 6851773 TI - [Dietary survey of children in a middle school, a primary school and a kindergarten]. PMID- 6851775 TI - [Peripheral blood lymphocyte chromosome aberration and the sister chromatid exchange in patients with lead poisoning caused by alcohol drinking]. PMID- 6851772 TI - [Investigation on air pollution caused by cyanide-borne waste water and its effect on human body]. PMID- 6851777 TI - [Preliminary experimental observation on the effects of magnetism and "native copper" on fracture healing]. PMID- 6851776 TI - [Toxicological studies on a synthetic insecticide-4(methyloxymethyl) benzyl chrysanthemum-monocarboxylate]. PMID- 6851778 TI - [Transection of cervical cord complicated by cardio-vascular disorders and hypothermia: a preliminary study]. PMID- 6851780 TI - [Patho-biomechanics of scoliosis and improvement of Harrington's correction technic]. PMID- 6851779 TI - [Percutaneous needle biopsy of vertebral bodies]. PMID- 6851781 TI - [Microlumbar discectomy: a preliminary report]. PMID- 6851784 TI - [Problem of blood viscosity in surgical patients]. PMID- 6851783 TI - [Transplantation of a pedicled omentum in the treatment of a postphlebitic syndrome of the iliofemoral veins]. PMID- 6851782 TI - [Surgical correction of hypertelorism]. PMID- 6851785 TI - [Clinico-pathological classification of colorectal cancer]. PMID- 6851786 TI - [Experimental study on inferior tibiofibula diastasis]. PMID- 6851787 TI - [Perforation due to gastric wall necrosis after resection of esophageal carcinoma: report of 2 cases]. PMID- 6851788 TI - [Free autologous perichondrial grafts for the reconstruction of joint cartilage: an experimental study in rabbits]. PMID- 6851789 TI - Chromosome analysis by high illumination flow cytometry. AB - Fluorescence measurements from metaphase chromosomes of the Chinese hamster, stained with propidium iodide excited at high illumination irradiance, completely resolve each chromosome type. The measurements are performed in a specially designed flow cytometer that achieves high irradiance (4 MW/cm2) by using high power laser output (2 W at 488 nm) focused to small spot size (1% irradiance variation over 2 microns). The coefficient of variation of each chromosome peak is near 1.5%. Saturation of the fluorescence transition and photobleaching, two consequences of high irradiance, are shown to occur. Even with a nonlinear dependence of fluorescence upon illumination irradiance, fluorescence retains a proportional response to chromosome type; each chromosome peak maintains a consistent ratio to the others at every irradiance. No perturbation of fluorescence by the optical or geometrical properties of the chromosomes is evident. The advantages of high irradiance illumination are an increase in fluorescence sufficient to reduce the statistical error in photoelectron number to a low level and reduced influence of laser power fluctuations and variable chromosome flow trajectories on the precision. These benefits improve the resolution of chromosome analysis by flow cytometry, particularly the resolution of smaller chromosomes. PMID- 6851791 TI - Isovolumetric sphering of erythrocytes for more accurate and precise cell volume measurement by flow cytometry. PMID- 6851792 TI - Classification of immature and mature cells of the neutrophil series using morphometrical parameters. AB - Quantitative morphological data of six classes of immature and mature cells of the neutrophil series of the bone marrow of normal persons were used for statistical classification experiments (myeloblasts, promyelocytes, myelocytes, metamyelocytes, bands and segments). On each cell, parameters were measured directly from the image or calculated from the shape of the density histogram or the counting densitogram using a Texture Analysis System (E. Leitz, Wetzlar, Germany). The parameters were analyzed with the interactive statistical pattern recognition system ISPAHAN. One half of the data were used as a learning set and the other half as the test set. The parameters were compared according to their performance in discrimination between the classes, alone and in combinations. Parameters not contributing to an improvement of the discrimination were disregarded. Eleven parameters were selected and used for classification by two different methods: a stepwise and a "one-shot" method. Stepwise classification resulted in a 79% correct classification rate. Most errors occurred between cell classes in neighboring stages of maturation. In 96% of all cases the computer classification was either in accordance with that of the technician or with a cell class of a neighboring maturation stage. One step classification by the computer was in agreement with the technicians in 82% of the cases. For 98% of the cells the computer classification was either in accordance with that of the technician or with a cell class of a neighboring maturation stage. The data set was collected by two technicians, operating independently. Differences in their interpretation of the maturation stage were found by comparing the performance of classifiers based on both cell samples. Since the images of the cells were not available for reexamination, the causes of disagreement in classification between the technicians and between computer and technicians could not be evaluated. PMID- 6851790 TI - Flow sorting in the study of cell-cell interaction. AB - Undifferentiated mouse teratocarcinoma cells were cocultivated with differentiated mouse endoderm cells in order to study the possible induction of teratocarcinoma cell differentiation. A difference in DNA content between the two cell types was experimentally introduced to enable the reisolation of the teratocarcinoma cells after cocultivation. Pseudotetraploid (2s) endoderm cell lines were produced from pseudodiploid (1s) cells by treatment of these cells with cytochalasin B and flow sorting of tetraploid cells, using Hoechst 33342 as a viable DNA stain, with subsequent cloning of sorted single cells. In model experiments, where mixtures of 1s teratocarcinoma and 2s endoderm cells were stained with Hoechst 33342, the teratocarcinoma cells could be reisolated with a purity of about 97%. After a cocultivation period of 24 days viable teratocarcinoma cells could be isolated from the cocultivation mixture with a purity of 95%. Two dimensional analysis of the protein pattern of these cells indicated that cocultivation did not induce a differentiated (endoderm) pattern. Therefore according to this analysis the teratocarcinoma cells were not induced to differentiate during a 24 day cocultivation period. The method described offers excellent possibilities for studying cell-cell interaction in vitro. PMID- 6851793 TI - In-use evaluation of the Omnicon automated tumor colony counter. AB - The reproducibility and accuracy of the Omnicon (Bausch and Lomb Inc., Rochester, NY) automated tumor colony counter for counting tumor colonies growing in double layer soft agar is evaluated and the reproducibility is compared with manual tumor colony counting. Replicate within day run-to-run colony counts of the Omnicon show a median correlation coefficient (r) of greater than 0.985, and day to-day median r of greater than 0.980. In contrast, for manual colony counting, the best intra-observer reproducibility achieved is a r of 0.943 and the best inter-observer reproducibility is a r of 0.831. Analysis of results from individual culture plates counted by the Omnicon on 5 separate days shows a median coefficient of variation of 10% with 77% of the culture dishes showing coefficients of variation of colony counts over 5 days of less than 20%. Counting of culture plates during incubation shows that the Omnicon is counting tumor colonies developing after plating of a single cell suspension. PMID- 6851795 TI - The "central dogma" of flow cytometry. PMID- 6851794 TI - Direct determination of cell diameter, surface area, and volume with an electronic volume sensing flow cytometer. PMID- 6851796 TI - Evacuation pouchography in the evaluation of ileoanal reservoir function. AB - Thirty four patients with restorative proctocolectomy and ileoanal pelvic reservoirs were studied by "evacuation pouchography" to determine why only some patients could evacuate spontaneously. The 50 per cent who were able had a significantly shorter distal segment (P less than 0.02) of mean length (8 +/- 3 cm) that filled on straining, compared with those who had to use a catheter to empty the pouch, in whom the distal segment was longer (mean 11 +/- 4 cm) and often failed to fill on straining. The longer the distal segment, the more likely it was to be angulated, causing difficulty in passage of the catheter with possible ulceration and stenosis from minor trauma. Stricturing in the distal segment was associated with minor nocturnal leakage. A short distal segment is recommended to allow spontaneous evacuation and avoid the risks of repeated catheterization. PMID- 6851799 TI - Vermiform appendix located within the cecal wall. Anomalies and bizarre locations. AB - The unusual finding of an acute appendix located within the posterior wall of the cecum, beneath the serosa, and its surgical removal is described. In order to remove the appendix, the cecal wall had to be incised. The appendix had no serosal covering, and had the gross appearance of a peeled seedless grape. The anatomy and embryology of the vermiform appendix, including this aberration, are presented briefly. A discussion of the difficult-to-find appendix is presented. The possibility exists that some of the reported cases of agenesis of the appendix could have been an overlooked intracecal appendix. PMID- 6851798 TI - Anorectal diseases in Western Nigerian adults. A field survey. AB - A survey of anorectal diseases in parts of Western Nigeria was performed by examining 336 adults in various locations. It was concluded that anorectal diseases are more common among the population than is suggested in reviews of hospital cases--a fact largely due to poor health awareness and consequently poor hospital attendance. The fairly generally high prevalence of these diseases does, in fact, mirror holoendemic conditions such as schistosomiasis, amebiasis, and intestinal tuberculosis. In spite of known western influence on food preparation and dietary habits, particularly among the urban dwellers, it is probably too early to expect any impact on bowel habits and large-bowel and anorectal diseases. In view of the significant association, the author suggests than any disturbance in bowel action should prompt a thorough investigation for anorectal diseases. PMID- 6851797 TI - Adenocarcinoma of the colon masquerading as primary ovarian neoplasia. An analysis of ten cases. AB - This paper reviews the clinical characteristics of a group of patients in whom unsuspected primary adenocarcinoma of the colon presented with signs and symptoms of a primary ovarian neoplasia. In most patients, the ovaries were removed, the correct diagnosis was established at a later time, and a second surgery for resection of the primary adenocarcinoma of the colon was then performed. Preoperative use of colonoscopy or barium-enema examination would have helped. We compared these patients to a group of patients with similar clinical characteristics, but in whom the ovarian metastases were clinically apparent months after the resection of a primary colorectal cancer. We found that, in both groups, age of the patients, anatomic distribution of the primary tumor, histologic differentiation, serosal or mesenteric lymph node tumor involvement, and timing of the oophorectomy in relationship to removal of the primary colorectal tumor did not affect the overall survival. Once ovarian metastases were documented, patients died regardless of treatment, approximately 16 1/2 months after the diagnosis. PMID- 6851800 TI - Psoas abscess resulting from perforating carcinoma of the sigmoid colon. Report of a case. AB - We report a case of a left psoas abscess resulting from a perforating carcinoma of the sigmoid colon. The chief complaints were edema of the left leg and pain in the left thigh. Single and double contrast barium-enema film demonstrated an extrinsic inflammatory mass distorting the sigmoid colon. A preoperative diagnosis of sigmoid carcinoma was not made on these examinations, nor on flexible colonoscopy. Carcinoma of the colon should be considered as a cause of an unexplained psoas abscess. PMID- 6851801 TI - Trends in right and left-sided colon cancer. AB - The increasing ratio of proximal to distal colorectal carcinomas was confirmed in this population-based study of 668 new cases diagnosed among Rochester, Minnesota residents between 1940 and 1979. The change was due to a rise in the incidence of proximal lesions (from 15.1 per 100,000 person-years in 1940-59 to 17.3 per 100,000 in 1960-79) and a simultaneous fall in the incidence of distal lesions (from 35.5 to 28.2 per 100,000 person-years). Changes in definitions or referral patterns played no role in these observations, although improved diagnostic capabilities may have had an impact on the incidence of proximal lesions. These discrepant changes in incidence strongly suggest that proximal and distal colonic cancers are different diseases or have a different pathogenesis. The changing incidence rates were not associated with consistent differences in clinical characteristics at the time of initial diagnosis. PMID- 6851802 TI - Research efforts in hereditary intestinal polyposes and cancer of the gastrointestinal tract. PMID- 6851804 TI - CEA and genetics. Gardner's syndrome. AB - During an eight-year period, serial plasma determinations were made on members of a Gardner's syndrome family in order to see if 1. levels rise when polyps first appear, and when cancer occurs; and 2. levels fall after colectomy with ileoproctostomy, ileostomy, or rectal mucosal replacement surgery. CEA analyses were carried out in the laboratory of Norman Zamcheck, M.D., using the Roche method. Small increases in CEA titer accompanied the appearance of polyps and small decreases accompanied their removal. Further serial studies are needed to determine whether changes in CEA titer can be indicators of polyp and/or cancer occurrence. PMID- 6851803 TI - Medical aspects of hereditary intestinal polyposis. AB - Extracolonic manifestations are often associated with familial polyposis coli, but the cysts and osteomas may be few and inconspicuous. Abnormal fibrous reactions may also occur and may be a cause of death. These manifestations act as "external markers" for the later appearances of adenomas. In any family, some individuals may manifest some extracolonic manifestations and other individuals may not. Other abnormalities, usually neoplastic, described in familial polyposis coli families, are probably fortuitous occurrences, but medulloblastoma has been found relatively frequently. Turcot's syndrome, described in a unique family, should be used more restrictively. Diagnosis depends on histology showing adenomas, but no particular number is required in an afflicted family member. Total reliance on sigmoidoscopy alone is potentially hazardous as the descending colon may be affected initially. Inherent problems regarding "isolated cases" are outlined. PMID- 6851805 TI - Pathogenesis of polyps (adenomas). AB - The pathogenesis of adenomas in adenomatous polyposis of the gastrointestinal tract (familial polyposis coli, FPC) is not completely known. The morphologic features of the dysplastic epithelium and the morphogenesis of adenomas in FPC have been well described. Studies of the precursors to adenomatous epithelium have identified histopathologic, ultrastructural, and epithelial proliferative abnormalities in grossly normal colonic mucosa of FPC patients. The role of the intraluminal environment and the mechanisms of its interaction with the mucosa appear to be important areas for research directed at the pathogenesis of adenomas in FPC, due to the implications for therapy. PMID- 6851806 TI - Classic articles in colonic and rectal surgery. Rupert Beach Turnbull, Jr., 1913 1981. Management of the ileostomy. PMID- 6851810 TI - Pascal's law in lymphography. PMID- 6851809 TI - Scleredema diabeticorum: a common and distinct cutaneous manifestation of diabetes mellitus. AB - Scleredema diabeticorum is characterized by a dramatic increase in the thickness of the skin of the posterior neck and upper back. Of the 17 scleredema patients diagnosed by us in the last 15 yr, 16 have had type II diabetes mellitus. In a prospective study of 484 diabetic outpatients we found the prevalence of scleredema to be 2.5%. Angina pectoris was the only complication that occurred significantly more frequently in scleredematous diabetic patients than in a control group of diabetic patients without scleredema. Scleredema diabeticorum is a distinct cutaneous condition peculiar to diabetic individuals and ought not to be confused with scleredema of Buschke or scleroderma. PMID- 6851807 TI - Prediction of diabetic retinopathy from clinical variables and color vision data. AB - Predictions about the onset of retinopathy in 295 diabetic patients, all originally having no evidence of retinopathy, have been made in a longitudinal study over 7 yr. Out of many color vision tests and clinical variables, the best individual predictor was a measure of yellow-blue discrimination, using an anomaloscope. The other predictors of significance were the degree of blood glucose control and the duration of diabetes. Although the predictions from a linear logistic model were significant in classifying the diabetic subjects into those whose fundus will remain normal and those in whom it will develop retinopathy, the number of misclassifications was substantial. An examination of the goodness of fit between the data and the model suggested a criterion value (P) of around P = 0.3 for the probability that a patient develops retinopathy. At this value, the probability of being normal for an individual classed as normal was 0.82, and the probability of developing retinopathy for an individual classed as having retinopathy was 0.54. PMID- 6851808 TI - The effect of fenfluramine and caloric restriction on carbohydrate homeostasis in patients with lipodystrophy. AB - In an attempt to differentiate the effect of fenfluramine hydrochloride from that of caloric restriction on carbohydrate tolerance in patients with lipodystrophy, parameters of carbohydrate homeostasis were studied in patients with lipodystrophy during periods of fenfluramine treatment and during periods of caloric restriction. Although, carbohydrate tolerance appeared to improve initially in one patient when treated with fenfluramine, this improvement did not permit. No beneficial influence of fenfluramine on carbohydrate tolerance could be identified in the other patients studied. By contrast, all patients demonstrated an improvement in carbohydrate tolerance in response to caloric restriction. These data suggest that caloric restriction improved carbohydrate tolerance in patients with lipodystrophy whereas fenfluramine, in the absence of caloric restriction, has no long-term beneficial effect. PMID- 6851812 TI - Treatment of 20 direct carotid-cavernous fistulas. AB - This review describes the results obtained in the treatment of direct carotid cavernous fistulas in 20 patients. The fistulas were occluded by intraarterial detachable balloons as described by Serbinenko and later modified by Debrun. The advantage of this method over most others is that it closes the fistula but leaves carotid patency intact. We succeeded in this respect in 15 of our patients. With the exception of an abducens paresis in 1 patient, no irreversible neurological or other complications were caused by the procedure. PMID- 6851811 TI - Spinal cord angiography and radiocinematography in arteriovenous malformations. AB - Spinal angiography is the method of choice to detect arteriovenous malformations (AVM) of the medulla spinalis. In a series of 90 patients, 13 cases of AVM were found. Most patients had a long period of disability previous to the diagnosis. 9 patients who underwent myelography showed positive signs: obstruction or worm shaped contrast-filling defects. 4 patients were referred after a subarachnoidal bleeding without myelography. Four different types of spinal AVM are distinguished, the combination of a spinal AVM with a vertebral hemangioma is introduced as type IV. Radiocinematography makes the work easier and shortens the procedure. No complications in 90 patients were met. PMID- 6851814 TI - Corpus cavernosography. AB - The cavernous spaces of the penis can be demonstrated by injecting 20 cm3 contrast agent (Urografin 60%) dorsolaterally behind the gland penis. By injecting the contrast agent into one corpus cavernosum, both corpora become visible by X-ray. Pathologic conditions (trauma, Peyronie's disease, priapism, malignancy, etc.) cause typical changes in the cavernous spaces and blood drainage. The literature has been reviewed. PMID- 6851813 TI - Comparison of pain and heat sensation of contrast media in aortofemoral angiography: meglumine-amidotrizoate (Angiografin) mixed with lidocaine versus sodium-meglumine-ioxaglate (Hexabrix). AB - A total of 116 translumbar aortofemoral angiograms were performed in 92 patients. At random, 58 contrast injections were done with Hexabrix and 58 with Angiografin mixed with lidocaine. Pain and heat sensation was evaluated by a verbal rating system. Most patients in both groups had no or mild pain sensation. There was, however, a slight but statistically significant difference (p less than 0.05) in favor of Hexabrix. No difference was found in heat sensation in either of the groups. PMID- 6851816 TI - Receiver operating characteristic curves in diagnostic imaging. AB - The evaluation of medical imaging systems is normally done by quantifying the physical properties of the equipment. Since a diagnosis by the radiologist is the result of a combination of equipment and radiologist, it is preferable to evaluate the system as a whole by the use of receiver operating characteristic curves. The aid of this article is to explain this evaluation technique to the radiologist and indicate why this technique in many cases is the proper way to evaluate imaging systems. PMID- 6851815 TI - Double-contrast Arthrography of the shoulder. AB - Although single-contrast arthrography has been advocated since 1933 it is the use of water-soluble contrast agents together with the simultaneous injection of air which have made shoulder arthrography a rather painless procedure yielding much additional information. Double-contrast arthrography has been used at our institution to demonstrate or exclude lesions of the rotator cuff, the biceps tendon, the capsule, the articular surfaces of the joint and adhesive capsulitis. In this review the technique and results in 58 consecutive cases are presented. PMID- 6851819 TI - Demonstration of two cases of uncommon lung disease, with emphasis on the chest X ray. AB - A patient with a unilateral obstructive emphysema due to a centrally localized carcinoid of the bronchus is presented. The chest X-ray is very suggestive; nevertheless, the diagnosis is often delayed. A patient with echinococcosis of the lung is described. A Turkish woman presented with multiple varying round masses, hydatid cysts. A short description of the disease is given. As in the previous case the chest X-ray is suggestive of the diagnosis if one takes into account the nationality of the patient. The case histories of 2 patients with an uncommon disease of the lungs elucidated by misleading and/or unexpected radiologic findings, will be presented in detail. PMID- 6851817 TI - Tuberculosis in the district of Nijmegen. PMID- 6851820 TI - Flow and movement phenomena in modern real-time ultrasound examination. PMID- 6851818 TI - Parasitic blood supply of malignant renal tumors. AB - Eleven malignant renal tumors, which showed parasitic blood supply on arteriography, were compared with operative and histopathologic findings. Mesenteric vascularization of renal tumors indicates perirenal infiltration more than retroperitoneal blood supply. PMID- 6851823 TI - Experience with the Artronix Torso-Cat-Scanner in the examination of the thorax, particularly the mediastinum: comparison with mediastinoscopy and operation. AB - In order to ascertain the diagnostic value of computed tomography (CT) of the thorax, the reports of the CT investigations of the thorax, carried out over a 2 year period, were compared with the actual final diagnosis. This study was narrowed down to those patients on whom a mediastinoscopy and/or an operation was performed. There appears to be a good correlation between the CT findings and the mediastinoscopy if no tumor or metastases are present in the mediastinum. This means that, where the CT scan shows a patient to have a normal mediastinum, it is not necessary to perform mediastinoscopy as a preoperative diagnostic aid. PMID- 6851821 TI - Traction radiography of the hip and fluid in the hip joint. AB - Applying traction to the hip joint normally creates a 'vacuum phenomenon' between the femoral head and the acetabulum. With the presence of fluid in the hip joint, this effect does not occur. Traction radiography thus gives the clinician and radiologist an easy and noninvasive method for detecting fluid in the hip joint. The subsequent article illustrates the potentialities of traction radiography in several hip diseases. PMID- 6851822 TI - Continuous imaging of regional blood flow in peripheral vascular disease using Krypton-81m: effect of Ketanserin, a new selective serotonin antagonist. AB - A new technique consisting of continuous intraarterial infusion of the ultra short-lived 81mKr for the study of blood flow in patients with severe peripheral vascular disease is described. With the gamma camera high resolution images and typical time activity curves, reflecting local regional blood flow in the feet, could be obtained under resting conditions during reactive hyperemia and administration of vasodilating drugs. Preliminary promising results of Ketanserin, a new selective serotonin antagonist, in patients with impending gangrene and ulcerations are discussed. PMID- 6851825 TI - [Comparison of established esophageal cancer cells in culture (Eca 109 cell line) and those in smears]. PMID- 6851826 TI - [Mycoflora in gastric juice of patients with chronic gastritis]. PMID- 6851824 TI - [Studies on canceration of esophageal epithelium--(SEM) and (TEM) observations]. PMID- 6851827 TI - [Pharmacologic studies of Radix Paeoniae Rubia in experimental tumors with special reference to growth and metastases]. PMID- 6851828 TI - [Study on familial 46, XY gonadal dysgenesis and high risk of gonadal tumors. III. Establishment of a fibroblast cell line (TGD-8F) on individual with 46, XY gonadal dysgenesis]. PMID- 6851830 TI - [Application of fine needle aspiration cytology]. PMID- 6851829 TI - [Pathologic study of 724 operated advanced gastric cancers in Gansu Province]. PMID- 6851831 TI - [Analysis of epidemiologic factors of cancer in Jiangsu, Zhejiang and Shanghai]. PMID- 6851832 TI - [Analysis of the temperature and power-output changes during hyperthermia in esophageal cancer]. PMID- 6851834 TI - [Multiple primary malignant tumors--a report of 30 cases]. PMID- 6851837 TI - [DNA geometry in the nucleosomes and the problem of the topological invariant]. PMID- 6851833 TI - [Carcinoma of the extrahepatic bile duct--pathologic study on 5 autopsied cases]. PMID- 6851835 TI - [Localized mesothelioma of the pleura]. PMID- 6851836 TI - [Selenium effect on ascitic tumor growth, mitochondrial respiration and oxidative phosphorylation]. PMID- 6851838 TI - [Intestinal hormone system and the mechanism of the specific dynamic action of food]. PMID- 6851839 TI - [Primary structure of the repeating element B2 and of the adjoining sequences in cloned mRNA actively transcribing in mouse liver cells]. PMID- 6851840 TI - [Microhemocirculatory bed of the capsule induced by Hydatigera taeniaeformis cysticerci in the liver of white rats]. PMID- 6851841 TI - [Ontogenetic rule of sexual dimorphism]. PMID- 6851842 TI - [Decreased yield of pyrimidine dimers in poly-dT under high-intensity picosecond laser UV irradiation]. PMID- 6851843 TI - [Micelle enzymology. The catalytic activity of peroxidase in a colloid solution of water in an organic solvent]. PMID- 6851844 TI - [Spatial organization of intracortical inhibition mechanisms]. PMID- 6851845 TI - [Role of gastric and intestinal evacuatory activity in regulating the rate of nutrient absorption during natural digestion]. PMID- 6851846 TI - Opiate addiction and depression--cause or effect? PMID- 6851848 TI - [Future aspects of research and clinical practice in the area of alcoholism]. PMID- 6851849 TI - [The dangers of alcohol - the situation in the Federal Republic of Germany]. AB - In 1975 an action programme on the prevention and containment of alcohol abuse was decided upon for the Federal Republic of Germany. Many items of this program are tasks of a long standing nature. Many an effort has since then led to success: the population has increasingly become aware of the dangers of alcohol abuse. The number of people drinking alcoholic beverages daily or almost daily decreased, the number of those drinking hardly ever or never increased. The group of people in danger of becoming dependent on alcohol grew smaller and alcohol consumption per head of population remained at the same level. The groups in need of special attention are children and young people and here particularly girls because of the fetal alcohol syndrome, as well as parents and teachers because they are called upon to set an example. Health education for these particular groups of people is of prime importance because it is essentially responsible for the success in combating alcohol abuse. In future, however, even more effective strategies for health education and research will have to be developed. PMID- 6851847 TI - Treatment of dependence upon stimulants and hallucinogens. PMID- 6851851 TI - Physiological basis of opiate dependence. PMID- 6851850 TI - Personal reflections. PMID- 6851852 TI - Observations on a decade of alcohol and drug dependence research. PMID- 6851854 TI - Some personal reflections on drug abuse research, chiefly epidemiology and prevention. PMID- 6851853 TI - Current trends in biologic research on alcoholism. PMID- 6851855 TI - [The drug scene during the past 10 years of experience and inquiries]. AB - Drug dependence has been defined in 1964 as 'a state arriving from repeated administration of a drug on a periodic or continuous basis'. Its characteristics would vary with the agent involved, but partly with individual and social characteristics, too. Multiple interactions between various distal and/or immediate psychosocial antecedents with aversive and/or reinforcing consequences of drug use lead to a state of neuroadaptation. This term needs further explanation in the light of research regarding biological aspects (e.g. peptides, neurotransmitters, tetrahydroisoquinolines) as well as psychosocial theories (e.g. social learning, systems theory). In the field of rehabilitation one is struck by the relatively high rate of prosocial behavioral change looking on different samples surveyed. It seems that change takes place virtually irrespective of the type of treatment. Nevertheless diversification of rehabilitative procedures and study of comparative virtues of different strategies should be promoted. PMID- 6851856 TI - Drug abuse in the United States: the past decade. PMID- 6851857 TI - A birds eye view of the present state of drug abuse in Japan. PMID- 6851858 TI - Alcohol and Islamic faith. PMID- 6851859 TI - [The alcohol and drug problem as a task of health education]. AB - Using the term 'chemische Inweltverschmutzung' (internal pollution by chemicals) as opposed to 'Umweltverschmutzung' (environmental pollution) the need is emphasized for effective preventive measures against internal pollution analogous to those taken against environmental pollution. In addition to measures of prohibitive character enacted under governmental authority in both the areas of external and internal pollution, health education as a key instrument in prevention of the latter should, not least, activate the individual's responsibility in maintaining one's health. PMID- 6851860 TI - [Primary prevention in the area of drug addiction: perspectives, errors and fallacies]. AB - Primary prevention in drug abuse has been, most of the time, reduced to its informational aspect. This paper points out some of the errors made in this field, both by contributing to the 'inflation' of the drug problem and by using scare tactics as preventive arguments. It invites consideration of drug addiction not as an isolated problem, but as one of the multiple results of an existential crisis, the author tries to show that in this field the emphasis of primary prevention should be on education. PMID- 6851861 TI - Rehabilitation of drug-dependent persons: where are we going wrong? PMID- 6851862 TI - Back to fundamentalism. PMID- 6851863 TI - 1983 perspectives on the pharmacotherapy of opiate addiction. PMID- 6851865 TI - Modern treatment of substance abuse. PMID- 6851864 TI - Thoughts about the relevance of neurochemistry, neurophysiology and neuropsychopharmacology to the social problems of drug abuse. PMID- 6851866 TI - The case of the Swedish methadone maintenance treatment programme. PMID- 6851867 TI - Management of non-specific urethritis in men. PMID- 6851869 TI - Epidural analgesia in obstetrics. PMID- 6851868 TI - Lidoflazine (Clinium) for angina? PMID- 6851870 TI - [Isosorbide mononitrate or dinitrate in coronary disease?]. PMID- 6851871 TI - [Combined cytostatic chemotherapy of advanced non-small-cell bronchial carcinoma with doxorubicin and ifosfamide]. AB - Fifty-three patients with inoperable non-small cell bronchial carcinoma were treated at four-weekly intervals with two cytostatic drugs, doxorubicin (50 mg/m2 on day 1) and ifosfamide (2000 mg/m2 on days 1-3). To avoid urotoxicity of ifosfamide, mesna, a uroprotective drug, was additionally given intravenously at a dose of three times 400 mg/m2 on days 1-3. All diagnoses had been histologically and/or cytologically confirmed. Adenocarcinoma was present in 22, large-cell undifferentiated carcinoma in 18, and squamous-cell carcinoma in 13. Distant metastases were present in 46, seven had a regionally localized tumour growth. There were one complete and 20 partial remissions (response rate 40%). Among a further 19 patients temporary growth arrest was registered. The remissions occurred in seven with adenocarcinoma, nine with large-cell carcinoma and five with squamous-cell carcinoma. Median remission was 8.3 months, mean survival time 10.5 months. Patients without response survived a mean of 5.5 months, patients with tumour progression for 1.3 months (Kaplan-Meier method). Most prominent among side-effects were cardiotoxicity and infection during the leukopenic phase. Urotoxicity was minor, due to treatment with mesna. The results suggest that doxorubicin and ifosfamide in combination can be considered an effective means, with acceptable toxicity, of treating advanced non-small cell bronchial carcinoma. PMID- 6851872 TI - [The sterile Behcet pustule: a typical skin manifestation of the Behcet syndrome]. AB - Solitary pustules were excised from five patients with Behcet's syndrome and examined histologically, immunohistologically, and--in one case--by immunoelectron microscopy. Histologically the changes were largely confined to the venules of the middle and lower corium. The endothelium was swollen, in part the vascular walls were destroyed. In the perivascular spaces there was round cell infiltration, mixed with numerous neutrophilic granulocytes, some of them disintegrated. Immunofluorescence-microscopy revealed perivascular deposition of complement C3 and C1q. In fresh lesions there were also IgG or IgM precipitates. Immuno-electron microscopy also demonstrated complement C3 subendothelially. Fibrin deposition and disintegrating neutrophilic granulocytes marked the leukocytoclastic vasculitis. Taken together the findings indicate that an immune complex vasculitis takes part in the pathogenic mechanism of pustule formation in Behcet's syndrome. PMID- 6851874 TI - [Sonographic studies in endocrine diseases]. PMID- 6851876 TI - [Death caused by alcohol]. PMID- 6851873 TI - [Diagnosis after recent myocardial infarct]. PMID- 6851875 TI - [Stomach ulcer and pregnancy]. PMID- 6851879 TI - [Erythropoietic protoporphyria]. AB - A 21-year-old patient was observed with oedematous-purpura-like skin changes since earliest childhood occurring in areas with short-term exposure to sunlight. The history suggested erythropoetic protoporphyria and the diagnosis was established by demonstration of fluorocytes in peripheral blood and subsequent porphyrin analysis. Whereas chronic persistent skin changes characteristic of erythropoetic protoporphyria were largely absent, histologic and immunohistologic findings were typical. The patient had been considered a "neurotic outsider" for many years because of his aversion to light which was considered abnormal. PMID- 6851878 TI - [Follow-up control after long-term withdrawal therapy in heroin and multiple drug addicts]. AB - A follow-up study was done in 31 rehabilitation probands who were discharged consecutively from a long term drug withdrawal centre for heroin and multiple drug addiction. Referral had been on the basis of section 64 of the penal code and a motivation for treatment had to be established first. After discharge the majority of probands could be reassessed repeatedly. A total of 180 follow-up investigations included also urinanalysis and in 170 of these cannabinoids were looked for. Cannabis was detected in only two cases. When other addictives were demonstrated in a few cases they could be attributed to codeine-containing medicines beyond doubt. Regular follow-up assessments of past drug addicts including urinanalyses serve for further stabilisation of the patients and at the same time indicate long-term success of treatment. PMID- 6851880 TI - [Diagnosis of Amanita phalloides poisoning]. PMID- 6851882 TI - [Quack diagnostic methods]. PMID- 6851877 TI - [Plasma cell granuloma of the lung (inflammatory pseudotumor)]. AB - Plasma cell granuloma of the lung is a rare, benign focal lesion of nonspecific inflammatory genesis with few symptoms and often discovered by chance during mass radiography. Radiologically it is characterized by a usually well-circumscribed solitary round focus (70% of cases), as an infiltrate or as atelectasis if it grows endobronchially. The histological picture is polymorph with mature plasma cells, lymphocytes, vacuolized histiocytes, fibroblasts and other elements of the reticulo-endothelial system. It has been given many names, pseudotumour appearing in the older literature. In the differential diagnosis a peripheral lesion can be mistaken for benign tumour, specific granuloma or metastasis, the more central form for bronchial carcinoma. The condition was observed in six personal cases, operated on between 1967 and 1982. PMID- 6851881 TI - [Therapy of Amanita phalloides poisoning]. PMID- 6851884 TI - [Incidence of hospitalizations and operations for ulcer disease 1970-1981]. AB - Since 1970 there has been a slight reduction, since 1977 a marked one, in the number of admissions for peptic ulcer at the two medical and the surgical clinics of the University of Mainz. This trend was interrupted by a peak from 1975-77, due to an increase of overall admissions at that time, after vagotomy procedures had been started at the surgical clinic. The reduction in admissions only related to uncomplicated ulcer and the admissions to the surgical clinic. Admissions for ulcer complications and to the medical clinics remained unchanged. The reduction in the number of operations for uncomplicated duodenal ulcer was 62%, for uncomplicated gastric ulcer 60%. Operative mortality rate for the former was 1.6%, for the latter 1.86%, while it was 10-25% for ulcer complications. PMID- 6851883 TI - [The physician's obligation to warn of a possible refusal by the private insurance company to assume payment of fees]. PMID- 6851885 TI - [Therapy of otosclerosis]. PMID- 6851886 TI - [Toxic shock syndrome. Pathogenesis, diagnosis, therapy]. PMID- 6851887 TI - [Perioperative plasma-antithrombin activity during low-dose heparin prophylaxis]. PMID- 6851888 TI - [Quadriplegia in heroin dependence]. PMID- 6851890 TI - [Renal artery occlusion. Blood pressure and kidney function before and after surgical treatment]. AB - Angioplasty was performed in 16 patients with renal artery occlusion. It was successful in each of six acute occlusions, although four patients died later of their underlying disease. Two patients are long-term survivors and have normal or compensated renal function up to three years postoperatively. Vessel reconstruction was successful in eight of ten patients with chronic occlusion. In seven there was definite improvement or normalization of the hypertension, in six renal function returned to normal. Thus the success rate as to organ preservation with improvement in pressure and function was 60%. PMID- 6851889 TI - [Gastro-esophageal reflux: is there a correlation between the degree of reflux and its effects?]. AB - In 77 patients suspected of having gastric reflux, long-term pH measurements obtained by an intraluminal pH probe were compared with manometric or endoscopic findings. There was a definite correlation between gastro-oesophageal reflux and both mild and severe stages of reflux disease. Diagnostically the significance and role of endoscopy in the course of routine diagnosis was confirmed. Analysis of the reflux pattern by long-term pH measurement made it possible to provide appropriate drug or surgical treatment of reflux disease. PMID- 6851891 TI - [Ultrasound diagnosis in thyroid diseases]. PMID- 6851892 TI - [The value of computerized tomography in the detection of spinal tumors]. PMID- 6851894 TI - [Postoperative thrombosis prevention with heparin and dihydroergotamine]. PMID- 6851893 TI - [Myocardial infarct during ergotamine medication in a young man with normal coronary arteries]. PMID- 6851895 TI - [Adrenaline in the treatment of severe bronchial asthma]. PMID- 6851896 TI - [Prevention of cytostatic-induced vomiting with high-dose metoclopramide]. PMID- 6851897 TI - [Accidents to drug smugglers: the "body-packer" syndrome]. PMID- 6851898 TI - [Social consequences of Crohn's disease]. AB - Impairment of social function was measured by questionnaire in 270 patients with Crohn's disease. In about half of them, the disease had had its onset below the age of 20 years. In 10%, schooling or job training was delayed or even had to be abandoned. Ten percent of the patients were forced to change their occupation because of the disease. 23.5% of the patients stated that their illness had prevented them from having whole-day jobs. Ten percent had temporary or permanent pensions; 3.8% were unemployed. 43.7% of patients stated that the relation to their family and (or) partner was impaired by the disease; in 36.4% the disease had interfered with leisure time activities. The results show that Crohn's disease has social effects which in the individual case can be very serious; they correlate with the duration and severity of the disease. Nonetheless, the majority of patients succeeds in mastering their chosen training and occupation and leading an active life. PMID- 6851899 TI - [Diagnosis of thoracic aortic aneurysms with 2-dimensional echography]. AB - Eight patients with thoracic aortic aneurysms were investigated by angiography, computed tomography and two-dimensional echography. According to results of computed tomography or angiography six patients had a dissecting aortic aneurysm (five patients type 1 and one patient type 3 according to DeBakey) and two patients had a thoracic aortic aneurysm without dissection. In addition, thrombi in the descending aorta were shown in three patients by computed tomography or by angiography. Type and extent of the aneurysms could be evaluated by two dimensional echography in all patients. Only in one patient could the origin of dissection in the ascending aorta not be localised precisely by echography. In three patients thrombi in the descending aorta could be demonstrated. For assessment of type and extent of the aneurysm the suprasternal approach was superior to precordial, subcostal and apical imaging. Parasternal investigation resulted in echographic demonstration of dissection in only two cases. Two dimensional echography is a technically less demanding and useful method in the diagnosis of thoracic aortic aneurysms. PMID- 6851902 TI - [Toward a better epidemiology of iodine deficiency goiter]. PMID- 6851900 TI - [Infusion-associated kidney and liver failure in undiagnosed hereditary fructose intolerance]. AB - Appendectomy was performed in a 14 1/2-year-old boy with undiagnosed hereditary fructose intolerance because of chronic recurrent abdominal pain. During and after operation fructose containing solutions were infused. The patient received a total of 250 g fructose intravenously over 30 hours. Hours after onset of infusion he became soporous, hypoglycaemic and acidotic and was anuric after one day. Although the diagnosis was suspected by the end of the first postoperative day and fructose had been cancelled and haemodialysis been started, the boy died after a further 3 days with signs of acute kidney and liver failure. The diagnosis of hereditary fructose intolerance was biochemically established in post mortem liver tissue. This case recalls the fact that fructose, sorbitol or invert sugars should not be added to infusion solutions as they may be toxic for healthy persons and imply a lethal risk for patients with undiagnosed hereditary fructose intolerance, even well beyond the baby and infant period. PMID- 6851901 TI - [Risk and dangers in nuclear magnetic resonance tomography. Suggestions for protection and surveillance]. PMID- 6851906 TI - [Efficacy-risk relationship in heparin-dihydroergotamine]. PMID- 6851905 TI - [The staging theory of sarcoidosis]. PMID- 6851903 TI - [Critique of goiter epidemiology. I. Goiter size]. AB - Comparison of three methods for demonstration of thyroid enlargement in 92 patients showed that the sensitivity of sonographic volumetrics (93%) and palpation (91%) is superior to radiography (45%). Sonography has the disadvantage of lack of quantitative demonstration of retrosternal goitre. Palpation and chest radiograph had the disadvantage of a frequency of false positive findings in 8.7 and 10.9%. PMID- 6851904 TI - [Critique of goiter epidemiology. II. Age dependence]. AB - Chest radiographs (n = 2000) of the public health office of Eutin were evaluated for the frequency of goitre in northern West-Germany. Up to the 40th year of age the frequency was 5%. Thereafter the prevalence of goitre-suspect radiographs gradually rose to 25% and to 50% after the 65th year of life. The radiographic method indicates that endemic goitre exists in Schleswig-Holstein as was to be expected due to formerly demonstrated alimentary iodine deficiency. PMID- 6851907 TI - [Irrigation treatment of a common bile duct calculus]. PMID- 6851908 TI - [Formation of a bundle branch block with flecainide]. PMID- 6851909 TI - Prophylaxis and treatment of infective endocarditis. Current recommendations. PMID- 6851910 TI - Growth and development of human adipose tissue during early gestation. AB - 805 normal-for-age human embryos and fetuses were used to study early prenatal fat development. The investigation included observations on stages of fat morphogenesis at the light microscopic level and computerized image analyses of fat lobule size and number. The buccal fat pad was selected as a model system for the analyses. Fat tissue differentiates between the 14th and the 16th weeks: there are five morphogenic phases in adipose tissue formation, strongly associated with the formation of blood vessels. Fat lobules are the earliest structures to be identified before typical vacuolated fat cells appear. Concerning fat lobule size and number, we show that after the 23rd week the total number of fat lobules remains approximately constant, while from the 23rd to 29th week the growth of adipose tissue is determined mainly by an increase in size of the lobules. These results suggest that the 14th through the 23rd week is a sensitive period in fat lobule development, and that disturbances of normal adipogenesis during this period may play a role in the etiology of obesity in later life. PMID- 6851911 TI - The effect of maternal hyperglycemia on gross body movements in human fetuses at 32-34 weeks' gestation. AB - This study demonstrated that fetal gross body movements were not significantly altered by fluctuations in maternal plasma glucose concentration. Fetuses moved episodically a relatively constant amount of time whether mother received water orally, 50 g of glucose orally or a 25 g bolus of glucose intravenously. In addition, depending on the length of the observational epoch, the incidence of fetal gross body movements differed. As the length of the observational period increased, the chance of finding no fetal gross body movements decreased and at intervals of 24 min duration, fetal gross body movements were absent in only 2% of 24 min periods examined, irrespective of whether they had received water orally, 50 g of glucose orally or 25 g of glucose intravenously. It is concluded that maternal carbohydrate intake was not an important determinant of fetal body movements in healthy fetuses at 32-34 weeks' gestation. PMID- 6851912 TI - Impact of thermal vasomotor control on the heart rate variability of newborn infants. AB - The reactivity of the periodic heart rate variability (HRV) to the thermal vasomotor control was studied during quiet sleep in a total of 20 neonates which were classified in 5 groups according to their maturity. Thermal stimulation on the peripheral skin was applied by an air blower at the rates of 5, 2.5 and 1.5 cycles/min. The oscillation of successive R-R intervals of the ECG was determined by a hybrid computer technique during thermal stimulations and compared to spontaneous HRV activity. The indices of the HRV and the total power of the periodic HRV remained unchanged during thermal stimulations. The response of the periodic HRV was selective at the spectral band corresponding to the frequency of stimulation. It was maximal at 5 cycles/min. The relative response was highly significant (P less than 0.001) and it increased with increasing maturity. The state of SGA (small for gestational age) seemed to decrease the vasomotor response of the HRV. The results suggested that the thermal vasomotor control was functional already in small preterm infants and it tended to increase with increasing maturity as does the autonomic cardiac control in general. PMID- 6851914 TI - Respiratory reflexes in ventilated premature babies. AB - The respiratory response to therapeutic lung inflation by artificial ventilation in premature babies has been studied. Both the Hering-Breuer and an augmented inspiratory reflex could be provoked by ventilator inflation in neonates as premature as 25 weeks gestational age. No chemo-receptor control was demonstrated on the presence of these reflexes. Augmented inspirations were only seen in the first five postnatal days regardless of gestational age, but the Hering-Breuer reflex persisted throughout the period of study of 11 days. The frequency of elicitation of augmented inspirations was shown to be inversely related to the dynamic compliance. The relative stimulation of these two respiratory reflexes may explain why some infants are easy to ventilate and others difficult. PMID- 6851916 TI - Chromosome investigations of workers exposed to cadmium in the manufacturing of cadmium stabilizers and pigments. AB - Chromosome analyses were undertaken on 14 workers exposed to cadmium and the results were compared with a corresponding control group. All probands have been employed for many years in cadmium pigment and stabilizer production plants (between 6 and 25 years). The results of the clinical investigations were, for the most part, unspecific, although at the same time some parameters were above the normal (transaminase, beta 2-microglobulin deposit in the urine, as well as cadmium in the blood and urine). The chromosome analyses were undertaken on the lymphocytes of the peripheral blood with the aid of the so-called "micromethod." Metaphases, 150 per person, were analyzed. The statistical evaluation was made according to the Fisher-Yates test. The chromosome aberration rate of the group investigated was not higher than that of the control group, inclusive and exclusive of gaps. PMID- 6851915 TI - Ecotoxicology of cadmium: interpretation of data and evaluation of current knowledge. PMID- 6851913 TI - Factors affecting the duration of breast feeding: 1. Measurement of breast milk intake in the first week of life. AB - Test-weigh measurements of 24 h milk intake by babies in the immediate puerperium (days 1-9) were carried out in a group of 18 mothers and babies using an accurate electronic balance. Estimated milk intakes were then calculated on the basis of one, and of two consecutive, breast feeds. These estimates were then compared with the actual total intake to give a measurement of reliability. Significant positive correlations were found between both the one-feed and the two-feed estimated intake, and the measured 24 h intake. Accuracy increased from day 3 onwards. These results show that using an electronic balance an accurate estimate of 24 h milk intake during the first week of life can be obtained by using one or two test-weigh measurements. While this gives a minimally invasive and reliable method for estimating daily milk intake, it is not advocated as a routine procedure in postnatal wards. PMID- 6851918 TI - Use and possibilities for substitution of cadmium stabilizers. AB - Of all plastics, Polyvinyl chloride is the only product stabilized with cadmium compounds, and then only to a certain extent. The amount of cadmium used as stabilizers is approximately 15% of the world production. The general importance of stabilization in view of ecotoxicological problems is discussed, leading to a more detailed consideration of the specific sectors in which plastic materials are used. Stabilization is strongly connected with the intended application and processing technology. It is obvious that stabilization of rigid PVC is indispensable in outdoor applications. If, at present, no substitute for cadmium stabilization is available, it is emphasized that the industry is strongly interested in resolving the problem, i.e., in searching for a cadmium-free stabilizer, for economic as well as environmental reasons. PMID- 6851917 TI - Impact of cadmium in the environment of the Federal Republic of Germany. AB - Under present conditions, a further increase of environmental pollution due to cadmium must be expected. The resulting effects would be seen particularly in an increase of cadmium concentration in the food chain and would lead to a higher average intake of cadmium by man. This means that the relatively small percentage of the population who are now exposed to the risk of renal malfunction due to cadmium would increase significantly. The subsequent decontamination of an area once it has been polluted is not possible according to our present knowledge. The consequences could include considerable limitation of land use for agriculture. It must, therefore, be considered essential to undertake preventative measures in order to limit the further output of cadmium to a minimum. To achieve this there are many possibilities in the field of reduction and prevention technology, possibilities which are worth examining and considering individually. PMID- 6851919 TI - Cadmium in soil and terrestrial biota, with emphasis on the Danish situation. AB - The cadmium load on the soil and terrestrial biota in the industrialized countries appears to be on the increase. Due to a relatively high mobility of this metal in the soil-plant system, the likely gradual increase in soil concentrations will influence the cadmium load on organisms in the terrestrial biota. It might be too early to predict the actual rate of increase in the cadmium load on specific organisms but some attempts to do so have suggested an annual increase rate of 0.5-2% in the human food intake of the metal. Although the present cadmium pollution of the environment at large is not yet crucial, the most sensitive species, man and other long-lived mammals, might soon need introduction of countermeasures to seriously reduce the load of this toxic metal. The most feasible countermeasures to be taken are reductions in emission to air directly or indirectly via reduction of the indiscriminate use of the metal for common consumer goods. A decrease of the inflow to soils in phosphate fertilizer may be more difficult to curb, but a reduced fertilization rate on most areas might be possible without loss of fertility. Sludge may not be a major source of cadmium nationally, but may locally significantly increase the inflows to agriculture (Statens Naturvardsverk, 1978; Miljostyrelsen, 1980; Umweltbundesamt, 1981; Department of the Environment, 1980. PMID- 6851922 TI - Trends in the uses of cadmium (1970-1979). PMID- 6851921 TI - The effect of cadmium on the environment. AB - Information on the effect of cadmium in the environment reported during the past several years has raised considerable questions about the validity of past conclusions. For example, it appears that the critical concentration of cadmium in the renal cortex may be significantly higher than previously thought, and also, there is growing evidence that cadmium was not responsible for Itai-Itai disease in Japan. These findings concerning cadmium are encouraging and indicate that while cadmium is certainly toxic, the new information should be considered by governmental authorities before steps are taken to enact overly stringent regulations based on assumptions and regulations that may no longer be correct. PMID- 6851920 TI - Waste-related cadmium cycle in Switzerland. AB - The anthropogenic contribution to the global cadmium flux exceeds natural sources by a factor of three. The most important pathway is the atmosphere; therefore, high cadmium concentrations can be found even in remote areas. On a local level, the increase in cadmium consumption can be observed in increasing concentrations in the soil, plants, and food. The question arises as to what extent the soil plant-man-waste-soil cycle can be loaded with cadmium in order to function without negative impact on the environment. In Switzerland, 120 tons (t) of cadmium are consumed per year. Of this amount, 25 t end up in municipal solid waste, 3 t in wastewater, and 19 t in precipitation and dry fallout. As a consequence of today's waste management practice (75% incineration, 20% sanitary landfill, 5% composting; 75% of all sewage is purified), the annual input to the soil is 40 t: 18 t concentrated in landfills, 19 t dissipated via the atmosphere, and 3 t directly spread via sewage sludge, compost, and fertilizer on agricultural land. If even distribution were possible, the cadmium content of the soil would theoretically double in 150 years. The accumulation in the soil will increase the cadmium content of plants grown on such a soil. According to a simple model, the level of 3 ppm cadmium in soils should not be surpassed. At such concentrations, plants are likely to contain greater than 0.4 mg Cd/kg, a concentration which can cause toxic effects in long-term experiments. The safe level in food might be even lower. In reality, cadmium is not evenly distributed over Switzerland. According to today's practice, it must be assumed that in only 14 years the use of compost will have enriched soils to such an extent that its cadmium content will prohibit the production of food for human consumption. For sewage sludge, this timespan is 130 years. If heavy metal limits in food are to be observed, the input of such metals to the soil has to be limited. In a steady state, the cadmium input to the soil should be equal to its output via plants, leachate, and erosion. This implies that today's dissipative use of cadmium must be stopped. PMID- 6851923 TI - Ecotoxicology of cadmium: general overview. PMID- 6851924 TI - The significance of the accumulation of cadmium by aquatic organisms. AB - Cadmium, by virtue of its toxicity, persistence, and bioaccumulation appears on the "black list" of all the international conventions aimed at protecting the aquatic environment from pollution. Although there is no doubt that cadmium is both persistent and toxic to aquatic life at relatively low concentrations, its bioaccumulation potential appears to have been somewhat exaggerated. Median concentration factors for both marine and freshwater organisms are less than 100 times and for vertebrate (fish) species concentration factors are less than 20 times. There is no evidence in the literature for biomagnification of cadmium and bioconcentration is only likely to be of significance in a restricted range of gastropod mollusks and some crustacea. PMID- 6851925 TI - Accumulation of cadmium in a freshwater food chain experimental model. AB - The study of food chain contamination in nature or in the laboratory requires precise definitions of some terms. A simplified model of a freshwater food chain has been elaborated to try to point out hazards related to the presence of cadmium in the aquatic environment. Three different species belonging to various trophic levels, but to the same aquatic systems were used. The required biological and analytical criteria are described. The time course of the experiment was 34 days starting with a 10-day contamination of the first trophic level (algae). The algae were then separated, washed with fresh medium, and given to the second trophic level (daphnids) to eat for 20 days. The third trophic level (fish) was then introduced for 4 days as a scavenger. The methodology was designed to determine the accumulation of cadmium by daphnids and then fish from the algal source. The results show a high direct bioaccumulation of cadmium in algae. The indirect bioaccumulation of daphnids was of the same order of magnitude, but for fish it was smaller. Nevertheless the cadmium transfer from daphnids to fish was obvious. PMID- 6851927 TI - Cadmium concentrations in tobacco and tobacco smoke. AB - The amount of cadmium in tobacco depends on the variety and origin of the plant as well as on the analytical method used to determine cadmium. In the literature, cadmium concentrations in tobacco of between 0.5 and 5 ppm are reported. Modern German cigarette tobacco contains about 0.5-1.5 micrograms cadmium/cigarette. Of importance for the smoker is the amount of the metal in the mainstream smoke. The cadmium level in the mainstream smoke of modern cigarettes is reduced by means of filters and other construction features. The average Cd value of German filter cigarettes is less than 0.1 microgram/cigarette in mainstream smoke. An average daily intake of about 1 microgram cadmium by smoking 20 cigarettes can be calculated on the basis of an experimentally proved pulmonary retention rate of 50%. Pulmonary resorption rates relevant to uptake rates of cadmium by smoking are discussed. It can be assumed that cadmium uptake by smoking modern cigarettes has been reduced because of modifications in tobacco processing and cigarette construction in the last few decades. PMID- 6851926 TI - National and local dietary impact of cadmium in south coastal California soils. AB - The south coastal area of California contains agricultural soils that are important producers of vegetables for the nation. Some of these soils contain anomalous, high concentrations of cadmium which are variably reflected as increases of the cadmium concentration of the vegetables growing thereon. The response ranges from strong to moderate to zero increase in tissue cadmium with increasing soil cadmium. Although the source of the high levels of cadmium is the rocks of the region and is not anthropogenic, it is considered likely that some steps should be taken to diminish dietary exposure to local consumers and especially to vegetable gardeners with large gardens. PMID- 6851928 TI - Influence of cadmium on placental structure. AB - Placentas of smoking and nonsmoking mothers have been investigated with light microscopical techniques. The cadmium content of the same placentas had been determined in a previous study by means of atomic absorption spectrophotometry (AAS). The cadmium content of the placentas from smokers was found to be elevated, compared to that of nonsmokers. The volume density of the vascular bed in the terminal villi of the placentas of smokers was found to be decreased. Preliminary results of experiments in course with rats exposed to 0.2 mg CdCl2/kg body wt/day (by subcutaneous injection) seem to indicate that in the placenta of rats, the volume density of the blood vessels in the placental stroma is likewise reduced in the exposed animals. PMID- 6851929 TI - The influence of tin, nickel, and cadmium on the intestinal absorption of iron. AB - The influence of increasing doses of cadmium, nickel, and tin on the net absorption of fluid as well as upon the absorption of 59Fe, administered as 59Fe (FeSO4), from tied-off jejunal segments of male Sprague-Dawley rats were investigated. The three metals examined decreased the net absorption of fluid from the jejunal segments progressively with increasing metal doses. Cadmium was the most potent inhibitor of fluid absorption followed by tin and nickel. Tin, cadmium, and nickel diminished the absorption of 59Fe with increasing doses. The content of 59Fe of the jejunal tissue was not statistically significantly influenced by nickel, whereas tin as well as cadmium diminished the content of 59Fe significantly. Cadmium decreased the content of 59Fe to a greater extent than tin. Obviously nickel influences the rate-limiting process of iron absorption, i.e., the transfer of iron from mucosal cells into blood. Tin and cadmium appear to interact with the process of iron uptake on the surface within the mucosal cells as well as with the iron-releasing process at the contraluminal side. Cadmium as compared with tin is a stronger inhibitor for the processes involved in iron absorption. PMID- 6851931 TI - Non-steady-state equilibrium model for the preliminary prediction of the fate of chemicals in the environment. AB - Prediction of the fate of chemicals in the environment is essential to the assessment of the potential hazard of chemicals. The fate of a chemical in the environment depends mainly upon (1) transfer processes between environmental compartments due to physicochemical properties, (2) transformation processes in each compartment, and (3) characteristics of the environment. Many equilibrium or kinetic models have been proposed to predict the fate of chemicals in the environment. Though kinetic models are useful in predicting the concentration time profile of a chemical at the non-steady state, they are rather complicated. In this work is proposed a simple and useful equilibrium model for prediction of the mass and concentration distribution fraction, mean residence time, and concentration-time profile of a chemical released into the environment, an advantage of our model. For the validation of this model, the results were compared with data from Neely's pond experiment and field data monitored by the Japanese Environment Agency. The results show that the equilibrium model is valuable for preliminary prediction of the fate of chemicals that are priority chemicals for hazard assessment in the environment. PMID- 6851930 TI - Forecast of cadmium impact on the environment using environmental models. AB - A study of the pathway of cadmium in the European Community (EC) has led to the development of a time-dependent computer model that relates past and present environmental cadmium levels to the inputs of cadmium. Information on the origin and movement of environmental cadmium through the different compartments of the biosphere has been obtained from a literature study and has been used to simulate the pathway of cadmium in the EC. The model is used to investigate the future evolution of the average cadmium concentrations in air, soil, and sediments in the EC, based on assumptions for the future evolution of consumption and for possible environmental policies to be adopted. The results are averages taken over the whole Community, which implies that no local pollution can be obtained from this model that only indicates the possible future trend. PMID- 6851932 TI - Adsorption, percolation, and decomposition methods for forecasting the behavior of organic chemicals in soils. AB - Sorption, movement, and decomposition of trichlorphenoxyacetic acid (2,4,5-T) in two Berlin soils were investigated in field experiments in summer and winter time. Contemporary with simple laboratory methods, it was attempted to predict the behavior under field conditions. For this purpose, adsorption and desorption experiments were carried out and isotherms were calculated using the Freundlich equation. Second, percolation studies under saturated and unsaturated conditions were considered. Finally, the decomposition of 2,4,5-T in soil samples at different temperature was determined. A sorption experiment at the beginning of a test program for prediction the behavior from chemical compounds at least with four soil samples, a Chernozem-Ah, a Cambisol-Ap, a Podsol Ah, and a Pelosol-B, completed by decomposition experiments measuring the CO2-respiration, is proposed. PMID- 6851933 TI - Interest of dynamic tests in acute ecotoxicity assessment in algae. AB - Sorption of toxics by algae may be important and occurs very early. Thus, a decrease of the experimental toxic concentrations in the medium results in understating toxicity when tests are conducted under static conditions. In this work, two different methods of exposure of algae (Chlorella vulgaris) are studied, the static test and the pseudodynamic test. Acute effects (biological and analytical effects) of inorganic compounds (Cu2+, Cd2+, Pb2+, Cr6+) have been evaluated for 96 hr of exposure; in each case, IC50 is much lower in the dynamic condition than in the static one. The percentage of reduction varies from 55 to 75% after 96 hr. Accumulation of metal by chlorellae is greater when testing by the pseudodynamic way, with Cu2+ and Pb2+. But in the case of Cd2+ and Cr6+, the concentration factors are similar in the two kinds of exposure. These results point out the advantage of the pseudodynamic test, of which the methodology is very easy, for a more realistic assessment of acute ecotoxicity in these organisms. PMID- 6851934 TI - The effect of methyl oleate hydroperoxide, a possible toxic ozone intermediate, on human normal and glucose-6-phosphate dehydrogenase-deficient erythrocytes. AB - Erythrocytes of both normal and glucose-6-phosphate dehydrogenase (G-6-PD) deficient humans responded in a dose-dependent manner to the oxidant stress of methyl oleate hydroperoxide (MOHP) as measured by decreases in G-6-PD activity, increases in methemoglobin (METHB) levels, and decreases in reduced glutathione (GSH). The G-6-PD-deficient erythrocytes displayed a markedly enhanced sensitivity to MOHP-induced decreases in G-6-PD activity and METHB increases while being less sensitive than normal erythrocytes to changes in GSH levels. PMID- 6851935 TI - Ca2+-calmodulin-dependent phosphorylation of soluble and nuclear proteins in the rat ovary. AB - Studies were undertaken to determine if calmodulin-regulated Ca2+-dependent protein kinase system(s) exist in the prepubertal rat ovary. Phosphorylation studies were performed with ovarian cytosol, calmodulin-depleted cytosol, and nuclear extracts. In vitro phosphorylation of endogenous substrate proteins was accomplished by incubation of tissue fractions with [gamma-32P]ATP followed by electrophoretic separation and autoradiographic demonstration of phosphorylated proteins. Calmodulin-dependent phosphorylations of a cytosol protein, mol wt, 95,000, and of three nuclear proteins in the mol wt range of 50,000-60,000, were established by demonstrating: Ca2+ requirement; inhibition by the phenothiazine derivative chlorpromazine; and dependence upon addition of exogenous calmodulin to the calmodulin-depleted cytosol, or to the nuclear extract. These findings demonstrate the presence of rat ovarian cytosol and nuclear Ca2+-calmodulin dependent protein kinase activities capable of recognizing endogenous substrate proteins. PMID- 6851937 TI - Transplacental effects of 3,5-dimethyl-3'-isopropyl-L-thyronine on fetal hypothyroidism in primates. AB - Pregnant Rhesus monkeys treated with 131I at midgestation become hypothyroid and produce fetuses without demonstrable thyroid tissue. In an effort to prevent both maternal and fetal hypothyroidism, we treated 131I-treated pregnant monkeys with 3,5-dimethyl-3'-isopropyl-L-thyronine (DIMIT), a thyroid hormone analog with structural changes which facilitate placental transfer. Five pregnant monkeys were treated with 131I (mCi/kg) at 83-87 days of gestation. One week later, three monkeys were started on treatment with DIMIT (10 micrograms kg-1 day-1, im) and two on im L-T4 (2 micrograms kg-1 day-1). Treatment was continued until delivery by Caesarian section at 152-157 days of gestation. None of the DIMIT-treated mothers became clinically hypothyroid, nor did they have elevated serum TSH concentrations despite low serum levels of T3 and T4. T4-treated mothers were also maintained clinically and biochemically euthyroid. At delivery, infants of DIMIT-treated mothers had normal respiratory function and skeletal maturation. Basal and TRH-stimulated TSH concentrations were suppressed in two of the three infants. By contrast, both T4-treated infants resembled untreated cretinous newborns and died soon after delivery from respiratory failure. Serum TSH concentrations were elevated and skeletal maturation was markedly delayed in these animals. We conclude that DIMIT administration to 131I-treated monkeys prevents clinical and biochemical hypothyroidism in the mother and prevents the major clinical manifestations of cretinism in the fetus. PMID- 6851936 TI - Effect of environmental hydrogen ion concentration on regulation of insulin receptors in cultured R3230AC mammary carcinoma cells. AB - Insulin binding and responsiveness in primary cultures of R3230AC rat mammary tumor cells were studied as a function of the hydrogen ion concentration of the culture medium. When insulin binding was assayed at pH 7.4, cultures that were maintained for a sufficient length of time in acidic medium demonstrated a significant increase in insulin receptor concentration compared to control cultures. The increase in insulin binding, which occurred as cultures approached confluency, was attributed to the increased acidity rather than nutrient depletion of the culture medium. In contrast, maximum binding was observed when the pH of the assay buffer was above 8.0, independent of the culture conditions. Binding of Concanavalin A, reflecting more generalized cell surface glycoproteins, decreased as cultures approached confluency, but was unaffected by the pH of either the culture medium or the assay buffer. The effect of pH on insulin responsiveness was studied. Insulin receptors generated by acidic culture conditions demonstrated insulin-induced down-regulation. Regardless of the pH environment, all cells demonstrated the same amount of insulin binding after exposure to 10(-6) M insulin. Under the in vitro conditions employed, cultured cells did not demonstrate a significant response to added insulin by alteration in growth, substrate transport, or incorporation of precursors into macromolecules, although the basal rates of these parameters were lower in cells maintained in acidic pH environments. The data presented indicate the necessity of considering the pH of the culture medium in studies of receptor regulation. It is possible that tumor cells, due to increased lactic acid production, may be especially prone to these changes. PMID- 6851938 TI - Changes in tissue concentrations of thyrotropin, free thyrotropin beta, and alpha subunits after thyroxine administration: comparison of mouse hypothyroid pituitary and thyrotropic tumors. AB - We have previously demonstrated divergent changes in pituitary free TSH beta and alpha-subunit concentrations in hypothyroid mice during prolongation of experimental hypothyroidism and after T4 administration. This report compares the simultaneous responses of pituitary and thyrotropic tumor TSH, TSH beta, and alpha-subunit to 12 days of T4 administration in four groups of hypothyroid LAF1 mice bearing thyrotropic tumors. Half of each group received daily injections of T4 (10 micrograms/100 g BW, ip) for 12 days; the other half of each group received saline. Plasma concentrations of TSH, free TSH beta, and free alpha subunit were suppressed by T4 administration to 0.1-1.5%, 2.0-3.9%, and 4.1-25% of control concentrations, respectively. Pituitary TSH and free TSH beta concentrations fell significantly with treatment to 24-43% and 10-28% of control concentrations, respectively. In contrast, pituitary alpha-subunit concentrations did not fall (they were 106-203% of control values), and a rise in the pituitary alpha-subunit concentration was statistically significant in one group (P less than 0.02). Thyrotropic tumor TSH and free TSH beta concentrations fell significantly with treatment to 9-31% and 8-35% of control concentrations, respectively. Tumor alpha-subunit concentrations did not fall (they were 87-195% of control values), and a 2-fold rise was statistically significant in one group (P less than 0.05). Both pituitary and tumor alpha-subunit to TSH beta molar ratios increased significantly with T4 administration in all groups. We conclude that (1) pituitary and thyrotropic tumor TSH beta concentrations fall after 12 days of T4 administration while alpha-subunit concentrations are unchanged or actually rise; (2) this divergent response is qualitatively similar in hypothyroid mouse pituitary and thyrotropic tumors; and (3) these data suggest differences between the regulation of intracellular TSH beta and alpha-subunit. PMID- 6851940 TI - Induction of estrogen and progesterone receptors and decidualization in the hamster uterus by cholera toxin. AB - Cholera toxin (CT) injected ip on day 1 (day of ovulation) of the 4-day hamster estrous cycle, when circulatory progesterone is high and estrogen low, induced a massive uterine decidual reaction, a progesterone-dependent growth normally triggered by the implanting blastocyst. However, CT injected ip on day 3, when circulatory estrogen is high and progesterone low, did not induce a decidual reaction but, instead, intensified the effects of estrogen (stromal edema and stimulation of the mucosa). These cycle day effects were reproduced in one uterine horn injected intraluminally with CT, but not in the other horn of the same animal given solvent alone as a control. The intrauterine injection of CT had no effect on the concentration of serum estrogen or progesterone. The decidual reaction resulting from intrauterine injection of CT on day 1 was accompanied by increases in estrogen receptor (femtomoles per mg DNA) in both cytoplasm and nucleus. In long term ovariectomized hamsters, an ip or intrauterine injection of CT induced only histological effects of estrogen (stromal edema and mucosal mitosis) without affecting circulatory estrogen. These estrogenic effects were accompanied by increases in receptors for estrogen and progesterone in both cytoplasm and nucleus. CT injected ip into ovariectomized hamsters primed with estrogen intensified the stromal edema and mucosal mitosis and resulted in progesterone and estrogen receptor levels equal to or greater than those after the administration of CT or estrogen alone. When progesterone was included in the priming (estrogen + progesterone + CT), all receptor levels were decreased, and a massive decidual reaction resulted. Thus, the induction of estrogen receptor by CT may have been the primary event that triggered the decidual reaction. Whether CT-induced estrogen receptor is mediated by cAMP, a known mediator of CT, remains to be determined. PMID- 6851939 TI - In vitro stabilization of the unoccupied glucocorticoid receptor by adenosine 5' diphosphate. AB - The addition of ATP to rat liver cytosol slows the rate of heat inactivation of the unoccupied glucocorticoid receptor (25 C) and stimulates the rate of activation of the preformed glucocorticoid-receptor complex (15 C). Dose-response curves and kinetic studies show that ADP is as effective as ATP in stabilizing the unoccupied glucocorticoid receptor against heat inactivation. ATP can also be replaced by analogs with a hydrolysis-resistant alpha, beta-pyrophosphate linkage (5'-adenylyl methylenephosphonophosphate or 5'-adenylyl methylenephosphonate); however, the hydrolysis-resistant beta, gamma analog (5'-adenylyl methylenediphosophonate) is ineffective. The addition of creatine phosphate plus creatine kinase, a condition favoring ATP formation, stimulates the rate of inactivation of the unoccupied glucocorticoid receptor, and the effect is only partially overcome by ADP. A condition that favors ADP formation, the addition of creatine plus creatine kinase, has no effect on the rate of inactivation of the unoccupied receptor and does not decrease the protective effect afforded by ATP alone. Collectively, these results suggest that ATP stabilization of the steroid binding site in vitro is due to ADP generated from the triphosphate by endogenous enzymes and is not due to phosphorylation or adenylation of the receptor by ATP. Unlike ATP stabilization of the steroid-binding site, the ATP-stimulated increase in the rate of activation of the preformed glucocorticoid-receptor complex (15 C) does not require hydrolysis of the beta, gamma-pyrophosphate bond. Dose-response curves show that both ATP and 5'-adenylyl methylenediphosophonate stimulate the rate of activation of the glucocorticoid-receptor complex. Quantitation of nucleotide levels in unfractionated rat liver cytosol by high performance liquid chromatography shows that the effective concentration of added ATP that produces an optimal response is within the physiological range reported for intact cells. PMID- 6851941 TI - Effects of changes in steady state plasma vasopressin levels on renal and urinary vasopressin clearances in the dog. AB - A study was made of the effects of changes in the plasma vasopressin concentration on the extraction ratio and the renal organ and urinary clearances of vasopressin. Plasma vasopressin levels were increased in a stepwise fashion in anesthetized dogs by the iv infusion of vasopressin at rates of 100, 400, and 800 microU/min . kg. A steady state was achieved by infusing vasopressin for 60 min at each dose. Before the infusion of vasopressin, the extraction ratio and the renal and urinary clearances of vasopressin (one kidney) were 0.30 +/- 0.04, 1.8 +/- 0.2, and 1.4 +/- 0.1 ml/min . kg, respectively. The urinary clearance of vasopressin did not differ significantly from the inulin clearance (1.5 +/- 0.1 ml/min . kg). The infusion of vasopressin, which increased the plasma vasopressin concentration from an initial value of 4.3 +/- 1.3 to 54.6 +/- 2.4 microU/ml at the highest rate of infusion, was without effect on the vasopressin extraction ratio and the renal and urinary clearances of vasopressin. The MCR of vasopressin was estimated to be approximately 16 ml/min . kg. The renal clearance of vasopressin, calculated for both kidneys in all periods of all experiments, accounted for approximately 27% of the total clearance of vasopressin from the plasma. Thus, over a broad range of plasma vasopressin concentrations, a constant fraction of the vasopressin delivered to the kidney was removed from the blood perfusing the kidney, and the mechanisms for the renal extraction of vasopressin were not saturated. PMID- 6851942 TI - Effects of nonhypotensive hemorrhage on renal organ and urinary clearances of vasopressin in the dog. AB - A study was undertaken to investigate the effects of moderate nonhypotensive hemorrhage on the renal organ and urinary clearances of vasopressin in anesthetized dogs. A nonhypotensive hemorrhage was conducted in nine dogs by withdrawal of 12 ml/kg arterial blood over 10 min. This reduction in blood volume increased the plasma vasopressin concentration from a prehemorrhage value of 4.3 +/- 0.5 to 12.5 +/- 3.4 microU/ml (P less than 0.01) in the 15-min period immediately after hemorrhage and to 8.1 +/- 1.4 microU/ml (P less than 0.01) in the 45- to 60-min period after hemorrhage. The increased plasma vasopressin concentration was not associated with changes in either plasma osmolality or mean arterial blood pressure. The urinary excretion of vasopressin increased significantly after hemorrhage (P less than 0.01, 0-15 min after hemorrhage; P less than 0.05, 45-60 min after hemorrhage) and correlated significantly with the plasma vasopressin concentration (r = 0.92; P less than 0.001). However, this moderate nonhypotensive hemorrhage did not change the renal vasopressin extraction ratio or the renal organ and urinary clearances of vasopressin from their prehemorrhage values of 0.27 +/- 0.02, 2.00 +/- 0.20 ml/min X kg, and 1.43 +/- 0.13 ml/min X kg, respectively. At no time were these values different from those in nine time control dogs. Thus, changes in the renal handling of vasopressin do not contribute to the increase in the plasma vasopressin concentration after moderate nonhypotensive hemorrhage. PMID- 6851943 TI - The ontogeny of estrogen responsiveness reexamined: the differential effectiveness of diethylstilbestrol and estradiol on uterine deoxyribonucleic acid synthesis in neonatal rats. AB - Previous reports have indicated that 17 beta-estradiol is unable to stimulate DNA synthesis in the neonatal rat uterus. Possible causes for this unresponsiveness that have been suggested include the ontogenic acquisition of late responses to estrogen and the sequestering of injected estradiol by the higher concentration of serum alpha-fetoprotein. To test these hypotheses we have examined the mitogenic potency of diethylstilbestrol (DES), a nonsteroidal estrogen which has a lower affinity for alpha-fetoprotein. Our results reveal that 1.0 microgram DES administered in a single injection can stimulate DNA synthesis 24 h later in 5 day-old rats, the youngest tested. By comparison, a single injection of 1.0 microgram estradiol did not stimulate DNA synthesis until rats reached an age of 10-15 days. Higher doses of estradiol administered in a single injection stimulated DNA synthesis in neonates but to a lesser extent than DES. The potency of estradiol relative to DES increased with age up to 28 days, at which time they were equipotent. The magnitude of the stimulation of DNA synthesis increased with age even with DES because control levels of DNA synthesis are high in young rats and decreased as the rats matured. These results indicate that uterine cells of neonatal rats have no inherent inability to synthesize DNA in response to estrogen and are consistent with the hypothesis that serum alpha-fetoprotein is responsible for the decreased potency of estradiol. PMID- 6851944 TI - In vivo activation and nuclear binding of the AtT-20 mouse pituitary tumor cell glucocorticoid receptor. AB - AtT-20 mouse pituitary tumor cells were incubated at 25 C with the tritiated glucocorticoids triamcinolone acetonide (9 alpha-fluoro-11 beta, 16 alpha, 17,21 tetrahydroxy-pregna-1, 4-diene-3,20-dione 16,17-acetal with acetone), dexamethasone (9 alpha-fluoro-11 beta, 17,21-trihydroxy-16 alpha-methyl-pregna 1,4-diene-3, 20-dione), prednisolone (11 beta, 17,21-trihydroxypregna-1,4-diene 3,20-dione), and corticosterone (11 beta, 21-hydroxypregn-4-ene-3,20-dione) in order to examine the nuclear binding and glucocorticoid receptor activation produced in vivo. Although the total amounts of intracellular receptor labeled by each steroid were similar, each steroid caused different and characteristic percentages of occupied receptor to be translocated into the nucleus. DEAE chromatography of the nuclear receptor extracted in the presence of sodium molybdate to prevent spontaneous activation showed that, as expected, the nuclear receptor was in the activated form. Activated receptor in the cytosol was determined by DEAE chromatography of cytosol prepared from cells that had been incubated with the various labeled glucocorticoids mentioned above. Total intracellular activated receptor was determined as cytosolic activated receptor plus total nuclear receptor. The results showed that for the four agonists used, the extent of nuclear binding is proportional to the degree of activation and that both of these parameters correlate with steroid-receptor affinity. It was also found that the removal of steroid from the cell incubation medium caused the rapid return of nuclear receptor to the cytosolic compartment in an unactivated form. This reversal was not dependent on protein synthesis. These results are consistent with a model of nuclear binding in which the proportion of steroid bound receptor that becomes activated is determined by steroid binding affinity. However, the activated receptor partitions between the cytoplasmic and nuclear compartments to the same extent regardless of the steroid used, suggesting that although the percentage of activated receptors is steroid dependent, the nuclear binding ability of the activated receptor is an intrinsic and constant property of the protein itself. PMID- 6851945 TI - The role of decidual tissue in the development of the dependency on luteinizing hormone in the rat corpus luteum. AB - In pregnant rats, treatment with an antiserum to LH (LHAS) on days 2-5 inclusive (early LHAS treatment; day 1 = insemination) delayed implantation by about 4 days. The appearance of the dependency of the corpora lutea on LH for the maintenance of progesterone secretion (LH dependency), as determined by the rate of fall in progesterone secretion after a single test injection of LHAS, was also delayed by 4 days. Treatment with a small amount of estradiol on either day 4 or days 4-9 prevented the delay in both implantation and LH dependency. Implantation thus prevented early LHAS treatment from delaying LH dependency, but its effect seems to have been due to decidualization, which accompanies implantation in the rat. In decidual tissue (DT)-bearing pseudopregnant rats, early LHAS treatment delayed LH dependency for only 1 day, while it delayed LH dependency for at least 3 days in ordinary pseudopregnant rats and for at least 4 days in hysterectomized pseudopregnant rats. Estrogen itself seems to have prevented the delay in LH dependency only by inducing implantation, since it had no effect in the DT bearing pseudopregnant rats. How DT affects the corpus luteum's dependency on LH is unknown, but it may be related to whatever effect DT has on prostaglandin production in the endometrium. PMID- 6851946 TI - Rat chorionic gonadotropin: augmentation of bioactivity in the absence of the pituitary. AB - Significant gonadotropin-like bioactivity, as measured by rat interstitial cell testosterone assay, is present in the serum and placenta of pregnant rats. The patterns of activity for this putative rat chorionic gonadotropin (rCG) in serum and placenta are distinct from those observed for rat placental lactogen (rPL) radioreceptor activity. Placental and serum rCG (and rPL) activities are substantially increased, as are placental weights, following removal of the maternal pituitary on day 12 of pregnancy. These findings strengthen the evidence for the existence of a rat CG and suggest a novel role for the maternal pituitary in regulating placental function during normal gestation. PMID- 6851947 TI - Estrogen and antiestrogen binding to different forms of the molybdate-stabilized estrogen receptor. AB - We report that the calf uterine estrogen receptor, prepared in a Tris-molybdate buffer, bound by 10 nM [3H]estradiol and eluted by a KCl gradient from DEAE cellulose columns, yielded only one very sharp receptor peak. Estrogen receptor prepared in phosphate buffer with molybdate and eluted with KCl also yielded only one sharp peak on DEAE-cellulose. However, if DEAE-Sephadex (with phosphate buffer plus molybdate) was used, the [3H]estradiol-receptor complex eluted with two sharp peaks at approximately 0.21 and 0.25 M KCl (Peaks I and II, respectively). But the high-affinity antiestrogen, [3H]H1285, bound to estrogen receptor, eluted only as Peak I and not as Peak II. Both the [3H]estradiol and [3H]H1285 binding peaks were saturable since they could be eliminated with 200 fold excess estradiol. Therefore, ion exchange chromatography using different resins and/or buffers may be useful for determining physicochemical differences in estrogen versus antiestrogen receptor complexes. PMID- 6851948 TI - Stimulation of phospholipid synthesis by luteinizing hormone in isolated rat granulosa cells. AB - This report describes the effect of LH on phospholipid metabolism in rat granulosa cells isolated from mature Graafian follicles. As indicated by the incorporation of radioactive phosphate, LH specifically stimulated the labeling of phosphatidic acid (PA) and phosphatidylinositol (PI). This effect was observed after 2 min and was more pronounced with further incubation with LH. Increases in PI labeling were correlated with increases in LH-induced progesterone accumulation. LH also increased the tissue concentrations of PI. Addition of exogenous PA or PI, but not other phospholipids, increased progesterone accumulation by granulosa cells. These results indicate that LH has selective effects on phospholipid metabolism in rat granulosa cells which may play a role in ovarian steroidogenesis. PMID- 6851949 TI - "Splitting" and stretching dilation of esophageal strictures. AB - The "Splitting" action of metal olives, and the stretching effect of tapering Neoplex tubes of increasing diameter on dysphagia in a group of 55 consecutive patients with esophageal strictures are compared. Dilators were passed over a fibreoptic endoscopically positioned guide wire. Greater relief of dysphagic symptoms was obtained with the stretching procedure, mainly in postanastomotic and peptic strictures. Both procedures were safe, but the stretching technique was easier and resulted in wider dilations in most patients. Consecutive dilations using stretching procedures in malignant strictures appear to be an appropriate easy and safe alternative to endoprosthesis insertion. PMID- 6851951 TI - Where have peptic lesions gone? AB - The endoscopic diagnoses of the GI unit of a hospital department and of the private practice of a gastroenterologist were compared in a prospective study. Peptic lesions were found twice as often during endoscopy of GI outpatients than of GI inpatients. The results suggest that nowadays diagnosis and treatment of peptic lesions are largely a domain of private practice. PMID- 6851952 TI - Results of endoscopic removal of villous tumors of the colon. AB - The author analyses the results of endoscopic removal of 136 villous tumors of the colon in 125 patients. The tumors ranged from 2 cm to over 6 cm in size. In the article emphasis is placed on the fact that multi-stage interventions are mainly practiced in the removal of villous tumors. A study of the histological structure has shown that malignancy in the group of villous tumors is considerably more rarely encountered than in the group of combined papillary adenomas, despite the fact that villous tumors are larger than glandular-villous adenomas. Dynamic supervision over a period of up to 7 years shows that in 68 out of 95 men there were no signs of recurrence, in 16 men the so-called "growth recurrence" was seen, and in 5 men continued growth of the primary tumor; in 2 cases new villous tumors were detected, and in 4 carcinomas were detected at the sites at which villous tumors had been previously removed. Endoscopic removal of villous tumors should rightfully be considered the procedure of choice in dealing with nodal and spreading tumors of the colon, especially in elderly patients suffering from severe accompanying diseases. PMID- 6851950 TI - Obstructive syndrome due to a bezoar in a B-II gastric stump. Endoscopic treatment. AB - Three cases of a phytobezoar in B-II-gastrectomy are considered in relation to their development around a suture thread acting as precipitating factor; the bezoar was responsible for the presenting obstructive syndrome. Endoscopic diagnosis and definitive treatment by removal of the bezoar together with the thread after cutting the fixed end is stressed. Various kinds of treatment proposed by other authors for the common types of bezoar are discussed. PMID- 6851953 TI - A multiple-diameter bougie fitted over a small-caliber fiberscope. AB - New instruments for dilatation of the upper gastrointestinal tract are described: 1. A hollow plastic bougie with an inside diameter of approximately 10 mm to allow a 9 mm endoscope to pass. The diameter of this tube-like bougie increases in four steps up to 16 mm. 2. A second-similar bougie employs a flexible bronchoscope for guidance of the bougie. This system permits bougienage from 4 to 11.5 mm. The system permits stepwise bougienage of stenoses using only two instruments. For the first time complete endoscopic control of bougienage is possible. PMID- 6851954 TI - The importance of ERCP for the surgical tactic in haemorrhagic necrotizing pancreatitis (preliminary report). AB - In patients with haemorrhagic necrotizing pancreatitis who are scheduled for surgery, we have been carrying out a preoperative retrograde investigation of the pancreatic duct system for the past 3 months. The results in, to date, ten patients, all of whom survived their severe illness, revealed four different morphological findings of importance for the surgical tactic. 1. A normal pancreatic duct system with no signs of fistulae: only peripancreatic necrosectomy is required. 2. Contrast medium leaks via a ductal fistula: left resection, including the removal of the fistulous area, must be done. 3. Normal duct system with complete segmental parenchymal staining, representing total necrosis in this region: left resection of the pancreas. 4. Duodenoscopically demonstrable perforation into the duodenum of a necrotic cavity in the head of the pancreas: conservative management only, no surgery, since this lesions, resulting in drainage of the necrotic cavity into the bowel, permits self healing, while the site of the perforation within the necrotic wall cannot be dealt with by surgery. The experience gained so far indicates that the surgical tactic can be determined with greater selectivity by the use of ERCP. PMID- 6851955 TI - Endoscopic discovery and capture of Necator americanus in the stomach. AB - We report a case of the endoscopic discovery and removal of a specimen of Necator americanus hooked into the gastric mucosa of a black woman from Zaire. We extracted the parasite by means of biopsy forceps. Signs of previous bites were seen in the antrum. This exceptional localization might be due to a jejuno duodeno-gastric reflux. PMID- 6851956 TI - Successful treatment of a post-operative external biliary fistula by endoscopic papillotomy. AB - A patient presenting with a bile collection in his abdominal wound following an oesophagogastrectomy was found to have an external biliary fistula. The obstruction in the common bile duct was due to gallstones. The patient underwent endoscopic papillotomy and his fistula closed without further surgery. PMID- 6851957 TI - Pancreatico-pleural fistula with chronic pleural effusion--endoscopic-retrograde visualization and therapy by ultrasonically--guided drainage. AB - In a patient with alcohol-induced chronic pancreatitis, a large chronic left sided pleural effusion persisted after partial pancreatectomy (resection of the pancreatic tail). ERCP outlined a transdiaphragmatic fistula between the duct of the remaining pancreas and the pleural cavity. The effusion was removed by ultrasound-assisted thoracocentesis, and the fistulous canal was obliterated permanently. PMID- 6851959 TI - A quantitative light and electron microscopic study of hamster tracheal epithelium with special attention to so-called intermediate cells. AB - Epithelial cells of the lower trachea of the hamster were studied and quantified by high resolution light microscopy and electron microscopy. The epithelium was composed of basal cells, secretory cells, and ciliated cells; preciliated cells were extremely rare in the undisturbed epithelium. In addition, a few cells were of indeterminate character. Correlative light and electron microscopy indicated that about 10% of the basal cell population, categorized by light microscopy, was composed of the nucleated basal portions of tortuous secretory cells. Electron microscopy revealed that the light microscopic indeterminate category was heterogeneous, being composed of several cell types, including secretory cells with scant secretion granules, some "tall" basal cells, and very few cells that were truly indeterminate. Furthermore, review of the literature and the results of this study indicated that several different cell types, including secretory cells with sparse secretions and preciliated cells, have been previously called "intermediate cells." The study focuses attention upon the difficulties in accurately classifying certain types of tracheal epithelial cells, especially at the light microscopic level. PMID- 6851958 TI - Rapid isolation of type II pneumocytes with magnetic removal of macrophages. AB - A method is described for the rapid preparation of lung cell fractions enriched in type II alveolar pneumocytes. Isolated perfused rabbit lungs are exposed to Fe3O4 by tracheal lavage, which permits pulmonary alveolar macrophages to phagocytize the particles. Alveolar epithelial cells are then selectively freed from the basement membrane matrix by critical placement of collagenase and elastase. Detached cells are harvested either by repeated tracheal lavage or by mincing the lobes and filtering freed cells through a series of nylon mesh sieves. Iron oxide-containing macrophages are then removed from the harvested cells by a strong magnetic field. A final sizing of the macrophage-depleted suspension yields a preparation enriched in alveolar type II cells. Eight million viable cells (95% type II) were obtained per rabbit lung when harvested by lavage, while 32 x 10(6) (88% type II) cells were obtained from minced lungs. These values for cell yield and relative purity are comparable to previously described separation methods that depend upon differences in cell density or size. A major advantage of the magnetic separation procedure is the substantially shortened preparation time, typically 2 hr instead of 4. The viability (90-95%), oxygen consumption (88 nmol/10(6) cells/hr), and incorporation of [14C]acetate and [14C]choline (0.44 and 0.115 nmol/10(6) cells/hr, respectively) indicate that these cells will be suitable for pharmacologic and toxicologic investigation. PMID- 6851961 TI - Effect of cimetidine on phenytoin serum levels. AB - Cimetidine, 300 mg p.o. four times a day, was administered for 5 days to nine epileptics who were stabilized while receiving phenytoin. Five patients had statistically significant increases in phenytoin serum levels, including two who became clinically toxic. One patient had a statistically significant decrease in phenytoin serum concentration. A relationship was not found between cimetidine levels and change in phenytoin serum levels. Cimetidine can cause significant changes in phenytoin serum levels which may be manifested clinically. PMID- 6851963 TI - Long-term prognosis of convulsive disorders in the first year of life: mental and physical development and seizure persistence. AB - A follow-up study was made on 304 children (164 boys, 140 girls) with convulsive disorders, excluding occasional convulsions, in the first year of life. All patients except 45 who died were followed until 6 years of age or older. At the final follow-up, the subjects were divided into six groups according to the degree of mental and physical development (groups I-VI). Seizures were regarded as absent if the patient had been seizure free for more than 3 years. At the final follow-up, seizures had ceased in 57.7%, and 43.4% had normal mental and physical development (group I). As to the initial diagnosis, the percentage of group I at the final follow-up was 81.8% with febrile convulsions and 37.6% with epilepsy. In patients without seizures it was 69.7% with febrile convulsions and 55.8% with epilepsy. Some 80.6% of patients with unclassified generalized motor seizures, 11.5% of those with infantile spasms, 2.9% of those with secondary generalized epilepsy other than infantile spasms, 46.4% of those with partial seizures, and 25.0% of those with hemiconvulsive seizures were finally placed in group I. The percentage of patients without seizures was 81.4, 33.0, 34.4, 57.7, and 100%, respectively. As has been suggested, among the first-year epilepsies, a subgroup with a more favorable prognosis may exist. Further studies regarding the etiology, ictal EEGs, and effectiveness of treatment and long-term prognosis of these cryptogenic benign infantile convulsions are needed to provide a firm basis for understanding convulsive disorders in the first year of life. PMID- 6851962 TI - Seizures and civilian head injuries. AB - Although several studies have reported on the risk of "early seizures" (seizures occurring within 7 days following a head injury), the reported proportions of patients experiencing these seizures vary from 1.4 to 15%. This wide divergence may be due to problems with methodology such as case selection and definitions of head injury and early seizures. In a series of 702 patients admitted with a head injury to Cook County Hospital (CCH), Chicago, Illinois, 29 (4.1%) had early seizures. This proportion is twice as high as one previously reported in a comparable series. This may reflect an actual difference between the two series or a case selection bias serving to elevate the proportion of patients with early seizures at CCH. PMID- 6851965 TI - Intractable seizures: long-term follow-up after prolonged inpatient treatment in an epilepsy unit. AB - Seventy-four patients with intractable seizures were followed up 6 to 57 months (mean 25 months) after intensive monitoring. At discharge from the hospital, 59% of the patients had at least a 50% reduction in seizure frequency and 63% had decreased antiepileptic drug toxicity. The findings at follow-up compared with those at admission showed reduced seizure frequency in 55% of the patients, diminished medication toxicity in 54%, and improved social adjustment in 38%. A change in the seizure diagnosis was the best predictor of a favorable outcome. Patients with impaired mental status were not less likely to improve. The relationship between seizure type and outcome was not significant, although patients with complex partial seizures tended to be less likely to improve. Intensive monitoring can lead to significant long-lasting improvement of patients with severe epilepsy. PMID- 6851964 TI - Anticonvulsant serum levels are useful only if the physician appropriately uses them: an assessment of the impact of providing serum level data to physicians. AB - The ability to measure serum levels of anticonvulsants has been a significant advance in the treatment of epilepsy. This technique enables practitioners to monitor a patient's plasma concentration, to detect potential toxicity, and to assess compliance with the prescribed regimen. A retrospective study of 164 adults with epilepsy was conducted to evaluate how serum anticonvulsant determinations were used by physicians in their treatment of epilepsy. Results indicate that the availability of test results did not improve the degree of seizure control, nor did it diminish patient reports of toxicity. In 17% of therapeutic decisions, prescribers did not appear to use the blood levels appropriately in their therapeutic decision-making process. When physicians did appropriately utilize information from serum levels, the degree of seizure control improved significantly compared with when the prescribers did not use this information. The cost of determining serum levels of anticonvulsants is justified only if the information is appropriately utilized. PMID- 6851960 TI - Amygdala kindling in the classical conditioning paradigm. AB - The hypothesis was tested that epileptiform alterations of brain excitability may be elicited by a conditioning stimulus (CS) in a classical conditioning paradigm. Fifteen male albino rats were chronically implanted with electrodes in the amygdala and over the visual cortex. A train of six stroboscopic flashes served as the CS and the unconditioned stimulus was the amygdaloid electrical stimulation, delivered together with the sixth flash in the course of the kindling procedure. Rats were randomly assigned to two groups. Rats in Group 1 were exposed to one or two kindling sessions per day, and those in Group 2 were exposed to 10 such sessions every day. All rats in Group 1 showed fully mature seizures within 15 +/- 5.5 sessions, whereas none of those in Group 2 displayed kindled seizures. There was no evidence of amygdaloid afterdischarges or enhanced spiking as a response to the CS. A gradual selective suppression of the visual evoked potentials (VEP) secondary components, i.e., slow negative wave and sensory afterdischarge, paralleled kindling in Group 1. This effect was weak in Group 2. There was no change in the primary response of VEPs in either group. No recovery of VEPs followed the extinction of conditioning. PMID- 6851966 TI - Falsely localizing ictal onsets with depth EEG telemetry during anticonvulsant withdrawal. AB - A patient with partial complex seizures evaluated for surgery with chronic depth electrode recordings demonstrated falsely localizing ictal onsets during anticonvulsant drug withdrawal. When phenytoin was being reduced, more seizures appeared to originate from the left temporal lobe than from the right. Right anterior temporal lobectomy, performed on the basis of other findings, revealed a small unsuspected tumor in the resected specimen, and the patient has remained seizure free for 3 years. The seizures that originated from the left temporal lobe were different from the patient's habitual attacks and appeared to be the result of anticonvulsant withdrawal and, perhaps, electrode irritation. Four other patients who received anterior temporal lobectomies at UCLA between 1977 and 1980 had at least one stereotaxic EEG (SEEG)-recorded contralateral seizure onset, and all have benefited from surgery. Although multifocal SEEG-recorded ictal onsets should be considered a poor prognostic sign, distant sites that give rise to atypical seizures during drug withdrawal may not generate spontaneous seizures postoperatively. Consequently, this finding should not be used as a sole criterion against the recommendation of surgical therapy. PMID- 6851968 TI - Effect of norethisterone on seizures associated with menstruation. AB - The effect of high and low doses of norethisterone on seizure frequency was studied in nine epileptic patients, aged 20-30 years. All patients satisfied the defined criteria of having catamenial exacerbation. The study was double blind, placebo controlled, and randomised. Each patient was followed through four menstrual cycles with each drug dose and also with placebo. The results of this study suggest that norethisterone is not effective in the control of seizures associated with the menstrual period. PMID- 6851967 TI - Cortical kindled seizures: modification by excitant and depressant drugs. AB - The effects of several excitant-convulsants, cataleptic anesthetics, and gamma acetylenic gamma-aminobutyric acid (GABA) were tested on seizures kindled by repetitive electrical stimulation of the motor cortex in the rat. A dose response was determined for each drug. For most of the drugs, the doses tested ranged from those causing some signs of behavioral excitation to those inducing epileptoid activity. None of the excitant-convulsants, including strychnine, physostigmine, amphetamine, bicuculline, or pentylenetetrazol, increased the afterdischarge duration (AD) or behavioral response (BR) of the partially developed (PD-KCS) or generalized fully developed (KCS) kindled cortical seizures. Whereas pentylenetetrazol had no effect on the PD-KCS, it has been previously shown to increase significantly the AD and BR of the developing or partially developed amygdaloid kindled seizures. Lidocaine, gamma-butyrolactone, gamma-acetylenic GABA, phencyclidine, and ketamine inhibited the AD of the KCS by greater than or equal to 80%. Lidocaine, phencyclidine, and ketamine decreased whereas gamma butyrolactone and gamma-acetylenic GABA increased the AD of the PD-KCS. The ability of gamma-butyrolactone and gamma-acetylenic GABA to potentiate the PD-KCS while inhibiting the KCS presents a paradox not readily explained. Our results combined with previous reports of the effects of gamma-butyrolactone and gamma acetylenic GABA on amygdaloid kindled seizures indicate that the KCS is more susceptible to GABAnergic and cataleptic inhibition than is the fully developed amygdaloid kindled seizures. The differences between the response of cortical kindled and that of amygdaloid kindled seizures to some of the drugs tested may indicate differences in the physiological and biochemical mechanisms involved in producing these seizures. PMID- 6851969 TI - Chemical mutagen testing: a committee report. PMID- 6851970 TI - Chromosome damage and SCE induced by the cytostatic factor homo-aza-steroidal ester of P-bis (2-chloro-ethyl) amino phenyl acetic acid in CHO cells in culture. AB - The cytogenetic effects of homo-aza-steroidal ester (ASE) on Chinese hamster ovary (CHO) cells in vitro are reported. It was found that treatment of cells with a dose as low as 0.025 micrograms/ml of ASE causes a significant number of abnormal metaphases containing mostly chromatid-type aberrations. Similarly, significant frequencies of SCE were induced with only 0.075 micrograms/ml of ASE. PMID- 6851973 TI - Abstracts of the fourteenth annual meeting of the Environmental Mutagen Society. San Antonio, Texas, March 3-6, 1983. PMID- 6851972 TI - Chromosomal aberrations and delays in cell progression induced by X-rays in Tradescantia clone 02 meristems. AB - In root meristems of Tradescantia clone 02 (developed by Sparrow and his colleagues for mutation studies), X-rays interfere with the progression of cells through the cell cycle and induce chromosomal aberrations in a dose-dependent manner consistent with linear-quadratic kinetics. Sequential mitotic cell accumulations after irradiation indicate that sensitivity to aberration induction is probably greatest in cells from late S to early G2, with chromatid interchanges the most frequent aberration type and all aberrations consistent with initiation from the interaction between two lesions. The ratio of the coefficients in the linear (alpha) and the quadratic (beta) terms (alpha/beta) is equal to the dose average of specific energy produced by individual particles in the site where interaction takes place. The ratio alpha/beta for chromosomal aberrations is similar to that previously found for X-ray-induced mutation in Tradescantia stamen hairs, supporting the proposal that radiation-induced mutational events are due to chromosomal aberrations with interaction distances of about 1 micron. Abrahamson and co-workers have noted that both alpha/beta ratios appear to be related to nuclear target size and are similar for chromosomal and mutational endpoints in the same organism. These findings support this concept; however, it is apparent that any situation which diminishes yield at high doses (eg, mitotic delay) will primarily affect the beta component, resulting in low assessments of interaction site diameters. PMID- 6851971 TI - Chromosome aberrations and sister chromatid exchanges in styrene-exposed workers with reference to their smoking habits. AB - The incidences of chromosome aberrations and the frequencies of sister chromatid exchanges (SCE) were investigated in cultured lymphocytes of 18 styrene-exposed workers in comparison with six controls. There was a marginal increase in the incidence of structural chromosomal aberrations in first-division metaphases in the styrene-exposed workers, as compared with the nonexposed controls. However, there was no difference in SCE frequencies. When each group was divided into smokers and nonsmokers, styrene-exposed smokers tended to have higher SCE frequencies than styrene-exposed nonsmokers. Furthermore, cell proliferation was inhibited in styrene-exposed workers (both smokers and nonsmokers) and control smokers. PMID- 6851974 TI - Embryotoxic effects of 2,3,7,8 tetrachlorodibenzo-p-dioxin administered to female rats before mating. AB - 2,3,7,8-Tetrachlorodibenzo-p-dioxin was administered to female rats by gavage for 2 consecutive weeks at daily doses of 0, 0.125, 0.5, and 2 micrograms/kg. After treatment females were caged with untreated males. All dams were killed on Day 21 of gestation. Their reproductive statuses were recorded and live fetuses were examined for external, visceral, and skeletal malformations. At 0.125 micrograms/kg no effects were observed on both maternal and fetal toxicity; 0.5 micrograms/kg reduced maternal weight gain and increased postimplantation loss. At 2 micrograms/kg the following features became evident: reduction of both maternal weight gain and ovulation rate, increase of pre- and postimplantation loss, and fetal growth retardation. Also, malformed fetuses were observed at this dose level. PMID- 6851975 TI - Age and intestinal retention of mercury and cadmium in rats. AB - The site of cadmium and mercury retention in the intestine was determined in 6 day-old sucklings and 6-week-old weaned rats 6 days after oral administration of 115mCd and 203Hg. The ileum was found to be the main site of intestinal retention of both cations in sucklings but not in weaned rats. Other age- and element specific differences in the site of metal retention in the intestine were also found. These differences indicate that even in neonates, metal absorption might be a more specific process than previously assumed. PMID- 6851976 TI - Perinatal hexachlorobenzene toxicity in the mink. AB - Adult female standard dark mink were exposed to hexachlorobenzene (HCB) at concentrations of 0, 1, and 5 ppm in the feed and bred with males on the same treatments. Female offspring were allowed to mature to 16-17 weeks and killed. At 16-17 weeks of age, HCB had no effect on body weights or liver weights. Hepatic cytochrome P-450 and ethoxyresorufin-O-deethylase were significantly increased 2.0- and 1.5-fold, respectively, in the 5-ppm treatment group. Electron microscopy failed to reveal proliferation of the smooth endoplasmic reticulum. No hepatic damage was observed. No changes in in vitro renal function, measured as accumulation of para-aminohippurate and tetraethylammonium by renal cortical slices, were detected in any treatment group. Histological examination of renal slices did not reveal any alterations in morphology. Fat was the predominate site of HCB disposition; samples from the 5-ppm treatment group contained 626.10 +/- 12.01 ng HCB/g tissue. Whereas perinatal HCB administration has profound effects on the survival of offspring born to exposed mink, only induction of hepatic mixed-function oxidases was observed in the surviving kits without any observable frank hepatotoxicity. PMID- 6851978 TI - Pathologic effects in rodents exposed to sodium combustion products. AB - Three species of rodents exhibited respiratory distress when exposed to aerosols of sodium combustion products, the major constituent of which was shown to be sodium carbonate. At the higher doses, animals died during or shortly after 2 hr exposures. Lesions, primarily involving the pharynx and larynx, included accumulation of mucus, vesiculation, and mucosal edema. Other lesions included edema and vesiculation of the anterior trachea, hemorrhage in the lungs, and severe gastric tympany. Basal epithelial cells of the posterior pharynx and anterior trachea had enlarged mitochondria following exposures of 1 hr or more. PMID- 6851977 TI - Interaction of ozone and cigarette smoke exposure. AB - Possible interactions of ozone and cigarette smoke exposure have been tested in 2 hr chamber exposures of 26 male and 6 female subjects, all of whom were habitual smokers. Treatment conditions were air alone, air + cigarette smoking, ozone alone, and ozone + cigarette smoking. Ozone levels were increased progressively over four trials (0.37 ppm, 0.75 ppm, 0.50 ppm + intermittent exercise, and 0.75 ppm + intermittent exercise); exercise (50 W for 15 min alternating with 15-min rest) was intended to increase ventilation by a factor of 2.5. Ozone exposure reduced the carbon monoxide intake normally seen with smoking, as judged from smaller increments of blood carboxyhemoglobin readings. Ozone exposure alone gave rise to a decrease of lung function (forced vital capacity (VC), 1-sec forced expiratory volume, and maximum flow rates at 25 and 50% of VC), but the onset was slower and the response less dramatic than previously seen in nonsmokers, suggesting that the chronic effect of smoking may be to delay bronchial irritation by ozone. Smoking increased heart rate both at rest and during exercise, but this response was not materially influenced by simultaneous ozone exposure. It is concluded that over an acute 2-hr exposure, there is no appreciable interaction between cigarette smoking and responses to ozone. PMID- 6851979 TI - The effect of aerosol charge on the deposition and clearance of TiO2 particles in rats. AB - A titanium dioxide aerosol when generated by a Wright dust feed will have a higher electrostatic charge by a factor of 5.5 than one which has been discharged by a bipolar ion field produced by a 7.5 mCi 85Kr source. The deposition of particles in the lung of rats was lower by approximately 21% when an aerosol discharger was used. Particle clearance from the lung alveoli was not affected by the use of the discharger. PMID- 6851981 TI - Nonasbestos pulmonary mineral fibers in the general population. AB - Total pulmonary nonasbestos mineral content was determined for a series of 20 patients who had no occupational dust exposure. To extract mineral fibers, lung tissue was dissolved in bleach and the treated sediment transferred to the electron microscope grid. Mineral fibers were identified using electron diffraction and energy dispersive x-ray spectroscopy. The mean number of nonasbestos fibers, 106 X 10(3)/g wet lung, was almost identical to the mean number of asbestos fibers, 102 X 10(3)/g. Thirteen different species or groups of nonasbestos minerals were found: apatite accounted for 18% of the total and talc for 16%. All other forms accounted for less than 8% each. Silica was found in every lung, and talc in 19 of 20 lungs. Of the fibers, 86% were shorter than 5 microns, and most of the fibers had aspect ratios less than 15. No correlations were seen between numbers or types of fibers and age, sex, or smoking. It is concluded that (1) substantial numbers of nonasbestos fibers are present in lungs of the general population. Most of these fibers are short and of low aspect ratio; and (2) by phase microscopy one is as likely to observe nonasbestos as asbestos fibers in these preparations, indicating that light microscopic methods are not suitable for this type of analysis. These data provide a baseline for comparison with patients believed to have a mineral fiber-related disease. PMID- 6851980 TI - Pulmonary tissue and cigarette smoke. 2. Parenchymal response. AB - Cigarette smoke and hydrocortisone acetate (HCA) induce marked abnormalities in lungs of C57BL/6J male mice. In many pulmonary regions of smoke-exposed, HCA treated animals, alveoli were highly congested with surfactant and flocculent material. In addition, prominent alveolar collapse and septal hypertrophy were common. These conditions resembled pulmonary alveolar proteinosis described in humans. Administration of HCA to sham-treated animals also produced lung abnormalities, however, considerably milder in severity, while stress (resulting from sham treatment) or HCA injections of mice alone failed to induce any pulmonary tissue disorder. Data reported indicate that the genesis of abnormal conditions which resemble pulmonary alveolar proteinosis is potentiated by cumulative effects of different treatments (i.e., smoke, HCA, and stress), most significant being the interaction between cigarette smoke and the steroid. PMID- 6851982 TI - The effect of particle size and different extractants on the contents of heavy metals in roadside dusts. AB - The roadside dusts collected from three selected sites with marked differences in annual average daily traffic (AADT) values were divided into size classes according to particle size. The total, extractable, and water-soluble metal contents were determined using mixed acid, 1 M NH4OAc (pH 7.0), and distilled water as extractants. It was found that dust particles with a size smaller than 125 microns belonged to a homogeneous group and did not have a significant difference in metal contents. In using dust as a parameter to indicate the level of Pb contamination, a particle size of 125 microns and the extractable metal contents, using NH4OAc, should be used. PMID- 6851983 TI - Tissue distribution of cadmium and metallothionein as a function of time of day and dosage. AB - Cadmium-109 chloride (1 mg or 48 ng Cd2+/kg body wt) was administered intraperitoneally to rats at one of eight selected times of day. Exactly 48 hr later each animal was sacrificed, and the cadmium content of the blood, brain, heart, kidney, liver, and testes was determined. Metallothionein levels in the liver and kidney were also measured. Distribution and retention of cadmium was very different at the different dose levels. Approximately 60% of the higher dose of cadmium was retained in the six tissues examined, while only 11.5% of the lower dose could be accounted for in these six tissues. The liver retained the largest percentage of the administered cadmium at both dose levels, but the magnitude of the retention differed by a factor of 6 (57.3% of the higher dose and 9.6% of the lower dose). The pattern of cadmium distribution among the other tissues was also different. At the 1-mg Cd2+/kg body wt level, the kidneys accumulated the second largest fraction of cadmium, followed by the blood, heart, testes, and brain. In the 48-ng Cd2+/kg body wt groups the order was kidney, testes, blood, heart, and brain. Only in the testes of animals receiving the low dose of cadmium was there an effect of time of day, and here the effect was marked. When cadmium was administered during the dark phase of the daily cycle, the testes contained an average of six times more cadmium than when cadmium was given during the light phase. Similarly, levels of metallothionein in the kidney were significantly higher when cadmium was administered during the dark phase. A trend toward higher metallothionein levels in the liver during the dark phase was also observed, but this trend was not statistically significant. PMID- 6851985 TI - N-nitrosodiethanolamine in antifreeze. AB - Carcinogenic N-nitrosodiethanolamine has been found at concentrations varying from 15 to 5700 mg/liter in several leading French brands of antifreeze. Moreover, mixtures of antifreezes which, separately, are innocuous, can form this nitrosamine which appears to arise from interaction of triethanolamine derivatives with sodium nitrite. It is recommended that sodium nitrite be abandoned as an anticorrosion additive. PMID- 6851984 TI - The effects of chronic tobacco smoke exposure from high-tar cigarettes on the phagocytic and killing capacity of polymorphonuclear cells of mice. AB - Mice were exposed to high-tar (HT) (16 mg tar/cigarette) filtered cigarettes for up to 32 weeks. Intraperitoneal caseinate induction of polymorphonuclear (PMN) cells in both tobacco smoke (TS)-exposed and age-matched control mice provided the source of cells which enabled an assessment to be made in vitro of both their phagocytic and degradative properties. Radioactive Staphylococcus aureus were opsonized with either immune serum or heat-inactivated (complement deficient) immune serum for the tests. Two strains of mice were used in all trials. The PMN cells from BALB/c strain mice were less affected by TS exposure than those of C57 Black mice in both phagocytic and degradative capacities when the S. aureus were opsonized with immune serum. However, heat inactivation of complement within the serum reduced the differences between TS-exposed animals and age-matched controls in both strains of mice. The treatment effects were seen at all times tested from 3 days to 32 weeks of TS exposure. The results suggest that fc-receptor site activity of PMN cells is not significantly affected by TS exposure but that complement interactions within the phagocytic process are significantly suppressed. Whether this is due directly to complement receptors or metabolic associations of phagocytosis of the complement/opsonin/antigen complex is unclear. PMID- 6851987 TI - A simple method for the calculation of the inhibitor concentration necessary to produce 50% inhibition of an enzyme. PMID- 6851986 TI - Kinetic assay of aldehyde oxidase with 2,2'-azino-di-(3-ethylbenzthiazoline-6 sulfonate) as chromogen. AB - A new kinetic method for the assay of aldehyde oxidase (EC 1.2.3.1) is described. By the oxidation of pyridoxal as a substrate, pyridoxic acid and hydrogen peroxide are formed. Hydrogen peroxide is subsequently reduced to water by the action of peroxidase, while the chromogen 2,2'-azino-di-(3-ethylbenzthiazoline-6 sulfonate) (ABTS) is oxidized to a blue-greenish-dyed product. The absorbance increase of the oxidized form of ABTS, registered every minute at 410 nm, is proportional to aldehyde oxidase activity. PMID- 6851988 TI - Activities of enzymes of rat hepatic mitochondrial fatty acid oxidation during increased fatty acid degradation. AB - The activities of the enzymes of hepatic mitochondrial fatty acid oxidation have been compared in normal and fat-fed, streptozotocin diabetic, starved and hyperthyroid adult female rats. The various experimental states resulted in hyperketonaemia and marked increases in the activities of palmitoyl-CoA synthetase and carnitine palmitoyltransferase I, but had little effect on the other enzymes involved. PMID- 6851989 TI - Mellituria screening in some metabolic diseases. AB - Mellituria was studied in 83 subjects: 25 normal adults and children and 58 patients with several metabolic diseases. In comparison to the controls, no significant differences were found in 9 patients with cystinuria and in 2 patients with Apert's syndrome. The large excretion of glucose was the only important pattern of the 11 patients with insulin-dependent diabetes. In 23 patients with porphyria cutanea tarda a statistically significant increase in the excretion of pentose was observed. In 16 children with the classical form of phenylketonuria, a significant hypoexcretion of glucose was found. This latter observation could be explained by the carbohydrate metabolic alterations described in experimental hyperphenylalaninemia. PMID- 6851990 TI - A comparative polyacrylamide gel electrophoretic study of arginase in vertebrate tissues. AB - The electrophoretic behaviour of arginase in the tissue extracts of rat, beef, lizard and frog was studied by bidirectional polyacrylamide gel electrophoresis. The enzyme from rat liver and submaxillary gland migrated to the cathode with the activity concentrated in a single peak. Arginase from beef liver emerged as a single peak of anodal migration with a significant shoulder in the sample gel. Frog liver and kidney enzymes also appeared as single peaks with a distinct anodal movement. The activity in mammalian kidney and lizard liver and kidney resolved into two peaks of anodal migration suggesting the presence of two isoenzymes of arginase in these tissues. PMID- 6851991 TI - Influence of inactivation of trypsin on immunoreactivity and serum immunoreactive trypsin concentration measured by radioimmunoassay. AB - The influences of various active site-specific reagents of trypsin and protease inhibitors on the immunoreactivity of trypsin and serum trypsin concentration have been studied by radioimmunoassay (RIA). The RIA using inactivated 125I trypsin as tracer showed lower Bo/T than the RIA using active 125I-trypsin, but the coefficient of variance of the former was smaller than that of the latter. Normal serum trypsin concentrations were 26.12-36.38 ng/ml with the RIA using inactivated 125I-trypsin as antigen tracer, and 201.15 ng/ml with the RIA using active 125I-trypsin as tracer. The recovery experiment showed that the difference was due to the interaction of serum protease inhibitors and labeled active trypsin. PMID- 6851992 TI - Changes in serum lipids and lecithin: cholesterol acyltransferase enzyme during 1 week weight reduction of women on a low-calorie diet. AB - In 32 women of normal body weight who volunteered to participate in the study, the effect of rapid weight reduction by a low-calorie liquid diet on serum lipids and lecithin:cholesterol acyltransferase (LCAT) enzyme activity was studied. Women were on this 400 kJ/day diet for 7 days and fasting blood samples were drawn before and immediately after the diet. Serum cholesterol decreased from 5.7 +/- 1.0 to 5.2 +/- 1.1 mmol/l and high density lipoprotein cholesterol from 1.77 +/- 0.43 to 1.50 +/- 0.35 mmol/l. The serum LCAT activity decreased significantly during the weight reduction period. When serum LCAT activity was correlated to lipid parameters, a positive correlation was found with total cholesterol and triglyceride concentrations before weight reduction and also between changes in LCAT activity and total cholesterol concentration. The data suggest that serum LCAT activity might have a prominent role in the regulation of serum lipid levels. PMID- 6851993 TI - Altered hepatic microsomal drug-metabolizing enzyme activity resulting from experimental infection of rats with Trypanosoma b. brucei. AB - Infection of experimental rats with Trypanosoma brucei (T. b. brucei) results in a decrease in the activities of aniline hydroxylase, aminopyrine-N-demethylase and a lowering of the level of reduced glutathione in the liver. The activity of cytochrome c reductase remains above normal 50 h after infection. Infection of animals previously treated with either phenobarbitone or 3-methylcholanthrene results in a reduction in the specific activity of aniline hydroxylase and aminopyrine-N-demethylase. However, the specific activity of aromatic hydrocarbon hydroxylase is not depressed in 3-methylcholanthrene-treated rats. PMID- 6851994 TI - Erythrocyte pyruvate kinase deficiency. A kinetic study of the membrane-localised and cytoplasmatic enzyme from six patients. AB - Investigations on the activity and the kinetic behavior of red cell pyruvate kinase in the erythrocyte membrane and hemolysate of 6 patients with pyruvate kinase (PK) deficiency are presented and compared with those of normal individuals. Hemolysate: The PK in the hemolysate of normal individuals showed the well-known allosteric properties, reflected by sigmoidal reaction kinetics (Hill-coefficient greater than 1). In contrast to these findings the enzymes of 4 of the patients which had not been splenectomised and which were all in satisfactory condition showed between 15 and 35% of the PK activity of normal individuals in the hemolysates, whereas in the case of the 2 splenectomised patients only 5 and 15% of this activity could be measured. All of the patients' enzymes showed non allosteric (hyperbolic) reaction kinetics (Hill-coefficient approximately 1.0). Red cell membranes: Our studies confirmed earlier reports that not only the hemolysate of the patients, but also their red cell membranes ('ghosts') exhibit PK activity. In normal individuals the activity of the membrane-localised PK is about 5% of the cytoplasmatic one. In case of the membrane-localised enzyme of all patients--irrespective if they were splenectomised or not--the activity is decreased to 30-50%, compared to the activity of ghosts of the control persons. Reaction kinetic studies on the PK isolated from red cell membranes from normal individuals as well as from all 6 patients exhibited hyperbolic Michaelis-Menten kinetics with Hill coefficients around 1.0. PMID- 6851995 TI - Enzyme kinetics: a new procedure for data normalization. AB - A procedure is proposed to normalize enzymatic reaction velocities measured in separate experiments. After calculation of the Km and maximum velocity in each individual set of data, the velocities measured in each experiment are reanalyzed by regression analysis with the constraint that they yield a Km identical to the geometric mean of the individual Km's calculated originally. The V derived from this second analysis can be taken, in each experiment, as the reference value relative to which all reaction velocities are normalized. All normalized velocities are eventually pooled together to establish the final regression line. This relatively simple and reliable procedure overcomes several difficulties otherwise encountered when the kinetics of an enzymatic reaction are judged from data collected in separate experiments. PMID- 6851998 TI - Effects of low intensity, continuous and intermittent noise on mental performance and writing pressure of children with different intelligence and personality characteristics. PMID- 6851997 TI - The subjective equivalence of sinusoidal and random whole-body vibration in the sitting position (an experimental study using the "floating reference vibration" method). PMID- 6851996 TI - Circadian rhythm amplitude--is it related to rhythm adjustment and/or worker motivation? PMID- 6852001 TI - Ainhum. PMID- 6852000 TI - Tuberculosis and its control: lessons to be learned from past experience, and implications for leprosy control programmes. PMID- 6851999 TI - Comparison between load carriage and grade walking on a treadmill. PMID- 6852002 TI - Fistula--a socio-medical problem. PMID- 6852003 TI - Methyl bromide and phosphine residues in cereal grains and pulses. PMID- 6852004 TI - Nephropathy in Ethiopian diabetics. PMID- 6852005 TI - Toxicity of kosso (Hagenia abyssinica), 1: acute toxicity in mice. PMID- 6852006 TI - Oesophagogastroduodenoscopies: a review of 720 cases. PMID- 6852008 TI - Purification and characterization of a beta-N-acetylglucosaminidase from Octopus vulgaris. Determination of specificity by using 360-MHz 1H-NMR spectroscopy. AB - We have purified a beta-N-acetylglucosaminidase from the hepatopancreas of the octopus which we have called beta I. The enzyme was homogeneous as judged by Sephadex column chromatography, isoelectric focusing, non-denaturing gel electrophoresis at two different pH and with sodium dodecyl sulphate/polyacrylamide gel electrophoresis. The native protein has an apparent molecular weight of 120 000 and we can conclude that it is a tetramer made up of two alpha and two beta subunits with apparent Mr of 27 000 and 34 000, respectively. Using NMR spectroscopy we have examined the specificity of beta I and have established that the enzyme hydrolyses the beta 1,4 linkage of N acetylglucosamine but at only a specific site of the substrates used, two glycopeptides isolated from ovalbumin. To our knowledge this is the first known exoglycosidase which has both linkage and site specificity. PMID- 6852009 TI - Chemical-modification studies on rat olfactory mucosa using a thiol-specific reagent and enzymatic iodination. AB - 1. A rat olfactory preparation, suitable for biochemical studies in vitro on olfactory mechanisms, is described. 2. The effects of the impermeant chemical modification reagents mersalyl (a thiol reagent) and enzymatic iodination, on the amplitude of the electroolfactogram (EOG) responses elicited from rat olfactory mucosa by pulses of odorant vapours was studied using 12 odorants differing widely in odour quality and molecular structure: amyl acetate, carvone, decanal, butylamine, cineole, citronellol, cresol, diacetyl, dimethylethyl-pyrazine, naphthalene, octanethiol and valeric acid. 3. Both reagents irreversibly reduced the EOG amplitude to all odorants to an extent dependent on the reagent concentration. Two subpopulations of animal preparations could be distinguished on the basis of the extent to which they survived the iodination whereas mersalyl appeared to sample a single population of preparations. 4. Small but statistically significant differences were observed between the responses of each odorant with each reagent but no simple correlation between either the molecular structure or odour quality of the odorants and the reagent effect is apparent for the case of mersalyl. With iodination the responses from the three flexible aliphatic-chain odorants were reduced to a greater extent than the other odorants, all of which had a dissimilar molecular structure. 5. The ability of three odorants, amyl acetate, carvone and decanal, to protect the receptors for the odorants against chemical modification was investigated. The protecting odorants were applied directly to the mucosa as a dilute solution in Ringer's medium. No specific odorant protection effects were observed. 6. The results are discussed in relation to a model of the olfactory mechanism involving relatively non-specific receptor proteins. Each receptor type is envisaged as interacting weakly with a number of odorants and each odorant interacts with a number of receptors. PMID- 6852007 TI - Magnetic and spectral properties of carp carbonmonoxyhemoglobin. Competitive effects of chloride ions and inositol hexakisphosphate. AB - We have extended our studies on the magnetic properties of carp carbonmonoxyhemoglobin and the dependence of these properties upon solution variables. Using an improved version of the superconducting magnetometer, we have found that the magnetic susceptibility of carp carbonmonoxyhemoglobin is sensitive to both inositol hexakisphosphate and chloride ion. The dependence upon chloride ion concentration is complex. At relatively low concentrations this anion reverses the effect of inositol hexakisphosphate, restoring paramagnetism. At higher chloride concentrations the protein is converted to a roughly diamagnetic state in the absence of inositol hexakisphosphate. Along with these susceptibility studies, we have examined the effects of these anions on other properties of carp carbonmonoxyhemoglobin. The positions of the Soret bands of human and carp methemoglobin derivatives are correlated with spin state; changes in the magnetic susceptibility of carbonmonoxyhemoglobin are similarly associated with alterations in this spectral band. We have also examined the effects of these anions on the proton nuclear magnetic resonance spectrum of carp carbonmonoxyhemoglobin. Both chloride and inositol hexakisphosphate alter the position of the proton resonances in the ring-current-shifted region of the spectrum. PMID- 6852010 TI - Ribosomal proteins cross-linked to 28-S and 18-S rRNA separated by sedimentation after ultraviolet irradiation of rat-liver ribosomes. AB - Rat liver 80-S ribosomes, irradiated with 254 nm ultraviolet light for 15-60 min (0.63-2.5 X 10(5) quanta/ribosome), were treated with sodium dodecyl sulfate; 18 S and 28-S RNA fractions were isolated by sucrose density-gradient centrifugation. The protein moieties of the 18-S and 28-S rRNA fractions were labeled with 125I. After digestion of the rRNA fractions with RNase A and T1, the cross-linked proteins were analyzed by two-dimensional acrylamide gel electrophoresis and then autoradiography. Cross-linked proteins were examined further by dodecyl sulfate/acrylamide gel electrophoresis of individual radioactive spots of proteins and their proteolytic peptides on two-dimensional gels. The results showed that S2 and S15 were cross-linked to 18-S rRNA, and L5, L6 and L8 to 28-S rRNA. Similar results were obtained when isolated 40-S or 60-S subunits were irradiated. PMID- 6852011 TI - Lipid domains in plasma membranes from rat liver. AB - The existence of fluid and solid lipid domains in isolated rat-liver plasma membranes was evaluated using the fluorescent fatty acids trans-parinaric and cis parinaric acid as probe molecules for solid and fluid membrane areas, respectively. The fluorescence probe 1,6-diphenyl-1,3,5-hexatriene indicated that a phase transition was present in the liver plasma membrane between 18 degrees C and 30 degrees C. At intermediate temperatures, cis-parinaric acid, which partitioned approximately equally into fluid and solid lipid areas, detected two lipid domains: the mole fractions of fluid and solid lipid domains at 24 degrees C were 0.32 and 0.68 while the mole fractions of cis-parinaric acid in each domain were 0.34 and 0.66, respectively. The dissociation constant, aqueous to membrane lipid partition coefficient, and bound to free ratio for trans-parinaric acid were 7.0 +/- 0.7 microM, 4.0 +/- 0.6 x 10(6), and 83:17, respectively. The affinity of the membrane for cis-parinaric acid was twofold lower than for trans parinaric acid. The trans-parinaric acid partitioned preferentially into solid lipid, Ksp/f = 3.30, while the cis-parinaric acid partitioned equally between fluid and solid phases Ksp/f = 0.92. Thus, the data demonstrate the coexistence of fluid and solid domains in rat liver plasma membranes. PMID- 6852012 TI - Characterization of phosphoenolpyruvate transport across the erythrocyte membrane. Evidence for involvement of band 3 in the transport system. AB - Phosphoenolpyruvate was found to be transported across the erythrocyte membrane by a carrier-mediated transport system. The transport of phosphoenolpyruvate was competitively inhibited by inorganic phosphate (Ki = 24 mM) and pyridoxal 5 phosphate (Ki = 0.2 mM), whereas the transport was noncompetitively inhibited by L(+)-lactate (Ki = 37 mM). Specific inhibitors for the inorganic anion transport system such as 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid and 4,4' dinitrostilbene-2,2'-disulfonic acid strongly inhibited the phosphoenolpyruvate transport. The transport was irreversibly inhibited by treating erythrocytes with pyridoxal 5-phosphate and NaBH4. Transport activities of phosphoenolpyruvate and inorganic phosphate in the treated cells were similarly inhibited by pyridoxal 5 phosphate depending on its concentrations. 4,4'-Dinitrostilbene-2,2'-disulfonic acid protected both transport activities against the pyridoxal 5-phosphate/NaBH4 treatment. The major integral membrane protein, band 3, was preferentially labelled by treating erythrocytes with pyridoxal 5-phosphate and NaB[3H]H4. The radioactive incorporation into band 3 was confirmed by two-dimensional gel electrophoresis combining isoelectric focusing in the first dimension and sodium dodecyl sulfate/polyacrylamide gel electrophoresis in the second dimension. Taken together, these results suggest that band 3 mediates the transport of phosphoenolpyruvate as well as inorganic phosphate. PMID- 6852013 TI - Destruction of phospholipids and respiratory-chain activity in pig-heart submitochondrial particles induced by an adriamycin-iron complex. AB - Ferric ion complexes of the antibiotic and antitumor agent adriamycin support peroxidation of phospholipids in pig heart submitochondrial particles as judged by disappearance of polyunsaturated fatty acids, loss in extractable phospholipid, adriamycin-Fe3+-dependent oxygen consumption and formation of material with ultraviolet absorption. Peroxidation was stimulated to an extent of about 100% at low rates of NADH oxidation in the submitochondrial particles, whereas oxidation rates higher than 50 nmol NADH oxidized x min-1 x mg protein-1 appeared to protect the membrane lipids. NADH oxidase, NADH-cytochrome c reductase as well as cytochrome c oxidase activities in the submitochondrial particles were progressively inactivated during incubation with adriamycin in the presence of Fe3+ ions, whereas NADH-ferricyanide reductase activity remained fully stable. PMID- 6852014 TI - Metal-ion-promoted dephosphorylation of the 5'-triphosphates of uridine and thymidine, and a comparison with the reactivity in the corresponding cytidine and adenosine nucleotide systems. AB - First-order rate constants (50 degrees C; I = 0.1 M, NaClO4) for the dephosphorylation of UTP and TTP (1 mM) in the pH range 2-10 are compared with those of ATP and CTP; they all show the same properties indicating that the nucleic base has no influence on the rate. In the presence of Cu2+ or Zn2+ (NTP:M2+ = 1:1) this changes drastically: ATP-M2+ much greater than UTP-M2+ approximately equal to TTP-M2+ approximately equal to CTP-M2+ greater than NTP, the Cu2+ systems being always more reactive than the Zn2+ systems, and these more than the Ni2+ systems. An interaction between the nucleic base and metal ion is important for the Cu2+-ATP and Zn2+-ATP systems, but not for the pyrimidine nucleotide systems (these behave like methyltriphosphate). Accordingly, prevention of the Cu2+-purine interaction by the addition of one equivalent of 2,2'-bipyridyl, leading to Cu(Bpy) (NTP)2-, strongly reduces the activity and all four ternary Cu2+ systems now show the same dephosphorylation rate. Addition of a second equivalent of Cu2+ to the Cu2+-UTP 1:1 system enhances the dephosphorylation rate significantly and Job's method provides evidence that a 2:1 complex is the most reactive intermediate. The relation between the initial rate, vo = d[PO3-4]/dt, and the concentration of Cu2+-UTP in 1:1 and 2:1 systems was determined. The results suggest that the reactive complex with pyrimidine nucleotides is a monomeric, dinuclear species of the type M2(NTP) (OH)- (its formation is inhibited by ligands like tryptophanate), while with M2+-ATP the reactive complex is a dimer. The connection between the indicated dephosphorylations in vitro, i.e. trans-phosphorylations to H2O, and related reactions in vivo are discussed. PMID- 6852018 TI - Hydrolysis of mixed monomolecular films of phosphatidylcholine/triacylglycerol by pancreatic phospholipase A2. AB - We studied the effect of glycerides on pancreatic phospholipase A2 hydrolysis of mixed monomolecular films of trioctanoylglycerol/1,2-didodecanoyl-sn-glycero-3 phosphocholine with the technique of Pieroni and Verger [(1979) J. Biol. Chem. 254, 10090-10094]. The quantity of enzyme adsorbed to the interface was concomitantly determined with [3H]amidinated phospholipase. At phospholipid packing above the critical penetration pressure, triacylglycerol stimulates phosphatidylcholine hydrolysis to a great extent. On the other hand, the activity of pancreatic phospholipase A2 on a mixed film is inhibited by the action of pancreatic lipase. Interface binding of phospholipase A2 to the lipid substrate does not imply activity. PMID- 6852015 TI - Purification and characterization of a new sodium-transport decarboxylase. Methylmalonyl-CoA decarboxylase from Veillonella alcalescens. AB - Upon resolution of the particulate cell fraction of Veillonella alcalescens by gel chromatography, membranes and ribosomes were clearly resolved. Methylmalonyl CoA decarboxylase was bound to the membranes and not to ribosomes as reported earlier. Membrane vesicles containing methylmalonyl-CoA decarboxylase were prepared by disrupting V. alcalescens cells with a French pressure chamber. About 64% of the decarboxylase was oriented in these vesicles with the substrate binding site facing to the outside. The vesicles performed a rapid accumulation of Na+ ions in response to the decarboxylation of methylmalonyl-CoA. Decarboxylation and transport were highly uncoupled. The efficiency of the transport was considerably increased if methylmalonyl-CoA decarboxylation was retarded by using a low temperature or by slowly generating the substrate enzymically from propionyl-CoA. Under optimized conditions Na+ was concentrated inside the inverted vesicles eight-times higher than in the incubation medium. Methylmalonyl-CoA decarboxylase was solubilized from the membranes with Triton X 100 and purified about 20-fold by affinity chromatography on monomeric avidin Sepharose columns. The decarboxylase was specifically activated by Na+ ions (apparent Km approximately equal to 0.6 mM). Whereas (S)-methylmalonyl-CoA was the superior substrate (apparent Km approximately equal to 7 microM), malonyl-CoA was also decarboxylated (apparent Km approximately equal to 35 microM). The decarboxylation of methylmalonyl-CoA yielded CO2 and not HCO-3 as the primary reaction product. Analysis of the purified enzyme by dodecylsulfate gel electrophoresis indicated the presence of four different polypeptides alpha, beta, gamma, delta with Mr 60 000, 33 000, 18 5000 and 14 000. The latter of these polypeptides was clearly visible only after silver staining but not after staining with Coomassie brilliant blue. A low molecular weight polypeptide with similar staining properties was also found in oxaloacetate decarboxylase. Methylmalonyl-CoA decarboxylase contained about 1 mol covalently bound biotin per 125 500 g protein which was localized exclusively in the gamma-subunit. This subunit therefore represents the biotin carboxyl carrier protein of methylmalonyl CoA decarboxylase. A new very sensitive method for the detection of biotin containing proteins is described. PMID- 6852017 TI - Subcellular distribution in Xenopus laevis oocytes of a microinjected poly(A) binding protein from Artemia salina gastrulae. AB - The poly(A)-binding protein P38 of non-polysomal mRNP from Artemia salina gastrulae was labelled by reductive methylation and microinjected into the cytoplasm of Xenopus laevis oocytes. The labelled protein has a half-life of approximately 20 h and accumulated in the nucleus of the oocyte. The kinetics of accumulation reached a plateau at about 15 h after microinjection. P38 accumulates in the nucleus to a final concentration 3.15 times higher than that reached by free diffusion. This fact suggests that P38, a cytoplasmic poly(A) binding protein, might also play some role in the nucleus of the cell. PMID- 6852016 TI - Site-directed fluorogenic modification of bacteriorhodopsin by 7-chloro-4 nitrobenz-2-oxa-1,3-diazole. AB - Site-directed covalent modification of bacteriorhodopsin is achieved by reacting the hydrophobic probe 7-chloro-4-nitrobenz-2-oxa-1,3-diazole (NBD-Cl) at neutral pH with purple membranes. The bacteriorhodopsin fluorescence thus produced is specific for a nucleophilic group. The spectral properties of NBD-modified bacteriorhodopsin indicate covalent interaction of the probe with the nucleophilic epsilon-amino group of a lysine residue. Modification of tyrosine can be excluded. As demonstrated by polypeptide fragmentation and subsequent sequence analysis, NBD binding is confined to lysine 41 within the primary structure of bacteriorhodopsin. Collisional fluorescence quenching with iodide demonstrates that, in NBD-treated purple membranes, the covalently bound label is not accessible in the aqueous phase. A hydrophobic location for the introduced fluorophor is thereby implied. PMID- 6852020 TI - 6-phosphogluconolactonase. Purification, properties and activities in various tissues. AB - 6-Phosphogluconolactonase was purified to apparent homogeneity in a four-step procedure from bovine erythrocytes. The extent of purification and the kinetic properties of the enzyme were evaluated with an optical test that was based on the hydrolysis of synthetic 6-phosphogluconolactone. The active enzyme from bovine erythrocytes is a monomer with an approximate molecular weight of 30000. It exhibits Michaelis-Menten kinetics and cofactors are not required for activity. The enzyme was found in a number of tissues. Its activity, when compared to the activity of the glycolytic enzymes, illustrates the importance of glucose oxidation via the pentose phosphate pathway relative to glycolysis. PMID- 6852019 TI - A new myofibrillar protein characteristic of type I human skeletal muscle fibres. AB - Analysis of a single human type I (slow-twitch) skeletal muscle fibres by two dimensional gel electrophoresis shows that they contain a specific protein of subunit Mr 34 x 10(3) and pI 6.0, 6.1 and 6.2 (three spots) which is absent from type IIA and IIB muscle fibres. This type I protein is located in the I-band of isolated myofibrils as demonstrated by the indirect immunofluorescence using specific antisera against the denatured form of type I protein. Type I protein could only be extracted from myofibrils with high salt solutions (0.6-1 M KCl), conditions which also coextract actin and myosin, demonstrating its firm attachment. Rat and cat type I muscle fibres as well as the slow-tonic fibres from chicken anterior latissimus dorsi also contained a protein homologous to the human type I protein. The human type I protein was found to be different from the known regulatory and contractile muscle proteins by electrophoretic and immunological criteria, and may therefore be a new myofibrillar protein in type I muscle fibres. PMID- 6852021 TI - The alpha beta-methylene analogues of ADP and ATP act as substrates for creatine kinase. delta G0 for this reaction and for the hydrolysis of the alpha beta methylene analogue of ATP. AB - The alpha beta-methylene analogues of ATP and ADP, [alpha beta CH2]ATP and [alpha beta CH2]ADP, are substrates for creatine kinase. However, the rate of the phosphoryl transfer reaction catalysed is about 10(-5)-times lower than that with normal ATP. The affinities of the analogues (especially [alpha beta CH2]ADP) for the enzyme are lower than those of the normal substrates. The equilibrium constant at 25 degrees C, measured using 31P NMR, for the reaction Mg[alpha beta CH2]ATP + creatine in equilibrium Mg[alpha beta CH2]ADP + phosphocreatine + H+ is 2.2 X 10(-12) M compared with a value of 2.5 X 10(-10) M for the same reaction with the normal substrates, corresponding to a difference in delta G0 values of 11.7 kJ X mol-1. It follows that delta G0 for the hydrolysis of the terminal phosphate group of Mg[alpha beta CH2]ATP is less favourable by 11.7 kJ X mol-1 than that for MgATP. PMID- 6852022 TI - Patterns of amino acids near signal-sequence cleavage sites. AB - According to the signal hypothesis, a signal sequence, once having initiated export of a growing protein chain across the rough endoplasmic reticulum, is cleaved from the mature protein at a specific site. It has long been known that some part of the cleavage specificity resides in the last residue of the signal sequence, which invariably is one with a small, uncharged side-chain, but no further specific patterns of amino acids near the point of cleavage have been discovered so far. In this paper, some such patterns, based on a sample of 78 eukaryotic signal sequences, are presented and discussed, and a first attempt at formulating rules for the prediction of cleavage sites is made. PMID- 6852024 TI - Binding of ethidium bromide to self-complementary deoxydinucleotides. AB - Optical spectra titrations were performed with ethidium bromide and the self complementary deoxydinucleotides pdCpdG, pdGpdC, pdTpdA, and pdApdT. The titrations were performed in 7.5 mM phosphate buffer, pH 7.0, at 7 degrees C, and with varying dinucleotide concentrations always in large excess of the dye concentration. Well-defined isosbestic points were present in each titration after correction for dinucleotide light absorption. The binding curves were evaluated in terms of simple bimolecular or termolecular reaction models. The bimolecular reaction model gave a significantly better fit to the experimental data, judging from a computerized nonlinear least-squares fitting procedure. The following equilibrium constants were obtained: KC-G = 2000 M-1; KG-C = 950 M-1; KT-A = 370 M-1; KA-T = 350 M-1. From these data the absorption spectra of the completely bound dye were evaluated. These spectra showed bathchromic shifts of their maxima, increasing with the magnitude of K. Fluorescence spectra of ethidium bromide/dinucleotide mixtures were recorded under conditions similar to those for absorption spectra. From the known equilibrium constants the contributions of the bound dye could be estimated. The following fluorescence enhancements Ib/If were found: IC-Gb/If = 6.5; IG-Cb/If = 3.0; IT-Ab/If = 2.0; IA bT/If = 2.0. From our results, in relation to other theoretical and experimental studies, we conclude that electrostatic phosphate-dye interactions give rise to a major part of the binding energy, which varies with dinucleotide geometry. The more strongly bound complexes exhibit less exposure of the dye to the solvent. PMID- 6852023 TI - Time-dependent fluorescence intensity and depolarization of diphenylhexatriene in micellar complexes of apolipoprotein C-I and dimyristoylglycerophosphocholine. AB - The lipophilic fluorescent probe diphenylhexatriene was used to probe the lipid order and dynamics in apolipoprotein C-I . dimyristoylglycerophosphocholine (Myr2Gro-P-Cho) complexes. These complexes contain on the average 25 mol Myr2Gro P-Cho/mol of apolipoprotein C-I, have a molecular weight around 200 000, and appear as discoidal, stacked particles by negative-stain electron microscopy. Steady-state fluorescence polarization of diphenylhexatriene as a function of temperature gives a broadened and shifted phase transition for Myr2Gro-P-Cho from the gel to liquid-crystalline state, with a mid-point around 27 degrees C. Time dependent fluorescence intensity and anisotropy measurements of the diphenylhexatriene probe at 15 degrees C and 35 degrees C give fluorescence decay curves which can best be fit by two exponential functions, in each case. The fluorescence lifetimes and their fractional amplitudes approach the corresponding parameters in Myr2Gro-P-Cho vesicles and suggest insignificant effects of the protein on the microenvironment and conformations of the probe. The rotational correlation times and their fractional anisotropies indicate similar local motions of the probe in complexes and in vesicles, but reveal a significant ordering effect of the protein at both temperatures. The overall complex rotation at 15 degrees C has a correlation time of 136 +/- 13 ns, consistent with the size (approximately equal to 200 kDa) and shape (disc approximately equal to 5 x 15 nm) of the particle. PMID- 6852025 TI - The relationship between extramitochondrial Ca2+ concentration, respiratory rate, and membrane potential in mitochondria from brown adipose tissue of the rat. AB - The ability of isolated mitochondria from rat brown-adipose tissue to regulate extramitochondrial Ca2+ (measured by arsenazo) was studied in relation to their ability to produce heat (measured polarographically). The energetic state of the mitochondria was expressed as a membrane potential, delta psi (estimated with safranine), and was varied semi-physiologically by the use of different GDP concentrations. In these mitochondria GDP binds to the 32-kDa polypeptide, thermogenin, which regulates coupling. Ca2+ uptake (at 5 microM extramitochondrial Ca2+) was maximal at delta psi greater than 150 mV. Basal Ca2+ release increased from 1 to 2 nmol x min-1 x mg-1 below 150 mV. Na+ -stimulated rate of Ca2+ release was stable within the investigated delta psi span (100-160 mV). Initial Ca2+ levels were maintained below 0.2 microM for 100 mV less than delta psi less than 160 mV. Ca2+ levels maintained after Ca2+ challenge (20 nmol Ca2+ x mg-1) were below 0.4 microM for delta psi greater than 135 mM. Respiration was unstimulated for delta psi greater than 150 mV and was maximal at delta psi less than or equal to 135 mV. In the presence of well-oxidised substrates, the respiration at maximally activated thermogenin was markedly below fully uncoupled respiration and was probably limited by thermogenin activity--i.e. by a limited H+ reentry (OH- exit) and therefore by a membrane potential maintained at about 135 mV. It is concluded that at membrane potentials of 135 mV and above the mitochondria exhibit full Ca2+ control and are able to regulate thermogenic output up to maximum without interfering with this Ca2+ control. Membrane potential probably does not decrease below 135 mV in vivo. Therefore, Ca2+ homeostasis and thermogenesis are non-interfering and can be hormonally independently regulated, e.g. by alpha-adrenergic and beta-adrenergic stimuli, respectively. PMID- 6852026 TI - Calcium-binding proteins from human platelets. A study using crossed immunoelectrophoresis and 45Ca2+. AB - Calcium-binding platelet proteins were examined by crossed immunoelectrophoresis of solubilized platelets against antibodies to whole platelets followed by incubation of the immunoplates with 45Ca2+ and autoradiography. When the immunoplates had been pretreated with EDTA at pH 9.0 in order to remove divalent cations, three immunoprecipitates were markedly labelled with 45Ca2+. These corresponded to the glycoprotein IIb-IIIa complex, glycoprotein Ia and a presently unidentified antigen termed G18. These antigens were membrane-bound and surface-oriented. When an excess of EDTA was introduced in the incubation media the results revealed that the glycoprotein IIb-IIIa complex and antigen G18, but not glycoprotein Ia, contained sites with a stronger affinity for calcium than has EDTA at pH 7.4. Immunoprecipitates of the separate glycoproteins IIb and IIIa both bound calcium in the same manner as the glycoprotein IIb-IIIa complex. As another approach, platelet-rich plasma was incubated with 45Ca2+ prior to crossed immunoelectrophoresis of the solubilized platelets. A single immunoprecipitate was weakly labelled. This did not correspond to any of the immunoprecipitates which were visible after staining with Coomassie blue. The labelling of this antigen was markedly increased when the platelet-rich plasma had been preincubated with EDTA and in this case a weak labelling of the glycoprotein IIb IIIa precipitate also became apparent. No increased incorporation of calcium occurred in any of these immunoprecipitates when the platelets were aggregated with ADP in the presence of 45Ca2+. PMID- 6852028 TI - Fusion of sulfatide-containing vesicles of phosphatidylcholine. AB - Positively charged albumin is described as a 'useful tool' to induce both aggregation and fusion of phosphatidylcholine vesicles containing sulfatide. Techniques that include light-scattering, Sepharose chromatography, centrifugation, electron microscopy, trapped volume determination and scanning calorimetry demonstrate that extensive fusion occurs during aggregation when sulfatide concentrations are above 4-5 mol%. The rate of fusion increases with time for 1-2 h, then reaches a plateau. Fusion occurs extensively above the transition temperature of the phospholipid and is strongly inhibited by increasing concentration of vesicle cholesterol. The significance of both membrane fluidity and sulfatide-phospholipid organization in the fusion mechanism are discussed. PMID- 6852027 TI - Carboxylesterases in rat and human sera and their relationship of serum aryl acylamidases and cholinesterases. AB - The three enzyme activities, carboxylesterase, aryl acylamidase and cholinesterase activities, have been found in rat and human sera. Rat serum carboxylesterase associated with serum aryl acylamidase activity, but not with serum cholinesterase activity, was purified by ammonium sulfate precipitation, followed by successive chromatographies on DEAE-cellulose, blue Sepharose and QAE Sephadex, and then electrophoresis. Evidence for the identity of the two enzymes, carboxylesterase and aryl acylamidase, was their co-elution profiles and co purification in the different steps, including electrophoresis, with constant ratios of specific activities and percentage recoveries. Human serum carboxylesterase associated with serum cholinesterase, purified earlier, was compared with the rat serum esterase. Human serum carboxylesterase and aryl acylamidase activities were inhibited by serotonin and neostigmine, whereas rat serum carboxylesterase and aryl acylamidase activities were not affected by these compounds. Tyramine activated human but not rat aryl acylamidase. Rat and human serum esterase activities were both strongly inhibited by the diisopropylfluorophosphate. Both esterases catalyzed the hydrolysis of short chain triacylglycerols, such as tributyrin, and medium-chain monoacylglycerols, such as monocaprin, but not the hydrolysis of long-chain triacylglycerols. PMID- 6852030 TI - Control of rat-liver glutaminase by ammonia and pH. AB - Regulation by ammonia of phosphate-dependent glutaminase in isolated rat-liver mitochondria was studied at pH values near the cytosolic pH of 7.0. 1. Glutaminase activity, both in the absence and presence of bicarbonate, was completely dependent on the presence of ammonia. 2. Glutaminase activity, both in the absence and presence of bicarbonate, was strongly depressed by decreasing the pH of the incubation medium from 7.0 to 6.8 when the ammonia concentration was below 0.5 mM. 3. Bicarbonate stimulated glutaminase activity only in the presence of low concentrations of ammonia. 4. The data indicate that the reported inhibition of glutamine degradation in the perfused liver at low pH [e.g. Haussinger et al. (1980) Hoppe-Seyler's Z. Physiol. Chem. 361, 995-1001] is due to a decreased affinity of glutaminase for ammonia. PMID- 6852029 TI - Nuclear matrix: a cell-cycle-dependent site of increased intranuclear protein phosphorylation. AB - Evidence is presented that the nuclear matrix is a cell-cycle-dependent site of increased intranuclear protein phosphorylation. The incorporation of radioactive phosphate (32P) is highest during the premitotic (G2) phase and 40-50% less in the postmitotic phase (G1). This is observed for both total matrix protein and for several individual polypeptides ranging in molecular mass from greater than 200 kDa to 19 kDa. The phenomenon can be demonstrated when the matrix is isolated from orthophosphate-labeled intact cells, as well as when the matrix is isolated and then incubated in vitro in a protein kinase reaction mixture. The ability of the isolated matrix to mimic the events in vivo indicates the presence of endogenous protein phosphokinase activity and physiological substrates in this isolated nuclear fraction. Further evidence for such mimicry was obtained when amino acid phosphorylation sites were determined. Phosphoserine is the most abundant phosphoamino acid in the matrix labelled both in vitro and in vivo, although phosphothreonine and phosphotyrosine are also present. On the basis of several pieces of data, the endogenous matrix activity appears to be due to multiple protein phosphokinases. Since the maximum phosphorylation coincides with premitosis, the phosphoproteins may play a role in mitotic events. These observations extend and expand the application of this fraction to the study of nuclear structure/function relationships, particularly at the time of mitosis. PMID- 6852032 TI - Relationship of collagen-tailed acetylcholinesterase with basal lamina components. Absence of binding with laminin, fibronectin, and collagen types IV and V and lack of reactivity with different anti-collagen sera. AB - In view of their supposed localization in extracellular structures, such as basal lamina, we have investigated the possible interactions of collagen-tailed forms of acetylcholinesterase from Electrophorus and bovine superior cervical ganglion with matrix proteins: laminin, fibronectin and types IV and V collagens. Using binding and sedimentation assays, with iodinated or non-radioactive matrix proteins, we have not observed any significant interaction, in conditions of high or low ionic strength. We also examined whether the collagen tail of acetylcholinesterase asymmetric forms possessed an immunological relationship with known collagen types (I, III, IV, V) from mammalian sources. We found no specific immunoreactivity with any of the 32 sera studied, either with the iodinated Electrophorus or with the native bovine enzyme. We conclude from these negative results that the collagen-like tail of acetylcholinesterase is clearly distinct from the classical types of collagen and that asymmetric forms of the enzyme do not interact specifically with the matrix proteins studied. This does not exclude the possibility of specific interactions with other components, remaining to be identified. PMID- 6852031 TI - Bicarbonate and the pathway of glutamate oxidation in isolated rat-liver mitochondria. AB - 1. The factors affecting the pathway of glutamate oxidation were studied in isolated rat-liver mitochondria in incubations of 2-3 min. 2. It was found that bicarbonate at a physiological concentration has a profound effect on the pathway of glutamate oxidation. Ammonia formation via glutamate dehydrogenase is stimulated by bicarbonate [from 5.48 +/- 0.29 (n = 10) to 9.57 +/- 0.73 (n = 8) nmol X min-1 X mg protein-1], whereas aspartate formation via the transamination pathway is inhibited [from 38.41 +/- 2.24 (n = 9) to 24.56 +/- 3.28 (n = 6) nmol X min-1 X mg protein-1]. 3. Bicarbonate has no effect on the rate of transport of glutamate via the glutamate-hydroxyl translocator. 4. The interaction of bicarbonate with the pathway of glutamate oxidation occurs primarily at the level of succinate dehydrogenase, due to competitive inhibition of the enzyme by bicarbonate. 5. Inhibition by bicarbonate of the transamination pathway leads to a decrease in intramitochondrial 2-oxoglutarate, so that the deamination pathway is stimulated. 6. Using an equation which describes flux through glutamate dehydrogenase kinetically, it could be shown that the bicarbonate-induced decrease in intramitochondrial 2-oxoglutarate quantitatively accounts for the enhanced rate of deamination. 7. It is concluded that in the intact liver flux through glutamate dehydrogenase is sufficient to account for the ammonia formation required for urea synthesis from substrates such as alanine. PMID- 6852034 TI - Interaction of a coenzyme analog with aspartate aminotransferase isoenzymes in the crystal. AB - The interaction between the coenzyme derivative 4'-N-(2,4-dinitro-5-fluorophenyl) pyridoxamine 5'-phosphate with cytoplasmic and mitochondrial apo-aspartate aminotransferase in the crystalline state was investigated to establish whether the structural differences, known to exist between the active sites of the two isoenzymes in solution, are maintained in the crystal although they are not apparent from the available crystallographic data. In the crystal, as in solution, both apo-isoenzymes reversibly bind the coenzyme derivative and catalyze a slow cleavage reaction, by which pyridoxal 5'-phosphate is produced and bound to the active-site lysine. In the case of the cytoplasmic isoenzyme, however, in the crystal as in solution, the initial complex can follow an alternative reaction path that leads to the formation of a covalent bond between the active-site lysine and the C-5 of the 2,4-dinitrophenyl moiety of the reagent. Therefore, crystal-packing forces neither abolish the active site properties that are needed to cleave the specifically bound reagent and are common to the two isoenzymes nor mask the subtle differences that allow for the selective irreversible labeling of the cytoplasmic isoenzyme. PMID- 6852033 TI - Further characterization of the three polypeptide chains of bovine and human short-chain collagen (intima collagen). AB - Short-chain collagen was isolated from bovine and from human placenta after limited pepsin digestion. By reductive cleavage of disulfide bonds under non denaturing conditions, mainly non-collagenous domains were cleaved off yielding a uniform component composed of three polypeptide chains with molecular masses between 37 kDa and 48 kDa in a nearly equimolar ratio. The chains (SC1*, SC2* and SC3*) were isolated and characterized. By comparison of peptide patterns obtained after various cleavage procedures, they could be identified as more or less shortened forms of SC1, SC2 and SC3, the isolation of which from bovine short chain collagen has been described [Jander et al. (1981) Eur. J. Biochem. 114, 17 25]. The peptide patterns; as well as N-terminal sequence determination, give evidence for the genetic individuality of the three chains; the data so far available suggest that together they form one triple-helical structure which represents the collagenous domain of the basic molecular unit of short-chain collagen. PMID- 6852035 TI - The refined structure of the selenoenzyme glutathione peroxidase at 0.2-nm resolution. PMID- 6852036 TI - Semisynthesis of phospholipase A2. The effect of substitution of amino-acid residues at positions 6 and 7 in bovine and porcine pancreatic phospholipases A2 on catalytic and substrate-binding properties. AB - The N-terminal alpha-helical region of phospholipase A2 is an important part of the enzyme for catalytic activity and lipid binding. Porcine pancreatic phospholipase A2 has Arg-Ser at positions 6 and 7, whereas the bovine enzyme has Asn-Gly. To pursue further the effects of these variable residues on differences in enzymatic properties, we prepared and studied the following semisynthetic analogs of epsilon-amidinated phospholipase A2 (AMPA): porcine [Ala7]AMPA, [Gly7]AMPA, [Asn6]AMPA, [Asn6-Gly7]AMPA and bovine [Ser7]AMPA and [Arg6 Ser7]AMPA. As we had previously found for the Asn6 leads to Arg bovine substitution, an Asn6-Gly7 leads to Arg5-Ser7 bovine substitution similarly improves the catalytic activity, the affinity for neutral lipid-water interfaces and the capacity to penetrate lecithin monolayers, while just changing Gly7 leads to Ser produces almost no effect on these properties. Ser7 leads to Ala and Ser7 leads to Gly substitutions in porcine AMPA did not affect penetration or lipid binding, although they did diminish catalytic activity (which is true of all substitutions made in the porcine enzyme). Arg6 leads to Asn substitution in porcine AMPA decreases penetration of lecithin monolayers, but not as much as it was improved by the Asn6 leads to Arg substitution in bovine AMPA. In contrast to the dramatic increase in affinity for lipid-water interfaces of Asn6 leads to Arg substitution in bovine AMPA, no decrease in affinity was found for Arg6 leads to Asn substitution in porcine AMPA. This difference is most likely due to the fact that the porcine enzyme has positively charged Lys and His in place of the Lys10, Glu17 pair that lie very close to residue 6 in the bovine structure. It can thus be conclude that (with the exception of Gly7 leads to Ser in bovine AMPA) all the substitutions tried at positions 6 and 7 in bovine and porcine AMPAs have definite effects on the catalytic activity. PMID- 6852037 TI - Characterization of a salivary agglutinin reacting with a serotype c strain of Streptococcus mutans. AB - A protein, which can agglutinate a Streptococcus mutans serotype c strain, was isolated from parotid saliva by affinity adsorption of the salivary agglutinin to the microorganism followed by a desorption with a 10 mM phosphate buffer. The agglutinin was subjected to preparative ultracentrifugation, gel filtration, and ultrafiltration. The native purified agglutinin is active only in the presence of Ca. Polyacrylamide gel electrophoresis, analytical centrifugation, and analyses of amino acids and carbohydrates showed that the native agglutinin was a fucose rich glycoprotein with a carbohydrate content of 45% and with a molecular weight of at least 5 X 10(6). After sodium dodecyl sulphate treatment the molecular weight was 4.4 X 10(5). There was a low content of proline and a high content of aspartic acid, serine and threonine. The concentration of agglutinin in parotid saliva is less than 0.5% of total protein. It has high biological activity: 0.1 microgram agglutinin causes a rapid aggregation of approximately 10(8) bacteria. PMID- 6852038 TI - Characterization of the trimeric, self-recognizing Geodia cydonium lectin I. AB - A D-galactose-specific lectin I was extracted from the sponge Geodia cydonium and purified by affinity chromatography. The molecular weight of lectin I as determined by high-pressure liquid gel chromatography, was found to be 36500 +/- 1300. Disc gel electrophoresis in the presence and in the absence of sodium dodecyl sulfate showed that lectin I is a trimer composed of three different subunits (Mr: 13800, 13000 and 12200); two of the three subunits are linked by one disulfide bond. Isoelectric focusing gave a pI of 5.6 for the native molecule and a pI of 4.4 and of 7.4 for the subunits. The three subunits carry carbohydrate side chains, composed of D-galactose (94%) and of arabinose (5%). Based on experiments with lectins, the terminal D-galactose residues are bound by beta 1 leads to 6 and/or beta 1 leads to 4 glycosidic linkages. The Geodia lectin I contains, besides two carbohydrate recognition sites, at least one receptor site for a second lectin I molecule. PMID- 6852039 TI - Hepatocyte heterogeneity in glutamine and ammonia metabolism and the role of an intercellular glutamine cycle during ureogenesis in perfused rat liver. AB - 1. The metabolism of glutamine and ammonia was studied in isolated perfused rat liver in relation to its dependence on the direction of perfusion by comparing the physiological antegrade (portal to caval vein) to the retrograde direction (caval to portal vein). 2. Added ammonium ions are mainly converted to urea in antegrade and to glutamine in retrograde perfusions. In the absence of added ammonia, endogenously arising ammonium ions are converted to glutamine in antegrade, but are washed out in retrograde perfusions. When glutamine synthetase is inhibited by methionine sulfoximine, direction of perfusion has no effect on urea synthesis from added or endogenous ammonia. 3. 14CO2 production from [1 14C]glutamine is higher in antegrade than in retrograde perfusions as a consequence of label dilution during retrograde perfusions. 4. The results are explained by substrate and enzyme activity gradients along the liver lobule under conditions of limiting ammonia supply for glutamine and urea synthesis, and they are consistent with a perivenous localization of glutamine synthetase and a predominantly periportal localization of glutaminase and urea synthesis. Further, the data indicate a predominantly periportal localization of endogenous ammonia production. The results provide a basis for an intercellular (as opposed to intracellular) glutamine cycling and its role under different metabolic conditions. PMID- 6852040 TI - Characterization of messenger RNA for chick-embryo DNA polymerase beta and its translation product in vitro. AB - A specific immunoprecipitation method, using rabbit anti-(chick DNA polymerase beta) IgG was applied to detect the polypeptide of DNA polymerase beta among translation products obtained in vitro with mRNA extracted from chick embryos. A polypeptide of Mr = 40 000 was specifically immunoprecipitated from [35S]methionine-labeled translation products and was competitive with the purified DNA polymerase beta for the antibody. Furthermore, the 40 000-Mr translation product obtained in vitro had DNA polymerase activity, which was detected by assay in situ after electrophoresis in a polyacrylamide gel containing DNA. The mRNA for DNA polymerase beta was polyadenylated and its content was estimated as the range of 0.001% of total poly(A)-rich RNA on the basis of [35S]methionine incorporation in the translation in vitro. The size of this mRNA was determined to be about 1800 nucleotides by zone sedimentation and agarose gel electrophoresis under denaturating conditions. PMID- 6852041 TI - Acyl-coenzyme A: cholesterol acyltransferase. Transfer of cholesterol to its substrate pool and modulation of activity. AB - The preincubation at 37 degrees C of rat liver microsomal fraction, followed by re-isolation of the treated vesicles, results in a time-dependent increase in the activity of acyl-CoA: cholesterol acyltransferase. The presence of cholesterol phospholipid (1:1, mol/mol) liposomes results in higher rate of increase in activity and under these conditions the rate of increase is liposomal cholesterol concentration-dependent. The preincubation of the microsomal fraction in the presence of [3H]cholesterol-phospholipid liposomes results in transfer of [3H]cholesterol to the re-isolated microsomal vesicles and this transfer follows first-order kinetics in respect to the donor concentration. These preincubations result also in a time-dependent and liposomal cholesterol concentration-dependent increase in the incorporation of [3H]cholesterol into the cholesteryl oleate produced on assay of cholesterol acyltransferase activity. From specific radioactivity data of the cholesteryl esters synthesised on assay of cholesterol acyltransferase in treated microsomal preparations, the rate of liposomal [3H]cholesterol equilibration with the cholesterol acyltransferase substrate pool can be calculated. The half-time of this transfer decreased with the concentration of liposomal cholesterol present during the preincubation. The activation energy for the transfer of liposomal cholesterol to the cholesterol acyltransferase substrate pool was 87.9 kJ/mol and was independent of the concentration of liposomal cholesterol. The activation energy for the rate of increase of total cholesteryl oleate was similar to this value for low concentrations of liposomal cholesterol and progressively decreased with increasing concentrations of liposomal cholesterol. The data suggest that under the present conditions, the time-dependent and temperature-dependent increase in cholesterol acyltransferase activity is due to the transfer of non-esterified cholesterol from other microsomal and/or liposomal vesicles to the vesicles that contain the enzyme and therefore to increased availability of substrate. PMID- 6852042 TI - Neutron diffraction of chromatin in interphase nuclei and metaphase chromosomes. AB - We have used neutron diffraction to study chromatin structure in interphase nuclei and metaphase chromosomes as a function of decreasing ion concentration. Aliquots of a suspension of rat liver nuclei prepared in a polyamine-free buffer were washed in buffers of 1/3, 1/6 and 1/12 if the original concentration of monovalent and divalent cations (40 mM KCl; 20 mM NaCl; 1.2 mM MgCl2). After the first dilution step (1/1 to 1/3), only small changes occurred in the diffraction pattern. They can be interpreted by a loosening of the original structure, i.e. by the formation of isolated buffer-filled spaces with an overall size of the order of 35-45 nm. Drastic changes in the diffraction pattern were observed, however, when the nuclei were washed in the more diluted buffers (1/6 and 1/12). The profiles of the distances distribution functions indicate the formation of supranucleosomal particles with an overall diameter of 40-50 nm. The compact chromatin structure disassembled directly into these fundamental structural units. Structural transformations in the Chinese hamster ovary metaphase chromosomes were induced by diminishing the Ca2+ ion concentration of the buffer from originally 3.0 mM to 0.3 mM and/or by increasing the pH value of the buffer from originally 7.0 up to 8.0. The neutron diffraction patterns remained essentially unchanged during these treatments, i.e. the decondensation of the chromosomes as observed in the light microscope is not accompanied by disassembly at the ultrastructural level between 2 nm and 150 nm. PMID- 6852043 TI - Secretion of plant storage globulin polypeptides by Xenopus laevis oocytes. AB - Xenopus oocytes injected with poly(A)-containing RNA from developing cotyledons of field beans (Vicia faba L. var. minor) synthesize precursor polypeptides to the major storage globulins legumin and vicilin. These polypeptides are secreted into the medium without proteolytic cleavage of the legumin propolypeptides into the mature disulfide-linked alpha and beta chains. Similarly, storage globulin polypeptides from pea (Pisum sativum L.) and french bean (Phaseolus vulgaris L.) were secreted from oocytes. Inhibition of glycosylation by tunicamycin does not prevent secretion. This first report on the secretion of plant polypeptides by Xenopus oocytes shows that (a) intracellular deposition of storage proteins in membrane-bounded organelles (protein bodies) of plants and extracellular secretion have step(s) in common, and (b) the cell, in addition to the mRNA, determines the final destination of these polypeptides. PMID- 6852044 TI - On the probable involvement of arginine residues in the bile-salt-binding site of human pancreatic carboxylic ester hydrolase. AB - Modification of arginine residues with 2,3-butanedione inhibits the carboxylic ester hydrolase activity on soluble and emulsified substrates when assayed with bile salts. The alpha-dicarbonyl reagent modifies seven of the nineteen arginine residues present per enzyme molecule. Nevertheless the inactivation with butanedione is greatly diminished when the protein is in the presence of negatively charged micellar bile salt. In these conditions we observe the protection of one arginine residue by sodium taurodeoxycholate and of two arginine residues by sodium cholate. This suggests that the carboxylic-ester hydrolase from human pancreatic juice contains at least two arginine residues essential for the activation by bile salts. All our data confirm the presence of two bile-salt-binding sites on the enzyme in which one arginine per site is involved and plays the general role of an anionic binding site. This study provides evidence that arginine residues may play an essential role in the interaction between bile salts and protein. PMID- 6852045 TI - Transport of methionine in sea-urchin sperm by a neutral amino-acid carrier. AB - A carrier-mediated transport for L-methionine and other neutral amino acids exists in sperm of the sea urchin Lytechinus pictus. The initial rate of L methionine entry is a Michaelis-Menten function of the methionine concentration in the external medium. The maximum velocity is low [V = 250 pmol h-1 (10(9) sperm)-1 at 22 degrees C] and the affinity is high (Km = 6-10 microM). The initial rate of transport under steady-state exchange conditions is also a Michaelis-Menten function of the external concentration of methionine. The Km determined by this method is about 14 microM. Neutral amino acids compete with L methionine transport as shown by initial velocity measurements. These results indicate that L-methionine transport is a carrier-mediated process. The temperature dependence of the process is approximately 84 kJ (20 kcal) mol-1 K-1, which is not compatible with a simple diffusion mechanism, but in the range of values usually found for a mediated transport. The transport is largely Na+ independent and does not depend on Ca2+, K+ or H+ gradients. It is only partially sensitive to KCN, showing it is mainly independent of oxidative phosphorylation. The steady-state internal methionine concentration is not a linear function of the external amino acid concentration. This suggests that an exit by diffusion competes with a carrier-mediated concentrative transport in a cellular compartment. This mediated transport is compared to those of higher animal cells. PMID- 6852046 TI - Localization of ellipticine derivatives interacting with membranes. A fluorescence-quenching study. AB - The interaction with membranes of three anti-cancer drugs of the ellipticine family was studied by fluorescence quenching of membrane probes. The fluorescence of three probes, located at different levels in membranes, was quenched by addition of two types of ellipticine derivatives, one amphiphilic drug (9 methoxyellipticine) and two dipolar molecules (9-aminoellipticine and 9 hydroxyellipticine). By comparing the quenching curves obtained, the following can be proposed. a) 9-Methoxyellipticine can penetrate deeper in the lipid layers than 9-aminoellipticine and 9-hydroxyellipticine can. b) The three drugs are able to penetrate at least between the first methylene groups of the acyl chains of lipids in liposomes. c) In an isolated bacterial membrane, only 9 methoxyellipticine can be located in the region of the first methylene groups of lipids, the two dipolar drugs being adsorbed on the membrane surface. It was also shown that cholesterol hindered the penetration of 9-methoxyellipticine in the bilayer of liposomes. PMID- 6852047 TI - Partial purification of rat and human serum factors inhibiting the G1-S transition in rat hepatocytes. AB - A low molecular weight compound, which inhibits the G1-S transition in rat hepatocytes, was purified from rat trypsin-treated serum by DEAE-cellulose chromatography and high-performance liquid chromatography on three different stationary phases. This procedure led to a 34500-fold purification with a 29% yield. Inactivation of the purified material by specific enzymes showed that the inhibitor is a glycopeptide containing a peptide moiety, N-acetylneuraminic acid and galactose residues. Amino acid analyses indicated the possible existence of a pentapeptide structure. The same purification procedure was applied to the corresponding human inhibitor. Inactivation by specific enzymes showed that it is also a glycopeptide. PMID- 6852048 TI - Histone acetylation in chromatin containing mouse satellite DNA. AB - Histone acetylation in transcriptionally inactive chromatin has been studied with chromatin containing mouse satellite DNA. The latter was obtained by digestion of nuclei from Ehrlich ascites tumor cells with the restriction nuclease Bsp, which degrades main-band DNA but leaves satellite DNA intact. The enzyme-resistant material was separated by gel filtration. Satellite DNA amounted to 65% of the total DNA in this fraction. When the cells were grown in the presence of sodium n butyrate to inhibit histone deacetylation, a few, if any, hyperacetylated forms of core histones were found in satellite chromatin. Conversely, the highest quantity of tetraacetylated H4 molecules was found in the fractions containing the most extensively degraded chromatin. PMID- 6852050 TI - The core protein of alphaviruses. 1. Purification of peptides and complete amino acid sequence of Semliki Forest virus core protein. AB - The primary structure of the core protein of Semliki Forest virus has been established by protein chemical characterization of 102 peptides, generated by digestion with trypsin, pepsin, thermolysin, and by partial acid cleavage of the protein. Besides a difference in one position, the sequence as established by these experiments is in agreement with the sequence predicted from the nucleotide sequence of the mRNA [Garoff et al. (1980) Proc. Natl Acad. Sci. USA, 77, 6376 6380]. The core protein has a blocked N terminus, consists of 267 amino acid residues, and has the following amino acid composition: Asp12, Asn9, Thr16, Ser10, Glu11, Gln15, Pro23, Gly20, Ala23, Val19, Met8, Ile11, Leu9, Tyr7, Phe6, His7, Lys37, Arg15, Trp5, Cys4, and an Mr of 29919. It contains 22.1% basic amino acids, mainly lysines, compared with a total of 8.6% acidic residues. The resulting surplus of positive charge is located in the N-terminal half of the protein (predominantly arginines at positions 12-21 and lysines at positions 66 114). Other amino acids are also unevenly distributed; proline and glutamine are accumulated in the N-terminal half of the sequence whereas histidine, glycine and the acidic residues are mainly present in the C-terminal part. This distribution suggests that the virus core protein consists of two or more structural domains. PMID- 6852049 TI - Neutron-scattering studies of accurately reconstituted nucleosome core particles and the effect of ionic strength on core particle structure. AB - Chicken erythrocyte nucleosome core particles can be dissociated quantitatively into histones (H3, H4)2 bound to 146 base pairs of DNA, and 2(H2A, H2B). Reconstitution of core particles from the two components produces an 85% yield of particles which neutron scattering studies show to be accurate stoichiometrically and indistinguishable from native core particles: the radii of gyration of the shape, the protein components and the DNA components of the particles are 4.02 nm, 3.3 nm and 4.95 nm respectively. The largest distance and most probable distance which can be drawn in the particles are 11.5 nm and 4.3 nm respectively. The molecular weight of the particles is identical to that of control 'native' core particles. All of these values, within limits of error, are the same as known values for 'native' core particles. These experiments confirm the essential role of histones H3 and H4 in the initial organisation of core-particle structure, make possible the manufacture of perfectly pure and homogeneous core particle preparations and allow the 100% incorporation of labelled or modified histones. Neutron scattering studies of core particles at high contrast (in D2O and H2O) have been carried out over a range of ionic strengths and pH. No change in structure is detected down to pH 5.5 in 20 mM NaCl or down to ionic strength 2.0 mM at pH 7. PMID- 6852051 TI - The core protein of alphaviruses. 2. Purification of peptides and complete amino acid sequence of Sindbis virus core protein. AB - The primary structure of the core protein of Sindbis virus has been established by protein chemical characterization of peptides derived by enzymatic digestion with trypsin, pepsin and thermolysin and by chemical cleavage with cyanogen bromide. The peptide chain consists of 264 amino acids and has the composition Asp8, Asn8, Thr17, Ser12, Glu12, Gln14, Pro28, Gly24, Ala22, Val16, Met10, Ile8, Leu14, Tyr4, Phe9, His6, Lys25, Arg23 and Trp4 and an Mr of 29 382. Comparison of this structure with the primary structure of the SF virus core protein revealed several important common characteristics of alphavirus core proteins. 1. The N terminal halves (1-110) of the proteins are rich in basic amino acids and proline. 2. The C-terminal part (approximately equal to 110-264/267) is highly conserved: 70% of the amino acid residues are in identical positions. 3. The conserved part contains a possible catalytic centre for the presumed protease activity of the core protein. The similarities between the primary structures of both core proteins are reflected in their predicted secondary structures. PMID- 6852052 TI - Biosynthesis of the major glycoprotein associated with zymogen-granule membranes in the pancreas. AB - The biosynthesis of GP-2, the major glycoprotein associated with zymogen-granule membranes in the pancreas, was studied in acinar cell suspensions from rat pancreas. Pulse-chase experiments, using [35S]methionine, were performed and the processing of GP-2 was analyzed by immunoprecipitation and sodium dodecyl sulfate/polyacrylamide gel electrophoresis. GP-2 is synthesized as a precursor glycoprotein with apparent molecular weight Mr = 73000. Within 60 min after synthesis it is almost completely converted to the mature form (Mr = 78000 80000). Only the precursor form of GP-2 is sensitive to digestion with the glycosidase endo-beta-N-acetylglucosaminidase H, indicating that the observed conversion reflects the processing of 'high-mannose' oligosaccharides into complex type oligosaccharides. Acinar cells cultured in the presence of increasing concentrations of the N-glycosylation inhibitor tunicamycin synthesize 5-6 distinct precursor GP-2 species with apparent molecular weights decreasing from 73000-61000. We conclude that GP-2 contains five or six N-linked carbohydrate chains. From cell fractionation studies it was established that the precursor GP-2 is present in a microsomal fraction with high density (greater than 1.169 g/ml) presumably derived from the rough endoplasmic reticulum; mature GP-2 is localized in low density microsomes (less than 1.130 g/ml) probably Golgi vesicles. The GP-2 in zymogen granule membranes is also in the mature form. PMID- 6852053 TI - On the mobility of riboflavin 5'-phosphate in Megasphaera elsdenii flavodoxin as studied by 13C-nuclear-magnetic-resonance relaxation. AB - The mobility of the isoalloxazine ring of the prosthetic group of Megasphaera elsdenii flavodoxin was investigated by a 13C relaxation study of the non protonated ring atoms 2, 4, 4a and 10a. In this study a selectively enriched (greater than 90% 13C) prosthetic group was bound to the apoprotein. T1 and T2 values were determined at two magnetic field strengths, i.e. 8.46 T (90.5 MHz) and 5.88 T (62.8 MHz). Values of nuclear Overhauser effects (NOE) were determined at 5.88 T. It is shown that both the dipole-dipole interaction and the chemical shift anisotropy are important relaxation sources for all the carbon atoms investigated. The results are in agreement with a spectral density function of the isoalloxazine ring in which only the overall reorientational motion of the protein is accounted for. From this it is concluded that the isoalloxazine ring is tightly associated with the apoprotein. The protein-bound isoalloxazine ring does not exhibit large fluctuations on the nanosecond time scale, although small amplitude fluctuations cannot be excluded. This information was obtained by a combination of field-dependent T1 and NOE measurements. T2 values are in agreement with these results. On the basis of the dipolar part of the overall T1 values, the distance between the carbon investigated and the nearest proton was calculated and found to be in fair agreement with the crystallographic results of the related flavodoxin from Clostridium MP. In addition, it is shown that, based on the chemical shift anisotropy as a relaxation source, information on the internal mobility is difficult to obtain. The main reason for this is the low precision in the determination of the chemical shift anisotropy tensor. PMID- 6852054 TI - A form of the DNA-dependent RNA polymerase of Halobacterium halobium, containing an additional component, is able to transcribe native DNA. AB - A revised procedure for the purification of DNA-dependent RNA polymerase from Halobacterium halobium, including two-phase partition, yields pure, highly active and absolutely DNA-dependent enzyme. Two forms of the enzyme, one containing, the other not containing a previously not observed component, epsilon, show striking differences in activity. RNA polymerase without component epsilon has a significant activity on poly[d(A-T)] but only insignificant activity on all other templates. The enzyme containing a stoichiometric amount of component epsilon transcribes poly[d(A-T)] and native templates efficiently. PMID- 6852055 TI - Quaternary structure and spin equilibria in ferric hemoglobins. A room temperature study. AB - The effective magnetic moments for a number of human and carp methemoglobin derivatives were determined in solution at room temperature. The data permit us to confirm the dependence of the spin-state equilibrium of azide methemoglobin on the quarternary state of the hemoglobin and to demonstrate a similar dependence for both human and carp aquomethemoglobin. In addition, the pH dependence of the effective magnetic moment and the Soret spectrum of carp azidemethemoglobin are compared. PMID- 6852057 TI - Isolated intestinal mucosa cells of high viability from guinea pig. AB - A simple method for preparing isolated enterocytes from the guinea pig is described. The procedure allows isolation of cell suspensions with high yield, outstanding viability and free of mucus. The isolated enterocytes were structurally intact. They largely excluded Trypane blue (94%), and lost smaller amounts of LDH than preparations from others. The cells accumulated K+ (greater than 90 mM) during incubation at 37 degrees and transported uridine actively. Incorporation of uridine and phenylalanine into macromolecules proceeded in a linear fashion for more than 40 min. Naphthol was efficiently conjugated with sulfate and glucuronic acid. The intracellular mitochondria exhibited well coupled respiration. Since all the examined parameters indicate functional intactness, these cells appear to be very valuable for studying the biochemistry, pharmacology, and pathology of the intestinal mucosa. PMID- 6852056 TI - Perinatal development of the distributions of phosphoenolpyruvate carboxykinase and succinate dehydrogenase in rat liver parenchyma. AB - Parenchymal distributions and activities of mitochondrial succinate dehydrogenase and cytosolic phosphoenolpyruvate carboxy-kinase were studied during perinatal development of rat liver. 1. Succinate dehydrogenase activity increased almost linearly from day 5 before to day 5 after birth. Hepatocytes with higher enzyme activities were disseminated heterogeneously, zonal heterogeneity developed during the second week. 2. Cytosolic phosphoenolpyruvate carboxykinase was not detectable before birth; it was induced to high levels during day 1 and increased further to a maximum during days 5 to 10. It decreased again to adult levels at the end of the third week. The enzyme distribution already showed signs of a zonal heterogeneity at day 1, which became fully developed during the second week. The results indicate that the zonal heterogeneity typical of adult liver was established for the two enzymes during the second week of life. They revealed in addition that the two enzymes, representing two different subcellular compartments, had an individual development towards the zonal heterogeneity. PMID- 6852059 TI - Kinetics of Golgi apparatus membrane flux following monensin treatment of embryogenic carrot cells. AB - Ultrastructural changes resulting from treatment with the sodium selective ionophore, monensin, were studied in embryogenic suspension cultures of carrot, Daucus carota (L.) in the presence of 10 microM monensin, an early change in the Golgi apparatus was an increase in the number of cisternae per stack (dictyosome). An average of one additional cisterna per stack was formed within the first 2 to 4 min of monensin treatment; in some experiments a second cisterna was formed within about 8 min. Thereafter, large vacuoles began to appear in the cytoplasm adjacent to the Golgi apparatus with a return of the number of cisternae per dictyosomal stack to the control number of about 5. Cells treated comparable but in the absence of monensin showed no ultrastructural changes during the entire observation period. By 1 h of monensin treatment, the regions of the cells containing dictyosomes were populated by large number of vacuoles (up to 20 or more per electron microscope section). These vacuoles were interpreted as swollen dictyosome cisternae that separated from the stack but had not migrated from the Golgi apparatus zone in the monensin-treated cells. The results permitted an estimation of the average time for formation of a new dictyosome cisterna of 2 to 4 min. This range of values agreed with estimates for mammalian cells from short time labeling and turnover experiments of 3 to 4 min assuming a dynamic model for Golgi apparatus function in which cisternae are released from a maturing face and new cisternae are built up at an opposite or forming face. PMID- 6852058 TI - Structural and biochemical characterisation of the paraflagellar rod of Crithidia fasciculata. AB - The trypanosomatid Crithidia fasciculata possesses an intraflagellar structure known as the paraflagellar or paraxial rod which runs from a point 1 to 2 micrometer distal to the basal body to the flagellar tip. In longitudinal section the paraflagellar rod was composed of three "sets" of parallel filaments arranged in a lattice. In cross section it consisted of two electron dense "plaques", one near the flagellar membrane, the other near the axoneme, separated by 6 to 7 fibrous elements. The position of the paraflagellar rod in relation to the axonemal central pair remained static along the length of the flagellum and was the same in all flagella examined. The paraflagellar rod was anchored to the axoneme by a regular array of 5 to 7 nm diameter links. These rod/axoneme links were sensitive to trypsin digestion enabling the rod to be separated from the axoneme. SDS-polyacrylamide gel electrophoresis (SDS-PAGE) demonstrated that the paraflagellar rod consisted mainly of two proteins, PFR1 (76 000 Daltons) and PFR2 (68 000 Daltons). The isoelectric points of these two proteins were remarkably similar. A PFR-enriched fraction was obtained by prolonged dialysis of demembranated flagella against a low concentration buffer. The paraflagellar rod and the central pair of singlet microtubules went into solution, leaving only the outer doublets intact. The relevance of these results to the study of the role of the paraflagellar rod in flagellar motility were discussed. PMID- 6852060 TI - Cytochemical localization of lipases during spore germination from Bryum capillare. AB - In the oil containing spores of Bryum capillare, lipid breakdown occurs within three days after sowing. The periods of activity of acid, neutral and alkaline lipases are coincident. They start at the first day after sowing the spores. After 3 days of germination, when storage fats forming large globules are mobilised no lipase activity could be detected any longer in the glyoxysomes. Acid lipase is preferentially located in spherosomal membrane but is also present at the glyoxysomal membrane. Alkaline lipase is specifically located in the glyoxysomes and mitochondria. A cooperation presumably exists between acid and alkaline lipases in the hydrolysis of monoglycerides at the glyoxysomal level. Neutral lipase activity is localized at the spherosomal membrane, in the endoplasmic reticulum and in dictyosomes. It is absent from glyoxysomes. PMID- 6852061 TI - Nuclear pore clusters and perinuclear material in midgut epithelial cells of Dytiscus marginalis (Insecta, Coleoptera). AB - In ultrathin sections and freeze-fractures in hexagonal nuclear pore arrangement is described in midgut epithelial cells of Dytiscus marginalis. The majority of the pores is concentrated in several cup-like indentations of the nuclear envelope and the pore center-to-center distance is about 130 to 140 nm. In addition, in the regions of the nuclear pore clusters, patches of cytoplasm containing paracrystalline structures of closely packed hexagons of 18 to 20 nm width are found sandwiched between the nuclear envelope and a "secondary" envelope. In such areas, structures are commonly observed that suggest transfer of material from the nucleus to the cytoplasm, sometimes in a dumb-bell-shaped state and more often as slender filaments which migrate across the nuclear pores. PMID- 6852062 TI - Actin isotype biosynthetic transitions in early cardiac organogenesis. PMID- 6852064 TI - Reassessment of the relation between QRS forces of the orthogonal electrocardiogram and left ventricular ejection fraction. AB - Previous studies have demonstrated the existence of a strong positive correlation between the amplitude of QRS forces of the orthogonal electrocardiogram and the angiographically determined left ventricular ejection fraction. In a large group of patients evaluated for chest pain, we examined the relationship between the arithmetic summation of RX + RY + QZ (sigma R), the maximal and mean spatial QRS vectors and the ejection fraction (EF). In a total of 252 patients, there was a statistically significant correlation between sigma R and EF but a low correlation coefficient value (r:0.22, P less than 0.001). This relationship was essentially due to the group of patients with coronary artery disease and myocardial infarction (r:0.24, P less than 0.015) whereas there was no correlation in the group of normal subjects or in patients with coronary artery disease without myocardial infarction. In the group with myocardial infarction, a significant correlation between sigma R and EF existed only in patients with anterior myocardial infarction (r:0.41, P less than 0.025). In conclusion, both ejection fraction and amplitude of QRS forces decrease in coronary artery disease especially when an anterior myocardial infarction is present. However, despite the positive association between these angiographic and electrocardiographic indices, the low value of the correlation coefficient indicates that it is not possible to predict ejection fraction from the value of sigma R in individual patients. PMID- 6852069 TI - Seminars in cardiovascular disease. 1. Bedside examination of peripheral vascular disease. PMID- 6852063 TI - Supramolecular forms of actin induced by polyamines; an electron microscopic study. AB - Electron microscopy of negatively stained samples shows that spermine and spermidine induce the polymerization of G-actin into filaments and paracrystalline bundles. In the presence of low concentrations of polyamines (0.02 mM spermine or 0.2 mM spermidine), filaments resembling salt-induced F actin were observed, but as the concentration of polyamine was increased, relatively unordered bundles appeared. At about 0.2 mM spermine or 2.5 mM spermidine, the width of the bundles increased and they appeared more ordered with paracrystalline regions. This change was correlated with the gelation of the actin-polyamine mixture. At higher concentrations of polyamines (greater than 5 mM spermine or greater than 8 mM spermidine), the bundles had a similar ordered structure but, instead of gelation, there was an immediate precipitation of actin bundles. Spermine and spermidine also promote bundle formation from salt-induced F-actin. Two major paracrystalline forms were observed. Type I resembles the Hanson-type paracrystals induced by magnesium. Type II, characterized by an axial striation of 5.9 nm appears to be unique to polyamine-induced actin bundles. PMID- 6852067 TI - M-mode echocardiographic features of severe aortic valve endocarditis. AB - We describe and discuss the M-mode echocardiographic features in 10 patients with infective endocarditis of the aortic valve requiring surgery. Operative findings and aortic valve histology were obtained in each case. Vegetations were visualized in six out of seven patients (86%) with proven vegetations while pre existing aortic valve disease masked their echocardiographic recognition in one patient. Diastolic echoes indistinguishable from vegetations were recorded from the ragged edge of a perforated aortic cusp in one patient who at operation had no demonstrable vegetations. Left ventricular outflow tract (LVOT) echoes were seen in five patients. Non-vibrating LVOT echoes were identified as vegetations while rapidly vibrating LVOT echoes were recorded from a flail aortic cusp. Premature mitral valve closure (PMVC) was seen in five out of seven patients (70%) with a short (less than or equal to four month) history of severe aortic regurgitation. Subannular aneurysms were detected in three out of five patients (60%) with this complication. Increased septal and left ventricular posterior wall motion suggestive of severe aortic regurgitation was seen in each case. The detection of a flail aortic valve leaflet, PMVC and subannular aneurysms indicates the need for surgery. The demonstration of vegetations defines a further subgroup of patients who should be managed in a centre with facilities for cardiac surgery. Echocardiography obviated the need for pre-operative cardiac catheterization in nine out of 10 patients (90%). PMID- 6852066 TI - Correlation between echocardiography and cardiac catheterization in assessing the severity of aortic stenosis. AB - The severity of aortic stenosis was assessed by echocardiography in 81 consecutive adult patients, 40 of whom underwent cardiac catheterization. The patients' mean age was 54 +/- 16.4 years. A good correlation was found between the severity of aortic stenosis assessed by cross-sectional echocardiography and cardiac catheterization. Aortic valve separation of 7 mm or less occurred only in severe aortic stenosis whereas a separation of 12 mm ruled out any significant aortic stenosis. A separation of 8-11 mm constituted a 'grey' area between mild and severe aortic stenosis. Cross-sectional echocardiography provides a reliable method for crude evaluation of aortic stenosis. PMID- 6852065 TI - Acute hemodynamic effects of nifedipine at rest and during stress in severe aortic incompetence. AB - To determine whether afterload reduction with nifedipine is effective both at rest and during stress tests (rapid atrial pacing and contrast material overload), 14 patients with chronic severe isolated aortic insufficiency (10 asymptomatic) underwent right and left cardiac catheterization. Forty-five minutes after 20 mg of nifedipine (sublingually), left ventricular end-diastolic pressure, peak aortic pressure, systemic vascular resistance and double product decreased significantly at rest, at peak paced rate, and after angiography (P values from less than 0.05 to less than 0.001). Cardiac index increased at resting heart rate (P less than 0.01) but was unchanged during pacing. The reduction of systemic vascular resistances was inversely correlated with its initial value (r = -0.69). After nifedipine, average regurgitant fraction did not change; however its variations were significantly correlated with those of systemic vascular resistance (r = 0.69). It is concluded that in severe aortic insufficiency, nifedipine induces an effective reduction of left ventricular pre- and afterload, accompanied by an enhanced mechanical efficiency (unchanged or increased cardiac index with lower double product), both at rest and during stress tests. PMID- 6852068 TI - Contrast echocardiographic shunts may persist after atrial septal defect repair. AB - We performed contrast echocardiography on 19 subjects who were asymptomatic in the postoperative period after surgical repair of atrial septal defects. Eighteen of these subjects had adequate right heart echocardiographic contrast to assess the presence or absence of right-to-left shunting. Multiple M-mode and two dimensional echocardiographic views were studied during several contrast injections with and without the Valsalva manoeuvre. Six patients had postoperative shunts and 12 patients had no postoperative shunts. The age of the six patients with postoperative shunts was 26 +/- 10 years (mean +/- s.d.) and that of the 12 patients without postoperative shunts was 39 +/- 14 years. Four out of six of the postoperative shunt group were males and of these three had patch repairs compared with two males out of 12 with patch repair in the no shunt group. There were no definite differences between the two groups in the following variables: type of atrial septal defect (primum v. secundum), preoperative shunt size, pre-operative peak right ventricular pressure, pre-operative New York Heart Association functional class, pre- or postoperative right ventricular or left ventricular dimensions, aortic and left atrial dimensions. Four of the six patients with postoperative contrast echo shunting underwent cardiac catheterization, showing no significant step-up in oxygen saturation in three, and a significant shunt in one patient who had patch dehiscence at re-operation. We conclude that right-to-left shunts as demonstrated by contrast echocardiography are common in the late postoperative period after atrial septal defect repair. They need not indicate unsuccessful repair or a haemodynamically important residual shunt. PMID- 6852070 TI - Multilevel disease of the conduction system. AB - We found that the incidence and distribution of conduction system disease simultaneously affecting several levels of the system had been incompletely described. We therefore analysed all patients in whom conduction disease had been diagnosed and a complete electrophysiological study of the conduction system had been made, during a defined period. Patients were classified as to the presence or absence of sinus node disease, and proximal and distal atrioventricular disease. Since our hospital serves a defined population and a large proportion of all patients with conduction disease seen during the period was included, the series probably is representative of conduction disease in general. Twenty-four of the 59 patients had defects at more than one of the three levels (41%). Fifty five per cent of the patients with sinus node disease had some kind of atrioventricular disease, while 42% of the latter had evidence of sinus node failure. The patients with multilevel disease were characterized by more severe symptoms, higher age and a higher incidence of generalized heart disease than those with single-level disease. The observations fit the concept that conduction system disease in most patients is part of a diffuse disease process progressively involving various parts of the system. PMID- 6852071 TI - Repetitive responses to ventricular extrastimuli: incidence and significance in patients without organic heart disease. AB - Of 110 patients without organic heart disease undergoing electrophysiological evaluation, 72 patients (65%) manifested some form of repetitive ventricular response to ventricular stimulation. In 58 (53%) bundle branch re-entry was induced and in 19 patients (17%) intraventricular re-entry. In five patients (4%) both types of repetitive responses were initiated. The indication for study was documented as ventricular tachycardia or fibrillation in 13% of the patients, supraventricular tachycardia in 51% and Wolff-Parkinson-White syndrome, syncope or conduction disturbances in the remaining patients. The incidence of clinical and inducible ventricular tachycardia or fibrillation was 8 and 2% respectively, in the group of patients manifesting only bundle branch re-entry, 37 and 32% in patients with intraventricular re-entry and 8 and 11% in patients without repetitive ventricular responses during ventricular stimulation. The predictive value of intraventricular re-entry as an indicator of severe ventricular arrhythmias was 36%. We conclude that in our population of patients without organic heart disease, bundle branch re-entry is a frequent finding and is not related to ventricular arrhythmias, that intraventricular re-entry is less frequent and although it is associated with a higher incidence of ventricular tachycardia or fibrillation, it is a poor predictor of these arrhythmias in this study population. PMID- 6852072 TI - Electrocardiographic features at onset of ventricular fibrillation in acute myocardial infarction. Relation to intraventricular conduction defects, configuration of initiating QRS complex, preceding heart rate and initiating coupling interval. AB - In prospectively collected consecutive patient data from two coronary care units (CCU), 32 patients with acute myocardial infarction (AMI) developed primary or complicating ventricular fibrillation (VF). A 12-lead ECG on the day of admission was available in 30 patients, and was compared to similar ECGs from a control group of 90 consecutive AMI patients without VF. Left anterior hemiblock (LAH) occurred in 33% of the VF patients and in 11% of the controls; the difference is statistically significant. In 20 of the 32 patients the VF occurred during continuous ECG registration. The QRS complex initiating the VF was as frequently of left as it was of right bundle branch block configuration. When compared with a second control group of 77 consecutive AMI patients under continuous ECG recording who did not develop VF, the heart rate in the VF patients was significantly higher just prior to the development of this arrhythmia. The VF initiating coupling interval was shorter than the upper normal limit of the QT interval in 40% of the VFs. In primary VF and in patients not treated with antiarrhythmic drugs the coupling intervals were close to the upper normal limit of the QT interval. In complicating VF and particularly when antiarrhythmic therapy was used the coupling intervals showed a wider variation. PMID- 6852073 TI - A comparison of the antiarrhythmic effects on AV junctional re-entrant tachycardia of oral and intravenous flecainide acetate. AB - Both the electrophysiological and antiarrhythmic effects of some antiarrhythmic agents may differ markedly depending on their route of administration. Flecainide acetate, a new class 1 agent, was therefore administered both intravenously and orally to 13 patients with recurrent paroxysmal tachycardia to assess whether the acute response to intravenous flecainide accurately predicts the response to oral therapy. Eight patients had atrioventricular re-entrant tachycardia (AVRT) and five patients intra AV nodal re-entrant tachycardia (AVNRT). When administered by either route, flecainide markedly prolonged both the anterograde and retrograde conduction intervals during constant rate pacing and the anterograde and retrograde Wenckebach cycle lengths during incremental pacing. Five of the 13 patients developed complete retrograde block after both routes of administration of the drug. All 13 patients received intravenous flecainide during tachycardia with successful reversion to sinus rhythm in all cases. Tachycardia could be reinitiated in five of the patients with AVRT after intravenous flecainide and in one further patient after oral administration. It was not possible to reinitiate tachycardia in any of the five patients with AVNRT after either intravenous or oral flecainide. The size of the tachycardia initiation windows, by either atrial or ventricular premature stimuli, were significantly reduced by both intravenous and oral flecainide. In those patients in whom tachycardia could be reinitiated, tachycardia cycle length was significantly increased, and to a similar degree, by both routes of administration of the drug. This increase in cycle length was predominantly due to prolongation in retrograde conduction. It is concluded that flecainide acetate is a potent antiarrhythmic agent for use in patients with junctional tachycardia. The intravenous administration of flecainide reliably predicts the subsequent response to oral therapy. PMID- 6852075 TI - Revascularized periosteum transplantations. AB - A controlled experiment was performed in 56 African pygmy goats, analyzing the bone-forming capacity of two different revascularized periosteum grafts in midshaft tibial defects. At radiological examination revascularized tibial periosteum grafts firmly bridged the defect within 8 weeks, revascularized costal periosteum grafts did not. PMID- 6852074 TI - Functional anatomic reconstruction of the cardia. AB - Experiments on bastard dogs have shown that cardia reconstruction using an omega sling is effective. This sling is a pedicled, extramucosally excised, longitudinal muscle flap from the ventral aspect of the greater gastric curvature, which is prestretched at least 100%, wrapped around the cardia twice and sutured to the posterior gastric wall. A physiological pressure gradient is created with the help of intraoperative manometry. Perfusion manometry, radiology, histology and microangiographs demonstrate the competence of the omega sling. PMID- 6852076 TI - Decreased acute thrombogenicity of human umbilical veins after heparin and alcohol treatment. AB - Nine glutaraldehyde-tanned human umbilical veins (GAUV) were incubated in heparin followed by storage in ethyl alcohol 50% (HAUV). These grafts were compared to five GAUV flushed with a heparinized solution without subsequent treatment in alcohol (HsAUV) and four nonheparinized GAUV (NHUV) placed in the contralateral carotid arteries of dogs for approximately 3 h. The thrombogenicity was evaluated by measuring the platelet adhesion and aggregation (51Cr), fibrinogen accumulation (125I-fibrinogen), the thrombus-free surface and the thrombus weight. The HAUV had the lowest 51Cr radioactivity. The means of thrombus-free surface and thrombus weight for the grafts were as follows: HAUV, 82% and 0.3 g (n = 9); HsAUV, 53% and 0.6 g (n = 5); NHUV, 13% and 1.2 g (n = 4). The HAUV showed a lower thrombogenicity than both the NHUV and the HsAUV grafts. PMID- 6852077 TI - Choice of suture materials for wound closure. PMID- 6852078 TI - The spleen and wound healing. AB - The effect of splenectomy on wound healing has been studied in standard laparotomy wounds in rats. Significant differences in wound histology, fibroblastic labelling indices, bursting pressure, and IgM levels were found between chronically asplenic rats and controls. Autotransplantation of the spleen conferred some increase to wound strength. Acute asplenic rats have not demonstrated the same changes. It is concluded that the spleen influences wound healing probably through a fibroblastic stimulating mechanism. PMID- 6852079 TI - Increased susceptibility to pneumococci after ligation of the splenic artery in experimental hypersplenism. AB - 22 male Sprague-Dawley rats were divided into two groups, of which group I received methylcellulose and group II saline intraperitoneally for 12 weeks. After ligation of the splenic artery of the animals in group I and sham operation of the rats in group II, the injections were continued for a further 9 weeks. At the operation, the group I animals all showed signs of hypersplenism with anemia, and leuko- and thrombocytopenia. The platelet counts normalized after the operation, a marked leukocytosis developed and the anemia was further aggravated. At the end of the study, the animals were challenged with 4 x 10(6) colony forming units of pneumococci type 1, resulting in deaths of 11 of 12 animals in group I, in contrast to survival of all 10 rats in group II (p = 0.000017). PMID- 6852081 TI - Renal blood flow alterations after temporary ischemia. An experimental model in the rabbit. AB - In an effort to investigate the efficiency of various pharmacological agents in protecting the kidney against normothermic ischemia, an animal model was developed and the post-ischemic hemodynamics in the renal cortex of rabbit kidneys were studied. Renal cortical blood flow was evaluated 5-30 min after 60 min of normothermic ischemia of the left kidney using 141Ce-, 51Cr-, and 85Sr labelled microspheres. Control groups were subjected to sham operation. The right kidneys served as individual controls. Ischemic kidneys showed a significant weight increase independent of reperfusion. Furthermore, a transient highly significant increase of cortical blood flow was found with an absolute maximum about 10 min after termination of ischemia. This increase in cortical blood flow was paralleled by a highly significant decrease of vascular resistance. PMID- 6852080 TI - Chronic stimulation of the sacral roots in dogs. AB - To investigate the feasibility of chronic stimulation of the sacral nerves for control of sphincter and bladder function, we implanted bipolar electrodes in 10 dogs. These electrodes, of conventional cuff (4 dogs), as well as innovative spiral designs (6 dogs) were placed around the S2 roots of the 10 dogs and in 3 of them around the S1 root additionally. The electrodes were connected to subcutaneous radiofrequency receivers for external activation. Microsurgical techniques were employed to perform dorsal rhizotomy and ganglionectomy. 5 dogs, 3 kept as long as 8 months, were chronically stimulated to a cumulated time of 100-150 h each. Functional and histological results reveal that sacral root nerves can be stimulated safely on a chronic basis for effective control of the lower urinary tract. PMID- 6852082 TI - Solitary Aspergillus mycetoma of the kidney. AB - A case of Aspergillus mycetoma of the kidney in a patient with lymphoblastoma receiving intensive cytostatic and steroid drugs is reported. Only four cases of Aspergillus infection of the kidney have so far been reported. Aspergillus infection of the kidney without disseminated fungal disease is a very rare clinical entity. In an extensive review of the world literature we have found only four cases previously reported [1-3], three in insulin-dependent diabetic patients and one in a patient with a ureteropelvic junction obstruction. Herein we describe the first case of a right kidney mycetoma in a patient with lymphoblastoma and treated intensively with cytostatic drugs and steroids. PMID- 6852084 TI - Bladder flap for reconstruction of congenital absence of the vagina. AB - An original method for vaginal reconstruction, using a pedunculated bladder wall flap is described. The method can be applied for vaginal reconstruction in cases of congenital absence or hypoplasia, as well as in cases of male transsexualism. 4 patients have been operated by this method without complications. In 2 patients, with 11 and 8 months follow-up, the results are satisfactory. The authors clearly describe the technical method of operation. PMID- 6852085 TI - Renal dysplasia and duplex kidneys. AB - 34 children with double ureters (n = 26), bifid ureters (n = 7) or bifid renal pelvis (n = 1) had heminephrectomy, leaving a normal portion of kidney. Patients with ectopic ureteroceles and ectopic ureters had upper pole lesions (18 of 18) whilst the lower pole was more often involved in those with vesico-ureteric reflux (9 of 11). Histological changes of renal dysplasia were present in both upper and lower pole lesions, being generally less severe at the lower pole. These findings suggest that prolonged urinary obstruction plays a major role in the formation of dysplasia in developing kidneys. PMID- 6852086 TI - Embryonal rhabdomyosarcoma of the urogenital tract in childhood. AB - 18 children, 12 boys and 6 girls, were treated in our hospital for rhabdomyosarcoma of the urogenital tract between 1970 and 1980. This period saw a gradual change in the therapeutic approach to this disease as new therapeutic modalities became available. 7 of the patients (39%) died of the disease which, in 5 of them, arose from the prostate. The surviving children have no evidence of recurrent disease, although 1 is still undergoing chemotherapy. Surgical intervention was always required. To date, chemotherapy alone, or in combination with radiation, has not sufficed in our management of rhabdomyosarcoma of the urogenital tract. PMID- 6852087 TI - Urological aspects of Wolfram's syndrome. AB - Two new cases of Wolfram's syndrome associated with progressive urinary tract dilatation are reported. The possibility of anatomic outlet obstruction or neurogenic bladder was eliminated radiologically and urodynamically. Dilatation of the urinary tract was considered to be a consequence of high diuresis associated with diabetes insipidus. A very important improvement in bilateral urinary tract distension was achieved with bladder drainage while dDAVP therapy dramatically decreased the daily urinary output. A review of diabetes insipidus and its urological implications is presented. PMID- 6852083 TI - Percutaneous pyelolysis. AB - Pelvi-ureteric junction obstruction has been treated in 3 patients using a percutaneous modification of the Davis intubated ureterostomy technique. A 10 French tube is introduced into the obstructed upper ureter through a percutaneous nephrostomy puncture. Full thickness incision of the upper ureter and pelvi ureteric junction is then carried out using a standard endoscopic urethrotome. The splint tube and diverting proximal nephrostomy remain in situ for 1 month. Good drainage was established in 2 cases following de-tubing. Further cases are under study. PMID- 6852089 TI - Spastic striated external sphincter syndrome imitating recurrent urinary tract infection in females. Effect of long-term alpha-adrenergic blockade with phenoxybenzamine. AB - 6 women with spastic striated external sphincter syndrome were studied urodynamically and subsequently treated with an alpha-adrenoceptor-blocking agent. Symptoms were abolished, and prolonged, fluctuating flow curves were nearly normalized by phenoxybenzamine, 15 mg daily, in 5 of 6 patients despite the unchanged spasticity of the external striated urethral sphincter. PMID- 6852088 TI - Total cystectomy and ureterosygmoidostomy for carcinoma of the bladder. AB - The results obtained in a series of 233 subjects who underwent surgery for total cystectomy and ureterosygmoidostomy for carcinoma of the bladder are analyzed. The immediate and long-term results, the complications and length of survival, both in general and in relation to the stage of the neoplasia, have been considered. The surgical death rate was 7%. Survival, taking all cases into account, was 80% after 1 year, 55% after 3 years, 36% after 5 years and 8.3% after 10 years. Significant differences in survival were found among those patients with pathologic stage PIS-P1-P2 and those with P3-P4. From a survival of 64% after 5 years in the first group, we pass to 23% for P3 and 0% for P4. The precocious complications are anastomosis stenosis (1.8%), uro-fecal fistulae (1.8%) and urinary fistulae (1.4%). Late complications are anastomosis stenosis (13.6%), pyelonephritis with episodes of fever (19.3%), severe acidosis (1.8%) and kidney stones (1.8%). PMID- 6852090 TI - 12-year experience using the dormia basket for the extraction of ureteric stones. AB - 201 patients underwent attempted extraction of a ureteric stone using the Dormia basket. This was successful in 52% of the cases. Failure was due to the inability to pass the catheter (13%) or failure to catch the stone (30%). Operative complications were seen in a further seven cases (3%) and the overall complication rate was 11% (23 cases). An experienced operator had a slightly improved chance of extracting a stone successfully when compared with a trainee, but this was not significant. In approximately half the cases in which the stone was not extracted, it passed spontaneously. The remainder required a further procedure to remove the stone. PMID- 6852091 TI - Investigation of ABH antigenicity of random mucosal biopsies and transitional cell carcinoma of the urinary bladder. AB - Blood group isoantigens can be demonstrated immunohistologically on normal bladder urothelium by means of the specific red cell adherence test. In preneoplastic and reactive changes of the urothelium as well as in carcinoma in situ, a loss of these antigens occurs. Blood group isoantigen content decreases with higher anaplasia of transitional cell carcinoma. Overt tumors without blood group isoantigens are associated with carcinoma in situ and severe dysplasia at a high percentage. These tumors are associated significantly more often with antigen-negative light-microscopically normal-appearing urothelium than antigen positive ones do. PMID- 6852094 TI - Partial purification of [3H]mianserin binding sites. AB - Frontal cortex membranes were solubilized with digitonin, prelabelled with 4 nM [3H]mianserin, and partially purified by isoelectric focussing. Bound [3H]mianserin separated from free [3H]mianserin as a single radioactive peak with a pI value of 5.03. A 14-fold purification was achieved. Focussing in the presence of 1 microM ketanserin (R 41468) or 1 microM chlorpyramine (a histamine H1-antagonist) or 10 microM spiperone (an S2-antagonist) completely abolished the peak of radioactivity at pH 5. Pharmacological characterization of the eluted radioactive peak revealed both histaminergic and serotonergic binding properties. The data suggest that the serotonergic and histaminergic components of [3H]mianserin binding to frontal cortex are not separable by solubilization, gel filtration or isoelectric focussing. PMID- 6852092 TI - IgG subclass distributions in anti-hapten and anti-polysaccharide antibodies induced by haptenated polysaccharides. AB - Mice were immunized with hapten [NIP, (4-hydroxy-5-iodo-3-nitrophenyl)acetyl or TNP (2,4,6-trinitrophenyl)] conjugates of Ficoll or pneumococcal polysaccharide type 14 (S14), and they were bled on days 10 or 14. Anti-hapten and anti polysaccharide antibodies were determined from the sera or from fractions (IgM + IgA). IgG1, IgG2a, IgG3 or IgG2b separated by a gradual acid elution from protein A. Approximately one-half of both anti-hapten and anti-polysaccharide antibodies was found in the IgM + IgA fraction. The subclass distribution of the IgG antibodies was dependent on the antigenic determinants. Polysaccharide antibodies were mostly in the IgG3 fraction (36-62%) and in the IgG1 fraction (18-36%). Hapten IgG antibodies were mostly in the IgG1 fraction (38-74%): each of the other three subclasses contributed the average of 13%. These results provide the first evidence that antibodies to different determinants of one antigen have grossly different isotype distributions. PMID- 6852093 TI - Spontaneous increase of DNA turnover in murine systemic lupus erythematosus. AB - DNA synthesis and release was studied in unstimulated splenocytes of strains of mice known to develop spontaneous systemic lupus erythematosus (SLE)-like disease and in non-SLE age- and sex-matched strains as well. Newly synthesized DNA was measured as total acid-insoluble radioactive material present in cell pellet plus supernatant of unstimulated 0-72 h cell cultures [3H]thymidine-pulsed, whereas DNA release was measured as amount of acid-precipitable radioactivity found in supernatant of those cultures. In all strains known to develop spontaneous murine SLE the amount of newly synthesized DNA was 1.3-2.1-fold increased when compared to normal strains studied concomitantly. Furthermore, a significant increase in DNA release into medium, unrelated to cell viability, was observed in those strains as well. These observations clearly demonstrate different metabolic rates of synthesis and release of DNA in murine SLE. This difference suggests the existence of an underlying mechanism responsible for extracellular DNA abundancy, which may be important for the formation of circulating DNA-anti-DNA immune complexes. PMID- 6852096 TI - Role of the two N-terminal residues of angiotensin II in the production of tachyphylaxis. AB - The structural requirements for the production of angiotensin tachyphylaxis in the guinea-pig ileum were studied by analyzing the tachyphylactic properties of the following synthetic analogues of angiotensin II (AII): [1-sarcosine]AII, [1 betaine]AII; [1-guanidinoacetic]AII; betainyl-AII; [2-lysine]AII; [2 ornithine]AII. In the non-atropinized ileum, no tachyphylaxis was observed with any of the following analogues: [2-lysine]AII, [2-ornithine]AII, [2 ornithine]AII, [1-betaine]AII and betainyl-AII. [1-Guanidinoacetic]AII induced tachyphylaxis, but to a smaller degree than AII, while [1-sarcosine]AII was significantly more tachyphylactic than AII. Similar results were obtained in the atropinized ileum, except that moderate tachyphylaxis was also observed with betainyl-AII and [1-betaine]AII. The analogues with lysine or ornithine residues in position 2 did not induce tachyphylaxis under any of the conditions studied. It is concluded that, besides the protonated N-terminal amino group, the guanidino group of the Arg2 side-chain is essential for the manifestation of angiotensin tachyphylaxis in the guinea-pig ileum. PMID- 6852095 TI - Muscarinic activity of some secondary and tertiary amines and quaternary ammonium salts structurally related to oxotremorine. AB - A number of secondary and tertiary amines as well as quaternary ammonium compounds, obtained by structural modification of the amino group of oxotremorine (1) and its acetamide analogue (14), were investigated for muscarinic and antimuscarinic activity in vivo and in vitro. For the quaternary ammonium analogues, decrease of in vitro muscarinic potency is well correlated with increase of the size of the quaternary ammonium group, as estimated from increments in apparent molal volumes. A similar decrease of muscarinic potency with increasing substitution at the nitrogen atom is generally observed for the secondary and tertiary amines. For the latter the reduction in muscarinic activity appears to be due to loss of efficacy, since the higher homologues are partial agonists or antagonists. There is a highly significant correlation between muscarinic activity in vitro and central tremorogenic activity of the tertiary amines. PMID- 6852097 TI - Ventricular fibrillation in a conscious canine model--its prevention by UM-272. AB - The antifibrillatory properties of UM-272 (dimethylpropranolol; Pranolium) were evaluated in a conscious canine model of sudden coronary death. The initial preparation of the animal model was carried out under surgical anesthesia and involved the intraluminal implantation of a Teflon-coated silver wire into the circumflex coronary artery so that 3 mm of the bared electrode was in contact with the endothelial surface. The left anterior descending coronary artery then was occluded for a period of 90 min and reperfused in the presence of a critical stenosis. Three days after myocardial infarction, they were randomized into two groups. One group (n = 10) served as controls and received saline. The second group (n = 10) received UM-272 in a dose of 5 mg/kg every 6 h. On day 4, a 150 microA current was applied to the intimal surface of the left circumflex coronary artery, resulting in transient or permanent alterations in circumflex coronary blood flow accompanied by electrocardiographic evidence of regional myocardial ischemia. The time to onset of ST-segment changes in the saline control group was 99 +/- 34 min and was followed by the appearance of premature ventricular complexes (111 +/- 34 min) and subsequent ventricular tachycardia (131 +/- 37 min) which terminated in ventricular fibrillation in each of the 10 dogs. Animals treated with UM-272 likewise developed ST-segment changes (156 +/- 28 min) and premature ventricular complexes (168 +/- 29 min), but 4 of 10 animals failed to develop ventricular fibrillation (P less than 0.05 vs. saline). These results demonstrate that UM-272, the dimethyl quaternary analog of propranolol, is effective in reducing the incidence of ventricular fibrillation in a conscious canine model in which the superimposition of a transient ischemic event upon an already jeopardized heart leads to the development of sudden death. PMID- 6852099 TI - The effects of d-amphetamine on visual sensitivity in the rat. PMID- 6852098 TI - Antagonism between tilidine and naloxone on cerebral potentials and pain ratings in man. AB - The effects of the opioid tilidine and the opiate antagonist naloxone on somatosensory evoked potentials (SSEP) and pain ratings (E), elicited by electrical skin stimuli with randomized intensities, were investigated for different, orally administered tilidine and naloxone combinations in a double blind Latin square design in 15 healthy humans. A high correlation between SSEP amplitudes and E was found for all treatments investigated. Tilidine (100 mg) decreased both SSEP amplitudes and E by about 25% compared to the placebo. No significant differences were found between the analgesic effects of tilidine and TN8 (tilidine 100 mg; naloxone 8 mg). The effects of both treatments were significantly different from those of the naloxone, placebo and TN32 treatments (tilidine 100 mg; naloxone 32 mg), indicating a marked naloxone-induced reversal of tilidine analgesia. Naloxone (32 mg) increased the SSEP amplitudes. No naloxone-induced hyperalgesia was seen in the pain ratings. PMID- 6852101 TI - Cardiovascular and biochemical effects of L-DOPA in the sea-gull, Larus argentatus. AB - We have investigated the effects of L-DOPA alone and in combination with three different inhibitors of L-aromatic aminoacid decarboxylase (DC), carbidopa, benserazid and alpha-monofluoromethyldopa (MFMD) on blood pressure (BP) and catecholamine content in conscious or anaesthetized sea-gulls, Larus argentatus. The results show that L-DOPA, given i.p., is taken up and decarboxylated to dopamine (DA) in brain and heart. Carbidopa inhibits the peripheral synthesis of DA from exogenous L-DOPA while central decarboxylation is enhanced when compared to the effects of L-DOPA alone. Benserazid and MFMD inhibit both central and peripheral formation of DA after L-DOPA injections. L-DOPA given alone leads to a slight increase in BP, while heart rate (HR) decreases somewhat. After peripheral inhibition of DC using carbidopa, L-DOPA elicits a reduction in BP both in conscious and anaesthetized birds. HR is significantly reduced in anaesthetized birds. Pretreatment with benserazid or MFMD abolishes the cardiovascular effects of L-DOPA. It is concluded that L-DOPA lowers the BP via activation of central mechanisms. PMID- 6852102 TI - Histamine-induced inositol phospholipid breakdown mirrors H1-receptor density in brain. PMID- 6852100 TI - Reserpine-induced locomotor stimulation in mice chronically treated with typical and atypical antidepressants. AB - Previous studies have shown that chronic treatment with antidepressants (AD) leads to an increased responsiveness of NA systems to noradrenaline (NA) or its agonist. In the present paper the influence is described of a prolonged treatment with AD of different pharmacological profiles on the effect of reserpine in the first phase of its action (amine release). It has been found that in mice treated chronically (14 days, twice a day, i.p.) with imipramine, amitriptyline, maprotiline, (+)-oxaprotiline, zimelidine, citalopram, mianserin and iprindole, the injection of reserpine induces stimulation of the locomotor activity. Only ( )-oxaprotiline and fluvoxamine do not evoke this effect. AD given alone (both single and repeated doses), reserpine alone, AD in a single dose administered jointly with reserpine do not induce the locomotor stimulation. These results suggest that a prolonged treatment with AD increases the responsiveness of the dopamine (DA) mesolimbic system and/or the NA system. PMID- 6852103 TI - Demonstration of S2-receptor binding sites on cat blood platelets using [3H]ketanserin. AB - [3H]Ketanserin showed substantial binding to cat platelet membranes; 40% of this was specific binding, characterized by a plateau in serotonin antagonist inhibition curves, and another 40% was non-specific binding to structural recognition sites displaceable by unlabelled ketanserin. Specific [3H]ketanserin binding to platelets shows the features of serotonin S2-receptor binding sites previously identified in rat pre-frontal cortex and in striatum. In platelets, KD = 1.02 nM and Bmax = 86 fmol/10(9) platelets; the Ki values of 21 compounds were similar in the three different tissues. PMID- 6852105 TI - Cholinergic mechanisms in the nucleus tractus solitarii and cardiovascular regulation in the rat. AB - To determine the role played by cholinergic neurons in cardiovascular regulation by the nucleus tractus solitarii (NTS), microinjections (0.1 microliter) of acetylcholine (ACh) or carbachol (C) were made into the NTS of rats, and the changes in arterial pressure and heart rate were recorded. The dose-dependent hypotension and bradycardia which resulted were mediated by the activation of muscarinic, but not nicotinic, receptors confined to the NTS. Blockade of muscarinic receptors bilaterally in the NTS resulted in mild hypertension and attenuated, but did not abolish, the baroreceptor reflex. Eserine, injected into the NTS, augmented and prolonged the action of acetylcholine and slightly increased the maximal baroreceptor reflex response. Thus, cholinergic mechanisms in the NTS tend tonically to lower arterial pressure and may modulate the baroreceptor reflex, without being an integral part of the reflex arc. PMID- 6852106 TI - Stereoisomers of apomorphine differ in affinity and intrinsic activity at presynaptic dopamine receptors modulating [3H]dopamine and [3H]acetylcholine release in slices of cat caudate. AB - We investigated the effects of R(-)-apomorphine and S(+)-apomorphine on dopamine receptors modulating electrically evoked [3H]dopamine and [3H]acetylcholine release from slices of cat caudate nucleus. R(-)-Apomorphine inhibited the release of both [3H]dopamine and [3H]acetylcholine with an IC50 of 20 nM, while S(+)-apomorphine was without inhibitory action on the electrically evoked release of either neurotransmitter at concentrations up to 1 microM. At a concentration of 1 microM, however, S(+)-apomorphine antagonized the inhibition by R(-) apomorphine, producing a parallel five-fold shift to the right in the concentration-response curve to R(-)-apomorphine. These results indicate that S(+)-apomorphine is devoid of intrinsic activity to stimulate presynaptic dopamine receptors modulating the electrically evoked release of dopamine and acetylcholine. In addition, S(+)-apomorphine has an approximately ten-fold lower affinity for presynaptic dopamine receptors compared to R(-)-apomorphine. PMID- 6852107 TI - The metabolic role of endogenous catecholamines in acute myocardial infarction: effects of reserpinization and of infused noradrenaline. AB - A significant decrease of the noradrenaline content of the ischemic as well as non-ischemic parts of the myocardium was found in rats after ligation of the left coronary artery. The eventual role of released noradrenaline in the anaerobic metabolism of the heart was investigated. A highly significant decrease of ATP and glycogen was obtained in the ischemic myocardium 10 min after coronary ligation whereas glucose-6-phosphate (g-6-p) was significantly increased. Catecholamine depletion by reserpine pretreatment did not reduce the loss of ATP, although the hearts had broken down rather higher amounts of glycogen. Glycolytic energy production was obviously inhibited, as the accumulation of g-6-p was significantly greater than in non-reserpinized animals. However when a high breakdown of glycogen was induced by noradrenaline infusion into coronary ligated animals, the g-6-p levels were no higher than those in untreated coronary-ligated rats. The results suggest that the ischemic breakdown of glycogen is independent of endogenous noradrenaline. The metabolic conversion of g-6-p, however, may need sufficient catecholaminergic stimulation to become fully activated. PMID- 6852104 TI - Opposing effects of apomorphine on pain in rats. Evaluation of the dose-response curve. AB - The effect of apomorphine on a supraspinally mediated response to pain was studied after subcutaneous administration of 10 different doses (25 micrograms/kg up to 10 mg/kg). Depending on the dose given, apomorphine was found to induce opposing effects on pain, so that low doses, 25-100 micrograms/kg, dose dependently increased the sensitivity to pain. This effect then gradually declined in potency with increasing doses and high doses induced antinociception. The data therefore suggest that the net effect recorded involves the sum of responses from at least two functional systems. Using the Hill equation and the digital computer program NONLIN, we have dissociated the observed effect into two components, each having its particular dose-response characteristics: low doses having an ED50 value of 36 micrograms/kg produced hyperreactivity to pain, and high doses having an ED50 of 465 micrograms/kg (in the absence of hyperalgesia) induced antinociception. PMID- 6852108 TI - Re-appraisal of the role of histamine in carrageenan-induced paw oedema. AB - A single sub-plantar injection of 1% carrageenan in saline produced a bi-phasic paw volume increase, phase 1 plateauing at 0.5-1 h, phase 2 at 3-6 h. Subtraction of the non-specific contralateral paw response produced by saline injection revealed a monophasic carrageenan response. Mepyramine maleate at a dose maximally effective on histamine-induced paw oedema (1 mg X kg-1 i.p.) failed to suppress carrageenan-induced inflammation. Maximally effective doses of cimetidine HCl (1-100 mg X kg-1) suppressed the response by no more than 53%. In animals treated with cimetidine HCl (1 mg X kg-1), pretreatment with indomethacin (2.5 mg X kg-1) further suppressed the mean oedema response by 59% compared with cimetidine alone. The indomethacin dose suppressed mean volume increase by 41%. Mepyramine alone or combined with cimetidine showed no anti-inflammatory activity. Following pretreatment with indomethacin (2.5 mg X kg-1), mepyramine maleate further suppressed the carrageenan oedema by 41% compared with indomethacin alone. While supporting a role for prostanoid formation, or other indomethacin-sensitive mechanisms, the results show that the mechanism of carrageenan-induced rat paw oedema also involves histamine acting largely through H2-receptors, although a role for H1-receptors can not be excluded. The interaction between mepyramine and indomethacin is discussed. PMID- 6852109 TI - Regulation of brain ornithine decarboxylase activity in the neonatal rat. PMID- 6852111 TI - The effect of atropine, cimetidine and FPL 52694 on duodenal ulcers in mice. AB - Cysteamine-induced duodenal ulcers were compared in rats and mice. Mice were slightly less sensitive to cysteamine ulcerogenesis than rats, but the ulcers were similar in location, histopathology and responses to drugs. Cysteamine treated mice rather than rats are advocated for screening purposes since less test compound is required. Atropine, 3-30 mg/kg orally, reduced the incidence, number, size and severity of duodenal ulcers in both species. Cimetidine, 300-500 mg/kg orally, reduced the size and number of ulcers in rats but was less effective on the incidence and severity of ulcers. 300 mg/kg orally reduced only ulcer size significantly in mice. FPL 52694, 300 mg/kg orally, reduced the incidence, number, size and severity of cysteamine-induced duodenal ulcers in rats and mice. The anti-ulcer activities of atropine, FPL 52694 and cimetidine are discussed in relation to their gastric anti-secretory actions. PMID- 6852110 TI - Comparison of the effects of several calcium antagonistic drugs on the electrical activity of guinea pig Purkinje fibers. AB - The effects of several slow channel blockers were compared on the normal fast action potentials (APs) and the slow APs of guinea pig Purkinje fibers. In spontaneously-firing Purkinje fibers perfused with normal Tyrode solution, mesudipine (analog of nifedipine) at 10(-7) and 10(-6) M, had no significant effect on the fast AP parameters (at 5 X 10(-6) M, excitability was abolished due to depolarization to about -45 mV). Washout of the drug rapidly (within 3 min) repolarized the preparations and restored automatic activity. In order to determine the effect of the calcium antagonists on the slow APs, the fast Na+ channels were inactivated by partial depolarization (to about -45 mV) by perfusing with 20 mM K+-Tyrode solution and isoproterenol (10(-6) M), or histamine (10(-5) M) were used to induce slow APs upon stimulation. Verapamil (10(-6) M) and nifedipine (10(-7) M) completely blocked the slow APs. Mesudipine at 10(-8) and 4 X 10(-8) M depressed the Vmax, amplitude and duration of the slow APs and abolished excitability within 11 min at 10(-7) M. At 10(-7) M, mesudipine blocked the slow APs earlier (within 3 min) at higher stimulation frequency (from the usual drive rate of 0.5-1.5 Hz). Lowering the stimulation frequency to 0.1 Hz restored the slow APs; however, the mesudipine block was independent of the stimulating frequency after 20 min. The dose/response curve for the mesudipine effect was shifted to the right in high Ca2+ concentration (5.4 mM). Washout of mesudipine and nifedipine restored the slow APs within 15 min, whereas verapamil required about 1 h. The results indicate that mesudipine has potent Ca2+ slow channel blocking properties in Purkinje fibers. Mesudipine and nifedipine are about ten times more potent than verapamil. This effect is not mediated by beta adrenergic receptor antagonism, because the histamine-induced slow APs were also blocked. PMID- 6852112 TI - Reduction of myocardial infarction and dysrhythmic activity by nafazatrom in the conscious rat. AB - The effects of nafazatrom (30 and 100 mg/kg b.i.d.) on myocardial lesions caused by coronary artery ligation were determined in rats. The treatment lasted ten days preceding and twenty days following the cardiac insult, and its effects were compared with the effects of oral 1% Tylose suspension as drug vehicle. Nafazatrom reduced the number of extrasystoles and the duration of ventricular tachycardia and fibrillation occurring in the early (0-10 min) and late phases (2 4 h) of cardiac arrhythmias observed in the controls. Pretreatment with nafazatrom reduced the size of the ultimate infarct by 36 and 48 percent (P less than 0.05), and by 28 and 39% (P less than 0.05) with post-ligature nafazatrom treatment. PMID- 6852113 TI - GTP increases airway muscarinic antagonist binding sites: an effect regulated by Mg2+. AB - Using [3H]QNB, we demonstrated that GTP and Gpp(NH)p increased muscarinic receptor high affinity sites in bovine tracheal muscle preparations; however, neither the dissociation constant of [3H]QNB binding sites nor pulmonary beta adrenergic receptor sites was altered. The GTP effect on increasing the receptor sites was relatively small (16%), sensitive (ED50 0.48 microM) and specific (Gpp(NH)p greater than GTP = GDP greater than GMP much greater than ATP). Mg2+ potentiated this increase by up to 94.8%, whereas Na+, K+ and Ca2+ had no such effect. PMID- 6852114 TI - (-)-10,11-Methylenedioxy-N-propylnoraporphine, an orally effective dopamine agonist and duodenal antiulcerogen in the rat. PMID- 6852115 TI - In vivo identification of calcium antagonist binding sites using [3H]nitrendipine. PMID- 6852116 TI - Binding of [3H]nitrendipine to heart and brain membranes from normotensive and spontaneously hypertensive rats. PMID- 6852117 TI - Effects of room temperature on reproduction, body and organ weights, food and water intakes, and hematology in mice. AB - Two consecutive generations of mice were raised at graded room temperatures ranging from 12 to 32 degrees C at intervals of 2 degrees C. The delivery rate decreased at 30 and 32 degrees C, and the litter size and weaning rate decreased above 28 degrees C. No significant difference was demonstrated within the 12-26 degrees C range for any reproduction parameters observed. The body weights of the first-generation mice born at 22 degrees C and transferred to rooms at assigned temperature did not significantly differ within the 14-28 degrees C range after 8 and 16 weeks of exposure. The second-generation mice born and reared at various temperature levels did not show significant inter-group difference in weight within the 20-26 degrees C range at any age in the growth period. No significant inter-group difference was observed within the 20-26 degrees C range in respect of food and water intakes in the second-generation mice. Hematological values and organ weights in the first and second generation mice of both sexes did not significantly differ in any parameter within the 20-26 degrees C range. The results suggest the temperature range of 20-26 degrees C to be optimal for laboratory mouse rooms. PMID- 6852118 TI - An epizootic of pneumococcal infection occurred in inbred guinea pig colonies. AB - Epizootiological observations were made on an outbreak of pneumococcal infection occurred in 14 inbred guinea pig colonies during January to October, 1981. Monthly incidences of diseased animals ranged from 16.6 to 0%, showing the highest rate in the first month of the occurrence. Affection rates were remarkably different according to guinea pig strains, being 75% in JY-1 but 0% in JYG and Strain 2. Affected animals showed ruffled fur, dry-dirty noses, emaciated abdomen and dyspnea, and some of them were resulted in death. At necropsy, the fibrinopurulent pneumonia, pleuropneumonia and pleuritis were found as the major pathological features, and in addition, the fibrinopurulent pericarditis and peritonitis with a large amount of exudate were also observed in some cases. Streptococcus pneumoniae was isolated from nearly all the affected organs, and also from the external nares and trachea. Isolation rate from the external nares was especially high, thus 97.1% of infected guinea pigs including healthy carriers were detected by cultivation of nasal swab samples. Carrier rates of healthy animals were gradually increased from 17.2% in April to 36.5% in October, but the organism was not detected from JYG strain at all. During the observation period, vaccination, advance of weaning age of animals and administration of high vitamin C dose were taken as preventive measures of the epizootic, but no remarkable effect was obtained. The same diseased conditions were successfully produced in Hartley guinea pigs by experimental nasal infection of a pneumococcal strain isolated from this epizootic. PMID- 6852120 TI - [Length and weight of gastrointestinal tracts of pikas, suncus, millardias, mice and rats]. AB - The length and weight of gastrointestinal tracts including contents of ten week old male pikas (Ochotona rufescens rufescens) and suncus (Suncus murinus) were measured and they were investigated and compared with those of millardias, ICR mice and Wistar-rats. The length from the duodenum to the anus of pikas was much longer and the weight from the stomach to the anus was about 16g per 100g of body weight. The weight of cecum was about 7g per body weight and they were heavier than those of other species. The length from the duodenum to the anus of the suncus was short but the weight of the small intestine plus colon and rectum per body weight did not differ from that of other species. The suncus has no cecum but the weight from the stomach to the anus was almost the same as that of rats. PMID- 6852121 TI - Clonal myoblasts and myotubes show differences in lectin-binding patterns. AB - To determine changes in distribution or mobility of cell-surface glycoconjugates during myogenesis the binding of fluorescein-conjugated plant lectins to myoblasts and myotubes of the L6 rat skeletal muscle cell line has been studied. Binding has been carried out at 4 degrees C on either live or glutaraldehyde fixed cells. Fluorescein conjugates of soybean agglutinin (Fl-SBA), wheat germ agglutinin (Fl-WGA), concanavalin A (Fl-conA) and Lens culinaris agglutinin (Fl LCA) produced predominantly uniform fluorescence on both live and fixed myoblasts. On fixed myotubes, Fl-LCA, Fl-conA and Fl-SBA again produced predominantly uniform fluorescence, whereas Fl-WGA showed a pattern of diffuse, irregular spots in addition to uniform fluorescence. Fl-conA, Fl-LCA and Fl-WGA binding to live myotubes resulted in patterns quite similar to those on fixed myotubes; the only differences being the presence of weak patterns of diffuse spots with Fl-LCA and Fl-conA and an enhanced pattern of diffuse spots with Fl WGA. Fl-SBA, however, showed a unique pattern on live myotubes which consisted of discrete, round spots and minimal uniform fluorescence. With shorter labeling times, Fl-SBA produced relatively more prominent uniform fluorescence on live myotubes. It appears, therefore, that the native distribution of SBA, conA and LCA-binding sites is similar and predominantly random on L6 myoblasts and myotubes, whereas some WGA-binding sites may be aggregated on myotubes. The results also suggest that SBA-binding sites readily cluster at 4 degrees C on myotubes but not myoblasts, whereas the other lectin sites undergo little or no redistribution on either cell type. Thus the mobility of SBA-binding sites may increase with differentiation. PMID- 6852119 TI - Plasma lipid concentrations and enzyme activities in Nagase analbuminemia rats (NAR). AB - Plasma lipid concentrations in NAR (Nagase Analbuminemia Rats) of 4 to 52 weeks old were examined. Plasma enzymes of NAR were also measured in relation to liver function. The concentrations of total lipid, total cholesterol, phospholipid and triglyceride tended to be increased in NAR, while that of non-esterified fatty acid (NEFA) was decreased. The lipid levels (except NEFA) were especially high in female adult NAR, and they were increased with aging. The effect of 17 beta estradiol or testosterone administration on serum lipid concentrations was studied in gonadectomized NAR. Administration of 17 beta-estradiol to gonadectomized NAR increased lipid concentrations, while testosterone administration did not affect lipid levels. The effect of albumin injection on lipid concentrations in female NAR was also investigated. Albumin treatment to female NAR lowered serum lipid concentrations. Plasma glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, lactate dehydrogenase and leucine aminopeptidase activities were higher in NAR than in normal rats. Plasma alkaline phosphatase and cholinesterase activities of NAR were similar to those of normal rats. PMID- 6852122 TI - Relationship between the extended, non-nucleosomal intranucleolar chromatin in situ and ribosomal RNA synthesis. AB - In the present study we have investigated the relationship between the structure of intranucleolar chromatin in situ and the synthesis of rRNA. Using thin sections selectively stained for DNA we observed that intranucleolar chromatin of cortisol-stimulated rat hepatocytes consisted of clumps and fibres, both showing a nucleosomal configuration, and by loose agglomerates of extended DNA filaments, with a thickness of 2-3 nm, which never formed nucleosomal structures. After inhibition of rRNA synthesis by actinomycin D, the agglomerates of extended DNA filaments without nucleosomal configuration were noticed to be still present even at 3 h after drug treatment. In human resting lymphocytes, with a very low rate of rRNA synthesis, a large roundish, loose agglomerate of DNA filaments without nucleosomal configuration was found in the central zone of the nucleolar body. After a 16-fold increase in rRNA synthesis induced by a 48-h stimulation with phytohemagglutinin (PHA) the loose agglomerates appeared to be more numerous, but markedly reduced in size. We concluded that the extended non-nucleosomal configuration is a permanent feature of intranucleolar loose chromatin agglomerates and not a consequence of transcriptional activity. PMID- 6852124 TI - Kinetic analysis of entry into S phase in resting rat 3Y1 cells stimulated by serum. Effects of serum concentration and temperature. AB - The kinetics of entry into S phase after stimulation of resting 3Y1 cells by serum was examined in relation to serum concentration, temperature and the time at which the serum was withdrawn or at which the temperature was shifted. The kinetics of entry into S phase could be represented not only by a lag phase followed by a negative exponential curve (fit 1), but also by a normal distribution of the reciprocals of the time required for cells to enter S phase (velocities) (fit 2). As the temperature was lowered below 37 degrees C, the exponential slope decreased and the lag period increased (fit 1), and both the mean velocity and its standard deviation decreased (fit 2). As the serum concentration decreased below 10%, the exponential slope decreased without change in the lag period (fit 1), and the mean velocity decreased with increase in the standard deviation (fit 2). The cells which did not enter S phase within 8 h on removal of serum, stopped or delayed entry into S phase. In this case the lag phase was not changed (11 h). When serum was removed just before the end of the lag phase, no effect was seen on the kinetic curve. When the temperature was shifted at any time, including after the lag phase, the characteristics of the kinetic curve (lag phase, synchrony) changed. These facts indicate that there is a serum-non-requiring, but temperature-dependent period before S phase. Most of the asynchrony in entry into S phase under conditions of low serum seems to be generated during the serum-requiring period presumably by the random transition to the state in which cells are committed to enter S phase or by the variability of reaction rates at unpredictable times due to undeterministic effects. PMID- 6852127 TI - Inhibition of DNA synthesis in young cycling human diploid fibroblast-like cells upon fusion to enucleate cytoplasts from senescent cells. AB - Previous studies have demonstrated that upon fusion with actively cycling human diploid fibroblast-like (HDFL) cells, senescent HDFL are capable of inhibiting the young nucleus from entry into DNA synthesis (Norwood et al. (1974) [10]; Rabinovitch et al. (1980) [1]). These studies have been interpreted as evidence in favor of the existence of cell cycle inhibitors in senescent cells. Enucleate cytoplasts derived from senescent HDFL cells are also capable of inhibiting the young nucleus from entry into DNA synthesis upon fusion with whole cycling HDFL cells. In contrast, no inhibition was observed in fusions between enucleate young cells and whole cycling cells. These results provide evidence for transmissible cell cycle-inhibitory factors in the cytoplasm of senescent cells. PMID- 6852126 TI - Transcriptional activity in previtellogenic oocyte germinal vesicles from Xenopus laevis. AB - We have isolated germinal vesicles from previtellogenic Xenopus oocytes on a scale suitable for biochemical studies. The organelles were active in RNA synthesis, mainly mediated by endogenous RNA polymerase I. Nascent transcripts were 5-18S in size and complementary to DNA sequences present at intermediate reiteration frequency (several hundred copies per haploid genome). Hybridization to cloned 5S and 40S ribosomal genes demonstrated that the in vitro transcripts contained the latter, but not the former sequences in detectable amounts. The germinal vesicles also exhibited an ability to take up and retain UTP and a UTP binding activity, probably protein(s), was extractable from the organelles with 0.35 M NaCl. PMID- 6852125 TI - The nuclear-cytoplasmic relationship in 'mosaic' skeletal muscle fibers from mouse chimaeras. AB - In mouse chimaeras, individual skeletal muscle fibers typically contain populations of myonuclei derived from both cell lines. This 'mosaic' circumstance has provided an opportunity to investigate directly whether the mammalian myofiber syncytium is functionally subdivided into territories, each preferentially influenced by products encoded by the local myonucleus, or whether the multiple nuclei direct the synthesis of products that achieve a uniform distribution throughout the fiber. Chimaeras were produced in which one cell line was derived from an embryo homozygous for gpi-1a, whereas the other was homozygous for the gpi-1b; each allele specifies electrophoretically distinguishable isozymes of the cytosolic enzyme glucosephosphate isomerase (GPI 1). Microtechniques capable of measuring the proportion of each isozyme expressed within small samples of individual muscle fibers have been established, permitting the comparison of the relative quantitative distributions of the GPI-1 isozyme types along the length of individual chimaera fibers. From individual mosaic fibers, all samples yielded identical isozyme profiles, demonstrating that GPI-1 is not sequestered adjacent to the nucleus directing its synthesis; rather, it achieves a homogeneous distribution throughout the mosaic syncytium. The GPI-1 gene locus encodes only the GPI-1 monomer, whereas the functional enzyme detected in our analysis is a dimer that results from the aggregation of monomers in the cytoplasm. The quantitative distribution of dimer types within each mosaic fiber was consistent with random aggregation amongst all monomers represented in the final isozyme pattern, a result requiring that monomers or earlier precursors were mixed in the myofiber cytoplasm prior to assembly of the enzymatically active dimer. Thus, both the final distribution of enzyme dimers within fibers and the patterns of monomer aggregation suggest that there are no subdivisions related to the spatial separation of the genotypically distinct myonuclei within mosaic muscle fibers. PMID- 6852123 TI - Biochemical assay of inhibitors of metabolic cooperation. AB - A significant and reproducible enhancement of purine nucleotide synthesis from hypoxanthine occurs in HAT medium, when communication-competent hypoxanthine guanine phosphoribosyltransferase (HGPRT+) cells are co-cultured with communication-competent (HGPRT-) LN cells. This enhancement of purine nucleotide synthesis is dependent upon the hypoxanthine concentration and upon the ratio of (HGPRT-): (HGPRT+) cells. Based upon these results a simple biochemical method for the detection of inhibitors of metabolic cooperation between (HGPRT+) cells and (HGPRT-) LN cells is presented. The biochemical method distinguishes inhibitors of metabolic cooperation from inhibitors of hypoxanthine uptake, of hypoxanthine phosphorylation and of nucleic acid synthesis, as well as from general metabolic inhibitors. This method has the advantage that it can be used on a relatively large number of cells, it is simple and not time-consuming, and distinguishes the inhibition of metabolic cooperation by compounds that have a variety of sites of inhibition. PMID- 6852128 TI - The transcorneal permeability of sulfonamide carbonic anhydrase inhibitors and their effect on aqueous humor secretion. AB - Eleven sulfonamide carbonic anhydrase inhibitors of varied chemical and physical types were studied with respect to transcorneal permeability and reduction of intraocular flow and pressure. Using the isolated rabbit cornea, a constant drug concentration on the epithelial side and 6 ml solution in the endothelial chamber, first order rate constants (kin) ranged from 0 . 1-40 X 10(-3)/hr, roughly proportional to their lipid solubility. Drugs on the high side of this range were generally water insoluble and had pKa's too high to yield sodium salts at useful pH; therefore, the actual amount of drug delivered was small. We sought compounds which combined low pKa, good lipid solubility, and high activity against the enzyme. Trifluormethazolamide (TFM) has a pKa of 6 . 6, ether partition coefficient of 6, and a K1 of 2 X 10(-8)M. kin is 3 X 10(-3)/hr. TFM and five other compounds were also studied in vivo for their ability to penetrate the eye into the anterior and posterior chambers. These rate constants were roughly proportional to those measured in vitro; however, significant differences in accession to the two chambers were observed, as a function of varying physico chemical properties of the drugs. A 3% solution of TFM (100 mM) applied to the rabbit eye for 25 min generated 0 . 7 mM in the anterior chamber and 0 . 07 mM in the posterior. Tissue distribution of TFM (and its metabolite) showed a relatively high concentration in the ciliary body 6 hr after dose. Intraocular pressure was reduced by 4 mmHg. With 10 min exposure this concentration of TFM reduced pressure by about 1 . 7 mmHg. Although the use of this drug is limited by its chemical instability and the length of exposure needed, the principle of treating glaucoma by the topical use of carbonic anhydrase inhibitors appears feasible. PMID- 6852129 TI - The molecular weight of hyaluronate in the aqueous humour and vitreous body of rabbit and cattle eyes. AB - The molecular weight distribution of hyaluronate in the aqueous humour and vitreous body of rabbit and cattle has been determined by gel chromatography. The eluate from the column was monitored by a radioassay, whereby the molecular weight distribution of 15-20 microgram samples could be analysed. Control experiments were carried out with radioactively-labelled hyaluronate added to bovine material to estimate the degradation of the polymer during handling of the ocular fluids. It was shown that in vitro degradation does not appreciably affect the results. The analyses show a considerable polydispersity of the hyaluronate preparations. There is also a marked variation in the degree of polymerization between the two species. Hyaluronate from rabbit vitreous has a weight-average molecular weight (MW) of 2-3 X 10(6) while adult bovine vitreous displays a value of about 5-8 X 10(5). The hyaluronate of bovine vitreous varies with age. In newborn calf, a value of 3 X 10(6) was registered. This value dropped to about 5 X 10(5) in old cattle. The hyaluronate in the aqueous humour of rabbit showed a considerably higher molecular weight than that of the vitreous indicating that part of the hyaluronate in the anterior segment originates elsewhere than the vitreous. The differences between hyaluronate from the aqueous humour of adult cattle and that from the vitreous were more complex. As with the rabbit, a relatively large proportion of hyaluronate in the aqueous humour was of high molecular weight, but, in contrast, the aqueous humour also contained material which had a lower degree of polymerization than the hyaluronate in the vitreous. The proportion of high-molecular weight material in bovine aqueous humour seemed to be lower in the summer than in the winter. PMID- 6852130 TI - Turnover of hyaluronate in the aqueous humour and vitreous body of the rabbit. AB - Sodium hyaluronates with molecular weights of 18000, 500000 and 4 x 10(6), labelled with either 3H or 14C, were injected into the anterior chamber or into the centre of the vitreous body of rabbits and their rates of disappearance were followed. The out-flow from the anterior chamber in anaesthetized animals was virtually independent of the molecular weight indicating that the disappearance of the polysaccharide is controlled by bulk flow. The rate constant for the disappearance of sodium hyaluronate was 0.0094/min and after treatment with indomethacin 0.0061/min. These figures are in general agreement with published flow-rates of aqueous humour in the rabbit. The disappearance from the vitreous body was strongly molecular weight dependent indicating a diffusion controlled transport. The rate constant for hyaluronate with mean molecular weight of 18000 was 0.16/day and 500000, 0.024/day. The rate constant for endogenous hyaluronate was estimated to be about 0.01/day. A calculation using these rate constants shows that the turnover of sodium hyaluronate in the rabbit anterior chamber is about 3 micrograms per 24 hr while the turnover in the vitreous body is only 15% of that. This confirms an earlier conclusion (Laurent and Granath, 1983) that the preponderant part of the hyaluronate in aqueous humour is not a general degradation product from the vitreous body. PMID- 6852131 TI - Proteoglycans of rabbit cornea: labelling in organ culture and in vivo. AB - Rabbit corneas maintained with radioactively-labelled precursors in organ culture for up to 42 hr produced labelled proteoglycans of the same kind as those that exist normally or that are produced by labelling in vivo. Whole corneas, including a narrow strip of sclera, were kept in culture in the presence of [3H] glucosamine and [35S]-sulfate. The rate of incorporation of sulfate into extractable proteoglycans was linear over the time investigated, as was the rate of incorporation of glucosamine after a short lag. Three labelled proteoglycans were isolated and found to behave in ion-exchange chromatography and gel chromatography in the same way as they did in previous studies by chemical analysis. Their labelled glycosaminoglycans were primarily dermatan sulfate and keratan sulfate, with traces of hyaluronic acid and heparan sulfate. When labelled precursors were injected directly into the anterior chamber of rabbit eyes, the resulting labelled proteoglycans were similar to those obtained in organ culture. Both in vivo and during organ culture, the specific activity of hexosamine in the keratan sulfate proteoglycans was about one-half that in dermatan sulfate, probably because of different synthetic rates or different specific activities of immediate precursors. PMID- 6852132 TI - Active and passive rubidium influx in normal human lenses and in senile cataracts. AB - The aim of this study was to investigate the mechanisms responsible for the osmotic imbalance which occurs in a majority of human senile cataracts. Active and passive influx of rubidium has been determined in vitro in human lenses both normal and cataractous. It is concluded that the active transport of cations is on the average normal in senile cataractous lenses. It is possible that the activity of the cation pump is defective in a few cataractous lenses but no direct evidence of this can be given. The results indicate that cryo-extracted lenses may be utilized in this type of study provided that cryo-treatment during surgery is kept at the lowest possible level. PMID- 6852134 TI - Relative inhibitory effects of ATP depletion, ouabain and calcium on retinal photoreceptors. AB - The relative inhibitory effects of ATP depletion, ouabain and calcium on the receptor potential of the isolated rat retina were investigated. The principal experimental test used to assess these effects was the rate and extent of recovery of the receptor potential after re-establishing the transmembrane sodium gradient. Retinas were incubated in 25 mM-sodium for 10-20 min and then the external concentration of sodium was increased to 155 mM in control retinas, in retinas exposed to 10(-4) M-ouabain, and in retinas depleted of ATP (glucose-free medium plus 10 mM 2-deoxyglucose). Measurements showed that by 10-20 min ouabain completely inhibited the activity of the sodium-potassium ATPase and 2 deoxyglucose caused almost total loss of retinal ATP. In control retinas, the increase in sodium led to a rapid, full recovery of the receptor potential. When the sodium-potassium pump was blocked by ouabain, a return to the normal level of sodium led within seconds to a small (30%) recovery of the potential which decayed over 5 min. In ATP depleted retinas no recovery of the receptor potential was observed. However, if glucose was added at the time of changing to 155 mM sodium in depleted retinas then a substantial recovery of the receptor potential was observed, but the return of the potential was delayed relative to the instantaneous re-establishment of the sodium gradient. After ouabain caused the receptor potential to decay in the presence of 2 mM-calcium and 155 mM-sodium, the potential was restored within seconds upon a reduction of external calcium to 10(-7)M. At this low calcium concentration, but not at 2 mM-calcium, an inverted receptor potential was observed transiently when the membrane sodium gradient was reversed during ouabain treatment. No recovery of the receptor potential was seen if the concentrations of calcium and sodium were raised to their control levels after incubation of the retina in a low sodium, low calcium, ouabain-containing medium. These results show that the receptor potential is elicited by changing the sodium gradient when the sodium-potassium pump is blocked, but is not evoked when either retinal ATP content is low or the external level of calcium is increased. The similarity in the inhibitory effects of ATP depletion and calcium suggest that high energy phosphates play a role in maintaining a low intracellular concentration of calcium, possibly by influencing sodium-calcium exchange or calcium pumps. PMID- 6852133 TI - Rod photoreceptor disc shedding in eye cups: relationship to bicarbonate and amino acids. AB - We previously demonstrated that disc shedding in eye cups from Xenopus laevis depends on medium bicarbonate concentration, but also found that other unidentified medium components influenced the response. Here, in order to determine which medium components influence shedding, we used high bicarbonate salt solutions supplemented with medium components in amphibian tissue culture medium. Compared to the high bicarbonate salt solution alone, addition of fetal bovine serum or whole egg ultrafiltrate enhanced disc shedding. However, a response fully comparable to that in intact animals was obtained on addition of a mixture of 14 amino acids. The full light-evoked response depended on the simultaneous presence of high bicarbonate (35 mM) and amino acids. In the presence of amino acids, photoreceptor tips and RPE showed tight interdigitation and less tendency for in vitro separation, suggesting that these medium components promote such interdigitation. Using the defined medium we have additionally shown that shedding is related to HCO3- concentration under conditions of controlled medium pH, Cl- content and osmolality. PMID- 6852135 TI - Characteristics of bicarbonate, sodium, and chloride fluxes in the rabbit corneal endothelium. AB - Unidirectional fluxes of bicarbonate, sodium and chloride were measured across the isolated rabbit corneal endothelium. Bicarbonate and sodium fluxes were measured between 13 and 37 degrees C and were found to be temperature-sensitive. Ouabain (10(-6)M), which inhibits endothelial fluid transport, reduced the net bicarbonate flux by 32% but had no significant effect on sodium fluxes. Amiloride (10(-4)M) did not alter sodium transport, but slightly increased the unidirectional bicarbonate fluxes. Sodium fluxes were unchanged in chloride-free and potassium-free Ringer solutions, and net sodium transport was unaffected in the presence of carbonic anhydrase, acetazolamide, or low (5 mM) bicarbonate Ringer, but was reduced by 45% in bicarbonate-free Ringer. A net chloride flux was found in the same direction (stroma to aqueous) as bicarbonate and sodium. This chloride flux (2.18 muEq/cm2/hr) was of the same magnitude as bicarbonate but was sodium-independent. These findings suggest that: (1) like bicarbonate and fluid transport, sodium transport is bicarbonate-dependent, temperature sensitive, and chloride-independent; (2) sodium transport is not stoichiometrically coupled to bicarbonate; and (3) neither sodium nor bicarbonate transport are coupled to that of chloride. PMID- 6852136 TI - An animal model for cataract research: cataract formation in developing chick embryo by glucocorticoid. PMID- 6852137 TI - Biochemical investigation of cells from keratoconus and normal cornea. AB - Collagen is the major structural protein in the cornea. In keratoconus the central cornea is thin, opaque and weak. Collagen synthesis was investigated in cells derived from the stroma of cornea with keratoconus and from controls. No difference was found in the ratio of collagens type I and type III synthesized, which were investigated as procollagens and after conversion to collagen as well. The alpha 1/alpha 2 ratio in type I collagen was similar in keratoconus cells and controls. PMID- 6852138 TI - Phosphorylated metabolites and effects of amphotericin B and ouabain on phosphorylation state in amphibian cornea. AB - The phosphorylated metabolite content of endothelial denuded frog corneas and toad corneal epithelial cells was measured. The extract of frog corneas contained adenine, uridine and guanine nucleotides, in addition to various glycolytic intermediates, orthophosphate (Pi) and creatine phosphate. The relationship between the phosphorylation state: PS = [ATP]/[ADP] X [Pi] and the rate of active ion transport was studied in the toad cornea. This was considered by measuring the effects of 10(-5) M-amphotericin B and 10(-2) M-ouabain on the adenine nucleotide and Pi content of toad epithelial cells since these drugs selectively stimulate and inhibit active ion transport and metabolic rates, respectively. In order to calculate PS values, we derived and validated a relationship for converting content in terms of nmol/mg protein into concentration (mM). Incubation with amphotericin B in six different cell suspensions resulted in decreases of the ATP and ADP concentrations from 2.3 to 1.2 mM and 0.7 and 0.4 mM, respectively. The Pi concentration increased more than the ATP decrease from 6.2 to 12.2 mM. The average of these individual changes in each of the suspensions resulted in a significant decrease of the calculated PS from 599 +/- 226 to 342 +/- 127 M-1. However, ouabain increased the ATP concentration from 2.3 to 2.6 mM and decreased the ADP and Pi concentrations from 0.7 to 0.3 mM and 6.2 to 5.4 mM, respectively. The average of these individual changes in each of the suspensions resulted in a significant increase of the PS from 599 +/- 226 to 2975 +/- 1639 M-1. These results support the current notion that the PS is the feedback signal synchronizing metabolic rates with the energetic requirements of active Na and K transport. PMID- 6852139 TI - Radiation cataract formation diminished by vitamin E in rat lenses in vitro. AB - Eye lens cataract is a late effect of exposure to ionizing radiation. Depending on the dose and quality of radiation impinging on the lens, the development of a clinically discernible cataract usually takes several months in animal models, when the lens is irradiated in situ. However, we have developed a rapid in vitro assay with the isolated intact rat lens to study the effect of radiation and influence of antioxidants as protective agents. After only 24 hr of post irradiation incubation at 35.5 degrees C in complete medium 199 + 10% foetal calf serum, damage in the form of globular degeneration subcapsularly and 'holes' in the cortical fibre cells is detectable. Doses as low as 0.10 Gy seem to be capable of causing some damage, and vitamin E (2.4 microns) in the medium confers some protection to the irradiated lens. PMID- 6852140 TI - Water fractions in normal and senile cataractous eye lenses studied by NMR. AB - The state of water and water fractions in normal and senile cataractous eye lenses was studied by the NMR method. Combining NMR with vacuum dehydration provided additional information on multifractional samples. A new mathematical procedure is presented which separates the characteristic parameters of the different fractions and helps to determine the relaxation times and amounts of the fractions. The measurement accuracy enables separation of three different water fractions both in normal and in cataractous lenses. PMID- 6852141 TI - Age-related and distributional changes in the trypsin inhibitor activity of bovine lens. AB - Age-related changes in the bovine lens trypsin inhibitor activity were measured by assaying water soluble extracts of 10 concentric slices from the periphery to the center of the lens. Inhibitor assays were carried out at pH 7.0 and 7.9 using prenatal, calf and mature lenses. The inhibitor at pH 7.0 remained constant throughout the lens but the pH 7.9 activity decreased sharply in the lens nucleus. This was particularly true for the prenatal and calf lenses. Agarose A 15 m gel filtration of the water soluble inhibitor activity showed a decrease in inhibitor in the alpha-crystallin region and a corresponding increase in inhibitor activity in the HMW protein peak. Inhibitor assays were carried out on the water insoluble fractions following solubilization in 6.0 M-urea. Little or no inhibitor activity was seen in the outer cortical fractions but the inner cortex and nucleus contained high levels of inhibitor activity in the water insoluble fraction with specific activities 7- to 10-fold higher than the comparable crude lens extracts. These data suggest that the lens inhibitor activity at pH 7.0 and 7.9 aggregate into a HMW complex and with time preferentially enter the water insoluble fraction. The distribution of a purified 5.5 K inhibitor protein between the water soluble and the water insoluble fraction was measured. In the periphery all of this inhibitor was in the water soluble fraction, but toward the center of the lens this inhibitor began shifting to the water insoluble fraction. Slices taken from the lens nuclear region showed that all the inhibitor was in the water insoluble fraction as detected by both activity measurements and SDS-PAGE. PMID- 6852144 TI - Retinal degeneration in NIH (inbred) mice. PMID- 6852143 TI - Transparency and power of post-mortem human lenses: variation with age and sex. AB - Lenses of various ages were immersed in castor-oil and used to project gratings of known spatial frequency. Measurements were made of the highest frequency that could be resolved, and also of the optical power of each lens. Parameters included age, days post-mortem, and sex. The variation of the power differed appreciably as between infant and adult lenses, reflecting on the mechanical components of the lenses. Women's lenses were found to be more powerful than those of men. There was no decrease in transparency for up to seven weeks post mortem. There was no significant variation of transparency with age, but women's lenses were somewhat less transparent than those of men. PMID- 6852145 TI - The tolerance of human platelets to osmotic stress. AB - To determine the osmotic limits of human platelets, cells in plasma were exposed to either hypertonic or hypotonic conditions. Platelet rich plasma (PRP) was placed in dialysis tubes which were then immersed into non-isotonic solutions at room temperature. When the cells were exposed to concentrations of 150 mOsm or 790 mOsm and returned to isotonic condition, a substantial proportion of platelets lost their discoid shape and assumed spherical or dendritic form. The decrease in morphologic score was gradual towards either side of isotonicity. The loss in the number of platelets was independent of the osmolalities and averaged 12%. The drop in pH was small. Platelet aggregation induced by calcium ionophore (A23187) was not changed when the cells were exposed to 150 or 750 mOsm and returned to isotonicity, but aggregation induced by ADP or collagen was greatly reduced. The response of platelets to the hypotonic stress reversal assay was also impaired. These results suggest that the ability of human platelets to tolerate non-isotonic conditions is limited and that care should be exercised in the addition and removal of cryoprotective agents during the process of platelet freezing. PMID- 6852146 TI - Splenic accumulation of stromal progenitor cells in response to bacterial lipopolysaccharides. AB - An analysis was made of fibroblastoid colony-forming units (CFUF) in spleens of mice treated with bacterial lipopolysaccharide (LPS). Increased CFUF numbers were observed on days 2, 3 and 4 after treatment with 10, 30 and 100 micrograms of LPS. The splenic CFUF accumulation occurred at the same time as spleen hemopoiesis increased, however, the CFUF returned to normal and subnormal numbers on day 5, while the spleen cellularity was still elevated on day 21 after LPS treatment. The mechanism of splenic CFUF accumulation appeared to involve CFUF migration via the blood from other sites of hemopoiesis rather than increased CFUF plating efficiency in vitro or enhanced CFUF proliferation. The results suggest a relationship between the LPS-induced fibroblastoid progenitor cell increase and a requirement for splenic microenvironments to support LPS-induced hemopoiesis. PMID- 6852142 TI - Charge and molecular weight heterogeneity of EDTA-extractable proteins from calf lens membranes. AB - The EDTA-extractable proteins (EEP) of calf lens fiber cell membranes have been further characterized. Fiber EEP has been purified by gel filtration and resolved into eight bands with molecular weights of 30-38 K dalton by SDS-polyacrylamide gel electrophoresis. For epithelial EEP the same range has been obtained. In agreement with these findings a value of 33 K has been determined for fiber EEP by Sephadex G200 thin-layer gel filtration, while 34 K dalton was found by high performance gel permeation chromatography in combination with low-angle laser light scattering (HPGPC-LALLS). The isoelectric focusing patterns of fiber and epithelial EEP show considerable charge heterogeneity. By two-dimensional electrophoresis the relation molecular weight-isoelectric point has been established for most EEP components. Peptide maps of the individual protein bands of fiber EEP differ from each other and from those of the beta Bp-, beta B1a- and beta B1b-crystallin bands, which have about the same molecular weight. From our results we conclude that EEP is not an oligomeric nor a multisubunit protein, but a collection of different extrinsic membrane proteins, biochemically unrelated to lens crystallins. The fact that removal of the cytoskeleton by urea-treatment of the membranes is a prerequisite for its isolation by EDTA or EGTA suggests that EEP is bound to the inner surface of the plasma membranes, probably via calcium. PMID- 6852148 TI - Use of 5-BrdUrd/313 nm light technique for identification of cells in initial S phase within GM-CFCc compartment. AB - Long-term, low-level, BrdUrd infusion identifies two subpopulations of GM-CFCc with quite dissimilar sensitivities to 313 nm light. The responses of these two GM-CFCc subpopulations to hydroxyurea indicate that both are rapidly proliferating at the time of the assay. However, the absolute UV-light sensitivity of the S-phase components and the effects of increasing BrdUrd concentration indicate that the two GM-CFCc subpopulations passed through the previous cell cycle at widely disparate rates. Further, those GM-CFCc originating from a parental cell with a slow turnover are associated with a lower buoyant density than those GM-CFCc that have been in rapid cycle for at least two generations. These results indicate that the resistance to 313 nm-light irradiation, shown by S-phase cells in the first cell cycle of the BrdUrd labeling, may provide evidence of the proliferative history of the cell being assayed. PMID- 6852147 TI - Lithium stimulated in vitro megakaryocytopoiesis. AB - We have investigated the effects of lithium on the proliferative potential of murine megakaryocyte stem cells (CFUMeg) in vitro and on circulating platelet levels in vivo. At optimal levels of megakaryocyte-colony stimulating factor (Meg CSF) (10%) concentrations of 0.5, 1.0 and 3.0 meq/L augmented CFUMeg numbers. Significant increases of 133% and 125% over control levels were observed at 1.0 and 3.0 meq/L, respectively. At suboptimal concentrations of Meg-CSF (1.0%), Li effected a maximum increase of 200% over control levels at 1.0 meq/L suggesting a greater sensitivity of CFUMeg to stimulatory factors in the presence of Li. To better define the mode of action of Li, heterogenous bone marrow was separated into adherent and non-adherent cell populations and cultured in the presence of Li. Non-adherent cells cultured in the presence of 0.5, 1.0 and 3.0 meq/L Li showed significant increases in CFUMeg over non-adherent cells cultured without Li. These results suggest a direct effect of Li on CFUMeg. Cells cultured from the adherent cell population also responded to Li with enhanced CFUMeg numbers. This response may be a direct stem cell effect or an indirect effect via the production of endogenous Meg-CSF. One meq/L of Li when injected i.p., produced a thrombocytosis from days 4 through 15, with a maximum at 6 days post-Li treatment. These results suggest Li is an effective agent for stimulating megakaryocytopoiesis and has both direct and possibly indirect effects on the megakaryocyte stem cell. PMID- 6852149 TI - Effect of protein synthesis inhibitors on the trophic action of the nerve stump. AB - We report that protein synthesis inhibitors exert an inhibitory effect on the trophic action of the nerve stump. The sciatic nerve innervating the extensor digitorum longus muscles of mice was cut either as close to, or as far from, the muscle as possible. Denervation changes in the muscle were evaluated using the resting membrane potential and dose-response curves obtained by plotting acetylcholine-induced contractures. Actinomycin D (2 micrograms/kg, i.p.), ethidium bromide (10 micrograms/kg, i.p.), cycloheximide (1 or 5 mg/kg, i.p.), or chloramphenicol (100 mg/kg, p.o.) administration was immediately after neurotomy and continued daily until the day preceding muscle removal. Although denervation changes occurred significantly later in muscles with a long rather than a short nerve stump, the administrated antibiotics, excluding cycloheximide, accelerated the manifestation of denervation changes in muscles with long nerve stumps without affecting those in muscles with short nerve stumps. PMID- 6852152 TI - Extracellular calcium activity in the injured spinal cord. AB - The extracellular concentration of calcium ion was measured in canine spinal cord subsequent to spinal injury. In the control animal, we found that calcium activities changed little independent of electrode placement in the spinal cord, were stable during the 3 h necessary to make injury measurements, and were comparable to other estimates of calcium in the interstitial space. After injury, calcium activities decreased to micromolar levels that were incompatible with neural function. An incomplete recovery of extracellular calcium occurred during the next 3 h to about one-third (0.44 +/- 0.01 mM) of the normal value (1.1 +/- 0.08 mM). Such a pattern of changes in extracellular calcium was specific for the injury site itself and did not occur at nearby anatomic loci. These results are interpreted as having both short- and long-term effects on neuronal function and subsequent reorganization of spinal pathways. PMID- 6852150 TI - Effects of compression and ischemia on spinal cord evoked potentials. AB - Ascending and descending spinal cord potentials were recorded during conduction block produced by compression and ischemia to the spinal cord of cats. Dorsally and ventrally applied compression produced proportional changes in both ascending and descending potentials. Results for induced ischemia were much more variable. Although both systems were significantly affected by extreme ischemia, loss of descending activity was not always accompanied by a loss of ascending activity for lesser ischemic insults. This finding was attributed to the variability of the spinal cord vascular supply. It is concluded that monitoring of ascending evoked activity (e.g., somatosensory evoked potentials) would reflect changes in descending spinal cord conduction for compressive and higher magnitude ischemic spinal cord insult. It is also pointed out that lesser degrees of spinal cord ischemia can produce dysfunction in descending systems which may not be detected by monitoring of somatosensory evoked potentials. The significance of the observed relationship between ascending spinal cord and cortical evoked potentials is also discussed. PMID- 6852151 TI - "Convulsoid responses" suggesting development of autonomous epileptogenicity. AB - To test a convenient and reliable neuronal index that suggests the development of autonomous epileptogenicity, we conducted in acute experiments on rabbits a comparative study of the changes in direct cortical responses (DCRs) in primary and mirror sites during electrically induced primary (PRID) and projected seizure discharges (PROD). It has been assumed that the primary site shows autonomous epileptogenicity during the PRID, whereas the mirror site during the PROD does not. We observed that in the primary site, the dendritic potentials (field EPSPs) were remarkably suppressed in amplitude or disappeared during the PRID and that there was a loss of the after-positivity (field IPSPs); these DCRs recovered gradually after termination of the PRID. Instead of DCRs, "convulsoid responses" (a general term for responses similar to the individual spontaneous waves which occur in all types of seizures discharges) were usually elicited in the primary site during PRID. In the mirror site during PROD, the DCRs showed three different behaviors: they were either unaffected, increased, or suppressed. Convulsoid responses were never elicited. In a few cases, independent seizure discharges were induced in the mirror site. During the independent seizure discharges, the DCRs in the mirror site disappeared and convulsoid responses similar to the individual independent waves were usually elicited, as in the primary site during PRID. We conclude that the convulsoid response was the most reliable indicator of the development of autonomous epileptogenicity, and that suppression or disappearance of DCRs was the supplementary sign of that development. These neuronal indexes may be useful for identification of secondary epileptogenesis. PMID- 6852153 TI - Spinal input pathways affecting the medullary gigantocellular reticular nucleus. PMID- 6852154 TI - Corticostriate projections from reciprocally connected sectors of areas 4 and 5 in the dog. AB - Injections of tritiated leucine were made into area 4 on the medial part of the posterior sigmoid gyrus and area 5 on the rostral part of the lateral gyrus. Both areas were found to project to each other as well as to an overlapping area in the caudate nucleus. These data suggest that areas 4 and 5 in the dog may relate to each other not only through direct reciprocal connections but also through overlapping projections to the neostriatum. PMID- 6852156 TI - On the origin of the compound action potentials (N1, N2) of the cochlea of the rat. AB - The origin of N2 component of the compound action potential was studied by comparing the potential recorded at the round window with the response recorded from the cochlear nucleus, by comparing the potential recorded at the round window before and after the cochlear nucleus was removed by suction, and by comparing latencies of unit responses from auditory nerve fibers and cochlear nucleus units with the responses from the round window. The results indicated that the N2 potential, as well as the positive potential between the N1 and N2, was generated by secondary auditory neurons situated in the cochlear nucleus. The results were based on the response to click sounds and cross correlograms of the response to continuous sounds that were amplitude-modulated with pseudorandom noise. PMID- 6852155 TI - Activity-induced morphologic changes in rat soleus nerve. AB - The effects of 8 to 12 weeks of intense running or swimming on the morphology of the soleus nerve of the adult male albino rat were investigated. Nerve fiber diameter and number, axon diameter, and myelin area were determined. Mean fiber diameter (5.50 +/- 0.47) of the trained rats was smaller (P less than 0.05) than for sedentary control rats (6.19 +/- 0.27). The decrease in fiber size in the trained rats appeared to be reflected by a combination of smaller (P greater than 0.05) mean axon diameter and myelin area. Total fiber number was not different in the control (means = 113 +/- 6) and trained (means = 108 +/- 4) rats. These results provide further evidence that a chronic, intense but physiologic exercise can impose a functional demand on peripheral nerves that can alter morphologic features that are closely related to conduction velocity and commonly are associated with neuronal cell size. PMID- 6852157 TI - Absence of fibrillation after muscle injury. AB - The possibility was examined that fibrillation potentials may occur in those parts of muscle fibers which become functionally denervated following segmental necrosis. Focal necrotic lesions were induced in rat semitendinosus muscles by crushing, ligating, or cutting muscle fibers. When the treated muscles were examined microscopically and recordings made with intracellular or extracellular electrodes, fibrillations were found to be either completely absent or extremely infrequent. Fibrillation potentials were also absent in the brachioradialis muscle of a human subject after myotomy. In contrast to these negative results, surgical denervation of the rat semitendinosus induced fibrillation activity within 3 days; when fully developed, fibrillations occurred in approximately one half of the fibers at any time. The findings are considered to have significance for an understanding of the pathogenesis of those "myopathic" disorders in which fibrillations are found. PMID- 6852158 TI - Impulse conduction velocities in human biceps brachii muscles. AB - Measurements of impulse conduction velocity were made in biceps brachii muscle fibers of male or female controls and of male body-builders. The technique involved exciting bundles of fibers with stimulating electrodes applied over the surface of the muscle, and recording compound action potentials with three small surface electrodes spaced 3 cm apart. By measuring latencies to the onsets and to the peaks of the negative deflections, it was possible to estimate conduction velocities in the fastest-conducting (FC) and intermediate-conducting (IC) fibers; the observed values ranged from 2.8 to 5.5 m X s-1 in normal men and women. The mean conduction velocity for FC fibers was significantly higher in body-builders than in normal men and women; the mean IC value was significantly lower in women. In all three groups of subjects a decrease in conduction velocity could be demonstrated for FC fibers at the end of 1 min of maximal isometric contraction. In the body-builders, and probably in the other two groups of subjects, the FC fibers are considered to correspond to type II muscle fibers. PMID- 6852159 TI - Laminar distribution and the response of superior colliculus neurons to stimulation of the periodontal ligament in the rabbit. AB - Unit discharges of superior colliculus neurons fired by electrical stimulation of the periodontal ligament and/or mechanical stimulation of the mandibular incisor tooth were extracellularly recorded, and their laminar distribution and response properties were examined. The neurons were widely distributed in the deep layer of the anterior two-thirds of the superior colliculus. Most of them were located in the lateral site of the profound layer, a few in the lateral site of the intermediate layer. Their locations correspond to the lower nasal quadrant of the visual field. The mean first-spike latency of the intermediate layer neurons (7.2 ms) elicited by electrical stimulation of the periodontal ligament was shorter than that of the profound-layer neurons (13.8 ms). About one-third of the neurons were suppressed by conditioning electrical stimulation of the optic chiasma. These results suggested that in addition to visual, auditory, and body surface tactile sensations, intraoral somesthetic sensations also participate in the functioning of the superior colliculus which appears to play a role in orienting the animal toward visual, somesthetic, and auditory stimuli. PMID- 6852160 TI - Cytological effects of triiodothyronine on dorsal root regeneration in adult rat. PMID- 6852162 TI - Interneuronal synchrony in precentral cortex of monkeys during operant conditioning. AB - One hundred thirty-three pairs of precentral neurons were recorded simultaneously from four Macaca mulatta monkeys during participation in an operant conditioning paradigm that required one of the two units to be fired tonically within a 30- to 60-ms interspike interval (ISI) range. At the end of each 5-min behavioral period, a correlation between the two units' firing rate fluctuations was computed. These correlations were used as a measure of synchrony between units. For the majority of unit pairs, the unit for which reinforcement was contingent upon could be controlled independently from the activity of the simultaneously recorded unit. In 75% of experiments the synchrony between units decreased during the operant periods in comparison to the time-out periods. In only 5% of the experiments did unit pairs consistently exhibit increased synchrony during operant periods compared with time-out periods. If the monkey developed EEG signs of drowsiness during time-out periods, the synchrony between units became greater. PMID- 6852161 TI - Characteristics of cat skeletal muscles grafted with intact nerves or with anastomosed nerves. AB - Grafting of 3-g extensor digitorum longus (EDL) muscles of cats may be made with (i) severence of the nerve with spontaneous reinnervation, termed standard grafts (ii) severence of the nerve with reinnervation facilitated by anastomosis of the nerve, termed nerve-anastomosed grafts; and (iii) preservation of the nerve, termed nerve-intact grafts. In previous studies, standard grafts developed a maximum isometric tetanic tension (P0) that was 22% of the value for control EDL muscles. We hypothesized that the low values of P0 resulted from incomplete reinnervation of muscle fibers. To test this hypothesis, EDL muscles were grafted in cats with nerves intact and with nerves anastomosed. In standard grafts differences were observed in both structure and function at 120 compared with 240 days after grafting. Characteristics of the nerve-intact and nerve-anastomosed grafts did not change significantly between 120 and 240 days and the data were pooled for comparisons with control EDL muscles. Nerve-anastomosed and nerve intact grafts developed P0 values that were 34 and 64% of the control values, respectively. Nerve-intact grafts had a mass and fiber cross-sectional area not different from control EDL muscles. Compared with control values, all grafts had fewer fibers, more connective tissue, lower absolute and normalized P0, reduced capillary density, and increased fatigability. The greater P0 of nerve-intact compared with standard and nerve-anastomosed grafts supported our hypothesis that the degree of reinnervation is a factor that limits graft development. The presence of a necrotic core and the low tension development of even the nerve intact grafts suggested that revascularization is a significant limitation as well. PMID- 6852163 TI - Observations on the early mechanisms of severed nerve regeneration after compressive tubulation repair. AB - A moderately compressive tubulation procedure has been devised to improve regeneration that follows fascicular neurorrhaphy. The early phases of the regenerative process were analyzed to identify the underlying cellular mechanisms. Adult Sprague-Dawley rats were subjected to bilateral fascicular neurorrhaphy involving tubulation on one side with a dura mater sheet closely apposed to the suture site. One to 16 days postoperatively the nerves were processed for histological analysis. Compared with nontubulated nerves, the cuffed side displayed a longer extent of retrograde myelin and axonal degeneration, a faster rate of orthograde remyelination, axonal invasion of the suture plane at about the same period (fifth postoperative day), larger contingent of regenerating fibers invading the distal stump, more longitudinally oriented fibers at the repair level, no escape of regenerating fibers into the extraneural tissue through the repair borders, and less intraneural edema. These findings have implications for the potentially beneficial effects of mechanically restricting post-traumatic intraneural edema buildup during nerve regeneration. PMID- 6852168 TI - Caenorhabditis elegans: characters of negatively charged groups on the cuticle and intestine. AB - Partial characterization of carboxyl, sulfate, and phosphate groups on the Caenorhabditis elegans cuticle and intestinal microvilli was achieved by en face labeling of floating cryosections at two pH levels and specific blockage of sulfate groups by Alcian blue. All negatively charged groups on the cuticle and intestinal microvilli labeled heavily at pH 7.2-7.4. Pretreatment to block sulfate groups followed by ferritin labeling at pH 7.2-7.4 gave a 35% reduction of binding on the cuticle and an 80% reduction in binding on the microvilli. At pH 1.8 or 2.5, only the sulfate groups labeled as shown by the complete abolition of labeling on the cuticle and the microvilli following blockage of the sulfate groups. Molecules with accessible sulfate groups were distributed in clusters throughout the cortical layer of the cuticle, were present in the struts of the median layer but were absent from the basal layer. The advantages of applying molecular probes to cryosections as compared to sections prepared by standard electron microscopical techniques are discussed. PMID- 6852164 TI - Does neurotoxic conditioning accelerate nerve regeneration? AB - The prototype environmental neurotoxin, 2,5-hexanedione (2,5-HD), induces changes in somata of sensory ganglia that are morphologically similar to chromatolysis: this study assessed the functional significance of neuronal alterations. Experimental rats were exposed 6 weeks to 2,5-HD, and after 1 week without treatment were then subjected to experimental crush of the sciatic nerve (paired controls were unintoxicated). Nerve regeneration was assayed by the pinch test 4 to 13 days after crush. These preliminary results did not show an accelerated rate of axonal outgrowth; however, there was a small but significant (P less than 0.05) decrease in the initial delay. PMID- 6852165 TI - Leishmania tropica and Leishmania donovani: solid phase radioimmunoassay using leishmanial excreted factor. AB - A radioimmunoassay for the quantitative determination of anti-leishmanial excreted factor (EF) antibody in rabbit sera was developed. The assay, using Leishmania tropica and Leishmania donovani promastigotes EF, purified by either extraction with phenol followed by fractionation on a Sephadex G-100 column or by the dissociation of EF antibody complexes, was shown to be sensitive and reproducible. Using monospecific anti-EF antibodies, levels of as low as 0.06 0.12 micrograms/ml of anti-EF IgG could be detected. The specificity of the assay was assessed by inhibition with homologous and heterologous EF. Only minor cross reactivity with heterologous EF was observed, and as little as 2.5 micrograms/ml of EF could be detected. Sera from kala-azar patients showed only 1.8-3.1 times more anti-EF activity, as compared with uninfected controls. No specificity was observed with sera from kala-azar patients with regard to the type of EF used. Almost the same activity was obtained with both EF from L. tropica and L. donovani. No anti-EF antibodies were detected in sera from patients with cutaneous leishmaniasis. PMID- 6852170 TI - Brachymeria lasus: effects of nutrient level on in vitro larval growth of a chalcid insect parasite. AB - Exponential weight gain equations and growth rates were determined during larval development of Brachymeria lasus reared aseptically on chemically defined media with varying amino acid and glucose levels. The rate of weight gain increased from 0 to 2% dietary glucose and mean growth rate increased from 160 to 260 micrograms/mg x day. Similar results were observed for larvae reared on media containing 1 to 4% free amino acids. At higher nutrient levels, growth rate and rate of weight gain declined and maximal growth occurred at dietary osmolalities of 500-700 mOsm/kg. A further experiment utilizing nutritionally inert L-glucose suggested that this osmolality range does not reflect the optimal for growth but rather the point at which the detrimental effects of dietary osmotic pressure exceed the nutritive benefit of the dietary ingredients. PMID- 6852166 TI - Leishmania tropica major: effect of paromomycin and pentamidine on polyamine levels in the skin of normal and infected mice. AB - The polyamine content of the skin of BALB/c and C3H mice was determined at intervals, after injecting Leishmania tropica major. In BALB/c mice, putrescine and spermidine levels increased three- to seven-fold; in C3H mice, spontaneous recovery occurred after 3 weeks, accompanied by a reduction in putrescine and spermidine levels. Ornithine decarboxylase activity was negligible in normal, uninfected skin of both BALB/c and C3H mice, but increased steadily during infection. Treatment with drugs that inhibit the growth of leishmanial amastigotes in the skin of mice also reduced polyamine levels and ornithine decarboxylase activity of previously infected skin. There was a close correlation between the therapeutic activity of the drugs and their effect on polyamine content and synthesis. The aminoglycoside paromomycin, which was chemotherapeutically more effective than pentamidine, also had a greater effect on polyamine levels. S-adenosyl-L-Methionine decarboxylase activity in the skin of BALB/c and C3H mice was only slightly affected by the parasites. Polyamine levels and ornithine decarboxylase activity could possibly serve as means for measuring the growth of leishmanial parasites in skin and other tissues and as a measure of the efficacy of anti-leishmanial chemotherapeutics. PMID- 6852167 TI - Anisakis simplex and Terranova sp.: inhibition by larval excretory-secretory products of mitogen-induced rodent lymphoblast proliferation. AB - Excretory-secretory products were collected from supernatants of in vitro cultures of larval nematodes, Anisakis simplex (type I) and Terranova sp. (Hawaii type A). These materials were found to be more potent inhibitors of rodent lymphocyte blast transformation induced by concanavalin A and bacterial lipopolysaccaride than whole worm extracts of the same parasites. Inhibition of blast transformation was a result of cytostatic rather than toxic effects on proliferating lymphoid cells. The material(s) responsible for suppression are greater than 10,000 MW and are heat labile. PMID- 6852169 TI - Plasmodium knowlesi: studies on invasion of rhesus erythrocytes by merozoites in the presence of protease inhibitors. AB - The effect of protease inhibitors on invasion of rhesus erythrocytes by Plasmodium knowlesi merozoites was evaluated. Chymostatin, N-alpha-p-tosyl-L lysine chloromethyl ketone (TLCK), and L-1-tosylamide-2-phenylethylchloromethyl ketone (TPCK) inhibited invasion. Leupeptin, antipain, pepstatin, and phenylmethylsulfonyl fluoride (PMSF) had no effect. TLCK and TPCK inhibited attachment of merozoites to host erythrocytes. Chymostatin had no adverse effect on attachment, and in its presence junction formation between the merozoite and host erythrocyte occurred. Both chymostatin and leupeptin inhibited normal rupture of schizont-infected erythrocytes. It is suggested that proteolytic activity may be important both in the rupture of schizont-infected erythrocytes and in the invasion of erythrocytes by malaria parasites. PMID- 6852173 TI - Schistosoma japonicum: immunological response to circulating polysaccharide antigens in rabbits with a light infection. AB - To study the detectability of circulating polysaccharide antigens and the immunological response to such antigens in rabbits with a light Schistosoma japonicum infection, sera of five rabbits infected with 50 cercariae were studied up to 29 weeks post infection (p.i.). While one rabbit developed no worm burden, the other rabbits developed low worm burdens (4 to 16 worms). In the sera of these rabbits, the only polysaccharide antigen demonstrable with immunoelectrophoresis (IEF), was the circulating anodic antigen (CAA). With the enzyme-linked immunosorbent assay (ELISA), CAA was detectable from 5 to 6 weeks p.i. in the sera of the two rabbits with the highest number of worm couples. The lowest CAA level which was detectable in unconcentrated sera from which serum proteins had been removed was 125 ng CAA/ml, corresponding with a worm burden of 4.5 worm/kg body wt. During the entire infection, CAA-specific immune complexes were only demonstrable in very low concentrations. Antibodies against polysaccharide antigens were assessed with immunofluorescent antibody (IFA) on Rossman's fixed sections of adult worms, with the ELISA, and with IEF. Specific IgA, IgG, and IgM antibodies were detectable from 2 to 3 weeks p.i. with IFA and ELISA. These early antibodies were shown to be directed against gut-associated antigens, while antibodies against parenchyma-associated antigens were found later in the infection. With IEF, antibodies against two trichloroacetic acid (TCA)-soluble antigens were detectable, including the major, S. japonicum specific antigen 2. PMID- 6852171 TI - Taenia solium: immunity in hogs to the Cysticercus. AB - Protection was induced in hogs against Taenia solium cysticercosis using an immunogenic complex obtained from its larval "bladder worm" form, Cysticercus cellulosae. Immunoelectrophoresis revealed that this complex contained at least eight antigens. In immunized hogs a total of 71 (mean 11.8) cysticerci were found, whereas in the control animals 397 (mean 74.9) were found. Histopathological studies showed that more than 40% of larvae obtained from immunized hogs were completely destroyed and the others were seen in various stages of degeneration. Eosinophils and mononuclear cells were observed infiltrating the internal structures of the larvae. Intense granulomatous reactions of eosinophils, lymphocytes, macrophages, epithelioid cells, plasma cells, and fibroblasts surrounded the larvae. Larvae from control hogs were intact and surrounded by a small inflammatory reaction. The cellular response was measured by the macrophage migration inhibition test, which was higher in immunized hogs when compared with control animals, either before the infection with T. solium eggs or before slaughter. No significant difference was found in the humoral response of immunized and control hogs. PMID- 6852172 TI - Leishmania species: comparative ultrastructure of experimental nodules and diffuse human cutaneous lesions in American leishmaniases. AB - Experimental nodules of American leishmaniases were obtained by inoculating 0.1-1 x 10(5) amastigotes into the dorsum of the hindpaws of golden hamsters and of C57Bl/6J mice. The amastigotes were obtained by biopsy of lesions in six human cases of cutaneous leishmaniases and were serially maintained in golden hamsters and in a fetal calf serum-containing medium. Human nodules were obtained by biopsy from several patients with diffuse cutaneous leishmaniases, always prior to treatment. Within the same host species, no ultrastructural differences were seen in the tissue response to isolates of Leishmania mexicana, L. brasiliensis, or L. garnhami, nor were there differences between the host species in response to a particular isolate of the genus Leishmania. The typical inflammatory response was a macrophage granuloma with abundant polymorphonuclear neutrophils, some eosinophils, and plasma cells. Simple human cutaneous leishmanial lesions, as well as experimental nodules in regression, show many fibroblasts, much collagen fiber, but very few parasites. In typical lesions, parasites occurred within macrophage phagolysosomes, within distended lacunar cells, and in the intercellular spaces. Leishmaniae strongly adhered to parasitophorous vacuoles by a site of their plasma membrane directly opposite the flagellum, and the host cell cytoplasm close to the adherence site became highly vacuolated. In most cases the intra- and extracellular parasites show normal morphology, which suggest the inability of phagocytic cells to attack them. PMID- 6852174 TI - The transmembrane gradient of osmotic pressure modifies the kinetics of sodium currents in perfused neurons. PMID- 6852175 TI - Plasma catecholamines in children. PMID- 6852176 TI - Inability of thiamine phosphates transport in isolated rat hepatocyte. PMID- 6852177 TI - Monoamine oxidase A deficit in liver of germ-free rats. PMID- 6852179 TI - Disruption of the goblet cell intercellular junction following histamine infusion of the rabbit ileum. PMID- 6852178 TI - Combined effect of ascorbic acid deficiency and underfeeding on the hepatic carnitine level in guinea-pigs. AB - Liver carnitine level decreased from 249 +/- 16.1 nmoles/g (mean +/- SEM) control value to 148 +/- 9.8 nmoles/g (59.4%) in ascorbic acid deficient guinea-pigs, while in the underfed ('pair-fed') group it decreased to 181 +/- 14.1 nmoles/g (72.6%). Underfeeding also resulted in lower ascorbic acid levels; the depression of carnitine in the underfed animals could be prevented by an overdose (200 mg daily) of ascorbic acid. PMID- 6852180 TI - Sensitivity of vibrios to sanguinarine. PMID- 6852182 TI - Karyotypes of rats of the genus Rattus from the USSR. PMID- 6852181 TI - Cytogenetic evidence for hemizygosity at the thymidine kinase locus in P388 mouse lymphoma cells. AB - A detailed cytogenetic investigation was carried out on P388 mouse lymphoma cells. The cells have a mean chromosome number of 36.86 with a mode and median of 37 chromosomes. G-banding analysis of 12 spreads revealed a total of 15 marker chromosomes with chromosome 11, the determinant of thymidine kinase, being present only in single copy per cell. It is therefore concluded that the P388 cell line is hemizygous at the thymidine kinase locus. Thymidine kinase activities were assayed in P388 cells and two other malignant cell lines, clone 707 Friend mouse leukaemia cells and L5178Y mouse lymphoma cells. No clear relationship was observed between enzyme activity and gene dosage. PMID- 6852183 TI - Inhibition of tumor-induced angiogenesis and of tumor growth by activated lymphocytes. PMID- 6852184 TI - Triiodothyronine and tetraiodothyronine in human semen prior to, and following, treatment with thyroid extracts. PMID- 6852185 TI - Alterations in the morphology of the neuromuscular junctions following experimental immobilization in cats. AB - Immobilization of the hindlimbs in cats, in the neutral position, by applying a plaster cast for 4 weeks, led to paler and larger neuromuscular junctions. Beyond 8 weeks, this procedure caused elaborately branched-out and paler junctions which were significantly larger in their diameters than those of the contralateral control limbs. PMID- 6852186 TI - Fetal gastric and colonic implants in syngeneic and allogeneic mice developing typical inflammatory changes. AB - Implants of fetal stomach and colon under the kidney capsule of syngeneic, and H 2 compatible and H-2 incompatible allogeneic mice were examined histologically at different time intervals after the procedure. According to the time of implantation typical inflammatory changes were seen in syngeneic stomach and colon implants, which resembled changes seen in chronic atrophic gastritis and chronic ulcerative colitis. Immunofluorescence studies showed that the host developed antibodies against fetal antigens, while there was no evidence for cellular immune response to fetal syngeneic antigens with the direct leukocyte migration inhibition test. Possible explanations for these results are discussed. PMID- 6852187 TI - Relaxation of isolated rabbit veins mediated by latent histamine H2-receptors. AB - Isolated rabbit veins preconstricted by either norepinephrine, methoxamine or potassium were relaxed by histamine in the presence of mepyramine, a histamine H1 antagonist. The relaxation was not antagonized by atropine, propranolol and indomethacin but by an H2-antagonist cimetidine. It is likely that histamine relaxes the rabbit veins through H2-receptors. PMID- 6852188 TI - Effects of hypo and hyperosmotic media on rabbit renal cortical slices. AB - Rabbit kidney cortex slices behave as osmometers when withstanding either hyperosmotic shocks or hypo-osmotic shocks of amplitude up to P1/P2 = 1.25. For hypo-osmotic shocks of amplitude larger or equal to P1/P2 = 1.5 a volume regulation process occurs. Na+ is the main osmotic effector implicated in volume control. PMID- 6852189 TI - Acute heat/exercise stress in rats: effects on fluid and electrolyte regulatory hormones. AB - Adult, male rats were exercised in the heat until hyperthermic exhaustion ensued. Plasma aldosterone levels were significantly (p less than 0.001) elevated after 8 min of exercise and remained increased throughout the exercise and recovery periods. Alternatively, plasma angiotensin I levels were unaffected during exercise, but increased significantly (p less than 0.001) during the recovery period. These rapid elevations in hormonal levels may be part of a sympathicoadrenal response to heat/exercise stress as well as an adaptational response to maintain plasma volume during and following exercise in the heat. PMID- 6852190 TI - Angiogenic factor in vitreous from diabetic retinopathy. AB - Vitreous from patients with proliferative diabetic retinopathy contains an angiogenic substance which stimulates the proliferation of blood vessels on the chick chorioallantoic membrane, whereas vitreous from non-diabetics who do not have a proliferative retinopathy does not. PMID- 6852191 TI - Hepatic proline after bile duct ligation in rats. AB - Since biliary hyperplasia of fascioliasis correlated with hepatic proline level, we examined the occurrence of a similar chemical stimulus during bile obstruction. Uptake of tritiated proline and glycine rose in both hepatocytes and a bile duct enriched cell fraction, following duct ligation in rats. The increased hepatic content of proline but not glycine suggests that proline has a role in post-obstructive biliary proliferation. PMID- 6852192 TI - Stereoselective binding of 4,5-dihydrodiazepam to human serum albumin. PMID- 6852195 TI - Cardiovascular-compensatory and decompensatory responses in rats anesthetized with pentobarbital compared to chloralose-urethane. AB - The data presented in these studies suggests that rats anesthetized with pentobarbital are better able to compensate for acute blood loss, but are less able to sustain the compensatory effort during hemorrhagic hypotension than rats anesthetized with chloralose-urethane. However, following reinfusion of shed blood the pentobarbital rats are better able to maintain their blood pressure. PMID- 6852194 TI - Acetylcholinesterase localization at synapses in chick embryo ciliary ganglion. AB - The cytochemical localization of acetylcholinesterase (AChE) at calyciform synapses of the chick ciliary ganglion during embryonic development has been investigated. AChE activity is present at the surface membrane of newly formed calyciform synapses and closely follows the progressive enlargement of the synaptic area. The occurrence of a retrograde iris-dependent influence on ganglionic AChE is considered. AChE seems to be a suitable marker for synaptic maturation. PMID- 6852193 TI - Styrene oxidation to styrene oxide in human erythrocytes is catalyzed by oxyhemoglobin. AB - Oxygenated human erythrocytes catalyzed the oxidation of styrene to styrene oxide. This reaction was inhibited by CO but not by superoxide dismutase, catalase and scavengers of hydroxyl radicals. In partially deoxygenated erythrocytes styrene oxidation showed a linear relationship with the molar fraction of oxyhemoglobin. These data indicate that oxyhemoglobin and not free oxygen radicals are involved in styrene oxidation. PMID- 6852197 TI - Karyological studies on established mosquito cell lines. AB - Chromosome frequency distribution and cellular DNA estimations in different established mosquito cell lines were studied. These cell lines exhibited a wide range of cell types with a diploid stem-line comprising 50-55% and a haploid substem-line comprising 12-30% of the population. Estimation of cellular DNA contents by impulse cytoflowmetry and by Feulgen cytophotometry supported these observations. Because of their low diploid counts, these cell lines cannot be classified as diploid. PMID- 6852196 TI - Enhancement of human neutrophil oxygen consumption by chemotactic factors. PMID- 6852198 TI - Testosterone secretion of rat and mouse Leydig cells cultured at plates precoated with collagen taken from male and female rats. AB - Testosterone secretion by Leydig cells in vitro was significantly higher on male collagen coated, than on female collagen coated plates. The castration of male rat-donors of collagen demonstrated that 2 months of androgen deprivation eliminated the effect. PMID- 6852200 TI - Intramural distribution of neuron specific enolase (NSE) in the human gastrointestinal tract. AB - NSE concentrations were measured by radioimmunoassay in the main separated layers of the human gastrointestinal tract. At all levels, a similar pattern of distribution of this protein was found, primarily parallel to that of nerve elements. Lower amounts of NSE were detected in the separated mucosal epithelium, containing the endocrine cells. PMID- 6852201 TI - Immobilization of rat brain synaptic vesicles on positively-charged glass microspheres. AB - Synaptic vesicles from rat brain were immobilized on glass microspheres covalently coated with poly-L-lysine. Using a potassium tartrate perfusion medium, the vesicular accumulation and methamphetamine-induced release of (L)-3H norephinephrine could be conveniently monitored in a flow experiment. PMID- 6852199 TI - Arginine-vasotocin and gonadal activity in the lizard, Podarcis s. sicula Raf. AB - Arginine-vasotocine (AVT) injected into male adult lizards, Podarcis s. sicula Raf., inhibits the last phases of spermatogenesis and the endocrine activity of gonads. In female lizards the substance induces an early interruption of egg deposition. PMID- 6852202 TI - Bromocriptine reduces the size of cells in prolactin-secreting pituitary adenomas. AB - The morphometric analysis of the size of adenomatous prolactin cells shows that bromocriptine-induced cell shrinkage halts if treatment with the drug is discontinued for more than 2 days. Different cell components (nucleus, cytoplasm, nucleolus) do not react to treatment to the same extent. PMID- 6852203 TI - Union of Swiss Societies of experimental biology: abstracts of the 15th annual meeting. Fribourg, 17-18 March 1983. PMID- 6852205 TI - Chlorphentermine-induced neonatal and maternal pulmonary phospholipidosis in rats. AB - Pregnant rats were treated on Days 16-20 of pregnancy with 30 mg/kg chlorphentermine hydrochloride (CP) or an equal volume of 0.9% NaCl. Females delivered on Day 21 and neonates were examined 12 hr postpartum. Electron micrographs showed the CP neonates to have lamellar inclusions, characteristic of drug-induced phospholipidosis in Type I and Type II cells, macrophages, and nonciliated bronchiolar epithelial cells of the lung. These inclusions were either unicentric, multicentric, or consisted of whorls of membranous material. The content of total phospholipids was increased in neonatal lung as a result of CP treatment. A decrease in the percentage of total phospholipid present as phosphatidylinositol plus phosphatidylserine and an increase in the content of disaturated phosphatidylcholine were found in neonatal lung as a result of maternal chlorphentermine treatment. In maternal lung, increases were seen in the content of total phospholipids, total phosphatidylcholine, disaturated phosphatidylcholine, and phosphatidylinositol plus phosphatidylserine. A decrease in the percentage of sphingomyelin was also found. The results of this study indicate that following prepartum maternal administration of CP morphological changes are accompanied by biochemical alterations which are consistent with the induction of phospholipidosis as observed in neonatal lung. These biochemical changes were different than those associated with the induction of this disorder in the maternal lung. PMID- 6852204 TI - Pathogenesis of skeletal muscle necrosis induced by tarantula venom. AB - The pathogenesis of myonecrosis induced by venoms of the Arkansas tarantula (Dugesiella hentzi, Girard) and the Honduran tarantula (Aphonopelma spp.) was studied using light and electron microscopy, scanning electron microscopy and x ray microprobe analysis, and histochemistry. White mice were injected intraperitoneally with a sublethal dose of tarantula venom. Gross examination 24 hr after injection revealed white areas of apparent calcification in the diaphragm muscle. Light microscopic examination at 15 min revealed hypercontracted muscle cells, and necrotic masses containing areas of condensed myofibrils and clumps of mitochondria. By 12 hr numerous phagocytic cells were present around degenerated muscle cells. Electron microscopic examination revealed a myonecrosis of rapid onset with plasma membrane rupture and contraction bands 15 min after injection. At 3 hr only small patches of plasma membrane remained and mitochondrial changes such as swelling, dense intracristal spaces, partitioning, and flocculent densities were prominent. By 12 and 24 hr very dark spicular densities were present in mitochondria and numerous phagocytic cells were located within the intact basal lamina of necrotic cells. X-ray analysis and histochemistry of 24 hr samples showed that necrotic cells contained very high levels of calcium and phosphate. These two tarantula venoms caused a rapid onset myonecrosis in which the primary injury was rupture of the plasma membrane followed by inability of mitochondria and sarcoplasmic reticulum to maintain normal levels of calcium in the cytoplasm leading to cell death. PMID- 6852207 TI - Effect of chlorpromazine on lipid metabolism in aortas from cholesterol-fed rabbits and normal rats, in vitro: inhibition of sterol esterification and modification of phospholipid synthesis. AB - Chlorpromazine (CPZ), a major tranquilizer, was found to be a potent inhibitor of acylCoA:cholesterol acyltransferase (ACAT, EC 2.3.1.26) in isolated arterial microsomes and in intact arterial tissue from the rat and cholesterol-fed rabbit in vitro. In isolated rabbit arterial microsomes, CPZ resulted in a concentration dependent inhibition of ACAT with 50% inhibition of [1-14C]oleoylCoA incorporation into [14C]cholesteryl esters occurring at 0.1 mM CPZ. CPZ also effectively inhibited the incorporation of [14C]oleate into triglycerides without affecting incorporation into diglycerides. Additionally, CPZ altered the pattern of arterial phospholipids synthesized from [1-14C]oleate. Incorporation into phosphatidylcholine was depressed while incorporation into phosphatidylinositol was increased. Since diglyceride synthesis appeared to be unaffected by CPZ, a redirection of phosphatidic acid into the CDP-diglyceride pathway of glycerolipid synthesis does not adequately account for the effect of CPZ on arterial phospholipid and triglyceride synthesis in these experiments. PMID- 6852206 TI - The effect of the association of Gossypol and Lonidamine on the energy metabolism of Ehrlich ascites tumor cells. AB - The effect of the association of Gossypol and Lonidamine on the energy metabolism of Ehrlich ascites tumor cells has been investigated. The action of the drug on tumor cells was studied by addition of the drugs to cells harvested from Swiss male mice. The results may be summarized as follows: (1) Low concentrations of Gossypol increase the rate of oxygen consumption by uncoupling oxidative phosphorylation. High concentrations result in an inhibition of oxygen consumption with a mechanism that must be regarded as not directly related to the uncoupling activity. (2) Gossypol, at concentrations at which it exerts an uncoupling activity, stimulates mitochondrial ATPase which in turn increases the aerobic and anaerobic rates of lactate production. The decrease of glycolysis at high concentrations of Gossypol does not depend on the inhibition of enzymes of the glycolytic pathway, but must be ascribed to cell death. (3) The association of a low concentration of Gossypol with Lonidamine brings about a further inhibition of oxygen consumption. Moreover, Lonidamine abolishes the stimulation of glycolysis induced by Gossypol and lowers lactate production to values that are quite similar to those found with Lonidamine alone. (4) It may be concluded that the association of Gossypol and Lonidamine results in a very effective decrease of the energy requirements of cancer cells. PMID- 6852210 TI - Lipid peroxidation in exercise myopathy. AB - Selected estimates of lipid peroxidation were analyzed in mouse quadriceps femoris muscle immediately after submaximal prolonged (9 hr) and exhaustive maximal running (2-3 hr), and at intervals 1-10 days afterward during the exercise-induced myopathy. Immediately after the two types of exertion no significant changes were observed in the concentrations of lipid peroxidation products (thiobarbituric acid (TBA) reactive substances, and lipofuscin) or in the estimates of autoxidation (spontaneous and Fe2+-induced autoxidations) and antioxidant (catalase, glutathione peroxidase, and vitamin E) capacities. The enzymatic estimate of exercise myopathy (beta-glucuronidase) increased considerably (2-6 days) after both types of exertion. Simultaneously, the lipid peroxidation rate of muscle homogenates in vitro increased markedly and in highly significant correlation with the activity of beta-glucuronidase. The concentrations of TBA reactants and lipofuscin as well as Fe2+-induced lipid peroxidation were not affected during exercise myopathy. The activities of catalase and glutathione peroxidase increased significantly after both exertions, while the concentration of vitamin E was unchanged. Exhaustive running of endurance-trained mice caused only slight signs of myopathy and no increase in the rate of lipid peroxidation in vitro. PMID- 6852211 TI - Leptomeningitis and polycaryocyte formation in the CNS of rats inoculated subcutaneously with herpes simplex virus. AB - Wistar rats were inoculated subcutaneously with either type 1 (HSV1) or type 2 (HSV2) Herpes simplex virus at 5 days of age. Animals were killed in extremis or at the end of the 14-day observation period postinoculation. Acute destructive meningoencephalitis with hemorrhage and leukocytic infiltration was observed in both groups. Polycaryocytes comprised of cells of the internal granular layer of the cerebellum were observed in some animals inoculated with HSV1. These multinucleated cells appeared to be formed by fusion of virus-infected cells, and intranuclear inclusion bodies were observed. Lesions in the leptomeninges were particularly striking in animals inoculated with HSV2. Viral replication in resident cells of the leptomeninges was demonstrated by electron microscopy. PMID- 6852208 TI - Tryptophan-induced stimulation of hepatic ornithine decarboxylase activity in the rat. AB - The effect of a single tube feeding of L-tryptophan on hepatic ornithine decarboxylase (ODC) activity in rats was investigated. The levels of ODC activity in the livers of control and experimental rats were assayed in vitro by measuring the release of 14CO2 from DL-[1-14C]ornithine. Single tube feedings of varying levels of L-tryptophan (2.5-30 mg/100 g body wt) to overnight-fasted rats 1 hr before sacrifice exhibited increases in the hepatic ODC activities. L-Tryptophan (30 mg/100 g body wt) tube fed to overnight-fasted rats 1/6 to 12 hr before sacrifice induced hepatic ODC activities which were significantly elevated beginning at 1 hr and peaking at 2 hr (6.5-fold increase over controls). In vitro [14C]leucine incorporation into protein using hepatic microsomes of tryptophan treated rats was significantly increased at 1 hr in comparison with that of controls. The tryptophan-induced stimulation of hepatic ODC activity was not affected by prior adrenalectomy but was abolished by pretreatment with cycloheximide. These studies demonstrate that a single feeding of L-tryptophan can significantly enhance in the rat the activity of ODC, a key enzyme in the biosynthesis of polyamines. PMID- 6852209 TI - Chlorphentermine-induced alterations in the lungs of vitamin E-deficient and supplemented rats: 1. Biochemical and morphometric analysis of the pulmonary response. AB - Male Sprague-Dawley rats were maintained on diets containing 0.60, or 300 ppm vitamin E (VE) for 9 weeks with chlorphentermine (CP) or saline vehicle (SV) treatments administered over the last 3 weeks (20 mg CP/kg for one week and 30 mg CP/kg for subsequent 2 weeks or equivalent volume of saline vehicle). Spontaneous erythrocyte hemolysis averaged 68% for VE-deficient (0 ppm) and less than 9% for VE-supplemented (60 and 300 ppm) animals prior to saline and CP treatments. These values were not changed significantly by vehicle or drug administration. The lung to-body weight ratios nearly doubled and the total lung phospholipid levels increased equivalently (three- to fourfold) in all three CP-treated VE groups as compared to corresponding SV controls. The levels of thiobarbituric acid-reactive material (TBA-RM), an index of lipid peroxidation, was increased in the lung tissue above SV controls in all dietary groups with the deficient group being the highest. There was no difference in the TBA-RM values of 60 and 300 ppm groups within each group. Quantitative morphometric analysis revealed that in the VE supplemented groups, CP treatment caused a significant increase in the number of alveolar macrophage foam cells (FC) with a slight increase in the volume density of surfactant-like material (SLM). By comparison, there were fewer FCs but a larger quantity of SLM in the VE-deficient group. The results suggest that VE deficiency modifies the pulmonary response to CP resulting in lipid peroxidation induced FC disintegration and the accumulation of SLM. PMID- 6852212 TI - [Efficacy of the phenol compounds of Arnica in toxic lesion of the liver]. AB - Experiments on rats with toxic liver injury induced by carbon tetrachloride have shown that the preparation presenting a sum of phenolic compounds of Arnica montana and foliated Arnica favours a more complete recovery of the bile secretion intensity, synthesis and excretion with bile of bile acids and bilirubin, and cholesterol excretion. It also accelerates the recovery of activity of serum enzymes. PMID- 6852214 TI - [Mechanism of the acute toxic action of N-nitrosodimethylamine]. PMID- 6852213 TI - [Eye lesion from chromium compounds and its treatment in an experiment]. AB - Experiments on 68 rabbits with degree III burn induced by potassium bichromate were made to study and compare the therapeutic effect of subconjunctival injections of autoplasma with heparin and penicillin and instillations of spermaceti oil. Administration of spermaceti oil for the treatment of burns provides a more remarkable clinical effect, contributing to a milder course of burn process. PMID- 6852216 TI - [Characteristics of the effect of ether, sodium thiopental, fentanyl and naloxone on respiration]. AB - It has been demonstrated in experiments on rabbits that anesthetic ether sodium thiopental, phentanyl and leucine-enkephalin have different inhibitory effects on the activity of inspiratory and expiratory neurons in the medulla oblongata. Bemegrid recovers the activity of the respiratory center inhibited by all the substances under study whereas naloxone eliminates apnea induced by phentanyl or leucine-encephalin alone. Besides, it has been ascertained that naloxone effectively abolishes the inhibition of the respiratory center caused by hyperventilation in rats. PMID- 6852217 TI - [Effect of cholinolytics on thermoregulation processes in hypothermia]. AB - Acute experiments on rats were made to study variations of the hypothermia development ratio (HDR) under the effect of cholinolytics at mild, medium and deep hypothermia stages, corresponding with 33,26 and 19 degrees C of rectal temperature. Amizyl (20 mg/kg) and spasmolytin (10 mg/kg) were used as central cholinolytics, whereas metacin (20 mg/kg), isoverin (10 mg/kg) and diplacin (8 mg/kg) as peripheral ones. The character of the action of central cholinolytics of the HDR is largely determined by the hypothermia stage, while that of peripheral ones by the type and localization of cholinoreceptors under blockade. PMID- 6852215 TI - [Effect of DOPA and haloperidol on experimental torticollis originating in the mesencephalon and its modulation by stimulation of the caudate nucleus]. AB - Electrolytic injury to dopaminergic neurons of the mesencephalic tegmentum in cats produced a steady experimental torticollis (ET) with contralateral turning of the head and body. DOPA potentiated and haloperidol mostly reduced ET. Analogous changes were induced by electrical stimulation of the ipsi- and contralateral caudate nucleus, respectively. Stimulation of the contralateral nucleus coupled with haloperidol administration led to a more pronounced restriction of ET. Unexpectedly, the same result was obtained after DOPA administration coupled with stimulation of the ipsi-lateral caudate nucleus. It is suggested that pharmacological treatment of torsion diseases should be combined with physical treatment methods. PMID- 6852219 TI - [Clinical study of the pharmacodynamics of drugs used for premedication]. AB - The use of premedication varieties in surgical treatment of 52 patients with heart diseases of varying etiology has demonstrated that the most effective were antihypoxic agents (sodium hydroxybutyrate), substances reducing myocardial requirement of oxygen (cardiac glycosides) and decreasing load of the heart (anapriline, verapamil), normalizing myocardial function (a polarizing mixture, cardiac glycosides), antithrombotic substances (heparin), antihistamine and antishock agents (diphenhydramine, pipolphen, morphine, promedol, prednisolone, neuroleptics, tranquilizers), and substances that enhance the neutralizing liver function (vitamins B and C). Drug correction of the functional and biochemical indicators should be strictly individualized with regard to the patient's age, type of pathology, and the scope of the coming surgical intervention. PMID- 6852218 TI - [Potential use of the antiserotonin preparation cyproheptadine (peritol) in Itsenko-Cushing disease]. AB - Experiments on male rats have shown that the inhibitory effect of peritol on the hypothalamohypophyseal-adrenal system (HHAS) is determined both by its influence on the regulatory mechanisms of the CNS and direct action on secretion and, possibly, synthesis of steroids. The degree of the antiserotonin and the HHAS inhibiting effects depends on the frequency of drug administrations rather than on its dose. The experimental studies made it possible to successfully apply peritol to the treatment of inpatients suffering from Icenko-Cushing's disease. Almost 60% of the inpatients manifested a remission, which was confirmed by the reduced blood content of ACTH, hydrocortisone and aldosterone. PMID- 6852220 TI - [Pharmacological correction of cerebral circulation in experimental acute myocardial ischemia]. AB - In acute experiments on anesthetized cats myocardial ischemia led to a reduction of the total brain circulation because of the increased resistance of brain vessels and lowered perfusion pressure. After administering curantyl, euphylline and nonachlazine myocardial ischemia brought about less pronounced decrease of the total brain circulation largely at the expense of elimination of brain vessels constriction. After administering strophanthine alone or combined with curantyl myocardial ischemia did not lead to any essential alterations in brain blood supply. It is likely that strophanthine and curantyl recover the compensatory mechanisms of the brain vessels lost during acute myocardial ischemia. PMID- 6852221 TI - [Anti-inflammatory activity of immunostimulants and their combinations with antiphlogistics]. AB - A study was made of anti-inflammatory action of prodigiozan, levamisole and methyluracil and their combinations with butadion, brufen and prednisolone. Prodigiozan was more active than levamisole and methyluracil, while levamisole appeared to be more active than methyluracil. Prodigiozan was effective when given both in a single dose and repeated doses. The immunostimulants did not reduce the efficacy of butadion, brufen and prednisolone, and in some cases they made the drug action more powerful. After administration of metopyrone the action of prodigiozan was more potent. Prednisolone reduced the anti-inflammatory effect of prodigiozan. PMID- 6852222 TI - [Effect of hyperbaric oxygenation on the microsomal enzymes of the liver monooxygenase system in the rat]. AB - Hyperbaric oxygenation of rats made at a pressure of 303.9 kPa (3 at. abs.) and 3 hour exposure induces in liver microsomes an increase (for 12 h) followed by a drop of NADP X H-ferricytochrome-c-reductase activity, reversible fall of cytochrome P-450 content, and inhibition of the rates of amidopyrine N demethylation and aniline p-hydroxylation. Activity of NADP X H-nitrotetrasolium , NAD X H-ferricyanide-, NAD X H-cytochrome-c-reductase and the content of cytochrome b5 remains essentially unchanged. PMID- 6852225 TI - [Effect of substances altering the metabolism of endogenous serotonin on mitotic activity in the regenerating liver of mice]. AB - The serotonin (S) precursor 5-hydroxytryptophan and MAO inhibitor o chlorpargyline injected alone or combined increase the endogenous S level in the regenerating liver and stimulate mitotic activity. The tryptophan hydroxylase inhibitor p-chlorophenylalanine and reserpine decrease both the endogenous S level and the mitotic index (MI). There is a close correlation between the endogenous S level and the MI. PMID- 6852227 TI - comparative analysis of cellular respiratory inhibition by substituted phenylglyoxal-bis-(4-methyl-3-thiosemicarbazone) zinc chelates. AB - Fourteen para-substituted phenylglyoxal-bis-(4-methyl-3-thiosemicarbazone) zinc chelates have been synthesized as inhibitors of cellular respiration and therefore as potential antineoplastic agents. Each chelate has been evaluated as an inhibitor of Ehrlich ascites tumor cell and of rat liver slice respiration. The molar I50 values for respiratory inhibition have been subjected to computerized correlation to delineate quantitative relationships between biological activity and chemical structure. Activity against the tumor cell model is characterized by a positive lipophilic and a detrimental steric influence while activity against rat liver slice displays only a weak positive lipophilic effect. Quantitative comparative analysis suggests that selective action against the tumor cell system can be improved by substituents which are electron withdrawing and lipophilic in nature. PMID- 6852224 TI - [Pharmacology of a new drug form, fenasal granules]. AB - Experiments on mice and rats were made to study a new medicinal form, fenasal granules given per os and to compare it with ground tablets and powder of fenasal as regards the intestinal content, absorption capacity, anthelminthic activity and toxicity. The intestinal content and absorption capacity of fenasal were medicinal form-dependent. The highest anthelminthic activity was exhibited by fenasal granules. Acute toxicity of powder, ground tablets and granules of fenasal administered to mice and rats per os remained the same. PMID- 6852226 TI - [Effect of the proteolytic enzyme papain on the body organs and systems of experimental animals]. AB - When administered intravenously and intraarterially papaine (2.5 and 10 mg/kg) produces no toxic effects on respiration, arterial pressure, brain and intracranial circulation. Intrapleural, intraperitoneal and interstitial administration of papaine solutions in doses under 4.5 mg/kg produces no local or general changes on the part of experimental animals' organism. PMID- 6852223 TI - [Assessment of the effect of sex steroids on the sexual behavior of the rat at late periods of observation]. AB - A study was made of sexual behavior of male rats exposed to prolonged (4 months) metandrostenolone (MAS) inhalations at the level Limch spec as of the effect of methyltestosterone (MT) on sexual behavior of the progeny following drug applications to the skin of pregnant rats in a dose at the level Limac spec. Methodological approaches to the appraisal of sexual behavior of rats are described. MAS (0.01 mg/m3) did not produce any deviations in sexual behavior of males. MT (1 mg/kg) applied during pregnancy had a masculinizing effect on the progeny females, that manifested in anatomical disorders of the urogenital area, thereby giving rise to alterations in sexual behavior of the progeny females and in that of their partners--intact males. The conclusion is made about high risk of the manifestations of specific effects of sexual steroids applied to the skin in the doses approximating the Limac spec. PMID- 6852229 TI - EEG profile of the anticonvulsant action of viloxazine in the rabbit. AB - The intravenous administration of the bicyclic antidepressant viloxazine, 0.5-2 mg/kg in rabbits, caused changes in the EEG profile with increased synchronous activity and shorter duration of the hippocampal afterdischarge following electrical stimulation. In animals exhibiting spontaneous epileptiform discharges, the injection of 1-2 mg/kg viloxazine was associated with disappearance of the paroxysmal EEG pattern that was substituted by a synchronous low frequency activity. This study also provided evidence of non-interactive effects of viloxazine (1-2 mg/kg i.v.) and alcohol (0.6 g/kg i.v.) on the EEG of normal rabbits. PMID- 6852228 TI - Opioid peptides. Structure-activity relationships in dermorphin pentapeptides III. AB - The synthesis and preliminary pharmacological in vitro of seventeen pentapeptide analogs of the opioid peptide dermorphin are reported. Substitution at residue Tyr5 and/or modification of C-terminal are generally well tolerated. PMID- 6852231 TI - Cyclic hydrazides. V - synthesis and antiinflammatory activity of derivatives of the 2-amino-1,4-dihydroisoquinolin-3(2H)-one. AB - The synthesis of the 2-amino-1,4-dihydroisoquinolin-3(2H)-one (II a) and of some of its derivatives starting from the o.methylphenylacetic acid, is described. Some of the described compounds possess a moderate antiinflammatory activity. PMID- 6852230 TI - [Hydrazines containing 1H-indene units]. AB - Some derivatives of N'-(5-nitro-2-furoyl)-N2-(3-chloro-1H-indenyl-2 methylene)hydrazine (I) were synthesized and screened for in vitro antimicrobial activity. None was more active than the parent compound and the greater hydrophilic character was associated with loss of inhibitory activity against gram-negative bacteria. PMID- 6852232 TI - How good are predictions of protein secondary structure? AB - The three most widely used methods for the prediction of protein secondary structure from the amino acid sequence are tested on 62 proteins of known structure using a program package and data collection not previously available. None of these methods predicts better than 56% of the residues correctly, for a three state model (helix, sheet and loop). The algorithms of Robson et al. [J. Mol. Biol. (1978) 120, 97-120] and Lim [J. Mol. Biol. (1974) 88, 873-894] are the best of those tested. New methods, now under development, can be tested against this benchmark. PMID- 6852233 TI - Role of phosphorylation on the maturation pathways of a 100 kDa nucleolar protein. PMID- 6852234 TI - Thermostability of alpha-mannosidase in plasma from cystic fibrosis patients and carriers. PMID- 6852235 TI - The recognition of a soluble cytochrome P450 in rat liver. AB - The presence of hepatic soluble cytochrome P450 was investigated in the rats that were pretreated with CCl4, CS2 and DENA + PCBs. The dithionite-reduced CO difference spectrum of the hepatic 204000 x g supernatant of these rats showed its maximum at 455 nm. Aniline and hexobarbital could react with the hepatic 204000 x g supernatant to give the substrate binding spectra of P450; differences were observed between the substrate-induced difference spectra of the 204000 x g supernatant and that of the microsomal fraction. These results indicate the existence of a hepatic soluble P450. PMID- 6852236 TI - Role of the quinone structure in the mitochondrial damage induced by antitumor anthracyclines. Comparison of adriamycin and 5-iminodaunorubicin. AB - Adriamycin cardiotoxicity has been correlated with a disturbance of heart mitochondrial functions. Here, 5-iminodaunorubicin was compared with adriamycin for its capability to interfere in the mitochondrial electron transport with subsequent membrane damaging. The results suggest that minor chemical modifications of the anthraquinone moiety of anthracycline glycoside drugs should be a promising way to decrease mitochondrial membrane damage induced by this class of antitumor drugs. PMID- 6852238 TI - The amino acid sequences of homologous hydroxyproline-containing myotoxins from the marine snail Conus geographus venom. PMID- 6852237 TI - Inhibition of microtubule assembly in vitro by TN-16, a synthetic antitumor drug. AB - An antitumor drug, 3-(1-anilinoethylidene)-5-benzylpyrrolidine-2,4-dione (TN-16) inhibited the assembly of porcine brain microtubules in vitro. The assembly induced by taxol was also suppressed by the drug. However, the latter required much higher concentration of TN-16 than the former. Binding studies by means of the fluorometric method and the spun-column procedure indicate that the inhibition was caused by the reversible binding of the drug to the colchicine sensitive site of tubulin. The affinity of TN-16 to tubulin was almost equal to that of nocodazole. PMID- 6852240 TI - Laser Raman studies of the 5 S rRNA-protein L5 complex of rat liver ribosomes. AB - The effects of ribosomal protein L5 on the conformation of 5 S rRNA in the 5 S rRNA-protein L5 complex extracted from rat liver ribosomes have been studied by laser Raman spectroscopy. A comparison of the spectra shows small protein-induced conformational changes in the 5 S rRNA, but most of the base-paired regions appear to be present in the complex with protein L5 as well as in the free 5 S rRNA. Furthermore specific interactions between 5 S rRNA and protein L5 are indicated. Cytosine (and/or uracil) residues in single-stranded regions and the N(7) of guanine are engaged in interactions with the protein as suggested by the Raman data. PMID- 6852243 TI - A large cathepsin D-derived fragment from the central part of the fibronectin subunit chains. AB - A mild cathepsin D digest of fibronectin only contained single-chain peptides of 200, 140 and 70 kDa and double-chain fragments of about 300 and 140 kDa containing the C-terminal disulfide link. Among the single-chain fragments the 200 kDa peptide was a precursor of the 140 kDa and 70 kDa peptides. The latter was correlated to the N-terminal and the former to the central region of the fibronectin subunit chains. PMID- 6852241 TI - Octamer reconstitution from acid-extracted chicken erythrocyte histones. AB - Histone octamers have been reconstituted from acid-extracted chicken erythrocyte histones. By the criteria of molecular size on exclusion chromatography as well as sedimentation velocity and conformational properties established by circular dichroism, fluorescence spectroscopy and imido-ester cross-linking, the reconstituted octamers have a structure identical to that of salt-extracted octamers. PMID- 6852242 TI - Monoclonal antibodies to choline acetyltransferase of rat brain. AB - Monoclonal antibodies to rat brain choline acetyltransferase were produced by the hybridoma technique. Two stable cell lines, Ab-57 and Ab-60, secreted immunoglobulin of subclass IgG1. The monoclonal antibodies bound to choline acetyltransferase without blocking catalytic activity. Affinity of Ab-57 was 100 times higher than that of Ab-60. Both antibodies bound to the rat enzyme in a mutually exclusive fashion. The antibodies showed cross-species reactivity with choline acetyltransferase from several mammalian brains. PMID- 6852244 TI - Early presence of phospholamban in developing a chick heart. AB - Phosphorylation of phospholamban and development of reticular Ca2+ transport were studied in crude membrane preparations of embryonic, newborn and adult chick heart. Maximal phosphorylation of phospholamban by added catalytic subunit of cyclic AMP-dependent protein kinase increases from embryonic day 4-15. It decreases with further development. In the same membrane preparations active Ca2+ uptake into vesicles of sarcoplasmic reticulum rises from day 4-7 and decreases then slightly until day 20. A several-fold increase in Ca2+-transport activity occurs at the time of hatching. The data indicate separate genetic control for synthesis of phospholamban and sarcoplasmic reticulum Ca2+-ATPase. PMID- 6852246 TI - Effect of starvation on the N-acetylglutamate system of rat liver. AB - Rats fasted for 3 and 6 days showed an increase in the activity, per g of liver but not per total liver, of the mitochondrial urea cycle enzymes, carbamylphosphate synthetase and ornithine transcarbamylase. The activity of N acetylglutamate synthetase, both per g and per total liver, increased by the third day and then decreased on the sixth day of fasting. The cytosolic enzyme N acetyldeacylase showed the same general pattern as the N-acetylglutamate synthetase except that the relative proportion of synthetase over deacylase was higher at the third day of starvation. The N-acetylglutamate level/g liver increases in relation to the number of days of fasting. PMID- 6852247 TI - Platelet-derived growth factor stimulates the phosphorylation of ribosomal protein S6. AB - The human platelet derived-growth factor (PDGF) is both a potent mitogen and a strong chemoattractant protein for cells involved in inflammation and repair. In seeking mechanisms by which PDGF might initiate specific activities in target cells, it was found that highly purified PDGF stimulates the phosphorylation of an Mr approximately 33000 protein in confluent Swiss mouse 3T3 cells [Biochem. Biophys. Res. Commun. (1981) 103, 355-361]. The Mr approximately 33000 protein has now been recovered in polysomes by differential centrifugation and identified as ribosomal protein S6 by two-dimensional polyacrylamide gel electrophoresis. PMID- 6852245 TI - Short-term disappearance of muscarinic cell surface receptors in carbachol induced desensitization. AB - A rapid carbachol-induced disappearance of muscarinic cell surface receptors was shown using [3H]methyl scopolamine as ligand on intact 108CC15 hybrid cells or rat cerebellar cells. This phenomenon is temperature-dependent, correlated to agonist stimulation and reversible. In these short time periods (less than or equal to 30 min), no change was observed in the total receptor amount measured on membrane preparations. This disappearance of cell surface receptors could represent the first event in cell desensitization which could be followed by receptor recycling in physiological conditions or by receptor degradation if the stimulation by agonists persists, as in long-term regulation. PMID- 6852248 TI - Macrophages contain at least two myosins. AB - A number of motile functions of macrophages are thought to be mediated by myosin. We have observed that myosin from rabbit alveolar macrophages is heterogeneous with respect to its 20 kDa light chain: two species of 20 kDa light chain are identified by one-dimensional and two-dimensional polyacrylamide gel electrophoresis, in a ratio of 2:1. Native myosin, analyzed on non-denaturing gels, is also composed of two species, in a ratio of 2:1. These results indicate that macrophages contain at least two different myosins, which might have different physiological functions. PMID- 6852239 TI - Neo-kyotorphin (Thr-Ser-Lys-Tyr-Arg), a new analgesic peptide. AB - The amino acid sequence of a newly isolated pentapeptide, neo-kyotorphin from bovine brain was synthetically verified to be Thr-Ser-Lys-Tyr-Arg corresponding to the C-terminal portion of hemoglobin alpha-chain. The synthetic neo-kyotorphin showed the dose-dependent analgesia in mice which was approximately equal to that of Leu-enkephalin. PMID- 6852249 TI - Analysis of erythrocyte membrane proteins from dystrophic hamsters. AB - To search for potentially mutant proteins, we have investigated erythrocyte ghost proteins from normal and dystrophic hamster by two-dimensional gel electrophoresis. No significant differences are observed between dystrophic and normal erythrocytes in their peptide patterns on SDS-polyacrylamide gel electrophoresis while on two-dimensional gels a protein spot of approximate Mr 20 000 with an approximate isoelectric point of 4.5 is found in erythrocytes from dystrophic animals and is consistently absent in normal erythrocytes. A large population of erythrocyte (60%) from dystrophic hamsters shows distorted shape as visualized by scanning electron microscopy. The nature of this protein and its relevance in hamster muscular dystrophy are at present not known. PMID- 6852250 TI - Band-3 protein-mediated anion conductance of the red cell membrane. Slippage vs ionic diffusion. AB - The band 3 protein-mediated, valinomycin-induced KCl efflux continues to increase with increasing [KCl] when the Cl-/Cl- equilibrium exchange becomes saturated. This suggests the existence of a band 3-mediated component of Cl- flux that contributes to the electrical conductance without being related to slippage; i.e., equilibration of the unloaded transport protein between the two membrane surfaces. PMID- 6852251 TI - Hemoglobin Okayama [beta 2 (NA 2) His replaced by Gln]: a new 'silent' hemoglobin variant with substituted amino acid residue at the 2,3-diphosphoglycerate binding site. AB - A new 'silent' abnormal hemoglobin, Hb Okayama [beta 2 (NA 2) His replaced by Gln], happened to be discovered in a diabetic Japanese female living in Okayama Prefecture, Japan, in the course of glyco-Hb measurement of the blood samples of diabetic patients. This variant did not differ from Hb A by conventional electrophoretic tests. Only the isoelectric focusing on PAG plate for the determination of glyco-Hb and the cation exchanger chromatography were successful in the separation of this abnormal variant from Hb A and glyco-Hb. Functional study of the whole blood demonstrated a slight increase of oxygen affinity. PMID- 6852252 TI - Melittin-induced fusion of acidic liposomes. AB - Melittin-induced fusion of acidic liposomes. Fusion was observed in the electron microscope and assayed as intermixing of both liposomes' contents and membranes. The melittin concentrations required for fusion induction were in the microM range compared to over 10 mM Ca2+ required for a comparable effect. It is suggested that the high efficiency of melittin is due to its amphipathic nature. Its hydrophobic moiety is probably anchored in one liposome while the positively charged hydrophilic moiety attracts another liposome. PMID- 6852255 TI - Location of tRNA on the ribosome. AB - Electron microscopy results of Lake [J. Mol. Biol. (1976) 105, 131-159] and Vasiliev et al. [FEBS Lett. (1983) 155, 167-172] suggest that the 70 S ribosome has an open pocket or a cavity at the base of the L7/L12 stalk of the 50 S subunit, on the side of the 30 S subunit opposite to its bulge or platform. It is this pocket that is proposed here to be the site for binding and retention of two L-shaped tRNA molecules on the ribosome. The model proposed is consistent with the facts about interactions of the protein L7/L12 with the elongation factors (EF-Tu and EF-G) involved in tRNA binding and translocation, as well as with the data available on the participation of proteins S3, S5, S10, S14 and S19 in the formation of tRNA sites. PMID- 6852257 TI - Intracellular pH topography: determination by a fluorescent probe. AB - The distribution of pH inside the yeast Endomyces magnusii was measured at 1 micron resolution using different external pH values. In a neutral buffer the pH of the cytoplasm was 6.7-7.2 in the center, decreasing to 6.0 toward the periphery of the cell. A decrease of external pH was followed by a gradual uniform decrease of internal pH. Using a comparison of the 'pH map' with phase contrast picture of the same cell, the pH of the vacuoles was estimated to be 5.5 5.6. PMID- 6852253 TI - Stereochemistry of an alpha, beta-elimination reaction by D-glucosaminate dehydratase. AB - The proton NMR analysis of D-glucosaminate dehydratase reaction in D2O revealed the incorporation of a deuterium atom at C-3 carbon of the product, 2-keto-3 deoxy-D-gluconate. Based on the chemical shift of C-3 proton of the product and the coupling constant characteristic for the C-3 and C-4 axial-axial coupling in the 2C5 pyranose conformation, the deuterium is in the pro-S position. Thus, the dehydration of D-glucosaminate by the enzyme proceeds in a retention mode at C-3 carbon. Kinetic parameters show that the rate-determining step is the abstraction of alpha-proton from the substrate. PMID- 6852254 TI - Deoxycytidylate shortage is a cause of G1 arrest of ascites tumor cells under oxygen deficiency. PMID- 6852256 TI - Localization of the chemotactic domain in fibronectin. AB - Fragments derived from human plasma fibronectin by enzymatic degradation were tested in the Boyden chamber for chemotactic activity towards various fibroblast strains. The results provide clear evidence that the chemotactic activity is restricted to a defined region of the fibronectin molecule which is the same for various fibroblast strains. The active domain is localized between the collagen binding site and the major heparin binding site, about 170 kDa apart from the N terminal and about 70 kDa from the C-terminal ends of the two subunit peptide chains. PMID- 6852258 TI - Absorption spectra of cytochrome P450CAM in the reaction with peroxy acids. AB - The reaction of Fe(III) cytochrome P450CAM with m-chloroperbenzoic acid was studied by rapid scanning absorption spectroscopy. Native low-spin enzyme produced spectra characteristic of two reaction phases that were marked by time intervals with isosbestic positions. The high-spin enzyme substrate complex yielded a series of Soret-region spectra whose properties were dependent on peracid concentration. The simplest model describing the results was a sequence of at least two spectral intermediates, that were not entirely homologous with data measured in reactions with microsomal P450LM2. Comparisons with related heme protein states indicate higher Fe(IV) oxidation levels provide a plausible interpretation of the P450CAM spectra. PMID- 6852259 TI - A non-micellar mode of cholesterol transport in human bile. AB - Quasi-elastic light scattering (QELS) was used to measure particle size in fresh human hepatic bile of 14 subjects. Particles with an approximate diameter of 700 A were found in all biles. The particles were almost unchanged after the bile salt concentration was reduced to 0.06 mM by dilution or dialysis against 150 mM NaCl. During dialysis bile salts were removed, while cholesterol and phospholipids remained in solution apparently in the large particles-vesicles. These experiments suggest the presence of a novel, bile salt-independent, mode of cholesterol transport in saturated human bile. PMID- 6852260 TI - Amino acid sequence of equine platelet tropomyosin. Correlation with interaction properties. AB - Equine platelet beta tropomyosin (247 residues), like rabbit skeletal muscle alpha tropomyosin (284 residues) has a repeating pattern of amino acid residues characteristic of a coiled-coil structure. When compared with the muscle protein, it is extended by 5 residues at the NH2-terminus and possesses two 21 residue deletions (positions 23-43 and 60-80 of the muscle sequence). The two proteins are highly conserved from residues 81-260, but are significantly different at their COOH-termini (residues 261-284). These differences in platelet tropomyosin can be correlated with its diminished head-to-tail polymerization, a weaker interaction with F-actin and a reduced affinity for muscle troponin and the T1 fragment of troponin-T. PMID- 6852261 TI - Chromatin maturation depends on continued DNA-replication. AB - The structure of [3H]thymidine pulse-labeled chromatin in lymphocytes differs from that of non-replicating chromatin by several operational criteria which are related to the higher nuclease sensitivity of replicating chromatin. These structural features of replicating chromatin rapidly disappear when the [3H]thymidine pulse is followed by a chase in the presence of an excess of non radioactive thymidine. However, when the rate of DNA replication is reduced, as in cycloheximide-treated lymphocytes, chromatin maturation is retarded. No chromatin maturation is observed when nuclei from pulse-labeled lymphocytes are incubated in vitro in the absence of DNA precursors. In contrast, when these nuclei are incubated under conditions known to be optimal for DNA replication, the structure of replicating chromatin is efficiently converted to that of 'mature', non-replicating chromatin. We conclude that the properties of nascent DNA and/or the distance from the replication fork are important factors in chromatin maturation. PMID- 6852262 TI - Evidence for two structurally related progesterone receptors in chick oviduct cytosol. AB - The existence of two progesterone receptor forms present in crude cytosol of chick oviduct has been demonstrated by photoaffinity labelling using [3H]R5020. On SDS-polyacrylamide gels these two forms exhibit app. Mr-values of 79000 and 109000 corresponding to the progesterone receptor forms A and B. Peptide maps of photoaffinity-labelled steroid receptors have been established by limited proteolysis with alpha-chymotrypsin. The peptide map obtained for chick oviduct cytosol progesterone receptor crosslinked with [3H]R5020 proved to be the sum of peptides obtained from partially purified preparations of forms A and B. The peptide maps of both progesterone receptor forms were identical for peptides below the Mr-value of form A, indicating extensive homology of the two forms. A significantly different peptide pattern was observed for the rat liver glucocorticoid receptor crosslinked with [3H]triamcinolone acetonide. Prolonged proteolysis with chymotrypsin gave rise to peptides with Mr-values of 6000 and 10000 from the hormone-binding domain of progesterone and glucocorticoid receptors, respectively. PMID- 6852264 TI - A membrane-bound protein kinase from mouse liver stimulated by iron. AB - At microM levels, iron stimulates strongly the in vitro phosphorylation of a membrane protein from mouse liver. This phosphorylation also occurs in the absence of other added divalent cations but to a lower degree. In SDS gels the phosphorylated protein has app. Mr 250 000 in the absence of mercaptoethanol and Mr 130 000 in its presence. It is phosphorylated on threonine residues. PMID- 6852265 TI - The stereochemical configuration of the natural 23,25,26-trihydroxyvitamin D3. AB - Four possible diastereoisomers of 23,25,26-trihydroxyvitamin D3 were synthesized and compared with the natural metabolite. The 4 synthetic diastereoisomers could be separated into 4 peaks by high-performance liquid chromatography. The natural 23,25,26-trihydroxyvitamin D3 comigrated with 23(S),25(R),26-trihydroxyvitamin D3. This result unequivocally demonstrates that the stereochemistry of the natural 23,25,26-trihydroxyvitamin D3 has the 23(S) and 25(R) configuration. PMID- 6852263 TI - Energetics of smooth muscle taenia caecum of guinea-pig: a 31P-NMR study. AB - Smooth muscle cell energetics of taenia caeci during relaxation, spontaneous activity and maximal contraction were investigated using 31P-NMR. In relaxed muscle obtained in calcium-free medium, [ATP], [phosphocreatine] and [sugar phosphate] were 4.4 mM, 7.7 mM and 2.8 mM, respectively. There was only a small difference in the energetics of spontaneously active and maximally contracted muscles, but under both conditions substantial changes occurred as compared with relaxed muscles. The internal pH in relaxed muscle was found to be 7.05, which acidified to 6.5 during contraction. The level of sugar phosphates was found to be not a limiting factor in energetics. PMID- 6852266 TI - Thyroidal and neural control of myosin transitions during development of rat fast and slow muscles. AB - Experiments with developing euthyroid, hypothyroid and hyperthyroid rats show that the transition from neonatal to adult fast myosin is orchestrated by thyroid hormones acting directly upon fast muscle cells. Denervation studies reveal the switch from neonatal to adult fast myosin synthesis is independent of the motoneuron. However the synthesis of slow myosin during development is critically dependent on innervation. PMID- 6852267 TI - Identification and characterization of variant forms of the gastrin-releasing peptide (GRP). AB - Porcine intestinal gastrin-releasing peptide (GRP) has been demonstrated to be structurally identical to the previously characterized gastric GRP. Ion-exchange and high-performance liquid chromatography of porcine intestinal extracts have identified two variant GRP forms. Studies on one of these variant forms suggest that a beta-aspartyl shift has occurred in the Asn-His structure of GRP; such a modification in an Asn-His structure occurring in a natural peptide or protein has not been previously reported. This variant GRP, although retaining bioactivity, appears to have reduced potency in elevating canine plasma gastrin levels. PMID- 6852268 TI - Carbohydrate structures of hen ovomucoid. A mass spectrometric analysis. AB - The apparently homogenous N-glycosidically-linked glycans 1, 7, 11 and 14 released by hydrazinolysis from hen ovomucoid were analysed by fast atom bombardment and electron-impact mass spectrometry after reduction and permethylation. The spectra support the primary structures established independently [FEBS Letters (1983) 152, 145-152] using methylation analysis, partial acid hydrolysis and 500 MHz 1H NMR spectroscopy. In addition to the major constituents present in fractions 1, 7, 11 and 14, four minor components not detected by other methods could be characterized with the aid of the mass spectrometry data as: Man2GlcNAcGlcNAc-o1, GlcNAc4Man3GlcNAc-o1, GlcNAc6Man3GlcNAc-o1 and GalGlcNAc6-Man3GlcNAc-o1. Our results show that the physical techniques used provide valuable data on the structure of complex glycans. In addition they can be employed to ascertain the homogeneity of the compounds examined as well as to detect trace amounts of homologs that might not be noticed by other methods. PMID- 6852269 TI - Boring's formulation: a scheme for identifying functional neuron groups in a sensory system. AB - In 1935 Edwin Boring proposed that each attribute of sensation reflects the activity of a different neural circuit. If this idea is valid, it could facilitate both psychophysical and neurophysiological research on sensory systems. We think it likely that Boring's formulation is correct for three reasons: 1) Different sensory attributes reflect conscious information about different parameters of a stimulus. To be measured by any device, each of these parameters must be individually computed. Different neural circuits would appear to be necessary for the nervous system to carry out these different computations. 2) Perceived information about different sensory attributes can be made to diverge by appropriate manipulations of the stimuli. If there is a rigorous relationship between conscious sensory experience and neural activity, such a divergence implies that different sensory attributes are served by different neural circuits. 3) Accurate information about a sensory attribute requires that a human observer's attention be focused on that attribute. Changes in direction of attention are thought to involve a process of switching from one neural circuit to another, and provide another way to cause perceived information about different sensory attributes to diverge. PMID- 6852270 TI - Tactile receptor discharge and mechanical properties of glabrous skin. AB - Current knowledge of the functional properties of mammalian cutaneous mechanoreceptors is reviewed with special reference to receptors associated with the glabrous skin of the raccoon and squirrel monkey hand. Four physiologically defined mechanoreceptor types are recognized: Pacinian afferents, rapidly adapting (RA), and slowly adapting type I (SAI), and slowly adapting type II (SAII). The SAI category is divided into moderately slowly adapting and very slowly adapting (VSA) types in terms of the duration of their response to a prolonged mechanical displacement of skin. Although both RA and SA units are capable of signaling displacement ramp velocity, the pattern of discharge during ramp stimulation may vary widely among units. SAI units also code the depth of skin displacement, but there is no best-fitting function describing the relationship. Static discharge is also markedly influenced by prior ramp velocity. Both raccoon and squirrel monkey VSA units show wide variation in the regularity of their discharge during static displacement. The rate of adaptation of SAI units is less when constant force stimuli are applied to the skin than when constant displacement stimuli are applied. This is partly attributable to mechanical properties of the skin. When either constant force or constant displacement stimuli are spaced too closely in time, there is a progressive (trial-to-trial) decrement in response rate, accounted for in part by failure of the skin to recover to its initial resting level. PMID- 6852272 TI - Neural mechanisms of tactual form and texture discrimination. AB - The mechanisms of fine form discrimination and texture discrimination are discussed in terms of a set of working hypotheses. 1) The limits of fine form discrimination at the fingertips are set by peripheral, not central, factors. 2) The critical information is relayed by slowly adapting (SA) afferents. 3) Texture is coded by the relative discharge rates in the quickly adapting, Pacinian, and SA populations. 4) SA transduction and transmission properties are particularly adapted for signaling spatial information. 5) The skin of the finger pad behaves like an ideal continuous medium. PMID- 6852273 TI - Information processing in cutaneous nociceptors in relation to sensations of pain. AB - The phenomena of fatigue and sensitization have been observed in the responses to heat of A-fiber and C-fiber mechanoheat nociceptors (AMHs and CMHs, respectively). After heat stimulation that is sufficiently intense to sensitize AMHs, CMHs within the stimulated area become fatigued, which suggests a dominant role of AMHs in contributing to cutaneous hyperalgesia under these conditions. Mild heat injuries, on the other hand, not sufficiently intense to sensitize AMHs, result in a characteristic time course in development of sensitization of CMHs that is matched by similar changes in pain threshold and in magnitude ratings of pain. Although available evidence does not suggest a simple relation between the shapes of psychophysical magnitude scaling functions and the average responses of nociceptors, it does support the conclusions that CMHs encode the intensity of painful heating of skin and that the alterations in responses of CMHs after mild heat injury contribute to the observed changes in scaling functions during the development of hyperalgesia. PMID- 6852271 TI - Spatial properties of receptive fields of mechanosensitive primary afferent nerve fibers. AB - Tactile sensation is rich and varied, requiring input from a variety of mechanoreceptors whose spatiotemporal aspects deserve careful study. Recent data for virtually every class of sensitive mechanoreceptor have revealed spatial inhomogeneities in sensitivity reflecting the distribution of sense organ terminals and the complexity of gradients in the complex spatial organization of receptive fields. Controlled surface parallel stimulation provides a means for examining sensitivity in a manner that may shed light on active tactile exploration and allow quantitative analysis of orientation, direction, and velocity properties underlying some aspects of feature extraction by the central nervous system. PMID- 6852276 TI - Glial growth factor: a mitogenic polypeptide of the brain and pituitary. AB - Purified rat Schwann cells divide slowly in tissue culture medium containing 10% fetal calf serum. They are stimulated to divide by a polypeptide growth factor present in extracts of the bovine brain and pituitary, but not by a variety of purified growth factors and hormones, nor by extracts of nonneural tissues. The activity resides in a component of Mr = 31,000, as evidenced by purification, reactivity with a set of monoclonal antibodies, and recovery of mitogenicity after sodium dodecyl sulfate gel electrophoresis. The activity is present in comparable levels in the anterior and posterior lobes of the pituitary and shows a regional variation in specific activity in different areas of the bovine brain. The caudate nucleus has a higher (1.2-fold) specific activity than the pituitary. When incubated with dissociated cultures of the rat corpus callosum, the purified factor stimulated division of astrocytes, but not of oligodendrocytes or macrophage-like microglial cells. It was also active on fibroblasts derived from newborn rat muscle cultures. In view of the importance of the Schwann cell in its definition, as well as its action on astrocytes, the factor has been tentatively named glial growth factor. PMID- 6852274 TI - Disposition of phencyclidine and its pyrolytic products in mice exposed to smoke. AB - Phencyclidine (PCP) is a drug that is frequently misused by smoking. Recent popularity of PCP abuse by this method probably stems from the fact that smoking allows users to titrate themselves as well as reduce the incidence of adverse reactions. PCP is pyrolyzed at high temperatures to form predominantly 1-phenyl-1 cyclohexene (PC). Piperidine and related products are formed in smaller quantities. Smoke from cigarettes impregnated with PCP contains approximately equimolar concentrations of PCP and PC. It has been shown that PCP and PC are present in the circulation of individuals after they smoke PCP-laden cigarettes. In addition, PCP and PC can be found in plasma as well as in all major organs of mice exposed to smoke from PCP-containing cigarettes. The brain concentrations of PC in mice are comparable to those of PCP immediately after exposure but the PC levels decline somewhat more rapidly. Actually the time course of behavioral activity correlates better with PCP levels than with PC levels. In addition, PC and its major metabolites, as well as piperidine, are considerably less active behaviorally than PCP, which suggests that pyrolysis represents an inactivation process for PCP. However, a total lack of contribution of pyrolysis products to PCP's actions has not been ruled out. PMID- 6852277 TI - Clomiphene citrate induction of ovulation. PMID- 6852278 TI - A graduated regimen of clomiphene citrate: its correlation to glycogen content of the endometrium and serum levels of estradiol and progesterone in infertile patients at the midluteal phase. AB - The glycogen content, glycogen synthetase level, and glycogen phosphorylase level were studied in endometrial samples obtained from 14 infertile patients during the midluteal phase before and after clomiphene citrate (Clomid, Shionogi & Company, Ltd., Osaka, Japan) treatment, simultaneously with measurement of the serum concentrations of estradiol and progesterone. Increase in the endometrial glycogen content in the clomiphene cycle was accompanied by a corresponding increase of the dosage of clomiphene. Also, the midluteal concentrations of estradiol and progesterone in the clomiphene cycle were significantly higher (P less than 0.005 and P less than 0.005, respectively) than those in the nontreatment cycle. Clomiphene therapy at 50 mg/day resulted in pregnancy in three of ten patients, while clomiphene at 100 mg/day resulted in pregnancy in three of six patients. These results suggest a fair correlation between the dosage of clomiphene and the improvement of endometrial function in infertile patients following stimulated ovarian steroidogenesis. PMID- 6852275 TI - Phencyclidine disposition in humans after small doses of radiolabeled drug. AB - Administration of small doses of radiolabeled phencyclidine hydrochloride (PCP X HCl) to normal volunteers has resulted in basic information on the disposition of PCP in humans. The drug and its metabolites were excreted mainly in the urine whether it was given orally or i.v. (73 +/- 4% of dose was recovered in urine after i.v. administration of 1 mg), with very little fecal excretion (3-5%) and some excretion in sweat. Oral bioavailability was 72 +/- 8%. Major metabolic pathways found involved hydroxylation of the cyclohexane and piperidine rings followed by conjugation. Oxidation to an aminopentanoic acid also occurred. PCP and phenylcyclohexene were inhaled when PCP was smoked. For PCP the weighted mean apparent terminal rate constant (beta) was 0.0395 +/- 0.0008 h-1 for 16 subjects, equivalent to a half-life of 17.6 h, but 2 subjects had half-lives of over 2 days. The volume of distribution (Vd, beta) was 6.2 +/- 0.3 liters/kg. At usual urinary pH, PCP excretion represented less than 10% of total clearance, but marked lowering of urinary pH can significantly increase the contribution of renal clearance to overall clearance. PMID- 6852279 TI - Success following vaginal creation for Mullerian agenesis. AB - Eighty-eight women with Mullerian agenesis underwent vaginal dilatation (n = 21) and/or vaginal creation using a modified McIndoe technique (n = 79). Patient and family counseling was considered an essential component of the therapy regimen. An initial trial of vaginal dilatation was successful in 9 of 21 patients (43%). Failure was associated with a prior vaginal exploration in eight women. All of the 79 women experienced satisfactory sexual activity and were satisfied with vaginal depth following vaginal creation using a split thickness graft technique. However, anatomic success, as judged by the surgeon, was noted in 72 patients (91%). Our experience suggests an initial trial of vaginal dilatation coupled with careful instruction and family counseling is appropriate in the motivated patient. However, vaginoplasty using a split thickness graft technique is highly successful and should be offered to those patients unwilling or unable to obtain an adequate neovagina with dilatation. PMID- 6852281 TI - Significance of testicular size measurement in andrology. I. A new orchiometer and its clinical application. AB - When performing a physical examination in the andrology clinic, accurate measurement of testicular size is important. Two methods for measuring testicular size have been developed using calipers for measurement and comparison with plastic testicular models. We have developed a new orchiometer, which consists of a graded series of punched-out elliptical rings with the volume of the ellipsoids indicated on each ring. Testicular sizes measured by our orchiometer had a better correlation with real testicular size determined by water displacement of testes after castration when compared with those data obtained by using calipers. By the use of this orchiometer, the normal range of the adult testicular size was greater than 14 ml in Japan and greater than 17 ml in the United States. This orchiometer is valuable for the rapid and accurate assessment of sexual maturation in children and men. PMID- 6852280 TI - The role of mycoplasmas in reproduction. AB - A study of the incidence of genital tract mycoplasmas in couples attending an infertility clinic and in a group of pregnant women showed that the frequency of isolation was significantly higher in the infertile group (P less than 0.001). In pregnancy, if mycoplasmas were isolated at the first prenatal visit, these organisms were harbored throughout pregnancy. Five percent of the women, however, developed the infection during pregnancy. No relationship was observed of female genital mycoplasmas with prematurity or babies small for gestational age. Treatment with doxycycline (Vibramycin, Pfizer Ltd., Sandwich, Kent, UK) was effective in eradicating mycoplasmas in 91% of couples, but the subsequent pregnancy rates in treated and untreated groups were similar. It appears that mycoplasmas are implicated neither in the etiology of reproductive failure nor in a poor pregnancy outcome. PMID- 6852284 TI - Use of glucagon for hysterosalpingography. PMID- 6852282 TI - Maintenance of pregnancy in rabbits treated with long-lasting progestins. AB - Fertilized eggs from rabbits 1 or 2.5 days after insemination were transferred to the oviduct or uterine horn of recipients that had received a single subcutaneous injection of 20 or 30 mg of one of seven long-acting progestins. The rabbits were observed daily, and the number of implantation sites was determined 10 or 11 days after egg transfer. No implantation sites were recorded in the recipient does treated with progesterone or ZK-5623 (Schering AG, Berlin, West Germany), a nor steroid compound. Thirty-nine percent and 51% of the transferred eggs implanted in the recipient does treated with ZK-5410 (Schering AG) and chloromadinone acetate (Eli Lilly & Company, Indianapolis, IN), respectively. However, most of the pregnant animals aborted 14 to 20 days after egg transfer. The pregnancy was either maintained to term or was prolonged beyond the normal gestation length in the does treated with other compounds, ZK-53915, ZK-9349 (Schering AG) or Depo Provera (Upjohn Company, Kalamazoo, MI). The young delivered after a subcutaneous injection of 17 beta-estradiol and oxytocin were found normal and active. PMID- 6852285 TI - [Role of the amygdala in the evaluation of the biological significance of conditioned stimuli]. AB - Lesions of the amygdala in cats and dogs prevent some animals to respond adequately to signals of different biological significance; the amplitudes and probabilities of EPs appearance in the sensomotor cortex lose their maximums at 0.8 and 1.6 frequencies within the range of 2.0 to 3.0 kHz which are formant ones of some communication signals in cats. Rendering an indifferent stimulus a signal, i. e. food significance, becomes reflected in the amygdala neuronal activity, the amygdala starting to respond to the signal as if it were an unconditioned stimulus. The data obtained are used to discuss the role of amygdala in assessment of conditioned stimuli biological significance as well as in differentiation of incoming afferent influences. PMID- 6852283 TI - The relationship between the lengths of the follicular and luteal phases of the menstrual cycle and the fertility potential of the female. PMID- 6852286 TI - [Role of the suprachiasmatic nuclei of the anterior hypothalamus in regulating the circadian rhythms of rat locomotor activity]. AB - Effect of bilateral lesions of suprachiasmatic nuclei (SCN) of anterior hypothalamus on circadian rhythms of locomotor activity in a treadmill was studied in blinded rats. Immediately after the SCN lesion the free-run circadian rhythm of locomotor activity disappeared: the animals became arrhythmic. Partial lesion of SCN weakened the circadian component of rhythm and led to irregular oscillations within 0.5--3.5 hrs range which put on circadian periodicity. Significance of the anterior hypothalamus SCN in organization of circadian rhythms in rats was discussed. PMID- 6852288 TI - [Synthesis of catecholamines in the nigro-striatal dopaminergic system during food-seeking behavior in rats]. PMID- 6852287 TI - [Mechanism of responses to movement in the visual cortex neurons unresponsive to light flicker]. AB - The responses to moving and stationary stimuli in cat's striate cortical units were studied. Two stationary light bars, one located in the receptive field centre, and another--in the periphery, were used. The sequence of presentation and the time-interval between the stimuli varied thus making the presentation of a pair of stationary bars an analogue of a moving stimulus. Responses occurred in the neurons previously unresponsive to stationary stimuli when two stationary stimuli were presented successively in certain order. A model is proposed explaining the occurrence of responses to moving stimuli in the neurons, unresponsive to stationary ones. PMID- 6852289 TI - [Specificity of the selective sensitivity of electrosensitive neuron membranes to low-frequency sinusoidal stimulation]. AB - A difference in sensitivity of mollusk's neuron to intracellular injection of sinusoidal current (1-10 Hz; 5.10(-10)--5.10(-9) A) was found as well as the complete cessation of activity at certain frequency--amplitude characteristics of the current ("windows" of blocked activity) and an increasing activity at other frequency--amplitude parameters of the current ("windows" of growing activity). This may be due to some properties of the neuron's electrosensitive membrane: the specifics of the voltage--current characteristics, membrane capacity as well as the property known as "force--duration" relationship. The key importance lies in the dependence of the hyperpolarization of the neuron upon the amplitude and the frequency of the sinusoidal irritant. PMID- 6852290 TI - [Electrophysiological characteristics of muscle fibers in cold-adapted rats]. AB - In rats, the membrane APs of single muscle fibers of fast (m. gastrocnemius) and slow (m. soleus) muscles were measured in cold--adapted animals and in a control group. In cold--adapted rats the membrane AP of slow muscle fibers was higher than in the control group, whereas in the fast muscle fibers the AP was decreased. The AP in cold--adapted rats fast muscle fibers was shorter and in the slow muscle fibers longer than in muscles of the control group. The data suggest that the excitation processes are changed in both types of muscles in cold- adapted rats. PMID- 6852291 TI - [Effect of changes in electrolyte composition of the perilymph on endocochlear potentials]. AB - Perfusion of the cochlear perilymphatic space was performed in guinea pigs with complete or partial removal of K+, Na+ or Ca++ from the solution. The most obvious changes of the endocochlear potential occurred in the deficiency of Na+ in the perilymph: i. e., after a short increase the potential steadily diminished in accordance with the degree of Na+ deficit in the perilymph. The deficit of K+ in the perilymph caused a lesser and reversible reduction of the potential. The absence of Ca++ in the perilymph did not affect the potential. PMID- 6852292 TI - [Effect of noradrenaline on skin thermoreceptors]. AB - I. p. administration of noradrenaline augmented the skin cold receptor activity in rats. This response occurred earlier than the rectal temperature rise induced by the noradrenaline. The data obtained suggest an interrelationship between the peripheral thermoreceptors and the sympatho--adrenal system. PMID- 6852293 TI - [Activity of the neurons of the abdominal-aortic plexus in the guinea pig during preservation of its connections with the large intestine]. AB - With intracellular recording, peripheral inputs from the mechanoreceptor C- afferents of the colon which signal the motor status of its isolated oral and aboral segments were shown to converge on neurons of the abdominal aortic plexus of the guinea pig. A proportion (19.8%) of synapthcally activated neurons of this plexus send axons to the periphery within mesenteric nerves, thus forming the efferent link of an extracentral intestio--intestinal reflex. PMID- 6852294 TI - [Mechanism of "autoregulation" of the cerebral circulation: role of neurogenic and myogenic vascular reactions]. AB - The neurogenic and pure myogenic responses of the dog circulatory isolated internal carotid artery were studied under conditions of controlled intraluminal pressure changes. The artery was continuously perfused with the oxygenated bicarbonate Ringer-Krebs solution, and the vascular responses were estimated as changes in the perfusion fluid flow rate recorded with a drop-flowmeter. The quantitative analysis of the vascular responses showed that a comparatively constant perfusion fluid flow independent of the rate of perfusion pressure changes only occurred when the neurogenic control of the artery was preserved. The pure myogenic responses of the artery were only observed in 25% of tests, were four times weaker and present only within the narrow limits and at a specific rate of the intraluminal pressure changes. PMID- 6852295 TI - [Experimental study of the output characteristics of the left heart ventricle]. AB - A method is suggested of evaluating the cardiac internal hydraulic resistance R0 and maximal blood flow at zero post load Q0. R0 in intact dogs is 11.9 mm/Hg/l/min and Q0 is 27.1 l/min. In the condition of acute cardiac insufficiency and under the effect of large adrenaline doses these parameters were, respectively, 8.8 mm Hg/l/min, 7.0 mm Hg/l/min and 36.9 l/min, 38.8 l/min. The reducing of of R0 reflect the reduction of rigidity of the myocardial wall, and the increase of Q0 reflects the increase of the cardiac muscle inotropism connected with the compensatory increase of the catecholamines level in blood. PMID- 6852296 TI - [Effect of partial sympathectomy of the stomach and small intestine on the neurogenic inhibition of gastric secretion]. AB - In acute experiments on dogs, inhibition of the stomach secretion produced by the stimulation of major splanchnic nerves was studied. The extensive postganglionic stomach desympathization failed to eliminate this inhibition whereas the partial postganglionic small intestine denervation decreased it. In neurogenic inhibition of the stomach secretion, sympathetic nerves, apart from their direct effect on the stomach, seem to inhibit the stomach secretion through the inhibitory mechanisms of the small intestine. PMID- 6852297 TI - [Effect of serotonin on the flow of intestinal contents in the proximal region of the ileum in the dog]. AB - In chronic experiments on dogs, the i. v. and s. c. administration of serotonin in different doses changed the speed of contents passage in the proximal part of ileum. I. v. injection of serotonin induced phasic changes of contents passage in the small intestine: stimulation--inhibition--stimulation. No such obvious reactions occurred after s. c. injection of this amine. The duration and intensity of small intestine responses depended on its initial functional state at the moment of injection, dose and the way of drug administration. PMID- 6852298 TI - [Stabilization of the flow rate of perfusion solutions by the means of a floating chamber]. PMID- 6852299 TI - [A precision instrument for determining the osmolar concentration of body fluids]. PMID- 6852300 TI - [Regional distribution of pancreatic polypeptide-like immunoreactivity in the canine brain]. AB - Recently many gut hormones have been found in the brain, and there is some evidence to suggest that pancreatic polypeptide-like immunoreactivity (PP-LI) is also present in the brain. Although in mammals, confirmative evidence is not yet shown. In the present paper we report the distribution and tissue localization of PP-LI in the canine brain by radio-immunoassay (RIA) and immunohistochemistry. Normal, fasted mongrel dogs were used. Brain tissue was extracted by boiling water. High concentrations of PP-LI were found in the pituitary gland (3.67 +/- 1.10 ng/g wet wt), substantia nigra (1.58 +/- 0.36 ng/g wet wt), hypothalamus (0.74 +/- 0.28 ng/g wet wt) and olfactory lobe (0.58 +/- 0.21 ng/g wet wt). PP-LI was not detectable in the frontal lobe, parietal lobe, striatum, thalamus, hippocampus, pons, cerebellum and medulla oblongata. The amounts of PP-LI in the brain were more less than the amounts of PP present in the pancreas (duodenal lobe, 29.3 +/- 1.1 microgram/g wet wt). The dilution curve of the brain tissue extracts showed parallelism with the standard curve of human and porcine PP on the RIA system. On Bio-Gel P-30 column chromatography, PP-LI from the pituitary gland and olfactory lobe eluted as a single peak coincided with highly purified bovine PP. In immunohistochemical study, PP-LI was found in the intermediate lobe and the stalk of the pituitary gland by means of anti-bovine PP antiserum. These findings of the specific regional localization suggest that PP or PP-LI may have a physiological role in the central nervous system. PMID- 6852301 TI - [Erythrocyte insulin receptors from normal and diabetic pregnant women]. AB - Insulin receptors on erythrocytes were studied in normal and diabetic pregnant women to clarify the mechanism of insulin resistance in pregnancy. The assays of insulin receptors were performed according to the method of Kobayashi, which is a slight modification of the method of Gambhir. 125I-insulin binding showed no significant differences between normal pregnant women during the first (n=18), the second (n=15) and the third (n=54) trimesters and nonpregnant controls (n=52). There were also no significant differences between the values before and after delivery (n=8). Reticulocyte counts significantly increased in pregnant women during the second trimester and during the later periods. There was a positive correlation between 125I-insulin binding and reticulocyte counts in late pregnancy. These findings suggest that reticulocyte counts should always be considered in estimating erythrocyte insulin receptors in pregnancy. Then, insulin binding in late pregnant women with reticulocyte counts below 10% (n=20) was studied. The value was slightly decreased as compared to that in the nonpregnant controls, but difference was not significant. 125I-insulin binding in gestational diabetes (n=6) was decreased, but that in overt diabetes (n=4) was not. Patients with overt diabetes had been receiving insulin therapy. Insulin resistance in normal pregnancy cannot be explained by the changes of insulin receptors from this study. It may be due to some post-receptor abnormalities. But decreased insulin binding might be one of the factors that manifest or deteriorate gestational diabetes. PMID- 6852302 TI - Fetal bleeding and bradycardia following diagnostic amniocentesis. PMID- 6852303 TI - Adolescent sexuality: one clinician's reflections. PMID- 6852304 TI - What's new in pulmonary medicine. PMID- 6852305 TI - [Occurrence of contact dermatitis in East Germany and Poland--a comparative study. IV. Skin diseases caused by topical agents]. PMID- 6852306 TI - [Modification of lymphocytic glycocalyx and E-rosette formation with 8-MOP and UVA]. PMID- 6852307 TI - [Effect of Tigason on the membrane of human spermatozoa (Rb+ uptake)]. PMID- 6852308 TI - [Malignant non-Hodgkin lymphoma in the clinical course of Arndt-Gottron scleromyxedema]. PMID- 6852309 TI - [Malignant degeneration of Gottron's carcinoid papillomatosis of the skin in pre existing genital lichen sclerosus et atrophicans]. PMID- 6852310 TI - [Xanthoma disseminatum (Montgomery syndrome). A disease with increased lipid metabolism]. PMID- 6852311 TI - [Familial cases of lupus erythematosus. Results of systematic studies]. PMID- 6852312 TI - [Effect of 5-methoxypsoralen on the phytohemagglutinin-stimulated lymphocyte transformation rate in vitro]. PMID- 6852314 TI - Inflammatory linear verrucous epidermal naevus. Report of a case with bilateral distribution and nail involvement. PMID- 6852315 TI - Coexistence of discoid lupus erythematosus and dermatitis herpetiformis. PMID- 6852317 TI - Electron-microscopic changes in xerosis senilis epidermis. Its abnormal membrane coating granule formation. AB - Skin specimens of patients with xerosis senilis were examined electron microscopically. The changes were as follows: (1) The electron density of the stratum corneum was uniformly low and no keratin pattern was observed in the lowermost cells of the stratum corneum. (2) The number of keratohyalin granules was decreased but their electron density was normal. (3) There were no lamellate membrane-coating granules formed in the cells of the stratum granulosum and there were many small vesicles which were similar in size and shape to membrane-coating granules, but lacked a lamellate internal structure. This abnormal vesicle formation occurred in the epidermis of the same xerosis senilis patients both in winter and summer. This observation indicates that the change in the formation of membrane-coating granules could be an age-dependent disorder of the differentiation of keratinocytes. (4) Being accompanied by an age-related reduction in lipid production, the deficient formation of membrane-coating granules leads to the disappearance of the lipid film which surrounds the stratum corneum cells. This and the reduction in the surface lipid originating in the sebaceous glands could result in an increase in transepidermal water loss leading to the asteatotic scaly stratum corneum seen in the skin of patients with xerosis senilis in winter. PMID- 6852316 TI - Cutaneous leishmaniasis - a few salient revelations. PMID- 6852318 TI - IgE and immune complexes in the serum of patients with urticaria and urticarial vasculitis. PMID- 6852313 TI - Perineal cloacogenic cyst. PMID- 6852319 TI - Buschke-Ollendorf syndrome. An electron microscopic study. AB - Two identical twins with the Buschke-Ollendorf syndrome (dermatofibrosis lenticularis disseminata with osteopoikilosis) are described. Ultrastructurally elastic fibers show clumps of electron-lucent elastin material coated with fine fibrils. The fibroblasts show enlarged endoplasmic reticulum containing abnormal fibrillar material. Juvenile elastoma seems to be a better term than dermatofibrosis. The pathogenesis of the elastic defect is discussed. PMID- 6852321 TI - Age-related severity of male-pattern alopecia. PMID- 6852323 TI - A case of cellulitis generalisata. PMID- 6852320 TI - Selection of the acceptor medium in in vitro measurements of drug release from dermatological ointments. AB - Comparative measurements of in vitro agent release using hydrophilic, intermediate, and lipophilic acceptor phases and in vivo measurements of the blanching effect with triamcinolone acetonide are reported. White petrolatum, wool alcohols ointment, and polyethylene glycol ointment served as donator phases. The results demonstrate that the lipophilic acceptor phase (isopropyl palmitate) is most representative for the in vivo acceptor phase. Conclusions cannot be drawn regarding in vivo effectiveness from measurements of agent release to the hydrophilic (phosphate buffer, pH 6) and intermediate (n-octanol) acceptor phases. In vitro measurements of agent release have a screening character and must usually be supplemented by very elaborate penetration models of the human skin for a definitive evaluation of an ointment. PMID- 6852322 TI - Eccrine nevus with epidermal changes. AB - A 22-year-old woman with papular lesions on the extensor aspect of the left leg, present since childhood, with linear distribution is described. Histology of the lesion showed malformed eccrine sweat apparatus with ductal hyperplasia, in addition to the serrated configuration of the epidermis. It appears that the lesions of the eccrine apparatus in this case represent a nevus. PMID- 6852324 TI - Recurrent pyogenic granuloma with multiple satellites. Clinicopathological and ultrastructural study. PMID- 6852325 TI - Possible dosage regimens for topical steroids, assessed by vasoconstrictor assays using multiple applications. AB - The bioavailabilities and activities of three amcinonide preparations and Betnovate cream were assessed using three multiple-dosage regimen vasoconstrictor assays in 10 volunteers. Applications were made once daily, twice daily and every alternate day with an initial three times daily loading dose applied on the first day only. Blanching responses first increased and then decreased due to tachyphylaxis. It is proposed that clinically the most advantageous dosage regimen is a once daily application with no loading dose. PMID- 6852326 TI - PUVA therapy does not modify arsenic carcinogenesis in psoriatics. PMID- 6852327 TI - Cutis verticis gyrata with metabolic abnormalities. AB - An adult Black South African man with forme fruste pachydermoperiostosis is described. The patient had cutis verticis gyrata, hyperhidrosis, sebaceous plugging and an acneform rash. Basal and dynamic endocrine studies revealed that the hypothalamic, pituitary, thyroid, adrenal, gonadal axes and growth hormone secretion were all normal, but urinary excretion of 17-hydroxy-and corticosteroids, and the prolactin response to thyrotropin-releasing hormone were depressed. Urinary levels of asparagine were markedly elevated and serum levels were subnormal indicating a possible renal leak of this amino acid; glutamic acid and ornithine were present in smaller quantities in the urine. All other tests of proximal and distal renal tubular function were normal. There is no evidence from our studies to suggest a hormonal basis for pachydermoperiostosis. The amino aciduria may be a chance association of, or an (additional) occasional manifestation of the syndrome. PMID- 6852328 TI - Solar urticaria inhibited by visible light. AB - A 25-year-old man with solar urticaria is described. The action spectrum ranged from 400 to 500 nm. An inhibition spectrum was found to be in the visible light range above 660 nm. Simultaneous or alternate exposure to 'blue-violet light' and 'red light' mostly inhibited weal formation. The urticarial reaction was not blocked by local injection of antihistamines and not prevented by histamine depletion with polymyxin B sulfate. These data suggest that histamine may not play a major role in weal production in this case. PMID- 6852330 TI - [Retinoid oral photochemotherapy (RePUVA) as a combination treatment of mycosis fungoides]. PMID- 6852329 TI - HLA system and therapy of psoriasis. AB - In 192 patients with psoriasis an increased frequency of the antigens HLA-B13 (19.79%, X2 = 32.79, p less than 0.001), HLA-B17 (24.47%, X2 = 64,84, p less than 0.001), and HLA-B27 (19.27%, X2 = 11.07, p less than 0.001) in comparison with the control group of 1,085 clinically healthy persons, was established. After 4 weeks of thalassotherapy 3 groups of patients could be distinguished: (1) those with full clinical remission - 50 (26.8%), (2) those with great or moderate improvement - 116 (60.4%), and (3) those with no improvement - 26 patients (13.6%). In the first two groups there is a statistically significant association with the HLA antigens B13 and B17. In the third group (no improvement) there is no such association with HLA-B13 (p less than 0.01). Consequently, patients in whom psoriasis is associated with HLA-B13 were better influenced by the thalassotherapy. The variability in the therapeutic efficiency means that perhaps there is a genetic heterogenicity in the group of common psoriasis. PMID- 6852331 TI - Comparison between plasma levels of 8-methoxypsoralen and skin photosensitivity: the interest of pharmacokinetic studies during photochemotherapy of psoriasis. PMID- 6852332 TI - Serum vitamin A levels and pruritus in patients on hemodialysis. AB - 35 patients attending a hospital dialysis unit were questioned for the presence and severity of pruritus. Attention was given to skin anomalies and loss of hair. In all patients the serum vitamin A level was determined. Although all of them showed an increased serum vitamin A level, no correlation could be found between the vitamin A content and the presence of pruritus. PMID- 6852333 TI - Development of a malignant proliferating trichilemmal cyst in a patient with multiple trichilemmal cysts. AB - A case of multiple trichilemmal cysts is presented. After trauma, a large tumor developed on one of the cysts. The histologic features of this tumor were similar to those of proliferating trichilemmal cyst, but some of the tumor cells showed definite nuclear atypicality. The malignant potential of this tumor was confirmed by later development of metastases to the regional lymph nodes. PMID- 6852334 TI - Crateriform depression--an unusual clinical expression of pitted keratolysis. PMID- 6852335 TI - Hereditary vitreoretinal degenerations. PMID- 6852338 TI - Coronary angiography in diabetic and non-diabetic patients with severe ischaemic heart disease. AB - In this retrospective study, the coronary angiograms of 36 diabetic and 36 non diabetic patients, with severe ischaemic heart disease, were compared. Patient groups were closely matched for age, sex, cardiovascular risk factors, duration and functional disability of angina. Coronary angiograms were assessed by an independent observer without knowledge of the clinical status of the patients, and graded using a coronary score system. Left ventricular function was analyzed using computerized angiographic data. The same percentage of diabetic and non diabetic patients had three-vessel disease. The mean coronary score per patient was similar in the two groups. Diabetic and non-diabetic patients had a statistically similar percentage of diseased vessels considered suitable for coronary bypass surgery. Left ventricular function was similar in the two groups. Thus diabetic patients with symptomatic coronary artery disease should be considered for angiographic evaluation using the same criteria as non-diabetics. PMID- 6852337 TI - Long-term management of insulin-treated diabetic patients with continuous subcutaneous insulin infusion. AB - Ten ambulatory diabetics were submitted to continuous subcutaneous insulin infusion (CSII) for periods of 6-18 months. With the exception of a patient who demonstrated a subcutaneous abscess, local tolerance was good. One patient suffered a severe hypoglycemic attack during the first days of CSII. Among the other subjects, hypoglycemic reactions were rare. However, blood glucose values under 50 mg/dl were recorded as frequently as during the control period. There was a non significant increment in insulin requirements and weight increased in almost all patients. In comparison with prepump period, we observed at the end of the study a significant decrease of mean blood glucose (140 vs 203 mg %), of urinary glucose output (8 vs 21 g/24 hr) and of HbA1 levels (7.6 vs 9.6%). As a rule, the improvement of diabetes control was noted throughout the study period. Nevertheless, normoglycemia was rarely reached. Diabetes stability improved as evidenced by a decrease of the standard deviation of monthly blood glucose values and by a reduction of M and MAGE indexes. In spite of the better metabolic control, we did not observe an improvement of renal function while lipid values were slightly modified. Motor nerve conduction velocities increased in 6 patients and ocular fluoroangiographic records demonstrated a reduction of microaneurysms and/or microhemorrhagic dots. As a group, the patients were satisfied with CSII and 8 of them wished to continue indefinitely with this treatment. PMID- 6852336 TI - Comparison of 5 reflectance meters for capillary blood glucose determination. AB - Manufacturing quality, accuracy and users opinion (i.e. medical and nurses staff and patients) were compared among five Destrostix reading reflectance-meters for home-blood-glucose-monitoring. Two machines (dextrometer and glucometer) equipped with microprocessors, integrated circuits and good quality wiring are best made. Reflectance-meter capillary blood glucose measurements were found to be accurate enough for home-blood-glucose-monitoring, compared to a reference method. However, two machines from the same brand were different in blood glucose accuracy. Glucocheck had poorest results. Users prefer small sized, battery powered machines. Glucometer appears to be best suited to home-blood-glucose monitoring. PMID- 6852340 TI - Epidemiology of diabetes mellitus in an Italian rural community. AB - To evaluate the prevalence of diabetes in a rural community, 589 subjects in Laurino, Southern Italy, were submitted to a 50 g oral glucose tolerance test. Two hours later, blood glucose levels revealed 453 normal subjects, 36 diabetics and 100 borderline subjects. The borderline subjects were re-examined with 75 g OGTT and, according to criteria recommended by the National Diabetes Data Groups (NDDG), 29 subjects were found normal, 35 with impaired glucose tolerance (IGT) and 36 with diabetes. Final figures showed 72 diabetics (12.2%) and 35 IGT cases (5.9%). Obesity appeared strongly related to diabetes (p less than 0.05 in males and p less than 0.01 in females 40 years old and over). Diabetes was more prevalent in subjects with a positive family history (p less than 0.01). No significant difference in number was observed between male and female diabetics, nor between big babies delivered by normal women and big babies by diabetic women. The high diabetes prevalence might be partly explained by the changes created by an industrially-established dietetic influence on the rural communities in Southern Italy. PMID- 6852341 TI - Characteristics of mast cells in Chediak-Higashi mice: light and electron microscopic studies of connective tissue and mucosal mast cells. AB - The beige mouse, a homologue of the Chediak-Higashi syndrome in man, possesses abnormally large granules in many tissue cells. The granules in the mucosal mast cells (MMC) of the small intestine of beige and littermate C57BL/6J mice were examined after infecting the mice with the intestinal parasite, Nippostrongylus brasiliensis. MMC in both beige and littermate mice had irregular granules which contained paracrystalline substructures embedded in an amorphous matrix. Granules were not observed in fusion with the cell membrane. Instead, in late-stage mast cells, the granule membrane broke down, the granule contents were spread throughout the cytoplasm, and the cell organelles disintegrated. Unlike connective tissue mast cells, MMC were poorly demonstrated with formalin fixation and toluidine blue staining. PMID- 6852342 TI - The cell surface sulphydryl content of metastatic variants of B16 murine melanoma. AB - The cell surface sulphydryl content of three metastatic variants of the B16 murine melanoma has been determined using isoelectric equilibrium techniques. The F1 variant, which has no ability for natural metastasis, and the F10 variant with moderate metastatic ability appeared to have no detectable surface thiol groups. The variant BL6, which shows a high degree of natural metastasis, possessed surface thiol groups. The variants were found to be heterogeneous in isoelectric distribution. Three subpopulations were identified based on isoelectric criteria. The size of the pI 5.0 subpopulation appeared to increase with metastatic ability. A proportion of this subpopulation, approximately 4% in the F10 and 10% in the BL6, was found to possess surface thiol groups. In the BL6 line, 10-20% of the pI 4.6 subpopulation possessed surface thiol groups. The surface negative charge density of the cell types showed no correlation with their natural metastatic ability. PMID- 6852344 TI - Discrimination between macrophage-and NK-type tumoricidal activities via anti asialo GM1 antibody. AB - The usefulness of asialo GM1, a glycolipid surface marker, to define the effector cell types involved in tumor resistance in vitro and in vivo was assessed. Pretreatment of rat effector cells with anti-asialo GM1 antibody plus complement in vitro either abrogated or markedly diminished NK activity; in contrast, macrophage-type cytocidal activity was not diminished by such pretreatment. Similarly, systemic inoculation of anti-asialo GM1 antibody selectively eliminated NK activity, leaving macrophage-type tumoricidal reactivity intact. Finally, such pretreatment did not diminish host resistance in an in vivo tumor model in which the available evidence suggests a critical role for macrophages. The asialo GM1 marker may thus be useful in delimitating the tumoricidal capacity of cells exhibiting NK activity from that mediated by other cell types. PMID- 6852343 TI - Mechanisms of lysosomal enzyme secretion by human U-937 monocytes. AB - Lysosomal enzyme secretion was studied in U-937, a mononuclear phagocyte cell line. The secretion of the marker enzyme, beta-N-acetyl-D-glucosaminidase, was low when the cells were challenged with phagocytosable stimuli (asbestos, zymosan, opsonised zymosan). Ammonium chloride and cytochalasin B induced secretion over 24 h of incubation. Phorbol myristate acetate and F-methyl-leucyl phenylalanine, did not have any effect on secretion. It is suggested that U-937 cells may provide a useful model for the study of mononuclear phagocyte secretory pathways. PMID- 6852345 TI - Macrophage-mediated inhibition of melanoma cell growth in nude mice. AB - The effects of macrophages or sera from tumor-transplanted or control syngeneic and allogeneic mice on the latency and growth rate of P51 murine melanoma cells were determined after transplantation into congenitally athymic (nude) mice (tumor neutralization test). Syngeneic macrophages from tumor-bearing mice (TBM) inhibited melanoma growth in the nude mouse more than control macrophages, additionally macrophages from sensitized allogeneic mice inhibited melanoma growth to a greater degree than did allogeneic control macrophages. Sera from TBM inhibited melanoma growth as compared to control cells alone. Macrophages obtained after 14 days were also cytolytic towards the melanoma target in vitro. Despite the growth of large local masses, no evidence of distant metastases was found. The nude mouse thus provides an appropriate model for this tumor to portray in vivo immunotherapy. PMID- 6852339 TI - [Diabetes in private practice. Data of the INSERM national survey on private practice (1974-1975)]. AB - Data from a national survey of private medicine in France were used to estimate the frequency of diabetes in primary care and to analyse both patient characteristics and therapeutic management. An approach was made to 2012 physicians who were requested to complete a questionnaire for each patient they saw during the course of a single day; 1103 responded and completed more than 20000 questionnaires. An additional investigation looked into the nature of the non responders. Diabetics represent 2,2% of patients in private medicine. Each year about 5,5 million consultations in private practice in France are for diabetes alone or for diabetes in association with other illnesses. 89% of diabetic patients are over 45 years of age and more than 48% older than 65. In most cases (80%), diabetes is associated with other medical problems, half of them being consequences of diabetes (cardio-vascular diseases, ocular and renal diseases). In 85% of cases, diabetics receive their basic care from a general practitioner. Therapeutic management is based mainly on drugs; diet or advice about life style are mentioned in barely one third of cases. Using linkage with social security data, it was possible to make a crude estimate of the number of diabetics in France. It was estimated at about 1 million for 52,6 million inhabitants. PMID- 6852347 TI - Histone H1 and chromatin higher order structure. Does histone H1 exhibit specific self-association? AB - 1. Histones H1 and H5 in chromatin and in free solution can be cross-linked to higher multimers. Is this due to a specific protein/protein interaction? If so, this interaction might be the structural basis of the condensation of the chromosomal nucleofilament, known to be mediated by histones H1 and H5. 2. Since only the central domain of H1 and H5 exhibits tertiary folding and globular structure, this is the most likely site of specific interaction. 3. Formaldehyde has been used to test whether the central domains of histone H1 from calf thymus or from sea urchin sperm or histone H5 from chicken erythrocytes self-interact. 4. The cross-linking shown by each globular peptide was compared with that of its parent histone. 5. In all three cases the peptide cross-linked to a much lower extent than its intact parent histone and the observed cross-linked rates were roughly in proportion to the relative number of lysine residues parent histone and peptide. 6. It is concluded that there is no specific self-interaction between the globular domains of either H1 or H5 molecules in free solution. 7. This result suggests that specific H1/H1 protein/protein interactions are not the basic cause of chromatin condensation. PMID- 6852348 TI - Beef liver glutamate dehydrogenase: a study of the oxidation of various alternative amino acid substrates retaining the correct spacing of the two carboxylate groups. AB - 1. Several glutamate analogues substituted at the beta- or gamma-carbon atoms have been tested as substrates for glutamate dehydrogenase. 2. The two gamma methyl derivatives and DL-beta-methylglutamate give the same pH optimum (8.7) as L-glutamate, but show inhibition by ADP and activation by GTP as pH 8, unlike glutamate and like the monocarboxylic substrate L-norvaline, which gives a pH optimum of 10. 3. L-gamma-methyleneglutamate, the poorest substrate tested (0.28% of rate with glutamate) gives a high pH optimum (10), like norvaline, but shows marked activation by both ADP (13-fold) and GTP (27-fold). 4. Despite the correct dicarboxylate spacing, all the analogues were much poorer substrates than L norvaline. PMID- 6852346 TI - Light microscopy investigation of the action of the unsaponifiable residue of vegetable oils on rat periodontal disease induced by a high carbohydrate diet. AB - Rats, submitted to a sucrose diet for 12 months, were normally fed for another 6 months either with or without addition of the unsaponifiable residue of vegetable oils. It appears that unsaponifiable substances reinforce the collagen fiber network of the periodontium. The presence of a dense supracristal barrier accounts for the lack of an infraosseous pocket and for the limitation of bone resorption despite the high level of the sucrose diet. PMID- 6852349 TI - Purification and properties of sorbitol dehydrogenase from mouse liver. AB - 1. The sorbitol dehydrogenase (L-iditol: NAD oxidoreductase, EC 1.1.1.14) from mouse liver has been purified to homogeneity. 2. The enzyme has a mol. wt of 140,000 and is composed of four identical subunits of mol. wt 35,000. 3. the purified enzyme catalyses both sorbitol oxidation and fructose reduction. 4. It is specific for NAD+ (NADH) and does not function with NADP+ (NADPH). 5. The Michaelis constants for sorbitol, fructose, NAD+ and NADPH are 1.54 and 154 mM, 58.8 and 15 microM, respectively. 6. The enzyme is SH-group reagent sensitive and is strongly inhibited by 1,10-phenanthroline. PMID- 6852350 TI - Increased fraction of acid-soluble proteins in 0.35 M NaCl extracts of nuclei from rat liver tumors. AB - 1. The fraction of proteins extracted from nuclei with 0.35 M NaCl and soluble in 2% trichloroacetic acid was examined in five Morris hepatomas and rat liver. 2. This fraction was a much greater percentage of the total 0.35 M NaCl soluble proteins in the tumors than in normal or regenerating liver. 3. In part, this difference was due to proteins with molecular weights greater than high mobility group proteins. 4. The conditions for precipitation of high mobility group proteins 1 and 2 with trichloroacetic acid were found to differ in hepatoma and liver fractions. PMID- 6852352 TI - Kinetic mechanism of the molecular forms of chicken liver mitochondrial malate dehydrogenase. AB - 1. The reaction kinetic mechanism (pH 7.4) of the molecular forms of chicken liver m-MDH is of the order bi-bi ternary complex type with the existence of the E-oxaloacetate, E-L-malate, E-NAD+-oxaloacetate, E-NADH-L-malate, E-NAD+-NADH, E NAD+-NAD+, E-NADH-NAD+ and E-NAD-NADH abortive complexes. 2. The saturating concentration values of the substrates are notably modified, in certain cases, in the presence of the reaction products. PMID- 6852351 TI - Hepatic mitochondrial fatty acid oxidation during the perinatal period in the rat. AB - 1. The activity of hepatic mitochondrial carnitine acyltransferase I increases rapidly after birth, is high during the suckling period and falls after weaning. In contrast, carnitine acyltransferase II and acyl-CpA dehydrogenase exhibit few developmental changes. 2. These and previous studies indicate that outer mitochondrial membrane acyl-CoA synthetase and inner membrane carnitine acyltransferase I increase in activity after birth much more rapidly than to any other enzymes of fatty acid oxidation. 3. Studies of the 18 hr after caesarian delivery indicate that whereas the major increase in the activity of acyl-CoA synthetase occurs within 3 hr of birth the change in carnitine acyltransferase I activity is less rapid. 4. Prolonged pregnancy, starvation of the mother or feeding the mother a high polyunsaturated fat content diet resulted in increased activities of acyl-CoA synthetase and carnitine acyltransferase I in the fetal liver. PMID- 6852353 TI - The DNA extruded by rat spleen cells in culture. AB - 1. Part of the DNA extruded by cultured rat spleen cells occurs in the form of a low density lipid complex. 2. The present work indicates that this complex is also associated with protein but not with RNA and its elementary properties have been studied. 3. For example, it is destroyed by freezing and thawing or by deoxycholate treatment and small quantities of copper salts added to the medium may either inhibit or stimulate its release depending on the conditions. PMID- 6852354 TI - Evidence for a biologically active, carrier-bound form of non-suppressible insulin-like activity (NSILA) in human serum. AB - 1. Quantitative gel filtration of Cohn fraction IV-1 has shown that high MW NSILA recovered under "neutral" conditions (pH 5.5) was greater in magnitude (approximately X 2) than acid-stable high MW NSILA obtained under acid conditions. 2. Recombination, at neutral poH, of high and low MW NSILA, obtained by previous acid gel filtration, gave quantitative recovery of activity which was solely of high MW. 3. These data indicate that a biologically active, and dissociable high MW form of NSILA exists in serum. 4. Con A-Sepharose affinity chromatography gave one unbound NSILA fraction and two bound fractions, which both gave high and low MW activity after acid chromatography. 5. This study provides the first evidence for a carrier-bound form of low MW NSILA which retains biological activity. PMID- 6852358 TI - Effects of allopurinol (Zyloric) in patients with long-term indwelling urethral catheters. PMID- 6852355 TI - Effect of D-glucosamine on the content and synthesis of UDP-sugars and plasma membrane associated carbohydrates in chicken liver and hepatoma Mc-29. AB - 1. Comparative studies on the effect of D-glucosamine on the synthesis of UDP sugars and on the incorporation rate of [14C]glucose into neutral sugars, sialic acid and glucosamine isolated from chicken liver and hepatoma Mc-29 plasma membranes have been carried out. 2. The influence of D-glucosamine on the activity of microsomal UDP-N-acetylglucosamine: glycoprotein N acetylglucosaminyltransferase to lipid (dolichol monophosphate) and to protein acceptor was studied too. 3. It has been shown that D-glucosamine provokes alterations in the content and synthesis of UDP-sugars and it is an inhibitor of the glycosylation processes. An inhibitory effect of this sugar analog on the N acetylglycosaminyltransferase has been established. PMID- 6852356 TI - Experimental evidence for biosynthesis of steroids in metastatic tissue originating from a primitive adrenocortical carcinoma. AB - 1. Cortisol, cortisone, 11-deoxycortisol and deoxycorticosterone were synthesized in large amounts in vitro by a metastatic tissue from an adrenocortical carcinoma. 2. Both 11 beta- and 21-hydroxylase were very active. 3. A secreting metastasis can be thus responsible for a biological relapse. 4. A metastasis originating from another secreting adrenocortical carcinoma was found to be non secreting. PMID- 6852359 TI - Treatment of constipation with chenodeoxycholic acid. AB - The aim of this study was to investigate whether the cathartic effect of chenodeoxycholic acid (CDCA) could be helpful in the management of chronic constipation. Twenty cholesterol gall-stone patients with chronic constipation were randomly treated with either CDCA (750 mg/day in three divided doses at meals) or placebo for a period of 4 weeks. The administration of CDCA produced a significant increase of stool frequency and a decrease of stool consistency, while placebo was not effective in improving the bowel habit of the patients. As some patients complained of diarrhoea, and some had no modification of bowel frequency, further studies are needed to determine the most appropriate dose for each patient. PMID- 6852357 TI - Effect of salicylic acid on the activity of betamethasone-17,21-dipropionate in the treatment of erythematous squamous dermatoses. AB - Forty adult out-patients with erythematous squamous dermatoses of the scalp were treated in this 21-day double-blind study with an alcohol base lotion containing either 0.05% betamethasone-17,21-dipropionate, 2% salicylic acid, 0.05% betamethasone-17,21-dipropionate + 2% salicylic acid or their respective placebo. The four treatments were assigned randomly to the patients according to a 2 x 2 orthogonal factorial design. Changes in severity of redness, scaling, pruritus and size of lesions were evaluated. Since very few patients presented with excoriation and lichenification, these symptoms could not be ascertained. Results were assessed for significance by covariance analysis where initial status was used as regressor. A potentiation of the betamethasone-17,21-dipropionate activity by salicylic acid was observed for scaling. An additive effect was noted for redness and pruritus. According to the physician's global evaluation, patients treated with the combination drug showed a better evolution than those treated with placebo. The results suggest that addition of a keratolytic agent enhances the corticosteroid effect in the treatment of erythematous squamous dermatoses. PMID- 6852361 TI - Dextromethorphan and codeine: objective assessment of antitussive activity in patients with chronic cough. AB - Dextromethorphan, the most widely used cough suppressant in the U.S.A., was compared with codeine, the traditional European antitussive, in a double-blind, crossover trial using both an objective and subjective assessment of efficacy in sixteen patients with chronic, stable cough. Both preparations, at a dose of 20 mg, were similarly effective in reducing cough frequency. Dextromethorphan lowered cough intensity to a greater degree than codeine (p less than 0.0008) and was considered the better antitussive by the majority of patients (p less than 0.001). In view of its lack of side-effects, its safety even in overdose and its non-narcotic status, the increasing trend in Europe to use dextromethorphan as a substitute for codeine in the treatment of cough is to be welcomed. PMID- 6852360 TI - Treatment of chronic constipation by a bulk-forming laxative (Fibrolax). AB - Seventy-five patients affected by chronic constipation were treated for 4 weeks with an Ispaghula Husk preparation (Fibrolax), a bulk-forming laxative. Frequency, stool consistency, abdominal pain and signs of venous stasis improved after treatment. No important side-effect was recorded. Cholesterol, HDL cholesterol and triglycerides did not show significant changes. PMID- 6852364 TI - Aqueous two-phase partition studies of glucocorticoid receptors exposed to limited trypsination. AB - In a previous investigation the properties of glucocorticoid receptors exposed to partial proteolysis by chymotrypsin were studied by aqueous two-phase partitioning (Andreasen, P.A. and Gehring, U. (1981) Eur. J. Biochem. 120, 443 449). This paper describes studies of the properties of cytosolic glucocorticoid receptors submitted to limited trypsination, employing phase partitioning of rat thymocyte cytosol labelled with tritiated triamcinolone acetonide. Trypsin treatment of labelled cytosol at 0 degrees C does not result in any dissociation of steroid from the receptor. The partition properties of the trypsin-treated receptors exposed to receptor-activating conditions are indistinguishable from those of the activated native and chymotrypsin-treated receptors, although the trypsin-treated receptors have lost the affinity for DNA and dextran sulphate. Trypsin treatment of cytosol not exposed to receptor-activating conditions results in a rapid change in the receptor partition coefficients identical to that following chymotrypsin treatment. However, during incubations under conditions at which activation of native and chymotrypsin-treated receptors is very slow, the trypsin-treated receptor is converted to a form with partition properties indistinguishable from those of the activated receptors. During exposure of the cytosol to activating conditions, the time-course of the partition coefficient of the trypsin-treated receptors is only slightly different from that of the native and chymotrypsin-treated receptors, but the trypsin treated receptors are far less susceptible to the activation inhibitors ATP, Li+ and MoO42-. We conclude that the proteolytic cleavages induced by trypsin in the non-activated receptor do not lead to any immediate changes in the charge and surface properties of the receptor different from those following chymotrypsin treatment, but that the trypsin-treated receptor is not able to maintain a non activated state and a normal susceptibility to activation inhibitors. PMID- 6852363 TI - DNA fragmentation in S49 lymphoma cells killed with glucocorticoids and other agents. AB - The effects of glucocorticoids on DNA integrity in the mouse S49 lymphoma cell line were assessed. DNA cleavage at the internucleosomal regions was observed, and this response was correlated to the dose of hormone used and the time of treatment. Also, an apparent steroid specificity was observed: internucleosomal cleavage was associated only with treatment of the cells with glucocorticoids. Cells treated with dibutyryl cyclic AMP (which also causes lymphocytolysis) also exhibited DNA cleavage. However, when cells were killed with various DNA synthesis inhibitors and other lethal agents, the same DNA cleavage pattern was observed. Furthermore, new protein synthesis did not seem to be required, since cells killed with puromycin and cycloheximide also exhibited internucleosomal DNA fragmentation. Although DNA fragmentation may not be a specific early effect of glucocorticoid-mediated lymphocytolysis, it may be the final, irrevocable step in this complex process. PMID- 6852362 TI - Effect of prolactin, testosterone and estrogen on prolactin binding in the rat testis, prostate, seminal vesicle and liver. AB - We have studied the hormonal control of prolactin (PRL) binding in the male rat sex glands and liver, subsequent to the recent demonstration and characterization of specific PRL binding sites in rat testis, prostate and seminal vesicle. Ovine PRL (200 micrograms/rat/day, 7 days) caused a time-dependent reduction in testicular binding of 125I-labelled PRL (measured 2 days after last injection) to 58% of control. Testosterone alone (1 mg/rat/day, 7 days) or PRL caused similar reductions in binding, while their coadministration further lowered PRL binding to 10% of control. The synergism of PRL and testosterone suggests that either these doses are submaximal, or that they are acting on different systems. Estradiol was administered as a single dose of 2 mg/rat and the PRL binding determined on day 10 and day 19 was reduced to 37% of control, as after testosterone. Addition of PRL whether from day 1 to day 7 or from day 11 to day 17 of estradiol injection had no effect, suggesting that the EB site of action is closer to the PRL receptor than that for PRL or testosterone. Estradiol resulted in a 72% reduction of PRL binding in the prostate, after 10 days, which subsequent PRL completely restored. PRL also partially restored the estradiol induced time-dependent weight reduction of the prostate, but PRL coadministered from day 1 of estradiol did not inhibit the estradiol effects, suggesting a competitive mechanism for the two. While testosterone more than doubled PRL binding in the seminal vesicle, estradiol reduced it by 32% and organ weight by 21%. PRL given after estradiol restored the weight loss, but not the binding, suggesting that two different mechanisms of action are involved. In the liver, coadministration of testosterone with PRL could not inhibit the induction by PRL of its own hepatic sites, in keeping with a more direct site of action for PRL than for testosterone. These results demonstrate the profound effects of PRL, and of the sex steroids testosterone and estrogen, on PRL binding in the male sex glands and liver. The physiological implication of these findings on the role of PRL in male sexual function is currently being investigated. PMID- 6852366 TI - Mammary ductal elongation: differentiation of myoepithelium and basal lamina during branching morphogenesis. AB - Elongation of mammary ducts in the immature mouse takes place as a result of rapid growth in end buds. These structures proliferate at the apex of elongating ducts and are responsible for penetration of the surrounding adipose stroma; by turning and branching, end buds give rise to the characteristic open pattern of the mammary ductal tree. We have used a variety of techniques to determine the cellular and structural basis for certain of these end bud activities, and now report the following. (1) The end bud tip is covered with a monolayer of epithelium, the "cap cells," which are characterized by a relative lack of intercellular junctions and other specialized features. (2) The cap cell layer extends along the end bud flank and neck regions where it is continuous with the myoepithelium which surrounds the subtending mature duct. A linear sequence of differentiative changes occur in the cap cells in this region as they progressively alter in shape and accumulate the cytological features of mature myoepithelium. Cap cells may therefore be defined as a stem cell population providing new myoepithelial cells for ductal morphogenesis and elongation. (3) Differentiation of cap cells into myoepithelium is associated with conspicuous changes in the basal lamina. At the tip, cap cells form a 104-nm lamina similar to that described in expanding mammary alveoli and in embryonic tissues. Along the end bud flanks the basal lamina is raised from the cell surface and extensively folded, resulting in a greatly thickened lamina, measuring as much as 1.4 microns. At the surface of the subtending ducts the lamina becomes structurally simplified and resembles that at the tip, but has a significantly greater thickness, averaging 130 nm. (4) The codifferentiation of myoepithelium and its basement membrane is associated with changes in the surrounding stroma. Undifferentiated mesenchymal-like cells attach to the surface of the basal lamina in the midportion of the end buds and become increasingly numerous in the neck region, forming a monolayer over the myoepithelial basal lamina. These stromal cells progressively differentiated into fibrocytes which participate in collagen fibrillogenesis and give rise to the fibrous components of the stroma surrounding the mature duct. PMID- 6852365 TI - Target influences on [3H]ACh synthesis and release by ciliary ganglion neurons in vitro. AB - The developmental influence of neuron-target interaction upon transmitter synthesis from labeled precursor and the capacity to release labeled transmitter were examined in dispersed cell cultures of embryonic ciliary ganglion neurons by comparing cultures of neurons plated alone and neurons plated upon pectoral myotubes. Of the total ACh synthesized from radiolabeled choline by neurons plated alone, more than half is via a Na+-dependent path, but a larger fraction of the synthesis is Na+ insensitive in culture than in mature neurons in vivo. In addition, at 1 week in culture the neurons lacking target failed to significantly increase ACh synthesis from the labeled choline in response to a previous high [K+]0 depolarization. Synthetic responsiveness to depolarization is a characteristic of mature nerve terminals in this preparation. One week after plating neurons onto myotube cultures, synthesis of ACh from the exogenous precursor is double that of sibling cultures lacking muscle, and prior depolarization with [K+]0 results in an increase in labeled product. Release from the labeled transmitter pool by the neurons with myotubes was also enhanced. [3H]ACh release elicited by depolarization via a Ca2+-dependent mechanism was more than fivefold higher in the cocultures. The influence of coculture with myotubes upon neuronal development is not duplicated by the neurons themselves despite formation of apparent interneuronal synapses (G. Crean, G. Pilar, J. Tuttle, and K. Vaca, 1982, J. Physiol. (London). 331, 87-104), by "fibroblasts" or medium conditioned over myotube cultures. Neurons under these conditions neither increase synthesis of [3H]ACh in response to a prior depolarization nor demonstrate enhanced basal [3H]ACh synthesis and release. Thus, coculture of embryonic ciliary ganglion neurons with a striated muscle target has a somewhat specific inductive effect, enhancing the capacity for neuronal [3H]ACh synthesis and release toward mature levels. This influence of a readily accessible target upon ciliary neuron cholinergic development in vitro may reflect a normal neuromuscular interaction occurring during embryogenesis. PMID- 6852367 TI - Intracellular pH plays a role in regulating protein synthesis in Xenopus oocytes. AB - Full-grown Xenopus oocytes undergo meiotic maturation in response to progesterone stimulation. Using [14C]dimethyloxazolidine dione (DMO), we have measured a cytoplasmic alkalization in these oocytes starting at pH 7.14 +/- 0.17 during the germinal vesicle (GV) stage, and increasing to 7.56 +/- 0.14 at the time of germinal vesicle breakdown (GVBD). During this period, the rate of protein synthesis increases 2-fold from 18.9 +/- 3.1 to 37.7 +/- 8.8 ng/hr/oocyte. Artificial alkalization of GV stage oocytes to pHi 7.68 +/- 0.16, by exposure to the weak bases trimethylamine, methylamine, procaine, or imidazole, led to a 1.8 fold increase in the synthetic rate. Intracellular acidification from 7.5 back to 7.0 had no apparent effect on the elevated rate of protein synthesis following GVBD. Therefore, a cytoplasmic alkalization in the range of 7.5 to 7.6 seems to be one of the events that is necessary for initiating the increase in protein synthesis in maturing Xenopus oocytes; however, it does not appear that an elevated pHi is necessary to maintain the increased synthetic rate following GVBD. PMID- 6852368 TI - Developmental and sex-dependent regulation of storage protein synthesis in the silkworm, Bombyx mori. AB - The mechanism of sex-dependent expression of a major plasma protein, referred to as storage protein 1 (SP-1) was studied during development of the silkworm, Bombyx mori. SP-1 occurred in the hemolymph of the female as well as in the male larvae until the end of the fourth larval instar. In the last instar larvae, the amount of SP-1 in the hemolymph greatly increased in females, but markedly declined in males. The level of fat body mRNA for SP-1 reflected the developmental and sex-dependent changes in the hemolymph concentration of SP-1. The developmental patterns of hemolymph proteins in the third and the fourth instar larvae of sex-mosaic individuals were quite analogous to those observed in normal larvae at the same developmental stages. The hemolymph concentration of SP 1 at the last larval instar of the sex mosaics varied among individuals irrespective of the gonad compositions. In vitro culture of the fat body cells dissected from several locations of a sex-mosaic larva provided evidence that each fat body cell in a common hemolymph milieu synthesizes a high (female type) or a low (male type) level of SP-1 depending on the sex chromosome composition. The amount of vitellogenin in the hemolymph of the sex-mosaic pupae was in proportion to that of SP-1 at the last larval instar. From these results, it is suggested that the sex-dependent expression of SP-1 and vitellogenin in B. mori is genetically determined and developmentally regulated without participation of the reproductive organs or any sex-specific humoral factors. PMID- 6852369 TI - The establishment of vascular-derived microenvironments in the developing chick wing. AB - The results of previous studies on the temporal sequence of limb vascularization suggest that the prospective myogenic and chondrogenic areas of the mesoderm are distinguished by a differential vascularization pattern prior to the overt expression of muscle- and cartilage-specific phenotypes. The experiments presented here are designed to reveal the dynamic aspects of vascular flow in the limb by the observation of how an inert, particular tracer (india ink) is mobilized and dispersed at specific points in the mesoderm. Data are presented as a temporal sequence of fluid flow "maps" which detail both the rate and the direction of vascular flow in the limb. It is proposed that not only does the vasculature compartmentalize the mesoderm into prospective myogenic and chondrogenic zones but also that these broad areas are subcompartmentalized into discrete microenvironments that are spatially distinct with regard to their capacity for transporting the carbon particles. The developmental significance of this observation may be that limb mesodermal cells are granted precise, "positional" information in the form of the specific nutrient and oxygen levels they encounter during critical, or decisional, phases of morphogenesis. PMID- 6852371 TI - Developmental variations of a nonfibroin mRNA of Bombyx mori silkgland, encoding for a low-molecular-weight silk protein. AB - The characterization of a new silk protein mRNA (P25 mRNA) in posterior silkgland cells (PSG) and the developmental variations of its cell molecular concentration versus that of fibroin mRNA are described. A 80% pure P25 cDNA was obtained by class separation of total nonfibroin cDNA from PSG and used to identify the mRNA in blotted PSG mRNA as a single 1100 nucleotide long species. When purified from agarose gel and translated in a reticulocyte cell-free system, P25 mRNA yielded a 25-kD polypeptide (P25), identical to a 25-kD protein of the cocoon in terms of pI value and partial peptide mapping pattern. Moreover, this protein comigrated with an abundant polypeptide of the posterior silkgland (PSG) and of the middle silkgland (MSG). When tritiated leucine was injected in vivo, labeled P25 showed up in the PSG after a 2-hr pulse but appeared in the MSG only after 24 hr of labeling. Since MSG cells were found to be devoid of P25 mRNA, we concluded that P25 is exclusively synthesized in the PSG, that it accumulates in the MSG lumen and that it is spun out in the same way as fibroin. Specific probes were used to measure the concentrations of P25 mRNA and also fibroin mRNA in PSG total RNA by hybridization with an excess of cDNA. Both species are highly degraded in the few hours following the physiological arrest of feeding which precedes the fourth molting period. Their subsequent accumulation during the fifth intermolt is triggered by food uptake and proceeds in such a way that a constant 1:1 molar ratio is maintained during the period of silk secretion. PMID- 6852370 TI - Structural alterations in fibronectin correlated with morphological changes in smooth muscle cells. AB - Nontransformed cultures of vascular smooth muscle cells proliferate until they form a confluent sheet of cells. Subsequently, the cells become reorganized to form multicellular nodules that are loosely attached to the substrate. The formation of nodules is facilitated by the addition of medium conditioned by nodular cultures. Nodulation is inhibited by the addition of fibronectin. Fibronectins derived from monolayer culture conditioned medium or from plasma are maximally effective while fibronectin isolated from nodular cell conditioned medium is inactive. Analysis by NaDodSO4-polyacrylamide gel electrophoresis reveals that the nodular cell fibronectin has a molecular weight that is about 20 30 kd less than that of monolayer cell fibronectin. Further, nodular cell conditioned medium contains an activity that can convert both plasma fibronectin and monolayer cell fibronectin to the lower molecular weight correlated with the loss of biological activity. PMID- 6852372 TI - Specific attachment of collagen to cardiac myocytes: in vivo and in vitro. AB - The formation and attachment of collagen to the sarcolemma of cardiac myocytes were examined in vivo in neonatal rats and hamsters and in vitro in cultures of neonatal rat myocytes. Scanning, transmission, and high-voltage electron microscopy were used to show that the collagen struts attach to specific sites on the sarcolemma just lateral to the Z band of neonatal animals. In vitro, collagen preferentially attaches to distal end of myocytes at a site where internal stress fibers also attach to the sarcolemma. Formation of the collagen struts appeared to be a multistep process involving several components of the extracellular matrix. The role of the collagen struts is involved in the distribution of force generated by muscle contraction. PMID- 6852373 TI - Does anterior (non-polarizing region) tissue signal in the developing chick limb? AB - The morphogenetic properties of embryonic chick limb bud tissue from anterior positions and from the posterior (polarizing) region are compared. Quail grafts, which possess the distinctive nucleolar cell marker, and gamma-irradiation are used. Supernumerary limb structures induced by anterior tissue wedge grafts are found to be nearly exclusively graft, donor tissue derived. This contrasts with the duplicate limb structures formed in response to posterior (polarizing region) tissue grafts in which host cells predominate. Distinction between anterior and posterior tissue properties was also demonstrated using doses of radiation (approximately 12 Gy = 1200 rad) which inhibit cell proliferation, but have negligible effects on avian polarizing activity. These doses, however, are found to completely abolish morphogenetic activity by chick or quail anterior tissue grafts. The results of anterior (non-polarizing) region tissue grafts are best interpreted as graft self-differentiation under the influence of a posterior signalling region, whose properties in the limb bud are demonstrably unique. PMID- 6852374 TI - Neural crest origin of cardiac ganglion cells in the chick embryo: identification and extirpation. AB - Using interspecific grafting of neural crest between quail and chick embryos, it was determined that the cardiac ganglia originate from the cranial region (somites 1-2) of the vagal neural crest (somites 1-7). Neuronal uptake of [3H]choline was used as an index of neuronal development in the chick atrium. Normal uptake was found to be quite high between Days 8 and 14 of incubation. Following extirpation of neural crest over somites 1 to 3 at stages 8 to 10, neuronal uptake in 8-day chick atrium was decreased by 25-60% depending on the stage at which the lesion was performed. It is thought that the residual uptake represents preganglionic terminals from the dorsal motor nucleus of the vagus. Embryos with extirpations of neural crest over somites 1-3 performed at stage 9 showed the greatest decrease of neuronal choline uptake and did not live beyond 11 days of incubation. However, hearts from embryos with partial lesions (performed at stage 10) were treated on incubation Days 12 and 15 for demonstration of acetylcholinesterase in the subepicardial plexus. These hearts showed much less extensive neural plexus with sparse, small cardiac ganglia. PMID- 6852375 TI - Computer simulation of organogenesis: an approach to the analysis of shape changes in epithelial organs. AB - Embryonic development of epithelial organ primordia often involves changes in several parameters, such as cell height, cell width, cell volume, amount of extracellular space, and cell number. Since these changes often occur simultaneously, it becomes difficult to "separate out" the role that each plays in the developmental process. A computer program has been written that allows the shape of epithelial organs to be reproduced based upon measurements of the primordium. A developmental sequence can be simulated by changing the dimensions of the primordium based upon either measurements of the developmental stages or theoretical projections of changes. The primordium is divided into blocks representing groups of cells, based upon characteristics of the different cell groups. The program allows differences in cell height and circular and spiral curvatures of the primordium to be simulated. Analysis of the optic primordium using this method has allowed recognition of several regional changes during optic cup formation. These are sequential constriction of cell apices at the margin of the optic cup, expansion of the apical surface toward the center of the retinal disc, and spreading of the future pigmented layer. Simulation of other organs permits regions of morphogenetic activity to be identified. PMID- 6852377 TI - Sensory receptor differentiation and axonal pathfinding in the cercus of the grasshopper embryo. AB - An immunological probe selective for insect neurons (L.Y. Jan and Y.N. Jan, 1982, Proc. Nat. Acad. Sci. USA 79, 2700-2704) was used to characterize the genesis of sensory neurons and the formation of the peripheral nerves in the grasshopper cercus. During embryogenesis the cercal ectoderm produces a characteristic set of sensory neurons in a precise spatiotemporal order. The first neurons migrate from the epidermis into the lumen and send out axons toward the CNS along the epidermal wall. These luminal neurons arise in four distinct groups, each of which establishes a separate branch of the cercal nerve, with the axons of the three distal groups converging onto the cell bodies of the more proximal neurons and thus seeming to use them as an intermediate target on route to the CNS. Epidermal neurons, whose cell bodies remain within the epithelium, begin to appear at a later stage. These cells come to innervate external sensory hairs, and in general their axons grow to the CNS along the preexisting nerves. Each sensory hair possesses two nonneuronal cells--the trichogen (shaft-forming) and tormogen (socket-forming) cells--which also stain with the antibody and begin to display immunoreactivity at the same time as the allied sensory neuron. The trichogen and tormogen cells do not form the hair shaft and socket until much later, with outgrowth occurring in an order quite distinct from that in which the receptors undertook their initial, biochemical differentiation. Thus, these two aspects of trichogen/tormogen differentiation appear to be under separate developmental control. PMID- 6852376 TI - Ionic dependence and transmission of epidermal action potentials in a newt embryo. AB - The ionic dependency and transmission of epidermal action potentials have been examined from tailbud to hatching stages of newt embryos. Previously we have reported that the epidermal action potential is composed of a fast- and slow action component; only the slow-action component, however, is transmitted to other cells. We address in this report the mechanism by which these responses are mediated. The slow-action potential is not produced in Na+-free saline, tricaine saline, or following the application of TTX, and thus appears to be Na+ dependent. The fast-action potential on the other hand is blocked by application of Co2+ and verapamil saline and thus appears to be Ca2+ dependent. The slow action potentials appear to be chemically transmitted since they are transmitted even to those cells which are electrically uncoupled at low intracellular pH (NaHCO3 + HCl, pH 6.2). Furthermore 1 microM curare and atropine are inhibitory to transmission of the slow potential. Epidermal cells of the newt embryo are sensitive to acetylcholine (ACh) applied by hydrostatic ejection through a micropipet. The latter observation further suggests that propagation of the slow action potential is, in part, a chemical event. PMID- 6852379 TI - Child abuse and cerebral palsy. PMID- 6852380 TI - Child abuse in a cerebral-palsied population. PMID- 6852378 TI - Infection of mouse teratocarcinoma stem cells with influenza virus: normal expression of proteins derived from spliced messenger RNAs. AB - Mouse teratocarcinoma stem cells before and after induction of differentiation have been infected with influenza virus. This virus is able to infect the cells irrespective of the state of differentiation. In addition, viral-encoded proteins that are known to be translated from spliced messenger RNAs are produced in normal amounts in the infected cells, and this expression is also independent of differentiation. These results indicate that both the stem cells and their differentiated progeny can efficiently splice the precursor RNAs for these influenza virus messengers. PMID- 6852381 TI - Electromyographic investigation of extensor activity in cerebral-palsied children in different seating positions. AB - This study was designed to determine whether tonic myoelectric activity of low back extensors of spastic cerebral-palsied children changed in response to changes in seating position, and if so, which position was coincident with the least extensor activity. Using two pairs of surface electrodes, the electrical activity of the lumbar erector spinae muscles was monitored in seven combinations of backrest inclinations (75 degrees, 90 degrees, 105 degrees and 120 degrees) and seat surface elevations (0 degrees and 15 degrees). Off-line analysis of action potential counts per second of recorded electromyographic signals showed that electrical activity was least when the seat surface elevation was 0 degrees and the backrest inclination 75 degrees. The results showed that differences existed in the activity of the low-back extensors in the seating positions that were assessed. PMID- 6852382 TI - Energy cost of walking in normal children and teenagers. AB - Oxygen consumption during free level walking was determined in 114 children and teenaged subjects between the ages of 6 and 19 years and compared with a group of 47 normal adults. Subjects were divided into two age groups: children (6-12 years) and adolescents (13-19 years). The mean rate of oxygen uptake for children was significantly greater, 15.3 ml/kg/min, than the value for teenaged subjects, 12.9 ml/kg/min. The oxygen cost to walk a unit distance (meter) was higher in children than adolescent subjects. The mean values averaged .22 ml/kg/min and .18 ml/kg/min respectively. The data on heart rate paralleled the findings on oxygen consumption. The mean heart rate for children, 114 beats per minute (bpm), was significantly higher than the mean values for adolescent subjects, 97 bpm. PMID- 6852383 TI - A modified isokinetic strengthening program for patients with severe hemophilia. AB - A modified isokinetic strengthening program for the knee flexors and extensors was evaluated in 32 patients with severe hemophilia. The program was effective in significantly strengthening the knee flexors and extensors; it did not increase the number of knee hemarthroses; and it could be done at home without special equipment. The greater increases in extensor and flexor strength among adolescents and adults were associated with less severe arthropathy, a 1 cm increase in thigh girth, and a greater number of days on which the exercises were done. PMID- 6852385 TI - The effects on auditory and linguistic deprivation of lateral preference of deaf children. AB - In the light of recent evidence for an altered pattern of cerebral specialisation among the deaf, this study compared hand and foot preference of age-matched samples of deaf and hearing children. Significantly fewer deaf children were fully right-handed and there was a small shift to the left on the handedness continuum. This shift was more marked in children with a greater hearing-loss but was not particularly related to the cause of deafness. No significant difference was found in foot preference. The variation in hand preference is thought to be a function of the differences in hemisphere specialisation found in the deaf, but other explanations are also considered. PMID- 6852384 TI - Sequential and non-speech praxic abilities in developmental verbal apraxia. AB - Verbal and non-verbal sequential abilities were compared in a group of 10 children with developmental verbal apraxia. Manual gestures, constructional praxic abilities and non-speech volitional oral movements were also studied. Results indicated that these children were deficient in verbal sequential abilities, both with reference to their non-verbal sequential abilities and to normative data. As a group, the children did not present manual-gestural or constructional apraxias, nor oral apraxias for single non-speech volitional movements. However, most had difficulty with sequences of non-speech volitional oral movements. PMID- 6852386 TI - A proposed neuropathological basis for learning disabilities in children born prematurely. AB - This study aimed at providing understanding of the etiology and mechanisms responsible for the learning and behavioral disabilities in the increasing numbers of survivors of neonatal intensive care units who develop MBD/LD-type (minimal brain dysfunction, learning disabilities) complications. The brains of 16 premature infants who died within the first month of life were studied by microscopic examination. Significant neuropathological findings in gray-matter and white-matter were found in many areas, including both superficial cortical and deep basal brain structures. These lesions are postulated to be precursors to later LD and MBD syndromes in infants who survive, such that similar lesions of varying severity correlate with varying degrees of brain dysfunction. Premature infants who survive are known from other studies to be high-risk candidates for LD- and MBD- type developmental disabilities. PMID- 6852387 TI - Proliferative vasculopathy and an hydranencephalic-hydrocephalic syndrome: a neuropathological study of two siblings. AB - Two female siblings were born with an hydranencephalic-hydrocephalic syndrome, following pregnancies complicated by hydramnios. No environmental factors such as infections, drugs or metabolic disorders were noted during either pregnancy. Neuropathological studies revealed identical changes in each case. The characteristic feature of the pathology was a proliferative vasculopathy throughout the central nervous system, which apparently caused focal ischaemic lesions and progressive destruction of CNS tissue. The defect probably is inherited as an autosomal recessive trait. PMID- 6852389 TI - Modern approaches to the treatment of medulloblastoma. PMID- 6852388 TI - Two half-siblings with tuberous sclerosis, polycystic kidneys and hypertension. AB - Two half-brothers with tuberous sclerosis (TS) presented with polycystic kidneys in early childhood, before the classical stigmata became apparent. Their father shows no evidence of the disease. The older boys subsequently developed adenoma sebaceum at nine years and the younger boy developed infantile spasms. Hypertension occurred in both cases but neither showed evidence of renal failure. Extensive renal cyst formation in TS is rare, but when it does occur it differs from both infantile and adult-type polycystic disease. TS should be considered in the differential diagnosis of renal enlargement, haematuria and hypertension in childhood. PMID- 6852391 TI - Pertussis, pertussis vaccination and postnatal aetiology of cerebral palsy in Western Australia. PMID- 6852390 TI - Rectal diazepam in the management of febrile convulsions. PMID- 6852392 TI - Assessment of two children born after in vitro fertilisation. PMID- 6852393 TI - Effect of deoxycholate on the perfused rat colon. Concentration dependence of the effect on net fluid and electrolyte transfer and the correlation with paracellular permeability. AB - We reexamined the question whether the deoxycholate-evoked alteration of net transfer of fluid and electrolytes is primarily caused by active secretion or paracellular filtration. In the in vivo perfused rat colon, deoxycholate caused a dose-related increase in 51Cr-EDTA clearance proportional to the rate of fluid, sodium, and chloride secretion. These increases of fluid production and epithelial permeability were reversible and showed the same time dependence. Potassium, however, was already maximally secreted at the lowest deoxycholate concentration (1 mmol/l). This study supports the hypothesis that the secretion of fluid in the deoxycholate-treated colon is quantitatively determined by the increase of the paracellular permeability. PMID- 6852394 TI - Calcium metabolism in subjects living with a permanent ileostomy. AB - Several indices of calcium metabolism have been studied in 39 subjects living with a permanent ileostomy after proctocolectomy for ulcerative colitis, and in a control group of 39 healthy volunteers, matched for age and sex. No significant differences were found in plasma levels of calcium, phosphate, magnesium, parathyroid hormone, calcitonin and 25-hydroxy-vitamin D nor in the urinary excretion of calcium and phosphate, but the alkaline phosphatase was raised in the ileostomists. The bone density of the ileostomists was rather low, but the difference from the control subjects was not statistically significant. The absorption of calcium was measured by means of a total body counter. The ileostomists retained significantly more calcium than expected. It is suggested that this may represent the correction of a state of calcium deficiency at the time of proctocolectomy, due to the effects of the colitis and its medical treatment with corticosteroids. PMID- 6852398 TI - Central laundry services: a look behind the scenes. PMID- 6852395 TI - Arhus county vagotomy trial. Acid secretory patterns in patients with prepyloric, pyloric, and duodenal ulcer. AB - Prepyloric (PPU), pyloric (PU), and duodenal bulb ulcers (DU) are traditionally incorporated in the clinical entity 'duodenal ulcer disease'. Clinical and gastric secretory data were analyzed with respect to the ulcer location in a prospective study with complete data from 776 patients. 574 had DU, and the female/male ratio was 0.39. 95 had PU (female/male ratio = 0.61) and 107 PPU (female/male ratio = 0.53). The higher female/male ratio for PU and PPU as compared to DU was significant. The age distribution showed a significant trend to younger age representation of males in the DU group, while the age distribution of the females was equal for the three groups. The duration of symptoms before elective surgery was equal for all three groups. The pentagastrin stimulated peak acid output was significantly higher for DU compared to PPU, and this applied for both sexes even when the values were corrected for body weight as well as for age differences. Our results indicate DU and PPU to be materially different while PU constitute an intermediary group. PMID- 6852397 TI - Cimetidine in gastro-oesophageal reflux. AB - 15-hour intra-oesophageal pH monitoring and symptom scores were used to compare the effect of cimetidine, 1 or 2 g daily with placebo on patients with acid gastro-oesophageal reflux. Night pain and antacid consumption were reduced by cimetidine, but other symptoms did not show significant differences. Symptomatic improvement appeared greater in smokers than non-smokers. 15-hour intra oesophageal pH measurements showed that the number of reflux episodes was reduced in the cimetidine-treated groups. PMID- 6852396 TI - Bile acid pattern and cholesterol saturation of bile after cholecystectomy and endoscopic sphincterotomy. AB - The effect of endoscopic sphincterotomy on bile acid composition and cholesterol saturation of bile has been studied in cholecystectomized patients. Individual bile acids and biliary lipids were measured in hepatic bile of 13 cholecystectomized females aged 56.8 +/- 16.6 years more than 9 months (mean 16.7 +/- 8.8 months) after sphincterotomy and of 12 cholecystectomized females aged 59.3 +/- 11.5 years who served as controls. The sphincterotomy group exhibited a significantly (p less than 0.01) higher percentage of chenodeoxycholic acid in bile--39.2 +/- (SD) 7.7%--than the controls with cholecystectomy only (29.1 +/- 7.4%), but showed no differences in the proportion of cholic acid (32.4 +/- 6.2 vs. 33.6 +/- 7.8%). The percentages of the secondary bile acids, deoxycholic acid (25.0 +/- 8.8 vs. 32.3 +/- 8.3%), and lithocholic acid (1.7 +/- 0.8 vs. 2.6 +/- 2.3%) were lower, but these differences were not statistically significant. The biliary lipid composition in the sphincterotomy group was not different from that in the controls, resulting in a similar cholesterol saturation index in both groups (1.87 +/- 0.60 vs. 2.02 +/- 0.60 according to Carey and Small; 1.45 +/- 0.32 vs. 1.55 +/- 0.32 according to Hegardt and Dam). These findings do not demonstrate any alterations of the bile composition after sphincterotomy which may be expected to have undesirable effects on the biliary and/or gastrointestinal system. PMID- 6852399 TI - Housekeeping: a vital information resource. PMID- 6852400 TI - How to evaluate a germicidal detergent. PMID- 6852401 TI - Refusing medical treatment: incompetent adults. PMID- 6852402 TI - Media: making sure they get the message. PMID- 6852403 TI - On the segregation of the germ and somatic cell lines in the embryo. AB - In this paper we argue that the mechanisms underlying the segregation of the somatic and germ cell lines are basically similar. The interaction of the genome with specific cytoplasmic factors is responsible for the restriction of their developmental potencies in the somatic cell lines, and for the prevention of such a restriction in the germ cell line. In particular, it is suggested that meiosis is part of the differentiation program of the germ cells. PMID- 6852405 TI - Sodium cellulose phosphate approved for absorptive hypercalciuria. PMID- 6852404 TI - Effects of inducers on inner and outer gastrula ectoderm layers of Xenopus laevis. AB - Gastrula ectoderm, isolated from Xenopus laevis, was cultured in Holtfreter solution or modified Leibovitz medium (L-15) by the sandwich-method with or without inducer. The ectoderm (SD cell layers) consisted of two cell sheets, representing a superficial (S) and a deep (D) layer. In the L-15 medium rather than in Holtfreter solution, the two cell layers separate out into distinct cell masses. This difference in cell affinity under certain experimental conditions could indicate that the deep layer contains endodermal cells. However, an endodermal character of the deep layer can be ruled out by induction experiments with vegetalizing factor or dorsal blastopore lip as inducers. Under the influence of vegetalizing factor the outer as well as the inner ectoderm layer differentiated into mesodermal derivatives such as notochord and somites. The results of the experiments with dorsal blastopore lip as inducer indicate that both inner and outer ectoderm layers are responsive to the neural stimulus. The lower neural competence of the outer ectoderm layer observed by several authors in normogenesis is discussed with regard to the hypothesis about short distance diffusion of the neutralizing factor and/or close cell-to-cell contact between inducing tissue and ectodermal target cells. PMID- 6852406 TI - Development of orphan products. PMID- 6852407 TI - Two dosage forms of acyclovir available. PMID- 6852408 TI - Mercury toxicity in ear irrigation. PMID- 6852409 TI - Steps taken to lessen tampering with OTC drugs. PMID- 6852410 TI - [Current surgical possibilities in the treatment of hepatic metastases of colorectal adenocarcinomas]. PMID- 6852413 TI - [Massive hepatic steatosis disclosing adult celiac disease. Study of a case and review of the literature]. AB - The authors report the case of a 32-year old woman admitted for hepatomegaly, weight loss, and moderate diarrhea. Liver function tests showed anicteric cholestasis with slight increase in serum level of transaminases. Liver biopsy demonstrated massive steatosis. Biological and radiological investigations of the small intestine showed a malabsorption pattern. Stool fat excretion was 54 g per day. Duodenal biopsies disclosed total villous atrophy. A ten-day treatment with metronidazole (1,5 g per day), followed by a gluten-free diet, resulted in rapid improvement of hepatic and intestinal symptoms. This case report shows that: 1) adult celiac disease may be the cause of severe steatosis; 2) anicteric cholestasis with or without hepatomegaly during the course of adult celiac disease may be secondary to steatosis, as well as primary biliary cirrhosis or malignant infiltration of the liver; 3) bacterial overgrowth should be searched and eventually treated in the case of massive fatty liver occurring in adult celiac disease. PMID- 6852412 TI - [Pharmacokinetics of cimetidine in ascitic cirrhotics]. AB - Eleven patients with ascitic cirrhosis and eleven patients without liver disease received 200 mg of cimetidine orally and intravenously. Plasma concentrations of cimetidine were analysed by high pressure liquid chromatography. No differences were observed in cimetidine half-life (2.53 +/- 0.63 and 2.33 +/- 0.40 h) between the two groups. Cimetidine clearance was diminished by about 30 p 100 in cirrhotic patients (0.426 +/- 0.138 vs. 0.649 +/- 0.163 l/h/kg). The apparent volume of distribution was also significantly diminished (1.50 +/- 0.44 vs. 2.14 +/- 0.55 l/kg) in patients with cirrhosis and ascites. PMID- 6852414 TI - [Diet and cancers of the colon and rectum]. PMID- 6852416 TI - [Diet and rectocolonic cancer]. PMID- 6852411 TI - [Surgical resection of hepatic metastases of cancers of the colon and rectum]. AB - Surgical resection of metastatic colorectal carcinoma remains controversial. Few patients are eligible for resection since out of 2,725 patients operated upon for colonic or rectal adenocarcinomas in 11 years, 14 p. 100 had liver metastases and only 0.9 p. 100 could be resected. Twenty-nine patients who have undergone partial liver resections for metastatic colorectal carcinomas are reported. The primary neoplasms were Duke's class B(8), Dukes' C (12) or extended to another organ (5). Local extension was unknown in 4 cases. Eight metastases were unique and measured less than 5 cm; seven, although unique, measured more than 5 cm. Fourteen patients had multiple but unilateral hepatic deposits. Twenty major resections and 9 wedge liver resections were performed. One patient died (3.4 p. 100). Average hospital stay was 19 days. Pain was relieved by surgery in 10/11 patients. In 19 patients follow-up exceeds one year: six underwent the resection of a unique and small liver metastasis: one died after 3 and a half years and two are doing well 4 and 10 years after surgery. Thirteen patients underwent major liver resections for large or multiple liver deposits: 9 lived less than one year and 4 are alive after 16, 19, 26 and 60 months respectively. All patients with a follow-up of less than one year are alive. The low operative mortality, the efficacy in relieving pain, and the prolonged survival which can be obtained in some cases justify an aggressive surgical approach to colorectal liver metastases. PMID- 6852417 TI - [Treatment of pancreas divisum. Preliminary results]. PMID- 6852415 TI - [Comparative study of gastric emptying of digestible and nondigestible solids in normal man and duodenal ulcer patients]. AB - Few studies have compared the gastric emptying of digestible and non-digestible solids in man. In 9 normal subjects and 16 duodenal ulcer patients, we measured simultaneously and during 3 h, the gastric emptying of: (a) radioopaque pellets (n = 100; volume = 30 mm3) ingested with an ordinary meal (450 kcal, 500 ml) and counted on X-ray series; and (b) digestible solids of the meal (99mtechnetium tagged egg white) detected by an isotopic method. Gastric emptying of liquids (labelled with 113mindium DTPA) was also determined. In normal subjects, emptying rates of the pellets was 5 +/- 2 p. 100 per hour while that of digestible solids was 29 +/- 1 p. 100 per hour (P less than 0.01). No correlation was evidenced between the emptying rates of either kind of solids. Emptying of liquids was faster than that of both digestible solids and pellets. Similar results were obtained in duodenal ulcer patients; no significant difference was found between patients and normal subjects for the three meal phases tested. These results are consistent with the hypothesis that digestible solids are retained in stomach until they are ground, and show that inert particles do not always reflect the gastric emptying of natural solids of the meal. PMID- 6852418 TI - [Abdominal forms of Castleman's disease]. AB - Two cases of Castleman's disease (angiofollicular lymphoid hyperplasia) with abdominal localisation are reported. The first case was a mesenteric localisation with compressive symptoms in a sixty year-old patient; its histological type was hyalino-vascular; the evolution was favorable one year later following cobaltherapy; but ultimately pathological examination of a peripheral lymph node led to the discovery of a malignant nodular lymphoma of the follicular center cell type. The second case involved the retroperitoneal space with multiple lymph nodes and IgA dysglobulinemia in a 49 year-old patient; its evolution was favorable as judged six months after surgical resection. Twenty cases of mesenteric and thirty one of retroperitoneal involvement of Castleman's diseases have been previously reported. The nosology and pathogenesis of this disease remain unclear. PMID- 6852419 TI - [Hepatitis caused by diclofenac]. PMID- 6852420 TI - [Abnormal pseudo-choreoathetotic movements in cirrhosis]. PMID- 6852421 TI - [Preparation for endoscopic and radiologic examination of the colon by ingestion of a nonabsorbable solution of polyethylene glycol: experiences from 129 cases]. PMID- 6852422 TI - [Gastric angiodysplasias and Rendu-Osler's disease]. PMID- 6852423 TI - [Extensive cancer development of a caustic stenosis of the esophagus; gastric recurrence after excision and coloplasty]. PMID- 6852424 TI - [Esophageal ulcer after ingestion of florocycline]. PMID- 6852425 TI - Esophageal involvement in epidermolysis bullosa dystrophica: clinical and roentgenographic manifestations. AB - Epidermolysis bullosa is a rare hereditary mechanobullous skin disorder. Four patients with esophageal involvement are reported. These cases and review of reported cases of epidermolysis bullosa dystrophica-recessive (EBD-R) showed distinct clinical and roentgenographie features of esophageal involvement: diffuse inflammatory changes, motility disorders, small blisters or bullae seen as constant nodular-filling defects, esophageal ulcers, scars, pseudodiverticula, transverse and circumferential webs, various size strictures, shortening of the esophagus with development of traction hiatal hernia and gastroesophageal reflux, perforation, and complete obstruction of the esophageal lumen. Dysphagia is reversible when caused by bullae or webs and permanent when due to cicatrizing strictures. The strictures may remain unchanged in size for many years despite variations in dysphagic symptoms. PMID- 6852427 TI - Computed tomography of gastric lipomas. PMID- 6852428 TI - Non-vaterian duodenal adenomas: report of 24 cases and review of the literature. AB - Twenty-four cases of duodenal adenomas which did not originate at the ampulla of Vater are discussed. The radiographic and clinical features of these lesions are presented together with a review of 120 cases previously reported in the literature. The role of barium studies and endoscopy in the evaluation of these adenomas is emphasized. A diameter of more than 5 cm represents a criterion favoring malignant degeneration of such non-Vaterian adenomas. PMID- 6852426 TI - Esophageal tuberculosis: findings on barium swallow and computed tomography. AB - Esophageal tuberculosis secondary to tuberculous mediastinal lymphadenopathy is a very unusual presentation of adult tuberculosis. We report a patient presenting with fever of unknown origin and dysphagia. Barium swallow demonstrated esophageal displacement, mucosal ulceration and perforation with a fistulous tract into the mediastinum. CT of the mediastinum gave the most complete delineation of the tuberculous mediastinal lymphadenopathy which surrounded and displaced the esophagus. The fistulous tract extending from the esophagus into the nodal mass was also seen on CT. PMID- 6852429 TI - CT demonstration of annular pancreas: case report. PMID- 6852430 TI - Fluoroscopically guided percutaneous pancreatography. PMID- 6852431 TI - Percutaneous placement of a transcystic duct internal biliary drainage catheter. PMID- 6852432 TI - Short segment involvement of the common bile duct in pancreatic carcinoma. AB - Short segment involvement of the midportion of the common bile duct by pancreatic carcinoma is common. It is generally not appreciated on transhepatic cholangiograms or during percutaneous drainage procedures since the uninvolved distal duct is rarely opacified. This pattern helps explain the ease of passing guidewires beyond the initial point of obstruction during drainage procedures. Knowledge of this anatomy may also have diagnostic and therapeutic significance. In some situations a special effort to opacify the distal duct may be warranted. PMID- 6852433 TI - Filiform polyposis of the small bowel in Crohn's disease. PMID- 6852434 TI - 111Indium leukocyte scanning in small-bowel Crohn's disease. PMID- 6852435 TI - Retroperitoneal abscess: a presentation of colon carcinoma. AB - Retroperitoneal abscess as an initial manifestation of carcinoma of the colon is unusual. Inappropriate management of an unrecognized lesion is invariably fatal. Awareness of this uncommon presentation can lead to a precise preoperative diagnosis and appropriate therapy. The possibility of a perforated colon carcinoma should be considered in instances of unexplained retroperitoneal mass and infection, and a barium enema performed on all such patients. The authors report 3 cases and illustrate the radiological features of retroperitoneal abscesses due to perforated colon carcinoma. PMID- 6852437 TI - Induction of liver cell injury by antibody-dependent monocyte-mediated cytotoxicity in vitro. AB - The isolated liver cells coated with the anti-liver cell membrane antibody were damaged by incubation with the peripheral blood mononuclear cells. This was demonstrated by measuring the reduction of protein synthesis in the target liver cells. Adherent cells from the peripheral blood mononuclear cells were shown to have a sufficient capacity acting on the isolated liver cells as an effector when they were separated from the peripheral blood of normal and patients with acute or chronic active hepatitis. However, those from patients with liver cirrhosis or hepatoma did not show such effector activity in antibody-dependent cell-mediated liver cell damage. These results suggest that possibly antibody-dependent macrophage-mediated cytotoxicity may play some role in the induction of liver cell injury because the anti-hepatocyte membrane antibody is frequently detected in patient's sera, especially in those with chronic active hepatitis. PMID- 6852436 TI - Ranking of liver tests for differential diagnosis of liver parenchymal diseases. AB - Liver function tests were ranked in the order useful to differentiate 8 liver parenchymal diseases in combination of tests by forward selection and backward elimination procedures in the likelihood method using a microcomputer. The orders were almost same in both procedures: indocyanine green plasma disappearance rate, glutamic pyruvic transaminase (GPT), zinc turbidity test, alkaline phosphatase, age, HBsAg, RA test, glutamic oxaloacetic transaminase (GOT)/GPT ratio, GOT, cholesterol, total protein, total bilirubin, albumin/globulin ratio and gamma globulin. The first 9 tests had almost all informations of all tests. The first likelihood diagnosis using the 9 tests was correct in 53% and the first or the second diagnosis was correct in 71% of 444 cases of 8 liver parenchymal diseases. A score table of likelihood diagnosis using the 9 tests was presented for manual application to new cases. PMID- 6852439 TI - Usefulness of antithrombin III and alpha 2-plasmin inhibitor in early differentiation of fulminant hepatitis and severe form of acute hepatitis. AB - To evaluate the usefulness of antithrombin III (AT III) and alpha 2-plasmin inhibitor (alpha 2PI) in early differential diagnosis of fulminant hepatitis from the severe form of acute hepatitis, the activities of AT III and alpha 2PI were measured in plasma of 15 patients with fulminant hepatitis and 6 patients with severe form of acute hepatitis. The activities of prothrombin time (PT), hepaplastintest (HPT) and thrombotest (TT) were also evaluated. The mean values and the standard errors (SE) for PT, HPT and TT were 21.1 +/- 2.6%, 14.0 +/- 1.6% and 10.3 +/- 1.7%, respectively, in the early stage of fulminant hepatitis and 25.3 +/- 2.4%, 21.6 +/- 4.6% and 15.8 +/- 3.6%, respectively, in the severe form of acute hepatitis. No significant difference in the tests between these two diseases was noted. On the other hand, the mean values +/- SE for AT III and alpha 2PI were 13.7 +/- 4.6% and 25.6 +/- 8.6% in fulminant hepatitis and 70.2 +/ 28.5% and 98.7 +/- 9.7% in the severe form of acute hepatitis. A significant difference between the two diseases was observed. From the above, it is concluded that measuring AT III and alpha 2PI along with PT, HPT and TT is useful for early diagnosis of fulminant hepatitis. PMID- 6852440 TI - Serum gastrin levels in patients with thyroid dysfunction. AB - Fasting serum gastrin levels measured by radioimmunoassay were found to be elevated in patients with hyperthyroidism and low in patients with hypothyroidism. The oral administration of beef extracts resulted in more increase of serum gastrin in hyperthyroid patients than in normal subjects. After restoration of the euthyroid state by treatment, no more increase in serum gastrin levels was observed. Slight correlation between gastrin levels and serum T3 levels was observed in pretreated hyperthyroid patients (r = 0.40), but significant correlation between them was found after restoration of the euthyroid state by treatment (r = 0.50). However, it seemed to be able to divide into two groups in the pretreated patients. One was a patient group whose gastrin levels correlated closely to serum T3 levels (r = 0.83, p less than 0.01). The other was a group whose serum gastrin levels remained in low even in high T3 levels (r = 0.81, p less than 0.01). Different sensitivity to thyroid hormone in the G-cells of gastrointestinal tract may exist in these two groups, because patients age and duration of their illness were not different between them. PMID- 6852438 TI - Experimental production of portal hypertension in dogs by a whole liver compression. AB - In spite of many attempts to produce an experimental model for studying the pathogenesis and the pathophysiology of portal hypertension and esophageal varices, satisfactory results have not been reported. Since most attempts involved multiple operations or complicated surgical maneuvers to achieve portal hypertension, experimental animals could not survive easily. This new procedure requires only a simple operation, so experimental animal survival is high. The portal venous pressure can be raised immediately by increasing intrahepatic vascular resistance. This is done by wrapping and compressing the whole liver with polypropylene mesh, which also prevents the development of hepatopetal collaterals. The experimental production of portal hypertension in fifteen dogs resulted in only one death. The remaining fourteen dogs were in good condition for nine weeks after the operation and were maintaining elevated ranges of portal pressure with an average of 326 mmH2O. Varying degrees of esophageal venous dilatation were evident. Based on the results, this newly developed method seems to be useful for studying the pathophysiology of the portal hypertension and esophageal varices. PMID- 6852441 TI - Hepatic artery aneurysm. Report of a case and review of the literature. AB - One hundred and nineteen cases, including the one reported here, of hepatic artery aneurysm were reviewed. The clinical features and surgical management in four etiologic groups, consisting of arteriosclerosis, cholecystolithiasis, trauma and, specific diseases, were investigated. Interruption of the hepatic artery, entailing ligation of the hepatic artery, excision of the aneurysm without vascular reconstruction, and obliterative aneurysmorrhaphy, was done in 50 patients. Its high mortality rate (26%) was principally ascribed to delayed diagnosis or inappropriate site of interruption. If conditions such as shock, anoxia and portal thrombosis are avoided, interruption of the hepatic artery seems to be a safe and useful operative method for hepatic artery aneurysms, especially accompanied by severe local infection. PMID- 6852442 TI - Liquid crystal formation in ursodeoxycholate-rich human gallbladder bile. AB - We studied liquid crystal formation in bile samples obtained from the patients with radiolucent gallstones who had been administered either ursodeoxycholic acid (UDCA) at a dose of 600 mg/day or chenodeoxycholic acid (CDCA) at 400 mg/day for one week preoperatively. The UDCA/total bile acids ratio was found to range from 50 to 60% and the CDCA/total bile acids ratio ranged from 70 to 80%. Cholesterol molar percent was 5 in UDCA-rich bile and 6 in CDCA-rich bile. Phospholipid molar percentage was about the same in both groups. Liquid crystal formation was confirmed only in the UDCA-rich bile samples but not in the CDCA-rich bile samples. This result suggests that cholesterol in the UDCA-rich bile samples is not solubilized by the bile salt and phospholipid mixed micelles but also consumed to form liquid crystals. PMID- 6852443 TI - Changes in high density lipoproteins in patients with hepatobiliary diseases. Levels and lipid composition of HDL2 and HDL3 and LCAT reaction. AB - Lipids of HDL (high density lipoproteins) and their subfractions (HDL2 and HDL3), and LCAT activity (lecithin: cholesterol acyltransferase) were determined in hepatobiliary diseases without severe hyperbilirubinemia (less than 10 mg/dl). The decrease in major lipid constituents (cholesterol and phospholipids) of HDL was mainly attributable to the decrease in those of HDL3, except in some liver diseases of acute or severe stage (acute hepatitis in an acute stage and hepatoma) which were accompanied with a simultaneous moderate decrease in those of HDL2 and in fatty liver which showed a preferential decrease in those of HDL2. The LCAT activity also decreased in several diseases. Some of the hepatobiliary diseases, on the contrary, showed an increase in HDL-triglycerides (mostly in HDL3 and in some diseases also in HDL2) which might participate to some extent in secondary hyperlipidemia in the liver parenchymal diseases, although they were the minor lipid constituents of HDL. From results that HDL3- but not HDL2 cholesterol levels significantly correlated with serum total protein, albumin and choline esterase, it was suggested that the decrease in large constituents of HDL, particularly of HDL3, is caused by hepatocellular dysfunction which causes inhibition of protein and lipid syntheses in the liver in most of the hepatobiliary diseases except for fatty liver which has a preferential decrease in HDL2 lipids. PMID- 6852445 TI - Use of anorectal manometry during rectal infusion of saline to investigate sphincter function in incontinent patients. AB - Anal and rectal pressures and external sphincter electromyogram were recorded continuously during rectal infusion of 1.5 L saline in 18 normal subjects and 37 patients who complained of diarrhea and fecal incontinence. All subjects exhibited a pattern of regular fluctuations in anorectal pressure and electromyogram. All except 1 of the normal subjects were able to retain 1500 ml saline without leakage, and their pressure record comprised simultaneous rectal contractions, internal sphincter relaxations, and external sphincter contractions. None of the incontinent patients were able to retain 1500 ml saline without leakages, and leakages always coincided with the peaks of rectal pressure. Two manometric patterns were observed. Fifty-nine percent of incontinent patients exhibited a pattern of contractions of similar profile occurring throughout the anorectum. This finding was associated with low basal sphincter pressures, an easily inhibited anal sphincter tone, an obtuse anorectal angle, and a funnel-shaped configuration to the anal canal. These results suggested that, in this group, the internal sphincter was weak and easily inhibited so that the whole anorectum behaved as one fluid-filled compartment recording contractions of the external sphincter. The remaining 41% of incontinent patients exhibited a normal pattern of anorectal pressure fluctuations and had normal maximum basal pressures, although maximum squeeze pressures, rectoanal inhibitory reflex, and anorectal angles were abnormal. Peak rectal pressures were abnormally high in this group during saline infusion, suggesting that abnormally strong rectal contractions may play a role in the incontinence in this group. PMID- 6852444 TI - Nonspecific proctocolitis in northeastern Scotland: a community study. AB - An extensive retrospective survey of patients with onset of symptoms of nonspecific protocolitis arising in the decade 1967-1976 was carried out in northeastern Scotland, including the Grampian region, Orkney, and Shetland. Five hundred and thirty-seven cases were identified, and a 97% follow-up was achieved. One hundred and twenty nonhospitalized cases were included. The average annual incidence was 11.3 per 10(5) population, the highest recorded in Europe to date. Moreover, a striking rise in the incidence was noted. A bimodal age distribution and urban predominance was found. The frequency of both nonspecific proctocolitis and Crohn's disease in first-degree relatives was high. The disease was found to be less severe and extensive at onset than suggested by other surveys, 70% having only distal involvement and 68% having a mild first attack. The overall mortality and surgical resection rates in the first attack were both 3%. Severe first attacks carried a striking 23% mortality. The observed long-term mortality differed little from the expected, except in patients with extensive disease or severe first attacks, or both. The risk of relapse correlated with decreasing age at onset but not with the initial extent or severity of disease. The surgical resection rate after 5 yr was 8%. Twelve percent of patients extended their disease by 5 yr. Using the patient-year concept, 68% of patient years were remission years. The youngest age group had the highest percentage of attack years. The percentage of attack years for all patients correlated more closely with extent of disease in each patient year rather than extent of disease at diagnosis. PMID- 6852447 TI - Interaction between hepatitis b virus and alcohol consumption in liver cirrhosis. An epidemiologic study. AB - The relationship between alcohol consumption and the presence of seric hepatitis B virus markers has been studied in 125 male patients with liver cirrhosis and 126 control subjects. Mean daily alcohol consumption was found to be higher in patients than in controls. Hepatitis B virus seric markers were also more frequently observed in patients than in controls (53.6% vs. 36.5%, 2p less than 0.05). This was due to the greater frequency of hepatitis B core antibody alone or with hepatitis B surface antigen in the patients (2p less than 0.05). The possible interaction between alcohol and B virus was studied by log-linear hierarchic models for contingency tables. Data were displayed in a three-way classification frequency table (diagnosis, daily alcohol consumption, and hepatitis B virus seric markers). A model assuming that alcohol and seric markers of unresolved infection by hepatitis B virus are independently linked to cirrhosis gives the better goodness of fit between observed and estimated frequencies. The result however, suggests, that hepatitis B virus infection does not increase the influence of alcohol consumption on the production of cirrhosis. PMID- 6852446 TI - Prevention of acetaminophen and cocaine hepatotoxicity in mice by cimetidine treatment. AB - Hepatotoxicity occurs in animals after administration of large doses of acetaminophen and cocaine and is thought to result from production of reactive metabolites of these parent drugs by cytochrome P450. Because cimetidine binds to cytochrome P450 and inhibits hepatic drug metabolism in both humans and animals, we determined the effects of cimetidine coadministration on acetaminophen and cocaine hepatotoxicity in mice. Marked elevations of serum glutamic pyruvic transaminase and severe pericentral hepatocellular necrosis occurred in animals receiving intraperitoneal doses of 350 mg/kg acetaminophen or 35 mg/kg cocaine, while minimal serum glutamic pyruvic transaminase elevations and liver necrosis were seen in animals who also received 100 mg/kg cimetidine 1 h before and 1 h after administration of either acetaminophen or cocaine. Consistent with the hypothesis that these in vivo protective effects resulted from interaction with cytochrome P450, cimetidine inhibited in vitro hepatic microsomal metabolism of cocaine. However, despite its protective effect against acetaminophen-induced hepatic injury, concomitant administration of cimetidine did not significantly affect plasma pharmacokinetics of acetaminophen, prevent depletion of hepatic glutathione after acetaminophen administration, or alter in vivo covalent binding of [3H]acetaminophen to hepatic proteins. These studies suggest that current theories regarding production of acetaminophen-induced liver damage require reexamination. The possibility that cimetidine treatment might be useful in preventing hepatic damage due to acetaminophen and other hepatotoxins in humans is intriguing and also warrants consideration. PMID- 6852448 TI - An evaluation of the respective roles of portosystemic shunting and portal hypertension in rats upon the production of gonadal dysfunction in cirrhosis. AB - To evaluate the differential effects of portal hypertension and portosystemic shunting upon the endocrine changes that occur in men with advanced chronic liver disease, male rats underwent either partial portal vein ligation or direct portocaval anastomosis. Testicular mass was found to be reduced in both models (p less than 0.05). Similarly, estradiol levels were found to be increased (p less than 0.05) in both models when compared with sham-operated controls. The increase in estradiol levels was greater in the animals with a complete shunt than in those animals with incomplete shunts developed as a consequence of portal hypertension (p less than 0.05). Luteinizing hormone levels were reduced (p less than 0.01) in the animals with the greater estradiol levels. As expected, testosterone levels were reduced (p less than 0.01) only in the animals with reduced luteinizing hormone levels. These data suggest that portosystemic shunting, and not portal hypertension per se, is responsible, at least in part, for the gonadal injury that occurs with advanced liver disease. PMID- 6852449 TI - Prevalence of delta-antibody among chronic hepatitis B virus infected patients in the Los Angeles area: its correlation with liver biopsy diagnosis. AB - The overall prevalence of delta-antibody among 80 patients with chronic infection of hepatitis B virus in the Los Angeles area was found to be 24%. Twenty-three patients had a histologic diagnosis of persistent hepatitis and 57 had chronic active hepatitis with or without cirrhosis. Only 1 patient among those with persistent viral hepatitis had delta-antibody, whereas 18 with chronic active hepatitis had delta-antibody in their sera (p less than 0.05). PMID- 6852450 TI - Familial recurrent intrahepatic cholestasis of pregnancy: a genetic study providing evidence for transmission of a sex-limited, dominant trait. AB - Three generations of a kindred comprising 50 individuals are described in which recurrent intrahepatic cholestasis of pregnancy has occurred with high frequency. A uniform expression and complete penetrance of the trait in the women of a limited "affected" portion of the kindred (6 affected of 10 women), along with the direct parent-to-child inheritance mode, supports the conclusion that the inheritance mode is Mendelian dominant in type. Male expression of the phenotype seems to be inhibited. This is derived from observations that unmasking of carriers in the kindred by normal challenge provided useful information only in women, and was unhelpful when applied to a male obligate carrier. A linkage analysis is presented that explores the possibility of a relationship between the syndrome and homologous leukocyte antibody histocompatibility antigens. On the basis of present data, no conclusion can presently be reached regarding this possibility. PMID- 6852452 TI - Incidence of inflammatory bowel disease: going up or down? PMID- 6852451 TI - Perineal Crohn's disease complicated by pyogenic liver abscess during metronidazole therapy. AB - A patient with ileal and perineal Crohn's disease developed a pyogenic liver abscess caused by Streptococcus milleri. The perineal process had been treated with high-dose metronidazole for the preceding 6 mo, and culture of a perianal abscess 2 mo before admission revealed heavy growth of Streptococcus milleri (which was misidentified as an anaerobic Peptostreptococcus). This case illustrates the difficulty in correctly identifying Streptococcus milleri, the most frequent isolate from pyogenic liver abscesses. Furthermore, the events suggest that metronidazole therapy can allow overgrowth of this organism in perineal abscesses which, in turn, may predispose to the development of purulent foci such as liver abscesses. This effect on the bacterial ecology of the perineum should be considered when opting for metronidazole therapy of perineal Crohn's disease. PMID- 6852453 TI - Cancer in inflammatory bowel disease: how serious is the problem and what should be done about it? PMID- 6852457 TI - "When is esophageal spasm, spasm?". PMID- 6852454 TI - Activation of carcinogens by bacterial and microsomal enzyme systems. PMID- 6852455 TI - Covalent binding theory for acetaminophen hepatotoxicity. PMID- 6852456 TI - Dietary management of short bowel syndrome. PMID- 6852458 TI - Assessment of colorectal cancer risk in patients with ulcerative colitis: experience from a private practice. AB - The cumulative risk of developing colon cancer in patients with ulcerative colitis has been stated to increase 10%-20% for every decade of duration of disease after 10 yr. We reviewed the clinical course of 673 patients with inflammatory bowel disease restricted to the colon who were seen by the authors since 1955. A subset of 258 patients with a diagnosis of ulcerative colitis established before 1970 and followed by the authors was studied by both the classical life table and a generalized approach to estimate the risk of colorectal carcinoma. Only nine instances of colorectal carcinoma occurred. Using the former method and eliminating 3 patients referred with known colorectal carcinoma, the actuarial risk for developing this complication for all patients, regardless of extent of disease, was computed to be only 6.6% at 26 yr and 11.4% at 32 yr following the onset of ulcerative colitis. The cumulative probability of colorectal carcinoma among patients with universal colitis at 26 yr was 19.7% by the generalized method and 11.6% using the standard life table. The generalized approach consistently gave higher risk estimates due to a smaller number of patients in the denominator of the risk calculation. Using an alternative method, we calculated cancer risk from the date first seen for patients with universal extent and a history of greater than or equal to 10 yr of disease (means = 17.4 yr). The magnitude of the resulting colorectal carcinoma risk was even less than previously reported in hospitalized patients. This method is more suited for colorectal carcinoma risk assessment of a large series of ulcerative colitis patients seen in private practice and the results should modify the fear of cancer development in these patients. PMID- 6852459 TI - Effect of human colonic microsomes and cell-free extracts of Bacteroides fragilis on the mutagenicity of 2-aminoanthracene. AB - It has been previously demonstrated that whereas the microsomal fraction of rat colonic tissue and cell-free extract of Bacteroides fragilis alone do not convert 2-aminoanthracene into a mutagen, both together have this capacity in a model using the Ames technique. The aim of the present study was to extend these observations to human colonic tissue and to compare colonic mucosa with other tissues. It was found that whereas colonic microsomal fraction and cell-free extract of Bacteroides fragilis alone possessed little activating capacity with regard to 2-aminoanthracene, both together activated 2-aminoanthracene into a mutagen in this model. The microsomal fraction of other tissues, such as kidney, brain, muscle, and gastric and ileal mucosae, possessed activities similar to colonic mucosa. PMID- 6852460 TI - Biochemical and ultrastructural characterization of the molecular topography of the rat intestinal microvillous membrane. Asymmetric distribution of hydrophilic groups and anionic binding sites. AB - The topography of the intestinal microvillous membrane and its surface components was examined using biochemical and ultrastructural techniques. Microvillous membrane surface glycoproteins were labeled using everted intact intestinal sacs, prepared from rat proximal small intestine. Galactosyl residues were identified by labeling with galactose oxidase/sodium boro[3H]hydride and free amino groups with pyridoxal phosphate/sodium boro[3H]hydride. Membranes were purified, solubilized in sodium dodecyl sulfate, and protein labeling analyzed by acrylamide electrophoresis. Using the intact intestine, only microvillous membrane surface amino groups were labeled. However, when microvillous membrane vesicles were purified first and then labeled, radioligand binding to galactoproteins and free amino groups substantially increased. Ultrastructural and cytochemical studies with ruthenium red revealed the intact intestinal surface to have a strong electronegative charge due to the presence of anionic sites in both the thick mucopolysaccharide surface coat and its underlying glycocalyx. During purification of microvillous membrane, the mucous coat was detached from the membrane surface, leaving the glycocalyx directly exposed to the external environment. Enzymatic probing of microvillous membrane vesicles with papain left the vesicles intact and revealed the membrane to be asymmetric with the majority of its integral proteins located at the outer membrane surface. This orientation of galactosyl and amino groups towards the intestinal lumen plus the overlying thick mucopolysaccharide coat should theoretically afford a greater degree of protection against destruction by luminal proteases and bile acids. Moreover, the shedding of membrane-bound hydrolases into the mucous layer may allow the "membrane surface" phase of digestion to commence before nutrients have diffused completely through the surface coat to reach the enterocyte surface. PMID- 6852461 TI - Architecture of human pancreas: implications for early changes in pancreatic disease. AB - An increased proportion of ductulelike structures, sometimes dilated, occurs in association with pancreatic adenocarcinoma, chronic pancreatitis, cystic fibrosis, and pancreatic ectasia associated with conditions such as uremia. This frequently is interpreted as ductular proliferation, implying origin in ductal elements. Recent animal studies have provided an altered view of pancreatic architecture that is consistent with acinar dedifferentiation leading to the ductulelike structures, or tubular complexes. The architecture of pancreas from organ donors was studied by light and scanning electron microscopy and by wax reconstruction of serial sections. It is concluded that the zymogen granule containing cells of normal human exocrine pancreas are arranged as branching tubules that vary in diameter and curve acutely. The tubules frequently end blindly to form acinar structures; less frequently they anastomose. This arrangement is consistent with the interpretation that tubular complexes associated with pancreatic disease result from dedifferentiative changes in acinar cells. Tubular complexes may reflect a defect or defects common to pancreatic disease rather than ductular proliferation specific to each one. PMID- 6852462 TI - Colorectal spirochetosis: clinical significance of the infestation. AB - Mucosal biopsy specimens from 300 consecutive patients with symptoms requiring sigmoidoscopy were examined for spirochetosis by light and electron microscopy. Colorectal spirochetosis was detected in 15 of the patients (5%). Apart from the spirochetal infestation, the mucosa appeared normal with no inflammatory reaction. The spirochetes were eliminated upon treatment with neomycin and bacitracin, but the symptoms of the patients remained unchanged. It is concluded that in the present material, colorectal spirochetosis was without clinical significance. PMID- 6852463 TI - Differences in anal sphincter function and clinical presentation in patients with pelvic floor descent. AB - Perineal descent is found in patients with idiopathic fecal incontinence and patients with the descending perineum syndrome, who have little or no incontinence but present with a symptom pattern that suggests obstructed defecation. To investigate why patients with perineal descent present in different ways, manometric, radiologic, and neurophysiologic studies were performed in 53 patients with radiologically proven perineal descent and 34 control subjects. Thirty-two patients exhibited incontinence to rectally infused saline, while 21 patients presented with obstructed defecation but exhibited no incontinence. Both patient groups exhibited similar degrees of perineal descent on straining and increases in the motor unit potential duration of the external anal sphincter, indicative of neuropathic damage. Both groups had an abnormal rectoanal inhibitory reflex and an abnormal anorectal angle, though the latter was more obtuse in idiopathic fecal incontinence. However, although patients with incontinence had lower maximum basal and maximum squeeze sphincter pressures than normal, these values were normal in patients with obstructed defecation. Our findings suggest that perineal descent and neuropathy are not necessarily associated with incontinence as long as sphincter pressures remain normal. PMID- 6852465 TI - Squamous papillomas of the esophagus. AB - Fifteen cases of squamous papilloma of the esophagus were found in 20,000 upper gastrointestinal endoscopies. Squamous papillomas are usually incidental findings; symptoms are related to associated esophageal or gastrointestinal lesions. Chronic irritation from gastric acid reflux may play an etiological role. PMID- 6852464 TI - Regulation of the gastric emptying of glucose. AB - The gastric emptying characteristics of physiological saline (0.9% NaCl) and glucose solutions of three different concentrations (0.05, 0.125, 0.25 g/ml) were examined in order to identify distinctions in the control of the stomach's activity. Saline emptied rapidly and exponentially. Glucose assumed, soon after filling the stomach, a slow and calorie-constant emptying pattern such that 2.13 kcal of glucose were delivered per minute to the duodenum for all three concentrations of glucose. When, by means of a catheter passed beyond the pylorus, glucose was infused into the duodenum in amounts varying from 26.5 to 120 kcal, an inhibition on the gastric emptying of physiological saline of 0.46 min/kcal of intraduodenal glucose was demonstrated. Since 2.13 kcal/min and 0.46 min/kcal are reciprocals, it appeared that in emptying saline, the gastroduodenal system acts as an "open-loop" system passing liquids from the stomach at a rate primarily determined by the volume of gastric contents. With glucose, however, a "closed-loop" system is established that assumes a steady-state balance between the delivery of glucose to the duodenum and the inhibition of this delivery evoked from the duodenum by the glucose that enters it. PMID- 6852466 TI - Gastroduodenal fistula complicating a prepyloric ulcer. PMID- 6852467 TI - Spontaneous gastroileal fistula: unique cause of a "bubbling ulcer". PMID- 6852468 TI - Multiple esophageal dilations at a single session. PMID- 6852469 TI - ERCP and endoscopic papillotomy in patients with a Billroth II gastrectomy: report of a method. PMID- 6852470 TI - Endoscopic choledochoduodenostomy. PMID- 6852471 TI - Flexible fiberoptic sigmoidoscopy in the practice of a surgeon. PMID- 6852472 TI - Flexible sigmoidoscopy versus colonoscopy--when to use which instrument. PMID- 6852473 TI - Variations in the normal duodenal papilla. PMID- 6852476 TI - The road to heterotopia and metaplasia. PMID- 6852475 TI - Toward a better endoscopic terminology. PMID- 6852474 TI - How good is the manometric evidence for postcholecystectomy dyskinesia? PMID- 6852477 TI - There is no right way to do the wrong thing. PMID- 6852478 TI - Enteroscopy and small bowel biopsy utilizing a peroral colonoscope. PMID- 6852479 TI - A new papillotome. PMID- 6852481 TI - Safe retrieval of a swallowed denture using a hooded panendoscope. PMID- 6852480 TI - Hyperplastic and metaplastic polyps of the duodenum. PMID- 6852482 TI - Colonoscopic extraction of dentures. PMID- 6852483 TI - False teeth in the cecum. PMID- 6852484 TI - Endoscopic removal of a toothbrush. PMID- 6852485 TI - Continuous measurement of common bile duct pressure with an indwelling microtransducer catheter introduced by duodenoscopy: new diagnostic aid for postcholecystectomy dyskinesia--a preliminary report. AB - Morphine was given to two patients suspected of having postcholecystectomy dyskinesia to induce spasm of sphincter of Oddi and was successful in reproducing pain, while common bile duct pressure was continuously monitored with an indwelling high fidelity microtransducer catheter introduced by duodenoscopy. The rise of intracholedochal pressure was found to coincide exactly with the occurrence of the pain, thus suggesting the biliary origin of the symptom. The common bile duct pressure started to rise immediately after the injection of morphine, and the pressure waves initially showing biphasic variation of respiratory origin became irregular in shape and height, probably reflecting the spasm of the sphincter; these changes were well related to the intensity of the pain. Endoscopic sphincterotomy gave complete relief. A repeat morphine-induced pressure study after the sphincterotomy confirmed the disappearance of both the pain and the irregular waves. PMID- 6852487 TI - Clinical significance of anomalous pancreaticobiliary union. AB - Anomalous pancreaticobiliary union was found in nine cases among 300 consecutive adult patients examined by endoscopic retrograde cholangiopancreatography. Three had congenital choledochal cysts: one had a cyst of the choledochus associated with a cyst of the intrahepatic bile duct, another had a fusiform dilation of the choledochus, and the third had a choledochal diverticulum. Five of the nine patients had biliary malignancies (55.6%): four carcinomas of the gallbladder and one carcinoma of the choledochus. On the other hand, 18 of 291 patients without anomalous pancreaticobiliary union had biliary malignancies (6.2%): four carcinomas of the gallbladder and 14 carcinomas of the choledochus. When anomalous pancreaticobiliary union is detected, biliary malignancy, especially carcinoma of the gallbladder, should be considered as a possible complication. PMID- 6852486 TI - Parapapillary choledochoduodenal fistula: an analysis of 83 consecutive patients diagnosed at ERCP. AB - Eighty-three patients with parapapillary choledochoduodenal fistula diagnosed at endoscopic retrograde cholangiopancreatography over a 10-year period were reviewed. Three cases were associated with carcinoma of the papilla; the remaining 80 (37 female, 43 male) had gallstones. Thirty-one patients had choledocholithiasis, 12 had gallbladder stones, and 14 had intrahepatic stones. Fifty-five patients (69%) had a history of jaundice, whereas 23 (29%) had never experienced jaundice. PMID- 6852488 TI - Endoscopic cholangiopancreatoplasty: hydrostatic balloon dilation in the bile duct and pancreas. AB - Specially designed catheters containing durable polyethylene balloons have been employed in the treatment of strictures of the bile duct and pancreas and the sphincter of Oddi during the performance of endoscopic retrograde cholangiopancreatography (ERCP). Twenty-four patients with strictures of the distal common bile duct and/or dysfunction of the sphincter of Oddi and six patients with proximal biliary strictures comprised the biliary group, while six patients with strictures of either the primary pancreatic duct or accessory systems made up the pancreatic group. No significant complications occurred following biliary dilation, while uncomplicated, mild pancreatitis was associated with pancreatic manipulation. The early results of hydrostatic dilation are encouraging, but larger series and longer term follow-ups are necessary before its efficacy can be determined. PMID- 6852490 TI - [Variability of quantitative markers of irradiated and non-irradiated fish from experimental populations. II. Changes in the values of some quantitative markers in relation to body length]. AB - The influences of a single rtg irradiation dose (14 mGy) on some quantitative signs in dependence on the body length was studied in the experimental fishes Barbus conchonius and B. tetrazona. The values of all followed signs increased positively due to the body length growth. The irradiation with the abovementioned dose in the given conditions had relative small influence on the growth course of the chosen quantitative sign values in the control and irradiated fishes of both species is the same (the regression lines are in good agreement, resp. they are parallel). The statistically significant difference was stated only between the irradiated the non-irradiated groups of B. tetrazona due to the head height (the regression lines are divergent). PMID- 6852489 TI - [Metamorphosis of cells and intercellular substances in skeletogenesis]. AB - We investigated the attachment of tendons to the skeleton (tubercula humeri, patella) in regard to the chondrogenesis and osteogenesis in these areas. Then we compared our findings with those in other sites of skeletogenesis. A metamorphosis, transformation, of structure and nature of cells and intercellular susbstances in correlation with another by feedback characterized the transition from perichondrium and periost or tendon to the skeleton. The initial form of cells are in the case of tendons without doubt the special form of fibrocytes, the tendocytes. We believe that this finding confirm the earlier expressed opinion fibrocytes of the periost with the same structure as tendocytes metamorphose to osteoblasts. The metamorphosis of cells and intercellular substances at tendon attachments occur like in other regions of skeletogenesis (periost, epiphysis) in relative clearly definable stages: tendon, Ansatzstruktur (attachment structure), Ansatzknorpel (attachment cartilage) as a part of apophysis or Einstrahlungsknochen (invading bone). In regard to histogenesis periost and attachment structure are homologous formations. The latter one may be a reticular structure of collagen fibers or a fibrocartilage of which the cells are surrounded from a polysaccharide capsule and a fiber capsule partly accompanied by needle like minerals. The osseous attachment is composed from parallel running fibrils. This structure forms a Grenzstreifen (border sector) with a varied number of needle like crystals along the fibrils. The amount of minerals are increased in the Grenzlinie (border line) to bone and subsequently the crystals disappear. The tendinous mineralisation is a temporary one. However, the fibrils get the Fibrillencharakter (nature of fibrills) of the fibrils of lamellar bone. Later on the bone minerals appear. It is doubtful that osteogenesis occur always in the same manner. However, the vague term ossification can only concern the bone specific metamorphosis of fibrils, never the widely distributed mineralisation. Therefore, skeletogenesis ist one of the metamorphosis stages from the embryonal (!) determinated skeletal mesenchyme to mature and finally to old and atrophying bone. This metamorphosis may be a process probably following a controlled program. A developmental stage releases the development of the next one. A feedback influences the organisation of the different parts, e.g. cells and intercellularsubstances. The increasing diversity of the system developed in the way of Selbstorganisation (self-reproduction). With the exhaustion of the program informations started the ageing. PMID- 6852491 TI - [Proteoglycan synthesis in the endothelium of embryonal vertebrate hearts: significance for the development of cardiovascular function]. AB - The endothelium of the embryonic heart is able to synthetize proteoglycans (PG) as it is the myocardium. In the extracellular matrix, PG form highly polymeric visco-elastic networks, which besides others act as shock absorber. That is apparently of evidence for the modulation of embryonic heart actions. Because during the embryonic period the large arteries are simple endothelial tubes without having an elastic-muscular wall. That means the typical "windkessel" function such as dumping of pulse waves or a continues pressure distribution is not existent. The embryonic vessels are perfused like rigid tubes. The continuous rhythmic flow pattern in the endothelial tubes, necessary for perfusion of the different organs, is apparently compensated by a high initial pressure level initiated by the heart. It is concluded that the continuity of the pressure profile is caused by intracardial PG. The endothelial synthesis of the PG of the heart decreases with increasing development of the muscular wall of the vessels and disappears completely post partum. PMID- 6852492 TI - A quantitative study on the myenteric plexus of the distal end of the duodenum and the proximal part of the jejunum. AB - 4 necropsy specimens taken from adult individuals were used in order to estimate the density of nerve cell bodies of the myenteric plexus in the last distal 5 cm of the duodenum and the proximal 5 cm of the jejunum (including the duodenojejunal flexure), that were subdivided into parts of approximately 1 cm and stained by Giemsa's method according to Barbosa (1970). Except for the first 2 parts, an increase of the neuron number was observed toward the duodenojejunal flexure, the greatest being at this point, and then decreasing progressively. The first duodenal parts, which corresponds approximately to the intersection of the mesenteric artery with the duodenum, showed the same neuron density as the duodenojejunal flexure. In this paper the 2 parts with higher neuron density were related to functional sphincteric zones, previously described. PMID- 6852493 TI - [Vascular supply of the spinal cord]. AB - Occurrence, width and course of the radicular arteries and veins between the occiput and L3 level of the spinal cord were described. The diameter of the anterior spinal, posterior spinal, and posterolateral arteries, was also measured on the segments C2 to C6 and T2 to T10, and L2. Likewise the anterior and posterior spinal veins and the anterolateral and posterolateral veins were determined. PMID- 6852496 TI - [Changes in hemodynamic and acid-base indices in burn patients with various degrees of severity of burn shock]. PMID- 6852494 TI - [Treatment of burn patients in the period of shock using different transfusion schemes]. PMID- 6852495 TI - [Evaluation of the effectiveness of infusion therapy using whole body rheography with burn patients in the period of burn shock]. PMID- 6852498 TI - [Dielectric properties of the blood in burn patients in the period of shock]. PMID- 6852497 TI - [Hemodynamic effect of plasma substitutes used for treating burn shock in children]. PMID- 6852499 TI - [Importance of disorders of hemostasis system function in the pathogenesis of burn shock]. PMID- 6852500 TI - [Programs for the infusion and transfusion treatment of burn patients in the period of shock]. PMID- 6852501 TI - [Plethoric hemodilution in the surgical treatment of mechanical jaundice of tumor origin]. PMID- 6852502 TI - [Effect of plasma substitutes on the functional characteristics of the blood in vitro]. PMID- 6852507 TI - [Importance of the composition and the amount of transfusion and infusion media in treating patients in the period of burn shock]. PMID- 6852504 TI - [Comparative characteristics of the rheological properties of current transfusion media]. PMID- 6852503 TI - [Systemic hemodynamics, microcirculation and oxygen transport in burn shock and its combined treatment]. PMID- 6852508 TI - [Changes in the content and composition of nuclear histones of the leukocytes in different forms of acute leukemia]. PMID- 6852509 TI - [Isolation of an extract from regenerating splenic tissue inhibiting DNA synthesis predominantly in leukemic cells]. PMID- 6852510 TI - [Effect of fatty emulsions for parenteral feeding on erythrocytes]. PMID- 6852506 TI - [T-, B-, D- and O-lymphocyte count in the peripheral blood of donors]. PMID- 6852505 TI - [Effective method of obtaining a thrombocyte-enriched cell suspension from preserved blood (in glass vials) for clinical purposes]. PMID- 6852512 TI - [Dynamics of arterial pressure and gas exchange in dogs with acute blood loss replaced by an emulsion of carbon tetrafluoride]. PMID- 6852513 TI - [Elimination of perfluoro-organic compounds from rat organs]. PMID- 6852515 TI - [Hairy cell leukemia]. PMID- 6852511 TI - [Microcirculatory indices in the experimental therapy of acute blood loss using a blood substitute--an oxygen carrier based on perfluorodecalin]. PMID- 6852514 TI - [Comparative histological studies in an experiment on the action of different perfluoro-organic compounds]. PMID- 6852516 TI - [Inventions in hematology and blood transfusion and their patentability]. PMID- 6852518 TI - Variations in the photoperiodic cloacal response of Japanese quail: association with testes weight and feather color. AB - The size of the cloacal gland was found to be a reliable indicator of testicular activity of Japanese quail. Six experiments were performed to examine the effects of alternating long and short photoperiod on the size of the cloacal gland of male Japanese quail. Three types of photoperiodic cloacal responses were distinguished. Type I birds became refractory to short photoperiods after they had experienced 5 weeks or more of short days. They maintained large cloacal glands under subsequent condition of alternating long and short photoperiod. Type II birds were intermediate types I and III birds did not become refractory to short photoperiods after experiencing 5 weeks or more of short days. The cloacal glands responded to conditions of alternating long and short photoperiods with increases or decreases in size. Feather color on the throat was found to correspond to the type of cloacal response. Type I birds had brick-red throat feathers. Type II birds had white feathers intermingled with brick-red feathers. Type III had white throat feathers. The percentages of types I, II, and III observed in the experimental population was 67, 18, and 15%, respectively. Type III birds were used to study the effects of blinding on the cloacal response to short photoperiod. Five out of eight blinded type III birds did not lose the responsiveness to short photoperiod. These results are consistent with the view that extraocular photoreceptors participate in the photoperiodic gonadal response of Japanese quail. PMID- 6852517 TI - [Treatment of chronic lympholeukemia patients with a combination of pafencil and cyclophosphane]. PMID- 6852520 TI - [Masculinization of prepubertal and pubertal females of Sphaeroma serratum Fabr., (Crustacea Isopoda Flabellifera) by implantation of an androgenic gland of pubertal male]. AB - In Sphaeroma serratum, the differentiation of the male external sexual characteristics, as a result of an androgenic gland implant, proceeds more easily in females in vitellogenesis than in immature females. On the contrary, the transformation of the gonads is quicker and more obvious in immature females than in mature ones. This transformation which leads, in all cases, to an inversion of the ovary to a functional testicle able to produce spermatozoa, always occurs without any differentiation of an androgenic gland, contrary to what can be observed with Oniscoids. The details of the external sexual differentiation of the grafted females can be related to the functioning of a protocerebral neurosecretory center having, as in males, an androinhibitory effect on the androgenic gland implant; the activity of this center, which seems to correspond to the center secreting VIH, would be particularly high with immature females and would become very low--or nonexistent--in females in vitellogenesis. PMID- 6852519 TI - The effect of temperature and gonadotropin on testicular steroidogenesis in Sarotherodon (Tilapia) mossambicus in vitro. AB - Testes of sexually mature Sarotherodon mossambicus were incubated at 15, 22, 30, and 40 degrees with (a) tritiated testosterone and (b) salmon pituitary extract. Formation of 11-keto- and 11 beta-hydroxytestosterone from the tritiated precursor showed little change in yield between 15 and 30 degrees but yields of glucuronides rose dramatically between 22 and 30 degrees and a significant rise was observed for formation of 5 beta-androstane-3 alpha, 17 beta-diol between 15 and 40 degrees. Yields of 3 alpha, 17 beta-dihydroxy-5 beta-androstan-11-one followed a pattern similar to that of 11-ketotestosterone. With endogenous precursors under the stimulation of salmon pituitary extract, yields of testosterone, 11-ketotestosterone, and 11 beta-hydroxytestosterone were maximal at 22 degrees after which they declined to very low levels at 40 degrees. Yields of testosterone and 11-ketotestosterone glucuronides while showing a peak at 22 degrees declined much more slowly at higher temperatures than did those of the free steroids. In the absence of pituitary stimulation, levels of all steroids were below the limits of detection. Plasma levels of testosterone (15.3 +/- 1.5 ng/ml), 11-ketotestosterone (5.3 +/- 2.7 ng/ml), 11 beta-hydroxytestosterone (5.5 +/- 2.6 ng/ml), and their glucuromides (1.5 +/- 0.5, 0.14 +/- 0.1, and 1.5 +/- 0.5 ng/ml, respectively) were measured in fish held at 25 degrees. A rapid conchromatographic method for the assay of the three free steroids is described and the results are shown to be comparable to those obtained after chromatography. PMID- 6852521 TI - Activation of neurosecretory protocerebral cells by 20-hydroxyecdysone in Lithobius forficatus L. (Myriapoda Chilopoda). PMID- 6852523 TI - Plasma androgen patterns during delayed implantation in the European badger (Meles meles L.). AB - Androstenedione and testosterone were measured by radioimmunoassay after chromatography on celite microcolumns throughout the delayed implantation period in the European badger (Meles meles L.). Androstenedione and testosterone concentrations varied from 0.05 to 22 ng/ml, and from 30 pg/ml to 359 pg/ml, respectively. There was a typical biphasic pattern in the fluctuation of these two steroids. Androstenedione levels increased between June and August (X= 7.9 +/ 0.8 ng/ml), decreased from September to November (X = 2.3 +/- 0.3 ng/ml), and then increased again from December to February (X = 6.1 +/- 0.7 ng/ml). The same fluctuations of the testosterone levels were observed throughout the diapause, but the concentrations were lower. The overall correlation between androstenedione and testosterone was highly significant (r = 0.75, P less than 0.001). There was also a similarity between the androgen and progesterone patterns of secretion (r = 0.31), particularly at the end of the delay period (r = 0.73, P less than 0.001). No correlation could be demonstrated between androgens and estrogens. PMID- 6852522 TI - The differentiation of Leydig cells, steroidogenesis, and the spermatogenetic wave in the testis of Necturus maculosus. AB - The study of seminiferous tubule--Leydig cell interactions in relation to specific germ cell stages during the cycle of the seminiferous epithelium is extremely difficult in most mammalian species due to the continual presence of different spermatogenetic stages in the testis from the onset of puberty. The problem is also compounded by the uniform distribution of both seminiferous tubules and interstitial tissue throughout the entire testis. This difficulty can be circumvented, however, by studying certain species where there is a topographical distribution of germ cell stages within the testis. The urodele amphibian Necturus maculosus exhibits a breeding cycle during which a longitudinal wave of spermatogenesis occurs along the length of the testis, resulting in a spatial and temporal segregation of differentiating germ cells. Moreover, this topographical pattern of spermatogenesis is also reflected in the degree of development of adjacent Leydig cells. This anatomical arrangement allows distinct testicular regions to be obtained using a dissecting microscope. The isolated zones, containing germ cells and Leydig cells in various stages of development, were analyzed for 17 alpha-hydroxylase, C-17,20-lyase, and aromatase activities (key enzymes for the synthesis of androgens and estrogen), estrogen binding, and cytochrome P-450 content. Functional parameters were then correlated with the morphology of Leydig cells in the various zones observed by both light and electron microscopy. It was found that there existed a distinct correlation between the state of differentiation of the leydig cells, their steroidogenic potential, and the distribution of estrogen receptors. These results in Necturus indicate indicate in this species, at least, the steroidal microenvironment of different germ cell associations may be quite specific. PMID- 6852524 TI - Further evidence for a polymorphism in gametic segregation in the tetraploid treefrog Hyla versicolor using a glutamate oxaloacetic transaminase locus. AB - Intra- and interspecific cross combinations between the tetraploid treefrog Hyla versicolor, and between H. versicolor and the diploid treefrog Hyla chrysoscelis were performed. Progeny phenotypes resulting from these crosses were examined electrophoretically using a polymorphic glutamate oxaloacetic transaminase (GOT 1) locus, to determine the mechanism of chromosome segregation in H. versicolor, and to test theoretical expectations for isozyme expression in interspecific (2n X 4n or 4n X 2n) hybrids. In some intraspecific tetraploid crosses progeny phenotypes fit a disomic mode of segregation, whereas in other crosses a tetrasomic mode of segregation was the most probable. Additional crosses produced phenotypic ratios that conformed to either a disomic or tetrasomic mode of segregation. These results suggest that a polymorphism, with respect to segregation of gametes, exists in H. versicolor, resulting from differences in chromosome pairings during meiosis I. This polymorphism in gametic segregation occurred in both sexes. Certain crosses, however, produced phenotypic ratios that did not conform to any chromosome segregation model. Progeny phenotypes observed from most interspecific crosses conformed to expected interspecific isozyme staining intensity models. Symmetrical heterozygotes, representing either a single dose for both alternate alleles or double doses for both alternate alleles, were also observed. Such phenotypes are unexpected in triploid progeny. A null allele was postulated to account for the aberrant segregation ratios and phenotypes observed in certain intra- and interspecific crosses. PMID- 6852525 TI - Electrophoretic variation for X chromosome-linked hypoxanthine phosphoribosyl transferase (HPRT) in wild-derived mice. AB - An electrophoretic variation for hypoxanthine phosphoribosyltransferase, HPRT, has been identified in samples of Mus spretus, a field mouse from southern Europe and in M. m. castaneus, a house mouse from southeast Asia. These mice will interbreed with laboratory mice to produce viable, fertile F1 progeny. The variation for HPRT segregates as an X chromosome gene in F1 and backcross progeny. Linkage analysis involving the markers Pgk-1 and Ags indicated a gene order of centromere--Hprt--Pgk-1--Ags in crosses involving both stocks of wild mice. PMID- 6852526 TI - Application of the ovarian teratoma mapping method in the mouse. AB - Murine ovarian teratomas were used to determine recombination percentages for gene-gene and centromere-gene intervals. Data were obtained utilizing a recombinant inbred strain, LTXBJ, and a number of newly developed LT/SvEi congenic strains.--Centromere-gene recombination was measured at 11.3 +/- 1.2% for the centromere of chromosome 7 - Gpi-1 interval and 15.8 +/- 2.4% for the centromere of chromosome 14 - Np-1 interval using the ovarian teratoma method. The centromere - Np-1 interval was measured at 26.5 +/- 3.6% using a standard backcross involving the Rb6Bnr Robertsonian translocation as a centromere marker. -To assess the accuracy of the ovarian teratoma mapping method, we compared the recombination frequency obtained for the Mpi-1-Mod-1 interval on chromosome 9 using the ovarian teratoma method to that obtained using a standard backcross. The recombination percentage was 22.9 +/- 5.4 using the ovarian teratoma method and 18.6 +/- 3.3 using the backcross method, indicating that the two methods produce equivalent estimates of recombination. In addition, for centromere-gene intervals known to be more than 30 cM in length, the ovarian teratoma method was consistent with classical recombination methods, yielding high recombination percentages. We conclude from these results that the ovarian teratoma mapping method is a reliable method for estimating recombination frequencies and the most accurate method available for estimating centromere-gene recombination frequency in the mouse. PMID- 6852527 TI - Comparison of the nucleotide sequences of early region E1b DNA of human adenovirus types 12, 7 and 5 (subgroups A, B and C). AB - The nucleotide sequences of human adenovirus serotypes 12 (Ad12, oncogenic subgroups A), 7 (Ad7, weakly oncogenic subgroup B) and 5 (Ad5, non-oncogenic subgroup C) DNAs have been compared. The region studied stretches from the termination codon of region E1a (m.p. 4.2) and comprises the entire region of the three viral DNAs, ending at the polyadenylation signal of the gene for viral polypeptide IVa2 (m.p. 11.2). The homology in the sequences encoding the E1b proteins of Mr 20 000 and Mr 55 000 is 55-60%, when two serotypes are compared, and about 45% in a three-strain comparison. However, a short internal segment encoding the C terminus of the Mr 20 000 protein, and at the same time amino acids 23-120 of the Mr 55 000 protein show a much higher degree of divergence in the three strains, as do the noncoding areas. The present study does not reveal how the three serotypes are phylogenetically related. PMID- 6852532 TI - Medical hazards of air travel for older people. PMID- 6852533 TI - Practical management of neuromuscular diseases in the elderly. PMID- 6852531 TI - Diagnosis and management of leg ulcer. PMID- 6852530 TI - Should digitalis be used in elderly patients? PMID- 6852534 TI - Digitalis therapy in the elderly. PMID- 6852528 TI - Construction of the physical map of the chloroplast DNA of Phaseolus vulgaris and localization of ribosomal and transfer RNA genes. AB - Construction of a physical map of the chloroplast DNA from Phaseolus vulgaris showed that this circular molecule is segmentally organized into four regions. Unlike other chloroplast DNAs which have analogous organization, two single-copy regions that separate two inverted repeats have been demonstrated to exist in both relative orientations, giving rise to two populations of DNA molecules. Hybridization studies using individual rRNA and tRNA species revealed the location of a set of rRNA genes and at least seven tRNA genes in each inverted repeat region, a minimum of 17 tRNA genes in the large single-copy region and one tRNA gene in the small single-copy region. The tRNA genes code for 24 tRNA species corresponding to 16 amino acids. Comparison of this gene map with those of other chloroplast DNAs suggests that DNA sequence rearrangements, involving some tRNA genes, have occurred. PMID- 6852529 TI - Amplification of a chimeric plasmid carrying an erythromycin-resistance determinant introduced into the genome of Streptococcus pneumoniae. AB - Hybrid plasmid molecules carrying an insert of pneumococcal DNA can integrate into the pneumococcal genome by homologous recombination. The resulting structure is a duplication of the pneumococcal DNA insert bracketing a vector genome. To select for plasmid integration, the vector plasmid was marked with an erythromycin (ery) resistance determinant (eryr) originating from pVA736, a streptococcal plasmid. Experiments with pR27 and pR28, two plasmids carrying the same insert of pneumococcal DNA but in opposite orientations, led to the following observation: (i) In one orientation of the ery region with respect to the amiA locus, cells exhibited a low-level resistance to ery; when these cells were grown in the presence of ery, amplification of the integrated plasmid occurred and cells became resistant to a high level of antibiotic. (ii) In the opposite orientation, a high level of resistance was observed, without need for amplification. These results indicate that, in the orientation conferring a high level resistance without amplification, the ery region is transcribed both from its own promoter and from the promoter of the amiA locus. In the opposite orientation, a low level of transcription from the eryr promoter could account for a strong selective pressure for the amplified state, which then allows for rapid growth in the presence of ery. PMID- 6852536 TI - "Hearts too good to die". PMID- 6852535 TI - Early retirement: a catalyst for health problems? PMID- 6852537 TI - Cimetidine: optimal use in older patients. PMID- 6852538 TI - Sudden cardiac death: risk, evaluation, and primary prevention. PMID- 6852539 TI - Decubitus ulcers: principles of prevention and management. PMID- 6852540 TI - Stupor and coma: a clinical approach. PMID- 6852541 TI - Managing benign esophageal stricture. PMID- 6852542 TI - Heart rate reactivity during minor mental stress in men in their 50s and 70s. AB - Modifications with aging in heart rate reactivity was investigated during minor mental stress. 27 normal male volunteers, aged 51-55 years (n = 10) and 71-74 years (n = 17), were studied in control conditions and while passing a series of 5 psychometric test measuring memory or intellectual speed. Men in their 70s had both lower heart rate baseline levels and lower reactivity during cognitive tasks. PMID- 6852543 TI - Changes in the concentration and composition of human brain gangliosides with aging. AB - Ganglioside content and composition were studied in whole brains from 9 neurologically normal male individuals ranging from 25 to 85 years in age. The content of ganglioside-bound sialic acid decreased from 1,070 to 380 micrograms/g fresh tissue at 85 years. Ten individual ganglioside fractions were identified on high-performance thin-layer chromatography, seven of which were quantified. With age, ganglioside composition shifted to a more polar pattern due to an increase in the relative concentration of the more polar fractions GQ1b, GT1b and GD1b and a decrease in GD1a and GM1. Except for GQ1b, the absolute concentration of all gangliosides decreased with age. All changes were more pronounced in younger ages. Results are discussed in relation to structural changes occurring in the aging brain, and the involvement of gangliosides is suggested. PMID- 6852544 TI - Human life span stopped increasing: why? AB - To account for the cessation of human life span increase in developed countries, we have studied the Swedish vital statistics over the period of 1901-1978. Approximating age-related mortality dynamics as the sum of the constant (age independent mortality) and exponential (age-dependent mortality), we have discovered a striking phenomenon consisting in historical stability of age dependent mortality. It appeared that decrease in total mortality was exclusively due to age-independent mortality which is close now to the limiting (zero) level. The results obtained prove the existence of the biological limit for the average life span and show that the conventional reserves for decrease in mortality have been exhausted. Thus, the problem of life prolongation requires a new way of thinking. PMID- 6852546 TI - The Sandoz Clinical Assessment-Geriatric (SCAG) scale. A general-purpose psychogeriatric rating scale. AB - In response to a need for an easily used general-purpose rating scale designed specifically for the evaluation of pharmacotherapy in senile dementia and related conditions, the Sandoz Clinical Assessment-Geriatric (SCAG) scale was developed. This scale has been widely used in geriatric psychopharmacologic research and has been found to be sensitive, valid, and reliable for this purpose. In order to provide investigators with guidelines for the evaluation of the 18 items and global evaluation provided on the scale, with a view to improving interrater reliability, a manual was developed for this purpose. As the existence of this manual is not widely known, it is presented so that the SCAG scale may be used in a more uniform manner from investigator to investigator. PMID- 6852545 TI - Constipation in long-stay elderly patients: its treatment and prevention by lactulose, poloxalkol-dihydroxyanthroquinolone and phosphate enemas. AB - 37 long-stay geriatric patients were studied. All had 80% transit time (TT) in excess of 6 days. Only an average of 23% of markers were passed by day 6 and 30% of patients still had markers in situ after 2 weeks. Three daily enemas had no effect on TT and three daily enemas together with a laxative for 6 days normalized TT in 40% only. A further 3 weeks of laxatives did not prevent constipation from getting worse. The effectiveness of lactulose and poloxalkol dihydroxyanthroquinolone, respectively, were the same and better than no treatment. PMID- 6852549 TI - Histopathologic changes following carmustine treatment of uveal Greene melanoma in rabbits. AB - Uveal Greene melanoma was produced in the anterior chamber of 47 eyes in 29 rabbits. One group of rabbits was untreated and served as controls. One group was treated with carmustine (1,3-bis(2-chloroethyl)-1-nitro-sourea; BCNU) intravenously and one group was treated with BCNU both intravenously and locally via an implanted silicone device. Tumor specimens were studied histopathologically with light and electron microscopy. Compared with controls, the treated tumors were smaller, more necrotic, and contained more spindle-shaped cells intermingled with inflammatory cells. Changes were particularly striking in the combined-treatment group. Treated tumors of both groups also showed less invasion into surrounding ocular tissues. Morphologic changes after treatment included the development of numerous degenerative tumor cells with calcium deposition, fragmentation of nuclei, degeneration of mitochondria, accumulation of fat droplets, and disorganization of cytoplasm. These changes may indicate that the drug, particularly following combined delivery, has a cytotoxic effect directly on the tumor cells. PMID- 6852548 TI - Dietary intakes reported in a group of chronic geriatric psychiatric patients. PMID- 6852547 TI - A pharmacokinetic study of acebutolol in aged subjects as compared to young subjects. AB - Pharmacokinetics of acebutolol have been studied in hypertensive aged patients (79.4 +/- 3.8 years) and in young healthy subjects (23.4 +/- 0.7 years) after intravenous (0.35 mg/kg bolus) and oral administration (400 mg). Acebutolol and diacetolol, the main metabolite, plasma levels were determined by high-pressure liquid chromatography. After intravenous administration, apparent volume of distribution (1.5 vs. 2.4 liter . kg-1, p less than 0.05) and total body clearance (6.2 vs. 8.8 ml . min-1 . kg-1, n.s.) of acebutolol are smaller in elderly than in young men. After oral administration, maximum plasma levels (28.03 vs. 9.68 micrograms . l-1 . kg-1) and area under the curve (163.1 vs. 57.5 micrograms . l-1 . h . kg-1) are significantly higher in aged patients than in young subjects (p less than 0.001). Acebutolol and diacetolol plasma half-lives increase in elderly patients (11.6 vs. 7.2 h and 14.8 vs. 12 h respectively). These results suggest a possible accumulation of acebutolol and diacetolol in elderly. PMID- 6852550 TI - Direct vitreous reaction to intraocular lens implants. AB - Three intraocular lens implants removed during keratoplasty between 1 1/2 and 5 years after implantation revealed attachments of reactive vitreous strands and membranes contained bundles of fibers with associated small bipolar cells, pigment, and blood remnants. Some of the fibrous vitreous strands were wound around the haptics of the implants for firm anchoring. The usual reactive cell membranes on the surface of the implants were interrupted in the areas of the attachment of formed vitreous and vitreous membranes. PMID- 6852552 TI - The development of the chamber angle in the rat eye. Morphological characteristics of developmental stages. AB - The pre- and postnatal development of the chamber angle region was studied in the rat. The eyes of five weight-matched littermates were investigated by light- and electron microscopy at each of the following times: prenatal days 14, 17, 18, 21; day of birth; postnatal days 5, 10, 15, 20, 40, 60, 100, 200. Major developmental stages are demonstrated and the morphological characteristics of each stage shown. Developmental periods in the rat are correlated with periods that have previously been outlined in the human (Reme and Lalive 1981). Major periods comprise the following events: I. anlage formation (day 17 prenatal - day postnatal); II. differentiation into definitive structures (days 5-10); III. specialization of definitive structures (days 10-20); IV. final components (days 20-60); V. final molding and rarefaction (days 60-100). Our data indicate that the developing rat eye is a suitable experimental model for studies on the development of the chamber angle. Moreover, this study provides baseline data for a separate investigation on morphogenetic events contributing to the remodeling processes occurring within the vertebrate chamber angle. PMID- 6852551 TI - Changes in corneal DC-potentials associated with changes in pupillary diameter. AB - Using light-emitting diodes we stimulated monocularly with light intensities of between 7.5 and 1,800 cd/m2, and recorded simultaneously the Dc-electroretinogram and pupillary movements of the stimulated and the contralateral eye. In some investigations, the visual evoked potential and the activity from the periorbicular muscles were also recorded. Various drugs acting on the autonomous nervous system were topically applied and their efforts studied. In the eye with an untreated pupil, stimulated or contralateral, a corneo positive potential coincident with pupillary constriction was seen (cu-wave), provided the pupil was large beforehand, a corneonegative deflection dominated, which was also coincident with pupillary constriction (mu-wave). Parasympathicolytics or mimetics abolished both the cu and mu-wave. We conclude that the cu-wave is related to depolarization of the sphincter pupillae during constriction, whereas the mu-wave might be related to a modification of the potential distribution between the pigment epithelium and the tissue surrounding the eye in the case where the pupil is constricted beyond a critical point. PMID- 6852553 TI - [Modification by environmental chemical factors of the blastomogenesis induced by nitrosodimethylamine]. PMID- 6852554 TI - [Hygienic evaluation of the methods for treating animal husbandry effluents]. PMID- 6852555 TI - [Characteristics of the biological reaction of the body to exposure to pesticides and their mixtures in relation to the chemical structure]. PMID- 6852557 TI - [Radiation control over the radionuclide intake into the water system during the operation of an atomic electric power station]. PMID- 6852556 TI - [Characteristics of kelthane distribution and accumulation in the tissues of warm blooded animals]. PMID- 6852558 TI - [Tasks of environmental hygiene in light of the resolution of the Central Committee of the CPSU and of the Council of Ministers of the USSR on "Additional Measures for Improving Health Protection for the Population"]. PMID- 6852559 TI - [Health and hygiene aspects of the main trends in the work of the National Commission on Radiation Protection in 1982-1986]. PMID- 6852563 TI - [Gas chromatographic determination of nicotine in the air]. PMID- 6852562 TI - [Method of evaluating the reliability of differences in sample data by standardized indices]. PMID- 6852560 TI - [Methods of introducing the results of the scientific activities of the Central Research Institute of Health Education into public health practice in the period of 1976-1981]. PMID- 6852561 TI - [Determination of the scope of laboratory studies of the air of industrial facilities]. PMID- 6852564 TI - [Determination of the active principle of a plictran preparation and its metabolites in environmental objects]. PMID- 6852565 TI - [Sanitary chemistry evaluation of polysulfonamide membranes]. PMID- 6852567 TI - [Air permeability of materials as an index of the hygienic properties of summer clothing]. PMID- 6852566 TI - [New approach to evaluating the physical development of children and adolescents]. PMID- 6852568 TI - [Conversion and outfitting of the UAZ-452 truck for performing health and hygiene studies]. PMID- 6852569 TI - [Improved training of the hygienist and epidemiologist in light of the resolution of the Central Committee of the CPSU and of the Council of Ministers of the USSR on "Additional Measures for Improving Health Protection for the Population"]. PMID- 6852570 TI - [Assessment of the irradiation of the organs in children in x-raying the chest cavity]. PMID- 6852571 TI - [Hygienic standard for the resin of hardwoods in the water of reservoirs]. PMID- 6852572 TI - [Margarine, its nutritional and biological properties]. PMID- 6852573 TI - [Morphofunctional study of the ovaries in long-term exposure to styrene]. PMID- 6852575 TI - [Ratio between the oxidizability value and the toxicity of aqueous extracts of rubbers]. PMID- 6852574 TI - [Principles and methods of regulating chemical blastomogens]. PMID- 6852576 TI - [Comparative analysis of the structure and permeability of mammalian skin]. PMID- 6852579 TI - [Combined effects of vibration and toxic substances]. PMID- 6852577 TI - [Age-related sensitivity of the body of an animal to superhigh-frequency electromagnetic fields]. PMID- 6852581 TI - [Methodological approaches to the organization of preliminary and regular medical examinations of workers exposed to allergens and irritants]. PMID- 6852580 TI - [Changes in the health status of workers engaged in the production of primary aliphatic alcohols as an index of the efficacy of hygienic measures]. PMID- 6852578 TI - [New approaches to the standardization of microwave electromagnetic fields]. PMID- 6852582 TI - [Clinical manifestations of chronic occupational phosphorus poisoning]. PMID- 6852583 TI - [Various biochemical criteria of exposure to acrylonitrile]. PMID- 6852585 TI - [Subjective and objective methods in the diagnosis of fatigue]. PMID- 6852586 TI - [Physical stress during work, and worker morbidity]. PMID- 6852584 TI - [Toxicological and hygienic aspects of the railroad transportation of chemical cargo in the USSR]. PMID- 6852587 TI - [Test for evaluating muscle fatigue]. PMID- 6852589 TI - [New principles in improving the standardization of local vibration]. PMID- 6852588 TI - [Effects of low-frequency acoustic oscillations on phospholipid composition of whole blood and various tissues of the rat]. PMID- 6852590 TI - [Various effects of continuous and intermittent work with vibrating hand-held tools]. PMID- 6852592 TI - [Vibration sensitivities of workers in various vibration-hazardous occupations]. PMID- 6852591 TI - [Study of the biodynamic properties of human body during general low-frequency vibration]. PMID- 6852593 TI - [Cerebral circulation in patients with vibration disease during treatment at health resorts]. PMID- 6852595 TI - [Effects of ship noise on sailors during prolonged sea voyages]. PMID- 6852594 TI - [Noise control in modern metallurgical plants]. PMID- 6852596 TI - [2 cases of acute dinil poisoning]. PMID- 6852597 TI - [Experimental evaluation of the toxic effect of copolymer NB]. PMID- 6852599 TI - [Functional capacity of the spontaneous rhythm monitor in patients with artificial pacemaker]. PMID- 6852600 TI - [Arrhythmia in the immediate period after heart valve prosthesis: incidence and prognostic significance]. PMID- 6852601 TI - [Assisted circulation with the "reverse" balloon pump]. PMID- 6852602 TI - [Hydrodynamic properties of xenoaortic transplants sterilized in antibiotic solutions with addition of hyperimmune antistaphylococcal plasma]. PMID- 6852604 TI - [Hemosorption among the complex therapeutic measures in destructive purulent processes in the lung and pleura]. PMID- 6852603 TI - [Treatment of postoperative coagulated hemothorax with papain]. PMID- 6852598 TI - [Various characteristics of adaptation to vibration in grinders]. PMID- 6852607 TI - [Lobectomy in patients with diffuse forms of pulmonary tuberculosis]. PMID- 6852606 TI - [Needle aspiration roentgen biopsy of the lungs with coagulation]. PMID- 6852605 TI - [Pneumonectomy with resection of the tracheal bifurcation in surgical and combined treatment of lung cancer]. PMID- 6852608 TI - [Complications of postoperative reflux esophagitis]. PMID- 6852609 TI - [Surgical treatment of myxomas of the atrium]. PMID- 6852610 TI - [Lymphography of the thoracic duct in chronic inflammatory processes in the mediastinum]. PMID- 6852611 TI - [Immediate results of resection of the proximal segment of the stomach in care depending on the degree of esophageal involvement]. PMID- 6852612 TI - [Etiology and pathogenesis of spontaneous chylothorax]. PMID- 6852613 TI - [Pulmonary embolectomy]. PMID- 6852614 TI - [Favorable outcome of the surgical treatment of cardiac myxoma (data from a 3 year observation)]. PMID- 6852615 TI - [Tetralogy of Fallot associated with a defect of the aortopulmonary septum]. PMID- 6852616 TI - [Protective effect of multiple cardioplegia with blood perfusate]. PMID- 6852617 TI - [Case of leiomyosarcoma of the vena cava inferior]. PMID- 6852618 TI - [Case of primary sarcoma of the lung in a child]. PMID- 6852619 TI - [Spontaneous pneumothorax of a solitary lung]. PMID- 6852620 TI - [Multiple leiomyofibroma of the thoracic segment of the esophagus]. PMID- 6852621 TI - Split ileostomy and ileocolostomy for Crohn's disease of the colon and ulcerative colitis: a 20 year survey. AB - The clinical course of 140 patients who have had a split ileostomy for ulcerative colitis or colonic Crohn's disease over a 20 year period is reported. In 37 patients with ulcerative colitis there was no sustained improvement. In the 102 patients with Crohn's disease there was an immediate clinical improvement in 95, which was sustained in 65. Thirty patients have subsequently required a proctocolectomy for persistent inflammation, and 28 are still defunctioned. Bowel continuity was restored after 61 split ileostomies and in 44 patients intestinal continuity remains intact at the present time (mean follow up since closure = 62.5 months, range 0-231 months). It is concluded that a split ileostomy is a safe conservative operation producing at least temporary improvement in severely ill and malnourished patients with Crohn's colitis, and that if a subsequent resection becomes necessary it may be less extensive than was thought applicable at the initial operation. In 27 patients a resection has not been required. PMID- 6852622 TI - Small intestinal nodular lymphoid hyperplasia in patients with giardiasis and normal serum immunoglobulins. AB - Nodular lymphoid hyperplasia of the upper small intestine was demonstrated in 25 patients with giardiasis. All had normal serum immunoglobulin levels and seven patients initially presented with clinical findings suggestive of an abdominal lymphoma. In only two, however, was the diagnosis of primary jejunal lymphoma confirmed. It is possible that an aetiological relationship exists between recurrent parasitic infestation and nodular lymphoid hyperplasia of the upper small intestine. PMID- 6852623 TI - Enzymes of collagen synthesis and type III procollagen aminopropeptide in the evaluation of D-penicillamine and medroxyprogesterone treatments of primary biliary cirrhosis. AB - Changes in serum immunoreactive prolyl hydroxylase protein (IRPH), galactosylhydroxylysyl glucosyltransferase activity (GGT) and the aminoterminal propeptide of type III procollagen [Pro(III)-N-P] were studied in 21 patients with primary biliary cirrhosis during a follow-up period of up to three years. The patients received either D-penicillamine (600 mg/day), medroxyprogesterone acetate (5 mg/day), or a placebo, or no treatment after the D-penicillamine or medroxyprogesterone medication, each period lasting from nine to 15 months. The individual serum IRPH, GGT, and Pro(III)-N-P concentrations exceeded the upper normal limit in most patients. No significant changes were found in any of these three serum markers during any of the five different periods, nor was there any evidence for a decrease in the raised prolyl 4-hydroxylase activity in the hepatic biopsy specimens in response to any of the treatments. Galactosylhydroxylysyl glucosyltransferase activity decreased significantly in these specimens during medroxyprogesterone therapy, but the interpretation of this, the only positive change, remains unclear. The data suggest that D penicillamine or medroxyprogesterone therapy may have no favourable effect on the increased hepatic collagen formation involved in primary biliary cirrhosis. PMID- 6852624 TI - Relationship between HBV-specific DNA polymerase and HBe antigen/antibody system in chronic HBV infection: factors determining selection of patients and outcome of antiviral therapy. AB - The sera of 23% of HBe antigen positive patients with chronic hepatitis are HBV DNA polymerase negative. These patients are probably undergoing spontaneous seroconversion from a state of high to low viral replication and do not require antiviral therapy. In chronic HBV infection rapid changes in viral replication as a result of antiviral therapy are reflected by changes in HBV-DNA and HBV-DNA polymerase but not by changes in HBe antigen concentrations. Disappearance of HBe antigen from serum may be delayed for 180 days after permanent inhibition of HBV replication with adenine arabinoside or its monophosphate derivative. PMID- 6852626 TI - Serum isoamylase as a test for pancreatic insufficiency. AB - Total and pancreatic serum isoamylases were performed on 38 control subjects (21 non-smokers and 17 smokers) and 21 consecutive patients with pancreatic insufficiency before and after meal stimulation. There was no difference in the fasting or stimulated levels of total amylase (T), pancreatic isoamylase (P), or % P/T between smokers and non-smokers. The P/T ratio was significantly reduced in patients with pancreatic insufficiency when compared with each of the control groups (p less than 0.0005). Eleven of 21 patients with pancreatic insufficiency had raised total serum amylase, but none had a rise in the pancreatic fraction or P/T ratio. Our findings indicate that the T, P, and P/T ratio of serum amylase are not influenced by smoking or meal stimulation. A reduced P/T ratio in a patient with steatorrhoea suggests pancreatic insufficiency as the cause. Hyperamylasaemia in patients with pancreatic insufficiency does not necessarily imply a relapse. PMID- 6852625 TI - Vagotomy by chemoneurolysis: an experimental study in the rat. AB - In the pylorus ligated rat vagotomy has been attempted by chemoneurolysis with alcohol. Surgical truncal vagotomy reduced the intragastric acid produced in a five-hour period from 310 +/- 17.6 (SD) mumol to 5.4 +/- 2.4 mumol with a marked reduction in the ulcer score. Injection of 30% alcohol in the region of the vagal trunks at the level of the lower oesophagus produced a marked reduction in gastric acid secretion (7.6 +/- 3.7 mumol). Injection of solutions of alcohol in concentrations over 10% along the lesser curvature reduced gastric acid output to less than 10 mumol with a corresponding reduction in the ulcer score. Four months after the injection of 30% alcohol along the lesser curvature the acid output was 23.0 +/- 5.7 mumol and no gastric ulceration occurred. PMID- 6852628 TI - Endoscopic transmission of hepatitis B virus. AB - Although transmission of hepatitis B virus (HBV) infection has long been recognised as a potential hazard of gastrointestinal endoscopy, there has been little evidence of direct patient-to-patient cross-infection after such procedures. We wish to report a case of type B viral hepatitis almost certainly acquired at endoscopy from an instrument sterilised in the conventional manner, but which had been used on the previous day on a patient with bleeding oesophageal varices who was incubating type B viral hepatitis. PMID- 6852627 TI - Combined cow's milk protein and gluten-induced enteropathy: common or rare? AB - A child is reported with unequivocal gluten and cow's milk protein-induced enteropathy. This is believed to be the first reported case of this association. PMID- 6852629 TI - Pancreatic Society of Great Britain and Ireland. Seventh annual meeting, London, 12 November 1982. Abstracts. PMID- 6852630 TI - Duodenogastric reflux. PMID- 6852631 TI - Novel approach to quantify duodenogastric reflux in healthy volunteers and in patients with type I gastric ulcer. AB - A new method is described which allows simultaneous measurement of gastric emptying and duodenogastric reflux and avoids transpyloric intubation. After intragastric instillation of a liquid lipid meal in six healthy volunteers the fractional gastric emptying rate was 2.9 +/- 0.3 in the upright and 2.5 +/- 0.6 SEM X 10(-2)/min in the supine position, respectively (p greater than 0.5). The duodenogastric reflux rate (expressed as fraction of the intraduodenal amount of duodenal marker) was 0.30 (range 0.03-0.81) and 0.22 (0.01-0.55) X 10(-2)/min, respectively (p greater than 0.2). Atropine (40 micrograms/kg) decreased the supine gastric emptying rate to 1.1 +/- 0.2 (p less than 0.05) and increased the supine duodenogastric reflux rate to 2.74 (0.04-9.80) X 10(-2)/min (p less than 0.05). Fasting duodenogastric reflux rate was similar in the supine and upright position, 0.49 (0.04-0.89) and 0.42 (0.06-0.97) X 10(-2)/min, respectively (p greater than 0.5). Fractional gastric emptying rate was similar in 10 volunteers and 17 patients with type I gastric ulcer (2.1 +/- 0.4 vs 1.7 +/- 0.2 SEM X 10( 2)/min, p greater than 0.2). Their duodenogastric reflux rates were also similar, 0.65 (0.01-5.24) vs 1.10 (0.01-10.83) X 10(-2)/min (p greater than 0.5). We conclude therefore that (1) gastric emptying and both fasting and postprandial duodenogastric reflux are independent of the posture; (2) fasting and postprandial reflux are of similar magnitude; (3) atropine shows gastric emptying and increases duodenogastric reflux; and (4) patients with type I gastric ulcer have neither slowed gastric emptying nor increased duodenogastric reflux. PMID- 6852632 TI - Rectal mucosal plasma cells in inflammatory bowel disease. AB - To achieve optimum staining and reproducible counts of plasma cells in paraffin embedded tissue with the immunoperoxidase technique we have found it essential to obtain a plateau count by titration of antisera for each specimen. This modification was used to study IgA, IgM, IgE, and IgG plasma cells in rectal biopsies from 20 controls, 20 patients with ulcerative proctocolitis, 20 with Crohn's colitis, 20 with non-specific proctitis, 15 with bacterial colitis, and seven with Crohn's disease but no apparent large bowel involvement. Counts were correlated with the characteristic histological features of inflammatory bowel disease. In controls the ratio of the mean counts for IgA, IgM, IgE, and IgG plasma cells was 8:3:3:1. All types of plasma cells were very significantly increased in the patients with ulcerative proctocolitis, Crohn's colitis, and non specific proctitis and counts correlated with the severity of inflammation. There was no significant difference between the counts in these three groups. All counts tended to be higher in bacterial colitis than in controls, the difference being significant for IgA and IgE. When matched for severity of inflammation there was no significant difference between the counts in bacterial colitis and inflammatory bowel disease. The counts in patients with Crohn's disease but no large bowel involvement were not significantly different from controls. These results suggest that changes in plasma cell counts in inflammatory bowel disease are a non-specific response to mucosal damage, possible by a luminal irritant, and do not differentiate the type of inflammatory bowel disease. PMID- 6852636 TI - Enterochromaffin cell hyperplasia and megacolon: report of a case. AB - A case of megacolon is described in which there was an unusual and focal hyperplasia of enterochromaffin cells in the mucosa. These formed discrete spherical acini in the lamina propria. These acini were not neoplastic and their significance is discussed. PMID- 6852637 TI - Bile salt-induced gastric mucosal damage. PMID- 6852638 TI - [Family planning, wish for children and birth control of Swiss couples - results of a representative survey. I. Family planning and wish for children]. PMID- 6852634 TI - 5-Hydroxytryptamine and cholera secretion: a histochemical and physiological study in cats. AB - The effect of cholera toxin on the content of 5-hydroxytryptamine (5-HT) in the enterochromaffin cells of the cat small intestine was estimated by cytofluorimetry of individual enterochromaffin cells at varying times after exposing the intestinal mucosa to the toxin. The observed changes in 5-HT levels in the enterochromaffin cells were correlated with the simultaneously measured rate of net fluid transport across the intestinal epithelium. Intestinal segments exposed to cholera toxin showed a statistically significant decrease in 5-HT levels of enterochromaffin cells compared with segments exposed to heat inactivated cholera toxin. A good correlation (r = 0.73) was found between relative 5-HT fluorescence in enterochromaffin cells and net fluid transport across the intestinal epithelium. Thus, a diminished 5-HT content was associated with a decreased rate of fluid absorption or an increased rate of secretion. A hypothesis is presented for explaining the possible role of the enterochromaffin cells in the pathophysiology of cholera secretion. PMID- 6852635 TI - Small intestinal ulceration: diagnostic difficulties in relation to coeliac disease. AB - Seven cases of ulceration of the small intestine are described and the relationship to coeliac disease is discussed. Evidence for coeliac disease is found in all cases but is less strong in some than in others, and coeliac disease was proved in only two cases. The ulcers were examined histologically in each case and in three cases were associated with malignant histiocytosis but the others showed only non-specific chronic inflammation. This suggests a spectrum of disorders with an inconsistent relationship to gluten sensitivity and small intestinal lymphoma. PMID- 6852639 TI - [Toxoplasmosis control during pregnancy]. PMID- 6852640 TI - [Gynecologic examination during puberty and adolescence]. PMID- 6852633 TI - Defective release of C5a related chemo-attractant activity from complement in Crohn's disease. AB - Complement was studied in 20 untreated cases of Crohn's disease and in 20 healthy volunteers by an in vitro activation of the cascade reaction. Total haemolytic complement was normal in all patients. In contrast, activation of the alternative pathway lead to a decreased release of C5a related chemo-attractant activity together with a subnormal utilisation of the main complement component C3. This abnormality of complement function was not related to the activity of the disease, site of involvement or to disease duration. The results suggest that an inadequate stimulation of important neutrophil functions may result when bacterial lipopolysaccharides and other macromolecules activating the alternative pathway penetrate the gut mucosa. A delayed clearance from the tissue of such foreign material could be a further pathogenic factor in Crohn's disease leading to granulomatous inflammation by a foreign body reaction. PMID- 6852641 TI - [Colposcopy during puberty and adolescence]. PMID- 6852642 TI - [Endocrine and morphologic changes in puberty and adolescence]. PMID- 6852643 TI - [Diagnosis and therapy of menstruation disorders in puberty and adolescence]. PMID- 6852644 TI - [Diagnosis and therapy of genital infections in childhood, puberty and adolescence]. PMID- 6852645 TI - [Diagnosis and therapy of tall stature in girls]. PMID- 6852646 TI - Sequential study of plasma euglobulin fibrinolytic activity during the normal menstrual cycle and in women on oral contraceptives low in estrogen. AB - Determinations of plasma euglobulin fibrinolytic activity were made in samples of plasma collected during one normal or hormone-simulated cycle in 15 young, normal women and in 11 women using an oral contraceptive low in estrogen. Distinct, individual levels caused the variations of fibrinolytic activity to be larger within the group than individually, and the activity showed only small changes during the cycle. The hormone group showed a marked increase in fibrinolytic activity with distinct fluctuations related to the phase of the cycle. This increase corresponded to that previously reported to be caused by oral contraceptives containing higher concentrations of estrogen. PMID- 6852650 TI - Compression of the deep palmar branch of the ulnar nerve: clinical and electromyographic findings after a new method of decompression. AB - Five cases of compression of the deep palmar branch of the ulnar nerve were operated upon and the hiatus released by subperiosteal removal of the pisiform bone. The clinical and electromyographical results after a minimum follow-up of eight months showed an improvement in all cases. The authors stress the importance of accurate electromyographic examination for a correct preoperative diagnosis. PMID- 6852648 TI - Effects of temperature on arterial and cutaneous pO2 in the rabbit. AB - Continuous transcutaneous measurement of pO2 (tcpO2) has been adapted to fetal and neonatal use, utilizing a noninvasive miniaturized modified Clark pO2 electrode attached to the skin by adhesive. The unprepared ear of the adult female Flemish Giant rabbit was used for attachment of the electrode, and blood for arterial pO2 (apO2) was taken from the auricular artery. The rabbits were gently restrained and unanesthetized. The tcpO2 and pO2 were compared at environmental temperatures of 20-23, 50, and 60 degrees C, in separate experiments. The data demonstrated that tcpO2 is not the same as pO2. It is most clearly related to local blood flow. tcpO2 only indirectly reflects apO2, when peripheral flow is comparable to central flow. Proper use of tcpO2 in the fetus and neonate requires cognizance of blood flow conditions for correct interpretation. tcpO2 is not indicative of apO2 when reduced peripheral circulation is present, in the rabbit ear. PMID- 6852649 TI - Trigger thumb in adults after hyperextension injury. AB - Three cases of trigger thumb in adults developing after hyperextension injury are described. The similarity of the mode of injury in the cases and its possible role in the production of initial stenosis in the tendon sheath is discussed. Trauma alone may not cause triggering in the fingers, for there are other important factors such as rheumatoid disease, which with trauma may play a part. Trauma may however be the sole initiating factor in other cases of adult trigger thumbs. PMID- 6852647 TI - Oral contraception with a nonalkylated estrogen component. Effects on lipid metabolism. AB - All commercially available combined oral contraceptives have 17-C-alkylated estrogens (ethinylestradiol or mestranol) as their estrogen components. In postmenopausal replacement therapy nonalkylated 'natural' estrogens have been shown to induce less adverse effects in lipid metabolism than alkylated estrogens. To see if this difference is valid also when the respective kinds of estrogens are used as components in oral contraceptives, the lipid metabolic effects from two preparations with the same progestogen component (norethisterone acetate) but with nonalkylated (17 beta-estradiol; Netagen) and alkylated (ethinylestradiol) estrogen (Netasyn) have been evaluated. Phospholipids, cholesterol, and triglycerides have been assessed in serum and in ultracentrifugally isolated lipoprotein fractions. The serum lecithin fatty acid composition has been analysed by gas-liquid chromatography. Netasyn increased the triglyceride content of serum and all lipoprotein fractions while Netagen did not. Netasyn caused a redistribution in the 1-position fatty acids of serum lecithin with an increase in palmitic and a concomitant decrease in stearic acid, a pattern associated with the 17-C-alkylation of a steroid and probably its capacity to inhibit liver excretory function. In the present study the preparation with the non-alkylated estrogen component had less adverse lipid metabolic effects than the conventional oral contraceptive. PMID- 6852652 TI - Thumb reconstruction using second-toe transfer. PMID- 6852651 TI - Superselective digital sympathectomy in Raynaud's phenomenon. PMID- 6852653 TI - Pectus excavatum and polydactyly; an innocent syndrome. AB - A number of potentially serious congenital cardiac defects are associated with polydactyly. Of these, the best-known is that of Holt-Oram (Sanz 1973; Poznanski et al 1971, 1973) because of its surgical implications, described by Rainer (1972). Familial association has been reported by Yujnovsky (1974) with Polydactyly in three generations. It is the purpose of this report to record a case of accessory thumb and pectus excavatum in an otherwise healthy young woman of normal karyotype who asked that the extra thumb be removed for cosmetic reasons. PMID- 6852654 TI - Non-traumatic flexion deformity of the proximal interphalangeal joint-its pathogenesis and treatment. AB - The pathogenesis of camptodactyly may be the lack of equilibrium between the flexion and extension forces. The imbalance must be a result of palmar translocation of lateral slips of the extensor apparatus due to anchoring of the middle phalanx in the flexed position by fibrous substrata, abnormal shortening of the flexor digitorum superficialis or abnormal insertion of the lumbricals. It is reasonable therefore to start dynamic splint therapy as early as possible and carry on for a long time. Long-standing malposition of the extensor lateral slips possibly introduced contracture of periarticular tissues and the transverse retinacular ligament, making treatment more difficult. For those patients resistant to dynamic splint therapy, a surgical procedure is necessary. Surgical procedures are discussed. PMID- 6852655 TI - Bone marrow pressure changes under an inflatable tourniquet. AB - Theoretical calculations suggest that under a limb tourniquet, the pressure at the bone/tissue interface is greater than it is more peripherally. The central bony core must be incompressible for this hypothesis to be correct. Experiments designed to measure the intramedullary pressure confirm that this pressure does not rise at tourniquet pressures above the systolic blood pressure. It has also been suggested that shear stresses are the most likely cause of nerve damage under a tourniquet but this depends on the conversion of the tissue under compression into a fibro-elastic solid. This is likely to occur when all fluid has been driven out. From the experiments such a fluid shift does not seen to occur via the intramedullary cavity but it must nevertheless occur at an early stage of rising tourniquet pressure, probably by fluid shift through the veins proximal and distal to the tourniquet. PMID- 6852657 TI - Structure of capsules around silicone implants in hand surgery. AB - Histological examination was made of twenty-three capsules around silicone implants used in hand surgery. The structure of the capsules was found to be similar to that seen in animal experiments, though they tended to be thicker. A further difference was the frequent occurrence of histiocytes accumulating near the inner margin of the capsule; these would quite frequently form a pseudoepithelium. Possible reasons for these differences are discussed. Silicone particles were found in the walls of two capsules around joint implants and their origin from the surface of the prosthesis demonstrated. PMID- 6852656 TI - A new surgical technique to correct triceps paralysis. AB - A new surgical procedure is described to restore elbow extension in tetraplegic patients. The authors have operated on thirteen cases using Moberg's technique. In his procedure Moberg uses the posterior part of the deltoid muscle as a motor. This muscle is attached to the olecranon insertion of the triceps by means of free grafts of tendons from toe extensors. Using this technique the authors have obtained satisfactory results. Nevertheless, the main problem presented by Moberg's technique is the very long postoperative period for which the patient is immobilized. The technique avoids the above mentioned inconvenience and other minor problems. The procedure is based on the same principles as Moberg's. The tendons of toe extensors are replaced by the triceps tendon itself incised lengthwise. The pertinent technical items are explained in detail. The case histories and results are cited. PMID- 6852658 TI - Replacement of the trapezium with a silicone rubber ball spacer. PMID- 6852659 TI - The laboratory development of a new metacarpophalangeal prosthesis. AB - The paper describes the design and laboratory testing of a new metacarpophalangeal prosthesis. The novel features of the new design include the joining of pairs of prostheses by common hinge-pins and the inclusion of bearings within the proximal phalanges. The common hinge-pins are designed to prevent the recurrence of ulnar drift by sharing the forces on one finger with a neighbouring joint, and together with the intramedullary bearings to prevent potentially loosening torques from acting on the fixation of the components. PMID- 6852661 TI - Rupture of flexor tendon associated with previous fracture of the hook of the hamate. PMID- 6852660 TI - Stabilisation of distal ulna after excessive Darrach's procedure. AB - A patient is presented in whom painful instability persisted more than a year after the resection of 1 1/2 inches of the distal ulna, for a painfully subluxed distal radio-ulnar joint. The palmaris longus tendon was detached distally, passed through a drill hole in the distal radius and then wrapped and stitched, as a sling, around the distal ulna stump. Two years later the patient's symptoms were relieved. PMID- 6852662 TI - Trigger wrist phenomenon in rheumatoid arthritis. AB - Flexor tendon synovitis in patients with rheumatoid arthritis commonly presents with a carpal tunnel syndrome and a concomitant trigger finger. Triggering at the wrist joint is in this disease an uncommon additional feature. In the two cases reported, histological examination of the tissue has indicated that, as well as chronic synovitis, there was a true rheumatoid nodule present at the wrist joint, either pedunculated or fusiform. The passage of the nodule, with a 'Click' from the proximal side of the transverse carpal ligament to the distal aspect, when the fingers are flexed, creates the sensation, signs and symptoms of a trigger wrist. PMID- 6852663 TI - Dupuytren's contracture in a black female child. PMID- 6852664 TI - Thrombosis of the ulnar artery: resection and microvascular vein graft. AB - Thrombosis of the ulnar artery occurs in an unprotected region of the hypothenar area secondary to trauma. The anatomical and pathological considerations, clinical presentations, and therapeutic management is reviewed. Two cases treated by interpositional microvascular vein grafting are presented. In the patient with severe symptoms, it is recommended that flow be restored by vein grafting when facilities and expertise are available. PMID- 6852665 TI - The blood supply of the tendon with a paratenon. An experimental study using hydrogen washout technique. AB - The blood supply to the central third of the Achilles tendon was studied in adult rabbits using the hydrogen washout technique before and after soft tissue dissection including paratenon. The soft tissue dissection caused a decrease of the blood flow rate in the Achilles tendon by approximately 35 per cent. These results may indicate that the central third of the tendon with a paratenon receives its blood supply from the extrinsic vascular system by approximately 35 per cent and from the intrinsic vascular system by approximately 65 per cent. PMID- 6852666 TI - Ulnar artery aneurysm in osteogenesis imperfecta. AB - A case of acute thrombosis of an ulnar artery aneurysm in a patient with osteogenesis imperfecta tarda is described. The pathophysiology of osteogenesis imperfecta is reviewed and the possible association of defective collagen maturation and aneurysm formation is postulated. Most ulnar artery aneurysms or thromboses should be surgically resected and the artery repaired by microsurgical technique with primary anastomosis if possible or a venous interpositional graft if direct repair is not possible without tension. PMID- 6852667 TI - The radial transposition flap. A useful composite flap. AB - This paper describes the application of a radial transposition flap raised on the dorsum of the index finger to cover the skin defect on the thumb in eleven patients. The operative technique is described in detail. The flap is easy to perform. It provides good quality of skin with sensation. The donor site can be closed primarily. PMID- 6852670 TI - [Use of the mammography tube for better roentgen diagnosis in hand surgery]. AB - Mammography using X-ray with low penetration allows a sharp picture with very good contrast of the trabecular medulla and the diaphyseal cortex in the hand skeleton. Because of the higher X-ray dosage the technique should be used only in the following indications: 1. Fractures and fissures in the joints. 2. Evaluation of osseous consolidation in doubtful cases. 3. Distinction between recent and old changes. PMID- 6852668 TI - [Arthrodesis of the interphalangeal joint of the thumb: indication, technic, results]. AB - A series of 32 arthrodeses of the interphalangeal joint of the thumb has been reviewed and the results are presented. Using a figure-of-eight wire and two crossed K-wires, the tension band principle is observed. Thus, with a minimum of material, durable stability is achieved that permits reliable healing and early use of the thumb under increasing load. The morbidity is reduced to a reasonable duration of five weeks. The angle of arthrodesis should be adapted to the professional requirements: Instrument grip (large or disc grip) is best with a small angulation of 5 to 10 degrees, while for precision grip a larger angle of 20 to 30 degrees is preferred. Tactile gnosis is best preserved when pronation of 5 to 10 degrees and slight ulnar deviation of 5 degrees of the distal phalanx in relation to the proximal phalanx is achieved. For ten years, the H-shaped incision has been used with good results in our department. However, some patients have shown anesthetic skin areas distal to the incision. We therefore have changed to a fork-shaped incision, which better preserves the cutaneous innervation. PMID- 6852669 TI - [Exercise stabile treatment of osseous ligament ruptures of the metacarpophalangeal thumb joint]. PMID- 6852671 TI - [Course of treatment of a luxation of the 4th and 5th carpometacarpal joint with hamate involvement]. AB - An uncommon case of a closed dorsal dislocation of the fourth and fifth metacarpal bases associated with a flake fracture of the hamate bone is described because of the rarity of this injury. In order to regain full function, an open reduction was necessary. Stability of the carpometacarpal joints was achieved by osteosynthesis using a Kirschner wire. PMID- 6852672 TI - Universe of finger postures and finger dynamography. A conceptual methodological tool for assessing and recording the motor capacity of the finger. AB - The sum total of all postures actively possible at a joint constitutes its "universe of postures". This universe can be identified by its limits. The universe of a biarticular system like the finger can be mapped out visually, by identifying the limiting postures, plotting them as points in a graph sheet in which the postures of the MP joint are represented in the horizontal axis and the postures of the PIP joint are represented in the vertical axis, and connecting the points serially. The closed figure thus obtained represents the universe of postures of the finger and shows at a glance the motor deficits of the finger as a whole. It also remains as an objective record of the universe, available for comparison after treatment. This method of evaluation of the finger has been found to be particularly useful in assessing fingers with paralytic problems. Such a visual representation of the universe, called "dynamogram" here, can also be used for kinesiological studies. PMID- 6852674 TI - [Stabilization of comminuted fractures of the distal radius, using the external midifixateur]. PMID- 6852673 TI - [Reconstruction of the base of phalanges using Kirschner wire and synthetically absorbable thread]. PMID- 6852675 TI - [Musculocutaneous flaps for increased load capacity of the above-elbow stump]. AB - Above-elbow amputations for severe injury or fourth degree burns may leave an unsatisfactory stump. Fitting of a prosthesis is always difficult. Similar difficulties may arise with congenital transverse absence, while all childhood amputations have the potential problem of bony overgrowth threatening to penetrate skin. Because the stump is already too short, re-amputation is not an acceptable solution. We recommend improvement of such stumps by the transfer of a latissimus dorsi musculocutaneous flap. The principles and details are discussed. PMID- 6852677 TI - [Problems with vascular end-to-end anastomoses]. AB - Despite accurate preoperative investigation of the vessels of the lower part of the leg using angiography and plethysmography as a preparation for a free latissimus dorsi myocutaneous flap, problems can appear at the anastomosis during the operation. In the reported case using a free latissimus dorsi myocutaneous flap for coverage of a tissue defect at the lower leg, thrombosis appeared due to a difference between the calibers of the vein graft and the thoraco-dorsal artery. The existing difference of the calibers was therefore equalized by controlled narrowing of the vein graft. Thereby patency of the anastomosis was achieved and circulation in the free flap was guaranteed. PMID- 6852678 TI - [The compression glove--a useful tool in hand surgery]. AB - Edema of the hand of no matter which cause prevents adequate active finger motion. Persistent swelling may lead to secondary shrinkage of collateral ligaments and fibrosis of paratenon. A custom made compression glove has proven to be an effective tool in reducing edema and preventing secondary damage. It has been useful in treating posttraumatic or postoperative edema and trophic disturbances of the hand. PMID- 6852676 TI - [On-top plasty. Indications and technic in the reconstruction of severely injured hands]. AB - The possibilities and advantages of the on-top plasty in the reconstruction of severely damaged hands are described. Based upon ten cases, a classification into four groups is made. In each of these groups different reconstructive procedures are applicable. Group 1: Intact thumb with loss of all fingers. PROCEDURE: Lengthening of the third metacarpal by on-top-plasty of the distal half of the second metacarpal. This simultaneously widens the first intermetacarpal space. Group 2: Partial amputation of the thumb with severe damage to several fingers. PROCEDURE: Thumb reconstruction by transposition of two phalanges of an otherwise useless finger. Group 3: Loss of the thumb and of two and a half fingers. PROCEDURE: Thumb reconstruction by transposition of the remaining basal phalanx. Group 4: Loss of the thumb and of three fingers. PROCEDURE: Thumb reconstruction by on top-plasty of the distal half of the metacarpals and rotational angulatory osteotomy of the fifth metacarpal. PMID- 6852679 TI - [Ergotism causing peripheral arterial occlusion in the hand]. AB - Ergotamine is used today for the symptomatic treatment of migraine. It is known that the intake of ergotamine-containing medicaments in cases of migraine causes disturbance of the blood-flow to the peripheral arteries of the extremities. Most of these spastic occlusions are due to medicaments containing ergotamine tartrate. Thus, ergotism is one of the frequent causes of spastic occlusion. The symptoms of blood-flow disturbances due to ergotamines do not differ from other geneses. Extreme cases develop gangrene of the finger tips, leading to a wrong diagnosis and subsequent amputation. A careful history and arteriography showing smooth stenoses usually give the correct diagnosis. An antidote to ergotamine is not known but the spastic occlusion and the neuropsychiatric complications are usually gone some days after the ergotamine-containing substance is discontinued. Anticoagulants and low-molecular dextran are indicated in order to prevent irreversible thrombosis. PMID- 6852680 TI - [Effect of brovanexine on secretory activities of tracheal secretory cells]. AB - The expectorant effect of brovanexine (BvX) was investigated histologically and histochemically using isolated canine trachea. Following BvX treatment, the number of goblet cells (GC) stained positively with the combination procedure of alcian blue at pH 2.5 or pH 1.0 and periodic acid-Schiff was unaffected. The number of GC which stained blue and purple (stain index B & P) was reduced, while the number of GC that stained red (stain index R) was increased. The thickness of the acini of submucosal glands (SG) markedly decreased with 10(-5) and 10(-4)M BvX, and the ratio of the acinar inner diameter to the tracheal wall thickness significantly increased with 10(-4)M BvX. Stain index B & P of glandular cells decreased with 10(-5) and 10(-4)M BvX, which was accompanied by a marked increase in the stain index R. BvX treatment caused increases in total saccharide and protein concentrations in the incubation fluid, while N-acetylhexosamine slightly decreased. Both the BvX-induced histological changes in glandular cells and changes in concentrations of macromolecular components in the incubation fluid were much the same degree as those induced by bromhexine (Bh). The BvX-induced histochemical changes in secretory cells, however, were slighter than those induced by Bh. These findings suggest that BvX is an expectorant possessing both the secretagogic action selectively on SG and a mucolytic action toward acid glycoproteins in granules of secretory cells. PMID- 6852683 TI - [Effects of lorcainide, a new antiarrhythmic agent, on experimental cardiac arrhythmias]. AB - Antiarrhythmic actions of lorcainide were compared with those of disopyramide on different types of arrhythmias in animal models. It was shown in dogs that lorcainide and disopyramide were approximately equipotent against the arrhythmias following coronary occlusion. In guinea pigs, lorcainide was less effective than disopyramide against the ouabain-induced arrhythmia. Both drugs showed a weak protective action against the aconitine-induced ventricular arrhythmias, but had no effect on the cardiac arrest. In the arrhythmias induced by the application of acetylcholine on the right auricle of guinea pigs, the disappearance of P-waves and the disturbance of R-R intervals were inhibited by disopyramide, but lorcainide had no influence on these events; both prevented the atrial fibrillation induced by acetylcholine application. Both drugs by themselves induced ventricular arrhythmias in guinea pigs. PMID- 6852681 TI - [Effects of guanabenz on the cardiovascular system, in comparison with clonidine and guanethidine]. AB - Cardiovascular actions of guanabenz, a new antihypertensive agent, were studied in comparison with those of clonidine and guanethidine. Guanabenz, administered intravenously, produced a rise of blood pressure which was followed by a prolonged fall in anesthetized dogs. Guanabenz also decreased the heart rate, inhibited the respiration, and produced an alteration in T wave and a prolongation of PQ or TP interval in the ECG of the dog. Such effects of guanabenz on blood pressure and heart rate were observed in the cat, rabbit and rat, but there was a slight species-difference in the effects. Clonidine, but not guanethidine, produced responses similar to those of guanabenz. The potency of guanabenz to produce hypotension and bradycardia was approximately 1/10 that of clonidine and 10 times higher than that of guanethidine. The depressor effect of guanabenz was not observed in the spinal cats; thus, the blood pressure rose after the administration. When guanabenz was administered intracerebroventricularly or into the nucleus tractus solitarius of rats, the initial pressor response was not produced, and the depressor and bradycardiac responses were observed. Guanabenz, administered intravenously or intra arterially, produced an inhibition of cardiac functions, decreased the blood flow of common carotid and femoral arteries, and elevated the perfusion-pressure of the hindlimb in the dog. In the isolated rabbit and guinea-pig atria, guanabenz produced negative inotropic and chronotropic effects and attenuated the rate of rise of the action potential. The contractile responses to serotonin and histamine in the isolated rabbit thoracic aorta were noncompetitively inhibited by guanabenz. From these results, it is suggested that the hypotensive and bradycardiac actions of guanabenz are mediated via central actions, as well as those of clonidine. Furthermore, in addition to the central actions, it was found that guanabenz acts directly on cardiovascular tissues and attenuates the responsiveness. PMID- 6852682 TI - [Pharmacological studies of guanabenz. Effects on the peripheral nervous and other organ systems]. AB - General pharmacological properties of guanabenz (GUB), a new anti-hypertensive agent, were studied in comparison with those of clonidine (CLD) and guanethidine (GUD). Intravenous or peroral administration of GUB caused a contraction of the nictitating membrane in cats and mydriasis in mice, while it produced an inhibitions of the gastrointestinal motility in dogs; the motility of isolated rabbit ileum; and chacol transport, salivation and gastric acid secretion in rats. GUB had no or slight inhibitory actions on contractile responses induced by peripheral sympathetic or parasympathetic nerve stimulation in various organs; however, it had antagonistic actions against the norepinephrine-induced contraction of isolated guinea-pig vas deferens. The contractile responses to epinephrine and tyramine in the nictitating membrane and to sympathetic nerve stimulation in isolated guinea-pig vas deferens were potentiated by GUB. GUB specifically antagonized the serotonin-induced contraction of the isolated rat fundus strip and nonspecifically inhibited acetylcholine, histamine or Ba2+ induced contractions of isolated guinea-pig ileum at higher concentrations. GUB exhibited local anesthetic actions and diuretic effects, but had no particular actions on neuromuscular transmission, isolated rat uterus, guinea-pig tracheal muscle and the hematic system. These effects of GUB were found to be almost identical with but less potent than those of CLD. The effects of GUD were basically different from GUB. PMID- 6852684 TI - [The involvement of the cholinergic system in the tremor induced by phenol]. AB - The effect of cholinergic drugs on the tremor induced by subcutaneous (s.c.) injection of a 1 v/v% phenol solution was investigated. Male dd-Y strain mice weighing 18-24 g were used in all experiments. Intraperitoneal (i.p.) administration of physostigmine (0.05-0.1 mg/kg) did not alter the tremor. Neostigmine (0.05-0.1 mg/kg i.p.) increased the strength of the tremor weakly and shortened the latency of the tremor. I.p. administrations of methacholine, atropine, methylatropine, and scopolamine did not produce significant effects on the tremor. I.p. injection of nicotine (0.5-1 mg/kg) shortened the duration of the tremor. Intracerebro-ventricular (i.c.v.) infusions of nicotine (4 micrograms/mouse) and carbachol (5 micrograms/mouse) prolonged the latency of the tremor. Furthermore, i.c.v. infusion of nicotine (4 micrograms/mouse) reduced the strength of the tremor slightly. On the contrary, i.p. (10-20 mg/kg) or i.c.v. (20-60 micrograms/mouse) administration of mecamylamine potentiated the strength and prolonged the duration of the tremor in a dose dependent manner. Hexamethonium (10-20 micrograms/mouse, i.c.v.) also potentiated the strength and prolonged the duration of the tremor. These results suggest that a peripheral increase of acetylcholine level may potentiate the tremor induced by phenol, and the tremor may be suppressed by a negative feedback mechanism involving the nicotinic cholinergic system of the central nervous system. PMID- 6852685 TI - Production of plant growth regulators by some Fusarium species. AB - About 10 species of Fusarium were screened and tested for their growth regulatory activity on oat coleoptile straight growth test. Culture filtrates of four species contained growth-stimulating factors while others showed growth inhibition responses on oat sections. On the whole, F. moniliforme was found to be produce higher stimulatory effects. Chromatographic analysis revealed the presence of several indole auxin and gibberellin-like plant-growth regulators in their culture filtrates. The quantity and biological activity of each indole spot was also measured. PMID- 6852686 TI - The effect of pH and 1,4-dithiothreitol on the adhesion of rumen bacteria. PMID- 6852689 TI - Urease activity in Trichophyton mentagrophytes. AB - Urease activity was detected in the dermatophyte Trichophyton mentagrophytes cells at early exponential phase of growth. Specific activity of urease decreased with culture age. At exogenous urea concentrations above 2 mM formation of urease was inhibited. The pH optimum lay at 7-7.5, the Km being 14 mM. No urease activity could be detected in cell-free culture fluid of T. mentagrophytes. No endo- or exocellular urease activity could be detected in a T. rubrum strain grown with or without urea. PMID- 6852687 TI - The use of vancomycin for the isolation of auxotrophic mutants in Mycobacterium smegmatis. PMID- 6852690 TI - Degenerating fibres in the gracilis and cuneate nucleus after ligation of the middle cerebral artery in the dog. PMID- 6852688 TI - Regulatory role of nucleotides, nucleosides and their deoxy derivatives on adenylate cyclase of Mycobacterium smegmatis. AB - Nucleotides, nucleosides and their deoxy derivatives inhibited adenylate cyclase activity in Mycobacterium smegmatis. Nucleosides with a triphosphate group were the most effective inhibitors. Amongst the deoxy derivatives, the cytidine derivatives were most inhibitory while deoxyadenosine and deoxyguanosine at 1 mM had no effect of the enzyme. PMID- 6852691 TI - Impregnoarchitechtonics of the ventromedial hypothalamic nucleus and the ventrolateral hypothalamic nucleus in ruminants. PMID- 6852692 TI - Development of the pharyngeal tonsil with reference to commencement of its immunocompetence. PMID- 6852693 TI - The effect of nerves on bone growth: a macromorphologic, organ--level phenomenon. PMID- 6852694 TI - Joint regional lymph nodes of the human stomach and duodenum. PMID- 6852695 TI - Developmental view of the origination of limb malformations. PMID- 6852696 TI - Quantitative analysis of morphological changes in the spinal cord of the hibernating bat. I. The size and shape of the neurons evaluated in the light microscope. PMID- 6852698 TI - Development of internodal connections of the conduction system of the human heart. PMID- 6852699 TI - The incidence of accessory ganglia associated with the branches of the trigeminal nerve. PMID- 6852697 TI - Ultrastructural differentiation of the cellular elements of the internodal connections of the human embryonic and foetal heart. PMID- 6852700 TI - Structure and histochemistry of the testis in an inbred strain of mice under normal and experimental conditions. PMID- 6852701 TI - Quantitative analysis of morphological changes in the spinal cord of the hibernating bat. III. Ultrastructure of the synapses. PMID- 6852702 TI - Quantitative analysis of morphological changes in the spinal cord of the hibernating bat. II. Ultrastructure of the cytoplasm organelles. PMID- 6852703 TI - Incidence of the Carabelli anomalous tubercle in Romanies (gypsies). PMID- 6852704 TI - Transplantation of chick limb buds to the chorioallantois of older hosts. A. Development of vascularization and its relationship to morphological differentiation of the grafts. PMID- 6852705 TI - Electronoptic image of regeneration of the spermatogonia of rats continuously exposed to gamma radiation. PMID- 6852706 TI - Development of the elastic fibres of chick embryo lungs. PMID- 6852707 TI - [Who is admitted to medical school? Empiric results of the personality and intelligence structure of 637 medical students]. PMID- 6852708 TI - [Early symptoms of malignant skin changes]. PMID- 6852709 TI - [Antimycotic therapy. 3: Polyene antimycotic antibiotics, antimycotic antibiotics without polyene structure]. PMID- 6852711 TI - [Differential diagnosis and therapy of male urethritis]. AB - The infectious male urethritis is characterized by the urethral discharge, which is clear or purulent due to the number of leucocytes. Infection occurs mostly in sexual intercourse. Neisseria gonorrhoeae today causes only about 20-30% of the infections. Gramnegative bacteria are demonstrable by microscopic examination of the urethral discharge, otherwise by cultivation. Ureaplasma and chlamydia trachomatis, an intracellular growing bacterium, are the most frequent agents in infectious urethritis. They are often found together, the cultivation requires special laboratory conditions. They are common saprophytis bacteria within the urethra (u. urealyticum in up to 50%), their number of colony forming units of urethritis, like yeasts, viruses, trichomonas are rare. The treatment of gonorrhoic urethritis is done by penicillin or spectinomycin. Infections by u. urealyticum and c. trachomatis are treated with tetracyclin. Although spontaneous healing is not uncommon, therapy should be performed with respect to the high risk of following prostatitis and epididymitis. PMID- 6852710 TI - [Development of electroencephalography for the localization of invasive lesions]. AB - Hjorth described a special multielectrode derived from a theory of Laplace. This type of derivation will accentuate the contribution of the potential field under the active electrode relative to the surrounding electrical activity and is therefore called "source derivation". Preliminary clinical studies seem to confirm the supposition that source derivations tend to focus activity from individual electrodes in a better way than standard derivations do. Technical changes in a 16-channel EEG are the reason for simultaneously EEG-recording to test the method of the standard derivation (uni- and bipolar) against the source derivation. Total of 4280 EEGs have been recorded concerning the generalisation of activity, focal activity by epilepsia, cerebro-vascular disease and tumors of the brain. In most of the recordings focal activity was more sharply pronounced in source than in conventional derivations with problematical reference points. PMID- 6852712 TI - [Urea and its therapeutic possibilities]. AB - Origin of epidermal urea and the therapeutical possibilities are shown: the waterbinding, keratolytic, epidermal thinning, antipruriginous, and the penetrating-supporting effects. Our clinical studies revealed mild to moderate eczemas and psoriasis capitis to be treated with a 10% urea-, 1% hydrocortisone cream. A 10% urea cream is well indicated for mild palmar and plantar hyperkeratotic dermatitis, the after treatment of contact dermatitis, and senile atrophic skin. Serious hyperkeratotic palmar dermatitis gives better results when handled alternately with triamcinolone-acetonid cream and a 10% urea cream. PMID- 6852713 TI - [Terminal care in the hospital. Possibilities and helplessness of those who render help]. PMID- 6852714 TI - [Surgery of liver metastases. Indications and results]. PMID- 6852716 TI - [Peritonitis]. PMID- 6852717 TI - [Antimycotic therapy. 4: Practical implementation of therapy. Infections caused by dermatophytes]. PMID- 6852715 TI - [Significance of peritoneal irrigation in the treatment of hemorrhagic necrotizing pancreatitis]. AB - Irrigation of the peritoneal cavity proves reliable in the treatment of acute hemorrhagic necrotizing pancreatitis. Two different applications must be distinguished: peritoneal dialysis and postoperative irrigation and sump drainage. Peritoneal dialysis should be performed at the beginning of the disease and has the aim to overcome the serious--often deadly--early phase of pancreatitis. Irrigation and sump drainage is carried out after a previous necrosectomy is performed to wash out retained or new by developed necroses. This management shall prevent a late intoxication of the organism. PMID- 6852718 TI - [Immunity following polytrauma]. PMID- 6852719 TI - [Motility of the jejunal replacement stomach]. AB - The food retaining and reservoir-function of the intestinal pouch seems to be characterized by the following mechanism: After being filled with a few foodboli arriving from the oesophagus, segmentary contractions arise and thus continuously propulse the food into the duodenum. In other words the interposed jejunal-loop, due to its decreased motility, rather represents a physiological restraint to the chyme passage, than a real food reservoir. For mixing, predigestion and food storage the duodenum is more apt, as clinical studies could demonstrate. Furthermore we have shown that any type of surgical manipulation concerning the intestine has severe effects regarding its mechanical activity. This should always be kept in mind when performing Roux-en-Y-anastomosis, correctly intestinal atresia or planning a jejunal by-pass. PMID- 6852720 TI - [Drug prevention of recurrence in bladder tumors. Intravesical adriblastin instillation following transurethral resection of non-infiltrating bladder tumors]. AB - 29 patients were treated with intravesical adriamycin-instillations after transurethral resection of non-infiltrating bladder tumor. 50 mg Adriblastin were administered every four weeks during one year. In no case there were severe side effects. Endoscopic controls were performed every three months. 12-28 months after beginning of therapy 6 recurrences (20,7%) were noted. PMID- 6852721 TI - [Geriatrics--a specialty with a future]. PMID- 6852722 TI - [Gastrointestinal tuberculosis--a diagnostic challenge]. AB - Gastrointestinal tuberculosis has become a rare disease. Lesions are predominantly located in the ileocecal region, but all parts of intestinum can be involved. Occurrence in the esophagus is very rare. Protean manifestations often prevent an accurate diagnosis on time, especially if pulmonary symptoms are absent or misjudged. The further clinical course is determined by late complications of tuberculosis. We present 3 cases of gastrointestinal tuberculosis (two of esophagus, one of ileocecal region) in order to remind of this rare disease, which is associated with so many pitfalls. PMID- 6852724 TI - [Geroprophylaxis - gerohygiene - gerotherapy]. PMID- 6852723 TI - [Gastrointestinal tumors: chemotherapeutic preparations]. AB - According to the unfavorable prognosis for patients who underwent surgical resection of gastrointestinal carcinoma, an additional systemic treatment is necessary, however chemotherapeutic results are still unsatisfactory. In advanced gastric carcinoma combination chemotherapy including 5-fluorouracil and adriamycin (FAMe, FAB, FAM) suggests response rates of 30-40% and a significantly prolonged median survival time of the responders compared to non-responders. Therefore cytostatic treatment should be tried under controlled conditions. Summarizing the treatment results of advanced colorectal carcinoma, combination chemotherapy did not exceed monotherapy with 5-fluorouracil. For the management of metastatic disease an attempt to reduce the tumor mass by 5-fluorouracil may be indicated. In non-responders nitrosoureas additionally should be given. In advanced pancreatic carcinomas the three drug combinations (e.g. FAM) obviously show similar response rates (about 40%) as in gastric carcinoma. However the treatment response is dependent on a favorable performance status. PMID- 6852726 TI - [Pseudo-immunopathy]. AB - Symptoms similar to phenomena in immunologic diseases but without specific reactions are classified as pseudo-immunologic. They are caused, especially when allergoid, by complement-activation via the alternate pathway or are due to a lack of inhibitors. Other symptoms are based upon receptor-substrate interactions or enzymatic deficiency. Diagnosis is confirmed by characterization of the pathogenic mechanisms and by missing immunological phenomena. In the majority of cases therapy is similar to measures in true immunologic diseases. Prophylaxis by substitution is only possible in a few situations. PMID- 6852727 TI - [Treatment of allergies using standard immunoglobulin preparations]. PMID- 6852725 TI - [Heart infarction in persons over 70. Epidemiologic studies of the clinical course]. AB - 1158 patients with acute myocardial infarction hospitalized in 6 clinics at Hamburg were analyzed retrospectively with special regard to older patients. 46% of all patients were older than 70 years. In contrast to former investigations the rate of myocardial infarction of women over 70 is arised. The reason of admission was reinfarction in 39%. The most frequent risk factors were hypertension and diabetes mellitus; but hypertension is not more frequent than in this age-group of the whole population. A so-called "silent" myocardial infarction occurred in 10-15% of patients over 70 years. The clinical course of acute myocardial infarction was injured by hemodynamic complications in 66%. Ventricular fibrillation was more frequent in younger than in older patients. The reanimation of older patients was successful in 25% primary, but the inhospital mortality was unchanged high (50%). In contrast to younger patients 40% of cases of death occurred after the acute phase in the 2.-4. week of hospital treatment. PMID- 6852728 TI - [Basic therapy of rheumatoid arthritis with D-penicillamine. Personal contribution and critical observations]. PMID- 6852729 TI - [Destruction of ureteral tumors with the neodymium-YAG laser. A new, organ preserving surgical procedure]. AB - Only the neodymium-YAG laser is suitable for destroying tumors endoscopically, because it shows a very high transmission through water and a slight absorption in the tissue. It means scattering becomes important and leads to a homogeneous and uniform distribution of the radiation in the tissue producing a deep thermal effect. An examination of a section through a bladder wall under light microscope after neodymium-YAG laser irradiation shows a layered, sharply delimited coagulation necrosis that extends to all of the bladder wall layers and reaches the outermost zones. In this way it is possible to destroy not only the exophytic part of a tumor but also the tumor base in the tissue. Since 1976 we destroyed more than 4000 bladder tumors by laser application. For tumors on the ureter or kidney pelvis a special endoscope, described by Perez-Castro Ellendt and modified by us, can be used, if it is not possible to perform a conventional operation. It is reported about four cases of distal ureter tumors (GI-II) in patients who had refused an operation for removing the tumor bearing ureter segments. Now, for more than one and half a year all patients are free of tumors and the irradiated ureters show a good function. This novel procedure is not for routine, but for high risk patients or patients, who refuse an open operation. PMID- 6852730 TI - [Features of therapy of hematologic diseases in old age. 3. Features in the occurrence and clinical course of aplastic and neoplastic diseases of the blood]. AB - The development and course of blood diseases in the aged often are determined by two factors: The first is the disturbance of the immune system based on a defective interaction between the T- and B-cell system. These are due to the involution of the thymus gland accompanied by reduced incretion of thymus hormones. The second factor consists in a regressive alteration of a "haemopoietic inductive micro-environment (Trentin), which has its morphological substrate in the circulatory system and the stroma of the bone marrow. Both factors lead to atrophic or diminished recovery of the bone marrow. Specific therapeutic problems are presented on the basis of several selected disease entities. Anaemias, cytopenias, the myeloproliferative syndrome and the lymphomas of low malignancy as well as the paraproteinaemias reveal the importance of the above-mentioned factors not only for the pathogenesis and the course but also for the treatment of these conditions in old age. PMID- 6852731 TI - [How long is BCG vaccination effective?]. PMID- 6852732 TI - [Antimycotic therapy. 5: Practical application of therapy. Infections caused by dermatophytes. Infections caused by yeasts]. PMID- 6852733 TI - [Abdominal uterus extirpation. Retrospective study of over 2617 cases in 1969 - 1982 at the Gynecologic Clinic of the Mannheim Clinics]. PMID- 6852734 TI - [The upper urinary tract and ureterocystoneostomy]. PMID- 6852735 TI - [Mechanism of proteinuria: filtration and resorption of plasma proteins]. AB - Glomerular filtration and tubular reabsorption of endogenous serum proteins were measured using micropuncture technique in the rat kidney. Data resulting from experiments on the single nephron level are compared with human overall kidney function. Reabsorption of filtered protein was virtually complete (84 to 96%) at endogenous serum levels. Tubular reabsorption capacity is almost reached under control conditions. In human infants, tubular protein reabsorption capacity increases with maturation. PMID- 6852736 TI - [Diagnosis and therapy of brain function disorders]. PMID- 6852737 TI - [Alizapride in the treatment of vomiting induced by cytostatic agents]. AB - Most antineoplastic agents, particularly cisplatinum, cause nausea and vomiting. In an open study, 30 subjects receiving anticancer drugs were given the antiemetic Alizapride. The incidence of severe nausea was reduced from 50% to 24% on day 3. The percentage of patients without vomiting was raised to 77% until day 5. These results are in line with those of other clinical studies on Alizapride. PMID- 6852738 TI - [Mental patients in general practice. A psychiatric-epidemiological study in the district of Traunstein]. AB - In 1973/74 in the district of Traunstein a study was conducted which, like a corresponding study in Mannheim, aimed at the determination of the frequency of mental disorders among patients in general practices. Three research psychiatrists evaluated 1.274 patients in 18 general practices by means of an interview developed by Goldberg et al. (1970) and diagnosed patients according to the ICD (International Classification of Diseases). The study was based on a representative sample of all patients who consulted a physician during a 14-day period. About 1/3 of all patients (32%) showed psychiatric symptoms according to the evaluation of the interviewers, but only about 1/4 (26%) according to the opinion of the general practitioners. The bulk lies in neurotic and psychosomatic illnesses, comprising more than half (57%) of the mentally ill. About 10% each are listed for psychogeriatric disorders, affective and other psychoses as well as personality disorders. The results largely coincide with those for comparable studies in Mannheim and Norway. PMID- 6852739 TI - [Daily plans for nutrition during pregnancy and lactation and under normal conditions]. PMID- 6852740 TI - [Management of pregnant women with thalassemia minor]. AB - Owing to the fact that Germany has become the domicile of a great number of aliens from Mediterranean countries, an increasing number of thalassaemia cases have been reported and given cause for a thorough investigation. Since thalassaemia minor is a hereditary disease, a special prophylaxis has to take place in case of pregnancy: 1. examination of child's generator, 2. genetic counselling, 3. embryoscopy and extraction of embryonic blood, 4. if thalassaemia is diagnosed, an abortion should be taken into consideration. PMID- 6852741 TI - [Hyalinosis cutis et mucosae (Urbach-Wiethe lipoidproteinosis)]. AB - Hyalinosis cutis et mucosae is a rare, probably autosomal-recessively inherited disease, which begins in the first weeks of life with a remarkable hoarseness due to deposits of hyaline material in the larynx. Later on alterations of the mucous membranes and the skin are involved. Etiology and pathogenesis are unknown. An effective treatment does not exist. We present a Turkish family whose 4 children show the typical picture of hyalinosis cutis et mucosae. The skin alterations at the mother's eyelids, however, cannot be submitted to the lipoid proteinosis Urbach-Wiethe with certainty. The occurrence of hyalinosis cutis et mucosae in the 4 children makes the hitherto presumed autosomal-recessive heredity of the disease questionable. PMID- 6852743 TI - [Antispasm therapy: memantine. Symposium 29-30 October 1982 at Frankfurt am Main]. PMID- 6852742 TI - [Medicinal charcoal--the oldest and most important antidote]. PMID- 6852744 TI - [The human body and mortality. Philosophical thoughts on dying and death]. PMID- 6852746 TI - [Efficiency of the TNM system of tumor classification. Epidemiologic studies]. PMID- 6852745 TI - [Hepatitis markers in gastroenterological diseases in southwest Germany]. AB - In 360 unselected patients with different gastroenterological diseases we found higher rates of positive hepatitis markers in non-specific inflammation and ulcer of stomach or small bowel as well as in liver diseases (24.5 resp. 41.7%) in comparison to a healthy population. There were no pathogenetic connections to the gastroenterological disease, HBs-antigen-carriers were not increased. PMID- 6852747 TI - [Significance of lymph node metastasis within the scope of the TNM system]. PMID- 6852748 TI - [Antimycotic therapy. 6. Practical application of therapy. Tinea nigra, trichomycosis nodularis (piedra), otomycosis, subcutaneous mycoses, systemic mycoses]. PMID- 6852750 TI - [What is progress in medicine?]. PMID- 6852751 TI - [Prevention and therapy of infections in intensive internal medicine]. PMID- 6852749 TI - [Prevention of osteoporosis. Review of recent literature]. AB - A review of papers issued in the last 2 years concerning the menopausal osteoporosis is given. The quantitative computed tomography proves a spinal mineral bone loss during the first 6 months after oophorectomy. During the 6 years following menopause there is a high turnover, afterwards a low turnover of bone demineralisation. Experiences taken from different treatments are compared. In their sixties, 25% of Caucasian women have spinal compression fractures. The socio-economic aspects of increasing bone fractures of elderly women must be considered, too. All studies conclude that estrogen deficiency leads to bone loss. In order to prevent osteoporosis only a small dose of 0,6 mg conjugated estrogens is needed if treatment begins immediately after the menopause. PMID- 6852752 TI - [Treatment of coronary heart disease. Oxycardin retard in simultaneously existing arterial hypertension]. PMID- 6852754 TI - [Parasitic diarrheas]. AB - The role of parasites as etiologic agents in diarrhoea is emphasized. In countries of Western Europe, Entamoeba histolytica and Giardia lamblia are the most prevalent species, although some other 20 protozoans and helminths may lead to diarrhoeic disturbances. Parasitology, pathogenesis, clinical signs, diagnosis, and therapy are briefly outlined. The need for competence on the part of the personnel responsible for laboratory diagnosis is emphasized; also, newly developed immunodiagnostic methods may render appreciable services in doubtful cases. Adequate therapy yields successful results in over 90% of the cases. PMID- 6852755 TI - [Nutrition and capacity for concentration in automobile drivers]. AB - One of the most important food components for the ability to concentrate is protein because certain amino acids are precursors of neurotransmitters, e.g. serotonin from tryptophan. There is a close relation between tryptophan content in the diet, serotonin biosynthesis in the brain and food intake. While lack of carbohydrates causes a symptomatic hypoglycemia which leeds to decreases in different functions and performances (e.g. memory and concentration, orientation, critical evaluation of environmental influences), glucose load does not mean an increased performance. In this respect dietary fats and minerals have not been investigated, some vitamins, e.g. thiamin, influence the functions of the nervous system. With coffee and caffeine containing beverages a drop of performance can be compensated for only a short time at the expense of energy reserves. Under the moderate influence of alcohol the function of nervous cells is markedly affected. In connection with medicine this negative effect is aggravated. After coffee and alcohol consumption events are subjectively experienced on quite a different level than can be objectively measured; misleading estimations are the consequence. A high meal frequency with small meals stimulates the serotonin biosynthesis and seems to reduce fatigue. PMID- 6852753 TI - [General medicine between yesterday and today]. PMID- 6852757 TI - [Chronic reactive depression. Disorders following imprisonment and persecution]. AB - Ever since mankind exists, ethnic minorities, political adversaries etc. have been discriminated, pursued, tortured and killed. The twentieth century shows such examples too, also in post-war Europe of our days. But nothing exceeds the disastrous extent of the destruction machinery of the "3rd Reich". Still today, 50 years after the "Machtergreifung" delayed symptoms in the victims must be cared for. This and the realization that in future, too, terror of any variety will demand its victims make it necessary to deal directly with the consequences in order to ensure victims of greatest possible care and alleviation of their fate. PMID- 6852756 TI - [Therapy of spondylitis ankylopoetica with levamisole. Behavior of clinical and immunological parameters]. AB - The therapeutical effect of levamisole in ankylosing spondylitis as well as the effect of this therapy on the immunologic parameters were to be examined. Since the sample consisted of 10 patients only, statistically relevant results were not to be expected. Only male patients with positive HLA-B 27 have been examined. The therapeutical effect after treatment of 3 months has been observed as good to very good. The immunologic parameters reacted in a mode which had formerly been described as immunomodulating. PMID- 6852758 TI - [Inhibition of the renin-angiotensin system in the ischemic kidney]. AB - By blocking the renin-angiotensin-system with saralasin or salt-loading the postischemic damage of the renal microcirculation is diminished. This can be realized in a markedly improved oxygenation of renal tissue. As a result of the improved microcirculation 60 minutes after a 120-minutes ischemic damage one can find a better filtration rate, i.e. tubular function in treated kidneys. PMID- 6852760 TI - [The BTD-thermography system. Increased application in practice]. PMID- 6852759 TI - [Interaction of spermatozoa and the cervical mucus]. AB - Interactions between spermatozoa and cervical mucus are important for the process of fertilization, especially in cases of sterility, whereby the whole system including both participants has to be evaluated. We have investigated couples, where the husband was suffering from a reduced fructose content or increased viscosity of the seminal plasma. We found that reduced fructose did not interfere with fertility; however increased viscosity of the seminal plasma did significantly reduce the chances of pregnancy. The various disturbances in spermatozoal morphology (Dusseldorf scheme) interfered with fertility in quite different ways. From the different forms of spermatozoa in cervical mucus one can define a specific disturbance in the man. Using cytophotometry for multiple spermatozoa, Feulgen-DNS-determination and aktin-determination of the single spermatozoon we found additional parameters to evaluate the infertile couple. PMID- 6852761 TI - [Plasma and renal tissue - concentrations of sulfametrol-trimethoprim following parenteral administration]. PMID- 6852762 TI - [Relation between multiple infarcts and vascular (multi-infarct) dementia]. AB - 77 patients with multiple infarcts in computerized tomography have been investigated. In 10 patients no definitive stroke could be found in the history, 2 had TIAs only. In 20 cases a PRIND and in 45 a completed stroke could be observed. More than one stroke was only present in 28 patients. In 68 of the patients without remarkable aphasia or decreased level of consciousness the psychiatric findings showed 37 patients with and 31 without a dementia. The CT findings showed in the patients with dementia significantly more often infarcts in the dominant hemisphere, whereas atrophy was found in a similar distribution in both groups. PMID- 6852763 TI - [Analysis of the regulating mechanisms of fetal heart rate changes using a mathematical model]. PMID- 6852765 TI - [Comparative review of normal echocardiographic values from the premature infant to the adolescent]. AB - Normal M-mode echocardiographic values were analyzed from premature and term newborn infants with a body weight of 500 to 4000 g (n = 105) as well as from children ranging in age from one to 15 years with a body surface area of 0.4 to 1.6 m2 (n = 80). Standardized positioning of the recorded M-mode beam was assured through 2-dimensional echocardiographic monitoring. The maximal diastolic dimension of the right and left ventricles as well as the diastolic dimension of the aorta and the maximal dimension of the left atrium were assessed. The normal values were found to demonstrate linear relationships with weights up to 4000 g and, for larger children, with body surface areas from 0.4 to 1.6 m2. A review of values reported in the literature, of which there is a scarcity in the premature age, showed good general agreement of the mea values. The normal ranges, however, differed markedly, in some cases to such an extent that interpretation of individual echocardiographic findings would be rendered quite problematic. The explanation for these discrepancies appears most likely based on inconsistencies in spatial orientation and, subsequently, inaccurate measurements. It is apparent that establishment of normal values in a large patient population prerequisites guidelines for standardization which should include monitoring of the M-mode beam with two-dimensional echocardiography as well as use of tracings of superior quality only. PMID- 6852766 TI - Calcium antagonists in heart failure. AB - Clinical experience with calcium antagonists in congestive heart failure has, to date, been mainly restricted to the use of nifedipine but there is either no or only a limited extent of information available on diltiazem and verapamil. In patients with acute and chronic congestive heart failure, single-dose administration of nifedipine was seen to lead to a decrease in systemic vascular resistance, left ventricular filling pressure and ventricular volumes as well as to an increase in stroke volume, ejection fraction and mean velocity of circumferential fiber shortening. These favorable effects could not be detected in eight patients during a three-week treatment phase with 80 mg nifedipine daily: resting blood pressure, cardiac volumes, echocardiographically-dimensions and exercise tolerance were unchanged as compared with placebo. In patients with ischemic heart disease and impaired ventricular function, in addition to an improvement in systolic function, single-dose nifedipine administration led to favorable effects on diastolic function with a shift of the diastolic pressure volume relationship downward and to the diastolic pressure-volume relationship downward and to the left. In patients with severe aortic regurgitation, the observed increase in effective cardiac output affected by nifedipine was primarily attributable to an increase in heart rate. In the presence of an initially-elevated systemic vascular resistance, the regurgitation fraction decreased. In pulmonary hypertension, favorable hemodynamic effects have been reported after acute administration of verapamil as well as diltiazem and nifedipine. In individual cases, promising results in patients with primary pulmonary hypertension have been reported during long-term therapy with nifedipine provided that a favorable initial response could be documented. PMID- 6852764 TI - [Hypothalamic regulatory mechanism of sexual behavior in the male monkey]. PMID- 6852768 TI - Hyperosmolar non-ketotic diabetic coma in the nonhuman primate: a first report. AB - Diabetes mellitus was diagnosed in an aged bonnet macaque (Macaca radiata). Six months later the monkey was found comatose. Laboratory findings of extreme hyperglycemia, hyperosmolality, and glycosuria without ketonuria were consistent with a diagnosis of hyperosmolar, non-ketotic diabetic coma (NKC). Further laboratory studies disclosed very low levels of immunoreactive insulin and depressed free fatty acid values. Growth hormone and cortisol levels were within normal limits. PMID- 6852769 TI - Characterization of insulin binding sites in cultured smooth muscle cells of rat aorta. AB - Insulin receptors could be demonstrated in cultured smooth muscle cells of rat aorta. The specific binding of 125I-insulin was time-, temperature- and pH dependent. The optimal temperature for our studies was 12 degrees C. At this temperature maximal specific binding was 0.5% of total counts at 120 min incubation. The pH-optimum for the binding process was between 7.5 and 8. Degradation of 125I-insulin at 12 degrees C was 14%, no degradation of binding sites could be measured at this temperature. Dissociation of 125I-insulin was rapid. 50% of the labeled hormone remained associated with the cells. Half maximal inhibition of 125I-insulin binding was produced by insulin at 4 X 10(-11) mol/l. Scatchard-analysis gave curvilinear plots, that may suggest negative cooperativity. Specificity of binding was studied in competition experiments between 125I-insulin, insulin, proinsulin, insulin-like growth factors and human growth hormone. Half-maximal inhibition of 125I-insulin binding was produced by proinsulin at 2 X 10(-9) mol/l and by insulin-like growth factors at 9 X 10(-9) mol/l. Human growth hormone had no significant effect on the insulin binding. PMID- 6852772 TI - Pancreatic glucagon secretion in hypoparathyroidism, lack of effect of serum calcium on glucagon release. PMID- 6852767 TI - [Anomalous coronary drainage from the pulmonary artery with associated heart and vascular abnormalities. Report on 3 patients and review of the literature]. AB - The clinical and cineangiocardiographic findings of three children with anomalous coronary artery origin were analyzed: in the first case, associated with Scimitar syndrome, the left coronary artery arose from the left posterior pulmonary sinus; in the second case, in addition to Fallot's tetralogy, the left coronary artery had its origin from the right pulmonary artery; and in the third case, the left circumflex artery arose anomalously from the right pulmonary artery in association with coarctation of the aorta, aortic valve stenosis and diverticulum of the left ventricle. The findings of 46 cases reported in the literature to have anomalous origin of one or both coronary arteries, a single coronary artery, or of the left anterior descending coronary artery reveal that additional cardiovascular anomalies can also be found in 4 to 17% of the cases described in collectives of more than ten patients. Almost any type of cardiovascular malformation can coexist with anomalous origin of a coronary artery from the pulmonary artery. There seems to be a preponderance of conotruncal malformations accounting for 33%, whereas their incidence among all congenital heart defects is 15%. The effect of the hemodynamics of the associated malformation can exert can influence on the natural history of the disease and, experience indicates that the coronary anomaly may be masked by the signs and symptoms of the associated cardiovascular malformation. Accordingly, to exclude such anomalies, preoperative studies should include assessment of the coronary arteries. To establish the diagnosis of anomalous origin of a coronary artery from the pulmonary artery, in addition to an injection of contrast medium into the main pulmonary artery, an aortic root injection is adequate in the majority of patients and, in general, selective coronary arteriography is not required. PMID- 6852771 TI - Intracellular electrolytes and lipid metabolism in obesity. PMID- 6852770 TI - In vivo study of iodothyronine deiodination in rat liver: effect of salicylate on biliary excretion of several iodothyronines. AB - Biliary excretion of total (i.e. conjugated plus unconjugated) thyroxine (T4), 3,5,3'-triiodothyronine (T3), 3,3',5'-triiodothyronine (rT3), 3,5-diiodothyronine (3,5-T2), 3,3'-diiodothyronine (3,3'-T2) and 3',5'-diiodothyronine (3',5'-T2) was measured with the aid of specific radioimmunoassay in 17 control rats and in 31 rats injected sodium salicylate i.v. (200 mg kg-1). The animals were anesthetized with pentobarbiturate and the samples of bile were taken in subsequent 2 h periods from a drained bile duct. In controls a gradual decrease of excretion of all compounds measured was found during 10 h observation period. In contrast, after salicylate injection a transient increase of total bile volume and of T4, T3 and 3,5-T2 excretion was observed followed by a remarkable decrease, while a multifold and prolonged increase of the excretion of rT3, 3,3'-T2 and 3',5'-T2 was found. These data suggest an acute and remarkable effect of salicylate on T4 deiodinating pathway in the liver. PMID- 6852773 TI - Effect of streptozotocin diabetes on tissue ascorbic acid and dehydroascorbic acid. PMID- 6852774 TI - Does Ca2+-calmodulin control liver protein synthesis? PMID- 6852776 TI - Continuous urine collection in the study of vasopressin in the newborn. AB - We have evaluated the use of urinary vasopressin (AVP) measurements in human newborns to see if urinary AVP excretion is a true reflection of the plasma level. AVP was measured in 37 simultaneously collected plasma and urine samples. The correlation coefficient was 0.8 (p less than 0.001). AVP extracted in duplicate from six urine samples was measured by bioassay and radioimmunoassay. The correlation coefficient was 0.85 (p less than 0.05). To facilitate long-term urine collection we have developed a urine collecting tray to fit a standard incubator or cot. Urinary AVP as measured in 24-hour urine collections in 37 normal infants. AVP excretion was higher in the first 48 h of life than subsequently. Continuous 4-hour urine collections were made in 1 sick infant to assess AVP excretion when urine flow is variable. PMID- 6852775 TI - Normal osmotic threshold for vasopressin release in the hyponatremia of hypothyroidism. AB - To explore a possible downward setting of the hypothalamic osmoreceptors in the hyponatremia of hypothyroidism, 4 adolescent patients with hypothyroidism were studied. Plasma and urine osmolality were measured on random paired simultaneous samples, and following a water load. The osmotic threshold was determined by the isovolemic infusion of hypertonic NaCl, and compared to the osmotic threshold of 6 healthy subjects. Random paired urine and plasma osmolality revealed inappropriately high urine osmolality for the given plasma osmolality. A water load produced a normal dilution of urine. Osmotic threshold was found at plasma osmolality of 286-287 mosm/kg, compared to 286.7 +/- 1.0 in 6 normal individuals. It is concluded that none of the known types of the syndrome of inappropriate ADH secretion could account for the hyponatremia in the hypothyroid patients, and that patients with hypothyroidism have normal osmoreceptors as measured by the osmotic threshold test. PMID- 6852777 TI - Radioimmunoassay of progesterone in saliva. AB - A rapid specific radioimmunoassay for progesterone in mixed, unstimulated saliva is described. Column chromatography is not necessary. One single extraction with petroleum ether provides a fractional recovery of 75-95%. The assay sensitivity is 9 pg progesterone/tube. The intra- and interassay variation for low, medium, and highly concentrated progesterone pools is 13.1-9.5 and 17.4-13.9%, respectively. Analytical recovery documents excellent correlation between expected and detected progesterone concentrations (r = 0.994). Data from salivary progesterone of a regularly menstruating girl and of a patient with XO Turner's syndrome are provided. PMID- 6852778 TI - Uptake, receptor and biological response of estrone in the fetal uterus of guinea pig. AB - In vivo and in situ subcutaneous injection of 30 muCi of 3H-estrone (3H-E1) to guinea pig fetuses was carried out to study the dynamics of the selective uptake and retention of this estrogen in the uterus and other fetal organs. In the fetal uterus an increase in the uptake of radioactivity with time was found which was maximal 1 h after injection of 3H-E1. The analysis of radioactive material showed that in the fetal uterus unmetabolized 3H-E1 accounts for 65-75% of the total radioactivity between 10 and 60 min after the injection and its maximal concentration is 2.5-15 times and 10 times higher than the maximal concentrations found in other fetal organs and fetal plasma, respectively. Significant amounts of 3H-E1 were also present in lung (33-60% of the total radioactivity in this tissue), brain (37-52%) and ovary (18-47%), while an important conversion of 3H E1 into 3H-estradiol was observed in the kidney (20-26%). Estrogen sulfates, essentially estrone sulfate, represented the greater part of the fetal plasma radioactivity (30-49%). 3H-E1-specific binding sites in the cytosol of the fetal uterus were found with physicochemical characteristics (specifically limited to natural and synthetic estrogens, Kd = 8.1 +/- 1.2 x 10(-10) M (SD), sedimentation coefficient 8S) similar to those of the typical estrogen receptor. The cytosol receptor-3H-E1 complex has a dissociation rate constant (K-1) of 16 +/- 0.7 x 10( 4) s-1 at 25 degrees C. The responsiveness of the fetal uterus to estrone treatment was studied after subcutaneous administration of estrone to pregnant guinea pigs (1 mg/kg/day for 3 consecutive days). Two biological responses were observed: an increase in fetal uterine weight (50-100% in relation to the nontreated animals) and a significant stimulation of progesterone receptor protein (10-16 times higher than in control animals). At the same time, there was a 50-70% decrease in the total estrogen receptor concentration. It is concluded that estrone could be involved in the biological responses to estrogen in the fetal uterus of guinea pig. PMID- 6852779 TI - The structure of bronchial plugs in mucoid impaction, bronchocentric granulomatosis and asthma. AB - The structure of bronchial plugs was examined in 12 lobectomy specimens from patients with bronchocentric granulomatosis and mucoid impaction, two bronchial biopsies from patients with mucoid impaction, sections from one post-mortem showing evidence of mucoid impaction and bronchocentric granulomatosis as well as aspergilloma with tissue invasion and from post-mortems on eight patients who had died during a persisting exacerbation of their asthma. In both mucoid impaction and asthma eosinophils were arranged in layers within the mucus, but the pattern of lamination was different in the two groups. In asthma the layers of eosinophils appeared as whorls and eddies. In mucoid impaction the lamination was parallel to the circumference of the plug and the eosinophils were tightly compacted and appeared degenerate; fungal elements were found in all cases and were more readily seen among the eosinophils than in the mucus. The histological appearance of even small fragments of such plugs is diagnostic of allergic bronchopulmonary fungal disease with mucoid impaction. In all our cases bronchocentric granulomatosis appears to have been a complication of allergic bronchopulmonary aspergillosis with mucoid impaction. The clusters of inspissated eosinophils so typical of the peripheral lesion of bronchocentric granulomatosis appear to be fragments of the mucus plugs formed in the larger bronchi. PMID- 6852780 TI - Microglandular adenosis of the breast--a lesion simulating tubular carcinoma. AB - The clinical and pathological features of six cases of a hitherto undescribed lesion of the breast are reported for which the term 'microglandular adenosis' has been proposed. This is characterized by a proliferation of small uniform glands lined by epithelial cells without apparent myoepithelial cells and with usually open lumina. The glands lie 'naked' in adipose tissue or within fibrous tissue. Because of these features, the lesion mimics and is easily confused with tubular carcinoma, but attention to a set of criteria which are discussed should allow for their separation. PMID- 6852781 TI - A classification of gastric dysplasia. AB - Epithelial dysplasia was studied in 53 surgical specimens of gastric carcinoma and eight gastric adenomas. A spectrum of dysplasia was observed, but there were two principal types. Type I resembled the epithelium lining colonic adenomas whereas type II was composed of eosinophilic cells with basally sited vesicular nuclei. These findings are compared with reports on heterogeneity within both gastric dysplasia and dysplasia in other areas of the gastrointestinal tract. A link is demonstrated between incomplete intestinal metaplasia, type II dysplasia and the more poorly differentiated cancers of intestinal type. PMID- 6852785 TI - Pulmonary plasma cell granuloma--an electron microscopic and tissue culture study. AB - A case of pulmonary plasma cell granuloma studied by electron microscopy and tissue culture is reported. Ultrastructurally, it showed a polymorphic composition in which a variety of inflammatory cells, collagen fibres and capillary vessels were identified. In vitro there was an initial emigration of inflammatory cells, followed by a predominance of fibroblasts and histiocytes. This pattern of growth is similar to that obtained from explants of granulation tissue and gives support to the previously suggested view that these lesions are inflammatory pseudotumours. PMID- 6852782 TI - Necrotizing pseudolymphomatous lymphadenitis and rapidly fatal lymphoma in Okinawa. AB - Thirty-one cases of a peculiar lymphadenitis with pathognomonic necrosis and prominent infiltration with immunoblasts were studied together with 36 cases of a rapidly fatal lymphoma of distinctive morphological pattern and characterized by massive coagulative necrosis. These cases all occurred on the island of Okinawa, and the lesions have not, to our knowledge, been reported previously. This further example of a type of geographically confined lymph nodal disease may, on further study yield insights into pathogenetic mechanisms in lymphomas. Further studies should include cell marker and virological investigations, which were not available to us at the time of the study. PMID- 6852786 TI - Papillary mesothelioma of ovary. AB - A case of primary papillary mesothelioma of the ovary is reported and its microscopic and ultrastructural features described. This tumour was an incidental surgical finding and was accompanied by multiple, partially cystic, peritoneal lesions with similar microscopic features. The histological pattern was predominantly papillary with well-differentiated mesothelial cells and a prominent stromal infiltrate that included large numbers of lymphocytes and lipid filled macrophages. A comparison is made with adenomatoid tumours and with other tumours of ovarian epithelium and it is suggested that this tumour may represent the benign counterpart of one form of clear cell carcinoma of the ovary. The presence of multiple peritoneal lesions may indicate limited malignant potential comparable to some other papillary epithelial neoplasms of the ovary. PMID- 6852783 TI - Basal cell carcinomatous changes on the lower leg: a possible association with chronic venous stasis. AB - Twenty-one patients are reported who developed basal cell carcinomas on the lower leg. The commonest presentation was of a chronic 'stasis' ulcer which usually occurred at atypical sites. It is suggested that the development of basal cell carcinoma changes on the lower leg is a not infrequent complication of chronic venous stasis. PMID- 6852784 TI - Merkel cell carcinoma of the skin: the structure and origin of normal Merkel cells. AB - A series of 15 Merkel cell tumours of skin is reported. They occur dominantly on the head and neck and on the extremities of elderly women, frequently presenting as a reddish nodule. Three cases were associated with squamous carcinoma at the same site, an association deserving further study. There are two main patterns: the commoner one takes the form of a trabecular carcinoma in the dermis mimicking metastatic carcinoma, including oat-cell carcinoma and neuroblastoma: a dissociated-cell form mimicks malignant lymphoma. The triad of vesicular nuclei with very small nucleoli, abundant mitotic activity and apoptosis is so characteristic as to be virtually pathognomonic in conjunction with structural features. Argyrophilia is common, but Bouin fixation is necessary to demonstrate it regularly. Small round secretory granules (89 +/- 18 nm) with narrow haloes, and an abundance of intermediate size filaments are among the ultrastructural hallmarks. There is a close similarity between better differentiated tumour cells and normal Merkel cells. The neural crest origin of MC is in doubt both on the basis of studies of the development and regeneration of MC and from the study of Merkel cell tumours. PMID- 6852787 TI - Filamentous organisms in ulcerated intestinal type carcinoma of the stomach: an aid to biopsy diagnosis. PMID- 6852789 TI - The zoning out of the mentally disabled. PMID- 6852788 TI - The darker side of unemployment. PMID- 6852790 TI - ECT: assuring benefits and minimizing risks. PMID- 6852791 TI - The genetics of affective disorder: data, theory, and clinical applications. AB - A genetic factor in the etiology of the affective disorders has been a subject of considerable interest and investigation during the last five decades. Data from twin studies, family studies, and adoption studies strongly support three major findings: genetic factors are significant in the etiology of both bipolar and unipolar affective disorder; bipolar and unipolar affective disorder tend to breed true and are genetically distinct diseases; and both bipolar and unipolar affective disorder are genetically distinct from schizophrenia. While the mode of transmission for the affective disorders remains unclear, the genetic data already afford clinical applications pertinent to diagnosis, prognosis, treatment response, and both immediate and longitudinal clinical course. Pharmacogenetic factors unrelated to the illness are also relevant to the management of antidepressant pharmacotherapy. PMID- 6852792 TI - The relationship between job loss and physical and mental illness. AB - A number of studies in recent years have examined the relationship between economic trends and mental and physical health. This review focuses specifically on the impact of unemployment and job loss on employees and their families. The author cites studies by Brenner and others showing a strong association between unemployment and loss of self-esteem, increased suicide rates, state mental hospital admissions, state prison admissions, and increased incidence of physical illness. He concludes that unemployment has a profound impact on emotional and physical health, and that clinicians should begin now to apply the knowledge gained from these studies to patient care. PMID- 6852794 TI - Establishing a psychiatric library. AB - The amount of information in the psychiatric field has increased to such an extent that a specialized library is an essential part of the mental health facility. Guidelines are presented for establishing a psychiatric library, including staffing, budgeting, physical layout, and selection and handling of books, reference materials, journals and annuals, microfilm and microfiche, and audiovisuals. The expertise of the librarian is the single most important factor in determining the quality of the collection and the services provided, the author believes. Because of escalating costs, developing a cooperative library network of small, specialized mental health collections may be the most productive course for the future. PMID- 6852795 TI - A computer-supported information system for forensic services. AB - Recently many state departments of mental health have decentralized their forensic services programs. This trend has increased administrative needs for accurate, easily accessible information on the forensic services' caseload. The Missouri Department of Mental Health and the Missouri Institute of Psychiatry have developed and implemented a computer-supported system that provides data on the number of cases referred by criminal courts, the questions asked by the courts, the clinical answers to those questions, and demographic information about the evaluated population. The system is a part of the department's other computer systems so that forensic clients may be tracked through various mental health facilities. Mental health administrators may use the system to monitor department policies, ensure appropriate allocation of resources, and improve the quality of forensic reports. PMID- 6852796 TI - Creative financing and the Halfway House. PMID- 6852797 TI - Childhood sexual abuse. PMID- 6852793 TI - What's new in administration. AB - The author reviews some of the trends and issues that have emerged in mental health administration over the past 20 years. They include the growing awareness of the need for clinicians to receive training in administration, the expanding body of knowledge in the management field, the availability of statistical methods to help manage uncertainty, and advances in treatment techniques and management information systems. Other developments are changes in the delivery of services, external controls on institutions and professionals, scarcity of resources, the important role of politics and public relations in ensuring adequate services, and sensitization to the social responsibility of the mental health system. PMID- 6852798 TI - House panel clears planning bill. PMID- 6852800 TI - Energy use, cost highest in New England. PMID- 6852801 TI - FDA issues guidelines to protect transfusion recipients from AIDS. PMID- 6852799 TI - Now may be the time to consider advance refunding. PMID- 6852802 TI - Dispatch system eases patient transports. PMID- 6852803 TI - Pediatric pavilion's Disney characters divert patients. PMID- 6852804 TI - Era of responsibility. PMID- 6852805 TI - The pendulum swings. PMID- 6852806 TI - Target portion of marketing efforts to public: surveys. PMID- 6852807 TI - Admissions program frees hospital's beds. PMID- 6852809 TI - Hospital economic forecast. PMID- 6852808 TI - New MDs exposed to business world. PMID- 6852810 TI - Declaration of interdependence. More and more physicians find salaried status attractive. PMID- 6852811 TI - Economic trends assessment. Sources of hospital expense increases are rooted in inflation. PMID- 6852812 TI - Court proposes workable way to end life support. PMID- 6852813 TI - Why are there old people. Senescence as biological and cultural preparedness for the transmission of information. PMID- 6852817 TI - The immediate autopsy consultation report. PMID- 6852816 TI - Intramyofiber metastases in skeletal muscle. PMID- 6852814 TI - Renal papillary necrosis associated with Wegener's granulomatosis. AB - Review of the kidneys from 23 cases of Wegener's granulomatosis revealed necrosis of the renal papillae in five (21.7 per cent). These cases took a fulminant course of the disease consistent with the classic description of Wegener's granulomatosis, prevalence in the older age group, and rapid deterioration of renal function. Morphologic examination of the kidneys uniformly disclosed a variety of lesions in the blood vessels supplying the renal papilla. The most conspicuous was the widely distributed glomerular lesion represented by thrombotic and necrotic occlusion of capillary loops and crescent formation. A medullary interstitial lesion characterized by fibrinoid necrosis of the vasa recta was invariably found in the outer portion of the necrotic papilla. In addition, acute segmental and diffuse necrosis and occlusion by thrombosis were identified in the branches of spiral arteries in the adjoining papilla. The results provide an anatomic basis for the assumption that papillary ischemia due to impairment of the dual blood supply from the vasa recta and the calyceal arteries is the essential factor in papillary necrosis. PMID- 6852815 TI - "Myeloma lung"--a previously unreported complication of multiple myeloma. AB - A 52-year-old man with known lambda light-chain multiple myeloma developed chronic renal failure, which was proven by renal biopsy to be the result of "myeloma kidney." Terminally, disseminated pulmonary infiltrates developed. Postmortem examination showed the infiltrates to consist of neoplastic plasma cells with crystalline casts, strikingly similar to those found in the kidneys. The term "myeloma lung" is proposed to describe this unusual and heretofore unreported complication of multiple myeloma. PMID- 6852818 TI - The Hellinger distance as used for the representation of serological ABO distances among earlier human populations. AB - The Hellinger (arccos) distance is examined for the purpose of demonstrating to what extent it represents the differences among populations. When the Hellinger distance is employed to estimate gene frequencies, a result very similar to that of the maximum likelihood (Bernstein) method can be gained. It is pointed out that in palaeoserological examinations the Dobson/Ikin method usually mentioned as Fisher method is not equivalent to the Bernstein method. PMID- 6852821 TI - Balanced translocations among couples with two or more spontaneous abortions: are males and females equally likely to be carriers? AB - Chromosome studies were performed on a series of 177 couples referred for genetic counseling following two or more spontaneous abortions to clarify the relationship between karyotype and fertility in males and females and to provide risk figures for genetic counseling. The results of these investigations, when combined with those in the literature, suggest that 2-3% of individuals in couples experiencing early fetal losses carry a balanced translocation and that this is not markedly influenced by the number of losses greater than two. Females are more likely than males to be the carrier, reflecting the fact that structural abnormalities of the chromosomes that are compatible with fertility in the female may be associated with sterility in the male. Karyotyping should be performed on both members of a couple following two spontaneous abortions and the products of conception should be studied whenever possible to begin to determine the biological basis of the association between parental rearrangement and fetal loss. PMID- 6852820 TI - Human red cell butyrylesterase, and its homologies in thirteen other mammalian species. AB - The selective staining of a single butyrylesterase, following isoelectric focusing of red cell lysates from 14 mammalian species, including man, was achieved using the chromogenic substrate N-acetyl-L-alanine-alpha-naphthyl ester. This procedure optimized the identification of this enzyme, and a close correspondence of its properties was observed in all the species investigated. The inhibition profile, using a range of inhibitors, was identical in all cases. Particularly noteworthy was the activation of the enzyme by p chloromercuribenzoate at low (2-20 x 10(-6) M) concentrations, but inhibition at higher (greater than 10(-3) M) concentrations. The isoelectric points of all samples fell within a narrow range, pI 4.00-4.43. Descriptions of this activity in different animals, under different designations, could be identified in earlier studies, and the enzyme was uniformly designated "butyrylesterase 1". A tetrameric subunit structure, previously established for the human enzyme, was also demonstrated in the case of mouse butyrylesterase 1. A list of diagnostic characteristics for the enzyme was presented, and it was assumed that the 14 enzymes investigated are orthologous. It was not possible to group butyrylesterase 1 with any other known esterase within the system of enzymes recommended by the IUB, and it was proposed that this enzyme be assigned to a new esterase subclass. PMID- 6852819 TI - A cell surface abnormality in Duchenne muscular dystrophy: intercellular adhesiveness of skin fibroblasts from patients and carriers. AB - The intercellular adhesiveness of skin fibroblasts from patients and carriers of Duchenne muscular dystrophy (DMD) and control subjects has been determined using couette viscometers. The values for 12 DMD patients (mean = 1.38, SEM = 0.1, n = 32) were significantly lower than for ten control subjects (mean = 3.17, SEM = 0.2, n = 22). According to the Lyon hypothesis, carriers of DMD should be mosaics of cells expressing the normal and DMD phenotypes, and their cultured skin fibroblasts should have intercellular adhesiveness intermediate between that for normal and DMD cells. Cells from three obligate heterozygotes and five individuals at high risk of being carriers had normal values (in both groups mean = 2.82) in contrast to artificial 1:1 mixtures of normal and DMD cells that had intermediate values (mean = 2.22, SEM = 0.2, n = 15). This unexpected finding is probably the result of "correction" of the DMD cells by normal gene product from the cells expressing the normal gene. PMID- 6852822 TI - Evidence for the presence of beta-subunit of hexosaminidase in a case of Sandhoff disease using a blotting technique. AB - Hexosaminidases, lysosomal enzymes whose deficiency is responsible for several genetic disorders, exist as two major forms: form A, containing two types of subunits alpha and beta; and form B, containing only beta subunits. We have used a technique involving successively electrophoresis of denatured proteins, transfer (blotting) onto nitrocellulose, and labelling by appropriate antibodies raised against the dissociated forms of hexosaminidases A and B. This technique allows the detection of alpha and beta subunits in crude extracts of normal tissues. The presence of beta chains was demonstrated in the liver of a fetus affected with Sandhoff's disease, deficient in functional hexosaminidases A and B. PMID- 6852825 TI - Absence of correlation between Y chromosome heterochromatin and several anthropometric measurements in a Mexican population. PMID- 6852823 TI - Two-dimensional electrophoresis of soluble and structure-bound proteins from cultured human fibroblasts and hair root cells: qualitative and quantitative variation. AB - Proteins from cultured human fibroblasts and native human hair root cells were investigated using the two-dimensional electrophoresis (2DE) technique. Cell material from 35 different healthy persons was examined. Proteins of different sources were separated: total proteins of fibroblasts (12 cell lines), soluble proteins of fibroblasts (12 cell lines), structure-bound proteins of fibroblasts (eight cell lines) and soluble proteins of hair root cells (12 subjects). The protein samples of different individuals were run in pairs through the electrophoresis procedure and the two patterns of each pair were compared. All changes in the electrophoretic mobility of polypeptide spots (qualitative variants) and all clearly visible differences in the staining intensity of the spots (quantitative variants) were scored. Less than 1% of the qualitative variants per pattern was found in total cell proteins and this percentage was not increased in soluble proteins. No qualitative variation was detected in structure bound proteins. Quantitative variation occurred to a considerably higher degree in the 2DE patterns than qualitative changes. The incidence of quantitative variants was about three times higher in soluble proteins (11%) than in structure bound proteins (3.5%); in the total cell proteins it lay in between (7%). Cultured cells (fibroblasts) and native cells (hair root cells) showed a similar degree of variation. A comparison of the data shown here with data obtained by an investigation on inbred strains of the mouse suggest that the major part of the quantitative variants observed in the 2DE patterns of proteins were genetically determined. The results presented here and the mouse data mentioned above lead us to the conclusion that the genetic variability of proteins may be characterized by quantitative changes rather than by qualitative changes, and that the genetic variability occurs to quite different degrees in different classes of proteins: structure-bound proteins less than soluble non-enzymatic proteins less than enzymes (certain groups). PMID- 6852824 TI - Meiotic behavior of alloxan-treated diabetic and nondiabetic T(;13)70H/+ mice. AB - The influence of diabetes on first meiotic segregation behavior in female and male T(1;13)70H/+ mice was studied. By treatment with alloxan 60 mg/kg bodyweight both diabetic and non-diabetic control mice were obtained. All female mice were treated with gonadotropins to obtain reasonable numbers of secondary oocytes per female. As a result of this treatment the number of oocytes ovulated and the percentage that could be analyzed were not different in diabetics and controls, indicating that no severe selection occurred as a result of the diabetic state. Male mice were not treated with gonadotropins, and here the low quality of the air-dried preparations and the scarcity of secondary spermatocytes in diabetics suggest that degeneration occurs. In primary spermatocytes we found higher chiasma frequencies in the translocation multivalent in diabetic males than in controls, probably as a result of reduced chiasma terminalization. The analysis of metaphase-II cells in the females revealed less 3:1 segregation and more adjacent-II segregation in the diabetics. In the males no 3:1 segregation was found in either group, but here adjacent-II segregation was lower in diabetics than in controls. No significant differences were found in nondisjunction frequencies of non-translocation-involved bivalents. We conclude that diabetes influences the meiotic segregation behavior of chromosomes and that chromosomes showing higher incidences of unbalanced segregation behavior (i.e., multivalent involved chromosomes) are more susceptible to this influence than other chromosomes. In the diabetic males this influence is undone by the severe selection, affecting primarily the cells, that would give rise to unbalanced metaphase II cells, resulting in even lower frequencies of adjacent-II segregation than in controls. PMID- 6852826 TI - Cytogenetic effects of acetaldehyde in lymphocytes of Germans and Japanese: SCE, clastogenic activity, and cell cycle delay. AB - Acetaldehyde, the first metabolite of ethanol oxidation, caused a dose-dependent linear increase in the induction of sister chromatid exchanges in lymphocytes from both Germans and Japanese. Japanese, possessing only aldehyde dehydrogenase II isozyme (ALDH I deficient phenotype) and showing adverse effects after alcohol ingestion, did not differ in SCE rates from Germans and Japanese possessing isozymes I and II. At acetaldehyde concentrations above 360 microM, a significant chromosome breaking effect and a definite delay in cell cycle events, as evaluated by the BdUrd labeling technique, was registered in all individuals. Pyridoxal 5'-phosphate showed no protective effect against acetaldehyde-induced SCE formation in our system. A 24-h extension of the normal culture period revealed significantly higher rates of SCE at acetaldehyde doses above 360 microM. PMID- 6852828 TI - A new inducible fragile site on chromosome 3(p14.2) in human lymphocytes. AB - A fragile site on chromosome 3(p14.2) was found in lymphocytes of two unrelated patients. Expression of the trait with 6%-18% affected cells could only be demonstrated under culture conditions favouring a low concentration of folic acid. Family investigations proved the maternal transmission of the cytologic marker in one case. In contrast to other fragile sites chromatid type aberrations predominated. PMID- 6852827 TI - Segregation of a 22 ring chromosome in three generations. PMID- 6852829 TI - Coincidence between fragile site expression and interstitial deletion of chromosome 11 in a case of myelofibrosis. AB - Cytogenetic examination of multiple peripheral blood cultures of a patient with myelofibrosis with myeloid metaplasia revealed the presence of an interstitial deletion of the long arm of chromosome 11, del(11)(q13q21). A folic acid dependent fragile site fra(11)(q13) was found in about 12% of the cells. The possible correlation between constitutional fragile site and acquired chromosomal alteration is discussed briefly. PMID- 6852830 TI - Paternal age. PMID- 6852831 TI - A simple method for R-banding combined with in situ hybridization. PMID- 6852833 TI - Organ explant culture of adult Syrian golden hamster pancreas. AB - An organ explant culture system has been developed for long term maintenance of adult pancreatic tissue from the Syrian golden hamster. Gastric and duodenal lobe explants of up to 0.5 cm2 size were placed in tissue culture dishes (60 mm2) on Gelfoam sponge rafts to which was added 5 ml of CMRL medium 1066 supplemented with heat inactivated newborn bovine serum, L-glutamine, hydrocortisone, insulin, and antibiotics. Dishes were placed in a controlled atmosphere chamber, which was gassed with 45% O2, 50% N2, and 5% CO2 and incubated at 36.5 degrees C. Viability of the tissues was determined by light and electron microscopy as well as by [3]thymidine incorporation. Explants were viable for up to 70 d. Zymogen granule containing cells characteristic of acinar cells and mucus-containing cells characteristic of ductal cells were present throughout this period. However, endocrine cells were only present for the 1st wk in culture. PMID- 6852832 TI - Altered rates of collagen synthesis in in vitro aged human lung fibroblasts. AB - Absolute rates of protein and collagen synthesis based on prolyl-tRNA as the precursor were determined in two age groups of IMR-90 human lung fibroblasts. Compared with midrange fibroblasts [population doubling level (PDL) = 20 to 30] aged fibroblasts (PDL greater than 40] were larger in size in terms of protein and RNA per cell, generally proliferated more slowly, exhibited different steady state [3H] proline transfer RNA (tRNA) precursor pool specific radioactivities, synthesized collagen at a substantially lower rate, and exhibited a reduction in the percent commitment to collagen synthesis. Total protein synthetic rates were reduced slightly in aged versus midrange fibroblasts but the difference was not statistically significant. Proliferative capacity (PDL/wk) correlated better with these changes than cumulative PDL. Cell size (protein/cell) was the variable that had the highest correlation with the reduction in collagen synthesis observed in human lung fibroblasts. Thus, an important differentiated function of human lung fibroblasts, collagen synthesis, is greatly diminished in vitro in large, slowly dividing fibroblasts. PMID- 6852834 TI - Growth and characterization of normal human urothelium in vitro. AB - A method for initiating rapidly growing cultures of normal human transitional cells from ureter and embryonic bladder specimens has been developed and quantified. A new microdissection technique was used to nonenzymatically separate the urothelium. The use of enriched medium containing 10 micrograms/ml insulin, 5 micrograms/ml transferrin, and 1 microgram/ml hydrocortisone resulted in improved growth. The use of thin collagen gel substrates (0.6 ml/60 mm petri dish) resulted in 97% attachment of explants compared to 77% attachment on plastic. Explants grown on thicker collagen (2 ml/60 mm petri dish) showed, in addition to better attachment, enhanced growth of cells as determined both by measurements of colony size and cell density. Cultures of transitional cells that were initiated using explants could be passed three to five times using 0.1% EDTA for dispersion. Autoradiography of [3H]thymidine-labeled cells showed an initial phase of rapid cell division in primary explant cultures and restimulation of cell division in passaged cultures. Transmission electron microscopy showed that the cells growing out from the explants were continuous with the stratified urothelium maintained in the original explant. Stratification of transitional cells occurred in cultures of both ureter and embryonic bladder cells. Surface cells were joined near their apices by junctional complexes. Desmosomes and Golgi vesicles were present in all cells. Passage in culture did not alter the morphological characteristics of cells. PMID- 6852835 TI - Partial reversal by sodium ascorbate of hyperoxia-induced damage to HEp-2 cell cultures. AB - Hyperoxia induced cellular damage was used as an experimental model system for examining the ameliorative role of antioxidants. Multiplication of HEp-2 cells in monolayer culture was inhibited after exposure to 100% O2 either hyperbarically at 3 atm absolute (atma) or normobarically at 1 atma for periods from 15 s to 4 h. The inhibition was characterized by a slower rate of replication for a period from 1 to 3 d after exposure than in unexposed cultures, and then massive cellular death. Less killing followed exposure to normobaric O2 than to hyperbaric O2, and the shorter the period of exposure to hyperoxia the less killing. Addition of 100 micrograms/ml of sodium L-ascorbate to unexposed cultures enhanced growth (cell number at 6 d) almost twofold. When added ascorbate was present only during hyperoxic exposure (but not afterward), subsequent growth in air was enhanced 1.6-fold. However, when cells were exposed without added ascorbate, there was from 2 to 12-fold greater growth in air in the presence of the added ascorbate (as compared to exposed controls). This greater growth was always only a partial reversal of the lethal effect resulting from hyperoxia. Addition of 25 micrograms/ml catalase did not affect control or exposed cultures. Addition of ascorbate plus catalase was not as effective as ascorbate alone in promoting growth; the catalase moiety antagonized some of the growth enhancing influence of ascorbate. This suggests that extracellular H2O2 was not a factor in the lethal effect resulting from hyperoxia. PMID- 6852836 TI - Use of a sedimentation column to obtain uniformly sized populations of multicell spheroids. AB - Multicell spheroids are useful as in vitro models for certain nodular tumors. Spheroids may contain subpopulations of cells that are necrotic, hypoxic, and redistributed through the cell cycle, and the relative fractions of these subpopulations can change as the spheroids grow. As a result, spheroids of different sizes may respond differently to any given treatment. For experimental studies it is important to use populations of spheroids of homogeneous size. Here we report the design and use of a sedimentation column that uses precision woven screen to obtain homogeneously sized populations of multicell spheroids quickly, accurately, aseptically, and reproducibly. This device may be applied in other biological fields also where separation of cell aggregates of a specific size is required. PMID- 6852837 TI - Prophylaxis of rheumatic fever. PMID- 6852838 TI - Safety of selective coronary arteriography: an Indian experience. PMID- 6852839 TI - Acute blood pressure lowering effect of sublingual nifedipine--a variable dose clinical study. PMID- 6852840 TI - Rheumatic fever prophylaxis in developing countries--why earlier injections needed. PMID- 6852841 TI - Electrocardiographic changes at high attitude. PMID- 6852842 TI - Tricuspid regurgitation by contrast two dimensional echocardiography. PMID- 6852843 TI - Impedance cardiography in valvular diseases of the heart. PMID- 6852844 TI - Role of oesophageal lead in cardiac arrhythmias. PMID- 6852847 TI - Profile of gastric carcinoma as seen in a rural institute. PMID- 6852845 TI - Unit dose analysis of digoxin in tablet formulations marketed in India. PMID- 6852846 TI - Mechanism of termination of reentrant atrioventricular nodal paroxysmal supraventricular tachycardia by intravenous verapamil--an intracardiac electrophysiologic study. PMID- 6852850 TI - Experimental production of keloids. PMID- 6852849 TI - The pathologic profile of invasive breast cancer I. Factors intrinsic to the tumour. PMID- 6852848 TI - Histology and histochemistry of endemic ethmoid carcinoma in bovines. PMID- 6852851 TI - Leser Trelat sign associated with carcinoma of gastro-oesophageal junction. PMID- 6852853 TI - Hodgkin's disease in Nasopharynx and nasal fossa. PMID- 6852852 TI - Pancreatic ascites due to Hodgkin's lymphoma pancreas. PMID- 6852855 TI - In-vitro differentiation of human monocytes into mature macrophages during long term cultures. AB - A method is described which allows human peripheral blood monocytes from any given donor to differentiate in vitro into mature macrophages. About 90% of the starting monocytes are maintained during the long-term culture and are matured to macrophages. Thus cell loss is minimal and the resulting population of mature macrophages can be regarded as representative for all possible macrophage subpopulations present in peripheral blood. These cultures represent a standardized model for in-vitro studies on the role of mature macrophages in various immunological reactions. PMID- 6852854 TI - Epidemiology of ethmoid carcinoma in bovines. PMID- 6852856 TI - Natural killer (NK) cells in the rat: "heterogeneity" as reflection of the activation status. AB - Rat natural killer (NK)/natural cytotoxic (NC) cell activity was tested in a 4-h and a 20-h 51-Cr-release assay. In the 4-h assay, NK activity was high with peritoneal cells (PC), medium with peripheral blood lymphocytes (PBL) and spleen cells and low with bone marrow (BM), thymus and lymph node (LN) cells. The differences in lytic capacity were less pronounced in a 20-h assay. This led to the suggestion that NK/NC cells may get activated upon coculture with tumor cells during the long-term assay and that the short-term assay actually reflects the activation status of NK/NC cells in different organs rather than non-identity of cells with natural cytotoxic potential. This was supported by the following observations: 1. After in-vivo or in-vitro activation of NK cells, increased reactivity was observed in a 4-h assay especially with lymphoid cells of organs with low or medium NK activity and the differences to a priori highly active organs were significantly diminished. 2. Neither by biophysical (density) nor by biochemical (surface markers) methods differences between NK versus NC cells could be substantiated. 3. Closely related patterns of cytotoxicity were observed using adherently growing or lymphoid tumor target cells. PMID- 6852857 TI - In vitro humoral immune response of human peripheral blood lymphocytes to tetanus toxoid sepharose 4B. AB - The in vitro immune response of unfractionated human peripheral blood lymphocytes (PBL) from immune donors who had not been re-immunized with tetanus toxoid (TT) prior to donation was investigated. In this study we were able to stimulate PBL with tetanus toxoid coupled to Sepharose 4B (STT) for production of anti-tetanus toxoid antibody (Ab). Soluble tetanus toxoid or STT alone did not stimulate production of specific Ab. Pokeweed mitogen (PWM) and STT were required for optimal production of IgG and IgM antibodies specific to tetanus toxoid. Specific Ab responses were reduced in low and high concentrations of STT. Depletion of monocytes had no effect on either total IgG or specific IgG synthesis, but decreased the synthesis of both total and specific IgM. Depletion of E-rosette forming cells decreased the production of specific Ab, suggesting T-dependency of the immune response to STT. Simultaneous production of total immunoglobulin and specific Ab by Sepharose 4B was negligible in the absence of PWM. In the presence of PWM, total immunoglobulin production was optimal, and specific anti-TT Ab production was undetectable. The specificity of the anti-TT Ab was studied by absorption of the culture supernates with an STT column which removed all measurable specific Ab. PMID- 6852858 TI - Phenotypes of human large granular lymphocytes as defined by monoclonal antibodies. AB - Four monoclonal antibodies VEP8, VEP9, VIM-D5, VIB-C5 against antigens expressed on human mature myeloid cells (polymorphonuclear leukocytes [PMNL] and/or monocytes) as well as on immature cells in the bone marrow were tested for reactivity with cell preparations highly enriched for large granular lymphocytes (LGL). These cells are known to be the main effector cells responsible for natural killer (NK) cell activity in human peripheral blood. Using indirect membrane immunofluorescence (IMF), none of these antibodies showed any reactivity at all. In addition, LGL-enriched cell preparations were tested with the anti lymphocyte monoclonal antibodies OKT6, anti-Leu1, anti-Leu2a, anti-Leu3a, and anti-human Lyt3, and also with OKM1 antibody. Significant reactivity was found with anti-Leu2a (59 +/- 8%), anti-Lyt3 (55 +/- 4%) and OKM1 (81 +/- 11%) antibodies, whereas T6, Leu1, and Leu3a antigens were less pronounced or missing on LGL. As a further approach, another monoclonal antibody, VEP13, which reacts with LGL, granulocytes but not monocytes and is therefore different in its specificity from OKM1 and OKT10, was used for identification of LGL. The coexpression of antigens as defined by the above-mentioned antibodies and OKT10 on VEP13+ cells was studied. Again, phenotypes similar to those observed on LGL enriched by Percoll gradient centrifugation were found: of VEP13+ cells 84 +/- 6% reacted with OKM1, 82 +/- 5% with OKT10, 52 +/- 17% with anti-human Lyt3, and 48 +/- 14% with anti-Leu2a, whereas VEP8, VEP9, VIM-D5, VIB-C5, T6, Leu1, Leu3a antigens were not expressed on VEP13+ cells. Taken together as an overall evaluation of phenotypic characteristics, our data indicate that LGL cannot be integrated into one of the known lymphocytic or myelomonocytic lineages. LGL show an intermediate phenotype depending possibly on varying differentiation or activation stages of haemopoietic cells. However, the possibility also exists that LGL belong to a separate, yet undefined cell lineage. PMID- 6852859 TI - Natural antibodies against a polysaccharide (Bo) from sugar cane mediate its complement-activating effect. AB - The interaction of a complement activating glucan from sugar cane (Bo) with immunoglobulins was studied. Bo precipitates a small fraction of IgG from human serum. In combination with this fraction, it activates complement by the classical pathway, not in its absence. Bo is adsorbed to and can be eluted from Sepharose containing covalently coupled IgG; it is not bound when the IgG Sepharose is lacking the Bo-reactive IgG fraction. Bo-IgG complexes activate and fix C1. The binding of C1 to aggregated IgG is not inhibited by Bo. This is in contrast to the strong inhibition of C1 fixation by the Fc-binding protein A. It is concluded that normal human serum contains natural antibodies against Bo which form complement-activating immune complexes with Bo by binding it to their F(ab) region. The antibodies do not cross-react with dextran, a glucan from barley, nor with surface constituents of E. coli. PMID- 6852860 TI - Lysis of paroxysmal nocturnal hemoglobinuria erythrocytes by acid-activated serum. AB - Erythrocytes from paroxysmal nocturnal hemoglobinuria patients (PNH-E) are much more susceptible to lysis by acid-activated human serum than normal human erythrocytes. Acidification of normal human serum to pH 6.4 in the absence of erythrocytes generates this lytic activity independently of the alternative pathway of complement activation. A shift of pH of a mixture of purified human C5 and C6 to 6.4 at 0 degrees C generates a similar activity C(56)a that lyses PNH-E together with C7-C9 much more efficiently than normal erythrocytes. Since acid activation of normal human serum occurs in the absence of C3, the acid-activated C56 appears to be the lytic principle in acidified human serum. PMID- 6852861 TI - Role of filter-bound IgA in inhibiting polymorphonuclear leukocyte chemotaxis. AB - The effects of human serum IgA on human polymorphonuclear leukocyte (PMN) function were studied. In Boyden chambers, chemotactic migration against semipurified C5a as well as the formylated tripeptide FMLP was inhibited in the presence of IgA. Under such conditions, the release of superoxide anion was not changed. In addition, chemotaxis "under agarose" using the leading front evaluation remained unaltered in the presence of IgA despite IgA-induced aggregation of PMN and reduced density of migrating cells. Chemotaxis filters incubated with radiolabelled IgA demonstrated strong binding of IgA, and further, these IgA-pretreated filters impeded PMN migration. Incubation of PMN with IgA followed by subsequent washings did not affect chemotactic migration. These data show that filter binding of IgA is responsible for the inhibition of chemotactic PMN-migration in the Boyden chambers, most probably mediated by increased cell substrate adhesion. Experiments using casein showed displacement of IgA by casein which enables PMN to fully respond to casein. PMID- 6852862 TI - Leukocyte subpopulations which amplify or suppress antigen-induced proliferation in Syrian hamsters. AB - The proliferative response of spleen cells, obtained from Syrian hamsters sensitized to hen egg albumin emulsified in complete Freund's adjuvant, is lower in magnitude than the response of draining lymph node cells. In this study, the cellular regulatory mechanisms which may lead to splenic hyporesponsiveness were examined. Although unfractionated spleen cells were not suppressive, the addition of nylon wool nonadherent normal spleen cells to sensitized draining lymph node (target) cells markedly suppressed antigen- but not mitogen-induced proliferation. Suppressor cell activity was not detected in normal lymph nodes. Suppression could be overcome by culturing splenic suppressor plus target cell mixtures in the presence of large quantities of antigen. Suppressor cell activity was radioresistant. In addition to nonadherent suppressor cells, the hamster spleen also contains an adherent cell population(s) which amplified antigen induced proliferation. Adherent cells with amplifying activity were also present in lymph nodes. The addition of adherent cells abrogated splenic suppression of proliferation. Collectively, these data indicate that the hamster spleen contains both suppressive and amplifying leukocyte subpopulations which may be involved in the regulation of the immune response to certain antigenic stimuli. PMID- 6852864 TI - The binding of different lectins on peripheral blood mononuclear cells from patients with chronic inflammatory and malignant diseases. AB - Peripheral blood mononuclear cells from patients with multiple myeloma, gastrointestinal tumors, and inflammatory bowel disease were analyzed for binding of various lectins. The results demonstrated that in most of the patients with multiple myeloma a significantly increased percentage of cells positive for Lotus tetragonolobus agglutinin (LTA), peanut agglutinin (PNA), soybean agglutinin (SBA), and wheat germ agglutinin (WGA), and a decreased number of Agaricus bisporus agglutinin (ABA) positive cells were present as compared to a normal control group. This could not be shown in malignant or inflammatory disorders of the gastrointestinal tract where only some patients exhibited an increased PNA and LTA binding, respectively. Patients with the systemic malignant disease differed from patients with solid localized tumors by a significantly altered number of ABA, LTA and SBA-positive peripheral blood mononuclear cells. Double fluorescence studies using monoclonal antibodies and lectins revealed that most of the cells expressing receptors for ABA had also receptors for OKT3, whereas most of the cells with receptors for LTA, PNA, SBA, and WGA were found to be positive for OKM. PMID- 6852863 TI - Statement on the nomenclature of human C4 allotypes. PMID- 6852865 TI - The kinetics of leucocyte migration into rabbit knee joints elicited by preformed immune complexes with different in vitro characteristics. AB - Immune complexes were formed in vitro with antibodies obtained from rabbits immunized with bovine serum albumin in Freund's complete (FCA) or incomplete (FIA) adjuvant. The antibodies were mixed with different amounts of antigen. Immune complexes formed at maximum precipitation proportions were efficient in complement activation, whereas immune complexes formed at antigen excess had weak complement-activating properties. When injected into rabbit knee joints, the immune complexes formed at maximum precipitation proportions with FCA or FIA antibodies caused a moderate leucocyte migration into the joints with maximum cell counts 6-8 hr after injection. Injection into the joints of immune complexes formed with FCA antibodies at antigen excess induced a pronounced leucocyte migration with maximum numbers 18 hr after injection. Immunofluorescent studies indicated that these immune complexes became associated with the leucocyte membrane, whereas immune complexes formed at maximum precipitation proportions were found in the leucocyte granulae, indicating that only the complement activating immune complexes were efficiently eliminated. PMID- 6852868 TI - Sequence of mast-cell changes in ocular anaphylaxis. AB - Ocular anaphylaxis was produced in rats by the injection of egg albumin into ocular adnexal tissues of immunized animals. Mast cells in the tip of the eyelid from normal, antigen-injected control and antigen-injected immunized rats were examined at 1/2, 1, 6 and 24 hr. The number of cells and their morphology was determined. All three groups had the same number of mast cells at all time intervals. Extensive mast-cell degranulation was observed at 1/2 and 1 hr in lid tips of immunized, antigen-challenged rats. By 24 hr, the mast cells appeared to have 'healed' and regranulated, although it was possible to distinguish these cells from mast cells of normal animals. We conclude that under certain conditions, mast cells participating in ocular anaphylaxis are not destroyed but survive and regenerate granules within the first 24 hr. PMID- 6852866 TI - C1- inactivator: its efficiency as a regulator of classical complement pathway activation by soluble IgG aggregates. AB - The role of C1- inactivator (C1(-)-In) during activation of the classical complement pathway by soluble immune complexes was studied using purified human complement components C1, C4 and C1(-)-In, and stabilized soluble aggregates of normal human IgG as a model for soluble immune complexes. The C4-consuming ability that could be generated by incubation of precursor C1 with IgG aggregates was abolished completely by the presence of a large excess of C1(-)-In during the C1 activation step. Kinetic studies confirmed that this inhibition was due to a second-order reaction between C1- and C1(-)-In resulting in the irreversible inactivation of C1-. When aggregates of various sizes were enabled to induce C4 conversion in mixtures of C1, C4 and a variable concentration of C1(-)-In, the presence of C1(-)-In had two effects. Firstly, the efficiency of the aggregates in causing C4 consumption was reduced remarkably. At a C1(-)-In:C1 ratio of 8, which can be found in normal human serum, approximately eight to ten times as many aggregates were required for a given level of C4 consumption as when no C1( )-In was present. Secondly, C1(-)-In diminished the maximum C4 consumption that could be achieved, especially with smaller aggregates. Thus, a complete or partial C1(-)-In deficiency probably facilitates complement activation by soluble immune complexes in two ways: it may enhance the efficiency of classical pathway activation by all C1-activating complexes, and it may enable small complexes, which normally cannot overcome the C1(-)-In barrier, to activate the classical pathway to the C4 level. PMID- 6852867 TI - An immunoelectron microscopic study of immunoglobulin G in the postcapillary venules of normal and nude mouse lymph nodes. AB - Ultrastructural localization of immunoglobulin G (IgG) in the postcapillary venules (PVC) of normal and nude mouse lymph nodes was examined in thin sections which had been stained sequentially with primary exposure to biotin-conjugated goat anti-mouse IgG serum and a secondary immersion in a ferritin-linked avidin (IF). In the normal mouse PCV, reaction products showing IgG-binding sites were detected as large IF clusters on the luminal membrane of the endothelial cells, as small IF clusters in the intercellular spaces between the endothelial cells and some migrating lymphocytes, and as uniform precipitates of large numbers of IF particles in the basement membrane. By contrast, nude mouse PCV retained a few or almost no IgG-binding sites in portions comparable to those observed in the normal mouse. A relatively large number of plasma cells in the lymphoid stroma of both strains possessed large IF clusters on the cell surfaces. The significance of the IgG localization in the PCV of the two strains is discussed in relation to the mechanism of lymphocyte recirculation. PMID- 6852869 TI - Immunoglobulins of rnu/rnu 'nude' rats with congenital aplasia of the thymus. AB - The levels of immunoglobulins (Ig) in the serum and saliva of nude (rnu/rnu) congenitally athymic rats and control (rnu/+) thymic heterozygous rats have been studied. Serum IgM, and serum and salivary IgA levels were virtually identical between rnu/rnu and rnu/+ rats. Serum IgG was drastically reduced in nude rats during the period when endogenous IgG synthesis was predominant. The most consistent and pronounced differences in Ig levels between rnu/rnu and rnu/+ rats involved the IgG isotype. PMID- 6852871 TI - Inhibition of polymorphonuclear leucocyte locomotion by surface-bound antigen antibody complexes. AB - Locomotion of polymorphonuclear leucocytes (PMNL) on solid surfaces with bound antigen-antibody complexes was studied. The amount of surface-bound antibody was determined with ellipsometry, a surface-sensitive optical method. Locomotion of PMNL was inhibited on surfaces coated with bilayers of human serum albumin and the corresponding antibody. The critical amount of antibody required for inhibition was measured to 0.50 X 10(-8) micrograms/microns 2, corresponding to 1.6 X 10(6) antibody molecules per PMNL. Once immobilized on antigen-antibody coated surfaces, PMNL did not move chemotactically in response to formylmethionyl leucyl-phenylalanine (fMLP). The receptor for fMLP appeared to be intact, however, since the cells responded metabolically to the chemotactic peptide. PMID- 6852870 TI - Auto-antibody dependent activation of the autologous classical complement pathway by guinea-pig red cells treated with influenza virus or neuraminidase: in vitro and in vivo study. AB - Guinea-pig erythrocytes that had been exposed to influenza A virus or Vibrio cholerae neuraminidase activated the classical complement pathway in autologous serum. Because all viral particles were eluted from the treated cells, activation was not dependent on anti-viral antibodies or on the particles themselves. After a threshold of 45-55% desialation, had been reached, the relative capacity of treated cells to activate complement increased very rapidly with desialation. Desialation unmasked sites on which natural auto-antibodies of the IgM class were fixed. Antibody fixation on the membrane led to C3b deposition on the cell membrane and activation of the classical complement sequence then cell lysis. The relevance of in vitro lysis of desialated cells to in vivo clearance of these cells is not certain because C4-deficient guinea-pigs were able to eliminate desialated cells from the blood stream as efficiently as did normal guinea-pigs. Nevertheless, membrane desialation occurring during myxovirus infection could lead to autoimmunity and tissue changes, as well as to recovery by eliminating virus-modified cells. PMID- 6852872 TI - Steroid hormone regulation of free secretory component in the rat uterus. AB - The present studies analysed the uterine free secretory component (SC) response to steroid hormones, and correlated effects on SC with those on IgA. Administration of oestradiol for 3 days to ovariectomized rats significantly increased the levels of SC in uterine secretions, when compared to those in saline-injected controls. This response was dose-dependent and specific for oestrogens, since progesterone, testosterone and glucocorticoids had no effect. The oestradiol-induced elevation in SC levels occurred in parallel with that of IgA. Time course studies of SC and IgA in uterine secretions indicated that both proteins accumulated in nearly identical patterns following oestradiol administration. The oestradiol-stimulated accumulation of SC, however, appears to be independent of IgA since dexamethasone treatment with oestradiol decreased IgA but not SC levels in uterine secretions. In contrast to dexamethasone, progesterone antagonized the oestradiol effect on both uterine IgA and SC. The uterine SC response to oestradiol was also observed in vitro. Incubation of uterine tissue following oestradiol exposure in vivo resulted in a significant accumulation of SC in the culture medium, when compared to levels from control uteri. Addition of either cycloheximide or colchicine to uterine incubation media significantly decreased the effect of oestradiol on SC accumulation. These results suggest that oestrogen regulation of uterine SC may involve stimulation of its synthesis. In addition, our findings indicate that oestradiol control of SC in uterine secretions may be responsible for the movement of IgA from uterine tissues to lumen. PMID- 6852873 TI - Phagocytosis of antibody-sensitized Trypanosoma brucei in vitro by bovine peripheral blood monocytes. AB - The interaction between bovine peripheral blood monocytes and Trypanosoma brucei organisms in the presence of immune whole serum or specific purified IgM or IgG1 antibodies from infected cattle was investigated. Adherence of antibody sensitized trypanosomes to freshly isolated monocytes from non-infected animals was not observed, confirming the absence of receptors for IgM and IgG1 on fresh monocytes. After in-vitro cultivation of the monocytes for at least 3 hr, adherence of IgM-sensitized trypanosomes was consistently demonstrable, while the adherence of IgG1-sensitized trypanosomes was not observed until the monocytes had been cultured for 7 days. The adherence of IgM-sensitized trypanosomes occurred in the absence of bovine complement and was Ca++-dependent, indicating that the interaction between sensitized trypanosomes and bovine monocytes was mediated through a specific combining site for monocytes in the Fc region of the IgM molecule rather than through a C3b receptor. In contrast to the monocytes from uninfected animals, freshly isolated peripheral blood monocytes from T. brucei- or T. congolense-infected cattle were capable of binding IgM- or IgG1 sensitized trypanosomes after only 30 min and 24 hr of in-vitro cultivation, respectively, suggesting that peripheral blood monocytes from infected animals were already in an "activated' state. Electronmicroscopic examination revealed that IgM- or IgG1-sensitized trypanosomes were rapidly engulfed and digested by the monocytes. PMID- 6852875 TI - Effect of in vivo inoculation of bacteria on the spontaneous cytotoxicity of axial organ cells from Asterias rubens. AB - In vivo inoculation of heat-killed bacteria in the coelomic cavity of starfish induces an increase of spontaneous cytotoxicity developed by axial organ (an ancestral lymphoid organ) cells, phenomenon demonstrated by an in vitro [51Cr] release assay. This observation corroborates the existence of a sophisticated immune system in the echinoderms, a first-rate model for phylogenic study of the immune response. PMID- 6852874 TI - Neutrophil-mediated antibody-dependent cellular cytotoxicity: morphological concomitants of 51Cr-release. PMID- 6852878 TI - Surface temperature of bald and hairy scalp in reference to leprosy affection. PMID- 6852877 TI - Allotypic phenotypes displaying different frequencies in healthy and beta thalassemic sample populations. AB - This paper presents data on the identification of an allotypic polymorphism carried on a beta-lipoprotein in human serum. The antigen, whose inheritance is investigated in 78 families, is coded by a polymorphic locus (As) existing in 4 allelic states. The products of these alleles exhibit a serological linear subtyping pattern with respect to the alloantisera recognizing the allotypes. The allelic frequencies prove different in healthy (beta beta) and thalassemic (beta beta thal) sample populations, thus suggesting linkage dysequilibrium between the recessive alleles of the As and beta loci. PMID- 6852876 TI - Circulating immune complexes in murine neuroblastoma: quantification and shifts in immunoglobulin composition. AB - Circulating immune complexes (CIC) in sera obtained from neuroblastoma (NB) bearing A/J mice were quantitated using a modified conglutinin (Kg) RIA technique which--in this case--gives very reproducible results. It shows that CIC levels in these sera increase almost linearly as a function of time after tumor challenge. Three weeks after inoculation values ranging from about 4 to up to 10 times those of normal sera are obtained, depending on the type of inoculum (NB tumor or established NB cell lines). However, when tumor is adapted to cell culture, these CIC levels, measured at a constant time interval after challenge, decrease on continued subcultivation in vitro. Furthermore, analyses of the immunoglobulin classes involved in the complexes show that this decrease is more pronounced for the IgG2a and IgG2b subclasses than for IgG1 and IgM, resulting in a shift of the ratio of immunoglobulin classes as a function of subcultivation of these tumor derived cells. PMID- 6852880 TI - Tinea faciei caused by Microsporum canis. A case report. PMID- 6852879 TI - Pathogenesis of acute lepromatous activation. PMID- 6852882 TI - Cyclophosphamide in vitiligo. PMID- 6852881 TI - Sporotrichosis treated with garlic juice. A case report. PMID- 6852883 TI - Measurement of osmotic resistance of normal and pathological human red blood cells. AB - The changes in the osmotic resistance of red blood cells (RBC), due to various pathological conditions like exposure to heat, anemia as well as the effect of storage and anticoagulants have been investigated. The results have shown that exposure to a temperature of 50 degrees C makes the red blood cells fragile to osmotic pressures. Also, red blood cells from the patients suffering from anemia exhibited decreased osmotic resistance. Storage upto 9 days showed a marginal increase in the osmotic fragility of the RBC and beyond that, there was no significant effect upto 15 days. Also, exposure to anticoagulants like citrate, ammonium oxalate, and EDTA increased the osmotic fragility of the cells. The present study shows that the various traumas investigated will affect the mechanical properties of the red blood cell membrane. PMID- 6852884 TI - Effects of dynamic and static body weight loss on taste responses. AB - Effects of body weight (bw) decrease induced by restruction of food intake by 75%, 50% and 25% on responses to 1-hr single bottle gustatory tests with glucose, saccharin, salt and quinine were investigated. Rats fed ad libitum served as controls. Food-restricted rats showed dynamic and static loss of bw, the rate and magnitude being proportional to food intake. With the increase in static bw loss across groups, intake on sweet and salt taste was increased and on bitter taste decreased as compared to controls. Though on rapid dynamic bw loss, progressive increase on sweet and salt taste, and gradual decrease on bitter taste was seen with duration of adaptation, it was not commensurate with magnitude of bw loss. However, on slow loss of bw, taste based intake was proportional to bw loss. PMID- 6852885 TI - Steroid depressed wound healing and Tridax procumbens. AB - Dexamethasone 0.33 mg/kg (I.M.) on first day and half this dose thereafter daily, depressed wound contraction, epithelization, tensile strength and process of granulation of wounds in experimental animals. Juice from the leaves of Tridex procumbens (T.P. 1 ml, I.P., daily) resembled dexamethasone in effects on wound contraction and granulation; but it significantly (P less than 0.001) counteracted the effects of dexamethasone on tensile strength and epithelization. TP caused increase in adrenal weight and decrease in thymus weight. These observations suggest that TP exerts a direct pro-healing effect along with an indirect anti-healing influences probably mediated through release of adrenal steroids. PMID- 6852886 TI - Effect of isoprenaline and cigarette smoking on airways. AB - After two hours of abstinence from smoking pulmonary functions were assessed in twenty-seven asymptomatic male smokers by spirometry and Wright Peak Flow Meter, recording FVC, FEV1, FEV1%, FEF25-75%, and FEF75-85% of FVC, MVV and PEFR. These tests were repeated immediately after smoking and again after one hr. Only PEFR decreased significantly (P less than 0.01) and returned to nearly basal level after one hr. Sixteen of these smokers were subjected to further study. Isoprenaline inhalation in these smokers caused a significant improvement in most of the flow rates. Smoking of cigarettes at this stage decreased flow rates. After one hr the effect of smoking was over and most of the parameters were between basal and post-isoprenaline levels. Smoking affects the flow rates more than other parameters. An improvement in FEV1, FEV1%, FEF25-75% and FEF75-85% of FVC, after bronchodilator inhalation suggests the presence of some reversible bronchoconstriction specially of smaller airways basically present in chronic smokers. PMID- 6852887 TI - Phenotypical expression of finger print patterns, A hypothesis. AB - The finger print patterns (F.P.Ps.) were studied in 1120 healthy individuals of Bundelkhand region. It was found that the type of F.P.Ps. in one particular hand, is dependent upon the finger on which the pattern is manifested, and the specific print patter on the corresponding finger of the other hand. It is discussed that the phynotypical expression of F.P.P. is due to the interaction between various factors including the hypothetical 'F.P.P. Genes' among themselves and/or with the 'specific finger genes'. PMID- 6852888 TI - Prediction of some ventilatory 'norms' in healthy Indian males 21-69 years age. AB - This paper presents regression equations for predicting some ventilatory 'norms' (viz. vital capacity, forced vital capacity, forced expiratory volume for one second, expiratory reserve volume, inspiratory capacity and maximum voluntary ventilation) from physical characteristics of healthy Indian males. These equations have been constructed on the basis of multivariate regression analysis of the data of ventilatory 'norms' and physical characteristics collected on 171 healthy Indian males of age ranging from 21-69 years. Applications of these regression equations will be of practiced importance to biomedical scientists interested in the indirect assessment of ventilatory 'norms for a wider age range (21-69 years) which has not been covered by earlier studies carried out in this direction. PMID- 6852889 TI - Branched chain aminoacid aminotransferase activity in the denervation atrophy of amphibian skeletal muscle. PMID- 6852891 TI - Tolbutamide and indomethacin interaction. PMID- 6852890 TI - Fitting curves to physiological data. AB - This paper deals with fitting of a parabola and three parameter logistic curve to relate heart output and initial index finger temperature with ambient temperature in human subjects. The coefficients of determination (R2%) between observed and estimated values of heat output and initial index finger temperature were close to 98% indicating the high percentage of variation of the total sum of squares absorbed by the fit of the curves. The superiority of the fitted curves over the other curves have been proved. Thus it is concluded that parabola and three parameter logistic curve may explain the relationships of heat output and initial index finger temperature with ambient temperature more precisely than other curves. PMID- 6852892 TI - Reflections on pathology in trauma. PMID- 6852894 TI - Closed medullary nailing of fractures of the femoral shaft using the AO method. PMID- 6852893 TI - Ender's nailing of femoral shaft fractures. PMID- 6852895 TI - Fractures of the proximal tibial epiphysis. AB - Fractures of the upper tibial epiphysis are rare. We report on three cases classified according to the Salter and Harris method. Case one, a Type III injury, was associated with a neurovascular lesion. Case two, a Type II injury, was associated with rupture of the medial collateral ligament of the knee, which was treated by internal fixation of the fracture and repair of the ligament. Case three was an unusual fracture, which has not previously been reported in the literature, a Type II injury with an accompanying fracture of the tibial tubercle. PMID- 6852896 TI - Analysis of terrorist injuries treated at Craigavon Area Hospital, Northern Ireland, 1972-1980. AB - As a result of terrorist incidents, 482 patients were seen at a district hospital between September 1972 and December 1980. Details of 339 bomb victims and 115 gunshot victims were available for analysis. Most patients in both categories suffered injuries not affecting vital structures and there was an admission rate of 42 per cent for bomb victims and 81 per cent for gunshot victims. Five patients died in hospital as a result of explosions, and 12 of gunshot wounds. The majority of patients (72 per cent) were seen outside normal working hours (9.00 am-5.00 pm). Initial emergency treatment was carried out at Craigavon Area Hospital and ultimately 41 cases were transferred for either security or medical reasons. PMID- 6852897 TI - Fractures of the femoral neck. A follow-up study after non-operative treatment of Garden's stage 1 and 2 fractures. PMID- 6852899 TI - Surgical treatment of T and Y fractures of the distal humerus. AB - Intercondylar T and Y fractures of the distal humerus in adults present a challenge. Open reduction and internal fixation in 19 cases over a 7-year period gave excellent or good results in 15 cases. Campbell's posterior approach to the elbow joint gave a satisfactory exposure. Anterior transposition of the ulnar nerve is a very useful adjunct to prevent late neuritis. A new method of classification is suggested, taking into account the importance of the supracondylar ridge for adequate stability. PMID- 6852898 TI - The selective reporting of X-ray films from the Accident and Emergency Department. PMID- 6852901 TI - Bullworker's fracture. PMID- 6852900 TI - Bilateral traumatic dislocation of the hip. PMID- 6852902 TI - The stability of the tibio-fibular syndesmosis following rigid internal fixation for type C malleolar fractures: an experimental and clinical study. AB - In 5 cadavers, type C malleolar fractures of the pronation-eversion rotation type, were produced. The stability of the ankle mortice under stress was tested before and after rigid internal fixation of the fracture in the fibula. The intact interosseous membrane above the fracture in combination with the internal fixation of the fibula was sufficient to keep the lateral malleolus in place. A clinical series of 8 equivalent fractures treated with rigid internal fixation without suture of the syndesmodesis was collected and evaluated clinically and radiologically 3 years after the injury. None of the patients had significant complaints and all ankle joints were stable. PMID- 6852903 TI - Bilateral anterior fracture-dislocation of the shoulder joints due to severe electric shock. PMID- 6852904 TI - Complete transection of the main bronchus. PMID- 6852905 TI - Traumatic lumbar spondylolisthesis: Anterior fusion by means of a fibular graft. PMID- 6852907 TI - Salmonella osteomyelitis with femoral fracture. PMID- 6852906 TI - An iliac crest bone biopsy trephine. PMID- 6852908 TI - The reduction of supracondylar fractures of the humerus in children treated by traction-in-extension. A review of 18 cases. PMID- 6852909 TI - Immunogenicity of soluble and particulate antigens from Leishmania donovani: effect of glucan as an adjuvant. AB - The protective efficacy of glucan as an adjuvant with killed promastigotes of Leishmania donovani was compared with that of soluble or particulate fractions of the parasite. When these vaccine preparations were injected either intravenously or subcutaneously in CF-1 mice, glucan potentiated resistance against L. donovani infections as reflected by significant reductions in hepatic amastigote counts relative to infected control mice. The leishmanial antigens alone afforded no protection. Serum direct agglutination titers to leishmanial antigens were highest in all groups given the vaccine intravenously, whereas the delayed-type hypersensitivity response to the antigen was positive only in groups immunized subcutaneously with glucan as an adjuvant. Some index of protection and immune response against visceral infection with the parasite was seen in groups vaccinated with glucan and soluble antigens. However, the protection afforded by glucan and particulate antigens of L. donovani more closely paralleled the resistance of mice treated with glucan and unfractionated killed promastigotes. Further antigenic analysis of particulate fractions of L. donovani may optimize effective immunization when used with appropriate adjuvants, e.g., glucan. PMID- 6852910 TI - Dose response of A/Alaska/6/77 (H3N2) cold-adapted reassortant vaccine virus in adult volunteers: role of local antibody in resistance to infection with vaccine virus. AB - An attenuated influenza A candidate vaccine virus, derived from the A/Ann Arbor/6/60 (H2N2) cold-adapted (ca) donor virus and the A/Alaska/6/77 (H3N2) wild type virus, was evaluated in adult seronegative volunteers (serum hemagglutination-inhibiting antibody titer, less than or equal to 1:8) for level of attenuation, infectivity, antigenicity, and genetic stability. Four groups with similar preinoculation mean titers of serum and nasal wash antibodies were inoculated intranasally with 10(4.5), 10(5.5), 10(6.5), or 10(7.5) 50% tissue culture infectious doses (TCID50) of the ca reassortant virus, and eight other seronegative adult volunteers received the wild-type virus. Only 2 of 66 vaccinees developed fever or mild and brief systemic or upper respiratory tract illness or both. Both volunteers with vaccine-related reactions received the highest dose (10(7.5) TCID50) of ca virus, which indicates that the vaccine retains some mild reactogenicity at a high dosage. In contrast, four of eight volunteers infected with the wild-type virus became ill. Each of the 54 isolates tested retained the temperature-sensitive phenotype of the vaccine virus. Thus, the ca reassortant was genetically stable and attenuated at 10(4.5) to 10(7.5) TCID50 for seronegative adults. The 50% human infective dose of ca virus was approximately 10(5.3) TCID50. Ten and one hundred 50% human infectious doses infected 73 and 83% of vaccinees, respectively, and approximately 75% developed an immunological response at these doses. The failure of the vaccine virus to infect some volunteers was correlated with the presence of pre-inoculation nasal wash immunoglobulin A hemagglutinin antibody. PMID- 6852912 TI - Lack of antibodies to human heart tissue in sera of rhesus monkeys immunized with Streptococcus mutans antigens and comparative study with rabbit antisera. AB - Immunization of rabbits and rhesus monkeys with Streptococcus mutans whole cells, cell walls, and defined streptococcal antigens (SAs) SA I/II, SA I, and SA II resulted in high antibody titers to SA I/II (10(-4) to 10(-6)) when tested by the solid-phase radioimmunoassay. Cross-reactive antibodies to heart homogenates (HH) were not elicited in rhesus monkeys. A few rabbits immunized with cell wall or SA II preparation in Freund complete adjuvant followed by the incomplete adjuvant yielded low antibody titers (up to 10(-2)) to the HH. The specificity of the putative heart cross-reactive antibodies was tested by immunoadsorption with related and unrelated antigens. Whereas antibody to SA I/II showed specific adsorption with SA I/II but not with HH, immunoglobulin G, or the unrelated antigens, antibody to HH seemed to have been adsorbed with all of the related and unrelated antigens. There was no evidence for the development of heart cross reactive antibodies on immunization of rhesus monkeys or rabbits with SA I/II and aluminium hydroxide or Freund incomplete adjuvant, administered by the subcutaneous or intramuscular route in doses of up to 13 mg of the immunogen. PMID- 6852911 TI - Comparison of proteins synthesized by two different isolates of Anaplasma marginale. AB - We present results on the initial definition of proteins synthesized by two isolates of Anaplasma marginale. Bovine erythrocytes infected with A. marginale were radioactively labeled with [35S]methionine or a 3H-amino acid mixture during short-term in vitro culture. The labeled proteins were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. This technique revealed protein bands of various apparent molecular weights from less than 14,000 to greater than 200,000. The bands observed represented A. marginale proteins because (i) uninfected erythrocytes from the same animal did not incorporate radioisotope during identical culture conditions, and (ii) the incorporation of radioisotope into proteins during culture of infected erythrocytes was inhibited by tetracycline but not by cycloheximide. The radioactive protein profiles of two different isolates of A. marginale, from Washington and Florida, were compared by two-dimensional gel electrophoresis. About 200 proteins were resolved in each case. Several proteins differed in position when the two-dimensional gel maps were compared, indicating variations in protein structure between the two A. marginale isolates. PMID- 6852913 TI - Vibrio factors cause rapid fluid accumulation in suckling mice. AB - Non-O-1 and O-1 Vibrio cholerae and Vibrio fluvialis isolated from clinical and environmental sources were examined for virulence factor production in 3-day-old suckling mice and in Y-1 tissue culture. The responses of the suckling mice to intragastrically administered bacterial cultures were measured by intestinal fluid accumulation (FA), diarrhea, and mortality. Regardless of the O-serovar, source of isolation, or ability to produce cholera toxin, all strains of V. cholerae stimulated increased FA, which was measurable in the mice at 4 h post inoculation. The factor(s) causing these symptoms was found to be distinct from cholera toxin by the kinetics of FA and serological difference from cholera toxin based on in vivo neutralization tests. In most instances, FA was followed by high rates of mortality. Y-1 mouse adrenal tumor cell assays also showed that many V. cholerae produced extracellular heat-labile cytotoxic factor(s), and many cholera toxin-negative strains also caused a cytotonic-like morphological response. The majority of V. fluvialis strains produced smaller amounts of cytotoxic factor(s) but no cytotoxic reactions. The factor which stimulates rapid FA in suckling mice could be one of several virulence-associated factors contributing to diarrheal disease by nontoxigenic vibrios, but this is not verified at present. PMID- 6852915 TI - Binding of Todd-Hewitt broth antigens by Streptococcus mutans. AB - Streptococcus mutans 10449, grown in chemically defined culture medium, was tested for its ability to bind 3H-labeled Todd-Hewitt broth components (greater than 12,000 Mr). Maximum adsorption of radioactivity occurred within 5 min at room temperature, and cell-bound material was not completely removed by extended washing with buffer. Heat-killed, arsenate-inhibited, and viable bacteria bound similar quantities. Only 0.09% of the radioactivity in the preparation of high Mr Todd-Hewitt broth components was removed by absorption with excess numbers of S. mutans 10449 cells. Binding followed saturation kinetics and was competitively inhibited by unlabeled medium components, both the dialyzable and nondialyzable fractions. Other oral streptococci were also found to bind these complex medium components. Rabbit antiserum elicited to the high-molecular-weight Todd-Hewitt broth components reacted with monkey cardiac muscle and with S. mutans coated with medium components. Absorption of the anti-Todd-Hewitt broth serum with homogenized heart removed antibodies that reacted with Todd-Hewitt broth-coated S. mutans. Therefore, the tissue-specific antigens of this beef heart infusion medium that adsorb to S. mutans can interfere with the detection and characterization of antigens shared by these bacteria and animal tissues. PMID- 6852914 TI - Secretory immunological response after intranasal inactivated influenza A virus vaccinations: evidence for immunoglobulin A memory. AB - An intranasal, inactivated trivalent influenza A vaccine containing 7 micrograms of A/Bangkok/1/79 (H3N2) hemagglutinin was administered to 20 children aged 1 to 6 years to assess the local and systemic immune responses to antigen delivered to the respiratory tract. Six children without prior influenza virus infection exhibited no local immune response and manifested only a minimal systemic response to the intranasal vaccine. In contrast, five individuals who were previously infected with a live attenuated influenza A H3N2 virus vaccine, although having no residual secretory antibody at the time of challenge, promptly developed a local antibody response to intranasal, inactivated antigen. Therefore, the live influenza A virus vaccine had induced memory in the local immunoglobulin A (IgA) immune system. The third group of nine children had previously been infected with wild-type H3N2 influenza virus. A majority of these children had residual local and systemic antibody at the time of challenge but they demonstrated some boosting of local IgA antibody with administration of intranasal inactivated vaccine. The competence of the secretory IgA immune system in young children in mounting primary and secondary responses to influenza antigens has important implications for approaches to prevention of influenzal illness. PMID- 6852916 TI - Lysosomal response of a murine macrophage-like cell line persistently infected with Coxiella burnetii. AB - The lysosomal response of a murine macrophage-like tumor cell line (J774) during persistent infection with Coxiella burnettii was examined. By using acid phosphatase as a lysosomal marker, it was shown that phagosome-lysosome fusion occurred in J774 cells persistently infected with C. burnetii. This observation was verified using thorium dioxide, an electron-dense compound that is sequestered in secondary lysosomes. The phagolysosomes contained viable replicating rickettsiae. Spectrofluorometric analysis indicated that the phagolysosomal pH of persistently infected cells was acidic. In attempts to correlate rickettsial survival with lysosome function, the activities of several lysosomal enzymes were assayed in both infected and uninfected cells. Activities of acid phosphatase and beta-acetylglucosaminidase were not significantly altered during infection. However, infected cells appeared to display slightly higher intracellular lysozyme, beta-glucuronidase, and beta-galactosidase activities. PMID- 6852917 TI - Synthesis and biological assays of peptides from a tuberculin-active protein. AB - The octapeptide Asp-Gly-Gly-Ser-Glu-Ser-Glu-Gly and the hexadecapeptide Asp-Gly Gly-Ser-Glu-Ser-Glu-Gly-Lys-Asn-Gly-Ser-Gln-Met-Arg-Leu, part of a tuberculin active intracellular mycobacterial protein, were synthesized. The synthetic peptides were shown to possess tuberculin activity by their ability to elicit a delayed-type allergic reaction in skin tests on Mycobacterium tuberculosis sensitized guinea pigs. Purified protein derivative, the complex mixture of proteins of unknown composition which are excreted into the culture medium by M. tuberculosis and which is in wide use as a tuberculin-active preparation, was shown to cross-react weakly in the radioimmunoassays with the synthetic octapeptide when the 125I-labeled octapeptide and an anti-octapeptide antiserum were used. PMID- 6852919 TI - Cytopathogenicity of Naegleria fowleri for rat neuroblastoma cell cultures: scanning electron microscopy study. AB - Neuroblastoma cells were inoculated with Naegleria fowleri Lee and examined for cytopathology at various periods post-inoculation by scanning electron microscopy. By 18 h post-inoculation, approximately 50% of neuroblastoma cells were nonviable, as evidenced by trypan blue exclusion and light microscopic examination. This cytopathology resulted from piecemeal consumption of target cells mediated by a sucker apparatus extending from the surface of N. fowleri. PMID- 6852918 TI - Common antigens of streptococcal and nonstreptococcal oral bacteria: characterization of wall-associated protein and comparison with extracellular protein antigen. AB - A soluble wall-associated common protein (WAP) has been isolated from cell wall extracted antigens of exponentially growing cells of Streptococcus sanguis OMZ9, two serotypes (a and e), of Streptococcus mutans and Actinomyces viscosus OMZ104. The WAP antigens from the different strains were obtained by chromatography on an anti-rabbit immunoglobulin column of sodium dodecyl sulfate-dissociated immunoprecipitates. The affinity-isolated WAP antigens from the different oral bacteria were identical, as demonstrated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (showing an apparent molecular weight of 80,000) and amino acid and sugar compositions. This WAP antigen, common to all bacterial strains tested, consisted of 90% protein and 10% sugar. A comparison of the chemical properties of this WAP antigen and of the soluble extracellular common protein antigen showed that, although having similar amino acid and sugar compositions, the two proteins are different. Electron micrographs developed after immunocytological labeling of the WAP antigen on whole cells confirmed that it is located on the cell wall. PMID- 6852920 TI - Immunoglobulin and complement in tissues of mice infected with Nocardia brasiliensis. AB - Two weeks after mice had been infected in the footpad with cells of Nocardia brasiliensis, immunoglobulin and C3 deposits were observed in tissue from the inoculation site. Both immunoglobulin and C3 were found in the actinomycotic granules that characterize the mycetoma and in the surrounding inflammatory zones, in which plasma cells were also present. Although anti-N. brasiliensis specificity was evidenced at 14 days postinfection in an eluate of infected tissue by an immunoenzymatic assay, no such antibody was found in the serum until 45 days postinfection. Immune complexes in the lesions, as indicated by the presence of C3, may also contribute to the pathology of the disease. PMID- 6852921 TI - Cross-resistance to fecal excretion of Yersinia enterocolitica in mice by oral vaccination of killed cells. AB - Mice vaccinated orally with heat-killed cells of serovar O3 of Yersinia enterocolitica were protected only against fecal excretion of the homologous serovar, whereas Formalin-killed cells provided cross-protection against serovar O9 and vice versa. Serovar IVA of Yersinia pseudotuberculosis, when Formalin killed, also provided cross-protection against Y. enterocolitica. On the other hand, Serratia liquefaciens and serovar O6 strains did not furnish cross protection. PMID- 6852922 TI - Elevated antibody levels against measles virus P protein in sera of patients with multiple sclerosis. AB - Immune precipitation followed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and densitometry was used to estimate immunoglobulin G antibody levels against the H, P, and M proteins of measles virus in the sera of 24 patients with multiple sclerosis and 24 serologically matched controls. Of the 24 multiple sclerosis sera, 5 showed a statistically significant increase in antibody titer to the P protein as compared with the control sera. Antibody titers to the H and M proteins in multiple sclerosis and control sera were not significantly different. PMID- 6852923 TI - Immunogenic properties in mice of hexasaccharide from the capsular polysaccharide of Streptococcus pneumoniae type 3. AB - Hexasaccharide (HS) containing 3 U of cellobiuronic acid was isolated from Streptococcus pneumoniae type 3 capsular polysaccharide S3 and coupled to bovine serum albumin (BSA), keyhole limpet hemocyanin (KLH), or tetanus toxoid (TT). The immunogenicity of these HS-protein conjugates in BALB/c mice was studied by measuring the production of circulating antibodies and the induction of protective immunity to viable S. pneumoniae type 3. Immunization of BALB/c mice with 0.5 micrograms of S3 resulted in the induction of immunoglobulin M (IgM) antibodies and complete protection against 25 U of a mean lethal dose of S. pneumoniae type 3 for 19 weeks after immunization. BALB/c mice immunized with 100 micrograms of HS9-BSA (containing 12 micrograms of HS) were also protected due to circulating IgM antibodies. Repeated injections with either 100 micrograms of HS9 BSA (three immunizations) or 100 micrograms of HS6-KLH (two immunizations) resulted in high levels of circulating IgG antibodies. These HS-protein conjugates induced complete protection which lasted at least 14 (HS9-BSA), 23 (HS6-KLH), or 8 (HS16-TT) weeks after the last immunization. Protection against viable S. pneumoniae type 3 could be passively transferred to nonimmunized mice by antisera containing IgM or IgG antibodies or both. Sera containing both IgM and IgG antibodies gave better protection than sera containing only IgM antibodies. The specificity of the induced protection was confirmed by challenge with the non-cross-reacting S. pneumoniae type 11. PMID- 6852924 TI - Antibody responses induced by immunization of inbred mice susceptible and resistant to African trypanosomes. AB - We tested the ability of inbred mice that were either susceptible (strain A/J) or resistant (strain C57BL/6 and A/J X C57BL/6 hybrids) to African trypanosomes to produce specific antibodies to trypanosome antigens in the absence of living parasites. This experiment was carried out to eliminate the influence of trypanosome growth or metabolism on immune responsiveness. Mice were immunized with keyhole limpet hemocyanin or solubilized Trypanosoma brucei gambiense, and serum antibodies were measured in solid-phase radioimmunometric assays after primary and challenge injections. Both susceptible and resistant mice showed increases in keyhole limpet hemocyanin-specific or trypanosome-specific immunoglobulin M and immunoglobulin G after immunization. When immunized with trypanosome antigens, resistant mice made qualitatively and quantitatively superior specific immunoglobulin M responses, particularly to the trypanosome major variable surface glycoprotein. Susceptible A/J mice produced good specific antibody responses, although these were predominantly of the immunoglobulin G isotypes. These results show that A/J and C57BL/6 mice respond differentially in terms of immunoglobulin isotype and repertoire in response to injected antigens. The possibility that this differential antibody response influences susceptibility to African trypanosomes is discussed. PMID- 6852925 TI - Inbred mouse strains differ in resistance to lethal Coccidioides immitis infection. AB - Inbred strains of mice were infected intraperitoneally with Coccidioides immitis, and the mean lethal dose was determined after 28 days. DBA/2N mice had a mean lethal dose of greater than 10(5) arthroconidia, whereas BALB/cAnN, C57BL/6N, and C57L/J mice had a mean lethal dose of less than or equal to 10(3). Since both BALB/c and DBA/2 mice are the H-2d haplotype, resistance is not primarily determined by the major histocompatibility locus. Resistance was the dominant phenotype. The pattern of C. immitis-resistant strains does not correspond to the strain distribution of the lsh gene or to the pattern of resistance to Blastomyces dermatitidis or Cryptococcus neoformans. Both resistant and susceptible mice, however, could be successfully immunized with a killed spherule vaccine, and susceptible BALB/cAnN mice were protected from an otherwise lethal infection by prior immunization with an attenuated mutant of C. immitis. Despite the evidence that BALB/cAnN mice could respond to immunization, nonimmune mice did not control the later phase of intraabdominal infection as well as DBA/2N mice. Dissemination of C. immitis to the lung occurred frequently in BALB/cAnN but not in DBA/2N mice. This suggests that BALB/cAnN mice cannot mount an effective immune response to C. immitis during the course of infection. PMID- 6852927 TI - Exposure to terpenes: effects on pulmonary function. AB - Forty-eight subjects exposed to terpenes (mean air concentration 258 mg m-3) and 47 unexposed subjects, all employed at sawmills, were studied with regard to symptoms and pulmonary function. Dyspnoea and chest oppression were significantly increased in the exposed subjects compared to the unexposed controls. A reduced FEV1, on spirometry and an increased CV% and slope of the alveolar plateau (phase III) on single breath nitrogen washout were seen on Monday morning before exposure to terpenes. There was no correlation between exposure time (duration of employment) and lung function impairment. A day of industrial exposure to terpenes caused no further change in any lung function variable. The unexposed controls showed normal spirometry and nitrogen washouts. The findings indicate a slight stable lung function impairment of an obstructive nature which does not necessarily undergo further deterioration with increased duration of exposure. PMID- 6852926 TI - Isolation and characterization of macrophage phagosomes containing infectious and heat-inactivated Chlamydia psittaci: two phagosomes with different intracellular behaviors. AB - Infectious Chlamydia psittaci enters macrophages via a cytochalasin B-insensitive pathway in which chlamydia-containing phagosomes do not fuse with lysosomes; heat inactivated C. psittaci enters macrophages via a route in which phagosomes do fuse with lysosomes. In an attempt to explain these differences, phagosomes containing infectious and heated chlamydiae were isolated from mouse macrophages by a procedure developed to isolate L-cell chlamydial phagosomes by rate zonal centrifugation. Macrophage phagosomes acted similarly to L-cell phagosomes on dextran and discontinuous sucrose gradients and exhibited similar detergent sensitivities. Total proteins of the two phagosomes were compared with each other, L-cell proteins, and surface-labeled proteins from macrophages. Both macrophage phagosome membranes had at least nine proteins with equal sodium dodecyl sulfate-polyacrylamide gel electrophoresis mobilities; some were the same as L-cell phagosome proteins. Each phagosome had at least one protein not seen in the other. Only two phagosome proteins had mobilities equal to macrophage plasma membrane proteins. Macrophage phagosomes containing infectious and heat inactivated C. psittaci, although created by different entry mechanisms and destined for different intracellular fates, exhibited only a few differences in their proteins. PMID- 6852928 TI - [Behavior of free catecholamines in blood and urine of ambulance men and physicians during quick responses]. AB - Free urine adrenaline, noradrenaline, (additional free plasma catecholamines in the physicians), and blood lactate were determined in 11 ambulance men and 5 physicians to assess stress during medical service. Stress was evaluated employing a stress index, based on difficulties in driving, traffic, severity of injuries or illness. Emergency cases with seriously injured subjects or reanimation were judged to have a 4-fold higher stress index than routine cases where strong physiological or psychological stress was absent. Urine catecholamines and stress indices were estimated in 3-h intervals. The calculations were based on the stress induced catecholamine concentrations minus the basal excretion during the same 3-h interval. Urine adrenaline and noradrenaline in ambulance men and physicians correlated directly with the stress index, as well as the plasma catecholamines of the physicians. Lactate levels showed similar behaviour and a descriptive direct correlation with the plasma catecholamines. Urine adrenaline increased more--dependent on the stress index- than urine noradrenaline. This over-proportional adrenaline response may be an indicator for the additional psychological stress in emergency cases. Therefore physicians showed--based on the same stress index--a tendency to higher urine adrenaline excretion and blood lactate levels than the ambulance men, which might be the consequence of the overall responsibility of the physicians. Because of the observed catecholamine responses during medical service, coronary insufficiency or hypertension might be contra-indications for participation in the medical service; regular clinical investigations including ergometric tests are advisable. PMID- 6852929 TI - Traffic noise and hypertension: an epidemiological study on the role of subjective reactions. AB - Traffic noise is discussed as a possible risk factor for hypertension. However, no data are available concerning the moderating effect of the subjective reactions and the noise attitudes. In the present epidemiological study the relationship between these subjective factors and blood pressure was investigated separately for the inhabitants of two residential areas. One area had high traffic volumes, resulting in a high sound level (Leq greater than 73 db (A), noisy area); the other was socially comparable but with an essentially low sound level (Leq less than 51 db (A), control area). The relationship between the subjective reactions and blood pressure was checked by analyzing the incidence of treatment for hypertension (n = 919) and by analyzing the change of casual blood pressure after living 2.25 years in the respective residential area in a subgroup of those who had been normotensive (n = 36). The results obtained by either of these approaches indicate that the subjective factors do not modify the risk of hypertension in noisy areas, whereas they seem to be relevant for medium size stimuli. It is concluded that one can physiologically cope with low stimuli, but this is impossible for extreme stimuli. The results suggest also that the subjective reaction to extreme stimuli is strongly biased by attitudes which cannot be related to blood pressure. The family history of hypertension was found to be independent of the subjective reactions to noise. PMID- 6852930 TI - Neuropsychological studies in children with elevated tooth-lead concentrations. II. Extended study. AB - Results from neuropsychological tests, collected under double-blind-precautions, were evaluated for 115 schoolage children (mean age: 9.4 years) living in a lead smelter area (Stolberg, FRG). Tooth-lead concentrations (PbT) from shed incisor teeth as measures of longtime lead-exposure were available for these children (mean = 6.16 ppm; range: 1.9-38.5 ppm), and for 83 of them blood-lead concentrations (PbB) were available as well (mean = 14.3 micrograms/dl; range: 6.8-33.8 micrograms/dl). The following functional capacities were tested: intelligence (German WISC), perceptual-motor integration (Gottinger Formreproduktionstest = GFT, Diagnosticum for Cerebralschadigung = DCS), reaction performance (Wiener Determinationsgerat), finger-wrist tapping-speed, and repetitive cancellation-performance (Differentieller Leistungstest). In addition standardized behavior ratings were obtained by the examiners, the mothers, and the teachers. Multiple stepwise regression-analysis (forced solution) was calculated for outcome-variables and Pb-tooth, including age, sex, duration of labor, and socio-hereditary background as covariates. Significant (P less than 0.05) or near-significant (P less than 0.1) association was established between Pb-tooth and GFT-performance (errors), reaction-performance (false reactions), and four behavioral dimensions as rated by the mothers, namely distractability, restlessness, lack of information, and wasting of time; the proportion of explained variance never exceeded 6%, however. No significant association was found between PbT and WISC verbal-IQ after the effects of "socio-hereditary background" had been eliminated, although there was still a tendency for high level-children (PbT greater than 10 ppm) to be inferior to low level-children (PbT less than or equal to 4 ppm) by 4.6 IQ-points after correction for confounding. There was a near-significant, inverse relationship between finger wrist tapping-speed and Pb-blood. The results are discussed within the framework of attention-deficit disorder, and compared to neurobehavioral Pb-effects from animal-experiments, which provide suggestive evidence for a causal relationship between developmental lead-exposure and certain neurobehavioral deficits. PMID- 6852932 TI - [Development of demands with increasing technology in text processing]. AB - Text-processing task demands are inquired about by means of an Ergonomic Job Description Questionnaire. The tasks are related to 5 steps of technologies and demands are documented for each of the technologies. With increasing technology demands on visual perception and work organisation dominate, while some demands on energetic work and environmental conditions decrease. PMID- 6852934 TI - Recovery room care. PMID- 6852931 TI - A study on biological monitoring of n-hexane exposure. AB - n-Hexane is one of the solvents widely used in industry and well known to be neurotoxic. Recently it was clearly revealed that n-hexane is metabolized in vivo and its metabolites are excreted in the urine. However, the relationship between the exposed dose of n-hexane and the metabolites in the urine has not yet been substantially determined. Therefore, in this investigation we intended to clarify the above relationship in order to establish its usefulness for biological monitoring of n-hexane exposure. The exposed dose was measured by means of a personal monitoring badge worn by workers in seven factories manufacturing vinyl sandals. The time-weighted average (TWA) concentration of n-hexane was 0.2-47.4 ppm. The n-hexane metabolites in the urine of 22 workers were measured with modified Perbellini's method [12] in the early morning (6:00-7:00 hrs) and at 17:00 hrs. 2,5-Dimethylfuran, 2,5-hexanedione and gamma-valerolactone were identified by gas chromatography and mass spectrometory. At 17:00 hrs the means +/- SD of the metabolites were 0.21 +/- 0.11 mg/l for 2,5-dimethylfuran, 1.13 +/- 0.71 mg/l for 2,5-hexanedione, and 2.04 +/- 2.31 mg/l for gamma-valerolactone. The metabolites were also found in the urine in the early morning. 2-Hexanol was not detected in the urine of any worker examined. A strong correlation between TWA concentration of n-hexane and 2,5-hexanedione in the urine was found at 17:00 hrs (r = 0.895, P less than 0.001). The results suggest that the urinary metabolites of n-hexane, especially 2,5-hexanedione, could be useful indicators for biological monitoring of n-hexane exposure. Furthermore the present study offers the advantage of a better estimate of n-hexane TWA. PMID- 6852933 TI - Studies of combined effects of sinusoidal whole body vibrations and noise of varying bandwidths and intensities on TTS2 in men. AB - This study analyses the data from three laboratory experiments concerning the separate and combined effects on temporary threshold shifts in hearing (TTS2) of sinusoidal low-frequency (5 Hz--2.12 m/s2 and 10 Hz--2.65 m/s2), whole body vibration (along the Z-axis), and continuous (white) noise with eight different bandwidths and intensity levels of 85 dB(A), 90 dB(A) and 98 dB(A). Altogether 370 separate personal experiments were performed using a one-man exposure chamber system. A single experiment consisted of a 30-min pre-exposure period, three 16 min exposure periods, and a 15-min post-exposure period. The data suggested that the TTS2 induced by noise was increased by vibration. Actually, vibration at a frequency of 5 Hz and noise with bandwidths of 1-4 kHz, 1-8 kHz or 0.2-16 kHz comprised the most significant exposure combinations. After such exposures, the increase in TTS2 values was defined most clearly for 4 kHz and 6 kHz test frequencies. The increase of thresholds was most marked during the first 16-min exposure period, even though most TTS2 values determined after the third consecutive exposure period were higher than after the first and second exposures. Figures obtained after the third exposure period proved that exposure to simultaneous vibration and broad band noise (i.e. noise with a bandwidth of 0.2-16 kHz) increased TTS2 values 1.2-1.5 times more in the 4 kHz audio range than such a broad band noise alone. No single vibration condition induced the same amount of TTS2. PMID- 6852935 TI - Care of infants and children. PMID- 6852936 TI - Differential diagnosis of postoperative coma. PMID- 6852937 TI - Postoperative care of neurosurgical patients. PMID- 6852938 TI - Postoperative care after regional anesthesia. PMID- 6852939 TI - Recovery room care after thoracic surgery. PMID- 6852940 TI - Admission assessment and general monitoring. PMID- 6852942 TI - Cardiac instability in the recovery room. PMID- 6852941 TI - Fluid management in the recovery room. PMID- 6852943 TI - Postoperative respiratory care. PMID- 6852944 TI - Drug interactions in the recovery room. PMID- 6852945 TI - Leukotriene C4 and dimethylphenylpiperazinium-induced responses in canine airway tracheal muscle contraction and fluid secretion. AB - Leukotrienes have been implicated as putative mediators in several air way diseases. In previous canine studies it was shown that leukotriene C4 (LTC4) enhanced fluid secretion over baseline values and this enhancement could be blocked by hexamethonium. This indicates that leukotrienes have as one of their actions, stimulation of ganglionic motor neurons. In the present study, we determined that LTC4 acts at a similar site as the specific nicotinic receptor agonist dimethylphenylpiperazinium (DMPP). Both LTC4 and DMPP when given alone enhanced mucus secretion and induced tracheal muscle contraction over control baseline (p less than 0.05). When added to DMPP, LTC4 enhanced the DMPP effect of muscle contraction at 5 and 8 micrograms by a synergistic amount, while the secretion was only additive. The slopes of the dose-response curves for DMPP + LTC4 did not differ by a statistically significant amount. LTC4 and DMPP act on a similar, if not the same, ganglionic receptor. PMID- 6852946 TI - Circulating immune complexes in rats with metastasizing or nonmetastasizing mammary tumor. AB - The dual rat metastatic and nonmetastatic mammary tumor model was characterized by the level of immune complexes in the sera of rats bearing these tumors. Circulating immune complexes (CIC) were measured at various intervals posttumor injection in Wistar-Furth (W/Fu) rats inoculated at 2 months of age with either 1 X 10(6) viable metastasizing (TMT-081) or nonmetastasizing (MT-100) tumor cells into the mammary fat pads. The Raji cell assay was used to measure CIC. No correlation between tumor size and CIC levels in the tumors were observed. While none of the sera from the rats bearing the nonmetastasizing tumors had CIC levels higher than 30 micrograms/ml, a small percentage of the animals bearing the metastasizing tumors had serum CIC levels higher than 30 micrograms/ml. This study suggests no clear difference between the amount of CIC in the sera of animals bearing either metastasizing or nonmetastasizing tumors. PMID- 6852947 TI - Assessment of venom-specific IgG antibody in patients treated for hymenoptera allergy. AB - The IgG antibody (Ab) response achieved with specific venom immunotherapy was explored in 32 patients with Hymenoptera hypersensitivity. Venom-specific IgG Ab was quantitated before and after 1 year of immunotherapy using two solid phase radioimmunoassay (SPRIA) methods. An agarose-based test using 125I-Staphylococcus aureus Protein A (SPRIA) was used to determine specific IgG for five Hymenoptera species: yellow jacket (YJ), honeybee (HB), yellow-faced hornet (YH), white-faced hornet (WFH), and Polistes (POL). A cellulose disk test using 125I-anti-IgG (IgG RAST) was available only for YJ and HB venoms. Acceptable agreement (90% concordance) was observed with IgG anti-HB levels measured in the two assays. For the YJ-IgG, however, 17/69 (25%) of sera positive in the SPRIA were negative in the IgG RAST, whereas the converse was not observed. This result suggests that the IgG RAST is insufficiently sensitive to detect YJ-IgG responses in all patients on maintenance level immunotherapy. Using the Protein A SPRIA, there was excellent agreement between the venom used for immunotherapy and the specificity of the IgG Ab response. In 31 patients treated with a total of 90 venom species, 90/90 venom IgG levels were increased or maintained at high pretreatment levels in response to immunotherapy. In the same patients venom IgG levels obtained for venom species not included in therapy were undetectable or declined in 55/60 cases; in 4 cases treatment with YJ venom stimulated a WFH and/or YH IgG response, the remaining case, YJ venom stimulated a small rise in POL IgG. These apparent discrepancies can be explained by variable cross-reactivity among vespid and POL venoms. Among 32 patients with a combined total of 87 positive venom skin tests, 1 year of specific immunotherapy resulted in greater than 5 micrograms/ml of venom-specific IgG in 61 instances. In 25 instances, the level of venom IgG was detectable but less than 5 micrograms/ml, and in 1 case venom IgG could not be detected. Based on recent analyses by Golden et al., some or all of these latter 26 cases may represent suboptimal therapy despite a standard immunotherapy regimen. We conclude that venom IgG measurements can provide a specific and quantitative assessment of the immunologic response to venom therapy, and that such assessment may be clinically useful in detecting instances of suboptimal immunotherapy. PMID- 6852948 TI - Cross-reactivity of cat and dog allergen extracts. RAST inhibition studies with special reference to the allergenic activity in saliva and urine. AB - The commercial cat and dog allergen extracts are traditionally prepared from pelt, fur or dander. However, there is increased evidence of the allergenicity of saliva and urine of the animals. We have investigated 25 asthmatic children with a positive cat and/or dog RAST result. All 20 subjects with a positive cat RAST gave a positive skin prick test result to cat saliva, cat urine and cat hair. Analogously, all 20 subjects with a positive dog RAST had a positive skin reaction to dog saliva, urine and dander. In RAST inhibition experiments with dog and cat allergen discs, dog saliva appeared to be at least as potent as a commercial dog dander and hair extract, while cat saliva was less potent than the respective commercial extract. Both dog and cat salivas were clearly more potent than the respective urine. Significant cross-reactivity was observed between cat hair and dog dander in the RAST inhibition, whereas saliva and urine were shown to be more species-specific. An experimental dog dander preparation had about the same specificity as, and even higher allergenic activity than, that of dog saliva or urine. Our results suggest that saliva actually may be the best source of cat and dog allergen preparations. The importance of urine warrants further investigation. PMID- 6852949 TI - Detection of complexed IgE in sera of patients allergic to the pollen of Parietaria officinalis. AB - 34 sera of patients allergic to the pollen of Parietaria officinalis were analyzed by ultracentrifugation on sucrose gradient (40-10%) in 0.9% NaCl at 24,000 rpm with a SW 27.1 rotor for complexed circulating IgE. Total and specific anti-PO IgE content of the gradient's fractions were determined by radioimmunoassay. IgE presence was demonstrated in at least two peaks; one corresponding to monomeric IgE, another corresponding to IgE with a sedimentation constant higher than that of the monomers. The ratio between monomeric and complexed IgE was different for each serum. Discordant results of PRIST and RIST analyses suggest that complexed IgE has fewer sites available for reaction with anti-IgE than the monomers. PMID- 6852951 TI - Determinants of cognitive abilities in the elderly. AB - One hundred and fifteen men between the ages of fifty and ninety-three were administered six cognitive tasks: a verbal intelligence subtest, a nonverbal intelligence subtest, two tests of concrete operations, one test of formal operations, and a problem-solving task. The obtained scores were factor analyzed. Two factors were obtained, a nonverbal, performance factor and a verbal-reasoning factor. Regression analyses in which age, education, occupation, years since retirement, health status, activity level, and marital status were predictor variables performed on the factor scores obtained for each of the factors. The nonverbal performance factor was significantly predicted by age while the verbal factor was significantly predicted by education. None of the other predictors were significant. The results suggest that verbal and nonverbal abilities may be determined by different antecedents. Since different cognitive abilities may have different antecedents and since these antecedents may have different relationships to age, it is important to view adult cognitive development as multidimensional and multidirectional rather than as normative and unidirectional. PMID- 6852950 TI - Understanding senile dementia: a challenge for the future. AB - The causes of dementia in later life are reviewed. Special attention is paid to senile dementia of the Alzheimer's type, its prevelance, the characteristic structural changes in the brains of persons suffering from this disorder, and the hypothesized causes of the disease. The hypothesis that Alzheimer's disease represents accelerated aging is described. Treatment issues are discussed, primarily in terms of supportive environments, differential diagnosis, and assistance to the caregiver. PMID- 6852952 TI - Aging and changes in attitudes about the women's liberation movement. AB - Using data from a four-year national panel study, this research examines changes in attitudinal support for the women's liberation movement over the period 1972 1976. All age groups became more favorable, but the extent of these shifts was greater among the older members of the panel than among the younger members. The findings provide no support for the notions that social and political attitudes become more conservative with aging or that they become rigid and fixed. PMID- 6852953 TI - Correlates of dimensions of happiness in urban and nonurban settings. AB - The NORC happiness scale, widely used in Administration on Aging (A.O.A.) needs assessment surveys, is a composite of both a negative and a positive dimension. A re-examination of this scale based on a survey of 1400 urban and nonurban elderly indicates that the independence of these two dimensions varies for different residences. Results indicate that a high proportion of urban elderly were bored, depressed, and lonely as well as pleased, proud, excited, and interested in things about them. This group of urban elders was extremely disadvantaged in a wide range of both objective and subjective indices; their apparent inconsistent feeling states may result from a general feeling of relative deprivation. PMID- 6852955 TI - Pathogenic life changes in middle adulthood and coronary heart disease: a life span developmental perspective. AB - Empirical evidence is reviewed about the contributions of life changes and the coronary-prone behavior pattern in the development of myocardial infarction in middle adulthood. Since established clinical risk factors account for about half of the total variance, it is necessary to explore in more detail the crucial developmental role that distressing psychologic and social parameters should play. Because of the generally prolonged incubation period of the effects of psychosocial risk factors, it is proposed that they should be studied from a life span developmental perspective. Two metamodels seem appropriate in this respect: a mechanistic model by Dohrenwend and Dohrenwend, and an organismic model by Levinson. After scrutinizing some properties of these models, including their potential explanatory power, it is argued that an organismic model may predict better the pathogenic development of distressing psychosocial risk constellations over consecutive phases in the life course of the heart patient. PMID- 6852954 TI - Transition to grandmotherhood. AB - This exploratory study examines grandparenthood as a role relationship. Grandmothers, in describing the transition to grandparenthood, tended to emphasize emotional/symbolic investment in grandchildren rather than instrumental/interactional dimensions of relationships. The data suggest that grandparental role conceptions are modified by family network variable: Ambiguity in the grandmother role is magnified by geographical distance and by paternal (rather than maternal) grandmotherhood. PMID- 6852956 TI - Housing for the aged: new roles for social work. AB - As the elderly population increases, social workers and planners of housing must coordinate efforts and combine resources as they explore new channels for meeting the housing needs of the aged. In evaluating new roles for social work in this field, three basic areas are discussed: 1) the nature of the housing problem, 2) the needs of the elderly, and 3) the role of social work in meeting these needs. PMID- 6852957 TI - Correlates of changes in desired control scores and in life satisfaction scores among elderly persons. AB - This report describes the correlates of Life Satisfaction and Desired Control among seventy-nine elderly residents, with an average age of seventy-eight, of a partial-support apartment complex. The residents were assessed at three points in time: shortly after moving into the building, six months later, and after a total of eighteen months. Both Life Satisfaction and Desired Control (a measure of the extent to which a person reports control over desired outcomes) are intercorrelated and related to other indices of psychological well-being at all three points in time. Cross-lag correlations also indicate an enduring relationship between Life Satisfaction, Desired Control, Activity, and Rated Vitality. A residual regression analysis employing hierarchical procedures for evaluating significance of added variance yielded only one predictor of changes in Life Satisfaction: an initial measure of psychomotor speed. The residual regression analysis yielded one predictor of changes--[in Desired Control- initial activity level.] PMID- 6852958 TI - Elderly adults' perception of their own cognitive development during the adult years. AB - Individuals between the ages of sixty-five and seventy-five were asked a number of questions regarding which of their cognitive abilities they think have changed with age and, further, what factors they think are responsible for such age changes. Questions were asked in two areas of cognitive functioning--memory and problem solving. With respect to memory, the reports of the elderly adults corresponded well with the results of memory research, which indicates that most memory abilities tend to decrease with increasing age. The elderly adults suggested that activity level, amount of contact with the information to be remembered, practice remembering, the perceived importance of the information to be remembered, and expectations regarding changes in memory are all factors that may contribute to age changes in memory. With respect to problem solving, on the other hand, the reports of the elderly did not correspond with the research. Research indicates that such abilities probably decline with increasing age while the elderly reported that they think that their problem-solving abilities have actually increased with age. Factors that were mentioned as possible causes of the reported increases in problem-solving ability were experience, good health, and taking more time to solve a problem. PMID- 6852959 TI - A cognitive developmental model of rigidity in senescence. PMID- 6852962 TI - Therapeutic pretense in reality orientation. AB - Based on a three month period of intensive observation in a nursing home, this study examines several aspects of the staff's work in the application of reality orientation (RO) to patients who are confused or disoriented. It is argued that in the application of RO and similar behavioral therapies, a clear analytic separation between the problems of patients and the work of caregivers cannot be justified. Caregivers do more than provide care; they help to constitute problems. PMID- 6852961 TI - Materialism and the future of aging in America. AB - In Growing Old in America, David Fischer argues that colonial America witnessed a sudden and revolutionary shift in social attitude from gerontophilia to gerontophobia. It is argued here that the shift can be explained as the necessary result of an emerging materialism which came to dominate mercantile America. It is shown how philosophical materialism requires an attitude of denigration toward aging and the elderly, and that the future of our collective attitude toward the elderly is wedded philosophically to the future success or failure of philosophical materialism. It is also suggested that the future of materialism in America looks dim and that there will emerge a strong philosophical base adequate for reforming ethical attitudes and engendering a much more favorable attitude toward the elderly in general. It is suggested that positive or negative attitudes toward aging and the elderly are rooted in unconscious commitments to non-materialistic (dualistic) or materialistic views on the nature of man. The two basically different views on the nature of man beget the two basically different views and attitudes toward aging and the elderly. Which attitude is right is a function of which philosophical view is correct and the paper closes with some evidence that materialism is on the wane. PMID- 6852960 TI - Interbehavioral perspectives on aging. AB - This paper questions the assumption that behavioral, mental, or cognitive incompetence accompanies the biological aging process, a fundamental assumption underlying a great deal of the geropsychological research. Using Kantor's analysis of the history of psychological thought and systems, the philosophical, psychological, social, and cultural-historical bases to this erroneous assumption are investigated. It is concluded that gerontological psychologists have, through their uncritical use of medieval conceptions of behavior, directly contributed to the negative stereotypes of elderly persons found in our society. This has resulted in what is termed "scientific ageism". PMID- 6852963 TI - Self-perceived age changes in sex role self concept. AB - A prospective/retrospective study of sex role self concept was conducted in order to explore the hypothesis that adult men and women experience a convergence of sex roles in later life. Young (age seventeen to twenty-nine), middle aged (age thirty to fifty-nine), and older (age sixty to eighty-five) adults (twenty-one male, forty-one female in each group) rated themselves on Bem Sex Role Inventory items, first describing themselves at age twenty, next at age forty-five, and finally at age seventy. Self-perceived age changes in sex role self concept reported by these three groups of adults produced strikingly similar patterns. In each case, both men and women evidenced high masculine self descriptions related to middle age (projected age forty-five) followed by decreases in masculinity in later life (projected age seventy). Only the projections of middle aged respondents displayed even marginally significant evidence in favor of sex role convergence. PMID- 6852964 TI - The hub of a wheel: a neighborhood support network. AB - In a neighborhood where elderly residents have known each other for years, a closely-knit network of mutual assistance and support has developed among a few of the oldest residents. The network and its functions are described in detail, and two features are discussed as being unusual. First, the "old old" people help each other on a daily basis, and second, the routine nature of the assistance is taken for granted by all concerned, except for the author, who observed the evolution of this network over a period of several years. The network's theoretical implications for social integration and its practical implications for the maintenance of independent living are summarized. PMID- 6852965 TI - A study of a stress questionnaire: the later years. AB - A twenty-seven item life stress questionnaire was derived from the Holmes-Rahe Social Readjustment Rating Scale, modified for older respondents, and administered to sixty-two patients hospitalized for neuro-behavioral diagnosis and treatment. The aims were to focus on significant life stresses and the patients' responses to these, and to identify those life events that were subjectively evaluated by the patients as significantly affecting their life adjustment. The study suggests that fewer than twenty items--seventeen in this investigation--may be an efficient range of events to estimate life change effects and that the degree of impact of these stresses must be sought out systematically if these phenomena are to be better understood. PMID- 6852967 TI - Levinson's model as a predictor of the adult development of policemen. AB - In the early 1970s Levinson and his associates completed a landmark study of adult development. Based on the Interviewing and testing of forty men, Levinson proposed a comprehensive model of adult growth. Although his sample contained men of diverse occupational groups, it did not include policemen or other workers who faced physical danger in their job. We interviewed twenty-three male policemen and found that, in general, the policeman's lives corresponded to Levinson's theory. Participants experienced a series of psychosocial stages, including some stressful transitional periods, but the nature of these stages was similar to Levinson's model for some age periods (e.g., Age 30 Transition), and not for others (e.g., Midlife Transition). PMID- 6852966 TI - Community access and satisfaction: racial differences in later life. AB - Community access can be expected to have an important influence on the life satisfaction of the aged because of age-linked restrictions in social life space. Such access may be less important for older blacks, however, as a consequence of lifelong "ghettoization". These hypotheses are tested using national survey data. Community mobility is found to have a stronger association with life satisfaction for older whites, while having only an indirect effect through social interaction for older blacks. Directions for future research are suggested. PMID- 6852968 TI - Discovering a good age. AB - In the past, gerontologists often used sick or institutionalized people in their research. As a result, aging came to be seen as a time of decline filled with problems. Even today some of the best research dwells on the problems that come with age. To balance this view, in a recent study I spoke with over sixty of the "best" older people I could find. These were people who exemplified a good age- they were healthy, happy, active, involved and eager to tell about their lives. From their comments, it appears that a good age does not happen by accident. It is something people work for and discover for themselves; a process described in this paper. PMID- 6852969 TI - Synthesis, tissue distribution and tumor uptake of [99Tc]tetrasulfophthalocyanine. AB - 99Tc-labeled-tetrasulfophthalocyanine was prepared by the condensing of sulfophthalic acid and pertechnetate in the presence of a reducing agent. Reaction products were purified in various chromatographic systems and characterized by combustion, specific activity and spectral analyses. The tissue distribution pattern of the major product was studied in tumor-bearing rats. Most of the activity accumulated in the liver, kidneys, ovaries and uterus, whereas tumor uptake mainly occurred in the exterior cell layers. The in vivo stability of the complex was evidenced by the absence of 99Tc accumulation in the thyroid and the stomach. PMID- 6852970 TI - Preparation, characterization and evaluation of DMPE as a myocardial imaging agent. AB - A method for the preparation of 99mTc labeled bis(1,2-dimethylphosphino) ethane, ([99mTc]DMPE) is described. More than one positively charged compound produced were separated. Two of the compounds were evaluated as agents for myocardial imaging. Only one was taken up by myocardium. In three normal dogs, the total cardiac uptake measured 2.7 +/- 0.5% of the administered dose. The administration of 74-111 MBq (2-3 mCi) of the compound allowed scintigraphic detection of normal myocardium in a characteristic doughnut shape. The distribution of the compound in healthy as well as infarcted myocardium had an excellent correlation to the regional myocardial blood flow as measured with 85Sr microspheres (r = 0.85), and 201Tl (r = 0.8). The agent is worthy of further investigation. PMID- 6852972 TI - Differential reactivity of monoclonal antibodies with human colon adenocarcinomas and adenomas. AB - Monoclonal antibodies have been generated using membrane-enriched extracts of human metastatic mammary carcinoma lesions (Colcher et al., 1981), some of which demonstrated binding to the surface of human colon carcinoma cell lines. We report here an analysis of the reactivity of three of these monoclonal antibodies with formalin fixed tissue sections of human colon adenocarcinomas and adenomas. The three monoclonals employed were B72.3, which is reactive with a 220-400 kdal high molecular weight glycoprotein complex; B6.2, reactive with a 90 kdal glycoprotein, and B1.1, which is reactive with the 180 kdal glycoprotein CEA. B1.1 was least selective in its reactivity to colon carcinoma versus adenoma lesions. When 10 micrograms/ml of purified B1.1 IgG were used per slide, 94% (15 of 16) of carcinomas and 83% (15 of 18) adenomas showed reactivity. Monoclonal B72.3 demonstrated the most selective reactivity for carcinomas. Eighty-two percent (14 of 17) of carcinomas were positive while none of 18 adenomas examined showed reactivity with more than a few percent of adenoma cells positive. When a low concentration of purified B72.3 immunoglobulin was used per slide, 8 of 16 carcinomas and none of 46 adenomas or normal colon epithelium samples scored positive. Monoclonal B72.3 also reacted with cells in areas of "atypia" within adenomas. The reactivity of monoclonal B6.2 was intermediate as compared to B1.1 and B72.3 in its selectivity of reactivity for carcinoma cells. A heterogeneity in the populations of tumor cells showing reactivity with the three monoclonals was observed within many of the tumor masses. Both colon adenocarcinomas and adenomas can now be placed in several distinct groups based on their expression of antigens reactive with the three monoclonal antibodies employed. PMID- 6852971 TI - Formation and growth of multicellular spheroids of human origin. AB - Different types of human cells which normally grow as monolayers or suspension cultures were tested for their capacity to form and grow as spheroids. Sixteen out of the 27 tested tumour cell lines formed spheroids. Nearly all of these spheroids also grew. With only two exceptions the doubling times were longer when the tumour cells grew as spheroids than when they grew in conventional mass culture. Eleven out of 13 tested human non-tumour cells formed small spheroids but of these only the spheroids of lymphoid origin could grow. These lymphoid cells grew faster when aggregated to spheroids than when in single-cell suspension culture. None of the other non-tumour cells, which normally grew as monolayers, could grow as spheroids. The normally monolayer-cultured tumour cells formed symmetrical spheroids with smooth surfaces while the normally suspension cultured cells formed irregular spheroids with rough surfaces. All large spheroids had a necrotic centre surrounded by a shell of viable cells. The thickness of the viable cell layer varied depending on cell type. The shape and organization of cells within the spheroids also varied largely. The results show that many types of human cells can be cultured as spheroids and that a wide spectrum of morphological appearances and growth rates can be obtained. PMID- 6852973 TI - Melanoma-associated antigen p97 continues to be expressed after prolonged exposure of cells to specific antibody. AB - p97, a 97,000 molecular weight cell surface glycoprotein associated with human melanoma, has attracted attention as a possible target for tumor therapy. Melanoma cells were grown overnight in the presence of IgG2a or IgG1 monoclonal antibodies specific for p97, and then exposed to complement and also tested for binding of monoclonal antibodies specific for other epitopes of p97. The results indicated that melanoma cells continued to express p97 after prolonged exposure to specific antibody, a prerequisite for many therapeutic applications. PMID- 6852976 TI - Cytogenetic studies on an epithelial cell line derived from poorly differentiated nasopharyngeal carcinoma. AB - An epithelial cell line, CNE-2, has been recently established from a poorly differentiated nasopharyngeal carcinoma, and it represents the first of its kind. Using chromosome banding techniques, cytogenetic analysis of the cell line was carried out. It was demonstrated that the chromosome numbers of the CNE-2 cells varied from 87 to 107 and the modal number was 104-103. All cells contained a series of structurally abnormal chromosomes, and most of them were either consistent or frequently found. Among these chromosomes there were two giant markers which, by banding pattern analysis, proved to be distinct from the so called giant group A marker chromosomes previously found in many lymphoblastoid cell lines from NPC. Comparison between the CNE-2 and CNE, another epithelial cell line, which was established from well-differentiated squamous NPC, showed that while they were quite different in many cytogenetic aspects, they had three marker chromosomes in common, namely, an iso8q, a t(?;3q) and a small acrocentric one. The question of whether chromosome markers specific for NPC exist is discussed in the light of the data presented. PMID- 6852974 TI - High-density lipoprotein and extracellular matrix promotes growth and plating efficiency of normal human mammary epithelial cells in serum-free medium. AB - A routine procedure has been developed for the establishment in culture of normal primary and secondary human mammary epithelial cells. The high (80-100%) rate of success resulted from the combined use of a serum-free medium supplemented with high-density lipoprotein (HDL) and of cell plating on a naturally produced extracellular matrix (ECM). Plating on ECM greatly improved cell attachment, plating efficiency and initial outgrowth. HDL supported epithelial cell proliferation and prevented their detachment and degeneration while the omission of serum prevented the growth of stromal fibroblasts. Under these conditions we obtained from each specimen, and regardless of the patient's age, pure and actively dividing epithelial cell cultures forming a tightly packed and non overlapping cell monolayer covering the entire area of the culture dish. These epithelial cultures could be easily dissociated and subcultured at a split ratio of 1:10. The described procedure will promote studies on the role of hormones and growth factors in the proliferation and differentiation of human mammary epithelial cells and on the susceptibility of human breast epithelial cells to various transforming agents and anti-cancer treatments. PMID- 6852975 TI - Serological responses of melanoma patients to vaccines derived from allogeneic cultured melanoma cells. AB - Twenty melanoma patients were immunized with a whole-cell vaccine prepared from irradiated cells of the melanoma cell line SK-MEL-13. This line, derived from the melanoma of patient AH, expresses a differentiation antigen (initially defined by autologous antibody) which is restricted to melanomas and other cells of neural crest origin. The patients' sera were tested in rosetting assays before and after vaccination for antibodies against cell surface antigens of autologous cultured melanoma cells and SK-MEL-13, and the specificity of observed reactions was defined by absorption tests. Nine patients developed antibodies against autologous cultured melanoma cells. In only one case, patient DM, were these antibodies directed against the AH antigen. In the remaining patients, the antibodies were related to fetal bovine serum in the vaccine growth medium. All patients developed antibodies against cell surface HLA alloantigens of the immunizing cell, SK-MEL-13, as demonstrated by absorption analysis with B cells from the donor of SK-MEL-13 and by serological typing with a panel of HLA typed peripheral blood T cells and B-cell CLL cells. No specificity other than the AH antibody found in patient DM was detected after removal of alloantigens with B cells. We conclude that vaccines prepared from irradiated allogeneic melanoma cells expressing AH antigen, a demonstrably immunogenic differentiation antigen of the melanocyte lineage, are not effective in inducing AH antibody. PMID- 6852977 TI - Biological characterization and clinical applications of a monoclonal antibody recognizing an antigen restricted to neuroectodermal tissues. AB - The monoclonal antibody UJ13A was raised following immunization of mice with human foetal brain and subsequent somatic cell hyridization of spleen cells with the mouse myeloma cell line P3-X63-AG8-653. The antibody is of the IgG1 subclass and has been shown by indirect immunofluorescence studies on normal foetal, paediatric and adult tissues to selectively bind to most tissues of neuroectodermal origin. Many tumours of neural origin also express the UJ13A antigen and the reagent can be used to distinguish primary intracranial neural tumours from secondary carcinomas and lymphomas. UJ13A is also useful as one of a panel of reagents employed for the identification of metastatic spread of neuroblastoma cells to bone marrow and cerebrospinal fluid. Knowledge of the full spectrum of normal and malignant tissues binding UJ13A suggests that the antibody may have a role in the radioimmunolocalization of neuronal tumours such as neuroblastoma. PMID- 6852978 TI - Inhibition of experimental and spontaneous lung metastases of highly metastatic Syrian hamster sarcoma cells by non-activated bone marrow and peritoneal exudate cells. AB - The possibility of inhibiting local tumor growth (experimental and spontaneous lung metastases) of the selected highly-metastatic Syrian hamster sarcoma of STHE LM8 subline by means of non-activated syngeneic and allogeneic spleen, bone marrow (BMC) and peritoneal exudate (PEC) cells was studied. Retroorbital inoculation of Syrian hamsters with native, or lethally irradiated allogeneic BMC and PEC, but not spleen cells, or hamster embryo cells effectively inhibited the development of experimental and spontaneous lung metastases induced by STHE-LM8 cells in the animals. Spontaneous lung metastases were effectively inhibited in about 50% of STHE-LM8 tumor-bearing animals (with or without tumor excision) inoculated with BMC five times at 5- to 7-day intervals beginning from 1-10 days after subcutaneous palpable tumor appearance. Experimental lung metastases were inhibited in 20-80% of animals inoculated with BMC or PEC once 5-7 days before the tumor cells, simultaneously with them, or during the 5-7 days following the inoculation of tumor cells, thus demonstrating that BMC metastasis-inhibiting activity was expressed during 10-14 days against single tumor cells, or small clusters of tumor cells, and was not effective at the stage of micro-, or macrometastasis formation. BMC and PEC of normal allogeneic donors were significantly more active in metastasis inhibition than the same cells of tumor bearing animals. BMC of inbred normal Syrian hamsters of the ICV line were significantly less active, or did not inhibit experimental lung metastases either in syngeneic or in random-bred allogeneic hamsters, thus apparently demonstrating an unknown genetic defect of their NR system. PMID- 6852979 TI - Cellular immune response in the blood of cats is restricted to autochthonous feline sarcoma virus-transformed cells. AB - The blood-borne cytotoxic cellular immune response of cats to autochthonous fibroblasts transformed with feline sarcoma virus (FeSV) was examined. Peripheral blood lymphocytes (PBL) from immune animals were assayed for cytotoxic activity using a 51Cr release microcytotoxicity assay. The time courses for appearance of cytotoxic cells were similar for all cats: effector lymphocytes appeared in the blood 7 days after immunization; peak activity occurred about day 16, and cytotoxic PBL were no longer detectable by 35 days. The specificity of cytotoxic lymphocytes was studied using autochthonous and allogeneic targets. PBL from each of five immunized cats killed autochthonous transformed fibroblast (ATF) targets, but the immune lymphocytes were not cytotoxic for non-transformed autochthonous fibroblasts, for allogeneic fibroblasts transformed with FeSV, or for an allogeneic lymphoma cell line which produces feline leukemia virus (FeLV). Specific restriction of target-cell killing to the ATF occurred at all effector:target-cell ratios tested, and was maintained throughout prolonged assay incubation periods. The results suggest that for cytotoxicity to occur it is necessary for the immune lymphocytes to recognize a combination of virus associated antigens and "self" antigens on the ATF. The similarities between this restricted killing and that caused by cytotoxic T lymphocytes in other mammalian systems are discussed. PMID- 6852982 TI - Preparation and properties of a drug-carrier-antibody conjugate showing selective antibody-directed cytotoxicity in vitro. AB - The preparation and properties of a drug-carrier-antibody preparation are reported. The antifolate chemotherapeutic agent methotrexate was covalently coupled to human serum albumin as a carrier. The carrier-drug preparation was then chemically linked to a monoclonal antibody, raised originally against a human osteogenic sarcoma cell line, 791T, in a manner permitting retention of antibody-binding activity. The cytotoxic properties of the conjugate were tested in vitro in comparison with carrier-methotrexate and free methotrexate against a panel of tumour cell lines containing both antigenically cross-reactive cell lines and cell lines having low antigenic cross-reactivity with the monoclonal antibody. The cytotoxicity tests demonstrated that coupling of methotrexate to carrier caused a loss of some drug activity but that coupling of the antibody to the carrier-drug preparation permitted full expression of drug cytotoxicity against antibody-reactive cell lines. It was further demonstrated that the conjugate was selective in its action and was preferentially cytotoxic towards antibody-reactive cell types. The cytotoxicity against antibody-reactive cell lines was shown by competitive inhibition by free antibody to be entirely dependent on antibody binding. A clonogenic assay showed that the conjugate was capable of killing greater than 99% of 791T target cells. These results indicate that a drug-carrier antibody conjugate can be synthesized which has all the in vitro properties theoretically necessary for a successful antibody-targeted cytotoxic agent. PMID- 6852981 TI - Characterization of "H-2K,D-like structures" on MM2 x mouse L cell hybrids. II. An "H-2Kd-like" structure on C3H-derived tumor. AB - Anti-MM2 serum, which had been prepared by immunizing C3H/He mice with syngeneic MM2 mouse mammary ascites tumor, immunoprecipitated "H-2K,D-like" molecules on DBA/2 and C3H.H-2 degrees lymph node cells as well as on somatic cell hybrids between MM2 tumor and mouse L cells. Preclearing of lysates from C3H.H-2 degrees lymph node cells with anti-H-2.31 serum removed all "H-2K,D-like" molecules reactive with anti-MM2 serum, indicating that the molecules detected by anti-MM2 serum are H-2Kd antigens. The anti-H-2.31 serum detected an "H-2K,D-like structure" on the hybrid cells and absorption of the anti-H-2.31 serum with the hybrid cells deprived the serum of anti-H-2Kd reactivity. The hybrid cells could induce antibodies against the H-2Kd antigen in C3H/He mice. These results indicate that on the hybrid cells, whose parental cells were both derived from C3H mice, there is an "H-2K,D-like structure" that has the H-2Kd private specificity. Absorption of anti-MM2 serum with EL4 cells did not affect the capacity of the serum to detect the H-2Kd antigen on C3H.H-2 degrees lymph node cells, indicating that the "H-2Kd-like structure" is distinct from "H-2K,D-like structure A" which was previously reported. Nine isozymes were examined and MM2 cells, mouse L cells, and the hybrids were found to have the same isozyme markers as those of the C3H/He mouse. PMID- 6852980 TI - Cell-mediated immune reactivity of Sinclair melanoma-bearing swine to 3 M KCl extracts of swine and human melanoma. AB - Leukocyte migration inhibition (LMI) assays were performed using 3 M KCI extracts to detect cell-mediated immune reactions against tumor-associated antigens (TAA) of swine melanoma. Positive LMI reactivity was 70% or greater in melanoma-bearing swine compared to 10% reactivity or less in normal swine tested with extracts of either fresh or tissue-cultured swine melanoma cells. Positive LMI reactivity was 10% or less in both melanoma and normal swine tested with extracts of normal fetal and adult swine tissues. Extracts of tissue-cultured swine melanoma and human melanoma cells were equally capable of stimulating positive LMI reactivity in melanoma swine and human melanoma patients; normal swine and human donors demonstrated 10% or less positive LMI reactivity to these extracts. Positive LMI reactivity was not stimulated in swine melanoma or human melanoma donors by extracts of tissue-cultured human breast tumor cells or fresh and tissue-cultured mouse B16 melanoma cells. Evaluation of these results indicate that melanoma bearing swine develop cell-mediated immune reactivity toward TAA on swine melanomas and, inasmuch as LMI assays were performed with allogeneic extracts, suggests the presence of common TAA on swine melanomas. Furthermore, these data suggest that swine and human melanoma cells may share some common TAA and that this common TAA is not expressed on mouse B16 melanoma cells. PMID- 6852983 TI - Diastolic murmurs in the newborn of benign nature. PMID- 6852984 TI - Rapid increase of intraventricular conduction delay in the genesis of ventricular fibrillation after atropine. PMID- 6852985 TI - Corrected transposition of the great arteries without associated defects--study of 10 patients. PMID- 6852986 TI - Silent mitral stenosis masquerading as pulmonary neoplasm. PMID- 6852987 TI - Improved exercise performance following single daily dose of atenolol in stable angina. AB - We administered atenolol to 10 patients with effort limiting angina pectoris. Doses of 50 mg, 100 mg and 200 mg provided significant improvement (P less than 0.05) in exercise tolerance tested 24 hours after the drug was given. Twenty-five milligrams was not significantly better than placebo in increasing work tolerance. Side effects were minimal, and treatment could be continued throughout the study. The beta-blocker atenolol is an effective drug in the treatment of exercise-induced angina. PMID- 6852988 TI - Prognostic value of risk factors and exercise testing in men with atypical chest pain. AB - Of 551 men with atypical chest pain enrolled in the Seattle Heart Watch Study, annual follow-up over a 5- to 10-year period identified 36 persons who experienced a primary coronary heart disease event. Only three events were fatal, and they were in men over the age of 50. Cox's regression model confirmed a significant association of the conventional risk factors of smoking (P = 0.03), elevated resting systolic blood pressure (P = 0.02) and hypercholesterolemia (P = 0.03) with primary coronary heart disease events. A count of these three variables was highly predictive (P = 0.002). A positive family history was not predictive. Functional aerobic impairment (P = 0.002) and ST depression (P = 0.0003) were the most useful exercise predictors. In men who had neither risk factors nor abnormal exercise predictors, the percentage free of coronary events at 9 years was 96% compared to 76% in men with one or more of the abnormal exercise findings (P less than 0.0001). Of men with only risk factors, 86% remained free of events at 9 years. This study demonstrates that the evaluation of both risk factors and exercise responses enhances the prognostic evaluation of men with atypical chest pain. The classification of men into low-, medium- and high-risk groups can be easily accomplished in office practice. PMID- 6852989 TI - Exercise testing and prognosis in patients with atypical chest pain. PMID- 6852990 TI - The patient speaks. PMID- 6852992 TI - Syntactic orphans and adoptees: unattached participles. I. Mischievous intruders. PMID- 6852991 TI - The healing heart. PMID- 6852993 TI - The efficacy of amiodarone for ventricular arrhythmias can be predicted with clinical electrophysiological studies. PMID- 6852994 TI - The efficacy of amiodarone for ventricular arrhythmias cannot be predicted with clinical electrophysiological studies. PMID- 6852995 TI - Doppler echocardiography. PMID- 6852996 TI - The prevention of prosthetic valve thromboembolism. Uses and limitations of anti platelet drugs. PMID- 6852997 TI - Is left ventricular dysfunction present in patients with atrial septal defect and signs and symptoms of left-sided heart failure? PMID- 6852998 TI - Cardiovascular adaptations to obesity and arterial hypertension: detrimental or beneficial? PMID- 6852999 TI - The pharmacokinetics and availability of niflumic acid in humans. AB - The pharmacokinetic parameters and relative availability of niflumic acid in two different pharmaceutical preparations were studied in 12 subjects after a single oral administration. Total plasma clearance averaged 45 ml/min, and the half-life of elimination approximately 2 h, giving a distribution volume of 0.12 l/kg on the average. The values of these pharmacokinetic parameters were in agreement with the general characteristics of this type of substance, a weak acid strongly bound to plasma proteins. Comparison of the systemic availability of the two oral forms showed no difference; they were probably close to 100%. PMID- 6853000 TI - Therapeutic and prophylactic effects of cephalexin and bromhexine in respiratory tract complications of abdominal surgery. AB - We report the results of a study carried out with cephalexin and bromhexine in a group of 100 patients at risk for bronchopulmonary complications following abdominal surgery. The treatment achieved very good activity and excellent tolerance. We consider this therapy very useful for prophylaxis and treatment of bronchopulmonary complications in patients who have undergone surgery. PMID- 6853001 TI - On the concept of a socialist health system: a question of Marxist epistemology. AB - This paper concerns the best approach to the concept of a socialist health system. It first criticizes a narrow empiricism, which reduces the subject to a phenomenalistic study of existing health systems in socialist countries, paying insufficient attention to historical contexts and developments and to the worldwide evolution of socialist ideas. Such a rightist empiricism, separating practice from theory, is then contrasted with a leftist idealism, which separates theory from practice. The latter approach entails abstract models of an ideal socialist health system with many characteristics, without specifying which are the necessary and sufficient ones for applying the global designation "socialist." This leads to epistemological confusion and a deterministic view of the relation of the social formation to the health system, which is in fact complex. A socialist health system is best seen as an aspect of socialist theory rather than as an actual social entity. Viewed this way, it can act as a continuing guide to social practice and be enriched by that practice. Taking an appropriate class standpoint, socialist health theory should relate to social factors in the causation of disease and in the capacity of peoples to undertake health-related activities and to the social control of health care services and related industries. PMID- 6853003 TI - Building illness in the white-collar workplace. AB - An increasing incidence of "building illness" is being noted among white-collar workers due to the high pollutant content of air in modern energy-efficient office buildings. These buildings are hermetically sealed, mechanically ventilated, and contain many materials that give off a variety of toxic fumes and aerosols. Severe outbreaks of illness have also been traced to ventilation problems in sealed hospital buildings. Similarly, tightly sealed and well insulated private homes present many sources of toxic pollutants to homemakers. Recent studies linking increases in the frequency and duration of respiratory illnesses with increasing pollution levels warn us that increases in indoor pollution levels should be avoided in the white-collar workplace, hospital, and private residence. Unfortunately, the cost of adequate ventilation of modern air tight buildings is high. However, proper planning must be conducted to foresee and correct the impact of energy management policies on the livability and healthfulness of the indoor environment. PMID- 6853002 TI - Human rights versus occupational medicine. AB - This paper examines the conflict between the medical monitoring of workers and human rights. A lead regulation in force in Ontario, despite its absolute conflict with an important guideline established by the Canadian Human Rights Commission, is presented as an example of the erosion of human rights by certain legislated activities in occupational medicine. The question of whether the benefits of occupational medical activities outweigh the disadvantages attendant upon the erosion of human rights is raised. It is concluded that these are political and ethical issues, not merely technical ones, and should be debated publicly. PMID- 6853004 TI - Comparative nutrition and health services for victims of drought and hostilities in the Ogaden: Somalia and Ethiopia, 1980-1981. AB - The civil chaos created by a combination of drought and hostilities in the Ogaden region of southern Ethiopia during the past five years has caused the majority of the indigenous, principally nomadic population to flee the area and seek refuge either in Somali refugee camps or in Ethiopian shelters for displaced persons. This paper compares the provision of basic food rations, selective feeding programs, primary health care, and preventive health measures between the two groups. During 1980-1981 Somalia received more international assistance per capita than Ethiopia. Large numbers of Western personnel provided health and nutrition services in Somali refugee camps, whereas no foreigners were involved in Ethiopian shelters. These disparities were largely due to inadequate publicity concerning the problems Ethiopia faces, partly resulting from real and perceived political limitations related to the Soviet presence in that country. Refugee needs in Somalia have been publicized far more adequately, partly due to that country's alignment with the West. The Ethiopians nevertheless demonstrated greater efficiency in assisting their disaster victims; camp services comparable to those in Somalia were available despite greater logistic difficulties and fewer donated resources. The effectiveness of relief operations in Somalia was reduced by political constraints on governmental agencies. PMID- 6853005 TI - Psichiatria democratica: a case study of an Italian community mental health service. AB - The Italian Mental Health Act of 1978 signified a major reform of the psychiatric system in that country and included directives for the closing down of all mental hospitals. This paper reports the structure and mode of work of the newly created community mental health services in a Tuscan town. It further investigates the background that made such a major change possible, and details its successes and problems to date. In addition, the relevance of the Italian experience to policy changes in other national psychiatric systems which so far have been unable to produce a comprehensive community-centered service is discussed. PMID- 6853006 TI - Do solvents cause scleroderma? PMID- 6853007 TI - Epidemiology of an outbreak of erythema infectiosum in Tokyo. AB - Endemic outbreaks of erythema infectiosum were observed in various areas of Japan from 1977 to 1981. Even in a limited district of Tokyo, we recorded 395 cases until June 1981, so this might be the largest epidemic in Japan. Most cases occurred from January to June. The peak incidence was at the age of 7 years and the average age was 8.9 years. The outbreak also occurred among our hospital nurses, but no severe case was observed in hospitalized patients. Furthermore, the symptoms in adults were as mild as in children, suggesting the little participation of immunity in this disease. By epidemiologic survey, erythema infectiosum was distinct from rubella. PMID- 6853008 TI - Extracutaneous sporotrichosis. AB - The typical infection with Sporothrix schenckii is characterized by superficial cutaneous nodules occurring along the lines of lymphatic drainage of the limbs. Review of the medical records at the Mayo Clinic from 1937 to the present disclosed 58 patients with sporotrichosis. Eleven patients had evidence of extracutaneous infection. Eight of the patients were men whose ages ranged from 25 to 71 years; the ages of the three women were 54, 64, and 67. Seven patients had predominantly joint involvement, with the knee and wrist joints being most often infected. Other sites of infection included the mandible and ethmoid sinuses. Three patients had disseminated systemic infection, and one patient died within a year of the initial diagnosis. Nine patients had been in good health before the infection, although five patients were taking systemic corticosteroids before their infection was diagnosed. Therapies included supersaturated potassium iodide, amphotericin B, and 2-hydroxystilbamidine isethionate. Although most commonly seen as a cutaneous disease, sporotrichosis is a potentially disseminated infection with life-threatening consequences. PMID- 6853010 TI - Onchocerciasis. PMID- 6853009 TI - Imported skin diseases--a case of subcutaneous chromomycosis caused by Phialophora gougerotii. PMID- 6853011 TI - Nonsuture surgery under microscopic control for basal cell carcinoma. AB - Nonsuture surgery under microscopic control consists of conservative surgical excision of the tumor leaving the wound open and allowing it to granulate. Using fresh tissue technique, the lesion is cut in multiple horizontal sections from the depth up and examined under the microscope. In this form, a simple office procedure, removal is complete with minimum destruction of normal tissue. Cosmetic results are excellent. PMID- 6853012 TI - Cimetidine-associated alopecia. PMID- 6853013 TI - Occupational exposure control by simultaneous determination of N-methylcarbamates and organophosphorus pesticide residues in human urine. AB - On-column transesterification with methanol was applied for the gas chromatographic determination of N-methylcarbamates extracted from human urine. Transesterification conversion efficiencies of N-methylcarbamates dioxacarb, carbofuran and OMS-22, calculated from the amount of the on-column produced O methyl-N-methylcarbamate (DMC), were 96, 77 and 76% with detection limits of 8, 10 and 10 ng, respectively. In the investigated concentration range of 0.2-3 micrograms/ml of urine the extraction efficiencies with methylene chloride were independent of the initial concentration of N-methylcarbamate added to urine samples of non-exposed persons. The recoveries and rel. S.D. were 74 +/- 11, 64 +/- 8 and 79 +/- 12% for dioxacarb, carbofuran and OMS-22, respectively. The procedure was applied for the gas chromatographic determination of carbofuran and its metabolites containing the N-methylcarbamic group extracted from urine samples of occupationally exposed persons in a pesticide formulating plant. The level of extracted N-methylcarbamates and the concentration of degradation products of organophosphorus pesticides detected in the urine of the same persons were correlated with the blood and plasma cholinesterase activities. Although the determination of DMC includes only a smaller part of the excreted N methylcarbamate, a simultaneous determination of both carbamates and organophosphorus residues made it possible to distinguish the cause of depression in cholinesterase activity, indicating early and specifically the exposure to a particular group of agents hazardous to health. PMID- 6853014 TI - Development of anthelmintic resistance in nematodes from sheep in Australia subjected to different treatment frequencies. PMID- 6853015 TI - Seasonal changes of gastrointestinal nematode populations in yearling beef cattle in Louisiana with emphasis on prevalence of inhibition in Ostertagia ostertagi. PMID- 6853016 TI - Comparative strobilar development of Echinococcus granulosus of sheep origin from different geographical areas of Australia in vivo and in vitro. PMID- 6853017 TI - The role of the spleen in protective immunity against Angiostrongylus cantonensis in rats: splenectomy and passive spleen cell transfers. PMID- 6853018 TI - The effect of osmotic stress on behaviour and water content of infective larvae of Trichostrongylus colubriformis. PMID- 6853019 TI - Gene activity and the development of early parasitic stages of nematodes. PMID- 6853021 TI - Cultivation of excysted metacercariae of Echinostoma revolutum (Trematoda) in chick embryos. PMID- 6853020 TI - In vitro bioassay of sheep gastrointestinal mucus for nematode paralysing activity mediated by substances with some properties characteristic of SRS-A. PMID- 6853022 TI - Schistosoma haematobium: oxidoreductase histochemistry and ultrastructure of niridazole-treated females. PMID- 6853023 TI - Synthesis and properties of dermorphin and an analog of beta-endorphin containing the dermorphin sequence. AB - Dermorphin (I) and [D-Ala2, Phe3, Gly4, Tyr5, Pro6]-beta c-EP (II) have been synthesized by the solid-phase method (beta c-EP, camel beta-endorphin). Positions 1 through 7 of II correspond to the sequence of I. Relative potencies of synthetic peptides in the mouse tail-flick test for analgesia by the intracerebroventricular route were: human beta-endorphin, 100; camel beta endorphin, 164; I, 450; II, 440. The dermorphin was about 670 times more potent than morphine in the assay. Peptide II represents a rare instance where the enkephalin moiety of beta-endorphin has been altered to produce a more potent analgesic. PMID- 6853024 TI - X-ray studies on crystalline complexes involving amino acids and peptides. VIII. Head-to-tail arrangement and a specific interaction in the crystal structure of L arginine acetate. AB - L-Arginine acetate crystallizes in the monoclinic space group P2(1) with a = 9.229(2), b = 5.178(3), c = 13.271(4) A and beta = 111.4(1) degrees. The crystal structure was solved by direct methods and refined to an R value of 0.058 for 1333 observed reflections. The conformation of the arginine molecules in the crystal is different from those observed in the crystals of L-arginine, its salts and complexes. The crystal structure indicates that complexation with a small carboxylic acid like acetic acid is sufficient to align arginine molecules in a head-to-tail fashion. The structure contains a specific ion-pair interaction, involving electrostatic attraction as well as two nearly parallel, N-H ... O hydrogen bonds, between the guanidyl group and the acetate ion. PMID- 6853025 TI - Preparation and analytical data of some unusual t-butyloxycarbonyl-amino acids. PMID- 6853026 TI - 1H n.m.r. parameters of the N-terminal 19-residue S-peptide of ribonuclease in aqueous solution. AB - The 1H n.m.r. chemical shifts and the spin-spin coupling constants of the N terminal 19-residue S-peptide of ribonuclease A have been measured in a 10 mM solution in D2O, pD 3.0, 27 degrees, at 300 MHz. The titration parameters for end groups Lys-1 and Ala-19 and side chains Lys-1, Glu-2, Lys-7, Glu-9, Arg-10, His 12 and Asp-14 have been determined at 90 MHz. An assignment of observed signals to individual residue protons based upon characteristic shifts, spectral analysis, double resonance, titration shifts and comparison with the spectrum of C-peptide (N-terminal 13-residue) is proposed. Differences in the observed chemical shifts, pKa's and titration shifts with reference to those proposed as "random coil" parameters are not large enough to assume the existence of a significant population of secondary structure in the conditions studied. The H alpha chemical shifts differences can be accounted for by the Phe-8 phenyl ring current for an extended peptide backbone conformation and appropriate values for the torsion angles chi 1 Phe-8 and chi 2 Phe-8. PMID- 6853027 TI - Partially modified retro-inverso peptides. Comparative Curtius rearrangements to prepare 1,1-diaminoalkane derivatives. AB - Several synthetic routes are reported to prepare the hetero diprotected 1,1 diaminoalkanes from N-acylated amino acids or peptides for incorporation into partially modified retro-inverso peptides. The Curtius rearrangement was carried out on the N-protected aminoacyl azides obtained from the N-protected aminoacyl hydrazide by nitrosyl chloride or by sodium azide reaction with an appropriate mixed carboxylic carbonic acid anhydride. The resulting isocyanate was allowed to react with alcohol to give a urethane-type protecting group or, via a "one-pot" approach, directly with a carboxyl carrying component to yield the modified (reversed) peptide bond. The carboxyl component can be either an N-acylated amino acid or a malonic acid. The more standard route involves selective deprotection of the 1,1-diaminoalkane residue followed immediately by coupling with a carboxyl component to yield the same modified peptide derivative. PMID- 6853028 TI - Synthesis and backbone conformations of cyclic hexapeptides cyclo-(Xxx-Pro-D Gln)2. AB - The solution syntheses of cyclo-(Xxx-Pro-D-Gln)2, where Xxx = Gly, Ala, Leu, Phe and Val are described. Several routes were examined, the most successful involving the intermediate Z-Xxx-Pro-D-Gln-O-tBu and proceeding to cyclization of H-Xxx-Pro-D-Gln-Xxx-Pro-D-Gln-OH using diphenylphosphoryl azide. The N--H regions of the proton magnetic resonance spectra of aqueous solutions of these peptides were examined, and in the Xxx = Leu and Val peptides an unsymmetrical backbone, presumably with one cis Xxx-Pro peptide bond, was found to be important. Previous reports of cyclo-(Xxx-Pro-D-Yyy)2 peptides have shown only C2-symmetric forms. PMID- 6853029 TI - Conformational study of the salivary proline-rich polypeptides. AB - The conformational study of three proline-rich polypeptides of human whole saliva, with known primary structures, was performed by CD and 1H-n.m.r. spectra measurements. All these polypeptides contained more than four consecutive prolyl residues in their amino acid sequences. The occurrence of the poly-L-proline form II conformation in their structures was demonstrated with two of these polypeptides. The continuous prolyl residues in the third was suggested to take the same structure as the others. PMID- 6853030 TI - Conformation and structure of acidic dipeptides. Crystal structures of L-alanyl-L aspartic acid and alpha-L-glutamyl-L-aspartic acid. AB - The crystal structures of the dipeptides L-alanyl-L-aspartic acid, C7H12N2O5, and alpha-L-glutamyl-L-aspartic acid, C9H14N2O7, have been determined from three dimensional X-ray diffractometer data. Alanylaspartic acid crystallizes in the orthorhombic space group P2(1)2(1)2(1) with four formula units in a cell of dimensions a = 13.389(5), b = 14.467(3), c = 4.781(1) A. Glutamylaspartic acid also crystallizes in space group P2(1)2(1)2(1) with four formula units in a cell of dimensions a = 13.709(5), b = 16.126(7), c = 4.939(5) A. Both structures were solved by direct methods and refined by full-matrix least squares methods; the final value of the weighted R-factors (on F) were 0.040 based on 790 independent intensities with I greater than or equal to 2 sigma (I) for Ala-Asp and 0.033 based on 1105 intensities with I greater than or equal to 2 sigma (I) for Glu Asp. Each dipeptide occurs as a zwitterion with the amino terminus protonated and the main chain carboxyl group deprotonated. The conformation of the peptide linkage is trans in both molecules, the omega torsion angle being - 175.9 degrees in Ala-Asp and 174.3 degrees in Glu-Asp. There is considerable intermolecular, but not intramolecular, hydrogen bonding in the crystals. The conformations and structures of Ala-Asp and Glu-Asp are compared to those of other structurally characterized acidic dipeptides. PMID- 6853034 TI - Absorption of oral vancomycin - possible associated toxicity. AB - We report a case of an anephric child who accumulated significant concentrations of vancomycin during oral therapy for Clostridium difficile pseudomembranous colitis. Sustained serum vancomycin levels of 34 microgram/ml and CSF level of 4.2 microgram/ml were documented during an unexplained clinical syndrome of fever and encephalopathy. Discontinuation of drug and performance of hemodialysis reduced serum concentrations to 24 microgram/ml and were associated with rapid resolution of symptoms. Patients with renal impairment and intestinal disease who receive oral vancomycin may absorb and accumulate significant amounts of drug. PMID- 6853031 TI - Conformation of model, alanine and proline containing tetrapeptides in water. Comparison of 13C-n.m.r. and CD results. AB - CD spectra of model alanine and prolyl-alanine tetrapeptides were measured at different pH values. An analysis of the spectra shows that proline in position 2 or 4 of a tetrapeptide favours folding of the peptide chain, and unfolding when it is in position 3. Changes in CD spectra evidence growing amounts of the beta turn conformation upon increasing pH, independent of proline position in the peptide chain. PMID- 6853032 TI - Fluorescence study on the solution conformation to dynorphin in comparison of enkephalin. AB - Conformational parameters of the opioid peptides dynorphin and [Leu5] enkephalin in dilute aqueous solution (3 X 10(-5) M) were investigated by performing singlet singlet energy transfer experiments with dynorphin and with the biologically active 4-tryptophan analogs of dynorphin-(1-13) and [Leu5] enkephalin at pH 5.5 and 8.0. Efficiencies of transfer of excitation energy from the phenol ring of tyrosine (donor) to the indole moiety of tryptophan (acceptor) were determined and average intramolecular Tyr-Trp distances were calculated on the basis of the Forster equation. The observed absence of energy transfer between Tyr1 and Trp14 of dynorphin indicates that the two fluorophores are at least 20 A apart and rules out a close proximity between the N- and C-terminal segments of the peptide. Evaluation of energy transfer in [Trp4] dynorphin-(1-13) resulted in an average intramolecular Tyr1-Trp4 distance of at least 15 A whereas the corresponding average distance in [Trp4, Leu5] enkephalin was found to be much shorter (10 A). It thus appears that in [Trp4] dynorphin-(1-13) the predominant conformation of the N-terminal tetrapeptide segment is almost completely extended, whereas in [Trp4, Leu5] enkephalin folded conformations of that same segment occur in a major proportion. This drastic conformational difference is of interest with regard to the different preferences of dynorphin and [Leu5] enkephalin for the various opiate receptor subclasses. PMID- 6853033 TI - Alcohol induced conformational transitions of proteins and polypeptides. Thermodynamic studies of some model compounds. AB - Integral enthalpies of solution of diglycine in tert.-butyl alcohol + water and of diglycine and beta-alanine in ethanol + water mixtures were measured at 298.15 K as a function of alcohol concentration. Enthalpies of transfer of the solutes from water to aqueous alcohol mixtures were evaluated from these data. Entropies of transfer of a peptide backbone unit (CH2CONH) and peptide group (CONH) from water to aqueous ethanol solutions were derived from the enthalpy of transfer data and the free energies of transfer of glycine, alpha-alanine, beta-alanine and diglycine. The thermodynamic transfer functions are discussed in terms of "water structure" mediated solute-solute interactions. The observed trends in the thermodynamic transfer functions have also been utilized to rationalize the effect of alcohols on the conformational stability of proteins and polypeptides in aqueous solutions. PMID- 6853035 TI - IgA nephropathy (Berger's disease) - a clinicopathologic study in children. AB - Clinicopathologic features and follow up of 21 children with IgA nephropathy (Berger's disease) is discussed. The disease predominantly affected males. Although no definite prediction for any age group was observed, a majority (71.5%) of patient were six years or older. Macroscopic hematuria was the presenting feature in 71.5%, while as 28.5% had microscopic hematuria. Isolated proteinuria was not observed in any. 81% of the patients continue to have recurrent episodes of macroscopic hematuria, and 76% of the patients have microscopic hematuria during the symptom free intervals. Hypertension, azotemia and nephrotic syndrome were absent in all patients at the time of onset of the disease, and have not developed in any patient during follow up (mean 5.4 yrs). Serum IgA level elevated in only one (7.7%) of the thirteen patients in whom this was tested, and did not appear to be a diagnostic test of IgA nephropathy in children. The histologic features of renal biopsy did not correlate with known duration of the disease, extent of proteinuria at the time of biopsy or the degree of IgA deposits in the renal tissues. During childhood. IgA nephropathy appears to have an excellent prognosis, but longterm outlook can be projected only by following these children into adulthood. PMID- 6853037 TI - Renal anomalies in neonates with spontaneous pneumothorax - incidence and evaluation. AB - Over a seven year period 23 neonates with spontaneous pneumothorax and/or pneumomediastinum (SPP) were diagnosed in 24,739 live birth infants (0.09 percent). Of these, eight (35 percent) had renal anomalies. Three showed severe renal dysfunction and typical Potter facies and died within 34 hours. Their lungs were shown to be hypoplastic with a reduced lung weight: body weight ratio or a low radial alveolar count. One patient had left hypoplastic and right polycystic kidneys. Four patients with obstructive uropathies did not show the typical facies, and SPP was the only sign leading to their early diagnosis and therapy. We conclude that nephrologic evaluation is indicated in newborns with unexplained SPP and recommend abdominal ultrasound and if indicated renal scan and/or intravenous pyelography as part of the initial evaluation. PMID- 6853036 TI - Effects of dopamine on renal functions in premature neonates with respiratory distress syndrome. AB - The renal effects of dopamine have been studied in preterm infants with RDS. Dopamine has been given in doses of 0.5-2.0 microgram/kg/min as a continuous intravenous infusion in cases of peripheral circulatory disturbances. As a result, the circulation became stable and some renal parameters improved. There was a + 106% increase of urine output as well as a + 73%, + 140%, + 21% increase in Na-excretion, FeNa, creatinine clearance respectively. In accordance with the marked increase in phosphorus excretion the titratable acidity was also increased. There was a significant decrease in the renal urea excretion and free water clearance. These alterations were probably caused by an intrarenal hemodynamic redistribution. The possible mechanism of the renal changes are also discussed. The observations demonstrate the functional maturity of renal dopaminergic receptors in the preterm infants. PMID- 6853038 TI - Somatomedin in children with chronic renal insufficiency - relationship to growth rate and energy intake. AB - The relationship of energy intake, growth rate and serum concentration of somatomedin-A was evaluated in eighteen children with chronic renal insufficiency. Serum concentrations of somatomedin-A were found to be 0.84 micro/ml in normal children and were elevated to 3.06 micro/ml in children with chronic renal insufficiency prior to dialysis (p less than 0.01). Somatomedin-A concentrations increased during chronic hemodialysis to 5.81 micro/ml and decreased to 1.59 micro/ml following successful renal transplantation (p less than 0.01). Serum concentrations of somatomedin-A correlated with residual glomerular filtration rates (r = -0.5), serum creatinine concentration (r = 0.59), and blood urea nitrogen (r = 0.6). Growth rates correlated with energy intake (r = 0.58) and somatomedin-A concentrations (r = 0.4) in the children with chronic renal insufficiency. Both energy intake and somatomedin-A increased significantly after one year of nutritional supplementation. Our findings are consistent with the hypothesis that somatomedin, like other polypeptide hormones, is elevated in uremia and that increased energy intake may affect the growth of children with chronic renal insufficiency by increasing somatomedin levels. PMID- 6853039 TI - Renal amyloidosis in a child with Behcet's syndrome. PMID- 6853040 TI - Nephrotic syndrome in Hodgkins disease. AB - A case of nephrotic syndrome due to minimal lesion glomerulonephritis associated with Hodgkins disease is described. The course of the nephrotic syndrome was relapsing, preceeding the development of lymphoma by eighteen months. Treatment of this nephrotic syndrome with repeated courses of Prednisone and Cyclophosphamide resulted only in partial improvement of his proteinuria. However, complete absence of proteinuria only occurred with successful therapy of Hodgkins disease. PMID- 6853041 TI - Urinary tract calculi in children. AB - One hundred and nine children with urinary tract calculi were reviewed and in some cases reinvestigated. Eighteen children had lower urinary tract calculi, which in all cases were associated with an underlying urodynamic abnormality. Sixty percent of 91 children with upper urinary tract calculi could be classified into 4 similarly sized etiological groups: an underlying urodynamic abnormality; urinary tract infection without a urodynamic abnormality; metabolic disorders; idiopathic hypercalciuria. An underlying abnormality was not found in 32% of cases. A painless presentation occurred in 39% of those with upper tract calculi. A family history of urinary calculi occurred in approximately one-half of children with either an idiopathic calculus or a calculus associated with cystinuria or idiopathic hypercalciuria. We conclude that urinary tract calculi, though rare in children, require extensive investigation to rule out urodynamic, infective and metabolic abnormalities. If such abnormalities are not found, the recurrence rate in the remainder is small and conservative treatment can usually be recommended. PMID- 6853042 TI - Hypercalciuria in a child with primary Fanconi syndrome and hearing loss. AB - A hitherto undescribed association of sensorineural hearing loss and Fanconi syndrome (FS) is reported in a 10 year old black male. The patient presented with growth failure developing at the age of 6 and rachitic changes were detected the following year. No known cause for FS was identified, and renal biopsy was within normal limits. Distal tubular acidification and the threshold for proximal tubular bicarbonate reabsorption were normal, as was urine concentrating capacity. He was found to have significant hypercalciuria (urine calcium excretion 10 mg/kg/day) despite dietary calcium restriction, and urine calcium excretion increased further following an oral calcium load. Dietary sodium restriction to 16 mEq/kg/day resulted in a fall in urine calcium loss, which remained elevated at 6 mg/kg/day. Serum parathyroid hormone and 1,25 dihydroxy vitamin D3 (1,25(OH)2D3) concentrations were in the normal range. Treatment with neutral phosphate dietary supplementation resulted in partial healing of rickets and normal growth rate. Hypercalciuria resolved during phosphate administration (urine calcium excretion 3 mg/kg/day) without a fall in urine sodium excretion. It is concluded that in this patient with FS, hyperphosphaturia resulted in phosphate depletion and secondary hypercalciuria. A similar mechanism of hypercalciuria may be operative in a variety of renal tubular disorders affecting children and adults. PMID- 6853046 TI - Reflections on some relations between psychoanalytic concepts and psychoanalytic practice. AB - This paper adopts the standpoint that psychoanalytic theory has been in a state of continuous organic development from the beginning, with states of theoretical strain being generated with each new advance in theory. The meaning of concepts becomes stretched, and psychoanalysts develop implicit theories, concepts and definitions that differ from the 'official' or 'public' formulations. While flexible concepts play an important part in psychoanalytic theory, it should be accepted that each may have a number of dimensions of meaning, and that these dimensions may differ from one psychoanalyst to another. Research should be directed towards making explicit the implicit concepts of practising psychoanalysts, and it is suggested that this process will result in the accelerated development of psychoanalytic theory. The essentials of that theory must be those aspects which relate to the work the psychoanalyst has to do, and therefore its main emphasis needs to be clinical. In the second part of the paper, the expansion of the concept of transference with the introduction of defence analysis is discussed, with particular reference to the class of object related defences, which involve some combination of identification and projection. It is argued that major changes in technical emphasis brought about the extension of the transference concept, which now has dimensions of meaning which differ from the official definition of the term. Finally, three areas among many in which there is a significant distance between theory and practice are discussed. The public and official theories relating to drives, conflict, and internal object-relationships and transference are discussed, and suggestions made in regard to possible developments which might lessen the gap between the public theories and the implicit private clinical formulations of the practising psychoanalyst. PMID- 6853043 TI - Early detection of congenital nephrotic syndrome of finnish type by the neonatal hypothyroid screening program. PMID- 6853044 TI - Process and non-process in analytic work. AB - The 'talking cure', named by Anna O. and discovered by Freud, has been widely expanded and diversified throughout our century. Our objective in this paper is to underline several points which seem to define the analytic process. We believe that forthcoming progress in psychoanalysis must arise from the study of clinical experience at its frontiers, at its topmost limits, in its failures. For this reason, we have concentrated our search on the analytic non-process, in the very places where the process stumbles or halts. This has led us to propose the introduction of several terms: 'field', 'bastion', 'second look'. When the process stumbles or halts, the analyst must question himself about the obstacle. The obstacle involves the analysand's transference and the analyst's countertransference, and poses rather confusing problems. The arrest of the process introduces us fully into the nature of its movement, its inherent temporality. If the process is to continue, then by what main-spring can we accomplish it? We describe this particular dialectic of processes and non-process as a task of overcoming the obstacles which describe its success or failure. PMID- 6853045 TI - The psychoanalytic process and analytic inference: a clinical study of a lie and loss. AB - The nature of analytic evidence derived from the analytic process is illustrated and reviewed. The initial acting out of flight from analysis concomitant with an egregious lie later surprisingly proved to be analysable. The lie of loss was a leitmotiv in the analysis which revealed a neurotic structure strongly influenced by actual and threatened traumatic parent loss in childhood. Analytic explanation of psychopathology and pathogenesis is based on insightful inference at increasing distance from the direct analytic data. The meanings inferred and understanding achieved are progressively refined to minimize suggestion and subjectivity. Clinical inference may be tested in the analytic process, but inferences concerning the distant past, or on higher levels of abstraction or generalization require consistency and coherence and articulation with analytic knowledge and principles. The reconstruction of traumatic experience is re emphasized as a significant dimension of analytic work, with reciprocal illumination of transference and resistance. In the case presented the evidence was drawn from the totality of the analytic process, in which shared inferences become a part of the process in which they are further evaluated and extended. PMID- 6853047 TI - The cognitive arrest hypothesis of denial. AB - This paper has presented a microanalysis of the psychic actions and processes involved in the following four phases of the denial defence: (1) preconscious appraisal of danger, (2) painful affect, (3) cognitive arrest, and (4) screen behaviour. The subject's preconscious appraisal of some situation as actually or potentially dangerous or traumatic brings about the formation of some painful affect. The painful affect initiates a reaction in which the subject turns his focal attention from whatever disturbs him to something less threatening. This turning away or rejection of what is disturbing involves an arrest of the subject's perceiving and/or thinking about the painful object. In the cognitive arrest phase, the subject unconsciously in fantasy attacks the concrete representation of whatever he considers to be the cause of his psychic pain. These fantasy attempts to destroy the painful object arrest the subject's thinking at a primary process level. The fantasy attacks on the painful object and the consequent cognitive arrest is followed by screen behaviour. Screen behaviour is defined as the ideas, fantasies, affects, and overt behaviours motivated by the need to fill in the gaps created by the cognitive arrest, to substitute a different object relation for the one subjectively lost, and to support the defensive aims of the preceding phase. Auxiliary defences acting in conjunction with denial are frequently used in the screen behaviour phase. PMID- 6853049 TI - Freud's 'thought-transference', repression, and the future of psychoanalysis. AB - Psychoanalysts since Freud have largely neglected his important, paradigmatic ideas on the possibility of 'thought-transference' (telepathy) as an influence in mental life. A chance recording of two dreams which proved to coincide in some detail with distant reality events again suggests evidence in favour of the telepathy hypothesis. On interpretation, one of these dreams reveals even greater correspondence with the reality event and shows the mechanism of transformation of the repressed wish from latent dream content into manifest dream, utilizing a number of elements of the dream instigator, an apparently telepathically received day residue. Working with this material proceeded against very strong resistance, most evident in repeated forgetting of one or another bit of the clinical data. This has been the fate of ideas pertaining to the occult since Freud's first formulations, as is documented here by references to the early history of psychoanalysis. The issue now and for the future is whether psychoanalysis will continue to ignore the crucial question of validity in regard to the telepathy hypothesis. The psychoanalytic method is uniquely qualified to investigate so called parapsychological phenomena and has the same obligation to do so as with other mental events. We need to examine the evidence in spite of the threat posed to our conventional understanding of the limits of the mind by the very act of acknowledging the question. If we can overcome our resistance to undertaking this task, we may find that, once again, Freud pointed the way towards discovery of a new paradigm in science. PMID- 6853050 TI - Pre-oedipal development of the superego. AB - The literature pertaining to the development of early superego precursors is reviewed. This development is traced through the oral, anal, and phallic levels of psychosexual development. Additional attention is paid to such significant theoretical issues as the 'auditive sphere' and the shifting nature of ideal types. Ego ideal and superego are treated as an integrated system comprised of cognitive, affective, and behavioural components. A sequential developmental scheme is proposed for understanding the evolution of superego primordia. PMID- 6853051 TI - A study on feminine sexuality. AB - This article tends to demonstrate the existence of an early feminine identification in the girl. For this purpose it presents some clinical material pertaining to a woman with clear evidence of an early Oedipus complex, involving a precocious link with the penis and the father. We found that the difficulties revealed by the patient with respect to her feminine identifications and her sexuality, are due to deficiencies in relation to the primary object, that were shifted to a difficult link with the penis. The material also shows that some positive elements in the tie of this particular patient with the father, were subsequently important in the acquisition of feminine aspects. PMID- 6853048 TI - Annihilation anxiety: the experience of deficit in neurotic compromise formation. AB - This paper considers the problem of annihilation anxiety as a 'test case' to question some polarization tendencies in psychoanalysis. One such polarization, deficit versus conflict, encourages either-or diagnoses, such as narcissistic or neurotic. An alternative scheme is proposed here, a continuum on which most cases are 'mixed' rather than 'pure', and where annihilation concerns along the range are reviewed and documented. The non-specific dread of the strength of the instincts reactivates what Kohut has called early traumatic failures in maternal empathy. Conversely, current failures in empathy may produce great intensities of signal anxiety, anticipating the helplessness of the original traumatic state. These accruals may be experienced in terms of self annihilation. It is here proposed that the term annihilation anxiety be used to refer to a variety of phenomena, including susceptibility to traumatic states, and intensities of anxiety which may always be further elaborated with conscious or unconscious mental content. Once that anxiety, whatever its origin, oedipal or pre-oedipal, is capable of psychic representation, it may become a component of intrapsychic conflict. PMID- 6853052 TI - The role of imported grain on the selenium intake of Finnish population in 1941 1981. AB - When the average intake of selenium among the Finnish population during the period 1941 to 1981 was estimated, the proportion of imported grain used for human consumption, as well as its country of origin, was taken into account as a factor increasing the total intake. The figures indicting the intake of selenium during the study period range from 21 to 56 micrograms/day, clearly exceeding the values obtained when the intake is assessed on the basis of the selenium content of Finnish grain only. The proportion of selenium derived from grain out of the total intake of selenium ranged from 10 to 67% during the study period. PMID- 6853053 TI - Hydrolysis of FMN and FAD by alkaline phosphatase of the intestinal brush-border membrane. AB - Both FMN and FAD were found to be hydrolysed with saturation kinetics by purified alkaline phosphatase (aPase E.C. 3.1.3.1) as well as by a brush-border membrane preparation (BBMp) from rat jejunum. With aPase the KM-value was 11.0 mmole/l when FMN was applied and 4.4 mmole/l when FAD was used. The apparent KM-values with the BBMp were calculated to be 22.9 mmole/l for FMN and 5.7 mmole/l for FAD as substrates. The BBMp contained FMN- and FAD-hydrolysing activity besides that due to the aPase. Regarding the high phosphatase activities associated with the brush-border membrane, it seems unlikely that FMN and FAD penetrate this membrane without being split. The transmural intestinal transport of 14C-riboflavin was tested in vitro in the presence of non-labelled FMN and FAD. The transport rate of the labelled riboflavin was found to be reduced by the coenzymes. It could be concluded that 14C-riboflavin competed with the non-labelled riboflavin released by the phosphatases for the binding sites of a hypothetical transport carrier. PMID- 6853054 TI - Adipose tissue labelling in man, using a structurally-labelled fatty acid as tracer. AB - Three healthy male subjects had their adipose tissue enriched with a structurally labelled fatty acid, 13-methyltetradecanoic acid (13-MTD), occurring naturally only in trace amounts. Needle biopsies from femoral, gluteal and abdominal adipose tissue were obtained at several intervals during a 6-week 13-MTD ingestion period and also along an 11-week period following the cessation of the label intake. Fatty acid composition was analysed by gas-liquid chromatography. Using this method, it was possible to show that different adipose tissues had various responsiveness to labelling (with abdominal fat having the highest one) and hence had different turnover rates. Incorporation and particularly disappearance rates were slow, half-lifes for label incorporation ranged from 2 to 12 weeks and that for label mobilization ranged from 4 to 10 months, thus confirming few other published results. The unexpected observation that incorporation of the label did not cease at the end of the 13-MTD feeding period, but did continue for at least a fortnight, might indicate that existence of a buffer pool where fatty acids may be momentarily stored before their definite incorporation into adipose tissue, as suggested in few other studies. PMID- 6853057 TI - Effect of undernutrition and vitamin A deficiency on the phospholipid composition of rat tissues at 21 days of age. -- I. Liver, spleen and kidney. AB - Studies were made of the effects of undernutrition and Vitamin A deficiency on the phospholipid composition of liver, spleen and kidney in rat. Undernutrition and vitamin A deficiency cause a significant deficit in body and tissue weights. But the deficit seems to be more in undernourished rats. Significant deficits were found in the concentration of total phospholipid in livers from both the experimental groups. This decrease in total phospholipid was reflected in most of the phospholipids with a significant decrease in phosphatidyl serine and inositol fraction of undernourished rats. The concentration of total phospholipid in the spleen was increased in undernourished rats. This increase was mainly confined to the sphingomyelin fraction. However the phosphatidyl choline was found to decrease in undernourished rats. No major changes were observed in the concentration of different phospholipids of kidney from the experimental rats. These results suggest that undernutrition and vitamin A deficiency have differential effects on the phospholipid composition of different tissues and the effects of vitamin A deficiency seems to be due to general growth retardation rather than the specific effect of vitamin A per se. PMID- 6853055 TI - Variations in liver concentrations of iron and vitamin A as a function of age in young American children dying of the sudden infant death syndrome as well as of other causes. AB - Concentrations of total iron and of vitamin A were determined in the livers of 33 Midwestern children, varying in age from 2 weeks to 9 years, who had died from the sudden infant death syndrome (SIDS) as well as from other causes. The median liver iron concentration was high (500 micrograms/g wet weight) in infants up to one month of age, fell rapidly during the ensuing months, and reached a plateau of 125 micrograms/g at approximately 1 year of age. No differences were noted between male and female children. The median liver vitamin A concentration was very low (4 micrograms/g) in infants less than or equal to 1 month of age, rapidly increased during the ensuing months, and reached a value of 100 micrograms/g by one year. The ratio of vitamin A to iron in the liver increased roughly 100-fold during the first few years of life. Infants dying of SIDS had stores of iron and vitamin A that fell in the normal range for age. Only one subject of the 33 studied showed an iron value less than 50 micrograms/g, and no infants more than 5 months of age showed a vitamin A value less than 20 micrograms/g. Thus, the storage of iron and vitamin A appear to be normal in the livers of infants suffering from SIDS. PMID- 6853056 TI - Impaired Myelination in rats given excess vitamin A postnatally. AB - The effect of postnatal administration of 1000 I.U. of Vitamin A on 4th, 6th, 8th, and 10th day of age to rat pups has been studied on brain myelin lipid and sulphatide synthesis from Na235SO4. Administration of vitamin A reduced brain weight, free cholesterol, phosphatidal ethanolamine and the synthesis of myelin sulphatides from Na235SO4. PMID- 6853058 TI - The biotin status of weanling pigs fed semipurified diets as evaluated by plasma and hepatic parameters. AB - Twenty-four pigs were weaned at four weeks of age and fed either spray dried egg albumen (DA) or autoclaved DA (ADA) as the only protein source were used to evaluate plasma and hepatic parameters as indicators of biotin status. Pigs were fed one of four semipurified diets during the 42-day study: DA basal, DA + 1.1 g sulfamethazine/day (DA + S), ADA basal or ADA + .5 mg biotin/day (ADA + H). Autoclaving DA at 121 degrees C for 30 minutes reduced both the biotin binding properties of the avidin fraction and the trypsin inhibitor activity of DA. Pigs fed ADA and ADA + H had greater (P less than .05) liver pyruvate carboxylase (EC 6.4.1.1) activity and DNA concentrations, lower (P less than .05) plasma urea nitrogen levels and greater and more efficient (P less than .05) weight gain than either DA or DA + S fed pigs. Biotin supplementation further enhanced (P less than .05) liver DNA concentration but had no effect on the liver levels of RNA or total protein. Plasma levels of glucose and free fatty acids or blood levels of lactate and pyruvate were not influenced by the addition of biotin to the ADA basal diet. PMID- 6853059 TI - Reinvestigation of the diabetogenic effect of dehydroascorbic acid. AB - To investigate the diabetogenic effect of pure dehydroascorbic acid, male Wister- and Sprague-Dawley rats received i.v. injections of the substance. No hyperglycemia and no decreased glucose tolerance were found. I.v. administration of the hydrolysis products of dehydroascorbic acid and of a solution containing monodehydroascorbate likewise did not increase blood glucose values. It is concluded that in previously performed experiments not dehydroascorbic acid itself but one or several impurities might have produced hyperglycemia in the rat. The electron transfer proteins tested (ascorbate:ferricytochrome b5 oxidoreductase, cytochrome b5, NADH:ferricytochrome b5 oxidoreductase, NADH:monodehydroascorbate oxidoreductase), which might participate in the reduction of dehydroascorbic acid, could not be induced in liver microsomes from Wistar rats by the injection of dehydroascorbic acid, its hydrolysis products, or monodehydroascorbate. PMID- 6853061 TI - Effect of undernutrition and vitamin A deficiency on the phospholipid composition of rat tissues at 21 days of age. -- II. Lung, heart and testes. AB - Undernutrition and vitamin A deficiency during early period of life causes a significant decrease in lung, heart and testes weights. But the concentration of total phospholipid was unaffected. However the individual phospholipids showed some changes. The concentration of phosphatidyl ethanolamine was decreased in the lung from vitamin A deficient rats. On the other hand sphingomyelin and cardiolipin showed a marked increase in heart. The concentration of phosphatidyl serine and inositol fraction was significantly lower in testes from undernourished rats as compared to controls. PMID- 6853060 TI - The effect of vitamin C supplementation on lactating women in Keneba, a West African rural community. AB - A study of vitamin C requirements was undertaken in the village of Keneba, The Gambia, during the rainy season, when the intake of vitamin C-rich foods is very low. The effect of four supplementary levels of vitamin C (0, 24, 47 and 60 mg/day), together with a milk and biscuit food supplement which provided 34 mg vitamin C/day, was studied for a five-week period. Plasma ascorbate increased from 0.25 to 0.72 mg/dl; buffy coat ascorbate increased from 14.7 to 24.3 micrograms/10(8) cells and breast milk ascorbate increased from 3.4 to 5.5 mg/dl as intake increased from 34 to 103 mg/dl. Breast milk ascorbate approached a plateau at the high intakes. A fasting plasma ascorbate of at least 0.3 mg/dl in 97.5% of the population of lactating women in Keneba would require a daily vitamin C intake of about 117 mg. No differences between vitamin C supplementation levels were observed with respect to changes in plasma iron, total iron-binding capacity or its percentage saturation. Whole blood histamine levels showed a slight downward trend as the vitamin C intake increased. PMID- 6853062 TI - Zinc nutriture and cell-mediated immunity in the aged. PMID- 6853063 TI - Histopathology of ocular histoplasmosis. PMID- 6853064 TI - Irradiation of the central lesion of presumed histoplasmic chorioretinitis. PMID- 6853068 TI - Attitudes of Israeli Arabs towards the mentally ill. PMID- 6853066 TI - Long-term follow-up of the second eye in ocular histoplasmosis. PMID- 6853065 TI - Corticosteroids in the treatment of ocular histoplasmosis. PMID- 6853067 TI - Anatomical considerations in streak lesions of the fundus. PMID- 6853069 TI - Somatic neurosis in middle-aged Hindu women. AB - Somatization in neurotic disorders was noted as a significant complication in their classification. Besides being an aspect of other neurotic disorders somatization becomes primary and chronic neurotic problem running true to type for several years in some patients. Recent evidence indicated that the syndrome "Somatic Neurosis" occurs not only in Muslim women but in middled-aged women of other communities too. A group of 20 middle-aged women with somatic neurosis were compared with an equal number of age-matched Neurotic Depressive patients. The former had significantly lower scores on Hamilton's Rating Scale for Depression and higher scores on the Intrafamily Interpersonal Trust Scale. The groups, however, did not differ on Srole's Anomia scale scores. It was argued that the good expressed interpersonal trust with specified family members in contrast to the high anomia indexes, a particular dynamic in the family. The study points to the need for further study of this condition. PMID- 6853070 TI - Customer approach and Walk-in Clinic drop-out phenomenon. PMID- 6853071 TI - A suicide by self-immolation--psychosocial perspectives. PMID- 6853072 TI - The relation of interpersonal attraction to clinical adjustment in psychiatric patients. PMID- 6853074 TI - 'New Town Blues': Planning versus mutual. PMID- 6853073 TI - Psychiatric symptoms of maritally-distressed wives and husbands. AB - The relationship between marital distress and psychiatric symptoms of wives and husbands was investigated by comparing the number, intensity, and types of symptoms reported by each spouse in a group of maritally-distressed couples. Wives reported a significantly higher number and intensity of symptoms on the overall SCL-90 and on four of the eight sub-scales. Possible explanations for these findings are discussed. PMID- 6853075 TI - A model project of comprehensive psychiatry. PMID- 6853076 TI - The changing perceptions of mental illness in a Mexican-American community. PMID- 6853078 TI - The role of irradiation in the conservative treatment of rectal cancer. PMID- 6853077 TI - Rectal cancer: restorative surgery with the EEA stapling device. AB - In the surgical treatment of tumors of the middle third of the rectum, we have been performing low colorectal anastomoses, with the EEA stapler introduced transanally, as a sphincter-saving operation, during the last three years. Our experience covers 134 patients; in 89 of these, manual reconstruction was found to be technically impossible. In such cases, the alternative sphincter-saving operation, in our department, would be a pull-through operation. In 16.4%, anastomotic dehiscence with stercoraceous fistula was observed; the operative mortality was 1.4%. At follow-up, there were no colon problems, in 85.2%; in 13.7%, three or four defecations of formed stools occurred daily; in 6.8%, there was a reduction in the calibre of the anastomosis. In these patients, dilation was performed. Loss of the capacity to discriminate between feces and flatus and a poor control of flatus with occasional fecal incontinence were present in six and three patients, respectively. Clinical and functional results, when compared with those of other sphincter-saving operations, confirm that the use of the EEA stapler allows the construction of anastomoses so low in the rectum that it would be difficult, risky or impossible to perform them manually. A reduction in the incidence of anastomotic dehiscence and length of hospital stay was also obtained. PMID- 6853079 TI - The efficacy of adhesive plastic incise drapes in preventing wound contamination. AB - A direct method of tracing the bacterial indicators (Human Albumin Microspheres) for evaluation of adhesive plastic incision drapes was used. The particles were sprayed on the prepared skin beneath the plastic incision drape in 30 operations. At the end of the operation, wound irrigates were collected for retrieval of the particles. No particles could be detected in any of the procedures studied. It was shown that, when a plastic incise drape is properly applied, it conforms to the skin and no air bubbles or pockets of fluid will form beneath or around the incised edge of the drape. It will remain tightly adherent to the skin throughout the operative procedure. Used in this manner, plastic incise drapes can aid in preventing the migration of skin microbes into the surgical wound as was demonstrated by the complete absence of simulated bacterial indicators in all 30 of the wound irrigates that were examined. PMID- 6853080 TI - Autotransfusion in vascular surgery. AB - A randomized prospective study of 202 patients undergoing peripheral vascular surgery, with the use of autotransfusion, is presented. Hematologic and hemostatic studies were performed on 50 samples of reclaimed and bank blood. The study showed a lower hemoglobin content in autotransfused blood. At the same time it showed a higher platelet count and higher concentration of labile clotting factors. When the patient's blood was tested 24 hours post-transfusion there was no significant residual hematologic or hemostatic defect. There were 15 complications related to blood transfusion including two deaths. The author concludes that autotransfusion significantly reduces the need for bank blood and post-transfusion complications and that it is safe and easy to use. PMID- 6853081 TI - Autotransfusion with hemodilution in vascular surgery. PMID- 6853082 TI - Iatrogenic vascular lesions: tactical procedure and late follow-up studies. AB - The problems associated with postoperative iatrogenic vascular lesions in 13 patients are discussed. In general surgery, there is no particular procedure which entails an extremely high risk of iatrogenic vascular lesions. Depending on the kind of lesion, hemorrhage and ischemia are the most frequent symptoms. The IVL was recognized during the initial operation in only two cases. Interposition of autologous saphenous vein is the safest therapeutic procedure. End-to-end anastomosis and patches to enlarge the anastomosis can also be used. In venous lesions, we recommend the creation of a temporary AV-fistula. In one case a thigh amputation was necessary because of progressive venous gangrene; operation was performed five days after the lesion. Postoperatively, two cubital interpositions were occluded; but the patients did not suffer from circulatory problems. One female patient died following resection of a carotid aneurysm originating from a glomectomy. Good postoperative results were reported for the other patients. PMID- 6853084 TI - Intrahepatic biliary exploration for removal of gallstones. PMID- 6853083 TI - Long-term results of omental transplantation for chronic occlusive arterial diseases. AB - Twenty cases of thromboangitis obliterans (21 limbs) and five cases of atherosclerosis obliterans (five limbs) were treated with omental transplantation. Angiographic findings in these patients showed poor distal run off, and direct reconstructive surgery was not indicated. Follow-up studies were conducted for an average of five years and one month (3 mos to 9 yrs. and 8 mos.). The long-term follow-up of 19 cases with thromboangitis obliterans (TAO) (20 limbs) revealed excellent results in 62%, good results in 19% and poor results in 19%. The results of the five cases with atherosclerosis obliterans (ASO) (5 limbs) were good in 20% and poor in 80%. Long-term results of omental transplantation show it to be remarkably effective in treating TAO but not ASO. PMID- 6853085 TI - Reoperations after choledochoduodenostomy: a new approach. AB - Reoperation after choledochoduodenostomy was performed in seven cases. Stenosis of the anastomosis, bile duct stones, cholangitis and stump syndrome were found in five cases. In the first two cases, disconnection of the choledochoduodenostomy and sphincteroplasty were performed: one patient died of duodenal leakage. In the third case, retrograde sphincteroplasty was performed with lethal failure. In the following four cases, a new approach which consisted of antropyloroduodenotomy, catheter guided sphincteroplasty, extraction of stones and debris, and reconstruction with a Finney gastroduodenostomy was used. Endoluminal suture of previous choledochoduodenostomy was also performed in three cases and vagotomy in two. This approach resulted in no mortality and the results were excellent in all cases. The patients were followed up for from nine months to three and a half years. The authors found this endoluminal approach an easier and safer surgical procedure. PMID- 6853086 TI - A new procedure for Billroth-I anastomoses with the EEA stapler. PMID- 6853087 TI - Postoperative functioning of the remaining stomach after pyloric sphincter preserving gastrectomy. AB - Pyloric sphincter preserving gastrectomy (SPG) has been used in 120 cases and the results were compared with those obtained in 73 cases who underwent the Billroth I operation (B-I). No significant differences were observed in postoperative complications or anastomotic dysfunction. SPG patients, however, showed a longer gastric emptying time than the B-I patients, whereas the B-I patients showed a markedly greater increase in duodenogastric reflux than the SPG patients. PMID- 6853089 TI - Infectious complications of vasectomy: a study of 200 cases. AB - Semen and urine were cultured prior to vasectomy. Infectious complications only occurred in patients with positive semen and urine cultures and the offending organism was the same as that found in the semen and urine cultures. This evidence for an endogenous cause of postoperative vasectomy infection suggests that semen and urine cultures should be obtained prior to vasectomy. In this manner, the correct antimicrobial agent can be applied as an aid to rapid solution of a postvasectomy infection. PMID- 6853088 TI - Rectal carcinoma; restorative resection using a sutured colo-anal anastomosis. AB - Over the last forty years, rectal resection with preservation of the anal sphincters has become widely accepted as satisfactory treatment for carcinoma of the upper rectum. Tumors lower in the rectum are more difficult to treat in this way because of the difficulty of performing an anastomosis low in the pelvis. Seventy-six patients have had a rectal carcinoma resected and bowel continuity restored by means of a sutured anastomosis between colon and anal canal. Ten patients developed significant pelvic sepsis. 69 of the 70 patients whose bowel function could be assessed were either completely normal or had only minor functional defects. Four of the 39 patients who had the operation three or more years ago have developed recurrent pelvic tumor. 21 of 32 patients are alive three years and 12 of 19 are alive five years after a curative operation for rectal carcinoma. The survival rate is similar to that seen following total excision of the rectum and pelvic floor for tumors in similar sites. PMID- 6853090 TI - Fascial arthroplasty for elbow ankylosis. AB - Fifty-one cases of elbow ankylosis treated with fascial arthroplasty were studied. Forty-two cases (85.4%) of elbow ankylosis were due to injuries; chronic dislocation (24), traumatic myositis ossificans (14) and gunshot wounds (4). Eight were due to infection and one to congenital humero-radial synostosis. Seventy-six per cent of all cases had fairly good results and 24% were regarded as failures. The results obtained justify the use of fascial elbow arthroplasty for elbow ankylosis. PMID- 6853091 TI - Total replacement of knee and elbow in hemophilia: three cases. PMID- 6853092 TI - Family occurrence and hla system in tumoral calcinosis. AB - A 35-year-old patient, from a ten sibling family, was eight years old at the first presentation of tumoral calcinosis. Since then, in spite of several surgical excisions, the masses have increased in number and size are to be found in various para-articular areas. One brother and one sister of the patient, of 39 and 45 years respectively, had also had tumoral calcinosis, but recovered completely, on surgical removal of the masses. The HLA system studies carried out in the siblings revealed the HLA A10 BW16 haplotype in nine of them, including the three patients. If confirmed in other cases, our data might indicate that tumoral calcinosis is a disease associated with the HLA system. PMID- 6853093 TI - Partial purification of cathepsin B in the bovine ciliary body and iris. AB - Cathepsin B in the bovine ciliary body and iris was studied biochemically using alpha-N-benzoyl-D,L-arginine-2-naphthylamide as substrate. The enzyme was purified to 210-fold from the autolyzed extract. The partially purified enzyme had a pH optimum at 6.0 and a molecular weight of 27,000. The apparent Km value for the substrate was 1.6 mM. The enzyme was activated by disodium ethylenediamine tetraacetate, cysteine, and dithiothreitol. The enzyme activity was inhibited strongly by leupeptin and partially by hyaluronate and chondroitin sulfate A. PMID- 6853095 TI - Distributions of 35S-sulfate and 3H-glucosamine in the angular region of the hamster: light and electron microscopic autoradiography. AB - The distribution of 35S-sulfate and 3H-glucosamine in the angular region of the hamster was studied by light and electron microscopic autoradiography following intraperitoneal injection of these compounds to hamsters. Exposed silver grains of 35S-sulfate were concentrated in the trabecular meshwork, sclera, and cornea, and grains of 3H-glucosamine were localized in the trabecular region. The radioactivity of both isotopes was observed in the Golgi apparatuses of the endothelial cells of the angular aqueous plexus and the trabecular meshwork. The grains were noted over the entire cytoplasm, except for the nucleus, and then were incorporated into the amorphous substance and collagen fibers in the region adjacent to the angular aqueous sinus. These results suggest that endothelial cells in the angular region synthesize and secrete the sulfated glycosaminoglycans and hyaluronic acid. PMID- 6853094 TI - Human ciliary body epithelium in culture. AB - Human ciliary body epithelial cells have been maintained in vitro and have been partially characterized by the determination of growth rate, morphology, and ultrastructural parameters. The dissection technique employed allows the separation of pure ciliary body epithelium with a predominance of cells being from the nonpigmented layer. Growth curves indicate this cell population follows a prolonged rate of growth compared to other primary cell cultures. Loss of pigment granules noted by light microscopy were documented by morphometric analysis of electron micrographs. Thirty-two percent of the cultures attempted were successful. Maintenance of these cells in vitro may provide a means for studying their enzyme systems, growth factors, reactions to various stimuli, and the effects of this cell population on other intraocular tissues. PMID- 6853096 TI - The effect of dexamethasone on the in vitro incorporation of precursors of extracellular matrix components in the outflow pathway region of the rabbit eye. AB - The present study demonstrates that the cells of the outflow pathway region incorporate precursors of the extracellular matrix components during in vitro incubation. Addition of dexamethasone (10(-7) M) to the incubation mixture led to changes in precursor incorporation that were precursor and cell specific. The steroid significantly decreased the incorporation of 3H-glucosamine and increased the incorporation of 3H-proline in the outflow pathway cells and in the fibroblasts of the adjacent sclera. The specificity of the hormone effect was demonstrated by its inability to alter 3H-leucine incorporation. By contrast, in iridial fibroblasts dexamethasone caused a decreased incorporation of 3H glucosamine while not affecting the incorporation of 3H-proline. Our results suggest that dexamethasone causes an increase in collagen synthesis in the target cells most closely related to the outflow pathway. Further, the decreased incorporation of 3H-glucosamine with dexamethasone suggests decreased synthesis of glycosaminoglycans, glycoproteins or possibly glycolipids in these same cells. PMID- 6853097 TI - Morphology and function of the aqueous outflow system in monkey eyes perfused with sulfhydryl reagents. AB - The aqueous outflow system from anterior chamber to Schlemm's canal was examined by electron microscopy in pairs of enucleated macaque and baboon eyes, perfused via the anterior chamber with mock aqueous humor in one eye and the same fluid with added iodoacetamide (IA) or N-ethyl maleimide (NEM) in the other eye. Many details of the electron micrographs were analyzed in a masked manner using a digitizing bit pad and computer, and also using visual evaluation. Both IA and NEM increased aqueous humor outflow facility, but the morphologic changes induced by IA were quantitatively different from those induced by NEM. Intercellular junctions were not affected by IA, but were disrupted by NEM (P less than 0.01). Vacuoles in the endothelial lining of Schlemm's canal tended to increase in area, but not in number, under the influence of IA, whereas they were not so affected by NEM. No loss of extracellular material was observed in either IA- or NEM treated eyes. The results indicate that the chemical status of cellular-SH groups may influence aqueous humor outflow facility at multiple sites in the outflow pathway. PMID- 6853098 TI - Conjunctival and episcleral blood vessels are permeable to blood-borne horseradish peroxidase. AB - The vessels of the conjunctival and episcleral plexuses of Macaca mulatta eye are of the continuous type. Most of the vessels in the conjunctival plexus have the diameter of capillaries, while the vast majority of the vessels in the episcleral plexus are venules. Both types of vessels have a simple wall, which consists of an endothelium and a discontinuous layer of pericytes. The aim of this study was to establish their permeability properties to blood-borne horseradish peroxidase (HRP). After intravenous injection of HRP, in 200 microns chopper sections of the anterior segment of the eye examined with the light microscope, the subconjunctival and episcleral tissues appear intensely and diffusely stained by the reaction product. The electron microscope shows that HRP escapes from the vessels lumen by crossing the interendothelial clefts and, in addition, a great number of pinocytotic vesicles loaded with HRP are present on the luminal, tissue front and in the cytoplasm of the endothelial cells. HRP, which rapidly penetrates the loose connective tissue of the region, reaches the spaces between the cells of the conjunctival epithelium where it is finally blocked by the zonulae occludentes that connect the most superficial epithelial cells. A slow diffusion into the compact tissue of the cornea and of the sclera was also observed. Thus, under normal conditions, blood-borne macromolecules can freely diffuse into the subconjunctival and episcleral loose connective tissues. On the other hand, one can equally expect that the aqueous humor that reaches the episcleral and conjunctival blood plexuses through the canal of Schlemm and collector channels can freely diffuse into the subconjunctival spaces across the walls of these permeable vessels. PMID- 6853100 TI - Iris arteriolar diameters in hypoxia and hyperoxia: a photographic study in albino guinea pigs. AB - The irides of albino guinea pigs were photographed, and the iris arteriolar diameters were measured with the animal breathing room air, 10% O2/90% N2, or 100% O2. The iris arterioles constrict significantly in hyperoxia and dilate in hypoxia. The average constriction in 100% O2 was 27% +/- 8%, and the average dilatation in 10% oxygen was 34% +/- 20%. PMID- 6853099 TI - Reactivity of the human retinal circulation to darkness: a laser Doppler velocimetry study. AB - Bidirectional laser Doppler velocimetry (LDV) and fundus photography were applied to investigate the effects of light and darkness on retinal blood flow. Blood flow had increased by an average of 67% after 5 min of darkness. This increase persisted for periods of darkness as long as 80 min (the longest period tested). The magnitude of this elevation, its time course, and its neutralization by the breathing of 100% O2 suggest that, in vivo, the retina consumes more O2 in the dark than in light. This effect is, most probably, associated with the maintenance of the photoreceptor dark current. LDV in light and darkness may become a useful probe of retinal function. PMID- 6853101 TI - Pattern-reversal electroretinograms in unilateral glaucoma. AB - Pattern-reversal and flash electroretinograms (ERG) and oscillatory potentials (OP) were recorded from 11 patients with unilateral glaucoma. All glaucomatous eyes had reduced amplitudes both compared to the opposite eye in the same patient and to reference values. In 10 of the 11 cases this reduction was below the level of normal variation. The difference in pattern-reversal ERG amplitude means from glaucomatous and opposite eyes was statistically significant. No differences were observed in flash ERGs or OPs. The histopathologic correlate to the visual field defects in glaucoma is retinal ganglion cell degeneration. The present electrophysiologic findings support the view, based on results from animal experiments, that the pattern-reversal ERG reflects ganglion cell activity. PMID- 6853102 TI - Visual fields described by contrast sensitivity, by acuity, and by relative sensitivity to different orientations. AB - Sinewave grating contrast sensitivity was measured as a function of eccentricity and azimuthal angle for four orientations of gratings whose spatial frequencies ranged from 2 to 20 c/deg. Visual fields for cutoff spatial frequency were also mapped. Log contrast sensitivity fell off approximately linearly with eccentricity for all azimuths. Orientational differences in contrast sensitivity varied irregularly over the visual field and, though small for central vision, could reach as high as 25 dB in localized patches at eccentricities greater than about 12 degrees. PMID- 6853103 TI - Cholinergic inhibitory response in the bovine iris dilator muscle. AB - Isometric tension changes of the bovine iris dilator muscle were investigated in vitro. Electrical field stimulation (0.03-1 msec duration) produced a relaxation, which was abolished by the addition of tetrodotoxin, thereby suggesting a neuronal origin. Marked relaxation was also initiated in high K solution. Both of these relaxations were potentiated by neostigmine, while atropine abolished the relaxations. Exogenous application of acetylcholine or carbachol produced dose dependent relaxations that were not antagonized by adrenoceptor blocking agents. These observations indicate that the relaxations induced either by electrical nerve stimulation or by high K are mainly mediated via excitation of cholinergic nerves and that the consequent release of acetylcholine relaxes the muscle. The cholinergic inhibitory mechanism may be accompanied by hyperpolarization of the muscle membrane or be due to a direct transmitter action via "pharmacomechanical coupling." Adrenergic agonists and high K produced weak contractions even when the muscle relaxed with carbachol application. The adrenergic system and the depolarization of the muscle seem to play some role on the motor function of the bovine dilator. The present experiment suggests that the cholinergic system plays an unexpectedly dominant part in dilation of the bovine pupil, since cholinergic agents produced considerable responses of the dilator muscle, as compared to findings in the case of adrenergic agonists. The inhibitory cholinergic nerves innervating the bovine dilator are closely related to the miotic action of the sphincter muscle. The unexpected inhibitory action of acetylcholine may possibly be a general occurrence among mammals. PMID- 6853104 TI - Identification of accommodative vergence contribution to the near response using response variance. AB - An experimental method was developed to isolate accommodative and disparity vergence contributions to coordinated near vergence motor responses. The variability normally associated with the neural control signal was used as an identifying marker or tag. Using this approach, the results showed an increased variability associated with the blur-driven, accommodative vergence component that is particularly noticeable during the latter half of the movement. This indicated that accommodative vergence provides a moderate contribution to the near vergence response primarily in the late and post-transient period when the movement is essentially complete. Presence of this accommodative contribution lends further support to the "dual interactive model" of near triad control. PMID- 6853105 TI - The effect of minimal occlusion therapy on binocular visual functions in amblyopia. AB - The binocular visual functions of amblyopic children were studied during treatment involving brief weekly periods of occlusion of the unaffected eye while the child performed demanding visuomotor tasks against either a background of rotating gratings or a stationary uniform gray stimulus. The gains in stereoacuity were quite significant and in most cases more obvious than the rather small gains in letter visual acuity. On initial presentation only 21 of the 60 patients showed evidence of stereopsis and of these only seven possessed a stereoacuity of 100 secs or better. Following six treatment sessions the number of patients that demonstrated stereopsis increased to 36 of whom 17 possessed reasonably good stereoacuity (100 secs or better). However, there was no difference in the degree of improvement exhibited by those patients that viewed rotating grating patterns during treatment and others from the control group that viewed the uniform gray stimulus. Thus, there was no evidence that any of the visual gains were enhanced or promoted by active visual stimulation of the amblyopic eye with rotating gratings during the brief periods of occlusion of the unaffected eye. Finally, a comparison of the scores of the children on various stereo-tests suggest that tests comprised of small figure elements that are present in high density may be best for screening purposes. On the other hand, for quantifying the stereoacuity of children known to possess abnormal binocular vision it may be more appropriate to employ tests that use large figure elements that provide strong fusion cues. PMID- 6853106 TI - Contrast thresholds for sine gratings of children with amblyopia. AB - Contrast threshold functions were measured on 26 amblyopic children before and after minimal occlusion therapy. On initial presentation the relative contrast sensitivity deficit the amblyopic eye was in every case much less than that predicted from the deficit in visual acuity for letters. In fact, in seven of the children the contrast sensitivity functions for the amblyopic and fellow nonamblyopic eye were indistinguishable despite the expression of substantial amblyopia on letter charts. Only four children exhibited a substantial contrast sensitive loss in the amblyopic eye with a cut-off spatial frequency below 30 cycles/degree. The majority of children who showed deficits in contrast sensitivity did so only at medium and high spatial frequencies. On the basis of these findings it appears that measurements of contrast thresholds for single sinusoidal gratings do not probe fully the deficits of spatial resolution in amblyopia. Finally, among the few children who exhibited a sizeable initial deficit, only two showed obvious improvement in contrast sensitivity in response to minimal occlusion therapy. PMID- 6853107 TI - The lateral geniculate nucleus in human anisometropic amblyopia. AB - Experimental amblyopia in animal models causes a reduction of cell sizes in lateral geniculate nucleus (LGN) laminae connected with the amblyopic eye. However, direct evidence that the human amblyopic visual system is affected in a similar manner has been lacking. Histologic study of the LGNs from a patient with ophthalmologically confirmed anisometropic amblyopia shows a decrease of cell sizes in the parvocellular layers innervated by the amblyopic eye. This decrease was more pronounced in laminae receiving crossed fibers. To our knowledge this is the first report about structural alterations in the afferent visual pathway of a human amblyope and the data reaffirm the validity of the monkey model for further study of the basic mechanisms in amblyopia. PMID- 6853109 TI - An early peak of the pattern reversal evoked potential (PREP). AB - An early peak of the pattern reversal evoked potential with an implicit time between 30 and 50 msec, and an amplitude of 0.5-1 muv was demonstrated. The peak varies with the spatial frequency of the stimulus (checksize), and, the viewing condition (binocular vs monocular). Further study is being done to determine the origin. PMID- 6853108 TI - Normal fluorescein iris angiographic pattern in subhuman primates. PMID- 6853112 TI - An update on the Irish and international mortality from cancer of the intestine and rectum (1976). PMID- 6853111 TI - Comparison of three methods for rapid determination of threshold contrast sensitivity. AB - Threshold contrast sensitivity functions for 13 subjects were determined on 5 consecutive days using three psychophysical methods. Each method was implemented on a microprocessor controlled display system and considered as a possible candidate for a rapid visual screening test. The methods used were Bekesy tracking, method of adjustment, and method of increasing contrast. The method of increasing contrast proved superior to the other methods in repeatability, speed, and the preservation of individual differences in contrast sensitivity over the testing period. PMID- 6853110 TI - Recording the pattern electroretinogram: a cautionary note. AB - It is possible to record a pattern electroretinogram (PERG) of near normal amplitude in a situation when the eye containing the active electrode is occluded. Because PERG recording requires high amplification and sensitive signal retrieval techniques, the electrode in the occluded eye records a distant potential from the unoccluded eye. Referencing the active electrode to an ipsilateral ear diminishes, but does not eliminate the referred PERG potential. Such unlooked for interaction may provide misleading data in situations where binocular viewing is used because of poor vision in one eye; therefore, occlusion of the eye not being tested should be undertaken whenever possible. PMID- 6853113 TI - Colorectal cancer screening of asymptomatic patients in Ireland. PMID- 6853114 TI - Serum lysozyme: is it a useful marker of malignant lymphoma in coeliac disease? PMID- 6853115 TI - Extrinsic compression of the duodenum -- Wilkies syndrome. PMID- 6853116 TI - Obstructed labour due to locked twins. PMID- 6853117 TI - Sarcoidosis, anterior pituitary failure, and diabetes insipidus. PMID- 6853118 TI - Causes of agranulocytosis in a hospital population: identification of dipyrone as an important causative agent. AB - A population of patients with agranulocytosis admitted to a general hospital over a period of 12 yr was studied retrospectively in order to determine the causes of the disease. Of the 48 cases identified, 31 (65%) had drug-induced neutropenia, whereas 17 (35%) had chronic neutropenia unrelated to the use of drugs. Eight patients had an underlying hematological malignancy. Patients with agranulocytosis not induced by drugs more frequently had hepatomegaly, splenomegaly, enlarged lymph glands, or thrombocytopenia together with severe anemia. In contrast, drug-induced agranulocytosis was more severe, with a higher incidence of positive blood cultures, low cellularity of initial bone marrow aspirates, and a shorter duration of neutropenia. Dipyrone and methimazole were the drugs most commonly associated with agranulocytosis. Dipyrone was probably the causative agent in two of the seven drug-induced fatalities. In view of these findings, and those of several previous reports, it is proposed that the use of dipyrone in Israel be severely restricted or discontinued altogether. PMID- 6853119 TI - Multicentric giant lymph node hyperplasia clinically simulating angioimmunoblastic lymphadenopathy. Associated Kaposi's sarcoma in two of three cases. AB - We report on three patients whose clinical presentation and laboratory findings were similar to those of angioimmunoblastic lymphadenopathy (AILD). The pathology findings in the lymph nodes were characterized by enlarged lymph follicles, a massive plasma cell infiltration, and marked vascularization. These morphological features were similar to those of giant lymph node hyperplasia, plasma cell type. In two of the patients, there was an associated Kaposi's sarcoma. PMID- 6853120 TI - Angioimmunoblastic lymphadenopathy with scleromyxedema-like lesions and serum monoclonal protein. AB - A patient was followed up for 5 yr for an illness diagnosed histologically as angioimmunoblastic lymphadenopathy. His serum contained a monoclonal protein of the IgM type, and biopsies from papular skin lesions revealed scleromyxedema-like features. The unusual association of this kind of cutaneous lesion with angioimmunoblastic lymphadenopathy and a monoclonal IgM is discussed. PMID- 6853121 TI - Chemotherapeutic activity of rifampicin on leishmanial amastigotes and promastigotes in vitro. AB - Rifampicin reduced the in vitro growth of Leishmania tropica major promastigotes and amastigotes: 100 micrograms/ml reducing the growth of amastigotes on Day 2 and 250 to 500 micrograms/ml reducing the growth of promastigotes on Day 1. A distinct effect of solvents was noted. Methanol, dimethylsulfoxide and Tween 80 appeared to increase drug effectiveness. Pretreatment of L. tropica major promastigotes with 200 micrograms/ml rifampicin for 3 days had no effect on either macrophage engulfment of the treated promastigotes or their transformation into amastigotes. Intracellular amastigotes treated for only 3 days recovered and 8-day treatment with 100 micrograms/ml rifampicin was insufficient to totally eliminate the amastigotes. The promastigotes of different strains of Leishmania showed different sensitivities to rifampicin, L. aethiopica being more sensitive than L. donovani, L. tropica minor and L. tropica major. PMID- 6853122 TI - Electrocardiographic patterns in diabetics without clinical ischemic heart disease. AB - Resting ECG patterns were studied in 42 young diabetic patients and in 40 matched control subjects. There was no clinical ischemic heart disease in either group. Discriminant analysis showed significant differences between the two groups: diabetics typically had a higher heart rate, a leftward frontal QRS axis, a prolonged corrected QT interval and ST segment and T wave changes. Using resting ECG variables we were able to correctly classify 62 (75%) of the 82 patients studied. The findings support the existence of a nonischemic diabetic cardiopathy. PMID- 6853123 TI - Prepatellar bursitis due to anaerobic Streptococcus. AB - A previously healthy 65-yr-old man developed clinical signs of prepatellar bursitis. Aerobic cultures from fluid aspirated from the inflamed prepatellar bursa were negative. Direct microscopic examination of the fluid showed gram positive cocci, and anaerobic cultures grew Streptococcus hemalyticus group A. The bacterial etiology of bursitis has recently been emphasized in the literature; in most of our cases Staphylococcus was responsible. Negative cultures were next in frequency. Other microorganisms may indeed be responsible for prepatellar bursitis and should be sought where aerobic cultures are negative. PMID- 6853124 TI - Reactivated musculoskeletal tuberculosis with concomitant asymptomatic genitourinary infection. AB - A case is presented of local recurrence of tuberculosis after successful hip arthrodesis, in a patient subsequently found to have active asymptomatic renal tuberculosis. The possibility of hematogenous spread is raised, and the importance of thorough genitourinary evaluation in cases of reactivated skeletal tuberculosis is discussed. PMID- 6853125 TI - Acute oral management of hypertension: blood pressure response to prazosin and nifedipine. PMID- 6853126 TI - Plasma norepinephrine levels in normotensive and hypertensive subjects. PMID- 6853127 TI - Abdominal pregnancy following hysterectomy. PMID- 6853128 TI - Normal values of urinary-free cortisol in children and adolescents. PMID- 6853129 TI - Gluten-sensitive enteropathy: value of oral triglyceride loading test in the follow-up of patients on gluten challenge. AB - Oral triglyceride (TG) loading tests were performed in 31 patients with gluten sensitive enteropathy (GSE) upon gluten challenge, and the results were compared with the mucosal histology. Of 19 prechallenge tests, 16 were in the normal range previously established in this laboratory (2-h postcibal plasma TG rise greater than or equal to 55 mg/dl) although values were lower (76 +/- 38 mg/dl, mean +/- SD) than those of healthy age-matched controls (116 +/- 34 mg/dl). Postchallenge tests performed in 29 patients (both symptomatic and asymptomatic) were all pathologic (postcibal TG rise 9 +/- 18 mg/dl). Three tests performed in two patients in whom GSE was ultimately not confirmed remained normal (postcibal TG rise 82 +/- 21 mg/dl) during a 24-mo follow-up. A significant correlation was demonstrated between the TG loading test and the mucosal pathology. The test is useful in the follow-up of patients of gluten challenge and in directing the postchallenge biopsy. PMID- 6853130 TI - Hepatic lesions in patients on anabolic androgenic therapy. AB - The histopathological changes in the livers of 11 patients treated with alkylated and nonalkylated anabolic androgenic steroids are presented. The histological changes in the liver included: proliferation of the bile ducts with or without cystic dilatation (9/11), peliosis (8/11), atypical hyperplasia of liver cells (2/11), and tumors (3/11). The latter included one case of cholangiocarcinoma, one of hepatocellular carcinoma, and one of combined cholangiocellular and hepatocellular carcinoma. The pathological changes in the liver in this series suggest a possible relationship between anabolic androgenic steroids and bile duct proliferation and/or cholangiocarcinoma. PMID- 6853133 TI - Subphrenic abscess following percutaneous liver needle biopsy. AB - A 65-yr-old diabetic woman had air in the bile ducts after a choledochoduodenostomy. Following a liver needle biopsy (LNB) she developed a subphrenic abscess with an air-fluid level. Presence of air in the bile ducts in a diabetic patient is a predisposing factor for infection and a contraindication for LNB. PMID- 6853131 TI - Parathyroid hormone secretion and responsiveness to parathyroid hormone in primary hypomagnesemia. AB - Parathyroid function was studied in two infant sisters with primary hypomagnesemia while they were both hypomagnesemic and hypocalcemic. In one of the infants, plasma immunoreactive parathyroid hormone (iPTH) was elevated, the calcemic response to exogenous parathyroid hormone (PTH) was absent, and the phosphaturic response was normal. Restoration of serum magnesium with i.v. magnesium corrected the hypocalcemia, with no further rise of plasma iPTH. In the other infant, plasma iPTH was undetectable, and exogenous PTH produced both phosphaturic and calcemic responses. Normalization of serum magnesium with i.v. magnesium resulted in a prompt release of endogenous PTH and correction of the hypocalcemia. These findings suggest that, in the first patient, hypocalcemia was associated with lack of response of the bone to both endogenous and exogenous PTH, while in the second patient, hypocalcemia was associated with inhibition of PTH release and a normal calcemic response to exogenous PTH. The factors that determine whether magnesium deficiency will result in inhibition of PTH release, in a lack of response of the bone to endogenous and exogenous PTH, or both, remain to be clarified. PMID- 6853132 TI - Hydromediastinum and hydrothorax in the neonate with central vein catheterization. AB - A near fatal complication of central venous catheterization in a newborn infant is reported. Five days after insertion, the catheter tip eroded through the wall of the vein, causing hydromediastinum and hydrothorax with acute circulatory and respiratory distress. The diagnosis was confirmed by noting that the tip of the catheter had become curved downwards, by aspirating slightly bloodstained fluid from the pleural space and by injecting radio-opaque dye through the catheter. Recovery followed removal of the catheter, intercostal drainage, intubation and positive pressure respiration. The erosion of the vein may have been brought about by the location of the catheter tip at the junction of the left subclavian and innominate veins--a less than optimal position. The factors causing this complication are discussed. Recommendations are made about the type of catheter, its appropriate placement and maintenance. The diagnosis and management are surveyed. PMID- 6853134 TI - Inhibitory effect of synovial fluid on mitogen-induced blast transformation. PMID- 6853135 TI - Systolic fluttering of the tricuspid valve in a patient with high interventricular-septal defect. PMID- 6853136 TI - Effect of intracranial pressure changes on the fetal heart rate. Study of a hydrocephalic fetus. PMID- 6853137 TI - Acetylator phenotype in rheumatoid arthritis. PMID- 6853138 TI - A simple device for inflicting standard burns in mice. PMID- 6853139 TI - Incidence of hepatitis B surface antigen and antibody in blood donors and in patients with liver diseases and leprosy in Eastern India. PMID- 6853140 TI - Calciuric effect of probenecid in gouty patients. PMID- 6853141 TI - Legionnaires' Disease in Israel: serological evidence of childhood infection. PMID- 6853142 TI - Cardiovascular disease in Israel. PMID- 6853143 TI - Effect of nonsteroidal antiinflammatory drugs on human monocyte chemotaxis in vitro. AB - Human blood monocytes were incubated in vitro with ibuprofen, naproxen, and indomethacin at clinically relevant concentrations and were subsequently tested for chemotactic responsiveness in a modified Boyden chamber with zymosan activated serum as the chemotactic agent. Ibuprofen and naproxen inhibited monocyte chemotaxis at concentrations above 25 micrograms/ml. The inhibition was dose dependent and a 50% inhibition (ID50) was seen at 70 and 62 micrograms/ml, respectively. Indomethacin inhibited monocyte chemotaxis at concentrations above 1 microgram/ml, but never reached ID50. It is concluded that the suppression of blood monocyte migration (ID50) is not a general property of all nonsteroidal antiinflammatory drugs. PMID- 6853144 TI - Dose-dependent responses of murine pluripotent stem cells and myeloid and erythroid progenitor cells following administration of the immunomodulating agent glucan. AB - The hemopoietic effects produced by six different doses of a commercially available glucan preparation were investigated. C3H/HeN mice were intravenously injected with either 0.1, 0.4, 0.8, 1.2, 1.6, or 2.0 mg of glucan. Five days later, total nucleated cellularity, pluripotent stem cells (CFU-s), granulocyte macrophage colony-forming cells (GM-CFC), macrophage colony-forming cells (M CFC), and erythroid burst- and colony-forming cells (BFU-e and CFU-e) were assayed in the bone marrow and spleen. Neither femoral cellularity nor GM-CFC content was altered by any of the glucan doses tested. By contrast, bone marrow CFU-s content increased and CFU-e and BFU-e contents decreased with increasing glucan doses. In the spleen, all aspects of hemopoiesis (i.e., cellularity, CFU s, GM-CFC, M-CFC, and CFU-e) increased after glucan administration. The degree of splenic enhancement was directly correlated with the dose of glucan administered. PMID- 6853145 TI - The psychiatric will of Dr. Szasz. PMID- 6853146 TI - The least worst death. PMID- 6853147 TI - Barney Clark's key. PMID- 6853148 TI - Consent to the artificial heart: the lion and the crocodiles. PMID- 6853149 TI - The real & alleged problems of utilitarianism. PMID- 6853150 TI - Spare embryos: a Jewish view. PMID- 6853151 TI - At the end of life, "what if"? PMID- 6853152 TI - Prison hunger strikes: the view from inside. PMID- 6853153 TI - Migraine patients exhibit abnormalities in the visual evoked potential. PMID- 6853154 TI - Medical evaluation of migraineurs: review of the value of laboratory and radiologic tests. PMID- 6853155 TI - Acupuncture treatment of chronic facial pain--a controlled cross-over trial. PMID- 6853156 TI - A comparison of MMPI personality data and frontalis electromyographic readings in migraine and combination headache patients. PMID- 6853157 TI - A comparison of MMPI personality data and frontalis electromyographic readings in two groups of daily headache sufferers. PMID- 6853158 TI - Neck musculature and EMG biofeedback in treatment of muscle contraction headache. PMID- 6853159 TI - [External corticoid therapy: continuous versus discontinuous use]. AB - Taking into account the factors of local bioavailability, the phenomenon of tachyphylaxis and biorhythm as well as the skin and the internal production of cortisone, side effects can be reduced by the intermittent use of topical corticoid preparations and reduced dosage. Atopic dermatitis is taken as an example to explain some corticoid-saving measures during long-term treatment. PMID- 6853160 TI - [Roentgen soft radiotherapy of eyelid basaliomas]. AB - Reported are the results of soft X-ray therapy of 237 patients with 245 basal cell carcinomas of the eye lids. The medial angle of the eye and the lower eye lid were mostly affected. Histologically in 62% solid basal cell carcinomas and in 14% sclerodermiform basal cell carcinomas could be diagnostized. By soft X-ray therapy 92% of all basal cell carcinomas could be healed. All recurrences were observed in the first 2 years following radiotherapy. They were relatively more frequent at the lateral angle of the eye. Recurrences occurred in 4.9% of female patients, and in 13.0% of male patients. In two thirds they may be due to elected conditions of radiotherapy; in one third the cause of recurrences are not known. The cosmetic result was good or excellent in 95% of patients during the first 2 years following radiotherapy. After more than 5 years this rate declined to 65%. A good functional result could be obtained in 88% of the patients. PMID- 6853161 TI - [Gianotti-Crosti syndrome as a result of prenatal hepatitis B virus infection]. PMID- 6853162 TI - [Dermabrasion of an extensive congenital pigmented nevus in late infancy]. PMID- 6853163 TI - [Persistent papular acantholytic dermatosis]. PMID- 6853164 TI - [Normolipemic xanthoma planum and its associated syndromes]. AB - The clinical feature of xanthoma is related to syndromes with quite different dignity. The clinical picture of diffuse plane normolipemic xanthoma represents a benign skin disease while the form of so-called plane xanthoma is frequently associated with lymphoproliferative processes (paraproteinemia, myeloma, lymphoma, leukemia). In this paper these principal points are stressed on the base of own cases and by survey of literature. PMID- 6853165 TI - [Merkel cell carcinoma (trabecular carcinoma) of the skin]. AB - The Merkel cell carcinoma was first designated some years ago by the descriptive term trabecular carcinoma. Both names refer to a skin tumor occurring in elderly patients. This is another example where ultrastructural differentiating criteria are necessary for a definite diagnosis i.e., identification of so-called neurosecretory-like granules by electron microscopy. We report clinical, histological, ultrastructural, and histogenetic aspects of such a disease in a woman suffering from a metastasizing Merkel cell carcinoma. PMID- 6853166 TI - [Supidimide, a non-teratogenic thalidomide analog for the treatment of leprosy reaction?]. PMID- 6853167 TI - [Soft-roentgen radiotherapy of induratio penis plastica]. PMID- 6853168 TI - [PUPPP dermatosis (pruritic urticarial papules and plaques of pregnancy]. PMID- 6853169 TI - Transfer of 226Ra, 210Pb and uranium from soil to garden produce: assessment of risk. AB - A study of gardens contaminated by uranium processing wastes was carried out in the town of Port Hope, Ontario, during the summer of 1976. Concentrations of 226Ra, 210Pb, and total uranium were measured in soils and in garden produce. Highest concentrations were found in root and stem vegetables and, for radium, also in leafy vegetables. Fruit generally showed the lowest values. Uptake was consistent with a linear dependence on soil concentration. Mean concentration factors of 1.1 X 10(-3), 0.37 X 10(-3), and 0.075 X 10(-3) were obtained for 226Ra, 210Pb, and uranium, respectively. The highest estimated dose to an individual who ingested produce from a contaminated garden was 68 mrem/yr to bone surface from 226Ra. The implications of these findings for other communities affected by nuclear fuel-cycle operations are discussed. PMID- 6853171 TI - Diagnostic X-ray shielding design based on an empirical model of photon attenuation. AB - A series of nomograms that simplify determination of diagnostic X-ray shielding requirements with lead are presented. All recommendations of the NCRP, except that to "add one half value layer" in determining secondary barriers, were followed in the production of these curves. For secondary barriers, the shielding required to reduce the weekly exposure to the applicable MPD has been determined. This eliminates the over-shielding inherent in the "add one HVL" approximation and allows a variety of more cost effective materials to be considered for secondary barriers. PMID- 6853170 TI - Occupational exposure to dial painters and assemblers of radioluminous timepieces. AB - An evaluation of available personnel monitoring data and radium body burden records of dial painters handling an annual average of 1.5 Ci of radium indicates that they received an average of about 2 rem/person whole body exposure, 3 rem to the lungs from radon inhalation and 0.2 rad to the bone from radium body burdens. Among groups of similar workers handling tritium in Texas plants, the highest occupational exposures were about 160 mrem annually per person received by refinishers of tritium dial timepieces and back-lit watch assemblers. Based upon scenarios of exposures to 147Pm, repairers of timepieces containing 147Pm receive about 4.4 X 10(-4) mrem/person/yr whole body dose equivalent. The amounts that they process are in the microcurie range. Although the trend is away from the use of radium as a luminizing activator, there are indications that it is still used in timepieces even as tritium and 147Pm are increasingly being used for this purpose. PMID- 6853172 TI - Experimental studies of laser thermal retinal injury. AB - In damage tests conducted on rabbit and monkey eyes, the threshold values for retinal damage resulting from different laser radiation were determined. The reproduction of the "worst-case" situation was ensured by the test apparatus. All physical parameters, such as power/energy, exposure time, and retinal spot, were carefully controlled. Probit analysis showed a very precise determination of the threshold values based on ophthalmoscopical visibility. The attempt of a simple physical interpretation of the thresholds leads to contradictions in major points, so a detailed calculation of damage functions and thermal model calculations are necessary. PMID- 6853173 TI - An evaluation of soil sampling for 137Cs using various field-sampling volumes. AB - The sediments from a liquid effluent receiving area at the Los Alamos National Laboratory and soils from an intensive study area in the fallout pathway of Trinity were sampled for 137Cs using 25-, 500-, 2500- and 12,500-cm3 field sampling volumes. A highly replicated sampling program was used to determine mean concentrations and inventories of 137Cs at each site, as well as estimates of spatial, aliquoting, and counting variance components of the radionuclide data. The sampling methods were also analyzed as a function of soil size fractions collected in each field sampling volume and of the total cost of the program for a given variation in the radionuclide survey results. Coefficients of variation (CV) of 137Cs inventory estimates ranged from 0.063 to 0.14 for Mortandad Canyon sediments, whereas CV values for Trinity soils were observed from 0.38 to 0.57. Spatial variance components of 137Cs concentration data were usually found to be larger than either the aliquoting or counting variance estimates and were inversely related to field sampling volume at the Trinity intensive site. Subsequent optimization studies of the sampling schemes demonstrated that each aliquot should be counted once, and that only 2-4 aliquots out of as many as 30 collected need be assayed for 137Cs. The optimization studies showed that as sample costs increased to 45 man-hours of labor per sample, the variance of the mean 137Cs concentration decreased dramatically, but decreased very little with additional labor. PMID- 6853174 TI - Errors in isocenter of Picker C-9000 teletherapeutic unit. PMID- 6853175 TI - Shielding device for brachytherapy sources. PMID- 6853176 TI - Mucosal structure and radon in head carcinoma dosimetry. AB - (1) The location of the epithelial cells implied by ICRP Publication 26 is incorrect. It leads to dose rates from bone and to dose rate ratios which are much too high. (2) Epithelial thickness has little effect on the ratio of dose rates. (3) The dose rate ratio is strongly dependent on the thickness of the lamina propria and would depend strongly on the thickness of the cytoplasm layer if direct nuclear hits were required for cell transformation. (4) Based on the limited data available for lamina propria and epithelial thicknesses, the airspaces would probably be the dominant source of dose in the mastoid air cells if the ratio of radioactivity levels in bone and airspace were no more than 1 l./g. This would be true whether targets were spread throughout the whole cell or confined to the nucleus alone. (5) The airspaces would probably be the dominant source of dose in the paranasal sinuses if the ratio of radioactivity levels were no more than 1 l./g. and targets were spread throughout the cell. If targets were confined to the nucleus, no conclusion could be drawn due to the lack of information on the thickness of the nucleus-free region of cytoplasm. (6) Four quantities require further study for a better understanding of the importance of radon: (a) the airspace radon concentration, (b) the specific activity of bone adjacent to the mucous membrane, (c) the thickness of the nucleus-free region of cytoplasm, and (d) the thickness of the lamina propria. PMID- 6853177 TI - Effects of recent neptunium studies on high-level waste hazard assessments. PMID- 6853178 TI - A new technique for recovery of Insta-Gel used in tritium counting. PMID- 6853179 TI - Informing the public. PMID- 6853180 TI - Uncertainty and radiation risk. PMID- 6853181 TI - Projected responses of dosimeters to noble gases in the environment. PMID- 6853182 TI - Guest editorial: concern over recent use of the ALARA philosophy. PMID- 6853183 TI - An analysis of health physics employee recruitment activity: 1977-82. AB - Monthly listings of the Health Physics Society Placement Center from 8/77 to 6/82 were tabulated and analyzed for the temporal and regional trends in various areas of health physics. Almost half of listing employers advertised only a single position in 5 yr. Civilian nuclear power and its associated industrial support accounted for approximately half of the total positions available. Total annual employer and position listings increased sharply several months after the Three Mile Island incident. Activity has remained elevated since that time, and appears to have reached a plateau within the past year. A wide variety of professional positions were advertised in each region of the U.S. Recent data on numbers of graduating health physicists, plus a reasonable estimate of the number of new positions made available in recent years, imply current regional shortages of adequately trained personnel, particularly in the Far West, Rocky Mountain and South Central regions, but possibly also nationwide. PMID- 6853184 TI - An age-dependent model for the kinetics of uptake and removal of radionuclides from the G.I. tract. AB - An age-dependent model for the transit of radionuclides through the four segments of the G.I. tract is presented. In addition, a compartmental model of the absorption of a large class of radionuclides from the small intestinal contents to the bloodstream is developed. The model includes uptake into the epithelial cells of the gut wall, from which material is lost either by sloughing of cells or passing into the bloodstream. Relevant empirical data are analyzed to provide estimates of values to be assigned to parameters appearing in the model. A marked age dependence in uptake is noted, but this uptake appears to return to adult values at approximately one year in humans. It is suggested that the processes giving rise to the age dependence are brought on by the changing dietary habits of the neonate. Pertinent equations are presented for incorporating future experimental data into the predictions of the model. PMID- 6853186 TI - Technetium and uranium: sorption by and plant uptake from peat and sand. AB - The objectives of this study were to compare the effects of technetium and uranium on the yield and uptake, and to identify the organ of accumulation, of an edible leafy vegetable growing in sandy and peaty soils. In sand, where the soil's sorption capacity is negligible, technetium uptake is four orders of magnitude higher than from peat, suggesting no plant mediation of uptake and thus a constant concentration factor (greater than 50) in an oxidizing environment where technetium is continuously supplied. The technetium is predominantly translocated to the shoots. When soil fixation occurs, as in peat, this becomes the controlling factor in the plant uptake of technetium. In the case of uranium, plant mediation is more significant. Uranium uptake by Swiss chard is up to 80 times higher from sand than from peat. The uranium is restricted to the root system and may only be precipitated on the outer root membrane and may not accumulate in the roots. PMID- 6853185 TI - Metabolism of plutonium introduced as Tri-N-Butylphosphate complex in the rat and removal attempts by DTPA. AB - The metabolism of plutonium introduced as the Pu-Tri-N-Butylphosphate complex (Pu TBP) was studied in rats after inhalation, injection and ingestion. Early translocation and distribution of 239Pu in organs for 30-400 days after inhalation exposure are presented. The tracheobronchial clearance was impaired at early times, followed from about one week by clearance from the deep lung as characterized by a half time of 100 days. Skeleton was the main organ for deposition of the transferable fraction. The bone burden reached a plateau value of 10% of Initial Lung Burden (ILB) at 50 days after inhalation, while retention in liver reached 2% of ILB at 50 days and decreased to 0.3% by 1 yr after inhalation. Thirty days after intramuscular injection, translocated plutonium (15% of injected activity) resulted in a skeletal deposit that was 17.5 times higher than the deposit in the liver. By both routes, inhalation and intramuscular injection, 239Pu was transported in the blood as a Pu-transferrin complex. However, therapy with 30 mumol . kg-1 DTPA was ineffective. This result, together with the magnitude of the skeletal deposit observed, indicate that Pu TBP follows a specific metabolic pathway that results in a Pu-transferrin complex that is more stable than the complexes described after Pu nitrate or citrate contamination. Lastly, absorption of Pu-TBP from the gut was poor, reaching 0.015% of the Pu given by gavage, a value not significantly different from the values assumed by ICRP 30 for class W compounds. PMID- 6853187 TI - The efficacy of Zn DTPA for the decorporation of 238Pu-TBP injected into the lungs of hamsters. PMID- 6853188 TI - Re-identification of 232Th content and relative radioactivity measurements in a number of imported gas mantles. PMID- 6853189 TI - Computation of radionuclide particulate finite area fugitive source strengths. PMID- 6853190 TI - Numerical analysis of burial ground geography. PMID- 6853192 TI - Calculating the gastrointestinal tract activity following the inhalation of a radioactive aerosol. PMID- 6853191 TI - Comparative behavior of 99Tc, 129I, 127I and 137Cs in the environment adjacent to a fuels reprocessing facility. PMID- 6853193 TI - Incorporation of tritium into organic matter of terrestrial plants exposed to tritiated-water releases of short duration. PMID- 6853194 TI - Estimated alpha-dose to the epithelial and basal cells of the bronchial tree from acute radioaerosol exposure. PMID- 6853196 TI - A linear X-ray sensor for quality assurance measurements. PMID- 6853195 TI - Quantitative determination of the low-dose radiation-induced teratogenic effect during embryonic growth. PMID- 6853197 TI - An alpha-beta-gamma spectrometer for directing decontamination of soils. PMID- 6853198 TI - A rapid method for the determination of americium-curium, plutonium and thorium in biological and environmental samples. PMID- 6853200 TI - Comments on "Environmental power frequency magnetic fields and suicide". PMID- 6853199 TI - Dose revision for A-bomb survivors and the question of fallout contribution. PMID- 6853201 TI - Positioning of personnel monitoring badges. PMID- 6853204 TI - Third annual conference of the Canadian Radiation Protection Association. 4-6 May 1982 Vancouver, British Columbia, Canada. Abstracts of papers presented. PMID- 6853202 TI - Comments on "Difficulties in calculating spectrum-averaged values of neutron dose equivalent". PMID- 6853203 TI - Comment on "An evaluation of working level measurements using a generalized Kusnetz method" and "Evaluation and modification of working level measurement methods". PMID- 6853205 TI - [Physiopathology and classification of soft tissue lesion]. PMID- 6853206 TI - [After care guidelines in fractures with severe soft tissue lesions]. PMID- 6853207 TI - [Early complications following fractures with soft tissue lesions]. PMID- 6853208 TI - [Plastic surgery measures in large soft tissue defects]. PMID- 6853210 TI - [Treatment results in open fractures, aspects of antibiotic therapy]. PMID- 6853209 TI - [Replantation surgery--indications and limits]. PMID- 6853211 TI - [Treatment of closed fractures with soft tissue lesions]. PMID- 6853212 TI - [Surgical care of tibial fractures with soft tissue lesions]. PMID- 6853213 TI - [Compartment syndrome. Etiology--physiopathology--localization--diagnosis- therapy]. PMID- 6853214 TI - [Joint transfixation in joint injuries with severe soft tissue lesions]. PMID- 6853216 TI - A Swedish method of fingerprint classification. PMID- 6853217 TI - The mutagenic effect of methyl violet in phage T4D. PMID- 6853215 TI - Chromosome aberrations and micronuclei in bone marrow cells and peripheral blood lymphocytes in humans exposed to ethylene oxide. PMID- 6853218 TI - Statistical aspects of the design of biological tests for the detection of low genotoxic activity. PMID- 6853219 TI - Effects of inorganic metal salts on chromosome length in human lymphocytes. PMID- 6853221 TI - Abstracts: Immunocytochemistry Club meeting, London, 15th March 1983. PMID- 6853220 TI - Sister chromatid exchanges and structural chromosome aberrations in relation to smoking in 91 individuals. PMID- 6853224 TI - Sensitivity to light of solutions of phenazine methosulphate. PMID- 6853223 TI - Correlation of lymphocyte beta-glucuronidase and N-acetyl-beta-glucosaminidase with E-rosette formation. PMID- 6853225 TI - [Significance of ERA for differentiating hearing disorders of different origins]. AB - The reliability on audiometric findings in hearing disorders of different genesis has been considerably improved by the ERA. By no means, the ERA can replace the conventional hearing tests, rather it is an additional technique of examination. Apparently it does not reveal specific findings of psychogenic hearing disorders unless the prolongation of the cortical response as repeatedly seen by us. In case of aggravation ERA renders us possible to detect the kind of hearing defects and the actual threshold - e.g. with respect to high frequency range by brain stem responses, for 500 and 1,000 Hz according to the cortical responses. The neural hearing impairment caused by tumours always exhibits extremely prolonged latencies even at high intensities, eventually concomitant with a response threshold elevated versus the subjective threshold. These reactions, above all, become apparent in the brain stem rather than in the cortex. In contrast to this the sensoric hearing disorders the ERA elucidates even objectively the recruitment: normal latencies at high intensities. The latency of the objective response, thus, corresponds to the sound stimulus is perceived loud, and it is long for stimuli perceived relatively low - even in spite of great intensity. Comprising the ERA the quote of audiometric failures in excluding an acoustic neuroma is reduced to a minimum. PMID- 6853222 TI - A microscope-based flow cytophotometer. AB - By means of a new flow chamber, a standard fluorescence microscope with Epi illumination and 100 W mercury arc excitation has been turned into a flow cytophotometer combining high resolution and sensitivity with simplicity of operation. In the flow chamber, cells are passed in a narrow stream through the microscope focus carried by a laminar flow of water running on the open surface of a cover glass which is coupled to the oil immersion microscope objective. Two spectral components of the fluorescence, for example, resulting from specific staining of two different cellular constituents with different dyes, can be measured simultaneously in separate channels so as to produce three-dimensional histograms. The scattered light of the cells is detected in dark field by a second microscope situated opposite the primary objective. Scattered light detection is integrating with regard to scattering angle from 0 degree to 90 degrees. Hence, diffraction pattern effects are eliminated and the light scatter signal is approximately proportional to cell dry weight. The Epi illumination, which implies that excitation and fluorescence collection are parfocal, greatly simplifies instrument adjustment, which is further facilitated by the fact that the cell stream can be viewed at high magnification. Cell measuring time is about 3 microseconds which implies a measuring rate of 3 x 10(3) cells/s at 1% coincidence rate. Sensitivity is sufficient for measuring the DNA content of bacteria (that is, approximately 5 x 10(-15) g/cell) with a coefficient of variance (CV) of about 6%. CV less than 1% is achieved for DNA histograms of mammalian cells. A 5 W argon laser as excitation source facilitates slit scan analysis and increases the sensitivity and measuring rate by one to two orders of magnitude. PMID- 6853226 TI - [Hearing and equilibrium disorders in patients with neurosyphilis]. AB - 83 patients with neurosyphilis and 12 patients with latent syphilis underwent a cochleovestibular examination. Pathological changes were present in 54% of the patients with neurosyphilis. In the group of patients with latent syphilis functional changes could only be found in 25% of the patients. The greatest number of hearing disturbances occurred in persons suffering from general paresis, 65% were affected. Usually damage occurred in both ears. Specific topical diagnosis was often not possible although the results of the stapedial reflex indicated that peripheral cochlear lesions were present. In particular damage in the level of the high frequencies seemed to be prevalent. Disturbances of the vestibular system occurred in 25% of neurosyphilis patients. Most frequently lesions occurred in patients with cerebrospinal syphilis (40%). The comparison of subjective and objective symptoms of the vestibular system were very similar in most groups. As for the results presented it is suggested that a serological treponemal test should be undertaken in patients with non-specific disturbances of the vestibulo-cochlear system. PMID- 6853227 TI - [Neuro-otologic findings in the Wernicke-Korsakoff syndrome]. AB - The Wernicke-Korsakoff syndrome is induced by thiamine deficiency. It occurs mainly in subjects with chronic alcoholism. It begins with an acute phase (Wernicke's encephalopathy) and changes to a chronic phase, which is characterized by a symptomatology varying from subclinical findings to a fully developed Korsakoff psychosis. We examined otoneurologically eight patients with Wernicke-Korsakoff syndrome. The examination included: clinical status, caloric stimulation, optokinetic nystagmus, pure tone audiogram (air- and bone conduction), speech audiogram, and brain-stem auditory evoked potentials. The typical findings of the chronic phase are: gaze nystagmus and reduced gain of the optokinetic nystagmus. In five of seven patients OK gain was reduced by more than two standard-deviations. The other examinations including brain-stem potentials did not reveal any specific findings. The symptomatology of the acute phase is well known: nystagmus (mostly lateral gaze nystagmus) and reduced by caloric responses. Early diagnosis of a Wernicke-Korsakoff syndrome is of great importance since its treatment is simple and efficient. The results of a thorough neuro-otologic examination are of considerable diagnostic value, particularly during the chronic phase of the disease. PMID- 6853229 TI - [Differential diagnostic reflections on sudden deafness: rupture of the round window membrane]. AB - The rupture of the round window membrane has been the origin of sudden deafness in two cases that are described in this presentation. We are able to verify the rupture of the round window membrane before surgery by using differential diagnostic criteria, though there existed only relative slight hearing losses of about 40 dB. After surgery we found normal hearing in one case and a decreased hearing loss in the other. Vestibular symptoms have been leading to the diagnosis in both cases and the middle ear effusion in one case. PMID- 6853230 TI - [Suggestion therapy of sudden deafness]. AB - The author's method of suggestion therapy can lead to a total remission of sudden deafness or to a favourable precondition for later infusion therapy (Onkovertin with Sorbit + Trental). Several examples are quoted to show that an improvement of hearing of 20 DB can be attained within 30 min over different frequencies. PMID- 6853228 TI - [Therapy of acute hearing loss]. AB - In the treatment of sudden deafness there is no significant difference between Rheomacrodex i.v., Procain i.v., Dusodril i.v., Ronicol i.v., Complamin i.v. or anaesthesia of Ganglion stellatum. We show that good outcomes are attributed to spontaneous recovery. The so called "good effect of early therapy" in sudden deafness is the result of selection of spontaneous recovery. The prognosis of sudden deafness with according vestibular symptoms is less favourable. A definite clarifying of spontaneous recovery needs a prospective randomised double blind study. PMID- 6853232 TI - Adenocarcinoma of the prostate gland. PMID- 6853231 TI - [Pathogenesis and clinical aspects of Meniere disease. A study of 739 patients]. AB - The symptomatology of Menier's disease is delineated by means of 739 cases observed in a period of 25 years. The dilation of the endolymphatic space accompanied by a temporary mixture of endolymph and perilymph substantiates the idea of a nosologic entity as well as the interpretation of the symptoms: vertigo, fluctuating hearing loss, tinnitus, and fullness of the ear. The medical treatment by infusions of Rheomacrodex, vasodilatory substances, antivertiginosa, and psychosedatives is unsatisfying just as surgical treatment by saccotomy, sacculotomy, labyrinthectomy, and other operations at the inner ear. Local application of gentamycin into the middle ear can produce good results; in cases of failure the neurectomy should be taken in consideration. The neurectomy eliminates vertigo, but there remains the need of central compensation and the possibility of appearance of Meniere's disease on the other ear. PMID- 6853233 TI - Primary transitional cell carcinoma of the prostate: report of two cases. PMID- 6853234 TI - Endometrial carcinoma of the prostatic utricle: report of a case. PMID- 6853235 TI - Renal cell carcinoma: a series review. PMID- 6853236 TI - Primary renal leiomyosarcoma: report of two cases. PMID- 6853237 TI - Simultaneous renal cell carcinoma, adrenal adenoma, and carcinoma of the esophagus: report of a case. PMID- 6853239 TI - Study of hematuria in a general urology practice. PMID- 6853238 TI - Solitary renal adenoma in apolycystic kidney: a unique case. PMID- 6853240 TI - Leiomyoma of the urinary bladder associated with in situ transitional cell carcinoma: report of a case and review of the literature. PMID- 6853241 TI - Incidence, etiology, diagnosis, and treatment of recurrent urolithiasis: results of a 5-year study at an osteopathic referral center. PMID- 6853242 TI - Coagulum pyelolithotomy. PMID- 6853243 TI - Impotence. PMID- 6853244 TI - Evaluation and treatment of impotence using the inflatable penile prosthesis. PMID- 6853246 TI - Traumatic amputation of the glans penis: report of a case. PMID- 6853245 TI - Ureteral obstruction secondary to metastatic breast carcinoma: report of a case. PMID- 6853247 TI - Female urethral syndrome: treatment by internal urethrotomy. PMID- 6853248 TI - Surgical correction of hydronephrosis: report of a case. PMID- 6853250 TI - RTOG Phase I study on fast neutron teletherapy for squamous cell carcinoma of the esophagus. AB - From August, 1977, through January, 1981, the Radiation Therapy Oncology Group sponsored a Phase I study (RTOG 77-09) on the use of fast neutrons for treating inoperable squamous cell carcinomas of the esophagus. A total of 39 evaluable patients were treated with curative intent using either fast neutrons alone or in combination with low LET irradiation as part of a mixed beam fractionation scheme. Actuarial survival curves are presented for both the "neutrons alone" and the "mixed beam" treatment groups. There was no significant survival difference between these groups of patients. The projected survival at two years is less than 10%, which is comparable with megavoltage photon results for an unselected series of patients. The size of the primary lesion and the initial Karnofsky performance status were found to be the most important prognostic indications for prolonged survival. Sixteen of 39 patients were felt to have achieved local clearance of their tumor at some time during their follow-up with the median time until a local recurrence being 17 months. Treatment related complications and patterns of metastatic spread are discussed. In general, it appeared that the response of large tumors to neutron irradiation resulted in necrosis and fistula formation. In many cases this was accompanied by persistent/recurrent tumor within the high dose radiation volume. PMID- 6853252 TI - Radiation therapy in craniopharyngiomas. AB - Eighteen patients with cranipharyngiomas, who were studied and treated between 1970-1980, are presented. Each patient was treated with surgery and radiotherapy (50-60 Gy). Six patients were treated with radiotherapy because the tumor recurred after surgery. An extensive representation of the clinical symptomatology typical of this tumor was seen. In 3 patients an improvement in visual symptoms was demonstrated; in 11 the headaches and vomiting were controlled after treatment. The 18 treated patients are still alive without evidence of progression of the tumor, after a period of 2 to 12 years. Our experience supports the contention that conservative surgery coupled with radical radiotherapy remains the treatment of choice for the craniopharyngioma. PMID- 6853251 TI - Cancer of the urinary bladder category T2, T3, (NxMo) treated by interstitial radium implant: second report. AB - Three-hundred-twenty-eight patients with bladder cancer category T2NxMo and 63 patients with category T3NxMo have been treated by 3 times 3.5 Gy external irradiation followed by a radium implant. Overall 5- and 10-year survival in the T2 category are 56%. In the T3 category they are 39% and 13%, respectively. The intercurrent death (i.e. without evidence of bladder malignancy) corrected actuarial survival percentage in the T2 category is 75% at 5 years and 69% at 10 years. The corresponding percentages in the T3 category are 62% and 59%. Prognosis is worsened by the following factors: more than 1 diagnostic transurethral resection, a pathological intravenous pyelography, non-papillary structure and poor degree of differentiation of the growth. Prognosis in category T3, as compared with category T2, is worse because of the prevalence of bad prognosticators in this T3 category. Therapeutic adaptation to these findings might improve prognosis in the future. PMID- 6853249 TI - Pretreatment prognostic factors in carcinoma of the uterine cervix: a multivariable analysis of the effect of age, stage, histology and blood counts on survival. AB - From January, 1953 through December, 1977, 910 previously untreated patients with invasive carcinoma of the uterine cervix (Stages IB-IVB) were seen at Yale-New Haven Medical Center and affiliated hospitals. An extensive retrospective analysis was undertaken in an attempt to identify prognostically significant pretreatment factors. The patients studied were uniformly staged according to the current FIGO recommendations and the majority of patients had been treated under standardized protocols combining external beam radiation therapy and intracavitary radium. Pretreatment parameters, including prior medical illnesses, gross tumor characteristics, histology, and blood parameters were studied, employing stepwise Cox regression analyses to identify the possible effects of all factors and all two-way interactions among factors on survival, disease-free survival and freedom from local-regional failure, controlling for stage of disease. FIGO stage, patient age at diagnosis, pretreatment neutrophil count and hematocrit, uterine position, prior subtotal hysterectomy, histology, history of diabetes mellitus and number of pregnancies were all found to have prognostic significance. When other factors including stage of disease were controlled for, increased tumor size was associated with decrease disease-free survival and local regional control rates. PMID- 6853253 TI - Cytosar-U (Ara-C) induced changes in mouse jejunal crypt epithelial kinetics and radiosensitivity to gamma rays and fast neutrons. AB - Pretreatment with the S phase specific cytotoxic agent Cytosine Arabinoside (Ara C) protects the intestinal stem cells from gamma radiation injury by nearly tenfold. Studies were undertaken to test whether an altered cell age distribution could account for the reported duration and degree of Ara-C induced protection and to measure the degree of protection from the high energy neutrons of the Fermilab Cancer Treatment Facility. Twelve hours after treatment with Ara-C, B6CF1/ANL mice were exposed to increasing single doses of either 137Cs gamma-rays or neutrons from the Fermilab accelerator, or a split dose of neutrons with intervals of 1, 2, and 3 hours. The number of regenerating microcolonies per jejunal circumference in Ara-C treated and irradiated animals was compared to irradiated controls. Another group of mice was given Ara-C but in the 12-hour interval between Ara-C and irradiation, colcemid was given every 3 hours to continuously block and kill cells in mitosis. The results suggest that Ara-C given 12 hours prior to neutron irradiation protects intestinal stem cells to nearly the same degree as it does from 137Cs gamma-ray damage. Furthermore, the control split-dose recovery ratio to neutron irradiation at 1, 2, or 3 hours was 1.8 and was unchanged 12 hours after Ara-C. Colcemid reduced the crypt cell population to less than half the normal 250 cells per crypt; however, the cell survival curve was unaltered from the survival curve 12 hours after Ara-C. These results suggest that Ara-C recruits intestinal clonogenic stem cells, but inhibits their normal passage through DNA synthesis. These cells, responsible for intestinal mucosal regeneration, appear to be held in a radioresistant portion of the cell cycle for a period of about 10-16 hours after Ara-C. PMID- 6853255 TI - Blood flow and intravascular volume of mammary adenocarcinoma 13726A and normal tissues of rat during and following hyperthermia. AB - The effects of hyperthermia on blood flow and intravascular volume were studied in mammary adenocarcinoma 13762A growing subcutaneously in the leg of Fischer F344 rats. The blood flow was determined using microspheres labelled with 125I, and the blood volume was determined using red blood cells labelled with 51Cr. At the end of heating with water bath at 43.5 degrees C for 1 hour, there was a marked elevation of 51Cr in tumor. The 125I content in tumor also was mildly elevated. Histologically there was a greater number of patent blood vessels per unit area, and they were dilated and hyperemic. In addition, widespread and diffuse hemorrhage could be seen. It appeared, therefore, that the increased 51Cr and 125I label in the tumors immediately after heating was, at least in part, a result of leakage of the labels to extravascular space in addition to possible vasodilation and increased blood flow. At 1 and 5 hours after heating, tumor blood flow was considerably reduced, and at 16 hours both tumor blood flow and blood volume were considerably reduced. Histological examination demonstrated that the tumor blood vessels remained dilated and hyperemic after heating. The effect of heat on blood flow and blood volume in the skin and muscle adjacent to the tumors was also investigated. Blood flow and blood volume in the surrounding normal tissues were significantly elevated at the end of heating. Blood flow was relatively unchanged at 1, 5, and 16 hours after heating, but blood volume was reduced to about one half. These findings indicate that hyperthermia may induce greater damage to vasculature of tumors than normal tissues, and that vascular damage in tumors may take some time to express itself following moderate hyperthermia. PMID- 6853254 TI - Active specific immunotherapy using the immune reaction of a low-dose irradiated tumor tissue. AB - Active specific immunotherapy using the immune reaction of a low-dose irradiated tumor tissue was studied on the transplanted MM46 tumor of female C3H/He mice after radiotherapy. MM46 tumor cells were inoculated into the right hind paws of mice. On the 5th day, irradiation with the dose of 3000 rad was performed. On the 11th day, tumor cells and mononuclear cells, which were separated from the low dose irradiated tumor tissue (2000 rad on the fifth day), were injected into the left hind paws of the tumor-bearing mice. Effectiveness of this active specific immunotherapy against tumor was evaluated by the regression of tumor and survival rate of mice. Tumor was markedly regressed and survival rate was significantly increased by the active specific immunotherapy. PMID- 6853256 TI - Hyperthermia by magnetic induction: II. Clinical experience with concentric electrodes. AB - Thirty-one patients with visceral or extensive superficial malignant tumors of various histologies and sites have been evaluated for our hyperthermia protocols employing magnetic induction at 13.56 MHz with concentric electrodes associated with a commercially available device. Response data in patients completing combined hyperthermia and radiation treatment was difficult to analyze because of the short survival of these patients with advanced disease. Acute toxicity, however, was limited to 2/31 patients with minor skin blistering from excessive superficial heating. In this report we focus on clinical thermometric results. In 6/31 (19%) of patients, portions of the tumor achieved greater than or equal to 42.5 degrees C. In 3/31 (10%), nearly all the tumor achieved greater than or equal to 42.5 degrees C. Those tumors successfully heated to greater than or equal to 42.5 degrees C throughout were relatively superficial. In 22/31 (71%), temperature greater than or equal to 42.5 degrees C were not achieved at any measured site. Maximum applied power levels were limited by development of painful superficial hot spots in 21/31 (68%), by diffuse discomfort or systemic intolerance in 9/31 (29%), by maximum power output from the generator in 1/31, or by other factors in 2/31 patients. Some patients had both local and systemic discomfort that limited power levels. Based upon analysis of the thermometric results, we discuss the anatomic sites and tumor depths for which this technique is most applicable. PMID- 6853258 TI - A linear accelerator couch attachment for extended SSD treatments. AB - An attachment to an existing linear accelerator couch is described that extends the range of SSD's at which patients can be treated. This couch attachment, which is mounted on castors for ease of mobility, is attached to and locks into the rail of the accelerator couch such that the axis of the new device is normal to the existing couch. All motions of this assembly are then under the control of the existing couch. The overall size of the couch attachment is 215 cm x 90 cm, sufficiently large to treat all clinically used fields. PMID- 6853257 TI - Silicone plesiotherapy molds. AB - Plesiotherapy, the treatment of superficial lesions by radioactive molds has largely been replaced by teletherapy techniques involving high energy photon and electron beams. There are, however, situations for which a short distance type treatment, in one form or another, is superior to any other presently available. Traditionally, molds have taken the form of rigid devices incorporating clamps to attach them to the patient. This ensures a reproducible geometry about a localized region since the molds are applied on a daily basis. To make such devices requires considerable skill and patience. This article describes an alternative method that eliminates the use of cumbersome devices in many situations. Silicone molds made from a plaster cast model have been found suitable for the treatment of surface lesions and especially for lesions in the oral and nasal cavities. With the use of radioactive gold seeds the molds may be left in place for a few days without fear of them moving. PMID- 6853259 TI - Endobronchial brachytherapy in the treatment of recurrent bronchogenic carcinoma. PMID- 6853260 TI - Three-field technique for breast irradiation using tangential field corner blocks. AB - A further modification of the three-field technique for the radiotherapy of the breast has been developed. Two isocentric opposing tangential fields encompass the breast, chest wall, and may include the internal mammary lymph nodes. The third, an anterior field, encompasses the axilla and supraclavicular areas. As with our previously reported techniques, the objectives of the present modification is to make the posterior edges of the tangential fields coplanar and to match the cephalad geometric edges of the tangential fields to the caudad geometric edge of the supraclavicular field. A half-beam block is used to shield the caudad half of the anterior field, thus producing a vertical transverse plane to which the tangential fields are matched. Small corner blocks are used on the cephalad edges of the tangential fields to produce the vertical edge necessary for matching to the anterior field. It is essential that the match between the tangential fields and the anterior field be geometrically correct to ensure both local control of disease and good cosmetic results. Two advantages of the present technique are the ease with which it can be carried out and the precision of the match plane without the use of cumbersome mechanical accessories. PMID- 6853261 TI - Irradiation of true pelvis for bladder and prostatic carcinoma in supine, prone or Trendelenburg position. AB - Small bowel transit was performed in 50 patients with bladder or prostatic carcinoma. The patients were all examined in supine and prone positions; some were also studied in 25 degrees Trendelenburg position and 25 degrees inclined procubitus to investigate the effect of the various positions on the displacement of the small bowel loops out of the true pelvis. The prone position proved to be superior to the supine position in 78% of patients. A mean displacement of 0.9 cm was obtained. Greatest shifts generally were found in the Trendelenburg position and inclined procubitus, with a mean displacement of 1.9 and 2.0 cm, respectively. The patients' height, weight, maximal abdominal circumference and Quetelet's index were analyzed with regard to the shifts of bowel loops under the various conditions. Only weight and Quetelet's index were correlated with the shifts in the Trendelenburg and inclined procubitus positions. The shifts were generally larger in case of heavier patients. We conclude that pelvic irradiation should preferably be done in the Trendelenburg or inclined procubitus position, especially in case of obesity. PMID- 6853262 TI - Radiation therapy of prostatic carcinoma. PMID- 6853263 TI - The influence of surgery and radiation therapy on patients with brain metastases. AB - The place for operation and for radiation therapy in the management of brain metastases is reviewed from the experience of 1895 patients treated in two studies of the Radiation Therapy Oncology Group. Operative removal may be of benefit to patients with solitary peripheral lesions in non-critical brain locations. Operation is also appropriate when the diagnosis is in doubt. Radiation therapy with appropriate steroid management is of benefit to patients with multiple metastases or where operative intervention is not reasonable. Short course low-dose treatment has been as beneficial as more aggressive prolonged radiation therapy. PMID- 6853264 TI - Radical irradiation and misonidazole in the treatment of T2 grade III and T3 bladder cancer. AB - The results of 2 pilot studies using a new radiation fractionation schedule plus misonidazole (MISO) in the radical radiotherapy of T2 Grade III and T3 carcinoma of the bladder are presented. Forty Gy in 20 daily fractions of 2 Gy was administered to the whole pelvis over 4 weeks followed by 12 Gy in 2 weekly fractions of 6 Gy. These last 2 doses were given after MISO administration. In an initial pilot study (Pilot Study I) MISO was administered orally only. The first two patients received MISO at a dose of 4.5g/m2 orally with each radiation fraction, after which the dose was reduced to 3.0g/m2 because of drug toxicity. In the second pilot study (Pilot Study II) MISO was administered orally at a dose of 3.0g/m2 and intravesically at a dose of 1.0g to 22 patients. The complete response rate at cystoscopy at 6 months in the latter group of patients is 73%, which is significantly better than that of 43% obtained in a retrospective study of historical controls. There have been no late radiation complications in any of the patients nor any MISO toxicity apart from nausea in the patients receiving 3.0g/m2 orally with or without the intravesical MISO. PMID- 6853265 TI - Radiation induced osteochondroma in long-term survivors of childhood cancer. AB - The records of 200 long term survivors of childhood cancer where reviewed. Radiation induced osteochondromata were detected in 12 patients (6%). Radiation had been administered in doses ranging from 1250 R (approximately 1500 rad) to 5500 rad between the ages of 8 months and 11 1/2 years. Radiation-induced osteochrondromata were detected 3 to 13 1/2 years later, with a median of 5 years. The osteochrondomata were single in 7 patients and multiple (2-4) in 5. Two occurred at sites of previous thoracotomy. Factors related to radiation induced osteochondromata are discussed. PMID- 6853268 TI - Lung damage in mice from cyclophosphamide and thoracic irradiation: the effect of timing. AB - The development of lung damage in mice following thoracic irradiation is enhanced by cyclophosphamide (CY). CY was given at various times from 28 days before to 28 days after irradiation. Although increased damage was seen at all times, the extent showed marked variation according to the time interval. The most marked variations were seen when CY was given within 24 hours of irradiation; maximal enhancement was seen when CY was given before or with irradiation and minimal response when given 12 hrs before or 12 hrs after irradiation. It may therefore be prudent for the clinician to avoid such close time intervals between cytotoxic drugs and irradiation, unless a specific time-related therapeutic gain can be exploited. PMID- 6853267 TI - Postoperative beta radiation treatment of pterygium. PMID- 6853266 TI - Experimental studies on the response of growing bones to X ray and neutron irradiation. AB - The effects of X ray and 14 MeV neutron irradiation on growing tibia of mice were studied. As reported in the literature, the age of the animal at irradiation was an important factor if the endpoint in analyzing the radiation effect is the absolute shortening, difference in length between unirradiated and irradiated tibia, achieved by the treatment. However, if the growth remaining at the moment of irradiation is taken into account no significant differences in effect were observed with aging, and the dose given appeared to be the overruling factor. This was valid for both X ray and neutron irradiation. Absorbed dose-response curves after X ray irradiation showed a shoulder in the lower range of absorbed doses, which was not the case for neutron irradiation. RBE values for 14 MeV neutrons as compared to 250 kV X rays varied from 3.6 to 2.0 depending on the single absorbed dose level. No differences in RBE were found with aging. A mathematical formula was derived which can predict the absolute shortening when the initial and final length of the tibia are known as well as the absorbed dose of irradiation to be administered. PMID- 6853269 TI - Is there a loss of repair capacity in mouse lungs with increasing numbers of dose fractions? AB - The capability of mouse lung to repair sublethal damage after up to 10 fractions of X rays was assessed by an in situ breathing rate assay and lethality. The whole thorax of mice was irradiated "daily" with 4, 7 or 10 fractions of 2.75 or 3.0 Gy of X rays followed at 24 hours by graded "test" doses of X rays or neutrons. Repair capability was measured by determining the difference in test dose between 4 and 7 fractions or 7 and 10 fractions at a given isoeffect. Damage was assessed monthly up to 76 weeks after irradiation, during pneumonitis and chronic fibrosis. The data from both assays for the pneumonitis phase suggested that there may be some loss of repair between 7 and 10 fractions, although it was not large enough in only 10 fractions to be clearly demonstrated. In contrast, there was no suggestion of loss of repair for late damage after up to 10 fractions of X rays using either assay. PMID- 6853270 TI - Studies on fractionated hyperthermia in experimental animals systems III. Uneven daily doses. AB - The effect of daily hyperthermia on the murine normal and tumor tissues was investigated. Tumors were early generation isotransplants of a fibrosarcoma (FSa II) and a mammary carcinoma (MCa) in C3Hf/Sed mice. Hyperthermia was given by immersing animal feet into a water bath at 45.5 degrees C. Tumor response was studied by TG time assay (determination of the time required for half of the treated animals' tumors to reach 1000 mm3 from the treatment day). Average peak foot reaction was also investigated to compare the therapeutic effectiveness of various fractionation regimens. In the first experiment the first dose (D1) of 10 min was followed by 10, 20, or 30 min daily doses. The treatment regimen "D1 of 10 min + daily 30 min" resulted in a significant therapeutic gain. The smaller doses were unable to overcome the repopulation of surviving tumor cells and the increasing magnitude of thermal resistance. To overcome tumor cell repopulation and thermal resistance, a regimen of increasing daily doses was attempted without success. These results indicated that doses following a D1 of 10 min must be as large as 30 min to obtain a therapeutic gain. Any fractionation regimens for MCa tumors, which developed the greatest thermal resistance among our animal tumors tested, failed to result in a therapeutic gain. PMID- 6853271 TI - Dose optimization with computer-controlled gantry rotation, collimator motion and dose-rate variation. AB - The applications of a computer-controlled radiation therapy system to optimize dose distributions in two dimensions are explored. This study is limited to a target volume with constant cross-section along an axis parallel to the long axis of the patient. The machine components that are continuously varied during treatment are the dose rate, the gantry angle, and the four independent collimator jaws, two of which can cross the beam centerline. Basic control strategies, treatment planning and delivery techniques are illustrated with clinical examples. We conclude that the computer-controlled radiation therapy system can easily and reliably deliver dose distributions which are significantly better than those produced by conventional multiple-field techniques. PMID- 6853272 TI - On some general concepts in oncology with special reference to Hodgkin's disease. PMID- 6853273 TI - Chemotherapeutic drugs as indirect oxygen radiosensitizer. AB - We have characterized the oxygen distribution in V-79 spheroids which were grown by the spinner flask method. Using ultramicroelectrodes with tip diameters of 1-5 microns and a perfusion system whereby the spheroids' milieu could be maintained and controlled, we found plateau pO2 values of less than 10 mm Hg in spheroids of greater than 500 microns in diameter. Data from experiments using respiration inhibitory drugs indicate that the characteristics of the outer layers of cells is the major determinant of the oxygen profile in the interior. Parallel control radiobiological experiments confirmed the control pO2 measurements, and formed the basis for the experiments using the potential indirect radiation sensitizers: Chlorambucil and Mustargen. PMID- 6853274 TI - Fletcher-Suit-Delclos gynecologic applicator: evaluation of a new instrument. AB - A new instrument has been added to the Fletcher-Suit-Delclos group of gynecologic applicators. The colpostats can be used as mini-ovoids, but by adding a shielded cap, the instrument has the configuration of the original preload Fletcher colpostat. Dosimetric studies show that this applicator produced transmission ratios (the fraction of radiation transmitted through the tungsten shield) and isodose curves similar to the bladder trigone and anterior rectal wall of 10-25%. With the shield-containing cap removed, the mini-ovoid provides little reduction in dose to those areas and should be used with caution. PMID- 6853276 TI - Extra-alveolar vessel contribution to hydrostatic pulmonary edema in in situ dog lungs. AB - We determined the relative contribution of larger extra-alveolar arteries and veins to hydrostatic edema in in situ dog lungs. Left lower lobe alveolar and vascular pressures were controlled in 24 open-chest, anesthetized, heparinized dogs. Zero pressure was at the lobe base. Normal blood gases were maintained by ventilating the right lung. The left lower lobe was inflated with 5% CO2 and air to an alveolar pressure of 10 or 25 cmH2O and suspended from a strain gauge, which allowed continual weight recording. Vascular pressures were raised to alveolar pressure plus lung height (zone III) before and after pulmonary arterial or venous embolization with 37- to 74-microns polystyrene beads, which isolated the larger extra-alveolar arteries or veins from alveolar vessels. The weight change occurring during the last 3 min of the 5-min hydrostatic stress was taken to represent transvascular fluid flux. At an alveolar pressure of 25 cmH2O (estimated transmural pressure 40 cmH2O), leakage from the larger extra-alveolar arteries and veins accounted for 41 and 32%, respectively, of the total transvascular fluid flux occurring after embolization. At an alveolar pressure of 10 cmH2O (estimated transmural pressure 22 cmH2O), no extra-alveolar vessel leakage occurred. However, when vascular pressures were raised to provide a transmural pressure similar to that present at the higher alveolar pressure, the same contribution from larger extra-alveolar vessels was observed. PMID- 6853275 TI - Fluid shifts and muscle function in humans during acute simulated weightlessness. AB - Head-down tilt is considered an effective experimental model to simulate weightlessness. To determine the acute effects of simulated weightlessness on transcapillary fluid balance, tissue fluid shifts, muscle function, and triceps surae reflex time, eight supine subjects were tilted 5 degrees head down for 8 h. A cephalic fluid shift from the legs was indicated by facial edema, nasal congestion, increased urine flow, decreased creatinine excretion, reduced calf girth, and decreased lower leg volume. As measured by wick catheters inserted under local anesthesia, interstitial fluid pressure in the tibialis anterior muscle (4.6 +/- 0.6 mmHg) and subcutaneous tissue (0.6 +/- 0.5 mmHg) of the lower leg fell significantly to -2.8 +/- 0.5 and -3.8 +/- 0.4 mmHg, respectively. Other transcapillary pressures (capillary and interstitial fluid colloid osmotic pressures) were relatively unchanged. Needle-biopsy specimens, obtained just before and after tilt, indicated that total water content of soleus muscle was unchanged during 8 h of head-down tilt. After head-down tilt, isometric strength and isokinetic strength of the plantar flexors were unchanged. Triceps surae reflex time associated with plantar flexion movement slowed slightly after the tilt maneuver. Collectively these results demonstrated a dehydration effect of head-down tilt on muscle and subcutaneous tissues of the lower leg that may affect muscle function. PMID- 6853277 TI - Regional lung function in erect humans after lobectomy. AB - By using the 133Xe technique, we studied five erect adult subjects who had undergone lobectomy at least 2 mo previously and were otherwise normal, to allow comparison between operated and unoperated lungs; four subjects had undergone upper lobectomy, and one had undergone lower lobectomy. In addition we studied a sixth subject who had undergone lower lobectomy and had residual disease in the contralateral lung, and results from the diseased lung were discarded. At the same overall volume, lungs that had undergone lobectomy were more expanded than contralateral control lungs, and their washout half times were prolonged more than could be accounted for by their increased functional residual capacity-to total lung capacity ratio. In subjects with upper lobectomy, apex-to-base gradients of regional lung volume were normal on the operated side when lung expansion was accounted for. In subjects with lower lobectomy, apex-to-base volume gradients were reduced on the side that had undergone resection, suggesting relative overexpansion of basal regions. These interpretations were supported by distributions of regional washout half times and of boluses inhaled at residual volume. We interpreted these results as indicating that both lung weight and lung-chest wall shape interaction determine the distribution of regional lung volumes. PMID- 6853278 TI - Effect of cold exposure on various sites of core temperature measurements. AB - Rectal, esophageal, auditory canal, gastrointestinal tract, and sublingual temperature were recorded on five young Caucasian males who, in an environment of -32 degrees C and 11-km/h wind, sat during one 90-min exposure and walked on a treadmill at 2.9 km/h during another. The clothing permitted cooling of their torsos while giving adequate protection to their extremities. Control exposures involved subjects sitting in still air at 24-26 degrees C dressed only in thermal underwear. In the control environment all of the internal body temperatures measured gave comparable and consistent values; however, cold exposure affected the various sites differently. Esophageal temperatures fluctuated rapidly as a result of subjects swallowing cold saliva. Sublingual temperatures were below the lower limit of a clinical thermometer, possibly because of facial cooling. Auditory canal temperatures were low, perhaps also because of facial cooling. Rectal temperatures were high as were the gastrointestinal tract temperatures, due perhaps to local heat production in response to cold stimulation. Metabolic rate increased initially in the cold and again toward the end of the cold exposure. PMID- 6853279 TI - Anaerobic threshold, blood lactate, and muscle metabolites in progressive exercise. AB - The purpose of this study was to investigate the interrelationship between the ventilatory anaerobic threshold (VAT), the blood lactate anaerobic threshold (LAT), and the alteration in muscle metabolism. Ten subjects (5 men and 5 women) performed progressive exercise to exhaustion on two occasions for determination of the VAT and the LAT. For both AT criteria, the initial breakpoints (P less than 0.05) in the relationship between ventilation (VE) and O2 uptake (VO2VAT) and lactate (La) and power output (POLAT) were determined by multisegmental linear regression. During three subsequent tests the subjects performed progressive exercise to various percentages of the VO2VAT. Biopsies were obtained from the musculus vastus lateralis for determination of selected glycolytic intermediates at the cessation of exercise. It was found that the VO2VAT, expressed in terms of power output (POVAT), occurred at a higher value (P less than 0.05) than the POLAT (1,004 vs. 621 kg X min-1). Blood La values at these power outputs were 2.09 and 1.25 mM, respectively. Determination of the muscle La concentration at 79, 94, and 110% of VO2VAT indicated significant increases (P less than 0.05) from rest values of 1.59 to 4.49, 6.37, and 11.3 mmol X kg wet wt 1, respectively. It is concluded that the gas exchange AT as determined by the relationship between VE and VO2VAT and the AT as determined by blood La accumulation (LAT) are not coincidental. In addition the elevation in muscle anaerobic glycolysis precedes both the VAT and the blood LAT in this progressive exercise test. PMID- 6853282 TI - Estimation of human susceptibility to the high-pressure nervous syndrome. AB - Twenty-four professional divers were put through a series of electroencephalographic (EEG) and psychometric tests at the surface and at 180 m after a fast compression (15 min) in an attempt to determine their susceptibility to high-pressure nervous syndrome (HPNS). The subjects were classified according to the EEG changes between the surface and 180 m: group 0, less than 10% increase in theta-band activity in the anterior region of the scalp; group 1, between 10 and 100% increase in theta-activity; group 2, theta-activity increase above 100%. Eight subjects were selected to make a dive to 450 m to verify the quality of our classification (3 from group 0, 3 from group 1, 2 from group 2). The results showed that, for the psychometric tests, the large individual variability between the surface and 180 m does not allow us to prejudge the behavior of each subject at 450 m, but the classification established from absolute values is stable from the surface to 450 m. For the EEG activities, intensity of the modifications at 450 m can be predicted at group level by a 180-m dive, performed with fast compression and similar breathing mixtures. PMID- 6853281 TI - Changes in diastolic coronary resistance during submaximal exercise in conditioned dogs. AB - Diastolic coronary resistance (DCR) was studied in 10 conscious dogs in the untrained (UT) and partially trained (PT) condition. The PT regime consisted of treadmill running 5 days/wk for 4-5 wk. Left circumflex coronary flow, aortic pressure, and heart rate were measured, and diastolic coronary resistance (DCR) was calculated. Adrenergic blockade was achieved with propranolol (1 mg/kg, iv) (beta B) and phentolamine (1 mg/kg, iv) (alpha B). During submaximal exercise in the UT condition, DCR fell from a resting value of 3.84 +/- 0.24 Torr . ml-1 . min with increasing work load to 1.57 +/- 0.12 Torr . ml-1 . min at 6.4 km/h (speed)/16% (grade). The decrease in DCR during submaximal exercise was greater in the PT than in the UT condition. DCR following alpha-adrenergic blockade was not significantly changed in the UT and PT conditions (e.g., at 6.4 km/h (speed)/16% (grade), 1.10 +/- 0.141 vs. 1.03 +/- 0.107 Torr . ml-1 . min, whereas following beta-adrenergic blockade, DCR was larger in the UT compared with the PT condition (e.g., at 6.4 km/h (speed)/16% (grade), 2.03 +/- 0.091 vs. 1.73 +/- 0.073 Torr . ml-1 X min). Myocardial oxygen consumption was not significantly different in the PT and UT conditions, indicating no difference in metabolism with partial training. The present study suggests that during submaximal exercise in the PT condition there is a change in the neurogenic control of the coronary vasculature by a reduction in sympathetic neural activity on the coronary resistance vessels. PMID- 6853280 TI - Topographical distribution of regional lung volume in anesthetized dogs. AB - The distribution of regional lung volume during static deflation from total lung capacity to functional residual capacity was determined from the positions of intraparenchymal metallic markers ascertained by a biplane video roentgenographic technique in supine and prone anesthetized dogs. Regional lung volumes were linearly related to overall lung volume so that regional volume could be characterized by a ventilation index (VI), which is the ventilation per alveolus relative to the ventilation of the overall lung. For the supine position, there were vertical and cephalocaudal gradients in VI in both the upper and lower lobes. Mean VI was greater in the lower lobe than in the upper lobe, but VI was less than would be predicted from extrapolation of the upper lobe relationship. For the prone position, there was no consistent gradient in VI in any direction. The magnitude of the gradients in VI and the effects of body position suggest that, in the recumbent dog, the thoracic cavity shape is a more important determinant of regional lung volume than is the effect of gravity on the lung itself. PMID- 6853283 TI - Ventilation-perfusion relationships during hemorrhagic hypotension and reinfusion in the dog. AB - The inert gas elimination technique was used to estimate pulmonary ventilation perfusion (VA/Q) mismatching in heparinized, ventilated, anesthetized dogs during a 90-min period of hemorrhagic hypotension (mean arterial pressure 40 Torr) and subsequent reinfusion of the shed blood. Systemic and pulmonary arterial pressures, as well as cardiac output, were similar to those in previously reported studies using this protocol. Mean arterial O2 partial pressure (PO2) fell from 86 to 75 Torr after hemorrhage and rose to a mean value of 78 Torr after reinfusion. The VA/Q distributions showed that a mean of 56.7% of the ventilation was associated with unperfused or poorly perfused (VA/Q greater than 10) regions during hypotension (control 33.7%). After reinfusion, a mean of 47.8% of the ventilation was still directed to lung with little or no perfusion. This could not be explained on a hydrostatic basis, since pulmonary arterial pressure after reinfusion was greater than the control value. Shunt or blood flow to low VA/Q regions did not increase at any time during hemorrhagic hypotension or reinfusion. Microscopic examination of lung tissue revealed extensive leukocyte aggregation that was not seen in control animals. The mean diameter of obstructed pulmonary vessels was 35 microns (range 13.8-59.8 microns). Storing the shed blood in acid-citrate-dextrose instead of heparin had no significant effect on the extent of leukocyte aggregation. We suggest that leukocyte aggregation and margination may be related to the high VA/Q regions seen in these animals. PMID- 6853284 TI - Effect of exercise on QRS duration in healthy men: a computer ECG analysis. AB - Increased sympathetic tone with exercise enhances ventricular conduction and would be predicted to shorten QRS duration. Previous studies, however, have not consistently documented such changes. Using a digital electrocardiograph (ECG) cart sampling at 500 Hz, a bipolar precordial lead (V5-V2) was recorded (supine, at end expiration) in 25 healthy men (mean age 29 yr, range 19-37) at rest and immediately after submaximal treadmill exercise. QRS duration was measured on complexes recorded at high gain and expanded time scale. A significant (P less than 0.0005) decrease [4.9 +/- 2.3 (SD) ms] in QRS duration was noted, and decreased QRS duration was observed in all 25 subjects (range 1-10 ms). Furthermore there was significant (P less than 0.01) shortening of the intervals between QRS onset and Q-wave nadir (1.2 +/- 2.0 ms) and between QRS onset and R wave peak (2.4 +/- 2.5 ms), as well as of the Q-R interval (1.3 +/- 2.7 ms). However, there were no significant differences in percent shortening of early vs. later phases of the QRS. To exclude digital sampling errors the same protocol was also applied in 11 healthy men by using an analog ECG cart. QRS duration immediately postexercise shortened by 7.1 +/- 4.3 ms (range 2-11.5 ms), which was not significantly different from the results obtained with the digital ECG. We conclude that decreased QRS duration is a physiological response to moderate treadmill exercise in healthy men, reflecting enhancement of conduction in early, middle, and later phases of ventricular activation. PMID- 6853286 TI - Effect of central vascular engorgement and immersion on various lung volumes. AB - The purpose of this study was to determine the relative contribution of central vascular engorgement (CVE) and increased hydrostatic pressure on various lung volumes during head-out immersion in water. Residual volume (RV) and vital capacity (VC) were determined on 12 male volunteers under three randomly assigned conditions: control, CVE, and immersion. CVE was produced via G-suit inflation. There were significant (P less than 0.01) mean decreases, compared with the control value, of 4.9% (280 ml) and 5.9% (340 ml) in VC during CVE and immersion, respectively. RV was not significantly changed across the three conditions. It was concluded that more than 80% of the decrease in VC during immersion can be attributed to CVE. However, the mechanism by which CVE decreased VC is still unclear. In addition, these data suggest that RV is relatively insensitive to the increase in CVE normally associated with immersion. Therefore, during immersion, RV is not simply the result of the balance of these opposing forces (i.e., CVE and hydrostatic pressure), as previously suggested. PMID- 6853285 TI - Paraquat inhibits mixed-function oxidation by rat lung. AB - The effect of paraquat on 7-ethoxycoumarin (7-EC)deethylation, an NADPH-dependent cytochrome P-450-linked reaction, was studied in isolated rat lungs. Control lungs oxidatively deethylated 7-EC at a constant rate, metabolizing 178 +/- 12 nmol/g dry wt in 50 min (n=3, mean +/- SE). When glucose was omitted from the perfusate, 7-EC deethylation was lower (85 +/- 17 nmol/g, P less than 0.05), and the rate progressively decreased, suggesting inadequate pentose shunt regeneration of NADPH. During perfusion with paraquat (10(-3) M), 7-EC metabolism was still lower (75 +/- 5 nmol/g in the presence of glucose and 18 +/- 4 nmol/g in the absence of glucose, P less than 0.05). Addition of lactate plus pyruvate partially restored 7-EC deethylase activity in control lungs but had no effect in lungs perfused with paraquat. Varying perfusate paraquat concentrations (10(-6) to 10(-3) M) inhibited 7-EC deethylation in a dose-dependent fashion (r = 0.79, P less than 0.02). Oxidative demethylation of p-nitroanisole, another cytochrome P 450-linked reaction, was similarly inhibited by paraquat. In contrast, microsomes isolated from paraquat-perfused lungs showed no inhibition of 7-EC metabolism (measured in the presence of an NADPH-regenerating system). We conclude that paraquat depletes NADPH in the isolated lung to a sufficient extent to impair mixed-function oxidation. Such NADPH depletion may play a role in the toxicity of paraquat. PMID- 6853288 TI - Effects of low concentrations of chlorine on pulmonary function in humans. AB - Eight healthy unacclimated volunteers were exposed to chlorine gas in concentrations of 0.5 or 1 ppm, and several pulmonary function measurements were made. Comparisons were made by paired t test between the percent change from base line values obtained at various times after chlorine exposure and the percent change from base line at analogous times after a sham exposure. With the sham vs. 0.5-ppm exposure, there were trivial changes observed. Total lung capacity (TLC) was lower before 0.5-ppm exposure than before sham exposure, and the percent decrease in carbon dioxide pulmonary diffusing capacity was smaller 24 h after 0.5-ppm exposure than 24 h after sham exposure. With the sham vs. 1-ppm exposure, there were many differences in percent change from base line that were significant at the P less than 0.05 level or better. These were in forced vital capacity (FVC), forced expiratory volume at 1 s (FEV1), peak expiratory flow rate (PEFR), forced expiratory flow rate at 50 and 25% vital capacity (FEF50 and FEF25, respectively), and airway resistance (Raw). There were, in addition, significant changes after only 4 h of exposure. These were in FEV1, PEFR, FEF50, FEF25, TLC, Raw, and the difference in nitrogen concentration. Most of the test results had returned to normal by the next day. We conclude that even though chlorine at low concentrations does not produce any serious subjective symptoms, it adversely affects pulmonary function transiently. PMID- 6853287 TI - Effect of triiodothyronine on body temperature at rest and during exercise in dogs. AB - To determine the effect of the thyroid hormones on body temperature at rest and during exercise, five mongrel dogs were trained to run on a treadmill and then treated with exogenous triiodothyronine (T3) (1 mg/kg) to elevate circulating T3 levels or propylthiouracil (PTU) (200 mg/day for 14 days) to lower endogenous T3 levels. When compared with levels in euthyroid controls at rest and during exercise, rectal temperature (Tre) was increased (P less than or equal to 0.01 and P less than or equal to 0.02, rest and exercise, respectively) in T3-treated dogs and decreased (P less than 0.05 and P less than 0.01) in the PTU-treated dogs. Although the rise in Tre from rest to exercise in the PTU trial was slightly less than that of the control runs (1.23 vs 1.44 degrees C, respectively; P = 0.05), it was similar to the rise in Tre observed in the T3 experiments (1.37 degrees C). Because T3 treatment resulted in an elevation in exercise oxygen consumption (VO2), untreated dogs were run at elevated work loads such that their VO2 matched that recorded when pretreated with T3. Exercise Tre in these experiments was lower (P less than 0.02) than after T3 treatment, even though the exercise metabolic rates were equivalent. It was concluded that 1) although T3 alters body temperature, the magnitude of the rise in Tre during exercise is not dependent on T3 concentration and 2) the effects of T3 on body temperature at rest and during exercise are mediated through mechanisms other than alterations in metabolic rate. PMID- 6853290 TI - A pinhole method for measuring chest wall compliance. AB - We describe a method of measuring chest wall compliance (Cw) that readily detects whether respiratory muscles are relaxed. The method simulates a normal slow sigh, with the subject exhaling through a needle valve. Cw is calculated from the slope of the volume-esophageal pressure line. With relaxed subjects, repeated measurements yield similar slopes. When subjects cannot relax, the volume pressure line is irregular and variable. In 26 subjects who could relax, Cw averaged 0.208 +/- 0.05 (SD) l/cmH2O. PMID- 6853289 TI - Ventilation distribution and density dependence of expiratory flow in asthmatic children. AB - Of 114 asthmatic children, 21% had abnormally steep phase III slopes from a modified single-breath oxygen (SBO2) procedure. We hypothesized that the steep slopes reflect inequality of time constants caused by obstruction of peripheral airways and tested this by using a bronchodilator to reduce overall time constants in subgroups of 10 children with steep slopes (SS) and 20 children with normal slopes (NS). Maximum expiratory flow increased by equivalent degrees (0.65 0.70 l/s) in both groups, but slope decreased significantly only in the SS group. Moreover, the single-breath mixing efficiency of inspired oxygen with resident nitrogen was normal in the NS group but significantly low in the SS group. Density dependence of maximum expiratory flow (DD) was abnormally small in the SS group [15 +/- 6% (SD) increase compared with 57 +/- 13% increase in a separate group of normal children] and was independent of the anatomical dead space. In contrast, DD was normal and varied inversely with anatomical dead space (r = 0.62, P less than 0.01) in the NS group. These results indicate that 1) steep SBO2 slopes found in asthmatic children between acute episodes reflect unequal time constants caused by obstruction of peripheral airways and 2) part of the variation in DD among asthmatic children is caused by variation in convective accelerative pressure losses in major airways. PMID- 6853291 TI - Relationship between esophageal and alveolar pressure variations-during occlusion. PMID- 6853292 TI - Body size, energy metabolism, and the lungs. AB - The theoretical basis for applying the power function y = aMb to the study of structure-function relationships is discussed. Dimensional analysis and the distinction between intensive and extensive properties of animals show that the mass coefficient a represents the effect of intensive or qualitative factors on the considered function or structure. The theoretical mass exponent is a criterion for the constancy of a and the qualitative sameness of the compared structure or function. Examples from respiratory and metabolic physiology are given. PMID- 6853293 TI - Sexual influence on the control of breathing. AB - Previous investigation has demonstrated that progesterone, a hormone found in premenopausal women, is a ventilatory stimulant. However, fragmentary data suggest that normal women may have lower ventilatory responses to chemical stimuli than men, in whom progesterone is found at low levels. As male-female differences have not been carefully studied, we undertook a systematic comparison of resting ventilation and ventilatory responses to chemical stimuli in men and women. Resting ventilation was found to correlate closely with CO2 production in all subjects (r = 0.71, P less than 0.001), but women tended to have a greater minute ventilation per milliliter of CO2 produced (P less than 0.05) and consequently a lower CO2 partial pressure (PCO2) (men 35.1 +/- 0.5 Torr, women 33.2 +/- 0.5 Torr; P less than 0.02). Women were also found to have lower tidal volumes, even when corrected from body surface area (BSA), and greater respiratory frequency than comparable males. The hypoxic ventilatory response (HVR) quantitated by the shape parameter A was significantly greater in men [167 +/- 22 (SE)] than in women (109 +/- 13; P less than 0.05). In men this hypoxic response was found to correlate closely with O2 consumption (r = 0.75, P less than 0.001) but with no measure of size or metabolic rate in women. The hypercapnic ventilatory response, expressed as the slope of ventilation vs. PCO2, was also greater in men (2.30 +/- 0.23) than in women (1.58 +/- 0.19, P less than 0.05). Finally women tended to have higher ventilatory responses in the luteal than in the follicular menstrual phase, but this was significant only for HVR (P less than 0.05). Women, with relatively higher resting ventilation, have lower responses to hypoxia and hypercapnia. PMID- 6853294 TI - Temperature sensitivity of skeletal muscle in the conscious goat. AB - A method has been developed to test the hypothesis that the deep tissues of the legs, e.g., skeletal muscle and/or periosteum, contain thermosensitive elements feeding signals into the temperature-regulating system. Stainless steel thermodes of 10 to 12-mm diameter and 100 to 150-mm length were chronically implanted into the marrow spaces of both humeri and femora, all of which have wide cavities and thin walls. Perfusing the thermodes with water of 0 degree C altered the temperature of the deep muscle layers by several degrees. The animals were further equipped with intravascular heat exchangers, which served to keep general body temperature constant during periods of leg cooling. Eighty experiments were performed in a hot and dry environment. During the middle period of each experiment the legs were cooled by perfusing the thermodes with water of 0 degree C. This caused respiratory evaporative heat loss to decrease by 0.15-0.20 W/kg. The small but significant response occurred at constant general body temperature and is therefore indicative of a local effect of the cooling on deep thermosensitive elements in the legs themselves and a neural afferent transmission of temperature signals into the temperature-regulating system. PMID- 6853295 TI - Gravity dependence of phases III, IV, and V in single-breath washout curves. AB - The gravity dependence of phases III (IIIa and IIIb), IV, and V of simultaneously performed He-bolus and N2-resident gas single-breath washout curves was studied in different body positions by the technique of 180 degrees body inversion between inspiration and expiration. Phase IIIa was mainly determined by nongravitational factors. Phase IIIb was influenced by gravitational, as well as nongravitational, factors. The former were more important with the bolus method in both lateral decubitus positions and the latter with the N2 method in the prone and supine positions. Phases IV and V were mainly gravity dependent. The difference in gravity dependence between the He and N2 methods appeared to be correlated with the vertical interregional concentration gradients of both gases; indeed the vertical gradient was larger for the 133Xe bolus inhaled at residual volume (which is comparable to the He-bolus distribution) than for the 133Xe residual volume-to-total lung capacity ratio (which is comparable to the N2 resident gas distribution). The greater gravity dependence in the lateral decubitus positions than in the supine or prone postures was related to the larger vertical interregional concentration difference as well as to the more pronounced sequential ventilation in the former positions. Finally the negligible effect of gravity on phase IIIa, its moderate effect on phase IIIb, and its predominant effect on phases IV and V were in agreement with the increased sequential filling and emptying due to gravity near residual volume. PMID- 6853297 TI - Effect of inflation on trachealis muscle tone in canine tracheal segments in vitro. AB - Isolated tracheal segments were studied in vitro to determine how inflation affects the length and tension of the contracted and relaxed trachealis muscle. Circumferential trachealis muscle lengths were measured from cross-sectional radiographs taken during stepwise inflation of intact 20-cm-long tracheal segments to an inflation pressure of 25 cmH2O. A tracheal length spanning two cartilage rings was then cut out and mounted in a tissue bath using clips attached at the points of muscle insertion into the cartilage. The ring was stretched open along the axis of the muscle, and the resulting forces of the relaxed and contracted muscle and the cartilage were measured. Muscle lengths and tensions during inflation of the trachea were determined by comparing pressure vs. length and force vs. length measurements. During inflation from 0 to 25 cmH2O, the circumferential length of the trachealis muscle contracted with 10(-5) M acetylcholine increased from 48 to 70% of its length of maximal active tension (Lmax), while the relaxed muscle increased from 80 to 93% Lmax. The length of the contracted muscle was maintained at a nearly constant proportion of its relaxed length at each pressure. PMID- 6853296 TI - Sympathoadrenal responses to cold and ketamine anesthesia in the rhesus monkey. AB - The effect of cold exposure on the sympathoadrenal system in primates was studied with and without ketamine anesthesia in eight adult rhesus monkeys. Each monkey was placed in a primate chair at a thermoneutral temperature (25 degrees C) for 1 h (control) followed by cold exposure (12 degrees C) for 3 h or placed in a circulating water bath (28 degrees C) to induce a decrease in core temperature (Tre) to 35 and 33 degrees C. Plasma catecholamines were analyzed by high pressure liquid chromatography with electrochemical detection (60-65% recovery, coefficient of variation = 15%). The 3-h cold exposure was associated with a 175% increase above control levels of norepinephrine (NE) and a 100% increase in epinephrine (E). Decreases were evident in Tre (0.5 degree C), mean skin temperature (Tsk, 5.5 degrees C), and mean body temperature (Tb, 2.0 degrees C). Continuous infusion of ketamine (0.65 mg . kg-1 . min-1) resulted in no change in the plasma levels of NE and E from the control levels. Tre, Tsk, and Tb all showed greater declines with the addition of ketamine infusion to the cold exposure. Water exposure (28 degrees C) under ketamine anesthesia resulted in a drop in Tre to 33 degrees C within 1 h. Plasma levels of NE and E were unchanged from control values at Tre of 35 and 33 degrees C. The data suggest that the administration of ketamine abolished both the thermoregulatory response and the catecholamine response to acute cold exposure. PMID- 6853302 TI - Pressure-flow relationships in a collaterally ventilating dog lung segment. AB - We evaluated the pressure (P)-flow (V) relationship in collaterally ventilating dog lung segments by passing He, N2, and SF6 through a bronchoscope (5 mm OD) wedged in a peripheral airway. Measurements were made at functional residual capacity (FRC) and two higher lung volumes, keeping segment-to-airway opening pressure constant (3 cmH2O) in five anesthetized, paralyzed, vagotomized, supine dogs. Average flows ranged from 5.0 to 8.0 ml/s for He, 4.5 to 7.5 ml/s for N2, and 3.4 to 4.7 ml/s for SF6. When these data were fitted as P = K1/3/3 mu V + K2 rho V2, density-dependent pressure losses were unimportant when He and N2 were used, suggesting laminar flow with these gases. A dimensionless plot of the total pressure drop relative to a reference dynamic pressure as a function of Reynolds number at the bronchoscope tip suggested that flow through the segment behaved as if it were laminar at Reynolds numbers less than 100. Furthermore, when the airway diameter used to compute the normalized pressure and Reynolds number was scaled as the cubic root of lung volume, curves for all three gases were superimposed, suggesting that the dimensions of intrasegmental/collateral airways scale as lung volume 1/3. PMID- 6853299 TI - Methylprednisolone prevents venous resistance increase in oleic acid lung injury. PMID- 6853301 TI - Augmentation of cardiac function by elevation of intrathoracic pressure. AB - We studied the cardiovascular effects of increasing intrathoracic pressure in an acute pentobarbital-anesthetized canine model of acute ventricular failure induced by large doses of propranolol. Left ventricular (LV) function curves were generated by volume loading from LV filling pressures of 5-20 Torr. The animals were ventilated by using intermittent positive-pressure ventilation with large tidal volumes (30 ml/kg). Chest and abdominal pneumatic binders were used to increase intrathoracic pressure. When compared with the control state, acute ventricular failure was associated with a decrease in the slope of the LV function curves (P less than 0.01). After binding the increase in intrathoracic pressure (1.1 +/- 1.6 to 12.1 +/- 2.4 Torr, P less than 0.01) was associated with an improvement in both right ventricular and LV function. Our study demonstrates that in this model of acute ventricular failure, increasing intrathoracic pressure improves cardiac function. We postulate that this observed improvement with increased intrathoracic pressure is due to reduced LV wall stress in a manner analogous to that seen with arterial vasodilator therapy in congestive heart failure. PMID- 6853300 TI - Characteristics of airway tone during exercise in patients with asthma. AB - In 10 nonasthmatic subjects and 11 patients with asthma, we measured pulmonary resistance (RL), functional residual capacity (FRC), and specific conductance (sGaw) before, during, and after submaximal treadmill exercise. Nonasthmatic subjects did not change RL, FRC, or sGaw from base-line resting values during or after exercise. In patients with asthma, RL decreased significantly during exercise, both when exercise was begun from the control resting state and from conditions of elevated RL after a preceding period of exercise. When asthmatic patients inhaled a standardized dose of aerosolized histamine, the increase in RL during exercise was significantly less than the increase in RL when they breathed histamine at rest. When patients hyperventilated at rest with tidal volumes, breathing frequencies, and end-tidal CO2 tensions similar to those during exercise conditions, bronchodilatation also occurred, and the increase in RL following inhaled histamine during isocapnic hyperventilation was also less than at rest. Since bronchodilatation and inhibition of histamine-induced bronchoconstriction occur during both exercise and isocapnic hyperventilation, we suggest that the mechanism of bronchodilatation during exercise may not necessarily be related to metabolic factors associated with exercise. PMID- 6853298 TI - Histamine decreases selectivity of sheep lung blood-lymph barrier. AB - Histamine increases lymph flow and protein flux from the sheep lung. This increase in water and protein movement has been attributed to an increase in lung microvascular permeability-surface area product caused by histamine. Whether it was permeability that was changed or whether it was surface area cannot be discerned from past work. Histamine might increase either of these determinants of transport in the sheep lung. Previous measurements of several plasma protein fractions in plasma and lymph showed no change in the sieving behavior of the microcirculation with intravenous histamine, suggesting that only surface area was changed. In the present study, even larger test molecules were used to probe the limits of transport through the lung's blood-lymph barrier. Fluorescein isothiocyanate-labeled dextrans (FITC-dextran) that can normally permeate lung lymph do so more readily after intravenous histamine infusion (3 micrograms X kg 1 X min-1). Formerly impermeable FITC-dextran fractions also appear after histamine administration. No definitive size limit to the transport of dextran was found in histamine-stimulated sheep lungs. Intra-arterial histamine does not increase lung lymph, protein, or FITC-dextran flow. These results suggest that histamine changes the permeability or sieving characteristics of the lung microvascular barrier making it less size selective to large molecules. Surface area for transport may also increase. PMID- 6853303 TI - Human sinus arrhythmia as an index of vagal cardiac outflow. AB - Since changes of heart period follow changes of cardiac vagal efferent activity quantitatively with nearly fixed latencies, measurements of respiratory sinus arrhythmia may provide insights into human central vagal mechanisms. Accordingly, I measured intervals between heartbeats during controlled breathing (at breathing intervals of 2.5-10 s and nominal tidal volumes of 1,000 and 1,500 ml) in six healthy young men and women. As breathing interval increased, the longest heart periods became longer, the shortest heart periods became shorter, and the peak valley P-P intervals increased asymptotically. Peak-valley P-P intervals also increased in proportion to tidal volume. However, this influence was small: a 50% increase of tidal volume increased the average peak-valley P-P interval by only about 15%. The phase angles between heart period changes and respiration varied as linear functions of breathing interval. Heart period shortening (cardioacceleration) began in inspiration at short breathing intervals and in expiration at long breathing intervals. Heart period lengthening, however, began in early expiration at all breathing intervals studied. These results point toward a close relationship between variations of respiratory depth and interval and the quantity, periodicity, and timing of vagal cardiac outflow in conscious humans. They suggest that, at usual breathing rates, phasic respiration-related changes of vagal motoneuron activity began in expiration, progress slowly, and are incompletely expressed at fast breathing rates. PMID- 6853304 TI - Sweating efficiency in acclimated men and women exercising in humid and dry heat. PMID- 6853305 TI - Acid-base curve and alignment nomograms for swine blood. AB - To construct acid-base curves and alignment nomograms for swine blood, we added known amounts of acid or base to aliquots of swine blood with three different concentrations of hemoglobin. Pairs of blood samples were equilibrated at two different CO2 partial pressures, and blood pH was measured. Data were analyzed by computer, and mean values were created for complete data of four swine. Curve and alignment nomograms were constructed by computer. The resultant nomograms for swine blood differ from those constructed by Siggaard-Andersen for human blood, most importantly at base-excess values of +10 to +25 mmol/l. The possible reasons for the observed differences are discussed and, although not completely resolved, may be related in large measure to the accuracy of pH determination and the methodology of nomogram construction. PMID- 6853306 TI - Atropine complications. PMID- 6853307 TI - Area rates and new benefits for AVMA members. PMID- 6853308 TI - ECG of the month: an 11-year-old male poodle with 2 syncopal episodes. PMID- 6853309 TI - Vesicoureteral reflux induced by manual compression of the urinary bladder of dogs and cats. AB - Vesicoureteral reflux caused by manual compression of the urinary bladder performed to obtain urine samples was evaluated by contrast radiography in 10 sedated, clinically normal male and female dogs and in 10 sedated, clinically normal male and female cats. Vesicoureteral reflux occurred in 50% of the dogs and in 40% of the cats. Application of digital pressure to the urinary bladder for a prolonged period to initiate urine voiding was associated with a greater occurrence of reflux than was application of digital pressure for a transient period. Contrast material refluxed into the prostate gland of 3 of 6 male dogs. PMID- 6853310 TI - Surgical manipulation of intrahepatic portocaval shunts in dogs. PMID- 6853311 TI - Anaerobic bacteria associated with osteomyelitis in domestic animals. AB - Specimens of bony tissue or adjacent soft tissue from 19 animals with osteomyelitis were cultured aerobically and anaerobically. Fourteen specimens (74%) yielded anaerobic bacteria in pure culture or mixed with aerobic or facultative anaerobic bacteria. The most predominant genus encountered was an obligate anaerobe, Bacteroides. The most frequently isolated Bacteroides species was Bacteroides asaccharolyticus, which was isolated 5 times. The most frequently isolated anaerobe was Peptostreptococcus anaerobius, which was isolated 6 times. Staphylococcus aureus and Escherichia coli were the most frequently isolated aerobic bacteria, with 7 and 6 isolates, respectively. PMID- 6853313 TI - Parietal hernia in a horse. PMID- 6853312 TI - Apparent brodifacoum poisoning in a dog. PMID- 6853315 TI - Veterinary service categories and 1981 gross practice income. PMID- 6853314 TI - Jejunal intussusception associated with leiomyoma in an aged horse. PMID- 6853316 TI - What is your diagnosis? Large, fluid-dense circular mass in the left perineal area. PMID- 6853317 TI - Diagnosis of a diagnosis. PMID- 6853318 TI - Test for estimation of bovine hepatic lipid content. AB - The lipid content of bovine liver was found to be highly correlated with its specific gravity. This observation was used as the basis for a clinical test to estimate the liver lipid content in dairy cows. The test consisted of submerging needle biopsy specimens of liver into water and copper sulfate solutions with specific gravities of 1.025 and 1.055. On the basis of buoyancy in these liquids, bovine liver samples were classified accurately as containing greater than 34% lipid, greater than 25% lipid, greater than 13% lipid, or less than 15% lipid. PMID- 6853319 TI - Cause and pathogenesis of middle ear infection in young feedlot cattle. AB - Two populations of feedlot cattle--weaned calves and yearlings--suffered otitis media. In calves the disease was acute and epizootic and had a prevalence of about 400 cases per 2000 cattle, whereas in yearlings, it was chronic and sporadic and had a prevalence of 1 case per 2000 cattle. Clinical signs were facial paralysis, otorrhea, and head tilt. The middle ears from 64 dead calves and 22 dead yearlings were examined. Calf ears had acute infection, with exudate in air cells and rupture of tympanic membranes. Yearling ears had chronic infection, with exudate in air cells, rupture or destruction of tympanic membranes, and necrosis of air cell partitions. Mixtures of Pasteurella multocida and Corynebacterium pseudotuberculosis were isolated from diseased ears, but Pasteurella multocida predominated in acute infections and Corynebacterium pseudotuberculosis predominated in chronic infections. PMID- 6853320 TI - Hypernatremic, hypertonic dehydration in a dog with diabetes insipidus and gastric dilation-volvulus. PMID- 6853321 TI - Babesiosis in the Greyhound. AB - Babesiosis was diagnosed in five 11- to 18-day old Greyhound pups. In 3 pups, Babesia canis organisms were identified by examination of a Wright's-Giemsa stained smear of blood. In 2 pups, the diagnosis was established by examination of a splenic impression smear obtained at necropsy. Findings in the 3 clinical cases included depression, weakness, anorexia, pallor, anemia, and thrombocytopenia. Subcutaneous administration of diminazene aceturate resulted in rapid clinical recovery in these cases. In the 2 pups that were necropsied, variable numbers of erythrocytes containing Babesia organisms were observed in the microvasculature of tissues. Subinoculation of blood into an intact dog and a splenectomized dog resulted in parasitemia and B canis serum titers, as determined by indirect fluorescent antibody testing. A site visit to the kennel from which the pups had originated led to identification of numerous Rhipicephalus sanguineus in small buildings and pens. Of 107 dogs from this kennel that were tested, 63 had an indirect fluorescent antibody titer for B canis. A limited serologic survey of Greyhound kennels in West Virginia, Oklahoma, Texas, Mississippi, and Florida identified a large number of dogs with indirect fluorescent antibody titers for B canis. PMID- 6853322 TI - X-Chromosome monosomy (37,XO) in a Burmese cat with gonadal dysgenesis. AB - A 37,XO-chromosome complement was detected in a 21/2-year-old sable Burmese cat examined because of primary anestrus. The cat was smaller than its littermates; other somatic abnormalities associated with the XO karyotype in other species were not present. The ovaries, which did not respond to gonadotropin stimulation, contained inactive germinal epithelium (lacking follicles and primordial germ cells), which was similar to that of adult human patients with XO-gonadal dysgenesis. PMID- 6853323 TI - Suppurative epididymitis in a ram infected with Actinobacillus seminis. PMID- 6853324 TI - Primidone intoxication associated with concurrent use of chloramphenicol. PMID- 6853325 TI - Postoperative orthovoltage radiation therapy of parotid salivary gland adenocarcinoma in three dogs. PMID- 6853326 TI - What is your diagnosis? Gastrointestinal foreign bodies. PMID- 6853328 TI - Unilateral pseudophakia and extended-wear aphakic contact lenses. A comparative study in a single patient population. AB - Twenty-nine patients who were pseudophakic in one eye and wearing a Permalens in the other eye were evaluated. Pseudophakic correction provided the patient with good, stable visual acuity, minimal risks, and an excellent long-term prognosis. Permalens aphakic correction also provided the patient with good, but fluctuating visual acuity. Risks such as deposit formation, tight lens syndrome, and corneal infections were not infrequently associated with the Permalens, and Permalens patients were also faced with the recurring cost of lens replacement. While both modalities of aphakic visual rehabilitation are acceptable, pseudophakia appears to provide the patient with better visual acuity, fewer risks, and lower financial costs in the long run. PMID- 6853327 TI - Effect of ultraviolet radiation (300-400 nanometers) on polypropylene. AB - Polypropylene discs and shavings were exposed to simulated ambient ultraviolet (UV) radiation (lambda 300-400 nm) for a period equivalent to at least two years of wear within the eye, assuming the eye to be exposed to ambient UV radiation for four hours per day at 1 mW/cm2. The polypropylene and the incubation media were measured by several forms of optical spectroscopy, and there was no photochemical change in either. Where polypropylene discs were exposed to a very high level of UV radiation (greater than 500 W/cm2), they became brittle and discolored within five to ten days. This level of exposure, however, was equivalent to a total of over 20 million joules/cm2, which is at least one million times levels for expected ambient UV exposure to polypropylene within the eye. PMID- 6853329 TI - Two-looped anterior chamber lenses in complicated extracapsular cases. AB - Informal allusions to the widespread use of two-looped semiflexible anterior chamber lens implants as "back-up" lenses in patients originally selected for posterior chamber implantation led the authors to do a retrospective study of complicated cases in their practice during a two-year period. While there may be some surgeons who simply abort implantation in the case of loss of posterior capsule integrity, vitreous loss or vitreous instrumentation, there seems to be a trend for extracapsular surgeons to substitute an anterior chamber lens under these conditions. During the study period, no planned lens implantation procedure was aborted. The postoperative complications and visual results of those eyes in which anterior chamber lenses were substituted are the subject of this presentation. As expected, the results in patients with a surgical complication are worse than in uncomplicated cases, but the visual reduction is nominal. The prognosis if capsule disruption occurs without vitreous complication is excellent. PMID- 6853330 TI - Descemet's membrane separation during five hundred forty-four intraocular lens implantations. 1975-1982. PMID- 6853334 TI - The Healon tamponade. PMID- 6853331 TI - Intraocular lens implantation in traumatic cataract in children. PMID- 6853336 TI - Lens implant--corneal touch in extracapsular surgery. PMID- 6853332 TI - Evaluation of semiflexible and flexible anterior chamber intraocular lenses. PMID- 6853337 TI - Ugh-like syndromes caused by detergents. PMID- 6853333 TI - Spontaneous iris retraction occurring after extracapsular cataract extraction and posterior lens implantation in patients with glaucoma. PMID- 6853335 TI - Omission of injection for lid akinesia. PMID- 6853339 TI - Football mnemonic for correction of preoperative astigmatism. PMID- 6853340 TI - Surgical management of intraocular lens dislocation into the vitreous: case report. PMID- 6853341 TI - How do you handle a small, undilatable pupil for extracapsular cataract extraction with intraocular lens implantation? PMID- 6853338 TI - Complication in planned extracapsular cataract extraction. PMID- 6853342 TI - The musculature of the gall bladder and biliary pathways in the guinea-pig. AB - A study of the gall bladder and the biliary pathways was carried out in the guinea-pig by light and electron microscopy. The musculature of the distended gall bladder measures only about 220 microns in thickness and consists of muscle bundles running in various directions. The muscle cells are loosely packed and are much smaller than the muscle cells of the intestinal muscularis externa. They resemble, in structure and arrangement, the cells of the muscularis mucosae of the intestine. In the cystic duct, the hepatic duct and the upper third of the bile duct, the musculature is similar to that of the gall bladder but is sparser and mixed with abundant connective tissue (fibromuscular layer). In the middle and lower portions of the bile duct there is a progressive increase in the amount of musculature. While the outer diameter of the organ remains constant (about 1.3 mm), the amount of muscle in a transverse section of the duct increases more than ten times along the length of the duct. Here the muscle cells are large and densely packed and closely resemble those of the duodenal muscularis externa. The bile duct forms with the duodenum an angle of about 30 degrees and it opens into a large cavity within the duodenal wall, the ampulla, which has a complex muscular system of its own. The ampulla is drained into the duodenal lumen through a duct within the papilla, around which lies a ring of circular musculature. The pancreatic duct opens independently into the duodenum about 6 cm aboral to the bile duct. PMID- 6853343 TI - Scanning electron microscopy of amoeboid microglial cells in the transient cavum septum pellucidum in pre- and postnatal rats. AB - The cavum septum pellucidum in rats of different ages was studied by light and scanning electron microscopy. A reconstruction from serial paraffin sections showed that the cavum was a pyramidal shaped closed cavity which was bounded above by the corpus callosum and inferolaterally by the lateral septal nuclei. The first sign of the cavum formation was noted in the 20 days post conception rat where there was a loosening up of the neuropil beneath the corpus callosum deep to the longitudinal fissure. A variable number of amoeboid microglial cells, characterised by their abundant eosinophilic cytoplasm, was seen among the smaller immature cells in the wide interstitial spaces. A definitive cavity was formed in the 21 days post conception rat and it continued to grow until the fifth postnatal day when it gradually diminished in size to become slit-like by the fifteenth postnatal day. The scanning electron microscope showed that the wall of the cavum was composed of a feltwork of glial and nerve fibres. Two types of cells were present in the cavum: cells identified as glioblasts, and amoeboid microglial cells. The glioblasts were were characterised by having a smooth cell body with radiating long processes. The amoeboid microglial cells showed diverse forms of surface protrusions: blebs, filopodia and membrane ruffles similar to other tissue macrophages. They were either adherent to the walls of the cavum, clustered around the blood vessel which traversed the cavum, or floating freely in the lumen. It was suggested that the amoeboid microglial cells were probably derived from extravasated blood monocytes in response to the physical damage resulting from the formation of the cavum septum pellucidum in the developing brain. PMID- 6853344 TI - Comparison of the growth of the tunica media of the ascending aorta, aortic isthmus and descending aorta in infants and children. AB - This study concerns the normal histological growth of the aorta in infants and children. We measured, in post mortem material consisting of 69 hearts and great vessels of infants and children who died from non-vascular diseases, the internal diameters of the ascending aorta, aortic isthmus and descending aorta together with the thickness of the tunica media and the packing density of its elastic fibres. Age range was from 27 weeks of gestational age up to 10 years after birth. The growth of the tunica media of the ascending aorta was, in part, different from that of the aortic isthmus and descending aorta. Notwithstanding an increase in the thickness of the tunica media parallelling, in all three parts of the aorta, an increase in their internal diameters, the packing density of the elastic fibres of the tunica media of the aortic isthmus and of the descending aorta showed no tendency to increase with age. However, the packing density of the elastic fibres of the ascending aorta showed a continuing increase with age parallelling the increase of the internal diameter. This can probably be better explained as a result of functional difference than as a result of different embryological origin. PMID- 6853346 TI - Neurons and glial cells in long term cultures of previously dissociated newborn mouse cerebral cortex. AB - In long term cultures of newborn mouse spinal cord neurons, glial cells and macrophage-like cells may frequently be located in their entirety. Many neurons possessed processes which could be traced from their cell bodies to their growth cones, a feature which indicated that the cells remained immature. The identification of neurons with certainty is a major problem when live cells are observed by light microscopy, but their size, nuclear and cytoplasmic content and the arrangement and number of their processes were features which helped to locate them. After many weeks in culture, however, astrocytes also became extremely large and it became increasingly difficult to separate them from neurons unless features within the cells were clearly seen. The shape and size of glial cells, especially astrocytes, may alter rapidly in culture, and a wide range of features was present for each cell type. It was therefore often impossible to categorize them with certainty when viewed live, but the identification of many was subsequently confirmed with the use of electron microscopic sections. Macrophage-like cells were numerous in older cultures where they engulfed the ever increasing number of dead cells. The size of the cell bodies of many macrophages matched those of neurons, but their stumpy processes and largely granular content were generally adequate to identify them. The persistent immaturity of the neurons and their apparent dependence both on environmental conditions and synaptic relations, and the characteristics of glial cells in long term cell cultures are discussed. PMID- 6853345 TI - Mononuclear cell accumulations in the trophoblastic giant cell circulation in inbred strains of mice. AB - Marked accumulations of mononuclear cells in the trophoblastic giant cell layer of the pregnant mouse uterus have been investigated in the B10, B10.A, SWR/J and DBA/2J strains. Relatively low and approximately equal numbers of mononuclear cells in the trophoblastic giant cell layer were found throughout the ninth and eleventh days in conceptuses of both isogenically mated B10 female mice and those mated with B10.A males. Increased numbers of mononuclear cells in the trophoblastic giant cell layer were found throughout the tenth day in conceptuses of the former mating, while an even greater increase was found at approximately 9 am. on the tenth day in conceptuses of the latter. Conceptuses from B10.A females mated with B10 males have a higher number of mononuclear cells at about 9 am. on the tenth day than those from isogenically mated B10.A females, although the numbers are not as high as those found in conceptuses from B10 females mated with B10.A males. There appears to be no significant difference in numbers of mononuclear cells, at about 6 am, 9 am. and noon on the tenth day, between conceptuses from isogenically mated B10, B10.A, SWR/J and DBA/2J female mice. PMID- 6853347 TI - The maintenance of rat metrial gland explants in vitro, in the presence and absence of progesterone. AB - Explants of metrial gland were taken from uteri of rats at day 13 of pregnancy and maintained in vitro for up to 9 days. Some cultures were supplemented with progesterone. The progress of the explants was monitored by light and electron microscopy. In the absence of progesterone, large amounts of collagen were apparent and many cells contained lipid inclusions. The granulated cells which are characteristic of the gland were not seen after 4 days in culture. In the presence of progesterone, though apparently normal granulated cells were readily found after 4 days in culture and could be identified after 9 days, some showed changes which do not occur in vivo. Collagen accumulation and the development of lipid inclusions were less extensive in the presence of progesterone. PMID- 6853349 TI - Oxytalan fibres in the rat pineal gland. AB - The present study shows the existence of oxytalan fibres in the connective tissue spaces of the rat pineal gland. The identification of these fibres with light microscopy is based on their ability to stain with aldehyde-fuchsin and orcein after oxidation with peracetic acid. Using the electron microscope, oxytalan fibres appear as bundles of fibrils of 12-15 nm without transverse striation. Oxytalan fibres increase with age, being most abundant in the old rat. PMID- 6853351 TI - Pregnancy-associated changes in the physical and microscopic characteristics of the ovine cervix. AB - Ovine cervices were obtained at slaughter from 18 sheep comprising six groups of three--cycling ewe lambs, non-pregnant, and four groups of pregnant animals of progressively longer gestation PI to PIV. Physical and microscopic analyses carried out on these cervices showed consistent results throughout any individual tissue. A number of factors changed with increasing gestational age and some of these changes were noted from early gestation. No significant change in water content was observed through pregnancy. With increasing length of gestation the cervix increased in length and width, there were relative increases in fibroblasts, smooth muscle and softening of the tissue, and relative decreases in collagen and fibrocytes. An increased vascularity was observed in the tissues from late gestation sheep, and a change in the nature of the epithelial secretion, from neutral to acidic mucins, was also associated with late pregnancy. PMID- 6853348 TI - Light microscopic, histochemical and ultrastructural studies of human lymph node paracortical venules. AB - The light microscopic, histochemical and electron microscopic appearances of human lymph node paracortical high endothelial venules are described, and indicate that the vessels are metabolically active and involved in secretion. A comparison is drawn between these vessels and the majority of lymph node vessels lined by flat endothelium. The evidence suggests that these vessels are identical to similar vessels in the lymph nodes of experimental animals and which are known to be the site of selective migration of lymphocytes into lymph nodes. The correlation between the structural and cytochemical findings and their probable function is discussed. PMID- 6853352 TI - Maturation in the ferret ileal epithelium and the effect of cortisone acetate. AB - Normal maturation ('closure') in the ferret ileal epithelium occurs, between 35 and 39 days after birth, by a process of cellular replacement. The administration of cortisone acetate at doses up to 1.2 mg/g body weight for 5 days failed to promote any morphological changes in the ileal epithelium in this non-rodent species, and the results suggest that the maturing effect of cortisone acetate in the rat might be peculiar to the rodents. PMID- 6853350 TI - The permeability of the epithelium of the skin of fetal rats demonstrated with a lanthanum-containing solution. AB - The permeability of the skin of fetal rats between 14 and 21 days of intrauterine life was investigated by injecting lanthanum nitrate solution subepidermally and by exposing the external surface of other fetuses to the same solution. Up to the age of 18 days, the epidermis was freely permeable from the basal surface and lanthanum entered junctional complexes between periderm cells. After 18 days, the limit of permeation corresponded to the level at which membrane-coating granules were released into the intercellular spaces. At all ages, permeation from the outer surface was limited to the junctional complexes between the periderm cells covering the epidermis throughout fetal life. Damage to the periderm at early ages resulted in complete penetration of the epidermis by lanthanum. It was concluded that, prior to secretion of the epidermal permeability barrier at 18 days, the periderm was the principal barrier to permeation by lanthanum. PMID- 6853353 TI - Cell kinetics of growth cartilage in stumpy: a new chondrodystrophic mutant in the mouse. AB - The proximal growth plates of the tibiae in normal and stumpy mice aged 10-41 days were studied. Autoradiographic studies using tritiated thymidine enabled the size of the proliferating cell population and the labelling indices of the growth plates to be determined. Hypertrophic cell heights were also measured. From these data the overall growth rates for the proximal growth plate of the tibia in normal and stumpy mice were calculated. It was found that the major factor responsible for the reduced growth rate in stumpy up to 21 days was the small hypertrophic cell height, while cell proliferation zone size and labelling indices were of minor importance. Histological observations also revealed a lack of organised endochondral ossification, which worsens with age. PMID- 6853354 TI - Bilateral innervation of the anterior digastric muscle by trigeminal motor neurons. AB - The locations and numbers of trigeminal motor neurons supplying the anterior digastric muscle in the rat were observed following retrograde transport of horseradish peroxidase. Unilateral injection of horseradish peroxidase into the muscle resulted in bilateral labelling of cells in the ventromedial region of the caudal trigeminal nucleus. The numbers of cells on the contralateral side were consistently lower than those in the ipsilateral nucleus (30 cells compared to 171). Bilateral injection of horseradish peroxidase resulted in higher numbers of cells on both sides than was seen ipsilaterally after unilateral injection: these numbers corresponded roughly to the sum of ipsilateral and contralateral labelled cells after a single injection. The contralateral reaction product survived removal of the opposite muscle and nerve immediately before injection. Ablation of one trigeminal motor nucleus caused degeneration in the opposite nucleus, and some degenerating fibres crossed the mid-line at the level of the motor nucleus, in the bundle of fibres decussating in the dorsal pons. PMID- 6853355 TI - Ultrastructural changes in articular cartilage after experimental section of the anterior cruciate ligament of the dog knee. AB - Ultrastructural changes in articular cartilage were studied in joint laxity induced by severing the anterior cruciate ligament of the right knee in sixteen mature dogs. The left knees provided controls; sham operations on six other dogs consisted of stab incision only, leaving the ligament intact. Cartilage from the medial tibial condyles was examined at intervals from two days to eighteen months later. In the superficial zone of the cartilage, collagen fibrils became abnormally widely spaced at four days, and narrower fibrils appeared from seven days after operation. Chondrocytes, particularly in the middle zone, became more active, with hypertrophy of cytoplasmic organelles detectable from four days. Superficial cells were initially healthy and became more numerous while their lipid content increased. The articular surface was fissured from two months and cell degeneration was rarely seen until several months after operation. These findings correlate with previous biochemical studies and are similar to early changes noted in degeneration of human articular cartilage. PMID- 6853356 TI - Sperm morphology assessment as an indicator of human fertilizing capacity. AB - Semen samples from 95 men were examined by routine semen analysis and specific histologic staining for sperm morphology. The men were classified into fertile and infertile groups on the basis of clinical evaluation and in vitro testing, using the zona-free hamster egg penetration assay. Thirty men were designated as fertile, as they had fathered children and their sperm showed penetration of greater than 20% of the zona-free hamster eggs with the in vitro fertilization test. Subjects classified as infertile were men from infertile couples whose wives showed no evidence of infertility and whose in vitro fertilization ability was 10% or less. The semen analysis parameters of the fertile and infertile groups were significantly different. Fertile men had mean values of 108 X 10(6) sperm/ml, 61% motile, 64% normal forms (sperm with oval morphology), and 69% penetration in vitro. The mean values for infertile men were significantly lower: 42 X 10(6) sperm/ml, 45% motile, 32% normal forms, and 3.2% penetration in vitro. The importance of the morphology parameter was revealed by comparison of the percentage of penetration with count, motility, and morphology. Penetration correlated best with morphology (r = 0.730) as compared with motility (r = 0.451) and count (r = 0.605). The distribution of abnormalities in the infertile group revealed 81.6% with abnormal morphology (less than 50%), 53.8% with abnormal motility (less than 50%), and 38.5% with abnormal count (less than 20 million/ml). As a single parameter, decreased number of normal forms appears to be a good indicator for clinical infertility if in vitro fertilization testing is not available. PMID- 6853357 TI - Improvement in the sperm penetration (hamster ova) assay (SPA) results after doxycycline treatment of infertile men. AB - Thirty-two men with abnormal (less than or equal to 11% penetration) Sperm Penetration (hamster ova) Assay (SPA) results were treated with doxycycline and reevaluated by SPA and seminal fluid analysis. Eighteen of the 32 infertile men with initially abnormal SPAs had normal SPAs (greater than or equal to 15% egg penetration) after treatment. None of 30 untreated infertile men with abnormal SPAs had a normal SPA on repeat testing (P less than 0.001). Improvement in SPA results was associated with a decrease in the number of leukocytes/ml in seminal fluid. Seven of the wives of the treated men conceived, while none of the wives of the untreated infertile men conceived during comparable intervals of time. PMID- 6853360 TI - A study of phospholipase in albumin and its role in inducing the acrosome reaction of guinea pig spermatozoa in vitro. AB - Phospholipase activity associated with guinea pig spermatozoa during capacitation and the acrosome reaction (AR) was determined by measuring the production of [14C] glycerylphosphorylcholine (GPC) from [14C] phosphatidylcholine (PTC) over a 2-hour period at the beginning and at the end of a 6-hour incubation. Spermatozoa converted 13 X more [14C] PTC to [14C] GPC during the last 2 hours of incubation than during the first 2 hours which corresponded to an increase in AR from 7% at 2 hours to 55% at 6 hours. In vitro studies also were performed to assess the role of phospholipase activity in bovine serum albumin (BSA) in inducing the AR of guinea pig spermatozoa. Spermatozoa, obtained by backflushing the cauda epididymidis, were incubated for up to 6 hours in Biggers, Whitten, and Whittinghams' (BWW) medium alone or containing various additives. These additives were: 0.1% BSA, phospholipase A2, p-bromophenacyl bromide, DMSO, 0.1% BSA plus p bromophenacyl bromide, or 0.1% BSA plus DMSO. Each hour of incubation, samples were assessed for the percentage of AR sperm and sperm motility. The percentage of AR sperm after 6 hours in BWW supplemented with phospholipase A2, at the level of PTC hydrolyzing ability detected in BWW with 0.1% BSA, was similar to that of BWW and BSA. However, the percentage of AR sperm in BWW with BSA and the phospholipase inhibitor p-bromophenacyl bromide was significantly lower than that in BWW with BSA or phospholipase A2 and similar to that in BWW without BSA. Sperm motility was significantly less in incubations containing phospholipase A2, but lacking BSA. It was concluded that phospholipase activity in BSA may contribute to capacitation and the AR of guinea pig sperm in vitro by mimicking the action of native sperm phospholipase. PMID- 6853359 TI - Influence of estradiol on accessory reproductive organs in the castrated male rat. Effects of bromocriptine and flutamide. AB - Estradiol partially maintained the weights of the dorsolateral prostate and seminal vesicles in castrated adult male rats. One group of animals received subcutaneous injections of estradiol (0.01 mg/kg) daily, while a second group of animals received estradiol plus bromocriptine (4.0 mg/kg). Changes in weights of accessory reproductive organs were correlated with serum prolactin levels. Estradiol significantly increased serum prolactin levels while concomitant treatment with bromocriptine caused serum prolactin to remain at castrate levels. Bromocriptine slightly decreased, but did not abolish, the effect of estradiol on weights of the dorsolateral prostate and seminal vesicles. To determine if the effect of estradiol was mediated by androgen receptors in the dorsolateral prostate and seminal vesicles, a third group of animals was treated with flutamide. Flutamide, at a dosage (20 mg/kg) that abolished the effects of dihydrotestosterone on the weights of these tissues, produced no alternation of the effects of estradiol. Treatment of animals with a combination of flutamide, bromocriptine, and estradiol did not significantly alter organ weights from the results obtained with bromocriptine and estradiol. Scatchard plot analysis of the effect of estradiol treatment on cytosol binding of estradiol demonstrated increased quantities of estradiol binding in dorsolateral prostate and seminal vesicles which correlated with the changes in weights noted. Although part of the effect of estradiol on regression of male accessory reproductive organs of castrated rats may be mediated by prolactin, the principal effect appears to be a direct action on responsive tissues. PMID- 6853362 TI - Enhanced daily sperm production in the remaining testis of aged rats following hemicastration. PMID- 6853358 TI - The nonprogressive motility of sperm populations from mice with a tw32 haplotype. AB - We have previously reported that epididymal spermatozoa from mice carrying a tw32 haplotype have a lower net velocity than do spermatozoa from congenic +/+ males. Using a test for nonprogressive motility based on the inability of a spermatazoon to leave a cube 200 micron on each side in less than 4 seconds, the frequency of nonprogressively motile sperm in these populations now has been determined to be above 90% after 2 to 5 hours of incubation in vitro. The nonprogressive motility never appears in sperm populations incubated in media with less than 0.1 mM Ca2+, although normal motility is well-maintained. Nonprogressive motility was also observed at low frequencies in uterine sperm populations, and at higher frequencies among uterotubal sperm from both +/+ and tw32/+ males. These observations suggest that nonprogressive motility may be a component of normal sperm function, either during sperm transport within the oviduct, or during fertilization. PMID- 6853361 TI - Synthesis and secretion of glycoprotein by the epididymal epithelium. AB - The secretory activity of the middle segment of the mouse caput epididymidis was studied using 3H-fucose as a precursor to glycoprotein. Young adult male mice were injected with a concentrated solution of 3H-fucose interstitially, ie beneath the connective tissue capsule of the epididymis. Two animals were killed and prepared for light microscopic radioautography at each of six intervals between 10 minutes and 24 hours after injection. Silver grains were concentrated over the supranuclear Golgi region at 10 minutes and over the apical ends of the cells 30 minutes and 1 hour after injection. Quantitative analysis showed that luminal radioactivity increased greatly beginning with the 2-hour samples. The results indicate that the epididymal epithelium synthesizes and secretes glycoproteins, and that 1 to 2 hours are required for terminal glycosylation, intracellular transport, and release of the secretory product. PMID- 6853363 TI - Suppression of the proliferative response of the seminal vesicles to testosterone by inhibitors of prostaglandin synthesis. Testosterone, indomethacin, and proliferation in seminal vesicles. AB - Effects of indomethacin (1.25 mg/kg) and aspirin (20 mg/kg) on testosterone induced (0.25 mg/rat), and of indomethacin on dihydrotestosterone-induced (0.25 mg/rat) mitotic activity of the seminal vesicles and the ventral prostate in rats were examined. The results demonstrate that the seminal vesicles' proliferative reaction induced by testosterone was suppressed by treatment with indomethacin and aspirin; whereas, in the ventral prostate, the mitogenic effect of testosterone was not blocked by either of these inhibitors of prostaglandin synthesis. Cellular proliferation induced by dihydrotestosterone was not inhibited by indomethacin in either the seminal vesicles or the ventral prostate. These results suggest the existence of different mechanisms of proliferative reactions of the seminal vesicles and the ventral prostate to testosterone. The results further suggest an involvement of prostaglandins in the mitogenic effect of testosterone on the seminal vesicles. PMID- 6853366 TI - Characterization of novel antibiotics of the triostin group by fast atom bombardment mass spectrometry. PMID- 6853365 TI - Ravidomycin (AY-25,545), a new antitumor antibiotic. AB - A streptomycete was isolated from a Guatemala soil sample and found to inhibit Grampositive bacteria including mycobacteria. The antibiotic-producing microorganism was characterized, identified as a new species and named Streptomyces ravidus. The antibiotic principle was extracted with organic solvent from the mycelium, isolated in crystalline form and named ravidomycin. Ravidomycin is mainly active against Gram-positive bacteria including mycobacteria. It shows only weak activity against Gram-negative organisms and no activity against fungi. Ravidomycin exhibits potent antitumor activity against P388 lymphocytic leukemia, Colon 38 tumor and CD8F1 mammary tumor. Acute toxicity in mice is low. PMID- 6853364 TI - Novel polyether antibiotics X-14868A, B, C, and D produced by a Nocardia. Discovery, fermentation, biological as well as ionophore properties and taxonomy of the producing culture. PMID- 6853368 TI - Studies on a new antibiotic M-92 produced by micromonospora. V. Mechanism of action of the component VA-2. AB - Effects of VA-2, a component of quinoid antibiotic M-92, on the incorporation of radioisotope-labeled compounds into the cells of Staphylococcus aureus were studied. Deoxyribonucleic acid (DNA) synthesis was immediately inhibited by the addition of VA-2. Significant inhibitions of ribonucleic acid and protein syntheses and minor reduction of peptidoglycan synthesis were observed after a short delay. VA-2 immediately induced the degradation of DNA prelabelled with [14C]thymidine in the cells of S. aureus. In the examinations using E. coli enzyme and calf thymus DNA as a template, VA-2 prevented DNA-dependent DNA polymerase reaction. The inhibition of DNA polymerase I reaction was fairly reversed by increasing the concentration of template DNA, but slightly by that of the enzyme. Agarose gel electrophoresis showed that VA-2 elicited an extensive cleavage of PM2 cccDNA. VA-2 caused a primary conversion of the cccDNA to ocDNA at a low concentration (0.2 micrograms/ml), while at high concentrations (2.0 and 20 micrograms/ml) it cleaved the cccDNA to ocDNA and linear DNA progressively. These cleavages were observed even at 0 degrees C as well as at 37 degrees C, and were enhanced with the addition of a reducing agent such as 2-mercaptoethanol or sodium borohydride. PMID- 6853370 TI - Pock forming plasmids from antibiotic-producing Streptomyces. AB - Pock forming ability of fifteen plasmids isolated from antibiotic-producing Streptomyces was examined with polyethylene glycol mediated protoplast transformation. Four plasmids (pSF765, pSF689, pSF674 and pSF601) were found to have pock forming ability on Streptomyces lividans 66. Each putative transformants isolated from the center of pock regions harbored plasmids with same restriction enzyme cleavage sites as original plasmids. The plasmids from the transformants produced pock, which were morphologically identical to the original plasmids. Transformation frequency of S. lividans 66 with pSF689 from S. lividans 66 was at least 500-fold higher (5 x 10(5) transformants per 1 microgram DNA) than that with the plasmid isolated from the original strain (10(3) transformants per 1 microgram DNA). In case of pSF765 the transformation frequency was not changed (about 10(5) transformants per 1 microgram DNA) by replications in S. lividans 66. Expanded restriction enzyme maps for the four plasmids are reported. PMID- 6853371 TI - Erythronolide A glycosidation to erythromycin A by a blocked mutant of Streptomyces erythraeus. PMID- 6853369 TI - Chemical modification of carbapenem antibiotics. Versatile methods for displacement of the C-3 sulfur side chain of carbapenems with other thiol groups. PMID- 6853367 TI - Elucidation of structure of novel macrolide antibiotics produced by mutant strains of Streptomyces fradiae. PMID- 6853372 TI - Milbemycins, a new family of macrolide antibiotics: producing organism and its mutants. PMID- 6853373 TI - Biosynthesis and the metabolic fate of carbon-14 labeled spiramycin I. PMID- 6853374 TI - A new antibiotic, 3,6-dihydroxyindoxazene. PMID- 6853375 TI - Decilorubicin, a new anthracycline antibiotic. PMID- 6853376 TI - Decilonitrose and 4-O-succinyl-L-diginose, sugar components of decilorubicin. PMID- 6853377 TI - Influence of different ratios of corn and corn silage, housing systems and seasons on the performance of feedlot steers. AB - Observations on the effects of season, housing and diet were made on 916 steers in three winter and two summer trials. Diets consisted of corn grain and corn silage, in balanced rations, fed ad libitum with energy ratios of 25:75 (Diet 1), 55:45 (Diet 2) and 85:15 (Diet 3). There were three types of housing systems: outside lots without access to overhead shelter (NS), outside lots with access to overhead shelter (OS) and an open-front confinement building (C). Average ambient temperatures and precipitation for winter and summer trials were -1.0 and 15.3 C and 4.67 and 10.81 cm/mo, respectively. Steers gained more (P less than .05) in summer than in winter. Within housing system, OS and NS steers gained faster and consumed more dry matter (DM) and energy (P less than .05) than C steers; C-fed steers were less (P less than .05) efficient (kg feed DM/kg gain) than OS steers. Steers fed Diet 1 had lower (P less than .05) average daily gain (ADG) than those fed Diets 2 and 3. Steers on Diet 3 consumed less DM (P less than .05) than those on Diets 1 and 2. Estimated metabolizable energy intake (MEI) was significantly less for cattle fed Diet 1 than those fed Diets 2 or 3. Diet 3 was more (P less than .05) efficient than Diet 1. Season x diet (P less than .10) and season x housing (P less than .10) interactions were found for daily DM intake and MEI. This resulted in greater cattle growth rate responses to higher grain diets in summer than in winter and more pronounced adverse effects of confinement rearing in summer than in winter. No evidence was found of other two-way or three-way interactions for any of the performance characteristics studied. These results indicate that in addition to important singular effects of season, housing and diet, important interactions of these factors also exist. PMID- 6853378 TI - Nutrient requirements to maintain weight of mature, nonlactating, nonpregnant cows of four diverse breed types. AB - Four breed types with 12 cows/breed-type (Hereford x Angus, AHx; Charolais and Angus and Charolais x Hereford, Cx; Jersey x Angus, Jersey x Hereford, Jx and Simmental x Angus, Simmental x Hereford, Sx) were used to estimate nutrient requirements for zero daily weight change. Four nonpregnant, nonlactating cows of each breed type were assigned to one of three feeding levels [90 kcal metabolizable energy (ME).kg body wt (kg)-.75 . d-1, 150 kcal ME.kg-.75.d-1 and ad libitum] for a 140 d feeding period. The feeding trial was: Period 1 (d 0 to 70) and Period 2 (d 70 to 140). Effect of breed type, feeding level and the two way interaction upon weight, weight change and feed intake data were initially analyzed. Two-factor interactions tended not to be significant for weight and weight change. The main effects of breed type and feeding level tended to be significant for weight and weight change in each of the periods. On d 0, the Sx (570 +/- 13 kg) and Cx (578 +/- 14 kg) were heavier (P less than .05) than the AHx (527 +/- 13 kg) all of which were heavier than the Jx (458 +/- 14 kg). Under the two restricted diets, the breed type ranking for dry matter intake corresponded to the ranking for initial body weight. However, at the ad libitum feeding level, the Cx tended to consume less dry matter than the other breed types. Measures of weight change were evaluated to test the effect of breed type and dry matter intake. The effect of breed type was significant only for daily weight change (kg/d) during Period 2. The linear and(or) quadratic effects of dry matter intake (2.53 Mcal ME/kg dry matter) on measures of weight change were significant in all periods. During Period 1, the pooled dry matter intake estimate for zero daily weight change and zero metabolic weight change were 8.1 kg/d and 75.3 g.kg-.75.d-1, respectively. For AHx, Cx, Jx and Sx during Period 2, daily dry matter intake for zero weight gain was 4.2, 5.3, 4.2 and 5.5 kg/d, respectively. A pooled estimate of 43.9 g . kg-.75 . d-1 was obtained for dry matter intake relative to metabolic size in Period 2. PMID- 6853379 TI - Use of lambing cubicles and the behavior of ewes at parturition. AB - Three trials were conducted involving 393 ewes to determine the feasibility of using cubicles to provide isolation for parturient ewes in lambing pens. The cubicles consisted of an enclosure with 1 m high walls and a small (.6 m wide) opening to allow ewes free access. In trial 1, 42% of the parturitions occurred in the cubicles, which occupied only 19% of the pen area. No preference was noted for large (1.8 x 1.8 m) vs small (1.8 x 1.2 m) cubicles. Use of the cubicles increased from 4% of the time 24 h before parturition to 25% of the time during the 6 h immediately preceding parturition. In trial 2, ewes did not show a preference for open vs covered walls on cubicles or for open vs covered cubicle ceilings. Cubicles were again used to a greater (P less than .01) extent than would be predicted by their relative area (26% use, 18% area). In the final trial, mature ewes used cubicles to a greater (P less than .10) extent than did yearlings (55 vs 38%, respectively). Cubicles and areas of the pen farthest from the working area of the herdsman were most frequently (P less than .001) used during parturition. Cubicles appeared to be effective in preventing separation of newborn lambs from their dam and in reducing interference by other ewes. PMID- 6853380 TI - Effect of growth hormone, testosterone and serum concentration on actin synthesis in cultured satellite cells. AB - Because most of the DNA in a mature muscle accumulates during postnatal life and is derived from satellite cells, cellular regulation of protein accumulation in muscle fibers originating from satellite cells is an important aspect of muscle growth control. These experiments were designed to study the modulation of a alpha-actin accumulation in satellite cell-derived myotubes by serum and two anabolic hormones commonly assumed to be involved in muscle growth regulation; growth hormone and testosterone. Satellite cells were cultured from rats ranging in age from 5 d to 1 yr. After fusion into myotubes, various levels of pig serum, 3 to 20%, were added to culture medium, and the amount of alpha-actin per myotube nucleus was determined 4 d later. The quantity increased with increasing percentages of serum in the medium. For an assessment of the extent to which serum stimulatory activity was due to growth hormone or testosterone in the serum, similar experiments were conducted with medium containing 10% pig serum plus various levels of porcine growth hormone or testosterone. Neither of these hormones stimulated actin accumulation at concentrations from 10(-9) to 10(-6) M, a range encompassing physiological levels for each hormone. These experiments do not support the premise that either growth hormone and (or) testosterone are the blood-borne agents that interact directly with muscle to stimulate protein accretion, because neither growth hormone nor testosterone acted directly on muscle cells in vitro to stimulate muscle protein accumulation. PMID- 6853381 TI - Compensatory responses to short-term feed restriction during the growing period in swine. PMID- 6853382 TI - Nutritive value of acetate in growing pigs. AB - Twelve crossbred barrows from four litters (average initial body weight of 21 kg) were used to examine the nutritive value of acetate in growing pigs. The treatments were the addition of acetate in the form of triacetin to the basal diet at 0, 5 and 10% of the metabolizable energy (ME) intake. Metabolism tests were conducted during wk 1 and 4 on acetate. The responses of weight gain and N retention to increasing levels of acetate were linear (P less than .001). Efficiency of acetate utilization for body weight gain was .90 g/g acetate, and the mean N-sparing effect of acetate was 32.9 mg N/g acetate. In the liver, heart and femoral muscle examined from d 36 to 47 on acetate, there was a linear increase in RNA content (P less than .05) and in protein content (P less than .01), as the level of acetate intake was increased. Digestible energy and N corrected ME (MEn) of acetate found in the first week on acetate were not different from its heat of combustion. Those found in the fourth week on acetate, however, were larger (P less than .05) than the heat of combustion. It was considered that a nutritional adaptation to acetate utilization, or a synergistic action of acetate with other energy sources, occurred. The energetic efficiency of acetate utilization for growth was estimated to be 56 to 59%. PMID- 6853383 TI - Acetate-glucose relationship in growing pigs. AB - Twelve crossbred barrows from four litters (average initial body weight of 21 kg) were used to examine the relationship between acetate and glucose metabolism in pigs. The treatments were the addition of acetate in the form of triacetin to the basal diet at 0, 5 and 10% of the metabolizable energy intake. In the immediate postprandial period, the administered acetate decreased the venous plasma glucose concentration linearly (P less than .05) and increased linearly the venous plasma concentrations of lactate (P less than .01) and ketone bodies (P less than .001). There was a linear increase in the glycogen content of the liver (P less than .001), heart (P less than .001) and femoral muscle (P less than .01), as the level of acetate intake was increased. In the remote postprandial period (12 h after the last meal), glucose, which was considered to have been derived from hepatic glycogen storage, became the dominant blood metabolite in place of the acetate administered with the diet. This led to the reduction in hepatic production of endogenous acetate, arterial acetate concentration and in acetate utilization in the hind limb. Hepatic urea production was also decreased. Thus, there was a reciprocal change in acetate and glucose metabolism. PMID- 6853384 TI - Restricted energy intake and elevated calcium and phosphorus intake for gilts during growth. III. Characterization of feet and limbs and soundness scores of sows during three parities. AB - Gilts that had previously been fed ad libitum or 75% ad libitum intake and 100 or 150% National Research Council recommended daily Ca and P from weaning to 100 kg were used in a reproductive study in which a 14% protein diet was fed. Foot and leg measurements, subjective toe scores and structural soundness scores were taken at each of three parities, 21 d postweaning. Sows previously ad libitum-fed generally had larger front toes than limit-fed sows; whereas, hind toes were larger for sows previously fed 150% Ca and P levels than sows fed 100% Ca and P. Sows previously fed the ad libitum-150% Ca and P diet had the largest toes. Front inside toes were larger than hind inside toes, but the reverse was observed for front and hind outside toes, with the magnitude of the difference between the inside and outside toes greater for the hind foot. Toe size increased over parities with the greatest increase from parity 2 to 3. Incidence and severity of toe pad and horn scores were generally unaffected by previously fed energy and Ca and P levels and were not correlated to toe size. Hind feet exhibited a larger number of lesions than front feet and outside toes exhibited a larger number of lesions than inside toes, with the hind outside toe exhibiting the greatest number of lesions. In general, incidence and severity of toe lesions decreased or were unchanged from parity 1 to 3. Structural soundness scores were unaffected by previously fed energy or Ca and P levels, but were quadratically affected by parity, with a small increase (poorer) from parity 1 to 2 and a large improvement from parity 2 to 3. Soundness scores were not related to any of the feet or leg measurements and characteristics. Restricting growth rate and feeding elevated Ca and P levels during growth had no effect on incidence and severity of lesions on the toes and overall structural soundness of sows kept for three parities. PMID- 6853385 TI - Effect of phenobarbital on toxicity of pyrrolizidine (Senecio) alkaloids in sheep. AB - The effect of prolonged phenobarbital (PB) administration on the toxicity of Senecio jacobaea (SJ) was studied in sheep. Hepatic microsomal mixed function oxidase (MFO) activity was monitored. Pentobarbital sleeping times were decreased after 17 d of treatment, indicating initial induction of MFO. At 105 d of treatment, hepatic microsomal aminopyrine N-demethylase activity and cytochrome P 450 levels were increased (P less than .05) as a result of PB administration. No differences (P greater than .05) were observed in activity of microsomal epoxide hydrolase, glutathione S-transferase or liver glutathione as a result of SJ and (or) PB. Epoxide hydrolase activity in control sheep was about fivefold higher than values previously reported for rats. Liver Cu concentration was increased (P less than .05) in sheep receiving PB and SJ when compared with controls, but no differences (P greater than .05) were observed in the hepatic intracellular distribution of Cu as a result of PB and(or) SJ. Histopathological examination of liver revealed greater incidence and severity of lesions in animals receiving SJ, but PB did not appear to potentiate SJ intoxication. The results suggest that MFO induction by PB does not increase the susceptibility of sheep to SJ intoxication. Sheep possess a high activity of hepatic microsomal epoxide hydrolase which could account for their resistance to SJ intoxication. PMID- 6853386 TI - Phosphorus: ruminal availability and effects on digestion. AB - The availability of P for ruminal digestion in vivo from a mono-dicalcium phosphate containing 21% P (mono-dical), a mono-dicalcium phosphate containing 18.5% P (dical), and defluorinated rock phosphate was compared with sodium phosphate (Na2HPO4 X 7H2O). Mono-dical, dical and defluorinated rock phosphate were found to be 88, 62 and 40% as available as sodium phosphate in the rumen. Compared with sodium phosphate, P from mono-dical, dical and defluorinated rock phosphate was 46.4, 28.8 and 2.5% as soluble in an in vitro ruminal buffer. In vitro P solubility in abomasal fluid increased with incubation time up to 1 h. Relative solubilities of the P sources at 1 h were 100, 71.6, 41.3 and 29.7% for sodium phosphate, mono-dical, dical and defluorinated rock phosphate, respectively. These sources can be solubilized in the abomasum and become available postruminally despite low solubility in the rumen. To determine the effect of P on ruminal and total tract digestion, diets low (.12%) and adequate (.23%) in P were fed to ruminally cannulated steers (700 kg) in a crossover design. Although higher ruminal P concentrations were detected with the high P diet than with the low P diet (398 vs 208 mg/liter), dry matter disappearance rate from nylon bags of ground corn, cotton duck or cottonseed hulls was unchanged. Estimated retention of P was higher (P less than .01) with the high P diet (8.3 g/d) than with the low P diet (1.0 g/d), but total tract digestibility was not enhanced significantly by added P. It appears that increasing ruminal P concentration from 208 to 398 mg/liter did not increase microbial cellulose digestion, but the low level was inadequate for maintaining the adult ruminant animal's P stores. PMID- 6853387 TI - Effect of dietary calcium and zinc levels on weight gain and blood and tissue mineral concentrations of growing Columbia- and Suffolk-sired lambs. AB - One hundred and sixty Columbia- and Suffolk-cross intact male and female growing lambs (8 wk of age) were used in an 84-d feeding trial to determine the effect of two levels dietary Ca and Zn on weight gain, feed utilization and several blood and tissue traits. Two levels of Ca (.5 and .8%) and two levels of Zn (20 and 100 ppm) were fed in a 2 X 2 factorial arrangement of dietary treatments. There was no effect of diet on performance or on blood traits. Columbia lambs had heavier fleeces at slaughter than Suffolks (P less than .01) and males had heavier fleeces than females (P less than .01). Based on the similarity in performance among lambs fed the four diets differing in Ca and Zn level, it is concluded that a dietary Ca level of .5% and a Zn level of 19 to 26 ppm is adequate for normal weight gain, feed utilization, liver and humerus ash concentrations and blood plasma concentrations of Ca, P, Zn, total protein, albumin, alkaline phosphatase and blood hemoglobin and hematocrit. Further, it appears that an elevated level of dietary Ca does not precipitate a clinical Zn deficiency in the growing lamb, in contrast to the general observation in growing swine. PMID- 6853388 TI - Phenotype x nutritional environment interactions in forage intake and efficiency of Angus cows grazing fescue-legume or fescue pastures. AB - Forage intake, milk production, calf growth and efficiencies of milk production and calf growth were estimated for 198 lactations of 91 mature Angus cows grazing fescue-legume or fescue pastures. Cows calved January through March and calves were weaned in October in each of the 5 yr of the experiment. Cows grazing fescue legume consumed 1.7 kg/d more (P less than .01) dry matter (DM) that was 4.6 percentage units more (P less than .01) digestible than cows grazing fescue. Cows grazing fescue-legume produced .4 kg/d more (P less than .01) milk and weaned 23.8 kg more (P less than .01) calf than cows grazing fescue. This increased production required an additional intake/cow-calf unit of 2.3 kg of digestible DM for each additional kilogram of calf weaned. Cows grazing fescue-legume were less efficient in calf production at least partially because they gained 33.3 kg more (P less than .01) weight and 1.82 mm more (P less than .01) fat cover at the 12th rib during lactation than cows grazing fescue. Cows producing relatively large amounts of milk consumed more digestible DM, weaned heavier calves, and were more efficient producers of milk and weaned calf regardless of pasture type grazed. The influence of milk production on these variables was more dramatic for cows grazing fescue than for those grazing fescue-legume. Cow type favoring maximum conversion of digestible DM intake by cow and calf to calf gain was different for the two types of pasture. For cows grazing fescue, those having either small amounts of fatness or having small structural sizes, regardless of milk production, were the most efficient. Structural size was not related to efficiency for cows grazing fescue-legume. Fatness had little influence on efficiency of low milking cows. The relationship of structural dimension and efficiency for cows grazing fescue was due to interrelationships of structural dimension, change in cow weight and fatness during lactation, and calf weaning weight: cow weight ratio. Relationships between efficiency and fatness could not be attributed to these variables. PMID- 6853391 TI - A note on the preparation and use of a selective differential medium for the isolation of Acinetobacter spp. from clinical sources. PMID- 6853390 TI - A note on the microbial spoilage of undercooked chub-packed luncheon meat. AB - Contrary to expectations slight undercooking 968.5 degrees C instead of 70 degrees C for 90 min) dramatically increased the shelf-life of chub-packed luncheon meat stored at 25 degrees C. The pH of undercooked chubs fell rapidly to below 5.0 as a result of the growth of enterococci. The accumulated acid prevented the growth of Bacillus spores and gave the luncheon meat a not unpleasant tangy flavour. Degradative changes associated with the spoilage of commercially cooked chub-packed luncheon meat did not occur, even after 42 d storage. Apparently, post-cooking fermentation by enterococci can effectively convert a perishable product into a 'shelf stable' one by lowering the pH below 5.0. PMID- 6853389 TI - Development of a blood-free Campylobacter medium: screening tests on basal media and supplements, and the ability of selected supplements to facilitate aerotolerance. AB - The capacity of six basal media to support the growth of thermophilic campylobacters was tested. The most successful was Nutrient Broth No. 2 (Oxoid) solidified with New Zealand agar but it gave at best only a 9% recovery rate. Various blood products, iron compounds, detoxifying agents, reducing agents, growth stimulants and an antimetabolite were added to the selected basal medium and counts of inoculated organisms were compared with counts on basal medium containing 5% lysed horse blood. Of 22 supplements tried only blood, Fildes' peptic digest of blood, heamatin, iron salts, charcoal, sodium metabisulphite and sodium pyruvate greatly improved the basal medium. The ability of these supplements used singly and in combinations to facilitate aerotolerance of campylobacters was investigated. Two aspects of aerotolerance were tested; (a) the ability of the supplements to sustain the viability of campylobacters seeded onto culture plates left on the bench for up to 6 h before microaerobic incubation; and (b) the ability of the supplements to facilitate the growth of campylobacters at increasing oxygen tension (6, 10 and 17% oxygen). A combination of 0.4% charcoal, 0.025% ferrous sulphate and 0.025% sodium pyruvate was found to be as effective as blood in both tests. PMID- 6853392 TI - Effect of inoculation sequence and nutrients upon Streptococcus mutans BHT and Streptococcus mitior LPA-1 growing on human teeth in an artificial mouth. AB - Human teeth in an artificial mouth were inoculated with Streptococcus mutans BHT, Streptococcus mitior LPA-1, or sequentially with both organisms. Incubation was continued for 90 h. Mixed populations were largest when a nutrient supplement containing 5.0% (w/v) sucrose was supplied. Fewer organisms were recovered from experiments with synthetic saliva only, or when a supplement containing 0.05% (w/v) glucose was available. The inoculation sequence determined the total viable count and a larger population resulted when Strep. mutans was the initial colonizer (P less than 0.01). Strep. mutans was always able to become established even when super-infected on to a 24 h plaque of Strep. mitior. The final proportion of Strep mutans was lower when it was the superinfecting organism and the sucrose (P less than 0.01) or glucose (P less than 0.05) nutrient supplement was provided. This work confirms the importance of inoculation sequence and presence of sugars in plaque accumulation and demonstrates the fundamental role of microbial interactions in this process. PMID- 6853393 TI - Effect of fatty acid supplementation on the lipid composition of Mycobacterium smegmatis ATCC 607, grown at 27 degrees and 37 degrees C. AB - Mycobacterium smegmatis ATCC 607 was grown at 27 and 37 degrees C, with and without exogenous unsaturated fatty acids, viz. elaidic, oleic and palmitoleic acids, added to the growth medium. The total lipid content of M. smegmatis ATCC 607 was lower at 27 degrees C, and with added oleic acid, when compared with the controls, but higher in presence of palmitoleic acid. At 37 degrees C no significant differences were noted in the total lipid content. In general, the total lipid content was lower with all of the fatty acid supplementations at both 27 and 37 degrees C. The phosphatidylethanolamine content was slightly higher at 27 degrees C in the presence of elaidic or palmitoleic acid, but was markedly lower with oleic acid supplementation at 37 degrees C. The cardiolipin content was lower in the presence of any of the fatty acids at 27 degrees C, and higher in the medium supplemented with elaidic or oleic acid at 37 degrees C. The unsaturated to saturated fatty acids ratio was higher with palmitoleic acid supplementation at 27 degrees C, but remained unchanged in cells grown at 37 degrees C. The modifications in mycobacterial lipids are a reflection of the organism's ability to adapt to changing growth conditions. PMID- 6853394 TI - The Rappaport-Vassiliadis (RV) enrichment medium for the isolation of salmonellas: an overview. PMID- 6853395 TI - Differentiation of Salmonella typhi using resistotyping. PMID- 6853396 TI - The vitamin requirements of Staphylococcus cohnii. AB - The vitamin requirements of 66 strains of Staphylococcus cohnii from various sources were determined using solidified and liquid chemically defined media. All the strains tested required nicotinic acid and thiamine. Biotin was either growth stimulatory or essential for 34 strains. Pantothenic acid was required by 21 of the 30 strains of known human origin but was not required by any of the 24 strains of murine origin. There was an association among Staph. cohnii strains to grow in the absence of pantothenic acid and biotin and the ability to produce acid from lactose and the possession of phosphatase activity (20 strains). The majority of strains requiring pantothenic acid and biotin were unable to ferment lactose and did not possess phosphatase activity (22 strains). PMID- 6853397 TI - Dynamics of salmonella isolation with modified Rappaport's medium (R10). AB - Enhanced growth of salmonellas in Rappaport's medium as modified by Vassiliadis et al. (1976) after pre-enrichment in buffered peptone water during the first 6 h was obtained by replacement of tryptone by soya peptone. The competing bacteria, i.e. those which grow on brilliant green agar and which may interfere with the isolation of salmonellas when Rappaport's medium (R10) incubated at 43 degrees C is used for enrichment were inhibited or reduced in numbers when the normal amount of 5 g soya peptone/litre was used. When the amount was increased to 10 g/l, growth occurred, mainly of Enterobacter and Klebsiella species. The isolation of salmonellas was found to be largely dependent on the number and the ratio of their competitors. Every measure taken to reduce the number of competitive bacteria increases the possibility of isolating salmonellas. This explains the effect of improved selectivity of Rappaport's medium when small inocula are used. Rapid onset of growth of salmonellas by employing soya peptone introduces the possibility of using shorter incubation times 48 h. PMID- 6853398 TI - The effect of variation of thermal processing on the microbial spoilage of chub packed luncheon meat. AB - Process pasteurization values for reference temperature 70 degrees C (P70) were calculated from the temperature profiles of 250 g luncheon meat chubs cooked under experimental conditions. A simple equation relating Process P70-value and the time and temperature of cooking was derived. With minimal cooking (P70 = 40) the surviving microflora (10(3)/g) wad dominated by species of Lactobacillus, Brochothrix and Micrococcus. These organisms were destroyed by more intensive cooking (P70 = 105), leaving a flora (10(2)/g) composed of Bacillus and Micrococcus species. The spoilage that developed after 14 d storage at 25 degrees C reflected the severity of the heat treatment received by each chub: with P70 between 40 and 90, a Streptococcus spoilage sequence occurred; with P70 between 105 and 120, a Bacillus/Streptococcus spoilage sequence occurred; with P70 of 135 and above, a Bacillus spoilage sequence occurred. Cooking to a P70 = 75 was adequate to reduce the surviving microflora to the 10(2)/g level associated with current good manufacturing practice. PMID- 6853399 TI - Enterotoxin production by atypical Staphylococcus aureus from poultry. AB - Phenotypically typical Staphylococcus aureus was isolated frequently from the necrotic bone and liver of poultry suffering from femoral head necrosis. Occasionally strains were isolated that differed from typical Staph. aureus in one or more of the major diagnostic tests, i.e. coagulase production, anaerobic fermentation of mannitol and production of a heat-stable deoxyribonuclease. Such atypical strains were also isolated from nasal swabs of healthy birds. Tests for enterotoxin production demonstrated that some atypical strains from both sick and healthy birds are capable of producing staphylococcal enterotoxins. PMID- 6853400 TI - Selective method for the isolation of Sporolactobacillus from food and environment sources. AB - A detection procedure was developed in which a modified Lactobacilli MRS medium was used to enrich for Sporolactobacillus from a variety of foods, feed soil and environmental samples. Each sample was rinsed with 50 ml of a modified Lactobacilli MRS broth containing 1.0% (w/v) alpha-methyl glucoside 0.1% (w/v) potassium sorbate, 0.00224% (w/v) bromocresol green indicator, adjusted to pH 5.5 with acetic acid and incubated at 37 degrees C for 7 d under 5% CO2. Volumes of 2 ml from each sample were heat shocked at 80 degrees C for 5 min and 0.1 ml spread onto plates of Lactobacilli MRS agar (Difco), pH 5.5 and APT agar (BBL), pH 5.5. Plates were incubated for 5 d and suspect colonies were tested for catalase production, benzidine reaction, nitrate reduction, motility and Gram stain reaction. This method was demonstrated to be selective for Sporolactobacillus. PMID- 6853401 TI - Effect of eight growth media upon fermentation profiles of ten anaerobic bacteria. AB - A study was made of the influence of eight growth media upon the fermentation end product patterns obtained with ten species of anaerobes. Acidic and neutral end products of fermentation were analysed by gas chromatography and the results were examined statistically by computer. Differences in end-product profile were at least as great between different media used to grow a single anaerobic species, as between different anaerobes grown in a single type of medium. When individual fermentation end-products produced by a single anaerobe species were examined statistically significant differences were found between different media for individual end-products. It is concluded that standardisation of growth medium is essential in diagnostic laboratories concerned with identification of anaerobes with the aid of gas chromatography. PMID- 6853402 TI - The penetration of mammalian cells by antibiotics. PMID- 6853403 TI - Effects of erythromycin and gentamicin in experimental peritonitis. AB - Erythromycin and gentamicin were used to analyse the concept of bacterial synergy in an experimental model of acute appendicitis. Erythromycin given orally suppressed the aerobic flora other than the Enterobacteriaceae. When given by injection, a notable reduction in the counts of bacteroides and other anaerobic Gram-negative bacteria was also achieved. The addition of gentamicin, itself inactive against bacteroides, resulted in their total suppression. The implications of these findings are discussed. PMID- 6853404 TI - The pharmacokinetics of temocillin in patients with normal and impaired renal function. AB - The pharmacokinetics of temocillin was studied in 16 subjects with varying degrees of renal functional impairment. The subjects were divided into three groups, depending on their creatinine clearance: Group A greater than 70 ml/min/1.73 m2; Group B 20-70ml/min/1.73 m2 and Group C less than 20 ml/min/1.72 m2. Following intravenous administration the total serum clearance of temocillin was reduced in patients with renal insufficiency. The distribution of temocillin into the tissues was not affected by renal dysfunction, apparent distribution volumes being 15.11, 16.01 and 13.81 in Groups A, B and C respectively. The change in clearance was reflected in an increased area under the serum concentration versus time curve from 418 mg h/l in Group A to 1301 mg h/l and 1553 mg h/l in Groups B and C respectively. The beta elimination half-life was also prolonged from 3.5 h in Group A 12.7 h in Group B and 17.5 h in Group C. The urinary excretion of temocillin was both delayed and reduced according to the extent of kidney damage. The reduction in temocillin clearance was proportional to the extent of reduction from normal of the clearance of creatinine. This relationship has been used to suggest dosage schedules for temocillin in patients with renal insufficiency. PMID- 6853405 TI - Penetration of metronidazole to tissues. AB - One dose of 500 mg metronidazole (M) was given to 21 patients before appendectomy and the concentrations of the parent compound and the major metabolite hydroxymetronidazole (OH-M), assayed in serum and tissue homogenates of appendix and subcutaneous tissues by high pressure liquid chromatography. Based on determinations in one specimen per patient during the initial 1.25-4 h after end of the 50 min infusion, the levels of M in relation to serum were 60.8% (+/- S.D. 19.8) for the appendix and 29.0% +/- 8.7 for subcutaneous tissue. The corresponding values for OH-M were 103.9 +/- 28.2 and 57.0% +/- 16.8. The slope of the log-linear regression curves of M corresponded to elimination half-life (T 1/2) values of 5.2 h in serum, 2.7 h in appendix and 2.6 h in subcutis tissue, but the differences were not statistically significant. The values of OH-M were similar for serum and appendix. OH-M had T 1/2 of 7.9 and 6.1 h for serum and subcutaneous tissue and 21.3 h in the appendix, but the values were not significantly different. PMID- 6853406 TI - Wiley Award address. Successful interagency cooperation--the Diehlstadt story. PMID- 6853407 TI - Gas chromatographic determination of fumigant residues in stored grains, using isooctane partitioning and dual column packings. AB - A gas chromatographic (GC) procedure for determining fumigants in grains was developed. Fumigants were leached from grain samples with the official AOAC method using acetone-water (5 + 1). They were then partitioned from the leachate with isooctane, yielding a dry, stable extract that was analyzed by GC. Fortified sample recoveries ranged from 90 to 100%. Two GC columns were used, 20% OV-101 and 20% OV-225/20% OV-17 (2 + 1). These columns gave dissimilar retention profiles and baseline resolution for the 7 fumigants investigated: chloroform, ethylene dichloride, carbon tetrachloride, trichloroethylene, chloropicrin, ethylene dibromide, and tetrachloroethylene. Further tests showed that grain samples could be screened for fumigant residues by direct injection of the acetone-water leachates obtained using the AOAC method. PMID- 6853408 TI - Applicability of a carbamate insecticide multiresidue method for determining additional types of pesticides in fruits and vegetables. AB - Several fruits and vegetables were fortified at a low (0.02-0.5 ppm) and at a high (0.1-5 ppm) level with pesticides and with a synergist, and recoveries were determined. Analyses were performed by using 3 steps of a multiresidue method for determining N-methylcarbamates in crops: methanol extraction followed by removal of plant co-extractives by solvent partitioning and chromatography with a charcoal-silanized Celite column. Eleven compounds were determined by using a high performance liquid chromatograph equipped with a reverse phase column and a fluorescence detector. Twelve additional compounds were determined by using a gas liquid chromatograph equipped with a nonpolar packed column and an electron capture or flame photometric detector. Recoveries of 10 pesticides (azinphos ethyl, azinphos methyl, azinphos methyl oxygen analog, carbaryl, carbofuran, naphthalene acetamide, naphthalene acetic acid methyl ester, napropamide, phosalone, and phosalone oxygen analog) and the synergist piperonyl butoxide, which were determined by high performance liquid chromatography, averaged 100% (range 86-117) at the low fortification level and 102% (range 93-115) at the high fortification level. Quantitative recovery of naphthalene acetamide through the method required that an additional portion of eluting solution be passed through the charcoal column. Recoveries of 7 additional pesticides (dimethoate, malathion, methyl parathion, mevinphos, parathion, phorate oxygen analog, and pronamide), which were determined by gas-liquid chromatography (GLC), averaged 108% (range 100-120) at the low fortification level and 107% (range 99-122) at the high fortification level. DDT, diazinon, dieldrin, phorate, and pirimiphos ethyl, which were determined by GLC, were not quantitatively recovered. PMID- 6853409 TI - International mycotoxin check sample survey program. Part III. Report on performance of participating laboratories for determining ochratoxin A in animal feed. AB - A sample of animal feed made from barley, naturally contaminated at about 1000 micrograms ochratoxin A/kg, was analyzed by 44 laboratories in 24 countries. The AOAC method for determining ochratoxin A in barley was used by 27 (61%) of the participating laboratories. Results from laboratories using this method were grouped around 2 maxima: one below 100 micrograms/kg and a second near 940 micrograms/kg, the median concentration for results reported by all 44 participating laboratories. Results from laboratories using methods other than the AOAC method were more widely distributed with no apparent maximum near 1000 micrograms/kg. PMID- 6853410 TI - High pressure liquid chromatographic assay for prednisone in bulk drug substances and tablets. AB - A high pressure liquid chromatographic (HPLC) method was developed for the assay of prednisone in bulk drug substances and tablets. The sample was dissolved in water-methanol and an aliquot was analyzed by using HPLC. The average recovery of prednisone added to a prednisone tablet composite was 99.5% with a coefficient of variation of 1.07%. Prednisone was determined in 46 tablets (1-50 mg prednisone/tablet) formulated by 22 manufacturers, using the HPLC method and the USP blue tetrazolium assay. The results show that the HPLC method is more specific and faster than the USP method. PMID- 6853412 TI - Diagnosis of ethylene glycol (antifreeze) intoxication in dogs by determination of glycolic acid in serum and urine with high pressure liquid chromatography and gas chromatography-mass spectrometry. AB - A relatively fast and sensitive high pressure liquid chromatographic (HPLC) and gas chromatographic-mass spectrometric (GC/MS) method was developed for determination of glycolic acid, one of the major metabolites of ethylene glycol, in extracts of canine urine and serum. The procedure involves extraction of glycolic acid with methyl ethyl ketone and derivatization with O-p-nitrobenzyl N,N'-diisopropylisourea (PNBDI) in ethyl acetate solution. Recovery was greater than 94% from spiked samples. Ethylene glycol and commercial antifreeze were administered to experimental dogs at different dosage levels to reproduce the naturally occurring toxicosis associated with the consumption of commercial antifreeze. Glycolic acid was determined in either the urine or serum or both from these dogs by HPLC and GC/MS. 1,3-Butanediol, a competitive inhibitor of ethylene glycol biotransformation, was administered to one dog concurrently with antifreeze. In that experiment, it was effective in decreasing glycolic acid formation and prevented acute metabolic acidosis, kidney damage, and death. PMID- 6853411 TI - Spectrofluorometric determination of pindolol and its dosage form. AB - A new direct, simple, and sensitive spectrofluorometric method is described for the assay of pindolol and its tablets at room temperature, using ethanol (96% v/v) as solvent. The drug exhibits intrinsic fluorescence. Working wavelengths are 263 nm for excitation and 305 nm for emission. The calibration curve is linear in the range 1.0 X 10(-7) to 1.5 X 10(-6)M pindolol. PMID- 6853413 TI - High pressure liquid chromatographic determination of Monensin in feed premixes. AB - A high pressure liquid chromatographic (HPLC) method has been developed to determine monensin in feed premixes. The method is simple and rapid. Monensin is extracted with methanol-water and determined in the extracting solution by HPLC. Average recovery for monensin from a 13.2% premix sample was 103% (coefficient of variation (CV), 2.6%) by HPLC and compares with the value of 100% (CV, 3.4%) obtained by the turbidimetric bioassay method. PMID- 6853414 TI - Rapid gas-liquid chromatographic method for determination of sulfathiazole in swine feed. AB - A gas-liquid chromatographic (GLC) method for determining residues of sulfathiazole (STZ) in swine feed has been developed. Feed is extracted first with acetone and then with ammonia-acetone. STZ is isolated from other feed extractives on a Sephadex LH-20 column with methanol-toluene. The sulfa residues are methylated with diazomethane, and the eluate is evaporated to dryness. A solution containing an internal standard of methyl sulfasymazine is used to dilute the sample before injection onto an OV-25 GLC column. The precision of the method was determined by assaying 10 sets of feed spiked at 0.5, 1, 2, and 5 ppm STZ. The mean recoveries and coefficients of variation were 90.2 (5.90), 89.5 (4.67), 87.4 (5.62), and 87.7% (4.29), respectively. The critical steps of the method, including the stability of STZ, were also determined. PMID- 6853415 TI - High pressure liquid chromatographic determination of toxins associated with paralytic shellfish poisoning. AB - A high pressure liquid chromatographic procedure is described for assay of toxins associated with paralytic shellfish poisoning (PSP). The method is applicable to saxitoxin, neosaxitoxin, gonyautoxins I through IV, and their sulfocarbamoyl derivatives. Toxins are separated on a bonded phase cyano column and detected by fluorescence following alkaline oxidation (NH+4 and periodic acid). The utility of the HPLC procedure for research and monitoring is discussed. PMID- 6853416 TI - Modification of Klein's wet ashing procedure for determination of mercury. AB - An investigation of the use of HCl in Klein's method (25.108-25.115) to prevent loss of mercury during wet digestion resulted in consistently good recoveries from jowar and fish samples. Recoveries for the modified method ranged from 90.9 to 97.0% compared with 14.4 to 35.5% for the original method. PMID- 6853417 TI - Rasterstereography: a photogrammetric method for measurement of body surfaces. PMID- 6853420 TI - Moire topography in medicine. PMID- 6853418 TI - Multiple camera production with the portable television console. PMID- 6853419 TI - Low cost microcomputers. A lot of power for very little money. PMID- 6853421 TI - JNHAC to CARIH to NAC: a nostalgic view of 20 years. PMID- 6853423 TI - St. Mary's Hospital for Children: a model regional residential center for children with chronic asthma. PMID- 6853422 TI - Changing behavioral and social variables at a residential treatment facility for childhood asthma. PMID- 6853424 TI - Assessment of acute asthma in the emergency room: evaluation of compliance and combined drug therapy. AB - Thirty-three chronic asthmatic children and adolescents on predetermined doses of theophylline preparations who arrived at the Emergency Room with an acute episode of wheezing were evaluated to determine compliance, and if therapeutic plasma theophylline levels (PTLs) facilitate the effectiveness of epinephrine. Patients were divided into three groups based on the requirement of one, two, or three doses of epinephrine. In the total group of patient visits, only 25% took the theophylline preparations as prescribed. The poor responders group requiring three injections of epinephrine was characterized by the lowest compliance and the highest unacceptable PTLs. It appears that therapeutic PTLs enhance the response to epinephrine. The evaluation of compliance in case of epinephrine failure is recommended. PMID- 6853425 TI - Effects of ascorbic acid on pulmonary functions in mild asthma. AB - Twenty subjects with mild asthma took a short course of moderately high doses of Vitamin C (500 mg four times daily for 3 days and 1 g prior to spirometric evaluation). There were no differences in pulmonary functions just prior to and after therapy. There were no adverse reactions noted. If, as reported, Vitamin C has a beneficial effect in asthma, it does not appear to be due to a bronchodilatory effect. PMID- 6853426 TI - Value and limitations of specialized centers for asthma. PMID- 6853427 TI - Patient mislabeling of symptoms and rehospitalization in asthma. PMID- 6853428 TI - Dynamic approach to asthma. AB - A clinical trial, with historical controls, as of way of conceptualizing labile asthma, which in my experience has proven useful in planning long term ambulatory management, in communicating with and enlisting the support of referring physicians, and in enlisting patient confidence and cooperation in home monitoring and medical management of changes in disease activity is reported. PMID- 6853429 TI - Asthma and chronic bronchitis: contrasting changes in body weight and hematocrit values during recovery from acute episodes. AB - Two groups of hospital inpatients, one with asthma and the other with chronic bronchitis were studied during the course of an acute episode. All had comparable airways obstruction and were free of cardiac involvement. They were treated on roughly similar lines and without the use of adrenal corticosteroids or any other agent that may influence body water balance. Body weight and hematocrit values done on admission and following recovery from dyspnoes, show that the asthmatics gained in weight and showed significant decrease in hematocrit on recovery, while there was no appreciable changes in the bronchitic group. PMID- 6853430 TI - Lung injury and the law. PMID- 6853432 TI - Adverse effects of monosodium glutamate. PMID- 6853431 TI - The promises and the problems of institutional care: a synthesis of opposites. PMID- 6853433 TI - Serum IgE levels and specific IgE antibodies in house dust mite allergy: predictive value. PMID- 6853434 TI - Asthma problem behavior checklist: parental perceptions of the behavior of asthmatic children. PMID- 6853435 TI - Communicative behavior of adults with an autistic four-year-old boy and his nonhandicapped twin brother. AB - Sixteen female preschool teachers were videotaped playing in dyads with a nonverbal, socially unresponsive autistic 4-year-old boy and his nonhandicapped fraternal twin brother. Eight adults were informed that the autistic child had a language disability and did not talk or understand much language; eight adults were not informed about any differences between the children. Language to the autistic child was simpler, more concrete, and more often accompanied by gestures than language to his brother for both groups of subjects. Informed teachers made greater speech modifications to the autistic child and were more successful at keeping him on-task than uninformed adults. The theoretical and practical implications of communicative adjustments to children with language and social impairments are discussed. PMID- 6853436 TI - An interdisciplinary approach to the diagnosis and management of a complex case of postencephalitic behavioral disorder. AB - Postencephalitic behavioral syndrome secondary to measles is an almost extinct condition in Western culture. The present paper describes the clinical state of a 13-year-old pubertal female who presented nine years after the original acute febrile illness. In addition, an innovative behavioral approach to treatment of intractable seizures and aggressive behavior is described. PMID- 6853437 TI - Childhood psychosis and computed tomographic brain scan findings. AB - Twenty-seven infantile autistic children, nine children with other kinds of childhood psychoses, 23 children with mental retardation, and 16 normal children were examined with computerized tomography of the brain. Gross abnormalities were seen in 26% of the autism cases. It was also estimated that about the same proportion of a total population of infantile autistic children show gross changes of CT brain scan. Abnormalities in the region of the frontal horns of the ventricular system tended to be more common in the psychosis groups than in the normal group. Clear-cut right occipital protuberation was rather common in the small group of other psychoses cases but was only marginally more common in the autism than in the normal group. Evans' ratio was significantly higher in all three abnormal groups than in the normal group. PMID- 6853439 TI - Etiological implication of maternal age and birth order in infantile autism. AB - Birth orders and maternal ages of the 113 autistic patients were compared with those of the general population. An excess of mothers aged 35 or older was observed in the autistic group, though the mean maternal age for the whole group was very similar to those of the general population. A deviation from average in birth order was observed in autistics. Significantly more autistics were products of at-risk pregnancies (defined as either first, fourth, or later born, or born to mothers aged 30 or older) than the base population. The results suggest that at least some environmental factors are involved in the causation of autism. The findings support the idea that a multifactorial mechanism is responsible for some or all of the cases. PMID- 6853438 TI - Developmental effects in the cerebral lateralization of autistic, retarded, and normal children. AB - This experiment was designed to determine whether increasing evidence of generalized developmental delay in early-onset psychosis was apparent at a cortical level in autistic children. Using magnitude of dominant ear advantage as an indicator of relative cerebral dominance, unwarned simple reaction time (RT) to monaural presentation of tones was investigated in matched groups of autistic, retarded, and normal children. Analysis of RTs and relative ear advantage as a function of group membership and chronological age indicated that the autistic children showed significant developmental delay in both RT and the establishment of cerebral dominance compared to the control groups. These results thus provide additional evidence of generalized maturational delay at a cortical level in early-onset psychosis, and suggest that the maturational delay of the autistic children is more extensive than the developmental deficits implied by their intellectual impairment. PMID- 6853440 TI - "Borderline" children. AB - Sixteen children said to be "borderline" were referred for comprehensive evaluation. None met DSM III criteria for borderline personality disorder. Referring psychiatrists and psychologists seemed to base their impressions on the child's disorganized thinking and irrational, erratic behavior, problems that were better understood and treated from a developmental perspective. The borderline label had a negative impact on some children, and was not helpful for treatment planning or disposition. Clear guidelines for the application of this ambiguous and controversial diagnostic term in child psychiatry are nonexistent. PMID- 6853441 TI - Using pictorial representations as communication means with low-functioning children. AB - Three low-functioning children were successfully taught pictorial representations as communication means. Initially, the subjects were trained to associate cards representing objects with the corresponding objects. Then, they were trained to respond to: (a) cards depicting body positions, (b) cards depicting body positions related to objects, and (c) cards representing simple activities as well as activities involving two children. Subsequently, they were trained to complete cards representing activities involving two children, independently, and to choose the roles for the execution of these activities. At last, they were taught to select from among cards on display, to complete such cards, and to choose the roles for the execution of the activities all by themselves. During the program high generalization learning was observed. PMID- 6853443 TI - Model for bacterial culture growth rate throughout the entire biokinetic temperature range. AB - The "square-root" relationship proposed by Ratkowsky et al. (J. Bacteriol. 149:1 5, 1982) for modeling the growth rate of bacteria below the optimum growth temperature was extended to cover the full biokinetic temperature range. Two of the four parameters of this new nonlinear regression model represent minimum and maximum temperature bounds, respectively, for the predicted growth of the culture. The new model is easy to fit and has other desirable statistical properties. For example, the least-squares estimators of the parameters of the model were almost unbiased and normally distributed. The model applied without exception to all bacterial cultures for which we were able to obtain data. Results for 30 strains are reported. PMID- 6853442 TI - Synthesis and assembly of flagellar components by Caulobacter crescentus motility mutants. AB - Cultures of wild-type Caulobacter crescentus and strains with fla mutations representing 24 genes were pulse-labeled with 14C-amino acids and analyzed by immunoprecipitation to study the synthesis of flagellar components. Most fla mutants synthesize flagellin proteins at a reduced rate, suggesting the existence of some mechanism to prevent the accumulation of unpolymerized flagellin subunits. Two strains contain deletions that appear to remove a region necessary for this regulation. The hook protein does not seem to be subject to this type of regulation and, in addition, appears to be synthesized as a faster-sedimenting precursor. Mutations in a number of genes result in the appearance of degradation products of either the flagellin or the hook proteins. Mutations in flaA, -X, -Y, or -Z result in the production of filaments (stubs) that contain altered ratios of the flagellin proteins. In some flaA mutants, other flagellin-related proteins were assembled into the stub structures in addition to the flagellins normally present. Taken together, these analyses have begun to provide insight into the roles of individual fla genes in flagellum biogenesis in C. crescentus. PMID- 6853444 TI - In vivo cloning of Erwinia carotovora genes involved in the catabolism of hexuronates. AB - Using the RP4::mini-Mu pULB113 plasmid, an RP4 derivative carrying a deleted Mu prophage which allows the plasmid to pick up any chromosomal DNA segment to form R' plasmids, we cloned all of the genes of Erwinia carotovora involved in the catabolism of the hexuronates and in the transport of these substrates. With the R' plasmids we isolated, we performed complementation analysis and found that, in the Erwinia carotovora strain we used, the genes involved in the catabolism of the hexuronates are clustered in four regions of the chromosome. This genetic organization is compared with that of Escherichia coli K-12. PMID- 6853445 TI - Characterization of lactose transport in Kluyveromyces lactis. AB - We have determined that lactose uptake in Kluyveromyces lactis is mediated by an inducible transport system. Induction, elicited by lactose or galactose, of the transporter required protein synthesis. Transport of lactose required an energy generating system and occurred by an active process, since an intracellular lactose concentration 175 times greater than the extracellular concentration could be obtained. The Km for lactose transport was about 2.8 mM in uninduced and lactose- or galactose-induced cells. The lactose transporters in K. lactis and Escherichia coli appear to be different since they respond uniquely to inhibition by substrate analogs. PMID- 6853446 TI - Lipid composition of Zymomonas mobilis: effects of ethanol and glucose. AB - Zymomonas mobilis is an alcohol-tolerant microorganism which is potentially useful for the commercial production of ethanol. This organism was found to contain cardiolipin, phosphatidylethanolamine, phosphatidylglycerol, and phosphatidylcholine as major phospholipids. Vaccenic acid was the most abundant fatty acid, with lesser amounts of myristic, palmitic, and palmitoleic acids. No branched-chain or cyclopropane fatty acids were found. Previous studies in our laboratory have shown that ethanol induces the synthesis of phospholipids enriched in vaccenic acid in Escherichia coli (L. O. Ingram, J. Bacteriol. 125:670-678, 1976). The fatty acid composition of Z. mobilis, an obligately ethanol-producing microorganism, represents an extreme of the trend observed in E. coli. In Z. mobilis, vaccenic acid represents over 75% of the acyl chains in the polar membrane lipids. Glucose and ethanol had no major effect on the fatty acid composition of Z. mobilis. However, both glucose and ethanol caused a decrease in phosphatidylethanolamine and phosphatidylglycerol and an increase in cardiolipin and phosphatidylcholine. Ethanol also caused a dose-dependent reduction in the lipid-to-protein ratios of crude membranes. The lipid composition of Z. mobilis may represent an evolutionary adaptation for survival in the presence of ethanol. PMID- 6853447 TI - Control of catechol meta-cleavage pathway in Alcaligenes eutrophus. AB - Alcaligenes eutrophus 335 (ATCC 17697) metabolizes phenol and p-cresol via a catechol meta-cleavage pathway. Studies with mutant strains, each defective in an enzyme of the pathway, showed that the six enzymes assayed are induced by the primary substrate. Studies with a putative polarity mutant defective in the expression of aldehyde dehydrogenase suggested that the structural genes encoding this and subsequent enzymes of the pathway exist in the same operon. From studies with mutant strains that constitutively synthesize catechol 2,3-oxygenase and subsequent enzymes and from the coordination of repression of these enzymes by p toluate, benzoate, and acetate, it is proposed the catechol 2,3-oxygenase structural gene is situated in this operon (2,3-oxygenase operon). Studies with regulatory mutant strains suggest that the 2,3-oxygenase operon is under negative control. PMID- 6853448 TI - Symbiotic properties of C4-dicarboxylic acid transport mutants of Rhizobium leguminosarum. AB - The transport of succinate was studied in bacteroids of an effective, streptomycin-resistant strain (GF160) of Rhizobium leguminosarum. High levels of succinate transport occurred, and the kinetics, specificity, and sensitivity to metabolic inhibitors were similar to those previously described for free-living cells. The symbiotic properties of two transposon (Tn5)-mediated C4-dicarboxylate transport mutants (strains GF31 and GF252) were determined. Strain GF31 formed ineffective nodules, and bacteroids from these nodules showed no succinate transport activity. Strain GF252 formed partially effective nodules, and bacteroids from these nodules showed about 50% of the succinate transport activity of the parent bacteroids. Another dicarboxylic acid transport mutant (Dct-), strain GFS5, isolated after N-methyl-N'-nitro-N-nitrosoguanidine mutagenesis, formed ineffective nodules. The ability to form ineffective nodules in strains GF31 and GFS5 was shown to correlate with the Dct- phenotype. The data indicate that the presence of a functional C4-dicarboxylic acid transport system is essential for N2 fixation to occur in pea nodules. PMID- 6853451 TI - Narcolepsy: an initial clinical approach. AB - Pragmatic, empirical methods are available for the diagnosis and treatment of narcolepsy. Diagnosis can be based on the history of specific symptoms; a questionnaire scale can reliably confirm sleepiness, while performance tests and other laboratory procedures may illuminate the clinical picture when the diagnosis is unclear. A treatment program includes scheduling of sleep and naps, careful progressive refinement of the drug regimen, dependable record keeping, and supportive or insight-oriented psychotherapy aimed at enhancing adherence to prescribed regimens. PMID- 6853449 TI - Bacteriophage in the Ixodes dammini spirochete, etiological agent of Lyme disease. AB - A bacteriophage with a B-3 morphology was detected by electron microscopy in a spirochete isolated from the tick Ixodes dammini. It has a 40- to 50-nm elongated head and a tail 50 to 70 nm in length. It appears devoid of collars or kite-tail structure. The spirochete has been identified as the causative agent of Lyme disease. PMID- 6853450 TI - Cyclic nucleotide-independent protein kinases from ribosomes and phosphorylation of a single 40S ribosomal subunit protein in zoospores of Blastocladiella emersonii. AB - Cyclic nucleotide-independent protein kinase (EC 2.7.1.37) activity was found in the nuclear cap organelle, within which ribosomes of zoospores of Blastocladiella emersonii are sequestered. Two protein kinase activities were resolved from the high-salt wash fraction of zoospore ribosomes by selective adsorption to DEAE cellulose. Both enzymes phosphorylated in vitro a 32,000 Mr protein of the 40S ribosomal subunit. Phosphorylation of this ribosomal protein, which exhibits electrophoretic properties similar to those of mammalian ribosomal protein S6, was also observed in vivo in 32P-labeled zoospores. PMID- 6853452 TI - Tricyclic antidepressants and delirium. AB - Some patients who take tricyclic antidepressants (TCAs) develop delirium. Charts were reviewed of 125 inpatients whose TCA plasma levels had been assayed. Delirium was documented in 10 cases. The occurrence of delirium was statistically related to age, race, and loge plasma TCA levels. PMID- 6853453 TI - Phencyclidine intoxication, physical restraint, and acute renal failure: case report. PMID- 6853454 TI - Psychophysiologic aspects of denial in pregnancy: case report. AB - A pregnant patient who presented with physiologic as well as psychologic denial throughout the course of pregnancy is described. Despite the intensity of her defensive system, the patient was able to function adequately in all other areas of her life before, during, and after the pregnancy. This case illustrates the need for pregnancy testing in any female of childbearing age who ceases menses. PMID- 6853455 TI - Is amitriptyline + perphenazine superior to doxepin? PMID- 6853456 TI - Some conceptual aspects of laboratory tests in depression. PMID- 6853457 TI - Use of the Children's Depression Rating Scale in an inpatient psychiatric population. AB - The Children's Depression Rating Scale is a useful and reliable instrument for measuring the severity of depression in children. The scale was initially used in a pediatric liaison population. This study reports its use in consecutive admissions to a child inpatient unit. Systematic evaluations of the children resulted in many diagnoses of depression which were missed by the clinical staff. Two relatively inexperienced raters did nearly as well as two raters who originated the scale, suggesting that the CDRS may have practical utility in many settings. PMID- 6853460 TI - Anorexia nervosa in treated gonadal dysgenesis: case report and review. AB - The 12th reported case of anorexia nervosa in association with the 45,XO genotype and Turner's phenotype is presented. This patient received hormonal treatment but had a poor psychological outcome. Reasons for a possible increased coincidence of the two disorders, and the relationships among hormonal treatment, onset of puberty, and development of anorexia nervosa, are discussed in light of this and previous cases. PMID- 6853459 TI - Improving accuracy in the diagnosis of Alzheimer's disease. AB - During a longitudinal study of outpatients with early Alzheimer's disease, several patients were found to have been incorrectly diagnosed as having a progressive dementia; case histories of three such patients are presented. Certain objective tests of dementia (The Extended Scale for Dementia, Mini-Mental Status, etc.) and language functions (The Porch Index of Communicative Ability), as well as The London Psychogeriatric Rating Scale (completed by a family member), have been found useful and are described briefly. The importance of reevaluating demented patients to document the course of their illness is emphasized to improve the accuracy of diagnosis in suspected cases of Alzheimer's disease. PMID- 6853461 TI - Imipramine-induced tremor: effects of a beta-adrenergic blocking agent. AB - Assessment of an elderly depressed patient with an imipramine-induced tremor led to the conclusions that imipramine tremor (1) can be severe and incapacitating, (2) is most pronounced early in the treatment, (3) does not seem to be dose related, and (4) is readily reversible with a beta-adrenergic blocking agent. PMID- 6853463 TI - Pimozide in delusions of parasitosis. PMID- 6853462 TI - A study of blood total protein and albumin levels in psychiatric patients. AB - Statistical analyses showed that blood levels of albumin and total protein in psychiatric patients (N = 97) were significantly lower than those for the nonpsychiatric controls used to standardize the test values (N = 2,793). Levels did not differ as a function of discharge diagnosis. Thus, low blood total protein and albumin levels seem characteristic of the overall psychiatric inpatient population. PMID- 6853458 TI - Psychiatric symptomatology in an outpatient neurology clinic. AB - The self-report Symptom Checklist-90 (SCL-90) was used to screen 105 consecutive first-visit patients in an outpatient neurology clinic. Neurologists diagnosed a primary psychiatric disorder in 35 patients (33%) and a secondary psychiatric disorder in 5. The SCL-90 uncovered previously unidentified emotional distress in 14 patients, for an overall incidence of psychiatric symptoms of 51%. Pain was the most common chief complaint (N = 49), and pain patients accounted for 86% of the primary psychiatric diagnoses. Tricyclic antidepressants were the most often prescribed medications; 81% of these prescriptions were given to pain patients, usually in low doses. Depression was the most common diagnosis (N = 15). Despite the high incidence of psychiatric symptoms, only 3 patients received a psychiatric referral. Neurologists and consulting psychiatrists should maintain a high index of suspicion for psychiatric symptoms when examining patients complaining of pain and, after assessing the presence and severity of depression, prescribe tricyclics judiciously. PMID- 6853464 TI - Single phenothiazines and tardive dyskinesia. PMID- 6853466 TI - Patient rights versus patient needs: who decides? AB - The rights of patients both to receive and to refuse treatment, often seen as contradictory within the profession of psychiatry, are discussed, and the cases on which these principles have been based are reviewed. Difficulties and discrepancies in defining "emergency situations" in which treatment can be given against a patient's will are enumerated. It is clear that legal and psychiatric perceptions of emergency situations differ in many respects. Authors are now beginning to discuss concepts such as the patient's responsibilities in treatment, as well as the right of the caregiver to treat. Other related issues include adjudication of competency to refuse treatment, the rights of families, and the difficulties inherent in attempts to predict dangerousness. PMID- 6853467 TI - The effectiveness of videotape in patient education on depression. AB - The effectiveness of videotape for patient education on depression was assessed. The videotape was shown to members of a general patient population and accompanying persons in the waiting area of a health maintenance organization (HMO) clinic, then evaluated according to pre- and post-test questionnaire responses before and after viewing the tape. The patients' knowledge of depression increased significantly (p less than or equal to 0.002) as a result of the videotape intervention. Although attitudes were not affected, 91.7% found it useful and 38.3% thought it reassuring. There was a high demand for access to more health educational videotapes. PMID- 6853465 TI - PCP, physical restraint, and rhabdomyolysis. PMID- 6853468 TI - Academic information management and the biocommunicator. PMID- 6853470 TI - Providing information more efficiently in pediatric practice. AB - Information delivery in a pediatric practice must be efficient in order to provide the vast amount of health care information available. The individual practitioner often has difficulty finding enough time to provide the information, in an optimal fashion, on a one-to-one basis. Three techniques are recommended to more efficiently transmit information: taping recorded messages on pediatric health topics; referring parents to sources of information specific to their children's ages; and establishing classes or group meetings. These educational approaches can greatly facilitate the delivery of health care to children. PMID- 6853469 TI - The use of color in medical illustration II. PMID- 6853471 TI - "Good" TV visuals: do they make a difference? AB - Media producers generally urge health science instructors to plan television visuals that conform to accepted ideas of what is "good" for television. Experiments in a class of nursing students taught entirely by television tested whether learning was affected by differences in visual aspect ratio, color, and seeing the instructor on the screen. It was found that alterations in these characteristics did not affect performances on post-tests, but the students did have definite preferences in some areas. PMID- 6853472 TI - Phosphate transport system in paracoccus denitrificans. AB - Pi uptake in cells or spheroplasts of Paracoccus denitrificans is biphasic; only the first rapid phase represents net Pi transport. The second phase is limited by the rate of Pi utilization inside the cell, i.e., mainly by its esterification, and as such it was inhibited by DCCD. The Pi/dicarboxylate antiporter does not seem to be operative, and its inhibitor n-butylmalonate did not exert specific inhibition. Pi transport is inhibited by SH reagents; the most potent inhibitor is PCMB, and mersalyl is much less effective. However, neither inhibitor affects efflux of accumulated Pi. The gradient of potassium ions may be involved in the Pi uptake, which is lowered in the presence of valinomycin. FCCP alone does not release accumulated Pi from spheroplasts unless they are preincubated with SCN-. The results indicate that Pi enters the cell by symport with protons. PMID- 6853473 TI - Action of mercurials on the active and passive transport properties of sarcoplasmic reticulum. AB - The effect of Hg2+ and CH3-Hg+ on the passive and active transport properties of the Ca2+-Mg2+-ATPase-rich fraction of skeletal sarcoplasmic reticulum (SR) is reported. The agents abolish active transport, at 10(-5) and 10(-4) M concentrations, respectively. Addition of the mercurials was also shown to release actively accumulated Ca2+. The mercurials increase the passive Ca2+ and Mg2+ permeability in the absence of ATP at the same concentrations at which they inhibit transport. It is proposed that both effects are the result of direct binding of the mercurials to the SH groups of the Ca2+-Mg2+-ATPase pump, altering the conformational equilibria of the pump. The agents were also shown to increase the passive KCl permeability. The SR preparation consists of two vesicle populations with respect to K+ permeability, one with rapid KCl equilibration faciliated by a monovalent cation channel function and one with slow KCl equilibration. The mercurials increase the rates of KCl equilibration in both fractions, but produce higher rates in the fraction containing the channel function. The results are discussed in terms of pump and channel function and are compared with results for the electrical behavior of the CA2+-Mg2+-ATPase and other SR proteins in black lipid membranes, as presented by others. PMID- 6853474 TI - Singlet oxygen production by lactoperoxidase. AB - Infrared chemiluminescence with maximum intensity near 1270 nm was detected in the lactoperoxidase, H2O2, Br- system. No emission was observed when heat inactivated enzyme was used or when Br- or H2O2 was deleted from the system. The chemiluminescence was increased by a factor of 42 +/- 5 (mean +/- S.E.) in 98% 2H2O. These results are strong evidence for the production of 1O2 in this system. PMID- 6853475 TI - Isolation and characterization of the pseudocatalase of Lactobacillus plantarum. AB - The nonheme, or pseudo, catalase of Lactobacillus plantarum has been purified to homogeneity. This enzyme is pink in concentrated solutions and has a molecular weight of 172,000 +/- 4,000. It is composed of six noncovalently associated subunits of molecular weight 28,300 +/- 600. This pseudocatalase contains 1.12 +/ 0.37 atoms of manganese per subunit. Fe, Co, Cu, and Zn, if present at all, were at less than 0.1 atom per subunit. At pH 7.0 and at 25 degrees C the Km for H2O2 is 250 mM and the turnover number at Vm was 3.9 x 10(5) mol of H2O2 per mol of enzyme per s. The optical spectrum of pseudocatalase is similar to that of the manganese superoxide dismutase and indicates the presence of Mn(III) in the resting enzyme. Pseudocatalase does not exhibit superoxide dismutase activity nor does the manganese-containing superoxide dismutase exhibit catalase activity. This pseudocatalase is stable to freezing and thawing and lost only 40% of its activity when heated to 80 degrees C for 5 min. Strains of L. plantarum which contain pseudocatalase did not accumulate H2O2 in the growth medium. PMID- 6853476 TI - The structures of the carbohydrate moieties of bovine blood coagulation factor IX (Christmas factor). AB - Bovine blood coagulation factor IX (Christmas factor) contains four asparagine linked sugar chains in one molecule. The sugar chains were quantitatively liberated as radioactive oligosaccharides from the polypeptide moiety by hydrazinolysis followed by N-acetylation and NaB3H4 reduction. The structures of these sugar chains were determined by sequential exoglycosidase digestion in combination with methylation analysis. Bovine factor IX contained two unique penta- and tetrasialyl triantennary sugar chains with the structures shown below in addition to tetra-, tri-, and disialyl biantennary sugar chains of Sia alpha 2 leads to 3 Gal beta 1 leads 3(Sia alpha 2 leads to 6)GlcNAc beta 1 leads to 2Man alpha 1 leads to 6[Sia alpha 2 leads to 3Gal beta 1 leads to 3(Sia alpha 2 leads to 6)GlcNac beta 1 leads to 2Man alpha 1 leads to 3]Man beta 1 leads to 4GlcNAc beta 1 leads to 4GlcNAc, Sia alpha 2 leads to 6Gal beta 1 leads to 4GlcNAc beta 1 leads to 2Man alpha 1 leads to 6[Sia alpha 2 leads to 3Gal beta 1 leads to 3(Sia alpha 2 leads to 6)GlcNAc beta 1 leads to 2Man alpha 1 leads to 3]Man beta 1 leads to 4GlcNAc beta 1 leads to 4GlcNAc, and Sia alpha 2 leads to 6Gal beta 1 leads to 4GlcNAc beta 1 leads to 2Man alpha 1 leads to 6(Sia alpha 2 leads to 6Gal beta 1 leads to 4GlcNAc beta 1 leads to 2Man alpha 1 leads to 3)Man beta 1 leads to 4GlcNAc beta 1 leads to 4GlcNAc and their partially desialized forms. PMID- 6853478 TI - The serotonin transporter-imipramine "receptor". AB - The platelet plasma membrane serotonin transporter requires Na+ for two reactions, serotonin transport and imipramine binding. Although imipramine binding has been thought to reflect the same process required for serotonin binding prior to transport (Talvenheimo, J., Nelson, P.J., and Rudnick, G. (1979) J. Biol. Chem. 254, 4631-4635), binding and transport display markedly different responses to Na+. Imipramine binding (and competitive inhibition of transport) apparently requires two sodium ions which bind with a KD of 300 +/- 70 meq/liter. The total number of sites (Bmax) is the same at all Na+ concentrations, but the affinity for imipramine increases from 7.3 x 10(6) M-1 at 20 meq/liter to 110 x 10(6) M-1 at 200 meq/liter. Na+ acts, at least in part, by decreasing the rate of imipramine dissociation from its binding site. Serotonin binding displaces imipramine from its site on the membrane. In contrast to imipramine binding, this displacement is a simple, hyperbolic function of Na+ concentration with a KD for Na+ of 400 +/- 100 meq/liter, which suggests that only one Na+ is required. Serotonin transport is also much less responsive to Na+ concentration. Over the same concentration range in which the affinity for imipramine increases 15-fold, the affinity for serotonin increases only 2-fold. Despite the lack of Na+ effect on the Bmax for imipramine binding, the Vmax for serotonin transport increases as a simple saturable function of Na+ with a KM (Na+) of 52 meq/liter. Thus, substrate translocation as well as binding requires Na+. Since serotonin is cotransported with Na+, the serotonin gradient accumulated depends on the coupling stoichiometry and the magnitude of the Na+ gradient imposed. From the response of the serotonin gradient to imposed Na+ gradients, we calculated a serotonin:Na+ cotransport stoichiometry of 0.9. Taken together, the results suggest that serotonin and imipramine bind either to the same site or to mutually exclusive sites, but maximal imipramine binding requires two sodium ions, while maximal serotonin binding and translocation requires only one. PMID- 6853480 TI - The principal site of nonenzymatic glycosylation of human serum albumin in vivo. AB - We have determined the major site of nonenzymatic glycosylation of human serum albumin in vivo. This was accomplished by reacting freshly purified human serum albumin with sodium [3H]borohydride followed by aminoethylation and tryptic digestion. The tryptic peptides were separated into a soluble fraction which contained 88% of the total 3H radioactivity and an insoluble fraction. In order to isolate the 3H-labeled glycosylated peptides, the soluble tryptic peptide fraction was first subjected to boronic acid affinity chromatography. Cation exchange chromatography then separated the soluble glycosylated peptides into a major peak which contained 48% of the total recovered 3H radioactivity and a number of minor peptide fractions. The amino acid composition of the major peptide was: Thr, Glu2, Ala, Val2, Leu2, Lys, lysino-1-deoxysorbitol. In accord with the primary structure of human serum albumin, this amino acid composition corresponds precisely to residues 525-534. Glucitol-lysine, the NH2-terminal residue of this peptide, is totally resistant to cleavage by trypsin. Thus, lysine-525 is the predominant site of nonenzymatic glycosylation of human serum albumin in vivo. Chromatography on GlycoGel B boronic acid affinity gel indicates that 10-12% of normal serum albumin is glycosylated. The rate of nonenzymatic glycosylation of this protein in vivo is approximately 9 times that of human hemoglobin. PMID- 6853479 TI - Proton nuclear magnetic resonance studies of isonitrile-heme protein complexes. AB - Steric interactions between bound ligand molecules and the valine E11 methyl groups of human hemoglobin and sperm whale myoglobin have been examined directly by high resolution NMR techniques. The methyl proton resonances of this amino acid are shifted markedly upfield and away from the bulk of the protein resonances by the shielding effect of circulating pi electrons in the porphyrin ring. We have monitored the valine resonance in the presence of CO and a series of isonitriles and found considerable shifts in its position, both between the various protein complexes and among the different liganded states. The ring current shifts of the gamma 1-methyl group of Val E11 in the CO forms of isolated alpha and beta chains and myoglobin are -2.70, -2.91, and -3.30 ppm, respectively. In all the proteins, these positions show little change in going from bound CO to bound methyl and ethyl isocyanide. In alpha subunits and myoglobin, n-propyl and n-butyl isocyanide binding produces marked decreases in the magnitude of these shifts, indicating that the valine residue has been forced away from the center of ring by the presence of these large ligand molecules. In the case of beta subunits, however, only tert-butyl isocyanide produces a marked decrease (from -2.91 to -1.99 ppm) in the ring current shift of the valine methyl protons. New peaks were observed in the isonitrile-protein spectra and identified as ligand proton resonances by comparing the spectra of normal and totally deuterated isonitrile complexes. The magnitudes of the ring current shifts for the terminal methyl protons of ethyl isocyanide suggest a linear geometry for the Fe equal to C equal to N - C bonds in beta chains and a bent geometry for alpha chains. The bent geometry in alpha subunits appears to be dictated by the position of the Val E11 methyl group which is located further up from the heme plane but closer to the heme center than the corresponding position of the beta subunit residue. The free energy changes for ethyl isocyanide binding to the two chains are nearly identical, suggesting that the linear and bent geometries are energetically equivalent. Myoglobin ethyl isocyanide complexes exhibit ligand ring current shifts intermediate to those observed for the hemoglobin subunits. Assignment of resonances and positions to the alkyl protons of the longer isonitriles is more difficult. PMID- 6853477 TI - A hydrogen ion flux mediates stimulation of respiratory activity by speract in sea urchin spermatozoa. AB - Speract (Gly-Phe-Asp-Leu-Asn-Gly-Gly-Gly-Val-Gly), a Tyr analogue (Tyr-Asp-Leu Asn-Gly-Gly-Gly-Val-Gly), carboxyl-terminal fragment (Gly-Gly-Gly-Val-Gly), and an NH2-terminal fragment (Gly-Phe-Asp-Leu-Asn-Gly-Gly-Gly) were tested for their effects on sea urchin sperm respiration and net H+ efflux. The stimulation of net H+ efflux by these peptides was highly correlated with their ability to stimulate cell respiration rates. At an extracellular pH of 6.6, the release of approximately 2.5 ng ions of H+/mg of sperm caused a 1.3 ng atoms of O/min/mg of sperm increase in the respiration rate, independent of the peptide used. As the extracellular pH was raised toward pH 7.5, a much larger stimulation of respiration occurred with a given amount of H+ efflux. The converse was true when the pH was lowered to pH 6.0. Narasin caused a net H+ influx or net H+ efflux dependent on the extracellular pH; respiration rates were increased under conditions of narasin-induced net H+ efflux and were decreased under conditions of net H+ influx. Weak bases (NH3 or Tris) stimulated sperm respiration, whereas a weak acid (acetic) inhibited sperm respiration rates at constant extracellular pH. Ammonia or speract counteracted the acetic acid inhibition, but speract failed to further stimulate spermatozoa in the presence of ammonia. Raising the extracellular pH also stimulated spermatozoa, and such elevations were shown to increase the intracellular pH. These data suggest that sea urchin sperm respiration rates can be regulated by the intracellular pH and that speract (and analogues) stimulate sperm respiration by primary effects on H+ efflux. PMID- 6853481 TI - The purification and characterization of a proline dipeptidase from guinea pig brain. AB - A proline dipeptidase (EC 3.4.13.9) from guinea pig brain was purified to over 90% homogeneity by a combination of ammonium sulfate fractionation, DEAE cellulose chromatography, calcium phosphate-cellulose chromatography, chromatofocusing, and gel filtration on Sephadex G-200. A purification factor of 2718-fold was obtained with a yield of 7%. The purified enzyme was found to have an apparent molecular weight of 132,000 and to consist of two dissimilar subunits of molecular weights 64,000 and 68,000. The substrate specificity of the enzyme is not that of a strict proline dipeptidase. Although it preferentially hydrolyzes proline dipeptides (Leu-Pro) it also hydrolyzes prolyl dipeptides (Pro Leu) and dipeptides not containing proline (Leu-Leu). The purified enzyme preparation exhibited weak aminoacylproline aminopeptidase activity against Arg Pro-Pro but it did not exhibit any post-proline dipeptidyl aminopeptidase, post proline cleaving endopeptidase, proline iminopeptidase, prolyl carboxypeptidase or carboxypeptidase P activities when tested with a large variety of peptides and arylamides. With all of the proline and prolyl dipeptides examined the enzyme exhibited biphasic kinetics (two distinct slopes on Lineweaver-Burk plots). However, with Leu-Leu as substrate normal Michaelis-Menten kinetics were obeyed. PMID- 6853483 TI - Single crystals of cadmium, zinc metallothionein. AB - Single crystals have been grown of Cd,Zn metallothionein isoform II from rat liver. The space group is P4(1)2(1)2 (P4(3)2(1)2) with unit cell dimensions a = b = 31.0 A and c = 120.0 A, and one molecule in the crystallographic asymmetric unit. The crystals are square bipyramids elongated on the tetragonal c-axis and are grown by repetitive seeding. The crystals are suitable for high resolution structure analysis. Assays of dissolved crystals show that the crystals have the same Cd and Zn content and amino acid composition as the native, as-isolated protein. PMID- 6853482 TI - Stimulation of calf thymus DNA alpha-polymerase by ATP. AB - ATP stimulates the activity of the A and C forms of calf thymus DNA alpha polymerase on several natural and synthetic primer-templates. Stimulations ranging from 1.5- to 8-fold were observed on gapped bacteriophage fd replicative form DNA, poly(dA) x oligo(dT)10, and poly(dT) x oligo(A)10, at ATP concentrations of 1-5 mM. CTP, dATP, and dCTP can substitute for ATP but are less effective. The nonhydrolyzable ATP analogs, adenyl-5'-yl imidodiphosphate and adenosine 5'-O-(thiotriphosphate), and other deoxy- and ribonucleoside triphosphates are essentially inactive for stimulation. Stimulation does not result from polymerase-associated DNA primase activity. The size of products synthesized processively by each enzyme on the two homopolymer templates was determined by gel filtration of primers extended under conditions where the enzyme did not react with a given 3'-OH terminus more than once. The size of products synthesized by the A and D forms on poly(dA) x oligo(dT)10 increased by a factor of 3-6 in the presence of ATP. This suggests a direct effect of ATP on the primer elongation reaction. Finally, presynthesis incubation of enzyme plus template at 37 degrees C in the presence or absence of ATP demonstrates that ATP stabilizes the enzyme against breakdown. PMID- 6853484 TI - Synthesis and hydrolysis of ADP-arsenate by beef heart submitochondrial particles. AB - The kinetic parameters for inorganic phosphate and inorganic arsenate as substrates for the synthesis of ATP and ADP-arsenate, respectively, by beef heart submitochondrial particles have been determined. The Vm and Km values for arsenate and phosphate, as well as the Km values for ADP in the two reactions, are the same within experimental error of the measurements. These data are consistent with covalent bond formation not being the rate-limiting step for either ATP or ADP-arsenate synthesis. The hydrolysis of ATP and of ADP-arsenate was studied under conditions of net synthesis of ATP or ADP-arsenate. The apparent first order rate constant for ATP hydrolysis increased with submitochondrial particle concentration, indicating that hydrolysis of ATP was catalyzed by the submitochondrial particle preparation. Nonenzymic hydrolysis of ATP was negligible compared to enzymic hydrolysis. The apparent first order rate constant for ADP-arsenate hydrolysis did not vary with submitochondrial particle concentration, indicating that ADP-arsenate hydrolysis was nonenzymic. Enzymic hydrolysis of ADP-arsenate was too slow, compared with its rapid nonenzymic hydrolysis, to be detected. The first order rate constant for ADP-arsenate hydrolysis at pH 7.5, 30 degrees C, was determined to be greater than 5 min-1 and was estimated to be 70 min-1. These data confirm previous suggestions that arsenate "uncouples" oxidative phosphorylation by a mechanism involving synthesis of ADP-arsenate, followed by its rapid nonenzymic hydrolysis. PMID- 6853485 TI - Albumin-bilirubin binding mechanism. AB - After binding of bilirubin to human serum albumin (1:1), a train of relaxational changes of conformation takes place. The late part of these processes, occurring in the time interval 1-500 s, has been studied by recording the changes of light absorption. Similar processes have been demonstrated after binding of fatty acid anion to the bilirubin-albumin complex as well as after a pH-jump from 6 to 9. Solvent perturbation spectra obtained on the addition of 20% sucrose have failed to demonstrate exposure of the bilirubin chromophores in the complex to the surrounding medium. Xanthobilirubinate which has a single dipyrrolic chromophore compared to the two of bilirubin is bound to albumin in competition with bilirubin, as concluded from co-binding studies with monoacetyldiaminodiphenylsulfone and diazepam, probing two different binding functions of the albumin molecule. Late conformational changes were absent after binding of xanthobilirubinate. Binding of fatty acid to the complex and a pH-jump did not affect the spectrum of xanthobilirubinate-human serum albumin. The findings can be explained by a model, previously proposed, in which the late spectral changes are affected by rotation of one half-domain of albumin, binding one bilirubin chromophore, relative to another half-domain to which the second bilirubin chromophore is bound, whereby a change of exiton splitting occurs. Such changes are not seen with the complex of xanthobilirubinate and albumin, since only a single chromophore is present. PMID- 6853486 TI - Metabolic fate of platelet-activating factor in neutrophils. AB - 1-O-[3H]Alkyl-2-acetyl-sn-glycero-3-phosphocholine (1-O-[3H]alkyl-2-acetyl-GPC) incubated with rabbit polymorphonuclear leukocytes was metabolized to 1-O-alkyl-2 acyl-GPC containing long chain groups at the 2 position. Within 5 min, 60% of the total label added to the cell suspension was found in the 1-O-[3H]alkyl-2-acyl GPC. At earlier time points, 1-O-[3H]alkyl-2-lyso-GPC was present. No metabolites were detected that would indicate the ether bond had been cleaved or the polar head group had been altered by the cells. At subaggregating and subdegranulating concentrations of labeled 1-O-[3H]alkyl-2-acyl-GPC, the same pattern of product formation was observed. Furthermore, when 1-O-[3H]alkyl-2-lyso-GPC was added to the cells, it was taken up and acylated in the same manner as that from 1-O-alkyl 2-acetyl-GPC. The nature of the long chain acyl residues incorporated into the 2 position was then examined by argentation chromatography and high performance liquid chromatography. Argentation chromatography of 1-O-[3H]alkyl-2-acyl-3 acetylglycerols obtained from 1-O-[3H]alkyl-2-acyl-GPC after acetolysis indicated that mono-, di-, and tetraenoic fatty acids were the predominant molecular species being incorporated into the 2 position of the molecule (18, 55, and 18%, respectively). Furthermore, high performance liquid chromatographic analysis using synthetic 1-O-alkyl-2-acyl-GPC standards indicated that three fatty acids, linoleic, arachidonic, and oleic (50, 15, and 12%, respectively), were the major chains being incorporated into the 1-O-hexadecyl-linked species. Analysis of 1-O [3H]alkyl-2-acyl-GPC derived from exogenously added 1-O-[3H]alkyl-2-lyso-GPC revealed the same distribution of acyl groups linked to the 2 position. The findings are consistent with a pathway in which two enzymatic activities are responsible for the metabolism of exogenous platelet-activating factor in the rabbit neutrophils: one that hydrolyzes the acetyl residue (acetylhydrolase) and another that transfers a fatty acyl chain to the 1-O-alkyl-2-lyso-GPC formed (possibly acyl-CoA:1-O-alkyl-2-lyso-GPC acyltransferase). These events appear to play an important role in inactivating this potentially lethal phospholipid. PMID- 6853487 TI - The influence of bile salt structure on self-association in aqueous solutions. AB - The relationship between chemical structure and the concentration at which self association occurs in water or in 0.15 M Na+ ion was examined for more than 50 bile salts and bile salt analogues varying in substituents on the steroid nucleus or in the structure of the side chain. Nuclear substituents varied in type (alpha or beta-hydroxy, or oxo group) and number (1, 2, or 3); side chain structure varied in the nature of the ionic group (unconjugated, glycine- or taurine conjugated, or zwitterion) or length of the side chain (5-, 4-, or 3-carbon atoms). The midpoint of the concentration range over which aggregation occurred was called the critical micellar concentration (CMC), even though bile salt aggregation is known to be more gradual than that of most typical ionic detergents. CMC values were obtained by surface tension measurements using an improved maximum bubble-pressure method, as well as by dye solubilization. Results obtained by the two methods agreed well. The CMC values varied from about 1 to greater than 250 mM. For a given bile salt, the addition of a hydroxy or oxo group increased the CMC; and for a given number of substituents, the changing of a hydroxy group to an oxo group increased the CMC values as well. The orientation of hydroxy substituents also influenced the CMC values: the changing of a hydroxy substituent from an alpha- to a beta-configuration increased the CMC values, as bile salts possessing alpha- and beta-hydroxy substituents had higher CMC values than bile salts with only alpha-hydroxy substituents. Inspection of space-filling models suggested the hypothesis that the greater contiguous hydrophobic area of the molecule, the lower the CMC value. The CMC value also increased exponentially as the side chain was shortened from C5 to C4 to C3. Conjugation of the side chain carboxylic group with glycine or taurine, although increasing the length of the side chain, caused little change in the CMC values. The addition of Na+ ion to a total concentration of 0.15 M lowered the CMC in a predictable manner for all anionic bile salts. The results indicate that the concentration at which bile salt aggregation occurs varies widely and is determined not only by the number, type, and orientation of nuclear substituents, but also by side chain structure. PMID- 6853488 TI - Examination of the intracellular ionic environment and of ionophore action by null point measurements employing the fluorescein chromophore. AB - Fluorescein and carboxyfluorescein have found recent application as probes of intracellular pH. The present study examines several parameters required for interpretation of the spectral information derived from fluorescein and carboxyfluorescein generated intracellularly from their permeant diacetate derivatives. Coefficients were determined for the pH dependence of the difference absorbance, of the absorbance ratios, and of the fluorescence emission intensity ratios at selected wavelength pairs for carboxyfluorescein in aqueous buffers. The effect of light scattering on the apparent pH reported by carboxyfluorescein in dilute cell suspensions was assessed. An apparent intracellular acidification associated with increasing internal dye concentration was found to result probably from interactions of the intracellular probe with itself. Working within the experimental limitations imposed by these considerations, protocols utilizing either direct measurement of absorbance or fluorescence or determination of the null spectral response observed upon release of internal carboxyfluorescein all indicate that the cytosolic space of bovine epididymal sperm is maintained at pH 6.5-6.6. The monovalent-cation-specific, carboxylic acid ionophores, nigericin and monensin, were utilized to produce transmembrane proton gradients in cells that were allowed to generate intracellular carboxyfluorescein in a preliminary incubation, then resuspended in media buffered at the same pH as the sperm cytosol but of varying cation composition. By interpolation to the null response, the initial internal Na+ and K+ concentrations in bovine sperm were estimated as 14 +/- 2 and 120 +/- 5 mM, respectively. The ability of initial transmembrane gradients of either protons or of monovalent cations to promote equivalent changes in internal pH following ionophore addition to sperm suspensions supports application of a simple model that predicts steady state cation distributions. With the assumption that the cytosolic proton buffer has a pKa near the determined internal pH, these experiments allow the additional calculation that this buffer is present at a concentration of 190 +/- 20 meq/liter in the bovine sperm. PMID- 6853489 TI - Two Ca2+ functions are demonstrated by the substitution of specific divalent and lanthanide cations for the Ca2+ required by the aggregation factor complex from the marine sponge, Microciona prolifera. AB - Multivalent cations were tested for their ability to replace the Ca2+ requirements of aggregation factor (AF) complex in activity, stability, and integrity assays. The ability of each cation to replace the Ca2+ required for the cell aggregation-enhancing activity of AF was examined by replacing the usual 10 mM Ca2+ with the test cation at various concentrations in the serial dilution assay of the AF. The other alkaline earth cations, Mg2+, Sr2+, and Ba2+, could not replace Ca2+; two transition elements, Mn2+ and Cd2+, partially replaced calcium. All 15 of the available lanthanides (including La3+ and Y3+) produced normal activity but only at 10-400-fold lower cation concentrations than Ca2+. An AF preparation is stable and remains active for months in 1 mM Ca2+ but decays rapidly when Ca2+ is lowered. Sr2+ and Ba2+ at 20 mM but not at 1 mM could replace 1 mM Ca2+ and give long term stability. AF was not stable in the presence of Mg2+, even at 100 mM. High Mn2+ concentrations did not stabilize AF even though AF was partially active in Mn2+. Cd2+ gave full stability at 75 mM and La3+ at about 0.1 mM. When Ca2+ is chelated, the macromolecular subunits of the AF slowly dissociate. Permeation chromatography and analytical ultracentrifugation showed that the cations that stabilized activity maintained the integrity of AF complex while those that failed to stabilize activity allowed the complex to dissociate into subunits, indicating that these two Ca2+ requirements are related. The cation specificities for activity and for stability integrity are different indicating that these are separate Ca2+-dependent functions. PMID- 6853490 TI - Human hypoxanthine-guanine phosphoribosyltransferase. AB - A mutant form of human hypoxanthine-guanine phosphoribosyltransferase (HPRTToronto) was isolated from erythrocytes of a male patient with gout due to a partial deficiency of enzyme activity. The tryptic peptides of HPRTToronto were mapped by reverse-phase high pressure liquid chromatography in an attempt to define the precise abnormality in its primary structure. Sequence analysis of the single aberrant peptide in HPRTToronto revealed an arginine to glycine amino acid substitution at position 50. A single nucleotide change in the codon for arginine 50 (CGA leads to GGA) could explain this substitution. PMID- 6853491 TI - Characterization of nonactivated and activated glucocorticoid-receptor complexes from intact rat thymus cells. AB - In cells exposed to glucocorticoids at 37 degrees C activated glucocorticoid receptor complexes (complexes with affinity for nuclei and DNA) are formed after nonactivated complexes. Activation thus appears to be an obligatory physiological process. To investigate this process we have characterized cytoplasmic complexes formed in rat thymocytes at 0 and 37 degrees C. Complexes in cytosols stabilized with molybdate were analyzed by sucrose gradient centrifugation and by chromatography on DNA-cellulose, DEAE-cellulose, and agarose gels. Two major complexes were observed: the nonactivated complex, eluted from DEAE at approximately 200 mM KCl, was formed at 0 and 37 degrees C, gave S20,w = 9.2 S, Stokes radius = 8.3 nm, and calculated Mr = 330,000; the activated complex, eluted from DEAE at approximately 50 mM KCl, appeared only at 37 degrees C, gave S20,w = 4.8 S, Stokes radius = 5.0 nm, and Mr = 100,000. A third, minor complex, probably mero-receptor, which appeared mainly at 37 degrees C, bound to neither DNA nor DEAE, and gave S20,w = 2.9 S, Stokes radius = 2.3 nm, and Mr = 27,000. With three small columns in series (DNA-cellulose, DEAE-cellulose and hydroxylapatite), the three complexes can be separated in 5-10 min. By this method we have examined the stability of complexes under our conditions. We conclude that in intact thymus cells glucocorticoid-receptor complexes occur principally in two forms, nonactivated and activated, and that activation is accompanied by a large reduction in size. The origin of the mero-receptor complex remains uncertain. PMID- 6853492 TI - Isolation and characterization of the major androgen-dependent glycoprotein of canine prostatic fluid. AB - Canine prostatic fluid, analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis under non-reducing conditions, is characterized by the presence of a single diffuse band (Mr approximately 30,000) which accounts for over 90% of the total protein. The biosynthesis of this protein is under androgen control. Castration results in the disappearance of this protein, whereas its presence in the prostate can be maintained in the castrated animal with exogenous androgen. Analysis of the native protein by isoelectric focusing revealed the presence of 10-13 charged variants with pI values in the range of 6.5 to 8.4. Analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis under reducing conditions revealed that each isoform is constructed of two dissimilar polypeptide subunits covalently linked through disulfide bonds. One subunit has a molecular weight of 15,000 (H chain); the second subunit (L chain) has a variable molecular weight in the 12,000-14,000 range. The H and L subunits have been purified by preparative isoelectric focusing and chemically characterized. Based on tryptic peptide mapping, NH2-terminal analysis, amino acid and carbohydrate composition, the H and L subunits are structurally unrelated and consequently appear to be unique gene products. Furthermore, the L subunit is glycosylated which potentially accounts for its size heterogeneity. Quantitative NH2-terminal analysis indicated that the H and L subunits are present in the native molecule in a ratio of 2:1, suggesting that the native molecule is a trimer with an apparent molecular weight of 43,000. Based on electrophoretic data, the glycoprotein also constitutes the major fraction of the soluble protein in canine prostatic tissue; its presence is organ specific. This glycoprotein should prove useful as a marker for prostatic function under varying hormonal and environmental conditions. PMID- 6853493 TI - Induction of protein and glycoprotein synthesis in rat submandibular glands by isoproterenol. AB - A family of proline-rich proteins which contain over 40% proline and a glycoprotein were isolated from submandibular glands of isoproterenol-treated rats by extraction with 10% trichloroacetic acid and fractionation of the acid soluble portion on Bio-Gel A-1.5m. The proline-rich proteins were subsequently separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Proteins were detected by formaldehyde fixation and Coomassie staining. After elution from the gels, amino acid compositions were determined. The family of proline-rich proteins (about six) appears to be qualitatively identical with a family of proteins from parotid glands of isoproterenol-treated rats (Muenzer J., Bildstein, C., Gleason, M., and Carlson, D. M. (1979) J. Biol. Chem. 254, 5623 5628, 5629-5634), except for a substantial change in the relative amount of each protein. An acid-soluble glycoprotein (GP-158) was not detected in extracts of submandibular glands of normal rats, but GP-158 was highly induced by isoproterenol treatment. This glycoprotein has an apparent Mr = 158,000 as determined by sodium dodecyl sulfate polyacrylamide gel electrophoresis. The major amino acids were Asx, 13%; Glx, 18%; Pro, 29% and Gly, 11%. GP-158 contained about 37% carbohydrate, and its sugar composition on a molar basis was mannose, 3.0; galactose, 2.1; N-acetylglucosamine, 3.5; fucose, 1.2; and sialic acid (N-glycolyl(4-O-acetyl)neuraminic acid), 0.9. N-Acetylgalactosamine was not detected. A glycopeptide isolated from GP-158 had the same sugar composition as GP-158. The amino acid sequence of the glycopeptide was shown to be Asp-Gly-(Asn) Gln-Thr-Gln-Pro-Arg-Pro-(Gly-Pro). Only the parotid and submandibular glands of rats responded in this dramatic fashion to isoproterenol. The isoproterenol treated rat is considered an appropriate model system for studying the overall effects of catecholamine beta-agonists on gene expression in these secretory tissues. PMID- 6853494 TI - Structural and genetic heterogeneity of the receptor mediating translocation of immunoglobulin A dimer antibodies across epithelia in the rabbit. AB - Secretory component (SC), synthesized as a transmembrane protein, acts as the receptor that binds IgA dimers and mediates their transepithelial transport. Cleavage of the receptor (membrane SC) apparently occurs during transport and a fragment, the secreted form, is generated, which remains tightly bound to the IgA dimer. In the rabbit, variation in the size of membrane SC is observed with both a high and a low molecular weight family, each composed either of two or of four distinct polypeptides depending on the individual rabbit. The same degree of size heterogeneity is observed for secreted SC. Part of this size heterogeneity is related to genetic polymorphism. The milk of individual rabbits typed with anti SC-allotype sera reveals three different banding patterns. The simplest pattern, found in t61/t61 and t62/t62 homozygotes, consists of an upper and a lower doublet. Since each band of these two doublets in the t62 allotype migrates slightly faster than its counterpart in the t61 allotype, a composite pattern is observed in the heterozygotes (t61/t62). Within a given allotypic group, all SC polypeptide chains expressed the identical allotypic specificity. The 2000 to 4000 difference in molecular weight between the two forms of a doublet probably reflects differences in the number of glycosylated asparagine residues, since individual bands of a doublet show identical peptide maps. High and low molecular weight families are also structurally related to each other as shown by one dimensional peptide maps and identical NH2- and COOH-terminal amino acid sequences. These results indicate that the 25-kDa size difference between SC from the high and low molecular weight families reflects an intramolecular deletion. PMID- 6853495 TI - Membrane and cytosolic components affecting transport of the precursor for ornithine carbamyltransferase into mitochondria. AB - A higher molecular weight precursor (Mr = 39,000) to the liver mitochondrial matrix enzyme, ornithine carbamyltransferase (Mr = 36,000), is imported and processed by heart mitochondria in vitro in a manner similar to liver mitochondria. In both systems, however, an additional 37-kDa ornithine carbamyltransferase polypeptide appears, but this arises from nonspecific events and, therefore, does not represent a bona fide intermediate in the overall processing sequence. Our experiments demonstrate that the outer mitochondrial membrane of mitochondria contains a protease-sensitive (5 micrograms of trypsin or chymotrypsin/ml, 15 min at 2 degrees C), salt-resistant (1.0 M KCl) protein which is required to maintain import functions. In addition, functional post translational import requires a component of the reticulocyte lysate (i.e. cytosol) that is used for initially synthesizing precursor enzyme. The component is retained by Sephadex G-25. Import of Sephadex G-25-excluded precursor is restored by fresh reticulocyte lysate but not by a combination of other additives, including Mg2+, K+, ATP, ADP, Pi, succinate, and total translation mixture (minus lysate). PMID- 6853496 TI - Transport of ornithine carbamoyltransferase precursor into mitochondria. Stimulation by potassium ion, magnesium ion, and a reticulocyte cytosolic protein(s). AB - The precursor of rat liver ornithine carbamoyltransferase (EC 2.1.3.3) synthesized in vitro was taken up and processed to the mature enzyme by isolated rat liver mitochondria. Potassium ion, magnesium ion, and a reticulocyte cytosolic protein(s), in addition to the precursor and the mitochondria, were required for maximal transport and processing of the precursor. The concentrations of potassium and magnesium ions required for maximal transport and processing were about 120 and 0.8-1.6 mM, respectively. Dialyzed postribosomal supernatant of rabbit reticulocyte lysate (36 mg of protein/ml), in combination with potassium and magnesium ions, stimulated the transport and processing severalfold. The stimulatory activity of the dialyzed lysate was inactivated by trypsin treatment or heating at 100 degrees C for 2 min. No significant amount of the precursor was associated with the mitochondria when incubation was performed in the absence of these components. These results suggest that potassium ion, magnesium ion, and a reticulocyte cytosolic protein(s) stimulate the binding and transport of the ornithine carbamoyltransferase precursor to the mitochondria. Dialyzed supernatant of rabbit erythrocyte lysate was equally effective in stimulating the precursor transport and processing, and a dialyzed cytosol fraction of Ehrlich ascites cells was partly stimulatory. On the other hand, dialyzed cytosol fractions of rat liver and rat kidney, and dialyzed supernatant of wheat germ extracts did not stimulate the precursor transport and processing but rather inhibited it. PMID- 6853497 TI - Molecular approach to thermogenesis in brown adipose tissue. Cell-free translation of mRNA and characterization of the mitochondrial uncoupling protein. AB - In order to develop a molecular approach of the thermogenesis mechanism in brown adipose tissue, cell-free translation was performed with mRNA obtained from control or thermoactive brown adipose tissue. Alterations were observed on analysis of the newly synthesized proteins and in particular at the 32,000 dalton level. Experiments using antibodies against the purified characteristic 32,000 dalton uncoupling protein of brown fat mitochondria were carried out. They indicated that the uncoupling protein was synthesized in the reticulocyte lysate with the same apparent molecular weight as the mature form. It is suggested that the development of the thermogenic capacity of brown fat cells is accompanied by an increase in specific mRNA coding for the uncoupling mitochondrial protein and that such a system could be an interesting one for study of mitochondrial membrane biogenesis. PMID- 6853500 TI - Methionine synthesis from 5'-S-Methylthioadenosine. Resolution of enzyme activities and identification of 1-phospho-5-S methylthioribulose. AB - 5'-S-Methylthioadenosine is converted to methionine in mammalian systems, microorganisms and plants. 5'-S-Methylthioadenosine is first converted to 1 phospho-5-S-methylthioribofuranoside (1-PMTR) which is then converted to 2-keto-4 S-methylthiobutyrate, the precursor of methionine. We have now investigated the conversion of 1-PMTR to the keto acid. This conversion requires at least three protein fractions designated A, B, and C. Fraction A catalyzes an isomerization of 1-PMTR to form 1-phospho-5-S-methylthioribulose. The identification of this compound is based in part on the products obtained after NaIO4 oxidation, i.e. S methylthioacetaldehyde, formate, and phosphoglycolic acid. When fractions A and B are added to 1-PMTR, two additional compounds, designated II and III, were detected. No O2 was consumed in the formation of compounds II and III. These compounds are, therefore, at the oxidation state of 5-S-methylthioribose. Compound II is phosphorylated as evidenced by its electrophoretic behavior before and after alkaline phosphatase treatment. Addition of fraction C to compounds II and III leads to O2 consumption and to the conversion of these compounds to 2 keto-4-S-methylthiobutyrate. Thus, compounds II and III are precursors of the keto acid. These compounds have not been fully characterized. PMID- 6853498 TI - The arrangement of the subunits of the acetylcholine receptor of Torpedo californica. AB - The monomeric form of the acetylcholine receptor from torpedo is composed of five, membrane-spanning chains with the stoichiometry alpha 2 beta gamma delta. The native receptor is predominantly a dimer cross-linked by a disulfide bridge between delta chains. We reduced native dimer to monomer and generated a different dimer by diamide-induced disulfide formation specifically between beta chains. Purified beta-beta cross-linked dimer, when adsorbed to a carbon film and negatively stained, appears in the electron microscope as two contiguous disks, frequently with central, stain-filled pits; i.e. it looks like native receptor in situ viewed normal to the plane of the membrane. We take the region of closest approach of the disks to mark the portions of the beta chains involved in the cross-link. In addition, we tagged the acetylcholine binding sites (one on each alpha chain) for electron microscopic identification, using a complex of monobiotinylated cobratoxin and avidin. Based on the locations of avidins bound to the beta-beta cross-linked dimer, the two toxin binding sites/monomer appear to be separated on the average by 110 degrees, as measured between lines from the center of the monomer to the centers of the avidins. One toxin binding site appears close to the beta-beta cross-link and the other close to the end of the monomer opposite to the cross-link; these locations are similar to the locations of the toxin binding sites relative to the delta-delta cross-link in native dimer. On the assumptions that the chains are compact units and are arranged in a unique order around the central pit, we interpret these results as indicating that the alpha chains are not contiguous and that neither the beta chain nor the delta chain lies between them. Therefore, the arrangement of the chains most easily reconciled with our assumptions and observations is alpha gamma alpha beta delta. PMID- 6853499 TI - Phosphorylation of chloroplast ribulose bisphosphate carboxylase/oxygenase small subunit by an envelope-bound protein kinase in situ. AB - A new protein kinase of the cAMP independent type was found to be bound to the outer envelope membrane of spinach chloroplasts. While stimulated by Mg2+ and inhibited by ADP, the enzyme showed no response to conventional protein substrates and was essentially independent of pH in the physiological (pH 7 to 8) range. The new protein kinase phosphorylated the mature form of the small subunit of ribulose 1,5-bisphosphate carboxylase/oxygenase and, to a lesser extent, an unidentified 24-kDa polypeptide, both of which were bound to the outer envelope membrane. The results suggest that phosphorylation of cytoplasmically synthesized protein constituents of chloroplasts is involved in their transport through the chloroplast envelope membrane barrier. PMID- 6853501 TI - Acetylenic mechanism-based inhibitors of cholesterol side chain cleavage by cytochrome P-450scc. AB - The following acetylenic steroids appear to be the first reported mechanism-based inhibitors of cytochrome P-450scc: 20-(1-propynyl)-5-pregnen-3 beta, 20 alpha diol, 20-(1-hexynyl)-5-pregnen-3 beta, 20 alpha-diol, and 20-(1,5-hexadiynyl)5 pregnen-3 beta, 20 alpha-diol. Oxygen and NADPH are required for enzymatic oxidation and all three steroids yield pregnenolone as a major product. Incubation of P-450scc with 20-(1,5-hexadiynyl)-5-pregnen-3 beta, 20 alpha-diol under turnover conditions completely inactivates the enzyme with a half-time of 11 min. The partition ratio for inactivation by the steroid was determined to be about 6 molecules of the steroid processed per molecule of P-450scc inactivated. PMID- 6853503 TI - Ornithine decarboxylase in mouse kidney. Purification, characterization, and radioimmunological determination of the enzyme protein. AB - Ornithine decarboxylase was purified from kidneys of androgen-treated mice to a greater than 95% purity. Two-dimensional gel electrophoresis revealed charge heterogeneity in the enzyme (pI 4.7-4.9) which was observed both by protein staining and by covalent labeling with [3H]alpha-difluoromethylornithine. Antibodies raised in rabbits inhibited the activity of the enzyme, formed a single rocket in crossed immunoelectrophoresis, and bound [3H]alpha difluoromethylornithine-labeled enzyme as well as [125I]iodoornithine decarboxylase. A sensitive radioimmunoassay for the enzyme was established; the minimal detectable enzyme concentration was 0.1 ng/assay tube that corresponded to about 0.1-0.2 ng/mg of cytosol protein. The antiserum cross-reacted with enzymes from different tissues from mouse, rat, hamster, and human. Immunoreactive ornithine decarboxylase concentration in renal cytosol of male mice was 13-fold higher than that in the females (36.2 +/- 2.7 versus 2.8 +/- 0.2 ng/mg of cytosol protein; mean +/- S.E.); treatment with testosterone implants for 5-7 days increased the concentration to 522 +/- 66 ng/mg of protein. After administration of a single dose of testosterone (10 mg) to female mice, an increased immunoreactive ornithine decarboxylase concentration was detected as soon as 2 h, and rose sharply between 8 and 24 h after steroid administration. These changes were similar to those seen by assays of the catalytically active enzyme. The half-life of immunoreactive ornithine decarboxylase in mouse kidney, as measured after inhibition of protein synthesis in vivo by cycloheximide administration, was 16 min in nontreated and 140 min in androgen-treated male animals, while the corresponding values for the catalytically active enzyme were 9 and 90 min. PMID- 6853505 TI - Medium chain fatty acids as specific substrates for diglyceride acyltransferase in cultured hepatocytes. AB - The fatty acyl substrate specificity for de novo diglyceride, triglyceride, and phospholipid synthesis in cultured hepatocytes was evaluated. The fatty acyl availability for diglyceride and phospholipid synthesis is restricted to fatty acids longer than myristic acid with octanoic and decanoic acids being excluded. On the other hand, octanoic and decanoic acids may serve as substrates for the diglyceride acyltransferase. Dodecanoic acid appears to occupy an intermediate position between medium and long chain fatty acids with respect to its availability as substrate for the esterification sites concerned. The availability of octanoate as a specific substrate for the diglyceride acyltransferase reaction in cultured hepatocytes enables the measurement of this activity in situ under conditions of overall triglyceride synthesis. PMID- 6853504 TI - Purification of Thiobacillus novellus sulfite oxidase. Evidence for the presence of heme and molybdenum. AB - Sulfite oxidase from Thiobacillus novellus has been purified 206-fold. The enzyme reduced both ferricyanide and cytochrome c. The ferricyanide activity was 3-5% of the cytochrome c activity. During purification, the absorbance ratio of A413 nm/A280 nm showed a continual increase, suggesting the presence of heme in the T. novellus sulfite oxidase molecule. The absorption spectrum of the enzyme is very similar to that of rat liver sulfite oxidase which contains cytochrome b5 type heme. Gel electrophoresis of the purified protein in the presence of sodium dodecyl sulfate revealed a protein staining band of approximately 41,000 Da. Gel filtration chromatography of the enzyme in aqueous media indicated a molecular weight of 38,000. These results suggest that T. novellus sulfite oxidase is a monomer of approximately 40,000 Da. Moreover, analysis of the visible absorption spectrum of the purified enzyme and the co-elution of 413 and 280 nm absorbing material during high pressure liquid chromatography gel chromatography provided clear evidence for the presence of heme in T. novellus sulfite oxidase. EPR spectroscopy of the enzyme revealed a characteristic molybdenum spectrum, which was observed only in the presence of sulfite. Analysis of the T. novellus sulfite oxidase molybdenum cofactor showed a fluorescence spectrum indistinguishable from that displayed by the molybdenum cofactor of chicken liver sulfite oxidase. Therefore, it is concluded that T. novellus sulfite oxidase is a monomeric (Mr approximately 40,000) molybdohemoprotein. PMID- 6853507 TI - Phosphatidylinositol synthesis and phosphorylation are enhanced by light in rat retinas. AB - Incorporation of labeled precursors (glycerol, glucose, or 32Pi) into phosphatidylinositol (PI) was 2-3-fold higher in rat retinas incubated in light compared to those in dark. During brief (30 min) incubations with labeled glycerol, there was a selective increase in the radioactivity associated with PI and phosphatidic acid, whereas, upon longer (60 min) incubations, synthesis of other lipids was also enhanced in light. Accumulation of the precursors was similar in light or dark throughout 60 min of incubation. Phosphorylation of PI to triphosphoinositide (TPI) was also enhanced in light, and, in both light and dark, up to 40-50% of the total 32Pi incorporated was associated with TPI. A model is proposed for PI metabolism based on two pathways: 1) a PI cycle representing synthesis and turnover of PI, and 2) phosphorylation of PI to TPI and possible hydrolysis of TPI. Light stimulation was shown to enhance the synthesis of PI within the photoreceptor cell layer and truncated rods and to increase the phosphorylation of PI to TPI within the inner retina and synaptosomes. Parallel studies with retinas from Royal College of Surgeons rats with advanced photoreceptor cell degeneration and intact inner retina showed that loss of the photoreceptor cells did not affect the capacity for phosphorylation of PI to TPI, but was associated with reduced capacity for PI synthesis. These results provide evidence that light stimulation affects different pathways of PI metabolism within different cells of the retina. PMID- 6853506 TI - 13C NMR studies of the product complex of glyoxalase I. AB - The paramagnetic effects of Mn2+ . glyoxalase I on the 13C relaxation rates of the reaction product, S-(D-lactoyl)glutathione, separately enriched in the lactoyl carbonyl (C-1) and hydroxymethylene (C-2) carbons, have been measured at 62.8 MHz. The 1/fT1p values of C-1 (1100 +/- 120 s-1) and C-2 (712 +/- 290 s-1) and the previously determined tau c (0.74 ns) yield Mn2+ to carbon distances of 5.7 +/- 0.3 and 6.1 +/- 0.5 A, respectively. These distances, together with previously determined Mn2+-proton distances (Sellin, S., Rosevear, P.R., Mannervik, B., and Mildvan, A.S. (1982) J. Biol. Chem. 257, 10023-10029) constrain the thioester carbonyl group of the product to point toward the metal, with the oxygen positioned to accept a hydrogen bond from a water ligand, in a kinetically competent, second sphere complex. Model-building studies indicate that any averaging of multiple second sphere complexes would require as a major contributor at least one conformation with the lactoyl carbonyl oxygen within hydrogen-bonding distance of an intervening water ligand. Such a structure would facilitate polarization of the carbonyl group in the reverse glyoxalase reaction. PMID- 6853502 TI - Substrate specificity of chalcone synthase from Petroselinum hortense. Formation of phloroglucinol derivatives from aliphatic substrates. AB - The substrate specificity of chalcone synthase, the key enzyme of flavonoid biosynthesis, was investigated. A purified enzyme preparation from cell suspension cultures of parsley (Petroselinum hortense) catalyzed chain elongations with acetate units from malonyl-CoA, using various aromatic and aliphatic CoA esters as starter molecules. Malonyl-CoA could not be replaced by malonyl acyl carrier protein in the standard chalcone synthase assay. Butyryl CoA, hexanoyl-CoA, and benzoyl-CoA served as substrates for the condensation reaction with similar efficiency as 4-coumaroyl-CoA, the natural substrate of the enzyme. Acetyl-CoA and octanoyl-CoA were relatively poor substrates. Among the products formed with the two most efficient aliphatic substrates tested, butyryl CoA and hexanoyl-CoA, were the respective chalcone analogues, phlorobutyrophenone and phlorocaprophenone. The possibility is discussed that chalcone synthase and the corresponding enzyme of fatty acid synthesis in higher plants, beta-ketoacyl acyl carrier protein synthase, have a common evolutionary origin. PMID- 6853508 TI - Regulation of protein synthesis in Tetrahymena. Quantitative estimates of the parameters determining the rates of protein synthesis in growing, starved, and starved-deciliated cells. AB - The calculated rate of protein synthesis for growing Tetrahymena is 360 pg/h, whereas starved cells synthesize only about 3 pg of protein/h. Within 50 min after deciliation of starved cells, the rate of protein synthesis increases to about 60 pg/h. The major mechanism to accomplish these large and rapid changes in the rate of bulk protein synthesis involves regulation of the number of messages loaded on polysomes. Logarithmically growing cells contain about 3.2 X 10(7) mRNA molecules/cell, of which approximately 60% is loaded on polysomes. Starved cells contain about 0.8 X 10(7) messages and the percentage of messages loaded is reduced to 4%. Thus, the number of loaded messages is approximately 60-fold lower in starved cells than in growing cells, although the total message content of cells in these two physiological states differs by only a factor of 4. After deciliation of starved cells, message loading increases about 10-fold. It seems likely that much of the message loaded after deciliation is derived from the large pool of nonpolysomal message in starved cells. Although large differences in message loading exist for growing, starved, and starved-deciliated cells, measurements of the rate of polypeptide elongation and the rate of message initiation indicate the translational efficiency of loaded messages (pg of protein synthesized per pg of message/unit time) is very similar under all conditions. PMID- 6853510 TI - Evolutionary relationships of vertebrate lactate dehydrogenase isozymes A4 (muscle), B4 (heart), and C4 (testis). AB - The amino acid sequence variation among seven lactate dehydrogenase isozymes from dogfish muscle, chicken muscle and heart, pig muscle and heart, and mouse and rat testes were compared with respect to the whole lactate dehydrogenase polypeptide chain as well as their four functional domains. The coenzyme-binding domain is more conserved than the substrate-binding domain. The sequence of the loop and helix alpha D region of testicular LDH-C4 isozymes is very different from those of somatic LDH-A4 and LDH-B4 isozymes, while the NH2-terminal arm is extremely variable. The most parsimonious phylogenetic tree among these seven vertebrate lactate dehydrogenase sequences clearly indicates that the LDH-A4 and LDH-B4 isozymes are more closely related to each other than either to the LDH-C4 isozymes. PMID- 6853509 TI - On the mechanism of transfer of cholesterol between human erythrocytes and plasma. AB - The kinetics of transfer of [3H]cholesterol between human erythrocytes and plasma at 37 degrees C in physiological buffer had these features. 1) Cholesterol transfer was strikingly similar in both directions. 2) Transfer progressed to isotopic equilibrium in a monotonic, apparently first order fashion, except for a minor rapid component (approximately 15%) observed in the transfer of cholesterol from cells to plasma. 3) The mechanism of transfer was not via transient collisions in that the rate of the reaction was quite insensitive to the concentration of reactants over a wide range. 4) The mechanism of transfer did not involve specific, stable complex formation in that there was little difference in the behavior of erythrocytes and inside-out plasma membrane vesicles derived therefrom or between plasma and sonicated liposomes as acceptors. Furthermore, transfer was not affected by vigorous proteolysis of either the cells or the plasma. 5) The kinetics of transfer were fully compatible with diffusion of cholesterol through the aqueous compartment. This was shown by fitting our data to a rigorous model for diffusion equilibrium between three compartments. 6) The partition coefficient of [3H]cholesterol between red cells and buffer was shown to be 10(7). 7) The rate constants for cholesterol release from both red cells and plasma were approximately 1 X 10(-4) s-1 (t 1/2 approximately 2 h). The rate constant for cholesterol uptake into red cells was approximately 1 X 10(3) s-1 (t 1/2 approximately 1 ms). 8) The similarity of the corresponding kinetic constants among red cells, plasma, and liposomes suggests that phospholipids in a variety of physical forms are equivalent solvents for cholesterol. We conclude that despite its extremely low solubility in water, cholesterol moves between lipid compartments by aqueous diffusion. PMID- 6853511 TI - Purification and properties of a novel pyrimidine-specific endoribonuclease termed endoribonuclease VII from calf thymus that is modulated by polyadenylate. AB - Endoribonuclease VII, a novel endoribonuclease from calf thymus, was identified and purified by us. The purified enzyme has Mr = 74,000; its homogeneity was checked by analysis in polyacrylamide gels (both in the presence and in the absence of sodium dodecyl sulfate). The nuclease cleaves poly(U) and poly(C) while other single-stranded homopolyribo- as well as polydeoxyribonucleotides are not degraded; poly(A,C) is hydrolyzed to a smaller extent, while poly(U) X poly(A) is not degraded at all. Poly(A) modulates the poly(U)-degrading activity; at a molar ratio of approximately 1 [poly(A)]:10 [poly(U)], a more than 100% stimulation of the enzyme activity was achieved, while at lower ratios an almost complete inhibition of the enzyme activity resulted. Binding studies revealed that endoribonuclease VII has a marked affinity for poly(A) and poly(U). During hydrolysis, oligo(U)12 fragments with 3'-OH and 5'-P termini are formed. The basic enzyme (pI = 8.5) has its activity optimum at pH 7.2, requiring neither monovalent nor divalent cations; the enzyme is not inhibited by thiol group reagents. Several lines of evidence suggesting a role of endoribonuclease VII in mRNA processing are presented. PMID- 6853512 TI - Monensin inhibition of hyaluronate synthesis in rat fibrosarcoma cells. AB - Evidence is presented that monensin-sensitive membranes, presumably the Golgi apparatus, are involved in the synthesis of hyaluronate in rat fibrosarcoma cells. Monensin caused the inhibition of incorporation of metabolic precursors into hyaluronate produced by rat fibrosarcoma cells in a concentration- and time dependent manner. Maximum inhibition (70-80%) was obtained on treatment with 10( 7) M monensin for 24 h. Incorporation of label into secreted hyaluronate and into that associated with the cell surface was inhibited, but incorporation into intracellular hyaluronate was not inhibited. In 3T3 cells, treatment for 24 h with 10(-7) M monensin inhibited incorporation of label only into secreted hyaluronate. The hyaluronate-rich pericellular coat, revealed by exclusion of fixed red blood cells, was depleted on treatment with monensin under the same conditions which caused inhibition of hyaluronate synthesis in the fibrosarcoma cells. Cell proliferation, as measured by DNA content/culture and [3H]thymidine incorporation, was also inhibited in a dose-dependent manner by monensin (10(-8) 10(-6) M). Protein synthesis was not inhibited at these doses, nor was monensin cytotoxic as judged by a 51Cr release assay. The inhibition of hyaluronate synthesis was independent of the antiproliferative effect of monensin because it was obtained during log phase growth or confluency and in the presence or in the absence of serum. PMID- 6853513 TI - Separation, recombination, and characterization of dissimilar subunits of the DPN dependent isocitrate dehydrogenase from pig heart. AB - The three dissimilar subunits of pig heart DPN-dependent isocitrate dehydrogenase, which normally occur in the ratio 2 alpha:1 beta:1 gamma, have been separated by chromatofocusing. The subunits were first dissociated from native enzyme (specific activity, 15-20 units/mg) with minimal unfolding in 2 M urea and chromatofocused in the range pH 8-5 in the presence of 1 M urea. Isolated alpha, beta, and gamma subunits had specific activities of 0.4, 0.04, and less than 0.01 unit/mg, respectively, suggesting that at least 3 of the 4 subunits of the alpha 2 beta gamma tetramer contain elements of the catalytic site. Addition of pairs of subunits to assay mixtures resulted in markedly enhanced activity for alpha plus gamma (specific activity, 7.8 units/mg) and alpha plus beta (2.9 units/mg), but not for beta plus gamma. The subunit concentration dependence of enhanced activity indicated formation of stoichiometric alpha beta and alpha gamma complexes. Sedimentation equilibrium experiments revealed that alpha, as isolated, exists primarily as a dimer, while beta and gamma are monomeric. The combinations of alpha and beta and alpha and gamma are dimers. Under the conditions used, no larger complexes were formed when all 3 subunits were added in the ratio (2 alpha:1 beta:1 gamma) found in native enzyme and these mixtures failed to show increased activity above that found with alpha beta and alpha gamma. Native enzyme exhibits a reduced Km for the substrate, isocitrate, in the presence of ADP, but this allosteric effect was not observed for the isolated subunits or for combinations of alpha with beta or gamma. However, ADP binding to isolated alpha and beta subunits as well as to alpha beta and alpha gamma dimers was only slightly reduced from that of native enzyme. These results indicate that although all subunits may have the elements of the catalytic and allosteric sites, optimum activity and regulatory properties may require the association of dissimilar subunits. PMID- 6853514 TI - Protein carboxylmethylation in intact rat posterior pituitary lobes in vitro. AB - Methylation of proteins was studied in intact rat posterior pituitary lobes in vitro. Posterior pituitary lobes can catalyze the formation of protein carboxylmethyl esters using methionine as a precursor. Methylation inhibitors inhibited formation of protein carboxylmethyl esters, indicating that the reaction proceeded via an enzymatic methylation pathway. At least six proteins were methylated in the intact lobe. Among these are the neurophysins as identified by their characteristic properties: molecular weight, [35S]cysteine labeling, disappearance after salt loading or pituitary stalk section, and low levels in the homozygous Brattleboro rat. Other still unidentified proteins of molecular weight lower than 21,000 were also methylated. Their disappearance after pituitary section and salt loading indicates that, like the neurophysins, these proteins are localized within the hypothalamoneuro-hypophysial axon terminals. PMID- 6853516 TI - Identification and quantitation of levels of protein synthesis initiation factors in crude HeLa cell lysates by two-dimensional polyacrylamide gel electrophoresis. AB - Protein synthesis initiation factors in purified preparations and in crude lysates of HeLa cells were fractionated by two-dimensional polyacrylamide gel electrophoresis in order to characterize their molecular forms. Specific spots in the complex cytoplasmic protein gel pattern which corresponded to the initiation factor proteins were identified by co-migration of purified initiation factors with 35S-labeled cell lysates, partial proteolytic digestion mapping, and immunoblotting analysis using antisera or affinity-purified antibodies to the initiation factors. Spots identified as eukaryotic initiation factor (eIF) 2 alpha, eIF-2 beta, eIF-2 gamma, eIF-4A, and four eIF-3 proteins of less than 50,000 Da corresponded to moderately abundant lysate proteins. Minor isoelectric variant forms of eIF-2 beta, eIF-2 gamma, and eIF-4A were detected by immunoblot analysis of lysate proteins, suggesting either covalent modification of these factor proteins or contaminating antibodies. eIF-2 beta and eIF-4B were present in at least two isoelectric forms, confirming covalent modification of these proteins. The cellular levels of the initiation factor proteins were measured by excising and counting radioactivity in gel-resolved spots corresponding to factors in lysates labeled in vivo. The individual factor protein abundancies span nearly a 10-fold range, from 1.1 to 9.8 million molecules/cell. The factor to ribosome ratio for eIF-2 was 0.8, for the average eIF-3 protein about 0.6, and for eIF-4A it was significantly higher at 3.0. PMID- 6853517 TI - Degradation of different molecular species of phosphatidylinositol in thrombin stimulated human platelets. AB - The relative degradation of the various molecular species of phosphatidylinositol in response to thrombin was studied in human platelets. For this purpose, platelets were prelabeled with [2-3H]glycerol and the loss of radioactivity from the saturated, monoenoic, dienoic, trienoic, tetraenoic, and greater than tetraenoic [3H]phosphatidylinositols was determined after conversion to their 1,2 diacylglycerol acetate derivatives and fractionation by argentation thin layer chromatography. Within 90 s, when the thrombin-dependent degradation of total [3H] phosphatidylinositol amounted to 49.5%, the percentage loss of radioactivity from the tetraenoic (1-stearoyl 2-arachidonoyl) species and greater than tetraenes was significantly greater than that for the other molecular classes and approximately twice that for the monoenes. Furthermore, the extent of degradation tended to decrease with decreasing unsaturation of the phosphatidylinositols in intact platelets. These results indicate that the thrombin-dependent hydrolysis of phosphatidylinositol in intact human platelets exhibits a preferential degradation of 1-acyl (predominantly stearoyl plus oleoyl) 2-arachidonoyl species relative to other molecular species which may possibly be of importance in platelet aggregation. PMID- 6853515 TI - Inactivation of Ricin using 4-azidophenyl-beta-D-galactopyranoside and 4 diazophenyl-beta-D-galactopyranoside. AB - 4-Azidophenyl-beta-D-galactopyranoside and 4-diazophenyl-beta-D-galactopyranoside were used to inactivate ricin. Galactose, but not glucose, protected against inactivation as measured by the retention of the ability of ricin to bind to Bio Gel A, a galactose-containing gel. Nearly complete inhibition of binding to Bio Gel A, to monosaccharides, or to cell surface receptors could be achieved by reaction of ricin with either label, but neither label impaired the ability of the A chain to inhibit translation in vitro. The diazonium salt-modified ricin still inhibited cellular protein synthesis, but ricin modified by the photoactivated label was 280 times less efficient than ricin in inhibition of cellular protein synthesis. PMID- 6853521 TI - A reaction pathway for transimination of the pyridoxal 5'-phosphate in D-serine dehydratase by amino acids. AB - Transimination of the enzyme-linked cofactor by an amino acid is the first chemical transformation in the reactions catalyzed by pyridoxal 5'-phosphate requiring enzymes. In this work, stopped flow fluorimetry was used to characterize the kinetics of transimination of the cofactor in D-serine dehydratase by several amino acids. The results of these studies indicate that transimination is a multistep process, the first step of which is probably formation of a noncovalent complex between the enzyme and the amino acid. D Serine dehydratase was found to exhibit considerable specificity in the transimination reaction. Furthermore, the enzyme was shown to facilitate the transimination reaction with amino acids and inhibit transimination of the bound cofactor by amines lacking a carboxylate group. A reaction pathway was proposed for the transimination process which accounts for the specificity of the enzyme and indicates the changes in the conformation of the bound cofactor as dictated by the stereoelectronic requirements of the transimination reaction. PMID- 6853518 TI - Specific binding of the calcium antagonist [3H]nitrendipine to subcellular fractions isolated from canine myocardium. Evidence for high affinity binding to ryanodine-sensitive sarcoplasmic reticulum vesicles. PMID- 6853520 TI - Resonance energy transfer assay of protein-mediated lipid transfer between vesicles. PMID- 6853522 TI - The effect of NADH and low oxygen pressure on the hepatic microsomal ethylmorphine N-demethylase activity of the male rat. AB - Plots of reciprocal initial rate of formaldehyde formation as a function of reciprocal ethylmorphine concentration provide parallel lines for oxygen concentrations ranging from 5.41 to 211 microM, and the apparent Km values for ethylmorphine at these extremes are 167 and 417 microM, respectively. Similarly, the apparent Km for O2 decreases from 7.69 microM at 2 mM ethylmorphine to 3.64 microM at 0.2 mM ethylmorphine. Reciprocal plots of 1/Km app and 1/Vm for ethylmorphine against 1/[O2] give Km values for O2 of 9.35 microM and 9.09 microM, respectively. Similar plots give Km values for ethylmorphine of 0.28 mM and 0.36 mM. Similarly, NADH causes an uncompetitive stimulation. These data suggest that hepatic microsomal ethylmorphine N-demethylase follows parallel plot sequential kinetics. These results, along with studies of other workers, suggest that cytochrome P-450 forms an active complex with O2 which is stable for at least many milliseconds. PMID- 6853519 TI - Carboxylmethylation of calmodulin inhibits calmodulin-dependent phosphorylation in rat brain membranes and cytosol. PMID- 6853523 TI - Different regulatory mechanisms for serum amyloid A and serum amyloid P synthesis by cultured mouse hepatocytes. AB - Regulation of the in vitro synthesis of the serum amyloid proteins A and P has been studied with hepatocyte cultures from CBA/J and C3H/HeJ mice. Liver cells were isolated by the collagenase perfusion technique and established for 48 h in the presence of fetal calf serum. Viable cells could then be maintained in the absence of serum for at least 72 h and in the presence of serum for up to 2 weeks. Serum amyloid A synthesis differed from serum amyloid P synthesis in three significant ways. 1) Serum amyloid A production was stimulated in the presence of fetal calf serum, whereas serum amyloid P was not; 2) serum amyloid A synthesis was increased 200% by monokine-rich macrophage supernatants while serum amyloid P was increased only 10 to 20%; 3) serum amyloid A synthesis was strikingly resistant to cycloheximide inhibition as compared with serum amyloid P and other liver proteins. It is concluded that the in vivo asynchrony of the acute phase serum amyloid A and serum amyloid P responses results at least in part from differences in regulatory mechanisms for their synthesis by hepatocytes. PMID- 6853524 TI - pH and polymerization dependence of the site of labeling of actin by 7-chloro-4 nitrobenzo-2-oxa-1,3-diazole. AB - The influence of pH and state of polymerization on the site of attachment of the fluorophore 7-chloro-4-nitrobenzo-2-oxa-1,3-diazole (NBD-Cl) to actin was examined. Possible interference of buffer constituents which react with NBD-Cl was also observed. F-actin is primarily labeled at cysteine below pH 6.5 and at lysine at values of pH above neutrality. Time dependences of the excitation spectra support the contention that NBD-Cl may react first with cysteine and then undergo transfer to a neighboring lysine. The quantum yield enhancement of NBD bound to cysteine upon polymerization is markedly less than the 2-fold increase observed when it is bound to lysine. Labeling reactions carried out with G-actin give predominantly the lysine derivative regardless of pH. NBD-Cl was found to react with a number of the constituents of buffer systems normally employed with actin. The spectra of these reaction products are sufficiently similar to those of the NBD-amino acid derivatives to require care when interpreting reaction rate data by spectrophotometric or fluorometric methods. PMID- 6853525 TI - Reaction of 2-thio-FAD-reconstituted p-hydroxybenzoate hydroxylase with hydrogen peroxide. Formation of a covalent flavin-protein linkage. AB - Hydrogen peroxide reacts with 2-thio-FAD-reconstituted p-hydroxybenzoate hydroxylase to yield a long wavelength intermediate (lambda max = 360, 620 nm) which can be isolated in stable form on removal of excess H2O2. The blue flavin derivative slowly decays in a second peroxide-dependent reaction to yield a new flavin product lacking long wavelength absorbance (lambda max = 408, 472 nm). This final peroxide-modified enzyme binds p-hydroxybenzoate with a 10-fold lower affinity than does the native enzyme; furthermore, substrate binding leads to the inhibition of enzyme reduction by NADPH. Trichloroacetic acid treatment of the final peroxide-modified enzyme results in the quantitative conversion of the bound flavin to free FAD. However, gel filtration of the modified enzyme in guanidine hydrochloride at neutral pH leads to the co-elution of protein and modified flavin. The nondenatured peroxide product reacts rapidly with hydroxylamine to yield 2-NHOH-substituted FAD. These observations indicate that the secondary reaction of peroxide with the blue intermediate from 2-thio-FAD p hydroxybenzoate hydroxylase results in the formation of an acid-labile covalent flavin-protein linkage within the enzyme active site, involving the flavin C-2 position. PMID- 6853527 TI - Kinetics of sodium succinate cotransport across renal brush-border membranes. AB - The kinetics of Na/succinate cotransport across renal brush-borders was studied using membrane vesicles. Initial rates of succinate uptake (Js) were estimated from 1-s uptakes measured under voltage-clamped conditions. Lowering the external (cis) sodium concentration reduced the succinate Kt without affecting the Jsmax. Increasing the intravesicular (trans) sodium concentration reduced both Jsmax and Kt. This trans inhibition by Na was relieved by trans-succinate. Varying the membrane potential from -60 to +60 reduced succinate transport in an exponential manner, which was reflected by a Kt effect, i.e. an increase in the Kt with no change in Jsmax. The membrane potential results suggest that the succinate/sodium carrier complex bears a net positive charge. On the basis of these and earlier observations, we propose that Na/succinate cotransport across renal brush-borders is described by an Iso Ordered Quad Quad reaction kinetics in which three Na ions first bind to the carrier to increase its affinity for succinate. PMID- 6853526 TI - Oxidation of 2-thioflavins by peroxides. Formation of flavin 2-S-oxides. AB - The reaction of 2-thioriboflavin (sulfur replacing the oxygen substituent at position 2 alpha) with hydrogen peroxide at pH approximately 10 leads to a blue flavin (lambda max = 565 nm) which was purified in stable, homogeneous form. Titrations of 2-thioflavins with m-chloroperoxybenzoic acid also yield the same blue flavins with consumption of 1 eq of peracid. Anaerobic reduction of the blue flavin by sodium dithionite requires 4e- eq, and leads to formation of 1,5 dihydro-2-thioflavin. Oxidation of the latter with O2 restores the original 2 thioflavin. pH titration of the blue flavin shows two pKa values of 2.4 and 6.6, with no apparent ionization in the pH range 8-11. These results suggest that the blue flavin is a flavin 2-S-oxide. The visible absorption spectra of flavin 2-S oxides show a pronounced dependence on solvent polarity. This property suggests that these flavin analogs may be useful hydrophilic/hydrophobic probes of flavoprotein active sites. Flavin 2-S-oxides can be oxidized further to the 2 sulfinate and 2-sulfonate analogs, some properties of which are described. PMID- 6853528 TI - Purification and amino acid sequence of a noncalcitonin secretory peptide derived from preprocalcitonin. AB - A previous report from this laboratory (Birnbaum R. S., O'Neil, J. A., Muszynski, M., Aron, D. C., and Roos, B. A. (1982) J. Biol. Chem. 257, 241-244) provided immunochemical and biochemical evidence for the existence of a secretory peptide derived from the noncalcitonin region of rat preprocalcitonin. By a variety of criteria, we demonstrated that this naturally occurring peptide was similar, if not identical, to a synthetic peptide which consisted of the NH2-terminal 16 residues of the calcitonin mRNA translation product. We have now purified this peptide from rat medullary thyroid carcinoma and sequenced it. A rat tumor of the 1-2-4 tumor series was extracted in 0.1 N HCl yielding 900 micrograms of immunoreactive peptide. The peptide was purified to homogeneity by: 1) trichloroacetic acid precipitation of contaminating protein; 2) gel filtration; and finally, 3) reverse phase high pressure liquid chromatography. Overall yield was approximately 24%. Amino acid analysis and sequencing of the peptide yielded a composition and sequence identical with that of the synthetic peptide. PMID- 6853529 TI - Action of lipoprotein lipase on mixed triacylglycerol/phosphatidylcholine monolayers. Activation by apolipoprotein C-II. PMID- 6853530 TI - Nucleotide sequences of five maize chloroplast transfer RNA genes and their flanking regions. AB - Maize chloroplast tRNA genes encoding tRNA3Ser, tRNAPhe, tRNA2Thr, tRNA2Leu, and tRNAmMet, and their flanking regions have been sequenced. All five gene sequences show features commonly found in the few chloroplast tRNA genes sequenced so far; none of them encodes the 3'-terminal CCA triplet and none of them shows abnormal loop or stem lengths as seen in some genes for mammalian mitochondrial tRNAs. The 5'-flanking regions of some of these tRNA genes contain nucleotide stretches strongly homologous to -35 and -10 promoter regions of bacterial genes. Analysis of these conserved regions together with those seen in other plastid genes yields the consensus sequences ATTGANA at "-35" and TAAGAT at "-10." The 3'-flanking regions of some tRNA genes show dyad symmetries followed by a stretch of Thds. These and other regions may be involved in transcription termination or transcript processing. PMID- 6853531 TI - Binding of an indole derivative to micelles as quantified by phase-sensitive detection of fluorescence. AB - Phase-sensitive detection of fluorescence was used to measure the fractional binding of an amphipathic derivative of indole to detergent micelles. By selection of the detector phase angle, the emissions from the free and bound indole could be individually suppressed. The phase-sensitive intensity was then proportional to the concentrations of the bound and free indole, respectively. Also, the ratio of the phase-sensitive intensities, recorded at the phase angles for suppression, revealed the ratio of the fluorophore present in each environment. As the detergent concentration was increased, the measurements revealed a cooperative formation of detergent micelles and binding of the indole derivative to these micelles. The theory and procedures for this specific analysis can be applied to the analysis of any association reaction in which one of the species is fluorescent, and in which the fluorescence lifetime is altered by the binding process. An advantage of this procedure is that binding can be quantified without physical separation of the individual species. PMID- 6853532 TI - Amino acid sequences of three bombesin-like peptides from canine intestine extracts. AB - Amino acid sequences of three canine bombesin-like peptides were determined after sequential purification of an extract obtained from 820 g of intestinal muscle. These three peptides contained 27, 23, and 10 amino acid residues. The sequences of the two shorter forms were identical to the corresponding carboxyl-terminal sequence of the heptacosapeptide. The sequence of the largest peptide is H2N-Ala Pro-Val-Pro-Gly-Gly-Gln-Gly-Thr-Val-Leu-Asp-Lys-Met-Tyr-Pro-Arg-Gly-Asn - His(Trp Ala-Val-Gly-His-Leu-Met-CONH2). The sequence of the 23-residue peptide is H2N-Gly Gly-Gln-Gly-Thr-Val-Leu-Asp-Lys-Met-Tyr-Pro-Arg-Gly-Asn-His-Trp-Ala- Val-Gly(His Leu-Met-CONH2). The sequence of the decapeptide is: H2N-Gly-Asn-His-Trp-Ala-Val Gly-His-Leu-Met-CONH2. Comparison of the 27-residue peptide with the known structure of porcine gastrin-releasing peptide, another bombesin-like heptacosapeptide, reveals four amino acid substitutions: canine bombesin-like peptide had Pro 4, Gly 5, Gln 7, Asp 12, whereas porcine gastrin-releasing peptide had Ser 4, Val 5, Gly 7, Ala 12. Radioimmunoassay of brain extracts after similar purification revealed the presence of similar large and small forms of immunoreactive bombesin peptides, but with apparent tissue concentrations of about 4% of those present in intestinal muscle. Canine bombesin-like peptides represent another example of mammalian neuropeptides existing in more than one biologically active molecular form. PMID- 6853533 TI - Cytochrome P-450scc-adrenodoxin complex. Reduction properties of the substrate associated cytochrome and relation of the reduction states of heme and iron sulfur centers to association of the proteins. PMID- 6853534 TI - Monoclonal antibodies selective for activated Factor V. Immunochemical probes for structural transitions occurring during the thrombin-catalyzed activation of the procofactor. AB - Monoclonal antibodies have been used to probe for structural transitions which potentially occur during the activation of bovine Factor V by thrombin. One of these antibodies (alpha 2D) is reactive with an epitope on the NH2-terminal segment of Factor V (i.e. the Mr = 94,000 component D), while a second antibody (alpha 2E) recognizes an epitope on the carboxyl-terminal segment of Factor V (the Mr = 74,000 component E). Neither antibody reacts with native unactivated Factor V. The alpha 2D-reactive epitope requires at least two proteolytic events for expression, and the alpha 2E-reactive epitope is expressed following the initial cleavage catalyzed by thrombin. In addition, the alpha 2E-reactive epitope is expressed upon the addition of chelators to Factor V. However, the alpha 2D epitope is not influenced by the removal of calcium ions. The interactions of these antibodies with Factor V and Factor V-derived peptides suggest that conformational changes occur in both the NH2-terminal and carboxyl terminal regions of Factor V concomitant with activation by thrombin, which give rise to the antibody recognition sites. PMID- 6853535 TI - Initial products of photophosphorylation with AMP and [32P]Pi. AB - The role of AMP in photophosphorylation was studied using rapid mixing acid quench techniques. Fragmented spinach chloroplast membranes or subchloroplast particles were illuminated and rapidly mixed with [32P]orthophosphate and AMP at pH 7 for 10 ms to 60 s after which time perchloric acid was added to quench the reaction. ATP was found to be the primary and predominant nucleotide labeled. It was found that after illumination, an adenylate kinase-like activity carried out an AMP-dependent conversion of labeled ATP to labeled ADP which was inhibited by the presence of ADP. This reaction was characterized as being similar to chloroplast adenylate kinase in Mg2+ dependency and in sensitivity to phlorizin and tentoxin and distinct from chloroplast coupling factor 1. The small amounts of adenylate kinase activity present in fragmented well washed chloroplast membranes were found to be sufficient to carry out this rapid reaction. These results necessitated a reinterpretation of the earlier findings of Tiefert and Moudrianakis (Tiefert, M.A., and Moudrianakis, E.N. (1979) J. Biol. Chem. 254, 9500-9508) and no longer support the role of ADP as a phosphorylated intermediate in ATP synthesis. PMID- 6853537 TI - Resonance Raman spectra of photodissociated carbonmonoxy hemoglobin and deoxy hemoglobin at 10 K. AB - Resonance Raman data from deoxy hemoglobin and photodissociated carbonmonoxy hemoglobin (Hb*) at low temperature (10 K) are reported. At this temperature with 457.9 nm excitation, the iron-histidine (Fe-His) stretching mode in deoxy hemoglobin disappears, although with 441.6 nm excitation it is detected at 235 cm 1. The intensity change is interpreted as resulting from changes in energy of iron d orbitals induced by the shortening of the Fe-His bond on temperature reduction. The previously reported narrowing of the Fe-His mode with temperature reduction has been found to be artifact. In Hb*, the Fe-His stretching mode is present with 457.9 nm as well as 441.6 nm excitation and is at higher frequency (242-244 cm-1) than it is in the deoxy samples. Several porphyrin skeletal frequencies are also shifted in Hb* with respect to deoxy hemoglobin. These data are interpreted as resulting from perturbations on the ligand-free histidine porphyrin complex by the liganded conformation of the heme pocket. We find no evidence that the dissociated CO molecule interacts with the heme in Hb*. PMID- 6853536 TI - Hydroxylation of the 7- and 8-methyl groups of riboflavin by the microsomal electron transfer system of rat liver. PMID- 6853538 TI - Metabolism of alpha-naphthoflavone and beta-naphthoflavone by rat liver microsomes and highly purified reconstituted cytochrome P-450 systems. PMID- 6853539 TI - Regulation of the glutathione S-transferase activity of bilirubin transport protein (ligandin) from human liver. Enzymic memory involving protein-protein interactions. PMID- 6853540 TI - Selective removal of alkaline phosphatase from renal brush-border membrane and sodium-dependent brush-border membrane transport. PMID- 6853541 TI - Polymer-protein interactions. Comparison of experiment and excluded volume theory. PMID- 6853542 TI - Probable helical conformation of poly(ADP-ribose). The effect of cations on spectral properties. PMID- 6853544 TI - Novel formation of S-methylacylthioester from oleoyl coenzyme A and S adenosylmethionine in the presence of FeSO4. PMID- 6853543 TI - T4 phage deoxyribonucleotide-synthesizing enzyme complex. Further studies on enzyme composition and regulation. PMID- 6853545 TI - Troponin subunit stoichiometry and content in rabbit skeletal muscle and myofibrils. AB - The quantity and molar ratio of the three troponin subunits to actin were determined in rabbit psoas muscle, muscle homogenates (800 X g pellet), and purified myofibrils. Proteins were separated by polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate. The quantities of the separated proteins were determined directly from the gel slices by amino acid analysis after correction for losses and background. The molar ratio of actin, troponin T, troponin I, and troponin C was found to be 6.99:1:05:1:04:0.92 in purified myofibrils and was not significantly different (p greater than 0.05) from those obtained from 800 X g pellets of muscle homogenates or intact muscle tissue. Isolated troponin purified by several different procedures also had a 1:1:1 subunit ratio although the variability was much greater than that found in myofibrils. The troponin content of rabbit psoas muscle and myofibrils was 91 +/- 16 and 770 +/- 110 pmol/mg, respectively. PMID- 6853546 TI - Fluorescence energy transfer studies on the proximity of the two essential thiols of myosin subfragment-1. PMID- 6853547 TI - The use of monoclonal antibodies to fragments of chicken type IV collagen in structural and localization studies. AB - In previous experiments, three pepsin-resistant fragments of type IV collagen were isolated from chicken gizzards and designated 7S, F3, and (F1)2F2 (Mayne, R., and Zettergren, J. G. (1980) Biochemistry 19, 4065-4072). In the present experiments, a series of monoclonal antibodies to type IV collagen were prepared, each one of which recognized an epitope present in only one of the three fragments. A high molecular weight fraction of type IV collagen (designated 7S + arms (215 nm)) was isolated after agarose gel filtration and characterized by electron microscopy after rotary shadowing and by gel electrophoresis. Analysis of 7S + arms (215 nm) by inhibition enzyme-linked immunosorbent assay demonstrated the presence of the epitopes for 7S and F3 but not for (F1)2F2. This result, therefore, provides additional evidence that the order of the pepsin resistant fragments of chicken type IV collagen is 7S-F3-(F1)2F2. PMID- 6853549 TI - Microheterogeneity and physical properties of human lecithin-cholesterol acyltransferase. PMID- 6853550 TI - The two molecular weight forms of rat phenylalanine hydroxylase are encoded by different messenger RNAs. AB - Immunoprecipitation of the phenylalanine hydroxylase formed by translation of rat liver RNA in a rabbit reticulocyte cell-free protein synthesis system was used to examine the origin of the molecular weight heterogeneity of the enzyme. Sodium dodecyl sulfate-polyacrylamide electrophoresis of the immunoprecipitated products showed that in most cases a single specifically immunoprecipitated polypeptide was produced which corresponded to the higher molecular weight (H) form of phenylalanine hydroxylase (Mr = 50,000). The identity of the product was confirmed by immunological competition and peptide mapping. RNA from other rats, however, coded for both the H-form and the lower molecular weight (L) form of phenylalanine hydroxylase or for only the L-form. The evidence suggests that the L-form derives from a different mRNA, rather than by proteolysis of the H-form, an interpretation which is supported by the isolation of the lower form of phenylalanine hydroxylase from livers of some rats. PMID- 6853548 TI - New initiation factor activity required for globin mRNA translation. AB - A reconstituted reticulocyte translation system originally designed to be deficient in eukaryotic initiation factor 4B (eIF-4B) was used to identify a new activity required for maximal synthesis of rabbit globin. This new activity purifies as a stable, high molecular weight complex by a variety of chromatographic procedures and is termed eIF-4F. The purified globin stimulatory activity also restores translation of capped mRNAs in extracts of poliovirus infected HeLa cells. Like restoring activity that was obtained as a protein complex by different procedures (Tahara, S. M., Morgan, M. A. and Shatkin, A. J. (1981) J. Biol. Chem. 256, 791-794), eIF-4F includes the 24,000-dalton cap binding protein and major polypeptides of Mr approximately 200,000 and approximately 46,000. The latter component comigrates with eIF-4A by two dimensional gel electrophoresis and, like eIF-4A, chemically cross-links to the 5'-end of capped mRNA by an ATP-dependent, m7GDP-sensitive reaction. Unlike eIF 4F, cap binding protein of Mr approximately 24,000 isolated by affinity chromatography on m7GDP-Sepharose does not stimulate globin synthesis in the reconstituted system. PMID- 6853551 TI - In vitro biosynthesis of three sulfated glycoproteins of murine zonae pellucidae by oocytes grown in follicle culture. AB - The zona pellucida is an extracellular glycocalyx that surrounds the growing oocyte and mediates specific biological functions essential to early mammalian development. We have isolated by a novel technique intact zonae pellucidae from a murine follicle culture system which mimics in vivo granulosa cell-oocyte interactions. Using radioactive precursors we have demonstrated that all three zona proteins, ZP-1, ZP-2, and ZP-3, are sulfated glycoproteins. Incubation of the follicle culture with tunicamycin (0.5 microgram/ml), an antibiotic that blocks N-glycosylation, inhibits new protein deposition in the zona. Under these same conditions overall protein synthesis is decreased only 30%. Biosynthetic studies indicate that after 6 days in culture the zona proteins are produced at 0.4 pg/oocyte/h, which represents 2-3% of the total oocyte protein synthesis. This synthesis stops at or before ovulation and the extremely long half-life (greater than 100 h) of the zona may be essential to preserve its known biological functions, all of which occur after ovulation. PMID- 6853552 TI - Preliminary x-ray analysis of single crystals of ovalbumin and plakalbumin. AB - Two crystal forms of hen ovalbumin have been grown and were characterized by x ray diffraction. Crystals of ovalbumin grown at pH 5.4 are monoclinic, belonging to the space group C2 (a = 116.5 A, b = 41.8 A, c = 70.5 A, beta = 101.5 degrees). At pH 5.8 or higher ovalbumin forms triclinic crystals of space group P1 (a = 62.0 A, b = 84.3 A, c = 72.2 A, alpha = 87.4 degrees, beta = 103.9 degrees, gamma = 108.7 degrees). These crystals are usually small and difficult to grow reproducibly. Crystals of plakalbumin (a proteolytic modification of ovalbumin) are much easier to grow and appear suitable for three-dimensional structure determination. Their space group is C2 (a = 99.9 A, b = 102.0 A, c = 79.3 A, beta = 112.1 degrees) with two plakalbumin molecules in each asymmetric unit. PMID- 6853553 TI - Crystallization and preliminary x-ray data for glucose-6-phosphate dehydrogenase from Leuconostoc mesenteroides. AB - The enzyme glucose-6-phosphate dehydrogenase from Leuconostoc mesenteroides has been crystallized from phosphate buffer in a form suitable for x-ray crystallographic studies. The crystals diffract to better than 2.4 A. The spacegroup is P3121 (P3221) a = 105.8 A, c = 225.1 A, V = 2.18 X 10(6) A3. The asymmetric unit probably contains a single dimer. PMID- 6853556 TI - Glycolipids of murine lymphocyte subpopulations. Structural characterization of thymus gangliosides. AB - Several sialic acid-containing glycolipids have been isolated and purified from murine thymus. Eleven of these acidic glycolipids (gangliosides) have been analyzed by several techniques, permitting us to propose a tentative structure for each. Sugar analysis reveals that all 11 gangliosides contain the same base structure, Gal(beta 1-3)GalNAc(beta 1-4)Gal(beta 1-4)Glc(beta 1-1) ceramide, which is gangliotetraosylceramide. No glucosamine or fucose is present in glycolipids from this tissue. There appears to be considerable heterogeneity in the sialic acid moiety of these gangliosides with respect to their structures and linkages. One ganglioside contains only N-glycolylneuraminic acid. Four of the gangliosides are common brain-type structures and contain sialic acid linked to internal galactose which is insusceptible to Vibrio cholerae neuraminidase. In addition, four of the gangliosides are susceptible to base hydrolysis and are believed to contain O-acetyl derivatives of sialic acid. Two gangliosides have also been shown to contain both N-acetyl- and N-glycolylneuraminic acid. There is also heterogeneity within the ceramide portion of some gangliosides which may be responsible for the appearance of an additional three ganglioside bands on thin layer chromatography. PMID- 6853554 TI - Procollagen IV. Association to tetramers. AB - Procollagen IV was isolated from culture media of the mouse endodermal cell line PF-HR9. Some of the triple helical procollagen IV molecules were associated at their NH2 ends to tetramers which were identified by electron microscopy, velocity sedimentation, and electrophoresis. The formation of these tetramers in cell cultures and from isolated procollagen IV molecules was investigated. After an initial noncovalent association, which is reversible, disulfide bonds form between molecules. Even alkylated molecules form disulfide-linked tetramers when exposed to a mixture of reduced and oxidized glutathione. This reaction requires an adequate concentration of procollagen and is not facilitated by added laminin, Ca2+, or Mg2+ ions. Cystine, as a normal constituent of cell culture media, interferes in tetramer assembly, presumably by forming mixed disulfides. Tetramers formed normally and under the influence of glutathione are similar, but probably not identical, and resemble those isolated from fragmented basement membranes. We conclude that the NH2 ends of procollagen IV molecules can associate into tetramers without the help of other molecules and that disulfide bridges subsequently stabilize the association in various ways. PMID- 6853557 TI - Binding and partial inactivation of Staphylococcus aureus alpha-toxin by human plasma low density lipoprotein. PMID- 6853559 TI - Lipid-protein interactions during ricin toxin insertion into membranes. Evidence for A and B chain penetration. PMID- 6853558 TI - Effects of phospholipase C on the Na+-Ca2+ exchange and Ca2+ permeability of cardiac sarcolemmal vesicles. AB - We have examined the effects of phospholipase C pretreatment on Ca2+ transport in highly purified canine cardiac sarcolemmal vesicles. Na+-Ca2+ exchange, measured as Nai+-dependent Ca2+ uptake, is stimulated when 10-70% of the membrane phospholipid has been hydrolyzed. Although the phospholipase C treatment also increases sarcolemmal passive Ca2+ flux, the membrane maintains a sufficient permeability barrier for enhanced transport (via Na+-Ca2+ exchange) to be observed. These effects can be obtained with phospholipase C from either Clostridium perfringens or Bacillus cereus. We find that the phospholipase C (C. perfringens) preferentially hydrolyzes phosphatidylcholine, phosphatidylethanolamine, and sphingomyelin leaving the negatively charged phospholipids, phosphatidylserine and phosphatidylinositol, intact. This suggests that the presence of negatively charged phospholipids is sufficient to ensure Na+ Ca2+ exchange activity. Thin section electron microscopy reveals gross morphological changes in phospholipase C-treated sarcolemma. The vesicles are aggregated and diacylglycerol droplets are visible. Fusion occurs such that adjacent vesicles share a common bilayer. It is surprising that vesicles displaying severe structural damage can demonstrate enhanced transport activity. PMID- 6853555 TI - Synthesis of related forms of the lysosomal enzyme alpha-mannosidase in Dictyostelium discoideum. AB - Purified lysosomal alpha-mannosidase from the cellular slime mold, Dictyostelium discoideum, is composed of two subunits of Mr = 58,000 and 60,000 as revealed by polyacrylamide gel electrophoresis under denaturing conditions. The pattern of peptide fragments produced when these two species are digested with proteases indicates that they are related but not identical. Using monoclonal antibodies prepared against purified alpha-mannosidase, we have analyzed the different forms of the enzyme synthesized in vivo. In addition to two bands that co-migrate with the pure enzyme, a large Mr (140,000) species is found in immunoprecipitated [35S] methionine-labeled extracts of cellular and secreted proteins. The precipitation of all three bands is inhibited by preadsorption of the antibodies with pure enzyme and all three proteins are absent in extracts of an alpha mannosidase structural gene mutant. One-dimensional peptide maps indicate that all sequences present in the smaller species are found in the Mr = 140,000 form. In addition, the large form accounts for about 20% of the extracellular alpha mannosidase activity secreted by amoebae during growth in axenic culture. These results lead to the conclusion that alpha-mannosidase is first synthesized as a large enzymatically active precursor which is modified and proteolytically cleaved to form the smaller subunits. PMID- 6853560 TI - Rat intestine secretes spherical high density lipoproteins. PMID- 6853561 TI - Affinity labeling of erythrocyte band 3 protein with pyridoxal 5-phosphate. Involvement of the 35,000-dalton fragment in anion transport. AB - Transport of pyridoxal 5-phosphate (PLP) into erythrocytes was inhibited by inhibitors of anion transport including stilbene disulfonate compounds, indicating that it is mediated by Band 3 protein. When erythrocytes were treated with PLP and large amounts of free lysine and NaBH4, two membrane-spanning fragments of Band 3 (Mr = 17,000 and 35,000) were specifically labeled. When the cells were pretreated with 4,4'-dinitrostilbene 2,2'-disulfonate, the labeling in the 35,000-dalton fragment was inhibited. Erythrocytes labeled by PLP in both the 17,000- and 35,000-dalton fragments transported PLP at a decreased rate, whereas the cells labeled in only the 17,000-dalton fragment had essentially the same transport activity as the control when 4,4'-dinitrostilbene 2,2'-disulfonate was removed. The extent of inhibition of transport of inorganic phosphate in the labeled cells was similar to that of PLP. The results indicate that the 35,000 dalton fragment participates in the anion transport of the cell membrane. PMID- 6853563 TI - Duplication of the thumb. A retrospective review of two hundred and thirty-seven cases. AB - Over a twenty-two-year period, 237 patients (261 hands) with duplication of the thumb were seen in the Hand Clinic of Osaka University Hospital. Two groups were identified: Group A, 141 patients without previous surgical treatment, and Group B, ninety-six patients with residual deformity despite previous surgical treatment. Using a modification of Wassel's classification, seven types of deformity were defined. In Group A these types were identified on the basis of the observed duplications of bone and soft tissue. In all but ten of the Group-B patients preoperative roentgenograms were not available and the type of deformity had to be deduced from the residual duplicated bone, the surgical scar, and the residual deformity. Surgery, performed on 193 hands (125 in Group A and sixty eight in Group B), attempted to restore normal anatomical relationships. The results could be evaluated in 130 hands according to the range of motion, joint stability, and alignment of the remaining thumb after an average follow-up of 35.0 months. According to the rating system described, the results were rated as good in 75.5 per cent, fair in 20.2 per cent, and poor in 4.3 per cent of the ninety-four hands in Group-A patients who were followed. In the thirty-six hands of Group-B patients who could be followed, the preoperative and postoperative scores were compared. Thirteen were not improved while the other twenty-three, sixteen improved from fair to good and seven improved from poor to fair, to give a good result in 63.9 per cent of the Group-B patients who were followed. The results in these 130 Group-A and B hands emphasize the importance of providing muscle balance and, in young patients, of performing an arthroplasty of the interphalangeal or metacarpophalangeal joint when indicated, although arthrodesis was indicated as a salvage operation for Group-B patients who were more than fifteen years old. PMID- 6853562 TI - Differences between receptors for 5-hydroxytryptamine on autonomic neurones revealed by nor-(-)-cocaine. AB - 1 The interaction between nor-(-)-cocaine and 5-hydroxytryptamine (5-HT) at autonomic neuronal 5-hydroxytryptamine (5-HT) receptors has been investigated on the rabbit heart and guinea-pig ileum. 2 The chronotropic response to 5-HT mediated through activation of receptors on the terminal sympathetic fibres of the rabbit heart was antagonized selectively and surmountably by nor-(-)-cocaine. Schild analysis yielded a pA2 value for the interaction of 7.79 +/- 0.11, n = 13. 3 On the guinea-pig ileum induced to contract by activation of 5-HT receptors on the intramural cholinergic nerves, nor-(-)-cocaine was also a selective and surmountable antagonist of 5-HT, although the concentrations needed were higher than those shown to be effective on the heart. The pA2 value for the interaction was 6.49 +/- 0.07, n = 16. 4 The differential blocking effect of nor-(-)-cocaine in the two tissues suggests that the receptors for 5-HT on the cholinergic nerves of the ileum and the sympathetic fibres of the heart are different. The data thus lend support to the earlier similar conclusion based on the observation that 5 methoxytryptamine is a potent agonist on the ileum yet inactive on the heart. PMID- 6853564 TI - Ambulation levels of bilateral lower-extremity amputees. Analysis of one hundred and three cases. AB - One hundred and three bilateral lower-extremity amputees were evaluated to determine their eventual ambulation level. Of thirty-eight bilateral above-the knee amputees, two with traumatic amputation were prosthetically rehabilitated, while none of the thirty-five with dysvascular amputation were so rehabilitated. Twenty-two of the dysvascular above-the-knee amputees were wheelchair ambulators and thirteen were bedridden. Prosthetic rehabilitation has been successful for traumatic bilateral above-the-knee amputees but has never been successful for our dysvascular bilateral above-the-knee amputees. The goal for dysvascular bilateral above-the-knee amputees is wheelchair ambulation. Of twenty-one patients with combinations of above-the-knee and below-the-knee amputations, five were prosthetically rehabilitated, including four dysvascular amputees; ten were wheelchair ambulators; and six were bedridden. Of forty-four patients with bilateral below-the-knee amputation, thirty-five were prosthetically rehabilitated and the remaining nine were wheelchair ambulators. Since the success rate for prosthetic rehabilitation is higher for amputees with combination above-the-knee and below-the-knee amputation than for those with bilateral above-the-knee amputation, and again increases for those with bilateral below-the-knee amputation, the significance of preserving the knee joint, even a single knee, cannot be overemphasized. PMID- 6853566 TI - Acute posterolateral rotatory instability of the knee. AB - We reviewed the clinical records and operative notes of seventeen consecutive patients who were treated by surgical repair for acute posterolateral rotatory instability in order to determine the diagnostic features of the instability and the effectiveness of our surgical repair in thirteen patients who returned for objective and subjective evaluation after a mean follow-up of 53.3 months. Sixteen of the seventeen knees had a positive external-rotation recurvatum test; fifteen, a positive adduction-stress test at 30 degrees of knee flexion; and twelve, a positive posterolateral-drawer test. Associated rotatory instabilities were found in ten of the seventeen knees, with anterolateral rotatory instability being the most frequent. Two patients had associated peroneal-nerve palsy. One or more components of the arcuate ligament complex were injured in all seventeen knees. None of the thirteen patients who were followed required subsequent reconstruction for any chronic instability. Of these thirteen, the results in 85 per cent were rated good subjectively and in 77 per cent, good objectively. Eighty-five per cent of these patients had returned to athletic activity at their preinjury level; the remaining 15 per cent did not participate in sports activities. A positive posterolateral-drawer test or external rotation recurvatum test, or both, was diagnostic of posterolateral rotatory instability. The adduction stress test at 30 degrees of knee flexion was usually positive, but was not diagnostic. Accurate diagnosis and treatment of posterolateral rotatory instability in the acute stage can result in subjectively and objectively acceptable knee function. PMID- 6853565 TI - Quantitative gait analysis after total knee arthroplasty for monarticular degenerative arthritis. AB - By quantitative gait analysis, we characterized the functional results of total knee arthroplasty in a group of twelve elderly patients with isolated degenerative arthritis of one knee. All patients had had a standard replacement arthroplasty performed at least two years before the study. In the gait analysis we used high-speed movie cameras synchronized with force platforms and electromyograms to provide kinetic and kinematic data. The data were compared with those obtained from an age-matched control group. In the patients most of the measurements of gait had been restored to normal levels. These measurements included: velocity; stride length; arcs of motion of the hip, knee, and ankle bilaterally; phasic muscle activity; and the amount of mechanical work performed. There were three patterns of external torque across the implants and in the control knee which were comparable in magnitude but varied in relative frequency between the two groups. As compared with the controls, the patients spent approximately 30 per cent more time in double-limb stance and had prolonged cycle times. These findings may have been the result of muscle weakness, neural impairment, or habit, but the cause could not be determined by this study. PMID- 6853567 TI - The total condylar knee prosthesis in gonarthrosis. A five to nine-year follow-up of the first one hundred consecutive replacements. AB - We studied the first 100 consecutive patients (125 knees) to undergo knee arthroplasty with the original total condylar-I prosthesis for either osteoarthritis or osteonecrosis on the Knee Service at The Hospital for Special Surgery. They were followed for an average of 6.6 years (range, five to nine years), which is the longest follow-up of a total knee prosthesis that is still widely used in its original and unmodified form. At five to nine years of follow up, eleven patients (fourteen knees) were dead and ten patients (eleven knees) could not be traced, leaving 100 knees (seventy-nine patients) for clinical evaluation. This included one knee from which the prosthesis was removed for sepsis at six months, four that were revised for pain, and two that were revised because of subluxation. Two patients had a loose tibial component. Sixty-four knees were rated as excellent and twenty-seven were rated as good. There were two fair and seven poor results. Detailed radiographic evaluation of the 100 knees showed that only minimum changes in the varus or valgus alignment or the fixation of the prosthetic components had occurred with time. At follow-up, 41 per cent of the tibial components showed some evidence of radiolucency, although with the exception of the two loose components just mentioned there were no complete or circumferential radiolucent lines. Most radiolucencies were present by the end of the first postoperative year, and in 81 per cent of the knees there was no further change. Although a special attempt was made to determine any evidence of wear of the polyethylene tibial component, we were unable to demonstrate unequivocal wear in any knee. Our experience had led us to conclude that the long term success of current total knee designs will probably not be significantly affected by polyethylene wear or loss of component fixation. The majority of failures in our series were attributed to errors in surgical technique. PMID- 6853568 TI - Irrigating solutions for arthroscopy. A metabolic study. AB - In an effort to determine the optimum solution for irrigation during arthroscopic procedures, an in vitro metabolic experiment was performed in which cartilage slices were incubated with 35SO4 in various commercially available solutions, harvested at regular intervals, and assayed for incorporated radioactivity. The solutions were compared with Ham F12 medium, a complex, ionically balanced salt and amino-acid solution that is used for tissue culture. The data show that neither normal saline or phosphate-buffered saline supports metabolic activity as well as Ringer lactate or acetate, both of which approximate the values for the control, Ham F12 solution. CLINICAL RELEVANCE: Arthroscopy and arthroscopic surgical procedures have become commonplace in orthopaedic practice. Normal saline solution, commonly used in large quantities as an irrigating solution, is in fact not physiological, and we showed that it inhibits normal synthesis of proteoglycan by the chondrocytes. Ringer lactate seemed to support cartilage metabolism as well as an "ideal" tissue-culture medium (Ham F12 solution). Since Ringer solution and normal saline cost the same in our hospital, we strongly recommend that this more physiological solution be used for arthroscopic procedures. PMID- 6853570 TI - Osteoid-osteoma of the foot. PMID- 6853569 TI - Sensibility testing in peripheral-nerve compression syndromes. An experimental study in humans. AB - Sensibility testing in peripheral-nerve compression syndromes was investigated in an experimental study in humans. Twelve volunteer subjects had controlled external compression of the median nerve at the carpal tunnel at a level of forty, fifty, sixty, and seventy millimeters of mercury. The subjects were then monitored for thirty to 240 minutes with four sensory tests: two-point discrimination, moving two-point discrimination, Semmes-Weinstein pressure monofilaments, and vibration. Sensory and motor conduction, subjective sensations, and motor strength were also continuously tested. The threshold tests (vibration and Semmes-Weinstein monofilaments testing) consistently reflected gradual decreases in nerve function in both subjective sensation and electrical testing, while the innervation density tests (two-point discrimination and moving two-point discrimination) remained normal until nearly all sensory conduction had ceased. Decreased muscle strength occurred late, and not until changes had already occurred in each of the sensory tests. Threshold tests of sensibility correlated accurately with symptoms of nerve compression and electrodiagnostic studies, and are being evaluated for clinical use in a variety of peripheral nerve compression syndromes. PMID- 6853572 TI - Medial knee instability complicating the Pavlik-harness treatment of congenital hip subluxation. Case report. PMID- 6853571 TI - Reduction of skeletal muscle necrosis using intermittent hyperbaric oxygen in a model compartment syndrome. PMID- 6853574 TI - Unilateral atlanto-occipital dislocation complicating an anomaly of the atlas. A case report. PMID- 6853573 TI - Salvage of an infected total knee prosthesis with medial and lateral gastrocnemius muscle flaps. A case report. PMID- 6853576 TI - Acute displaced femoral-shaft fractures in long-distance runners. Two case reports. PMID- 6853577 TI - A giant-cell tumor in the hand presenting as an expansile diaphyseal lesion. Case report. PMID- 6853575 TI - Occult fracture of the glenoid without dislocation. A case report. PMID- 6853578 TI - Popliteal pseudoaneurysm. A case report. PMID- 6853579 TI - Disengagement and intrapelvic protrusion of the screw from a sliding screw-plate device. A case report. PMID- 6853580 TI - Scoliosis secondary to an osteoid-osteoma of the rib. A case report. PMID- 6853581 TI - Osteotomy of the tibial tubercle in total knee replacement. A technical note. PMID- 6853582 TI - Spinal cord monitoring. PMID- 6853583 TI - Late results after total hip replacement. PMID- 6853584 TI - Influence of vasoactive drugs on the intratumor distribution of blood flow and vascular volume in a transplantable rat fibrosarcoma. AB - The intratumor distribution of plasma volume and of blood flow was studied simultaneously by radioisotope techniques in a transplantable rat fibrosarcoma. Intravenous administration of norepinephrine changed the distribution of both plasma volume and blood flow to produce low values in tumor and in normal muscle. Intravenous administration of papaverine was surprisingly followed by similar effects, probably due to a direct influence of papaverine on cardiac function. Intraaortal administration of papaverine into the studied tissue area did not influence tumor blood flow or plasma volume but increased normal muscle plasma volume. The results might support a previously suggested possibility that one can directly influence the tumor vascular bed with vasoconstricting drugs, while tumor vessels are more resistant to pharmacologic dilatation probably because of their normal state of close to maximal dilatation. PMID- 6853586 TI - Carcinoembryonic antigen (CEA) in human colorectal cancers growing subcutaneously in nude mice. AB - Eleven human colorectal xenografts from 26 tumor lines established in nude mice in our laboratory were investigated for carcinoembryonic antigen (CEA) production. Serum levels of CEA in nude mice were markedly elevated in all cases but one, median values ranging from 3.7 to 42.8 ng/ml. Carcinoembryonic-antigen levels for ten nontumor-bearing nude mice ranged from 0.00 to 0.12 ng/ml (median value 0.07). A clear linear correlation could be demonstrated between log CEA serum levels and log tumor volumes in serial measurements. In one case, CEA was normal in the cancer patient's serum and gave the lowest value (3.7 ng/ml) in nude mice bearing the xenograft. By the indirect peroxidase technique, CEA was localized mainly on the apical cell membranes of the cancerous glands and in necrotic areas; only small amounts were detectable in the cytoplasm. Transplantation of human colorectal carcinomas into nude mice offers an excellent experimental in vivo system to study the mechanism of release, metabolism, and excretion of the marker. PMID- 6853585 TI - Simultaneous occurrence of receptors for estradiol, progesterone, and dihydrotestosterone in canine mammary tumors. AB - Fifty-nine canine mammary tumors have been simultaneously assayed for their histological nature and their content of cytosolic receptors for estradiol (ER), progesterone (PGR), and dihydrotestosterone (DHTR). The tumors were histologically defined as benign tumors, malignant mixed tumors, sarcomas, and simple or complex carcinomas. The tumors exhibited a high incidence of steroid receptors (ER in 61% of the tumors, PGR in 69%, DHTR in 36%). It could be demonstrated that, in cytosols of canine mammary tumors, binding sites for different steroids may simultaneously occur. Twenty four percent of the tumors were able to bind specifically all three hormones tested. No tumor class displayed a specific receptor profile in regard to the receptor incidence, KD, and binding capacity. Also no correlation could be detected between histological grading of carcinomas and receptor incidence. In these tumors, however, the amount of ER and PGR binding showed changes dependent on differentiation. Noteworthy tumors simultaneously removed from the same bitch and with identical histological diagnosis were different in their receptor characteristics. PMID- 6853587 TI - Perinatal carcinogenicity of isoniazid (INH) in Swiss mice. AB - Tumorigenicity of isoniazid (INH) and hydrazine sulfate (HS) was studied in male and virgin Swiss mice. The INH and HS induced 50% und 84% lung tumors in males and 67% and 72% in females, respectively. Both chemicals induced lung tumors in animals of the F1 generation that were exposed to INH or HS during intrauterine life, lactation, and in the postweaning period. Surprisingly, the F2 generation from these F1 animals, which were exposed to INH only during gestation and lactation, showed earlier and much higher tumor incidence than the parent generation. PMID- 6853588 TI - Studies on the tumor-inhibiting efficacy of Iscador in experimental animal tumors. AB - The effect of Iscador was tested in a total of four tumor models involving some 214 rats and 93 mice. Although several doses of the agent were used, no significant antitumor effect was observed. PMID- 6853589 TI - Studies on the so-called "synchronization therapy" of tumors with vincristine. AB - Cell kinetic studies on the effect of vincristine (VCR) on cells in different cell-cycle phases were carried out using single- and double-labeling methods with 3H- and 14C-thymidine. Studies on mouse L 1210 and JB-1 ascites tumor cells, mouse jejunal crypt cells as well as on HeLa cells have shown that VCR affects cells not only during or prior to mitosis, but also cells that are in S phase at the time of VCR application. These cells are arrested during the next mitosis. Cells arrested in mitosis even with small doses of VCR subsequently become necrotic. Thus, it has been shown experimentally that an in vivo synchronization of tumor cells cannot be achieved with VCR and, therefore, the effect of a so called synchronization therapy with VCR is not due to synchronization of tumor cells. PMID- 6853590 TI - Identification of three indolic compounds in a pigmented-melanoma cell-culture supernatant by gas chromatography-mass spectrometry. AB - In the supernatant of melanoma cell culture SK mel 25 three indolic compounds - 5 hydroxy-6-methoxyindole, 5-hydroxy-6-methoxyindolyl-2-carboxylic, and 6-hydroxy-5 methoxyindolyl-2-carboxylic acids - have been identified. The supernatants were extracted with ethyl acetate, derivatized, and analyzed by gas chromatography mass spectrometry. The significance of this finding is discussed. PMID- 6853591 TI - Microfluorimetric and X-ray microanalytic studies on the DNA content and Na+:K+ ratios of the cell nuclei in various types of thyroid tumors. AB - Parallel studies were performed using microfluorimetric DNA determination and X ray microanalysis on the same thyroid biopsy material to compare the intranuclear DNA and monovalent electrolyte contents (Na+, K+, Cl-). Samples were taken from apparently healthy, adenomatous, and cancerous parts of human thyroid glands removed surgically. The time interval was less than 1 min. The tissues were classified by the pathologist into four main classes: 1) Normal thyroid tissue; 2) benign adenomas; 3) differentiated (follicular and papillary) carcinomas; and 4) anaplastic cancers. The results revealed that the level of aneuploidization showed an increase parallel with the malignancy of the studied tumor. At the same time, a similar tendency was found in the average values of the intranuclear Na+:K+ ratios. The results obtained in this way confirm the possibility that the electric properties of the cell membrane, that is the sustained membrane depolarization, may have a role in the regulation of DNA synthesis and in mitogenesis. These results may offer new diagnostic and/or therapeutic possibilities. PMID- 6853592 TI - On the ultrastructure of the gastric "borderline lesion". AB - The "borderline lesion" of the stomach (severe dysplasia of the protruded type) is nowadays considered to be a true precancerous lesion. Histologically, this lesion is characterized by a proliferation in the area of the glandular neck, combined with severe cellular atypia. Investigation by means of transmission electron microscopy reveals the structure of these cells to be very similar to the structure of cells of an intestinal-cell-type carcinoma of the stomach. In addition to signs for a loss of differentiation of the cells, such as the absence of rough-surfaced endoplasmatic reticulum, mucin granules, and of the polarity of the cells, remarkably frequently luminal bulges and "blebs" developed to various extents can be detected. Morphometric analysis is delineating the tendency of structural features of the borderline lesion to develop toward the gastric cancer cell. These irregularities might be expressions of the beginning of expansive growth and signs pointing to differentiation into malignant neoplasia. PMID- 6853594 TI - Experimental evidence for a hyperthermia-induced breakdown of tumor blood flow during normoglycemia. PMID- 6853593 TI - Population based pathology statistics of oesophageal carcinoma. AB - The frequency of oesophageal carcinoma among autopsies performed in the Institute of Pathology in Heidelberg between 1900 and 1979 is estimated and compared with the findings of the patho-anatomically based Regional Cancer Registry of North Baden. The autopsy data suggest that there is no increase in the percentage of oesophageal carcinoma in the area of Heidelberg during the period considered. The average age of oesophageal carcinoma patients at death remained nearly unchanged during the study period, while the average age of death for all autopsies showed a steep increase. In a retrospective study of the registry data, oesophageal carcinoma patients showed a higher percentage of alcohol consumers and heavy smokers over patients with stomach, colon, and rectal cancer. The retrospective study of clinical findings further revealed liver cirrhosis in 8%. This was not documented in patients with other gastro-intestinal carcinomas. The results obtained suggest that patho-anatomical data may be useful for checking the applicability of results obtained elsewhere. PMID- 6853595 TI - Regulation of rat myosin light-chain synthesis in heterokaryons between 5 bromodeoxyuridine-blocked rat myoblasts and differentiated chick myocytes. AB - Terminal cell differentiation in a variety of model systems is inhibited by the thymidine analogue 5-bromodeoxyuridine (BUdR). We investigated the mode of action of BUdR by forming heterokaryons between undifferentiated BUdR-blocked rat myoblasts and differentiated chick skeletal myocytes. We analyzed newly synthesized proteins on two-dimensional polyacrylamide gels. The induction of rat skeletal myosin light-chain synthesis was reduced fivefold, as compared with controls, when chick myocytes were fused to BUdR-blocked rat myoblasts. This indicates that plasma membrane effects cannot be the proximate cause for the inhibition of myogenesis by BUdR, since BUdR is able to block the effect of chick inducing factors even when a differentiated chick myocyte is in direct cytoplasmic continuity with the BUdR-blocked rat nucleus. The observation that chick cells required an 80% substitution of BUdR for thymidine to block myogenesis, whereas L6 rat myoblasts required only a 20% substitution led to a hypothesis involving a DNA-mediated action of BUdR. This model yielded three testable predictions: (a) putative chick inducing molecules should be present in limiting quantities, (b) exploiting gene-dosage effects to increase the quantity of putative chick inducing factors might overcome the inhibition produced in the rat myoblasts by a 35% BUdR for thymidine substitution, and (c) these gene-dosage effects should be abolished by increasing the level of BUdR substitution in the rat myoblast to 60-80%. All three of these predictions have been verified, providing strong indirect evidence that the inhibition of myogenesis produced by BUdR is a direct result of its incorporation into cellular DNA. PMID- 6853596 TI - Pinocytosis and intracellular degradation of exogenous protein: modulation by amino acids. AB - Intracellular degradation of exogenous (serum) proteins provides a source of amino acids for cellular protein synthesis. Pinocytosis serves as the mechanism for delivering exogenous protein to the lysosomes, the major site of intracellular degradation of exogenous protein. To determine whether the availability of extracellular free amino acids altered pinocytic function, we incubated monolayers of pulmonary alveolar macrophages with the fluid-phase marker, [14C]sucrose, and we dissected the pinocytic process by kinetic analysis. Additionally, intracellular degradation of endogenous and exogenous protein was monitored by measuring phenylalanine released from the cell monolayers in the presence of cycloheximide. Results revealed that in response to a subphysiological level of essential amino acids or to amino acid deprivation, (a) the rate of fluid-phase pinocytosis increased in such a manner as to preferentially increase both delivery to and size of an intracellular compartment believed to be the lysosomes, (b) the degradation of exogenously supplied albumin increased, and (c) the fraction of phenylalanine derived from degradation of exogenous albumin and reutilized for de novo protein synthesis increased. Thus, modulation of the pinosome-lysosome pathway may represent a homeostatic mechanism sensitive to the availability of extracellular free amino acids. PMID- 6853597 TI - Epithelial-mesenchymal interactions in prostatic development. I. morphological observations of prostatic induction by urogenital sinus mesenchyme in epithelium of the adult rodent urinary bladder. AB - Tissue recombinants of embryonic urogenital sinus mesenchyme (UGM) and epithelium of the urinary bladder (urothelium, BLE) of adult rats and mice were grown for 3 30 d in male syngeneic hosts. Short-term in vivo growth indicated that prostatic morphogenesis is initiated as focal outgrowths from the basal aspect of the adult urothelium. The solid epithelial buds elongate, branch, and subsequently canalize, forming prostatic acini. After 30 d of growth in the male hosts, prostatic acini exhibit secretory activity. The marked changes in urothelial morphology induced by the UGM are accompanied by the expression of fine structural features indicative of secretory function (rough endoplasmic reticulum, Golgi apparatus, and secretory granules). During this process, urothelial cells express prostatic histochemical markers (alkaline phosphatase, nonspecific esterase, glycosaminoglycans) and prostate-specific antigens. The expression within BLE of prostatic characteristics is associated with the loss of urothelial characteristics. These data indicate that adult urothelial cells retain a responsiveness to embryonic mesenchymal inductors. Furthermore, mesenchyme-induced changes in urothelial cytodifferentiation appear to be coupled to changes in functional activity. PMID- 6853598 TI - Epithelial-mesenchymal interactions in prostatic development. II. Biochemical observations of prostatic induction by urogenital sinus mesenchyme in epithelium of the adult rodent urinary bladder. AB - Adult bladder epithelium (BLE) is induced to differentiate into glandular epithelium after association with urogenital sinus mesenchyme (UGM) and subsequent in vivo growth in syngeneic male hosts. Alteration of epithelial cytodifferentiation is associated with the expression of prostate-specific antigens, histochemical and steroid metabolic activities. These observations suggest that the inductive influence of the UGM has reprogrammed both the morphological and functional characteristics of the urothelium. In this report, differences regarding the mechanisms and effects of androgenic stimulation of prostate and bladder are exploited to determine the extent to which UGM plus BLE recombinants express a prostatelike, androgen-dependent phenotype. Results from cytosolic and autoradiographic binding studies suggest that androgen binding is induced in UGM plus BLE recombinants and that this activity is accounted for by the induced urothelial cells. In UGM plus BLE recombinants, androgen-induced [3H]thymidine or [35S]-methionine uptake analyzed by two-dimensional gel electrophoresis was qualitatively and quantitatively similar to that of prostate as opposed to bladder. These studies indicate that expression within BLE of prostatic phenotype is associated with a loss of urothelial characteristics and that androgen sensitivity is presumably a function of the inductive activities of the stroma. PMID- 6853599 TI - Visualization of the binding, endocytosis, and transcytosis of low-density lipoprotein in the arterial endothelium in situ. AB - We investigated the interaction and transport of low-density lipoprotein (LDL) through the arterial endothelium in rat aorta and coronary artery, by perfusing in situ native, untagged human, and rat LDL. The latter was rendered electron opaque after it interacted with the endothelial cell and was subsequently fixed within tissue. We achieved LDL electron-opacity by an improved fixation procedure using 3,3'-diaminobenzidine, and mordanting with tannic acid. The unequivocal identification of LDL was implemented by reacting immunocytochemically the perfused LDL with anti LDL-horseradish peroxidase conjugate. Results indicate that LDL is taken up and internalized through two parallel compartmented routes. (a) A relatively small amount of LDL is taken up by endocytosis via: (i) a receptor-mediated process (adsorptive endocytosis) that involved coated pits/vesicles, and endosomes, and, probably, (ii) a receptor-independent process (fluid endocytosis) carried out by a fraction of plasmalemmal vesicles. Both mechanisms bringing LDL to lysosomes supply cholesterol to the endothelial cell itself. (b) Most circulating LDL is transported across the endothelial cell by transcytosis via plasmalemmal vesicles which deliver LDL to the other cells of the vessel wall. Endocytosis is not enhanced by increasing LDL concentration, but the receptor-mediated internalization decreases at low temperature. Transcytosis is less modified by low temperature but is remarkably augmented at high concentration of LDL. While the endocytosis of homologous (rat) LDL is markedly more pronounced than that of heterologous (human) LDL, both types of LDL are similarly transported by transcytosis. These results indicate that the arterial endothelium possesses a dual mechanism for handling circulating LDL: by a high affinity process, endocytosis secures the endothelial cells' need for cholesterol; by a low-affinity nonsaturable uptake process, transcytosis supplies cholesterol to the other cells of the vascular wall, and can monitor an excessive accumulation of plasma LDL. Since in most of our experiments we used LDL concentrations above those found in normal rats, we presume that at low LDL concentrations saturable high-affinity uptake would be enhanced in relation to nonsaturable pathways. PMID- 6853600 TI - Abnormal basal-body number, location, and orientation in a striated fiber defective mutant of Chlamydomonas reinhardtii. AB - We describe a mutant of Chlamydomonas reinhardtii in which basal body associated striated fibers are absent or incomplete. Basal body spacing, angle, and relative rotational orientation are abnormal and extremely variable. Abnormal partitioning of cellular contents at cytokinesis is also evident. Mating, maintenance of flagellar length equality, and backward swimming response are normal. Genetic analysis indicates mutation of a new Mendelian gene--vfl-3--linked to the centromere of Chromosome VI. PMID- 6853601 TI - Analysis of the directed and nondirected movement of human granulocytes: influence of temperature and ECHO 9 virus on N-formylmethionylleucylphenylalanine induced chemokinesis and chemotaxis. AB - The directed movement of human polymorphonuclear leukocytes (PMN) in a plane (Zigmond chamber assay) is described by a statistical model. We demonstrate that (a) the movement of a single cell is a superposition of a directed and a random movement, and (b) the degree of orientation, P1, of moving cells in a chemotactic gradient can be determined either by the time average of a single cell or by the average of movement of multiple cells at a fixed time (Ergoden hypothesis). However, an homogeneous cell population is a necessary condition. P1, which is identical with the McCutcheon index, is derived from the measured angular distribution function of moving cells. The statistical model allows one to distinguish between chemotaxis and chemokinesis. Applying this model to the temperature-dependent changes of cell movement, we found that P1 = 0.82 (37 degrees C) decreased to P1 = 0.4 (22 degrees C). The average speed of moving cells exhibits a very strong temperature-dependent variation from 30 microns/min (37 degrees C) to 5 microns/min (22 degrees C), indicating a different temperature dependence of chemotaxis and chemokinesis. At a fixed temperature (37 degrees C) the stability of the chemotactic gradient can also be checked by the angular distribution function. In addition, this model was applied to investigate the enteric cytopathogenic human orphan, strain 9 (ECHO 9) virus-induced disturbances of cell movement. We found: (a) The average speed of cell movement is not affected by the virus. (b) The degree of orientation is not affected for virus doses below a critical virus dose, ao (virus/PMN = 0.8:1). (c) The degree of orientation above this critical value exhibits a time- and virus-dose dependence. (d) At a fixed viral dose, the time-dependent decrease of P1 is described by an exponential law (virus/PMN = 5:1, the characteristic time is 110 min). (e) This characteristic time investigated as a function of viral dose results in a logarithmic law analogous with the Weber-Fechner law. These findings indicate that only chemotactic and not chemokinetic response is disturbed by ECHO 9 virus. PMID- 6853603 TI - Regionalization and lateral diffusion of membrane proteins in unfertilized and fertilized mouse eggs. AB - The unfertilized mouse egg has a round and highly villated main body and a "nipple" that is unvillated and buds off on fertilization to form the second polar body. Fluorescent markers stain the body more intensely than the nipple, which has been assumed to result from surface amplification due to microvilli. Using fluorescence recovery after photobleaching and microfluorescence photometry, we have measured the membrane protein diffusion and concentration on the main body and nipple region of unfertilized and on fertilized CD-1 mouse eggs. Two general membrane protein labels were used: rhodamine-labeled succinylated concanavalin A and trinitrobenzene sulfonate visualized with a rhodamine Fab fragment of a sheep anti-trinitrophenyl. We found that while the diffusion coefficient was the same on the nipple and main body, considerably higher recovery was observed on the nipple for both probes. The ratio of intensity of fluorescence on the nipple to main body was significantly lower for the concanavalin A stain than for the trinitrophenyl stain, indicating that true concentration gradients exist beyond those that result from surface amplification. The effect of fertilization was not general. No effect was observed for the concanavalin A stain for either diffusion coefficient or percent recovery. For the trinitrophenyl stain, percent recovery decreased approximately twofold while diffusion coefficient increased approximately threefold. PMID- 6853602 TI - Distribution and turnover rate of acetylcholine receptors throughout the junction folds at a vertebrate neuromuscular junction. AB - The distribution and turnover rate of acetylcholine receptors labeled with 125I alpha-bungarotoxin were examined in innervated mouse sternomastoid muscle by electron microscope autoradiography using the "mask" analysis procedure. We compared the total population of receptors with receptors newly inserted at the junction 2 d after inactivation with nonradioactive alpha-bungarotoxin, both at the top (thickened) region of the postjunctional folds (pjm) and the nonthickened bottom folds. We found that the receptor site density was approximately 10 times greater on the thickened pjm than on the nonthickened bottom folds for both total and newly inserted receptors. This ratio does not change significantly during a 6 d period after labeling the new receptors. Furthermore, calculated values for turnover time of receptors show that both total and newly inserted receptors at both regions of the junctional folds have half-lives for degradation within the range given in the literature for slow junctional receptors. These data exclude a simple migration model whereby receptors are preferentially inserted in the nonthickened region of the junctional folds and then migrate into the thickened membrane at a rate equal to the turnover rate of the receptors. PMID- 6853604 TI - Localization of GTP-stimulated core glycosylation to fused microsomes. AB - Purified rough microsomes from liver maximally incorporated N-acetyl [3H]glucosamine into endogenous acceptors from UDP-N-acetyl-[3H]glucosamine substrate, providing the associated ribosomes were removed and 0.5 mM GTP was added. These conditions also led to the coalescence of microsomes into large fused membranes. By measurement of membrane profiles on electron micrographs, a correlation was observed between GTP-stimulated glycosylation and microsomal membrane length (r2 = 0.92). Membrane fusion was not observed in the absence of GTP, with sugar transfer inhibited by greater than 90% for acid-resistant acceptors (protein), and approximately 50% for acid-labile acceptors (lipid linked intermediates). When radiolabeled acceptors were localized by electron microscope radioautography, high concentrations of silver grains (83 grains/100 microns membrane length) were observed over fused membranes with lower grain densities observed over unfused membranes in the same preparation (20 grains/100 microns). These studies directly link microsomal membrane fusion to GTP stimulated core glycosylation. The observations extend the suggestion of Godelaine et al. (1979, Eur. J. Biochem. 96:17-26) that physiological levels of GTP promote the translocation of substrate across endoplasmic reticulum membranes which, we propose, occurs via a membrane fusion phenomenon. PMID- 6853607 TI - Synergistic killing of HeLa cells by hydroxyurea and caffeine. AB - Synchronous populations of HeLa S3 cells suffer synergistic killing during S phase in the presence of 0.5-5 mM hydroxyurea together with 5-10 mM caffeine. Both the rate and the extent of killing are greater than expected for independent action of the two drugs. Only simultaneous treatment is effective. The dependence of the synergistic killing on cell age resembles the age dependence for killing by hydroxyurea alone (greater than 3 mM), but not that by high concentrations of caffeine. In addition, rapid killing occurs if caffeine is added to cultures that have been incubated in the presence of hydroxyurea from early G1 and are blocked at the beginning of S, although such cells are killed only slowly on continued incubation in greater than or equal to 10 mM hydroxyurea alone. Furthermore, cells that are incubated with the two drugs from early G1 begin to undergo synergistic killing at about 12 h after mitotic collection, but they do not commence DNA replication for another 2-3 h if the drugs are removed. It is concluded that cells that have reached a point in the cycle identical with or close to the end of G1 are sensitive to the combination whether or not they are able to synthesize DNA, and whether or not they are sensitive to hydroxyurea alone. A tentative model is proposed: hydroxyurea is postulated to kill cells by interacting with sites of replication in DNA, and the synergism is attributed to the extra replication points that caffeine is known to induce. PMID- 6853606 TI - A voltage-clamp study of the effects of colchicine on the squid giant axon. AB - The effects of colchicine applied inside a squid giant axon were studied using voltage-clamp and internal perfusion techniques. It was found that colchicine selectively and reversibly suppresses the sodium conductance during excitation. The possible involvement of the microtubular structure in the functioning of the excitable channel is discussed. PMID- 6853605 TI - Serum-free culture of PC13 murine embryonal carcinoma cells. AB - The requirements for the serum-free culture of PC13 murine embryonal carcinoma cells were determined. Supplementation of a 50:50 mixture of Dulbecco's modified Eagles medium and MCDB104 with transferrin (5 micrograms/ml), human high-density lipoprotein (HDL) (100 micrograms/ml), and human low-density lipoprotein (LDL) (50 micrograms/ml) supported growth comparable to that observed with 5% foetal calf serum. Media supplementation with lipoproteins apparently substitutes for the effects of insulin, desoctapeptide insulin, (DOP), or multiplication stimulating activity (MSA) on EC cell multiplication. Clonal growth of PC13 EC cells in this serum-free medium could only be achieved in the presence of suitable feeder cell monolayers. These observations demonstrate that PC13 EC cells do not have an absolute requirement for exogenous mitogens to support multiplication. PMID- 6853608 TI - Comparative energy metabolism in cultured heart muscle and HeLa cells. AB - The yields of energy from oxidation of fatty acids, glucose, and glutamine were compared in cultures of chick embryo heart muscle (heart) and HeLa cells. Aerobic energy production, as measured by oxygen utilization, was comparable in the two cell types. In media containing dialyzed sera, the rates of incorporation of fatty acids directly into lipids were similar in both cells and accounted for greater than 97% of fatty acid metabolism in HeLa cells. However, in heart cells only 45% ended in lipid, 42% in protein, and 13% was released as CO2; the latter two products probably reflect the oxidation of fatty acids to acetyl-coenzyme A ( CoA) and its subsequent metabolism in the citrate cycle. Increased serum concentration in the medium did not affect fatty acid metabolism in HeLa cultures, but resulted in greater oxidation by heart cells (greater than 100 times that by HeLa cells). The metabolisms of both glucose and glutamine were similar in heart and HeLa cells with greater than or equal to 60% of glucose carbon ending as medium lactate and only 3-5% converted to acetyl-CoA. About 25% of glutamine carbon ended as CO2 and increased utilizations with increasing serum concentrations was accountable in both cells by increased lactate from glucose and glutamate from glutamine. CO2 production (and energy) from glutamine was independent of glutamine concentration within a tenfold range of physiological concentrations. The yields of energy have been calculated. In 10% dialyzed calf serum, oxidation of glutamine carbon provided about half of the total energy in heart cells; glucose about 35-45%, with most coming from glycolysis; oxidation of fatty acid carbon provided only 5-10%. That greater than 90% of the aerobic energy comes from glutamine in both cells can account for the comparable rates of oxygen utilization. HeLa cells derived little or no energy from fatty acids. PMID- 6853609 TI - Degradation of microinjected proteins: effects of lysosomotropic agents and inhibitors of autophagy. AB - HeLa cells, injected with radioiodinated proteins by fusion with RBC ghosts, were exposed to inhibitors of lysosomal proteolysis and autophagy. The degradation of injected [125I]bovine serum albumin (BSA) was unaffected by chloroquine, NH4Cl, nocodazole, colcemid, puromycin, cycloheximide, or enucleation. Although degradation of [125I]lactate dehydrogenase (LDH) and [125I]pyruvate kinase (PK) was inhibited one-third by chloroquine or ammonia, their degradation was unaffected by the other compounds. In contrast, enhanced degradation of 125I-PK resulting from depriving injected HeLa cells of amino acids and serum was inhibited 70% by colcemid and abolished by chloroquine or ammonia. Similarly, degradation of [14C]sucrose-labeled BSA-polylysine conjugates that entered HeLa cells by endocytosis was inhibited as much as 80% by chloroquine and ammonia. Sensitivity of both enhanced proteolysis and degradation of exogenous proteins to ammonia or chloroquine indicates they are effective inhibitors of lysosomal proteolysis in HeLa cells. Failure of ammonia or chloroquine to inhibit degradation of injected 125I-BSA and the modest inhibition of degradation of injected 125I-LDH or 125I-PK indicates that virtually all BSA molecules and most PK or LDH molecules are degraded by a nonlysosomal proteolytic system. Components of this degradative system are present in vast excess or are long lived, since inhibition of protein synthesis for 20 hr had no effect on the degradation of injected proteins. PMID- 6853610 TI - Recovery of HeLa cell population growth after treatment with 5,6-dichloro-1-beta D-ribofuranosylbenzimidazole (DRB). AB - Dose-response curves for the inhibition of heterogeneous nuclear RNA (hnRNA) synthesis in HeLa cells by 5,6-dichloro-1-beta-D-ribofuranosylbenzimidazole (DRB; 5-100 microM; 30 min) are biphasic and indicate the existence of two subpopulations of hnRNA molecules, one highly sensitive and the other completely resistant, as previously reported for molecules greater than 1,000 nucleotides long (Tamm et al., 1976; Sehgal et al., 1976a). In the short-term experiments, the drug-sensitive synthesis of hnRNA was inhibited 50% at a DRB concentration of approximately 7 microM, and 70% at 20 microM, whereas drug-resistant synthesis, which comprises approximately 20% of total, continued at DRB concentrations as high as 100 microM. After 24 hr of DRB treatment in medium containing 5% fetal calf serum, the increase in cell number in the exponentially growing population was inhibited by only 42% at 20 microM DRB, and the formation of colonies of greater than or equal to ten cells was not decreased. DRB at 40 microM concentration decreased population growth by 76% and colony formation by 63%. Treatment with 60 microM DRB was sufficient to prevent a net increase in cell number and to reduce colony formation by 78%. After termination of treatment, the time required for the surviving population to begin rapid proliferation was directly related to the concentration of DRB used to treat cells and to the duration of treatment. After 24-hr treatment with 40 microM DRB, cultures recovered within 1 day, whereas after 60 microM DRB, 3-4 days were required. After 40-hr treatment with 60 microM DRB, 5-6 days were required for recovery, and after 80 microM DRB, 9-11 days. During the "dormant" period the cell number ranged from 15 to 60% of the initial number and was fairly stable for given conditions. After the "dormant" period, recovery was rapid. The population growth rate in cultures undergoing treatment with DRB is directly related to serum concentration; however, the recovery rate during the post-treatment period is unaffected by serum concentration. PMID- 6853611 TI - Adhesion of endothelial cells to extracellular matrix proteins. AB - Human and bovine endothelial cells were used in a series of studies examining cell adhesion to extracellular matrix macromolecules. Collagen types I and III, an acetic acid extract of bovine lens capsule basement membrane, laminin, and fibronectin were demonstrated to affect, in varying degrees, cell adhesion, cell growth, and "sprout cell" formation in endothelial cell cultures. All the matrix macromolecules tested promoted endothelial cell adhesion, and the adhesion to the basement membrane extract was blocked by antibodies to fibronectin. When human endothelial cells were grown on defined matrices, the level of serum required for optimum growth was decreased, while bovine endothelium grown on defined matrices did not show sprout cell formation. These data suggest that endothelial cells are able to adhere to a wide variety of connective tissue components and that extracellular matrices significantly influence cell behavior. PMID- 6853612 TI - Hybrids between irradiated and unirradiated mammalian cells: survival and chromosome segregation. AB - We have studied the effect of X or gamma irradiation, of one parent of a cell hybrid, on hybrid viability and chromosome segregation. The hybrid types studied were mouse--Chinese hamster (which spontaneously lose a few hamster chromosomes) and Chinese hamster--human (which spontaneously lose most of the human complement). Preirradiation of the segregated and retained cell parent resulted in highly asymmetric hybrid survival curves; survival was greatly reduced when the retained parent was irradiated, especially for hamster-human fusions. Preirradiation of the parents of mouse-hamster hybrids modified both the direction and the extent of chromosome segregation, but no consistent effect on elimination was observed for hamster-human hybrids, and reversal of the direction of loss was never observed. These results are more consistent with the hypothesis that chromosome segregation from hybrids results from an intracellular chromosome selection, than with the hypothesis that cellular selection acts on randomly generated chromosome variants. PMID- 6853613 TI - [Conservative surgery of the spleen]. AB - Conservative surgery of the spleen only has to overcome certain prejudices to become generally accepted. Today, we are convinced of the essential role of the spleen in the body's anti-infection defence mechanisms and the surgeon now has the means to repair a damaged spleen. We report the simplicity, effectiveness and reliability of three techniques of splenorraphy. Two of these techniques are our own and have been well tested in very extensive animal experiments and in our first clinical applications. Capsular sutures or partial splenectomy can treat the great majority of the lesions seen. When this is not possible, devascularisation of the spleen or autotransplantation of the splenic tissue are simple palliative measures, although there functional value has not been clearly established. The results of this approach are now numerous with adequate follow up and have revealed no complications, immediate or delayed, inherent in the technique. PMID- 6853614 TI - [Colon injuries from seat belts]. PMID- 6853615 TI - [Acute intrahepatic lithiasic cholecystitis. Apropos of a case]. AB - Pre-operative diagnosis in a case of acute intrahepatic lithiasic cholecystitis was an intrahepatic cystic formation. Treatment was by cholecystectomy. A review of the published literature demonstrated that the usual pre-operative diagnosis in these cases was either a cystic formation or an intrahepatic tumor. When cholecystectomy is not possible, therapy involves extraction of all gallbladder stones and main biliary tract drainage. PMID- 6853617 TI - [The choice of a prophylactic antibiotic by the surgeon]. AB - The difficult problem of the choice of antibiotic, when treatment is assumed to be necessary for prevention of postoperative infection, is discussed in relation to published data and the rules for prescribing antibiotics. Complications of antibiotic therapy are summarized, and the principal etiologic bacteria, as a function of the type of operation, are described. Surgical acts can be grouped in four categories as a function of the frequency with which they are followed by infection. Criteria of choice of antibiotic and the advantages and inconveniences of preventive antibiotic treatment are outlined. Results of the main controlled studies are reviewed in relation to the type of surgery performed, and an attempt made to choose from among the most effective products. As the ecological risk appears to be of primary importance, narrow spectrum antibiotics are preferred, as they have the minimum effect on host flora. These include penicillin G for certain gynecological operations, as well as in ENT surgical procedures, and metronidazole (Flagyl) for lower digestive tract surgery or gynecological procedures. PMID- 6853616 TI - [Effects of irradiation on vascular microsurgical sutures. Experimental study on 125 rats]. AB - The effects of irradiation on microsurgical sutures following vascular surgical procedures were studied in 125 rats divided into 7 groups, animals in 5 groups being irradiated at different doses. Follow-up examinations were conducted a minimum of 6 months after suturing and 2 months after irradiation. Evaluations included precise histological study of each vascular specimen removed, arteriography, and scanning electron microscopy. Findings demonstrated that it is possible to obtain satisfactory early functional results after irradiation of microsurgical anastomoses, and that the relation in time between trauma produced by radiotherapy and surgery plays an important role. PMID- 6853618 TI - [Anatomical basis for the surgical use of the cephalic vein (V. Cephalica). 74 anatomical dissections. 189 surgical dissections]. AB - The delto-pectoral portion of V. Cephalica was dissected 189 times during surgery and 74 times on cadavers. In 8 out of 10 cases the disposition was of the classical type and the diameter was wide enough to allow catheterization with a 3,4 mm catheter. In 2 out of 10 cases the vein was absent or toothin. This anomaly was most often unilateral with a normal disposition on the other side in 2/3 of cases. PMID- 6853619 TI - [Diagnosis of acute abdomen]. PMID- 6853620 TI - [Ischemic necrosis of the lesser curvature of the stomach after supraselective vagotomy. Apropos of 2 personal cases and 43 cases published in the literature]. AB - The author presents two personal cases (from a series of 176 operations) of this complication of which 43 cases have already been reported in the literature. Necrosis perforating into the peritoneum is the most dramatic form: fever, pain, abdominal distension and most importantly, the appearance of gastric fluid in the drain (hence the importance of drainage). X-rays show a gas-fluid level in the left hypochondrium. It is important to be aware of this complication, as the prognosis depends on early re-operation (most often an overlapping suture): the mortality is presently 23,5%. One external gastric fistula has been reported. A common form is a necrotic ulcer walled off by neighbouring tissues. It is sometimes quite small, revealed by endoscopy in which case it generally heals with medical treatment. It can be very large requiring operation because of its persistence or because of haemorrhages. In this case, it is most often treated by gastrectomy. The pathogenesis of this condition is uncertain; it seems preferable not to denude the esophagus too much and not to interfere with collateral blood supply: ligature of small vessels, splenectomy, fundoplication has also been implicated. Only one fact is certain: the high incidence in patients with renal failure and hypertension; in no case should these patients be submitted to a highly selective vagotomy. PMID- 6853622 TI - [Secondary hyperparathyroidism. Modern concepts of its diagnosis and treatment. Apropos of 45 cases]. AB - An analysis of different problems raised by secondary hyperparathyroidism. This condition most often follows chronic renal failure responsible for hyperphosphataemia followed by hypocalcaemia which causes parathyroid stimulation with hyperplasia. Clinical features are dominated by osteopathic manifestations and pruritus. The diagnosis is based upon radiological examination of the skeleton, repeated measurement of serum calcium and phosphate levels and above all iliac crest biopsy. Surgical treatment is based essentially on total parathyroidectomy with autologous transplantation of parathyroid tissue into the muscles of the forearm. This is followed by study of 45 cases undergoing surgery with details concerning surveillance and postoperative care. The results were very satisfactory since amongst these 45 patients undergoing total parathyroidectomy, only two continued to suffer from bone pain. PMID- 6853623 TI - Advances in fused-silica column technology for the analysis of underivatized drugs. AB - The chemical durability of a cross-linked 5% phenyl methylsilicone stationary phase is investigated for the analysis of underivatized drugs. Column performance is tested with respect to quantitative reproducibility, solvent extractability, selectivity for various drug families, and capacity for the polar solute. Data are presented showing the effects of a polar solvent and a serum extract on column lifetime with splitless and cool on-column injection. Examples of a human drug screen and the forensic analysis of street heroin are provided. PMID- 6853624 TI - Affinity chromatography of acetylcholinesterase from Electrophorus electricus electroplax. Investigations on 9-aminoalkylacridine affinity ligands. AB - The neural enzyme 11-S acetylcholinesterase (E.C. 3.1.1.7) was purified by affinity chromatography from a trypsin digest of Electrophorus electricus electric organ. Unquaternized affinity ligands were reported which were comparable in efficacy to the routinely employed "quaternized acridine MAC ligand". A study was made of the quaternization reactions of various 9 aminoalkylacridines and 9-aminoacridine along with their relative binding affinities to acetylcholinesterase. Ease of synthesis in conjunction with the column performance of these unquaternized 9-aminoalkylacridine compounds made them the preferred affinity ligand in acetylcholinesterase chromatography. A new carbodiimide synthetic route for these unquaternized ligands was described. PMID- 6853625 TI - Comparative affinity chromatography of acetylcholinesterases from five vertebrate species. AB - The efficacy of N-methylacridinium affinity chromatography in the purification of acetylcholinesterases from chicken, rat, calf and human brain and from the electric organ of the electric fish Torpedo marmorata has been investigated. Retention of the enzymes on the N-methylacridinium columns exceeded 90% in all instances except for the chicken enzyme, where 40-80% retention was observed depending on the acridinium concentration. Sucrose density gradient centrifugation profiles revealed no difference between the distribution of molecular forms in the crude extracts and in the partially purified fractions eluted from the columns by decamethonium iodide. PMID- 6853621 TI - [The abdomen in multiple-injured patients. Comparative study on 225 multiple injured patients with and without abdominal lesions. Incidence of abdominal complications]. AB - Of 225 patients with multiple injuries and a high lesional score, 100 presented traumatic abdominal lesions. Comparison of the two groups confirmed both the usefulness and validity of a traumatic index and the reliability of abdominal puncture-lavage. Abdominal complications were analyzed. Mortality in all multiple injury cases, with or without abdominal lesions, was identical in this series where emergency surgery was performed only for lesions affecting vital organs, the mean age of patients with abdominal lesion being significantly lower. An attitude to adopt when deciding whether surgery is necessary is proposed. PMID- 6853626 TI - Determination of the enantiomeric purity of levodopa, methyldopa, carbidopa and tryptophan by use of chiral mobile phase high-performance liquid chromatography. AB - Chiral mobile phase high-performance liquid chromatography was used successfully for the determination of the enantiomeric purity of levodopa, methyldopa, carbidopa and tryptophan. The method investigated uses phenylalanine and copper sulfate in the mobile phase and a C18 column. Linearity, precision, accuracy, detection limit and interference from expected impurities were assessed. The method is also applicable to the measurement of enantiomeric purity in levodopa tablets and capsules. PMID- 6853627 TI - Automated high-performance liquid chromatographic column switching technique for the on-line clean-up and analysis of drugs in topical cream formulations. AB - The automation of a high-performance liquid chromatographic column switching technique for the on-line clean-up and analysis of drug substances in topical cream formulations is described. A short reversed-phase precolumn used for primary sample clean-up was coupled to a reversed-phase analytical column. This allowed cream samples dissolved in methanol-tetrahydrofuran to be injected directly into the analysis system without prior laborious and time-consuming clean-up procedures. This application was successfully extended to the analysis of sulconazole nitrate, and a triple corticoid cream. The effects of precolumns on some chromatographic parameters were studied. PMID- 6853631 TI - Determination of thiabendazole residues in marmalades by high-performance liquid chromatography. PMID- 6853628 TI - Sample preparation by salts precipitation and quantitation by high-performance liquid chromatography with UV detection of selected drugs in biological fluids. AB - A quantitative clean-up procedure for drugs in plasma and urine in preparation for high-performance liquid chromatographic analysis is discussed. Samples are mixed with zinc sulfate, barium hydroxide, and acetonitrile (or methanol). Resultant solutions are clear and free of visible residue. Injections of over 420 samples of treated urine and 120 samples of treated plasma had no noticeable effect on pressure drop and column performance. An examination of the column head indicated no damage or discoloration to the packing. Baselines of the controls show no interference from endogenous compounds for the drugs studied. Precision study using cyclobenzeprine . HCl in plasma and urine by internal standard and external standard methods has within-run and day-to-day variations of under 5%. Drugs studied in urine and plasma are amiloride . HCl, cyclobenzeprine . HCl, cyproheptadine . HCl, diflunisal, indomethacin, phenylbutazone and sulindac. These drugs are selected for the various functional groups, their binding by proteins and their natural UV absorptivity. Conditions to improve recovery, advantages and limitations are discussed. PMID- 6853630 TI - Quantitative determination of myo-inositol in pharmaceutical preparations and organic extracts by high-performance thin-layer chromatography using fluorescence. PMID- 6853632 TI - Quantitative analysis of minaprine and some of its metabolites with application to kinetic studies in rats. AB - A simple and rapid high-performance liquid chromatographic method is described for the quantitative analysis of the psychotropic drug minaprine and three of its metabolites (M1, M3 and M11), including one as yet undetected metabolite (M11) known as a monoamine oxidase type A inhibitor in vitro. After selective extraction all four compounds were separated on a reversed-phase muBondapak C18 column using sodium acetate (0.03 M)-acetonitrile-methanol (88:7:5) (pH 3.3) as the mobile phase. The eluted compounds were detected with a UV detector at 254 nm. The sensitivity of the method is 0.02 microgram per millilitre of body fluid or per gram of tissue for M1 and M11 and 0.05 microgram per minaprine and M3. The method has been applied successfully to the determination of minaprine and the metabolites in plasma and brain and is compared here with an gas-liquid chromatographic method with an electron-capture detector previously developed for the detection of minaprine and M11. M11 was identified in rat urine by gas chromatography-mass spectrometry. PMID- 6853629 TI - Separation of tetrodotoxin and paralytic shellfish poisons by high-performance liquid chromatography with a fluorometric detection using o-phthalaldehyde. AB - Tetrodotoxin (TTX) and a variety of paralytic shellfish poisons (PSPs) were extracted from toxic specimens of puffer and scallop, and quantitated by high performance liquid chromatography with a fluorometric detection using o phthalaldehyde. Fluorescence spectra for the TTX- and PSP-fluorophors in 0.05 M borate buffer (pH 10) showed maxima at 453 nm with 332-nm excitation. The fluorescence intensity per nM of TTX was found to be 3 and those of PSP to be 4 12. This fluorometric technique may be useful for the simultaneous quantitation of TTX and PSP in small volumes of toxin extracts. PMID- 6853633 TI - Study of the high-performance liquid chromatographic separation of reducing sugars, applied to the determination of lactose in milk. AB - The loss of reducing sugars by formation of Schiff bases on amino-bonded silica or on dynamically coated amino-silica columns was investigated at two column temperatures. Depending on the type, age and temperature of the column, these losses were in the range of 0-100%. A dimethylamino-bonded silica column did not cause loss of reducing sugars, but the retention of sugars was too weak to allow separation. The analysis of reducing sugars can be carried out on diol-modified silica with diisopropylethylamine in the eluent to enhance mutarotation. It is also possible to use a cation-exchange resin (Ca2+) column, equipped with a pre column packed with a mixed-bed ion-exchange to remove interfering salts and acids. In combination with an acetate-acetonitrile sample clean-up, this method results in coefficients of variation of less than 1% for the determination of lactose in skim-milk. PMID- 6853634 TI - Separation by different methods of soluble proteins isolated from sympathetic splenic nerves. AB - The soluble proteins of sympathetic splenic nerves were separated by high performance liquid chromatography (HPLC), sodium dodecyl sulphate (SDS)-HPLC on TSK-GEL-SW columns and SDS-polyacrylamide gel electrophoresis (PAGE). With HPLC the main fractions had apparent molecular weights Mr 150,000, 75,000-85,000, 27,000 and less 5000, with SDS-HPLC the Mr values were 75,000, 13,500 and less 5000 and with SDS-PAGE the Mr were 75,000, 55,000, 45,000 and less 12,500. Of the proteins eluted after electrofocusing, the bands of pH 4.0-5.2 showed a single peak of Mr 75,000 in all separation methods used; in the range pH 5.8-6.5, proteins with Mr 150,000 were found by HPLC, 75,000 by SDS-HPLC and 55,000 and 45,000 by SDS-PAGE. The Mr 150,000 fraction in the range pH 5.8-6.5 showed DOPA decarboxylase (E.C. 4.1.1.28) activity. The results provide new information about the soluble proteins of sympathetic nerve. PMID- 6853635 TI - Preliminary evaluation of high-performance liquid chromatography with photoconductivity detection for the determination of selected pesticides as potential food contaminants. AB - The applicability of the Tracor Model 965 photoconductivity detector to the determination of a variety of pesticide chemicals, particularly polar and/or thermally labile compounds which are troublesome in gas chromatographic analysis, has been investigated. The effects of various operating parameters (e.g., mobile phase composition, flow-rate and irradiation wavelength) on signal-to-noise output for selected compounds have been evaluated. A comparison of photoconductivity responses with those obtained from a UV detector connected in tandem was made for selected reference standards and food sample extracts. The photoconductivity detector was found to be suitable for the determination of pesticide residues at sub-parts-per-million levels. The linearity and reproducibility of response are adequate for practical quantitative applications. PMID- 6853637 TI - Rapid technique for the radiometric assay of phospholipase A2. PMID- 6853638 TI - Post mortem brain alcohol levels. PMID- 6853636 TI - Model study of hydrophobic interactions of alpha- and beta-trypsin and alpha chymotrypsin. AB - The hydrophobic interactions of alpha- and beta-trypsin as a function of ionic strength and pH were studied by hydrophobic chromatography. Evidence was obtained that in spite of the identical specificities and similar activities of alpha- and beta-trypsin, the cleavage of the Lys-Ser bond induces conformational changes in the neighbourhood of the active site. Over a wide range of pH and salt concentration the non-polar residues on the surface of the molecule of beta trypsin are more exposed to an external environment than on the molecule of alpha trypsin. In the trypsin(chymotrypsin)-inhibitor complexes the majority of hydrophobic amino acids are buried; other hydrophobic residues localized on the surface contribute only very slightly to the interaction with the chromatographic support. The retention of trypsin, chymotrypsin and their diisopropylphosphoryl derivatives on a support with flexible hydrophobic ligands bonded to the matrix through a spacer (octyl-Sepharose) was correlated with the retention on a support with hydrophobic binding sites incorporated into the rigid matrix of the resin (Spheron). The native enzymes are always more retained; this indicates that the substitution results in the shielding of the non-polar residues in the neighbourhood of the active site. The differences in the slope of individual proteins, resulting from the correlation of the retention values obtained with both supports at several sodium chloride concentrations are explained by differences in the accessibility of the surface non-polar residues in the individual proteins. In experiments with model peptides the contribution of the individual hydrophobic amino acids to the retention was investigated. PMID- 6853639 TI - [Determination of chlorhexidine and tetracaine in pharmaceutical preparations by ion-pair liquid chromatography on a nitrile-type fused phase]. PMID- 6853640 TI - Separation of the subunits of crotoxin by high-performance liquid chromatography. PMID- 6853641 TI - Separation of urine proteins on the anion-exchange resin mono Q. AB - Proteins excreted in urine due to renal failure were separated on Mono Q, a new strong anion exchange designed for fast high-resolution protein separations. The separation procedure was divided into two steps. The first step involved removal of low-molecular-weight substances by rapid desalting on a Sephadex G-25 Superfine column. In the second step, the total protein fraction (3--6 ml) was loaded onto the Mono Q column with the aid of a superloop. The proteins were adsorbed onto the top of the ion-exchanger column and gradually displaced by a combined pH and salt gradient in 40 min. The choice of ion exchanger and initial operating conditions were based on data obtained from electrophoretic titration curve experiments. Identification of separated proteins was achieved by fused rocket electrophoresis and sodium dodecyl sulphate-polyacrylamide gel electrophoresis, respectively. PMID- 6853643 TI - Pentafluorobenzoyl derivatives of doping agents. I. Extractive benzoylation and gas chromatography with electron-capture detection of primary and secondary amines. AB - A sensitive and rapid method for the gas chromatographic (with electron-capture detection) confirmation of derivable sympathomimetic amines is described. Extractive derivatization with pentafluorobenzoyl chloride is performed on 2-ml urine or plasma samples. Especially for primary amines, the method appears to be very sensitive. Mass spectral data allowed confirmation of the monobenzoylation of all congeners. PMID- 6853642 TI - Gas chromatography with nitrogen-selective detection of metoprolol from human plasma after reaction with phosgene. AB - A method for the determination of therapeutic levels of metoprolol in human plasma is presented. Metoprolol and the internal standard are extracted from the buffered plasma sample to an organic phase containing 4 X 10(-3) M phosgene. After 10 min the organic phase is taken to dryness. The residue is dissolved in ethyl acetate and the formed oxazolidine derivatives are analyzed by gas chromatography with nitrogen-selective detection. With packed columns, rectilinear standard curves through the origin were obtained down to 80 nmoles/l of plasma. The precision of the method at 200 nmoles/l was 1.5% (n = 8). The sensitivity of the method was improved by using capillary column gas chromatography. Linear standard curves were obtained down to 10 nmoles/l of metoprolol in plasma. The precision of the method at the 50 nmoles/l level was 2.2% (n = 7). With this simple and straightforward method using extractive derivatization 30 samples can be handled in a day. PMID- 6853644 TI - Solvent extraction of tricyclic amines from blood plasma and liquid chromatographic determination. AB - The extraction of seven tricyclic antidepressant amines from human plasma at different pH values was investigated for dichloromethane, diethyl ether and hexane--1-pentanol (95:5). The amines were extracted as bases and back-extracted to sulphuric acid, 0.10 mol/l, prior to the separation by bonded-phase liquid chromatography. Ether and hexane--1-pentanol (95:5) were most suitable, tertiary amines being best extracted at pH 8, and secondary amines at pH 10. Using ether, both while 15 min ws sufficient for hexane--1-pentanol (95:5). UV detection allowed concentrations down to 10 ng in 1 ml of plasma to be determined. Three ammonium ions--octylammonium, dimethylammonium, and trimethylammonium--were added as modifiers to the mobile phase containing acetonitrile in phosphoric acid, 0.10 mol/l. In the concentration interval 0.010--0.030 mol/l all of the amine modifiers gave on Polygosil C8 peak asymmetry factors of sufficiently low magnitude, while on Li-Chrosorb RP-18 this was so only for di- and trimethylammonium in a concentration of 0.030 mol/l. PMID- 6853645 TI - Direct coupling of fused silica columns to the ion source of a mass spectrometer applied to studies of arachidonic acid metabolism in human fibroblasts. PMID- 6853646 TI - Gas-liquid chromatographic analysis of intact long-chain triglycerides. PMID- 6853649 TI - Analytical strategies for therapeutic monitoring of drugs and metabolites in biological fluids. Plenary lecture. AB - Therapeutic drug monitoring can involve quantitation in either microgram, nanogram or picogram concentrations present in a complex biological matrix (whole blood, urine or tissue). The chemical structure of a compound influences not only the analytical method best suited to its quantitation, but also its acid/base character (pKa) and its extractability. The dose administered, the bioavailability of the dosage form, and the pharmacokinetic profile of the drug govern the circulating concentrations of either the parent drug and/or its metabolites present in vivo, and dictate the ultimate sensitivity nd specificity required of the analytical method. The degree of sample preparation required is dependent on the analytical method used (gas--liquid chromatography, thin-layer chromatography, high-performance liquid chromatography) and on the tolerance of the specific type of detection system to contamination. Factors leading to compound losses during sample preparation (adsorption, stability) are critical at low concentrations and can adversely affect the reliability of an assay, therefore maximizing the overall recovery of the assay is essential not only for high sensitivity but also for good precision and accuracy. Therefore, the criteria to be used in sample preparation should aim to optimize all of the above factors in the overall development of a reliable and validated method for the compound suitable for use in clinical therapeutic monitoring. PMID- 6853647 TI - Gas-liquid chromatography profiling of intact lipids. Observation of differences between triglyceride structure of lipoproteins in type III and type IV hyperlipoproteinemia. PMID- 6853650 TI - Gas-liquid and column liquid chromatography for studying vitamin U metabolism in humans and animals. PMID- 6853651 TI - Detection of acridine in human urine after topical coal-tar treatment. PMID- 6853648 TI - Influence of corticosteroid therapy on the fatty acid composition of serum lecithins monitored by means of thin-layer and gas-liquid chromatography. PMID- 6853652 TI - Capillary gas chromatographic method for determination of flumecinol in plasma and saliva. PMID- 6853654 TI - Rapid method for determination of cimetidine in biological fluids by high performance liquid chromatography using Extrelut extraction. PMID- 6853653 TI - Monitoring of ethimizol and its metabolites in serum or saliva by means of high performance liquid chromatography. PMID- 6853655 TI - Some quantitative aspects of UV detection in capillary isotachophoresis as applied to bioavailability studies. PMID- 6853656 TI - Applications of rapid-scanning multichannel detectors in chromatography. Plenary lecture. AB - A review of progress in the field of multichannel detection in column and thin layer chromatography is presented, together with some novel applications of a computer-based, linear photodiode array UV--visible spectrophotometer for detection in high-performance liquid chromatography (HPLC). Computer-aided methods for simultaneous monitoring of the elution profile at three wavelengths with automatic peak detection and capture of UV spectra are described. The continuous calculation of absorbance ratios during elution is discussed as an index of peak homogeneity. A novel technique for the enhancement of qualitative identification in HPLC, based on transformation of captured spectra to the second derivative or to the decadic logarithm, is proposed. These developments are exemplified by a model system of diacetylmorphine and its principal metabolites and degradation products, morphine and 6-acetylmorphine. The potential utility of three-dimensional projections of (A, lambda, t) data is discussed in the context of pharmaceutical, bioanalytical and forensic applications. PMID- 6853657 TI - Gas chromatographic--mass spectrometric determination of total 4-heptanone, a new marker in diabetes mellitus. AB - Total 4-heptanone is the sum of a beta-oxocarboxylic acid, 2-ethyl-3-oxohexanoic acid, and its decarboxylation product, 4-heptanone. The beta-oxocarboxylic acid is found in serum and in urine, and is detected by gas chromatography--mass spectrometry in the form of its methyl ester or its O-methyloximated acid methyl ester. The ketone is detected within the profile of volatile metabolites in serum and in urine. However, the analytical procedure includes some ketone coming from in vitro decarboxylation. Total 4-heptanone is measured by gas chromatography- mass fragmentography. The method includes a quantitative transformation of the beta-oxocarboxylic acid into the ketone. A comparative study with 270 patients with diabetes mellitus, 2 healthy individuals and 143 non-diabetic hospitalized patients showed that the urinary excretion of total 4-heptanone is increased in diabetes mellitus. The mean values are 1073 micrograms per 24 h for diabetics, compared with 207 micrograms per 24 h and 246 micrograms per 24 h for healthy individuals and Non-diabetic patients, respectively. Diabetic ketoacidosis and fasting conditions decrease the total 4-heptanone. PMID- 6853658 TI - High-performance liquid chromatography of biologically important pyrimidine derivatives with ultraviolet--voltammetric--polarographic detection. AB - High-performance liquid chromatographic separation of a number of biologically important pyrimidine derivatives was studied in the reversed-phase system. Good results were obtained using a C18 alkyl-bonded silica column and an aqueous citrate--phosphate mobile phase of pH 3.5. All eluted components are detected with the UV absorbance detector at 254 nm, whereas the voltammetric detector with a polymeric carbon-paste electrode detects only derivatives containing oxidizable functional groups (amino, mercapto) and the polarographic detector with a mercury electrode only those with reducible groups (nitro, aza). The signal of the electrochemical detectors is proportional to the number of electroactive groups in the solute molecule. The use of two or three detectors in series thus improves the resolution of complex mixtures and facilitates identification. PMID- 6853659 TI - Microbore column exclusion chromatographic method for studying protein association and its relation with enzymatic activity. PMID- 6853662 TI - Rauwolfia and breast cancer: no relation found in long term users age fifty and over. AB - It has been suggested that conflicting findings regarding rauwolfia drugs as predisposing factors for breast cancer can be explained by the hypothesis that use for a long duration predisposes to breast cancer occurring after age 50. In a follow-up study of 2077 women who received prescriptions for rauwolfia drugs there was no excess risk for breast cancer diagnosed at age 50 or greater (morbidity ratio = 0.9 compared to 1.0 expected). In comparing 35 patients in this age group with 168 women who received rauwolfia but remained free of breast cancer, there was no excess risk for long (greater than or equal to 5 yr) duration of use (relative risk = 0.9). Thus, the hypothesis could not be confirmed in this study group. It is likely that the excess risk among long duration rauwolfia users, if present at all, is less than 2-fold. PMID- 6853660 TI - Evaluation of a semi-automatic radioimmunoassay for hepatitis B surface antigen (HBsAg). AB - The recently developed semi-automatic Hepatube system was evaluated in comparison to another radioimmunoassay for the detection of hepatitis B surface antigen (HBsAg), the manual Ausria II-125 test. After incubation of serum in anti-HBs coated tubes, the Hepatube system uses a machine to wash the tubes and to add tracer. After a second incubation, tubes are washed again in the machine and are manually transferred to the gamma counter. Two machines were used. Machine 1 had an undefined defect. Of 1490 samples tested, 69 (4.6%) gave false-positive results versus 11 (0.7%) in the Ausria II-125 test. Machine 2 had one false positive result among 920 samples versus 5 in the Ausria II-125 test. The sensitivity was measured with reference panels from Wellcome and Abbott as well as in titration series. The Hepatube system was found to be a factor three less sensitive than the Ausria II-125 test. The Hepatube processor is easy to handle; radioactive material can be held at a distance during the whole procedure; waste material is limited and less voluminous than in the Ausria II-125 test. PMID- 6853663 TI - Multiple regression analysis of risk factors for cardiovascular disease and cancer mortality in Busselton, Western Australia--13-year study. AB - The mortality of 1564 Busselton subjects has been studied from 1966-79 to determine whether risk factors for cardiovascular disease (CVD) and coronary heart disease (CHD) showed any change in emphasis compared with the Framingham Population Study of 20 yr previously. The Busselton analysis used subjects free of probable and suspect coronary heart disease at onset. In men aged 40-59, systolic blood pressure (SBP), forced expiratory volume (FEV), and serum cholesterol levels were significant independent determining variables for CVD mortality and cholesterol for CHD mortality, with SBP being related to CVD in men aged 60-74 yr. In women, there were few indicators of future vascular risk with no significant determining variable for CVD and CHD in 40-59 yr olds, but blood glucose and FEV were significant risk factors for CVD in women aged 60-74 yr. Cholesterol was unrelated to mortality in women but showed negative relationship with cancer in 60-74 yr old men. In total mortality, smoking in men and women, and obesity in women were significant risk factors; 1 hr serum insulin had a negative relationship in men aged 40-59 yr, and a stronger positive relationship in men aged 60-74 yr, but this may have been due to the close negative association of the variable with body size (i.e. height). More studies are required to ascertain whether glucose and insulin have an aetiological role in vascular disease. PMID- 6853661 TI - Risk of lymphoma in individuals with diabetes mellitus. PMID- 6853664 TI - Interim recruitment goals in clinical trials. AB - The recruitment rate or duration of a clinical trial must be so determined that the required number of patients may be assured within the given design frame. Establishing interim recruitment goals in clinical trials will not only help keep the clinical investigator from falling too far behind in recruitment but will also enable the sponsor of the study to decide in the early stages of the study whether the investigator can achieve the final recruitment goal. We propose statistical methods for determining a proper recruitment rate, duration and interim recruitment goals. A method of projecting the final recruitment at interims and a method of adjusting the recruitment duration at interims are discussed. Seasonal adjustment methods are also noted. PMID- 6853665 TI - Appendectomy and subsequent cancer risk. AB - Although earlier epidemiologic studies reported a positive association between appendectomy and certain cancers, interest was limited due to lack of confidence in the study findings. However, recent morphologic studies on the immune structure of the vermiform appendix in the rabbit and man argue for a reevaluation of the appendectomy--cancer association. This paper reviews briefly the morphologic and epidemiologic literature on the subject to date. The validity of the earlier epidemiologic findings is discussed and avenues for further research assessing the relationship of appendectomy to subsequent cancer risk are proposed. PMID- 6853666 TI - Altitude and blood pressure in children. AB - People living at high altitude are generally observed to have lower blood pressure than those residing at sea level. To investigate whether low pO2 or low body weight accounts for this, blood pressure, weight, height and pulse rate were measured in 847 Peruvian children residing at 3500 m and compared to previously collected data in 3924 Dutch children living at sea level. In the two study populations the same protocol for measurement of blood pressure was used by observers who showed no systematic differences in average blood pressure readings during training sessions. Systolic as well as diastolic blood pressure was found to increase with age in both Peruvian and Dutch children. Systolic blood pressure by age was 5-10 mmHg lower in Peruvian boys and girls than in their Dutch counterparts. However, virtually no differences in systolic blood pressure, and to a lesser extent diastolic blood pressure, by body weight or height between Peruvian and Dutch subjects were found. These findings are in agreement with the hypothesis that differences in body weight, rather than in pO2, explain most of the observed differences in blood pressure between children of the same age living at different altitudes. PMID- 6853668 TI - The intellectual imperative (and its prodigious progeny). PMID- 6853667 TI - Effect of 131I on the anemia of hyperthyroidism. AB - Data from the National Thyrotoxicosis Therapy Follow-Up Study (NTTFS) are presented here to document the existence of anemia in hyperthyroidism, a mild and reversible anemia that is simultaneously ameliorated with reversal of the hyperthyroid state. Among 20,600 women entered into the NTTF study with no previous history of hematological disorders, the prevalence of anemia was found to range from 10-15%, appearing to be higher in those selected for treatment with 131I when compared to those selected for surgery. An attempt is made to verify the recent hypothesis that thyroid hormone levels in the supraphysiologic range may suppress erythrogenesis. Two statistically significant regression models are consistent with a hypothesis of thyrotoxic bone marrow suppression. However, both associations are weak enough to suggest that some other physiologic improvement underlies the amelioration of anemia when hyperthyroidism is reversed. The degree of improvement in hematological status is similar for women in both treatment groups. Among 4464 women for whom serial hematological tests are obtained, over 3/4 of anemic patients are no longer anemic after an average 6.2 yr of follow-up. Clinicians are reassured that radioactive iodine exposure causes no further insult to the bone marrow, no matter what the cumulative dosage. The highly fractionated low dose bone marrow exposures to radiation account for the minimal hematological risks of 131I treatment. PMID- 6853670 TI - Development and validation of a radioimmunoassay for prostaglandin E2 metabolite levels in plasma. AB - Measurements of primary prostaglandins (PGs) in plasma are unreliable, and determinations of their metabolite levels are to be preferred. The principal circulating metabolite of PGE2 [13,14-dihydro-15-keto-PGE2 (PGEM)] is itself unstable however, and this has hindered development of PGE2 metabolite assays. Alkalinization of plasma uniformly converts PGEM and its degradation products to a stable bicyclo compound 11-deoxy-13,14-dihydro-15-keto-11 beta, 16 epsilon cyclo PGE2 (bicyclo-PGEM). Measurement of bicyclo-PGEM, therefore, enables the PGEM instability problem to be circumvented. This paper describes a specific and sensitive RIA for bicyclo-PGEM in plasma. The assay uses a rabbit antiserum against bicyclo-PGEM and a radiolabel produced by alkalinization of tritiated PGEM. The assay is direct, employing neither chromatographic nor extraction steps. The least detectable mass of bicyclo-PGEM is 1 pg, and the mean mass of added bicyclo-PGEM required to displace zero point binding by 50% is 15 pg. Cross reactivities of the antiserum against prostanoids are less than 1%. The assay is both accurate and reproducible. Intra- and interassay coefficients of variation are 9.8% and 15.3%, respectively. Plasma concentrations of bicyclo-PGEM in man, rhesus monkey, sheep, and rabbit are reported. This assay allows for reliable measurements of plasma PGE2 metabolites and opens the way for in vivo studies on the significance of PGE2 in health and disease. PMID- 6853669 TI - An integrated programme for the prevention and control of noncommunicable diseases. A Kaunas report. PMID- 6853672 TI - Relationship between thyrotropin stimulation and radioiodine uptake in lung metastases of differentiated thyroid carcinoma. AB - To examine whether the injection of bovine TSH (bTSH) produces maximal radioactive iodine uptake (RAIU) in lung metastases in patients with differentiated thyroid cancer, 10 patients were studied 12 times. In 10 of these studies, an initial RAIU measurement was performed immediately after 3 injections of 10 IU bTSH given immediately after T3 withdrawal. Another RAIU measurement was performed 7-19 days after T3 withdrawal. Uptake increased in all patients even when it was clearly detectable immediately after bTSH stimulation. Thus, 3 days of bTSH stimulation in these patients did not lead to maximal 131I uptake, and it could only be reached after prolonged endogenous TSH stimulation. bTSH was not injected in the 2 other patients, in whom 6 RAIU measurements were carried out. Radioiodine uptake increased with time in both patients. It appears that both the level of endogenous TSH and the length of stimulation play a determining role in RAIU. This might explain why 3 days of bTSH stimulation are insufficient to elicit maximal 131I uptake. PMID- 6853671 TI - Radioactive iodine in the treatment of medullary carcinoma of the thyroid. AB - To determine the value of adjunct 131I therapy in medullary carcinoma of the thyroid (MCT), two groups of patients with histologically proved MCT were studied. Group A consisted of 15 patients (6 men and 9 women) treated by surgery, followed by an ablative dose of 131I, and group B included 84 patients (39 men and 45 women) treated by surgery alone. Patients in group A were followed for 1.5 14 yr (median, 53 months), and those in group B were followed for 1-27 hr (median, 75 months). Seven patients (46.6%) from group A and 36 patients (42.9%) from group B developed recurrence or metastasis. The 5- and 10-yr survival rates were 87.5% and 75% for group A and 89% and 74% for group B; the difference was not significant (P greater than 0.05). The changes in serum calcitonin levels in 4 patients of group A were not different from those in patients who did not receive 131I. We conclude that 131I has no value as an adjunct to surgery in the management of MCT. PMID- 6853673 TI - Stimulation of spermatogenesis in stalk-sectioned rhesus monkeys by testosterone alone. AB - Testosterone alone stimulated spermatogenesis in four adult, pituitary stalk sectioned rhesus monkeys. Ten to 14 weeks after transection of the pituitary stalk, testicular volumes declined to about one fifth of the presurgical values. Serum LH levels declined precipitously, being undetectable 1 week postsurgery, and serum testosterone levels were indistinguishable from those of castrated male monkeys by the 5th week postsurgery. After a transient decline, serum PRL levels increased to high values in all four monkeys throughout the rest of the postsurgery period. Twelve weekly injections of 250 mg testosterone enanthate resulted in peak testosterone levels around 25-fold higher than presurgical levels. Estradiol levels increased about 4-fold over presurgical levels, and PRL also increased further during the treatment phase. Small ejaculates were produced by electrostimulation by the 5th week of treatment. Thereafter, the ejaculate weight increased. Sperm were found from the 10th week in all four monkeys. By the 13th week of treatment, sperm counts in three monkeys ranged from 17-60 X 10(6) sperm/ejaculate. The sperm counts continued to increase for the first 4 weeks after the cessation of the testosterone enanthate injections. Thereafter, the sperm counts declined, and all four animals produced azoospermic ejaculates between 10 and 31 weeks posttreatment. Moreover, testosterone levels declined slowly and nonuniformly among the four animals. Testicular volumes declined and were at the lowest levels 14 weeks posttreatment. Estradiol and PRL levels also declined posttreatment. It is concluded that testosterone alone can stimulate spermatogenesis in stalk-sectioned rhesus monkeys even in the face of high serum PRL and estradiol levels. PMID- 6853674 TI - Protein-bound corticosteroid in human serum is selectively transported into rat brain and liver in vivo. AB - It is generally regarded that only free corticosteroid is available for entry into tissues in vivo, although some studies have suggested that albumin-bound corticosteroid is available for liver uptake. However, recent studies suggest that owing to favorable kinetic relationships among tissue capillary transit times and hormone dissociation rates from plasma proteins, free plus albumin bound hormone may be available to peripheral tissues. Moreover, globulin-bound hormone may enter the liver under normal conditions and be available to peripheral tissues under pathological circumstances. The present studies measure the free and noncorticosteroid-binding globulin (non-CBG)-bound corticosteroid fractions in vitro and compare these measurements to the fraction of corticosteroid in human sera that is available for entry into rat brain and rat liver in vivo. Corticosterone was used as the model corticosteroid, since this compound binds to CBG with the same affinity as does cortisol, and the brain extraction of corticosterone is more readily measured in vivo than is the brain extraction of cortisol. Serum was obtained from 51 human subjects and included samples from newborns, pregnant mothers, normal subjects, and patients with either cirrhosis or renal failure. Serum levels of CBG varied more than 6-fold, and both the free and the non-CBG-bound fractions were generally inversely related to the CBG concentration. The fraction of corticosterone available for entry into the brain was much greater than the free fraction, but was not significantly different from the non-CBG-bound moiety. Moreover, the rate of corticosterone dissociation from CBG (t 1/2 = 27 +/- 1 sec at 22 C) was not increased in any of the serum samples studied. The fraction of corticosterone available for uptake by the liver was up to 3-fold greater than that of the non CBG fraction and had no relationship with the serum concentration of CBG. These studies indicate that albumin-bound, but not globulin-bound, corticosteroid is available for entry into a peripheral tissue such as the brain. However, globulin bound corticosteroid is readily transported into the liver. It is suggested that the routine measurements of the non-CBG-bound corticosteroid provide a more accurate index of the corticosteroid available to peripheral tissues in vivo than does the measurement of free corticosteroid. PMID- 6853676 TI - Basic and clinical reevaluation of tyramine and histamine tests for the investigation of adrenomedullary sympathetic functions. AB - In vitro and in vivo studies using histamine and tyramine tests were carried out to investigate adrenomedullary sympathetic functions. Administration of 10(-3) M tyramine enhanced catecholamine release from both the perifused swine adrenal medulla and human pheochromocytoma tissue, whereas histamine did not show this effect. Tyramine also induced release of catecholamine from the isolated catecholamine granules in vitro, but histamine did not. The tyramine or histamine test was performed in vivo on groups of 16 subjects, respectively, consisting of healthy adults and hypertensive patients. In all cases, a rise in blood pressure was observed after loading with either tyramine or histamine. On the other hand, when urinary catecholamine output was examined during the first 2 h after loading, a significant increase was not observed in 4/16 after tyramine administration, and in 6/16 after histamine loading. Thus, using an in vitro system, we showed a difference between tyramine and histamine in the mode of direct action on adrenal medulla. We also conclude that urinary catecholamine output is of less significance than the blood pressure response as an index of tyramine or histamine test. PMID- 6853675 TI - Serum reverse triiodothyronine and thyroxine kinetics in patients with chronic renal failure. PMID- 6853678 TI - Seasonal variation in serum concentrations of parathyroid hormone in elderly people. AB - In 124 patients with femoral neck fracture and 74 aged control subjects a seasonal variation was observed in the serum concentrations of 25-hydroxyvitamin D, 24,25-dihydroxyvitamin D, and PTH. The serum PTH concentrations were maximal in winter, when the vitamin D metabolites were lowest, suggesting a secondary phenomenon. PMID- 6853677 TI - Dopaminergic inhibition of aldosterone secretion in man is independent of the autonomic nervous system. AB - To determine whether the plasma aldosterone response to metoclopramide, a dopamine antagonist, is mediated by the autonomic nervous system in man, five healthy male volunteers were injected with metoclopramide during an infusion of either 5% dextrose in water or trimethaphan, a ganglionic blocker. Despite evidence of ganglionic blockade during the trimethaphan infusion, the aldosterone response to metoclopramide remained intact. This suggests that the aldosterone response to metoclopramide is not mediated by the autonomic nervous system in man as it appears to be in the sheep, and suggests species variation in the mechanism of this this mineralocorticoid response. PMID- 6853679 TI - Effects of cholecystographic agents and sulfobromophthalein on binding of thyroid hormones to serum proteins. AB - A number of interactions between thyroid hormones and cholecystographic agents have previously been demonstrated. In the present study we show that cholecystographic agents also interfere with the binding of thyroid hormones to serum proteins. A commercial kit (Tri-Tab) was used in which the uptake of labeled hormone from serum by a silicate adsorbent tablet is measured. In the presence of cholecystographic agents or sulfobromophthalein (BSP), the amount of labeled hormone bound to adsorbent increased in a dose-dependent fashion, reflecting displacement from protein-binding sites. The order of potency was BSP greater than ipodate greater than iopanoate greater than tyropanoate. Displacement of hormone was confirmed by a second methodology in which graded amounts of unlabeled T4 were added to the system. This allowed a Scatchard analysis to be performed for binding sites on T4-binding globulin. The cholecystographic agents and BSP caused displacement of the Scatchard slopes, again demonstrating interference with binding to serum protein sites. A method is described in which the change in Scatchard slope produced by an inhibitor is employed to compute the association constant between T4-binding sites on T4 binding globulin and the inhibitors. The values were: BSP, 14.6 X 10(3) M-1; ipodate, 4.7 X 10(3) M-1, iopanoate, 2.2 X 10(3) M-1; and tyropanoate, 0.1 X 10(3) M-1. Because of these relatively low values and the rapidity with which these agents are normally cleared from serum, it seems likely that effects on free hormone levels would be transient and of small magnitude during routine cholecystography. Also, ipodate, in the 1 g/day dose that has been employed experimentally to treat hyperthyroidism, should have a negligible effect on protein binding. On the other hand, when high levels of these compounds are used in experimental settings to study other aspects of thyroid hormone metabolism, changes in protein binding can occur and confound interpretation of results. PMID- 6853680 TI - Male pseudohermaphroditism due to 17,20-desmolase deficiency. AB - In a 5-yr-old 46,XY male pseudohermaphrodite with microphallus, perineal hypospadias, chordee and cryptorchidism, serum C19 steroid levels were abnormally low in the basal state and after adrenal and testicular stimulation. Serum C21 steroid levels were elevated in the basal state and increased further after adrenal, but not after gonadal, stimulation. Urinary excretion of pregnanetriolone, a metabolite of 17-hydroxypregnenolone and 17 hydroxyprogesterone not normally present in the urine, was increased in the basal and stimulated states. Cortisol production was normal, and all steroid hormone levels were suppressed by dexamethasone. Testicular biopsy was consistent with prepubertal cryptorchid testes. Incubation of testicular tissue with labeled 17 hydroxyprogesterone revealed failure of conversion of precursor to androstenedione and testosterone. A significant increase in phallic length occurred after treatment with exogenous androgen. These findings are consistent with 17,20-desmolase deficiency in both gonads and adrenal glands. PMID- 6853681 TI - 3'-isopropyl-3,5-diiodo-L-thyronine: a potent synthetic thyromimetic thyronine analog. Studies of its kinetics and biological potency in man and rats and its toxicology. AB - In order to compare phenolic and tyrosyl ring monodeiodination, we investigated 3'-isopropyl-3,5-diiodo-L-thyronine (DIIP), a potent thyronine analog which can only be monodeiodinated on the tyrosyl ring. A specific RIA was developed. The in vivo metabolism and biological potency of DIIP and T3 were compared. DIIP and T3 kinetic studies were performed in vivo using 40 male SIVZ rats who received 5 micrograms DIIP and 0.5 microCi 131I-T3. Blood samples were obtained for up to 15 h. The MCR of DIIP was 2.8 ml/h/100 g BW and the volume of distribution was 27 ml/100 g BW, corresponding values for T3 being 34 ml/h/100 g BW and 175 ml/100 g BW. Subacute toxicology studies in rats showed that DIIP was not more toxic than T3. On the basis of these results, experiments were performed in man. Five male subjects received 40 micrograms DIIP p.o. and blood samples were collected over 17 days. The MCR was 54 ml/kg . day, the volume of distribution 188 ml/kg and the fractional disappearance rate 0.0119/h. When given to an hypothyroid patient, 16 20 micrograms DIIP daily was sufficient to restore clinical and biochemical euthyroidism. These studies demonstrate that a decreased MCR can be accompanied by increased biological activity. It is suggested that the limited monodeiodination of DIIP is one of the factors explaining the differences observed in the potency and metabolism of DIIP and T3. PMID- 6853682 TI - Radioimmunoassay of 3-L-monoiodothyronine: application in normal human physiology and thyroid disease. AB - A RIA for 3-monoiodothyronine (3T1) using tritiated ligand, has been validated for measurement of extracted serum. The mean euthyroid level of serum 3T1 was 2.9 +/- 1.7 ng/dl. In thyrotoxic patients, the mean serum 3T1 was significantly higher: 6.2 +/- 3.9 ng/dl (P less than 0.001) and in hypothyroid patients, the mean level was 2.1 +/- 1.5 ng/dl, lower but not significantly lower than the mean euthyroid level (P greater than 0.05). The mean serum level in severely ill patients was 2.5 +/- 1.5 ng/dl (P greater than 0.05) and in cord blood was significantly higher at 9.1 +/- 2.6 ng/dl (P less than 0.001). The appearance of 3T1 within 5 min in two normal volunteers after iv injection of 3,3' diiodothyronine was followed over 2 1/2 h. Thus 3T1 is a normal constituent of human plasma and is derived from 3,3'-diiodothyronine. Its concentrations appear to be severalfold higher than those reported for 3'T1. PMID- 6853683 TI - Use of oral calcium loading to characterize the hypercalciuria of young insulin dependent diabetics. AB - To investigate the pathogenesis of the alterations in bone and mineral metabolism that are found in young insulin-dependent diabetics (IDDs), we performed a standard oral calcium load in 26 IDDs, 7-18 yr of age, and in 17 normal children, 9-18 yr of age. Eighty-five percent of the IDDs had second metacarpal cortical bone widths below the mean for matched controls. Calcium excretion in the IDDs fell along a continuous spectrum, ranging from normal to values consistent with renal hypercalciuria. Immunoreactive PTH was significantly (P less than 0.03) lower in the IDDs compared to that in the controls, and 24,25-dihydroxyvitamin D was significantly elevated (P less than 0.001). We were not able to document a significantly lower concentration of 1,25-dihydroxyvitamin D in the IDDs. Serum calcium, phosphate, and PRL levels were normal, as were creatinine (Cr) clearance and 24-hr urinary cortisol excretion. There was no apparent correlation between the fasting and postload urinary Ca to Cr and glucose to Cr concentration ratios. The accumulated data suggest that in many young IDDs, there is a component of intestinal calcium hyperabsorption which results in appropriate feedback responses by the parathyroid gland and vitamin D metabolic pathway(s). This imbalance between circulating PTH and vitamin D metabolites could result in defective bone remodeling and decreased cortical thickness. PMID- 6853684 TI - Serum suppression of lymphocyte activation in vitro in acquired immunodeficiency disease. PMID- 6853685 TI - Circulating immune complexes in infected ventriculoatrial and ventriculoperitoneal shunts. AB - Distinguishing infected from noninfected ventriculoatrial (VA) or ventriculoperitoneal (VP) shunts is prognostically and therapeutically important. Eighty-seven serum samples from twenty-seven patients with VA or VP shunts were studied for the presence and quantification of circulating immune complexes. Eighty-three percent of the samples from infected shunts presented circulating immune complexes. Mean values of immune complexes in patients with infected shunts were significantly higher than in those without infection. In febrile, septicemic patients with few clinical symptoms, immune complexes were present, and their measurement in serial serum samples was a significant diagnostic aid. If circulating immune complex levels are not detectable, a shunt infection is less likely to be present. PMID- 6853687 TI - Phenotypic markers associated with gastrointestinal Aeromonas hydrophila isolates from symptomatic children. AB - Aeromonas hydrophila gastroenteritis was detected in 12 pediatric patients during a 5-month period. Chief complaints included bloody diarrhea, fever, vomiting, and abdominal pain. Severe symptoms in two patients necessitated hospitalization and supportive care. Phenotypic characteristics associated with enterotoxigenicity of A. hydrophila strains demonstrated that all 12 isolates were cytotoxic to HeLa cells and most were lysine decarboxylase positive (75%). A correlation existed between the presence of the five virulence-associated markers of two isolates of A. hydrophila and the severity of disease. Although the length and symptoms of gastroenteritis varied among all 12 patients, most had self-limiting diarrhea. The frequent occurrence of A. hydrophila gastroenteritis in pediatric patients warrants a greater appreciation of this agent as a significant cause of diarrhea, especially in summer. PMID- 6853686 TI - Agglutination of Naegleria fowleri and Naegleria gruberi by antibodies in human serum. AB - The capability of serum samples from 423 human subjects to agglutinate rounded cells of Naegleria fowleri nN68 was assessed. Sera from the umbilical cords of seven infants failed to agglutinate N. fowleri cells. The median agglutination titer was 1:4 for sera from children through age 4 years, 1:8 for sera from juveniles 5 to 15 years of age, and 1:16 for sera from subjects 15 to 30 years old. The agglutination titers of sera from older adults decreased to a median of 1:8 for the 40- to 60-year-old age group and to 1:4 for the 60- to 90-year-old subjects. Serum samples from young adults agglutinated rounded cells of both N. fowleri and N. gruberi. The agglutination activity for N. fowleri was removed by absorption with N. fowleri but not with N. gruberi. Conversely, agglutination activity for N. gruberi was removed by absorption with N. gruberi but not with N. fowleri. The agglutinating activity for N. fowleri was immunoglobulin M. Serum samples from children displayed markedly disparate capabilities to agglutinate N. fowleri and N. gruberi. Only rounded cells of N. fowleri or N. gruberi were reliably agglutinated by human serum samples. Live or paraformaldehyde-killed cells could be used in the assay, but live N. gruberi cells returned to the amoeboid form, and these agglutinated poorly. PMID- 6853689 TI - Enzyme-linked immunosorbent assay for detection of human antibodies to Salmonella typhi Vi antigen. AB - An enzyme-linked immunosorbent assay (ELISA) was developed to detect antibodies to Salmonella typhi Vi antigen in human serum, and the results were compared with those from a previously described hemagglutination assay (HA). The ELISA detected Vi antibodies at a titer of greater than or equal to 20 in 40 (52%) of 77 sera from typhoid fever patients, whereas the HA gave titers of greater than or equal to 20 in 35 (47%). Determination of titers of serum specimens from 170 persons without typhoid fever revealed Vi antibody titers of greater than or equal to 20 in 4 (2.3%) by the ELISA and 3 (1.7%) by the HA. Unlike the sensitized erythrocytes used in the HA, the ELISA reagents have a shelf life of greater than or equal to 1 year. The ELISA may be preferred by some laboratories, especially those already performing other ELISA tests. PMID- 6853688 TI - Evaluation of the usefulness of counterimmunoelectrophoresis for diagnosis of Clostridium difficile-associated colitis in clinical specimens. AB - Results of counterimmunoelectrophoresis (CIE) were compared with those of isolation of Clostridium difficile and assay for cytotoxicity in HeLa cells. On the basis of 471 stool specimens, CIE exhibited a sensitivity of 38% and a specificity of 88% as compared with the cytotoxin assay. The predictive value of a reactive CIE results is low (17%), whereas the predictive value of a nonreactive CIE result is significant (96%) and therefore warrants its use as a screening test. In addition, stool filtrates may nonspecifically precipitate with the C. difficile antitoxin in the CIE test. Such nonspecific reactions may be identified by simultaneous electrophoresis against nonimmune serum. PMID- 6853690 TI - Evidence for transient Staphylococcus epidermidis bacteremia in patients and in healthy humans. AB - A new blood lysis-filtration culture technique revealed a high incidence of Staphylococcus epidermidis in the blood of patients and of healthy people. Of 2,004 blood cultures from patients, the blood lysis method grew S. epidermidis in 233 (11.6%), whereas a conventional two-bottle culture system grew this organism in 48 (2.4%). To determine the incidence deriving from the skin, 100 mock blood cultures by each technique were performed. The antecubital fossa was prepared as for a phlebotomy. The needle was inserted through the skin but not into the vein. Needles were cultured by conventional and lysis-filtration culture. A total of 1 conventional culture of 100 (1%) and 2 lysis-filtration cultures of 100 (2%) grew S. epidermidis. Of 100 lysis-filtration and conventional control cultures with broth in place of blood, no cultures were positive. Blood samples from 8 of 117 (6.8%) healthy blood donors were positive for S. epidermidis by lysis-filtration, whereas no matching conventional cultures were positive. Phage typing patterns of skin and blood strains from selected individuals were the same. S. epidermidis isolates were often concomitant with isolates of bona fide pathogens. I conclude that intermittent, transient, asymptomatic S. epidermidis bacteremia occurs frequently in patients and in healthy humans. PMID- 6853691 TI - Enzyme-linked immunosorbent assay for antibodies against teichoic acid in patients with staphylococcal infections. AB - A highly purified teichoic acid preparation was used in an enzyme-linked immunosorbent assay to measure the specific immunoglobulin G (IgG) and IgM response in staphylococcal disease. Antibody determination in a normal population, showing a difference of up to 20-fold in the mean IgG titers between the youngest children and adults, was used to establish age-correlated upper normal values. IgM antibodies were found to be of little diagnostic value since their response was often low or absent. Increased IgG titers were found in 24 of 27 (89%) patients with endocarditis, in 11 of 14 (79%) with complicated septicemia, and in 10 of 20 (50%) with uncomplicated septicemia with serum samples drawn between days 7 and 30 of disease. With paired samples, the numbers of patients with increased IgG titers were 17 of 17, 3 of 4, and 6 of 7, respectively, in the same patient groups. Increased IgG titers were less often demonstrated in patients with chronic osteomyelitis (7 of 22). The enzyme-linked immunosorbent assay for teichoic acid antibodies was found to be a sensitive and specific method for diagnosing staphylococcal endocarditis and septicemia. For optimal results, both the substantial age-correlated variation in normal titers and the importance of adequately spaced samples should be considered. PMID- 6853692 TI - Edwardsiella tarda isolated in Israel between 1961 and 1980. AB - Edwardsiella tarda was isolated from patients, water tortoises (Clemmys caspica), and samples of water from Lake Kinnereth, the river Jordan, well water, and sewage water. Of the 53 isolates, 35 belonged to completely identified serotypes, among them 7 new ones. Fourteen cultures had O antigens, and one had an H antigen, different from those previously described. Three serotypes isolated from patients were also found in other sources: water tortoises, lake water, or both. PMID- 6853695 TI - Myasthenia gravis and multiple sclerosis. PMID- 6853694 TI - Outbreak of food poisoning caused by lactose-fermenting Salmonella tuebingen. AB - An outbreak of food poisoning occurred in a cafeteria and involved 102 student nurses. A lactose-fermenting strain of Salmonella tuebingen was isolated. The source was traced to the chicken consumed. Production of H2S was not evident on triple sugar iron but was detected on lysine iron agar. Therefore, the present report emphasizes the importance of bismuth sulfite agar and lysine iron agar for routine use in the isolation of salmonellae from stool. PMID- 6853696 TI - Interaction of foetal and adult human acetylcholine receptors with serum from patients with myasthenia gravis. AB - Acetylcholine receptors were partially purified from foetal and adult human muscle and their binding to myasthenic serum was compared. No significant differences between the binding characteristics of the two receptor types were detected; indicating the absence, at least in 14-22-week-old foetuses of antigenic sites unique to foetal receptor and recognised by myasthenic sera. PMID- 6853698 TI - The world need for schools of public health. PMID- 6853693 TI - Association of Streptococcus bovis bacteremia with bowel disease. AB - We reviewed the medical records of 19 patients who had Streptococcus bovis bacteremia. Eight patients had diverticulosis, four had benign adenomatous colonic polyps, and three had adenocarcinomas of the gastrointestinal tract. Laboratory workers and clinicians should be aware of the association of S. bovis bacteremia and gastrointestinal disease. PMID- 6853697 TI - Characterization of immune complexes in multiple sclerosis by an antigen-specific immune complex radioimmunoassay. AB - Serum and cerebrospinal fluid samples from multiple sclerosis (MS) patients containing various levels of Clq-reactive immune complexes (IC) and samples from age- and sex-matched controls were tested by an antigen-specific IC radioimmunoassay which detects IC containing myelin membrane-related antigens. Positive reactivity in the assay was significantly associated with IC-containing MS sera (P less than 0.005) but such an association was not observed with MS cerebrospinal fluid. Analysis of longitudinal specimens revealed that the levels of the antigen-specific serum IC fluctuated with time. Significant correlation between serum levels of Clq-reactive IC and serum levels of IC containing myelin membrane-related antigens was observed (r = 0.62; P less than 0.001). Sucrose gradient centrifugation of sera from 1 patient showed that the IC had a peak density of 1.075 g/ml, indicating the presence of lipid material. The results suggest that serum IC of MS patients frequently contain myelin membrane-related antigens and that these antigens may be lipids or lipid-associated. PMID- 6853699 TI - Down solid: the origins and development of the black lung insurgency. PMID- 6853702 TI - Integrated housing for the elderly. PMID- 6853700 TI - Employer consideration of health promotion programs: financial variables. PMID- 6853701 TI - Uranium mining in Northwest New Jersey. PMID- 6853703 TI - Mental disorder and primary care in the United Kingdom. PMID- 6853704 TI - Health services in the Socialist Republic of Romania: structural features and cost-containment policies. PMID- 6853705 TI - Influence of successive vagal stimulations on contractions in esophageal smooth muscle of opossum. AB - Studies were performed in anesthetized opossums to investigate the influence of successive vagal stimuli on esophageal contractions. Mechanical activity was recorded manometrically 5 cm above the lower esophageal sphincter. Contractions in the esophagus were evoked by electrical stimuli of 2.5 mA, and 1-ms pulse duration applied to the cervical vagi, at various train durations and frequencies. Paired or multiple stimuli of 1-s train length were also tested at different interstimulus intervals (ISI). Paired stimuli at an ISI of less than or equal to 3 s and at a frequency of less than or equal to 10 Hz showed refractoriness, i.e., the contractions to the first stimulus inhibited the contraction to the second stimulus. A frequency of 50 Hz showed initial inhibition, i.e., the second stimulus inhibited the contraction to the first stimulus. Repetitive stimuli applied at a rate of 8/min (ISI 6.5 s) evoked contractions to each stimulus. At 15/min, every second or third contraction was inhibited. With stimuli applied at 30/min, contractions occurred only in response to the first and/or the last stimulus; depending upon the frequency of vagal stimulation. The intervening stimuli did not evoke any contractions. A long train stimulus produced an initial, a terminal, or both contractions depending on the stimulation value. These studies show that (a) vagal efferent stimulation causes initial inhibition and refractoriness in the esophageal smooth muscle; (b) the degree of initial inhibition increases with increasing frequency of stimulation; (c) the occurrence of contractions only at the onset and the end of a long train stimulus may be due to the influence of initial inhibition and refractoriness. PMID- 6853706 TI - Metabolic alkalosis in the rat. Evidence that reduced glomerular filtration rather than enhanced tubular bicarbonate reabsorption is responsible for maintaining the alkalotic state. AB - Maintenance of chronic metabolic alkalosis might occur by a reduction in glomerular filtration rate (GFR) without increased bicarbonate reabsorption or, alternatively, by augmentation of bicarbonate reabsorption with a normal GFR. To differentiate these possibilities, free-flow micropuncture was performed in alkalotic Munich-Wistar rats with a glomerular ultrafiltrate total CO2 concentration of 46.5 +/- 0.9 mM (vs. 27.7 +/- 0.9 mM in controls). Alkalotic animals had a markedly reduced single nephron GFR compared with controls (27.4 +/ 1.5 vs. 51.6 +/- 1.6 nl/min) and consequently unchanged filtered load of bicarbonate. Absolute proximal bicarbonate reabsorption in alkalotic animals was similar to controls (981 +/- 49 vs. 1,081 +/- 57 pmol/min), despite a higher luminal bicarbonate concentration, contracted extracellular volume, and potassium depletion. When single nephron GFR during alkalosis was increased toward normal by isohydric volume expansion or in another group by isotonic bicarbonate loading, absolute proximal bicarbonate reabsorption was not substantially augmented and bicarbonaturia developed. To confirm that a fall in GFR occurs during metabolic alkalosis, additional clearance studies were performed. Awake rats were studied before and after induction of metabolic alkalosis associated with varying amounts of potassium and chloride depletion. In all cases, the rise in blood bicarbonate concentration was inversely proportional to a reduction in GFR; filtered bicarbonate load remained normal. In conclusion, a reduction in GFR is proposed as being critical for maintaining chronic metabolic alkalosis in the rat. Constancy of the filtered bicarbonate load allows normal rates of renal bicarbonate reabsorption to maintain the alkalotic state. PMID- 6853708 TI - Platelet-derived growth factor promotes proliferation of erythropoietic progenitor cells in vitro. AB - To investigate serum requirements for optimal erythropoiesis in vitro, we studied the response of erythroid progenitor cell proliferation in culture to platelet derived growth factor (PDGF). Human bone marrow cells cultured with platelet-poor plasma-derived serum (PDS) form fewer erythroid colonies than do cells cultured with human whole blood serum or fetal calf serum (P less than 0.05). Treatment of washed platelets with thrombin releases a low molecular weight (less than 100,000) factor that enhances colony growth. This secreted factor appears to be PDGF, based upon the ability of partially purified and electrophoretically pure PDGF to restore colony-forming capacity of PDS-containing cultures to 70-96% of the level found in control cultures with whole blood serum or fetal calf serum. Enhancement of colony growth by PDGF was noted only in marrow cultures supplemented with erythropoietin and PDS. Presence of bioactive erythropoietin in PDGF preparations was excluded by assay in hypertransfused, polycythemic mice, and in fasted rats. Although PDGF stimulates erythroid burst formation in marrow cultures containing optimal concentrations of burst-promoting activity (BPA), it does not influence proliferation of circulating erythroid bursts, regardless of BPA concentration added to culture. We conclude that PDGF is a serum determinant of optimal erythroid progenitor cell proliferation in marrow culture. The activity of PDGF is distinct from that of the apparent erythroid specific growth factors erythropoietin and BPA. PMID- 6853710 TI - Pyridoxal phosphate as an antisickling agent in vitro. AB - Although pyridoxal phosphate is known to inhibit gelation of purified hemoglobin S, antisickling activity has never been demonstrated for intact erythrocytes. We incubated washed erythrocytes at 37 degrees C either in buffer alone, or with added pyridoxal phosphate or pyridoxal, washed these cells, suspended them in untreated buffer, and compared the percent modified hemoglobin, the oxygen affinity, and the extent of sickling under hypoxia. Pyridoxal phosphate modified intracellular hemoglobin more slowly than pyridoxal. Pyridoxal phosphate lowered the oxygen affinity of normal cells, but had no effect on oxygen binding by sickle cells. Pyridoxal increased the oxygen affinity of normal and sickle erythrocytes equally. Pyridoxal phosphate significantly inhibited sickling of sickle or sickle trait erythrocytes (P less than 0.001). Inhibition of sickling by pyridoxal phosphate was largely independent of oxygen binding; whereas inhibition of sickling by pyridoxal was almost entirely dependent on increased oxygen binding. Although pyridoxal phosphate and pyridoxal both inhibit sickling by modification of hemoglobin S, they differ in the kinetics of whole cell modification, the effect on oxygen affinity of intact cells, and the mechanism of action of the antisickling activity. PMID- 6853709 TI - Oxidant damage of the lipids and proteins of the erythrocyte membranes in unstable hemoglobin disease. Evidence for the role of lipid peroxidation. AB - Since unstable hemoglobins have been considered a source of reactive oxygen radicals, and oxidative membrane damage a prehemolytic event, we examined the erythrocyte membranes of six patients (three splenectomized) with hemoglobin Koln disease. In the hydrogen peroxide stress test, the patients' erythrocytes generated more than twice the malonyldialdehyde (a lipid peroxidative product) than control erythrocytes. Fluorescence spectra of lipid extracts of the patients' erythrocytes showed an excitation maximum at 400 nm and an emission maximum of 460 nm, characteristic of malonyldialdehyde lipid adducts. Two types of membrane polypeptide aggregates were found in the erythrocytes of the splenectomized patients. The first, which were dissociable by treatment with mercaptoethanol, contained disulfide-linked spectrin, band 3 and globin. The second, not dissociable by mercaptoethanol, had an amino acid composition similar to that of erythrocyte membranes and spectrin (unlike globin) and like that of aggregates produced by the action of malonyldialdehyde on normal erythrocyte membranes. Atomic absorption spectroscopy of hemoglobin Koln erythrocytes showed no increase in calcium content implying that these cross-links were not due to calcium-stimulated transglutaminase. Using a micropipette technique, we demonstrated that erythrocytes containing membrane aggregates from splenectomized patients were less deformable while aggregate-free erythrocytes from non splenectomized patients had normal deformability. We conclude that the erythrocyte membranes in hemoglobin Koln disease show evidence of lipid peroxidation with production of malonyldialdehyde, and that the nondissociable membrane aggregates formed in this disease are likely cross-linked by malonyldialdehyde. Because the erythrocytes containing membrane aggregates from splenectomized patients with unstable hemoglobin disease show decreased membrane deformability, we hypothesize that this abnormality results in premature erythrocyte destruction in vivo. PMID- 6853707 TI - Chronic cobalamin inactivation impairs folate polyglutamate synthesis in the rat. AB - Nitrous oxide, by inactivating cobalamin in vivo, produces a suitable animal model for cobalamin 'deficiency.' The synthesis of folate polyglutamate with tetrahydrofolate as substrate is severely impaired in the N2O-treated rat, but is normal with formyltetrahydrofolate as substrate. Methionine restores the capacity of the N2O-treated rat to utilize tetrahydrofolate the minimum effective dose being 16 mumol. S-Adenosylmethionine was somewhat less effective than methionine but 5'methylthioadenosine, a product of S-adenosylmethionine metabolism, was significantly more effective than methionine in correcting the defect in folate polyglutamate synthesis. 5'Methylthioadenosine is metabolised to yield formate. It is suggested that these compounds have their effect in correcting folate polyglutamate synthesis by supplying formate for the formylation of tetrahydrofolate. Formyltetrahydrofolate, at least in the cobalamin-inactivated animal, is the required substrate for folate polyglutamate synthesis. Cobalamin is concerned with the maintenance of normal levels of methionine and this in turn is a major source of formate through S-adenosylmethionine and 5'methylthioadenosine. PMID- 6853712 TI - Inhibition of cardiac sympathetic nerve activity during intravenous administration of lidocaine. AB - The antiarrhythmic action of lidocaine has been attributed solely to its direct electrophysiological effects on the heart. However, lidocaine is particularly effective in treating ventricular arrhythmias associated with increased sympathetic activity, e.g., in myocardial infarction and digitalis toxicity. We tested the hypothesis that lidocaine administered intravenously depressed cardiac sympathetic nerve activity (CSNA). We measured CSNA in six dogs in control state and after lidocaine in doses of 0.625, 1.25, and 2.5 mg/kg i.v. over 2 min. These doses of lidocaine produced graded decreases of CSNA of -8 +/- 2, -18 +/- 1, and 41 +/- 5%, respectively (P less than 0.05, mean +/- SE). In six additional experiments the bolus of lidocaine was followed by an infusion for 20 min (1.25 mg/kg followed by 100 micrograms/kg per min and 2.5 mg/kg followed by 200 micrograms/kg per min). Infusion of lidocaine maintained depression of CSNA at a level that was 23 +/- 3 and 35 +/- 5% less than control (P less than 0.05), respectively, at plasma lidocaine levels of 5.2 +/- 0.6 and 7.5 +/- 1.4 micrograms/ml, respectively. CSNA returned to control during recovery periods. CSNA did not decrease with the passage of time or administration of vehicle. In five dogs with vagi intact, carotid sinuses isolated and held at a pressure of 100 mmHg, and aortic baroreceptors denervated, administration of lidocaine (2.5 mg/kg followed by 200 micrograms/kg per min) decreased renal nerve activity to 71 +/- 8% of control. Increases in left ventricular systolic pressure and maximum derivative of pressure with respect to time (dP/dtmax) resulting from electrical stimulation of preganglionic sympathetic nerves were not significantly altered by lidocaine, but were markedly attenuated by hexamethonium, a ganglionic blocker. In conclusion, lidocaine administered intravenously produces dose-dependent and sustained decreases in cardiac sympathetic nerve activity. These decreases can occur with therapeutic plasma levels. We speculate that this effect is due to central nervous system effects of the drug and that this effect may contribute to the antiarrhythmic actions of lidocaine. PMID- 6853711 TI - Natural killer cell in systemic lupus erythematosus. Defects in effector lytic activity and response to interferon and interferon inducers. AB - Spontaneous cytotoxicity mediated by natural killer (NK) cells is impaired in several human diseases including systemic lupus erythematosus (SLE). The precise mechanism(s) by which NK activity is suppressed in patients with SLE is generally unknown. The present study was designed to focus on cellular defects per se in NK cells from patients with SLE. It was observed that the usual enhancing effect of interferon (IF) and IF inducers was markedly impaired in SLE patients. Of 24 SLE patients studied, 17 had significantly decreased NK activity relative to controls. NK activity had a significant negative correlation with clinical activity score (r = -0.56, P less than 0.005) but was not correlated with corticosteroid dose, antinuclear antibody titers, total hemolytic complement (CH50), or sedimentation rate. Furthermore, significant depressions in NK activity correlated with variations in disease activity in six patients followed serially. Depressed NK function could not be reversed by prolonged in vitro incubation at 37 degrees C or with protease treatment. Furthermore, depressed NK activity was not altered by removal of glass adherent cells nor was a suppression of NK activity in normal controls seen by the addition of SLE peripheral mononuclear cells. No reversal of depressed activity to normal levels was seen by the addition of indomethacin nor did the supernatants from SLE cell cultures cause a suppression of normal NK function. NK activity in SLE patients did not respond normally to IF inducers (poly-I:C and concanavalin A) even if the SLE patients had normal NK function. The response of SLE cells to exogenous IF was also impaired. The number of effector-target conjugates was quantitated with several target cells (K562, Yac-1, Fravel) in SLE patients and controls. A significant correlation between the proportion of glass nonadherent mononuclear cells that formed effector-target conjugates with these various targets and the magnitude of NK lysis was observed. However, SLE and normal subjects had equal numbers of effector-target conjugates independent of NK function. Release of a soluble cytotoxic factor was induced with concanavalin A, and was markedly impaired in SLE patients relative to normal controls. Thus, impaired NK cell function in SLE does not appear to be related to cell-mediated suppressive mechanisms or to the deletion of effector cells; rather, the decreased NK activity may be related to an impaired release of a soluble cytotoxic factor. PMID- 6853713 TI - Intravenous infusion of L-isomers of phenylalanine and tryptophan stimulate gastric acid secretion at physiologic plasma concentrations in normal subjects and after parietal cell vagotomy. AB - To determine whether intravenous infusion of individual amino acids stimulated gastric acid secretion in man, graded doses of phenylalanine, tryptophan, glycine, alanine, histidine, and NaCl control were infused on separate days in nine healthy subjects. Intravenous infusion of phenylalanine and tryptophan significantly stimulated gastric acid secretion to 50 and 52%, respectively, of the acid secretory response to intragastric peptone. Intravenous alanine and histidine were without effect, whereas glycine produced a slight response. Serum gastrin concentrations did not significantly change during intravenous amino acid infusion, except in response to 0.1 M phenylalanine. However, the increase in serum gastrin occurred 2 h after acid secretion had significantly increased in response to the 0.025 M phenylalanine infusion. Plasma amino acid concentrations were measured during intravenous amino acid infusion and in response to a steak meal in five of the subjects. At a time when acid secretion was significantly increased during intravenous infusion of phenylalanine and tryptophan, plasma amino acids were similar to, or less than, that observed after the steak meal, suggesting that circulating levels of these three amino acids have a physiologic effect on gastric secretion in man. Intravenous infusion of a combination of graded doses of phenylalanine plus a continuous infusion of 0.01 M tryptophan shifted the dose-response curve to the left and resulted in a significantly greater response than to either amino acid alone. In five subjects with parietal cell vagotomy, intravenous phenylalanine and tryptophan stimulated acid secretion, whereas histidine was without effect, similar to normal subjects. These studies indicate that intravenous infusion of small amounts of phenylalanine (0.025 M, 3.1 mmol/h) and tryptophan (0.01 M, 1.25 mmol/h) stimulated gastric acid secretion at plasma concentrations similar to those observed after a steak meal, suggesting a physiologic role for circulating levels of these amino acids on gastric acid secretion. Because acid secretion increased at a time when serum gastrin was unchanged and since there was no correlation between changes in serum gastrin and acid secretion, the responses to phenylalanine and tryptophan are probably mediated by a nongastrin-related mechanism(s). Since both phenylalanine and tryptophan stimulated secretion in vagotomized subjects, the response is vagally independent. These observations suggest that circulating levels of these two amino acids have either a direct or indirect effect on or near the human parietal cell. PMID- 6853714 TI - Sympathoadrenal responses to acute and chronic hypoxia in the rat. AB - The sympathoadrenal responses to acute and chronic hypoxic exposure at 10.5 and 7.5% oxygen were determined in the rat. Cardiac norepinephrine (NE) turnover was used to assess sympathetic nervous system (SNS) activity, and urinary excretion of epinephrine (E) was measured as an index of adrenal medullary activity. The responses of the adrenal medulla and SNS were distinct and dependent upon the degree and duration of hypoxic exposure. Chronic hypoxia at 10.5% oxygen increased cardiac NE turnover by 130% after 3, 7, and 14 d of hypoxic exposure. Urinary excretion of NE was similarly increased over this time interval, while urinary E excretion was marginally elevated. In contrast, acute exposure to moderate hypoxia at 10.5% oxygen was not associated with an increase in SNS activity; in fact, decreased SNS activity was suggested by diminished cardiac NE turnover and urinary NE excretion over the first 12 h of hypoxic exposure, and by a rebound increase in NE turnover after reexposure to normal oxygen tension. Adrenal medullary activity, on the other hand, increased substantially during acute exposure to moderate hypoxia (2-fold increase in urinary E excretion) and severe hypoxia (greater than 10-fold). In distinction to the lack of effect of acute hypoxic exposure (10.5% oxygen), the SNS was markedly stimulated during the first day of hypoxia exposure at 7.5% oxygen, an increase that was sustained throughout at least 7 d at 7.5% oxygen. These results demonstrate that chronic exposure to moderate and severe hypoxia increases the activity of the SNS and adrenal medulla, the effect being greater in severe hypoxic exposure. The response to acute hypoxic exposure is more complicated; during the first 12 h of exposure at 10.5% oxygen, the SNS is not stimulated and appears to be restrained, while adrenal medullary activity is enhanced. Acute exposure to a more severe degree of hypoxia (7.5% oxygen), however, is associated with stimulation of both the SNS and adrenal medulla. PMID- 6853715 TI - Isolation and chemical characterization of 2-hydroxybenzoylglycine as a drug binding inhibitor in uremia. AB - An organic compound that inhibits drug binding in uremia has been isolated from the sera of chronic renal failure patients, and its chemical structure has been determined. Addition of the compound to normal human sera in vitro resulted in drug binding defects similar to those seen in uremia. The purification of this substance was accomplished by n-butyl chloride extraction of acidified (pH 3.0) uremic sera followed by column chromatography, thin-layer chromatography, and paper electrophoresis. From analytical studies including ultraviolet and fluorescence spectroscopy, gas chromatography, chemical ionization and electron impact mass spectrometry, and proton nuclear magnetic resonance spectroscopy, the chemical structure of the uremic binding inhibitor was deduced to be 2 hydroxybenzoylglycine. This confirms the hypothesis that the drug binding defect in uremia is due to the accumulation of endogenous metabolic products rather than an intrinsic structural defect in albumin. PMID- 6853716 TI - Molecular basis of hypoxanthine-guanine phosphoribosyltransferase deficiency in a patient with the Lesch-Nyhan syndrome. AB - We have investigated the molecular basis of hypoxanthine-guanine phosphoribosyltransferase (HPRT) deficiency in a patient who presented with the Lesch-Nyhan syndrome. A catalytically incompetent form of HPRT has been isolated from this patient's erythrocytes and lymphoblasts. This enzyme variant, which we have termed HPRTKinston, is indistinguishable from the normal enzyme in terms of its intracellular concentration and maximal velocity, but differs with respect to its isoelectric point (more basic) and Michaelis constants for both substrates (markedly elevated). The tryptic peptides of HPRTKinston were mapped by reverse phase high pressure liquid chromatography in an attempt to define the precise abnormality in its primary structure. Sequence analysis of the single aberrant tryptic peptide in HPRTKinston revealed an aspartic acid to asparagine amino acid substitution at position 193. Electrophoretic analysis of the CNBr peptides of HPRTKinston confirmed the location of the proposed mutation. This amino acid substitution can be explained by a single nucleotide change in the codon for aspartic acid 193 (GAC leads to AAC). This is the first specific mutation described at the molecular level in a patient with the Lesch-Nyhan syndrome. PMID- 6853717 TI - Contribution of fibrin stabilization to clot strength. Supplementation of factor XIII-deficient plasma with the purified zymogen. AB - The contribution of fibrin stabilization to clot strength, measured as the static elastic modulus, was evaluated in human plasma by two independent procedures. In the first approach, amine inhibitors of fibrin stabilization were examined for their effects on the rigidity of normal plasma clots. It is a unique property of these inhibitors that they do not interfere with the reversible aggregation of fibrin molecules, i.e., do not delay clotting time, but selectively prevent only the formation of gamma-glutamyl-epsilon-lysine protein-to-protein linkages. Though the compounds tested were of different chemical structures and potencies, a fivefold reduction in clot strength was obtained in each instance. This value of 20% of normal seems to correspond to the rigidity of the Factor XIII-deficient plasma clot because, as demonstrated by the second approach, when a plasma specimen that genetically lacked the fibrin stabilizing factor was supplemented by the addition of measured amounts of the purified zymogen, a fivefold increase in clot strength could be achieved. The described procedure of evaluating Factor XIII in terms of correcting the elastic modulus of a deficient plasma clot is considered an important assay for the functional competence of purified preparations of the zymogen for the purpose of therapeutic application. PMID- 6853719 TI - Intracellular chloride activities in canine tracheal epithelium. Direct evidence for sodium-coupled intracellular chloride accumulation in a chloride-secreting epithelium. AB - Canine tracheal epithelium secretes Cl via an electrogenic transport process that appears to apply to a wide variety of secretory epithelia. To examine the mechanisms involved, intracellular chloride activity, acCl, was measured with Cl selective intracellular microelectrodes. The results indicate that when the rate of secretion was minimal acCl was 37 mM; with stimulation of secretion the intracellular voltage depolarized, but acCl was not significantly altered, at 39 mM. These findings indicate that: (a) Cl is accumulated across the basolateral membrane under nonsecreting and secreting conditions at an activity 3.8 and 2.4 times, respectively, that predicted for an equilibrium distribution; (b) Cl exit across the apical membrane may be passive with an electrochemical driving force of 22 mV; and (c) stimulation of secretion enhanced the rate of Cl entry across the basolateral membrane, since Cl transport increased without a change in acCl. In the absence of Na in the extracellular fluid, acCl approached the value expected for an equilibrium distribution. This finding suggests that "uphill" entry of Cl into the cell against its electrochemical gradient is dependent upon, and energized by, the entry of Na down its gradient. Submucosal bumetanide, a loop diuretic, also decreased the rate of Cl secretion and decreased acCl, indicating an inhibition of Cl entry. These findings indicate that Cl entry into the cell is directed against its electrochemical gradient and is mediated by a Na coupled, bumetanide-inhibitable, transport process at the basolateral membrane and that Cl may exit passively down a favorable electrochemical gradient across the apical membrane. PMID- 6853718 TI - Canine cyclic hematopoiesis is associated with abnormal purine and pyrimidine metabolism. AB - Canine cyclic hematopoiesis is an autosomal recessive disease characterized by regular 11-13-d cycles of the neutrophil, reticulocyte, and platelet counts caused by a defect in regulation of marrow stem cell proliferation. Treatment with lithium abrogates cycling of the cell counts in these grey collie dogs. Aware of the defective lymphopoiesis associated with adenosine deaminase and purine nucleoside phosphorylase deficiencies, we hypothesized that abnormal purine or pyrimidine metabolism might be present in these dogs. Using high pressure liquid chromatography, we measured erythrocyte purine and pyrimidine nucleotide levels and plasma purine and pyrimidine nucleosides and bases in normal and grey collie dogs before and during lithium treatment. During neutropenic periods in the grey collies, erythrocyte ATP, GTP, and UTP levels were significantly elevated. Normal dogs made neutropenic with cyclophosphamide did not show such elevations. Lithium treatment normalized the levels of erythrocyte ATP, GTP, and UTP in the grey collies and eliminated the differences between normal and grey collie nucleotide levels. Plasma thymine levels were markedly increased during neutropenia in the grey collie but were not increased in cyclophosphamide-treated normal dogs. The finding of abnormal concentrations of purine and pyrimidine metabolites in these dogs suggest that a metabolic derangement in purine or pyrimidine metabolism may be the cause of the defective stem cell proliferation in this disease. PMID- 6853720 TI - Relative ion permeability of normal and cystic fibrosis nasal epithelium. AB - The raised transepithelial electric potential difference (PD) across respiratory epithelia in cystic fibrosis (CF) has suggested an abnormality in ion permeation. We characterized this abnormality further by measuring in the nasal epithelia of CF and normal subjects the concentration-PD relationship for amiloride, an inhibitor of cell Na+ permeability, and PD responses to superfusion with solutions of different composition. Amiloride was more efficacious in the CF subjects but the ED50 was not different from that of normals (approximately 2 X 10(-6) M). Na+ replacement by choline induced effects similar to those of amiloride, i.e. a greater depolarization in CF subjects. A 10-fold increase in the K+ concentration of the perfusate induced a small (less than 10 mV) depolarization in both subject populations. When Cl- in the perfusate was replaced by gluconate or SO2-(4) the nasal PD of normal subjects hyperpolarized (lumen became more negative) by approximately 35 mV. A significantly smaller response (less than 17 mV) was induced in CF homozygotes but not in heterozygotes (38 mV). The smaller response of CF subjects appears to reflect an absolute decrease in luminal surface Cl- permeability because pretreatment with amiloride did not increase the response to Cl- free solution (7 mV). Accordingly, three abnormalities (decreased Cl- permeability, raised PD, greater amiloride efficacy) have been identified in CF respiratory epithelia. Whereas "excessive" active Na+ transport can account for these abnormalities and the dessication of airway surface liquid, it is possible that a lower lumenal cell membrane Cl- permeability and inhibition of a potential path of Cl- secretion can also explain the observations. PMID- 6853721 TI - Acute effects of amiodarone upon the canine sinus node and atrioventricular junctional region. AB - Amiodarone was selectively perfused into the sinus node artery and atrioventricular node artery of 51 dogs. Amiodarone had an immediate negative chronotropic and dromotropic effect. Threshold concentration was 2.5 micrograms/ml. 25 and 50 micrograms/ml of amiodarone injected into the sinus node artery slowed the heart by 25.6 +/- 3.1 and 33.7 +/- 2.6 beats/min (mean +/- 1 SEM), respectively. Amiodarone 25 and 50 micrograms/ml injected into the AV node artery during AV junctional rhythm slowed the AV junctional pacemaker by 12.2 +/- 1.8 and 17.4 +/- 1.7 beats/min, respectively. Injections of amiodarone into the AV node artery during sinus rhythm regularly increased AV conduction time sometimes causing 2 degrees AV block at the highest concentration used. Impaired conduction was exclusively measured at the level of the A-H interval in the His electrogram. Neither atropine nor propranolol prevented the negative chronotropic effects of amiodarone. Amiodarone had no significant effect on sinus node response to either stellate stimulation or intranodal administration of norepinephrine. The negative chronotropic action of amiodarone was significantly enhanced when amiodarone was administered in a perfusate containing low (0.6 mM) instead of normal calcium. Taken collectively these observations indicate that amiodarone has immediate depressant electrophysiologic effects on both the sinus node and the AV junction and that these early effects might involve the blockade of the slow channel. PMID- 6853722 TI - Iron binding proteins of iron-absorbing rat intestinal mucosa. AB - The distribution and quantitation of the iron-binding proteins of rat small intestinal mucosa was studied, in iron-deficient and replete animals, to explore their role in the absorption of iron. Adsorption (mucosal uptake) of iron in in situ ligated loops of small intestinal mucosa was found to be uniform throughout the length of the small intestine whereas absorption (carcass uptake) showed a steep decreasing gradient from the duodenum to the ileum. The disrupted, in vivo labeled mucosal cells were fractionated by isopycnic centrifugation and transferrin and ferritin were quantitated by radioimmunoassay. Transferrin derived from mucosal cells was shown to have a higher affinity for the antibody than transferrin in serum. Of the transferrin present in the mucosal extract, only a portion could be accounted for by contamination from the serum; the proteolysis resistant and intrinsic transferrin may be mucosal cell specific. Transferrin was found in similar amounts in all regions of the small intestine, was not affected by iron loading but doubled in response to iron deficiency. Mucosal ferritin was found in greater amounts in the iron-absorbing areas of the intestine, increased in the duodenum of iron-loaded animals, and decreased in iron-deficient animals. The incorporation of newly absorbed radioiron into ferritin was only found in iron absorbing regions and was completely inhibited by colchicine and cytochalasin-B, suggesting that ferritin was loaded with iron at the point of iron absorption and that the process is associated with vesicle movement and not simple diffusion. Transferrin and ferritin-specific immunoabsorption and also gel filtration established that no other soluble iron binding proteins were involved in absorption. PMID- 6853723 TI - Hydrophobic surfactant treatment prevents atherosclerosis in the rabbit. AB - The hypocholesterolemic effect of the hydrophobic surfactant, poloxalene 2930, was studied in the rabbit to determine whether this agent prevents experimentally produced atherosclerosis. Male rabbits were divided into four groups and fed a control diet (group A) or an atherogenic diet (groups B, C, and D) for 10 wk. Diets of groups C and D were supplemented with 0.5 and 1% poloxalene 2930, respectively. Animals in group B developed significantly greater levels of cholesterol in the serum and aorta compared with group A. Addition of poloxalene 2930 to the diets of groups C and D prevented significant elevations in cholesterol concentrations of both serum and aorta compared with group B with values for group D being essentially similar to those observed in group A. Groups C and D also had significant increases of fecal excretion of both neutral fat and neutral steroids as compared with either groups A or B. There were no atherosclerotic lesions of the aortas from group D. Aortas from rabbits in group B had numerous atheromatous plaques while one rabbit each from groups A and C had several very small atheromatous lesions. These results demonstrate that poloxalene 2930 reduces the rise of serum cholesterol in rabbits in response to an atherogenic diet and prevents the development of atherosclerosis. This hypocholesterolemic effect is likely mediated by the effect of this surfactant on the small intestine. PMID- 6853725 TI - Decreased atherogenic response to dietary cholesterol in pigeons after stimulation of cholesterol catabolism in early life. AB - Cholesterol catabolism was stimulated in 6-wk-old White Carneau pigeons using a laboratory stock diet containing 1.3% cholestyramine resin. After 8 wk on this diet the animals were returned to control stock diet (no resin) for another 8-wk period. When subsequently challenged with a diet containing 0.5% cholesterol, cholestyramine-pretreated pigeons exhibited significantly lower serum cholesterol level when compared with controls and this "hyporesponder" behavior persisted throughout the study period. Furthermore, the aorta of cholestyramine-treated animals exhibited significantly (a) lower prevalence and severity of atherosclerosis and (b) lower cholesterol content. These studies demonstrate for the first time that enhancement of cholesterol catabolism in early life improves resistance to diet-induced atherosclerosis in later life in this avian model. PMID- 6853726 TI - The cytochemical bioassay of parathyroid hormone: further experience. AB - The procedure for the cytochemical bioassay of parathyroid hormone has been examined to improve the reliability and robustness of the assay. It has been shown that the control of the pH, at all stages of the assay, is essential. The use of the assay confirmed that the circulating level of the biologically active form of this hormone is less than one tenth of the values found by the more recent immunoassays, and is in good agreement with previously calculated values. The assay clearly distinguished between normal, hypoparathyroid and hyperparathyroid levels and allowed relative potencies to be ascribed to preparations of the hormone obtained from human, bovine and porcine sources. PMID- 6853724 TI - Anion dependence of rabbit medullary collecting duct acidification. AB - Rabbit medullary collecting duct (MCD) acidification has been demonstrated to occur by means of a sodium-independent, aldosterone-stimulated mechanism. We have examined the anionic dependence of this process by means of the isolated perfused tubule technique. Total replacement of perfusate chloride with gluconate enhanced tubular bicarbonate reabsorption (JHCO3), from a basal rate of 10.7 +/- 1.0 pmol X mm-1 X min-1 to a rate of 15.01 +/- 1.0 pmol X mm-1 X min-1. Removal of bath chloride, with and without removal of perfusate chloride completely abolished acidification. Bath, but not luminal 4-acetamido-4' isothiocyano-2,2'-disulfonic stilbene provoked a marked decrease in JHCO3 from 10.1 +/- 1.2 pmol X mm-1 X min 1 to 2.3 +/- 0.3 pmol X mm-1 X min-1. Measurement of chloride reabsorptive rate (JCl) revealed colinearity between JHCO3 (9.18 +/- 0.9 pmol X mm-1 X min-1) and JCl (9.75 +/- 1.18 pmol X mm-1 X min-1). We propose a model of mammalian distal nephron acidification in which (a) cellular base exit is effected by means of a basolateral membrane Cl-base exchanger and (b) net electroneutrality of electrogenic proton secretion is maintained by the parallel movement of an anionic species, functionally chloride. PMID- 6853727 TI - A homologous biological probe for parathyroid hormone in human serum. AB - A method of measuring the biological activity of parathyroid hormone (PTH) in human serum that depends on the activation of its natural target enzyme, human renal cortical adenylate cyclase, is described. Optimal sensitivity ranging in different assays from 14 to 20 pg 1-34 hPTH/ml was achieved in the presence of the GTP-analogue GppNHp (10 mumol/L), 5 mmol/L MgCl2 and 1.25 mmol/L EGTA. Basal and stimulated cAMP production was reproducible within assays (c.v. below 7%, S.E.M., n = 3) and between assays (c.v. 5 to 14%, S.E.M., n = 4). The recovery of 1-34 hPTH added to individual test sera averaged 94%. The specificity of the method was established as follows: 1.) Other tested hormones, at 100 ng/ml, were ineffective; 2.) In the majority of peripheral sera from patients with hyperfunctioning parathyroid glands elevated bio-activity was detected; 3.) The circulating bio-activity fell rapidly after removal of parathyroid adenomata; 4.) Treatment with antisera for hPTH reduced the bio-activity; 5.) A PTH-antagonist inhibited the bio-activity. PMID- 6853729 TI - Screening hospital patients for uterine cervical cancer. AB - Women patients admitted to a district general hospital with non-gynaecological conditions were offered a cervical smear test. In three years 2296 women were tested. Serious uterine pathology was detected in 13 patients (5.7 per 1000) and significant cytological abnormalities (dyskaryosis of all grades) in 46 (20.0 per 1000). Of the women screened 963 (41.9%) had never had a smear test before and 1608 (70.0%) were over 39 yr. The results show that cervical screening of non gynaecological patients in hospital reaches many of the women at risk for cervical cancer who do not otherwise have smears taken and reveals considerable uterine pathology. PMID- 6853728 TI - A sensitive double isotope modification of the Farr assay using beta-particle emitters. AB - A sensitive modification of the ammonium sulfate precipitation assay for antibody affinity is described. The assay combines small reaction volumes and a 32P volume marker to determine the average relative affinity of small amounts of antibody to DNP hapten. The assay is relatively safe since two beta-particle emitters are utilized instead of two gamma-ray emitters. The assay has proven useful for the determination of small amounts of antibody such as might be found in secretions and column fractions. PMID- 6853730 TI - Granulomatous disease in the vermiform appendix. AB - In a twenty-year period 19 appendicectomy specimens were diagnosed as primary Crohn's disease. This represents 4.9% of the total number of both resection specimens and mucosal biopsies diagnosed as Crohn's disease during that time. This is a review of the main histopathological features found in these appendices and their subsequent clinical outcome. The predominant feature is transmural inflammation characterised by fibrosis and giant cell epithelioid granulomata. An accompanying spectrum of acute inflammatory changes is also seen. One patient progressed to more widespread ileal and caecal disease 17 months later. One patient developed perianal fistulae and chronic non-specific proctitis 24 months later. This represents a proven recurrence of one case in a study population of 19. The conclusion is that primary Crohn's disease of the appendix is usually an isolated phenomenon but rarely it may forewarn of more widespread bowel disease in the future. A discussion regarding the differential diagnosis of granulomatous appendiceal lesions is included. PMID- 6853731 TI - Preliminary report of an association between measles virus and achalasia. AB - Complement fixation tests were performed on sera from 18 patients with achalasia and 12 age- and sex-matched controls against a number of bacterial and viral agents in an attempt to ascertain any association with previous infection or any evidence of an altered immune response. There was a statistically significant increase of antibody titre against measles virus in the sera of 21 patients with achalasia compared with age- and sex-matched controls and this was confirmed by haemagglutination inhibition. PMID- 6853732 TI - Attempts to isolate Campylobacter jejuni from various body sites. AB - Clinical material collected from various body sites, but excluding faeces, was cultured on either selective or non-selective media for Campylobacter spp. Campylobacter jejuni was found in only two (0.18%) of 1100 specimens; both positive specimens were urine. From these results it is suggested that C jejuni is an uncommon finding in clinical material other than faeces. PMID- 6853733 TI - Effect of adding a papain digest of ox liver to brain heart infusion cysteine broth on the recovery of non-sporing anaerobes from simulated blood cultures. AB - Panmede, a papain digest of ox liver, added to brain heart infusion cysteine broth improved the recovery of non-sporing anaerobes from simulated blood cultures where human blood was added to each broth. The brain heart infusion broth containing both cysteine and Panmede supported the best isolation of non sporing anaerobes during the first 48 h incubation compared with the four commercial media tested in parallel. Good recovery of anaerobes during the first 24 h was obtained with the brain heart infusion broth supplemented with cysteine and Panmede, fastidious anaerobe broth and Brewer's thioglycollate from Southern Group Laboratories but not from Thiol medium and the other type of Brewer's thioglycollate medium tested. PMID- 6853734 TI - A fluorimetric method for red blood cell sorbitol dehydrogenase activity. AB - A new fluorimetric method for the quantification of red blood cell (RBC) sorbitol dehydrogenase is described. It is based on the oxidation of sorbitol to fructose, in presence of NAD+, catalysed by the RBC-sorbitol dehydrogenase. The quantity of NADH formed is then measured in a filter fluorimeter. Comparison with an indirect spectrophotometric assay yielded good correlation; however, the present method offers several advantages: it is more rapid, simple and inexpensive. It should be useful to screen for sorbitol dehydrogenase deficiency in large numbers of individuals, particularly patients with diabetes or cataracts. PMID- 6853735 TI - A fluorimetric method for the measurement of pyridoxal and pyridoxal phosphate in human plasma and leucocytes, and its application to patients with sideroblastic marrows. AB - A highly sensitive fluorimetric assay for the measurement of pyridoxal and pyridoxal phosphate in biological tissues is described. The method involves the enzymic hydrolysis of pyridoxal phosphate to pyridoxal. The pyridoxal (free or total) is separated on an anion-exchange column, concentrated by cation-exchange chromatography and reacted with potassium cyanide under slightly alkaline conditions to form 4-pyridoxolactone, a highly fluorescent compound. The method is applied to the measurement of pyridoxal, pyridoxal phosphate and total pyridoxal in plasma and neutrophils from control subjects and patients with sideroblastic marrow and identified the patient with pyridoxine-responsive sideroblastic anaemia. PMID- 6853739 TI - In vitro stability of cyclosporin A. PMID- 6853740 TI - Recognition of Haemophilus species. PMID- 6853738 TI - Increased erythrocyte rigidity in chlorate poisoning. PMID- 6853737 TI - Use of total cholesterol/albumin ratio as an alternative to high density lipoprotein cholesterol measurement. AB - In a study of apparently healthy males, we noted a correlation between serum albumin and high density lipoprotein cholesterol (HDL-C) (r = 0.32, p less than 0.001). We then correlated the total cholesterol:albumin ratio (TC:Alb) with the TC:HDL-C ratio (r = 0.89, p less than 0.001). We used the TC:Alb ratio to determine whether this was better than TC by itself in predicting whether an individual had a TC:HDL-C ratio of less than or greater than or equal to 5. The ratio performed better than TC and correctly classified 89% of individuals (66% with TC) (p less than 0.001). Since measurements of TC and Alb are routinely available on multichannel analysers, use of this ratio would provide a less expensive alternative to HDL-C measurement. PMID- 6853736 TI - Serum malondialdehyde-like material (MDA-LM) in acute myocardial infarction. AB - Serum malondialdehyde-like material (MDA-LM), as an index of lipid peroxidation, and the serum enzymes CK, CK-MB, LDH, LDH1 and, alpha-HBDH were evaluated in a group of 26 patients with acute myocardial infarction (AMI), seven with angina pectoris (AP), and in a normal control group of 94 subjects. MDA-LM values were within the normal range in AP patients, while in AMI patients a significant increase in serum MDA-LM was observed in the days following the acute event, reaching a maximum 6-8 days later, when 90% of the patients had values higher than the upper normal limit (mean +/- 2SD) of the control group. A significant correlation was found between the integrated concentration-time MDA-LM curve and the integrated serum enzymes activity curves reached during the nine days after the acute event. The "in vivo" relevance of the increased serum MDA-LM in the post-infarct period is unknown at the present, but as lipid peroxides are known to harm cellular structures and to inhibit prostacyclin synthesis, it may be of interest with regard to the long term secondary effects in AMI patients. PMID- 6853741 TI - Trimethoprim susceptibility to staphylococci. PMID- 6853742 TI - Chloramphenicol dosage and pharmacokinetics in infants and children. AB - Twenty infants and children receiving intravenous chloramphenicol were studied to examine the pharmacokinetics of the parent compound and its precursor, the succinate ester (CAP-S). Plasma samples were obtained just prior to a 30-minute infusion of chloramphenicol succinate, immediately after or 30 minutes after infusion, and 90, 210, and 330 minutes after infusion. Complete 6-hour urine collections were obtained during 11 studies. Plasma and urine were assayed for chloramphenicol and its succinate ester by high-performance liquid chromatography. Peak plasma concentrations ranged from 11.0 to 51.1 micrograms/ml on doses of 50 to 100 mg/kg/day and were higher in the youngest age group. The elimination half-life of chloramphenicol averaged 4.0 hours. Multilinear regression analysis demonstrated an excellent relationship between body surface area, trough plasma chloramphenicol concentration, and total body chloramphenicol clearance. The hydrolysis of succinate ester to free chloramphenicol may delay the peak free concentration, and its renal elimination (average 21 per cent of the dose administered) significantly affects chloramphenicol pharmacokinetics. The clearance of chloramphenicol exhibited enzyme saturation kinetics in one patient studied at two different doses. Dosage adjustments of intravenous chloramphenicol in children must be made in relation to the trough chloramphenicol plasma concentration, renal elimination of CAP-S, and possible saturation of chloramphenicol metabolism. PMID- 6853743 TI - Disposition of intravenous pirmenol. AB - Twelve patients having frequent premature ventricular complexes (PVCs) averaging more than 60 per hour received a single 150-mg intravenous dose of pirmenol. Plasma pirmenol concentration declined biexponentially following the infusion and was analyzed according to a two-compartment open model. Following an erratic distribution phase, the terminal elimination half-life ranged from 4.2 to 16.9 hours, with a geometric mean of 7.6 hours. Total body clearance averaged 164 +/- 58 ml/min, and the mean volume of distribution was 1.45 +/- 0.38 liter/kg. Renal clearance averaged 46.6 +/- 21.2 ml/min, representing 30 +/- 10 per cent of total body clearance. Excretion of unchanged drug in the urine averaged 31.8 +/- 8 per cent of the dose. Renal clearance and elimination half-life were correlated (r = 0.61, P less than 0.05). Eight of the 12 patients achieved greater than 95 per cent suppression of PVCs with a duration between 20 minutes and 23 hours. These favorable pharmacokinetics indicate that pirmenol may be a useful addition to the therapy of ventricular arrhythmias. PMID- 6853744 TI - Plasma dipyridamole concentrations after two different dosage regimens in patients. AB - Twenty patients received dipyridamole by two different dosage regimens yielding a total daily dose of 150 mg, either as 50 mg three times a day or 75 mg twice a day. The rationale for comparing these two regimens is that dipyridamole is usually given three times a day, but recent studies have revealed a final elimination half-life of the drug of about half a day. Based on drug cumulation during chronic dosing, the final half-life of dipyridamole observed in this study also averaged about half a day. The 75 mg b.i.d. regimen did not result in lower trough concentrations than the 50 mg t.i.d. regimen. There was wide interpatient variability in observed plasma dipyridamole concentrations for both regimens, averaging about 10-fold. These results suggest that dipyridamole could be administered twice a day and that dipyridamole levels should be monitored in clinical studies on the antithrombotic effect of the drug. PMID- 6853745 TI - Pharmacokinetic principles of antineoplastic drug therapy. AB - Determinants of host-drug interaction comprise a complex of potentially variable factors. The complexity of this variability compromises the forecasting of favorable response in individual patients given standard therapy. Substantial success with current forms of chemotherapy may require that biochemical, pharmacologic, and clinical profiles be established for each cancer patient whereby the use of drug and drug combination can be rationally applied. The significance of evaluating clinical pharmacokinetic parameters in patients with cancer is placed in perspective with other factors relevant to individual drug response. PMID- 6853749 TI - "Tuning in" and "fading out": performance of aphasic patients on ordered PICA subtests. AB - Performance of 182 aphasic patients was examined on 11 PICA subtests for which the order of presentation of items is specified in an attempt to determine possible "tuning in" and "fading out" behavior. Results indicate that these phenomena occur as measurable patterns, which are to some degree dependent on the severity of aphasia as measured by each patient's overall PICA percentile. PMID- 6853748 TI - Spastic dysphonia: a perceptual test of recurrent laryngeal nerve section. AB - An objective test of the efficacy of recurrent nerve section in the treatment of spastic dysphonia was conducted with partially trained observers in a blind rating task. It was found that, although immediate effects of the surgery as measured by a general communication effectiveness instrument could not be established, long-term (1-yr post-surgery) effects did emerge and at a high level of confidence. The results corroborate subjective judgments of the effectiveness of the Dedo procedure. PMID- 6853750 TI - The implementation of laughter as a therapy facilitator with adult aphasics. PMID- 6853752 TI - Frequency and amplitude perturbation in the voices of female speakers. AB - Vocal jitter and shimmer during the sustained phonation of /a/, /i/, and /u/ were investigated for twenty adult female speakers using an automatic analysis program. The results showed overall average shimmer of 0.25 dB and overall average jitter of 0.84%. The critical value for shimmer was 0.48 dB. Significant differences between males and females were found. PMID- 6853751 TI - Judgments of vocal affect by language-delayed children. AB - Judgment of vocal affect was studied in 19 language-delayed children and 19 children with normal language. The children responded to utterances spoken in an angry, happy, or sad tone of voice by pointing to a picture of an angry, a happy, or a sad face. The language-delayed children made significantly fewer correct judgments. The normal children judged all three emotions quite accurately, whereas the language-delayed children were very poor in judging sadness and showed a bias for judging all three emotional tones as anger. The language delayed children tended to improve with age, but age trends in normal children were obscured by near-perfect performance of many children. The practical and theoretical importance of further research was discussed. PMID- 6853746 TI - Comparison of fenoterol, isoproterenol, and isoetharine with phenylephrine aerosol in asthma. AB - The bronchodilator effect of fenoterol hydrobromide (0.5, 1.25, and 2.5 mg) was compared with either isoproterenol (2.8 mg) or isoetharine (5 mg) with phenylephrine (1.25 mg) in a double-blind placebo-controlled study. When delivered by an intermittent positive-pressure breathing device to 24 nonsmoking young adult asthmatic subjects, fenoterol produced significant improvement in forced expiratory volume at 1 second (FEV1), in maximum midexpiratory flow (FEF25 75%), and in forced expiratory flow at 25 per cent of vital capacity (FEF25%) for 6 to 8 hours, whereas isoproterenol and isoetharine with phenylephrine produced improvement for 1 and 2 hours, respectively. The lowest dosage of fenoterol was as effective as the highest but had fewer adverse effects. PMID- 6853747 TI - Mexiletine in the treatment of recurrent ventricular tachycardia. Prediction of long-term arrhythmia suppression from acute and short-term response. AB - Acute intravenous and short-term oral mexiletine therapy was effective in suppressing the arrhythmia in six of eight patients with recurrent ventricular tachycardia. Five of the six patients who were placed on maintenance therapy remained asymptomatic during a mean follow-up of 15 months. The study shows that the acute and short-term suppression of ventricular tachycardia by mexiletine can be a useful predictor of its long-term efficacy. PMID- 6853754 TI - A quantitative electron microscope study of the perikaryal projections of sensory ganglion neurons. I. Cat and rabbit. AB - With a quantitative method and serial sections a study was carried out under the electron microscope of the perikaryal projections of the neurons in the thoracic spinal ganglia of cat and rabbit. These projections usually appear as finger shaped evaginations which run roughly parallel to the surface of the nerve cell body. Their length ranges between 0.3 and 3.25 microns, and they show a nearly circular cross section with a rather uniform transverse diameter having an average value of about 0.2 microns. Both in cat and rabbit a very high correlation was found between the surface area of perikaryal projections and both the volume and smoothed surface area of the corresponding nerve cell body. Perikaryal projections increase the surface area of the nerve cell body by 43% in cat and 39.5% in rabbit. These findings support the idea that perikaryal projections in sensory ganglion neurons are normal formations, which maintain the surface-to-volume ratio above the critical level for metabolic exchanges. PMID- 6853753 TI - Cough offset schwa as a means of eliciting initial phonation in functional aphonia: two case reports. AB - The use of the schwa vowel at cough offset is an automatic production that can be easily prolonged and modified as a phonation-producing device without requesting initial voluntary phonation on the part of the patient. It is presented as a clinical method that was successful for the author with two female patients presenting functional aphonia. The technique lends support to the suggestions by Aronson (1969) and Boone (1971) that the symptomatic approach can be successful with the functional aphonic patient. The clinician should be mindful of the fact that in certain cases of functional aphonia an appropriate referral might be needed to deal with emotional aspects after voice is regained. PMID- 6853756 TI - Reorganization in granuloprival cerebellar cultures after transplantation of granule cells and glia. I. Light microscopic and electrophysiological studies. AB - Granuloprival cerebellar cultures were transplanted after 9 or 16 days in vitro with cerebellar explants that had been exposed to kainic acid. The latter contained granule cells and differentiated glia, elements lacking in granuloprival cultures. Changes induced by transplantation observed by light microscopy included interposition of granule cells among the large cortical neurons of host explants; a reduction of the excess neurites of the Purkinje cell axon collateral system that is characteristic of granuloprival explants; and the appearance of myelinated fibers in previously unmyelinated cultures. The most notable electrophysiologic consequence of transplantation was the disappearance of inhibition of cortical spontaneous activity in response to antidromic stimulation of Purkinje cell axons, correlating with the disappearance of excess neurites, and suggesting that Purkinje cell recurrent collateral inhibition was no longer the dominant mode of cortical inhibition. Restoration of missing elements in granuloprival cultures incited development of structural and functional characteristics resembling those of normal cerebellar explants. PMID- 6853755 TI - Cell death and changes in the retrograde transport of horseradish peroxidase in rubrospinal neurons following spinal cord hemisection in the adult rat. PMID- 6853757 TI - Reorganization in granuloprival cerebellar cultures after transplantation of granule cells and glia. II. Ultrastructural studies. AB - Cytosine arabinoside-induced granuloprival cerebellar cultures lack both granule cells and differentiated glia and demonstrate marked synaptic reorganization. After kainic acid-exposed cerebellar explants, which contain granule cells and mature glia, were transplanted to the granuloprival cultures, the following ultrastructural features were noted: (1) parallel fibers formed normal synapses with Purkinje cell dendritic spines as well as with basket/stellate cell somata; (2) sprouted Purkinje cell recurrent axon collateral terminals were markedly reduced in number; (3) Purkinje cells matured and lost perisomatic spines; (4) astroglia formed sheaths around Purkinje cell somata and dendrites; and (5) axonal myelination occurred. The transplanted cultures demonstrated ultrastructural restitution toward normal after addition of missing elements. PMID- 6853758 TI - Afferent and efferent pathways of the vibrissal region of primary motor cortex in the mouse. AB - The afferent and efferent connections of the vibrissal representation within the mouse primary motor cortex (MsI) were identified by using the retrograde transport of horseradish peroxidase (HRP) and the anterograde transport of tritiated amino acids injected into MsI. Following aldehyde perfusion brains were frozen-sectioned at 40 microns and reacted for HRP using the 3-3' diaminobenzidine-cobalt chloride technique of Adams ('77). Alternate HRP reacted sections were processed for autoradiography. HRP-filled pyramidal cell somata and concentrations of developed silver grains above background levels were observed in both the vibrissal area of primary somatosensory cortex (SmI) cortex (i.e., the posteromedial barrel subfield; PMBSF cortex) and in the face region of SmII (area 40). In both regions labeled somata occurred predominantly in cortical layers II-III and V. Autoradiographic label was superimposed over the regions containing labeled somata but exhibited a less distinct laminar organization. A dense reciprocal projection connected the injection site with the homotopic area in contralateral MsI; somata occurred for the most part in layers III and V. Developed silver grains were uniformly dispersed over the area containing labeled cell bodies. HRP-labeled pyramidal somata were noted in contralateral PMBSF cortex, but no silver grains occurred in this region. Reciprocal projections linked MsI cortex with the ipsilateral thalamic nuclei: ventralis pars lateralis (VL) and centralis pars lateralis (CL) and with the zona incerta (ZI). Labeled cell bodies and developed silver grains were more dense in VL than in CL. The ipsilateral striatum and thalamic reticular nucleus (NRT) received afferents from the motor cortex but did not project to it. Thus, the vibrissal area of primary motor cortex is connected with a number of cortical and subcortical structures, each of which has been shown to play a role in motor performance. Identification of the afferent and efferent pathways of MsI cortex will now enable further investigation of the ultrastructural and synaptic organization of the vibrissal area of MsI. PMID- 6853759 TI - The development of the Purkinje cell in the cerebellar cortex of the opossum. PMID- 6853761 TI - A crossed corticotectal projection from the lateral suprasylvian area in the cat. AB - Crossed cortical projections to the superior colliculus of the cat were demonstrated by unilateral superior colliculus injections of horseradish peroxidase (HRP) and by cortical injections of radioactive amino acids. This crossed corticotectal projection originates in the lateral bank of the middle suprasylvian sulcus and in both banks of the posterior suprasylvian sulcus. The site of termination of the contralateral corticotectal projection is restricted to the anterior margin of the superior colliculus (SC) while the ipsilateral projection spreads over the whole SC. The contralateral terminal areas are restricted to the superficial tectal layers. The projection fibers reach the contralateral superior colliculus by crossing the collicular commissure. The existence of such a connection may help to explain certain electrophysiological observations. PMID- 6853760 TI - Neurons at the origin of the medial component of the bulbopontine spinoreticular tract in the rat: an anatomical study using horseradish peroxidase retrograde transport. AB - An anatomical technique based on the retrograde transport of horseradish peroxidase (HRP) was used to investigate the projections of spinal cord neurons to the reticular formations in the rat. Both large and restricted injections were staggered all along the bulbar and pontine levels, involving the nucleus gigantocellularis, the nuclei reticularis pontis, pars oralis and caudalis and in some cases the nucleus raphe magnus. Labeled cells were constantly encountered in the reticular part of the neck of the dorsal horn throughout the whole length of the cord, mainly contralateral to the central core of the injection site. This area was taken as the equivalent of lamina V in the cat. Other labeled cells were observed in the medial parts of the intermediate and ventral horns, in areas considered similar to laminae VII and VIII in the cat. The two most rostral cervical segments were characterized by an additional bilateral projection originating from the dorsolateral part of ventral horns. Thus, this study is a clear confirmation that the bulbopontine reticular formations constitute a target for various somatosensory inputs originating in spinal cord. It demonstrates that the medial spinoreticular tract (mSRT) differs from the other main ascending tracts by the absence of projections from (1) superficial layers and nucleus of the dorsolateral funiculus contrary to the spinomesencephalic tract; (2) ventromedial zone of the lumbar dorsal horn unlike the spinothalamic tract; (3) the neck of the dorsal horn in its medial portion contrary to the spinoreticular component reaching the lateral reticular nucleus; and (4) central cervical nucleus and Clarke's columns, unlike the spinocerebellar tracts. The difficulty in demonstrating retrograde labeling from discrete injections could result from the fact that mSRT neurons have sparsely ramified collaterals on their terminal zones. PMID- 6853762 TI - Distribution patterns of individual medial lemniscal axons in the ventrobasal complex of the monkey thalamus. AB - Twenty-seven medial lemniscal axons were traced to their terminations in the thalamic ventrobasal complex of monkeys, following injection of horseradish peroxidase into the lemniscus at midbrain levels. Most axons had terminal ramifications at one horizontal level in the ventrobasal complex. All terminations were focal, many were anteroposteriorly elongated, though none were sufficiently long to occupy more than one-third to one-half of the anteroposterior extent of the VPLc nucleus. All terminal ramifications were compressed sagittally into a slab 200-300 micrometers wide. There was modest overlap in the terminal territories of adjacent labelled axons and, as judged light microscopically, only a small amount of convergence onto the vicinities of single cells. Axons terminating selectively in the anterodorsal shell or central core of VPLc could be identified. In the anterodorsal shell (of neurons responding to stimulation of deep tissues) axons tended to terminate either in the part projecting to area 3a or in that projecting to areas 3a and 2 of the cortex. In the central core (of neurons responding to cutaneous stimulation and projecting to areas 3b and 1) larger ramifications were present in its center and smaller ramifications in its ventral part. A few axons had terminal ramifications at two dorsoventral levels in the cutaneous core; others had terminations in both the dorsal deep shell and the cutaneous core. In both cases, one ramification was always smaller than the other. The termination of lemniscal axons at defined foci instead of along the dorsoventral extent of the representational lamellae of the ventrobasal complex has implications for the nature of the body representation in the nuclei. Their tendency to be focal implies that not all members of an anteroposteriorly elongated rod of place-and-modality-specific ventrobasal cells that project their axon to a single column in the somatic sensory cortex receive afferent inputs from the same lemniscal fibers. PMID- 6853764 TI - Interneurons in the flight system of the locust: distribution, connections, and resetting properties. AB - The organization and functional properties of interneurons in the flight system of the locust, Locusta migratoria, were investigated by using intracellular recording and staining techniques. Interneurons were found to be distributed within the three thoracic and the first three abdominal ganglia, and they could be subdivided into three organizational categories: (1) members of one of two serially homologous groups controlling either the forewing or the hindwing, (2) unique individuals with no known homologues in other ganglia, and (3) members of a set of serial homologous in the metathoracic and first three abdominal ganglia. Interneurons in the last two categories influenced both forewing and hindwing motoneurons in a similar manner. Thus interneuronal organization is not characterized by two distinct homologous groups of interneurons for the separate control of forewing and hindwing motor activity. Flight interneurons may also form two separate functional categories: (1) those making short latency connections to motoneurons (premotor interneurons), and (2) those which reset the flight rhythm when depolarized by brief current pulses (pattern generator interneurons). None of the ten premotor interneurons we identified influenced the flight rhythm when depolarized and none of the three groups of pattern generator interneurons were found to form short latency connections with motoneurons. This separation of function may allow phase-shifts in motor output for flight control without changes in wingbeat frequency. Pattern generator interneurons influence motor output to both forewings and hindwings. Thus we conclude that the flight rhythm is generated in a distributed neuronal oscillator driving both the pairs of wings. The organization of flight interneurons is considerably more complex than predicted from existing models of the flight system, or anticipated from the relative simplicity of the motor output. Our finding of homologous sets of interneurons in the abdominal ganglia supports the notion that insect flight evoked from a behavior using appendages distributed along the thorax and the abdomen. Thus the organization of flight interneurons may reflect an interneuronal system which controlled the behavior from which flight evolved. PMID- 6853763 TI - The sources of supraspinal afferents to the spinal cord in a variety of limbed reptiles. I. Reticulospinal systems. AB - Horseradish peroxidase was injected into various levels of the spinal cord of turtles (Pseudemys and Chrysemys), lizards (Tupinambis, Iquana, Gekko, Sauromelus, and Gerrhonotus), and a crocodilian (Caiman). The results suggest that brainstem reticulospinal projections in limbed reptiles rival mammalian reticulospinal systems in complexity. The reptilian myelencephalic reticular formation can be divided into four distinct reticulospinal nuclei. Reticularis inferior pars dorsalis (RID) contains multipolar neurons which project bilaterally to the spinal cord. Reticularis inferior pars ventralis (RIV), which is only found in lizards and crocodilians, contains fusiform neurons with horizontally running dendrites and it projects ipsilaterally to the spinal cord. Reticularis ventrolateralis (RVL), which is found only in field lizards, contains triangular neurons whose dendrites parallel the ventrolateral edge of the brainstem and it projects ipsilaterally to the spinal cord. The myelencephalic raphe (RaI) varies considerably. RaI of turtles contains large reticulospinal neurons which form a continuous population with more laterally situated RID cells. RaI of lizards contains a few small reticulospinal neurons. RaI of the crocodilian Caiman contains giant reticulospinal neurons with laterally directed dendrites. The caudal metencephalic reticular formation of reptiles can be divided into two distinct reticulospinal nuclei. Reticularis medius (RM) contains large neurons with long, ventrally directed dendrites; it projects ipsilaterally to the spinal cord. Reticularis medius pars lateralis (RML) contains small neurons with laterally directed dendrites; it projects contralaterally to the spinal cord. The rostral mesencephalic and caudal mesencephalic reticular formation of reptiles can be divided into three distinct reticulospinal nuclei. Reticularis superior pars medialis (RSM) consists mostly of small, spindle-shaped neurons which project bilaterally to the spinal cord. In the lizard Tupinambis, however, large multipolar, ipsilaterally projecting neurons are occasionally seen in RSM. Reticularis superior pars lateralis (RSL) contains large, ipsilaterally projecting neurons with long, ventrolaterally directed dendrites. SRL in lizards can be divided into a dorsomedial portion, which projects ipsilaterally to the spinal cord, and a ventrolateral portion which projects contralaterally. The locus ceruleus-subceruleus field (LC-SC) contains small spindle-shaped neurons which project bilaterally to the spinal cord. Labelled reticulospinal neurons were also observed in the rostral metencephalic raphe (RaS) of the turtle brainstem. These cells are small, spindle-shaped neurons which resemble the small cells of the adjacent RSM field. PMID- 6853766 TI - Dual olfactory representation in the rat thalamus: an anatomical and electrophysiological study. AB - A combination of electrophysiological and anatomical techniques was used to determine the sites of termination of olfactory projections to the thalamus and the distribution of the cells of origin of these projections within the olfactory cortex. Following electrical stimulation of the olfactory bulb, short-latency unit responses were recorded not only in the central segment of the mediodorsal thalamic nucleus but also in the ventral and anterior parts of the submedial thalamic nucleus. Responses were not obtained in the ventral or lateral parts of the mediodorsal nucleus, in the dorsal part of the submedial nucleus, or in the intralaminar nuclei between the mediodorsal and submedial nuclei. The cells of origin of the projection were identified by making injections of horseradish peroxidase conjugated to wheat germ agglutinin (HRP WGA) into the thalamus and examining the olfactory cortex for retrogradely labeled cells. Following injections into the mediodorsal nucleus, labeled cells were found in the polymorphic cell zone deep to the olfactory tubercle, in the ventral endopiriform nucleus deep to the piriform cortex, and in an equivalent position deep to the periamygdaloid and lateral entorhinal cortices. After injections into the submedial nucleus, a smaller number of labeled cells were found in similar locations, except that they were restricted to the rostral olfactory cortical areas and were not found deep to the lateral part of the piriform cortex. Retrogradely labeled cells and anterogradely labeled axons were also found in the lateral orbital and ventral agranular insular areas of the prefrontal cortex with injections into the mediodorsal nucleus, and in the ventrolateral orbital area with injections into the submedial nucleus. Anterograde tracing experiments, using the autoradiographic method, have confirmed these results. Injections of 3H leucine deep to the junction between the anterior piriform cortex and the olfactory tubercle label axons in both the central segment of the mediodorsal nucleus and the ventral part of the submedial nucleus, while injections deep to the posterior piriform cortex label axons in the mediodorsal nucleus only. Within the mediodorsal nucleus, the projection also appears to be organized so that fibers which arise more rostrally terminate ventrolaterally in the central segment, while fibers which arise more caudally terminate more dorsomedially. These results indicate that there is a substantial and possibly dual thalamocortical mechanism available for processing of olfactory stimuli. PMID- 6853765 TI - The visual cells of the skate retina: structure, histochemistry, and disc shedding properties. AB - Earlier studies have shown that visual function in skate is subserved solely by the rod mechanism and that the retina of this elasmobranch contains only rod photoreceptors. Nevertheless, the skate retina is capable of responding to levels of illumination that extend well into the photopic range, and we have detected in histological sections (usually from younger animals) small, proximally displaced, conelike photoreceptors which possibly represent another class of visual cell. However, ultrastructural and histochemical studies showed that the membranous discs of the outer segments of these cells were isolated from the plasma membrane, and that their synaptic terminals appeared immature and unlike those usually associated with cone receptors. In addition, the pattern of incorporation of 3H-fucose, as revealed by radioautography, was similar for both the rods and the smaller visual cells; i.e., the label was concentrated along the basal discs of the outer segment. When we examined the disc-shedding behavior of the visual cells in skates entrained for 2 weeks or longer to a 12-hour light:12-hour dark cycle, enhanced phagocytic activity was seen only following light onset; there was no significant increase following light offset. On the available evidence, it seems reasonable to conclude that the small visual cells are rods that have recently differentiated, and are growing and being incorporated into the photoreceptor layer of the retina. PMID- 6853768 TI - Claustroneocortical projections studied in the cat by means of multiple retrograde fluorescent tracing. AB - The topographical interrelations of claustroneocortical cells and their degree of divergent collateralization were investigated in cat by means of retrograde fluorescent double labeling. The tracers Fast Blue (FB) and Nuclear Yellow (NY) were injected in several combinations in two different cortical fields. FB labeled and NY-labeled cells were found in all cases in the insular portion of the ipsilateral claustrum (CII). The distributions of labeled cells confirmed the organization reported in previous studies. In some cases the two labeled cell populations were segregated in different parts of the CII; in other cases there was more or less overlap in the two distributions. The degree of overlap was not simply related to the topographic proximity of the injected cortical territories. In all cases the vast majority of cells were single labeled. In one case both FB and NY were injected in the same cortical area in order to control that claustral axons can retrogradely transport two tracers back to the same parent cell bodies. In this control case CII cells were double labeled. All together these data indicate that widely divergent claustroneocortical projection take origin mainly from separate cells. PMID- 6853769 TI - Cortical and thalamic afferent connections of the insular and adjacent cortex of the rat. AB - Thalamic and cortical afferents to the insular and perirhinal cortex of the rat were investigated. Unilateral injections of horseradish peroxidase (HRP) were made iontophoretically along the rhinal sulcus. HRP injections covered or invaded areas along the rhinal fissure from about the level of the middle cerebral artery to the posterior end of the fissure. The most anterior injection labeled a few cells in the mediodorsal nucleus. More posterior injections labeled neurons in the basal portion of the nucleus ventralis medialis, thus suggesting that this cortical region constitutes the rat's gustatory (insular) cortex. We consider the cortex situated posterior to the gustatory cortex in and above the rhinal sulcus as the core region of the rat's (associative) insular cortex, as this cortex receives afferents from the regions of and between the nuclei suprageniculatus and geniculatus medialis, pars magnocellularis. It includes parts of the cortex termed perirhinal in other studies. The cortex dorsal and posterior to the insular cortex we consider auditory cortex, as it receives afferents from the principal part of the medial geniculate nucleus, and the cortex ventral to the insular cortex (below the fundus of the rhinal sulcus) we consider to constitute the prepiriform cortex, which is athalamic. The posterior part of the perirhinal cortex (area 35) receives afferents from nonspecific thalamic nuclei (midline nuclei). Cortical afferents to the injection loci arise from a number of regions, above all from regions of the medial and sulcal prefrontal cortex. Those injections confined to the projection cortex of the suprageniculate-magnocellular medial geniculate nuclear complex also led to labeling in contralateral prefrontal regions, particularly in area 25 (infralimbic region). A comparison of our results with those on the insular cortex of cats and monkeys suggests that on the basis of thalamocortical connections, topographical relations, and involvements of neurons in information processing and overt behavior, the insular cortex has to be regarded as a heterogeneous region which may be separated into prefrontal insular, gustatory (somatosensory) insular, and associative insular portions. PMID- 6853767 TI - The superior vestibular nucleus: an intracellular HRP study in the cat. I. Vestibulo-ocular neurons. AB - Superior vestibular neurons were penetrated with horseradish peroxidase (HRP) loaded glass microelectrodes in anesthetized cats. Responses to electrical stimulation of the oculomotor complex and the vestibular nerves were characterized and selected neurons were injected with HRP. Neurons antidromically activated by oculomotor complex stimulation were generally monosynaptically excited by the ipsilateral vestibular nerve. Notable was the absence of strong commissural inhibition by stimulation of the contralateral vestibular nerve. Light microscopy of antidromically identified injected cells demonstrated that these cells are predominantly located at the central levels of the superior vestibular nucleus along the incoming vestibular nerve fibers but a few are found at more caudal levels. Cell bodies, elongated or pyramidal, are mainly medium sized to large (30-50 micrometers). Dendritic trees extend in a plane at an acute to the collaterals of the vestibular nerve fibers. Dendrites remain within the nuclear territory and generally display an isodendritic branching pattern. Dendritic spines and appendages are mainly distributed on secondary and distal dendrites. A few terminal enlargements similar to growth cones are observed in these neurons. Axons of these neurons project rostrally via the medial longitudinal fasciculus, while a minor projection via the brachium conjunctivum is also found. Axon collaterals, when present, originate in the nucleus itself and in the pontine reticular formation. PMID- 6853771 TI - Gradients of cellular maturation and synaptogenesis in the superior colliculus of the fetal rhesus monkey. AB - Light (LM) and electron microscopic (EM) qualitative and quantitative analyses were employed to determine the tempo and spatial gradients of synaptogenesis and cellular differentiation in the superficial superior colliculus (SC) of the rhesus monkey between embryonic (E) days E47 and E84. By E47, a majority of the neurons of the prospective superficial gray layer (SGS) have arrived at their final positions and contribute to a uniform band of small, darkly Nissl-stained neurons at the outer surface of the SC. By E54, cells in the middle of the rostral pole of the superficial SC become considerably larger, paler staining, and less densely packed than the more medially or laterally located cells. These regional differences, which extend posteriorly through about the middle of the SC at this age, are evident on both the LM and EM levels and were confirmed by a quantitative EM analysis of the cytodifferentiation and synaptogenesis in the SGS. Several overlapping EM probes made across the medial, middle, and lateral regions of the SGS at each of three coronal levels reveal consistently more developed neuropil and smaller amounts of extracellular space in the middle region than in the medial and lateral portions of the more anterior SC. Further, the densities of synapses, both in terms of synapses/micron2 of total cross sectional area and synapses/micron2 of neuropil alone, are also higher in the middle than the peripheral regions. Most of the middle-peripheral differences found in the mid-E50s are still evident by the early E60s, but have disappeared by midgestation (E80s). The present results are interpreted to indicate that the middle region of the SGS at a given transverse level begins to mature significantly earlier than the medial or lateral areas. Since our previous 3H thymidine analysis (Cooper and Rakic, '81a) failed to reveal significant regional variation in the time of neuron origin in the superficial SC, the observed spatiotemporal gradients of neuronal maturation in the primate SGS probably do not arise from underlying gradients of cellular proliferation. PMID- 6853772 TI - An examination of intraspinal sprouting in dorsal root axons with the tracer horseradish peroxidase. AB - Postdeafferentation reorganization in the central terminal fields of spared dorsal root axons was evaluated by examining the intraspinal distribution of horseradish peroxidase-labeled sciatic nerve afferent fibers at various intervals following the removal of several lumbar dorsal root ganglia. The sciatic projection to the spinal cord, as determined by the pattern and density of intraspinal reaction product, was remarkably stable following the ganglionectomies. For as long as 3 months later, there was no evidence that sciatic afferent fibers had formed anomalous connections either with new spinal segments or in denervated areas within normal segments of entry. These findings cast doubt upon the existence of anatomic reorganization within the spinal cord following its partial deafferentation and suggest that physiological processes other than new axonal growth underlie observations such as postdenervation alterations in the response properties of dorsal horn neurons and the recovery of behavioral function. PMID- 6853770 TI - Morphometric analysis of granule cell dendrites in the mouse dentate gyrus. AB - We devised a computer program to analyze the dendritic geometry of dentate granule cells as seen in rapid Golgi impregnations from the mouse. Three dimensional coordinates were recorded by using a computer-assisted microscope. Geometric parameters are of two general types: (1) LINEAR parameters include the number of dendritic segments per branch order and their individual and aggregate lengths. (2) ANGULAR parameters define the spatial relationships of branch points and segment terminals with each other and with the axis of symmetry derived for all the dendrites. We find that values for linear parameters are highly variable and more susceptible to artifacts. Values for most angular parameters are more highly constrained and are presumably the best descriptors of the class characteristic conical shape of granule cell dendrites. Additional features which are necessary to describe granule cell dendrites fully are: (1) Branching frequency is highest proximal to the cell soma, (2) deviant segments are kept "on course" to ensure axial symmetry, and (3) terminal segments end at the plane of the cortical surface. A critical analysis of the various parameters suggests the hypothesis that the characteristic and uniform geometry of granule cell dendrites is controlled largely by factors residing in the molecular layer where growth and differentiation are sustained. An additional finding of potential interest is that there are two subpopulations of granule cells with a twofold difference in spine density. PMID- 6853773 TI - Neural basis of developing salt taste sensation: response changes in fetal, postnatal, and adult sheep. AB - To learn whether salt taste responses change during mammalian development, we recorded from multifiber preparations of the chorda tympani while stimulating the anterior tongue in sheep fetuses, lambs, and adults. Stimuli were 0.5 M NH4Cl, KCl, NaCl, and LiCl, and 0.05-0.75 M concentration series of the first three salts. Ultrastructural studies were made of taste buds at different ages to determine whether morphological elements such as microvilli and tight junctions are present in young fetuses. Substantial changes occur in relative salt taste responses, throughout development. In fetuses that are beginning the last third of gestation, NaCl and LiCl elicit much smaller response magnitudes than NH4Cl and KCl. Throughout the rest of gestation and postnatally, the NaCl and LiCl responses gradually increase in magnitude relative to NH4Cl and KCl. In adults, NaCl, LiCl, and NH4Cl all elicit similar response magnitudes and KCl is less effective as a taste stimulus. At ages when response ratios for the 0.5 M salts are changing, there are no changes in shapes of the response/concentration functions for individual salts. Furthermore, microvilli are present on taste bud cell apices and tight junctions are found between cells in the youngest fetuses studied. Therefore, initial stimulus-receptor membrane contacts are probably similar to those in adults. Our data suggest that different membrane components interact with the various monochloride salts and that taste receptors contain different proportions of these various membrane components at different developmental stages. Therefore young taste bud cells do not have the same salt response characteristics as mature cells, and a changing neural substrate underlies development of salt taste function, both pre- and postnatally. PMID- 6853774 TI - Sex differences in the pattern of steroid accumulation by motoneurons of the rat lumbar spinal cord. AB - We previously reported that male rat lumbar motoneurons accumulate radioactivity after injection of tritiated testosterone (T) or dihydrotestosterone (DHT), but not estradiol (E). We now report autoradiographic evidence that lumbar motoneurons in male rats accumulate T or its metabolites more frequently than do female motoneurons. However, this sex difference in hormone accumulation by motoneurons is not observed following the injection of DHT or E, both of which are normal metabolites of T. Very few motoneurons from any population accumulated E or its metabolites. In fact, some motoneurons had fewer silver grains over their nuclei than would be expected by chance, thus suggesting that these cells not only failed to accumulate E or its metabolites, but actively or passively excluded them from their nuclei. Virtually every motoneuron of either sex accumulated hormone after DHT injection. Following T injection, more motoneurons were labeled in males (72-77%) than in females (28-39%), indicating a sex difference in hormone accumulation. Taken together, these results suggest that either (1) there are separate receptors for T and DHT, and motoneurons have more T receptors (but equal numbers of DHT receptors) in males than in females, or (2) the motoneurons of male rats have greater access to systemically administered T or its metabolites than do those of females. PMID- 6853775 TI - The growth of nerves in relation to the formation of premuscle cell masses in the developing chick forelimb. AB - A description is given of the growth of segmental nerves 13 to 16 (SN13 to SN16) from the brachial myotomes into the ventral and dorsal premuscle cell masses of the chick forelimb. At stage 25 (Hamburger and Hamilton, '51), segmental nerves have converged to form two nerve trunks which enter the ventral and dorsal premuscle cell masses. These nerves grow into the limb, parallel to its proximodistal axis. The nerve trunk in the ventral compartment, the brachialis longus inferior (bli n), grows on the brachial artery as far as the metacarpals. The nerve trunk in the dorsal compartment, the brachialis longus superior (bls n), grows on the precartilage adjacent to a dorsal premuscle density as far as the metacarpals. The brachialis longus inferior and superior nerve trunks give rise to a number of nerves during their growth to the metacarpals. Each of these nerves appears at the time of formation of a new premuscle cell density. At late stage 25, a posterior and ventral premuscle density forms in the middle of the stylopodium; posterior fascicles of the bli n diverge at this level and grow toward this new density to form the ulnar nerve. By stage 26 a posterior and ventral premuscle density is prominent over the bli n, at the junction of the stylopodium and the zeugopodium; ventral fascicles of the bli n grow into this density to form the flexor digitorum profundus nerve. At this stage a posterior and dorsal premuscle density forms just beyond the junction of the stylopodium and zeugopodium. Posterior fascicles of the bls n diverge at this level and grow toward this density to form a nerve from which the extensor metacarpi ulnaris, extensor digitorum communis, and radialis laterialis nerves are destined to form. At stage 29 the premuscle cell masses of the autopodium have formed. The remaining nerve fascicles comprising the bls n (the radialis profundus nerve) grow into the autopodium and branch to innervate each of the dorsal premuscles. The remaining nerve fascicles comprising the bli n (the middle nerve) grow into the autopodium and branch to innervate each of the ventral premuscles. PMID- 6853777 TI - Early prenatal development of the human precommissural septum. AB - The development of the septum was studied in human embryos and fetuses ranging from 8 to 24.5 weeks of menstrual age (22.2 to 216 mm crown-rump length). Neuroblasts migrating from the ventricular layer of the ventromedial hemispheric wall form a narrow intermediate layer that constitutes the primordial septum (8 weeks). Only a primordial nucleus of the diagonal band is identifiable within the gradually enlarging primordial septum at early stages. By 10 weeks the primordial septum is subdivided into medial and lateral zones. At 11.5 weeks well-defined medial nuclei and the nucleus of the diagonal band are evident within the medial zone. Differentiation within the lateral zone occurs by 12.5 weeks with the appearance of nucleus lateralis pars interna. Nucleus dorsalis is developing in the lateral zone by 14.5 weeks and, by 15.5 weeks, well-defined nuclei are present throughout the lateral zone. Further neuronal maturation and conformational changes result in the nearly adult appearance of the septum in older fetuses. Although a definite mediolateral differentiation-gradient occurs, individual nuclei appear to differentiate along their own longitudinal gradient. Evidence presented suggests that the earliest fibers within the primordial septum are related to the tuberculum olfactorium and the medial forebrain bundle, that septohippocampal fibers appear at 10 weeks, hippocamposeptal fibers by 11.5 weeks, and that, later, stria terminalis fibers develop. The suggested developmental relationships of the septum with the hypothalamus (and brainstem), tuberculum, hippocampus, and amygdala emphasizes its role as an internode in the limbic system. PMID- 6853776 TI - Somatosensory properties of the inferior olive of the cat. AB - We examined the somatosensory properties of 391 neurons in the inferior olive in 20 cats that were anesthetized with barbiturate or decerebrated. A response consisted of a single spike with a variable number of wavelets followed by a long refractory period. Neurons responsive to natural somatosensory stimuli were recorded in all olivary subdivisions. The dorsal accessory olive (DAO) contained the highest proportion of responsive units (96%), compared with 66% for the medial accessory olive (MAO) and 43% for the principal olivary (PO) nucleus. Within the rostral DAO we found a refined cutaneous map of the entire contralateral body surface. In the caudal DAO responsiveness to manipulation of deep tissues became prominent, and both individual limbs and bilateral pairs were represented. In the medial region of the PO responsiveness to taps predominated and bilaterally symmetrical fields were frequent. The lateral PO was unresponsive under the conditions of these experiments. The MAO was distinguished by a greater complexity of receptive field and by a preponderance of deep over cutaneous modality. The lateral part of caudal MAO contained cells with interesting spatial patterns of excitation and inhibition, whereas most cells in the rostral MAO had purely excitatory fields. A teleceptive area receiving visual and auditory input was recognized in the medial MAO and nearby structures such as the dorsal cap. Contact and proprioceptive signals arriving via climbing fibers may provide the cerebellum with information necessary to relate the body to external objects. PMID- 6853778 TI - 3H-GABA uptake selectively labels identifiable neurons in the leech central nervous system. AB - Segmental ganglia of the leech ventral nerve cord synthesize the neurotransmitter gamma-aminobutyric acid (GABA) when incubated in the presence of the precursor glutamate, suggesting that there may be GABA-ergic neurons in the leech nerve cord. GABA-accumulating neurons of the two taxonomically distant leech species, Haementeria ghilianii and Hirudo medicinalis, have been labeled by taking advantage of their high-affinity uptake system for the neurotransmitter. Autoradiography of sectioned segmental ganglia previously exposed to 3H-GABA reveals a reproducible pattern of about thirty 3H-GABA-labeled neuronal cell bodies per ganglion. The majority of 3H-GABA-labeled neuronal cell bodies are bilaterally paired, although some apparently unpaired cell bodies also accumulate label. Neuronal processes were reproducibly labeled by GABA uptake and could be traced in the neuropil through commissures and fiber tracts into the segmental nerve roots and interganglionic connectives, respectively. PMID- 6853779 TI - Verruciform xanthoma. Occurrence in eroded skin in a patient with recessive dystrophic epidermolysis bullosa. AB - Verruciform xanthoma is a rare, granular, plaque-like lesion which occurs on mucosal surfaces and is characterized by acanthosis with xanthoma cells in the dermis between rete pegs. A case of verruciform xanthoma is reported which occurred on the sacral region in a patient with recessive dystrophic epidermolysis bullosa (RDEB). Electron microscopic studies suggested that many of the xanthoma cells were fibroblasts whose vacuolated appearance was expressed in cell culture and persisted for several passages. The occurrence of a verruciform xanthoma in a patient with severe recessive dystrophic epidermolysis bullosa suggests that repeated epidermal and/or dermal damage gave rise to a reactive process involving the formation of lipid-laden cells. PMID- 6853782 TI - Curettage and electrodesiccation in the treatment of midfacial basal cell epithelioma. AB - In this study the nose and nasolabial folds are identified as high-risk areas for recurrence of basal cell epithelioma (BCE) following curettage and electrodesiccation (C and D). Following adequate C and D, 30% of lesions in these areas were found to contain residual tumor, compared to only 12% of lesions located elsewhere on the head and neck. Local anatomic determinants of the midface region, which include embryologic fusion planes, close-set rigid sebaceous follicles, and origin of tumor from the outer root sheath of the pilosebaceous unit, may conspire to exceed the inherent limitations of the C and D procedure and clarify the high recurrence rates in this area. PMID- 6853781 TI - Sinus tracts to the chin and jaw of dental origin. AB - This is a report of seven patients with cutaneous sinus tracts of dental origin who were seen in the past 10 years at the Mayo Clinic. Cutaneous sinus tracts of dental origin most commonly present on the chin or the mandibular region as nodulocystic lesions with suppuration. The lesion may be confused with pyogenic granuloma, foreign body reaction, deep fungal infection, squamous cell carcinoma, or osteomyelitis. However, if the lesion is suspected of being of dental origin, the diagnosis is easily confirmed by dental examination and dental roentgenograms of the involved area. Once the correct diagnosis has been made, treatment by appropriate endodontic therapy leads to prompt resolution of the sinus tract. This is an uncommon disease but one for which a high degree of alertness must be maintained when one sees a nodulocystic or ulcerative lesion of the face. PMID- 6853780 TI - Unilateral dermatomal superficial telangiectasia. Nine new cases and a review of unilateral dermatomal superficial telangiectasia. AB - Unilateral dermatomal superficial telangiectasia (UDST) may be congenital or acquired. Acquired UDST may occur coincident with physiologic states of estrogen increase, including puberty and pregnancy in women and adrenarche in men. Acquired UDST may also occur in estrogenized pathologic states such as chronic hepatic disease in alcoholism. The occurrence during estrogenized states, the dermatomes of distribution, and the presence of anemic halos suggest kinship with arterial spiders. UDST and some cases of benign, generalized telangiectasia may be local and universal forms, respectively, of the same pathologic process in the cutaneous microvasculature. Further, this is compatible with both the concept that UDST results from a somatic mutation and the usual nonfamilial presentation of UDST. PMID- 6853783 TI - Kasabach-Merritt syndrome in infants. AB - Kasabach-Merritt syndrome consists of thrombocytopenia, microangiopathic hemolytic anemia, and an acute or chronic consumption coagulopathy in association with a rapidly enlarging hemangioma. Although the potential for serious morbidity is great, the condition remits when the hemangioma begins to involute. Four infants with large congenital cavernous hemangiomas and Kasabach-Merritt syndrome are described. All four received oral prednisone for variable periods; two received aspirin and one dipyridamole. Two patients required intravenous heparin because of life-threatening disseminated intravascular coagulation and bleeding. Two patients experienced almost total involution of their hemangiomas by the age of 2 years, and one by the age of 13 months. The fourth patient showed signs of beginning resolution of the hemangioma at the age of 8 months and hematologic values returned to normal levels. No side effects from therapy were noted in any of these infants. PMID- 6853784 TI - Complications of cutaneous cryosurgery. AB - The complications of cutaneous cryosurgery may be divided into technical problems, those involving patient selection, reactions of the immediate and acute type, short-term reactions, and long-term complications. Technical problems involve primarily the delivery system and temperature monitoring. Proper patient selection is essential for avoiding complications. Reactions to cryotherapy vary widely from those which may be considered normal to hemorrhage, severe systemic reactions in cold-sensitive individuals, full-thickness skin necrosis, syncope, and sudden death. Short-term complications include hemorrhage, infection, and granuloma pyogenicum. Long-term reactions include pseudoepitheliomatous hyperplasia, nerve damage, pigmentary problems, tissue defects, delayed healing, scar formation, and the recurrence of benign and malignant lesions. PMID- 6853785 TI - Once-daily treatment of psoriasis with topical glucocorticosteroid ointments. AB - A double-blind, vehicle-controlled comparison of two glucocorticosteroid ointments demonstrated that once-daily therapy for psoriasis was effective. After 3 weeks of once-daily therapy, psoriasis subjects treated with betamethasone dipropionate (BD) ointment or diflorasone diacetate (DD) ointment showed statistically significant (p less than 0.01) improvement compared to subjects using vehicle alone. PMID- 6853787 TI - Radiographic artifacts produced by silver nitrate and Monsel's solution. PMID- 6853788 TI - Prolonged topical maintenance therapy for mycosis fungoides. PMID- 6853789 TI - Cupping: an erstwhile common modality of therapy. PMID- 6853786 TI - Granuloma faciale: treatment with topical psoralen and UVA. PMID- 6853790 TI - Partial unilateral lentiginosis in a black patient with sickle cell anemia. PMID- 6853791 TI - Photosensitivity to saccharin. PMID- 6853792 TI - The invisible dermatoses. AB - It is understandable that clinically normal skin may show abnormalities when examined with the light microscope, but paradoxical that biopsy of a clinically significant skin disorder may show a histologic picture that looks like normal skin. From the perspective of the dermatopathologist, the invisible dermatoses are clinically evident skin diseases that show a histologic picture resembling normal skin. A strategy for approaching the problem of the invisible dermatoses is to first examine the epidermis for fungi, cornoid lamellae (disseminated superficial actinic porokeratosis), and absence of the granular layer (dominant ichthyosis vulgaris). The cutis is then studied for hyalin deposition (macular amyloidosis), mast cells, microfilaria, dermal melanocytosis, silver granules, and absence of sweat glands (anhidrotic ectodermal dysplasia). Special stains may be required to uncover conditions like anetoderma and nevus elasticus. Comparison of the specimen with normal skin may disclose atrophoderma, lipoatrophy, vitiligo, or cafe au lait spot. Finally, technical problems should be considered, including sampling errors and mixup of specimens, either by the clinician or the laboratory. PMID- 6853793 TI - Colloid and elastic fibre: ultrastructural study on the histogenesis of colloid milium. AB - Tissues peripheral to well-developed papules of colloid milium were chosen for biopsy and electron microscopy examination. Evidence was presented that colloid is derived from elastic fibres through sequential degenerative change. In the upper to middle dermis of the peripheral tissue, a number of abnormal masses in the vicinity of small colloid depositions were observed. Ultrastructurally, those abnormal masses were degenerating elastic fibres in which "electron-dense layers" of normal elastic fibre increased in amount, although their electron density diminished. Electron-light layers were gradually diminished in quantity. Degenerated elastic fibres finally became granulo-fibrillar and were indistinguishable from colloid. Many fibrils which closely resembled 10 nm tubular microfibrils of normal elastic fibre were observed in the granulo fibrillar substance. Since one stage of the degeneration of elastic fibre which eventually leads to the formation of colloid milium was very similar to that of actinic elastosis, a direct role of sunlight in the formation of colloid milium is suggested. PMID- 6853794 TI - Alternariasis: ultrastructure of skin granuloma. AB - An ultrastructural investigation of dermal altenariasis has complemented previous studies. Alternaria tenuis was seen to be profusely present within the cytoplasm of multinucleate giant cells. Healthy elements were characterized by a thick, electron-lucent wall, ovoid osmiophilic inclusions and a poorly defined nucleus. Homogenous liquefaction and granular degeneration represented various types and steps of degradation; the wall subsisted for a while before collapsing and breaking into pieces. Penetration of the giant cell's cytoplasm within hollow tubes was observed. PMID- 6853795 TI - Ultrastructure of hypertrophic hemangioma. AB - A hypertrophic hemangioma of a 6-month-old girl was studied electron microscopically. Hypertrophic hemangioma is characterized by few patent vessels, high cellularity, local aggressiveness, occasional mitotic figures and frequent recurrence after operation. The ultrastructural examination showed the tumor to be composed of three types of cells: endothelial cells, pericytes and phagocytic fibroblasts. PMID- 6853796 TI - Electron microscopic observations of mitotic Langerhans' cells as possible sign of retinoid-induced stimulation. PMID- 6853797 TI - Utilization of ruminally infused acetate or propionate and abomasally infused casein by lactating goats. PMID- 6853798 TI - Effect of carbohydrate limitation on degradation and utilization of casein by mixed rumen bacteria. AB - Mixed rumen bacteria were incubated in media containing salts, ammonia, vitamins, volatile fatty acids, sulfide, and casein. When initial cell density was 1.0 absorbance unit and mixed carbohydrates (glucose, sucrose, maltose, cellobiose, and soluble starch) were provided at 0, 40, 80, and 160 mg/liter per h, cell growth was limited by carbohydrates, average bacterial growth rate was slow (less than .07/h), and types of bacteria did not appear to change during 7 h. Growth was small if casein was the sole source of energy. Addition of casein to incubations fed carbohydrates caused cell yield to double. Casein hydrolysis was accompanied by marked accumulation of peptides that were metabolized slowly by rumen bacteria. High pressure liquid chromatography indicated that the peptide pool was composed primarily of four fractions. Carbohydrate availability or bacterial growth had little influence on proteolysis or peptide accumulation. Ammonia production was always inversely proportional to rate of carbohydrate feeding. Nitrogen-15 labeling studies indicated that 66% of the cell nitrogen was derived directly from casein at all rates of carbohydrate addition. If average bacterial growth rate was approximately .07/h, little casein entered the ammonia pool even though large amounts of peptide or casein remained undegraded. PMID- 6853799 TI - Effect of exogenous growth hormone in early and late lactation on lactational performance of dairy cows. AB - Bovine growth hormone (51.5 IU/day) and placebo injections were administered for 10 days to four Holstein cows in early lactation (wk 12) and again in late lactation (wk 35). Milk productions in the last 5 days of each period were compared. In early lactation, growth hormone increased milk yield by 15%, fat yield by 17%, protein yield by 14%, and lactose yield by 21%. In late lactation the respective increases were 31, 42, 18, and 35%. For responses of early and late lactation to growth hormone on a quantitative basis, increases for milk yield (4.3 versus 3.9 kg/day) and milk energy secretion (3.3 versus 3.4 Mcal/day) were similar. Concurrent with these increased milk yields, ad libitum intakes of a complete mixed diet declined during the period of growth hormone treatment by 3% in early lactation and 16% in late lactation. During the 6 h immediately following injections of growth hormone, blood plasma concentrations of growth hormone were elevated about 400% in early lactation and 700% in late lactation. Concentrations in plasma of free fatty acids were also higher during growth hormone treatment in late lactation but not in early lactation. Treatments did not affect plasma concentrations of glucose, insulin, glucagon, prolactin, tri iodothyronine, thyroxine, or cortisol in either early or late lactation. Daily administration of growth hormone in early or late lactation resulted in similar and substantial increases of milk yield and efficiency of milk production. PMID- 6853800 TI - Effects of diet, pregnancy, and lactation on enzyme activities and gluconeogenesis in ruminant liver. AB - Changes of activities of liver enzymes and of metabolism during pregnancy and lactation have been documented in studies with rodents. Therefore, a study of activities of ruminant liver enzymes and metabolism was undertaken. Several changes of activities of enzymes involved in lipogenesis and gluconeogenesis were observed. However, magnitudes of enzyme change were less than expected from major changes in liver function that accompany lactation. Also, a number of enzymatic changes expected from rodent data were absent. Effects of breed and diet on enzyme activities in cow livers were minimal or absent. Changes in rates of glucose metabolism from lactation were greater than implied by enzyme adaptations. Analysis of kinetic data according to Michaelis-Menten kinetics indicated that apparent maximal velocities of conversion of lactate and propionate to glucose by liver slices from cattle ranged from 10 to 30 mumoles/(g.h) and apparent coefficients were 1.8 to 2.0- mM. Rates of gluconeogenesis with lactate plus propionate were not additive at saturating concentrations. The background data on enzymatic activities, glucose metabolism, lipogenesis, and gluconeogenesis in ruminant liver indicate that sophisticated studies with isolated hepatocytes from ruminants will be required to clarify metabolic adaptations, metabolic patterns, and regulatory mechanism in this tissue. PMID- 6853801 TI - Weight changes of male dairy calves following zeranol implants. AB - In a trial to determine the effect of zeranol implants on weight gains from birth to 180 days of age, 269 male Holstein calves were assigned randomly to one of three groups: a) 56 intact calves, b) 106 castrated calves implanted at birth and again at 90 days with 36 mg zeranol, and c) 107 castrated controls. All calves were weighed at 0, 28, 56, 90, and 180 days of age. Zeranol-implanted steers averaged 9.2% greater average daily gain at 90 days and 9.5% greater at the end of the trial than control steers. Intact male calves' weight gains were intermediate between the two steer groups. There was no correlation between implant status, total protein of blood serum, mortality, birth weight, or parity of the dam. During the first 180 days of age, implanting the first 180 days of age, implanting Holstein calves with zeranol at birth and reimplanting at 90 days can return upwards of $14.89 per dollar invested. PMID- 6853803 TI - Effectiveness of model for cow evaluation intraherd. AB - Cow evaluations for production derived from an intraherd model for six dairy breeds were studied. Cow evaluations calculated within each of two herds were correlated and agreed closely with correlations expected from selection index. Another study compared genetic trends from sires, dams, and cows and found that trends from sire usage were more than twice as large as trends from dams. Comparison of sire evaluations with average evaluations of mates showed that nonrandom mating of sires with dams occurred infrequently and likely had no influence on sire evaluations. Other possible uses of cow evaluations were for differences between herds, genetic trends within herds, pedigree indexes for future offspring, and relation of pedigree indexes to Estimated Transmitting Abilities. PMID- 6853802 TI - Variation in serum immunoglobulins in Canadian Holstein-Friesians. AB - Variation, and relation to pneumonia and mastitis, of four immunoglobulins, G1, G2, M, and A of blood serum measured by radial immunodiffusion, was studied in a sample of 190 Canadian Holstein-Friesian females sired by 22 bulls in artificial insemination. Regression analyses indicated that combined effects of age, stage of lactation, parity, and cow's sire's milk rating accounted for 6, 37, 2, and 3% of the total variation in G1, G2, M, and A. The G2 increased significantly with age, parity, and stage of lactation and decreased slightly with increasing sire milk ratings. Heritabilities by paternal half-sister correlation varied from 0 for G1 and A through .28 to .68 for IgG2 and .08 to .85 for IgM. Immunoglobulin G2 was positively correlated with clinical mastitis (.24) and incidence of enzootic pneumonia (.13) indicating further study of immunoglobulin G2 and its relationship to disease is warranted. No significant correlations existed between other immunoglobulins and mastitis or pneumonia, nor was a cow's production related to immunoglobulin. Selection to alter immunoglobulin content and reduce disease may be feasible and should be examined further. PMID- 6853804 TI - Failure of hair analysis to reflect excessive sodium chloride ingestion by Holstein heifers. AB - Mineral analysis of hair samples was to assess its value as an indicator of excessive salt ingestion. Ten pregnant Holstein heifers averaging 499 +/- 32 kg were group-fed 9 kg of alfalfa hay cubes and 2 kg of a 14% dairy concentrate mix per head per day. Salt and dicalcium phosphate were available free choice. Prior to treatment animals received fresh water containing 450 ppm total dissolved salts. During treatment, sodium chloride was added to the fresh water at 3500 ppm. Hair samples together with blood and urine were taken immediately prior to start of the experiment and at 30 and 60 days after initiation. Hair samples from two previously marked areas were composited, washed with hot detergent, rinsed, dried with ethanol and then acetone, and wet-ashed. Blood electrolytes and hair and urinary minerals were measured by atomic absorption spectrophotometry. Analysis yielded no significant treatment effects for sodium, potassium, calcium, magnesium in hair and blood serum, and no correlations between hair, blood serum, and urinary minerals. Only urinary sodium reflected the increased sodium ingestion. PMID- 6853805 TI - Methoxychlor residues in milk of cattle treated with Marlate 50 insecticide as a dermal spray. AB - Lactating Holstein cattle were treated twice at an interval of 14 days with methoxychlor (Marlate 50 insecticide) as a 0, .25, or .50% dermal spray, with 2 quarts of spray mix applied to each animal. Residues of methoxychlor in whole milk were highest on the 1st or 2nd day after treatment and, when expressed as part per million equivalent in milk fat, were as high as 2.0 and 3.0 ppm in samples from the low and high dosage sprays. Residues in milk dropped rapidly after residues were at most only slightly above the sensitivity limit (.005 ppm in whole milk) of the analytical method. Applicative specifications for Marlate 50 insecticide use on lactating dairy cattle might result in violative methoxychlor residues in milk during the first 1 to 3 days after treatment. PMID- 6853806 TI - Modification of surgical gloves. PMID- 6853807 TI - Regarding venous or cavernous hemangioma. PMID- 6853808 TI - Hair transplantation: a grafting funnel. PMID- 6853809 TI - Two primary basal-cell carcinomas on an eyelid. PMID- 6853810 TI - Dual inner lip mucous membrane advancement--rotation flaps for lower lip surface defects. PMID- 6853811 TI - Surgical treatment of recalcitrant warts. AB - Cryosurgery is the first choice for surgical treatment of viral warts. It is applied in two ways: with blister induction in extraplantar common warts and without blister induction in genital, filiform, and mosaic warts. Plantar and periungual warts are enucleated with a spoon or scraped off with a curet after preparatory focal electrocoagulation with a ball probe. Genital warts may be treated with "extracutaneous" electrosection and electrocoagulation. PMID- 6853812 TI - Managing digital mucoid cysts by cryosurgery with liquid nitrogen: preliminary report. AB - Fourteen patients with digital mucoid cysts were treated by cryosurgery with liquid nitrogen using an intermittent spray technique. The cysts were punctured and the contents expressed preoperatively. Treatment was well tolerated without local anesthesia. Cysts ranged in size from 0.4 to 1.5 cm. Average follow-up was 18.6 months. Twelve patients were cured to date, in some instances after many prior unsuccessful attempts with other treatment modalities. In one patient a cyst recurred after 10 months and was retreated by cryosurgery. In another patient a much smaller cyst recurred after 12 months. Cosmetic results were gratifying, with absent or minimal scarring. From these preliminary observations it may be concluded that liquid nitrogen cryospraying of digital mucoid cysts is a valuable therapeutic modality in these notoriously recalcitrant lesions. PMID- 6853813 TI - Evaluation of various therapies for damaged scalps due to hair and fiber implants. AB - Thatching (simple interrupted suture implant) can be corrected by removing the interrupted sutures. To date, no method has been devised to totally eradicate the problem of multiple suture implants; this is particularly true for knotted-fiber implants. Various corrective methods have been discussed. These techniques were performed to counteract the damage caused by implant procedures. The techniques and their ensuing complications are based on the author's experience with 127 patients. In selected cases, autograft punch and excision with rotation flaps appeared to be the most cosmetically acceptable surgical approach to the hair and fiber implant problem. PMID- 6853814 TI - Dermabrasion for telangiectasia. AB - A case of profuse yet distinct telangiectasia of the nose was successfully treated by light dermabrasion. Dermabrasion may be useful for treating superficial telangiectasia that are numerous and occupy a considerable area. A small test patch is recommended. PMID- 6853817 TI - Malignant sun-induced squamous-cell carcinoma of the skin. PMID- 6853815 TI - Cytologically malignant squamous-cell carcinoma arising in a verrucous carcinoma of the penis. AB - A case of verrucous carcinoma with a focus of cytologically malignant squamous cell carcinoma is presented. This usually occurs following radiation therapy of the verrucous carcinoma, but may rarely occur de novo, as in this case. The potential usefulness of fine-needle aspiration in detecting focal anaplasia in verrucous carcinoma is discussed. This technique may be especially useful if the lesion is to be destroyed cryosurgically. PMID- 6853816 TI - Basal cell nevus syndrome. PMID- 6853818 TI - Tumor Conference #48. Massive congenital hemangioma resulting in death. PMID- 6853819 TI - Penrose sleeve. PMID- 6853821 TI - Donor plug replacement: the final common pathway in hair transplantation. PMID- 6853820 TI - Malignant melanoma prognostic factors 2: the subsite concept. PMID- 6853822 TI - Keloids of the earlobes: a surgical technique. AB - "Core" excision of dumbbell-shaped keloids of the earlobe is described. This technique combined with intralesional steroids resulted in an apparent cure of six patients followed for over 1 year. The cosmetic results have been excellent. PMID- 6853823 TI - Punch biopsy of the skin: effect of temperature and local anesthesia with ethyl chloride freezing. AB - The effect of local anesthesia with ethyl chloride freezing on biopsy size and quality for microscopy was studied postmortem. Four-mm punch biopsies were taken from the abdominal skin by different techniques: manual punch and drill (250 RPM) at 8 degrees C and 33 to 36 degrees C, ethyl chloride, and injection of lidocaine for local anesthesia. Histologic sections were assessed, and defatted dried weight (DW) was determined as an expression of biopsy size. After ethyl chloride freezing, microscopy showed more trauma (p less than 0.001) and characteristic, marginal tissue-breaks (p less than 0.01). More biopsies (p less than 0.05) were not proper for microscopy. DW and the variances showed no differences. It is concluded that local anesthesia with ethyl chloride freezing results in tissue trauma and inferior quality of the tissue specimens for microscopy. PMID- 6853824 TI - [Light-sensitive antibiotic effect in phototrophic microorganisms]. PMID- 6853825 TI - [Biological aspects of the pathogenesis of periodontosis]. PMID- 6853826 TI - [Molecular mechanisms of the action of endogenous and exogenous ethanol]. PMID- 6853827 TI - [Analysis of the correlation of a quantitative trait with human susceptibility to disease]. PMID- 6853828 TI - [Species characteristics of heat stress in the microwave irradiation of mammals (a theoretical analysis)]. PMID- 6853829 TI - [Acoustic stimulation of the food reaction in young hens]. PMID- 6853831 TI - A simplified technique for measuring intracranial pressure. PMID- 6853830 TI - [Change in the secondary structure of DNA as affected by a liver extract of the spiny dogfish]. PMID- 6853832 TI - Monitoring aminophylline therapy using Jusko's dosage guidelines. AB - Treatment with aminophylline, according to the nomogram published by Jusko and coworkers, was monitored in 13 patients suffering from acute exacerbations of COPD. After 24 h of therapy, the clinical state, the pO2 and the pCO2 values were markedly improved. Theophylline plasma concentrations were maintained within the therapeutic range. A slight but noticeable increase of drug serum levels during therapy could be related to changes in the arterial pH; the implications of this finding are discussed. PMID- 6853833 TI - The reliability of electrolyte measurements in plasma. AB - The difference between serum and plasma electrolyte measurements and the effects of delay, cooling and addition of sodium heparin on plasma electrolyte measurements were observed. Delay of more than 30 min from sampling to analysis renders plasma potassium measurements unreliable. All other factors assessed produced no changes in plasma electrolyte measurements. Arterial blood gas laboratories can, therefore, reliably provide rapid or serial measurements of plasma sodium and potassium provided the analysis is performed within 30 min of obtaining an appropriate arterial blood sample. PMID- 6853834 TI - Stevens-Johnson syndrome managed in the Clinitron bed. PMID- 6853835 TI - Frequency-domain investigations of cochlear stability in the presence of active elements. AB - For a linear, time-invariant cochlear response function, the requirements of causality and stability imply the absence of poles of the spectral response function g(omega) for Im omega greater than 0, with e-i omega t as the time dependent factor. The existence of such poles invalidate conventional Hilbert transform (dispersion) relations. The testing of these dispersion relations provides a frequency-domain check of system stability for cochlear models which contain active elements such as negative resistance. The stability of several one and two-dimensional cochlear models with active elements is checked using these dispersion relations. A simple circuit analog of the cochlea, which contains active elements, is used to illustrate the relationship between the pole locations of g(omega) and the strength of active elements. PMID- 6853836 TI - Growth of forward masking for sinusoidal and noise maskers as a function of signal delay; implications for suppression in noise. AB - The first two experiments were designed to determine whether mutual suppression in broadband noise increases in strength with increasing overall level. In experiment I masking functions (signal threshold versus masker level) were measured in forward masking as a function of the delay time of a 10-ms signal, both for a broadband noise masker (low-pass filtered at 8 kHz) and for sinusoidal maskers at 1, 2 and 4 kHz. In the latter case the signal frequency equaled the masker frequency. For short signal delays the masking functions were steeper for the sinusoidal masker than for the noise masker. At longer delays the slopes for both masker types decreased and the slopes for the two masker types became more nearly equal. In experiment II we investigated the effect of gating a low-level noise cue with the sinusoidal masker. At the longer signal delays the masking functions had equal slopes for the broadband noise masker and the sinusoidal masker with cue. At short signal delays the masking functions for sinusoidal maskers may be "artificially" steepened, since the subject lacks an effective cue to distinguish the signal from the masker. The equal slopes at longer delays indicate that mutual suppression of the components within a broadband noise does not increase in strength with increasing overall level. In experiment III we attempted to estimate the magnitude of mutual suppression in a broadband noise by comparing masking functions for a broadband noise and for a noise whose bandwidth was 20% of the center frequency. The suppression was estimated to be about 2 dB at 4 kHz and 8 dB at 2 kHz. A simple mathematical expression, suggested by Jesteadt et al. [J. Acoust. Soc. Am. 71, 950-962 (1982)], was found to give an accurate description of the amount of masking produced by the broadband masker as a function of masker level and signal delay. PMID- 6853838 TI - A central spectrum model: a synthesis of auditory-nerve timing and place cues in monaural communication of frequency spectrum. AB - A probabilistic psychophysical model for monaural communication from the auditory nerve to the brain is given in the form of a tonotopic display of stimulus spectrum, termed central spectrum. The model builds upon prior research demonstrating the potential of neural timing cues from the auditory nerve for conveying information on complex spectra, and was designed to meet the quantified demands of the psychophysics of frequency measurement. The central spectrum magnitude at each frequency is determined by the response of the auditory-nerve fibre with characteristic frequency matching that frequency. An interval histogram from each fiber is passed through a filter matched to the characteristic frequency of the fiber. This output versus characteristic frequency defines the central spectrum. Detailed analysis demonstrates that efficient probabilistic processing of the central spectrum described known psychophysical properties of frequency measurement in discrimination and periodicity pitch experiments. Psychophysical models based upon the central spectrum model followed by optimum probabilistic pattern recognition are potentially relevant for predicting human communication limits in response to arbitrary sounds of speech and music. PMID- 6853837 TI - Further studies of auditory profile analysis. AB - The discrimination of a change in the intensity of a component or components of a multitone complex is reported as a function of a number of experimental variables. In one experiment, changes in the shape of the spectrum were explored to determine which kinds of changes are more easily detected. Although different signal spectra produced different thresholds, the change in a single component produced the lowest threshold on an energy basis. Various binaural conditions were tested to determine if the shape or profile of the stimulus could be supplied by the ear opposite the one in which the signal was presented. Conditions where spectral contrasts were available to both ears simultaneously (diotic conditions) were much more sensitive than conditions where the spectral contrasts occured for opposite ears (dichotic conditions). Finally, the level of the component at the signal frequency was varied relative to the other, equal amplitude, components to form a "pedestal" upon which the signal was added. Detection of the signal was roughly the same for pedestal levels within about +/- 12 dB of the background except for conditions where masking was apparent. PMID- 6853839 TI - The ear effect as a function of age and hearing loss. AB - Many studies have shown that the right ear statistically is slightly more sensitive than the left ear, particularly in the male adult population. In this study, we examined the lateral difference in hearing sensitivity, termed the ear effect here, in an industrial noise-exposed, nonshooting population, by sex, age, and hearing level. It was found that the male population had a larger ear effect (right ear being more sensitive) than the female population. The magnitude of the ear effect was found to be significantly related to the hearing threshold level. The ear effect was highest when the threshold was between 30- and 40-dB HL. Several possible causes for the ear effect are discussed. PMID- 6853840 TI - Vibrotacile masking of Pacinian and non-Pacinian channels. AB - Vibrotactile masking functions were determined using sinusoidal and noise maskers. Results were nearly identical within the Pacinian (P) and non-Pacinian (NP) channels. At low maskers SLs there was a substantial amount of negative masking which proved not be an artifact of stimulus definition. The critical parameters for successful prediction of the data were a peripheral threshold and internal Gaussian noise. Threshold shifts in cross-channel stimulation can be attributed to the masker exceeding the detection threshold of the signal channel. PMID- 6853841 TI - Laryngeal vibrations: a comparison between high-speed filming and glottographic techniques. AB - This study was designed to compare information on laryngeal vibrations obtained by high-speed filming, photoglottography (PGG), and electroglottography (ECG). Simultaneous glottographic signals and high-speed films were obtained from two subjects producing steady phonation. Measurements of glottal width were made at three points along the glottis in the anterior--posterior dimension and aligned with the other records. Results indicate that PGG and film measurements give essentially the same information for peak glottal opening and glottal closure. The EGG signal appears to reliably indicate vocal-fold contact. Together, PGG and EGG may provide much of the information obtained from high-speed filming as well as potentially detect horizontal phase differences during opening and closing. PMID- 6853842 TI - Computerized measurement of tongue dorsum movements with pulsed-echo ultrasound. AB - A computerized system for the measurement of tongue dorsum movements with pulsed echo ultrasound is described. The presentation focuses on technical and methodological considerations in the on-line acquisition of vertical tongue movement information, its digital processing and display. Problems associated with transducer placement, peak detection, data averaging, and curve fitting are considered, and validation procedures based on x ray and indicators of measurement reliability are reported. The discussion centers on advantages and disadvantages of the technique and its applications. PMID- 6853843 TI - Relationships between vocal intensity and noninvasively obtained aerodynamic parameters in normal subjects. AB - The relationships between vocal intensity (sound pressure level) and intrapulmonic pressure, mean flow rate, and aerodynamic powere were investigated in ten normal subjects. The intrapulmonic pressure was measured noninvasively and simultaneously with sound pressure level and mean flow rate during sustained phonation of the vowel/a/by means of plethysmographic and pneumotachographic methods. The aerodynamic power was calculated as intrapulmonic pressure times mean flow rate. The averaged values for the normal subjects represented (sound power) alpha (intrapulmonic pressure), (sound power) alpha (mean flow rate), and (sound power) alpha (aerodynamic power), where sound power at the open end of the pneumotachograph was estimated from sound pressure level. Vocal efficiency was defined as the ratio of sound power to aerodynamic power. Individual variation of coal efficiency (in dB) was satisfactorily small in the normal subjects, and was determined by the simple addition of individual variations of intrapulmonic pressure and mean flow rate (in dB) from the averaged values. These findings strongly suggested that the comparison of those three measurements against normative data for normal subjects such as provided by this study is useful in evaluating and clarifying the ineffective voice production of the pathological larynx. PMID- 6853844 TI - Enlargement of the supraglottal cavity and its relation to stop consonant voicing. AB - Measurements were made of saggital plane movements of the larynx, soft palate, and portions of the tongue, from a high-speed cinefluorographic film of utterances produced by one adult male speaker of American English. These measures were then used to approximate the temporal variations in supraglottal cavity volume during the closures of voiced and voiceless stop consonants. All data were subsequently related to a synchronous acoustic recording of the utterances. Instances of /p,t,k/ were always accompanied by silent closures, and sometimes accompanied by decreases in supraglottal volume. In contrast, instances of /b,d,g/ were always accompanied both by significant intervals of vocal fold vibration during closure, and relatively large increases in supraglottal volume. However, the magnitudes of volume increments during the voiced stops, and the means by which those increments were achieved, differed considerably across place of articulation and phonetic environment. These results are discussed in the context of a well-known model of the breath-stream control mechanism, and their relevance for a general theory of speech motor control is considered. PMID- 6853845 TI - Reiterant speech: an acoustic and perceptual validation. AB - Reiterant speech, or nonsense syllable mimicry, has been proposed as a way to study prosody, particularly syllable and word durations, unconfounded by segmental influences. Researchers have shown that segmental influences on durations can be neutralized in reiterant speech. If it is to be a useful tool in the study of prosody, it must also be shown that reiterant speech preserves the suprasegmental duration and intonation differences relevant to perception. In the present study, syllable durations for nonreiterant and reiterant ambiguous sentences were measured to seek evidence of the duration differences which can enable listeners to resolve surface structure ambiguities in nonreiterant speech. These duration patterns were found in both nonreiterant and reiterant speech. A perceptual study tested listeners' perception of these ambiguous sentences as spoken by four "good" speakers--speakers who neutralized intrinsic duration differences and whose sentences were independently rated by skilled listeners as good imitations of normal speech. The listeners were able to choose the correct interpretation when the ambiguous sentences were in reiterant form as well as they did when the sentences were spoken normally. These results support the notion that reiterant speech is like nonreiterant speech in aspects which are important in the study of prosody. PMID- 6853846 TI - Place cues for nasal consonants with special reference to Catalan. AB - This study investigates the perceptual contributions of formant transitions and nasal murmurs to the identification of the unreleased Catalan nasal consonants [n], [n], [n] (alveolar, palatal, velar, respectively) after [a] in absolute final position. Transition and murmur patterns were synthesized and varied simultaneously and systematically by interpolating between optimal values obtained from spectrographic analysis of natural speech. Catalan subjects were asked to identify the synthetic stimuli as [n], [n], and [n]. The main findings were: (1) Although transitions provided more effective cues for place of articulation than murmurs, the murmurs did make a significant contribution to the [n]-[n] distinction. (2) The cue value of the transitions ([n] greater than [n], [n]) was inversely related to that of the murmurs ([n], [n] greater than [n]). It is concluded that static and dynamic place cues for nasals in an [aC#] context are perceptually integrated with reference to the typical pattern of production of these consonants. PMID- 6853847 TI - Acoustic and perceptual indicators of emotional stress. AB - Tape recordings of telephone conversations of Consolidated Edison's system operator (SO) and his immediate superior (CSO), beginning an hour before the 1977 New York blackout, were analyzed for indications of psychological stress. (SO was responsible for monitoring and switching power loads within the Con Ed network.) Utterances from the two individuals were analyzed to yield several pitch and amplitude statistics. To assess the perceptual correlates of stress, four groups of listeners used a seven-point scale to rate the stress of SO and CSO from either randomized vocal utterances or transcripts of the randomized utterances. Results indicated that whereas CSO's vocal pitch increased significantly with increased situational stress, SO's pitch decreased. Listener ratings of stress from the voice were positively related to average pitch. It appears that listener's stereotype of psychological stress includes elevated pitch and amplitude levels, as well as their increased variability. PMID- 6853848 TI - Theoretical framework for spectrum analysis in ultrasonic tissue characterization. AB - An analytic model is described for application in ultrasonic tissue characterization. The model is applicable to clinical broadband pulse echo systems. It treats spectra derived from received echo signals and relates them to physical tissue properties. The model can be applied to deterministic tissue structures (e.g., retinal detachments, larger blood vessels, and surface layers of the kidney) and to stochastic tissue structures (e.g., various tumors). The beam patterns included in the model are those generated by focused transducers typically used in high-resolution clinical ultrasound. Appropriate calibration procedures are also treated; these are needed for interpretation of absolute spectral parameters. The results obtained with the analytic model have been used to design a digital processing system and the associated techniques which are now being applied during examinations of the eye and abdominal organs. The results have proven useful in interpreting data from various types of tissues. To illustrate the application of these results, representative clinical data, obtained from the digital system, are presented for two types of tissue architectures. The first case is a detached retina representing a deterministic structure characterized by well-defined thickness and reflection coefficients. The second case is asteroid hyalosis and represents a stochastic entity in which the positions of small scattering particles are best described in statistical terms, and characterization is accompanied by means of normalized power spectra. PMID- 6853849 TI - Starch-xanthate-encapsulated pesticides: a preliminary toxicological evaluation. PMID- 6853850 TI - Degradation of disulfoton in soil and its translocation into asparagus. PMID- 6853851 TI - Determination of carbosulfan and carbofuran residues in plants, soil, and water by gas chromatography. PMID- 6853853 TI - Methyl bromide fumigation of tree fruits for control of the Mediterranean fruit fly: concentrations, sorption, and residues. PMID- 6853852 TI - Diphenyl ether herbicides: mutagenic metabolites and photoproducts of nitrofen. PMID- 6853856 TI - Analysis of 6-hydroxy-1-methyl-1,2,3,4-tetrahydro-beta-carboline in alcoholic beverages and food. PMID- 6853855 TI - A method for the quantitative determination of 1-naphthaleneacetic acid, 1 naphthalenylacetylaspartic acid, and beta-D-glucose 1-(1-naphthalene)acetate in grapes. PMID- 6853854 TI - Comparison of free and total residues of (2,4-dichlorophenoxy)acetic acid and 2,4 dichlorophenol in millet resulting from postemergence and preharvest treatment. PMID- 6853857 TI - Radioimmunoassay for diethylstilbestrol and the monoglucuronide metabolite in bovine liver. PMID- 6853858 TI - Formation of mutagens in sugar-amino acid model systems. PMID- 6853859 TI - In vitro methods to assess the nutritive value of leaf protein concentrate. PMID- 6853860 TI - Rapeseed protein isolates: effect of processing on yield and composition of protein. PMID- 6853861 TI - Phosphorylation of casein and lysozyme by phosphorus oxychloride. PMID- 6853862 TI - Caloric utilization and disposition of [14C]polydextrose in man. PMID- 6853863 TI - Reduction in alkaloid content of ergot sclerotia by chemical and physical treatment. PMID- 6853864 TI - Effects of processing on the sodium:potassium and calcium:phosphorus content in foods. PMID- 6853866 TI - Differences in observed mutagenicity associated with the extraction of mutagens from cooked fish. PMID- 6853865 TI - Properties of two toxins newly isolated from oysters. PMID- 6853867 TI - Effect of pre heat treatment on tryptic hydrolysis of Maillard-reacted ovalbumin. PMID- 6853868 TI - A rapid gas chromatographic method for the determination of free phenol in blood. PMID- 6853870 TI - Determination of emodin in feeds. PMID- 6853869 TI - Analysis of potatoes treated with dinoseb and chlorbromuron herbicides. PMID- 6853871 TI - Determination of dithiocarbamate fungicides in vegetable foodstuffs by high performance liquid chromatography. PMID- 6853872 TI - Family interactions of assaultive adolescents, stealers, and nondelinquents. AB - Eleven adolescent chronic offenders apprehended for assaultive crimes in the community were observed in their family homes. This group was matched with 11 adolescents apprehended for stealing and with 11 adolescents with no court contact. Assaultive adolescents, unlike their controls, ranked significantly higher among their own family members in terms of their total aversive behavior in the family home. The results support the notion that assaultive adolescents are more involved with fighting with their siblings in the family home and consequently have had more practice in fighting than their controls, thereby preparing them for assaultive behavior in the community. Assaultive adolescents had more female siblings than male siblings, whereas nondelinquent adolescents had more male than female siblings. PMID- 6853873 TI - The generalization of the effects of a cognitive-behavioral treatment program for aggressive children. AB - A cognitive-behavioral treatment program for aggressive children was assessed using 12 outcome measures classified into five categories which reflected a continuum of generalization of treatment effects. From a summer daycamp 41 children, ages 7 through 12, were selected based on aggressive behavior displayed during the first week of camp. They were randomly assigned to either a treatment group or a non-treatment control group. Treatment consisted of four weeks of coping-skills training using behavioral rehearsal and self-instruction training. Considering all 12 measures, treatment was found effective (F = 2.90, p less than .01). The most meaningful results included improved interpersonal problem-solving skills and a decrease in being disciplined for fighting. No changes were found, however, in physical or verbal aggression and in peer rating of aggression. Modest support for the effectiveness of these treatment procedures was identified, although caution is needed in considering their clinical utility. Further research and application appear justified. PMID- 6853874 TI - Modification of anger in children by affective imagery training. AB - From a school population of normal children (third through fifth grades), thirty children initially identified as "angry" were randomly assigned to either an affective imagery training group, an attention group, or a control group. The treatment group received three sessions of affective imagery in which they focused on physiological changes and on their thoughts associated with prior emotional experiences. Teachers recorded pre-, post-, and short term follow-up aggressive behaviors for all thirty children. Cognitive perceptions and attributions were recorded at the same three occasions on the Affect Questionnaire. Results suggested that, as a result of affective imagery training, angry children's perceptions and cognitions shifted from "angry" towards "sad," and there was a concomitant decrease in observed aggressive classroom behavior. PMID- 6853876 TI - An analysis of the physical punishment component of a parent training program. AB - One component of a well-researched, standardized parent training program is to spank children for escape from time-out. The contribution of the spanking component to compliance acquisition in a clinic analog setting was evaluated. Time-out duration and child disruption at time-out release were balanced across spank and no-spank ("barrier") conditions. Sixteen noncompliant, clinic-referred pre-school children participated. The data indicated that both spank and barrier procedures were equally effective at increasing compliance ratios. Physical punishment did not appear to be a critical component. Given prior research, it was concluded that the enforcement of a minimum time-out duration is critical for compliance acquisition within the analog setting. PMID- 6853875 TI - Stimulus-seeking behavior in hyperactive and nonhyperactive children. AB - Auditory and visual stimulus-seeking behavior was measured in hyperactive and nonhyperactive youngsters. The design controlled for motor activity level. The results indicate that hyperactive children preferred auditory stimulation more than the control children. There were no differences in stimulus-seeking preferences in the visual modality. The groups did not differ in motor activity. It was concluded that abnormally high needs for stimulation are important in hyperactivity. PMID- 6853877 TI - Social problem solving training: a follow-up study of cognitive and behavioral effects. AB - The long term effects of Spivack and Shures' social problem-solving training were assessed and compared to an attention-placebo control. Thirty-seven preschool age children were involved in this year's long intervention project and six month follow-up. All subjects received 46 sessions of intervention by specially trained assistants. Support was found for the cognitive effectiveness of social problem solving training with aberrant children at post test in that they gained significantly in their ability to generate alternative solutions to interpersonal problems. This differential effect was not sustained at follow-up. Blind teacher ratings of behavioral adjustment and independent observers' ratings of behavior (using a naturalistic observation scale developed for this study) revealed no significant behavioral training effects at post test or at follow-up. Findings are discussed with the suggestion that behavior change in young children may not be mediated through a strictly cognitive intervention, and may more logically require an integration of behavioral and cognitive techniques. PMID- 6853878 TI - Parental characteristics and interactional dysfunction in families with child behavior problems: a preliminary investigation. AB - Thirty-six families with a preteenage behavior problem child were assessed on measures of marital discord, parental psychopathology, and three parental cognitive factors: knowledge of behavioral principles, tolerance for child deviancy, and expectations regarding their child's behavior. Nine nonproblem families with demographic characteristics similar to the problem families were also assessed. Correlational analyses across all families revealed a strong association between marital discord and the parental index of child behavior problems. While a number of significant associations were discovered between the various measures of marital discord, parental psychopathology, and parental cognitive factors, no other measure besides marital discord was associated with parental perception of child behavior problems. The nonproblem families and 15 of the problem families also participated in home observations obtained through random audio recordings during high interaction periods. These observational data indicated a significant relationship between parental perception of child behavior problems and parental negative behavior toward the child, but no significant relationship between parental perception of child behavior problems and child behavior, even when child behavior was weighted by parents' reactions to that behavior. Through sequential analysis, several contingent relations between parent and child behavior were discovered. Findings are discussed in relation to family systems theory. PMID- 6853880 TI - Parental interrater reliability as a function of situational specificity and familiarity of target child. AB - Child behavior ratings were made by 17 mothers and fathers of the same child. Agreement was computed for each parent pair under the following experimental conditions: (1) Ratings of their own child's behavior in general (CBC); (2) ratings of own child based on observations of him/her in a videotaped sample; (3) ratings of an unknown child based on observations of him/her in a videotaped sample; and (4) ratings of the videotaped sample of own child and unknown child using a one minute time-sampling procedure. Parents achieved higher rates of agreement (X = .81) than have previously been reported. Increasing the specificity of the behavior being rated did not significantly affect agreement. Those parent pairs who agreed the most did not necessarily spend a large amount of time in the same kind of situations with their child. Agreement was significantly greater when parents rated their own children's videotaped behavior sample as opposed to that of an unknown child. PMID- 6853879 TI - Correlates of depressed mood in normal children. AB - Two instruments which have been proposed as measures of clinical depression in children and an ad hoc teacher rating were given to a group of 109 normal children. The Children's Depression Inventory (CDI), the Peer Nomination Inventory for Depression (PNID), and a teacher rating of depression were given along with the Conners Teacher Rating Scale (TRS), teacher ratings of somatic complaints, peer popularity, and absenteeism, and peer ratings of popularity to examine the behavioral correlates of depressed mood in normal children. While few sex differences were found on mean depression scores, different patterns of correlations were found for the two sexes. For males, there were no significant correlations among the three depression measures, but all three depression measures were correlated with unpopularity and conduct problem ratings on the TRS. For females, the three depression measures were adequately intercorrelated. The teacher rating of depression was correlated with general deviance as measured by the TRS, but the CDI and PNID were correlated with TRS ratings of conduct problems, with peer ratings of unpopularity, and with teacher ratings of somatic complaints. Implications for the issue of the possible existence of a clinical syndrome of depression in children were discussed. PMID- 6853882 TI - Stimulus overselectivity in autistic, trainable mentally retarded, and non handicapped children: comparative research controlling chronological (rather than mental) age. AB - Much of the comparative research on stimulus overselectivity has been flawed by either failure to control for chronological age and language ability of the subjects or reliance on the controversial technique of matching on mental age. The present study investigated the prevalence of overselectivity in autistic, trainable mentally retarded, and nonhandicapped children demonstrating some expressive speech. The ages of the children were between 6 years-6 months and 9 years-3 months. Thus, chronological age and language ability were controlled, rather than allowed to vary unsystematically. Results indicated no significant differences between the autistic and TMR samples, but significant differences between the handicapped samples and the non-handicapped group. Some, but not all, of the handicapped children displayed overselectivity. PMID- 6853883 TI - Torque, lateral preference, and cognitive ability in primary-grade children. AB - It has been suggested that torque, the tendency to draw circles in the clockwise direction, is related to left-handedness and is a marker for psychopathology. Results of recent studies conflict with this hypothesis but are weakened by imprecise definition and unreliable assessment of torque. Measures of torque, lateral preference, and cognitive ability were administered to 181 children in kindergarten and first grade. As reported previously, rate of torque decreased with age and was greater among males. Children with complete clockwise or counter clockwise circling at both assessments differed in pattern but not in overall level of cognitive ability. No differences were found in strength, direction, or concordance of hand and foot preference. Results of this and other studies are seen as inconsistent with proposals that torque is symptomatic of psychopathology. PMID- 6853881 TI - Children's perceptions of parental behaviors. AB - Children's perceptions of positive and negative parental behaviors were assessed using a newly-developed scale, the Parent Perception Inventory (PPI). Reliability and validity were examined across a sample of 75 children aged 5 to 13 using additional measures administered to the children and measures completed by their parents. The scale showed acceptable levels of internal consistency. No effects of children's age were apparent, but effects of the child's and parent's gender were found. Boys reported more positive parental behaviors, particularly for fathers, and children reported more negative (disciplinary) behaviors by mothers. PPI scores were predictably related to child's self-concept and behavior problems (convergent validity) and generally unrelated to measures of child's achievement (discriminant validity). As predicted by family systems theory, children from nondistressed families viewed their parents as behaving more similarly on the PPI than did children from distressed families. PMID- 6853885 TI - Predictors of alcohol use among college students in New York State. PMID- 6853884 TI - Physiological correlates of conduct problems and anxiety in hyperactive and learning-disabled children. AB - Thirty-six learning disabled children (21 of whom were also classified as hyperactive) were subgrouped according to teacher ratings of tension-anxiety and conduct problems and then compared on measures of tonic and phasic autonomic arousal. The results indicated that children rated high on the conduct problem dimension evidenced smaller amplitude specific skin conductance responses, and that anxiety appeared to exert a moderating effect on physiological responses. When the hyperactive sample was considered separately, lower skin conductance levels were observed in children rated high on conduct problems than in hyperactive children rated low in conduct problems. These findings support the notion that hyperactive and learning-disabled children are heterogeneous at a physiological level and suggest that physiological differences previously attributed to hyperactivity may actually be correlates of the conduct problem dimension. PMID- 6853886 TI - Measles: the epidemiology and control of an outbreak. PMID- 6853887 TI - Health alive! PMID- 6853888 TI - The development of a student-run ambulance. PMID- 6853889 TI - Fertility awareness: the University of California/Berkeley experience. PMID- 6853890 TI - The development and implementation of a nursing clinic on a college campus. PMID- 6853892 TI - Speaking the same language. PMID- 6853893 TI - Emerging issues for college students in the 1980s. PMID- 6853891 TI - Loneliness and the college therapist. PMID- 6853894 TI - Angina caused by reduced vasodilator reserve of the small coronary arteries. PMID- 6853895 TI - Evaluation of platelet reactivity in patients with valvular heart disease. AB - Transmission electron microscopy with a standardized in vitro method was used to evaluate the degree of blood platelet reactivity in 72 normal subjects and 72 patients with valvular heart disease. Among the patients with abnormal natural heart valves, 51 had either aortic insufficiency or aortic stenosis, and 21 patients showed either mitral insufficiency or mitral stenosis. For normal subjects, the platelet differential counts were dominated by the dendritic type platelet, and only a few platelets showed cytoplasmic spreading between adjacent pseudopodia (spread type). A hyperactive response was defined as greater than 20% of the spread type platelet or more than 93 aggregates per 100 single platelets counted, or both. Only 6 (8%) of the 72 normal subjects showed hyperactive platelets. In contrast, 45 (62%) of the 72 patients with valvular heart disease had hyperactive platelets (p less than 0.01). For patients with abnormal valves, the mean percent of the spread type platelet was 35% with a mean value of 105 platelet aggregates. The increased level of platelet reactivity was independent of both the position of the valve (aortic versus mitral) and its functional status (insufficient versus stenotic). Disturbed flow and the exposure of subendothelial thrombus-producing materials are features associated with abnormal heart valves. These factors, which usually occur in combination, may explain the hyperactive platelet response found in these patients. PMID- 6853896 TI - Regional blood flow response to orthostasis in patients with congestive heart failure. AB - To investigate the central and regional circulatory response to orthostasis in congestive heart failure, hemodynamic variables and forearm and hepatic blood flow were measured in 22 patients at supine rest and during a 65 degrees head-up tilt. Results were compared with those in nine normal subjects. Heart rate and mean arterial blood pressure increased during tilt in normal subjects, but not in patients with heart failure. Forearm blood flow decreased in normal subjects from 3.7 +/- 1.1 to 2.7 +/- 1.5 ml/min per 100 g (probability [p] less than 0.02), but did not change from a lower baseline (1.65 +/- 0.78 ml/min per 100 g) in patients. Forearm vascular resistance increased in normal subjects but not in patients. Hepatic blood flow did not change during tilt in either group, but hepatic vascular resistance increased in normal subjects from 0.37 +/- 0.13 to 0.47 +/- 0.15 U, (p less than 0.02). The increase was not seen in patients (1.2 +/- 1.1 to 1.4 +/- 1.0 U, p = not significant [NS] ). Total systemic resistance increased in patients from 1,848 +/- 560 to 2,132 +/- 731 dynes.s.cm-5 (p less than 0.005) indicating that resistance did increase in some vascular beds. Plasma norepinephrine also increased modestly in these patients from 665 +/- 377 to 761 +/- 379 pg/ml (p = 0.035), but individual changes in plasma norepinephrine did not correlate with changes in hepatic or forearm resistance. Thus, both the overall hemodynamic response and the regulation of regional blood flow and resistance differ in several respects in patients with congestive heart failure when compared with normal subjects. Changes in heart rate, blood pressure, forearm flow and forearm and hepatic vascular resistance are all blunted in patients. Reasons for the differences are not yet clear, but may be associated with abnormalities in reflex control of the circulation in patients with congestive heart failure. PMID- 6853897 TI - Adverse acute and chronic effects of electrical defibrillation and cardioversion on implanted unipolar cardiac pacing systems. AB - Six cases are presented in which a transient or chronic rise in the stimulation threshold of a permanently implanted unipolar pacemaker resulted in the loss of effective pacing after therapeutic defibrillation or cardioversion. Although damage to the pulse generator may still occur, leading to a loss of function as demonstrated in a seventh patient, improvements in the internal protection circuits of the present generation of pacemakers makes this less likely while possibly predisposing to endocardial burns and increased fibrosis at the electrode-endocardial interface. The theoretical explanations for this phenomenon are discussed, along with recommendations for the prospective and retrospective management of the pacemaker patient who requires defibrillation or cardioversion. PMID- 6853899 TI - Effects of lidocaine and droxicainide on myocardial necrosis: a comparative study. AB - Lidocaine has been shown to protect ischemic myocardium, but the degree of its effectiveness is not yet well established. Therefore, in this study, the effects of this drug on ultimate infarct size were examined quantitatively. Another member of the same class of drugs, droxicainide (ALS1249), DL-N-(2-hydroxyethyl) pipecolinyl-2,6-dimethylanilide hydrochloride, is a new antiarrhythmic agent that has shown a good therapeutic index in the initial experimental studies. Accordingly, the effects of this drug on ultimate infarct size were examined and compared with those of lidocaine. Coronary artery occlusion was performed on 29 dogs. One minute later, technetium-99m labeled microspheres were injected into the left atrium for assessment of the hypoperfused zone (the zone at risk of infarction). Fifteen minutes after occlusion, the dogs were randomized into three groups: 9 dogs served as a control group, 10 were given lidocaine and 10 were given the same dosage of droxicainide. Six hours after occlusion, the dogs were sacrificed and the hearts cut into 3 mm thick slices and incubated in triphenyltetrazolium chloride to delineate the area of myocardial damage. Autoradiography of the same slices provided images of the areas of myocardial hypoperfusion. Thereafter, in each dog, the percent of hypoperfused area that evolved to necrosis was calculated. In control dogs, it was 85.6 +/- 2.0%; in lidocaine-treated dogs, 68.1 +/- 4.1% (p less than 0.01), a reduction of 20%; and in droxicainide-treated dogs, 50.1 +/- 5.3%, a reduction of 41% (p less than 0.001 versus control and p less than 0.005 versus lidocaine). PMID- 6853898 TI - Localization of septal pacing sites in the dog heart by epicardial mapping. AB - To examine whether different septal pacing sites could be distinguished by their epicardial activation patterns, six to eight stimulating electrodes were placed throughout the septum in seven open chest dogs. Unipolar electrograms were obtained from 52 epicardial electrodes during pacing from each stimulating electrode and isochronous epicardial maps were constructed. The location of each stimulating electrode was found by dissection, and its distance from the overlying epicardium was measured. To allow comparison among epicardial maps, the septum was conceptually subdivided into nine regions to which stimulating electrodes were assigned. Epicardial activation patterns from the same region were similar and these patterns allowed the region containing a stimulating electrode to be identified in many cases. Three other variables were found to have additional localizing value. There were: 1) the time from the stimulus to epicardial breakthrough, 2) the duration of epicardial activation, and 3) the area of epicardium activated in the first 5 ms after epicardial breakthrough. For those stimulating electrodes that could not be localized by their epicardial activation patterns, the distance of the stimulating electrode beneath the epicardium was well fit from these three variables by multiple regression (correlation coefficient [r] = 0.97). Thus, using all the previous factors, localization of septal pacing sites was possible in the noninfarcted dog heart by epicardial mapping. PMID- 6853901 TI - Changes in QTc interval induced with Renografin-76 and Hypaque-76 during coronary arteriography. AB - Renografin-76 and Hypaque-76 are both recommended for coronary arteriography. Both have the same osmolality and iodine concentration, but differ in their calcium binding properties. After selective right or left coronary arteriography in patients, Renografin-76 caused significantly more prolongation of the QTc interval than did Hypaque-76. Less calcium binding in the Hypaque formulation is probably responsible for its lesser effect on the QTc interval. This study suggests, but does not prove, that Hypaque-76 is safer than Renografin-76 for coronary arteriography. PMID- 6853900 TI - Limitations of electrocardiographic scoring systems for estimation of left ventricular function. AB - Four electrocardiographic scoring systems for the assessment of left ventricular function or presence of myocardial infarction were evaluated in 231 patients with coronary artery disease. Electrocardiographic scores were compared with radionuclide ejection fraction and thallium perfusion studies. The correlation between Wagner's modified QRS score and ejection fraction was only fair (r = 0.60). Askenazi's sum of R wave voltage score correlated poorly with ejection fraction (r = 0.44), as did Gottwik's sum of voltage score from the Frank lead electrocardiogram (r = 0.44). Rautaharju's Cardiac Infarction Injury Score did not reliably predict presence of infarction in the patient group, nor did it correlate well with ejection fraction (r = -0.49). None of the correlations were significantly improved when only patients with a history of a myocardial infarction, a thallium defect compatible with a scar or a diagnostic Q wave were considered. Although Wagner's QRS score correlated best with ejection fraction, all scoring systems had limited clinical usefulness for estimating ejection fraction. PMID- 6853902 TI - Induction of ventricular tachycardia during electrophysiologic study after repair of tetralogy of Fallot. AB - An association among premature ventricular complexes on routine electrocardiogram, elevated right ventricular systolic pressure and sudden death after repair of tetralogy of Fallot was previously reported. To examine this relation further, noninvasive, hemodynamic and invasive electrophysiologic data were studied in 27 patients who had undergone repair of tetralogy of Fallot 7 months to 21 years (mean 1.75 years) previously. Syncope, which had occurred in four patients, was not significantly related to ventricular arrhythmia on rest electrocardiogram, 24 hour electrocardiogram or treadmill test. All four patients with syncope had either nonsustained (two patients) or sustained (two patients) ventricular tachycardia induced at electrophysiologic study. His bundle to ventricle conduction interval was prolonged in two patients and Q to right ventricular apex interval was prolonged in three of the four patients. All four had abnormal anatomic or hemodynamic findings: two had a right ventricular systolic pressure of 70 mm Hg or more, one had right ventricular dysfunction with tricuspid insufficiency and one a septal aneurysm. The 9 patients with induced nonsustained or sustained ventricular tachycardia were then compared with the 15 patients without induced ventricular arrhythmias. Those with ventricular tachycardia had a greater prevalence of: more complex ventricular arrhythmia on 24 hour electrocardiogram (63 versus 0%, p less than 0.001), long His bundle to ventricle interval (44 versus 0%, p less than 0.001), right ventricular systolic pressure of 70 mm Hg or more (56 versus 0%, p less than 0.01) and reduced right ventricular ejection fraction (33 versus 7%, p less than 0.025). It is concluded that: 1) induction of nonsustained or sustained ventricular tachycardia was associated with a history of syncope; 2) all patients at risk for syncope could not be identified by routine electrocardiogram 24 hour electrocardiogram or treadmill test; 3) hemodynamic alterations may interact with intraventricular conduction abnormalities and predispose to ventricular tachycardia. PMID- 6853904 TI - Nonatherosclerotic myocardial ischemia. PMID- 6853906 TI - Two-dimensional echocardiographic measurement of right pulmonary artery diameter in infants and children. PMID- 6853903 TI - Prevention of cardiovascular events in variant angina by long-term diltiazem therapy. AB - In 43 patients with variant angina, the cardiovascular event rate during diltiazem therapy was compared with that in an equal time period before initiation of therapy. Cardiovascular events, that is, myocardial infarction, sudden death and hospitalization for prolonged angina, were decreased significantly (p less than 0.01) during the initial 6 months and mean 19.6 months of therapy. Based on the binomial principle, there were 22 events during the mean 19.6 months before therapy and 2 events during the equal time period on therapy. No patient died during follow-up. The frequency of angina was decreased by 94%. Diltiazem was well tolerated by all patients and no patient had to discontinue therapy because of adverse effects. It is concluded that long-term diltiazem therapy reduces cardiovascular events in patients with variant angina. PMID- 6853905 TI - Electrophysiologic and antiarrhythmic effects of oral flecainide in patients with inducible ventricular tachycardia. PMID- 6853908 TI - Serial left ventricular wall measurements in Duchenne's muscular dystrophy. AB - In 19 patients with Duchenne's muscular dystrophy, left ventricular wall thickness in end-systole and end-diastole was determined serially every 12 months by echocardiography and compared with ventricular wall growth in normal subjects. In the normal subjects, left ventricular wall thickness increased linearly with increasing body surface area. A control group of wheelchair-bound patients with a variety of neurologic disorders, although not followed serially, had a distribution of end-diastolic wall thickness values similar to that of the normal subjects. In patients with muscular dystrophy, wall thickness increased linearly with respect to body surface area for some time and then began to thin. The time at which thinning began was not directly related to age, although it was more common in older than in younger patients. Those patients who died demonstrated marked deviation from normal wall growth. Free wall thinning is probably a result of fibrosis and loss of myofibrils. PMID- 6853909 TI - Noninvasive evaluation of normal and abnormal prosthetic valve function. AB - Noninvasive techniques are helpful in evaluating the function of mechanical prostheses and tissue valves. Combined phonocardiography and M-mode echocardiography together with cinefluoroscopy are the most useful noninvasive techniques in differentiating normal from abnormal metallic prosthetic valve function. The intensity of the opening and closing clicks and associated murmurs will depend on the type of prosthetic valve, the heart rate and rhythm and the underlying hemodynamic status. Arrhythmias or conduction disturbances, or both, may produce motion patterns that mimic some of the echocardiographic signs of malfunctioning prosthetic valves. Differentiation of thrombus formation or tissue ingrowth from paravalvular regurgitation or dehiscence is possible by noninvasive techniques. Disc variance, a potentially serious and lethal problem with the older Beall valves, can be readily detected by cinefluoroscopy and echophonocardiography. With regard to bioprosthetic valves, two-dimensional echocardiography is superior to M-mode echocardiography in detecting primary valve failure. In addition, detection of vegetations, valve alignment and ring and individual leaflet motion can be best accomplished by two-dimensional echocardiography. Of greater importance is the patient serving as his or her own control in the follow-up assessment of prosthetic valve function by noninvasive techniques. PMID- 6853907 TI - Sensitivity of two-dimensional echocardiography in the direct visualization of atrial septal defect utilizing the subcostal approach: experience with 154 patients. AB - In the standard precordial echocardiographic imaging planes, there is frequent dropout of atrial septal echoes in the region of the fossa ovalis that can be minimized by use of the subcostal imaging approach. The diagnostic sensitivity of this approach was reviewed in 154 patients (mean age 31 years, range 2 months to 74 years) with documented atrial septal defect in whom a satisfactory image of the atrial septum could be obtained. Subcostal two-dimensional echocardiography successfully visualized 93 (89%) of the 105 ostium secundum atrial septal defects, all 32 (100%) ostium primum defects and 7 (44%) of the 16 sinus venosus defects. A defect was not visualized (false negative response) in 12 patients (11%) with an ostium secundum defect and in 9 patients (56%) with a sinus venosus defect. In three of the former and five of the latter, a two-dimensional echocardiographic contrast examination established the presence of the interatrial shunt. Twenty-four patients (16%) with clinical findings of uncomplicated atrial septal defect confirmed by two-dimensional echocardiography underwent surgical repair of the defect without preoperative cardiac catheterization. There were no perioperative complications. Two-dimensional echocardiographic examination of the atrial septum utilizing the subcostal approach is the preferred method for the confident, noninvasive diagnosis and categorization of atrial septal defects. Two-dimensional echocardiographic contrast and Doppler examinations complement the technique and enhance diagnostic accuracy. PMID- 6853910 TI - Hemodynamic effects of nifedipine in primary pulmonary hypertension. AB - Progressive dyspnea and syncope occurred in a young woman with primary pulmonary hypertension despite therapy with hydralazine. Abnormal pulmonary artery reactivity was documented by an additional increase in pulmonary artery pressure and pulmonary vascular resistance during exercise and after an episode of hydralazine-induced hypotension. Nifedipine reduced rest and exercise pulmonary artery pressure, pulmonary vascular resistance and right ventricular stroke work, and increased cardiac output and markedly improved exercise capacity. Reevaluation after 6 months showed persistence of the favorable hemodynamic and clinical effects. Vasodilator therapy, potentially hazardous because of effects on systemic vascular resistance, can be evaluated safely only with hemodynamic monitoring. Nifedipine may be a useful drug in selected patients with primary pulmonary hypertension. PMID- 6853911 TI - Radiation-induced valvular dysfunction. PMID- 6853913 TI - Rehabilitation of phonocardiography. PMID- 6853912 TI - Sterile, caseous mitral anular abscess. AB - Echocardiography identified three patients with a mitral anular mass. Fluoroscopy demonstrated a faint, homogeneous intracardiac calcific density in each patient. Cardiac catheterization and angiography were performed and showed no left ventricular inflow or outflow obstruction. One patient died suddenly and two patients had cardiac surgery (one for mitral regurgitation and another for constrictive pericarditis). Examination demonstrated that each mass was nonencapsulated, sterile and acellular and contained cholesterol, calcium and fatty acids. The clinical significance and cause of these masses are unclear at present. PMID- 6853914 TI - Hemodynamic, angiographic and scintigraphic correlates of positive exercise electrocardiograms: emphasis on strongly positive exercise electrocardiograms. AB - The results of treadmill exercise electrocardiograms were analyzed in 179 patients with coronary artery disease (greater than or equal to 50% diameter narrowing of one or more vessels). Exercise thallium-201 images were available in 141 of these patients. The exercise electrocardiograms were strongly positive in 51 patients, mildly positive (1 to 1.9 mm ST depression) in 28 patients, falsely negative in 23 patients and uninterpretable in 77 patients. The degree of exercise-induced ST depression did not correlate with left ventricular function, extent of coronary artery disease, exercise heart rates and rate-pressure product and extent of exercise-induced thallium-201 perfusion abnormality. However, the presence of a strongly positive exercise electrocardiogram only at heart rates of 140 beats/min or more or stage III or higher of the Bruce protocol was predictive of less extensive coronary disease and perfusion abnormalities. Thus, the magnitude of ST depression as such during exercise is not predictive of the extent of coronary disease, even in patients with 3 mm or greater ST depression. However, a strongly positive exercise electrocardiogram in the first two stages of the Bruce protocol or at a heart rate of less than 140 beats/min was related to the extent of coronary artery disease and impaired myocardial perfusion, and identified patients with more extensive coronary artery disease and jeopardized myocardium. Therefore, caution should be used in interpreting prognostic data on the basis of the degree of exercise-induced ST depression alone. PMID- 6853916 TI - The QRS scoring system for estimating myocardial infarct size: clinical, angiographic and prognostic correlations. AB - The relation between a QRS score derived from the routine electrocardiogram and left ventricular function was investigated in 181 patients after myocardial infarction. Patients with left ventricular hypertrophy and conduction defects were excluded. The QRS score correlated closely with the severity of wall motion abnormalities and left ventricular ejection fraction. The more severe the dyssynergy, the higher the QRS score (hypokinesia = 3.0; akinesia = 5.4; dyskinesia = 9.1). The left ventricular ejection fraction (percent) = 66 - (3.3 x QRS score) (correlation coefficient [r] = -0.81, probability [p] less than 0.001). With use of this regression equation, the QRS score predicted angiographic left ventricular ejection fraction to within 12% of the angiographic ejection fraction in 29 of 30 additional patients studied prospectively. The QRS score was also related to clinical functional class. The worse the clinical manifestation of left ventricular dysfunction, the higher the QRS score (Killip class I = 3.5; class II = 6.5; class III = 7.1). A QRS score greater than or equal to 7 had a specificity of 97% and a sensitivity of 59% for predicting an ejection fraction of less than 45%. Patients with a QRS score of 7 or greater had severe wall motion abnormalities, higher peak serum creatine kinase levels, higher prevalence of multivessel coronary disease, poor clinical functional class and an unfavorable outcome. The QRS score provides an inexpensive, clinically useful estimate of left ventricular function after myocardial infarction and can identify patients at high risk. PMID- 6853915 TI - Clinical improvement after ventricular aneurysm repair: prediction by angiographic and hemodynamic variables. AB - Surgical repair of a left ventricular aneurysm is associated with significant perioperative mortality and substantial mortality in the first 2 years after operation. In a retrospective review of 42 patients undergoing repair of an anteroapical aneurysm, two cardiac catheterization variables were identified that predicted a good surgical outcome, defined as perioperative survival and improved functional status. Specifically, patients with an ejection fraction of the contractile section (nonaneurysmal) of the left ventricle of 35% or greater and a left ventricular end-diastolic pressure of 25 mm Hg or less had a low perioperative mortality rate (6.5%), experienced no late mortality and had sustained clinical improvement of at least one New York Heart Association functional class (93.5%). In contrast, patients with a contractile section ejection fraction of less than 35% or a left ventricular end-diastolic pressure greater than 25 mm Hg had a higher perioperative mortality rate (27.3%), experienced a substantial late mortality rate (27.3%) or had no significant functional class improvement (9%); only 36.4% had sustained clinical improvement. This study suggests that the postoperative results of left ventricular aneurysm repair are dependent on the hemodynamic status of the nonresected left ventricle. PMID- 6853917 TI - Susceptibility of infarcted canine hearts to digitalis-toxic ventricular tachycardia. PMID- 6853918 TI - Assessment of location and size of myocardial infarction with contrast-enhanced echocardiography. PMID- 6853919 TI - Quantitative assessment of segmental wall motion abnormalities at rest and after atrial pacing using digital intravenous ventriculography. AB - Digital intravenous ventriculography lends itself readily to quantitative assessment of ventricular wall motion with computer algorithms. Forty-five patients referred for cardiac catheterization were studied by digital intravenous ventriculography (mask mode) and direct ventriculography in the 30 degrees right anterior oblique position. Quantitative wall motion was analyzed by a radial shortening method applied to both studies. Lower limits of normal radial shortening were determined for each technique and used to determine the presence or absence of wall motion disorders. The inter- and intraobserver variability of radial shortening measurements was +/- 5.3 and +/- 8.8%, respectively, with maximal discrepancies of -6 and +7% fractional shortening units. The overall agreement between the two techniques in wall motion assessment was 87% (274 of 315 radii). A subset of patients also underwent atrial pacing, and a second digital intravenous ventriculogram was obtained (5 normal subjects and 15 patients with coronary artery disease). Although analysis of wall motion at rest showed a poor sensitivity for detection of significant coronary stenoses, nine of nine patients with coronary artery disease and normal wall motion at rest showed a quantitative decrease in radial wall motion after atrial pacing. Thus, digital intravenous ventriculograms can be used to provide quantitative wall motion analyses that show a high degree of agreement with those of standard, direct left ventriculography. Atrial pacing can be used to increase the sensitivity of wall motion analysis for the detection of significant coronary disease. PMID- 6853920 TI - Estimation of circumferential fiber shortening velocity by echocardiography. AB - The M-mode and two-dimensional echocardiograms of 40 young patients were analyzed to compare the mean circumferential fiber shortening velocity (Vcf) of the left ventricle calculated separately by two methods. The mean circumferential fiber shortening velocity was derived from the M-mode echocardiogram as minor axis shortening/ejection time and derived from the two-dimensional echocardiogram as actual circumference change/ejection time. With computer assistance, circumference was determined from the short-axis two-dimensional echocardiographic images during end-diastole and end-systole. Good correlations were obtained between the left ventricular diameter derived by M-mode echocardiography and the vertical axis during end-diastole (r = 0.79) and end systole (r = 0.88) derived by two-dimensional echocardiography. Likewise, high correlations were noted between diameter and circumference in end-diastole (r = 0.89) and end-systole (r = 0.88). However, comparison of Vcf obtained by M-mode echocardiography with that obtained by two-dimensional echocardiography showed only fair correlation (r = 0.68). Moreover, the diameter/circumference ratio determined in end-diastole and end-systole differed significantly (p less than 0.001), possibly owing to the change in geometry of the ventricular sector image during systole. Although Vcf derived by M-mode echocardiography is a useful index of left ventricular performance, it does not truly reflect the circumference change during systole. PMID- 6853921 TI - Comparative plasma catecholamine and hemodynamic responses to handgrip, cold pressor and supine bicycle exercise testing in normal subjects. AB - Serial hemodynamic and plasma catecholamine responses were compared among 10 healthy men (27 +/- 3 years) (+/- 1 standard deviation) during symptom-limited handgrip (33% maximal voluntary contraction for 4.4 +/- 1.8 minutes), cold pressor testing (6 minutes) and symptom-limited supine bicycle exercise (22 +/- 5 minutes). Plasma catecholamine concentrations were measured by radioenzymatic assays: ejection fraction and changes in cardiac volumes were assessed by equilibrium radionuclide angiography. During maximal supine exercise, plasma norepinephrine and epinephrine concentrations increased three to six times more than during either symptom-limited handgrip or cold pressor testing. Additionally, increases in heart rate, systolic blood pressure, rate-pressure product, stroke volume, ejection fraction and cardiac output were significantly greater during bicycle exercise than during the other two tests. A decrease in ejection fraction of 0.05 units or more was common in young normal subjects during the first 2 minutes of cold pressor testing (6 of 10 subjects) or at symptom-limited handgrip (3 of 10), but never occurred during maximal supine bicycle exercise. The magnitude of hemodynamic changes with maximal supine bicycle exercise was greater, more consistent and associated with much higher sympathetic nervous system activation, making this a potentially more useful diagnostic stress than either handgrip exercise or cold pressor testing. PMID- 6853922 TI - Continuing medical education. This continuing medical education self-assessment program is sponsored by the American Academy of Allergy and Immunology and supported by a grant-in-aid from Fisons Corporation. PMID- 6853923 TI - Immediate-type reactions in patients with allergic bronchopulmonary aspergillosis. AB - Allergic features of 38 patients with allergic bronchopulmonary aspergillosis (ABPA) were reviewed. These features included skin reactivity to other inhalant antigens and to molds other than Aspergillus fumigatus (Af) plus clinical manifestations of rhinitis, conjunctivitis, asthma, eczema, urticaria, anaphylaxis, food allergy, and drug allergy. ABPA patients have a high degree of allergic reactivity in all these clinical features, in particular, clearly documented food allergy. These findings differ from those previously reported in ABPA patients in England, where it was noted that patients with ABPA whose asthma began after age 30 had few manifestations of other allergic diseases. By contrast, our patients in the same age group (onset of asthma after age 30) had the same multiple allergic manifestations as younger patients. These results show that ABPA patients are a subset of atopic individuals with a greater predisposition for the development of a wide spectrum of allergic diseases, despite the lack of manifestations of other major immunologic disease patterns. PMID- 6853924 TI - Improvement in aspirin-sensitive asthmatic subjects after rapid aspirin desensitization and aspirin maintenance (ADAM) treatment. AB - Twelve ASA-sensitive (AS) asthmatics, including nine over age 35 years and three under age 19, were successfully desensitized to the adverse effects of ASA in an average of 322 min without any serious untoward sequelae. Six subjects (50%) experienced subjective improvement, three (25%) no change, and three (25%) worsening in their asthma while on a daily maintenance dose of ASA (mean = 539 mg) for an average follow-up period of 115 days. Six subjects (50%) were able to discontinue one or more antiasthma medications, including systemic steroid in one (8%) and aerosol steroid in three (25%). The incidence of subjective improvement in asthma status (67% vs. 44%) was higher in those under 19 than in those over 35, and none of the younger vs. 30% of the older subgroup experienced worsening in their asthma. ASA desensitization (AD) followed by an ASA maintenance program (ADAM) therefore appeared to be beneficial in approximately 50% of AS asthmatics. In this study an improvement in postdesensitization peak expiratory flow rate with a repeat ASA challenge appeared to correlate best with subjective improvement in asthma and/or reduction in antiasthma medication requirement after AD. However, the number of subjects studied was relatively small and the conclusions drawn will require confirmation. PMID- 6853925 TI - The safety of egg-containing vaccines for egg-allergic patients. AB - Forty-two patients with a history of egg sensitivity were evaluated for receiving avian-grown vaccines. After giving a history and undergoing physical examination, each patient was skin-tested with egg antigens and six egg-propagated vaccines, given an oral egg challenge, and finally, when possible, given a vaccine challenge. Thirty-seven of the 42 patients (88%) were ultimately given one or more of the vaccines with no reactions or only minimal ones to both egg protein and vaccine; they had mild reactions consisting of pruritus, headache, and apprehension. Immunization was withheld from three patients who had a history of severe reactions after egg ingestion and strongly positive skin reactivity to both egg and vaccine. A history of egg intolerance should not, by itself, disqualify a patient from receiving one of these vaccines. However, a history of exquisite sensitivity to egg protein indicates that a severe vaccine reaction is likely. An intradermal skin test utilizing 0.02 ml of a 1:100 dilution of the vaccine and resulting in a wheal of greater than 5 mm was found to be the test that most reliably predicted those patients who should not receive the vaccine. PMID- 6853927 TI - Aspirin-sensitive rhinosinusitis: the clinical syndrome and effects of aspirin administration. AB - Nineteen aspirin sensitive adult patients were identified who experienced naso ocular responses without associated bronchospasm during standardized oral aspirin challenge. These 19 patients exhibited the characteristics of the aspirin triad except asthma. These included hypertrophic rhinitis with or without associated nasal polyps, abnormal sinus roentgenograms, nasal eosinophilia, aspirin-provoked responses of the upper airway identical to those observed in aspirin-sensitive asthmatics, capacity of the upper airway to be desensitized to aspirin, and cross reactivity and/or cross-desensitization of the upper airway to indomethacin. Of the 17 patients who were treated with daily aspirin after desensitization, 77% experienced improvement in their nasal symptoms. PMID- 6853929 TI - Current and future perspectives of the American Academy of Allergy and Immunology: the continuum of leadership. PMID- 6853928 TI - Comparison of antigenic and allergenic composition of two partially purified extracts from Dermatophagoides farinae and Dermatophagoides pteronyssinus mite cultures. AB - Dermatophagoides farinae (Df 80d) and Dermatophagoides pteronyssinus (Dp 80d) extracts were analyzed for their antigenic and allergenic composition by means of crossed immunoelectrophoresis (CIE) and crossed radioimmunoelectrophoresis (CRIE). By CIE, 11 antigens could be numbered in Df 80d (Df 1 to Df 11) and seven antigens in Dp 80d (Dp 1 to Dp 7). This technique allowed us also to define antigens with common as well as specific parts for the two mite species. Among the antigens of D. farinae and D. pteronyssinus, only the antigen corresponding to Df 5 and Dp 5 seems to bear common epitopes to the two mite species, whereas Df 6 and Dp 4 appear to bear, respectively, specific epitopes of each species. Moreover, Df 11 appears to bear specific epitopes of D. farinae, although it shows a partial identity with Dp 7. By CRIE, on 20 mite-sensitive patients' sera, we identified, for each mite extract, the allergens responsive to human specific IgE. The allergograms show that the majority of mite-sensitive patients react with Df 11 and Df 6 and with Dp 7 and Dp 4. Thus, these antigens can be considered as major allergens. The minor allergens were also identified. None of these antigens was recognized by the control sera. Moreover, we observed that for one antigen (antigen 5) there exist antigenic determinants common to the two species of mites toward the rabbit serum and specific allergenic determinants to the human IgE response. A significant correlation was found between the specific IgE binding in CRIE and in RAST (Spearman coefficient: "rs" = 0.61 p less than 0.01 for Df; "rs" = 0.78 p less than 0.01 for Dp). PMID- 6853926 TI - Aspirin-sensitive rhinosinusitis/asthma: spectrum of adverse reactions to aspirin. AB - In order to determine the types of respiratory responses observed during aspirin induced reactions, 50 consecutive asthmatic patients with a history of aspirin sensitivity underwent prospective oral aspirin challenges between 1979 and 1981. Oral aspirin challenges produced 36 asthmatic responses (33 combined with rhinitis and three purely asthmatic) and six acute rhinoconjunctivitis responses (three combined with mild asthma and three purely rhinoconjunctivitis) but failed to stimulate any reaction in eight patients. The results produced by these challenges were then compared with results recorded during additional aspirin challenges in 28 of these patients, performed after the index challenge in 1979 1981 in 26 patients and in the case of two patients before 1979. The type of respiratory response to aspirin varied significantly in 11 (39%) of the 28 patients and included disappearance of aspirin reactivity in four patients. PMID- 6853930 TI - Quantitative assessments of IgG and IgE antibodies to inhalant allergens in patients with atopic dermatitis. AB - Using antigen-binding radioimmunoassays, we have measured class specific antibodies against two major inhalant allergens, antigen P1 from D. pteronyssinus and Rye I from grass pollen, in sera from 69 patients with atopic dermatitis. The results show that many of the patients have IgE ab to these allergens in keeping with their skin tests. In all cases, the IgE ab was paralleled by IgG ab to the same allergen. In many sera, IgE ab to these inhalant allergens made a significant contribution to the total serum IgE. With two other allergens to which these patients had not been exposed, specific IgE ab was detected in only one serum, whereas the 42 sera tested did not contain IgE ab to diphtheria toxin. Eleven of the adult patients with atopic dermatitis had no history of asthma and had strongly positive skin tests. This group of patients had levels of total IgE and specific ab to antigen P1 that were very similar to those found in a comparable group of patients who had both atopic dermatitis and asthma. Our recent finding that allergens applied to the skin can induce delayed eczematous lesions provides a mechanism by which allergens could contribute to skin lesions. Our present results support the view that specific sensitivity to common allergens should be taken into account in considering the causes of these patients' skin lesions. PMID- 6853931 TI - Multiplicity of allergens in peanuts. AB - Crude peanut protein fractions from raw and roasted peanuts were examined in the RAST with 10 sera from patients showing clinical peanut sensitivity. The radioactive uptake results, which were generally high, did not reveal any distinguishable pattern. Two commercially available peanut proteins, peanut lectin and phospholipase D, gave poor RAST responses. Three purified peanut proteins, alpha-arachin, conarachin I, and concanavalin A-reactive glycoprotein, all gave significant RAST results that were generally lower than those obtained with the crude extracts. The extent of RAST inhibition obtained with these materials was inversely related to their abundance in the total peanut protein. Crossed immunoelectrophoresis with extracts from raw and roasted peanut indicated the presence of 22 and 10 anodically migrating antigens, respectively. Sixteen IgE binding antigens were revealed for raw peanut and seven for roasted peanut after incubation with a mixed serum from the 10 patients in crossed radioimmunoelectrophoresis (CRIE) using 125I-labeled anti-IgE. CRIE plates treated with individual serum samples showed that all the patients had specific IgE for the major antigen peak, which has been tentatively identified as alpha arachin. This major storage protein of peanut, which is known to be particularly heat resistant; may be of greater clinical significance than its apparently low RAST activity would seem to indicate. PMID- 6853932 TI - The immediate effects of cortisol on pulmonary function in normals and asthmatics. AB - We investigated short-term effects of corticosteroids on airway caliber, measured by spirometry and body plethysmography, over a period of 6 hr after an intravenous bolus of cortisol (8 mg/kg) or saline placebo was administered in a double-blind crossover format comparing 10 normal and nine asymptomatic unmedicated asthmatics. After 6 hrs isoproterenol (240 micrograms) was administered to compare the effects of cortisol with a beta-agonist bronchodilator. Serum cortisol levels remained greater than 100 micrograms/dl after cortisol and normal after placebo. Cortisol had no effect on pulmonary function except for a trend of improved flows and decreasing ratios of residual volume to total lung capacity in asthmatics that was not significant at 6 hr. Isoproterenol resulted in immediate improvement in specific conductance and flows in both groups; no interaction with cortisol was seen. We conclude that cortisol had no short-term effect on airway caliber in normals, at best a slowly evolving effect in asymptomatic unmedicated asthmatics, and no interaction with the bronchodilator effects of a maximal dose of isoproterenol in these groups. PMID- 6853933 TI - Allergic Aspergillus sinusitis: a newly recognized form of sinusitis. AB - The clinical and pathologic features of seven cases of a newly recognized form of chronic sinusitis are described. Most patients were young adults with a history of asthma, and all had chronic nasal polyps. Radiographically, there was opacification of multiple sinuses. Recurrent sinusitis was common, and several patients underwent numerous surgical drainage procedures. Histologically, a distinct mucinous material containing eosinophils, Charcot-Leyden crystals, and fungal hyphae was found in tissue resected from the sinuses. We believe that these findings constitute a distinct clinicopathologic entity that we term allergic Aspergillus sinusitis. This condition shares similar histopathologic features with allergic bronchopulmonary aspergillosis (ABPA) but affects the paranasal sinuses rather than the lung. Implications for therapy of this form of sinusitis and its possible relationship to allergic lung diseases are discussed. PMID- 6853934 TI - Energy and nutrient intake of children with cancer. AB - Two hundred seventy-seven pediatric cancer patients received a nutritional assessment. Initial dietary intakes of patients with no prior treatment indicated a diet similar to that of the general population. The caloric intake was 75% of the RDA in a group of patients with non-malignant diseases and 80% of the RDA in the groups of patients with solid tumors and hematopoietic malignancies. Protein intake was greater than 100% of the RDA for all groups. Dietary iron was the nutrient lowest in intake, with a range of 70% to 78% of the RDA. At six-month evaluations, no significant changes occurred except for an increase in iron, niacin, riboflavin, and protein intakes in the group with solid tumors. PMID- 6853935 TI - Nutritional parameters in children with cancer. AB - An analysis of commonly used nutritional parameters was made for 277 pediatric cancer patients. It is apparent that standard nutritional assessment parameters in the pediatric cancer patient may be difficult to interpret because of the disease state as well as of the treatment. On the basis of the findings of this study, dietary histories to determine caloric and protein adequacy and a measurement of weight/height percent may, in fact, be the most reliable indicators of nutritional status. PMID- 6853936 TI - Vitamin contents of pre-prepared foods sampled from a hospital food service line. AB - Thiamin, riboflavin, and ascorbic acid in pre-prepared foods sampled from a hospital food service line decreased slightly during a one and one-half hour serving period and differed somewhat according to month of sampling. On a per serving basis, entree foods supplied 4% to 17% of the RDA for thiamin and 12% to 18% of the RDA for riboflavin for adult men and women. Potato dishes and fruit gelatins furnished 12% to 26% of the RDA for ascorbic acid, but salads were negligible sources. The data suggest a need to furnish additional sources of these vitamins. PMID- 6853937 TI - Folacin content of tea. AB - Total folacin and free folacin activities of 22 commercial tea samples, involving 5 types and 14 brands, were determined by a microbiological assay, using Lactobacillus casei (ATCC 7469). Substantially higher amounts of folacin were found in tea leaves than had been reported previously, due to an improved assay method with added ascorbic acid to protect the labile folate forms. Tea brews made from green and black teas contained approximately three to four times more folacin than the brews made from oolong tea, herb tea, and instant tea powders. Tea brews made from loose leaf teas and tea bags did not differ appreciably in folacin content. However, the tea bag itself inhibited folacin extraction. A range of 3% to 25% of the RDA for folacin can be met by consuming five servings (5 to 6 oz. per serving) of tea daily. PMID- 6853938 TI - Four-year study of university athletes' dietary intake. AB - Baseline dietary intake data were collected for four years on 10 men's and 6 women's university athletic teams. Caloric intake means for specific teams were higher than those stated in nutrition textbooks (5,270 kcal for football, with a 14,000 kcal per day maximum). Athletes' caloric intakes cannot be grouped, as some athletes (wrestlers and gymnasts) have low intakes (400 kcal per day). Protein intake of all athletes except wrestlers and gymnasts is high (in many cases more than twice any recommendation). The diets of teams with high caloric intakes had a high (more than 50%) fat content. The fat content of the diets of other athletes ranged from 30% to 40%. The wrestling team had more members with poor nutrient intake (less than two-thirds of recommendations) than any other team. Poor vitamin A intakes were noted for all athletic teams studied. Low potassium intakes also were common. Members of women's teams had low iron intakes even though their protein and caloric intakes were high. PMID- 6853939 TI - Socioeconomic factors and dietary intake of elderly Missourians. AB - Nutrient intake of elderly persons as determined by dietary histories based on food frequencies was examined in relation to various socioeconomic factors. A significantly larger proportion of women than of men had inadequate intakes for energy, calcium, iron, thiamin, and riboflavin. Housing, education, marital status, and work experiences were significantly related to the intake of one or more nutrients. Dietary ratings based on the Recommended Dietary Allowances for nine nutrients indicated that women, persons living in high-rise apartments for the elderly, and individuals who had recently retired were more likely to have poor ratings. PMID- 6853940 TI - Nutritional care of the surgical neonate. AB - The function of the nutritionist was to identify and anticipate nutritional problems, to facilitate complete care for each infant, and to serve as an educational resource to staff, patients, and families. Neonatal nutrition is an open and challenging field for nutritionists. An expanded role for the nutritionist as a member of the physician-nutritionist team, as demonstrated in this article, may provide direction for the organization of such a team in other health care facilities with neonatal intensive care units. PMID- 6853942 TI - Sodium intake from meals and snacks consumed by college students. AB - This investigation was designed to compute the total sodium intake from meals and snacks consumed by selected college students. Most students used carbonated beverages, candies, gums, cookies, and salted snack items. They consumed salted snack items mostly as evening snacks. Mean sodium intake was found to be 3,904 mg. for men and 2,628 mg. for women, without taking into consideration the use of table salt. Sodium density per kilocalorie per day was 1.40 and 1.41 for men and women, respectively, suggesting that the differences in intakes were due to women's lower caloric intake. Sodium intake was greater from regular meals than from snack foods. Evening snacks contributed more to the daily sodium intake than morning and afternoon snacks. It can be concluded that sodium intake of college students needs careful assessment. According to the Food and Nutrition Board, the most effective way to maintain intake within the suggested range is to reduce the amount of salt added at table or in cooking and to reduce moderately the selection of obviously salty foods (9). College students need to be made aware of the sodium content of foods they select for lunch, dinner, and evening snacks, as well as the amount of salt they add at the table. PMID- 6853941 TI - Assessment of the diet of patients with rheumatoid arthritis and osteoarthritis. AB - There have been many and divergent thoughts expressed both in the scientific and in the lay literature regarding diets for patients with arthritis (1-8). However, few experimental observations pertain to either the nutritional status of arthritis patients or the clinical value of putative nutritional therapies (1-8). Until such time as the notion that dietary manipulation can alleviate particular symptoms for selected patients is proved, it is prudent to advise patients to maintain sound nutritional practices in accordance with contemporary standards (4 8, 13-16). Our data indicate that many arthritis patients are at least marginally inadequate in selected nutrients, some of which (vitamin E and zinc) might relate to immunologic events important in perpetuating the disease. These observations provide a basis for nutritional counseling of arthritis patients. PMID- 6853943 TI - Demography and old age. AB - Demography is of great importance for those involved in caring for the elderly or in planning services. In this paper, current and future variations in the proportions of elderly people around the world are reviewed. The determinants of age structure are considered, and aging and aged populations are defined and discussed. The consequences of population aging extend into every sphere of life; particular attention is paid to the health service and economic implications. Attitudes to population aging and some of the special characteristics of the elderly in the West today are also considered. The paper concludes with a discussion of probable future trends in both the developed and the less developed parts of the world. PMID- 6853945 TI - Impending death and the use of hospitals by the elderly. AB - Much attention is now focused on high users of health care. The literature indicates that elderly decedents are more often hospitalized than survivors, but little is known about the relationship of age, sex, and decedents to hospital usage. This paper uses the Manitoba Longitudinal Study on Aging to compare the hospital utilization patterns of elderly survivors and decedents. The results show that (1) the 5 per cent of the elderly who died accounted for 20 per cent of all the hospital days used by all the elderly; (2) impending death was associated with a substantial increase in the relative odds of being hospitalized and of using more than 18 hospital days; and (3) once hospitalized, the youngest decedents, who make up the largest proportion of the elderly population, spent more time in the hospital than those who were older. The findings underline the need for research into what hospitals are doing for decedents and into the quality of decedents' hospital stays. PMID- 6853944 TI - A comparison of clinical methods for assessing dementia. AB - General practice physicians and clinical specialists use various methods for assessing dementia, including the Mental State Questionnaire (MSQ), Face-Hand Test (FHT), Dementia Rating Scale (DRS), tests for developmental reflexes and focal neurologic signs, and examination for evidence of clinical depression, stroke, or other physical health problems. In order to determine how these various methods concur, a sample of elderly persons living in the community were evaluated on eight indices. When MSQ scores were used as criteria, the DRS and FHT concurred with classification of impairment in 76 per cent and 45 per cent of cases, respectively. Positive focal signs and developmental reflexes were significantly related to cognitive impairment but were not common features in this sample. Physical health, drug use, and demographic variables did not appear to be related to cognitive function. Although dysphoric mood was related to cognitive impairment, pseudodementia was not identified. After one year the subjects were retested with the MSQ and the DRS; 14 per cent and 20 per cent, respectively, had improved, indicating a lack of predictive validity of these measures. Results are discussed in the context of the utility of clinical methods for screening and staging cognitive impairment, and recommendations are made regarding a standardized battery. PMID- 6853946 TI - Myasthenia gravis in the elderly: report of 37 cases. AB - The treatment of myasthenia gravis in the elderly is controversial. Thirty-seven myasthenic patients with onset of the disease after the age of 60 were followed for a period of 14 years. All of the 37 patients received anticholinesterase drugs during this period, ten underwent thymectomy, and 24 were treated with corticosteroids. At present, one patient is in remission, 28 are improved, one is unchanged, and seven have died. Only one death was directly related to myasthenia. In the authors' experience thymectomy can be an effective treatment of myasthenia gravis in elderly patients; corticosteroid therapy can also be useful in addition to or as an alternative to surgery. Using a "personalized" schedule the authors obtained good results in 78 per cent of their patients. PMID- 6853947 TI - Age-related sleep-wake disorders at a sleep disorder center. AB - The specific sleep disorders of 97 patients 61-81 years old were compared with those of 264 middle-aged (41-60 years old) and 202 young (20-40 years old) patients. Sleep disorder diagnoses were made according to the Diagnostic Classification of the Association of Sleep Disorders Centers based on evaluations consisting of mental and physical examinations and all-night sleep recordings. Most young and middle-aged patients complained of excessive daytime sleepiness; the elderly complained of insomnia as often as excessive daytime sleepiness. The evaluations revealed objective findings in 93 per cent of the elderly, but only 77 per cent of younger patients. Nocturnal myoclonus or restless leg syndrome was the diagnosed cause of 23 per cent of elderly patients' sleep-wake problems, but only 11 per cent of middle-aged and 4 per cent of young patients had this problem. Respiratory disorders of sleep were found in 27 per cent of elderly, 35 per cent of middle-aged, and 20 per cent of young patients. Elderly patients (6 per cent) had psychiatric disorders diagnosed as the causes for their problems less frequently than did younger patients (22 per cent). PMID- 6853949 TI - Biomarkers of aging. PMID- 6853948 TI - Indomethacin-associated hyperkalemia in the elderly. PMID- 6853951 TI - Prolonging the act of dying. PMID- 6853950 TI - Short report from Tokyo. PMID- 6853952 TI - Sound general quarters! A crusade of commitment. PMID- 6853953 TI - An emphasis on prevention. The revitalization of Optometric Extension Program. PMID- 6853954 TI - Prevention of what? PMID- 6853955 TI - Optometric preventive health care. AB - As a primary provider of health care services, optometry must assume a leadership role in the provision of optometric preventive health care services. The ultimate goal of a visual prevention strategy is to enable each person to live free of visual maladaptation, injury or disease. PMID- 6853956 TI - The challenge of an interdisciplinary approach in optometry. AB - Opportunities for practice development abound in the area of learning related vision problems. The integration of an interdisciplinary team of professionals within an optometric practice is described. Several compelling socio-economic realities are discussed which speak to the need for optometrists to explore the potentials of interdisciplinary practice. PMID- 6853957 TI - Prevention: lessons from video display installations. AB - Workers interacting with video display units for periods in excess of two hours per day report significantly increased visual discomfort, fatigue and inefficiencies, as compared with workers performing similar tasks, but without the video viewing component. Difficulties in focusing and the appearance of myopia are among the problems being described. With a view to preventing or minimizing such problems, principles and procedures are presented providing for (a) modification of physical features of the video workstation and (b) improvement in the visual performances of the individual video unit operator. PMID- 6853958 TI - OEPF funded research--its impact on prevention. AB - Of the many assessment techniques and treatment regimens available to the behavioral optometrist, a large majority were developed through formal or informal research conducted under the aegis of the Optometric Extension Program Foundation, Inc. A summary of the various phases of the OEPF research effort since its beginning in 1928 is presented. Clinically applied, the regimens refined by clinical associates of OEPF have the potential to reduce the social and economic impact of vision problems which are increasing in our technological society. PMID- 6853960 TI - Optometry on Guam. PMID- 6853959 TI - Cost and quality implications of changes in tonometry use by optometrists. AB - Tonometry, as a test for glaucoma, traditionally was performed routinely only on patients over age 40. In 1974 in the Helling v. Carey case the Supreme Court of Washington (state) held that an ophthalmologist was negligent in failing to administer a glaucoma test to a patient under age 40, and thus failing to diagnose primary open angle glaucoma. In a study performed at the Pennsylvania College of Optometry and the Optometric Center of Maryland an increase of utilization of tonometry on patients under the age of 40 was measured. Available literature indicates that this change occurred nationwide for optometrists in private practice. This change may result in an additional cost for eye care, without a strong indication of an improvement in quality of care. PMID- 6853961 TI - Vision care benefit plans: understanding the complexity of current and emerging third party programs. PMID- 6853962 TI - Kinetics of aqueous base and acid hydrolysis of aldicarb, aldicarb sulfoxide and aldicarb sulfone. AB - The kinetics of degradation of aqueous solutions of aldicarb, aldicarb sulfoxide and aldicarb sul fone by base hydrolysis were investigated. Pseudo first order rate constants of 37 micrograms/l solutions were determined at different hydroxide concentrations by acid-base titration. Second order rate constants were calculated, and it was found that aldicarb sulfone is more sensitive to hydroxide ion concentration than aldicarb sulfoxide which is more sensitive than aldicarb. Temperature effects were determined by measuring the base hydrolysis rate constant for aldicarb sulfone at 5, 15, 20, 25, 30, and 35 degrees C. An activation energy of 15.2 +/- 0.1 kcal/mole was calculated. Addition of a neutral electrolyte decreased the rate constant for base hydrolysis. Acid catalyzed hydrolysis rate constants were also measured for aldicarb sulfone, and, as expected, the reaction was much slower. The second order (reaction) rate constant for base hydrolysis of aldicarb sulfone is 40.3 (+/- 0.5) liter mole-1min-1; for acid catalyzed hydrolysis it is 7.33 (+/- 0.06) X 10(-4) liter mole-1min-1. PMID- 6853963 TI - On-line trace enrichment of difenzoquat in water and its determination by HPLC. AB - A high performance liquid chromatographic method involving an integrated enrichment step is described for the quantitative determination of low levels of difenzoquat residues in water. Difenzoquat is trapped from the flowing water sample by strong adsorption onto the enrichment column. It is then desorbed, separated, and subsequently analyzed in a single step process by reverse phase high performance liquid chromatography using ultraviolet detection at 255 nm. Average recovery of difenzoquat from organic free water at spiking levels of 20, 10 and 5 ppb was 97.0%. The lower detection limit reached was 0.25 ppb difenzoquat in organic free water. PMID- 6853964 TI - Further water solubility determinations of insecticidal compounds. AB - The aqueous solubility of 39 insecticidal and related compounds was determined at 20 +/- 1.5 degrees C, using a previously described shaking and centrifugation method. Fenamiphos, fenthion and methidathion produced values substantially less than those reported in the literature whereas, aminocarb, diazinon, dicapthon, pirimiphos-ethyl and pirimiphos-methyl gave solubilities substantially greater than reported literature values. PMID- 6853965 TI - [Effect of application of a herbicide propyzamide into the soil by study of mineralization of glucose 14C(U) and distribution of radioactivity in various fractions of the soil (laboratory and open field tests)]. AB - The effects of the herbicide PROPYZAMIDE are studied in laboratory and field conditions. The modifications involved are characterized by measurement of 14C glucose mineralization and radioactivity incorporation into the soil fractions. In laboratory conditions, temperature and moisture are kept stable and the experiment is performed during less than 24 hours. In these conditions, Kerb 50 (commercial formulation of propyzamide) and the emulsifier (material used in propyzamide formulation) exert little effect on 14CO2 evolution. In field conditions, propyzamide andKerb 50 are applied once at two different doses: at field rate (1,5 kg/ha) and twentyfold this rate. Essays are duplicated. The herbicide (propyzamide in Celanol and Kerb 50) and the emulsifiers alone (Celanol and the material used in propyzamide formulation) are applied on the soil surface (application date: 3.02.81). Two weeks later and then every month during four months, samples are taken to the depth of about 5 cm (Propyzamide migrates very slowly in the first centimeters of the soil). The characterization experiment is performed on 10 g soil samples by 14C-glucose incubation at 28 degrees C during two hours. 14CO2 evolved is measured after incubation and acidification with HCl. Then radioactivity distribution in the soil is counted after chemical fractionation of soil. This distribution is about 10-16.5% as 14CO2, 22-37% in the acid-soluble fraction, 10-25% in the alkali-soluble fraction and 15-45% in the human fraction (measured as 14CO2 evolved after combustion). This distribution is little modified by the herbicides or the emulsifiers but its evolution is significantly related to environmental conditions (temperature). Nevertheless a few modifications are observed. They can be due to the herbicide propyzamide itself but the emulsifiers and the degradation products of propyzamide can also influence the measurement (After forty days in the soil, 70 95% of the starting active ingredient have disappeared). They can also be a result of the initial effects of the products (modification of the microflora and of the environment). PMID- 6853966 TI - Interaction between co-solvents and algae in the residue dynamics of fenitrothion. AB - Fresh and estuarine water algae maintained in laboratory microcosms simulating river-lake/estuary-bay systems were exposed to 14C-fenitrothion formulated with Atlox and tank mixed with Aerotex or Dowanol (11.5:1.5:1.5 w/v/v). Generally, the tank mix co-solvents determined the amount of uptake and the array of derivatives formed by the algae. Typically, exposed to an Aerotex mix the ratio of ethyl acetate extractable (NP) fraction: ethyl acetate unextractable (P) fraction was as 3.5:1.0, exposed to a Dowanol mix the ratio was as 1.5:1.0. Within any comparable time period, fresh water algae turned over more of the 14C-ring of fenitrothion than the estuarine genera. Turn-over was enhanced when Aerotex was the tank mix co-solvent. PMID- 6853967 TI - Residues of carbofuran and its two carbamate metabolites in field-treated rutabaga. AB - Carbofuran was applied over seeded rutabaga cv. York and residues (corrected for recovery) of carbofuran, 3-hydroxy- and 3-ketocarbofuran in the harvested roots averaged 0.15, 0.23 and 0.07 ppm in peel and 0.09, 0.14 and 0.05 ppm in pulp, respectively. Samples were extracted by hot acid digestion, partitioned in methylene chloride and cleaned up on Florisil. The 3-hydroxy-carbofuran was ethoxylated and the compounds were converted into their dinitrophenyl ethers and analysed by electron capture gas chromatography using 3% OV-3 column. PMID- 6853969 TI - [Testicular aging and its consequences]. AB - Testicular aging is of concern at the same time to the individual and to his lineage. In the individual, vascular changes which come about because of age lead to diminished oxygenation of the tissues; modifications occurring in the endocrine cells lead to a lowering in androgen production; modifications in the enzymes lead to a lowering of the efficiency of the blood-testis barrier; modifications in Sertoli cells lead to a lowering of production of androgen binding protein. Parallel with the diminished number of spermatozoids and the alteration in their form and mobility is a lowering in fertility. As far as the offspring of these men is concerned, paternal aging is responsible for new dominant autosomic mutations which themselves cause numerous malformations and also of chromosome X linked recessive mutations, and of haemophilia A and Duchenne's muscular dystrophy. Experimentally, paternal aging has been shown in the rat to be responsible for a lowering in the level of learning capacity in the offspring. The possible mechanism by which genetic alterations occur has been briefly considered. Certain authors believe that gonadal aging and its consequences for the offspring start in men as in women about the age of 35-40. PMID- 6853970 TI - [Reabsorption of amniotic fluid through parietal fetal membranes. A hypothesis based on an ultrastructure study]. AB - Recent investigations have shown that the link between water transport and solute transport in epithelia is made possible by subcellular structure build on a striking geometrical plan, namely, long and narrow dead end channels. The most striking feature of our electron microscopic study of the amnion as well as the chorionic cytotrophoblast, was the demonstration of the existence of intercellular channels running between the lateral sides of the cells with typical junctional complexes sealing their proximal ends; thus they constitute long and narrow dead-end channels. In the amnion, these channels open through the basal lamina into the connective tissue, and in the chorionic cytotrophoblast they open in the direction of the decidua. This situation seems to indicate that fluid emerges from the open mouth of the amniotic intercellular channels and then continues to flow into the channels of the cytotrophoblast, across its podocytic processes, to be dumped into the decidua, and finally drained by maternal decidual vessels. This morphological study suggests that parietal fetal membranes might be an important route for transport of solute and fluid from the liquor amnii into the maternal circulation. PMID- 6853971 TI - [Androgens: a critical study of the biological diagnosis of the hirsute women. Screening for incomplete blockage of 21-hydroxylase]. AB - In 19 patients with unexplained hirsutism without virilisation, a check-up includes delta 4- androstenedione (A), testosterone, DHEA-S. A appears like the best hyperandrogenemia parameter. Nevertheless 5 patients among this group have normal values of all these hormones. A mild congenital adrenal hyperplasia by 21 hydroxylase deficiency is revealed by abnormal response of 17 -OH-progesterone in the cosyntropin test. Our normal value of delta-OHP is, according to Gutai, method, 1.58 +/- 0.83 NG/DL/MN. PMID- 6853972 TI - [Clinical, hormonal and celioscopic examination of the corpus luteum in sterility without pelvic lesions]. AB - 58 sterile women who had perfect biphasic temperature curves through their menstrual cycles were examined by laparoscopy in the luteal phase of the cycle. No pelvic lesion was found. In 21 patients it was seen that the follicle had not ruptured (the so-called non-ruptured follicle syndrome). In a further 9 cases there was no luteal follicle to be seen on the surface of the ovary. The respective values of the plasma biochemical parameters which reflect ovarian secretion in the luteal phase are discussed; the importance of oestrogen secretion at the 6th day of the luteal phase is emphasized. It has been shown that there are significant statistical differences in the levels of oestradiol in the blood. PMID- 6853974 TI - [Abdominal cystic lymphangioma. Apropos of a case in an adult]. AB - The authors report a case of cystic abdominal lymphangioma that appeared 4 months after delivery in a woman of 31 years of age. As in most of these cases, the exact diagnosis was not made before operation. Its occurrence following recent pregnancy makes one think that it could have arisen from a lymphatic block. PMID- 6853973 TI - [Predicting ovulation by detecting the preovulatory rise of estrogens and LH in the urine]. AB - The preovulatory LH surge induces final maturation of the ovocyte which makes it suitable for in vitro fertilization. The spontaneous LH peak can be detected in blood or in the urine. Whatever the method of determination, the diagnosis of the triggering LH surge can be done only on strict criteria. This work defines these criteria when urinary Higonavis is used: a rise in the plus signs in two successive samples or a positive result in urine diluted fourfold. PMID- 6853975 TI - [Intravenous urography in pregnancy and the risks of fetal hypothyroidism]. AB - The authors approach the question of the risk of fetal and neonatal hypothyroidism when intravenous pyelography is carried out in the pregnant woman. They looked at a continuous series of 15 cases in 7 years, of which 8 were studied retrospectively and 7 prospectively. They did not find any clinical or biological signs of hypothyroidism when the children were from 10 months to 9 years of age at review. The authors approached the reaction of the fetal thyroid to this excess dose of iodine considering what is known about the physiology of this gland in utero and the publications concerning hypothyroidism occurring after prolonged administration of iodine or amniofetography. They conclude that there is probably a temporary disturbance of fetal thyroid function but it does not continue into the neonatal period. All the same, caution is advocated because intravenous urography during pregnancy should be carried out only for very tight indications and the newborn should be carefully examined. PMID- 6853968 TI - [Immunological aspects of pregnancy]. AB - The authors undertake a review of the literature so that they can point out present knowledge of the immunological relationship between mother and fetus. The fetus is a true allograft since it carries paternal antigens. Total harmony occurs so that immunisation of the mother against the feto-placental unit is recognised. This immunological reaction must occur to allow smooth development of the fetus with, at the same time, protection of the mother against trophoblastic invasion. Many regulatory mechanisms are summoned up to bring about this immunological response. While the progress in immunological knowledge has enabled us to glimpse this immunological relationship, it seems strongly probable that knowledge of these mechanisms can have applications outside gynaecology and obstetrics and be of equal value in the interpretation of immunological reactions which are found on oncology and parasitology. PMID- 6853976 TI - [Anencephaly and prolonged pregnancy. Apropos of the etiology of prolonged pregnancy]. AB - The authors report on a study carried out in the University Clinic of Gynaecology and Obstetrics in Rabat on 13 cases of anencephaly without hydramnios in which post-maturity occurred. This gives them an opportunity of pointing out: --that there is a raised level of anencephaly in Morocco: --that the male sex is more commonly affected with anencephaly associated with post-maturity. And they wish to go through: --the physiological theories that are concerned with the role of the fetus in the onset of labour: --and the screening that has become possible since ultrasound and estimation of alpha-feto-protein levels have been in use, and that these should be used systematically in all pregnant women before they deliver an infant with a central nervous system malformation. PMID- 6853978 TI - [Microsurgical treatment of proximal lesions of the fallopian tubes. Apropos of 51 cases]. AB - Microsurgical anastomosis was carried out on 51 patients who had proximal tubal lesions that were either purely isthmal, interstitial or isthmo-interstitial. 18 24 months later there were, using an actuarial method of calculation, 64% of intra-uterine pregnancies (+/- 2 X 8% skew) (line 8, Table IV). There has not been a single case of extra-uterine pregnancy so far. These results confirm the superiority of microsurgical anastomosis over implantation of the tube into the uterus. PMID- 6853977 TI - [Fertility following celioscopic ovarian biopsy. Apropos of 477 cases of sterility]. AB - The authors report a continuous series of 477 ovarian biopsies carried out laparoscopically between 1971 and 1980. They analyse the effects of this operative manoeuvre in curing sterility. 37% of the women became pregnant, the percentage being calculated by taking those patients who could not be traced as failure. This percentage reaches 57% of those patients who were followed up and who had no other obvious cause for their sterility. There were no anatomical or histological factors that could have brought about or explained this therapeutic success. The authors conclude that it is worth while to carry out ovarian biopsy when performing laparoscopy, but they also point out its difficulties and its risks. PMID- 6853981 TI - Studies on experimental growth retardation in sheep. Plasma catecholamines in fetuses with small placenta. AB - Fetal growth rate in sheep has been reduced by removal of endometrial caruncles prior to conception. Fetuses were studied between 120-140 days. When small they had much higher plasma catecholamine concentrations than normal which was closely related to plasma pH and PaO2. The increase was predominantly of noradrenaline. During hypoxia, caused by giving ewes 9% O2 and 3% CO2 in N2 to breathe, plasma catecholamine concentrations in small fetuses rose further to levels approximately three times those in normal-sized fetal sheep. Again the increase was predominantly of plasma noradrenaline. During hypoxia the cardiovascular and metabolic responses of the small fetuses were correlated closely with the changes in plasma noradrenaline. PMID- 6853979 TI - [Digestive complications of radiotherapy of gynecologic cancers: therapeutic possibilities]. AB - It appears that there are a certain number of complications in the digestive tract that still occur in spite of improvements in techniques of irradiation therapy. They may only appear a few months or even a few years after the treatment, and sometimes they only appear when the initial growth is considered to have been cured. The clinical picture is dominated by the appearance of fistulae, of adhesions and of stenoses which give rise to sub-acute or sometimes acute obstructions. From the anatomical point of view all elements of the digestive tube are affected with a predominance of the fibro-hyaline elements of the muscles and the arteries. The possibilities for surgical treatment are limited. Excision with anastomosis would seem to be more risky than diversion. We have had to operate on ten of our eleven patients, of whom six died and only one of these directly because of recurrence of the initial growth. Only prevention can lessen the mortality of these severe complications. PMID- 6853980 TI - [Systematic prevention of deep vein thrombosis with subcutaneous heparin therapy following cesarean section. Advantages and disadvantages]. AB - The study was carried out on 234 women who had undergone caesarean sections. Hematoma in the area of the incision represents a major obstacle to the prevention of deep vein thrombosis through systematic subcutaneous heparin therapy. Even though anticoagulant therapy is not 100% effective, complications in this particular treatment appear to be minor. In our opinion, this therapy should be reserved for certain favorable cases and should not be generally used for all women undergoing caesarean sections. PMID- 6853982 TI - Pregnancy and inflammatory bowel disease. PMID- 6853983 TI - Bacteremia associated with esophageal dilatation. AB - The present study was undertaken because the previously reported incidence of bacteremia associated with esophageal dilatation seemed high, and did not correlate well with clinical experience. Seventeen adult patients were dilated for benign esophageal strictures with one to three dilators on 41 occasions. Five blood cultures were taken over the 30-minute period after each dilatation. Either routinely sterilized dilators or dilators resterilized just before the procedure were used in a random fashion. On 22 of the occasions that routinely sterilized dilators were used in 17 patients, temperatures, white blood counts, and blood cultures were normal in each instance. Resterilized dilators were used on 19 occasions in 15 subjects, and postdilation temperatures and white blood counts were also normal. Two blood cultures from different patients grew Staphylococcus epidermidis, which were felt to be contaminants. On the basis of this and previous studies, extra precautions do not appear to be necessary for dilatation of routine benign strictures. In patients at risk for endocarditis, or those with cancer or tight strictures, it seems advisable to sterilize dilators just before use, and take extra precautions. PMID- 6853984 TI - Cimetidine for recurrent ulcer after gastric surgery. AB - Seven of nine patients with ulcers recurring after a variety of gastric operations enjoyed loss of dyspeptic symptoms within 2 days of taking cimetidine, 1,200 mg/day for 6 weeks, and endoscopic confirmation of healing of the recurrent ulcer was established within 6 weeks of therapy. Once ulcer healing had been achieved in these seven patients, symptomatic remission persisted for over 19 months without maintenance therapy with cimetidine, and no complications suggestive of recurrent ulcerations occurred during this period in these seven patients. The eighth patient with a recurrent ulcer after vagotomy and pyloroplasty had symptoms suggestive of a gastric outlet obstruction in association with a bezoar and an elevated fasting serum gastrin concentration; cimetidine failed to heal the ulcer and a partial gastrectomy with Billroth I anastomosis was undertaken. The ninth patient lost his dyspeptic symptoms while on cimetidine, but 1 month after stopping therapy he succumbed to a massive hemorrhage; autopsy revealed a large pyloric channel ulcer. We suggest that cimetidine is helpful for the control of symptoms and the healing of recurrent ulcers after gastric surgery, but that endoscopy be repeated after an appropriate interval while such patients remain on cimetidine to assure that the disappearance of symptoms is truly associated with a lack of peptic ulceration. If the ulceration persists, we believe that cimetidine should be continued for a longer period. PMID- 6853985 TI - Sensitivity of guaiac-impregnated cards for the detection of colorectal neoplasia. AB - The sensitivity of the guaiac-impregnated card, hemoccult II, for the detection of colorectal neoplasia was tested in 213 patients undergoing elective colonoscopy over a 10-month period. Contrary to statements in standard texts as to the high sensitivity of guaiac-impregnated cards for the detection of these tumors, our results demonstrate only a 52% sensitivity for colorectal carcinoma and a 23% sensitivity for adenomatous polyps over 1.0 cm in diameter. We compare these results to other studies testing hemoccult sensitivity in the presence of colorectal neoplasia. This relatively low sensitivity rate emphasizes that the use of guaiac-impregnated cards alone does not exclude colorectal carcinoma in any patient. PMID- 6853986 TI - Clinical implications derived from the morphological classification of 89 patients with acute pancreatitis. AB - A morphologic categorization of pancreatitis which can only be made at operation or at autopsy has prognostic and therapeutic implications. We reviewed 89 such cases and classified them as follows: 1) Edematous in 54 (60.7%). All patients underwent operation; five (9.2%) died. 2) Necrotizing in 20 (22.5%). Eighteen patients required operation. Seven (39%) patients died; two patients treated nonoperatively died. 3) Hemorrhagic in 15 (16.8%). Operation was performed in nine with five (55.5) deaths; six patients treated without operation died. These observations suggest that 50% of patients operated on for pancreatitis have the mild edematous form; most of them survive the operation. In the severe forms of pancreatitis with necrosis or hemorrhage of the pancreas, about 50% of patients die postoperatively. There were no survivors in those treated without operation, suggesting the usefulness of surgical treatment once pancreatic necrosis is suspected. However, the advisability of operation and the prognostic implications derived from the morphologic categorization of acute pancreatitis are applicable (only retrospectively) after the pancreas has been examined at operation. PMID- 6853987 TI - Pouch ileitis: report of a case with severe systemic manifestations. AB - A 28-year-old man with chronic ulcerative colitis had a proctocolectomy with creation of a continent ileostomy. Six months later, he developed a severe systemic illness characterized by malaise, 24-lb. weight loss, fever, night sweats, arthralgias, bloody diarrhea, and problems with ileostomy function. On endoscopy, the pouch showed erythema, edema, friability, and ulceration; on biopsy, there was severe mucosal disruption with ulceration into the submucosa. Features consistent with chronic ulcerative colitis were also present. Laboratory investigation ruled out other causes of the illness so that a diagnosis of pouch ileitis was made. The patient responded dramatically to a 10-day course of metronidazole and remains well 2 years later. In patients with continent ileostomy after proctocolectomy for chronic ulcerative colitis, inflammation of the pouch may be associated with a severe systemic illness. The pathogenesis is unclear, but may involve the interaction of colonic type bacterial flora with ileal mucosa in immunologically susceptible patients. PMID- 6853988 TI - Hypertensive crisis induced by eating in a patient with pheochromocytoma. AB - Catecholamines have an important effect on the gastrointestinal tract. Patients with pheochromocytomas frequently have gastrointestinal complaints. We report a 13-year-old girl with a 250-g intra-abdominal pheochromocytoma who presented with symptoms of excessive catecholamines release and hypertensive crisis that was provoked by eating. The patient's pheochromocytoma was so large that it was palpable and compressing the greater curvature of the stomach. PMID- 6853989 TI - Gastric infarction: a complication of endocarditis due to Staphylococcus aureus. AB - We describe a 62-year-old man with diabetes mellitus and peripheral vascular insufficiency, with an ulcer on his foot which led to staphylococcal septicemia, endocarditis, and disseminated intravascular coagulation. All these factors contributed to thromboembolic occlusion of the terminal arteries and veins supplying the stomach, causing gastric infarction. PMID- 6853990 TI - Heterotopic pancreas mimicking carcinoma of the head of the pancreas: a rare cause of obstructive jaundice. AB - A 61-year-old man developed obstructive jaundice and had ultrasonographic and cholangiopancreatographic findings consistent with carcinoma of the pancreas. However, pathologically the obstruction proved to be from heterotopic pancreatic tissue compressing the common bile duct. This patient and eight previously reported patients with a similar problem are the subjects of this report. PMID- 6853991 TI - Air within a pancreatic inflammatory mass: not necessarily a sign of abscess. AB - Intrapancreatic air is considered to be a reliable if not a diagnostic sign of pancreatic abscess. The presence of extraluminal air within the pancreatic bed may also result from perforation of a pseudocyst into adjacent bowel. We describe a patient believed to have a pancreatic phlegmon both clinically and radiographically, in whom intrapancreatic air could be demonstrated on multiple abdominal CT scans over several months. The relatively unremarkable clinical course of this patient during an 11-month interval is incompatible with the usual rapid deterioration and high mortality rate of untreated pancreatic abscess. PMID- 6853992 TI - Reassessment of esophageal histology in normal subjects: a comparison of suction and endoscopic techniques. AB - We have examined esophageal biopsies from 18 asymptomatic volunteers. These normal subjects were also evaluated by esophageal manometry with determination of motor function of the esophagus and lower esophageal sphincter pressure, a modified Bernstein acid infusion test, and a basal pH reflux test. In 12 subjects, biopsies were obtained by suction technique; the remaining six had pinch biopsies performed during upper gastrointestinal endoscopy. Forty-nine (92.5%) of the 53 suction biopsies yielded tissue as deep as muscularis mucosa or at least ample amounts of lamina propria. In contrast, all 28 endoscopic biopsies yielded squamous epithelium only. Moreover, suction biopsies were generally well oriented (83%), whereas endoscopic biopsies were less commonly well-oriented (35.7%). All volunteer subjects had a negative acid reflux test confirming the absence of latent or asymptomatic reflux. Only one subject (5.6%) had biopsies which met histologic criteria for gastroesophageal reflux. We conclude that: 1) more tissue, more information, and better orientation is achieved with suction than with endoscopic biopsies of the esophagus; 2) the low false-positive rate observed in volunteers in whom gastroesophageal reflux was objectively excluded emphasizes the value of esophageal biopsy as a reliable index in the evaluation of gastroesophageal reflux. PMID- 6853994 TI - Proctitis. PMID- 6853993 TI - The gastroenterologist and the doctrine of informed consent. PMID- 6853995 TI - Multiple roles and physical health of women and men. PMID- 6853996 TI - Class and psychological vulnerability among women: the significance of social support and personal control. PMID- 6853998 TI - Health effects of economic instability: a test of economic stress hypothesis. PMID- 6853997 TI - Life stress, social support, and emotional disequilibrium in complications of pregnancy: a prospective, multivariate study. PMID- 6854002 TI - Theoretical distinctions between causal and interaction effects of social support. PMID- 6854001 TI - Development of attitudes about sharing decision-making: a comparison of medical and surgical residents. PMID- 6853999 TI - Reward system of psychotherapy: Implication for inequities in service delivery. PMID- 6854000 TI - Labeling theory and the attitudes of mental patients: a review. PMID- 6854003 TI - The presence of ethylenic bonds and vic-glycol groups in neuromelanin and lipofuscin in the human brain. AB - Through use of oxidation and blockading reactions, chemical group precursors of aldehyde demonstrable with Schiff reaction staining were identified in the soluble lipid-free lipofuscin component of neuromelanin of human substantia nigra and in lipofuscin of human inferior olive. Aldehyde generation was implied by moderate staining after bleaching neuromelanin and oxidizing lipofuscin with potassium permanganate followed by oxalic acid. Confirmation of aldehyde generation was achieved when diminished staining followed a sulfite addition blockade obtained by replacing oxalic acid with metabisulfite or bisulfite as well as by condensation blockades obtained with phenylhydrazine or aniline without replacing oxalic acid. Vic-glycol precursors of aldehyde were demonstrated in both pigments when acetylation or bromination preceded permanganate-oxalic acid and staining was unequivocally diminished only after acetylation. Vic-glycols were also demonstrated in lipofuscin by diminished staining when acetylation preceded periodic acid oxidation. Ethylenic precursors of aldehyde were suggested in performic acid-bleached neuromelanin when the minimal staining that followed this peracid's generation of Schiff reaction negative dihydroxy groups became greatly intensified following an additional oxidation with periodic acid. This additional oxidation converted the dihydroxys to Schiff reaction-positive aldehyde. Ethylenes in lipofuscin were indicated when bromination before performic acid reduced subsequent staining. PMID- 6854004 TI - Alterations in membrane sugars during epidermal differentiation: visualization with lectins and role of glycosidases. AB - Differentiation in keratinizing epithelia involves the orderly transformation of basal germinal cells into an exterior cornified layer. We have employed rhodamine conjugated lectins to visualize distinctive changes in the localization of keratinocyte membrane glycoconjugates during epidermal differentiation. The dermis, basement membrane, and epidermal cell membranes stained positively for mannose, alpha- and beta-galactose, N-acetyl-glucosamine, and sialic acid. In contrast, only the viable epidermis demonstrated N-acetyl-galactosamine, while alpha-L-fucose staining was limited to the upper stratum spinosum and stratum granulosum. Neuraminidase treatment extended the binding of certain lectins, e.g., peanut agglutinin, to regions of the skin that otherwise did not label. Whereas the granular cell membranes displayed the largest number of carbohydrates, these sugars could no longer be visualized after granular cells differentiated into the stratum corneum. Loss of lectin staining may be attributable to the presence of a family of sugar-specific glycosidases that we obtained from granular and cornified cell cytosol fractions. Finally, as further support for sugar deletion during cornification, we found that glycosphingolipids are hydrolyzed to ceramides coincident with both loss of lectin staining and the emergence of glycosidase activity. These results suggest: 1) that carbohydrates on keratinocyte cell membranes can be used as markers of epidermal differentiation, and 2) that removal of cell surface sugars during cornification may be due to the action of specific glycosidases in the outer epidermis. PMID- 6854008 TI - Effects of endogenous antidiuretic hormone (ADH) on macrophage phagocytosis. AB - Although several studies have indicated that antidiuretic hormone (ADH) enhances the phagocytic function of the reticuloendothelial system (RES) in shock syndromes, it remains unknown what influence ADH exerts upon the individual phagocytic components of this system. The present investigation was designed to evaluate the effects of endogenous ADH on the phagocytic activity of peritoneal macrophage cells. As a phagocytic stimuli, fluorescent methacrylate microbeads were injected intraperitoneally into Brattleboro (ADH deficient) and normal Long Evans rats in the presence and absence of exogenous ADH. Peritoneal cells were harvested 19-22 hr after the administration of the microbeads and the percent phagocytosis was determined in macrophage cells using a fluorescence-activated cell sorter (FACS II). Our results indicate that the percentage of peritoneal macrophages ingesting the fluorescent methacrylate microbeads was significantly reduced in the absence of ADH (Brattleboro rats: 5.4 +/- 0.6% versus Long Evans rats: 16.8 +/- 2.3%; p less than 0.001). In addition, our data demonstrate that exogenous administration of ADH significantly enhanced macrophage phagocytosis in Brattleboro (14.7 +/- 2.2%) and normal Long Evans (49.6 +/- 4.5%) rats. These data suggest, for the first time, that endogenous ADH might play a modulatory role in the phagocytic activity of a specific component of the RES, namely, the macrophage cell. PMID- 6854011 TI - Post coital pin-worm infection. AB - In Ibadan, Nigeria, an Enterobius vermicularis worm was found in the urine of a soldier complaining of urethral irritation that had started 4 hours after coitus. After his first post-coital micturition, which yielded the worm, the irritation stopped. There was convincing evidence that the worm had entered the soldier's urethra from his partner's perianal region (rear-entry coital position, no ejaculation because of partner's complaint of painful coitus, the partner was a school girl of 15, enterobiasis is common in young school girls in the city, etc.). PMID- 6854006 TI - Regional distributions of choline acetyltransferase and acetylcholinesterase activities in layers of rat cerebellar vermis. AB - Entire sagittal sections of rat cerebellar vermis were dissected into microgram sized samples of molecular, granular, and white matter layers. Assayed activities of choline acetyltransferase and acetylcholinesterase were plotted back onto sectional maps of exact sample locations. On the average, the activities of choline acetyltransferase and acetylcholinesterase in the granular layer were about four and five times, respectively, those in the molecular layer. The highest activity of both enzymes was in the granular layer of the vestibulocerebellum, the nodulus and ventral uvula (lobules X and IXc of Larsell). This activity might be related to the secondary vestibulocerebellar projection, terminating as mossy fibers in the granular layer of this region. Intermediate levels of activity were found in the granular layer of the dorsal uvula (lobule IX, a and b). The lowest activities of both enzymes in the granular layer were in the culmen (lobule V). A 7.1-fold difference in choline acetyltransferase activity and a 4.5-fold difference in acetylcholinesterase activity were found between the granular layer of lobules V and X. The numerical density of aggregates of acetylcholinesterase staining product in the granular layer correlated much better with assayed acetylcholinesterase activity than with choline acetyltransferase activity. PMID- 6854010 TI - Five years of freedom from smallpox. AB - In 1967, when the intensified global eradication programme was launched, smallpox was still endemic in 35 countries with a total population of 1200 million and caused an estimated 10-15 million cases, resulting in 2 million deaths. Ten years and ten months later, on 26 October 1977 through intensified public health activities, the chain of smallpox transmission was finally broken in Merka, south Somalia; the World Health Organization missed its ten-year target line by ten months. In December 1979, the Global Commission concluded that the global eradication of smallpox had been achieved and the Organization formulated its policy for the post-eradication era. In May 1980, the 33rd World Health Assembly endorsed the Commission's conclusion and officially confirmed the international acceptance of smallpox eradication as the most outstanding achievement in international public health. This achievement has unmistakably demonstrated that the concept of disease eradication is correct and feasible. WHO encouraged countries to discontinue smallpox vaccination and/or the need for a smallpox vaccination certificate from international travellers. However, WHO is continuing its vigilance over the disease and promoting further research on orthopox viruses. Globally, US$ 313 million were spent on the eradication of smallpox from the world. However, conservative calculations indicate that in the post eradication era, concrete economic returns resulting from the eradication of smallpox throughout the world, are estimated at US$ 1000 to 2000 million, annually. For the last five years of smallpox-free status, savings of about US$ 5000-10 000 million could be diverted for other health projects, which has had a major impact on international public health. However, there are other dividends similarly worthy as those of economic value. The most important of these are the hundreds of thousands of experienced and dedicated health workers who remain now in the countries as a solid base for implementing other important public health programmes. PMID- 6854007 TI - Differential filipin labeling of the luminal membranes lining the pancreatic acinus. AB - The cytochemical labeling of cholesterol by filipin in plasma membranes of the exocrine pancreas has shown a difference in the reactivity to filipin between the acinar and centro-acinar cells. The acinar cell has a poorly labeled luminal membrane but numerous filipin-cholesterol complexes on the basolateral membrane. In contrast, the centro-acinar cell shows a comparable degree of filipin labeling on both luminal and basolateral membrane. This difference in the distribution of filipin labeling suggests underlying differences in the organization of the respective membranes, probably related to their specific functions. PMID- 6854005 TI - A comparative study of polyclonal and monoclonal antibodies for immunocytochemical localization of cytosolic aspartate aminotransferase in rat liver. AB - The rabbit antiserum and mouse monoclonal hybridoma antibody against porcine cytosolic aspartate aminotransferase (c-AAT) (or cytosolic glutamic oxaloacetic transaminase (c-GOT)) were produced and compared for the localization of c-AAT in rat liver. An indirect immunocytochemical technique was performed using peroxidase-conjugated goat immunoglobulin (Ig) G anti-rabbit IgG and peroxidase conjugated rabbit IgG anti-mouse IgG as the second antibody. Rats were perfused with paraformaldehyde-lysine-periodate fixative and the liver fragments were immersed in 4% paraformaldehyde and transferred to 10% dimethyl sulfoxide overnight and subjected to cryostat sectioning. The rabbit IgG antibody, 3 individual monoclonal antibodies, and a mixture of these 3 monoclonal antibodies were applied to the tissue sections, respectively, using the same concentration. Under the same experimental conditions, the c-AAT was localized in each individual hepatocyte by both monoclonal and polyclonal antibodies. However, a mixture of three monoclonal antibodies gave stronger staining than a single monoclonal antibody; although two antibodies yield more intense staining than just one, it was still less intense than for three. The conventional rabbit polyclonal antibody against c-AAT produced more reaction product than the combined three monoclonal antibodies. It is concluded that for immunocytochemical study, the use of a single monoclonal antibody is sensitive enough to localize its tissue antigen under the present experimental condition. To obtain a stronger reaction product, a combination of several monoclonal antibodies, at least three or more, may give better staining. PMID- 6854014 TI - Molecular aspects of polyvalent sensitization of erythrocytes by proteins. AB - The role of the size of the protein molecule in polyvalent sensitization of erythrocytes was studied. The significance of the molecular parameters of protein sensitins was demonstrated by their blocking each other's accessible antigenic determinants. Steric disturbances increased with the increase in the surface density of the proteins and with differences in their molecular mass. The significance of the molecular parameters of the proteins for the surface architectonics of artificial and natural surfaces is discussed. PMID- 6854012 TI - Analysis of epidemiological peculiarities of rubella based on a mathematical model (according to observations over 10 years in Moscow). AB - The main epidemiological values characterizing rubella in Moscow were calculated on the basis of a new mathematical model. Quantitative estimates of the intensity of infection in different age groups of the population were obtained. It has been established that the risk of infection in children is especially high in comparison with adult population. That is why 98% of the population aged 15 are immune. The probability of falling ill with rubella was determined for persons with different antibody levels. The cases of congenital rubella in Moscow are rare due to the low risk of infection in adults and to their immunity acquired in childhood. Consequently, there is no necessity for vaccination against rubella in Moscow at the present time, but it should be recommended to organize constant epidemiological surveillance of congenital rubella. PMID- 6854013 TI - Migration inhibition tests in penicillin allergy. AB - The lymphocyte blastic transformation (TTB), leucocyte and macrophage inhibition tests has been compared in 18 hypersensitive to penicillin patients and in 15 patients with hypersensitivity to PPD. It has been shown that TTB was positive in all penicillin allergy cases, due to the constantly LT sensitization, and therefore this test constitutes an efficient method for the in vitro diagnosis of penicillin hypersensitivity. Macrophage inhibitory factor (MIF) was absent in all penicillin allergic subjects. Leucocyte migration inhibition test was positive only when gamma globulin coupled penicillin was used or in the presence of autologous plasma pretreated penicillin. This suggests that leucocyte migration inhibition resulted from the specific penicillin antibodies. PMID- 6854015 TI - Ontogeny of con A and PHA responses of chicken blood cells in MHC-compatible lines 6(3) and 7(2). AB - The development of T cell responsiveness to Con A and PHA was examined in two MHC compatible inbred chicken lines, RPRL 6(3) and 7(2), at ages 2 to 118 days posthatching. These lines are respectively resistant or susceptible to Marek's disease, a naturally occurring, virally induced T cell lymphoma. Between-line comparisons were made of optimal in vitro responses of diluted serum-free blood cells to each mitogen in two groups of chicks tested over ages 2 to 63 and 41 to 118 days. Over 2 to 63 days, Con A responses increased with age at the same rate in each line, but 7(2) responses averaged 2.3 times higher than 6(3). The increase with age was dependent on blood lymphocyte counts, which also increased with age in parallel in both lines. In contrast, the between-line difference in responsiveness was dependent on intrinsic reactivity of cells as well as lymphocyte counts. Covariance analysis was used to estimate that line 7(2) was 1.4 times higher than 6(3) in intrinsic cell reactivity, after accounting for the effect of the twofold higher blood lymphocyte counts in 7(2), and that this intrinsic difference contributed almost one-half the total difference. Over 41 to 118 days Con A responses no longer increased with age, although lymphocyte counts were still increasing, and the line difference (2.6 times) was now almost entirely contributed by a 2.3-fold superiority of 7(2) blood cells in intrinsic reactivity. The line difference in PHA responses was the reverse of the above in young chicks, with 6(3) responses greater than 7(2) in spite of lower lymphocyte counts. In additional chicks tested over 5 to 26 days, intrinsic reactivity of 6(3) cells to PHA averaged 4.5 times higher than 7(2). There was an abrupt decline in intrinsic reactivity of line 6(3) blood cells between 26 and 41 days to a level equal with 7(2). After this age, line 7(2) responses were 1.8 times greater than those of 6(3), and this difference was dependent solely on lymphocyte count differences. The results suggest that different gene systems mediate blood cell responses to PHA as compared with Con A. The pattern of developmental differences between inbred lines indicates the existence of distinct or partly overlapping T cell subsets with different reactivities to PHA or Con A, and of higher suppressor activity of adherent cells in line 6(3) blood. Both these differences may be related to line 6(3) inherited resistance to Marek's disease. PMID- 6854009 TI - Combined quantitative cytophotometric method for staining indolyl and sulfhydryl groups and protein. AB - Sulfenylation with 2-nitrophenylsulfenyl chloride (NPS-Cl), which is specific for tryptophyl and cysteinyl residues in protein, was applied to quantitative histochemistry. By measurement of the absorbance values at 370 nm of sections stained with NPS-Cl, Beer-Lambert's law was found to hold for NPS staining. Treatment of NPS-stained sections with 2-mercaptoethanol (ME) (NPS-ME staining) resulted in sulfenylation of tryptophyl residues only. For determination of the amounts of tryptophyl and cysteinyl residues per unit of protein, protein staining with Coomassie Brilliant Blue (CB) was combined with NPS and NPS-ME staining. CB and NPS-CBB staining also followed Beer-Lambert's law. By measuring the absorbance values at 370 and 650 nm of doubly stained sections, the relative contents of tryptophyl and cysteinyl residues in various tissue proteins were calculated. This method will be useful for the investigation of changes in both protein amount and composition. PMID- 6854016 TI - The complement-mediated binding of soluble antibody/dsDNA immune complexes to human neutrophils. AB - The complement-mediated binding of soluble antibody/3H-dsDNA immune complexes (prepared in vitro) to human polymorphonuclear leukocytes (PMN) has been investigated quantitatively. Studies with isolated complement components in conjunction with experiments on the binding of these complexes to human red blood cells suggest that the binding to both cell types is mediated predominantly by CR1 (C4b-C3b) receptors but that CR3 (iC3b or C3d-g) receptors may play a role in binding to PMN but probably not to RBC. Our results also indicate that under the standard conditions of these assays (37 degrees C, 20 to 40 min incubations) there is no significant internalization of the soluble antibody/dsDNA immune complexes after they are bound by the PMN. PMID- 6854017 TI - Decreased C5b67-inhibitor activity in two families with hereditary functional deficiency of the eighth component of complement. AB - In addition to its role in hemolysis and host defense against Neisseria infection, the eighth component of human complement (C8) is one of several plasma proteins that are C5b67-inhibitors (C5b67-INH). The recent identification in our laboratory of two new families with hereditary deficiency of C8 provided an opportunity to study further the role of C8 as a C5b67-INH. Based on mixing and reconstitution experiments, the deficiency of C8 seemed to be due to a selective lack of the C8 beta-chain in one family and the C8 alpha-gamma subunit in the other family. Sera from individuals homozygous for the C8 abnormality were substantially deficient in C5b67-INH activity as well as totally deficient in hemolytic activity. Sera from control individuals possessed approximately 2500 C5b67-INH U/ml, whereas sera from the C8-deficient individuals had markedly depressed C5b67-INH activity, with a mean of only 428 U/ml. C5b67-INH activity was completely reconstituted in C8-deficient serum by the addition of purified human C8. We conclude that C8 constitutes the substantial majority of the C5b67 INH activity of normal human serum. PMID- 6854018 TI - The biologic activity of mast cell granules. VI. The effect of vinblastine induced neutropenia on rat cutaneous late phase reactions. AB - Type I immediate hypersensitivity reactions in human and rat skin may be followed by late phase reactions (LPR). A consistent feature of both human and rat LPR is the early histologic appearance of neutrophils, which, in rats, is followed by the later appearance (8 to 24 hr) of mononuclear cells. To determine the importance of the neutrophil in the development of LPR, rats were depleted of neutrophils using parenteral injections of vinblastine sulfate (VS). VS produced a dose-dependent neutropenia, with the maximal effect on day 4. LPR that were induced with anti-IgE, isolated mast cell granules (MCG), or purified high (greater than 10,000 daltons) and low (500 to 10,000 daltons) m.w. fractions obtained from MCG were significantly abrogated in VS-treated rats. In neutropenic rats previously immunized with complete Freund's adjuvant, the intensity of inflammatory reactions produced by skin testing with purified protein derivatives was also significantly reduced. Administration of exogenous neutrophils to neutropenic animals partially reconstituted the reduced LPR. These data confirm and extend previous observations on the contribution of neutrophils to delayed hypersensitivity reactions and provide evidence that the neutrophil is critical for the development of rat cutaneous LPR as well. PMID- 6854019 TI - A phenotypically normal revertant of an adenosine deaminase-deficient lymphoblast cell line. AB - Two lymphoblast lines from a patient with partial adenosine deaminase deficiency have been obtained. The patient has a T cell deficiency, with normal B cell function, and has been successfully treated by multiple partial exchange transfusions with normal erythrocytes. The patient's lymphocytes have about 8% of normal adenosine deaminase activity. The derived lymphoblast line that initially had low adenosine deaminase activity has undergone spontaneous reversion to normal enzyme activity. The HL-A types remain the same as the patient's. Both cell lines have the same HL-A types, and eight isoenzymes are identical. In addition, the isoenzymes of a fibroblast line derived earlier, GM-2445, are identical with those in our lymphoblast lines. The following characteristics of the enzyme in the cell lines are normal: Km, Vmax, inhibitor sensitivity, heat sensitivity, and m.w. This suggests, but does not prove, that the low adenosine deaminase activity in this patient is caused by underproduction of a normal enzyme, and the observed reversion to normal activity in one line is a correction of this regulation defect. PMID- 6854021 TI - IgA blocks IgM and IgG-initiated immune lysis by separate molecular mechanisms. AB - Circulating IgA which does not bind the first component of complement (C) and does not activate the classical C pathway, blocks the initiation of C-mediated immune effector mechanisms. In at least two clinical situations, epidemic meningococcal disease and severe hepatic dysfunction, IgA blockade of one such mechanism, immune lysis, results in susceptibility to hematogenous bacterial dissemination. The presence of strain-specific IgM, but not IgG, in the sera of susceptibles at the time of dissemination suggested that IgA blockade of IgM initiated lysis involves a separate mechanism more sensitive to quantitative changes than that involved in IgA blockade of IgG-initiated lysis. We report here that whereas IgA blockade of IgG-initiated immune lysis is a competitive function of the ratio of IgA to IgG, the blocking of IgM-initiated lysis is a noncompetitive function of the ratio of IgA to target cells, independent of the concentration of IgM. In the presence of sufficient IgA to saturate binding sites, IgM is an impotent bystander unable to compete for sites or initiate lysis. Therefore, C-mediated effector mechanisms are more sensitive to quantitative changes in circulating IgA and target cells (binding sites) in the absence of IgG than in its presence. Neither mechanism appears related to binding kinetics. PMID- 6854023 TI - ELISA solid phase: partial denaturation of coating antibody yields a more efficient solid phase. AB - We have examined conditions which will improve the solid phase in ELISAs for HBsAg and ferritin in human serum. Sheep and rabbit antibodies were used. It was found that pre-exposure of antibody to low pH, 3 M urea and temperatures as high as 82 degrees C will enhance ELISA colour in these assays. Further experiments indicate that these conditions perturb the structure of the antibody molecules and results in the exposure of new hydrophobic regions. It is speculated that these more hydrophobic molecules can bind to regions on the plastic surface normally not coated by non-perturbed molecules. PMID- 6854022 TI - Monoclonal antibody information. PMID- 6854020 TI - Resistance to Streptococcus pneumoniae is induced by a phosphocholine-protein conjugate. AB - Previous studies demonstrated that naturally occurring antibodies to the pneumococcal cell wall hapten phosphocholine (PC) are important for the survival of mice against infection with Streptococcus pneumoniae, and that passively administered hybridoma antibody to PC results in added resistance. To determine if a PC-protein conjugate could elicit protective levels of anti-PC antibody, mice were immunized with PC-keyhole limpet hemocyanin (KLH) and tested for their ability to resist challenge with virulent S. pneumoniae. PC-KLH-immunized mice were observed to be resistant to 10- to 1000-fold more organisms than unimmunized control animals. The levels of protection were comparable to those induced with capsular polysaccharide antigens, but had the advantage of not being type specific; immunization with PC-KLH protected mice against both type 1 and type 3 organisms. The induced immunity appeared to be antibody-mediated; it could be passively transferred with immune serum, and absorption of the immune serum with PC-Sepharose removed its protective capacity. Anti-PC antibodies in the serum of immunized mice were primarily IgM and IgG3 and possessed predominantly the T15 idiotype. Antibodies with these particular isotypes and this idiotype also arise after immunization with heat-killed rough pneumococci and recently were shown to be important in the resistance of mice to pneumococcal infection. PMID- 6854025 TI - A quantitative examination of the light scattering properties of immune complexes in polyethylene glycol. AB - The effect of polyethylene glycol on the light scattering properties of immune complexes prepared in vitro was examined. Immune complexes were prepared in the zone of antigen excess from purified rabbit anti-ovalbumin and ovalbumin at 2-32 times (X) the equivalence ratio. Immune complex concentration was determined by analytical ultracentrifugation. Immune complexes were then incubated for 1 h in solutions containing 0, 1, 2, 3 and 4% polyethylene glycol (PEG), and examined in a laser nephelometer. The effect of PEG on light scattering (%RLS) was different for each immune complex combining ratio, although for each immune complex combining ratio, there was a linear relationship between the light scattered and immune complex concentration. To evaluate the effect of serum proteins on the light scattered by the immune complexes, immune complexes made at 4X and 16X the equivalence ratio were placed in serum and the sera containing these immune complexes were examined in the nephelometer. The ratio of the %RLS of the immune complexes in serum to the sum of the %RLS of the same immune complexes in saline plus the %RLS of serum alone was determined. This ratio varied systematically with changes in combining ratio and PEG concentration, as well as the concentration of the immune complexes themselves. Depending on the combination of these 3 factors, serum could increase, decrease or have no effect on the quantity of light scattered by the immune complexes. Discrimination between serum alone and serum containing immune complexes was best in 3% PEG. PMID- 6854024 TI - A standardized method for quantitating the complement-mediated immune complex solubilizing capacity of human serum. AB - A standardized radioassay for measuring the complement-mediated immune complex solubilizing capacity (CMSC) and the initial kinetics of the solubilization (IKS) reaction is described. The total complement (C)-mediated solubilizing capacity was determined after incubation of diluted serum and 125I-BSA-anti-BSA. Percentage C-mediated solubilization (CMS) was measured after centrifugation by determining the distribution of radioactivity. The dependency of CMSC upon factors such as serum dilution and buffer system used, amount of IC added to serum, serum storage conditions and centrifugation conditions was investigated in order to optimize the assay. The CVt of the standardized assay was 0.10-0.17 depending upon the CMSC level measured. Treatment which inactivates C factors (heating), interferes with C activation (EDTA) or activates and consumes C components (zymosan) markedly reduces the CMSC. Preliminary investigation of pathological sera showed that both IKS and CMSC were clearly reduced in SLE sera. By contrast, rheumatoid arthritis sera exhibited normal IKS and only marginal reduction in CMSC. PMID- 6854026 TI - The kinetic measurement of phagocyte function in whole blood. AB - A technique has been developed for the kinetic measurement on the same blood sample of a variety of functions of phagocytic cells. Adherence to glass, the clearance of a mixture of microorganisms and their subsequent solubilisation, and the secretion of granule contents from the cells were determined. The numbers of residual viable intracellular staphylococci were measured at the completion of the study. These methods were used to investigate phagocyte function in 33 normal subjects and 6 patients with chronic granulomatous disease. PMID- 6854028 TI - Microtiter latex antiglobulin test for the detection of antibodies to DNP, digoxin, HCG and similar antigens. AB - A microtiter latex antiglobulin test (LAGT) with heavy-and-stable latex particles was developed. Antibodies of weak avidity, such as rabbit antisera to DNP or digoxin were much enhanced by the LAGT, whereas the method only slightly promoted strong avidity antibody, such as that found in rabbit antisera to human chorionic gonadotrophin. A microtiter latex agglutination-inhibition test (LAGIT) proved to be an effective tool for detection of weak antigenic substances such as digoxin and DNP. PMID- 6854027 TI - Detection of antibodies against Streptococcus mutans cell wall contaminating sera against ribosomal fractions. AB - A modification of the immunoprecipitation technique was developed to precipitate ribosomal proteins from Streptococcus mutans in isoelectric focusing gels. The method was established in order to determine whether the ribosomal immunogen was contaminated with cell surface proteins. Isoelectric focusing was used to separate the proteins into bands in the gel and various antisera utilized to precipitate the antigens. Electrophoresis of the ribosomal preparation produced 19 protein bands. A rat antiserum raised against the preparation reacted with 8 of these bands and an aliquot of the same antiserum which had been adsorbed with whole S. mutans cells reacted with only 6 bands. This procedure allowed us to detect contamination of the ribosomal preparation with cell surface antigens. The method may be used to detect contamination with cell surface antigens in many different subcellular preparations. PMID- 6854029 TI - Quantitation of DNP, digoxin, HCG and anti-DNP antibody by electronic data processing of latex antiglobulin reaction results. AB - Volumes of agglutinates produced by the microtiter latex antiglobulin test (LAGT) were measured by an electronic data processing (EDP) method using a particle volume distribution analyzer. This method proved highly sensitive for quantitating weak antibodies, such as anti-digoxin and anti-DNP. EDP measurement of the microtiter latex antiglobulin-inhibition test (LAGIT) is also a suitable method for quantitating HCG, digoxin and DNP. PMID- 6854030 TI - Use of protein A to remove immunoglobulins from serum in hybridoma culture media. AB - The levels of protein A-reactive immunoglobulin (PA-Ig) in foetal bovine serum were measured in commercial batches. For tissue culture media incorporating 10% foetal bovine serum, the levels of bovine PA-Ig were of a similar order to those of mouse monoclonal antibodies produced by hybridomas grown in such media. The equilibrium constants were calculated for the binding to protein A-Sepharose of a number of mouse monoclonal antibodies, and of PA-Ig in foetal bovine serum and normal mouse serum. The average affinity of the mouse PA-Ig was 10 times higher than that of the bovine PA-Ig, suggesting that the two could be separated by affinity chromatography on protein A-Sepharose. The mouse monoclonal antibodies, however, displayed a range of affinity 1.5-100 times that of the bovine PA-Ig, indicating that such separation could not be generally applied. The optimal technique involved removing PA-Ig from bovine serum before its inclusion in the culture medium and then purifying the monoclonal antibody on a second protein A Sepharose column. PMID- 6854031 TI - Enhanced Detection of immunoglobulin binding by a modified ELISA. AB - A modification of the ELISA assay is described which significantly enhances the chromogenic signal, thereby increasing the sensitivity of the assay. This enhanced ELISA employs a protein A-HRP conjugate to detect antibody bound to antigen coated polystyrene plates, followed by incubation with an anti-protein A HRP conjugate as the amplification step. This enhanced ELISA is rapid, inexpensive, uses commercially available reagents and maintains the low background and high specificity of standard ELISA. PMID- 6854032 TI - Measurement of ultraviolet light-induced photolesions in mammalian DNA by microELISA. AB - A sensitive microELISA was developed for titration of anti-UV-DNA antisera and measurement of photolesions in DNA using UV-irradiated DNA as antigen coupled to the wells of microtitre plates. Efficient and reproducible immobilization of the antigen required precoating of the plates with poly(L-lysine). Antisera from 2 rabbits immunized with UVdsDNA recognized specifically thymine dimer associated lesions. The antiserum from one animal was used to probe photodamage in DNA. Lesions induced by an irradiation dose as small as 2.5 J/m2 could be detected. PMID- 6854037 TI - An improved method of unit gravity sedimentation separation for murine peritoneal macrophage populations. AB - A new method for the separation of murine peritoneal macrophage populations is described. Different macrophage populations were separated by velocity sedimentation in a Percoll gradient. The macrophages were separated by size as was shown by a morphometrical analysis. The different macrophage populations differed in their enzyme cytochemical profile. The overall recovery of peritoneal cells is more than 95% and the macrophages adhered normally to glass surfaces after washing. This indicated that this l X g sedimentation separation of macrophages, which is relatively simple to perform, is suitable for the study of macrophage heterogeneity. PMID- 6854034 TI - A single step immunoelectrophoresis method for the quantitation of complement C3c in biological fluids. AB - An intermediate gel rocket immunoelectrophoresis (IRI) suitable for direct quantitation of complement split products with C3c specificity is described. The technique represents a simple, quick, and reproducible method for the assessment of complement activity in biological fluids in diseases. The advantages of the quantitative approach of the IRI method as compared to the conventional crossed immunoelectrophoresis (CIE) are the increased sensitivity, specificity, and precision of the method; also, the assay capacity is superior to CIE. The IRI-C3c assay is therefore highly suitable as a scientific tool, and may also be useful for routine laboratory investigations. PMID- 6854033 TI - A homogeneous sol particle immunoassay for human chorionic gonadotrophin using monoclonal antibodies. AB - A mixture of monoclonal antibodies against human chorionic gonadotrophin (HCG) from 2 different clones was used to develop a homogeneous sol particle immunoassay (SPIA) for HCG, with high discrimination against luteinizing hormone (LH). The optimization of this assay is described. The work resulted in a spectrophotometric and a visual reading version. In an evaluation of the tests with 348 urines from pregnant women, 530 urines of non-pregnant women of fertile age and 100 post-menopausal women, the spectrophotometric screening test was 100% correct in the groups of urines from pregnant women and from post-menopausal women, and 99.8% correct in the group of urines from non-pregnant women of fertile age. This spectrophotometric screening test required an incubation period of 1 h and detected 280 IU/1 HCG. The eye reading test required an incubation period of 2 h and was able to detect about 450 IU/1 HCG. This test showed 100% correct results in the group of urines from non-pregnant women and from post menopausal women, and 99.1% correct results in the group of pregnant women. In both test versions HCG concentrations up to 200,000 IU/1 did not result in false negative reactions. Urines of non-pregnant women, with an added 1000 IU/1 LH, gave correct negative test results. PMID- 6854035 TI - Enzyme-linked immunosorbent assay (ELISA) for antibodies to Clostridium difficile toxins in patients with pseudomembranous colitis and antibiotic-associated diarrhoea. AB - Enzyme-linked immunosorbent assay (ELISA) was established with purified toxins from Clostridium difficile as antigen to measure antibody response in patients with pseudomembranous colitis (PMC) and prolonged antibiotic-associated diarrhoea (AAD). Positive ELISA titres were defined in a control population. Antibodies of IgG class against toxin B were demonstrated in 6/88 (7%) control sera and in 31/61 (51%) sera from 11/19 (58%) patients. Antibodies of IgA class were found in one patient while antibodies of IgM class were not demonstrated. ELISA antibodies against toxin A were not demonstrated. For comparison a neutralization test was performed and neutralizing antibodies to toxin B but not to toxin A were demonstrated in 10/61 (16%) sera from 4/19 (21%) patients and in none of the controls. ELISA was found to be a more sensitive assay than neutralization. ELISA antibodies were detected from the third week of the disease while neutralizing antibodies appeared after 5 weeks. Lack of an antibody response in ELISA seemed to correlate to a more severe colitis. PMID- 6854036 TI - Rapid, efficient cloning of murine hybridoma cells in low gelation temperature agarose. AB - A rapid, efficient method is described for cloning of lymphocyte hybridoma cells. The method utilizes ultra-low gelation temperature agarose. PMID- 6854038 TI - The production of high affinity monoclonal antibodies to human growth hormone. AB - The primary aim of this work was to produce specific monoclonal antibodies to human growth hormone (hGH) for use in a diagnostic RIA of hGH levels in serum. Three different schedules were used for immunization of BALB/c mice and the splenocytes from each mouse were fused with myeloma cells Sp 2/0 Ag 14. Each fusion resulted in the production of hundreds of hybridomas secreting hGH directed antibodies. Six antibodies have been fully characterized and have been grouped into pairs which recognize 3 different epitopes on the hGH molecule. One pair exhibits no cross reaction with the structurally related placental hormone, human placental lactogen (hPL), a second pair has low cross reaction with hPL (1.6-3%) and a third pair reacts equally well with hGH and hPL indicating binding to a common epitope in the 2 molecules. The highest affinity antibody, 74/6, which has an affinity constant of 4.4 X 10(10) l/mol and 3% cross-reactivity with hPL, has been used to establish a RIA for serum hGH measurements. Evidence is provided that hGH levels measured in this assay correlate well with those obtained in a conventional rabbit antiserum assay. PMID- 6854039 TI - Influence of erythrocyte contamination on the optimal phytohaemagglutinin concentration in Chinese hamster lymphocyte cultures. AB - Lymphocyte cultures from the Chinese hamster were made with lymphocytes isolated with Ficoll-Isopaque or with Haemaccel. In some experiments the red blood cells (r.b.c.) that remained after lymphocyte isolation were lysed. Optimum phytohaemagglutinin (PHA) concentration for lymphocyte proliferation depended upon the manner in which the lymphocytes were obtained. Lower PHA concentrations were needed for optimum stimulation of lymphocytes isolated with Ficoll-Isopaque than for lymphocytes isolated with Haemaccel. Lysis of the r.b.c. remaining after isolation of lymphocytes with Haemaccel resulted in a decrease of optimum PHA concentration. The optimum PHA concentration depended strongly on r.b.c. contamination, the higher the r.b.c. contamination the higher the optimum PHA concentration. However, only part of the differences found in optimum PHA concentrations can be attributed to r.b.c. contamination. PMID- 6854041 TI - Lack of H-2Ld locus products on a BALB/c fibrosarcoma expressing H-2k-like alien antigens. AB - The presence of H-2Ld antigens was evaluated in methylcholanthrene-induced BALB/c fibrosarcomas by a variety of approaches. Transplantation experiments showed that BALB/c-H-2dm2 mice, a mutant strain whose cells do not express H-2Ld antigens, after immunization with BALB/c normal tissues developed a resistance to the growth of two tumours (C-3 and GI-17), but not to a third neoplasm, C-1, which is known to have H-2d- as well as H-2k-like alien antigens. In vitro experiments with cytotoxic T lymphocytes generated against Ld antigens confirmed a loss of Ld antigens on C-1 but not on C-3 tumour cells. Serological experiments with an anti Ld serum again revealed the presence of H-2Ld determinants on C-3 but not on C-1 cells. Biochemical analysis in SDS-PAGE of immunoprecipitates obtained by specific anti-H-2 sera with NP40 lysates of the tumours studied could detect H 2Kd, H-2Dd and H-2Ld antigens in C-3 fibrosarcoma cells whereas Kd and Dd were the only H-2d molecules found in C-1 lysate along with the H-2k-like specificities. The possible genetic mechanisms which may explain this apparent gain and loss modification of the H-2 profile of C-1 are discussed. PMID- 6854043 TI - Radiation therapy in the treatment of recurrent carcinoma of the cervix. PMID- 6854042 TI - Factitious illness reconsidered. PMID- 6854040 TI - A monoclonal antibody related to the human blood group Gerbich. AB - The monoclonal antibody, GERO, agglutinated all samples of red cells with the exception of Gerbich-negative cells of both Ge and Yus types. Using the antiglobulin test, Gerbich-negative cells reacted as strongly with GERO as did Gerbich-positive cells. PMID- 6854044 TI - Emergency surgery for strokes-in-evolution. PMID- 6854046 TI - Topical sunscreens. PMID- 6854045 TI - The diagnosis and management of impotence. PMID- 6854047 TI - Creatine phosphokinase-MB isoenzyme in a patient with alcoholic myopathy. PMID- 6854048 TI - Efficiency studies: aspiration, chest injury and prone CPR. PMID- 6854049 TI - Dietary gluten challenge does not influence the levels of circulating immune complexes in patients with dermatitis herpetiformis. AB - To examine the relationship between the gluten-sensitive enteropathy (GSE) and IgA circulating immune complexes (CIC) in dermatitis herpetiformis (DH) a series of dietary gluten-challenge studies were performed in patients with DH and patients with ordinary GSE. Serial serum samples were monitored for IgA-, IgG-, and IgM-containing CIC levels. In the first study, 9 DH patients and 5 controls were fed 20 g of gluten flour as a breakfast meal on 1 of 2 consecutive study days. DH patients did not develop or increase their levels of CIC after gluten challenge or gluten-free meals. There was no significant difference between the DH patients and the control group in regard to development of CIC. To evaluate the effect of dietary gluten in another form, 8 DH patients were given meals containing 100 g of boiled Canadian cracked wheat. Two patients with ordinary GSE were also challenged with cracked wheat. Again there was no elevation or induction of CIC above baseline determinations by gluten-challenge meals. These studies suggest that dietary gluten does not induce the formation of CIC in patients with DH. PMID- 6854050 TI - Noninvasive assessment of local nicotinate pharmacodynamics by photoplethysmography. AB - The local pharmacodynamics of a topical vasodilator (methyl nicotinate) has been followed noninvasively using photopulse plethysmography. This technique is sensitive to changes in blood flow through the cutaneous microcirculation and responds to the pharmacologic stimulus of the vasoactive agent employed. Five different application sites for the drug were studied and the time course of the local effect (i.e., onset, duration, and decay) was recorded. The applied amount of drug elicited, within a short period, a response which was saturable such that the observed increase in blood flow reached a plateau level. The decay of the elevated perfusion required approximately 1 h, suggesting a half-life for elimination of the drug from the skin of about 10 min. This result agrees closely with other reported values and suggests that the pharmacodynamic measurements of this study may prove useful in elucidating aspects of dermal pharmacokinetics. PMID- 6854051 TI - Penetration enhancers for human skin: mode of action of 2-pyrrolidone and dimethylformamide on partition and diffusion of model compounds water, n alcohols, and caffeine. AB - Penetration-enhancing solvents may modify diffusional routes through the stratum corneum and the partitioning of drugs into these pathways. To investigate the mechanisms of action of enhancers, steady-state fluxes were measured in vitro for polar methanol, nonpolar octanol, and an intermediate compound, caffeine, selected as model penetrants; human stratum corneum conditioned on both sides with water or accelerants (2-pyrrolidone or dimethylformamide solutions) was used. We determined partition, permeability, and apparent diffusion coefficients, and derived the standard free energy of transfer of the methylene group from water to stratum corneum (-423 cal mol-1); less negative values were obtained for transfer from 2-pyrrolidone solutions. We conclude that for these model compounds, and taking a fully hydrated membrane as a standard: (a) 2-pyrrolidone enhances permeation through the polar route of the skin by increasing the diffusivity, and reduces passage through the nonpolar route by decreasing diffusivity and partitioning, (b) dimethylformamide promotes polar route absorption by raising diffusivity and partitioning and reduces nonpolar absorption by decreasing both parameters, and (c) for caffeine, the markedly increased absorption (15-fold) caused by dimethylformamide is associated with damage to the membrane. PMID- 6854052 TI - Circadian rhythm in human epidermis. PMID- 6854053 TI - Mast cells in cutaneous inflammatory disorders. AB - Mast cells in skin are distributed around dermal and subcutaneous blood vessels. Activation of tissue mast cells produces secretion and/or generation and secretion of a variety of biologically active molecules. Mast-cell-dependent mediators may be classified as smooth-muscle-contracting and vasoactive activities, chemotactic factors, enzymes, and proteoglycans. These mediators alter the microenvironment to produce a biphasic response. The initial or humoral phase of the response is mediated by materials that alter vascular permeability; peripheral blood leukocytes attracted by chemotactic factors establish the cellular phase. Failure to limit the humoral phase creates a pharmacologic state that may be recognized in skin as urticaria/angioedema. The inability to control the cellular phase permits progression to a local inflammatory state with subacute and chronic tissue injury recognized in skin, for example, as necrotizing vasculitis. As an example of the former, certain forms of physical urticaria have provided experimental models in humans to allow observation of the clinical manifestations, study of tissue alterations by histologic analysis, measurement of mediators released into the circulation, and assessment of motility of peripheral blood leukocytes. An example of the role of the mast cell in the production of subacute and chronic inflammatory cutaneous disease is suggested by studies in a patient in whom exposure to the physical stimuli of cold and trauma was followed by initial mast cell degranulation, subsequent tissue deposition of circulating immune complexes, and the development of a necrotizing vasculitis. PMID- 6854054 TI - Early death from clinical stage I melanoma. AB - We studied 13 prognostic factors in 582 patients with clinical stage I melanoma to determine which factor or combination of factors was associated with death from melanoma within the first 24 months following diagnosis. Thirty-six patients died during this period. Only 2 deaths occurred in patients with primary tumors thinner than 1.70 mm, and only 2 patients of 189 died with tumors located on the non-BANS extremities, excluding the hands and feet. Individual factors associated with high risk for death within 2 years included level V tumors, acral location, thickness greater than or equal to 3.65 mm, histologic ulceration greater than 3 mm, nodular type, presence of microscopic satellites, greater than 6 mitoses/mm2, positive elective node dissection, absence of lymphocyte response at the tumor base, and absence of an associated nevus histologically. Many of the preceding individual factors are highly correlated. By the use of logistic regression analysis, only one very high risk group was found: 71 percent of patients with level V tumors greater than 1.70 mm thick with histologic ulceration width greater than 3 mm located in an area other than the extremities (excluding hands and feet) had died within 2 years of diagnosis. The ability to select high-risk groups should be useful to investigators involved with the design and evaluation of adjuvant therapy studies. PMID- 6854056 TI - The chemotherapy of malignant melanoma. AB - Advanced human malignant melanoma continues to be an intractable tumor unresponsive to most forms of therapy. We have been engaged in the design of selective agents for the chemotherapy of malignant melanoma based on the unique biochemical features within this tumor. Several analogues have been prepared with significant antitumor activity against experimental melanoma models, and these include levodopa, dopamine, and the nonneurotoxic analogue 3,4 dihydroxybenzylamine. Pending the clinical availability of the improved analogues, we have investigated the effects of levodopa and dopamine on advanced human malignant melanoma. Dopamine has been shown to cause a significant biochemical inhibition of tumor in 4 patients treated, but cardiovascular effects have precluded its repetitive use. The combination of levodopa/carbidopa has been used in an attempt to circumvent these toxicities as well as deliver drug to the central nervous system (CNS). Of 12 patients treated to date, 8 are evaluable, and there have been 4 significant clinical responses. Importantly, the plasma levels achievable with levodopa are in tumoricidal range as predicted by in vivo assays (10(-5) M). One patient had a complete resolution of a CNS lesion as measured by CAT scan and a corresponding improvement in symptoms. Pending the availability of improved analogues, further study of the use of levodopa/carbidopa as therapy for malignant melanoma in humans appears warranted, and different methods of delivery, either alone or in combination with conventional agents, will be explored. PMID- 6854055 TI - Factors associated with death from melanoma from 2 to 5 years following diagnosis in clinical stage I patients. AB - We studied 14 prognostic factors in 428 patients with clinical stage I melanoma to determine which factor or combination of factors was associated with death from melanoma from 24 to 60 months following diagnosis. Forty-eight patients (11 percent) died during this period. All 17 patients who had visceral metastases present at 24 months died during this period. All surviving patients were followed for at least 60 months. Individual high risk factors included ulceration width (as determined by histology), level IV or V tumor, recurrence other than visceral, 6 or more mitoses per square millimeter, presence of involved nodes on elective dissection, absent or slight lymphocyte response, tumor type other than superficial spreading, location other than extremities (excluding hands and feet), microscopic satellites, thickness, sex, and wide local excision. The presence of sex as a risk factor for patients dying from 2 to 5 years following diagnosis is noteworthy because no sex difference was noted in the early death (less than 24 months) group. Age, presence of a nevus, and histologic regression were not significant factors. A logistic regression analysis selected a combination of the following independent factors: (1) location on extremities excluding hands and feet (favorable), (2) thickness, (3) recurrence other than visceral, (4) positive elective nodal dissection, (5) 6 or more mitoses per square millimeter, and (6) moderate to marked lymphocyte response (favorable). Twenty-five percent of patients with level IV lesions died between 24 and 60 months compared with only a 6 percent death rate within the first 24 months. PMID- 6854057 TI - Minimal deviation melanoma: a histologic variant of cutaneous malignant melanoma in its vertical growth phase. AB - Minimal deviation melanomas are uncommon nevomelanocytic tumors of indeterminate risk that appear as pigmented or nonpigmented skin nodules and are clinically diagnosed as Spitz nevi, hemangiomas, or malignant melanomas. They are characterized histologically by expansile growth in the papillary dermis with reticular dermal infiltration (minimal deviation type) or without reticular dermal invasion (borderline type). The tumors exhibit lesser cytologic atypia in their vertical growth phase (histologic variance) than observed in common forms of melanoma. A retrospective study of outcome in 21 patients with minimal deviation melanoma (mean tumor thickness by Breslow's measurement = 3.6 mm) disclosed recurrent disease in only 3 patients after a mean observation period of 57 months, supporting the impression that these tumors are not as biologically aggressive as common malignant melanomas. The histologic subtypes of minimal deviation melanoma are reviewed along with a discussion of the concept of histologic variance. PMID- 6854058 TI - The nature and molecular basis of cutaneous photosensitivity reactions to psoralens and coal tar. AB - The basic aspects of cutaneous photosensitization reactions and the mode of therapeutic effectiveness of psoralens and coal tar, the two groups of photosensitizing agents used extensively in the photochemotherapy of psoriasis, have been reviewed. Psoralen-induced skin photosensitization and the therapeutic action of psoralens involve two distinct types of reactions, and these two reactions occur independently of each other and concurrently when the psoralen treated skin (oral or topical) is exposed to 320 to 400 nm of radiation. The first, type I, is an oxygen-independent reaction and primarily involves photoreaction with DNA; the second, type II, is a sensitized reaction dependent on oxygen and involves the formation of singlet oxygen (1O2). The photoreactive form of psoralen is its triplet state, and the sites of reaction are (1) the cell membrane of the epidermal, dermal, and endothelial cells; (2) the cytoplasmic constituents, such as enzymes, RNA, lysosomes, etc.; (3) the cell nuclei (DNA and chromatin); and (4) the sensitized production of 1O2, which is responsible for cell-membrane damage and vasodilation. The major damage would be initiated by a type I reaction and would be seen in the form of nuclear damage to DNA resulting from the interaction of psoralen with DNA and to a lesser extent with RNA. The skin photosensitization response (erythema, edema, membrane damage, etc.) would result from a type II reaction involving the generation of 1O2. Crude coal tar (CCT), widely used in the Goeckerman therapy for psoriasis, also produces type I and type II reactions. The therapeutic and photosensitizing actions of CCT are due to (1) the photoconjugation of the photoreactive ingredients of CCT with DNA, causing interstrand cross-links; and (2) the production of 1O2. CCT is an efficient producer of 1O2, more so than 8-methoxypsoralen, and is responsible for cell-membrane damage and cellular edema. PMID- 6854059 TI - Selective thermal effects with pulsed irradiation from lasers: from organ to organelle. AB - Specific damage by selectively absorbed, pulsed lasers can be predicted based on physical models. Thermally mediated alterations can be confined to pigmented targets from the level of subcellular organelles (e.g., melanosomes) to large multicellular tissue structures (e.g., blood vessels) by the appropriate manipulation of wavelength and pulse duration. Highly selective damage to human cutaneous microvessels in vivo is shown to occur after 0.3-microseconds 577-nm dye laser pulses; the epidermis and dermal structures other than vessels are spared. Observations in an animal model suggest that hemorrhage or, at lower doses, selective intravascular coagulation and permanent microvascular hemostasis occur. Highly selective damage to melanized cells and to single melanosomes in situ was shown to occur after single 20-ns 351-nm pulses from a XeF excimer laser. Basal-cell- and melanocyte-specific necrosis is followed by gross hypopigmentation. In this case there is no evidence of vascular damage. The most likely modes of selective alterations include localized thermal denaturation, vaporization, and shock-wave generation. Means of predicting and controlling histologically selective radiant heating effects in skin are suggested. PMID- 6854060 TI - Chronologic and actinically induced aging in human facial skin. AB - Clinical and histologic stigmata of aging are much more prominent in habitually sun-exposed skin than in sun-protected skin, but other possible manifestations of actinically induced aging are almost unexplored. We have examined the interrelation of chronologic and actinic aging using paired preauricular (sun exposed) and postauricular (sun-protected) skin specimens. Keratinocyte cultures derived from sun-exposed skin consistently had a shorter in vitro lifespan but increased plating efficiency compared with cultures derived from adjacent sun protected skin of the same individual, confirming a previous study of different paired body sites. Electron microscopic histologic sections revealed focal abnormalities of keratinocyte proliferation and alignment in vitro especially in those cultures derived from sun-exposed skin and decreased intercellular contact in stratified colonies at late passage, regardless of donor site. One-micron histologic sections of the original biopsy specimens revealed no striking site related keratinocyte alterations, but sun-exposed specimens had fewer epidermal Langerhans cells (p less than 0.001), averaging approximately 50 percent the number in sun-protected skin, a possible exaggeration of the previously reported age-associated decrease in this cell population. These data suggest that sun exposure indeed accelerates aging by several criteria and that, regardless of mechanism, environmental factors may adversely affect the appearance and function of aging skin in ways amenable to experimental quantitation. PMID- 6854062 TI - Peritoneal macrophages and opsonins: antibacterial defense in patients undergoing chronic peritoneal dialysis. AB - The antibacterial activity of phagocytic cells and opsonins in peritoneal dialysis effluents from 21 patients undergoing chronic peritoneal dialysis (CPD) was studied. Effluents contained an average of 12 x 10(6) cells per liter that were predominantly macrophages. Macrophages phagocytized and killed opsonized Staphylococcus epidermidis, Staphylococcus aureus, and Escherichia coli as efficiently as did polymorphonuclear neutrophils (PMNs) from healthy donors. Macrophage chemiluminescence was one-third of that observed with donor PMNs. In the absence of opsonins, macrophages efficiently phagocytized and killed S. aureus by binding S. aureus cell wall protein A to macrophage surface IgG. Nine (43%) of 21 effluents failed to opsonize S. epidermidis, and none opsonized E. coli. When present, titers of S. epidermidis opsonins were 50- to 100-fold lower than that of normal serum. IgG and C3 concentrations in effluent reflected its opsonic capacity. Macrophages from patients undergoing CPD thus have intact phagocytic and bactericidal functions. However, the low level of opsonic molecules and inadequate numbers of macrophages in the peritoneal cavity may predispose patients undergoing CPD to peritonitis. PMID- 6854061 TI - Bactericidal and opsonic activity of ascitic fluid from cirrhotic and noncirrhotic patients. AB - Cirrhotic patients with ascites are highly susceptible to spontaneous bacterial peritonitis. Patients with ascites due to causes other than cirrhosis very seldom develop peritonitis. The antibacterial activity of these ascitic fluids is not known. The present study was undertaken to evaluate the bactericidal and opsonic activity in ascitic fluid from patients with and without cirrhosis and in normal (nonascitic) peritoneal fluid. Normal peritoneal fluids of 20 control subjects and ascitic fluids of 22 patients with noncirrhotic ascites all had normal bactericidal activity. The bactericidal activity of ascitic fluid was diminished in all 25 patients with cirrhosis (P less than 0.00005 by Fisher's exact test). Similar results were found when opsonic activity was evaluated. Complement and immunoglobulin concentrations in cirrhotic ascites were significantly lower than those in the other two groups. The present study demonstrates that noncirrhotic ascitic fluid has antibacterial activity similar to normal peritoneal fluid, whereas cirrhotic ascitic fluid has a marked reduction of both bactericidal and opsonic activities. These defects may explain the high incidence of peritonitis in cirrhotic patients. PMID- 6854064 TI - Efficacy of single-dose influenza in Air Force recruits. PMID- 6854063 TI - Type variation of strains of Streptococcus pneumoniae in capsular serogroup 15. AB - The repeated finding of two capsular types of Streptococcus pneumoniae in serogroup 15 in infected exudate from the middle ear led to the demonstration of type variation in pneumococcal types 15B and 15C. Determination of the chemical composition of the capsular polysaccharides of the pneumococci in serogroup 15 showed that the observed variation was related to the presence of an O-acetyl group in the capsular polysaccharide of type 15B which was lacking from the otherwise identical polysaccharide of type 15C. The phenomenon appears similar to that reported in several other bacterial species in which it has been ascribed to labile inversion of a segment of DNA. PMID- 6854065 TI - IgM and IgG antibody response to teichoic acid in infections due to Staphylococcus aureus. PMID- 6854067 TI - A simplified under-agarose method for measuring neutrophil chemotaxis. PMID- 6854068 TI - Splenic abscess due to Clostridium difficile. PMID- 6854066 TI - Circulating immune complexes and rheumatoid factors in visceral leishmaniasis. PMID- 6854069 TI - Endocarditis due to Corynebacterium CDC group G2. PMID- 6854070 TI - Leptospirosis with bacteriologic diagnosis. PMID- 6854071 TI - Attitude toward hepatitis vaccination among high-risk hospital employees. PMID- 6854072 TI - Cimetidine in the treatment of hyperimmunoglobulinemia E with impaired chemotaxis. PMID- 6854073 TI - Two cases of endocarditis due to Candida albicans discovered at autopsy. PMID- 6854074 TI - Conventional therapy and levamisole in the management of chronic brucellosis. PMID- 6854076 TI - A new University of Iowa Medical Humanities program. PMID- 6854075 TI - Age dependence of paralysis induced by echovirus type 9 in infant mice. AB - Newborn mice of different strains (including NMRI) infected with 2-5 x 10(6) pfu of echovirus type 9 strain A. Barty developed progressive flaccid paralysis five days after inoculation, followed by death. Suckling mice injected with the same infective dose two, four, or six days after birth disclosed at most transient paresis and survived. Infectivity titrations revealed in all groups a similar rate of virus multiplication exceeding 10(8) 50% tissue culture infective doses per mouse four days after virus inoculation. Histologically, polymyositis resulting in muscle fiber necrosis was seen. The percentage of damaged muscle tissue declined with increasing age of the experimental groups. It is concluded that in order for paralysis to occur, at least 50% of skeletal muscle tissue must be destroyed by virus-induced lesions before the sixth day of life. Electron microscopy demonstrated additional age-dependent, virus-mediated disturbances of postnatal muscle growth. Reparative events in destroyed muscle fibers seemed to be unaffected in all age groups. PMID- 6854077 TI - Putting practice management into the learning process. PMID- 6854078 TI - Program focuses on Iowa health management issues. PMID- 6854079 TI - Adverse drug reactions in the nervous system. PMID- 6854080 TI - The proposed new hospital licensing law: some questions and answers. PMID- 6854081 TI - [Extracorporeal circulation for diabetic heart: effects of extracorporeal circulation on cardiac function and myocardial metabolism in canine diabetes]. PMID- 6854083 TI - [Emergency double valve-replacement in the active stage of bacterial endocarditis]. PMID- 6854082 TI - [Myasthenia Gravis with systemic lupus erythematosus: report of two cases and review of the literature]. PMID- 6854084 TI - [A case report of complete right lung collapse due to the endobronchial fibroma- a successful treatment with resection and end to end anastomosis of the right main bronchus]. PMID- 6854085 TI - [A study on pre-and postoperative pulmonary circulation and gas-exchange in patients with pneumonectomy, lobectomy and thoracotomy]. PMID- 6854086 TI - [Left ventricular functional assessment after Fontan type operation]. PMID- 6854088 TI - [Acute renal failure after open heart surgery in children]. PMID- 6854087 TI - [Experimental studies on heart rate control with electrical vagus nerve stimulation]. PMID- 6854090 TI - [The studies of coronary circulation after cardiac surgery--the measurement of coronary sinus blood flow]. PMID- 6854089 TI - [Echocardiographic evaluation of the serial changes in cardiac functions before and after surgery of valvular heart diseases and the left ventricular reserve by the dynamic exercise]. PMID- 6854092 TI - [A scanning electron microscope study of the fine angioarchitecture of the uterine cervix - the process of mosaic formation and analysis of mosaic patterns]. AB - This study was designed to analyze the process of mosaic formation by a newly established cast formation technique utilizing the scanning electron microscope. RESULTS: 1) The angioarchitecture of the mosaic pattern in squamous metaplasia shows only a loop in the minute vessel. 2) The angioarchitecture of the mosaic pattern in neoplastic lesions shows various types of basket-like structures protruding into the epithelial layer from the subepithelial capillary network. 3) The basket formation begins in low degree dysplasia when the interconnection of the hairpin-like vessels protruding into the epithelial layer from the capillary network takes place. 4) The basket is almost completely formed in high degree dysplasia and become much firmer in carcinoma in situ. 5) With advancement of the neoplastic change the basket becomes bigger and deeper, especially at the rim of basket where it becomes much thicker due to the proliferation, conglutination and enlargement of superficial vessels. 6) The destructive changes in the basket appear in early invasive carcinoma and is observed at first on the bottom and rim. This study has elucidated the fine angioarchitecture of various types of mosaic patterns and made it possible to estimate the histological change by colposcopy. PMID- 6854091 TI - [The effect of indomethacin on placental permeability and the fetal lung circulation]. AB - Administration of indomethacin, a typical representative agent among the prostaglandin synthetase inhibitors (PGSI) causes contraction of the fetal ductus arteriosus and recently the relationship between these PGSI-type agents and the development of persistent fetal circulation (PFC) has been gaining attention in medical circles. Therefore, we studied the pharmacokinetics of indomethacin and its effect on the fetal lung. 1) Indomethacin (i.v.) was administered to near term rabbits and its placental passage was studied. As to the chronological changes of this preparation in fetal blood, the maximum concentration and half life were delayed compared with the changes in maternal blood. The concentration of indomethacin in fetal blood remained constant at around 33 percent irrespective of the doses to the mother and the number of gestational days. 2) When we administered indomethacin (0.5mg X 5 days, s.c.) to pregnant Wistar rats, neonatal findings (after spontaneous delivery) showed death in 7.0% and asphyxia in 10.5% of the neonates. Thus a significantly higher rate of abnormalities was observed in the neonates after spontaneous delivery compared with those delivered by laparotomy. During our histopathological studies of the lungs of the neonates, the complication of emphysema was observed in 2/4 of the dead neonates but no other abnormal findings were made. Hypertrophy of the pulmonary vascular bed in neonatal rats was not observed. PMID- 6854093 TI - [Pregnancy-associated alpha 2-glycoprotein in patients with gynecologic cancer]. AB - Pregnancy-associated alpha 2-glycoprotein (alpha 2-PAG) levels were measured in human sera by a modification of Laurell's electroimmunoassay using rabbit anti alpha 2-PAG serum. Sera were obtained from healthy controls (68 females), patients with myoma uteri (25 cases), patients with benign ovarian tumors (23 cases) and patients with cervical (19 cases), endometrial (4 cases) or ovarian (23 cases) cancers. The mean values of alpha 2-PAG in patients with myoma uteri (7.3 +/- 2.3U/microliters), benign ovarian tumors (5.0 +/- 3.1U/microliters), cervical cancer (8.8 +/- 4.4U/microliters), endometrial cancer (17.5 +/- 7.6U/microliters) and ovarian cancer (12.0 +/- 4.0U/microliters) were statistically significantly higher than that of controls (2.0 +/- 2.8U/microliters). Elevated levels of alpha 2-PAG were found in sera of 44% patients with myoma uteri, 17% of benign ovarian tumors, 63% of cervical cancer, 100% of endometrial cancer and 83% of ovarian cancer. Elevation of alpha 2-PAG was recognized in 100% patients with endometrial cancer and in 67% patients with ovarian cancer in stage I, while no patient with cervical cancer in stage I showed elevated alpha 2-PAG. No clear relationship of the alpha 2-PAG levels with the stages of the patients nor with the histological types of tumor was found. Serial alpha 2-PAG determination appeared to provide a useful marker in cancer patients. The measurement of serum alpha 2-PAG is recommended as an addition to the conventional diagnostic system. PMID- 6854094 TI - [The influence of bromocriptine-induced pregnancy and delivery on infertile cases with pituitary microadenoma]. AB - Two consecutive pregnancies were induced in three hyperprolactinemic primary infertile patients bearing intrasellar microadenoma without visual disturbance. Pretreatment prolactin levels, 224 -496ng/ml, were normalized by 10-22.5mg/day of bromocriptine and the initial conceptions occurred. No abnormal sign due to pituitary enlargement was detected throughout the period of gestation and they delivered single full-term babies. Since no significant change was observed in puerperium, it was decided to give the second bromocriptine therapy. The prolactin levels, 80-190ng/ml, measured before the second therapy were apparently lower than those seen prior to the first therapy and the minimum effective dose used to induce the second pregnancy (5-7.5mg/day) was identical to 1/3-1/2 of the first one. The course of the second pregnancy of each case was also uneventful and the babies were all normal and mature. The magnitude of the rise in the prolactin level during the second pregnancy was smaller than that observed during the first pregnancy. The present longitudinal study throughout two consecutive pregnancies in three cases indicates that resolution of prolactinoma was resulted in some extent after withdrawal of stimulative factors associated with pregnancy. Hence, hyperprolactinemic infertile cases with intrasellar microadenoma can be subjected to bromocriptine therapies inducing consecutive pregnancies under intensive follow-up. PMID- 6854096 TI - [The maternal and fetal acid-base status during general or spinal anesthesia for elective cesarean section in the left tilt position]. AB - Thirty one healthy parturients received spinal or general anesthesia for elective cesarean section. Maternal blood pressures, maternal and fetal acid-base values, induction to delivery intervals (I-DI) and Apgar scores were determined. On spinal anesthesia, acute hydration by 6% hydroxyethyl starch solution and intramuscular injection of ephedrine were enforced prior to the block and in the left tilt position (17 degrees) oxygen inhalation immediately after the block was begun (group OII: 16 cases). As to general anesthesia, the same left tilt position was applied before the anesthesia by thiopental-0.5% halothane with-50% nitrous oxide in oxygen (group G: 15 cases). No significant decrease in maternal blood pressure was noticed, and maternal and the fetal acid-base status and Apgar scores were excellent in both groups. A positive correlation between umbilical venous pH values and 1 or 5 minutes Apgar scores was confirmed in group OII, and a negative correlation between 1 minute Apgar scores and I-DI was noticed in group G. Fetal acid-base values were not correlated with I-DI in either group, and it was postulated that placental or fetal circulation was sufficiently maintained. Biochemical status and clinical conditions in mothers and their infants are very favorable in well-conducted general or spinal anesthesia for elective cesarean section. PMID- 6854095 TI - [Lectin binding of membrane proteins from human placental villi]. AB - The binding of membrane proteins from human placental villi to lectins such as concanavalin A (Con A), wheat germ agglutinin (WGA) and Riccinus communis agglutinin (RCA) was examined. Five major components of 66K, 69K, 100K, 130K and 170K dalton showed specific binding to WGA, whereas two other major components of 43K and 40K dalton had only weak binding. There were no membrane proteins which bound specifically to either Con A or RCA. The WGA-Sepharose column is considered useful for the purification of human placental membrane proteins. Although the function of these proteins is still unknown, a diagnostic method not only for determining the pathological state of the placenta, but also for cancer will possibly be developed by taking advantage of them. PMID- 6854097 TI - [Studies on non-surgical therapy of tubal pregnancy]. AB - 8 cases of tubal pregnancy in the pre-abortional stage were detected by B-scope examination. The administration of MTX (total doses: 60-300mg) resulted in complete remission in 7 cases; the other received tubectomy because of the progression of abortion. The dose of MTX used to obtain remission is responsible for the HCG titer of urine before the treatment; 60-150mg of MTX was sufficient in cases which showed a titer below 1,000iu/l, although 75-300mg was necessary in cases over 4,000iu/l. The patency of tubes after the regimen was confirmed in 4 out of 5 cases with hystero-salpingography. Serious side effects were not observed in the present study in spite of the great efficacy; transient suppression of liver has been observed in 2 cases. Two patients had normal intra uterine pregnancy subsequent to the treatment; one had a matured full-term female neonate and the other received D & C in 9 gestational weeks. These results suggest that the MTX regimen is practical for the treatment of patients with tubal pregnancy. This is characterized by unimpaired fertility following the treatment, although the detection of patients in the pre-abortional stage is absolutely necessary. PMID- 6854099 TI - [Cytological and ultrastructural studies of cervical adenocarcinoma according to histological types]. AB - This report describes the characteristic features of the exfoliated cells according to histological types, such as the type of early cervical adenocarcinoma for the diagnosis of cervical carcinoma of adenoid type (hereinafter called cervical adenocarcinoma). Further, the characteristics of cervical adenocarcinoma and its histogenesis were studied in an ultrastructural approach and we obtained the following results. 1) The exfoliated cells of adenocarcinoma in situ (hereinafter called AIS) show the characteristic features that assist the early detection of cancer. 2) The histological types for diagnostic use in characterizing the exfoliated cells are clear cell adenocarcinoma and adenosquamous carcinoma. Further, the histological structure of both well differentiated and poorly differentiated endocervical types can be deduced from the cytologic features. 3) Since the transitional cells of both squamous and columnar types and also the intestinal epithelial metaplastic cells were ultrastructurally observed in adenosquamous carcinoma and adenoacanthoma, the reserve cells are considered to act as an original cell and eventually participate in the histogenesis of these types of carcinomas. 4) The cells of both secretory granules and tonofibrils were detected in the AIS foci. This finding indicates the involvement of the subcolumnar basal cells which can eventually be differentiated into the secretory or ciliated cells of the columnar epithelium of the endocervical canal during the histogenesis of cervical adenocarcinoma of the endocervical type. PMID- 6854100 TI - [Immunological studies on cervical mucus in women with unexplained infertility]. AB - The author tried to make clear some physiological and pathological aspects of immunological states of human cervical mucus in two groups of women: 27 unexplained infertile women (group A) and 45 normal women whose husbands were azoospermic (group B). The following data were obtained. 1. IgG and IgA concentrations in the cervical mucus extracts (CME) were 15-45 mg/dl and 5-7 mg/dl, respectively, calculated to be approximately 2-4% of the serum levels. 2. IgG and IgA levels were significantly (p less than 0.01) elevated in group A compared to those in group B. 3. Secretory IgA was more elevated in group A (24.4 mg/dl) than that in group B (13.2 mg/dl). 4. IgM was detected in 11.1% in group A and in none in group B. 5. A complementary activity was observed in all the fresh CME judging from 1-9 (mostly 1-3) CH50 units. This activity tended to be higher in group A than in group B. 6. C3 proactivator was detected in 30% of the specimens, but C4 was found only in one case, suggesting the physiological importance of the alternative pathway than the classical pathway at the site of the cervix. 7. Both in sperm agglutination and sperm immobilization tests, higher positive incidence were obtained in group A than in group B. Briefly the conclusion of this study was that the cervical mucus was confirmed to have sufficient immunological elements and to show local immunity to sperm in vitro in some unexplained infertile women. PMID- 6854098 TI - [Glucose oxidation and insulin receptors in isolated adipocytes from rats treated with progesterone and estradiol]. AB - To find the cause of insulin resistance in pregnancy, the effects of estradiol (0.002 mg/day) treatment in male (n = 6) and ovariectomized (n = 8) rats, progesterone (0.05 mg/day) treatment in male (n = 9) and female (n = 6) and ovariectomized (n = 8) rats and combined estradiol and progesterone treatment in male (n = 7) and ovariectomized (n = 8) rats on (1-14C) glucose oxidation and insulin receptors in isolated fat cells were examined. All groups were treated for 5 days. Control rats were treated with the solvents. The results were as follows: 1) Decreased responsiveness to insulin on (1-14C) glucose oxidation was observed in adipocytes from male rats treated with estradiol and estradiol + progesterone, female rats treated with progesterone and ovariectomized rats treated with estradiol + progesterone. 2) There was no significant difference among the insulin bindings to adipocytes from rats treated with estradiol, progesterone and estradiol + progesterone. These results suggest that estradiol itself is potent in inducing insulin resistance in male rats, but in female rats progesterone primed with estradiol is necessary to induce insulin resistance, and that they may act at some post-receptor sites. These sex hormones may play an important role in inducing the insulin resistance in pregnancy. PMID- 6854102 TI - [Hormone therapy--experimental studies]. PMID- 6854103 TI - [Fetal prognosis by fetal heart rate monitoring]. PMID- 6854101 TI - Successful pregnancies in patients with hyperprolactinemia--clinical and endocrinological studies on mothers and babies. AB - To study the effect of pregnancy and lactation on the clinical course of patients with pituitary adenoma and the influence of maternal hyperprolactinemia and bromocriptine treatment on fetal and neonatal development, prolactin levels were serially determined and abnormalities of newborn babies were examined. Ninety nine patients with hyperprolactinemic amenorrhea were treated by surgery, bromocriptine therapy, and a combination of them; thus 34 patients conceived and gave birth to 43 babies. Almost all patients progressed uneventfully except for 2 cases who manifested diabetes insipidus and acute visual impairment. After the end of lactation, prolactin levels declined to lower values than before attempting pregnancy, except in 3 patients. Furthermore, those diagnosed as functional hyperprolactinemia before pregnancy were not found to have developed microadenoma. These results suggest that there is little influence on growth and activity of tumor throughout pregnancy and lactation. All of the newborns were normal and their growth up to 2 years after birth showed no special abnormalities. It was therefore concluded that maternal hyperprolactinemia or bromocriptine therapy in early pregnancy do not cause any deleterious effect on fetal and neonatal development. PMID- 6854104 TI - [Vulvar dystrophies--international nomenclature and clinical pathology]. PMID- 6854106 TI - [Endometriosis in ileocecum, sigmoid colon, uterus, ovary and oviduct--a case report]. PMID- 6854105 TI - [Idiopathic pericarditis in pregnancy]. PMID- 6854107 TI - [Pregnancy and delivery in hip joint movement disorder caused by congenital hip dislocation]. PMID- 6854108 TI - [The clinical significance of the F-wave of upper limb on cervical myelopathy]. AB - The physiological characteristics of F-wave on the evoked EMG has been investigated and the utility of the objective index on cervical myelopathy was discussed. The wave pattern of F-wave varied each time, but the resembling wave shapes could be recognized while series of recording was done. The latency and amplitude of F-wave in resembling wave-shapes were equal. The F-wave could therefore be differentiated into several wave patterns. The wave patterns of the pathologic cases were almost the same as normal patterns. There is no any meaningful difference in conduction velocity between the normal and abnormal cases. Concerning the amplitude and the frequency of occurrence, the utilities are recognized. There has been a tendency in parallel with the severity of myelopathy, the more severe was the involvement, the more frequently occurred the big F-waves. It was also related to the motor function of the extremities and the degree of the acceleration of tendon reflex. Moreover, along with the postoperative improvement of the clinical symptoms, the occurrences of big F-wave approached that in normal cases. Apparently, the F-waves well reflected the clinically abnormal state. In other word, under the discussion of the amplitude and frequency, the F-wave of upper limb is believed to be useful as an objective index in cervical myelopathy. PMID- 6854110 TI - [The effects of pulsed micro-electrical currents on internal remodeling in long tubular bone and bone healing]. AB - The effects of pulsed micro-electrical currents on internal remodeling in the cortex of long tubular bone were evaluated by the following three experiments. 1. Electrodes were inserted in both femora of 14 adult mongrel dogs, 15 mm apart, and pulsed micro-electrical current was applied in the right femoral cortex for 4 weeks, but not in the left femur, which was left as a control. Dogs were divided into 4 groups; in each of these groups current with 1Hz-10 microA, 0.1 Hz-10 microA, 50 Hz-10 microA and 1Hz-20 microA was applied. The effects were evaluated by histometric parameters, i.e. number of resorption cavities (Ar), osteons with osteoid seam (osAf), mineralization rate of osteoid seam (Mo), and perimeter of osteoid seam (Sf). Number of Ar and osAf increased. Bone formation rate (Vf) which is the product of osAf, Mo and Sf increased, especially in the group in which current with 1Hz-10 microA was applied. The main reason for increase of Vf was considered due to that the activation frequency in internal remodeling increased by electrical stimulation. 2. A metal plate was placed on the right humerus, not on the left humerus, both femora of 5 dogs, and electrical current of 1Hz-10 microA was applied in the right femur for either 12 or 16 weeks. Decrease of internal remodeling tended to take place in the mid-portion of the plated area of femur, whereas Vf increased by pulsed micro-electrical currents. Decrease of internal remodeling thus caused by placing a plate and screws increased by pulsed micro-electrical current. 3. Number of osteons in the newly formed bone in the osteotomized gap and in the cortex adjacent to the gap of femora of 7 dogs, which were plated for either 4 or 6 weeks, was measured in longitudinal sections labelled by tetracycline. The number of osteons increased more in the right femur in which current of 1Hz-10 microA was applied than in the left femur. Based on the results above described, it was concluded that bone healing was enhanced by pulsed micro-electrical currents. PMID- 6854109 TI - [Clinical and experimental studies on muscle contracture]. AB - Concerning muscle contracture, etiology, diagnosis and treatment still remain a problem. The author examined diagnosis and treatment clinically and examined the influence of muscle fiber after intramuscular injection of some drugs. Clinical and experimental results were as follows. 1) In the diagnosis of quadriceps muscle contracture, the measurement of buttock elevation phenomenon varies according to the examiner, and in healthy people, the same phenomenon may occur. Hence, the necessity of not over-estimating the phenomenon itself should be emphasized. 2) Adult cases with deltoid muscle contracture are accompanied by pain. 3) Intramuscular injection of chloramphenicol sol on rabbit brought remarkable muscle lesion (fibrosis, lowering of phosphorylase activity) one year after ten consecutive daily injections. Intramuscular injection of chloramphenicol sol causes irreversible lesion in the muscle and this is one of the main causes of etiology of muscle contracture. PMID- 6854111 TI - [Ultrastructural studies of healing process of injured articular cartilage]. AB - This study was undertaken to investigate the healing process and the nature of the repaired tissue of injured articular cartilage. Full-thickness defects were made in the articular cartilage of the femoral condyles of 48 immature rats, and were examined by using light and transmission electron microscopes from one to 48 weeks after the injury. Under the light microscope, toluidine blue metachromasia was demonstrated in the deep matrix at 4 weeks after the injury. The repaired tissue was similar to the articular cartilage in controls at 12 weeks after the injury, but decreased number of cells and irregular surface were recognized in the specimen taken at 48 weeks after the injury. By electron microscopic examinations, at 12 weeks after the injury, cells in the repaired tissue were indistinguishable from chondrocytes, and the tidemark showed a fine structure similar to that in the articular cartilage in controls where many electron dense particles were observed. Collagen fibrils in the superficial layer were arranged in parallel to the articular surface. Three dimensional meshwork of collagen fibrils was also recognized in the intermediate and deep layers, but was inferior to that in the articular cartilage in controls. At 48 weeks after the injury, the surviving cells in the repaired tissue contained deposits of glycogen, large lipid droplets and vacuoles. Amianthoid change and fibrous long-spaced collagen were occasionally observed in the matrix. Collagen fibrils in the areas with poor cell population were smaller in diameter and loosely arranged. The above findings indicate that the anomalous arrangement of collagen fibrils is a main cause for the weakness of the repaired tissue to the mechanical load, resulting the degeneration. PMID- 6854113 TI - [Surgical management of hallux valgus]. PMID- 6854112 TI - Isozymes of glycogen phosphorylase in human cartilage and cartilage tumors. AB - Isozyme patterns of glycogen phosphorylase in normal fetal and adult human cartilage and benign and malignant cartilage tumors were investigated by means of polyacrylamide gel disc electrophoresis. In both normal cartilage and cartilage tumors four distinct bands were observable: these were of the liver, liver-like and fetal types and of a hybrid type between the muscle and fetal types judging by their mobilities in the small-pore gels containing 0.01% and 0.1% glycogen. The isozyme pattern of benign cartilage tumors was almost identical with that of normal cartilage. In normal fetal and adult cartilage and benign cartilage tumors, the liver and liver-like types were predominant, whereas in malignant cartilage tumors they were minor and the fetal type was predominant. These results indicate fetal deviation of phosphorylase isozymes in malignant transformation of cartilage cells. PMID- 6854114 TI - [Transitions and developments of therapeutics]. PMID- 6854115 TI - [Clinical application of the analysis of cardiac dipole estimated from the body surface potential mapping-normal cases]. PMID- 6854116 TI - [A case of generalized Paget's disease of bone complicating high output heart failure]. PMID- 6854117 TI - [A case of pulmonary hamartoangiomyomatosis with tuberous sclerosis]. PMID- 6854118 TI - [A case of Werner's syndrome associated with atrio-ventricular conduction disturbance]. PMID- 6854119 TI - [An autopsy case of spindle cell type primary pericardial mesothelioma]. PMID- 6854120 TI - [A case of Rendu-Osler-Weber disease with intra-hepatic arteriovenous fistula and porto-systemic encephalopathy]. PMID- 6854121 TI - Alport's syndrome: a genetic defect in biochemical composition of basement membrane of glomerulus, lens, and inner ear? PMID- 6854122 TI - Oral contraceptive steroids impair the elimination of theophylline. AB - The influence of OCS and sex differences on the disposition of theophylline has been studied in 12 healthy young men (29 +/- 4 years old), 13 healthy young women (29 +/- 12), and 10 healthy young women (24 +/- 3) receiving OCS for a period greater than 6 months. The elimination t1/2 was longer in women taking oral contraceptives (523 +/- 110 min) than in women not on oral contraceptives (386 +/ 157). Weight-normalized plasma clearance of theophylline was less in women taking oral contraceptive steroids (0.70 +/- 0.15 ml X min-1 X kg-1) than in women not on oral contraceptive steroids (0.98 +/- 0.32). Plasma binding and volume of distribution were not different between the two groups of women. Weight normalized clearance, weight-normalized volume of distribution, plasma t1/2, and plasma binding were not different between men and women not taking OCS. PMID- 6854124 TI - Agglutination and phagocytosis of pneumococci by immunoglobulin G antibodies of restricted heterogeneity. AB - Sera from rabbits that were hyperimmune to type 3 or type 8 pneumococcal capsular polysaccharide were fractionated by starch block electrophoresis, and fractions containing large quantities of anticapsular IgG of restricted molecular heterogeneity were evaluated for their ability to agglutinate and opsonize encapsulated pneumococci. Specific anticapsular IgG was readily absorbed by the organisms. Each CFU of type 3 organisms was capable of absorbing 5 X 10(7) molecules of IgG, and the type 8 organisms absorbed 5 X 10(6) molecules/CFU. Only small amounts of nonimmune IgG were absorbed. Agglutination occurred only after 10(6) molecules/CFU IgG had been absorbed by type 3 organisms, and 10(4) to 10(5) molecules/CFU had been absorbed by type 8 organisms. After larger quantities of IgG had been absorbed, a prozone phenomenon was apparent. Anticapsular IgG in the absence of complement did not promote phagocytosis by human or rabbit PMNs below levels that caused agglutination. In the presence of complement, only about one tenth as much IgG was necessary to promote phagocytosis. Thus these encapsulated pneumococci can absorb large quantities of specific rabbit IgG antibody of restricted heterogeneity. In the presence of complement, approximately 1% of the antibody that can be absorbed by the organisms will promote phagocytosis. In the absence of complement, approximately 10% of the antibody that can be absorbed is required for agglutination or phagocytosis. PMID- 6854123 TI - Inhibition of caffeine elimination by short-term ethanol administration. AB - Short-term ethanol ingestion has been shown to inhibit the metabolism of a number of drugs metabolized by cytochrome P-450 in both man and laboratory animals. However, the effects of short-term ethanol administration on the metabolism of cytochrome P-448-dependent drugs in man is unknown. Caffeine is a commonly used drug that is metabolized predominantly by a component of the hepatic microsomal mixed-function oxidase complex, known as cytochrome P-448. Therefore the elimination of caffeine given orally was studied in normal volunteers after receiving either orange juice or 0.8 gm/kg ethanol as a 25% solution in orange juice. Short-term administration of ethanol resulted in a significant decrease in the plasma clearance of caffeine from 96.6 +/- 13.4 ml/min to 60.7 +/- 10.5 (mean +/- S.E., p less than 0.05). There was also a corresponding significant increase in the elimination half-life of caffeine from 4.03 +/- 0.52 hr to 6.04 + 0.73 (mean + S.E., p less than 0.01). To determine whether the decrease in caffeine elimination was due to an inhibition of caffeine metabolism by ethanol or to an effect on caffeine absorption, caffeine disposition was studied in four healthy, mongrel dogs after intravenous administration. Each animal served as its own control. Caffeine clearance decreased significantly from a baseline value of 19.6 +/- 1.5 ml/min to 8.0 +/- 1.5 (mean +/- S.E., p less than 0.05) after administration of 3.0 gm/kg ethanol given orally 1 hr before intravenous caffeine injection. These results imply that short-term administration of ethanol inhibits the metabolism of caffeine, a predominantly cytochrome P-448-dependent substrate, in both man and dogs. PMID- 6854125 TI - Degradation of human 125I-interferon alpha by isolated perfused rabbit kidney and liver. AB - Rabbit livers and kidneys were isolated and perfused with homologous blood. After equilibration, human IFN alpha labeled with 125I and an excess of cold IFN alpha were added, and blood samples were withdrawn at predetermined times. Protein bound and acid-soluble radioactivity together with biological (antiviral) activity were measured. Our results show that although liver exerts a minimal catabolism, the kidney filters and breaks down a considerable amount of IFN alpha. The parallelism between protein-bound radioactivity and biological activity decay curves indicates that IFN carefully labeled with 125I can be reliably used for metabolic investigations. PMID- 6854126 TI - Impaired polymorphonuclear leukocyte motility in malnourished infants: relationship to functional abnormalities of cell adherence. AB - The humoral and cellular contributions to PMN motility in vitro were studied in 37 malnourished (PCM) pediatric patients. Early-phase directed migration to BCF and to ZANS was diminished significantly (p less than 0.001) in severe PCM patients as compared to healthy adult or age-matched controls or respective nutritionally restored patients. Abnormalities were reversible after nutritional restoration and unrelated to occurrence of clinical infection. To determine the pathogenic mechanism of impaired PMN mobility in PCM, studies of cell morphology and adhesive function were performed. Abnormalities observed in severe PCM suspensions included significantly (p less than 0.001) increased baseline (unstimulated) adherence values and impaired CF modulation of adhesive function. Diminished enhancement of PMN adherence or decreased (relative to baseline) adherence values were observed in response to BCF (mean % delta = +5) or f-Met Leu-Phe (mean % delta = -6) as compared to adult PMN values of +28% delta and +31% delta, respectively. That these abnormalities may result from in vivo CF prestimulation was suggested by findings of "activated" PMN morphology in suspensions prior to in vitro stimulation, and abnormalities of the distribution of PMN surface adhesion sites under conditions of chemotactic stimulation. Further investigations will be required to determine the underlying pathogenic mechanism(s) accounting for our observations. PMID- 6854127 TI - Fibrinogen, a modulator of erythrocyte adhesion to vascular endothelium. AB - The high incidence of thrombosis in inflammatory states and previous reports of increased adhesion of erythrocytes to endothelial cells in diabetes mellitus and sickle cell anemia prompted us to study the effect of fibrinogen and fibronectin on erythrocyte-endothelial interactions. Purified human fibrinogen enhanced erythrocyte adhesion in a concentration-dependent fashion. Erythrocytes from normal subjects, diabetics, and patients with sickle cell anemia were studied. The ratio between the adhesion of normal red cells in a 4 gm/L fibrinogen to adhesion in buffer without fibrinogen was 3.6 (p less than 0.001). Fibronectin also increased red cell adhesion but the effect was less than that of fibrinogen. The addition of fibronectin to fibrinogen limited the enhancing effect of fibrinogen, although the effect of the mixture was greater than that of fibronectin alone (p less than 0.05). Anti-von Willebrand factor and antifibronectin, which react with endothelial cells, also produced an increase in erythrocyte adhesion. The potentiation of adhesion by fibrinogen was also seen in experiments using red cells from patients with sickle cell anemia or diabetes mellitus. These observations provide possible mechanisms for the involvement of plasma proteins in vascular occlusive diseases. PMID- 6854128 TI - DNA hybridization studies of the association of Pseudomonas maltophilia with inflammatory bowel diseases. AB - An infectious etiology has been suggested for the inflammatory bowel diseases, Crohn's disease and ulcerative colitis, and an association of cell wall-defective variants of Pseudomonas maltophilia and Pseudomonas-like group Va bacteria with Crohn's disease has been reported by Parent and Mitchell. Seven of the Parent Mitchell isolates were compared by using DNA hybridization and six were identical and similar, but not identical, to a type strain of P. maltophilia. The seventh isolate showed extensive homology with VARC, a reference strain of group Va organism, but not with P. maltophilia. Pseudomonas DNAs were radiolabeled by nick translation and used as probes for homologous DNA in hybridization experiments involving 48 different tissues. The presence of DNA with sequences homologous to those of P. maltophilia was detected in three of 23 Crohn's disease samples, two of 10 ulcerative colitis samples, and none of 15 control samples. There was no hybridization with VARC or Pseudomonas aeruginosa probes. We were unable to culture cell wall-defective organisms from patients' tissues but have detected pleomorphic organisms in hypertonic cultures of 14 of 53 Crohn's disease specimens, none of six ulcerative colitis specimens, and none of 11 control specimens. None reverted to normal bacteria. These results do not support an exclusive association of P. maltophilia with Crohn's disease but rather suggest a possible association of P. maltophilia with IBD. Technical limitations currently preclude definitive conclusions regarding the significance of this association. Although we demonstrated the presence of DNA sequences with homology to P. maltophilia DNA in tissues of some patients with IBD, the role, if any, of these bacteria in the pathogenesis of IBD has yet to be established. PMID- 6854129 TI - Heart rate responsiveness after sustained chronotropic stimulation with a beta 1 adrenergic receptor agonist. AB - Six normal male human subjects underwent two 72 hr infusions of saline (control) and butopamine, a beta-adrenergic agonist with strong positive chronotropic properties, in order to determine the chronotropic responsiveness of the human heart after sustained chronotropic stimulation. Chronotropic responsiveness was assessed by heart rate responses to intravenous isoproterenol and bicycle ergometry before and serially over 50 hr after discontinuation of the infusions. Chronotropic responsiveness to isoproterenol and exercise was reduced significantly in the butopamine group compared to control; this blunted chronotropic effect persisted beyond 48 hr. Positive inotropic responsiveness, assessed by echocardiography and systolic time intervals, was reduced modestly for the butopamine-treated group up to 24 hr after infusion. Although the precise mechanisms are not fully elucidated, continuous chronotropic stimulation of the human heart with the beta 1 agonist, butopamine, elicits a significant reduction in the heart rate response to isoproterenol and exercise challenges. In addition, the degree and time course of suppression of the chronotropic vs. inotropic responsiveness are disparate. PMID- 6854130 TI - The measurement of exchangeable sodium and total body sodium in rats in vivo compared with chemical analysis postmortem. AB - Measurements of body sodium content in rats were made in vivo by either neutron activation analysis or the use of the radioisotope, 22Na. The results were compared with estimates of TBNa of the carcases. Neutron activation analysis provided an accurate measure of total body sodium content. NaE, measured with 22Na, was consistently and quantitatively lower than total body sodium content. Each of these methods may be useful in the study of body sodium content in small animals during growth and during the evolution of experimental hypertension. PMID- 6854131 TI - Breath hydrogen (H2) response to carbohydrate malabsorption after exercise. AB - Ten subjects were studied in order to determine whether mild exercise after an overnight fast would influence the baseline breath H2 concentration or breath H2 response to the nonabsorbable disaccharide, lactulose. Breath H2 concentrations immediately after exercise were significantly lowered (p less than 0.0001) but rapidly returned to baseline values. Exercise did cause a significant change in the overall response after oral lactulose and must be considered when sequential breath H2 tests are undertaken. PMID- 6854132 TI - Isoenzymes of alkaline phosphatase in infantile hypophosphatasia. AB - Infantile hypophosphatasia is a rare inborn error of metabolism in which the expression of the liver/kidney/bone locus of the alkaline phosphatase gene is defective. Analysis of tissues from a suspected case of hypophosphatasia for alkaline phosphatase activity demonstrated very low levels of activity in liver, kidney, and rib as compared to tissues from a case of osteogenesis imperfecta or normal adult tissues. Intestinal and placental tissues demonstrated significant levels of activity. Gene-specific amino acid inhibitors and isoelectric focusing demonstrated that the activity which was present in the liver, kidney, and rib tissues from the case of hypophosphatasia was of the intestinal type and not the normal liver/kidney/bone form of the enzyme. PMID- 6854135 TI - Plasma platelet products and exercise-induced myocardial ischemia. AB - Peripheral plasma concentrations of PF-4 and TxB2 were measured by RIA in 26 patients who underwent exercise stress testing. In group A (n = 15; age 50 +/- 16, mean +/- S.D.) in whom blood sampling was performed by venipuncture, seven patients had a positive stress test associated with an increase in PF-4 concentrations from 3.3 +/- 1.6 ng/ml to 6.9 +/- 3.6 (mean +/- S.D.); six of them demonstrated a greater than 50% increase in PF-4; and only one of eight with a negative stress test had such an increase. In group B (n = 11; 49 +/- 10 yr), patients also underwent postexercise thallium-201 scanning and blood samples were obtained through an intravenous catheter. These patients consistently demonstrated higher PF-4 values (before exercise 7.5 +/- 3.9 ng/ml; after exercise 11.9 +/- 7.1), regardless of the results of the exercise and thallium studies. TxB2 concentrations were unchanged in both groups. To further evaluate the effect of catheter-collected samples on PF-4, five healthy males had serial concurrent blood sampling in opposite arms via both venipuncture and catheter. Although PF-4 concentrations in venipuncture samples were constant, those collected through the catheter increased as a function of time. On the basis of the findings in group A, enhanced platelet activation appears to be associated with exercise-induced ischemia. The observations in group B and the healthy controls indicated that catheter-collection of samples artifactually increased PF 4 concentrations. PMID- 6854136 TI - Effect of plasma calcium concentration on the metabolic clearance rate of parathyroid hormone in the dog. AB - Low perfusate calcium concentrations reportedly enhance the degradation of intact bPTH in isolated rat liver and dog kidney. Depending on the magnitude of such effects, they might affect the metabolic clearance of intact PTH in vivo. Therefore we have investigated the effect of acute and chronic hypocalcemia and hypercalcemia on the MCR of intact PTH in vivo in dogs. The t 1/2 of endogenous PTH was unchanged after 5, 30, and 480 min of hypocalcemia and ranged from 1.2 to 2.8 min. The MCR of bPTH infused to constant plasma levels in TPTX dogs also did not change with short- or long-term changes in the plasma calcium concentration by approximately 7 mg/dl. The MCR averaged 13 ml/min per kilogram for fully biologically active bPTH and 6 ml/min per kilogram for oxidized bPTH. Thus neither acute nor chronic hypocalcemia or hypercalcemia at extremes observed in disease states significantly altered the MCR of PTH. We conclude that changes in plasma intact PTH concentrations during changes in plasma calcium accurately reflect PTH secretion rate. PMID- 6854134 TI - Storage of red cell concentrates in CPD-A2 for 42 and 49 days. AB - CPD-A2 is a modified CPD blood preservative with adenine, containing 1 1/2 times as much glucose as CPD. Units (450 ml) of blood from 21 normal donors were collected in CPD-A2 in plastic bags and held at room temperature for 8 hr. An 80% red cell concentrate was prepared and this was stored for 42 or 49 days at 4 degrees C, with the containers in either a standing or lying position. Measurements of glucose consumption, red cell ATP, and 2,3-DPG and of plasma hemoglobin, pH, Na+, and K+ were performed on all samples. The size of the "fragile tail" of osmotically fragile red cells was estimated in 12 samples. The poststorage 24 hr viability of their own stored 51Cr-tagged red cells was documented in 19 of the volunteers. At least 4 months after the original donation, a second unit of blood was collected from eight of the donors to make possible intradonor comparison of the biochemical effects of storage position. After 42 days but not after 49 days of storage, red cells in concentrates stored in the lying position had consumed more glucose and had a higher poststorage pH than did cells stored in the standing position. The poststorage 24 hr viability of red cells stored for 42 days averaged 83.6%, with all units exceeding 70% viability. At 49 days the average viability was 69.1%. Although the average viability of cells stored in the lying position for 42 days was higher than that of concentrates stored standing, the difference was not statistically significant at the 5% level. The plasma hemoglobin level showed a weak correlation with viability of stored cells. Red cell ATP levels were correlated with viability only at 42 days' and not at 49 days' storage. Concentrates of red cell collected in CPD-A2 manifested fully satisfactory viability for 42 days. At 49 days storage the results of viability studies were borderline. High plasma hemoglobin values are observed at both 42 and 49 days' storage and may limit the usefulness of red cell concentrates stored for prolonged periods of time. PMID- 6854133 TI - Increased sensitivity of isolated alpha subunits of normal human hemoglobin to oxidative damage and crosslinkage with spectrin. AB - After peroxidation, alpha and beta subunits of normal human hemoglobin demonstrated a significant differential reactivity in their ability to form methemoglobin subunits and irreducible crosslinkages with spectrin. The alpha subunits formed crosslinks with spectrin in the absence of exogenous hydrogen peroxide, whereas both the beta subunit and the intact hemoglobin molecule required a minimum of 40 and 4 microM peroxide, respectively, in order to form these crosslinks. Changes in the amount of methemoglobin occurred at much higher concentrations of hydrogen peroxide for the beta hemoglobin subunit (100 microM H2O2) than for the alpha subunit (0.1 microM H2O2). A possible explanation for the existing reactivity between each of the two hemoglobin subunits and spectrin is considered and discussed. In our notation, alpha subunit = alpha SH and the beta subunit = beta SH. PMID- 6854137 TI - Fluid spaces in normal and osteomyelitic canine bone. AB - When cortical bone is afflicted by an infectious process, significant alterations in the physiology and anatomy occur at the cellular level. Included in these alterations are modulations of the various fluid spaces of cortical bone. Volume of distribution studies with 14C-labeled sucrose and 99Tc-labeled red blood cells in an animal model of acute, subacute, and chronic osteomyelitis of the tibia were performed to quantitate the various fluid spaces in cortical bone. Additionally, the studies were performed in cortical bone from the radius and tibiae (following sham operations) to allow comparison with normal and control values. The total exchangeable water, vascular, and interstitial fluid spaces were increased in all three types of osteomyelitic bone. With one-way analysis of variance and Duncan's multiple range test, the alterations observed in each type of osteomyelitic bone (acute, subacute, or chronic) were statistically different from those observed in normal bone (p = 0.001) and controls (p less than or equal to 0.01). The differences of the mean values observed among the three types of osteomyelitic bone were not statistically significant (p greater than 0.05). These pathophysiologic alterations in osteomyelitic bone must be considered when one studies the ability of various antimicrobials to reach bactericidal concentrations in the interstitial fluid space, the primary site of drug microorganism interaction. PMID- 6854138 TI - X-ray fluorescence spectrometry in the analysis of trace elements in human milk. AB - XRF has broad applications in the quantitative analysis of trace elements in biological materials. Evaluation of its potential for the analysis of trace elements in human milk was performed. Precision of the method was demonstrated by the low (less than 3%) coefficient of variation in reproducibility of analyses performed within a given day, on different days, and by different operators. Standard curves were constructed for human milk and correlation was high (r greater than 0.98) for each of nine metals analyzed. The lower limits of determination and minimum detection limits were calculated for nine elements. Excellent correlation (r greater than 0.99) was achieved in comparison of XRF TO AA in analysis of zinc in human milk. Preliminary results of the analysis of milk zinc, copper, and iron throughout the initial 8 months of lactation disclose a decrease in trace metal concentration, most notable for zinc, during the first 60 days. PMID- 6854139 TI - Dimethyl sulfoxide inhibits bioactivation of sulindac. AB - Sulindac, a nonsteroidal anti-inflammatory agent, is converted to a bioactive sulfide metabolite via reversible reduction of its sulfoxide moiety. To test whether DMSO can inhibit conversion of sulindac to its active form, eight healthy men received, in a randomized, crossover manner, 400 mg of sulindac, orally, either alone or 60 min after an oral dose of DMSO (30 ml, 70% solution). After the drug combination, mean plasma concentrations of the sulfide metabolite were significantly lower than in controls at 1.5, 2, 3, 4, and 8 hr after sulindac administration. The mean area under the plasma sulfide concentration-time curve for 0 to 12 hr was 30% (range 7% to 56%) lower after DMSO treatment. This study suggests that DMSO can inhibit metabolism of other sulfoxides in man and may antagonize the therapeutic efficacy of sulindac. PMID- 6854140 TI - Post-operative roentgenological findings and changes after mastoid obliteration. AB - This study consisted of the evaluation of the plain X-ray findings of films taken at early follow-up (mean 1.5 months after surgery) and at late follow-up (4-14 years after the early films) of 211 ears which had been operated on radically and obliterated. Residual cells which were detected on the basis of the early films were associated with a more frequent occurrence of post-operative infection and were thus hallmarks of a poorer prognosis. Changes in the bone surrounding the surgical cavity and the radiological quality of the walls of the surgical cavity, the presence of new bone formation in the cavity and other radiological features did not yield useful information about post-operative complications. New bone formation was associated with a smaller amount of post-operative cavitation. Post operative X-ray examination of the obliterated ear is a prognostically useful examination, but it does not significantly contribute further to the information available by clinical and otomicroscopic examination in regards to the complications of infection and cholesteatoma. PMID- 6854142 TI - Metastatic carcinoma of the external auditory meatus secondary to carcinoma of the rectum. A case report. AB - A case of metastatic carcinoma of the external auditory meatus secondary to a primary adenocarcinoma of the rectum is presented, together with histological evidence of the association of these tumours. PMID- 6854141 TI - Role of myocutaneous flaps in reconstruction of the head and neck. AB - To otolaryngologists involved in ablative surgery for tumours, restoration of function and appearance after extirpation has always been a matter of concern. This is particularly important for two reasons. In the first place, the function of the pharynx as a pathway for deglutition and respiration makes reconstruction of this area of vital importance. Secondly, while scars, defects and prosthetics in other parts of the body can be easily hidden and camouflaged, this is difficult in the head and neck area. For almost a century skin grafts, free, pedicled or as rotation flaps, have been used for reconstruction. In recent years the development of myocutaneous flaps has considerably altered this picture and this field is rapidly advancing. The purpose of this paper is to acquaint ourselves with this advance and to present our own experience. PMID- 6854143 TI - A mixed carcinoid tumour of the middle ear. AB - Carcinoid tumours belong to the rarest neoplasms of the middle ear. Murphy et al. (1980) described an interesting carcinoid tumour of the middle ear displaying adenomatous features. The histological similarity of carcinoid tumours to adenomatous tumours of the middle ear has also been noted by Fayemi and Toker (1975). We describe a similar case which caused certain diagnostic difficulties. Light microscopy on frozen sections favoured the diagnosis of a low-grade adenocarcinoma but electron microscopy has revealed the presence of many intracellular membrane-bound neurosecretory granules and the diagnosis was revised to that of a mixed carcinoid tumour. PMID- 6854144 TI - Leiomyoma of the palate. AB - Leiomyoma, a benign neoplasm of smooth muscle cell origin, has been documented infrequently in the oral cavity. It may arise wherever unstriated muscle is present including the arterial wall (Cherrick et al., 1973). The most common site is the uterus, followed by the wall of the alimentary canal and in subcutaneous tissue (McCaffrey et al., 1978). A search of the literature revealed 51 cases of oral leiomyomas. Cherrick et al. (1973) reviewed 35 cases, including seven of their own. Galili and Shteyer (1974) summarized the clinical data of 42 cases of oral leiomyomas reported since 1884. We can find only nine more reported cases of leiomyoma in the oral cavity: one each by Rhatigan and Kim (1976), Shirota et al. (1976), Kelly and Harrigan (1977), Schweigel (1980), Davis (1980) and Mechlin et al. (1980); and three cases by Damm and Neville (1979). The common sites in the oral cavity are the tongue and cheek but its occurrence on the palate is rare for out of the 51 cases of oral leiomyomas, only 10 involved the palate (one case each was reported by Fein, 1905; Kist and Bhaskar, 1964; Garrett, 1969; Galili and Shteyer, 1974; Rhatigan and Kim, 1976; and Davis, 1980; and four cases by Cherrick et al., 1973). Its rarity and large size make the tumour worth reporting. PMID- 6854145 TI - Lingual infarction in giant cell arteritis. A case report. AB - Giant cell arteritis is a disease of the elderly, affecting the temporal or other cranial arteries, often in patients with polymyalgia rheumatica. A case of giant cell arteritis with necrosis of the tongue in a 77-year-old woman is reported. It is important to be aware of this condition because of the serious complications. As the lesion is focally distributed, it is necessary to obtain a large biopsy specimen from the superficial temporal artery in order to make a correct diagnosis. Prompt treatment with corticosteroid in large doses followed by a lower maintenance dose is important to prevent vascular complications. PMID- 6854146 TI - Cholesterol absorption and transport in thoracic duct lymph lipoproteins of nonhuman primates. Effect of dietary cholesterol level. AB - The effect of dietary cholesterol level on cholesterol absorption and its subsequent transport in thoracic duct lymph lipoproteins was studied in two species of nonhuman primates, namely the African green monkey (Cercopithecus aethiops) and the cynomolgus macaque (Macaca fascicularis). Each animal served as its own control because each received sequential, intraduodenal infusions of two fat-rich liquid diets that differed only in the amounts of cholesterol. The percentage of dietary cholesterol absorbed was calculated by dividing the rate of appearance of exogenous cholesterol radioactivity in lymph by the rate of infusion of dietary cholesterol radioactivity at a time when lymph cholesterol specific activity was constant relative to that of diet. The percentage of dietary cholesterol absorbed was similar during both diet infusions in African green monkeys but was significantly decreased during the high cholesterol diet infusion in cynomolgus macaques. Rates of appearance of lymph total cholesterol mass were significantly increased during infusion of high cholesterol diets due to a statistically significant increase in cholesteryl ester transport rates. This increase was due in large part to the preferential esterification of exogenous cholesterol that was incorporated into lymph chylomicrons and VLDL. The rate of appearance in lymph of exogenous cholesterol significantly increased during the high cholesterol diet infusion while that of endogenous cholesterol decreased. This decrease or compensation in endogenous cholesterol transport occurred during absorption of increased levels of dietary cholesterol and apparently was due to an approximate 50% decrease in the absorption of lumenal cholesterol. Our data demonstrated that there was not a simple one-to-one relationship between the amount of isotopic dietary cholesterol absorbed from the intestinal lumen and the mass of cholesterol moved into lymph via the intestine. Rather, the amount of sterol transported into the body depends on the degree of the decrease in endogenous cholesterol transport and probably on the efficiency of cholesterol esterification during absorption. PMID- 6854147 TI - Effect of dietary cholesterol level on the composition of thoracic duct lymph lipoproteins isolated from nonhuman primates. AB - The effect of two different levels of dietary cholesterol (0.16 mg/Kcal and 0.79 mg/cal) on the composition of thoracic lymph duct lipoproteins was studied in two species of nonhuman primates, Ceropithecus aethiops (African green monkey) and Macaca fascicularis (cynomolgus monkey). Diet was infused intraduodenally at a constant rate to facilitate comparisons among animals. The higher level of dietary cholesterol resulted in an increase in the amount of cholesteryl ester in lymph chylomicrons and VLDL. Cholesteryl oleate was the predominant cholesteryl ester present in lymph d less than 1.006 g/ml lipoproteins and it was the predominant cholesteryl ester formed from exogenous radiolabeled cholesterol. The percentage of saturated and monounsaturated cholesteryl esters in lymph chylomicrons and VLDL significantly increased with the higher dietary cholesterol level. The apoprotein distribution of chylomicrons and VLDL was qualitatively similar during infusions of both diets. The apoprotein B of intestinal chylomicrons and VLDL, termed apoprotein B2, was qualitatively similar during low and high cholesterol diet infusion and was significantly smaller than that of plasma LDL apoB, termed apoprotein B1, as indicated by its electrophoretic mobility in SDS-polyacrylamide gels. The major phospholipid present in lymph chylomicrons and VLDL was phosphatidylcholine and the phospholipid composition of the particles was not affected by diet. Lymph d greater than 1.006 g/ml lipoproteins were separated and the cholesterol mass distribution among lipoprotein fractions was found to be similar during both diet infusions. With an increase in the level of dietary cholesterol, the percentage esterification of cholesterol mass and of exogenous cholesterol radioactivity increased in LDL and HDL from lymph. Lymph LDL and HDL contained less free and esterified cholesterol when their composition was compared to that for these lipoproteins in plasma. We conclude that the primary effect of increased dietary cholesterol level was to increase the cholesteryl ester content of all lymph lipoproteins; cholesterol distribution among lymph lipoproteins was unaffected. PMID- 6854148 TI - Concurrent inductions of avian hepatic lipogenesis, plasma lipids, and plasma apolipoprotein B by estrogen. AB - The inductions of hepatic fatty acid synthesis, estrogen-specific plasma proteins, plasma lipids, and apolipoproteins by a single subcutaneous injection of diethylstilbestrol (40 mg/kg body weight) have been examined in immature male turkeys. Estrogen induced the appearance of phosvitin, lipovitellin, and apoVLDL II in the blood plasma. The highest concentrations of these estrogen-specific plasma proteins were observed 48 hr following hormone administration. Estrogen increased the concentration of triglyceride in the liver, predominantly those molecular species containing 16 carbon fatty acids (triglycerides with 53 and 55 carbon atoms). Liver cholesterol was present predominantly as free cholesterol. Although estrogen did not affect the concentrations of free or esterified cholesterol in the liver, the hormone increased the amount of cholesterol esterified with 20-carbon fatty acids and caused a corresponding decrease in cholesterol esterified with 18 carbon fatty acids. Estrogen treatment elevated the plasma triglycerides 55-fold, tripled the plasma phospholipid, and approximately doubled the plasma cholesterol. The de novo synthesis of fatty acids in the liver in vivo was stimulated by estrogen administration, as exhibited by increased 3H2O incorporation into the phospholipids and triglycerides of both liver and plasma. In contrast, hepatic cholesterol synthesis was unaffected. The amounts of newly synthesized triglyceride in the liver and plasma and the specific radioactivities of the plasma triglyceride following 1-hr in vivo labeling periods, 0, 24, 48, and 72 hr after estrogen injection indicate that increased hepatic fatty acid synthesis is a primary and major casuative factor in the development of estrogen-induced hyperglyceridemia in this avian species. The concentration of apolipoprotein B in the plasma increased in parallel with hepatic fatty acid synthesis and the appearance of newly synthesized triglyceride in the plasma, whereas the plasma apolipoprotein A I level decreased. These observations indicate that in the avian liver estrogen causes a coordination of inductions in the conversion of carbohydrate to triglyceride and in the production of proteins (apolipoprotein B and apoVLDL-II) involved in the assembly of triglyceride-rich lipoprotein particles, leading to hypersecretion of these lipoproteins into the circulation. PMID- 6854149 TI - Intermembrane transfer of squalene promoted by supernatant protein factor. AB - Supernatant protein factor (SPF), a protein that stimulates squalene epoxidation, mediates the transfer of squalene between two separable microsomal populations (Kojima, Y., E. J. Friedlander, and K. Bloch, 1981. J. Biol Chem. 256: 7235 7239). We now show that SPF also promotes the transfer of squalene associated with mitochondria or with plasma membranes to total microsomes or rough or smooth microsomal subfractions. Both rough and smooth microsomes have squalene epoxidase activity that is stimulated by SPF. PMID- 6854150 TI - beta-sitosterol: esterification by intestinal acylcoenzyme A: cholesterol acyltransferase (ACAT) and its effect on cholesterol esterification. AB - Rabbits were fed either 10% coconut oil, 10% coconut oil and 1% beta-sitosterol, 10% coconut oil and 1% cholesterol, or 10% coconut oil and 1% beta-sitosterol plus 1% cholesterol for 4 weeks. Microsomal membranes from intestines of animals fed the 1% beta-sitosterol diet had 48% less cholesterol and were enriched twofold in beta-sitosterol compared to membranes from animals fed the coconut oil diet alone. Acylcoenzyme A:cholesterol acyltransferase (ACAT) activity in jejunum and ileum was decreased significantly in animals fed the plant sterol alone. In membranes from animals fed 1% beta-sitosterol and 1% cholesterol, beta-sitosterol content increased 50% whereas cholesterol was modestly decreased compared to their controls fed only cholesterol. Intestinal ACAT was unchanged in the animals fed both sterols when compared to their controls. beta-Sitosterol esterification was determined by incubating intestinal microsomal membranes with either [(14)C]beta-sitosterol-albumin emulsion or [(14)C]beta-sitosterol:dipalmitoyl phosphatidylcholine (DPPC) liposomes to radiolabel the endogenous sterol pool. Oleoyl-CoA was then added. The CoA-dependent esterification rate of beta sitosterol was very slow compared to that of cholesterol using both techniques. An increased amount of endogenous microsomal beta-sitosterol, which occurs in animals fed 1% beta-sitosterol, did not interfere with the stimulation of ACAT activity secondary to cholesterol enrichment of the membranes. Enriching microsomal membranes three- to five-fold with beta-sitosterol did not affect ACAT activity. Freshly isolated intestinal cells were incubated for 1 hour with [(3)H]oleic acid and beta-sitosterol:DPPC or 25-hydroxycholesterol:DPPC. Incorporation of oleic acid into cholesteryl esters did not change in the presence of beta-sitosterol but increased fourfold after the addition of 25 hydroxycholesterol. We conclude that the CoA-dependent esterification rate of cholesterol is at least 60 times greater than that of beta-sitosterol. Membrane beta-sitosterol does not interfere with nor compete with cholesterol esterification. Inadequate esterification of this plant sterol may play a role in the poor absorption of beta-sitosterol by the gut.-Field, F. J., and S. N. Mathur. beta-Sitosterol: esterification by intestinal acylcoenzyme A:cholesterol acyltransferase (ACAT) and its effect on cholesterol esterification. PMID- 6854151 TI - Effect of removal of lipoproteins of different composition on hepatic 3-hydroxy-3 methylglutaryl coenzyme A reductase activity and hepatic very low density lipoprotein secretion. AB - The effect of remnant lipoproteins on hepatic 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase and hepatic very low density lipoprotein (VLDL) secretion was studied in the perfused rat liver and in vivo. As had been observed previously, when the liver was perfused with a lipid-free medium, HMG-CoA reductase activity increased about twofold after 150 min, and this increase could be prevented by the addition of chylomicron remnants to the medium. However, suppression below base line activity did not occur even with increasing amounts of remnant cholesterol. When chylomicron remnants prepared from triglyceride-rich particles were included in the medium, reductase activity was increased even above that in the control perfusions despite the fact that approximately the same amount of cholesterol was removed from these particles as from standard particles. In contrast, particles that were low in triglycerides and rich in cholesterol not only prevented the rise in reductase activity but inhibited it significantly below base line activity. Again, the total amount of cholesterol removed was the same as with the other types of particles. These results suggested that both the triglycerides and cholesterol exerted an effect on HMG CoA reductase. Consistent with this hypothesis, a significant correlation was found between reductase activity and the ratio of triglycerides to cholesterol removed, but not to either alone. To explore the role of triglycerides further, the effect of these lipoprotein particles on VLDL secretion was determined. VLDL secretion was stimulated by both standard and triglyceride-rich remnants but not by triglyceride-poor remnants. The degree of stimulation with standard chylomicron was comparable to that induced by infusion of a comparable fatty acid load as oleic acid bound to albumin. In vivo a similar effect of these lipoproteins on HMG-CoA reductase activity was observed. Rats were injected with a lipoprotein bolus containing 7 mg of cholesterol, and reductase activity in the liver was measured 2 hr later. Standard chylomicrons and triglyceride-rich chylomicrons stimulated reductase to 157% and 187% of control activity, respectively, whereas cholesterol-rich VLDL suppressed reductase activity to 30% of control activity. These observations support the hypothesis that remnant lipoproteins have a dual effect on hepatic HMG-CoA reductase activity; the cholesterol in these lipoproteins suppresses hepatic reductase activity while the triglycerides concommitantly delivered stimulate reductase activity at least in part because they stimulate hepatic VLDL secretion. Therefore, the net response of hepatic HMG-CoA reductase to a particular dietary lipoprotein will depend upon the balance between the cholesterol and triglycerides carried to the liver.-Van Zuiden, P. E. A., S. K. Erickson, and A. D. Cooper. Effect of removal of lipoproteins of different composition on hepatic 3-hydroxy-3-methylglutaryl coenzyme A reductase activity and hepatic very low density lipoprotein secretion. PMID- 6854152 TI - Ammonia chemical ionization mass spectrometry of intact diacyl phosphatidylcholine. AB - Mass spectra have been obtained on molecular species of intact diacyl phosphatidylcholine by means of ammonia gas-induced chemical ionization. MH(+) ions were observed with all species, and other prominent ions in the spectra identified the fatty acid composition. Spectra of phosphatidylcholine containing deuterated methyl groups and spectra obtained using [(15)N]ammonia have allowed identification of fragments containing choline methyl groups and ammonium adducts.-Crawford, C. G., and R. D. Plattner. Ammonia chemical ionization mass spectrometry of intact diacyl phosphatidylcholine. PMID- 6854153 TI - Ursodeoxycholic acid treatment in cholesterol gallstone disease: effects on hepatic 3-hydroxy-3-methylglutaryl coenzyme A reductase activity, biliary lipid composition, and plasma lipid levels. AB - The present study was undertaken to characterize the effects of ursodeoxycholic acid on biliary lipid metabolism in man. Fifteen gallstone patients were treated with ursodeoxycholic acid at a daily dosage of 15 mg per kg body weight for about 4 weeks before cholecystectomy. At operation a liver biopsy, together with gallbladder and hepatic bile, were obtained. Eighteen untreated gallstone patients undergoing cholecystectomy served as controls. During treatment with ursodeoxycholic acid, hepatic bile became unsaturated with cholesterol in all patients investigated. The total biliary lipid concentration remained unchanged. The hepatic cholesterol concentration decreased by about 20%. No significant change in the microsomal HMG CoA reductase activity was observed (38.5 +/- 6.7 pmol . min-1 . mg protein-1 vs 38.3 +/- 4.7 pmol . min-1 . mg protein-1 in the controls; means +/- SEM). Plasma concentrations of total cholesterol were reduced by about 10%, and those of high density lipoprotein (HDL) and low density lipoprotein (LDL) cholesterol by about 15%. Plasma triglyceride levels remained essentially unchanged during treatment. We conclude that, similar to chenodeoxycholic acid therapy, ursodeoxycholic acid treatment results in unsaturation of fasting hepatic bile. In contrast to the changes seen during chenodeoxycholic acid feeding, however, the unsaturation of hepatic bile during ursodeoxycholic acid treatment is not primarily related to a decreased hepatic HMG CoA reductase activity. Furthermore, while chenodeoxycholic acid tends to increase plasma LDL levels, such changes are not seen during ursodeoxycholic acid treatment. PMID- 6854154 TI - Application of high-performance liquid chromatography to assay phylloquinone (vitamin K1) in rat liver. AB - A specific and sensitive method based on high-performance liquid chromatography to measure vitamin K1 in rat liver is described. The procedure consists of three chromatographic steps, a preliminary purification of lipid extracts on Sep-Pak silica columns, a preparative stage using adsorption HPLC, and a final reversed phase HPLC stage in which vitamin K1 is resolved from remaining contaminants and quantified by reference to an internal standard (vitamin K1 2,3-epoxide). The "within-run" coefficient of variation of the assay for vitamin K1 in 12 livers was 11.1% (n = 24). The concentration of vitamin K1 in liver of male rats fed a control diet containing no alfalfa was 8.0 ng/g (wet weight of liver) while female rat liver gave a mean value of 7.3 ng/g (wet weight of liver). Liver from male rats fed chow containing alfalfa gave a mean value of 44 ng K1/g (wet weight of liver). PMID- 6854156 TI - An evaluation of the effect of chiropractic manipulative therapy on hypolordosis of the cervical spine. AB - Cervical curve depth (CCD) was radiographically evaluated in 35 patients who presented with cervical hypolordosis or kyphosis (CH/K). Of these, one group of 20 patients received chiropractic manipulative therapy (CMT) for the purpose of correcting the disorder. A second group of nine patients received both CMT and an orthopedic cervical pillow for in home correction of the CH/K. A control group of six patients received CMT which was not intended to correct the CH/K. The purpose of the study was to determine the efficacy of CMT in the correction of CH/K. Analysis of the data indicated that CMT is significantly effective in the treatment of CH/K. There was a mean improvement of 4.55 degrees (p less than 0.01) in the group receiving only CMT, as assessed by CCD radiographic analysis. There was also significant improvement of 2.22 degrees (p less than 0.05) in the group receiving both CMT and orthopedic cervical pillow therapy. The findings lend support to fundamental chiropractic tenets such as that spinal manipulation is beneficial in correcting biomechanical disorders of the spine. Specifically, the study documents the role of chiropractic care in the correction of CH/K as may result from postural, musculoligamentous, or traumatic etiology such as the so-called "whiplash" injury. PMID- 6854155 TI - Purification of oleic acid and linoleic acid. AB - To permit kinetic studies of the reactivity of unsaturated fatty acids towards oxygen radicals, it is essential to remove traces of hydroperoxides and other conjugated lipid impurities commonly present in commercial samples. Removal of these impurities has been satisfactorily achieved for oleic and linoleic acids by anaerobic low temperature recrystallization from acetonitrile. The UV spectra of commercial and purified samples are compared. PMID- 6854158 TI - Resolving noncompliance in patient care. PMID- 6854157 TI - Reliability of faculty assessments of student case histories: a problem in chiropractic education. AB - A competency based educational model necessitates reliable evaluation. This study examined faculty reliability in assessing students' case histories at one chiropractic college. Previous studies have found great variation in faculty assessment of clinical performance in medical residents. In this study, sixteen faculty members at the Canadian Memorial Chiropractic College evaluated three case histories by completing five rating scales on each one. The study found little faculty agreement in judging the case histories. Faculty evaluations ranged from extremely poor to extremely excellent for the same case history. In addition, the data indicate that the faculty's ratings were influenced by a halo effect. Evaluators made a general judgement, which influenced the ratings on the five scales. It is suggested that meetings of clinical instructors to standardize criteria of assessment may be beneficial. PMID- 6854159 TI - Full spine wedge compensating filter. PMID- 6854160 TI - The public speaks -- Part IV. PMID- 6854161 TI - Medical students' report on the 1982 AMA interim meeting. PMID- 6854162 TI - Pre- and postoperative respiratory care. PMID- 6854164 TI - To extend our "Reach To Recovery". PMID- 6854165 TI - Bedside hemodynamic monitoring. PMID- 6854166 TI - Tuberculosis of the spine in southern Thailand. PMID- 6854163 TI - The great "informed consent" debate: should the disclosure of risks and alternatives by physicians be standard pre-operating procedure? PMID- 6854167 TI - Secondary amenorrhea with deletion of the short arm of the X chromosome (46 XXp ): a case report. PMID- 6854168 TI - Primary mediastinal seminoma: a case report. PMID- 6854170 TI - Mucormycosis in severely burned patients. Report of two cases with extensive destructive lesions. PMID- 6854169 TI - Intestinal capillariasis from Udon Thani province, northeastern part of Thailand: report of an autopsy case. PMID- 6854172 TI - Growth and growth hormone. PMID- 6854171 TI - Safety evaluation of ethambutol in children. PMID- 6854174 TI - Perinatal mortality survey: Siriraj Hospital, Thailand, 1979. PMID- 6854175 TI - Arterial embolism of the limbs: a study of 43 cases. PMID- 6854173 TI - Neoplasms of sympathetic nervous system: study of 152 cases. PMID- 6854176 TI - The estimation of body fat from skinfold thickness in normal healthy university female students. PMID- 6854177 TI - Prevalence of abortive canine rabies in Chiang Mai, Thailand. PMID- 6854179 TI - Recommended food intakes for pregnant, lactating women, and infants. PMID- 6854178 TI - Midtrimester abortion by hypertonic saline instillation experience in Ramathibodi Hospital. PMID- 6854182 TI - The electrogenesis of terminal QRS notches in normal subjects. AB - This study was undertaken to explore the mechanisms responsible for the low amplitude, low frequency notches commonly recorded at the end of the QRS complex. Such waves were registered in tracings from twenty-three of fifty normal volunteers evaluated. In fourteen cases, notches were localized to the lateral precordial leads (V3-6), in six they were limited to right precordial leads (V1 2) and in three, notches were found in both right and lateral lead records. Isopotential maps were constructed from potentials registered from one-hundred fifty torso electrodes. Results demonstrated that: 1) notches in lateral precordial leads (V3-V6) were due to either movement of or changes in potential of early ventricular repolarization effects; and 2) notches in right precordial leads (V1-V2) were caused by migration of terminal ventricular activation currents. These findings document the necessity for study of factors that determine the spatial as well as the temporal and magnitude parameters of electrocardiographic waveforms. PMID- 6854183 TI - Function of atrial preferential conduction routes under normal and abnormal conditions. AB - The function of the atrial preferential conduction routes was examined by the microelectrode technique under normal and abnormal conditions in excised rabbit hearts. The sinus impulse during normal conditions traveled faster along the left and the right branch of the crista terminalis (anterior and posterior preferential routes, respectively) in the atrium toward the A-V node. Cutting of either route caused a delay of the impulse arrival in the zone beyond the lesion. The internodal conduction time was delayed 12 msec upon cutting of the posterior route, but there was no conduction delay after cutting the anterior route. This indicates that the posterior path is the dominant conduction route under normal conditions. When both routes were cut, the internodal conduction time was delayed 33 msec from the control value. During abnormal conditions, an ectopic pacemaker was found to occur mainly in the regions of two routes, as well as in the coronary sinus region. The cutting of either route, combined with the application of acetylcholine or high external K+, resulted in easier provocation of re entrant arrhythmias in response to premature-stimuli than before the cutting. PMID- 6854180 TI - Intraspinal sarcoma of the nerve sheath: a case report. PMID- 6854181 TI - A clinical study on the use of progesterone for patients with ureteral stones. PMID- 6854184 TI - Human body surface mapping during atrial depolarization in normal and diseased subjects. AB - Body surface isopotential distributions during atrial excitation were examined in 21 normal subjects--12 cases with right atrial overload (RAO-group) and nine cases with left atrial overload (LAO-group). Each subject showed both a single maximum and a minimum during the atrial excitation. In normal subjects, a maximum initially appeared throughout the central region of the anterior chest. Later, it moved to the left and to the subjects' back. To analyze this movement we divided a maximum into two parts and named them the anterior maximum and the left maximum, respectively, dependent upon their location relative to the left midclavicular line. We measured durations of three parameters of the maxima movements, namely: (A) the duration of the anterior maximum, (B) the duration of the left maximum and (C) the shift time from the anterior maximum to the left maximum. In the normal group, (A) was 32 +/- 11 msec (mean +/- S.D.), (B) was 38 +/- 6 msec and (C) was 51 +/- 12 msec. In the RAO-group, (A) time period was prolonged, (B) time period was shortened, and (C) time period was delayed in comparison to the respective values in the normal group. In the LAO-group, the (B) time period was longer than in the normal group. These changes were statistically significant, so that these findings suggest that the anterior maximum reflects mainly right atrial activation, and the left maximum, left atrial activation. PMID- 6854185 TI - The effect of maximal treadmill exercise on the axis and amplitude of the ventricular depolarization wave. PMID- 6854186 TI - Alterations induced by a single defibrillating shock applied through a chronically implanted catheter electrode. AB - In ten beagles ranging in weight from 7.4 to 13.0 kg, a defibrillating shock of 10 A (three dogs), 20 A (four dogs), or 30 A (three dogs) intensity was applied through a chronically implanted right ventricular catheter electrode. Ten-lead ECG, right ventricular electrogram, and right ventricular impedance were recorded prior to, immediately following, and 48 hours post-shock. A single shock of 10 A, 20 A, and 30 A intensity succeeded in defibrillating nine of ten dogs. One dog required two 20 A shocks to defibrillate. No shock was fatal. Post-shock arrhythmias increased in duration and severity as the shock strength increased. ECG vector analysis suggested damage to the right ventricle in eight of ten dogs. The impedance signal amplitude increased directly after the shock, but dropped below control level by 200 seconds post-shock and remained below control by 48 hours post-shock. Pale areas of shock-induced myocardial necrosis were concentrated in the right ventricular walls adjacent to the distal electrode. The mean weight of necrotic myocardium was 0.043 + 0.006 grams at 10 A, 1.203 + 0.268 grams at 20 A, and 1.397 + 1.218 grams at 30 A (mean + sd). Defibrillation was effective after long-term implantation. The alterations sustained from defibrillation were minimized by using a low intensity shock. PMID- 6854187 TI - Sudden death in two patients with variant angina and apparently minimal fixed coronary stenoses. PMID- 6854188 TI - Differential effects of ornithine on placental lactogen and growth hormone secretion in the pregnant ewe and fetus. AB - The intravenous infusion of ornithine (0.5-0.9 g/kg) into five fetal sheep of 116 141 days gestation caused no significant change in concentrations of fetal plasma placental lactogen (PL) or GH as determined by specific homologous radioimmunoassays. In contrast, the intravenous infusion of ornithine (0.3-0.5 g/kg) into three of the ewes caused a 144.5 +/- 74.7 (S.E.M.)% increase in maternal plasma PL concentrations and a 255.2 +/- 55.0% increase in maternal GH concentrations. Fetal PL concentrations remained unchanged depsite the large increase in maternal PL concentrations. This study, which indicates a differential effect of ornithine on PL and GH secretion in the mother and fetus, suggests that the factors regulating PL and GH secretion in the mother and fetus are distinct. PMID- 6854189 TI - Effect of photoperiod and gonadectomy on testosterone metabolism in vitro by the prostate of the golden hamster. AB - Testosterone metabolism was studied in vitro in the prostate of intact and castrated golden hamsters maintained either in short days (8 h light: 16 h darkness, 8L: 16D) or in long days (14L: 10D). Testosterone was found to be converted into 17 beta-hydroxy-5 alpha-androstan-3-one (5 alpha-DHT), 5 alpha androstane-3 alpha, 17 beta-diol, 5 alpha-androstane-3, 17-dione and androstenedione. The mean conversion of testosterone to 5 alpha-DHT was higher in prostates from animals maintained in long days than in short days (P less than 0.0025) while that to androstenedione was higher in short days (P less than 0.0005); no significant changes in the formation of the other three metabolites were noted. Castration of animals maintained in short days resulted in a significant (P less than 0.05) decrease in the mean conversion to all four metabolites. In contrast, castration of animals kept in a long-day regime caused a significant (P less than 0.01) decrease in the mean formation of 5 alpha-DHT but a significant (P less than 0.05) increase in the mean formation of 5 alpha androstane-3 alpha, 17 beta-diol. PMID- 6854190 TI - Incidence of ovulation in the years after the menarche. AB - Urine for the analysis of pregnanediol was collected weekly for 3 months from 209 menstruant women aged 11-24 years who lived with their parents and from 59 women aged 17-23 years who had left the parental home. Menstrual cycles were classed as ovulatory if the 24-h pregnanediol output in the 12 days preceding menstruation was greater than or equal to 5 mumol on a single occasion or if the total excreted on 2 days, 1 week apart, was greater than or equal to 7 mumol. In the first group, ovulatory incidence increased with menarchal age. Unfailing ovulation occurred in 22.9, 25.0, 44.8, 42.9, 63.2, 71.8 and 82.6% of those who were less than 1, 1- less than 2, 2- less than 3, 3- less than 4, 4- less than 5, 5-8 and 9-12 years from menarche. Comparable figures for the women who lived in flats and hostels were 40.0% (menarchal age, 5-8 years) and 78.6% (9-12 years). It is concluded that a regular pattern of ovulatory menstrual cycles is established in most young women within 5 years of the menarche, and that departure from the family home is often associated with a regression to a juvenile pattern of anovulatory menstrual cycles. PMID- 6854191 TI - Cell-density dependence of the rate of prolactin secretion from perifused rat anterior pituitary cells. AB - Anterior pituitary glands from female rats were dispersed enzymically in the absence of dopamine. Dispersed cells (10(6)-10(7)) were layered onto columns containing Bio-Gel P-2 and were then perifused for 3 h with Dulbecco's Modified Eagle's Medium. The prolactin content of the perifusate and cell homogenates was determined by radioimmunoassay. Prolactin secretion during the third hour of perifusion increased as the loading of cells increased. However, the increase was not linear, and when secretion rate per 10(6) cells was calculated it was found that increased loading decreased the rate, which fell to a plateau of 1.3 +/- 0.1 (S.E.M.) ng/min per 10(6) cells at a loading of about 8 x 10(6) cells from 3.8 +/ 0.1 ng/min per 10(6) cells for a loading of 10(6) cells. This cell-density dependence of the rate of prolactin secretion in the perifusion system may be due to intercellular contact since the isolation of the tissue removes the influence of hypothalamic factors, while localized build up of prolactin (potentially causing direct autoregulation on the lactotroph) seems unlikely because of the continuous flow of medium. PMID- 6854192 TI - Patterns of progesterone, melatonin and prolactin secretion in ewes maintained in four different photoperiods. AB - Twenty-four-hour patterns of serum melatonin and prolactin levels were determined in ewes on nine occasions during a year. The sheep were maintained in four different photoperiods: room 1, simulated natural photoperiod; room 2, normal daylength extremes twice in 12 months, changes occurring in a regular fashion; room 3, alternating long (16 h) and short (8 h) days for 90 days; room 4, constant light. Cyclic ovarian activity, determined by twice-weekly determinations of serum progesterone, commenced in rooms 1, 2 and 3 after a transition from long to short daylength and terminated during long daylength. Thus in rooms 2 and 3 there were two periods of ovarian activity. In room 4 (constant light) ovarian activity began earlier than in room 1 and was of greater duration (240 days v. 190 days). Basal prolactin levels were highest (50-134 micrograms/l) during periods of long daylength and lowest (less than 10 micrograms/l) in short daylength. Ewes maintained in constant light had an intermediate level (21-62 micrograms/l) throughout the study. Melatonin secretion was lowest during daylight (less than 78 pmol/l) and highest during darkness. Night-time melatonin levels varied markedly from hour to hour and between individuals in rooms 1, 2 and 3. There was, however, no consistent seasonal change in the absolute levels of melatonin, although the duration of melatonin secretion did closely follow the length of the dark phase. There were no significant changes in melatonin levels during the oestrous cycle. Ewes kept in constant light had less than 78 pmol melatonin/l throughout the period of study. If the pineal gland is involved in transmitting photoperiodic information to the endocrine system, then it is most likely to be by means of an interaction between duration of melatonin secretion and an underlying change in sensitivity of end organs to melatonin. PMID- 6854193 TI - Effect of tamoxifen on growth and prolactin secretion of rat pituitary tumours. AB - The antioestrogenic drug tamoxifen was administered to rats bearing transplanted prolactin-secreting tumours derived from spontaneously occurring pituitary adenomas in Wistar-Furth rats. Some inhibition of tumour growth was observed but this was accompanied by an increase in plasma prolactin concentrations. Bromocriptine, however, consistently inhibited both growth and prolactin secretion of these tumours. The addition of tamoxifen to bromocriptine treatment produced no increased response to the dopamine agonist. Tamoxifen increased prolactin secretion by tumour cells in vitro but did not affect DNA synthesis. Normal rats responded to tamoxifen with a moderate increase in plasma prolactin concentrations and there was no change in pituitary DNA synthesis. PMID- 6854194 TI - Measurement of immunoreactive alpha-melanocyte-stimulating hormone in the blood of rainbow trout kept under various conditions. AB - Initial attempts to measure alpha-MSH in trout blood by radioimmunoassay proved unsuccessful due to apparent losses of immunoreactive hormone, especially in the plasma of trout adapted to a black background. An extraction protocol for alpha MSH from plasma is described. Subsequent radioimmunoassay revealed progressive increases in immunoreactive alpha-MSH as trout became adapted to a black background. Plasma alpha-MSH titres were raised during fungal infection, and also showed significant differences in fish obtained from different fish farms. PMID- 6854195 TI - L-thyroxine enters the rat liver cell by simple diffusion. AB - The mode of uptake of L-[125I]thyroxine by freshly isolated rat liver parenchymal cells was studied by a rapid centrifugation technique. Using conditions for measuring initial rates of uptake, uptake by liver cells was not saturable when exposed to hormone concentrations in the incubation medium ranging from 2 pmol/l to 10 mumol/l. The Arrhenius plot was linear from 2 to 37 degrees C; the temperature coefficient was 1.4. The uptake of L-[125I]thyroxine by liver cells was 35% when compared with that of L-[125I]tri-iodothyronine. In the presence of 2.8% bovine serum albumin the rate of uptake of L-[125I]thyroxine by liver cells was reduced by 90%. These results suggest that L-[125I]thyroxine enters the rat liver parenchymal cell by simple diffusion and only the free hormone crosses the plasma membrane. PMID- 6854196 TI - Binding of oestradiol, progesterone and prolactin in rat lung. AB - Binding of [3H]oestradiol and of [3H]progesterone in the cytosol from lungs of adult male rats was suppressible, dependent on incubation time and on protein concentration and was protein in nature. Suppressible binding of oestradiol consisted of a high affinity site (dissociation constant (Kd), 1 x 10(-9) +/- 0.2 x 10(-9) mol/l; maximum number of binding sites (Bmax), 0.7 +/- 0.2 pmol/mg protein) and a lower affinity site (Kd, 2.4 x 10(-8) +/- 0.6 x 10(-8) mol/l; Bmax, 6.3 +/- 0.4 pmol/mg protein) and showed evidence of positive co-operation. Suppressible binding of progesterone consisted of a single site with a Kd of 6 x 10(-9) +/- 1 x 10(-9) mol/l and Bmax of 44.5 +/- 8 fmol/mg protein. Binding of 125I-labelled ovine prolactin was found in homogenates of fetal lung (20 days of gestation) but not of adult lung (80 days of age). Treatment of adult rats with ovine prolactin was associated with an increase in the number of binding sites of high affinity for 125I-labelled ovine prolactin but these sites showed an altered specificity. This 'up-regulation' of the prolactin binding may provide a mechanism by which prolactin stimulates surfactant production in lung. These results, together with the known effects of these hormones on certain lung functions, provide further evidence that lung is a target organ for oestradiol, progesterone and prolactin. PMID- 6854197 TI - Allosteric interactions governing oxygen equilibria in the haemoglobin system of the spiny dogfish, Squalus acanthias. AB - The oxygenation-linked, allosteric interactions of erythrocytic organic phosphates and urea with the haemoglobin (Hb), and the functional significance of the Hb multiplicity, were studies in an elasmobranch, Squalus acanthias. The autochthonous red cell nucleoside triphosphates (NTP) ATP and GTP (guanosine triphosphate) strongly depress O2 affinity of the stripped (cofactor-free) Hb and increase cooperativity in O2 binding. As previously found in teleost Hbs, GTP exerts a greater effect than ATP at the same concentration. Urea, in contrast, increases O2 affinity and depresses cooperativity. It also antagonizes the modulator effectivity of NTP at physiological NTP/Hb concentration ratios. Deoxygenation of the Hb raises blood pH. This Haldane effect contrasts with earlier findings for Pacific specimens, but accords with the presence of a Bohr effect (phi = delta log P50/delta pH). S. acanthias Hb resolves into six main components (three pairs) on the basis of isoelectric point. There is no evidence for radical functional differentiation as found in teleosts with electrophoretically anodal and cathodal Hb components. The physiological implications of the findings and the possible molecular mechanisms basic to the NTP and urea effects are discussed. PMID- 6854198 TI - Gas exchange and energy cost of flight in the white-necked raven, Corvus cryptoleucus. AB - Energy expenditure during steady-state, wind tunnel flights was estimated from O2 and CO2 exchange in five white-necked ravens (Corvus cryptoleucus, mean mass, 0.48 kg) at air speeds of 8-11 m/s. Power input was closely similar to allometric predictions based on data from other species of smaller birds. It increased significantly with air speed and flight angle above horizontal, and decreased with increasing angles below horizontal. Maximum power input reached seven times the preflight value measured under resting but not basal conditions, 14 times the previously measured basal values and three times the calculated maximum for a similar sized running mammal. Energy cost to travel 1 km decreased with increasing air speed. These trends are similar to those previously observed in smaller birds. PMID- 6854199 TI - Locomotory stresses in the limb bones of two small mammals: the ground squirrel and chipmunk. AB - Peak stresses acting in limb bones should increase with increasing size if the forces acting on the bones increase in direct proportion to the animal's body weight. This is a direct consequence of the scaling of limb bone geometry over a wide range in size in mammals. In addition, recent work has shown that the material strength of bone is similar in large and small animals. If the assumptions in this analysis are correct, large animals would have a lower safety factor to failure than small animals. The purpose of this study was to measure peak stresses acting in the limb bones of small animals during locomotion and compare the results with similar measurements available for larger animals. Locomotory stresses acting in the fore and hindlimb bones of two rodents, the ground squirrel (Spermophilus tridecemlineatus) and chipmunk (Tamais striatus), were calculated using ground force recordings and measurements of limb position taken from high speed x-ray cine films. Peak (compressive) stresses calculated to act in the bones of these animals (-31 to -86 MN/m2) are similar in magnitude to those determined for much larger mammals. The more proximal bones of the fore and hindlimb, the humerus and femur, were found to develop stresses (-31 to -42 MN/m2) significantly lower than those acting in the more distal bones of each limb: the radius, ulna and tibia (-58 to -86 MN/m2). All of the long bones from both species, except their femora, were found to be loaded principally in bending. The caudal cortices of each bone developed a peak compressive stress, whereas the cranial cortices were loaded in tension. Various features of the musculo-skeletal organization and manner of locomotion of these rodents are considered to explain how animals of different size maintain a uniform safety factor to failure. PMID- 6854200 TI - Locomotion in the North American mink, a semi-aquatic mammal. I. Swimming energetics and body drag. AB - Oxygen consumption (VO2) during surface swimming and total body drag were investigated in the North American mink, Mustela vision Schreber. Over the range of 0.13-0.70 ms-1, VO2 increased curvilinearly with speed for minks swimming against a current in a water flume. Similarly, body drag of a mink carcass increased non-linearly with speed and was described by the equation, Drag = 1.24 velocity. A streamlined body shape, characteristic of many mustelids, aided in reducing drag at high speeds. Net swimming efficiencies were comparatively low (less than 2.8%) and were attributed to hig levels of drag when on the water surface and the absence of appendage specialization for aquatic locomotion. This lack of specialization probably contributes to high energetic costs but enables the mink to forage in both the aquatic and terrestrial environments. PMID- 6854201 TI - Energetic cost of active branchial ventilation in the sharksucker, Echeneis naucrates. AB - 1. Sharksuckers use active branchial ventilation when swimming or at rest in stationary water. When attached to a moving object or when placed in a water current, they shift to ram gill ventilation as water velocity exceeds a certain threshold. 2. Water velocities required for the transition from active to ram gill ventilation were from 10-50 cm s-1, depending on the size of the fish. 3. Oxygen consumption increased between 3.7 and 5.7% when the fish shifted from ram gill ventilation to active branchial pumping. 4. When water velocity was increased beyond the threshold for ram gill ventilation, no further increase in oxygen consumption was observed. 5. It is concluded that the energetic cost of active ventilation in sharksuckers is lower than has previously been reported for fish in general. PMID- 6854202 TI - Contribution of net ion transfer mechanisms to acid-base regulation after exhausting activity in the larger spotted dogfish (Scyliorhinus stellaris). AB - Specimens of the larger spotted dogfish (Scyliorhinus stellaris) were electrically stimulated to exhaustion in a closed seawater recirculation system. The production of large quantities of lactic acid by anaerobic metabolism and the resultant efflux of the dissociation products, H+ and lactate, from the white musculature resulted in severe acid-base disturbances and in increases in plasma lactate concentration, the two effects having extremely different time courses. Plasma pH and bicarbonate were maximally depressed 15-30 min after exercise, whereas peak lactate concentrations of up to 30 mM were not attained before 4-8 h after exercise. The acid-base status were restored to normal 10-14 h after exercise, long before the aerobic processing of surplus lactic acid was complete 22-30 h after exercise. This behaviour can be explained on the basis of an interaction of transfer rates, buffer values and equilibria between intracellular and extracellular compartments with the transient net transfer of surplus H+ ions to the environmental water. About half of the original quantity of H+ was transferred net to the environment via the branchial epithelium during the first 8-10 h, and it was later taken up again at the rate of aerobic lactic acid processing in the metabolism of the fish, whereas a transfer of lactate was not observed at any time during the experiment. As a result, the distribution patterns of H+ and lactate differed from each other and varied with time elapsed after anaerobic exercise, leading to the apparent 'H+ ion deficit' which has been observed in the blood of several fish species during lactacidosis. Net transfer of H+ ions to the environment facilitates rapid normalization of the acid-base status long before the original stress, lactic acid, is removed from the organism and thus represents an effective regulatory mechanism for the defence of the internal milieu in fish. PMID- 6854203 TI - Oxygenational properties and phosphorylated metabolic intermediates in blood and erythrocytes of the dogfish, Squalus acanthias. AB - A typical whole blood O2-equilibrium curve from Squalus acanthias had a P50 of 13.2 mmHg and was slightly sigmoidal, having an n value of 1.6 at 15 degrees C, PCO2 = 2.2 mmHg (pH = 7.85). A small Bohr effect was present (phi = -0.28) together with a weak Haldane effect and no Root shift. The predominant trinucleotide, determined by thin layer chromatography, was ATP (0.44 +/- 0.13 S.D. mmol 1(-1) blood) with smaller amounts of GTP present (0.07 +/- 0.02) S.D. mmol 1(-1). Total nucleotide concentrations, determined enzymatically, were low by comparison with teleosts. Incubation of erythrocytes with or without oxygen, or in the presence of a metabolite-enriched 'cocktail' showed limited potential for phosphate cofactor regulation of blood oxygen affinity. PMID- 6854204 TI - Long-term erythropoietic repopulating ability of old, young, and fetal stem cells. AB - It is possible that erythropoietic stem cells do not age. This would mean that stem cells from old donors can function as well as those from young or fetal donors. The competitive repopulation assay has been used to test long-term stem cell function by directly comparing how well competing stem cells repopulate a recipient and produce differentiated cell types. C57BL/6J (B6) mice were used as donors, while recipients and competitors were WBB6F1 hybrids with genetically distinguishable hemoglobin. Lethally irradiated young WBB6F1 recipients were given a mixture of 2.5 X 10(6) cells from B6 old marrow, young marrow, or fetal liver donors; each recipient also received a standard dose of 1 X 10(6) marrow cells from a pool of young WBB6F1 competitors. Surprisingly, the old marrow cells competed the best in repopulating the recipients. This pattern was maintained even after recovery from sublethal irradiation, a treatment that severely stresses stem cells. This stress was demonstrated when sublethal irradiation caused a 20-fold decline in repopulating ability measured using hemoglobin markers, and a 3- to 7-fold decline using chromosome markers. Stem cells from old marrow competed better than young or fetal cells in similar experiments using immunologically crippled recipients or using unirradiated W/Wv recipients that are immunologically intact. In both types of recipients, the advantage of old marrow cells again persisted after recovery from sublethal irradiation. Other genotypes were tested, and marrow cells from old B6CBAF1 donors competed better than those from young donors of that genotype. However, marrow cells from young CBA donors completed better than those from old CBA donors. These results support the hypothesis that stem cells do not age, and suggest that regulatory changes with age promote rapid stem cell repopulation in B6 and B6CBAF1 mice, but inhibit it in CBA mice. PMID- 6854206 TI - Mononuclear phagocyte system of the mouse defined by immunohistochemical localization of antigen F4/80. Identification of resident macrophages in renal medullary and cortical interstitium and the juxtaglomerular complex. AB - Macrophages have been identified in mouse kidney by immunohistochemical localization of the macrophage-specific antigen F4/80. They constitute the majority of the renal medullary interstitial cell population and are also found in contact with cortical distal and proximal tubules and Bowman's capsule. They are a physical component of the juxtaglomerular complex. PMID- 6854205 TI - Surface antigens of Leishmania donovani promastigotes. AB - Surface antigen profiles of Leishmania donovani promastigote isolates have been studied. Surface patterns of Brazilian and African isolates display remarkable similarities and are extremely simple, consisting of three major peptides of 65,000, 25,000, and 23,000 mol wt. Surface iodination and biosynthetic labeling coupled to immunoprecipitation techniques revealed that a single major determinant of 65,000 mol wt is recognized in all strains by sera from kala-azar patients from both Brazil and Africa. This major determinant is not brought down by sera from normal individuals and shows no significant cross-reactivity with sera from Chagas' disease, leprosy, or syphilis patients. Binding to concanavalin A suggests a glycoprotein nature for this antigen. Sera from patients with cutaneous leishmaniasis (L. braziliensis) also recognized the same 65,000-mol wt determinant, although to a lesser extent. The possibility that this major surface antigen is shared, with minor differences, not only by L. donovani strains but between Leishmania species in general is suggested. PMID- 6854207 TI - Modulation of Fc receptors of mononuclear phagocytes by immobilized antigen antibody complexes. Quantitative analysis of the relationship between ligand number and Fc receptor response. AB - Macrophages plated on surfaces coated with antigen-IgG complexes lose the capacity to bind and ingest IgG-coated particles via their Fc receptors (FcR). Macrophages plated on surfaces containing a similar number of IgG molecules that are not complexed to antigen show little or no decrease in FcR activity. Using a rat monoclonal antibody (2.4G2 IgG) directed against the trypsin-resistant FcR (FcRII) of mouse macrophages we show that the decrease in receptor activity induced by substrate-adherent immune complexes is caused by the physical removal of 60 and 75% of FcRII from the nonadherent membrane surfaces of resident and thioglycollate broth-induced macrophages, respectively. Macrophages maintained on antigen-IgG-coated surfaces for up to 44 h show no recovery in FcRII activity or number, while macrophages on control surfaces exhibit two and threefold increases, respectively, in these parameters. Macrophages maintained for 72 h on antigen-IgG-coated surfaces show a small recovery in FcRII activity, and in the number of FcRII that is accessible to bind 125I-2.4G2 IgG. FcRII modulation, as measured by the binding of 125I-labeled 2.4G2 IgG, is initiated when the number of IgG molecules bound to the substrate is approximately equal to the total number of FcRII on the plasma membranes of all the macrophages on the substrate. FcRII activity and number decrease linearly as the number of substrate-bound IgG molecules increases exponentially, and are maximally reduced when the number of IgG molecules on the substrate is 20-fold greater than the total number of all FcRII on the surfaces of all the macrophages in the culture. Thus there is a stoichiometric relationship between the number of IgG molecules on the substrate and the extent of FcRII modulation. PMID- 6854209 TI - Enhancement of human eosinophil-mediated killing of Schistosoma mansoni larvae by mononuclear cell products in vitro. AB - Previous studies have shown that eosinophils from eosinophilic individuals differ functionally from those of normal individuals. In order to test whether agents that might induce eosinophilia could also affect eosinophil function, we have compared the capacity of culture supernatants from mononuclear cells of eosinophilic or normal individuals to enhance eosinophil activity, as reflected by an increased killing of schistosomula of Schistosoma mansoni in vitro. An enhancing activity was detected, which increased both the antibody-dependent, and to some extent the antibody-independent killing of schistosomula by eosinophils, in the absence of complement. Under similar conditions, the supernatants failed to stimulate an otherwise undetectable neutrophil-mediated killing. The activity could be removed from the assay by washing, without reversing previous eosinophil stimulation, and was not directly toxic to the schistosomula. Preliminary characterization of the activity indicated that it was relatively heat-stable at 100 degrees C for 30 min, and had an estimated molecular weight of 35,000-45,000 as judged by G-200 Sephadex fractionation. The activity was produced by a nonlymphocytic, nonspecific esterase-containing adherent mononuclear cell in the absence of either Con A or antigenic stimulation. Significant enhancing activity was detectable after 1 h of culture and continued for at least 25 h. Protein synthesis was required for its production or release. Although the activity was detectable in supernatants from both eosinophilic and normal individuals, the supernatants that demonstrated highest activity and that could be titrated out furthest were generally derived from eosinophilic individuals, suggesting that there might be some association between eosinophilia and enhanced eosinophil function. PMID- 6854208 TI - Characterization of nonlymphoid cells derived from rat peripheral lymph. AB - Mesenteric lymphadenectomy in rats is followed by union of peripheral and central lymphatics, allowing the collection of intestine-derived peripheral lymph cells via the thoracic duct for several days. These cells include a proportion of nonlymphoid cells (NLC) that show irregular and heterogeneous surface morphology including long pseudopodia and veils. They stain variably for nonspecific esterase and acid phosphatase and are ATPase-positive. Their nuclei are irregular and some contain cytoplasmic inclusions, some of which show peroxidase activity and/or contain DNA. NLC have a range of densitites generally lower than that of lymphocytes. Freshly collected NLC express the leukocyte-common antigen (defined by monoclonal antibody MRC Ox 1) and Ia antigens (I-A and I-E subregion products defined by monoclonal antibodies) but they show a relative lack of other surface markers normally found on rat B or T lymphocytes (W3/13, W3/25, MRC Ox 12 (sIg), MRC Ox 19) or rat macrophages (FcR, C'R, mannose R, W3/25). In general NLC are only weakly adherent to glass or plastic. Although a subpopulation of NLC appear to have had a phagocytic past, freshly collected NLC fail to phagocytose a variety of test particles in vitro. NLC also appear incapable of pinocytosis in vitro. This heterogeneity may represent distinct subpopulations of NLC or different stages in the development of a single cell lineage. Direct cannulation of mesenteric lacteals shows that the majority of NLC are derived from the small intestine and their precursors appear to be present both in lamina propria and Peyer's patches. Kinetic studies, following irradiation or intravenous tritiated thymidine, show that the majority of NLC turn over rapidly in the intestine with a modal time of 3-5 d. Studies with bone marrow chimeras show that they are derived from a rapidly dividing precursor present in normal bone marrow. NLC occur at very low frequencies in normal thoracic duct lymph at all times following cannulation. The evidence presented suggests that NLC closely resemble mouse lymphoid dendritic cells. This conclusion is supported by evidence already obtained showing that NLC are potent stimulators of the semi-allogeneic rat primary mixed leukocyte reaction. In addition to the ceils resembling dendritic cells rare monocytoid cells are found in thoracic duct lymph of lymphadenectomized specific pathogen-free rats. The proportion of these cells increases greatly when the animals are conventionally housed. It seems probable that the physiological function of NLC is to act as accessory cells in the lymph nodes to which they normally drain. Methods for enriching NLC and thus facilitating analysis of their functions are discussed. PMID- 6854210 TI - Plasma fibronectin enhances phagocytosis of opsonized particles by human peripheral blood monocytes. AB - We have investigated the effect of plasma fibronectin (Fn) on binding and phagocytosis of sheep erythrocytes (E) by human peripheral blood monocytes. Unopsonized E were not phagocytosed in the absence or presence of Fn, but Fn enhanced the phagocytosis of E bearing IgG. Sheep erythrocytes sensitized with IgM and C3b were ingested only when monocytes were exposed to Fn. The Fn enhancement of phagocytosis occurred for both fluid-phase and glass-adherent monocytes. Experiments in which Fn was washed out before mixing monocytes with opsonized E demonstrated that the Fn effect occurred because of interaction with the monocytes and not the opsonized particles. Chromatography of the Fn on Biogel A 1.5m showed that the phagocytosis-enhancing activity exactly co-chromatographed with the Fn protein. Fn did not increase the number of monocyte membrane receptors for the Fc fragment of monomeric IgG. We conclude that Fn enhances monocyte phagocytosis, not by binding to particles as a conventional opsonin, but by stimulating monocytes to ingest already opsonized particles more avidly. PMID- 6854211 TI - Regulation of natural antiallotype antibody responses by idiotype network-induced auto-antiidiotypic antibodies. AB - This study was designed to determine whether natural immune responses could elicit immunoregulatory auto-antiidiotypic antibodies. Female rabbits heterozygous at the a and b Ig loci were bred to homozygous males. Offspring of one such breeding were studied for natural production of antibodies specific for the noninherited allotypes and for the production of immunoregulatory auto antiidiotypic antibodies. All offspring mounted natural antiallotype responses. The anti-a1 responses cycled as a function of time whereas the anti-b5 responses were invariant. Anti-a1 responses from two offspring were shown to change specificity for different a1 subsets as they cycled. Anti-a1 was purified from the first cycle and was used to assay for auto-antiidiotypic responses. Auto antiidiotypic antibodies were detected and were found to cycle in an inverse way with the anti-a1 cycles. The idiotopes detected using the natural auto antiidiotypic antisera were strongly cross-reactive. Subsequent deliberate immunization showed that antibodies specific for all a1 subsets could be elicited after auto-antiidiotypic regulation had functioned. The data support the interpretation that idiotype network interactions indeed function in naturally occurring immunologic situations and are not merely laboratory curiosities or artifacts. PMID- 6854212 TI - Activation of basophil and mast cell histamine release by eosinophil granule major basic protein. AB - Major basic protein (MBP) is a primary constituent of eosinophil granules. In this report, we demonstrate that MBP from human eosinophil granules initiates a nonlytic histamine release from human leukocytes. A direct effect of MBP on basophils was confirmed using purified human basophils. The kinetics of release were similar to those reported for poly-L-arginine, although MBP was less potent than poly-L-arginine of similar molecular weight. Reduction and alkylation of MBP diminished both the potency and efficacy of the molecule. Native MBP also stimulated histamine secretion from purified rat peritoneal mast cells in a manner characteristic of other polycations. These results emphasize the bidirectional nature of the basophil/mast cell-eosinophil regulatory axis. PMID- 6854213 TI - A protein anomaly in erythrocyte membranes of patients with Duchenne muscular dystrophy. AB - Raman spectroscopic comparisons of erythrocyte membranes from 20 patients with Duchenne muscular dystrophy and 8 age-matched controls indicate a prominent and consistent protein anomaly in the patient samples. This was apparent in the following: (a) CH-stretching signals from control membranes reveal a thermotropic transition at 15.6 degrees C, attributable to a protein/lipid phase that is lacking in dystrophic membranes. (b) CH-stretching signals from control membranes also show a protein transition at 39 degrees C [pH 7.4] that is shifted to 45 degrees in dystrophic membranes. (c) A reduction in pH to 5.7 shifts this transition from 39 degrees C to 7 degrees C in normal membranes and from 45 degrees C to 24 degrees C in dystrophic membranes. (d) The Amide I/Amide III regions indicate a significant proportion of beta-structured peptide in dystrophic but not normal membranes. (e) Analysis of tyrosine signals indicates greater polar exposure of tyrosine hydroxyl groups in dystrophic vs normal membranes. All of the differences between dystrophic and normal membranes are highly significant (P less than 0.001). PMID- 6854214 TI - Release of enzymes from rat jejunal mucosa by bile salts. AB - The technique of segmental perfusion was applied in vivo to study the release of enzymes from the mucosa cells under the influence of bile salts. Five brush border membrane enzymes, five cytosolic, one mitochondrial and two lysosomal enzymes were measured. Spontaneous release (Ringer solution), due to their superficial localization, was greatest for enteropeptidase and alpha-glucosidase. 3 and 10 mmol/l sodium taurocholate, and 0.5 and 3.0 mmol/l chenodeoxycholate were used. Surprisingly, the majority of cytosolic enzymes was released to a greater extent than membrane enzymes. On the other hand, lysosomal or mitochondrial enzymes were low or absent in the perfusion medium, a finding that excludes a serious injury to the mucosa cells. It must be inferred, therefore, that cytosolic enzymes are regularly externalized during the digestive process, the glycocalyx perhaps being a common matrix for pancreatic, membrane-associated and cytosolic enzymes. PMID- 6854215 TI - Metabolism and proliferation of cultured fibroblasts from specimens of human palmar fascia and Dupuytren's contracture. The pathobiochemistry of connective tissue proliferation, II. AB - Cell Cultures from 11 Dupuytren's contracture and 6 normal palmar fascia specimens were established. The rates of sulphated glycosaminoglycan, collagen and DNA synthesis by means of incorporation of labelled precursors ([35S]sulphate, [3H]proline, [3]thymidine) as well as the growth characteristics of the cell lines of both healthy and diseased were compared. The incorporation rates of [35S]sulphate and [3H]proline were found to be significantly higher in Dupuytren than in healthy palmar fascia-deriving cell lines. In contrast, no differences in cell growth or DNA synthesis could be demonstrated. The abnormal capacity to synthesize sulphated glycosaminoglycans and collagen is attributed to a permanent modulation of cell characteristics which can be propagated into cell culture. PMID- 6854216 TI - The diagnostic potential of the combined determination of serum monoamine oxidase and N-acetyl-beta-D-glucosaminidase for fibroproliferative liver diseases. AB - The simultaneous determination of the catalytic activities in serum of monoamine oxidase (EC 1.4.3.4) and N-acetyl-beta-D-glucosaminidase (EC 3.2.1.30) was performed in patients with various non-liver diseases, acute hepatitis and fibroproliferative liver disorders (cirrhosis and fibrosis) and the predictive values of the positive (both activities are pathologically elevated) and negative test results (normal activity of monoamine oxidase and/or N-acetyl-beta-D glucosaminidase) were estimated. It was found that the incidence of the positive result is extremely low (0.024, 5/207) in patients suffering from a great variety of non-liver and liver diseases (except cirrhosis) but rather great in liver cirrhotic subjects (0.44, 18/41). A fraction of only 0.07 of liver fibrotic patients had a positive test result. Based on these data the estimated predictive value of the positive result for liver cirrhosis at a prevalence of 0.03 is 0.47. This value increases strongly with higher prevalence of cirrhosis (population preselected for chronic liver diseases). The negative predictive value for cirrhosis and the positive value for fibrosis are low. Thus, the probability of the presence of cirrhosis in patients with suspected chronic liver diseases is great in cases of abnormally high activities of both monoamine oxidase and N acetyl-beta-D-glucosaminidase. Negative test results (normal catalytic activities of one or both enzymes), however, do not prove the absence of liver cirrhosis and/or liver fibrosis. PMID- 6854217 TI - Latex immunoassay of urinary albumin. AB - A new non isotopic immunoassay based on latex particle agglutination has been developed for the determination of albumin in urine. The assay consists in incubating the urine sample for 30 min at 37 degrees C with latex particles coated with a specific antibody, followed by quantification of the resulting agglutination by particle counting or turbidimetry. The stability of antibody coated particles during incubation is achieved by diluting them just before the assay in a buffer containing bovine serum albumin. The pH of this buffer, the antibody loading and the concentration of latex particles in the incubation mixture were optimized to obtain the maximal specific and minimal nonspecific agglutination. The albumin standard curve ranges from 25 to 800 micrograms/l. Reproducibility tests performed within and between run gave CV's ranging from 8.2 to 11.6%. The recovery of albumin added to 10 urines averaged 95.5%. A correlation coefficient of 0.96 was obtained between latex immunoassay and nephelometry for the determination of albumin in 51 urines. PMID- 6854218 TI - Influence of bilirubin on the determination of acid phosphatase in serum. AB - Bilirubin interferes greatly in the continuous measurement of acid phosphatase, using alpha-naphthyl phosphate as substrate and diazotized 2-amino-5 chlorotoluene (Fast Red TR) as the colorimetric reagent. Fast Red TR and the so called "direct" (but not "indirect") bilirubin form a coloured azo-compound which absorbs light above 480 nm. Negative absorbance changes are observed at 405 nm, which is used in the determination of acid phosphatase. This leads to apparently negative activities. PMID- 6854219 TI - Polyamine excretion in the urine of cancer patients. AB - The polyamines putrescine, spermine, spermidine and cadaverine were determined in the urine of 56 cancer patients, most of whom suffered from breast or lung tumours. The excretion of spermine and putrescine was increased versus controls in a group of various cancers with metastases. The excretion of spermine, spermidine and cadaverine was increased in lung cancer without metastases. Polyamines were analysed in the urine of six women with breast cancer, before and after mastectomy. The excretion of putrescine, spermine and cadaverine was lower 6 to 9 months after the operation than before. PMID- 6854220 TI - [Proline arylamidase in human serum]. AB - The catalytic concentrations of proline arylamidase in human sera were determined with L-proline-beta-naphthylamide (endpoint-method) and L-proline-p-nitranilide (continuous reaction). The continuous method was optimized: Tris-HCl, 40 mmol/l, pH 7,2; [S] = 1.53 mmol/l; T = 37 degrees C, t = 5-15 min, no additives. The pH optimum was found to be 7.20; substrate excess inhibition was not observed. Tris (hydroxymethyl)-aminomethane und N-morpholino-3-propane sulfonic acid buffers gave similar reaction rates. Reducing substances, SH-reagents, complex-forming or buffer substances, anticoagulants, proteinase inhibitors and the chlorides of Na+, Cu++, Mn++ and Ni++ did not influence the activity of the enzyme. Slight activation by the chlorides of Cd++, Zn++, Hg++, Co++, Mg++ and Ca++ could not be clearly differentiated from the effects of metalloproteinate formation. EDTA and benzethonium chloride inhibited the catalytic activity. In human sera no low molecular weight inhibitors were detectable. Catalytic concentrations were usually in the range below 10 U/l (37 degrees C). The coefficients of variation were found to be 9.1% intraserial and about 14.5% day-to-day. The preliminary upper limit of "normal" range was established as 8.0 U/l (37 degrees C). Comparative simultaneous determinations of the catalytic concentrations, using L leucine-, L-alanine-, glycine, gamma-L-glutamic- and L-proline-p-nitranilide in the sera of 372 patients, suggest a special diagnostic role for proline arylamidase. The continuous method has been adapted for Vitatron-AKES-Analyser. PMID- 6854221 TI - Changes in plasma protein profiles in serum and in liver DNA synthesis of rats following administration of alpha-amanitin, phalloidin and/or carbon tetrachloride. AB - The aim of the present study is to investigate the capacity of damaged rat liver cells to respond to a second inflammation by a change in plasma protein profile, while the first inflammatory process is in progress. Quantitation of these effects would be useful, especially in situations where patients are suffering from complications due to emergence of a new pathological factor. We therefore studied the effect of phalloidin on rat livers already made necrotic by oral intubation of CCl4. Our data showed that a decrease in acute-phase response does not necessarily always imply healing, but may also be indicative of a second pathological complication. PMID- 6854222 TI - Serum total hydroxyproline assay: effects of age, sex and Paget's bone disease. AB - An assay was developed for total hydroxyproline (protein, peptide and free) in 12 h fasted human serum. Values obtained from 80 adults judged normal by laboratory and physical examinations showed age and sex effects; values increased with age and were higher for men. Assay of serum samples from 22 patients with Paget's bone disease revealed values significantly above normal taking age and sex into consideration (p = 0.001). Serum alkaline phosphatase and serum hydroxyproline values for these patients were correlated (r = 0.91). Serum total hydroxyproline may be a useful assay for evaluating metabolic bone diseases but age and sex must be taken into consideration in the interpretation. PMID- 6854223 TI - The measurement of amniotic fluid alpha 2 macroglobulin by fixed time kinetic immunoturbidimetry. AB - We have developed an assay for alpha 2 macroglobulin in amniotic fluid, based on the technique of Fixed Time Kinetic Immunoturbidimetry. The assay is precise (CV 5% between assays) and has a detection limit of 0.4 mg/l. We have determined the reference range for alpha 2 macroglobulin from 100 amniotic fluid samples from none Neural Tube Defect pregnancies. The data indicates no significant variation of alpha 2 macroglobulin with gestational age and that the results in none Neural Tube Defect pregnancies showed a narrow reference range with a mean of 1.67 mg/l and -/+ 2 SD range of 0.23--3.11 mg/l (99 percentile = 3.65 mg/l). Results in 25 Neural Tube Defect pregnancies are presented. PMID- 6854224 TI - HDL sphingomyelin determinations in normal individuals and patients with type IV hyperlipoproteinaemia. AB - In 138 men and 79 women sphingomyelin values in the supernatant of sera obtained by precipitation of apolipoprotein B-containing lipoproteins ( = high density lipoprotein-sphingomyelin, HDL sphingomyelin) were determined using an enzymatic method. In men, lower HDL sphingomyelin values were obtained (0.22 +/- 0.06 mmol/l) than for women (0.24 +/- 0.05 mmol/l) (p less than 0.05). In both sexes HDL sphingomyelin values were independent of age, with the exception that in men greater than or equal to 55 years, HDL sphingomyelin concentrations were lower. The correlation coefficients calculated for HDL sphingomyelin and hypertriglyceridaemia and relative body weight were lower than the correlation coefficients calculated for the corresponding HDL cholesterol values and both risk factors. In women with hypertriglyceridaemia (greater than or equal to 2.28 mmol/l) HDL sphingomyelin values were lower than those for normotriglyceridaemic women within the same age group, while in male hypertriglyceridaemic patients within the same age group there were no differences in HDL sphingomyelin values in comparison to normotriglyceridaemic male subjects. In both sexes the differences measured between hypertriglyceridaemic and normotriglyceridaemic subjects for HDL sphingomyelin were lower than for the corresponding HDL cholesterol values. The results obtained show that HDL sphingomyelin values are not simply a reflection of HDL cholesterol values. PMID- 6854225 TI - Determination of HDL phosphatidyl choline by an enzymatic method. AB - A routine method is described for the enzymatic determination of phosphatidyl choline in the apolipoprotein B-free supernatant after precipitation of blood sera with phosphotungstic acid/MgCl2. The principle of this method is based on the specific cleavage of phosphatidyl choline by purified phospholipase C from B. cereus, and the enzymatic determination of choline by choline kinase after hydrolysis of phosphoryl-choline. The enzymatic method provides HDL phosphatidyl choline values which coincide with those of the conventional chemical method. Furthermore, the values obtained with the enzymatic method for the HDL fraction isolated by ultracentrifugation (1.063--1.21 kg/l) also closely coincide with those of the apolipoprotein B-free supernatant fraction. The precision, linearity and sample stability were also checked. The findings obtained show that the enzymatic assay introduced here is suitable for the routine determination of phosphatidyl choline in the apolipoprotein B-free supernatant. PMID- 6854226 TI - [Determination of protein in cerebrospinal fluid: comparison of the Coomassie Blue method and the Cu-Folin differential test]. AB - Comparison of within-run and between-day imprecision of protein assays using CSF controls as well as 96 random CSF samples from the routine laboratory shows that the Cu-Folin differential test and the Coomassie-Brilliant-Blue method from Bio Rad are equally suited to total protein determination in cerebrospinal fluid. Problems possibly arising with very low concentrations of CSF or urine protein and the influence of some drugs often used in the neurological clinic are presented and discussed. PMID- 6854228 TI - Thiopental monitoring by gas-chromatography. AB - A gaschromatographic method is presented for the determination of thiopental (and of its metabolite pentobarbital) in cases of severe head injuries treated by induction of therapeutic barbiturate coma. To 1 ml serum the internal standard and saturated ammonium sulphate solution are added. The mixture is extracted by chloroform and the concentrated organic phase is injected into the gaschromatograph (stationary phase: SP 2510 DA). Imprecision from day to day: Coefficient of variation 7.7%; recovery 97%. The specificity was checked by comparison with the retention time of more than 80 drugs. One determination is accomplished within 1 hour. PMID- 6854229 TI - International Federation of Clinical Chemistry, Committee on Education: A scheme for a two year postgraduate course in clinical chemistry, recommendations 1981. PMID- 6854227 TI - [Collaborative tests of steroid hormone determinations: accuracy and precision of analytic results]. AB - In the years 1977 to 1981, 14 quality-control surveys for the determination of steroid hormones were performed in cooperation with the Deutsche Gesellschaft fur Klinische Chemie. Hereby the laboratories participating could in each case analyze the following steroids: aldosterone, cortisol, oestradiol-17 beta, oestriol, progesterone, and testosterone. In the light of the results an investigation was made as to whether, in the course of time, an improvement in the accuracy or in the precision of the determinations had been attained, and to what extent the determinations depend on the qualities of the test material. A clear improvement in the accuracy of the results of the analyses could only be ascertained for oestradiol-17 beta. For aldosterone and cortisol, values were found in pool-plasma whose medians were significantly above the definitive values. An improvement in precision could be noted especially with oestradiol-17 beta and to lesser degrees with cortisol and oestriol. The kind of test material- plasma which contained only the hormones to be analyzed on the one hand, and, on the other hand, pool-plasma, which also contained all endogenous hormones--had no influence on the precision of the results from various laboratories. Low concentrations of the individual steroids led--on the basis of the methodological principle of radioimmunoassays--in almost all cases to a reduced interlaboratory precision in regard to values. The accuracy of the analysis values was considerably impaired only with aldosterone and oestradiol-17 beta by low concentrations: the medians here were in part twice as high as the definitive values. PMID- 6854230 TI - Bioluminescent and fluorometric techniques for determinations of 19 metabolites of ADP/ATP-dependent transformations in energy metabolism in 200 (or 400) mg muscle. AB - A procedure is described for the determination of the following 19 metabolites in 200 mg gastrocnemius muscle from guinea pig: glucose 1-phosphate and 6-phosphate, fructose 6-phosphate, fructose 1,6-bisphosphate, glyceraldehyde 3-phosphate, dihydroxyacetone phosphate, 3-phospho- and 2-phosphoglyceric acid, phosphoenolpyruvate, pyruvate, glycerol, glycerol 3-phosphate, AMP, ADP, ATP, inorganic phosphate, creatine, creatine phosphate. Bioluminometric and fluorometric techniques for mono- and dinucleotide determinations were used. In the case of fluorometric measurement for NADH, 400 mg tissue were necessary. The coefficient of variation for assays on the same sample was 0.04 for bioluminometric techniques and 0.10 for fluorometric techniques. PMID- 6854231 TI - Species-dependent variables in blood cerebrospinal fluid barrier for proteins. AB - Cerebrospinal fluid/plasma concentration quotients for immunoglobulin G (I) and albumin (A) were determined in guinea pigs. Age and sex-dependent influences on these quotients (I/A) were analyzed and compared with the values for human lumbar, cisternal and ventricular cerebrospinal fluid. The ratio I/A, which characterizes the molecular size-dependent selectivity of the blood cerebrospinal fluid barrier function for proteins, was found to be a constant in a single species, but showed marked interspecies differences. PMID- 6854233 TI - Enzymes used in clinical chemical analysis. PMID- 6854232 TI - Plasma protein determination as a clinical probe for liver injury in rats induced by thioacetamide, alloxan or ixoten. AB - As a result of traumata, cancer or chemical poisoning the level of acute-phase proteins released by the liver undergoes a significant change which can be measured by two-dimensional immunoelectrophoresis. To investigate whether inflammatory reactions following chemical poisoning, tissue necrosis or other treatments result in an uniform change of the plasma protein profile, we examined quantitatively the change in plasma protein profile in the following model situations: 1) alloxan-induced diabetes in rats, 2) thioacetamide-induced liver cirrhosis and 3) ixoten-induced blocking of DNA synthesis in rat liver. Even though the three agents used in the present study or their metabolites directly interacted with liver cells, they did not evoke a uniform change of the plasma protein profile. PMID- 6854236 TI - [Urinary enzymes and other quantitative urinary parameters in animal research. Abstracts]. PMID- 6854235 TI - Immunonephelometric quantitation of apolipoprotein E in human serum. AB - A laser immunonephelometric procedure for the determination of apolipoprotein E in human serum and lipoprotein fractions was developed. Coefficients of variation were 2.3% within-run, 4.7% between-run. The distribution of apolipoprotein E in various lipoprotein fractions revealed a higher proportion of apolipoprotein E in VLDL in hypertriglyceridaemic subjects (especially marked in Type III patients) than in normal subjects. Laser immunonephelometry appears suitable for the routine measurement of apolipoprotein E. PMID- 6854234 TI - The chromatographic separation of glycosylated haemoglobins: a comparison between macro- and micromethods. AB - The microchromatographic determination of "fast haemoglobins" is currently used in long-term control of diabetes: its use is made easier by commercially available kits, that are impaired by some analytical variables. For a good standardization of these kits a comparison with an accurate method of analysis is necessary. The macrochromatographic column allows the determination of each fast component with a good precision, and reveals the great complexity of human haemoglobin. Comparison of the two methods shows that the most appropriate temperature of elution for the kit is 20 degrees C and that the increase in the fraction of "fast haemoglobins" in diabetic samples is only related to the HbA1c component. PMID- 6854237 TI - Empirical studies of ethics in family medicine. PMID- 6854238 TI - Continuity of care for families. PMID- 6854240 TI - Organic brain dysfunction and the difficult patient. AB - Sixteen patients considered "difficult" by the staff of a family practice center were matched for age and sex with sixteen "average" patients, and both groups were tested on two standard indicators of organic brain dysfunction. Both groups of patients showed abnormal impairment of visual-motor coordination, with greater impairment among the difficult patients. Difficult patients showed significantly greater impairment of verbal abstract reasoning, indicating problems with cognitive skills. These findings suggest the presence of organic brain dysfunction among the difficult patients, yet none carried a diagnostic listing or hypothesis of organicity. With the current emphasis upon the "biopsychosocial" medical model, patients with organic brain impairment may be mislabeled with psychiatric or psychosocial diagnoses. PMID- 6854239 TI - A patient homebound by panic: understanding and treating agoraphobia. PMID- 6854241 TI - Abdominal pain in a university family practice setting. AB - Abdominal pain is one of the most common complaints in the family practice setting. Abdominal pain has been the subject of many studies; however, the focus has been on abdominal pain as a final diagnosis rather than as a symptom or presenting complaint. A retrospective audit examined 133 charts of patients 18 years of age or older presenting to the University of Iowa Family Practice Center from July 1976 to October 1978. Abdominal pain, etiology undetermined, accounted for approximately one half of the final diagnoses. The patients tended to be young and female. Almost one half of the patients were seen only once for the problem. Conclusions concerning management are drawn, and suggestions for further studies are made. PMID- 6854242 TI - Sex bias in the assessment of patient complaints. AB - This study investigates the contention that physicians have prejudicial attitudes toward female patients. One hundred twenty of 220 (58 percent) primary care physicians returned questionnaires that recorded their attitudes toward two hypothetical patients, one with a headache, one with abdominal pain. By changing only the gender of nouns and pronouns, two otherwise identical versions of each case had been constructed, one case describing a female patient, one a male patient. The physician subjects recorded their attitudes on a semantic differential scale designed to measure three dimensions of attitudes toward patients: authenticity, impression of severity of illness, and emotionality. The physicians judged the female patients to be more emotional (P less than .05) but no less authentic or ill than the male patients. PMID- 6854244 TI - How family physicians approach ethical problems. AB - The defining features of family medicine as described in the literature have important ethical implications. In an attempt to study the day-to-day practice of family physicians regarding these ethical issues, a 28-item questionnaire was sent to 95 part-time and 17 full-time family physician teachers associated with the University of Western Ontario's Department of Family Medicine. Of the 112 questionnaires mailed out, 97 were returned for a response rate of 86.6 percent. There was a significant spread of answers, suggesting there is no uniform opinion in the sample population. The findings suggest that there are important differences between the description of family medicine in the literature and what the family physicians in this study do in their day-to-day practice. The family physicians in this study, while prepared to coerce patients, were not prepared to discharge from their practices patients who were noncompliant. Physician age is an important variable in some ethical decisions, but not in others. PMID- 6854243 TI - A study of family practice in New York City. AB - The purpose of this study was to describe the family physician's patient population in epidemiologic terms and to elucidate why a person would choose to see a family physician rather than other specialists in an urban area. The patient populations of family practices in New York City are described in terms of their demographic and practice attendance characteristics. Comparing their family physicians with other specialists, the patients rated their family physicians on the 12 aspects of care shown in the literature to be most important to patients in terms of physician consulting behavior (continuity, comprehensiveness, family care, rapport, low cost, convenience, interest, time with patient, support, personalized care, convenience of appointment and follow up, and waiting time). Family physicians scored significantly better than other specialists on each aspect of care (P less than .0001). This study indicates that patients choose to consult family physicians rather than other specialists in New York City because patients view the family physician as performing better than other specialists those aspects of care most important to the patient. There is a need for further study to determine the attitudes of patients seeing other specialists. PMID- 6854245 TI - A study of humanism in family physicians. AB - The purposes of this study were to examine humanism as exhibited in physicians and to develop and standardize an instrument measuring humanism in physicians. This study had four specific objectives: (1) to determine whether family practice residents are more humanistic than internal medicine and surgery residents, (2) to determine whether there is a difference in the level of humanism in residents in different years of training, (3) to determine the relationship of demographic characteristics to level of humanism, and (4) to determine the relationship of family practice residency characteristics to level of humanism. The Physician Humanism Scale was developed, pretested, modified, and then administered to a sample (600) of family practice, internal medicine, and surgery residents. The study identified that family practice residents are significantly more humanistic than internal medicine and surgery residents, although no difference in level of humanism was identified according to year in residency. Significant relationships were identified between humanism and sex, race, age, marital status, and college major. Residency characteristics significantly related to humanism were numbers of residents, full-time faculty, nonphysician faculty, and associated residencies; hospital size; and moonlighting policy. PMID- 6854247 TI - Practice location as a function of medical school and residency location: implications for resident selection. AB - Numerous studies have documented an association between the state in which a physician practices and prior education in that state. To determine whether this relationship exists for recent family practice residency graduates, 95 randomly selected programs in which residents completed training in 1979 were surveyed to obtain information regarding practice location and medical school location for their graduates. Seventy-nine percent of physicians completing residency and medical school in the same state also practiced in that state. Of those completing residency in a state other than that of their medical school, 43 percent stayed in the state of their residency to practice, and 22 percent returned to the state of their medical school. An analysis of the impact that a policy restricting house staff positions to in-state students would have on physician supply for the state reveals that only about 10 percent more physicians would be expected to start practice in a state if such a policy were implemented. PMID- 6854246 TI - Nutrition teaching for family practice residents. AB - A nutrition curriculum based on principles of adult education has been developed and implemented. Through use of joint counseling as the main educational process, patient education remains the resident's responsibility with the faculty dietitian acting as consultant. At any point the resident has the opportunity to apply nutrition knowledge and to give independent nutritional counseling. Videotapes of independent counseling sessions allow self-evaluation and also permit assessment of each resident's nutrition teaching competencies. Pre-testing of each resident entering the program, followed by post-testing one month prior to graduation, permits curricular evaluation. PMID- 6854248 TI - Teaching venous cutdown techniques with models. AB - A venous cutdown may be required in emergency situations in order to establish an intravenous line. Subclavian vein catheterization is now widely used, but may result in significant complications and is often inappropriate when a safer distal vein cutdown could be performed. Inanimate models can be used to teach this valuable technique and have the advantage of availability for repeated practice. PMID- 6854249 TI - Infectious mononucleosis in third trimester of pregnancy. PMID- 6854250 TI - Workplace observation: key to a meaningful office history. PMID- 6854251 TI - Availability time of tritium-labeled DNA precursors in newt eyes following intraperitoneal injection of 3H-thymidine. AB - Following intraperitoneal injection of 3H-thymidine into host newts, iris together with a regenerating lens was transplanted from a donor eye into a lentectomized host eye at frequent intervals for 20 hours and then every 1 or 2 days for 14 days. The eyes were fixed 2 hours and 1 or 2 days after implantation and autoradiographs prepared. Following fixation 2 hours after operation, incorporation of 3H-thymidine into DNA, as evidenced by grain counts over nuclei, fell rapidly for 3.5 hours after injection and was no longer apparent after 4.5 hours. However, almost one-half of the implants were lightly labeled when they remained in the host eyes for 1 or 2 days beginning from 1 to 14 days after isotope injection. When these implanted, regenerating lenses were left in the host eyes for longer periods of time, then a light label was found over nuclei in most of the implants remaining in the eye for 3 to 24 days. When 3H-thymidine was injected from 1 to 3 days after extirpation of both lens and neural retina, before DNA synthesis had been initiated in the pigmented retinal epithelium or iris, there were numerous cases of labeled nuclei among depigmenting cells of the pigmented retinal epithelium which was regenerating a new neural retina from 2 to 25 days after isotope injection. Depigmenting cells of the dorsal iris and regenerating lens were similarly labeled. These results provide evidence for the continued availability of small amounts of tritiated DNA-precursor molecules which can be incorporated in DNA of proliferating cells long after the initial injection of 3H-thymidine. PMID- 6854252 TI - Survival of mouse embryos frozen-thawed slowly or rapidly in the presence of various cryoprotectants. AB - Eight-cell mouse embryos were frozen by using glycerol, ethylene glycol, or erythritol as the cryoprotectant. The samples were slowly cooled (0.5 degrees C/min) to temperatures between -10 and -79 degrees C before direct transfer to liquid nitrogen (-196 degrees C) and thawed slowly (approximately 20 degrees C/min) or rapidly (approximately 500 degrees C/min). The highest survival rates of embryos in 1 and 2 M glycerol were obtained after transfer to -196 degrees C from -40 to -79 degrees C, regardless of the thawing rate (72 to 90%), except for those of embryos thawed slowly in 2 M glycerol, in which case highest survival rates were obtained after transfer from -70 and -79 degrees C (78 to 82%). With slow thawing, survival of embryos in 1.2 M ethylene glycol reached maximal levels at transfer temperatures between -50 and -79 degrees C (82 to 89%) and with rapid thawing at transfer temperatures between -40 and -79 degrees C (84 to 90%). The highest survival rates of slowly thawed embryos in 0.6 M erythritol were obtained after transfer to -196 degrees C from -35 and -40 degrees C (53 to 55%) and of rapidly thawed embryos after transfer from -30 degrees C (46%). These results show that the transfer temperatures to liquid nitrogen, at which the highest survival rates of mouse embryos are obtained, vary with the cryoprotectant and the thawing rate. It appears that with glycerol and ethylene glycol mouse embryos are less sensitive to the thawing rate when slowly cooled to lower subzero temperatures before rapid cooling. PMID- 6854253 TI - Intrafollicular pressure promotes partial evacuation of the antrum during hamster ovulation in vitro. PMID- 6854254 TI - Fertilization and cleavage of bovine follicular oocytes in rabbit reproductive tracts after maturation in vitro. AB - Bovine follicular oocytes cultured in vitro in Ham's F-12 based medium for 27 hours were transferred to the oviducts of rabbits pretreated with 75 IU hCG 24 hours previously. Frozen-thawed bull spermatozoa were inseminated into the uterus of rabbits 0, 2, 4, 6, 9, and 12 hours before oocyte transfer. Fertilization and cleavage were examined in the oocytes recovered from the oviduct and uterus 24 and 48 hours later. The criteria of fertilization were the presence of an enlarged sperm head, sperm tail, and pronuclei in the vitellus. Bull spermatozoa inseminated 4 hours before oocyte transfer showed the highest rates of fertilization at both 24 and 48 hours (35% and 38%) compared to the other preincubation times. The numbers of cleaved oocytes were also greater at these times. The results indicate that the capacitation time of cryopreserved bull spermatozoa in the rabbit reproductive tract is the same as in the bovine tract- i.e., 4-6 hours. PMID- 6854256 TI - Evidence for inherent morphogenetic properties of the myogenic regions of the embryonic chick wing. AB - The dorsal and ventral myogenic regions were isolated from the right and left wings of donor chick embryos. After removal of the ectoderm, the myogenic regions were grafted into the dorsal myogenic region of the right wing of host embryos in normal or reversed proximal-distal orientation. All grafts were made so that the surface of the graft originally in contact with ectoderm was dorsal. It was expected that myogenic regions grafted into the myogenic region would participate in the normal formation of the host wing. However, after 7 days of further development many of the host wings had developed abnormal cartilages. To investigate the interactions between the tissue of the host and the tissue of the graft and the source of the tissue giving rise to ectopic cartilages, the donor embryos were labeled with tritiated thymidine. The location and shape of the graft were recorded at the time of the operation. The host wings and adjacent body wall were fixed 1, 3, and 4 days after the operation, sectioned, and prepared as autoradiographs. The location of the grafted cells in the host wing was determined by reconstructing the host wing and adjacent body wall. Serial sections and the reconstructions were examined to discover the correlates of abnormal cartilage formation. The following observations were made: 1) Grafts from the dorsal region of the right and left wing in normal orientation participated in the formation of the groove at the base of the wing ventral to the nineteenth somite that produces the extensor surface of the elbow. Grafts from the ventral region of the right and left wing in normal orientation, and all grafts in reversed orientation, did not participate in the formation of the groove. 2) Grafts in normal orientation increased in length on the axis of the humerus and did not increase in width. Grafts in reversed orientation increased in both length and width. Increase in width caused the graft to extend into the proximo-caudal corner of the wing. 3) Wings with grafts from the dorsal regions of the right and left wings in normal orientation were not clearly abnormal 4 days after the operation. When the groove ventral to the nineteenth somite did not form normally, ectopic cartilage differentiated where the groove should have been from grafted cells of the myogenic region. Increase in width of the graft into the proximo-caudal corner of the wing produced an increased mass of graft cells ventral to the nineteenth somite and an increased amount of ectopic cartilage. PMID- 6854255 TI - Sustained branchial apnea in the Australian short-finned eel, Anguilla australis. AB - Branchial and cutaneous O2 uptake as well as branchial ventilatory stroke volume and frequency were measured by twin-chamber respirometry in conscious unoperated eels (Anguilla australis) at 20 degrees C. The branchial ventilatory pattern comprised alternating periods of apnea and eupnea, together constituting a "Standard Breathing Cycle" (SBC = 1 apneic period plus the ensuing period of eupnea). SBC time in 17 eels averaged 15.5 min of which only 23% was devoted to eupnea. Reduction of the PO2 of inspired water from 155 to 80 torr significantly increased the proportion of time devoted to eupnea to 49% of SBC time without significantly changing SBC time. Absolute cutaneous O2 uptake (5.8 ml O2 X h-1 X kg-1) was largely independent of the frequency or occurrence of eupnea, with the relative contribution of the skin to total O2 uptake averaging 47%. The histological appearance of the skin in A. australis is very similar to that described in A. anguilla: eel skin is only poorly vascularized. It was concluded that the skin may contribute to O2 requirements other than its own, and that this adaptation is a consequence of the unusual intermittent pattern of gill ventilation. PMID- 6854257 TI - Can differences in limb regeneration ability between individuals within certain amphibian species be explained by differences in the quantity of innervation? AB - In some species of amphibians, the regenerative response to limb amputation is not uniform. For example, regenerative ability varies from one individual to another within the species Xenopus laevis, Ambystoma maculatum, and Amphiuma tridactylum. In many species, limb regenerative ability declines with increasing age. The objective of this investigation was to determine if this variation in regenerative ability can be explained by variation in the quantity of innervation. In each of the above-named species, limbs were amputated and allowed to regenerate. The quantity of innervation (percentage of cross-sectional area of amputated surface occupied by nerves) was measured in the amputated part of the limb as close as possible to the amputation surface. The presence, rate, or extent of limb regeneration in that specific limb was then compared to the quantity of innervation at the amputation surface. The results indicated that there was no correlation between innervation and the rate or extent of regeneration in Xenopus laevis or Ambystoma maculatum. On the other hand, in Amphiuma tridactylum, those limbs that regenerated were the ones that had the highest levels of innervation. In Ambystoma maculatum, the quantity of innervation was measured at five different stages, from early larvae to mature adult. The results showed that the quantity of innervation was highest during the larval period, reaching a maximum at the late larval stage before declining greatly to the adult level. It appears that the decline in regenerative ability in the adult cannot be attributed solely to a reduction in innervation to below the threshold level. PMID- 6854258 TI - The culture of chick embryo mesoderm cells in hydrated collagen gels. AB - Chick embryo mesoderm cells are various stages of differentiation were cultured in three-dimensional matrices of hydrated collagen. The tissues used were: stage 5 mesoderm from regions adjacent to the primitive streak; stage 12 mesoderm, comprising somitic, unsegmented (segmental plate) and lateral plate mesoderm; and stage 18 sclerotome. Explants were examined by phase contrast microscopy, including time-lapse, and scanning and transmission electron microscopy. The cells showed an increased ability to adhere to, and move in, the collagen gel with advancing stage. Of the stage 12 tissues, the unsegmented mesoderm was initially the slowest to grow out of the explant. Sclerotome cells showed by far the greatest ability to move within the gel. Where the collagen fibrils were randomly oriented, the cell morphology was polypodial and advancing lamellipodia showed clear undulations at their leading edges. A distinction was drawn between these undulations and the classical major ruffles which are seen in two dimensional culture to uplift and pass back along the cell surface. The latter were not seen in the collagen matrix and were presumably suppressed by the three dimensional culture configuration while the leading edge undulations were not. Ultrastructural examination showed that the cells possessed patches of amorphous material on their surface, which was sometimes interposed between the plasma membrane and collagen fibrils. Addition of hyaluronic acid (2 mg/ml) had an effect only the segmented mesoderm, where outgrowth was enhanced. Although the addition of plasma fibronectin (50 micrograms/ml) to the cultures did not affect any of the tissues, the removal of this substance, by antifibronectin antiserum or by the use of fibronectin depleted serum, inhibited outgrowth in most cases. The only tissue not reproducibly inhibited in this way was sclerotome. Alignment of the collagen fibres by the explants was observed, accompanied by an elongation of the outgrowing cells which, in bipolar form, preferentially moved up and down the aligned tracts. Scanning electron microscopy suggested that cell processes attached to, and presumably exerted tension on, bundles of fibrils thereby pulling them into line. Cell-to-cell contact was not accompanied by contact paralysis as judged by time-lapse micrography. PMID- 6854259 TI - Neurologic constructs of learning disabilities: the physician's role. PMID- 6854260 TI - Psychiatric implication of learning disabilities. PMID- 6854261 TI - Language disorders: of primary concern in learning disabilities. PMID- 6854262 TI - Learning disabilities and language disorders: Florida schools report. PMID- 6854263 TI - The University of Florida Multidisciplinary Diagnostic and Training Program. PMID- 6854264 TI - Social skills affect quality of life for learning disabled. PMID- 6854265 TI - A survey of obstetrical practice activity in Florida. PMID- 6854266 TI - Selective phenylglyoxalation of functionally essential arginyl residues in the erythrocyte anion transport protein. AB - The red cell anion transport protein, band 3, can be selectively modified with phenylglyoxal, which modifies arginyl residues (arg) in proteins, usually with a phenylglyoxal: arg stoichiometry of 2:1. Indiscriminate modification of all arg in red cell membrane proteins occurred rapidly when both extra- and intracellular pH were above 10. Selective modification of extracellularly exposed arg was achieved when ghosts with a neutral or acid intracellular pH were treated with phenylglyoxal in an alkaline medium. The rate and specificity of modification depend on the extracellular chloride concentration. At 165 mM chloride maximum transport inactivation was accompanied by the binding of four phenylglyoxals per band 3 molecule. After removal of extracellular chloride, maximum transport inhibition was accompanied by the incorporation of two phenylglyoxals per band 3, which suggests that transport function is inactivated by the modification of a single arg. After cleavage of band 3 with extracellular chymotrypsin, [14C]phenylglyoxal was located almost exclusively in a 35,000-dalton peptide. In contrast, the primary covalent binding site of the isothiocyanostilbenedisulfonates is a lysyl residue in the second cleavage product, a 65,000-dalton fragment. This finding supports the view that the transport region of band 3 is composed of strands from both chymotryptic fragments. The binding of phenylglyoxal and the stilbene inhibitors interfered with each other. The rate of phenylglyoxal binding was reduced by a reversibly binding stilbenedisulfonate (DNDS), and covalent binding of [3H]DIDS to phenylglyoxal-modified membranes was strongly delayed. At DIDS concentrations below 10 10 micrometers, only 50% of the band 3 molecules were labeled with [3H] DIDS during 90 min at 38 degrees C, thereby demonstrating an interaction between binding of the two inhibitors to the protomers of the oligomeric band 3 molecules. PMID- 6854270 TI - 17D yellow fever virus infection of P388D1 cells mediated by monoclonal antibodies: properties of the macrophage Fc receptor. AB - Thirteen IgG monoclonal antibodies to the envelope protein of 17D yellow fever virus (17D YF) were produced. All of the antibodies, whether type-specific to 17D YF or flavivirus cross-reactive, mediated antibody-dependent enhancement (ADE) of virus growth in P388D1 cells. There was no consistent relationship between ADE titres and the degree or pattern of neutralizing and/or haemagglutination inhibition activity. Monoclonal antibodies of different isotypes were used to investigate further the properties of P388D1 Fc receptors. The effects of trypsin treatment of P388D1 on ADE were similar to those previously described in experiments measuring direct binding of IgG proteins or rosetting of sheep red blood cells (SRBC) by macrophages, demonstrating sensitivity to digestion by trypsin of the Fc receptor for monomeric IgG2a but not for IgG2b. Aggregated myeloma proteins of IgG2a and IgG2b isotypes competed equally well with either IgG2a or IgG2b monoclonal antibodies to 17D YF in inhibition of ADE. However, selective inhibition by the homologous isotype was observed when rosetting by P388D1 of SRBC coated with IgG2a or IgG2b monoclonal antibodies was examined. These results may help to explain apparent discrepancies previously reported between experiments utilizing direct binding of IgG proteins and those using rosetting of antibody-coated SRBC to examine Fc receptor properties and indicate that immune complexes of virus and antibody resemble aggregated immunoglobulins with respect to macrophage Fc receptor function and differ from antibody-coated SRBCs. PMID- 6854271 TI - A colorimetric assay for quantification of defective interfering particles of respiratory syncytial virus. AB - A colorimetric assay for defective interfering (DI) particles of respiratory syncytial (RS) virus was developed. This quantitative biological assay is based on neutral red dye uptake by DI particle-protected cells that survive standard virus challenge. This assay was more sensitive than the reduction of infectious yield (RIY) assay and was capable of detecting 1 X 10(4) to 2 X 10(4) DI particles/ml. The coefficient of variation for parallel, simultaneous replicates (n = 10) was 23%. Cell-protecting activity in the colorimetric assay appeared simultaneously with activity in the RIY assay on undiluted passage of plaque purified virus. Both activities were particulate, were inactivated by RS virus antiserum and exhibited similar ultraviolet-inactivation kinetics. The absolute values of the slopes of dilution curves for both assays were similar, and using regression analysis both assays enabled estimation of similar numbers of active particles. These results suggest that both activities are mediated by the same DI particle. The mechanism of cell protection does not appear to involve extracellular interferon because the inclusion of interferon antibody in the assay did not diminish DI particle cell protection. Finally, the colorimetric assay was used to reveal alternating cycles of infectious and DI virus production on serial undiluted passage. PMID- 6854269 TI - Patterns of single- and double-stranded hepatitis B virus DNA and viral antigen accumulation in infected liver cells. AB - Liver sections from five patients with persistent hepatitis B virus (HBV) infection and active cirrhosis were shown to contain intracellular HBV DNA by in situ hybridization using cloned 3H-labelled HBV DNA probes. Two classes of infected cells, with different distributions throughout the liver, were distinguished: (i) cells containing a low copy number of double-stranded HBV nucleotide sequences, confined to the cell nucleus and thought to represent HBV DNA, and (ii) cells containing large amounts (estimated to be greater than 10 or 15 genome copies per cell) of HBV DNA, much of it in a single-stranded form and largely confined to the cell cytoplasm; these single-stranded regions represented widely separated regions of the HBV genome, in contrast to the structure of the DNA in mature virions. It is likely that these latter cells may be supporting viral DNA synthesis. Cells with large amounts of cytoplasmic HBV DNA invariably contained hepatitis B surface antigen (HBsAg) and in addition contained either no detectable hepatitis B core antigen (HBcAg), or cytoplasmic HBcAg or nuclear HBcAg in that order of frequency. Cytoplasmic HBcAg was highly predictive of the presence of large amounts of cytoplasmic HBV DNA in the same cell, while either nuclear HBcAg, or cytoplasmic HBsAg, were often seen both in cells with and without such levels of DNA. These patterns, relating HBV DNA and antigen content in naturally occurring asynchronous infection in a heterogeneous cell population, should provide a background to further studies of the virus replication cycle with a defined experimental system, when such a system becomes available. PMID- 6854267 TI - Ionic mechanisms underlying the responses of off-center bipolar cells in the carp retina. I. Studies on responses evoked by light. AB - Off-center bipolar cells show hyperpolarizing responses to spot illumination in the receptive field center and depolarization responses to an annulus in the surround. To understand the ionic mechanisms underlying these responses, we examined the current-voltage relationship of these bipolar cells, input resistance changes during their light-evoked responses, and the reversal potentials of these responses. Off-center bipolar cells generally showed inward rectification when they were hyperpolarized and outward rectification when they were strongly depolarized. The membrane potential at which the I-V relationship deviated from linearity varied in individual cells. Hyperpolarizing center responses were generally accompanied by a resistance increase, irrespective of signal inputs either from red-sensitive cones or from rods, and the response polarities reversed at greater than +50 mV. Depolarizing surround responses were accompanied by a resistance decrease with a reversal potential at about +28 mV (one case). From the above observations, it is suggested that the center responses are generated by a decrease in sodium conductance (gNa) and the surround response is generated by an increase in gNa. PMID- 6854268 TI - Ionic mechanisms underlying the responses of off-center bipolar cells in the carp retina. II. Studies on responses evoked by transretinal current stimulation. AB - Transretinal current pulses flowing from the receptor side to the vitreous side of the retina cause transient release of transmitter from the photoreceptor terminals, and in off-center bipolar cells they evoke transient depolarizations with a brief (less than 1 ms) synaptic delay. Since it is known that the presence of Na+ in the external medium is not essential for this type of transmitter release, we used this procedure to examine the role of [Na+]o in the generation of light-evoked responses (hyperpolarizing to spot illumination in the receptive field center and depolarizing to an annulus in the surround) of this type of bipolar cell. When the cell membrane was steadily depolarized by current injection through the recording microelectrode, the depolarizing response evoked by the transretinal current pulses decreased in amplitude and reversed its polarity at above +45 mV. Conversely, the response amplitude increased when the cell was steadily hyperpolarized. The reversal potential seems to be lowered in low [Na+]o (28 mM). Removal of Na+ from the superfusate hyperpolarized the cell and both the light-evoked and current-evoked responses disappeared. From these observations, it is hypothesized that the hyperpolarizing center response of the off-center bipolar cells is a result of removal of sustained depolarization produced by sodium permeability increase. PMID- 6854273 TI - The avirulent A7 Strain of Semliki Forest virus has reduced cytopathogenicity for neuroblastoma cells compared to the virulent L10 strain. AB - Molecular and host range properties of the virulent L10 strain of Semliki Forest virus were compared to those of the avirulent A7 strain. No difference could be detected between the two strains in adsorption, nucleocapsid synthesis, protein synthesis, ratio of 42S:26S RNA, particle infectivity, interferon induction and susceptibility, or defective interfering particle production. A7 showed lower total RNA synthesis than L10 in BHK, G26-24 (oligodendroglioma) and C1300 (neuroblastoma) cells. Cytopathogenicity of A7 was reduced compared to L10 in C1300 cells but not in G26-24 cells. It is concluded that the avirulent A7 strain has similar host range and molecular properties to the neurovirulence mutants M9 and M136, and that demyelination may be produced by a similar mechanism. PMID- 6854272 TI - Analysis of sequences of simian adenovirus SA7 (C8) DNA in transformed rat cells and hamster tumour cells. AB - Different methods of molecular hybridization were used to study DNA sequences of the highly oncogenic simian adenovirus SA7 (C8) present in the genomes of two transformed rat cell lines and in cells from three hamster tumours induced by adenovirus SA7. The entire DNA or the left-hand terminal SalI C fragment (19.5% of the genome) were employed. All cell lines retained an intact left-hand region of the SA7 genome (0 to 12.4 map units). The blot hybridization technique failed to detect any site specificity of integration of SA7 DNA into the cell genome. In all cell lines the expression of the Bg/II D fragment (1.8 to 10 map units) of SA7 DNA was observed. As judged by the patterns of integration of virus sequences into the cell genome, the highly oncogenic simian adenovirus SA7 (C8) is similar to the non-oncogenic human adenoviruses of group C, and is different from the highly oncogenic human adenovirus type 12. PMID- 6854274 TI - Neutralizing and non-neutralizing monoclonal antibodies to the E2 glycoprotein of Semliki Forest virus can protect mice from lethal encephalitis. AB - Two monoclonal antibodies (UM 4.2 and UM 5.1) directed against the glycoprotein E2 of Semliki Forest virus (SFV) are described; both belong to the IgG2a isotype but are of different idiotype. Analysis employing isoelectric focusing resulted in different focusing patterns for both monoclonals (UM 4.2, pI 8; UM 5.1, pI 7.2). They further differed in their ability to neutralize virus. The UM 4.2 antibodies were inactive in neutralization, while the UM 5.1 antibodies exceeded conventional mouse hyperimmune serum in this respect. Both monoclonal antibodies, however, were able to protect mice passively from a lethal infection with SFV. Based on the amount of protein, the UM 5.1 antibodies were 100-fold more effective than the UM 4.2 antibodies in mouse protection tests. PMID- 6854275 TI - Purification and molecular weight determination of measles virus genomic RNA. AB - A purification procedure for genomic measles virus RNA, free of contaminating smaller RNA and of DNA, is described. Viral nucleocapsids were prepared from MA160 cells infected in spinner cultures with measles virus (Edmonston strain). Nucleic acid was extracted, treated with DNase and RNA sedimenting at about 50S in sucrose gradients was isolated. This method yielded 0.5 to 1.5 micrograms of genomic RNA per litre of culture. A molecular weight of 4.5 X 10(6) was determined by gel electrophoresis under fully denaturing conditions. PMID- 6854276 TI - Biochemical characterization of eel virus european. AB - The polypeptide and RNA compositions of purified virions of eel virus European were compared to those of three strains (VR-299, SP and AB) of infectious pancreatic necrosis virus (IPNV) isolated from trout. All three IPNV strains could be distinguished by the relative mobilities of either the virion polypeptides or the double-stranded RNA genome segments. The eel virus had a similar polypeptide profile to strain AB IPNV but differences between the two viruses in the migration of genome segments indicated each was unique. PMID- 6854278 TI - Family correlates of male childhood gender disturbance. AB - In the context of a review of adult cases of gender disturbance, a clinical study was pursued on the status of fathers, father-substitutes, and older male siblings for 46 boys with deviations in male role development. Significantly fewer male role models were found in the family backgrounds of the severely gender-disturbed boys as compared to the mild-to-moderately gender-disturbed boys. Male childhood gender disturbance was also found to be correlated with a high incidence of psychiatric problems in both the mothers and fathers and with atypical patterns of the boys' involvement with their mothers and fathers, as measured by the Bene Anthony Family Relations Test and the Rekers Behavior Checklist for Childhood Gender Problems. PMID- 6854277 TI - Infant Gesell scores vs. cognitive skills at age 12 years. AB - In an earlier study, it was found that infant performance on the Gesell correlated better with performance on nonverbal than verbal cognitive skills up to the age of 5 years. Recently, the same 26 male middle-class Ss, now 12 years old, were retested with the WISC-R, WRAT, and PPVT. Performance on the Gesell was found to relate significantly to WISC-R Performance IQ and to a lesser extent to PPVT IQ, but did not relate to WISC-R Verbal IQ nor to performance on the WRAT. The results suggest that the Gesell has a better predictive validity for nonverbal than verbal cognitive skills. PMID- 6854279 TI - The relationship between developments in self-and peer perception during adolescence. AB - The hypothesis that self-perceptions would be more advanced developmentally than peer perceptions was assessed. The sample consisted of 80 males between 15 and 18 years of age. A structured interview was employed to obtain descriptions of self and a best friend. These data were coded into systems defining the constructs of differentiation, abstraction, and integration. The study's hypothesis was supported. A developmental model was presented to integrate the data on self and social cognition. PMID- 6854280 TI - Tactual access and stimulus dimensionality as determinants of young children's identification and transformational questions. AB - Thirty-six preschool children were invited to look at a set of stimulus materials. One-third of the children were presented with three-dimensional materials that they were free to touch, one third with three-dimensional materials that they could not touch, and one-third with life-size photographs of the objects. Results revealed that the children in each group asked a similar number of questions to identify the names of the objects. However, children who could touch the objects asked the most "transformational" questions (e.g., questions involving broader speculations about the object's origin, function, and relation to other objects in the environment), while those who could not touch the objects asked the next most and those shown photos of the objects asked the least. PMID- 6854281 TI - Psychological sexual identity and hemispheric orientation. AB - The study examines gender and psychological sexual identity as alternative bases for the development of hemispheric orientation. Hypotheses anticipated that females place greater reliance upon right hemisphere functions, such as imagery and emotion, whereas males place more emphasis upon left hemisphere functions, such as logical reasoning. This was extended to an examination of the roles of masculinity and femininity within genders upon hemispheric orientation. With a sample of 219 male and 221 female adults, it was found that the male-left hemisphere orientation/female-right hemisphere orientation dichotomy was supported in part. However, this relationship appears to be moderated by a second dimension: females appear more internally oriented, males more externally oriented. PMID- 6854282 TI - Numerosity estimation with successive presentation: item organization. AB - Previous studies have shown that, with simultaneous presentation, highly organized patterns were overestimated in number compared with random patterns. In an exploratory attempt to apply Das et al.'s model of simultaneous and successive cognitive processes to perception, 62 Ss were asked to estimate the number of items presented visually one at a time. A rate of one item per second was used, and Ss were required to read each item aloud in order to prevent counting. When the stimuli were digits, no difference was found in the estimates for sets of stimuli containing high information vs those containing low information. When words were used as stimuli, estimates were significantly lower for words in sentences than for the same words in random order. PMID- 6854283 TI - Concept discrimination learning by preschool children using facial stimuli differing in age, sex, race, and eyeglasses. AB - In two experiments, the relative salience of the variables age, sex, race, and eyeglasses was determined with the use of a discrimination learning task and preschool-age Ss. The stimuli for the task were 112 frontal head and shoulder color photographs arranged in pairs. In both experiments, sex discrimination was the easiest to learn, followed by race and age, which did not differ from each other. Each of the variables of sex, age, and race, however, proved to be more salient than glasses which was not learned by any of the 19 Ss who were given a glasses discrimination problem in Experiment 1. Interestingly, specific cue salience may be a more valid concept than dimensional salience for preschool children. This was indicated by the asymmetry in performance on the black and white racial discrimination problems and on the male and female sexual discrimination problems: both black and male were significantly easier to learn. PMID- 6854284 TI - The effects of cigarette smoking on verbal learning and retention. AB - The effects of smoking a low (.7 mg) and a middle (1.3 mg) nicotine yield cigarette on paired-associate learning and retention under conditions of high and low intralist interference, and on serial learning and retention, were examined in groups of male undergraduate smokers (N = 24). The interaction between nicotine level and task difficulty in paired-associate learning was marginally significant. The 1.3-mg nicotine dose impeded learning under low interference conditions, but facilitated learning of high interference sets. Both nicotine levels significantly improved retention in paired-associate learning; task difficulty appearing to have little relevance. Serial learning data suggested that the effect is shown on long-term, rather than short-term memory. PMID- 6854285 TI - Saccharin hoarding by albino rats: further evidence on incentive and object retrieval. AB - Albino rats were allowed to retrieve dental pledgets soaked in water or pledgets soaked in 1.0% saccharin solution from wooden alleys into their home cages. Under ad lib conditions more saccharin pledgets were hoarded than water pledgets, but during water deprivation this preference was reversed. If rats were given saccharin pledgets alone, hoarding did not decline during water deprivation. Rats showed the ad lib saccharin preference although they did not hoard their normal diet of food pellets, and it was maintained in animals that had received saccharin since weaning. Hence sweetness of taste is a property of objects that can induce hoarding, and the reversal in hoarding during deprivation is due to an increased preference for water rather than a diminished saccharin preference. This indicates that incentive properties of objects are crucial to the expression of this species-typical behavior. PMID- 6854287 TI - The effect of problem difficulty, locus of control, and sex on task persistence. AB - The purpose of this study was to investigate the influence of problem difficulty, instructional set, locus of control, and sex of S on time expended by college students to solve a puzzle. Three groups of college students (N = 120), each equated for test scores on internal and external locus of control and for sex, were divided as follows: the members of one (n = 40) were told that the problem they were being asked to solve would be difficult; the members of a second were told the problem would be easy; and the members of a third were given no instructions on the difficulty of the problem. The task of the Ss was to form a pattern from a set of small plastic shapes; however, the problem was actually unsolvable. The response measure was the length of time the Ss chose to devote to solving the problem. The results revealed that the Ss in the high difficulty group devoted more time to the task than the Ss in the low difficulty (p less than .06) and control conditions (p less than .05). All other effects were nonsignificant. The results suggested that the Ss in the high-difficulty group perceived their failure to solve the problem to be less of a threat to their self esteem than did the Ss in the other groups, and as a result devoted more time to the task. PMID- 6854288 TI - Defensive burying: the effects of single vs multiple presentation of the aversive stimulus. PMID- 6854286 TI - Active and passive tactual recognition of form. AB - Subjects (N = 30) actively touched forms with the preferred palm or were restricted to passive touch, where forms were either statically or sequentially pressed on the palm. Visual matches to tactual standards were made with unlimited stimulus exposure time. Active touch was superior to both forms of passive touch in recognition accuracy. The provision of sequential presentations and stimulus change failed to aid passive touch. PMID- 6854289 TI - Social outcome compared in psychotic and nonpsychotic bipolar I patients. AB - Eighty-nine bipolar I patients were given a structured interview, the Schedule for Affective Disorders and Schizophrenia. Those who had experienced delusions or hallucinations at some time during the course of their illness were designated "psychotic," and those who had not were designated "nonpsychotic." The two groups were compared with regard to a number of outcome variables as well as age, age at first treatment, and duration of illness. The psychotic group had significantly poorer outcome in terms of social functioning. Although age, age at first treatment, and duration of illness distinguished between the two groups of patients, statistical analyses indicated that these variables did not account for differences in social outcome. PMID- 6854290 TI - Do alexithymic traits predict illness? AB - The common theoretical speculation that alexithymic personality characteristics (impoverished fantasy life and difficulty expressing feelings verbally) lead to psychosomatic disease was tested in a sample of 181 men. Unlike previous investigations, this study used a measure of alexithymic characteristics taken at least 1 year before any of the men became ill. Comparisons were made of the premorbid MMPI alexithymia scale scores of groups of men who remained well for 10 years or within 10 years developed either physical illness (cancer or benign tumors), "classical" psychosomatic disease (hypertension or gastrointestinal ulcers), or psychiatric disorder (schizophrenia). Results did not support the notion that alexithymia leads to illness onset. There were no significant differences among the groups in their premorbid alexithymia scores. Furthermore, the groups did not differ in the percentage of individuals labeled alexithymic with the use of previously established cut-off points. Although the findings cast doubt on alexithymia as a cause of illness, they do not conflict with the idea that alexithymia can result from the stress of disease or that this type of personality configuration may lead to a decreased response to treatment and a prolonged course of illness. PMID- 6854291 TI - Sleep in narcolepsy and depression. Does it all look alike? AB - Depression has been reported to be frequent in narcolepsy and has been considered to be variously a reaction to chronic sleepiness or an endogenous expression of the pathophysiology of narcolepsy. Supporting the latter possibility are reports of similarities between the nocturnal rapid eye movement (REM) sleep of narcoleptics and inpatients with endogenous depression. In a comparison of 25 consecutive narcoleptics and 25 age-matched outpatient primary depressives, significant group differences were found in nocturnal EEG sleep measures of sleep continuity, sleep architecture, and REM sleep. Twenty per cent of the narcoleptic sample met Research Diagnostic Criteria (RDC) for a past history of major or chronic intermittent depression, but 60 per cent did not meet RDC criteria for any present or past psychiatric disorder. These findings mandate a cautious reevaluation of the nature of depressive symptoms in narcolepsy and leave open the question of whether there are common neurobiological control mechanisms in narcolepsy and depression. PMID- 6854292 TI - The micropsychopathology of hebephrenic/catatonic schizophrenia. AB - All hospital records, interviews, and notes are reviewed on a group of 52 chronic hebephrenic/catatonic schizophrenics who were institutionalized before the era of antipsychotic medications. The authors catalog the presence or absence of individual symptoms of schizophrenia on a year by year basis over a span of 25 years and present this data in a series of bar graphs. Symptoms such as avolition, impaired social interaction, and flat affect become more frequent over the 25 years of follow-up. Hallucinations and delusions become less frequent. Eighteen of the patients are noted to have had a DSM-III personality disorder premorbidly and eight of these are characterized as schizoid personality disorder. Level of insight is found to be poor at the onset of schizophrenia and deteriorates further over the next 5 years. Although the study design contains a sampling bias in favor of chronically institutionalized cases, several lines of evidence suggest that the trends reported here are not artifacts of institutionalization but are due to schizophrenia. PMID- 6854293 TI - Inter-rater reliability of twelve diagnostic systems of schizophrenia. AB - The present and past symptomatology of 31 chronic schizophrenics was rated by four independent judges, two experienced clinical psychiatrists and two psychiatric residents, in a context more representative of actual clinical practice than most research studies. Ratings were made on 64 symptoms derived from 12 diagnostic systems, based on either live or videotaped interviews for present symptomatology and case records for past symptomatology. Inter-rater reliabilities were higher for present than for past symptoms, and in general did not approach those reported for highly trained raters. There were no differences between live and videotaped interviews. Diagnostic systems differed widely in rater agreement. The most consistent across both past and present symptomatology were the systems of Langfeldt, Schneider, and DSM-III, for which the level of reliability was consistent with other studies. PMID- 6854294 TI - Facial electromyography and reactivity in depression. PMID- 6854296 TI - Foreign body ingestion associated with delusional beliefs. PMID- 6854297 TI - Schizophrenia and multiple sclerosis. AB - A case of multiple sclerosis was diagnosed as paranoid schizophrenia 10 years earlier. The schizophrenic disorder, severe and almost nonremittent for 10 years, failed to respond to adequate drug therapy. The computerized axial tomography scan revealed moderate atrophy of the anterior cerebellar vermis, a finding of interest in view of studies which have implicated anterior vermis pathology in the pathogenesis of schizophrenia. PMID- 6854295 TI - The therapist as mentor: an aspect of clinical work with schizophrenic outpatients. AB - The schizophrenic's ability to master stressful situations, events, and internal states is a crucial dimension of his overall functioning. To the extent that the clinician can identify his patient's strengths and teach him how to utilize them constructively in moments of stress, he enhances the patient's potential to function more autonomously. The clinician must also have a good understanding of his patient's deficits, and must be aware of those times at which direct intervention in a patient's life may be necessary to prevent psychotic regression. This case history presents a clinical situation in which the therapist's understanding of his patient's strengths and weaknesses led to the resolution of a clinical crisis, and blocked the emergence of a full-blown psychotic episode. A model for understanding the nature of the therapeutic interaction is presented and discussed. PMID- 6854298 TI - Postpartum depression. A role for social network and life stress variables. AB - Depressed (N = 11) and nondepressed (N = 19) women who had recently given birth were compared on several life stress measures and indices of structural and qualitative characteristics of their social networks. We predicted that depressed subjects diagnosed on the basis of Research Diagnostic Criteria would have experienced more stressful life events since the beginning of pregnancy and since delivery. We also predicted that depressed subjects would have fewer confidants and receive less instrumental and emotional support from their network members. These predictions were largely confirmed, except that the two groups did not differ on number of confidants. The social support provided by spouses appeared to be especially important. Implications of these findings for life events and social network research are discussed. PMID- 6854299 TI - Psychological well-being in United States Air Force fliers. PMID- 6854301 TI - An empirical analysis of specific syndromes of violent behavior. AB - One hundred thirty-eight neuropsychiatric outpatients were rated according to relevant behavioral parameters of violence. A cluster analysis based on these ratings yielded five homogenous subgroups. Two groups, which differed only in severity of violence, were defined by a behavioral pattern closely resembling the episodic dyscontrol syndrome. One group was defined by infrequent but very severe violence, one by relatively infrequent violence of lesser severity, and one by no history of violence. These groups were clearly differentiated by a number of variables including neurological and psychiatric diagnoses, verbal aggression parameters, and neurological and psychiatric history variables. A specific etiology for violence, even within relatively homogenous subgroups, was not supported, with results suggestive of multiple determination by biological and psychosocial factors. On the other hand, different patterns of potential etiological factors were identified for different groups, which holds implications for theoretical understanding of violence and for differential diagnosis, treatment, and prevention. PMID- 6854300 TI - Selecting psychotherapists to participate in psychotherapy outcome studies. Relationship between psychotherapist characteristics and assessment of clinical skills. AB - The procedures developed for assessing specific psychotherapist skills are described, and the relationships among judges' ratings of these skills and selected therapist characteristics are examined and discussed. Data for 27 therapist applicants indicate a positive relationship between overall ratings of therapist skill and the age and level of experience of the psychotherapist applicants, with older, more experienced therapists being judged as more empathic and having greater potential to function effectively in short term interpersonal psychotherapy. In contrast, psychotherapists' gender and professional degree failed to predict judges' ratings. PMID- 6854303 TI - The near-death experience scale. Construction, reliability, and validity. AB - Near-death experiences (NDEs) have been described consistently since antiquity and more rigorously in recent years. Investigation into their mechanisms and effects has been impeded by the lack of quantitative measures of the NDE and its components. From an initial pool of 80 manifestations characteristic of NDEs, a 33-item scaled-response preliminary questionnaire was developed, which was completed by knowledgeable subjects describing their 74 NDEs. Items with significant item-total score correlations that could be grouped into clinically meaningful clusters constituted the final 16-item NDE Scale. The scale was found to have high internal consistency, split-half reliability, and test-retest reliability; was highly correlated with Ring's Weighted Core Experience Index; and differentiated those who unequivocally claimed to have had NDEs from those with qualified or questionable claims. This reliable, valid, and easily administered scale is clinically useful in differentiating NDEs from organic brain syndromes and nonspecific stress responses, and can standardize further research into mechanisms and effects of NDEs. PMID- 6854305 TI - Hostile words and assaultive behavior on an acute inpatient psychiatric unit. AB - This report analyzes the relationship of hostile verbalizations to assaultive acts committed by 110 male schizophrenic patients on an acute psychiatric unit. It was found that patients who were verbally assaultive and threatening also tended to be physically assaultive. Assaults rarely occurred in the absence of verbal threats or abuse, and 32 per cent of violent patients could be identified on the basis of the occurrence of hostile verbalizations. PMID- 6854304 TI - Differential effects of Vietnam combat experiences vs. criminality on dangerous behavior by Vietnam veterans with schizophrenia. AB - Psychiatric patients with Vietnam combat experience have often been described as violent, and it has been hypothesized that their violence may be due either to Vietnam combat experiences or longstanding psychopathic tendencies, including criminality before entering the service. Criminal and military history of Vietnam era veterans diagnosed schizophrenic by DSM-III criteria were examined in relation to inpatient measures of assault. Seventy subjects were examined, of which 27 were in Vietnam and 19 of these 27 in combat. By using multiple regression techniques, it was determined that certain violent tendencies in schizophrenic Vietnam era veterans are better related to their war experiences than premorbid criminal behavior. PMID- 6854306 TI - Multiple personality and primary affective disorder. AB - This report describes a young woman who met research criteria for both primary depression and multiple personality. Abnormal dexamethasone suppression test results supported the former diagnosis and returned to normal during electroconvulsive therapy in anticipation of depressive symptom resolution. This suggests that multiple personality may occur as an epiphenomenon of affective disorder or of other illnesses. PMID- 6854302 TI - Familial subtypes of childhood hyperactivity. AB - On the basis of family history data we defined two subtypes of childhood hyperactivity: family history-positive (FH+), in which at least one biological parent of the child had a diagnosis in the antisocial spectrum; and family history-negative (FH-), in which neither parent had such a diagnosis. While children in both subgroups were equally deviant on measures of the core components of childhood hyperactivity (e.g., inattention and reactivity), the FH+ children were also deviant on dimensions of conduct disturbance and had siblings with a high prevalence of conduct disorder. FH- children showed little evidence of conduct disturbance, had more learning and academic problems, and had siblings with attentional and learning disabilities, but not conduct disorder. These findings suggest that the study of family constellations should be a fruitful method for resolving the heterogeneity of the hyperactive child syndrome. PMID- 6854308 TI - Acyltryptophols reversibly inhibit muscle contractions caused by the actions of acetylcholine and raised potassium ion concentrations. AB - 1. Acetylmethoxytryptophol, originally isolated from the pineal gland, inhibits both the nicotinic and muscarinic receptor stimulatory activities of acetylcholine on frog rectus muscle and guinea pig ileum. 2. Synthetic homologues and analogues, including the acetyl-, propionyl-, butyryl-, and valeryl methoxytryptophols, tryptophols and alpha-methyl-tryptophols have been prepared and shown to possess similar activity on the frog muscle, with butyryl compounds being the most active. Methoxytryptophol, tryptophol, alpha-methyltryptophol and acetylhydroxytryptophol possess little or no activity. 3. All acyltryptophols tested inhibit the effect of increased potassium concentrations on frog muscle. 4. It is concluded that the acyltryptophols act not at the transmitter receptor level but either at the potassium ion channel or elsewhere in the cell membrane. PMID- 6854307 TI - A prostaglandin-adrenergic link occurs in the hypothalamic pathways which mediate the fever induced by vasopressin in the rat. AB - The effects of direct administration of vasopressin into the preoptic anterior hypothalamus on thermoregulatory functions were assessed in conscious rats at various ambient temperatures. Intrahypothalamic administration of vasopressin caused fever, increased metabolic heat production and decreased heat loss (cutaneous vasoconstriction) in rats. There was no changes in respiratory evaporative heat loss in response to administration of these drugs. Furthermore, it was found that the fever reactions induced by intrahypothalamic vasopressin was antagonized by pretreatment of animals with an intrahypothalamic dose of either yohimbine (an alpha-adrenergic receptor antagonist), propranolol (a beta adrenergic receptor antagonist), or sodium acetylsalicylate (a prostaglandin synthetase inhibitor). The data indicate that a prostaglandin-adrenergic link occurs in the hypothalamic pathways which mediate the vasopressin-induced fever in rats. PMID- 6854310 TI - Day/night rhythmicity in the methylating capacities for different 5 hydroxyindoles in the pineal, the retina and the Harderian gland of the golden hamster (Mesocricetus auratus) during the annual seasons. AB - In the pineal, the Harderian gland and the retina of the golden hamster the day/night capacity for the synthesis of different methoxyindoles is investigated under natural conditions for one 24-hour period in the months of December, March and June. The amounts of the methoxyindoles and the diurnal rhythms in the synthesis are different in the various months during which the tests were performed. There is a striking increase in the synthesis of melatonin and methoxytryptophol in all three organs in June as compared with December. Equally striking is the high synthesis of methoxytryptamine in the pineal in June, whereas this compound was not formed in the Harderian gland and the retina in this month. Methoxytryptophan synthesis was not observed in June in any of the three organs. Methoxyindoleacetic acid rhythmicity shows a pattern more or less identical to that of melatonin and methoxytryptophol. A high synthesis exists at the end of the June day, but greater fluctuations during the days of the two other months. Acetylmethoxytryptophol is synthesized in the pineal during the night in March, but in the late afternoon in June. The largest quantity of this compound is found in the Harderian gland in December, in the pineal in March and in the retina in June. The largest amounts of melatonin and methoxytryptophol are synthesized when gonadal weight is largest. The possible correlation between the amounts synthesized, the rhythmicities in synthesis and the reproductive system is discussed. PMID- 6854312 TI - Output of endogenous monoamine oxidase inhibitor in rats: effect of ethanol, tryptamine and tryptophan. AB - Contrary to prediction, loading rats with tryptamine, tryptophan or methanol failed to produce any rise in endogenous monoamine oxidase inhibitor output, whilst ethanol administration resulted in a significantly decreased excretion. These findings, which provide no support for the hypothesis that the inhibitor is a beta-carboline, may shed some light on the tranquilizing effect of ethanol in man. PMID- 6854311 TI - The activity of monoamine oxidase -A and -B in brains from chronic alcoholics. AB - The activity of monoamine oxidase--A was found to be lower in homogenates of hypothalamus and caudate nucleus, but not in cortex of the gyrus cinguli and hippocampus, from chronic alcoholics with respect to homogenates from autopsy cases without histories of alcohol abuse. The activity of monoamine oxidase--B was also lower in the alcoholics, but this could be due to the selective effect of age upon this enzyme form, since the alcoholics were younger than controls. No difference was found for either monoamine oxidase -A or -B activities in brain homogenates from an alcohol preferring (AA) strain of rats, with respect to those from a water preferring (ANA) strain. PMID- 6854313 TI - Inhibition by naloxone of the serotonin-induced prolactin release in free-moving rats. AB - The effect of the opiate antagonist naloxone on serum prolactin after treatment with serotonin, arginine vasotocin (AVT) or melatonin was studied in prepubertal and adult unanesthetized rats. Prolactin was quantified in blood samples withdrawn through an intrajugular silastic cannula from undisturbed ovariectomized adult rats. After taking a basal sample, animals were injected through the cannula with naloxone (0.8 mg/kg) and 5 min later with serotonin creatine sulphate (6.4 mg/kg), AVT (20 micrograms/kg), melatonin (4 mg/kg) or saline; new samples were taken 15 and 30 min thereafter. Injection of serotonin was followed by a 10-fold increase of prolactin levels 15 min later; this increase was drastically reduced, although not abolished, by pretreatment with naloxone. In animals injected with saline, AVT or melatonin, no significant changes in serum prolactin were observed. In a second group of experiments, 30 day-old female rats injected with serotonin creatinine sulphate (10 mg/kg, i.p.) exhibited a 6-fold increase in serum prolactin 15 min after injection; this increment was reduced but not abolished by pretreatment with naloxone (5 mg/kg, i.p.). It is postulated that the prolactin releasing effect of serotonin is mediated, at least in part, by an opioid receptor. PMID- 6854314 TI - Electroretinographic and ultrastructural study of the regenerated eye of the snail Cryptomphallus aspersa. AB - The electroretinographic responses of regenerated eyes of snails (C. aspersa) were studied by means of suction electrodes and single or repetitive flash stimulation. The eyes were fixed and observed under light and electron microscopy. The results indicate that the electroretinographic response of regenerated eyes does not differ from control eyes after dark adaptation. However, the repetitive stimulation of the regenerated eyes induced an earlier fatigue of the response, evident after the fifth stimulus. This fatigue is a function of light intensity. Ultrastructural features of the regenerated eyes are similar to those of the control eyes but regenerated eyes show smaller rhabdomeres, fewer photic vesicles, and fewer paracrystalline bodies. It is suggested that the regenerated eye lability to the repetitive stimulation might be due to the decrease in the amount of photic vesicles and paracrystalline bodies, to the decrease in membrane surface of the rhabdomeres, or to some other metabolic failure not distinguished at electron microscopic level, like the membrane ionic regulation. The appearance of photic vesicles in the axon cones of regenerated and stimulated cells also suggests a possible failure in the mechanism of transport of vesicles. PMID- 6854309 TI - Acyltryptophols reversibly inhibit the uptake of thymidine after phytohaemagglutinin transformation of human lymphocytes. AB - 1. Lymphocytes were stimulated for 72 hours with phytohaemagglutinin (PHA), [3H] thymidine was added and, after a further 4 hours incubation, its uptake into DNA was measured. 2. Addition of acetylmethoxytryptophol (aML) and other acyl tryptophols simultaneously with the PHA caused an immediately reversible, dose dependent reduction in uptake of thymidine into the DNA. 3. Similar additions one hour before the addition of thymidine had identical, immediately-reversible effects. 4. Similar addition up to about 30 min after the addition of thymidine showed a reduced but still dose-dependent effect on the amount of DNA radioactivity. 5. It is concluded that aML, and related acyltryptophols, act by inhibition of thymidine uptake into the lymphocyte, in which case the compounds probably dissolve in the lipid bilayer of the membrane and act as channel blockers. PMID- 6854317 TI - The nature of the Ln3+-angiotensin II complex. A 13C nmr study of the binding of Yb3+ to angiotensin II. AB - The nature of the Yb3+-angiotensin II complex is examined by 13C nuclear magnetic resonance. The ytterbium-induced shifts of most resonances are observed to be strongly dependent on pD, while a few are observed to be largely independent of pD. These observations are shown to be consistent with stepwise binding of the lanthanide ion to the carboxylates of aspartic acid and the C-terminus. PMID- 6854316 TI - Kinetics and mechanism of Zn(II) complexation with reduced glutathione. AB - The kinetics of formation and dissociation of mono and bis complexes of Zn(II) with reduced glutathione (H4L+ = fully protonated form) were studied in aqueous solution at 25.0 +/- 0.1 degrees C and ionic strength 0.30 M (NaNO3) in the pH range 4.58 to 4.98 by temperature-jump. The reaction was found to proceed via two different mechanisms depending on degree of ligand protonation. In both cases, complex formation is predominantly if not completely through the sulfur. Reaction with the form HL-2 (only the amino nitrogen protonated), the dominant form of this species, proceeds by the expected rat limiting water loss (dissociative or Eigen) mechanism with rate constants of 9.3 X 10(7) M-1 sec-1 (+/- 24%) for mono and 5.1 X 10(7) M-1 sec-1 (+/- 25%) for bis complex formation. Reaction with H2L- (sulfur protonated) yields rate constants of 3.9 X 10(3) M-1 sec-1 (+/- 43%) for mono and 1.95 X 10(3) M-1 sec-1 (+/- 43%) for bis complex formation. The decrease in rate constant is attributed to blockage of the complexing site on reduced glutathione by intramolecular hydrogen bonding, with proton removal being the rate determining step. PMID- 6854315 TI - Modifications of dynamic and static behavior by small-length perturbations in crayfish stretch receptor organs. AB - To investigate whether static and dynamic sensitivities of slowly and rapidly adapting stretch receptor organs (SAO and RAO, respectively) or crayfish are different when perturbed compared with those in conventional laboratory experiments, receptors were submitted to ramplike length changes of different velocities separated by long-duration, constant lengths of different values. They were perturbed at random by fast, small-amplitude length variations called "jitter." First-order afferent discharges were recorded extracellularly. Quantifications involved the separate estimation of static and dynamic response components. In the SAO, jitter (1) augmented the static sensitivity, (2) decreased the dynamic sensitivity, (3) simplified response profiles by decreasing nonlinearities and increasing transduction fidelity in terms of coding length. In the RAO, jitter (1) changed the behavior from phasic to tonic with length sensitivity, (2) decreased the dynamic sensitivity to values close to those of the unperturbed SAO, (3) increased transduction fidelity for stimulus length and decreased nonlinearities. Perturbation effects suggest that differences between SAO and RAO are more quantitative than qualitative. Moreover, they have general implications and are relevant to other mechanoreceptors at other levels in the CNS. PMID- 6854318 TI - Measurement of total opioid peptides in rat brain and pituitary by radioimmunoassay directed at the alpha-N-acetyl derivative. AB - A sensitive assay, which cross-reacts with and is specific for diverse opioid peptides, is described. This is based on the prior acetylation of samples and subsequent radioimmunoassay with an antiserum highly specific for the acetylated NH2 terminus of opioid peptides. The result is a procedure that can be used to investigate multiple forms of opioid peptides in extracts of biological material. The sensitivity of the assay is approximately 15 fmol of beta-endorphin per incubation tube, i.e., approximately 100-fold greater sensitivity than the radioreceptor assay used in our laboratory. The peptide concentration required for 50% displacement of trace ranged from 0.65 nM (beta-endorphin) to 1.6 nM (Met enkephalin). The assay apparently shows an absolute requirement for a free (or acetylated) NH2 terminus corresponding to either a Leu- or Met-enkephalin sequence. Use of the assay with and without prior acetylation of sample provides a method for estimation of the ratio of acetylated:nonacetylated opioid peptides in crude or fractionated extracts. The procedure is used to investigate the forms of opioid peptide found in rat brain and pituitary. PMID- 6854319 TI - Molecular forms of acetylcholinesterase: regulation in a testosterone-sensitive nerve-muscle axis. AB - We measured the distribution of molecular forms of acetylcholinesterase (AChE) in muscles of a song bird, the zebra finch, and found a pattern similar to those reported in other vertebrates. As in other species, the most rapidly sedimenting form of the enzyme decreases to barely detectable levels following denervation. In the muscles of the syrinx, castration causes a large decrease in AChE activity, but has little or no effect on the relative abundance of AChE forms. This suggests that the number of AChE catalytic sites is changing without affecting the distribution of catalytic sites among the molecular forms. This is in marked contrast with the effect of denervation in the syrinx, which causes changes in the distribution of activity, as well as in total activity. PMID- 6854320 TI - Kainate-enhanced release of D-[3H]aspartate from cerebral cortex and striatum: reversal by baclofen and pentobarbital. AB - A study was made of the actions of the excitant neurotoxin, kainic acid, on the uptake and the release of D-[2,3-3H]aspartate (D-ASP) in slices of guinea pig cerebral neocortex and striatum. The slices took up D-ASP, reaching concentrations of the amino acid in the tissue which were 14-23 times that in the medium. Subsequently, electrical stimulation of the slices evoked a Ca2+ dependent release of a portion of the D-ASP. Kainic acid (10(-5)-10(-3) M) produced a dose-dependent inhibition of D-ASP uptake. The electrically evoked release of D-ASP was increased 1.6-2.0 fold by 10(-5) and 10(-4)M kainic acid. The kainate-enlarged release was Ca2+-dependent. Dihydrokainic acid, an analogue of kainic acid with little excitatory or toxic action, did not increase D-ASP release but depressed D-ASP uptake. Attempts were made to block the action of kainic acid with baclofen and pentobarbital, compounds which depress the electrically evoked release of L-glutamate (L-GLU) and L-aspartate (L-ASP). Baclofen (4 X 10(-6)M), an antispastic drug, and pentobarbital (10(-4)M), an anesthetic agent, each inhibited the electrically evoked release of D-ASP and prevented the enhancement of the release above control levels usually produced by 10(-4)M kainic acid. It is proposed that 10(-5) and 10(-4)M kainic acid may enhance the synaptic release of L-GLU and L-ASP from neurons which use these amino acids as transmitters. This action is prevented by baclofen and pentobarbital. In view of the possibility that cell death in Huntington's disease could involve excessive depolarization of striatal and other cells by glutamate, baclofen might be effective in delaying the loss of neurons associated with this condition. PMID- 6854321 TI - Ceramide synthesis from free fatty acids in rat brain: function of NADPH and substrate specificity. AB - At the subcellular level, the synthesis of ceramide from free lignoceric acid and sphingosine in brain required reconstituted enzyme system (particulate fraction, heat-stable and heat-labile factors) and pyridine nucleotide (NADPH). The mitochondrial electron transfer inhibitors (KCN and antimycin A), energy uncouplers (oligomycin and 2,4-dinitrophenol), and carboxyatractyloside, which prevents the transport of ATP and ADP through the mitochondrial wall, inhibit the synthesis of ceramide in the presence of NADPH but have very little effect in the presence of ATP. Similar to the synthesis of ceramide, the synthesis of ATP from NADPH and NADH by the particulate fraction also required cytoplasmic factors (heat-stable and heat-labile factors). Moreover, ATP, but not its analog (AMP-CH2 P-O-P), can replace NADPH, thus suggesting that the function of the pyridine nucleotide is to provide ATP for the synthesis of ceramide. The cytoplasmic factors were not required for the synthesis of ceramide in the presence of ATP. The maximum velocity for synthesis of ceramide from free fatty acids of different chain lengths (C16-C26) was bimodal, with maxima around stearic acid (C18) and behenic acid (C22). The relative rate of synthesis of ceramide parallels the relative distribution of these fatty acids in brain cerebrosides and sulfatides. PMID- 6854322 TI - Identification of intrinsic sialidase and sialoglycoprotein substrates in rat brain synaptic junctions. AB - Sialidase activity associated with rat brain synaptic junctions (SJ) and synaptic membranes (SM) was determined. Both fractions released sialic acid from exogenous glycopeptides and gangliosides. SJ accounted for 5-10% of the total sialidase activity recovered from SM following extraction with Triton X-100, and the specific activity of SJ sialidase was 60% of that of the parent SM fraction. Intrinsic SJ sialidase hydrolysed 12-15% of the sialic acid associated with endogenous SJ glycoproteins. Sialic acid residues associated with SJ glycoproteins were labelled with sodium borotritide and SJ proteins fractionated by affinity chromatography on concanavalin A-agarose. SJ glycoproteins that reacted with concanavalin A (con A+ glycoproteins) accounted for 25% of the total SJ [3H]sialic acid. Intrinsic SJ sialidase hydrolysed 20% of the [3H]sialic acid associated with these glycoproteins. Each molecular weight class of con A+ glycoprotein previously shown to be a specific component of the postsynaptic apparatus contained sialic acid and was acted on by intrinsic SJ sialidase. PMID- 6854323 TI - Light enhances the turnover of phosphatidylinositol in rat retinas. AB - Light stimulation of isolated rat retinas is shown to enhance the turnover of phosphatidylinositol (PI) as demonstrated by a light-dependent increase in [3H]inositol incorporation and concurrent hydrolysis of existing PI. Studies with rat retinas incubated with [3H]inositol and then microdissected at the level of the outer plexiform layer into photoreceptor cell and inner retina layers indicated that the light-enhanced incorporation of [3H]inositol was associated with the photoreceptor cell layer. The rate of PI hydrolysis in retinas prelabeled in vivo with [3H]inositol was higher in light than in dark incubations and was higher in the photoreceptor cell layer than within the inner retina. Within the photoreceptor cell layer. PI turnover involved 2%/min of the total PI content in dark and 6-8%/min in light. In contrast to what has been reported for stimulus-enhanced turnover of PI in some tissues, this light-enhanced turnover of PI in the retina was not associated with detectable reductions in PI content. Parallel studies of sodium (22Na) uptake demonstrated that the photoreceptor cells remained functional during these incubations as they retained the capacity to restrict the entry of 22Na in light but not in dark. PMID- 6854324 TI - Regulation of rat pineal hydroxyindole-O-methyltransferase in neonatal and adult rats. AB - The relative importance of neural, and some nonneural, mechanisms in the control of pineal hydroxyindole-O-methyltransferase (HIOMT) activity during development and in the adult rat was studied. In neonatal rats, guanethidine-treatment, bilateral superior cervical ganglionectomy (SCGX), or exposure to constant light did not prevent the initial appearance of HIOMT activity, indicating that neural stimulation of the gland is not essential for the development of HIOMT activity. In adult rats, decentralization or removal of the SCG led to a slow fall in HIOMT activity, to about 30% of control activity, indicating that the enzyme is largely under neural control. Additionally, adrenalectomy or hypophysectomy had no effect on HIOMT activity, refuting the suggestion that adrenal and/or gonadal steroids are of major importance in the regulation of this enzyme. The fall in activity of the enzyme after SCGX or exposure to constant light probably does not represent a shift in the Km of the enzyme nor the selective disappearance of a distinct molecular species. Similar changes in HIOMT activity and cyclic GMP responsiveness occur in response to alterations in the length of the daily dark period, adding further evidence to our earlier speculation that there may be a functional relationship between these two. PMID- 6854325 TI - Serotonin-elicited amplification of adenylate cyclase activity in hippocampal membranes from adult rat. AB - The activity of the adenylate cyclase located in membranes prepared from hippocampus of adult rat can be stimulated by serotonin (5-HT) (Ka = 4 X 10(-7) M). The maximal effect is obtained with 10 microM 5-HT. Freezing of the tissue decreases the 5-HT stimulation; this stimulation is optimal in the presence of 82.5 mM Tris-maleate buffer (pH 7.4) and 50 microM GTP. The adenylate cyclase activity of membranes prepared from cortex, hypothalamus, and colliculi of adult rats is not significantly stimulated by 5-HT. Dopamine (DA) also stimulates adenylate cyclase located in hippocampal membranes; its effect can be blocked by haloperidol (10(-6) M), which fails to inhibit 5-HT stimulation. Moreover, p chlorophenylalanine treatment for 2 weeks or selective lesion of 5-HT axons afferent to the hippocampus increases the Vmax of 5-HT stimulation, but fails to change that of DA stimulation. The 5-HT stimulation can be inhibited by metergoline, spiroperidol, and pizotyline (10(-6) M), but not by the same concentrations of mianserin, ketanserine, alprenolol, phenoxybenzamine, and mepyramine. The 5-HT stimulation of adenylate cyclase of hippocampal membranes can be mimicked by tryptamine, 5-methoxytryptamine, bufotenine, and to a lesser extent by LSD; N-methyltryptamine, N-methyltryptophan, and 5-hydroxytryptophan are inactive. Studies with kainic acid suggest that the 5-HT recognition site (5 HT1) linked to adenylate cyclase is located on the membrane of intrinsic hippocampal neurons. PMID- 6854326 TI - Lanthanum binding to murine neuroblastoma cells. PMID- 6854327 TI - Isoguvacine binding, uptake, and release: relation to the GABA system. AB - Isoguvacine (1,2,3,6-tetrahydropyridine-4-carboxylic acid) is a GABA (gamma aminobutyric acid) agonist with limited conformational flexibility. In these studies we investigated the binding, uptake, and release of [3H] isoguvacine by use of tissue preparations of rat CNS, comparing the results with similar studies of [3H]GABA. The results from these investigations indicate that isoguvacine binds to membrane preparations of rat forebrain with pharmacological characteristics similar to the post-synaptic GABA recognition site; that it is transported into synaptosomal preparations by an uptake system similar to the high-affinity GABA uptake system; and that recently accumulated isoguvacine is released in a Ca2+-dependent manner and by heteroexchange with external GABA. The ability of isoguvacine and gamma-hydroxybutyric acid to decrease the K+ stimulated Ca2+-dependent release process was also investigated. The results indicate that isoguvacine interactions have many of the biochemical features of GABA synaptic function, isoguvacine being, however, less potent than GABA. PMID- 6854328 TI - Fractionation of isolated rat CNS myelinated axons by sucrose density gradient centrifugation in a zonal rotor. PMID- 6854329 TI - Purification and characterization of two distinct isozymes of protein carboxymethylase from bovine brain. AB - Protein carboxymethylase (EC 2.1.1.24) from cytosol of bovine brain was found to exist as two apparent isozymes that could be separated by chromatography on DEAE cellulose at pH 8.0. Rechromatography of the two forms, designated PCM I and PCM II, indicated that they are not interconvertible. Both enzymes have a molecular weight of 24,300 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, PCM I consists mainly of one isoelectric form, pI 6.5, whereas PCM II resolves into two forms of pI 5.6 and 5.7. The relative amounts of PCM I and PCM II show a marked tissue dependence. Brain has approximately twice as much PCM I as II, whereas liver contains only the type II enzyme. The two enzymes were found to have similar substrate specificities when tested with five different methyl accepting proteins. Synapsin I, a basic protein associated with synaptic vesicles, was found to be an excellent methyl-accepting protein with regard to its Km (1.2 microM), but it exhibited a low stoichiometry of methyl incorporation. PMID- 6854330 TI - An aminopeptidase from mouse brain cytosol that cleaves N-terminal acidic amino acid residues. AB - An aminopeptidase with specificity directed toward peptides with acidic N terminal amino acid residues has been isolated from mouse brain cytosol. Purification by ion-exchange chromatography and gel filtration resulted in an enzyme that hydrolyzed aspartyl-phenylalanine methyl ester at a rate of 13.2 mumols/min/mg protein at pH 7.5, an increase in specific activity of 1000-fold over that of brain homogenate. Its apparent molecular weight, determined by gel filtration, is approximately 450,000. Dipeptides with N-terminal aspartyl residues are cleaved preferentially to glutamic-containing analogs, and a neutral amino acid (or histidine) is necessary in the adjacent position. For peptides of the form aspartyl-X, relative activity was 100, 81, 71, 66, 19, or 0, where X was alanine, serine, leucine, phenylalanine, histidine, or proline, respectively. Tripeptides were more rapidly hydrolyzed than dipeptides; however, activity tended to decline with increasing chain length. The acidic aminopeptidase can account for almost all of the activity of brain cytosol toward the N-terminal aspartyl residue of angiotensin II, aspartyl-phenylalanine methyl ester or aspartyl-alanine, and the N-terminal glutamyl residue of adrenocorticotropin(5 10). The enzyme was unaffected by bestatin or amastatin. It was inhibited by o phenanthroline and EDTA. The latter effect could be reversed completely by Zn2+ and partially by Mn2+ or Mg2+; Co2+ and Fe2+ had no effect; Ca2+ was inhibitory. These properties distinguish the brain acidic aminopeptidase from aminopeptidase A isolated from human serum or pig kidney and the aspartyl aminopeptidase of dog kidney. PMID- 6854332 TI - Inhibition by quinacrine of depolarization-induced acetylcholine release and calcium influx in rat brain cortical synaptosomes. AB - The effects of quinacrine on depolarization-induced [3H]acetylcholine (ACh) release and 45Ca2+ influx were examined in rat brain cortical synaptosomes. Quinacrine significantly reduced the stimulated release of [3H]ACh by high K+ and veratridine without affecting the spontaneous efflux from the preloaded synaptosomes. Quinacrine had no effect on ionophore A23187-induced release of [3H]ACh from the synaptosomes. Quinacrine (100 microM) markedly diminished the stimulated Ca2+ influx by veratridine and high K+ but not that by "Na+-free." Trifluoperazine, a potent calmodulin antagonist, inhibited both Ca2+ influx and ACh release induced by the depolarizing agents. Inhibitory potencies of the two drugs on ACh release and Ca2+ influx were compared with the antagonism of calmodulin by two drugs, suggesting that the inhibition of depolarization-induced Ca2+ influx and ACh release by these drugs could not be explained by the antagonism of calmodulin. PMID- 6854334 TI - Effect of maternal iron deficiency in rat on serotonin uptake in vitro by brain synaptic vesicles in the offspring. PMID- 6854331 TI - Biochemical and pharmacological characteristics of conjugated catecholamines in the rat brain. AB - Mass-fragmentographic methods are described that enable the simultaneous measurement of total, free, and conjugated catecholamines in brain tissues. These methods were used to assess the distribution, kinetics, and pharmacological characteristics of total, free, and conjugated catecholamines in the hypothalamus, caudate nucleus, hippocampus, and septum. Conjugated norepinephrine (NE) represents approximately 20% of total NE in the hypothalamus, septum, and hippocampus, whereas the percentage is approximately 50% in the caudate nucleus. The percentages of conjugated dopamine (DA) in these brain areas are consistently less than those of NE (approximately 13%). Although in the hypothalamus the steady-state concentrations of total, free, and conjugated NE are over four times higher than those of the corresponding total, free, and conjugated DA, the turnover rates of this DA are comparable with those of the corresponding NE. Further, the ratios of conjugated NE or DA turnover rates to those of the total amines are higher than the corresponding ratios of their steady-state concentrations. Treatments with pargyline (75 mg/kg, i.p.; rats killed 30 and 60 min later) failed to change the contents of conjugated catecholamines in the hypothalamus and the caudate nucleus significantly. Pharmacological manipulation with a number of prototypic drugs revealed that although the assay of conjugated catecholamines might shed additional light on the effects of drugs on central catecholamines, the assessment of total or free amines are on the whole equally informative. In conclusion, a detailed assessment of brain conjugated catecholamines is reported. The information provided, fills a gap in our knowledge that has up to now not been adequately addressed. PMID- 6854335 TI - Non-competitive inhibition of hepatic and intestinal aryl hydrocarbon hydroxylase activities from rats by rifampin. AB - Rifampin is a semisynthetic antibiotic which is known to alter hepatic cytochrome P-450 mediated drug metabolizing enzymes. Using benzo(a)pyrene as the substrate we have shown that rifampin acts as a non-competitive inhibitor of hepatic microsomal aryl hydrocarbon hydroxylase in vitro at or below 0.10 mM and that it is also a non-competitive inhibitor of intestinal aryl hydrocarbon hydroxylase at or below 0.075 mM. These results suggest that the administration of rifampin with other drugs may result in altered drug biotransformation. PMID- 6854333 TI - The S100-b protein: tyrosine residues do not exhibit an abnormal fluorescence spectrum. AB - The beta subunit of the bovine brain S100-b protein (beta beta) lacks tryptophyl residue but contains one tyrosine. Our experiments show that this protein is characterized by a typical tyrosine fluorescence spectrum, with a maximum at 303 nm. Identical fluorescence properties were found for the rat brain S100-b protein. Comparison with the fluorescence spectrum of the bovine brain S100-a' protein (alpha'beta), which contains a tryptophan residue in the alpha' subunit, enables us to demonstrate that the recent report describing an abnormal fluorescence spectrum for the bovine brain S100-b protein may result from a contamination of the S100-b by the S100-a' protein. PMID- 6854336 TI - 3 beta-hydroxy-28-P-coumaroyloxy-lup-20(29)-en-27-oic acid from Caraipa densifolia. AB - Caraipa densifolia Mart. (Clusiaceae) has afforded the new lupene derivative 3 beta-hydroxy-28-p-coumarolyoxy-lup-20(29)-en-27-oic acid (8), whose structure was deduced by chemical correlation with betulin (6). Simiarenol (1), taraxerone (2), friedelin (3), lupeol (4), betulinic acid (5), betulin (6), and beta-sitosterol beta-D-glucoside (7) were also isolated in this study. PMID- 6854337 TI - Plant anticancer agents. XXII. Isolation of a phorbol diester and its delta 5,6-7 beta-hydroperoxide derivative from Ostodes paniculata. PMID- 6854338 TI - Constituents of Couepia paraensis. PMID- 6854340 TI - The sunflower syndrome. A new look at "self-induced" photosensitive epilepsy. AB - The stereotyped, episodic abnormal behaviour manifested by a child and her mother on exposure to a particular sort of sunlight is described in detail. The child is the first fully documented patient with this so-called "self-induced" form of photosensitive epilepsy in whom for several years no electroencephalographic sensitivity to flickering light could be demonstrated. The probability that the cingulate circuit may be the anatomical substrate involved in the pathogenesis of these patients' unusual response to sunlight is discussed. Both patients also exhibited remarkably persistent habit rhythmias--the one common to both being that of circling. PMID- 6854339 TI - Mammalian drug metabolism. AB - Drugs and other chemicals that do not occur in mammalian systems are metabolized by a wide variety of enzymes. Reactions catalyzed by these enzymes have been classified into two general phases. Phase I reactions include oxidations, reductions, and hydrolyses, whereas Phase II reactions are broadly defined as conjugation reactions and include glucuronidation, sulfation, acylation, methylation, and conjugation with glutathione. The mechanisms of these biotransformations are outlined to demonstrate how both non-toxic and toxic metabolites are produced. The mammalian metabolism of acetaminophen, a widely used mild analgesic, and R-(+)-pulegone, the major constituent terpene of pennyroyal oil, will be discussed to illustrate specific features of mammalian drug metabolism. PMID- 6854341 TI - In vivo demyelinating activity of sera from animals with chronic experimental allergic encephalomyelitis. Antibody nature of the demyelinating factor and the role of complement. AB - Sera from guinea pigs and rats with chronic experimental allergic encephalomyelitis were injected into the cerebrospinal fluid (CSF) of normal recipient rats. Guinea pig sera induced demyelination in the central and (or) peripheral nervous system, whereas injection of rat sera resulted in demyelination in the peripheral nervous system only. Control sera did not induce demyelination. Demyelinating activity in guinea pig sera was confined to the IgG fraction; in rat sera the IgG- as well as the IgM-fraction were able to induce demyelination. The demyelinating activity was abolished when the sera were absorbed with with sensitising antigen (guinea pig spinal cord tissue) or when immunoglobulins were removed from the sera. When chronic EAE sera from rats were injected into the CSF of rats, complement was not required for the induction of demyeLination. The presence of complement, however, augmented the demyelinating activity. Decomplemented chronic EAE sera from guinea pigs failed to induce demyelination after injection into the CSF of rats. Injection of control and non demyelinating or demyelinating EAE sera into the subarachnoid space of normal recipient rats induced a weak inflammatory response with increased numbers of large mononuclear cells in the meninges. It is discussed that in vivo a complex interaction of antibodies, complement and effector cells is responsible for induction of demyelination. PMID- 6854344 TI - Protein synthesis in rat brain following neonatal exposure to lead. AB - (1) Suckling rats were exposed to lead through the milk of their dams who received a diet of 4% lead carbonate and weanling rats were exposed to 2 injections of 5.0 mg Pb2+/100 g body weight. The brains were used to prepare the following homogenate fractions: postmitochondrial supernatant, postmicrosomal supernatant, ribosomes, initiation factors. (2) The postmitochondrial supernatant fractions were tested in vitro for protein synthesizing activity using the incorporation of labelled phenylalanine, and phenylalanyl-tRNA into peptide. The preparations from the lead-exposed rats had a significant reduction in activity. (3) Peptide formation with the brain ribosomes was not changed in the lead exposed rats. (4) The aminoacyl-tRNA synthetase reaction was significantly reduced and accounted for most of the reduced peptide formation with brain homogenates from lead-exposed rats. (5) The binding of methionyl-tRNAfMet to ribosomes was increased using initiation factor preparations from the brain of lead-exposed rats. PMID- 6854343 TI - Effect of sera from myasthenia gravis patients on acetylcholine receptors in myotube cultures. PMID- 6854346 TI - The overlapping innervation of the two sides of the external anal sphincter by the pudendal nerves. AB - Unilateral pudendal neurectomy in the monkey results in histological changes consistent with partial denervation on both sides of the external anal sphincter muscle, but much more marked ipsilaterally than contralaterally. Histological features consistent with reinnervation developed during the 9-13 weeks after unilateral neurectomy in the anterior parts of the muscle on both sides. These observations suggest that there is a substantial overlap in the pudendal innervation of the external anal sphincter muscles on the 2 sides. This derives from interdigitation of muscle fascicles across the midline in this circular muscle. This functionally overlapping innervation enables reinnervation to be partially accomplished from the contralateral side. This is important in understanding the results of electrophysiological and histopathological studies of this muscle in patients with idiopathic faecal incontinence, itself a neurogenic disorder. PMID- 6854345 TI - Chronic asymmetrical spinal muscular atrophy. AB - The clinical and neurophysiological features of 18 cases of chronic asymmetrical spinal muscular atrophy are described. These were patients presenting with asymmetrical neurogenic atrophy involving one or more limbs who had no evidence of pyramidal tract dysfunction after 3 or more years of symptoms. There were twice as many males as females and the mean age of onset of the disorder was about 32 years. None of the patients had bulbar involvement. The tendon reflexes tended to be depressed. The distribution of muscle weakness in the limbs was very variable, and only slowly progressive. In 5 cases symptoms and signs were confined to the hands and forearms. Motor nerve conduction velocities to wasted muscles were slightly reduced but there was no evidence of generalised neuropathy. A diagnosis of chronic asymmetrical spinal muscular atrophy, as opposed to that of classical motor neurone disease, is favoured by an age of onset under 40 years, an absence of pyramidal signs or bulbar involvement after 3 years or more of symptoms, and depressed or absent tendon reflexes. The 2 conditions appear to be clinically distinct and prognosis is considerably better in chronic asymmetrical spinal muscular atrophy. The aetiology of this condition in unknown; it may be of relevance that 2 patients in this series had close relatives with Werdnig-Hoffmann disease. PMID- 6854342 TI - Effect of ethanol on synaptosomal sialic acid metabolism in the developing rat brain. AB - The total, glycoprotein-bound and glycolipid-bound sialic acid concentration, ad the activities of ecto-sialyltransferase and neuraminidase were determined in synaptosomes from preweanling ethanol-treated and control rats. The period of treatment corresponded to that of maximal synaptogenesis and peak synthesis of sialoglycocompounds (days 27-37 postconception). The average of the peak blood ethanol concentration was 271 mg/100 ml. In the ethanol-treated animals the sialic acid concentration was significantly reduced (approximately 20%) with an equally distributed decrease of glycoprotein- and glycolipid-bound sialic acid. The activity of ecto-sialyltransferase with asialofetuin as exogeneous acceptor was significantly diminished (about 30%) in the ethanol-treated pups. Neuraminidase showed an unchanged activity after correction for the reduction of endogeneous sialic acid substrate concentration. The total protein and lipid concentrations of the synaptosomal preparations did not differ between the groups. These results suggest that ethanol treatment during on of the vulnerable periods of brain development causes an inhibition of the incorporation of sialic acid into synaptosomal membrane-bound sialoglycocompounds. Such an effect of ethanol exposure might disturb intercellular interactions and the functional performance of the membrane during development, and could be of importance in the pathogenesis of the central nervous system manifestations of the fetal alcohol syndrome. PMID- 6854348 TI - Anticomplementary activity in multiple sclerosis. AB - Anticomplementary activity (ACA) is a common problem in serological work. Often it is regarded as an indicator of circulating immune complexes and has been clinically used as such. In a longitudinal study (Ryberg 1982b) ACA was determined in heated (56 degrees C for 30 min) sera from 35 MS patients followed for up to 5 years; in 18 of them ACA in heated CSF was also assayed. Persistent or transitory ACA of low titre was found in some sequences, usually without evident correlation with clinical events. Marked ACA in unheated sera was found more often in MS patients than in controls and showed dramatic changes in most of 15 sequences studied for this property, sometimes in a way suggesting a correlation with clinical exacerbations. This activity was heat labile and was not bound by an immunosorbent with affinity to human IgG and, therefore, is not likely to represent IgG containing aggregates or immune complexes. PMID- 6854347 TI - The quantification of myotonia. A problem in the evaluation of new antimyotonic drugs. AB - The evaluation of an antimyotonic drug is often difficult since the severity of myotonia is itself hard to assess. The rise in arterial potassium level produced by the infusion of increasing concentrations of potassium chloride brought about reproducible changes in the excitability level of myotonic muscles proportional to the plasma potassium concentration. The excitability changes were assessed by three methods commonly used for evaluating antimyotonic drugs. The duration of the electromyographic relaxation time after maximal voluntary effort proved to be the only test which reliably assessed the variations of muscular excitability proportional to the increased plasma potassium. By contrast, the duration of percussion- or electrically-induced myotonic after-discharges was extremely variable and independent of plasma potassium. PMID- 6854350 TI - Distribution of scalp somatosensory potentials evoked by stimulation of the tibial nerve in man. AB - The scalp distribution of the response to stimulation of the tibial nerve at the medial malleolus was systematically analysed. The somatosensory evoked potential (SEP) was recorded with electrodes placed in a transversal line over the ipsilateral and contralateral postcentral gyri and in a sagittal line over the longitudinal brain fissure. The SEPs recorded over the ipsilateral hemisphere and along the sagittal line were similar to the F response (the response over the foot primary somatosensory region). Over the contralateral hemisphere the waveform of the responses changed obviously from point F to the point C (contralateral hand primary somatosensory region). The C response started with N37, P40 had a longer latency, N50 was not present and the subsequent waves were also considerably different. Mathematical simulation of the responses recorded from the electrodes between points F and C has shown that they represent an electrical algebraic summation of the activity over points F and C. Although the F and C responses may be 2 potentials arising from the opposite sides of a single dipole generator which is located in the medial fissure, it is more probable that the somatosensory evoked potential on tibial nerve stimulation reflects the activity of 2 separate generators. PMID- 6854349 TI - Muscle fiber necrosis associated with human marathon runners. AB - This study describes the events occurring in exercise-induced muscular necrosis. Biopsies of the gastrocnemius muscles of volunteer human marathon runners were extracted prior to and at intervals for 7 days following a marathon, and investigated ultrastructurally. Most of the preparations, including the pre marathon samples, showed evidence of muscle fiber necrosis and inflammation. These preparations had many mitochondria, erythrocytes, leukocytes and other phagocytic cells within the extracellular and extravascular spaces. Less frequently observed were Z-line streaming and degeneration, contracture knots, disrupted sarcolemma, presence of erythrocytes within the muscle fibers, and empty basal lamina tubes in which the contents of the fibers and the sarcolemma had broken down to leave only the basal lamina outlining the former fiber. These abnormal conditions were most prevalent at 1 and 3 days after the marathon. These ultrastructural changes are compared and correlated with the reports of clinical manifestations of rhabdomyolysis and myoglobinuria. Because the abnormalities persist for the 7 day duration of these observations, and because many of these were observed in the pre-marathon biopsies, we conclude that both the intensive training for, and the marathon itself, induce inflammation and fiber necrosis which are manifested in the clinical symptoms for rhabdomyolysis and myoglobinuria. The inflammatory reaction that accompanies these activities may be a major factor in post-exercise soreness. The combined influences of training and necrosis are discussed in relation to muscle fiber type compositions of endurance athletes. PMID- 6854351 TI - Localization of Horner's syndrome. Use and limitations of the hydroxyamphetamine test. AB - The pupillary response to hydroxyamphetamine eye-drops has been advocated as a test for sub-dividing patients with Horner's syndrome into those with lesions of the 1st or 2nd sympathetic neurone (normal dilatation) and those with lesions of the 3rd neurone (no or minimal dilatation). We compared the response of the right and the left eye in 40 control subjects and also in 25 consecutive patients with Horner's syndrome from a known lesion. In the controls, 1 eye might dilate up to 1.0 mm less than the other. In the patients, abnormally weak dilatation (difference with the other eye more than 1.0 mm) occurred only with lesions of the 3rd neurone, but in only 4 of 10 such cases. Of the other 6 patients with a lesion of the 3rd neurone, 2 had a minimal response of the normal eye, and 4 showed subsequent recovery of oculosympathetic function (which suggests that denervation had not occurred). In conclusion, an abnormal hydroxyamphetamine test reliably indicates a lesion of the 3rd neurone, but a normal test provides little diagnostic aid. PMID- 6854352 TI - A clinico-pathological study of a case of kuru. AB - Kuru was diagnosed in a 42-year-old Melanesian male from the Eastern Highlands Province of Papua New Guinea. The clinical features indicated predominant cerebellar degeneration together with widespread cortical neuronal dysfunction and involvement of the diencephalon, hippocampus and basal ganglia. Dementia was an early and prominent feature. The duration of clinical illness was about 12 months and atypically he spent the last 7 months in hospital allowing continuous assessment. At autopsy, spongiform encephalopathy was demonstrated, and inoculation of brain tissue into 4 squirrel monkeys and 1 capuchin monkey resulted in the development of kuru. This is the longest continuous study of kuru in a hospital setting to be recorded in the adult human subject. The virus isolated from the brain of this patient has been adopted as a standard reference strain of kuru for future use and repository. PMID- 6854353 TI - Pathological changes in the nucleus of Meynert in Alzheimer's and Parkinson's diseases. AB - Combined neuropathological and neurochemical assessment of the nucleus of Meynert in senile dementia of Alzheimer type (SDAT) have demonstrated that the cholinergic biochemical activity, choline acetyltransferase, is more extensively reduced in the nucleus (over 90%) than the loss of putative cholinergic perikarya (35%). Acetylcholinesterase histochemical activity was however substantially retained in individual neurones in the nucleus although virtually absent from the neocortex in SDAT. These abnormalities are consistent with a primary degeneration of cholinergic axons projecting to the cortex and secondary loss of perikarya from the subcortical nucleus. In contrast, preliminary observations on cases of Parkinson's disease suggest that the neuronal loss from the nucleus of Meynert may be greater in this disease than in SDAT, and previous studies have not consistently demonstrated a reduction in cortical choline acetyltransferase activities in Parkinson's disease. These observations, together with major differences in the neuropathology of the nucleus in SDAT and Parkinson's disease (neurofibrillary tangle and Lewy body formation, respectively) suggest that the involvement of the cholinergic system may differ in the two disease processes. PMID- 6854355 TI - Mechanisms of pattern generation underlying swimming in Tritonia. II. Network reconstruction. PMID- 6854354 TI - Lateral interactions in absence of feedback to cones. AB - 1. The reversal potential of the surround response in cones was measured by inactivating the outer segment, polarizing the cone to different potential levels with extrinsic current, and flashing a full-field stimulus. This elicited a 3- to 4-mV depolarizing response at the normal -40-mV dark level. Its reversal potential was typically near -60 mV. 2. Cones were also polarized by a steady center light while flashing an annulus. The annular response was suppressed when the cone was polarized to near -60 mV. No reversal was measured, presumably because the maximum center light response could not exceed -60 mV. 3. Items 1 and 2 provide a method for measuring surround responses in cells post-synaptic to the cones in the absence of the surround response in the cones themselves; cone surround responses are suppressed although some horizontal cell surround responses are enhanced (item 6) at high center intensities that polarize the cones to near -60 mV. 4. Bipolar cells of both types (depolarizing and hyperpolarizing) generate a surround response that opposes the center response. In both bipolar cell types, the surround response is completely suppressed near center intensities that suppress the surround response in the cones. 5. Narrow field horizontal cells behave like cones and bipolar cells; the depolarizing surround response is suppressed at high center intensities bright enough to suppress the cone surround response. At higher center intensities the surround response becomes hyperpolarizing, presumably due to direct coupling to peripheral horizontal cells. 6. Broad-field horizontal cells always hyperpolarize in response to surround illumination. The hyperpolarizing surround response is augmented at high center intensities, presumably because the depolarizing component, initiated in the cones, is suppressed, while the direct coupling to peripheral horizontal cells remains intact. PMID- 6854357 TI - Functional organization of neurons in cat striate cortex: variations in preferred orientation and orientation selectivity with receptive-field type, ocular dominance, and location in visual-field map. PMID- 6854356 TI - Mechanisms of pattern generation underlying swimming in Tritonia. III. Intrinsic and synaptic mechanisms for delayed excitation. PMID- 6854358 TI - Judgements about onset of rapid voluntary movements in man. PMID- 6854359 TI - Alpha-motoneuron EPSPs exhibit different frequency sensitivities to single Ia afferent fiber stimulation. PMID- 6854360 TI - Physiological organization of callosal connections of a visual lateral suprasylvian cortical area in the cat. PMID- 6854361 TI - Presynaptic inhibition, EPSP amplitude, and motor-unit type in triceps surae motoneurons in the cat. AB - 1. Composite group Ia excitatory postsynaptic potentials (EPSPs) produced by heteronymous nerve stimulation were recorded from triceps surae motoneurons of barbiturate-anesthetized cats. Motoneuron rheobase, input resistance, and axonal conduction velocity were measured, and motor units were classified on the basis of the mechanical responses of their muscle units. 2. The amplitude of EPSPs recorded from 33 medial gastrocnemius (MG) motoneurons ranged from 0.6 to 4.3 mV. The mean EPSP amplitude differed among the major MG motor-unit types, increasing in the order fast twitch, fast fatiguing (FF); fast twitch, fatigue resistant (FR); slow twitch, fatigue resistant (S) (FF less than FR less than S). The amplitude of EPSPs recorded from 15 soleus motoneurons ranged from 0.3 to 3.4 mV, with a mean of 1.4 mV. 3. Presynaptic inhibition of EPSPs was produced by trains of conditioning volleys in the posterior biceps-semitendinosus (PBST) nerve. In 33 MG cells PBST conditioning stimulation reduced the amplitude of EPSPs by 11 50%, with a mean inhibition of 27%. The amplitude of EPSPs in 15 soleus motoneurons was decreased by 5-84%, with a mean inhibition of 37%. 4. When the magnitude of presynaptic inhibition was expressed as percent inhibition, there was no relation between presynaptic inhibition and either motor-unit type or the amplitude of the EPSP. However, when presynaptic inhibition was expressed as the absolute amount of inhibition in millivolts, the magnitude of inhibition was highly correlated with EPSP amplitude both across the entire triceps surae population (MG, lateral gastrocnemius, soleus) as well as within each muscle population. This correlation was also significant within the MG FF and FR motor unit populations. 5. We conclude that EPSP amplitude and not motor-unit type is the major determinant of the magnitude of presynaptic inhibition. However, because of the effect of motor-unit type on EPSP amplitude, the net effect is that presynaptic inhibition increases in the order FF less than FR less than S. PMID- 6854362 TI - Descending inhibitory influences from periaqueductal gray, nucleus raphe magnus, and adjacent reticular formation. I. Effects on lumbar spinal cord nociceptive and nonnociceptive neurons. AB - 1. This study examined the inhibitory effects of conditioning stimuli delivered to the periaqueductal gray (PAG), nucleus cuneiformis (CU), nucleus raphe magnus (NRM), nucleus reticularis gigantocellularis (NGC), and nucleus reticularis magnocellularis (NMC) on functionally identified neurons of the lumbar spinal cord dorsal horn in chloralose-anesthetized or decerebrate cats. 2. Neurons were classified according to their responses to a variety of cutaneous stimuli as low threshold mechanoreceptive (LTM), wide dynamic range (WDR), or nociceptive specific (NS). The major aim of this study was to determine whether there was a difference in the effectiveness of the brain stem stimulation-produced inhibition of nociceptive (noci) neurons (consisting of both WDR and NS neurons) and the LTM non-nociceptive (nonnoci) neurons. There were no statistical differences in the susceptibility of WDR and NS neurons to brain stem-induced inhibition. 3. Most neurons tested could be inhibited by stimulation of any of the brain stem regions tested. In all cases the percentage of noci neurons inhibited from a given region was higher than the percentage of nonnoci neurons; however, this difference was only statistically significant in the case of NMC stimulation. 4. Threshold current intensities necessary to produce inhibition were determined for each neuron from each stimulation site. Although there was a trend for noci neurons to require slightly lower current intensities, there was in fact no statistically significant difference in the inhibitory thresholds between noci and nonnoci neurons for any of the regions tested. 5. A comparison of the mean threshold currents for the five regions studied revealed that the lowest stimulation currents were obtained in NMC with NRM, CU, NGC, and PAG, each requiring progressively higher current intensities in order to produce inhibition. 6. These results indicate that stimulation in PAG and NRM not only inhibits the responses of noci neurons but also those of nonnoci neurons. Moreover, stimulation in reticular regions adjacent to these two regions is effective in inhibiting the responses of both noci and nonnoci neurons. PMID- 6854363 TI - Descending inhibitory influences from periaqueductal gray, nucleus raphe magnus, and adjacent reticular formation. II. Effects on medullary dorsal horn nociceptive and nonnociceptive neurons. AB - 1. This study examined the inhibitory effects elicited by brain stem stimulation on the somatosensory responses of trigeminal medullary dorsal horn (subnucleus caudalis of the spinal trigeminal nucleus) neurons. Single-unit extracellular recordings were obtained in chloralose-anesthetized cats. Neurons were classified as wide dynamic range (WDR), nociceptive specific (NS), or low-threshold mechanoreceptive (LTM). Conditioning stimuli were delivered to the periaqueductal gray (PAG), nucleus cuneiformis (CU), nucleus raphe magnus (NRM), nucleus reticularis gigantocellularis (NGC), and nucleus reticularis magnocellularis (NMC). 2. Over 97% of the neurons tested could be inhibited by stimulation in all regions except PAG. Stimulation in the PAG inhibited 91% of the neurons tested. There was no statistically significant difference in the incidence of inhibition of WDR and NS nociceptive (noci) neurons and the LTM nonnociceptive (nonnoci) neurons. 3. Mean stimulation intensities necessary to produce inhibition were determined for each neuron from each stimulation site. The current thresholds necessary to inhibit the responses of noci neurons were found to be significantly lower, on the average, than those of nonnoci neurons at stimulation sites in the PAG, CU, and NGC. 4. Inhibition of the responses of WDR neurons required a lower mean current than for NS neurons but was statistically significant only for PAG and NGC. Thresholds for inhibiting the responses of NS neurons were similar to those for inhibiting the responses of LTM neurons for all regions except CU, where LTM thresholds were markedly but not significantly higher. 5. Stimulation thresholds were found to be lowest in NMC, while in NGC, NRM, and CU they were all similar and slightly higher. Stimulation in the PAG required the highest currents to produce inhibition. 6. These results indicate that stimulation in NRM and PAG not only inhibits the responses of noci neurons but also those of nonnoci neurons. Furthermore, stimulation in reticular regions adjacent to NRM and PAG is frequently even more effective in inhibiting the responses of both noci and nonnoci neurons. In addition, WDR neurons are more effectively inhibited than NS or LTM neurons. These results are compared with those obtained using similar methods in cat lumbar dorsal horn. PMID- 6854364 TI - Quantitative relations between color-opponent response of horizontal cells and action spectra of cones. AB - 1. Relations between cones and chromatic-type horizontal cells (C-cells) were investigated by intracellular recording in the retina of the walleye (Stizostedion vitreum). 2. The retina contains two classes of cones, midwave (M) and long wave (L). Their action spectra have maximum sensitivity at 533 and 605 nm, respectively, and have been measured with good precision from 400 to 750 nm. 3. C-cells generate relatively sustained depolarizing and hyperpolarizing responses to deep red (680 nm) and green (530 nm) test flashes, respectively, but prominent on and off transients are evoked by intermediate wavelengths. To minimize these temporal interactions, quantitative analysis was restricted to measurements of the apparent steady-state response amplitude. 4. Response amplitude was linearly related to flash intensity for responses that did not exceed 20% of their respective maxima. This is called the linear range. At higher levels, the nonlinear region of the Naka-Rushton relation holds approximately if input is largely confined to the hyperpolarizing or depolarizing mechanism. 5. Tests with red/green mixture flashes show that the hyperpolarizing and depolarizing inputs interact by simple summation for responses in the linear range. At higher levels, the interaction is complex. 6. Spectral-response curves (response amplitude versus wavelength for flashes of equal photon level) were determined for 16 C-cells in the linear range. The exact form of these curves varied considerably from cell to cell, reflecting differences in the relative strength of the hyperpolarizing and depolarizing mechanisms. 7. The spectral response curves were analyzed by a simple linear model based on the action spectra of the L and M cones. Measured and predicted spectral-response curves agree closely. The only free parameter in the analysis is a scaling factor that specifies the strength of the L cone input relative to the M cone input. 8. Triphasic spectral-response curves, as predicted by the model, were found in the sauger (Stizostedion canadense). These C-cells have short-wavelength responses due to input from long-wave cones, resemble certain triphasic cells in primate retina, and differ sharply from other triphasic C-cells found in other fish retinas. 9. Although the precise synaptic mechanisms must still be identified, the present results show that the functional information transfer from cones to C cells in the linear range can be closely approximated by simple operations of scaling, sign inversion, and simple summation. The C-cell thus effectively subtracts one cone action spectrum from the other and displays the difference in the form of the spectral-response curve. PMID- 6854365 TI - Responses of isolated Golgi tendon organs of cat to sinusoidal stretch. AB - 1. Receptor potential and tension have been recorded from isolated Golgi tendon organs in response to sinusoidal stretch. Responses depended on amplitude and frequency of stretch and on the initial (resting) tension of the preparation. 2. Both tension and receptor potential behaved as power functions of stretch amplitude over most of the range corresponding to physiological tendon strains. However, for very small stretch amplitudes (less than 8 microns), a more linear response was seen. Those characteristics of responses that depended on stretch amplitude behaved similarly at all frequencies examined. 3. Frequency dependence of tension was slight. Its character, a gradual monotonic increase in response with increasing stretch frequency and a constant phase lead of a few degrees, did not change over the examined frequency range from 0.12 to 80 Hz. In contrast, receptor potential displayed a marked frequency dependence, increasing rapidly with increasing frequency of stretch in the range from approximately 1 to 20 Hz, then slowly declining as frequency was further increased. 4. Changes in initial tension of the preparation produced marked parallel changes in the amplitude dependence of tension and receptor potential. Frequency response was not significantly affected. 5. By comparing tension and receptor potential responses, the relative contributions of mechanical and electrical properties of the receptor to the sensory transduction process was examined. The present results suggest that in tendon organs the observed nonlinear dependence on amplitude of stretch originates primarily in the mechanical stage of transduction. Dynamic sensitivity, however, seems largely attributable to ionic processes within the sensory terminal membranes. PMID- 6854366 TI - Axonal regeneration in lamprey spinal cord. AB - Spinal cords of sea lamprey larvae were transected at one of two levels: (a) rostral, at the last gill, or (b) caudal, at the cloaca. Following various recovery times, regeneration of the posteriorly projecting giant reticulospinal axons (RAs) was demonstrated by intra-axonal injection of horseradish peroxidase (HRP). Regeneration of axons of anteriorly projecting dorsal cells (DCs) and giant interneurons (GIs) was demonstrated by intrasomatic HRP injection into cells located just below the transection scar. After 40 days of recovery, 55% of proximally transected RAs (rostral cut) regenerated at least as far as the center of the scar, whereas only 15% of distally transected RAs (caudal cut) did so. Maximum distance of regeneration was 5.3 mm beyond the scar for proximally transected RAs but only 38 u for distally transected RAs. Proximally transected RAs also branched more profusely than distally transected ones. These data (when combined with others in the literature) suggest that the regenerative capacity of RAs may decrease with distance of axotomy from the cell body. Distance of regeneration and degree of branching of proximally transected RAs peaked between 40 and 100 days. Thereafter, there appeared to be a tendency toward neurite retraction. Of axotomized GIs, 76% regenerated anteriorly at least as far as the center of a caudal transection scar (GIs are located only in the caudal part of the cord). The maximum distance of regeneration was 1.3 mm beyond the scar. Of DC axons, 56% regenerated anteriorly at least as far as the transection site. The maximum distance was 1.1 mm beyond the scar. DCs located just below a caudal transection regenerated at least as well as those located below a rostral transection. Axonal regeneration was also demonstrated for a few lateral cells, edge cells, and crossed caudally projecting interneurons. PMID- 6854367 TI - Development of synapses in the antennal lobes of the moth Manduca sexta during metamorphosis. PMID- 6854368 TI - Thigh and calf discrimination in the motor innervation of the chick hindlimb following deletions of limb segments. PMID- 6854369 TI - Position-dependent motor innervation of the chick hindlimb following serial and parallel duplications of limb segments. AB - In this paper we report investigations of the innervation of duplicated limb segments to test whether the addition of limb segments along the proximodistal axons could stimulate the growth of appropriate motoneurons into double occurrences of these muscles. Our evidence indicates that it does not. Using retrograde horseradish peroxidase nerve-tracing techniques and reconstructions of experimental limbs, we investigated the motor projection to parallel and serially duplicated legs. In all cases, host limb segments were normally innervated. In a control experiment involving a host thigh connected to a graft calf, the innervation of both segments was normal. In serially duplicated limb segments, however, we found abnormal innervation. In limbs of the type thigh-thigh-calf foot, the innervation of the second thigh was accomplished by calf motoneurons. In limbs consisting of thigh-calf-calf-foot, the duplicated calf was served by foot motoneurons. The general pattern was that muscles were innervated as a function of their position along the proximodistal axis, irrespective of their identity. In no limb were axons found distal to the third limb segment even before the period of normal cell death. Despite the mismatched innervation with regard to the thigh/calf/foot distinction, axons retained their characteristic selectivity for either dorsally or ventrally derived muscles. The findings suggest that the projection of axons along the proximodistal axis of the limb is influenced by proximal growth cues associated with the formation of the limb plexus as well as by competitive interactions in the distal limb tissue. PMID- 6854372 TI - Rehabilitation of the neurologically disabled patient: principles, practice, and scientific basis. AB - Rehabilitation is a therapeutic program specifically directed toward restoring the optimum level of function available to patients with severe permanent disabilities. It complements standard care, which focuses on curing the primary pathology. Preventive rehabilitation is designed to minimize the complications of inactivity that tend to develop during a protracted curative process (contractures, pressure sores, muscle atrophy, cardiopulmonary deconditioning, cognitive dulling). Comprehensive rehabilitation focuses on the restoration of function. It encompasses physical reconditioning, teaching new ways to accomplish the basic tasks of locomotion, object handling, personal care, relationships with family and society, employment, and recreation. The rehabilitation program is largely designed and provided by a team of allied health professionals, each an expert in one area of function. Reverting to a less dominant role, the physician provides leadership by defining the stress (activity) tolerance of the patient's pathology, coordinates the team, and manages intercurrent problems that arise. Comprehensive rehabilitation is an in-hospital program. Less intense elements can be provided in a skilled nursing facility, out-patient clinic, or the patient's home. The details of the rehabilitation process vary with the nature of the patient's primary pathology. These have been illustrated in this review of the programs for two very diverse situations. Spinal cord injury introduces varying levels of physical incapacitation. Conversely, brain injury primarily creates a cognitive and behavioral deficit. Both are complex problems requiring comprehensive rehabilitation if the impairment is severe. PMID- 6854370 TI - Neural pathway constraints in the motor innervation of the chick hindlimb following dorsoventral rotations of distal limb segments. AB - Several studies have demonstrated that motor axons can discriminate between dorsally and ventrally derived muscles. In this paper we present evidence that (1) the pathway axons take in the limb constrain their access to either dorsally or ventrally derived muscles, and therefore (2) the axon's ability to discriminate between dorsal and ventral is expressed already at the level of pathway selection into the limb. Surgically manipulated hindlimbs were produced consisting of a normal host thigh connected to a dorsoventrally rotated calf or to rotated and duplicated donor limb segments. The limb rotations were done distal to the level at which axons select a dorsally or ventrally destined pathway through the limb, such that at the level of the rotation, axons in each nerve were confronted with the opposite-from-normal set of muscles. In this situation, the relative influence of pathway availability versus dorsal/ventral muscle recognition could be assessed. The innervation of rotated limb segments was, in all cases, opposite from normal. Motoneurons which normally innervate dorsal muscles innervated ventrally derived muscles that had been rotated into a dorsal position. Likewise, normally ventrally destined axons served dorsal muscles in the rotated segments. Thus, motor axons did not alter their distal path to reach their normal set of muscles. While these results do not rule out intrinsic dorsal/ventral differences between muscles, they do demonstrate that muscle surface recognition is not necessary to account for dorsal/ventral discrimination in the innervation of normal, supernumerary, or duplicated limbs, nor is it sufficient to account for the innervation of rotated limb segments. These results also indicate that pathway guidance cues are an important influence on innervation patterns. PMID- 6854371 TI - Light and electron microscopic immunocytochemical localization of glutamic acid decarboxylase in monkey geniculate complex: evidence for gabaergic neurons and synapses. PMID- 6854373 TI - Detachable calibrated-leak balloon for superselective angiography and embolization of dural arteriovenous malformations. AB - The authors describe a system comprising a small latex balloon attached to a Teflon catheter. The balloon has a distal calibrated leak which is used for intravascular embolization with isobutyl-2-cyanoacrylate. The balloon is easily detached after embolization. The combination of manual control of the balloon catheter system, plus the ability of the balloon to navigate intra-arterially with the blood flow, makes this system suitable for superselective angiography and embolization of lesions supplied by the external carotid artery (ECA). This system avoids intimal dissection and concomitant arterial vasospasm when trying to negotiate steep distal curves of the ECA branches. Experimental embolization of several branches of the ECA in the dog, and clinical examples of treatment of dural arteriovenous malformations in three patients are described. PMID- 6854374 TI - Direct microsurgical repair of intracavernous vascular lesions. AB - Three patients with aneurysms of the internal carotid artery (ICA) situated in the cavernous sinus (CS), and four patients with traumatic carotid-cavernous fistulas (CCF's) were treated by direct surgical approach. Two aneurysms were clipped, whereas the third (a giant aneurysm) was resected and the wall of the ICA reconstructed using interrupted sutures. In two CCF's, the shunt was excluded during reconstruction of the ICA wall by suturing. In the remaining two patients with CCF's, the shunt was excluded by clipping. The CS was attacked directly using a combination of three different techniques: the pterional, the subtemporal, and the petrosal approach. The ICA in its whole course through the CS, as well as the third through the sixth cranial nerves, were exposed. No special measures, such as hypotension, hypothermia, extracorporeal circulation and cardiac arrest, or dehydration, were taken during surgery. The aim of the direct approach to the CS was to exclude the aneurysm and/or the CCF and preserve the ICA patency. In all seven cases operated on, the lesions were excluded without inflicting any additional damage to the third through sixth cranial nerves, and in five cases carotid patency was preserved. PMID- 6854375 TI - Intracranial arterial aneurysms in children and adolescents. AB - Throughout the period 1943 to 1980, 1368 patients with verified intracranial saccular aneurysms were treated in the University of Aarhus neurosurgical department. Forty-three (3.1%) patients (25 boys and 18 girls) were 19 years old or younger, and 33 (77%) had an onset of symptoms typical of subarachnoid bleeding. Using the classification system of Hunt and Hess as a basis for clinical assessment on admission, 58% of the patients could be placed in Grade I or II. Cerebral vasospasm was demonstrated in 53% of the patients undergoing angiography between the 4th and 16th day after hemorrhage. There was no increased morbidity or mortality in the group of patients with vasospasm, and no cerebral infarction was demonstrated at necropsy. Therefore, it is possible that vasospasm is of minor prognostic significance in children. In 15 patients (37%), aneurysm rupture was accompanied by intracerebral hematoma. The mortality rate in this group of 15 patients was 50%, whereas in the group without hematoma it was 26%. The overall mortality rate was 33%. The surviving 29 patients were followed for 3 months to 14 years. Twenty-three patients made a good recovery (80% of survivors and 54% of the total series), five were moderately disabled, and one was severely disabled. PMID- 6854376 TI - Long-term evaluation of ultra-early operation for hypertensive intracerebral hemorrhage in 100 cases. AB - In the past 10 years, the authors performed microsurgical evacuation of hypertensive intracerebral hematoma in 100 cases during the ultra-early stage (within 7 hours) after the apoplectic attack. Operative indications were the presence of obvious hemiplegia and disturbed consciousness (from stupor to semicoma). Functional outcomes at 6 months postoperatively were as follows: 15 patients had returned to a full social life, 35 were capable of self-care at home, 33 required partial care at home, two were bedridden and in a vegetative state, and seven had died. PMID- 6854377 TI - Cerebral arterial pathology in experimental subarachnoid hemorrhage. AB - Pathological changes of the cerebral arteries were studied in 30 dogs after subarachnoid injections of saline, fresh autologous blood, epinephrine, blood plus epinephrine, norepinephrine, or blood plus norepinephrine. Macroscopically, the circle of Willis was maximally dilated after the injection of epinephrine and was constricted following administration of blood plus epinephrine. Microscopically, neither saline nor blood produced abnormalities, except for minor changes of the adventitia in the latter. Epinephrine produced frank necrosis of smooth-muscle cells, which was subsequently replaced by fibrosis in the media of larger subarachnoid arteries, and the leakage of necrotic material from the infarcted hypothalamus contributed to these lesions. Blood plus epinephrine produced marked changes in the internal elastic lamina and tortuosities of the nuclei of smooth-muscle cells, while norepinephrine and blood plus norepinephrine produced only minor changes. Previously reported findings of morphological changes due to vasospasm after subarachnoid hemorrhage were confirmed experimentally, but such changes were found only after application of epinephrine. It is suggested that epinephrine produced the most severe vasospasm among the five substances tested. PMID- 6854378 TI - Beagle puppy model of intraventricular hemorrhage. Effect of indomethacin on cerebral blood flow. AB - The newborn beagle puppy has been demonstrated to provide a good model for neonatal intraventricular hemorrhage (IVH). A study was designed to determine if indomethacin can prevent IVH and if indomethacin would produce changes in cerebral blood flow (CBF). Newborn beagle puppies were randomized by computer into two groups: one was pretreated with indomethacin, a known inhibitor of prostaglandin synthetase, and the other was saline. The dogs in both groups were then assigned either to undergo hemorrhagic hypotension/volume reexpansion insult or to receive no insult. Twenty percent of all pups receiving indomethacin and undergoing the insult experienced IVH, compared to 71% of the pups undergoing insult that had been pretreated with saline. Significant alterations in the blood pressure responses to the hemorrhagic hypotension/volume reexpansion insult were noted in the former group compared to the saline-pretreated pups subjected to insult. Finally, employing carbon-14 autoradiography for the determination of CBF, it was demonstrated that indomethacin decreases resting CBF of the newborn beagle pups and, in indomethacin-pretreated animals subjected to insult, prevents the increases in CBF seen in the saline-pretreated traumatized pups. PMID- 6854379 TI - Regional blood flow in RT-9 brain tumors. AB - Regional blood flow (BF) was measured in RT-9 experimental brain tumors using carbon-14 labeled iodoantipyrine, the Kety tissue-exchange equations, and quantitative autoradiographic techniques. Blood flow was variable within tumor tissue, and the range of BF increased with increasing tumor size; the overall range was 6 to 138 ml/100 gm/min and the maximum range within an individual tumor was 55 ml/100 gm/min. In all but one case, mean tumor BF was less than that in the same anatomic region of the contralateral hemisphere (CBA). The magnitude of BF within individual tumor foci generally could be related to tumor size, location (intraparenchymal versus extraparenchymal), and the presence of necrosis or cysts; it was lower in the geometric centers than in the periphery of medium sized and large tumors. Brain adjacent to tumor had higher BF's than the tumor periphery; generally, the BF in the brain adjacent to the tumor was less than that in the CBA. A global depression of BF was observed within tumor-free cortex and corpus callosum of the hemisphere ipsilateral to tumor implantation and primary growth, suggesting a hemispheric reduction in metabolic and functional activity. PMID- 6854382 TI - Selective posterior rhizotomy for treatment of spasticity. AB - In 1976, Fasano, et al., described a new technique of posterior rhizotomy for treatment of spasticity. They stimulated electrically fascicles of the posterior roots in spastic patients and found that some fascicles responded to stimulation with tonic muscle contractions. They cut these fascicles, preserving those with a weaker or no reaction. The present authors have used a fairly similar technique in the treatment of eight patients with spasticity of the legs and one patient with spasticity of the arm: all fascicles of the posterior roots T12-Sl and C6-8, respectively, were stimulated electrically during surgery under general anesthesia. Approximately 60% to 80% of the fascicles responded to stimulation with tonic muscle jerks, and only these fascicles were cut. All nine patients showed a good reduction of spasticity. The residual cutaneous and joint sensation remained unchanged. Motility of the limbs usually improved. PMID- 6854381 TI - Cortical somatosensory evoked potentials in response to hand stimulation. AB - Somatosensory evoked potentials were recorded from chronically implanted subdural electrodes in six patients with intractable seizures. The following conclusions were reached: 1) The initial cortical negativity-positivity (N1 with a latency of about 20 msec and P2 with a latency of about 24 msec) recorded in the postcentral area was an expression of the classical primary surface positivity, but N1 was generated by the posterior pole of an early horizontal dipole in area 3b, and P2 was generated by the positive pole of a slightly delayed vertical dipole in area 1 and 2.2) P2 permitted the most accurate localization of the primary somatosensory area. 3) No potentials were elicited in the primary somatosensory area by stimulation of the ipsilateral hand. 4) No cortical potentials were seen at stimulation intensities below the sensory threshold. The cortical distribution of evoked potentials evoked by weak and strong intensities had significantly different distribution. 5) The recovery function of cortical evoked potentials showed a U-curve with an early period of facilitation (10 to 30 msec) followed by a prolonged period of subnormality which peaked at about 50 msec. The recovery curve at different cortical loci differed. PMID- 6854380 TI - Regional blood-to-tissue transport in RT-9 brain tumors. AB - Regional blood-to-tissue transport, expressed as a unidirectional transfer rate constant (K), was measured in experimental RT-9 brain tumors using 14C-alpha aminoisobutyric acid (AIB) and quantitative autoradiographic techniques. The magnitude of K depends on the permeability, surface area, and blood flow of the tissue capillaries. The transfer rate constant was variable within tumor tissue (range 0.001 to 0.178 ml/gm/min) and depended on tumor size, location (intraparenchymal, meningeal, or choroid plexus associated), and to a lesser extent on necrosis and cyst formation. Brain adjacent to tumor had higher K values, particularly around larger tumors (0.004 to 0.014 ml/gm/min), than corresponding brain regions in the contralateral hemisphere (0.001 to 0.002 ml/gm/min). Estimates of the fractional extraction of AIB by intraparenchymal tumors were between 0.008 and 0.4 ml/gm/min. Values of fractional extraction in this range indicate that tumor capillaries are not freely permeable to this solute. The values of K measured with AIB in this study, for the most part, approximate the permeability-surface area product of tumor and brain capillaries. The experimental data suggest that the permeability-surface area characteristics of the microvasculature in small RT-9 tumors are similar to those of the host tissue, whereas the microvasculature of larger RT-9 tumors is influenced more by intrinsic tumor factors. PMID- 6854383 TI - Aminergic and cholinergic innervations of the spinal cord blood vessels of cats. A histochemical study. AB - The distribution patterns of aminergic and cholinergic nerve fibers in the feline spinal cord blood vessels were studied by means of amine histofluorescence and acetylcholinesterase (AChE) staining. These patterns were compared with those of the cerebral blood vessels. The anterior spinal artery had a dense network of aminergic and AChE-positive (probably cholinergic) nerve fibers. The posterior spinal vein, in contrast, exhibited only aminergic nerve fibers. Small intraparenchymal blood vessels in the spinal cord also had strongly fluorescent (probably peripheral) aminergic nerve fibers, as well as pial spinal blood vessels. This was a characteristic feature in the spinal cord. The distribution pattern and the density of these two sorts of nerve fibers in the anterior spinal artery varied widely with the individual segment of the spinal cord. The thoracic spinal cord had the lowest number of these nerve fibers of any part of the spinal cord. This fact may explain why the thoracic spinal cord is most susceptible to ischemic change. PMID- 6854384 TI - Brain abscess in congenital cyanotic heart disease. AB - Sixty-two cases of brain abscess with congenital cyanotic heart disease are reviewed. A sharp peak in the age distribution was seen at 4 to 7 years of age. Of 62 cases, 38 (61.2%) had a tetralogy of Fallot, and six had a transposition of the great vessels. The majority of these abscesses were supratentorial and 76% of abscesses were found in the frontal, temporal, and parietal lobes. Multiple abscesses were present in 19.4% of cases. Sterile cultures were obtained in 61% of the abscesses, and the increasing percentage of sterile cultures seems to be the result of broad-spectrum antibiotic therapy. The overall mortality rate was 37% but there were no deaths after surgical excision secondary to aspiration. Since the introduction of computerized tomography, aspiration without total excision has produced good results, and therefore it is believed that the number of cases which are cured with aspiration therapy alone will gradually increase in the future. PMID- 6854386 TI - Sphenoethmoidal cephalocele with cleft palate: transpalatal versus transcranial repair. Report of two cases. AB - Two cases of sphenoethmoidal encephalocele with cleft palate are reported in detail. The encephaloceles had prolapsed into the nose and nasopharynx, and protruded into the mouth. Previous examples of this entity are reviewed. Such patients have a typical facial appearance: hypertelorism, median cleft lip, and bifid nose of varied severity. Ocular findings include coloboma of the optic nerve or anophthalmia. The prolapsed cerebral tissue varies from nonfunctional glia elements to vital structures of the hypothalamus-pituitary area. Agenesis of the corpus callosum has been reported consistently. Transcranial access to the bone defect, particularly its posterior portion, is difficult because of distorted cerebral anatomy and abnormal vasculature. The fragility of the prolapsed cerebral tissue makes it difficult to preserve the cerebral tissue intact and to reposition it into the cranium. When there is a cleft palate, it is possible to repair the encephalocele extracranially through a transoral, transpalatal approach, preserving and repositioning the content of the sac. Dural closure and obliteration of the bone defects are other essential steps of the operation. Both patients reported here were successfully operated on by the transoral, transpalatal route, at the age of 3 months and 4 years, respectively. They were followed for several years and had comprehensive endocrinological work ups. One patient exhibited some pituitary deficiency requiring substitution therapy. PMID- 6854389 TI - Anomalous branch of the internal carotid artery supplying circulation of the anterior cerebral artery. Case report. AB - Angiographic and operative investigations revealed an anomalous branch of the internal carotid artery (ICA) in a patient with an anterior communicating artery (ACoA) aneurysm. The anomalous vessel originated from the right ICA at the level of the ophthalmic artery, and pursued an infraoptic and prechiasmatic path to supply both pericallosal arteries. The clinical features and possible genesis of this anomaly are discussed. This irregularity is frequently associated with intracranial aneurysms, especially those of the ACoA, and with other anomalies. PMID- 6854387 TI - Endarterectomy for atheromatous hypoglossal artery. Case report. AB - A 57-year-old white man developed transient ischemic symptoms of the posterior circulation in August, 1981. Serial arteriography revealed stenosis of a large right hypoglossal artery which narrowed from 50% to 90% after only 2 months. The hypoglossal artery occurs in the 4-mm human embryo, normally from Days 21 to 26 of gestation. This is the first reported case of hypoglossal endarterectomy. PMID- 6854390 TI - Occurrence of meningioma 36 years after treatment for craniopharyngioma without radiation therapy. Case report. AB - A meningioma occurred 36 years after surgical removal of a craniopharyngioma. No radiation therapy was instituted after the initial surgery. PMID- 6854391 TI - Disappearance and development of cerebral aneurysms in moyamoya disease. Case report. AB - The authors report a case of multiple cerebral aneurysms associated with moyamoya disease, in which the reduction and disappearance of bilateral internal carotid artery aneurysms and the new development and enlargement of bisilar artery aneurysms were demonstrated on sequential cerebral angiograms. Possible mechanisms of the spontaneous disappearance and development of cerebral aneurysms in association with moyamoya disease are discussed. PMID- 6854385 TI - Intermittent versus continuous brain retraction. An experimental study. AB - Brain damage due to retraction was studied morphologically and physiologically in the dog brain. Two methods of retraction were compared using a retractor with a strain gauge: 1) continuous retraction; and 2) intermittent retraction. Total retraction time was 60 minutes for each method. Brain damage started to appear at a retraction force of 30 gm with continuous retraction, and increased in proportion to the force used. The power spectrum of the electrocorticogram showed full recovery after the release of retraction when the retraction force was less than 40 gm. With intermittent retraction, the damage was morphologically minimal with a retraction force of less than 50 gm, and recovery of the power spectrum of the electrocorticogram was prompt in comparison with continuous retraction. The results indicate the superiority of intermittent over continuous retraction. PMID- 6854388 TI - Leptomeningeal angiomatosis and aplasia congenita of the scalp. Case report. AB - This 9-year-old boy had two circular areas of aplasia congenita of the scalp in the territory of the first division of the trigeminal nerve and an ipsilateral parieto-occipital leptomeningeal capillary venous angioma. He had an associated giant aneurysm of the distal posterior cerebral artery on the same side as the vascular malformation. The patient had a long history of seizures and presented with intracerebral bleeding. This case may be considered as a variant of Sturge Weber syndrome. Further observations must be added to consider this entity as a separate neurocutaneous disease. PMID- 6854392 TI - Diastematomyelia and intramedullary epidermoid spinal cord tumor combined with extradural teratoma in an adult. Case report. AB - Diastematomyelia is rarely diagnosed in the adult. Only a few such cases have been reported in the literature. A 26-year-old Mexican man with lumbar diastematomyelia is reported who also harbored a T-12 intramedullary epidermoid tumor and an extradural teratoma located in the dorsal aspect of the dural sac opposite L-4. These three rare coincidental lesions were removed at surgery. The patient's condition improved. PMID- 6854393 TI - Multiple cerebral gummata. Case report. AB - The case of a patient with multiple small cerebral gummata presenting with severely raised intracranial pressure is reported. The diagnosis, which was quite unexpected, was based on positive serological tests for syphilis. Computerized tomography (CT) showed small enhancing lesions with intense cerebral edema. The patient was treated successfully with penicillin, and resolution of the lesions was observed on CT scanning over a 1-year period. The importance of "routine" serological testing is noted. PMID- 6854394 TI - Cervical intramedullary schwannoma. Case report. AB - A case of cervical intramedullary schwannoma without evidence of von Recklinghausen's disease is reported. The hypotheses regarding its histogenesis and the difficulty in diagnosis on the frozen section obtained at biopsy are discussed, along with a review of literature covering 15 previously reported cases. PMID- 6854395 TI - Lumbosacral radiculopathy secondary to abdominal aortic aneurysms. Report of three cases. AB - Focal neurological deficits as the initial manifestation of expanding or ruptured abdominal aortic aneurysms are uncommon. When such a situation does occur, the femoral nerve is most often involved due to retroperitoneal or iliopsoas hematoma. Three cases of typical lumbosacral radiculopathy caused by an abdominal aortic aneurysm are reported to emphasize the importance of considering this diagnosis in the older patient with leg pain and radiculopathic findings. PMID- 6854396 TI - Vasospasm after pituitary surgery. PMID- 6854399 TI - Clinical assessment of a radioimmunoassay for free thyroxine using a modified tracer. AB - A radioimmunoassay for measuring free thyroxine in plasma was introduced by Amersham using a I-125-labeled T4 derivative that does not bind significantly to the thyroxine-binding proteins. We evaluated this RIA for its clinical utility in assessing 278 patients with thyroid and nonthyroidal diseases. The precision of the Amerlex free T4 assay, expressed as coefficient of variation, was 20% at 0.16 ng/dl, 6.9% at 0.55 ng/dl, 4.2% at 1.08 ng/dl, 5.3% at 2.29 ng/dl, and 6.3% at 3.18 ng/dl. A reference range for free T4 was established as 0.68-1.8 ng/dl, n = 171. The correlation coefficients (r) of a dialysis method and a free thyroxine index were 0.871 and 0.911, respectively. Free T4 correctly classified 98% euthyroid, 92% hypothyroid, 100% hyperthyroid, 100% euthyroid with elevated TBG, and 87% of phenytoin patients. In addition, 80 patients with acute nonthyroidal illness were studied. Most of these patients have normal to low free T4, very low T3, and elevated rT3. We found this free T4 assay to be precise, easy to perform, and reliable in classifying thyroid status in most patients. PMID- 6854397 TI - Radiographic and scintigraphic skeletal imaging in patients with neuroblastoma: concise communication. AB - Bone scans, bone-marrow scans, and radiographic skeletal surveys have been reviewed in 40 children with neuroblastoma. Bone scans are the most sensitive method for detecting metastases and should be used first. The additional yield from a skeletal survey is very small, so it should be done only if the bone scan is negative and major therapeutic decisions are to be made. Bone-marrow scans provide a sensitive method of identifying metastases, and may help in staging a patient as stage IV when the bone scan is negative. PMID- 6854398 TI - Technetium-99m(Sn2+)pyrophosphate in ischemic and infarcted dog myocardium in early stages of acute coronary occlusion: histochemical and tissue-counting comparisons. AB - We have investigated the pattern of accumulation of Tc-99m(Sn2+)pyrophosphate (Tc 99m PPi) in myocardial tissue of dogs during the early stages of acute occlusion of the left anterior descending coronary artery. Three groups were studied after: (a) 40 min occlusion followed by 6 hr reperfusion (n = 6); (b) 6 hr occlusion followed by one hour reperfusion (n = 5); and (c) 7 hr occlusion with no reperfusion (n = 4). Areas of myocardial infarction were defined with triphenyl tetrazolium chloride (TTC) staining, and blood flow was determined with 9-mu radioactive microspheres. In Group C uptake in infarcted and peri-infarct areas was not enhanced, most likely owing to low flow. In Group B, with late reperfusion, Tc-99m PPi sequestration was increased in both infarcted and peri infarcted tissues. In Group A, areas ischemic during occlusion but with normal flow and viability by TTC after 6 hr of reperfusion showed significant uptake of Tc-99m PPi (twice the uptake of nonischemic regions). PMID- 6854400 TI - [131I]iodocholesterol scintiscan and a rare "functional" black adenoma of the adrenal cortex. AB - A rare functional black adenoma (FBA) of the adrenal cortex was found to be the cause of hypertension and cushingold features in a 34-yr-old white female. Preoperative studies included [131I]iodocholesterol scanning (ICS) of the adrenal glands, which demonstrated the increased release of cortisol from the affected adrenal gland, with the failure of the opposite adrenal gland to record. This is evidence that cortisol was suppressing adrenocorticotropin (ACTH) output by the pituitary gland. This case documents the clinical utility of "functional" imaging techniques in this clinical setting. PMID- 6854401 TI - An automated method for the normalization of scintigraphic images. AB - The computer comparison of two images of the same organ requires normalization of the images. We propose an iterative, automated method of normalization that is highly insensitive to structural modifications in the images. The normalization factor is calculated by maximizing the number of sign changes in the scanned subtraction image with a unidimensionnal optimization method. This algorithm is efficient, computationally cheap, and can be implemented on most nuclear medicine data-processing systems. PMID- 6854403 TI - Statistics for nuclear medicine. Part 6: Normal values, evaluating a new diagnostic procedure, sequential methods, and conclusion. PMID- 6854402 TI - Noise reduction in nuclear medicine images. AB - Common methods of reducing random noise in nuclear medicine use lowpass filtering, which has the disadvantage that it affects high-frequency components of the image. We developed a noise-reduction approach that estimates signal and noise levels in each of several frequency bands and removes the appropriate amount of noise with little effect on the signal in each band. PMID- 6854404 TI - Re: Interpretation of multigated fourier functional images. PMID- 6854405 TI - Dependence of distribution of short-lived tracers on decay. A noncompartmental approach. PMID- 6854406 TI - On behalf of I-123 fatty acids for myocardial metabolic imaging. PMID- 6854407 TI - Influence of age on protein and energy utilization in adult rats. AB - Male, Sprague-Dawley rats at 15 and 25 months of age were fed for 21 days diets containing 2, 3, or 4% casein supplemented with 0.078 g methionine/g casein at three levels of intake. Metabolizable energy intakes (MEI) required to maintain energy of total carcass and carcass protein were predicted from regression equations relating change in energy of total carcass and carcass protein to MEI. Mean MEI required to maintain energy of total carcass for 15- and 25-month-old rats, respectively, were 112 versus 88, 99 versus 76 and 94 versus 74 kcal/(kg0.75 X day) for 2, 3 and 4% casein, respectively. Mean MEI required to maintain energy of carcass protein for 2, 3 and 4% casein were 103, 98 and 85 kcal/(kg0.75 X day) for the 15-month-old animals and 93, 90 and 62 kcal/(kg0.75 X day) for the 25-month-old animals. Confidence intervals for mean maintenance energy intakes were wide and overlapped as age and casein concentration were varied. However, trends were evident. For both ages, as casein concentration increased, mean requirements decreased, and at each casein concentration, the 25 month-old animals had lower mean requirements than the 15-month-old animals. PMID- 6854408 TI - Iron metabolism of mice fed low levels of physiologically bound cadmium in oyster or cadmium chloride. AB - Three feeding studies were conducted with young mice to compare the toxicity of cadmium (Cd) occurring in oyster tissue to that of cadmium chloride (CdCl2). In the first experiment, 5 or 20 ppm dietary Cd as CdCl2 depressed blood hematocrit and hemoglobin concentrations, which were further depressed by the addition of up to 3% oyster to the diet. In the second experiment, 1.5 or 3.0 ppm dietary Cd as CdCl2 did not influence hematopoiesis after 14 days exposure. The percent of the Cd dose retained in the kidney was inversely related to dosage level, directly related in the liver and femur and unaffected by dosage level in the small intestine. The liver-to-kidney ratio of retained Cd increased markedly with dose. In the last experiment, 0, 1.8 or 3.6 ppm Cd as CdCl2 or 1.8 ppm Cd from oyster was fed to mice for 28 days. Diets containing intrinsic oyster Cd at 1.8 ppm were more effective than diets containing CdCl2 at 3.6 ppm Cd for depressing total serum iron (Fe) and percent transferrin saturation and for enhancing ceruloplasmin activity. Oyster Cd was retained at a much lower rate in all tissues compared to CdCl2. Oyster Cd was preferentially retained in the kidney compared to the liver. Intrinsic oyster Cd may be more potent in altering normal Fe metabolism than CdCl2. Interactions with other dietary constituents in oysters which may also influence Fe metabolism, particularly zinc (Zn) and copper (Cu), are discussed. PMID- 6854409 TI - The influence of starvation and refeeding on the lipoprotein lipase activity of skeletal muscle and adipose tissue of lean and obese Zucker rats. AB - Lipoprotein lipase (LPL) activities of skeletal muscles, heart and adipose tissue were investigated during feeding, prolonged food restriction, and refeeding. The influence of the duration of starvation on adipose tissue LPL activity was to cause it to decrease throughout starvation, whereas heart LPL activity increased during the first 24 hours of fasting and then declined for the remainder of the fast. Starvation of 10-week-old female, lean and obese rats to 80% of initial body weight required 5 and 9 days, respectively. In fed controls, no differences between phenotypes were found for any tissue in the LPL activities expressed per gram tissue. However, obese rats exhibited significantly smaller muscle mass and a resulting 29% lower total skeletal muscle LPL activity. No phenotype differences were detected for tissue LPL activities during starvation or refeeding. During caloric restriction, the LPL activities were reduced in heart ( 18%) and adipose (-52%) tissues, but skeletal muscle was unchanged except for the slow-twitch, oxidative soleus muscle, which was increased approximately two-fold. After refeeding to initial body weight, the LPL activity of heart returned to normal, but adipose tissue was dramatically increased (+300%) for both lean and obese Zucker rats. These data suggest that reduced skeletal muscle mass with normal LPL activity per gram tissue may contribute to an increased availability of plasma triglyceride fatty acids to adipose tissue of the genetically obese rat. PMID- 6854412 TI - Magnesium stores and anemia in young Japanese quail. AB - Studies were conducted to determine the effect of age on magnesium requirement and whether high dietary magnesium during the first 7 days of life would protect against subsequent magnesium deficiency. Day-old Japanese quail were fed a casein gelatin diet containing either 300 (requirement) or 600 ppm Mg. Beginning on day 7, half of the birds in each group received either 160 (deficient) or 300 ppm Mg. In birds fed the requirement level during week 1 followed by the deficient diet, hemoglobin decreased on day 10, reaching the lowest value on day 14. Other adverse effects included mortality; slightly reduced growth rate; elevated iron in the liver, spleen, and tibia; decreased tibia magnesium; and increased spleen weight. Higher dietary magnesium (600 ppm) during week 1 prevented deficiency when 160 ppm Mg was fed in week 2; however, tibia magnesium was lower than that in birds fed 300 ppm Mg throughout. The protection may be related to reutilization of skeletal magnesium, which was elevated on day 7. In this and another experiment, birds initially fed 300 ppm Mg followed by 160 ppm (7-28 days) or 125 ppm Mg (14-28 days) had normal hemoglobin values at 21 and 28 days. These experiments showed that magnesium requirement decreased as quail aged (up to 4 weeks) and that a high magnesium diet (600 ppm) fed through days 0-7 protected against subsequent dietary inadequacy. PMID- 6854410 TI - Net nutrient absorption in beef steers fed silage or high concentrate diets containing four levels of limestone. AB - Net absorption of ammonia N, urea N, glucose, L-lactate, and volatile fatty acids was measured in four Hereford x Angus steers fed ad libitum orchard grass-clover silage. Net absorption was calculated as the product of blood plasma flow from portal-drained viscera and the difference in concentration between plasma from the portal vein and femoral artery. Measurements were made at 15-minute intervals for 4 hours. The steers were then adapted to four 92% concentrate diets containing 0.64, 1.42, 2.21, or 3.00% limestone. Net absorption measurements were repeated in a 4 x 4 Latin square design. Portal blood flow was slower (P less than 0.05), net ammonia N absorption was greater (P less than 0.05), and net absorption of L-lactate and propionate was lesser (P less than 0.10) when steers were fed silage than when they were fed 92% concentrate. There was net loss of urea N and glucose from plasma to the gut regardless of diet. Dietary limestone level did not affect net absorption rates of any nutrient measured except L lactate, which decreased (P less than 0.10) as limestone level in the diet increased. PMID- 6854413 TI - Comparison of copper metabolism between brindled mice and dietary copper deficient mice using 67Cu. PMID- 6854411 TI - Zinc and copper in rat bile and pancreatic fluid: effects of surgery. AB - The control of Zn and Cu homeostasis in the gut is not well understood; a role for bile and pancreatic secretions has been suggested. In the present study, the changes in biliary and pancreatic Zn and Cu after surgery were followed. Rats were prepared surgically with pancreatic, biliary, and intestinal cannulae, placed in restraint cages, and allowed to recover from anesthesia. Fluids were collected for up to 120 hours. Aliquots of the collected samples were analyzed for Zn and Cu. Zn in pancreatic juice did not follow a consistent pattern; however, the concentration of Zn was well correlated with pancreatic protein concentration. Cu in pancreatic juice was very low and was apparently not affected by surgery. In bile, Zn concentration increased markedly at about 40 hours postsurgery but declined to its initial level by days 4-5. Cu concentration in bile was similar to that of Zn initially, then increased 10-fold after 20-30 hours postsurgery, and returned to the initial level by days 4-5. These results demonstrate that the surgical procedure of cannulating bile and pancreatic ducts has a pronounced effect on the concentrations of Zn and Cu in bile and pancreatic fluid. This effect must be considered when designing and evaluating experiments concerned with the role of these secretions in trace element homeostasis. PMID- 6854414 TI - Influence of vitamin B-12 status on hepatic propionic acid uptake in sheep. AB - Pregnant ewes were fed a depletion diet low in cobalt (0.06 ppm) for 3 1/2 months. Chronic catheters were implanted 8 weeks postpartum and 7 experiments were performed on these nonlactating vitamin B-12-depleted sheep (de-B12: 340 +/- 30 ng vitamin B-12 per gram wet liver) prior to repletion by intramuscular injection of hydroxocobalamin. Six experiments were then repeated after vitamin B 12 repletion (re-B12: 2220 +/- 50 ng vitamin B-12 per gram wet liver). The hepatic extraction ratios (HER) in continuously fed sheep were 0.81 and 0.77 for de-B12 and re-B12 corresponding to net hepatic uptakes of 460 +/- 50 and 440 +/- 40 mumol propionate per minute, respectively. Continuous infusion of unlabeled propionate into a mesenteric vein at 1 mmol/minute reduced the HER, yet this depression was greatest for re-B12 (0.74 vs. 0.63 for de-B12 and re-B12, respectively). Net hepatic uptake of propionate was increased (1145 +/- 100 vs. 985 +/- 95 mumol/minute, respectively), although vitamin B-12 status was without effect. It is concluded that the ability of liver to extract propionate is not affected at vitamin B-12 concentrations greater than 250 ng/g wet liver. However, when propionate entry rate was enhanced by intramesenteric infusion, the livers of de-B12 sheep had a greater capacity to remove propionate suggesting that alternate routes of metabolism may occur. PMID- 6854416 TI - Inhibition of acetylcholinesterase from human erythrocytes by isocyanates. AB - Four isocyanates, two of which are widely used in industry, were found to be potent inhibitors of acetylcholinesterase from human erythrocytes. Aliphatic isocyanates are stronger inhibitors of the enzyme than are aromatic isocyanates. Incubation at 21 to 23 degrees C for several days leads to slow and limited spontaneous reactivation of the inhibited enzyme. This enzyme inhibition may be a contributing factor in the induction of respiratory disease observed in about 5% of workers exposed to isocyanate vapors. PMID- 6854415 TI - Effect of increased dietary carbohydrate on selenium metabolism and toxicity in rainbow trout (Salmo gairdneri). AB - Juvenile trout were reared on either a high available carbohydrate (HC) or low available carbohydrate (LC) diet supplemented with from 0 to 10 micrograms selenium per gram of diet for 16 weeks, to determine if excess liver glycogen deposition affected the metabolism and toxicity of dietary selenium. Trout reared on the HC diet with 10 micrograms selenium per gram diet first demonstrated signs of selenosis and had significantly higher (P less than 0.05) liver selenium levels than trout reared on the LC diet with 10 micrograms selenium per gram diet after 16 weeks, indicating that excess dietary carbohydrate enhances dietary selenium toxicity in trout. The mechanism of the interaction is unclear since neither selenium elimination rates nor carcass and kidney selenium levels were affected by the dietary carbohydrate level. Trout reared on high dietary selenium diets (10 micrograms/g) had an increased incidence of renal calcinosis. In addition, liver copper levels were significantly affected by both dietary selenium and liver glycogen content indicating a significant copper-selenium and copper-glycogen interaction in trout. The development of renal calcinosis and the copper interactions suggest a variety of toxic effects of selenium on trout that may all be responsible for the observed changes in growth and feed efficiency. PMID- 6854417 TI - Anatomy of the healthy worker effect: a critical review. AB - The healthy worker effect is the composite result from factors such as (1) selection of the work force, (2) changes in lifestyle accompanying employment, and (3) methodological characteristics of the standardized mortality ratio (SMR). While the choice of the general population as the comparison population is the underlying reason for this effect, no more feasible, widely accepted or "better" alternative is yet available. Much of the current understanding of the healthy worker effect has been limited to an examination of selection of the work force. The purpose of this report is to illustrate, using examples from a large cohort study, the importance of many factors other than selection. They include employment-associated benefits such as economic gain, medical insurance and lifestyle changes, the proportion of active workers, the calculation method, data completeness, length of follow-up and certain characteristics of SMR methodology. It is shown that some of the healthy worker effect is characteristic of SMR methodology and that the strength of the healthy worker effect depends on the proportion of active workers in the cohort. Furthermore, the disappearance of the healthy worker effect may be due to factors such as aging of the cohort and can be totally unrelated to the true increase in the mortality risk. In other words, its disappearance, in many instances, may be an artifact of SMR methodology. PMID- 6854418 TI - A study of dermatitis in trona miners and millers. AB - Trona (sodium sesquicarbonate) is mined from an underground deposit in Wyoming and processed for use in the manufacture of glass, paper, and detergents, and in chemical applications. Trona dust is alkaline (pH 10.5) and may have an irritant effect on the respiratory airways, mucous membranes, and the skin. One hundred forty-two underground miners and 88 surface workers from one trona facility participated voluntarily in an epidemiologic and clinical study. Their mean age was 37.6 and their mean working period, 10.0 years. One half of the study participants complained of skin symptoms; dermatologic symptoms increased from twofold to fifteenfold after the subjects began trona mining. Trona dermatitis consists of pruritic, erythematous, raised, dry, and fissured lesions commonly affecting the hands, arms, and legs. A dose-response relationship was observed among underground workers. Patch testing with 10% aqueous trona and sodium carbonate was negative, suggesting that the dermatitis was primarily irritant in nature. PMID- 6854419 TI - An alternative method in the treatment of alcoholism: the United Technologies Corporation day treatment program. AB - In monitoring alcoholism treatment for its employees, United Technologies Corporation concluded that additional levels of treatment alternatives were needed. In a five-year period the average length of alcoholism treatment doubled and costs per patient tripled without improving treatment outcome. In addition, certain clinical needs of some employees and their families were not best served by inpatient treatment. Analysis of the first year outcome of a day treatment program indicates that day treatment provides an effective alternative method for alcoholism treatment. Day treatment proves to be effective both as a first treatment intervention and in instances of relapse. PMID- 6854422 TI - Cancer morbidity among auto industry woodworkers. PMID- 6854421 TI - Herbicide exposure and pulmonary disease. PMID- 6854420 TI - A case-control study of chemical exposures and brain tumors in petrochemical workers. AB - The relationship between chemical exposures and deaths attributable to primary brain tumors among employees of a Texas petrochemical plant was investigated. Cases consisted of 21 deaths in which the underlying cause was confirmed as a primary brain tumor. Two control groups of 80 employees each were randomly selected from 450 decedents known to the company in June, 1979. Potential exposures while employed were compared between cases and controls for five known or suspect carcinogens. Exposure potentials were also compared for an additional 37 chemicals to which at least four cases were potentially exposed. Overall and 15-year latency analyses were performed. The proportion of cases exposed to the five potentially carcinogenic chemicals (including vinyl chloride) were lower than or consistent with the proportion of exposed controls. No statistically significant differences between the proportions of cases and controls exposed to the 37 other chemicals were found. PMID- 6854424 TI - Pipetter's shoulder--hazard III. PMID- 6854423 TI - Epileptics in mining. PMID- 6854425 TI - Occupational morbidity data in myocardial infarction. A case-referent study in West Germany. PMID- 6854426 TI - Occupational allergy to laboratory animals: employer practices. AB - Occupational asthma from exposure to laboratory animals has recently been recognized as a compensable prescribed disease in Britain. Current American employer attitudes and policies regarding laboratory animal allergy were surveyed by questionnaire and the findings compiled from 155 institutions. Laboratory animal allergy was reported as a workplace disease of animal house employees by 108 facilities (70%), with rat and rabbit exposure the most frequent cause. While 103 of 155 animal research facilities required a preemployment medical examination, only six of these included hypersensitivity screening. Applicants for jobs involving animal contact were rarely disqualified because of an allergic history. A uniform policy regarding the problem of allergy to laboratory animals in U.S. animal facilities is not presently apparent. PMID- 6854427 TI - A case-control study of brain tumor mortality at a Texas Chemical plant. AB - A plant-based case-control study was undertaken to investigate a possible excess of brain tumor mortality identified at a Texas Chemical plant from a sample-based cohort study. Work histories and presumptive exposures of 28 former employees who had died of primary intracranial neoplasms were contrasted with those of two matched comparison groups in an effort to identify a possible etiologic agent. Because the sample-based cohort study suggested they might be at increased risk, those employees hired prior to 1945, those employed from one to four years and those employed for 20 or more years were studied separately. No statistically significant associations were found, although an elevated risk was suggested for employment in the machine shop prior to 1945 based on three exposed cases. PMID- 6854428 TI - An investigation of brain tumors among chemical plant employees using a sample based cohort method. AB - Using a modification of the traditional cohort mortality methodology, risk estimates of death due to brain tumors were calculated for production and nonproduction employees of Dow Chemical U.S.A., Texas Division. A total of 25 malignant, benign and unspecified brain tumors were identified using a geographically limited record-linkage process. Expected deaths were extrapolated from 1,666 white males in a 5% sample of the 1940 through 1977 total workforce. The resulting sample-based standardized mortality ratios (which were not evaluated for statistical significance) suggest, at most, only a slight increased risk of mortality from brain tumors for the overall time period. There was, however, a probable elevated risk associated with first employment prior to 1945. To date, diminished risk has been noted for those hired during subsequent years. PMID- 6854429 TI - The risk of infertility and delayed conception associated with exposures in the Danish workplace. AB - The association between infertility and a number of occupations and occupational exposures was examined in a case-control study utilizing data collected from medical records and mailed questionnaires. The results suggest that male exposure to heat and female exposure to noise, textile dyes and lead, mercury, and cadmium are associated with infertility. Further research is needed to examine the entire spectrum of abnormal reproductive and developmental outcomes of exposure to these agents and to identify their full effects. PMID- 6854431 TI - Projections of asbestos-related disease 1980-2009. AB - Approximately 19,000 cases of mesothelioma and 55,000 cases of lung cancer will arise in U.S. men with histories of nontrivial occupational exposure to asbestos. There are approximately 65,000 U.S. men now alive with clinically diagnosable asbestosis. These estimates are based, in the case of the cancer, on estimates of the effective number of asbestos-exposed workers required to produce the current national incidence of mesothelioma. The asbestosis estimates are based on a number of rough measures relating the prevalence of asbestosis to the incidence of mesothelioma, the incidence of compensable asbestosis in other countries, the prevalence of and mortality from pneumoconioses generally, and the number of workers heavily exposed to asbestos. PMID- 6854432 TI - An ultrastructural study of the macrophages of the carrageenan-induced granuloma in the rat lung. AB - The intralobular injection of 0.17 ml of 2 per cent. carrageenan into the rat lung induced an inflammatory granulomatous response. This inflammation was characterized in the early stages by immediate polymorphonuclear (PMN) leucocyte infiltration into the alveoli. Within 2 days the PMN's began to disappear and were replaced by carrageenan-containing macrophages. Alveolar macrophages actively phagocytised the injected carrageenan and were the dominant cell type in he alveoli for the length of this study (365 days). These low-turnover alveolar macrophages, which with light microscopy stained pinkish-red metachromatically with toludine blue due to their carrageenan content, underwent changes in vacuole morphology as well as changes in size and shape. Throughout the course of this inflammation, these macrophages had carrageenan-containing vacuoles which could be seen undergoing fusion to form larger vacuoles which at times constituted half the size of the entire macrophage cytoplasm. The carrageenan in the vacuoles was an amorphous flocculent appearing material for the initial 14 days but changes to a more fine filamentous form for the remainder of the study. This was probably due to its partial digestion by lysosomal enzymes. The general composition of the cytoplasm remained fairly constant during the 365 days. Pinocytotic vesicles and free ribosomes were abundant and the many mitochondria were small and rounded. Smooth endoplasmic reticulum lysosomes, and Golgi apparati, although not prominent, were present but the most striking feature of the cytoplasm was the presence of numerous lamellar bodies (phagocytosised surfactant). Some of the macrophages increased greatly in overall size (five to seven times) compared to their initial size. A few isolated macrophages could be seen degenerating but no general necrosis was seen. Except for one isolated case, no epithelioid cells were observed in this carrageenan inflammation. Fibrosis, if present at all, was very localised and was only evident at day 340 post-injection. This fibrosis generally involved one or two carrageenan-containing macrophages encapsulated by a few collagen fibres. No widespread fibrosis was ever observed in this study which confirmed earlier histological and biochemical investigations. PMID- 6854430 TI - Vibration white finger disease among tree fellers in British columbia. AB - On the basis of symptomatology, 51% of 146 fellers from seven coastal lumber camps in British Columbia were found to be suffering from vibration white finger disease (VWFD). Symptoms were present in 70% of the men who had been engaged in felling for 11 to 15 years and in 75% of the men who had been employed in this occupation for more than 20 years. Prevalence rates were not changed by the exclusion of 57 fellers with a history of vibration exposure other than the chain saw, or with a history of other possible secondary causes. The prevalence of symptoms in an age-corrected control group was 2%. There was objective evidence of disease (delayed finger rewarming after cooling) in 31 of the 43 fellers with symptoms (72%) and in 13 of the 74 controls (18%) without symptoms. The median latency period for fellers with symptomatic VWFD was 7.3 years. There was no evidence that the condition was related to cigarette smoking. PMID- 6854433 TI - Induction of renal tumours in rats by the administration of 1,2 dimethylhydrazine. AB - Administration of dimethylhydrazine (DMH) to adult rats by two subcutaneous injections each of 120 mg(base)/kg body weight and spaced 10 days apart resulted in the development of renal tumours in over 90 per cent. of treated animals at 30 weeks after injection. The tumours were frequently bilateral and multiple, and had the structure of the "mesenchymal" tumours which occur in a high incidence following treatment with nitrosamines. The incidence of tumours both in the small intestine and in the colon was lower than that experienced using a weekly DMH treatment schedule. PMID- 6854436 TI - Ultrastructure of pulmonary alveoli and macrophages in experimental Legionnaires' disease. AB - Guinea pigs, rhesus monkeys and marmosets infected with Legionella pneumophila in small particle aerosols developed an acute fibrinopurulent bronchopneumonia. Changes from 24 hr included exudation into alveoli of protein-rich, often fibrinous fluid and many polymorphonuclear leucocytes (PMN) and macrophages. Damage to alveolar capillary endothelium consisted of widespread cytoplasmic swelling and vesiculation, but necrosis of endothelium and the associated alveolar epithelium was focal and less common. Phagocytosis of L. pneumophila organisms was predominantly by macrophages, but the bacteria were also seen in PMN. Free organisms were present in alveoli and capillary lumina at all stages of the infection but were not observed in lung parenchymal cells. Some infected macrophages and PMN became necrotic and lysed to release intact bacteria. In all species of experimental animal, intracytoplasmic aggregations of granular material, believed to be glycogen, were seen frequently in macrophages and PMN which had phagocytosed L. pneumophila. These deposits of glycogen may reflect either an increased energy demand by the host cell or an interference with its carbohydrate metabolism. PMID- 6854435 TI - Renal lesions in the obliterative cardiomyopathies: endomyocardial fibrosis and Loffler's endocarditis. AB - Electron and, or light microscopic examination of paraffin embedded renal tissue obtained from necropsies on eleven patients with obliterative cardiomyopathy showed a variety of abnormalities. Glomerular lesions present in patients with endomyocardial fibrosis included capillary wall thickening, basement membrane duplication, mesangial expansion and interposition, intraluminal fibrin and dense subendothelial deposits. These changes, some of which have been reported earlier in patients with Loffler's endocarditis, probably result from deposition and organisation of immune complexes. PMID- 6854437 TI - An electron microscopic study of the effects of vinblastine sulphate on the ultrastructure of the kidney, trachea, liver, peripheral nerve and small intestine of the rat. AB - The effects of vinblastine in high doses on the kidney, liver, trachea, peripheral nerve and small intestine of rats have been studied by scanning and transmission electron microscopy. Dramatic structural changes were seen in glomerular visceral epithelial cells, hepatocytes and small intestinal epithelial cells which appear to be due to the effect of vinblastine on microtubules and possibly also on other proteins and cell membranes. Ciliary microtubules appeared resistant to vinblastine effects. PMID- 6854438 TI - Teenage drug use: opportunities for the pediatrician. PMID- 6854434 TI - The role of plasma factors in the adherence of leucocytes to vascular endothelial cells. AB - Studies have been undertaken to search for humoral factors present in the plasma from animals undergoing inflammation which may promote specific cell types to adhere to vascular endothelium. We have tested both plasma from animals with "acute" pleural inflammation and animals with "chronic" carrageenan air pouch granulomata for the presence of leucocyte pro-adhesive activity. Plasma from animals with carrageenan pleurisy had augmented polymorph adhesive activity. This activity was absent in the plasma from animals with air pouch granulomata. No such pro-adhesive activity for mononuclear cells was detected in this plasma. We conclude that the initial influx of polymorphs during the early stages of inflammation may in part be due to systemic pro-adhesive factors. It is proposed that these factors in combination with chemotaxins released at the lesion site are responsible for the early dominance of polymorphs. PMID- 6854439 TI - Speak up for pediatricians! PMID- 6854440 TI - Gianotti-Crosti syndrome and Epstein-Barr virus infection. PMID- 6854443 TI - Closure of PDA re risk of IVH. PMID- 6854445 TI - Early-treated phenylketonuria: neuropsychologic consequences. AB - Twenty-seven children with phenylketonuria who had undergone dietary restriction of phenylalanine since infancy were administered a battery of neuropsychologic tests in childhood. Children without PKU were also assessed. Discriminant function analysis of the neuropsychologic measures resulted in correct diagnostic classification for 94% of the total sample. Measured intelligence, school achievement, concept formation, and tactile-motor problem solving were the most powerful discriminators. In general, motor speed and coordination were not significantly different in patients compared with nonpatients. Serum phenylalanine concentration on the day of neuropsychologic testing was negatively correlated with performance. Correlation coefficients between infant serum phenylalanine concentrations and later neuropsychologic performance did not reach statistical significance. We suggest that concurrent serum phenylalanine concentrations affect neuropsychologic performance and that therefore the practice of terminating dietary restriction requires further scrutiny. PMID- 6854441 TI - Effect of mode of delivery on leukocyte function of neonates. PMID- 6854442 TI - Breast-feeding and infant botulism. PMID- 6854444 TI - Bone mineral loss in lactating adolescents. PMID- 6854447 TI - Evolution of renal segmental atrophy (Ask-Upmark kidney) in children with vesicoureteric reflux: radiographic and morphologic studies. AB - A radiographic and morphologic study of nine patients with renal segmental "hypoplasia," whose kidneys were radiographically normal when first examined, showed the lesion to be a form of localized, progressive renal atrophy. The renal abnormality bears a strong relationship to vesicoureteric reflux, which could be demonstrated in every patient. No evidence of renal scarring or atrophy was observed in initial roentgenographic examinations at a mean age of 2.9 years (range 0.1 to 10 years); however, serial studies during five to 14 years after discovery of vesicoureteral reflux demonstrated both a lack of renal growth and a progressive loss of substance irrespective of infection. Radiographic lengths of scarred kidneys, as measures of renal growth, correlated poorly with the radiographic surface areas of the renal parenchymal outlines. The mean time from discovery of vesicoureteric reflux to appearance of a renal scar was 6.1 years, and to onset of hypertension in six patients was 7.8 years. The renal abnormality consisted of lobar atrophy with variable tubular atrophy and glomerular sclerosis and with parenchymal destruction that in some specimens had proceeded to a complete loss of nephronic elements. The occasional presence of relatively well preserved glomeruli and tubules and of focal segmental sclerosis within persisting glomeruli was taken as evidence of a progressive renal abnormality, as opposed to a static developmental hypoplasia. These observations indicate that renal scarring, the injury presumably having been initiated by vesicoureteric reflux, can progress despite correction of the reflux and despite prevention of urinary tract infection. PMID- 6854446 TI - Excessive fluid intake as a cause of chronic diarrhea in young children. AB - An increased incidence of chronic nonspecific diarrhea has been coincident with popularization of orally administered fluid-electrolyte therapy for management of diarrhea, and led up to postulate than an increase in fluid intake might be related to this increased incidence. Of 105 referred patients, 85 were found to have no clinical or laboratory evidence of malabsorption. Forty of these patients had characteristic features of CNSD: diarrhea for at least three weeks, normal growth, and no evidence of enteric pathogens. An outpatient study evaluated fecal output, dietary energy-protein intake, and nonprotein fluid intake. Patients were separated into two groups whose fluid intakes were highly different: group A, 196 +/- 32 ml/kg/day, and group B, 91 +/- 15 ml/kg/day (P less than 0.001). The nonprotein fluid intake was then reduced to 90 ml/kg/day with no change in diet. Evaluation at two weeks and again at six to eight weeks showed a decrease in stool frequency (from four to ten per day to zero to three per day) and increase in stool consistency in all patients in group A, but no significant change in stool patterns in group B. Our findings suggest a cause-and-effect relationship between excessive fluid intake and some cases of CNSD. PMID- 6854448 TI - Sleep EEG abnormalities in children with near-miss sudden infant death syndrome, in siblings, and in infants with recurrent apnea. AB - Electroencephalograms during light sleep were performed in controls and in infants with near-miss sudden infant death syndrome, in siblings of such infants, and in infants with recurrent apnea, all from 2 to 8 months of age. EEG background and multiple sleep spindle characteristics were compared for individual children in each of these groups. From 2 to 6 months of age, but not later, all at-risk groups differed from controls by the presence of excessive variability of sleep spindle frequency during sleep recordings. However, the three groups at risk for SIDS did not significantly differ from each other. It is concluded that careful analysis of routine sleep EEGs may in some cases help differentiate young infants at risk for apnea or SIDS from normal children. PMID- 6854449 TI - Ventilatory functions of normal children and young adults: Mexican-American, white, and black. III. Sitting height as a predictor. AB - We studied the ventilatory functions of 1800 normal children ranging in age 7 to 20 years. Boys and girls of black, white, and Mexican-American ethnic groups were represented adequately. The FVC and FEV1 of normal black children were fully 1 SD lower than those of white children with the same standing height. Such racial differences could not be corrected by a scaling factor, because the differences vary with sex and also with height as the children grow. Using sitting height as a predictor greatly reduced the racial differences of ventilatory functions and permitted the application of one set of prediction equations for children of all three groups. PMID- 6854451 TI - Abnormality of chromosome 11 in patients with features of Beckwith-Wiedemann syndrome. AB - Two unrelated children with features of Beckwith-Wiedemann syndrome have been found to have partial duplication of chromosome 11p. A review of six other reported cases of partial duplication of 11 p revealed features of this syndrome not previously recognized. We suggest that karyotype studies with banding techniques should be done in children with features of Beckwith-Wiedemann syndrome and developmental delay or retardation. PMID- 6854450 TI - Femoral hypoplasia-unusual facies syndrome in infants of diabetic mothers. AB - Three children with the femoral hypoplasia-unusual facies syndrome are described. Two had the characteristic facial pattern of upslanted palpebral fissures, long philtrum with thin upper lip, micrognathia, and hypoplastic alae nasi. The other, an infant girl who died within 24 hours after birth, had a cleft lip, which distorted some of the other features. She also had a cleft palate, as did one of the two older boys. All three children had ear defects, upper limb involvement, and rib, vertebral, lower extremity, and genitourinary tract abnormalities. The infant girl died of lung hypoplasia associated with dysplastic kidneys and widely patent ductus arteriosus. All three were infants of diabetic mothers, one mother having developed overt diabetes in the first trimester of pregnancy. A literature review of 36 reported cases of FH/UFS revealed 12 individuals who were IDMs, establishing a strong relationship of the syndrome with maternal diabetes. A multifactorial inheritance model fits with the reported patients, with the relationship to diabetes, and with the similarity of FH/UFS to caudal regression, another condition related to maternal diabetes. PMID- 6854452 TI - Scarlatiniform rash and pleural effusion in a patient with Yersinia pseudotuberculosis infection. PMID- 6854454 TI - Defective infant antiviral cytotoxicity to herpes simplex virus-infected cells. PMID- 6854453 TI - Paroxysmal supraventricular tachycardia precipitated by pertussis vaccine. PMID- 6854455 TI - Mosaic Turner syndrome with precocious puberty. PMID- 6854457 TI - Comparison of methods of measuring renal function in preterm babies using inulin. AB - Glomerular filtration rate and urine flow were measured in 40 babies of 26 to 40 weeks' gestation without the need for accurately timed collections of urine by infusing inulin continuously for greater than or equal to 24 hours. Estimates of GFR and urine flow were similar to those obtained when timed specimens of urine were also collected, the coefficient of variation being only 6.1% (22 studies). Although the plasma inulin concentration 80 minutes after a bolus and continuous infusion changed only slowly, it still closely reflected the size of the bolus dose (eight studies, P less than 0.001) and did not correlate with GFR (P = 0.48) as previously claimed. The GFR measured over two hours with a single injection of inulin correlated poorly with values recorded after a continuous 24-hour infusion of inulin (n = 5, P greater than 0.1). The agreement was closer (P less than 0.1) and the values lower (P less than 0.02) when the single-injection studies were extended to five hours. The half-life of inulin in the plasma of preterm babies was 4.3 +/- 0.8 hours (14 estimations in nine babies). This is longer than in adults because babies have a low GFR and a relatively large extracellular fluid compartment. The duration of some renal function test protocols needs to be extended because the long half-life leads to slower changes in plasma concentrations of test substances cleared by the kidney, and delayed equilibration. PMID- 6854456 TI - Effect of gestational age on ductus arteriosus response to circulating prostaglandin E2. AB - Premature newborn lambs with a patent ductus arteriosus have higher plasma prostaglandin E2 concentrations than near-term newborn lambs with a contricted ductus arteriosus. To see whether these concentrations of PGE2 could produce patency of the ductus arteriosus, we studied eight near-term lambs (with constricted ductuses) delivered by cesarean section, paralyzed, and mechanically ventilated. After ductus arteriosus resistance and plasma PGE2 concentrations had stabilized, a continuous PGE2 infusion into the superior vena cava was started to determine threshold concentrations needed to dilate the ductus in vivo. By two hours after birth, circulating PGE2 concentrations in near-term lambs were considerably less then the threshold concentration, and the ductuses were constricted. In five premature newborn lambs, significantly lower concentrations of PGE2 were required to dilate the ductus: threshold and ED50 concentrations were one sixth and one third, respectively. In these premature lambs during the first two hours after birth, circulating PGE2 concentrations were twice as high as the calculated in vivo threshold level. Therefore, circulating PGE2 concentrations probably played a significant role in the patency of the ductus arteriosus in these premature lambs. PMID- 6854458 TI - Iodine-induced alterations of thyroid function in newborn infants after prenatal and perinatal exposure to povidone iodine. PMID- 6854461 TI - Developmental framework of infants and children: a future for pediatric responsibility. PMID- 6854459 TI - Endogenous substance in newborn infants causing false positive digoxin measurements. AB - We report the detection of a digoxin-like immunoequivalent substance in the plasma of neonates and infants and in amniotic fluid. Time-course studies in individual infants indicate that the substance probably is produced endogenously and is not exclusively retained by the infants from external sources. Digoxin recovery studies demonstrated that the presence of this material caused falsely elevated digoxin values. Our results cast considerable doubt on the reliability and clinical utility of digoxin radioimmunoassay measurements on the serum or plasma of neonatal and infant patients. PMID- 6854462 TI - The family: a pediatric assessment. PMID- 6854460 TI - Recurrent wheezing and massive atelectasis in an adolescent. PMID- 6854463 TI - Family therapy: a view for pediatricians. PMID- 6854464 TI - The sick child and the family. PMID- 6854465 TI - Coping with major disease: child, family, pediatrician. PMID- 6854467 TI - Phobias in children. AB - Although fears are so common in children as to be "normal," phobias associated with prolonged avoidance of ordinary situations are distinctly uncommon, even among children in psychiatric treatment. Three treatment approaches are described, including traditional dynamically oriented psychotherapy and the use of antidepressant medication, with major emphasis given to the new supported exposure technique widely practiced in contemporary phobia programs. PMID- 6854466 TI - Assisting the bereaved. PMID- 6854469 TI - Preservation of Schistosoma mansoni eggs and of infected livers as a source of eggs for the circumoval precipitin test. AB - Eggs of Schistosoma mansoni and livers with numerous granulomata were preserved at -70 C in 1.7% salt solution plus an equal volume of water-soluble jelly. The eggs were suitable for circumoval tests after at least 1 yr of preservation and the livers supplied adequate eggs for the tests for at least 6 mo after preservation. This procedure may be useful where such storage facilities are available, and the COP test is used for diagnosis. PMID- 6854468 TI - Interrelationships of immunoconglutinin, immune complexes, and complement in anemia, thrombocytopenia, and parasitemia of acute and chronic malaria in rats. AB - Anemia, thrombocytopenia and reduction in parasitemia in P. chabaudi infection of rats were associated with appearance in blood of soluble immune complexes, immunoconglutinin (IK), and by reductions in titers of lytic complement. With reduction of parasitemia to subpatent levels, anemia, but not thrombocytopenia, persisted and erythrocyte counts did not return to preinfection levels for several weeks. This chronic anemia was accompanied by elevated amounts of soluble immune complex, depressed titers of lytic complement and persistence of IK. Evidence was presented indicating that the infections of the rats persisted in a chronic form. It was thus indicated that immune interactions, related to anemia and clearance of parasitemia, persisted in absence of microscopically evident parasitemia, and may have been in part responsible for the persistent anemia. Based on the evidence cited, it is suggested that complement-fixing immune complexes attach to blood cells, infected as well as uninfected, and that these cells are sequestered and phagocytized in the spleen after immunoconglutination by IK. It is also suggested that this interaction continued after the clearance of patent parasitemia and accounted for the persistence of anemia in the chronic phase of infection. PMID- 6854470 TI - Fascioliasis: bile duct collagen induced by proline from the worm. AB - We investigated whether collagen increases occur in the bile duct during fascioliasis, and their relationship to the release of proline by the worm. Experiments showed increased levels of collagen in the bile ducts of rats following 2 wk of infusion with proline or i.p. implantation with Fasciola. The increase in bile duct collagen in proline-infused animals and in worm-implanted animals could be completely inhibited to the amount in controls by 3,4 dehydroproline. These effects suggest that the hyperplasia of the bile duct that is induced by liver flukes involves stimulation of collagen deposition through their release of proline. PMID- 6854472 TI - Chromatography and isolation of the Kav 1.0 pheromone of female Nippostrongylus brasiliensis (Nematoda). AB - The Kav 1.0 pheromone from incubation of mouse-adapted females of Nippostrongylus brasiliensis was soluble in organic solvents, as shown by bioassay of males and presence of a peak at Kav 1.0 during gel filtration. Recovery of the biological activity from the females was enhanced when the Kav 1.0 component was purified by organic extraction-gel filtration, C-18 cartridge separation with 50% methanol, C 18 cartridge-gel filtration, and C-18 cartridge-TLC. The activity recovered from organic extraction, TLC, or gel filtration of solutions in which females had been incubated was less than the above combined techniques. Reverse-phase cartridges retained activity of 20,000 female-hr of incubation without loss and enabled storage of the pheromone component for 3 days at 4 C. The HPLC separation of incubate from females revealed an active peak(s) with a 4- to 5-min retention time. This peak(s) was present also in regions containing activity from other purification procedures. PMID- 6854473 TI - Schistosoma mansoni: morphologic changes induced by maintenance in vitro. AB - Adults of Schistosoma mansoni were incubated in several culture media at various time intervals ranging from 2 to 96 hr. The morphologic changes induced by the incubation were documented using both scanning and transmission electron microscopy. These included changes in the tegument, esophageal cells, and cecum. Variability was noted among worms within experimental groups and the surface changes on single worms were frequently observed to have patchy distribution. Based on morphologic changes observed, culture media were ranked as adequate, mediocre, or inadequate. RPMI-1640 + 50% fetal calf serum, Eagle's MEM with Earle's salts (no serum), and McCoy's 5A Medium + serum were judged adequate. Basal Eagle's Medium, Triple Eagle Medium, NCTC-135, and Earle's Balanced Salt Solution (all with or without serum) were judged mediocre. Hanks' Basal Salt Solution (with or without serum) was judged as severely inadequate. All media tested gave better results in the presence of serum. These factors point to the necessity for the use of carefully selected culture media, as well as adequate controls and sampling techniques in the interpretation of in vitro experiments with S. mansoni. PMID- 6854474 TI - Schistosoma mansoni: evaluation of selected preparative procedures for transmission and scanning electron microscopy. AB - Evaluation of numerous procedures for collection and preparation of Schistosoma mansoni for scanning (SEM) and transmission microscopy (TEM) revealed that some commonly used methods result in introduction of osmotic or mechanical damage. Modification and selection of appropriate procedures allowed elimination of these artifacts. Not eliminated by these procedures, however, were several kinds of spheres and blebs that were either external to the apical plasma membrane of the tegument or budding from it. After careful examination of all procedures, we concluded that these spheres appear to some extent on all schistosomes prepared for either SEM or TEM and may represent either a normal component of the schistosome surface, a constant host contaminant, or an artifact not eliminated by any of the multiple modifications of technique examined. PMID- 6854475 TI - Transplacental transmission of Dirofilaria immitis microfilariae in the dog. PMID- 6854476 TI - Interspecific interactions between Nippostrongylus brasiliensis and Eimeria nieschulzi in the rat. AB - Interspecific interactions between Nippostrongylus brasiliensis and Eimeria nieschulzi were studied by measuring parasite fecundity and patency in rats concurrently infected with both species. Nine groups of five rats each were inoculated with either 4 x 10(3) N. brasiliensis larvae or 2.6 x 10(5) E. nieschulzi sporulated oocysts or both. Groups 1 and 2 served as singly-infected controls. Group 3 rats were infected simultaneously with both parasites. Rats in Groups 4 to 8 were infected first with N. brasiliensis and later with E. nieschulzi on days 3, 4, 8, 9, and 14 PI. Rats in Group 9 were infected with E. nieschulzi and then with N. brasiliensis 2 days later. Patency of N. brasiliensis infections was extended significantly (P less than or equal to 0.05) beyond singly-infected controls in all groups with concurrent infections except Group 3, whereas ova production was significantly greater than that in singly-infected controls only when both parasites were administered simultaneously (Group 3). Patency of E. nieschulzi was significantly shorter in Group 7 rats and longer in Group 9 rats compared to that of singly-infected controls. Total oocyst production was unaltered except for Groups 5 and 7 in which there was a significant reduction. These results demonstrate that the endogenous stages of E. nieschulzi increased N. brasiliensis longevity. PMID- 6854477 TI - Dynamics of the platyhelminth fauna of wood ducks in relation to food habits and reproductive state. AB - The dynamics of the intestinal helminth fauna of wood ducks (Aix sponsa) and the relationship between changes in food habits and helminth populations during the bird's reproductive cycle were studied in southeast Missouri. A total of 11 species of helminths, comprised of four species of trematodes and seven species of cestodes, were recovered from the digestive tracts of 155 wood ducks. All species except one were found in both sexes. Significant differences were found in parasite numbers by season (spring vs. fall), sex, and stage of the reproductive cycle. Helminth infection in both sexes was higher in the spring than during fall courtship; however, the magnitude of the seasonal difference was considerably greater in females. Females contained significantly more helminths than males during spring, but no sex-related differences were detected in the fall. Seasonal changes and sex-related differences in parasite numbers corresponded closely with the consumption of invertebrates that serve as intermediate hosts. The average number of parasites in females was similar during fall courtship and pre-egg-laying, suggesting that little or no new infection occurred during winter. The most intensive infections were found in laying females and were attributed to hyperphagia and increased invertebrate consumption during egg production. A large decrease in the parasite numbers in females between incubation and fall courtship indicated that most of the helminths acquired by laying females were lost during summer; therefore, the long-term effects of the increased infection are probably negligible. PMID- 6854471 TI - Biochemical effects of thiabendazole and cambendazole on Hymenolepis diminuta (Cestoda) in vivo. AB - An investigation of the chemotherapeutic and biochemical effects of two benzimidazole anthelmintics, thiabendazole (TBZ) and cambendazole (CBZ), on Hymenolepis diminuta in experimentally infected rats is reported. Thiabendazole was active against H. diminuta at a relatively high dosage. A single oral dose of TBZ at 250 mg/kg body weight on day 15 of infection eliminated 100% of the tapeworms as determined at necropsy 5 days after treatment. The chemotherapeutic actions of TBZ on H. diminuta were accompanied by marked changes in worm weight and chemical composition. Tapeworms recovered from rats that had received a therapeutically effective dose of TBZ 24 hr earlier were significantly smaller and contained much less glycogen (as a percent of the wet weight) than worms from unmedicated controls. Protein concentrations increased in TBZ-treated worms and at a rate sufficient to offset the decline in glycogen concentration. Glycogen/protein ratios in TBZ-treated worms were significantly lower than the corresponding control values. Cambendazole proved to be five times more potent than TBZ against H. diminuta and produced the same basic changes in worm weight and chemical composition within 18 hr of treatment of the host. Administration of a single oral dose of TBZ or CBZ to the host produced in H. diminuta another change, the onset of which coincided with, or preceded, the gross alterations in worm weight and chemical composition. That change, observed in in vitro studies carried out 14 hr after treatment, revealed that tapeworms from drug-treated rats absorbed and metabolized much smaller quantities of exogenous glucose than did the controls, and the ability of the worm to accumulate glucose against a concentration difference was significantly depressed. PMID- 6854478 TI - Pathology (?) of Plagiorhynchus cylindraceus in the starling, Sturnus vulgaris. AB - Our field study did not support anecdotal claims alleging pathogenicity on the part of P. cylindraceus in starlings. Within-clutch analysis of nestling starling weights (n = 25) over time showed that P. cylindraceus had no effect on position in clutch relative to siblings. Parasitized nestlings tended to weigh more than control siblings. Within-sex analysis of wild adult starling weight (n = 103) showed no difference between animals with acanthocephalans and uninfected animals and weight was not related to intensity of infection. Host response to the proboscis was limited to immediately-surrounding tissue (90 microns). Other observations made in this study included the following: (1) no evidence for deleterious intraspecific interaction among adult P. cylindraceus in starlings; (2) no apparent interspecific interactions between P. cylindraceus and (unidentified) cestode species in starlings; and (3) copulatory caps on male P. cylindraceus may be a response to environmental deterioration in dead hosts. PMID- 6854479 TI - Spermatid production in unfed, Metastriata ticks. PMID- 6854480 TI - Trematodes from Goniobasis virginica (Gastropoda: Pleuroceridae) in Lake Musconetcong, New Jersey. PMID- 6854481 TI - Intestinal parasites and commensals in Saudi Arabian military recruits in Texas based on examination by the MIF and FE techniques. PMID- 6854486 TI - Elbow arteriovenous fistula (EAVF) for chronic hemodialysis in small children. AB - Elbow arteriovenous fistulae (EAVF) were constructed in 10 children aged 27 mo to 10 yr. There were no operative failures. Follow-up ranged from 5 to 22 mo. Three episodes of thrombosis occurred in a single child. The fistula was recanalized each time. The creation of an EAVF is a simple surgical procedure. Children weighing as little as 10 kg were efficiently dialysed for prolonged periods of time with this vascular access device. PMID- 6854482 TI - Infections with Eimeria species: the role of bile. PMID- 6854483 TI - Infections of Brugia pahangi in neonate mice. PMID- 6854487 TI - Hepatic artery ligation for hepatic hemangiomatosis of infancy. AB - Capillary and cavernous hemangiomas of the skin and subcutaneous tissue, usually follow a benign course with enlargement in the first year of life followed by gradual involution. Hemangiomas of the liver, on the other hand, can be responsible for life threatening complications in infancy. The presence of major intrahepatic arteriovenous communications may produce a high output cardiac failure, refractory to intensive medical therapy. Use of radiation therapy and high doses of steroids have proven to be of limited success with a 90% mortality in infants managed with nonoperative therapy. Hepatic artery ligation in such patients may provide dramatic control of the high output failure, with negligible side effects. Two infants are reported in whom bilateral hepatic artery ligation provided prompt control of fulminant congestive failure secondary to hepatic hemangiomatosis, after failure of medical therapy. PMID- 6854485 TI - An ultrastructural study of the intimal injury induced by an indwelling umbilical artery catheter. AB - In an experimental study, catheterization of the abdominal aorta with small umbilical artery catheters consistently produced significant intimal injury. The duration of catheterization varied from 1 hr to 7 days, and recovery periods following catheter removal varied from 1-150 days. Endothelial disruption was observed in all animals sacrificed within 24 hr of catheter removal. Healing progressed rapidly when the duration of catheterization was short, but was protracted with longer periods of catheterization. Thrombi were frequently found adhering to the exposed subendothelial surface. Routine light, scanning, and transmission electron microscopy demonstrated consistent cellular changes, which depended upon the duration of catheterization and the length of recovery periods. A consistent relationship between the degree of intimal injury and the duration of catheterization was observed. PMID- 6854484 TI - Relative insensitivity of a Kenyan strain of Leishmania donovani to pentavalent antimony therapy in hamsters. PMID- 6854488 TI - Intrahepatic bile ducts in biliary atresia--a possible factor determining the prognosis. AB - Intrahepatic bile ducts were investigated by operative cholangiography in 6 patients with the correctable type of biliary atresia, by percutaneous transhepatic cholangiography in 5 patients with noncorrectable type and by electron microscopy in biopsied hepatic tissues in 17 patients. Intrahepatic bile ducts were pathologic even in the early stage of the disease and they were involved all the way from bile ductules to large main hepatic ducts. The correlation between the prognosis and the electron microscopic presence of lumenal obstruction suggests that the pathologic change of intrahepatic bile ducts is one of the main factors determining prognosis. PMID- 6854489 TI - Experimental study of the pathogenesis of infantile obstructive cholangiopathy and its clinical evaluation. AB - 1,4-phenylenediisothiocyanate was given to five groups of rats of different developmental stages (97 in all), and the changes in the hepatobiliary system were compared histopathologically. Three groups of rats given the drug after birth showed dilatation of the extrahepatic bile ducts with inflammation. Two groups given the drug during the fetal period or added after birth showed stenotic or atretic extrahepatic bile ducts due to thickening and fibrosis of the wall. This experimental model suggests that differences in the pathologic features of infantile obstructive cholangiopathy (biliary atresia, neonatal hepatitis, and bile duct dilatation) may be the result of various developmental stages in the pathogenic process. After the experiment, 11 cases of correctable type biliary atresia were compared to 24 cases of noncorrectable type in various aspects. It is suggested that the correctable type may have suffered pathogenic process later in the developmental stages than noncorrectable type. PMID- 6854490 TI - An unusual association of small bowel atresia and biliary atresia: a case report. AB - The embryological development of the hepatobiliary bud presupposes that biliary and duodenal malformations are often associated. On the other hand, the association of biliary atresia with more distal small bowel malformations, possibly due to a vascular accident, seems to be fortuitous. We herewith report such a case and, on reviewing the literature, have found only two previous similar observations. PMID- 6854491 TI - Hydrops of the gallbladder in children. AB - Gallbladder disease in children today is being diagnosed increasingly because of better awareness of its existence and of improved diagnostic capability. A case is presented to describe an unusual pathologic variant termed "acute hydrops" of the gallbladder. This entity occurs specifically in children and is characterized by an acute illness with massive distention of the gallbladder in the absence of stones, bacteria, or congenital malformations. Differential diagnoses include appendiceal abscess, intussusception, volvulus, peritonitis, and pyelonephritis. Routine and contrast radiographic techniques may be combined with abdominal ultrasound to aid in the preoperative diagnosis. The etiology of hydrops is not known, but bile stasis and mesenteric lymphadenitis seem to be important factors. Treatment has varied from supportive observation to operative aspiration or cholecystectomy. PMID- 6854492 TI - Rhabdomyosarcoma in childhood: analysis of survival in 98 cases. AB - Ninety-eight infants and children with rhabdomyosarcoma were analyzed for age, stage, site, and therapy as they relate to survival. Age and sex were not factors. Survival was 91% (10/11) for Stage I, 86% (13/15) for Stage II, 35% (12/34) for Stage III, and 5.2% (2/38) for Stage IV. Overall survival was 37% (37/98); however, 75% had advanced disease at diagnosis. Primary tumor site was genitourinary (GU) (31), extremity (17), head-neck (14), trunk (14), orbit (8), paratesticular (4), retroperitoneal (3), paraspinal (3), buttocks (3), and perianal (1). Survival was favorable in orbital, paratesticular, and (GU) sites. Survival was 20% (9/45) before and 52% (28/53) after chemotherapy and irradiation. The only survivors had embryonal cell histology. Tumor stage and site are important prognostic indicators. Chemotherapy improves survival in Stage I (91%) and Stage II (86%) and shrinks bulky Stage III tumors allowing less radical procedures in selected sites (e.g., GU). Survival is poor in Stage III (35%) and dismal in Stage IV (5.2%) despite combined therapy. Relapse was fatal despite attempts at second-look resection, and altered chemotherapy and irradiation. PMID- 6854493 TI - An evaluation of the role of surgery in disseminated neuroblastoma: a report from the Children's Cancer Study Group. PMID- 6854494 TI - Resolution of prolonged neonatal apnea with hernia repair. AB - Three cases of hernia repair and simultaneous resolution of prolonged neonatal apnea are reported. An association has been made between vagal overactivity and apnea. Protrusion of a large hernia at times of vagal stimulation is suggested as a possible mechanism resulting in sustained inhibition of the respiratory control center by increasing vagal afferent traffic to this center. Consideration should be given to repair of hernias in the premature infant with neonatal apnea rather than wait for resolution of the apneic episodes. PMID- 6854495 TI - Femoral hernias in children. AB - This is a report of a personal series of 10 children seen with femoral hernias over a 15-yr-period. Femoral hernia in this age group is rare and a correct preoperative diagnosis is often overlooked. In nine of the 10 patients the preoperative diagnosis was correct. We attribute this to an accurate clinical examination and the awareness of this entity in the differential diagnosis of a groin lump. PMID- 6854496 TI - Lacuna magna: a hidden cause of dysuria and bloody spotting in boys. AB - Intermittent hematuria, dysuria, or bloody spotting of underwear are symptoms occasionally seen in young boys. The lacuna magna (valve of Guerin) is a common embryologic remnant often found to be the cause of these symptoms. While retrograde urethrography may occasionally be helpful, voiding films that include the distal penile urethra usually establish the diagnosis. Transmeatal excision or incision of the valve-like leaflet is curative, but often the problem is benign and self-limiting even without treatment. PMID- 6854499 TI - Snaring the guide for esophageal dilatation through a gastrostomy. PMID- 6854497 TI - Short segment Hirschsprung's disease as a cause of discrepancy between histologic, histochemical, and clinical features. AB - Diagnostic difficulty may be encountered in Hirschsprung's disease when discrepancy is noted between the histochemical pattern, the presence or absence of ganglion cells, and clinical features. This is mainly a problem in neonates, and the cause of the discrepancy is probably due to biopsy specimens being taken above a short aganglionic segment. When short segment Hirschsprung's disease is suspected, a low suction biopsy should be taken for the demonstration of acetylcholinesterase activity. PMID- 6854498 TI - The radiologic anatomy of the puborectalis muscle. AB - Dissections of the puborectalis muscle were made postmortem in seven newborns dying of non-surgical causes. The muscle was outlined with contrast material; lateral x-rays showed the normal radiologic position of this muscle to lie along a line drawn from pubis to the lowest point of the ischium. PMID- 6854500 TI - Bilateral choanal atresia in two members of one family. AB - Two children are presented with bilateral choanal atresia: a girl with the typical features of the Treacher Collins syndrome, and a boy, a third cousin of the girl, without mandibulo-facial dysostosis. Simultaneous occurrence of choanal atresia and the Treacher Collins syndrome may be based on a defective ossification of the mesenchyme of the first visceral arch. Choanal atresia may be due to nonabsorption of the bucconasal membrane and/or extension of the sphenoid or palate bone. PMID- 6854501 TI - Recurrent chylous ascites associated with intestinal malrotation and lymphatic rupture. AB - An 11-yr-old female with abdominal distension since birth, underwent four operations because of intractable and debilitating chylous ascites. The curative procedure consisted of preoperative ingestion of the lipophilic dye, a secondary Ladd's procedure, lysis of extensive adhesions, and ligation of an easily identifiable ruptured lymphatic. PMID- 6854503 TI - An unusual variant of a jejunoileal atresia. AB - This is a report of a patient with an unusual variant of intestinal atresia associated with third trimester bleeding that required an extensive small bowel resection. The patient had a 40 cm segment of atretic intestine removed, and continues to do well at age 11 mo despite a short-bowel syndrome and lack of ileocecal valve. No lumen was present in the atretic segment, but numerous foamy histiocytes were present. She weighs 8.1 kg, and is receiving a combination of parenteral nutrition and oral feedings. PMID- 6854504 TI - Retroperitoneal malignant schwannoma: a case report. AB - Malignant schwannomas are primary nerve sheath tumors that usually arise from peripheral nerves and only rarely occur within the retroperitoneum. Only 13 instances of this neoplasm occurring in such an anatomic location have been reported in the English literature, and none have been described previously in children. The present report details a case of a retroperitoneal malignant schwannoma in a 14-yr-old child. PMID- 6854502 TI - Jejunal carcinoma in a child. AB - A case of Peutz-Jeghers Syndrome in an 8-yr-old girl with an adenocarcinoma arising in the duodenum and jejunum is herein reported with a 9-yr follow-up. This carcinoma fulfills histologic criteria for malignancy in the Peutz-Jeghers Syndrome. We suggest that this represents a documented case of malignancy arising in a Peutz-Jeghers polyp. PMID- 6854505 TI - Ruptured abdominal aortic aneurysm in a 7-year-old girl. AB - A case of ruptured abdominal aortic aneurysm (AAA) in a 7-yr-old girl is reported. She required a graft of the abdominal aorta in an emergency operation and recovered successfully. AAA in children is extremely rare, and rupture of AAA to our knowledge has not been previously reported. The literature is reviewed and the possible etiology discussed. PMID- 6854506 TI - Idiopathic dilatation of the right atrium: postoperative follow-up in a child. PMID- 6854507 TI - Long-term outpatient amphotericin B therapy via a silicone central alimentation catheter. AB - A 6-yr-old boy with systemic histoplasmosis received intravenous amphotericin B for two months as an outpatient utilizing techniques developed for home parenteral nutrition. The therapy was administered on alternate days in the emergency room by nurses trained to use aseptic technique. No complications occurred. The merits of this technique include avoidance of prolonged hospitalization with its high cost and risk of nosocomial infection and better patient acceptance with the patient living at home and continuing many of his usual activities. PMID- 6854508 TI - Rhabdomyomatous dysplasia of lung and congenital diaphragmatic hernia. AB - A previously unrecognized association of pulmonary rhabdomyomatous dysplasia and congenital posterolateral diaphragmatic hernia is reported. The authors subscribe to the concept of ectopia and postulate an anomalous migration of cervical "diaphragmatic" rhabdomyoblasts as the most probable origin of the pulmonary muscle fibers. PMID- 6854509 TI - Blood and milk concentrations of metronidazole in mothers and infants. AB - In order to assess the amounts of metronidazole and its clearance in suckling neonates whose mothers received the drug in therapeutic doses, we measured its levels in maternal plasma and milk and in infant plasma. Eleven mothers receiving 600 mg metronidazole daily and 4 receiving 1200 mg and their 15 infants had milk and plasma levels determined with a specific semi-micro high-pressure liquid chromatographic method. Maternal mean plasma levels were 5.0 micrograms/ml, range 1.0 - 11.6 micrograms/ml (600 mg/day) and 12.5 micrograms/ml range 3.7 - 17.9 micrograms/ml (1200 mg/day) and corresponding infant plasma levels were 0.8 micrograms/ml, range 0.3 - 1.4 micrograms/ml and 2.4 micrograms/ml, range 0.6 - 4.9 micrograms/ml. Maternal milk/plasma ratio was 1 and baby/mother plasma ratio was 0.15, independent of dosage (Tab. I). The levels of metronidazole hydroxy metabolite (I) were all below those of metronidazole (Tab. II). Simultaneous milk and blood samples showed almost identical levels (Tab. III). Infant total clearance of metronidazole was calculated to be ca. 60% of maternal clearance by body weight and 24% by body surface, independent of dosage, while maximum infant metronidazole intake was estimated to be 3.0 mg/kg/day assuming a daily intake of 500 ml milk. It is recommended to avoid simultaneous breastfeeding and metronidazole therapy until possible harmful longterm effects on the neonates are known. PMID- 6854511 TI - Fetal heart rate monitoring on the operating table immediately before delivery by cesarean section. PMID- 6854510 TI - Serum calcium and 25-OH-D3 in mothers of newborns with craniotabes. AB - Serum calcium and 25-OH-D3 in mothers of newborns with craniotabes. The aim of this study was to investigate whether calcium or vitamin D balance during late pregnancy have influence on the outcome of newborn craniotabes. 27 mothers and their fullterm newborns with craniotabes in two series were studied for clinical findings, course of pregnancy and calcium and vitamin D metabolism after the pregnancy. Calcium and phosphorus balance were studied in the first 16 mother newborn pairs and were studied in the first 16 mother-newborn pairs and compared to a control group. Serum 25-OH-D3 concentrations were determined in the next 11 pairs and compared to a control group delivering in the same season and also to unpregnant women. The course of pregnancy did not show retrospectively any significant alterations and the clinical findings except craniotabes of the newborns were normal. In four cases the fetal head was engaged before 33th of gestation. In mothers serum calcium level was lower (p less than 0.05) and the excretion of phosphorus decreased (p less than 0.05) after the pregnancy as compared to controls. The values of serum 25-OH-D3 were at the same level in mothers and newborns with craniotabes as compared to controls but the values of mothers were lower (p less than 0.001) as compared to unpregnant controls In conclusion, craniotabes of the newborns seems to have no unique etiologic factor. The changes of calcium and vitamin D metabolism during pregnancy may be considered as predisposing factors in some cases and early engagement in some other. Perhaps also other reasons can be found. PMID- 6854512 TI - A survey of MMPI teaching in APA-approved clinical training programs. AB - A questionnaire on teaching of the MMPI was sent to all APA-approved clinical training programs. The questionnaire asked the faculty member primarily responsible for teaching the MMPI to indicate how much emphasis was placed on it, how they made use of it, and how valuable it was felt to be. A return rate of 83% was achieved. It was found that: a) 92% of the responding programs offer courses dealing with the MMPI; b) 74% of the programs that teach the MMPI put major emphasis on it; c) emphasis placed on the instrument is holding steady; d) instructors with 10 years or less teaching experience rate the test as highly and are as likely to use it outside the classroom as their more experienced colleagues. PMID- 6854515 TI - Diagnosing multiple personalities with the Rorschach: a confirmation. PMID- 6854513 TI - Borderline psychopathology as displayed on psychological tests. AB - Despite the surge of interest in borderline psychopathology in psychiatric quarters, contributions from the perspective of psychological testing have been few. A brief delineation of the range of borderline psychopathology is offered. Broad trends in the test performance of patients within the borderline range are described with regard to: intelligence and cognitive operations, thought and language, reality testing, organization of affect, configuration of defenses, structure of the object world, dynamics and the interpersonal aspects of the test process. PMID- 6854514 TI - The use of the psychological test report in setting the focus of psychotherapy. AB - One of the values of psychological testing is the help it can provide in setting the focus of psychotherapy. Especially in long-term treatments, psychotherapists can fail to address certain characteristics of the patient and a poor outcome results. Using three case examples with post-termination follow-up reports, this paper illustrates the potential usefulness of test reports which identify key treatment issues for the psychotherapist. PMID- 6854516 TI - The effects of state anxiety and limited social-evaluative stress on the Rorschach. AB - It is generally assumed that Rorschach shading responses (Sh) are related to anxiety, especially state anxiety. To test this hypothesis, 60 nonpatients were administered Rorschachs, 30 under high social-evaluative stress and 30 under minimal stress. The high stress group reported more state anxiety but no more Sh than did the other group. These negative findings were interpreted as suggestive of the test's lack of sensitivity to mild, laboratory social-evaluative stress. PMID- 6854518 TI - Holtzman Inkblot Technique scores of delinquent adolescents: a replication and extension. AB - The Holtzman Inkblot Technique (HIT) was administered to 83 male juvenile delinquents, ranging in age from 13 to 16 years (mean age: 15.2 years), who were being detained at the Texas Youth Council Reception Center. Scores from 22 HIT variables scored were factor-analyzed and then compared with Megargee's pioneering normative HIT study of juvenile delinquents published in 1965. Results of the two investigations were strikingly similar, reinforcing Megargee's finding that norms for nondelinquent adolescents are not appropriate for use with a confined delinquent group. Important differences were discovered, however, and these are discussed. PMID- 6854517 TI - Rorschach norms for inner city children. AB - Rorschach data for 272 Black children are presented in age groups from 3 to 12. The Rorschach characteristics presented are F+%, A%, Fabulized Combinations, Perseverations, Color Naming, Rejections, Wholes, Details, Small Details (Dd), R, M, and P. Comparisons with Ames and Exner reveal a lower form accuracy level, and a lower percentage of Wholes, with a higher D level. Response rate, rate of development of the M response, rate of development of the P response, and of the Animal response are very similar to the other normative samples. PMID- 6854520 TI - Hierarchical clustering of pain patients' MMPI profiles: a replication note. PMID- 6854519 TI - Goal-directed thinking in schizophrenics' associations. AB - The relationships between associative structure and higher order cognitive processes in schizophrenia were investigated with a continuous word association technique. The chaining hypothesis involves the derailment of organized thought by response-produced stimuli, and the continuity hypothesis postulates a progressive disorganization of connotative meaning. Neither hypothesis was confirmed, as both schizophrenics and nonschizophrenics maintained the set of guiding responses according to the starting stimuli. Further, both groups showed progressive response disorganization despite the overall higher degree of relatedness in the nonschizophrenics. There was also no differential performance observed when comparing schizophrenics subgrouped by paranoid status and premorbid adjustment. PMID- 6854521 TI - Pharmacological studies on supersensitization. X. Effect of tripelennamine, N,N dimethyl-N',N'-dibenzylethylenediamine and N,N-dibenzyl-N',N'-dimethyl-1,2 propanediamine on the utilization of calcium in acetylcholine-induced contraction of isolated vas deferens of guinea pig. AB - Effects of tripelennamine, N,N-dimethyl-N',N'-dibenzylethylenediamine (DBED) and N,N-dibenzyl-N',N'-dimethyl-1,2-propanediamine (DBPD) on the isotonic contractions of isolated vas deferens of guinea pig were examined. Tripelennamine and DBED potentiated the contractile responses to acetylcholine and potassium chloride in Ca2+-free Tyrode solution. DBPD potentiated the contractile responses to lower concentrations of acetylcholine in Ca2+-free Tyrode solution, but did not affect contractions induced by potassium and higher concentrations of acetylcholine in Ca2+-free Tyrode solution. In depolarized vas deferens, tripelennamine and DBED augmented the maximum response to Ca2+, while DBPD did not affect the maximum response to Ca2+ and decrease the sensitivity to Ca2+. The contractile responses to acetylcholine in standard Tyrode solution were attenuated by lanthanum chloride and the residual contractions were not affected by tripelennamine, DBED and DBPD or decreased by DBPD. The contractile responses to potassium chloride were completely abolished by lanthanum chloride. The half time of decrease in acetylcholine-contraction in Ca2+-free Tyrode solution was significantly different from that of potassium-contraction in Ca2+-free Tyrode solution. The contractile response of the glycerinated muscle piece of vas deferens to calcium chloride was potentiated by DBED, but was not affected by tripelennamine and DBPD. These results suggest that tripelennamine and DBED facilitate nonselectively the transmembrane influx of calcium from extracellular fluid and superficial calcium-binding sites. In addition, DBED increases the sensitivity of contractile element to cytoplasmic free calcium ion. DBPD potentiates the contractile response without affecting the transmembrane mobilization of Ca2+ induced by excitation of cell membrane. PMID- 6854522 TI - Bioavailability of phenytoin on single and multiple oral doses of two dosage forms in normal subjects. AB - The extent and rate of absorption of phenytoin (PHT) from tablet and powder were studied in four healthy adult volunteers. It was demonstrated by urinary and fecal excretion that the almost all quantity of PHT in tablet was absorbed through the gastrointestinal tract, and the observed values of the estimated free concentration (Cest.f) estimated from mixed saliva concentration of PHT in the multiple dose were in fair agreement with the calculated values of that by using computer simulation in case of tablet. On the contrary, the variations were observed in Cest.f using therapeutic dose of PHT powder. The values of Cest.f at steady-state in tablet administration were higher than those in powder administration. The absorption ratio of PHT powder was low and variable, and decreased upon increase of dose. The ratio calculated from the Cest.f values of both dosage forms at steady-state were in good correspondence to the observed values of PHT excreted in feces. PMID- 6854523 TI - [Thoracic radiology in 80's]. PMID- 6854526 TI - [Fetal echocardiography during the 2nd half of pregnancy. Biometry and functional approach]. AB - Fetal cardiac biometry was conducted in the TM mode, after real time anatomical outlining of the plane of the four cardiac cavities, on 48 recordings of supposedly normal pregnancies of 23 to 39 weeks of amenorrhoea. Ten measurements were made for each patient, in an immediately subvalvular plane perpendicular to the septum (dimensions of the two ventricular cavities, of the wall of the two ventricles, and of the septum, in diastole and systole respectively). Functional results derived from this data showed that the difference between diastolic and systolic values for ventricular diameters increased with term, the ratio of the diastolic diameter of the right ventricle (RV) to that of the left ventricle (LV) was a constant: 1.23 +/- 0.12, and the size of the RV was always superior to that of the LV (+ + +). Alson noted was that percentage shortening of the LV was superior to that of the RV, and mean percentage thickenings of the RV and septum were inferior to that of the LV. A further observation was that interpretation of the kinetic of the septum requires precise knowledge of the plane of the section in relation to "the pivot point". PMID- 6854524 TI - [Comparative echographic and scanographic study of a series of 19 hepatic angiomas]. AB - The correlation of sonography with CT was studied in a series of 19 hepatic angiomas. CT is more specific, since it can demonstrate the vascular nature of the lesion. But it is less sensitive: in three cases it remained negative even after bolus injection of contrast medium. A follow-up strategy, and a decision policy regarding the different examination procedures is discussed. PMID- 6854525 TI - [Angiography and perfusion pulmonary scintigraphy in pulmonary embolism]. AB - Clinical signs suggestive of pulmonary embolism require diagnostic confirmation from complementary scintigraphic and/or angiographic examinations, therapy being adapted to the results obtained. A comparative study of the value of the two techniques was conducted in 20 patients with suspected pulmonary embolism investigated by a perfusion pulmonary scan and selective pulmonary angiography. Results confirmed the diagnostic superiority of angiography, the high percentage of false positives obtained by perfusion scintigraphy alone indicating the need for associated ventilatory function tests. PMID- 6854528 TI - [Echographic symptomatology of peritonitis encapsulans]. AB - The authors, try to establish an approach about ultrasonic pattern of capsulated peritonitis through study of four cases. The echographical semeology of this affection is based on: echoscopic signs which study the intestinal mobility and lumen, and the associated ascits: --echographic signs represented essentially by: --intestinal agglutination; --the presence of real or virtual capsula; --meso retraction. The frequency of this affection seems to be not negligible in Tunisia. The tuberculosis is the most frequent cause, as an etiology. PMID- 6854527 TI - [Accessory spleens. Scanographic and ultrasonic study]. AB - Accessory spleens can contribute to diagnostic difficulties when evaluating a left upper quadrant mass. Sonography often displays a parenchymal bridge between the accessory element and the organ itself. When such a pattern is absent, contrast enhanced CT is instrumental to permit one a correct diagnosis since it confirms isodensity. PMID- 6854530 TI - [Cervical osteolysis. Initial manifestation of embryonal rhabdomyosarcoma]. AB - Initial manifestations in a patient with an embryonic rhabdomyosarcoma were signs of cervical spine osteolysis. Initial histological diagnosis of a chordoma was rejected on the basis of the site of the tumor and then eliminated by a second histological study. The course was fulminating over a period of 8 months. Comparison between this case and intracranial localizations of the tumor are possible because of mild initial involvement of the soft tissues. PMID- 6854531 TI - [Malabsorption and complex superior mesenteric vascular anomalies. Apropos of a case]. AB - Radiological, and particularly arteriographic examinations in a 28-year-old man investigated for a malabsorption syndrome with exsudative enteropathy demonstrated the presence of a complex anomaly of mesenteric artery and vein vascularization. The diagnosis, based on these findings, was chronic or recurrent valvulus of the mesentery on an intestinal malposition. PMID- 6854529 TI - [Iodized contrast media. I. effector action on serum enzymes]. AB - In vitro studies were done to examine the effects of contrast media on blood enzymatic activities. The results observed are very significant: in the most simple cases they result in a competitive or mixed-type type inhibition of these enzymes. In systems which involve two substrates and two products a Bi-Bi ping pong enzymatic mechanism is transformed in Bi-Bi random enzymatic mechanism. PMID- 6854532 TI - [Tomodensitometry and pancreatic pathology]. AB - Computed tomography is currently the most effective method for investigating the pancreas. Though far from superseding ultrasonography, which should always precede it, possible insufficiences of this examination can be corrected and doubtful images clarified. Its greatest usefulness is in acute pancreatitis, as the size of the lesion can be defined as well as subsequent therapeutic measures. It also appears to be the most reliable examination for chronic pancreatitis or cancer of the pancreas at the present time, but their differential diagnosis can raise problems when certain localized hypertrophic lesions exist. However, diagnosis of a pancreatic lesion is only possible when it deforms the gland or modifies its density, and it is illusory to expect early detection of lesions less than 2 or 3 cm in diameter, particularly in cancer cases. PMID- 6854533 TI - The use of chaperones by general practitioners. AB - A postal questionnaire was sent to 200 male general practitioners to assess attitudes towards chaperones and the extent of their use when female patients are being examined. The response rate was 85.5 per cent. Of the 171 respondents, 23 (13 per cent) claimed they always use a chaperone and 42 (25 per cent) said they never do. Reported use and non-use were related to the doctor's age and to the size of the practice in which he works. The patient's youth and single marital status are apparently important determinants of the decision to use a chaperone, although many of the general practitioners rely on ;instinct'. Reasons given for non-use included inconvenience and habit. Many of the doctors said they felt the presence of a third party to be detrimental to the doctor-patient relationship and just as many said they believed the chaperone's presence to be beneficial. PMID- 6854534 TI - General practitioners' satisfaction with a primary care clinical psychology service. AB - A specialist Clinical Psychology Service in Primary Care was set up in one health district in 1979 on a three-year experimental basis. A survey conducted among the general practitioners who had used the service during this period found a high level of satisfaction. The views of the general practitioners are reported and also their ratings of the outcome of psychological treatment in each of 305 cases. The relationship between certain patient characteristics and treatment outcome is also presented. These results are discussed in relation to further research required in this area and the future of liaison between clinical psychologists and general practitioners. PMID- 6854535 TI - Influence of trainers on trainees in general practice. PMID- 6854536 TI - Referrals from general practitioners to a social services department. AB - One year's referrals from general practitioners to a social services department were studied. There was a low referral rate and a bias towards women, the elderly and the less affluent. The referrals were predominantly made for practical help with problems of ill health. A high proportion of clients were allocated to non social work staff, and the social service intervention, generally of short duration, showed a sympathetic response to the practical requests of general practitioners. The limited use of social workers by doctors is considered to be the result of ignorance or scepticism about psychodynamic social work skills. Closer liaison between general practitioners and social workers, and a clearer presentation by social workers of their professional skills, are suggested solutions to this problem. PMID- 6854537 TI - Medical provision for the homeless in Manchester. AB - The events leading up to the establishment of a separate primary care service for the homeless and rootless population in Manchester are described.The organization, funding and commitment of the project are outlined and an insight into the life-style of this population is provided.During the first quarter of 1981, 2,049 consultations were given. The most common causes for consultation were psychiatric, alcoholic and respiratory conditions. PMID- 6854539 TI - Why not tell the hospital about a patient's social needs? PMID- 6854538 TI - Behcet's syndrome: a case study. AB - This is the case report of a woman who for many years was a diagnostic puzzle. Her various problems were eventually identified as features of Behcet's syndrome, which is uncommon in this country. Besides the known clinical symptoms of the disease, this patient has suffered intermittently from dysmenorrhoea and menorrhagia, which may well be features of this disorder which have not previously been documented. There is no sign of remission for this patient, but awareness of her condition should lead to more sympathetic management of these cases. PMID- 6854540 TI - Patients' views of general practice. PMID- 6854542 TI - Is Peyronie's disease iatrogenic? PMID- 6854541 TI - Chlamydia trachomatis in general practice. PMID- 6854544 TI - Alcohol -- looking for problems. PMID- 6854543 TI - Lithium therapy--side effects and hazards. PMID- 6854545 TI - Clinical relevance of steroid receptor analysis. PMID- 6854546 TI - Effects of GTP on 3H-domperidone binding and its displacement by dopamine in rat striatal homogenates. AB - The potency of dopamine in displacing 3H-domperidone from rat striatal membranes was reduced by GTP and enhanced by Mg++. GTP also increased specific binding, and this effect was larger in the presence of Mg++, which itself inhibited binding. In differently washed and incubated preparations the magnitude of both GTP and Mg++ effects correlated well with the endogenous dopamine content of the membranes. Na+ reduced the potency of dopamine, the GTP effect and specific binding. Saturation experiments revealed that these effects of ions and GTP reflected changes in both the apparent Bmax and KD of 3H-domperidone. It was possible to eliminate the GTP effect on specific binding by extensive washing and incubation, but this treatment may also alter other receptor binding characteristics. It remains unclear whether the enhancing effect of GTP reflects contamination of endogenous dopamine or a genuine property of the D2 receptor. PMID- 6854547 TI - Solubilisation and molecular characterisation of muscarinic acetylcholine receptors. AB - Stable, soluble preparations of rat brain muscarinic receptors can be prepared by extracting membranes with digitonin, or with combinations of sodium cholate and sodium chloride. The stability of the cholate/NaCl extract is enhanced by the addition of egg phosphatidylcholine, which, at the same time, suppresses the considerable dispersity apparent in the hydrodynamic behaviour of the solubilised receptor. The Stokes radius of the brain muscarinic receptor in cholate/NaCl/lecithin extracts is 6.7 nm, with very similar values in other detergents, including digitonin and sodium dodecyl sulphate. Its sedimentation coefficient is 3.78s, and its molecular weight approximately 110,000 after correction for detergent binding. The isoelectric point of the digitonin - solubilised receptor is approximately 4.5. PMID- 6854549 TI - Comparison of urinary estrogens, contraction stress tests and nonstress tests in the management of postterm pregnancy. AB - In a retrospective review of 697 postterm pregnancies we attempted to validate three tests used to identify the fetus at increased risk: the 24-hour urinary estrogen per gram creatinine (E/Cr), the nonstress test (NST) and the contraction stress test (CST). Using the corrected perinatal mortality rate (PMR) among term pregnancies (0.23%) as a standard for comparison, we found the PMRs among postterm patients with negative screening tests to be as follows: 0.23% with normal E/Crs, 0.65% with negative CSTs (not significantly different) and 2.4% with reactive NSTs (p less than 0.005). When we used intrapartum fetal distress as a standard for comparison, the E/Cr exhibited the highest sensitivity (88%) whereas those of the CST and NST were much lower (7-10%). The specificities were 63%, 98% and 92%, respectively. From this retrospective study the E/Cr appears to be of most assistance in identifying fetuses at increased risk, the CST is of intermediate assistance, and the NST is of least assistance. PMID- 6854548 TI - Menstrual pattern changes following laparoscopic sterilization. PMID- 6854550 TI - Comparative trials of low-dose combined oral contraceptives. PMID- 6854551 TI - A system for reporting gynecologic procedures. A linguistic-logical approach. AB - A system was developed for reporting gynecologic procedures at Chicago Lying-In Hospital. The system is designed to report procedures and treatments performed during both inpatient stays and outpatient visits. Key features of the system are (1) the automatic encoding of all gynecologic procedures in both the ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) coding systems, (2) the use of an independent program to maintain and update a multiply referenced network of operative procedures and (3) the use of a cross-indexing system that allows each procedure to be accessed in several ways and according to several patterns of keys (billing code number, CPT category, common abbreviation and/or linguistic feature). PMID- 6854552 TI - Listeria monocytogenes. An important pathogen in premature labor and intrauterine fetal sepsis. AB - Listeria monocytogenes is a rare complication of pregnancy. Maternal listeriosis often causes premature labor and congenital infections. High perinatal morbidity and mortality rates are associated with this disease. Two cases of fetal perinatal infections, complications and management are discussed. PMID- 6854553 TI - 45, X/46, XY gonadal dysgenesis. A case report. PMID- 6854554 TI - Renal-cell carcinoma metastatic to the ovary. A case report. PMID- 6854555 TI - Extensive intraperitoneal hemorrhage from a uterine laceration. An unusual complication of culdocentesis. PMID- 6854557 TI - Simultaneous bilateral tubal pregnancy. A case report. AB - A woman was treated for a simultaneous bilateral tubal pregnancy that had an unusual presentation and unusual diagnostic problems. The diagnosis of ectopic pregnancy may be overlooked in a semiconscious patient if a proper history and examination are not carried out. During surgery for ectopic pregnancy it is important to look at both adnexae. PMID- 6854556 TI - Early-onset preeclampsia, triploidy and fetal hydrops. AB - Early-onset preeclampsia (16-24 weeks) is frequently associated with fetal and placental anomalies. Hydatidiform mole, fetoplacental triploidy with partial molar changes and idiopathic hydrops fetalis are commonly associated ones. Two patients had severe, early-onset preeclampsia and ultrasonically documented fetal anomalies, one fetal triploidy, the other idiopathic hydrops with normal karyotype. The management of early-onset preeclampsia benefits from ultrasonography, and an aggressive search for fetal anomalies is recommended. Seventy-two percent of cases of early-onset preeclampsia in our institution were associated with significant fetal and placental malformations. An immunologic basis of the preeclampsia in these cases seems likely but remains unproven. PMID- 6854561 TI - Rehabilitation: in need of its own service. PMID- 6854559 TI - A comparison of three-dimensional growth characteristics of cultured primitive marrow stroma derived from genetically anemic and normal mice. AB - This study examines the ultrastructure of mouse defective marrow stroma when cultured as a three-dimensional organization of cells. Gelfoam sponges impregnated with agar medium allowed the three-dimensional organization of newly formed stromal cells derived from the crevices of marrow-depleted bones of Steel mutant mice (Sl/Sld) with defective stroma and also from mice with normal stroma (Sl +/+, W/Wv, and W +/+. Ultrastructural comparisons of 5- to 14-day cultures revealed that the mutant defective stromal cells developed normally, viz. i) proliferated and formed a three-dimensional organization of stroma, ii) stimulated residual hemopoietic precursors to form myeloid cells, and iii) formed a variety of stromal cell types characterized by variable quantities of Golgi bodies and ER, glycogen, filaments, and round cytoplasmic granules. The Steel Dickie strain, however, included bacilliform electron-dense granules in both normal and mutant stroma. The only ultrastructural deficiency in Sl/Sld stroma was the absence of a category of "activated" cells that occurred within normal cell populations. PMID- 6854558 TI - A morphological study of the role of phagocytes in the clearance of Staphylococcus aureus from the lung. AB - A nonlethal dose of Staphylococcus aureus was inoculated into the mainstem bronchus of mice in order to study the influx of polymorphonuclear leukocytes (PMN). The goal was to determine the routes of entry of PMN into the lung following bacterial challenge, the relative importance of PMN as compared to alveolar macrophages (AM) in the uptake of S aureus, and the role of lymphatics in clearance of intact microorganisms. Resident AM took up S aureus within minutes of inoculation, but PMN were subsequently recruited to the lung and were the predominant cell containing S aureus by 4 hours following inoculation. PMN were recruited from arteries, capillaries, and venules. Emigration of PMN into alveolar spaces occurred between type I epithelial cells as well as between type I and type II epithelial cells. Lymphatics played only a minor role in the clearance of S aureus. PMID- 6854562 TI - Vocational adjustment of Vietnam era veterans. PMID- 6854560 TI - Macrophage requirement for induction of in vitro anti-2,4,6-trinitrophenyl response in low-affinity receptor lymphocytes. AB - The possibility that the requirement for macrophages in the induction of an immune response is related to the antigen (Ag)-binding capacity of the lymphocyte populations that undergo activation has been examined. Spleen cells from mice immunized with 2,4,6-trinitrophenyl (TNP)-conjugated sheep red blood cells (TNP SRBC) were filtered on a TNP-substituted Bio Gel column. The excluded cells were shown to be mainly low-affinity anti-TNP cells by using an anti-TNP plaque forming assay and assessing the avidity of the plaque forming cells (PFC). In order to obtain a low-affinity anti-TNP precursor cell population, lymphocytes from nonimmunized mice were filtered as above. Unfiltered and filtered excluded nonimmune cells were cultured in the presence of Ag-pulsed macrophages or with the supernatants of the pulsed macrophage cultures. The filtered cells produced a specific antibody response only in the presence of the Ag-pulsed macrophages, while the total (nonfiltered) lymphocyte population contained PFC when cultured with free antigen. Determination of the avidity of the PFC confirmed the presence of low-affinity cells in the filtered population and the high affinity of the antibody-producing cells cultured in the absence of macrophages. The induction of a response in low-affinity lymphocytes appeared to require the presence of macrophages rather than that of a soluble factor present in the supernatant. It is suggested that the Ag-presenting role of macrophages are essential for the induction of the immune response in low-affinity cells, while high-affinity lymphocytes could be directly activated by free Ag. PMID- 6854563 TI - Cooperative programming with the schools: a proposal. PMID- 6854564 TI - Foster care and mentally ill persons. PMID- 6854567 TI - A comparison of job development strategies in rehabilitation. PMID- 6854566 TI - Rehabilitation in China: impressions and perspectives. PMID- 6854565 TI - The effects of learning disabilities on postschool adjustment. PMID- 6854568 TI - Complementary concepts: independent living and in-home respite care. PMID- 6854569 TI - "RAAT". The rehabilitation acronym and abbreviation test. PMID- 6854570 TI - The future role of meat inspection in the field of meat hygiene. PMID- 6854571 TI - An assessment of waste disposal options for the 1980s. PMID- 6854573 TI - Metropolitan waste management decisions in developing countries. PMID- 6854572 TI - The Internal Drinking Water Supply and Sanitation Decade in Europe. PMID- 6854576 TI - The medicinal leech. PMID- 6854574 TI - The policy of the Peoples Democratic Republic of South Yemen concerning the feeding of boarding school children. PMID- 6854575 TI - Ready, willing but able?--the self help group. PMID- 6854577 TI - Old age. PMID- 6854578 TI - Hong Kong's health service--full care for less than 50p a day. PMID- 6854579 TI - Growth promoting hormones. PMID- 6854580 TI - Synthesis and gastric antisecretory properties of 4,5-unsaturated derivatives of 15-deoxy-16-hydroxy-16-methylprostaglandin E1. AB - The synthesis and gastric antisecretory activities of the delta 4,5-cis, delta 4,5-trans, and 4,5-acetylenic analogues of 15-deoxy-16-hydroxy-16-methyl prostaglandin E1 methyl ester are described. The key step in the preparation of these compounds involved the stereospecific conjugate addition of a cuprate reagent to the appropriate cyclopentenones. Although the trans and acetylenic derivatives were weak inhibitors of gastric acid secretion, the cis olefin was more potent and longer acting than the saturated parent compound. Selectivity with respect to unwanted diarrheagenic effects was found to be improved over that of both the parent 16-hydroxy compound and the reference standards, (15S)-15 methyl- and 16,16-dimethylprostaglandin E2. PMID- 6854582 TI - 6-Aryl-4,5-dihydro-3(2H)-pyridazinones. A new class of compounds with platelet aggregation inhibiting and hypotensive activities. AB - This paper reports on the synthesis and pharmacological activity of 6-aryl-4,5 dihydro-3(2H)-pyridazinone derivatives. The compounds exhibit an aggregation inhibiting action on human platelets in vitro and on rat platelets under ex vivo conditions, as well as a hypotensive action on rats. The strongest pharmacological effects were found with dihydropyridazinones, which have a 6-[p [(chloroalkanoyl)amino]phenyl] substituent, together with a methyl group in the 5 position. The antiaggregation activity of compounds of this type is in vitro up to 16000 times and ex vivo up to 370 times greater than that of acetylsalicylic acid; the hypotensive action is up to 40 times as great as that of the comparative substance dihydralazine. PMID- 6854581 TI - Synthesis and platelet aggregation inhibiting activity of prostaglandin D analogues. AB - Several prostaglandin D (PGD) analogues have been synthesized, incorporating the following variations: (a) varying degrees of side-chain unsaturation, (b) C-9 hydroxy removed or in the unnatural 9 beta configuration, (c) metabolically stabilized analogues (e.g., 15-methyl, 16,16-dimethyl, 17-phenyl, etc.), and (d) delta 12 isomers resulting from decomposition of PGD2. With regard to their ability to inhibit adenosine diphosphate (ADP) induced human platelet aggregation: (a) PGD3 greater than or equal to PGD2 greater than PGD1 greater than 13,14-dihydro-PGD1, (b) the 9 beta- and 9-deoxy-PGD2 analogues are more potent than PGD2, (c) metabolically stabilized analogues with bulky substituents at or near C-15 have substantially reduced antiaggregatory activity relative to PGD2 and (d) the delta 12 isomers of PGD2 are much less active than PGD2. PMID- 6854583 TI - Synthesis and antiarrhythmic and parasympatholytic properties of substituted phenols. 1. Heteroarylamine derivatives. AB - Twenty-four structural derivatives of the antiarrhythmic drug changrolin were synthesized and tested for antiarrhythmic and parasympatholytic activities. It was found that while the bis(pyrrolidinylmethyl)phenol pattern of changrolin appeared to be optimal in this series, a wide latitude existed for the heteroaryl substituent for maintaining good antiarrhythmic activity. Further, the antiarrhythmic and parasympatholytic activities tended to exhibit parallel changes. PMID- 6854584 TI - 1-(Aminomethyl)-6,7-dihydroxytetralin derivatives: synthesis and assessment of dopamine-like effects. AB - The title compounds were designed as flexible congeners of trans octahydrobenz[h]isoquinoline, in which the dopamine moiety can exist in the alpha conformation. Extremely low dopamine-like effects in the title series in the cat cardioaccelerator nerve assay paralleled low activity in the trans octahydrobenz[h]isoquinoline compounds and was consistent with a prior proposal of the presence of a bulky region on the dopamine receptor(s). PMID- 6854586 TI - Quantitative aspects of the receptor binding of cytokinin agonists and antagonists. AB - Congeneric 4-anilino- and 4-(alkylamino)-2-methylpyrrolo[2,3-d]pyrimidines showed cytokinin and anticytokinin activities, depending on the structure of their 4 substituents, and the antagonistic nature of the latter was established kinetically. The effect of the substituent on these activities was analyzed quantitatively by using physicochemical parameters and regression analysis to give a single, common equation for both the agonists and antagonists. The results indicated that the maximum width of the N4 substituents is an important factor both for binding to the receptor, thus the extent of activity, and for the quality of activity, agonistic or antagonistic. The electron-withdrawing effect and hydrophobicity of the substituents further enhance binding and, thus, activity, irrespective of the quality of the activity. These results coincide with and/or provide evidence for the hypothesis that in hormonal action, agonist binding causes a conformational change of an otherwise inactive receptor to the active form and that antagonists are species that bind similarly to the receptor but do not cause the effective conformational change. PMID- 6854585 TI - Recognition of cholinergic agonists by the muscarinic receptor. 1. Acetylcholine and other agonists with the NCCOCC backbone. AB - A theoretical model is used to deduce the pharmacologically active conformation of acetylcholine and other agonists interacting with the muscarinic receptor of the parasympathetic and central nervous systems. This is accomplished by replacing the usual dihedral angles tau 1 and tau 2, which define the conformations of cholinergic drugs, with two new geometric parameters more suitable for describing the muscarinic pharmacophore: a characteristic distance, [PQ], and a dihedral angle, PNOQ. Values for these parameters are determined by conformational analysis on semirigid muscarinic agonists using molecular mechanics and ab initio molecular orbital methods. In addition to deducing the active conformation of acetylcholine and other agonists, the model also rationalizes the pattern of stereoselectivity in agonists related to 3 acetoxyquinuclidine (aceclidine) and furnishes a geometric criterion for partial agonism and antagonism. PMID- 6854587 TI - Quantitative structure-inotropy relationship applied to substituted grayanotoxins. AB - Nine 14 beta-O-acylated grayanotoxins were synthesized by ozonolysis of 14,16 alkylidenegrayanotoxin III. The correlation between positive inotropic potency (PIE) in guinea pigs and physicochemical parameters (Vw, Mw, and Rm50) in 14 14 substituted grayanotoxins were quantitatively analyzed. It became clear that a parabolic relation existed between the bulkiness of the 14-substituents and PIE and that some electronic factor and the hydrophilic-hydrophobic balance would be related to the development of PIE. PMID- 6854588 TI - Oxidation of uric acid. 4. Synthesis, structure, and diabetogenic action of 5 imino-2,4,6(1H,3H,5H)-pyrimidinetrione salts and their alloxan-like covalent adducts. AB - Three synthetic routes to salts of 5-amino-5-hydroxy-2,4,6(1H,3H,5H) pyrimidinetrione (10) are described. The key reactions involved acid-catalyzed cleavage of 5-amino-5-ureido-2,4,6(1H,3H,5H)-pyrimidinetrione (7), conversion of uramil (8) to dehydrouramil (9) and subsequent hydration, and the condensation of alloxan (5) with ammonium salts. The carbinol ammonium salt structure 10a was unambiguously established by X-ray crystallography. New alloxan-like compounds 7, 9, and 10 were evaluated for diabetogenic activity in rats. Compound 7 was inactive, whereas compounds 9 and 10 showed the highest activity comparable to that of streptozotocin (12). PMID- 6854590 TI - 4'-Methylangelicins: new potential agents for the photochemotherapy of psoriasis. AB - Three derivatives of angelicin (1) [4'-methyl-, 4,4'-dimethyl-, and 4',5 dimethylangelicin (2a-c)] have been prepared with the aim of obtaining new agents for the photochemotherapy of psoriasis. These compounds form a complex in the dark with DNA that shows an affinity for the macromolecule higher than that of the parent angelicin (1). A correlation between their octanol/water partition coefficients and the association constants of the complexes has been observed. Compounds 2a-c photobind to DNA to a much higher extent than 1 and also more effectively than 8-methoxypsoralen (8-MOP), taken as reference compound. When activated with UV-A, the three compounds strongly inactivate T2 phage and inhibit epidermal DNA synthesis in mice. Moreover, they show a mutagenic activity markedly lower than that of 8-methoxypsoralen on Escherichia coli wild-type strain. Due to its lack of skin phototoxicity, its low mutagenic activity, and its antiproliferative activity, 2c was chosen for clinical evaluation. It proved to be effective in clearing psoriasis in two patients. PMID- 6854589 TI - 1,3-Diaryltriazenes: a new class of anorectic agents. AB - A series of substituted 1,3-diaryltriazenes has been synthesized and tested for anorectic activity. Several members of the series were effective; one compound, 1,3-bis[2-cyano-5-(trifluoromethyl)phenyl]triazene, was particularly active, causing weight loss in rats, dogs, and squirrel monkeys. It was devoid of overt central nervous system activity, and compared to previously reported biologically active triazenes, it was relatively nontoxic up to 30 days of drug administration. PMID- 6854591 TI - Synthesis and antitumor evaluation of selected 5,6-disubstituted 1(2)H-indazole 4,7-diones. AB - A series of novel aziridinyl-substituted 1(2)H-indazole-4,7-diones and related 1(2)H-indazole-4,7-diones was synthesized and tested against Ehrlich ascites carcinoma growth in male CF1 mice. Ten of the test compounds, including two aziridinyl-substituted 1(2)H-indazole-4,7-diones, were found to be significantly active (inhibition of tumor growth greater than 80%) in the Ehrlich ascites carcinoma screen. Several structure-activity relationships were indicated for antitumor activity in this screen. An aziridinyl-substituted derivative, 5 aziridinyl-6-chloro-1H-indazole-4,7-dione (8a), also exhibited significant activity against the growth of P-388 lymphocytic leukemia cells in male BDF1 mice (% T/C = 145; % T/C greater than 125 is considered significant). PMID- 6854592 TI - 3'-Amino-2',3'-dideoxyribonucleosides of some pyrimidines: synthesis and biological activities. AB - 3'-Amino-2',3'-dideoxyribonucleosides of thymine, uracil, and 5-iodouracil (1-3) were synthesized from the corresponding 2'-deoxyribonucleosides via the threo-3' chloro and the erythro-3'-azido derivatives. Corresponding aminonucleosides of 5 bromouracil, 5-chlorouracil, and 5-fluorouracil (4-6) were synthesized enzymatically with 3'-amino-2',3'-dideoxythymidine as the aminopentosyl donor and thymidine phosphorylase (EC 2.4.2.4) as the catalyst. 3'-Amino-2',3' dideoxycytidine (7) was synthesized by amination of the 3'-azido precursor of 3' amino-2',3'-dideoxyuridine. The biological activity of 3'-amino-2',3'-dideoxy-5 fluorouridine (6) was notable among this group of aminonucleosides. It had an ED50 of 10 microM against adenovirus and was not appreciably cytotoxic to mammalian cells in culture. It also had activity against some Gram-positive bacteria but not against a variety of Gram-negative bacteria. The other aminonucleosides (1-5 and 7) lacked or exhibited weak antiviral and antibacterial activities. The only compounds in this group that were appreciably toxic to mammalian cells in culture were the thymidine and deoxycytidine analogues (1 and 7). PMID- 6854593 TI - Synthesis and biological properties of new hexapeptide substrates for vitamin K dependent carboxylase. Evidence for X-Pro cis/trans amide bond interconversions in prothrombin precursor fragment 18-23. AB - Three hexapeptide analogues, corresponding to sequence 18-23 of bovine prothrombin precursor [-Cys-Leu-Glu-Glu-Pro-Cys-] have been synthesized and evaluated as substrates for vitamin K dependent carboxylase. These new hexapeptides are moderately good substrates for the carboxylase but do not significantly inhibit carboxylation of Phe-Leu-Glu-Glu-Leu, a good substrate for the enzyme. Based on proton and carbon-13 NMR experiments, it is established that the conformation of sequence 18-23, which contains proline at position 22, has a trans amide bond for the Glu-Pro22 sequence in chloroform-d. This amide bond is converted to the cis amide geometry in Me2-SO-d6. It is proposed that good substrates for the carboxylase require a trans amide bond between residues 21 and 22. PMID- 6854595 TI - A committee on well-being of medical students and house staff. AB - A committee on well-being of medical students and house staff was established in a university medical center to address some of the socioemotional aspects of medical education and training. The overall goal was to influence the learning climate in ways that would enhance positively the educational experience. Several problem areas were identified. They included poor communication, stressful effects of medical education both on self and on relationships, a need for advocacy, and a lack of support for house staff members. A series of programs were designed and implemented in response to these issues. With institutional support, a committee on well-being may serve as an effective approach in alleviating some of the stresses of the medical training process. PMID- 6854594 TI - The question of stress among first-year medical students. AB - In a study reported in this article, the authors investigated the presence of stress in two successive classes of first-year medical students at a private midwestern medical school. Support groups, didactic sessions, and no-contact control conditions were used. Few differences in personality measures were found among the groups, and all group means were within the normal range. Support groups did not facilitate academic performance. The results bring into question the previously reported extent of chronic stress among students in the first year of medical school as well as the need for support groups in this population. PMID- 6854596 TI - Physicians who move and why: from residency to practice, 1974-1978. AB - As medical residents leave their residencies, a majority also move away from the locales in which they received their training. Data presented in this paper on physicians entering their first professional positions between 1974 and 1978 show that over 65 percent left the counties of their residencies. Following the national migration pattern of the civilian population, the medical residents left the northern "Frost Belt" and entered the southern "Sun Belt" of the United States. Physician "movers" typically were in nonprimary care medical specialties and moved into self-employment or office-based medical practices. These migrating physicians, compared with physician "stayers," were disproportionately male, more often resided in states other than those of their medical education, and moved into smaller urban or nonurban centers of the United States. Other characteristics that distinguish movers from stayers also are presented here. PMID- 6854597 TI - Health-related experimental learning for college undergraduates. AB - Guided service experience commonly enriches medical education at the doctoral and postdoctoral levels but rarely has been offered to premedical students. Internships in health agencies were individually arranged for 198 self-selected college undergraduates in 101 different settings which emphasized the social, economic, and interpersonal factors in health care. Students served as nursing aides, clinical assistants, and health educators and in other nontechnical roles; each wrote an analytical report based upon a study plan and firsthand observations. The expectations of both students and host institutions were usually exceeded. Benefits included help in career decisions, exercise in self directed learning, and demonstration of noncognitive qualities desired in professional work. The authors conclude that undergraduate students are competent to deal with sensitive ethical and social issues in patient care and to provide needed health services of high quality. PMID- 6854598 TI - Medical students' skills, attitudes, and behavior needed for literature reading. AB - Skills, attitudes, confidence, and behavior needed for literature reading were studied in first- versus fourth-year medical students at George Washington University in Washington, D.C. Questions on diagnostic test skills were used for comparison. Anonymous questionnaires were completed by 114 first-year and 84 fourth-year students. Fourth-year students read considerably more literature than first-year students, valued reviews over original research, and placed more value on the journal's reputation. They had greater confidence and objective knowledge than first-year students on diagnostic test skills but not greater confidence or objective knowledge on literature reading skills. Most dramatic was their "lower" willingness to admit uncertainty, even when taking into account their level of knowledge. Less willingness to admit uncertainty on the part of fourth-year medical students than first-year students may reflect medical education's emphasis on specific answers and its failure to teach students how to analyze data and draw conclusions. A need exists for specific training in literature reading skills with preevaluations and postevaluations of skills, attitudes, and behavior. PMID- 6854599 TI - A senior medical student seminar designed to promote problem-solving. PMID- 6854601 TI - Alcoholism education in the medical curriculum. PMID- 6854603 TI - Videotape teaching in family practice residencies. PMID- 6854602 TI - An evaluation of trainee performance in the case presentation. PMID- 6854604 TI - Stress in the medical career. PMID- 6854600 TI - Medical history as an introduction to clinical reasoning. PMID- 6854605 TI - Results of the NRMP for 1983. PMID- 6854606 TI - Career development of female and male physicians. AB - In this article, the authors compare the career development of female and male physicians who were graduated from medical school in 1960 and followed through 1976. Working with a sample matched for type and location of medical school and admission test scores, the authors analyzed the effects of achievement motivation, performance in medical school, peer evaluation, prestige of internship hospital, and family responsibilities on professional attainment. The findings indicate that the careers of male physicians build in a sustained way, with the input factors during and following medical school remaining consistent in their effects; in the careers of female physicians, factors crosscut each other, with some being positive and some negative in their effect on professional attainment. Family responsibility is not the only negative factor for women, and this indicates that other elements in career development that help men do not similarly contribute to the advancement of women physicians. A strong positive factor for women is prestige of internship hospital. PMID- 6854607 TI - Peer review of teaching in medicine. AB - The design, development, and implementation of procedures for peer review of teaching are described. Peer review is one component of a comprehensive system to evaluate and improve teaching in a school of medicine. Colleague observations and judgments are used to augment student/resident ratings of teaching for purposes of instructional improvement and academic promotions. School policies have standardized evaluation criteria and instrumentation while granting departments flexibility in conducting peer review. Three different departmental peer review committee structures and procedures are reviewed. With the emphasis upon improvement, faculty acceptance of peer review of teaching has been positive. Peer review reports have had a positive impact on academic promotions. The inherent strengths and limitations of peer review of teaching are discussed in relation to the literature and to the medical school environment. PMID- 6854608 TI - Educational contracts: a basis for effective clinical teaching. AB - An educational contract is a negotiated agreement between a teacher and a learner. It addresses four elements: needs, expectations, roles, and content. Contracts should develop and evolve via explicit negotiation between the teacher and the learner. Research to validate the concept of the educational contract and to document its utility is important to understanding effective clinical teaching. PMID- 6854609 TI - Increasing physicians' antismoking influence by applying an inexpensive feedback technique. AB - Continuing medical education that ignores motivational and environmental determinants of continued skill use will have little impact. Physicians who were trained to give antismoking advice to patients did so effectively soon after training, but their performance deteriorated during the next nine months. A subsequent study showed that antismoking effectiveness is maintained for extended periods if advice-giving rates are monitored monthly and physicians receive immediate corrective feedback whenever their performance declines. PMID- 6854610 TI - Usefulness of videotape instruction in an academic department of neurology. AB - A group of medical students was shown a series of instructional videotapes while taking a required neurology clerkship. Overall, this study group was more accurate (p less than 0.01) in diagnosing illustrated conditions than a control group that did not see the videotapes. Videotape instruction produced better performance in identification in only certain areas: neuropsychologic phenomena, disorders with subtle or unique movements, and seizures. The choice and cost of equipment and some professional assurances are discussed. Costs and professional expectations, as well as the limited usefulness of videotapes, must be acknowledged by clinical departments before embarking on videotape instruction. PMID- 6854612 TI - The organization of a teaching nursing home: an eight-year experience. PMID- 6854611 TI - The grading system as a factor in the selection of residents. PMID- 6854614 TI - Selection biases versus training in the psychosocial aspects of primary care. PMID- 6854613 TI - Student learning on a pediatric clerkship. PMID- 6854615 TI - The development of professional identity in the family practice resident. PMID- 6854616 TI - Preparing future physicians to care for an aging population. PMID- 6854617 TI - Residency matching. PMID- 6854618 TI - Preparation in undergraduate medical education for improved geriatric care. A guideline for curriculum assessment. PMID- 6854619 TI - Electrophysiology of Cl secretion in canine trachea. AB - Conventional microelectrode techniques were employed to determine the mechanism of Cl secretion by canine tracheal epithelium. Epinephrine, a potent stimulator of Cl secretion in these cells, hyperpolarized both the transepithelial potential (20 to 38.9 mV) and the potential across the basolateral membrane (-63.9 to -68.2 mV) and depolarized the potential across the apical membrane (-43.9 to -29.3 mV). Epinephrine also caused a decrease in the transepithelial resistance and ratio of apical to apical + basolateral membrane resistances (777 to 379 omega cm2 and 0.71 to 0.35, respectively) though the change in the latter was biphasic, first decreasing then slightly increasing. Ionic substitutions, either Na, K or Cl, in the mucosal bathing solutions were found to cause changes in the resistances and potentials measured. In the presence of epinephrine, the changes produced by the Na and K substitutions decreased, while those produced by altering the mucosal Cl concentration increased. A model was designed to analyze the results from these experiments. When used in conjunction with the Goldman-Hodgkin-Katz equation, the results from this model indicate that epinephrine caused a large increase in the Cl permeability of the apical membrane of the cell. From these results we conclude that the increase in Cl secretion caused by epinephrine is accompanied by at least two cellular events: the primary event is an increase in the Cl conductance of the apical membrane; the second event is either an increase in the conductance of the basolateral membrane (probably due to an increase in K permeability) or an increase in shunt conductance or a combination of both. PMID- 6854620 TI - Lithium absorption in tight and leaky segments of intestine. AB - There is significant absorption of Li+ by human jejunum and ileum, but negligible absorption by human colon. Thus, a proximal-to-distal gradient of decreasing Li+ absorption and increasing junctional tightness exists in intestine as well as in renal tubule. For six leaky epithelia the relative permeabilities of K+, Na+, and Li+ by the junctional route are in the sequence PK greater than PNa greater than PLi and all fall within a factor of 2.5. In contrast, for tight epithelia PLi approximately PNa much greater than PK in the amiloride-sensitive channel of the apical membrane, but PK much greater than PLi approximately PNa in the basolateral membrane. The ability of several tight epithelia to sustain nonzero transepithelial Li+ absorption despite this basolateral barrier may be due to Na+/Li+ countertransport at the basolateral membrane, resulting in secondary active transport of Li+ across the epithelium. PMID- 6854621 TI - The band 3-rich membrane of llama erythrocytes: studies on cell shape and the organization of membrane proteins. AB - The erythrocyte membrane of the llama was characterized in comparison to that of the human. The llama erythrocyte was an elliptical disk that resisted shape alterations in hyperosmotic buffers and following metabolic depletion, both of which induce speculation of the human red cell. Lysophosphatidylcholine incorporation produced minor serrations of the edge of the llama disk but no spicules, whereas human red cells became sphero-echinocytes. The polypeptide profiles in the membranes of the two species were similar, except for several noteworthy differences: a marked elevation in the relative content of band 3; the absence of membrane-bound band 6; and simpler glycoprotein pattern in the llama. The concentration of band 3 in llama was about two and a half to three times that in the human and intramembrane particles in the protoplasmic leaflet of freeze fractured llama membrane were correspondingly increased. The selective solubilization of bands 1, 2 and 5 in low ionic strength buffer, and all of the peripheral proteins in high alkaline buffer were similar except for increased retention of ankyrin by the llama membrane. These data suggest a similar disposition of membrane proteins. The llama membrane was markedly resistant to the solubilization of integral proteins by the nonionic detergent, Triton X-100. This property and the general resistance to shape changes may be related to the high concentration of band 3. PMID- 6854623 TI - Ionic currents in cultured dorsal root ganglion cells from adult guinea pigs. AB - Ionic currents in cultured dorsal root ganglion (DRG) neurons from adult guinea pigs were analyzed by voltage-clamp techniques. The Na+ inward current had a reversal potential at +33 mV, and revealed activation and inactivation kinetics similar to those of squid giant axons. A typical value for the maximum Na+ conductance was 178 mS/cm2 and the peak current was 2.5 mA/cm2. The delayed K+ outward current showed a fast and a slow phase of inactivation and was sensitive to tetraethylammonium (TEA; approximately 130 mM) and 4-aminopyridine (approximately 2 mM). The maximum K+ conductance was 26 +/- 9 (mean +/- SD) mS/cm2. The slow Ca2+ inward current was identified in Na+-free, TEA-containing solution. Its peak value was increased by 1.7-fold when [Ca2+]o was increased from 5 to 10 mM. The current was blocked by Co2+ but not by tetrodotoxin. Sr2+ and Ba2+ could substitute in carrying this current. The maximum peak of the Ca2+ current was 0.22 +/- 0.14 mA/cm2. At potentials positive to 0 mV, the Ca2+ current was often followed by a slowly developing outward current, which was also sensitive to Co2+, suggesting a Ca2+-activated outward current. It is concluded that the action potential of the adult guinea pig DRG neuron is mediated by Ca2+ as well as by Na+ and K+ currents. The current densities of these ionic channels are considered to be different from embryonic neurons and from nodes of Ranvier. PMID- 6854622 TI - Sodium-chloride transport in the medullary thick ascending limb of Henle's loop: evidence for a sodium-chloride cotransport system in plasma membrane vesicles. AB - Sodium transport mechanisms were investigated in plasma membrane vesicles prepared from the medullary thick ascending limb of Henle's loop (TALH) of rabbit kidney. The uptake of 22Na into the plasma membrane vesicles was investigated by a rapid filtration technique. Sodium uptake was greatest in the presence of chloride; it was reduced when chloride was replaced by nitrate, gluconate or sulfate. The stimulation of sodium uptake by chloride was seen in the presence of a chloride gradient directed into the vesicle and when the vesicles were equilibrated with NaCl, KCl plus valinomycin so that no chemical or electrical gradients existed across the vesicle (tracer exchange experiments). Furosemide decreased sodium uptake into the vesicles in a dose-dependent manner only in the presence of chloride, with a Ki of around 5 X 10(-6) M. Amiloride, at 2 mM, had no effect on the chloride-dependent sodium uptake. Similarly, potassium removal had no effect on the chloride-dependent sodium uptake and furosemide was an effective inhibitor of sodium uptake in a potassium-free medium. The results show the presence of a furosemide-sensitive sodium-chloride cotransport system in the plasma membranes of the medullary TALH. There is no evidence for a Na+/H+ exchange mechanism or a Na+ -K+ -Cl- cotransport system. The sodium-chloride cotransport system would effect the uphill transport of chloride against its electrochemical potential gradient at the luminal membrane of the cell. PMID- 6854626 TI - Melamine resins, a new class of water-soluble embedding media for electron microscopy. PMID- 6854624 TI - Optical evidence for calcium-action potentials in early embryonic precontractile chick heart using a potential-sensitive dye. AB - Using an optical method for monitoring membrane potential, spontaneous action potentials in the 7- to 9-somite embryonic precontractile chick hearts were measured. The optical action potential in the 7- to 9-somite embryonic heart was lacking 'phase 0' and 'phase 1' attributable to the fast Na+ current. The embryonic precontractile heart continued to generate spontaneous action potentials in a Na+-free solution or in the presence of tetrodotoxin. Such an action potential was blocked by adding Co2+, Mn2+, Ni2+, La3+, D-600 or GEDTA, and the frequency, the amplitude, and the rate of rise of the spontaneous action potentials depended closely upon the external Ca2+ concentration; reducing the external Ca2+ concentration resulted in suppression of the spontaneous excitability. From the above results, we concluded that the spontaneous action potential in the early phases of cardiogenesis is characterized as a Ca2+ dependent action potential. PMID- 6854627 TI - Enhancement of contrast in living and fixed specimens by the use of fibre optics. AB - A method is described which enhances the contrast of living and fixed specimens examined with the stereomicroscope. It consists of immersing the ends of flexible fibre optic light sources together with the specimen in the fluid used for examination. It is reported that not only does this method increase the contrast of living specimens but that it may also be applied to specimens being prepared as thin sections or freeze fracture surfaces for examination with the transmission electron microscope. A further method of enhancement of contrast is suggested which involves the fitting of light filters of complementary colours, one to each of the fibre optic light sources, before immersion with the specimen. PMID- 6854625 TI - Specificity of the Na+-dependent monocarboxylic acid transport pathway in rabbit renal brush border membranes. AB - The substrate specificity of a Na+-dependent transport pathway for L-lactate was studied in rabbit renal brush border membrane vesicles. Jmax for L-lactate transport was unaffected by the presence of a fixed concentration of two different short-chain monocarboxylic acids, while the apparent Kt(Ka) for L lactate increased, and this is compatible with competitive inhibition. The inhibitor constants ("Ki"'s) for the transport pathway for the two solutes examined closely corresponded to the respective "Ki"'s derived from a Dixon plot. A broad range of compounds were then tested as potential inhibitors of L-lactate transport, and the "Ki"'s thereby derived yielded specific information regarding optimal substrate recognition by the carrier. A single carboxyl group is an absolute requirement for recognition, and preference is given to 3 to 6 C chain molecules. Addition of ketone, hydroxyl and, particularly, amine groups at any carbon position, diminishes substrate-carrier interaction. Intramolecular forces, notably the inductive effects of halogens, may play a role in enhancing substrate carrier interaction; however, no correlation was found between pKa and "Ki" for the substrates examined. We conclude that a separate monocarboxylic acid transport pathway, discrete from either the D-glucose, alpha or beta neutral amino-acid, or dicarboxylic acid carriers, exists in the renal brush border, and this handles a broad range of monocarboxylates. PMID- 6854628 TI - A simple and efficient method for objective discrimination between pseudostratified, metaplastic and dysplastic nasal epithelium. AB - Morphologic features may sometimes be interpreted differently by different pathologists. By introducing objective methods in the histological evaluation the subjectivity of the judgement is reduced and a higher degree of consistency achieved. In the present study three linear parameters of nasal epithelial basal cells: the largest transversal nuclear diameter, the sum of the longitudinal and transversal nucleolar axes and the basal cell width, i.e. the width of the attachment face to the basement membrane, were classified by means of three-class rulers. From this classification weighted indices were made which were then given equal weight and transformed, so that when added up their sum, the joint index (Q) to the largest possible extent was consistent with pseudostratified/stratified cuboidal, stratified squamous and dysplastic epithelium when Q less than or equal to 1, 1 less than Q less than or equal to 2 and Q greater than 2 respectively. Tested prospectively we found 91% agreement between the morphometric and histological classification. The method presented is extremely simple and rapid to perform, and appears to have diagnostic potential in distinguishing various types of epithelial alterations of the nasal mucosa. The method may also be useful in approaching similar problems in other epithelia. PMID- 6854629 TI - Core and E antigen synthesis in rodent cells transformed with hepatitis B virus DNA is associated with greater than genome length viral messenger RNAs. AB - The viral RNA sequences in a number of rodent cell lines which contain integrated hepatitis B virus DNA were examined. In one of the cell lines, which produces the hepatitis B virus surface, core and e antigens, there are four polyadenylated, cytoplasmic RNA species, estimated to be 4425, 3968, 2435 and 1054 nucleotides in length, which hybridize with hepatitis B virus DNA. All four were shown to be transcripts of the coding strand of the virus genome and the regions contained in each RNA molecule were determined by hybridization with probes from different parts of the genome. The two largest RNAs hybridized with probes from all parts of the genome. The 2.4 x 10(3) nucleotide RNA, which is the same size as the previously identified surface antigen messenger RNA, hybridized with probes covering the surface antigen gene but not with probes corresponding to the core antigen gene. It also hybridized with a probe mapping upstream of a sequence previously suggested to be its promoter. The 10(3) nucleotide RNA was mapped to the X gene region and thus provides evidence that this open translational reading frame does encode a product. This RNA is possibly 3' coterminal with the surface antigen mRNA. The two largest RNAs, which are greater than the length of the hepatitis B virus genome, are present in three independent cell lines which produce core antigen and e antigen in addition to surface antigen, but absent from two cell lines which produce only surface antigen. Therefore, it appears that these RNAs are entirely hepatitis B virus-specified, rather than being co transcripts with cellular sequences, and also that one of them encodes the core and e antigen produced by these cells. PMID- 6854630 TI - Structural comparisons of some small spherical plant viruses. AB - The structures of tomato bushy stunt virus, southern bean mosaic virus and satellite tobacco necrosis virus have been compared quantitatively. The organization of the shell domains of tomato bushy stunt virus and southern bean mosaic virus within the icosahedral envelope is identical. The wedge-shaped end of the subunit is closer to the fivefold or quasi-sixfold axes in all three viruses but the packing about the three- and twofold axes is quite different in satellite tobacco necrosis virus as compared to tomato bushy stunt virus or southern bean mosaic virus. The polypeptide folds of these viruses have greatest similarity in the beta-sheet region of the eight-stranded anti-parallel beta barrel. The largest differences occur in the connecting segments. There is no clear indication of homologous amino acid sequences between southern bean mosaic virus and satellite tobacco necrosis virus. However, there is some conservation of the following functional groups. (1) Threonines and serines at the hexagonal pentagonal wedge-shaped end of the subunit. (2) Lysines and arginines at the protein-RNA interface. (3) Hydrophobic residues in the cavity within the anti parallel beta-barrel. (4) An aspartic acid near a site which binds Ca in tomato bushy stunt virus. (5) Ionic interactions in the contacts between fivefold related subunits. These virus coat protein structures are not as similar to each other as the alpha and beta chains of hemoglobin but have greater likeness to one another than the NAD-binding domains of dehydrogenases or lysozymes from hen egg white and T4 phage. The surface domains of tomato bushy stunt virus and southern bean mosaic virus are more like each other than like satellite tobacco necrosis virus. A divergent evolutionary tree is proposed on the basis of these observations. PMID- 6854631 TI - Structure of Alamethicin in solution. One- and two-dimensional 1H nuclear magnetic resonance studies at 500 MHz. AB - We report here the 500 MHz 1H nuclear magnetic resonance spectra of Alamethicin, an icosapeptide antibiotic isolated from Trichoderma viride, in methanol, water and methanol/water mixtures. At this frequency, resonances from all the protons are well-resolved in methanol and may be assigned unambiguously. Spectral assignments were made using two-dimensional spin-echo correlated spectroscopy and by spin-decoupling experiments. The amide coupling constants (JNH-alpha CH) facilitated conformational predictions, which were confirmed in part by two dimensional nuclear Overhauser experiments. On the basis of these data, we propose a secondary structure for Alamethicin that is alpha-helical toward the N terminus and extended beta-sheet at the C-terminal end. This structure is consistent with earlier circular dichroism measurements (McMullen et al., 1971), infrared attenuated total reflection spectroscopy studies (Fringeli & Fringeli, 1979) and proton exchange data (Davis & Gisin, 1981). The proposed structure is a tightly bound dimer, wherein the beta-sheet is stabilized by intermolecular hydrogen-bonds between opposing molecules. An interesting feature of this structure is that it exhibits both a hydrophobic and a hydrophilic surface. This highly amphiphilic nature of the dimer structure may account for the extensive further aggregation of Alamethicin in water. The 1H n.m.r. spectrum of Alamethicin in water is broad, suggesting extensive association. However, spectral assignments and amide coupling constant measurements in water, which were accomplished by titration of methanolic solution of Alamethicin by water, revealed no gross changes in the basic secondary structure of the molecule. PMID- 6854632 TI - Three-dimensional structure of luminal plasma membrane protein from urinary bladder. AB - The structure of the membrane protein from urothelial plasma membrane has been investigated. A three-dimensional map has been obtained at 35 A resolution from negatively stained two-dimensional arrays of membrane proteins. The lattice space group has the symmetry p6. Twelve stain-excluding areas are resolvable on projections perpendicular to the membrane plane. In the three-dimensional reconstruction these areas appear to be restricted to one side of the membrane and form protrusions that extend 50 A out of the membrane. No periodic structure is observed at the cytoplasmic side of the membrane, which suggests that the protein is not a transmembrane protein. PMID- 6854633 TI - Subunit interactions in southern bean mosaic virus. PMID- 6854634 TI - RNA-protein binding in southern bean mosaic virus. PMID- 6854635 TI - Quality of the electron density map. PMID- 6854636 TI - Salt-induced conformational transition of poly[d(A-T)] X poly[d(A-T)]. AB - Unique chiroptical properties of poly[d(A-T)] X poly[d(A-T)] observed in CsF solutions (Vorlickova et al., 1980) were specified by circular dichroism, ultraviolet light and 31P nuclear magnetic resonance spectroscopy. It was found that up to a 3 M concentration of the salt, caesium cations induced a gradual rearrangement of the polynucleotide double helix during which the phosphodiester bonds in one sequence changed the geometry and the base stacking decreased. At higher CsF concentrations poly[d(A-T)] X poly[d(A-T)] underwent a transition toward a novel conformation which had phosphodiester bonds in both sequences in considerably different non-B-DNA geometries. PMID- 6854637 TI - Protection against nuclease cleavage of pBR322 DNA by the cAMP receptor protein of Escherichia coli. PMID- 6854638 TI - Crystallization and preliminary X-ray diffraction studies of the mitogenic lentil (Lens culinaris) lectin. PMID- 6854639 TI - Two gene families clustered in a small region of the Drosophila genome. AB - Three Drosophila genes that are clustered within 8 X 10(3) bases of DNA at the chromosomal region 44D have been identified and mapped, and the gene cluster entirely sequenced. The three genes are 55 to 60% homologous in DNA sequence. One gene contains an intron in its 5'-proximal protein coding sequence while the other two have none at this position; similarly, another gene has an intron in its 3'-proximal protein coding sequence which is not found in the other genes. All three genes are abundantly expressed together in Drosophila first, second, and early third instar larval stages and in adults, but they are not abundantly expressed in either embryonic, late third instar larval, or pupal stages. This gene family lies 11 X 10(3) bases away from another cluster containing four Drosophila larval cuticle protein genes plus a pseudogene. The cuticle genes are all abundantly expressed throughout third instar larval development. Thus, at least seven protein-coding genes and one pseudogene lie within 27 X 10(3) bases of DNA. Moreover, two small gene families can lie adjacent on a chromosome and exhibit different patterns of developmental regulation, even though individual genes within each clustered family are co-ordinately expressed. PMID- 6854640 TI - Structural changes in tubulin sheets upon removal of microtubule-associated proteins. AB - Zinc-induced tubulin sheets without microtubule-associated proteins (MAPs) were assembled from tubulin purified by phosphocellulose chromatography. Large, open sheets were obtained in five-minute incubations at pH 5.7. Electron micrographs of negatively stained sheets showed a protofilament arrangement similar to that observed for zinc-induced sheets with MAPs but with altered lattice parameters. The spacings measured from optical diffraction patterns demonstrated that the protofilaments were 2.2 A closer together in the sheets without MAPs. Each MAP free sheet was also divided roughly in half by a discontinuity which was parallel to the protofilaments and the relationship between the two domains was deduced from computed transforms. Two-dimensional image processing was carried out by conventional Fourier techniques and by correlation analysis. The correlation analysis improved the reconstructions in this application, with the resolution limited by the inherent properties of the negative stain method to about 14 A. A prominent feature of the computed reconstructions was an alternation of light and dark protofilaments due to differential staining, as revealed by a study of folded sheets. Neighboring protofilaments are related by a 2-fold screw axis, as they are in zinc-induced sheets with MAPs, but the symmetry is masked by the differential staining. The major effect of MAP removal on the structure of the sheets is that the bilobed structure of alternate tubulin subunits is no longer observed. This observation and the closer spacing of protofilaments is consistent with the postulate that some of the MAP molecules lie in the groove between protofilaments and bind to several tubulin dimers. PMID- 6854641 TI - Ultrastructural localization of M-band proteins in chicken breast muscle as revealed by combined immunocytochemistry and ultramicrotomy. AB - Cryo-ultramicrotomy and "conventional" plastic sectioning have been used in combination with extraction and immunolabeling techniques to determine the location of the two M-band proteins characterized to date, MM-creatine kinase (MM CK: Mr, 80,000) and M-protein "myomesin" (Mr, 165,000) within the M-region of chicken pectoralis muscle. The following main results were obtained. (1) The M band in chicken pectoralis muscle contains five major striations (M1, M4 and M4', M6 and M6' in the terminology of Sjostrom & Squire, 1977a). (2) Extraction of the bulk of the electron-dense M-band with low ionic strength removes the M striations M1, M4 and M4' while M6 and M6' are retained. Cross-sections through the M-region of such muscles lack primary M-bridges connecting the thick myosin filaments. (3) Labeling with antibodies against MM-CK enhances the M-striations M4 and M4'; sometimes the whole region between M4 and M4' is labeled. (4) Incubation with antibodies against myomesin results in the labeling of the whole M-band from M6 to M6'; no label is found in the rest of the bare zone outside M6 and M6'. (5) Incubation of low ionic strength extracted muscle fibers with antibodies against myomesin leads to an "incomplete" labeling of the M-band between M6 and M6'; lines M6 and M6' are sometimes seen to be enhanced presumably due to antibody labeling. From these results it is concluded that MM-CK is the major protein of the M4 and M4' (and possibly also of the M1) M-bridges. Myomesin is bound within the M-band along the thick filaments from M6 to M6'. Two hypothetical models for the possible location of myomesin are discussed. According to these models myomesin would either make up the M-filaments or be directly attached to and along the central bare zone of thick myosin filaments. PMID- 6854642 TI - Sequence-dependent conformation of an A-DNA double helix. The crystal structure of the octamer d(G-G-T-A-T-A-C-C). AB - The crystal structures of the synthetic self-complementary octamer d(G-G-T-A-T-A C-C) and its 5-bromouracil-containing analogue have been refined to R values of 20% and 14% at resolutions of 1.8 and 2.25 A, respectively. The molecules adopt and A-DNA type double-helical conformation, which is minimally affected by crystal forces. A detailed analysis of the structure shows a considerable influence of the nucleotide sequence on the base-pair stacking patterns. In particular, the electrostatic stacking interactions between adjacent guanine and thymine bases produce symmetric bending of the double helix and a major-groove widening. The sugar-phosphate backbone appears to be only slightly affected by the base sequence. The local variations in the base-pair orientation are brought about by correlated adjustments in the backbone torsion angles and the glycosidic orientation. Sequence-dependent conformational variations of the type observed here may contribute to the specificity of certain protein-DNA interactions. PMID- 6854643 TI - Bacteriorhodopsin remains dispersed in fluid phospholipid bilayers over a wide range of bilayer thicknesses. AB - We have used vesicles made from delipidated bacteriorhodopsin and synthetic lecithins to address the following questions. If the transmembrane dimension of a protein hydrophobic surface differs from the equilibrium thickness of its lipid bilayer environment, will protein monomers aggregate to decrease the protein lipid contact surface area? If so, how large must the difference be to induce aggregation? Using lecithins with acyl chains from di-10:0 to di-24:1, the thickness of the bilayer hydrocarbon region above the lipid phase transition temperature (tm) was varied from 14.5 A less than to 7.5 A more than the transmembrane dimension of the bacteriorhodopsin hydrophobic region. Bacteriorhodopsin remains dispersed when the surrounding bilayer hydrophobic region is 4 A thicker or 10 A thinner than the bacteriorhodopsin hydrophobic surface. Only the thin- (10:0) and thick- (24:1) bilayer samples showed any bacteriorhodopsin aggregation above tm. Thus a surprisingly large difference between protein and lipid hydrophobic thicknesses can be accommodated without protein aggregation. The lipid bilayer can evidently sustain large local distortions with a small change in free energy. PMID- 6854644 TI - Lipid bilayer thickness varies linearly with acyl chain length in fluid phosphatidylcholine vesicles. AB - The thickness of the lipid bilayer in vesicles made of pure phosphatidylcholines, with acyl chain lengths ranging from 10 to 24 carbons, has been determined by analysis of continuous X-ray scattering data from vesicle pellets at temperatures above the lipid phase transition temperature. Bilayer thickness was found to vary linearly with the number of carbons per acyl chain. The lines for saturated and monounsaturated acyl chains were slightly displaced but had similar slopes. For the saturated species di-12:0, di-14:0, di-16:0, and di-18:0 phosphatidylcholine the surface areas per molecule were all 65.7 to 66.5 A2, while the monounsaturated species and di-10:0 phosphatidylcholine all occupied 67.7 to 70.1 A2 per molecule. PMID- 6854645 TI - Nuclear magnetic resonance evidence for a flexible region at the C-terminus of alpha-tropomyosin. AB - The 1H nuclear magnetic resonance spectrum of alpha-tropomyosin contains a number of sharp peaks indicative of the presence of small regions of high flexibility in the molecule. Removal of 9 to 11 residues from the C-terminus by digestion with carboxypeptidase A causes a marked decline in the intensity of these peaks. The difference is consistent with at least the C-terminal four residues of the sequence (-Met-Thr-Ser-Ile) being highly mobile. The conformation of the C terminus is thus radically different from the alpha-helical coiled-coil from which the bulk of the molecule is constructed. PMID- 6854646 TI - Conformations of oligonucleotides in solution as determined by sequence-specific antibodies. AB - The conformations of some related oligoribonucleotides in solution were investigated immunochemically with antisera specific for two synthetic oligonucleotide sequences, A-A-U and A-A-U-U. Radioimmunoassay showed differences of as much as three or more orders of magnitude in binding among oligonucleotides with commonly shared sequences. These large differences, which reflect the loss of many points of contact with antibody because of changes in overall conformation, allow the following conclusions: (1) A-A-U and A-A-U-U have conformations distinct from any present in the Un family of oligomers. (2) Conformations of A-A-U and A-A-U-U differ markedly from those of oligomers of A. The dinucleotide A-A, in particular, bears little resemblance in conformation to the A-A sequence in A-A-U and A-A-U-U. (3) The recognizable conformational unit appears to be the triplet A-A-U, which binds as well as A-A-U-U and far better than its component dimers. Interactions between non-adjacent bases may be a factor here, as well as in codon recognition. The immunological data support the conclusion that, in oligonucleotides, as in polypeptides, primary sequence can determine conformation in solution. PMID- 6854647 TI - Changes of conformation of DNA produced by mechanical forces. AB - It is shown that when tension is applied to DNA it can change its conformation. In the relaxed state, DNA adopts the A form in the absence of excess salt. When tension is applied, either the B, C or stretched conformations of DNA are observed, depending on the humidity of the sample. PMID- 6854648 TI - Electron microscopic comparison of the sequences of single-stranded genomes of mammalian parvoviruses by heteroduplex mapping. AB - The sequence homologies among the linear single-stranded genomes of several mammalian parvoviruses have been studied by electron microscopic analysis of the heteroduplexes produced by reannealing the complementary strands of their DNAs. The genomes of Kilham rat virus, H-1, minute virus of mice and LuIII, which are antigenically distinct non-defective parvoviruses, have considerable homology: about 70% of their sequences are conserved. The homologous regions map at similar locations in the left halves (from the 3' ends) of the genomes. No sequence homology, however, is observed between the DNAs of these nondefective parvoviruses and that of bovine parvovirus, another non-defective virus, or that of defective adenoassociated virus, nor between the genomes of bovine parvovirus and adenoassociated virus. This suggests that only very short, if any, homologous regions are present. From our results, we predict an evolutionary relationship among Kilham rat virus, H-1, minute virus of mice and LuIII. It is interesting to note that, although LuIII was originally isolated from a human cell line and is specific for human cells in vitro, its genome has sequences in common only with the rodent viruses Kilham rat virus, minute virus of mice and H-1, and not with the other two mammalian parvoviruses tested. PMID- 6854649 TI - Sequence-specific adenylations and deadenylations accompany changes in the translation of maternal messenger RNA after fertilization of Spisula oocytes. AB - A dramatic change in the pattern of protein synthesis occurs within ten minutes after fertilization of Spisula oocytes. This change is regulated entirely at the translational level. We have used DNA clones complementary to five translationally regulated messenger RNAs to follow shifts in mRNA utilization at fertilization and to characterize alterations in mRNA structure that accompany switches in translational activity in vivo. Four of the mRNAs studied are translationally inactive in the oocyte. After fertilization two of these mRNAs are completely recruited onto polysomes, and two are partially recruited. All four of these mRNAs have very short poly(A) tracts in the oocyte; after fertilization the poly(A) tails lengthen considerably. In contrast, a fifth mRNA, that encoding alpha-tubulin mRNA, is translated very efficiently in the oocyte and is rapidly lost from polysomes after fertilization. Essentially all alpha tubulin mRNA in the oocyte is poly(A)+ and a large portion of this mRNA undergoes complete deadenylation after fertilization. These results reveal a striking relationship between changes in adenylation and translational activity in vivo. This correlation is not perfect, however. Evidence for and against a direct role for polyadenylation in regulating these translational changes is discussed. Changes in poly(A) tails are the only alterations in mRNA sizes that we have been able to detect. This indicates that, at least for the mRNAs studied here, translational activation is not due to extensive processing of larger translationally incompetent precursors. We have also isolated several complementary DNA clones to RNAs encoded by the mitochondrial genome. Surprisingly, the poly(A) tracts of at least two of the mitochondrial RNAs also lengthen in response to fertilization. PMID- 6854650 TI - Base sequence and helix structure variation in B and A DNA. AB - The observed propeller twist in base-pairs of crystalline double-helical DNA oligomers improves the stacking overlap along each individual helix strand. But, as proposed by Calladine, it also leads to clash or steric hindrance between purines at adjacent base-pairs on opposite strands of the helix. This clash can be relieved by: (1) decreasing the local helix twist angle between base-pairs; (2) opening up the roll angle between base-pairs on the side on which the clash occurs; (3) separating purines by sliding base-pairs along their long axes so that the purines are partially pulled out of the stack (leading to equal but opposite alterations in main-chain torsion angle delta at the two ends of the base-pair); and (4) flattening the propeller twist of the offending base-pairs. Simple sum functions, sigma 1 through sigma 4, are defined, by which the expected local variation in helix twist, base roll angle, torsion angle delta and propeller twist may be calculated from base sequence. All four functions are quite successful in predicting the behavior of B DNA. Only the helix twist and base roll functions are applicable to A DNA, and the helix twist function begins to fail for an A helical RNA/DNA hybrid. Within these limits, the sequence derived sum functions match the observed helix parameter variation quite closely, with correlation coefficients greater than 0.900 in nearly all cases. Implications of this sequence-derived helix parameter variation for repressor operator interactions are considered. PMID- 6854651 TI - Geminate recombination of carbon monoxide to myoglobin. AB - Transient absorption spectra of myoglobin, following photolysis of the carbon monoxide complex at room temperature, were measured using a newly developed, sensitive nanosecond absorption spectrometer. The Soret spectrum of the immediate photoproduct is almost identical to that of deoxymyoglobin at equilibrium, suggesting that the heme group has changed from a planar to a domed structure in less than about 3 ns. About 4% of the photodissociated carbon monoxide molecules rebind to the hemes to which they were initially bound, with a relaxation time of 180 ns. Duddell et al. (1980) observed a geminate yield of 27% and a relaxation time of approximately 55 ns for the photolysis of oxymyoglobin. Comparison of the two results using the simplest kinetic model suggests that the 30-fold more rapid overall association rate for the reaction of oxygen with myoglobin compared to carbon monoxide results mainly from faster binding at the heme, with a small contribution from more rapid entry of oxygen into the protein from the solvent. The data on carbon monoxide are also compared with predictions from low temperature studies of Frauenfelder and co-workers. This comparison points to the need for further experiments to demonstrate the correspondence between the ligand rebinding processes observed at high and low temperatures. PMID- 6854652 TI - Structural and functional organization of the suprapatella in two cercopithecines. AB - Gross and microscopic study of Cercopithecus aethiops pygerythrus and Papio cyanocephalus anubis shows that these cercopithecines have a quadriceps tendon the distal portion of which consists mostly of dense collagenous bundles with scattered fine elastic fibres most of which lie in the loose connective tissue planes within and around the tendon and around blood vessels. A distinct fibrovesicular structure, the suprapatella, lies within the tendon of the vastus intermedius above the pony patella. Histologically, this structure is characterised by interwoven bundles of collagenous fibres, among which are enmeshed large cells containing prominent nuclei surrounded by large clear spaces. It is postulated that this structure facilitates hyperflexion of the knee during the initial phases of springing and jumping. PMID- 6854653 TI - Aspects of masticatory form and function in common tree shrews, Tupaia glis. AB - Tree shrews have relatively primitive tribosphenic molars that are apparently similar to those of basal eutherians; thus, these animals have been used as a model to describe mastication in early mammals. In this study the gross morphology of the bony skull, joints, dentition, and muscles of mastication are related to potential jaw movements and cuspal relationships. Potential for complex mandibular movements is indicated by a mobile mandibular symphysis, shallow mandibular fossa that is large compared to its resident condyle, and relatively loose temporomandibular joint ligaments. Abrasive tooth wear is noticeable, and is most marked at the first molars and buccal aspects of the upper cheek teeth distal to P2. Muscle morphology is basically similar to that previously described for Tupaia minor and Ptilocercus lowii. However, in T. glis, an intraorbital part of deep temporalis has the potential for inducing lingual translation of its dentary, and the large medial pterygoid has extended its origin anteriorly to the floor of the orbit, which would enhance protrusion. The importance of the tongue and hyoid muscles during mastication is suggested by broadly expanded anterior bellies of digastrics, which may assist mylohyoids in tensing the floor of the mouth during forceful tongue actions, and by preliminary electromyography, which suggests that masticatory muscles alone cannot fully account for jaw movements in this species. PMID- 6854654 TI - Muscles of the masticatory apparatus in two genera of hyraces (Procavia and Heterohyrax). AB - Subungulate hyraces are similar to the condition assumed to have characterized primitive ungulates and subungulates by virtue of their small body size, relatively unspecialized cranial and postcranial anatomy, and primitive type of lophodont dentition. The muscles of mastication of Procavia habesssinica and Heterohyrax brucei are here compared with those of other mammals, both with ungulates, as an example of more specialized mammals, and with opossums, as an example of more generalized mammals, to determine aspects of hyrax myology that represent the retention of a condition primitive for herbivorous mammals. The masticatory muscles of hyraces retain the primitive ungulate/subungulate condition in the large, complexly subdivided temporalis, and in the enlarged, pinnated, bilayered medial pterygoid. The medial pterygoid originates from the pterygoid hamulus, a condition that may also be primitive for this assemblage. The large complex superficial masseter is derived compared with the condition in ruminant artiodactyls, but may represent the condition primitive for perissodactyls. The architectural modifications of this muscle in hyraces may represent adaptations to allow a wide gape threat display. Hyraces possess a posterior belly of the digastric alone, paralleling the condition in some perissodactyls. They possess a large and complexly subdivided styloglossus, which may be a shared derived character of subungulates. Hyraces are unique among ungulates and subungulates in the extreme reduction of the anterior hyoid cornua, and may be unique among mammals in the development of paired lingual processes from the ceratohyal ossifications. PMID- 6854655 TI - A correlated light and electron microscopic study of the structure and secretory activity of the accessory salivary glands of the marine gastropods, Conus flavidus and C. vexillum (neogastropoda, conacea). AB - The structure and secretory activity of the accessory salivary gland in two species of Conus were examined using routine and histochemical techniques of light, scanning and transmission electron microscopy. The composite layers of the accessory salivary gland of Conus are a luminal epithelium, fibromuscular layer, submuscular layer, and a capsule. In C. flavidus and C. vexillum, the luminal epithelium is formed by epitheliocytes and cytoplasmic processes extending from the secretory cells, whose perikarya form the submuscular layer. The processes carry secretory cell products (chiefly Golgi-derived glycoprotein) across the fibromuscular layer and terminate between epitheliocytes (at the bases of the secretory canaliculi) or beyond the surface of the epithelial cells. Conus vexillum is distinguished from C. flavidus by its high content of lipofuscin. Epitheliocytes are the only microvillated cells in the accessory salivary gland of Conus. In C. flavidus, epitheliocytes extrude secretory granules, various types of cytoplasmic blebs and clear vesicles by apocrine "pinching off." Clear vesicles are shed from the tips of microvilli. The luminal epithelial cells of C. vexillum similarly egest clear vesicles, but normally undergo additional holocrine secretion to release lipofuscin. The secretions of epitheliocytes appear to be major products of the accessory salivary gland: consideration of secretory activities by both epitheliocytes and secretory cells will therefore be necessary when directly investigating accessory salivary gland function in Conus. PMID- 6854656 TI - The effects of ischemia on myocardial vascular flow and permeability. AB - The effects of brief periods of ischemia on vascular space size, vascular permeability to albumin, tissue water and extracellular space size, and vascular resistance were studied in the perfused isolated rabbit interventricular septum. Vascular space size increased 264% over control after 30 min ischemia and 52% after 60 min ischemia, but vascular resistance increased. Total tissue water did not change after ischemia and extracellular space size did not increase after 30 min ischemia and decreased slightly after 60 min ischemia. These results demonstrate that the initial increase in vascular resistance after ischemia is not initiated by interstitial edema or cellular edema. These events appear to be later phenomena. The initiating cause of the increased vascular resistance appears to be a combination of increased vascular tone and conversion of a portion of vascular flow from low resistance large vessel flow to higher resistance small vessel flow (capillary recruitment). PMID- 6854658 TI - The establishment of regular beating in populations of pacemaker heart cells. A study with tissue-cultured rat heart cells. AB - Single isolated neonatal rat heart cells beat slowly (mean beating interval duration in the range of seconds) and irregularly (coefficient of variation greater than 40%). It is shown that slowness and irregularity of beating are intrinsic properties of the cells and are not caused by dissociation damage or lack of conditioning factors in the culture medium. When cell contacts are established either by letting the cultures grow for given amounts of time or by plating cells at increasing densities both interval duration and irregularity decrease. The beating regularity of small groups of interconnected cells (3 to 35 cells) and larger groups (200 to 15000 cells) is comparable. There is no clear cut proportionality between number of interconnected cells and beating regularity. Confluent monolayers beat fast (mean interval duration ranging between 200 and 400 ms and regular (coefficient of variation less than 5%). The hypothesis is discussed that this clock-like behavior of monolayers of heart cells is caused by the interaction of several pacemaker centers which are by themselves less regular and beat more slowly. PMID- 6854659 TI - Contraction band necrosis and irreversible myocardial injury. PMID- 6854657 TI - In vivo effects of ethanol on the rat myocardium: evidence for a reversible, non specific increase of sarcolemmal permeability. AB - Weight paired (approximately 200 g) Long-Evans male rats (n = 48) were divided into two groups: an ethanol-consuming (A) and a water-consuming control (C) group. Ethanol concentration was raised incrementally over a one month period until it reached 25% (v/v). The diet of group C was regulated calorically to minimize differences between the two groups in the consumption of protein, fat, and carbohydrate. Half the members of each group were killed 12 weeks after initiating the special diets for the determination of myocardial electrolyte and water distributions and uptake of a tracer normally restricted to the extracellular space (ECS). The remaining rats were returned to a normal diet (recovery groups AR and CR) and killed 8 weeks later. Left ventricular tissue and plasma were analyzed for Na, K, Ca, and Mg; ECS was assessed in the same samples by tracer distribution and morphometric methods. Comparison of the myocardial [35S]sulfate space as a function of equilibration duration in the four groups indicates that the tracer leaks into the cellular compartment of alcoholic rats, suggesting that myocardial sarcolemmal permeability is increased in alcoholism. This interpretation is supported by the finding that all cations studied either were (Na, Ca) or tended to be (K, Mg) displaced down their respective electrochemical gradients. It is concluded that a reversible, non-selective sarcolemmal leakiness may be one of the earliest effects of alcoholism on the heart, eventually resulting in a redistribution of myocardial electrolytes and associated alterations of electrical, metabolic, and contractile activities. PMID- 6854660 TI - An ultrastructural study of the effects of age on sympathetic innervation and atrial tissue in the rat. AB - Previous work on the rat heart has demonstrated an age-related reduction in catecholamines and a decline in myocardial cell sensitivity to catecholamines in vitro. We used ultrastructural cytochemical techniques to label noradrenergic vesicles of the sympathetic nerve terminals of the rat heart atrium, and addressed the question of whether these deficits are accompanied by a decrease in the number of synaptic vesicles or by progressive axonal degeneration. Our results demonstrate a significant sympathetic axonal degeneration between 3 and 24 months of age. No decrease in noradrenergic vesicle population in the intact nerve terminals could be discerned over this age span. Atrial cell structural alterations observed with age include: (1) increased quantities of residual bodies; (2) infrequent but definite myofibrillar disorganization at cell peripheries; (3) infrequent regional discontinuity of cell attachments and (4) increased extracellular collagen. We suggest that the apparent integrity of noradrenergic vesicle populations is consistent with reports by other investigators that levels of the catecholamine synthesizing enzyme, tyrosine hydroxylase, in sympathetic ganglia increase with age. The previously observed decline in cardiac catecholamines with age may be due to axonal degeneration rather than to reduced noradrenergic vesicles in intact terminals. PMID- 6854661 TI - New government proposals: the effect on minority medical education. PMID- 6854662 TI - Rickets as an unexpected x-ray finding. AB - Rickets, whether due to lack of proper nutrition or secondary to disease or medication, may be unexpectedly detected on radiographs obtained for other reasons. Several recent examples are reported here. It is important to be aware of the manifestations of rickets so that appropriate treatment is not delayed. Physicians should be alert for signs of rickets in the x-ray examination of any child. PMID- 6854663 TI - Cerebral aneurysm: report of two cases and clinical update. AB - Two cases of cerebral aneurysms are presented. The first concerned a 26-year-old woman who complained of vague headaches and was found to have a saccular aneurysm of the internal carotid artery. The second involved a 45-year-old woman with a unilateral headache. Third-nerve palsy prompted an investigation that revealed multiple berry aneurysms. Therapy for the prevention of recurrent bleeding, as well as laboratory aids to index this risk, are discussed, and an update on medical and surgical treatments is presented. PMID- 6854664 TI - Radiotherapy in Tanzania. AB - The treatment of malignancies with radiotherapy and intracavitary techniques at the Tanzanian Tumor Center in Dar es Salaam, Tanzania, during an eight-month period in 1979 is reported. Cancer of the uterine cervix was the tumor most frequently treated by radiation, as well as breast, esophagus, skin, and bladder cancers. PMID- 6854667 TI - Legal options in securing hospital appointments. PMID- 6854665 TI - Asbestosis and the serratus anterior muscle. AB - Twenty-seven patients with a history of asbestos exposure were reviewed at the UCLA Medical Center in December 1981. All patients were referred by the United States Department of Labor. The patients were told they had asbestosis on the basis of their history of exposure and chest radiographs taken at a local asbestos screening program and initially interpreted by a "B" reader. None of the 27 patients reviewed were found to have evidence of asbestosis either clinically or radiographically. The false-positive radiographic interpretations were due to the extrathoracic musculature (serratus anterior) mimicking intrathoracic disease. Since the study described here was done, an additional 330 patients have had their radiographs reviewed. PMID- 6854666 TI - Synchronous cancers of the gastrointestinal tract: results, diagnosis, and treatment. AB - During the period of January 1, 1957 to January 1, 1982, complete inpatient and outpatient records of 62 cases of synchronous cancers of the gastrointestinal tract were submitted for a retrospective analysis. The total number of gastrointestinal cancer cases from the Saint Francis General Hospital and two affiliating hospitals was 1,550 with a resultant synchronous cancer incidence of 4 percent. In this small series of 62 cases, the operability rate was 100 percent, with a resectability rate of 96 percent. The surgical morbidity and mortality rates were 12 percent and 3.2 percent, respectively.The most frequent clinical manifestations were pain, borborygmi, nausea, vomiting, food intolerance, dysphagia, hematemesis, rectal bleeding, and weight loss.The five and ten year survival in the synchronous group was 82 percent and 64 percent, respectively, as compared with 36.1 percent and 27.8 percent for the single malignant group. PMID- 6854668 TI - Ion dependency of uptake and release of GABA and (RS)-nipecotic acid studied in cultured mouse brain cortex neurons. AB - The influence of sodium ions on GABA uptake into neurons cultured from cerebral cortex was investigated at sodium concentrations ranging from 16 to 151 mM. Sodium did not affect the Km for GABA uptake but the uptake rates as a function of the sodium concentration was sigmoid at all GABA concentrations studied (1-200 microM). Hill plots of these curves exhibited straight lines with slopes of 1.7 2.1, suggesting that the coupling ratio between sodium and GABA is at least 2. (RS)-Nipecotic acid, a GABA analogue, was transported with high affinity (Km 8.0 +/- 2.1 microM) like GABA, but the Vmax for nipecotic acid was lower than found for GABA (0.664 +/- 0.035 versus 0.955 +/- 0.059 nmol X min-1 X mg-1), suggesting a microheterogeneity of the GABA transport sites. Neurons loaded with the respective tritiated compounds exhibited a pronounced K+-stimulated, calcium dependent release of both GABA and nipecotic acid indicating that these cultured cells have developed functionally active GABA-ergic synapses. PMID- 6854669 TI - Growth, differentiation, and viability of fetal rat cortical and spinal cord implants into adult rat spinal cord. AB - Successful transplantation of the fetal brain into adult host brain has been accomplished. These studies explore the growth, differentiation, and viability of E11, E12, and E15 rat fetal cortex and fetal spinal cord implantation into the spinal cord of adult rats (donor and host, Sprague-Dawley). Under deep Chloropent anesthesia, 70 rats had 1-mm cubes of fetal cortex inserted with pressure or by stylus injection subpially between the dorsal horn and dorsal column (left side), or implantation of whole segments of fetal spinal cord. Animals were prepared for light microscopy 14 and 21 days and 1, 2, and 3 months later. Implants by both fetal tissues had a 69% survival rate. The younger the fetal implant the higher the success of the implant (E11 greater than E15). The diameter of fetal spinal cord implants reached the diameter of control postnatal animals after 30 days. The implants not only increased in mass (up to 7-fold in some cases) but differentiated and matured (apolar, unipolar, bipolar, and multipolar) neurons were observed one to three months postimplantation. By 30 days postimplantation, fetal neurons had large, often crenated nuclei, with a large single prominent nucleolus. The most successful implants were the young E11 fetal spinal cord into the adult host spinal cord. These implants represent an initial successful transplantation of fetal spinal cord into adult spinal cord. PMID- 6854670 TI - Mouse sciatic nerve regeneration through semipermeable tubes: a quantitative model. AB - The regeneration of transected mouse sciatic nerves using semipermeable acrylic copolymer tubes to enclose both stumps has been qualitatively assessed from 1 to 30 weeks post-operative. Quantitative morphometric analysis of electron micrograph montages of complete transverse sections of the segment regenerated between stumps has permitted determinations of the percents of total area occupied by the various tissue constituents--blood vessels, epineurium, perineurium, endoneurium, myelinated axon/Schwann cell units, and unmyelinated axon/Schwann cell units. Significant differences were found in the total cross sectional area of segments regenerated through tubes of 1.0 mm versus 0.5 mm internal diameters. Segments regenerated with the distal stump inserted in the tube contained significantly greater percentages of neural units and were significantly larger at 8 weeks post-operative compared to segments regenerated for 9-10 weeks with the distal stump avulsed. The morphometric method permits rapid quantitation of sizeable electron micrograph montages which at 1300 X permit all types of tissue components, including the unmyelinated axons, to be visualized. PMID- 6854671 TI - Synaptogenesis and myelination in dissociated cerebral microcarrier cell cultures. AB - A new approach for cultivating dissociated cerebral neurons is described. It is based on a rapid attachment of neurons to the DEAE-cellulose cylindrical MC and their subsequent interconnection to form cell-MC conglomerates. Intensive fiber growth followed by synaptogenesis and progressive myelin formation are indicative of optimal conditions of nutrition and oxygenation. PMID- 6854672 TI - Truncal vascular injury--factors influencing survival. AB - During the 10-year period ending June 1982, 219 patients were treated for 269 injuries to the major vessels of the abdominal and thoracic cavities, with 28% morbidity and 32% mortality. One hundred eighty patients (82%) had 377 associated injuries consisting primarily of damage to the small intestine (79), liver (45), and large intestine (34). Factors associated with an increased mortality included: more than three associated injuries; two or more nonvascular complications; more than two vessels injured; admission to ER in shock; injury to abdominal aorta or inferior vena cava; and injury to the porta hepatis. The majority of deaths (73%) were due to acute blood loss and irreversible shock. Factors unrelated to acute blood loss and shock had minimal effects on survival. PMID- 6854673 TI - Computed tomography of the pelvis in patients with multiple injuries. AB - The extent of osseous pelvic injury in patients suffering multiple organ trauma is difficult to assess. However, accurate information is essential in order to determine an acceptable treatment regimen, either operative (external or internal fixation), or nonoperative (bed rest and early ambulation). Twenty consecutive patients were treated for pelvic fractures from January 1981 through February 1982. All patients had multiple organ injuries, (average = 3.5 organ systems per patient). Each patient had an A-P X-ray projection of the pelvis in the emergency department (E.D.) as a part of the initial evaluation. Three patients (15%) required immediate laparotomy for associated abdominal injuries. Six patients (30%) required prolonged ventilatory support for pulmonary injuries. Computed tomography (CT) of the pelvis was performed on all patients within 4 days of admission. In seven patients, CT examination confirmed the findings of the routine X-rays obtained in the E.D. In 13 patients the CT examination demonstrated significant additional fractures of the pelvis which were not initially demonstrated in the E.D. A consistent pattern of either sacral fracture or injury to the sacroiliac joint which was not appreciated on the initial E.D. X rays was demonstrated in these 13 patients. Six patients underwent operative intervention, four with Hoffmann frames (external fixation), and two with reduction and internal fixation. CT examination of the pelvis provides a rapid and thorough evaluation which is extremely useful in demonstrating all the fractures of the pelvis on the single examination, thereby allowing the early determination of the best treatment plan for patients with such major injuries. PMID- 6854674 TI - Blunt injury to the colon and rectum. AB - One hundred nine patients suffering blunt injury to the colon or rectum were treated between 1 January 1970 and 31 December 1980. Vehicular accidents accounted for 90% of the injuries and 91% of the fatalities. Multiple system injury predominated, with survivors averaging 1.9 and nonsurvivors 3.8 injuries/patient. Six cases were complicated by abdominal sepsis directly related to their colon injury. There were no deaths and no episodes of colon-related abdominal sepsis among patients with isolated colon trauma. Of the 32 patients not surviving, four (3.7%), died as a direct result of their colon injury. Three of the four deaths appear to have been preventable. PMID- 6854676 TI - The effect of naloxone and cyproheptadine on pulmonary platelet trapping, hypotension, and platelet aggregability in traumatized dogs. AB - Adult respiratory distress syndrome (ARDS) is a serious complication of trauma and sepsis. We have earlier shown naloxone, an opiate antagonist, and cyproheptadine, an antiserotonin drug, to be effective in reducing pulmonary platelet trapping (PPT), which is thought to play an important role in the evolution of ARDS in endotoxin-shocked dogs. Endorphins are implicated as pathophysiologic factors in shock, and serotonin is a possible mediator of their action. The present study shows naloxone and cyproheptadine to be equally effective in protecting against PPT in dogs subjected to trauma, and when naloxone is given before the trauma it also obviates the hypotension associated with trauma. In addition, the naloxone- and cyproheptadine-treated animals did not show the increased platelet aggregability usually seen in traumatized dogs. PMID- 6854675 TI - Hepatic and splenic injury in dogs caused by direct impact to the heart. AB - The purpose of this study was to explore the possibility that nonpenetrating cardiac impact can directly result in hepatic and splenic injury through hemodynamic effects. Impact upon the anterior surface of the heart was produced in 34 open-chest anesthetized dogs. In 15 dogs the velocity of impact was 12 m/sec and in 19 dogs it was 18 m/sec. Pressure in the inferior vena cava transiently reached 194 +/- 25 mm Hg in the dogs impacted at 12 m/sec and 377 +/- 44 mm Hg in dogs impacted in 18 m/sec. Aortic pressure transiently reached 449 +/ 32 mm Hg in dogs impacted at 12 m/sec and 682 +/- 33 mm Hg in dogs impacted at 18 m/sec. Gross capsular lacerations of the liver occurred in six dogs (18%) following cardiac impact. All dogs showed hepatic congestion and most showed microscopic injury of liver cords, central veins, and portal tracts. Dogs that survived cardiac impact for the duration of observation (90 minutes) showed focal acute inflammation of liver triads and hepatic sinusoids, indicating a more subtle degree of injury. The spleens of eight dogs showed areas of grossly visible subcapsular hemorrhage. Subcapsular congestion of the spleen occurred in almost all dogs. This study shows therefore that nonpenetrating cardiac impact may result in hepatic and splenic injury. A likely mechanism may be the extraordinarily high venous pressure that develops at the instant of impact, although transient striking elevations of arterial pressure may also contribute. PMID- 6854677 TI - A single venipuncture technique for placement of multiple central venous catheters. AB - Surgeons are frequently called upon to place central venous catheters for various purposes. With the increasing used of central vein hyperalimentation, these catheters have become quite widely used. Often, critically ill patients require simultaneous infusions of vasopressors, fluids, blood and/or blood products, and hyperalimentation. In patients who have had peripheral intravenous catheters indwelling for long periods, often no peripheral access routes are available. Central venipuncture carries a definite risk of pneumothorax, hemothorax, and arterial puncture. The technique presented here allows the placement of multiple centra venous catheters via a single venipuncture. Each catheter is a completely separate venous conduit and may be used to infuse any number of substances alone or concurrently with others. Materials needed for this technique are: One 18 gauge Thinwall needle Two 20-cc Luer tip syringes Two 16-gauge 8" or 12" intravenous catheters* Two separate bags of infusion fluids and tubings One bottle 1% xylocaine Two .035" floppy end spring guidewires, 40 cm long One 8 French percutaneous dilator-introducer kit One 11 knife blade One mosquito curved hemostat Sterile towels, gauze sponges, sutures of choice, antiseptic *(This equipment is required for the placement of only two catheters). PMID- 6854679 TI - Fracture-dislocation of the ankle with anterior dislocation of the fibula. AB - A fracture-dislocation of the ankle with fixed anterior displacement of the proximal fibular fragment is reported. The mechanism of this injury was likely eversion of the foot which produced rupture of the deltoid ligament and distal tibiofibular diastasis, and lateral dislocation of the talus. The proximal fibular fragment was probably displaced laterally and returned to a position anterior to the fibular notch of the tibia. This injury was extremely unstable and required open reduction with internal fixation, not only to reduce the anterior displacement of the fibula but also to repair the associated disruption of the syndesmotic ligament and anterior capsule. The key radiographic finding was anterior displacement of the distal fibula seen on the lateral view. PMID- 6854678 TI - Closure of osteomyelitic and traumatic defects of the leg by muscle and musculocutaneous flaps. AB - A retrospective review was carried out of 17 muscle and musculocutaneous flaps in the leg performed for traumatic and osteomyelitic defects in two groups of patients. One group of ten patients with soft-tissue defects resulting from trauma underwent muscle flap coverage in nine and musculocutaneous flap cover in one. Nine of the ten healed uneventfully. The second group of seven patients with defects resulting from chronic osteomyelitis underwent muscle flap cover in two, musculocutaneous flap cover in three, and combined muscle and musculocutaneous flap cover in two. All seven of the flaps transposed healed well without recurrence of infection. This series illustrates that the technique of muscle and musculocutaneous flap transposition can provide a safe, relatively straightforward method of cover for defects of the leg from trauma and chronic osteomyelitis with predictable results. PMID- 6854680 TI - Intra-aortic balloon counterpulsation in blunt cardiac injury. AB - Intra-aortic balloon counterpulsation (IABC) is a widely used form of mechanical circulatory assistance. We have successfully employed IABC in three patients with refractory cardiogenic shock secondary to cardiac contusion. All patients had multiple blunt injuries with cardiac contusion documented electrocardiographically, by CPK isoenzyme determinations, and clinically. IABC was instituted for hypotension refractory to vasoactive drugs and optimization of intravascular volume status. Cardiac output and blood pressure rose in all cases and fewer ventricular arrhythmias were noted. Discontinuation of IABC was possible within 48 hours in all cases with adequate cardiac performance. We conclude that IABC is a useful approach in the treatment of refractory cardiogenic shock associated with cardiac contusion. PMID- 6854681 TI - Pneumoperitoneum after cardiopulmonary resuscitation: a therapeutic dilemma. AB - We report a patient who developed pneumoperitoneum after cardiopulmonary resuscitation. Ten cases have been reported in the literature. Despite the patient's serious condition, celiotomy was performed to rule out perforation of a hollow viscus and none was found. The likelihood of visceral perforation in this setting is high and despite increasing recognition of pneumoperitoneum that does not require surgical intervention, nonoperative management should not be entertained in this setting unless visceral perforation can be excluded. PMID- 6854682 TI - Axillary artery injury with minimally displaced fracture of the neck of the humerus. AB - A case of axillary artery injury resulting from a minimally displaced fracture of the neck of the humerus is reported. Very few such injuries have been reported previously. The mechanism of injury can be from sharp bony fragments, overstretching of the artery especially when atheromatous, or torn intima. Angiography should be performed, followed by exploration where indicated. PMID- 6854683 TI - Luxatio erecta. AB - A case of luxatio erecta associated with a fracture of the greater tuberosity and a mixed nerve lesion is presented. The arm is abducted with the elbow flexed and the hand above the head, and there are creases on the shoulder. Reduction may be accomplished by upward traction on the extended arm with countertraction on the top of the shoulder and carrying the arm through an arc to the side of the body. PMID- 6854685 TI - Local metabolic changes in skeletal muscle following high-energy missile injury. PMID- 6854684 TI - A three-part distal clavicle fracture. AB - A three-part clavicle fracture not previously described is presented. Treatment of distal clavicle fractures is reviewed, and operative treatment for this type of fracture is recommended. A 3/32 K-wire is inserted under direct vision and X ray control. The acromioclavicular joint is not entered, and the wire is bent 90 degrees at its distal tip and removed once the fracture has united. In the case reported full use was possible in 6 months. PMID- 6854686 TI - Concanavalin A sites in urothelium and milk fat globules of essential fatty acid (EFA) deficient rats. AB - We studied the ultrastructural distribution of Concanavalin A sites of urothelial and milk fat globule membranes in situ in EFA-deficient and control rats using the peroxidase-diaminobenzidine procedure in unfixed and glutaraldehyde-fixed materials and incubating temperatures of 4 degrees C and 37 degrees C of the Con A media. In the glutaraldehyde ('prefixed') bladders the lectin marker was homogeneously distributed at the surface of the urothelial membrane with no difference between experimental and control animals. In unfixed bladders ('non prefixed') of EFA-deficient rats, Con A sites distribution was also homogeneous and similar to that observed in 'prefixed' bladders. In bladders of controls in the 'non-prefixed' condition incubated at both 4 degrees and 37 degrees C, there was a noticeable change in the distribution of Con A sites consisting in a distinct clumping of Con A sites. In 'prefixed' and 'non-prefixed' cream samples of both EFA-deficient and control animals, there was a similar, uniform distribution of Con A sites at the surface of the milk fat globule membrane. The reported changes seemed to suggest that the fluidity of the urothelial membrane but not of milk fat globules was diminished in EFA-deficient rats. Present data do not permit evaluation of the role of cytoskeletal components and/or the variations of the fluidity of the membranes on the distribution of Con A sites at cell surfaces, as herein reported. PMID- 6854688 TI - Morphometry on the rat thyroid gland: evaluation of the apical plasma membrane (microvilli and zonula occludens) in freeze-fracture replicas under different functional conditions. AB - Morphometry was employed on freeze-fracture replicas of the rat thyroid gland following long-term TSH stimulation and hypophysectomy. Our results demonstrate two conspicuous alterations of the luminal (apical) plasma membrane in comparison to normal control specimens: firstly there is an augmentation of surface area after TSH administration which is related to the novel formation of microplicae (pseudopods), but not an increase in the total number of microvillous structures per unit area. In addition an occurrence of numerous endocytic invaginations is observed. Secondly the zonula occludens reveals a loosening of its reticular structure by showing wider meshes without increase in discontinuities of ridges (grooves respectively) following activation of the thyroid gland. These ultrastructural features corroborate electrophysiological findings of an increase in capacitance and a rapid fall of the transepithelial resistance in TSH stimulated thyroid follicle cells. PMID- 6854689 TI - Freeze-fracture study of the hamster ovary surface epithelium intercellular junctions. AB - The apical intercellular junctions between the hamster ovary surface epithelial cells were studied by freeze-fracture. The results showed tight junctions consisting of intertwining ridges on P faces and complementary furrows on E faces. Typical gap junctions, in the form of clusters of particles on P faces and complementary pits on E faces, were also observed associated with the tight junctional elements. Sometimes the gap junction are the outermost element of the junctional complexes. These observations explain data previously obtained in tracer experiments with lanthanum. PMID- 6854687 TI - Study of the periosteal and arachnoidal aspects of dura mater implanted surgically in the ventricular wall of the canine heart. AB - After surgical removal of a portion of the cardiac wall, homologous dura mater cardiac grafts were sutured to the margins of the incision in the sternocostal wall of the right ventricle of the canine heart and recovered after 1, 4, 6 and 8 weeks of implantation. Representative tissue specimens were processed for and studied by means of SEM and TEM. The primary objectives were to study morphological changes in the dura mater grafts used to repair the lesions or defects in the cardiac wall and to compare alterations in the periosteal and arachnoidal aspects of the dura mater grafts after being implanted for varying periods of time. After one week of implantation, an amorphous layer of fibrin was deposited on or near the luminal surface of the original dura mater grafts. At four weeks of grafts implantation, a 'remodeling' process was apparent below the luminal surface of the graft. Although a large accumulation of fibrin was still present at this time, there was also an increase in the number of cellular and fibrillar components within the implant. Large numbers of macrophages and active fibroblasts were visible at this time along with new collagen. At the sixth week of implantation, an abundance of active fibroblasts, the presence of normal collagen and a darkly staining material interpreted as recently synthesized connective tissue components, fibrin deposits and/or degenerating collagen were also observed. Phagocytosis of the remaining fibrin was noted during this period indicating a continuation of the remodeling process at the luminal surface. Finally, after eight weeks of implantation, it was revealed that the original densely woven and relatively acellular graft had become infiltrated with various blood cells and vascular channels. PMID- 6854690 TI - Increased Ca2+ in the sarcoplasm of aortic smooth muscle cells from rats made hypertensive with DOC. A quantitative ultrastructural and cytochemical study. AB - Uninephrectomized rats were made hypertensive by subcutaneous implantation of pellets of deoxycorticosterone (DOC) and intake of 1% NaCl as drinking solution. Smooth muscle cells from the media of the abdominal aorta of the hypertensive animals and of normotensive rats were studied after fixation in osmium tetroxide containing a calcium precipitating agent (potassium pyroantimonate), a cytochemical method that identifies calcium ions. Specificity of the reaction product was demonstrated by examining samples of the same tissue fixed by a similar solution containing a calcium chelating agent (EGTA). Calcium precipitates were especially numerous in the area of sarcoplasm bordering the nucleus of muscle cells in both groups; in filament rich areas, precipitates were also frequently seen, usually distributed in a linear pattern oriented in the direction of the filaments. Electron opaque reaction product in hypertensive and normotensive rats was quantitated by stereological techniques. Smooth muscle cells from hypertensive animals showed a significant increase in calcium ions within the sarcoplasm (volume density = 0.037 +/- 0.001 SEM) when compared with normotensive controls (volume density = 0.028 +/- 0.002 SEM) (p less than 0.02). The increase in calcium ion in vascular myocytes of hypertensive rats suggest at least in part that intrasarcoplasmic calcium is involved in the pathogenesis of increased arterial tone observed in hypertension. PMID- 6854691 TI - Ultrastructural study of the effects of trichlorotrifluoroethane on the liver of hairless mice. AB - Fluorocarbon 113 was applied to the backs of male hairless mice for 10 days, 20 days and 40 days. After each exposure period, the mice were anesthetized and the liver biopsied. The tissue was prepared for light and electron microscopy. The resultant micrographs were stereologically analyzed. N differences in mitochondrial structure were observed between the controls and the animals exposed for 10 days and 40 days. In the animals exposed for 20 days, the mitochondria appeared swollen with a loss of matrix and cristae and a breakdown of one of the mitochondrial membranes. Stereological analysis demonstrated a significant increase in mitochondrial volume in the 20 day exposure group. The relative volume of the endoplasmic reticulum increased significantly over the controls in the animals exposed for 10 days, 20 days and 40 days based on stereological analysis. PMID- 6854692 TI - Alkaline phosphatase activity in phagocytizing granulocytes: a backscattered electron imaging study. AB - The scanning electron microscope (SEM) in the backscattered electron imaging (BEI) mode has been used to detect alkaline phosphatase activity in normal human PMNs using a lead method. Unfortunately commercial scanning electron microscopes do not allow resolution of the small and dispersed lead depositions in the secondary granules. However, polymorphonuclear leukocytes (PMNs) previously incubated with latex particles, show well evident lead precipitates allowing identification of different phases of the phagocytic sequence. In fact the finding of irregular depositions arranged around a central not-emitting zone might be due to the secondary granules gathering near the phagocytic vacuole. Moreover, homogeneous, round, well defined precipitates, having a diameter slightly larger than latex particles, probably corresponding to vacuoles filled with the enzyme after granules coaslescence and fusion. PMID- 6854693 TI - Electron microscopy of intimal lesions in the pulmonary trunk of a dog with Dirofilaria immitis. AB - Protruding intimal lesions in canine pulmonary trunk induced by naturally occurring heartworm disease were further characterized at light and electron microscopic levels. The pulmonary trunk was dissected free, fixed and subdivided into many specimens which were routinely prepared for scanning electron microscopy (SEM). After SEM observation, selected samples were embedded in Epon Araldite and sectioned for correlated light (LM) and transmission electron microscopic (TEM) observation. SEM observation revealed protruding lesions of various sizes and shapes on the luminal surface. These ranged from papillae to complex lamellar projections extending far into the lumen. This suggests a progressive growth pattern. A layer of cells covered most of the lesion surface and between the lesions. These cells had a rounded conformation and no uniform orientation on the luminal surface. Other areas of the lesion surface appeared fibrous and devoid of cells. LM and TEM sections of the SEM specimens revealed three types of surfaces on the protruding fibro-muscular lesion. The lesion was primarily covered by cells which were (1) endothelial or (2) non-endothelial in nature. The non-endothelial surface cells were separated from each other and did not have the typical characteristics of endothelial cells. The third region was acellular and had the fibrous appearance of extracellular matrix. The acellular and non-endothelial portions formed a significant amount of the lesion surface. Previous reports have indicated these lesions were covered by typical endothelium. This report indicates that further characterization and quantitation of the cells covering the lesion surfaces is necessary. PMID- 6854694 TI - Ultrastructure of mink submandibular gland. AB - The submandibular gland of the North American mink, a strict carnivore, was studied by light and electron microscopy. The gland is mixed in nature, consisting of mucous tubules capped by mucous demilunes. Mucous droplets in the tubule cells are structureless, but those in the demilune cells contain a dense spherule. Intercalated ducts are extremely short. Striated duct cells contain numerous crystalloids, often rhomboidal, in their apical cytoplasm. These crystalloids are equally abundant in males and females. The presence of these structures lends credence to the supposition that in addition to their role in electrolyte transport, striated ducts may be actively engaged in secretion of organic products. PMID- 6854695 TI - Healthy and diseased epithelium of the oral and maxillary sinus mucosa studied by X-ray microanalysis. AB - Concentrations of Na, Mg, P, S, Cl, K, and Ca in healthy and pathologically transformed epithelial cells of oral cavity and maxillary sinus mucosa in man were measured by X-ray microanalysis. Biopsies from normal mucosa, irradiated and clinically cured squamous cell carcinoma, mucoepidermoid carcinoma from the oral cavity, and polyposis in the maxillary sinus were prepared by rapid freezing and cryosectioning. In normal mucosa, nuclei and cytoplasm of basal, intermediate and apical epithelial cells were analyzed. A slight decrease in the concentration of Na, Mg, P and Cl was found towards the apical cells. The concentration of Na in the nuclei of the different cell layers parallelled that of P. The elemental composition of the pathologically transformed cells differed markedly from that of the cells of healthy oral mucosa (higher Na and Cl). In the irradiated squamous cell carcinoma the concentrations of Mg and K were extremely low. PMID- 6854696 TI - Auto-rosette formation in the peripheral blood of a patient with infectious mononucleosis. AB - Auto-rosette formation by peripheral blood lymphocytes was observed in a patient with infectious mononucleosis (IM), with the scanning electron microscope (SEM). The red blood cells adhered to lymphocytes with numerous microvilli on their surface. This phenomenon was observed only during the acute stage of the disease and not in the recovery period. Auto-rosette formation was detected neither in 7 other patients with IM, nor in control subjects. PMID- 6854697 TI - Skin diseases in Socialist Peoples Libyan Arab Jamhiriya. PMID- 6854698 TI - Histamine poisoning on ingestion of tuna fish. AB - When tuberculosis patients on isoniazid eat certain varieties of fish they may develop a histamine reaction. The occurrence of this reaction in a mother and daughter on ingestion of tuna fish is reported. Two other members of the family who were on treatment for tuberculosis but had not taken isoniazid on the day of the episode were unaffected by the same meal. PMID- 6854699 TI - Regulation of Leishmania populations within the host. V. Resistance to L.donovani in wild mice. AB - Samples of wild Mus musculus from two populations in areas endemic for leishmaniasis and from seven populations in non-endemic areas were found to be uniformly resistant when tested for their early response to Leishmania donovani infection. Males from one endemic and one non-endemic population were crossed to females from two inbred strains of mice carrying the susceptible allele for the innate resistance gene, Lsh, on different genetic backgrounds. Bimodality of liver parasite counts and a close fit to Mendelian ratios obtained in F2 and backcross mice indicate that the uniform resistance observed in wild mice is most probably due to mono-morphism for the resistant allele at the Lsh locus. The relevance of these findings to the potential capacity of Mus musculus to act as a reservoir for visceral leishmaniasis for for other intracellular pathogens thought to be under the control of the same gene is discussed. PMID- 6854700 TI - Human water contact activities related to the transmission of bilharziasis (schistosomiasis). PMID- 6854701 TI - High prevalence of eye disease in a Haitian locale. PMID- 6854702 TI - The bearing of diverse patterns of diet on growth and menarche in four ethnic groups of South African girls. AB - Anthropemetric and development studies were made on 4390 black rural and urban, coloured, Indian and white school girls of 6-17 years and a 24-h dietary recall recorded on subsamples. Mean weights and heights of non-white were lower at all ages than those of white girls. Prevalences of obesity (greater than or equal to 120% weight-for-height), were higher in black and coloured than in Indian and white girls, but mean percentage body fat was not significantly different at 17 years. Growth attained was in response to very different dietary patterns. However, this did not delay breast development, which occurred at much the same time in all groups. However, menstruation was delayed in black compared with coloured, Indian and white girls. Although breast development was present in all at 14 years, proportions (%) menstruating differed: 33 rural and urban black; 84 coloured; 93 Indian; 97 white. in non-menstruating girls of 8 years of age all had mean fat greater than 17% (the expected level of menstruation) and, except in black rural and coloured girls, this was greater than 22%, the critical level for regular ovulation. These studies throw doubt on the nutritional components as being wholly responsible for the delay of menarche, as breast development, the earliest sign of puberty in girls, is not delayed despite marked dietary differences. The emergence of obesity without dietary intervention in the 'poorest' of adolescent girls, further questions this hypothesis. PMID- 6854703 TI - Morbidity of homozygous sickle cell anaemia in Nigerian children. PMID- 6854704 TI - The influence of rooming-in on breastfeeding. PMID- 6854705 TI - Benefits of early maternal participation in care of low birth weight infants leading to early discharge. PMID- 6854706 TI - Breastfeeding in rural and urban areas of Tanzania. PMID- 6854707 TI - Oral rehydration of infants with diarrhoea. Nigerian experience. PMID- 6854708 TI - Anthropometric assessment of young children's nutritional status as an indicator of subsequent risk of dying. PMID- 6854709 TI - Anaemia and the Caribbean. PMID- 6854710 TI - Customs and beliefs relating to the mother and infant in an area of rural Andhra Pradesh. PMID- 6854712 TI - Origins of frustration and success in efforts to combat malnutrition in preschool children. PMID- 6854711 TI - Bacteriological profile and sensitivity pattern in childhood urinary tract infection in Benin City. PMID- 6854714 TI - III. Three-dimensional electron microscopy of mammalian cardiac sarcoplasmic reticulum at 80 kV. AB - The Golgi black reaction method was combined with stereoscopic techniques to obtain three-dimensional views of cardiac sarcoplasmic reticulum (SR) using a conventional electron microscope operating at 80 kV. We have previously described the SR in avian and mammalian skeletal muscles with similar techniques. It was necessary to modify these earlier techniques for cardiac muscle. Two regions of mammalian heart were explored: trabecular and papillary muscles. These muscles presented striking differences with regard to relative volume of mitochondria and myofibrils, but both muscles presented similar dispositions of the inner tubules of SR. The SR near myofibrils appeared heterogeneous and consisted of fenestrated collar, bulbous extensions at the Z line (corbular SR), and flat extended regions (cisternal SR). The SR near mitochondria, however, always formed a simple rete with occasional cisternal SR. Specific "staining" of the inner tubules of cardiac SR by the Golgi method offers new views of cardiac fibers that suggest a more extensively developed SR than previously acknowledged. PMID- 6854713 TI - Placental morphology of newborns at risk for congenital toxoplasmosis. PMID- 6854715 TI - Intranuclear inclusions containing melanosomes observed after PUVA therapy: a study of five psoriatic patients. AB - Skin biopsies were obtained before and after PUVA therapy from five psoriatic patients and epidermal melanocytes surveyed for the presence of intranuclear melanosome-like bodies and nuclear bodies. Intranuclear melanosome-like bodies were observed after PUVA therapy whereas none were found before therapy. Nuclear bodies were found to increase in frequency after PUVA therapy. Remnants of a nuclear envelope membrane were not found around the intranuclear melanosome-like bodies. Nor were remnants of a nuclear envelope membrane found in or around the nuclear bodies. The results are discussed in view of the possible sites of origin of intranuclear melanosome-like bodies and nuclear bodies. PMID- 6854717 TI - Comparative analysis of ultrasonographic methods of gestational age assessment. AB - Measurement of crown-rump length (CRL) is widely accepted as the most accurate method of gestational dating. The statistical accuracy of growth-adjusted sonographic age (GASA) determinations has been demonstrated to be similar. Ninety six patients were prospectively examined by use of serial ultrasonography, and findings were evaluated to correlate CRL with a single biparietal diameter (BPD) obtained between 20 and 24 weeks of gestation, with GASA, and with accurate maternal dates. Growth-adjusted sonographic age was shown to be not as accurate as CRL and no more accurate than a single BPD obtained between 20 and 24 weeks or reliable maternal dates. PMID- 6854716 TI - Secretion from the rhoptries of Toxoplasma gondii during host-cell invasion. AB - To determine whether the rhoptries of Toxoplasma gondii play a role in the invasion of host cells by this parasite, we inoculated toxoplasmas into the peritoneal cavities of normal mice and into macrophage cultures, fixed the specimens at various intervals thereafter, and analyzed them by electron microscopy. We found that during host-cell invasion, the rhoptry membrane fused with the anterior limiting membrane of the toxoplasma, producing an opening to the exterior. Since such openings were formed when the host-cell membrane was disrupted, it appears that the rhoptries may secrete a lytic product that facilitates invasion through the host-cell membrane. Such a "penetration enhancing factor" was previously isolated from lysed toxoplasmas (Lycke and Norrby, 1966). Occasionally, when secretion was incomplete, masses of tubules were found in the rhoptries, sometimes as soon as 15 sec after the toxoplasms had been injected into mice. Similar tubules were found in the parasitophorous vacuole that was formed 10-15 min later, and such tubules are typical of vacuoles containing replicating parasites. Because these tubules are in continuity with the vacuolar membrane, it appears to be a hybrid membrane, composed in part of toxoplasma products. We speculate that the hybrid nature of the vacuolar membrane prevents it from fusing with the lysosomes of phagocytes and thereby contributes to the intracellular survival of the parasites. PMID- 6854720 TI - The "scar sign" in hepatic neoplasia. PMID- 6854719 TI - Ultrasonographic findings in placenta increta. AB - Placenta increta, invasion of the myometrium by normal placental (chorionic) villi, can be life-threatening to a mother at delivery. In two reported cases of pathologically proven placenta increta, the abnormal areas were retrospectively identified on ultrasonographic images. In both cases, there was consistent focal obliteration of the hypoechoic retroplacental zone by either tissue of echogenicity similar to that of the normal placenta or tissue of slightly decreased echogenicity. This was found to represent extension of the villi through the decidua basalis into the myometrium. The spectrum of non-malignant invasive placentas and the specific ultrasonographic findings that should allow prospective diagnosis are discussed. PMID- 6854718 TI - Ultrasonographic determination of renal mass and renal volume. AB - Volumes and surface areas of 45 kidneys were determined ultrasonographically in vivo before autopsy and in a water bath phantom after autopsy by means of both the ellipsoid and the stepped section methods. Comparison of results revealed that renal volume may be determined by the simplest method, the ellipsoid method, with sufficient accuracy for clinical use. Results also revealed that renal mass expressed in grams may be directly obtained from renal volume expressed in milliliters, but mass in grams was found to correlate better with renal surface area than with renal volume. A formula relating renal mass to both volume and surface area was developed from regression analysis of the data and was found to provide a more precise estimate of renal mass than does mass computed from either volume or surface area alone. PMID- 6854721 TI - The butterfly sign: an indicator of fluid within both the greater peritoneal cavity and the lesser omental bursa. AB - Fluid accumulations present in the lesser omental bursa and the greater peritoneal cavity simultaneously outline a pattern resembling a butterfly. This "butterfly sign" can contribute to a more accurate diagnosis in evaluation of acute pancreatic processes and, more generally, acute abdominal syndromes. PMID- 6854722 TI - Prostate biopsy utilizing transrectal ultrasound guidance: diagnosis of nonpalpable cancers. AB - A long-axis real-time ultrasonic transrectal probe was utilized in transperineal biopsies to detect three nonpalpable prostate cancers. It was found that ultrasonically guided percutaneous perineal biopsy allows for the accurate placement of the biopsy needle tip into suspicious areas of the prostate. Ultrasonographic examination prior to biopsy is recommended to provide confirmation of palpable masses and to reveal other suspicious but not clinically suspected areas. PMID- 6854723 TI - Perfluorochemicals as liver- and spleen-seeking ultrasound contrast agents. AB - In this study, Fluosol-DA, 20 per cent (composed of perfluorodecalin and perfluorotripropylamine) was tested as a liver-specific ultrasound contrast agent. Twelve normal rabbits were scanned, utilizing the Picker Microview (10 MHz), prior to and two days following the intravenous administration of 24 ml/kg of Fluosol (or 4.8 g/kg of perfluorochemicals) emulsion to ten of the rabbits and 24 ml/kg of Ringer's solution to two rabbits as control. In all ten rabbits given Fluosol, liver echogenicity increased relative to that of the kidney, whereas the liver remained less echogenic than the kidney in the two rabbits given Ringer's solution. Four independent reviewers correctly identified all rabbits that received Fluosol and both rabbits that received Ringer's solution. It is demonstrated that, similar to PFOB, Fluosol serves as an echogenic contrast material for ultrasound and opacifies the normal rabbit liver. PMID- 6854724 TI - Ultrasonographic failure of early detection of fetal microcephaly in maternal phenylketonuria. PMID- 6854725 TI - Imaging of cholecystocolic fistulas. PMID- 6854726 TI - Diagnosis of ovarian vein thrombophlebitis by ultrasonography. PMID- 6854727 TI - Renal cell carcinoma and acquired cystic disease of the kidneys in a chronically dialyzed patient. PMID- 6854728 TI - Safety Standard for Diagnostic Ultrasound Equipment. PMID- 6854729 TI - Effect of age on the acetylation and deacetylation reactions of sulphadimidine and N4-acetylsulphadimidine in calves. AB - Following intravenous (i.v.) or intramuscular (i.m.) administration of sulphadimidine (SDM), the pharmacokinetics of SDM and N4-acetylsulphadimidine (N4 SDM) were studied in plasma of calves from the first day of life to the age of about 6 months. An obvious age dependency was observed for the elimination half life (t1/2) of SDM: the first day of life the t1/2 ranged between 13.5 and 17 h, and decreased in approximately 3 weeks to 4-6 h and remained constant from this time. The metabolite N4-SDM, as a percentage of the total concentration of the sulphonamide measured in plasma of neonatal calves, ranged between 21.6 and 25.5% at the first day of life, declined in 3 weeks to approximately 12.8%, and at 5 till 9 weeks the final percentage was about 6.8%. Following administration of N4 SDM, the elimination half-life of N4-SDM was 3 h in an 8-day-old calf declined to 1.4-1.7 h in 4-week-old calves, and was 0.9 h in calves older than 11 weeks. The percentage of SDM (a metabolite of N4-SDM) in plasma increased with time after injection from 5.5 to 62.8% of the total sulphonamide plasma concentration. This value was age-related. The total body clearance of N4-SDM was three- to five-fold higher than that of SDM. PMID- 6854730 TI - Clinical pharmacology of tiamulin in ruminants. AB - Median values for the minimum inhibitory concentrations (MIC) of tiamulin for Mycoplasma and Acholeplasma isolated from ruminants were 0.05 micrograms/ml and 0.025 micrograms/ml, respectively. These values were close to the MIC values of tylosin and considerably lower than the respective values for spectinomycin, Spiramycin and oxytetracycline. The serum concentration--time profile of tiamulin after intramuscular (i.m.) injection to goats, ewes, cows and calves, and after oral administration to preruminant calves was characterized by a rapid absorption phase (absorption t1/2 of less than 30 min.), a short plateau phase, an elimination t1/2 ranging between 3 and 6 h, and low peak serum drug levels. The serum elimination t1/2 of the drug after intravenous (i.v.) injection was 25 min. It appears that tiamulin is extensively metabolized in ruminants and is well distributed throughout the body. Drug concentrations in the lungs, liver, and the kidneys 1 h after i.v. injection were four to seven times higher than in blood. The drug penetrated very rapidly into the milk after i.m. administration; mean peak drug concentrations in normal milk and in milk secreted from inflamed glands of cows were 7.5 times and 1.2 times higher respectively, than the mean peak serum drug concentrations. Concentrations of tiamulin of potential therapeutic value in the treatment of mycoplasmal infections can be maintained in the lungs for at least 12 h after i.m. injection at 10 mg/kg, and in preruminant calves after an oral dose of 20 mg/kg. However, tiamulin possesses several very serious side-effects and the i.v. route of administration is definitely contraindicated. PMID- 6854731 TI - Concentrations of methicillin in blood, normal milk and mastitic milk of cows after intramuscular injection of methicillin and tamethicillin. AB - Tamethicillin (TAM) is a basic ester pro-drug of methicillin (MET) which is converted in the body by non-specific esterases to MET. Equal doses of MET and TAM were administered intramuscularly in a crossover trial involving four dairy cows. Acute mastitis was induced in each cow by infusing two quarters of the udder with Escherichia coli endotoxin 3 h before antibiotic administration. Peak serum MET concentrations after MET injection were significantly (P less than 0.001) higher than peak serum drug concentrations after TAM injection. The t1/2 of MET in serum after MET and TAM treatments were 18 min and 2 h, respectively. Normal milk MET concentrations during the first 8 h after TAM administration were significantly (P less than 0.05) higher than after MET treatment. Mastitic milk MET concentrations during the period 2-6 after MET injection were significantly (P less than 0.01) higher than after TAM administration. However, MET concentrations which were equal to or higher than the minimal inhibitory concentrations for penicillin G-resistant staphylococci were maintained in the mastitic milk for 8 h after treatment with MET and TAM. PMID- 6854732 TI - Pharmacokinetics of lidocaine and its active metabolites in dogs. AB - The pharmacokinetics of lidocaine in dogs were investigated following the intravenous and intramuscular administration of single doses of lidocaine hydrochloride. The mean elimination rate constant and the mean specific clearance determined for the intravenous portion of the study were 0.786 h-1 and 2.40 1/kg/h, respectively. Following intramuscular administration the mean absorption rate constant was 7.74 h-1. Absorption was nearly complete as the percentage of an intramuscular dose absorbed averaged 91.9%. Concentrations of two N deethylated metabolites, determined following the administration of lidocaine suggest that monoethylglycinexylidide is eliminated rapidly while glycinexylidide is more slowly eliminated. The relative contribution of these metabolites to the therapeutic and toxic effects of lidocaine and the potential for glycinexylidide accumulation during lidocaine administration remain to be investigated. PMID- 6854733 TI - Age-dependent pharmacokinetics of oxytetracycline in ruminants. AB - Oxytetracycline (OTC) was administered intravenously (i.v.) to 3- and 12-week-old calves and lactating cows, and both i.v. and intramuscularly (i.m.) to 14-week old calves and non-lactating cows. Concentrations of OTC were determined in plasma and were analysed kinetically. The pharmacokinetic parameters which were derived using the three-compartment open model were inadequate to describe plasma drug levels in six out of the 23 animals treated i.v., and, therefore, model independent kinetic parameters were utilized for evaluating age-dependent pharmacokinetics of OTC. In the 3-week-old calves, the total body clearance (ClB) was 0.0022 ml/min/kg, the total distribution volume (Vd area) was 2.48 l/kg, and the distribution volume of the central compartment (V1) was 0.56 l/kg. Mean values for ClB, Vd area, and V1 in 3-week-old calves were two-, three- and four fold greater, respectively, than the corresponding values in cows. Mean values of ClB and Vd area for the 12- and 14-week-old calves were intermediate between the corresponding values in 3-week-old calves and cows. Dose and state of lactation did not affect the model-independent parameters. The i.v. and i.m. data illustrated that the recommended dose levels of OTC in young calves should be twice those employed in cows for obtaining similar plasma OTC concentration--time profiles. PMID- 6854734 TI - Pharmacokinetics of erythromycin in foals and in adult horses. AB - The pharmacokinetic parameters of erythromycin in foals were determined following intravenous administration of 5.0 mg/kg to animals aged 1, 3, 5 and 7 weeks. The distribution of the drug was described by a two-compartment open model, and no significant differences were observed between coefficients on which the parameters were based. Pharmacokinetic values were also determined for four mares given 5.0 mg/kg intravenously and for six 10-12-week-old foals given 20.0 mg/kg intravenously. The half-life of erythromycin for all groups of animals (foals less than 7 weeks, mares, foals 10-12 weeks) was 1.0-1.1 h; the apparent volume of distribution was between 2.3 and 7.2 l/kg, and the clearance of the drug from the body was between 1.9 and 5.0 mg/kg/h. No drug could be detected in the serum following oral administration of 5.0 mg/kg erythromycin estolate; detectable levels were found for 5 h in mares given 12.5 mg/kg, and for 8 h in foals given 20.0 mg/kg orally. Peak levels in foals given the drug orally were 0.42 micrograms/ml at 120 min after administration. Foals given 10.0 mg/kg of erythromycin base intramuscularly had serum concentrations detectable 12 h later; the peak level achieved was 1.44 micrograms/ml serum 90 min after administration and concentrations exceeded 0.25 micrograms/ml for 6 h. In the mares the milk concentrations were approximately twice those in serum. Recommendations were made for drug dosage to be used in the treatment of Corynebacterium equi pneumonia of foals. PMID- 6854735 TI - Placental transfer and renal clearance of sulphamethoxazole and its metabolite N4 acetylsulphamethoxazole in a pregnant ewe. AB - Sulphamethoxazole and its metabolite, N4-acetylsulphamethoxazole, were shown to cross the placenta of a pregnant ewe. The plasma concentration of N4 acetylsulphamethoxazole increased in the foetus due to the limited elimination properties of the immature kidney. The amniotic fluid concentration of sulphamethoxazole and N4-acetylsulphamethoxazole were low, amounting to 2.0 and 0.46 micrograms/ml respectively. Protein binding of the sulphonamides was slightly higher in the foetus than in the ewe. PMID- 6854736 TI - Hemolysis by liposomes containing influenza virus hemagglutinins. AB - Liposomes containing influenza virus hemagglutinin were reassembled from envelopes solubilized with Nonidet P-40 and were shown to induce hemolysis and cell fusion at low pH. PMID- 6854737 TI - Structure of Erwinia carotovora temperate bacteriophage 59 and its DNA. AB - The temperate phage 59 from Erwinia carotovora and its DNA were studied. The phage particles have an icosahedral head and a long noncontractile tail with a base plate. The virus DNA makes up 50% of the total virus and exists as a linear molecule (molecular weight, 2.6 X 10(7)). A model of virus structural organization is presented. PMID- 6854738 TI - Transformation of rodent cells by DNA extracted from transformation-defective adenovirus mutants. AB - Complementation group II host range mutants of adenovirus type 5 which map in early region 1B (E1B, 4.5 to 11.0 map units) have been shown to be defective for the synthesis of the E1B 58,000-dalton (58K) antigen in infections of HeLa or KB cells (Lassam et al., Cell 18:781-791, 1979) and unable to transform cultured rodent cells (Graham et al., Virology 86:10-21, 1978). In this report we show that DNA extracted from group II mutants hr6 and hr50 can transform rat cells with the same efficiency as wild-type DNA. Furthermore, group II mutant transformed hamster cells were shown to contain no detectable E1B 58K tumor antigen but were capable of inducing tumors in newborn hamsters. Hamster cell lines 1019-3 and 1019-C3, transformed by hr50 DNA, produced no detectable quantities of either the E1B 58K or 19K antigen but nonetheless exhibited a fully transformed oncogenic phenotype. Our results show that the E1B 58K antigen is not absolutely required for oncogenic transformation and suggest that even cells lacking the 19K protein can be oncogenic. PMID- 6854739 TI - Identification of adenovirus genes that require template replication for expression. AB - The relationship between adenovirus type 2 DNA replication and expression of intermediate stage viral genes was investigated. The 1.03-kilobase mRNA from early region 1b (E1b) and the mRNAs coding for proteins IX and IVa2 were first detected between 6 and 8 h postinfection. Inhibition of viral DNA replication with hydroxyurea prevented expression of the IX and IVa2 mRNAs, but not of the E1b mRNA. Pulse-labeling experiments demonstrated that the block of IX and IVa2 expression in hydroxyurea-treated cells was at the level of transcription. By a series of superinfection experiments, it was determined that the viral and cellular factors present during the late stage of adenovirus infection are insufficient to activate IX gene expression. The viral DNA template must first replicate before IX transcription can begin. PMID- 6854740 TI - Rubella virus contains one capsid protein and three envelope glycoproteins, E1, E2a, and E2b. AB - We have analyzed the structure of rubella virus proteins labeled metabolically with [35S]methionine, [3H]mannose, and [3H]glucosamine or externally with [3H]borohydride after galactose oxidase treatment. Four structural proteins, with MrS of about 58,000 (E1), 47,000 (E2a), 42,000 (E2b), and 33,000 (C), were resolved on sodium dodecyl sulfate-polyacrylamide gels. Tryptic peptide maps obtained from [35S]methionine-labeled proteins indicated that E1 and C were unrelated to each other and to E2a and E2b, whereas the latter two gave similar, if not identical, maps. E1, E2a, and E2b were associated with the envelope and were located externally on the virus particle, whereas the C protein was associated with the RNA in the nucleocapsid. Solubilization of the virus with Triton X-100, followed by removal of the nucleocapsid and the detergent, resulted in the formation of soluble envelope protein complexes (rosettes) containing E1, E2a, and E2b. Although external labeling with [3H]borohydride and metabolic labeling with [3H]glucosamine suggested that all three proteins were glycosylated, only E1 and E2b were efficiently labeled with [3H]mannose. It is thus possible that the difference in migration between E2a and E2b is due to differences in glycosylation. Analysis by immunoprecipitation and sodium dodecyl sulfate-gel electrophoresis of intracellular [35S]methionine-labeled structural proteins synthesized in the presence and absence of tunicamycin supported the conclusion that E1 and E2 are glycoproteins. Unglycosylated E1 and E2 had an Mr of about 53,000 and 30,000, respectively. PMID- 6854741 TI - Risk of urinary incontinence following radical prostatectomy. AB - Of 143 prostatic cancer patients treated with radical prostatectomy 38 had undergone transurethral resection of the prostate before the prostatectomy. After radical prostatectomy 5 per cent of the patients who did not have a resection and 8.1 per cent of those who did were severely incontinent. This difference is not statistically significant. PMID- 6854742 TI - Abnormal urinalysis in appendicitis. AB - In a retrospective review of 100 consecutive patients (50 adults and 50 children) with acute appendicitis we correlated abnormal urinalysis (positive occult blood and more than 4 red or white blood cells per high power field) with the operative findings. Abnormal results on urinalysis were noted in 18 adults and 12 children. All urine specimens were collected by the clean-catch method. Abnormal findings were found more frequently in female patients. A majority of patients (53 per cent) with abnormal results on urinalysis had a ruptured or inflamed appendix in proximity to the urinary tract. PMID- 6854743 TI - Pelvic sling for perineal surgery. AB - A universal traction belt is used for patients undergoing a perineal operation. All patients have been held securely in the desired position and without additional support. No pulmonary or cardiovascular disturbances, or pressure induced cutaneous or neurlogic injuries have been noted. PMID- 6854744 TI - Cystitis follicularis in children with primary vesicoureteral reflux. AB - In an attempt to determine whether cystitis follicularis affects the spontaneous resolution of primary vesicoureteral reflux we reviewed the records of 65 children with reflux and cystitis follicularis. A group of children with primary vesicoureteral reflux but without cystitis follicularis was included as controls. The data did not reveal a statistically significant difference in either the rate of spontaneous resolution of reflux or the need for surgical correction between these 2 groups of children. PMID- 6854745 TI - Management of unilateral reflux by ipsilateral ureteroneocystostomy--is it sufficient? AB - The records of 105 patients who had undergone unilateral reimplantation for ipsilateral reflux were reviewed. Patient age, grade of preoperative reflux, completely duplicated collecting systems, preoperative findings of contralateral dilatation of the lower ureter or radiographic evidence of pyelonephritis had no predictive value in regard to the appearance of postoperative contralateral reflux. Of the 105 patients 16 had postoperative contralateral reflux: neurogenic problems were found later in 3, reflux resolved spontaneously within 18 months postoperatively in 9, 1 remains in followup and 3 have undergone repeat operations, for a rectified rate of treatment failure of 3 of 102 (2.9 per cent). PMID- 6854746 TI - Feminizing genitoplasty: a synthesis. AB - The female child with the adrenogenital syndrome is subject to a variable degree of masculinization. Surgery should be directed to 3 goals: 1) removing the corpora and preserving the glans with its innervation to create a clitoris with normal sensation, 2) creating a normal-appearing introitus by fashioning labia minora from phallic skin and foreskin, and 3) vaginoplasty to provide an adequate opening for the vagina onto the perineum. The entire repair may be completed before the age of 6 months unless the vagina enters the urogenital sinus at a high level in which case vaginoplasty should be delayed until the child is older. The evolution of this operative approach is described and the details of the operative technique are presented. PMID- 6854747 TI - Adrenal cysts in the newborn. AB - We report on 2 newborns with adrenal cysts who were treated successfully with an operation. One patient had been well after birth with no adrenal insufficiency. However, 2 large and 2 small cysts were found, all of which were attached to the adrenal gland without a clear vascular stalk. The other patient had adrenal cortical insufficiency. His mother had had gestational diabetes and hypertension during pregnancy. The adrenal cyst was partially resected. Both patients were in good condition 5 years postoperatively. PMID- 6854748 TI - Unicaliceal kidney associated with posterior urethral valves. AB - Unicaliceal kidneys are normal in several mammals, including monkeys. There have been 10 patients with this anomaly reported on in the literature and most have had additional anomalies of the urinary tract. We report on a man with a unicaliceal kidney who also had posterior urethral valves. PMID- 6854749 TI - Ectopic ureter with seminal vesicle insertion in an infant with tracheoesophageal fistula and possible adult polycystic kidney disease. AB - We report on a male newborn with a tracheoesophageal fistula and possible adult polycystic kidney disease as well as a single ectopic ureter with seminal vesicle insertion. There is an association of tracheoesophageal fistula, hindgut and sacral anomalies with ureteral ectopia but adult polycystic kidney disease has not been described. The diagnostic modalities currently available are discussed, as well as the implications of the association with other anomalies. PMID- 6854750 TI - Stenosing ureteritis in Henoch-Schonlein purpura. AB - We report on a boy with Henoch-Schonlein purpura in whom flank pain and gross hematuria developed during the early phase of the disease. Urologic investigations revealed hydronephrosis and ureteral stenosis. Pyeloplasty was done to relieve ureteropelvic junction obstruction. Severe hemorrhagic ureteritis and vasculitis were noted on the ureteral biopsy. Recovery was slow and residual hydronephrosis persisted. Although abdominal pain usually accompanies Henoch Schonlein purpura, colicky flank pain associated with hematuria should alert the physician to the presence of ureteritis. Recognition and early surgical treatment of this urologic complication of Henoch-Schonlein purpura may prevent a potentially serious outcome. PMID- 6854751 TI - A case of ureteral intussusception associated with ureteral polyp. AB - We report a case of left ureteral intussusception associated with a ureteral polyp. At operation a 7 cm. long polyp was seen originating from the tip of the inside of the proximal ureter, causing 1.7 cm. of antegrade invagination. The polyp was resected and the invaginated region was repaired since pathological examination revealed a benign tumor. At followup an excretory urogram demonstrated prompt improvement of left hydronephrosis. PMID- 6854755 TI - Juvenile granulosa cell (sex cord-stromal) tumor of fetal testis. AB - A case is reported of a juvenile variant of the rare, testicular granulosa cell (sex cord-stromal) tumor in a fetus. The variant has been reported in the ovary but not in the testis. Sex cord-stromal tumors in general have not been reported in fetal testes. PMID- 6854753 TI - Lymphangioma of bladder. AB - We report the first case of a lymphangioma arising from the wall of the bladder, protruding into the lumen on 1 side and invading the peritoneal cavity on the other side. The presenting sign was painless macroscopic hematuria that had occurred initially 2 months before hospitalization. Treatment consisted of partial cystectomy. A review of the literature failed to reveal a report of an identical case. PMID- 6854752 TI - Primary leiomyosarcoma of the ureter: a case report with electron microscopy. AB - We report the twelfth case of primary leiomyosarcoma of the ureter, which is also the first such case studied with transmission electron microscopy. The clinical appearance of this case was that of acute urinary obstruction. PMID- 6854756 TI - Assessment of cystine solubility in urine and of heterogeneous nucleation. AB - Factors affecting cystine solubility were sought in an effort to derive a reliable method for estimating urinary saturation with respect to cystine. In synthetic solutions, cystine solubility was measured from the maximum ambient cystine concentration reached after incubation with an excess of solid cystine. It rose progressively as the ionic strength increased from addition of mineral electrolytes. The increment in cystine solubility between ionic strength of 0.005 and 0.3 ranged from 13 mg./1. for potassium chloride to 70 mg./1. for calcium chloride. Urinary macromolecules (less than 5,000 daltons, obtained by ultrafiltration), at concentrations normally expected to be found in urine, increased cystine solubility by as much as 45 mg./1. Because of these actions of electrolytes and macromolecules, cystine solubility in urine (from control subjects and patients with cystinuria) exceeded solubility in synthetic solution containing 5 mM sodium cacodylate by 68 to 89 mg./1. Thus, the saturation of cystine in individual urine samples cannot be estimated by comparing the original cystine concentration with a defined cystine solubility curve. It may be more accurately measured as the ratio of original cystine concentration and the directly determined cystine solubility in urine. The estimated assessment of urinary saturation with respect to cystine was shown to deviate from the empirically derived measure from -33 to +44 per cent. In conclusion, cystine is more soluble in urine because of the effects of electrolytes and macromolecules. Thus, urinary saturation of cystine cannot be estimated from solubility curves but must be empirically derived from the direct assessment of cystine solubility in individual urine samples. PMID- 6854757 TI - Immunotherapy of a murine renal cancer. AB - A preliminary study of the response to various immunotherapy models in a spontaneous murine nal cell carcinoma model is reported. Tumor cells were implanted intrarenally and nephrectomy performed at a later time. Specific immunotherapy using irradiated whole tumor cells plus complete Freund's adjuvant and a crude membrane preparation plus the same adjuvant were compared to nonspecific immunotherapy with adjuvant alone. In the 1st of 2 response criteria examined, there was a statistically significant decrease in tumor growth following hind limb rechallenge in those animals immunized with the membrane preparation plus adjuvant (p less than 0.01). This form of therapy also produced a statistically significant (p = .024) increase in survival in a second experimental model in which locally recurrent tumor was induced. Whole irradiated cells plus adjuvant slightly enhanced tumor growth, while adjuvant alone had no effect. Treatment with adjuvant alone did, however, result in an increase in the incidence of pulmonary metastases in both groups of animals. The practical and theoretical applicability of a membrane preparation vaccine in human tumors is discussed. PMID- 6854758 TI - Elective percutaneous nephrolithotomy in 50 patients: an analysis of the technique, results and complications. AB - Elective percutaneous nephrolithotomy in 50 consecutive patients is reviewed. Of the 50 patients 24 had never had a renal operation. Radiological puncture, dilation and subsequent placement of a nephrostomy tube were done in a single session when possible. An adequate tract was formed in 84 per cent of the cases. Of 42 patients who presented for endoscopic lithotomy 71 per cent had completely successful removal of the calculi. The mean hospital stay was 8.3 days. PMID- 6854754 TI - Transitional cell carcinoma of the fossa navicularis of the male urethra. AB - We report a case of transitional cell carcinoma arising in the fossa navicularis, a portion of the male urethra ordinarily lined by squamous epithelium. This is the third reported case of transitional cell carcinoma of the distal urethra. The neoplasm metastasized to superficial inguinal lymph nodes. PMID- 6854760 TI - Well differentiated (grade 1) clear cell renal carcinoma. AB - We reviewed the experience at this clinic from 1950 to 1980 with cases of grade 1 clear cell renal carcinoma. We wanted to determine whether patients with well differentiated clear cell renal tumors had the favorable clinical course that has been demonstrated for those with well differentiated oncocytic renal tumors. Of the 46 patients identified with pure grade 1 clear cell renal carcinoma two thirds were discovered incidentally during diagnostic tests for unrelated complaints. These tumors generally were small, with 67 per cent being 6 cm. in diameter or smaller. Of all tumors 83 per cent were pathologic stage 1 (confined within the renal capsule). However, 10 patients have died of metastatic renal carcinoma and 3 are alive with disease. Actuarial survival curves show a significantly poorer prognosis for patients with grade 1 clear cell renal tumors compared to patients with grade 1 oncocytic renal tumors or to an age and sex matched control group. We conclude that whereas well differentiated oncocytic renal tumors behave like benign renal tumors, well differentiated clear cell renal tumors can behave like aggressively malignant renal carcinomas and should be treated as such. PMID- 6854759 TI - Revascularization for preservation of renal function in patients with atherosclerotic renovascular disease. AB - Fifty-one patients with atherosclerotic renovascular disease have undergone elective revascularization primarily to preserve renal function. In all patients the blood pressure was well controlled preoperatively with medical therapy and was not an indication for revascularization. The preoperative serum creatinine value was 2.0 mg./dl. or more in 35 patients and less than 2.0 mg./dl. in 16. Vascular reconstruction was technically successful in all patients, with postoperative followup ranging from 4 to 76 months. The current level of over-all renal function is improved in 34 patients (67 per cent), unchanged in 14 (27 per cent) and deteriorated in 3 (6 per cent). In selected patients with atherosclerotic renal artery disease revascularization can achieve preservation or improvement of renal function. PMID- 6854761 TI - The emergency management of patients with ureteral calculi and fever. AB - Patients presenting with ureteral calculi and fever were treated with antibiotics, fluids and careful monitoring. An emergency operation or ureteral manipulation was withheld until the patient became afebrile. In 14 patients so treated all became afebrile and 11 required no surgical intervention. It is suggested that carefully monitored resuscitation should precede instrumentation in patients with urinary stones and fever. PMID- 6854762 TI - Antidiuretic hormone levels and the effect of indomethacin on ureteral colic. AB - We treated 25 patients with ureteral colic and urographically verified stones with 50 mg. indomethacin intravenously. Pain was relieved completely in 17 patients, while in 8 incomplete or no pain relief was achieved after the infusion of indomethacin. Patients completely relieved of pain had significantly higher levels of antidiuretic hormone in plasma before the infusion of indomethacin (18.2 plus or minus 3.4 pg./ml.) than patients with incomplete or no pain relief (7.2 plus or minus 1.3 pg./ml.) (p less than 0.01). These findings indicate that the volume status and/or the level of antidiuretic hormone may be of critical importance for pain relief after infusion of indomethacin in patients with ureteral colic. PMID- 6854763 TI - Ureterolithotomy for juxtavesicular stone. AB - Stones within the distal 8 cm. of the ureter often can be approached more readily through the posterior wall of the bladder than extravesically. The method and its indications are described. PMID- 6854764 TI - Management of the ruptured bladder secondary to blunt abdominal trauma. AB - During a 4-year 9-month interval 51 patients were seen with ruptured bladders. Of these patients 42 had suffered blunt trauma: 19 intraperitoneal, 22 extraperitoneal and 1 combined intraperitoneal and extraperitoneal injury. All patients with intraperitoneal injuries, 5 with extraperitoneal injuries and the 1 with combined injury were treated successfully by exploration, debridement, formal closure and catheter drainage. Of the patients with extraperitoneal injuries 16 were treated successfully by catheter drainage alone. PMID- 6854765 TI - Use of clonal assay in determination of urothelial drug sensitivity in carcinoma in situ of the bladder: clinical correlations in 5 patients. AB - Five patients with carcinoma in situ of the bladder, including 4 with associated grossly apparent tumors, were followed for 2 years or until invasive disease appeared while receiving intravesical chemotherapy. In vitro drug sensitivity determinations were made using the clonal assay. Of 9 retrospective and prospective in vitro/in vivo drug sensitivity correlations 7 proved correct. However, in vitro growth occurred in only 50 per cent of the urothelial samplings in which adequate cells were present. The assay has some potential use in selecting agents for intravesical chemotherapy but the problem of unpredictable and limited in vitro growth must be overcome. PMID- 6854766 TI - Controlled hypotensive anesthesia to reduce blood loss in radical cystectomy for bladder cancer. AB - Controlled intraoperative hypotension has been reported to reduce blood loss in major cancer operations. We did a retrospective evaluation on the effects of induced controlled hypotensive anesthesia using enflurane or trimethaphan compared to standard normotensive anesthesia in 37 consecutive patients who were undergoing single stage radical cystectomy with pelvic lymphadenectomy and bilateral ureteroileal cutaneous urinary diversion. Group 1 contained 16 patients who received induced hypotensive anesthesia and group 2 contained 21 patients who received normotensive anesthesia. Average age, pathological stage, and hematocrit values preoperatively and 5 days postoperatively were not significantly different. The average blood loss in group 1 was 821 plus or minus 78 cc and in group 2 it was 1,740 plus or minus 132 cc, a difference of 919 cc (p less than 0.001). Concomitantly, total blood replacement was significantly different. The hypotensive group required an average of 1.38 plus or minus 0.25 units or 700 plus or minus 100 cc and the normotensive group averaged 3.25 plus or minus 0.45 units or 1,600 plus or minus 225 cc (p less than 0.05). In addition, only 69 per cent of the hypotensive group required blood replacement compared to 90 per cent of the normotensive group. Our data demonstrate that controlled hypotensive anesthesia markedly reduces blood loss for radical bladder cancer surgery. PMID- 6854767 TI - Urethrotomy technique in urethral strictures: 6-year results. AB - Our urethrotomy technique for strictures during the last 6 years is analyzed. Each stricture was widened radially over the entire circumference with incisions made close together. In this way a short or moderately long stricture can be eliminated completely in 1 session. For long and multiple strictures only the most distal portion was incised as far as possible. Then, after 2 to 3 weeks, control urethroscopy was done and the remaining stricture subsequently was incised without difficulty using the same technique. Urethrotomy was done with the patient under local anesthesia with mepivacaine because of the better field of view. Instillagel was not used. This technique does not require any followup treatment of the urethra. Since no indwelling catheter is needed foreign body urethritis, which can be the cause of stricture recurrences, is avoided. The postoperative course is shortened greatly. There is greater freedom from complications and the chances of healing are improved. The operation can be performed rapidly and the burden for the patient is slight. Secondary injuries are rare. Sessions can be repeated without complications. Potency is not endangered. This operation can be done on an ambulatory patient with any type of stricture. The late results in 202 patients with simple and complicated strictures who underwent this technique were evaluated. Most strictures were incised in 2 or 3 sessions, which gave the best results. A few complicated callous strictures that had been treated for years with bougienage were incised in 4 or 5 sessions. The over-all success rate of the late results is more than 80 per cent. PMID- 6854768 TI - Carcinoma of the female urethra: reassessment of modes of therapy. AB - Of 15 women with primary urethral carcinoma 2 had tumors confined to the urethra and were managed successfully by an operation. Of the 9 patients with tumor extending to the surrounding structures 6 (67 per cent) died of complications related to inadequate control of the primary tumor. The last 4 patients had stage D1 disease or greater at initial diagnosis and died of distant metastases. Our current approach for patients with locally advanced disease is combined brachytherapy and operation in an effort to eradicate the primary tumor, since morbidity and mortality result from failure to control the local tumor. PMID- 6854770 TI - Nocturnal penile rigidity measured by the snap-gauge band. AB - Nocturnal penile tumescence is used commonly to evaluate erectile dysfunction. However, this test is not equivalent to erection since it measures circumferential change only rather than the crucial variable of penile rigidity. We present a new concept in the measurement of penile rigidity--the capability of a patient during sleep to break a band furnished with pre-set snap-gauges with different release-force constants applied around the penile shaft. The snap-gauge band was tested simultaneously with the recording of nocturnal penile tumescence measuring penile rigidity rather than tumescence. PMID- 6854769 TI - Further experience with the artificial urinary sphincter. AB - Since December 1977, 78 patients with severe urinary incontinence have been treated by insertion of an artificial sphincter at our medical center. In 53 patients the device was inserted and activated at the same time. Of these 53 patients 21 (40 per cent) are perfectly dry, 8 (15 per cent) are improved but are occasionally wet and 24 (45 per cent) have failed. In 25 patients activation of the sphincter was delayed. Of this group 14 patients (56 per cent) are perfectly dry, 2 (8 per cent) are occasionally wet and 9 (36 per cent) have failed. The delayed activation technique has reduced the failure rate from 45 to 36 per cent and we recommend its use in high risk patients. PMID- 6854771 TI - Experience with semirigid rod and inflatable penile prostheses. AB - Between 1975 and 1980, 169 patients received a penile prosthesis. Followup for these patients ranges from 1 to 6 years. The following prostheses were implanted: 9 Small-Carrion, 13 Finney, 26 Jonas and 121 Scott. In the 48 patients receiving a semirigid rod prosthesis the only complication was a urethral erosion. In the 121 patients receiving an inflatable prosthesis the first 70 were implanted through a lower abdominal incision and 34 of these patients required a total of 63 revisions. The last 51 inflatable prostheses were implanted through a scrotal incision along with the use of rear tip extenders and 4 of these patients have required surgical revision. PMID- 6854772 TI - The failed penile prosthetic implantation despite technical success. AB - Successful implantation of a penile prosthesis involves more than an operation. Psychological factors can be crucial before, during and after the operation. If these issues are not addressed the true goal of restoring the pleasure of sexual intercourse will not be achieved, regardless of the type of prosthesis used or the technical success of the procedure. PMID- 6854773 TI - Diagnosis of acute testicular torsion using radionuclide scanning. AB - We analyzed retrospectively 99mtechnetium scrotal scan findings in 37 patients with acute scrotal pain. Correlation between scan interpretation, and either surgical findings and/or final clinical diagnosis revealed an accuracy of 89 per cent. Only 1 false negative and 3 false positive results were recorded. Scan data revealed a positive predictive value of 75 per cent, negative predictive value of 96 per cent, sensitivity of 90 per cent and specificity of 89 per cent. An inter institutional observer study also was conducted to assess reliability of the scan, resulting in an 88 per cent agreement. The testicular scan has been found to be an accurate and reliable method to distinguish between epididymo-orchitis and testicular torsion. PMID- 6854774 TI - Ultrasonography of testis tumors. AB - Intratesticular masses can be identified with a high degree of accuracy using recently refined techniques of scrotal ultrasonography. In an attempt to correlate sonographic findings with histopathologic features the sonograms performed on 17 consecutive patients with testis tumors were reviewed. Two distinct categories were identified. Seminomas and lymphomas appeared hypoechoic and homogeneous, and had sharply demarcated intratesticular borders. Nonseminomatous germ cell tumors, although also of lower echogenicity than normal testis, appeared to have cystic spaces, acoustic shadowing and irregular margins extending into the testis parenchyma. Preoperative characterization of a scrotal mass with ultrasound can facilitate surgical excision of the tumor. Scrotal ultrasonography also is useful in the detection of tumor in a palpable normal testis and is a convenient method for the examination of patients who have had a testis tumor previously. PMID- 6854775 TI - Simple testicular cyst diagnosed preoperatively by ultrasound. AB - While fluid collections within the scrotum are not uncommon, an uncomplicated cyst attached to or within the various components of the scrotum is unusual. We report a case of a rare simple cyst of the testicle, which was diagnosed accurately by preoperative ultrasound examination. PMID- 6854776 TI - Selected experience with surgery and combination chemotherapy in the treatment of nonseminomatous testis tumors. AB - We treated 208 patients with newly diagnosed nonseminomatous germ cell tumors of the testis between January 1975 and March 1978. Patients with stages I and II disease underwent retroperitoneal lymph node dissection, and the majority of patients with stage II neoplasm received adjuvant chemotherapy afterwards. Patients with stage III and palpable stage II neoplasm had initial chemotherapy with or without subsequent surgery. The over-all cure rates were 96 per cent (76 of 79) for patients with stage A, 94 per cent (31 of 33) with stage IIA, 83 per cent (35 of 42) with stage IIB and 35 per cent (15 of 43) with stage III disease. The stage of disease at the time of diagnosis, local extent of the primary tumor, nodal category in stages I and II cancer, and chemotherapy were factors influencing relapse rate and over-all survival. PMID- 6854777 TI - Bilateral testicular tumor. AB - Of 396 cases of bilateral testicular tumors reported in the literature through 1979 the tumors were the same histologically in 217 cases (seminoma in 163 and nonseminoma in 54), different in 47 and malignant lymphomas in 68; no histological details were given in 64 cases. In our 18 cases of bilateral testicular tumors the tumors were the same histologically in 5 patients (seminoma in 4 and nonseminoma in 1), different in 6 and malignant lymphomas in 7. The epidemiology, interval between the first and second tumors, histology, diagnosis, therapy and prognosis are discussed. Diagnostic measures are determined by the histology of the first tumor and its treatment. Therapy of the second tumor depends on the interval between the 2 tumors as well as on histologic differentiation of the second tumor. The exceptions in the diagnosis, therapy and prognosis for malignant lymphomas are discussed. We do not believe that the prognosis in cases of bilateral germinal cell tumors is poor. PMID- 6854779 TI - The cytological diagnosis of prostatic carcinoma by transrectal fine needle aspiration. AB - During a 2-year period a prospective study was conducted, comparing the accuracy of transrectal fine needle aspiration with that of transperineal needle biopsy in the diagnosis of prostatic carcinoma. With increasing experience the accuracy of aspiration was found to be at least equal to that of biopsy. Blood cultures 1 hour postoperatively in 1 group and 5 minutes postoperatively in another revealed a low incidence of bacteremia. Our findings suggest that prostatic aspiration should be used more widely as the initial diagnostic procedure for suspected prostatic cancer. PMID- 6854778 TI - Microsurgical vasovasostomy: an outpatient procedure under local anesthesia. AB - We performed microsurgical vasovasostomy on 25 outpatients using spermatic cord block anesthesia, an infrapubic incision and the 1 1/2-layer anastomosis technique. The average operating time was 2 hours 18 minutes and patients usually were discharged home after approximately 1 hour in the recovery room. Of the 21 patients who have had sperm counts performed 3 or more months postoperatively 19 have counts equal to or more than 20 million per ml., with an average motility of 43 per cent. Exclusive of the surgeon's fee, which is the same for inpatient and outpatient vasovasostomies, the average cost of the operation was +650, a savings of 41 per cent over the cost of an outpatient microsurgical vasovasostomy under general anesthesia and of 61 per cent over the cost of the procedure done on an inpatient basis under general anesthesia. The operation as described is safe and economical with minimal morbidity and has results comparable to those obtained with more complex and extensive vasovasostomy techniques. PMID- 6854780 TI - Transient reduction in renal function following arteriography: a radionuclide study. AB - The effects of iodinated contrast agents upon renal function were determined in 11 patients undergoing arteriography. Serial radionuclide renograms were performed to calculate the glomerular filtration rate, effective renal plasma flow and filtration fraction before and after arteriography. The effective renal plasma flow was the parameter most adversely affected. The magnitude of renal dysfunction depended upon the amount of contrast medium administered, as well as probably pre-existing renal disease and site of injection. PMID- 6854781 TI - Computerized tomography scan for diagnosis and staging of renal cell carcinoma. AB - A comparison of computerized tomography and arteriography for the diagnosis and staging of renal cell carcinoma was done in 45 patients during a 2-year interval. Compared to arteriography, computerized tomography was more accurate in the diagnosis of renal cell carcinoma (95 versus 85 per cent), equivalent in the determination of renal vein involvement and superior in the determination of regional nodal involvement. Because of the increased diagnostic accuracy, better delineation of the local extent of the tumor and less invasive nature we recommend computerized tomography as the preferred procedure for diagnosis and staging of renal cell carcinoma. However, in patients with questionable findings arteriography and/or inferior venacavography should be used as complementary studies. PMID- 6854782 TI - Transureteroureterostomy in spinal cord injury patients for persistent vesicoureteral reflux: 6 to 14-year followup. AB - We did a long-term followup for spinal cord injury patients who had undergone transureteroureterostomy for persistent reflux after failed vesicoureteroplasty. Particular attention was paid to the complications that are unique to these patients and include the trapping of ureteral calculi, recurrent vesicoureteral reflux and bladder hypertrophy with vesicoureteral junction obstruction. Caution is advised in using this procedure in the spinal cord injury patient because of these problems despite the over-all success in maintaining the patency of the anastomosis. PMID- 6854783 TI - Fate of patients started on clean intermittent self-catheterization therapy 10 years ago. AB - We evaluated 60 patients placed on a clean intermittent catheterization program more than 10 years ago to determine their outcome. To date 27 patients still are performing self-catheterization, 18 have discontinued the procedure and 15 have been lost to followup. No patient has had deterioration in renal function. Prior incontinence was alleviated completely in 10 of the 27 patients still on the program and 10 of the 18 patients no longer on catheterization have returned to normal voiding. Clean intermittent catheterization is an effective treatment modality in properly selected patients, with few complications and excellent long term results. PMID- 6854784 TI - Urinary infections following transurethral resection of bladder tumors--rate and source. AB - The incidence of urinary infection and its source after transurethral resection of bladder tumors were investigated. Patients undergoing transurethral prostatectomy constituted the control group. All patients had proved preoperative sterile urine and did not receive any antimicrobial treatment. The incidence of urinary infection following transurethral resection of bladder tumors was 19.4 per cent, with an incidence of positive tumor chip cultures of 3.2 per cent. The incidence of urinary infection after transurethral prostatectomy was 32 per cent, with an incidence of positive prostate chip cultures of 8 per cent. We concluded that the source of urinary infection following transurethral resection of bladder tumors and transurethral prostatectomy in most cases is not from within the tissue but rather from perioperative manipulations. PMID- 6854785 TI - The association of urothelial abnormalities with neoplasia: a 10-year followup. AB - More than 10 years ago we reported on the histological appearance and clinical significance of random biopsies of the intervening urothelium in 100 patients with transitional cell carcinoma of the bladder. Although the biopsied mucosa appeared normal cystoscopically a surprisingly large number of abnormalities were found: only 5 per cent of the patients had normal urothelium, 40 per cent had established carcinoma in situ and the remaining 55 per cent had changes described variously as cystitis glandularis, atypia and metaplasia. In the intervening decade these patients have been followed carefully and have been reviewed to determine their fate. Of the original 100 cases 92 were sufficiently well documented to make a meaningful analysis. The outstanding finding was that patients with carcinoma in situ had a significantly worse outcome statistically than those with normal mucosa or nonmalignant aberrations regardless of the characteristics of the primary tumor and its grade or stage (p less than 0.001). A detailed analysis is presented in relation to the clinical and experimental findings, suggesting that patients with carcinoma in situ associated with the primary tumor may require treatment to supplement the initial tumor resection. PMID- 6854786 TI - Asymmetric inflation of the penile cylinders: etiology and management. AB - Asymmetric inflation of the penile cylinder has been encountered in the intraoperative and postoperative period. The condition appears as penile deformity of varying degrees that, when left alone, can lead to recurrent cylinder rupture. The usual cause of cylinder asymmetry is the presence of localized fibrous tissue in the corpora and/or weakened tunica albuginea, which causes the cylinder to over inflate at the area of least resistance. Treatment involves replacement of the cylinder, incision of the fibrous tissue internally or externally and strengthening of the tunica albuginea. PMID- 6854788 TI - Morbidity from pelvic lymphadenectomy in staging carcinoma of the prostate. AB - A retrospective review of 150 patients with adenocarcinoma of the prostate was done to determine the morbidity associated with lymphadenectomy performed as an independent procedure. A total of 77 complications, 17 of which were considered major, was noted in 50 patients. Wound drainage and transection of the spermatic cord were associated with increased morbidity. Systemic antibiotic therapy afforded no protection against wound infections, while intraoperative irrigation was protective. Lymphoceles and lower extremity edema occurred infrequently in our series, although only a few patients underwent postoperative pelvic irradiation therapy. PMID- 6854789 TI - Radical retropubic prostatectomy. AB - We herein present a modification of the Campbell technique for radical retropubic prostatectomy used in 75 consecutive patients undergoing surgical extirpation of the malignant gland. This technique provides for predictable and careful anatomic removal of the prostate. The postoperative complications have been minimal and urinary incontinence has been negligible. PMID- 6854787 TI - Prostatic acid phosphatase: comparison of radioimmunoassay and enzyme activity assay. AB - Aspects of the clinical use of an enzymatic assay and a double antibody radioimmunoassay for prostatic acid phosphatase are compared. Standard blood sample collection and transport did not have a negative effect on the results of either assay. Our results show no substantial advantage in the use of a radioimmunoassay but emphasize the reliability of the enzymatic assay using alpha naphthylphosphate as a substrate with respect to its predictive value and specificity in diagnosis and followup of patients with prostatic carcinoma. PMID- 6854791 TI - The determination of urinary oxalate by gas chromatography. AB - A new quantitative determination method for urinary oxalate by gas chromatography has been established. This method consists of concentration of urine to dryness followed by methylation of the oxalic acid with 7 per cent hydrochloric acid methanol, subsequent extraction with chloroform and gas chromatographic analysis. The advantages of the technique are smaller sample sizes (only 5 ml.), rapidity (within 2 to 3 hours) and accuracy (99.14 plus or minus 1.34 per cent recovery). In addition, the treatment of the sample is simple and no specialized equipment is required. Therefore, this method is recommended to clinicians for routine determination of oxalic acid in urine. Urinary oxalate content was analyzed with this method in 62 male patients with calcium oxalate stones. Urinary oxalate concentration and excretion in 33 patients with recurrent stones were significantly higher than in the 22 controls using Welch's test. PMID- 6854792 TI - Clinical experience with pediatric urolithiasis. AB - Our clinical experience with 47 pediatric patients with stones is reviewed. Surgical therapy was standard with successful stone manipulation in 12 of 13 patients. In 91 per cent of our patients factors causing or predisposing to stone disease were discovered. A thorough metabolic evaluation, including an oral calcium loading test in 20 children, proved to be helpful. A new patient subgroup relating unexplained hematuria to eventual stone formation is described. Our protocol for metabolic evaluation and recommendations for treatment based on the results of such an evaluation are given. We have found the metabolic evaluation of the child with stones meaningful and particularly helpful in planning subsequent therapy for these patients. PMID- 6854790 TI - Urinary citrate excretion in patients with renal calculi. AB - Urinary citrate excretion was measured with a specific enzymatic technique in normal subjects and in an unselected group of patients with recurrent calcium oxalate stones. Hypocitraturia (citrate levels less than those present in 95 per cent of the normal population) was detected in 7 of 46 patients with stones (15 per cent). Hypocitraturia was the only metabolic abnormality in 6 patients. PMID- 6854794 TI - Treatment of acute autonomic dysreflexia. AB - Chlorpromazine has proved useful in the control of sustained dysreflexia in patients with spinal cord injury. Sustained autonomic dysreflexia can be life threatening and may occur after dysfunctional urethrovesical activity or after urological operations, such as external sphincterotomy. Given by injection chlorpromazine reduced blood pressure safely and effectively. PMID- 6854793 TI - A diagnostic dilemma: when urodynamic findings differ from the clinical impression. AB - We evaluated prospectively 425 consecutive patients with respect to the correlation between the clinical and urodynamic assessment of the symptoms. A disparity between the clinical and urodynamic diagnosis was found in 45 per cent of the patients who were believed to have storage problems, 25 per cent with emptying problems, and 54 per cent with storage and emptying problems on clinical examination. The reasons for these disparities are outlined and a rationale for including urodynamic studies in the evaluation of patients with voiding dysfunction is presented. PMID- 6854795 TI - Clinical application of sacral reflex latency. AB - We determined the sacral reflex latency in 108 neurologically normal subjects and 110 patients with neurological lesions by applying stimulating current to the glans penis or clitoris and measuring the response with electrodes inserted in the external urethral and anal sphincters. In normal men the mean latencies were 34.6 plus or minus 5.1 (standard deviation) msec. at the external urethral sphincter and 36.0 plus or minus 5.2 msec. at the external anal sphincter. In normal women the mean latencies were 37.4 plus or minus 5.5 msec. at the external urethral sphincter and 38.6 plus or minus 4.0 msec. at the external anal sphincter. The mean reflex latency in patients with upper motor neuron lesions was significantly shorter. To our knowledge this is the first single electrophysiological test to show a difference between such patients and normal subjects. An increased mean latency was found in patients with lower motor neuron impairment. We conclude that measurement of sacral reflex latency can add to the diagnostic information obtained from conventional electromyography and cystometry. PMID- 6854796 TI - Acquired renal scars in children. AB - To determine the important factors involved in the etiology of renal scarring we studied 37 children with renal scars seen at our hospital since 1965. This is the second largest series reported to date. Children who had neurogenic bladders or any structural abnormalities of the urinary tract other than vesicoureteral reflex were excluded. The study group included 36 girls and 1 boy. The average age at first detection of renal scars was 5.7 years. Acute pyelonephritic episodes, which were treated early and aggressively, infrequently led to renal scarring. However, the initial prolonged or poorly treated episode of acute pyelonephritis was followed invariably by the development of renal scarring. The severity of renal scarring was related to the grade of vesicoureteral reflux (p less than 0.05), although some scars did develop in the absence of reflux. Neither the shape and position of the ureteral orifice nor the ureteral tunnel length correlated with the severity of renal scarring. Treatment with prophylactic antibiotics may have lessened the severity of renal scarring (0.1 less than p less than 0.2) but treatment with reimplantation surgery did not appear to alter the course of renal scarring. This study suggests that the key to the prevention of renal scarring is the early and aggressive treatment of acute pyelonephritis. PMID- 6854797 TI - Management of reflux in the myelodysplastic child. AB - More than 75 per cent of the patients with spinal dysrhaphisms followed at our hospital are on intermittent catheterization. A previous report indicated that 62 per cent of 200 children with reflux and a neurogenic bladder either ceased to have reflux or reflux was downgraded while on intermittent catheterization and chronic antibiotics. We report on those children in whom either reflux did not stop while on the program, or who presented with high grades of reflux not amenable to cure by intermittent catheterization. During the last 4 years 25 children (40 ureters) required antireflux surgery. The criterion of repair was persistent reflux of at least grade IIB, associated with recurrent episodes of infection. A modified Leadbetter-Politano technique was used in 5 children (7 ureters) and the Cohen cross-trigonal technique was used in 20 children (33 ureters). A successful result, that is cessation of reflux and no obstruction, was achieved in 96 per cent of the patients. During the last 2 years the Cohen cross-trigonal technique has been used exclusively and there have been no failures. This successful result in 96 per cent of the children with neurogenic bladder indicates that while clean intermittent catheterization should be used primarily to relieve reflux, in a select group of children antireflux surgery should be done and clean intermittent catheterization should be continued. PMID- 6854798 TI - Initial results with the Cohen cross-trigonal ureteroneocystotomy. AB - Between January 1976 and December 1980, 109 children with 157 ureters with reflux were seen in consultation. Of these ureters 52 were operated upon using the Cohen cross-trigonal technique, while 105 were followed conservatively. The operative procedure is a complete intravesical ureteral mobilization followed by the creation of a submucosal tunnel across the base of the bladder. Followup studies, including an excretory urogram and voiding cystourethrogram, showed minimal hydronephrosis in 1 ureter and persistent grade I reflux in 1 ureter. Evaluation of these initial results indicates that the Cohen cross-trigonal ureteroneocystotomy is a safe and effective antireflux procedure. PMID- 6854799 TI - Urethral strictures in children. AB - During a 12-year period 57 children presented for treatment of urethral strictures. The patients ranged in age from 2 months to 18 years and there was 1 girl. Of the strictures 8 were congenital, 34 were iatrogenic, 4 were inflammatory and 11 were traumatic. Diagnosis can be suspected from the history and physical examination (observation of the voided stream), and confirmed radiographically and endoscopically. Urethral dilation was definitive treatment in only 28.6 per cent of the patients in whom it was used. Of 4 inflammatory strictures 2 responded to dilation as the only treatment, while only 1 of 5 congenital strictures and 1 of 5 iatrogenic strictures responded to dilation. Direct vision urethrotomy was successful in 1 of 2 congenital and in 5 of 5 iatrogenic bulbar strictures. A 1-stage urethroplasty seems preferable to multistaged procedures, since only 2 of 7 patients managed with staged procedures were treated successfully in 2 operations, while 5 of 9 treated with a 1-stage procedure have required no further intervention. PMID- 6854800 TI - Multiple primary tumors in a 72-year-old woman. PMID- 6854801 TI - Percutaneous nephrolithotomy with Mazzariello-Caprini forceps. AB - Mazzariello-Caprini forceps were used percutaneously to remove a stone that was impacted distal to the ureteropelvic junction in a patient who had undergone several previous open pyelolithotomies. These forceps open by a rotational rather than a scissoring movement so the shaft size does not increase and they are well suited for operation through a narrow nephrostomy tract. The original design has been modified to allow passage over an angiographic guide wire, thereby placing the forceps precisely at the site of the stone. Also, with the angiographic guide wire to direct them the forceps can be used in a freshly established nephrostomy tract as well as in a mature tract. In our experience the Mazzariello-Caprini forceps have been most useful for nonoperative manipulation of renal and upper ureteral calculi. PMID- 6854803 TI - Bilateral renal oncocytomas: a case report. AB - We report on a man with bilateral multiple renal oncocytomas who had enlarged kidneys, and presented with loin pain and gross hematuria. A provisional diagnosis of multiple renal oncocytomas was made after renal angiography demonstrated the characteristic appearance of this tumor. The diagnosis was confirmed with histology of an open renal biopsy specimen. This case is unique in that the lesions were multiple and bilateral. The patient had impaired renal function and, hence, the necessity for conservative management once the histological diagnosis had been established. Since in previously reported cases oncocytomas have been removed completely our case provides an opportunity to observe the natural history of the disease. PMID- 6854805 TI - Transluminal balloon dilation of a tuberculous ureteral stricture. PMID- 6854802 TI - Concurrent renal tuberculosis and contralateral transitional cell carcinoma of the renal pelvis: a case report. AB - We report a case of 2 concurrent serious renal problems in opposite kidneys. The patient presented with gross hematuria, which resulted in a diagnosis of transitional cell carcinoma of the renal pelvis and tuberculosis of the contralateral kidney. Intraoperative nephroscopy allowed for appropriate diagnosis and surgical therapy. PMID- 6854806 TI - Ureterocele of the lower pole ureter and an ectopic upper pole ureter in a duplex system. AB - We report an unusual case of a ureterocele in a duplex system, which was associated with an ectopic (vulval) upper moiety ureter. This is the second case reported in the literature of a ureterocele arising from the lower pole ureter. Surgical treatment consisted of removal of the upper segment of the kidney and its ureter. The ureterocele was excised and the lower pole ureter was reimplanted in the bladder. At followup 14 years postoperatively the patient was cured and free of urinary infection. PMID- 6854804 TI - Congenital ureteral valves: report of 2 patients, including one with a solitary kidney and associated hypertension. AB - We report 2 cases of congenital ureteral valves treated successfully by excision of the involved segment and ureteroureterostomy. Hypertension in 1 patient and recurrent urinary tract infection in the other prompted initial evaluation. In the hypertensive patient renin collections from the vena cava and the renal vein of the solitary kidney were normal. Nevertheless, relief of obstruction has resolved the hypertension for 3 years. We review the literature regarding ureteral valves and discuss the mechanism by which unilateral hydronephrosis probably produces hypertension. PMID- 6854807 TI - Rapid spread of transitional ureteral tumor: a serious unusual complication of ureteral brush biopsy. AB - We report a case of rapid spread of a stable ureteral tumor following retrograde brush biopsy. This unusual complication should be considered when planning the management of patients with suspected ureteral carcinoma. PMID- 6854808 TI - Pelvic lipomatosis: 9-year followup in a woman. AB - Pelvic lipomatosis is uncommon in female subjects. The symptoms and signs are vague in all patients but radiologic studies, especially pelvic computerized tomography, should provide data for the diagnosis and obviate operative intervention. All patients should have careful followup to rule out obstructive uropathy. PMID- 6854809 TI - Absence of the bladder. AB - Agenesis of the bladder is a rare anomaly involving the development of the urogenital sinus. We report on 3 patients who survived the initial perinatal period and 2 are alive for more than 4 years. Renal and genital anomalies accompany this abnormality, and recurrent urinary tract infections and incontinence are prominent. Treatment of choice is urinary diversion in the hope of stabilizing renal function and an antirefluxing procedure is deemed preferable. PMID- 6854811 TI - Appendicitis presenting with painless hematuria. AB - Microscopic hematuria is a well recognized, incidental finding in many patients presenting with acute appendicitis. We report a case of gross, painless hematuria as the late and only presenting feature of appendicitis. PMID- 6854810 TI - Fetal posterior urethral valves and renal dysplasia at 15 weeks gestational age. AB - An enlarged bladder secondary to posterior urethral valves was detected by ultrasound in a 15-week-old fetus. Autopsy at 18 weeks of gestation revealed severe renal dysplasia. Intervention, even at this early gestational age, would be unlikely to reverse these pathologic changes. PMID- 6854812 TI - The effect of different agars, agaroses and methyl cellulose on the in vitro proliferation of a human urinary transitional cell carcinoma cell line. AB - The effects of different agars (Bacto-agar and deoxycholate lactose agar), agaroses (LE, ME, Sea Plaque and Sea Prep 15/45) and methyl cellulose on the growth of a human tumor cell line, derived from a transitional cell carcinoma of the urinary bladder, were examined. The overall growth in the presence of agars and agarose was generally less than in liquid medium alone. In contrast, growth in the presence of methyl cellulose was significantly enhanced. Thus, methyl cellulose may be a useful agent for optimizing the proliferation of primary tissue cultures prepared from human transitional cell carcinomas. PMID- 6854813 TI - Follow-up of drug therapy efficacy to prevent recurrence of calcium oxalate kidney stone formation. AB - Results of a prospective study of response to phosphate treatment after surgery in a group of kidney stone formers, some of them recurrent are presented. The follow-up, of 1 year duration, was carried out by periodic tests of the stone formers' urine using the Discriminating Index (DI) procedure. In a group of 32 stone formers, 30 individuals showed a remarkable change in the DI value; i.e., the inhibiting potential of their urine was similar to that of normals. Two of the patients did not respond well, and their drug treatment was adjusted accordingly. During this year no recurrency was reported. PMID- 6854815 TI - Study indicates salt is an acquired taste. PMID- 6854814 TI - A comparative study of the intravesical MTP and BCG treatment of transplantable bladder cancer. AB - We induced transitional cell cancer of the urinary bladder in Fischer rats by feeding them N-[4(5-nitro-2-furyl)-2-thiazolyl] formamide (FANFT). Tumors were subsequently transplanted orthotopically in the bladder submucosa of Fischer rats. This animal model was used to compare the therapeutic effects of maltose tetrapalmitate (MTP), and bacillus Calmette Guerin (BCG). The routes of administration compared were intravesical alone or intravesical and oral for MTP, and intravesical alone or intravesical and subcutaneous for BCG. The intravesical and oral MTP treatment was more effective than the intravesical and subcutaneous BCG as regards the tumor size, incidence of tumor metastasis and the immunologic status of the tumor bearing host. PMID- 6854816 TI - Suction-assisted lipectomy attracting interest. PMID- 6854817 TI - Leads from the MMWR. Tubal sterilization-related deaths in US, 1977-1981. PMID- 6854818 TI - Misplaced table regarding dosage of Miconazole (Monistat i.v.) PMID- 6854819 TI - Funding for research. PMID- 6854820 TI - Blinking and blepharospasm. PMID- 6854822 TI - Renal failure, rhabdomyolysis, and phenylpropanolamine. PMID- 6854821 TI - Systemic Actinomyces infection. PMID- 6854823 TI - Myocardial infarction or acute myopericarditis. PMID- 6854824 TI - Ordering laboratory tests. PMID- 6854825 TI - Anonymity and Alcoholics Anonymous. PMID- 6854826 TI - The impact of a rotorcraft aeromedical emergency care service on trauma mortality. AB - The mortality of 150 consecutive trauma patients treated at the site of injury and transported to a trauma center by standard land prehospital care services was compared with that of 150 consecutive trauma patients treated at the site of injury and transported to the same trauma center by a rotorcraft aeromedical service staffed by a physician and nurse. A statistical analysis designed to predict mortality based on injury severity revealed that the mortality of the land group was statistically no different from that of a large index trauma patient population treated at a major trauma center. There was a 52% reduction in predicted mortality of the aeromedical group, which was highly significant. PMID- 6854828 TI - Secondary syphillis. Still the great imitator. PMID- 6854827 TI - Physical fitness and subsequent myocardial infarction in healthy workers. AB - Physical work capacity (PWC), a measure of physical fitness, was assessed by bicycle ergometry on 2,779 healthy men younger than 55 years who were subsequently followed up for an average of 4.8 years for symptomatic myocardial infarction (MI). There were 36 MIs. The relative risk (RR) of MI for below median PWC, adjusted for conventional risk factors for heart disease, was 2.2 (95% confidence limits, 1.1 and 4.7). This increased risk appeared to be limited to men with certain other risk factors present simultaneously: above-median cholesterol level, smoking, above-median systolic BP, or a combination of these. Among men with at least two of these factors, the adjusted RR for below-median PWC was 6.6 (95% confidence limits, 2.3 and 27.8). Poor physical fitness may be an important risk factor for heart disease, especially when conventional risk factors are also present. PMID- 6854829 TI - Primary torsion of the greater omentum. A rare cause of abdominal pain in children. PMID- 6854830 TI - Helicopters in emergency trauma care. PMID- 6854832 TI - Ordering of laboratory tests in a teaching hospital. Can it be improved? AB - A review of ordering patterns for thyroid function tests and for measurements of creatine kinase (CK) isoenzyme and lactate dehydrogenase (LDH) isoenzyme levels indicated considerable misuse. We employed an educational program for both types of tests, but changed the request form only for ordering the thyroid function tests. No changes were made in the forms for ordering CK and LDH isoenzyme tests. The effect was a prompt decrease in ordering triiodothyronine radioimmunoassay and thyrotropin tests to 38% and 61%, respectively, of baseline rates. There was no effect on rates of ordering CK and LDH isoenzyme tests, which were 102% and 96%, respectively, of baseline rates. The improved use of thyroid function tests was likely because of the change in the laboratory request form, since the educational strategy by itself had no effect on the ordering of CK and LDH isoenzyme tests. PMID- 6854831 TI - Laboratory request forms (menus) that guide and teach. PMID- 6854834 TI - Newly identified particle may explain spurious platelet count. PMID- 6854833 TI - Of red cell bondage. PMID- 6854835 TI - Greater IUD perforation risk, lactation linked. PMID- 6854836 TI - Leads from the MMWR. Cytogenetic patterns in Love Canal, NY, residents. PMID- 6854837 TI - Leads from the MMWR. Exposure to perchloroethylene in US dry-cleaning workers. PMID- 6854838 TI - Intravenous epinephrine therapy in anaphylaxis. PMID- 6854839 TI - Recurrent perineal and urethral pain. PMID- 6854840 TI - Hickman catheters in leukemic patients. PMID- 6854841 TI - Screening for cystic fibrosis. PMID- 6854842 TI - Self-administered Heimlich maneuver. PMID- 6854843 TI - Treatment of theophylline overdose. PMID- 6854844 TI - Dioxin exposure and sarcoma. PMID- 6854845 TI - Aspirin and Reye's syndrome. PMID- 6854846 TI - Why not share the secrets of good health? PMID- 6854847 TI - Nosocomial Legionnaires' disease uncovered in a prospective pneumonia study. AB - Most hospitals have yet to record a case of nosocomial legionnaires' disease; the importance of isolation of Legionella pneumophila in the water system of such an institution is unclear. We undertook a prospective pneumonia study in tandem at a veterans hospital where legionnaires' disease was known to be endemic and a community teaching hospital where legionnaires' disease had never been documented. Legionella serological tests were performed on all patients with pneumonia; selective culture media and direct fluorescent antibody testing for Legionella were made readily available. Simultaneous environmental surveys for Legionella were performed. At the community hospital, we discovered that 64% of sites in the water distribution system yielded L pneumophila and that 14.3% of nosocomial pneumonias were legionnaires' disease. The epidemiologic implications of these findings are discussed. Options concerning case detection and eradication measures in the face of hospital water contamination with L pneumophila are presented. PMID- 6854848 TI - A trichinosis outbreak in Iowa. AB - During December 1975 and January 1976, seventy-nine persons in Postville, Iowa, and nearby communities were infected with trichinosis by eating locally produced summer sausage made from a mixture of venison (provided by deer-hunting parties) and pork. More than 242 local residents and holiday visitors from five other states and Canada were exposed to the sausage, in which the venison was mixed in a 2:1 ratio with government-inspected and commercially obtained pork. Laboratory examinations of incriminated sausage samples showed one to 65 Trichinella larvae per 100 g and indicated that temperatures during processing had not exceeded 54 degrees C. Corrective measures centered on improving temperature monitoring during the smoking process at the sausage-preparation plant to ensure that adequate temperatures are achieved. Persons possessing the implicated sausage were advised to destroy it or to cook it adequately before eating it. PMID- 6854849 TI - Clinical findings in Southeast Asian refugees. AB - Since 1979, we have provided comprehensive medical care to a group of 142 Southeast Asian refugees who relocated in Connecticut. In this group, we identified clinically important issues in child development. As plotted on standard growth curves, 47% of refugee children were below the fifth percentile in height for age and 22% were below the fifth percentile in weight for height. Although these children are potentially at increased risk for nutrition-related health problems, our clinical assessment did not confirm malnutrition. We also confirm a high prevalence of intestinal parasitism (59%), positive tuberculin test results (40%), and hepatitis B antigenemia (16%), as observed previously by health authorities. We conclude that anthropometry should not replace a clinical nutritional assessment of refugee children. PMID- 6854850 TI - Hematologic abnormalities in Southeast Asian refugees. AB - Since 1979, we have provided comprehensive medical care to a group of 142 Southeast Asian refugees who relocated in Connecticut. In this group, we identified many hematologic abnormalities in both adults and children (18% anemias, 35% microcytosis). The majority of anemias were microcytic, secondary to iron deficiency and inherited disorders of hemoglobin synthesis. The latter were present in at least 7.5% of our population and accounted for the majority of patients with microcytosis. We conclude that hemoglobin electrophoresis and serological tests for iron stores can detect the cause of anemia found in most Southeast Asian refugees. PMID- 6854851 TI - What to do about Legionella? PMID- 6854852 TI - Automobile-related injuries. PMID- 6854853 TI - Sudden onset of headache, proptosis, and roaring tinnitus in a hypertensive 60 year-old woman. PMID- 6854854 TI - Danazol for severe disease. PMID- 6854855 TI - Physicians join athletes in trying out for Olympics. PMID- 6854856 TI - Prophylactic rabies vaccine dose, cost cut. PMID- 6854857 TI - New surgical techniques ease incontinence. PMID- 6854858 TI - Leads from the MMWR. Annual mussel quarantine--California, 1983. PMID- 6854859 TI - Benefits of a computerized pharmacy. PMID- 6854860 TI - Alfalfa of the family Leguminosae. PMID- 6854861 TI - Anesthetic management in electroconvulsive therapy. PMID- 6854862 TI - Alcoholism and liver disease. PMID- 6854863 TI - Factitious illness v conversion disorder. PMID- 6854864 TI - Anticoagulant therapy for senile dementia. PMID- 6854865 TI - Diagnosis of metastatic liver cancer. PMID- 6854866 TI - Hemorrhage into the round ligament. PMID- 6854867 TI - Treatment of a professional degree and license on divorce. PMID- 6854868 TI - Emporiatric policy and practice. Protecting the health of Americans abroad. PMID- 6854869 TI - Maintaining competency in advanced cardiac life support skills. AB - One hundred thirty-two physicians who successfully completed advanced cardiac life support (ACLS) training were randomly placed in a control group or one of two groups receiving interventions designed to provide reinforcement of previously mastered knowledge and skills. These interventions included mailed periodic reprints (group 1) or quarterly patient management problems (group 2). All physicians were retested for knowledge and skills related to ACLS one year later. Fifty-two (39.4%) could successfully ventilate the mannequin, and 62 (47.0%) could perform cardiac compression adequately. No differences were noted among groups. Significant differences in knowledge were found. The control group initiated appropriate therapy in a mock-arrest situation 52% of the time, while group 1 averaged 75% and group 2 averaged 82%. These results indicate that reinforcement after continuing medical education may enhance knowledge retention, but does not maintain motor skills. Yearly recertification in ACLS skills should be considered, and frequent practice sessions should be encouraged for those physicians who are not active participants in ACLS activities. PMID- 6854870 TI - Traumatic dislocation of the hip. AB - Traumatic dislocation of the hip (TDH) is an absolute orthopedic emergency that is increasing steadily in incidence. Sixty-two to ninety-three percent of reported cases were the result of high-speed motor vehicle accidents in which seat belts were not used. Post-TDH complications and morbidity, particularly femoral head necrosis, are related to the severity of injury, skeletal maturity, and duration of dislocation. Prompt, gentle reduction within 12 hours remains the cornerstone of successful therapy. In a variety of other clinical condition, TDH may be masked, and specific appropriate evaluation is thus necessary to detect the occasionally occult TDH. The regular use of seat belts would virtually eliminate this injury. PMID- 6854871 TI - Physical and emotional function of primary care patients: scientific requirements for the measurement of functional health status. PMID- 6854872 TI - Supraventricular tachycardias. PMID- 6854873 TI - The Missouri controversy: is NMR ready for clinical use? PMID- 6854874 TI - HBV vaccine immunogenic in neonates. PMID- 6854875 TI - No obvious reason for HBV double hit. PMID- 6854877 TI - Leads from the MMWR. Fireworks-related injuries--Washington State. PMID- 6854876 TI - A new biological marker for depression? PMID- 6854878 TI - Leads from the MMWR. Staphylococcal food poisoning on a cruise ship. PMID- 6854879 TI - Gene evolution v special creation. PMID- 6854880 TI - Phthirus pubis infestation of the eyelashes. PMID- 6854881 TI - Aortic valve endocarditis. PMID- 6854882 TI - Sulindac and renal failure. PMID- 6854883 TI - Organic brain syndrome: diagnostic value of the EEG. PMID- 6854884 TI - Fusobacterium necrophorum septicemia. PMID- 6854885 TI - Marketing and medicine. Why advertising is not an issue. PMID- 6854886 TI - Superior vena cava syndrome due to non--small-cell lung cancer. Resolution with chemotherapy alone. AB - Three patients with superior vena cava syndrome due to non--small-cell lung cancer were treated with chemotherapy alone. Symptomatic relief began within three days of treatment and substantial resolution of the syndrome occurred in all three patients. One patient had complete remission of tumor and the other two had more than a 50% tumor reduction within the first month of therapy. These are the first case reports indicating that combination chemotherapy may be effective as initial management of the superior vena cava syndrome due to non--small-cell lung cancer. PMID- 6854887 TI - Percutaneous nephrolithotomy. An approach to branched and staghorn renal calculi. AB - Using electrohydraulic lithotripsy, we removed branched or staghorn calculi from four patients via a percutaneous nephrostomy tract with local anesthesia. There were no serious complications, and the patients were able to resume their preadmission activities immediately after discharge from the hospital. Our experience suggests that, eventually, all upper urinary tract calculi may be treatable by a percutaneous approach. PMID- 6854889 TI - Morphological analyses of active genes and chromatin. AB - Chromatin with nascent ribonuclear protein (RNP) fibers representing transcription of ribosomal DNA (top) and nonribosomal DNA (bottom). These two types of transcription can be distinguished on the basis of the size of transcription units, chromatin morphology and the inferred ratio of DNA packing, the frequency of RNP fibers (number of fibers per micrometer of chromatin), and the solitary v tandem repeat occurrence of fiber arrays. In some cases, the structure of RNP fibers is also distinctive for different transcription units. The micrographs presented herein, from Laird and Chooi, were taken of chromatin samples prepared similarly to the method described by Miller and Bakken. Cells and nuclei from Drosophila were ruptured in low ionic strength buffer; nuclear and cytoplasmic constituents were recovered on electron microscopic grids under conditions that facilitated spreading of chromatin and nascent ribonuclear protein fibers. Bar represents 1 micron. PMID- 6854888 TI - Calcification in soft tissues. PMID- 6854890 TI - New drugs selectively inhibit kidney stone formation. PMID- 6854891 TI - Portable ECG recorder catches syncope in the act. PMID- 6854892 TI - Solving big problems for little people. PMID- 6854893 TI - Leads from the MMWR. Acquired immunodeficiency syndrome (AIDS) update--United States. PMID- 6854894 TI - Leads from the MMWR. Condyloma acuminatum--United States, 1966-1981. PMID- 6854895 TI - Treatment of impaired physicians. PMID- 6854896 TI - Unnecessary speculation about glucose and RBCs. PMID- 6854897 TI - Complications of sickle cell trait. PMID- 6854898 TI - Mortality from abortion and childbirth. PMID- 6854899 TI - Frictional dermatitis of Onan. PMID- 6854900 TI - Dietary salt intake and blood pressure. AB - With an index for dietary salt use designed to provide a semiquantitative estimate of salt intake, we have found that in a sample representative of the 2.1 million adults in Connecticut, the mean BP of those at the 90th percentile or higher of salt intake differs by a quantitatively insignificant amount from the mean BP of those at the tenth percentile or lower of salt intake. When we examined the obese (body mass index, 90th percentile or higher) separately, similar results were obtained. These findings indicate that it is unlikely dietary salt intake has a clinically significant effect on BP in the majority of individuals in a large defined population, but do not exclude the possibility of a clinically significant effect in a small subgroup of salt-sensitive individuals. PMID- 6854901 TI - Suppression of lymphocyte stimulation following bereavement. AB - In a prospective study of 15 spouses of women with advanced breast carcinoma, lymphocyte stimulation responses to phytohemagglutinin, concanavalin A, and pokeweed mitogen were significantly suppressed during the first two months following the death of a spouse compared with prebereavement levels. A highly significant suppression was seen as early as one month after bereavement. No differences were found in total lymphocyte or B- or T-cell numbers. An intermediate level of mitogen responsivity was found during the four- to 14-month period after bereavement. Suppressed immunity following the death of a spouse may be related to the increased morbidity and mortality associated with bereavement. PMID- 6854902 TI - Normal and pathological grief. AB - Physicians are often called on to care for patients and members of patients' families during the period of bereavement. The grief process serves a psychologically adaptive function and usually progresses in a predictable manner. Under certain unusual circumstances, however, the grieving process may become pathologically delayed or distorted, with serious consequences for the survivor's emotional and physical health. There are three phases of the normal grief process and particular guidelines for physician recognition and management of pathological grief reactions. PMID- 6854903 TI - Legionella bozemanii. Still another cause of pneumonia. PMID- 6854904 TI - Aspiration of a balloon by a 3-month-old infant. PMID- 6854905 TI - The American Medical Association's Diagnostic and Therapeutic Technology Assessment Program. PMID- 6854906 TI - Salt and hypertension. PMID- 6854907 TI - Sodium and blood pressure in infancy. PMID- 6854908 TI - Apparent right midlung mass in a dyspneic man. PMID- 6854909 TI - A new method for quantitative analysis of thallium-201 myocardial image "corrected" circumferential profile method. AB - A new method for computer-assisted quantitative analysis of a thallium (Tl)-201 myocardial image ("corrected" circumferential profile method) was described. Since the Tl-201 myocardial image of a normal subject is not homogeneous, an attempt was made to correct for this non-homogeneity. Three groups of subjects were studied, including 10 normal volunteers (group A, mean age of 27.5 years), 14 patients with atypical chest pain and normal coronary arteriogram (group B, mean age of 56.7 years) and 16 patients with first transmural myocardial infarction (group C, mean age of 71.0 years). The myocardial images were acquired at rest at anterior, left anterior oblique (30 degrees and 60 degrees) and left lateral projections. With a scintigram, the left ventricle was outlined and divided into 24 radial segments by radii drawn from the center of the left ventricle. Average radioactivity per pixel in normal subjects was obtained in each segment and normalized to the highest segment (= 100%). The ratio of 100% to the mean of normalized radioactivity in percent in each segment from 10 normal volunteers was calculated and designated as a correction factor for each segment. After the correction of average radioactivity per pixel in each segment using this correction factor and after relating it to the highest radioactive segment, the mean (= 100%) and standard deviation (SD) were calculated and (100-4SD)% was defined as the normal lower limit. In the scintigram of groups B and C, "corrected" circumferential profiles were obtained from the regional radioactivity multiplied by the correction factor, normalized to the highest segment (100%) and compared with the lower normal limit. The ratio (%) of the area of patient's circumferential profile curve below the normal limit to the total area below the normal limit was obtained at each view and the sum of them was called the total "corrected" defect score. Infarct size analyzed by the "corrected" circumferential profile method correlated well with that analyzed by visual interpretation, and was useful in differentiating group C from group B. PMID- 6854910 TI - Effects of L-carnitine on ventricular arrhythmias after coronary reperfusion. AB - Effects of L-carnitine on ventricular arrhythmias and myocardial metabolism in a reperfused ischemic myocardium were studied in 35 anesthetized mongrel dogs. The left anterior descending coronary artery was ligated for 40 min and then reperfused for 15 min. L-carnitine (100 mg/kg) was administered intravenously 5 min before the coronary ligation and infused continuously at a rate of 20 mg/kg/min from 5 min before the reperfusion to the end of the experiment. Electrocardiograms were recorded continuously throughout the experiment. Transmural myocardial samples were obtained from both the ischemic and the nonischemic areas after 15 min of reperfusion and used for the determination of ATP, free carnitine, long chain acyl carnitine and long chain acyl CoA. L carnitine significantly reduced the incidence rate of ventricular fibrillation after reperfusion (from 29% in the controls to 5%, p less than 0.05). ATP in the ischemic myocardium in the L-carnitine group was significantly higher than that in the control group (p less than 0.05). Free carnitine in the control group significantly decreased in the ischemic area as compared with the nonischemic area (p less than 0.01). In L-carnitine group, on the other hand, no difference was observed between them. Long chain acyl CoA in the control group significantly increased in the ischemic area as compared with the non-ischemic area (p less than 0.01). In L-carnitine group, on the other hand, no difference was observed between them. Thus, the accumulation of long chain acyl CoA in the ischemic myocardium was reduced by the L-carnitine treatment. These data suggest that L carnitine has protective effects on ventricular arrhythmias and on metabolic changes after coronary artery reperfusion following coronary artery occlusion. PMID- 6854911 TI - Recurrent pulmonary embolism. AB - Five cases with recurrent pulmonary embolism (RPE), all having severe chronic cor pulmonale due to marked pulmonary hypertension, were reported. None of them had a history of thrombophlebitis of the legs. Dyspnea was the common symptom and signs of pulmonary hypertension were usual. Focal oligemia, cardiomegaly and plump pulmonary arteries on chest X-ray films, right axis deviation, clockwise rotation, ST-segment depression and T-wave inversion on electrocardiograms, and dilatations of the pulmonary arterial trunk, the right ventricle and the right atrium, and the posterior displacement of a small, compressed left ventricle on echocardiograms were the common findings. Gas exchange abnormalities were severe and they were considered the characteristic findings of this disease. Multiple perfusion defects were observed by a lung scan in all cases. Marked pulmonary hypertension with low cardiac output was the usual feature of RPE. Actual cutoffs or filling defects were demonstrated on a pulmonary angiogram. Deep vein of the legs were all intact and no thrombi were found. Pulmonary embolectomy was performed on one case. The importance of early diagnosis and early treatment of acute pulmonary embolism was emphasized for preventing the progress of this debilitating disease. PMID- 6854912 TI - Sudden unexpected deaths in a Japanese community--Hisayama study. AB - Six hundred and fifty-eight autopsy cases of both sexes in a general population of Hisayama town (autopsy rate 85%) were examined to determine the frequency and causes of sudden and unexpected death. Seventy-three sudden deaths (11.1%) were identified when sudden death was defined as death occurring within 24 hours after the onset of clinical symptoms. Thirty-nine deaths (54%) were due to intracranial hemorrhage (cerebral and subarachnoid) and 17 (23%) were due to coronary heart disease. An instantaneous death occurred within one hour was observed in 20 of the 73 cases (27%), of which 8 were attributed to coronary heart disease (40%) and one (0.5%) to subarachnoid hemorrhage. Pathologic evidence of recent myocardial infarcts or coronary thrombosis was found less frequently in cases who died within one hour than in those who died between one and 24 hours. An annual incidence of sudden death due to various etiologies, calculated from the population study on Hisayama residents who were aged 40 or over, was 1.7/1,000. Deaths from coronary heart disease in this community were much less common as compared with those reported in Western communities. PMID- 6854914 TI - Histopathology of the conduction system in sudden cardiac death. AB - In order to clarify the importance of the conduction system involvement in cases of sudden cardiac death, 35 autopsied hearts, obtained from the patients who died within one hour after the onset of a critical attack, were examined histopathologically and compared with 27 both age- and disease-matched and 30 only age-matched control hearts from individuals who had not died suddenly. The conduction system was serially sectioned using Lev's method and observed under a light microscope. Purkinje cell lesions, which made a structural maze compatible to the electrophysiological re-entry mechanism, abnormalities of the AV node artery and hypertrophy of the AV node and the bundle of His were more prominent in the sudden-death group with long QT syndrome, isolated ventricular fibrillation and AV and bundle branch blocks due to both ischemic heart and myocardial diseases. Sinus node fibrosis with minor anomalies of the sinus node artery was specifically seen in the sudden death of apparently healthy young males (Pokkuri disease). The same lesion, but with sclerosis of the sinus node artery, was seen in the cases of sudden death with hypertensive heart disease. PMID- 6854913 TI - Sudden cardiac death at exertion. AB - In order to investigate sudden cardiac death at exertion (sports, and light work in daily life), 226 cases of sudden death during sports and 1,729 autopsy cases of sudden death were studied, and exercise tests were performed on 138 patients with various cardiac diseases. Among sports, marathon or jogging caused sudden death most frequently (52.7%). It occurred often immediately after goal (41.3%) or before goal (28.0%), but cases with a history of heart disease died at the beginning of the race. Severe heat, overwork and other factors may precipitate the sudden death. In autopsy cases of sudden cardiac death which occurred at exertion, coronary arteriosclerosis (C) was found in 67.0%, cardiac hypertrophy of unknown etiology (H) in 7.8% and valvular heart diseases (V) in 7.1%. Sudden death in patients with C or H were more frequent at exertion than at rest. Patients with C were older and died at light work. Those with H of a high degree also died at light work, but the younger ones with a mild H died at sports activity. At exercise test, in patients with arrhythmia or hypertrophic cardiomyopathy, abnormalities may occur after exercise. Sudden death at exertion may depend on the predisposing heart disease. Care should be taken especially at the end of the race. PMID- 6854915 TI - Sudden death of the young with cardiovascular diseases. AB - Sudden death due to cardiovascular diseases was studied in 142 children who died suddenly during the period from 1969 to 1981. The age-distribution analysis showed that death occurred most frequently in infancy and it decreased with age. The subjects were divided into 7 groups, of which the hypoxemic group, consisting of 45 cases (32%), was the largest, followed by the congestive heart failure (CHF) group (33 cases, 23%), the primary endomyocardial disease (PMD)-coronary heart disease (CorHD) group (21 cases, 15%), the postoperative group (18 cases, 13%), the pulmonary vascular obstruction group (17 cases, 12%), the arrhythmia group of 3 cases and the miscellaneous group of the remaining cases. In the hypoxemic, CHF and arrhythmia groups, the majority of the cases were infants, while in the other groups the cases were distributed among all age groups. The relative incidence of each group showed that non-surgical and inoperable cases and postoperative cases increased with age and this increase has occurred in the last few years. This change has been brought about by the recent advances in medical and surgical treatments for infants with congenital heart diseases. It is hoped that in the future the number of cases which are too late for treatment will decrease further. PMID- 6854916 TI - Transient high degree AV block as a cause of Stokes-Adams syndrome--clinical observation and experimental study. AB - A case of Stokes-Adams syndrome, caused by a high degree AV block due to repetitive concealed conduction in the AV node, was presented. Experimental study in dogs with impaired AV conduction by verapamil showed that the favourable conditions for appearance of "repetitive" concealed conduction were as follows: 1) prolonged effective refractory period (ERP) of the AV node, 2) atrial stimulations applied at or just inside of ERP of the AV node successively (deeper penetration of concealed conduction), 3) a prolonged preceding PQ interval (slower speed of concealed conduction) and 4) overdrive suppression of subsidiary pacemaker(s). In clinical cases with apparently normal AV conduction but with prolonged ERP of the AV node, atrial excitations with suitable timing may cause repetitive concealed conduction, resulting in a high degree AV block and Stokes Adams syndrome. PMID- 6854917 TI - Angiocardiographic evaluation of ventricular septal defect--pre- and post operative cardiac volume characteristics. AB - The characteristics of the left and the right heart volume in isolated ventricular septal defect were investigated in 62 patients before surgery and in 17 after corrective surgery, which was undergone at ages ranging from 0.5 to 13. Postoperative cardiac catheterization was performed one to two months after surgery. Preoperatively, the right atrial maximal volume increased in accordance with the pulmonary to systemic pressure ratio, and the left ventricular end diastolic volume, the left atrial maximal volume and the right ventricular end diastolic volume increased in accordance with the degree of the left-to-right shunt. These volumes decreased considerably after surgery, although they still remained above normal. The left ventricular mass also increased in accordance with the degree of the left-to-right shunt preoperatively and did not decrease postoperatively. The left and the right ventricular ejection fractions were close to or within normal limits preoperatively and remained so after surgery. On the basis of our results and the findings previously published in the literature, factors which may influence the postoperative cardiac function in ventricular septal defects were discussed. PMID- 6854918 TI - Reversibility of the left ventricular function after aortic valve replacement for aortic regurgitation. AB - Ten patients with aortic regurgitation underwent aortic valve replacement using a Bjork-Shiley valve prosthesis. They ranged from 27 to 58 years of age. The studies were centered around the postoperative hemodynamics, especially concerning the function of the left ventricle during a follow-up period which averaged about 8 months. The left ventricular end-diastolic volume (LVEDV) returned to the normal range, and the muscle mass of the left ventricle decreased remarkably after surgery. The ejection fraction and mean velocity of the circumferential fiber shortening both increased up to the normal range. The left ventricular end-diastolic pressure exhibited normal values with a decrease of the LVEDV. The depressed left ventricular function was largely reversible after surgery. PMID- 6854919 TI - Alcoholic cardiomyopathy--acetaldehyde poisoning rat: myocardial and serum enzyme changes in acute exposure. AB - In order to clarify the pathogenesis of alcoholic cardiomyopathy, acetaldehyde (Ach) was administered to rats using the inhalation method. Serum enzyme changes and structural alterations of the heart were observed at various time intervals after 2 ml of Ach exposure for 2 hours. Possible myocardium-related enzymes, such as glutamic oxaloacetic transaminase, lactic dehydrogenase and creatine phosphokinase, were elevated within 24 hours and then returned almost to the previous levels. The most significant change seen using light microscopy was a prominent contraction band scattered throughout the specimen in the groups exposed for 12 and 24 hours, respectively. Ultrastructually, mitochondrial swelling and crystal disarray concomitant with myofibrillar change (swelling of Z band) were observed. The former was seen most prominently immediately after exposure, while the latter was observed 24 hours after exposure. The significance of these findings and the difference between alcoholic cardiomyopathy and ischemic lesions were discussed. PMID- 6854920 TI - Alterations in electrophysiological properties during canine myocardial ischemia- variation with location in the ischemic zone in vivo. AB - We examined electrophysiological properties of the ischemic myocardium of the canine heart. Multiple bipolar electrodes for stimulation or for recording electrograms were placed on the epicardial surface and at the endocardium of the ventricle. The time course of changes in excitability threshold, in effective refractory period and in local conduction time during ischemia was estimated at the epicardial and endocardial sides of the central ischemic zone, at the epicardial side of the peripheral ischemic zone and at both sides of the normal zone. Soon after left anterior descending coronary artery occlusion, a rise of excitability threshold, a lengthening of effective refractory period and a prolongation of conduction time consistently occurred in all portions of the ischemic zone. The degree of changes, however, was not uniform: it was greater at the epicardial side of the central ischemic zone. In most experiments, the changes reached maximum within 10 min after occlusion. Then, altered electrophysiological properties recovered to some extent or stabilized. The results indicate that electrophysiological properties deteriorate momentarily after coronary occlusion but then recover or stabilize, and that their changes during acute ischemia are not uniform in the ischemic region but severer at the central zone and epicardial side. PMID- 6854921 TI - An autopsy case of rheumatoid arthritis with an involvement of the cardiac conduction system. AB - A case of rheumatoid arthritis with an involvement of the cardiac conduction system was described. The patient was a 65-year-old man who had a 15-year history of classical rheumatoid arthritis combined with an advanced atrioventricular (AV) block resulting in Adams-Stokes seizure. Prior to the occurrence of the AV block, a complete right bundle branch block with a left axis deviation and a first degree AV block were found on an electrocardiogram (ECG). The histological examination of the conduction system according to the serial sectioning method disclosed that the branching portion of the His bundle and anterior fascicle of the left bundle branch were replaced by the scarring tissue and that the penetrating portion of the His bundle, the AV node and the right bundle branch had rheumatoid granulomatous lesions. The extent and localization of the lesions in the conduction system were well correlated with the findings on the ECG. PMID- 6854922 TI - Exercise capacity of the patients with myocardial infarction. AB - This study was conducted to investigate the functional capacity in postmyocardial infarction. Eighty-four multistage treadmill exercise tests were performed on 60 patients, none of whom had had any formal rehabilitation or regular exercise. There were 50 men and 10 women, ranging in age from 30 to 81 with an average age of 60. The time interval between the acute attack and the exercise test ranged from one month to 9 years. Even though severe infarction affects the exercise capacity for a long time after an acute attack, its effect on cardiac function was more obvious than that on physical capacity. Age was the most important determinant of physical capacity, and the slope of decreasing physical capacity with age in patients with infarct was the same as that in normal subjects. Cardiac function also decreased with age. However, during the early recovery phase, cardiac function was influenced by the severity of infarction and the influence of age could not be established. There was no significant correlation between early ambulation and physical capacity. The beneficial effects of early ambulation may be lost if physical activity is discontinued for some time after the acute attack. The physical capacity increased 2-3 years after the acute attack, but myocardial function did not change significantly. PMID- 6854923 TI - Clinical problems in the management of patients with acute myocardial infarction from its onset to the patients' return to work. AB - Out of 330 patients with acute myocardial infarction (AMI) admitted to our institution, 256 patients entered our 3-week rehabilitation program and discharged from the hospital. Through the execution of the program, its feasibility and safety were examined, and guidelines for the progress of the program were re-evaluated. The state of outpatient community life and its determining factors were also investigated by a questionnaire. The following results were obtained: 1) Over 90% of patients with uncomplicated MI could complete the rehabilitation nearly on schedule, indicating the feasibility of the program. 2) Mortality after ambulation and serious complications related to rehabilitative activities were very few, indicating the safety of our rehabilitation program. 3) Among guidelines for the progression of the program generally accepted, the case for an elevation of blood pressure as well as an ST depression was found to be especially important in order to prevent serious complications. 4) Age, discharge exercise capacity, left ventricular function and the severity of coronary disease were important factors influencing the patients' returning to work. PMID- 6854924 TI - Study of the rehabilitation, prognosis and capacity to resume work of patients with myocardial infarction--comparison of 4-week and 8-week rehabilitation programs. AB - The relative benefits of 4- and 8-week rehabilitation programs were compared in inpatients with myocardial infarction. In the 8-week program, complete bed rest was instituted for the initial 3 days, followed by walking around the bed from the 14th day; exercise was gradually increased to target levels such as walking for distances of 500m per time up to a total of 2 to 3 km and climbing up and down several sets of 20 stairs daily. In the 4-week program, complete bed rest was provided for the initial 3 days, and exercise was more rapidly increased for 4 weeks to reach the same exercise level as that of the 8-week program. The duration of hospitalization, and the clinical progress, prognosis and the ability to return to work after discharge of the patients were compared in each program. The percentage of patients who were hospitalized for 40 days or less increased from 0% in the 8-week program to 15.9% in the 4-week program, while the percentage of patients who were hospitalized from 41 to 60 days increased from 13.3 to 37.0%. Shortening of the program did not cause significant differences in the incidence of serious complications such as heart failure, arrhythmia and infarction. The 2-year mortality was 15.9% in the 8-week program and 7.9% in the 4-week program. The state of work after discharge was comparable in both programs. Exercise tolerance, measured by bicycle ergometer, tended to improve remarkably 6 months after infarction. Based on the above results, the 4-week program is considered to be more practical than the 8-week program. PMID- 6854925 TI - Exercise parameters for the prediction of post-training increase in exercise tolerance in patient with stable angina pectoris. AB - Twenty cases with effort angina underwent exercise training for a mean follow-up period of 38 weeks. Various parameters were investigated to clarify whether or not such parameters can be used to predict an increase in exercise tolerance of patients with effort angina. The increase of exercise tolerance after training was found to be related to a reduction of the myocardial oxygen demand at a given external work load. The maximal heart rate (max HR) the maximal systolic blood pressure (max SBP) and the maximal rate-pressure product (max RPP) could not predict the post-training increase in exercise tolerance. Before training, the maximal oxygen intake (VO2max) was found to be lower, and the HR/VO2max and the SBP/VO2max were higher in the group (11 patients) which showed a good response to the exercise program (effective group) than those in the group (9 patients) which did not (unchanged group). Before training, the HR/VO2max and the SBP/VO2max in the effective group were also higher than those of 96 healthy adults. On the other hand, the HR/VO2max and the SBP/VO2max in the unchanged group were not different from those of the healthy adults throughout the training. It is useful to compare the values of the HR/VO2max and the SBP/VO2max of patients with effort angina to those of healthy adults for the prediction of post-training increase in exercise tolerance. PMID- 6854926 TI - The relationship between mental disorders and physical severities in patients with acute myocardial infarction. AB - We studied the relationship between the mental disorders and the mental severities of 163 patients with acute myocardial infarction (AMI), who were admitted to the CCU (Coronary Care Unit) of Nippon Medical School Hospital during the past 2 years. Their mental disorders were diagnosed by psychiatrists, and the relationship between their physical severities according to Killip's classification and their mental severities was investigated. Based on these studies, the authors described the way to manage AMI patients in a CCU, especially from a psychiatric point of view. 1) About 64% of all the patients showed some mental disorders, and many of them were in a state of anxiety or depression. In most of the cases their mental severities were considered to be mild or moderate. 2) We found some correlation between physical severities according to Killip's classification and mental severities (r = 0.3061, p less than 0.005). Many patients with grade I of Killip's classification showed a normal or mild severity, and many with grade II had a mild or moderate severity. About one half of the patients with grades III and IV showed moderate and severe severities, respectively. 3) About 26% of the subjects were in need of psychotropic medication. 4) About 10% of the subjects showed disorientation or cloudy consciousness. The mental severity of patients with an acute lidocaine intoxication was severe. These results showed that there was a significant correlation between physical severity according to Killip's classification and mental severity of AMI patients in the CCU. Patients whose physical severity was not so great showed comparatively mild mental disorders. As Killip's grade of physical severity progressed, mental disorder became more severe. PMID- 6854927 TI - Evaluation of cardiac rehabilitation in relation to prognosis. AB - We designed a rehabilitation program for patients with post-myocardial infarction by modifying the 14-step program of Emory University into a more suitable form for a Japanese. The usefulness of this rehabilitation program was evaluated by comparing the clinical course of our patients with that of the patients in our affiliated institutions, where patients had no systematic rehabilitation therapy. The following results were obtained: 1) Most patients of the rehabilitation completed group were living a non-restricted life 6 months after discharge. The life style of the rehabilitation group even including the rehabilitation-non completed group, was far better than that of the non-rehabilitation group. 2) Many patients of the rehabilitation group were working at the same job as before infarction 3 years after discharge, while a substantial number of the patients of the non-rehabilitation group had changed their job or retired within 3 years after discharge. 3) The reason for changing job or retiring was primarily subjective symptoms or objective findings in the rehabilitation-completed group, while it was mostly fear in the non-rehabilitation group. 4) Patients who could not complete our program were mainly old patients of over 70 years of age, patients with extensive anterior infarction and subendocardial infarction and ones with complications such as shock and cardiac failure. PMID- 6854928 TI - Semi-supervised exercise training program for patients with coronary heart disease--its effectiveness and possible diagnostic implications for predicting their severity. AB - Semi-supervised physical training for 12 weeks was performed on 60 patients with coronary heart disease including 48 patients with myocardial infarction and 12 with angina pectoris. The training program consisted of medically-supervised training at the institute once a week and unsupervised training at home at least twice a week with an intensity of 70 to 85% of the maximum heart rate which had been attained by a symptom-limited multiphasic treadmill stress testing according to Bruce's protocol. The results showed an average increase of maximum oxygen consumption from 27.0 +/- 5.7 to 31.0 +/- 7.8 ml/min X kg (p less than 0.01) and of treadmill time from 507 +/- 120 to 673 +/- 140 sec (p less than 0.0001). Cardiovascular responses reduced at a submaximal level of exercise and remained unchanged at the maximal level of exercise. No detrimental events were encountered during the program. The left heart catheterization and coronary angiogram were performed on 35 out of 60 patients. The trainability was higher in patients with single-vessel disease than in those with multi-vessel disease. Based on these results, supervised training should be required mostly for patients with low physical fitness, and patients with high physical fitness can probably improve their physical abilities by self-training at home following a proper exercise program. PMID- 6854929 TI - In-hospital rehabilitation at the recovery phase after acute myocardial infarction. AB - In order to investigate how rehabilitation during hospitalization influences the prognosis of patients with acute myocardial infarction, the authors investigated 496 cases, including 405 males and 91 females hospitalized in the institutes participating in the Cardiac Rehabilitation Research Conference, during the period of 10 years from 1969 through 1978. Patients' ages averaged 59.2 years for males and 66.5 years for females. The total number of deaths during the average follow-up period of 5 years and 7 months was 104 (21.0%), of which 73 cases of cardiac death were included, showing 14.7% of the total cases and 70.2% of the total deaths. The incidence of bed-ridden patients after discharge was as low as 1.0%, and the rate of returning to work varied according to age: it decreased from 86.7% to 9.3% with age, averaging 54.4%. The rate of rehabilitation performance in the hospitals was 73.7% for patients under 69 years of age and 48% for those under 70. The rate of cardiac death was 8.4% in the rehabilitated group (exercise group), and 27% in the non-rehabilitated (control) group, and the rates of returning to work were 50.2% and 25%, respectively, and there were significant differences in both the mortality rate and the working rate between these 2 groups (p less than 0.01). As for the severity of myocardial infarction, the more severe the disease, the wider the difference in the prognosis between the exercise and the control group. PMID- 6854930 TI - [Extreme hemodilution under simple hypothermia]. PMID- 6854931 TI - [Pain and noradrenaline concentration in cerebrospinal fluid]. PMID- 6854934 TI - [2 cases of mediastinal and subcutaneous emphysema as sudden complications of anesthesia]. PMID- 6854933 TI - [Case of unilateral pulmonary edema during thoracotomy]. PMID- 6854932 TI - [Influences of Fluosol-DA infusion on the complement activation and on the blood level of histamine in man]. PMID- 6854935 TI - [Respiratory depression after epidural morphine: two case reports]. PMID- 6854936 TI - [Marked resistance to pancuronium in severely burned patients]. PMID- 6854937 TI - [Clinical evaluation of antibiotics in gynecologic infections]. AB - The clinical effects of antibiotics (lincomycin, cefotaxime, ceftizoxime, piperacillin, fosfomycin, cefmenoxime, cefotetan, cefbuperazone, cefpiramide and ceftazidime) were evaluated in gynecologic infections. 1. A total of 161 patients with gynecologic infections was treated with each antibiotic and an overall response rate was 150/161 (93.2%). The efficacy rate was 72/78 (92.3%) in intrauterine infection, 29/31 (93.5%) in uterine adnexitis, 22/25 (88.0%) in intrapelvic infection and 27/27 (100%) in external genital infection. 2. Each antibiotic proved bacteriologically effective in 94.3% of the patients with simple intrauterine infection, in 84.0% of patients with mixed intrauterine infection, in 100% of 6 patients with uterine adnexitis, in 100% of 11 with intrapelvic infection and in 100% of 25 with external genital infection. There were 160 isolated organisms with clinical effective rate of 93.8%. Eleven (6.8%) of 161 patients had infections caused by anaerobic bacteria and all of them showed clinical response to therapy. PMID- 6854938 TI - [Study on the serum concentrations of gentamicin after intravenous drip infusion]. AB - Serum concentrations of gentamicin (GM) were monitored after intravenous drip infusion of 60 mg over 30 minutes, 1 hour and 2 hours. These concentrations were compared with those after intramuscular injection. The mean peak serum concentration obtained at 30 minutes after intramuscular injection (5.09 micrograms/ml) and those obtained at the end of intravenous drip infusion (5.17- 6.66 micrograms/ml) were comparable. Serum concentrations decreased to less than 2.0 micrograms/ml at 6 to 8 hours after injection or infusion in all cases except 1 with less body weight than others. Pharmacokinetic analysis showed that the T1/2 of GM ranged from 2.49 to 4.33 hours and that the AUC ranged from 19.66 to 27.09 hr X micrograms/ml. Results obtained in this study suggested that the usefulness of intravenous drip infusion over the time from 30 minutes to 2 hours is equal to that of intramuscular injection in the GM therapy. PMID- 6854940 TI - [Clinical study on long acting amoxicillin in urinary tract infection]. AB - Amoxicillin (AMPC), a widely used oral penicillin exhibites a strong bactericidal activity and a high level of safety. In the present study we administered L-AMPC, long acting AMPC granule, to 18 cases with urinary tract infections and obtained the following clinical results. 1. In all cases with acute simple cystitis, the effect was excellent. 2. Of 12 cases with chronic complicated UTI, the effect was excellent in 1 case, good in 4 cases and no effect was noted in 7 cases. The efficacy rate was 41.7%. 3. No side effects nor abnormal values in the laboratory examinations were noted. 4. Sixteen of 18 cases reported that this preparation was very agreeable to take compared with other powder type drugs, capsules and tablets. From these results we can confidently state that L-AMPC is a highly useful drug combining the excellent properties of AMPC, the convenience of b.i.d. dosage which improves patients compliance and satisfactory efficacy. PMID- 6854939 TI - [Clinical evaluation of high dose intravenous injection of fosfomycin on the severe infections associated with the treatment of haematological disorders]. AB - Fosfomycin (FOM) was administered intravenously to 65 cases of severe infections complicated with 62 cases of several haematological disorders. Out of 65 cases, 45 were treated with high doses FOM, i.e., 8 g per day or more. Another 20 cases were treated in usual doses of 4--6 g per day. Causative organisms were isolated from 52 cases of which 32 cases were Gram-negative bacilli and 19 cases were Gram positive cocci. The effective rate of FOM was 57.8% in the high-dose treatment group (26/45) and 45.0% in the usual-dose treatment group (9/20), but the significant difference was not defined. Among 32 cases with Gram-negative bacilli infections, including Pseudomonas aeruginosa or Serratia marcescens, 15 cases were effective (47%). On the contrary, 14 out of 19 cases with Gram-positive cocci infections were effective (74%). Thirteen cases (50.0%) were effective even in which neutrophils were less than 500/cmm before FOM administration. Severe side effects were not observed, without 2 cases. One was skin eruption due to drug allergy and the other was suspected to be interstitial pneumonitis, but not confirmed pathologically. These data suggest that high dose treatment of FOM were useful for the severe infections even in neutropenic state in haematological disorders. PMID- 6854942 TI - [Study on distribution to oral tissues of long acting amoxicillin]. AB - The distribution of L-AMPC, a newly developed long acting amoxicillin granules, was studied in oral tissues using New Zealand White rabbits. The antibiotic was dosed at 20 mg/kg and the tissue concentrations were measured in the tongue, gingiva, submaxillary gland, cervical lymph node and the parotid gland. Amoxicillin concentrations in liver and kidney were monitored for reference and urinary recovery was measured over 5 hours. All tissue concentrations were both high and persistent whereas amoxicillin concentrations in kidney and liver were high and low, respectively, the observation consistent with the published data for amoxicillin. PMID- 6854941 TI - [Clinical studies on long acting amoxicillin in the field of urology]. AB - Long acting amoxicillin (L-AMPC) was studied in the treatment of 40 patients with urinary tract infections. The dosage administered was 1,000 mg/day (b.i.d.) consecutively for 3 days in acute simple UTI and 5 days in chronic complicated UTI. Clinical efficacy was assessed according to the criteria established by the UTI Committee in Japan. Accordingly the response to therapy in 27 patients with acute simple cystitis was excellent in 17, moderate in 8 and poor in 2 cases and for chronic complicated UTI was excellent in 2, moderate in 3 and poor in 6 cases. Thus the overall clinical efficacy ratios for acute simple cystitis and chronic complicated UTI were 93% and 45% respectively. The bacteriological elimination ratios were 25 out of 27 of the causative organisms (93%) for acute simple cystitis and 6 out of 11 for chronic complicated UTI (55%). No side effects of significance were observed. The results obtained demonstrated the usefulness of the b.i.d. administration of L-AMPC and were considered, in the light of previous experience to be similar to those obtained with conventional amoxicillin dosage schedules. PMID- 6854943 TI - [Fundamental and clinical studies of long acting amoxicillin granules in oral and maxillofacial surgery infections]. AB - Long acting amoxicillin granules (L-AMPC), a newly developed presentation of amoxicillin (AMPC), maintains an effective blood level for an extended period. The following results were obtained from fundamental and clinical studies of L AMPC. Serum and gingiva levels of AMPC were measured in 5 patients at 2 (Patient 1), 3 (Patient 2), 4 (Patient 3), 5 (Patient 4) and 6 (Patient 5) hours. Serum levels were 4.1, 5.2, 3.0, 1.7 micrograms/ml and 1.2 micrograms/ml respectively, and gingiva levels were 1.3, 2.6, 2.1, 1.1 micrograms/g and 1.1 micrograms/g respectively. Twenty-five patients with oral and maxillofacial infections containing maxillary or mandibular osteitis were treated with L-AMPC. Clinical efficacy was assessed according to the criteria of numerical judgement established by the Japanese Society of Oral Surgery (1973) and also by the global evaluation of the clinician. In numerical judgement there were 1 excellent case, 19 good cases and 5 poor cases (efficacy ratio; 80%). The clinician's assessment was 4 excellent cases, 17 good cases, 3 fair cases and 1 poor case (84%). Although 2 slight side effects, diarrhea and black hairy tongue were observed, both treatments were completed without problem. L-AMPC therapy (b.i.d.) showed good prolonged tissue levels and satisfactory clinical results. PMID- 6854945 TI - [56th meeting of the Japanese Society for Bacteriology. Osaka, 5-7 April 1983. Symposia and abstracts]. PMID- 6854944 TI - [Studies on Clostridium difficile and antimicrobial associated diarrhea or colitis]. AB - Clostridium difficile has been implicated as the major cause of antimicrobial associated colitis or diarrhea. C. difficile was found in stools from 21 of 120 healthy subjects. C. difficile was found in stools from 8 of 9 patients with antimicrobial associated pseudomembranous colitis and in stools from 16 of 96 patients with antimicrobial associated diarrhea. The cytopathic toxin to HeLa cell neutralized by antitoxin to C. difficile was found in stools from all patients with antimicrobial associated colitis or diarrhea. Of 21 strains isolated in the stools from healthy subjects, 19 strains were toxigenic. Some of them were highly toxigenic strains. Such highly toxigenic strains, however, did not give rise to any clinical symptoms probably because of the limited number of this organisms in the normal flora of human intestines; the number of C. difficile ranged between less than 10 and 10(2) level per gram of stool when the organism was found. Of the 24 isolates from antimicrobial associated colitis or diarrheal patients, 4 were highly toxigenic. The susceptibilities of 65 isolates to various antimicrobial agents were determined by the agar dilution technique. All of the 65 strains were inhibited by low concentration of rifampicin, metronidazole, vancomycin, ampicillin and amoxicillin. The isolates were highly resistant to gentamicin, cefoxitin, cefotaxime and cefmenoxime. Wide variations in susceptibility of C. difficile strains to erythromycin, clindamycin and lincomycin were found. The studies have shown that subinhibitory concentrations of clindamycin, cephalothin and amoxicillin cause an increase in cytotoxin levels of C. difficile during broth culture. The increase in supernatant toxin levels occurs concomitant with a decrease in sonicated cell extract toxin levels. The data suggest that a number of factor can cause a release of toxin from C. difficile into the surrounding medium or the intestine. PMID- 6854946 TI - Coarctation of the aorta in early infancy. Left ventricular outflow tract obstruction and its clinical implications. AB - In order to clarify the clinical significance of left ventricular outflow tract obstruction, 11 infants with coarctation of the aorta and ventricular septal defect were subjected to cineangiography (or autopsy) analysis. Three infants without left ventricular outflow tract obstruction were salvaged by aortoplasty using a subclavian flap or a Dacron patch with concomitant pulmonary artery banding. The remaining 8 infants died surgically or nonsurgically, and were confirmed retrospectively to have had left ventricular outflow tract obstruction. It seems worthwhile to stress that the presence of an abnormal muscle bundle in the left ventricle can be demonstrated angiographically, especially by the axial technique. From our present study, though the number of cases examined is limited, we have an impression that left ventricular outflow tract obstruction may be a determining factor with regard to the appropriateness of pulmonary artery banding in the two-stage operation for infantile coarctation associated with a large ventricular septal defect. PMID- 6854947 TI - Beneficial effects of the coronary collateral circulation on tachycardia-induced myocardial ischemia during experimental coronary stenosis. AB - This study was designed to determine whether coronary collaterals have preventive effects on tachycardia-induced myocardial ischemia under partial restriction of proximal coronary artery inflow. Studies were carried out in dogs with developed coronary collaterals and control dogs. ST-elevation in epicardial and intramyocardial electrograms was used for assessing the degree of regional myocardial ischemia. In control dogs with coronary constriction (80% reduction of i.d.) pacing-induced tachycardia produced significant ST-elevation, 1.48 +/- 0.17 mV in the inner layer and 0.79 +/- 0.29 mV in the middle layer at a cardiac rate of 150/min, 3.58 +/- 0.38 mV in the inner layer, 2.73 +/- 0.38 mV in the middle layer, and 1.93 +/- 0.36 mV in the outer layer at a rate of 180/min. In dogs with moderate collaterals ST-segment elevation was only 1.41 +/- 0.18 mV in the inner layer and 0.96 +/- 0.24 mV in the middle layer at a rate of 180/min. In dogs with abundant collaterals there was no significant ST-elevation during tachycardia. These findings indicate that blood supply to the affected myocardium via developed collaterals is sufficient to meet graded increases in metabolic requirements under the condition of limited coronary flow reserve in an experimental model simulating angina pectoris. PMID- 6854948 TI - Effects of ergonovine-induced vasoconstriction on the genesis of myocardial ischemia during coronary stenosis in dogs. AB - We developed a canine model with coronary stenosis produced by intraluminal obstruction with a micro-balloon occluder to assess the role of vasomotor tone of a large coronary artery with a preexisting fixed stenosis in the genesis of myocardial ischemia. Hemodynamic and electrocardiographic responses to ergonovine, an agent capable of provoking coronary spasm, were evaluated. In the absence of coronary stenosis, intracoronary infusion of 4 micrograms/min ergonovine had no systemic and coronary hemodynamic effects. Similarly, with various degrees of external obstruction created by a screw-type metal constrictor, ergonovine had little hemodynamic effects. By contrast, with a stenosis greater than 28.4 +/- 5.0 mmHg in pressure gradient, created by intraluminal obstruction which preserved active arterial vasomotion, ergonovine induced vasoconstriction produced a marked decrease in coronary blood flow and distal coronary pressure, followed by ST-elevation. These deleterious effects of ergonovine on coronary hemodynamics were reversed completely by intracoronary infusion of nitroglycerin. Our results indicate that the effects of normal coronary arterial vasomotor activity on a stenosed vessel can cause myocardial ischemia. PMID- 6854949 TI - Effects of morphine and pethidine on coronary vascular resistance, blood pressure, and myocardial infarction-induced cardiac arrhythmias. AB - In the present study, the effects of morphine and pethidine on coronary vessel resistance (CPP), blood pressure (BP), and experimental myocardial infarction induced cardiac arrhythmia were investigated. Both morphine and pethidine induced a fall in CPP and BP and inhibited the cardiac arrhythmia. The morphine effects on CPP and BP were largely blocked by mepyramine. The effects of pethidine, on the other hand, were not blocked by mepyramine, propranolol, or atropine. An interesting dose dependent inhibition of cardiac arrhythmia was observed with pethidine. PMID- 6854950 TI - The relationship of aging to histological changes in the conduction system of the normal human heart. AB - The effect of aging on histological changes of the conduction system was studied by serially sectioning 55 autopsied hearts weighing less than 300 Gm. None of the hearts showed evidence of cardiovascular disease nor were there any abnormalities in the clinical findings and ECG taken during the last 3 months of life. A reduction in the number of muscle cells and an increase in the number of collagen fibers were apparent in hearts taken from patients over 70 years of age. These findings were most evident in the S-A node and less so in A-V node, bundle of His, and left and right bundle branches. Deposition of amyloid substances was not observed in any portion of the conduction system. PMID- 6854951 TI - Cardiac involvement in mucolipidosis. Importance of non-invasive studies for detection of cardiac abnormalities. AB - Although mucolipidosis, a fatal metabolic storage disorder, is associated with cardiovascular abnormalities, detailed, non-invasive cardiac examinations have not been well documented. We studied 4 children with type II and type III mucolipidosis, 3 of whom had unequivocal evidence of aortic regurgitation characterized by phonocardiography and M-mode echocardiography. Two-dimensional echocardiography showed an aortic valve prolapse in 3, a mitral valve prolapse in 2 and a tricuspid valve prolapse in 1. The QT interval was prolonged in 2 cases. In 1 autopsy case, we found considerably thickened and retracted aortic, mitral, and tricuspid valves, and accumulation of the foam cells in the myocardium. Echocardiography revealed similar findings in another 3 cases. We conclude that cardiac manifestations in this disorder should be examined carefully particularly by the use of echocardiography which is an excellent technique for detecting cardiovascular abnormalities in mucolipidosis. PMID- 6854952 TI - Exercise test in variant form of angina pectoris. Comparison of the results with spontaneous attacks. AB - Exercise tests were performed in 14 patients with untreated variant angina with frequent spontaneous attacks and in 15 patients after treatment abolished the attacks. (1) Anginal attacks associated with ST elevation were induced by exercise in 79% of untreated patients. By contrast, ST elevation was not observed in treated patients and ST depression was induced in 53% of the cases. (2) Exercise-induced ST elevation in untreated patients was shown in the same leads as the spontaneous attacks. (3) Exercise-induced ST elevation appeared initially during the recovery phase after exercise in 36% of untreated patients. Exercise induced ST depression appeared during or immediately after exercise. (4) The reproducibility of exercise-induced ST elevation was low with repeated tests at different stages, but exercise-induced ST depression was consistently observed. (5) The exercise-induced ST depression and lack of ST changes in treated patients were highly suggestive of the presence and absence of organic coronary artery disease, respectively. However, the exercise-induced ST elevation in untreated patients did not differentiate between the presence or absence of organic stenosis of the coronary arteries. The results of exercise tests vary with the stage of variant angina. It is suggested that a coronary arterial spasm is a trigger mechanism for exercise-induced angina in cases of variant angina with frequent spontaneous attacks. PMID- 6854953 TI - The relationship of transmembrane potential to surface morphology of human atrial muscle and cardiac hemodynamics. AB - A correlative study of transmembrane potential characteristics, surface morphological features of human atrial muscle, and cardiac hemodynamics was carried out in 41 patients, who were divided into 2 groups based on the level of the mean maximum diastolic potentials (MDP). Group A consisted of 19 patients with MDP values ranging from -60.0 to -82.0 mV (mean +/- S.D. = -65.70 +/- 6.63 mV). Group B included 22 patients who had abnormally low MDP (range -36.0- -58.5 mV, mean +/- S.D. = -48.14 +/- 6.72 mV). The differences in electrophysiological data were statistically significant. However, there were no significant differences in the hemodynamic data between the 2 groups. Furthermore, there was poor correlation between the electrophysiological and hemodynamic data in both groups. In group A, scanning and transmission electron microscopy revealed either no changes or only mild alterations in the surface morphology of the atrial myocardium. Various degrees of surface morphological changes, including a focal loss of the endothelium which was always associated with endocardial fibrosis, irregular thickening and lamination of the glycocalyx, disruption of the sarcolemma and complete destruction of the surface membrane structures were more often observed in group B. These results provide valuable evidence that sarcolemmal changes may underlie the electrophysiological alterations in diseased human atria. We suggest that the principal pathogenetic mechanisms leading to the transmembrane potential changes are the altered surface morphology of atrial myocardial cells, resulting from underlying disease processes. PMID- 6854954 TI - A study of the diastolic flow velocity profile of the clinically uncomplicated mitral porcine bioprosthesis using an echo-Doppler technique. AB - Pulsed Doppler echocardiography was performed in 17 subjects who had clinically uncomplicated porcine bioprosthesis in the mitral position. A positive initial diastolic flow wave was present in all patients; end-diastolic A waves were seen in the sinus rhythm of every patient. The peak of the diastolic wave was delayed when compared with the normals in our laboratory. This wave had clearly demarcated ascending, mid- and descending segments. When contrasted with normal subjects, the slope of the diastolic wave was mildly reduced in all patients. Fine to coarse indentations on the descending and mid-segments were seen in 15/17 (88%) of the patients. We conclude that the diastolic flow profile of the clinically uncomplicated mitral bioprosthesis resembles mild mitral stenosis. Reduced orifice size and/or the physical properties of the bioprosthesis are the likely mechanisms for these alterations. PMID- 6854955 TI - Echocardiography in pulmonary embolism. AB - Echocardiography was performed on 10 patients with suspected acute pulmonary embolism. In 3 patients with normal echocardiograms, the diagnosis was excluded by pulmonary angiography. Two with small emboli on angiography had a pulmonary arterial pressure less than or equal to 35 mmHg and normal echocardiograms. Five had an increased right ventricular end-diastolic dimension (RV-EDD) and 4 had a left ventricular end-diastolic dimension (LV-EDD) below normal or in low normal levels. The RVEDD/LVEDD ratio was increased in 4 patients, 3 of whom had paradoxical interventricular septal motion. The mitral valve E-F slope and left atrial dimension changed variably. The posterior aortic wall O-V excursion (PAW OV-Ex) decreased in 5 and was correlated with LVEDD (r = +0.92, p less than 0.01) and the RVEDD/LVEDD ratio (r = -0.87, p less than 0.025). Follow-up echocardiography in 3 cases after recovery showed a decreased RVEDD/LVEDD ratio, normal septal motion and improved LVEDD and PAW-OV-Ex. The PAW-OV-Ex seems to mirror the abnormalities in volume changes of the left side of the heart resulting from pulmonary embolism. An entirely normal echocardiogram would be unlikely in the presence of a hemodynamically significant pulmonary embolism. PMID- 6854956 TI - Decrease of urinary taurine in essential hypertension. AB - In order to evaluate how taurine relates to the pathogenesis of essential hypertension, the taurine content of plasma, whole blood and urine was measured in 18 normals and in 79 hypertensive patients. The patients included 32 untreated cases of essential hypertension, 32 treated cases and 15 cases with labile hypertension. There were no statistically significant differences between normals and essential hypertensives in either plasma or whole blood taurine content. However, in comparison to urinary taurine excretion in normals, 1594.0 +/- 143.7 mumol/day (mean +/- SE), that for untreated essential hypertensives, 708.1 +/- 57.1 mumol/day (p less than 0.001), and for treated essential hypertensives, 953.6 +/- 94.3 mumol/day (p less than 0.001), were significantly lower. Those with labile hypertension showed almost the same value, 1478.3 +/- 134.3 mumol/day, as normals. Taurine clearance and the taurine/creatinine ratio were also markedly decreased in essential hypertensives without treatment. For all subjects, taurine clearance had a positive correlation (r = 0.327, p less than 0.01) with creatinine clearance, but there were significant negative correlations between systolic blood pressure and daily urinary taurine excretion (r = -0.472, p less than 0.01) and between diastolic blood pressure and daily urinary taurine excretion (r = -0.382, p less than 0.01). There were also significant positive correlations between daily urinary taurine excretion and serum high-density lipoprotein cholesterol (r = 0.559, p less than 0.01) and between the former and cardiac index (r = 0.547, p less than 0.01). These results suggest that a deficiency of taurine plays an important role not only in elevating blood pressure in essential hypertension but also in atherogenesis as well. PMID- 6854957 TI - Role of exercise echocardiography as a predictor of coronary artery disease. Detection of exercise-induced asynergy by M-mode echocardiography. AB - Left ventricular asynergy has been shown to occur commonly in patients with coronary artery disease (CAD) and to be induced or exaggerated by exercise. The purpose of this study is to report on a method to detect asynergy and estimate its severity by M-mode echocardiographic analysis of left ventricular wall motion at rest and during supine ergometric exercise. Sixteen patients with CAD underwent graded supine ergometric exercise until anginal pain occurred or apparent ischemic changes were noted on ECG. This study was done using the following criteria: 1) Asynergy at rest was defined as occurring when the amplitudes of the interventricular septum and/or the posterior left ventricular wall were below normal values at rest. 2) Asynergy during exercise was defined as occurring when one or both of the two amplitudes were more than 2 mm below the values at rest (severe) or were unchanged in spite of sufficient exercise load (mild). The results were as follows: 1) In the normal subjects, the septal and posterior wall amplitudes increased during exercise (ranging from 7 mm to 9 mm for the septum, and from 13 mm to 16 for the posterior wall). In patients with CAD, asynergy at rest was demonstrated in only 3 cases (19%), whereas septal and/or posterior wall asynergy during exercise was noted in 75% of cases. 2) The location of exercise-induced asynergy detected by echocardiography showed a good correlation with that of coronary artery lesions (greater than or equal to 75% stenosis) recognized by angiography. 3) Significant differences were observed between changes in left ventricular dimensions in patients with CAD and those of normals during exercise. In the normal subjects, left ventricular end-systolic dimension (ESD) decreased without significant change in end-diastolic dimension (EDD) during exercise. On the other hand, both ESD and EDD increased during exercise in patients with CAD. Although echocardiographic analysis of left ventricular wall motion during exercise has some limitations, this study suggests that asynergy induced or exaggerated by ergometric exercise can be successfully detected by M-mode echocardiography. PMID- 6854958 TI - Pulsed Doppler echocardiographic evaluation of the shunt flow in ventricular septal defect. PMID- 6854959 TI - Effect of mental stress on R wave amplitude of the electrocardiogram in young healthy male subjects. AB - The electrocardiographic effects of mental arithmetic stress were studied in 19 young, healthy male subjects. Blood pressure was measured by the cuff method before and during mental stress and electrocardiogram (V5) was monitored and recorded continuously throughout the study using a computerized ECG monitoring system. Heart rate increased from 65.8 +/- 7.0 (mean +/- standard deviation) to 76.7 +/- 9.9 beats/min (p less than 0.001). Systolic blood pressure rose from 122.7 +/- 9.6 to 129.1 +/- 11.7 mmHg (p less than 0.05), diastolic blood pressure from 76.2 +/- 8.8 to 83.0 +/0 11.0 mmHg (p less than 0.001), and mean blood pressure from 91.7 +/- 7.9 to 98.5 +/- 10.1 mmHg (p less than 0.001). These changes were all statistically significant. R wave amplitude decreased significantly from 18.6 +/- 6.9 to 17.0 +/- 6.5 mm for the group (p less than 0.001). No changes in the ST segment were observed; ST depression decreased from 0.56 +/- 0.47 to 0.54 +/- 0.43 mm (N.S.) and ST slope from 0.87 +/- 0.59 to 0.77 +/- 0.63 mm/sec (N.S.). Thus it is apparent that mental stress reduced R wave amplitude without causing ST segment changes in young, healthy subjects. The mechanism and clinical implications are discussed. PMID- 6854960 TI - Changes in erythrocyte potassium concentration in Goldblatt hypertension of the rabbit. AB - Changes in potassium (K) concentration in erythrocytes (RBC) were investigated during the early developing stage (1 and 2 weeks after) and the chronic established stage (12 to 16 weeks after the renal artery constriction) in two kidney (group 2H) and one-kidney Goldblatt hypertension (group 1H) of the rabbit. In both group 2H and group 1H, blood pressure was already elevated significantly during week 1, and reached a level about 70 mmHg higher than the pre-constriction level at the chronic stage. It did not change in the control group (group C). During week 2, the change in RBC K concentration showed a significant negative correlation with the change in blood pressure In group 2H (r = -0.529, n = 26, p less than 0.01). During the chronic stage, the RBC K concentration was lower in group 2H (103.5 +/- 1.7 mEq/1 RBC, n = 10, p less than 0.01 compared with group C) and in group 1H (102.1 +/- 1.6, n = 7, p less than 0.001) than in group C (111.6 +/- 2.2, n = 9). The change in this parameter from the pre-constriction value was -11.9 +/- 2.1 mEq/1 RBC (p less than 0.001) in group 2H, -13.0 +/- 1.8 (p less than 0.001) in group 1H, and -2.4 +/- 2.6 (not significant) in group C. The results suggest that the intracellular electrolyte metabolism is altered in both types of chronic Goldblatt hypertension. PMID- 6854961 TI - Angiotensin II-induced myocardial damage with a special reference to low cardiac output syndrome. AB - The effects of large doses of angiotensin II on the rabbit kidney and heart and or the ability of perfused canine kidney to inactivate angiotensin II were examined to clarify the role of angiotensin II in the low cardiac output syndrome after open-heart surgery. Intravenous infusion of angiotensin II at a rate of 1.1 to 1.4 microgram/Kg/min for 48 hours caused multifocal myocardial necrosis and renal mononuclear cell infiltration and necrosis. Isolated canine kidney preparations inactivated 76% of angiotensin I and 79% of angiotensin II. The results indicates that the kidney can inactivate angiotensin and that high doses of angiotensin II can produce myocardial and renal lesions. It is suggested that an increased concentration of angiotensin II may result in the low cardiac output syndrome through myocardial damage, and that decreased inactivation of angiotensin II by the kidney accelerates the myocardial damage. PMID- 6854962 TI - Ischemia-reperfusion induced elevation of diastolic tension in the isolated guinea pig heart and the effects of calcium antagonists. AB - Characteristics of the temporal elevation of diastolic tension, produced by ischemia-reperfusion in isolated and paced Langendorff's hearts of guinea pigs, were studied. The elevation of diastolic tension corresponded with an elevation of left ventricular end diastolic pressure after a short ischemic period in the isovolumic heart. These phenomena were thought to be a result of incomplete relaxation. The degree of the elevation of diastolic tension depended upon the duration of ischemic period (3-10 min). This elevation was reproducible in one preparation; nearly the same changes were obtained in a second trial after 35 min of reperfusion when the ischemic period was within 5 min. An increment in the pacing rate to 150% of the first trial value doubled the elevation of diastolic tension by the second 5 min ischemia. Inhibition of glycolytic flux by iode acetic acid augmented the elevation after 3 min of ischemia. In addition, 5 min of ischemia with iode acetic acid caused contracture and recovery was slight. On the other hand, either lowering the Ca2+ concentration in the perfusing solution to a half the normal value, or treatment with Ca2+ antagonists (such as diltiazem), reduced the elevation of diastolic tension significantly. Diltiazem also suppressed the increment in elevation produced by a high pacing rate. It can be concluded that the temporal elevation of diastolic tension during reperfusion reflects the ischemic failure of the heart. This change is presumably due to intracellular Ca2+ overload or accumulation. In addition, since ischemic changes were reproducible in this preparation, it is a useful model for estimating the effects of drugs on the ischemic heart. PMID- 6854963 TI - Right ventricular massive calcification associated with pulmonic stenosis and incompetence. PMID- 6854964 TI - Two cases of myocardial infarction with coronary arteriovenous fistula. AB - Myocardial infarction in the presence of coronary arteriovenous fistula (CAVF) has rarely been reported. Two young male patients with dual abnormalities, an organic stenosis and a CAVF in the left anterior descending artery, were reported. Each fistula originated closely proximal to the stenotic lesion and drained into the main pulmonary artery. It was thought that the coronary steal phenomenon through the fistula further reduced the coronary blood flow distal to the stenosis. Thus, both the stenotic lesion and the fistula possibly contributed to the occurrence of the myocardial infarction. Since angiographic details of myocardial infarction with CAVF have rarely been reported these findings may be important in clarifying the mechanism of myocardial infarction with CAVF. PMID- 6854965 TI - [Efficacy of chemo-endocrine therapy for recurrent breast cancer]. AB - Recurrent breast cancer can now be treated more effectively with endocrine therapy, combined with chemotherapy. Between April 1977 and March 1982, 127 breast cancer operations were performed at Kumamoto Municipal Hospital; recurrence was found in 13 cases (approx. 10%). Treatment of 7 of these cases with endocrine therapy (mainly Nolvadex, anti-estrogen) combined with chemotherapy resulted in 6 cases showing either complete response (CR) or partial response (PR). The efficacy of chemo-endocrine therapy was obvious when compared with cases without therapy. Further studies on hormone receptors and the establishment of guidelines for chemo-endocrine therapy as post-operative adjuvant therapy are justified. PMID- 6854966 TI - [Clinical use of the serum level of immuno-suppressive acidic protein (IAP) in gastroenterological surgery]. AB - Between September, 1981 and August, 1982, the IAP serum levels were measured in 151 patients to evaluate the correlation between these levels and the clinical spectrum. Pre- and postoperative IAP levels were also compared with the hospital course. Abnormally high IAP levels (greater than 450 micrograms/ml) were observed in malignant diseases, especially in patients with cancer of the pancreas, choledochus, gall-bladder, and esophagus. Of 193 patients, 81 revealed abnormal levels; 28 of these (34.6%) died during this study. The average of their survival time was 2.7 months. Nine of 81 patients (11.1%) experienced severe complications, but recovered. On the other hand, 112 patients with normal IAP levels had a relatively good hospital course; 9 (8%) died. None of the 112 patients experienced any complications. These results suggest that the IAP level may be a good tool in predicting clinical features and prognoses. PMID- 6854967 TI - [Report on 15 cases of multiple primary cancers in our department]. AB - Of 512 gynecological malignant cases treated in our department, 22 were suspected of multiple primary cancer; 15 were confirmed by clinical and pathological findings, representing an incidence of 2.9% (15/512) of all malignant cases. The most frequent sites of other cancers in patients with cervical cancer were intestinal (5/15), mammary (3/15) and urinary (2/15). Nine (60%) of 15 multiple primary cancers were noted within 12 months. Two rare combinations are also reported. There was a patient with Grawitz's tumor (kidney) and epidermoid cancer (uterine cervix) and one with leiomyosarcoma (uterine corpus) and epidermoid cancer (uterine cervix). PMID- 6854968 TI - [Clinical evaluation of serum CEA levels in uterine cervix cancer]. AB - Serum CEA levels were measured in the blood of 98 patients with uterine cervix cancer before, during, and after treatment to investigate the relationship among the CEA level, the extent of the disease, and recovery. The CEA level rose as the disease progressed. Although there was no significant difference in the survival rates of patients with various CEA levels, those who returned to normal levels after treatment recuperated better. There was not clear evidence that CEA levels are clinically significant. However, it can be concluded that CEA levels at pre- and post-treatment times are helpful in the early detection of disease, prognosis, and in predicting recurrence or metastasis. PMID- 6854969 TI - [A case of malignant reticulosis with pericardial effusion and central nervous system involvement]. AB - A 64-year-old man was admitted with complaints of lethargy, malaise, weight loss and transient left-hemiplegia and aphasia. Initial physical and laboratory findings showed splenomegaly and pericardial effusion. During his hospital stay, his mental status deteriorated progressively. The characteristic pathology of malignant reticulosis was noted at autopsy. Microscopic examination of the brain demonstrated accumulations of malignant histiocytic cells confined within small vessels and subsequent multiple hemorrhages and necroses in the gray matter. Malignant reticulosis with antemortem manifestations of pericardial effusion and central nervous system involvement is rare. PMID- 6854970 TI - [A case of solitary myeloma (BJ-lambda) showing marked morphological changes]. AB - The case report here was documented clinically, cytologically and histologically over a period of 5 years. A 49-year-old man was admitted to our hospital in September, 1975 because of a painful lump over the sternum and a diagnosis of solitary well-differentiated plasmocytoma (BJ-lambda) was made. The tumor promptly subsided following chemotherapy. In July, 1980 as it had in June, 1979, the sternal tumor relapsed; morphologically it was a poorly differentiated plasmocytoma. It promptly subsided following the start of chemotherapy and/or radiation therapy. In February, 1981, an abdominal tumor and ascites developed, morphologically it was plasma cell sarcoma composed of giant and bizarre tumor cells of plasma cell origin as demonstrated by immunoelectron microscopy. In April, 1981, the patient died of cachexia. At autopsy, multiple tumor formations consisting of giant and bizarre myeloma cells were found in the abdominal cavity, liver, retroperitoneum, diaphragm, left adrenal gland, mediastinum and lymph nodes. There was no infiltration of myeloma cells into bones other than the sternum. PMID- 6854971 TI - [A case of metastasis of rectal cancer to the thyroid gland]. AB - A 34-year-old male who showed a rectal mass upon irrigoradioscopy was admitted on October 6, 1979. Abdominoperineal amputation of the rectum was performed on October 11. Histopathological examination revealed that the tumor was adenocarcinoma of the well differentiated type, s, n0., stage II. The patient received chemotherapy and immunotherapy for 10 months postoperatively. In September 1981, enlargement of the thyroid gland associated with pain was noted and on January 12, 1982 total thyroidectomy was performed. Histologically, a diagnosis of well-differentiated adenocarcinoma, which was a metastasis from the rectal cancer, was made. On August 15, 1982, the patient died of generalized metastases. PMID- 6854972 TI - [Glucagon-producing carcinoid of the rectum--report of a case]. AB - A 22-year-old male who had been receiving insulin therapy to treat uncontrollable hyperglycemia, was diagnosed to have a carcinoid in the lower rectum. The excised tumor was 1.5 cm in diameter, and showed a yellowish-white cut surface. It did not invade into the proper muscle. Numerous glucagon immunoreactive cells were found. The tumor cells contained many rounded neurosecretory granules. After tumor excision, the patient's hyperglycemia did not return in the absence of insulin administration. We suggest that the tumor may have secreted glucagon which may have acted as an antagonist against insulin in the circulation. PMID- 6854973 TI - [Case report of large endometrial stromal sarcoma]. AB - A 56-year-old-married woman, gravida 3, para 2, was admitted with chief complaints of atypical genital bleeding, large abdominal and genital tumors, dysuria and abdominal pain. All laboratory examinations were noncontributory. Abdominal total hysterectomy with bilateral salpingo-oophorectomy was performed. The tumor measured 30 X 11 X 8 cm and weighed 1,600 g. It showed polypoid growth and most of the tumor was necrotic. The tumor cells resembled endometrial cells and 20 mitotic figures per 10 high-power fields were noted. Ten months postoperatively, the patient was in good condition with use of PSK. PMID- 6854974 TI - [Classification of pneumonia]. PMID- 6854975 TI - [Radiographic imaging of pneumonia (with special reference to x-ray diagnosis)]. PMID- 6854976 TI - [Pathological diagnosis by biopsy]. PMID- 6854977 TI - [Abnormal respiratory functions in pneumonia]. PMID- 6854978 TI - [Development of pneumonia and the immunological background--with special reference to opportunistic infection]. PMID- 6854980 TI - [Diagnosis and therapy of pulmonary tuberculosis (including atypical mycobacterial infections)]. PMID- 6854981 TI - [Pneumonia caused by gram-negative rods]. PMID- 6854979 TI - [Idiopathic interstitial pneumonia (including lymphatic interstitial pneumonia)]. PMID- 6854982 TI - [Respiratory tract infections by anaerobic bacteria]. PMID- 6854983 TI - [Chlamydia pneumonia]. PMID- 6854984 TI - [Fungal infections]. PMID- 6854985 TI - [Allergic lung diseases--classification]. PMID- 6854986 TI - [Simple and prolonged pulmonary eosinophilia]. PMID- 6854987 TI - [Asthmatic pulmonary eosinophilia]. PMID- 6854988 TI - [Tropical eosinophilia]. PMID- 6854989 TI - [Allergic bronchitis--relationship between asthmatic bronchitis and bronchial asthma]. PMID- 6854990 TI - [Hemorrhagic pneumonia]. PMID- 6854991 TI - [Therapeutic plasma exchange]. PMID- 6854992 TI - [Pulmonary vascular lesions in transposition of great vessels--evaluation of the lesions and their pathogenesis]. PMID- 6854993 TI - [Measurement of HDL subfractions and its clinical significance]. PMID- 6854995 TI - [Evaluation indicator for the protein fractionation assay]. PMID- 6854994 TI - [Oral fat tolerance test to lipoproteins]. PMID- 6854996 TI - [Iso-electric focusing method for the analysis of apolipoprotein E in very-low density lipoprotein]. PMID- 6854997 TI - [Study on the determination of urinary proteins--discrepancy between sulfosalicylic acid method and coomassie brilliant blue G-250 method]. PMID- 6854999 TI - [Study on normal range of pulmonary function tests]. PMID- 6854998 TI - [Fundamental studies on the measurement of urinary NAG and determination of the normal values for NAG activity in various age groups]. PMID- 6855000 TI - [Transcutaneous Po2 monitoring in exercise test]. PMID- 6855002 TI - [Proceedings of the fifty--third annual meeting of the Japanese Society for Hygiene. April 5-7, 1983, Osaka, Japan. Symposia and abstracts]. PMID- 6855001 TI - [Evaluation of prothrombin time and thrombotest and hepaplastin test for the control of oral anticoagulant therapy]. PMID- 6855003 TI - Ocular candidiasis without other organ involvement: report of an autopsy case. AB - This paper reports the occurrence of candidal chorioretinitis in a 78-year-old male patient with malignant lymphoma. Macroscopically there were multiple lesions observed in the posterior pole of the left fundus. A main lesion, white, elevated and associating with hemorrhage, was present laterally to the macula and small, white satellite lesions were found scattered. Histopathologically the lesions showed typical features of candidiasis including suppurative and granulomatous chorioretinitis. It seems this is only the second reported case of ocular candidiasis without other organ involvement in the literature. It was suggested that candidal infection possibly occurred only in the eye. PMID- 6855004 TI - Aminoadipic acid toxic effects on retinal glial cells. AB - The toxic effects of DL-alpha-aminoadipic acid on retinal glial cells were examined histologically following intravitreal injection to rats or rabbits. There was a marked swelling Muller cells, astrocytes and oligodendrocytes, but no changes in the microglia. Injections of a low concentration of the solution (0.1 mg in 0.01 ml) produced no irreversible damage to the Muller cells. With high concentrations (1 mg in 0.01 ml), there was a necrosis of Muller cells followed by thinning of the retina and disruption of the outer limiting membrane, PMID- 6855006 TI - Electron microscopic study of uveal circulatory disturbance in experimental diabetic rats--intraluminal changes of uveal vessels. AB - Intraluminal changes of uveal vessels in streptozotocin--diabetic rats, maintained for 1-12 months, were studied electron microscopically. In diabetic rats maintained for 10-12 months, microthrombus formation was observed in the various sized choroidal, ciliary and iridial vessels. The microthrombi were mainly composed of fibrin strands and platelets and there was no definite evidence of detachment or loss of endothelial cells. This microthrombus formation may play an important role in the development of diabetic uveal circulatory disturbance. PMID- 6855007 TI - Origin of macrophage in photocoagulated rabbit retina. AB - To identify the hematogenous origin of macrophages in the photocoagulated retina, a technique of labeling blood monocytes with colloidal carbon prior to the coagulation was used. Colloidal carbon was given intravenously to adult pigmented rabbits twice daily for 5 days, and 3 days after the last injection xenon flash photocoagulation was performed on the retina. The circulating blood cells and the coagulated portions of the retina and choroid were then examined using electron microscopy. At the time of photocoagulation, circulating blood monocytes contained several clusters of carbon granules in the cytoplasm. Two days after coagulation, monocytes with carbon granules were observed to penetrate the Bruch's membrane. In the coagulated retina, macrophages with carbon granules were observed, while retinal pigment epithelial cells contained no carbon granules. Two months after coagulation, macrophages with carbon granules remained in the retina, and a few proliferated pigment epithelial cells contained carbon granules in the cytoplasm. These carbon granules were considered to be derived from degenerated macrophages. These results indicate that hematogenous monocytes invade the retina from the choroid through the Bruch's membrane and are transformed into macrophages, some of which degenerate in the retina and are phagocytized by pigment epithelial cells. PMID- 6855005 TI - Localization fo 3H-glucosamine and 35S-sulfate in the hamster retina--light and electron microscopic autoradiography. AB - The localization of 3H-glucosamine and 35S-sulfate in the hamster retina was studied by light and electron microscopic autoradiography. Exposed silver grains were concentrated in the nerve fiber, inner plexiform, outer plexiform and inner segment layers. The heaviest labeling was observed over the inner segment layer in the glucosamine experiment and over the nerve fiber layers in the sulfate experiment. Specimens from 12- and 16-day-old hamsters showed slightly heavier labeling than did those from adult animals. In the electron microscopic autoradiography using 3H-glucosamine, grains were initially associated with the retinal pigment epithelium, the inner segment and the Muller cell and were subsequently displaced into the spaces between the retinal pigment epithelium and the other segment and into the nerve fiber layers. The labelled sulfates in the electron microscopic autoradiography were seen in the nerve fiber, plexiform and photoreceptor layers. These data indicate that glycosaminoglycans may be synthesized in the retinal pigment epithelium, the inner segment and the Muller cell. PMID- 6855009 TI - Morphological study of age-related changes in mouse lens. AB - Age-related changes in the lenses of ddy strain mice, ranging from 4 to 24 months old, were studied histologically. The early change of aging lens was noted as a slight extension of fiber cells into the posterior capsule in the area behind the nuclear bow around 6 months of age. Those cell extensions formed villous projections reaching up to one half of the total capsule by 18 months of age. Another notable change was a decreasing cell population of the lens epithelium and the appearance of their nuclear inclusions. The latter contained rough endoplasmic reticulum, free ribosomes and filamentous matrix at the early stage and a mass of filamentous material at the later stage. This change was initiated by 12 months of age, and became profound with the increase of age. Moreover, the bow nuclei became markedly displaced posteriorly after 14 months of age. At about 18 months of age, when the pathological changes in both epithelial and bow regions became severe, the superficial cells in the posterior cortex showed swelling and atrophy, which soon led to the lens opacity due to accumulation of cell debris and fluid. These histopathological changes associated with aging appear to correspond to the incipient form of posterior subcapsular cataract which is detectable by clinical examinations. PMID- 6855008 TI - Experimental macular edema of commotio retinae: preliminary report. AB - Experimental macular edema of commotio retinae was studied in rhesus monkeys. Clinically, opacification of the retina in these experimental animals closely resembled commotio retinae of man. No pigment epithelial damage was detected by ophthalmoscopy and fluorescein angiography showed no leakage from the retinal and choroidal circulations in the macular region. Histologically, macular swelling was apparent and was due primarily to changes of the outer plexiform layer. In this layer, swelling of the axons of the photoreceptor cells was prominent. Intracellular edema was also detected in the Muller cell processes in the inner retina and in the pigment epithelial cells. Prominent changes also occurred in the inner and outer segments of the photoreceptor cells. Disruption of the blood retinal barrier was not found using horseradish peroxidase as a tracer. We concluded that retinal opacification was due to disagreement and intracellular edema of the cellular elements of the retina, perhaps a direct result of movement of intracellular fluid in response to mechanical injury. PMID- 6855010 TI - Prognosis of pregnancy in patients with toxoplasmic retinochoroiditis. AB - From the study of 18 pregnancies in 10 patients with toxoplasmic retinochoroiditis, it was concluded that the most important factor to be considered in advising pregnant patients with this disease is whether or not the antibody titer increases during pregnancy rather than the clinical pictures or the absolute values of antibody titer. Periodical titration of the antitoxoplasma antibody during pregnancy was recommended as a preventive measure against congenital toxoplasmosis. Pregnancy may be continued if antibody titer does not increase during pregnancy, and it may be interrupted if the antibody titer increases. PMID- 6855011 TI - Malignant tumor of the eyelid--clinical survey during 22-year period. AB - A total of 52 malignant tumors of the eyelid treated at Kyushu University Hospital during the 22-year period from 1960 through 1981 were analyzed. The peak incidence in this series was in patients 70-79 years of age. There were 26 each of men and women. Squamous cell carcinoma was the lesion most frequently seen, i.e. in 25 cases (48.1%). Basal cell carcinomas were detected in 17, sebaceous adenocarcinomas in 7 malignant melanomas in 2 and malignant lymphoma in 1. In 13 cases, there were squamous cell carcinomas in the upper eyelid, 10 with basal cell carcinomas in the lower eyelid, and all with sebaceous adenocarcinomas in the upper eyelid. Follow-up information was obtained on 42 of the 52 cases. Twenty-four out of these 42 patients were living and 18 had died. There were two recurrences of squamous cell carcinomas and two of basal cell carcinomas. In two, there was a metastasis to the lung and in one the regional lymph nodes were involved. Thus, squamous cell carcinoma was the most frequently encountered malignant tumor of the eyelid seen in this series. We wish to stress the importance of examining specimens histologically, to ensure a rapid diagnosis and pertinent treatment. PMID- 6855012 TI - Macular involvement in morning glory syndrome. AB - Clinical features of morning glory syndrome were studied in 8 eyes of 7 patients. The cases were divided into two groups according to the size of the elevated peripapillary white ring. The size of the ring was expressed as an average disk diameter of normal control eyes. In 2 eyes of Group I with the ring less than 2.0 disk diameters, white tissue on the disk was less pronounced than in Group II, and vascular pattern in the posterior retina was almost normal. The macular ring reflex was present. In 6 eyes of Group II with the ring exceeding 2.0 disk diameters, white tissue on the disk was more marked than in Group I, and retinal vessels were narrow and extended straight toward the midperiphery. the macula was not formed, but a yellowish retinal area was observed on the center or temporal part of the elevated peripapillary white ring. It was concluded that in morning glory syndrome the macula may often by involved when anomaly of the optic disk is remarkable. PMID- 6855013 TI - D-scan ultrasonography of orbital lesion. AB - Ultrasonography has evolved recently into a valuable technique for examining intraocular and orbital lesions. However, ultrasound examinations usually have been performed using A- and B-scan. We report D-scan ultrasonography or orbital lesions that include orbital tumors, endocrine exophthalmos, vascular lesions and inflammatory changes. D-scan ultrasonography is a useful diagnostic method because of the three-dimensional presentation. It serves to pinpoint not only the location of the orbital lesion but also internal reflectivity showing tissue characterization. PMID- 6855014 TI - Early signs of diabetic retinopathy by fluorescein angiography. AB - The initial sign of diabetic retinopathy is considered to be microaneurysm, determined by ophthalmoscopy. To elucidate early vascular changes in diabetes, fluorescein angiography was performed in 272 eyes of 166 patients who had shown no evidence of diabetic retinopathy by ophthalmoscopy. Early retinal vascular changes shown by fluorescein angiography were seen in 181 eyes (66.5%) out of 272 eyes. These angiographic findings embraced dye leakage, dilatation of capillaries, filling defect of capillaries, microaneurysm-like spot dilatation and microaneurysm. Statistical analysis and follow-up studies for 1 to 5 years revealed that, with progression of the disease, the angiographic changes progressed in the following order: dye leakage, dilatation of capillaries, filling defect of capillaries, microaneurysm-like spot dilatation and microaneurysm. PMID- 6855015 TI - Electron microscopic studies of pipestem sheathed vessel in human retina. AB - Histopathology of a clinically observed pipestem sheathed vessel in the retina was studied by electron microscopy. This vessel was characterized by a marked increase and disarrangement of collagen fibrils in the media and adventitia, and invasion of the cytoplasmic processes of Muller cells into the adventitia. The lumen of the vessel was extremely narrow but was preserved with healthy endothelial cells. It is suggested that increased and disarranged collagen fibrils in the vessel wall is related mainly to the ophthalmoscopic appearance of the pipestem sheathing. The infiltration of glial cells in the vessel wall may be of less significance to the pipestem sheathing. PMID- 6855016 TI - Empty sella syndrome with visual field disturbance. AB - Three patients with empty sella syndrome with various visual field disturbances were reported. In one patient there was evidence of enlargement of Mariotte spots, and in the others, irregular visual field defects. These three patients were initially suspected to have intraocular tumors because of the balloonings of the sella and visual field disturbances. However, the diagnosis of empty sella was confirmed by metrizamide cisternography and metrizamide computed tomography(CT). The results indicate that the patient with enlargement of the sella on the plain skull X-ray and visual field disturbance should be examined by metrizamide cisternography and metrizamide CT scan to differentiate from the intrasellar tumor. PMID- 6855017 TI - Diabetic retinopathy and hemoglobin A1. AB - A prospective study was conducted in 36 diabetic patients to correlate the fasting blood sugar level (FBS) and the levels of hemoglobin A1 (HbA1) with the severity and progression of diabetic retinopathy. During an average follow-up of 12.6 +/- 2.9 months, the FBS and HbA1 levels were determined and progression of diabetic retinopathy assessed by fluorescein fundus angiography. The time averaged HbA1 and FBS were correlated significantly. The HbA1 levels were significantly augmented in the order of good, fair and poor sugar control groups. The patients with progressive retinopathy had significantly higher FBS and HbA1 levels than the patients whose retinopathy remained unchanged. The correlation between the HbA1 level and the severity of retinopathy was not statistically significant. It was concluded that the combination of HbA1 and FBS levels will be useful for long-term control of diabetes and of progression of retinopathy. PMID- 6855018 TI - Three types of blink reflex evoked by supraorbital nerve, light flash and corneal stimulations. AB - Three types of blink reflex were evoked by 1) supraorbital nerve stimulation, 2) light flash stimulation and 3) corneal touch. The blink reflex response was recorded simultaneously for both eyes by electromyography of the orbicularis oculi muscles of the lower eyelid. After supraorbital nerve stimulation, ipsilateral early response (R1) and bilateral late responses (R2) were demonstrated. The light flash stimulation evoked the photic early and late responses. The latency times of the R1, R2 and the photic early responses were determined in 22 normal subjects. The corneal touch was exactly timed using a new device and the latency time of the corneal blink reflex was determined. The latency of the ipsilateral corneal blink reflex was significantly shorter than that of the contralateral reflex. The blink reflexes by supraorbital nerve stimulation and light flash were studied concurrently in 7 patients with neurological disorders of vascular origin. The photic reflex was disturbed by bilateral occipital lobe lesions and also by affection of the rostral midbrain. The reflexes were not affected by lesions in the medial longitudinal fasciculus but were disturbed by widespread brainstem lesions of Foville syndrome. Clinical significance of a combined use of the supraorbital nerve and light flash stimulation was emphasized. PMID- 6855019 TI - Case of sarcoidosis with uncommon tumorous mass formation in bulbar conjunctiva. AB - A case of sarcoidosis with ocular involvement, including uncommon tumorous mass formation on the bulbar conjunctiva, was reported. The patient was a 62-year-old woman who had been suffering from chronic bronchiolitis for several years. The conjuctival masses, yellowish brown in color with localized injection and follicles, were found in both eyes. In addition to the conjunctival masses, the common manifestations of sarcoidosis were observed in the eyes, showing nodules on the iris and trabeculum, discrete fluffy "snowball" opacities in the vitreous, and perivascular nodules on the retinal vessels. Microscopically, the biopsy specimen obtained from he conjunctival masses was composed of epithelioid tubercles with Langhans type and foreign body type giant cells. Ziehl-Neelsen stain revealed no tuberculous bacilli. Transbronchial lung biopsy also revealed epithelioid tubercles. Both ocular and pulmonary lesions were observed to respond well to treatment with corticosteroid hormone. We emphasized that patients with interstitial pneumonitis or pulmonary fibrosis should be examined ophthalmologically, and recommended conjunctival biopsy in patients with suspected sarcoidosis. PMID- 6855020 TI - Falciform retinal fold as sign of familial exudative vitreoretinopathy. AB - We studied family members of 9 patients with falciform retinal fold, and found a number of cases showing features of familial exudative vitreoretinopathy (FEVR) in the fundi. Retinal fold was also seen in the eye of a cousin of the propositus. Three cases with falciform retinal fold were bilateral and 7 cases were unilateral. Retinal folds were located in the temporal half of the fundis in 11 of the 13 eyes with retinal fold. These 11 eyes showed avascularized zones of retinal vessels with scalloped edges in the periphery; in the 2 remaining eyes the retinal vessels were restricted within the fold. Thirty-one eyes of 18 cases, members of 7 pedigrees, showed features of FEVR. The observed avascularized zones with scalloped pattern of the vessels and vitreoretinal involvements were divided into 3 groups: 23 eyes of stage 1, 6 eyes of stage 2, and 2 eyes of stage 3, respectively. It was, therefore, concluded that falciform retinal fold being located temporally or bilaterally could be one of the signs of FEVR and that FEVR was a disease affecting regression of the hyaloid vascular system and development of the retinal vessels during fetal life. FEVR was classified into 4 groups: type 1, type 2, type 3 and type 4 of falciform retinal fold. The disease may be transmitted as autosomal dominant inheritance. PMID- 6855021 TI - Familial cases of congenital microcoria associated with late onset congenital glaucoma and goniodysgenesis. AB - We presented a familial case of congenital microcoria associated with late onset congenital glaucoma. The proband, a 36-year-old man, had abnormally small pupils with diameters of 3.5 mm in the right eye and 1.5 mm in the left. Mydriatics, such as 1.25% epinephrine, 5% neosynephrine, 5% tyramine, and 1% atropine did not dilate the pupils fully. The iris showed poor development of collarettes and crypts, and lacked circular contraction folds bilaterally. Gonioscopic examination revealed developmental anomalies of the anterior chamber angles in both eyes. Abundant iris processes, which fused together partially in the right and circumferentially in the left, inserted from the iris root onto the scleral spur or further near to the Schwalbe's line. Applanation tonometry measured high intraocular pressure in both eyes. The anterior chamber angle tissues obtained by trabeculectomy were studied histopathologically. In the trabecular meshwork, a thick endothelial meshwork with many layers of cells embedded in prominent extracellular materials was observed on the canal side. On the anterior chamber side, there were several layers of trabecular sheet. These findings indicate underdevelopment of the trabecular meshwork. We examined three generations of his family and found that 5 members showed bilateral congenital microcoria, and another, deceased, was said also to have had congenital microcoria. All 5 surviving patients (3 males and 2 females) with microcoria were found to have bilateral goniodysgenesis also. Two of the 5 were affected with bilateral late onset congenital glaucoma. The congenital disorders in this family, congenital microcoria and goniodysgenesis, appeared in close relation, and were transmitted by autosomal dominant inheritance. PMID- 6855022 TI - Anterior pars plana vitrectomy for phakic malignant glaucoma. AB - Phakic malignant glaucoma was seen in five eyes of four patients: it occurred in four eyes after trabeculectomy and in one eye after peripheral iridectomy. They were treated by anterior pars plana vitrectomy combined with intracapsular lens extraction through a corneal incision. In all eyes the anterior chamber regained its normal depth, and the intraocular pressure could be controlled by medical treatment in three eyes. The remaining two eyes required further filtering procedure and subsequently the intraocular pressure was controlled by medical treatment. No serious complications were encountered throughout the postoperative follow-up period of 7-26 months. PMID- 6855023 TI - Orbital inflammatory pseudotumor: clinicopathologic study of 22 cases. AB - Clinicopathologic features of orbital inflammatory pseudotumors were examined in 22 cases at the Kyushu University Hospital during the period from 1965 through 1981. These cases were divided into three groups according to the location of the tumors. Group I included 13 cases with the lesions located in the anterior portion of the orbit. The lesions of this group were often seen as a palpable mass without proptosis or visual disturbance. Histologically, most of them showed reactive lymphoid hyperplasia. In some lesions, fibrous tissue, in which eosinophils were scattered, was found around the lymph follicles. Group II consisted of 4 cases with the lesions situated in the anterior and posterior portion of the orbit. The patients of this group had severe proptosis without loss of vision. Histologically, reactive lymphoid hyperplasia was seen in all cases. Group III comprised 5 cases in which the tumor existed in the posterior portion of the orbit. The patients with these lesions had proptosis and visual disturbance. Histologically, the lesions of this group showed infiltration of various inflammatory cells including lymphocytes, plasma cells, mast cells and eosinophils. Most tumors in Group I were stationary for a long time without steroid therapy. Steroid therapy was effective to the patients of Group III. However, the lesion infiltrated progressively after steroid therapy in some patients of Group II. PMID- 6855024 TI - Quantitative analysis of the sympathetic efferent activity to characterize the integrative function of the sympathetic ganglion. AB - Using the concept of the Markov dependency, we analyzed the spontaneous activity in the pre- and postganglionic nerve trunks of the feline superior cervical ganglion. The time structure (order and value of time dependency) of the sequence of compound action potentials was determined. The analysis revealed that the time dependency of the postganglionic activity is of higher order and is generally more consistent than that of the preganglionic one. The difference in orders and values between the pre- and postganglionic activities was found to be a measure of the integrative function of the ganglion. A transformation by the ganglion of some additional information, inaccessible in the time structure of the preganglionic activity, seems to underlie this difference. PMID- 6855025 TI - The transmural potential of the newt ureter: evidence for amiloride-sensitive active sodium transport. AB - Transmural electrical potential difference (PD) of the newt ureter was measured with glass microelectrodes and its nature was studied pharmacologically or by ion replacement experiments. The PD in the presence of standard Ringer solution on both sides averaged -76.0 +/- 1.3 mV, lumen negative. The magnitude of the PD depended on the Na+ concentration of the luminal fluid; the PD increased in a saturable way with increase in the Na+ concentration. Amiloride added to the luminal fluid at 10(-4) M greatly reduced the PD and increased the transmural resistance. The half maximum inhibition was seen at 2.6 x 10(-6) M and the maximum inhibition at 10(-4) M where the PD reduced to 3.8% of control. Amiloride added to the external medium at 10(-4) M had no effect on both the PD and the resistance. Ouabain added to the external medium at 10(-3) M caused a gradual decrease in the PD, which fell to 36% of its initial value after 60 min. The specific transmural resistance (Rt) was estimated by recording spatially decaying electrotonic potentials along the ureter and applying cable analysis. The short circuit current (Isc) was calculated from the PD and the Rt. The Rt and the Isc averaged 31.7 +/- 7.7 k omega X cm2 and 3.9 +/- 1.5 microA X cm-2, respectively. The results indicate that the epithelial cells of the newt ureter have amiloride sensitive Na+ channels at the luminal membrane and are transporting Na+ actively, like epithelia of the urinary bladder and the skin of amphibia. PMID- 6855026 TI - The cumulative sum analysis of spike discharges in a small sample. PMID- 6855027 TI - Membrane potential of rat urinary bladder epithelial cells. AB - Rat urinary bladder epithelial cells exhibited a membrane potential of about -22 (apical) and -24 (basal) mV in normal Krebs solution. Blockade of Na+ entry through the apical membrane by Na+ depletion of administration of amiloride, or inactivation of the Na pump in the basal membrane by ouabain resulted in marked hyperpolarization of the epithelial cells. N-butyl-N-(4-hydroxybutyl) nitrosamine (BBN), a specific carcinogen, and saccharin, a potent enhancer of carcinogenesis, inhibited development of the Na+ channel and/or Na pump on the bladder epithelium. This physiology may contribute to the abnormal intracellular environment leading to bladder carcinoma. PMID- 6855028 TI - Action of angiotensin II on cultured brain stem neurons of the rat. AB - Following the application of angiotensin II to cultured lower brain stem neurons of rat embryos, the facilitatory response was mostly seen in small-sized oval, fusiform, and polygonal neurons, while the inhibitory response was seen in medium sized pyramidal and multipolar neurons. Saralasin blocked both facilitatory and slow inhibitory responses, but had no effect on the fast inhibitory response. PMID- 6855029 TI - In vivo 31P NMR studies on experimental cerebral infarction. AB - Sequential metabolic changes in rat brain were monitored by in vivo measurements of 31P NMR spectra using a topical magnetic resonance (TMR) spectrometer, during the course of experimentally induced cerebral infarction and also during recovery produced by restoration of circulation. The experimental cerebral infarction was rendered by a slightly modified version of the method of Pulsinelli and Brierley (1979). The bilateral coagulation of the vertebral arteries at the level of alar foramina of the first cervical vertebra (preinfarction) did not show any change in NMR spectrum, but the subsequent bilateral ligation of internal carotid arteries produced a decrease in the peaks of ATP and phosphocreatine and a concomitant increase in the peak of inorganic phosphate within a few minutes. Intracellular pH, calculated from the chemical shift of inorganic phosphate, declined. These changes became maximal at approximately 30 min after the infarction. Reinstatement of blood flow to the cerebrum, produced by untying the ligature of internal carotid arteries, resulted in an immediate restoration of the peaks of ATP and phosphocreatine, which was followed by a reduction in the peak of inorganic phosphate within a few minutes. The spectrum recovered to its preinfarction pattern about 30 min after the restoration of the circulation. These experiments demonstrate that phosphorus compounds change very rapidly during infarction, and that these changes were reversible at least during a 30 min period. PMID- 6855031 TI - Intracellular calcium store and transport of elements in acinar cells of the salivary gland determined by electron probe X-ray microanalysis. AB - Electron probe X-ray microanalysis using freshly frozen hydrated and dried thin sections of dog submandibular gland was performed to determine the distribution of elements and water in the acinar cells of resting and stimulating states. The results obtained are as follows: (a) The secretory granules contained high concentrations of Ca and S while high concentrations of K and P were present in the cytoplasm and/or nucleus of acinar mucous cells of the gland in the resting state. (b) With pilocarpine stimulation, the concentration of Ca increased in the cytoplasm and decreased in the secretory granules, while there was an increase in the concentration of Na and Cl in both the cytoplasm and secretory granules of the cells. (c) The local dry-mass fractions of acinar cells, estimated by comparing the continuum radiation of X-ray spectrum from the frozen hydrated sections with that from the frozen dehydrated sections, were approximately 20 and 33% in the cytoplasm and secretory granules of resting acinar cells, respectively, and each value was not significantly altered under conditions of stimulation having a tendency to decrease slightly. Therefore, the passive Na and Cl influx and the cytoplasmic Ca flowed in from extracellular spaces and released from secretory granules, an intracellular calcium store, by secretory stimulation probably triggers the passive or active Na and Cl extrusion and consequently the osmotic water flux from the basal part of acinar cells to the secretory granules and the lumen, as well as the serial exocytosis of the granules in the luminal side of the acinar cells. PMID- 6855030 TI - Effects of magnesium, oxytocin, and prostaglandin F2 alpha on the generation and propagation of excitation in the longitudinal muscle of rat myometrium during late pregnancy. AB - In order to find out the changes in myometrial properties towards parturition, effects of Mg, oxytocin, and prostaglandin F2 alpha (PGF2 alpha) were investigated on longitudinal muscle strips taken from rat uteri on Days 20 and 22 of pregnancy. With intracellular recording by microelectrode, membrane potential was 50.5 +/- 1.4 mV on Day 20, and 49.9 +/- 1.0 mV on Day 22 in the Mg-free Krebs solution. The slow potential was larger, and the spike potentials during a burst discharge exhibited variable amplitude on Day 20, whereas these were regular on Day 22. With extracellular recording by the rubber gap method, spike potentials discharged in a synchronized manner on Day 22, suggesting a better coordination between cell groups. When 1.2 mM Mg was applied, the spontaneous activity was depressed more strongly on Day 22. The excitatory effect of PGF2 alpha faded sooner, whereas that of oxytocin persisted. When the fading of PGF2 alpha had occurred, the excitatory effect of oxytocin was weaker than when it was given alone. Because propagation of spontaneous activity, occurring either in the Mg free solution or in the presence of oxytocin and PGF2 alpha in normal Krebs solution, did not show a definite direction from ovarian to vaginal side of the longitudinal muscle, it was concluded that generation of spontaneous activity was not localized in a given site of the muscle, but originated anywhere in Days 20 and 22 preparations. PMID- 6855032 TI - Temperature dependence of spontaneous electrical activity in early embryonic heart monitored optically with a potential-sensitive dye. AB - The effects of temperature on spontaneous action potential activity in the 7-9 somite embryonic precontractile chick hearts were investigated using an optical method for monitoring membrane potential. A potential-sensitive merocyanine rhodanine dye was used as an optical probe. Cooling caused a marked decrease in the frequency of occurrence of the spontaneous action potential. This slowing was associated with a decreased rate of diastolic depolarization of the pacemaker action potential. When the temperature was lowered, a decrease in the rate of rise and a prolongation of duration of the optical action signal also occurred. In addition, cooling resulted in a disordering of the rhythmicity of the action potential, and a decrease in the conduction velocity of excitation. Q10 values for such parameters were calculated: there were slight decreases in the Q10 values for the frequency and conduction velocity for 7-9 somite embryonic hearts. PMID- 6855033 TI - [Surgical correction of isolated congenital mitral regurgitation by clefted anterior leaflet--report of three cases]. PMID- 6855034 TI - [Efficacy of intravenous human immune globulin for the prevention of infection after open heart surgery]. PMID- 6855035 TI - [Use of clips for transvenous planting of pacemakers]. PMID- 6855036 TI - [Clinical application of fiber optic cable for mitral valve operations]. PMID- 6855037 TI - [Experimental studies on hemolysis in a patient with unstable hemoglobinopathy (Hb Zurich) by using extracorporeal circulation model]. PMID- 6855039 TI - [Case of left aortic arch with right descending aorta]. PMID- 6855038 TI - [Case of solitary plasmacytoma originating from the rib]. PMID- 6855041 TI - [Evaluation of sternal inversion on a M. rectus abdominis pedicle flap for infantile funnel chest deformity: intraoperative internal thoracic arteriography and venography]. PMID- 6855040 TI - [Coronary ostial stenosis following combined valvular disease operation]. PMID- 6855042 TI - [Case of malignant schwannoma in the posterior mediastinum]. PMID- 6855044 TI - [Tuberculosis in dialysis patients. 8. Characteristics of lymph node tuberculosis]. PMID- 6855043 TI - [Discussion on time of BCG revaccination]. PMID- 6855045 TI - [Relapse in tuberculosis]. PMID- 6855046 TI - [Factors interfering with the effects of antitubercular chemotherapy and their management]. PMID- 6855047 TI - [58th meeting of the Japanese Society for Tuberculosis. Kyoto, 11-12 April 1983. Abstracts]. PMID- 6855049 TI - [Electromagnetic and magnetic fields in the treatment of ischemic heart disease]. PMID- 6855048 TI - [State of resistive blood vessels of the rat kidney during development of hereditary (spontaneous) hypertension]. AB - Renal perfusion with Tyrode solution to which gelatinol was added revealed gradual development of structural changes in renal vessels as arterial hypertension was developing and stabilizing in spontaneously hypertensive rats, as evidenced by shifts in "perfusion pressure--perfusion rate" and "glomerular filtration rate--perfusion pressure" curves, increased afferent/efferent arteriole resistance ratio and enhanced renal vascular response to angiotensin II due to hypertrophy and reduced inner radius of smooth-muscle afferent arterioles. Considerable reduction in glomerular filtration rate combined with increased resistance to tissue liquid flow and less pronounced changes in renal flow suggests increased fluid elimination via arteriolovenous shunts at the stage of stable hypertension. The established renal vascular transformation may be needed to maintain high arterial blood pressure during stable hypertension. PMID- 6855050 TI - [Hemosorption - a method of rapid elimination of cholesterol from the plasma and its effect on the regression of experimental atherosclerosis]. AB - Hemosorption is a method of rapid control of hypercholesterolemia. A study of hemocompatibility of an alumosilicate sorbent which is relatively selective with respect to cholesterol demonstrated a possibility of its being used in hemosorption devices. Rabbits with spontaneous regression of two-month duration were given three hemosorption sessions. A drop in cholesterol and triglycerides was noted after each session. By the end of the experiment, the area of aortal atherosclerotic lesion was reduced twofold as compared to the controls (19% vs. 41%). Rapid regression of diffuse lipid deposits from the surface and marginal zones of the patches was observed. "New" secondary lipid deposits were absent. A possibility of using hemosorption in patients with pronounced hypercholesterolemia is discussed. PMID- 6855051 TI - [Characteristics of blood pressure curves in the right segments of the heart and pulmonary artery in patients with myocardial infarction of the right ventricle]. PMID- 6855052 TI - [Problems of vocational rehabilitation of patients after myocardial infarction]. PMID- 6855053 TI - [Nonspecific aortoarteritis with coronary syndrome]. PMID- 6855054 TI - [Case of cardiac asystole during an attempt to control paroxysmal supraventricular tachycardia with electroimpulse therapy]. PMID- 6855055 TI - [Protective effect of extracellular K+ in the myocardium in disorders of energy metabolism]. AB - In an experimental study on isolated isovolumetric guinea-pig hearts, a 2.2-fold reduction of the coronary duct combined with metabolic block caused by dinitrophenol (0.05 mM) resulted in an eleven-fold drop in the attained pressure, and a shorter electric systole, a smaller P wave, and an ST displacement on the ECG. Deep suppression of mechanical and electric activity was combined with reduced glycogen content, and greater K+ and Na+ withdrawal from the heart. Quantitatively, the drop in contractility correlated with K+ withdrawal and ST displacement. A sudden increase in coronary perfusion rate was accompanied by a rapid increase in the rate of K+ elimination from the heart which was proportionate to the rate of hyperfusion, with a simultaneous transitory rise in attained pressure, a great increment in diastolic pressure and the emergence of arrhythmia and fibrillation, the severity of the changes correlating with the degree of K+ loss. A moderate increase in K+ concentration of the perfusate prevented the development of fibrillation and drastically reduced the degree of contracture and glycogen drop during hyperfusion. The obtained results suggest that moderate accumulation of extracellular K+ during the early phase of energy generation disorder can be of a protective nature, as it contributes to a sharp reduction in contractility and energy spending to improve cell survivability in critical conditions. PMID- 6855056 TI - [Role of collateral coronary circulation in the compensation of regional disorders of energy metabolism in the myocardium in experimental myocardial ischemia]. AB - Patterns of glucose, pyruvate and lactate consumption by the ischemized myocardium were studied in dog experiments with reference to the leve of retrograde inflow to the network of the ligated coronary artery. For this purpose, blood samples were taken from distal portion of ligated anterior descending coronary artery and the great cardiac vein accompanying the branches of the former. The increase of the lactate level, "excessive" lactate, the redox potential of the lactate/pyruvate system (E), delta E was shown to be less pronounced in those experiments where collateral coronary flow volumetric rate was above 1.5 ml/min, whereas pH and pO2 values dropped more steeply following coronary ligation in the experiments with small retrograde inflow to the ischemized area. The differences between glucose and pyruvate consumption by the ischemized myocardium were not significant. PMID- 6855057 TI - [Effect of stenosing coronary arteriosclerosis on myocardial mast cells]. AB - Mast cells were examined in the left ventricular myocardium of 134 patients who had died of different diseases. Myocardial mast cells were smaller in quantity and size and somewhat degranulated where coronary arteries were stenosed due to atherosclerosis. These changes in mast cells can be used as a criterion of chronic myocardial ischemia. The findings are suggestive of functional insufficiency in myocardial mast cells associated with coronary disease. PMID- 6855058 TI - [Phospholipid content of subfractions of high density lipoproteins in women with angiographically documented coronary arteriosclerosis]. AB - The concentration of high density lipoproteins (HDL) and the phospholipid content of HDL2 and HDL3 were estimated in the plasma of 23 women with coronary heart disease (CHD) and in the control group of 38 healthy women. The concentration of HDL cholesterol (HDL-C) was significantly reduced in patients with CHD in comparison with the control group. There was also a significant decrease of the per cent content of lecithin and an increased content of sphingomyelin, especially in HDL2 subfraction. It is concluded that the reduction of HDL-C content is accompanied by changes in the phospholipid content of HDL that may result in reduction of cholesterol-acceptor properties of these particles. PMID- 6855060 TI - [Plasma levels of testosterone and lipid-protein components of high density lipoproteins and their subclasses in the native population of the Chukotka national autonomic region]. AB - In a representative aboriginal male Chukchi population, relationships were examined between major lipid-protein components of high-density lipoproteins (HDLP) and their subclasses (HDLP2 and HDLP3) and physiological plasma testosterone patterns. A single-trend correlation was established between cholesterol and phospholipids of each of the HDLP subclasses, and plasma triglycerides and testosterone. Apo-AI for each of the HDLP subclasses showed different trends of correlation with both triglycerides and normal range of testosterone. The findings are indicative of different patterns in the formation of HDLP2 and HDLP3 particles. PMID- 6855059 TI - [Effect of disorders of lipid metabolism on the rheological properties of blood in patients with ischemic heart disease]. AB - A comparative study of the effects of changes in erythrocytic membrane and serum lipid metabolism on rheologic blood properties (total blood and plasma viscosity, erythrocyte aggregation and deformability) was conducted in 70 patients with chronic coronary disease. A positive correlation was established between total blood and plasma viscosity and serum triglyceride levels. Increased serum cholesterol levels were not found to affect plasma viscosity in any significant manner. Erythrocyte deformability was reduced in coronary patients with high molar cholesterol/phospholipids ratio in erythrocyte membranes, patients with high serum cholesterol levels showing the highest membrane molar cholesterol/phospholipids ratio. PMID- 6855062 TI - [Methodological aspects of the etiology and pathogenesis of atherosclerosis]. PMID- 6855061 TI - [Diagnostic possibilities of myocardial scintigraphy using T1-201 in acute myocardial infarction]. AB - Myocardial scintigraphic investigation using 201T1 was performed in 36 patients with suspected acute myocardial infarction and 11 clinically normal controls. The scintigrams were assessed visually and using a computer program for semiquantitative assessment of 201T1 distribution across the myocardium. The control subjects' scintigrams show a comparatively even myocardial distribution of the label. Patients with acute myocardial infarction were divided into 2 groups: those with large-focal (28) and small-focal (8) infarctions. All the patients from the large-focal group showed perfusion defects in their scintigrams. Clinical and autopsy diagnoses coincided in all the cases, and the vital scintigraphic pattern correlated with the posthumous localization of the myocardial infarction. However, the method of myocardial scintigraphy with 201T1 in acute myocardial infarction is of low specificity. To improve the differential diagnosis of myocardial infarction, repeated scintigraphy is needed. PMID- 6855063 TI - [Glycogen phosphorylase activity in acute myocardial infarction]. AB - The activity of glycogen phosphorylase (GP) and creatine phosphokinase isoenzyme MB (CPK MB) was measured in patients with myocardial infarction over 72 hours after the anginal attack. In most clinical observations, CPK MB and GP patterns were similar, however, the GP activity reached its peak 4-6 hours earlier, and sooner returned to normal, as compared to that of CPK MB. The measurement of GP and CPK MB activity at early dates of myocardial infarction provides more evidence of new lesion foci or expanding necrotic area. In one-third of the infarction patients, the said enzymes showed different patterns of activity. It is suggested that the assessment of GP and CPK MB activity in cases of myocardial infarction may contribute to better insight into both necrotic and ischemic myocardial processes associated with myocardial infarction, with similar trends in enzyme patterns indicating necrotic myocardial changes, and high GP activity coupled with unchanged CPK MB signalling myocardial ischemia. PMID- 6855064 TI - [Elevation of the ST segment during physical exertion: computer analysis, comparison with angiographic data; clinical significance]. AB - A total of 41 male patients responding with ST elevation to treadmill exercise were investigated using coronaro- and ventriculography, and sector-scanning echocardiography. All the patients had a history of anterior myocardial infarction. Computer analysis of changes in ST interval showed ST incline and integral to be the most informative parameters. Angiographically, marked stenosis (75% and more of the lumen) of one coronary artery was established in 21, two arteries, in 10, and three arteries, in 2 patients; coronary arteries were intact in 1 case. It is suggested that resting ST elevation as recorded from the leads with QS complex is more commonly associated with left ventricular aneurysm. The location of exercise-related ST elevation correlates well with marked proximal stenosis of a corresponding coronary artery an is not dependent on the presence of left ventricular aneurysm or the number of affected arteries. In patients with a history of transmural anterior myocardial infarction, the elevation of ST interval in response to exercise is due to dyssynergy of the left ventricular wall, rather than myocardial ischemia. PMID- 6855065 TI - [Nonparoxysmal tachycardia and accelerated ectopic rhythms]. AB - Ectopic rhythms with impulse frequency of 60-90 per minute are referred to as "accelerated"; those with the frequency of 91-130 impulses per minute are termed "nonparoxysmal tachycardia". Forty patients (27 with nonparoxysmal tachycardia and 13 with accelerated ectopic rhythms) were under observation. Accelerated rhythms were nearly always free of clinical symptoms and did not require an anti arrhythmia treatment. Nonparoxysmal supraventricular and ventricular tachycardia was usually accompanied by aggravation of the patient's condition. Nonparoxysmal tachycardia turned to paroxysmal one or vice versa in 7 patients. Cordarone, beta adrenergic agents and isoptin were particularly effective in the treatment of nonparoxysmal supraventricular tachycardia, while ethmosine, cordaron and rhythmodan proved most effective against ventricular arrhythmia. PMID- 6855066 TI - [Current methods of automatic processing of the results of electrophysiological studies in heart surgery]. AB - A new system is developed for the diagnosis and surgical treatment of arrhythmias. It comprises a programmed stimulator and an automated system for the charting of cardiac stimulation. PMID- 6855068 TI - [Effect of seduxen on stress-induced hemodynamic reactions in patients with hypertension]. AB - Some circulatory parameters were examined, using tetrapolar chest rheography and rheoencephalography, in patients with essential hypertension of stages I-II during emotional stress after oral administration of 5 mg seduxen. Seduxen was not shown to prevent hypertensive response to emotional stress. In the post stress recovery period, this drug reduces the duration of hypertension. Seduxen is conducive to redirecting the trends of hemodynamic response of hypertensive patients so that it becomes similar to that of normal subjects. In patients with hypokinetic response to emotional stress, seduxen restores the autoregulation capacity of cerebral vessels. PMID- 6855067 TI - [Psychophysiological aspect of the therapeutic use of pyridinolcarbamate]. AB - The effect of prodectin was examined in 79 patients with coronary disease after a course of treatment, and in 16 normal subjects. A series of electrocardiographic and hemodynamic parameters were investigated at rest and during bicycle ergometric exercise. Resultant psycho-physiologic shifts were reviewed with the aid of the information test recording the time of response, errors and vegetative changes in response to colour and mathematical stimuli. Pyridinol carbamate was found to produce a psychostimulating effect, with information processing and vegetative control improved significantly. Therefore the drug appears to be advisable for patients with coronary disease exposed to increased information inflow which requires greater concentration of their attention in short time. PMID- 6855070 TI - [Differential diagnosis of functional heart murmurs and various heart defects using the ultrasonic impulse-Doppler method]. PMID- 6855069 TI - [Sodium transport in the erythrocytes of patients with essential and symptomatic (renal) hypertension]. AB - Sodium transport was investigated, using the isotope exchange method, in the erythrocyte membranes of normal subjects and patients with essential and symptomatic (renal) hypertension. In hypertensive patients, the constant of balanced Na/Na exchange rate was increased by more than 60%, and the balance concentration of erythrocytic sodium by 30%, as compared to the controls, in the presence of ouabain. These differences become far less pronounced if furosemide is added to the incubation medium. In patients with secondary (renal) hypertension, the Na/Na exchange rate and erythrocytic balance concentration of sodium are not affected by ouabain as compared to the controls. It is suggested that Na/Na-countertransport plays the principal role in the disruption of erythrocyte membrane permeability by sodium in essential hypertension. PMID- 6855073 TI - [Effect of calcium on the diastolic phases in healthy persons and in patients with cardiac insufficiency]. AB - Variations in the duration of diastolic phases under acute calcium loading were studied in normal subjects and patients with heart failure, using left ventricular apexcardiography (ACG). Certain changes in diastolic phases were revealed in patients with heart failure as compared to normal subjects, which corresponded to the severity of heart failure. The phase of isometric relaxation as well as those of rapid and slow filling showed the most dynamic variation. The calcium test brought out differences in the effects of calcium on normal and affected myocardium. The established variations may be due to changes in mechanisms of calcium fixation in and the elimination from sarcoplasmatic reticulum. PMID- 6855071 TI - [Evaluation of cardiac function in patients with ischemic heart disease in the early stages of controlled physical exercise]. AB - Fifty-nine coronary patients and 20 clinically normal subjects were investigated. Coronarography was performed in 21 patients. Everybody was referred to one of the three functional classes. Central hemodynamic parameters were measured using tetrapolar chest rheography. Venous levels of lactic and pyruvic acids were also measured. The measurements were taken in resting conditions and under threefold increase in systemic oxygen consumption following bicycle ergometry in supine position. Three types of response were identified: normal, compensated and decompensated ones. On the basis of these, functional reserves of the heart can be evaluated at earlier stages of rationed exercise, this being particularly important for coronary patients not to be exposed to maximum and submaximum physical stress. PMID- 6855072 TI - [Characteristics and significance of cardiodynamic disorders in patients with stenocardia and a history of myocardial infarction]. AB - To judge of the contractile function of the heart polycardiography and apical cardiography were used to study a male population aged 40-49 years and 57 patients up to 50 years with ischaemic heart disease (IHD). The investigations were made at rest and after a tread-mill test. Patients with IHD were divided into 3 groups: those who had myocardial infarction from 6 months to 3 years with high and low tolerance to exercise and persons with angina pectoris. All patients with IHD were found to have extension of the isometric contraction on the polycardiogram and enhanced amplitude of the atrial wave in relation to the main systolic wave of the apexcardiogram, and also decreased tolerance to exercise. Cardiodynamic disorders in patients with angina pectoris were manifest as clearly as in many patients who had had myocardial infarction. PMID- 6855074 TI - [Use of antipotassiuretic diuretic amiloride in patients with chronic cardiac failure]. AB - Amyloride causes moderate natriuresis and a considerable reduction in urinary potassium excretion. Chlorine excretion and diuresis are less affected in their increase, while hydrogen ions secretion shows a slight decrease. Amyloride effect is localized in convoluted tubules of the kidney, and perhaps collecting tubules as well. When taken orally, its effect becomes evident within 2-3 hours, reaches its peak within 5-6 hours, and slowly declines within 16-18 hours. A daily dose of 10-15 mg is recommended. During a treatment course, the effect is in evidence throughout the whole of the 6-8 days of observation, without any signs of hyperpotassemia or shifts in acid-base balance. Amyloride combined with furosemide, uregit or hypothiazid produces an additive effect on natriuresis and essentially reduces renal loss of potassium and hydrogen ions. PMID- 6855076 TI - [Effect of surgical treatment on various indices of homeostasis in patients with burns]. PMID- 6855075 TI - [Surgical treatment of patients with burn cachexia]. PMID- 6855077 TI - [Effect of hemosorption on blood rheological properties and the coagulation system in patients subjected to bile duct surgery]. PMID- 6855078 TI - [Use of local isolators in plastic surgery of burns]. PMID- 6855079 TI - [Hemosorption in the early stages of burns]. PMID- 6855080 TI - [Surgical treatment of children with burn deformities of the lower extremities]. PMID- 6855081 TI - [Is the discussion on a classification of burns necessary?]. PMID- 6855082 TI - [Organization and delivery of medical care in group and mass thermal injuries]. PMID- 6855083 TI - [Changes in systemic and peripheral hemodynamics during transfusion therapy of patients in acute stages of burn disease]. PMID- 6855084 TI - [Experience in organizing socialist competition at the Kiev Research Institute of Orthopedics]. PMID- 6855085 TI - [Quality control of the work of a surgeon]. PMID- 6855086 TI - [Clinical thinking of students during study of surgery, and approaches to its improvement]. PMID- 6855087 TI - [Organization and methodological basis of postgraduate training in surgery]. PMID- 6855088 TI - [Evaluation of the severity of burns by changes in serum creatine phosphokinase activity]. PMID- 6855089 TI - [Device for the oxygenation of transfusion media]. PMID- 6855091 TI - [Device for blood reinfusion]. PMID- 6855090 TI - [Method of intraoperative blood return from the removed lung]. PMID- 6855092 TI - [Morphofunctional state of the neuroendocrine system in combined radiation thermal injuries]. PMID- 6855093 TI - [Use of the "Sterzhen'-l" ultrasonic apparatus in the complex treatment of patients after downward transposition of the intestine]. PMID- 6855094 TI - [Use of lasers in surgery]. PMID- 6855095 TI - [Use of lasers in esophageal and gastric surgery]. PMID- 6855096 TI - [Intraoperative diagnosis of chronic pancreatitis]. PMID- 6855097 TI - [Treatment of obstruction caused by cancer of the large intestine]. PMID- 6855098 TI - [Selection of a rational method of treating rectal cancer]. PMID- 6855099 TI - [Multistage operations with preservation of the sphincter in rectal cancer]. PMID- 6855100 TI - [Surgical treatment of cancer of the large intestine]. PMID- 6855101 TI - [Remote results of the surgical treatment of patients with cancer of the colon]. PMID- 6855102 TI - [Selection of the method of operation in the surgical treatment of diffuse polyposis of the large intestine]. PMID- 6855103 TI - [Reconstruction of the continuity of the large intestine in colostomy patients]. PMID- 6855104 TI - [Diagnosis and treatment of megacolon in adults]. PMID- 6855105 TI - [Surgical rehabilitation of patients with the loss of the anal sphincter]. PMID- 6855106 TI - [Simultaneous extensive and combined operations]. PMID- 6855107 TI - [Treatment of incompetence of the anal sphincter]. PMID- 6855108 TI - [Endoscopy in proctology]. PMID- 6855109 TI - [Prevention and treatment of suppurative complications after surgical treatment of colonic and rectal cancer]. PMID- 6855110 TI - [Acute corneal endothelial cell loss]. AB - Corneal endothelial cell loss may result from endogenic causes, such as acute angle-closure glaucoma, or exogenic causes, such as corneal contusion, corneal perforation or surgery involving the anterior chamber. The extent of endothelial cell loss varies with the severity of trauma. Despite the different causes the response of the corneal endothelium is always an endothelial cell loss. Corneal endothelial decomposition may result from an acute endothelial cell loss. PMID- 6855111 TI - [Lens holder for vitrectomies in the posterior segment of the eye]. AB - A lens holder for posterior segment vitrectomy is described. Its advantages are: better centering, optional use during surgery, simple handling and optimal exploitation of the prismatic effect for a better view into the periphery. PMID- 6855112 TI - [New forceps for the implantation of posterior chamber lenses]. AB - Forceps used for implanting posterior chamber lenses of the Shearing or Sinskey/Kratz type have the disadvantage that they do not permit the lens to be safely guided during implantation. This advantage is avoided by a special pair of forceps (made by Klein ophthalmological instruments of Heidelberg, Germany). The branches of the forceps are designed in such a way that the angle between them and the lens is constantly 130 degrees, thus insuring an unobstructed view into the eye while inserting the lens. Moreover, the lens cannot shift laterally around the branch inserted into the hole. Slight opening of the branch causes the lens to slide off the forceps. With these new implantation forceps the lens can thus be inserted into the eye safely and in a predetermined position during the first stage of implantation. PMID- 6855113 TI - ["Christmas tree decoration" crystals in the lens]. AB - In lens crystal cataracts resembling Christmas tree decorations there are, most commonly in the nucleus, crystals in tubular cavities whose double refraction corresponds to that of cholesterol. There are considerable differences in the sizes of the crystals and they are not restricted to the borders of the lens fibers. In the cortex the cholesterol crystals minute if they are found here at all are situated in areas disposed to water-cleft formation. PMID- 6855114 TI - [Surgical procedure for restoration of the physiological alignment of the eyes following muscular dysfunction]. AB - Eight adult patients suffering from bilateral or unilateral N VI paralysis of more than one year's standing, and from rupture of the inferior rectus muscle due to accident underwent transposition of the muscle venter, a method which has been practiced now for five years. In all these patients the starting point of eyeball movement was shifted either outward or downward with the result that the primary position of the yeses could be used for either full or intermittent binocular vision. Where the patient had monocular vision either unilateral or alternating, at least spatial orientation was improved, as a result of the restored physiological alignment of the visual axes with the sagittal plane of the body. PMID- 6855116 TI - [Proliferative diabetic retinopathy at the time of diabetes diagnosis]. AB - The diagnosis of proliferative retinopathy led to a search for a hitherto undiagnosed diabetes mellitus in 5 patients. In 3 further patients advanced proliferative retinopathy was found only a few months after diagnosis of diabetes. In all 8 patients it was possible to regulate the diabetes with oral medication. The mean age of the patients was 49.1 years, the youngest being 42, the oldest 54. The question as to whether the courses of proliferative retinopathy and diabetes mellitus may be heterogeneous is discussed. PMID- 6855115 TI - [Use of vitrectomy instruments in anterior segment surgery]. AB - The use of vitreous surgery instruments in anterior segment surgery is described. The bimanual ocutome technique has been used, in some cases in combination with the special infusion/cutting needle. Three different approaches (limbus, pars plana, limbus and pars plana) are illustrated. The choice of surgical procedure is discussed; it depends mainly on the anterior segment pathology. Personal views and experience (64 eyes) are compared with those of other authors. PMID- 6855117 TI - [Macular edema due to posterior vitreous detachment--observations with fluorescein angiography]. AB - Description of five characteristic cases of macular edema caused by senile posterior vitreous detachment. Fluorescein angiography revealed no abnormalities and the macula remained devoid of significant changes. In cases where a fluorescein leakage in the macular area was found, a thick preretinal fibrosis occurred after several months with a decrease in visual acuity, which was initially good. PMID- 6855118 TI - [Papillomatous hyperplastic conjunctivitis caused by contact lenses]. AB - The characteristic features of contact lens-induced giant papillary conjunctivitis, as observed in 64 cases between 1978 and 1980, are described. The main symptoms are increasing lens intolerance with foreign body sensation, mucus discharge and reduced vision. The typical subtarsal sign is cobblestone formation resembling vernal conjunctivitis. Therapy must achieve complete disappearance of the conjunctival lesions, to avoid recurrences. Discontinuing lens wear is sufficient only in the less pronounced cases (stage I and II). In the fully developed cases, additional cryocoagulation of the lesions proved to be effective. The differences in the clinical pattern between our group of patients and that of Allansmith et al. (1977) support the opinion that surface deposits on the contact lenses are pathogenetically of prime importance. PMID- 6855119 TI - [Examinations of color vision in the differentiation of retinopathia pigmentosa]. AB - Quantitative analyses of color vision using the Farns-worth-Munsell 100-hue test confirm that the mode of inheritance is important for the prognosis of retinopathia pigmentosa. Cases involving the autosomal dominant mode of inheritance are characterized by slight functional losses whereas patients with the autosomal-recessive or the X-chromosomal-recessive mode of inheritance show pronounced defects in the photopic system. With time the degeneration affects the blue, the green and finally the red areas of the color spectrum. PMID- 6855120 TI - [Echographic findings in choroidal detachment]. AB - A- and B-scan sonography was performed in 83 patients with choroidal detachment; a serous choroidal detachment is characterized by high, bifurcated echospikes and an echo-free subchoroidal space in A-scan sonography. The B-scan presents a typical arc shape. In hemorrhagic choroidal detachment multiple echoes with low to medium reflectivity can be demonstrated in the subchoroidal space. The echographic differential diagnosis of other intraocular diseases is discussed. PMID- 6855121 TI - [Morphometric study of the sclerocorneal trabeculum of rabbits after treatment with corticosteroids or hyaluronidase]. AB - In eyes treated with corticosteroids the thickness of the trabecula is increased, the width of the intertrabecular spaces reduced and the number of trabecula per surface unit greater. In eyes perfused with hyaluronidase the opposite is seen, i.e., the thickness of the trabecular is reduced, the width of the intertrabecular spaces increased and the number of trabecula per surface unit diminished. The number of glycoproteins in the ground substance increases after treatment with corticosteroids while perfusion with hyaluronidase has the opposite effect. We have treated 27 rabbits, of which 17 with local administration of Dexamethasone 0,1%, 5 with subconjunctival injections and 5 as controls. PMID- 6855122 TI - [Stress on the eyeball caused by mechanical vibration. Studies of patient transport and experimental models]. AB - The acceleration forces which occur in the eye and in the head region in transport of patients were investigated. It was to be established whether the finding often deteriorates appreciably in perforating eye injuries between the accident site and the ophthalmological operating theater. The investigation showed that smaller acceleration forces become active in the eye in the sitting position than in the lying position in patient transport. In transport in the hospital area, e.g., in the patient lift and on a stretcher, the maximum acceleration amplitudes which occur are greater than those occurring in the ambulance.--In the second part of the study, the region of the eyeball most sensitive to oscillation was determined experimentally in cadaver eyes in order to permit an evaluation of the acceleration parameters relevant in patient transport. It was shown that the eye is largely insensitive to the accelerations occurring in patient transport. It was shown that the eye is largely insensitive to the accelerations occurring in patient transport. Furthermore, it was shown that a vitreous prolapse cannot occur for this reason in an experimentally induced sclera injury.--Therefore, deteriorations in the condition of the bulb occurring in patient transport are due to movements of the eyelid and eyeball. PMID- 6855123 TI - [Initial results of studies on stereo-visual acuity for moving objects]. AB - Besides dynamic visual acuity, dynamic stereo visual acuity can also be interesting in ergophthalmology. This was investigated in 11 test persons by means of two synchronously rotating prisms simulating circular motion. The dynamic stereo visual acuity decreases more steeply with increasing speed than dynamic visual acuity. The interindividual standard deviation is considerable, especially in cases of reduced vision. Bilateral good vision or good stereopsis does not always result in good dynamic stereo visual acuity, because of differences in the ability to achieve stereopsis and to follow to object by rolling the eyes. PMID- 6855125 TI - [Congenital staphyloma of the cornea]. PMID- 6855124 TI - [Calcinosis of the eyelid]. AB - Subepidermal calcified nodules are a well known clinical and histologic entity. Their occurrence in the lids should be recognized. Their origin remains obscure. All of the authors' patients were under 21 years old and had had the lesion for a number of years. The calcinosis must be a lesion which is acquired in early life and grows slowly for a few years. It does not cause any clinical symptoms. Histologically, the lesion consists of calcium deposits which are only rarely surrounded by an inflammatory (granulomatous) reaction. PMID- 6855126 TI - [A rare from of congenital cataract]. AB - In 1943 a 3 year-old-girl with hard star-like nuclear cataracts in both eyes underwent surgery. The white star-like nuclear remnants remained unchanged in the anterior chamber for more than 20 years. The son of this patient had the same rare cataract; surgery was performed on both eyes with practically the same results. PMID- 6855127 TI - [Differential diagnostic considerations in aniridia congenita and progressive iris atrophy]. AB - The autosomal dominant mode of inheritance in aniridia congenita and in dysgenesis mesodermalis (Rieger's syndrome) usually facilitates differentiation from progressive iris atrophy, whose occurrence is, with very few exceptions, sporadic. However, due to incomplete penetration, aniridia and Rieger's syndrome cannot be ruled out by family history alone. In addition, aniridia may closely resemble certain stages of iris atrophy. For appropriate genetic counseling, the reliability of differentiation between the dominantly inherited conditions and sporadic dystrophy has to be verified by: a) looking for extraocular manifestations of Rieger's syndrome or b) clear evidence of a progressive course in cases of essential iris atrophy. PMID- 6855128 TI - [Pulsating macroaneurysm of a retinal arterial branch]. AB - Pulsating macroaneurysms of retinal vessels have so far been described only as isolated cases. The case reported here was a 72-year-old female patient with systemic hypertension and suspected Raynaud's disease. The pulsating macroaneurysm was only observed for a few days; subsequently it fibrosed and an arterial branch occlusion was demonstrated. Retinal macroaneurysms have been mentioned in combination with aneurysmal cerebral vessels in hypertonic patients, suggesting generalized vessel wall disease. This patient's central visual acuity was hardly affected, even after a number of months, and photocoagulation treatment was thus unnecessary. Such treatment for retinal macroaneurysms should be considered in each case individually, depending on the extent of bleeding and edema. PMID- 6855129 TI - [Pathogenesis of papilledema in polycythemia]. AB - In a 47-year-old man papilledema and hemorrhages of the fundus were found to be related to polycythemia and hyperviscosity of the blood. The pathologic blood flow properties were normalized by isovolemic hemodilution, and reabsorption of the papilledema and hemorrhages was accomplished as a result. PMID- 6855130 TI - [Clinical application of Scheimpflug photography in the anterior segment]. AB - Scheimpflug photography gives increased depth of field, enabling a sharp optical section through the whole anterior segment of the eye to be obtained without leaving any structures out of focus. With the Topcon SL-45 the Scheimpflug optical section can be reproduced exactly. It is the method of choice for observing lens opacities. In addition, Scheimpflug photography offers an improved method of monitoring natural courses and/or the effects of treatment in, e.g., keratoconus, lenticonus, aphakia and pseudophakia. PMID- 6855131 TI - [Water-cushion contact lens for pars plana vitrectomy]. AB - Our water-cushion contact lens satisfies same requirements as the lenses we used previously: stabilization of the anterior segment, perfect attachment to the eye, freedom of movement of the eye in all directions. A rather important additional advantage is achieved by virtue of the fact that the lens floats on a constantly renewed fluid layer in a ring-shaped pool. Even in diabetic patients postoperative damage to the corneal epithelium no longer occur. A planoconcave or prismatic quartz lens may be placed into the pool. The lenses are scratch resistant and have an antireflective coating. Direct observation of the equatorial area in phakic and of the oraserrata area in aphakic eyes is possible with this perfect optical system. PMID- 6855133 TI - [Papilloarterial ischemia]. AB - Papilloarterial ischemia (PI) is the designation for a clinical picture characterized by circulatory insufficiency of the optic disk and the retinal arteries. Optic disk ischemia leads to visual loss, altitudinal field defects, pale papilledema and fluorescein angiographic filling defects of the disk capillaries. Retinal ischemia manifests itself by ophthalmoscopic and angiographic signs of caliber variations, focal constrictions or even occlusions of peripapillary retinal arteries. PI occurs more frequently in young females, in whom an inflammatory origin must be suspected in view of the angiographic staining of arterial walls, elevated sedimentation rates and clinical remission with systemic corticosteroids. Medical check-ups rarely relate PI convincingly with systemic disease, except in the elderly, where arterial hypertension or arteriosclerosis are often seen, and where the condition may improve after medical treatment of the cardiovascular status. PI was first described by the author in 1981; 10 cases are described in this paper and nosologically differentiated from other diseases of the optic disk and the retina. PMID- 6855132 TI - [Direct complete intubation of the lacrimal ducts in dacryocystorhinostomy]. AB - A new variant of the direct complete method of intubation of the lacrimal drainage system. The newly created lacrimal sac/nasal cavity anastomosis is intubated with a y-shaped silicon tube. A U-shaped bicanalicular silicon tube is inserted, end to side, into the y-shaped tubing, thus producing a complete intubation of the lacrimal drainage system. This technique has proved successful in 30 operations and is the operation of choice for revisions and "improvisations". At follow-up examinations performed between 3 weeks and 15 months later a total of 26 cases were found to have unobstructed passage from both the upper and lower punctum. Complete intubation of the lacrimal system permits safe orthograde and retrograde irrigation, promotes the reepithelialization of the new mucosa and prevents scarring and shrinkage in the area of the common duct orifice and the newly formed lacrimal sac/nasal-cavity anastomosis. PMID- 6855134 TI - [Arterial vascular occlusions of the eye following surgical intervention]. AB - In this paper the author reports on 6 patients who developed occlusion of a retinal artery following trauma or surgery. Three of these occlusions occurred in the central retinal artery after operations in the orbital area. Two of the operations were ear-nose-throat procedures with subsequent infection, causing compression of the optic nerve and a decrease in circulation. Two patients probably had genuine embolisms after either a carotid angiography or the removal of an aneurysm complex of the anterior communicating artery. An occlusion of the central retinal artery was also observed in one case after trauma (impact of a fist). All 6 patients experienced a large-scale decrease in visual acuity. When there is a risk of embolism or compression of the optic nerve, prophylactic measures such as a thrombosis prophylaxis or the prompt relief of pressure in the orbit should be considered. PMID- 6855135 TI - [Sequelae of injuries following eye contusion. Results of a study of 313 cases]. PMID- 6855136 TI - [Morphometry of the endothelium using automated television image analysis]. AB - Report on the use of a new image processing system (IPS) for automated morphometry of the corneal endothelium. The method is demonstrated with endothelial photographs taken with the aid of a Keeler-Konan wide angle specular microscope. The original picture is enlarged ten times, then digitized, detected, and analyzed. Areas containing 100-250 endothelial cells can be evaluated automatically. Depending on the quality of the photographs, larger areas sometimes require interaction by the investigator. The evaluation of a 621-cell picture is demonstrated step by step. The time saving which the method offers and its objectivity are discussed, as well as its use in combination with different specular microscopes. PMID- 6855137 TI - [Improvement of differential diagnosis of pigmented changes in the fundus using multispectral image analysis]. AB - On the basis of preliminary investigations completed in 1978 dealing with computer-assisted analysis of infrared photographs of the ocular fundus, multispectral photograph analysis methods were tested as to their usefulness in improving differential diagnosis. The computer used in this case was a process control computer with special peripheral equipment. Computer programs were developed to solve problems relating to photograph analysis and classification. Information obtained by computer processing should prove helpful in the differential diagnosis of pigmented changes in the fundus. Since melanomas cannot always be clearly differentiated by purely visual examination, and since the "extra-visual" spectra are often more easily interpreted with the aid of computerized photograph analysis, this paper presents examples illustrating the anticipated practical value of our investigations. PMID- 6855138 TI - [Clinical course of a choroidal melanoma observed for over 30 years]. AB - A newly developed choroidal tumor was observed by an ophthalmologist in 1946. Clinically, it was obviously a malignant melanoma and showed signs of growth. The patient, a 57 year-old woman, refused enucleation because her vision was good. She was examined at intervals by her ophthalmologist. Ten years later the tumor had attained a prominence of 18 D and shortly afterwards the patient developed visual disturbances. Another 11 years later vitreous opacities occurred. After a further 5 years the patient presented with glaucoma which led to chronic corneal edema. The eye was finally enucleated in 1977. Now, four years later, the patient is still well and without any sign of metastases. Histopathologic examination revealed a melanoma of spindle-cell type A, measuring 16 X 16 X 16 mm. The tumor had infiltrated the proximal optic fascicle and the overlying retina. As most prognostic data are based on histopathologic findings it seems essential for the future to find out more about the untreated melanomas (growth rate, vascularization, secondary changes such as perifocal inflammatory reactions, lesions of the retinal pigment epithelium barrier, retinal detachment, cyclitis and glaucoma). PMID- 6855139 TI - [Tyrosinosis with hepatolenticular degeneration (Wilson's disease)]. AB - A 23-year old man had suffered since the age of one year from recurring pain and reddening of one or both eyes. Additionally, striated compaction in the corneal epithelium and at the level of Bowman's membrane was observed while he was still a child. A corneal lattice dystrophy was therefore suspected, even though there was hereditary reason for it. The disease was subsequently identified clinically and serologically as Richner-Hanhart syndrome, accompanied in this patient by hepatolenticular degeneration (Wilson's disease) with a Kayser-Fleischer corneal ring. PMID- 6855140 TI - [Bilateral exophthalmos in sinus cavernosus thrombosis]. PMID- 6855141 TI - [Multiple vitelliform retinal cysts]. AB - The authors report on a case of multiple vitelliform retinal cysts which were observed by chance during an examination for an expert opinion on a bulbar contusion. It is shown that these cysts are hard to recognize by simple ophthalmoscopy, but may be visualized by fluorescein angiography in the form of bright circular areas, sometimes differently colored. The developmental mechanism is illustrated with histologic pictures. PMID- 6855142 TI - [Ocular pressure preceding intraocular interventions]. PMID- 6855143 TI - [From non-protein nitrogen to convergent squint. Expression and logic in medicine]. PMID- 6855144 TI - [Clinical course and prognosis in medulloblastoma in infants and young children]. AB - From 1962 until 1981 six children with histologically assured medulloblastoma younger than three years of age have been treated at Munster University Clinics. The interval from the onset of symptoms until the clinical admission lasted six weeks, a very short time compared with the admission interval of adults. The survival time after admission was only sixteen days in average. All children died because of central disregulation due to their disease. PMID- 6855145 TI - [Poland syndrome]. AB - We present two patients with symptoms typical of Poland's Syndrome: unilateral hypoplasia of the pectoral muscle and dysplastic anomalies of the ipsilateral upper limb. Additionally skeletal and G.U. tract abnormalities can be found. One of our cases shows stenosis of the ureterovesical junction which led to hydronephrosis and dilation of the ureter; in the other case the ventral portions of the 3rd and 4th right ribs are missing. PMID- 6855146 TI - [Calcium-phosphate metabolism in pre-term infants]. AB - Physiological and clinical aspects are discussed in this review on calcium phosphate metabolism in pre-term infants. Calcium accumulation in the bone mass of the foetus is related to the gestational age, and mainly occurs during the last weeks of gestation. Therefore, after birth, hypocalcemia is more frequent in pre-term than term infants. However, clinical symptoms of hypocalcemia, e.g. attacks of apnea, hyperexcitability and hypotonia, are rarely observed. Such symptoms depend upon the serum concentration of ionized calcium and this concentration is influenced by various metabolic factors. During the first two weeks of life phosphate is elevated in comparison to later periods. In spite of sufficient vitamin D supplementation low serum phosphate levels occur due to insufficient supply of phosphate. This correlates with evidence of rickets. An increased alkaline phosphatase activity can be considered an early and sensitive indicator. Pre-term infants develop rickets more frequently than term infants due to calcium-phosphate deficiency. Vitamin D supplementation alone is insufficient and should be combined with phosphate, as had been stated previously. PMID- 6855147 TI - [The cavum septi pellucidi and cavum Vergae in infants -- an investigation with 2 dimensional sector-echo encephalography]. AB - Using a two-dimensional sector-scanner the brains of 642 preterm and term infants between 28 weeks of gestation and 12 months of age were examined for the incidence of a cavum septi pellucidi (CSP) and a cavum Vergae (CV). In 100 out of 642 infants we saw a CSP. The highest incidence (52%) was found among the infants of very low gestational age (-33 weeks) within the first seven days of life. After the second month the incidence decreases rapidly (only 1% in infants - months). We saw a CV only in combination with a CSP, less frequent, however, than a CSP alone (26 out of 642 infants): the incidence was 33% in infants of very low gestational age (-33 weeks) within the first seven days of live, only 4% in term neonates and 0% after the second month of life. Finally, the rupture of a septum with CSP and CV by stretching forces is demonstrated in an infant with progressive hydrocephalus. The data of this paper contribute to the knowledge of the morphological development of the normal fetal and newborn brain. PMID- 6855148 TI - Pancreatic sonography in thalassemia major. AB - Four patients with thalassemia major and well documented transfusional anamnesis were investigated sonographically. Beside the fibrous reaction of iron overload in the liver the outstanding finding was the grossly increased echogenicity of the normal sized fibrotic pancreas in transfusional hemosiderosis. Upper abdominal sonography may be an useful - noninvasive - method for the assessment of iron load in regularly transfused patients. Moreover, pancreatic sonography may be helpful as follow-up method of chelation therapy. PMID- 6855149 TI - [Aortic rupture diagnosed by the method of sectorial scanning]. PMID- 6855150 TI - [Problems of diagnosis and prevention of subacute septic endocarditis]. PMID- 6855151 TI - [Dysbacteriosis and superinfection as a result of the use of antibiotics]. PMID- 6855152 TI - [Effect of various psychotropic drugs on the tolerance of patients with angina pectoris to dynamic and isometric exercise]. PMID- 6855153 TI - [Retrospective evaluation of unstable angina pectoris in various types of myocardial infarct]. PMID- 6855154 TI - [Problems of diagnosis of embolic and post-embolic lesions of the trunk and the main pulmonary arteries]. PMID- 6855155 TI - [Effectiveness of digoxin emergency therapy of paroxysmal supraventricular tachycardia]. PMID- 6855156 TI - [Glucosaminidase activity in the leukocytes of patients with myocardial infarction]. PMID- 6855157 TI - [Diagnosis of atherosclerosis of the peripheral arteries in patients with ischemic heart disease]. PMID- 6855158 TI - [Detection of latent arterial hypertension during preventive examination]. PMID- 6855159 TI - [Withdrawal syndrome in the treatment of arterial hypertension with clofelin]. PMID- 6855160 TI - [Rupture of the chords of the mitral valve in patients with infectious endocarditis]. PMID- 6855161 TI - [Various problems of diagnosis, pathogenesis and treatment of bronchial asthma]. PMID- 6855162 TI - [Drainage of the thoracic duct in the treatment of severe forms of bronchial asthma]. PMID- 6855163 TI - [Various characteristics of the clinical course and diagnosis of acute pneumonia]. PMID- 6855164 TI - [Endovascular correction of the bronchopulmonary blood flow in the treatment of pulmonary hypertension]. PMID- 6855165 TI - [Systemic spontaneous panniculitis]. PMID- 6855166 TI - [Case of unrecognized Conn's disease]. PMID- 6855167 TI - [Protracted septic endocarditis with destruction of the interatrial septum]. PMID- 6855168 TI - [Rupture of the aortic aneurysm in young age]. PMID- 6855171 TI - [Physical status and biochemical indices of obese pilots after prophylactic measures]. PMID- 6855169 TI - [Effect of a 140-day flight on the amino acid content of the blood of cosmonauts]. AB - The results of studying 17 free amino acids in the plasma of the 140-day Salyut-6 crewmembers are presented. The measurements were carried out by means of a Hitachi KLA-3B amino acid analyzer. The data obtained give evidence that the dietary uptake of amino acids before and during flight should be better controlled, the dietary content of amino acids should be enriched with certain amino acids (primarily methionine and cystine) and more adequately balanced. It is recommended to select space diets on an individual basis, taking into consideration anthropometric and metabolic characteristics of cosmonauts. PMID- 6855170 TI - [Nutritive value of preserved products in tubes for the feeding of pilots and cosmonauts]. AB - The nutritional value of new canned liquid and puree-like foodstuffs in aluminum tubes for aircraft and spacecraft pilots has been determined. The recipes and chemical composition of the food items are described. Particular attention is given to the content of amino acids, fatty acids and minerals. It is shown that canned foodstuffs are inhomogeneous in their chemical composition which is to be taken into consideration when they are used as menu items. PMID- 6855173 TI - [Postural hemodynamic shifts following short-term space flights]. AB - Variations in the pulse blood content and tone of cerebral vessels, vertebrobasilar system, lungs and legs during the antiorthostatic tests were examined rheographically in 14 cosmonauts after 8-day space flights. The results of adaptation of the vascular system to zero-g which included smaller changes in hemodynamic parameters of the hemispheres and vertebrobasilar system during postflight tests were seen during the first days of the recovery period. Regional hemodynamic parameters returned to the preflight level within 3 to 14 days postflight. The vascular response to the head-down tilt at --15 and --30 degrees was the most informative. This led to the recommendations concerning modifications of antiorthostatic tests to be used in the selection of space crewmembers for short-term flights. PMID- 6855172 TI - [Effect of a 7-day space flight on the structure and function of the human locomotor apparatus]. AB - The goal of the joint USSR-Cuba experiment Support was to study the support properties of the foot arch in weightlessness-induced motor changes and their prevention with the help of the Cupula Sand-501 device. Comparison of the responses of the crewmembers shows that support simulation diminished the level of many of the adverse effects of zero-g in the Cuban pilot who used the prophylactic device. It is suggested that the efficiency of the device is due to its activation of the system of support reactions. The mechanisms of the effects of weightlessness on the structure and function of the bones and joints in humans are discussed. PMID- 6855174 TI - [Content of biogenic amines and their precursors in human blood during head-down tilt and in taking pharmacological agents to prevent the motion sickness syndrome]. AB - The 6-hour exposure to head-down tilt at --15 degrees was accompanied by an increased blood content of adrenaline and noradrenaline, thus indicating the activation of the sympathoadrenal system. The catecholamine concentration was shown to be proportional to the head-down tilt time. The exposure also led to an increase of the content of serotonin and left the content of 5-hydroxytryptophan, tryptophan, histamine and histidine unchanged. After administration of ephedrine and especially, ephedrine in combination with pipolphen the increase in the concentration of catecholamines and serotonin became significantly less pronounced. PMID- 6855175 TI - [Results of a quantitative cytological analysis of the thymus of rats exposed on biosatellites]. AB - The mitotic activity, destruction and volume of nuclei of thymocytes were investigated on histological preparations of the thymus of rats flown onboard Cosmos-782 and Cosmos-936. The cytological data showed that immediately after touchdown large quantities of thymocytes of the cortical matter perished. The mitotic activity of the remaining undamaged thymocytes declined and returned to normal 9 hours after recovery. The rats that were centrifuged inflight (at 1 g) did not display a lower mitotic activity or noticeable destruction of thymocytes. Karyometric measurements demonstrated that the population of thymic lymphocytes was heterogeneous in the nuclear volume: it consisted of three peak classes of nuclear volumes. The variance curves of nuclear volumes of lymphocytes of the medullary matter were drastically shifted toward large numbers. An increase in the nuclei of thymocytes of the cortical matter in the flight rats was stable and persisted till R+25. PMID- 6855176 TI - [Morphofunctional properties of the peripheral blood and bone marrow cells of rats following a flight on board the Kosmos-936 biosatellite]. AB - Morphofunctional properties of peripheral blood cells of Cosmos-936 rats were examined, using morphological, interferometric and electron microscopic techniques. As follows from the morphological data, immediately after recovery the weightless rats showed symptoms of a stress reaction which disappeared by R+3. The centrifuged rats exhibited less expressed symptoms of this sort. The percentage of bone marrow cell distribution was shifted towards enhanced myelopoiesis and diminished erythropoiesis. By the end of the readaptation period the ratio of bone marrow cell composition returned to normal. Interferometric and electron microscopic examinations did not reveal any irreversible changes in the structure and function of cells that may be caused by zero-g. PMID- 6855177 TI - [Enzyme activity in the subcellular fractions of the liver of rats following a flight on board the Kosmos-1129 biosatellite]. AB - The activities of malate, isocitrate, and lactate dehydrogenases were measured in the liver mitochondrial and cytoplasmatic fractions of rats flown for 18.5 days onboard Cosmos-1129. The activities of the oxidative enzymes, malate and isocitrate dehydrogenases, in the mitochondrial fraction and those of the glycolytic enzyme, lactate dehydrogenase, in the cytoplasmatic fraction were found to decrease. PMID- 6855178 TI - [Hemodynamics of the lesser circulation in prolonged hypokinesia (based on data from a morphological study)]. AB - This paper presents data on pulmonary circulation of rats during prolonged hypokinesia (30 to 165 days). It was found that the hypokinetic exposure of 30 to 60 days produced venous and, in particular, capillary plethora associated with blood redistribution and pooling in the lungs. As the exposure continued, the plethora level decreased due to the development of compensatory-adaptive reactions in the lung vessels. For instance, on hypokinetic day 90 small arteries of the muscle type developed a spasm which accelerated circulation stabilization. By hypokinetic days 120-165 pulmonary circulation returned to normal due to the further development of compensatory-adaptive mechanisms in lung vessels (tendency for hypertrophy of the media of small arteries and increase of its cross sectional area). PMID- 6855179 TI - [Psychophysiological characteristics of monkeys according to the delayed reactions test]. PMID- 6855180 TI - [Circadian rhythm of human urinary potassium excretion during head-down tilt]. PMID- 6855181 TI - [Effect of sidnocarb and dihydroergotamine during 6-hour head-down tilt hypokinesia on human physical work capacity]. PMID- 6855182 TI - Diagnostic exercise: copper deficiency in piglets. PMID- 6855183 TI - Effect of propoxur-impregnated pesticide tape on mouse cholinesterase levels. AB - Mice housed in polycarbonate cages, either with or without fiberglass filter bonnets, were exposed to propoxur-impregnated tape for 2 hours, 24 hours, or 7 days. Both erythrocyte and serum cholinesterase levels were determined at each time point. Body weights were also measured. There was no change in body weight or serum cholinesterase level. Erythrocyte cholinesterase level showed significant decrease, related to increasing length of exposure. PMID- 6855184 TI - N-nitrosamines in laboratory animal feed and bedding. AB - Volatile nitrosamine concentrations in laboratory animal feeds and bedding were determined by gas chromatography with a thermal energy analyzer. N nitrosodimethylamine was detected in all samples of NIH-07 meal (range of 1.2 to 65.9 parts per billion) and 62% of NIH-07 pellet samples (0.6 to 35.2 parts per billion). It was also detected in 66% of closed formula meal (1.9 to 45.1 parts per billion) and 83% of closed formula pellets (0.2 to 21.3 parts per billion). Low concentrations were found in samples of hardwood chip and corncob bedding. Less frequently found in feed samples were N-nitrosodipropylamine, N nitrosoethylmethylamine, and N-nitrosopyrrolidine. The latter was not detected in the closed formula diets. Traces of three nitrosamines (N-nitrosodimethylamine, N nitrosodipropylamine, and N-nitrosomorpholine) were found in a single sample of AIN-76 mineral mix. These latter two nitrosamines and N-nitrosoethylmethylamine have not been reported previously in laboratory animal feeds. PMID- 6855185 TI - A pelvimetry method for predicting perinatal mortality in pregnant squirrel monkeys (Saimiri sciuresus). AB - High perinatal mortality has impaired the reproductive performance of female squirrel monkeys in captivity. A pelvimetry method as a potential predictor of pregnancy outcome was devised to evaluate the bony pelvic structures of females for which records of previous pregnancies were available. By utilizing lateral and anteroposterior radiographic views of the pelvis, the inlet, the midpelvis, and the outlet were measured. In the colony, 21 females had livebirths, 13 delivered dead term fetuses (stillbirths), and six aborted. Comparison of the pelvic outlet of the females with liveborn fetuses (1.81 +/- 0.12 cm) with those which had stillbirths (1.64 +/- 0.09 cm) revealed a highly significant difference (p less than 0.001). Discriminant analysis demonstrated a 95.2% predictability of females which had liveborn and a 92.1% rate in females with stillborn fetuses. Pelvimetry may be a useful tool in predicting pregnancy outcome, as narrow pelvic outlets were consistently observed in females that delivered stillborn infants. PMID- 6855186 TI - A sugar and electrolyte drinking solution for long-term maintenance of adrenalectomized rats. AB - Adrenalectomized rats maintained on a diet containing the normal concentration of electrolytes and given physiological saline to drink had low growth rates and abnormal serum electrolytes. The presence of 29 mM (10 g/liter) sucrose in the drinking solution stimulated the animals to drink. The enhanced drinking resulted in an increase in the growth rate and improved the animals electrolyte status. This treatment was used to maintain adrenalectomized rats for more than 16 weeks and adrenalectomized-diabetic rats for 8 weeks. PMID- 6855187 TI - Chronic intraperitoneal administration of fluids in rats. AB - A simple method for continuous long-term intraperitoneal administration in rats was devised. Polyethylene tubing was inserted into the peritoneal cavity through an incision in the abdominal wall just below the rib cage. The other end of the catheter was then guided subcutaneously toward an incision located in the back of the neck. The external opening of the catheter was blocked with a small piece of stainless steel wire. The indwelling intraperitoneal catheter permitted instillation of various solutions in rats four times daily for up to 94 consecutive days without apparent stress or pain on the treated animals. The catheter remained patent for the duration of the study in 39 of 60 (65%) rats. PMID- 6855188 TI - Adrenalectomy in the guinea pig: operative and perioperative management. AB - Guinea pigs were anesthetized by epidural injection of xylocaine 20 minutes following the administration of chlorpromazine, cortisone, and hydrocortisone. The right adrenal gland was removed aseptically by careful blunt dissection. Ten milliliters of warm saline containing tobramycin was given subcutaneously at the conclusion of the surgery, and the guinea pig was returned to a recovery cage containing a heating pad. Ten days later, the left adrenal gland was removed using similar procedures. PMID- 6855189 TI - Droperidol-fentanyl as an aid to blood collection in rabbits. AB - Administration of a droperidol-fentanyl combination to laboratory rabbits at a dose of 2.5 mg/kg and 0.05 mg/kg body weight, respectively, produced vasodilatation which greatly facilitated blood withdrawal from the central auricular artery. The method eliminated the need for vacuum devices or topical irritants and posed little risk or discomfort to the animal. PMID- 6855190 TI - Arteriovenous malformation in a rhesus monkey (Macaca mulatta). AB - A developmental arteriovenous malformation of the right arm was recognized in a 1 year-old rhesus monkey. The diagnosis was based on physical findings, ultrasound, and angiography. Treatment consisting of therapeutic transcatheter embolization using polyvinyl alcohol was performed with partial success. Necropsy revealed a lesion that was limited to the skin and subcutis. An abnormal vascular pattern was present leading to and within the lesion. PMID- 6855192 TI - Automatic watering device for owl monkeys. PMID- 6855191 TI - Identification of Campylobacter jejuni in Macaca fascicularis imported from Indonesia. AB - Campylobacter jejuni was selectively cultured in 33 (66%) of 50 Macaca fascicularis that had been imported from Indonesia. As there was no published information on the incidence of Campylobacter infection in nonhuman primates from Indonesia, a survey was conducted to determine the presence and incidence of Campylobacter jejuni in 50 macaques before they were exported from Indonesia. The organism was positively identified in 18 (36%) of the specimens examined. Repeat cultures after importation and during the quarantine period produced 37 of 48 (77%) positive results. Stool cultures from 57 other Macaca fascicularis and Macaca nemestrina in more preliminary stages of captivity in Indonesia produced only two positive identifications. These findings suggest that Campylobacter jejuni is not a natural pathogen of macaques in Indonesia, but it infects them after capture. PMID- 6855193 TI - Bile restitution procedures for studying bile secretion in fistulated pigs. AB - In order to study bile secretion in the fistulated pig, an apparatus which reinfused the secreted bile at a rate reflecting the secretion rate, was used. The essential parts were a glass container equipped with two platinum wire electrodes, an electronic relay, a stop valve, and a peristaltic pump. This apparatus allowed a reinfusion of collected bile in a volume determined by the position of one of the electrodes, the recording of bile flow, and a continuous sampling for chemical analysis. PMID- 6855195 TI - Endothelial cell activity in experimental hypertension. Effects of hemodynamic factors. AB - The cause of the increased endothelial cell proliferative activity found in experimental hypertension in the rat is not clear. In this experiment the part played by altered vascular hemodynamics was explored in a model in which part of the aorta was subjected to a high blood pressure and the other not. Hypertension was produced by the application of a tight ligature to the aorta between the levels of the two renal arteries, the mechanism being interference with the blood supply to the more distally placed kidney. Because the aorta is constricted, the segment above the ligature is subjected to high blood pressure and the segment below it to lowered pressure, although both segments are exposed to humoral factors such as renin and angiotensin II. Aortic endothelial cells were labeled with tritiated thymidine and cell replication and cell density studies carried out using en face monolayer preparations of endothelium. It was found that endothelial cell replication was considerably increased at 7 days following induction of hypertension in segments of aorta above the ligature but not in the segment below the ligature. The increased activity was short-lived and had returned to normal levels at 4 weeks. Cell density was increased above the ligature at both 1 and 4 weeks following induction of hypertension. The changes are consistent with the idea that the increased cell replication and consequent increased cell density above the ligature were initiated by the increased stretching of the aortic wall attending the development of hypertension. PMID- 6855194 TI - Full and empty particles of hepatitis B virus in hepatocytes from patients with HBsAg-positive chronic active hepatitis. AB - Complete and defective hepatitis B virus (HBV) particles in sera and hepatocytes were observed by electron microscopy for an understanding of the maturation process of hepatitis B virus. To distinguish Dane particles with or without DNA on the basis of staining density with uranyl acetate, Dane particles, purified from sera of asymptomatic carriers, and Dane particle cores, separated by ultracentrifugation in a metrizamide density gradient, were observed by electron microscopy. Complete cores at a low density (1.19 to 1.23 gm/cm3) were electron dense and incomplete cores at a high density (1.23 to 1.27 gm/cm3) were partially electron dense or empty. These findings demonstrated that the presence or absence of DNA is reflected by the electron density of the core. Our result, in which less than 10% serum Dane particles have full cores in ultrathin sections of the pellet, is in agreement with Gerin's finding that defective Dane particles are predominent in sera. Naked core particles and Dane particles in two biopsy specimens from patients with hepatitis B surface antigen, hepatitis B e antigen, and DNA polymerase-positive, chronic active hepatitis were classified into complete versus incomplete particles on the basis of electron density. Nine hundred and fourteen naked core particles were detected in nuclei and cytosol of 68 hepatocytes. One hundred and five core particles (11.5%) were electron dense and 809 core particles (88.5%) were partially electron dense or empty. Furthermore, 488 Dane particles were observed in the cisternae of the endoplasmic reticulum of these hepatocytes. Fifty Dane particles (10.2%) had full cores, and 438 Dane particles (89.8%) had partially full or empty cores. These findings suggest that DNA may be incorporated into about 1 to 10% of core particles when they are assembled in nuclei of hepatocytes. Morphologic differences in damage to hepatocytes containing various frequencies of full Dane particles were also studied, but no significant correlation was found between damage in hepatocytes and frequency of full Dane particles. PMID- 6855196 TI - Effect of prolonged exposure to 80% oxygen on the lung of the newborn mouse. AB - Continuous exposure of newborn C57BL mice to 80% oxygen at normal atmospheric pressure for as many as 6 weeks results in significant pulmonary injury. This injury is reflected morphometrically and morphologically primarily in an increase in the pulmonary interstitial compartment and in pulmonary fibrosis. The fibrotic response is both peribronchiolar and parenchymal. Lowering the oxygen concentration of continuous exposure from 100 to 80% appears to reduce the cellular response of the alveolar lining cells and the bronchiolar mucosa in the newborn lung more than the fibrotic response. This suggests that the most persistent response in the growing lung to supplemental oxygen concentrations at or below 80% will be peribronchiolar and parenchymal fibrosis. These findings would account for the clinically observed reduction of stage II bronchopulmonary dysplasia, yet persistence of chronic bronchopulmonary dysplasia in human infants treated with supplemental oxygen concentrations below 100%. PMID- 6855198 TI - Lavage type III procollagen N-terminal peptides in human pulmonary fibrosis and sarcoidosis. AB - Levels of type III procollagen N-terminal peptide were immunoassayed in sera and bronchoalveolar lavage fluids from healthy volunteers and patients with idiopathic pulmonary fibrosis or sarcoidosis. Peptide levels normalized to protein were higher than corresponding serum levels in all groups, suggesting that the lung is a producer of this peptide. Levels were significantly elevated in both patient groups, suggesting increased rates of type III collagen synthesis. Values were highest in idiopathic pulmonary fibrosis samples. Correlation of peptide levels with clinical severity of disease and lavage cell profiles was poor, perhaps because the latter reflects aspects of the disease process other than that stage in which type III collagen synthesis is altered. Lavage analyses of procollagen peptides may provide an important index of altered collagen synthesis in interstitial lung disease. PMID- 6855197 TI - Cell proliferation in normal and atherosclerotic human aorta. II. Autoradiographic observation on deoxyribonucleic acid synthesis in primary cell culture. AB - Proliferative potentiality of cells from atherosclerotic and nonatherosclerotic human aorta was evaluated in culture by the incorporation of radioactive thymidine. Thymidine index was determined autoradiographically in primary cultures of intimal and medial cells isolated from zones of fatty infiltration, fatty streaks, atherosclerotic plaques, and uninvolved areas. The thymidine index in medial cultures was higher than in the intimal ones and was unrelated to the type of lesion. In intimal cultures obtained from zones of fatty infiltration and fatty streaks the thymidine index exceeded the normal value by 4.5- and 3-fold, respectively. In cell cultures of the plaque and unaffected intima the thymidine index was the same. PMID- 6855199 TI - Ethanol, hepatocellular organelles, and microtubules. A morphometric study in vivo and in vitro. AB - The effects of chronic ethanol intoxication on hepatic microtubules are controversial. We, therefore, designed a morphometric study to examine ethanol induced alterations in microtubules in vivo and in vitro. Using a computer assisted point-counting system we determined the volume, surface, and length densities of hepatic microtubules, in addition to those of other hepatic organelles. Consistent with previous qualitative descriptions, chronic ethanol feeding caused increases in the volume and surface densities of mitochondria and microsomes. These changes account, in part, for the increased protein content of hepatocytes after chronic ethanol consumption. However, there was no effect on the volume, surface, or length densities of hepatic microtubules, nor on their calculated radii. The structure of isolated bovine brain microtubules after polymerization in vitro was not changed by ethanol or its metabolites, acetaldehyde and acetate. These data indicate that neither chronic ethanol intoxication nor the presence of ethanol, or its metabolites, affects the number or structure of microtubules. PMID- 6855200 TI - A comparison of the extent and site of energy and protein digestion of wheat, lupin and meat and bone meal by pigs. PMID- 6855201 TI - Turnover and hydrolysis of vicine and convicine in avian tissues and digesta. PMID- 6855202 TI - Saponin content of food plants and some prepared foods. PMID- 6855203 TI - Fenthion residues in milk and milk products following treatment of dairy cows for warble-fly. PMID- 6855204 TI - Analytical method for the determination of acrylonitrile in rat plasma at the nanograms per milliliter level. AB - A method is described for the determination of acrylonitrile (propenenitrile, vinyl cyanide, AN) in rat plasma at the ng/mL level by gas chromatography (GC) utilizing a modified delayed injection technique (DIT) and a nitrogen-phosphorus detector. The method was developed to determine the acrylonitrile plasma profile following administration of various dose levels of AN via different routes. A remote injection apparatus was placed in-line with the purge gas to the precolumn of the DIT. Using this arrangement, matrix interferences in rat plasma samples normally incurred during GC analysis were overcome, while a high sensitivity for acrylonitrile was maintained. The ability to analyze 20-microL samples made serial kills unnecessary and duplicate injections possible with an analysis time of approximately 10 min/sample. The average detection limit for the entire study (3 x background) was 2.0 ng/mL. PMID- 6855205 TI - A low-cost differential fluorimeter for the detection and determination of LSD in illicit preparations. AB - The construction and use of a differential fluorimeter for rapid detection of LSD in confiscated material under field conditions is described. The apparatus is robust, electronics-free, compact and inexpensive. Adequate sensitivity is ensured by the high quantum yield of LSD fluorescence and a large degree of specificity is obtained by carrying-out two separate measurements: one in water and one in 1 M NaOH. PMID- 6855206 TI - A report on the analysis of orphenadrine in post mortem specimens. AB - A discussion of the methods reported for the analysis of orphenadrine is given. The drug levels in biological specimens and the methods reported vary widely. The stability and extractability of orphenadrine is investigated and a method suggested, which uses subtilisin digestion of tissue followed by extraction with 1-chlorobutane. Body fluids are extracted directly by 1-chlorobutane after pH adjustment. Analysis is performed by gas chromatography with a nitrogen selective detector and no interferences are observed from bland specimens. The following levels are results from a case of a 19-year-old male who was found dead 2.5 hours after last being seen alive. This laboratory analysed the case using diphenhydramine as an internal standard: blood 18.1 micrograms/mL, liver 242 micrograms/g, urine 7.0 micrograms/mL, stomach contents 1452 mg. PMID- 6855207 TI - The unusual occurrence of 4-aminoantipyrine (4-aminophenazone) in human biological fluids. AB - During toxicology screening of human biological fluids, 4-aminoantipyrine (4-AAP) was detected in 19 patients and identified by two-dimensional TLC and UV spectrophotometry with whole blood concentrations of 4-AAP ranging from 0.4 to greater than 4.9 mg/dL. Of the 19 patients, 15 had received prior treatment at a Mexican health-care facility before transfer to this medical center. Since 4-AAP is a known metabolite of aminopyrine, it is likely that the patients had ingested this anti-inflammatory, analgesic agent in Mexico; however, the clinical histories in this respect were vague. Recognition of the presence of 4-AAP in biological fluids is important, since the parent drug may produce fatal agranulocytosis and the compound may complicate the detection of other compounds that simultaneously partition into the weak-base fraction in toxicology screening. PMID- 6855208 TI - Suicidal poisoning by endothall. AB - A fatal case of suicidal ingestion of the herbicide endothall (7-oxabicyclo [2,2,1]heptane-2,3-dicarboxylic acid) is described. Endothall was determined after initial phosphotungstic acid deproteination followed by extraction using 1,2-dichloroethane:tert-butanol (2:1) and subsequent injection into the gas chromatograph equipped with a flame ionization detector. Identity was confirmed by thin-layer chromatography, infrared spectrophotometry, and gas chromatography/mass spectrometry. PMID- 6855209 TI - An automated analysis of glutathione peroxidase, S-transferase, and reductase activity in animal tissue. AB - A centrifugal analyzer and a spectrophotometer were compared for routine analysis of xenobiotic metabolizing enzymes glutathione (GSH) peroxidase, GSH-S transferase, and GSH reductase. Lung, liver, and kidney from 60-day-old male rats were used as the source of enzymes. Linear regression analysis was used to assess the accuracy and precision of the centrifugal analyzer method in measuring enzyme activities. Biologically and statistically, the centrifugal analyzer proved to be acceptable for routine measurement of these GSH-dependent enzymes. PMID- 6855210 TI - A therapeutic monitoring assay for N-methylformamide in human serum and urine. AB - This report describes a gas chromatographic procedure using a packed column and a flame ionization detector, which is suitable for the therapeutic monitoring of N methylformamide (N-MF). N-MF is a polar compound that induces cancer cell maturation in vitro and exhibits antitumor activity with human tumors xenografted in nude mice. Toxicology studies with mice have shown this compound to be hepatotoxic. N-MF is currently undergoing Phase I clinical trial as an anticancer drug at this institution. In concert with its clinical trial, a method for the analysis of N-MF in biological fluids has been developed to study its pharmacokinetics. This method involves direct injection of urine or acetone deproteinized serum onto a Chromosorb 103 column, using N,N-diethylformamide as an internal standard. PMID- 6855212 TI - A comparative analysis of suicide and religiosity. PMID- 6855211 TI - Effects of varied smoking machine parameters on deliveries of total particulate matter and selected smoke constituents from an ultra low-tar cigarette. AB - A typical ultra low-tar cigarette was mechanically smoked under varying conditions designed to simulate potential changes in human smoking behavior. Determination of the yields of total particulate matter and analyses of individual smoke components, including nicotine, phenolics, acids, and the humectant, glycerol, demonstrated significant changes in smoke composition as related to intensity and frequency of inhalation. Physical obstruction of tipping paper ventilation, by negating the effects of air dilution of smoke, resulted in increased smoke deliveries similar to those observed when puffing volume and frequency were increased. PMID- 6855213 TI - Measurement of cardiac pressure-length loops using an improved sonomicrometer. Accuracy and effect of respiration. AB - A transit-time sono-micrometer for measurement of myocardial dimensions is described. Crystals of frequencies 1-10 MHz can be used, enabling a large range of distances to be measured. The meter has two channels, operated in sequence to avoid interference between channels. By combining local muscle segment length with the left ventricular pressure in open-chest cats, the pressure-length loop for that segment was continuously displayed. A calibration procedure was developed, permitting calibration to be registered on a recorder and on a storage monitor at any time. Detailed interpretation of loops from normal and ischaemic segments of the left ventricle is presented. Variation of the loop form with respiration is demonstrated, which clearly necessitates a standardized reference point in the respiratory phase for comparing loops from two or more experimental situations. PMID- 6855214 TI - Blade implants: presurgical preparation procedures and radiographical analyses. AB - In dental implantology the selection of the implants, the design of the prosthetic appliance and the relationship between implant and occlusal antagonists are based on clinical evaluation, the study of mounted casts, as well as radiography. The simulated data from the articulator must be transferred to the oral cavity during surgery. The alveolar bone height is critical for treatment planning. Determination of the height of the alveolar process, the location of the alveolar nerve and the maxillary sinus may be based on measurements on radiographs or intra oral evaluation. A comparison study of the radiological analysis based on pantomography or free focus radiography, with actual measurements in the oral cavity was carried out in a patient. The results indicated major discrepancies between direct measurements on radiographs and those carried out clinically. PMID- 6855215 TI - Adaptive microcomputer control of an artificial knee in level walking. AB - An experimental microcomputer controlled prosthesis is discussed, where knee damping is governed by kinematic signals, picked up from both legs. The control algorithm is based on division of the walking cycle into ten stages; each stage characterized by an appropriate damping level which governs the restraining moment at the knee, as functionally required. Stage identification is carried out by the kinematic inputs. The experimental prosthesis was tested on one amputee, the first author of this paper. The control system was found to be more advantageous than a conventional valve system in significantly reducing hip muscular effort on the prosthetic side. Gait symmetry is also improved. PMID- 6855216 TI - Static response of a simple piezoelectric load cell. PMID- 6855217 TI - A battery powered constant current stimulator. PMID- 6855218 TI - Conductive rubber footswitch design. PMID- 6855219 TI - The design of digital filters for biomedical signal processing. Part 3: The design of Butterworth and Chebychev filters. AB - The first two papers in this series reviewed the basic concepts which apply to digital filter theory and presented design techniques based on the z plane pole zero plot. In this paper these methods are used to develop digital versions of Butterworth and Chebychev filters. The basic theory of both filter types is reviewed and the bilinear transformation is used to derive the z-transforms of the filters from their s-plane continuous time descriptions. Recurrence relationships which may be used to implement filters of various orders are developed. The impulse and frequency responses of the elements are illustrated and examples are given of their application to ECG data. PMID- 6855220 TI - Does interstitial pressure oppose lung water formation? PMID- 6855221 TI - Videodensitometric quantitation of mean blood flow. AB - Standard angiography demonstrates the anatomy of arterial occlusive disease but does not define its physiological significance. However, measurement of flow in a compromised vessel at rest and following peripheral dilatation provides important physiological information. Using digital subtraction angiography, femoral arterial flows determined by the cross-correlation transit time technique were compared to measurements by electromagnetic flowmeter. Thirty-five femoral arterial flow measurements were obtained in nine dogs instrumented with an electromagnetic flow probe and balloon occluder. Renografin 76 (7 cc) was power injected at 14 cc/sec into the distal abdominal aorta. Angiographic flow measurements correlated well with electromagnetic flowmeter measurements (r = 0.94, standard deviation of the difference (SDD) = 15 ml/min). Intravenous studies provided somewhat poorer correlation due to difficulties in defining dimensions (r = 0.72, SDD = 36). Paired contrast injections (2 injections in succession) in 11 studies increased flow from an average of 80 to 250 ml/min (a 210 +/- 100% increase), providing an estimate of a vessel's capacity to provide increased flow during peripheral dilatation. Thus, reliable angiographic flow determinations may be obtained by arterial and intravenous contrast injections, adding physiological information to anatomical definition. PMID- 6855222 TI - Myocardial protection by lidocaine during cardioplegia. AB - This study was undertaken to examine the effects of lidocaine (L) (400 mg/liter) in a normokalemic crystalloid (S) (K +: 5 meq/liter, Na+: 120 meq/liter) and in a hyperkalemic crystalloid cardioplegic solution (K) (K+: 25 meq/liter, Na+: 120 meq/liter) during 90 min of hypothermic (28 degrees C) aortic occlusion followed by 45 min of reperfusion (R). Four groups of dogs were studied: group 1 (S), n = 6; group 2 (S + L), n = 6; group 3 (K), n = 6; group 4 (K + L), n = 6. Left ventricular (LV) function was defined as percentage changes in center of mass between pre- and postarrest function curves. Regional myocardial flow was measured with 9 mu radioactive microspheres and myocardial metabolism monitored by lactate and oxygen utilization. Ventricular biopsies were obtained for measurement of myocardial ATP, creatine phosphate, and water content. Percent recovery of LV function curves at the end of (R) was 59.2 +/- 3.9% in group 1, 85.0 +/- 4.3% in group 2, 71.5 +/- 4.9% in group 3, and 87.0 +/- 4.5 in group 4 (group 1 vs group 2, P less than 0.01; group 3 vs group 4, P less than 0.05). Metabolic recovery was evaluated at 5, 20, and 45 min of (R). Only group 3 (K) demonstrated persistent lactate production at 5 min of (R) (P less than 0.01). The hyperkalemic groups failed to return to control levels of oxygen utilization after 5 min of (R) (group 3, P less than 0.05; group 4, P less than 0.05). LV endocardial/epicardial myocardial blood flow ratio demonstrated greater increase in hyperkalemic groups (group 3, P less than 0.01; group 4, P less than 0.01) at 5 min of (R). ATP was significantly decreased in groups 1, 3 and 4, but not in group 2 at the end of ischemia (group 1, P less than 0.01; group 3, P less than 0.01; group 4, P less than 0.05) and after 45 min of (R) (group 1, P less than 0.05; group 3, P less than 0.01; group 4, P less than 0.01). These results demonstrate that lidocaine has a myocardial protective effect which is superior to standard hyperkalemic cardioplegia. Moreover, lidocaine has an additive salutary effect during potassium cardioplegia. Persistent metabolic derangements post reflow in the hyperkalemic groups suggest deleterious effects of hyperkalemia on subendocardial protection. PMID- 6855223 TI - Limiting ischemic liver injury by interfering with lysosomal autophagy. AB - Two regimens designed to ameliorate hepatic injury from complete liver dearterialization (LD) by interfering with lysosome-mediated proteolysis were studied in 200-g Buffalo rats. Five rats received a lysosome membrane-stabilizing flavenoid, catechin, 200 mg/kg/day for 5 days pre-LD. Five others were infused with lysosome protease inhibitors (LPI), leupeptin and pepstatin, delivered in 0.22-micron multilamellar liposomes at 500 micrograms each per hour for 2 hr, beginning 20 min before LD. Control groups (n = 4 or 5) were untreated LD, and treated and untreated sham LD rats. Blood from an arterial catheter pre-LD and 2 hr (peak enzyme release), 2 days, and 4 days post-LD yielded beta-glucuronidase (BG), aspartate transaminase (AST), and alkaline phosphatase values for each rat. Liver histology was not different between groups at 4 days post-LD. Untreated controls and the catechin LD group had similar enzyme levels at all points. LPI treatment values were statistically similar to sham LD values and had peak values significantly lower (P less than 0.05) than untreated LD controls at 2 hr. BG, 75 +/- 10 (SD) units per liter versus 185 +/- 32 units per liter; AST, 134 +/- 47 units per liter versus 459 +/- 175 units per liter. The BG lowering persisted to day 2 (55 +/- 25 units per liter versus 93 +/- 40 units per liter). Other values remained normal or normalized by Day 2. Hepatic damage as measured by enzyme release was not diminished by the membrane stabilizer catechin but was diminished after ischemic injury by specific targeted lysosomal protease inhibitors. PMID- 6855224 TI - Fecal steroid excretion and degradation and breast cancer stage. AB - Evaluation of excretion and degradation of fecal steroids in 74 women with breast cancer in relation to stage, tumor size, and histopathologic nodal status revealed significant differences in relation to stage of disease and tumor size. The level of total fecal steroids (mean +/- SD in mg/g dry wt) in patients with Stage I disease was 40 + 20, Stage II = 56 +/- 32, and Stage III = 75 +/- 57 (P = 0.006). Secondary fecal steroids in women with Stage I disease were 26 +/- 16, Stage II = 40 +/- 27, and Stage III = 57 +/- 34 (P = 0.003). Fecal steroid excretion and degradation was significantly higher in women with larger tumors, whereas nodal status did not contribute to observed differences indicating that dissemination of disease did not influence the results. These differences were noted to be independent of obesity since similar patterns of fecal steroid excretion were noted within the subgroups of both lean and obese women. Increased levels of total fecal steroids and secondary compounds apparently contribute to tumor promotion and may reflect a potential for excess estrogen synthesis since intestinal bacteria have the ability to synthesize estradiol, estrone, and 3,17 methoxyestradiol from secondary steroids present in the colon. PMID- 6855225 TI - Decreased pulmonary alveolar macrophage bactericidal activity in splenectomized rats. AB - The organism most frequently encountered in postsplenectomy sepsis is Streptococcus pneumoniae, which is thought to invade via the upper respiratory tract. This study assesses the phagocytic and bactericidal activity of pulmonary alveolar macrophages (PAM) in normal, splenectomized, and one-third splenectomized autotransplanted rats at 8 weeks of age, 7 weeks post surgery. The PAMs from both the splenectomized and control rats all expressed the same ability to phagocytose latex beads and Fc-receptor-mediated phagocytosis of SRBC. In the bactericidal assay, bacterial growth, after 1 hr without macrophages, was 31 X 10(3) colony-forming units (CFU). In the presence of PAMs from splenectomized rats, the colony count was 22 X 10(3) (P less than 0.2). Bactericidal activity was highly evident when PAMs from control and autotransplanted rats were assayed, with CFU of 11.3 X 10(3) and 14.6 X 10(3), respectively (P less than 0.001, P less than 0.002, respectively). It is concluded that antibody-dependent and independent phagocytic activity of PAMs is unimpaired in splenectomized rats as compared to controls. The defect in rats splenectomized at 1 week of age resides in poor pneumococcal bactericidal activity of PAMs and is almost completely corrected by ip autotransplantation of one-third of the spleen. PMID- 6855226 TI - Cyclosporine A impairs wound healing in rats. AB - Cellular immune responses may play an important role in the early inflammatory and cellular phases of wound healing. Cyclosporine A (CSA), a new immunosuppressive agent, impairs cellular immunity and T-cell-dependent humoral immunity. Therefore, the effect of CSA-induced immunosuppression in a rat wound healing model was studied. Sprague-Dawley rats underwent a standardized skin incision and subcutaneous implantation of sterile polyvinyl alcohol sponges. CSA was dissolved in olive oil and given by gavage to one group of animals at a total dose of 125 mg/kg/10 days. The control group received an equivalent volume of olive oil. Ten-day-old wounds were weaker in CSA-treated animals, both in the fresh state (282 +/- 19 g vs 380 +/- 27 g, P less than 0.01), and after formalin fixation (1111 +/- 74 g vs 1419 +/- 57 g, P less than 0.01). In addition, CSA treated rats accumulated significantly less hydroxyproline in the wound sponge granuloma, an index of reparative collagen deposition. The impairment in wound healing occurred without differences in body weight gain or organ weights. There was a profound immunosuppression in the animals receiving CSA as determined by thymic lymphocyte blastogenesis in response to Con A and PHA. These findings suggest that immunosuppression in otherwise healthy animals impairs wound healing. PMID- 6855227 TI - Superoxide dismutase: a cellular protective enzyme in bowel ischemia. AB - Recent data suggest that the free-radical anion superoxide (O-2), an unstable, cytotoxic form of oxygen, is implicated in the pathogenesis of ischemic bowel injury. This study evaluates the role of superoxide dismutase (SOD), an enzyme specific for enzymatic conversion of O-2 in protecting the bowel from an ischemic insult. At laparotomy, the superior mesenteric artery was occluded for 1 min in 90-g weanling rats (n = 144). Animals were divided into four groups: I, untreated controls (n = 41); II, received aminophylline (AMN) 40 mg/kg ip, a substrate for (O-2) generation (n = 21); III, received superoxide dismutase (SOD) 2.5 mg/kg iv (n = 20); IV, received both AMN and SOD (n = 22). Rats were evaluated for bowel infarction, perforation, and mortality over a 7-day observation period. In 40 additional rats (10 per group) bowel ultrastructure was evaluated by scanning electron microscopy (EM) during occlusive ischemia and at various time intervals following reperfusion. Mortality was 63.4% in controls (26/41) with necrosis noted in 19 and perforation in 7. AMN resulted in a 90% mortality (19/21) (chi 2, P less than 0.05 vs control), with necrosis in 15 and perforation in 4. SOD reduced mortality to 25% (5/20) with necrosis in 4 and perforation in 1 (chi 2, P less than 0.02 vs controls) and, when added to AMN, 45.5% (10/22) (chi 2, P less than 0.01 vs AMN alone). On EM, tissue damage was minimal during occlusive ischemia, worsened by duration of reperfusion, enhanced by AMN, and reduced by SOD. These data suggest that following hypoxia, the injured bowel may be unable to appropriately handle reoxygenation. Tissue damage was related to duration of reperfusion and was worse following AMN, a xanthine derivative that might generate (O-2), a cytotoxic free radical. SOD detoxifies O2-, increases survival, and protects the bowel during reperfusion. PMID- 6855228 TI - Studies of the mechanism of glucocorticoid-induced pyknosis in isolated rat thymocytes. AB - The lethal action of glucocorticoids on rat thymocytes in vitro is associated with the progressive accumulation of cells that display a discrete reduction in size. Techniques for the separation and quantitation of these structurally transformed cells have now been used to investigate the relationship between cell size changes and the effects of dexamethasone treatment on chromatin condensation and DNA fragmentation. The steroid-induced reduction in thymocyte size was invariably and exclusively associated with morphologically evident chromatin condensation and with fragmentation of DNA into units that were acid-precipitable but failed to sediment on low-speed centrifugation. The generation of cells of reduced size in response to dexamethasone was inhibited by actinomycin D, cordycepin and cycloheximide; the kinetics of inhibition indicate that glucocorticoid-induced cell death depends on the synthesis, processing and translation of mRNA coding for a protein or proteins whose subsequent lethal effect is expressed in a stochastic manner. PMID- 6855229 TI - Oestradiol induced changes of soluble protein synthesis in human endometrium. AB - The effect of an in vitro application of oestradiol-17-beta on the soluble protein synthesis in human endometrium during the menstrual cycle was investigated. Results obtained by double-label technique and SDS-polyacrylamide gel or Cellogel electrophoresis show that synthesis of soluble proteins in human endometrium is affected by oestradiol in both follicular and luteal phases of the cycle. One of the proteins obtained after oestradiol treatment seems to be similar to IP of rat uterus as judged from its molecular weight (41,000 daltons) and electrophoretic mobility (RF:1.18-1.24 relative to BSA on Cellogel). The magnitude of this protein synthesis correlates significantly with cytoplasmic oestradiol receptor concentration in endometrium throughout the cycle. The highest induction of IP like protein(s) synthesis at follicular phase and a decreased induction during the luteal phase was detected. No quantitative relationship between the changes of progesterone receptor concentration and IP like protein synthesis was found. PMID- 6855231 TI - Specific estrogen binding sites in human lymphoid cells and thymic cells. AB - The binding of estrogen in preparations of human peripheral blood mononuclear cells, as well as by splenic and thymic cells is demonstrated by three different approaches (Dextran-coated charcoal method, whole cell assay, and gel filtration on a sepharose 4B column). Scatchard's analysis of [3H]-moxestrol (R2858) and [3H]-estradiol binding proves the existence of a single class of receptor sites having a dissociation constant of 0.18-2.4 X 10(-9) M. Physicochemical properties of the binder, including binding capacity and steroid specificity, are quite similar to those reported for the thymus of small mammalian species or human thymoma. PMID- 6855230 TI - Inhibitory effects of some steroidal 6-methylene derivatives on 5 alpha-reductase activity in human and rat prostate. AB - Using a short-term organ culture assay, some 6-methylene derivatives of progesterone and testosterone have been evaluated for their effects on testosterone metabolism in rat and human prostatic tissues, and on DNA synthesis in explants from 7-day castrated rats. Comparative studies showed that the ability to inhibit 5 alpha-reductase activity was fairly specific with respect to structural requirements. Methylene substitution at the C6 position of the progesterone molecule was associated with high inhibitory activity. In explants prepared from human prostates, 6-methylene progesterone (II) had 70-85% (mean of 79% for 4 BPH tissues) of the potency of unmodified progesterone (I). Its 17 alpha-acetoxy-6-methylene analog (III), however, had only 32-73% (mean of 53% for 5 BPH specimens) of the activity of (I). The degrees of inhibition in rat and human prostatic tissues were similar. Inhibition of 5 alpha-reductase activity in cultured explants by 6-methylene progesterone (II) could not be reversed by change in media. The 6-methylene derivatives had little or no effect on DNA synthesis. Histological examination confirmed a lack of effect on basal cell proliferation. However, morphological alterations affecting epithelial cell height and secretory activity were clearly evident. These results indicate that, under our experimental conditions, the main effect of inhibition of 5 alpha reductase activity in prostatic tissues by 6-methylene derivatives of progesterone is related to suppression of differentiated function. PMID- 6855232 TI - Pharmacokinetics and metabolism of moxestrol in humans. AB - Moxestrol, the 11 beta-methoxy derivative of ethynyl estradiol and a highly potent estrogen, is rapidly distributed in the body (AIVD = 148.6 +/- 19.71, MCR = 79.9 +/- 10.5 1/h) after i.v. administration because it is not bound by SBP and has low affinity for albumin. Its oral bioavailability is about 33% after administration of 30 or 100 micrograms to healthy volunteers and slightly lower than that of ethynyl estradiol (50%) due to a "first-pass effect". Moxestrol is rapidly metabolized by the liver as shown by the much increased bioavailability (60.5%) in patients with impaired liver function. The radioimmunoassay for moxestrol measures plasma moxestrol levels ranging from 100 pg/ml (maximum) to 10 pg/ml (24 h value) after treatment with a 100 micrograms commercial formulation (Surestryl). Moxestrol metabolism was studied on urine which contained 28% of administered radioactivity after i.v. or oral administration. Hydroxylation was the main transformation pathway as for ethynyl estradiol. Moxestrol yielded metabolites hydroxylated (or methoxylated) at C-2, C-15 and C-16, but not at C-6, and also gave rise to D-homo derivatives. The main difference between moxestrol and ethynyl estradiol lies in the relative importance of these pathways. The presence of the ethynyl group of ethynyl estradiol impedes attack at C-16 and hydroxylation at C-2 to form catechol estrogens becomes a major pathway, whereas the 11 beta-methoxy group of moxestrol impedes hydroxylation at C-2 and ring D hydroxylated products of moxestrol are formed. The low amount of catechol estrogens obtained with moxestrol compared to ethynyl estradiol could have important physiological implications in the human. PMID- 6855234 TI - The determination of maternal and foetal rat plasma corticosterone concentration in late pregnancy by competitive protein binding analysis. AB - A procedure for the determination of corticosterone in 20 microliters of rat plasma, in maternal and foetal late pregnancy with a protein binding radioassay, is described. The method is suitable in a range of 0.5-3 ng of corticosterone. An amount of 0.5 ng can be detected with a coefficient of variation for duplicate of 13%. This procedure seems to be specific for glucocorticosteroids. The comparison of the results obtained with fluorimetry and the competitive protein binding radioassay show the reliability of both methods although the protein binding radioassay is much more sensitive. PMID- 6855233 TI - Regulation of 18-hydroxycorticosterone formation in bovine adrenocortical mitochondria. AB - The conversion of deoxycorticosterone to 18-hydroxycorticosterone was examined by using sonicated mitochondrial suspension of bovine adrenocortex. The KM's of deoxycorticosterone for the 11 beta- and 18-hydroxylations were in the same range (1 microM), while the turnover number for the 11 beta-hydroxylation (50 nmol/min/nmol cytochrome P-450) was 6 times as great as that for the 18 hydroxylation (7.3). The KM and turnover number for the 18-hydroxylation of corticosterone were 6 microM and 0.4, respectively. Those for the 11 beta hydroxylation of 18-hydroxy-11-deoxycorticosterone were 120 microM and 5. When products were analysed in the incubation of deoxycorticosterone with the mitochondrial suspension containing a larger amount of cytochrome P-450, the formation of 18-hydroxycorticosterone was observed in addition to the formation of corticosterone and 18-hydroxy-11-deoxycorticosterone. The kinetic interrelation between the two pathways was further examined together with consideration of the cytochrome P-450-linked hydroxylation system. The result suggests that the pathway via 18-hydroxy-11-deoxycorticosterone substantially participates in the formation of 18-hydroxycorticosterone from deoxycorticosterone. The perturbation of this network by an artificial means, such as the addition of Triton X-100, revealed that the detergent (0.02%) facilitated the production of 18-hydroxycorticosterone from deoxycorticosterone, regardless of its inhibitory effect on the production of corticosterone and 18 hydroxy-11-deoxycorticosterone from deoxycorticosterone. These studies provide an important insight into the regulation mechanism of 18-hydroxycorticosterone formation from the precursors on the mitochondrial level. PMID- 6855235 TI - The influence of estrogen administration on the subcellular receptors distribution and its biological effect in the rat anterior pituitary gland. AB - We studied the effects of estrogen administration in the anterior pituitary gland (APG) of male rats. The subcellular distribution of estradiol receptors, and some biological responses, such as prolactin secretion and progestine receptors were examined. In the presence of circulating estrogens, the binding of [3H]-estradiol decreased in the cytosol and increased in nuclei. The total binding augmented significantly (P less than 0.05). These changes were dose and time dependent. So, in long chronic treatment, the changes in subcellular receptor distribution were greater, in accordance with higher serum estrogen level. Serum prolactin concentration and progestin receptor in the APG increased continuously as a function of time of the estrogen treatment. They were related to the presence of nuclear estradiol receptors, which remained elevated throughout the entire experimental period. PMID- 6855236 TI - A novel pseudohomogeneous radioimmunoassay for the measurement of plasma testosterone. AB - A description is given of a novel liquid phase immunoassay for the measurement of testosterone in peripheral venous plasma from men and women. The procedure involves: (i) competitive binding of the analyte and tritiated antigen to specific antibodies; (ii) enzymatic conjugation of the free ligand with glucuronic acid; and (iii) separation of the antibody-bound and free ligand by partition of the reactants into an organic and aqueous phase. The technique has been called ligand differentiation immunoassay (LIDIA). The mean sensitivity was 5 pg/tube (equivalent to 0.35 nmol/l female plasma; 0.87 nmol/l male plasma). The mean reagent blank (+/- SD) was 0.24 (0.12) nmol/l female plasma; 0.61 (0.30) nmol/l male plasma. A precision profile gave values less than 50%; the within batch variation was less than 8.3% and the between batch variation over three months was 12.3%. An accuracy profile between the second and penultimate points on the calibration curve gave values between 77 and 103%. The correlation coefficient 'r' between LIDIA and a heterogeneous radioimmunoassay was 0.92 when applied to plasma from men and 0.95 to samples from women. PMID- 6855237 TI - A solid phase chemiluminescent immunoassay (LIA) for testosterone glicuronide in diluted urines. AB - A chemiluminescent immunoassay (LIA) method in solid phase for the measurement of testosterone 17 beta-D-glicuronide (TG) in diluted urine is described, which utilizes as tracer a TG-isoluminol conjugate (TG-ABEI). An IgG fraction of antiserum of TG-BSA, has been passively adsorbed to the walls of polystyrene tubes. After the binding reaction the coated tubes were washed with buffer and the measure of chemiluminescence reaction was performed at high pH. The assay was validated in terms of specificity, accuracy, sensitivity and precision. The values obtained by chemiluminescence immunoassay were compared with that obtained by the RIA method, and the two methods agreed well (r = 0.95, n = 28). The assay method offers the advantage of speed and does not involve the use of radioisotopes or of a centrifugation step. Preliminary results show that the mean 24 h urinary TG excretion in a group of hirsute women is higher than in the control group, and decreases after suppression with dexamethasone for 1 month of therapy. PMID- 6855238 TI - Aggressive surgery for management of recurrent intraabdominal carcinoma. AB - With the evolution of effective multimodality control of various tumors, the role of surgery for recurrent malignancies is emerging as significant factor in not only maintaining that control, but in permitting the possibility of late cure of certain, even advanced intraabdominal malignancies. Several patients with Stage IV colon or ovarian carcinoma were evaluated and found to benefit from such an aggressive surgical approach with the result of long term control as well as apparent clinical cure in the several instances. These possibilities are becoming increasingly significant as progress is made in the various treatment modalities for neoplastic diseases. PMID- 6855239 TI - Chondrosarcoma of the first metatarsal. AB - Chondrosarcoma of the first metatarsal was observed in an 84-year-old man. Chondrosarcoma of the small bones of the foot is comparatively rare. These tumors generally arise de novo rather than from a preexisting benign cartilage lesion. Pedal chondrosarcoma presents as a painful enlarging mass. Radiographs show lytic destruction of bone with or without calcification. The histological grade, location of the tumor, and adequacy of surgical excision are the major determinants of long-term survival. PMID- 6855240 TI - Assessment of avascular renal masses. PMID- 6855242 TI - Blood flow in human tumors during hyperthermia therapy: demonstration of vasoregulation and an applicable physiological model. AB - A quantitative assessment of the effect of localized magnetic-loop hyperthermia on blood flow was performed in 12 human tumors using the 133Xe clearance method. Because blood flow in these tumors changed in response to needle injection, a physiologically based, one-compartment model was developed that included both a hyperemic and a steady-state component. In six tumors, changes in blood flow induced by heat were also observed. The ability of tumor vessels to respond dynamically to stress and the degree of response may be predictive of tumor heating capacity and subsequent therapeutic response. PMID- 6855241 TI - Clinical aspects of steroid hormone receptors in human renal cell carcinoma. AB - A review of the role of steroid hormone receptors and hormonal dependence of renal cell carcinoma in certain patients is presented. The results of a cumulative series of estrogen, progesterone, and androgen receptor assays performed on 48 normal and malignant human renal tumor specimens are given. The detectable presence of receptor proteins in certain patients could obviate the empirical use of hormonal therapy, an issue that may be resolved through a randomized multiinstitutional trial. PMID- 6855243 TI - Extraskeletal Ewings sarcoma. AB - A case of Ewings sarcoma arising in the soft tissue of the thumb is described. This appears to be the first case of digital extraskeletal Ewings sarcoma. The soft tissue location, the primary rather than metastatic nature, and the tumor type in this case were well documented. PMID- 6855244 TI - Metastatic cancer from an undetermined primary site. AB - The charts of 285 patients diagnosed as metastatic cancer from an undetermined primary site were reviewed. An attempt was made to characterize this disease entity more specifically, and to evaluate the various modes of therapy utilized in such patients. Adenocarcinoma is the most common histologic type overall; squamous cell carcinoma is most common in 5-year survivors. Lymph nodes are the most common metastatic site overall and in 5-year survivors. The mean overall survival is 8.69 months with 8.7% 2-year survivors and 2.8% 5-year survivors. Surgery alone, radiation alone or in combination, and chemotherapy alone or in combination were utilized in these patients with 5-year survivals of 11, 3.7, and 1.1%, respectively. The 5-year survivors all had therapy initiated immediately after histologic diagnosis and medical workup, and all of their tumors were less than 8 cm in diameter. In view of this data, patients with metastatic cancer from an undetermined primary site should always be considered for early, aggressive therapy. PMID- 6855245 TI - A product report: Osto-Zyme as an odor eliminator. AB - A product, Osto-Zyme, was clinically tested at our Institute for the elimination of odor. Thirteen clients were chosen by enterostomal therapists to be tested. The product was sprayed directly into pouch, peristomal skin, and into night drainage units. This product proved very effective in the elimination of odor. The manufacturer of Osto-Zyme is the Richard C. Shelton Co., Wright Brothers Branch, Dayton, Ohio. PMID- 6855246 TI - Computed tomography and radiotherapy in the treatment of cancer. AB - Computed tomography (CT) has shown to be of great value in the treatment of cancer with radiation therapy. It is used more and more in the estimation of tumor volume and for treatment planning, with the aid of the computerized treatment unit. At the James Graham Brown Cancer Center, Department of Radiation Oncology, CT has been used routinely for the treatment planning. From October 1, 1981 to June 30, 1982, we performed 180 CT scans for the treatment planning, 380 simple dose calculations, 237 complex treatment plans, and 42 intracavitary dosimetry using the treatment planning unit. This is a review of our experience with some illustrations. Accurate tumor dose can be delivered with reducing the complications with the use of CT and the computerized treatment unit. PMID- 6855247 TI - Clinically significant intestinal metastasis from a primary bronchogenic carcinoma. AB - Although abdominal metastasis from lung cancer are not unusual postmortem findings, they are rarely of clinical significance. Our patient's clinical course was complicated by intestinal obstruction secondary to metastatic lung cancer. With the current epidemic of lung cancer, we can expect more patients with abdominal complaints secondary to metastatic disease. In these patients, survival time averaged less than 60 days. PMID- 6855248 TI - Anaplastic transformation of thyroid cancer: report of two cases and review of the literature. AB - Transformation of well-differentiated thyroid adenocarcinoma to anaplastic cancer has been occasionally reported. Two new cases of such transformation are now described. The time interval from diagnosis to the development of anaplastic cancer was 15 years in the first patient and 10 years in the second. Both patients ultimately developed extensive bilateral pulmonary metastases and died within 6 months from the diagnosis of the transformation. Hypotheses concerning the pathogenesis of the transformation and the literature were reviewed. We believe that histopathological confirmation of recurrent and rapidly progressive thyroid tumors is necessary prior to initiation of therapy. PMID- 6855249 TI - Long-term survivors after adjuvant pelvic irradiation in rectal and sigmoid carcinoma: an assessment of late results. AB - Twenty-six patients with adenocarcinomas of the rectum, rectosigmoid, or sigmoid colon given adjuvant pre- or postoperative pelvic radiation therapy followed at least 5 years were retrospectively reviewed to evaluate late tumor control and complication rates. The overall 7-year survival rate was 80 +/- 8% with B2,3 patients faring better than C2,3 (94 +/- 6% versus 43 +/- 19%, p less than 0.005). Local pelvic tumor control was achieved in 23/26 patients (88%); patients with high-stage (C2,3) or poorly-differentiated adenocarcinomas had a higher postirradiation pelvic relapse rate (3/11) versus low stage, well or moderately well differentiated tumors (0/15). A major complication (none fatal) occurred in 2 of 26 patients (8%) and was not correlated with either irradiation dose nor volume. Long-term follow-up is now available on patients who received adjuvant pelvic irradiation for rectal or sigmoid carcinomas and indicates a high pelvic tumor control rate. The 8% major complication rate may be decreased in the future by more sophisticated irradiation treatment planning. PMID- 6855250 TI - The isolated human pectinate muscle: a reliable preparation of human cardiac tissue. AB - We have developed an anatomically and functionally intact preparation of isolated pectinate muscles from readily-available surgical specimens of human right atrial appendage. Individual pectinate muscles (2-3 per specimen) are dissected free and mounted in a tissue bath. Field stimulation is used for electrical pacing, and isometric contractions are recorded. The pectinate muscle develops a stable and large force of contraction and hence is superior to strips cut from atrial appendage specimens. Isolated pectinate muscles develop spontaneous beating or can be induced to beat spontaneously by brief periods of electrical pacing or transient exposure to epinephrine or histamine. Spontaneously-beating muscles increase their rate and force of contraction in response to drugs which have positive chronotropic and inotropic effects in the whole heart. Because the force of contraction of the pectinate muscle is a function of the rate of beating, inotropic effects of agents should also be evaluated in preparations which are electrically paced at a constant rate. PMID- 6855251 TI - The rabbit isolated arterially perfused intestinal segment preparation: a model for vascular dopamine receptors. AB - A simple and inexpensive method for the evaluation in vitro of the effects of compounds on postjunctional vascular dopamine (DA) receptors is described. The rabbit isolated perfused K+-contracted mesenteric and ileal vasculature dilates in response to DA, DA receptor agonists, and papaverine. Responses to DA receptor agonists, but not those to papaverine, can be selectively antagonised by cis-(Z) flupenthixol (pA2 8.5), yet remain unaffected by sulpiride. Comparisons with other models of vascular DA receptors have been made. PMID- 6855252 TI - A method for determining the atrial effective refractory period in the unanesthetized dog. AB - Extension to the unanesthetized dog with chronic A-V block of the method of determination of the atrial effective refractory period described in vitro by Dawes provides a useful model for the study in atria of potential antiarrhythmic agents. This model, which comes fairly close to physiological conditions, is capable of furnishing reproducible results which correlate well with those obtained by other techniques, as shown by a study of quinidine chosen as reference. It also makes possible long-term studies of the effects of prolonged administration of antiarrhythmic agents on atrial effective refractory period, under conditions close to those of therapeutic practice, and so is likely to have predictive value. PMID- 6855253 TI - Mechanical assistance of the pulmonary circulation after right ventricular exclusion. AB - The Fontan procedure is often associated with elevated right-sided pressures and low cardiac output during the early postoperative period. A dog model was established to test the effect of pulmonary artery counterpulsation after atriopulmonary anastomosis. After exclusion of the right ventricle by a purse string suture at the right AV orifice, placed during inflow occlusion, a valved conduit was inserted between the right atrial appendage and the pulmonary artery. This created a circulatory pattern comparable to a Fontan procedure. Counterpulsation was achieved by inserting a cannula into the conduit distal to the valve in eight dogs; alternatively, in four, counterpulsation could be achieved through a 10 mm side-arm graft connected to the conduit distal to the valve. Twenty-four observations were made. Without counterpulsation the circulatory status of the dog deteriorated rapidly. Counterpulsation resulted in a mean increase in cardiac output of 48% (p less than 0.0001). Right atrial pressure fell significantly with a mean drop of 4 mm Hg (p less than 0.003). This allowed for a further increase in right-sided filling pressure by transfusion, with a subsequent further increase in cardiac output. Left atrial pressure did not change significantly unless altered by transfusion. Counterpulsation instituted through the 10 mm side-arm graft gave similar results. Pulmonary vascular resistance decreased with counterpulsation (mean decrease 35%; p less than 0.002). The use of a side-arm graft connected to the conduit after a Fontan procedure affords a clinical method of circulatory support without the need for additional surgical intervention for decannulation. These data suggest that mechanical assistance of the failing right atrium after atriopulmonary anastomosis is both feasible and effective. PMID- 6855255 TI - Implantation of atrioventricular synchronous and atrioventricular universal pacemakers. AB - Implantation of pacemakers which sense in the atrium and the ventricle requires understanding of both antegrade conduction, from the atrium to the ventricle, and retrograde conduction, from the ventricle to the atrium. Of 53 patients undergoing pacemaker implantation, 25 (47%) had retained VA conduction and 25% of those with complete heart block had 1:1 retrograde (VA) conduction. Determination of both conduction intervals is made by recording the intrinsic deflections of the atrium and the ventricle and measuring the interval. Antegrade intervals (IDA leads to IDV) for those with intact conduction ranged from 189 to 325 msec (mean 212 msec). Retrograde intervals (StV leads to IDA) for those with intact VA conduction ranged from 110 to 346 msec (mean 235 msec). Of 16 patients having VDD and DDD pacemakers implanted without conduction studies, seven (44%) developed pacemaker-mediated tachycardia. The prevention of pacemaker-mediated reentry tachycardia requires knowledge of the VA conduction interval (if it exists) and programming of the atrial refractory period so that retrograde P waves fall within it and are unsensed. PMID- 6855254 TI - The mechanism of halothane-induced myocardial depression. Altered diastolic mechanics versus impaired contractility. AB - Although halothane has been shown to depress left ventricular function, it remains a common alternative to narcotic anesthesia in cardiac operations. To clarify the mechanism by which this functional depression occurs (direct decrease in contractility versus altered diastolic compliance), we studied seven dogs in the closed-chest state following instrumentation with ultrasonic dimension transducers to measure left ventricular anteroposterior diameter and micromanometers to measure transmural left ventricular pressure. Ventricular volumes were varied with transient vena caval occlusions in the awake state and following general anesthesia with halothane at 1% and 2% end-tidal concentrations. Ventricular contractility was assessed by the slope of the end systolic pressure-diameter relationship (EES). Following normalization of end diastolic diameters with a Lagrangian strain definition (E), diastolic compliance was assessed by fitting end-diastolic pressure-strain data to the exponential: P = alpha (e beta E -1), where alpha and beta are nonlinear elastic coefficients. Halothane was found to produce a significant, dose-dependent decrease in EES from 10.6 +/- 0.6 control to 6.7 +/- 0.4 at 1% halothane and 4.2 +/- 0.5 at 2% halothane (p less than 0.05, control versus both 1% and 2% halothane). Furthermore, halothane at the concentrations studied did not significantly alter alpha and beta nor significantly shift the exponential end-diastolic pressure strain curve from control. These data indicate that halothane produces a direct, severe depression of left ventricular contractility without primarily altering the diastolic mechanical properties of the myocardium. PMID- 6855256 TI - The hemodynamic effects of intra-aortic versus intravenous administration of protamine for reversal of heparin in pigs. AB - The hemodynamic effects of intra-aortic (IA) versus intravenous (IV) administration of protamine for reversal of heparin were studied in pigs. The animals were anesthetized with sodium thiopental, nitrous oxide, oxygen, and halothane. Twenty minutes after heparinization (3 mg/kg) the following hemodynamic parameters were measured: heart rate, arterial pressure, pulmonary artery pressure (PAP), left ventricular end-diastolic pressure, and cardiac output. Protamine sulfate (3 mg/kg) was injected over 30 seconds IV in Group I (five pigs) and into the ascending aorta (IA) in Group II (five pigs). After injection, the above measurements were repeated at 1.0, 2.5, 5, and 15 minutes. The hemodynamic effects of intravenous protamine (3 mg/kg) without prior heparinization were studied in Group III (four pigs). Groups I and II experienced a decrease in cardiac output (Group I, 14%; Group II, 29%) and a marked increase in PAP (Group I, 78%; Group II, 79%) and pulmonary vascular resistance (PVR) (Group I, 174%; Group II, 559%) which peaked at 1 minute after protamine injection (p less than 0.05). Cardiac output, PAP, and PVR returned to baseline within 15 minutes. Heart rate, arterial pressure, left ventricular end-diastolic pressure, and systemic vascular resistance (SVR) were unchanged. No hemodynamic abnormalities occurred in animals injected with protamine alone (Group III). It is concluded that IV or IA administration of protamine causes marked hemodynamic changes in heparinized pigs. This does not confirm a recent clinical study reporting stable hemodynamics after IA administration of protamine. The lack of circulatory effects of protamine in unheparinized pigs suggests that a protamine heparin interaction may be involved. PMID- 6855257 TI - Pericardiocentesis assisted by two-dimensional echocardiography. AB - Pericardiocentesis assisted by two-dimensional echocardiography was performed in 40 patients with effusions of various types and causes; no complications occurred. This approach combines several advantages, including visualization of the fluid-filled sac and determination of its location, estimation of the amount of fluid, and identification of structures intervening between the body surface and the pericardial sac (for example, the liver). The ideal point of needle entry caned. This approach combines several advantages, including visualization of the fluid-filled sac and determination of its location, estimation of the amount of fluid, and identification of structures intervening between the body surface and the pericardial sac (for example, the liver). The ideal point of needle entry caned. This approach combines several advantages, including visualization of the fluid-filled sac and determination of its location, estimation of the amount of fluid, and identification of structures intervening between the body surface and the pericardial sac (for example, the liver). The ideal point of needle entry can be selected to avoid contact with the heart and can be marked on the body wall. This method combines the safety and visibility of the open (surgical) approach with the simplicity of the direct ("blind") puncture method. Locating the optimal point on the body wall, closest to the pericardial fluid, allows a short, plastic sheathed needle to be used. Pericardiocentesis by this method can be performed with ease and safety. PMID- 6855258 TI - Surgical treatment of giant left atrium combined with mitral valvular disease. Plication procedure for reduction of compression to the left ventricle, bronchus, and pulmonary parenchyma. AB - Giant left atrium associated with mitral valvular disease frequently produce postoperative problems with regard to hemodynamical and respiratory management. A new procedure of para-annular and superior plication combined with the conventional right-side plication with trimming of the left atrial wall was devised to relieve compression induced by the giant left atrium. A total of 40 patients with giant left atrium underwent operation. Ten had the valvular procedure only and 30 had the valvular and plication procedures. The plication procedure resulted in a significant decrease in the incidence of low-output syndrome and respiratory failure postoperatively, as well as a marked decrease in mortality. We conclude that the plication procedure is an effective means of relieving compression in the presence of giant left atrium. PMID- 6855259 TI - Effect of valve orientation on flow development past aortic valve prostheses in a model human aorta. AB - The effect of valve orientation on flow development in a model human aorta was studied by means of a qualitative flow visualization technique. The model replicated the geometry of the human aorta and the experiment simulated a physiologically realistic pulsatile flow. The following valves were studied: Starr-Edwards Stellite, Starr-Edwards silicone, Bjork-Shiley spherical disc, Bjork-Shiley convexo-concave disc, and Hall-Kaster tilting disc. All the valves had a tissue anulus diameter of 27 mm. With the ball-in-cage valves, the flow in the ascending aorta was predominantly axial and uniform throughout systole, while vortex formation was observed downstream from the ball. With the tilting disc valves, the flow development in the aorta was a function of the orientation of the valves. With the major flow orifice directed toward the commissure between the right and noncoronary cusps, the fluid motion was predominantly in the axial direction through early systole. A vortex developed along the wall of lesser curvature of the aorta with the progression of systole. In early diastole, a well defined flow reversal was observed along the lesser curvature of the aorta. With the major flow orifice directed toward the left coronary cusp, the fluid motion, although predominantly axial, was not uniform in the ascending aorta. Regions of relative stasis present near the wall of greater curvature subsequently developed into a trapped vortex throughout the cardiac cycle. With the major flow orifice directed more posteriorly, an improved fluid dynamic characteristic was observed, and there was no trapped vortex present near the wall of greater curvature. The flow visualization study in the model human aorta suggests that, from a fluid dynamic point of view, orientation of the major flow orifice of the tilting disc valve toward the wall of lesser curvature is not advisable. PMID- 6855260 TI - Pulmonary vasculature of piglets after correction of aorta-pulmonary shunts. AB - In a previous article we described the functional and structural changes produced in the pulmonary arterial circulation of the growing pig by an aorta-pulmonary shunt. The present work describes the hemodynamic and morphologic adaptation that follows correction of the shunt. In four piglets, aged 5 weeks, an anastomosis was made between the thoracic descending aorta and the pulmonary trunk and left patent for 5 weeks. At the end of that time the mean pulmonary artery pressure (PAP) was 20 +/- 3.8 mm Hg (mean +/- SD), compared with 9 +/- 2.1 mm Hg in a group of four age-matched sham-operated control piglets. The shunt was then surgically closed. After 10 weeks' recovery, the PAP was similar and normal in the two groups. We have already shown that pulmonary hypertension of similar degree and duration to that at the end of the patent shunt period produces the following structural changes, assessed by quantitative techniques: (1) preacinar arteries of normal external diameter but with a thicker medial coat than normal and (2) intra-acinar arteries in normal concentration, of smaller external diameter than normal, but with a medial coat appropriate to the external diameter: Smooth muscle is found in more peripheral arteries than is normal. In the present study, at the end of the recovery period, the shunt animals were compared with the sham-operated animals and had thicker medial coats in preacinar and intra-acinar arteries, muscle in more peripheral arteries than is normal, and an increased arterial and alveolar concentration for unit lung area. These results indicate that, in the growing porcine lung, "recovery" from an aorta pulmonary shunt that was associated with moderate pulmonary hypertension restores external arterial diameter to normal but leaves a thicker medial coat at the preacinar and intra-acinar levels and muscle more peripheral in the arterial bed. In addition, after shunt correction, multiplication of alveoli and arteries proceeds at a faster rate than normal, at least during the first 10 weeks of recovery. PMID- 6855261 TI - The Fontan procedure in the absence of the interatrial septum. Failure of its principle? AB - The Fontan principle, defined as a procedure in which the right ventricle is bypassed in order to convey desaturated venous blood from the right atrium to the lungs, is presently applied for a wide variety of congenital heart malformations including those in which there is no suitable ventricular pumping chamber. Recently, the procedure has also been advocated for complex malformations that require atrial septation or intra-atrial rerouting. The present report evaluates our experience in four patients with such complex malformations. Three had a complete form of atrioventricular septal defect with double-outlet right ventricle and one patient had left atrioventricular valve atresia. The common atrium was morphologically right in two patients and morphologically left in one. In each of these instances anomalous pulmonary venous connections were present, together with abnormal systemic venous connections. The results were unsatisfactory. Three of the four patients died. The only survivor had no pulmonary or systemic venous abnormalities. Severe impairment of pulmonary blood flow was one of the most important postoperative complications. The findings suggest that the complexities of rerouting the blood within the atria play an important role. The excess proportion of prosthetic material to atrial myocardium may result in excessive loss of contractile atrial myocardium and, probably equally significant, in a complex intra-atrial geometry of pathways that may cause a critical pressure gradient. The results clearly show that with an expanding horizon of the application of the Fontan principle, new pitfalls may arise which presently appear to be the prevailing factors limiting its success. PMID- 6855262 TI - Dysrhythmias following the Senning operation for dextro-transposition of the great arteries. AB - Twenty-nine patients have undergone the Senning operation for repair of dextro transposition of the great arteries (TGA) since 1979 at St. Louis Children's Hospital. The early mortality has been comparable to that reported for the Mustard operation (10%). Electrocardiograms (ECGs) following the Senning operation reveal abnormalities similar to those noted after the Mustard operation; 63% of survivors were in normal sinus rhythm 1 week postoperatively, and 86% demonstrated normal sinus rhythm at a mean of 15 months after operation. Twenty-four hour ambulatory monitoring revealed normal sinus rhythm in 35% and occasional premature atrial or ventricular contractions in another 30%. No cases of sudden unexpected death have been noted, and no pacemakers have been inserted. Possible mechanisms for rhythm disturbances following venous transposition operations are discussed. PMID- 6855265 TI - Ambiguity of end-diastolic pressure-strain curves. PMID- 6855264 TI - Pulsatile reperfusion: the effects on coronary blood flow and myocardial ischemic injury. PMID- 6855263 TI - Vancomycin prophylaxis in cardiac operations: determination of an optimal dosage regimen. AB - Vancomycin is thought to be an acceptable alternative prophylactic antibiotic to the cephalosporins in penicillin allergic patients undergoing cardiopulmonary bypass. We studied the pharmacokinetics of vancomycin in 10 patients undergoing cardiopulmonary bypass. Our results suggest that the commonly used 500 mg dose (7 mg/kg) of vancomycin given preoperatively may provide serum concentrations during cardiopulmonary bypass which are not bactericidal for many S. epidermidis strains. Thus we believe that a higher initial dose, at least 15 mg/kg, should be given. PMID- 6855266 TI - Inhibition by colchicine of human lymphocytotoxic function: dependence on cell bound drug level, spontaneous reversibility and antagonism by desacetylcolchicine (DAC). AB - Colchicine elicits inhibition of spontaneous, PHA-dependent and antibody dependent forms of lymphocytotoxicity of peripheral blood lymphocytes (PBL) against allogeneic target cells. The findings are that it does so in cell-bound form and to near-maximum effect in the amount of this produced in PBL exposed to it at 10(-6)M concentration for 2 h at 37 degrees C. This represents only a small fraction of the cells' binding capacity, which suggests that it involves sites special in kind (localisation) rather than number (occupied at random). Desacetylcolchicine (DAC) (a known inhibitor of the colchicine-tubulin binding reaction) afforded the PBL protection at concentrations that antagonised the binding of colchicine to them. That DAC itself hardly inhibited PBL function is attributed by inference to a weaker binding affinity making for readier loss of it upon removal of the free drug. It did, however, exhibit a tight form of binding to other, functionally-insensitive cell sites not competed for by colchicine at 100-fold higher concentration. Contrary to the impression lent by other workers' studies (on mouse lymphocytes), colchicine-induced suppression of cytotoxic function is not necessarily irreversible. PBL cultured in drug-free medium gradually lost bound colchicine and they recovered in capacity to express spontaneous and PHA-dependent activity, but not in antibody-dependent activity. The residual cytolytic activity shown by colchicine pre-treated PBL appears in the case of antibody-dependent activity to be truly colchicine resistant; it survived unchanged a 10-fold increase in cell-bound drug level and it cannot be explained as a possible product of recovery. This colchicine-independence may reflect the existence of tubulin/microtubule-independent mechanisms contributing to antibody-dependent activity. Examination of colchicine-treated PBL for membrane fluidity changes, using the probe molecule DPH and the technique of fluorescence polarisation, has yielded negative results, even for cells treated at excessively high colchicine concentration (10(-4)M). All three forms of lymphocytotoxic activity were retained in PBL reconstituted after cryopreservation in liquid nitrogen. PMID- 6855267 TI - The fatty acyl chain composition of human normal and leukaemic lymphocytes and its modulation by specialised hydrogenation. AB - Thirty species of fatty acyl chain have been quantitatively identified in human normal peripheral blood lymphocytes (four donors) and lymphocytes circulating in eight patients with chronic lymphocytic leukaemia (CLL). Towards the aim of influencing cell behaviour by lowering membrane fluidity, reaction conditions for catalytic hydrogenation at physiological temperature and pH have been established that effect reduction of the unsaturated species, and preferentially the polyunsaturated forms, but this has not yet been accomplished without killing the cells. That saturation of ethylenic linkages per se is the cause of death is indicated by separate findings showing that the lymphocytes are capable of withstanding hydrogen gas at the requisite high pressure (9 atm.) or exposure alone to the rhodium catalyst [chlorotris (sodium diphenylphosphinobenzene-m sulphonate)-rhodium(I) tetrahydrate]. It remains feasible that future use of these two agents in combination under milder conditions to produce much lower degrees of hydrogenation than those reported here will permit the cells to survive. Concerning fatty acyl chain composition, the lymphocytes from most of the patients exhibited an inversion in the level of palmitic and stearic acid. A consistently abnormal pattern exhibited by the patients was a rise in oleic acid and a fall in arachidonic acid content. This same alteration has been demonstrated elsewhere in transformed/neoplastic cell types and hence it could well represent phenotypic expression in the CLL lymphocyte of malignant change. Fatty acyl chain composition remained unchanged in lymphocytes reconstituted after cryopreservation in liquid nitrogen. PMID- 6855268 TI - Accumulation of leukemic cell DNA strand breaks with adriamycin and cytosine arabinoside. AB - Adriamycin (doxorubicin) and cytosine arabinoside (Ara-C) induce single strand DNA breaks and DNA fragmentation. In view of the therapeutic efficacy of adriamycin in combination with Ara-C in the treatment of human acute non lymphocytic leukemia, we have attempted to assess the accumulation of DNA strand breaks and DNA fragmentation with these agents by alkaline elution analysis. Although a less than additive enhancement was noted for the elution of pulse labelled, replicating DNA, the results demonstrate an additive effect of adriamycin and Ara-C on the elution of pre-labelled L1210 murine leukemia DNA. PMID- 6855270 TI - Prognostic value of the combined suicide level of granulocyte progenitors and the labelling index of precursors in preleukemic states and oligoblastic leukemias. AB - Although abnormalities in granulopoiesis detected by means of bone marrow cytology, culture and kinetic studies have provided prognostic data in preleukemic states and oligoblastic leukemias, this information cannot be applied to individual cases. In order to determine the indications for treatment and the form it should take in a given case, data would be required concerning the probability of impending transformation into acute leukemia. In 45 studies involving 34 patients who were followed for 10-42 months, a combination of a rise in the proportion of granulocyte precursors in S-phase, indicated by a colony forming cell suicide rate of over 40%, and a low labelling index of myeloblasts and promyelocytes, was always followed by the onset of acute leukemia within 10 months. Sequential studies in 13 patients revealed an increase in cluster-forming cells and in the suicide level in the second study. The changed kinetics of granulopoietic proliferation may provide an indication for chemotherapy. PMID- 6855269 TI - Differential sensitivity of normal and leukaemic haemopoietic cells to methionine deprivation by L-methioninase. AB - The in vitro sensitivity of bone marrow cells from patients with leukaemia and from patients with non-malignant diseases to L-methionine removal by L methioninase (L-methionine-alpha-deamino-gamma-mercaptomethane-lyase, EC 4.4.1.11) was determined using the incorporation of [methyl-3H]thymidine into acid-insoluble material as an index of survival. When compared with controls growing in medium containing 10 micrograms/ml of L-methionine, leukaemic cells showed a lower incorporation of [methyl-3H]thymidine after 24 h in the presence of 0.1 (normal 78 +/- 24%; leukaemic 26 +/- 18%, p less than 0.01) or 0.05 (normal 84 +/- 15%; leukaemic 50 +/- 21%, p less than 0.01) units of L methioninase per ml. A similar differential sensitivity of leukaemic cells to L methioninase was seen after 48 h of incubation. There was little effect on [methyl-3H]thymidine incorporation in the presence of boiled enzyme. Attempts to reverse L-methioninase toxicity with D-homocystine did not result in a differential effect on the normal cell population. The effects of L-methionine removal with L-methioninase were similar to those observed in L-methionine depleted culture medium supplemented with 0.1 mM L-homocysteine. After 24 h in such depleted media leukaemic cells showed a lower incorporation of [methyl 3H]thymidine into acid-insoluble material (normal 88 +/- 17%; leukaemic 35 +/- 14%, p less than 0.01) and there was an elevation of the L-methionine-dependent enzymes: methionine adenosyltransferase, tRNA methyltransferase and S adenosylmethionine decarboxylase. These results suggest the possibility of trying L-methioninase in the treatment of suitable leukaemias. PMID- 6855271 TI - The Hemalog D automated differential counter in the diagnosis of hairy cell leukemia. AB - We studied the peripheral blood of 37 patients with hairy cell leukemia (HCL) prior to (n = 24) or following (n = 19) splenectomy, in the Hemalog D multi channel white cell differential counter, to investigate whether the apparatus could contribute to the (early) diagnosis of this entity and to the differential diagnosis of HCL from atypical hairy cell leukemia (AHCL; n = 9), chronic lymphocytic leukemia (CLL; n = 21) and leukemic non-Hodgkin lymphoma of low-grade malignancy (LNHL; n = 19). HCL showed almost invariably monocytopenia, neutropenia and an increased percentage of LUC, with a rather typical picture of the X-Y display of the peroxidase channel. The percentage of hairy cells closely correlated with the percentage of the LUC from the Hemalog D. Discriminant analysis using several parameters of the Hemalog D differential count resulted in a complete separation of HCL from CLL, and a fair, although not complete, distinction of HCL from AHCL and LNHL. It was impossible to discriminate between AHCL and LNHL. The most important discriminating (single or combined) parameters were the absolute monocyte count, the TWBC and the absolute neutrophil number. It is concluded that the Hemalog D is a valuable tool in the (early) diagnosis of HCL and in the discrimination between HCL and other leukemic lymphoproliferative disorders. PMID- 6855273 TI - Postoperative follow-up of patients with carcinoma of the colon. PMID- 6855274 TI - Clear cell carcinoma of the thymus. PMID- 6855272 TI - Upper airway obstruction and disordered nocturnal breathing in children. AB - Fourteen children with disordered breathing during sleep (obstructive apnea, obstructive hypopnea, or snoring) and anatomic obstruction of the upper airway were studied. Twelve children had hypertrophied tonsils and adenoids, and two had a deviated nasal septum. No child had sequelae of severe sleep apnea--that is, cor pulmonale, pulmonary hypertension, or alveolar hypoventilation. Results of polysomnographic studies were abnormal in all and revealed that obstructive hypopnea (increased respiratory effort with decreased airflow) was more common than obstructive apnea (increased respiratory effort without airflow). Surgical removal or correction of the upper airway obstructive lesion in 12 children resulted in normal nocturnal respiration. Surgical intervention was declined in two patients, and their symptoms persist. We conclude that surgical removal of upper airway obstructive lesions in children with disturbed nocturnal sleep should not be reserved only for those with serious sequelae of obstructive sleep apnea; considerable benefit is gained in selected patients with mild obstructive sleep apnea or hypopnea. PMID- 6855276 TI - The chronically snoring child: an acoustic annoyance or cause for concern? PMID- 6855275 TI - Airway obstruction due to inhalation of ammonia. AB - Ammonia is an important chemical in industry. Accidental inhalation of ammonia has resulted in upper airway and bronchoalveolar injury, and even fatal inhalation of anhydrous ammonia has occurred. We present herein a 5-year follow up on a patient who had no prior history of smoking or pulmonary symptoms and had overwhelming exposure to ammonia which resulted in acute respiratory failure with diffuse lung parenchymal and airway involvement. The extreme inflammation and desquamation of the mucosa of the central bronchial tree, as observed bronchoscopically, have apparently resulted in a hyperreactive bronchoconstrictive component. Because our patient had never smoked and had no history of pulmonary symptoms or wheezing, we speculate that both the central and the peripheral residual airway obstructions were a result of his inhalation injury. In addition, peripheral airway disease, suggested by the postbronchodilator flow-volume curves present during the first year of follow-up, has gradually cleared even though there is evidence of parenchymal scarring. PMID- 6855277 TI - Who should perform chemonucleolysis? PMID- 6855278 TI - Erythromycin-induced ototoxicity. PMID- 6855279 TI - Side effects of metronidazole. PMID- 6855280 TI - Stability and buffered form of methicillin. PMID- 6855281 TI - Health Manpower Committee. Characteristics of physician practice patterns in Maryland, 1980-81. PMID- 6855282 TI - Bedrail palsy: the etiology of bilateral footdrop. PMID- 6855283 TI - Utility of liver biopsy. PMID- 6855285 TI - The insanity plea: getting away with murder? PMID- 6855284 TI - Rheumatoid arthritis XI: the pathogenesis of rheumatoid synovitis. PMID- 6855286 TI - Paraplegia secondary to epidural hemorrhage into spinal lipomatous tissue. PMID- 6855287 TI - [Incidence and significance of monoclonal gammopathy in a Spanish nosocomial population]. PMID- 6855288 TI - [Pyogenic sacroiliitis: study of seven cases]. PMID- 6855289 TI - [Minoxidil, timolol and furosemide, an effective hypotensive combination. Advantages and inconveniences]. PMID- 6855290 TI - [Present and future trends in nuclear medicine]. PMID- 6855291 TI - [Duodenal ulcer: a triple therapeutic possibility]. PMID- 6855292 TI - [Midline malignant reticulosis with histiocytic erythrophagocytosis in the bone marrow suggesting malignant histiocytosis]. PMID- 6855293 TI - [Simultaneous presence of inhibitors of coagulation factors V and VII in the same patient]. PMID- 6855294 TI - [The concept of myelopathy as a syndrome and its practical significance. Preleukemic states]. PMID- 6855296 TI - [Chemotherapy of advanced breast cancer]. PMID- 6855295 TI - [ABO system weak phenotypes. Apropos of 2 new cases: phenotypes Ax and Bx]. PMID- 6855297 TI - [Marfan's syndrome with dissecting aneurysm of aorta: clinical case]. PMID- 6855298 TI - [Kala-azar: 4 new cases in the endemic zone of Toledo]. PMID- 6855300 TI - [Primary and secondary renal amyloidosis: clinical manifestations, development and survival. Comparative study of 37 patients]. PMID- 6855299 TI - [Unilateral exophthalmos as primary manifestation of an adenocarcinoma of the colon]. PMID- 6855301 TI - [Listeriosis in the adult: clinical epidemiology, prognosis and treatment]. PMID- 6855302 TI - [Effect of penbutolol (HOE 893 d), a non-selective beta blocker, in the control of essential arterial hypertension]. PMID- 6855303 TI - [Leptomeningitis of fatal outcome as the primary manifestation of a non-Hodgkin's lymphoma]. PMID- 6855304 TI - [Pneumatosis cystoides intestinalis: report of a case of spontaneous pneumoperitoneum]. PMID- 6855305 TI - [Clinical value of the antineuronal antibodies in systemic lupus erythematosus]. PMID- 6855306 TI - [Cardiac heterotaxia and ciliary anomalies]. PMID- 6855307 TI - [Familial Noonan syndrome]. PMID- 6855308 TI - [Hematogenous osteomyelitis and septic arthritis in drug addicts]. PMID- 6855309 TI - [Infectious endocarditis in drug addicts. Presentation of 25 cases from the Barcelona area]. PMID- 6855310 TI - [Evaluation of the hypothalamo-hypophyseal-gonadal axis in male infertility (III). The chorionic gonadotropin test]. PMID- 6855312 TI - [Viral hepatitis. Role of drug dependence in its epidemiology and clinical features. Study of its incidence in hospitals in the Bilbao area]. PMID- 6855311 TI - [Left ventricular function in uremic patients on hemodialysis: echocardiographic study]. PMID- 6855314 TI - [Oncogenes]. PMID- 6855313 TI - [Treatment of transient cerebrovascular accidents]. PMID- 6855315 TI - [Post-transfusional non-cardiogenic pulmonary edema]. PMID- 6855316 TI - [Cryofibrinogenemia in a Klebsiella infection]. PMID- 6855317 TI - [Muscular manifestations in heroin addicts]. PMID- 6855318 TI - [Reversible paraplegia caused by a spinal subarachnoid hematoma following lumbar puncture in a thrombocytopenic patient]. PMID- 6855319 TI - [Psittacosis. Clinico-radiological features of a series of 13 cases]. PMID- 6855320 TI - [Myocardial gammagraphy during exercise using thallium-201. Correlation with coronariography and stress electrocardiogram]. PMID- 6855322 TI - [Non-Hodgkin lymphomas: a new anatomopathologic working formula]. PMID- 6855321 TI - [Antihypertensive effect of metoprolol in essential hypertension]. PMID- 6855323 TI - [Pulmonary thromboembolism: a diagnostic problems]. PMID- 6855324 TI - [Cimetidine and stomach cancer: deceptive response and diagnostic delay]. PMID- 6855325 TI - [Diffuse alveoloseptal amyloidosis. Apropos of a case]. PMID- 6855326 TI - [LDH and isoenzyme 5 in the differential diagnosis of infectious meningitis]. PMID- 6855327 TI - [Spontaneous pneumomediastinum]. PMID- 6855328 TI - [Paraplegia in a young man: presenting form of neurosyphilis]. PMID- 6855329 TI - [Inflammatory colonic stenosis secondary to pancreatitis]. PMID- 6855330 TI - [Epidemiologic study of a water-borne outbreak of hepatitis A]. PMID- 6855331 TI - [Insulin-dependent diabetes mellitus: subcutaneous insulin therapy with a portable infusion pump]. PMID- 6855333 TI - [Blood cholesterol in the acute phase of myocardial infarct]. PMID- 6855332 TI - [Hepatic involvement during sepsis]. PMID- 6855334 TI - [Reactive arthritis and Reiter's disease, where is the dividing line?]. PMID- 6855335 TI - [Systems of continuous infusion of insulin]. PMID- 6855336 TI - [Postoperative infection due to Mycobacterium fortuitum]. PMID- 6855337 TI - [Diagnostic criteria for Reiter's disease]. PMID- 6855338 TI - [The Milk-alkali syndrome]. PMID- 6855339 TI - [Hypertrophy of the gastric folds: apropos of a case of Menetrier's disease]. PMID- 6855340 TI - [Streptococcus milleri meningitis]. PMID- 6855341 TI - Effect of combined treatment of diphenylhydantoin with clonazepam and chlordiazepoxide on the threshold for maximal electroconvulsions in mice. AB - The anticonvulsant effect of either clonazepam (0.2-6.4 mg/kg) or chlordiazepoxide (2.5-40 mg/kg) alone or in combination with diphenylhydantoin (4 16 mg/kg) was studied against electroconvulsions in mice. All drugs were injected intraperitoneally, diphenylhydantoin - 75 min and the benzodiazepines - 60 min before the test. Adding either clonazepam or chlordiazepoxide (in doses moderately increasing the convulsive threshold) was more effective than doubling the dose of diphenylhydantoin. Both the interaction between benzodiazepines and diphenylhydantoin at the level of the receptor for picrotoxin-barbiturates and benzodiazepine-induced potentiation of specific diphenylhydantoin binding are likely to contribute to the observed phenomenon. On the other hand, a diphenylhydantoin-induced increase in the total number of specific benzodiazepine binding sites seems of minor importance since clonazepam (with a high affinity for these sites) and chlordiazepoxide (with a low affinity) were equipotent in the enhancement of the combined treatment efficacy. PMID- 6855342 TI - The effect of coumarin and 7-hydroxycoumarin on in vitro macrophage phagocytosis of latex particles. AB - The influence of various concentrations of coumarin (C) and 7-Hydroxycoumarin (7HC) upon in vitro macrophage phagocytosis of latex particles was investigated. A C dose of 20 micrograms/ml was indicated to have the greatest stimulating effect of all doses used with a percent effect of 25.6. A C dose of 80 micrograms/ml showed no apparent activity. C doses of 40, 10 and 1 microgram/ml had only a slight positive effect on phagocytosis compared to the control. 7HC concentrations of 80, 40, 20, 10 and 1 microgram/ml did not show any influence on the phagocytotic activity compared to the control. These preliminary data indicate a direct effect of C on macrophage function as has been suggested and refutes the hypothesis that 7HC is the pharmacologically active agent in reduction of high protein edemas. PMID- 6855343 TI - The filaricidal activity of some derivatives of N-[2-(4-thiazolyl)benzimidazol-5 yl]benzamide against Brugia pahangi adults. AB - A series of analogues of N-[2-(4-thiazolyl)benzamidazol-5-yl]benzamide with halogen substituents on the benzamide ring was tested for activity against adult Brugia pahangi in the peritoneal cavities of jirds. None of the chloro, bromo or iodo analogues was active at 5 x 100 mg/kg by subcutaneous injection. The 2 fluoro, 3-fluoro and 4-fluoro analogues showed greater activity than the parent compound and the 2,5-difluoro analogue had the same activity as the parent. The 3 fluoro, 4-fluoro and 2,5-difluoro analogues were not active in cats treated per os with 5 x 50 mg/kg. PMID- 6855344 TI - Cimetidine-theophylline complex formation. AB - Cimetidine forms a complex with theophylline in vitro in both pH 7.4 buffer and human plasma. The increase in the amount of theophylline in solution is about 20% in the buffer system and about 36% in plasma. It is hypothesized that this complex formation may contribute to and be part of the mechanism of the clinically observed decreased theophylline clearance in man in presence of cimetidine. PMID- 6855345 TI - Chlormezanone: its effects on subjective aspects of sleep and on skilled performance related to car driving. AB - A double-blind, crossover study compared chlormezanone 200 mg t.d.s., chlormezanone 400 mg nocte and placebo in twelve female volunteers. There was no obvious evidence of chlormezanone causing an impairment in early morning psychomotor performance, car driving ability or subjective ratings of early morning behaviour. Subjectively reported mood changes were consistent with those expected of a tranquillising drug and the sleep-inducing and improving properties of chlormezanone were confirmed. This volunteer study suggests that chlormezanone may well be a nocturnal sedative which does not have a morning hangover effect. PMID- 6855346 TI - [Incidence of inflammatory rheumatic spinal diseases at a steel plant]. PMID- 6855347 TI - [Immunologic aspects of the intestines in early infancy and in infants with celiac disease]. PMID- 6855348 TI - [Who should be vaccinated against hepatitis B?]. PMID- 6855350 TI - [Swedish pediatrics before 1980 and in the 1990's. A program from the Pediatric Society]. PMID- 6855349 TI - [Clonorchiasis--an unusual cause of cholangitis]. PMID- 6855351 TI - [Diabetes and pregnancy]. PMID- 6855352 TI - [Triplet pregnancies in Linkoping 1973-1981]. PMID- 6855353 TI - [2 functional scales for registering results of rehabilitation in cerebrovascular diseases]. PMID- 6855354 TI - [Repeated operation before wound healing often causes orthopedic-surgical infections]. PMID- 6855355 TI - [Intracranial subdural hematoma--an unusual complication of spinal anesthesia]. PMID- 6855356 TI - [Only a few die of leprosy but 1 billion are at risk of infection]. PMID- 6855357 TI - [Pharmacokinetics in chloroquine overdosage]. PMID- 6855358 TI - [Local therapy using a venous cannule, an effective way for pain relief in ununited fractures]. PMID- 6855359 TI - [Minipills as an alternative for many women of various ages in the choice of preventive methods]. PMID- 6855360 TI - [The children of non-European refugees need health control]. PMID- 6855361 TI - [Preservation rather than amputation of the breast with a tumor smaller than 2 cm]. PMID- 6855362 TI - [Local anesthesia in hernia surgery--an easy, safe and economic method]. PMID- 6855363 TI - [Abdominal pain in patients with cystic fibrosis]. PMID- 6855364 TI - [Partial esophageal rupture following intake of bulk-laxative]. PMID- 6855366 TI - [Report of a case of gas gangrene--an alternative interpretation]. PMID- 6855367 TI - [Fiberbronchoscopy opens new methods in lung biopsy, bronchial lavage, laser therapy]. PMID- 6855365 TI - [Mortality of influenza does not increase in persons with predisposing factors]. PMID- 6855368 TI - [Instrumental injuries to the esophagus can be avoided by proper training and practice]. PMID- 6855369 TI - [Ski injuries in Jamtland county in 1981. The number of serious accidents is increasing]. PMID- 6855370 TI - [Anatomic variants of the pancreatic duct system--theoretical and practical aspects]. PMID- 6855371 TI - [Intensified drug control--with drawbacks?]. PMID- 6855372 TI - [The number of elderly with orthopedic diseases is increasing. Effective cooperation between orthopedics and outpatient care is needed in general geriatric care]. PMID- 6855373 TI - [Patients with brain stem injury may cause problems in the diagnosis of brain death]. PMID- 6855374 TI - [Acute compartment syndrome in knee arthroscopy]. PMID- 6855375 TI - [Immunology and psychology--a comparison]. PMID- 6855376 TI - [A treatment program for the management of oral galvanism screens out cases unsuitable for specialized clinics]. PMID- 6855377 TI - [The blind or blunt transmediastinal dissection of the esophagus]. PMID- 6855378 TI - A new approach to the thoracic esophagus by the abdominal transdiaphragmatic route. AB - A total of 113 patients affected by several esophageal and gastric alterations underwent operations through the cervicoabdominal transdiaphragmatic route, such as partial resections of the distal segment of the esophagus or subtotal esophagectomy. This method proved to have much fewer postoperative complications or deaths as well as more advantages, especially since most of the patients presented moderate to severe malnutrition and could not easily endure more aggressive procedures such as the thoracotomy with its obvious respiratory complications. PMID- 6855380 TI - [Experiences with recurrent malignant goiter]. AB - At the Surgical Department of the Kaiserin Elisabeth Spital, Vienna, 30,301 thyroid operations have been performed from 1949 to 1981. Out of this number thyroid carcinomas were 1051 cases, 112 of them developed in recurrent goiter. Recurrencies of benign goiter were 2,743 (9.1%) cases. Overall frequency of thyroid carcinoma was 3.5% and they had a recurrency rate of 8.3% where reoperation was necessary. The percentage of thyroid carcinoma developing in operated benign goiter was 6.9%. PMID- 6855379 TI - [Appendectomy - tenets of a century]. AB - A small hospital reports on the results of 1302 appendectomies: all degrees of morbidity of the appendix and all patient ages are represented. There were only 2 deaths (0.15%), which also illustrates the very satisfactory success rate in the 16 "urgent early relaparotomies" (only 1 of 11 patients died). Richly demonstrated by case reports, it deals with diagnostic, indicative, and intraoperative problems and finally broaches the subject of "suppurative pylethrombophlebitis" secondary to acute appendicitis, including the question about its fateful course. PMID- 6855382 TI - [Electrical and motor activity of the rectum following low anastomosis]. AB - Electrical and motor activity of smooth muscle of the canine rectum was registered by transanal recording following low rectum anastomosis. The relaxation reflex of the anal canal had disappeared distal of the anastomosis in the first postoperative week, and electrical slow waves and pressure waves were desynchronized proximal and distal of the anastomosis. The resting pressure of the rectal wall had increased above preoperative values. After wound healing had accomplished the relaxation reflex and the synchronization of electrical and mechanical activity proximal and distal of the anastomosis did occur again. It is concluded that the rectal wall provides the pathways for the relaxation reflex of the anal canal. After wound healing has finished these pathways are restored across the anastomosis. PMID- 6855383 TI - [Intraoperative diagnosis of pancreatic carcinoma]. AB - Between 1978 and 1981 634 frozen section examinations were performed during 185 operations on patients with pancreatic or periampullary carcinoma. The frozen section findings and the definite reports after paraffin embedding were identical in 97.2% of all examinations. 1.6% of frozen section findings were false negative, 0.2% false positive. The positive predictive value, especially important for the surgeon, was 100% for examinations of the pancreas and the primary tumor and 98.9% for metastases and structures suspicious of metastases. The negative predictive value was 94.3% and 99.6% respectively. Serious complications of pancreatic biopsies were not observed. On 438 pancreatic resection specimens after intraoperative frozen section examination a benign disease was diagnosed between 1971 and 1981. By further work-up after paraffin embedding at another institution a carcinoma was detected surprisingly only in two cases (0.5%). A pancreatic resection based on a false positive frozen section finding was never performed. The results prove that intraoperative frozen section examination is a useful and reliable diagnostic procedure. A review of the recent literature demonstrates as well that similar results cannot be achieved by other methods including intraoperative fine needle aspiration biopsy. PMID- 6855381 TI - [Experimental gallstone formation. Etiological significance of beta-glucuronidase producing bacteria and biliary obstruction]. AB - Bile pigment gallstones were produced in six of six mongrel dogs by narrowing the cystic duct with ligature after a postoperative interval of seven days. beta Glucuronidase producing group G Streptococcus and Staphylococcus aureus were found in the bile, the gallbladder wall, and the liver. In another trial similar gallstones were produced in four of eight dogs after mere injection of beta glucuronidase producing Escherichia coli into the spleen resp. in six of eight dogs after injection of E. coli into the colon without ligature of the cystic duct. In an additional series gallstones were produced in six dogs after injection of beta-glucuronidase producing E. coli into the colon plus ligature of the cystic duct. The injected strain of E. coli was found in the bile, the gallbladder wall, the liver, and even within the produced gallstones. In a control group in none of six dogs gallstones were present. beta-Glucuronidase producing group G Streptococcus was found in the gallbladder of one dog, Pseudomonas aeruginosa was found in the gallbladder of another dog and Staphylococcus aureus in the liver and gallbladder wall of a third dog. We conclude from our experiments that merely bacterial infection of the biliary tract can lead to gallstone formation. The bacterial colonization of the liver and the biliary tract is promoted by biliary tract obstruction. beta Glucuronidase producing bacteria increase the amount of beta-glucuronidase in the bile thus leading to calcium bilirubinate precipitation and gallstone formation by deconjugation of bilirubindiglucuronide. PMID- 6855384 TI - [Treatment of hyperlipidemia in 1982]. PMID- 6855385 TI - [Clinical use of aminoglycosides]. PMID- 6855386 TI - [Injuries of the dorsolumbar spine. Clinical forms--treatment]. PMID- 6855387 TI - [Facing spasmodic paraplegia, arguments in favor of multiple sclerosis]. PMID- 6855388 TI - [Current aspects of hypothyroidism in adults encountered in a nonspecialized medical milieu (apropos of 23 cases collected in 12 months)]. PMID- 6855389 TI - [Colonic pneumatosis]. PMID- 6855390 TI - [Hypertension and pregnancy]. PMID- 6855391 TI - [Nuclear magnetic resonance of living tissues (II)]. PMID- 6855392 TI - [Clinical aspects of hyperlipoproteinemia]. PMID- 6855393 TI - [Biological study of hyperlipemia]. PMID- 6855394 TI - Panel discussion on allergy in ENT practice. PMID- 6855395 TI - Stage II glottic carcinoma: prognostic factors and management. AB - Three hundred thirty-six patients with squamous cell carcinoma of the glottic larynx treated at the University of Virginia Medical Center from 1960 through 1977 were reviewed. Seventy patients with T2N0M0 disease, grouped according to the criteria of the American Joint Committee on Cancer, 1978, form the basis of this report. The 5-year actuarial survivals, recurrences, salvages, and prognostic factors were examined. Treatment was radiation, surgery, or a combination of radiation and surgery. Impaired vocal cord mobility in Stage II glottic squamous cell carcinoma is the crucial significant prognostic factor in predicting response to therapy, survival, and response to salvage therapy for recurrences. The 90% 5-year recurrence-free rate with freely mobile cords is comparable to that achieved with Stage I lesions. Impaired mobility resulted in a 5-year recurrence-free rate of 73%, which is comparable to that of T3N0 lesions. We support the concept of reclassifying Stage II disease into Stage IIa (mobile cords) and Stage IIb (impaired mobility). Based on this review and those reported in the literature, we recommend radiation therapy for Stage IIa disease. Surgery results in fewer recurrences and in longer survival than irradiation when the vocal cords are not freely mobile (Stage IIb). PMID- 6855396 TI - Laryngeal pseudosarcoma. AB - In the past laryngeal pseudosarcomas have been diagnosed as a. carcinosarcomas, b. pleomorphic or spindle cell carcinomas, or c. squamous cell carcinomas with pseudosarcomatous reactive stroma. Arguments have centered around the nature of the sarcomatous stroma. Because of this confusion there is disagreement as to the treatment and prognosis of these tumors. Seven pseudosarcomas were treated between 1969-1979, 4 were pedunculated and 3 exophytic. Treatment consisted of primary CO60 irradiation in 2 patients, surgery in 3 cases and combined therapy in 2 cases with no recurrences. Three of the 7 have died, 1 of a poorly differentiated adenosquamous carcinoma of the right main stem bronchus and the other 2 of natural causes at ages 77 and 85. From a review of the literature as well as our experience, we have reached the following conclusions. 1. Stromal cells are a malignant morphologic variant of the squamous cell and are best termed spindled cells. 2. Neck metastasis at any time is a poor prognostic sign. 3. The pattern of metastasis and survival seems to parallel laryngeal squamous cell carcinoma, and thus treatment should be similar for given stages. PMID- 6855397 TI - Plasmacytoma of the larynx. AB - Plasmacytoma involving the larynx is very rare. To the best of our knowledge there are only 79 cases reported in the world literature. We are adding 3 more cases; 2 cases were associated with multiple myeloma and 1 was considered to be a solitary or extramedullary plasmacytoma. The clinical picture was hoarseness and upper airway obstruction. In plasmacytoma of the larynx multiple biopsies are often nondiagnostic, sometimes revealing only chronic inflammation and amyloid infiltration in the tissues. Most authors agree that the treatment of choice is conservative surgical excision and radiation therapy. Surgery may also be reserved to excise residual scar tissue and fibrosis after treatment mainly to improve the airway and eliminate the tracheostomy tube. To confirm the definitive diagnosis of solitary plasmacytoma of the larynx, long-term follow-up of many years is necessary in order to rule out multiple myeloma. PMID- 6855398 TI - Severe laryngeal stenosis repair: long-term follow-up using conjoint hyoid bone segments. AB - In early 1983 the authors presented an innovative procedure for the management of severe laryngeal stenosis. Because of the severity of the stenosis and the large surgical defect created by excision of the stenosis, multiple pieces of the hyoid bone were sewn together conjointly to bridge the surgical defect. The authors are now able to report follow-up in 6 patients ranging from 11 to 60 months and discuss their favorable experience with this procedure. PMID- 6855399 TI - The pectoralis major myocutaneous flap: an angiographic study. AB - A new era in head and neck reconstruction has been opened with the use of myocutaneous flaps. The pectoralis major myocutaneous flap is considered the most reliable of its kind but flap failures still occur secondary to tension and infection. Our standard procedure has been to follow the acromioxiphoid line as a guide to the location of the blood supply of the pectoralis major muscle. We have noticed in the operating room and during cadaver dissection that the vascular supply is sometimes more laterally located than usually described. A review of the vascular supply of this anatomic area using angiographic studies of the subclavian and its branches is presented, with important findings critical to the surgical technique used to protect the flap's blood supply. PMID- 6855400 TI - Application of posterior neck dissection in treating malignant melanoma of the posterior scalp. AB - Utilization of a posterior neck dissection in the treatment of nine patients with malignant melanoma of the posterior scalp is presented. Seven of nine patients presented with metastatic disease present in the posterior neck after initial treatment elsewhere. Four of the seven patients developed regional disease 4 months to 4 years following initial diagnosis. Variables dictating surgical treatment included the Clark's level, Breslow depth of invasion of original lesion, evidence of metastatic disease, and type of melanoma. The surgical technique of the posterior neck dissection is graphically depicted and the indications outlined. The posterior neck dissection is mandatory to adequately resect the primary lymphatics of the posterior scalp. Controlled studies are urged to determine the efficacy of prophylactic surgical lymphadenectomy in malignant melanoma of the head and neck. PMID- 6855401 TI - Serial section reconstruction of the neural poles of hair cells in the human organ of Corti. II. outer hair cells. AB - Study of the anatomy of the cochlea, and in particular the morphology of synaptic relationships between hair cells and cochlear neurons, is essential for elucidation of the mechanisms of transduction of mechanical acoustic signals into electrical neural events. Because considerable gaps remain in our understanding of the microscopic anatomy of these synapses, particularly in the human, a reconstruction of the neural pole of outer hair cells of the human organ of Corti was performed. The data are based on 577 serial sections from the basal turn and 368 sections from the middle turn. This provided complete data on 11 and partial data on 9 outer hair cells. Terminal size of afferent fibers on outer hair cells was much more uniform than that found at the base of inner hair cells. Only small bouton-like terminals were found. Branching of afferent fibers was also seen at the base of outer hair cells. Each outer hair cell received approximately two to eight afferent nerve terminals. Multiple synaptic contacts between a single afferent terminal and an outer hair cell were common. Junctional membrane specialization consisted of synapses, desmosomes, coated vesicles and arrays of microtubules and membrane cisternae. Specialization at synapses consisted of asymmetrical membrane thickening. At outer hair cells the presynaptic membrane was thicker than the postsynaptic membrane. At inner hair cells the converse was true. At outer hair cells 35% of synapses had presynaptic bodies, compared to 83% of synapses at inner hair cells. Reciprocal synapses, with both hair cell to neuron and neuron to hair cell polarities, were found only on outer hair cells. Vesiculated efferent terminals were common at the base of outer hair cells. Both axosomatic and axodendritic efferent synapses were found. In addition, the same efferent fibers were found to synapse both on an outer hair cell and on an afferent dendrite. One example of a probable dendro-dendritic synapse in the outer spiral bundle is presented. PMID- 6855403 TI - Cavernous sinus thrombophlebitis secondary to sphenoid sinusitis. AB - Cavernous sinus thrombosis is a serious life threatening condition which usually results from midfacial skin infections. Preantibiotic era mortality rates of 80% have improved markedly because of an early awareness of the condition and prompt initiation of parenteral antibiotics. Sphenoid sinusitis is an uncommon associated cause of cavernous sinus infection and is itself a rare and elusive clinical problem. A case of sphenoid sinusitis and concurrent cavernous sinus thrombophlebitis is presented to highlight the clinical diagnostic considerations with special emphasis on bilateral eye signs as indicators of the impending thrombophlebitic process. PMID- 6855402 TI - Combined preoperative radiotherapy and surgery in the treatment of carcinoma of the anterior two-thirds of the tongue. AB - Sixty-three patients with squamous cell carcinoma of the anterior two-thirds of the tongue were treated with preoperative external radiotherapy (mean target dose 42.60 Gray or 4260 rad) and surgery. The expected 5-year survival, expressed as life table estimate of percent of survivors, was 77% for patients with Stage I tumors, 69% with Stage II, and 13% for patients with tumors in Stages III-IV (p less than 0.001). Fourteen patients experienced local recurrences, 7 had homolateral neck metastases, 4 had contralateral neck metastases and 3 had distant metastases. In 15 cases no cancer could be detected at review of the surgical specimens, but 2 of these died of their cancers. In 43 cases cancer was present in the specimens, and 26 of these died of their cancer (p less than 0.01). PMID- 6855404 TI - Surgical and nonsurgical treatment of penetrating injuries to the cervical esophagus. AB - We presented two patients with gunshot wounds and one patient with a stab wound of the cervical esophagus, managed conservatively, which resulted in no deaths. Results of eight studies of cervical esophageal injuries are reviewed and presented in Table I. One must consider both the surgical and conservative methods of management in planning treatment for the given patient. PMID- 6855405 TI - Primary cysts of the mastoid process. AB - Two patients with primary mastoid cysts are presented. These examples stress the importance of regular follow-up of patients with chronic serous otitis media so that the complications or associated abnormalities may be treated early prior to extensive destructive erosion. The formation of these cysts may be due to changes brought about by chronic serous otitis media, or they may be of congenital origin with middle ear effusion as a sequela. PMID- 6855406 TI - Intranasal airway/pack: description of a new device. AB - We have designed and developed a new intranasal pack which has been found to be most effective in controlling anterior and posterior epistaxis. Its ease of introduction and patient tolerance make it ideal for treating posterior epistaxis on an outpatient basis, and as packing for septal, sinus, or rhinoplastic surgery. The unique features of a breathing cannula and total intranasal tamponade distinguish this device from all preceding ones. PMID- 6855407 TI - Hydrops following perilymph fistula repair. AB - A series of 15 ears were explored for perilymph fistulas. Fifteen fistulas were found in 13 ears. Two cases are presented which developed hydrops-like symptoms only after closure of their fistulas. Closure of the other patients' fistulas was successful in relieving vertiginous symptoms, although hearing seldom improved. There were no significant complications of surgery. Fat failed as a graft material 4 of 10 times, whereas vein and perichondrium were not associated with recurrence of symptoms. The ENG-fistula test, as described by Daspit and associates, correctly predicted the presence or absence of a fistula in 7 of 8 ears tested. Hennebert's sign correctly predicted fistulae in 2 ears, and Hennebert's symptom was associated with proven fistulae in 9 of the 10 times it was present. Because of the low morbidity and the high success rate of surgery, a patient with a history suggestive of a perilymph fistula should have exploratory tympanotomy, particularly if the ENG-fistula test is positive. PMID- 6855408 TI - Total glossectomy sans laryngectomy--are we justified? AB - Eighty-five cases of cancer of the tongue treated with total glossectomy are presented; 82 had a squamous carcinoma. The majority had a large primary with no disease in the neck. Thus only 6 patients required concurrent therapeutic radical neck dissection. A laryngectomy was done in 9 cases for gross extension of disease and in 1, as prophylaxis against aspiration. In 75 cases the larynx was preserved. Mortality from aspiration pneumonitis was 4%. Local recurrence rate was 42% for predominantly posterior lesions and 27% for anterior lesions. The speech, though not quite articulate, was fairly understandable. Thus, in cases of total glossectomy preservation of larynx is worthwhile and justifiable except when involved with disease, when the risk of even minor degrees of aspiration is high (elderly, frail individuals) and with associated extensive pharyngeal resection hampering the swallowing machanism. PMID- 6855409 TI - "How I do it"--head and neck and plastic surgery. A targeted problem and its solution. The split muscle flap in pharyngeal closure after laryngectomy. PMID- 6855410 TI - An anesthesia technique for laser surgery of the larynx. PMID- 6855411 TI - "How I do it"--otology and neurotology. A specific issue and its solution. The promontorial window technique. PMID- 6855412 TI - Atelectatic middle ear. PMID- 6855413 TI - [Esophageal carcinoma in Croatia]. PMID- 6855414 TI - [The influence of occupation on the development of hyperemesis gravidarum]. PMID- 6855416 TI - [Syncope of the carotid sinus]. PMID- 6855415 TI - [Generalized disease of the newborn infant caused by enteroviruses - a report on 3 patients]. PMID- 6855417 TI - [Familial histiocytosis]. PMID- 6855418 TI - [Analysis of the use of digoxin in a hospital setting. II. Prospective study]. PMID- 6855419 TI - [Rehabilitation of breast cancer patients]. PMID- 6855420 TI - [Study of specific bronchial hypersensitivity in allergic diseases of the respiratory tract]. PMID- 6855421 TI - [Gastroduodenal surgery in elderly patients]. PMID- 6855422 TI - [Development of aseptic necrosis of the femur head as a complication in the treatment of congenital dislocation of the hip]. PMID- 6855423 TI - [Immunoproliferative diseases]. PMID- 6855424 TI - [The role of immunodeficiency in the pathogenesis of secondary lymphomas and leukemias]. PMID- 6855425 TI - [Immunological classification of immunoproliferative diseases]. PMID- 6855426 TI - [Angioimmunoblastic lymphadenopathy - disregulation or neoplasm?]. PMID- 6855427 TI - [Radiological treatment of non-Hodgkin lymphoma as an immunoproliferative disease]. PMID- 6855428 TI - [Chemotherapy of immunoproliferative diseases--achievements and perspectives]. PMID- 6855429 TI - [A study of nephrolithiasis in Primosten with special attention to its familial occurrence]. PMID- 6855430 TI - [Pathological changes in the media of the aorta in routine autopsy material. A supplement to the study of the pathogenesis of dissecting aneurysms]. PMID- 6855431 TI - [Obscure erythrocytosis - an ominous sign of the primary disease (with a case report)]. PMID- 6855432 TI - [Chondroma of the larynx]. PMID- 6855433 TI - [Computerized tomography in the diagnosis of intracranial hemorrhage in premature infants and neonates at term. Results of a preliminary study]. PMID- 6855434 TI - [Echocardiographic control of postoperative results in children]. PMID- 6855435 TI - [Therapeutic approach to the irritable bowel syndrome]. PMID- 6855436 TI - [Correlation between a time series of meteorological parameters and the incidence of myocardial infarct]. PMID- 6855437 TI - [Emotional origin of disorders in verbal communication in children caused by surgical procedures]. PMID- 6855438 TI - [The relation between childbirth and hormonal contraception and the incidence of varices]. PMID- 6855439 TI - [A case report of an adult patient with a clinical manifestation of the hemolytic uremic syndrome]. PMID- 6855440 TI - [Uveal cysts]. PMID- 6855441 TI - [Myocardial infarct in early pregnancy in a woman with normal coronarography findings]. PMID- 6855442 TI - [A large myxoma of the right atrium in a 34-day-old infant]. PMID- 6855443 TI - [Patient compliance]. PMID- 6855444 TI - [The saga of prostaglandins and the winners of the Nobel Prize for achievements in medicine in 1982]. PMID- 6855445 TI - [The fate of bioactive substances in the pulmonary circulation]. PMID- 6855446 TI - [Psychiatric disorders caused by drugs]. PMID- 6855447 TI - 3-carboethoxy-beta-carboline (beta-CCE) elicits electroencephalographic seizures in rats: reversal by the benzodiazepine antagonist CGS 8216. AB - Intravenous administration of 3-carboethoxy-beta-carboline (beta-CCE, 10 mg/kg) to rats resulted in multiple bursts of rhythmic waves (2-4 second duration, 5-7 Hz) with amplitudes of 100-250 microV. Pretreatment of animals with the benzodiazepine receptor antagonists CGS 8216 prevented the electroencephalographic seizures elicited by beta-CCE. This dose of CGS 8216 did not produce any electroencephalographic abnormalities when administered alone. These observations suggest that the electroencephalographic seizures elicited by beta-CCE are mediated via an interaction with benzodiazepine receptors. An in vitro study of the rate of degradation of beta-CCE and 3-carbomethoxy-beta carboline (beta-CCM) in rat plasma demonstrated that the rate of degradation of the former compound was three times more rapid than the latter. These observations, taken together with previous studies demonstrating that parenteral administration of beta-CCM elicits tonic and clonic seizures, suggests that pharmacokinetic factors may be involved in defining the pharmacologic profile of beta-carboline-3-carboxylic acid esters. PMID- 6855449 TI - Effects of chlordiazepoxide on drinking compared in rats challenged with hypertonic saline, isoproterenol or polyethylene glycol. AB - Several investigators have shown that anxiolytic benzodiazepines stimulate additional water consumption in rats made thirsty by water deprivation. The present report extends this work by showing that chlordiazepoxide (CDP) enhanced drinking in rats challenged with either cellular or extracellular dehydration, following hypertonic saline or polyethylene glycol injection respectively. Since CDP also increased drinking in control animals, it may have produced a direct dipsogenic effect which acted additively with respect to the physiological thirst challenges. In contrast, CDP did not enhance water intake during the dipsogenic action of the beta-adrenergic agonist, isoproterenol. The data provide new evidence that benzodiazepine mechanisms may be involved in thirst and the controls of drinking. PMID- 6855448 TI - Plasma homovanillic acid as an index of brain dopamine metabolism: enhancement with debrisoquin. AB - Plasma levels of the dopamine (DA) metabolite homovanillic acid (HVA) may be a useful measure of brain HVA production by central DA systems. Even though there is a significant peripheral contribution to plasma HVA, experimental manipulations that alter brain HVA produce parallel changes in plasma HVA levels. This study was designed to assess whether the ability of plasma HVA to reflect haloperidol induced increases in brain HVA could be strengthened by reducing the contribution to plasma HVA from peripheral sources. Debrisoquin sulfate, a monoamine oxidase inhibitor that does not enter the brain, was given in a low dose schedule to rats and lowered the peripheral contribution to plasma HVA by between 42 and 68%, resulting in a situation where between 62 and 87% of plasma HVA derived from brain. Using this dose schedule, rats pretreated with debrisoquin displayed a significant increase in plasma HVA following a lower dose of haloperidol than that required in the vehicle pretreated rats. In the debrisoquin pretreated group, a 71% increase in brain HVA was accompanied by a significant 60% increase in plasma HVA, whereas the vehicle pretreated group required a 136% increase in brain HVA to display a significant 50% increase in plasma. These findings indicate that debrisoquin pretreatment improves the reliability of plasma HVA to reflect changes in brain DA metabolism. Plasma HVA samples obtained from humans following debrisoquin may provide a clinically applicable method for assessing brain DA systems in neurologic and psychiatric illness. PMID- 6855450 TI - The effect of arylazido aminopropionyl ATP on atropine resistant contractions of the cat urinary bladder. AB - This work was designed to study neurogenic, atropine resistant contractions of the cat urinary bladder. Urinary bladder contractions were induced by pelvic nerve stimulation (PNS) and the administration of acetylcholine (Ach) and purine compounds. The results show that atropine (2 mg/kg) depresses the maintained portion (phase 2) of PNS-induced contractions and Ach-induced contractions while having no effect on the initial portion (phase 1) of the PNS-induced contractions or those contractions induced by the purines. Arylazido aminopropionyl ATP (ANAPP3), an ATP antagonist, depressed phase 1 of the PNS contraction and the purine induced contractions. These results suggest that ATP is responsible for at least part of the atropine-resistant contractions of the cat urinary bladder. PMID- 6855451 TI - [3H]Mesulergine, a selective ligand for serotonin-2 receptors. AB - [3H]Mesulergine binds with high affinity to rat cerebral cortex membranes. (KD = 1.9 nM, Bmax = 11.3 pM/g tissue). The binding of this ligand is selective for serotonin-2 receptors: Its next highest affinity, which is for dopamine receptors labelled by neuroleptics, is about 50 times weaker than its affinity for serotonin-2 receptors. No significant affinity for serotonin-1, alpha 1 adrenergic or histamine H1 receptors was observed. Specific [3H]mesulergine binding was diminished in the presence of low concentrations of lithium ions. PMID- 6855452 TI - Abnormal development of blood pressure and growth in rats exposed to perinatal injection stress. AB - Subcutaneous injections of alkaline saline were made perinatally in Sprague Dawley rats according to two schedules. In a pre-/postnatal group, dams were treated from 19th gestational day to 9th day postpartum and pups from day 0-9. In a postnatal group, pups alone were injected from day 0-6. At 19-23, 50-56 and 82 86 days of age, injected rats and uninjected controls were anesthetized and arterial blood pressure measured. Rats from the pre-/postnatal group had higher blood pressures (58%) and body weights at 19-23 days and lower blood pressure (35%) and body weight at 82-86 days of age. Blood pressure and body weight were comparable to control at all ages in the postnatal injection group. It is concluded that as a result of the maternal stress produced by the injections there was a generalized disturbance of growth processes resulting in hypotension and decreased body weight in adulthood. PMID- 6855453 TI - Bombesin produces hypothermia in hypophysectomized rats. AB - Intracerebroventricular administration of bombesin, a naturally-occurring peptide, produces hypothermia in the rat. To determine whether a pituitary dependent step is necessary for this effect, the thermoregulatory response was followed in hypophysectomized and intact rats maintained at room temperature. Significant hypothermia was produced in both experimental groups. This study supports an extra-pituitary mechanism for bombesin-induced hypothermia. PMID- 6855454 TI - Lysine vasopressin fails to alter (3H)-noradrenaline uptake or release from hippocampal tissue in vitro. AB - Lysine vasopressin (5.2 and 10.4 microM) failed to significantly alter the spontaneous release of (3H)-noradrenaline from hippocampal slices in vitro or the release observed after stimulation with potassium chloride (15 and 25 mM). Uptake of (3H)-noradrenaline by synaptosomes prepared from hippocampal tissue was not significantly changed by incubation with vasopressin (5.2 and 10.4 mu M). Our results fail to support the hypothesis, derived from behavioural and in vivo biochemical studies, that vasopressin modulates the activity of noradrenergic nerve terminals in this part of the limbic system. PMID- 6855455 TI - Naloxone blocks exercise-stimulated water intake in the rat. AB - To examine whether opiate receptors modulate exercise-induced water intake, we measured water intake during four consecutive hours after a one-hour swim stress in male, Sprague-Dawley rats. Increased cumulative water intake was found four hours following exercise and this response was naloxone-reversible (P = 0.06). Suppression of water intake in the naloxone-treated, exercised group was most marked in the first two hours after exercise (P less than 0.05). Non-exercised rats consumed water at a constant, linear rate (P less than 0.05) whether treated with naloxone or saline. These results indicate an endogenous opioid role in regulating exercise-induced water intake in the rat, but do not delineate whether this role reflects a non-specific stress behavior or specific physiological processes related to thirst. PMID- 6855457 TI - Cholecystokinin varies in the posterior pituitary and external median eminence of the rat according to factors affecting vasopressin and oxytocin. AB - Using radioimmunoassay (RIA), the content of gastrin-cholecystokinin family peptide immunoreactivity (G-CCK-IR), in the posterointermediate lobe (PIL) of the rat pituitary, has been determined in several experimental conditions. G-CCK-IR levels are significantly higher in males than in females. Salt loading induces a significant decrease of G-CCK-IR in animals of either sex. In males, G-CCK-IR levels are lower than controls 21 days after either castration or daily subcutaneous oestradiol injections. Using immunocytochemistry, G-CCK-IR disappears from the external median eminence 21 days after adrenalectomy. Our results show that, in addition to sex difference, factors affecting the vasopressin and/or oxytocin levels in the posterior pituitary and external median eminence also affect G-CCK-IR in the same regions. Cholecystokinin may therefore be of importance in functions related to these hormones. PMID- 6855456 TI - Norepinephrine stimulation of phospholipid methylation in rat cortical synaptosomes: fact or artifact? AB - Synaptosomes from rat cerebral cortex incubated with 3H-S-adenosyl-L-methionine (3H-SAM) displayed an increase in chloroform- extractable tritium when norepinephrine was added to the reaction mixture. The products of this mixture were maximally generated from intact synaptosomes, only partially inhibited by propranolol, and not enhanced by exogenous phospholipids. Thin layer chromatographic analysis of these chloroform extracts in three solvent systems yielded large norepinephrine- stimulated peaks of radioactivity that did not consistently co-chromatograph with authentic methylated phospholipid standards: phosphatidylmonomethylethanolamine (PME), phosphatidyldimethylethanolamine (PDE), and phosphatidylcholine (PC). Further, attempts to identify these peaks of radioactivity using as standards several putative methylated products of varied chemical classes, failed to elucidate likely candidates. It appears that while norepinephrine markedly stimulates the amount of tritium extracted into the chloroform phase, careful and positive structural elucidation of formed products is required before it can be concluded that these are indeed methylated phospholipids. PMID- 6855458 TI - The affinity of metergoline for 3H-serotonin (5HT) binding sites is regulated by guanine nucleotide. AB - 100 microM guanine nucleotide Gpp (NH)p reduces the affinity of the serotonergic antagonist metergoline for 3H-5HT binding sites in rat cerebral cortex. This effect is present both in inhibition binding and in saturation experiments. The hypothesis that the interaction of some serotonergic antagonists with 3H-5HT binding sites is regulated by guanine nucleotides is discussed. PMID- 6855459 TI - Teratogenicity of acetaldehyde in vitro: relevance to the fetal alcohol syndrome. AB - Day 10 rat embryos grown in vitro showed significant retardation in growth and development when culture media contained acetaldehyde. A concentration-response range for acetaldehyde-induced embryotoxicity was defined, from no effect at 5 microM to complete lethality at 100 microM. The relative teratogenicity of ethanol and acetaldehyde, and the potential roles of these compounds in producing the Fetal Alcohol Syndrome are discussed. Despite intensive investigation into alcohol teratogenicity, the mechanism that produces the Fetal Alcohol Syndrome (FAS) remains unknown. Observed anomalies may result from direct embryonic exposure to ethanol or one of its metabolites, or from some indirect effect such as altered placental function or maternal nutritional status. Use of in vitro techniques allows study of direct embryonic exposures in the absence of indirect influences. Under such conditions, ethanol has been found to exert direct embryotoxicity (1). Rat embryos, grown as cultured explants and subjected to ethanol concentrations of 32.5 or 65 mM, were retarded in growth and development when compared to untreated controls. In this paper, we report direct embrytoxic effects of acetaldehyde, the primary metabolite of ethanol, at concentrations as low as 25 microM. Acetaldehyde teratogenicity has not been extensively studied. Veghelyi et al. (2) and Lambert, Papp and Nishiura (3) employed a combination of ethanol and disulfiram (an inhibitor of acetaldehyde-oxidizing enzymes). Teratogenic effects exceeded expectations based upon assumption of an additive interaction between these two compounds, and were attributed to elevated maternal blood acetaldehyde. O'Shea and Kauffman (4,5) and Dreosti et al. (6) administered acetaldehyde to pregnant animals by injection. Treatment resulted in retarded growth and development, decreased DNA synthesis, and increased frequencies of malformation and resorption. While these studies imply a role for acetaldehyde in alcohol-induced teratogenesis, indirect effects through altered maternal or placental factors cannot be eliminated. We present here the first concentration response data for direct embryonic exposure to acetaldehyde. PMID- 6855460 TI - Effects of haloperidol and sulpiride on dopamine-induced inhibition of nucleus accumbens neurons. AB - Microiontophoretic study was performed to elucidate dopaminergic mechanism in the nucleus accumbens (Acc) of rats anesthetized with chloral hydrate. Iontophoretically applied dopamine produced an inhibition of glutamate-induced firing in 28 (62%) out of 45 Acc neurons tested. The dopamine-induced inhibition of 14 Acc neurons was clearly antagonized by simultaneous application of haloperidol, and a partial antagonism by sulpiride was observed in 3 out of 10 Acc neurons. These results indicate that dopamine produces an inhibition of the Acc neuron and that, compared to haloperidol, sulpiride is a less potent blocker of the postsynaptic dopamine receptor involved in the dopamine-induced inhibition. PMID- 6855461 TI - Oxalate-stimulation of ATP-dependent Ca-uptake is diminished during smooth muscle subcellular fractionation. AB - The ATP-dependent azide-insensitive Ca-uptake by the postnuclear supernatant from rat myometrium is stimulated more by 5 mM oxalate than by 25 mM phosphate. During subcellular fractionation, however, the percent recovery of the oxalate stimulated Ca-uptake diminishes more rapidly than that of the Ca-uptake without any added oxalate or phosphate. The percent recovery of the phosphate stimulated Ca-uptake also diminishes but not to as low levels as that of the oxalate stimulated Ca-uptake. The net result is higher stimulation of this uptake by 25 mM phosphate than by 5 mM oxalate in the various sucrose density gradient fractions. This discrepancy in percent recoveries presents a major concern about the use of oxalate or phosphate stimulated Ca-uptake as a marker for smooth muscle membranes. PMID- 6855462 TI - Calcium uptake by isolated nerve endings: evidence for a rapid component mediated by the breakdown of phosphatidylinositol. AB - Several physiological stimuli, including neuronal depolarization, increase the production of phosphatidate (PA) from phosphatidylinositol (PI) and increase calcium fluxes across cell membranes. To determine if breakdown of PI is required for neuronal calcium uptake, we tested inhibitors of PI-specific phospholipase C on depolarization-dependent uptake of calcium by isolated brain synaptosomes. At a concentration of 0.1 mM these inhibitors reduced calcium uptake produced by depolarization for 1 to 3 sec, but did not affect uptake due to more prolonged depolarization. Exogenous PA also stimulated calcium accumulation by synaptosomes and this uptake was not reduced by the enzyme inhibitors. These results suggest that the rapid calcium influx produced by neuronal depolarization may be mediated by the breakdown of PI. PMID- 6855464 TI - The importance of experience in the development of tolerance to ethanol hypothermia. AB - Studies were conducted to determine if an animal has to experience a reduction in body temperature during the acquisition period in order to develop tolerance to the hypothermic effect of ethanol. Adult, drug-naive C57BL/6J mice were injected with 2.6 or 3.6 g/kg ethanol or normal saline once daily for 6 days. During the tolerance acquisition period, days 1-5, mice were placed into warmed chambers (36 +/- 2(0)C) which offset ethanol hypothermia or into chambers at room temperature (24 +/- 1(0)C). On day 6, all mice were injected with ethanol and placed into chambers at room temperature. Tolerance to ethanol's hypothermic effect did not develop in the ethanol-warm acquisition group. These mice had a significantly greater degree of hypothermia on test day than the ethanol-room temperature acquisition group, which showed tolerance, and their degree of hypothermic response was similar to that of mice injected with saline during acquisition. The differences between groups cannot be attributed to pharmacokinetic alterations or to conditioned responses since there were no differences between groups in blood or brain ethanol concentrations on test day and all groups were exposed to the same acquisition and test situations. These results extend previous work to suggest that the development of tolerance to the physiological, as well as behavioral, aspects of ethanol intoxication requires more than simple exposure to ethanol. PMID- 6855463 TI - Comparative analysis of indices of central dopaminergic functions in man. AB - Various postulated indices of central dopaminergic activity - cerebrospinal fluid (CSF) dopamine (DA), dihydroxy-phenylacetic acid (DOPAC), homovanillic acid (HVA), noradrenaline (NA), plasma NA, serum prolactin, serum dopamine-hydroxylase (DBH), and platelet monoamine oxidase (MAO) activity - were measured in 30 drug free inpatients. The mean values and the ranges were similar to those described in the literature. Plasma NA showed significant positive correlation with age. Significant positive correlation was found between CSF DA and its metabolites DOPAC and HVA. Serum DBH activity showed a slight but significant inverse correlation with CSF DA and its two metabolites. CSF NA showed a significant positive correlation with CSF DOPAC, but only in females. Serum DBH activity had no significant correlation either with CSF or with plasma NA levels. These findings suggest that either CSF HVA or DOPAC and DA may be useful indicators of DA metabolism in humans. Serum DBH activity may be in relationship with the central dopaminergic functions. PMID- 6855466 TI - Age-related changes in rat adipose tissue in response to fasting: protein, lactate and pyruvate levels. AB - 1. The evolution with age of the metabolic response of adipose tissue to fasting has been investigated in two groups of rats, at different ages, fed and fasted. 2. The protein tissue content increases in response to fasting in young rats but not in adult-old ones. This indicates a lower lipomobilizing response to starvation with increasing age. 3. In contrast to young rats, the adult rat lactate is not increased by fasting while pyruvate is increased. 4. As a result of lactate and pyruvate variations, NAD/NADH is also changed: after fasting it decreases in young rats, while it increases in older rats. 5. Absolute NAD level is decreased by fasting both in young and older rats. 6. These data provide experimental support for the decreased sensitivity of fat pads from older animals to stimuli affecting lipolysis. PMID- 6855465 TI - Microsomal and cytosolic epoxide hydrolases in rhesus monkey liver, and in normal and neoplastic human liver. AB - The cytosolic epoxide hydrolase (EH-LC) was observed in rhesus monkey liver cytosol, and in both normal and neoplastic human liver. Microsomal epoxide hydrolase (EH-LM) was detected not only in the microsomes of normal and neoplastic human liver and normal rhesus monkey liver, but also in the cytosol of these tissues. No apparent differences were observed between the EH-LM in liver cytosol and that in microsomes. No major differences were observed between the levels of EH-LM in the cytosol of normal and that in neoplastic human liver. PMID- 6855468 TI - Effects of phencyclidine on rat prolactin, dopamine receptor and locomotor activity. AB - Plasma prolactin (PRL) was decreased in naive rats sacrificed 30 min after phencyclidine (PCP) administration (10 mg/kg, s.c.). There was, however, no decrease in plasma PRL 30 min after s.c. injection of PCP (10 mg/kg) on the 29th day following 28 days of chronic PCP administration. These data suggest the development of tolerance to the PRL-suppressive effect of PCP as result of long term administration of the drug. The Bmax of [3H]-spiperone binding to rat striatal membranes was decreased 24 hrs after 28 days of PCP treatment without change in affinity (Kd). No indication of the development of tolerance in these rats was found with regard to the locomotor-stimulating effect of PCP. The plasma PRL-suppressive effect of the PCP analog PCMP was found to be stereospecific; (-) PCMP was much less potent than (+)-PCMP. PMID- 6855467 TI - In vitro and in vivo effects on brain GABA metabolism of (S)-4-amino-5 fluoropentanoic acid, a mechanism-based inactivator of gamma-aminobutyric acid transaminase. AB - The effects of intraperitoneal administration of (S)-4-amino-5-fluoropentanoic acid, a mechanism-based covalent inactivator of gamma-aminobutyric acid transaminase (GABA-T), on whole brain GABA metabolism in mice were investigated. A dose-dependent and time-dependent irreversible inactivation of GABA-T was observed with a concomitant increase in whole brain GABA levels. The compound exhibited no in vitro nor in vivo time-dependent inhibition of glutamate decarboxylase (GAD), alanine transaminase, or aspartate transaminase (Asp-T). It was, however, a potent competitive reversible inhibitor of GAD and a weak competitive inhibitor of Asp-T. The chloro analogue, (S)-4-amino-5 chloropentanoic acid, was ineffective. PMID- 6855469 TI - The absolute configuration of precocene I dihydrodiols produced by metabolism of precocene I by corpora allata of Locusta migratoria, in vitro. AB - The corpora allata from adult female Locusta migratoria metabolize precocene I (7 methoxy-2,2-dimethyl-2H-benzo [b]pyran to cis- & trans-precocene I dihydrodiols (3,4-dihydro-7-methoxy-2,2-dimethyl-2H-benzo [b]pyran-3,4-diol). Derivatization of the dihydrodiols with (-)menthoxy acetyl chloride allowed complete resolution of all four optical isomers. When [4-3H]-precocene I was incubated in vitro with Locusta migratoria corpora allata, it was metabolized stereospecifically to ( )trans-(3R,4S) and (+)cis-(3R,4R) dihydrodiols. Approximately half the precosyl residues bound to cellular macromolecules were discharged by heating to 95 degrees C at neutral pH, as dihydrodiols of the same stereochemistry. PMID- 6855470 TI - Chromatin organization and transcriptional activity in human embryonic lung fibroblasts aged in vitro. AB - Chromatin organization was examined in confluent cultures of embryonic lung fibroblasts in the middle and at the end of their replicative lifespan. Age related modifications resulted in an unusually wide spacing of the chromatin threads induced by a mild loosening treatment and an increased sensitivity of the nucleosomes to the Joy-containing hypotonic medium used in Miller's spreads. The profound changes in chromatin response to various hypotonic solutions were not associated with the disappearance of RNA synthesis in old type nuclei as demonstrated by high-resolution autoradiographical studies. PMID- 6855471 TI - Incorporation of inositol hexaphosphate into red blood cells mediated by dimethyl sulfoxide. AB - Inositol hexaphosphate (IHP) binds to deoxyhemoglobin and markedly decreases the affinity of hemoglobin for oxygen. We introduce here a method for incorporating this polyphosphate into erythrocytes, thus preparing very low affinity cells for use in respiration research. The method uses dimethyl sulfoxide (DMSO) to facilitate entry of IHP. The cells are exposed to a high concentration of DMSO which is rapidly diluted with IHP solution. During this dilution the cells become leaky and IHP enters. The influence of several variables at each step of the process has been investigated and the data support a transient osmotic gradient mechanism for IHP incorporation. PMID- 6855472 TI - The effects of aging on opioid modulation of feeding in rats. AB - Feeding responses to naloxone and butorphanol tartrate were measured in Fisher 344 rats with ages of 2, 12, 22 and 28 months. The two younger groups were 10-100 times more sensitive than the older groups to the suppressive effects of naloxone on feeding. Additionally, the older rats were less responsive to the feeding enhancement following butorphanol injections. These results are consistent with reports of age-related changes in endogenous opioid systems. PMID- 6855473 TI - Studies on the activities of some methyltransferases in the livers and tumor cells from tumor-bearing mice. AB - The activities of S-adenosylmethionine synthetase isozymes and some methyltransferases have been measured in liver and tumor cells of tumor-bearing mice. Following intraperitoneal transplantation of Ehrlich ascites tumor cells into mice, the activity of the beta-form of the synthetase isozymes markedly increased, whereas that of the alpha-form did not increase so much, and the activity of tRNA methyltransferases increased gradually, while that of phospholipid, glycine and guanidoacetate methyltransferases did not. It was shown that tumor cells have only the gamma-form of the synthetase and that the activity of tRNA methyltransferases in the tumor cells was very high, while that of other methyltransferases was not detectable. PMID- 6855474 TI - Assessment of the tracheal ring bioassay for detection of the cystic fibrosis serum factor. AB - We have examined the effects of serum from cystic fibrosis patients, healthy human volunteers and from guinea pigs on ciliary activity of guinea pig tracheal ring explants after 48 hours in culture. Sera from 9 out of 10 cystic fibrosis patients produced ciliostasis. This is a significantly greater percentage than the 7 out of 21 serum samples from healthy volunteers that produced ciliostosis. Ninety-two percent of the explants in guinea pig serum had unaltered ciliary activity, illustrating the importance of intrinsic control in the bioassay design. These results suggest that the guinea pig tracheal ring bioassay may be of value as a means of identifying the presence of the ciliotoxic factor in cystic fibrosis serum for research use but is a poor discriminator for diagnostic purposes. Modification such as rinsing the tracheal mucosa with sterile medium and a new chamber for the microscopic observation of the tissue have simplified the assay. PMID- 6855475 TI - Effects of a series of substituted benzamides on rat prolactin secretion and 3H spiperone binding to bovine anterior pituitary membranes. AB - The potency of seven substituted benzamide drugs (AHR-5531B, AHR-5645B, AHR-6092, AHR-8764, bromopride, sultopride and tiapride) to stimulate rat prolactin (PRL) secretion in vivo was found to be three orders of magnitude greater than that of non-benzamide neuroleptic drugs relative to their respective abilities to inhibit 3H-spiperone binding to bovine anterior pituitary membranes. Nevertheless, the IC50 values for the inhibition of 3H-spiperone binding by the seven substituted benzamide drugs was significantly correlated with their high potency to stimulate rat PRL secretion in vivo. Further, the slope of the regression line for these substituted benzamides paralleled that of a series of butyrophenone, phenothiazine, morphanthridine and dibenzodiazepine neuroleptic drugs. Two benzamide (sulpiride and metoclopramide) and three non-benzamide neuroleptic drugs gave intermediate results. This data suggests that blockade of different subgroups of dopamine receptors in the anterior pituitary gland labeled by 3H spiperone may be responsible for the in vivo stimulation of PRL secretion by the benzamide and non-benzamide neuroleptic drugs. PMID- 6855476 TI - Effects of alpha-fluoromethylhistidine (FMH), an irreversible inhibitor of histidine decarboxylase, on development of brain histamine and catecholamine systems in the neonatal rat. AB - Daily administration of FMH to neonatal rats produced long-lasting inhibition of histidine decarboxylase in hypothalamus and cerebral cortex and led to depletion of histamine in both brain regions. The onset of depletion was more rapid in cerebral cortex, a region in which non-neurotransmitter pools of histamine predominate in early postnatal life, appearing as early as postnatal day 3; depletion in the hypothalamus, a region rich in histaminergic neuronal projections, appeared later. No effects were seen on body or brain growth, nor was development of other biogenic amine systems affected. FMH thus provides a selective probe for examining the role of histamine in brain development. PMID- 6855478 TI - The effect of dietary partially hydrogenated marine oils on desaturation of fatty acids in rat liver microsomes. AB - The influence of dietary partially hydrogenated marine oils on distribution of phospholipid fatty acids in rat liver microsomes was studied with particular reference to the metabolism of linoleic acid. Five groups of weanling rats were fed diets containing 20% (w/w) peanut oil (PO), partially hydrogenated peanut oil (HPO), partially hydrogenated Norwegian capelin oil (HCO), partially hydrogenated herring oil (HHO), and rapeseed oil (RSO) for 10 weeks. The partially hydrogenated oils were supplemented with linoleic acid corresponding to 4.6 cal % in the diets. Accumulation of linoleic acid and reduced amount of total linoleic acid metabolites were observed in liver microsomal phospholipids from rats fed partially hydrogenated oils as compared to PO feeding. The most striking effects on the distribution of omega 6-polyunsaturated fatty acids was obtained after feeding HHO, a marine oil with a moderate content of trans fatty acids in comparison with HPO but rich in isomers of eicosenoic and docosenoic acids. Liver microsomal delta 6- as well as delta 5-desaturase activities as measured in vitro were reduced in rats kept on HHO as compared to PO dietary treatment. The results obtained suggest that the dietary influence of partially hydrogenated marine oils on the metabolism of linoleic acid might be better related to the intake of isomeric eicosenoic and docosenoic acids than to the total intake of trans fatty acids. PMID- 6855477 TI - The effects of partially hydrogenated marine oils on the mitochondrial function and membrane phospholipid fatty acids in rat heart. AB - The influence of dietary partially hydrogenated marine oils containing docosenoic acid on rat heart mitochondrial membrane phospholipid fatty acid composition was studied with particular reference to cardiolipin and oxidative phosphorylation. Five groups of male weanling rats were fed diets containing 20% (w/w) peanut oil (PO), partially hydrogenated peanut oil (HPO), partially hydrogenated Norwegian capelin oil (HCO), partially hydrogenated herring oil (HHO), and rapeseed oil (RSO) for 10 weeks. All the cardiac phospholipids investigated were influenced by the experimental diets. An increased amount of arachidonic acid observed in phosphatidylethanolamine (PE) after feeding partially hydrogenated oils suggests a changed regulation of the arachidonic acid metabolism in comparison with PO treatment. 22:1 originating from the dietary oils was incorporated only to a small extent into phosphatidylcholine (PC) and PE. A selective incorporation of 18:1 isomers into the 1- and 2-positions of PC and PE with respect to geometry and position of the double bond was observed. Large amounts of 18:1 trans were incorporated into the 1-position of PC and PE, irrespective of the amount of 18:2 supplemented to the diets, replacing a considerable proportion of stearic acid in this position. After feeding HHO and RSO, the content of 22:1 in mitochondrial cardiolipin of rat heart was found to be 3% (mainly cetoleic acid) and 10% (mainly erucic acid), respectively, indicating a high affinity for cis isomers of 22:1, but also a considerable resistance against incorporation of trans isomers was observed. The ability of rat cardiac mitochondria to oxidize palmitoylcarnitine and to synthesize ATP was depressed after feeding HHO and RSO. Dietary cis isomers of 22:1 seem to have a specific ability to interfere with cardiac ATP synthesis and also to alter the fatty acid composition of cardiolipin of rat heart. PMID- 6855479 TI - Lipid deterioration: beta-carotene destruction and oxygen evolution in a system containing lactoperoxidase, hydrogen peroxide and halides. AB - A model system containing lactoperoxidase/H2O2/halide decomposed beta-carotene in a reaction greatly affected by the concentration of H2O2. The optimal concentrations of H2O2 for activation of iodide and bromide were 2 mM and 10 microM, respectively. The oxidation of chloride by a lactoperoxidase, using beta carotene destruction as a sensitive method to determine the activity of the enzyme, is reported herein. In the presence of optimal amounts of H2O2, the rate of beta-carotene destruction increases slowly until a critical concentration of the halides, followed by a rapid increase in the rate when halide concentrations were further increased. A lactoperoxidase/H2O2/iodide and/or bromide system generates oxygen in the presence of high H2O2 and halide concentrations. beta Carotene inhibited the evolution of oxygen. A possible mechanism of beta-carotene destruction and triplet unexcited oxygen evolution by a lactoperoxidase/H2O2/halide system are proposed. PMID- 6855480 TI - Initiation of lipid peroxidation by a peroxidase/hydrogen peroxide/halide system. AB - A lactoperoxidase/H2O2/halide system caused the initiation of linoleate peroxidation as indicated by diene conjugation. Coupled lipid peroxidation was accelerated by iodide, chloride and bromide ions at pH 4.0 and 6.2. No peroxidation occurred in the presence of H2O2 or lactoperoxidase alone. The rate of linoleate peroxidation by lactoperoxidase in the presence of chloride depended on the concentration of H2O2. Linoleate peroxidation by the enzymatic system was inhibited by high concentration of H2O2 by methionine, tryptophan and BHT. Oxygen was absorbed during peroxidation and the major products were the 13 hydroperoxides. The mechanisms of the initiation of lipid peroxidation by a peroxidase/H2O2/halide system are discussed. PMID- 6855481 TI - Effect of the plasticizer di(2-ethylhexyl) adipate (dioctyladipate, DOA) on lipid metabolism in the rat: I. Inhibition of cholesterolgenesis and modification of phospholipid synthesis. AB - DOA (di[2-ethylhexyl] adipate, dioctyladipate), a plasticizer used in the manufacture of polyvinyl-chloride plastic products, has been considered as a suitable substitute for di(2-ethylhexyl)phthalate (DEHP) in some applications. In the present studies, hepatic lipid metabolism was examined in liver mince preparations from rats fed 0.5% or 1.0% DOA in the diet for 2 weeks. By studying patterns of lipid synthesis from [14C] acetate, [14C] oleate, [14C] mevalonate, and [14C] octanoate, it was concluded that DOA feeding inhibits hepatic cholesterolgenesis and alters the pattern of phospholipids synthesized by the liver. DOA also exerted a cholesterol-lowering effect at the 1% level but did not affect plasma triglyceride levels. The results suggest that the biological effects of DOA in the rat are similar to those produced by DEHP. PMID- 6855485 TI - Desmosterol in human milk. AB - Milk samples were collected from mothers at 2, 6, 12 and 16 weeks postpartum. Desmosterol was found to be present in all the milk samples. Identification of desmosterol was based on retention times with two gas liquid chromatography (GLC) columns and verified by GC-mass spectrometry. The concentration of desmosterol in breast milk increased significantly (P less than .05) from 0.6 mg/100 ml at 2 weeks to 1.3 mg/100 ml at 16 weeks postpartum. Desmosterol was not significantly correlated with total lipid, total cholesterol or free cholesterol in the milk. PMID- 6855483 TI - Absorption and metabolic fate of dietary 3H-squalene in the rat. AB - The absorption and metabolic fate of dietary squalene was investigated on the rat by administering a single oral dose of 3H-squalene and 14C-cholesterol. Experiments on rats with cannulated thoracic duct revealed that 3H-squalene was, like 14C-cholesterol, absorbed through the lymphatic vessels and that ca. 20% of absorbed 3H-squalene was cyclized to sterols during the transit through the intestinal wall. Feces contained 3H-sterols, indicating that newly synthesized mucosal sterols had been secreted into the gut lumen. In intact animals, 3H squalene appeared in the circulation more rapidly than 14C-cholesterol and did not persist to any significant extent in the squalene-rich adipose and muscle tissues. The increase in dietary squalene load (8-48 mg) decreased the absorption percentage of 3H-squalene (45-26%) but did not affect the absorption of 14C cholesterol (47%). Determination of fecal steroids revealed that during the first days absorbed 3H-squalene was eliminated to a significantly higher extent than 14C-cholesterol as fecal bile acids (34% vs 11%). The experiments indicate that the rat intestine has a marked capacity for absorbing dietary squalene and that the absorbed squalene is preferentially converted to bile acids in the liver. PMID- 6855484 TI - Determination of lycopene, alpha- and beta-carotene and retinyl esters in human serum by reversed-phase high performance liquid chromatography. AB - A rapid specific, microdetermination of the major human blood carotenoids by high performance liquid chromatography (HPLC) separation and quantitation at 466 nm is detailed in this paper. Serum retinyl esters can also be quantified utilizing the same separation procedure but detected at 325 nm. One hundred microliters of deproteinated serum were extracted with chloroform and injected on a reverse phase column. Separation occurred within 16 min for all compounds of interest employing a mobile solvent of MeOH/AcN/CHCl3 (47:47:6). All compounds were quantified at the wavelengths cited by integrated peak areas using retinyl acetate as a daily standard. Analysis of serum from a hypercarotenemic anorexia nervosa patient and a person suffering from hypervitaminosis A are presented as examples of the clinical application of this procedure. PMID- 6855482 TI - Relative contribution of the main tissues and organs to body fatty acid synthesis in the rat. AB - Tritiated water was used to measure the rate of fatty acid synthesis in the main tissues and organs of 7-week old Wistar male rats in order to determine the relative contribution of each tissue to body fatty acid synthesis. We reached the following conclusions: (a) the liver is the main site of fatty acid synthesis, it alone synthesizes 42% of the newly synthesized fatty acids in the body. (b) The dissectable white adipose tissues synthesize 27% of the fatty acids in the body. This group of tissues is heterogeneous because the mesenteric adipose tissue alone contains 40% of the labeled fatty acids present in the white adipose tissues. (c) Besides the intestines, organs other than the liver play a negligible role (2% of the total) in fatty acid synthesis. (d) The skin contributes 7% of the body fatty acid synthesis. (e) The rest of the carcass, essentially composed of the musculature and the skeleton, contributes 18% of body fatty acid synthesis and accounts for 33% of the extrahepatic tissue fatty acid synthesis. PMID- 6855488 TI - Hepatitis B virus replication and clinical outcome in carriers of HBsAg. Perspectives of treatment with DNA inhibitors. AB - HBV-DNA was measured by the spot hybridization technique in serial serum samples obtained from 47 HBsAg carriers followed up for a mean of 4 years. The levels of HBV-DNA were compared to the conventional HBV serology and immunopathology to determine the relation of active HBV replication to the outcome of hepatitis and the suitability of Italian HBsAg carriers for treatment with DNA inhibitors. HBV DNA was found in 26 carriers (53%) and persisted with comparable serum levels in 24 of them throughout the follow up. The occurrence rate of an unfavorable outcome as determined by histological evidence of cirrhosis was 6% versus 44% (p less than 0.01) in carriers with active viral infection (greater than 1 ng/ml of HBV-DNA) and in patients with absent or low levels of viral DNA (less than 1 pg/ml), respectively. Progression of the liver disease could not be predicted on the basis of active HBV replication and was presumably related to factors other than synthesis of HBV. In many patients with inactive viral infection a primary pathogenic factor was the HBV-associated delta, an agent with a putative RNA genome against which DNA inhibitors have no rationale and possibly no effects. The majority of Italian carriers do not appear suitable for treatment with DNA inhibitors and they should be considered for a different therapy. PMID- 6855487 TI - Different aetiology of chronic active hepatitis in U.K. and Iraq. AB - We have compared the clinical, biochemical and immunological features of patients with biopsy-proven chronic active hepatitis from Iraq and from the United Kingdom. Clear-cut differences emerge, which can mostly be attributed to the HBV status, as 91% of patients from Iraq were HBsAg-positive compared to only 6% from the U.K. Most patients from Iraq presented insidiously with established cirrhosis, while those from the U.K. presented more acutely and systemic symptoms were more common. Autoantibodies and associated autoimmune conditions were common in U.K. patients but extremely rare in Iraqis. PMID- 6855489 TI - Correlation between Ito cells and fibrogenesis in an experimental model of hepatic fibrosis. A sequential stereological study. AB - The relationship between Ito cells and hepatic fibrogenesis has been investigated in an experimental model: intraperitoneal injection of heterologous serum in rats leads to the appearance of fibrous septa within 5 weeks. Groups of rats were sacrificed at various intervals (from 2.5 to 20 weeks), saline-injected rats being used as controls. Liver fragments were prepared for light and electron microscopy and determination of hydroxyproline. Ito cells were identified by defined morphological criteria on 1 micron sections. The volume density (VD) of Ito cells and fibrous septa, and the Ito cell index were determined. Ito cells represent a very relevant component of early septa. In later stages, the VD of cells with morphological features of Ito cells falls to very low values. This might be related to modulation of Ito cells to fibroblasts. The increase of tissue hydroxyproline is delayed with respect to the peak VD of septal Ito cells, actually corresponding to the fall in the VD of septal Ito cells. The striking increase in the VD of total Ito cells cannot be related to a theoretically possible increase in the volume of single Ito cells, as VD always parallels the Ito cell index. These data suggest a hyperplastic reaction, possibly associated with a cellular migration from the lobules to early septa. PMID- 6855490 TI - [Dosage fields of the "ANET-B" apparatus with 252Cf]. AB - The paper is concerned with the results of the calculation of dose fields of neutron and gamma-radiation for an ANET-B unit. Experimental measurements were done in the tissue equivalent phantom by using photoluminescent and alumophosphate glasses, thermoluminescent and threshold detectors with neptunium foil. Divergences between calculated and all experimental data did not exceed 10 12%. It has been shown that the ratio of the contribution of neutron and gamma components of 252Cf radiation for the ANET-B unit to the summary absorbed dose at an arbitrary point of a tissue equivalent phantom depends considerably on a distance between this point and the center of a source and changes from 2 (for a distance of 0.5 cm) to 1 (for a distance of 10 cm). PMID- 6855486 TI - Modulation of platelet thromboxane and malonaldehyde by dietary vitamin E and linoleate. AB - Thromboxane (TXB2) and malonaldehyde (MDA) production by thrombin-stimulated washed platelet were evaluated in rats fed 6 combinations of dietary vitamin E (0, 100, 1000 ppm) and linoleate (6.5 and 17.0 en%) for 23 weeks. The molar ratio of MDA:TXB2 was consistently near 3 in all groups studied. In animals receiving the lower linoleate diets, TXB2 and MDA synthesis were inversely related to the dietary vitamin E concentrations and the levels of MDA and TXB2 were positively correlated (r = 0.99) with decreasing vitamin E in the diet. High dietary linoleate (17.0 en%), independent of vitamin E status, reduces TXB2 and MDA synthesis. The importance of dietary antioxidant on platelet prostanoid synthesis is discussed. PMID- 6855492 TI - [Computer input of graphic and alphanumeric information during radiation therapy dosage planning using the PAUK (semi-automatic coding) device]. AB - A system of the input of initial information on a patient into the ES-1022 computer in the on-line mode for dosimetric irradiation planning has been tested. A semi-automatic coding device (SACD) has been utilized. The system can operate in two modes: on-line calculation of dose distributions and irradiation conditions; archivization of input initial data. PMID- 6855491 TI - [Use of the EC 1010 computer to calculate dosimetric parameters for irradiation procedures in gamma teletherapy]. AB - An ever growing flow of patients requires a good deal of time for the planning of irradiation procedures of patients and causes errors during manual calculations. A small-size computer EC 1010 is proposed for the calculation of dosimetric parameters of irradiation procedures on gamma-beam therapeutic units. A specially designed program is intended for the calculation of dosimetric parameters for different methods of moving and static irradiation taking into account tissue heterogeneity: multifield static irradiation, multizone rotation irradiation, irradiation using dose field forming devices (V-shaped filters, edge blocks, a grid diaphragm). In addition to the main calculated values, the listing contains in a suitable form all necessary information: the patient's name, date of calculation, a unit type for irradiation, irradiation procedure parameters. The computation of output parameters according to each preset program of irradiation takes no more than 1 min. The use of the computer EC 1010 for the calculation of dosimetric parameters of irradiation procedures gives an opportunity to considerably reduce calculation time, to avoid possible errors and to simplify the drawing up of documents. PMID- 6855493 TI - [Use of computed tomography for planning intracavitary radiotherapy of cervical cancer]. AB - CT potentialities for irradiation planning have been demonstrated as a result of a study of 20 cervical cancer patients, Stages I-II, using a computerized tomograph for topometric preparation for intracavitary therapy with afterloading units, and subsequent gamma-beam therapy. Complete information on sections that are necessary for clinicodosimetric irradiation planning, has been obtained with the help of digital radiography, transversal tomography and mathematical reconstruction of secondary sections. The study was performed by inserting a centering mount and metrocolpostat after a preliminary determination of A point on the simulator. An effect of the degree of the bladder filling on the organs located in a given section has been shown. It has been established that the degree of the bladder filling at the level of A and B points does not influence a distance from its posterior wall to the metrostat. It is assumed that intestinal radiation injuries can be prevented by controlling the degree of the bladder filling. PMID- 6855496 TI - [Universal isoenergetic and dose functions of a point source]. AB - The authors describe in an analytical form isoenergy and dose functions of a point isotropic source of monoenergy electrons that can be applied to any initial energy electrons within the range of 0.5-10 MeV in a homogenous isotropic model of internal irradiation (aqueous medium). The above functions have a simple form that makes it possible to easily calculate dose exposure of tissue microstructures in internal irradiation with Coster-Crohnig, Auger and internal conversion electrons and photo-electrons for a wide range of problems in nuclear medicine and radiobiology. PMID- 6855495 TI - [Scintigraphic semeiotics of the polycystic kidney]. AB - Altogether 78 patients aged 12 to 62 with polycystic kidney disease were examined. Of these, 36 were examined while primary diagnosis was established; 42 patients were observed during treatment. Renoscintigraphy with 131I-hippuran and 99mTc-DTPA angionephroscintigraphy with 99mTc-dimercaptosuccinic acid, 99 Tc-tin gluconate, 99mTc-cyton and nephroscintigraphy with 107Hg-neohydrine were used. Renoscintigraphy was used to evaluate renal excretory function. It was computerized, 20-25 sequences with 1 min. exposure. Angionephroscintigraphy consisted of 3 stages: (1) indirect radionuclide angioscintigraphy of the kidneys to evaluate the renal blood flow; (2) nephroscintigraphy to evaluate the anatomotopographic condition of the kidneys and the amount of the functioning parenchyma; (3) nephroscintigraphy using a Pinkhol collimator to specify the anatomotopographic condition of the kidneys. Based on angionephroscintigraphy 3 degrees of renal lesion were singled out: mild (43.2% of the cases), moderate (24.3%) and severe (32.5%). In renoscintigraphy moderately expressed unilateral changes prevailed in 49.4% of the cases, pronounced unilateral changes in 8.6%, moderate bilateral changes in 31.3% and demonstrable bilateral changes in 6.5%. In 4.2% of the cases no changes were found on the computerized renograms. The diagnostic value of reno- and angionephroscintigraphy in polycystic kidney disease was 92.6%. The study has shown a high efficacy of radionuclide methods in the evaluation of the process over time, therapeutic results and the elucidation of the familial nature of the disease. PMID- 6855494 TI - [Cell kinetics of oral cancer during gamma teletherapy in combination with the administration of metronidazole]. AB - Proceeding from the clinical observation of 11 patients with cancer of the tongue, oral mucosa and stomatopharynx who received gamma-beam therapy according to the scheme of dynamic fractionation combined with metronidazole, it has been concluded that the drug enhances the degree of radiation injury of the above tumors. It is expressed in early time (the 2nd day of treatment) and a low dose level (8 Gy) at which tumor resorption starts and the completeness of gamma-beam therapy in summary doses of 30-60 Gy is revealed (a general index of a clinically complete resorption is 90.8% - 10 out of 11 patients). A simultaneous study of the proliferative activity on the biopsies from the same 11 patients has shown that tumors of the oral cavity contain a considerable amount of nonproliferating cells that reduces in the process of radiotherapy combined with metronidazole. No correlation was found between the initial content of these cells, the degree of its decrease during radiotherapy combined with metronidazole and the completeness of resorption at the end of radiotherapy. PMID- 6855497 TI - [Mathematical model of the kinetics of radiopharmaceutical preparations in the right compartments of the heart]. AB - The paper is concerned with the description of a mathematical model of the kinetics of radiopharmaceutical drugs (RPD) in the right heart with due regard for its two-compartmental structure. A formula has been obtained to describe a right heart radiogram (RHRG) for any RPD entry into the heart (with any type of entry function). It has been shown that in case of an impulsed entry a RHRG curve is described by the following formula (formula; see text) which is a biexponential one. The above formula shows that the determination of phi 1 and phi 2 factor on a curve gives an opportunity to obtain exact information on the correlation of cardiac chamber volumes (the auricle and ventricle). The authors point a possibility of using a RHRG curve for the determination of cardiac output and rate. The formulas obtained are of particular value for analysis of the curves of radiocardiography with 133Xe. PMID- 6855498 TI - [Simplified method of analyzing the results of radionuclide studies of gastric emptying]. AB - The authors present a simplified technique for the processing of the results of a study performed in a department that is not fitted out with a computer. Primary data are collected using a gamma-chamber with an analyzer or a radiocirculograph. Three examples of the graphic approximation of primary dynamic curves are given. PMID- 6855499 TI - [Quality control of gamma cameras]. AB - The authors present a detailed description of the parameters of gamma-chambers that are necessary to measure in order to assess the quality of the device as a whole. The main concepts have been laid down: resolution, spatial distortion, irregularity of the field of vision of a gamma-chamber, idle time of the system, sensitivity, etc. Methods for the evaluation of the main characteristic of gamma chambers are considered. A necessity to organize the checking of gamma-chambers in hospitals and other health care facilities and the making up of a common system of assessment are discussed. PMID- 6855500 TI - [Beta-therapy of skin and mucous membrane diseases]. PMID- 6855501 TI - [Methods of determining the quantity and intensity of laser radiation for therapeutic use]. PMID- 6855502 TI - [Experience in the use of the IKS-A thermoluminescent dosimeter in clinical practice]. PMID- 6855504 TI - [X-ray generator model URP-125/1000 for the Roentgen-50-2 and Roentgen-100T diagnostic systems]. AB - Basic specifications of a power supply model URP-125/1000 are as follows: automatic operation, asynchronous switching, operation of the main circuit following external characteristics, contactless regulation of the anode current, stabilization of the anode voltage while taking roentgenogram. These features allow automatic examination, improved diagnostic accuracy, and simplified design of the units. Stringent requirements are imposed upon reliable and accurate control of the filament voltage. PMID- 6855505 TI - [A method for providing dull surfaces on medical instruments made of different materials]. PMID- 6855503 TI - [Ultrahigh frequency measurements in the diagnosis of the functional state of human skin]. PMID- 6855509 TI - [Functional capabilities of devices for one-dimensional echography in the diagnosis of head and neck tumors]. PMID- 6855508 TI - [Multifactor analysis of the processes in a washing machine before sterilization of surgical gloves]. PMID- 6855506 TI - [Advanced training of technical personnel in bioengineering]. PMID- 6855507 TI - [Determination of demand for astigmatic contact lenses for children]. PMID- 6855510 TI - [The diagnostic efficacy of Soviet echotomoscope ETS-R-01 in pediatrics]. AB - Healthy (134) and diseased (852) children at the age of 1 to 15 have been examined using a multi-purpose ultrasonic diagnostic device model eTC-P-01. A special attention has been paid to methodological aspects of echographic examinations of different organs in children as well as to echotomographic semiotics characteristic for diseases of the soft tissues, thyroid gland, liver, spleen, kidneys, and urinary bladder. Follow-up echographic observations of internal organs have been pointed out to be useful in the course of prescribed therapy. The recommendations are given how to improve echotomoscopes for pediatric studies. PMID- 6855511 TI - [Microprobe for endoscopic pH-metry]. PMID- 6855512 TI - [Control of cassettes for general roentgenography]. AB - Testing a clamp and checking light-tight ability during cassette control are proposed to combine in one procedure using a specially designed phantom in order to save both films, chemical agents and operating time. The phantom shields from X-radiation 19% of marginal area where light exposure is permitted. The remaining phantom area is filled with the 5 x 5 mm grid made of radiopaque wires 0.5 mm in diameter. PMID- 6855513 TI - [Device for arm support during venipuncture]. PMID- 6855514 TI - [Device for control of the prismatic action of a prism ophthalmocompensator]. PMID- 6855515 TI - [Device for measuring microscopic objects]. PMID- 6855516 TI - [The "Biopul's-4" universal apparatus for assisted circulation]. PMID- 6855517 TI - [Device for evaluation of night vision ("Niktoskop-01")]. PMID- 6855518 TI - [Electrostatic recording of x-ray images]. PMID- 6855519 TI - [East German endoscopes]. PMID- 6855520 TI - [Fiber optic bundles with polished end faces]. PMID- 6855521 TI - [Reduction of recovery time of an amplifier of bioelectric potentials with an RC circuit]. AB - Capacitive electrodes produce low-frequency distortions of signals in the course of electrophysiologic measurements. One of the possible ways to compensate low frequency noise consists in connecting a compensating RC-circuit across an amplifier output. As a result, a recovery time is reduced under interference as compared to an amplifier having similar frequency response yet in the absence of the compensating circuit provided amplifier signals are limited. Presented in the paper relationships demonstrate applicable limits of the given compensating method. The results may be used in designing ultralow-frequency amplifiers with the isolating RC-circuit in the input. PMID- 6855522 TI - [Obstetrical activities at the Dakar Principal Hospital (a 4-year retrospective 1978-1981)]. AB - The authors give an account of the obstetrical activity at Dakar Principal Hospital over the last four years. After a short description of the operating conditions, they present two tables: one displays the comprehensive activity and the other lists the indications for the cesarean section which are, most frequently, carried out with an emergency background and the incidence of which rates much lower (2,9 p. 100) than reported in the industrialized countries. PMID- 6855524 TI - [Uterine ruptures overseas]. AB - Obstetrical hysterorrhexis, accident that has been described for a long time, is still of special concern in rural villages where sufficient health care facilities are not available. This accident is always serious, leading to the death of the newborn baby and, too frequently, to the death of the mother. A number, however, could be avoided with a better training of the paramedical staff, so that neither inadequate actions nor uncontrolled use of oxytocics be done. The author advocates to perform a systematic examination of the uterus after every difficult or outlasting delivery or having required either manual or instrumental help. That remains the best way to save the uterus of the mother and sometimes her life itself. PMID- 6855523 TI - [Parasitosis and pregnancy overseas]. AB - The influence of the parasitic diseases on pregnancy and the influence of pregnancy on the parasitic diseases are both well known concepts. The authors lay special interest on malaria, amebiasis and hookworm disease by giving a description of their effects and by mentioning the risks they may entail; then, they give practical directions intended for their detection and the treatment of their effects. It is, once again, emphasized on the utmost importance of performing antenatal examinations. PMID- 6855525 TI - [Uterine rupture in Rwanda (apropos of 87 cases)]. AB - The absence of obstetrical supervision and medical attention in dispensaries and health centers, the frequency of the hysterotomies are the reasons of numerous hysterorrhexis in Rwanda. This publication analyses the reasons and effects of this dreaded complications and proposes some prophylactic guidelines for this area of Africa, south of Sahara. PMID- 6855527 TI - [Retroplacental hematoma overseas]. AB - Abruptio placentae is a rather frequent syndrome in overseas countries. Leading to foetus death most of the time, it often endangers prognosis for the mother's life. Serious complications may be found such as shock due to hypovolaemia, coagulopathy among which process of disseminated intravascular coagulation prevail, organic renal insufficiency that may become unrecoverable because of the cortical atrophy of the kidney. The treatment combines obstetrical means with medical ones. Spontaneous uterine voiding will be tried for, since caesarian operation, often unavoidable, is not free from complication. Rehydration will be carried out by transfusing fresh blood and unfrozen plasma, the amount of which often enormous has to be dealt out in accordance with the central venous pressure. PMID- 6855526 TI - [Detection and treatment of renovascular syndromes of pregnancy excluding their progressive complications]. AB - Three symptoms define the renovascular syndromes during pregnancy: hypertension, edemas and proteinuria. It is essential to detect them as soon as possible during the antepartal examinations. The directions for treatment consist in simple acts which are easy to perform in overseas conditions. They intend to prevent very serious disorders such as abruptio placentae and eclampsia which should not be found any longer. PMID- 6855528 TI - [Current value of physical methods in obstetrics]. AB - The authors make a review of the physical methods available to obstetricians at the present time, i.e.: uterine contents, radiopelvimetry and more recently echography. They lay stress on echography, the contribution of which is of special interest for obstetrics, and they suggest directions adequate to the monitoring of pregnancy whether an echograph is available or not. PMID- 6855529 TI - [Obstetrical anesthesia and resuscitation in Africa]. AB - In Africa, the obstetrical risk is related to the difficulty to monitor the pregnancy during which obstetrical emergency may occur and will have to be treated by the practitioner with, sometimes, inadequate facilities. The authors examine the problems concerning successively the expectant mother, the foetus and the placenta. Then, they propose some solutions in the field of anesthesia and intensive care. The expectant mothers are exposed to the heat and sometimes are suffering from undernutrition, so it requires special attention when using anesthetics. In addition, they frequently present an increased morbidity:- universal diseases among which renovascular syndromes often lead to eclampsia and to abruptio placentae;--tropical diseases may raise problems either to anesthesia (sickle cell anemia, bilharziosis) or to intensive care (algid pernicious fever, malignant amebiasis). Children are subject to an increased stillbirth rate in accordance with pregnancy duration and with the intensive facilities available at the time of the birth. Either infective or mechanical complications may occur in placenta and they may cause some distress to both mother and foetus. With respect to all these cases, the authors examine the various analgesia methods for obstetrical purpose and point out their indications and contraindications. It seems that regional anesthesia is suitable for health posts without facilities. Peridural anesthesia is operative with a great number of situations but it requires some technical training. Then methods to monitor both mother and foetus are exposed. According to the available facilities, ways and means are given to solve problems of anesthesia: labour maternal complications (Mendelson's syndrome, eclampsia, obstetrical complications either mechanical and hemorrhagic) or secondary complications (bacterial or parasitic complications, renal insufficiency); foetal complications either during labour, or at birth, or after delivery. PMID- 6855530 TI - [An alternative to cesarean section: symphysiotomy (Zarate's operation)]. AB - The authors explain the technique and the indications of the Zarate's operation. This non-total subcutaneous symphysiotomy eases delivery through natural canals of a cephalic presentation blocked at either the interspinous or at the inferior strait of the pelvis. Such an intervention, almost ignored in France, is really useful in the developing countries. Rather easily performed, it makes possible to limit the necessity of a cesarean section, to prevent both mother and child from serious trauma when instrumental extraction has become necessary in a dystocic pelvis, and finally to reduce the occurrence of vesico-vaginal fistula and hysterorrhexis. On the credit of this method, a special notice must be given to its practicability and to the fact that the uterus remains undamaged. On the other hand, the post-operative recovery is somewhat longer and with more disabling conditions than with the cesarean section; some painful and motor side effects which may last for a rather long time may be imputable to it. PMID- 6855531 TI - [Obstetrics overseas]. PMID- 6855532 TI - [Birth control overseas]. AB - After reminding the changes of ovarian cycle during sexual life, the authors propose some indications on the reversible means that can be used for birth control in the developing countries where they practice. As practicing is very peculiar to these countries and in order to enable married couples to decide freely upon different advisable possibilities, the authors underline the importance to develop all the educational ways and means on this topic. PMID- 6855533 TI - [Primary amyloid tumor of the lung]. PMID- 6855535 TI - [Modified reduction plastic surgery of the breast to prevent nipple necrosis]. PMID- 6855534 TI - [Diagnostic problems in the aspiration cytological study of the endometrium]. PMID- 6855536 TI - [Important "reference conditions" in the interpretation of hormone receptor findings in human breast carcinomas. Studies of the nude mouse model]. PMID- 6855537 TI - [Antepartal cardiotocography. Recent aspects]. PMID- 6855538 TI - [Binding capacity of cortisol and 11-desoxycorticosterone during pregnancy and labor]. PMID- 6855539 TI - [Is there a concept of operable chronic appendicitis?]. PMID- 6855540 TI - [Pathology of Dupuytren's disease]. PMID- 6855541 TI - [Prognostic criteria and mortality in shock due to combined injuries]. PMID- 6855542 TI - [Prophylaxis of intraperitoneal adhesions with a fibrinolytic agent. Experimental studies of the efficacy and the possible effect on wound healing]. PMID- 6855543 TI - [Segmental rupture of an Carpentier-Edwards bioprosthesis in the echocardiographic picture]. PMID- 6855544 TI - [Treatment of hypertension with prazosin in the perioperative phase]. PMID- 6855545 TI - [Morphology of diabetic microangiopathy of the kidney]. PMID- 6855546 TI - [Therapy of angina pectoris with isosorbide dinitrate]. PMID- 6855547 TI - [Methodological prerequisites of clinical research]. PMID- 6855548 TI - [Classification and value of atherogenic risk factors]. PMID- 6855549 TI - [Gnathostomiasis]. PMID- 6855550 TI - [Results of streptokinase-plasminogen therapy in deep venous thrombosis]. PMID- 6855551 TI - [Cardiac glycosides and their use in daily general practice]. PMID- 6855552 TI - Proofreading familiar text: constraints on visual processing. PMID- 6855553 TI - Demand and the impact of leading questions on eyewitness testimony. PMID- 6855554 TI - Are the spoken durations of rare words longer than those of common words? PMID- 6855555 TI - Errors in proofreading: evidence for the use of word shape in word recognition. PMID- 6855556 TI - Constraints on access in a problem solving context. PMID- 6855557 TI - Control mechanisms in problem solving. PMID- 6855558 TI - Task-specific strategies of mental "rotation" of facial representations. PMID- 6855559 TI - The generalizability of context effects on word recognition: a reconsideration of the roles of parafoveal priming and sentence context. PMID- 6855560 TI - Grammatical priming of inflected nouns. PMID- 6855561 TI - Intonational marking of given and new information: some consequences for comprehension. PMID- 6855562 TI - Duration judgment and the segmentation of experience. PMID- 6855563 TI - Associative asymmetry, availability, and retrieval. PMID- 6855564 TI - Effects of semantic and cheremic context on acquisition of manual signs. PMID- 6855565 TI - Personal and service characteristics affecting group home placement success: a prospective analysis. PMID- 6855566 TI - Assessing Human Rights Committees: a mechanism for protecting the rights of institutionalized mentally retarded persons. PMID- 6855567 TI - Measuring variation and change in attitudes of residential care staff toward the sexuality of mentally retarded persons. PMID- 6855568 TI - Patterns of injury in institutionalized mentally retarded residents. PMID- 6855569 TI - Assessing professionals' prognostic impressions of mental retardation. PMID- 6855570 TI - Enzyme structure. Part I. PMID- 6855571 TI - Analysis of metal ions in proteins by X-ray fluorescence spectrometry. PMID- 6855572 TI - Analysis for gamma-carboxyglutamic acid. PMID- 6855573 TI - Analysis for imino acids with o-phthalaldehyde. PMID- 6855574 TI - Very-high-resolution two-dimensional electrophoretic separation of proteins on giant gels. PMID- 6855575 TI - Preparative polyacrylamide gel electrophoresis. PMID- 6855576 TI - Isolation of microgram quantities of proteins from polyacrylamide gels for amino acid sequence analysis. PMID- 6855577 TI - Sensitive detection of proteins and peptides in polyacrylamide gels after formaldehyde fixation. PMID- 6855578 TI - Removal of sodium dodecyl sulfate from proteins by ion-retardation chromatography. PMID- 6855580 TI - Desalting protein solutions in a centrifuge column. PMID- 6855579 TI - Single hydrolysis method for all amino acids, including cysteine and tryptophan. PMID- 6855582 TI - Use of noncommercial carrier ampholytes for chromatofocusing. PMID- 6855581 TI - Synthesis of carrier ampholytes for isoelectric focusing. PMID- 6855583 TI - A buffer system for amino acid analyzers with automatic integrators. PMID- 6855584 TI - Cleavage at tryptophan with o-iodosobenzoic acid. PMID- 6855585 TI - Cleavage at tryptophanyl residues with dimethyl sulfoxide-hydrochloric acid and cyanogen bromide. PMID- 6855586 TI - Countercurrent chromatography. PMID- 6855587 TI - Separation of peptides by reversed-phase high-performance liquid chromatography. PMID- 6855588 TI - Immobilized anhydrotrypsin as a specific affinity adsorbent for tryptic peptides. PMID- 6855589 TI - High-resolution analytical and preparative peptide mapping by a combination of ion-exchange chromatography and thin-layer chromatography. PMID- 6855590 TI - Isolation of sulfhydryl peptides alkylated with N-ethylmaleimide by diagonal electrophoresis. PMID- 6855591 TI - High-sensitivity sequencing with a gas-phase sequenator. PMID- 6855592 TI - Improvement of efficiency of commercial spinning-cup sequenators. PMID- 6855593 TI - Modified extraction procedure in spinning-cup sequenators. PMID- 6855594 TI - High-sensitivity sequence analysis of proteins recovered from sodium dodecyl sulfate gels. PMID- 6855595 TI - Thin-layer peptide mapping with sequencing at the nanomole level. PMID- 6855596 TI - Analysis of phenylthiohydantoins by ultrasensitive gradient high-performance liquid chromatography. PMID- 6855597 TI - Reassessment of Ellman's reagent. PMID- 6855598 TI - High-performance liquid chromatography of side chain-protected phenylthiohydantoins: application to solid-phase peptide synthesis. PMID- 6855599 TI - Establishing homologies in protein sequences. PMID- 6855600 TI - Reduction of sulfoxides in peptides and proteins. PMID- 6855601 TI - Amidination. PMID- 6855602 TI - Protein labeling by reductive alkylation. PMID- 6855603 TI - Bifunctional reagents. PMID- 6855604 TI - Relating proteins by amino acid composition. PMID- 6855605 TI - Labeling acyl-CoA binding sites with photolabile analogs. PMID- 6855606 TI - Micro-identification of amino-terminal acetylamino acids in proteins by using high-performance liquid chromatography. PMID- 6855608 TI - Immunochemical techniques. Part E. Monoclonal antibodies and general immunoassay methods. PMID- 6855607 TI - Determination of total protein. PMID- 6855609 TI - Indirect 125I-labeled protein A assay for monoclonal antibodies to cell-surface antigens. PMID- 6855610 TI - Methods of enhancing the frequency of antigen-specific hybridomas. PMID- 6855611 TI - Use of high-resolution two-dimensional gel electrophoresis for analysis of monoclonal antibodies and their specific antigens. PMID- 6855612 TI - Screening of monoclonal immunoglobulins by immunofixation on cellulose acetate. PMID- 6855613 TI - Distinction of epitopes by monoclonal antibodies. PMID- 6855614 TI - Methods for the attachment of haptens and proteins to erythrocytes. PMID- 6855615 TI - Iodine monochloride (IC1) iodination techniques. PMID- 6855616 TI - Noncentrifugation immunoassays: novel systems. PMID- 6855617 TI - Estimation of the number of monoclonal hybridomas in a cell-fusion experiment. PMID- 6855618 TI - Use of chromatography tubes in the separation of bound and free fractions in radioimmunoassay. PMID- 6855619 TI - Enzyme-linked immunoelectrotransfer blot techniques (EITB) for studying the specificities of antigens and antibodies separated by gel electrophoresis. PMID- 6855620 TI - Use of human endothelial culture supernatant (HECS) as a growth factor for hybridomas. PMID- 6855621 TI - Colorimetric immunoassays using flavin adenine dinucleotide as label. PMID- 6855622 TI - Bioluminescent immunoassays. AB - The procedures described here have been developed for only a few antigens at present. It seems very likely that they can be extended to any other antigen of choice. For sensitivities in the picomole range, the luciferase-antigen procedure is satisfactory. For increased sensitivity, the glucose-6-phosphate dehydrogenase antigen is the method of choice. With some minor modifications the sensitivity of this assay can certainly be increased. The lower limits of detection will ultimately be determined by the affinity of the antibody for the antigen, not by the detection system. PMID- 6855623 TI - Immunoassay by electrochemical techniques. PMID- 6855624 TI - Metalloimmunoassay: principles and practice. PMID- 6855625 TI - Fluorescence fluctuation immunoassay. AB - The homogeneous fluorescent immunoassay described above allows one to measure the brightness of fluorescently tagged carrier particles that are suspended in a background of free, unbound fluorescent sources. We have demonstrated the feasibility of our technique using a gentamicin competitive assay as well as idealized model systems. We have seen that the fluctuation-correlation method is able to discriminate against free background sources because each fluorescing particle in solution contributes to the correlation peak [Eq. (4)] with a weighting equal to the square of its respective intensity. Hence, a few very bright sources contribute disproportionately to the "signal" relative to many weak ones. To take advantage of this property, one would therefore design an assay that uses relatively larger carrier particles, each of which is capable of binding on the order of 10(3) to 10(4) tagged antibodies or antigens. Unfortunately, the nonlinear dependence of the correlation peak on the brightness of the fluorescing species causes the technique to be perturbed by carrier particle aggregation; the apparent bound fluorescence intensity increases with the extent of aggregation. The latter may be an unavoidable consequence of performing assays using raw blood serum, for example. The ultimate usefulness of this method will depend on its sensitivity and speed when applied to "real" assays of clinical significance. These characteristics will be influenced by a number of technical details. Given our limited experience with the method thus far, it would appear that its principal drawback is its relatively slow speed. In order to decrease the time needed for a reliable measurement, one must average the random fluctuations in the fluorescent intensity to zero more quickly. In principle, this can be accomplished by decreasing the shot noise by collecting a larger fraction of the fluorescent light, and increasing the sampling rate. The method requires rather complicated instrumentation; it is by no means clear that this level of complexity is justified given the realistic level of sensitivity that will be obtained by this technique. PMID- 6855626 TI - Methods of measuring confidence limits in radioimmunoassay. PMID- 6855627 TI - Interaction between biomolecules studied by phase partition. PMID- 6855628 TI - Recent developments in control of pH and similar variables. PMID- 6855629 TI - Gel sieving electrophoresis: a description of procedures and analysis of errors. PMID- 6855631 TI - A simple technique for the microscopic study of microvascular geometry and tissue perfusion, allowing simultaneous histopathologic evaluation. PMID- 6855630 TI - Anionic sites in basement membranes. Differences in their electrostatic properties in continuous and fenestrated capillaries. AB - We have used ruthenium red, a cationic dye, to detect at the electron microscopic level the presence of anionic sites in various murine basement membranes, with particular emphasis on those of the microvasculature. We have observed anionic sites in all continuous and fenestrated capillaries examined. Terminal lymphatics, which have a discontinuous basement membrane, have sites only where the basement membrane is present. Anionic sites are not present beneath sinusoidal lining cells of the liver which lack a basement membrane. Basement membranes of epithelial cells and those surrounding striated and smooth muscle cells, pericytes, fat cells, and Schwann cells also exhibit anionic sites. We compared the electrostatic properties of anionic sites in basement membranes of continuous and fenestrated capillaries by determining the salt concentration (critical electrolyte concentration, Scott and Dorling, 1965) required to displace ruthenium red from the sites. A concentration of 0.5 M Na+ was required to displace ruthenium red from the basement membrane of continuous capillaries of muscle whereas 1.3 M Na+ was required to displace ruthenium red from the basement membrane of fenestrated peritubular capillaries of the renal cortex. Our results suggest that anionic sites in the basement membrane of fenestrated peritubular capillaries are more strongly negatively charged than those in the basement membrane of continuous capillaries of muscle. We conclude from this study, first, that anionic sites are a general property of vascular, epithelial, and pericellular basement membranes and, second, that the electrostatic properties of the sites differ in different vascular basement membranes. We speculate that the anionic sites in vascular basement membranes and the variation in their electrostatic properties in different types of capillaries may have important implications for exchange of substances across the capillary wall. PMID- 6855632 TI - Analysis of relationships between pericytes and gas exchange capillaries in neonatal and mature bovine lungs. AB - Neonatal and mature bovine lungs were examined ultrastructurally to quantitatively assess pericyte envelopment of gas exchange capillaries and proximities of pericyte margins to endothelial cell junctions. Pericytes were observed on 91% of the cross-sectioned capillary profiles examined, with 18 and 26% coverage in neonatal and mature lungs, respectively. Chi-square analysis indicated a random occurrence of endothelial cell junctions under pericytes; however, pericyte processes tended to end near endothelial cell junctions. In the neonatal and mature lungs, 38 and 40%, respectively, of all endothelial junctions were within 0.5 microns of the margins of pericyte processes; such distances covered only 16 and 17% of the circumferences of the capillary profiles examined. Thus, endothelial cell junctions were located near pericyte margins over twice as often as would occur in a random distribution. If pericytes are contractile cells, as recent research indicates, they may function as regulators of lymph formation by influencing the permeability of endothelial cell junctions in the gas exchange capillaries. PMID- 6855633 TI - Influence of vascular and transpulmonary pressures on endothelial vesicles in nonedematous and edematous lungs. AB - We examined the effects of vascular and transpulmonary (Ptp) pressures on endothelial vesicles in nonedematous and edematous dog lungs by transmission electron microscopy (TEM). Edema was defined as a 30% increase in lung weight. Lungs were prepared for TEM by rapid freezing followed by freeze substitution. Using a random sampling procedure, the size and numerical density (Nv) of vesicles was obtained by standard morphometric techniques and the percentage of cytoplasm occupied by vesicles (Vv) calculated. Results show that at Ptp = 5 cm H2O, vascular pressure has no influence on the variables examined in nonedematous and edematous lungs. At Ptp = 25 cm H2O, increases in vascular pressure were associated with significant decreases in the percent cytoplasm occupied by vesicles for both series of experiments. When nonedematous lungs were compared to edematous lungs, we found increases in vesicle size, Nv, and the percentage of endothelial cell cytoplasm occupied by vesicles. The results confirm the increase in vesicles associated with edema. This result does not appear to be due to increased vascular pressure per se, although time related influences could be involved. PMID- 6855634 TI - The three-dimensional organization of plasmalemmal vesicular profiles in the endothelium of rat heart capillaries. AB - The organization of plasmalemmal vesicular profiles in the endothelium of rat heart capillaries has been reinvestigated. Judged from random thin sections approximately 50% of the vesicles appeared free in the cytoplasm, the rest opening to the surfaces of the endothelial cells--a distribution which corroborates previous studies. However, three-dimensional reconstructions based on ultrathin serial sections (thickness congruent to 12 nm) gave a very different picture. All plasmalemmal vesicular profiles (921 from 5 capillaries) were parts of the surface membrane either as caveolae or as more complex racemose invaginations. This organization has previously been observed in frog mesenteric capillaries ((M. Bundgaard, J. Frokjaer-Jensen, and C. Crone, 1979, Proc. Nat. Acad. Sci. USA 76, 6439-6442) and (J. Frokjaer-Jensen, 1980, J. Ultrastruct. Res. 73, 9-20)). It is therefore proposed that absence or extreme rarity of free plasmalemmal vesicles is a general feature of capillary endothelia. Consequently, we suggest that the term "endothelial, plasmalemmal vesicles" be replaced by "endothelial plasmalemmal invaginations." The results imply that trans endothelial vesicular transport is unlikely to occur and that this membrane system performs other--as yet unknown--functions. PMID- 6855635 TI - Varying total tissue pressures and the concentration of initial lymphatic lymph. AB - The concentration of protein in the initial lymphatics on the peritoneal surface of the diaphragms of mice was compared, by light microscopical photodensitometry, with that of the test solution introduced into the peritoneal cavity. Some diaphragms were studied, in vitro, at varying intervals (up to 30 min) after the initiation of a continuous contraction. There was an initial large increase in the concentration of the initial lymphatic lymph (at 10 sec), but this was less after 45 sec; it returned to equal that of the test solution by about 10 min, and then remained at this level. If the diaphragms were left in a relaxed state in an organ bath, the concentration of the lymph remained equal to that of the test solution. After this, the concentration again greatly increased 10 sec after a contraction was initiated, and was again somewhat less than this after 45 sec of contraction. If the test solution was left in the peritoneal cavity for 30 min, the intralymphatic concentration was once more considerably increased after 10 sec of contraction; it equalled the test solution if a 1-min relaxation was used in place of the contraction. These results imply that initial lymphatic lymph protein concentration should not be measured in immobilised tissue. They confirm that varying total tissue pressure is essential for the operation of the initial lymphatic force-pumps. Lack of motion may well cause increases in the measured tissue hydrostatic pressure (thus helping to explain differences between various techniques). This lack may well cause increases in the protein concentration of samples of interstitial tissue fluid. PMID- 6855636 TI - Dog lymph flow in increased capillary permeability states. AB - The lung lymph flow rate (QL) is increased in edema caused by an increase in lung microvascular permeability. This increase in QL could be caused by either a decrease in the effective resistance of the lymph vessels (RL), or by an increase in the effective lymph driving pressure (PL), or by a change in both RL and PL. We estimated PL and RL from the linear relationship between QL and the pressure at the outflow end (PO) of five cannulated dog lung lymph vessels (RL = - delta Po/delta QL and PL = the PO at which QL = 0). We increased lung microvascular permeability by giving the dogs 100 mg/kg of alloxan and found that QL increased from 24.5 +/- 8.9 microliters/min to 112 +/- 41 microliters/min (mean +/- SD). RL decreased from 0.35 +/- 0.12 to 0.11 +/- 0.04 cm H2O min/microliters and PL increased from 8.5 +/- 1.5 to 15.9 +/- 2.7 cm H2O. We then increased the capillary pressures from 18.3 +/- 3.8 to 41.3 +/- 7.3 cm H2O and QL increased to 169.9 +/- 47.8 microliters/min. PL increased by an additional 6.3 cm H2O but RL decreased by only an additional 0.02 cm H2O min/microliters. These results show that the QL vs PO relationship is changed in edema secondary to an increase in microvascular permeability, and that this change can be represented as changes in RL and PL. In terms of these parameters, QL increased in edema as a result of a decrease in RL and an increase in PL. PMID- 6855637 TI - Endocytosis and exocytosis of transferrin by isolated capillary endothelium. AB - Vesicular transport of solutes across capillary walls may be regulated by specific solute-endothelial interactions. Little data is available on the vesicular transport of serum proteins which may transit the capillary wall in situ. Capillaries were isolated from epididymal fat and incubated in fluorescent labeled transferrin and radiolabeled sucrose. Endocytosis and exocytosis of these tracers were quantitated on a picomolar basis over timed intervals and standardized against the amount of endothelial DNA present in the isolate. The rate of vesicular endocytosis of transferrin was 6-7 times greater than that of sucrose indicating a mechanism of selection for transferrin. Endocytosis as a function of external concentration exhibited complex kinetics for transferrin that was consistent with an adsorptive component and a fluid component. Sucrose uptake appeared to be simple fluid endocytosis but with a rate-limiting concentration at 500-600 microM. Vesicular exocytosis of both solutes from preloaded capillaries appeared to occur more rapidly than their endocytosis. This was probably not due to different rates of filling and emptying of attached vesicles nor to an intrinsic difference in rates of vesicle interiorization and refusing with the plasma membrane. Different rates of endocytosis and exocytosis may only be apparent since exocytosis of marker before the capillaries reach ingestion equilibrium would reduce the measured uptake rate. PMID- 6855638 TI - [Dynamics of the content of protein, its fractional composition and of the pool of free intracellular amino acids in the cultivation of Candida tropicalis, IBFM U-303 (Institute of the Biochemistry and Physiology of Microorganisms)]. PMID- 6855639 TI - [Effect of iron on the intensity of fermentation and catalase formation by propionic acid bacteria]. PMID- 6855640 TI - [Effect of alanine and cysteine on the formation of biologically active substances by Fusarium sp]. PMID- 6855641 TI - [Quantitative content of Bacteroides in normal human intestines and in dysbacteriosis]. PMID- 6855642 TI - [Possible reversion of the virulence of Vibrio cholerae]. PMID- 6855643 TI - [Sensitivity of Chlamydia isolated from swine to the action of physicochemical and biological factors]. PMID- 6855644 TI - [Antimicrobial activity of derivatives of capryl- and undecylene anilide]. PMID- 6855645 TI - Design of medical device alarm systems. AB - Medical device alarms are intended to enhance safety by augmenting the operator's ability to monitor an array of system and patient variables. To this end, alarm design must consider both technical and human requirements. Technical factors include selection of variables, limit-setting techniques, alarm reliability, and alarm output system. Human factors include the types of controls, displays, and instructional materials that assist the users in effective use of the machine. The designer and the user of medical devices must recognize that alarms can at times present problems unless the operator takes care to maintain correct use and to avoid false reliance on the alarm's ability to indicate all unacceptable conditions in the clinical setting. PMID- 6855646 TI - Operating room event analysis. AB - A time/motion study performed in the Department of Anesthesiology at Ohio State University divided intraoperative events into three categories: (1) patient centered, direct--activities that direct the anesthesiologist's attention to the patient; (2) patient-centered, indirect--observation of equipment or data related to patient status; and (3) non-patient-centered--activities that direct the anesthesiologist's attention away from the patient. Surprisingly, results of this study did not differ greatly from those of earlier investigators, who found that the anesthesiologist was distracted from the patient 46% of the time. Future studies and monitor development should address this problem by reducing non patient-centered activities and distractions to the anesthesiologist during surgery. PMID- 6855647 TI - Contribution of measurement system artifacts to systolic spikes. AB - A clinical study was conducted to determine if the systolic spike often observed in an invasive blood pressure display originates in the measurement system. The clinical system consisted of a catheter, stopcocks, 4 ft of tubing, an amplifier (containing a 12-Hz low-pass filter), and a continuous flush device. A second transducer was connected directly to the patient's catheter, in parallel with the clinical system. Its output was conditioned by an amplifier modified to exclude the low-pass filter. Simultaneous measurements were taken from both transducers, recorded, and later analyzed. A comparison of the traces in the time domain, as well as an analysis of the signals in the frequency domain, suggests that the systolic spike did not originate in the pressure tubing or in the amplifier system. PMID- 6855648 TI - A simple means for recording foot contact sequence during gait. PMID- 6855649 TI - Wherefore goest thou, clinical engineer? PMID- 6855650 TI - A microprocessor-based arrhythmia monitor/recorder for the operating and recovery rooms. AB - A microprocessor-based cardiac arrhythmia monitor/recorder was designed to detect and document arrhythmias that occur during general anesthesia. A Holter tape recorder controlled by the monitor records arrhythmias and associated annotation. These condensed records are later manually scanned for final classification. The project was undertaken to build a database of arrhythmias correlated with various inhalation anesthetic agents, while simultaneously evaluating-time rhythm analysis algorithms. PMID- 6855651 TI - Velocity detection of Korotkoff sounds. AB - High-speed oscillograms were made showing the time relationships between the ECG and arterial pressure waves detected by three microphones successively placed beneath a standard blood pressure cuff along the brachial artery. As the cuff was deflated through the systolic/diastolic range, the indicated propagation velocity of the Korotkoff waves changed from approximately 1 m/sec near systolic pressure to about 2.5 m/sec near diastolic pressure. Non-Korotkoff waves (noise artifacts), on the other hand, were observed to propagate at much higher velocities, on the order of 5-10 m/sec. This phenomenon can be utilized to identify Korotkoff waves in the presence of other disturbances, particularly in exercise situations, and to determine diastolic pressure in the presence of arterially conducted valve and turbulence noise. PMID- 6855652 TI - Measurement of plasma heparin levels using a fluorometric assay. AB - The performance of a fluorometric heparin assay system was evaluated. The system indirectly measures heparin by its inhibition of thrombin protease action on a synthetic substrate. Our results confirm that within the range of heparin concentrations recommended by the manufacturer, i.e., 0.1-0.8 units/ml, there is an excellent correlation between expected and observed values. Within-day coefficients of variation range from 1% to 2.6%; the between-day coefficient of variation is 6.5. The accuracy of the assay diminishes under 0.1 units/ml. The assay is not influenced by bilirubin, hemolysis, fibrin split products, or lipemia. Results can be generated in less than 5 min. Possible drawbacks are the wide range of acceptability for the supplied heparin standard, and the frequency of pipetting involved. PMID- 6855653 TI - Feasibility of ultrasound hyperthermia in the treatment of malignant brain tumors. AB - In order to test the biological feasibility of using ultrasound-generated hyperthermia for the treatment of brain tumors, damage threshold studied and thermal dosimetry studies as a function of temperature were performed in 44 acute experiments in cats. Bilateral craniotomies were performed to expose the dural surface. Ultrasonic radiation was applied for 50 minutes at different intensities to generate temperatures up to 48 degrees C. Thermal fields were mapped using an electrode array of three triple-junction thermocouple probes. Each probe left a track easily identified histologically. Serial sections of each brain were cut and stained, allowing for precise correlation of histology and thermocouple location and temperature. At temperatures of less than 42 degrees C for 50 minutes, no evidence of damage could be detected in either gray or white matter. At 43 degrees C partial loss of neurons was seen in the brain adjacent to the probe, but at the same temperature in white matter, only edema was seen. At temperatures of 44-45 degrees C there was definite loss of both neurons in the gray matter and myelin tracts in the white matter. The lesions created by using ultrasound-generated hyperthermia were sharply marginated. This sharp demarcation histologically correlated well with the abrupt fall off in temperature as a function of distance from the lesion edge. The results of this study are important in two respects. First, it demonstrates that ultrasound can effectively heat the brain in an extremely controlled and precise manner. Second, the brain can withstand temperatures to 42 degrees C without showing histological evidence of damage, which is the temperature range at which neoplastic cells begin to show cytotoxic effects. PMID- 6855654 TI - Vendor questionnaire to evaluate product quality, service, and support. AB - A questionnaire was developed to obtain verifiable data on the quality of a manufacturer's product, availability and quality of service, qualifications of service personnel, availability of spare parts, availability of inservice training programs for users and clinical engineering staff, history and future support of product, and technical requirements for preventive maintenance and repair. The questionnaire was constructed on the premise that product quality, service, and support throughout the life of the instrument are of equal importance to the function and price in purchase decisions. They play an important role in determining the true cost of patient monitoring equipment and contribute to the quality, safety, and efficiency of patient care. PMID- 6855655 TI - Acquired immune deficiency syndrome. PMID- 6855656 TI - Procaine. Will it keep you younger longer? PMID- 6855657 TI - Renal hypertension. PMID- 6855658 TI - WHO centre for hydatid disease research established in Australia. PMID- 6855659 TI - A black thyroid and minocycline therapy. PMID- 6855660 TI - Conjunctivitis spread by visual display units is unlikely. PMID- 6855661 TI - Hospitalization of Aboriginal and non-Aboriginal children. PMID- 6855662 TI - Increased sexual function with nomifensine. PMID- 6855664 TI - Orf. PMID- 6855663 TI - Stability of developed colour of "BM" glucose monitoring strips. PMID- 6855665 TI - Social workers and doctors. PMID- 6855666 TI - Irrigation of eyes during bush fires. PMID- 6855667 TI - Prodromal acquired immune deficiency syndrome in Australian homosexual men. AB - The acquired immune deficiency syndrome (AIDS) was first reported in 1981 in homosexual men. Since then, it has shown an alarming increase in frequency. The syndrome has now been described in other population groups as well, in particular in persons with haemophilia who are exposed to frequent parenteral injections of blood or blood products, and in sexual contacts of those in at-risk groups. This report deals with two cases of this syndrome which occurred in homosexual men residing in Sydney. These cases are among the first reported in Australia, but, undoubtedly, many more will be forthcoming. Both patients have a profound defect in cellular immunity. The cause of this condition remains a mystery, although viral infection has been suggested. Therapeutic approaches have not yet been established. Clinicians and laboratory workers should be aware that this condition is now present in Australia, and should take appropriate precautions to avoid infection and to limit its spread. PMID- 6855668 TI - Epidemic Kaposi's sarcoma and opportunistic infections. PMID- 6855669 TI - Understanding the management of the child with pain. AB - Pain experienced by the child or perceived by the child's parents generally results in the child being taken forthwith to the doctor. Often the cause of the pain is obvious, such as an injury or an "acute" abdomen, and resolution may be readily achieved with the aid of medical science, the concern of the doctor, and the dedication of the parents. However, there are situations in which, despite the full resources of the physician and other helping professionals, resolution of the child's pain may not be forthcoming. This can particularly be observed in infants and children who are at risk and may have injuries inflicted by the persons looking after them. Infants and children may experience, or are thought to experience, pain in a recurrent and often troublesome way. Yet physical examination often reveals no abnormalities and further investigation is unhelpful. Resolution of the pain requires an understanding of the meaning of the pain to the child and its significance within the family. The clinical features of this kind of pain are described to highlight those aspects which may be helpful in its resolution. PMID- 6855670 TI - Psychological mechanisms in the regression of cancer. PMID- 6855671 TI - Alcohol, drugs, and road accidents. PMID- 6855672 TI - Antiviral drugs today. PMID- 6855673 TI - Blood alcohol concentrations after three "light" beers. PMID- 6855674 TI - Lowered blood ethanol concentrations after a sugar-based drink. PMID- 6855675 TI - The clicking painful temporomandibular joint. PMID- 6855676 TI - Secretion of anti-diuretic hormone after metrizamide myelography. PMID- 6855677 TI - Some hospitals still use flammable anesthetics. PMID- 6855679 TI - Malignant tumours of the kidney. PMID- 6855680 TI - Drink-driver casualties in Victoria. Peak periods on Thursday, Friday and Saturday nights. AB - Blood alcohol estimations are compulsory for all road accident casualties aged 15 years or older who present at public hospitals in Victoria. This article examines the results of blood alcohol estimations performed between 1978 and 1980 in casualties known to have been motor vehicle drivers (excluding motorcyclists). There were three times more male than female driver casualties. Blood alcohol levels in excess of the legal limit of 11 mmol/L (0.05 g/100 mL) were found in 36% of male and 12% of female driver casualties; in approximately half of these, blood alcohol levels exceeded 33 mmol/L (0.15 g/100 mL). Between Monday and Wednesday inclusive, the legal limit was exceeded in 19% of driver casualties. On Friday, Saturday and Sunday, the percentage of driver casualties with blood alcohol levels above the legal limit was 30%, 40%, and 32%, respectively. The percentage of male driver casualties with illegal blood alcohol levels was highest on Thursday, Friday, and Saturday nights (6 p.m. to 6 a.m.), and attained 56%, 62%, and 65% respectively. Of all drink-driver casualties, 56% sustained their injuries on these three nights. These results direct attention to the need for improved driver education and behaviour, and for intensified law enforcement by traffic police during Thursday, Friday, and Saturday nights. PMID- 6855678 TI - Fentanyl in endoscopy of upper gastrointestinal tract. PMID- 6855681 TI - Driver casualties in Victoria (1978-1980). Predominant influences of driver inexperience and alcohol. AB - The driving experience and blood alcohol profiles of motor vehicle driver casualties in Victoria for the period 1978-1980 were examined. Drivers with less than five years' experience were markedly over-represented among the casualties. There was a progressive and marked decline in the number of driver casualties between each of the first five years of driving experience. First-year probationary drivers had three times the casualty involvement of drivers with five years' experience. Probationary licensed drivers, who hold approximately 13% of licenses, accounted for 28% of driver casualties. Blood alcohol levels in excess of the legal limit of 11 mmol/L (0.05 g/100 mL) were more frequent in probationary drivers than in fully licensed drivers (30.4%, compared with 24.4% in fully licensed drivers). These findings, in conjunction with the known impairment of driving skills caused even by blood alcohol levels lower than the legal limit, lead us to recommend that legislation should be enacted making it an offence for probationary license holders to drive a motor vehicle after the ingestion of alcohol. In addition, educational programmes about high-risk accident situations and the alcohol problem on the road should be instituted as an integral part of training before a driving license is issued. PMID- 6855683 TI - The impact of random breath testing in New South Wales, December, 1982 to February, 1983. AB - A survey to investigate the impact of random breath testing (RBT) was carried out in late February, 1983. The survey sample comprised 400 Sydney residents. In the first 10 weeks of operation, nearly half the Sydney population were directly exposed to RBT, either by being tested themselves or by driving past other people being tested. Despite this high penetration rate, many licence holders regarded their chances of being tested as lower than they were when RBT was first introduced, in December, 1982. Men, younger respondents, and heavy drinkers had higher rates of exposure to RBT, rated their chances of being tested more highly than did other groups and more often reported changes in behaviour due to RBT. However, respondents in these groups also more often reported drinking and driving since the advent of RBT. The implications of these findings for police law enforcement strategies and for the current debate on mandatory zero blood alcohol levels among provisionally licensed (P-plate) drivers are considered. PMID- 6855682 TI - Incidence of drug and alcohol intake in road traffic accident victims. AB - The analysis of 425 samples of blood, taken from people killed in motor vehicle accidents, showed that drugs were present in about 10% of samples, whereas alcohol was present in 51%. All drugs identified were available on prescription, and the most commonly found drug was diazepam. PMID- 6855684 TI - Random breath testing in New South Wales. PMID- 6855685 TI - Drinking and driving in Papua New Guinea. PMID- 6855686 TI - Television advertising of alcoholic liquor. PMID- 6855688 TI - Adverse reactions to alcuronium. An Australian disease? PMID- 6855687 TI - Meters of dangerous driving. PMID- 6855689 TI - [Urinary tract infections: adverse effects of chemotherapy]. PMID- 6855690 TI - [Causes of liver damage from drugs]. PMID- 6855691 TI - [Current pharmacology: flecainide]. PMID- 6855693 TI - [The pathophysiology of hypertension]. PMID- 6855692 TI - [Oral anticoagulants and platelet aggregation inhibition]. PMID- 6855694 TI - [Strychnine. An obsolete drug, but an important experimental tool in neurophysiology and -pharmacology]. PMID- 6855695 TI - Choice of cephalosporins. PMID- 6855696 TI - Bumetanide (Bumex) - a new "loop" diuretic. PMID- 6855697 TI - Neuroblastoma: therapy for infants with good prognosis. AB - Therapy was designed to achieve a high cure rate and to prevent serious therapeutic side effects for 11 infants younger than one year old with neuroblastoma who had a favorable prognosis (Evans Stages I, II, III, and IV-S). It consisted of surgery alone if the tumor was totally removed (one infant) and of surgery and low doses of cytoxan and vincristine for a period of 1 year if the tumor was incompletely removed (seven infants). In addition, radiation therapy was applied to unresected dumbbell tumors (three infants). All infants are alive without evidence of disease with the exception of one who died in an accident. The follow-up time varies from 2-8 years. The drug combination prevented recurrences in two infants whose tumor was reduced by surgery to less than 10% of the original size. In five infants, chemotherapy reduced the size of large residual tumor masses. Two of these masses were subsequently removed. The tumors of the three other infants recurred while on chemotherapy and were successfully eradicated by surgery or radiation therapy. Two infants were not treated according to this therapeutic plan. Although they had small residual masses after surgery, no chemotherapy was given. They are alive without recurrence of the disease 2 years or more after diagnosis. In summary, cure was achieved in these infants without intensive chemotherapy. PMID- 6855698 TI - Two sensitive echocardiographic techniques for detecting doxorubicin toxicity. AB - This investigation was designed to evaluate echoes of patients who received a course of doxorubicin (225-550 mg/m2) by two sensitive indicators of myocardial fibrosis: (1) M-mode scans of thickening-thinning curves of the left ventricular posterior wall (LVPW), and (2) two-dimensional qualitative evaluation of LVPW contraction at three levels of the LV short axis (leaflet, chordal, and papillary). These were compared to standard M-mode shortening fraction (delta S). Eighteen children with cancer were evaluated; 11 had received doxorubicin and 7 were treated with other agents. Echocardiographers were unaware of the treatment category. All controls and 10 of 11 doxorubicin patients had normal delta S. An M mode echocardiogram of the expanded LVPW was digitized and wall thickness was evaluated by determining if diastolic relaxation had the normal two phases or only one; six of ten doxorubicin patients and no controls had abnormal relaxation. Qualitative evaluation of LVPW and septal contraction toward the center of the ventricle showed that seven of eleven patients who received doxorubicin and one control (a postthoracotomy patient) had contraction deficits. Six of seven with contraction deficit were the same patients with slowed relaxation. The greatest contraction deficit occurred in the LVPW behind the posterior mitral leaflet. Patients with more extensive involvement had an additional contraction deficit extending to the apex. These tests are more sensitive for detection of doxorubicin toxicity than delta S. PMID- 6855699 TI - Case report: nasopharyngeal rhabdomyosarcoma and Gorlin's naevoid basal cell carcinoma syndrome. AB - A 4-year-old girl presented with a nasopharyngeal rhabdomyosarcoma and had the characteristic features of the naevoid basal cell carcinoma syndrome. She was treated with a modified standard combination of chemotherapy and radiotherapy. However, radiotherapy had to be interrupted because of severe radiation recall. PMID- 6855700 TI - [Seroepidemiologic study of echinococcosis foci in central Yakutia]. PMID- 6855701 TI - [Evaluation of the protective activity of purified fractions of the alveolar hydatid antigen in experimental alveolar hydatid disease in inbred mice]. PMID- 6855702 TI - [Evaluation of the detectability of Opisthorchis felineus eggs depending on the frequency of examination by the Kato method for a population in opisthorchiasis foci]. PMID- 6855705 TI - [Periods of the development and lifespan of Trichocephalus muris (Schrank, 1788) and Hymenolepis nana (Siebold, 1852) in mice with mono- and polyinfections]. PMID- 6855703 TI - [Effect of Opisthorchis infestation on free-radical oxidation, phospholipase and antioxidant activity of the blood in children]. PMID- 6855704 TI - [Improved methods of controlling human echinococcosis (the creation of a complex research program)]. PMID- 6855706 TI - [Indirect hemagglutination reaction in the diagnosis of larval ascariasis]. PMID- 6855707 TI - [Sandflies (Diptera, Phlebotominase) in Afghanistan. 3. The seasonal course of the population in Kabul]. PMID- 6855708 TI - [Effect of multiple sandfly attacks and superinfections on the degree of the external manifestations of leishmaniasis in great gerbils]. PMID- 6855709 TI - [Prolonging the time in which blood preparations can be used for analysis]. PMID- 6855710 TI - [Basic trends in research on opisthorchiasis under the 11th Five-Year Plan]. PMID- 6855711 TI - [DTIC, CTX, ADM and VCT in children with metastatic neuroblastoma]. PMID- 6855713 TI - [Evaluation of some biometric parameters in the newborn in function of the gestational age]. PMID- 6855715 TI - [Clinical case of Mycobacterium minetti endocarditis]. PMID- 6855712 TI - [Physiologic and paraphysiologic aminoacidurias revealed by high pressure electrophoresis followed by solvent chromatography]. PMID- 6855714 TI - [Interventions for craniosynostoses in childhood. Importance of anesthesia]. PMID- 6855716 TI - [Proximal tubular renal acidosis. Clinical case]. PMID- 6855717 TI - [Diphenoxylate and atropine poisoning. 4 clinical cases]. PMID- 6855718 TI - [Paraproteinemia in a case of "hyperIgE" syndrome in pediatric age. Preliminary observations]. PMID- 6855719 TI - [Calcium and fat balance in low birth weight newborn infants fed an adapted formula and mother's milk]. PMID- 6855721 TI - [Urinary osmolarity and the renal solute load in relation to a milk diet in the first 5 months of life]. PMID- 6855720 TI - [Microcranium or microcephaly?]. PMID- 6855723 TI - [Bifid epiglottis in a subject with multiple malformations. Case report]. PMID- 6855722 TI - [Study of serum immunoglobulin levels (IgG, IgA, IgM) in a population of children undergoing adenotonsillectomy]. PMID- 6855724 TI - [Ataxia-opsoclono--myoclonus (Kinsbourne syndrome). Apropos of a personal case]. PMID- 6855725 TI - [Menkes' syndrome. Description of a clinical use]. PMID- 6855726 TI - C7 burst fracture with initial "complete" tetraplegia. PMID- 6855728 TI - Post hospitalization care of the mentally ill in Minnesota. PMID- 6855727 TI - Pseudosarcomatous carcinoma. A pleomorphic pulmonary neoplasm. PMID- 6855729 TI - Blunt pancreatic trauma. PMID- 6855730 TI - HB E disorders in a Minnesota Southeast Asian immigrant population: morphology, indices, electrophoretic patterns and clinical manifestations. PMID- 6855732 TI - The Rural Physician Associate Program (RPAP). A Righton Program for all participants. PMID- 6855731 TI - Does continuing medical education affect medical care. A study of improved transfusion practices. PMID- 6855733 TI - Maintaining defensible medical records. Components of a defensible hospital chart. PMID- 6855734 TI - Double barrelled common bile duct. PMID- 6855737 TI - A comparison of thallium-201 myocardial imaging with exercise-ECG and coronary angiography in 28 patients with suspected ischemic heart disease. PMID- 6855736 TI - The foot in rheumatic disease. PMID- 6855738 TI - Warfarin. Pharmacokinetics and use in the elderly. PMID- 6855735 TI - Fatal fat embolism following total knee arthroplasty. PMID- 6855739 TI - Skin problems in athletics. PMID- 6855740 TI - Detection of the alcoholic patient in the acute care setting. PMID- 6855742 TI - AI/COAG, a knowledge-based surrogate for the human hemostasis expert. PMID- 6855741 TI - Incidence, prevalence, mortality and population-based profile of diabetes mellitus in Wadena, Minnesota. 1981. PMID- 6855743 TI - Giant cell arteritis with peripheral vascular compromise. Case reports. PMID- 6855744 TI - Brachytherapy and teletherapy for carcinoma of the prostate. University of Missouri-Columbia protocol. PMID- 6855745 TI - Changing concepts of cardiac tamponade. PMID- 6855746 TI - Identification of an apparent aminoacyl-tRNA synthetase activator factor as tRNA nucleotidyltransferase. AB - The ability of yeast extracts to aminoacylate crude yeast tRNA with leucine and other amino acids is largely lost after chromatography of the extracts in DEAE Sephadex. The original aminoacylating ability is restored by combining protein fractions from the DEAE-chromatogram. The characteristics of this reactivation are very similar to the activation, by protein factors, of certain aminoacyl-tRNA synthetases reported by others. The results in this work indicate that the apparent aminoacyl-tRNA synthetase activator factor is the tRNA nucleotidyltransferase and that the restoration of the original tRNA aminoacylating ability is a consequence of the repairing of the 3' end of incomplete tRNA chains. PMID- 6855748 TI - Cytoplasmic 3H-arginine polypeptides of Ehrlich ascites tumour cells. AB - Low molecular weight ninhydrin positive peptide fractions of the Ehrlich tumour cell cytoplasm were isolated and characterized. After preliminary gel filtration of the cytoplasm on Sephadex G-25 column, the peptide mixture was fractionated on cationic exchanger SP-Sephadex C-25 column and eluted with increasing pH gradient. Five peaks were obtained. Only the first peak contained sugar component. All five peptides were studied with respect to molecular weight, isoelectric point and electrophoretic homogeneity. The cytoplasm of Ehrlich tumour cells contains one peptide of acidic (pI-5.0), two slightly basic (pI-7.7 and pI-7.7) and two strongly basic nature (pI-8.7 and pI-8.9). Molecular weights varied from 8 500 to 18 500 daltons. The origin of these peptides is briefly discussed. PMID- 6855749 TI - Intermolecular double-stranded structures in RNA from nuclear and cytoplasmic ribonucleoproteins of rat liver. PMID- 6855750 TI - Biosynthesis of amino acids from sucrose and Krebs cycle metabolites by Rhizobium lupini bacteroids. AB - The possibility of amino acids biosynthesis from sucrose, metabolites of Krebs cycle or glyoxylate and ammonium by intact bacteroids has been studied. The suspension of intact Rhizobium lupini bacteroids in phosphate buffer solution pH 7.8 was shown to catalyse the biosynthesis from sucrose and ammonium of some amino acids, such as alanine, aspartic and glutamic acids, glycine and serine. The yield of alanine and aspartic acid was 2.5-3 times higher than that of other amino acids, which were formed in almost equal quantities. Intact bacteroids were also found to catalyse the biosynthesis of aspartic and glutamic acids, alanine and glycine from ammonium and Krebs cycle metabolites such as fumaric acid (FA), oxaloacetic acid (OAA), pyruvic acid (PA), alpha-ketoglutaric acid (alpha-KGA), malic acid (MA), as well as from glyoxylic acid (GOA). The biosynthesis of aspartic acid from fumaric acid was dominant. Besides that, the suspension of intact bacteroids catalysed transamination of aspartic and glutamic acids, the transamination of aspartic acid being especially intense with alpha-KGA and GOA. Aspartic acid was synthesized most efficiently through the amination of fumaric acid, while glutamic acid was better synthesized through the transamination of aspartic acid with alpha-KGA than through reductive amination of alpha-KGA. The experimental data proved that intact bacteroids possess Krebs cycle enzymes and primary ammonia assimilation enzymes. This enzyme complex permits bacteroids to detoxify ammonia, which they produce using sucrose and metabolites of Krebs cycle as the sources of carbon. The data obtained are of great interest as they prove the importance of bacteroids in the synthesis of amino acids from ammonium which is formed in the course of N2-fixation, and sucrose available from leaves. PMID- 6855747 TI - Chemical crosslinking of cell membranes. AB - The complexity of cell membranes makes the resolution of their macromolecular topology one of the more challenging problems in modern molecular and cellular biochemistry. Despite the difficulties inherent in any such analysis, a surprisingly simple yet powerful approach exists that has consistently yielded valuable results. This method is chemical crosslinking, in which cell membranes are treated with crosslinking reagents (usually bifunctional) which produce covalent linkages between membrane components. The resultant complexes are usually then separated and identified by electrophoresis. This review is intended to provide a guide to the investigator who is unfamiliar with this approach. The overall strategy of crosslinking is discussed including selection of reagents, conditions to optimize crosslinking and the cleavage of crosslinked complexes to regenerate the original target for identification purposes. The crosslinking of biological membranes is then reviewed with special emphasis on recent advances including macromolecular photoaffinity labeling, kinetic analysis to probe symmetry properties and potential artifacts that may complicate interpretation of results. Examples of specific applications of crosslinking to membranes are presented in tabular form. The final portion of the review discusses the synthesis and properties of the most widely employed crosslinking reagents. Available reagents are summarized in a series of comprehensive tables. It is hoped that our discussion will provide the uninitiated investigator with sufficient information to ascertain the applicability of chemical crosslinking to particular areas of interest. PMID- 6855751 TI - Peptide separation by reversed-phase high-performance liquid chromatography. PMID- 6855752 TI - Sheep ceruloplasmin: isolation and characterization. AB - Ceruloplasmin has been isolated from sheep plasma by a procedure involving two chromatographic steps and (NH4)2SO4 fractionation. The ovine protein is similar to ceruloplasmins from other species previously described (human, bovine), having a single chain of about 125 Kdal with a very high degree of homology in the amino acid composition. It differs, however, from human and bovine ceruloplasmin because of its lower copper content and its higher specific enzyme activity. The oxidase activity as well as the spectroscopic properties were found to be pH range 5-8 with a pH optimum for activity of 6.3. PMID- 6855753 TI - Enzyme-linked immunosorbent assay for use with nuclear protein-DNA complex antigens. AB - An enzyme-linked immunosorbent assay (ELISA) was developed for identification and quantification of nuclear antigens (nonhistone protein-DNA complexes from chromatin). Until now, the complement fixation assay has been the only immunoassay routinely applied to nonhistone protein-DNA complexes. The ELISA is considerably more sensitive than the micro-complement fixation test for assaying the immunospecificity of nuclear protein-DNA complexes. Dilutions of rabbit antisera as great as 1:6400 could be used to detect nanogram quantities of antigen, chicken reticulocyte chromatin or dehistonized rat liver chromatin. PMID- 6855754 TI - [Thermodynamic instability of cholesterol-containing vesicles]. AB - The temporal behavior of aqueous dispersion of the phosphatidylcholine cholesterol vesicles was studied by photon correlation spectroscopy. The analysis of scattered light spectra by the regularisation method permits one to determine the distribution of vesicles over their dimensions. It was found that the system of the phosphatidylcholine-cholesterol vesicles is thermodynamically instable; this system segregates with time into two fractions of large and small particles. The possible causes of this phenomenon are discussed. PMID- 6855755 TI - [Method for conformational calculations of large fragments of nucleic acids. III. Long range interactions]. AB - The interactions between atoms which are far away in the polynucleotide chain were analysed. The energy of these atom-atom interactions are turned into energy of group-group interactions (these groups of the nucleotide unit are phosphate, ribose and nucleic base). The analytical expressions for the van der Waals and electrostatic group-group interactions as functions of the mutual distances and orientations are proposed. The calculation of the internucleotide energy interactions as an effective group-group interactions permits to decrease the number of interacting centers and necessary computer operations by 30-100 fold with respect to the method of atom-atom potentials. PMID- 6855758 TI - [Two types of attachment points of DNA to the nuclear skeleton in Ehrlich ascites carcinoma cells]. AB - Two types of DNA fragments attached to the nuclear skeleton and protected from staphylococcal nuclease digestion by the nuclear skeleton's proteins were found in Ehrlich ascites carcinoma cells: (i) long (approximately 10 kb) satellite DNA fragments and (ii) short (approximately 140 b. p.) main band DNA fragments. The amount of short DNA fragments depends strongly on the conditions of nuclei isolation. In the preparations obtained from the cells lysed in the medium lacking Cu2+ or Zn2+ short DNA fragments were not found. On the contrary long satellite DNA fragments were found in presumably equal amounts in the nuclei obtained by a wide variety of experimental procedures. Different stability of the structures providing attachment and protection from nuclease digestion of long and short DNA fragments seem to be a good reasons to suggest the existence of two types of attachment points of DNA to the nuclear skeleton. PMID- 6855757 TI - [Conformational properties of protamines]. AB - Conformational peculiarities of protamines in a wide range of various conditions have been studied by the CD and X-ray analysis. Characteristic peculiarities of CD-spectra and position of diffraction maximum in X-ray diagrams of protamines argue in favor that their conformation is similar to that of the extended left handed helix of poly(L)-proline II. Though conformation parameters of this structure are very sensitive to temperature or pH variations, to specific action of different ions, alcohols, and detergents the structure itself is rather stable and is destroyed under extreme conditions only. This conformation seems to be optimal for protamines to interact with DNA and necessary for cross-linking of DNA molecules and for the more dense packing of chromatin. PMID- 6855756 TI - [Effect of urea on botulinum neurotoxin type A]. AB - Kinetic and concentration-mediated dependences of urea effects on toxicity and upon values of negative extremes (279, 287, 292 nm), shifts of lambda max fluorescence from 332 nm to the red region, decrease of fluorescence intensity, changes in accessibility of SH-groups were found. These data point to direct correlation between conformational changes in neurotoxin in urea solutions and decrease of toxicity. An investigation was carried out on renaturation of conformational changed neurotoxin in 8 M urea solution. In no cases was the toxicity restored, though there was a shift of lambda max fluorescence in protein from 340 to 333 nm, that was the evidence for reverse transition of the neurotoxin molecule from a disordered structure to the globule shape. The data lead to the conclusion that the toxicity region is probably a conformationally depending determinant. PMID- 6855760 TI - [Properties of the halide complexes of horseradish peroxidase in the presence of aromatic substrates]. AB - The fluoride, chloride and bromide complexes of horseradish peroxidase were investigated by optical methods, NMR and ESR. The galide binding may be increased or reduced by means of enzyme-substrate complex formation of horseradish peroxidase with aromatic donors. Both sign and magnitude of the effect depends on galide ligand properties and structure of the donor's molecule. The maximum of the galide complex optical density removes redwise with the galide weight increasing. Cloride and bromide binding leads to the appreciable decrease of the high-spin portion in ferriheme spin equilibrium. The cloride complex of horseradish peroxidase demonstrates a low symmetry of the ligand field, in comparison of the fluoride complex. PMID- 6855759 TI - [The domain organization of calmodulin]. AB - Differential scanning microcalorimetry was used to study the domain organization of calmodulin and its fragments obtained by trypsin and thrombin treatment of the protein. It has been shown that (1) at physiological concentrations of Ca2+ ions (10(-6) divided by 10(-5) M) the protein structure represents three cooperative blocks, one of which contains two Ca2+-binding domains and the two others contain one Ca2+-binding domain; (2) stability of the cooperative blocks strongly depends on the Ca2+ concentration and in the presence of 2 mM EDTA the cooperative block containing Ca2+-binding domain III melts already at room temperature; (3) in the absence of Ca2+ ions the addition of Mg2+ or Na+ ions to the buffer system (to the concentration of 2 mM and 150 mM, respectively) does not lead to stabilization of the cooperative structure of the block containing Ca2+-binding domain III; (4) judging by thermodynamic parameters of melting, the structure of cooperative blocks within the peptides coincides with their structure in the intact molecule. PMID- 6855761 TI - [Heterogeneity and homologies of the repeating and unique DNA of dragonflies (Odonata, Insecta)]. AB - A relative content of unique and reiterated nucleotide sequences in DNA of eleven dragonfly species was estimated. The degree of intra- and intergenomic divergence of these DNA sequences was determined by means of DNA-DNA hybridization. Species from different genera share 40-45% of the repetitive sequences and those from different families--from 11 to 20% only. Data on the thermostability of homo- and heteroduplexes suggest that new families of the repetitive sequences have arisen repeatedly during dragonflies evolution. The quality of homologous unique sequences in the DNA compared (20-97%) correlates with the taxonomic relationships of species. Phylogenesis of some dragonfly families is discussed in view of the results obtained. PMID- 6855762 TI - [Formation of the genome of the alligator gar Lepisosteus osseus (Ganoidomorpha) genome]. AB - Genome structure of the alligator gar was studied by means of a comparison of reassociation kinetics of short and long DNA fragments, an estimation of hyperchromicity of reassociated repetitive DNA as a function of fragments length, and length estimation of S1-resistant duplexes by gel filtration. It was shown that most of the repeated sequences in the alligator gar DNA are no less than 2000 b.p. long and weakly divergent. Little or no interspersion of unique and short repeated sequences were observed in this genome. No highly divergent repeats were found in the alligator gar genome. PMID- 6855763 TI - [Comparison of the genome of the alligator gar with the genomes of several other fish]. AB - Hybridization of alligator gar (Lepisosteus osseus, Lepisosteiformes, Ganoidomorpha) [125I]- or [3H]DNA fractions with DNAs of more or less phylogenetically related fishes was studied. Almost all of the repeated and unique sequences of alligator gar DNA and DNA of the spotted gar (from the same genus) are highly homologous (1-2% of nucleotide substitutions). The degrees of homology between repeated and unique sequences of alligator gar DNA and DNAs of the representatives of Acipenseriformes (the same super-order Ganoidomorpha), Latimeria chalumnae (another subclass, Sarcopterygii) and a shark (another class, Chondrichthyes) are of the same order, and the levels of divergency of their DNAs sequences are similar. These results demonstrate, that the joining of Lepisosteiformes and Acipenseriformes in one and the same group of Ganoidomorpha is artificial, and that the superclass of fishes, Pisces, includes more taxons of the class rank then it has been taken in theory. PMID- 6855764 TI - [Structural parameters of charge density, macroion mobility and dissociation constants of the phosphate groups from conductivity measurements of salt free solutions of poly(U) and its salt]. AB - Equivalent conductivity (lambda MeP) was studied for the Li+, Na+, K+, Cs+, NH4+ salts of poly(U) and for polyribouridilic acid. Concentration of the salt free solutions of poly(U) ranges from 1 . 10(-4) M-3 . 10(-3) M. Limiting equivalent conductivity (lambda 0 MeP) was obtained based on linear dependence of lambda MeP on Cp1/2 (where Cp is the concentration of nucleic phosphorus). The lambda 0 MeP values obtained were shown to increase linearly with the increase of the limiting mobility of counterion. These data were used to calculate limiting mobility of macroion (lambda p = 43 Ohm-1 Cm2 equiv-1) and parameter xi = 1.13 which characterizes charge density on a macroion. Linear dependence was shown to take place for poly(U) acid and it's salts in the Ostwald's coordinates; moreover, pK value for the phosphate groups is practically independent of the counterion's nature and equal 1.93 +/- 0.32. PMID- 6855766 TI - [Regulation of enzyme activity in adsorptive enzyme systems. III. Interaction of pig muscle lactate dehydrogenase with F-actin]. AB - The binding of pig skeletal muscle lactate dehydrogenase by F-actin has been studied using the sedimentation method in 10 mM Tris-acetate buffer, pH 6.0 at 20 degrees C. Adsorption capacity of F-actin is equal to (1 +/- 0.1) . 10(-5) moles of lactate dehydrogenase per 1 g of actin. NADH decreases the affinity of F-actin with respect to lactate dehydrogenase. The binding of lactate dehydrogenase by F actin in diminishing the rate of enzymatic reduction of alpha-ketoglutarate. The microscopic dissociation constant for the complex of the enzyme with F-actin which is estimated from the dependence of the enzymatic reaction rate of F-actin concentration at saturating NADH concentrations is equal (3.0 +2- 0.5) . 10(-7) M. It has been shown that the bound enzyme is characterized by the greater value of Km and the lower value of Vmax in comparison to the free enzyme. PMID- 6855767 TI - [Factors of the optimization of the light-harvesting antenna structure of the photosynthetic unit]. AB - The principles of model construction of pigment apparatus affecting the rate of energy trapping are analysed. The basic properties of the model system allowing optimization of this process are as follows: the spectral heterogeneity of light harvesting pigment antenna; the proper mutual orientation of transition moment vectors of antenna molecules; the space arrangement of light-harvesting antenna molecules; the availability of "the focusing zone" of reaction centers, which is formed by the nearest to reaction centers antenna molecules. PMID- 6855765 TI - [Ion-exchange properties of immobilized DNA: influence of the polymer concentration and the solvent nature on the exchange of alkali metals]. AB - The method of ion exchange on immobilized DNA, which allows to determine quantitative parameters of ion binding with a high precision, is used for studying of DNA ion selectivity. Insoluble ion exchangers on the DNA basis with the exchange capacity of 0.09 and 0.17 mg-equiv. per 1 g of dry gel are synthesized by means of immobilization of DNA gel in polyacrylamide gel. Constants of ion-exchange equilibrium for the exchanges K+-Na+ and K+-Li+ are determined on these exchangers in water and 50% water-dioxane solution. It is shown that DNA binds selectively only Li+. The selectivity to Li+ increases with the increase of DNA concentration in gel. The specific properties of Li+-DNA in solutions and in the solid state, for example, the impossibility of the B-A transition, are discussed. The selectivity reversal in favor of K+ is observed in water-dioxane solution. The cause of the selectivity reversal and the question of possible participation of cell polyelectrolytes in creation of ion gradients in the living cell are discussed. PMID- 6855768 TI - Characterization of a cycloheximide-resistant Tetrahymena thermophila mutant which also displays altered growth properties. AB - A cycloheximide-resistant strain of Tetrahymena thermophila, expressing a mutant chx-B gene (Ares and Bruns, Genetics 90:463-474, 1978), displayed very different temperature-dependent growth characteristics than either wild-type cells or another cycloheximide-resistant strain expressing a different mutant gene. Whereas wild-type cells showed an immediate decline in ribosome translocation rates when shifted from 30 to 38 or 40 degrees C, this mutant strain (X-8) showed no such decline. These results directly correlated with the growth rate differences we found for these cells at these temperatures. By genetic analysis, we showed that the phenotype of cycloheximide resistance cosegregated with the ability to grow rapidly at 40 degrees C. Analyses, both direct and indirect, suggested that a number of functional and structural characteristics of the ribosomes from strain X-8 cells are most likely conformationally different from those of wild-type ribosomes. PMID- 6855769 TI - Characterization of the gene and mRNA of the large subunit of ribulose-1,5 bisphosphate carboxylase in pea plants. AB - mRNA coding for the large subunit (LS) of ribulose-1,5-bisphosphate carboxylase was obtained by fractionating chloroplast polysomes on an affinity column, using anti-ribulose-1,5-bisphosphate carboxylase immunoglobulin G. Approximately 20% of the polysomal RNA specifically bound to the affinity column. LS mRNA was also isolated by fractionating chloroplast polysomal RNA on sucrose gradients. The LS mRNA fraction was identified by translation in vitro followed by immunoprecipitation with anti-ribulose-1,5-bisphosphate carboxylase immunoglobulin G. Labeled LS mRNA was hybridized to a genomic digests of pea chloroplast DNA. The LS gene was localized on a 3.55-kilobase pair BamHI fragment in SalI-SmaI DNA fragment 4. The BamHI fragment containing the LS gene was cloned, and a restriction endonuclease map was constructed. The LS gene was localized on a 1.9-kbp KpnI-EcoRI fragment. The LS gene was analyzed by electron microscopy, using the R loop mapping technique. LS mRNA was colinear with the gene, and its size was 1.35 +/- 0.2 kilobase pairs. When the LS mRNA was analyzed on methylmercury agarose gels, it comigrated with the 16S rRNA. The direction of transcription of the LS gene was in the same direction as that of the rRNA genes. PMID- 6855770 TI - Inheritance of extrachromosomal rDNA in Physarum polycephalum. AB - In the acellular slime mold Physarum polycephalum, the several hundred genes coding for rRNA are located on linear extrachromosomal DNA molecules of a discrete size, 60 kilobases. Each molecule contains two genes that are arranged in a palindromic fashion and separated by a central spacer region. We investigated how rDNA is inherited after meiosis. Two Physarum amoebal strains, each with an rDNA recognizable by its restriction endonuclease cleavage pattern, were mated, the resulting diploid plasmodium was induced to sporulate, and haploid progeny clones were isolated from the germinated spores. The type of rDNA in each was analyzed by blotting hybridization, with cloned rDNA sequences used as probes. This analysis showed that rDNA was inherited in an all-or-nothing fashion; that is, progeny clones contained one or the other parental rDNA type, but not both. However, the rDNA did not segregate in a simple Mendelian way; one rDNA type was inherited more frequently than the other. The same rDNA type was also in excess in the diploid plasmodium before meiosis, and the relative proportions of the two rDNAs changed after continued plasmodial growth. The proportion of the two rDNA types in the population of progeny clones reflected the proportion in the parent plasmodium before meoisis. The rDNAs in many of the progeny clones contained specific deletions of some of the inverted repeat sequences at the central palindromic symmetry axis. To explain the pattern of inheritance of Physarum rDNA, we postulate that a single copy of rDNA is inserted into each spore or is selectively replicated after meiosis. PMID- 6855771 TI - In vitro nuclear transport of ribosomal ribonucleoprotein: temperature affects quantity but not quality of exported particles. AB - The in vitro export of ribosomal ribonucleoprotein (rRNP) from Tetrahymena nuclei was investigated at the optimal growth temperature of 28 degrees C and at the nonlethal temperature of 8 degrees C. At both temperatures, nuclei exported ribosomal precursor particles that revealed the same physical qualities of size, appearance in negative-staining electron microscopy, sedimentation coefficient, buoyant density, and rRNA pattern. Surprisingly, fewer rRNP particles were exported at 8 than at 28 degrees C, as was revealed by a lower saturation plateau in the export kinetics from nuclei prelabeled with [3H]uridine. Upon a temperature increase from 8 to 28 degrees C, additional rRNP particles were exported. We conclude that nuclei export only a defined portion of rRNP particles at a given temperature, although enough potentially transportable rRNP particles are present in nuclei. Obviously, the reactivity of at least one of the reactants involved directly or indirectly in rRNP export changes with temperature. PMID- 6855772 TI - Evolution of chromosomal regions containing transfected and amplified dihydrofolate reductase sequences. AB - A modular dihydrofolate reductase gene has been introduced into Chinese hamster ovary cells lacking dihydrofolate reductase. Clones capable of growth in the absence of added nucleosides contain one to five copies of the plasmid DNA integrated into the host genome. Upon stepwise selection to increasing methotrexate concentrations, cells are obtained which have amplified the transforming DNA over several hundredfold. A detailed analysis of the chromosomes in three clones indicated the appearance of cytologically distinct chromosomal regions containing the amplified plasmid DNA which differ in surrounding sequence composition, structure, and location. Two of the clones examined have extensive, homogeneously staining regions. The DNA in these homogeneously staining regions replicates in the early part of the S phase. The amplified plasmid DNA is found associated at or near the ends of chromosomes or on dicentric chromosomes. We propose that integration of DNA may disrupt telomeric structures and facilitate the formation of dicentric chromosomes, which may then undergo bridge breakage fusion cycles. These phenomena are discussed in relation to DNA transfer experiments and modes of gene amplification and chromosome rearrangement. PMID- 6855773 TI - Regular arrangement of nucleosomes on 5S rRNA genes in Xenopus laevis. AB - The chromatin structure of the oocyte-type 5S RNA genes in Xenopus laevis was investigated. Blot hybridization analysis of DNA from micrococcal nuclease digests of erythrocyte nuclei showed that 5S DNA has the same average nucleosome repeat length, 192 +/- 4 base pairs, as two Xenopus satellite DNAs and bulk erythrocyte chromatin. The positions of nuclease-sensitive regions in the 5S DNA repeats of purified DNA and chromatin from erythrocytes were mapped by using an indirect end-labeling technique. Although most of the sites cleaved in purified DNA were also cleaved in chromatin, the patterns of intensities were strikingly different in the two cases. In 5S chromatin, three nuclease-sensitive regions were spaced approximately a nucleosome length apart, suggesting a single, regular arrangement of nucleosomes on most of the 5S DNA repeats. The observed nucleosome locations are discussed with respect to nucleotide sequences known to be important for expression of 5S RNA. Because the preferred locations appear to be reestablished in each repeating unit, despite spacer length heterogeneity, we suggest that the regular chromatin structure reflects the presence of a sequence specific DNA-binding component on inactive 5S RNA genes. PMID- 6855774 TI - Identification of the cloned gene for the murine transplantation antigen H-2Kb by hybridization with synthetic oligonucleotides. AB - The H-2K(b) gene is a member of the large major histocompatibility complex class I gene family. Since many members of this family cross-hybridize with class I cDNA probes, the cloned H-2K(b) gene was identified by hybridization with specific oligonucleotide probes. This clone was definitively shown to encode the H-2K(b) polypeptide by partial DNA sequencing and by serological and tryptic peptide analyses of the expressed product. PMID- 6855775 TI - Amino acid sequence of the cytoplasmic segment of the h-2Kd (H2.31) murine major histocompatibility antigen. AB - The primary structure of the carboxy-terminal portion of the H-2Kd murine major histocompatibility antigen has been determined using radiosequencing methodology. The two peptides encompassing the entire cytoplasmic portion of the H-2Kd molecule were isolated from cyanogen bromide digests of the detergent solubilized molecule. These two peptides are not present in CNBr digests of papain solubilized H-2Kd. Alignment of the two CNBr peptides was deduced from tryptic overlap peptides derived from the whole molecule. Alignment with the corresponding region of the H-2Kb antigen shows 90% homology and supports the assignment of this segment of H-2Kd as the C-terminal. The sequence obtained in this study is (Met)-Arg-Arg-Asn-Thr-Gly-Gly-Lys-Gly-Val-Asn-Tyr-Ala-Leu-Ala-Pro Gly-Ser-Gln- Thr-Ser-Asp-Leu-Ser-Leu-Pro-Asp-Pro-Lys-Val-Met-Val-His-Asp-Pro-His Ser-Leu- Ala. These data allow extensive comparisons with the protein sequences deduced from the 3' ends of H-2d haplotype cDNA and genomic clones as well as with the homologous regions of H-2Kb and H-2Db. PMID- 6855776 TI - Determination of dissociation constants and ligand specificity of detergent solubilized surface membrane immunoglobulin A from MOPC-315. AB - Surface membrane immunoglobulin from MOPC-315 plasmacytoma cells (smM315) was isolated by nonionic detergent lysis of radioiodinated cells and affinity chromatography on Dnp-aminohexyl-Sepharose 4B. Verification of the solubilized molecule as an integral membrane protein, distinct from secreted MOPC-315 IgA (M315) was accomplished by NaDodSO4-PAGE, charge-shift electrophoresis and molecular sieve gel filtration with NP-40 and deoxycholate. smM315 was compared to reduced and alkylated monomeric secreted immunoglobulins from MOPC-315, MOPC 460, and XRPC-25 by quantitative affinity chromatography (QAC) using two differently substituted Dnp-aminohexyl-Sepharose 4B resins. Unique patterns of cross-reactivity of all secreted myeloma proteins were independently established with a competitive hapten inhibition assay using 125I-Dnp26BSA as the precipitating probe. After derivation with dinitrobenzylsulfonate, Dnp-aminohexyl Sepharose 4B was modified with succinic anhydride which, with the inclusion of 0.03% Doc in a PBS and 0.1% NP-40 buffer, prevented nonhapten specific protein matrix interactions during QAC. Dissociation constants determined by QAC for three ligands, (dinitrophenyl-glycine, trinitrophenyl-amino-caproate and tetramethylrhodamine) were essentially the same for smM315 and M315. Both of the other nitrophenyl binding IgA myelomas had distinct and significant differences in dissociation constants. Thus, for a differentiated antibody secreting cell which has undergone a heavy chain class switch, such as MOPC-315, the cell surface immunoglobulin has an identical ligand binding active-site as the secreted immunoglobulin. PMID- 6855777 TI - Thymic microenvironmental factor: solubilization and preliminary characterization. PMID- 6855778 TI - Beta chain deficiency in three patients with dysfunctional C8 molecules. AB - Structural and functional studies were performed on a dysfunctional C8 molecule present in the serum of two siblings and an unrelated individual. The C8 in these three sera exhibited a pattern of partial immunologic identity with C8 in normal serum but was devoid of functional activity. The C8 was immunoprecipitated from the three sera and from a control serum with an antihuman C8 antiserum and analyzed by SDS-PAGE using highly purified human C8 as a reference. A selective absence of a band of 62,000 mol. wt was observed in the immunoprecipitates from the sera containing dysfunctional C8. Experiments performed with the purified alpha-gamma and beta subunits showed that the hemolytic activity of the C8 deficient sera could be reconstituted by the addition of the beta chain but not the alpha-gamma dimer. Binding of the dysfunctional C8 to C567 was excluded by the following observations: (1) EAC1-7 treated with the C8 deficient sera and then washed could not be lysed after the addition of the beta subunit and C9; and (2) the abnormal molecules did not interfere with the consumption of normal C8 by the soluble complex SC5b-7. PMID- 6855779 TI - [Bronchologic studies in the asthma syndrome]. AB - A comparison is made between today's results in bronchological examinations, and those of 1969 published in Monatsschr Kinderheilkd (1969) 117:611-613. Nowadays bronchial disorders are diagnosed more often by 13.95 compared to data a decade ago. This is not due to an absolute growth of numbers of cases but to a more precise method of diagnosis. Furthermore, chronic bronchitis in children previously accounted for only 76 cases but now is diagnosed in 25% of the total. No doubt the pediatrician has to reckon with this disease. The frequency of bacterial infections decreased from 48% to 23%; certainly this is related to massive antibiotic pretreatment. Attention is repeatedly drawn to the importance of diagnosing anatomical disorders. PMID- 6855780 TI - [The effect of hyposensitization in bronchial asthma of childhood with regard to the histamine reactivity of the bronchial tract]. AB - 86 children with asthma were re-examined after receiving hyposensitization for a period of two years. A measurable decrease in the bronchial hypersensitivity was recorded in 40 patients. The group of children suffering from asthma during the grass pollen season showed a more favourable result, compared to patients with perennial asthma. 16 patients demonstrated an unchanged histamine response. The bronchial hypersensitivity was increased in 30 patients. Personally interviewed, 39.5% indicated a notable improvement, 55.8% no change and 4.7% a deterioration. There was no significant change in the bronchial hypersensitivity to histamine following hyposensitization. Only in some cases there was a correlation between the results of bronchial hypersensitivity and the subjective changes. PMID- 6855781 TI - [Comparative studies of the psychopathology of bronchial asthma and cystic fibrosis]. AB - Comparative examinations were performed on each N = 36 subjects, with bronchial asthma, cystic fibrosis and healthy controls, with regard to individual psychopathology, family functioning, and the relationship of clinical parameters to psychopathology. Children suffering from cystic fibrosis had the highest prevalence rate of psychiatric disorder. Findings of the psychiatric assessment in general were cross-validated by parent's and teacher's questionnaires. Data relating to family function were less differentiating between the groups. In both groups of diseases significant correlations between clinical parameters and psychopathology were detected. PMID- 6855782 TI - [Clinical findings in children with selective deficiency of Clq, a subunit of the first component of complement]. AB - Recently we diagnosed a new complement defect, namely, selective deficiency of the Clq subcomponent of Cl. This defect was manifested by recurrent skin lesions, bouts of serious infections and membranoproliferative glomerulonephritis [4,5]. Within the past two years, we have diagnosed two new similar cases by paying attention to recurrent skin disease and associated symptomatology [7]. These patients had a bad prognosis due to severe bacterial infections and chronic kidney disease. In addition, discovery of new cases should be of help in explaining the importance of complement for host-parasite interactions and whether it is important for their management that an underlying deficiency of Clq be detected in similar cases. It is the purpose of this report to analyze common clinical findings and symptomatology in patients with selective complete Clq deficiency [4-7] and to compare them with other reported cases of Clq defects. PMID- 6855783 TI - [Asymptomatic, excessive hypercalcemia n a 12-year-old boy]. AB - A cervical lymph node enlarged since 3 weeks was to be removed in a 12-year-old boy, whose only complaint was slight fatigue. Routine screening revealed hypercalcemia of 7.3-8.1 mval/l. This rose to 9.2 mval/l despite furosemide induced high fluid turnover and prednisone while diagnostic evaluation proceeded. Serum phosphate was low consistently. Malignancy, vitamin D-intoxication, immobilisation and familial conditions could be ruled out as causes. Highly elevated serum-parathormone levels inspite of hypercalcemia, and ultrasonography of the neck were the most helpful evidence of a parathyroid adenoma. Calcitonin was effective in lowering serum-calcium to 6-7 mval/l preoperatively. PMID- 6855785 TI - ["Sugar-induced caries" due to excessive enjoyment of instant tea from nursing bottles]. PMID- 6855784 TI - [Multiple abnormalities as a result of partial trisomy 4p and partial monosomy 18q by meiotic recombination]. PMID- 6855786 TI - Specific gene mutations in L5178Y cells in culture. AB - The predominant test system uses a near-diploid L5178Y mouse lymphoma cell line and is based on the quantitation of forward mutations occurring at the heterozygous thymidine kinase (TK) locus (TK+/- leads to TK-/-). (Other markers, such as ouabain- or methothrexate-resistance and alanine independence, in other L5178Y mouse lymphoma cells were also examined, but our criteria for the acceptability of data or the paucity of data considerably reduced the value of these mutagenesis test systems to this study.) The biochemical basis for the L5178Y/TK+/- assay depends on the ability of TK-competent cells to phosphorylate 5-bromo-2'-deoxyuridine or trifluorothymidine. The phosphorylated product or its metabolites kill these cells, thus, medium containing 5-bromo-2'-deoxyuridine or trifluorothymidine is capable of selecting for cells that are lacking the TK enzyme (TK-/-). TK-/- cells eventually give rise to a bimodal distribution of colony sizes. The relative proportion of small and large colonies appears to be characteristic of the mutagen, its dose, and the length of the expression period. A total of 108 references were reviewed and 48 chemical agents were evaluated. Of these, in vivo carcinogenicity data existed for 44 and covered a wide variety of chemical classes (43 compounds) and a complex mixture. In this system, 39 agents were positive, 1 was negative, and 4 yielded inconclusive results. The 44 test substances evaluated were insufficient to single out agents or agent classes for which the assay was particularly well suited; however, with the exception of thymidine analogs, the system seems to be versatile. The correlation of the TK locus assay results with the carcinogenicity data revealed that 2 agents were definite false positives (sodium azide and methotrexate) and 1 agent was a definite false negative (1,1-dimethylhydrazine). Further evaluation suggested that 4-acetylaminofluorene and diphenylnitrosamine were questionable false positives, while benzo[e]pyrene was a questionable false negative. (The term questionable was used to imply uncertainties concerning the mutagenicity and/or carcinogenicity data). Thus, the assay is of value in the battery approach to mutagenicity/carcinogenicity screening. PMID- 6855787 TI - Cytogenetic effects of quinoxaline-1,4-dioxide-type growth-promoting agents. II. Metaphase analysis in mice. AB - The clastogenicity of the growth-promoting agents, carbadox, olaquindox and cyadox, was examined by the metaphase analysis of chromosome aberrations in bone marrow of mice. The agents were administered by a stomach tube to male ICR mice 24 h before they were killed. Single-dose levels were 50, 100 and 200 mg/kg for carbadox; 200, 400, 600 and 800 mg/kg for olaquindox; and 400, 800 and 1200 mg/kg for cyadox. Carbadox was the most active; it induced chromosome aberrations even at a dose of 100 mg/kg. Olaquindox had about the same activity at a dose of 800 mg/kg. No chromosome-damaging effect of cyadox was observed even at a dose of 1200 mg/kg. PMID- 6855788 TI - Induction of sister-chromatid exchange by 5-substituted 2'-deoxyuridines. AB - Several 5-substituted 2'-deoxyuridine (dUrd) analogues, known for their anti viral or anti-tumour potentials, were evaluated for their ability to induce sister-chromatid exchange (SCE) in human fibroblasts and lymphocytes. While the selective anti-herpes agents (E)-5-(2-bromovinyl)-dUrd, (E)-5-(2-chlorovinyl) dUrd, (E)-5-(2-iodovinyl)-dUrd, (E)-5-(3,3,3-trifluoro-1-propenyl)-dUrd and (E)-5 (1-propenyl)-dUrd did not induce SCE unless their concentration was about 1000 5000-fold greater than that required to inhibit herpes-virus replication, several other dUrd analogues such as 5-vinyl-dUrd, 5-ethynyl-dUrd, 5-formyl-dUrd, 5 hydroxymethyl-dUrd and 5-trifluoromethyl-dUrd induced SCE at a concentration closely corresponding to those required to inhibit either virus replication or tumour-cell growth. Only 2 compounds, 5-fluoro-dUrd and 5-nitro-dUrd (5' monophosphate), inhibited tumour-cell growth at a concentration well below that required for increased SCE induction. The ability of a given dUrd analogue to induce SCE may be related to its incorporation into DNA or, alternatively, may depend on an interaction with 5-bromo-dUrd, which is included in the tests to visualize SCE and which in itself produces SCE. PMID- 6855789 TI - Cytogenetic effects of pesticides. II. Induction of micronuclei in mouse bone marrow by the insecticide gardona. AB - The induction of micronuclei in mouse bone marrow by the organophosphorus insecticide gardona (also known as tetrachlorvinphos) was tested. 3 routes of administration were used for the pure insecticide: intraperitoneal, oral and dermal. The different routes of treatment with gardona caused toxicity of marrow indicated as significant increases in the percentage of polychromatic erythrocytes over that of the control. Intraperitoneal and oral treatments induced a statistically significant percentage of micronucleated PE. PMID- 6855790 TI - Dominant lethal studies in male mice after exposure to 2.45 GHz microwave radiation. AB - Adult male mice had the lower halves of their bodies exposed in a waveguide system to 2.45 GHz microwave radiation for 30 min. The half body dose-rate of 43 W kg-1 had been shown in a previous study [7] to deplete severely the heat sensitive stages of sperm production. The males were mated at intervals to adult hybrid females over the following 8-10 weeks. There was no significant reduction in post-implantation survival, suggesting that the microwave exposure did not have a mutagenic effect on the male germ cells. However, pregnancy rate was significantly reduced in weeks 3, 4, 5 and 6; reaching a minimum of about 10% of the control value in weeks 4 and 5. The occurrence of low values in weeks 4 and 5 correlated well with the expected reductions in sperm count due to the pattern of depletion of the spermatogenic epithelium of the testes. Thus it was concluded that the reduced pregnancy rate resulted from reduced male fertility. Pre implantation survival can also be affected by reduced sperm count [8] and was significantly reduced in this study but it correlated less well with the anticipated heat response. A further study is in progress looking at the contribution of sperm count and sperm abnormality to the results. PMID- 6855791 TI - The reproducibility of individual estimations in the covalent binding of N acetoxy-2-acetylaminofluorene to DNA and in the induction of unscheduled DNA synthesis. PMID- 6855792 TI - An application of Acridine Orange fluorescent staining to the micronucleus test. AB - Acridine Orange fluorescent staining was applied to the micronucleus test in mice and rats. Micronuclei emitted bright green fluorescence and were easily distinguished from micronucleus-like inclusions or contaminants. In rat bone marrow cells, micronuclei with green fluorescence could be easily distinguished from granules accidentally dispersed from broken mast cells, which showed bright red fluorescence. Therefore, it is recommended that the Acridine Orange staining method be used to provide more reliable data in the micronucleus test. PMID- 6855793 TI - SCE analysis in children exposed to lead emission from a smelting plant. AB - The frequency and location of SCE were evaluated in lymphocytes from peripheral blood cultures of 19 children living in a widely contaminated area and showing an increased absorption of lead. In the comparison between the exposed children and a control group living in an uncontaminated area, no significant differences were found in the mean values of SCE frequencies. The distributions of the SCE between chromosomes were proportional to chromosome length in both groups. PMID- 6855795 TI - Human lymphocytes/freeze-dried microsomes. An improved method for short-term mutagenesis and carcinogenesis testing. PMID- 6855794 TI - Absence of an effect of diagnostic ultrasound on sister-chromatid exchange induction in human lymphocytes in vitro. AB - The frequency of sister-chromatid exchanges in human lymphocytes cultured in vitro was not changed after a 30-min exposure to a 2 MHz focused, diagnostic ultrasound beam with a pulse repetition rate of 1000 Hz, 1 musec burst duration, 100 W/cm2 temporal peak, spatial peak intensity. These results are consistent with those obtained with a number of other cell types and are contrary to some previously reported effects for human lymphocytes. PMID- 6855796 TI - Myasthenia gravis immunoglobulin augments motor neuron survival without producing muscle paralysis. AB - Effects of sera or immunoglobulins from patients with acquired myasthenia gravis on motor neuron survival during critical stages of embryonic development were investigated in the trochlear nucleus-superior oblique muscle system of white Peking duck embryos. A significant increase in motor neuron survival occurred following application of myasthenia gravis sera or myasthenic immunoglobulin during the period of embryonic death of motor neurons. There was no reduction in limb or extraocular muscle movement in treated embryos. Trochlear motor neuron survival persisted after sera or immunoglobulin treatment was discontinued. The total number of muscle fibers and acetylcholine receptors were unchanged following immunoglobulin treatment. Myasthenic immunoglobulin is therefore unique in preventing motor neuron death without producing muscle paralysis and in promoting a prolonged augmentation of motor neuron survival. It is concluded that factors other than muscle activity may also control neuron survival during embryogenesis. Previous studies of myasthenic sera in muscle have shown effects only postsynaptically. This is the first demonstration that myasthenic immunoglobulin affects structures in the central nervous system. PMID- 6855797 TI - Morphometric analysis of aging skeletal muscle following endurance training. AB - Aging of skeletal muscle in the hindleg of the mouse is accompanied by a progressive increase in the amount of the interstitial tissue and especially that of lipid cells and fibroblasts. Quantitative analysis indicates that there was a nonsignificant increase in the total number of muscle fibers per unit area, perhaps due to a splitting process. The proportion of high oxidative fibers was decreased to a nonsignificant degree, and the remaining high oxidative fibers underwent a significant compensatory hypertrophy. Concomitantly, the number of low oxidative fibers increased significantly. This study revealed that endurance training in young animals induced morphometric changes very similar to those noticed in intact aging animals (i.e., splitting phenomenon, hypertrophy of high oxidative fibers, and an increased proportion of low oxidative fibers). It also became apparent that the skeletal muscle of old animals lacks the capacity to respond to enforced training, except for a further increase in the proportion of low oxidative fibers. It appears that aging muscle is unable to adapt to changing environmental circumstances. PMID- 6855798 TI - Autosomal recessive generalized myotonia. AB - Two siblings and a first degree cousin of a consanguinous marriage were afflicted with recessive generalized myotonia (RGMy). All had muscle weakness which was particularly prominent after rest, thinning of the forearms, weakness of anterior compartment muscles, and muscular contractures. The first degree cousin was the most severely afflicted with congenital myotonia. Muscle biopsy and electromyography were consistent with a myopathy. Exercise after rest demonstrated a marked reduction in muscle membrane excitability in all patients. PMID- 6855799 TI - Increase of muscle peroxisomal enzymes and myotonia induced by nafenopin, a hypolipidemic drug. AB - The chronic administration of nafenopin, a hypolipidemic drug, induced an increase in catalase and acyl-CoA oxidase activities in various skeletal muscles, including the gracilis, diaphragm, soleus, and extensor digitorum longus. The magnitude of the increase was around 100% for both enzymes in each of the muscles studied in spite of the different basal level. These changes seem to be specific of the peroxisomal enzymes because acetylcholinesterase, which is not peroxisomal, did not follow the same pattern in all the muscles. Concomitant with the increase in muscle peroxisomal enzymes, the skeletal muscles presented an altered electromyogram with prolonged insertional activity, repetitive firing of action potentials, and myotonic runs characteristic of myotonia. Our results suggest a role for peroxisomes in the myotonic disorder. PMID- 6855800 TI - D-pen associated MG. PMID- 6855801 TI - Possible biochemical consequences of different subsets of contractile proteins in single dystrophic muscle fibers. PMID- 6855802 TI - Serum creatine kinase isoenzymes: a review. PMID- 6855803 TI - Spinal muscular atrophy: the natural course of disease. AB - The infantile form of spinal muscular atrophy (Werdnig-Hoffmann disease) is thought to be progressive and usually fatal by age three. The intermediate and juvenile forms (Kugelberg-Welander disease) have been reported to be static in many cases. A review of 48 patients, 50% of whom had been followed for more than 10 years, were placed into four groups according to the maximum motor function attained. Progression of muscle weakness was assessed using functional criteria, including inability to walk, inability to use a manual wheelchair and inability to raise the hands above the head. The results of this analysis suggest that all patients with spinal muscular atrophy have a progressive disease and that the course of the deterioration is predictable in each of the four groups. This information allows one to offer realistic counseling and a rational rehabilitation program. PMID- 6855804 TI - Treatment of "permanent" muscle weakness in familial Hypokalemic Periodic Paralysis. AB - Three patients with Hypokalemic Periodic Paralysis (HOPP)-associated progressive interattack muscle weakness, who became unresponsive or worsened by acetazolamide, responded favorably to dichlorophenamide, a more potent carbonic anhydrase inhibitor. Dichlorophenamide in single-blind placebo-controlled trials, considerably improved functional strength in two of the patients and had a moderate but definite effect in the third. Muscle groups graded 4/5 (MRC scale)returned to normal; very weak (0-3/5) atrophic muscles, improved to a minor degree. In one patient with acetazolamide-resistant paralytic attacks, dichlorophenamide also diminished the frequency and severity of the acute attacks. Dichlorophenamide had, in the present study, less effect than acetazolamide in reducing serum HCO3(-) and elevating Cl-. Its effectiveness may be related to the degree of sensitivity of certain HOPP patients to alterations of Cl- and/or HCO3(-) serum levels or to a different action of the drug unrelated to carbonic anhydrase inhibition or acidosis. Dichlorophenamide should be considered as an alternate to acetazolamide in the treatment of patients with HOPP-associated interattack muscle weakness who have become unresponsive or worsened by acetazolamide. PMID- 6855805 TI - Skeletal muscle lysosomes: comparison of lysosomes from normal and dystrophic avian pectoralis muscle as a function of age. AB - The properties of skeletal muscle lysosomes from normal and dystrophic chickens were studied to assess their involvement in the dystrophic process. A method is described for isolation of a three-to-sevenfold purified lysosome fraction with 29-33% yield. Lysosomal enzymes in crude homogenates and isolated lysosome enriched fractions from dystrophic muscle exhibit decreased latency for N-acetyl beta-D-glucosaminidase, acid phosphatase, and cathepsin D. However, no differences in the fragility of lysosomes in isolated lysosome-enriched fractions from normal and dystrophic muscle were observed using shear, sonication and detergent stress. Lower percent recovery, enrichment factor and percent latency of acid phosphatase compared to N-acetyl-beta-D-glucosaminidase and cathepsin D were observed from both normal and dystrophic muscle. These results are consistent with the presence of a significant amount of nonlysosomal acid phosphatase activity in skeletal muscle. PMID- 6855806 TI - Ultrastructure of the developing myotendinous junction of genetic dystrophic chickens. AB - This paper presents an ultrastructural study of the changes occurring within the tendon and at the insertion of the developing gastrocnemius of White Leghorn chickens and the dystrophic lines 413 and 423 from Davis, CA. The study revealed that the Davis lines contained abnormalities in these areas as early as 13 d in ovo with progressive deterioration to 19 d in ovo. The fibroblasts, collagen, and myofibers showed significant alterations as early as 13 in ovo. Fibroblasts contained abnormal mitochondria and altered Golgi bodies. At day 19, many were ruptured. The average diameter of collagen fibrils was smaller in the dystrophic chickens and myofibers showed a variety of alterations, some of which were severe. The details of these alterations are described and their possible relationship with the etiology of genetic muscular dystrophy is discussed. PMID- 6855807 TI - Treatment of myotonic dystrophy with tricyclics. PMID- 6855808 TI - Immobilization of dystrophic mouse muscle prevents pathology and necrosis of muscle fibers. PMID- 6855809 TI - A major change in surface antigens during the maturation of newborn larvae of Trichinella spiralis. AB - Newborn larvae of Trichinella spiralis were collected for 30 min from female worms in culture, incubated in vitro for various times up to 18 h, and surface labelled with iodine. The detergent-solubilised products were examined by SDS polyacrylamide gel electrophoresis. At time periods up to 6 h these larvae expressed only one Mr 64 000 iodine-labelled surface protein. Some time between 6 h and 18 h a further three components (apparent Mr 58 000, 34 000 and 32 000) became accessible to surface labelling. All four of these components are antigenic in that they can be immunoprecipitated with T. spiralis immune sera. Tryptic peptide analysis revealed that the 32 and 34 kDa antigens were structurally very similar, but the 58 and 64 kDa proteins differed from each other and the 32-34 kDa pair. Thus T. spiralis not only undergoes a total change in surface antigens between moults, but also major changes in surface antigen expression within one stage. PMID- 6855810 TI - Isolation and characterization of infective and non-infective clones of Leishmania tropica. AB - Cloning by limit dilution of an isolate of Leishmania tropica (LRC-L137) that is infective for mice resulted in 7 stable clones, only one of which was infective in BALB/c mice. Three of the non-infective clones that were examined for survival in BALB/c macrophages in vitro seemed to be killed more readily, suggesting failure to establish in macrophages as the basis for non-infectivity in vivo. Promastigotes from three non-infective clones and one infective clone were biosynthetically labelled or surface radioiodinated, and the detergent lysates were analyzed by 2-dimensional gel electrophoresis. The pattern of the radiolabelled cytoplasmic and membrane proteins of promastigotes from all L. tropica clones was similar, with minor differences. All clones as well as the uncloned population bound to the same extent to a series of lectins with galactose and N-acetylgalactosamine as specificities. They also bound in a solid phase radioimmunoassay to 9 monoclonal antibodies raised against the uncloned L. tropica (LRC-L137). The genetic characterization of four L. tropica clones was attempted by analysis of their isolated kinetoplast DNA. The clones from two schizodemes since they possess kinetoplast DNAs which exhibit similar restriction endonuclease fingerprints and show extensive DNA sequence homology, suggesting that the four clones are closely related and that the non-infective variants may be derived from the infective presumptive parental clone L137-7-121. Further characterization of the clones of L. tropica should allow a better understanding of the genetic basis of parasite virulence in cutaneous leishmaniasis. PMID- 6855811 TI - Sequential removal of outer bilayer and apical plasma membrane from the surface epithelial syncytium of Schistosoma mansoni. AB - The outer and inner bilayers of the apical membrane complex of Schistosoma mansoni were sequentially stripped from adult worms by two incubations in 0.1% digitonin solutions. Membrane removal was evaluated by electron microscopy of worms and bilayer material, using Con A-ferritin as a marker for the outer bilayer. Amounts of Con A removed by the digests were measured with a tritiated Con A marker. To measure the purity of the fractions membrane markers were characterised and quantitated for both bilayers. In the absence of the usual enzymatic markers for plasma membrane diazotised [125I]-iodosulfanilic acid was used as a marker for the outer bilayer. Alkaline phosphatase and a Na+, Mg2+ ATPase were localised to the inner bilayer. From these results we can deduce that the inner bilayer is analogous to the typical, apical plasma membrane of other animal epithelia. The outer bilayer does not share these enzymatic similarities. The integrity of the syncytium after removal of the outer bilayer and the increased levels of lactate dehydrogenase in the supernatant after removal of the inner bilayer suggests that the outer bilayer is secondary in maintaining the permeability barrier of the apical membrane complex, with respect to soluble proteins. The possible significance of these results in terms of the destructive action of complement on the parasite are discussed. PMID- 6855812 TI - Enzymes of the de novo pyrimidine biosynthetic pathway in Toxoplasma gondii. AB - All six enzymes of the de novo biosynthetic pathway leading to the biosynthesis of UMP have been characterized in Toxoplasma gondii. The first three enzymes of the pathway, carbamyl phosphate synthetase-II (CPS-II), aspartate transcarbamylase (ATCase) and dihydroorotase (DHOase) could be consistently separated by sucrose gradient centrifugation. Their molecular weights were estimated to be approximately 540 000, 140 000 and 70 000, respectively. The last two enzymes, orotate phosphoribosyltransferase (OPRTase) and orotidylate decarboxylase (ODCase), cosedimented at the same position, corresponding also to a molecular weight of approximately 70 000. The fourth enzyme, dihydroorotate dehydrogenase (DHO-DHase), was associated with the particulate fraction. Apparent Km values for the respective enzymes were: CPS-II, MgATP2- (19.7 1.2 mM), L glutamine (12.0 +/- 1.7 microM), ammonia (15.5 +/- 2.7 mM); ATCase, carbamyl phosphate (26.2 +/- 3.5 microM), L-aspartate (17.6 +/- 8.5 mM); DHOase (reverse direction) dihydroorotate (1.6 +/- 0.08 microM); ODCase, orotidine 5' monophosphate (0.41 +/- 0.04 microM). MgUTP2- was found to act as an inhibitor of CPS-II, with an apparent Ki of 0.41 mM. However, 5-phospho-alpha-D-ribosyl-1 diphosphate, dimethyl sulphoxide and glycerol had no effect on the Km value for MgATP2-. The effect of some inhibitors, including pyrimidine and purine nucleotides and analogs and respiratory chain inhibitors, was also determined for the enzymes of the pathway. PMID- 6855813 TI - Absence of maternal contamination of chorionic villi used for fetal-gene analysis. AB - Chorionic villi can be obtained by direct transcervical aspiration at 9 to 10 weeks' gestation and used for analysis of fetal DNA. However, for the method to be reliable, there must be no detectable contamination by maternal DNA. To investigate the question of contamination, we compared the DNA of chorionic villi from five fetuses with that obtained from maternal lymphocytes, using the restriction endonuclease Taql and specific DNA probes for a pair of alleles on the X chromosome. The alleles yield fragments of different lengths when digested with Taql (length polymorphism), which can be demonstrated by electrophoresis and hybridization with the radioactive DNA probes. If the pattern obtained with the chorionic DNA is different from that obtained with the maternal DNA, contamination is not present. In two cases the fetal DNA of the chorionic villi was shown to be uncontaminated by maternal tissue. In one of these cases the mother was heterozygous and the fetus was homozygous; in the other the mother was homozygous and the fetus was heterozygous. In three other cases no definitive conclusions could be drawn, because the genotypes of the fetus and mother were identical. We conclude that chorionic villi at 9 to 10 weeks' gestation are a source of fetal DNA that can be used for gene analysis, with no detectable contamination by maternal DNA. PMID- 6855814 TI - Determinants of survival in patients with ventricular tachyarrhythmias. AB - We analyzed data from 239 patients with sustained ventricular tachycardia or ventricular fibrillation to determine prognosis, predictors of survival, and the prognostic value of inducing arrhythmia and assessing therapy at the time of electrophysiologic study. Therapy predicted to be effective on the basis of electrophysiologic study was administered over a sustained period. There were 71 cardiac deaths, including 44 sudden deaths, during a mean (+/- S.D.) follow-up period of 14.8 +/- 13.9 months (range, one day to 67 months). At one, two, and three years, the actuarial incidence of sudden death was 17 +/- 3, 25 +/- 4, and 34 +/- 6 per cent, and that of cardiac death was 28 +/- 3, 37 +/- 4, and 50 +/- 6 per cent. Multivariate regression analyses demonstrated that the two strongest predictors of both sudden death and cardiac death were a higher New York Heart Association functional class (P less than 0.0001 for sudden death and P less than 0.0001 for cardiac death) and the failure of any therapy to be identified as potentially effective on the basis of electrophysiologic study (P = 0.0019 and P = 0.0003). The majority of deaths in patients with ventricular tachyarrhythmias were sudden, but the severity of heart failure was the strongest independent predictor of mortality. Response to therapy during electrophysiologic study was also an independent predictor of survival. PMID- 6855815 TI - The Tromso heart study. Does coffee raise serum cholesterol? AB - We examined the relation between coffee consumption and levels of serum total cholesterol, high-density-lipoprotein (HDL) cholesterol, and triglycerides in a population of 7213 women and 7368 men between the ages of 20 and 54 years. Coffee consumption was positively associated with levels of total cholesterol and triglycerides in both sexes and was inversely associated with levels of HDL cholesterol in women. The coffee-cholesterol relation remained strong and statistically significant (P less than 0.0001 in a covariance analysis) after adjustment for age, logarithm of body-mass index, physical activity in leisure time, cigarette smoking, and alcohol consumption. After adjustment for all covariates, the total cholesterol level was 5.56 +/- 0.05 mmol per liter (mean +/ S.E.) in men drinking less than one cup of coffee a day, as compared with 6.23 +/- 0.03 mmol per liter in those consuming more than nine cups a day. The corresponding figures for women were 5.32 +/- 0.05 and 5.92 +/- 0.04 mmol per liter. None of the other variables considered could explain this relation. We conclude that coffee consumption is a major contributor to the variation in levels of total cholesterol. PMID- 6855816 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 24-1983. A 61-year-old man with a peripheral lung mass. PMID- 6855818 TI - Atypical mycobacteria and Kaposi's sarcoma in the same biopsy specimens. PMID- 6855819 TI - Cigarette smoking and ulcerative colitis. PMID- 6855817 TI - Sounding Board. Does being natural make it good? PMID- 6855820 TI - Human tumor stem-cell assay. PMID- 6855821 TI - Two cases of herpes simplex virus encephalitis in the same family. PMID- 6855822 TI - EKG changes after left pneumonectomy. PMID- 6855823 TI - Blizzard of '83 erythropsia. PMID- 6855824 TI - Current concepts in diagnosis. Approach to the patient with cholestatic jaundice. AB - On the basis of clinical evaluation, the physician should decide whether extrahepatic biliary obstruction is highly unlikely, possible, or very likely. If it is highly unlikely, no further workup for obstruction is indicated unless the clinical picture is altered on follow-up examination. Further evaluation of the biliary tree is warranted in other patients. Ultrasonography is currently the noninvasive imaging technique of first choice. Computed tomography is indicated if ultrasonography has yielded technically inadequate results or in special circumstances when it is anticipated that decisions regarding further diagnostic evaluation or treatment will be importantly influenced by the results. Negative findings obtained in a technically adequate examination may represent a logical stopping point in the workup of patients in whom obstruction is considered merely a possibility to be excluded, but they should not dissuade the clinician from further diagnostic evaluation if obstruction is considered very likely. Indeed, in selected circumstances, such as cases in which choledocholithiasis is suspected after cholecystectomy, direct cholangiography is appropriate as an initial test. If evidence of obstruction is obtained by noninvasive imaging, direct cholangiography will be required in many patients before treatment, and the choice between percutaneous or retrograde cholangiography should be made on an individual basis. The challenge to the clinician is to minimize the risk, expense, and time involved in obtaining sufficient information for a definitive diagnosis and treatment. PMID- 6855826 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 25-1983. A 30-year-old man with hypogonadism. PMID- 6855825 TI - Antepartum diagnosis and management of in utero intestinal volvulus with perforation. PMID- 6855827 TI - Watching the doctor. PMID- 6855828 TI - Ocular chloramphenicol and aplastic anemia. PMID- 6855829 TI - Severe anaphylaxis and drug-induced beta-blockade. PMID- 6855830 TI - Nemaline myopathy presenting as cardiomyopathy. PMID- 6855831 TI - End-stage renal disease in systemic lupus erythematosus. PMID- 6855832 TI - Nosocomial infections. PMID- 6855833 TI - Peritoneal-dialysis-spike elbow. PMID- 6855835 TI - "Obstetrical alert cards" after cesarean section. PMID- 6855836 TI - Caring for other physicians. PMID- 6855834 TI - Periumbilical hemorrhage complicating percutaneous liver biopsy. PMID- 6855837 TI - A word of caution on the implications of the GMENAC report. PMID- 6855838 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 26-1983. A 65-year-old woman with recurrent upper abdominal pain. PMID- 6855839 TI - Improved diabetic control and retinopathy. PMID- 6855840 TI - Caution in the use of drugs in the elderly. PMID- 6855842 TI - Protriptyline for snoring. PMID- 6855841 TI - Influenza vaccination and warfarin or theophylline toxicity in nursing-home residents. PMID- 6855843 TI - Pseudohemoptysis from isoetharine. PMID- 6855844 TI - Saliva on Hemastix produces false-positive results for blood. PMID- 6855845 TI - Thyroid needle aspiration: collecting and handling the specimen. PMID- 6855846 TI - Subclasses of 14q+ marker-positive lymphoid cancer. PMID- 6855847 TI - Litigation bias. PMID- 6855848 TI - The succussion splash as an infant "burp" sign. PMID- 6855849 TI - The teaching nursing home. PMID- 6855850 TI - Social environment and cancer mortality in men. PMID- 6855851 TI - Left ventricular function and rapid release of creatine kinase MB in acute myocardial infarction. Evidence for spontaneous reperfusion. AB - Intracoronary thrombolysis during acute myocardial infarction in human beings is associated with rapid release of creatine kinase and improvement of the cardiac ejection fraction. To examine the phenomenon of spontaneous coronary-artery recanalization, we studied the release of creatine kinase MB and sequential radionuclide ventriculograms in 52 patients with transmural myocardial infarction. Patients were divided into two groups according to whether the release of creatine kinase MB (time from base-line to peak serum level) was rapid (n = 24) or slow (n = 28). Patients with slow release had no significant change in global or regional ejection fraction from the time of admission to discharge. However, global ejection fraction in patients with rapid release improved from 0.38 +/- 0.09 (mean +/- S.D.) to 0.48 +/- 0.08 (P less than 0.001). The regional ejection fraction of Q-wave regions also improved, from 0.33 +/- 0.11 to 0.43 +/- 0.13 (P less than 0.001). A negative correlation (r = -0.52, P less than 0.001) existed between time to peak enzyme level and degree of improvement in ejection fraction. With increasing left ventricular damage, patients with rapid release had greater increments in creatine kinase MB than comparable patients with slow release (P = 0.03), suggesting enzyme washout. These data are consistent with the idea that spontaneous reperfusion, leading to altered enzyme release and improvement in ventricular function, is not uncommon after acute myocardial infarction. PMID- 6855852 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 27-1983. A 25-year-old homosexual man with persistent fever and liver disease. PMID- 6855853 TI - Food fallacies and blood sugar. PMID- 6855854 TI - Is running an analogue of anorexia nervosa? PMID- 6855855 TI - Human milk versus formula in preterm infants. PMID- 6855856 TI - Analgesic abuse and kidney disease. PMID- 6855857 TI - Fetal hydrops and "prune belly" in one identical twin. PMID- 6855858 TI - Still more on radiation hazard of video screens. PMID- 6855859 TI - Noise pollution in the hospital. PMID- 6855860 TI - Carcinogens, drugs, and cytochromes P-450. PMID- 6855862 TI - Whooping cough in the United States and Britain. PMID- 6855861 TI - To breathe or not to breathe--what have we learned about apneic spells and sudden infant death? PMID- 6855863 TI - A new iatrogenous lesion in newborns requiring assisted ventilation. PMID- 6855864 TI - Response to hypoglycemia masked by propranolol. PMID- 6855866 TI - The problems of public psychiatry. PMID- 6855865 TI - Erythrocyte fragmentation in disseminated intravascular coagulation and other diseases. PMID- 6855867 TI - Maternal bonding in early fetal ultrasound examinations. PMID- 6855868 TI - Nursing as metaphor. PMID- 6855869 TI - Leukotriene C4 and D4 in neonates with hypoxemia and pulmonary hypertension. AB - Persistent pulmonary hypertension of the newborn is a syndrome consisting of severe hypoxemia and pulmonary hypertension that appears within hours of birth. Since certain leukotrienes (C4, D4, and E4) are known to produce some of the features of persistent pulmonary hypertension of the newborn, including pulmonary vasoconstriction, bronchoconstriction, decreased lung compliance, and pulmonary edema, we studied five newborns with the syndrome to determine whether these leukotrienes were present in their airways. We found leukotriene C4 and leukotriene D4 in the lung lavage fluids of all five newborns who had the clinical diagnosis of persistent pulmonary hypertension and who required ventilatory assistance. In contrast, leukotrienes were not demonstrated in a control group of 14 infants requiring ventilatory assistance who did not have the clinical diagnosis of persistent pulmonary hypertension. We conclude that leukotrienes may have a role in persistent pulmonary hypertension of the newborn. PMID- 6855870 TI - Postprandial reduction in blood pressure in the elderly. AB - We evaluated the effects of a meal on systolic blood pressure and heart rate in elderly institutionalized subjects (mean age +/- S.E.M., 87 +/- 1) with and without histories of syncope and in young normal subjects. Pulse and blood pressure were measured before the test meal and at intervals for up to 60 minutes afterward. By 35 minutes mean systolic blood pressure had declined a maximum of 25 +/- 5 mm Hg in 10 elderly subjects with syncope and 24 +/- 9 mm Hg in 10 elderly subjects without syncope (P less than 0.03); the level then stabilized without further change until 60 minutes. There were no changes in blood pressure in 11 young subjects or in elderly subjects not given a meal. The postprandial change in systolic pressure was not related to medications or diagnoses. Compensatory cardioacceleration was minimal in the elderly, suggesting impaired baroreflexes. Our observations show that postprandial reductions in blood pressure may predispose the elderly to symptomatic hypotension. PMID- 6855871 TI - Test for chlorpropamide-alcohol flush becomes positive after prolonged chlorpropamide treatment in insulin-dependent and non-insulin-dependent diabetics. PMID- 6855872 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 28-1983. A 35-year-old woman with abdominal pain and a right lower-quadrant mass. PMID- 6855873 TI - Experimental candidiasis in rabbits: protective action of fructose-1,6 diphosphate. PMID- 6855874 TI - Vaccination procedures and the infectivity of dermatophyte lesions. AB - By means of an experimental guinea pig model, the immunogenicities of a live spore vaccine, a killed hyphal cell wall vaccine and a soluble cytoplasmic extract vaccine of Trichophyton mentagrophytes var. erinacei were compared, and their modifying influence on the infectivity and duration of experimental dermatophyte lesions examined. Of the three vaccines, the live-spore one was the most effective and closely simulated the type of immunity which develops following a natural infection. Lesions produced in cell wall vaccinated animals revealed significantly less infectivity and were reduced in duration as compared with lesions in unvaccinated animals. The cytoplasmic extract vaccine had no beneficial effect on the course of experimental infection; indeed it seemed to increase the infectivity of lesions. Acquired resistance to reinfection in a pregnant guinea pig was not passed on to the offspring. Significant levels (titer of greater than or equal to 1:16) of antibody were detected in the sera of all infected and vaccinated animals using an indirect fluorescent antibody technique and germling antigens. Using counterimmunoelectrophoresis, precipitating antibodies were detectable in the sera of all seven animals vaccinated with the cell wall or cytoplasmic extract, in one (20%) of the control animals after reinfection, and none of the four animals injected subcutaneously with the live spore vaccine. Thus no correlation between antibody titer and the severity and duration of lesions was observed. These results endorse the growing hypothesis that cell mediated immunity is of prime importance in protection again dermatophyte invasion and suggests that prophylactic vaccination procedures are worthy of further evaluation in lower animals. PMID- 6855875 TI - Gasophthalmus in black sea bream (Spondyliosoma cantharus) caused by Sarcinomyces crustaceus Lindner. PMID- 6855877 TI - Studies on the composition, quality and processing of triticale. Part I. Physico chemical characteristics. AB - Studies on the physico-chemical characteristics of 14 promising strains of triticale and two check wheat varieties (Kalyansona and WL 711) grown under similar agronomic conditions were conducted. Significant differences were obtained for 1000 kernel weight ranging from 34.9 to 51.8 g, hectolitre weight ranging from 64.7 to 73.5 kg and pearling index depicting grain hardness varying significantly from 22.3 to 39.9%. Higher contents of protein (13.1%), ash (1.83%), lipids (2.65%), crude fibre (2.37%), energy value (1486 KJ/100 g), diastatic activity (283 mg maltose/10 g flour), reducing sugars (65.6 mg maltose/10 g) and non-reducing sugars (244 mg maltose/10 g) were observed in triticale than those in wheat. Low values of PELSHENKE and sedimentation tests indicated poor gluten quality in triticale. PMID- 6855876 TI - Morphology of experimental actinomycotic abscess in mice with Dermatophilus-like microorganisms from porcine tonsil. AB - Experimental infection in mice with Dermatophilus (D.) congolensis-like microorganisms was carried out, intraperitoneally and subcutaneously. This strain had been isolated from porcine tonsil and reported to be different in some morphological and biological points from D. congolensis. Macroscopic examination revealed multiple abscesses in the peritoneal cavities, or subcutaneous abscesses after the intraperitoneal or subcutaneous injection respectively. Histopathologic examination revealed the characteristic arrangement of the neutrophils surrounding the bacterial colony and peripheral macrophages in the abscess lesions. The lesions contained many microorganisms which showed wide range of the characteristic morphologic variation such as: mycelial elements, coccoid elements and large coccoid elements with transverse or longitudinal septa. Chlamydospore like elements were sometimes found in the microcolonies in early lesions. The morphology of the lesions and the microorganisms was compared with those of other bacteria including D. congolensis. PMID- 6855878 TI - Studies on the composition, quality and processing of triticale. Part II. Mineral composition of grain and flour. AB - Mineral composition of grain and flour in 14 promising triticale strains from India are reported. The mean values for whole grain, i.e. Ca (0.47 mg/g), P (2.70 mg/g), K 4.60 mg/g, Na (352 micrograms/g), Zn (41.6 micrograms/g), Cu (7.0 micrograms/g), Fe (73.4 micrograms/g) and Mn (33.6 micrograms/g) were obtained as compared to those of flour, i.e. Ca (0.27 mg/g), P (0.97 mg/g), K (1.64 mg/g), Na (231 micrograms/g), Zn (26 micrograms/g), Cu (4.0 micrograms/g) and Mn (10.5 micrograms/g), respectively. These values were found to be considerably higher than those of wheat. Highly significant positive correlations of ash with sodium and zinc in whole grain were observed. In the case of triticale flour, highly significant positive correlations of ash with manganese, phosphorus and potassium were obtained. PMID- 6855879 TI - Evaluation of nutrient value and a classification of food products of animal origin in accordance with reconsidered water/protein ratio. AB - Water/protein ratio, criterion of evaluation of comparative nutrive value of meat products, fully used at present in some European countries, does not take into account the nutritive value of protein from the structure. This work presents a reconsideration of the evaluation of food proteinogenic value, on the basis of numerous analytical data from collagen dosing and setting of collagen/protein ratio as well as from biological tests on laboratory animals, thus correcting the amount of total protein and, implicitly, water/protein ratio. Tables of these products structure and classification in accordance with water/protein ratio are given. PMID- 6855880 TI - Nitrate and nitrite contents in Cuban cheese of the Gouda type. AB - The nitrate and nitrite contents in cheese of the Gouda type, produced by the Milk Complex of Havanna, were investigated and compared with those found in 5 types of imported cheese consumed in Cuba. No significant differences were found in the mean value (mean) of NaNO3, whereas in the mean value (mean) of NaNO2 differences were found when comparing all cheeses against each other. From these results it is inferred that the consumption of Gouda type cheese does not represent an important contribution to the daily intake of nitrates and nitrites, precursors in the synthesis of cancerogenic N-nitroso compounds. PMID- 6855881 TI - [Contamination of food and feeds from selected areas of the Erfurt district with lead and cadmium. 3. Burden in commercial agricultural stock animals in area of a lead emmitter as compared to a control area]. PMID- 6855882 TI - Enhancer elements in immunoglobulin genes. PMID- 6855883 TI - Chromosomal abnormalities in human embryos. PMID- 6855884 TI - Complex proteins coordinate simple behaviour. PMID- 6855885 TI - Chromosome abnormalities in human embryos after in vitro fertilization. AB - In vitro fertilization and embryo transfer is now an established treatment for certain forms of human infertility. High success rates have been reported following oocyte recovery and fertilization in vitro, the only major remaining difficulty being the high failure rate (80%) of implantation after replacement of the embryo into the mother. One possible reason for this failure of implantation is that some embryos may carry a lethal chromosome abnormality which does not allow development beyond the preimplantation stage. The need for information on the chromosomal status of early embryos fertilized and developed in vitro is recognized but two reported attempts to examine them have met with technical problems. Here we describe a method for examining chromosomes in 8-cell human embryos. Although we have made complete chromosome analyses for only three oocytes, our findings are surprising in that two of the three embryos were chromosomally abnormal. Data on the DNA content of the nuclei in a further eight cases showed that approximately 20% overall may be haploid. PMID- 6855886 TI - Sex reversal in XY mice caused by dominant mutation on chromosome 17. AB - A Y-linked gene(s) is undoubtedly a prerequisite for testicular development in mammals. However, exceptional cases suggest that the mere presence of the Y chromosome or the Y-linked testis-determining gene does not totally control the fate of the bipotential gonad. For example, in the mouse, a major as yet unmapped autosomal locus is necessary for normal testicular development and at least one additional autosomal locus is implicated. We present here a third autosomal sex determining locus. This dominantly inherited trait, tentatively named T associated sex reversal (gene symbol Tas), is closely linked to or a part of the T/t complex on chromosome 17 of the mouse. Gonads of chromosomally XY individuals who inherit Tas on the C57BL/6J inbred strain background differentiate as ovaries or ovotestes. PMID- 6855887 TI - Strong homology in promoter and 3'-untranslated regions of chick and rat alpha actin genes. AB - We report here a comparison of the nucleotide sequences of the chick and rat skeletal muscle alpha-actin genes which reveals strongly conserved blocks of sequence in the putative transcriptional promoter and 3'-untranslated regions. This is the first instance of strong sequence conservation in untranslated gene regions between birds and mammals, other than the CAAT and ATA promoter homologies and the putative poly(A) addition signal, AATAAA. The strong conservation of these sequences suggests that they may have a role in the tissue specific expression of the skeletal muscle alpha-actin gene. PMID- 6855888 TI - AIDS. More money promised. PMID- 6855889 TI - Scientific fraud. The system defends itself. PMID- 6855890 TI - AIDS not a "social disease". PMID- 6855891 TI - Lessons from mutant globins. PMID- 6855892 TI - Bacteria that grow at 250 degrees C. PMID- 6855893 TI - Environmental Protection Agency: pesticide approval challenged. PMID- 6855894 TI - Culture collectors. PMID- 6855895 TI - Data banking. PMID- 6855896 TI - Chromosome aberrations and oncogenes. PMID- 6855897 TI - ABO genes are differentially distributed in socio-economic groups in England. AB - No direct evidence is available concerning what average genetic differences, if any, characterize the segments of socially stratified human populations, although theoretical considerations suggest that genetic differentiation within such populations is to be expected. We have now analysed two large samples of data from blood donors in England to test whether the distributions of the ABO and Rhesus blood group phenotypes are random with respect to socio-economic groups as determined by occupational classification. We have found that in both native and migrant sections of the populations of two widely separated regions (south-west England and part of Yorkshire) and in both sexes, the A phenotype is highly significantly more, and the O phenotype significantly less, frequent than expected in social classes I and II, while the converse is seen in social classes III-V. An individual of the A phenotype has thus about 15% greater probability than chance would dictate of being placed in classes I and II. The distribution of the Rh+ and Rh- phenotypes does not differ significantly between classes. It seems unlikely that this nonrandom distribution of the ABO phenotypes among socio economic groups results from sampling, historical or migrational effects and we conclude that the observed association is likely to result from pleiotropic effects of the ABO alleles (or genes closely linked to them) on attributes influencing occupational type, social mobility and social class. PMID- 6855898 TI - 100 Hz remains upper limit of synchronous muscle contraction--an anomaly resolved. AB - Wootton and Newman introduced a problem when they showed, by high-speed cinematography, that a minute hemipteran insect, the whitefly Trialeurodes vaporariorum, achieves a wing-beat frequency of up to 181 Hz. 100 Hz had been regarded as the upper limit of contraction by myoneural synchrony, and whitefly flight muscle had been placed in the 'synchronous' category on structural grounds. The problem is resolved by evidence presented here, which reclassifies the power-producing flight muscles of whiteflies as 'asynchronous'. PMID- 6855899 TI - Who says what drugs to license? PMID- 6855900 TI - Cuts "disastrous" for Canada's MRC. PMID- 6855901 TI - NIH budget: political control a high price to pay for funds? PMID- 6855902 TI - Data falsification: innocents and culprits. PMID- 6855903 TI - Polish pollution: changes may come at last. PMID- 6855904 TI - Neurophysiology: anatomical logic of retinal nerve cells. PMID- 6855905 TI - Acquired immune deficiency syndrome. AIDS: the widening gyre. PMID- 6855906 TI - Colour-generating interactions across the corpus callosum. AB - Human vision has the remarkable property that, over a wide range, changes in the wavelength composition of the source light illuminating a scene result in very little change in the colour of any of the objects. This colour constancy can be explained by the retinex theory, which predicts the colour of a point on any object from a computed relationship between the radiation from that point and the radiation from all the other points in the field of view (Fig. 1). Thus the computations for colour perception occur across large distances in the visual field. It has not been clear, however, whether these long-range interactions take place in the retina or the cortex. Reports that long-range colour interactions can be reproduced binocularly when one band of wavelengths enters one eye and a different band enters the other might seem to establish the cortex as the site of the computation. Many observers, however, see very unsatisfactory colour or no colour at all in this binocular situation, suggesting that the cortex may not be the only site at which the computation is carried out, or even the most important site. We have now tested the role of the cortex in a human subject in whom the nerve fibres connecting cortical areas subserving two separate parts of the visual field had been severed, and find that the cortex is necessary for long range colour computations. PMID- 6855907 TI - Effect of haematopoietic cell growth factor on intracellular ATP levels. AB - Growth and development of haematopoietic cells in vitro require the presence of specific regulatory molecules. Some of these molecular species appear to have a broad specificity, being able to promote the proliferation and differentiation of multipotential cells, as well as megakaryocytic, erythroid and granulocytic progenitor cells. Such factors are present in medium conditioned by the growth of lectin-stimulated mouse spleen cells or WEHI-3 myelomonocytic leukaemia cells (WEHI-CM). Using WEHI-CM, we and other have been able to obtain permanently growing, non-leukaemic cell lines of a granulocytic or mast cell nature. Significantly, we have found that the factor in WEHI-CM necessary for the growth of these cells has co-purified with the multi-lineage stimulating activity present in WEHI-CM, suggesting that one molecule may be concerned in the development of multiple cell types. We have now used these cells to investigate the mode of action of this haematopoietic cell growth factor and have found that the requirement of this factor for survival and growth may lie in its ability to modulate ATP levels within the cells. PMID- 6855908 TI - Interaction between the Xce locus and imprinting of the paternal X chromosome in mouse yolk-sac endoderm. AB - In female eutherian mammals preferential inactivation of the paternally derived X chromosome (XP) takes place in certain extra-embryonic tissues such as mouse yolk sac endoderm, chorionic ectoderm and trophoblast and has been demonstrated both biochemically and cytologically. This is thought to be due to the paternal X chromosome being 'imprinted', that is, somehow marked as different, during either male gametogenesis or fertilization, causing primary nonrandom X-inactivation in tissues that differentiate early, such as trophectoderm and primitive endoderm, from which yolk-sac endoderm is derived. Different alleles of the X-chromosome controlling element, Xce locus, centrally located on the mouse X chromosome, also cause primary nonrandom X-chromosome inactivation in embryonic tissues which would otherwise show random inactivation. The work reported here was designed to elucidate whether the nonrandom inactivation of the imprinted XP in yolk-sac endoderm could be modified, or even overridden, by the effect of different Xce alleles. Using the modified Kanda method we have therefore studied the proportion of cells at metaphase with the XP inactive in separated yolk-sac endoderm and mesoderm of mouse embryos heterozygous for a marker X chromosome (Cattanach's translocation) carrying different Xce alleles on XP and XM. The results show that the extreme Xcec allele, when present on the paternally derived X, can significantly reduce the proportion of inactive XP seen in yolk-sac endoderm compared with controls. This is the first evidence that imprinting of XP is not an 'all or none' event but can be modified by a 'strong' allele at the Xce locus, and is another indication that the Xce locus may represent the inactivation centre. PMID- 6855909 TI - Failure of filipin to detect cholesterol-rich domains in smooth muscle plasma membrane. AB - Using the cholesterol probe filipin and freeze-fracture electron microscopy, Montesano reported an apparent difference in cholesterol content between contiguous zones of the smooth muscle plasma membrane. In this membrane, microinvaginations termed caveolae are organized in band-like domains, which were highly sensitive to filipin (and therefore cholesterol-rich) compared with the surrounding non-caveolar inter-band regions (assumed to be cholesterol-poor). Using another cholesterol probe, the saponin tomatin, applied alone and after filipin treatment, we now present evidence that both the band and inter-band domains of the smooth muscle plasma membrane are cholesterol-rich. This leads to the conclusion that the lack of inter-band response to filipin is a false negative cytochemical result. PMID- 6855910 TI - Chemical weaponry: thumbs-down for binary weapons from US Congress. PMID- 6855911 TI - Cancer causation in booklet form. PMID- 6855912 TI - A weighty issue. PMID- 6855913 TI - An embarrassment of peptides. PMID- 6855914 TI - Testing for carcinogenicity and the problem of pseudocarcinogenicity. PMID- 6855915 TI - Parallel versus serial processing in rapid pattern discrimination. AB - When stimuli are available for just a brief period (approximately 100 ms) only restricted spatial information can be processed by the visual system. If the stimuli are presented very briefly, eye movements are not possible. The time during which the after-image of the stimulus is available for inspection is terminated by presentation of a masking pattern. We show here that in these conditions a small pattern is easily detected against a background made up of many others, only if this target pattern differs from the background patterns in certain local features. In this case the detectability of the target is almost independent of the number of background elements, suggesting that a parallel process is operating. Detection of patterns not differing from their backgrounds in such features requires focal attention which is a serial process. The aperture of this attention is scaled to minimize the number of shifts of attention required. PMID- 6855916 TI - Factors underlying falcon grating acuity. PMID- 6855917 TI - [Dynamics of protein structures]. AB - This review presents a survey of experimental and theoretical methods capable of providing a many-parameter characterization of internal mobility of protein molecules. Special emphasis is on applications of high-resolution nuclear magnetic resonance for studies of non-crystalline proteins and discussions of possible correlations between protein dynamics and biological functions of proteins. PMID- 6855919 TI - Early receptor potential of pineal organ and lateral eye of the pike. PMID- 6855920 TI - Living with nuclear energy. PMID- 6855918 TI - [Biosynthesis of phenylalanine and tyrosine: arogenic acid, a new intermediate product]. AB - With the discovery of arogenic acid two new pathways for the biosynthesis of phenylalanine and tyrosine have been revealed. The occurrence of two, three, or four pathways for the biosynthesis of phenylalanine and tyrosine in microorganisms and plants may be a useful tool for taxonomic classifications. Investigations on enterobacteriaceae, pseudomonads, flavobacteria, streptomycetes, archaebacteria, and on Sphaerotilus, Trichococcus and Leptothrix species from bulking sludge are described. The possible role of arogenate in the evolution of the pathways for tyrosine and phenylalanine biosynthesis is discussed. PMID- 6855921 TI - [Motor intention potential. Electrophysiologic objectization of a single intended movement]. AB - Autocorrelation of the EEG was used to registrate a potential from the intact human scalp during intended, but not executed movements (dorsalflexion of the right hallux, imaginated in equal time intervals). This "Motor Intention Potential" (MIP) is a possible electrophysiological sign of the otherwise purely introspectively experienced intention of a voluntary movement and the cortex of the frontal lobes is suspected to be its origin. The average maximum amplitude height is 6 microV, and the potential shows a continuous decrease from the frontal to occipital region. The duration of MIP is in the range of seconds. Methodological questions are discussed, and the MIP is differentiated from other event-, movement- and imagination-related potentials. An attempt is made to place the motor intention potential in the context of existing movement theories. PMID- 6855924 TI - Myogenic electric organ precedes the neurogenic organ in apteronotid fish. PMID- 6855923 TI - Enhanced elimination of 64Cu in rats by cyclen, a macrocyclic polyamine. PMID- 6855925 TI - Deutsche Pharmakologische Gesellschaft, Deutsche Physiologische Gesellschaft: Abstracts. Joint spring meeting, March 14-18, 1983, Mainz. PMID- 6855922 TI - [New chromatography. Technics for the isolation and separation of natural products]. AB - Besides high-performance liquid chromatography (HPLC) which is now a well established and currently used technique, several emerging methods for the isolation and separation of natural products are receiving considerable attention. Centrifugal thin-layer chromatography is a very rapid technique, but limited in resolution. Of special interest are the recently developed support free liquid-liquid chromatography methods such as droplet counter-current chromatography (DCCC) and rotation locular counter-current chromatography (RLCC). This latter method was applied to the separation of the enantiomers of (+/-) norephedrine. PMID- 6855926 TI - [Hyperthyroidism due to indolent thyroiditis (atypical, silent, subacute thyroiditis)]. PMID- 6855927 TI - [Surgical correction of tetralogy of Fallot; long-term results]. PMID- 6855929 TI - [Hair analysis to determine the levels of trace elements in the human body?]. PMID- 6855928 TI - [Severe infections caused by Streptococcus milleri]. PMID- 6855930 TI - [Postnatal depression]. PMID- 6855931 TI - [Tachycardia originating from an abnormal right ventricle]. PMID- 6855932 TI - [Bronchoalveolar lavage, a new study method. I. Findings in healthy volunteers]. PMID- 6855934 TI - [Activated charcoal--"black magic"]. PMID- 6855933 TI - [A patient with oligomenorrhea and short stature]. PMID- 6855935 TI - [No further use of desiccated thyroid gland]. PMID- 6855936 TI - [Esophageal damage caused by pinaverium bromide]. PMID- 6855937 TI - [Another case of Q fever]. PMID- 6855938 TI - [The physician and society. Drug diplomacy]. PMID- 6855939 TI - [Indications for computerized tomography of the thorax]. PMID- 6855940 TI - [Impedance plethysmography in general practice for the diagnosis of deep venous thrombosis of the leg]. PMID- 6855941 TI - [Bronchoalveolar lavage, a new method of examination. II. Findings in patients with sarcoidosis]. PMID- 6855942 TI - [Tinkering with education]. PMID- 6855943 TI - [Clinical judgment, can it be taught?]. PMID- 6855944 TI - [Disinfection of fiber endoscopic equipment]. PMID- 6855945 TI - [Eye disorders in leprosy]. PMID- 6855946 TI - [Reticular erythematous mucinosis]. PMID- 6855947 TI - [Ergometrin poisoning in newborn infants]. PMID- 6855948 TI - [Uncertainty about the importance of significant differences]. PMID- 6855949 TI - [Clinical teaching on the block]. PMID- 6855950 TI - [Possibly declining incidence of acute myocardial infarct]. PMID- 6855951 TI - [So many heads, so many minds?]. PMID- 6855952 TI - [Infraclavicular exploration as a prognostic criterion and as a selection criterion for choice of treatment in breast cancer]. PMID- 6855953 TI - [Infraclavicular lymph node biopsy in the treatment of breast cancer]. PMID- 6855954 TI - [Infraclavicular lymph node metastasis in patients with clinically operable breast carcinoma; biopsy technic, incidence, correlation with clinical tumor characteristics]. PMID- 6855955 TI - [10 years of infraclavicular biopsy in breast cancer]. PMID- 6855956 TI - [The infraclavicular biopsy in operable breast cancer]. PMID- 6855957 TI - [Lymphomatoid papulosis]. PMID- 6855958 TI - [Medical assistance in suicide]. PMID- 6855959 TI - [Analgesic nephropathy]. PMID- 6855960 TI - [Various aspects of medical education]. PMID- 6855961 TI - [Anorectal Chlamydia infections in homosexual men; clinical and differential diagnosis aspects]. PMID- 6855962 TI - [Alcohol and drugs: reasons for restraint]. PMID- 6855963 TI - [Patients hospitalized for the adverse effects of the combined use of alcohol and certain drugs]. PMID- 6855964 TI - [Clinical judgement: practice makes perfect]. PMID- 6855965 TI - [Acquired immunodeficiency syndrome in the Netherlands]. PMID- 6855967 TI - [Regular self-catheterization]. PMID- 6855966 TI - [Documentation. I: Expertise and responsibility]. PMID- 6855969 TI - [A patient with liver abscesses caused by Yersinia enterocolitica infection]. PMID- 6855968 TI - [Long-term application of the percutaneous, suprapubic bladder catheter]. PMID- 6855971 TI - [A patient with a septic syndrome]. PMID- 6855972 TI - [80 internists per year for the 80s]. PMID- 6855973 TI - [Neurons and neuronal associations in the frontal cortex in the monkey]. AB - The Golgi and Golgi-Kopsh methods show that pyramidal cells in layers II-IV of the prefrontal cortex in Macaca rhesus have numerous, mainly recurrent, collaterals of axons which realize vertical connections. Three groups of stellate basket cells which have different axon collateral directions were identified. They unite the pyramidal cells both in horizontal (modules) and vertical (micromodules) directions. Arrangements of 14-16 pyramidal neurons which form dendritic bundles were found. Local neuronal groups with U-shape axons were observed near the bundles. PMID- 6855974 TI - [Activity of central neurons of the electroreceptor system of Glyptosternum reticulatum]. AB - Acute experiments with extracellular recording of pulse activity from neurons of lateral lobes of the Turkestan catfish Glyptosternum reticulatum revealed tonic and phasic neurons. Tonic neurons as compared to phasic ones were more sensitive to a potential gradient in water and has spontaneous activity. Phasic neurons had no spontaneous activity, their responses did not depend on the intensity and duration of electric stimuli. The functional significance of the phasic neurons remains so far unclear. PMID- 6855975 TI - [Vestibular projections to the temporal cortex in the cat]. AB - The exact borders of vestibular nerve projections in the temporal cortex of cat were investigated under chloralose-nembutal and chloralose anesthetics. The caudal border of the vestibular area coincided with the anterior ectosylvian gyrus. The focus of evoked potentials was located in the anterior suprasylvian sulcus or 1-2 mm rostrally. Short-latency potentials recorded in the temporal region caudally to the indicate border were due to current propagation and excitation of the cochlear structures. According to the data obtained the second vestibular area in the temporal cortex is absent. Vestibular projections are mostly contralateral (latency 5.2 +/- 0.7 ms). Ipsilateral responses have longer latency (8.4 +/- 1.3 ms) and their amplitude depends on the type of anesthetic. It is suggested that the ipsilateral vestibulocortical pathway includes one or more additional synaptic junctions. PMID- 6855970 TI - [Incontinence in the elderly]. PMID- 6855976 TI - [Shifts in the steady potential and intracellular concentration of potassium in the cerebral cortex in response to prolonged low-frequency electrical stimulation of the surface of the cortex in the rat]. AB - Cyclic discharges occurring during prolonged low-frequency electric stimulation of the cortical surface were studied in the rat neocortex by means of K+ selective microelectrodes. Duration of excitation cycles and intervals between them depended on the parameters of stimulation. Surface potential shift reached 4 5 mV and [K+]0 increased to 8-10 mM. The cyclic excitation process was not self sustained and stopped just after the current was switched off. Small doses of nembutal (10-20 mg/kg) increased both the threshold for the cyclic process onset and duration of the intervals between the active phases. Higher nembutal doses (30-40 mg/kg) abolished cyclic excitation for 2-3 hours. This model of cyclic discharges is supposed to be useful for investigation of the mechanism of seizure activity and of the effect of antiepileptic drugs. PMID- 6855977 TI - [Study of the receptor mechanisms of the electroreceptors of ampullae of Lorenzini in the skate]. AB - Responses of the sensory epithelium of the electrically insulated Lorenzinian ampullae in the Black Sea skates (Raja clavata) as well as their spike frequency reactions to electrical stimulation were studied under the current-clamp conditions. The preparations have the input resistance of 200-800 k omega, the transepithelial resting potential of 0 divided by -2 mV and ordinary impulse activity in afferent fibres. Electroreceptor thresholds were of 2-10 microV (current approximately 10-11 A). With adequate parameters of stimulation (current up to 1 nA, voltage drop across the epithelium to +/-500 microV) the current voltage relation of the epithelium was linear without any signs of both spike and oscillatory activity of the receptor cells. With negative currents more than 1-10 nA there appeared a regenerative spike in the epithelium. The spike was accompanied by abnormal impulse in an afferent fibre. PMID- 6855978 TI - [Localization of temperature-sensitive and non-temperature-sensitive cutaneous receptors in the forelimb of the cat]. AB - 87 afferent fibres in dorsal roots of lower cervical and upper thoracal segments of the spinal cord and their responses to thermal and mechanical stimulation of skin receptors were studied in adult cats. Higher conduction velocities and larger fibre diameters were found for receptors located more distally in the forepaw skin. The location of the receptive fields of thermosensitive and nonthermosensitive units is different. PMID- 6855979 TI - [Responses of neurons in the sensomotor cortex of the cat to auditory stimuli of different duration before and after elaboration of a conditioned reflex]. AB - Evoked activity of cells in the sensomotor cortex to sounds of various duration (0.001, 0.1, 1 s) before and after conditioning was studied in experiments with cats. The highest percentage of evoked responses, intensity and duration of neuronal reactions were observed during the long sound stimulation (1 s). A conclusion is made that the long sound was most effective for conditioning. PMID- 6855980 TI - [Changes in the concentration of extracellular potassium and the slow negative potential in the somatosensory area of the cortex in response to stimulation of the ventroposterolateral nucleus of the thalamus in the cat]. AB - A single electrical stimulus applied to the VPL nucleus with intensity, strong enough to elicit in gyrus sigmoideus posterior slow negativity following the primary response, caused a local increase in [K+]0 reaching 0.2 mM. On the basis of this finding it is supposed that the slow negativity reflects mainly depolarization. PMID- 6855981 TI - [Changes in the concentration of intracellular potassium and the phenomenon of dendritic potential depression against a slow negative potential background in the cat cerebral cortex]. AB - Two stimulating electrodes (S1 and S2), a recording macroelectrode and a K+ selective microelectrode were placed on g. suprasylvius of cat. A stimulus applied through S1 elicited slow negativity and an increase in [K+]0. At this time the dendritic potential evoked by stimulation through S was depressed. The depression of the dendritic potential was found to correlate with [K+]0. PMID- 6855982 TI - [Excitation of different terminal arborizations of an individual axon of a transcallosal neuron in the brain of a rabbit]. AB - Antidromic responses to electrical stimulation of symmetrical area of the contralateral cortex served for identification of sensorimotor and visual callosal units in the unanesthetized rabbits. 15 out of 160 callosal neurons showed to antidromic responses with alternative, discrete and stable latencies. This is considered to be a result of independent excitation of two loci in distal parts of the neuronal axon. PMID- 6855983 TI - [Plasma exchange treatment in neurologic diseases]. PMID- 6855984 TI - [Significance of diagnostic devices in the etiological classification of dementia processes]. PMID- 6855985 TI - [Intracerebral hemorrhage]. PMID- 6855986 TI - [Cerebral ventricle meningiomas. Case report on the clinical aspects and neuroradiology]. PMID- 6855987 TI - [Neurologic disorders and computer tomographic findings in retroperitoneal processes in the area of the iliopsoas muscle]. PMID- 6855988 TI - [Congenital lesions of the facial nerves and mimetic muscles]. PMID- 6855989 TI - [Glossopharyngeal neuralgia with syncope attacks in the foramen jugulare syndrome]. PMID- 6855990 TI - Clinical features of type III hyperlipoproteinaemia. PMID- 6855991 TI - A vaccine to eliminate hepatitis B? PMID- 6855992 TI - Immune response after vaccination with two hepatitis B vaccines differing in antigenic composition. PMID- 6855994 TI - Effect of dialysate temperature on peritoneal clearances. AB - Peritoneal dialysis was performed in 18 uremic patients using both room temperature (27-31 degrees C) and prewarmed (37 degrees C) dialysate. There were no significant differences between the two periods of the following parameters: urea clearance, creatinine clearance, inulin clearance, ratio of inulin to urea clearance, ratio of inulin to creatinine clearance, drainage volume, dialysate flow rate, ultrafiltration rate and total protein loss. Since the peritoneal dialysis efficiency was not improved by warming dialysate in this range of temperature, the warming procedure is not necessary in the countries where the average room temperature is 29 degrees C (27-31 degrees C). The exclusion of this procedure will decrease the work load and lessen the chance of dialysate contamination. PMID- 6855993 TI - Tamoxifen and prolactin secretion in postmenopausal women with advanced breast cancer. PMID- 6855995 TI - The thickness of the glomerular basement membrane in congenital nephrotic syndrome of the Finnish type. AB - Electron microscopic examination was carried out on 10 glomeruli from 4 infants with congenital nephrotic syndrome of the Finnish type (CNF) and 5 glomeruli from 1 control. The thickness of the peripheral glomerular basement membrane (GBM) and lamina densa were measured. The width of the GBM was thinner in CNF than in the control but still within normal limits for the age and the width of the lamina densa was thinner in CNF compared to the control. This study supports earlier findings that the basic defect in CNF could be a faulty synthesis of the lamina densa. PMID- 6855996 TI - Familial nephropathy with hyperuricemia and gout. AB - Chronic interstitial nephropathy with disproportionate hyperuricemia (serum uric acid 10.5-14.8 mg/dl [625-880 mumol/l] at a GFR of 40 ml/min/1.73 m2) was observed in 2 girls and their mother who suffered from gout since the age of 20 years. Urinary excretion of uric acid was normal. Renal biopsies in the 3 patients showed focal tubulointerstitial nephropathy. Absolute values of GFR remained stable in the 2 pediatric patients over a period of 10 years, whereas the older patient required dialysis at the age of 34 years. We speculate that this family suffers from a primary interstitial nephropathy which is accompanied by a subtle defect in tubular excretion of urate. A few similar observations have been reported in literature which suggests that dominantly inherited interstitial nephropathy with hyperuricemia and gout represents a distinct entity. PMID- 6855997 TI - Successful pregnancy following haemodialysis and pyeloplasty. AB - A successful pregnancy in a patient who presented with renal failure secondary to pelvi-ureteric obstruction is described. Haemodialysis was instituted during the pregnancy. An Anderson-Hynes pyeloplasty was performed, probably preventing deterioration of remaining renal function. Metabolic acidosis was managed using additional bicarbonate in the dialysate. An active, multidisciplinary approach is recommended in the management of such patients. PMID- 6855998 TI - Furosemide induced natriuresis in advanced renal failure. PMID- 6855999 TI - Viruses and glomerulonephritis. PMID- 6856000 TI - Caffeine and social investigation in the adult male rat. AB - In three experiments with adult rats, caffeine (0, 10, 20, 40 mg/kg) was found to increase the social investigation of a novel juvenile conspecific. Activity was elevated only after caffeine injections, whereas the duration of social investigation was raised after both the injection of caffeine and the administration of caffeine via the drinking water, suggesting the mechanisms of action of caffeine on these two behaviors may be independent. Duration and frequency of investigation were each increased following caffeine exposure, but the amount of investigation/episode was not influenced by this substance. Finally, the acute response to caffeine was not altered by prior exposure to the methylxanthine in the subject's drinking water. PMID- 6856001 TI - Caffeine: effects on the behaviors of juvenile rats. AB - Caffeine, a central nervous system stimulant, was found to alter the expression of 3 behaviors in the juvenile rat. After caffeine administration, locomotor activity was increased in rats of all ages studied (24-84 days old). Pinning, a behavior characteristic of the juvenile period and used as an index of play fighting, was suppressed following caffeine exposure, but only in rats 24-54 days old. Social investigation was not affected by caffeine in 24- and 34-day-old rats. However, in animals 44-84 days of age caffeine increased both the frequency and duration of investigation of a novel juvenile. Although caffeine influenced all the behaviors we observed, the developmental time course of caffeine's effects was different for each behavior. PMID- 6856003 TI - Permanent hippocampal mossy fiber hyperdevelopment following prenatal ethanol exposure. AB - Prenatal exposure to a liquid diet containing 35 percent ethanol derived calories during days 1-21 of gestation resulted in significant alterations in the topographical organization of the zinc-rich mossy fiber system of the rat hippocampus. Using the Timm's sulfide silver histochemical method, permanent alterations were found in the position of the mossy fiber terminal field. Aberrant distal infrapyramidal mossy fiber terminal staining occurred at midtemporal hippocampal levels in ethanol-exposed rats but not in the normal or pair-fed controls; the distribution of distal infrapyramidal mossy fibers in pair fed rats was even more restricted than in normal rats suggesting that the aberrant mossy fiber topography was the result of the ethanol exposure rather than undernutrition. The abnormal terminal field was found in ethanol-exposed rats up to nine months of age (the oldest animals tested). The results indicate that ethanol exposure in utero, during a period of brain development roughly equivalent to the first and second human trimesters, can produce permanent developmental alterations in brain circuitry. PMID- 6856002 TI - Effects of chronic alcohol exposure on offspring activity in rats. AB - The purpose of the present study was to investigate the postnatal effects of long term chronic exposure to ethanol in a treatment that has been shown to alter fetal viability and protein synthesis. Two groups of dams were included. One group (n = 7) received alcohol (6% w/v) in a liquid diet (Bio-Serve) prior to mating as well as throughout pregnancy. Another group consumed the same volume of the diet (isocalorically-matched, maltose-dextrines substituted for the alcohol) for the same time period. The ethanol treatment significantly reduced offspring body weights and increased offspring mortality. At adulthood, the treated offspring ambulated more than the non-treated offspring in an open field and made a higher number of entrances into a shocked area between trials on the first day of testing in an active-avoidance Y-maze task. These behavioral results are consistent with findings of increased open field activity and impaired ability to inhibit responding reported by other investigators in rats after prenatal alcohol administration. PMID- 6856004 TI - Altered behavioral response to apomorphine in cadmium exposed rats. AB - The present study investigated the hypothesis that changes in dopamine system functioning mediates cadmium induced hyperactivity. Two groups of twenty male Sprague-Dawley rat pups were treated with either 0.25 mg/kg of CdCl2 in saline or the saline vehicle only for ten consecutive days beginning on the fifth day of life. Beginning at 50 days of age, locomotor activity was recorded following each of three different doses of apomorphine HCl in saline or the saline vehicle only. Results indicated a significant cadmium by dose of apomorphine interaction when groups were first divided into high and low activity groups on the basis of baseline activity scores. These results are interpreted as indicating the existence of dopamine system supersensitivity in cadmium exposed animals. However, differences between treatment groups in baseline activity levels were not observed thus the relationship between alterations in DA system-functioning and Cd-induced hyperactivity could not be confirmed. In addition, a significant decrease in the body weights of Cd treated animals appeared approximately two weeks after the cessation of treatment and persisted through the testing period. Alternate hypothesis which might explain the observed behavioral differences are discussed. PMID- 6856005 TI - Reduced social dominance in rats perinatally exposed to methadone. AB - Offspring of female rats injected daily with dl-methadone hydrochloride (5 mg/kg, IP) or saline were cross-fostered at birth to form drug groups exposed throughout gestation only, or both gestation and lactation; controls were exposed only to saline. At approximately 80 days, 120 offspring (20 from each drug group and 60 controls, sexes equally represented) were adapted to a 23-hr water deprivation schedule and individually trained to obtain water in a test cage containing a single water spout. Each methadone-exposed rat then competed with a control animal for access to the water during two 5-min sessions. Under competitive conditions, methadone-exposed rats spent less time at the water spout than did the controls (p less than 0.02); this effect occurred in males and females from all three drug group, and was unrelated to body weight. These results suggest that social dominance may be reduced in the offspring of mother rats given methadone. PMID- 6856006 TI - Taste aversions to several halogenated hydrocarbons. AB - Five halogenated hydrocarbons (chloral; trichloroethylene; 1,2-dichloroethylene; 1,2-dichloroethane and 1,1,2-trichloroethane) were evaluated in the taste aversion paradigm to determine thresholds for producing aversion effects. Comparisons were made between threshold determination for acute and repetitive conditioning trials. All of the compounds produced saccharin aversions following one pairing of the chemical exposure with saccharin ingestion. Repetitive conditioning trials did not alter the thresholds for producing aversions with any of the five compounds evaluated. Potencies of the compounds in producing conditioned taste aversions were chloral greater than 1,1,2-trichloroethane greater than 1,2-dichloroethane greater than 1,2-dichloroethylene greater than trichloroethylene. PMID- 6856007 TI - Ultrasonic vocalizations as diagnostic tools in studies of developmental toxicity: an investigation of the effects of prenatal treatment with methylmercuric chloride. AB - Ultrasonic vocalizations were recorded during two tasks from four groups of neonatal CD rat pups. Groups 0, 2, 4 and 6 were the offspring from pregnant dams treated with 0, 2, 4 or 6 mg/kg methylmercuric chloride by gavage on gestation day 7. On the day of birth, Day 1, litters were randomly culled to 8 pups (4 males, 4 females). The pups were weighed on Days 1, 7, 14, 21 and 30, and no weight differences due to treatment were observed. At 5, 7, 9 and 11 days of age, ultrasonic vocalizations were recorded from the animals for 1 minute. Individual animals were placed in a small test chamber containing either soiled home cage bedding or clean bedding material. Half of the pups in each litter were tested in each "odor" condition, and the rate and duration of the vocalizations were measured for 1 minute. On days 8 and 9, pups were tested on a negative geotaxis incline during which time vocalizations were recorded. In both the "odor" and negative geotaxis tests, methylmercuric chloride affected vocalization rates in a nonlinear dose-response fashion. Regardless of treatment group, the pups vocalized at a higher rate and for a longer duration in the clean than in the soiled bedding test condition. These data showed the variability of the ultrasonic vocalization responses to be smallest for the animals tested at 11 days of age in the clean bedding condition. The results of this study suggest that the value of ultrasonic calls as dependent measures of toxicity may be strengthened by the use of multiple stimulus conditions in order to elicit a graded response pattern. This would facilitate the interpretation of potential nonlinear dose-response effects. PMID- 6856008 TI - Repeated systemic aluminum exposure effects on classical conditioning of the rabbit. AB - Excessive aluminum exposure and accumulation has been implicated as the cause of two disorders which display learning deficits (dialysis encephalopathy and Alzheimer's disease). To develop an animal model, rabbits were given 20 sc Al lactate injections (0, 25, 50, 100, 200 or 400 mumole/kg) over 4 weeks. Dose dependent weight reductions were observed. Two weeks later the baseline frequency of nictitating membrane extension (NME) was determined. Differential classical conditioning of the NME was then conducted. No treatment group differences were observed in frequency of baseline NME, amplitude of the response to shock, or shock threshold to produce NME, suggesting no aluminum effects on the subjects' ability to perform the response. All subjects developed the discrimination. The 200 and 400 group acquired the conditioned response less well than controls, as shown by a lower percent of conditioned responses in the second half of the conditioning sessions (80 and 74% of controls) and a greater latency to onset of the conditioned response (327 and 310 msec vs. 261 msec for controls). These results indicate that chronic systemic exposure of adult rabbits to 1 results in learning deficits not due to sensory or motor impairment of the learned response. PMID- 6856011 TI - Concentration-related effects of hexane on evoked responses from brain and peripheral nerve of the rat. AB - Sensory evoked responses were studied in 32 chronically implanted male Fischer 344 rats in order to characterize the electrophysiologic concomitants off hexacarbon polyneuropathy. The action potential (AP) of the ventral caudal (tail) nerve, the brainstem auditory-evoked response (BAER), and cortical somatosensory (SER)-, auditory- and visual-evoked responses were recorded from rats exposed to air or 500, 1000 or 1500 ppm hexane for 24 hrs/day, 5 days/week for 11 weeks. Concentration-related latency increases occurred within each sensory modality. The most pronounced effects were on the AP and SER. Latency of the fifth, but not the first, component of the BAER was prolonged, indicating an effect on central auditory tract conduction time. Amplitudes of response components were variable and rarely affected significantly by exposure to hexane. PMID- 6856010 TI - Toluene-induced hearing loss in rats evidenced by the brainstem auditory-evoked response. AB - Behavioral results showing that toluene causes hearing loss in rats precipitated an electrophysiologic study of the auditory thresholds of these rats using the brainstem auditory-evoked response (BAER). Twenty-three-day-old male Fischer-344 rats had been exposed to 1400 or 1200 ppm toluene 14 hrs/day, for 4 or 5 weeks while a control group was exposed only to air. The rats were tested 2.5 mo after termination of the exposures. BAERs, recorded with 25-gauge needle electrodes placed over the nose and posterior skull, were evoked by 100-microseconds duration clicks and 1-msec-duration tone pips at eight intensities. Thresholds for the appearance of BAERs in the toluene-exposed rats were elevated by 13 to 27 dB, and latency-intensity functions were consistent with the occurrence of sensorineural hearing loss. The amplitudes of the third and fifth components of the BAER were attenuated at high stimulus intensities in the toluene-exposed rats. These behavioral and electrophysiologic results are apparently the first to indicate the ototoxicity of toluene in experimental animals. PMID- 6856009 TI - Neurobehavioral effects of subchronic exposure of weanling rats to toluene or hexane. AB - Using several behavioral and neurophysiologic tests, we examined the effects of subchronic inhalation exposure of rats to toluene and compared them with the effects of the known neurotoxicant hexane. The rats were exposed to toluene (900 and 1400 ppm) or hexane (2000 ppm) 14 hr/day, 7 days/week for 14 weeks. Both solvents inhibited weight gain. Hexane caused a neurotoxic syndrome characterized by reductions of grip strength (especially hindlimb), motor activity, and startle responses, and increased latencies of several evoked potential components. Initial acquisition of a conditioned avoidance response (CAR) was also impaired, but subsequent performance was intact. Toluene did not cause the peripheral motor symptoms associated with exposure to hexane. However, a component of the brainstem auditory-evoked response was depressed and CAR acquisition was impaired along with the acquisition of a tone-intensity discrimination task when tested within hours after the daily exposure ended. PMID- 6856012 TI - A method for equating thermal stress parameters for neurobehavioral toxicity studies. AB - Rats were immersed in 20 cm of cold (15 or 20 degrees C) water for 1, 2.5 or 5 min and were tested 15 min later on fixed ratio 15 (FR15) operant behavior for 30 min. Linear regression analyses predicted that 4 min exposure to 20 degrees C would suppress FR15 behavior 50%. Subsequent exposure to 20 degrees C water for this time period resulted in 53% suppression of FR15 responding. Rats were then immersed in heated water for 4 min and tested 15 min later, exactly as in the cold stress experiment. Exposure to 44, 45 or 46 degrees C water suppressed FR15 responding 21, 46 and 94%, respectively. Significant alterations in colonic temperature indicated that the manipulations disrupted thermoregulatory mechanisms and were probably stressful. The procedure is an alternative to other methods used to index the intensity of stress. By manipulating selected variables (e.g., water temperature or exposure duration), qualitatively different stressors can be matched behaviorally prior to studying interactions between stress and various other manipulations such as drugs or toxic compounds. PMID- 6856013 TI - Behavioral toxicity of amphetamine is differentially affected by hot and cold water immersion stress. AB - The interaction of two qualitatively different but behaviorally equivalent stressors with the behavioral toxicity induced by d-amphetamine (AMPH) was examined in rats. Stress, administered by immersing the rats in either hot or cold water, suppressed fixed ratio 15 (FR15) operant responding 50% and disrupted thermoregulation. AMPH (1, 2 and 3 mg/kg) administered immediately prior to stress, once every 7 days, in ascending order, did not modify stress-induced changes in colonic temperature (Tc) immediately after water immersion but induced a decrease in Tc in all groups 45 min later. The behavioral suppressant effect of AMPH observed in the Non-Stressed group was attenuated at all doses in rats exposed to cold water. Although both stressed groups had equivalent baseline rates, only the Cold-Stressed group's response rate was relatively unaffected by AMPH, compared to non-drug response rates, as would be predicted by the rate dependency hypothesis. The hot stress appears to have activated processes antagonistic to those involved in the rate-dependent effect. The results indicate that AMPH interacts with hot and cold stressors differently when the intensity of the stressors are otherwise equivalent in their ability to alter the behavior which is used as the dependent variable to assess toxicity. PMID- 6856014 TI - The effects of chronic cobalt exposure on behavior and metallothionein levels in the adult rat. AB - Adult rats fed daily rations of laboratory chow laced with cobalt chloride were tested for operant (schedule-controlled) responding and conditioned suppression (CER). Animals exposed to 20 mg/kg Co, but not animals exposed to 5 mg/kg Co, lever pressed at a significantly slower rate than nontreated control subjects over the last 8 sessions of a 35 session operant training phase (1 session/day). Control and treatment subjects did not show significantly different CER performances. Nor were significant differences found on a test of mixed VI-2, DRO responding where subjects were required to lever press for reward during the first 15 min component and not lever press during the last 15 min component of the schedule. Testicular atrophy was evident among subjects exposed to 20 mg/kg Co. Atomic absorption spectrophotometric analyses revealed a dose-response effect regarding tissue accumulations of Co in blood, bone, brain, hair, small intestine, kidney, liver, and testes. Contrary to the biochemical pattern shown by some other heavy metals, prolonged Co exposure did not induce significant increases in metallothionein concentrations in the liver, kidney, or small intestine. PMID- 6856015 TI - Positive cooperativity in high affinity binding sites for gamma-hydroxybutyric acid in rat brain. AB - High affinity binding sites for gamma-hydroxybutyrate have recently been shown to exist on crude membranes of rat brain. These sites exhibit a dissociation constant of 95 nM and a capacity of 557 fentomoles per mg protein. However, after more extensive washing of the crude membrane fraction and performing binding experiments at a lower concentration of radioactive GHB (below 20 nM), the existence of another binding site for GHB with a higher affinity than previously described was discovered. The data concerning this binding site are in favour of positive cooperative binding characteristics. This binding site may play a role in the mediation of the multiple physiological and pharmacological effects of GHB in the rat CNS and its presence provides additional evidence in favour of a neuromodulator or neurotransmitter role of GHB. PMID- 6856016 TI - Calcium stimulation of glutamine hydrolysis in synaptosomes from rat brain. AB - Calcium stimulates the hydrolysis of glutamine in synaptosomes prepared from rat brain both by the sucrose- (12) and the Ficoll/sucrose-gradient techniques (13). The calcium activation is phosphate-dependent and maximal effect is obtained at a calcium concentration of 0.5-1.0 mM. It is reduced by increasing the numbers of synaptosomes in the incubation mixture, and abolished by the product inhibitors of glutaminase, glutamate and ammonia, but unaffected by the uncoupler 2,4 dinitrophenol which inhibits the mitochondrial proton pump. Moreover, since the hydrolysis of glutamine is mediated by glutaminase (EC 3.5.1.2), and calcium does not activate the purified enzyme, an indirect phosphate-dependent effect of calcium on glutaminase is most likely. Calcium activates preferentially the N ethylmaleimide insensitive fraction of glutaminase. The calcium activation is not dependent on synaptosomal membranes as it is found in synaptosomes subject to previous freezing. It is also found in isolated synaptosomal mitochondria and is thus a property of nerve endings. The calcium activation of glutaminase is unaffected by potassium in depolarizing concentrations, and may not be directly involved in the neurotransmission processes, but possibly in replenishing depleted stores of transmitter glutamate. PMID- 6856017 TI - Developmental changes in the breakdown of brain tubulin by cerebral cathepsin D. AB - The activity of cathepsin D on hemoglobin and on cytoplasmic tubulin was measured in brain preparations at different ages--in newborn, 10- and 21-day-old, and young adult rats. Enzyme activity increased after birth, reaching a maximum at around 21 days, and then declined. This increase was not parallel with decreased turnover of proteins during development, but was parallel with decreasing level and increasing microheterogeneity and rate of assembly of tubulin during development. The breakdown of tubulin was heterogeneous, with initial fast breakdown of a large portion, followed by breakdown at a lower rate. This heterogeneity in breakdown persisted throughout development. The breakdown of tubulin, unlike that of hemoglobin, was at all ages greater at pH 5.8 than at pH 3.2. The possible role of cathepsin D in tubulin metabolism and the developmental changes under physiological conditions need further exploration. PMID- 6856018 TI - Specific binding of the muscarinic antagonist [3H]quinuclidinyl benzilate is not associated with preganglionic motor neurons in the dorsal motor nucleus of the vagus. AB - The present study evaluates the binding of [3H]quinuclidinyl benzilate, [3H]QNB, as a measure of cholinergic muscarinic binding in six areas of the rat medulla oblongata associated with the cranial nerves. In an experimental group, the right vagus nerve was severed in the neck in order to determine whether the specific muscarinic binding sites might be located on cells that contribute efferent fibers to the vagus nerve. The level of activity of choline acetyltransferase (ChAT) also was determined in the same six areas. Additional experiments utilizing the retrograde transport of toxic ricin, a 60,000 dalton agglutinin that acts as a potent ribosomal toxin, was carried out to further evaluate localization of specific muscarinic binding in the DMN after destruction of the preganglionic efferent cells. These results support the conclusion that specific binding of the muscarinic antagonist [3H]QNB observed in the DMN of the vagus of the rat is not associated with the large cells that contribute efferent fibers into the vagus nerve. We suggest that the specific cholinergic muscarinic binding is located on interneuronal cell surfaces, on afferent terminals of local circuit neurons, or on afferent terminals of long projection axons which arise from neurons in the brainstem, hypothalamus, or forebrain. PMID- 6856019 TI - Deficiency of taurocholate-dependent phospholipase C acting on phosphatidylcholine in Niemann-Pick disease. AB - Examination of release of labeled glyceride from 2-[1-14C]oleoyl phosphatidylcholine by a soluble extract of human fibroblasts confirmed the presence of phosphodiesterase which is stimulated strongly by sodium taurocholate. This activity was maximal at pH 4.5 and was inhibited by sphingomyelin and 5' AMP. Assay of the phosphatidylcholine phosphodiesterase activity in fibroblast cultures from patients with Niemann-Pick disease revealed a severe deficiency in those cultures also deficient in sphingomyelinase (3 type A and 4 type B) whereas assay of cultures from Niemann-Pick patients without sphingomyelinase deficiency (3 type C and 1 with neurovisceral lipidosis and vertical supranuclear ophthalmoplegia) gave activities similar to controls. The distribution of label in the products of the reactions catalyzed by both control and Niemann-Pick extracts indicates that the phosphodiesterase activity observed was phospholipase C and that phospholipase D was not involved. The close correlation of phosphatidylcholine phospholipase C and sphingomyelinase activities in the control and mutant fibroblasts strongly suggests that both activities are catalyzed by one enzyme. Various alterations in the regulation of the specificity of a multifunctional phospholipase C may underlie phenotypic variation in Niemann-Pick disease. PMID- 6856020 TI - Properties of endogenous, membrane-associated sialidase activity (N acetylneuraminidase) of the goldfish visual system. AB - The endogenous sialidase (N-acetylneuraminidase) activity of membranes prepared from goldfish retina and optic tectum displays characteristics similar to those reported for neural plasma membrane sialidases of other organisms. Endogenous membrane sialidase activity was found to be optimal at ph 4.0, and maximal release was obtained at 37-50 degrees C, above which temperature thermal instability of the preparations was observed. Optic nerve crush, which results in regeneration of retinal ganglion cell axons, did not result in significant changes in measured endogenous membrane sialidase activity in either the retina or the optic tectum. Enzymatic hydrolysis of membrane sialoglycolipid (ganglioside) accounted for about 70% of the total sialic acid released. Ganglioside GM1 accumulated as the major lipid product in both retina and tectum, indicating that the inner sialosylgalactosyl linkage in the ganglio oligosaccharide series was resistant to hydrolysis by the endogenous enzyme. PMID- 6856021 TI - Developmental changes in synaptic membrane lipid composition and fluidity. AB - Synaptic membrane enriched fractions were prepared from 7 and 14 day and adult cortical nerve endings. (a) The levels of synaptic membrane phosphatidylcholine decrease 19% during development while the levels of ethanolamine phosphoglycerides increase 21%. (b) On day 7, desmosterol accounts for 33% of the total membrane sterols. With maturity, the desmosterol disappears and the molar sterol/lipid P ratio increases 56%. (c) The fatty acid composition of the membranes change during development. 16:0 decreases 36% while 18:1 increases 49%. 16:1, a minor component of adult membranes, is found in significant quantities in pup membranes. 22:6 (n-3) increases 34% during development while 22:5 (n-6) decreases 59%. (d) The microviscosity of synaptic membranes, as measured by the fluorescence depolarization technique, increases during development. This effect is observed in both intact membranes and bilayers prepared from lipid extracts of the membrane. PMID- 6856023 TI - Failure of atractyloside to inhibit synaptosomal mitochondrial energy transduction. AB - Studies on synaptosome mitochondrial respiration are complicated by "free" mitochondria. Veratridine stimulation of synaptosomal respiration was due to increased Na+ cycling at the synaptosome membrane associated with increased oxidative phosphorylation of intraterminal ADP and was inhibited by oligomycin, ouabain or Na+ free medium. Atractylate or carboxyatractyloside failed to block veratridine-stimulated respiration but inhibited exogenous-ADP-stimulated respiration. Protein synthesis in the synaptosome fraction was inhibited by oligomycin, valinomycin or 2,4-dinitrophenol but was unaffected by excess atractylate. No change in synaptosomal adenine nucleotide content was found in the presence of atractylate, although a significant decrease in the [ATP]/[ADP] was found with oligomycin, veratridine or valinomycin. These findings show that atractylate does not modify intraterminal mitochondrial energy transduction and indirectly suggest an impermeability of the synaptosome membrane to atractylate. PMID- 6856022 TI - Effect of undernutrition on some enzymes involved in the salvage pathway of purine nucleotides in different regions of developing rat brain. AB - The effect of undernutrition on the activity of two key enzymes of purine salvage pathway, namely hypoxanthine-guanine phosphoribosyltransferase (HGPRTase) and adenine phosphoribosyltransferase (APRTase), in cerebral hemispheres, cerebellum and brain stem of rats at different days of postnatal development was studied. The activity of HGPRTase and of APRTase is significantly lower in all brain regions of undernourished animals at 5 days after birth; between 10 and 15 days of age there is a recovery of the enzymatic activity which is particularly evident in the cerebellum. Successively both enzymatic activities decrease reaching at 30 days of age values quite similar to those of controls. These results indicate that undernutrition during fetal and postnatal development, impairs and delays the activity of the enzymes of purine salvage pathway. PMID- 6856024 TI - Age related changes in blood-to-brain amino acid transport and incorporation into brain protein. AB - Blood-to-brain amino acid transport consists of at least two components: 1. a fast rate or early process, commonly measured by the intra-carotid bolus injection method and attributed to transport across the capillary endothelium and entry into the astrocytes, and, 2. a slow rate or later component measured over 2 to 15 minutes probably associated with exit from the astrocytes and entry into the neurons. Incorporation into brain protein is temporally related to the second process. In the present study the slow and fast rate transport components and the incorporation into brain protein of tyrosine (Tyr) and Valine (Val) was measured in young adult and aged male C57BL/6 mice. The results indicate that the fast rate transport component is unaffected by age while the rates of the slow process and protein turnover show an exponential decline most marked between 3 and 8 months of age. Changes in the relative incorporation of Tyr and Val suggest that brain protein metabolism is altered qualitatively as well as quantitatively in aging, in these animals. PMID- 6856025 TI - Further studies on the role of calcium in the regulation of glutamate decarboxylase activity in brain slices. AB - [3H]GABA synthesis in brain slices was used as a model to study the role of Ca2+ in the regulation of GAD activity. Experimental conditions were chosen to increase and decrease the flux of Ca2+ and to promote the increase in free intracellular Ca2+. The blockade of electron transport and the inhibition of oxidative phosphorylation in the slices inhibited [3H]GABA synthesis. High K+ depolarization stimulated [3H]GABA synthesis and this effect was not blocked by lidocaine, trifluoperazine, or verapamil, but the stimulation was blocked by the intracellular Ca2+ antagonist TMB-8. The data do not differentiate between the relative contributions of extra- and intracellular Ca2+ but reflect that GAD activity is modulated by a dynamic balance between these two compartments as well as between stored and free Ca2+ within the cells. PMID- 6856026 TI - Resolution and purification of taurine- and GABA-synthesizing decarboxylases from calf brain. AB - The present work describes a procedure for the co-purification of cysteine sulfinate decarboxylase (CSAD) and glutamate decarboxylase (GAD) from calf brain. A crude enzyme preparation was first made from brain homogenate by acid precipitation and ammonium sulphate fractionation. Subsequent fractionation of the decarboxylase preparation by cation exchange chromatography on CM-Sepharose CL-6B revealed the existence of a specific CSAD enzyme, which has no GAD activity. The GAD activity peak was found to possess CSAD activity. Further fractionation by gel filtration on Sephacryl S-200 separated the specific CSAD activity into two enzyme forms, one of them having a molecular weight of 150,000 and the other of 71,000. GAD activity was eluted from the gel filtration column in a single peak (mol wt 330,000) and showed CSAD activity. The purification of the specific CSAD enzyme was 920-fold and that of GAD activity 850-fold as compared with the starting material, whole calf brain. SDS gel electrophoresis indicated that the purified CSAD and GAD enzymes consisted of two or more subunits. The crude decarboxylase preparation was analysed by isoelectric focusing in ultra-thin polyacrylamide gel in the pH range 3.5-10.0. The most active fraction of CSAD indicated an isoelectric point of 6.5 and that of GAD 6.8. The pH optimum for CSAD activity in the crude preparation was 7.2 and that for GAD activity 7.9. PMID- 6856027 TI - Effects of opiates on synaptosomal calmodulin and calcium uptake. AB - Acute opiate administration in vivo increases the level of cytoplasmic calmodulin in isolated rat brain synaptosomes. These synaptosomes do not, however, display decreased K+-stimulated 45Ca uptake in vitro. Opiates affect neither cytoplasmic calmodulin nor Ca uptake after incubation of synaptosomes with the drugs in vitro. In contrast to the interpretation of electrophysiological data, these results suggest that the observed inhibition by opiates of the release of several transmitters may not be mediated by presynaptic opiate receptors that inhibit Ca uptake. PMID- 6856028 TI - Characterization of uptake and release processes for D- and L-aspartate in primary cultures of astrocytes and cerebellar granule cells. AB - The uptake of L- and D-aspartate was studied in astrocytes cultured from prefrontal cortex and in granule cells cultured from cerebellum. A high affinity uptake system for L- and D-aspartate was found in both cell types, and the two stereoisomers exhibited essentially the same Km- and Vmax-values in both astrocytes (L-aspartate: Km 77 microM; Vmax 11.8 nmol X min-1 X mg-1; D aspartate: Km 83 microM; Vmax 14.0 nmol X min-1 X mg-1) and granule cells (L aspartate: Km 32 microM; Vmax 2.8 nmol X min-1 X mg-1; D-aspartate: Km 26 microM; Vmax 3.0 nmol X min-1 X mg-1). To investigate whether L-glutamate, L-aspartate and D-aspartate use the same uptake system a detailed kinetic analysis was performed. The uptake kinetics of each one of the three amino acids was studied in the presence of the two other amino acids, and no essential differences between the uptake characteristics of the amino acids were found. In addition to the uptake studies the release of D-aspartate from cerebellar granule cells was investigated and compared with L-glutamate release. A Ca2+-dependent, K+-induced release was found for both amino acids. PMID- 6856029 TI - In vitro release of endogenous monoamines and amino acids from several CNS regions of the rat. PMID- 6856031 TI - Molecular forms of sucrose extractable and particulate acetylcholinesterase in the developing and adult rat brain. AB - The activity of acetylcholinesterase in the rat striatum increased considerably during development, while activities in the cerebellum and midbrain increased only slightly. During maturation the activity of butyrylcholinesterase increased in all the brain regions examined except in cerebellum. The percentage of acetylcholinesterase extractable by isotonic sucrose solution from mature striatum was much smaller than those obtained for other regions of the rat brain. For the developing striatum, the percentage of isotonic sucrose extractable activity was almost three times that for adult striatum. Density gradient centrifugation showed that the membrane-bound particulate fraction of adult rat brain was mostly composed of the 10 S form of acetylcholinesterase with little activity of 4 S form of the enzyme. However, a much higher proportion of the 4S form was found in the isotonic sucrose soluble fraction. In contrast to the particulate fraction from adult brain, that from 6-day old rats contained a much higher proportion of the 4 S form of the enzyme. The sucrose soluble fraction from 6-day old rat brains contained in general much smaller proportion of 4S form as compared to those from adult rat brains. PMID- 6856030 TI - Changes induced by ischemia on some cerebral enzymatic activities related to energy transduction and amino acid metabolism. AB - The maximal rate of some cerebral enzymatic activities related to energy transduction (hexokinase; phosphofructokinase; lactate dehydrogenase; citrate synthase; malate dehydrogenase; total NADH-cytochrome c reductase; cytochrome oxidase), amino acid metabolism (glutamate decarboxylase; glutamate dehydrogenase) and cholinergic metabolism (acetylcholine esterase) were tested in the cerebral cortex and in sub-cortical area of rats. The evaluations were performed both in the homogenate in toto and in the crude mitochondrial fraction, before and after a postdecapitative normothermic ischemia of 5, 10, 20, and 40 min duration. The results are discussed also with respect to the pharmacological pretreatment with two biological substances which may modulate amino acid (L alanine) and phospholipid metabolism (CDP-choline). The analysis of the present data suggests the occurrence in brain tissue of a variety of interrelated factors implicated in the ischemia-induced changes of the maximal rate of the enzymatic activities related to the energy transduction. These include: (a) rearrangement of the enzymatic activities because of the changed metabolic and chemico-physical condition; (b) decrease in the activity of enzymes related to the electron transfer chain and glycolysis; (c) changes in enzymes related to mitochondrial membranes. The effects of in vivo administration of alanine or CDP-choline, even if significant, are not consistent throughout the time period studied. PMID- 6856032 TI - Free amino acid changes in the cerebral cortex of experimental uremic rat. AB - The levels of free amino acids in the cerebral cortex of acute and chronic uremic rats were examined. Amino acids significantly elevated were aspartate, glutamine, glycine, histidine, ornithine, phenylalanine, phosphoethanolamine and taurine, whereas 1-methyl histidine and 3-methyl histidine were specifically detected in uremic rats. Glutamate, arginine and carnosine disclosed a significant reduction. There was no change in the concentrations of gamma-aminobutyrate and alanine. The above findings were essentially identical in both acute and chronic uremia. It was conjectured that these changes of amino acid levels in the brain might participate in the progress of uremic encephalopathy. PMID- 6856033 TI - Uptake and utilization of CDP-choline in primary brain cell cultures from fetal brain. AB - The utilization of double-labeled CDP-choline by cultured brain cells has been studied. CDP-choline is demonstrated to be rapidly hydrolysed into CMP and choline phosphate. The fragments, or their hydrolysis products, penetrate into the cells and are utilized for lipid synthesis. At short times after the isotope administration a rapid labeling of phosphatidylcholine was detected, when cells were incubated with CDP-choline. The same was not seen when cells were incubated with labeled choline. From these observations it can be inferred that either CDP- choline can penetrate the cell membrane or that some mechanism involving CDP choline and leading to phospholipid synthesis can work at the external surface of the plasma membranes. PMID- 6856034 TI - Dose and time dependent effects of morphine on the incorporation of [3H]valine into soluble brain and liver proteins. AB - Morphine (10(-6)-10(-5) M) causes an increase in incorporation of [3H]valine into soluble proteins during 4 hr in rat brain cortical slices, liver slices and cultivated astroglial cells. The effects are dose-dependent. They are neither cell specific nor strictly related to classical opiate receptors. Pulse-labeling with [3H]valine for 60 min after incubation in 10(-6)-10(-5) M morphine, resolves time-dependent changes in incorporation, with both increases and decreases in protein metabolism. PMID- 6856036 TI - [Cerebral arteriovenous malformations--a discussion]. PMID- 6856037 TI - [Flow cytometric studies of human brain tumors. Part 3: Cultured glioma cells]. PMID- 6856035 TI - [Vertigo--their typical clinical pictures from neurosurgical standpoints]. AB - Although vertigo is commonly encountered in many clinical disciplines, meticulous analysis of the onset and nature of the vertigo is essential not to overlook the vertigo of brainstem or cerebral origin without any other neurological signs and symptoms. Three central vestibular projection pathways and their possible functional roles in relation to vertigo were briefly discussed. To illustrate the characteristic clinical features of vertigo of various origins, 16 typical cases were presented and discussed. Their etiology include Meniere's disease, vertigo of neurovascular compression, sudden deafness, acoustic neurinoma, Rumsay-Hunt's syndrome, BPPN (benign paroxysmal positioning nystagmus), vestibular neuronitis, brainstem infarct, MPPN (malignant persistent positional nystagmus) with brainstem midline hemorrhage, cerebellar hemorrhage followed by orthostatic hypotension, vertiginous epilepsy, TIA from MCA stenosis, intracerebral hemorrhage from a mycotic aneurysm, falx meningioma, subclavian steal phenomenon, and cervical spondylosis. It is wrong and quite dangerous to believe that vertigo of CNS origin should be associated with some definite neurological signs and symptoms and to diagnose the vertigo to be of peripheral origin merely based on normal findings of CT scan and angiography. Recently advanced detailed neurootological investigations are quite helpful in differentiating vertigo of various origins, but may totally overlook the vertigo of serious CNS pathology. For "solo vertigo," the key point is first differentiate BPPN and vertibular neuronitis from others after which careful neurosurgical and neurootological evaluation should be pursued regardless of presence or absence of concomitant neurological findings. PMID- 6856039 TI - [A case of aortitis syndrome with a ruptured cerebral aneurysm]. PMID- 6856038 TI - [The microsurgical interopercular approach based on the Sylvian Fissure Line-CT]. PMID- 6856042 TI - Quantitation of changes in the content of neurohypophyseal peptides in hypothalamic nuclei after adrenalectomy. AB - In adrenal insufficiency there is an increase in the content of vasopressin in the external zone of the median eminence as determined by immunohistology. We studied rats after bilateral adrenalectomy and obtained punched samples of the supraoptic, the paraventricular, and the suprachiasmatic nuclei, and from the median eminence and the posterior pituitary. Vasopressin, neurophysin and oxytocin were all decreased in content in the posterior pituitary but in the suprachiasmatic nucleus and in the median eminence there was a significant increase in the content of vasopressin. The increased levels of vasopressin in the median eminence are interpreted as representative of the content in axons and demonstrate a large increase of transport of vasopressin. In the SON and PVN there was no increase in the content of vasopressin during this state of augmented synthesis and transport, indicating that vasopressin moves rapidly from the site of synthesis into the transport system. The increased content of vasopressin in the suprachiasmatic nucleus shows that vasopressin at this level also varies with changes in adrenal function. Levels of oxytocin throughout the neurohypophysis did not change in parallel with vasopressin demonstrating relatively selective responses of the neurohypophyseal hormones. PMID- 6856041 TI - [A case of cerebral cysticercosis detected by computed tomography]. PMID- 6856040 TI - [A case of brain metastasis of primary pulmonary rhabdomyosarcoma in a child]. PMID- 6856044 TI - Role of prolactin feedback in the semicircadian rhythm of tuberoinfundibular dopaminergic neuronal activity during early pregnancy in the rat. PMID- 6856043 TI - Hypothalamic knife cuts alter fluid regulation, vasopressin secretion, and natriuresis during water deprivation. AB - To investigate central neural pathways involved in release of vasopressin and in fluid electrolyte regulation, a retractable wire knife was used to make coronal knife cuts posterior to the organum vasculosum lamina terminalis (OVLT). 4 days following cuts or control surgery, animals were housed in metabolism cages and: (1) deprived of food and water for 48 h; (2) deprived of water only for 48 h; or (3) allowed continuous access to food and water. Water ingestion, food ingestion, urine volume, sodium excretion and urine osmolality were recorded daily. Trunk blood was then collected following decapitation for determination of plasma vasopressin, sodium, and protein concentrations, and osmolality. Animals with knife cuts and ad libitum access to food and water had significantly higher plasma osmolality (310 +/- 2 mosm/kg), and plasma vasopressin concentration (2.02 +/- 0.5 microunits/ml) than controls (306 +/- 1 mosm/kg and 0.60 +/- 0.04 microunits/ml, respectively). When rats were deprived of both food and water, there were no significant differences between the two groups in plasma vasopressin concentration, although plasma osmolality wa higher in animals with cuts. However, rats with knife cuts deprived of water only had significantly higher plasma osmolality (358 +/- 8 mosm/kg), sodium (164 +/- 19 mEq/l) and vasopressin (17.7 +/- 4 microunits/ml), than similarly treated control animals (317 +/- 1 mosm/kg, 145.5 +/- 1.0 mEq/1, 5.5 +/- 3 microunits/ml, respectively). These data indicate that a neural pathway in this brain region is critical for normal fluid and electrolyte balance during ad libitum access to food and water, and during water deprivation. PMID- 6856045 TI - Melatonin accelerates the reentrainment of the circadian adrenocortical rhythm in inverted illumination cycle. AB - The effect of melatonin, para-chlorophenyl alanine (PCPA), gamma-aminobutyric acid (GABA) and dibutyryl-cAMP (d-cAMP) on the photoentrainment of the circadian adrenocortical rhythm was studied by the intrahypothalamic (near the SCN) implantation of a paraffin pellet mixed with each agent, in the rat. 2 weeks after implantation, the rats were moved to a room with a reversed lighting cycle (from LD to DL). Blood samples were taken from individual rats at 4-hour intervals for 24 h, and 2, 4, 6 and 10 days after movement, by the tail tip incision method. The effects of implantation of PCPA, GABA and d-cAMP on the reentrainment to the illumination cycle reversed were indistinguishable from those due to implantation of a pellet of paraffin alone. In these groups, more than half of the rats did not reentrain to the light cycle reversed in 4 (less than 18.1%) and 6 days (less than 36.3%), but did reentrain in 10 days. However, melatonin caused reentrainment of the circadian adrenocortical rhythm to reversed illumination between 4 (45.4%) and 6 days (72.7%). Pinealectomized rats receiving a melatonin pellet also exhibited an accelerated reentrainment to the light cycle reversed, when compared with the rat which received a pellet of paraffin alone. However, pinealectomized rats which received a pellet of paraffin alone did not require more time than intact rats to reentrain to the light cycle reversed. These results indicate that melatonin accelerates the reentrainment of the circadian adrenocortical rhythm to the light cycle reversed. PMID- 6856046 TI - Effects of confinement stress on episodic secretion of LH in ovariectomized sheep. AB - Episodic secretion of luteinizing hormone (LH) in ovariectomized ewes was evaluated before and during acute confinement and during several days of habituation to the same confinement. Plasma concentrations of LH were quantified in samples collected at 5-min intervals via indwelling jugular vein cannulae. Peaks in each time series of plasma LH were identified by a computer program (Pulsar) developed by Merriam and Wachter. In the first experiment, 6 ewes which had been familiarized with the sampling environment and procedures were abruptly moved into a confinement chamber midway through a 4- to 5-hour sampling. Compared with preconfinement sampling, average plasma LH concentrations as well as the incidence (average frequency) and amplitude of identified peaks of LH decreased. In the second experiment, 10 ewes which had not previously been sampled were transferred from their home pens directly into the confinement chamber for a 3- to 4-hour period of blood sampling. This procedure was repeated with the same 10 ewes on the following 2 days to assess the effect of habituation. The average frequency and amplitude of identified peaks of LH increased (p less than 0.05) in habituated ewes, but average plasma LH concentrations did not change. In summary, episodic secretion of LH was inhibited by the stress of initial confinement, but several days of habituation to the same daily periods of confinement minimized this inhibition and restored the episodic discharges of LH. PMID- 6856047 TI - Molecular mechanisms in the actions of drugs active in mania and depression. A symposium: Collegium Internationale Neuropsychopharmacologicum (C.I.N.P.) Congress, Jerusalem, Israel, 20-25 June 1982. PMID- 6856048 TI - Stimulation of spinal dopaminergic receptors: differential effects on tail reflexes in rats. AB - The tail-flick reflex to heat and tail-withdrawal reflex to touch were measured in spinal and intact rats given either apomorphine (0.02-1.75 mumol.kg-1) or dopamine (0.02-1.76 mumol.kg-1) in the lumbar subarachnoid space. In spinal rats both apomorphine and dopamine suppressed thermal tail-flick reflex and enhanced tactile tail-withdrawal response in a dose-dependent way. The effect of apomorphine in spinal rats was counteracted by dopaminergic receptor antagonists (cis-flupenthixol and (+)-butaclamol), but not by their stereoisomers. Phenoxybenzamine, propranolol, methysergide and naloxone failed to counteract the effects of apomorphine on tail-reflex responses in spinal rats. (+)-Butaclamol also counteracted effects of dopamine in spinal rats. Neither apomorphine nor dopamine influenced tail reflexes in intact rats, which suggests that effects of spinal dopaminergic mechanisms on these reflexes are influenced by descending supraspinal pathways. PMID- 6856049 TI - Effects of quipazine on pre- and postsynaptic serotonin receptors: single cell studies in the rat CNS. AB - Many behavioural and biochemical studies have pointed to an agonistic activity of quipazine on serotonin (5-HT) receptors. In the present electrophysiological study, the effect of quipazine on pre- and postsynaptic 5-HT receptors in the rat was studied. Quipazine, administered intravenously, depressed the firing rate of 5-HT-containing dorsal raphe neurones (ED50 = 0.82 mg/kg). Microiontophoretic applications of quipazine on 5-HT-containing neurones in the dorsal raphe and on neurones of two forebrain regions receiving a 5-HT input (the ventral lateral geniculate nucleus and the dorsal hippocampus) consistently depressed neuronal firing rate as did 5-HT and D-lysergic acid diethylamide (LSD). Quipazine was more potent on 5-HT neurones than on the ventral lateral geniculate nucleus and hippocampal neurones: the post/presynaptic efficacy ratio for quipazine was similar to that of LSD. Following a selective denervation of 5-HT neurones with intraventricular injection of 5,7-di-hydroxy-tryptamine in desipramine-pretreated rats, the responsiveness of neurones in the ventral lateral geniculate nucleus to quipazine, applied microiontophoretically, was increased as was that to 5-HT and to LSD. These results provide direct evidence for the agonistic activity of quipazine on both pre- and postsynaptic 5-HT receptors. PMID- 6856050 TI - Therapeutic practice with tricyclic antidepressants among expert and general practice psychiatrists. PMID- 6856051 TI - Dexamethasone suppression test in depression. PMID- 6856052 TI - Ethanol preference in rats: increased consumption after intraventricular administration of tetrahydropapaveroline. PMID- 6856053 TI - A novel cognitive function test for detection of alcoholic brain damage. PMID- 6856054 TI - Drinking histories: are they accurate? PMID- 6856055 TI - [Crisis situations in child and adolescent psychopathology. Specificity and diversity of possible responses]. PMID- 6856056 TI - [Reactions of parents to their children's psychotherapy]. PMID- 6856058 TI - [Failure at school. Psychopathologic and sociocultural factors]. PMID- 6856057 TI - [Stories of families]. PMID- 6856059 TI - [Child and failure at school]. PMID- 6856060 TI - Reflections on nuclear warfare. AB - The author looks back on his more than 70 years of familiarity with Americans involved in warfare, noting their loyal support for our country's objectives. Drawing on the Einstein equation, his own visits to Hiroshima and Nagasaki, and current literature, he, as a physician, belatedly concurs with those who look on the use of nuclear weapons as irrational and untenable. Their employment under present circumstances would create a "final epidemic" to be avoided only by prevention. He suggests that medical perceptions must be considered by our national leaders in assessing the many factors that he hopes will lead to rational answers to this urgent, highly complex, and vital enigma. He cites physicians' efforts to help in finding answers and asks that his colleagues consider the issues with attention to the gravity of the situation and act according to their best judgment. PMID- 6856061 TI - Pineal region meningioma: report of two cases and literature review. PMID- 6856062 TI - Chiari malformation presenting in adults: a surgical experience in 127 cases. AB - We reviewed 127 patients who were operated upon for adult presentation Chiari malformation and made six conclusions: (a) The clinical examination remains crucial in the diagnosis. (b) The surgical anatomy is highly varied. (c) Syrinxes can be missed on preoperative contrast studies. (d) By a conservative grading system, we determined that 46% of the patients improved during long term follow up. One-quarter deteriorated over the long run in spite of any treatment. (e) The overall results did not differ whether the treatment was plugging of the central canal plus decompression or decompression alone. (f) In patients with progression, plugging of the central canal obtained superior results. A review of the literature shows that the natural history of this complex disease process has not been established. This history is needed to identify the course of what may be several important factors that lead to the pathological condition in this disease. PMID- 6856064 TI - Barbiturate therapy in uncontrolled intracranial hypertension. AB - From July 1978 to September 1981, 27 patients from a group of 210 patients with severe head injuries developed uncontrolled intracranial hypertension despite intensive medical and surgical management. These 27 patients were considered appropriate candidates for barbiturate therapy. Abnormal posturing or flaccidity was present in 70% of the patients, and 41% had bilaterally fixed pupils. Twenty five of 27 patients had mass lesions requiring operation. Of the 15 patients who responded to barbiturate therapy with normalization of intracranial pressure for 24 hours, 5 died (33% mortality). Nine of the 12 patients who did not respond to the barbiturate therapy died (75% mortality). The total mortality in this group of 27 patients was 52%. Of the survivors, 69% had a recovery classified as good recovery/moderate disability, and 31% were in a severe disability/vegetative state. The morbidity and mortality in these patients is high, but comparisons with previous studies show that this is a selected group of severe head injuries with a high percentage of poor prognostic indicators. Our experience suggests that barbiturates can be effective in lowering intracranial pressure in patients with otherwise unresponsive intracranial hypertension, and, by doing so, may decrease the mortality in a group of patients considered untreatable by the usual therapeutic modalities. PMID- 6856063 TI - Can a patent extracranial-intracranial bypass provoke the conversion of an intracranial arterial stenosis to a symptomatic occlusion? AB - Although extracranial-intracranial (EC-IC) artery anastomosis seems to result in symptomatic improvement in certain types of cerebrovascular ischemic disease, this procedure can also be associated with significant morbidity, some of which paradoxically may be the direct result of a patent bypass. A review of the last 51/2 years at the Oregon Health Sciences University shows that 50 patients underwent 51 superficial temporal artery to middle cerebral artery bypass procedures with an angiographic patency rate of 91%. Of the 50 patients, 17 had intracranial stenotic lesions of either the middle cerebral artery (7 patients) or the internal carotid artery (10 patients). One patient had posterior cerebral artery stenosis. Five of the 18 patients with stenosis and a patent bypass developed a symptomatic occlusion of the stenotic lesion within 30 days after the anastomosis. It is hypothesized that the EC-IC bypass may have contributed to the occlusion in some of these patients by causing a change in the hemodynamic state. Possibly the bypass reversed the direction of flow distal to the stenosis to result in stasis and subsequent occlusion at the site of the stenosis or in some other manner affected hemostasis (i.e., the coagulation cascade). PMID- 6856065 TI - The Edinburgh-2 coma scale: a new scale for assessing impaired consciousness. AB - In the management of patients with acute cerebral disturbances, it is essential to determine precisely the degree of impaired consciousness. However, a coma scale for assessing impaired levels of consciousness has not yet been standardized internationally. The Edinburgh-2 coma scale (E2 CS) is introduced and compared with the Glasgow coma scale (GCS). The reliability of the E2 CS was tested by comparing levels of the E2 CS with the outcome of patients who underwent neurosurgical operations. A good correlation was observed between the levels of the E2 CS and the outcome. A change of two levels suggests that some change influencing the outcome has occurred or exists within the cranium of the patient. A correlation between the E2 CS and the GCS was proven to exist. The merits and drawbacks of both scales are discussed. One advantage of the E2 CS is that it has removed ambiguous terms, which are still present in the GCS. Also it is easier to grasp changes in a patient's condition shown on a chart because the levels of the E2 CS are arranged first-dimensionally. Use of the GCS should not preclude the use of other scales, such as the E2 CS; the E2 CS could be used together with the GCS. The accumulation of data on both scales would provide information useful in improving the existing coma scales. PMID- 6856066 TI - Evaluation of cervical spine surgery by postoperative myelography. AB - After spontaneous remission of nerve root compression, a myelographic defect may persist. Similarly, myelopathy may remain nonprogressive for long periods despite appreciable myelographic deformity. Although operation may arrest or improve the symptoms of cervical disc lesions and spondylosis, the ultimate confirmation that entrapped neural elements have been relieved permanently can only be provided by postoperative myelography. Preoperative and postoperative myelography documents the significant improvement that can be achieved by using posterolateral and posterior approaches to the cervical spine in patients with nerve root or spinal cord compression. The results in this group of patients were achieved with none of the disadvantages or complications of cervical spine fusion or of the interbody removal of cervical disc tissue, also leading to cervical fusion. PMID- 6856067 TI - Evoked potentials from the motor tracts in humans. AB - Spinal cord monitoring during operation is of increasing importance in the prevention of injury. However, there is no direct monitor of the motor tracts available. We have reported a system using direct stimulation of the area overlying the motor tract between the intermediolateral sulcus and the dentate ligament in cats. This produces a 100-m/second signal with later components, which is abolished by section of the motor area, but not by section of the dorsal columns or the anterior quadrant of the spinal cord. Such stimulation also produces motor movement when the correct frequency is used. We now report the first application of this technique in humans, in whom we found the same 100 m/second signal, as well as slower components. We were able to elicit distal limb motor movement with stimulation of the motor tract area, but not with stimulation of the dorsal column area. This technique can be used either in open surgical cases or percutaneously and should provide an additional valuable technique for assessing spinal cord function. PMID- 6856068 TI - Effect of low dose gamma-butyrolactone therapy on forebrain neuronal ischemia in the unrestrained, awake rat. AB - Low dose gamma-butyrolactone (GBL) therapy alters the natural history of experimental forebrain ischemia in the awake rat. After 30 minutes of four-vessel ischemia, repeated hydrogen cerebral blood flow determinations in awake rats over 72 hours revealed that low dose GBL therapy prevented the development of regional cerebral hyperemia and later the prolonged cerebral hypoperfusion that was experienced by the nontreated controls. Moreover, the low dose GBL-treated group had significantly less neuronal tissue loss than that in comparable brain regions of the nontreated controls. Before the stroke studies, GBL dose-response experiments performed on normal rats indicated that high dose GBL therapy produced seizures, systemic hypertension, metabolic acidosis, hyperthermia, and death. PMID- 6856071 TI - Congenital subgaleal (epidermoid) inclusion cyst of the anterior fontanel in a Mexican female child: case report. AB - A 30-month-old Mexican girl with an inclusion subgaleal cyst located over the anterior fontanel is described. This is the first such case ever diagnosed at our institution and, we believe, the first reported from Mexico. Radical excision of the lesion was accomplished. The internal table of the skull was eroded, but no intracranial extension was noticed. As the cyst contained no hair follicles nor any sebaceous or sweat glands, it was histologically classified as an epidermoid cyst. This is another example of such a lesion in an infant of non-African descent. PMID- 6856069 TI - Disturbances of cerebrospinal fluid circulation during the acute stage of subarachnoid hemorrhage. AB - Radioisotope cisternography was performed and the erythrocyte and hemoglobin contents of the cerebrospinal fluid (CSF) were determined within the first 4 days after subarachnoid hemorrhage in 42 patients. The clinical condition of the patients was related to the severity of the CSF circulation disturbances. Thirty five patients had some degree of disturbance of CSF flow, and only 2 of the 42 patients had normal flow. In 5 cases the cisternograms were inconclusive. The severity of CSF circulation disturbances correlated well with clinical condition. No relationship was found between the number of erythrocytes in the CSF and the development of CSF circulation disturbances. The CSF erythrocyte content did not correlate with the clinical condition. It is suggested that flow disturbances of the CSF during the acute stage of subarachnoid hemorrhage might play an important role in the pathomechanism of the disease. PMID- 6856070 TI - Traumatic paraplegia in children without contiguous spinal fracture or dislocation. AB - Traumatic paraplegia in children is uncommon and, in almost half of these injuries, no contiguous fracture or dislocation of the spine is found. This report presents eight such cases, three in detail. Most of the children were injured in motor vehicle accidents and sustained thoracic level injuries with a permanent loss of neurological function caudal to the injury. The clinical presentation and radiological diagnosis are reviewed. Four mechanisms of injury have been proposed: transient vertebral subluxation, transient disc herniation, traction and stretching of the spinal cord, and vascular compromise with infarction. Unless extramedullary spinal cord compression is present, laminectomy is not useful. PMID- 6856072 TI - Expanding bolt for anterior cervical spine osteosynthesis: technical note. PMID- 6856073 TI - Cervical spinal cord lipoma with extension into the posterior fossa. PMID- 6856074 TI - Sclerosing orbital pseudotumor. AB - We report two patients who underwent orbital exploration yielding the diagnosis of sclerosing orbital pseudotumor. The presenting symptoms were exophthalmos, visual loss, abnormal ocular mobility, and ocular pain. Computed tomographic (CT) scans showed masses in the orbital apex. Steroids were ineffective. Orbital pseudotumor is a heterogeneous diagnostic category of lymphoid infiltrations of the orbit with a wide spectrum of pathological conditions and intraorbital locations. The clinical presentation typically includes the sudden onset of pain, diplopia, lid edema, and exophthalmos. Visual loss is uncommon. Most cases resolve spontaneously or respond to steroid treatment. Although fibrosis may be a prominent histological finding, the literature contains little information concerning its significance. We discuss the evidence for considering the sclerosing pseudotumors to be a significant variant with unique clinical behavior. Although features suggestive of pseudotumor were present in our case, the presence of visual loss and an apical mass shown on the CT scan led to the presumptive diagnosis of tumor and exploratory operation. Neurosurgeons should be aware of this entity as a cause of visual loss and orbital mass. Proper suspicion may in some cases permit transorbital biopsy and avoid craniotomy, inasmuch as operation is of no therapeutic benefit in this disease. PMID- 6856075 TI - Diagnosis of an intracanalicular acoustic neuroma by air CT cisternography. PMID- 6856076 TI - Diagnosis of masses presenting within the ventricles on computed tomography. AB - The radiological and clinical features of 90 histologically verified intraventricular masses were reviewed. Computed tomography (CT) and plain X-rays were available in all and angiograms in over half the cases. The localisation, effects on the adjacent brain substance and the presence and degree of hydrocephalus was evident on CT. Two-thirds of colloid cysts presented as pathognomonic anterior third ventricular hyperdense masses and the other third were isodense; an alternative diagnosis should be considered for low density masses in this situation. Plexus papillomas and carcinomas mainly involved the trigone and body of a lateral ventricle of young children and caused asymmetrical hydrocephalus; the third ventricle was occasionally affected also in children and the fourth ventricle more frequently and usually in adults. Two-thirds were hyperdense, one-third of mixed or lower density. The meningiomas were dense trigonal tumours of adults generally arising in the choroid plexus, but two tentorial meningiomas passed through the choroidal fissure and caused a predominantly intraventricular mass. Gliomas frequently thickened the septum and generally involved the frontal segments of the lateral ventricles. They may be supplied by perforating as well as by the choroidal arteries, which supply most other vascularised masses within the ventricles. Only 10% of our cases did not fall into one of the former categories; these included low density non-enhancing dermoid or epidermoid tumours and higher density enhancing metastatic or angiomatous masses. PMID- 6856077 TI - Measurement of the area of the anterior horn of the right lateral ventricle for the diagnosis of brain atrophy by CT. Correlation with several ventricular indices. AB - The area of the anterior horn of the right lateral ventricle and five ventricular indices: (1) maximum width of the anterior horns, (2) minimum width of the anterior horns, (3) sum of these maximum and minimum widths, (4) ventricular index, and (5) cella media index were measured from the CT scans of 198 cases considered to be "normal". The area of the right anterior horn and indices 1-4 were measured on the slice which most clearly showed Monro's foramina and index 5 was measured on the slice 2 cm above. The size of the ventricular system increased steadily with age. The sum of the maximum and minimum widths of the anterior horns was most highly correlated with the area of the right anterior horn. Using this ventricular index, we graded brain "atrophy" in each age group. PMID- 6856078 TI - CT response of brain parenchyma to intravenous contrast injections. AB - Pre- and postcontrast scans of the same normal brain tissue layer were compared in 20 patients in order to evaluate postcontrast density response. The original purpose of this investigation was to explain a paradoxical phenomenon of density decrease, which has been regularly observed in our patients. Control phantom measurements revealed that the decrease of density values is a function of the time interval between the analysed and the previous scan. Prolonged interscan interval--due to contrast injection--enables a change in the sensitivity of CT detectors to be registered. It is probable that any study of cerebral blood volume could be unfavourably influenced by this phenomenon. Comparison between the postcontrast brain scan density decrease and density decrease of a phantom showed substantially no difference, so that we estimate the contrast response of the brain parenchyma in toto as insignificant. Further, a comparative analysis between contrast response of the white and gray matter has been made. The gray white matter difference increased from precontrast 4.56 H to postcontrast 7.82 H. The relatively high difference of 3.26 H between the white and gray matter enhancement compared with negligible enhancement of the brain slice as a whole leads us to the hypothesis, that an absolute decrease of white matter density, as a biological reaction to the injected contrast solution, has to be presumed. PMID- 6856079 TI - Iohexol compared to meglumine-Ca-metrizoate in common carotid angiography. A randomized double blind cross-over study in man. AB - A randomized double blind cross-over study with iohexol (Omnipaque) and meglumine Ca-metrizoate (Isopaque cerebral) was performed to answer questions concerning subjective side effects and tolerability that arose from a double blind parallel study with the same two media. The cross-over study design, with injection of the contrast media under identical conditions in the same artery, seems to be the most practical method of comparison of two well tolerated media. Iohexol showed significantly less side effects than meglumine-Ca-metrizoate. The routine premedication with atropine was neglected in this study to evaluate effects on heart rate due, for example, to the toxicity of the media. Small tachycardial and bradycardial reactions were equally divided between the media. However, a short asystolic period following the injection of meglumine-Ca-metrizoate in two different patients may indicate a higher toxicity of this medium. PMID- 6856080 TI - Computed tomography of the "armored brain". AB - A calcified chronic subdural hematoma may cover the surface of the cerebral hemispheres to such an extent that one can talk of an "armored brain". Pathogenesis, clinical course and treatment are discussed based on the computed tomograms of five cases. PMID- 6856081 TI - Fenestration and duplicate origin of the left vertebral artery in angiography. Report of three cases. AB - Three cases are shown; 2 of angiographically proven distal fenestration of the left vertebral artery and one of duplicate origin. Both anomalies are classified as of inhibitory type. Their incidence in the literature is reviewed. Underlined is the fact that variations of this nature frequently occur in combination with other inhibitory malformations particularly in the vascular and skeletal systems. PMID- 6856082 TI - Muscle reinnervation--II. Sprouting, synapse formation and repression. AB - Extensor digitorum longus muscle is reinnervated by the regenerating neurites at the end-plate region; as soon as the contact is made, the rate of neurite elongation inside the cleft decreases about 1000-fold while interfibre growth and sprout formation proceed unchanged. Polyinnervation reaches the maximum level 7 10 days after reinnervation, then synaptic repression begins. The elimination of redundant innervation takes place when the biophysical properties of the muscle are again normal. There is no sign of either phagocytosis or degeneration, therefore the process of synaptic repression is probably due to retraction, as neurites do when in culture. The role of Schwann cells and nerve sheath in the process of maintenance is suggested. PMID- 6856083 TI - Muscle reinnervation--III. Motoneuron sprouting capacity, enhancement by exogenous gangliosides. AB - Rat soleus muscle was partially denervated by resecting the L5 mixed nerve. Muscle reinnervation was monitored 10, 30 and 50 days after surgery. The extent of recovery was found to be dependent on the number of axons remaining in the muscle and appeared not to be influenced by the time allowed. If animals were treated daily with 5 mg/kg of gangliosides the enlargement of the motor units was further enforced. The index of sprouting (expressed as the ratio between the percentage of muscle reinnervation due to a certain number of motor neurons in reinnervation and in normal conditions) was increased in a significant way by gangliosides treatment, i.e. one motor unit can expand up to about 4.5-fold, but if the animal was treated with gangliosides the motor unit can expand up to about 6.3-fold. These results showed that motoneuron sprouting capacity is increased by treatment animals with gangliosides. PMID- 6856084 TI - Cholecystokinin-like immunoreactive neurons in rat cerebral cortex. AB - The distribution and form of cholecystokinin immunoreactive neurons in neocortical areas within the posterior pole of the rat cerebral hemisphere was examined using the immunoperoxidase technique. Although cholecystokinin-positive neurons are present throughout the cortex, they are most frequent in the supragranular layers. These neurons are of three kinds: layer I neurons, bipolar cells, and other non-pyramidal cells with either multipolar or bitufted dendritic trees. In electron-microscopic preparations, the horseradish peroxidase reaction product is found to form a granular deposit which occurs throughout the cytoplasm and nucleoplasm and shows no predilection for any particular type of organelle. Electron-microscopy also shows cholecystokinin-positive neurons to have both symmetric and asymmetric synapses on their perikarya, which is additional evidence in favor of the interpretation that they are non-pyramidal cells. In the light-microscopic preparations three types of CCK-positive axons are encountered. These are vertically-oriented axons considered to arise from bipolar cells, a plexus in the superficial portion of layer II/III which is believed to arise from the multipolar and bitufted cells, and a deep plexus of unknown origin in layers VI and V. Since the axons of bipolar cells form asymmetric synapses they are thought to be excitatory neurons. In contrast, the bitufted and multipolar neurons are probably inhibitory, for previous studies have shown neurons with similar features to have axons which form symmetric synapses and to contain glutamic acid decarboxylase. Thus, although iontophoretically-applied cholecystokinin excites cortical neurons, it appears to be present in some neurons which are excitatory and others which are inhibitory. PMID- 6856085 TI - Interactions between dopamine and gamma-aminobutyrate in the substantia nigra: implications for the striatonigral output hypothesis. AB - Experiments employing a rodent circling model were conducted to test the predictive capacity of the theory which states that striatonigral gamma aminobutyrate neurones transmit striatal information influencing the animal's locomotion and orientation. In agreement with this proposal, blocking nerve conduction in one substantia nigra with procaine, or nigral gamma-aminobutyrate receptors with bicuculline administered stereotaxically, frequently forced rats to move ipsiversively to systemic apomorphine, as though the treatment had impaired striatonigral transmission on that side of the brain. Attempts to reverse the direction of apomorphine circling by stimulating gamma-aminobutyrate receptors with muscimol, by facilitating the amino acid's action with flurazepam, or by increasing its synaptic concentration either with a breakdown inhibitor (ethanolamine O-sulphate or 4-amino-hex-5-enoic acid) or an uptake blocker (cis 1,3-aminocyclohexane carboxylic acid) in one nigra, proved unsuccessful. In fact, ethanolamine O-sulphate, flurazepam and muscimol all gave the appearance of hindering rather than enhancing the passage of striatal-derived motor information through the nigra. Broadly speaking, these drugs gave predictable behavioral responses from the ventromedial thalamus, suggesting they were acting in accordance with known mechanisms. The anomalous behaviour with ethanolamine O sulphate may be attributed to its elevating gamma-aminobutyrate levels in other brain areas, since similar ipsiversive rotations occurred if gamma-aminobutyrate catabolism was prevented at a wide variety of extranigral sites. A simple explanation for the paradoxical ipsiversive behaviours produced by intranigral flurazepam or muscimol in combination with systemic or intracerebral injection of dopamine agonists, is that they act via presynaptic receptors to inhibit the release of endogenous gamma-aminobutyrate and thereby impede striatonigral outflow ipsilaterally. PMID- 6856086 TI - Morphological studies of electrophysiologically-identified myenteric plexus neurons of the guinea-pig ileum. AB - The morphology of neurons in the myenteric plexus of the guinea-pig ileum has been studied by means of the intracellular application of Procion Yellow. Sixty six electrophysiologically-unidentified cells showed a great variety of soma shapes and number of processes, the vast majority of the longer of which were circumferentially-orientated. The electrophysiological properties of an additional 47 neurons were ascertained; 29 were neurons with a slow after hyperpolarization (AH-neurons), 14 showed fast excitatory synaptic potentials (S neurons) and 4 were of neither category. Twenty-two of the AH-neurons had a smooth soma outline and, on average, each had 5 processes, of which the great majority of long processes were circumferentially-orientated and intraganglionic. The projection ratios of oral:circumferential:aboral processes were 6:61:9. Branching was a prominent feature of the processes. In contrast, a large soma with many broad, short processes was a feature of 8 of 14 S-neurons studied. The average number of processes was 8.6 per cell and relatively more of them were aborally-directed, giving projection ratios of 2:21:7. There was, however, such a variation and overlap in the morphology of AH- and S-neurons that it was not possible to achieve a simple, reliable classification. It is concluded that many neuronal processes may be intraganglionic and that longitudinal ones are mainly aboral. From the varied morphological characteristics of AH-neurons, it is unlikely that these neurons subserve a single function in the plexus. For the same reasons S-neurons may fulfil different physiological roles. PMID- 6856087 TI - Relation between functional maturation of cervical sympathetic innervation and ontogeny of alpha-noradrenergic smooth muscle contraction in the rat. PMID- 6856088 TI - Ultrastructure of synaptic connections of a bimodal pacemaker giant neuron in the central nervous system of Helix pomatia L. AB - Following intracellular labelling with horseradish peroxidase, the arborization and synaptic connections of the bimodal pacemaker giant neuron (RPal) of Helix pomatia were investigated in the right parietal and visceral ganglia. The RPal neuron possesses extensive axonal branching, the elements of which could be observed and traced within the entire neuropil region of both ganglia. The main axonal branches showed further arborization. The thin axon processes enter the synaptic neuropil, where they receive numerous synapses. At least six ultra structurally different terminals form synaptic contacts on peroxidase-labelled axon processes of the cell. On the basis of their vesicle and granule content, they are likely to contain different neurotransmitters. Some intraganglionic efferent contacts of the RPal neuron were also observed. It is suggested that, besides its peripheral efferent connections, this cell might also serve as an interneuron. PMID- 6856089 TI - Characterization of the effects of autoimmune nerve growth factor deprivation in the developing guinea-pig. PMID- 6856091 TI - Effects of laser microirradiation in chromatophore organs of embryonic and juvenile Cephalopods. PMID- 6856090 TI - Acetylcholine-induced electrical responses in neuroblastoma cells. AB - The response to iontophoretic application of acetylcholine in the mouse neuroblastoma cell line N1E-115 was composed of three phases. The initial fast depolarizing phase was blocked by 10 microM d-tubocurarine, but not by 0.1 microM atropine. This phase was followed by a transient hyperpolarization which in turn was followed by a secondary slow depolarization. Both the hyperpolarization and slow depolarization were blocked by atropine (0.1 microM), but not by d tubocurarine (10 microM). The hyperpolarization and slow depolarization were also evoked by iontophoretic application of the muscarinic agonist methacholine. Under voltage-clamp conditions, an initial fast inward current, a transient outward current, and a secondary slow inward current were recorded in response to acetylcholine application. These three phases of current correspond to the three phases of the membrane potential response. The initial fast inward current increased in amplitude by hyperpolarization of the membrane, and decreased by depolarization. The mean reversal potential was estimated to be -1 mV. The outward current increased in amplitude by depolarization, decreased by hyperpolarization, and reversed its polarity at -67 mV. Alteration of external K+ concentration shifted the reversal potential in the manner expected for an increase in potassium permeability. The slow inward current increased in amplitude by hyperpolarization, decreased by depolarization, and reversed its polarity at +20 mV. It is concluded that the initial fast inward current is mediated by a nicotinic receptor similar to that in muscle end-plate membranes and in postsynaptic membranes of the sympathetic ganglia. Both the outward current and the slow inward current are mediated by muscarinic receptors. The outward current results from an increase in the membrane permeability to K+, and the slow current appears to be carried, at least in part, by Na+. PMID- 6856092 TI - Analysis of heterochromatin and identification of mitotic chromosomes in Drosophila virilis by GC- and AT-specific fluorochromes. PMID- 6856093 TI - Scanning electron microscopy of the mammalian adrenal medulla. PMID- 6856094 TI - [Proposed protocol for the evaluation and follow-up of the indications for permanent electrostimulation]. PMID- 6856095 TI - [Effects of prazepam in patients with cardiac neuroses]. PMID- 6856097 TI - [Stenosis of the common trunk of the left coronary artery. Personal clinical and angiographic experience]. PMID- 6856096 TI - [Calcium antagonists: effects on cardiotoxicity caused by adriamycin. Preliminary trials]. PMID- 6856098 TI - [Contribution of the Holter-type dynamic electrocardiogram to the diagnosis of ischemic cardiopathy]. PMID- 6856099 TI - [Velocitometric findings on vascular reactivity in diabetics. Study using the Doppler method]. PMID- 6856100 TI - ["Non-invasive" diagnostic methods for the preoperative evaluation of patients with cerebrovascular diseases]. PMID- 6856101 TI - [Problems in electrocardiographic and vectorcardiographic classification of ventricular pre-excitation]. PMID- 6856102 TI - [Asymptomatic carotid murmurs discovered during preoperative examination. Diagnostic and therapeutic management]. PMID- 6856104 TI - [Low-dose intramuscular ketamine in obstetrical analgesia]. PMID- 6856103 TI - [Effects of preanesthetic cimetidine on the pH and volume of gastric contents]. PMID- 6856106 TI - [Personal experience with ankle block]. PMID- 6856105 TI - [Epidural cervical anesthesia as an alternative to brachial plexus block by supraclavicular approach]. PMID- 6856107 TI - [The role of local health units in the organization and administration of emergencies]. PMID- 6856108 TI - [Contribution of the Pavia School to the development of plastic surgery]. PMID- 6856109 TI - [The training of the plastic surgeon in Italy and Europe today]. PMID- 6856110 TI - [Plastic surgery of the lower extremities: traditional flaps]. PMID- 6856111 TI - [Plastic surgery of the lower extremities: myocutaneous flaps]. PMID- 6856112 TI - [Severe trauma of the lower extremities. Follow-up study of results from the anatomo-functional point of view]. PMID- 6856114 TI - [Reconstruction of exposed fractures of the leg with osteocutaneous loss]. PMID- 6856113 TI - [Verrucous carcinoma of the role of the foot]. PMID- 6856115 TI - [Use of the island flap on the instep]. PMID- 6856116 TI - [Injuries of the lower extremities. Critical evaluation of the results obtained in cases treated with pedicled cutaneous flaps]. PMID- 6856118 TI - [Surgical treatment of cleft hands and cleft feet]. PMID- 6856120 TI - [The reconstruction of the loss of skin substance of the legs with double-folded local flaps. Technical and case contribution]. PMID- 6856117 TI - [A myocutaneous flap from the lateral gastrocnemius muscle as an island flap. Clinical case]. PMID- 6856119 TI - [Our experience in the reconstruction of the talar region]. PMID- 6856121 TI - [Local skin flaps with arterial blood supply used for the reconstruction of cutaneous defects of the calcaneal area]. PMID- 6856122 TI - [Myocutaneous and fasciocutaneous flaps in injuries of the lower extremities]. PMID- 6856123 TI - [Apropos of a rare malformation of the foot]. PMID- 6856124 TI - [Bilateral popliteal pterygium in siblings simultaneously affected with cleft lip and palate]. PMID- 6856125 TI - [Topical therapy of facial burns]. PMID- 6856126 TI - [Surgical treatment of burns of the face and neck]. PMID- 6856127 TI - [Long-term adaptation and psychological problems of the severely burned after discharge]. PMID- 6856128 TI - [Prevention of cicatrix retraction of the labial region after facial burns]. PMID- 6856130 TI - [Burns and viral hepatitis]. PMID- 6856129 TI - [Changes in the organic defense mechanisms after burns. Clinico-experimental study]. PMID- 6856131 TI - [Experience in the surgery of the cranial wall]. PMID- 6856132 TI - [Scalp flaps and flaps from distant sites in the restoration of osteo-cutaneous defects in the cranial region]. PMID- 6856133 TI - [Use of free microvascular flaps in cutaneous defects of the scalp]. PMID- 6856134 TI - [Clinical case of ependymoblastoma extending to the scalp]. PMID- 6856135 TI - [Cranio-facial neoplasia. Therapeutic possibilities and reconstructive modalities]. PMID- 6856136 TI - [Therapy of cicatricial alopecia caused by burns in the child]. PMID- 6856138 TI - [The parieto-retroauricular flap in the reconstruction of the temporal region]. PMID- 6856137 TI - [Tegmentary reconstruction in extensive tissue loss on the scalp]. PMID- 6856139 TI - [Tissue loss in the scalp. Outline of reparative procedures]. PMID- 6856140 TI - [Why aid to the elderly should not remain an affirmation of principle but should become an active reality]. AB - The most frequent causes of the feeling of "being a burden" in elderly people dependent on others due to chronic disabling pathologies are described. Often this feeling is the main, and sometimes the only reason for their isolation from the community. Suggestions are made for the removal of this feeling, which is felt to be caused mainly by social attitudes and the style and structure of existing social services. It is felt that education in social attitudes should be directed not only to the invalid concerned but also, and primarily, to the community as a whole. In terms of treatment, rehabilitation and social facilities, various appropriate activities are suggested. A careful reorganisation of the institutions offering these services is also recommended. PMID- 6856141 TI - [Clinico-rehabilitative follow-up of a group of aphasic patients treated in the last 10 years]. AB - Reference is made to a clinical and rehabilitative overview of 362 aphasic subjects, namely 221 males (61.05%) and 141 females (38.95%), treated over the last ten years. Of these, 36 males and 23 females (16.29%) had died. Only 19.8% were in a worse condition at follow-up, whereas the condition of the remainder was good and fair in 42% and 38.2% respectively. 79,6% lived with their families following rehabilitation. Where admission to an institution had taken place, this was always the result of socioeconomic conditions rather than clinical and functional problems. Medical management was nearly always a continuing necessity, and nearly all patients were taking drugs. The results are evaluated according to a double criterion with regard to communicative recovery. PMID- 6856143 TI - [Coordination of aid to the elderly in the environment of a local community health unit in Lombardy. Organizational experiences]. AB - A group of geriatric specialists retained their involvement after suppression of a geriatrics division as part of the Lombard Region's hospital plan. Reference is made to the geriatric orientation bestowed on a rehabilitation medicine division, the experiences of a geriatric out-patient department in a hospital, links with rest homes, the social services, the home care services, and family physicians. Updating, training and support activities that can be carried out to help domiciliary service workers are described, along with the support that can be given to rest homes, especially if they have no sheltered structures. Stress is laid on the possible coordination of aid to the elderly on the part of persons operating within a departmental rehabilitative structure. PMID- 6856142 TI - [Cardiological methods in geriatrics]. AB - A brief summary of a course in geriatric cardiology given to geriatric specialists is presented in the form of a review of cardiological methods applicable to the examination of the elderly, and the diagnosis of their heart diseases. Reference is made to the recent literature and work done at the University of Pavia with particular attention to "senile myocardiopathy" and "bundle-branch blocks and semiblocks in the elderly". The indications, modalities, meaning, and limits of non-invasive examinations are explained. Mention is also made of the usefulness of a study of His's bundle, cardiac catheterisation, and angiocardiography in selected cases, particularly when these are oriented towards therapeutic or rehabilitative management, bearing in mind the current tendency to enlarge the frontiers of heart surgery when the result will be to prolong or improve the quality of life, even in the elderly. PMID- 6856145 TI - [Classification of chronic hepatitis]. AB - After an examination of the classifications of chronic hepatitis put forward between 1968 and the present a critical review of the subject is presented. On the basis of personal experience and in the light of recent developments, another classification is proposed which together with morphological criteria, haematochemical evaluation and particularly, statistically processed immunological data would permit adequate monitoring of possible therapeutic treatments. PMID- 6856144 TI - [Clinico-statistical evaluation of the effects of cigarette smoke on the blood vessels of the lower extremities]. AB - The relation between cigarette smoke and cardiovascular disease is well known. Several studies have shown that the adverse effect of carbon monoxide on the vascular endothelium is the most serious of the many factors associated with the damage caused by cigarette smoke. Two groups of patients were examined, one admitted for serious lower-extremity arteriosclerosis, the other composed of out patients with symptoms referable to possible peripheral pathology. Invasive and non-invasive examinations were used to determine such pathology and relate it with cigarette smoking, in the absence of other greater vascular risk factors. The importance of cigarette smoke as a single vascular risk factor was further substantiated. PMID- 6856146 TI - [Hemodynamic consequences of paracentesis, evaluated by a bloodless method, in liver cirrhosis]. AB - Haemodynamic changes caused by paracentesis in cirrhosis of the liver with ascites have been studied, using systolic times in 11 patients. The use of a non surgical technique made it possible to repeat the test after a 24 hour interval. The basal TCI and PEP, expressed as percentage variation of the normal frequency value, were significantly lowered, but the TET was substantially unchanged. The PEP/TET ratio was also reduced. The PEP and TCI tend to increase 24 hours after paracentesis, though not to a uniform degree, while the TET increases slightly and diminishes 24 hours later. The PEP/TET ratio gets significantly worse (P = 0.05) compared to values 24 hours after the end of paracentesis, but not in comparison to initial values. These data reveal that cardiac capacity and myocardial contractility undergo no significant variations either immediately after the end of paracentesis or 24 hours later. This procedure is therefore indicated in cases where ascites interferes with cardiorespiratory function. In addition to haemodynamic changes, significant variations in potassaemia and ammoniaemia needing accurate monitoring were observed in individual cases. PMID- 6856147 TI - [Physical activities and sports in asthmatic patients]. AB - Asthma patients are too often advised to refrain from sport. Enforced sedentariness, especially in children, leads to muscle hypotonia, reduced mechanical efficiency, paramorphisms, and adverse psychological consequences. Not all asthmatics develop airway spasm as a result of exercise. On the other hand, there are subjects whose bronchial hyper-reactivity is stimulated solely by muscular effort. The pathogenesis of exercise-induced bronchospasm is not fully understood. In any event, numerous studies have demonstrated the beneficial and even therapeutic effect of physical exercise and sport in cases of asthma. Provided they are practised with judgment and in accordance with a suitable programme, swimming, activities of an alternating aerobic and anaerobic type, cross-country skiing, gymnastics, and fencing are primarily indicated. Some asthmatics have also won Olympic medals. In the light of the studies carried out so far, it is strongly suggested that asthmatics be encouraged to take up sport suitable to their psychophysical characteristics, and not kept wrapped up in cotton wool. PMID- 6856149 TI - [Clinico-radiological studies on an atypical osteoid osteoma]. PMID- 6856150 TI - [Nephrotoxicity of contrast media for urography in patients with chronic renal insufficiency]. AB - The incidence of nephrotoxicity caused by intravenous pielography (IVP) contrast media was retrospectively evaluated in 42 patients with chronic renal failure. In 14 patients renal function was acutely impaired after IVP. In most cases the dysfunction was only temporary; in 3 cases permanent damage was induced, one of which required dialytic treatment. In the cases described there appears to be no correlation between the degree of renal failure and the incidence of nephrotoxicity but the former is clearly linked to the severity of the nephrotoxic response. PMID- 6856151 TI - [Echography and percutaneous transhepatic cholangiography in the evaluation of obstructive lesions of the bile ducts]. AB - Among diagnostic techniques proposed for the study of obstructive jaundice, the initial use of echotomography clearly distinguishes between medical and surgical forms. If surgery is not indicated, further diagnostic investigations, (transhepatic percutaneous cholangiography followed if necessary by drainage of the bile duct) are conducted. Used in conjunction, echography and TPC will solve clinical doubts in most cases. PMID- 6856148 TI - [Dissecting aneurysm of the thoracic aorta with paraplegic onset. Diagnosis using computerized tomography]. AB - A case of dissecting aneurysm of the thoracic aorta (De Bakey type III) which first presented as paraplegia of the lower extremities, and the diagnosis of which was confirmed by computerised tomography, is reported. Examination of the literature confirms the rarity of neurological complications especially as an initial symptom. The ischaemia involving areas supplied by the intercostal arteries must be the pathogenetic mechanism of both the paraplegia and the significant increase in sero-enzymes (CPK-MB). The case observed confirms the opinion of other authors that computerised tomography permits rapid diagnosis. As it is also easily performed and not invasive it represents an alternative to conventional angiography. PMID- 6856152 TI - [Cytologic diagnosis of azoospermia]. AB - Pathology and Cytology departments are making increasing use of cytological examination of the semen as an aid to the diagnosis and prognosis of male infertility. Even in cases where it may seem superfluous, as in azoospermia, it can be used to reveal the presence of immature reproductive cells indicating retarded maturation. It may also reveal a greater or lesser number of inflamed cells, indicating swelling of the spermatic vesicles. In this case the patient will be subjected to more specific tests (the Stamey EPS-EVS tests). Spermatic and prostatic vesicle cells are not often examined but this may be done to investigate the origin of the secretion and the site of any swelling. PMID- 6856153 TI - [Rehabilitation of patients after colostomy. Personal experience]. AB - Personal experience of aiding 58 colostomised patients is reported. Certain basic aspects of aid in the immediate and later postoperative period are emphasised: diet, stools, irrigation, psychological support. Follow up showed that most patients returned successfully to normal life, returning to work and in some cases to the practice of sports. PMID- 6856154 TI - [Daniels' prescalenic biopsy in the diagnosis of pulmonary sarcoidosis]. AB - Prescalene biopsy according to Daniels has proved an excellent method for the histological detection of pulmonary sarcoidosis. Cooperation over a period of 15 years between the ear, nose and throat division of the Bassini Hospital, Milan, and the Lombardy Provincial Anti-TB Consortia (especially that of Milan) led to the performance of 533 biopsies in about 1700 cases with morphological and radiological pictures indicative of pulmonary sarcoidosis. Overall positivity was 81%. The disease has five radiological stages: I, I + II, II, II + III, and III. Patients with hilo-mediastinal polyadenopathy predominated numerically. Histological positivity greater in group A (stages I & I + II), i.e. 86%, 74% in group B (stage II), and 60% in group C (stages II + III, and III). The dependence of positivity on stage was further confirmed when series from different consortia were compared. Stress is laid on the high productivity of the method, its low risk, and its ready application to patients usually in apparently good health, following their detection by mass screening or general pneumological examinations. PMID- 6856155 TI - [Hypokalemic myopathy caused by fluoroprednisolone in a nasal spray. Observations 2 cases]. AB - Reference is made to the picture observed in two patients with flaccid tetraparesis, severe hypopotassaemia, and myoglobinuric muscle necrosis (hypokalaemic myopathy). Recent onset of hypertension was a feature of both cases. Initially, however, no reason could be assigned for this, nor for the massive loss of potassium. Numerous investigations in the first case (and relatively quick verification in the second) incriminated a steroid, 9-alpha fluoroprednisolone acetate, in a nasal spray. This has often been reported as the cause of an iatrogenic syndrome due to excess of mineral corticoids, with hypertension, hypokalaemia and alkalosis, suppression of plasma renin activity, and reduction of blood and urinary aldosterone, all of which were observed in these two patients. Withdrawal of the drug and treatment with potassium chloride led to relatively rapid normalisation of the serum electrolytes. Recovery of muscle strength took place after about 20 days, almost at the same time as the normalisation of muscle enzymes. Hypertension, on the other hand, regressed slowly. The nexus between chronic use of the spray and the occurrence of hypokalaemic muscle necrosis is examined in detail. Stress is laid on the importance of specific investigation of the prior use of intranasal steroids in the differentiation of muscle disturbances due to potassium depletion. PMID- 6856157 TI - [Monckeberg's mediocalcinosis associated with Raynaud's phenomenon]. AB - A case of Monckeberg's arteriosclerosis associated with Raynaud's phenomenon and diabetes is reported. It is probable that Monckeberg's arteriosclerosis could provoke a Raynaud's phenomenon when predisposing local conditions, such as microvasculature and/or haemorheological alterations, are present. Finally our findings seem to demonstrate that xeroradiographic investigation is most important for the early diagnosis of the disease. PMID- 6856156 TI - [Recurrent dermatofibrosarcoma protuberans of the nape of the neck. Clinico therapeutic evaluation]. AB - The use of a myocutaneous trapezium flap as a definitive cure for recurrent dermatofibrosarcoma protuberans of the nucha is proposed. It is also emphasised that the reconstructive technique suggested involves no functional sacrifice of the muscle, which may be repositioned once it ceases to function as a cutis vector. PMID- 6856159 TI - [Clinico-epidemiological study of patients with phlebolymphatic diseases admitted to the hospitals of the Piedmont region 1976-1979. II. Analysis of lymphatic diseases and pulmonary embolism]. AB - The second part of this research project looks at two very different pathologies. Pulmonary embolisms are usually emergency admissions, while lymphopathies, and this may well be an incorrect term, usually receive outpatient treatment and are only hospitalised in cases of serious incapacitation. Whereas lymphopathies were so few as to prevent any conclusions being drawn, regional admissions of pulmonary embolism occur every 28 hours and 44 minutes i.e. about 1 case per day. No particular relation between the distribution of pulmonary embolism and geographical area, level of industrialisation or migration was discovered. On the contrary there are few areas with higher figures than the expected regional average and these may be attributed to better medical organisation. Finally it should be emphasised that while cases of pulmonary embolism increase with age, the rise is less substantial than might have been expected. PMID- 6856158 TI - [Clinico-epidemiological study of patients with phlebolymphatic diseases admitted to the hospitals of the Piedmont region 1976-1979. I. Analysis of all phlebolymphatic diseases]. AB - In conjunction with the University Calculation Centre and the Piedmont Region, a computerised study was made of all patients (31,514 cases) admitted to Piedmont hospitals for phlebopathy and peripheral lymphopathy, including pulmonary embolism, in the period 1976-79. An account is given of the method used, the material, and the statistical technique. An 18.9% prevalence of women was noted. Occupation, age category, type of pathology, and treatment adopted were assessed for phlebopathies in toto and for each type. The data for each public health unit, divided by age category, were correlated with the general cases for the Region and those for each unit. In this way, it was possible to determine the incidence of phlebopathies in each unit and over the Region as a whole in relation to age. A map of the Region showing areas of higher, lower, and not significantly different from the regional mean hospitalisation (i.e. phlebopathy) was prepared. The significance of the different incidences in the several units is discussed in relation to their populations, geographical location, raye of migration, and types of occupational activity. PMID- 6856160 TI - [Clinico-epidemiologic study of patients with phlebolymphatic diseases admitted to the hospitals of the Piedmont region 1976-1979. III. Analysis of varicose disease]. AB - With the aid of the University and Piedmont Region Computer Centre all cases of varicose admitted to Piedmontese hospitals between 1976 and 1979 were examined. One admission every 1 hour 35 minutes is the regional average. In terms of age there is a numerical prevalence (8526 cases) of the under forty-fives, while in percentage terms, admissions appear to increase in proportion to age. Admissions in age groups to all the individual clinics were correlated with a view to the evaluation of any variations from the regional average, without incidentally confirming these figures. Detailed statistical analysis was employed to correlate the study. PMID- 6856161 TI - [Clinico-epidemiological study of patients with phlebolymphatic diseases admitted to the hospitals of the Piedmont region 1976-1979. IV. Analysis of thrombophlebitis]. AB - In the 1976-79 period, 8040 cases of thrombophlebitis, equivalent to 0.17% of the population, were admitted to Piedmontese hospitals, an average of 1 admission every 4 hours and 3 minutes. The present study revealed a numerical and percentage increase with increasing age. The figures per age group from each individual clinic revealed two large areas in the East and South West of the Region where phlebitis cases were numerically lower than the regional average. In other areas figures were higher than estimated, while still others produced statistically insignificant figures. An interpretation of these results is attempted. PMID- 6856162 TI - [Proglumetacine in rheumatoid arthritis]. AB - Proglumetacin, 450 mg/day, was administered during 1 month to 32 rheumatoid arthritis patients in anatomical and functional stage II or III. Overall, more than 50% of pts responded to the treatment, in particular those in stage II, in whom Ritchie's articular index, nightly and daily pain significantly decreased. Those pts in stage III who did not respond to proglumetacin even when administered at high dose, did not respond to indomethacin, either. Tolerance resulted very good, as only 3 complaints of mild and transient epigastric pain and 1 of skin rash were observed, but no one related to the C.N.S. High efficacy and good tolerance set therefore proglumetacin aside from indomethacin, A.S.A. and most of the recent non steroidal anti-inflammatory agents. PMID- 6856163 TI - [Short-term effects of proglumetacin in arthrosis]. AB - Proglumetacin was administered as a sole treatment during 15 days at 450 mg/day to 20 patients with osteoarthritis localized in several joints. Within the observation period, pain at rest and on loading, joint mobility and morning stiffness improved significantly. Tolerance also resulted very good, as only two patients reported mild and transient gastric upsets. The peculiar combination of good efficacy also in short-term treatment and very good tolerance, points to proglumetacin as a drug of choice for the ambulatory management also of degenerative-reactive joint disorders. PMID- 6856164 TI - [Proglumetacin for a wide spectrum of activity in clinical medicine]. AB - Twenty-nine patients with gouty arthritis, rheumatoid arthritis and osteoarthritis were treated as outpatients with proglumetacin, at different doses, during 5-30 days. In all patients with gout and osteoarthritis a significant improvement of pain and inflammatory symptoms was observed, together with a recovery of joint mobility. Seventy-nine per cent of patients with arthritis responded well or very well to the therapy. Tolerance was considered good or very good in 93% of patients. PMID- 6856167 TI - [Proglumetacin for fast and safe control of joint pain of orthopedic importance]. AB - Thirty patients with articular pain had been treated with proglumetacin during average 12 days. Twenty-three (77%) responded well to very well to the treatment. Total symptom score decreased by 49%, and each tested symptom (painful, inflammatory and functional) significantly improved, in spite of the short observation period. Tolerance was defined good to excellent in 26 patients (87%). Overall, 10 patients complained of mild to moderate accessory symptoms, mainly heartburn and epigastric pain. No C.N.S. symptoms were observed, nor variations of the laboratory tests, carried out in 16 patients. Proglumetacin, therefore, showed to be a suitable drug for the fast and safe management of articular pain of orthopedic interest. PMID- 6856165 TI - [Joint pain crises and chronic inflammatory-reactive phenomena: a unitary approach with proglumetacin]. AB - Nineteen patients with acute joint pain and 12 patients with chronic rheumatic disorders were treated with 450 mg/day of proglumetacin for a period ranging between 15 and 30 days. The overall results revealed a satisfactory response to treatment, and tolerance was rated as "good" or "very good" in all patients. PMID- 6856168 TI - [Value and limits of echography and abdominal lymphography in malignant lymphomas]. AB - Diagnostic results obtained by echography and lymphography in the study of abdominal lymphoglandular involvement in patients with lymphomas are compared. The data indicate that while lymphography is more revealing, the two examinations should be used together in staging. Echography, on the other hand, should be used for long-term surveillance, once the lymphographic contrast medium has been absorbed. PMID- 6856166 TI - [Proglumetacin: a simple and practical anti-inflammatory agent for the treatment of hospitalized orthopedic patients]. AB - Forty-six in-patients with osteoarticular and tendon inflammatory, traumatic, degenerative and neoplastic diseases were treated with 600 mg/day of proglumetacin for variable periods ranging between 16 and 60 days. Therapeutic efficacy was considerable, with a significant improvement of all symptoms, regardless of the disease condition the patients were suffering from. Tolerance resulted more than satisfactory, as in no case it was rated less than "good". PMID- 6856169 TI - [Food poisoning with marine animal toxins of invertebrate origin]. AB - The consumption of seafood is increasing and hence the risk of poisoning. For this reason, the study of food poisoning caused by zootoxins from marine invertebrates has become of signal importance. These toxins come from bivalve molluscs and other species. Depending on the type of toxin concerned, poisoning attributable to molluscs may give rise to paralysis, caused by saxitossin, neurotoxic effects (gimbretoxin), or haemolysis (venerupin). Poisoning caused by coelenterates, echinoderms, cephalopods, Neptunea, abalone, crabs and lobsters is less common, and its clinical pictures and pathogenesis have not been fully established. In some instances, toxins presented in the phytoplankton ingested by these animals appear to be responsible, whereas in others its would seem that they themselves elaborate the active principles directly. PMID- 6856171 TI - [Immunostimulation with levamisol in inoperable cancer of the esophagus]. AB - In the light of previous personal research indicative of immunodepression in patients with cancer of the oesophagus, the effect of aspecific immunostimulation with Levamisol was assessed on 70 patients with inoperable forms. All patients were treated by positioning of a Celestin endoesophageal prosthesis for the palliation of dysphagia, and submitted to a randomised protocol involving aspecific immunostimulation with 150 mg Levamisol per os twice a week on nonconsecutive days for an indefinite period. The mean survival of the treated group was not significantly better than that of the controls, nor was any real advantage detected on dividing the series in terms of age, tumour histology and degree of differentiation, extension, or the clinical stage. PMID- 6856170 TI - [Moulds and allergic respiratory syndromes]. AB - 1428 patients with respiratory conditions (rhinitis, asthma, rhinitis in association with asthma) were studied, 296 patients (20.72%) producing positive skin reaction to moulds either in isolation or in association. Of the 296, 29.95% of subjects with rhinitis, 38.74% of the asthmatics and 31.26% with rhinitis and asthma were sensitive to moulds. The onset of allergic symptoms occurs most frequently in 20-30 year olds. Most patients were permanently affected. The Mucoraceae were the phycomycetes most frequently producing an allergic reaction. PMID- 6856172 TI - [Function test of renal excretion of water and sodium after water loading in liver cirrhosis]. AB - Water loading was used as a diagnostic test in the study of renal excretion of water and sodium during the clinical stages of cirrhosis of the liver in 25 patients free from clinical and instrumental signs of ascites, 26 with treatable ascites, and 14 with intractable ascites. The water load consisted of 20 cc/kg water administered i.v. as a 5% glucose solution. Examination of diuresis in the ensuring 5 hr showed that: 1) clearance of free water is the most sensitive parameter for the detection of patients at short-term risk for the onset of ascites; 2) very low urinary sodium is an indicator of refractory ascites, whereas values are virtually the same and higher in subjects without ascites or with treatable forms; 3) chloruresis in only reduced significantly in cirrhosis with refractory ascites. PMID- 6856173 TI - [Behavior of serum immunoglobulins in boutonneuse fever]. AB - The behaviour of serum immunoglobulins in 35 patients suffering from Mediterranean exanthematous has been studied. No particular quantitative or qualitative change lieve noted. Supported by the scanty and contrasting data in existing literature, it is maintained that aspecific immunological serum doses are of little use, but research is urged into specific antibodies by means of indirect immunofluorescence and the Elisa method. PMID- 6856175 TI - [Vesical hernias. Considerations apropos of a case]. AB - A case of inguinoscrotal hernia involving the bladder is presented. This pathology is so frequent in males over 50 that preoperative diagnostic investigations should include retrograde cystography and if necessary urography. PMID- 6856176 TI - [Photo-biomolecular effects of laser radiation]. AB - The authors present the photo-biomolecular effects of laser rays by introducing their physical principles. The interaction between irradiated energy and matter is taken into consideration, by studying the wave length of the different types of laser, the emission and the energetic absorption. It is pointed out that the low-intensity laser radiations with given characteristics have no ionizing actions like X-rays or ultraviolet rays, and how the photo-biological and therapeutical action depends upon the absorption of rays and their diffusion. PMID- 6856174 TI - [Ectopic calcifications in adult hypophosphatasia]. AB - The first case of hypophosphatasia in adults reported in Italy (20th in the world) is described with remarks on the epidemiology, pathogenesis and therapeutic possibilities. The formation of renal and cholecystic calculi after long-term, intensive vitamin D and Calcium therapy indicates the limited capacity of pyrophosphate (PPi), even in large doses, to prevent the precipitation in man of calcium and phosphorus and the subsequent formation of ectopic calcifications. PMID- 6856177 TI - [Soft-laser therapy in the treatment of fibromyositis in sports medicine]. AB - 27 cases of sportsmen suffering from single or multiple myosis in different muscular groups (tendomyosis trapetii, splenii capitis, sacrospinalis, longissimus dorsi, glutaei medii) treated by combined soft-laser-therapy are presented. Pathogenesis of the disease and therapeutic results on the basis of recent clinical and experimental knowledge are discussed. PMID- 6856178 TI - [1st observations on the side effects of soft-laser therapy]. PMID- 6856179 TI - [Cardiovascular risk factors after menopause]. PMID- 6856181 TI - [Echography and CAT in the evaluation of gynecologic pelvic masses]. PMID- 6856180 TI - [The importance of ultrasonics in the early diagnosis of cervical pregnancy. Presentation of clinical case]. PMID- 6856183 TI - [Hysterosalpingography in the diagnosis of uterine malformations]. PMID- 6856182 TI - [The computerized radionephrogram. Uses in gynecologic oncology]. PMID- 6856184 TI - [Marital sterility. Statistical studies of the etiopathogenesis and therapeutic results obtained in 7 years of activity in a sterility center]. PMID- 6856185 TI - [Treatment of carcinoma of the cervical stump at the Obstetrical and Gynecological Clinic of Padua. 1969-1974]. PMID- 6856187 TI - [New trends in cesarean section at the Obstetrical and Gynecological Clinic of Parma]. PMID- 6856186 TI - [Personal experience in the treatment of cervico-vaginal infections with the nifuratel-nystatin combination]. PMID- 6856188 TI - [Breast reconstruction after mastectomy]. PMID- 6856189 TI - [Use of "extreme value" statistical models for study of the distribution of body weight of living and vital newborn infants]. PMID- 6856190 TI - Electrochemical delivery of dopamine. PMID- 6856191 TI - Rapid adjustment of sarcomere length in tenotomized muscles depends on an intact innervation. AB - Mean sarcomere length has been determined by laser diffraction in fibres of mouse soleus muscle at various times after division of the proximal tendon. Sarcomere length was initially reduced by 27% but was normal from 7 days after tenotomy. Initial shortening was less but recovery slower if the muscle was also denervated. Sarcomere length did not recover by 14 days if the tendon was cut soon after the muscle fibres became reinnervated after nerve section. It is suggested that afferent nervous pathways are involved in the short-term adjustment of sarcomere length to fibre length. PMID- 6856192 TI - Study of the subunit structure of rabbit nicotinic acetylcholine receptor. PMID- 6856193 TI - Neurotensin in the adrenal medulla. PMID- 6856194 TI - Total GABA and homocarnosine in CSF as indices of brain GABA concentrations. AB - Treatment of rats with gamma-vinyl-GABA, an inhibitor of GABA-transaminase, caused a dose- and time-related increase in brain GABA concentrations concomitant with increases in the concentrations of total GABA and homocarnosine in the CSF. At 18 h after treatment both CSF parameters correlated significantly with brain GABA concentrations. However, only total GABA in CSF accurately reflected brain GABA concentrations as a function of time after treatment and is therefore the preferred index. PMID- 6856196 TI - Modulation of unit activity in the amygdala of unrestrained cats during the sleep waking cycle. PMID- 6856195 TI - Persisting selective block of unmyelinated fibers in cutaneous nerves of the cat by distilled water. AB - Experiments were done in vivo on the sural nerve of the cat's hindlimb. The nerve was desheathed for a length of 8 mm and superfused by Tyrode solution or distilled water. Electrical stimulation and recording was used to evaluate conduction block of nerve fibers. Irrigation with distilled water for periods of 3-5 min caused a persisting selective block of conduction in C-fibers while most of the A-fibers were unaffected. Recovery of the C-fibers never occurred during the time of observation (up to 130 min). PMID- 6856197 TI - Monoclonal antibody binding to brain membranes is altered by iodonitrotetrazolium violet treatment. AB - Treatment of brain membrane preparations with para-iodonitrotetrazolium violet, used in preparing synaptic plasma membranes and related fractions, can either increase or decrease monoclonal antibody binding to the membranes. Thus, statements about the absolute amount of antigen present in such fractions cannot be made solely on the basis of antibody binding studies. However, such preparations remain useful as targets for monoclonal antibody screens, and in assays to determine the relative distribution of an antigen. For example, the G5 rat nervous system specific antigen can tentatively be considered a minor, developmentally regulated component of the extra-junctional portion of synaptic plasma membranes. PMID- 6856199 TI - The ipsilateral retinotectal projection in normal and albino channel catfish. AB - The retinal projection to the ipsilateral optic tectum was examined first in normal channel catfish. After unilateral optic nerve section and horseradish peroxidase (HRP) application, a sparse retinal projection was seen in the ipsilateral optic tectum. When HRP was applied to the ipsilateral rostral tectum, labeled ganglion cells were observed in the ventrotemporal quadrant of the ipsilateral eye. Electrophysiological mapping of the ipsilateral projection confirmed that cells in the temporal retina projected to the rostral tectum. When albino catfish were examined using these techniques, the ipsilateral retinotectal projection was found to be much sparser than the ipsilateral projection of normal catfish. PMID- 6856198 TI - Origin and topography of thalamocaudate projections in the opossum. AB - The origins of the thalamocadaute projections in the North American opossum include the intralaminar nuclei (parafascicular complex, the paracentral, centralis and central lateral nuclei) and the intermedial dorsal, medial dorsal and interanterior dorsal nuclei. Of these, portions of the intralaminar nuclei exhibit rudimentary elements of a topographically organized projection. However, it is obvious that the patterns observed here are much less specific than those reported in other mammalian species. We suggest that the question of topographic specificity may relate to the overlapping of sensory and motor representations in the neocortex. PMID- 6856200 TI - Claustral neurons projecting to the visual cortical areas in the cat: a retrograde double-labeling study. AB - Double retrograde axonal tracers (horseradish peroxidase, (HRP) and [3H]apo-HRP) have been used to study the distribution of labeled cells in the cat claustrum. Paired injections were made into different fields of the visual cortical areas. Although the areas of distribution of single-labeled claustral neurons from different cortical injection sites overlapped somewhat, no double-labeled neurons were found in the claustrum. Thus, it is suggested that individual claustral cells project only to one cortical target region. PMID- 6856201 TI - Brainstem projections of aortic baroreceptor afferent fibers in the rat. AB - Brainstem projections of the aortic nerve in the rat were studied using the transganglionic transport of horseradish peroxidase. Labeled axons were found to project predominantly to the ipsilateral interstitial nucleus and to the ipsilateral dorsolateral aspect of the nucleus of the solitary tract near the level of the obex. Lighter bilateral projections were also found to the medial, ventrolateral and dorsolateral aspects of the solitary complex, and to the commissural nucleus. These data provide evidence of direct aortic baroreceptor afferent projections to restricted regions of the solitary complex and indicate that these specific areas function in the integration of the baroreceptor reflex. PMID- 6856202 TI - Corticofugal influences in the rat on responses of neurons in the trigeminal nucleus interpolaris to mechanical stimulation. AB - We recorded effects of electrical stimulation of sensorimotor cortex on the responses of 45 neurons in the interpolar trigeminal nucleus to mechanical stimulation of vibrissae. Responses elicited by peripheral mechanical stimulation were enhanced when a neuron's receptive field (RF) included the RF of the cortical stimulating locus, and suppressed when the RFs of the cortical site and the interpolar neuron did not overlap. Several interpolaris neurons influenced by cortical stimulation were shown to project to the cerebellum. PMID- 6856203 TI - Does orderly recruitment of motoneurons depend on the existence of different types of motor units? AB - It has recently been proposed that the recruitment of motoneurons is correlated with their type rather than their size. To test this hypothesis the axonal conduction velocities (CVs) of 92 pairs of soleus motoneurons (all of the same histochemical type) were compared with their recruitment order. By means of spike triggered averaging it has been shown that in 89 out of 92 pairs of soleus units the motoneuron with the lower CV was recruited first. The results indicate that orderly recruitment occurs in the absence of different types of motoneurons and is correlated with cell size within a cell type. PMID- 6856204 TI - Catecholamine effects on frog dorsal root terminals. AB - Dopamine, norepinephrine and epinephrine applied to the isolated superfused frog spinal cord had complex effects on the terminals of primary afferent fibers. The most consistent finding was a slow hyperpolarization of terminals with lower concentrations (10 microM or lower), but depolarizations either following or admixed with the hyperpolarizations were seen. These were particularly prominent when the catecholamines were applied in high concentrations or for prolonged periods of time. A part of the response of afferent terminals appears to be indirect since the potential changes were reduced following exposure of the cord to tetrodotoxin, Mn2+, or mephenesin. The hyperpolarizations were augmented by imipramine, a known inhibitor of catcholamine uptake. These observations are consistent with a role of catecholamines in the processing of sensory input in the spinal cord. PMID- 6856205 TI - Abortive amygdaloid kindled seizures following microinjection of gamma-vinyl-GABA in the vicinity of substantia nigra in rats. AB - The effects of microinjection of a GABA-elevating substance (gamma-vinyl-GABA) in the substantia nigra were assessed on kindled convulsive seizures induced by daily appropriate amygdaloid stimulation in the rat. Bilateral administration of 20 micrograms of gamma-vinyl-GABA strongly reduced the afterdischarge duration of the seizures without significantly modifying the motor convulsions. This effect was noted 24 h after injection and lasted for up to 48 h. Administration of gamma vinyl-GABA in structures 1.5 mm distant from the substantia nigra had no effect on kindled seizures. It is suggested that the substantia nigra may intervene in a negative feedback system that tends to suppress the paroxysmal activity initiated from the amygdala. PMID- 6856206 TI - Kainic acid lesioning of alkaloid-sensitive brain sites and ethanol ingestion in the rat. AB - A control alcohol (ethanol) preference test was first given to adult male Sprague Dawley rats which were provided water together with alcohol increased in concentrations from 3 to 30% over 8 days. Then each rat was anesthetized and a two-stage, bilateral lesion was made stereotaxically by microinjection of kainic acid in a dose of 0.5 micrograms into the hippocampus, cingulate gyrus or periaqueductal gray. Specifically selected sites were based on earlier experiments in which the application of a tetrahydroisoquinoline alkaloid was found to induce an increase in alcohol drinking. Two weeks later, the 8-day test of self-selection for alcohol was repeated. Although neurological signs of kainic acid lesions were apparent, no significant differences in alcohol drinking in terms of proportion or g/kg intake occurred after either the first or second stage of the lesion. These results show that local destruction of an alkaloid sensitive site does not appear to be responsible for induction of aberrant drinking of alcohol. PMID- 6856207 TI - Legal issues. Part 2. Nursing advocacy of patients' right: myth or reality? PMID- 6856208 TI - Doctrine of delegated medical acts. PMID- 6856209 TI - Type of intrauterine device and the risk of pelvic inflammatory disease. AB - To study the association of pelvic inflammatory disease and various types of intrauterine devices (IUDs), data from the Women's Health Study were analyzed. The analysis included data from interviews of 622 women hospitalized with an initial episode of pelvic inflammatory disease and 2369 hospitalized control subjects reporting no history of pelvic inflammatory disease. Compared to the risk in women using no contraception, the relative risk of pelvic inflammatory disease in women currently using the Dalkon Shield was 8.3 (95% confidence limits 4.7 to 14.5). This represented a fivefold increase in risk compared to women currently using other types of IUDs. In this study, only 10% of women wearing an IUD were using the Dalkon Shield, yet they accounted for almost 20% of the excess risk of pelvic inflammatory disease occurring among all the IUD users. Most of the increased risk of pelvic inflammatory disease for women currently using other IUDs (excluding the Dalkon Shield) occurred in the first four months after insertion. These associations were not explained by differences between cases and controls in demographic variables, level of sexual activity, or medical history. The authors recommend that women still using a Dalkon Shield have it removed. PMID- 6856210 TI - Hepatitis B: a controllable disease. AB - Major advances have been made in understanding the epidemiology and biology of the hepatitis B virus. Two particular developments--hepatitis B immune globulin and a new hepatitis B virus vaccine--are of special interest to obstetricians, gynecologists, and others who provide health care to women. The appropriate use of hepatitis B immune globulin and hepatitis vaccine can prevent hepatitis B virus infections. PMID- 6856211 TI - Indium-labelled platelet imaging of postoperative pelvic vein thrombi. AB - Thrombosis of the pelvic veins remains a presumptive clinical diagnosis due to the lack of an accurate method of detection. The authors have evaluated the effectiveness of imaging indium 111-labeled platelets aggregated in pelvic vein thrombi after extended pelvic surgery in dogs. In all instances the thrombus imaged on the gamma scan correlated with a thrombus documented by venography and by postmortem dissection. Detection of the thrombi is attributed to the increased radioactivity of the incorporated platelets in the thrombus, compared to other tissues adjacent to the pelvic veins. From the authors' experience in a dog model it appears that indium 111-labeled platelet imaging is a satisfactory technique for the diagnosis of postoperative pelvic vein thrombosis. PMID- 6856212 TI - Reliability of antenatal testing: estriol levels versus nonstress testing. AB - During the third trimester of pregnancy, 334 high-risk patients were followed with antenatal fetal heart rate (FHR) evaluation and with serial determinations of unconjugated plasma estriol. The antenatal FHR tests included nonstress testing (NST) and investigation of beat-to-beat variability. Data indicate that the NST was more reliable than estriol analysis in assessing fetal compromise. While predictive values of negative test results did not differ statistically, the NST/beat-to-beat assessment was particularly accurate in identifying fetal jeopardy in more than 45.0% of the fetuses at risk, whereas only 22.8% cases of jeopardy were accurately predicted by abnormal estriol values. An abnormal NST with loss of beat-to-beat FHR variability should therefore take precedence over plasma estriol determinations during antenatal surveillance of high-risk obstetric patients. PMID- 6856213 TI - Site and origin of squamous cervical cancer: a histomorphologic study. AB - Based on extensive histomorphologic study, a concept of cervical carcinogenesis is formulated. Intraepithelial neoplasia arises in well defined and predestined fields that are well demarcated from each other. Different forms of intraepithelial neoplasia coexist and have different topographic distribution. Extension and enlargement of atypical epithelial fields are not brought about by active spread, but by apposition of new fields. Two different pathways exist for the genesis of intraepithelial neoplasia affecting cell types involved in regeneration or transformation. In the majority of cases the precursor lesion is atypical squamous metaplasia in the transformation zone. Less commonly, malignant change occurs in original squamous epithelium, probably via atypical basal hyperplasia. The role of the "last gland" is seen as the anatomic landmark dividing these two areas. So-called minor forms of intraepithelial neoplasia cannot progress and change into carcinoma in situ, as they are differently located. PMID- 6856216 TI - Microinvasive carcinoma of the vulva. PMID- 6856215 TI - Single-agent therapy. PMID- 6856217 TI - Prophylactic anticoagulation as a possible cause of inguinal lymphocyst after radical vulvectomy and inguinal lymphadenectomy. AB - From 1957 to 1982, 115 patients underwent radical vulvectomy and bilateral inguinal lymphadenectomy for invasive squamous carcinoma of the vulva. From 1957 to 1971, 57 patients received perioperative prophylactic sodium warfarin (Coumadin) as prophylaxis against pulmonary embolism. From 1971 to 1976, 27 consecutive patients received dextran-40 as prophylaxis for pulmonary embolism and to improve the microcirculation to the inguinal skin flaps. Because of the report that dextran-40 is a cause of acute renal failure, this study was terminated and the subsequent 19 patients were treated with mini-dose heparin because of the reported benefit as prophylaxis against thromboembolic disease. During the 25-year period, 12 patients received no prophylactic anticoagulants. Mini-dose heparin resulted in a significant morbidity not previously reported in patients undergoing inguinal lymphadenectomy: 43% (8/19) of the mini-dose heparin patients, 7% (2/27) of the dextran-40 patients, 0% (0/57) of the sodium warfarin patients, and none of the 12 patients not receiving perioperative prophylaxis developed inguinal lymphocysts (P less than .001). There was no significant difference in the prevention of pulmonary embolism between the mini-dose heparin (0/19), dextran-40 (0/27), and no treatment groups (0/12) as compared to the 5% (3/57) incidence in the sodium warfarin patients (.10 less than P less than .50). The significant relationship between prophylactic heparin and the subsequent development of inguinal lymphocysts and the need to reassess its role in prevention of pulmonary embolism in patients undergoing lymphadenectomy is discussed. PMID- 6856214 TI - Bilateral hilus cell tumors of the ovary. AB - A 51-year-old postmenopausal multipara with high plasma testosterone levels and virilization, as demonstrated by hirsutism, balding, increased libido, and clitoromegaly, is presented. The plasma testosterone levels exceeded 330 ng/dl on 3 occasions. The plasma androstenedione, urinary 17-ketosteroids, and 17 hydroxycorticosteroids, as well as the computed axial tomography scan of the adrenal glands were normal. Although no pelvic mass was detected by sonography or pelvic exam, the patient was found to have small bilateral hilus cell tumors of the ovary. Following total abdominal hysterectomy and bilateral salpingo oophorectomy, the plasma testosterone dropped to 14 ng/dl. This is the second case of bilateral hilus cell tumors of the ovary to be reported. PMID- 6856218 TI - Plasma unconjugated estriol as an indicator of fetal dysmaturity in postterm pregnancy. AB - The role of twice-weekly plasma unconjugated estriol determinations in the prediction of fetal dysmaturity was studied in 663 patients seen at the Postdates Clinic of the Los Angeles County/University of Southern California Medical Center. The correlation between estriol and gestational age was - 0.055. According to the criteria of the Postdates Clinic protocol, sensitivity, specificity, predictive values of positive results, and those of negative results of estriol determinations in predicting fetal dysmaturity were 44.4, 80.6, 32.9, and 87.1%, respectively. The major deficiency of this test for the detection of fetal dysmaturity was in the less-than-ideal predictive value of a negative result: 13% of patients who had normal estriol values had dysmature infants. When estriol was less than 12 ng/ml and the value fell more than 20% from the previous level, the predictive value of fetal dysmaturity was 56%. In these circumstances, the termination of pregnancy is a reasonable consideration. Until a more sensitive test for fetal dysmaturity is developed, plasma unconjugated estriol determination will retain its role as a screening test in managing postterm pregnancies in a large obstetric population. PMID- 6856219 TI - Accelerated pulmonary maturity as measured by the Lumadex-foam stability index test. AB - The Lumadex-foam stability index test and lecithin:sphingomyelin (L:S) ratio were compared in the small preterm fetus. Amniotic fluid was obtained within 72 hours of birth from 70 high-risk patients whose infants were at 34 weeks' gestation or less and/or weighed less than 2000 g. Twenty-nine infants were small for gestational age. Eleven of the 41 appropriate for gestational age babies developed respiratory distress syndrome. Conclusions of the study were as follows: 1. The Lumadex-foam stability index test is an accurate, quantitative, and rapid measure of fetal lung maturity. 2. Growth retardation accelerates functional lung maturity in the preterm fetus. 3. The foam stability index value can discriminate between the small for gestational age and appropriate for gestational age fetus at 32 weeks' gestation or less and/or less than 1500 g birth weight. 4. The L:S ratio cannot discriminate between the small for gestational age and appropriate for gestational age fetus because the false negative rate increases as fetal weight decreases. PMID- 6856220 TI - Determination of gestational age by serum concentrations of human chorionic gonadotropin. AB - To examine the accuracy and predictability of human chorionic gonadotropin concentrations in determining gestational age, serum concentrations of human chorionic gonadotropin (beta-subunit) were measured during the first 157 days after last menses. Using the regression curve generated, human chorionic gonadotropin concentrations obtained during the first 60 days accurately predicted the day of gestation. The difference (mean +/- SD) between the human chorionic gonadotropin-predicted estimated date of confinement and the estimated date of confinement established by known dates of last menses was 3.1 +/- 2.3 days. In patients followed to parturition, the difference between human chorionic gonadotropin-estimated gestational age and gestational age by physical assessment of the neonate was 8.1 +/- 7.1 days. After 60 days' gestation, human chorionic gonadotropin concentrations vary widely and are of little value in predicting gestational age. In addition to documenting conception, early human chorionic gonadotropin determinations accurately date the gestation and complement other clinical and biophysical methods for determining gestational age that are frequently used later in pregnancy. PMID- 6856221 TI - Circulating immune complexes in hypertensive disease of pregnancy. AB - Circulating immune complexes in the blood of patients with hypertensive diseases of pregnancy were investigated. Sixty women with pregnancies between 30 and 40 weeks were studied. Of these patients, 22 were normal, 18 developed preeclampsia, 2 developed eclampsia, 14 had essential hypertension, and four had hypertension of renal origin. Circulating immune complexes were determined by the method of phagocytosis and immunofluorescence. They were found only in patients with preeclampsia or eclampsia, and were constituted of IgG and C3. It is suggested that the detection of circulating immune complexes by this method can be useful in the differential diagnosis of preeclampsia from other hypertensive diseases of pregnancy. PMID- 6856222 TI - C-reactive protein with premature rupture of membranes and premature labor. AB - C-reactive protein (CRP) was determined serially in 31 patients with premature rupture of the membranes, 41 patients in premature labor, and 18 pregnant patients with a variety of high-risk conditions. Elevated levels of CRP were not predictive of clinical amnionitis, histologic chorioamnionitis, or neonatal sepsis. No discernible relationship was found between serum CRP and peripheral white blood cell count. CRP was not elevated (false negative) in two patients in the premature labor group with culture-proved bacterial amnionitis. Elevated CRP in the absence of infection (false positive) likewise occurred. The results suggest that CRP be used in conjunction with other signs and symptoms suggestive of chorioamnionitis, rather than as a pathognomonic test. PMID- 6856223 TI - Cardiac stimulation during ritodrine hydrochloride tocolytic therapy. AB - The effect of ritodrine hydrochloride tocolytic therapy on left ventricular size and performance was studied during pregnancy by M-mode echocardiography. Ritodrine therapy increased heart rate, calculated stroke volume, ejection fraction, and cardiac output. Left ventricular end-diastolic dimension and systemic arterial pressure were unchanged. Left ventricular velocity of circumferential fiber shortening was markedly augmented. Ritodrine, as currently used for tocolytic therapy, has potent inotropic and chronotropic effects on the maternal heart. These effects suggest that ritodrine tocolytic therapy should be used with caution in patients with latent or manifest heart disease. PMID- 6856224 TI - Pregnancy after spinal cord injury: altered maternal and fetal response to labor. AB - Four pregnancies in three patients with spinal cord injury are presented. The major complications encountered include anemia, pyelonephritis, decubiti, premature labor, precipitate labor, and autonomic hyperreflexia. Autonomic hyperreflexia, a severe mass autonomic reflex response to labor, is associated with tachycardia, hypertension, headache, diaphoresis, and severe anxiety. It is probably due to increased norepinephrine release, as very high urinary metanephrines were measured in the latter two cases presented. Maternal and fetal physiology in labor are altered. Despite severe maternal and fetal stress responses, no fetal depression was observed. PMID- 6856225 TI - The effect of an educational intervention on the rate of neonatal circumcision. AB - Despite the absence of verifiable indications, routine circumcision of the male neonate remains one of the most common surgical procedures in the United States. A sample of obstetric clinic patients in a large urban hospital was tested to determine whether spoken educational intervention would reduce the rate of circumcision. The results showed that the rate was lowered significantly (94.4% circumcised in the control group versus 72% circumcised in the study group). Nevertheless, the majority of the study mothers requested circumcision for their sons despite the educational intervention, suggesting the presence of strong social motives. The authors conclude that many mothers in this population chose circumcision because of inadequate medical information or strong social motives. Both must be addressed if the rate of elective circumcision is to be reduced. PMID- 6856226 TI - Intraoperative blood loss in midtrimester dilatation and extraction. AB - Intraoperative blood loss was evaluated in 215 patients undergoing a midtrimester dilatation and extraction procedure using a paracervical-intracervical block. Patients were assigned to four randomized drug regimens using a combination of 0.5% bupivacaine, dilute epinephrine, and methylergonovine maleate. From these four regimens, a select group of patients were given fentanyl. No significant difference in blood loss was observed in any group at less than 17 weeks' gestation. Only in gestations of 17 weeks or more was there a significant increase in blood loss, and this increase was associated specifically with the use of fentanyl in the nonrandomized selected group. PMID- 6856227 TI - Doppler ultrasound and maternal erythrocyte fragility. AB - Maternal erythrocyte fragility was studied in eight controls and in 16 women exposed to Doppler ultrasound monitoring during labor. Blood samples were taken before and after Doppler monitoring and no significant change in erythrocyte fragility was seen, although there was a trend toward increased fragility in patients exposed continuously for more than seven hours. PMID- 6856228 TI - Salpingitis isthmica nodosa: a high-risk factor for tubal pregnancy. AB - A prospective and retrospective study was undertaken to analyze pathologic lesions in fallopian tubes of 200 consecutive tubal pregnancies. In a retrospective analysis of 100 cases of tubal pregnancy, seven cases were reported to contain salpingitis isthmica nodosa. After review, 27 cases were found to have this lesion. The prospective study employed 100 consecutive tubal pregnancy specimens thoroughly sectioned for microscopic examination. Salpingitis isthmica nodosa was observed in 57 of these 100 cases. In a control series of 100 fallopian tubes obtained from autopsy and surgical specimens, five tubes showed salpingitis isthmica nodosa. These observations indicate a significant association between tubal pregnancy and salpingitis isthmica nodosa. PMID- 6856229 TI - Cervical pregnancy analysis: a review and report of five cases. AB - Five cases of cervical pregnancy are presented, with an incidence of 1:2400. Four of the cases, proved after hysterectomy and histopathologic confirmation, occurred in 1981. One was clinically most probable and was treated conservatively by curettage and packing. The distinction between proved and clinically probable cases of cervical pregnancy is defined. A review and analysis of the literature reveals an increasing incidence of cervical pregnancy. This may be due largely to increased numbers of induced abortions and sharp curetting. The maternal mortality rate has decreased from approximately 40 to 45% to zero in the past 30 years. Approximately 70% are treated necessarily by total hysterectomy. The remaining 30% are treated conservatively; however, ensuing pregnancies are rare in such women. Only three cases of pregnancy following probable cervical pregnancy have been reported. The last reported case was in 1953. PMID- 6856230 TI - Metabolic parameters and steroid levels in postmenopausal women receiving lower doses of natural estrogen replacement. AB - This study was carried out to determine whether some of the lowest doses of natural estrogens currently prescribed for postmenopausal women result in significant changes in plasma lipids, urinary calcium, urinary free cortisol, or level of androgens. Twenty-four postmenopausal women were studied and the estrogens ingested were either conjugated estrogens (0.3 or 0.6 mg), piperazine estrone sulfate (0.6 or 1.2 mg), or micronized estradiol (1 mg). Plasma lipids were unaltered, with the exception of a decrease in low-density lipoprotein cholesterol in women receiving conjugated estrogens, 0.625 mg, and micronized estradiol. The fasting calcium: creatinine ratio, which was significantly higher than that of premenopausal women, decreased significantly after treatment with all the prescribed doses. There was no correlation between the initial calcium: creatinine ratio and urinary free cortisol or androgen levels. Urinary free cortisol was in the premenopausal range and did not change with treatment; levels of dehydroepiandrosterone sulfate and testosterone were significantly lower than premenopausal levels but did not change with treatment. In conclusion, these natural estrogens have no effect on lipids, urinary free cortisol, and androgen levels, but they appear to reduce the urinary loss of calcium in the fasting state. PMID- 6856231 TI - After the hearing test--what then? AB - The credibility of industrial hearing test data should be established before it is evaluated for follow-up action. Once this is done, subsequent evaluation should determine 1) whether or not there is need for referral to a professional, 2) whether or not there has been a significant threshold shift (STS), and 3) provide for necessary within-company administrative follow-up, as appropriate. Caution should be used in releasing data to employees; however such release should be prompt and complete. Use of the term 'normal hearing' should be minimized; with 'satisfactory hearing' being substituted. Use of this term should include the criteria upon which it is based. There is some confusion on what is not meant by STS, and specific criteria pertaining thereto have been recommended. Using a computer to assist in the above processes can result in increased accuracy and economy, while at the same time providing for easy access to the collective data base thereafter. PMID- 6856232 TI - The hypertensive worker: whose patient is he? PMID- 6856235 TI - Educating employees about breast cancer. PMID- 6856233 TI - How the well cope with potential illness. PMID- 6856234 TI - Epidemic hysteria. A study of high risk factors. PMID- 6856236 TI - Worker health in the automated office. PMID- 6856237 TI - Muscle pain. PMID- 6856238 TI - At last--the hearing conservation standard. PMID- 6856239 TI - Genetic screening and the law: question waiting for an answer. PMID- 6856240 TI - Genetic screening in the workplace. PMID- 6856241 TI - Inflammation of the lacrimal drainage system--assessment by thermography. AB - Thermography is an investigative tool without side effects. To our knowledge thermography has not been evaluated in the assessment of lacrimal passage inflammation and obstruction. It can give an objective assessment of presence and degree of inflammation. An infrared scanning device was used to detect surface temperatures in 29 patients with known disorders of the lacrimal drainage passage. Thermal images were compared for bilateral symmetry and against the normal thermographic appearance of the face. Acute dacryocystitis and canaliculitis showed gross hyperthermia and asymmetry. Forty-two percent of patients with a picture of chronic dacryocystitis and 40% of patients with only tearing and no clinical evidence of inflammation showed temperature elevation on the side of involvement, whereas 58% and 60% of these respective groups showed symmetrical thermal patterns, suggesting no active inflammation. In a few cases there were discrepancies between clinical assessment and objective thermographic evaluation of the degree of inflammation. The implications of our results and possible applications of thermography are discussed. PMID- 6856242 TI - Exposed scleral buckle: a case report in an eleven-year course. AB - One patient with an exposed scleral buckling element in the left eye was initially followed conservatively. Soon after exposure, he developed a retinal detachment in the fellow eye, resulting in loss of useful vision. Because of concern over possible redetachment and loss of vision in the remaining eye, the patient has been followed with the exposed element for more than 11 years. Treatment has consisted solely of prophylactic topical antibiotics. PMID- 6856243 TI - Central cornea involvement in Terrien's degeneration. AB - A 15-year-old female showed classical signs of Terrien's corneal degeneration including peripheral corneal thinning, vascularization, lipid deposition, and ectasia. She also showed episodes of conjunctival inflammation and perforation following minor trauma, all in the presence of an intact epithelium. She also showed progressive central corneal thinning and opacification, features not reported in the literature in the last 30 years. PMID- 6856244 TI - Combined macroscopic, light microscopic, scanning, and transmission electron microscopic investigation of the vitreous body. 3. The structure of the anterior border layer of the vitreous. AB - The anterior vitreous border layer consists of multiple net-like densely compacted individual lamellae as shown by combined macroscopic, light microscopic, scanning, and transmission electron microscopic investigations. Each lamella displays a polygonal two-dimensional meshwork formed by vitreous fibrils. This multilamellar border layer is reinforced by zonula fibres which merge with anterior lamellae. Probably this special architecture corresponds to the membrane like function as mentioned by Balazs. PMID- 6856245 TI - Fructose, fructose 1-phosphate, and glyceraldehyde breakdown in carbohydrate metabolism. AB - Recent investigations showed that all enzymes that are involved in the catabolism of fructose via fructose 1-phosphate (F-1-p) are present in the bovine lens. The present studies were performed to provide information regarding the extent to which fructose, F-1-p and glyceraldehyde (GA) are actually catabolized via this pathway, and how they increase the lactate, alpha-glycerophosphate and glycerol concentrations. Incubation was performed with a homogenate of bovine lens equator. F-1-p, and particularly fructose + ATP, considerably increased lactate and alpha-glycerophosphate concentrations, while the glycerol concentration remained unchanged compared to controls. Lactate formation through GA was not observed; while small amounts of glycerol and alpha-glycerophosphate are formed, it seems that the major part is transformed to glycerate. The results show that the further breakdown of lenticular fructose occurs via F-1-p and that the phosphorylated C3 fragments (dihydroxyacetone phosphate) are transferred to the energy metabolism, which is not the case with GA. PMID- 6856246 TI - Gamma-crystallin-dodecyl sulfate complexes show discrete precipitation in non ionic detergents. AB - Gamma-crystallin-sodium dodecyl sulfate (SDS) complexes are precipitated by Triton X-100 and other non-ionic detergents. This is accomplished as discrete lines by double diffusion, radial diffusion and other immunotechniques. Many other protein-SDS complexes including those of alpha- and beta-crystallins remain soluble. Immunoglobulin G tends to precipitate under similar conditions, a reason why the use of detergents in immunoprecipitation reactions has to be carefully controlled. The phenomenon can be used for the estimation of SDS or non-ionic detergents in the presence of gamma-crystallin. PMID- 6856247 TI - Arylamidase and dipeptidase activities in human normal and brunescent cataractous lenses. PMID- 6856248 TI - The classification of retinal detachment with proliferative vitreoretinopathy. AB - The term proliferative vitreoretinopathy (PVR) is proposed as a designation for the clinical condition previously known variously as massive vitreous retraction, massive preretinal retraction, or massive periretinal proliferation. This is an abnormality in which rhegmatogenous retinal detachment is complicated by proliferation of membranes on both surfaces of the detached retina and on the posterior surface of the detached vitreous gel. The new classification subdivides PVR into four stages: A, minimal; B, moderate; C, marked; and D, massive. The extent of the fixed retinal folds is subdivided to indicate the number of involved quadrants. The degree of retinal shrinkage into a funnel-like configuration is subdivided into three grades. PMID- 6856249 TI - Retinitis pigmentosa. A symposium on terminology and methods of examination. AB - This report represents a summary of opinions expressed at a meeting of specialists interested in retinitis pigmentosa (RP) and allied diseases, at which an attempt was made to define some minimum guidelines for ocular evaluation of these disorders. The term RP would be reserved for a group of hereditary disorders that diffusely involve photoreceptor and pigment epithelial function, and should not be used when a secondary cause is suspected. RP may be classified by genetic type (single cases without known affected relatives should be termed isolated or simplex), by the topography of retinal involvement, and by the severity of disease (to identify subtypes with mild or localized disease). Patients should have at least one comprehensive examination that conforms to basic standards, preferable early in the course of the disease. The visual field examination should use both a small and a large test light. Electroretinographic testing should (1) use a full-field stimulus, and (2) routinely document three independent responses (cone, rod, and mixed cone-rod). Patients should be identifiable for future study or therapeutic trials. They should be counseled about the disease and followed regularly. No specific therapy exists at present for most of these diseases, but optical and night vision aids are available. Sunglasses for outdoor use are recommended until more is known about whether long term exposure to bright sunlight alters the course of these diseases. PMID- 6856250 TI - Early surgical alignment for congenital esotropia. AB - To provide sufficient numbers of patients varying in age of initial adequate surgical alignment for congenital esotropia, 162 patients managed by seven ophthalmologists in three countries were personally examined by the author and the results compiled for a clinical study. From this population group, 106 patients were chosen who had reliable answers, satisfactory alignment, and an ophthalmologist's confirmation examination of the congenital nature of the problem by at least 1 year of age. The results of sensory testing showed that those adequately aligned by the age of 6 months vs 12 months vs 24 months were not statistically different, but those patients aligned after 24 months of age demonstrated a significantly lower percentage with evidence for binocularity (P less than 0.001). Surgical alignment in the congenital esotropic patient should be accomplished by 2 years of age to attain the highest yield of binocular function. PMID- 6856251 TI - Massive exudative retinal and choroidal detachments following scleral buckling surgery. AB - Three aphakic male patients underwent successful scleral buckling surgery for unilateral rhegmatogenous retinal detachment. Within a two-week postoperative period, each developed severe ocular pain with massive exudative retinal and choroidal detachments resembling recurrent rhegmatogenous or traction retinal detachment or implant infection. Systemic prednisone therapy resulted in prompt resolution of ocular pain and reabsorption of subretinal and suprachoroidal fluid. It is important to recognize this uncommon postoperative syndrome so that proper medical therapy may be initiated and unnecessary additional retinal or vitreous surgery can be avoided. PMID- 6856252 TI - Extended wear contact lenses for myopes. A follow-up study of 400 cases. AB - The long-term effects of extended wear contact lenses (Perfilcon A [Permalens]) for myopia have been studied among 400 patients in a private clinic from December 1977 to September 1982. The drawbacks and possible complications were evaluated. With the exception of one case, no permanent modification of the cornea or ocular adnexa was found. The high rate of success among well-selected patients (without significant astigmatism or chronic infection of the eyelids) far outweighs the risks of radial keratotomy as it is known today. By and large patients opt for this method of optical correction once they are aware of its availability and remain with it despite the necessary frequent replacement of the lenses. PMID- 6856253 TI - Topical vs subconjunctival treatment of bacterial corneal ulcers. AB - The efficacy of eye drops and subconjunctival injections in the treatment of bacterial corneal ulcers for each of the following combinations were compared: cefazolin for staphylococcal ulcers, gentamicin for staphylococcal ulcers, and gentamicin for pseudomonal ulcers. Topical and subconjunctival therapy were equally effective in reducing the numbers of viable bacteria in experimental corneal ulcers. Subconjunctival injections produced high but transient peaks followed by persistent low troughs. In contrast, eye drops produced moderate but sustained concentrations throughout the treatment period. Under the conditions of this study, it appears that transient high peaks are not needed to eliminate bacteria effectively from a corneal ulcer. Since eye drops and subconjunctival injections are equally effective, other factors should determine the preferred route or routes of therapy. PMID- 6856254 TI - Retinoblastoma in a 26-year-old adult. AB - Retinoblastoma in a 26-year-old woman is reported clinicopathologically, and the difficulties in this clinical diagnosis are presented. Clinical and morphologic findings of this case suggest that rare embryonal retinal cells can persist and be subject to late malignant transformation. PMID- 6856255 TI - Present and future training of foreign ophthalmologists in the USA. The Academy's perspective. PMID- 6856256 TI - Present and future training of foreign ophthalmologists in the USA. Perspective of Association of University Professors of Ophthalmology. AB - A questionnaire entitled "Present and Future Training of Ophthalmologists in the USA" was sent to members of the Association of University Professors of Ophthalmology. Data obtained from the questionnaire indicate that: the complex regulations pertaining to training foreign medical graduates (FMGs) in the USA are often not fully understood by the chairmen, most programs are willing to accept but do not actively recruit FMGs, there are a number of obstacles encountered in selecting and training FMGs, and most resident and fellowship positions are filled by US graduates. PMID- 6856257 TI - Specialist training in the USA. Is the VQE really necessary? PMID- 6856258 TI - Present and future training of foreign ophthalmologists in USA. The perspective of the American Board of Ophthalmology. PMID- 6856259 TI - Response of the human vestibulo-ocular reflex system to constant angular acceleration. I. Theoretical study. AB - The response of the human vestibulo-ocular reflex system to a constant angular acceleration is calculated using a second order model with an adaptation term. After first reaching a maximum the peracceleratory response declines. When the stimulus duration is long the decay is mainly governed by the adaptation time constant Ta, which enables to reliably estimate this time constant. In the postacceleratory period of constant velocity there is a reversal in response. The magnitude and the time course of the per- and postacceleratory response are calculated for various values of the cupular time constant T1, the adaptation time constant Ta, and the stimulus duration, thus enabling their influence to be assessed. PMID- 6856260 TI - Response of the human vestibulo-ocular reflex system to constant angular acceleration. II. Experimental investigation. AB - The vestibulo-ocular reflex (VOR) response to a constant angular acceleration was investigated in a small group of subjects by varying the stimulus amplitude and the stimulus duration. Various parameters of the response were determined and compared with the results of the theoretical study. This form of stimulation yields a rather high value for the adaptation time constant Ta, which perhaps indicates that there is an adaptation gain of less than unity. This supposition is supported by finding of non-linearity within the VOR system at high stimulus amplitudes. PMID- 6856261 TI - Chronological changes of electrocochleogram in experimental endolymphatic hydrops. Special reference with AP output potential and hair cell cilia. AB - Chronological changes of the whole nerve action potential (AP), cochlear microphonics (CM) and summating potential (SP) in experimental endolymphatic hydrops in guinea pigs were studied during a period from 1 week to 13 months after the endolymphatic sac obliteration. Endolymphatic hydrops became extensive in month 3 and persisted thereafter. The threshold of AP increased with the lapse of time but good AP output potential was obtained, being maximum in month 3. The threshold of CM increased with the lapse of time. The CM output potential was the highest around week 3 when endolymphatic hydrops was slightly formed, and it decreased thereafter. SP responses at the frequencies of 8, 4, 1 and 0.5 kHz showed the reversed polarity of -SP in month 3 and changed towards potential 0 thereafter. In animals showing super-normal AP output potential, the cilia in the third row of outer hair cells were disarranged. This seems to be involved in recruitment. PMID- 6856262 TI - Prognosis and pathogenesis of sudden deafness with scaling out. AB - Recovery of hearing in sudden deafness is said to be such that the severer the hearing loss and the longer the period from the disease onset to the start of treatment, the poorer the recovery of hearing. However, the prognosis of the so called scaling out cases has not yet been fully studied. We have therefore studied 96 patients with severest sudden deafness who consulted us within 14 days after disease onset and who had scaling out in all the frequencies. We evaluated the extent to which recovery of hearing could be expected and whether any characteristics are seen in pathogenesis, etc. The results showed that there was no patient who experienced complete recovery, even when treatment was started as early as within 4 days. Recovery of hearing was better in low frequencies than in high frequencies. The site of the lesion was the inner ear in many cases, and some had retrocochlear lesions. Concerning pathogenesis, we think the difference in degree of lesion should be considered important, rather than there may be a substantial difference, compared to that of slight deafness. PMID- 6856264 TI - [Achievements and problems of geriatric traumatology]. PMID- 6856263 TI - [Human bone-joint apparatus during aging]. PMID- 6856265 TI - [Degenerative and dystrophic lesions in developmental anomalies of the joints in adults]. PMID- 6856266 TI - [Experience with endoprosthesis of the femur head and neck in middle-aged and elderly patients]. PMID- 6856267 TI - [Classification of hematogenic osteomyelitis of the spine]. PMID- 6856268 TI - [Aspects of the prevention, clinical picture and treatment of posttraumatic osteomyelitis]. PMID- 6856269 TI - [Structure of staphylococcal infection in an orthopedic hospital]. PMID- 6856270 TI - [Restoration of the vascular bed of the lumbar vertebral body in cuneiform compression and "blast" fractures (an experimental study)]. PMID- 6856271 TI - [Clinico-pathophysiological basis for the therapeutic procedure in combined craniocerebral injuries]. PMID- 6856272 TI - [Clinical aspects and correction of pathology of consciousness in injuries]. PMID- 6856273 TI - [Acupuncture procedure in the pain syndromes following amputation of the extremities]. PMID- 6856274 TI - [Light-weight extension plaster corset]. PMID- 6856275 TI - [Use of pneumomassage for treating posttraumatic edema of the lower extremities]. PMID- 6856276 TI - [Variant of the surgical treatment of femoral neck fractures and pseudarthroses]. PMID- 6856277 TI - [Surgical drainage as a means of preventing and treating suppurative complications]. PMID- 6856278 TI - [The pin holder]. PMID- 6856279 TI - [The gauge]. PMID- 6856280 TI - [Primary surgical management of injuries]. PMID- 6856281 TI - [Contrast echocardiography in the diagnosis of congenital heart defects]. PMID- 6856282 TI - [Zinc and iron levels in the blood during the acute phase of myocardial infarct]. PMID- 6856283 TI - [Bone metastases from stomach cancer]. PMID- 6856284 TI - [5-years' experience with cancer screening for the protection of the female population]. PMID- 6856285 TI - [Emphysematous giant bulla, causing respiratory insufficiency, treated by transthoracal suction]. PMID- 6856286 TI - [Is birth weight inherited?]. PMID- 6856287 TI - [Serum calcitonin in hyperthyroidism]. PMID- 6856288 TI - [Incidence of antibody against hepatitis B core antigen (anti-HBc) in chronic diffuse liver diseases]. PMID- 6856289 TI - [The incidence of conjoined twins, epidemiology and pathogenesis]. PMID- 6856290 TI - [Toxic shock syndrome]. PMID- 6856291 TI - [Aspiration cytology in the diagnosis of lymph node diseases]. PMID- 6856292 TI - [Direct effect of smoking and mental arithmetics on heart rate and systolic time intervals]. PMID- 6856293 TI - [20-years' experience at a pediatric poison control center]. PMID- 6856294 TI - [Experience with the use of artificial Goretex blood vessels in the surgical management of congenital heart defects associated with decreased pulmonary circulation]. PMID- 6856295 TI - [Management of bilateral ureteral occlusion, following aorto-bifemoral bypass, by creating an ureter from the descending colon]. PMID- 6856296 TI - Symposium on inner ear surgery. PMID- 6856297 TI - Case selection in surgery for Meniere's disease. PMID- 6856298 TI - Endolymphatic sac surgery. The Danish sham surgery study: an alternative analysis. PMID- 6856299 TI - Medical treatment of Meniere's disease compared to early sac surgery. PMID- 6856300 TI - Cochleostomy or endolymphatic sac surgery for advanced Meniere's disease. AB - The operation of cochleostomy is described. The surgical technique is vital for the true assessment of results. If the cochlear duct is punctured, the risk to hearing is unacceptably high. If only the osseous spiral lamina is punctured, the results are acceptable in the short term, though the rationale cannot be explained. In the management of difficult patients with more advanced Meniere's disease, some variant of cochleostomy should probably be included in the therapeutic options. The results of endolymphatic sac surgery are significantly better in a matched group of patients. PMID- 6856301 TI - Sac surgery on the only or better hearing ear. AB - In a neuro-otological practice, many patients are seen with bilateral Meniere's disease. Some of these poor prognostic cases start in childhood or adolescence. Of all the conservative operations, endolymphatic sac surgery alone should be considered for the only or better hearing ear. The risk of surgical anacusis is less than 2 per cent, a risk outweighed by the significant short and long term benefit for these difficult patients. Including patients who undergo revision surgery, control of vertigo is very acceptable, and hearing gain, especially in only hearing ears, is often essential for rehabilitation. The best results probably are obtained when surgery is performed early in the course of the disease. PMID- 6856302 TI - The results of the first 300 consecutive endolymphatic system-mastoid shunts with valve implants for hydrops. PMID- 6856304 TI - A study of endolymphatic sac surgery. The results after reconstructing the sac versus those in operations that failed to open the lumen and satisfactorily insert a silastic implant. PMID- 6856303 TI - Valve implants: comparative analysis of the first year's experience with results in other sac operations. PMID- 6856306 TI - The Tullio phenomenon, fistula test, and Hennebert's sign: clinical significance. PMID- 6856305 TI - Sudden sensorineural hearing loss. AB - Sudden sensorineural hearing loss is a frightening experience for the patient. The patient's worse fears concern tumors or stroke. Although the physician is often frustrated by a symptom whose cause at times is not apparent, every effort should be made to identify the causes of sudden sensorineural hearing loss and possible predisposing causes of idiopathic sudden sensorineural hearing loss. Therapy includes efforts to treat known causes either medically or surgically, to keep the patient at reduced physical activity, and depending upon the treating physician's own preference, attempts to favorably alter the ultimate prognosis through medical manipulation. PMID- 6856307 TI - Inner ear pressure measurements. Effects of obstruction of the cochlear aqueduct and endolymphatic duct on the perilymphatic pressure. PMID- 6856308 TI - Behavioral effects of deafening in young monkeys: a pilot study. PMID- 6856309 TI - Intracochlear shunt. PMID- 6856311 TI - Auditory dehydration testing in the evaluation of hydrops: a comparison of glycerol and urea. PMID- 6856310 TI - Glycerin and urea tests in Meniere's disease. A multifactorial analysis using a quantification method. AB - By using the quantification method for multidimensional qualitative data, 13 variables were analyzed. The younger the patient, the stronger was the correlation between age and positive glycerin and urea tests. At ages over 50 years no correlation with positive test results was found. The longer the duration of disease, the stronger was the correlation between this duration and a positive urea test. The glycerin test showed no correlation with the duration of the disease. Hearing losses of 40 to 69 dB. were correlated with both a positive glycerin test and a positive urea test. Greater hearing losses were correlated only to a positive glycerin test. Hearing losses less than 39 dB. were not correlated with positive results in either the glycerin or the urea test. PMID- 6856312 TI - Electrocochleography and its role in the diagnosis and understanding of Meniere's disease. PMID- 6856313 TI - The use of electrocochleography in the diagnosis, assessment, and monitoring of endolymphatic hydrops. PMID- 6856314 TI - The clinical value of computerized sinusoidal harmonic acceleration testing in patients with endolymphatic hydrops. PMID- 6856315 TI - [Areas of applicability of thin-layer chromatography. Practical mass screening; data on intestinal mucosa lesions]. AB - Thin layer chromatography is a useful method for diagnosis of metabolic disorders. The following clinical applications are described in this report: 1. Diagnosis of uncommon aminoacidopathies; 2. Screening of inborn errors of aminoacid metabolism in neonates; 3. Studies of transfer-inbalances of intestinal wall after per os aminoacid loading; 4. Completion of feeding formulas with aminoacids for patients with malabsorption. PMID- 6856317 TI - Intracranial haemorrhage in the term neonate diagnosed by computerised tomography -perinatal history, symptoms and outcome. AB - An intracranial haemorrhage was diagnosed by computerised tomography in 35 term neonates. Subarachnoid haemorrhage was found in 23, intracerebral haemorrhage in 9 and subdural haematoma in 3 patients. Perinatal risk factors indicating trauma or hypoxic events were evaluated in more than 50%. Clinical symptoms were independent of the site of the bleeding. An additional hypoxic-ischaemic brain injury seemed to be the cause of the observed clinical symptoms in many cases. The outcome was significantly better in patients with subarachnoid haemorrhage than in intracerebral haemorrhage or subdural haematoma. Respiratory arrest, increased muscle tone and seizures were frequently associated with an unfavourable outcome. PMID- 6856316 TI - [Disorders of calcium metabolism and ossification caused by anticonvulsants]. AB - Disturbances of Calcium-metabolism and of ossification are well known and well documented side-effects of anticonvulsant drugs since the first description in 1967. Elevated alkaline phosphatase and hypocalcemia till generalised osteoporosis and vitamin-D-sensitive rickets can be seen. The primary cause of these dose-related disturbances is an accelerated elimination of vitamin D because of induction of microsomal enzymes in the liver by anticonvulsant drugs; a suboptimal vitamin-D-intake and reduced sunlight exposure in institutionalised patients are often combined causative factors. In all patients treated with anticonvulsant drugs a sufficient supplementation with vitamin D is necessary. PMID- 6856321 TI - [You make the diagnosis: hypohidrotic ectodermal dysplasia]. PMID- 6856320 TI - ["Essential hypernatremia" as a result of on increased osmoreceptor threshold in a boy with Pierre-Robin disease and corpus callosum agenesis]. AB - Hypernatremia was found as a cause of recurrent fever episodes in a 18 month old boy with Mb, Pierre-Robin and agenesia of the corpus callosum. We found values of serum-sodium until 160 mVal/l. Examinations of the osmotic regulation showed a so called "essential hypernatremia" without polyuria and polydipsi. Therefore must be responsible a defect of the osmotic center and thirst center in the hypothalamic area. As therapy a diet of 1000 ml = 1000 kcal = 100 mg Sodium/d. was successful. PMID- 6856318 TI - [Physiology of parathyroid hormone and calcitonin]. AB - Parathyroid hormone, 1,25-vitamin D3 and calcitonin are the three major hormones in the control of calcium homeostasis. The physiological function of parathyroid hormone and 1,25-vitamin D3 in the short term regulation of calcium homeostasis by varying intestinal absorption and renal excretion are well established. However, there is still an ongoing debate on the physiological relevance of human calcitonin. Calcitonin seems to play an osteoprotective role over a longer period of time or during times in which the skeleton is under stress because large quantities of calcium are required like during pregnancy, lactation or growth. Some important physiological aspects of the two peptide hormones--parathyroid hormone and calcitonin--should be discussed within this article. PMID- 6856323 TI - Relationship between noxious cold stimuli and the magnitude of pain sensation in man. AB - Nine healthy subjects received noxious cold stimulations at 20, 15, 10, 5 and 0 degrees C on the thenar eminence of both hands. Each stimulus lasted 30 sec. At the end of the stimulus, subject estimated pain intensity on a scale graduated from 0 (no pain) to 10 (intolerable pain). The results showed that the intensity of cold pain and that of the stimulus are linearly correlated (Spearman test P less than 0.001). Cold pain obeys Stevens' law with an exponent equal to one. PMID- 6856325 TI - Activities as indices of illness behaviour in chronic pain. AB - Activities reported by pain sufferers over a 7 day period were categorised on the basis of social context, and sleep, passive and recreational activities were found to differentiate between groups when dimensions of illness behaviour, mood and pain intensity were taken into account. The most interesting differences between groups were between organic and non-organic pain patients where the latter reported more sleep-related activities and these were related to strong beliefs in disease conviction, intense pain, and intense sadness. Both non patient pain groups reported more passive activities indicating a greater awareness of the importance of rest. A comparison of qualitative and quantitative pain measures suggests that the MPQ may not be sufficient alone to measure the painful experience. The results have implications for the study and management of chronic pain patients, and provide evidence that reports of activity per se may be diagnostic indicators valuable in the study of illness behaviour. PMID- 6856324 TI - Preoperative predictors of postoperative pain. AB - This study attempted to predict postoperative pain from preoperative level of anxiety and the amount of information patients possessed regarding their surgery. Pain was assessed via the McGill Pain Questionnaire (MPQ) and a measure of pain complaints--number of analgesics taken. High levels of state anxiety and a high degree of information predicted the Present Pain Intensity measured of the MPQ, but did not predict the Pain Rating Index portion of the MPQ. The number of analgesics taken was predicted from the amount of information but not the level of presurgical anxiety. Biographical variables were unrelated to postoperative pain. The results were discussed in terms of State-Trait Anxiety theory, Janis' curvilinear prediction model and a contextual perspective of information imparting. PMID- 6856322 TI - Characteristics of spinal dorsal horn neurons after partial chronic deafferentation by dorsal root transection. AB - Unilateral transections of 1-3 lumbar dorsal roots were performed in 13 adult cats to investigate the effect of partial deafferentation on dorsal horn neurons. Eleven to 45 days after deafferentation various parameters of spontaneous and evoked activity of 169 neurons were measured and compared to the data of 168 neurons from previous experiments recorded under identical experimental conditions except that these animals had not been deafferented. Eighty-six of the units encountered were located in the segment of transected dorsal root(s) and 82 in the caudally adjacent segment. No significant differences could be observed in the functional properties of these two samples of units. Most parameters measured indicate that either no change at all in responsiveness or signs of decreased excitability occurred in the partially deafferented neurons compared to units recorded in control animals. Discharges evoked by noxious skin heating indicate a linear relationship between discharge frequency and skin temperature. This kind of encoding curve could also be measured during a reversible cold block of the spinal cord at segment L1. The mean encoding curves before and during spinal blockade were not different in deafferented compared to corresponding curves measured in control animals. The only finding that could be interpreted as an indication for increased excitability of partially deafferented neurons was that the mean frequency of spontaneous discharges of a subsample of heat-sensitive neurons was higher in deafferented compared to control animals. Possible mechanisms are discussed. PMID- 6856319 TI - [Threatened occupational situation of parents as a pathogenetic factor in childhood behavior disorders]. AB - Real or imminent loss of employment of family supporters (mostly fathers)- unfortunately nowadays a rather frequent event--has gained more and more importance with respect to genesis of child's behavioral disturbances. Different interaction patterns are listed here: family systems primarily regarded as free of conflicts can be desequilibrated by financial distress; especially by loss of self-value-feelings; by appearance of different child rearing methods. Sometimes the tolerance for already striking children decreases, resulting in decompensation. PMID- 6856326 TI - [Ultrastructural characteristics of the hemocytes of the ixodid tick Hyalomma asiaticum (Ixodidae)]. PMID- 6856327 TI - [Electron microscopic study of the malpighian tubules in fleas (Siphonaptera)]. AB - A study was carried out of ultrastructure of malpighian tubules of 4 species of fleas as follows: Xenopsylla cheopis, Ceratophyllus fasciatus, Leptopsylla segnis, Ctenophthalmus orientalis. All cells of malpighian tubules are of polar structure: their apical department is represented with microvilli while basal one -with a system of membrane invaginations forming the basal labyrinth. The most developed system of basal invaginations is observed in distal cells of the malpighian tubules. Microvilli of the apical surface of the cells do not contain mitochondria, the latter are localized mainly in supranuclear and basal parts of the cell. In cells and cavity of the central and proximal parts of the malpighian tubules there are sphere crystals. Malpighian tubules of fleas have no distinct morphological departments though ultrastructure of the cells in different parts of the tubules is not identical. PMID- 6856328 TI - [Enzyme activity of the tissues of chicks with coccidiosis (Eimeria tenella)]. AB - It has been established that during experimental infection of chickens with Eimeria tenella the decrease in the activity of lactatdehydrogenase of blood serum and the increase of the activity of glutathionereductase in erythrocytes take place. In birds treated with chemcoccid (70 mg/kg of food) the activity of these ferments does not change. The ferment activity of glucose-6 phosphatdehydrogenase does not change in erythrocytes of sick birds while during the treatment with chemcoccid its activity increases. The activity of aspartate aminotransferase decreases in tissues of muscles and increases in liver and brain of sick birds. The activity of alanine aminotransferase decreases in the brain in three and increases in seven days after the infection. PMID- 6856329 TI - The oocyst sporulation time of Eimeria species from the fowl. AB - Freshly isolated oocysts were sporulated at 29 degrees C with constant aeration. Minimum sporulation time was determined by dosing the developing oocysts at intervals of 1 h to successive groups of chickens to assess the first occurrence of infective forms. Microscopic analysis of the sporulating oocysts allowed calculation of the time required for 50% of the oocysts to complete the process. This was considered to be the most accurate determination and the most useful for comparative purposes. For 7 species of coccidia in the fowl, the 50% sporulation times were as follows: Eimeria acervulina 11.4 h; E. brunetti 38.3 h; E. maxima 38.1 h; E. mivati 19.0 h; E. necatrix 19.7 h; E. praecox 24.8 h; E. tenella 21.2 h. PMID- 6856330 TI - Serial passage of Eimeria tenella and E. necatrix in turkey embryos. AB - The serial passage of 3 strains of Eimeria from the chicken in embryonating turkey embryos is reported here. All 3 strains increased their reproduction in turkey embryos; reproduction being equal to or better than the same lines maintained in chicken embryos. Pathogenicity and immunogenicity trials conducted in chickens using these 3 strains of Eimeria showed that all 3 turkey embryo adapted lines were significantly less pathogenic than the parent lines. Only 1 of the lines (E. tenella (PS) turkey embryo-adapted) maintained its immunogenic potential. PMID- 6856332 TI - Kinetics of proglottid formation, maturation and shedding during development of Hymenolepis nana. AB - Growth of Hymenolepis nana in mice is analysed by identifying designated stages of proglottid maturation in the strobila, and by determining the numbers of proglottids between them and the posterior terminus of the worm, as a function of time after cysticercoid infection. The proglottid maturation rate was fairly constant between stage A (onset of the somatic primordium formation) and stage B (first appearance of sperms in the seminal vesicle), but gradually fell after stage B, during pre-patent development of the worm. The actual rate of proglottization during this period coincided well with that estimated from the number of proglottids between stages A and B on an assumption of a certain maturation rate. This procedure is extended to estimate the rates of proglottid formation and shedding during later development. It is deduced that the absolute rate of proglottization increases until day 12, gradually decreasing afterwards, and that from 2300 to 2800 proglottids are shed by day 20, until which from 4000 to 4500 proglottids have passed stage A. It is shown that the proportionate increase of the gravid region in older worms depends not only on a decrease in the rate of proglottization, but also on the prolonged period during which proglottids stay in the strobila. PMID- 6856331 TI - Observations on the morphology and electrophoretic variation of enzymes of the rodent malaria parasites of Cameroon, Plasmodium yoelii, P. chabaudi and P. vinckei. AB - Six samples of rodent blood infected with malaria parasites were isolated from Cameroon. Of these, 2 contained mixed infections of Plasmodium vinckei and P. yoelii, 3 contained P. vinckei alone and 1 P. chabaudi alone. Each isolate was cloned and the resulting lines examined for morphology of blood and mosquito forms, and for electrophoretic variation in enzymes. The P. chabaudi and P. yoelii lines were morphologically and enzymically identical to isolates of the Central African Republic. Similarly, 1 P. vinckei line was identical to an isolate of the Central African Republic. The remaining 4 P. vinckei lines showed considerable variation, some enzymes being like those in isolates of surrounding regions, while others were unique to Cameroon. PMID- 6856333 TI - Seasonal fluctuations and hypobiosis of gastro-intestinal nematodes of Awassi lambs in Iraq. AB - The results of an epidemiological study involving the estimation of worm counts of gastro-intestinal nematodes of lambs, during the period December 1978 to November 1979, in the Baghdad area are reported. Ostertagia spp. and Trichostrongylus spp. were the most abundant nematodes in the weaned lambs used in this study. Ostertagia spp. infection was present throughout the period of observation, the level of infection being the highest during early summer (May June). Trichostrongylus spp. infection, however, reached a peak during July August. In the tracer lambs the maximum population of Ostertagia spp. was found during February-March, while that of Trichostrongylus spp. could be observed only after mid-June. Other nematodes encountered were Haemonchus contortus and Trichuris sp. but they were only present in small numbers. The proportion of inhibited larvae of Ostertagia spp. was markedly high during the dry summer months. Little inhibition was noticed during autumn and the early winter months. It appears that if the seasonal inhibition of Ostertagia spp. in Iraq is brought about by an environmental stimulus acting upon pre-parasitic larval stages, that stimulus cannot be chilling or falling temperatures, as observed in temperate northern zones. PMID- 6856334 TI - The open-field behaviour of mice infected with Trichinella spiralis. AB - The behaviour of mice exposed to graded doses of Trichinella spiralis larvae was monitored in an open-field situation. Ambulatory and exploratory activity declined significantly as the infections progressed, whereas the time spent inactive increased concomitantly. The advent of these behavioural changes coincided with the expected release of larvae by the adult worms and showed no clear signs of abating as late as 90 days post-inoculation. The levels of activity were negatively correlated with the inoculating dose. Such behavioural changes may render the host more vulnerable to predation and thus enhance parasite transmission. PMID- 6856335 TI - Establishment and maintenance of behavioural dominance in male mice infected with Trichinella spiralis. AB - Trichinella spiralis infections influenced the establishment and maintenance of behavioural dominance among outbred male mice. Infected animals assumed a subordinate status when challenged by normal or more lightly infected conspecifics both in an unfamiliar test arena and in their established home cages. These effects were demonstrable during the acute and the chronic phases of infection. The significance of this phenomenon to the survival of the mouse host and the transmission of the parasite is discussed. PMID- 6856336 TI - Laboratory comparison of the relative success of Biomphalaria glabrata stocks which are susceptible and insusceptible to infection with Schistosoma mansoni. AB - A method of interrupting the life-cycle of the human blood fluke Schistosoma by increasing the proportion of genetically insusceptible intermediate host snails in natural populations was first proposed nearly 25 years ago. The method assumes that insusceptible snails will be at a selective advantage over susceptible snails when the schistosome parasite is present, and therefore natural selection will act to increase the proportion of alleles for insusceptibility. A major objection to the proposed technique is 'If insusceptible snails are at a selective advantage, then why are they not predominant in natural populations that transmit disease?' One explanation of this paradox is that insusceptibility may be associated with a disadvantageous character or a physiological defect. This study tests this hypothesis by measuring the relative reproductive success of susceptible and insusceptible snails under controlled conditions. Results indicate that insusceptible (unsuitable) snails are negatively affected in the presence of either susceptible snails or schistosome parasites. Furthermore, in the presence of both susceptible snails and schistosome parasites, insusceptible snails are selectively disadvantaged compared to susceptible snails. These results obtained under laboratory-controlled conditions suggest a plausible answer as to why insusceptible snails are not predominant in natural populations that transmit disease. PMID- 6856337 TI - Ultrastructural observations on the in vitro interaction of rat neutrophils with schistosomula of Schistosoma mansoni in the presence of antibody and/or complement. AB - Rat peritoneal neutrophils adhere to schistosomula of Schistosoma mansoni in vitro in the presence of antibody, complement, or both. Ultrastructural studies have demonstrated that cell adherence is not intimate, and that electron-dense secretions are not liberated onto the parasite surface in the manner described for eosinophils. Cytochemical techniques confirm that peroxidase is confined within intracellularly located neutrophil secretion granules. The metabolic burst is shown to operate during Fc-mediated interactions, but since morphological damage depends upon the presence of complement in the system, toxic oxygen products would seem not to be involved in the initiation of surface perturbation. Complement-dependent, neutrophil-mediated schistosomular damage is characterized by vesiculation of the tegumental outer membrane, an increase in density of the tegumental cytoplasm and the eventual development of focal lesions. The cells migrate laterally to push aside damaged surface tissues and then adhere intimately to the exposed musculature. Damage appears earlier when both antibody and complement are present in the system, and this correlates with higher killing efficiency. The frequently observed association of contaminant eosinophils with areas of parasite damage indicates that eosinophils and neutrophils may cooperate to effect schistosomular killing. In the presence of antibody alone, attached neutrophils exhibit intense phagocytic activity towards the antigen-antibody complex formed at the parasite surface. This phenomenon may account for the eventual detachment of cells and lack of significant parasite damage recorded in this system. PMID- 6856338 TI - Preparation and characterization of a human serum matrix suitable for quality control or reference materials. AB - We describe the preparation of a human serum based matrix suitable for inclusion in long-term control materials. The procedure entails the removal of cells, fibrin and lipoproteins from blood to produce a clear, stable material which has been stored frozen at -70 degrees C for up to 14 mth without any apparent deterioration. When incorporated into a quality control material, storage at 4 degrees and -20 degrees C may cause a change in several unstable constituents, but the material remains optically clear. A noticeable reduction in lipoprotein as a result of the preparative procedure is probably responsible for the continued clarity of the matrix. The nature of the matrix has been examined by polyacrylamide gel electrophoresis and does not reveal any unusual protein bands, whereas commercially available materials when similarly examined often reveal protein bands not present in normal serum. The matrix has been used to prepare control material for the Chemical Pathology Quality Assurance Programme Group of the Royal College of Pathologists of Australasia/Australian Association of Clinical Biochemists. PMID- 6856339 TI - A sensitive assay for creatine kinase in serum samples dried on paper: enhanced thermal stability of the dried enzyme. AB - A new bioluminescent creatine kinase (CK) assay using purified luciferase was used to analyse CK activity in serum samples dried on filter paper. Enzyme activity was preserved for over 1 wk on paper stored at room temperature. At 60 degrees C, CK activity in liquid serum samples was rapidly inactivated, but the activity of enzyme stored on paper was preserved for at least 2 days. PMID- 6856340 TI - Immunoradiometric assay of plasma lactoferrin. AB - The concentration of lactoferrin, a non-heme iron binding glycoprotein, was determined in more than 1500 EDTA plasma samples by a 2-site solid phase immunoradiometric assay to assess the significance of lactoferrin in plasma and to investigate applications for this assay. The use of commercially available antibody and antigen and a relatively short assay time make this assay more suitable for use in routine clinical laboratories than previous methods. A normal range of 250-750 micrograms/l was established. There was a correlation between plasma lactoferrin concentration and the circulating blood neutrophil count in most patients except those with splenomegaly, post-splenectomy and undergoing intensive chemotherapy. Patients with gross splenomegaly usually had an increased and post-splenectomy patients a decreased lactoferrin/neutrophil ratio indicating a respective increase and decrease in the marginated pool. In patients with acute leukemia after chemotherapy or transplantation plasma lactoferrin levels increased 1 to 5 d before blood neutrophil counts rose. As plasma lactoferrin seems to be derived from neutrophils, its concentration is probably related to the size of the total blood granulocyte pool. Calculation of the lactoferrin/neutrophil ratio demonstrated variations in the size of the bone marrow reserve and the marginated neutrophil pool. PMID- 6856341 TI - The diagnosis of Hutchinson's melanotic freckle (lentigo maligna) in Queensland. AB - Following an increase in the reported incidence of melanoma of Hutchinson's melanotic freckle type (HMFM) in Queensland, a review of its histological diagnosis was undertaken. Ninety-nine pigmented lesions reported by 13 different pathology laboratories throughout Queensland as having an in-situ component of Hutchinson's melanotic freckle (HMF) were reviewed by 2 pathologists with an interest in malignant melanoma. This diagnosis was confirmed in 76 cases while in a further 3 the reviewers regarded the in-situ component as indeterminate. It would seem that the level of agreement among pathologists reporting HMF(M) should be considered in any assessment of incidence patterns of melanoma. PMID- 6856342 TI - Medical research: goals, problems and impacts. PMID- 6856344 TI - Macrophages and glomerular crescent formation. Studies with rat nephrotoxic nephritis. AB - A model of crescentic glomerulonephritis in the rat was developed, based upon an augmented form of nephrotoxic nephritis. The glomerular lesions were relatively mild, permitting an analysis of the morphologic events in crescent formation to an extent not possible in models in other species in which the sequence of changes is obscured by the severity of the inflammatory process. Monocytes and macrophages accumulated in glomerular capillary lumens and walls. Crescents were composed of cells with ultrastructural features indistinguishable from those of the intracapillary mononuclear cells. The findings support the view that the crescent cells are predominantly composed of macrophages derived from circulating monocytes. PMID- 6856343 TI - Histological assessment of orthotopic aortic valve leaflet allografts: its role in selecting graft pre-treatment. AB - Histopathological studies of human cardiac valve grafts recovered at autopsy or re-operation, together with long-term clinical follow-up of valve graft recipients, have indicated that the success of grafts is largely dependent upon the extent to which they are replaced by host fibrous connective tissue. To find the valve preparation technique with least inhibitory effect on tissue ingrowth after grafting, various sterilizing and storage procedures were evaluated using a series of aortic valve leaflet allografts in dogs. To facilitate evaluation, a method for rapidly assaying relative degrees of colonization of grafts was first devised. Application of this method has unequivocally identified a newly formulated antibiotic solution as the pre-treatment most compatible with host tissue ingrowth. PMID- 6856345 TI - Hepatic pseudolipoma. AB - A pseudolipoma of the liver was an incidental finding in a 63-yr-old man. This is the 9th recorded case of hepatic pseudolipoma. Macroscopically these innocent lesions may mimic metastatic carcinoma whilst microscopically they must be distinguished from the equally rare true hepatic lipomas. Hepatic pseudolipomas probably represent trapped, detached appendices epiploicae. PMID- 6856346 TI - [Direct reactions of the smooth muscles of the major cerebral arteries to acute hypoxia and hypercapnia]. PMID- 6856347 TI - [Epiphysis cerebri and body resistance to extreme exposures]. PMID- 6856348 TI - [Characteristics of afferent signal conduction in the oral trigeminal nucleus with electroacupuncture action]. PMID- 6856349 TI - [Regional and tissue blood flow in the hindlimbs of cats with acute blood loss]. PMID- 6856350 TI - [Changes in the autonomic balance of the body in experimental hypokinesia]. PMID- 6856352 TI - [Pathogenesis of acute intravascular coagulation]. PMID- 6856351 TI - [Microcirculation in burn shock in rats after the prolonged limitation of motor activity]. PMID- 6856353 TI - [Circulatory dynamics in temporary occlusion of the inferior vena cava]. PMID- 6856354 TI - [Role of the afferent nerve in regulating the reparative regeneration of bone tissue]. PMID- 6856355 TI - [Temperature sensitivity of spinal osteochondrosis patients]. PMID- 6856356 TI - [Effect of D-penicillamine on collagen metabolism in experimental liver cirrhosis]. PMID- 6856358 TI - [Changes in the liver and muscles as affected by physical loading during overheating under different water regimens]. PMID- 6856359 TI - [Effect of injury on the activity of plastic processes in the body in an experiment]. PMID- 6856360 TI - [Computerized method of evaluating thyroid function during substitution therapy]. PMID- 6856361 TI - [Determination of the volume of rapidly circulating blood by a thermodilution method]. PMID- 6856357 TI - [Pathogenesis of atrophic changes in the intestinal mucosa in the biliary syndrome]. PMID- 6856362 TI - [Adrenoreactivity of the contractile myocardium and coronary arteries in chronic overloading and acute ischemic damage to the heart]. PMID- 6856363 TI - Effects of high and low dosages of methylphenidate in children with strong and sensitive nervous systems. AB - This investigation was undertaken to explore the possible causes and consequences of the finding that attention-and learning-disordered children with sensitive (weak) nervous systems were titrated at higher dosages of methylphenidate than those with strong nervous systems. Pretreatment parent and teacher ratings of hyperkinetic-associated behavior were no different for children typed as having strong or sensitive nervous systems or for those subsequently prescribed higher or lower dosages by a child psychiatrist "blind" to their type as well as condition (drug or placebo). However, those titrated at lower dosages, regardless of whether strong or sensitive, were rated as more improved than those given higher dosages. Pretreatment reaction time (RT) data suggested that sensitive types prescribed low dosages had less of a problem sustaining attention, and placebo RT data suggested that strong types titrated at low dosages had more of a problem sustaining attention. A contrast of placebo and drug RTs showed that strong types titrated at lower dosages improved more than strong types given higher dosages, whereas sensitive types given higher dosages improved more than sensitive types given lower dosages. The latter finding is thought to add support to the theory of Gray (1964), who suggested that, paradoxically, the weak nervous system needs a more intense stimulus than the strong to reach the concentration threshold. PMID- 6856364 TI - The effect of companion on consumption of ethanol solution in cats. AB - Social influences on drinking ethanol solution were studied in two cats ("drinkers") who voluntarily drank small amounts of 10% ethanol solution in milk and three other cats ("nondrinkers") who served as companions to the drinkers. A 15-minute session was conducted daily in a compartment divided into two even parts with a transparent Plexiglass partition. The cats were introduced to the compartment either singly or in pairs. Each pair consisted either of two drinkers or one drinker and one nondrinker. Each cat of the pair was placed in one part of the compartment; the cats could see each other, but they could not make physical contact. Each drinker was offered 10% ethanol solution in milk, while each nondrinker was given plain milk, and the amount of consumption was measured. A series of five to ten sessions with a drinker was followed by a series of sessions with a nondrinker or with no companion. There were a total of 13 series of sessions for each drinker. A statistical analysis of the data showed that, in most series, the mean amount of consumption of ethanol solution was significantly higher in the presence of a companion (either drinker or nondrinker) than in its absence. PMID- 6856366 TI - Management of neonatal sepsis and meningitis. PMID- 6856365 TI - Neurophysiologic mechanisms of internal inhibition. AB - The experimental results obtained in the authors' laboratory as a result of multiple recording of slow biopotentials, the recording of neuronal activity and of mathematical modeling, are reviewed. The authors conclude that the elaboration of internal inhibition is followed, and determined to a great extent, by the restriction in conduction of excitations due to the increase of inhibitory hyperpolarization and discordance in the periodicity of slow potentials, reflecting oscillations in excitability of neuronal populations in the cortex and other brain structures. PMID- 6856367 TI - Infectious disease problems in indochinese refugees. AB - It is necessary to systematically anticipate and sympathetically address a number of both emotional and physical problems with which Indochinese refugees commonly enter our society. Their infectious medical problems are generally common rather than exotic, although unusual diagnoses must occasionally be considered. If diagnosed, they are generally amenable to treatment. They pose little risk to the public health, and the little danger that they do represent can largely be obviated by attention to principles of infection control, personal hygiene, and public sanitation. Table 9 summarizes the screening and management recommendations appropriately applied to clinical care of this population. PMID- 6856368 TI - Neonatal septicemia. PMID- 6856370 TI - Treatment of childhood skeletal infections. PMID- 6856371 TI - Urinary tract infection in children. PMID- 6856369 TI - Treatment of meningitis in children. PMID- 6856372 TI - Anti-infective therapy of infectious endocarditis. AB - Because of its high morbidity and mortality, endocarditis will remain an important pediatric problem. Obtaining adequate culture information prior to starting antibiotics to ensure an accurate early diagnosis coupled with aggressive medical and surgical management is likely to give the best outcome. These patients are generally best handled by a team approach with the child's primary physician, cardiologist, infectious disease consultant, and cardiovascular surgeon working in close harmony. PMID- 6856373 TI - Septic shock. PMID- 6856374 TI - A therapeutic update of superficial skin infections. PMID- 6856375 TI - Animal bites. AB - Animal bites are an extremely common problem in the United States. Dogs are by far the most common offender, closely followed by cats, humans, and rats. Most injuries are trivial, but can become infected, and fatalities do occur. A wide variety of organisms cause a multitude of clinical problems, but cellulitis and lymphangitis caused by Pasteurella multocida are most common. Human bites, especially of the hand, present major problems in management, and staphylococci or streptococci are frequent pathogens. Penicillin is an effective first-line antibiotic for animal bites, while a penicillinase-resistant penicillin, a cephalosporin, or erythromycin should be used for human bites. Attention should always be paid to the potential problems of rabies and tetanus. PMID- 6856376 TI - A case of new chondrodystrophy. PMID- 6856377 TI - Kniest disease with Pierre Robin syndrome and hydrocephalus. AB - A 3-month-old male infant with clinical and radiological features of Kniest disease is reported. Additional findings were severe Pierre Robin syndrome and external hydrocephalus. The patient was retarded in mental and motor development. He died at 4 months of age from the complications of tracheostomy. The parents were both normal clinically and radiologically, thus the disease in the child was presumably due to a new mutation. The reported familial cases of Kniest disease suggest autosomal dominant inheritance. The differential diagnosis is discussed in detail. PMID- 6856378 TI - Tubular colonic duplication--review of 1876-1981 literature. AB - Four cases of tubular colonic duplication are reported and 53 more are reviewed from 1876-1981 literature. Eighty percent of these patients had other anomalies, most notably genital and bladder duplications. Females outnumbered the males 37 to 20. Fifty per cent of patients of either sex had some form of fistulous communication. In no one was the anomaly incompatible with life. Based on the anatomy of distal ends of duplicated colon, the patients are divided in five groups, for each of which the incidence and nature of concomitant anomalies are tabulated. Because of their anatomic complexity, most patients with colonic duplication require clinical evaluation by multiple subspecialists. We have also suggested the sequence and extent to which they should be evaluated by radiologists. PMID- 6856379 TI - Midline cerebral arterio-venous anomalies: ultrasound diagnosis. AB - Ultrasound features of three cases of midline cerebral arterio-venous anomalies of neonates presenting with congestive heart failure are presented. Two cases have CT and angiographic correlation. The third case has post-mortem correlation. Ultrasound easily detected the dilated midline vascular channels in all three cases. Angiography was needed to further define the abnormal anatomy. We suggest a role for ultrasound to screen for midline arteriovenous malformations in neonates with congestive heart failure of undetermined etiology. PMID- 6856381 TI - The role of bone scanning in neonatal rickets. AB - Preterm infants are at increased risk from rickets. Radionuclide bone scanning is a useful aid in suspected cases. It offers advantages over conventional radiology in terms of sensitivity, radiation dose and extent of examination. Unsuspected fractures of clinical or medicolegal significance may be detected. Two cases are described in which the technique confirmed the diagnosis and assisted management. PMID- 6856380 TI - Focal nodular hyperplasia of the liver imaging by differing modalities. AB - The logistic approach in diagnosis of focal nodular hyperplasia (FNH) of the liver is discussed, based on the experience with three children. In only one child could the diagnosis be made without angiography. In that child the combination of hypervascularity on the radionuclide angiogram and uptake of the radiocolloid by Kupffer cells was sufficient for the diagnosis of FNH. If the radionuclide scintigraphy is inconclusive, angiography has to be done to show the typical features of FNH, seen in all three patients. Only if scintigraphy and angiography are not able to differentiate FNH from hepatic adenoma, biopsy or exploratory laparotomy is indicated as a final diagnostic procedure. Ultrasonography or computerized tomography is of value only in screening for hepatic mass lesions. PMID- 6856382 TI - Primary squamous cell carcinoma of the lung in childhood. PMID- 6856383 TI - A case of microgastria in association with splenic-gonadal fusion. AB - Microgastria is a rare congenital anomaly usually associated with asplenia. In this 2 1/2-year-old presenting with left hydrocele and inguinal hernia multiple accessory spleens were found in the inguinal-scrotal region compatible with splenic-gonadal fusion. 99mTc-sulfur colloid scanning is helpful in microgastria searching for the presence of splenic tissue and in splenic-gonadal fusion for the location of accessory heterotopic spleens. PMID- 6856384 TI - Studies on human milk macrophages: effect of activation on phagocytosis and secretion of prostaglandin E2 and lysozyme. AB - Breast milk macrophages cultured in vitro synthesized and secreted increasing amounts of protein, lysozyme, and prostaglandin E2(PGE2) into the extracellular medium. These cells were also shown to actively phagocytose labeled zymosan particles in culture. Morphologic characteristics, phagocytosis, and secretory responses of the macrophages were altered depending on the presence of various stimuli in the culture. Concanavalin A, endotoxin and zymosan particles, but not latex particles, all resulted in an increased PGE2 secretion into the medium. Although total protein synthesis was not altered by any of these stimuli, Concanavalin A and endotoxin resulted in a decreased lysozyme concentration in the extracellular medium. Concanavalin A enhanced, whereas endotoxin and prior phagocytosis of latex particles inhibited phagocytosis of labeled zymosan particles. These findings indicate that phagocytosis and secretions of milk macrophages may be altered depending on the nature of the stimulating agent. PMID- 6856385 TI - Geometry of neonatal and adult red blood cells. AB - Red blood cell (RBC) geometry is a determinant of RBC deformability, survival time, osmotic resistance, and oxygen uptake. Because accurate information on the geometry of neonatal RBC appears lacking, a micropipette technique was employed to measure surface area and volume of individual neonatal and adult RBC. In addition, RBC diameter was determined microscopically. From these measurements, surface area index (actual surface area divided by area of sphere of same volume), swelling index (maximal volume divided by actual volume), minimum cylindrical diameter and mean thickness of RBC were calculated. Compared to adult cells, the volume of neonatal RBC was 21% larger, their surface area was 13% greater and their diameter 11% wider. The surface area-to-volume ratio of the neonatal RBC was 1.42 +/- 0.08 and that of the adult RBC was 1.49 +/- 0.06 (P less than 0.05). The minimum cylindrical diameter of the neonatal RBC was 3.04 +/ 0.25 microns and that of the adult RBC was 2.81 +/- 0.23 microns (P less than 0.05). Mean RBC thickness, surface area index and swelling index were not significantly different. PMID- 6856386 TI - Effects of ambient temperature on oxygen consumption and the circulation in newborn lambs at rest and during hypoxemia. AB - To assess the effects of environmental temperature on responses to hypoxemia, we studied five unsedated lambs in the first week after birth. We catheterized the carotid artery and pulmonary artery (via the jugular vein). After recovery of at least 1 day, we measured pH, blood gases, arterial and mixed venous blood O2 content, oxygen consumption (VO2), heart rate, carotid and pulmonary arterial pressures, and cardiac output in both warm (25 degrees C) and cool (17.4 +/- 1.1 degree C) environments. In the cool environment, with no shivering, VO2 increased 40% (14.9 to 20.8 ml/kg/min). There were also increases of arteriovenous blood O2 content difference of 19%, cardiac output of 18%, and heart rate of 14%. In four lambs, we studied the same variables during hypoxemia (FiO2 = 0.09 for 1 h) at both temperatures. In the cool environment, hypoxemia produced a greater fall of VO2 (26% versus 6%) and arteriovenous oxygen differences (30% versus 19%) and a smaller increase of cardiac output (8% versus 14%) and heart rate (26% versus 43%). Also in the cool environment, core temperature decreased more (2.1 versus 0.4 degree C), but base deficit was the same (-6 versus -5 mEq/liter). Despite the greater fall in VO2 during hypoxemia in the cool environment, the lowest value achieved was still higher than the level during normoxemia in the warm environment. Similarly, cardiac output during hypoxemia was greater in the cool than in the warm environment. These findings may explain the variability in reported normal resting values and responses to hypoxemia. Contrary to previous reports, they also indicate that during severe hypoxemia neonates have a decreased reserve of metabolic and cardiovascular responses in a cool compared with a warm environment. PMID- 6856388 TI - Manganese balance studies in infants after operations on the heart. AB - Manganese balance studies have been performed on 16 infants, aged 3 days to 8 months, in the period following operation for the correction of congenital heart defects. Samples were analyzed by flameless atomic absorption spectroscopy or by solvent extraction with 8-hydroxyquinoline followed by flame atomic absorption spectroscopy. A higher manganese content was found in either whole blood (710 +/- 320 nmole X litre-1) or purified plasma protein (1130 +/- 770 nmole X litre-1) compared with fresh frozen plasma (215 +/- 35 nmole X litre-1) used in intravenous drips. The manganese content of the milks used in oral feeding was 200-300 nmole X litre-1. PMID- 6856387 TI - An accurate and reproducible absorptiometric technique for determining bone mineral content in newborn infants. AB - At the Bone Mineral Laboratory of the University of Wisconsin a microcomputer based digital read-out system was designed specifically for determining bone mineral content (BMC) and bone width (BW) in newborn infants with the following features: (1) high accuracy and precision; (2) high reproducibility in vivo; (3) direct read-out of BMC and BW; (4) automatic data calibration; and (5) use of a low activity [125I] source (less than 50 mCi). BMC and BW were determined on the left radius on a series of 114 newborn infants of all gestational ages and a curve for intrauterine bone mineral content extrapolated from the data. Accuracy of the photon absorptiometric system was assessed by measuring BMC on a series of nine small bone sections (29-212 mg/cm) and confirmed by subsequent ashing of these bone sections (r = 0.99). Short-term precision (weekly, coefficient of variation 1.7%) and long-term precision (monthly, coefficient of variation 2.1%) for measuring BMC were determined by multiple determinations on a four-chambered bone phantom calibrated with the bone sections. Immediate reproducibility (without repositioning the arm) for the 4-6 scans performed for each determination of BMC and BW was good with a mean coefficient of variation of 3.9% for BMC and 3.6% for BW. In 84 infants, repositioning error was determined by repeating the measurement of BMC and BW after repositioning the arm. The correlation coefficients between measurements before and after repositioning the arm were 0.97 for BMC and 0.95 for BW. BMC correlated well with gestational age (r = 0.92), birth weight (r = 0.89) and bone width (r = 0.92). BW also correlated with gestational age (r = 0.84) and birth weight (r = 0.85). A multiple linear regression analysis of BMC versus BW, gestational age, and birth weight was done. The correlation coefficient between the predicted BMC from these variables and measured BMC was 0.95. Photon absorptiometry can be used with high accuracy, precision, and reproducibility in vivo in newborn infants. BMC correlates with gestational age, birth weight, and bone width. PMID- 6856389 TI - Granulocytic stem cell (CFUc) proliferation in experimental group B streptococcal sepsis. AB - Adult rats infected with group B streptococci (GBS) develop neutrophilia and display a marked increase in granulocytic stem cells (CFUc). In contrast, infected neonatal rats develop a profound neutropenia and their CFUc do not increase. In order to better understand this phenomenon, we assessed the CFUc proliferative rate in control and infected adult and neonatal rats using the technique of [3H]-thymidine suicide. Beginning only 3 h after GBS inoculation, adult rats increased CFUc proliferative activity, as illustrated by an increase in thymidine suicide, from 38 +/- 2% cell kill in control animals to 70 +/- 2% when infected (mean + S.E., P less than 0.001). In contrast, the CFUc thymidine suicide rate did not increase in infected neonates. It was noted, however, that the baseline CFUc thymidine suicide rate in uninfected neonatal rats exceeded the rate in uninfected adult rats by 2-3-fold. The CFUc thymidine suicide rate was therefore determined in uninfected premature (74 +/- 1%), newborn (70 +/- 2%), 1 wk-old (70 +/- 1%), 6-wk-old (32 +/- 1%) and 6-month-old (37 +/- 3%) rats. These findings suggest that the proliferative rate of granulocytic stem cells is already maximal or near maximal in noninfected neonatal animals. In contrast to adults, the neonates' granulocyte production from stem cells can not significantly increase, even if bacterial infection is present. PMID- 6856391 TI - The effects of liquid ventilation on cardiopulmonary function in preterm lambs. AB - The effects of fluorocarbon ventilation on cardiopulmonary function were studied in 8 preterm lambs, 132-136 days gestation. After mechanical ventilation with 100% oxygen (control period), the lambs were ventilated with fluorocarbon (PIO2 = 622 torr). The liquid was then removed from their lungs and gas ventilation resumed (recovery period). During normothermic liquid breathing the alveolar arterial O2 gradient (A-a DO2) decreased (P less than 0.01) from control by 154 torr and remained decreased (P less than 0.05) by 85 torr during recovery. Dynamic lung compliance (CL) increased 50% (P less than 0.05); PaO2 increased 50% (P less than 0.05); and PaCO2 decreased 29% (P less than 0.01) as compared to control values. The change in A-a DO2 and PaO2 before and after liquid ventilation was correlated (r = 0.79 and P less than 0.01) with control CL. There was a gradual decrease (P less than 0.01) in mean arterial pressure from 62 +/- 5.4 torr (control) to 53,1 +/- 9,3 torr (recovery); however, there were no significant alterations in mean central venous pressure, heart rate, or mean electrical axis. PMID- 6856390 TI - Hepatic and cerebral energy metabolism after neonatal canine alimentation. AB - Intrahepatic and intracerebral metabolic responses to neonatal fasting or enteric carbohydrate alimentation were investigated among newborn dogs. Pups were either fasted or given an intravenous glucose infusion (alimented) before an enteric feeding of physiologic quantities of either glucose or galactose. These pups were also compared to another group which was completely starved throughout the study period. Gastrointestinal carbohydrate feeding resulted in enhanced hepatic glycogen content among pups after a prior state of fasting. Though there were no differences of glycogen content between glucose or galactose feeding in this previously fasted group, combined intravenous glucose and enteric galactose administration produced the greatest effect on hepatic glycogen synthesis. Intrahepatic fructose 1, 6-diphosphate and phosphoenolpyruvate levels were increased among previously fasted pups fed enteric monosaccharides compared to completely starved control pups, whereas intrahepatic phosphoenolpyruvate and pyruvate levels were elevated after combined intravenous and enteric carbohydrate administration. Of greater interest was the observation that hepatic levels of ATP were significantly elevated among all groups given exogenous carbohydrates compared to the completely starved control group. In contrast to the augmented hepatic glycogen and ATP levels, there were no alterations of cerebral glycogen or ATP after alimentation. Nevertheless, cerebral pyruvate and/or phosphoenolpyruvate concentrations were elevated after enteric or combined intravenous and enteric alimentation compared to the totally starved control pups. PMID- 6856392 TI - The American Pediatric Society and the Society for Pediatric Research. Combined program and abstracts. Washington, D.C., May 3-6, 1983. PMID- 6856394 TI - Bronze baby syndrome: a new porphyrin-related disorder. PMID- 6856393 TI - Alterations in cultured fibroblasts of sibs with an infantile form of a free (unbound) sialic acid storage disorder. AB - Cultured fibroblasts from two sibs with generalized hypertonia, hepatosplenomegaly, and psychomotor retardation within the first year of life were found to have unusual morphologic features. When examined by phase microscopy, the unstained and unfixed cells contained a large number of vacuolated structures whose gross appearance resembled that of a honeycomb in the cell cytoplasm. Electron microscopy studies, following fixation, showed the "honeycombing" to be the result of numerous, closely packed, cytoplasmic, membrane-bound vacuoles. In some of these structures the remains of fibrilogranular material could be detected. Biochemical analysis of crude sonicates of these cells revealed increased levels (4--7 x N) of an acid soluble component that reacted with thiobarbituric acid. Analysis of trimethylsilyl derivatives of this material by gas liquid chromatography and mass spectrometry showed it to be indistinguishable from sialic acid (N-acetylneuraminic acid). Quantitation of this material from the cells of one of the sibs after isolation on a Dowex column yielded 39.8 nmoles of free (unbound) sialic acid per mg protein whereas normal fibroblasts had 1--2 nmoles per mg. Bound sialic acid levels were at the upper limits of normal (24.8 versus 11--23 nmoles per mg protein). The concentration of cytidine monophosphate-sialic acid was normal. After incubation of the patient's fibroblasts with [3H]-N-acetylmannosamine for 72 h, there was a 7-fold increase (compared to normal fibroblasts) in the amount of radioactivity in free sialic acid present in the acid soluble fraction. The amount of labeled, bound sialic acid in the acid-insoluble pool, however, was the same in both patient and control fibroblasts. PMID- 6856395 TI - Influenza infection in the infant mouse. AB - A nonlethal influenza infection [A/PC/1/73 (H3N2)] was given to infant mice to determine (1) the pathology of tracheal epithelium and lung, (2) the time course of viral shedding from the nose and lung, and (3) the subsequent development of protective immunity during adulthood. Both desquamation of the tracheal epithelium and lung pathology similar to that described in adults after influenza infection were observed in the infant. Animals infected at 3 days of age show virus shedding in 12 of 13 infant mice that persists for at least 2 days longer than in the adult. This longer duration of influenza infection did not result from either malnutrition or from intralitter transmission of virus. Recovery from virus shedding in both the upper and lower airway occurred in the absence of detectable serum antibody in six of seven mice. Infants that recover from infection, when rechallenged during adulthood, manifest complete protection in 11 of 13 mice after nonlethal challenge and no mortality after lethal challenge. PMID- 6856396 TI - Biochemical studies in a patient with subacute neuropathic Gaucher disease without visceral glucosylceramide storage. AB - Autopsy samples were obtained from a 12.5-year-old girl who died with a neurologic disorder consisting of myoclonus, myoclonic epilepsy, spasticity, strabismus, and mild mental retardation but no hepatosplenomegaly. Studies in leukocytes, cultured skin fibroblasts, brain, liver, and spleen of this patient revealed glucosylceramide beta-glucosidase (EC 3.2.1.45, glucocerebrosidase) activity about 10% of controls, and well in the range found in samples from Gaucher disease patients. Extraction of the lipids from liver and spleen with chloroform-methanol (2:1) did not show accumulation of glucosylceramide or other lipid. Examination of the lipids in brain by high performance liquid chromatography revealed the presence of glucosylceramide, which is not found in brain samples from controls. Pathologic examination of the liver and spleen revealed no evidence of Gaucher disease. The brain showed many degenerative lesions and loss of neurons. There was no complementation of glucocerebrosidase activity when the cells from this patient were hybridized with cells from patients with Type 1 or Type 2 Gaucher disease. The reason for the lack of glucosylceramide storage in the liver and spleen has not been determined. PMID- 6856397 TI - Identification and partial purification of phenylethanolamine N-methyl transferase in the developing ovine lung. AB - Phenylethanolamine N-methyl transferase (PNMT), the terminal enzyme in epinephrine biosynthesis, was identified in fetal and newborn ovine lung. The ovine lung PNMT demonstrated the appropriate substrate specificity and affinity (Km, 9 x 10(-6) M). Although some homology between adrenal and lung PNMT was observed on polyacrylamide gel electrophoresis, the lung PNMT differed in its migration on ion exchange chromatography and was not inhibited by pharmacologic inhibitors active against the adrenal enzyme. Activity increased from a mean of 132 pmole/(mg protein . h) x 10(-3) at 0 days gestation to 326 pmole/mg protein . h) x 10(-3) in newborn animals between 1-4 days of age (r = 0.571, P less than 0.05). The levels of N-methylating activity in extraadrenal tissues were relatively low; lesser but significant N-methylating activities were demonstrated in brown adipose tissue and myometrial tissues. Adrenal gland activity was 1000 fold greater than lung activity expressed on a per mg protein basis and 250-fold greater expressed per mg wet weight. PMID- 6856398 TI - Oxygen-induced alterations in lung vascular development in the newborn rat. AB - Newborn rats were exposed to air or hyperoxic conditions for the first 6 days of life. Resulting effects on the pulmonary vascular bed were determined by analysis of barium angiograms, scanning electron microscopy of methylmethacrylate corrosion casts and whole lung, morphometric estimations of pulmonary arteries/area and capillary number/area, and arterial blood gas measurements. Similar studies were also performed on the lungs of animals allowed to recover in air for 1 and 2 wk. Although the general pattern of the pulmonary arterial bed by barium angiograms appeared similar, diminished branching or underfilling of the distal arterial segments was more frequently encountered in hyperoxic-exposed animals. Morphometric examination and corrosion casts revealed differences in vascular pattern and density between hyperoxia and air-exposed animals. The number of capillaries/mm2 of lung tissue was less in hyperoxic-exposed pups than controls after 6 days of exposure to hyperoxia but markedly increased to slightly above control levels by 2 wk of air recovery. The number of 20--50 micrometers size vessels/mm2 followed a similar pattern of change. Corrosion casts of lung exposed to 6 days of hyperoxia revealed less microvascular density compared to air controls, but after 1 wk recovery in air, hyperoxic-exposed animal had a more extensive network of microvessels. Maximum PaO2 attained by animals in the various groups closely resembled the patterns of change in microvessel density. These findings support the thesis that a major alteration of lung vascular growth and development occurs subsequent to exposure of the newborn to hyperoxia. PMID- 6856399 TI - Disaccharide feedings enhance rat jejunal macromolecular absorption. AB - Disaccharide feedings to post-weaning rats alters their jejunal barrier to macromolecular absorption. Penetration of horseradish peroxidase (HRP) across the jejunum was enhanced after short-term high concentration gavage (30 g . kg-1 . day-1) of lactose that produces weight loss, osmotic diarrhea, and jejunal mucosal damage. HRP absorption was also increased by longer term feedings of lower levels of disaccharide that did not produce body weight alterations, diarrhea, or cell damage. Rats without diarrhea and gavaged with 7.5 g . kg-1 . day-1 of either lactose or maltose showed an increase in lumen to blood HRP absorption after 21 days of feedings. Also, lactose or maltose in the solid food diet at 30 g . kg-1 . day-1 for 21 days did not lead to diarrhea but produced an increase in jejunal lumen to blood HRP absorption. Rats having no diarrhea and receiving 15 g . kg-1 . day-1 of lactose or maltose in the drinking water for 21 days, showed an increase in jejunal HRP absorption. When rats were fed either lactose or maltose for 21 days glucose absorption became totally dependent upon the sugar concentration in the perfusion medium. The kinetics of this glucose absorption are compatible with a decrease in the "unstirred" layer. Disaccharide induced HRP absorption may be mediated by transport from endocytotic vesicles across the jejunal epithelium. PMID- 6856400 TI - Effect of iron therapy on behavior performance in nonanemic, iron-deficient infants. AB - In an effort to determine whether iron deficiency, in the absence of anemia (hemoglobin greater than 11.0 g/dL), might produce alterations in behavioral development, four groups of nonanemic infants, 9 to 12 months of age, with varying degrees of iron deficiency were studied. Infants were classified as iron sufficient, iron depleted, or iron deficient based on measurements of serum ferritin concentration, erythrocyte protoporphyrin values, and the mean cell volume of erythrocytes. Subjects in each group were tested with the Bayley Mental Development Index, treated with parenteral iron, and retested seven days later. The administration of iron produced a significant increase in the Mental Development Index scores (+21.6 points) in the infants with iron deficiency but no significant change in the scores of infants with iron sufficiency (+6.2 points) or only iron depletion (+5.6 points). It is concluded that iron deficiency, even in the absence of anemia, results in biochemical alterations that impair behavior in infants. PMID- 6856401 TI - Adolescent chest pain: a prospective study. AB - One hundred adolescents with chest pain were prospectively analyzed to determine the etiology, functional consequences, and illness attributions of patients seen in a general pediatric clinic. The typical patient had frequent pain (63% had two or more episodes weekly) of moderate duration (51% of the pain lasted longer than six minutes) that had been occurring for many months (36% had pain occurring longer than 6 months). Stressful events, such as a death in the family, major illness, an accident, family separations, and school changes occurred in 31% of patients. The most frequently diagnosed condition was musculoskeletal problems (31%) including costochondritis (14%), chest wall syndrome (13%), skeletal trauma (2%), and ribcage anomalies (2%). Hyperventilation accounted for 20% of diagnoses and 5% had breast-related problems. Thirty-nine percent of patients had pain not readily classifiable. Serious underlying illness was a rare cause of chest pain, although several patients had associated organic disease not responsible for their chest pain. More than two thirds of patients restricted physical activities; more than 40% were absent from school. When patients were questioned about their understanding of their illness, 44% were afraid that they were experiencing a heart attack, 12% worried about heart disease, and 12% feared cancer. Chest pain is a prevalent problem that is usually benign but is commonly misunderstood and causes considerable dysfunction and anxiety in adolescents. PMID- 6856402 TI - Seasonality of reported poison exposures. AB - Review of 3,381 records from New Hampshire Poison Center for July through September 1981 and January through March 1982 revealed no seasonal difference in the total number of calls. A significant predominance in the summer reports was noted for plants, pesticides, envenomations, and acetaminophen exposures. During the winter a predominance was noted for aspirin, vitamins, cold and cough remedies, liniments, foods, and calls with no specific agent identified. PMID- 6856403 TI - Current status of behavioral pediatric training for general pediatric residents: a study of 11 funded programs. AB - The W. T. Grant Foundation has funded training in behavioral pediatrics for pediatric residents at 11 medical centers. The approaches toward training taken by the 11 funded programs, based on information systematically collected by interviews conducted with departmental chairmen, faculty, and residents during a program visit to each medical center, are described. No single training site emerged as optimal for teaching behavioral pediatrics, although linking such teaching to a "low priority" setting was an educational obstacle. A serious problem in many programs was the lack of ongoing research in behavioral pediatrics. Success in teaching behavioral pediatrics was dependent upon faculty support and a mandatory experience in behavioral pediatrics for all residents. PMID- 6856404 TI - Effect of serum hyperosmolality on opening of blood-brain barrier for bilirubin in rat brain. AB - The effect of hyperosomolality on the blood-brain barrier for bilirubin was studied in rats. Hyperbilirubinemia was induced in the chronically catheterized rat by infusion of bilirubin at a rate of 30 mg/kg/h for three hours. After two hours of bilirubin infusion, three levels of hyperosmolality were induced by bolus of urea at three different doses: 50, 75, and 100 mmol/kg, respectively. The serum osmolality rose from 297 mosm/L in the control group to 345, 383, and 400 mosml/L in the three respective groups. No significant differences were found between the groups in levels of total or free serum bilirubin, serum albumin, blood pH, and blood gases. A significant dose relationship was found in both brain bilirubin and brain albumin content with reference to the serum hyperosmolality. The results indicate that hyperosmolality causes opening of the blood-brain barrier for bilirubin in the rat. It may be speculated that this adverse phenomenon (hyperosmolality) may play a role in the pathogenesis of kernicterus in infants whose serum bilirubin levels are below the range of saturated bilirubin binding capacity. PMID- 6856405 TI - An outbreak of Clostridium difficile necrotizing enterocolitis: a case for oral vancomycin therapy? AB - During a 2-month period, 13 infants in this neonatal intensive care unit developed necrotizing enterocolitis, increasing the prevalence in inborns from 5.2 to 20.5/1,000 live births. Fifty-seven perinatal and neonatal factors, many of which have previously been associated with necrotizing enterocolitis, were compared between the infants with necrotizing enterocolitis and 17 unaffected inborn control infants admitted concurrently. Clostridium difficile cytotoxin was detected in the stools of 12 affected infants (92.3%) in comparison with two control infants (11.8%) (P less than .001), and the organism was isolated in eight affected neonates (61.5%) compared to none of the control infants (P less than .001). The outbreak was terminated upon institution of oral vancomycin therapy in cases and infant contacts, and strict antiinfective measures in the neonatal intensive care unit. This indicates an etiologic role of C difficile in the outbreak. Oral vancomycin in the management of necrotizing enterocolitis was assessed by therapeutic response, drug levels, and occurrence of side effects. Oral vancomycin therapy is indicated in necrotizing enterocolitis outbreaks in units where C difficile is endemic. PMID- 6856406 TI - Cardiovascular manifestations in the Larsen syndrome. AB - The Larsen syndrome consists of a skeletal dysplasia with multiple joint dislocations and a characteristic facies. The basis of the abnormalities is felt to be a generalized mesenchymal disorder involving connective tissues. More than 80 cases have been reported in the literature with isolated reports of congenital cardiac septal defects and acquired abnormalities of the aorta and mitral valve. A case with marked aortic dilation and insufficiency as well as an aneurysm of the ductus arteriosus is presented. The aortic lesions are similar to those described in other connective tissue disorders, particularly the Marfan syndrome. Previous reports of ductal aneurysms have not revealed an association with connective tissue disorders, but have described a significant morbidity. In summary, patients with the Larsen syndrome are likely to have cardiac lesions similar to those classically associated with the Marfan syndrome; these patients deserve a careful investigation for cardiac anomalies. These aortic lesions may be as prognostically significant as cardiac lesions in the Marfan syndrome. PMID- 6856408 TI - Intracranial tuberculomas in a child: computed tomographic scan diagnosis and nonsurgical management. AB - Despite great strides in screening and detection of tuberculosis, urban areas still harbor many children with this disease. The case of a child with probable intracranial tuberculomas who was medically treated with antituberculous therapy and followed with frequent computed tomographic (CT) scans is reported. Despite older textbooks that espouse surgery as the treatment for intracranial tuberculomas, it is suggested that in the era of CT scanning, they should be treated the same as other focal CNS infections. Surgery should be reserved for medical failure or deteriorating conditions. PMID- 6856407 TI - Hypertension in children with neurogenic tumors. AB - Fifty-nine children with neurogenic tumors were examined for the presence of hypertension. Eleven of the 59 (19%) were found to have elevated blood pressure levels at the time of diagnosis or with progression of their disease. Several antihypertensive agents produced poor or only partial pressure control. All blood pressure levels returned to normal values after tumor excision or administration of effective antitumor therapy. There was no correlation of hypertension with urinary catecholamine levels. The etiologies of hypertension in children with neurogenic tumors are discussed. PMID- 6856409 TI - Digital deformity: an effect of frostbite in children. AB - Two young children, aged 2 1/2 and 3 1/2, were briefly exposed to temperatures of -20 degrees F (-29 degrees C) without adequate hand protection. Hand contact with snow and metal doorknobs also occurred. Second and third degree frostbite of the cold injured digits ensured. Within six months, and progressing thereafter, the fingers developed a stubby appearance and demonstrated distal angulation and weak extension. Roentgenograms revealed undermineralization of the phalanges and coarsening of the trabecular pattern. The epiphyses of the middle and distal epiphyses were absent or atrophic. The metaphyses were irregularly convoluted. The pathogenesis of this deformity appears to be the direct effect of freezing and of ischemia on the most metabolically active site in the digit--the growth plate. PMID- 6856411 TI - Mothers are always the problem--or are they? Old wine in new bottles. PMID- 6856412 TI - Differing opinions on the emergency treatment of choking. PMID- 6856410 TI - Nephrocalcinosis: detection by ultrasonography. PMID- 6856413 TI - Teaching hospitals today and the challenge for excellence. PMID- 6856414 TI - Principles of child health care financing. PMID- 6856415 TI - Back blows and choking. PMID- 6856416 TI - Breast-feeding or infant formula should be continued for 12 months. PMID- 6856417 TI - Temperature, mitochondria, and Reye's syndrome. PMID- 6856418 TI - Sudden infant death syndrome and phenothiazines. PMID- 6856419 TI - Transverse myelitis and penicillin. PMID- 6856420 TI - The irresponsible expert witness. PMID- 6856422 TI - Renal calcification in premature infants. PMID- 6856421 TI - Multiple anaerobic pulmonary abscesses. PMID- 6856423 TI - [Age-related dynamics of arterial pressure in preschool children (evaluation by the percentile method)]. PMID- 6856424 TI - [Disorders of lipid metabolism in young children with neurotoxicosis]. PMID- 6856425 TI - [The hypothalamo-hypophyseal system and thyroid gland function in young children with the hyperthermic syndrome]. PMID- 6856426 TI - [The state of osmohomeostasis and characteristics of adaptation of newborn infants whose mothers suffered from diabetes mellitus]. PMID- 6856427 TI - [Anti-measles immunity in mothers vaccinated with live measles vaccine and in their newborn infants]. PMID- 6856428 TI - [Heart catheterization and angiocardiography in newborn infants with congenital heart defects]. PMID- 6856429 TI - [Clinico-etiological characteristics of localized forms of suppurative-septic diseases in newborn infants]. PMID- 6856430 TI - [State of the hypophyseal-thyroid system in suppurative inflammatory diseases in newborn infants (radioimmunological study)]. PMID- 6856431 TI - [Diagnostic value of the counterimmunoelectrophoresis in children with staphylococcal infections]. PMID- 6856432 TI - [Etiological and immunological factors in the development of bronchopulmonary complications of acute respiratory viral infections in children]. PMID- 6856433 TI - [Lysozyme activity in the secretions and blood of children with uncomplicated and complicated forms of acute respiratory viral infections]. PMID- 6856434 TI - [Roentgenofunctional studies of feces retention and defecation]. PMID- 6856435 TI - [Errors in the diagnosis of peptic ulcer in children]. PMID- 6856436 TI - [Errors in the diagnosis of diaphragmatic hernia in children]. PMID- 6856437 TI - [Percentile and caliperometric characteristics of the morphofunctional state of children with excess body weight and obesity]. PMID- 6856438 TI - [Diagnosis of a congenital defect in an abnormal location]. PMID- 6856439 TI - [Nutritive and protective properties of new sour milk formulas "Baldyrgan" and "Balbobek"]. PMID- 6856440 TI - [Prognosis of the course of pneumonia in infants by using cytochemical methods]. PMID- 6856441 TI - [Aspiration of foreign bodies in childhood]. PMID- 6856442 TI - [Case of choreic hyperkinesis in systemic lupus erythematosus]. PMID- 6856443 TI - [Goodpasture's syndrome in a 10-year-old girl]. PMID- 6856444 TI - [So-called ectopic pinealoma]. PMID- 6856445 TI - [Complex evaluation of the health status of preschool children and its role in the prevention of chronic diseases]. PMID- 6856446 TI - Consumer concerns in prosthetics. PMID- 6856447 TI - A clinical standard of stump measurement and classification in lower limb amputees. AB - The dimensions and healing of 93 consecutive below-knee stumps were studied and based on observations a standard formula of stump classification was constructed (and discussed at the ISPO Meeting in Bologna 1980). Muscular atrophy and redistribution of oedema caused a mean reduction of calculated arbitrary stump volume of about 7% during the first 12 post-operative weeks accompanied by a change in distal circumferential measurement ranging between 7 centimetres reduction and 5 centimetres increase. The classification formula was tested in 135 examinations in 86 patients with 96 stumps in Lund. A new proportional definition of stump length was used. Eighty per cent were ordinary in length and shape. Ten of 59 were conical before one year compared to 12 of 42 after more than one year following amputation. Pain was a problem in 20%. Scar problems are common early but other skin damage increases with time. Skin problems are separated according to cause, i.e. pressure, suction, infection and allergy. One third of below-knee stumps had unhealed wound or damaged skin. Surgical correction was indicated in 2% and prosthetic correction in 7%. Prosthetic correction seemed to be more often needed in below-knee stumps and surgical correction in above-knee stumps. PMID- 6856448 TI - Structural matrices for use in rehabilitation. AB - Progress is reported on the development and application of structural matrices in rehabilitation. The development of a stronger and more adjustable matrix than was previously reported is detailed, together with the principles necessary to achieve this. Application of this new matrix to adult seating is described. The emergence of programmable beams and the need for containment matrices are also documented and the advantages of these approaches to a variety of problems in rehabilitation are given. PMID- 6856449 TI - A clinical study of post polio infantile paralysis. AB - This study reports on 3,000 cases of poliomyelitis seen at the Rehabilitation and Artificial Limb Centre at Lucknow between January 1976 and December 1980. Factors such as age and sex incidence, extremity involvement, incidence of deformities at hip, knee and ankle, lower limb discrepancy, treatment and orthoses prescribed are discussed. PMID- 6856450 TI - A comparison of the SACH and single axis foot in the gait of unilateral below knee amputees. PMID- 6856451 TI - Research and development of functional aids. AB - Four aids, developed by the Department for Research and Development from existing ideas and being used in Revalidatiecentrum "De Hoogstraat" by patients with a spinal cord injury, are described. These aids are: a dynamic elbow extension orthosis; a modified flexor hinge splint; a rolling writing aid, and a urinary device for females. PMID- 6856452 TI - Effects of alignment variables on thigh axial torque during swing phase in AK amputee gait. AB - It is suggested that a major source of discomfort for above-knee amputees during the swing phase of walking, is the thigh axial torque (TAT) transferred at the stump--socket interface. The relation between TAT and variations in its six relevant alignment adjustments, has been investigated. A computerized routine has been established which indicates optimum choice of alignment setting, based on minimal TAT peaks. Feasibility for attenuating swing phase TAT has been demonstrated in three simulated patterns of amputee gait. As a conclusion, it is suggested that a useful clinical tool could be based on the presented alignment optimization procedure and may be expanded to include other factors associated with swing and stance phase comfort and performance. PMID- 6856454 TI - Technical note--a wheelchair ergometer for assessing patients in their own wheelchairs. PMID- 6856453 TI - Technical note--modified above-knee socket to relieve anterior pressure caused by abdominal hernia. AB - The plastic quadrilateral socket has a high anterior brim which can cause considerable discomfort in some patients, especially when seated. A simple modification to the anterior brim is described allowing a female patient with a huge abdominal hernia a considerable degree of comfort when both sitting and standing. The creation of a large radius producing a wide area for adequate pressure relief proved valuable. This might be considered for patients with less pendulous abdomens who find conventional methods inadequate. PMID- 6856455 TI - Amputations for vascular insufficiency. AB - A study was carried out of 302 major amputations for vascular insufficiency in the lower limb with respect to levels of amputation, postoperative revisions, re amputations on a higher level and postoperative mortality. This information was related to vascular disease (diabetes mellitus/arteriosclerosis) and to the experience of the surgeon. There was a high incidence of above-knee amputations both of diabetics and arteriosclerotics and the rate of complications was high for "senior" as well as "junior" surgeons. The amputations were performed during 1978 and the study has shown that there is an urgent need to lower the level of amputation without increasing the rate of complications. The study indicates that there is a need for further information about the problems involved in rehabilitation of above-knee amputees. PMID- 6856456 TI - The 5-methylcytosine content of highly repeated sequences in human DNA. AB - Previously, we found much tissue- or cell-specificity in the levels of 5 methylcytosine (m5C) in the total human genome as well as in DNA fractions resolved by reassociation kinetics. We now report that there were even greater differences in the m5C content of the highly repeated, tandem EcoRI family of DNA sequences from different human organs or cell populations. The ratio of m5C levels in this DNA fraction from brain, placenta, and sperm was 2.0:1.2:1.0. At a HhaI site in this repeat family, sperm DNA was 5-10 fold less methylated than somatic DNAs. In contrast, the highly repeated Alu family, which is approximately 5% of the genome, had almost the same high m5C content in brain and placenta despite marked tissue-specific differences in m5C levels of the single copy sequences with which these repeats are interspersed. These data show that very different degrees of change in methylation levels of various highly repeated DNA sequences accompany differentiation. PMID- 6856457 TI - AAF linked to the guanine amino group: a B-Z junction. AB - Minimized conformational potential energy calculations have been performed for AAF linked to dCpdG at the guanine amino group. This is a model for the minor AAF adduct observed in DNA, whose conformational influence has been difficult to ascertain. A global minimum energy conformation was computed with torsion angles like those of the dCpdG residue of Z-DNA. This conformation was incorporated into a larger polymer model at a B-Z junction, with the carcinogen residing in the groove in the Z direction. Local minimum energy conformations of the B type were also computed. In addition, two minima were found with fluorenecytidine stacking. These results suggest that existing B-Z junctions may be vulnerable to modification by AAF at the guanine amino group, or that such junctions may be induced by the carcinogen if the base sequence is appropriate. Otherwise the carcinogen can be located in the minor groove of the B helix (5, 10, 11) or covalently intercalated (13-15). PMID- 6856458 TI - Assignment of non-exchangeable base proton and H1' resonances of a deoxyoctanucleoside heptaphosphate d(G-G-C*-C*-G-G-C-C) by using the nuclear Overhauser effect. AB - The resonances of the non-exchangeable base protons and 1' protons of the octamer d(G-G-C*-C*-G-G-C-C), C* = m5dC, have been assigned by means of NOE difference NMR spectroscopy at 500 MHz. From the measured J1'2' and J1'2" it follows that the octamer at low temperature prefers to adopt a B-DNA double-helical conformation in solution, however, some residual conformational freedom is detected at the 3' terminus. From the chemical shift versus temperature profiles it is concluded that no major conformational change occurs below 60-65 degrees C where the duplex formation for residues (2) to (6) is essentially completed under the conditions used. PMID- 6856459 TI - The nucleotide sequences of 5S rRNAs from two Annelida species, Perinereis brevicirris and Sabellastarte japonica, and an Echiura species, Urechis unicinctus. AB - The nucleotide sequences of 5S rRNAs from two Annelida species, Perinereis brevicirris and Sabellastarte japonica, and an Echiura species, Urechis unicinctus have been determined. Their sequences are all 120 nucleotides long. The sequence similarity percents are 88% (Perinereis/Sabellastarte), 90% (Sabellastarte/Urechis) and 92% (Perinereis/Urechis), indicating that the Echiura is indistinguishable from the Annelida by their 5S rRNAs. The 5S rRNA sequences from the Annelida/Echiura are most related to those from the Nemertinea (87%), the Mollusca (87%) and the Rotifera (88%). PMID- 6856460 TI - Specifically alkylated DNA fragments. Synthesis and physical characterization of d[CGC(O6Me)GCG] and d[CGT(O6Me)GCG]. AB - Two hexamer DNA fragments containing a carcinogenic modified base, O6-methyl guanine, have been synthesized by a solid-phase phosphotriester method, in which the unmodified guanine residues present were O6 protected with the 4 nitrophenylethyl group. These two alkylated oligonucleotides were found to have similar Tm's about 40 degrees lower than the unmodified parent compound, d(CG)3. Moreover, the presence of the (O6Me)G appears to inhibit the B leads to Z transition, as determined by CD spectroscopy. PMID- 6856461 TI - RNA polymerase of influenza virus. IV. Catalytic properties of the capped RNA endonuclease associated with the RNA polymerase. AB - Catalytic properties of the capped RNA-specific endonuclease associated with the influenza virus RNA polymerase were analyzed with use of synthetic hetero- and homopolymers containing 32P-labeled CAP structures at their 5' termini. The endonuclease displays its intrinsic activity provided that substrate RNA contains both the CAP-1 structure (m7GpppGm) and either A or U residues at 9 to 11 nucleotides distant from the CAP structure. Independent recognition of multiple RNA signals by the endonuclease was further supported by the findings that dinucleotide ApG, free CAP structures and RNA without the CAP structure inhibited the endonuclease activity to different extents. In the presence of four species of ribonucleoside 5'-triphosphates, the endonucleolytically cleaved fragments with the CAP-1 structure were incorporated into polynucleotides, supporting the concept that they are used as the primers for the transcription. The initial nucleotide linked to the primers was a G residue, the nucleotide complementary to the second base of the 3' termini of the vRNA segments. PMID- 6856462 TI - Characterization of a segmented double-stranded RNA virus in Drosophila Kc cells. AB - Drosophila Kc cells contain a series of RNA fragments ranging in size from 980 to 4600 bp. The fragments copurify with a virus-like nucleoprotein particle which has a density of 1.384 g/cm3 and is a 62 nm diameter icosahedron. There are 11-13 double stranded RNAs in the particles; they are not homologous with either cultured cell or embryo genomic DNA. The particle also contains a minimum of seven polypeptides, three of which are major, and all of which continue to be synthesized in Kc cells in heat shock when normal cellular protein synthesis is shut down. This virus-like particle occurs in large enough amounts in Kc cells to confuse molecular and physiological studies, however the cells continue to multiply in its presence. PMID- 6856463 TI - Synthesis and separation of diastereomers of deoxynucleoside 5'-O-(1 thio)triphosphates. AB - Treatment of unprotected nucleosides with an excess of phosphorous acid and stoichiometric proportions of N,N'-di-p-tolylcarbodiimide in anhydrous pyridine gives predominantly deoxynucleoside monophosphites and minor amounts of 5' :3' diphosphites; for deoxyadenosine and deoxyguanosine, the monophosphite products are exclusively 5'-phosphites, whereas for deoxycytidine and thymidine, the yields of the 5'-phosphites are 85% and 92% respectively. Sulfurization of these deoxynucleoside monophosphites with sulfur in the presence of trialkylamines and trimethylsilyl chloride in dry pyridine nearly quantitatively produces deoxynucleoside phosphorothioates. Condensation of these phosphorothioates with pyrophosphate forms diastereomers of the alpha-thio-derivatives of deoxynucleoside triphosphate. The individual diastereomers of each deoxynucleoside 5'-O-(1-thio)triphosphate can be separated, on a preparative scale, by ion exchange chromatography. PMID- 6856465 TI - Formation of stable preinitiation complexes is a prerequisite for ribosomal DNA transcription in vitro. AB - Cytoplasmic extracts from cultured mouse cells contain the factor(s) required for specific transcription initiation of rDNA by RNA polymerase I. Prior to transcription the essential proteins bind to the ribosomal gene and remain bound to the template for several rounds of transcription. The assembly of these preinitiation complexes in vitro has been demonstrated by kinetic analysis of the transcription reaction and by competition experiments. Complex formation involves an initial, rapid binding of transcription factor(s) to rDNA sequences followed by additional events which arrange the DNA-protein complex into a transcriptionally active state. Once the complexes have formed they persist for at least 2 hours in vitro and are resistant to elevated salt concentrations. The assembly of the complexes was inhibited when the template DNA was incubated with histones prior to the addition of S-100 extract. If, however, preinitiation complex formation was allowed to occur before the addition of histones, the interference of histones with specific transcription was much less pronounced. PMID- 6856464 TI - A 1H nOe and CD study of the salt-concentration dependence of the structure of d(G-C). AB - Intra- and internucleotide 1H nuclear Overhauser effects (nOes) have been observed in the synthetic decancleoside nonaphosphate d(G-C)5 at low and high salt concentrations, and in conditions under which duplex formation is complete. Comparison of the nOes with interproton distances derived from model and X-ray structures suggest that the duplex is right-handed up to a sodium chloride concentration of 4M, in contrast to the behaviour of poly [d(G-C)]. C.D. spectra are consistent with this suggestion. PMID- 6856466 TI - Nucleotide sequence-directed mapping of the nucleosomes. AB - The concept of sequence-dependent deformational anisotropy of DNA proposed earlier is further elaborated and a computational procedure is developed for the sequence-directed mapping of the nucleosomes along chromatin DNA nucleotide sequences. The deformational anisotropy is found to be nonuniform along the molecule of the nucleosomal DNA, suggesting that the DNA superhelix in the nucleosome is slightly oval rather than circular in projection. The number of superhelical turns in the nucleosome core particle is estimated to be 2.0 +/- 0.2. Preliminary mapping of the nucleosomes in various chromatin DNA sequences yields the distribution of linker lengths which shows several minima separated by about 10 base-pairs. This is explained by sterical exclusion effects due to overlapping of the nucleosomes in space when some specific linker lengths are chosen. The mapping procedure described is tested by comparing its results with all the most accurate experimental mapping data reported so far. The comparison demonstrates that the exact positions of all the nucleosomes appear to be determined exclusively by the nucleotide sequences. PMID- 6856467 TI - Purification of genomic sequences from bacteriophage libraries by recombination and selection in vivo. AB - Cloned genes have been purified from recombinant DNA bacteriophage libraries by a method exploiting homologous reciprocal recombination in vivo. In this method 'probe' sequences are inserted in a very small plasmid vector and introduced into recombination-proficient bacterial cells. Genomic bacteriophage libraries are propagated on the cells, and phage bearing sequences homologous to the probe acquire an integrated copy of the plasmid by reciprocal recombination. Phage bearing integrated plasmids can be purified from the larger pool of phage lacking plasmid integrates by growth under the appropriate selective conditions. PMID- 6856468 TI - Chicken lens delta-crystallin gene expression and methylation in several non-lens tissues. AB - RNA sequences coding for the most abundant chicken lens proteins, delta crystallin, were detected at very low levels in day old post hatch chick lung, heart, kidney and liver, and in 6 day embryo headless bodies. The pattern of cytosine methylation within the CCGG sequences of the delta-crystallin genes was also examined and shown to vary in several non-lens tissues, from several stages of development. Embryonic neural retina, which expresses a higher level of delta crystallin RNA than the above tissues, is no less methylated in the sites studied than the tissues which have no association with the eye, and is actually more heavily methylated than the kidney. Thus no obvious correlation was found between undermethylation and gene expression. PMID- 6856469 TI - The nucleotide sequence of the chicken apo very low density lipoprotein II gene. AB - The nucleotide sequence of the chicken apo Very Low Density Lipoprotein II (apoVLDL II) gene and the regions immediately flanking the gene was determined. Nuclease S1 mapping showed that transcription is initiated at two sites, about 11 bp apart, of which the one lying downstream is used preferentially. Comparison of the 2918-base pair gene sequence with the earlier determined cDNA sequence [Wieringa et al. (1981) Nucleic Acids Research 9, 489-501] enabled us to identify the four exons which are 38 (or 49), 100, 160 and 358 bp long. One of the intron exon junctions has an unusual sequence. In the 5' flanking region several palindromic sequences are observed. Sequences near the 5' and 3' ends show homologies with the ovalbumin gene. PMID- 6856470 TI - Improvements in the phosphoramidite procedure for the synthesis of oligodeoxyribonucleotides. AB - The paper describes an improved method for the synthesis of oligodeoxyribonucleotides using phosphoramidite chemistry. Our procedure relies on novel phosphoramidite intermediates, the deoxyribonucleoside-3'-morpholine methoxyphosphins. These compounds are extremely stable and can be purified readily. Condensation reactions during solid-phase synthesis can thus be performed with high efficiency and result in a high yield synthesis of long chain oligodeoxyribonucleotides. PMID- 6856471 TI - Human fibroblast interferon RNA transcripts of different sizes in poly(I).poly(C) induced cells. AB - Northern blot analysis reveals that total RNA from human fibroblastoid cells (MG 63) induced with poly(I).poly(C) under conditions of IFN-beta production, contains predominantly a +/- 1,200 nucleotide long poly (A) mRNA (mRNA.M) which hybridizes with a Hu IFN-beta cDNA specific probe. But hybridization with this probe also enabled the detection of a polyadenylated RNA (RNA.I) with a length of between 3.5 kb-3.8 kb, representing 0.6% of the total hybridizable cellular RNA in superinduced cells. Mapping shows that the RNA.I contains all the sequence information present in mRNA.M. Furthermore, it also hybridizes to sequences, located downstream from the IFN-beta gene up to 2.5 kb beyond its poly A attachment site, while no hybridization to fragments located upstream of the IFN beta mRNA cap site was observable. Hence this RNA.I corresponds to a transcript that starts at the same position as the major mRNA.M but which extends up to 2.5 kb beyond the 3'-end of mRNA.M where another polyadenylation signal is located. PMID- 6856472 TI - Quantitation of cation binding to wheat germ ribosomes: influences on subunit association equilibria and ribosome activity. AB - The binding of Mg2+, spermine, and spermidine to wheat germ ribosomes was quantitated following equilibrium dialysis. The Mg2+ binding data demonstrate that Mg2+ and K+ compete for binding to the ribosomes. Mg2+ binding saturates at approximately 0.56 positive charges per phosphate (+/P). The Mg2+, spermine and spermidine binding data indicate that either polyamine replaces Mg2+ upon binding to the ribosomes. Mg2+ and polyamine binding combined saturates at approximately 0.29 +/P under the conditions reported. When a critical number of Mg2+ ions are replaced by either polyamine, the activity of the ribosomes falls dramatically. Ribosomal subunit association increases with the degree of phosphate charge neutralization due to the binding of Mg2+. Total charge neutralization during subunit association by Mg2+ and polyamine binding combined, is much less than that achieved by Mg2+ alone. PMID- 6856473 TI - Stability of the conservative mode of nucleosome assembly. AB - The conservative assembly of nucleosome histone octamer cores has been confirmed by electrophoretic analysis of density labeled histones following equilibrium buoyant density centrifugation. After normal replication, crosslinked octamers are shown not to contain a mixture of new and old core histones. Moreover, when DNA synthesis is inhibited by ara-C nucleosome cores are still assembled exclusively from nascent histone. Similarly, after release from cycloheximide inhibition newly synthesized core histone is conservatively deposited. Thus, a conservative mechanism of histone octamer assembly occurs when nascent histone is present in the normal stoichiometry to nascent DNA and when chromatin is assembled in nascent histone or nascent DNA excess. PMID- 6856474 TI - A conserved nucleotide sequence, coding for a segment of the C-propeptide, is found at the same location in different collagen genes. AB - The nucleotide sequence of a segment of the chick alpha 1 type III collagen gene which codes for the C-propeptide was determined and compared with the corresponding sequence in the alpha 1 type I and alpha 2 type I collagen genes. As in the alpha 2 type I gene the coding information for the C-propeptide of the type III collagen gene is subdivided in four exons. Similarly, the amino proximal exon contains sequences for both the carboxy terminal end of the alpha-helical segment of collagen and for the beginning of the C-propeptide in both genes. Therefore, this organization of exons must have been established before these two collagen genes arose by duplication of a common ancestor. In several subsegments the deduced amino acid sequence for the C-propeptide of type III collagen shows a strong homology with the corresponding amino acid sequence in alpha 1 and alpha 2 type I. For one of these homologous amino acid sequences, however, the nucleotide sequence is much better conserved than for the others. It is possible that a mechanism of gene conversion has maintained the homogeneity of this nucleotide sequence among the interstitial collagen genes. Alternatively, the conserved nucleotide sequence may represent a regulatory signal which could function either in the DNA or in the RNA. PMID- 6856475 TI - Two Ustilago maydis viral dsRNAs of different size code for the same product. AB - UmV is a double-stranded RNA (dsRNA) virus of the corn fungus Ustilago maydis. There are three viral subtypes, P1, P4 and P6, which differ in the specificity of their secreted killer toxins. Each has three size classes of dsRNAs: H (heavy), M (medium), and L (light). We find that, unique among dsRNA viruses, two segments of different size code for the same product--the toxin resistance factor. The smaller dsRNA (L) is homologous to one end of the larger (M), and may have arisen by replication and packaging of a sub-genomic mRNA. We have also compared all the UmV dsRNAs with each other and with the dsRNAs of the similar yeast virus (ScV) by Northern gel and by 3' sequence analysis. Like those of ScV, many of the UmV dsRNAs have one 3' terminus with the sequence UUUUUCAOH or UUUUUCGOH. The H and L dsRNAs of similar size in different viral subtypes are generally related in sequence. The UmV H dsRNAs of different size are not detectably related in sequence. PMID- 6856476 TI - Structure of the 5'-terminal untranslated region of the genomic RNAs from two strains of alfalfa mosaic virus. AB - We report the sequences of the 5'-terminal regions of the 3 Alfalfa Mosaic Virus genomic RNAs for the Strasbourg strain (AlMV-S) and for a new isolate, AlMV-B; they are compared to similar data obtained by Koper-Zwarthoff et al. (Nucleic Acids Res. 1980, 8, 5635-5647) for strain 425. The structure of these leaders is highly conserved in RNAs 1 and 2. The length of the leader is 102, 100 and 101 nucleotides in RNA1 for strains S, B and 425 respectively; 55 and 56 in RNA2 for strains S and B respectively. In RNA3 however, there are important differences near the 5'-terminus between strain S and the other two: The total leader length is 258 nucleotides for strain S and 242 for strain B. The secondary structure models show a conserved hairpin near the 5'-end of each genomic RNA of AlMV-S. This hairpin is inexistent in RNA3 of the B and 425 strains. The degree of base pairing increases with leader length. The initiator codon is located in a single stranded region in RNA2 whereas it is found in a hairpin stem in RNA 3. PMID- 6856477 TI - Conformational analysis of a ribopentanucleoside tetraphosphate in aqueous solution. A two-dimensional NMR study at 500 MHz. AB - The 30 ribose proton resonances of the pentaribonucleoside tetraphosphate m6(2)AUm6(2)AUm6(2)A have been assigned unequivocally by means of spin-echo correlated spectroscopy, 2D J-resolved spectroscopy and Nuclear Overhauser difference spectroscopy, carried out at 500 MHz. A detailed comparison of the conformational properties of the title compound with its constituent fragments m6(2)AUm6(2)AU, m6(2)AUm6(2)A, m6(2)AU and the relevant monomers is given. Chemical shift data indicate the existence of a doubly "bulged out" conformer, in which the two interior U-fragments are not involved in regular nearest neighbour stacking interactions. The coupling constants of the ribose-ring are interpreted in terms of the N/S equilibrium, and population distributions along the backbone angles beta and gamma are presented. The combined data suggest a strong similarity between the 5'-terminal triplets in m6(2)AUm6(2)AUm6(2)A, m6(2)AUm6(2)AU and m6(2)AUm6(2)A2. PMID- 6856478 TI - The nucleotide sequences of the 5S rRNAs of four mushrooms and their use in studying the phylogenetic position of basidiomycetes among the eukaryotes. AB - The nucleotide sequences of the 5 S ribosomal RNAs of the mushrooms Russula cyanoxantha, Pleurotus ostreatus, Agaricus edulis, and Auricularia auricula-judae were determined. The sequences fit in a universal five-helix secondary structure model for 5 S RNA. As in most other 5 S RNAs, some helical areas contain non standard base pairs. A clustering method was used to reconstruct an evolutionary tree from 82 eukaryotic 5 S RNA sequences. It allows to make a choice between alternative systematic classifications for basidiomycetes and reveals that the fungal kingdom is highly polyphyletic. PMID- 6856479 TI - Complete nucleotide sequence of alfalfa mosaic virus RNA3. AB - A full-length cDNA clone of alfalfa mosaic virus (AMV) RNA3 was prepared and sequenced. The 2,037 base sequence contains two open reading frames of 903 and 666 nucleotides that code for a 32,400 dalton protein (32.4K protein) and the 24,380 dalton coat protein, respectively. A 5'-noncoding sequence of 240 bases preceeding the 32.4K protein contains homologous regions that may have a function in its translation. The intercistronic junction is 49 bases long, the last 36 bases representing the 5'-end of the subgenomic RNA4. The remaining 179 bases comprise the 3'-terminal noncoding sequence. PMID- 6856480 TI - A double helix B-type geometry based on high-resolution proton NMR of single helical DNA fragments: d(TA)5 x d(TA)5. AB - A single-helical B-type geometry is presented based on 1H NMR observations on d(TATA) and several other small single-helical DNA fragments. The structure is extended to one complete turn of double-helical DNA and its characteristics are compared with other known B-type structures. PMID- 6856482 TI - Effects of estrogen on the growth of mouse teratocarcinoma OTT6050 in vivo. AB - The effects of estrogen, antiestrogen and ovariectomy on the growth of a mouse teratocarcinoma, OTT6050, were studied in vivo. Subcutaneous tumors transplanted in syngeneic 129/Sv male and female mice were measured, and tumor-growth curves were constructed using the products of three principal tumor diameters, designated tumor volume. There was a linear correlation between the measured tumor volume and the actual excised tumor volume. The tumor growth rate in estrogen-treated groups was significantly greater than that in the control group, and the difference in tumor volume between treated groups and controls increased with time. However, dose responsiveness was not observed. In antiestrogen-treated or ovariectomized mice, tumor growth was partially inhibited only at the early stages. The mean survival time of estrogen-treated and ovariectomized groups was shorter than that of controls, while that of the antiestrogen-treated group was identical to that of controls. Histologically, no specifically different types of differentiated tissues were observed in any group. Our experiments show that estrogen is one important factor which stimulates the growth of one form of teratocarcinoma. PMID- 6856481 TI - Intramolecular stacking association and conformation properties of a 'cap' structure, m7G5'pppUm, and the related model compounds. AB - The stacking equilibrium quotient of the m7G5'pppUm unit, which occurs as the 5' terminal "cap" of certain eukaryotic mRNA's, was determined by temperature dependent difference spectrophotometry as Kstack = 1.82 at 25 degrees and pH 5. In order to evaluate the contribution of different structural modifications to the net stabilization of the cap structures of mRNA, a variety of compounds related to m7G5'pppUm were synthesized and their stacking properties were studied by the same method and compared. The results are summarized as: (1) Introduction of a methyl group into N-7 of G residue results in an increase in base stacking. (2) Methylation at 2'-OH of U residue also stabilizes the stacked structure of G containing dimers, but it does not influence stacking interaction in m7G containing dimers. (3) The effect of different types of internucleotide linkages on the order of stacking tendencies is: N5'ppN' greater than N5'pppN' greater than NpN'. UV hypochromicity and CD spectral measurements of the relevant dimers were also conducted, and the hypochromicity values and CD spectra of dimers in their stacked conformation were estimated by making use of the determined Kstack values. The results indicate that, while 2'-O-methylation exerts very little effect on the stacked conformation of the dimers, methylation at N-7 and the nature of the internucleotide linkage strongly influence the stacked conformation, thereby forming unusual left-handed conformations in m7G5'pppU(m), m7G5'ppU(m), and G5'ppU(m). PMID- 6856484 TI - Purification and characterization of two new soluble placental tissue proteins (PP13 and PP17). AB - Two new soluble placental tissue proteins (PP13 and PP17) have been isolated and characterized. PP13 has an electrophoretic mobility the same as that of albumin, an isoelectric point in the range 4.7-4.8 and a sedimentation coefficient of 3.1 S. Its molecular weight was found to be 30 000. PP13 appears to be composed of two identical subunits which are held together by disulfide bonds. PP17 has an electrophoretic mobility in between the beta 1- and alpha 2-globulins, an isoelectric point in the range 5.2-5.3 and a sedimentation coefficient of 2.7 S. Its molecular weight was determined to be 30 300 by ultracentrifugation and 38 000 by SDS-polyacrylamide gel electrophoresis. PP17 apparently consists of a single peptide chain. The amino acid and carbohydrate compositions of these proteins also have been determined. Immunochemical methods were used to detect and quantitate the new proteins in extracts of placental and other human tissues as well as in body fluids. From one human term placenta an average of 3.7 mg PP13 and 2.5 mg PP17 could be extracted. In concentrated extracts of other human tissues and in body fluids, these proteins could not be detected, at least not in concentrations higher than 1 mg/dl. The immunohistochemical localization of these proteins as well as measurement of their concentrations in body fluids by sensitive radioimmunoassays are presently under investigation. PMID- 6856483 TI - Antigenicity of a fetal extract in the leucocyte migration-inhibition test. AB - Leucocytes from patients with gastric or colorectal cancer as well as from normal subjects were tested by the leucocyte migration-inhibition test against 3 M KCl extracts of three whole fetuses and eight fetal gastrointestinal tract tissues. The incidence of pathologic results in patients with gastric and colorectal cancer was 26% (25/77) and 34% (25/74), respectively. The values were significantly higher than those of normal subjects (3%, 1/30). No significant difference in the migration index was found between whole fetal and fetal gastrointestinal tract extracts. The migration index did not depend on CEA concentration in these fetal extracts. These results show that leucocytes from patients with gastric or colorectal cancer were sensitized to antigenic substance(s) in the fetal extracts, and suggest that gastrointestinal cancer and fetal tissue may share some common antigens. PMID- 6856485 TI - When is an I.V. bolus a bolus? PMID- 6856486 TI - Indapamide: clinical pharmacology, therapeutic efficacy in hypertension, and adverse effects. AB - Indapamide will soon be marketed in the United States as an oral antihypertensive agent and diuretic. Its molecular structure includes both a polar sulfamoyl chlorobenzamide moiety and a lipid-soluble methylindoline moiety. It differs chemically from the thiazides in that it does not possess the thiazide ring system and it contains only one sulfonamide group. Indapamide is rapidly and well absorbed after oral ingestion, and it has a long terminal half-life in whole blood which permits once daily administration. Indapamide is extensively metabolized by the liver with excretion of unchanged drug accounting for approximately 5% of the total dose. Although indapamide is thought to exert its antihypertensive effect by its diuretic action, several investigations employing laboratory animal preparations have documented a direct vascular action. It has been categorized as a calcium channel blocking agent and this may account for a portion of its antihypertensive effectiveness. In both the treatment of edema and as an antihypertensive agent, indapamide appears to be comparable to hydrochlorothiazide, chlorthalidone and furosemide and seems to have no clinically important advantage over these agents. Side effects associated with indapamide are minimal and appear to be comparable to those observed with other antihypertensive diuretics. Based on few published studies, indapamide appears to be a useful long acting antihypertensive and diuretic agent that is well tolerated and associated with minimal biochemical abnormalities or side effects. PMID- 6856488 TI - Chemical and pharmacological properties of diflunisal. AB - Diflunisal, 5-(2',4'-difluorophenyl) salicylic acid, was discovered as a potent antiinflammatory analgesic agent after an extensive investigation of more than 500 salicylic acid analogs. The addition of a difluorophenyl substituent at the C5 position of salicylic acid yielded a new molecule with much improved lipophilicity, a longer duration of action, and a molecular configuration that is optimal for greater antiinflammatory and analgesic activities. The difluorophenyl group is metabolically stable; the acyl and phenolic glucuronides of the intact diflunisal are major urinary metabolites. The absence of an O-acetyl group in this novel salicylate analog circumvents the well-known in vivo acylation potential of aspirin and renders diflunisal a reversible cyclooxygenase inhibitor with a secondary oxygen radical scavenging effect. In a variety of analgesic, acute, and chronic antiinflammatory models, diflunisal is active at 10 mg/kg, approximately 5 to 10 times more potent than aspirin. It has a relatively low potential to cause gastrointestinal irritation as indicated by the lack of acute effect on the integrity of gastric mucosa barrier, no change of intragastric potential, and no disturbance of prostaglandin production by the gastric tissue. Diflunisal holds promise as a new clinically useful analgesic and antiinflammatory drug with good tolerance and a long duration of action. PMID- 6856487 TI - A method for the 12-hour evaluation of analgesic efficacy in outpatients with postoperative oral surgery pain. Three studies of diflunisal. AB - We have developed a method for measuring the efficacy of a single dose of an analgesic for 12 hours after administration of outpatients with postoperative oral surgery pain. Using a self-rating record, patients evaluate their pain and its relief for 12 hours after medication. We have used this method successfully in a series of three studies to compare diflunisal, a new nonsteroidal antiinflammatory analgesic, with placebo and aspirin 650 mg, acetaminophen 600 mg, propoxyphene napsylate 100 mg, or a combination of acetaminophen with either codeine 60 mg or propoxyphene 100 mg. Diflunisal evinced an unusually long duration of analgesic effect. In each study, all doses of diflunisal were significantly superior to placebo through the end of the 12-hour observation period, while the standards were superior for periods ranging from 2 to 7 hours. In terms of peak analgesia, diflunisal 1,000 mg was comparable to the acetaminophen-codeine combination and was significantly superior to all the other analgesic standards. PMID- 6856489 TI - Median sternotomy wound infections in children. AB - Nine children (25 days to 15 years of age) with infectious complications of median sternotomy are described. Six infections were superficial and in three the sternum and/or mediastinum was involved. Risk factors predisposing to sternal wound infections in six patients were a pump bypass time in excess of 1 hour, excessive postoperative bleeding, low cardiac output for 24 hours or more postoperatively, reexploration for control of bleeding and inadequate antimicrobial prophylaxis. Eight infections were diagnosed at a mean of 15 days postoperatively (range, 5 to 30 days), and chronic sternal osteomyelitis was diagnosed 4 years after operation in one patient. Stability of the sternum was a critical feature differentiating between superficial and deep wound infections. Staphylococcus aureus or Staphylococcus epidermidis was isolated from the wound and/or blood of five patients, and Gram-negative enteric rods were isolated in three patients (two with sternal osteomyelitis and mediastinitis). Local debridement was sufficient for adequate drainage in four patients, but reexploration for debridement and rewiring of the sternum or drainage of mediastinal contents was required in four. All patients improved initially following drainage and administration of parenteral antibiotics for a mean of 12 (superficial infection) or 28 (deep infection) days. Two patients developed chronic sternal osteomyelitis, and one died due to rupture of a mycotic aneurysm of the aorta 7 years postoperatively. PMID- 6856490 TI - Parasitic infections in a pediatric population. AB - We studied the frequency of parasitic infection and associated clinical symptoms in children who attended general pediatric and dental clinics at UCLA. Parasites were detected in stool specimens of 40 (38%) of the 1-4 children completing the study. Protozoan parasites were recovered in 39 (38%); one child had whipworm eggs. Parasites included Dientamoeba fragilis in 22 (21%) children and Giardia lamblia in 18 (17%) children; commensals were observed in 15 (14%) children. Parasitic infection was more frequent in younger children, those with a history of immigration or foreign travel and those attending a day care center. A significant proportion of children with parasites had vague gastrointestinal complaints; however, parasites had not been considered as the etiologic agent by the parent or child's physician. Anorexia, irritability and gas were frequent in children with G. lamblia; abdominal pain was more frequent in those with D fragilis. Intestinal parasitic infection should be considered in children with vague gastrointestional complaints, particularly those in endemic areas, with a history of foreign travel or immigration or attending a day care center. Siblings of infected children should have stool examination even if asymptomatic. PMID- 6856492 TI - A perineal rash in Kawasaki disease. PMID- 6856491 TI - The evaluation and treatment of the febrile infant. AB - Over a period of 5 1/2 years 305 infants less than 60 days of age with temperatures greater than or equal to 100.4 degrees F (38.0 degrees C) were evaluated for sepsis. Of these 20.6% of the infants had significant diseases although only 3.6% had bacteremia. Neither the age of the child (above or below 30 days of age) nor the height of the fever helped to identify infants with bacteremia. A white blood cell count of greater than 15,000/mm3 was useful in identifying bacteremic infants over 30 days of age only. The differential white blood cell count was not helpful in distinguishing between bacteremic and nonbacteremic infants. The appearance of the infant was the most significant predictor (P less than 0.001) of bacteremia in this age group. Infants between 30 and 60 days of age who both appeared ill and had white blood cell counts greater than or equal to 15,000/mm3 had a 27.3% chance of having bacteremia. PMID- 6856493 TI - Systematic decision-making in rabies prophylaxis. PMID- 6856494 TI - Acquired immune deficiency syndrome in children. PMID- 6856495 TI - The diagnostic value of C-reactive protein. PMID- 6856497 TI - [Effect of long-term hemodialysis on changes in the concentration of various trace elements in the blood of patients with chronic renal failure]. PMID- 6856496 TI - Long term sequelae of bacterial meningitis in children. PMID- 6856498 TI - [Effect of extracorporeal dialysis on the blood copper concentration and its relation to the hemoglobin level in patients with chronic renal failure]. PMID- 6856499 TI - [Urinary excretion of hydroxyproline in patients with fractures of the long bone shafts and articular fractures of the proximal base of the tibia treated by external immobilization and functional methods]. PMID- 6856500 TI - [Treatment of penile induration with mud]. PMID- 6856501 TI - [Arthritis of the knee joint caused by Chlamydia trachomatis infection]. PMID- 6856503 TI - [Glomerular filtration: functional analysis. II]. PMID- 6856502 TI - [Glomerular filtration: functional analysis. I]. PMID- 6856504 TI - [Studies on the causes of chronic atrophic gastritis]. PMID- 6856505 TI - [Health hazards and economic losses in peptic ulcer related to smoking]. PMID- 6856506 TI - [Intestinal absorption of D-xylose after transposition of the jejunum and ileum in the dog]. PMID- 6856507 TI - [Spontaneous remission of T4-toxicosis caused by multiple "hot" thyroid nodules]. PMID- 6856508 TI - [Incarcerated subpubic hernia as a cause of acute intestinal obstruction]. PMID- 6856509 TI - [Early diagnosis of galactosemia in infants apropos of 2 observed cases]. PMID- 6856510 TI - [Toxoplasmosis in women in relation to number of pregnancies]. PMID- 6856511 TI - [Plasmacytic leukemia in non-secreting multiple myeloma]. PMID- 6856512 TI - [Dramatic course of pregnancy after bromocriptine therapy of infertility of many years' duration complicated by hyperprolactinemia and suspected pituitary adenoma]. PMID- 6856513 TI - [Male sex differentiation in the embryo in light of new data]. PMID- 6856514 TI - Glomerular alterations in experimental diabetes of the rat. AB - To detect structural glomerular alterations in the early stages of diabetes mellitus glomeruli from young streptozotocin diabetic rats were studied by light microscopy with morphometric methods 2, 8, 12 and 24 weeks after induction of diabetes. It was found that there is a marked increase in the percentage mesangial surface as compared with the control animals already two weeks after induction of diabetes. The relative mesangial surface fraction was greater in the diabetic animals than in the controls at all test times. It was also demonstrated that the endothelial cell count was reduced in the diabetic animals in the first few weeks of the study. High-grade glycosuria and proteinuria were likewise observed in the diabetic animals. Hence the mesangium appears to be one of the glomerular structures which shows the first changes in the initial stages of diabetes mellitus. Possibly the most likely cause of the changes based on the present study is the diabetic metabolic state (or the insulin deficiency). PMID- 6856515 TI - Morphogenesis of pulmonary veno-occlusive disease in a newborn. Image analysis study. AB - A 9-day-old girl was admitted to hospital because of respiratory distress. The girl died on the 11th day of life shortly after an haemodynamic study and the autopsy disclosed a pulmonary veno-occlusive disease with lesions in relatively early stages of development. Morphological pattern and computerized image analysis data induce to rule out a thrombosis as a previous event to the development of fibrotic changes and point to a "primary" intimal involvement, presumably triggered by an endothelial injury, determining a myxoid change of the intima and leading to a cellular proliferation and ultimate fibrotic occlusion of the small pulmonary veins. Apparently the lesions progress from the smaller pulmonary veins to the larger ones, in which the involvement is focal in character and related to the openings of collateral branches. The homogeneous character of the more recent lesions in the larger veins is in contrast to the heterogeneity of the fibrotic process in the smaller ones. PMID- 6856517 TI - Amount and distribution of solid and fatty tissues in the female breast and their relationship to carcinoma. AB - The study is based on 112 consecutive mastectomy specimens with carcinoma. Breasts were grossly divided into three basic types: solid, when showing a sizable cone of solid tissue (mammary tissue and fibrous stroma), fatty when almost completely replaced by fat, and intermediary types Ia and Ib. It appears that these types represent stages of an evolutionary process involving the anatomical structure of the breast during life. Mammary alterations gradually lead to lobular atrophy. Generalized lobular atrophy characterizes mainly fatty breasts. Lesions of fibrocystic disease are frequent in breasts of all types. In all three types of breast carcinomas were more frequently located in the outer portion of the breast. Rare locations of carcinomas are associated with the type of breast: a central location is more frequent in fatty, an inner location in intermediary and a diffuse in solid breasts. In fatty breasts irregular tumors are common while in solid breasts tumors without clear borders appear to develop. Multicentric carcinomas were much more frequent in solid breasts than in the other types of breasts. Most multicentric carcinomas are accompanied by multicentric carcinoma in situ. Infiltrative lobular and mixed (lobular-ductal) carcinomas are accompanied by lobular carcinoma in situ, lobular cancerization or both. In infiltrative ductal and the special types of carcinomas the histology of carcinoma in situ differs according to whether or not the infiltrative tumor is single or multicentric. The difference concerns the complete lack of lobular cancerization from cases with single infiltrative tumors. PMID- 6856516 TI - Experimental studies on the effect of duodenal contents on the epithelium of the esophagus. AB - 10 male BD IX rats and 15 male and female Wistar rats weighing between 250 and 300 g had an esophago-jejunostomy according to the method described by Levrat et al. (1962). Four weeks after surgery all 40 animals were sacrificed and examined macroscopically as well as histologically. All animals had deep ulcerative lesions in the lower half of the esophagus associated with hyperplasia, hyperkeratosis and akanthosis. PMID- 6856518 TI - Ultrastructure of neoplastic cells in different histologic subtypes of pulmonary adenocarcinoma. AB - 57 pulmonary adenocarcinomas were classified according to the WHO Classification of Lung Tumours. 55 cases were primary adenocarcinomas and two were metastases from the gastrointestinal tract. The acinar, papillary and bronchiolo-alveolar carcinomas were well or moderately differentiated and the solid adenocarcinomas were poorly differentiated tumours secreting mucus in intracytoplasmic vacuoles. All tumours, including the two metastases, were analyzed by transmission electron microscopy. Most of the acinar, papillary and all bronchiolo-alveolar adenocarcinomas contained a great or moderate number of secretory granules which were pale fibrillar or dense homogeneous. Among the solid adenocarcinomas there were no tumours with a great number of secretory granules. The surface fine structure of the metastatic carcinomas differed from those of the primary adenocarcinomas, having a brush-border instead of microvilli. The ultrastructure of the primary adenocarcinomas resembled the normal surface epithelial cells of bronchi and bronchioli, and two papillary adenocarcinomas contained lamellar bodies similar to granular pneumocytes. Instead of dividing into four different subtypes pulmonary adenocarcinomas can be classified according to histological grading. PMID- 6856519 TI - Epithelial lesions antedating oesophageal carcinoma. I. Histologic study in mice. AB - The histological changes occurring in the oesophageal mucosa after protracted topical treatment with diethylnitrosamine was investigated in 87 C57B1 mice. The histological changes were classified into slight, moderate, severe dysplasia, carcinoma in situ, questionable invasive carcinoma and invasive carcinoma. Starting from moderate dysplasia, the epithelial-stroma border became irregular with formation of buds bulging into the stroma. Similar histological changes have been found in the same strain of animals during carcinogenesis of the cervix uteri, another organ covered by squamous epithelium. The findings strongly suggest an association between the degree of cellular atypia, the formation of epithelial buds and progression towards invasive carcinoma. PMID- 6856520 TI - A contribution to the morphology and pathogenesis of thyroid-like lesions in the kidney. AB - The morphological variations of thyroid-like lesions in the kidney in 15 cases with chronic destructive interstitial nephritis as the basic alteration were examined with light microscopy and immunohistological methods. Reflux pyelonephritis was present in some cases. Thyroid-like lesions can develop at any age. "Mature" thyroid-like lesions possess large follicular structures and solid tubular epithelial cell complexes, whereas the follicular structures in "young" thyroid-like lesions are small. The hyaline casts are Tamm-Horsfall protein positive in between one- and two-thirds of the follicles. IgA is present in all follicular lumina. The thyroid-like lesions are the result of a regenerative process. They develop after subtotal parenchymal destruction of remaining tubular epithelial cells from the ascending limb of the loop of Henle, the distal convoluted tubules and the collecting ducts. They are pathognomonic for healed destructive bacterial interstitial nephritis, but can also be observed in analgesic nephropathy, hydronephrosis, and nephronophthisis when these basic diseases are preceded by pyelonephritis. PMID- 6856521 TI - Changes in blood cortisol and aldosterone levels and ultrastructure of the adrenal cortex during hemorrhagic shock. AB - Changes of secretory activity and structure of the adrenal cortex were observed in dogs subjected to hemorrhagic shock. Blood cortisol and aldosterone levels were rapidly increased after hemorrhage. The cortisol level reached a maximum value about 5 times that of normal 1 h after hemorrhage, while aldosterone levels attained maximum levels showing a 10-fold increase over normal, considerably later (at the end of the impending stage) than the cortisol. Cortisol secretion was quickly depleted at the end of critical stage and terminal stage of normovolemic shock, while the aldosterone secretion remained relatively high. Morphologically, sticking of leukocytes to the sinusoidal wall and accumulation of SER around lipid droplets in the fasciculata and reticularis cells became conspicuous 1 h after hemorrhage. At the end of the impending stage, infiltration of leukocytes occurred in the zona fasciculata and reticularis. Irregular masses of fibrin strands appeared in the sinusoidal space and at large gaps of the sinusoidal wall. Degenerative changes such as aggregation of SER, dilatation of endoplasmic reticulum and edema were observed in the cells of zona fasciculata and reticularis, especially of inner half of the former. At the end of the critical stage, small necrotic foci and hemorrhage with inflammatory infiltration were scattered in the inner half of the zona fasciculata. Degeneration of the cells of zona fasciculata and reticularis became more severe in this period, while the cells of zona glomerulosa remained unchanged. At the terminal stage of normovolemic shock after reinfusion, degeneration and necrosis were remarkable in the cells of zona fasciculata and reticularis, especially of the inner half of the zona fasciculata. Moreover, destruction of cordal structure, hemorrhage and inflammatory infiltration were distinct in the zona fasciculata and reticularis, while the zona glomerulosa was relatively well preserved. PMID- 6856522 TI - How good is screening for colorectal cancer? AB - Colorectal cancer is potentially preventable. Use of fecal occult blood testing, flexible sigmoidoscopy, and a combination of air-contrast barium enema examination and colonoscopy has proved to be a safe, relatively inexpensive approach to detecting colon cancer in its early stages, decreasing morbidity and increasing survival. Future work in secondary prevention of colon cancer should be aimed at standardized trials of fecal occult blood agents, thus optimizing the yield of localized lesions and decreasing the cost so that mass screening becomes possible. Major efforts should be aimed at educating physicians and the public alike. Primary prevention will deserve greater emphasis when specific risk factors pathogenetic of colon cancer are discovered. PMID- 6856524 TI - Enhancement of hemostasis in surgery? PMID- 6856523 TI - Preferred provider organizations. New relation of the HMO. PMID- 6856525 TI - Aerobic exercise. Can you answer the questions your patients ask? AB - Aerobic exercise is a dynamic exercise form that has as a goal increased cardiovascular fitness. In addition to its potential for improved cardiovascular health, it may also help prevent hypertension, promote improved psychologic health, and help prevent osteoporosis. Certain conditions are contraindications to the undertaking of an exercise program, and some patients should undergo exercise stress testing before beginning. Dietary changes are probably not necessary for persons beginning moderate exercise programs, but in athletes taking part in strenuous forms of exercise, fluid and electrolyte balance and adequacy of muscle glycogen stores should be considered. Exercise, however, is only one of the factors important in fitness and cardiovascular risk reduction. PMID- 6856526 TI - Missed large left ventricular thrombus. Failure of two-dimensional echocardiography in one case. AB - In the case reported, two-dimensional echocardiographic study of a man six weeks after he sustained an extensive transmural anterolateral infarct failed to show evidence of an intraventricular thrombus. Ten days later the patient suddenly died. Autopsy findings included a large fibrin clot, weighing 50 gm, in the left ventricle. Two-dimensional echocardiography is a very sensitive method of defining aneurysm in the apex of the heart and identifying and locating ventricular thrombi usually associated with aneurysm. I consider the false negative finding in this case to be a rare exception. PMID- 6856527 TI - Cerebral bypass procedures. What have we learned so far? PMID- 6856528 TI - Carotid surgery. Community hospital experience. PMID- 6856529 TI - The alternate pathway of Moore or, the Moore epicycle. PMID- 6856530 TI - Shoulder radiography in acute trauma. True anteroposterior and true lateral views make for better reading. PMID- 6856531 TI - Fungal infection of the lung. The big 3--histoplasmosis, blastomycosis, coccidioidomycosis. AB - Diseases caused by the normally pathogenic fungi Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides immitis are common but seldom serious. Treatment is usually needed only if respiratory status is compromised, if there is progressive tissue destruction, or if the infection disseminates outside the lungs. The recent availability of ketoconazole has changed the approach to treatment of some forms of fungal disease. Although this drug has no firmly established role, it has proved useful for several aspects of disease. More experience with its use will prove whether it is truly curative or merely suppressive. PMID- 6856532 TI - Chronic airflow obstruction. Two-pronged approach to outpatient management. AB - The goal of outpatient management of chronic airflow obstruction is to relieve symptoms, which can be accomplished by smoking cessation and by use of bronchodilators. The inhaled beta agonists are the first choice for bronchodilator therapy, followed by oral theophylline if beta agonists alone are ineffective. If symptoms persist, corticosteroids should be tried. Because of the serious side effects of steroids, however, objective evidence of improvement must be documented before long-term use can be justified. PMID- 6856533 TI - Hydralazine: depressive potential questioned. PMID- 6856534 TI - Are you complying with reporting statutes? PMID- 6856535 TI - Raynaud's phenomenon. Role of diet pills and cold remedies. PMID- 6856537 TI - How to drive doctors crazy and ease them into malpractice suits. PMID- 6856536 TI - The attention deficit disorder. A learning and behavioral problem in children. AB - A large number of children exhibit characteristic abnormalities of attention, coordination, learning, and behavior, which together compose the attention deficit disorder. These abnormalities frequently lead to school failure and social maladjustment. A variety of therapies diminish the symptoms of this disorder, offering hope for improved prognosis. Management depends upon early identification, thorough evaluation, and appropriate intervention. PMID- 6856538 TI - Coughing in children; a relaxing solution. PMID- 6856539 TI - Symptomatic internal hemorrhoids. What are your options? AB - Treatments for symptomatic internal hemorrhoids are many; in general, the method is designed to fit the severity of prolapse. Stool softeners work well for first- and second-degree hemorrhoids. Rubberband ligation, which is an easy and inexpensive office procedure, is used to treat second-degree hemorrhoids, and surgery is often necessary for third- and fourth-degree hemorrhoids. Other methods include sclerotherapy, dilation of the anus, sphincterotomy, and infrared photocoagulation. PMID- 6856540 TI - Chest pain in children. Tip-offs to cause. AB - The primary care physician can often delineate the cause of chest pain in a patient under 21 years of age after a thoughtful, careful, and thorough history and physical examination. Occasionally, an ECG and a chest x-ray film may be helpful. Noncardiac causes for the chest pain should be explored, and if found, the child and the parents should be assured that the problem is not serious. Occasionally, psychotherapy may be indicated. A pediatric cardiologist should be consulted when a strong family history of coronary artery disease or a personal history of coronary risk factors is present or a murmur is detected that may not be innocent. The specialist also should evaluate children who have organic cardiac disease. Finally, although the primary care physician may strongly suspect that the chest pain has little or no significance, reassurance by a pediatric cardiologist is frequently helpful to the child and the family. PMID- 6856541 TI - Continuing symptoms of pyelonephritis raise concern for obstruction. PMID- 6856542 TI - Mammalian bites. Rational approach to management. AB - When a mammal's bite breaks the skin, aggressive management is indicated to prevent infection and provide for a good cosmetic and functional result. Vigorous irrigation and thorough debridement play a more important role than antibiotics in preventing infection. Whether antibiotics have prophylactic value in this situation remains controversial, but semisynthetic penicillins or cephalosporins may be worth a try in high-risk cases. Suturing may or may not be advisable, depending on cosmetic considerations and risk of infection. Prophylaxis against tetanus is a must, and hepatitis and rabies prophylaxis may also be necessary in selected cases. PMID- 6856543 TI - Intermittent fluid retention in women. Is it idiopathic edema? AB - When a capillary or renal disturbance is not apparent in a woman of reproductive age who presents with edema, a disorder referred to as idiopathic edema should be considered. This disorder, which is often intermittent, causes fluid to accumulate when the patient is upright. Because of this postural relationship, research into pathogenesis has focused on homeostatic adjustments to changes in posture. A number of mechanisms have been proposed, the most tenable of which seem to be increased capillary permeability, increased mineralocorticoid activity, and a faulty "escape mechanism." The diagnosis of idiopathic edema is established by documenting an excessive intradiem weight gain (greater than 1 kg) and performing a water-loading test. Because the pathogenesis remains obscure, no specific or uniformly successful therapy yet exists. Besides recumbency, restriction of calories, sodium, and fluids may be tried. If these measures do not bring adequate relief, diuretics or sympathomimetics may be prescribed. PMID- 6856545 TI - Disorders of the digestive tract. PMID- 6856544 TI - Wellness. The grand tradition of medicine. PMID- 6856546 TI - The digestive tract. PMID- 6856547 TI - Early diagnosis of gastric and oesophageal cancer. PMID- 6856548 TI - Intestinal malabsorption. PMID- 6856549 TI - A new look at Crohn's disease. PMID- 6856550 TI - Food allergy. Fact and fiction. PMID- 6856551 TI - Mouth lesions as markers of gastrointestinal disease. PMID- 6856552 TI - Radioisotope scanning in hepatobiliary disease. PMID- 6856553 TI - Prevention of dental disease. PMID- 6856554 TI - Managing obesity in general practice. PMID- 6856555 TI - Air-flow studies in excessive flatulence. PMID- 6856556 TI - The changing shape of obesity surgery. PMID- 6856557 TI - Hepatobiliary disease and chronic dental sepsis. PMID- 6856558 TI - Egg and meat consumption in myocardial infarction. PMID- 6856559 TI - How the other half eats. The health food movement. PMID- 6856560 TI - [Serum theophylline steady-state levels: comparative study of 2 retard preparations]. PMID- 6856561 TI - [Bronchial inhalation provocation test--diagnostic value of various function methods (spirography, pneumotachography, body plethysmography, oscillometry]. PMID- 6856562 TI - [Treatment of spontaneous hemopneumothorax]. PMID- 6856563 TI - [Accident caused by a vaccine error in BCG intradermal vaccination]. PMID- 6856564 TI - [Optimizing therapy with theophylline preparations in obstructive ventilation disorders. 3. Prediction of theophylline clearance with a simple pharmacokinetic method and comparison of bioavailability of various theophylline retard preparations]. PMID- 6856565 TI - [Blood pressure and the prevalence of hypertension in polycythemia vera and secondary polyglobulia]. PMID- 6856566 TI - [Acute cholecystitis complicating accidental trauma or non-biliary surgery. 29 cases]. PMID- 6856567 TI - [Acute renal failure with nephrotic syndrome caused by fenoprofen. Reflections apropos of a case and review of the literature]. PMID- 6856568 TI - [Alcohol and arterial hypertension. Case report and review of the literature]. PMID- 6856569 TI - [Isolated rupture of the anterior syndesmosis of the proximal ankle joint]. PMID- 6856570 TI - [Pacemaker problems in general practice]. PMID- 6856571 TI - [How long should an acquired heart valve disease be conservatively treated, when should surgery be done?]. PMID- 6856572 TI - [Diagnosis and therapy of sudden hearing loss]. PMID- 6856573 TI - [Geriatric psychiatry for the general practitioner]. PMID- 6856574 TI - [The general practitioner and psychogeriatrics]. PMID- 6856575 TI - [Treatment of fractures in children--diagnostic and therapeutic aspects]. PMID- 6856576 TI - [Pleomorphic lipoma. A casuistic and differential diagnosis contribution]. PMID- 6856577 TI - [Spurious aneurysm of the heart]. PMID- 6856578 TI - [The Opsi syndrome. Pathogenesis--clinical signs--pathological anatomy]. PMID- 6856579 TI - [Morphology and clinical signs of hemangiopericytoma. An analysis of 84 cases with a personal contribution]. PMID- 6856580 TI - [Significance of interstitial fibrosis and intratubular cylinders for kidney function in plasmacytoma]. PMID- 6856581 TI - [Air embolism in the lesser circulation--its demonstration in the cadaver]. PMID- 6856582 TI - Purification and characterization of guinea pig antithrombin III. AB - Antithrombin III (AT III) is a serine esterase inhibitor which regulates the activity of a number of coagulation factors. In this report, a three-step procedure for the purification of guinea pig AT III is described. This method, which involves affinity chromatography with heparin-Sepharose, ion exchange chromatography using DEAE-Sepharose, and Sephadex G-100 gel chromatography, results in purified, functionally active AT III with a 39% yield. The potential role of this molecule in the regulation of lymphocyte activation is discussed. PMID- 6856583 TI - Purification and characterization of the RNA polymerases of the sea urchin, Lytechinus variegatus. AB - We have identified four forms of sea urchin RNA polymerase (Ia, Ib, II and III). Three of the forms co-elute on DEAE cellulose chromatography but separate on DEAE Sephadex chromatography. The separation of these three enzyme forms by DEAE Sephadex chromatography can be eliminated with non-ionic detergent. We also demonstrate that either form I or form III RNA polymerase loses its resistance to alpha-amanitin after DEAE chromatography. A procedure for the purification of combined form I and III RNA polymerase and the purification of RNA polymerase II is also presented. PMID- 6856584 TI - Characterization of a lectin from cowpeas. AB - A lectin without blood group specificity was isolated from cowpeas (Vigna unguiculata (L.) Walp.). This lectin was prepared from a crude saline extract by acid precipitation and Sephadex gel filtration. Purification steps generally resulted in increased agglutination activity. Homogeneity was demonstrated by polyacrylamide gel electrophoresis, and ultracentrifugation. The native lectin had a molecular weight of approximately 55,000 as shown by gel filtration, polyacrylamide electrophoresis, and analytical ultracentrifugation. Amino acid analysis showed a very low sulfur amino acid content and relatively high content of aspartic and glutamic acids. Total neutral sugar analysis indicated less than 1% of saccharides. The lectin interacted with several saccharides. PMID- 6856585 TI - Histomorphometry of the human placenta in Class B diabetes mellitus. AB - Different morphometric parameters have been applied to the study of the morphological differences between a group of normal placentae and a group of placentae collected from Class B diabetic mothers. The placentae of the diabetics were divided in two groups based on the growth characteristics and neonatal outcome of the infants at birth. It has been shown that the placentae of the appropriate for gestational age infants were morphologically very similar to the control group except for a well-developed villous vascularization. In contrast, the placentae of the large for gestational age infants were shown to differ from the controls by having heavier placentae due mainly to a significant accumulation of non-parenchyma and a moderate increase in parenchymal tissue. Consequently, although there was significantly more villous tissue in these placentae, the surface areas of exchange between mother and fetus in terms of capillary and villous surface areas were only moderately enlarged due to a relatively lower number of villi containing non-parenchymal tissue. However, on a functional basis, despite these morphological differences, the results of this study suggest that placental function is not adversely affected in Class B diabetics, and the perinatal morbidity associated with this condition is probably the result of metabolic abnormalities present in the mother and the fetus. PMID- 6856586 TI - Placental blood flow and transfer of nutrient analogues during normal gestation in the guinea pig. AB - Simultaneous measurements of placental transfer of 14C-alpha-aminoisobutyric acid (AIB), 3H-methyl glucose (MG) and placental blood flow were performed in anaesthetized guinea pigs at various gestational ages. The results were correlated with the growth of the conceptus. The placenta increased its weight at a maximal rate (g/day) between days 31 and 40 of gestation while maximal fetal increments in weight occurred between days 51 and 60. Total net transfer of AIB and MG per gram of placenta increased progressively during pregnancy while net transfer per gram of fetus decreased approaching term. Placental blood flow in the maternal side increased linearly near term. The quantities of AIB and MG transferred by the placenta per ml of blood was maximal between 51 and 60 days of gestation. These data suggest that a relatively smaller placenta in relationship with fetal size limits the quantity of nutrients transferred to the fetus near term, and reduces the rate of fetal growth. PMID- 6856587 TI - Morphological study of the fetal vasculature of the human term placenta: scanning electron microscopy of corrosion casts. AB - Microvascular corrosion casts of the fetal vessels of the normal human placenta were studied using the scanning electron microscope. All available evidence suggests that when prepared under standard conditions the resultant casts accurately replicate the original luminal morphology of the vessels, and are comparable between placentae. In conjunction with stereo-pair photography this technique allows for the rapid and unequivocal interpretation of the three dimensional configuration of villous vasculature. Previously described structures such as dilated capillary loops and perivascular capillary networks can be viewed in new and dramatic perspective. It is hoped the technique may thus be of assistance to physiologists in the interpretation of experimental data concerning placental transport. Further work is in progress to apply the technique to the investigation of possible changes in fetal vasculature occurring in abnormal pregnancies. PMID- 6856588 TI - Placental monoamine oxidase content and inhibition: effect of enzyme inhibition on maternofetal transfer of noradrenaline (norepinephrine) in the human placenta in vitro. AB - The effect of monoamine oxidase (MAO) inhibition on maternofetal transfer of noradrenaline (NA) has been investigated in vitro using dual perfusion of isolated human placental lobules. As a first step, placental MAO content and its sensitivity to inhibition by pargyline were assessed in incubation studies of homogenates as well as during perfusion, taking rat liver as reference. Our results show that the human placenta, though it contains as great an enzyme activity as rat liver, was less sensitive to inhibition by pargyline than the latter. MAO inhibition by pargyline significantly reduced the NA clearance from maternal to fetal circulation. Thus the proportion of unmetabolized NA radioactivity in fetal venous samples decreased significantly after pargyline treatment. A concomitant rise in the proportion of mainly O-methylated metabolites was also observed. We speculate that the apparent activation of catechol-O-methyl transferase pathway, observed in our studies on MAO inhibition, may play an important role in limiting NA transfer towards the fetus in toxaemic pregnancies associated with the reduction in placental MAO. PMID- 6856589 TI - The human placenta in idiopathic intrauterine growth retardation: a light and electron microscopic study. AB - Six placentae from small for gestational age infants were examined by both light and electron microscopy. These were from pregnancies in which all maternal or fetal factors known to be associated with intrauterine growth retardation, including maternal cigarette smoking, were excluded. At the light microscopic level the only significant finding was an excess of villous cytotrophoblastic cells whilst electron microscopy showed these placentae to be characterized by villous cytotrophoblastic hyperplasia, focal syncytial necrosis, microvillous abnormalities, reduced syncytial secretory activity, irregular thickening of the trophoblastic basement membrane and the presence of small fetal villous vessels with multilayered basement membranes. It is thought that most of the observed abnormalities are due to uteroplacental ischaemia and it is possible that the fetal vascular abnormalities are a reflection of the fetal growth retardation. There is little evidence that the functional efficiency of the placenta is impaired in these cases and it is suggested that the principal factor in the pathogenesis of fetal growth retardation is a restriction of nutrient supply to the fetus because of an inadequate degree of physiological change within the maternal spiral vessels. PMID- 6856590 TI - Fibrinous vasculosis in the human placenta. AB - Approximately 6 per cent of placentae of babies admitted to a special care paediatric unit show evidence of peripheral villous stem branch oedema. In more than half of these cases there is evidence of fibrinous vasculosis (FV) in truncal veins. The affected placentae are generally thick and of small diameter, often of extrachorialis type, very congested and often cyanosed. The aetiology of the lesions is discussed with reference to abnormal fetal vascular patterns, poor perfusion, anoxia, oedema and spasm and the effect such factors may have on vessels with an irregularly distributed muscle coat and tendency to a spiral course. A small heterogeneous group with FV lesions unassociated with stem branch oedema was also identified. Chorionic vessels were more commonly involved in this group, and it would seem that, in addition to the other factors mentioned above, pressure variations may have some aetiological significance. Lesions of FV occurred mainly in mature placentae. The mothers showed a high incidence of pregnancy-induced hypertension and other complications. Fetal distress and asphyxia at birth were common. Where chorionic vessels were involved there was a high risk of intrauterine death (40 per cent) and coagulopathy among survivors (46.7 per cent). FV lesions affecting truncal vessels carried no greater risk than truncal arterial thrombotic lesions, which have been assessed in the past. In both these groups the hypoxia and intrauterine growth retardation which the babies showed are probably the most important factors, though one could postulate that their clotting mechanism was already triggered. PMID- 6856592 TI - [Levels of Krebs cycle metabolites in the blood and urine of patients with diabetes mellitus]. AB - The blood oxaloacetate, alpha-ketoglutarate, malate and citrate concentrations and citrate excretion with the urine were studied in 86 patients with diabetes mellitus. An enhanced citrate content and lowered oxaloacetate, malate and alpha ketoglutarate concentration were detected in the blood of patients with diabetes mellitus. Compensation of the disease and combined pathogenetic therapy are factors, promoting normalization of Krebs cycle metabolite content. PMID- 6856591 TI - [Immobilized luciferase of Luciola mingrelica fireflies. The kinetic properties and thermostability of luciferase immobilized on cellulose films]. AB - Luciferase of fireflies Luciola mingrelica was immobilized on cellulose films activated by cyanuric chloride or sodium periodate. Kinetic properties and the contribution of diffusional obstacles to the kinetics of the immobilized enzyme were examined. External and internal diffusion were found to influence the kinetic parameters. The stability of the enzyme was investigated at 25 degrees C and pH 7.8. Thermoactivation of the immobilized enzyme was shown to proceed in two stages: fast and slow. Dithiotreitol and cystein stabilized the enzyme at the fast stage while salt supplements at both stages. The fast thermoinactivation stage was apparently associated with the oxidation of luciferase SH-groups. It is demonstrated that the immobilized enzyme of Luciola mingrelica can be employed to measure ATP traces with the detection limit 0.1 mM. The enzyme immobilized on cellulose films can be used repeatedly. PMID- 6856593 TI - [Interrelations between blood coagulation and lipid metabolism in patients with diabetes mellitus]. AB - Glucocorticoid treatment was performed in 31 patients with diabetes mellitus (41 examinations). The therapy was effective in the patients with the labile form of the disease, in diabetic nephropathy not accompanied by stable azotemia and after administration of allergenic insulin drugs. Steroids should be combined with divided doses of short-acting insulin drugs within 24 hours. The adrenocortical drugs are absolutely contraindicated in pronounced ketosis. The treatment above can be aggravated by a chronic inflammatory process, especially by cholecystitis. PMID- 6856594 TI - [Plasma prolactin levels in men of various age groups]. AB - The blood plasma prolactin concentration was studied by radioimmunoassay in males of different age. The hormone level changed depending on age. A decrease in the reproductive function of the males over 40 years can be due to a fall of the blood plasma prolactin content. PMID- 6856595 TI - [Treatment of Cushing's syndrome with large doses of reserpine]. AB - The effectiveness of high doses of reserpine was studied in two groups of patients, suffering from Icenko-Cushing's disease. The patients of the first group received gamma-beam therapy combined with high doses of reserpine. The patients of the second group were treated with gamma-beam radiation associated with unilateral adrenalectomy plus high doses of reserpine. The controls were treated as described above, but without reserpine use. The results obtained have shown that reserpine monotherapy is not recommended in Icenko-Cushing's disease. High doses of reserpine combined with gamma-beam radiation alone or coupled with unilateral adrenalectomy shortened the period of the appearance of remission. The arterial blood pressure was significantly lower in patients treated with high doses of reserpine. PMID- 6856596 TI - [Effect of estradiol and testosterone, administered in the neonatal period, on the hypothalamo-hypophyseal-gonadal interrelations and fertility of the male rat]. AB - The influence of neonatal single subcutaneous injections of different testosterone propionate doses was studied comparatively to estradiol benzoate action on different parameters of genital function. Estradiol injections exert more pronounced injurious effect versus testosterone treatment, producing a decrease in luliberin, LH, testosterone synthesis and release, as well as a fall of the genital mass, resulting in 100% sterility of the animals. PMID- 6856597 TI - [Anti-androgenic activity of various substituted carboxyanilides]. AB - The synthesis of 10 substituted carboxy anilides was performed and their antiandrogenic activity was investigated. It was shown, that 4-nitro-3-trifluoro methyl-alpha-hydroxy-isobutyranilide, 4-nitro-3-trifluoro-methyl-isobutyranilide and 4-nitro-3-trifluoro-methyl-ethyl-methyl acetanilide exert the most pronounced antiandrogenic effects in experimental immature castrated male rats, given substituted doses of testosterone propionate. The antiandrogenic activity is mainly caused by the presence of trifluoro-methyl- and nitro-groups in meta- and para-positions of anilide benzene ring, as well as by hydroxyl group and hydrogen atom presence in alpha-carbon atom of the molecule alkyl moiety. A possible use of non-steroid antiandrogens for studying androgen mechanism of action and treating androgen-dependent diseases is discussed. PMID- 6856598 TI - [Effect of thyroxine on the integrity of chromosomes]. AB - Some features of the mechanism of thyroxin (T4) mutagenic effect in the culture of the human peripheral blood lymphocytes and the rat liver in vivo were studied. It was shown, that T4 mutagenic effect, discovered previously in the entire organism, can be stipulated by direct hormone-cell interaction. T4 mutagenic effect is associated with a change in DNA-dependent RNA polymerase activity and is realized during different phases of the cellular cycle. T4 modifying influence upon chromosome entirety is substantially limited by the age. PMID- 6856599 TI - [Complications of BCG vaccination in young children]. PMID- 6856600 TI - [Pulmonectomy and lung resection in caseous pneumonia]. PMID- 6856601 TI - [Results of the surgical treatment of hyperchronic destructive pulmonary tuberculosis]. PMID- 6856602 TI - [State of the cardiovascular system during surgical treatment of pulmonary tuberculosis]. PMID- 6856603 TI - [Diagnostic and therapeutic thoracoscopy in spontaneous pneumothorax and clotted hemothorax]. PMID- 6856604 TI - [Characteristics of contingents of children with positive tuberculin reactions and with tuberculosis]. PMID- 6856605 TI - [Disorders of the peripheral microcirculation in pulmonary tuberculosis]. PMID- 6856606 TI - [Thermography in the complex diagnosis of female genital tuberculosis]. PMID- 6856607 TI - [Basis for thoracic approach in kidney surgery for tuberculosis]. PMID- 6856608 TI - [Nonspecific spinal changes in young children with tuberculous spondylitis]. PMID- 6856609 TI - [Treatment of tuberculosis of the knee joint]. PMID- 6856610 TI - [Clinical picture and treatment of tuberculous meningitis in adults]. PMID- 6856611 TI - [Possibilities of using Nootropyl in the treatment of tuberculosis]. PMID- 6856612 TI - [Use of phytohemagglutinin as an immunoregulator in the treatment of experimental tuberculosis]. PMID- 6856613 TI - [Case of poorly differentiated cancer of the lung developing in a tuberculous cavern]. PMID- 6856614 TI - [Tuberculous exudative pleurisy in adolescents]. PMID- 6856616 TI - Vitamin K-dependent carboxylase: effect of endogenous microsomal protein precursors on the rate of exogenous substrate carboxylation. AB - Rat liver microsomes contain a Triton X-100 solubilizable vitamin K-dependent carboxylase activity that converts specific glutamyl residues of a microsomal prothrombin precursor to gamma-carboxyglutamyl residues. This activity has been studied in partially (0.25% Triton X-100) and completely (1.0% Triton X-100) solubilized rat liver microsomal preparations. The rate of vitamin K-dependent carboxylation of endogenous microsomal protein precursors was very rapid in the completely solubilized liver microsomal preparation, and carboxylation of an exogenous peptide substrate (Phe-Leu-Glu-Glu-Leu) proceeded at the same time. In the partially solubilized liver microsomal preparation, the rate of protein carboxylation was greatly reduced, and a lag in carboxylation of the exogenous substrate was observed. When microsomal preparations which were depleted of endogenous precursors were used, this lag was eliminated. These data suggest that both substrates utilize the same microsomal pool of carboxylase and that the fraction of the carboxylase bound to the endogenous precursors is not immediately available to exogenous substrates. PMID- 6856615 TI - Influence of dietary lipids on intestinal bile acid absorption. AB - The enterohepatic circulation and the inability of upper small intestine to actively absorb bile acid are physiological adaptations for maintaining adequate bile acid concentrations in the intestinal lumen for use in lipid digestion and absorption. Certain lipids inhibit bile acid absorption suggesting a possible role of lipids in this scheme. Using isolated intestinal villi preparations of hamster ileum, experiments were conducted to assess the degree of inhibition of bile acid absorption by lipids of various classes and to determine the possible mechanism of inhibition. At an initial bile acid concentration of 10.0 mM, triolein significantly reduced villus uptake of taurocholic acid by 50% and cholic acid by 38%. This inhibition was similar to the degree of inhibition produced by oleic acid (58 and 48%, respectively). Likewise, representative medium-chain and short-chain triglycerides inhibited taurocholic acid uptake by 35 and 39%, respectively. Results show that triglycerides as well as oleic acid inhibit ileal bile acid uptake. Neither oleic acid nor triolein altered bile acid uptake when micelles were absent from incubation solutions. Furthermore, lipids did not alter absorption of a nonmicelle-forming bile acid, taurodehydrocholic acid. These data imply that dietary lipids in general may inhibit intestinal bile acid absorption. Oleic acid significantly reduced the intermicellar bile acid concentration from 8.9 +/- 0.2 mM to 3.9 +/- 0.2 mM while tributyrin, tricaprylin, and triolein had no effect. Results from these studies suggest that the mechanism of inhibition appears to be an enhancement of micelle formation. We speculate that this mechanism may be an additional mechanism for maintaining adequate luminal bile acid concentrations and may be the pathophysiologic mechanism contributing to bile acid malabsorption in cystic fibrosis. PMID- 6856617 TI - Counteraction of underfeeding-induced inhibition of mammary tumor growth in rats by prolactin and estrogen administration. AB - The purpose of this study was to determine whether administration of estrogen or/and haloperidol (HAL), a drug that increases prolactin (PRL) secretion, could counteract the inhibitory effects of underfeeding on growth of established carcinogen-induced mammary cancers in rats. Sprague-Dawley female rats were fed half of the complete diet consumed daily by ad libitum fed controls, beginning 1 week before daily injection of estradiol benzoate (EB) or/and HAL for 3 weeks. Body weight, mammary tumor number, and mammary tumor diameter were measured at weekly intervals, and at the end of the 3 weeks blood was collected for assay of serum PRL. Full-fed (FF) control rats showed an increase by the end of 3 weeks in average body weight, mammary tumor number, and mammary tumor size whereas half fed (HF) rats showed a significant decrease in average body weight, tumor number, and tumor size, and serum PRL concentrations when compared with these parameters in FF rats. Administration of EB to the HF rats partially prevented loss of mammary tumor size and significantly increased serum PRL levels over those of HF or FF control rats. Injection of HAL or the combination of HAL and EB completely prevented the decrease in mammary tumor number and size in the HF rats. These results suggest that regression in number and size of established mammary tumors in HF rats during a 3-week period is due primarily to a decrease in secretion of estrogen and PRL, the two hormones essential for mammary tumor growth in rats. PMID- 6856618 TI - The effect of thyrotropin (TSH) levels on follicular cluster formation from grafted monodispersed rat thyroid cells. AB - The effect of experimental conditions which alter TSH levels on the number and size of the multifollicular thyroid clusters which develop from inoculated monodispersed thyroid cells was explored. Five week-old male Fischer rats were used as thyroid cell donors and recipients. The recipients were totally thyroidectomized (Tx) 1 week before thyroid cell transplantation (group A), hemithyroidectomized (hemi Tx) 1 week before transplantation (group B), or Tx 1 day before grafting (group C). Additional groups of recipients included intact animals maintained on low-iodine diet (LID) (group D), and on normal diet (ND) (group E). The FD50, the number of grafted cells required to produce at least one follicular cluster in 50% of the transplant sites, was the lowest in group A and the highest in group E. The TSH levels in the serum on the day of cell inoculation were highest in group A and lowest in group E. Large follicular clusters tended to be more frequent in groups A and C than in group B, but the data were variable; no large clusters were found in groups D or E. The TSH levels in groups A and C 28 days after cell implantation were higher than in group B. The FD50 is thus dependent on the concentration of circulating TSH for initiation of follicle formation; large follicular clusters result from continued elevation of TSH levels. PMID- 6856619 TI - The interrelationships between methionine, choline, and sulfate in turkey diets. AB - Two experiments were conducted with turkey poults to determine the interrelationship of choline, sulfate, and methionine. The addition of choline significantly increased growth and the addition of sulfate resulted in numerically improved growth. However, when the two were added in combination a further improvement in growth was obtained, indicating that both nutrients must be in the feed for maximum utilization of the other. These data also indicate that a complete understanding of the interrelationships between methionine choline and methionine-sulfate cannot be accomplished unless all three are studied simultaneously. PMID- 6856620 TI - Diminished respiratory responses of brown adipocytes isolated from BIO 14.6 dystrophic hamsters. AB - Catecholamine-induced thermogenesis is significantly diminished in BIO 14.6 cardiomyopathic hamsters as demonstrated by a reduced increase in oxygen consumption of these hamsters in response to administered isoproterenol. This decreased responsiveness is accompanied by a reduction in the amount of brown adipose tissue, a major nonshivering thermogenic effector. The present study demonstrates that the metabolic responses of individual brown fat cells are also altered in the dystrophic hamster. That is, 1 microM norepinephrine, the physiological mediator of nonshivering thermogenesis, evoked rates of oxygen consumption that were significantly lower in brown adipocytes isolated from the BIO 14.6 hamsters than in those from normal controls. Additionally, the dystrophic adipocytes exhibited: decreased maximal activity (per cell as well as per milligram protein) of citrate synthase; decreased cell size; and decreased amounts of protein per cell. These data indicate that the nonshivering thermogenic capacity of the intact BIO 14.6 hamsters reflects altered characteristics of the individual brown adipocytes themselves, as well as decreased amounts of the tissue. PMID- 6856621 TI - Secretion of calcitonin in the genetically obese Zucker rat (fa/fa). AB - Previously we found that adult Zucker fatty rats have C-cell hyperplasia and increased thyroidal calcitonin (CT) compared to lean controls. In this study we have evaluated both secretion of CT and responsiveness to CT in order to see whether they, too, were altered. Fat rats and lean littermates, 13-15 months old, were used. CT secretion was provoked by (1) feeding for 2 hr after an 18-hr fast, (2) giving pentagastrin iv, and (3) injecting CaCl2 iv. CT was measured by radioimmunoassay. Responsiveness to CT was examined by giving porcine or salmon CT iv and measuring serum Ca 1-3 hr later. For CT secretion, compared to leans the fat rats showed (1) higher fasting serum Ca and CT and a greater rise in CT after feeding, (2) a similar 5- to 10-fold increase in CT after iv pentagastrin, and (3) a greater rise in both serum Ca and CT at various times between 5 min and 3 hr after iv CaCl2. For CT responsiveness, fat and lean rats were equally responsive to iv CT in terms of the fall in plasma Ca 1-3 hr later. The results show that fat rats can secrete as much or more CT in response to provocative stimuli as lean rats and that they appear normally responsive to injected CT. Therefore, inability to release CT and insensitivity to CT do not underly the C cell hyperplasia, increased thyroidal CT, and increased circulating CT in the fat rat. PMID- 6856622 TI - Phenytoin teratogenicity in the primary and secondary mouse embryonic palate is influenced by the H-2 histocompatibility locus. AB - Inbred and congenic strains of mice have been studied for susceptibility to phenytoin-induced cleft lip with or without cleft palate (CLP) and isolated cleft palate (CP). The role of genes linked to the H-2 complex on chromosome 17 has been confirmed. Congenic strains with the A background have identical levels of spontaneous CLP, whereas those strains having the A background with the H-2a haplotype have significantly higher rates of induced CLP than their congenic partners with the H-2b or H-2s haplotype. No such significant difference in the degree of CLP produced by phenytoin is demonstrable in strains with the B background. Rates of isolated CP produced by phenytoin are significantly higher in strains with H-2a than in their congenic partner strains with either H-2b or H 2s, whether the background is A or B. PMID- 6856623 TI - Blood selenium and glutathione peroxidase levels and dietary selenium of free living and institutionalized elderly subjects. AB - The purpose of this study was to evaluate the selenium status of healthy free living and institutionalized elderly people. For the 36 free-living elderly dietary selenium intake averaged 94 +/- 44 micrograms Se/day and a positive correlation coefficient was found between dietary selenium and dietary calories (r = 0.46; P less than 0.05), dietary protein (r = 0.60; P less than 0.01), and dietary fat (r = 0.43; P less than 0.05). Diet histories from the institutionalized subjects revealed a strong correlation coefficient between selenium and carbohydrate (r = 0.51; P less than 0.005) and selenium and calories (r = 0.44; P less than 0.05). Mean erythrocyte and plasma selenium levels for the free-living subjects were 0.20 +/- 0.06 micrograms/ml and 0.10 +/- 0.03 micrograms/ml, respectively, while mean erythrocyte glutathione peroxidase (GSH Px) activity was 27.5 +/- 5.0 units/g protein. For the free-living subjects positive correlation was found between dietary selenium and erythrocyte selenium levels (r = 0.38; P less than 0.05) but no correlation existed between dietary selenium and plasma selenium (r = 0.13; P greater than 0.05) and RBC GSH-Px (r = 0.15; P greater than 0.05). The dietary selenium levels and blood selenium and GSH-Px levels were above the levels found in populations proposed to be at risk for selenium deficiency. Thus, these elderly appear to have adequate selenium status. PMID- 6856625 TI - Prevention of hereditary large bowel cancer. Proceedings of a conference held in Troy, Michigan, June 3-4, 1982. PMID- 6856624 TI - Prevention of hereditary large bowel cancer. Foreward. PMID- 6856626 TI - What are the pathologic features distinguishing large bowel cancer? PMID- 6856627 TI - How do we detect hereditary large bowel cancer? Clinical diagnosis. PMID- 6856628 TI - How do we detect hereditary large bowel cancer? Biochemical diagnosis. PMID- 6856629 TI - Prevention of hereditary large bowel cancer: tissue culture assays and logistics. AB - It is currently believed that normal genes, presumably in the class of tissue differentiation genes (proto-oncogenes), are responsible for the malignant transformation of human cells. As such, they cannot be appropriately used to identify individuals at risk for cancer. Based on our experience with a cell system from patients with adenomatosis of the colon and rectum (ACR), we suggest that predisposition to cancer can best be detected as a global syndrome at the phenotypic level. The ability to distinguish a cancer predisposed person from a normal individual in well-defined populations should qualify a test as "cancer specific". An underlying assumption in these studies is that predisposition to cancer, in general, is associated with an autosomal dominant trait in obligatory heterozygote gene carriers. PMID- 6856630 TI - Hereditary large bowel cancer: surveillance criteria for at risk patients. PMID- 6856632 TI - Counseling for patients and families with hereditary large bowel cancer. PMID- 6856631 TI - Treatment and follow-up of affected family members with familial polyposis. AB - In conclusion, it is the intention of our Familial Polyposis Registry to ensure that members of an affected family are aware of the reasons for ongoing surveillance and of the potential for developing extracolonic manifestations or malignancies. A second and equally important aim is to make available to the medical community-at-large reliable and progressive resource data, not only to stimulate discussion about the total management of familial polyposis, but to encourage cooperation in our common goal of cancer prevention. PMID- 6856633 TI - "What is the potential for a national pedigree and linkage data bank to facilitate prevention of hereditary large bowel cancer"? PMID- 6856634 TI - Protection of confidentiality and privacy in family studies. PMID- 6856635 TI - Determinants in malignant transformation: studies in hereditary bowel cancer. PMID- 6856636 TI - Prevention of hereditary large bowel cancer. Impact and implications. PMID- 6856637 TI - What is hereditary colon cancer? PMID- 6856638 TI - Familial polyposis coli and Gardner syndrome--is there a difference? PMID- 6856640 TI - Status of screening for large bowel cancers. PMID- 6856639 TI - The frequency of hereditary large bowel cancer. AB - In brief, an unknown but small fraction of colorectal cancer in the United States is due to single gene traits that are usually easy to identify by the clinician who is aware of the many disorders which predispose to colorectal cancer. An additional, perhaps a larger fraction could be attributed to familial cancer syndromes which may arise from environmental or genetic factors or both. In any case, once a familial or mendelian trait is recognized, the risk to offspring and sibs tends to be 50%, since most predisposing traits behave in an autosomal dominant fashion. Easy means of surveillance and surgical prophylaxis are at hand. The largest hurdle, in my opinion, is to prod the health care system into thinking of and acting on the family history and to overcome the misconception that genetic disease is untreatable and unpreventable. Indeed, given poor control of the best known environmental carcinogens (sunlight and tobacco use), heritable colorectal cancer may well be the most manageable determinant of colorectal cancer--much more so, perhaps, than environmental factors like diet. PMID- 6856642 TI - New concepts in thyroid disease. Proceedings of the international symposium held in Buenos Aires, Argentina, October 6-8, 1981. PMID- 6856641 TI - Identifying groups at high risk of colorectal cancer. PMID- 6856643 TI - Differential effects of d,l-amphetamine on licking maintained by electrical hypothalamic stimulation and/or water in rats. AB - The role of the reinforcer as a determinant of the behavioural effects of amphetamine was assessed with a procedure under which response requirements were equated. Eight rats were trained to lick on fixed-ratio schedules of rewarding lateral hypothalamic stimulation and water delivery, respectively. The effects of d,l-amphetamine (0.2-2.0 mg/kg) were investigated in the lateral hypothalamic stimulation condition and compared with the effects of the drug at 1.0 mg/kg in the water condition. Licking maintained by hypothalamic stimulation was increased after amphetamine administration to approximately 200% of control performance at 1.0 mg/kg. At this dose amphetamine administration resulted in a decrease in water maintained licking. A computer analysis of the temporal patterning of licking in both water and stimulation conditions was carried out. This analysis revealed that amphetamine may attenuate the disruptive effects of hypothalamic stimulation on the lick-interrupt cycle. The differential effects of amphetamine on licking maintained by the two events may reflect either unequal participation of catecholaminergic circuits in the two types of reward, or anti-inhibitory motor effects of amphetamine. PMID- 6856644 TI - Fasting and ketogenic diet effects on audiogenic seizures susceptibility of magnesium deficient rats. AB - Because fasting and ketogenic diets decrease seizure susceptibility in epileptics, their anticonvulsant effects were studied using sound-induced seizures in the magnesium-deficient rat. Fasting markedly depressed seizure incidence and severity but did not affect latency (sec to seizure onset). High fat diet increased incidence of audiogenic seizures and seizure severity, and decreased latency. Gavage of medium chain triglyceride, beta-hydroxybutyrate or glucose did not affect seizure incidence, seizure severity or latency. Nonspecific excitability level was not associated with treatment nor with seizure incidence, severity or latency time. PMID- 6856645 TI - Increasing the work requirements lowers the threshold of naloxone for reducing self-stimulation in the midbrain of rats. AB - Rats were trained to lever-press for intracranial self-stimulation (ICSS) with electrodes in the midbrain central gray area. The effects of naloxone (0.1-30.0 mg/kg, SC) on a continuous reinforcement (CRF) schedule were determined. Rats were then re-trained on higher fixed-ratio (FR) schedules, and naloxone was re tested at FR: 5, 10, 15 and 20. Only moderate reductions in lever-pressing rates were obtained at the highest dose of naloxone under CRF and FR: 5 schedules. In contrast, pronounced, dose-dependent reductions in ICSS rates occurred at FR: 10, 15 and 20. The time-course for this reduction at FR: 20 was consistent with an opiate-antagonistic action of naloxone. The modest decrease in locomotor activity produced by naloxone in a matched group of control rats was not sufficient to account for the effects on ICSS. The threshold of naloxone for reducing the rate of ICSS lever-pressing was lowered by increasing the effort and/or time requirement for each reinforcement. PMID- 6856646 TI - A comparison of the subjective and cardiovascular effects of cocaine and procaine in humans. AB - Four normal adult volunteers were given intravenous injections of 16, 32 and 48 mg cocaine, procaine, or saline, once daily in a balanced order. An additional dose of procaine, 96 mg, was also given. Heart rate, blood pressure, and responses on the Profile of Mood States (POMS), Addiction Research Center Inventory (ARCI), and a locally developed drug effects rating scale were measured before and periodically after drug or placebo injection. The profile of action of cocaine was significantly different from that produced by both saline and the lower doses of procaine. Although responses on the ARCI and POMS after all doses of procaine were similar to those obtained after placebo, three of the subjects identified 48 and 96 mg procaine as cocaine, and rated these two drugs similarly at the higher procaine doses. PMID- 6856647 TI - Sexual dimorphism in rats with respect to locomotor activity and circling behavior. AB - Male and female rats were tested for locomotor activity and spontaneous circling (rotation) at 4, 6, 8, 11, 13 and 15 weeks of age. Locomotor activity of females increased with age, and significant intersex differences which became apparent by 8 weeks of age were attributed to the greater persevering tendency of the females. Spontaneous rotation, on the other hand, did not change with age and significant intersex differences were not evident. Moreover, locomotor activity and rotation were not correlated at any age. In contrast to spontaneous rotation, amphetamine induced significantly more rotation in older (18 week) than in younger (5 week) females and males of both ages. Apomorphine, on the other hand, also elicited more rotation in older than in younger females, but not in males. In addition, intersex differences were not evident in younger animals tested with either drug. These data suggested that the greater persevering tendency and lateralization of females compared to males may be related to bilateral functional imbalances in nigrostriatal activity. PMID- 6856648 TI - Differential effects of amphetamine isomers on SN self-stimulation: evidence for DA neuron subtypes. AB - The present experiment investigated the effects of varying doses of D- and L amphetamine on intracranial self-stimulation (ICSS) in the medial or lateral substantia nigra (SN). It was found that the effects of D- and L-amphetamine on ICSS in the SN differ in these two sites. In the medial SN, there were no significant differences between the effects of D- and L-amphetamine on ICSS at any of the doses tested. Both isomers moderately facilitated ICSS with the peak effect at 0.8 to 2.0 mg/kg. By contrast, in the lateral SN, D-amphetamine produced a strong dose-dependent facilitation of ICSS which peaked at 2 mg/kg while L-amphetamine was ineffective below 7 mg/kg. Above 7 mg/kg L-amphetamine increased ICSS rates. The present experiments suggest that the medial and lateral SN are functionally different with respect to ICSS. The possibility that the present medial-lateral SN differences are mediated by two different types of dopamine cells is discussed. In addition, the effects of D- and L-amphetamine on ICSS in the lateral hypothalamus are discussed in light of the present findings. PMID- 6856649 TI - Effects of diazepam on responding suppressed by response-dependent and independent electric-shock delivery. AB - While the effects of benzodiazepines on punished responding (response-dependent shock) are straightforward and unambiguous, their effects on behavior suppressed by response-independent shock are conflicting and inconsistent. Some investigators reported that benzodiazepines either have no effect on, or suppress further, responding during response-independent shock, while others reported that benzodiazepines enhance response rates during independent shock delivery in the same manner as during dependent shock. The present study compared the effects of diazepam on rates of lever pressing maintained by a variable-interval 35-sec schedule of food delivery in rats exposed alternately to fixed-interval 180 sec (response-dependent) and fixed-time 180 sec (response-independent) schedules of shock delivery. Diazepam increased punished responding in a dose-dependent manner for each animal. "Rate-dependency," degree of suppression and presence of external stimuli influenced rate-enhancement by the drug. Effects of diazepam on responding suppressed by response-independent shock were inconsistent, with two animals revealing rate enhancement comparable to punished responding, and two others revealing further increases in response suppression. Reasons for the differential effects of diazepam on response-rates suppressed by the two forms of shock delivery remain obscure, although the basic phenomenon seems to be real and not merely an artifact of "rate-dependency." PMID- 6856651 TI - New multi-cannula pedestal device for micro-injection of drugs into brain tissue or cerebral ventricle. AB - A new multiple-cannula-pedestal system for micro-injection of drugs directly into either brain tissue or cerebral ventricle is described. Its features include ease of construction from commonly available materials, no specialized machining required, durability and economy. A special aspect of the cannula system is a protective cap containing a bolt which threads onto a nut fixed within the pedestal base. Since the cap cannot be dislodged, potential damage to indwelling stylets and exposed guide tubes is prevented. Moreover, an aseptic preparation is therefore provided so that test compounds can be infused repeatedly over a prolonged period. Finally, the protective caps are interchangeable and the pedestal base itself can be re-cycled for usage in different animals. PMID- 6856650 TI - Addictive agents and intracranial stimulation (ICS): novel antagonists and agonists of morphine and pressing for ICS. AB - Rats fixed with chronically indwelling bipolar electrodes pressed for intracranial stimulation (ICS) of the lateral hypothalamus during daily sessions. The effects of two antagonists of morphine (Win 44,441 and naloxone) were then assessed. Naloxone (10 mg/kg) produced its characteristic reduction in pressing. Win 44, 441 produced a reliable increase in pressing at doses as small as 1 mg/kg. Large doses of morphine (10 mg/kg) produced its characteristic effects: depression in pressing when given 1 hr before the test session and facilitation when given 3 hr before the test session. Win 44,441 antagonized morphine's depressive effects. Other compounds (Win 44,156, Win 42,156), having similar structure to Win 44,441 but having agonist and mixed agonist-antagonist activity with respect to analgesia, also facilitated pressing for ICS. All three compounds' effects on pressing for ICS were antagonized by naloxone. It is inferred that opioids' facilitatory effects on pressing for ICS are separable from opioids' other capabilities such as production of analgesia. PMID- 6856652 TI - Influence of chlordiazepoxide on alcohol consumption in mice. AB - In a free-choice situation, chlordiazepoxide (CDP; 12.5 or 25 mg/100 ml; groups B or C), when incorporated in ethanol solutions (2 to 20%, v/v), caused a significant decrease in ethanol preference index (P.I.). This was probably due to the combined CNS effects of both drugs rather than a taste effect, since the mice did not discriminate between aqueous CDP solutions and water. However, when the mice had prior exposure to ethanol and CDP was incorporated intermittently, no significant decreases in P.I. resulted. In a no-choice situation, ethanol intake was increased only on the first day of each intermittent incorporation of CDP (3 days for each 6-day cycle), being more persistent in group B (2 to 15% ethanol) than in group C (2 to 6.5%). Ethanol intake decreased in group C when alcohol concentrations exceeded 10%. The "first-day" CDP effect also occurred in the no choice situation of an ethanolic liquid diet. Possible factors for this effect are discussed. Thus the effects of CDP on alcohol consumption in non-deprived mice vary with experimental designs. PMID- 6856653 TI - Parachloroamphetamine toxicity in mice: influence of body weight, sex and dose. AB - Five doses of d,l-para-chloroamphetamine (0.0, 15,0, 30.0, 45.0 and 60.0 mg/kg) were used to challenge 10 groups of 16 male and 10 groups of 16 female CF-1 mice weighing either 16 to 25 g or 40 to 55 g. Twenty-four hours after intraperitoneal injection, rates of lethal toxicity were assessed. Effects for body weight and dose were found. In addition, a sex by dose interaction was demonstrated. It was hypothesized that the influence of weight might be related to thermoregulatory processes, since as weight rises, surface-to-volume ratios decline, and with them the efficiency of heat exchange. Caution is suggested in the interpretation of ontological studies of drug response. PMID- 6856654 TI - Suppression of saccharin-induced drinking in the nondeprived rat by low dose diazepam treatment. AB - Access to a highly palatable 0.005 M sodium saccharin solution resulted in considerable overdrinking in nondeprived rats over a 6 hr observation period. Contrary to previous reports documenting benzodiazepine-induced hyperdipsia in animals challenged with thirst stimuli or in animals exhibiting schedule-induced drinking, diazepam (0.1-3.0 mg/kg) had no effect to enhance the intake of the saccharin solution. Instead, diazepam produced a significant suppression of fluid consumption, in a manner not monotonically related to dose. Thus, diazepam (0.3 mg/kg) produced maximal suppression which did not dissipate over a 6 hr period, while diazepam (3.0 mg/kg) had no effect. Possible behavioral mechanisms by which low dose diazepam treatment might reduce the drinking are briefly considered. PMID- 6856655 TI - Effects of bromocriptine and dopamine on the binding of estradiol to its uterine cytoplasmic receptors. AB - The in vivo and in vitro effects of bromocriptine on the binding of estradiol 17 beta to its specific uterine receptors were studied in both mature and immature rats. A single i.p. injection of bromocriptine reduced the specific estradiol receptor interaction in adult rats, while it resulted ineffective in prepubertal animals. The effect of bromocriptine in mature rats was dose-dependent and evident only when using a dose of at least 0.70 mg/kg. Experiments in vitro also showed that in mature rats bromocriptine affected the estradiol-receptor interaction inducing a decrease in binding, which is well correlated to the concentration used. On the contrary, no effect of bromocriptine in vitro was observed when using cytosol obtained from uteri of immature rats. Very similar results were obtained in experiments in vitro when using dopamine instead of bromocriptine. Our results suggest that apparently there are two forms of estrogen receptors, one present both in prepubertal and pubertal age and the other present only in mature animals. The latter is the type of receptor sensitive to both bromocriptine and dopamine and presumably develops under the control of hormonal factors, which are only present at puberty. PMID- 6856656 TI - Chlorimipramine-induced phospholipidosis: biochemical and pharmacokinetic observations in the rat. AB - Subchronic treatment of rats with the antidepressant drug chlorimipramine produced an accumulation of phospholipids (PL) which was particularly evident in lung and to a lesser extent in liver and spleen. The overall increase in PL was mostly sustained by phosphatidylcholine. Both chlorimipramine and its demethylated metabolite were preferentially accumulated by lung reaching levels of about two orders of magnitude higher than those found in plasma. A significant correlation between the percentage increase in phospholipid contents and drug metabolite tissue level was evidentiated. PMID- 6856657 TI - Gastrin releasing peptide: endocrine functions in the rat. AB - The effect of porcine gastrin releasing peptide (GRP), a heptacosapeptide with potent gastrin releasing activity which has recently been isolated from porcine non-antral gastric tissue, on pituitary function was investigated in the rat. Graded doses of synthetic porcine GRP were injected intravenously and the animals were killed at various intervals after injection. Prolactin, growth hormone, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and thyroid stimulating hormone (TSH) were measured in serum by specific radioimmunoassays. GRP had no significant effect on prolactin, growth hormone or FSH serum concentrations at any dose or sampling time studied. In contrast, the heptacosapeptide significantly stimulated LH release and suppressed TSH secretion with injection of low doses. There are striking structural and some functional similarities between GRP and bombesin, an amphibian skin tetradecapeptide which shows amino acid homology with the C-terminal region of GRP. This suggests that the endocrine effects of GRP may be mediated by its bombesin-like residue. PMID- 6856658 TI - Anti-inflammatory, analgesic and antiproteolytic activities of some novel thiadiazoles. AB - Eighteen novel acetyl salicyloyl/butyroyl mercapto 1,3,4-thiadiazoles have been synthesized and characterized by their elemental analyses, IR and PMR spectral studies. Their efficacy against carrageenin induced paw oedema was tested in albino rats of either sex at a dose of 100 mg/kg p.o. In vitro antiproteolytic activity of the compounds was assessed by determining their ability to inhibit trypsin induced hydrolysis of bovine serum albumin. Active anti-inflammatory compounds were tested for their analgesic activity against aconitine induced writhing in albino mice. Approximate LD50 values were also determined in albino mice. PMID- 6856659 TI - Influence of cholinergic modifiers on phencyclidine-induced acute toxicity. AB - The effects of pretreatment with mecamylamine (ME), hexamethonium (C-6), d tubocurarine (DTC), atropine (AT), muscarinic agents 5-methylfurmethide (5-MFT) and O-ethylcholine (EtCh), physostigmine (PH) and cholineacetyltransferase inhibitors 2-benzoyl ethyltrimethylammonium (BETA) and N-naphthylvinylpyridine (NVP) were studied on the lethal action of phencyclidine (PCP) in male Swiss mice. The LD50 of PCP (237 mumol/kg, i.p.) significantly increased by 19% and 10% in ME (14.9 mumol/kg) and PH (0.08 mumol/kg) pretreated groups, respectively. The combined ME and PH pretreatment potentiated the survival of the mice. C-6 (7.3 mumol/kg), DTC (0.11 mumol/kg), AT (14.4 mumol/kg), 5-MFT (1.4 mumol/kg), EtCh (1.7 mumol/kg), BETA (88 mumol/kg) or NVP (74.7 mumol/kg) pretreatment had no significant effect on the LD50 of PCP. However, peripheral parasympathetic effects (defecation, urination, salivation, and lacrimation) of 5-MFT and EtCH in mice were abolished by PCP. Furthermore, low doses of PCP potentiated the peripheral signs in animals pretreated with 5-MFT or EtCh which, however, were abolished by higher doses of PCP. In vivo, administration of PCP was found to have no effect on brain cholinesterase (ChE) activity. These observations have indicated the possibility of central cholinergic mediation during acute toxicity of PCP. PMID- 6856660 TI - Centrally administered VIP increases spindle activity in unanaesthetized rabbits. AB - The action of VIP on structures responsible for cerebral electrical activity has been investigated in unanesthetized rabbits. VIP was given by slow infusion or bolus into the mesencephalic ventricle or the carotid artery, and topically applied on the motor or visual cortex. Both intracerebroventricular and intracarotid administration induced an increase of spindle activity of the cortex and an inhibition of the strychnine-transmitted spikes. These findings suggest a possible inhibitory role for VIP on certain CNS activity. PMID- 6856661 TI - [Inhibition of the renal excretion of PAH by probenecid homologs]. AB - The authors studied the effects of probenecid and five of its homologues on the renal excretion of p-amino-hippuric acid (PAH). All the compounds under study inhibited the excretion of PAH. Probenecid and its homologues were injected 15 min before the administration of PAH. With all the substances tested, the inhibition of the excretion of PAH was most marked during the first 30 min of the diuresis experiment. The extent of efficiency increases within the homologous series up to the diethyl compound; after that, the inhibitory effect decreases with the increase in chain length. In the dosage range under study, the probenecid homologues show linear dose-response relationships. With due regard to toxicity and efficiency, the authors conclude from the results obtained that the diethyl compound is the most potent substance; probenecid itself is less efficient, being twice as toxic. PMID- 6856662 TI - [Antineoplastic and curative antileukemic activity of 1,4-benzoquinone guanylhydrazone thiosemicarbazone and its hydrochloride on in vivo murine models]. AB - By means of four murine models, the authors demonstrated in vivo that 1,4 benzoquinone guanylhydrazone thiosemicarbazone (1), which is known to be antimicrobially active, and its hydrochloride (2) exert an antineoplastic effect. In leukaemia P 388 and leukaemia L 1210 both compounds had a curative action already after four oral administrations. The "cured" animals were resistant or cross-resistant to further transmissions of leukaemia. The resistance was transmissible by splenocytes. PMID- 6856663 TI - [Antineoplastic effect of 1,4-benzoquinone guanylhydrazone thiosemicarbazone in experimental tumor models]. PMID- 6856664 TI - Correlation between membrane potential, creatine phosphate, and lactate in rat myocardium. PMID- 6856665 TI - Preparation and antimicrobial properties of certain psoralens. PMID- 6856666 TI - [Analysis and the stability of codeine phosphate. 2: Stability of aqueous codeine phosphate solutions]. AB - The degradation velocity of aqueous codeine phosphate solutions is of first order. The formation of the degradation products (isomerization products) depends upon temperature, light and pH value. At pH = 3.5, codeine phosphate solutions are relatively stable. Atmospheric oxygen exerts no effect. Of the complexing agents and antioxidants tested, only citric acid and thiourea seem to be capable of reducing the rate of degradation. Besides glass ampoules, plastic containers of low-density polyethylene proved to be suited for codeine phosphate solutions. PMID- 6856667 TI - Effect of certain additives on stability of streptomycin sulphate. AB - The effect of certain additives on the stability of streptomycin sulphate at 37 and 60 degrees C, for one month was studied. In pure distilled water, streptomycin sulphate was stable for 21 d at 37 degrees C, while at 60 degrees C a significant loss occurred after only three d. The effect of McIlvain buffer at different pH values showed maximum stability at pH values of 6.5 and 7. The stability was altered when Sorensen buffer at pH = 6.5 was used. On the other hand, the effect of other commonly used additives demonstrated that at 37 degrees C Aerosil 200, kaolin and pectin did not cause any significant loss, while bentonite caused significant decrease in the activity after 15 d. In contrast, activated charcoal and veegum reduced the activity to 54.5% and 57.5%, after just 1 d and to zero after 4 d, respectively. At 60 degrees C, the rate of decomposition of streptomycin sulphate was highly accelerated. PMID- 6856668 TI - Binding of indomethacin ester with tropic acid to human serum albumin. AB - The binding affinities of the ester of indomethacin with tropic acid and of indomethacin to human serum albumin were studied using the method of equilibrium dialysis. The binding constants were calculated from the experimental data by the Scatchard model. Binding to human serum albumin (14 X 10(-5) mol/l) was significantly lower for esterified indomethacin than for nonesterified. The tropic ester of indomethacin has an association constant for the primary binding sites of 2.16 X 10(5) l/mol, and while the association constant for indomethacin is 8.15 X 10(5) l/mol. The differences found between the binding affinities of the ester of indomethacin and of indomethacin may contribute to the different pharmacokinetics of these drugs. PMID- 6856669 TI - Effect of chlorphentermine on the pulmonary clearance of 5-hydroxytryptamine in rabbits in vivo. AB - Previous studies from this laboratory demonstrated that the pulmonary clearance of 5-hydroxytryptamine (5-HT) is perturbed by pulmonary accumulation of chlorphentermine (CP) by isolated perfused lung preparations. This observation raises the possibility that depressed 5-HT clearance may be one factor contributing to CP-induced pulmonary hypertension. The primary objective of the present studies was to determine if the effect of CP could be demonstrated in vivo during single-pass circulation through the lungs. Pulmonary extraction and metabolism of [14C]-5-HT during single pulmonary passage were examined using the reference indicator radioisotope dilution technique in male New Zealand albino rabbits. In control or saline vehicle injected animals, it was established that 81% of administered [14C]-5-HT was extracted by the lung and 25% of total radioactivity in the blood stream was recovered as 5-hydroxyindoleacetic acid (5 HIAA) during single passage through the lungs. Appropriate control incubations of 5-HT with blood and simulated pulmonary circulation through the extracorporeal circulation system yielded only 2 and 5% metabolism, respectively. These results indicate that significant pulmonary metabolism of 5-HT followed by efflux of 5 HIAA into venous output occurs during single-pass circulation. Preadministration of CP (0.5, 1 and 3 mg/kg single dose, i.v.) caused a dose-related inhibition of pulmonary extraction of 5-HT. This effect was also accompanied by a dose-related suppression of the appearance of the metabolite of 5-HT. These results provide in vivo evidence for impairment of pulmonary extraction and deactivation of 5-HT as a result of prior pulmonary accumulation of CP. PMID- 6856671 TI - Proton spin-lattice relaxation studies of tissue response to radiotherapy in mice. AB - Proton spin-lattice relaxation times were measured with pulsed NMR spectroscopy at 60 MHz for a range of tissues from healthy and tumour-bearing mice. T1 appeared to be significantly longer in the tumour than in any other tissue. Clearly distinct values of T1 were found for the vital and necrotic parts of the tumour. Non-involved tissues of tumour-bearing mice, viz. spleen, muscle, and salivary gland tissue, showed an increase in T1 relative to normal values. Irradiation of healthy mice with 6 MeV x-rays to a total-body dose of 15 Gy induced a shortening of T1 in the spleen. Similar experiments on tumour-bearing mice showed a decrease of T1 in the tumour, the spleen, the kidneys, and the liver. Attempts were made to interpret the results in terms of tissue hydration. PMID- 6856670 TI - Clofibrate decreases jejunal cholesterol synthesis and activity of postheparin plasma lipoprotein lipase in the rat. AB - Clofibrate treatment decreased drastically the activity of serum postheparin lipoprotein lipase of rats fed with fat-free test diet but had no effect on hepatic lipase. 3 weeks' treatment was followed by a significant fall in serum cholesterol caused by a marked decrease in HDL-cholesterol. Clofibrate decreased in vitro synthesis of cholesterol and fatty acids in jejunal villous cells but not in the crypt cells. PMID- 6856672 TI - The UVB content of 'UVA fluorescent lamps' and its erythemal effectiveness in human skin. AB - The UVB emission from ten different types of 'UVA fluorescent lamp' has been measured by spectroradiometry. The mean ratio of UVB emission to UVA emission was found to be 0.94 +/- 0.35 (1 SD)%. By weighting the spectral irradiance of each lamp by the DIN standard erythemal curve, the mean erythemally effective UVB emission (normalised to 297 nm), expressed as a percentage of the UVA emission, was 0.076 +/- 0.049 (1 SD)%. PMID- 6856673 TI - Dose rate to the inner ear during Mossbauer experiments. AB - The most widely used technique for studying vibrations of the inner ear utilises the Mossbauer effect; this requires placement of a radioactive source on the basilar membrane. This source, although small in size and less than 37 MBq (1 mCi) in strength, is placed in close proximity to sensitive receptor cells. Using a series solution for the radiation field of a rectangular source the absorbed dose rate delivered to receptor cells at various depths and at points off-axis from the centre of the source is calculated. It is concluded that the dose delivered during the course of a Mossbauer experiment may well be sufficient to damage receptor cells and cause a loss of response. PMID- 6856674 TI - The retention and release of 37Ar from samples of human bone examined in vitro and a review of the implications for argon transfer from bone in vivo. AB - The release rates and long term retention of 37Ar produced by the reaction 40Ca(n, alpha) 37Ar, following fast neutron irradiation, have been measured in vitro, in three samples of dried human femur. For each sample, the release rates were fitted to three exponential curves, of half-times approximately 2, 20 and 300 min. Some 60-80% of the 37Ar released was contained in the first component. The release rates for samples of trabecular and cortical bone were qualitatively similar, but after some 20 h the retained fraction of 37Ar was 28 +/- 0.6% in a sample of predominantly trabecular bone, and 33 +/- 0.7% in samples of predominantly cortical bone. The processes affecting the trapping and release of 37Ar from bone crystals are discussed. It is suggested that 37Ar escapes from bone mineral by back-diffusion along recoil damage tracks. The factors affecting the release of 37Ar from bone into the venous blood supply are discussed in the context of in vivo measurements of body calcium by the 37Ar method. The physiological processes and compartments likely to give rise to the long 37Ar exhalation half-times following irradiation in vivo: transfer from the mineralised bone matrix to blood capillaries, and uptake and washout from bone marrow, are considered. Uptake in bone marrow may be responsible for both of the observed half-times. PMID- 6856675 TI - A comparison between two methods of estimating rate constants from liver uptake curves. PMID- 6856676 TI - Ideal versus actual dosimetry for iridium-192 template procedures. PMID- 6856677 TI - Calibration of coincidence counting assay of thyroidal iodine-125 by Monte Carlo simulation. PMID- 6856678 TI - Muscular strength development by electrical stimulation in healthy individuals. AB - The effects of electrical stimulation and its comparison with various resistance training modes were investigated in 34 subjects who trained their dominant leg isometrically three times a week for five weeks. Group E (n = 8) used maximum voluntary isometric contractions only, Group S (n = 8) received only electrical stimulation, and Group ES (n = 9) trained using a concurrent combination of isometric exercise and electrical stimulation. In addition, Group C (n = 9), a control group, did no experimental training. The expected gain in torque was shown in the isometric strength scores of the three experimental groups; however, there was little change in the isometric strength of the control group and in the isokinetic (100, 200, and 300 degrees/sec) results of any of the four groups. After adjustments were made for pretest strength results, a one-way analysis of covariance indicated that the posttest isometric strength scores of the three experimental groups differed significantly from those of the control group. No other posttest differences were found among any of the other training modes. PMID- 6856679 TI - Comparison of two methods of goniometry. AB - This investigation was conducted to determine if there are significant differences between the lateral and the over-the-joint methods of goniometry for measurements of the elbow joint. Forty physical therapy students with previous goniometric training were divided randomly into four goniometric measurement groups: 1) lateral method for an obtuse angle, 2) lateral method for an acute angle, 3) over-the-joint method for an obtuse angle, and 4) over-the-joint method for an acute angle. All students in each group participated in four sessions during which a proctor's elbow joint was measured according to the method of the assigned goniometric measurement group. The joint was held in a fixed position by a plywood stabilizing device. The results of a three-factor analysis of variance with repeated measures on one factor showed that there was no difference between the lateral and the over-the-joint methods of goniometric measurement of the elbow joint. PMID- 6856680 TI - Effect of vibration on tactile sensitivity. AB - Tactile hypersensitivity is a common sequela of traumatic hand injury. Vibration is used clinically to reduce this hypersensitivity. The purpose of this study was to determine if vibration has an effect on tactile threshold and if so to determine the duration of that effect. Mean tactile thresholds were determined for 24 healthy adults by means of a pressure aesthesiometer. The experimental group (6 men, 6 women) received 10 minutes of vibration. Mean tactile thresholds were redetermined at the end of the 10-minute treatment period in the experimental group and after a 10-minute rest period in the control group (6 men, 6 women). Thresholds were also redetermined at 5-minute intervals for the next 20 minutes in all subjects. The experimental group showed a significant change in mean tactile threshold after 10 minutes of vibration (p less than .001). This difference remained at 5 (p less than .001) and 10 (p less than .05) minutes postvibration but not at 15 and 20 minutes. No significant change in mean tactile threshold was found in the control group. The results indicate that vibration does increase tactile threshold in "normal" hands and the effect lasts for at least 10 minutes. The application of this information to the clinical setting is discussed. PMID- 6856681 TI - Isometric, isotonic, and isokinetic torque variations in four muscle groups through a range of joint motion. AB - The purpose of this investigation was to describe and examine variations in maximal torque produced by knee extension, knee flexion, elbow extension, and elbow flexion through a range of joint motion. Subjects were young, healthy men (n = 16) and women (n = 15). Torque was measured isometrically and isokinetically using a modified Cybex apparatus. Isotonic torque was calculated from a one repetition maximum using a modified N-K device. Joint angles were monitored with an electrogoniometer. Torque-joint angle curves were constructed for both men and women for each muscle group. Isometric torque was highest, followed by isotonic and isokinetic torque. Torque declined with increasing isokinetic velocity. The angle of peak torque was found to be highly variable in individual subjects. Variations in torque curves were explained in terms of mechanical characteristics of the musculoskeletal system. Muscle group capability was generally found to be well matched to the mechanical requirements of the movement. PMID- 6856682 TI - Pediatric practice in physical therapy. A survey. AB - This study was undertaken to define the role and functions of the physical therapist in pediatrics, specifically at the advanced clinical competence level. Questionnaires mailed to all members of the Section on Pediatrics of the American Physical Therapy Association were used to collect the data reported here. Of 109 consultative, evaluation, treatment planning, and implementation tasks, 37 were not considered important to the practice of physical therapy in pediatrics. Of the 72 tasks identified as important, 46 were at entry level and 10 at the advanced level. Sixteen tasks were not clearly defined. This initial survey provides useful data to begin to interpret the physical therapist's role in pediatrics. Validation studies are needed to verify that the identified advanced level responsibilities represent skills necessary for practice in pediatrics at the advanced competence level. PMID- 6856683 TI - Amputation as a consequence of diabetes mellitus. An epidemiological review. AB - Amputation as a consequence of diabetes mellitus is becoming an increasingly serious public health problem and a problem that is commonly treated in the physical therapy clinic. Traditionally, physical therapists have devoted most of their efforts to treating the residual limb and have neglected caring for the other leg. This review examines the epidemiology of diabetic gangrene with consequent amputation and provides ideas for preventive measures and research directed at decreasing the occurrence of gangrene and its complications. PMID- 6856684 TI - Results of resistance exercise on a patient with amyotrophic lateral sclerosis. A case report. AB - The application of resistance exercise to the upper extremities of an individual with ALS resulted in improved static strength in 14 muscle groups and diminished strength in 4 after 75 days. Precise documentation of changes in static strength were possible because a precise measuring device was used. Whether multiple muscle groups of other patients with ALS can be strengthened merits similar documentation as does the ability of such exercises to improve functional performance. PMID- 6856685 TI - The pneumatic lift as an aid to positioning the strength-compromised patient. Suggestion from the field. PMID- 6856686 TI - Texas Consortium for Physical Therapy Clinical Education. A model for Interinstitutional Consortium arrangements. AB - This article describes the Texas Consortium for Physical Therapy Clinical Education, which exemplifies one type of collaborative arrangement among universities. Coordination of physical therapy clinical education among five Texas universities is the major function of the Texas Consortium. Although originally developed from a federally funded project (1977-1980), it currently functions with sole financial support from the participating universities. The collaborative efforts of the Texas Consortium have resulted in 1) developing and implementing a common evaluation tool for students' clinical performance; 2) coordinating development of new clinical education centers, development of clinical instructors, and visits to students at clinical education centers; and 3) developing and using a shared computer program for data on clinical education centers. The successful functioning of the Texas Consortium with a resultant decrease in duplication of time, effort, and costs of clinical education demonstrates that this type of arrangement is feasible and beneficial. PMID- 6856687 TI - Characterization of photocycloaddition products from reaction between thymidine and the monofunctional 3-carbethoxypsoralen. PMID- 6856688 TI - Similarities in the induction of synthesis of a cell-surface polypeptide in Arthrobacter sp. by near-UV irradiation and photodynamic conditions. PMID- 6856689 TI - Temperature dependence of induction of cyclobutane-type pyrimidine photodimers in human fibroblasts by 313 nm light. PMID- 6856690 TI - A modulated lamp system for solar UV-B (280--320 nm). Supplementation studies in the field. PMID- 6856691 TI - Comparison of plasmids in strains of Zymomonas mobilis. AB - Four strains of Zymomonas mobilis were examined for their resistance to antimicrobial agents and found to have similar resistance profiles. Plasmid DNA was extracted and purified by CsCl dye-buoyant density centrifugation; molecular weights were determined by agarose gel electrophoresis and electron microscopy. All four strains harbored a large plasmid (46 X 10(6) Da) and a smaller plasmid (16-21 X 10(6) Da) whose molecular weight was strain dependent. Two strains, Ag11 and ATCC 10988, had smaller plasmids of unique molecular weight. Homology existed between the plasmids in the four strains as shown by cross-reaction in DNA-DNA blot hybridizations. Only one plasmid appeared unique to the host from which it was isolated. PMID- 6856692 TI - The role of lipopolysaccharide structure in the recipient cell during plasmid mediated bacterial conjugation. AB - The role of the lipopolysaccharide (LPS) structure in the recipient cell during bacterial conjugation was studied using a series of well-defined LPS mutations in Salmonella minnesota. The plasmids Flac (IncFI) and R1drd19 (IncFII) transferred at a high frequency to the smooth S218 parent strain and the rough LPS mutants. However, R64drd1 1 (IncI alpha) transferred poorly to the LPS mutants compared with transfer to the smooth LPS parent strain. The decrease in R64drd1 1 transfer frequency correlated with the extent of the defect in LPS structure, suggesting that intact LPS on the recipient is a major requirement for R64drd1 1 mating. Transfer of the P-group plasmid, RK2, was not affected by changes in LPS structure. These results show that plasmids use different cell surface structures during conjugation, and that LPS is particularly important for R64drd1 1 transfer. PMID- 6856693 TI - On the active principles of the Euphorbiaceae. VI: Isolation and biological activities of seven milliamines from Euphoria milii. PMID- 6856694 TI - Postmastectomy breast reconstruction: how to choose the best method for the specific case. PMID- 6856695 TI - Analysis of the surface morphology of recovered silicone mammary prostheses. AB - The surfaces of 11 silicone mammary prostheses were examined by scanning electron microscopy (SEM) and energy dispersive x-ray spectrography (XES). Three of the prostheses were recovered from clinical cases and eight from guinea pig models. The surfaces of the prostheses were covered with an investing film and by 2- to 5 microns spheres aggregated in 40- to 200-microns-wide patches. The embeddedded spheres were blebbed and surrounded by pits. X-ray energy spectrography showed high levels of sodium, chlorine, and potassium. It is concluded from this evidence that phagocytic cells embed themselves within the envelope, perhaps by an immune-mediated phagocytic process. PMID- 6856696 TI - Reconstruction of chest-wall radiation ulcer with free latissimus dorsi muscle flap and meshed skin graft. PMID- 6856697 TI - Pulmonary complications following abdominal lipectomy. AB - Previous reports underestimate the morbidity of a lipectomy, having focused on mortality statistics. Alterations of respiratory kinetics leading to complications do not always correlate with the usual signs and symptoms of respiratory failure. Patients at increased risk, namely, those with obesity, a smoking history, or lung disease, deserve special attention, including appropriate pulmonary function studies in the preoperative and postoperative phase. The following studies are indicated in the preoperative assessment of the high-risk patient: (1) vital capacity, (2) arterial blood gases, and (3) chest radiograph. PMID- 6856699 TI - The planimetric Z-plasty. AB - This paper presents the planimetric Z-plasty and compares it with the traditional stereometric Z-plasty. The main advantages of the planimetric Z-plasty are plane adjustment to the body surface, elimination of scarred skin areas, and variable scar lines. PMID- 6856698 TI - Surface quantification of injected fluorescein as a predictor of flap viability. AB - In a laboratory model, quantitative skin-surface fluorescence has been used to reliably measure skin perfusion in ischemic random flaps and to predict viability. The method is reproducible and allows investigators to sequentially monitor soft-tissue perfusion using a fluorescent indicator. It is superior to the conventional fluorescein test (Wood's lamp method), which allows only a single subjective assessment within a 24-hour period. PMID- 6856700 TI - Reporting or hiding a complication. PMID- 6856701 TI - One-stage reconstruction of full-thickness cheek defects. PMID- 6856702 TI - Ultrasound scanning as an aid in the diagnosis and treatment of periprosthetic hematoma after breast surgery. PMID- 6856703 TI - A new instrument useful in abdominoplasty. PMID- 6856704 TI - Treatment of the infected median sternotomy wound. PMID- 6856705 TI - [Results with the therapeutic community for neurotic patients]. AB - Of 1,343 neurotic patients who completed six-week courses of treatment in a therapeutic community, 60% were considered by the therapists to have improved greatly in terms of symptoms, 36% in terms of insight and 35% in terms of attitude and behaviour. Follow-up examination using questionnaires one year after treatment showed considerable improvement in symptoms in 45%, in insight in 62% and in attitude and behaviour in 49% of the cases; 16% of the cases failed to return the questionnaire. If slight improvements are included, the proportion of patients showing improvement varies between 82 and 92% upon completion of treatment and between 70 and 80% one year later. PMID- 6856706 TI - [Hysterical neurosis and its diagnosis (suggestion for a new hysteria scale]. AB - The contribution deals with the differential diagnostic problem presented by hysterical neurosis. After a review of the literature, the author describes a two stage diagnostic approach. A selected group of patients with the psychiatric diagnosis "hysterical neurosis" was used to check all questions of the MMPI and the FPI for their specificity in respect of hysteria. Due to numerous overlappings, especially between hypochondria and hysteria, in these inventories it is proposed that a new hysteria scale comprising 54 questions be used to delineate more clearly between these two neuroses. PMID- 6856707 TI - [Problems of education and personal experience with psychotherapeutic imagination]. PMID- 6856708 TI - [Are participants in basic psychotherapy courses neurotic? Problems and conclusions]. PMID- 6856709 TI - [Formation of a concentration training program for concentration disordered children]. PMID- 6856710 TI - [Possibilities for inclusion of group music therapeutic methods in the treatment of psychotic patients]. AB - Four types of music therapy (listening, singing, dancing and playing instruments) which can be combined to obtain a "graduated group-centred music therapy" are investigated in regard of their methodological and didactical organisation and their effects on a group of schizophrenics. Each of the therapy types acts in a different way on the variables "anxiety" and "activity". It seems possible to influence these variables during group-centered treatment and to lead the group towards modes of communication and behaviour that are more appropriate to reality. PMID- 6856711 TI - [Inpatient behavior therapy of depression--a multimodal approach in clinical practice]. AB - Using a reinforcement-oriented model of depression, we applied a multimodal approach of behavior therapy in clinical setting. We modified the self-control group-therapy of psychoreactive depression, developed by Fuchs und Rehm (1977) in order to reach applicability for inpatients of psychiatric hospital. Operant techniques, social skills training, self-control-techniques, and the cognitive techniques developed by Beck (1979) were used. In contrast to Becks cognitive therapy we emphasized both the motivational aspect of depression and the aspect of self-regulation and self-modification too. There was not only the therapist trying to change behavior, thinking, and feeling of the patient by cognitive techniques. The patient himself tried to develop cognitive and behavior coping strategies. The treatment of patients with severe depression in an early stage was controlled by the therapist, later on they learned to control themselves. A central point of the concept of self-modification is teaching well founded knowledge of behavior analyses to the patient. Self-modification is not very efficient without, and the patient's motivation to work on his own therapy is elevated significantly. In some cases we continue this form of therapy after the patient's leaving the hospital up to three months. PMID- 6856712 TI - [A unit for emergency psychiatry and crisis intervention--concepts, structure and initial experiences]. AB - The article reports on a ward with 12 beds which has been set up for emergency cases in psychiatry or for immediate intervention in case of a crisis experienced by a patient. In the theoretical part of this article, it is explained that crisis situations are present in most of the psychiatric emergency patients. The article then goes briefly into the fundamentals of therapeutic strategy in such patients: A therapy which helps to uncover hidden conflicts, the pros and cons of therapy focussed on conflict and on supportive measures; as well as a therapy which supports and promotes the ego. This is followed by a comparison of the ward with corresponding facilities in Germany and abroad and a description of their structure, their patients and their function within a psychiatric care system. The concluding part of the article is devoted to a description of the authors' initial experiences and impressions gained during their work with the ward patients, quoting several examples. PMID- 6856713 TI - [Family care--fossil or progress?]. PMID- 6856714 TI - Narcissus and nemesis. The 25th annual Frieda Fromm-Reichmann memorial lecture. PMID- 6856715 TI - "That in your hands". A comprehensive process analysis of a significant event in psychotherapy. AB - This article illustrates a new approach to the study of change processes in psychotherapy. The approach involves selecting significant change events and analyzing them according to the Comprehensive Process Model. In this model, client and therapist behaviors are analyzed for content, interpersonal action, style and response quality by using information derived from Interpersonal Process Recall, client and therapist objective process ratings and qualitative analyses. The event selected for analysis in this paper was rated by client and therapist as significantly helpful. The focal therapist response was a reflective interpretive intervention in which the therapist collaboratively and evocatively expanded the client's implicit meanings. The event involved working through an earlier insight and realization of progress by the client. The event suggests an association between subjective "felt shifts" and public "process shifts" in client in-therapy behaviors. A model, consistent with Gendlin's experiential psychotherapy (1970), is offered to describe the change process which occurred in this event. PMID- 6856716 TI - Learning during group dynamics training: the effects of silent versus traditional training formats. AB - According to practicing group psychotherapists, the two most valued components of training for group psychotherapy are: (1) the opportunity to conduct a therapy group under supervision, and (2) participation in experiential training (Dies 1974). It is no wonder, then, that a large spectrum of experiential training models has emerged (Lakin, Lieberman, and Whitaker 1969). What is learned from the various models relates to the milieu, the leader, and the group composition (Stone and Green 1978), and in part depends on the particular training format. In contrast to descriptions of training, however, is the relatively limited formal evaluation of the learning which occurs in these programs. This paper will focus on an evaluation of the learning which took place during the group dynamics component of group psychotherapy training. The effect on learning of variations in format in which the leader is either silent or explicates group processes was tested. PMID- 6856717 TI - The doing and undoing of surgical sterilization: a psychosocial profile of the tubal reimplantation patient. AB - A woman's decision to end her fertility surgically can be a well-founded decision with which she is satisfied, or it can be made for reasons that later lead to regret. What psychosocial factors distinguish the woman who will regret her sterilization and seek to have it reversed? Using a retrospective design, we compared 33 women who were satisfied with their ligations with 32 who chose to have the procedure reversed. We found that age, marital difficulties, emotional problems in the year prior to the ligation, and a history of unreliable contraceptive use differentiated the reversal patient from her satisfied counterpart. In addition, we found that the decision to be sterilized can occur in response to intrapsychic and interpersonal stresses that have little to do with fertility per se. In the reversal subjects, the decision to have and then reverse the ligation was part of the woman's characteristic use of fertility behavior to deal with conflicts about autonomy, dependency and self-esteem. PMID- 6856718 TI - Eye contact: the core of interpersonal relatedness. AB - This essay will attempt to show, citing evidence from diverse sources, that eye contact plays a central role in interpersonal relations. The eyes preface most new relationships, overshadowing other sensory inputs while transmitting a wide assortment of emotional cues. Visual behavior may at times prove decisive in assuring survival, in amorous encounters, and in clarifying interpersonal motives. Ocular performance, a final common pathway for many social, cultural and emotional determinants, is a crucial factor in defining relationships and in allowing reciprocal influences to be exchanged as persons relate. In psychiatric patients, ocular behavior may provide clues to diagnosis. A common finding in such persons is gaze aversion, a social avoidance phenomenon which indicates a desire to attenuate the interpersonal experience and thereby decrease anxiety. PMID- 6856719 TI - Age differences in children's attributions for deviant behaviors. AB - Previous research has described age-related changes in children's attributions for deviant behaviors. This research has suggested that children begin to develop a social psychiatric theory of deviant behavior by the end of the elementary school years. The current study extended this line of investigation to examine attributions for deviance by early and middle adolescents. Results suggested that adolescents view deviant behavior as caused not only by social and environmental factors but also by nonrational internal psychological states. PMID- 6856720 TI - A 1939 discussion on psychoanalysis by Edith Weigert. PMID- 6856721 TI - How Oedipus falsifies Popper: psychoanalysis as a normative science. AB - The scientific status of psychoanalysis has been the subject of continual debate. Influential philosophers of science have challenged the form of its theories and the nature of the evidence offered on their behalf. Some have concluded that the theories are beyond testing--i.e., they can neither be confirmed nor refuted, and psychoanalysis is thus intrinsically unscientific, akin to pseudosciences such as astrology. From that body of criticism, I have chosen for examination and rebuttal the issue of falsifiability. I refute the charge that psychoanalysis is not scientific because its theories are not "falsifiable." On the contrary, I show that psychoanalysis contains theories which make strong and unequivocal statements that are subject to the test of possible falsification. This capacity has been concealed and the falsifiability criticism rendered plausible because of the normative judgments which are latent in discussions of human development and human society. In explicating these judgments, I will move from the philosophy of science to the anthropology and sociology of science (and of the professions). The normative character of psychoanalytic science reinforces the ethical code of the therapeutic profession, a combination which imposes a disciplinary rigidity of the theoretical system. PMID- 6856722 TI - Some observations on the application of frame theory to the psychoanalytic situation and process. AB - Frame theory can contribute to our understanding of psychoanalytic work in ways compatible with established psychoanalytic theory. Its concepts and metaphor convey the relativism of the psychic realities both parties bring to the analytic situation, as well as the multiple levels of transference that become framed upon the relationship. Its linkages to game theory stress the power of play and illusion in transference actualization and working through. The importance of rules and conventions for all three theories, and for the ability to do analytic work, suggests their essential grounding in the child's capacities for play, particularly those capabilities elaborated in latency following oedipal conflict resolution. PMID- 6856724 TI - Some narcissistic consequences of object loss: a developmental view. AB - This paper examines the effects of object loss on narcissistic equilibrium from a developmental perspective. Such effects vary, depending on when the loss occurs in relation to the process of self-object differentiation, as well as on other characteristics in the loss situation. An effort is made to clarify the particular narcissistic elements which may be identified as involved in the experience of psychic pain following a loss. To this end, a distinction is made between feelings of omnipotence, of self-constancy, and of self-esteem, and their different developmental bases illustrated with clinical examples. PMID- 6856723 TI - On the concept of analyzability. AB - Much of our understanding of analyzability is based upon a model of inquiry that assumes a relative comparability among analysts as observing and influencing instruments. This paper suggests that the individuality in understanding and application of the psychoanalytic procedure inherent in the psychoanalytic enterprise raises questions about the comparability of clinical observation and data and must be taken into account in a realistic understanding of the factors that govern analyzability. PMID- 6856725 TI - Reflections on Freud's reaction to the death of his mother. AB - Freud's reaction to the death of his mother as he reported it in letters to Ernest Jones and Sandor Ferenczi is discussed. The sense of liberation and the absence of grief which he emphasized is given some analytic consideration. An attempt is then made to gain an understanding of Freud's somewhat cryptic remark that a change in the "values of life" in the "deeper layers" will have occurred following his mother's death. His discussion of these concepts in Civilization and Its Discontents, which was published just before her death, is utilized. The question is raised of whether the death of his mother may have been related to the change in Freud's view of the significance of the preoedipal mother which he presented in "Female Sexuality," the first paper he wrote after her death. PMID- 6856726 TI - Psychoanalysis abroad: a report from Greece. PMID- 6856727 TI - Effectiveness of a mobile breast screening service in the Blackburn Health District -- analysis of the first 3 years' results. PMID- 6856728 TI - A study of patient referrals. PMID- 6856729 TI - Falls in old people at home: intrinsic versus environmental factors in causation. PMID- 6856730 TI - Children with epilepsy: implications for the school health service. PMID- 6856731 TI - Peer audit and community dental health services. PMID- 6856732 TI - Cigarette smoking, road traffic accidents and seat belt usage. PMID- 6856733 TI - An operational classification of disease prevention. PMID- 6856734 TI - Ophthalmia neonatorum prophylaxis in Vermont. AB - Vermont birth certificates and hospital medical charts for 1979 were reviewed to determine whether infants born at home or in hospitals had documentation of prophylaxis against gonococcal ophthalmia neonatorum. Of the 139 home births recorded in 1979, 78 infants (54.0 percent) received no prophylaxis, compared with 97 (1.4 percent) of 7,156 infants born in hospitals (P less than 0.0001). Ophthalmic medications that have not been recommended for use for neonatal prophylaxis were being used in two hospitals in the State. A followup review of 7,668 Vermont birth certificates for 1980 indicated that hospital practices improved in that year, after the hospitals received a reminder on proper prophylactic procedures from the Vermont Department of Health. PMID- 6856735 TI - Predistribution of potassium iodide--the Tennessee experience. AB - Tennessee public health officials made a decision to predistribute potassium iodide tablets (KI) to householders in the vicinity of a nuclear powerplant. The tablets would be stored until needed in the event of a radiation emergency. The officials believed that it was important to have the option available as a means of protecting nearby residents. KI, ingested before or soon after exposure to radioactive iodine, can act as a thyroid blocker to protect the gland from accepting further iodine and, therefore, the radiation. A pilot project was undertaken to deliver, door to door, a package that contained KI tablets in sufficient quantity to supply a starter dose to each member of households within a 5-mile radius of the Sequoyah nuclear powerplant near Chattanooga. The package consisted of a vial of 14 130-mg tablets and a package insert from the manufacturer enclosed in a larger vial with a childproof cap. Home visitors who delivered the vials were professionals from the local public health departments, especially trained to answer questions about the project. About 66 percent of 5,591 homes accepted the medication. Extensive coverage of the project by information media was helpful in explaining local emergency plans as well as the KI distribution to the public. PMID- 6856736 TI - Worksite hypertension programs: results of a survey of 424 California employers. AB - More than 30 million American workers 17 years of age or older have some degree of hypertension, and nearly two-thirds of these workers have blood pressure greater than 160/95 mm Hg. Many employer-sponsored hypertension detection and control programs have been reported, but much of the information about these programs is anecdotal and based on perceptions rather than on formal evaluation. To gain an estimate of the number and nature of such programs among California employers, the authors surveyed 424 California organizations with more than 100 employees at one or more sites. Experienced survey researchers conducted 30 minute telephone interviews with key personnel of these firms to probe their companies' health promotion activities, including those devoted to hypertension screening and control. Of the 424 organizations, 43 (10.1 percent) had worksite hypertension programs, and 24 (5.7 percent) were planning to initiate such a program within the following 12 months. But 357 employers neither offered a hypertension program at the time of the survey nor planned to initiate one within the following year. Survey responses indicated that during the 3 years before the survey, the number of worksite hypertension programs among the organizations surveyed had increased by 110 percent. This rapid rate of increase, together with the nearly 50 percent increase in number of programs that employers were planning for the following 12 months, suggest that the number of similar programs in other regions may also be growing at an accelerating rate. The National Heart, Lung, and Blood Institute's strong endorsement of worksite hypertension programs and employers' current interest in health promotion and disease prevention activities should act as a spur for further growth of these programs. For maximum growth, however--especially among smaller companies--active promotion by business and community groups is essential. PMID- 6856737 TI - PHS perspectives on misconduct in science. AB - The Public Health Service (PHS) has undertaken a major effort to develop improved policies and procedures for dealing with misconduct in its research programs. Included in the definition of "misconduct" are the violation of Federal laws, regulations, or policies governing research or research training conducted, funded, or regulated by the Department of Health and Human Services; breaches of professional ethics that raise serious questions about an investigator's or institution's scientific or fiscal integrity; and serious failures to comply with other terms or conditions of an award. Recent incidents of falsification or misrepresentation of data and failure to comply with requirements for protection of human and animal subjects of research represent only a fraction of all research projects. However, they are troubling evidence that the traditional safeguards of science are not sufficient to prevent and detect willful wrongdoing. Research agencies, awardee institutions, and individual investigators have a collective responsibility to prevent misconduct in public research programs. The agencies and institutions, in turn, must deal promptly and equitably with allegations or evidence of misconduct. Individual research institutions and their professional organizations have developed policy statements affirming their responsibility for the integrity of the research enterprise and proposing specific procedures for dealing with incidents of misconduct. The National Institutes of Health currently serves as lead agency for a parallel PHS effort that includes a statement of general policies and principles, to be augmented by specific procedures for awarding agencies, regulatory agencies, and PHS intramural programs, as well as procedures for information sharing and joint investigations. PMID- 6856738 TI - Attitudes of faculty members of schools of public health toward public service. AB - Public service has long been considered one of a traditional triad of academic functions--teaching, research, and service. Yet even in schools of public health, where service is purported to be an integral component of the institution's mission, faculty generally do not accord as high a value to service performance or approach it with the same degree of commitment as they do research and teaching. A study was conducted to examine faculty perceptions and attitudes toward the service function and its relationship to teaching and research within schools of public health. The data were taken from a mailed questionnaire survey of 20-30 faculty members in each of 20 schools of public health in the United States. The response rate was 71 percent, or 387 returned questionnaires. Respondents generally felt that the greatest value of service lies in its potential for enhancing the image and prestige of the school, and in the fulfillment of the community obligation of the institution. The possibility that service might bring about improvements in faculty research and teaching, or improvements in health services and public health, was rated significantly lower. Thus, respondents did not view service as useful for its contribution to their own careers or to public health practice as much as they regarded it as a beneficial contribution to the reputation of the institution. This view undermines the traditionally held notion that public service either benefits a particular constituency outside the school or enhances the professional development of faculty members themselves. PMID- 6856739 TI - Differentials in the planning status of most recent live births to Mexican Americans and Anglos. AB - Data from personal interviews with 705 Mexican American and 363 Anglo women during the 1979 U.S. Mexico Border Survey were analyzed to answer the question, To what extent do Mexican Americans and Anglos differ in having the number of children they want, when they want them? Mexican Americans had a significantly higher percentage of unwanted births than did Anglos. Much of this difference is related to the fact that Mexican Americans, when compared with Anglos, have completed fewer years of schooling and have incomes closer to the poverty threshold than do Anglos. Both Mexican Americans and Anglos had relatively moderate levels of planned births; thus, neither group is in full control of the number and timing of their births. Our results suggest that there is a substantial need for family planning services for Mexican Americans and Anglos in the Southwest. PMID- 6856740 TI - Out-of-hospital births in Michigan, 1972-79: trends and implications for the safety of planned home deliveries. AB - Trends in out-of-hospital births for the State of Michigan, 1972-79, were examined by analyzing (a) location of deliveries, (b) characteristics of the mother, (c) use of health services, and (d) characteristics of the newborn. A large increase occurred in the number of births at the mother's home and other nonhospital sites for both the black and the white populations. For white women, the increase was associated with better education and greater use of prenatal care. Physician attendance for deliveries at mother's home declined. Birth weights for home-born infants increased significantly over the period, more so for whites than for blacks; mortality declined in some groups, especially for high-birth-weight babies born at the mother's home. Assuming that the rise in home births in the 1970s was due to an increase in planned and not precipitate home deliveries, the authors concluded that these trends reflect, at least in part, the impact of planned out-of-hospital births. Toward the end of the 1970s, both the conditions under which these births occurred and some of their outcome measures were more characteristic of safety than at the beginning of the period. Disaggregation by race demonstrated, however, that the safety factor was not necessarily present for out-of-hospital births of black infants. PMID- 6856741 TI - Where cancer patients die: an epidemiologic study. AB - In a sample of deaths among cancer patients, the relationship of place of death to age, sex, length of time between diagnosis and death, cancer site, and patients' socioeconomic status was investigated. The Rochester (N.Y.) Regional Tumor Registry provided these data for all cancer patients who died in Monroe County, N.Y., during 1976, 1977, and 1978. Patients who had not been residents of the county were excluded from the sample, as were patients under 15 years of age at death and those whose cancers had been diagnosed only at autopsy. Analysis with a logit model was used to estimate odds ratios that compared the probabilities of death in an acute care hospital and in a chronic care facility with the probability of death at home. Patients whose cancers had been diagnosed less than 1 month before their deaths were significantly more likely to die in a hospital than were patients whose cancers had been diagnosed earlier. Cancer sites, too, were significantly related to place of death: persons with leukemia or lymphoma were most likely to die in a hospital, followed by patients with lung, breast, and upper gastrointestinal tract cancers; persons with colorectal, genitourinary, and miscellaneous cancers were most likely to die at home. The patients whose deaths were studied were classified by socioeconomic area (SEA) ranking. Patients who had resided in higher level SEAs were more likely to die at home than those from lower level SEAs; however, this trend was reversed among patients from the lowest level SEAs, who had a relatively high rate of death at home and a low rate of death in chronic care facilities. PMID- 6856742 TI - Uterine cancers of unspecified origin--a reassessment. AB - Uterine cancer ranks third in cancer incidence and fifth in cancer mortality among American women. The epidemiologic characteristics of cancer of the cervix uteri and the corpus uteri are different. When only "cancer of the uterus, not otherwise specified (NOS)" is reported, problems arise in data analysis. In this study, uterine cancer deaths from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program, 1977-79, are compared with those from three previous studies. Uterine cancer deaths certified only as uterus, NOS, on death certificates have decreased 34 percent in the past 30 years. However, even in the late seventies, 25 percent of the uterine cancer deaths were still not being specified as either cervix uteri or corpus uteri on death certificates. Following the deaths certified as cancer of uterus, NOS, back to the pertinent hospital records showed that in recent years 75 percent of these deaths were actually diagnosed as cancer of the corpus uteri, compared with 20 percent 30 years ago. The failure to assign these unspecified uterine cancers to corpus uteri indicates that mortality from cancer of the corpus uteri is still underreported. Although the reporting of the specific subsites of cancer of the uterus on death certificates has improved during the past 30 years, every effort should be made to achieve further improvement in accuracy. PMID- 6856743 TI - A health needs index based on the health goals model. AB - A new quantitative index is proposed to measure the degree to which the health care needs of a population are met. It is based on the health goals model of Lester Breslow and A. R. Somers, who listed the kinds and frequencies of health services appropriate for each of 10 developmental and maturational stages of life. The population is further divided into the sick and well segments of each of the 10 groups; the sick need treatment and the well and asymptomatic need preventive care. The index is the geometric mean of the proportions of the people in the stages whose utilization experiences conform to the services and goals appropriate for their respective group. The counting system requires the minimum information as to whether the person has received the necessary treatment for his condition if he is sick or made the requisite number of professional visits for preventive care if he is well. The index is best considered a heuristic tool for understanding a complex problem. PMID- 6856744 TI - Designing primary health care teams for developing countries. AB - A time-honored industrial engineering technique, job evaluation, which was developed to set rates for manual labor, was used in the design of new teams for delivering primary health care in Latin America. The technique was used both in writing job descriptions for new allied health personnel and in designing the curriculums needed to train the personnel. PMID- 6856745 TI - Renal haemodynamics in conscious experimentally hypertensive rats. AB - The integrity of renal haemodynamics is essential for the maintenance of normal renal function in the normotensive and hypertensive state. Systemic and renal haemodynamics have been determined by the radioactively labelled microspheres technique in normotensive, Goldblatt I, Goldblatt II and deoxycorticosterone (DOC)-saline-treated hypertensive rats. Cardiac output was similar between normotensive and hypertensive rats, while total peripheral resistance was similarly higher in all hypertensive animals when compared to normotensive animals. Renal blood flow per weight unit was similarly decreased in all hypertensive animals (3.77 ml/min . g (S.D. 0.85, n = 11); the unclipped kidneys of Goldblatt II rats, 3.76 ml/min . g (S.D. 0.89, n = 11); the clipped kidneys of Goldblatt II rats, 3.62 ml/min . g (S.D. 0.78, n = 9); the kidneys of Goldblatt I rats and 2.95 ml/min . g (S.D. 0.83, n = 10) the kidneys of DOC-saline rats). It is concluded that kidneys from experimentally hypertensive rats fail to preserve normal renal blood flow, even at elevated arterial blood pressures, regardless of the pathophysiology of hypertension. PMID- 6856746 TI - The effects of sar1ala8-angiotensin II in vasopressin-treated dehydrated sheep. AB - Mildly dehydrated conscious Merino ewes were infused with vasopressin (AVP) at 5 mu x min-1 alone and simultaneously with the angiotensin II receptor blocker sar1ala8-angiotensin II (saralasin) at 15 micrograms x min-1. AVP was slightly pressor and produced an increase in the calculated total peripheral resistance, and an increase in glomerular filtration rate, urine flow and electrolyte excretion, without a change in total renal plasma flow. These results indicate renal efferent arteriolar vasoconstriction as well as other non-renal vasoconstriction. Saralasin infusion checked the rise in total peripheral resistance (which continued to increase after saralasin withdrawal), but caused a marked increase in renal vascular resistance resulting in a decrease in renal plasma flow and to a lesser extent in glomerular filtration rate. These results suggest that saralasin was acting as an angiotensin II agonist in the kidney, but as an antagonist elsewhere. Deductions from previous experiments in the literature of the renal function of angiotensin II, based on its supposed inhibition by saralasin, may not be justified. PMID- 6856747 TI - Diuresis from stimulation of left atrial receptors in dogs: further purification of the causative agent from plasma. AB - Stimulation of atrial receptors by distension of a balloon in the left atrium of anaesthetized dogs results in a reflex diuresis mediated by an unknown humoral agent. This paper reports the further purification from plasma of acetone extracts of the humoral agent which may mediate the diuretic response. Activity of the humoral agent was detected using the Malpighian tubules of Rhodnius prolixus. Gel filtration of the acetone extracts on Sephadex G-25 and G-100, followed by dialysis of the fraction from Sephadex G-100 that contained the humoral agent, showed that the activity of the agent was associated with a high molecular weight fraction (greater than 30000). Acetone extracts of the humoral agent were also shown to be stable to treatment with HCl for 1 h at 25 degrees C. After this acid treatment, gel filtration on Sephadex gels and Bio-Gel P-2 showed that the agent was of low molecular weight (less than 1800). It is concluded that the activity of the humoral agent, as detected by the Malpighian tubule preparation, is associated with a molecule of low molecular weight which may be bound to a larger molecule from which it can be dissociated by acid treatment. PMID- 6856748 TI - Abolition of atrial receptor diuresis and of release of humoral agent by cooling the vagal nerves. AB - Stimulation of atrial receptors in anaesthetized dogs results in a reflex increase in urine flow mediated by vagal myelinated fibres and, in part, by a humoral agent of unknown identity. The humoral agent has been detected by an in vitro preparation of the Malpighian tubules of Rhodnius prolixus. The purpose of this investigation was to determine whether the present extract of plasma purporting to contain the humoral agent is also related to the reflex diuresis. In nine chloralose anaesthetized dogs atrial receptors were stimulated by distension of a balloon in the left atrium. Plasma samples collected before and during distension of the balloon, respectively, were precipitated with acetone, acid-treated and fractionated on Bio-Gel P-2. The purified samples were tested for the activity of the humoral agent on the Malpighian tubule preparation. In each dog, distensions of the balloon were performed with the cervical vagal nerves at 9 and 37 degrees C. Cooling the vagal nerves to 9 degrees C abolished the reflex diuresis and abolished the activity of the humoral agent recovered from a Bio-Gel P-2 fraction (molecular weight range 100-1800) which elutes between the void volume and the salt fraction. It was concluded that the substance recovered from Bio-Gel P-2 is associated with the diuresis in response to stimulation of atrial receptors; it is suggested that its presence is dependent on the integrity of the afferent limb of the atrial receptor reflex. PMID- 6856749 TI - Properties of miniature post-synaptic currents at the Torpedo marmorata nerve electroplate junction. AB - The post-synaptic conductance changes induced by spontaneous release of neurotransmitter on the Torpedo marmorata electroplates were studied by focal extracellular recording methods. It was found that miniature post-synaptic currents (m.p.s.c.s) recorded on the innervated and non-innervated faces of the electrocyte are opposite in sense and the distribution of amplitudes is bimodal. The bimodal distribution could reflect the presence of two populations of m.p.s.c.s (smaller and giant m.p.s.c.s). In the smaller m.p.s.c.s the distribution of the ratio (amplitude/decay time constant) shows two populations that probably represent areas with different receptor densities. The value of the mean open-channel lifetime estimated from the decay time constant of the m.p.s.c. is 0.92 +/- 0.67 ms (n = 319, temperature 20 +/- 1 degree C). Prostigmine (10 microM) increases the amplitude, decay time constant and time to peak of the m.p.s.c. A decrease of temperature increases m.p.s.c. decay time, the activation energies found ranging from 8.0 to 12.6 kcal x mol-1. Increasing the external K+ concentration produces a decrease in the decay time constant. High concentrations of divalent ions, particularly Ca2+, increase the decay time constant of the m.p.s.c. Alkaline or acid bathing solution produces a decrease in the decay time constant. An almost total substitution of external Cl- by non-permeant SO42- does not modify the time course of the m.p.s.c. PMID- 6856750 TI - Effect of dietary linoleic and linolenic acids on testicular development in the rat. AB - In two experiments a total of twelve male rats were reared from weaning for up to 63 weeks on an essential fatty acid (EFA)-deficient diet alone (2 X two animals) or supplemented with the methyl esters of linoleic acid (18:2 omega 6) (2 X two animals) or linolenic acid (18:3 omega 3) (2 X two animals). Testicular development was normal in rats given 18:2 omega 6, but in rats fed the EFA deficient diet alone, and in those supplemented with 18:3 omega 3 the testes were reduced in size. Histologically, a degeneration of the seminiferous tubules was noted, with progressive loss of the germinal cells, and with an absence of spermatozoa in the lumina of the seminiferous tubules and epididymides. Leydig cells appeared unaffected, and were prominent. The six rats in Experiment 1 were capable of mating with females reared on commercial diets, but only the two 18:2 omega 6 supplemented animals were fertile. There was a marked reduction in the percentage of arachidonic acid (20:4 omega 6) and docosapentaenoic acid (22:5 omega 6) in the total fatty acids of the atrophic testes. There was no compensatory increase in long-chain derivatives of 18:3 omega 3 in the 18:3 omega 3 fed rats and it is concluded that linolenic acid cannot replace linoleic acid in the development of the rat testis. PMID- 6856751 TI - Calculation of low-energy neutron dose indices and depth doses in the ICRU tissue sphere. AB - Detailed neutron dose distributions were calculated for the ICRU tissue sphere for broad, parallel beams of incident neutrons with 10 different energies ranging from thermal to 0.3 MeV. The calculation was carried out by the Monte Carlo method on the CYBER 175 computer of the University of Illinois. From these calculated data, a set of fluence-to-dose-index conversion factors, needed to establish the allowable limits for exposure to external neutron beams, was obtained. Normalized depth doses along the principal axis at depths of 0.007, 0.3 and 1.0 cm are also provided. The fluence-to-dose-index conversion factors are compared to previous conversion factors based on cylindrical phantoms, and any differences are explained. PMID- 6856752 TI - The sequential irradiation of mammalian cells with X rays and charged particles of high LET. AB - Chinese hamster V79 cells, synchronized in late-S phase, were irradiated with high-LET charged particles or X rays, or exposed sequentially to a single dose of charged particles followed by graded doses of X rays. The charged-particle irradiations consisted of deuterons (LET, 50 keV/microns) or 3He ions (96 or 160 keV/microns). The survival data obtained following the sequential irradiations show a synergistic effect compared with exposure to the low-LET radiation. An enhancement ratio is defined in order to quantify this effect. On the basis of this concept the present data show an enhanced interaction effect as the LET of the primary dose is increased or the size of this dose is increased. The data are also discussed in terms of a recent theoretical formulation which predicts synergism as a result of the interaction between the sublethal damage produced by the two radiations. PMID- 6856753 TI - Irradiation of mammalian cells in the presence of diamide and low concentrations of oxygen at conventional and at ultrahigh dose rates. AB - The response of cultured CHO cells to ultrahigh-dose-rate radiation (approximately 10(9) Gy/sec) has been previously studied extensively using the thin-layer cell-handling technique developed in this laboratory. When the cells are equilibrated with a low concentration of oxygen, e.g., 0.44% O2, a breaking survival curve, due to radiolytic depletion of the oxygen, is observed. Hypoxic cells irradiated in the presence of the nitroimidazoles (e.g., misonidazole) are sensitized at ultrahigh dose rates in a dose-modifying manner, similar to that observed at conventional dose rates. These radiosensitizer compounds, if present in cells equilibrated with a low concentration of oxygen, prevent the breaking behavior of the survival curve, an observation believed to be due to the sensitizer interfering with the oxygen depletion process, leaving oxygen free to sensitize. Such experiments have recently been extended to studies with diamide, which, unlike the other sensitizers tested, acts primarily as a shoulder modifying rather than a dose-modifying agent in hypoxic mammalian cells. These data indicate that diamide is active as a sensitizer at ultrahigh dose rates in a manner similar to that observed at conventional dose rates, and does modify the shape of the breaking survival curve observed with low concentrations of oxygen. PMID- 6856754 TI - Factors influencing intracellular uptake and radiosensitization by 2 nitroimidazoles in vitro. AB - In this study it is shown that the radiosensitization of hypoxic Chinese hamster ovary (HA-1) cells in vitro by misonidazole (MIS) and other 1-substituted 2 nitroimidazoles depends on the rate and extent of intracellular uptake of these radiosensitizers, which in turn is governed by their lipophilicity [expressed as the octanol:water partition coefficient (P)]. As the lipophilicity of the compounds decreased, the rate of drug entry into the cells was slower, and below P values of approximately 0.05, peak intracellular drug concentrations were found to be lower than that of MIS (P = 0.43). In addition, the number of hydroxyl groups on the side chain of the nitroimidazole molecule influenced the uptake of drug into the cells. For compounds of similar P, but differing in the number of side-chain hydroxyl groups, the addition of a single hydroxyl group to the molecule decreased the amount of drug entering the cell by a factor of approximately 2. These compounds enter the cell by nonmediated passive diffusion since altering the energy (ATP) capacity of the cell by 2-deoxyglucose did not affect uptake. It is also shown that increases in temperature or decreases in pH can increase the intracellular uptake of MIS. For example, equal intracellular and extracellular concentrations (100% uptake) of MIS were obtained if cells were heated to 44-45 degrees C for 15 min compared to 20-40% uptake at 37 degrees C. Increases in MIS uptake by factors of 2 to 3 could be demonstrated within 30 min when cells were incubated in Hanks' balanced salt solution at pH between 6.0 and 6.3 without loss of cell viability. In addition, MIS uptake in aerobic cultured cells varied from 15 to 60% depending on the cell line and culture conditions used. PMID- 6856756 TI - Response of multicell spheroids to 1-MHz ultrasonic irradiation: cavitation related damage. AB - The response of EMT6/Ro single cells and multicell spheroids (150-800 microns diameter) to 1-MHz ultrasonic irradiation was determined for intensities of 0-5 W/cm2 for 1-5 min. Damage was assessed by evaluating both lysis and survival of individual spheroid cells, growth of whole spheroids, and the physical integrity of whole spheroids by histological and scanning electron microscopic techniques. The surviving fraction of spheroid cells was higher than that of single cells, and several of the intensity-duration combinations showed a statistically significant correlation between resistance to ultrasound and increased spheroid size. This resistance with size was also found in spheroid growth experiments. Histological sections showed that both peripheral and internal damage occur. The relationship of spheroid damage to studies of effects on tissues and possible therapeutic use of nonthermal ultrasound are discussed. PMID- 6856755 TI - Radiobiological effects of 131I and 125I on the DNA of the rat thyroid. I. Comparative study with emphasis on the postradiation hypothyroidism occurrence. AB - One of the major disadvantages of the use of 131I in the treatment of thyrotoxicosis is the development of hypothyroidism. Alternatively, 125I has been proposed for thyrotoxicosis therapy, and was thought to be preferable to 131I because of the short range of its emitted soft electrons. Several studies have shown 125I to be as effective as 131I in the treatment of thyrotoxicosis, and equally likely to produce hypothyroidism. This work compared the radiobiological effects of 131I and 125I given in doses to deliver the same amount of radiation to the rat thyroid gland. These effects were studied by in vivo determination of single-strand DNA breaks by alkaline sucrose gradient sedimentation using the DABA fluorescent technique to detect the DNA. Serum T4 and TSH concentrations and percentage T3 uptake were determined by RIA. The incidence of hypothyroidism following 131I and 125I therapy was found to be the same (10% in each group). The extent of DNA damage following 125I therapy was greater than the damage induced by a larger dose of 131I. PMID- 6856757 TI - Effect of 3-aminobenzamide on sister chromatid exchange frequency in X-irradiated cells. AB - To investigate whether a delay in the rejoining of radiation-induced strand breakage can lead to sister chromatid exchange formation, Chinese hamster ovary cells were prelabeled with 5-bromodeoxyuridine and X-irradiated in the presence of 3-aminobenzamide, an inhibitor of poly(ADP-ribose) polymerase. The resulting sister chromatid exchange frequencies were consistent with those expected if 3 aminobenzamide and X-ray treatments were independent and additive. A similar but much smaller additive effect was also observed in cells cultured in the presence of 3-aminobenzamide and X-irradiated immediately before the addition of bromodeoxyuridine to the culture medium. These findings support previous studies indicating that X rays are poor inducers of sister chromatid exchanges and suggest that the normally rapid resealing of DNA strand breaks does not account for this inefficiency. PMID- 6856758 TI - Heat-induced thermotolerance expressed in the energy metabolism of mammalian cells. AB - Measurements were made of the effect of heat treatment on ATP levels in control and thermotolerant populations of murine lymphoma (L5178YS) and Ehrlich ascites cells to investigate whether the development of thermotolerance is associated with an increased ability of cells to maintain energy metabolism when challenged with heat treatment. For the L5178YS cells a single heat treatment produced a rapid reduction in ATP levels. However, previously heat treated L5178YS cells showed an increased ability to maintain ATP levels when challenged with a second heat treatment, and this ability to maintain ATP levels varied in a manner which correlated with the appearance and decay of thermotolerance seen in the parallel cell survival studies. In contrast both single and fractionated heat treatments did not reduce ATP levels in Ehrlich ascites cells. PMID- 6856759 TI - Cytogenetic effects of argon laser irradiation on Chinese hamster cells. AB - The cytogenetic effects of argon laser light on V79 Chinese hamster cells were studied. Irradiation with a defocused continuous beam from an argon laser at doses of 100 to 400 J/cm2 had dose-related cytostatic and cytocidal effects. Cell cycle analysis by flow cytofluorometric measurement indicated that argon laser irradiation induced a temporary block at the G2 + M phase. The survival curve after laser irradiation was exponential without an initial shoulder and the D0 value (34% lethal dose) was calculated as 170 J/cm2. A significant increase in sister chromatid exchange was observed after laser irradiation. Laser irradiation also induced chromatid and chromosome aberrations, most of which were breaks and gaps. These chromosomal changes are probably not an artifact of the experimental procedures such as the use of phenol red and antibiotics or spontaneously emitted uv light. No mutation at the Na+/K+-dependent ATPase locus was induced by argon laser irradiation. Although the mechanism by which an argon laser beam induces cytogenetic damage remains to be investigated, the possible involvement of hyperthermia seemed to be excluded. PMID- 6856760 TI - Comments on 'an assessment of the role of microdosimetry in radiobilogy" by Dudley T. Goodhead. PMID- 6856761 TI - Failla Memorial Lectures. Radiation genetics: the mouse's view. AB - This report describes the lecturer's visit to Murinia where he consulted with the leading geneticists, including Dr. Maxie Mouse CXIV. The mice are greatly interested in the field of radiation genetics, but they no longer wish the honor of the major responsibility for setting our genetic radiation standards. PMID- 6856762 TI - Dose-rate effects in mammalian cells. IV. Repairable and nonrepairable damage in noncycling C3H 10T 1/2 cells. AB - Repairable and nonrepairable components of gamma-ray damage leading to cell reproductive death were determined by measuring the range over which dose rate influenced the response of non-cycling C3H 10T 1/2 mouse cells. Cell proliferation and cell cycle redistribution were eliminated as factors influencing the dose-rate effect in the system by irradiating confluent monolayers of contact inhibited cells. The radiosensitivity of the cells did not change, and no selective loss of damaged cells occurred over the extended treatment times. A pronounced dose-rate effect was observed over the range between 55.6 and 0.29 Gy/hr, but a limit to the repair-dependent dose-rate effect was reached at 0.29 Gy/hr since no further reduction in effect per unit dose was observed when the dose rate was reduced to 0.17 or 0.06 Gy/hr. The survival curves, which were simple exponential functions of dose at dose rates of 0.29 Gy/hr and below, have a common Do of 7.32 Gy and represent an accurate measurement of the nonrepairable component of damage. Log-phase cultures showed remarkably different responses over the range of dose rates, due in large part to cell cycle redistribution and in some cases, cell proliferation during exposures. The results of these studies were compared with time-dose relationships used in clinical brachy-therapy and agree remarkably well with corrections in total dose suggested by R. Paterson [Br. J. Radiol. 25, 505-516 (1952)] and A.E.S. Green [cited in F. Ellis, Curr. Top. Radiat. Res. Q. 4, 357-397 (1968)] when the standard treatment time is changed. Comparison of our data with in vivo isoeffect curves of total dose vs dose per fraction for "early" and "late" tissue responses indicate that cell cycle redistribution should not be ignored as a factor influencing time-dose relationships in radiotherapy. PMID- 6856763 TI - Radionuclide transport processes in terrestrial ecosystems. AB - Some major principles and the status of knowledge concerning the transport of radionuclides through terrestrial ecosystems are reviewed. Fundamental processes which control the flow of radionuclides between ecosystem components such as air, soil, plants, and animals are described, with emphasis on deposition, resuspension, plant uptake, ingestion, and assimilation. Properties of radionuclides, organisms, and ecosystems are examined in relation to their influence on the accumulation of radioactive materials by plants and animals. The effects of the physicochemical nature of the radionuclide; morphology, physiology, and behavior of the organism; and soil, nutrient, and trophic characteristics of the ecosystem are highlighted. Observations in natural ecosystems on radionuclides such as 137Cs, 90Sr, 131I, 3H, and 239Pu are used to illustrate current concepts. An assessment of the degree to which the processes controlling radionuclide behavior are understood and of our ability to simulate and predict such behavior with computerized models is offered. Finally, brief comments are made on research needs. PMID- 6856764 TI - The distribution of tritium among the amino acids of proteins obtained from mice exposed to tritiated water. AB - The distribution of tritium among the amino acids of serum proteins in mice chronically exposed to tritiated water was determined by ion exchange chromatography of the protein hydrolysate. The specific activity of nonexchangeable tritium in these amino acids relative to the specific activity of tritium in the tissue water of mice ranged from 0.04 for phenylalanine and threonine to 1.0 for glycine and alanine. Since tritium from tissue water can enter the nonexchangeable positions of amino acids only as the result of metabolic processing, the relative specific activity of tritium in each amino acid is an indicator of the extent of such processing. The tritium content of tyrosine and all the amino acids required in the diet for survival is quite low, except for histidine, and can be entirely accounted for by transamination or, in the case of methionine, by transmethylation. The tritium content of the other amino acids is too high to result from such minor processing and must reflect primarily the fraction synthesized de novo. The implications of these findings with respect to the radiobiological consequences of a diet containing tritiated proteins are discussed. PMID- 6856765 TI - Glass-ceramic-mediated, magnetic-field-induced localized hyperthermia: response of a murine mammary carcinoma. AB - Hyperthermia has been found to be a useful modality for cancer therapy. In this report, a biocompatible, ferrimagnetic glass-ceramic capable of inducing localized hyperthermia by hysteresis heating upon exposure to an alternating magnetic field is presented. When the glass-ceramic was placed in the region of a subcutaneously transplanted, weakly antigenic breast carcinoma and subjected to the magnetic field, sufficient temperature rise was obtained to cause significant (approximately 50%) tumor regrowth delay and a 12% permanent control. The data demonstrate that glass-ceramic-mediated hysteresis heating may be a useful therapeutic approach in the treatment of cancer which offers the advantage of producing a highly localized and predictable tumor volume hyperthermia. PMID- 6856766 TI - The effect of mass on the gastrointestinal absorption of plutonium and neptunium. AB - Absorption and retention of plutonium were determined in mice after intragastric administration of either 6 X 10(-4) or 1.5 mg/kg in bicarbonate, citrate, or nitrate media. At the higher concentration, absorption of the citrate was greater than that of the nitrate; at the lower concentration, chemical form was not an important factor in absorption. Concentration and chemical form had much less influence on absorption by the neonatal (versus the adult) rat. The transfer factor (f1) for neonates was between one and two orders of magnitude higher than for adults. Absorption and retention of neptunium were determined in rats and/or mice after intragastric administration at doses ranging from 2.2 X 10(-7) to 43 mg/kg in nitrate solutions of pH 1.5. At the higher concentrations, absorption was 1.5 to 2.7%. For lower concentrations, absorption was 25 to 65 times less. In contrast to results obtained in adult animals, absorption of neptunium by neonates decreased with increasing dose. The data obtained in adult animals suggest that the f1 factor recommended by the ICRP for plutonium should be increased by a factor of 10, but the neptunium f1 factor, in contrast, should be decreased by a factor of 10. PMID- 6856767 TI - Radium retention in mature beagles injected at 5 years of age. AB - Retention of 226Ra was substantially lower in mature beagles injected at 5 years of age compared to corresponding values for young adult beagles injected at 17 months of age. As with young adults, the percentage retention in mature dogs given about 10 microCi/kg exceeded that in mature dogs given 4 microCi/kg or less. Percentage retention, R, at t days after the injection of 10 microCi/kg in mature beagles could be represented by the equation, R = 64.1e-0.233t + 13.0e 0.0048lt + 22.9e-0.000329t, and for mature beagles given 4 microCi/kg or less, R = 38.8e-0.40t + 30.6e-0.0424t + 11.9e-0.00567t + 18.7e-0.000352t. Measured 222Rn/226Ra ratios in bone were similar in mature and young adults. Roughly 66% of the injected radium was excreted by mature dogs during the first 3 weeks, about two-thirds of the total excretion appearing in the feces. Distribution of 226Ra within the skeleton was similar in mature and young adult beagles. PMID- 6856769 TI - Inhalation carcinogenesis of high-fired 241AmO2 in rats. AB - Wistar rats were given a single inhalation exposure to high-fired 241AmO2 particles and examined over their life span. A total of 310 rats were used: 259 exposed to 241Am for life-span study, 30 exposed to 241Am for early metabolism study, and 21 unexposed life-span controls. The activity median aerodynamic diameter of the aerosols was 0.75-1.39 microns. About 55% of alveolarly deposited 241Am was cleared from the lung with a half-life of 0.5 days, 37% with a half life of 7 days, and 8% with a half-life of 580 days. Group mean lung doses ranged from less than 5.7 rad up to 1500 rad. Significant early mortality due to radiation pneumonitis was seen only in the highest exposure group. The percentage of rats with lung tumors was 0% for controls (21 rats), 1% at lifetime lung doses less than 10 rad (139 rats), 7% at 10-50 rad (86 rats), 0% at 50-100 rad (9 rats), 60% at 100-500 rad (10 rats), and 7% at 500 rad (15 rats). Only one liver and one bone tumor were found in all exposed rats, both at lifetime tissue doses less than 10 rad. The fate and carcinogenicity of inhaled 241AmO2 in the lung of rats were similar to what has previously been described for inhaled 244CmO2. PMID- 6856768 TI - The oxygen enhancement ratio for single- and double-strand breaks induced by tritium incorporated in DNA of cultured human T1 cells. Impact of the transmutation effect. AB - The effect of oxygen, expressed as the oxygen enhancement ratio (OER), on the number of single-strand breaks (SSB) and double-strand breaks (DSB) induced in DNA by the radioactive decay of tritium was measured in human T1 cells whose DNA had been labeled with tritium at carbon atom number 6 of thymidine. Decays were accumulated in vivo under aerobic conditions at 0-1 degrees C and at -196 degrees C and in a nitrogen atmosphere at 0-1 degrees C. The number of SSB and DSB produced was analyzed by sucrose gradient centrifugation. For each tritium decay there were 0.25 DSB in cells exposed to air at 0-1 degrees C and 0.07 in cells kept under nitrogen, indicating an OER of 3.6, a value expected for such low-LET radiation. However, for each tritium decay there were 1.25 SSB in cells exposed to air at 0-1 degrees C and 0.76 in cells kept under nitrogen indicating an OER of only 1.7. The corresponding values for 60Co gamma radiation, expressed as SSB per 100 eV absorbed energy, were 4.5 and 1.0, giving an OER of 4.5. The low OER value found for SSB induced by tritium decay can be explained if 31% of the total SSB produced in air result from transmutation by a mechanism which does not produce DSB and is unaffected by oxygen. PMID- 6856770 TI - Placental transfer and distribution of 241Am in the rat. AB - The placental transfer and distribution of 241Am in the feto-placental system were studied in pregnant rats. Rats were injected intravenously with 241Am citrate at 15 or 18 days of gestation. Groups injected at 15 days of gestation were sacrificed 2, 24, 48, or 120 hr after injection, and the group injected at 18 days was sacrificed 24 hr after. The radioactivities of 241Am in fetus, fetal membrane, and placenta were determined, and its distribution in the feto placental system was investigated by high-speed autoradiography using a silver activated zinc sulfide-coated membrane as an intensifying screen. The deposition of 241Am in feto-placental units increased with the number of days of gestation. Results of autoradiography revealed that major deposition sites of 241Am in the fetus are the skeleton and liver. Heavy deposition of 241Am in the yolk sac splanchnopleure and its existence in the exocoelom strongly suggest that the yolk sac placenta plays an important role in the placental transfer of this nuclide. PMID- 6856771 TI - The effect of X rays, DTPA, and aspirin on the absorption of plutonium from the gastrointestinal tract of rats. AB - To measure the effect of radiation on plutonium transport, rats that were exposed to 250-kVp X rays were given 238Pu 3 days afterwards by either gavage or injection into a ligated segment of the duodenum. In a second group of experiments, rats were either injected intraduodenally with 238Pu-DTPA or administered the chelate intravenously and the 238Pu by gavage. In a third experiment, rats that had been gavaged with 200 or 400 mg/kg/day of aspirin for 2 days were injected intragastrically with 238Pu nitrate. Results of the first experiment showed a dose-dependent increase in 238Pu absorption between 800 and 1500 rad of lower-body X irradiation. Intravenous or intraduodenal injections of DTPA caused a marked increase in 238Pu absorption but resulted in decreased plutonium deposition in the skeleton and liver. Retention of 238Pu in the skeleton of rats given aspirin was double that of controls, but the effect on plutonium absorption was less marked than that of DTPA. PMID- 6856773 TI - The effect of local hyperthermia on nonproliferative, compared with proliferative, epithelial cells of the mouse intestinal mucosa. AB - The effects of local hyperthermia on different components of mouse intestinal mucosa were investigated. The intestine was heated by immersion in Krebs-Ringer solution at various times after intraperitoneal injection of [3H]thymidine, and thermal injury was assessed by measuring loss of label. The interval between labeling and heating was either 14 hr, when the majority of labeled epithelial cells were still in the crypts, or 65-72 hr, when the majority of the label had moved onto the villi. Heating at 42 degrees C for up to 1 hr had no observable effect. When intestine was heated at 43 degrees C 14 hr after labeling, the characteristics of the loss of label were very similar to loss of crypts with regard to both the fraction lost and the time over which the response occurred. The threshold heating time to cause an effect was between 20 and 30 min and the response was complete by 6 hr after treatment. If, however, intestine was heated at 43 degrees C either 65 or 72 hr after injection of [3H]thymidine, the threshold heating time required to cause an effect was reduced to between 10 and 20 min and loss of label was not necessarily accompanied by crypt loss. For example, 40% of radioactivity could be lost from the villi without any corresponding loss of crypts. Both the labeling experiments and histological examination indicated that the nonproliferative cells of the intestinal mucosa that line the lumen are more susceptible to thermal injury than the crypt cells. Thus, although crypt loss may remain a useful endpoint in the assessment of thermal damage, the data would underestimate early mucosal injury and the impairment of functional integrity of small intestine. PMID- 6856772 TI - Action spectra for ultraviolet photosensitized killing of mammalian cells by misonidazole and para-nitroacetophenone. AB - V-79 Chinese hamster fibroblasts in monolayer culture were exposed to ultraviolet radiation at 313, 334, 365, 380, and 405 nm in the presence of either misonidazole or para-nitroacetophenone, drugs which act as both photosensitizers and radiosensitizers of cell killing. Survival was measured by a colony-forming assay. The resulting action spectra for cell death photosensitized by the drugs (the reciprocals of the exposures required at each wavelength to reduce cell survival to a given level) closely match their absorption spectra over a range of three orders of magnitude. These results demonstrate that cells can be killed upon excitation of misonidazole or para-nitroacetophenone in the absence of any other types of energy deposition or biomolecular damage. PMID- 6856774 TI - Optimal design of multifraction assays of colony survival in vivo. AB - Certain fractionation protocols for multifraction in vivo colony assays permit the use of a statistical method to test the hypothesis that equal dose fractions produce equal decrements in cell survival and to obtain an estimate of the number of clonogens initially capable of structure regeneration. The essential requirement is that common doses per fraction be given in two or more regimens consisting of different fraction numbers. It is shown that the accuracy of the method is dependent upon the particular selection of common-dose regimens used in the assay. Calculations with theoretical data were used to determine guidelines for selecting the optimal experimental design. It was found that the fraction number pairs (n, m) which result in observable levels of survival tend to lie in a triangular region when plotted in the plane. Use of regimens corresponding to points along the lower edge of this triangle can substantially improve the results of the statistical method. It was also found to be optimal to use a minimal dose for each regimen, subject to the constraint that survival levels lie in the observable range. An application of the main ideas to data from assays of mouse jejunal crypt cell survival illustrates that use of a near-optimal design would have produced better results with 80 mice than were obtained with 140 mice. PMID- 6856775 TI - Radium retention and dosimetry in juvenile beagles. AB - Retention of administered 226Ra was substantially greater in beagles injected as 3-month-old juveniles than as 1.4-year-old young adults, but the measured 222Rn/226Ra ratio in bone was significantly less in juveniles for about the first 600 days after injection. An equation that describes the total-body biological retention R in beagles injected with 226Ra at 3 months of age at any time t (in days) after injection during the first 6.6 years is R = 0.331e-0.206t + 0.245e 0.00374t + 0.424e-0.000114t. The rate constant of the final term in the equation for juveniles is similar to that for young adults, suggesting that this component reflects the net turnover rate in the slowly remodeling component of adult bone. Compared to young adult beagles, animals injected as juveniles had a greater fraction of their retained 226Ra in parts of the skeleton containing much cortical bone, such as paws, and a smaller fraction in those parts containing much trabecular bone. PMID- 6856776 TI - Sequential functional testing of radiation-induced renal damage in the mouse. AB - Two nondestructive assays of functional impairment were developed to measure renal damage in mice after local irradiation of both kidneys with 240-kV X rays. Daily urine output after irradiation was measured indirectly by determining urination frequency. A dose-related response began 17 weeks after treatment and then progressed; dose-response curves with a threshold of 12 Gy were established by 22 weeks. The time of onset of damage was dose related and there was some recovery of kidney function between 25 and 38 weeks. The rate of excretion of 51Cr-EDTA was measured as an estimate of glomerular filtration either by sequential external counting over 20 min or from the activity remaining in a single blood sample at 60 min. Both methods gave dose-response curves, but the results from the blood sample were more precise. These assays are suitable for sequential testing of individual mice and have been used to establish a dose related latent period of approximately 17 weeks after bilateral renal irradiation. PMID- 6856777 TI - Observations on the cellular effects of ethanol and hyperthermia in vivo. AB - The presence of ethanol in mice not previously exposed to the drug potentiates the damage caused by hyperthermia to the skin of the ear. Similarly, when thermotolerance is induced in the ear by a prior heat treatment, ethanol given before the second heat treatment reduces the amount of thermotolerance that is expressed. Conversely, mice that have developed ethanol tolerance after exposure to ethanol vapor for 7 days display resistance to hyperthermia-induced necrosis. It is possible that there may be similarities in the direct cellular effects of heat and ethanol, and that the development of tolerance to ethanol and hyperthermia may be by a similar mechanism. PMID- 6856778 TI - Repair in mouse lung between multiple small doses of X rays. AB - Multiple fraction experiments have been carried out to determine the response of mouse lung to repeated small doses of 240 kV X rays down to 150 rad/fraction using breathing rate and lethality to assess damage. Two experimental approaches were used to measure the effect of small doses in vivo: (1) multiple equal doses and (2) multiple priming doses followed by a large test dose. Analysis was performed using the multitarget two-component model and the linear quadratic model of cell survival. The amount of repair was calculated as a function of either dose per fraction (FR) or total dose (Frec). Both FR and Frec increased with decreasing dose per fraction but the change in FR was small. The advantage of Frec was that it varied more rapidly with dose per fraction than FR, so that possible differences between tissue repair capabilities are more visible on plots of repair as a function of dose per fraction. FR and Frec both decreased with the level of single-dose isoeffect injury; thus neither parameter is acceptable for comparing repair capability of different normal tissues with widely differing single-dose end point levels. Beta/alpha values were calculated and found to be a more acceptable index of repair capability than either FR or Frec because unlike those two parameters, beta/alpha varied little with level of damage. Beta/alpha values of 1.7 to 4.2 krad-1 were obtained for both lung death and increased breathing rate and are clearly intermediate between the lower beta/alpha ratios for acute reactions, i.e., skin and intestine, and the higher values for late reactions in kidney and spinal cord. PMID- 6856779 TI - The effect of step-down heating on murine normal and tumor tissues. AB - Cultured cells can be sensitized to low-temperature hyperthermia (below 43.0 degrees C) by a prior heat shock at a high temperature (above 43.0 degrees C) if the heat above 43.0 degrees C is immediately followed by the heat below 43.0 degrees C. This effect has been termed step-down heating (SDH). We have studied the effect of SDH on the response of murine tumor and normal tissues treated at 45.5 degrees C. Animal tumors were eighth-generation isotransplants of a spontaneous fibrosarcoma in C3Hf/Sed. mice. Tumor response was studied by TG (tumor growth) time assay, i.e., determination of the time required for half the treated tumors to reach 1000 mm3 from the first day of treatment. Normal tissue response was studied in the mouse foot. End point was the time to induction of a score 4.0 (loss of a toe) or greater reaction in half the treated animals, RD50. The SDH at 41.0 degrees C sensitized the response of tumor and normal tissues to 45.5 degrees C. The enhancement ratios were congruent to 1.7 for both tissues, indicating no differential sensitization between tumor and normal tissues. No sensitization was observed if the SDH was given immediately after a second dose of 45.5 degrees C given 6 hr to 5 days following the first dose of 10 min at 45.5 degrees C. The SDH appeared not to inhibit the development of thermal resistance as evidenced by no appreciable changes in the thermal resistance ratio. PMID- 6856780 TI - Effect of X irradiation and hyperthermia on vascular function in skin and muscle. AB - Vascular change by the combined treatments of radiation and hyperthermia was studied. The legs of rats were irradiated with 2000 rad of X rays in a single dose and heated at 43.0 degrees C for 1 hr at various times after irradiation, and the blood flow and vascular volume in the skin and muscle were determined with 125I-microspheres and 51Cr-RBC methods, respectively. Irradiation alone caused an immediate increase in blood flow and vascular volume in skin and muscle followed by a second increase during 2-4 weeks postirradiation. Heating also caused an immediate and profound increase in blood flow and vascular volume. When tissues were irradiated first and heated the increase in blood flow and vascular volume was generally greater than that caused by irradiation or heat alone for about 4 weeks postirradiation. The combined effects were either additive or more than additive depending on the interval between the irradiation and heating during this period. Hyperthermia at 40 days postirradiation increased the blood flow and vascular volume only slightly above that of the irradiated control, indicating that the combined effect of irradiation and hyperthermia became less than additive. It was concluded that the thermosensitivity of irradiated blood vessels in skin and muscle for 3-4 weeks postirradiation was at least similar or greater than that of unirradiated controls. The thermosensitivity of vessels appeared to decline 40 days after irradiation. PMID- 6856781 TI - Tissue, cellular, and subcellular distribution of 241Pu in the rat testis. AB - The distribution and localization of 241Pu in rat testes were determined by quantitative autoradiography. Rats were given an intravenous injection of 241Pu citrate and tissues were collected 1 week later. The tissue distribution of 241Pu was determined by light microscope autoradiography. Significant concentrations of 241Pu were observed in the interstitial tissue but not in seminiferous tubules. The cellular distribution and subcellular localization of 241Pu were determined by electron microscope autoradiography. Within the interstitial tissue, 241Pu was concentrated in macrophages. There was no preferential localization of 241Pu in any other interstitial tissue components. Within interstitial tissue macrophages, 241Pu was concentrated in the lysosomal system of the cell. Other organellar compartments of the cell did not preferentially incorporate 241Pu. The association of 241Pu with the macrophage lysosomal system may explain the long retention times of Pu in testes as observed in experimental studies. PMID- 6856782 TI - Differences in replicon behavior between X-irradiation-sensitive L5178Y mouse lymphoma cells and A-T fibroblasts using DNA fiber autoradiography. AB - Replicon behavior in radiosensitive Ataxia telangiectasia (A-T) fibroblasts and mouse lymphoma L5178Y (LS) cells was studied by DNA fiber autoradiography. LS cells, irradiated at 13 Gy, showed a similar reduction in rate of DNA chain growth and initiation of replicons as did resistant (LR) cells. A progressive increase in the intensity of [3H]TdR labeling of many replicons was observed after irradiation in the LS cells, but not in LR cells. This indicated a reduced or absent endogenous dTTP supply after irradiation in the LS cells, implicating a defect in nucleoside precursor production. Irradiated normal human and A-T cells did not show this effect. After 2 Gy, the frequency of initiation of replicons into synthesis was temporarily reduced in the normal human but not in the A-T cells. After 20 Gy, the rate of DNA chain growth was preferentially reduced in the normal human cells, but an increase was observed in the A-T cells. This increased rate could be explained in terms of a normal supply of complexes involved in chain elongation being distributed over a reduced number of initiated replicon clusters in the A-T cells. PMID- 6856783 TI - Behavior of some enzymatic activities in the serum of rabbits after tissue damage by CO2 laser radiation. AB - A comparative evaluation of the biochemical damage observed after tissue injury by high-power CO2 laser, scalpel, and electrical diathermy has been made in rabbits. The tissue injury consisted of surgery performed by making two perpendicular linear cuts on the muscle of the posterior thigh. At different times after surgery, enzymatic levels of creatine kinase, aspartate amino transferase, and lactate dehydrogenase were determined in the serum. Only creatine kinase showed an increase, and it was lower in both extent and dispersion in the animals treated with CO2 laser. The results suggest that CO2 laser radiation caused damage to muscular tissue which was moderately lower compared to that from scalpel or electrical diathermy. PMID- 6856784 TI - Growth and differentiation of spermatogenetic colonies in the mouse testis after irradiation with fission neutrons. AB - The longitudinal outgrowth of spermatogenetic colonies arising from stem cells that survived neutron doses of 150, 300, and 350 rad was studied up to 30 weeks in histological sections of CBA mouse testes. Two methods were used: (1) the repopulation index (RI) as a measure of the length of total colonies per testis and (2) measurement of the individual length of all colonies in serially sectioned testes 4 and 15 weeks after 300 rad and 15 weeks after 350 rad. The mean initial growth of the colonies is linear up to 8, 15, and 20 weeks after 150, 300, and 350 rad, respectively. Although after these doses the mean initial colony growth rate did not differ significantly (about 27 microns/day), both methods showed that the colonies grow about 20% slower after 350 rad. Screening of individual colonies revealed a great variation in colony length per testis and a higher frequency of short colonies with higher neutron doses. Counting of colonies after 300 rad showed that all surviving stem cells had started to form a colony within 4 weeks after irradiation. The development of spermatogenetic cells to mature spermatozoa was studied after 100, 150, 300, and 350 rad in sections of repopulating tubules used for RI determination as well as in serial sections of individual colonies. Although after 300 and 350 rad spermatogenetic cell types beyond the stage of young spermatocytes reappeared 1 week late, we found no great disturbances in the regular reappearance of the successive spermatogenetic cell types after irradiation. However, from the study of individual colonies it appeared that colonies differ widely in their development even within one testis. Moreover, the frequency of less developed colonies was higher after 350 rad than after 300 rad. Our data suggest that this retardation in the reappearance of further developed cells is caused by a delay in the production of developed cells in spermatogonia in an increasing fraction of the colonies after higher neutron doses. Even in fully developed colonies the production of differentiating spermatogenetic cell types was subnormal after 300 and 350 rad. This was caused by an extensive cell degeneration in the colonies as well as by a tendency of the undifferentiated and/or A1-spermatogonial population to increase its own number at the cost of the production of further developed cells. PMID- 6856785 TI - Gamma-ray-enhanced reactivation of irradiated adenovirus in Xeroderma pigmentosum and Cockayne syndrome fibroblasts. AB - A gamma-ray-enhanced reactivation (gamma RER) of uv-irradiated as well as of gamma-irradiated human adenovirus type 2 (Ad 2) was detected following infection of normal, Xeroderma pigmentosum (XP), and Cockayne syndrome (CS) fibroblasts that had been preirradiated with gamma rays. Gamma-irradiated or nonirradiated fibroblasts were infected with either nonirradiated or irradiated Ad 2, and 48 hr after infection cells were examined for the presence of viral structural antigens (Vag) using immunofluorescent staining. Results obtained using seven different normal fibroblast strains showed that irradiation of host monolayers with 1 krad immediately prior to infection resulted in a gamma RER factor +/- SE of 4.5 +/- 1.6 for uv-irradiated virus and 4.3 +/- 1.3 for gamma-irradiated virus. CS fibroblasts, as well as excision repair-deficient XP fibroblasts from complementation groups A and D, were all found to be capable of expressing gamma RER of irradiated Ad 2. XP variant cells expressed lower levels of gamma RER compared to most normal strains, suggesting a possible role for cellular postreplication repair in the mechanism responsible for ER in human cells. An excision-deficient XP fibroblast strain belonging to complementation group A, but derived from a patient afflicted with the severe De Sanctis-Cacchione form of XP, although proficient in gamma RER of gamma-irradiated Ad 2, yielded barely detectable levels of gamma RER for uv-irradiated Ad 2. PMID- 6856786 TI - Rapid rejoining of DNA strand breaks in resting human lymphocytes after irradiation by low doses of 60Co gamma rays or 14.6-MeV neutrons. AB - The production and repair of DNA strand breaks was studied in human lymphocytes by means of a sensitive fluorometric technique. Lymphocytes were isolated by conventional methods and air-equilibrated suspensions were irradiated by low doses (less than or equal to 2 Gy) of either 60Co gamma rays or 14.6-MeV neutrons at 0 degree C. The apparent yield of initial strand breaks induced by neutrons was only 36% of that induced by gamma rays, in agreement with the observations of other workers. Resting lymphocytes were found to be proficient in their ability to rejoin gamma-induced strand breaks at 37 degrees C; rejoining followed biphasic kinetics, with 70% of the breaks disappearing with a half-life of about 3 min. Although the initial number of breaks induced by neutron irradiation was low, after 20 min of incubation the residual number of breaks was very similar for the two forms of radiation. PMID- 6856787 TI - The effect of single-dose radiation on cell survival and growth hormone secretion by rat anterior pituitary cells. AB - Cranial irradiation has been shown to impair growth hormone secretion in children. In this study a cell culture of dispersed rat anterior pituitary cells was exposed to single doses of radiation in the range of 100-1500 rad: Survival curves were obtained for the different anterior pituitary cell lines, and growth hormone secretion was measured in the tissue culture medium. Both survival and growth hormone secretion curves showed an initial shoulder in the range of 0-300 rad, followed by a decline between 300-750 rad. It is concluded that growth hormone secreting acidophilic pituicytes are sensitive to radiation at single doses greater than 300 rad. PMID- 6856789 TI - [Principles of a new concept for the estimation of radiation burden and risk to patients in radiologic examinations]. PMID- 6856788 TI - Cataract production in mice by heavy charged argon, neon, and carbon particles. AB - The cataractogenic potential in mice of heavy charged particles from the Bevalac was examined in relation to dose, linear energy transfer (LET), and time following exposure. BALB/c X C57/b1(6) (CB6F1) mice were exposed to graded single doses (0.05-0.9 Gy) of 570-MeV 40Ar, 425-MeV 20Ne, or 400-MeV 12C particles in the plateau portion of the Bragg curve. Lenses were examined by slit lamp biomicroscopy over a 21-month period. The cataract severity was scored subjectively on a scale of 0 to 4 and compared to the opacities induced by 225 kVp X rays. Both the onset and density of the lens opacities were related to dose, and opacification progressed throughout the entire period of observation. In terms of degree of opacification and rates of onset and progression, the cataractogenic response to 40Ar particles was greater than to either 20Ne or 12C particles. Discrimination between the effects of 20Ne and 12C was possible only at the higher doses employed (0.6 and 0.9 Gy) and only at some observation times. Based on average cataract density at the several observation times, the relative biological effectiveness (RBE) of 40Ar particles is estimated to be 3 to 5 over a cataract score range of about 1.5-3.0 (0.15-0.9 Gy). The RBE for 20Ne and 12C particles is probably somewhat greater than 1.0. The consistency of replicate lens examinations and challenges of the subjective scoring system are discussed. PMID- 6856790 TI - [Estimation and effective equivalent dose and risk of nuclide-examined patients in East Germany]. PMID- 6856791 TI - [Recurrence of skin tumors]. PMID- 6856792 TI - Radiation risks to the patients in diagnostic nuclear medicine in Bulgaria, 1980. PMID- 6856793 TI - [Method for measurement of placental circulation in pregnancy]. PMID- 6856794 TI - [Delayed effects of irradiation. Blood formation in irradiated and unirradiated areas of the bone marrow (histologic findings)]. PMID- 6856795 TI - Factor analysis of the laboratory blood examination in research workers with ionizing radiation. PMID- 6856796 TI - Radioresponse of peripheral blood and its modification by MPG (2 mercaptopropionylglycine) in mice III leucocyte. PMID- 6856797 TI - Changes in the blood and haemopoiesis of rats exposed to exponentially decreasing dose rates of continuous gamma irradiation. I. Peripheral blood count. PMID- 6856798 TI - Changes in the blood and haemopoiesis of rats exposed to exponentially decreasing dose rates of continuous gamma irradiation. II. Cytological and cytogenetic changes in the bone marrow. PMID- 6856799 TI - [So-called preventive irradiation of cervical lymph duct in patients with malignant nasopharyngeal tumors]. PMID- 6856800 TI - [Changes in the blood and haemopoiesis of rats exposed to exponentially decreasing dose rates of continuous gamma irradiation. III. Serum proteins]. PMID- 6856801 TI - [Lung lesions in lymphogranulomatosis]. PMID- 6856802 TI - [Increased risk of myocardial infarct in left-sided breast and bronchial cancer]. PMID- 6856803 TI - [Use of a C-arch roentgen unit in afterloading radiotherapy]. PMID- 6856804 TI - [Radiopharmacology--status and trends]. PMID- 6856805 TI - [Hepatobiliary and renal excretion of Rotop-EHIDA--animal experimental studies]. PMID- 6856806 TI - Hyperthermia: a developing modality with potential for clinical application. PMID- 6856807 TI - The future of health care: a reflection of past issues. AB - Planning for the future of the health delivery system demands a basic understanding of the past and current pressure upon the system. A review of the economic pressures, the particular problems of the poor, the concerns of radiological technologists and other allied health professions, and the doctoral level providers, offers some direction for a continued maturation of the system of care. PMID- 6856808 TI - Distribution of Jungian personality types in an associate degree radiography program. PMID- 6856810 TI - Template film method: a new technique. PMID- 6856809 TI - Geometrical fallacies. AB - Below is a review of the main geometrical points made in this paper. 1) Distortion is caused by: a. angling the beam against any spherical anatomy. b. leaving the beam perpendicular to the film when the part is tilted. c. angling the beam perpendicular to the part when it is tilted. 2) Distortion is negligible or absent when: a. angling the beam against a part that is parallel to the film. b. angling the beam one-half of the tilted-part-film angle. c. not angling when the part is parallel to the film. d. tomographing. 3) Magnification is not caused by: a. angling the beam, regardless of tube-to-tabletop distance compensation. b. tomography. 4) To evaluate a radiograph for positioning rotation, tilt, or flexion/extension, the pair of anatomical parts observed should be: a. stable and immovable. b. with their long axes nearly perpendicular to the direction of shift being evaluated. c. as close to the CR or center of the film as possible. d. as far from each other and from the midline as possible. Many of the geometrical factors involved in radiography are more complex than we often appreciate. They are sometimes taught in the form of "blanket" statements or rules that are oversimplified. Nonspecific, vague, or "blanket" questions in this area should be avoided in constructing the registry examinations. Finally, teaching in radiography should be based upon objective, repeatable, and verifiable experimentation rather than on appeal to authority. Such an approach will not only make radiography training more accurate, but also more exciting and fun. PMID- 6856811 TI - The role of a research technologist in hyperthermia. PMID- 6856812 TI - [Morphology and dynamics of the spinal column]. AB - The function of the vertebral column--the supporting axial component of the body- can only be understood by detailed knowledge of its structure. For this reason the first part of the article gives a report of the latest findings on the ligaments and zygapophysial joints of the vertebral column. Particular emphasis has been laid on the functional cooperation of these ligaments and joints during movements of the segments of the column. The second part of the paper is concerned with the dynamic behaviour of the column in children and young people, and is described in terms of the anatomical information given before. The damping capacity of the spinal column and its rigidity depend on both the age of the subject and the position of the body. In the axial direction the damping effect of the column is relatively slight, but it becomes markedly increased during ventral flexion. PMID- 6856813 TI - [B-scan sonography of the carotid artery]. AB - 176 sonograms of carotid arteries are compared with the corresponding angiograms to evaluate the diagnostic possibilities of B-mode sonography in detecting arteriosclerotic vessel disease. Ultrasound tomography is proved to be a reliable method to rule out arteriosclerosis; the specificity of the investigation method is 100%. However, the diagnostic value varies concerning the visualization of different arteriosclerotic lesions. B-mode sonography is of minor significance in detecting arteriosclerotic ulcers. Fresh thrombi are often not diagnosed. The sensitivity of this investigation method therefore corresponds 85%. PMID- 6856814 TI - [Experimental studies on the question of tumor cell dislodgement following fine needle biopsy]. PMID- 6856815 TI - Liver size and its post-mortem change. PMID- 6856816 TI - Digital radiography of the chest: clinical experience with a prototype unit. AB - A prototype digital unit dedicated to chest radiography was used to examine 50 selected patients for a comparison study of the capability of digital images and conventional chest radiographs to reveal normal anatomic structures and a variety of pathologic states. The images in both modes were submitted for interpretation to seven experienced radiologists and a standardized questionnaire completed for each. Visibility of seven anatomic structures in the mediastinum was consistently better on the digital images than on the conventional radiographs. With minor exceptions, pathologic states were equally well seen in the two systems. Despite the less familiar viewing format of the digital images, the mean confidence levels achieved were higher than for those on the conventional radiographs; this difference was statistically significant both for normal anatomic structures (p = 0.001) and pathologic states (p = 0.01). The advantages and disadvantages of the digital technique are discussed. PMID- 6856817 TI - Neuroblastoma: diagnostic imaging and staging. AB - Results of computed tomography (CT), scintigraphy, excretory urography, and other imaging tests used to diagnose and stage 38 cases of neuroblastoma prior to treatment were reviewed. Findings of these examinations were correlated with clinical data, laboratory data, results of biopsy, and surgical findings. CT was the most sensitive single test (100%) for the detection and delineation of the primary tumor. Calcifications that suggested the histologic diagnosis of neuroblastoma were present in 79% of the cases. Rim calcifications, the most specific pattern for neuroblastoma, were identified in 29% of all cases. CT alone accurately staged 82% of cases; when complemented by bone marrow biopsy, staging accuracy was 97%. CT alone was more accurate than any combination of imaging tests that excluded CT. An algorithm using CT is presented for the diagnosis and staging of neuroblastoma at reduced cost and with increased efficiency. PMID- 6856818 TI - Recurrent neuroblastoma: the role of CT and alternative imaging tests. AB - One hundred twelve CT scans of 52 patients who were receiving treatment for neuroblastoma were reviewed for accuracy, and findings were correlated with data obtained from other imaging tests, physical examinations, laboratory tests, biopsies, surgery, and long-term clinical follow-up. CT was the most sensitive imaging test for tumor recurrence (85% detection rate), and it was also the most versatile in the ability to define recurrent disease in the retroperitoneum, liver, cranium, mediastinum, lymph nodes, and skeleton. All 30 tumor recurrences were detected by the combination of CT, bone-marrow biopsy, and selected spot radiographs at the sites of pain. CT was accurate and clinically useful both for assessing tumor response to therapy and for predicting findings at "second look" surgery (accuracy, 94%). CT is relatively cost effective by substituting for a more expensive but less accurate combination of competitive imaging studies. PMID- 6856819 TI - Yersinia enterocolitica colitis in infants: radiographic changes. AB - Radiographic changes of Yersinia enterocolitica colitis in 3 infants are presented. Findings included superficial aphthoid ulcers, submucosal ulcers, pancolitis (manifested by toxic megacolon), and involvement of the terminal ileum. PMID- 6856820 TI - Congenital diaphragmatic hernia diagnosed prenatally by ultrasound. AB - Seven infants born at our institution between July 1979 and June 1982 had congenital diaphragmatic hernia (CDH). Four cases of CDH were correctly identified by fetal ultrasonography. Diagnosis relied upon the demonstration of abdominal organs within the thorax. During this period, no false positive diagnoses of CDH were made. Significant associated sonographic features included polyhydramnios, mediastinal displacement, and distorted upper abdominal anatomy. PMID- 6856821 TI - Sonography of imperforate anus. AB - Real-time sonography provides a noninvasive method of determining the level of obstruction in patients with imperforate anus. The authors describe one technique for evaluating this anomaly which was employed in 6 neonates. A pouch-perineum distance of less than 1.5 cm is consistent with a low lesion, while a pouch that terminates above the base of the bladder is indicative of a high lesion. PMID- 6856822 TI - Intravenous digital subtraction angiography in the investigation of intracranial disease. AB - Eighty-six patients who presented with a variety of intracranial lesions were examined with intravenous digital subtraction angiography (IV-DSA). A grading system was used to evaluate the ability of IV-DSA to answer specific diagnostic questions regarding intracranial tumors, vasospasm following subarachnoid hemorrhage, lesions of the sella, dural sinus occlusion, and post-therapeutic embolization. Eighty-four per cent of the examinations provided clinically useful information. In 15% of the cases limited but useful information was obtained; only 1% of the examinations provided no useful information. We conclude that IV DSA can routinely provide useful information in the evaluation of the variety of intracranial lesions described above. PMID- 6856823 TI - Computed tomographic identification of calcified optic nerve drusen. AB - Four cases of optic disk drusen were accurately diagnosed with orbital computed tomography (CT). The radiologist should be aware of the characteristic CT finding of discrete calcification within an otherwise normal optic disk. This benign process is easily differentiated from lesions such as calcific neoplastic processes of the posterior globe. CT identification of optic disk drusen is essential in the evaluation of visual field defects, migraine-like headaches, and pseudopapilledema. PMID- 6856824 TI - Differential CT diagnosis of extruded nucleus pulposus. AB - The detection and differential diagnosis of extruded (free) disk fragments by CT has not been described in detail. We reviewed the lumbar CT scans of 57 patients with extruded disk fragments and of 31 patients in whom the CT appearance of disk fragments was simulated by other processes. An extruded disk fragment commonly appears on CT scans as an epidural mass that must be distinguished from either an epidural tumor or an anomalous root sheath. A normal posterior disk margin does not exclude a disk herniation when the nuclear fragment is extruded. Free disk fragments can be differentiated from root-sheath anomalies and tumors in most cases by measuring tissue densities and analyzing adjacent bone. PMID- 6856825 TI - Recurrent laryngeal nerve paralysis: a laryngographic and computed tomographic study. AB - Vocal cord paralysis is a relatively common entity, usually resulting from a pathologic process of the vagus nerve or its recurrent laryngeal branch. It is rarely caused by intralaryngeal lesions. Fourteen patients with recurrent laryngeal nerve paralysis (RLNP) were evaluated by laryngography, computed tomography (CT), or both. In the evaluation of the paramedian cord, CT was limited in its ability to differentiate between tumor or RLNP as the cause of the fixed cord, but it yielded more information than laryngography on the structural abnormalities of the larynx and pre-epiglottic and paralaryngeal spaces. Laryngography revealed distinct features of RLNP and is the procedure of choice for evaluation of functional abnormalities of the larynx until further experience with faster CT scanners and dynamic scanning of the larynx is gained. PMID- 6856826 TI - Computed tomography of the neck in the postoperative patient: radical neck dissection and the myocutaneous flap. AB - A prospective computed tomographic (CT)-clinical study was made of 40 consecutive patients who had undergone myocutaneous flap surgery of the neck and 30 consecutive patients who had undergone radical neck dissection. The postoperative CT appearance of tumor and infection is reviewed. The normal CT landmarks of the neck are also described. PMID- 6856827 TI - Nuclear magnetic resonance imaging of atherosclerotic disease. AB - Nuclear magnetic resonance (NMR) images of 93 patients undergoing studies of the abdomen and pelvis were studied for evidence of lesions of the aorta and the iliac and femoral arteries; atherosclerotic lesions were present in 13 of them. The lesions consisted of eccentric and concentric mural thickening with luminal narrowing and discrete plaques protruding into the vessel lumen. This appearance was distinctly different from the morphology of the internal vessel surface and uniformly thin vessel wall in normal patients and volunteers under the age of 30 years. Intraluminal flow signals observed in atherosclerotic and nonatherosclerotic subjects could be distinguished from mural lesions because of their lack of contiguity with the vessel wall and variation in appearance on multiple images obtained with the first and second spin echo. This initial experience suggests a potential role for NMR in the noninvasive imaging of atherosclerotic lesions. The natural contrast between flowing blood and the vessel wall indicates a distinct advantage of NMR for vascular imaging. PMID- 6856829 TI - Intra-arterial digital subtraction angiography: comparison with conventional hepatic arteriography. AB - To evaluate the efficacy of arterial digital subtraction angiography (DSA), 28 patients with a variety of hepatic lesions underwent intra-arterial DSA immediately following conventional celiac or hepatic arteriography. Thirty-one studies were obtained and the results of DSA were compared with the conventional arteriograms. DSA showed good visualization of the arteries in the early arterial phase of the examination. The late arterial phase was better evaluated on conventional arteriograms due to the decreased spatial resolution of DSA. Arterial DSA was most useful in the evaluation of the parenchyma of the liver; the use of remasking techniques allowed improved visualization of hepatic lesions, particularly in the left lobe of the liver. It is concluded that arterial DSA is useful in hepatic imaging and may supplant conventional hepatic arteriography as the technology improves. PMID- 6856828 TI - Nuclear magnetic resonance imaging of induced renal lesions. AB - Nuclear magnetic resonance (NMR) images obtained after unilateral ligation of the ureter, renal artery, or renal vein in the rat were analyzed and compared with NMR images of the normal rat kidney. Anatomic and functional correlation of the induced renal lesions was made by concurrent CT and by gross examination of the excised kidneys. Many normal anatomic structures at the level of the renal hilum can be identified by high resolution NMR imaging. Differentiation of urine from renal parenchyma permits detection of gross changes both in renal function and in the mass of the renal parenchyma. NMR imaging is capable of diagnosing hydronephrosis, acute renal ischemia, and acute venous congestion in this rat model. In addition, a trend toward prolongation of the relaxation times T1 and T2 for abnormal renal parenchyma is demonstrated. PMID- 6856830 TI - Work in progress: NMR anatomy of the larynx and tongue base. AB - The normal anatomy of the larynx and base of the tongue as seen on nuclear magnetic resonance (NMR) images was studied. Scans of normal volunteers were obtained using a 3.5 kilogauss (0.35 T) superconductive magnet and a 3.0 kilogauss (0.3 T) permanent magnet. The NMR images were compared with images obtained by CT and with anatomical sections of these regions. Although resolution is not comparable to that seen on scans obtained with modern CT equipment, there are some advantages to NMR imaging. These include availability of multiple projections, ease of identifying blood vessels and differentiating them from lymph nodes, and the possibility of improved tissue specificity. PMID- 6856831 TI - Nuclear magnetic resonance imaging of a fibrosarcoma tumor implanted in the rat. AB - Fibrosarcoma tumor cells were implanted in the hind legs of 25 rats and studied from the first to the sixth week postimplantation. Nuclear magnetic resonance imaging detected all tumors and did not yield any false-positives in five control rats. The T1 relaxation values of tumors overlapped those of muscle, and the T2 values overlapped those of fat, but the combination of the two values allowed discrimination of each of the three tissues with no overlap. The difference in relaxation time between tumor and muscle could be accounted for on the basis of water content, which was approximately 14% higher in the tumors. This study confirms data from previous studies suggesting that nuclear magnetic resonance imaging is a highly sensitive modality, but that T1 and T2 values are not specific for individual pathologic conditions. PMID- 6856832 TI - Nuclear magnetic resonance characteristics of fresh and fixed tissue: the effect of elapsed time. AB - The nuclear magnetic resonance relaxation times T1 and T2 of liver and spleen from freshly euthanized rats were measured over 48 hours for samples treated with normal saline, fixed with 70% ethanol, neutral buffered formalin, or 10% formalin, or left untreated. The initial values of T1 and T2 for both tissues agreed with previous determinations. For untreated tissues of both liver and spleen, T1 was stable for 6 hours and T2 was stable for 48 hours. For fixed tissues, T1 was stable for 0.5 hours, but T2 changed in 0.5 hours. PMID- 6856833 TI - Hemoperitoneum studied by computed tomography. AB - Three hundred patients who had sustained blunt abdominal injury were evaluated with computed tomography (CT). The images showed areas of hemorrhage by varying attenuation coefficients (average, 45 Hounsfield units; exceeding 30 Hounsfield units in all cases except in those patients with bleeding more than 48 hours old). Small hematomas tended to accumulate near the site of origin while free intraperitoneal bleeding most frequently accumulated in the Morison pouch, paracolic gutters, and pelvis. CT estimates of the extent of hemoperitoneum (small, moderate, or large) correlated well with clinical assessments and surgical findings. Only one false-negative and two false-positive CT interpretations occurred, and each was potentially avoidable in retrospect. CT is sensitive and specific for the diagnosis of hemoperitoneum and can estimate the extent and probable source of bleeding. This information may obviate the need for a peritoneal lavage and laparotomy in many instances. PMID- 6856834 TI - Large-cell lymphoma of the spleen: CT appearance. AB - CT and histopathological findings were correlated in 5 patients with large-cell lymphoma who presented with splenic enlargement. Prominent CT findings included splenomegaly with large solitary or multiple areas of low attenuation. The clinical presentation and operative findings are reviewed. PMID- 6856835 TI - Mycosis fungoides: manifestations on computed tomography. AB - Mycosis fungoides is a malignant lymphoma of the skin that causes intense erythema, plaques, edema, and induration. The primary computed tomographic findings of mycosis fungoides, i.e., skin thickening, tumorous infiltration, edema of the soft tissues, and lymphadenopathy, are presented in two patients. PMID- 6856836 TI - The traumatized scrotum. Ultrasound evaluation. AB - Testicular salvage rates are improved markedly when surgical correction of a ruptured tunica albuginea is performed within 72 hours after a scrotal injury. The authors studied 11 patients who had suffered various types of blunt or penetrating trauma to the scrotum. The importance of ultrasound for the evaluation of the traumatized scrotum and detection of a testicular rupture is stressed. The spectrum of abnormalities that may be present after a scrotal injury is described. PMID- 6856837 TI - Scrotal masses with a uniformly hyperechoic pattern. AB - Eight scrotal masses which appeared homogeneously hyperechoic on ultrasound were studied; 5 were testicular and 3 were extratesticular. Pathologically, there was no evidence of malignancy, and most lesions consisted of scar tissue or fibrosis. Two benign adenomatoid tumors were encountered. In this series, a homogeneously hyperechoic scrotal lesion was benign regardless of its location. PMID- 6856838 TI - Ultrasonically guided percutaneous opacification of a pancreatojejunostomy. PMID- 6856839 TI - Gangrenous cholecystitis: diagnosis by ultrasound. AB - Sonographic findings were analyzed in 19 patients with surgically proved gangrenous cholecystitis. In 8 patients (42%), there were no specific features that would allow differentiation from typical uncomplicated acute cholecystitis. However, in 11 patients (58%) atypical findings were present, including intraluminal membranes and/or marked irregularities of the gallbladder wall. These features are unusual in uncomplicated acute cholecystitis and should prompt close clinical observation for possible gangrenous cholecystitis. PMID- 6856840 TI - The Kimray-Greenfield filter: evaluation by duplex real-time/pulsed Doppler ultrasound. AB - The Kimray-Greenfield filter is a wire cage which is inserted into the inferior vena cava (IVC) to prevent thrombi originating in pelvic and leg veins from embolizing to the lungs. Duplex real-time/pulsed Doppler ultrasound was used to evaluate placement and function in 38 patients (46 examinations). Real-time examination successfully identified the IVC and filter in 89% of cases. Pulsed Doppler studies demonstrated flow above and below the filter in 76%, accurately predicting normal flow in most cases. In 4 patients, Doppler scans revealed little or no flow distal to the filter; contrast cavograms confirmed obstruction secondary to thrombosis. This appears to be an accurate, noninvasive method of assessing postoperative reliability of the Kimray-Greenfield filter. PMID- 6856841 TI - Work in progress. Gastrointestinal ulcerations: detection using a technetium-99m labeled ulcer-avid agent. AB - Technetium-99m-labeled sucralfate, an ulcer-avid material, was shown in preliminary animal and human studies to be stable in vivo with good sensitivity. Eight experimentally produced discrete gastric ulcers in three rabbits were visualized using this material. Of seven human studies, four studies were true positive and three were true-negative. It is suggested that Tc-99m-labeled sucralfate may prove to have significant clinical advantages for the evaluation of gastrointestinal ulcer disease and other diseases that are associated with loss of mucosal integrity. The method for labeling sucralfate with Tc-99m was developed by the authors. PMID- 6856842 TI - Radionuclide angiocardiography: an improved deconvolution technique for improvement after suboptimal bolus injection. AB - Deconvolution is a mathematical technique used to improve radionuclide angiocardiography after suboptimal injection of radiopharmaceutical. A new deconvolution algorithm designed to be relatively insensitive to the random errors that occur in experimental data was tested. First-pass radionuclide angiocardiography using iridium-191m was performed to quantitate left-to-right shunting in normal dogs and dogs with atrial septal defects. Deconvolution was used to correct for injection shape. Four quantitation techniques were studied (good injection/no deconvolution, good injection/deconvolution, fragmented injection/no deconvolution, fragmented injection/deconvolution). The mean (p less than .001) and standard deviation (p less than .0001) of the fragmented injection/no deconvolution technique were significantly different from the other three techniques, which were not significantly different from each other (mean or standard deviation) at the p = 0.05 level. This deconvolution method made it possible to accurately quantitate left-to-right shunts even with fragmented injections. PMID- 6856843 TI - Blood loss measured with indium-111-labeled red blood cells in dogs. AB - The authors describe a safe, simple, sensitive, and accurate technique of measuring moderate amounts of blood loss using erythrocytes labeled with indium 111. Donor red cells were labeled with indium-111 and tracer amounts infused into dogs. The magnitude of red cell loss was determined by the difference between two sequential volume measurements. The coefficient of variation of sequential measurements of the same red cell volume was 4.6 +/- 1%. The sensitivity of the technique, as determined by comparison of measured and estimated volumes, was 20.5 ml. The measured volume was related linearly to the calculated volume of red cells lost (r = 0.98). The authors recommend indium-111-labeled erythrocytes as a means of obtaining multiple measurements of small to moderate amounts of hemorrhage. PMID- 6856844 TI - Work in progress: californium-252 brachytherapy plus fractionated irradiation for advanced tonsillar carcinoma. AB - A feasibility trial of californium-252 neutron brachytherapy combined with fractionated cobalt-60 therapy for advanced but localized stage T4 tonsillar retromolar carcinoma is described. Seven patients with primary tumors who were not suitable for conventional radical surgery, chemoradiotherapy and surgery, or surgery plus irradiation were treated. There was complete tumor response in all cases. PMID- 6856845 TI - Nasopharyngeal carcinoma in the second decade of life. AB - The clinical findings and treatment results in 27 patients, 11 to 20 years of age, with nasopharyngeal carcinoma were retrospectively reviewed. The histological diagnosis was lymphoepithelioma in 18 patients and undifferentiated carcinoma in nine patients. Seven patients (26%) presented with T4 lesions, 24 patients (89%) with clinically positive cervical nodes, and two patients (7%) with distant metastases. All patients received radiation therapy to the primary site; chemotherapy was employed as an adjuvant in six patients. Overall survival was 64% at five years and 57% at 10 years. Local control of the primary tumor and regional lymph nodes was 85%. Distant metastases were more frequent in patients with advanced primary disease and were associated wtih extremely poor prognoses. A moderate dose of radiotherapy is the recommended treatment for primary tumors and neck nodes. More effective adjuvant chemotherapy is suggested as a possible way to improve therapeutic results. PMID- 6856846 TI - Pacemaker failure resulting from radiation damage. AB - The authors present a case of radiation-induced pacemaker failure. After 2,000 rad (20 Gy) of photon irradiation for metastatic bronchogenic carcinoma, the pulse generator circuitry failed, producing a "runaway" rhythm. This suggests that present pacemaker circuitry may be more susceptible to irradiation than previously believed, and that even modest radiation doses can induce life threatening arrhythmias. PMID- 6856847 TI - Digital radiography of the chest: design features and considerations for a prototype unit. AB - The general features of a prototype digital chest unit are described along with the rationale for the choice of design factors employed. It is shown that the scanning-slit, linear-detector-array approach employed can, with available x-ray tube technology, achieve a spatial resolution of 1 cy/mm and detector radiation levels comparable with those obtained with conventional screen-film systems. Also discussed are the unit's exposure latitude and its ability virtually to eliminate scatter. PMID- 6856848 TI - Work in progress: temporal energy hybrid subtraction in intravenous digital subtraction angiography. AB - A preliminary investigation of the feasibility and practical clinical utility of combined temporal energy (hybrid) subtraction for intravenous digital subtraction angiography (DSA) was performed in 19 selected patients. Studies of carotid, aortic arch, pulmonary, and aortorenal vessels were obtained. Soft-tissue misregistration artifacts were effectively removed with hybrid subtraction. Image integration was used to produce a signal-to-noise ratio equivalent to that of single frame temporal subtraction. Diagnostic improvements were produced in 20% of the examinations. Hybrid subtraction techniques resulted in an average increase of incident radiation dose to the skin of 15%. PMID- 6856849 TI - Computed tomography: beam hardening and environmental density artifact. AB - Phantoms designed to simulate cysts or avascular masses and other material encountered in computed tomographic (CT) body and head scanning were used to evaluate the effect of beam hardening in a GE CT/T 8800 scanner. The phantoms were scanned before and after the addition of iodinated contrast material to various compartments within the phantoms. The results indicate that in general the addition of contrast material in the CT body phantom resulted in a decrease in the CT numbers recorded from the cyst phantoms. Conversely, the addition of contrast material in a concentric peripheral cylinder (simulating the addition or presence of the calvarium in CT head scanning) resulted in a generalized inhomogeneous increase in CT numbers of specimen materials contained in that ring. PMID- 6856850 TI - Efficacy of prone positioning for intravenous digital angiography of the abdomen. AB - The authors perform intravenous digital angiography of the abdomen with the patient in a prone position. As a result, gas is reduced in the transverse colon and small bowel and vascular detail in the image is not obscured. PMID- 6856851 TI - A metric ruler for digital subtraction angiography. PMID- 6856852 TI - Parathyroid scanning by computed tomography. AB - Conventional parathyroid computed-tomographic scanning detected 51% (29/57) of tumors averaging 1.5 X 1.0 X 0.8 cm in size at surgery. Forty-six per cent (7/43) of the scans were uninterpretable due to shoulder-streak artifacts. Using a specially designed patient positioning device and a new imaging protocol involving dynamic scanning and the intravenous administration of a bolus of contrast material, 14 patients were scanned; 78% (18/23) of tumors averaging 1.4 X 1.0 X 0.8 cm in size were detected. All 14 scans were interpretable, and image quality was markedly improved. PMID- 6856853 TI - Percutaneous biopsy of difficult mediastinal, hilar, and pulmonary lesions by computed tomographic guidance and a modified coaxial technique. AB - A technique for biopsy of small or inaccessible mediastinal, hilar, or pulmonary lesions with computed-tomographic (CT) guidance is described. A modified coaxial system was used in order to make multiple passes possible without multiple punctures. The size of the original puncture needle (23 gauge) provided the inherent safety associated with a fine needle. All repositioning was done using this needle and CT until the lesion was engaged. The hub of the needle was then cut, and a 19-gauge needle was inserted coaxially over the larger needle. After removal of the 23-gauge needle, multiple biopsy specimens were then obtained coaxially with a 22-gauge needle through the 19-gauge needle. One small pneumothorax and no bleeding occurred in 10 instances. Results suggest that the combined use of CT guidance and this modified coaxial system may offer an extra margin of safety for difficult cases. PMID- 6856854 TI - New coaxial exchange guide wire with a variable-length tip. AB - A new coaxial exchange guide wire, which has a variable-length, flexible "J" shaped tip for exchanging drainage catheters in both large and small structures, is described. The design provides a gradual transition from the softness of the tip to the stiffness of the cannula. The system is presently available in two sizes (0.89 mm [0.035 in.] and 0.64 mm [0.025 in.]) and can also be used as a catheter end-hole dilator. PMID- 6856856 TI - Liver biopsy through the transjugular approach. Modification of instruments. AB - Two modifications of the needle to facilitate transjugular biopsy of the liver are described. The bevel is reversed to prevent perforation of the catheter by the needle, and a stylet is placed within the needle to prevent aspiration of fragmented specimens into the syringe. PMID- 6856855 TI - Vascular catheterization using a rigid guide. PMID- 6856857 TI - Simplified brush biopsy of the bile ducts. AB - A simple and convenient technique is presented for the performance of transluminal brush biopsies of biliary tract lesions. Since a guide wire is maintained in position through the obstruction, the technique can be performed at any time without loss of access to that lesion. PMID- 6856858 TI - Percutaneous transhepatic insertion of a jejunal feeding tube. AB - The insertion of a jejunal feeding tube through the same track used to decompress the biliary system is described in a patient with biliary and gastric outlet obstruction. PMID- 6856859 TI - Aspiration of enlarged parathyroid glands for parathyroid hormone assay. AB - Enlarged parathyroid glands were percutaneously aspirated under computed tomographic (CT) control in 7 patients, and levels of parathyroid hormone (PTH) and human thyroglobulin (HTg) were measured. All 7 patients had high levels of PTH in at least 1 specimen. It is concluded that the measurement of high concentrations of PTH in the aspirate from a cervical or mediastinal mass, with CT documentation of needle position, provides absolute localization of parathyroid masses. PMID- 6856860 TI - A comparative study of mesothelioma and asbestosis using computed tomography and conventional chest radiography. PMID- 6856861 TI - High-resolution dynamic ultrasound imaging of the carotid bifurcation: a prospective evaluation. PMID- 6856863 TI - Double-contrast small-bowel examination with barium and methylcellulose. AB - A modification of the small-bowel enema with barium and methylcellulose is described and findings in 300 consecutive examinations compared with the clinical diagnoses. The radiograph was positive in 37% of cases and the clinical examination in 29%. Diseases and abnormalities of the small bowel, including motility disorders, can be diagnosed with high sensitivity and specificity using this technique. PMID- 6856862 TI - Nonionic and dimeric ionic contrast agents. PMID- 6856864 TI - Control of hypertension by ethanol renal ablation. AB - Five patients underwent therapeutic renal ablation with intraarterial injection of ethanol as treatment for uncontrollable systemic hypertension. All patients either showed complete resolution of the hypertension or improved medical manageability of the hypertension became possible. Ethanol appears to cause permanent renal ablation by cell death while decreasing the risks associated with other embolization techniques. PMID- 6856866 TI - Thin needle aspiration biopsy of thoracic lesions: impact on hospital charges and patterns of patient care. AB - All patients who were admitted over a two-year period for evaluation of undiagnosed intrathoracic masses were selected for study. We assessed the impact of thin needle aspiration biopsy (TNAB) of thoracic lesions on actual hospital charges and patterns of patient care. Findings of TNAB reduced the need for diagnostic thoracotomy, shortened the time from admission to diagnosis, reduced the total number of thoracotomies, shortened the length of the hospital stay, and resulted in a significantly reduced average and total hospitalization charge. PMID- 6856867 TI - Percutaneous bone biopsy: the importance of aspirated osseous blood. AB - The diagnostic value of the microscopic examination of bone core specimen versus osseous blood, obtained by 110 percutaneous biopsies performed on 100 patients, was evaluated. A diagnosis of malignancy was made by biopsy in 54 cases. In 52 cases in which osseous blood (clot and smears) was available for examination, a positive diagnosis for malignancy was made microscopically in 49 (94%). In 46 cases in which bone cores were studied separately, a microscopic diagnosis of malignancy was made from the bone core in 39 (85%). If osseous blood had not been available for examination only 39 (72%) of the 54 biopsies would have been positive for malignancy; the other 14 biopsies would have been classified as either negative or insufficient for diagnosis. In those biopsies where both bone cores and osseous blood were available, the osseous blood showed better malignant tissue morphology and was considered better diagnostic material in 19 cases, whereas bone cores were considered better diagnostic material in only three cases. Osseous blood, which is usually easily available in bone biopsies, is valuable diagnostic material; it should be treated as a tissue specimen and not discarded. PMID- 6856865 TI - Work in progress: reduction of calcium activity by radiopaque contrast media. AB - An in vitro examination of the effects of radiopaque contrast media anions, cations, additives, and ionic strength on ionic calcium level using ion-specific electrodes was made. The calcium-binding additives sodium citrate and sodium EDTA produced the largest reduction in ionic calcium. At the same iodine concentration the anions diatrizoate, iothalamate, metrizoate, and ioxaglate reduced ionic calcium by essentially the same amount. Sodium compounds reduced ionic calcium more than did meglumine compounds, a difference that is probably related to dissociation. The nonionic compounds iohexol and iopamidol did not reduce ionic calcium significantly. Ionic strength appears to have little direct effect on ionic calcium at and above physiologic levels. All ionic contrast media bind significant amounts of ionic calcium at the high concentrations achieved during selective arteriography. Since the anions are only weak calcium binders supplemental calcium can restore the level of ionic calcium. PMID- 6856868 TI - Evaluation of aorto-iliac occlusive disease by intravenous digital subtraction angiography. AB - Intravenous digital subtraction angiography (DSA) was used to evaluate 22 patients with Leriche syndrome. The technique successfully demonstrated both the level of obstruction and the reconstitution of arterial flow to the lower extremities. In view of the relative safety of DSA, compared with the axillary approach in standard angiography, the authors believe that it should be the initial procedure for presurgical evaluation of Leriche syndrome. PMID- 6856869 TI - Cadaver radiography in the teaching of gross anatomy. AB - The authors describe a new teaching method for first-year medical students, involving preparation and use of cadaver radiographs in the gross anatomy laboratory. A standard series of radiographs of each cadaver was obtained prior to dissection and provided to each group of students. This technique offers a unique opportunity for radiographic/anatomical/pathological correlation, facilitates an understanding of complex anatomical relationships, and illustrates the application of anatomical knowledge to clinical practice. It can also generate intense student enthusiasm and improve student-faculty communication and teaching relationships. PMID- 6856870 TI - Spermatic vein obliteration using hot contrast medium in dogs. AB - Obliteration of varicoceles in men with infertility has been shown to improve semen quality and increase fertility rates. Many current techniques involve complex procedures and specialized equipment and may be associated with adverse effects. Transcatheter thermal vessel occlusion was utilized for spermatic vein obliteration in dogs. Diatrizoate (76%) contrast medium at a temperature of 100 degrees C was injected into canine spermatic veins. Follow-up venography and histologic examination revealed thrombosis of the injected veins without damage to the surrounding tissues in all cases. Clinical and laboratory examination of the animals revealed no adverse systemic effects. It is concluded that transcatheter thermal venous occlusion is an effective technique for spermatic vein occlusion in a canine model. PMID- 6856872 TI - Treatment of sleep disorders I: insomnia. PMID- 6856871 TI - Ureteroileal anastomotic leaks: percutaneous treatment. AB - Interventional techniques are increasingly important in patient care. We present new uses of these techniques in each of three patients who had rapidly deteriorating clinical status due to an anastomotic leak following the creation of a ureteroileal conduit. To divert urine flow and to promote healing, large bore nephrostomy tubes were placed percutaneously. Silastic ureteral stents were placed from above to help divert flow of urine, and to prevent the formation of strictures. The procedures, the nephrostomy tubes, and the stents were all well tolerated, and the clinical status of the patients improved rapidly. These three patients left the hospital with tubes and stents in place, and complete healing occurred without complications in one to three months. Following removal of the nephrostomy tubes and stents, all patients had good preservation of renal function and normal loopograms. PMID- 6856873 TI - Treatment of sleep disorders II: narcolepsy. PMID- 6856874 TI - Gas chromatographic--mass spectrometric quantitation of 16, 16-dimethyl-trans delta 2-PGE1. AB - Di-deuterated and di-tritiated 16,16-dimethyl-trans-delta 2-PGE1 has been synthesized and used for development of a GC-MS method for quantitation of corresponding unlabelled drug in patient plasma. Although these carrier/internal standard molecules only contain 2 deuterium atoms the lower limit of detection at each injection is as low as about 40 pg. The maximum plasma levels of this drug following administration of vaginal suppositories used in clinical studies (1 mg 16,16-dimethyl-trans-delta 2-PGE1 methyl ester in 0.8 g Witepsol S-52) were 100 350 pg/ml i.e. in the same order of magnitude as earlier seen for 16,16-dimethyl PGE2. PMID- 6856875 TI - Secretogogue responses of leukotriene C4, D4: comparison of potency in canine trachea in vivo. AB - By the use of close arterial injection of leukotrienes into the circulation supplying the upper cervical canine trachea, it has been possible to assess the secretogogue effects of leukotriene C4, and D4 on mucus secretion. Both LTC4 and LTD4 increased mucus secretion over baseline levels by a statistically significant level (p = less than 0.05). LTD4 was more potent than C4 with relative potencies of 2500, 320, 630, and 500 based on hillock formation (a measure of secretion) at 1, 2, 3, and 4 minutes after injection. The overall difference in potency in this animal model of mucus production was LTD4 greater than C4 by 1000-fold. PMID- 6856877 TI - Vasopressin retards the acquisition of positively reinforced lever pressing in homozygous Brattleboro rats. AB - Previous studies have indicated that vasopressin treatment improves the poor performance of congenitally vasopressin deficient (Brattleboro) rats on shock avoidance paradigms, an effect thought to relate to the peptide's enhancement of mnemonic processing. In the present study, a food rewarded autoshaping task was used to study the acquisition, retention, extinction and subsequent re acquisition of lever pressing. Vasopressin (1 microgram/rat, subcutaneous) was found to impair acquisition in these animals. The possibility that this deleterious effect was due to a transient suppression of motor capability was tested in a second experiment. Vasopressin increased overall locomotor activity levels, but there was an indication that rates immediately following injection were lower than usual. An explanation for the effects of vasopressin based on arousal enhancement is discussed, and it is suggested that the neuropeptide may be concerned with the regulation of arousal and hence performance. PMID- 6856878 TI - [Determination of gamma-ray peak efficiency including self-absorption correction for bulk environmental samples]. PMID- 6856876 TI - Conversion of 8,11,14-eicosatrienoic acid to 11,12-epoxy-10-hydroxy-8 heptadecenoic acid by aorta. AB - Particulate fractions from fetal calf aorta convert 8,11,14-eicosatrienoic acid to a number of products derived from 12-hydroperoxy-8,10-heptadecadienoic acid, including 2 stereoisomers of 11,12-epoxy-10-hydroxy-8-heptadecenoic acid (11,12e 10h-17:1), which were identified by mass spectrometry. In the early stages of the reaction, considerable amounts of the epoxyhydroxy isomers were formed, but the amounts of these products decreased as the reaction continued. There was a concomitant increase in the formation of 10,11,12-trihydroxy-8-heptadecenoic acid (10,11,12th-17:1), which was present only in small amounts initially. Incubation of the 2 isomers of 11,12e-10h-17:1 with microsomal and cytosolic fractions resulted in their conversion to isomers of 10,11,12th-17:1. No hydrolysis of the epoxides occurred in the presence of boiled tissue fractions. PMID- 6856880 TI - [Determination of Ca/P atomic ratio in calcium-hydroxyapatite by neutron activation analysis]. AB - The Ca/P atomic ratios of synthesized calcium-hydroxyapatite (Ca10(PO4)6(OH2) were determined by neutron activation analysis. In order to obtain calibration curves, the standard samples, such as calcium monohydrogenphosphate, calcium dihydrogenphosphate, etc., were prepared. gamma and beta ray spectra, and beta ray intensities of calcium-hydroxyapatite and standard samples irradiated with reactor neutrons were measured by using a Ge(Li) detector, a low background beta ray spectrometer and GM detector. Based on these results, deviation coefficient of the calibration curve, accuracy of the Ca/P atomic ratio, minimum determination limit, etc. were compared in detail. From the present analysis, the Ca/P atomic ratio of calcium-hydroxyapatite was able to obtain with the standard deviation of about 2% for 1 mg sample. PMID- 6856879 TI - [Determination of 238U, 234U, 226Ra and 228Ra in spring waters of sanin district]. AB - The 238U, 234U, 226Ra and 228Ra concentrations in the spring waters at the Sanbe and Misasa districts in Japan were investigated. In the spring water at Sanbe, high concentrations of the natural nuclides described above were found in which the maximum levels of 238U and 234U were 0.44 Bq/l and 0.91 Bq/l, respectively, while 234U/238U showed the range of 1.50 approximately 2.37. The maximum levels of 226Ra and 228Ra were found to be 1.95 Bq/l and 0.76 Bq/l, respectively, while 228Ra/226Ra mean value was 0.49. In the spring water at Misasa, the maximum levels of 226Ra and 228Ra were 0.60 Bq/l and 0.41 Bq/l, respectively, and 228Ra/226Ra mean value was 0.55. From the above-mentioned result and the fact that 228Ra is a decayed product of 232Th, it is thought that the rocks of the Sanbe and Misasa districts contain much uranium and thorium. PMID- 6856881 TI - [Clinical evaluation of the hepatobiliary scintigraphy using 99mTc-N-pyridoxyl-5 methyl tryptophan (99mTc-PMT)]. PMID- 6856882 TI - [Fundamental studies of RIA kit for anti rubella]. PMID- 6856884 TI - [Excessive external femoro-patellar pressure: value of direct radiological examination]. PMID- 6856883 TI - Studies on the percutaneous absorption of paeonol in experimental animals by a radioactive tracer technique. AB - Studies on in vivo percutaneous absorption of paeonol (2-hydroxy-4 methoxyacetophenone: I) in rabbits, guinea pigs, and rats were carried out by a radioactive tracer technique. Hydrophilic ointment (specific activity: 376 Bq (0.01016 microCi)/mg) containing I[carbonyl-14C] was applied for 24 h by occlusive dressing treatment on the shaven back of experimental animals. Then, the 14C-activity in urine, which is the dominant excretion route, was determined for 8 days. Percentage excreted within 24 h after application to rabbits, guinea pigs, and rats were 42.8%, 46.5% and 52.0%, respectively. Urinary metabolites were identified as 2,5-dihydroxy-4-methoxyacetophenone, resacetophenone, and substrate I in all the case. PMID- 6856885 TI - [Traditional and selective radiological study of the small intestine. Current state and prospects]. AB - The author, having noted that in radiology the small bowel is frequently ignored in comparison with the other digestive areas, proposes a "contract" examination of the digestive tract. Such a method, involving the acceleration of the transit induced by two metoclopramide tablets administered a few minutes before the examination, allows the small intestine to be included in the traditional investigations of the digestive system and, therefore, its complete visualization. Thus, it is possible to perform a larger and more detailed study of the under-evaluated jejunal and ileal pathology. Radiodiagnostic problems which cannot be adequately interpreted by the "contract" examination should be clarified by enteroclysis, the latter being considered a selective method. PMID- 6856886 TI - [A simple method for the measurement of human gastric emptying: standardization of operative parameters]. AB - The radioisotopic techniques used for the measurement of gastric emptying in man require complex and expensive scintiscanners or gamma-cameras. In this investigation, a simple method utilizing a single and inexpensive detector was evaluated; in addition, the suitability of 99Tcm sulphur colloid as a label for solid meals was assessed. The procedure was found to be accurate and its reproducibility high. The calculated absorbed dose to the gut was very low. Both in vitro and in vivo studies indicate that the radiocolloid used is a food non adsorbable marker for determining gastric emptying of solids. In a group of 50 healthy volunteers the emptying half-time (t1/2) ranged between 40 and 110 min, with a mean of 71.7 +/- 10.1 min, the male subjects exhibiting a significant lower t1/2 than females. In 5 volunteers with t1/2 within the normal range, the effect of drugs acting on gastric motility was evaluated. Hyoscine N-butyl bromide (20 mg) significantly delayed gastric emptying of solids, whereas metoclopramide (20 mg) was ineffective in these subjects. On the contrary, this drug was able to accelerate gastric emptying only in some patients with abnormally delayed emptying. On the whole, the method is simple, inexpensive and reproducible. It may be of great clinical value to investigate abnormalities of gastric function and to perform a better pharmacological approach to the medical treatment. PMID- 6856887 TI - [Results of a program of quality control in radiodiagnosis]. AB - The results of a program of quality control on about 30 tomographic and fluoroscopic radiological equipments in the Radiological Departments of Spedali Civili (Brescia, Italy), are reported; the physical performances of the beams (kVp, emission, linearity and reproducibility, HVL, focal spot size) and the geometrical conditions (alignment and beam size, thickness of cut for tomography, resolution and homogeneity) have been verified. During one month we have also verified the working conditions for two automatic film processing systems. Three commercial quality control equipments have been employed and tested. Our results recommend a periodic control of physical and geometrical performances (particularly kVp, emission and beam alignment) and a daily control of the working conditions for the film processing systems. The three quality control systems have given results each other comparable. PMID- 6856890 TI - [Angiographic study of a small intestinal neurinoma]. PMID- 6856889 TI - [Femoro-patellar congruence studied by dynamic axial radiography of the patellae]. PMID- 6856888 TI - [High-resolution computerized tomography with a special program of scanning and reconstruction: principles and results]. PMID- 6856891 TI - [Traumatic bending of the long bones in children]. PMID- 6856892 TI - [Diagnosis of diffuse pulmonary diseases. Symposium]. PMID- 6856893 TI - [Diffuse lung diseases of the interstitial, non-multinodular type]. PMID- 6856894 TI - [Serum dihydrotestosterone in studies of male fertility and infertility]. PMID- 6856895 TI - [Age at diagnosis of adult renal polycystosis. A health problem]. PMID- 6856896 TI - [Hospital infections in patients of the hematology service at our hospital. Preventive norms]. PMID- 6856897 TI - [Extrachromosomal resistance in enterobacteria isolated from hospital infections]. PMID- 6856898 TI - [Boutonneuse fever. Study of 6 patients]. PMID- 6856899 TI - [Fever of unknown origin. Analysis of 28 cases]. PMID- 6856902 TI - [Pathological rupture of the spleen secondary to polycythemia vera]. PMID- 6856901 TI - [Sjogren syndrome and systemic lupus erythematosus. Apropos of a case]. PMID- 6856903 TI - [Hepatic tuberculosis. Presentation of a case]. PMID- 6856900 TI - [Genital mycoplasma in pregnancy and in the newborn infant]. PMID- 6856904 TI - [Hepatic hydatidosis-hemoglobinopathy C. An unusual clinical association]. PMID- 6856905 TI - [Clinical use of S-adenosylmethionine]. PMID- 6856906 TI - [A new disease: acquired immune deficiency of homosexuals]. PMID- 6856908 TI - [Cardiac tamponade and constrictive pericarditis in the M-mode echocardiogram]. PMID- 6856909 TI - [Experimental hydronephrosis after ligation of 1 ureter. Various pathogenic aspects and renal structural and ultrastructural study]. PMID- 6856907 TI - [Erythrocyte levels of the enzyme ALA-dehydrase in various kinds and stages of liver disease]. PMID- 6856910 TI - [Nutritional effect of essential amino acid supplement during hemodialysis]. PMID- 6856911 TI - [Protein loss during peritoneal dialysis]. PMID- 6856913 TI - [Idiopathic myelofibrosis. Clinical description of 9 cases]. PMID- 6856914 TI - [Fasciola hepatica distomatosis. Apropos of 8 cases]. PMID- 6856912 TI - [Hepatic percutaneous biopsy in lymphoma]. PMID- 6856915 TI - [Eosinophilic fasciitis. Analysis of 3 new cases with atypical characteristics]. PMID- 6856916 TI - [Gardner syndrome. Apropos of 3 cases]. PMID- 6856917 TI - [Parathyroid gland carcinoma. Presentation of a case]. PMID- 6856918 TI - [Acute hemolytic anemia as a manifestation of Wilson's disease]. PMID- 6856919 TI - [Autoimmune hemolytic anemia 7 years after polycythemia vera]. PMID- 6856921 TI - [Sex of the first child : a risk co-factor in breast cancer?]. PMID- 6856922 TI - Drug utilization studies and epidemiology. AB - Drug utilization studies have developed rapidly over the last ten years to become not only a new tool of investigation for clinical pharmacology but also a source of suggestive information for epidemiology. This paper begins by reviewing the general terms of reference, with special emphasis on the WHO-recommended methodology based on defined daily doses (D.D.D.), then focuses on antidiabetic treatment, and antihypertensive therapy, and on the use of drugs in psychiatry, in pregnancy, in elderly people and in cancer patients. These examples are given to show how drug utilization studies can be of use for epidemiological studies. PMID- 6856923 TI - [Percutaneous insertion of the Swan-Ganz catheter via the internal jugular vein]. PMID- 6856924 TI - [Anesthesia in the cardiac patient subjected to general surgery: special reference to interactions between cardiologic drugs and anesthetics (I)]. PMID- 6856920 TI - The modified - Spillman model for asymptotic regression. AB - In order to describe teen-agers height growth a new asymptotic model called Spillman modified model is presented. The model introduces a non-linear enlargement of independent variable in the Spillman model and fits excellently to the observed data in comparison with the Spillman, logistic, Gompertz, and log inverse models. PMID- 6856927 TI - [Horner syndrome following epidural anesthesia]. PMID- 6856926 TI - [Hypoparathyroidism and anesthesia: apropos of 2 cases]. PMID- 6856925 TI - [Ventricular tachycardia of the Torsade de Pointes type as a postoperative complication]. PMID- 6856929 TI - [Anatomic vagotomy and pyloromyotomy. Experimental study]. PMID- 6856928 TI - [Extradural anesthesia in cesarean section using 0.75% bupivacaine and 1% etidocaine]. PMID- 6856931 TI - [In vitro neutralizing capacity of several antacid pharmaceutical preparations on the Spanish market. Practical implications]. PMID- 6856930 TI - [Hyperfunction of antral G cells with and without hyperplasia: apropos of 4 cases]. PMID- 6856932 TI - [Adenomas of the colon and rectum. Analysis of a series of 218 patients]. PMID- 6856934 TI - [Eosinophilic segmental enteritis with peritonitis]. PMID- 6856933 TI - [Treatment of the functional renal insufficiency in the cirrhotic patient using extraction, concentration and reinjection of his own ascitic fluid (Rhodiascit)]. PMID- 6856935 TI - [Acute ileocecal obstruction caused by an inflammatory pseudotumor of the cecum]. PMID- 6856937 TI - [Commentary on a new case of Dubin-Johnson syndrome]. PMID- 6856938 TI - [Cerebral abscess and pulmonary arteriovenous fistula. A clinical and respiratory function study]. AB - Liz... Josiane, a 9 year old girl, was admitted with a 24 hours history of severe headache and vomiting. On admission she was conscious, irritable and complained of a severe headache. Clinical examination revealed a right hemiparesis with cyanosis of the lips and extremities and clubbing of the fingers, all consistent with chronic hypoxia. Cardiovascular examination was normal apart from a systolic murmur which could be heard posteriorly under the left scapula. There were no angiomatous or telangiectatic lesions of the skin. A blood examination revealed a raised ESR, a marked polycythaemia with a decreased arterial oxygen tension. Chest x-rays showed the presence of an irregular well delineated opacity in the posterior basal segment of the left lower lobe. This opacity was confluent with the ipsilateral hilum and was suggestive of a pulmonary arteriovenous fistula. An intracranial space occupying lesion in the left temporal region of the brain was revealed by electroencephalographic and CT scan investigations; this proved to be an abscess which was surgically removed with no subsequent complications. Further radiological investigations of the chest revealed the pulmonary lesion was an arteriovenous aneurysm occupying the whole left inferior lobe. This was removed at thoracotomy three months after the acute neurological event. The results of respiratory function and regional isotopic investigations before and after surgery will be discussed. PMID- 6856936 TI - [Acute hepatitis following the administration of trithiozine. Apropos of a case]. PMID- 6856939 TI - [Diagnostic approach to pleurisy. Complementary cytologic and cytogenetic methods]. PMID- 6856940 TI - [Lymphomatoid granulomatosis and hypersensitivity pneumopathy. Clinical and biological study (serum and alveolar) toward a new pathogenic hypothesis of the disease]. AB - The authors discussed the malign form of lymphomatoid granulomatosis on the basis of two cases and consider the possible role of an aerocontaminant which is usually responsible for the extrinsic allergic type of alveolitis. A detailed biochemical and cytological study of the alveolar fluid from one of these patients is presented in parallel with immunofluorescent histology and electron microscopy of the lung. The observed biochemical abnormalities in the alveolar fluid could be superimposed on those formed in certain types of hypertensive lung disease. On the other hand the cytology was different, the cytofluorimetric technique revealed a mononuclear cell population rich in RNA whose role in the genesis of the disease of malign nature are discussed. The hypothesis of a hypersecretion of IgA by this malign process is raised by immunofluorescent studies of the lung. The role of IgA in lymphomatoid granulomatosis and bird fanciers lung is discussed in the light of recent work on pigeon IgA. PMID- 6856941 TI - [An unusual cause of hypoxia: anastomosis of the right superior vena cava into the left auricle. Surgical correction]. AB - Anomalies of drainage of the superior vena cava (S.V.C.) usually consists of a persistent left S.V.C. draining into the left auricle. Until now there has only been one published case of S.V.C. anastomosis with the left auricle. We describe a second case of a four year old boy who had undergone two operations for a recurrent cerebral abscess. This child presented with cyanosis, polycythaemia and arterial hypoxaemia. This abnormality is associated with a partially anomalous pulmonary venous drainage. Surgical correction using prosthetic and pericardial grafts enabled closure of the right to left shunt. PMID- 6856942 TI - [Problems posed by tuberculosis in the world in 1982]. AB - One hundred years after the discovery of the tubercle bacillus the struggle against tuberculosis still poses numerous problems on a world scale. Each year, 10 million new cases appear: nearly five million are highly contagious; 95% of these cases come from developing countries. The official notification system currently in force is imperfect but a reckoning of the annual infection risk, from a methodical enquiry into tuberculous disease gives exact information on the size of the problem and its evolutionary time scale in each country. This is the best epidemiological index currently available. The technical problems of the struggle against tubercle are resolved in theory: the selective detection of groups at risk, centered on a network of bacteriology laboratories enables identification of all the sources of infection; chemotherapy, becoming safer and safer, with a duration reduced to 6 or 9 months at the maximum and curing practically 100% of the patients; properly performed BCG vaccination reduces the risk of infantile tuberculosis. Operational problems remain the most serious. The greatest difficulties are seen in countries with the highest prevalence: they are linked to a global shortage of resources but also at times a poor utilisation of the resources available. A concerted international action could render antituberculous drugs and the appropriate sanitary technology to all countries. With a judicious use of available information and means each country could today achieve an effective national antituberculous programme. PMID- 6856943 TI - Organic cationic drugs and renal creatinine secretion. PMID- 6856944 TI - An analysis of the optimal conditions for perfusing an isolated rabbit kidney with homologous blood. AB - Isolated rabbit kidneys were perfused in a closed-circuit system with a number of media such a Krebs-Henseleit bicarbonate buffer with albumin, homologous platelet free plasma, serum and whole blood. All of these media were unsatisfactory. In contrast, fresh blood deprived of platelets, leukocytes, floating lipoproteins, microaggregates and microclots did not cause vasoconstriction of the isolated kidney. Renal blood flow, glomerular filtration rate, urinary flow and glucose, cations and renal water reabsorption were approximately normal. PMID- 6856945 TI - Glycoprotein synthesis of renal collecting duct epithelium cultured as globular bodies. AB - Cortical kidney explants from newborn New Zealand rabbits were cultured in Dulbecco's minimum essential medium (DMEM) containing 10% fetal calf serum. Within 24 h the explants formed 'globular bodies' which were completely covered by a monolayered epithelium. The cells were differentiated and resembled collecting duct epithelium. By culturing the globular bodies in Dulbecco's MEM with D-valine instead of L-valine, a monolayer of collecting duct cells was obtained and used for control experiments. For analysis and identification of synthesized glycoproteins, the globular bodies were incubated with various labelled carbohydrates and amino acids, and then fractionated. Glycoproteins secreted into the culture medium were not detected. Cell-associated glycoproteins were found in crude membrane fractions and then extracted with Triton X-100 for column chromatography, SDS-polyacrylamide electrophoresis in 6 M urea, isoelectrofocusing, and two-dimensional electrophoresis. Two prominent glycoproteins containing galactose and glucosamine were synthesized during the spreading of the epithelium, with an apparent molecular weight of 150,000 and 85,000 (SDS-PAGE). The synthesized glycoproteins differ in their content of radioactive glycoprotein precursor and leucine. The 85,000 dalton monomer glycoprotein has an isoelectric point of 3.5 and was identified by two dimensional electrophoresis. PMID- 6856946 TI - Dantrolene sodium: urinary metabolites and hepatotoxicity. AB - Dantrolene is metabolized by the hepatic MFO system to hydroxydantrolene which is conjugated with glucuronic acid or with sulfate. Dantrolene is also metabolized by nitroreductase to aminodantrolene. The aminodantrolene inhibits the hepatic MFO system. Acetylation of aminodantrolene blocks the inhibitory effects of aminodantrolene on the hepatic MFO system. Intermediates in the nitroreductase pathway form glucuronide and mercapturic acid conjugates. The mercapturic acid conjugation reaction is a detoxification mechanism for an electrophilic metabolite of dantrolene. PMID- 6856947 TI - Assessment of diisopropylfluorophosphate (DFP) toxicity and tolerance in rats. AB - Single s.c. injection of 1, 2, 3 or 4 mg/kg of DFP in saline was given to male rats. Control rats received saline. Beginning 24 hr after injections, body weights and food and water consumption were measured at 24 hr intervals. The 1 and 2 mg/kg DFP-treated group maintained these parameters at levels equal to those of the controls. The other DFP-treatment groups showed significant depressions in body weights and in food and water consumption, but these groups recovered 48 and 72 hrs after DFP administration of 3 mg/kg or 4 mg/kg, respectively. Daily injections of 2, 3 or 4 mg/kg of DFP, s.c., caused significant depressions of all three parameters, with only 75% of the 2 mg/kg group showing recovery over the 14 day treatment period. Of the 2 mg/kg group, 25% died following the 6th injection, 100% of the 3 mg/kg group were dead following the 4th injection and 100% of the 4 mg/kg group were dead following the 3rd injection. Prior to deaths in all DFP-treatment groups, the decreases in body weights and in food and water consumption were progressive and dose-dependent. The data show dose-dependency of general toxicity during acute and subacute exposure to DFP and of tolerance during subacute exposure. PMID- 6856948 TI - Calcium requirement for anoxic liver cell injury. AB - There is disagreement as to whether Ca2+ entrance into the cell constitutes a final common pathway in cell death by a variety of injurious conditions. Pre necrotic lesions and leakage of lactate dehydrogenase were induced both in isolated perfused rat livers and in freshly isolated hepatocytes by short exposure to anoxic conditions. Removal of Ca2+ from the media markedly reduced cell damage induced by anoxia in the perfused liver preparation but not in freshly isolated hepatocytes. Data obtained support the hypothesis that Ca2+ ions play a role in the process of cell death in intact preparations and possibly in vivo, and suggest that mechanism of cell necrosis may be different in the perfused liver than in freshly isolated suspended hepatocytes. PMID- 6856951 TI - Behavior of male rats fed low levels of metallic salts. AB - Male rats at 44 days of age were fed diets ad lib containing the following in ppm by weight: Co++(75), Cu++(75), Fe+++(150), Mn++(75), Ni++(75), Pb++(10) and Zn++(75), the controls receiving the basal ration. At days 55-56 of feeding, the rats were subjected to the poke test and no remarkable differences could be discerned in the 5-minute ratings; for the first one-minute scores, a small but significant change was apparent with Fe+++ vs Pb++. Performance of the animals in a runway was ascertained at days 73-74 of feeding and discounting the poor performers, namely, those which did not run the maze in 100 seconds, only few definite differences were noted (Zn++ vs Pb++ and Mn++ vs Pb++). PMID- 6856950 TI - High-performance size-exclusion chromatography of 63Ni-constituents in renal cytosol and microsomes from 63NiCl2-treated rats. AB - Fractionations of 63Ni-constituents were performed by high-performance size exclusion chromatography upon samples of renal cytosol and washed renal microsomes from rats that were killed 1 h after an im injection of 63NiCl2 (50 or 125 mumol/kg body wt). The kidney homogenates contained 2.0 +/- 0.4% of the total dose of 63Ni. Renal cytosol contained 55 +/- 5% and washed microsomes contained 5.4 +/- 1.2% of 63Ni that was present in the kidney homogenates. Chromatography of renal cytosol on TSK-GEL SW-2000 and SW-3000 separated 63Ni into six fractions. The largest component (Fraction F) contained approximately 80% of cytosolic 63Ni. Since Fraction F was eluted near the total permeation volume of SW-2000 columns and beyond the total permeation volume of SW-3000 columns, its molecular weight could not be reliably estimated. The other components, which comprised collectively the remaining 20% of cytosolic 63Ni, had apparent molecular weights of 168,000 (Fraction A), 84,000 (Fraction B), 51,000 (Fraction C), 24,000 (Fraction D), and approximately 10,000 (Fraction E). Solubilized washed microsomes from kidneys of 63NiCl2-treated rats contained 63Ni in five components with elution profiles and 63Ni-contents that resembled Fractions A, B, D, E, and F of renal cytosol, based upon chromatography on SW-3000 columns. The solubilized microsomes also contained a 63Ni-component with high molecular weight (Fraction M, greater than 700,000 daltons), which accounted for 3% of microsomal 63Ni. This study provides a rapid, convenient, and reproducible technique to fractionate 63Ni-components in tissue extracts, and it demonstrates in vivo binding of 63Ni to several constituents of renal cytosol and microsomes from 63NiCl2-treated rats. PMID- 6856949 TI - Effect of bestatin analogues and other compounds on enkephalin hydrolysis by an aminopeptidase from the mesophiles pseudomonas sp ATCC 11299A and chromobacterium violaceum ATCC 12540. AB - In our studies on newly synthesized compounds for their potential analgesic effect, we decided for purposes of convenience and economy to investigate non mammalian sources for the presence of enkephalin degrading enzymes. An aminopeptidase that catalyzes the hydrolysis of the tyrosylglycyl bond of leucine and methionine enkephalin was purified from the mesophiles Pseudomonas sp ATCC 11299a (Ps) and Chromobacterium violaceum ATCC 12540 (Cv). Each preparation also hydrolyzed to varying extents neutral dipeptides, tripeptides, tetrapeptides and amino acid beta-naphthylamides. The Ps enzyme has a pH optimum of 6.8, Km of 80 microM and a Vmax of 6.7 nmoles/min/mg of protein. The Cv enzyme has a pH optimum of 6.8-7.2, Km of 111 microM and a Vmax of 42 nmoles/min/mg of protein. Both are sulfhydryl enzymes since they are activated by dithiothreitol (DTT) and inactivated by p-chloro- and p-hydroxymercuribenzoate. They are not glycoproteins since they pass unretained through a Con A-Sepharose column. The activity lost by dialysis against EDTA can be restored, wholly or in part, by Co+2, Mg+2, Mn+2 and Ni+2; ions exerting an inhibitory effect were A1+3, Cd+2, Cu+2, Hg+2 and Zn+2. From a range of organic compounds, the greatest inhibition was elicited by the microbial peptides amastatin and bestatin. Several dipeptide analogues of bestatin, synthesized from DL-threo-2-amino-3-hydroxy-3-phenylpropanoic acid (AHPP) as the N-terminal residue in order to define the stereospecific requirements of the alpha, beta-functional groups for maximal activity, were not as active as the parent compound. PMID- 6856952 TI - Biphasic hypotensive effects of 5-methylfurmethide on the mean arterial blood pressure of rats. AB - The effects of 5-methylfurfuryltrimethylammonium iodide (5-methylfurmethide) on the mean arterial blood pressure of male Sprague-Dawley rats were investigated. The agent elicited a linear biphasic but non-parallel fall in the mean arterial blood pressure. The hypotensive effects were blocked by pretreatment of the animals with atropine suggesting the possible involvement of muscarinic receptors in the effects. PMID- 6856953 TI - Evidence for inhibition of monoamine oxidase in vivo in rat brain by 7,8-dichloro 1,2,3,4-tetrahydroisoquinoline. AB - 7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline (DCTQ) (50 mg/kg i.p.) antagonized the inactivation of MAO by pargyline as measured by direct enzyme assays in brain homogenates and by accumulation of hypothalamic catecholamines. These findings lend credence to the earlier interpretation that changes in brain concentrations of biogenic amines and their metabolites in DCTQ-treated rats were due at least in part to MAO inhibition. PMID- 6856954 TI - Effects of cardiac work and leucine on protein turnover. AB - The purpose of these experiments was to assess effects of cardiac work and leucine in hearts supplied only glucose or substrate and hormone mixtures that simulated plasma. Rates of protein degradation greatly exceeded protein synthesis in Langendorff preparations supplied glucose. This severely negative nitrogen balance was brought closer to zero by provision of more complete substrate mixtures. Cardiac work further improved the nitrogen balance by stimulating protein synthesis in hearts supplied glucose (mixture 1), glucose-insulin glucagon-lactate-beta-hydroxybutyrate (mixture 2), or palmitate-beta hydroxybutyrate-glucose (mixture 3) and inhibiting protein degradation in hearts supplied glucose. Cardiac work did not affect the rates of either protein synthesis or degradation in hearts provided insulin-lactate-glucose (mixture 4). The increase in protein synthesis was associated with increased rates of peptide chain initiation. Addition of 1 mM leucine had an additional effect to restore nitrogen balance to zero or to achieve positive balance in working hearts supplied substrate and hormone mixture 2. PMID- 6856955 TI - DNA synthesis and mitotic activity in adult atrial cardiocytes in culture. AB - Trypsin-dissociated adult rat atrial cardiocytes were exposed to [3H]thymidine for sequential 24-hr periods from day 3 to day 13 of culture. Following preparation for ultrastructural autoradiography, 1000 cells (at each daily interval) were examined with an electron microscope. Maximal incorporation occurred on day 5 when 63% of the cells were labeled. Small secondary peaks of incorporation occurred on days 8 and 11 following previous exposure to fresh serum. Mitotic activity never exceeded 0.5% of all cardiocytes examined. DNA synthesis and mitoses occurred only in immature cardiocytes characterized by subsarcolemmal filaments and Z-bands with or without specific granules; more mature cells were never labeled. PMID- 6856956 TI - DNA synthesis in atrial myocytes of rats with aortic stenosis. AB - Indices of labeled myonuclei have been determined in hypertrophying hearts of adult Wistar rats by autoradiography after single-pulse or repeated [3H]thymidine administration. After single [3H]thymidine injections, only 1.36 +/- 0.66 and 1.32 +/- 0.87% labeled myonuclei were observed in the left and right atria, respectively. In the experiments with multiple [3H]thymidine administration, the first injection of this precursor was given on the seventh day after aortic constriction; thereafter, 30 or 42 injections of [3H]thymidine were given at 12 hr intervals up to the fourth postoperation week. Following 30 repeated [3H]thymidine injections, 29.75 +/- 4.65 and 16.78 +/- 3.33% labeled myonuclei were visible in left and right atrial muscle cells, respectively. The cumulative labeling index for left atrium myocytes clearly correlates (r = 0.65-0.73) with an increase in the weight of the heart. Increase in heart weight to more than 160% of controls corresponds to [3H]thymidine labeling of 38.06 +/- +/- and 21.67 +/- 4.16% in left and right atrial myocytes, respectively, whereas in hearts weighing less than 140% of controls, [3H]thymidine labels only 8.20 +/- 1.93% in the left atrium and 3.94 +/- 1.57% in the right one. In the ventricles, cumulative indices of myonuclear labeling do not exceed 0.217 +/- 0.11% even in hearts weighing nearly 180% of controls. Cumulative frequencies of labeling for AV system myocytes are almost ten times higher (1.97 +/- 0.38). These results, together with our data concerning mycocardial infarction (27-29,31), make it necessary to reconsider the role of cardiomyocyte hyperplasia in different experimental and pathological conditions, paying special attention to the proliferative behavior of the atrial muscle cells. DNA synthesis in atrial myocytes seems to be stimulated by heart hyperfunction. PMID- 6856958 TI - Adaptation of the organism during long-lasting survival with a total artificial heart. PMID- 6856957 TI - Mechanisms of degradation of myofibrillar and nonmyofibrillar protein in heart. AB - The degradation of cardiac proteins is known to be altered by many physiological and pathological interventions, but the precise intracellular processes that regulate proteolysis and the relative roles of different proteolytic pathways in degrading different classes of protein remain poorly understood. Agents that interfere with lysosomal function produce major decreases in total protein breakdown; thus, lysosomes and lysosomal proteinases seem to be important in proteolysis. However, these same agents cause no change in the degradation of myofibrillar proteins, suggesting that this class of proteins is not dependent on lysosomal pathways for its turnover. PMID- 6856959 TI - A possible mechanism of adriamycin cardiotoxicity. Inhibition of NADP-linked isocitrate dehydrogenase. AB - In heart muscle, NADP-linked isocitrate dehydrogenase activity is particularly high when compared with that of the other representative NADPH-generating enzyme, glucose-6-phosphate dehydrogenase. Approximately 80% of cardiac NADP-linked isocitrate dehydrogenase activity originates in the mitochondria. Adriamycin inhibited the activity of both mitochondrial and cytoplasmic NADP-linked isocitrate dehydrogenase dose dependently but had no effect on glucose-6 phosphate dehydrogenase. The inhibition was kinetically distinguished as noncompetitive. Preincubation of crude cardiac enzyme preparations with adriamycin enhanced the inhibition time dependently for 45 min. However, there was no evidence to suggest that the metabolites of adriamycin produced in this system were active as inhibitors. Adriamycin-binding protein was fractionated by affinity chromatography, but NADP-linked isocitrate dehydrogenase activity was not detected in this fraction. PMID- 6856961 TI - Effect of exogenous amino acids on the contractility and nitrogenous metabolism of anoxic heart. AB - The effect of exogenous glutamic acid and arginine on the contractility of isolated perfused rat heart and on the metabolism of some nitrogenous compounds was studied. Sixty-minute anoxic perfusion (95% N2 + 5% CO2) led to a fall in developed isovolumic pressure and an elevation in diastolic pressure, to an increase in the production of alanine, glutamine, and ammonia, and to a decrease in the tissue content of aspartate and glutamate. The total pool of free amino acids and taurine under these conditions remained unchanged. Subsequent 40-min reoxygenation partially restored the contractile function. Addition of 3.5 mM glutamic acid or 5 mM arginine into the perfusate before anoxia resulted in a higher level of developed pressure and a lower level of diastolic pressure during anoxia and almost complete recovery of cardiac function after subsequent reoxygenation. Both amino acids had no effect on ammonia formation by the anoxic heart but enhanced its binding in myocardial tissue via formation of glutamine and urea. It is suggested that the exogenous amino acid effect on anoxic heart is mediated by activation of substrate phosphorylation rather than the ability to bind tissue ammonia. PMID- 6856960 TI - Effects of propranolol and hydrocortisone pretreatment on radiation-induced myocardial injury in rats. AB - Earlier studies in our laboratory (23) showed evidence of dose-related acute injury to the myocardium after exposure of rats to ionizing radiation. Biochemical, histological, and electrocardiographic parameters were studied. In further continuation of this study, the effects of intervention by pretreatment with propranolol (10 mg/kg body weight) and hydrocortisone (10 mg/kg body weight) have been studied. The above drugs were administered to male albino rats weighing 150 to 200 g 30 min before exposure to 6000-rad single-dose gamma radiation over the precordial area. The parameters observed were cardiac glycogen, serum enzymes, lactate, pyruvate, blood sugar, adrenal ascorbic acid, and histology of the myocardium. The beneficial effects of this procedure are discussed. PMID- 6856962 TI - Regulation of cardiac contractility and glycolysis by cyclic nucleotides during hypoxia. AB - It has been suggested that cyclic nucleotides (cAMP and cGMP) participate in the regulation of cardiac contractility and glycolysis. In the present study, this possible involvement was examined in spontaneously beating rat atria during hypoxia (50% oxygen saturation). Thirty seconds after reduction of high oxygen saturation (HiOxSa) in the incubation medium, the contraction amplitude declined to 50% of the initial level. The decline was partly antagonized by norepinephrine (NE) or hypercalcemia. The cAMP level remained unchanged during hypoxia, but the cGMP content gradually increased. Paradoxically, the production of lactate decreased after 30 sec of hypoxia but had increased by 2 min, when depletion of creatine phosphate and ATP stores was also initiated. Sodium nitroprusside (nitroprusside) and NE elevated the cGMP and cAMP, respectively, in both HiOxSa and hypoxia. Nitroprusside and NE also showed a positive inotropic effect in HiOxSa. Verapamil decreased contractility without changing the levels of cAMP or cGMP. In HiOxSa, both nitroprusside and verapamil decreased lactate production but were not able to resist the increase in atrial lactate level brought about by NE. In hypercalcemia the amplitude increased, but lactate production was slightly reduced in HiOxSa. Between 5 and 10 min of hypoxia, 45Ca uptake was reduced to about one-third of that in the control. It is suggested that lack of oxygen has direct and parallel effects on the sarcolemma and the mitochondria. The former induces deterioration of contractility, the latter termination of aerobic energy production. Cyclic nucleotides are not involved in either of these phenomena. However, at a low rate of anaerobic glycolysis, e.g., in HiOxSa or at the very early stage of hypoxia, cGMP could inhibit and cAMP accelerate lactate production. PMID- 6856963 TI - Hypoxia, calcium, and contracture as mediators of myocardial enzyme release. AB - During calcium-free perfusion, anoxic contracture of myocardial cells causes cells to separate at intercalated disks and leads to an energy-independent enzyme release in the absence of active transmembrane calcium fluxes. It is proposed that contracture mediates membrane damage and enzyme release in cells sensitized to the calcium paradox. PMID- 6856964 TI - Acid hydrolases in the initiation of ischemic myocardial necrosis. AB - Alterations in myocardial acid hydrolases in acute ischemia were studied in relation to the evolution of cardiac cellular necrosis by the determination of cathepsin D, acid phosphatase (AcPase), and beta-glucuronidase activities of the myocardial fractions and by electron microscopic cytochemical studies on AcPase in the canine heart. In the normal myocardium, the same level of activity of acid hydrolases was found in sarcoplasmic reticulum (SR) as in the lysosome fraction. In electron microscopy, AcPase reaction products were observed markedly in SR and moderately in lysosomes, in residual bodies, and in Golgi apparatus. In the ischemic myocardium, at 20 to 30 min after coronary ligation, activation of these enzymes was observed in both SR and lysosomes, and at 60 to 90 min they were decreased in the particles and, in turn, increased in the cytoplasm accompanying the ischemic fine structural changes. At 2 to 3 hr those acid hydrolase activities in the cytosol were decreased, indicating the loss of enzymes from necrotic myocardial cells. Acid hydrolases are the most important factor for the evolution of ischemic myocardial necrosis by being activated not only in lysosomes but also in SR and by being released to the cytoplasm to disintegrate the cellular structures. PMID- 6856965 TI - The effects of systole on left ventricular blood flow. AB - Coronary artery flow is complex. Flow in this system is divided into systolic and diastolic. However, systolic flow should be divided into two phases, isovolumetric and the ejection phase, since these two components are determined by completely different parameters. Flow through the myocardium is affected by the close mechanical coupling between myocytes and capillaries effected by the array of collagen struts and their disposition. This latter provides the anatomic arrangement that makes possible the integrated "massaging" effect postulated by Wiggers (26). PMID- 6856966 TI - Prolonged depletion of ATP because of delayed repletion of the adenine nucleotide pool following reversible myocardial ischemic injury in dogs. AB - Sixty-five percent of the ATP and 50% of the total adenine nucleotide (sigma Ad) pool is lost from the subendocardial myocardium after 15 min of severe ischemia induced by circumflex artery occlusion in open-chest dogs (12). In the present experiment, we assessed the effects of various periods of arterial reflow following 15 min of ischemic injury on resynthesis of ATP and sigma Ad. The circumflex artery was occluded for 15 min and reperfused for 20 or 60 min or 24 or 96 hr. The mean ATP after 15 min of ischemia was reduced 62% from 5.42 +/- 0.33 to 2.08 +/- 0.21 mumol/g; and the total nucleotide content was reduced by 50%. ATP content recovered slightly during the first 20 min of reperfusion but remained markedly depressed for at least 24 hr because of the initial depletion of adenine nucleotides and because minimal salvage of de novo repletion occurred in the injured muscle during this time period. By 4 days, ATP and total adenine nucleotides were still slightly depressed but had recovered to 88% and 91% of control. Electrolyte changes and an increased inulin-diffusible space, which are characteristic of irreversibly injured myocardium, reperfused for 20 or 60 min, were not observed. Also, tissue necrosis was absent in the hearts reperfused for 24 or 96 hr. These observations indicate that the marked depression of ATP and adenine nucleotides and the slow recovery of these metabolites occurred in myocardium that nevertheless was reversibly injured in terms of cellular viability. PMID- 6856967 TI - The effect of experimentally induced myocardial ischemia on the norepinephrine metabolism of the dog heart. AB - Myocardial ischemia is known to provoke an excess in circulating norepinephrine and thus be related to an increased irritability of the heart. In the present experiments, we studied the norepinephrine and potassium content, oxygen tension, and pH values of the effluent of coronary sinus after thoracotomy and catheter placement into the coronary sinus. Once a steady state was reached, the measurements were repeated in the fifth, tenth, 20th, and 60th minutes of experimental myocardial ischemia provoked by coronary ligation of the left anterior descending coronary artery. The parameters obtained were compared to the corresponding values measured in the peripheral vessels. The results indicate an increased release and probably an increased turnover of norepinephrine in the ischemic myocardium. The role of metabolism acidosis in the changes in norepinephrine metabolism was suggested. It is assumed that intracellular acidosis is involved in the enhanced accumulation and release of norepinephrine in the damaged myocardium and that an increase of norepinephrine concentration in the myocardium may be considered a risk factor in supporting heart function. PMID- 6856970 TI - Detection of intracellular anoxia and its relationship to onset of hemodynamic dysfunction and ST-segment elevation in the intact dog heart. AB - The temporal relationships among onset of cellular anoxia after coronary artery occlusion, contractile dysfunction, and electrocardiographic ischemia were studied in dogs with an intact circulation. Nicotinamide adenine dinucleotide (NADH) fluorescence was used to detect intracellular anoxia, using a fiber-optic method. Paired NADH concentrations from ischemic (394 +/- 10 mumol/g) and normoxic (285 +/- 11 mumol/g) regions of the heart were obtained, and the differences (delta[NADH]) were correlated with compensated fluorescence (r = 0.76, P less than 0.01). Onset of fluorescence occurred 1 to 2 sec after coronary artery occlusion, followed by hemodynamic (5 sec) and electrocardiographic (13 sec) changes. These data indicate that intracellular anoxia, with alterations in redox potential, is not synchronous with the onset of contractile failure and provide indirect support for intracellular acidosis as the likely mediator of contractile failure. PMID- 6856969 TI - Ultrastructural, functional, and metabolic correlates in the ischemic rat heart. Effects of free fatty acid. AB - A study correlating functional, metabolic, and ultrastructural changes in the ischemic myocardium was conducted on isolated working rat hearts, both in the presence and absence of fatty acid. Glucose alone (11 mM) or glucose plus palmitic acid (1.5 mM) were used as metabolic substrates. A 60-min period of whole-heart ischemia resulted in a more dramatic morphological alteration in those hearts receiving palmitate than in those receiving no palmitate. In ischemic hearts receiving palmitate, intramitochondrial amorphous densities of both rounded and elongated types were observed. These densities did not develop in hearts receiving glucose alone over the same period of ischemia. Such morphological alterations were associated with a more severe deterioration of mechanical function in the presence of palmitate. Biochemical determinations of fatty acid derivatives showed increased tissue levels of acyl esters of CoA and carnitine in ischemic hearts, but levels of long-chain acyl carnitine were much higher in those ischemic hearts receiving palmitate. Furthermore, from the data obtained on isolated mitochondria, it appeared that the mitochondrial level of long-chain acyl carnitine was approximately four times higher in the ischemic hearts receiving palmitate than in those receiving no palmitate. This great rise in mitochondrial levels of long-chain acyl carnitine correlated with modifications of the mitochondrial structure and with the appearance of amorphous densities. PMID- 6856968 TI - Reperfusion injury. A possible link between catecholamine-induced and ischemic myocardial alterations. AB - In this study we have compared myocardial lesions induced by catecholamines and coronary occlusion and reperfusion injuries in rats. Although microcirculatory factors were found to play an important role in catecholamine-induced cardiac muscle cell injury, alterations in sarcolemmal membrane permeability suggest a direct cardiotoxic effect. Cardiac muscle cells damaged irreversibly by ischemia reveal sarcomeres in extreme relaxation and mitochondria with floccular densities; cardiac muscle cells that die following reperfusion exhibit contraction band formation and mitochondria with calcium phosphate deposits. The ultrastructural appearance of reperfused ischemic cardiac muscle cells was similar to that observed following administration of catecholamines. These morphological similarities suggest a common causal pathway for stress-induced and ischemic heart diseases. PMID- 6856971 TI - The permissive role of catecholamines in the pathogenesis of hamster cardiomyopathy. AB - It was previously shown that beta-adrenergic blockers exert a protective action on the development of heart necrotic changes in cardiomyopathic hamsters. To further investigate the possible role of catecholamines in the pathogenesis of the hamster hereditary cardiomyopathy, the ventricular adrenergic nerve terminals were visualized by fluorescence histochemistry, and NE uptake and turnover were determined after i.v. injection of labeled NE. It was found that the fluorescent nerve endings strongly proliferate with the occurrence of heart necrotic changes. With healing of the myocardial lesions, the difference between control and myopathic hearts is less apparent, and NE nerve endings are literally absent in the terminal stage of the disease. There was a marked increase in NE uptake during the necrotic stage and, at the same time, a considerable rise in elimination rate constant with a maximum level at terminal state, suggesting that the NE turnover is related to the progression of the disease. In light of the present findings, it can be surmised that NE plays a permissive role in the genesis of the hamster disease by promoting the heart necrotic changes. PMID- 6856974 TI - Serial changes in cytosolic, mitochondrial, and lysosomal enzymes and cardiac myosin light chain II in plasma following coronary ligation in conscious closed chest dogs. AB - We studied serial changes in various myocardial enzymes and cardiac myosin light chain II (LCII) in plasma following coronary ligation in 14 conscious closed chest dogs. Cytoplasmic enzymes [creatine phosphokinase (CPK) and supernatant glutamic oxaloacetic transaminase (sGOT)] reached maximum at 12-24 hr and returned to normal at 72-96 hr. The mitochondrial isozyme of GOT (mGOT) began to rise at 6-9 hr, peaked at 12-30 hr (4.8-42.2 IU/liter), and stayed higher at 96 hr than before infarction. Glutamate dehydrogenase (GLDH), another mitochondrial enzyme, began to elevate at 6-16 hr and reached maximum at 24-60 hr (6.2-20.5 U/liter); GLDH also showed higher levels at 96 hr than before infarction. N Acetyl-beta-glucosaminidase (NAG), a lysosomal enzyme, showed a biphasic pattern in every case. The first peak appeared at 3-12 hr, and the second one at 36-72 hr. Myosin LCII began to rise at 3-9 hr, peaked at 30-120 hr (34-136 ng/ml), and remained elevated for 7 to 10 days. Determination of these myocardial enzymes or LCII in plasma is useful for the diagnosis of acute myocardial infarction. PMID- 6856972 TI - The relationship between glucose utilization during ischemia and ventricular fibrillation during early reperfusion. Evidence for two populations of guinea pig hearts. AB - Guinea pig hearts perfused in the presence of 9 mM glucose were subjected to 30 min of ischemia (coronary flow reduced to 6%) and were then reperfused. During reperfusion, 18 of the 34 hearts studied (first subgroup) exhibited irreversible ventricular fibrillation. The remaining 16 hearts (second subgroup) exhibited serious rhythm disturbances but did not fibrillate. Attempts to identify critical factors that might precipitate fibrillation led to an observation that hearts that fibrillated during reperfusion were characterized by low rates of glucose utilization (0.6 +/- 0.8 mumol/min per g dry wt. and low lactate plus pyruvate production (2.5 +/- 0.32 mumol/min per g dry wt.) during ischemia. In addition, these hearts had a low calculated cytoplasmic ATP-to-ADP ratio (10.0) and low residential glycogen levels (55 +/- 7.0 mumol glucose equivalents/g dry wt.) at the end of the ischemic period. In contrast, in hearts that did not fibrillate (group 2), glucose utilization (2.5 +/- 0.12 mumol/min per g dry wt.) was higher, lactate plus pyruvate production was higher (7.4 +/- 0.03 mumol/min per g dry wt.), cytoplasmic ATP-to-ADP ratio was higher (36.0), and residual glycogen levels were higher (163 +/- 23 mumol glucose equivalents/g dry wt.). Thus, two distinct populations of guinea pig hearts were apparent, and comparison between the two groups indicated an association among glucose utilization, cytoplasmic energy status, and myocardial electrical stability. PMID- 6856973 TI - Correlation among water content, left ventricular function, coronary blood flow, and myocardial metabolism after hypothermic ischemic cardiac arrest. AB - Subendocardial ischemia is a common cause of death following ischemic cardiac arrest. We studied relationships among myocardial water content (WC), left ventricular function, coronary blood flow, and myocardial metabolism following ischemic cardiac arrest. Under cardiopulmonary bypass with hypothermia, 120 min of aortic occlusion was employed, and myocardial temperature was kept around 20 degrees C in 10 mongrel dogs. Left ventricular function (peak LVP, max dp/dt, LVEDP, LVSWI), coronary blood flow, myocardial enzymes (m-GOT, total CPK, MB CPK), myocardial ATP and creatine phosphate (CP), and WC of the subendocardium of the left ventricle were measured. Data were obtained in the control state and immediately and 30 and 60 min after aortic unclamping. Significant negative correlations were obtained between WC and max dp/dt (r = -0.8384), coronary blood flow (r = -0.9928), ATP (r = -0.7038), and CP (r = -0.7835). Significant positive correlations were obtained between WC and LVEDP (r = 0.7525), m-GOT (r = 0.7638), and total CPK (r = 0.7079). These data suggest that myocardial edema results in depression of left ventricular function and metabolism. PMID- 6856977 TI - Biopsy assessment of preservation during open-heart surgery with cold cardioplegic arrest. AB - The efficacy of cold cardioplegic arrest as a method of myocardial preservation has been evaluated by cytochemical and biophysical assessments made on needle biopsies taken from 150 patients undergoing open-heart surgery (e.g., aortic valve replacement, aortic and mitral valve replacement, mitral valve replacement, coronary artery bypass graft, repair of atrial or ventricular septal defects). Comparison of endo- and epicardial preservation showed improved endocardial preservation with cardioplegia compared with that achieved with the previous method used--continuous coronary perfusion at 32 degrees C; however, care had to be taken to ensure adequate cooling of the epicardium. Biopsies also showed the need for repeated infusions of cardioplegic solution if the aorta was occluded for more than 70 min. Preservation of right and left ventricle has also been compared. PMID- 6856975 TI - Myosin light chain phosphorylation during regional myocardial ischemia. AB - The extent of cardiac myosin light chain phosphorylation was measured during regional myocardial ischemia in the dog. A multiple-projectile cutter was used to sample adjacent biopsies from the normal and ischemic areas of the myocardium in an open-chested dog heart following 30 min of coronary artery ligation. Measurement of metabolite levels and blood flow in the individual biopsies clearly defined the border zone between normal and ischemic myocardium. Myosin light chain phosphorylation was measured after isoelectric focusing of biopsy samples and subsequent densitometric analysis. A 50% increase in phosphorylation was observed in the ischemic zone which may correlate with the reduced contractility which is a feature of the ischemic myocardium. PMID- 6856976 TI - Myocardial infarct size from serum cardiac myosin light chain. Clinical and experimental studies. AB - The relationship between myocardial infarct size and serum cardiac light chain (LC) levels was studied in experimental and clinical myocardial infarction. In dogs with left anterior descending coronary artery occlusion, regression analysis showed good correlation between infarct size and LC II release, but CPK-MB release failed to correlate with infarct size because of a decreasing value of cumulative CPK with larger sized infarctions. In patients with acute myocardial infarction, Peak LC I levels correlated well with CPK release, since the phenomenon of the decreased CPK release in larger sized infarction was not so distinctive in human cases. Thus, LC determination may better quantitate the extent of myocardial damage as well as provide a specific and sensitive method for diagnosis of acute myocardial infarction. PMID- 6856978 TI - Calcium antagonistic activity and myocardial ischemic protection by both stereoisomers of verapamil. PMID- 6856979 TI - The effect of beta blockade and partial agonist activity during myocardial ischemia. AB - In this study, we have investigated the importance of partial agonist activity during myocardial ischemia by comparing the effects of equiblocking doses of oxprenolol, which possesses partial agonist activity, to propranolol which does not. In the isolated, globally ischemic (low-flow) rat heart, when propranolol or oxprenolol was added alone during the ischemic period, only propranolol reduced enzyme leakage relative to control. However, when the hearts were perfused (10 min) prior to ischemia with these drugs, both beta blockers caused a significant reduction in enzyme leakage. Under conditions of enhanced sympathetic drive (in the presence of 0.01 microM isoproterenol), both beta blockers reduced enzyme leakage to differing extents. In hearts with low sympathetic drive (reserpine pretreatment), enzyme leakage was unaffected by propranolol and exacerbated by oxprenolol. The results of this study suggest that oxprenolol and propranolol influence ischemic damage to differing extents and that this difference is due to partial agonist activity. Also, the protective action of all beta-blocking compounds depends greatly on the background level of sympathetic drive. PMID- 6856980 TI - Effects of L-carnitine on tissue levels of free fatty acid, acyl CoA, and acylcarnitine in ischemic heart. AB - In order to evaluate the protective effects of L-carnitine on ischemic myocardium, its effects on tissue levels of free fatty acid (FFA), acyl CoA, acyl carnitine, and adenosine triphosphate (ATP) were studied in ischemic dog hearts. Myocardial ischemia was induced by the ligation of left anterior descending coronary artery for 15 min. L-Carnitine (100 mg/kg) was administered intravenously prior to coronary ligation. In ischemic myocardium, tissue levels of free carnitine and ATP decreased, whereas long-chain acyl carnitine, long chain acyl CoA, and FFA increased. Pretreatment of L-carnitine prevented the decrease in free carnitine and ATP and the increase in long-chain acyl carnitine and long-chain acyl CoA. A positive correlation was observed between ATP and free carnitine. On the other hand, a negative correlation was observed not only between ATP and the ratio of long-chain acyl CoA to free carnitine but also between ATP and the ratio of long-chain acyl carnitine to free carnitine. These results suggest that L-carnitine has protective effects on ischemic myocardium, probably by preventing the accumulation of long-chain acyl carnitine and long chain acyl CoA. PMID- 6856981 TI - Preservation of oxidative phosphorylation by lidocaine in ischemic and reperfused myocardium. AB - The effect of lidocaine (2 mg/kg bolus, 0.04 mg/kg per min infusion) on ischemic and reperfused myocardial respiration was assessed in 32 dogs, using indices of mitochondrial respiration (ADP:O ratio, state 3 and state 4 respiration, and respiratory control index). Heart rate, left ventricular (LV) pressure, LV dp/dt, cardiac index, epicardial ST segment, and regional myocardial blood flow, using 9 +/- 1 micron radiospheres, were measured after 40 min of constriction of the anterior descending coronary artery (N = 16) and after 20 min of reperfusion (N = 16). Results showed that lidocaine increased state 3 respiration and respiratory control in reperfused myocardium (P less than 0.05) with both glutamate and succinate-rotenone as substrate. It is concluded that lidocaine improves postischemic mitochondrial oxidative phosphorylation independent of altered hemodynamics or change in myocardial blood flow. PMID- 6856982 TI - On the mechanism of action of the antianginal drug nonachlazine on ischemic myocardium. AB - The activity of a new antianginal drug, nonachlazine, synthetized in the Institute of Pharmacology, Academy of Medical Sciences of the USSR, has been demonstrated using model myocardial ischemias on anesthetized dogs and conscious cats. Antianginal activity was evaluated by ECG, epicardial electrogram, lactate level, and lactate/pyruvate ratio in the venous blood flowing from the ischemic myocardial area. The study of the cardiotropic effect of nonachlazine provided the following findings: (1) nonachlazine enhances ino- and chronotropic functions of the heart via stimulation of its beta-adrenergic receptors; (2) nonachlazine's positive chronotropic effect is substantially less marked than the inotropic one; (3) nonachlazine decreases the intensity of chronotropic reactions of the heart induced by isopreterenol. Biochemical analysis showed that in addition to its activation of oxidative phosphorylation, the ability of nonachlazine to stimulate glycogenolysis is also of importance in the development of its antianginal effect. This conclusion has been suggested by the following: (1) in acute myocardial ischemia, nonachlazine decreased lactate level and increased ATP level up to the norm; (2) at day 3 after ligation of the coronary artery, nonachlazine did not change lactate content, increased ATP and NAD, and decreased NADH2; (3) in experiments on rabbit myocardial mitochondria in vivo and in vitro nonachlazine was found to stimulate oxidative phosphorylation; (4) nonachlazine was found capable of increasing the norepinephrine level and of increasing phosphorylase a activity and the rate of glycogenolysis. PMID- 6856983 TI - Effects of ethanol on platelet aggregation: an in vitro study. AB - Alcohol ingestion results in the formation of circulating microaggregates in the pig. To investigate the underlying mechanism, the effects of alcohol on platelet aggregation using a Born-aggregometer, was investigated. After incubating unstirred platelet rich plasma (PRP) with moderate concentrations of alcohol (175 mmol/l) the aggregation induced by collagen was reduced. This was probably due to platelet refractoriness caused by platelet ADP release. We could also demonstrate that high concentrations of alcohol (630 mmol/l) caused platelet release in stirred PRP. Release of ADP from red cells, after incubating unstirred whole blood with low concentrations of alcohol (17 mmol/l), was the probable explanation to the observed platelet refractoriness to ADP and collagen. Alcohol causing release of ADP from red cells is likely the cause of platelet aggregation in circulating blood and is probably the mechanism in formation of circulating platelet aggregates after alcohol ingestion. PMID- 6856984 TI - Late phase of liver restoration following partial hepatectomy in phenobarbital treated rats. I. Effect of preoperative and postoperative phenobarbital treatment on organ weight, protein and DNA content of the normal and the regenerating liver. AB - Rats were treated with phenobarbital (50 mg/kg) for 7 days prior to or after partial hepatectomy. Liver weight, protein, DNA, and RNA content were determined in liver tissue removed at operation as well as in regenerating liver 7 days later at the time of death. When rats were treated with phenobarbital in the preoperative period an increase in liver weight secondary to cell hyperplasia was observed as compared to livers of rats treated with sodium chloride. The weight of regenerating liver of preoperatively treated rats did not differ from the controls, but protein concentration was significantly higher (P less than or equal to 0.001). When phenobarbital was applied only in the postoperative period, a highly significant (P less than or equal to 0.001) enlargement of the regenerating liver tissue was found secondary to cell hypertrophy without hyperplasia, whereas protein concentration was unchanged. An increased RNA/DNA ratio, however, suggests that further protein synthesis is enhanced. The results show that both preoperative and postoperative phenobarbital treatment aids in hepatic tissue enlargement, though by a different mechanism. PMID- 6856985 TI - [Influence of picolinic acid and citric acid on intestinal absorption of zinc in vitro and in vivo]. AB - The influence of the ligands picolinic acid and citric acid on the intestinal absorption of zinc was studied in two different experimental trials with Zn depleted and Zn-supplied pair-fed rats using everted sacs in vitro and the ligated small intestine in vivo. ZnSO4 was applied in water solution (pH 5.8) without ligands or together with picolinic acid at a molar ratio of 1:0.2, 1:2, and 1:20 or together with citric acid at a molar ratio of 1:1, 1:10, and 1:100. The intestinal Zn transfer of the Zn-depleted rats with picolinic acid is significantly increased only at a molar ratio of 1:20 (zinc:ligand) (P less than 0.001). The other in vitro results of Zn absorption were only slightly improved, mainly at the high molar excess of picolinic acid in comparison to ZnSO4 without ligands. Only a tendency for an increased Zn transfer--however, already at a narrow molar ratio of 1:1 or 1:10--could be seen when citric acid was added. The intestinal uptake was not influenced by citric acid. The absorption of zinc in vivo did not vary in dependence of the addition of picolinic or citric acid in different molar ratio in comparison to ZnSO4 addition without ligands. Zn depleted rats showed a significantly higher Zn absorption rate than Zn supplied pair-fed rats independently of the kind of ligand and the zinc:ligand ratio (P less than 0.001). These results are discussed in detail. PMID- 6856987 TI - Effect of fluoride on collagen synthesis in the rat. AB - Thirty-six young rats were used to determine the effect of the fluoride on collagen synthesis in healing of fracture. Eighteen rats received 100 ppm fluoride per day, the other 18 were not given fluoride and were used as controls. Then the tibiae of the 36 rats were successively fractured and the animals killed. That is, the first 14 animals of either group were killed one a day, and then the remaining four animals were killed on days 21, 28, 35, and 45 as the tibiae were fractured. Collagen synthesis of the callus was examined histochemically and histologically. In the fluoride-treated group, collagen synthesis was found to be defective, while it was normal in the controls. PMID- 6856988 TI - Identification of glucocorticoid receptors in normal and neoplastic adult human lung. AB - A dexamethasone-binding protein was detected in cytosol of five normal and three neoplastic lung tissue samples. The apparent dissociation constant of the dexamethasone protein complex ranged from 5.8 to 21 nM (11.4 +/- 5.7 nM for normal tissue cytosol, 12.1 +/- 7.7 nM for the neoplastic tissue cytosol). The binding protein sedimented at 8 S in sucrose density gradient at low ionic strength and showed a high specificity for glucocorticoids. It was concluded that the dexamethasone-binding protein had the characteristics of a glucocorticoid receptor. The glucocorticoid receptor content was determined to be 12-77 fmol/mg protein (37.1 +/- 18.9 fmol/mg protein for the normal tissue cytosol, 51.9 +/- 23.9 fmol/mg protein for the neoplastic tissue cytosol). PMID- 6856986 TI - [Demonstration of neo-intima in PTFE-prostheses after venous replacement in dogs]. AB - Because of the danger of thrombosis, venous replacement by prostheses is a yet clinically unsolved problem. We tested the PTFE-prosthesis at the positions of vena cava inferior and iliac veins in dogs. Already eight weeks after operation, the inner surface of the prosthesis was covered by a thin neo-intima, which by light microscopy, scanning and transmission electron microscopy was shown to contain a basal membrane and endothelial cells. This continuous layer may be responsible for the observed low rate of thrombosis. These findings suggest that the PTFE-prosthesis may offer advantages for venous replacement in patients. PMID- 6856989 TI - Experimental pancreatitis in the rat. Changes in pulmonary phospholipids during sodium taurocholate-induced acute pancreatitis. AB - Acute haemorrhagic pancreatitis was induced in rats by injecting aqueous solution of sodium taurocholate into the common biliopancreatic duct. Lecithin and lysolecithin were separated from pulmonary homogenate by thin layer chromatography and quantified by phosphorus determination. The ratio of lysolecithin to lecithin increased after the sodium taurocholate injection as well as after i.v. administration of porcine pancreatic phospholipase A2. It was concluded that phospholipase A2, released from pancreatic acinar cells into blood, may convert pulmonary lecithin into lysolecithin during acute pancreatitis. Destruction of pulmonary surfactant may contribute to the development of the adult respiratory distress syndrome as seen in patients suffering from severe acute pancreatitis. PMID- 6856991 TI - Urinary corticoids in the diagnosis of canine hyperadrenocorticism. AB - In 20 healthy experimental dogs the 24 hour urinary corticoid excretion as measured by cortisol radioimmunoassay on two consecutive days varied from 0.5 to 3.3 nmol/kg/24 hours and from 0.3 to 3.6 nmol/kg/24 hours. In 20 dogs with otherwise proven spontaneous hyperadrenocorticism these values varied from 4.4 to 35.7 nmol/kg/24 hours and from 3.6 to 26.8 nmol/kg/24 hours respectively. Corticoid/creatinine ratios in morning urine samples of 28 healthy pet dogs were 1.2 to 6.9 X 10(-6). In 27 dogs with spontaneous hyperadrenocorticism all ratios exceeded the range observed in the healthy pet dogs. PMID- 6856992 TI - Scanning and transmission electron microscopic observations on the host-parasite relationship in intestinal cryptosporidiosis of neonatal calves. AB - The association of cryptosporidia with the intestinal epithelium of three neonatal calves was studied by scanning (SEM) and transmission (TEM) electron microscopy. Trophozoites and schizonts were observed embedded in the microvillous brush border of epithelial cells. Merozoites, released from schizonts, were seen free in the lumen and penetrating epithelial cells by SEM and TEM. Incorporation of microvilli into the parasitophorous envelope of trophozoites was seen by TEM. These findings indicate that cryptosporidia develop at an intracellular position in the apex of the epithelial cells following merozoite penetration. PMID- 6856990 TI - Duration of immunity and absorption of cysticerci in calves after treatment of Taenia saginata cysticercosis with praziquantel. AB - Calves were first infected with 5000 Taenia saginata eggs at six to 10 weeks old and treated with praziquantel 12 weeks later. Complete immunity against challenge lasted for at least 12 weeks following anthelmintic treatment. Six months after drug treatment over 90 per cent of the cysticerci had been completely absorbed but some were still detectable especially in the heart. An increase was observed in the ELISA values of sera from infected calves following treatment with praziquantel, but no such rise was detected in sera from resistant calves after challenge infection. PMID- 6856993 TI - Studies of antibody titres in experimentally induced ovine toxoplasmosis. AB - Analysis of serological data from 63 experimentally infected sheep showed an inverse relationship between rise in toxoplasma indirect haemagglutination (IHA) titre after infection and titre at the time of infection. It was observed that, on average, sheep with a preinfection IHA titre of 1:200 or higher did not exhibit a significant rise in titre after infection. The ratio of toxoplasma antibody titres measured by the IHA and dye tests and the ratio of IHA titres in the IgM and IgG antibody fractions were shown to vary according to the duration of infection indicating that serological techniques could be developed to distinguish between latent and acute ovine toxoplasmosis. PMID- 6856995 TI - Efficacy of praziquantel against ovine cysticercosis caused by Taenia hydatigena. AB - Praziquantel was evaluated for its larvicidal activity against naturally or experimentally induced Taenia hydatigena infections in sheep. The major criterion used for assessing efficacy was an estimate of the dose rate required to free 90 per cent of the sheep from infection (ED90) together with a 95 per cent confidence interval. With both light and heavy infections of three-month-old T hydatigena in lambs up to 12 months old, many larvae were killed. The ED90 and 95 per cent confidence limits for six-month-old and aged organisms was estimated to be 13.1 (5.5 to 31.4) mg/kg and 6.1 (2.4 to 15.5) mg/kg, respectively. Equivalent data for the ED50 were 3.4 (1.4 to 8.3) mg/kg and 1.3 (0.3 to 5.4) mg/kg, respectively. It was established that one of the factors involved in the efficacy of praziquantel was associated with the age of the larvae at the time of treatment, the drug being markedly more effective against older than younger organisms. PMID- 6856994 TI - Quantitation of small intestinal structure and function in unthrifty piglets. AB - Litters of piglets were weighed at birth, weaning and five weeks later; pairs of thrifty and unthrifty weaned pigs were identified. Small intestinal structure and function were studied in 28 eight-week-old age-matched littermate pairs and in 16 weight-matched littermates. A comparison of age-matched piglets showed changes in mucosal structure in unthrifty piglets, a slight reduction in absorptive function but no biochemical evidence of small intestinal disease. Morphometric studies of weight-matched piglets revealed no differences between thrifty and unthrifty piglets, suggesting that the differences in the age-matched groups may have been an effect of body-weight. If unthrifty pigs grew slowly as a result of small intestinal damage and malfunction immediately after weaning no evidence of it remained when they were studied five weeks later. PMID- 6856996 TI - Microangiographic studies of metaphyseal vessels in young foals. AB - Selective perfusion and microangiographic examination of the radius and metacarpus of 30 foals were performed. Vessels of extraosseous origin supplying the peripheral part of the metaphysis were not demonstrated in young foals, but became more obvious in older animals. The development of this vessel system coincided with the reduction of transphyseal vessels from the epiphysis crossing the growth plate. PMID- 6856998 TI - Protection against Fasciola hepatica in rats with adult fluke antigen in Freund's adjuvant: influence of antigen batch, antigen dose and number of sensitising injections. AB - Protection of rats against Fasciola hepatica infection induced by intraperitoneal injection of adult fluke antigen in Freund's adjuvant was dependent on the batch of antigen. Relatively modest protection of 41 per cent and 55 per cent provided by some batches at one dose could be improved to 65 to 84 per cent and 86 per cent respectively by increasing the amount of antigen used for sensitisation. Protection was found to require at least two sensitising injections. Subcutaneous sensitisation with adult fluke antigen in Freund's adjuvant did not protect, whereas when this was given in conjunction with intraperitoneal injections of saline in Freund's adjuvant protection was achieved. PMID- 6856997 TI - Effects of dietary corticosterone on peripheral blood lymphocyte and granulocyte populations in immature domestic fowl. AB - Four-week-old chickens were fed on diets containing 0, 5, 10, 20 and 40 mg corticosterone per kg for eight days. Packed cell volume (PCV), the numbers of granulocytes (G) and lymphocytes (L), the G:L ratio and plasma corticosterone concentration were measured. Plasma corticosterone concentration was increased by dietary corticosterone from day 2 onwards. The number of lymphocytes was increased by serial bleeding but dietary corticosterone depressed the response and caused a dose-related lymphocytopenia from day 1. There was a dose related increase in granulocytes from day 4 and a dose-related increase in G:L ratio from day 1. A dose-related increase in PCV was evident only on days 2 and 4. Correlation coefficients showed little evidence of relationships between plasma corticosterone concentrations and the recorded blood variables. PMID- 6856999 TI - Comparison of biochemical and histological methods of estimating fat content of liver of dairy cows. AB - The degree of fatty infiltration of the liver was estimated in two herds of dairy cows using biochemical and stereological methods. Estimation of hepatic triglyceride content biochemically or of fractional volume of fat in hepatocytes stereologically are both reliable methods of assessing fatty infiltration of the liver in the dairy cow. Estimation of hepatic total lipid content is not considered an acceptable alternative because the high basal level of non triglyceride lipid masks the increase in hepatic triglyceride content which is characteristic of fatty liver. PMID- 6857000 TI - Ultrastructure of Babesia bovis sexual stages as observed in Boophilus microplus cell cultures. AB - Propagation of Babesia bovis in a Boophilus microplus cell line resulted in the appearance of the sexual stage of the parasite normally found only within tick intestine. These sexual stages, which possessed spike-like projections containing microtubules, were present in the medium and within cultured cells. Other ultrastructural characteristics of this sexual stage are described. PMID- 6857001 TI - Mixed venous PO2 during exercise in patients with different cardiopulmonary function. AB - The mixed venous PO2(PvO2) as a parameter of peripheral O2 supply correlates at rest and during exercise with the coefficient of oxygen delivery (COD = CaO2 x CO/VO2). PvO2 is determined by the O2 capacity, pulmonary and cardiac function. Values under 34 mm Hg at rest and a pronounced drop of PvO2 during exercise indicate a restriction of either pulmonary or cardiac function or both. The effect of respiratory disorder on PvO2 is striking only when the PaO2 is below 65 mm Hg. Besides PvO2, the meaning of the mean peripheral O2 capillary pressure (PacO2) for the peripheral O2 supply should also be considered. PMID- 6857002 TI - [Tobacco consumption and carboxyhemoglobin levels in blood donors]. AB - The authors studied the tobacco consumption of 283 blood donors and its consequences. 151 were nonsmokers and 132 were smokers (47.7% smoke more than 10 g/day). Their mean HbCO level was 4.3 +/- 0.2% (highest level 15%). HbCO levels are significantly correlated with daily tobacco consumption (p less than 0.001) and can be estimated with the following regression equation: HbCO% = 0.176 (tobacco in grams/day) + 1.976. For a similar consumption, inhalers exhibit significantly (p less than 0.001) higher HbCO levels than noninhalers and the increase is significantly higher (p less than 0.02) in inhalers who smoked 1 h or less prior to blood sampling. High HbCO levels have two consequences: in the donors they have caused a tobacco polycythemia syndrome and in the recipients they have caused acute problems in cases of massive blood transfusion and cardiovascular surgery with extracorporeal circulation. PMID- 6857003 TI - Effects of prolonged oxygen therapy on pulmonary hypertension and blood viscosity in patients with advanced cor pulmonale. AB - In 16 patients with chronic bronchitis and advanced cor pulmonale admitted to hospital due to heart failure, a controlled 6-weeks oxygen therapy, 17 h a day, was performed. The trial was started when patients were out of the exacerbation of the disease in a respiratory and circulatory steady state. Pulmonary hemodynamics, blood viscosity, packed cell volume and basic lung function data before and after oxygen therapy were compared. A significant fall of mean pulmonary arterial pressure from 42 to 30 mm Hg without a change in the cardiac output was found. Blood viscosity and packed cell volume-significantly decreased. Arterial oxygen tension did not significantly change. It seems that 17-hours per day oxygen therapy is sufficient to induce regression of anatomic changes in pulmonary arteries, a main cause of pulmonary hypertension in hypoxic cor pulmonale. PMID- 6857004 TI - The forced expiratory wheeze. Its site of origin and possible association with lung compliance. AB - When a subject exhales forcefully, a wheeze is usually heard during the latter part of the maneuver. The origin and mechanism of this wheeze has been the subject of speculation but this has never been approached experimentally. In this study, a computerized frequency analysis technique was used to count the number of discrete frequency components making up the forced expiratory wheeze (FEW) in 10 normal subjects. The number varied from 1 to 5 implying a source in the larger airways. The supports previous theoretical considerations that relate the FEW to the so-called "equal pressure point" (EPP) in the larger airways. Since the EPP is thought to be determined principally by lung static recoil pressure, it can be surmised that this also determines (roughly) the number of wheeze components in the FEW. PMID- 6857005 TI - Comparison between plethysmographic and forced oscillation techniques in the assessment of airflow obstruction. AB - We compared airway resistances (Raw, body plethysmograph) and total pulmonary resistance at 4 and 24 Hz (RRS 4 Hz, 24 Hz) as well as the resonant frequency (RF), both in normals and in patients with airway obstruction. Bronchodilatation (n = 38) was the best evaluated by the induced changes in RRS 4 Hz and RF. However, the importance of change of RRS 4 Hz was poorly correlated with the change in Raw. Bronchial challenge test with histamine and DPT was again the best evaluated by RRS 4 Hz and RF with maximal changes observed for the latter. Normal ranges for Raw, RRS 4 Hz and RF were computed (n = 41). For all patients studied (n = 42) concordance for abnormality was good but poor for normality. From this we conclude that the oscillation technique is a different approach for the evaluation of airway obstruction and that RRS 4 Hz or RF are easy and accurate measurements to follow during bronchodilatation and bronchoconstriction tests. PMID- 6857007 TI - Idiopathic diaphragmatic paralysis and asthma bronchiale. AB - A 38-year-old man suffered from chronic asthma. He also had paralysis of the right diaphragm which had been present for some years. During an acute asthmatic attack following administration of acetyl salicylic acid, a chest roentgenogram revealed hyperinflation of the lungs, especially of the right side. The paralytic diaphragm was pushed down considerably. After treatment of the acute attack of asthma, the diaphragm ascended to its 'normal' place. This case illustrates 'air trapping' in acute asthma and sheds some light on the mechanism behind it, which is discussed. PMID- 6857006 TI - Repeat fiberoptic bronchoscopy in patients with recurrent, unexplained hemoptysis. AB - Repeat fiberoptic bronchoscopy (FB) is indicated in patients with recurrent, unexplained hemoptysis to localize and/or diagnose the source of bleeding. The results of 34 bronchoscopies in 14 patients over a 6-year period were examined. 10 patients had 2 FBs each and 1 patient had 5 procedures at varying intervals. Only early FB detected active bleeding (12/25) early FBs) and localized a bleeding site (10/25). Definitive diagnoses (6/34 FBs) occurred only in patients with lung malignancy and were not necessarily influenced by the timing or frequency of FB. Clinical diagnoses and management were infrequently altered by each FB, except for management of malignancy. Thus, early, repeat FB in this diagnostically difficult group of patients contributes limited immediate information and minimally changes therapy in patients with nonneoplastic conditions. Despite these limitations, direct bronchial visualization by FB remains the most reliable standard available for localizing and, to a lesser extent, diagnosing the etiology of recurrent hemoptysis. PMID- 6857008 TI - Terbutaline aerosol from a metered dose inhaler with a 750-ml spacer or as a nebulized solution. Comparison of two delivery systems for bronchodilator aerosol. AB - The clinical effect of 1.0 mg terbutaline given as a pressurized aerosol with a 750-ml spacer was compared with that of 4.0 mg terbutaline given as a nebulized solution (Pari Inhalier Boy). No differences were found in the parameters measured--forced vital capacity, 1 s forced expiratory volume, forced mid expiratory flow, and oscillatory resistance. The results indicate that the same clinical response to a given dose of a pressurized aerosol supplied with a 750-ml spacer has the same effect as a fourfold dose via a nebulizer. It is concluded that the more practical 750-ml spacer should be tried when contemplating nebulization therapy. PMID- 6857009 TI - [Pulmonary embolism as a complication of transfemoral arteriography]. PMID- 6857010 TI - [Changes in myocardial norepinephrine and glycogen phosphorylase in ischemic and non-ischemic areas]. PMID- 6857011 TI - [Effects of L-carnitine on myocardial fatty acid metabolism impaired by catecholamines]. PMID- 6857013 TI - [Direct and indirect cardiac effects of dobutamine in isolated dog atrial and intact dog preparations]. PMID- 6857012 TI - [Significance of sympathetic nerve system on the precipitation of cardiac ischemia--effects of hyperlipidemia on the changes of coronary circulation, cardiac function and myocardial metabolism produced by sympathetic nerve stimulation in dog hearts with moderate coronary-constriction]. PMID- 6857016 TI - [A method to calculate regional myocardial tension by intramyocardial pressure recording and its application to estimate regional myocardial contractility in ischemic left ventricle]. PMID- 6857014 TI - [ST depression induced by sympathetic nerve stimulation with special reference to myocardial hypoxia]. PMID- 6857015 TI - [Plasma catecholamines during maximal exercise in patients with effort angina]. PMID- 6857017 TI - [Development of monitoring system of cerebral blood flow and cerebral metabolism. Part III. "In vitro module" of medical massspectrometer, and its clinical applications]. PMID- 6857018 TI - [Assessment of left ventricular isovolumetric contraction flow by the use of pulsed Doppler echocardiography]. PMID- 6857021 TI - [A study on the sleep apnea in patients with hypothyroidism]. PMID- 6857020 TI - [Physical work capacity in pacemaker implanted patients with fixed heart rate during exercise]. PMID- 6857022 TI - [2 cases of sleep apnea syndrome, and a few problems in sleep studies]. PMID- 6857019 TI - [Responsive changes of a rat papillary muscle relaxed with corticosterone]. PMID- 6857023 TI - [Ventilatory patterns during sleep and wakefulness measured by impedance pneumography]. PMID- 6857024 TI - [Investigation of A/D converter for automatic pulmonary function tests apparatus]. PMID- 6857025 TI - [Validity of treadmill exercise score quantifying the severity of coronary artery lesion and left ventricular function]. PMID- 6857026 TI - [Measurements of interstitial myocardial K+ with K+-sensitive electrodes]. PMID- 6857027 TI - [Assessment of diastolic properties of left ventricle by Fourier analysis of global left ventricular volume curve obtained from RI angiography]. PMID- 6857028 TI - [Diagnosis of mitral valve prolapse syndrome. Two-dimensional echocardiography]. PMID- 6857029 TI - [A case of probable myocardial sarcoidosis accompanied with reiterative Adams Stokes attacks]. PMID- 6857031 TI - [Physiology of the sinuses]. PMID- 6857030 TI - [A case of refractory ventricular tachycardia treated with permanent atrial pacemaker implantation]. PMID- 6857032 TI - [Surgical treatment of chronic frontal sinusitis]. PMID- 6857036 TI - [Endoscopy of the maxillary sinus. Its role in inflammatory pathology of the maxillary sinus]. PMID- 6857039 TI - [Pathology of sinusitis]. PMID- 6857033 TI - [Are there currently indications for crenotherapy in otorhinolaryngology?]. PMID- 6857035 TI - [Radiologic study of the sinuses]. PMID- 6857037 TI - [Ultrasonographic study of the facial sinuses]. PMID- 6857038 TI - [Value of nasosinal manometry in maxillary sinusitis]. PMID- 6857034 TI - [Radiologic study of the sinuses]. PMID- 6857040 TI - Scanning and transmission electron microscopy study of maxillary sinus mucosa in chronic sinusitis. PMID- 6857041 TI - Round table: sinus pathology in children. PMID- 6857042 TI - Round table: nasosinal allergy. PMID- 6857044 TI - [Sinusitis and childhood asthma: correlation and treatment]. PMID- 6857043 TI - [Rhinosinal mucormycosis]. PMID- 6857045 TI - [Associated diseases of the upper and lower airways. Apropos of 108 cases in a pneumology unit (1 January 1978-31 May 1979)]. PMID- 6857046 TI - [Round table: therapy of chronic sinusitis]. PMID- 6857047 TI - [Tumor markers and digestive neoplasms]. PMID- 6857048 TI - [Detection of precancerous lesions of stomach and intestine]. PMID- 6857049 TI - [Medical treatment of cancer of the esophagus, stomach and pancreas]. PMID- 6857050 TI - [Treatment of cancers of the colon and rectum]. PMID- 6857051 TI - [In vitro determination of the antitumor activity of chemotherapy]. PMID- 6857052 TI - [Fractures of the tibial shaft, analysis and discussion of 41 cases]. PMID- 6857053 TI - [Centro-medullary fixation of the tibia using Hackethal's method for fractures of the tibial shaft]. PMID- 6857054 TI - [Tracheobronchomegaly: a frequently ignored cause of recurrent bronchopulmonary infections]. PMID- 6857055 TI - [Cimetidine and neuropsychological disorders]. PMID- 6857056 TI - [Intestinal and systemic Campylobacter infections]. PMID- 6857057 TI - [Anal incontinence]. PMID- 6857059 TI - [Does therapy for common liver diseases exist?]. PMID- 6857062 TI - [Conservative treatment of cancer of the anus]. PMID- 6857058 TI - [Detection and treatment of pancreatic cysts and pseudocysts]. PMID- 6857061 TI - [Diverticular disease of the colon. Surgical treatment]. PMID- 6857060 TI - [Diverticular disease of the colon. Medical treatment]. PMID- 6857063 TI - [Hospital care for terminal patients. Comparative study of Swiss and foreign institutions]. PMID- 6857064 TI - [Myocarditis caused by drug-induced hypersensitivity (methyldopa)]. PMID- 6857065 TI - [The practitioner confronting diet]. PMID- 6857066 TI - [How should one examine for a disorder of the esophagus?]. PMID- 6857067 TI - [What drug treatment to choose for ulcer disease?]. PMID- 6857068 TI - [Vasectomy. Advantages, complications and consequences]. PMID- 6857069 TI - [Hip prosthesis without cement]. PMID- 6857070 TI - [Current indications for ultrasonography]. PMID- 6857071 TI - [Department of diabetes at La Source 1971-1981: report on more than 2000 hospitalizations]. PMID- 6857072 TI - [The value of endoscopy in the diagnosis and treatment of adenoid hyperplasia]. PMID- 6857073 TI - [Mason's method of gastroplasty in morbid exogenous obesity]. PMID- 6857075 TI - [Plastic surgery at La Source Clinic]. PMID- 6857074 TI - [Atheromatous obliterations of the arterial axes of the lower extremities. Diagnosis and surgical treatment]. PMID- 6857076 TI - [The value of colonoscopy]. PMID- 6857077 TI - [The Kveim test in sarcoidosis]. PMID- 6857078 TI - [The physician and home care]. PMID- 6857079 TI - [Th objective and specificity of geriatric psychiatry and psychogeriatrics]. PMID- 6857080 TI - [Controversial issues in medical psychology and psychiatry]. PMID- 6857081 TI - [Strategy in the choice of antibiotics in treating an acute infection caused by undetermined bacteria]. PMID- 6857082 TI - [Biological foundations of hemispheric specialization]. PMID- 6857083 TI - [Cognitive functions of the left hemisphere]. PMID- 6857084 TI - [Hemispheric specialization and emotional functions in man]. PMID- 6857085 TI - [Memory and hemispheric functional specialization. Neuropsychologic analysis]. PMID- 6857086 TI - [Memory and hemispheric functional specialization. Anatomo-clinical report]. PMID- 6857087 TI - [Language disorders in a right frontal lesion in a right-handed patient. Incoherent speech and extravagant paraphasias. Neuropsychologic study]. AB - Clinical, neuropsychological, and CT scan data are reported in a patient with a right prefrontal hematoma following meningeal hemorrhage due to the rupture of an aneurysm of the anterior communicating artery. Over a period of six weeks, before and after surgery, the patient presented a particular type of language disorder characterized by incoherent speech, verbal paraphasias, unexpected or guided along ideic perseverations, emphatic and affected terms, and impossibility of brief responses, particularly in denomination tests. Contrasting with the absurdity of the discourse, the respect of oral comprehension, the absence of grammatical disorders, and the perfect phonemic and phonetic organization provided evidence of the integrity of the linguistic code. The purely semantic disturbance, however, was the cause of the apparent alteration in reasoning and judgment. A major amnestic syndrome was also present. It improved concomitantly with the language disorders. The explanation proposed is that of a disturbance of an attention process and of word selection due to a prefrontal lesion. PMID- 6857089 TI - [Verbal and nonverbal dichotic listening test. Influence of the hemispheric activation state in normal subjects]. AB - The dichotomic listening test provides data for assessment of cerebral hemisphere activities in response to a given stimulus. Variations in results following verbal and non-verbal dichotomic listening tests to familiar sounds are described, as well as modifications when the activity of one or other hemisphere has been previously altered. Findings demonstrate that voluntary excentration of gaze modifies inter-hemispheric equilibrium and affects the results of the non verbal dichotomic listening test. PMID- 6857088 TI - [Contribution of the right hemisphere to language in aphasic patients. Disappearance of this language after a right-sided lesion]. AB - Assessments vary as to the contribution of the right hemisphere to language in aphasic patients. Results of a clinicopathologic study in two right-handed subjects with aphasia are reported. The lesions involved the territories of the left middle and anterior cerebral arteries. Oral productions in one case, studied during the three weeks of survival, were limited to automatic series, recitation of a fable, and completion of sentences. Follow-up in the other case was possible during 2 years of language rehabilitation. At the end of this period, repetition of an echolalic type was possible; a propositional expression had appeared, reduced to substantives and verb infinitives; denomination was possible but rich in semantic paraphasias. A second infarction in the right sylvian region caused the recovered language to disappear and to be replaced by an abolition of all communication. Proof was thus obtained that the progress accomplished was dependent on the right hemisphere. These findings are discussed in the light of observations of patients following left hemispherectomy and of the capacity of the right hemisphere to generate language as demonstrated in patients after commissurotomy. A dynamic interpretation of the taking over of expression by the right hemisphere during some aphasias is proposed. PMID- 6857090 TI - [HBs antigen in the blood donors of Calvados. Epidemiologic study and surveillance of the patients]. AB - 175 Chronic HBs Ag carriers have been discovered in the blood donors of the Calvados blood transfusion center from 1971 to 1979. 72 of them (41%) gave their consent for a clinical and biological study at the end of 1979, after receiving a convocation letter. This work had two aims: - to study the epidemiological factors in this population. - to evaluate the clinical and biological consequences of persistent antigenemia. 1. Epidemiological Study. Most results agree with the literature (higher prevalence in male, age, stay in endemic countries) but some results disagree for several reasons: our donors are all volunteers, HBs Ag prevalence is low in our region, most of the patients are caucasian and with life conditions and habits which may explain some particularities in contagion. Furthermore, the relative number of blood donors found every year as chronic HBs Ag carriers, does not increase in our country. 2. The Clinical and Biological follow-up of 62 HBs Ag carriers (alcoholics excluded) was carried out for 4,3 years on average. No patients developed clinical and biological features of chronic liver disease. After a mean term follow-up, we conclude that the asymptomatic HBs Ag carriers state seems not to be of bad prognostic. Since long term complications cannot be excluded, the follow-up of these patients must be maintained. PMID- 6857091 TI - [12th National Blood Transfusion Congress. St. Etienne, July 1982. Summaries of the data presented at the plenary sessions]. PMID- 6857092 TI - Proceedings of an International Conference on Plasmapheresis 82. Milano, 27th 28th May, 1982. PMID- 6857093 TI - Availability of plasma fractions for therapeutic use in Italy. (An introduction to the conference). PMID- 6857094 TI - Plasma-exchange in the treatment of cryoglobulinemia. AB - Plasma-exchange was used in 10 patients with mixed cryoglobulinemia. The procedure was used as a primary therapeutic tool to reduce cryoglobulin levels, and in combination with prednisone and cytotoxic drugs. The results show that PE alone is detrimental, although it may be an important adjunct to conventional therapy in MCG with progressive deterioration in the clinical condition, and in those patients who do not respond to drug therapy alone. The weak response to PE in MCG may be due to many technical variables, but mainly to the low percentage of circulating cryoglobulins removed. PMID- 6857095 TI - Plasma-exchange in immunologically mediated glomerular diseases. PMID- 6857096 TI - Plasma-exchange ten years later. PMID- 6857097 TI - The management of hereditary angioedema. PMID- 6857098 TI - Plasma-exchange in neurological diseases. AB - This paper summarizes experience with plasma-exchange therapy for neurological diseases at the Saronno hospital. Most treatments were performed by discontinuous flow centrifugation, but membrane plasma separation and cascade filtration were also employed. Eighty-five patients with demyelinating diseases of the peripheral nervous system (Guillain-Barre syndrome, immune complex polyneuropathies, paraneoplastic polyneuropathies), demyelinating diseases of the central nervous system (multiple sclerosis, subacute sclerosing panencephalitis), dermatopolymyositis and myasthenia gravis have been treated so far. Particular attention is paid to the combination of plasmapheresis with lymphocytapheresis and immunosuppressive drugs. This therapeutic approach appears to bring about dramatic and sustained improvement in most patients with neurological diseases, thus altering their natural course. PMID- 6857099 TI - [Diagnostic profile in hepatopathies]. PMID- 6857101 TI - Does septal surgery influence submucous congestion? AB - Nasal obstruction is brought about by many factors. The degree of filling of the submucous vascular plexus represents and important factor in this, but it is subject to a variety of influences and it is quantitatively rather unknown. In this study the influence of submucous congestion on nasal airway resistance is investigated in patients with complaints of nasal obstruction before and after septal surgery. The submucous congestion appeared to be the major determinant and was remarkably reduced after surgery. Local anatomical factors apparently are able to influence the behaviour of the submucous tissues in the nose, possibly by a mechanism of reflex origin. PMID- 6857103 TI - The pulsed ultrasound method adapted for examination of paranasal sinuses. AB - Three different ultrasonic display systems for examination of paranasal sinuses (oscilloscope; light emitting diodes; gas discharge display) have been evaluated in model experiments, on healthy subjects and in clinical materials. With the three different ultrasonic display systems air could be separated from other types of sinusal contents in model experiments. The detectable amount of saline solution in normal sinuses was 1-5 ml with all display units. The different display units showed the same screening capacity as radiography. The oscilloscope display system was significantly more efficient than the other display systems in separating different pathological conditions. Also regarding radiography the oscilloscope display was significantly more efficient in detecting secretion, but no difference was found in the capacity of predicting intrasinusal cysts. Thus, the oscilloscope display seems to be the most useful for both clinical and scientific purposes. PMID- 6857100 TI - Incidence of allergic rhinitis in children. AB - The authors give an account of the outcome of research done in the Allergo Immunological Centre of the IInd ENT Division of Rome University, carried out among 210 children who were affected by nasal atopy. Particular stress was placed on the involvement of the nasopharyngo-tubal system. The age of the children ranged from 2-12 years and they underwent: 1) ENT visit; 2) allergy tests; 3) anterior rhinorheomanometry; 4) tubal function tests; 5) mucociliary clearance time; 6) X-ray examination of paranasal sinuses. The results revealed that the most frequent symptom in these children is rhinitis, whatever the allergic sensitization was. The forms of atopy which manifested themselves by chronical allergic patients (D.Pt. and P.O.) were the cause of: 1. asthmatic-type syndromes; 2. early onset of atopic symptoms around 4-7 years of age (9-10 years in the seasonal forms); 3. greater degree of extrinsic rhinitis with edema of the turbinates - the first step towards a polypoid degeneration of such subjects; 4. tubal functional deficit (60% of subjects allergic to P.O. and 50% allergic to D.Pt whereas only 27% are found in the seasonal forms); 5. mucociliary clearance linked directly with the length of disease; involvement of the paranasal sinuses (53/61 patients allergic to D.Pt., 9/28 allergic to P.O., 9/56 allergic to Graminacee). Furthermore the nasal patency was more insufficient in patients affected by the chronical forms of the atopy. In the light of these results the authors advocate focus attention on the significance of an early diagnosis of nasal atopy in children and the need for interdisciplinary collaboration among specialists. PMID- 6857102 TI - Some immunological parameters in serum and nasal secretion in subjects with vasomotor and allergic rhinitis and nasal polyps - a comparative study. AB - We studied the levels of IgE, IgG, IgA and IgM in serum and nasal secretion in a group of 83 patients (57 with allergic rhinitis, 13 with vasomotor rhinitis and 13 with nasal polyps). For the measurement of the nasal IgE the RIST and PRIST techniques were used and the PRIST technique was used to measure the serum IgE. The remaining immunoglobulins were measured by means of nephelometry. For the clinical diagnosis of allergic rhinitis we took into account the positive reaction to some pneumoallergens, when performing the skin tests in addition to the clinical history. The levels of specific IgE in serum and nasal secretion were measured by the RAST technique. Our results may be summarized as follows: no significant change in the values of the serum immunoglobulins IgG, IgA, IgM; an increase in serum IgE in subjects with allergic rhinitis and allergic polyps, an increase in the IgE in nasal secretion in subjects with allergic rhinitis and bilateral polyps - whether allergic or not - as well as an increase in the three remaining immunoglobulins in the different groups studies whether they were atopic or not. PMID- 6857104 TI - Practical test kits for quantitatively evaluating the sense of smell. AB - A set of polypropylene squeeze-bottles, containing serial dilutions of pyridine in mineral oil, are used to deliver puffs of accurately odorized air to the nose. The patient's olfactory threshold can be quantitatively measured in a few minutes, and placed in the normal, hyposmic or hyperosmic range of sensitivity. PMID- 6857105 TI - Nasal responses to local unilateral stimuli in man. AB - The present study was designed to test the hypothesis that a feedback loop relaying information on the patency of one nasal cavity might be processed by the central nervous system to modify the vascular engorgement of the other, thereby minimizing total airflow resistance alterations during the nasal cycle. Histamine and xylometazoline were used to alter the degree of mucosal swelling and a cotton plug to alter airflow, in one nasal cavity and resistance measurements were made from its fellow. No changes in the latter were observed. It was concluded that this feedback arc does not exist. PMID- 6857106 TI - Comparative analysis of human nasal mucosa by standard neurohistochemical techniques. AB - The modified glyoxylic acid histofluorescent method (Torre and Surgeon) and Karnovsky-Roots method for acetylcholinesterase activity was applied to fresh animal and human material. Human material was obtained during ENT surgery and consisted of nasal, laryngeal and hypopharyngeal mucosa. Not only on animal, but also on human material adrenergic axons and varicosities were demonstrated around vessels in nasal mucosa, diffusely in nasal, laryngeal and hypopharyngeal mucosa and just below and intraepithelially in laryngeal mucosa. Abundant cholinergic innervation was found around vessels and glands in nasal, laryngeal and hypopharyngeal mucosa, as well as diffusely scattered in the tissue of their mucosa. PMID- 6857107 TI - Acute bronchitis-efficacy of erythromycin base (Ery-Max) administered twice or four times daily. PMID- 6857108 TI - [Application of noninvasive methods to the diagnosis of cerebrovascular diseases]. PMID- 6857110 TI - [Enzymatic study of peripheral nervous tissue and the retinas of rats subjected to experimental hyperglycemia: effect of ganglioside administration]. AB - The authors submitted to alloxan hyperglycemia albino rats of the Wistar strain. Alloxan is a sulphydryl poison, characterized by its selective action on the beta cells of the islets of Langerhans. Rats were partly treated with a mixture of gangliosides both for 10 days before hyperglycemia induction and during the following experimental period. Treatment with gangliosides caused in both groups a precocious and significant normalization of metabolic variation seen in hyperglycemic non treated rats. The Authors discuss the physiopathologic significance of the enzymatic variations found in two nervous structures, retina and sciatic nerve, in which initial diabetes-like condition has been induced. Gangliosides, whose use is warranted by recent studies about their effect in cell membrane function, seem to suggest, in this case, a preeminent metabolic action, also if their role is still not completely clear. PMID- 6857113 TI - [Pathologic relations and diagnostic difficulties in pancreatic and gallbladder diseases following gastric surgery]. AB - The authors studied the diagnostic possibilities of biliary and pancreatic diseases in patients after different types of operation of the stomach. In these cases, too, ERCP and PTC are suitable methods of examination. The authors studied 28 patients after gastric surgery: Billroth I gastrectomy: 6 cases, Billroth II gastrectomy: 21 cases and gastroenterostomy without gastrectomy: 1 case. Technical difficulties in connection with ERCP arose only with patients after Billroth II gastrectomy and the examination was successful in 67% only of the patients. The rate of successful examination of the bile duct system can be improved with the help of PTC. Apart from the technical difficulties, the analysis of the clinical material revealed data on the connections between gastric surgery and the development of biliary and pancreatic diseases. A few of these are well known in literature, but the traction and torsion of the duodenum during the preparation of the duodenal stump or gastroduodenostomy can also lead to the ductal deformity and the development of biliary and pancreatic diseases. PMID- 6857112 TI - [Hemiplegia: clinical picture and rehabilitation]. PMID- 6857111 TI - [Combined sclerosis of the spinal cord as an isolated clinical manifestation of folic acid deficiency]. PMID- 6857109 TI - [Clinical and electrophysiologic changes produced by (--) eburnamonine in acute and post-acute stages of head injuries]. AB - Two groups of patients suffering from cranial trauma have been submitted to a double-blind acute (1-2 per phlebo ampules/die for 7-10 days) and chronic (1 i.m. ampule for 30 days) at random treatment, respectively with (--) Eburnamonine and Papaverine. The evaluation of the clinical symptoms (state of consciousness, neurologic and post-traumatic symptoms) and of some electrophysiological responses (REG, visual and somato-sensorial evoked potentials) were investigated in basal conditions, during the acute stage, at the end of the chronic treatment and 30 days after the drugs withdrawal. The results showed (--) Eburnamonine to induce a superior improvement than Papaverine of some clinical symptoms (motor disorders, retrograde amnesia, vertigo) and of cortical bioelectrical activity, as rheoencephalographic data and reduction in early latencies of evoked response to somato-sensorial stimulation (SEP) revealed. Local and systemic tolerability was good with both drugs; a slight hypotensive action, more marked with Papaverine, was noted at the end of the treatment. PMID- 6857115 TI - [Sigmoid stenosis caused by a perityphlic abscess]. PMID- 6857114 TI - [Occurrence of stationary waves in angiography of peripheral vessels]. AB - Among 229 angiographies of peripheral vascular occlusions performed in 1981 and during the first half of 1982 at the Radiologic Clinic of Munster University, stationary waves developed in one case in the vascular band before the occlusion. This phenomenon can be a pointer towards assuming that over long distances before the occlusion there is no satisfactory outflow provided for by collaterals, intact arterio-arterial or arterio-venous connections. PMID- 6857116 TI - [Sonographic demonstration of upper abdominal vascular structures with special reference to the ascending lumbar vein]. AB - In a prospective study, we determined the relative frequency with which vascular upper abdominal structures could be demonstrated in a group of patients under radiological oncological treatment. Normal sono-topography is explained by means of representative illustrative material. On comparing sonography to angiography as well as to methods of nuclear medicine, it becomes evident that in all questions pertaining to angiology, sonography is of limited value as a screening method. PMID- 6857117 TI - [Cardiogenic shock. Diagnosis and methods of study]. PMID- 6857118 TI - [Treatment of shock in acute myocardial infarction]. PMID- 6857119 TI - [Postpericardiotomy syndrome]. PMID- 6857120 TI - [Physiology of the coronary circulation]. PMID- 6857122 TI - [Echocardiography in pericardial effusion]. PMID- 6857121 TI - [Role of spasm in coronary insufficiency]. PMID- 6857123 TI - [Plasma exchange and rheumatoid polyarthritis with vasculitis. Apropos of 6 case reports]. AB - The authors present six cases of rheumatoid arthritis (RA) complicated by vasculitis of varying clinical presentation: 2 cases of polyneuritis, 5 cases of skin lesions (dry gangrene, ulcers, purpura). The severity of the clinical picture required, in addition to the usual treatment (corticosteroids, immunosuppressants), plasma exchanges. A clinical stabilisation was obtained in every case with good tolerance. The development of a vasculitis would appear to be the prime indication for the use of plasma exchange in rheumatoid arthritis. PMID- 6857124 TI - [Lumbar phlebography. Contribution to the diagnosis of lumbo-sciatica of discal origin]. AB - The authors wanted to define the diagnostic value of lumbar phlebography in the investigation of intervertebral disc lesions and to compare these results with those obtained from clinical examination and plain Y-rays. They conducted a retrospective study of 200 cases of patients hospitalised for sciatica who were investigated by lumbar phlebography using selective catheterisation, without any prior neuro-radiological examination. 104 of these cases were operated. The lumbar phlebography was interpretable in 99 p. cent of cases. Severe thrombo embolic episodes occurred in two cases. In the 104 patients who went to operation, the surgical procedure confirmed the presence of a herniated disc (suspected on phlebography) in 96 p. cent of cases. Topographical agreement between the phlebographic data and the operative findings was observed in 81 p. cent of cases. Phlebography proved to be more reliable at L4-L5 than at L5-S1. In the patients in whom clinical examination and plain X-ray findings provided coherent information as to the site of the herniated disc, phlebography was considered to be of no use. In those patients for whom this examination did not provide coherent information, phlebography proved to be valuable in the topographical diagnosis of the herniated disc. PMID- 6857125 TI - [Serious thromboembolitic incidents during lumbar spine phlebography]. AB - From a series of 400 cases of lumbar spine phlebography by selective catheterisation, 4 serious thrombo-embolic episodes were observed, including 2 cases of severe pulmonary embolism which responded favourably to medical treatment. In 3 cases, risk factors were found (prolonged immobilisation in bed, past history of phlebitis). One case developed severe phlebitis of the lower limbs despite prophylactic treatment with low dose calcium heparin. In the other cases, no anti-coagulant therapy was prescribed before or during the examination. PMID- 6857126 TI - [Chronic corticodependent pericarditis complicated by tamponade treated with high doses of corticoids and by constriction treated by pericardectomy during stabilized rheumatoid polyarthritis]. PMID- 6857127 TI - [Osteomalacia in the metastatic region of prostatic origin resistant to vitamin and calcium therapy. Role of hypomagnesemia]. PMID- 6857131 TI - [Erythematous pemphigus induced by D penicillamine. Mortal course]. PMID- 6857130 TI - [Idiopathic ostonecrosis of the scaphoid tarsal bone (Kohler's second disease)]. AB - The authors report 9 cases of major radiological abnormality of the navicular bone, of which only 5 were cases of Kohler's disease. The diagnosis of this disease requires a combination of clinical and radiological signs, the isolated presence of radiological signs only represents abnormalities of ossification which are very common in this bone. The treatment is generally accepted to be plaster immobilisation, but its duration is a topic of debate, varying between 4 and 8 weeks, according to different authors. PMID- 6857129 TI - [Oligoarthritis in the framework of a Bruton-type agammaglobulinemia. Presentation of an atypical case in a 2-year-old child]. PMID- 6857128 TI - [Multiple bone necroses and familial type I hyperlipemia. Apropos of a case report]. PMID- 6857132 TI - [Hepatitis induced by pyrithioxine: direct toxicity or idiosyncrasy?]. PMID- 6857133 TI - [Hemopigmented villonodular synovitis: ultrastructural study and a comparison with hemophiliac synovitis]. AB - In a study of the ultrastructure of two cases of villonodular synovitis and two cases of haemophiliac synovitis, the authors observed very similar lesions. In both diseases, the lesions of the superficial layer of the synovium consisted of intermediate type (type C) synoviocytes loaded with iron pigments or lipid vacuoles. In the deep layer, the authors observed numerous macrophages loaded with siderosomes, lipid inclusions or phagocytosed red blood cells, giant cells and capillaries with a thickened basement membrane with a layered appearance. The cytoplasmic membranes of the synoviocytes were joined by desmosomes or filopodal digitations. The similarity of the lesions in the two diseases suggests a common histogenetic mechanism for the synovial lesions: chronic haemarthrosis. PMID- 6857135 TI - [Radionuclide purity of 99mTc emitters obtained from imported and domestically manufactured generators]. PMID- 6857134 TI - [Familial and recurrent hyperparathyroidism. Apropos of 7 adenomas in 3 members of the same family. Review of the literature]. AB - Over a period of 23 years, 3 members of a family of 5 presented with 7 parathyroid adenomas (4 in the first case, 2 in the second case, 1 in the third case). Excision of each adenoma, with systematic pre-operative assessment of the remaining parathyroid tissue, led to complete clinical and laboratory cure of each episode. The delay in the appearance of recurrence was between 3 and 9 years. After reviewing the literature, the authors stress the importance, in any case of hyperparathyroidism, of routinely investigating the serum calcium levels in members of the patient's family, especially if the patient is young and if he has had several episodes or a multiglandular involvement in the one episode. The authors discuss the literature concerning recurrent familial hyperparathyroidism with endocrine polyadenomatosis and the "hypercalcaemia - hypocalciuria" syndrome. PMID- 6857136 TI - [Cervical lymphoscintigraphy]. PMID- 6857137 TI - [Technical aspects of microwave hyperthermia]. PMID- 6857138 TI - [Possibilities and limitations of non-compartmental analysis in the modelling of biological systems]. PMID- 6857139 TI - [Evaluation of Gamma-11 equipment and its use in nuclear medicine]. PMID- 6857140 TI - Complement studies in splenectomized patients. AB - Total haemolytic complement activity, C2, C5, total alternative pathway activity, factor B, and C3d were measured in 85 splenectomized patients from 1 month to 32 years after splenectomy. Furthermore the patients were investigated for circulating immune complexes. No major deficiencies of the complement factors were detected. In a few patients a reduced C2 level was caused by genetically determined defects or was due to complement consumption in conjunction with circulating immune complexes. The complement levels were normal in 2 patients who had survived overwhelming infections after splenectomy. C5 was elevated in a major proportion of the patients, and it is suggested that this might be caused by post-splenectomy monocytosis. Circulating immune complexes were found in 20% of all cases, irrespective of the presence of residual splenic tissue. Thus the commonly cited impairment of the complement system after splenectomy does not seem to be substantiated, and the deficient resistance against bacterial infections in splenectomized patients does not seem to include abnormalities of the complement system. PMID- 6857141 TI - Effects of intensive plasmapheresis on the haemostatic system. AB - Intensive plasmapheresis was performed on 7 alloimmunized pregnant women. About 60% of the plasma volume was removed each day, Monday to Friday, with pauses over the weekends. This treatment resulted in drops in immunoglobulin levels to about 1/3 of the pre-treatment concentrations, whereas the haemostatic parameters studied remained within normal limits. Thus, generally the treatment (as performed in this study) does not seem to induce changes that predispose for thrombotic or haemorrhagic complications. However, in one of the patients, antithrombin III became progressively depleted over the weeks of treatment. Therefore it is suggested that the patients be screened for their haemostatic profile prior to and after a few weeks of plasmapheresis treatment. PMID- 6857142 TI - Increased incidence of Glanzmann's thrombasthenia in Jordan as compared with Scandinavia. AB - 12 Jordanian patients from 9 families with Glanzmann's thrombasthenia are described. All of them are products of consanguinous marriages. All cases are children with varying severity of mucosal bleeding. The clinical and laboratory findings are described. The importance of consanguinity is discussed and emphasized. Glanzmann's thrombasthenia is the second most common inherited haemorrhagic disorder in Jordan. PMID- 6857145 TI - Internal distribution of excess iron and sources of serum ferritin in patients with thalassemia. AB - Liver and spleen iron concentrations, serum ferritin level and binding of S ferritin to concanavalin A (Con A) were measured in 12 patients with thalassaemia major or intermedia at the time of splenectomy. All these subjects had increased liver iron concentration, most of them had hepatic fibrosis but none of them had histological evidence of chronic hepatitis. No patient had ascorbic acid deficiency. Serum ferritin concentration was increased in all cases, ranging from 266 to 5504 micrograms/l. In all but 2 subjects most of the protein did not bind to Con A, thus behaving as tissue ferritin. There were highly significant correlations between serum ferritin concentration, amount of blood transfused and liver iron concentration. On the average, iron concentration in the liver was about 3 times that in the spleen. The findings obtained suggest that in patients with thalassaemia major or intermedia most of the iron is deposited in parenchymal tissues and most of the S-ferritin derives by leakage from the cytosol of iron-loaded parenchymal cells. S-ferritin is a valid index of liver iron overload in thalassaemic patients without complications such as viral hepatitis and/or ascorbic acid deficiency. PMID- 6857144 TI - Aplastic anaemia associated with influenza A infection. PMID- 6857146 TI - Some haemorheological and haematological effects of alcohol. PMID- 6857147 TI - An assessment of the sensitivity of 3 bleeding time techniques. AB - The sensitivity of 3 bleeding time techniques to an aspirin-induced defect of platelet function has been assessed in 35 normal volunteers. A carefully standardised Ivy technique was compared with 2 commercial devices for a template bleeding time, the Simplate II and the Thrombolette. The standardised Ivy and the Simplate II were found to have a similar sensitivity; the Thrombolette tended to be less sensitive but the difference was not significant. PMID- 6857143 TI - Chromosome pattern and survival in acute non-lymphocytic leukaemia in relation to age and occupational exposure to potential mutagenic/carcinogenic agents. AB - The bone marrow karyotype was investigated in 98 patients with acute non lymphocytic leukaemia (ANLL). The patients were divided into two groups according to age. (1) 47 patients were 20-54 (median 40) years old. 21 had a history of occupational exposure to chemical solvents, insecticides, or petrol products, and 26 were considered occupationally not having been exposed to such agents. In 4 exposed patients (19%) all bone marrow cells had clonal chromosomal aberrations (designated AA), while also 4 of the non-exposed patients (15%) were AA. Thus in young ANLL patients, there was no significant association between occupational exposure to potential mutagenic/carcinogenic agents and the AA constitution of the leukaemic cells. (2) 51 patients were 55 years of age or older (median 65 years). 16 were exposed and 8 of these (50%) had the AA constitution. 35 patients were non-exposed and only 4 (11%) were AA. It is known from previous studies that the survival of ANLL patients with AA is extraordinarily short. Accordingly the overrepresentation of AA in exposed patients 55 years or older, was associated with a shorter survival than that of the non-exposed elderly patients. The results suggest that etiologic factors may influence the clinical course of ANLL, especially in elderly patients. PMID- 6857148 TI - Antibody response to pneumococcal vaccination in patients with myelomatosis. AB - 17 patients with myelomatosis were vaccinated with a 14-valent pneumococcal capsular polysaccharide vaccine. In comparison to 12 healthy controls, they had statistically significant lower combined geometric mean antibody concentrations (the geometric means of all 14 antigens), both before and 4 weeks after the immunization. Mean antibody increases, however, were remarkably similar in the 2 groups. After 18 months the geometric mean antibody concentrations of the patient group had returned to preimmunization levels or lower for 7 out of 14 antigens. 1 case of pneumococcal bacteraemia occurred in the patient group 8 1/2 months after vaccination in spite of a significant initial antibody response against the infecting serotype 23 F. Pneumococcal vaccination in patients with myelomatosis appears to yield subnormal antibody responses and therefore probably insufficient protection against pneumococcal infection. PMID- 6857151 TI - Hereditary ring sideroblastic anaemia and Christmas disease in a Swedish family. AB - The association of hereditary ring sideroblastic anaemia with Christmas disease in a Swedish family is described. We have studied the transmission of the sideroblastic trait, in relation to HLA groups and Christmas disease, and also evaluated the erythrocyte morphology, uroporphyrinogen-I-synthetase activity and S-ferritin for the detection of latent cases of ring sideroblastic anaemia. The proband had ring sideroblastic anaemia, Christmas disease and haemochromatosis. 3 cases of ring sideroblastic anaemia were found among the 12 family members studied. Using the factor IX deficiency as a marker of the X chromosome, it appeared that autosomal transmission of the sideroblastic trait was most likely. The sideroblastic trait did not seem to be linked to HLA-A3-alloantigen. Erythrocyte morphology was normal in all non-anaemic subjects. S-ferritin was found to be increased in all 3 cases of sideroblastic anaemia as well as in 1 non anaemic relative. Erythrocyte uroporphyrinogen-I-synthetase was elevated in 10 of the 12 family members; those with sideroblastic anaemia had the highest values indicating that uroporphyrinogen-I-synthetase is of importance in the disturbed haem-synthesis of ring sideroblastic anaemia. This interpretation is supported by the positive correlation between S-ferritin values and the uroporphyrinogen-I synthetase activity. PMID- 6857149 TI - Serum ferritin in non-dialysis patients with chronic renal failure: relation to bone marrow iron stores. AB - Serum ferritin and bone marrow haemosiderin iron was studied in 50 non-dialysis patients with chronic renal failure, and in 53 healthy subjects. S-ferritin was correlated to marrow iron both in patients with renal failure and in healthy subjects (P less than 0.001). Geometric-mean S-ferritin in patients with 0- (1+) marrow iron was 33 micrograms/l, 1+ marrow iron 166 micrograms/l, and 2+ marrow iron 519 micrograms/l. Healthy subjects with 0- (1+) marrow iron had a mean S ferritin of 16 micrograms/l and those with 1+ marrow iron a value of 65 micrograms/l. S-ferritin levels were higher in patients than in healthy subjects at all marrow iron grades (P less than 0.001). Healthy subjects with S-ferritin less than 15 micrograms/l had absent or reduced marrow iron, while those with S ferritin greater than 30 micrograms/l had normal marrow iron. Using a critical S ferritin value of less than or equal to 20 micrograms/l, the diagnostic efficiency in terms of diagnosing absent or reduced marrow iron was 0.90 (PV pos = 0.85, Pv neg = 0.91). In patients with renal failure S-ferritin less than 60 micrograms/l indicated absent or reduced marrow iron, while values greater than 80 micrograms/l were associated with normal marrow iron. The diagnostic efficiency of S-ferritin using a critical value of less than or equal to 60 micrograms/l was 0.94 (PV pos = 0.93, PV neg = 0.97). S-ferritin is a useful indicator of marrow iron stores in patients with chronic renal failure. PMID- 6857153 TI - Comparative studies of the in vivo kinetics of simultaneously injected 111In- and 51Cr-labelled human platelets. AB - The kinetics of simultaneously injected 111In- and 51Cr-labelled platelets have been assessed in 40 subjects, 13 of them thrombocytopenic. 4 platelet survival models were applied. The mean life-time (MLT) of 51Cr-platelets from non thrombocytopenic individuals was found to be slightly, but significantly, longer than that of 111In-platelets by applying linear and exponential models for data fitting. The in vivo recovery (IVR) of 111In-platelets was significantly higher than that of 51Cr-platelets in this patient group when using all 4 models. In the group of thrombocytopenic patients no statistically significant differences in MLT or IVR were found between 111In- and 51Cr-platelets. However, for each of the 11 51Cr-labelled platelet suspensions with the shortest MLT, a longer MLT was observed in the corresponding 111In-platelets, a finding probably related to antibody-induced elution of 51Cr-activity. The same mechanism might be responsible for an increasing 111In-/51Cr-recovery ratio in the early post injection period. The efficiency of platelet isolation from blood prior to labelling seemed to influence the IVR, inasmuch as the difference in IVR between 111In- and 51Cr-platelets was eliminated in the group where the yield of 111In platelets surpassed that of the 51Cr-platelets by more than 15%. PMID- 6857152 TI - K-cell activity in aplastic anaemia. AB - K-cell activity was measured by specific cytotoxicity and cytotoxic capacity in 29 patients with aplastic anaemia. 9 patients had a reduction of the specific cytotoxicity and 12 had a decreased cytotoxic capacity. The decreased cytotoxic capacity correlates with the severity of aplastic anaemia. Some of the possible causes of the reduction of this activity were investigated. PMID- 6857150 TI - Variation with age of reference values for P-cobalamins. AB - P-cobalamins were recorded on plasma from 279 persons (age interval 20-80 years) who participated in a population survey. The values obtained showed a decrease in the mean and a broadening of the reference interval with age. The justification of employing one reference interval, 200-650 pmol/l, is discussed. PMID- 6857154 TI - The blasted immature cells in the bone marrow. PMID- 6857155 TI - Liver disease in pregnancy with DIC and low levels of AT III. PMID- 6857156 TI - Genetic control of murine antibody-dependent cell-mediated cytotoxicity. Partial identity with the genetic control of NK activity. AB - We have observed that the intensity of the direct antibody-dependent cell mediated cytotoxicity (ADCC) response after an inoculation of foreign tumour cells varies with the strain of mice studied. The inoculation of a human lymphoblastoid cell-line into CBA/J, BALB/c, or DBA/2 mice gives rise to a good cytotoxic response by the host K cells armed with specific antibodies. In contrast, A/J, B10.A, C57BL/6 and B10.S mice respond poorly under the same conditions. The high response is dominant in F1 hybrids between high and low responders and is also expressed among F2 backcrosses with the H-2 phenotype of low responders, suggesting that non-H-2 genes are also implicated in the regulation of ADCC. The genetic control is not exerted at the level of antibody secretion but at that of K-cell activity, since sera from high or low responders are equally effective in arming an ADCC reaction, whereas K cells from low responder strains are less efficient than those from high-responder strains. The natural killer (NK) activity of the same strains has been screened. The results show a good correlation with some high- and low-responder strains, such as CBA and DBA/2 or A/J and SJL, respectively, but not with C57BL/6, B10.S or B10.A strains. Thus, in addition to common genes controlling both lytic functions, there are specific genetic factors influencing the balance between NK and K cells. These findings confirm the general view that NK and K cells represent only partially identical subsets. PMID- 6857158 TI - [Guardian activity and patient-equitable discretion in psychiatric admission procedures following Zurich Municipal Ordinance Article 397a]. PMID- 6857159 TI - [Comparative socioeconomic, anamnestic and psychological studies of patients with uterine myoma and uterine prolapse]. AB - 30 female patients with the diagnosis of "uterus myomatosus" and a control group of also 30 women with the diagnosis "descensus uteri et vaginae" were examined by a standardized questionnaire containing socio-economic, anamnestic and psychological data. To get information about their personality the "Freiburger Personlichkeitsinventar" (Freiburg Personality Inventory), half-form A, was administered at the end of the interview. The age limits were 35 and 55 years. The main socio-economic results are the following: during childhood and adolescence the myom-patients lived mainly near towns (p less than 0,01). The women of this group have better relationships to their husbands than the descensus-patients (p less than 0,01) and the husbands of the myom-patients are more often (p less than 0,01) of the same age or younger than their women. 18 out of the 30 women of the myom-group (i.e. more than 50%) said that their wish to become a mother has not been fulfilled while this answer was given by none of the 30 descensus-patients (p less than 0,01). The question is discussed in how far the uterus-myom can be understood as a somatic expression of the frustrated wish to get a child, as a "compensatory growth". Beside this, the authors are aware of the fact that other aspects, f.e. hormonal factors, may be important. PMID- 6857160 TI - [The night clinic--a social psychiatric facility]. AB - The concept of a psychiatric night clinic is shown on the basis of an experience made over 10, respectively 7 years in two such clinics belonging to a sociopsychiatric service. The importance of this halfway-house within the framework of a sociopsychiatric treatment is discussed as well as the indicative criteria, the therapeutic effect, the duration of the stay in the clinic, the organisational structure and the relationship with the family members. PMID- 6857157 TI - Simultaneous determination of the concentration and lytic activity of effector cells that mediate natural and antibody-dependent cytotoxicity. AB - Cellular cytotoxicity reactions can be studied in a manner analogous to that used to measure enzyme activity. This approach yields two parameters: Vmax, the maximal rate of target cell lysis that can be achieved by the lymphocyte preparation tested, and KMapp, the apparent Michaelis constant. By analogy to many enzyme-catalysed reactions, KMapp values for cytotoxicity reactions have generally been interpreted in terms of dissociation constants for the interaction of receptor sites on effector cells with antigens on the target cells. In this paper we demonstrate that experimentally determined KMapp values for natural or antibody-dependent cytotoxicity reactions are approximately equal to the concentration of NK or K effector cells in the lymphocyte preparation tested. This result makes possible the simultaneous determination of both effector cell frequency and lytic activity in a given lymphocyte preparation. PMID- 6857163 TI - [Human freedom between self realization and self destruction]. AB - Men consider only those motives valuable, which originate from inborn patterns of behaviour, and that means in the first place most of the different activities in the course of living together. In primitive communities, when holding together and wrestling with a combined effort against natural adversities or rival tribes, each individual acquires a homogeneous basis of habits in doing and thinking which become irrefutable matters of course.--In case of economical surplus consolidation of bigger social units gets under way.--That leads step by step- starting always from pioneering elites--in the course of many generations to increasing awareness in the conduct of life and at the same time to dwindling of the emotionally fixed matters of course. In the final stage of evolution, therefore, everyone should consequently acquire for himself a framework of habits and attitudes, representing a compromise between selfish and altruistic tendencies and granting his thoughts and actions steadiness, assurance, and self confidence.--If, however, owing to affluence, adverse living conditions do not force joint exertions and concord, individualistic expansion, competition, and rivalry arise and undermine the human relations. As a result increasingly self realization is claimed to the debit of the fellow-men. But in view of the fact that the individual as a gregarious being cannot exist without trustworthy social ties and esteem, a rising number of men comes into a conflict between individualistic desire for expansion and yearning for the security of a community. Exposed to such a situation a lot of people are unable to adjust to a harmonious living together. PMID- 6857161 TI - Spontaneous intracerebral haemorrhages (SICHs). Clinical and CT features; immediate evaluation of prognosis. AB - 108 cases of spontaneous intracerebral haemorrhages (SICHs) are reviewed. Over 50% were in a mild condition on admission. 31% could not be accurately diagnosed as SICHs before CT. Intraventricular haemorrhage (IVH) was observed in 38%. 36% of cases died during the first month and 13 patients died during the follow-up period. At the time of the follow-up or of death 66% of cases had a fair recovery. Level of consciousness predicted both mortality and functional recovery. Degree of initial neurologic deficit (IND) was correlated with functional recovery, not significantly with immediate mortality. CT images revealed that mortality and functional recovery were significantly correlated with size and location of SICHs as well as with the occurrence of an IVH involving two or more ventricles. Effects of intraparenchymatous haemorrhage and IVH upon mortality were additional. Casting of the third ventricle was indicative of poor outcome. PMID- 6857162 TI - [Clinical characteristics of a representative group of hospitalized depressed patients]. AB - In order to define some principal clinical characteristics of the hospitalised depressives, the authors have examined a group of 100 depressed patients consecutively admitted to the Psychiatric University Clinic of Lausanne. The clinic is at the same time a sector hospital. The depressives constituted 21% of all hospitalised patients. The number of depressives admitted during the duration of the study (6 months) permitted to calculate a hospitalisation rate of 86 patients per 100 000 inhabitants and per year. The 100 patients were subclassified in patients with a short depressive reaction, neurotic depressives, and endogenous depressives. Each of the 3 subgroups had about the same size. A modified version of the ICD 9 was used for the diagnostic classification. As a whole, the patients showed serious psychiatric manifestations and the majority presented suicidal tendencies. Besides, there were found characteristics which are not considered to be associated with depressions in general: an elevated proportion of unmarried persons in the total group, psychopathic traits among the reactive and neurotic depressives, and a considerable proportion of parental loss in early childhood in these two last mentioned subgroups. Furthermore, an accumulation of chronic and therapy resistant cases was observed in the group of neurotic depressives. A third of the endogenous depressives had been resistant to the ambulatory antidepressive treatment; a part of these patients responded well to the treatment in the hospital. PMID- 6857165 TI - [Semantic paraphasias, sometimes aberrant, in transcortical motor aphasia]. PMID- 6857164 TI - [Auditory evoked brain stem potentials, visual pattern evoked and somatosensory evoked potentials in transient ischemic attacks (TIA)]. AB - Auditory-evoked brainstem potentials, visual pattern-evoked and somatosensory evoked potentials in transitory ischemic attacks (TIA). Pathological findings in patients suffering from transitory ischemic attacks by means of using neuroradiological methods (CCT included) are a rare condition. The combination of visual checkerboard-evoked potentials (VEP), auditory brainstem-evoked (AEP) and somatosensory-evoked potentials (SSEP) can detect functional lesions in cerebral regions with different blood supply but without diagnostic risk. A delay of peak III of the AEP is possibly of specific value with regard to brainstem lesion caused by TIA in our patients. PMID- 6857166 TI - [Epistemologic models in psychoanalysis]. AB - The author proposes to make explicit various models underlying psychoanalytic epistemology. This is done in the spirit of enhancing dialogue with other epistemologies such as the theory of systems. Three main models are discussed: - the scientific model, based on the understanding of phenomena characterized by a splitting between object and subject according to the tradition of natural sciences; --the hermeneutic model, which proposes a search for meaning; --the intersubjective model, which centers all knowledge on the interrelation between analyst and patient. Crucial characteristics and drawbacks of these models are discussed; their necessary complementarity is presented. PMID- 6857167 TI - [Development of a HAWIE (Hamburg Wechsler Intelligence Test for Adults) short form for examination and assessment]. AB - As the use of the HAWIE complete form within the framework of conducting a forensic examination and producing an expert report seemed too extravagant to us, by means of using statistical procedures, we developed a short form consisting of the four sub-tests General Information (AW), Digit Span (ZN), Similarities (GF), and Block Design (MT), which correlated to the power of the long form (rxy = 0.905). 300 HAWIE reports by Ss, which were examined for forensic expert report purposes, served as our basis. Our new test form is to be recommended because of its great time saving factor (about 60%), especially when the question at issue within the framework of a forensic expert report is ability to feel guilt, credibility and fitness for questioning, and the general intellectual performance is to be globally determined. Advantages of our short form are economy, specific representativity and high multiple validity; it provides an ideal measuring instrument for investigators and experts. PMID- 6857168 TI - Metatarsal head resection in the treatment of the rheumatoid forefoot. AB - When conservative treatment in the management of the painful rheumatoid forefoot fails, surgery should be advocated. The aim is to relieve the sole from pressure on the metatarsal heads, which causes callosities on and pain in the forefoot. Various surgical procedures have been described, but they have in common to replace or remove the fat pad under the metatarsal phalangeal joints, to resect the metatarsal heads and, in doing this, restore the metatarsal ends to a flat arc. For if the intermediate metatarsals are left too long, new pressure points may develop, with ensuing pain. In this investigation a 4 1/2-year follow-up is presented of 32 patients operated on with metatarsal head resection in 59 feet. Twenty-two patients representing 39 feet were very satisfied, whereas 8 patients representing 15 feet were dissatisfied. Walking ability improved considerably; standing on toes improved; muscle power of toes improved. Despite attempting to maintain the metatarsal arc as a flat curve, this proved to be uneven in 25 feet, but did not jeopardize the results. The complications were minor and did not influence the final results. These, however, were decidedly influenced by the functional class of the patient at the time for investigation. Surgical management of the painful rheumatoid forefoot appears to be a recommendable procedure. PMID- 6857169 TI - Morphological and biochemical comparison of convex and concave articular surfaces from adult subtalar and midtarsal joints. AB - Convex and concave articular cartilage from adult subtalar and midtarsal joints showed depressions over surface chondrocytes and linear arrays of surface fibres when examined by scanning electron microscopy (SEM). Full-thickness cartilage from concave surfaces contained significantly less collagen than cartilage from convex surfaces (40.8% vs. 47.4%, p less than 0.05). Plano-concave surfaces contained 44.7% collagen. Water and uronic acid content did not differ significantly for the different shapes. A higher collagen content in convex surfaces is consistent with the hypothesis that collagen networks in these surfaces are subjected to higher tensile stress under load than are those in concave ones. PMID- 6857170 TI - Intestinal permeability to different-sized polyethyleneglycols in patients with rheumatoid arthritis. AB - The intestinal permeability to polyethyleneglycols (PEGs) of varying size in patients with rheumatoid arthritis has been investigated. Permeability was determined by measuring the 6-hour urinary recovery of different-sized PEGs after oral intake of PEG 400, PEG 1000, or PEG 3000. Patients with rheumatoid arthritis excreted significantly less PEG 400 and PEG 1000 than healthy individuals, whereas the excretion of PEG 3000 was the same or even greater than in healthy individuals. These findings point to the possibility that intestinal permeability is altered in rheumatoid arthritis. PMID- 6857171 TI - Prognosis in juvenile rheumatoid arthritis with systemic onset. A follow-up study. AB - Thirty-three patients with systemic onset JRA were followed up for 4 to 24 years (median 10 years). None had positive RF or ANA. Most patients developed polyarthritis. Cardiac involvement occurred in 14 patients (42%). Cardiac prognosis was good for pericarditis but seemed to be worse for myocarditis or perimyocarditis. Three patients contracted renal amyloidosis (9%). Severe growth retardation was observed in 39 per cent. Half of the patients had low activity or were in remission after in average 5.9 years' duration of the disease. Seventy per cent of the patients were in a good functional state. Patients with less than average radiological progression during the first 5 years of disease and those with onset of disease after the age of 5, seemed to have a better functional prognosis. PMID- 6857172 TI - Isometric muscle strength and endurance after knee arthroplasty with the modular knee in patients with osteoarthrosis and rheumatoid arthritis. AB - Maximum isometric muscle strength and endurance were used in an investigation of knee extension and knee flexion in patients with rheumatoid arthritis (RA) and osteoarthrosis (OA) with such severe changes of the joint that arthroplasty with the Modular prosthesis was performed. The measurements were done preoperatively and 3, 12, 24 and 36 months postoperatively. Muscle strength preoperatively was very weak compared with that of a group of healthy persons. The muscle strength 3 months postoperatively remained unchanged, which could mean a very slight trauma from the operation, very good pain relief and efficient physiotherapy. During the first 2 years the maximum isometric muscle strength was significantly increased both in patients with RA and in those with OA. Thereafter there was no increase in the RA patients, whereas in women with OA there was an improvement up to 3 years postoperatively. The improvement in the flexion strength was greater than that of the extension strength, thus indicating the importance of postoperative training of extension strength. Isometric muscle strength measurements show that there is an equalization between the non-diseased knee and the one operated with the Modular knee. PMID- 6857173 TI - Isometric strength and endurance in patients with severe rheumatoid arthritis or osteoarthrosis in the knee joints. A comparative study in healthy men and women. AB - Maximum isometric muscle strength on extension and flexion of the knee joints and endurance on extension has been studied in patients with rheumatoid arthritis (RA) and osteoarthrosis (OA), with such severe degeneration of the knees that arthroplasty was indicated. This material was compared with a group of healthy volunteers. The reduction in muscle strength was most pronounced in the RA group, which had 30-45% of the strength of the healthy volunteers. In the OA group the strength, similarly compared, was 55-70%. The difference is explained by the effect of the rheumatic disease on the muscles. The results indicate that in therapeutic measures due to trauma or in joint surgery, methods that contribute to a further decrease in muscle strength, e.g. immobilization with casts, bandages, or traction treatment, should be avoided. PMID- 6857174 TI - Specific plasma proteins as indices of inflammation during a modified fast in patients with rheumatoid arthritis. AB - Fourteen patients with classical rheumatoid arthritis and 7 healthy controls underwent a modified fast, containing diluted fruit and vegetable juices, for a 10-day period. To evaluate the effect of fasting on the inflammatory activity, plasma protein determinations were performed before and on the 10th day of fasting. Both patients and healthy controls developed reduced plasma levels of complement factor 3 (C3), orosomucoid and haptoglobin, although only the decrease in C3 and orosomucoid was greater in the patient group. An unchanged level in plasma of albumin, IgG, IgA, IgM and complement factor 4 was found. We conclude that determination of C3 and orosomucoid in plasma may be useful as indices of inflammation during fasting conditions. PMID- 6857175 TI - Effect of pregnancy and hormonal changes on the activity of rheumatoid arthritis. AB - The effect of pregnancy on the activity of rheumatoid arthritis (RA) was evaluated in 31 patients who had given birth to 49 infants after the onset of their disease. Pregnancy-associated remission of RA was experienced by 75% of the patients. On the other hand, disease exacerbation after delivery occurred in 62% of them. RA had no harmful effect on pregnancy or on the fetus. Hormonal changes during the menstrual cycle or during the use of hormonal contraceptives did not seem to influence the symptoms of RA. Factors possibly involved in remission of RA during pregnancy are discussed. PMID- 6857176 TI - Carcinoma of the bladder in a patient treated with cyclophosphamide for rheumatoid arthritis. AB - A woman treated with cyclophosphamide for rheumatoid arthritis developed carcinoma of the urinary bladder at the age of 51 years. Several similar cases reported in the literature suggests an increased risk of bladder cancer in patients treated with cyclophosphamide. There is need for a continuous follow-up with urinalysis in patients previously treated with this drug. PMID- 6857177 TI - Pleurisy in rheumatoid arthritis. AB - In 157 women and 77 men with rheumatoid arthritis, observed for a mean of 5.7 years, the annual incidence of pleural effusion was found to be 0.34% in the women and 1.54% in the men. In 4 pleural fluids the fluid-to-serum ratio for Waaler-Rose titres was 1:4, which agrees with the ratios for other proteins and does not suggest a pathogenetic role of the rheumatoid factor. In two other pleural fluids the findings suggested immune mechanisms implicating the rheumatoid factor. In general, the data, both clinical and any other, was compatible with the possibility of multiple etiological and pathogenetic factors in rheumatoid pleural effusions. These were: extrinsic factors causing pleural thickenings in 25% of non-rheumatoid men and in less than 10% of non-rheumatoid women aged more than 50 years; preceding lung disorder; particular inflammatory responsiveness due to rheumatoid disease, related or unrelated to rheumatoid factor; and some degree of transudation. PMID- 6857178 TI - Decreasing serum salicylate concentrations during long-term administration of acetylsalicylic acid in healthy volunteers. Discussion of possible clinical implications. AB - The suitability for multiple dosing of two acetylsalicylic acid (ASA) preparations was compared in 8 healthy volunteers. During this study a marked decrease in serum salicylate concentrations with time was observed in 7 of the subjects. These results are presented here. On day 16 of medications, levels were 60-80% of those on day 6. On day 38, when the study was discontinued, the levels had fallen to 50-65% of the values on day 6. The decrease in salicylate concentrations is probably due to induction of the salicyluric acid formation, one of the saturable pathways of salicylate elimination. Because of a narrow therapeutic range and large interindividual differences in salicylate concentrations with the same dose, determination of serum salicylate levels is an important tool in the adjustment of optimum individual ASA therapy. Our findings further emphasize this fact. They indicate that serum salicylate determinations should preferably be repeated a few times after initiation of ASA therapy. PMID- 6857179 TI - Arthritis and collagenous colitis. Report of a case with concomitant chronic polyarthritis and collagenous colitis. AB - A 26-year-old woman simultaneously developed chronic seronegative non-destructive polyarthritis and chronic watery diarrhoea. Biopsies from the colorectal mucosa showed a thickened subepithelial collagen layer consistent with collagenous colitis. The combination of these conditions has not, to our knowledge, been described previously. On the basis of only one patient it is too early to determine whether or not this case represents a new type of enteropathic arthritis. PMID- 6857180 TI - Can phonemic awareness be trained in kindergarten? PMID- 6857181 TI - Psychiatric labels in the military setting: some consequences on other persons' causality attribution of personal and situational factors. PMID- 6857182 TI - The stream of speech. PMID- 6857183 TI - Signalled and unsignalled avoidance impairments following noradrenaline depletion with DSP4: an hypothesis incorporating an associative and a non-associative factor. PMID- 6857184 TI - Time course of electrophysiological findings for patients with solvent poisoning. A descriptive study. AB - The time course of electroencephalographic (EEG) and electroneuromyographic (ENMG) findings was studied among 87 patients (40 men and 47 women) with a diagnosis of chronic solvent intoxication after occupational exposure. Neurophysiological studies were initially performed around the time of diagnosis, and all the patients were reexamined three to nine years later. No control group was available for the follow-up. Upon diagnosis 67% of the patients had an abnormal EEG, the majority with diffuse slow-wave abnormalities. The reexamination showed improvement in the EEGs of 47%, but the percentage of patients with paroxysmal abnormalities had increased from the initial 6 to 17. The percentage of patients with neuropathic findings was 62 for the first and 74 for the second ENMG. Upon reexamination fibrillations were seen in 46% (in 38% in the initial examination), and some loss of motor units was found for 61% (for 54% in the initial examination). Mild improvement in the neuropathic findings was noted for 60%, but the neuropathic findings of 25% showed slight deterioration during the follow-up period. The EEG findings showed a time course resembling that described after external head injuries. The ENMG findings resembled those described in hexa-carbon-induced or carbon disulfide-induced neuropathy. Controlled studies are recommended to examine the observed slight associations between electrophysiological findings and the type of chemical exposure. PMID- 6857186 TI - Turnover of professional drivers. AB - The aspects of turnover were studied in a cohort of 1,597 male drivers who had joined the trade union between 1967 and 1969 and who lived in six urban municipalities in different parts of the country. The retrospective study comprised the period from 1969 to 1979. At the end of this period, 1.5% of the cohort could not be traced, 3% were living abroad, and 5% were dead. An inquiry concerning occupation since 1969 was sent to 1,453 drivers (91% of the cohort). In all, 1,156 drivers responded (80%). A total of 69% of the subjects who answered the questions was still employed as drivers in 1979, 24% had turned to some other trade, 7% had retired, and less than 1% reported that they were out of work. The changes within the trade favored bus driving. The most common reasons for changing work were salary, the heaviness and irregularity of the work, and health. The major cause of death was accidents and other external causes, as could be expected in view of the drivers' comparatively young age in 1969 (mean age 29 years). PMID- 6857185 TI - A case-referent study on nasal cancer and exposure to wood dust in the province of Siena, Italy. AB - The aim of the present study was to assess the risk of nasal cancer associated with exposure to dust in the wood and furniture industry in the province of Siena, Italy. Four to seven percent of the active male population is employed in this sector. A case-referent approach was used. The cases included male subjects seen at the Ear, Nose and Throat Clinic and the Radiotherapy Unit of Siena and diagnosed as having cancer of the nasal cavities or paranasal sinuses between 1963 and 1981. The referents were male patients admitted to the Medical Clinic of Siena for all causes except nasal neoplasia; they were matched 5:1 to the cancer patients for age and time of admission. Information was gathered (by postal questionnaires) on the occupational histories of all 36 of the cancer patients and 164 of the 180 referents. The odds ratio associated with exposure to wood dust was 5.4 (1.7-17.2) for all carcinomas, and 87.7 (19.8-407.3) for mucinous adenocarcinoma. The woods used by the exposed cancer patients were mainly oak, chestnut, poplar, and fir. The median duration of exposure was 40 years; no exposed cancer patient reported the presence of exhaust systems in their work environment. PMID- 6857187 TI - Potential occupational health hazards in the microelectronics industry. AB - The microelectronics industry is a major user of a wide variety of chemicals and other toxic materials. In the recent past semiconductor manufacturers have located in many countries and brought a new set of challenging clinical problems to occupational physicians. California, an area with a significant history in the statistical study of health and safety in the microelectronics industry, presents some evidence of potential health hazards in the semiconductor manufacturing process. The Semiconductor Industry Study done in California in 1981 explains the application of many toxic materials in the semiconductor manufacturing process, including a variety of solvents, acids, and metals such as arsenic. The Study documents the extensive use of dopant gases, primarily arsine, phosphine and diborane. Further study is necessary to assure the health and safety of microelectronics workers, particularly in the application of dopant gases. PMID- 6857188 TI - Acute intoxication due to exposure to maneb and zineb. A case with behavioral and central nervous system changes. AB - The dithiocarbamates are considered chemicals of low toxicity. They are known to cause dermatitis, conjunctivitis, rhinitis, pharyngitis, and bronchitis in humans. Central nervous system effects in humans have not been found, but some cases have been reported in experimental animals. This case report concerns a 42 year-old man previously in good health, who sprayed a combined dithiocarbamate of maneb and zineb on a cucumber plantation twice during a week, the second time with a more concentrated solution than the first. Behavioral changes appeared after he walked through the sprayed area following the first application, and loss of consciousness, convulsions, and right hemiparesis with diffuse slow rhythm in the electroencephalogram occurred after the second exposure. Both the behavioral and central nervous system symptomatology disappeared spontaneously after a few days. An electroencephalogram was normal two weeks later. The absence of a positive previous history of the patient, the sudden appearance and spontaneous disappearance of the symptoms, and the apparent dose-response relationship strongly suggested that maneb and zineb were the cause of the illness. PMID- 6857189 TI - Can occupational exposure contribute to the development of malignant melanoma of the skin? PMID- 6857190 TI - Lung function of sheet metal workers exposed to fiber glass. AB - Out of 532 registered and contacted sheet metal workers, 251 responded, but only seven pairs were acceptable for the present study due to the following requirement: no history of smoking, pleural plaques or asbestos exposure. Seven of these workers were exposed daily to fiber glass, and seven were almost never exposed. In a second step nine additional exposed workers were included. Ordinary spirometry, lung volumes, closing volumes and the slope of the alveolar plateau, the maximum expiratory flow in air and after helium-oxygen breathing, and the elastic recoil pressures were measured. No evidence of small airway dysfunction or restrictive or obstructive ventilatory impairment was found, but the elastic recoil pressures of the exposed group were slightly increased. Fiber glass can conceivably cause a corresponding faint and probably harmless fibrous reaction in the lung parenchyma. PMID- 6857192 TI - [Has current adjuvant cytostatic therapy in radically operated breast cancer patients failed?]. AB - Ten years ago the first adjuvant study with combination chemotherapy for radically mastectomized mammary carcinoma patients was implemented. The results today show that 12 months' treatment with cyclophosphamide, methotrexate and 5 fluorouracil does not prolong survival. In the group of premenopausal women with 1 to 3 histologically positive axillary lymph nodes a lengthening of the time to relapse was observed (in 20% of the patients), but with no prolongation of survival. In the light of these results the ongoing Swiss trials should be reevaluated. PMID- 6857191 TI - Health evaluation of employees occupationally exposed to methylene chloride. AB - General study design and environmental considerations. Scand j work environ health 9 (1983): suppl 1, 1-7. Recent concern regarding health hazards of methylene chloride stem primarily from the discovery of its metabolism to carboxyhemoglobin. In this report, a research program is described, the purpose of which was to assess potential health effects of methylene chloride exposure in an occupational setting. Particular attention was given to evaluating possible direct and carboxyhemoglobin-mediated effects on the hematopoietic and circulatory systems. The study involved one fiber production plant which used a methylene chloride/methanol mixture and acetone as solvents and a second fiber production plant that used acetone only. The research design included a retrospective cohort mortality study and several health evaluation studies, as well as an environmental assessment of the two plants. Industrial hygiene monitoring indicated that typical methylene chloride exposures ranged from an 8-h time-weighted average of 140 ppm in areas of low methylene chloride use to a corresponding average of 475 ppm in areas of high methylene chloride use and that methanol was present in about a one to ten ratio to methylene chloride. Acetone exposures in both plants ranged from 100 to over 1,000 ppm (time-weighted average). PMID- 6857194 TI - [High-dosage methylprednisolone as an antiemetic in cytostatic-induced vomiting]. AB - The antiemetic efficacy of 375 mg methylprednisolone given as slow i.v. push injection was assessed in 27 tumor patients receiving strongly emetic cytostatic treatment. 13 of 27 patients were partially or completely protected from nausea and vomiting. Only minor side effects from methylprednisolone were observed: two patients complained of increased fatigue and four patients experienced facial rash with swelling 1 to 24 hours after the injection of methylprednisolone. High dose methylprednisolone is an effective antiemetic treatment for patients receiving cancer chemotherapy. PMID- 6857193 TI - [Pancreatic cancer. Epidemiology, etiology, diagnosis and therapy]. AB - The prognosis of pancreatic adenocarcinoma is still very poor. Research activities have, however, been instituted recently in all fields. Epidemiologic studies indicate etiologic roles of diabetes mellitus, smoking, and meat and coffee consumption. Sonography of the pancreas is at present the best screening method. The significance of computerized tomography, endoscopic retrograde cholangiopancreatography (ERCP), arteriography and tumor markers is discussed. A TNM staging system and prognostic factors are presented. Resection is the treatment of choice for organ-limited pancreatic cancer. The development of new radiation modalities (e.g. pi-mesons) promises improved loco-regional tumor control. The most effective chemotherapy consists of combinations containing 5 fluorouracil, adriamycin and mitomycin-C. Intensive future research in the field of pancreatic cancer is essential if the prognosis of this devastating disease is to be improved. PMID- 6857196 TI - [Appendicular invagination and post-appendectomy invagination]. AB - Intussusception of the appendix is an uncommon event (200 cases previously reported) and intussusception after appendicectomy is rare (20 cases previously published). Two recent cases are reported, the first with primary appendiceal intussusception and the second ileocolic intussusception after appendicectomy. In the second case the final pathology report revealed an intussuscepted caecal duplication responsible for the ileocolic intussusception. This event has not been previously reported. Symptomatology, investigation, classification, differential diagnosis and surgical tactics are discussed. PMID- 6857195 TI - [Glomerular changes in reflux nephropathy]. AB - Two patients with bilateral vesicoureteral reflux are presented. In both cases renal insufficiency progressed despite surgical correction of the vesicoureteral reflux and proteinuria persisted. Biopsy specimens from both patients revealed interstitial damage and segmental and focal glomerulosclerosis. These glomerular lesions in association with reflux nephropathy may be an important cause of renal function deterioration. PMID- 6857197 TI - [How atoxic are penicillins?]. PMID- 6857198 TI - [What determines the prognosis following cholecystectomy: anamnesis, surgical findings, postoperative complications?]. AB - In 346 patients followed up 6, 12, 24 and 48 months after cholecystectomy the clinical results (VISICK and self-assessment) were very good in over 80%, 1% had symptoms due to organic disturbances and 15-20% had mostly mild symptoms (pain, fullness, food tolerance) without detectable causes. These functional disorders were found frequently in female patients with long preoperative history and frequent attacks of pain. Age of patient, character of pain, therapy before the operation, postoperative complications or change of body weight showed no correlation with later results. The results were almost always good in patients with acute pancreatitis or acute cholecystitis before the operation, or who underwent choledochotomy. PMID- 6857200 TI - [Algodystrophy in the chronic stage following treatment with phenobarbital]. AB - A case of phenobarbital-induced algodystrophy is reported. The classical clinical picture is a very often bilateral "shoulder-hand" syndrome which, when associated with articular involvement in the two lower limbs, produces an unusual form known as "extensive". Interest lies in the possible confusion with rheumatoid arthritis. Doubts still persist concerning the physio-pathological mechanism by which the medication may lead to osteo-articular symptoms. An association of several factors is frequently found at the onset of the disease. PMID- 6857199 TI - [Effect of regular training on total and vital capacity of the lung in 17 to 25 year-old rowers]. AB - Lung volumes, FEV1 and airway resistance have been repeatedly measured from age 17 to 26 in a group of 16 rowers. Total capacity, vital capacity and FEV1 are in the upper normal range. Airway resistance is normal. The increase in total and vital capacity from age 17 to 26 has been within the normal limits of other young men in the same age group. Intensive training does not appear to influence total and vital capacity once the final height has been reached. Top Swiss rowers of the years 1981 and 1982 have total and vital capacity values well above the predicted values for men of the same height and age, and also above those measured in top Swiss rowers of the period 1968-1972. The latter finding can be explained by a difference in the selection process. PMID- 6857201 TI - The histological classification of polyps of the large intestine. AB - The World Health Organization's Histological Classification of Intestinal Tumors is presented in relation to the classification of polyps of the colon and rectum. Emphasis is placed on the terminology used to separate adenomas from tumour-like lesions because of the differences in their precancerous nature. The relevant terms are given in English, French, German, and Italian. PMID- 6857202 TI - [Methods for the early detection of colonic polyps and colonic cancers]. AB - The dramatically rising incidence of colorectal cancer and the fact that survival rates can only be improved by earlier diagnosis call for increased efforts aimed at early detection of colonic neoplasias. Present diagnostic methods--occult blood testing, digital exam, rigid and flexible sigmoidoscopy, double contrast barium enema and colonoscopy--are analyzed with regard to diagnostic yield, time requirement and patient acceptability. Flexible sigmoidoscopy has proved to be of high diagnostic value, to take relatively little time and to cause only minimal patient discomfort. It will therefore gradually replace rigid sigmoidoscopy. Various populations at risk for colorectal cancer are outlined and appropriate diagnostic screening methods are described. Finally, a plan for monitoring of the normal risk population is proposed. PMID- 6857203 TI - [Practical experiences with the stool test for occult blood]. AB - In the light of the literature and 10 years personal experience, the following conclusions are drawn: 1. Screening for colon cancer with Hemoccult works and is practicable. 2. Asymptomatic and unknown symptomatic cancers are detected. 3. These cancers are predominantly in an early stage (70% at Dukes A and B). 4. Large adenomatous polyps, i.e. precancerous neoplasias, can also be detected. 5. One-time testing may miss 15-20% of cancers and 40-50% of adenomatous polyps (depending on their size!). 6. Repeated screening during the 2 years before diagnosis lowers these false-negative figures to less than 10% in carcinomas and less than 30% in large polyps. 7. Screening for colon cancer should be started at age 45 and thereafter repeated annually. PMID- 6857204 TI - [Surgical treatment possibilities in colonic cancer]. AB - The standard patient with colonic cancer is described. For the last 30 years surgery has been able to cure nearly 50% of colorectal cancers with 5% perioperative mortality. Technical novelties such as the stapler, antibiotics and colon wash have not improved this crude rate. Moderate improvement in cure rates can reasonably be expected from early detection methods. Surgery and endoscopic surgery are complementary and not competitive techniques. PMID- 6857205 TI - [Non-surgical possibilities for the treatment of colorectal cancers]. AB - The 5-year survival rate after radical excision of colorectal carcinoma has not increased for thirty years. The development of adjuvant therapy should bring marked progress, but none of the clinical trials so far conducted has shown an improvement which could mean a statistically significant difference in survival. Preoperative radiotherapy decreases the tumor volume and the incidence of invaded lymph nodes. The results of postoperative radiotherapy and chemotherapy are favourable, and the final answer with regard to their effectiveness can be expected in the near future. PMID- 6857207 TI - [Results of colon resection in cancer of the large intestine based on 100 consecutive cases]. AB - 100 consecutive colonic resections for carcinoma are reported. The average age was 67.5 +/- 10.8 years. In 93% of all cases primary resection without colostomy was carried out. The overall operative mortality rate was 1% and the mean hospitalization period 19.8 +/- 7.3 days. PMID- 6857206 TI - [Abdomino-perineal amputation: socio-occupational reintegration and late postoperative complications]. AB - The major social, professional and organic sequelae of abdomino-peritoneal amputation are underestimated. A study covering 274 abdomino-perineal amputations performed between 1965 and 1981 served to determine the degree of social and professional reintegration in 64 patients who underwent surgery at age below 60. No patient was without sequelae. The leading complications are genital (87%) and urinary (30%). 65% of patients who had undergone surgery resumed work, but 26% were unable to work and are on national insurance. Specific "stoma care consultation" can help to reintegrate the patients who have undergone surgery and lessen their handicap by means, for example, of stoma irrigation. PMID- 6857208 TI - [Immunoreactivity in colorectal cancer. Approaches for an immunologic diagnosis?]. AB - An attempt was made to demonstrate a specific immunoreaction against antigens of colorectal carcinoma and its precursors in vitro. Lymphocytes of patients with colorectal carcinoma or adenoma were incubated with tumor antigens from various human carcinomas. The preparation of the tumor antigens was performed with 3 m KCl extraction from cancer tissue. The cellular immunoreactivity was measured by the electrophoretic mobility test (EMT). 51 of 57 patients with colorectal cancer had specific lymphocytic reactions to extracts isolated from colorectal cancer; 8 showed cross-reactivity to antigens from adenocarcinoma of the stomach, while there was a negative lymphocytic reaction to extracts from cancer of the breast or lung. In 10 of 15 patients with colorectal adenoma, values in the tumor range were found with extracts of colorectal carcinoma. In 16 healthy controls using identical tumor extracts, 158 measurements revealed 139 negative responses (90%). PMID- 6857209 TI - [Carcinoembryonic antigen (CEA) in surgically treated cancer of the large intestine]. AB - Preoperative CEA value. Dukes stage and recurrence rate have been evaluated in 112 patients with large bowel cancer. Recurrence rate within 24 months was significantly higher (33% vs. 10%, p = 0.01) for preoperative CEA values of more than 5 ng/ml. In patients with moderately or poorly differentiated adenocarcinoma the recurrence rate was nearly 40% if the preoperative CEA value was elevated. Among 13 CEA-detected early recurrences, 3 (23%) have been cured by resection. PMID- 6857210 TI - [Significance of preventive examination for the prognosis of cancer of the large intestine]. AB - Since screening for colorectal carcinoma was started in Germany (rectal digital palpation 1971, test for occult blood in stool 1977) the rate of early stage Dukes A in more than 3600 cases of colorectal carcinoma has increased significantly by 30%. The history of the disease has shortened and the number of inoperable patients has diminished by 10%. PMID- 6857211 TI - [When should cholecystectomy in acute cholecystitis be planned?]. AB - Acute cholecystitis may be treated either by removal of the inflamed gallbladder during the acute stage of the disease or by conservative measures followed later by cholecystectomy. Many authors recommend delayed operation in view of the possibly higher postoperative mortality with early operation. 394 early cholecystectomies for acute cholecystitis have been performed between 1970 and 1979 at the University Hospital of Basle. 14 patients died postoperatively, representing a mortality rate of 3.5%. Large series in the literature show similar mortality of 3.2-4.5%. In four prospective randomized studies no significant difference of the mortality rate has been demonstrated. One retrospective study of the two methods showed a reduction in mortality rate from 7.4% for late operation to 2.7% for early cholecystectomy. Based on our own studies and on the literature, we have come to the conclusion that early cholecystectomy must be recommended for acute cholecystitis. Its advantages are shorter hospital stay, less patient discomfort since there is only one hospitalization, and reduction of costs. These advantages are also coupled with a similar or even lower mortality rate. PMID- 6857213 TI - [Is technical progress in the diagnosis of acute abdomen in daily practice fiction or reality? Analysis of 660 cases]. AB - A clinical study of the cases of acute abdomen in 1970 and in 1980 has been conducted in two surgical departments (Zoug and Olten, Switzerland). In 660 cases the question was investigated whether progress has been made with the introduction of technical aids during the last ten years. In 1980 more specialized methods such as sonography, laparoscopy etc. were employed. Preoperative diagnosis was significantly improved and the agreement between pre- and postoperative diagnosis was markedly ameliorated. PMID- 6857212 TI - [Complications following cholecystectomy and their therapy]. AB - 426 patients who had undergone cholecystectomy took part in a retrospective study covering four years (1977-1980). 53 patients had gallbladder empyema. The complications in the 373 cholecystectomies without empyema were 4 wound infections (1.1%), 2 other infections, 10 postoperative hemorrhages (2.7%), 3 cases of retained stones (0.8%) and 7 other complications. Only 3 of the total of 6 infections required antibiotic therapy. Since the infection rate in the 373 patients without empyema was very low, and since it is known that bile is sterile in the early stages of acute cholecystitis, there is no indication even for prophylactic antibiotics. Treatment of acute cholecystitis is cholecystectomy within 24-48 h of onset of acute symptoms. The rate of infectious complications in patients with gallbladder empyema was 15.1%. Primary treatment for this disease is surgical removal of the infectious focus (cholecystectomy) and reduction of bacterial spread or treatment of peritonitis if already present. PMID- 6857214 TI - [Mechanical ileus: analysis following 360 operations]. AB - 360 laparotomies in mechanical bowel obstruction were performed in a five year period at the Department of Surgery of the University Hospital, Basel. The overall mortality rate was 50/360 = 14%. The most frequent cause of death was cardio-respiratory insufficiency (19/50 = 38%) and postoperative peritonitis (15/50 = 30%). The most common etiology of bowel obstruction and the corresponding mortality rate was adhesion (151/360 = 42%; mortality 8.5%), large bowel cancer 83/360 = 23%; mortality 13.0%) and incarcerated hernia (57/360 = 16%; mortality 10.5%). The interval between onset of symptoms and hospitalization and between hospitalization and operation in the nonfatal group was 19 days and 28 hours respectively, and in the fatal group 26 days and 21 hours respectively. In conclusion, early surgical intervention in bowel obstruction and a meticulous technique for anastomosis when bowel resection is necessary are the most important factors in improving the results. PMID- 6857216 TI - [17-year results following vagotomy and pyloroplasty]. AB - Report on 51 patients who underwent surgery for peptic ulcer between 1964 and 1966 by truncular vagotomy and pyloroplasty. The recurrence rate was 6.6% for duodenal ulcer and 19.9% for gastric ulcer. Two carcinomas were detected in the latter group. In neither group were dumping or diarrhea symptoms observed. PMID- 6857215 TI - [Epidemiology of stomach cancer in Basel]. PMID- 6857217 TI - [Data processing and meat inspection]. PMID- 6857218 TI - [An outbreak of Mycoplasma bovis mastitis in Switzerland]. PMID- 6857219 TI - [Giardia and other intestinal parasites of dogs and cats in Switzerland]. PMID- 6857221 TI - [To unity traditional and western sciences and modern pharmacology]. PMID- 6857220 TI - [Respiratory syncytial virus in bovine practice]. PMID- 6857223 TI - [Arterial chemoreceptors and regulation of pulmonary circulation]. PMID- 6857224 TI - [The pacemaker of the ureteral action potential and peristaltic activity]. PMID- 6857222 TI - [The current progress in breast feeding and maternal nutrition]. PMID- 6857225 TI - [Metabolism and physiological function of 2,3-diphosphoglyceric acid]. PMID- 6857227 TI - [Design and application of an oscilloscopic sphygmomanometer]. PMID- 6857226 TI - [Is thyroxine a precursor?]. PMID- 6857228 TI - [Physiological aspect of special environments]. PMID- 6857229 TI - Sudden cardia death: a problem in topology. PMID- 6857230 TI - Retina of river dolphin Lipotes Vexillifer. AB - The structure of retina of the Lipotes Vexillifer has been studied quantitatively under light microscope. The results obtained are as follows. (i) The thickness of the retina is 268 micrometer. The lamination of retina can be clearly distinguished. It consists of 10 layers. The thicknesses of the layers from pigment epithelium to internal limiting membrane are 12 micrometer, 44 micrometer, 2 micrometer, 48 micrometer, 20 micrometer, 36 micrometer, 68 micrometer, 32 micrometer, 8 micrometer and 2 micrometer respectively. (ii) The number of cells in the outer nuclear layer is larger than that in the inner nuclear layer. Two types of cell can be distinguished in this layer. The number of receptors and ganglion cells is in a ratio of 12 to 1. These results show that the retina type of the Lipotes corresponds to that of nocturnal animals. (iii) The diameters of ganglion cells range 1.5-37 micrometer with two peaks at 6 micrometer and 35 micrometer. This means that the ganglion cells fall into two groups according to size, and this has been proved by the observation on morphology of ganglion cells in the whole-mount preparation and sections of the retina. The percentages of large cells and small cells are 3% and 97% respectively. The proportion of small cells to large cells does not change greatly in different parts of the retina. (iv) No fovea and visual streak have been found in the retina. PMID- 6857231 TI - Isolation, purification and biochemical characterization of E-receptors on surfaces of porcine peripheral lymphocytes. AB - A report on the study of isolation, purification and biochemical characterization of two glycoproteins, designated as Gp1 and Gp2, with E-receptor activity from the surfaces of porcine peripheral lymphocytes is presented. The molecular weights of Gp1 and Gp2 have been found to be 58,000 and 29,000 Daltons, and the isoelectric points 6.8 and 5.5 respectively. N-terminal amino acid residues of Gp1 are glycine and alanine, and that of Gp2 is glycine. Monospecific rabbit anti Gp1 antiserum shown to inhibit E-rosette formation of porcine lymphocytes has been obtained. The present paper gives for the first time the evidence that the E receptor of porcine lymphocytes, Gp1 appears to have cross antigenicity with that of human lymphocytes. Further studies of Gp2 in detail and its relationship to Gp1 will be published elsewhere. PMID- 6857232 TI - Synthesis of delta sleep-inducing peptide (DSIP) and its physiological activity. AB - Protected nonapeptide--Delta Sleep-Inducing Peptide (DSIP) formula: see text has been synthesized by classical method. The product has been treated with TFA and purified on DEAE-Sephadex-A25 column, pure free nonapeptide obtained and alpha to beta transposition of Asp-residue found to be absent. It has been assayed by electrophoresis at pH 3.8, microcrystallinecellulose TLC and HPLC. The physiological activities of synthetic DSIP are performed on rabbits by using intravenous administration or mesodiencephalic ventricular infusion. Its function of intensifying delta and sigma waves on rabbit's electroencephalogram (EEG) is evident. There is no concomitant increase of delta- and sigma-enhancing effect following mesodiencephalic ventricular infusion of 10 or 20 times higher than 5 microgram/rabbit doses. Results of 6-day consecutive intravenous administration (50 microgram/kg) indicate that there is no obvious sign of adaptation to DSIP. Results suggest that the physiological function of endogenous sleep-inducing peptide is different from that of general sleeping draught. PMID- 6857233 TI - Human exposure to heavy metals in East Greenland. I. Mercury. AB - The concentration of mercury in 178 blood samples and 32 hair samples from the Angmagssalik district in East Greenland has been determined. For Greenlanders mercury concentrations are highly dependent on the amount of seal eaten. In the most heavily exposed group (eating more than six meals of seal per week), a significant positive correlation between blood mercury and age was demonstrated. No differences according to sex were demonstrated when the mean values were corrected for influence of age. In the most heavily exposed group, a mean value of 62.5 micrograms Hg/l was found, while in the group eating 1 meal of seal or less per week, the mean value was 22.2 micrograms Hg/l. In the control group consisting of Danes living temporarily in the district, the mean blood mercury concentration was 5.8 corresponding to the fact that they eat seal only occasionally. Hair mercury concentrations were found to correlate well with blood mercury concentrations (r=0.9222). The hair/blood ratio was estimated to 289. It is concluded that the present relatively high mercury exposure in Greenland does not exert any immediate risk of intoxication to the adult population, but supplementary investigation on fetal exposure is needed. PMID- 6857234 TI - Human exposure to heavy metals in East Greenland. II. Lead. AB - The concentration of lead in 175 blood samples originating from the district of Angmagssalik, East Greenland and 130 from Aarhus, Denmark, has been determined. Both Greenland and Danish males had significantly higher (5%) blood lead than females (Eskimoan males 14.8 micrograms Pb/100 ml, females 12.8 micrograms Pb/100 ml; Danish males 10.5 micrograms Pb/100 ml, females 7.7 micrograms Pb/100 ml). For Danes living temporarily in Greenland the values were: males 10.5 and females 10.2 micrograms Pb/100 ml. Eskimos of both sexes were found to have higher blood lead values than Danes living in the same area. Danish males from Greenland and Denmark were not found to be different, whereas Danish women living in Greenland had a significantly higher (5%) mean value than women living in Denmark. In the Eskimo group, but not in the Danish, a weak, positive, but significant age correlation was found. 4 samples of Eskimo origin exceeded 35 micrograms Pb/100 ml accepted in the EEC as a maximum value for non-occupationally exposed persons. When re-examined 5 months later, all values were below this limit. The influence of eating habits (local or imported food) and smoking habits was tested, but not found to influence the blood lead concentration. The results have confirmed that blood lead levels in Greenland are comparable to those found in European industrialized areas. The reason for the unexpected high level in the arctic area with minimum car driving and industry remains to be clarified. PMID- 6857236 TI - Antiviral agents. PMID- 6857235 TI - Advertising prescription drugs. PMID- 6857237 TI - The murky world of toxicity testing. PMID- 6857238 TI - New puzzles over estrogen and heart disease. PMID- 6857239 TI - Myosin light chain phosphorylation does not modulate cross-bridge cycling rate in mouse skeletal muscle. AB - An attempt was made to determine whether phosphorylation of the myosin light chain represents a thick filament-associated mechanism for modulating the rate of cross-bridge cycling in mouse skeletal muscle. When the degree of light chain phosphorylation was varied independently of tetanus duration, there was no correlation of phosphorylation with cross-bridge turnover rate, as measured by the shortening velocity of the muscle. It is concluded that in intact skeletal muscle phosphorylation of the myosin light chain does not in itself modulate cross-bridge cycling rate and that previously reported changes in cycling rate were due to other factors that may vary with tetanus duration. PMID- 6857240 TI - In vivo one-dimensional imaging of phosphorus metabolites by phosphorus-31 nuclear magnetic resonance. AB - A phosphorus-31 nuclear magnetic resonance imaging technique has been used to obtain information on phosphorus metabolites from different spatial regions of tissues in vivo. The technique for selection of planes through the tissue is based on phase-encoding of spin echoes and was used to obtain one-dimensional discrimination of phosphorus-31 spectra from different parts of the tissue simultaneously. Specimens were resolved into 16 distinct slices and a signal-to noise ratio of about 20 to 1 was obtained in 1/2 hour. Results are presented for phantoms, rat legs, and gerbil heads. PMID- 6857241 TI - Hemoglobin aggregation in single red blood cells of sickle cell anemia. AB - A laser light scattering technique was used to observe the extent of hemoglobin aggregation in solitary red blood cells of sickle cell anemia. Hemoglobin aggregation was confirmed in deoxygenated cells. The light scattering technique can also be applied to cytoplasmic studies of any biological cell. PMID- 6857242 TI - Hyaluronate in vasculogenesis. AB - Limb buds of chicken embryos contain within the peripheral mesoderm an avascular zone that is rich in hyaluronic acid. Epithelial tissues that synthesize large amounts of hyaluronic acid relative to other glycosaminoglycans caused avascularity when implanted into normally vascular wing mesoderm. Epithelia that synthesize little hyaluronic acid did not cause avascularity. Elvax implants containing hyaluronic acid caused the formation of avascular zones, whereas similar implants containing other glycosaminoglycans did not give rise to avascular zones. Hyaluronic acid may thus play a role in determining the location of blood vessels in the embryo. PMID- 6857244 TI - Endogenous opiates mediate radiogenic behavioral change. AB - Exposure of C57BL/6J mice to ionizing radiation caused stereotypical locomotor hyperactivity similar to that produced by morphine. Naloxone administration prevented this radiation-induced behavioral activation. These results support the hypothesis that endorphins are involved in some aspects of radiogenic behavioral change. PMID- 6857243 TI - Somatic mutations of immunoglobulin variable genes are restricted to the rearranged V gene. AB - An important question concerning the mechanism of somatic mutation of immunoglobulin variable (V) genes is whether it involves all of the numerous V genes in a differentiated B cell, independent of location, or if it is restricted to a particular chromosomal site. Comparison of the sequence of two alleles of a given V gene shows that the mutations are limited to the rearranged V gene, while the same V gene on the other chromosome has not undergone mutation. This indicates that a V gene sequence alone is not sufficient for somatic mutation to take place. The mutation is therefore restricted to the rearranged V gene and consequently does not occur before rearrangement. PMID- 6857245 TI - Urinary phenyl acetate: a diagnostic test for depression? AB - The compound 2-phenylethylamine is an "endogenous amphetamine" which may modulate central adrenergic functions. 2-Phenylethylamine is mainly metabolized by monoamine oxidase to form phenyl acetate (PAA). The 24-hour urinary excretion of PAA was measured in normal healthy volunteers and depressed patients. Patients were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, edition 3. In 70 percent of healthy volunteers of both sexes, the excretion of PAA ranged between 70 and 175 milligrams per 24 hours (mean = 141.1 +/- 10.2). Inpatients with major depressive disorder (unipolar type) (N = 31) excreted less PAA (68.7 +/- 7.0 milligrams per 24 hours) and 55 percent of them excreted less than 70 milligrams per 24 hours; there were no significant differences in the PAA excretion between untreated patients (N = 13) and those treated with antidepressants that were not effective (N = 18). The PAA excretion was reduced to a lesser extent in 35 less severely depressed unipolar outpatients (drug-free for 1 week) (86.3 +/- 11.8 milligrams per 24 hours). These results suggest that low PAA urinary excretion may be a reliable state marker for the diagnosis of some forms of unipolar major depressive disorders. PMID- 6857246 TI - Cancer Research. PMID- 6857247 TI - Mutations affecting programmed cell deaths in the nematode Caenorhabditis elegans. AB - Mutations in two nonessential genes specifically block the phagocytosis of cells programmed to die during development. With few exceptions, these cells still die, suggesting that, in nematodes, engulfment is not necessary for most programmed deaths. Instead, these deaths appear to occur by cell suicide. PMID- 6857248 TI - Pulsing electromagnetic fields induce cellular transcription. AB - Weak, pulsing electromagnetic fields can modify biological processes. The hypothesis that responses to such induced currents depend on pulse characteristics was evaluated by using transcription as the target process. Two pulses in clinical use, the repetitive single pulse and the repetitive pulse train, were tested. These pulses produced different results from each other and from controls when transcription in dipteran salivary gland cells was monitored with tritiated uridine in transcription autoradiography, cytological nick translation, and analysis of isolated RNA fractions. The single pulse increased the specific activity of messenger RNA after 15 and 45 minutes of exposure. The pulse train increased specific activity only after 45 minutes of exposure. PMID- 6857249 TI - Intermolecular interactions in collagen self-assembly as revealed by Fourier transform infrared spectroscopy. AB - When a solution of collagen molecules, at neutral pH and moderate ionic strength, is warmed from 4 degrees to 30 degrees C, a spontaneous self-assembly process takes place in which native-type collagen fibers are produced. Events occurring during thermally induced fibrillogenesis process can be monitored, in aqueous media and in real time, by Fourier transform infrared spectroscopic techniques. Tentative assignments of observed spectral bands are given. PMID- 6857250 TI - Nuclear transplantation in the mouse embryo by microsurgery and cell fusion. AB - Nuclear transplantation in the mouse embryo was achieved by using a method that combines microsurgical removal of the zygote pronuclei with the introduction of a donor nucleus by a virus-mediated cell fusion technique. Survival of embryos was greater than 90 per cent in tests of this procedure. The embryos developed to term at a frequency not significantly different from that of nonmanipulated control embryos. Because nuclei and cytoplasm from genetically distinct inbred mouse strains can be efficiently interchanged, this procedure may be useful in characterizing possible cytoplasmic contributions to the embryonic and adult phenotype. PMID- 6857251 TI - Pimozide blocks establishment but not expression of amphetamine-produced environment-specific conditioning. AB - Animals with a history of receiving daily injections of +-amphetamine in a specific environment showed a placebo effect (enhanced activity) when injected with saline and placed there; control animals with similar but dissociated drug histories and experience with the test chamber failed to show the effect. The dopamine receptor blocker pimozide antagonized the establishment of conditioning. However, the same dose of pimozide, when given to previously conditioned animals on the placebo test day, failed to antagonize the expression of conditioned activity. Thus, during conditioning dopaminergic neurons mediated a change that subsequently influenced behavior even when dopaminergic systems were blocked. Although schizophrenia may be related to hyperfunctioning of dopamine, neuroleptic drugs, which block dopamine receptors on their first administration, do not have therapeutic effects for a number of days. The results of the pimozide experiments may resolve this paradox. PMID- 6857253 TI - Hypothalamic gamma-aminobutyric acid neurons project to the neocortex. AB - Three groups of gamma-aminobutyric acid--containing neurons were found in the mammillary region of the posterior hypothalamus. The groups correspond to the tuberal, caudal, and postmammillary caudal magnocellular nuclei. Many cells in these nuclei were retrogradely labeled with fast blue after the injection of this fluorescent dye into the neocortex. Immunohistochemical experiments showed that these same neurons also contained the gamma-aminobutyric acid-synthesizing enzyme glutamate decarboxylase. These results provide morphological evidence for a gamma aminobutyric acid pathway arising in magnocellular neurons of the posterior hypothalamus and innervating the neocortex. PMID- 6857252 TI - High fetal estrogen concentrations: correlation with increased adult sexual activity and decreased aggression in male mice. AB - In the house mouse (Mus musculus), fetuses may develop in utero next to siblings of the same or opposite sex. The amniotic fluid of the female fetuses contains higher concentrations of estradiol than that of male fetuses. Male fetuses that developed in utero between female fetuses had higher concentrations of estradiol in their amniotic fluid than males that were located between other male fetuses during intrauterine development. They were also more sexually active as adults, less aggressive, and had smaller seminal vesicles than males that had developed between other male fetuses in utero. These findings raise the possibility that during fetal life circulating estrogens may interact with circulating androgens both in regulating the development of sex differences between males and females and in producing variation in phenotype among males and among females. PMID- 6857254 TI - Regenerative impulses in taste cells. AB - Taste cells and nongustatory epithelial cells in the isolated lingual mucosa from the mud puppy Necturus maculosus were impaled with microelectrodes. The taste cells, but not surrounding epithelial cells, were electrically excitable when directly stimulated with current passed through the recording electrode. Action potentials produced by taste cells had both a sodium and a calcium component. PMID- 6857255 TI - Chlorinated dioxins. PMID- 6857256 TI - The embarrassing odyssey of Seveso's dioxin. PMID- 6857257 TI - An unusual glucocerebroside in the crustacean nervous system. AB - High concentrations of glucocerebroside (glucosylceramide) were found in the ventral nerve cord, brain, optic nerve, and antenna, but not in the nonneural tissue, of the brown shrimp Penaeus aztecus aztecus. This lipid contained unusual sphingoid bases consisting of 14-, 15-, and 16-carbon sphinganines and sphingenines. The fatty acids were mainly nonhydroxylated homologs 22 carbons long and longer, similar to those found in galactocerebroside but differing from those in glucocerebroside in mammalian nervous systems. PMID- 6857259 TI - Accumulation of D-aspartic acid with age in the human brain. AB - An age-related accumulation of D-aspartic acid was detected in the white matter of ten normal brains from individuals aged 30 to 80 years. Gray matter showed no systematic increase in D-aspartic acid. The rate constant for D-aspartate formation in the brain is equal to the predicted value calculated for 37 degrees C. Accumulation of the uncommon D-aspartate isomer in myelinated white matter implies that there is little or no turnover of this tissue, and this may have a bearing on dysfunction of the aging brain or on other diseases of myelin. PMID- 6857258 TI - Serum factor supporting long-term survival of rat central neurons in culture. AB - Gel filtration of serum at pH 3.6 yielded a fraction that supported long-term (months) survival of dissociated rat central neurons in monolayer culture more reliably than the traditionally used unfractionated serum. The cultures remained neuron-rich, because this fraction did not support the proliferation of glia and fibroblasts that occurs in whole serum. With an apparent molecular weight of 55,000 and an isoelectric point of 5.6, the active factor (or factors) in this fraction is distinct from any well-defined growth factor. PMID- 6857260 TI - Organ shortage clouds new transplant era. PMID- 6857262 TI - Carcinogen risk assessment. AB - The National Academy of Sciences elected 12, not 6, new foreign associates (News and Comment, 3 June, p. 1028). The remaining six are Kimishige Ishizaka (Japan), medicine and microbiology, Johns Hopkins University School of Medicine; Ikuo Kushiro, petrology, University of Tokyo, Tokyo, Japan; Guido Pontecorvo (Italy). geneticist, Imperial Cancer Research Fund Laboratories, London, United Kingdom; Kai M. Siegbahn, University of Uppsala, Uppsala. Sweden; John R. Vane, research and development, Wellcome Research Laboratories, Kent, United Kingdom: Douglas F. Waterhouse (retired), entomology. CSIRO, Deakin, Australia. PMID- 6857261 TI - Inhibition by alcohols of the localization of radioactive nitrosonornicotine in sites of tumor formation. AB - Oral administration of ethanol, n-butanol, or t-butanol to mice 20 minutes before injection of carbon-14-labeled nitrosonornicotine inhibited the localization of radioactivity in bronchial and salivary duct epithelium and in the liver. Localization of radioactivity in the nasal epithelium and esophagus was not significantly reduced. These alcohols therefore may selectively inhibit tumor formation in three of the five sites where this carcinogen typically acts. PMID- 6857263 TI - Induction of neuronal branching in Caenorhabditis elegans. AB - The two postembryonic touch receptor neurons in the nematode Caenorhabditis elegans arise from essentially identical cell lineages and have the same ultrastructural features. The cells are found in different positions in the animal, however, and differ in neuronal branching, connectivity, and function. These structural and functional differences are not seen when cells are placed in similar positions by mutation or laser-induced damage. Thus, some, but probably not all, of the differentiated properties of these cells are a consequence of their cellular environment. PMID- 6857264 TI - Redox delivery system for brain-specific, sustained release of dopamine. AB - Dopamine was transformed into a redox chemical system for delivery to the brain. The lipoidal form allowed penetration of the blood-brain barrier. Oxidative and hydrolytic processes then transformed the delivery form into a quaternary ammonium precursor of dopamine. The quaternary ammonium precursor was rapidly eliminated from the general circulation, whereas that formed in the brain was locked in, thereby providing a significant and sustained brain-specific dopaminergic activity. PMID- 6857265 TI - Transmission of integrated sea urchin histone genes by nuclear transplantation in Xenopus laevis. AB - Sea urchin histone genes contained in a recombinant plasmid pSp102 were microinjected into the cytoplasm of fertilized eggs of Xenopus laevis. By the late blastula stage, plasmid DNA sequences were detected comigrating with the high molecular weight cellular DNA (greater than 48 kilobases). Analysis of the DNA from injected embryos digested with various restriction endonuclease demonstrated that the injected DNA was integrated into the frog genome. Clones of embryos containing the pSp102 DNA sequences were produced by means of nuclear transplantation. Individuals of the same clone contain the pSp102 sequences integrated into similar chromosomal locations. These sites vary between different clones. PMID- 6857266 TI - Isolation of human C-reactive protein complementary DNA and localization of the gene to chromosome 1. AB - With a synthetic oligonucleotide mixture as probe, complementary DNA clones of C reactive protein were isolated from an adult human liver complementary DNA library. The clones ranged in size from 700 to 1100 base pairs and were identified by partial DNA sequence analysis. One complementary DNA clone was used as a probe for hybridization with human-rodent DNA's isolated from somatic cell hybrids and bound to nitrocellulose filters (Southern blot analysis) to assign the human C-reactive protein gene to chromosome 1. PMID- 6857267 TI - Bioactive cardiac substances: potent vasorelaxant activity in mammalian atria. AB - Mammalian atrial extracts possess natriuretic and diuretic activity. In experiments reported here it was found that atrial, but not ventricular, extract also causes relaxation of isolated vascular and nonvascular smooth muscle preparations. The smooth muscle relaxant activity of atrial extract was heat stable and concentration-dependent and could be destroyed with protease. Rabbit aortic and chick rectum strips were used for the detection of atrial biological activity. The atrial activity was separated by column chromatography into two peaks having apparent molecular weights of 20,000 to 30,000 and less than 10,000. The atrial substance that copurified with the smooth muscle relaxant activity in both peaks caused natriuresis when injected into conscious rats. It appears that atria possess at least two peptides that elicit smooth muscle relaxation and natriuresis, suggesting an endogenous system of fluid volume regulation. PMID- 6857268 TI - Dicarboxylic aciduria: deficient [1-14C]octanoate oxidation and medium-chain acyl CoA dehydrogenase in fibroblasts. AB - Dicarboxylic aciduria, an inborn error of metabolism in man, is thought to be caused by defective beta-oxidation of six-carbon to ten-carbon fatty acids. Oxidation of [1-14C]octanoate was impaired in intact fibroblasts from three unrelated patients with dicarboxylic aciduria (19 percent of control), as was the activity of medium-chain (octanoyl-)acyl-CoA dehydrogenase in the supernatants of sonicated fibroblast mitochondria (5 percent of control). These data confirm that dicarboxylic aciduria is caused by an enzyme defect in the beta-oxidation cycle. PMID- 6857270 TI - Sulfation preceding deiodination of iodothyronines in rat hepatocytes. AB - In man and animals iodothyronines are metabolized by deiodination and conjugation with glucuronic acid or sulfate. Until now these processes have been regarded as independent reactions. However, in the present study a close interaction of these pathways was observed in the hepatic metabolism of 3,3'-diiodothyronine and 3,3',5-triiodothyronine. Studies with rat hepatocytes and liver microsomes indicated that sulfation of the phenolic hydroxyl group facilitates the deiodination of these compounds. PMID- 6857269 TI - Inhibition of tumor promotion by a biomimetic superoxide dismutase. AB - A low molecular weight, lipophilic, copper coordination complex with superoxide dismutase-mimetic activity inhibited biochemical and biological actions of a tumor promoter in mouse epidermis. Such inhibitory effects implicate reactive oxygen species in the tumor promotion process. PMID- 6857271 TI - Inhibitory conductance changes at synapses in the lamprey brainstem. AB - Although the conductance and kinetic behavior of inhibitory synaptic channels have been studied in a number of nerve and muscle cells, there has been little if any detailed study of such channels at synapses in the vertebrate central nervous system or of the relation of such channels to natural synaptic events. In the experiments reported here, current noise measurements were used to obtain such information at synapses on Muller cells in the lamprey brainstem. Application of glycine to the cells activated synaptic channels with large conductances and relaxation time constants (70 picosiemens and 33 milliseconds, respectively, at 3 degrees to 10 degrees C). Spontaneous inhibitory synaptic currents had a mean conductance of 107 nanosiemens and decayed with the same time constant. In addition, the glycine responses and the spontaneous currents had the same reversal potential and both were abolished by strychnine. These results support the idea that glycine is the natural inhibitory transmitter at these synapses and suggest that one quantum of transmitter activates about 1500 elementary conductance channels. PMID- 6857272 TI - Mutual coupling between the ocular circadian pacemakers of Bulla gouldiana. AB - The ocular circadian pacemakers of Bulla gouldiana were found to be mutually coupled, and their interaction could be observed in an isolated nervous system maintained in vitro. Experimentally induced phase separations between the two ocular pacemakers were reduced when the eyes were allowed to interact for 48 hours. The reduction in phase separation did not occur however when the cerebral commissure was severed, indicating that this neural tract is a critical pathway coupling these two circadian clocks. PMID- 6857273 TI - Indoor air pollution: a public health perspective. AB - Although official efforts to control air pollution have traditionally focused on outdoor air, it is now apparent that elevated contaminant concentrations are common inside some private and public buildings. Concerns about potential public health problems due to indoor air pollution are based on evidence that urban residents typically spend more than 90 percent of their time indoors, concentrations of some contaminants are higher indoors than outdoors, and for some pollutants personal exposures are not characterized adequately by outdoor measurements. Among the more important indoor contaminants associated with health or irritation effects are passive tobacco smoke, radon decay products, carbon monoxide, nitrogen dioxide, formaldehyde, asbestos fibers, microorganisms, and aeroallergens. Efforts to assess health risks associated with indoor air pollution are limited by insufficient information about the number of people exposed, the pattern and severity of exposures, and the health consequences of exposures. An overall strategy should be developed to investigate indoor exposures, health effects, control options, and public policy alternatives. PMID- 6857274 TI - Active shortening retards the decline of the intracellular calcium transient in mammalian heart muscle. AB - When active shortening of the cat papillary muscle was allowed at any time during a contraction, the intracellular concentration of free calcium ions, detected with the calcium-sensitive bioluminescent protein aequorin, was higher than at comparable times in isometric twitches. The difference was not attributable to the differences of length involved or to motion artifacts, and must have been related to the act of shortening or the difference in force development in the two types of contractions. This observation and the phenomenon of shortening deactivation are both consistent with the hypothesis that attachment of cross bridges increases the affinity of the myofilaments for calcium ions. PMID- 6857275 TI - Salicylate and mitochondrial injury in Reye's syndrome. AB - Electron microscopic and spectrophotometric studies showed that salicylate causes gross swelling of mitochondria in isotonic salt solutions. In overall morphology the salicylate-treated mitochondria resembled those from patients with Reye's syndrome. Salicylate analogs such as m-hydroxybenzoate, p-hydroxybenzoate, and benzoate did not exert this effect. The mitochondria deformed by salicylate tended to return to their original condensed form on removal of the drug. PMID- 6857276 TI - Combined lipase deficiency (cld): a lethal mutation on chromosome 17 of the mouse. AB - Two triglyceride lipases, lipoprotein lipase and hepatic triglyceride lipase, participate in the metabolism of plasma lipoproteins. A single recessive mutation, cld, on mouse chromosome 17 causes an apparent deficiency of both lipoprotein lipase and hepatic triglyceride lipase activities. Mice homozygous for this defect develop lethal hyperchylomicronemia within 2 days postpartum as a consequence of nursing. Plasma triglyceride values in affected mice often reach 20,000 milligrams per deciliter (100 times higher than that in normal littermates), and total lipase activity in plasma or tissues is 5 to 20 percent of that in controls. PMID- 6857277 TI - Direct in vivo monitoring of dopamine released from two striatal compartments in the rat. AB - Microvoltammetric electrodes were used to monitor dopamine released in the caudate nucleus of the rat after electrical stimulation of the medial forebrain bundle. The time resolution of the technique is sufficient to determine in vivo concentration changes on a time scale of seconds. Direct evidence identifying the substance released as dopamine was obtained both voltammetrically and pharmacologically. Administration of alpha-methyl-p-tyrosine terminates the release of dopamine, although tissue stores of dopamine are still present. Thus there appears to be a compartment for dopamine storage that is not available for immediate release. This compartment appears to be mobilized by amfonelic acid, since administration of this agent after alpha-methyl-p-tyrosine returns the concentration of dopamine released by electrical stimulation to 75 percent of the original amount. PMID- 6857279 TI - Inhibitory influence of unstimulated rods in the human retina: evidence provided by examining cone flicker. AB - In the parafoveal retina of human observers, cone-mediated sensitivity to flicker decreases as rods become progressively more dark-adapted. This effect is greatest when a rod response to flicker is precluded. These results indicate that rods tonically inhibit cone pathways in the dark. PMID- 6857278 TI - Very brief visual experience eliminates plasticity in the cat visual cortex. AB - Rearing cats in the dark extends the critical period for development of visual cortical neurons, which indicates that the experience of visual input is necessary to begin the developmental process. A single brief pulse of visual input (6 hours) during a period of dark-rearing eliminates delayed development in the visual cortex. Light therefore seems to rapidly trigger the developmental process, and once triggered, that process runs to completion in the absence of further input. PMID- 6857280 TI - Physiological correlates of prolonged sleep deprivation in rats. AB - The issue of whether sleep is physiologically necessary has been unresolved because experiments that reported deleterious effects of sleep deprivation did not control for the stimuli used to prevent sleep. In this experiment, however, experimental and control rats received the same relatively mild physical stimuli, but stimulus presentations were timed to reduce sleep severely in experimental rats but not in controls. Experimental rats suffered severe pathology and death; control rats did not. PMID- 6857281 TI - Recognition of H-2 types in relation to the blocking of pregnancy in mice. AB - Inbred BALB/c females were mated and subsequently exposed in a divided cage to "stimulus" males or females whose H-2 type was similar or dissimilar to the stud male's. The incidence of pregnancy blocking was considerably higher when stud and stimulus males differed in H-2 type than when they did not. Similar results were obtained with urine samples of H-2 identical and nonidentical males. Females exposed after mating to other females whose H-2 type differed from the stud male, under the same experimental conditions, also showed an appreciable incidence of pregnancy block. It is therefore concluded that chemosensory recognition of H-2 types affects the reproductive hormonal status of the pregnant female. PMID- 6857282 TI - Diabetes and diet. PMID- 6857283 TI - NIH pays a price for "stability". PMID- 6857284 TI - Cooperative immunoassays: ultrasensitive assays with mixed monoclonal antibodies. AB - Mixtures of certain monoclonal antibodies appear to bind human chorionic gonadotropin in a "cooperative" fashion because they form circular complexes with the hormone. Experiments illustrate how this property might be exploited to develop very sensitive immunoassays for human chorionic gonadotropin or any other antigen. Since the assays are not based on competitive inhibition between radiolabeled and unlabeled antigen, they are much more sensitive than a traditional radioimmunoassay in which either one of the same antibodies is used alone. PMID- 6857285 TI - Synthesis and secretion of the plasmid-coded heat-labile enterotoxin of Escherichia coli in Vibrio cholerae. AB - Both cholera toxin and heat-labile enterotoxin were made and secreted into culture supernatants by Vibrio cholerae containing the enterotoxin plasmid pCG86. Several regulatory mutations in V. cholerae that increased or decreased the synthesis of cholera toxin did not affect production of heat-labile enterotoxin. In contrast, a mutation in V. cholerae that interfered with the secretion of cholera toxin also decreased the secretion of heat-labile enterotoxin, indicating that they are processed by a common secretory pathway. Vibrio cholerae should be useful as a model system for analyzing the secretion of true extracellular proteins by Gram-negative bacteria. PMID- 6857286 TI - A cancer-associated lactate dehydrogenase is expressed in normal retina. AB - An unusual isozyme of lactate dehydrogenase, lactate dehydrogenase k, is found in high concentrations in cultured cells transformed by the Kirsten murine sarcoma virus and in many human cancer tissues. In experiments described here high levels of a lactate dehydrogenase k activity were detected in extracts of normal rodent retina. This activity had the same key properties as the human tumor isozyme, namely, a highly cathodic electrophoretic mobility and inhibition of enzymatic activity by oxygen and 5',5'-dipurinenucleoside tetraphosphates. Expression of this activity in the retina may be related to the high aerobic glycolysis characteristic of the retina, a metabolic feature shared with many tumors. PMID- 6857288 TI - Are traditional healers the solution to the failures of primary health care in rural Nepal? AB - In the last two decades the great expansion of Primary Health Care (PHC) in the rural areas of developing countries has not been matched by significant improvements in health standards. Nepal is no exception. This study explores the view that some of these failures derive from the communication difficulties that exist between the rural health services and the client population. In other parts of the world traditional healers have been used as go-betweens to overcome these difficulties. In this study a group of 22 Traditional Medical Practitioners in a district of North Eastern Nepal were trained as TB and Leprosy referral agents. Ways of integrating them into existing rural health services were explored by discussion between themselves and local government health workers. Our results suggest that they are interested in participating in PHC delivery. Their specific task of referring patients proved more successful for leprosy than for TB. While their most important influence was a general effect of improving attendance at rural health facilities. This improved attendance is likely to be their chief success at raising health standards. By improving the communication between the health facilities and the people; the confidence of local people in PHC is raised, this brings more people into contact with the services and thereby raises health standards. PMID- 6857287 TI - Eye dominance columns from an isogenic double-nasal frog eye. AB - Removing the posterior (temporal) two-thirds of the Xenopus eye bud produces a remaining fragment, which becomes round and grows to a normal adult size eye. Electrophysiological and anatomical analyses showed that each of the two halves of this eye projected across the entire optic tectum in mirror image (double nasal) fashion, and that fibers from each half-eye sorted out to form eye dominance stripes on the tectum. That both halves of the mirror-symmetric map were derived from only one animal, and from only one side of the head, rules out global markers such as right versus left and histocompatibility differences as causing the formation of these stripes. PMID- 6857289 TI - Styles of living with low back injury: the continuity dimension. PMID- 6857290 TI - Pluralism in the organisation of health services research. AB - The variety of methods used in health services research (HSR) embody categorically different epistemological assumptions. These are examined in an effort to contribute to a usable framework for the evaluation of HSR projects, and in the light of a need in the U.K. for adequate institutional arrangements for the promotion and funding of HSR. Research into organisation has revealed that if desired values are not explicitly built into the structure, other values may appear unbidden. The adequate institutional base is one which embodies, espouses and funds a meaningful and practical scientific pluralism. A possible classification is outlined and illustrated and its implications for competition amongst scientists and the social responsibility of scientists are briefly discussed. PMID- 6857292 TI - Pregnancy, social status and health in Sweden. AB - The variations in reproductive outcome according to marital and social status are of major interest in many countries. It has however been suggested recently in Sweden that socio-economic characteristics do not in general have a substantial effect on reproductive performance. It is noted that women living alone report more general health symptoms than women cohabiting whether or not they are pregnant which appears to contradict previous results. On the other hand pregnant women living alone report more pregnancy related symptoms than pregnant women who are cohabiting. Moreover, in both cases, upper social groups tend to be healthier. PMID- 6857291 TI - Factors affecting list size of general practitioners and number of drugs prescribed: findings of a recent study. AB - Using information obtained from a previous in-dept study on primary health care in one Italian region, we examined first the relationship between list size and the socio-professional profile of the doctor and second the relationship between the number of drugs prescribed at each visit and the social characteristics of both doctor and patient. Using the technique of multiple regression, these figures show that: (a) list size depends mainly on age of doctor, place of residence and that the doctor is primarily a general practitioner, i.e. he is not involved in any other medical activity; (b) the doctor's level of prescribing remains virtually constant, unaffected by his own or the patients' characteristics or the particular problem presented by the patient. PMID- 6857294 TI - The geographical distribution of mortality by cause in Chile. AB - Standardised mortality ratios for 19 causes of death are computed for the provinces of Chile. All have a particular geographical distribution in common: they are either positively or negatively associated with the availability of health services. This is likely to be the result of the propinquity of health services to populations of higher socio-economic status and also the differences in recording accuracy between urbanised provinces and provinces where access to health services is especially difficult. By holding the effects of health service variability constant, other geographical patterns in mortality rates emerge. For lung cancer, two northern provinces have death rates ten times those of central Chile. PMID- 6857293 TI - Gains in life expectancies if heart disease and stroke were eliminated among Caucasians, Filipinos and Japanese in Hawaii. AB - Life tables were constructed based on all deaths in Hawaii occurring between 1968 1972 for Caucasians, Filipinos and Japanese. Gains in life expectancies to be attained if coronary heart disease (CHD) and cerebrovascular accidents (CVA) were eliminated were presented by sex and ethnic group. The expectation of life at birth for both males and females is greatest for Japanese, followed by Filipinos and then Caucasians. The gain in life expectancy by eliminating CHD would not benefit Caucasians while Filipinos would benefit the most from the elimination of CVA. For all ethnic groups and both sexes, the gain in expectation of life due to the elimination of CHD is more than were CVA eliminated as a cause of death. PMID- 6857295 TI - The mental health of foreign students. AB - Because of the psychological stress associated with university life and the physical and mental stress associated with migration, researchers have become interested in psychological problems of foreign students. In this study four groups of foreign students from different parts of the world were compared with two British groups on a self-report measure of mental health. No sex differences were found yet the overseas students, as a whole, showed significantly more disturbance than either British control or first-year subjects. However, despite many differences between their countries of origin there were no significant differences between any of the overseas groups on the total scale score or any sub-scores. Further, with the exception of Malaysian students, the British subjects were significantly more satisfied with their social lives than the other groups. These findings are discussed in terms of the literature on life events and illness, culture shock and migration and mental health. PMID- 6857296 TI - The problem of truth in psychotherapy: a phenomenological approach to treatment. AB - Scientific method cannot establish whether a patient's productions in psychotherapy are truthful because of the nature of Cartesian dualism. Phenomenology, however, is an alternative that clarifies what is truthful in therapy and provides insight into the process of therapeutic change itself. Basic ideas of Paul Ricoeur and the epistemology of Michael Polanyi are applied to the treatment setting to evaluate change. Clinical examples illustrate the usefulness of exegesis as a paradigm for understanding the process of therapy. PMID- 6857297 TI - Professionalism in medicine: the buck stops here. PMID- 6857298 TI - EKG computers: a public health hazard. PMID- 6857299 TI - Inappropriate use of cimetidine in hospitalized patients. AB - We reviewed the records of 100 medical and surgical patients who received cimetidine while hospitalized. Cimetidine use was categorized by FDA criteria as justified (23%), acceptable (40%), or unjustified (37%); prescribing patterns were similar in medical and surgical patients. Furthermore, intravenous cimetidine was often given when patients were receiving oral feedings, which resulted in unnecessary increases in hospital costs. PMID- 6857300 TI - Surgical treatment of mitral valve disease: pathologic findings and atrial dysrhythmia. AB - One hundred fifty patients underwent surgery for mitral valve disease between January 1974 and May 1981. There were 98 female and 52 male patients with a mean age of 57 years (+/- 18.6). One hundred forty-six patients were in New York Heart Association functional class III or IV. Pathologic diagnoses included 67% rheumatic (55 calcified), 27% degenerative and fibrotic, 3.3% prosthetic valve malfunctions, and 2.6% acute papillary muscle dysfunction. Atrial biopsy material was normal in 72% (37/51) and Aschoff's bodies were present in 2% (1/51). Preoperative cardiac rhythm was regular sinus in 40%, atrial fibrillation in 59%, and pacemaker-induced in 1%. Valve replacement was performed in 119 patients, commissurotomy in 26, and annuloplasty in five. Left atrial thrombus was removed from 21 patients. Hospital mortality was 10%. The 135 survivors have been followed up for an average of 30.4 months. Of patients who were in regular sinus rhythm preoperatively, 90.7% maintained it postoperatively, and 9.3% converted to atrial fibrillation. Of patients in atrial fibrillation preoperatively, 33.8% converted to regular sinus rhythm postoperatively and 66.2% remained in atrial fibrillation. These data indicate that rheumatic mitral valve disease is still the most common finding in patients coming to surgery, followed by degenerative and fibrotic mitral valve disease. Acute papillary muscle dysfunction is uncommon. The chance of preserving preoperative regular sinus rhythm postoperatively is excellent (90.7%), and a 33% conversion rate of preoperative atrial fibrillation to postoperative regular sinus rhythm is encouraging. PMID- 6857301 TI - Association of mitral valve prolapse and intracranial aneurysms. AB - This paper describes five patients with mitral valve prolapse (MVP) and intracranial aneurysms. Patients with MVP frequently have evidence of a more generalized disorder of connective tissue. An association of intracranial aneurysms and MVP could be related to mesodermal disturbances involving collagen and elastic tissue in the vasculature. Further study is needed to confirm this association and to elucidate the nature of any underlying connective tissue defect. PMID- 6857303 TI - Congenital subglottic stenosis: diagnosis and management. AB - In contrast to the generally accepted concept, I have classified congenital subglottic stenosis in a different way. During the first months of life, the abnormality may be recognized by its frequent association with acute respiratory infections, providing the opportunity to recognize it once the infection has been controlled. I emphasize the role of the radiologic examination of the larynx for diagnosis and follow-up of this disorder and its different evolution from that of pure subglottic laryngitis. A comparison with subglottic laryngitis and laryngotracheobronchitis emphasizes the seriousness of this retardation in the normal development of the larynx. PMID- 6857304 TI - Computed tomography and hangman's fractures. PMID- 6857302 TI - Effect of erythromycin stearate on serum theophylline concentration in patients with chronic obstructive lung disease. AB - The effect of erythromycin stearate (ES) on serum theophylline concentration (STC) was studied in 15 male adult subjects taking maintenance oral theophylline for clinically stable chronic obstructive lung disease. Steady-state trough STCs were measured before and after two- and seven-day courses of ES, 500 mg every six hours. For the group as a whole, there was no significant increase in trough STC after either course of ES therapy, but five of 15 subjects exhibited increases in trough STC ranging from 4 to 8 micrograms/ml (mean increase of 5.4 micrograms/ml) within 48 to 96 hours of beginning ES therapy. Clinical theophylline toxicity developed in one of these subjects. Based on this study and others in the literature, erythromycin preparations may induce a clinically significant and potentially toxic increase in STC in a variable proportion of patients taking maintenance theophylline therapy. PMID- 6857305 TI - Hip dislocations in myelodysplasia: a functional assessment. AB - We reviewed the records of 281 patients with myelodysplasia to ascertain the effect of hip dislocation on their ability to walk. There was no difference in the prevalence of myelodysplasia by gender. When adjusted for neurologic level and patient age, no statistical differences were found in the methods of locomotion between patients with hip dislocations and those without. Data (from this report and other published investigations) show that treatment for hip dislocation in myelodysplasia is unnecessary and fraught with many complications. PMID- 6857306 TI - Lyme disease in North Carolina. AB - We report two cases of Lyme disease in North Carolina, further expanding the distribution of known sporadic cases of this predominantly northeastern problem in southern states. Physicians in areas where Lyme disease has traditionally not been recognized should be alerted to its characteristic rash (erythema chronicum migrans), tick vector (Ixodes species), possible severe manifestations (neurologic, arthritic, and cardiac), and response to appropriate antibiotic therapy (penicillin or tetracycline). PMID- 6857307 TI - Severe systemic sepsis resulting from neglected perineal infections. AB - Eleven patients with severe necrotizing fasciitis involving the soft tissues and muscles of the perineum, abdominal wall, buttocks, and thighs were treated on the Tulane Surgical Service in New Orleans between 1979 and 1981. The etiologic factor in ten of these patients was a neglected or inadequately drained perirectal abscess. Three of the 11 patients died of the disease and ensuing multiple organ failure, for a mortality of 27%. All of the patients had signs of systemic sepsis. Initial radical debridement of all involved tissues, diverting colostomy, and aggressive medical support of the multisystem failure that ensues from sepsis are essential for successful management. To decrease the prohibitive mortality, early treatment is essential. A preventive measure appears to be operative drainage under adequate anesthesia of all perirectal abscesses. PMID- 6857308 TI - Adolescent sexuality: a gynecologist's viewpoint. AB - Adolescent sexuality is affecting a younger age group each year. Diseases and conditions traditionally seen by the gynecologist are now found in both sexes in an age group seen in most cases only by the pediatrician. An awareness of these problems, a willingness to search out sexual involvement, and a close working relationship between the pediatrician and the gynecologist can do much to stem the rising tide of teen-age pregnancies and sexually transmitted diseases. PMID- 6857310 TI - Evaluating continuity of care in primary care internal medicine programs. AB - One goal of primary care training programs is to provide "continuity experiences" for residents. Although programs funded by the Health Resources Administration are mandated to provide and evaluate such experiences, a wide variety may exist in both the concept and the evaluation of continuity in these training programs. To investigate methods for evaluating this continuity experience, we surveyed 52 federally funded primary care internal medicine programs using a checklist of methods derived from the literature. Of the programs surveyed, 64% responded and all but two were evaluating continuity, most of them using several methods. Although it might be assumed that most programs would be assessing continuity in the ambulatory setting, most reported that "residents followed up assigned patients when admitted to the hospital." Assessment of continuity in the ambulatory setting, by determining the number of times the patient was seen by his assigned resident divided by total outpatient visits, ranked fourth behind "missed appointments" and "medical record audits." "Percentage of emergency room visits by assigned patients" was least frequently cited. PMID- 6857309 TI - Medical aspects of exposure to radiofrequency radiation including microwaves. PMID- 6857311 TI - Mitral and tricuspid valve prolapse in a patient with mixed connective tissue disease. PMID- 6857313 TI - Acute renal failure: a diagnostic dilemma. AB - This patient had severe dehydration and renal failure presumed to be extrarenal. After volume replacement, the course was not typical for simple extrarenal azotemia or acute tubular necrosis. Tubular handling of salt and water may not provide adequate criteria to evaluate the cause of reduced glomerular filtration rate. PMID- 6857314 TI - Lymphomatoid granulomatosis beginning as adult respiratory distress syndrome and rapidly progressing to lymphoma. PMID- 6857312 TI - Trichoderma viride peritonitis. AB - A patient with renal failure secondary to amyloidosis and undergoing continuous ambulatory peritoneal dialysis had fungal peritonitis due to Trichoderma viride, an organism ubiquitous in the soil. Tissue invasion by this species has not previously been reported. In vitro susceptibility of the organism suggests that such infections may respond to amphotericin B or ketoconazole although our patient died before a response to therapy could be evaluated. PMID- 6857315 TI - Staphylococcal infection of fascial space diagnosed by ultrasonography. AB - A patient with staphylococcal cellulitis of the right calf failed to respond to intravenous antibiotic therapy. Physical examination and repeated needle aspiration failed to locate any sequestered pus, but ultrasonic imaging showed increasing amounts of fluid (ie, pus) extending along a fascial plane. After surgical debridement the infection resolved. PMID- 6857316 TI - Pericarditis: a complication of minoxidil therapy. PMID- 6857317 TI - Intracranial placement of nasogastric tube: an unusual complication. AB - We have described a case of intracranial placement of a nasogastric tube in a patient with severe head trauma. This complication occurs as a result of either passage through a traumatic defect in the cribriform plate associated with a severe head injury or direct penetration through an intact cribriform plate by an improperly passed rigid nasogastric tube. In combative semicomatose or comatose patients, oral placement may be preferable to nasogastric placement of a gastric tube. PMID- 6857318 TI - Respiratory failure due to metoclopramide. AB - Metoclopramide is a promising drug used not infrequently by practicing physicians. Its dystonic reactions are uncommon in the general population but are not infrequent in children. These reactions can be serious, and appropriate understanding of their manifestations and treatment can be lifesaving. PMID- 6857319 TI - Serum haptoglobin as tumor marker. PMID- 6857320 TI - [An information system with regard to the correlation between health status and the quality of the environment]. PMID- 6857321 TI - [Effectiveness of dispensarization of patients with hypertension]. PMID- 6857322 TI - [Evaluation of the utilization and demand of first aid services]. PMID- 6857324 TI - [Training of miners in hygiene]. PMID- 6857325 TI - [Role of students' practical training in the training for personality and professional skills]. PMID- 6857323 TI - [Ways of improving public health services]. PMID- 6857326 TI - [Improving public health planning by using the Automated System of Management]. PMID- 6857327 TI - [Conceptual approach to the development of the 2d stage of the Gorzdrav Automated System of Management]. PMID- 6857328 TI - [Organization of periodic mass screening with the use of computers]. PMID- 6857329 TI - [Economic aspects of reducing the incidence of cardiovascular diseases]. PMID- 6857333 TI - [Improving the qualifications of head nurses]. PMID- 6857330 TI - [Employment of old age pensioners in agriculture]. PMID- 6857332 TI - [Health status of children in the high-risk group]. PMID- 6857331 TI - [Role of paramedical services facilities in detection of arterial hypertension]. PMID- 6857334 TI - [Problems of mass screening]. PMID- 6857336 TI - [Penetrating wounds of the esophagus]. PMID- 6857335 TI - [Disorders of resistance of the gastric and duodenal mucosa in chronic gastritis and peptic ulcer]. PMID- 6857337 TI - [Treatment of patients with abdominal and pelvic vascular injuries]. PMID- 6857338 TI - [Long-term intra-arterial therapy in the complex treatment of patients with traumatologic-orthopedic profile]. PMID- 6857339 TI - [Prognosis of surgical wound infection]. PMID- 6857340 TI - [Acute renal failure as a complication of chemotherapy]. PMID- 6857341 TI - [Drug-induced renal lesions]. PMID- 6857342 TI - [Characteristics of the development of respiratory insufficiency in patients with chronic pneumonia]. PMID- 6857344 TI - [Laser spectroscopy for the study of human microcirculation]. PMID- 6857343 TI - [Hemosorption in clinical practice]. PMID- 6857345 TI - [New approach to the evaluation of treatment results in cervical cancer]. PMID- 6857346 TI - [Use of alkalies and alkaline mineral waters in the complex treatment of peptic ulcer patients]. PMID- 6857347 TI - [Thermal injuries of the respiratory tract]. PMID- 6857348 TI - [Anaerobic nonsporogenous pleuropulmonary infection]. PMID- 6857350 TI - [Effect of hypnotic suggestion in bronchial asthma]. PMID- 6857351 TI - [Review of the methodological recommendations on first aid in trauma]. PMID- 6857352 TI - [Organization of cooperative research on the treatment of esophageal cancer]. PMID- 6857349 TI - [Etiology and pathogenesis of acute gastroduodenal ulcers]. PMID- 6857353 TI - [Mechanism of the effect of riboxin]. PMID- 6857355 TI - [Role of infection in the etiology of cerebrovascular diseases]. PMID- 6857354 TI - [Characteristics of the course and outcome of croupous pneumonia]. PMID- 6857356 TI - [Fever of unknown origin in the clinical aspects of internal diseases]. PMID- 6857357 TI - [Reinfusion of ascitic fluid in the treatment of ascites in patients with liver cirrhosis]. PMID- 6857358 TI - [Diagnosis and treatment of bile peritonitis]. PMID- 6857359 TI - [Leukocyte index of intoxication in the diagnosis of destructive forms of acute cholecystitis]. PMID- 6857360 TI - [Diagnostic and prognostic significance of paraneoplastic signs of kidney cancer]. PMID- 6857361 TI - [Treatment with ekmolin of nervous forms of epidemic parotitis in children]. PMID- 6857363 TI - [Surgical removal of tophi in the complex treatment of gout]. PMID- 6857362 TI - [Characteristics of nervous system lesions in children and adolescents with systemic lupus erythematosus]. PMID- 6857365 TI - [Congenital isolated mitral valve insufficiency]. PMID- 6857366 TI - [Case of open fracture in a deeply burned area of the leg]. PMID- 6857364 TI - [Central hemodynamics in acute poisoning with caustic liquids]. PMID- 6857367 TI - [Madelung's syndrome]. PMID- 6857368 TI - [Immunologic status in lung cancer]. PMID- 6857370 TI - [Nosological classification of chronic intestinal diseases]. PMID- 6857371 TI - [Therapeutic approaches to the management of patients following cholecystectomy]. PMID- 6857369 TI - [Significance of the strength of the central nervous system in the variability of reactions to acebutolol]. PMID- 6857372 TI - [State of the gastric mucosa in duodenal ulcer before and after selective proximal vagotomy]. PMID- 6857373 TI - [Results of studying skin reactivity in viral hepatitis during pathogenetic therapy]. PMID- 6857374 TI - [Glucocorticoid function of the adrenal cortex in infectious diseases]. PMID- 6857375 TI - [Possibilities for the use of optical holography in clinical studies]. PMID- 6857376 TI - [Computed tomography of the abdominal organs]. PMID- 6857377 TI - [Early diagnosis of acute left ventricular insufficiency]. PMID- 6857378 TI - [Diagnostic errors in the clinical picture of internal diseases]. PMID- 6857379 TI - [Main results of Soviet-Mongolian cooperation in studying viral hepatitis in the Mongolian People's Republic]. PMID- 6857381 TI - [Clinico-endoscopic and laboratory evaluation of the activity of the inflammatory process in gastric and duodenal ulcer]. PMID- 6857380 TI - [Diagnostic value of clinical syndromes in chronic pancreatitis]. PMID- 6857382 TI - [Therapeutic use of secretin in the postoperative dumping syndrome]. PMID- 6857383 TI - [Roentgen diagnosis of peritonitis of appendiceal origin]. PMID- 6857384 TI - Load-bearing characteristics of lumbar facets in normal and surgically altered spinal segments. AB - An in-vitro experimental study was carried out to measure the induced loading on human lumbar facets due to varying amounts of compressive axial load. Testing was done on L2-L3 and L4-L5 spinal motion segments obtained from cadavers at autopsy. The compressive loading was applied to the spinal specimens in first a neutral position and then in an extended position. The motion segments were tested in a normal state and after facetectomy of the left facet. Contact pressures were quantified using pressure-sensitive film. This film was inserted between the articulating surfaces of the two facet joints prior to placing axial loads on the motion segments. In addition to recording pressure, the film was also used to quantify contact area. This provided sufficient information to compute the total facet loadings for all cases studied. Results of this study show how facet loads, peak pressures and contact areas change with respect to the various loads, positions and states studied. In particular this study shows that the absolute facet loads remain relatively constant with increasing segmental compressive loads such that the facet load expressed as a percent of load applied to the segment decreases with increasing axial loads. It also shows that the contact area moves cranially at L2-L3 and caudally at L4-L5 with increasing loads in extension. Furthermore, this study indicates that the load on the remaining facet is reduced substantially after a facetectomy although peak pressure increases. Finally, this study demonstrates the substantial difference in facet loadings between L2-L3 segments and L4-L5 segments. PMID- 6857385 TI - Lumbar disc herniation. A controlled, prospective study with ten years of observation. AB - Two hundred eighty patients with herniated lumbar discs, verified by radiculography, were divided into three groups. One group, which mainly will be dealt with in this paper, consisted of 126 patients with uncertain indication for surgical treatment, who had their therapy decided by randomization which permitted comparison between the results of surgical and conservative treatment. Another group comprising 67 patients had symptoms and signs that beyond doubt, required surgical therapy. The third group of 87 patients was treated conservatively because there was no indication for operative intervention. Follow up examinations in the first group were performed after one, four, and ten years. The controlled trial showed a statistically significant better result in the surgically treated group at the one-year follow-up examination. After four years the operated patients still showed better results, but the difference was no longer statistically significant. Only minor changes took place during the last six years of observation. PMID- 6857387 TI - Observations of pressures within normal discs in the lumbar spine. AB - As a result of performing pressure standardised lumbar discography, in vivo pressure measurements within lumbar discs have been recorded. Our results support the theory that for normal discs, the internal pressure within the nucleus pulposus increases when the subject changes from lying prone to standing and thence to sitting. However, when comparing our results with other published data, we consistently show a reduction in the absolute values recorded. We discuss the possible reasons for this discrepancy. Arguments have been advanced in the literature both for and against the nucleus in a normal disc behaving hydrostatically. An hypothesis which occupies the middle ground between these two concepts is proposed which could well be consistent with all the published data including our own. PMID- 6857386 TI - On the mechanical behaviour of intervertebral discs. AB - The response to compression, shear, bending, and axial rotation of an intervertebral disc is studied by using a theoretical disc model. The annulus fibrosus is modelled by ten fibre layers with alternating fibre inclination. The nucleus pulposus as well as the substance filing the space between the fibre layers is assumed to consist of an incompressible fluid. The end-plates are assumed to bulge at action of the pressure in the fluid phase. Geometry of fibre layers and end-plates are chosen to agree as closely as possible with what is representative for lumbar discs. The results show considerable increase of the different stiffnesses at increasing levels of the axial load. They also show quite large fibre strains, well over 10% at motions within normal physiological limits. PMID- 6857388 TI - Computed tomography and cryomicrotomy of lumbar spine specimens. A new technique for multiplanar anatomic correlation. AB - To produce undistorted anatomic material accurately correlating with multiplanar computed tomograms of the lumbar spine, frozen cadaver specimens were embedded in well-defined positions and examined in a high resolution CT scanner in axial, coronal, sagittal and oblique projections and subsequently sectioned through in the same plane on a heavy-duty cryomicrotome. Photography of the slightly thawed surface of the specimens at cutting-height intervals corresponding to the feed of the scanner rendered anatomic images in natural colours and with excellent detail resolution. The accurate coincidence of the plane of cryosectioning with the plane of the computed tomography (CT) permits a detailed morphologic evaluation of CT scans in different projections. PMID- 6857389 TI - Computed tomography of bone fragments in the spinal canal. An experimental study. AB - The detectability of bone fragments of differing size and structure, placed epidurally in the spinal canal at different levels from T XI to L II, was studied in three vertebral preparations using three different CT scanners, Philips Tomoscan 310, General Electric 8800 and Siemens Somatom 2. The thickness of the bone fragment was the most decisive factor. Cortical bone fragments could be detected down to a thickness of 0.6 mm and spongy bone fragments down to 1.2 mm. No difference in detectability between the different CT scanners was found. PMID- 6857390 TI - Lumbar vertebral canal morphometry for computerised tomography in spinal stenosis. AB - Computerised tomography is described in recent literature as a sophisticated but noninvasive technique with a particularly appropriate application in the discovery of space-occupying lesions in the lumbar vertebral canal and nerve root tunnels. Although the spinal stenosis syndrome must remain a clinical diagnosis in the first instance, computerised tomography is expected to play an increasing role in confirming the presumptive diagnosis of developmental or degenerative spinal stenosis, and in confirming the presence of a trefoil configuration or narrow lateral recess. However, the diagnosis of spinal stenosis on computerised tomography is impossible unless dimensions can be compared with established ranges of normal. The morphometry of a large sample of human skeletons of both sexes, in two race groups, and for each of the five lumbar vertebral levels, is intended to provide this information. PMID- 6857391 TI - Lumbar spinal canal stenosis in Paget's disease. AB - Three patients with Paget's disease of the spine presented a non-characteristic lumbar syndrome with minor neuromuscular dysfunction. It is proposed that this be called a premyeloneuropathic syndrome since it is an early stage of an imminent severe myelopathic syndrome. The suspected lumbar canal stenosis in Paget's disease is diagnosed by computerised tomography and successfully reversed by calcitonin. PMID- 6857392 TI - Normal kinematics of the lumbar spine and pelvis. AB - A study was undertaken to provide a data base of pelvic and lumbar spinal movement during walking. The movements of the pelvis and lumbar spine in 48 male volunteers of age range 16 to 74 years were measured using a television/computer motion analysis system. The results were presented both as a range of movement in each plane and as a wave pattern for the movement in each plane. Cadence, the movements of the pelvis and spine in the sagittal plane, and the movement of the pelvis in the transverse plane all showed a negative correlation with age. Analysis of the wave patterns showed that the movements of the pelvis and lumbar spine relate to identifiable events in the gait cycle. PMID- 6857393 TI - [Technic of conventional tomography]. PMID- 6857394 TI - [Complications of contrast media studies of the colon]. PMID- 6857395 TI - Interaction between alcohol and metronidazole. PMID- 6857396 TI - Echocardiographically assisted balloon atrial septostomy for transposition of the great arteries. PMID- 6857397 TI - Eclampsia--a method of management. PMID- 6857399 TI - Computed tomographic and ultrasonic localization of adrenal mass lesions. AB - A study of 20 patients with adrenal mass lesions shown on computed tomography (CT) is reported. CT accurately localized a unilateral adrenal mass in 12 patients with Cushing's syndrome, primary hyperaldosteronism and phaeochromocytoma. Unsuspected primary or metastatic neoplasms of the adrenal glands were detected in 8 patients who underwent CT for other reasons. In 9 cases ultrasonography was also useful in localizing large adrenal masses. This study confirms the safety and accuracy of CT and ultrasonography in evaluating patients with adrenal masses, thereby obviating the need for more invasive diagnostic procedures. PMID- 6857398 TI - Metoclopramide-induced parkinsonism. PMID- 6857400 TI - Selenium-75-cholesterol imaging and computed tomography of the adrenal glands in differentiating the cause of Cushing's syndrome. AB - Measurement of 75Se-cholesterol (Scintadren) uptake and computed tomography (CT) of the adrenal glands were compared as a means of differentiating the cause of Cushing's syndrome in 11 patients over a 2-year period. Quantitative Scintadren imaging differentiated adrenocorticotrophic hormone (ACTH)-dependent disease from local adrenocortical lesions as the cause of Cushing's syndrome in all the patients studied. CT of the adrenal glands rapidly and accurately detected the adrenal mass lesions in 2 cases and was effective in documenting bilateral hyperplasia due to ectopic ACTH-dependent disease. However, in entopic ACTH (pituitary)-dependent disease the adrenal glands were of normal thickness in all but 2 patients, who had bilateral hyperplasia. Scintadren imaging and CT are useful non-invasive procedures for differentiating local adrenal disease from ACTH-dependent disease as the cause of Cushing's syndrome and should be the initial investigations once a firm clinical and biochemical diagnosis of Cushing's syndrome has been made. PMID- 6857401 TI - Criteria for the diagnosis of pulmonary tuberculosis. AB - Diagnostic criteria for pulmonary tuberculosis are presented in the form of a weighted diagnostic protocol. These criteria were evolved to standardize the diagnosis of pulmonary tuberculosis for a prospective study of the disease and its treatment, and were first tested in the evaluation of 469 referred patients, of whom 300 were found to have tuberculosis. The criteria have subsequently been validated clinically and statistically through their application to 1679 patients with radiological abnormalities suggestive of tuberculous disease, of whom 1154 were proved to have pulmonary tuberculosis. Application of these criteria whenever pulmonary tuberculosis is suspected has removed the dilemma often faced by clinicians when presented with a suggestive chest radiograph, a single sputum smear positive for acid-fast bacilli resembling Mycobacterium tuberculosis, or a strongly positive tuberculin test. We believe that these criteria put each of these separate findings into perspective. They allow the diagnosis of pulmonary tuberculosis to be made with confidence and prevent the erroneous diagnosis of non-tuberculous disease. Their use should alleviate the tendency towards an overdiagnosis of active pulmonary tuberculous disease, and thereby the waste of therapeutic and social resources. PMID- 6857402 TI - The peri-operative care of the geriatric patient. AB - Progress in the medical and social spheres has increased life expectancy by sustaining many who would otherwise have succumbed to congenital or acquired diseases. The number of aged and high-risk patients who require major surgical procedures for the cure or palliation of disease has therefore increased. The physiological and anatomical changes in and peri-operative evaluation of the geriatric patient are reviewed, as are the pharmacokinetics of drugs used in these patients. PMID- 6857404 TI - The Laingsburg flood disaster. AB - In January 1981 natural floods occurred in large areas of the semi-arid Karoo area. In terms of loss of human life the town most affected was Laingsburg, where over 100 persons were drowned. Most of the bodies were swept downstream in the abnormally swollen river and were never recovered. A flood disaster of this dimension is rare in South Africa. There were very few injuries associated with the disaster and no epidemic diseases followed in its wake, but there were certain aspects of medical services related to the disaster worth recording. PMID- 6857405 TI - Hazards of thyroid enlargement in pregnancy. PMID- 6857403 TI - Ganglioglioma of the optic nerve. A case report. AB - Gliomas of the optic nerve are rare, comprising only 1% of intracranial neoplasms in adults and 5% in children. This is the first recorded case of a ganglioglioma of the optic nerve. A 2-year-old White boy presented with a convergent squint and blindness of the left eye. At operation a pale, firm, fusiform swelling was found. The cytological and histopathological features are described. PMID- 6857406 TI - Suprapubic catheter insertion and bladder filling with a spinal needle. PMID- 6857407 TI - The Prader-Willi syndrome in Cape Town. PMID- 6857408 TI - Early surgical repair of post-hysterectomy vesicovaginal fistulas. AB - A technique for early suprapubic surgery which was successful in 5 out of 6 patients with post-hysterectomy vesicovaginal fistulas is described. A plea is made for early surgical repair, as a postoperative vaginal fistula is a serious complication for both the patient and the surgeon, and because early surgical repair is technically not significantly more difficult than delayed repair. PMID- 6857409 TI - Variation in left ventricular ejection fraction determination at rest and during exercise. AB - The results of multi-gated blood pool imaging (MBPI) for determination of left ventricular ejection fraction (LVEF) in 48 patients at rest and during exercise were analysed in order to evaluate observer variance and interstudy variance. Twenty-three MBPI studies carried out with the patient at rest and 37 studies carried out during graded ergometer exercise were analysed by two independent observers in order to determine intra- and inter-observer variance. On the intra observer level regression analysis yielded excellent correlation between rest and exercise studies (r = 0,998 at rest, r = 0,964 during exercise), and showed no statistically significant difference (P less than 0,01); this was also true of the inter-observer measurements (r = 0,999 at rest, r = 0,988 during exercise). In order to evaluate interstudy variance, MBPI was repeated in 15 patients at rest. Interstudy variation of the LVEF was minimal as indicated by regression analysis (r = 0,98), and showed no statistically significant difference (P less than 0,01). During the repeat study a mean increase in the LVEF of 2,1% was obtained, but this difference was not statistically significant. PMID- 6857410 TI - Congenital upper limb anomalies and scoliosis. AB - In 104 children with various forms of congenital upper limb anomalies the incidence of idiopathic scoliosis was 6,7%. This is significantly higher than the 2,5% incidence in the general population. Patients with more severe anomalies such as amelia, phocomelia, hemimelia and thumb anomalies had a 40% incidence of scoliosis. With the current emphasis on early detection of scoliosis by the screening of schoolchildren, the obvious clue offered by a congenital abnormality of an arm or a hand should not be ignored. PMID- 6857411 TI - Physical disease in the chronic mentally ill. AB - A group of 196 institutionalized patients with chronic mental illness was studied to determine the prevalence of unrecognized physical disease. Sixty per cent of the patients were found to have previously undiagnosed minor or major disorders, the most prevalent being scabies and fungal infections (24%), peripheral vascular disease (13%), dyskinetic movements (11%) and anaemia (5,5%). Forty-six per cent of the physical disorders were considered to be minor, and only 21% of the major disorders were likely to respond to treatment. In particular there was a striking correlation between peripheral vascular disease and Korsakoff's psychosis. This study shows that there is a need for regular on-going physical assessment of such patients. PMID- 6857412 TI - 'The singing hospital'--integrated group therapy in the Black mentally ill. AB - Integrated group therapy was originally introduced at Sterkfontein Hospital in 1957, and reintroduced 6 years ago in an effort to overcome difficulties in communication with approximately 100 Black male and female mental hospital patients. This therapy consisted mainly of song and dance activation, sociodrama, psychodrama and behavioural modification methods. These techniques are flexible, and can be carried out by proxy therapists working with doctors and psychologists. PMID- 6857413 TI - Protruding jugular bulb presenting as a middle ear mass. A case report. AB - Protrusion of the jugular bulb is an uncommon but important cause of a bluish purple mass behind the tympanic membrane. A knowledge of this condition is necessary to prevent massive haemorrhage following tympanotomy or during temporal bone surgery. The diagnosis can be established by jugular venography, which demonstrates the protrusion of the characteristic knuckle of the jugular bulb into the middle ear cavity. PMID- 6857414 TI - [Appendiceal abcess in the neonatal period: a case report]. PMID- 6857416 TI - The antirheumatic effect of benoxaprofen. AB - This study was undertaken to investigate the antirheumatic activity of the non steroidal anti-inflammatory drug benoxaprofen. Ten patients with definite or classic rheumatoid arthritis were assessed before beginning drug therapy, using standard clinical criteria and serological tests of disease activity. These tests were repeated monthly during treatment with benoxaprofen for a period of 6 months. The results showed that benoxaprofen improved clinical parameters of disease activity, including morning stiffness, walking time, tenderness and swelling of joints and pain rating, in 7 of the 10 patients studied. One patient's condition remained unchanged and 2 deteriorated during the trial period. In the group of 7 patients who showed clinical improvement there were significant reductions in serum levels of rheumatoid factor, C-reactive protein, alpha 1-antitrypsin, IgA, IgM and IgE, as well as in erythrocyte sedimentation rates. Five of the 10 patients, all of whom were initially seropositive for rheumatoid factor, became seronegative at the end of the trial and 5 of 6 with raised C-reactive protein levels registered undetectable levels. Although this trial was uncontrolled, these findings indicate that benoxaprofen has antirheumatic properties. PMID- 6857415 TI - Pseudosolid appearance of simple and echinococcal cysts on ultrasonography. A report of 2 cases. AB - The 2 cases reported here indicate that on ultrasound examination uninfected simple and echinococcal cysts can sometimes show a pseudosolid internal consistency like that of a neoplasm, probably owing to floating crystals or particles. This has important implications as far as further diagnostic and therapeutic measures are concerned. The presence of a regular and well-defined rim remains an important clue to the possibly cystic nature of such lesions. PMID- 6857417 TI - Paraplegia following abdominal aortic surgery. Case reports. AB - Well-known complications of abdominal aortic aneurysm surgery include haemorrhage, arterial occlusion, infection and aortoduodenal fistula. Less well known is the occurrence of paraplegia. At present there is no estimate of its incidence, and only isolated cases have been reported. We report 2 cases of paraplegia following elective aortic surgery and 2 others following acute occlusion of the abdominal aorta. PMID- 6857418 TI - Overdiagnosis of tuberculosis. Case reports. AB - Six cases are presented in which tuberculosis (TB) was wrongly diagnosed. The patients were all Blacks from areas of high TB prevalence, and treatment for presumed TB was instituted without bacteriological confirmation. There were delays of up to 2 years before the correct diagnosis was made, involving much morbidity and unnecessary treatment. There was one potentially preventable death. PMID- 6857419 TI - Antibiotic-associated diarrhoea and pseudomembranous colitis caused by Clostridium difficile. A review of 40 cases. AB - We found antibiotic-associated diarrhoea (AAD) and pseudomembranous colitis caused by Clostridium difficile in 19% of patients with diarrhoea related to antibiotic therapy or with diarrhoea for which no other cause could be found. Ampicillin, cephalosporins and co-trimoxazole appear to be the agents most commonly associated with this complication. The clinical presentation of AAD falls into two categories: (i) an early-onset type characterized by severe diarrhoea with watery stools which may contain mucus; and (ii) a late-onset variety characterized by chronic, persistent diarrhoea with bulky stools. A definitive diagnosis was made in all cases by the detection of the cytotoxin of Cl. difficile in patients' stools using tissue culture assay. Discontinuation of the implicated agent when possible together with a 14-day course of oral vancomycin effected a cure in 90% of patients. The remaining 10% were successfully treated with a similar course of oral bacitracin. PMID- 6857420 TI - Macrodactyly. A review with a case report. AB - Macrodactyly is an unsightly congenital abnormality of a digit (of the hand or foot) usually requiring multiple surgical procedures. A poor cosmetic result (usually more acceptable than the original finger, but still aesthetically unsatisfactory) is often the outcome. The surgical procedures which may be utilized for this problem are numerous, ranging from ablation of the digit as a primary surgical procedure to numerous defatting procedures combined with other techniques. PMID- 6857422 TI - Occupational health and safety in South Africa. PMID- 6857421 TI - Deculturation as a precipitant of parasuicide in an Asian group. AB - The Durban Indian community has been described as an acculturating or a deculturating community. The processes of acculturation and deculturation are seen to lead to a transitional state of values and norms which causes psychological stresses within the community. Deviation from accepted cultural norms and concomitant interpersonal disputes were major precipitating factors in parasuicidal acts in 54 of a sample of 100 patients, reflecting the stresses of the transitional state of the community. Culturally deviant precipitating factors in the parasuicidal act were more common in females, in the younger age group, in patients of the Christian religion, and in upper- and middle-class patients. PMID- 6857424 TI - The prevalence, course and management of some benign oesophageal diseases in the Black population. The Groote Schuur Hospital experience. PMID- 6857423 TI - The 'eager parent syndrome' and schoolboy injuries. PMID- 6857427 TI - Internal jugular vein catheterization in shocked patients. PMID- 6857426 TI - The prevalence of hypertension in the Indian population of Roodepoort (Transvaal). AB - In a house-to-house study of 318 Roodepoort Indians the prevalence of hypertension was 19% by 1962 World Health Organization criteria and 12% by 1978 WHO criteria. This change in criteria may lead to misinterpretation of trends in the prevalence of hypertension. The mean systolic and diastolic pressures rose with age. Sixty-three per cent of subjects found to be hypertensive were already on therapy and 26% of the hypertensives were undiagnosed until this survey. The proportion of undiagnosed cases has important health implications. PMID- 6857428 TI - Amputation of gangrenous toes--effect of sepsis, blood supply and debridement on healing rates. AB - While 32% of the patients in this series who required amputation in the lower limb presented with infected or gangrenous toes, only 9% had pedal pulses. In a prospective study of 26 phalangectomies and 9 ray or transmetatarsal amputations, the definition of a successful procedure was taken as a healed, painless wound at 1 month. By 1 month, 6 wounds were healed, 5 pain-free and granulating and 8 septic or painful; 16 patients had had further surgery. In the end 14 of 35 feet were salvaged, with 2 patients lost to follow-up and 4 with painful or septic feet. The 15 patients who later required below-knee or above-knee amputations were pain-free, but 7 could not be rehabilitated on prostheses. Blood supply and sepsis affected the healing rate, whereas diabetes was unimportant. The final salvage rate was apparent within 1 month of the initial surgery. In the absence of a pedal pulse, the use of clinical judgement for the selection of patients with dry gangrene gave a 50% salvage rate, but only 8 patients were selected for local surgery out of the total of 24 in this category. Sixteen amputations were performed for sepsis in the absence of a pedal pulse; no wound healed and only 2 patients had a clean, pain-free, granulating wound at the end of the 1-month period. Direct arterial surgery played an important role in restoring the pulse prior to amputation. PMID- 6857425 TI - Hepatic complications of antituberculosis therapy revisited. AB - Since 1973, when the incidence and pattern of adverse reactions to antituberculosis therapy were described by Rossouw and Saunders, para-amino salicylic acid, the major cause of drug-induced hepatitis, has been withdrawn from the regimen used in Cape Town and replaced with pyrazinamide (PZA). Our study in the same hospital indicates that although the substitution has resulted in a significant reduction in the incidence of all side-effects (4,1% v. 9%; P less than 0,001), the incidence of hepatitis is unchanged (0,3%). PZA is currently the major cause of hepatitis associated with antituberculosis therapy. PMID- 6857429 TI - Anatomical factors relating to difficult intubation. PMID- 6857431 TI - Benign intracranial hypertension associated with iron deficiency anaemia. A case report. PMID- 6857430 TI - The unusual presentation of acute osteomyelitis in Black children. PMID- 6857432 TI - Acute pancreatitis presenting as a large abdominal mass. A case report. PMID- 6857433 TI - One woman, two tubes, three ectopic pregnancies. A case report. PMID- 6857435 TI - Broncholithiasis--the endoscopic appearance and review of factors influencing management. A case report. PMID- 6857434 TI - Effect of heat treatment of human breast milk on its anti-endotoxin antibody activities. AB - Pooled human breast milk is frequently heat treated before administration to neonates in order to reduce the risk of spreading infection. However, heating such milk by two different routine hospital procedures totally inactivated anti endotoxin antibodies present, thus greatly reducing the benefit of administering breast milk. Temperature-time parameters of the heat treatment of human breast milk were studied to determine the limits of anti-endotoxin IgG and IgA activities. PMID- 6857436 TI - Putting community health into perspective. AB - The concept of community health is poorly understood by the average clinician. Community health is characterized by the unique emphasis of looking at disease in the community rather than in the individual. Its field ranges from the running of hospitals and health departments to the coordination and guidance of the whole medical profession. In addition to their basic patient-centred approach all doctors need to develop a complementary community-orientated perspective. PMID- 6857438 TI - Trends in ischemic heart disease. PMID- 6857437 TI - Three cot deaths in one family. A case report. AB - A case of 3 cot deaths in one family is described. Owing to the unexplained nature of this type of death the police sometimes call for investigation. The legal aspects of this investigation are discussed. PMID- 6857439 TI - Trends in age-specific mortality rates for ischaemic heart disease, 1968 - 1977. AB - Age-specific mortality rates (MRs) were calculated for each year of the period 1968 - 1977 for ischaemic heart disease (IHD) in males and females of the USA, Australia, Finland, Scotland, England and Wales, and of South Africa (Whites). The age range studied, in 10-year intervals, was 15 - 64 years. In the younger age groups (15-24, 25-34 and 35-44 years) the MRs of White South Africans were two to three times as high as those of other populations over the whole 10-year period. In the older age groups the differences narrowed. MRs for IHD in the USA decreased markedly in all age groups over the period studied, the decreases varying from 20% to 40%. Decreases in MRs for IHD also occurred among Australians and Finns but were neither as consistent nor as large as those occurring in the USA. No consistent changes were observed in the other three populations. PMID- 6857440 TI - Heart rate changes after acute fetal haemorrhage--a basis for the pathophysiology of the sinusoidal pattern. AB - The sequence of fetal heart rate (FHR) changes recorded in a case of acute fetal haemorrhage is reported. Initial bradycardia progressed through an undulatory phase to tachycardia. Analysis of these patterns in the context of experimental data on intrinsic heart rate control suggests that the FHR was limited by availability of local myocardial energy, which at a critical level produced low frequency FHR fluctuations. Extrapolation of this hypothesis to the pathophysiology of the true sinusoidal FHR pattern is discussed. PMID- 6857441 TI - Tuberculous aneurysm of the left ventricle. A case report. PMID- 6857442 TI - Salmonella typhi meningitis. A case report. AB - A case of purulent Salmonella typhi meningitis in a 5-month-old child is discussed. The patient was treated successfully with amoxycillin, and there were no neurological sequelae. S. typhi should be included in the differential diagnosis of Gram-negative bacillary meningitis, especially in children from areas in which typhoid is endemic. PMID- 6857443 TI - Cognitive dysfunction caused by non-steroidal anti-inflammatory drugs. PMID- 6857444 TI - Sphenopalatine ligation for epistaxis and postnasal drip. PMID- 6857445 TI - Assignment of gene coding for cell surface glycoprotein with a molecular weight of 75,000 to human chromosome 11. AB - The gene for a cell surface glycoprotein recognized by a mouse monoclonal antibody (Mab 4), has been assigned to human chromosome 11 by the study of mouse human lymphocyte hybrids. The antigen is present on all human peripheral blood leukocytes, on human fibroblasts, and on human lymphoid and erythroid cell lines, but not on erythrocytes. Immunoprecipitation and polyacrylamide slab gel electrophoresis of both human cells and mouse-human hybrid clones carrying human chromosome 11 show that the apparent molecular weight of this glycoprotein is 75,000. PMID- 6857446 TI - Assignment of the genes for mouse type I procollagen to chromosome 16 using mouse fibroblast-Chinese hamster somatic cell hybrids. AB - Somatic cell hybrids between mouse and Chinese hamster fibroblasts have been used to identify the chromosome responsible for the synthesis of both mouse type I procollagen subunit chains (MCOLA1 and MCOLA2). Thirty-one separate hybrid clones and subclones from ten separate hybridization events were isolated in hypoxanthine-aminopterin-thymidine (HAT) selection medium and were used for detailed gene-mapping studies. ELISA and "Western blotting" immunochemical analysis were used to detect the production of mouse type I procollagen in each hybrid clone. Mouse and Chinese hamster chromosomes were identified in each hybrid clone by trypsin-Giemsa banding of metaphase chromosome spreads and by isozyme analysis. We have found that mouse type I procollagen production segregates concordantly with mouse superoxide dismutase-1, previously mapped to mouse chromosome 16, and with the presence of mouse chromosome 16 karyotypically. Western blotting immunochemical analysis of the separated mouse procollagen chains produced by each hybrid line demonstrated that apparently the genes for both subunit chains are located on the same chromosome. These studies, therefore, assign the structural genes for mouse type I procollagen pro alpha 1 (MCOLA1) and pro alpha 2 (MCOLA2) chains to mouse chromosome 16. PMID- 6857447 TI - Purification of cybrids by fluorescence-activated cell sorting. AB - A general method to isolate and purify substantial numbers of viable cybrids from cultured mammalian cells immediately following cytoplast-cell fusion is described. This method uses cytoplasts whose mitochondria are selectively stained in vivo by the cationic fluorescent rhodamine dye, rhodamine 123. Large numbers of highly purified, rhodamine-stained cytoplasts are fused to appropriate recipient cell lines and then the fusion mixture is sorted based on forward angle scatter and fluorescence parameters. Plating the positively sorted population in culture for as short as 12 h eliminates contaminating cytoplasts which, lacking a nucleus, are unable to adhere or survive. The resultant population, based on an analysis of genetic markers, is 75-100% cybrids, an enrichment of 1000- to 10,000 fold over the initial fusion mixture. Cybrids purified by cell sorting may be useful for detailed molecular studies of mitochondrial DNA gene expression and in the specific induction of new mitochondrial DNA mutants. PMID- 6857448 TI - Human and mouse cellular myc protooncogenes reside on chromosomes involved in numerical and structural aberrations in cancer. AB - A molecular clone of viral myc (v-myc), the oncogene of avian myelocytomatosis virus, MC29, detected homologous human, mouse, and Chinese hamster cellular myc (c-myc) sequences by Southern filter hybridization. A v-myc probe, containing sequences from the 3' domain of the gene, hybridized to single human HindIII and mouse EcoRI genomic DNA fragments of the cellular myc genes whose segregation could be followed in interspecies somatic cell hybrids. Human c-myc segregated concordantly with the enzyme marker glutathione reductase and with a karyotypically normal chromosome 8. A rearrangement of human c-myc was observed in Burkitt's lymphoma cells possessing the t(8;14) translocation. These results suggest that human c-myc is located close to the breakpoint on chromosome 8 (q24) involved in the t(8;14) translocation. The mouse c-myc gene segregated concordantly with chromosome 15 in mouse-Chinese hamster cell hybrids. These gene assignments are noteworthy, as structural and numerical abnormalities of human chromosome 8 and mouse chromosome 15 are associated frequently with B-cell neoplasms. PMID- 6857449 TI - Differentiation is not restored in hybrids between independent variants of a rat hepatoma. AB - Crosses have been undertaken between cells of three independent clones of dedifferentiated rat hepatoma variants to investigate whether "complementation" leading to restoration of the original differentiation would occur. Hybrids were examined between ten days and two months after fusion for the presence of intracellular albumin and for their ability to proliferate in glucose-free medium where survival requires activity of the liver-specific gluconeogenic enzymes. In none of the three possible crosses involving the three variants was evidence of reexpression of hepatic functions obtained. PMID- 6857450 TI - Intraoperative antegrade irrigation of the large intestine. AB - The technique described herein permits antegrade irrigation of the intestine peroperatively to empty the obstructed or loaded colon of feces. This procedure extends the indication for safe primary anastomosis of the colon during surgical treatment of the left colon, and our experience with 64 patients is described. PMID- 6857451 TI - Surgical management of unilateral groin infection after aortofemoral bypass. AB - The most common site for infection in reconstructive peripheral vascular operations is the inguinal area. Treatment is controversial, with recommendations ranging from antiseptic irrigation techniques to total graft excision. We present a plan for the surgical management of unilateral groin infection after aortofemoral bypass that was used in five patients. After assuring the viability of the extremity independent of the prosthesis, by compression of the graft limb with a concurrent Doppler ankle to wrist ratio index exceeding 0.3, vascular repair was performed as a two-stage procedure combining clean retroperitoneal detachment of the infected graft limb and inguinal excision of the involved graft limb followed by delayed vascular reconstruction by extra-anatomic cross femoral bypass. This has shown to be a reliable surgical method for salvaging the aortofemoral bypass with unilateral groin infection. PMID- 6857452 TI - Morphologic changes of the vas deferens after vasectomy and vasovasostomy in dogs. AB - The fine structure of the vas deferens was studied by SEM and TEM after vasectomy and delayed vasovasostomy in 18 dogs. Mucosal changes were observed in the testicular end of the vas deferens after vasectomy. Identical changes have been observed in the vas deferens in humans after vasectomy. Microsurgical vasovasostomy resulted in reappearance of normal epithelial cells lining the lumen of the vas deferens by means of squamous metaplasia. In six dogs, prevasectomy and postvasovasostomy sperm counts were compared. These counts returned to normal levels, but they never reached or exceeded the prevasectomy values. PMID- 6857453 TI - Diverticulitis of the cecum. AB - Ten patients with diverticulitis of the cecum are reported upon herein. The disease is difficult to distinguish preoperatively from that of appendicitis and may be difficult to distinguish intraoperatively from carcinoma of the cecum. The diverticula are usually solitary and may be of the true or false variety. A review of the literature is presented, and the difficulties of diagnosis and treatment are discussed. We advocate local resection of the diverticulum, when possible, and a right hemicolectomy when the diagnosis is in doubt or when local resection or invagination would jeopardize the ileocecal valve or the blood supply to the intestine. With more awareness of diverticulitis of the cecum, intraoperative diagnosis may be made easier and the treatment simplified. PMID- 6857454 TI - A method for documentation of tissue perfusion using instant photography. AB - Two techniques for obtaining Polaroid pictures of tissue after the injection of fluorescein intravenously are presented. A rabbit small intestinal volvulus model was used to determine the accuracy of the techniques. Both methods are simple, accurate and relatively inexpensive, and immediate and permanent documentation is provided. While both methods provide results equivalent or superior to ultraviolet light fluorescence, the interference filter method produced brighter fluorescence and the results were more easily interpreted. Both methods can be performed by inexperienced personnel. PMID- 6857455 TI - Improved survival rate for intraperitoneal autotransplantation of the spleen following pneumococcal pneumonia. AB - One hundred and ten Sprague-Dawley rats were randomly assigned to one of four treatment groups: 1, sham control; 2, splenectomy; 3, splenectomy and implantation of diced splenic tissue among the leaves of the small intestinal mesentery, and 4, splenectomy and intraportal injection of emulsified splenic tissue. Twelve weeks postoperatively, all of the rats were challenged with Type III Streptococcus pneumoniae by transtracheal injection. Rats with intraportal splenic autotransplants had an early mortality significantly higher than that of asplenic rats. Rats with small intestinal mesentery implants had a mortality not significantly different from that of sham control rats but significantly lower than that of rats that underwent splenectomy. Thus, intraperitoneal splenic autotransplantation provides a protective effect against postsplenectomy pulmonary sepsis and serves as a method for preservation of splenic function. PMID- 6857456 TI - Brunner's gland hamartomas can mimic carcinoma of the head of the pancreas. AB - Three patients with Brunner's gland hamartomas had symptoms preoperatively and findings intraoperatively that were consistent with carcinoma of the head of the pancreas. It is important to differentiate between these two pathologic conditions because the operation required for the treatment of the two diseases is of a different order of magnitude. A diagnosis of a Brunner's gland hamartoma can be considered on the basis of the clinical history, physical findings, laboratory findings and the appearance of the duodenal mucosa surrounding the ampulla of Vater. Confirmation of the diagnosis can be made upon biopsy of the duodenum at operation. PMID- 6857457 TI - Monitoring of patients with carcinoma of the large intestine by use of acute phase proteins and carcinoembryonic antigen. AB - Fifty-two patients with resectable carcinoma of the colon and rectum have been monitored by three monthly serial estimations of three APRP (serum protein hexose, transferrin and ceruloplasmin) together with CEA. In 36 patients, subsequent clinical evidence of a recurrence of the disease developed during the study period. Monitoring with APRP can detect a recurrence of the disease at the subclinical stage in the majority of patients and appears to be complimentary to monitoring with CEA. However, due to the low incidence of surgical removal of recurrent carcinoma, this does not give real benefit for patients. PMID- 6857458 TI - Vasopressin release following operation upon the vagina performed under general anesthesia or epidural analgesis. AB - Plasma vasopressin concentrations were determined in 27 patients undergoing vaginal operations for pelvic relaxation. Thirteen of the 27 patients were operated upon under lumbar epidural analgesia and 14, under general anesthesia. The blood samples for plasma vasopressin determinations were taken before, during and after the operation. The blood pressure and plasma osmolality were measured each time a blood sample was taken. In patients receiving a general anesthetic, the plasma vasopressin concentration was significantly higher 30 minutes after the beginning of the operation and at the end of the operation than immediately before premedication, p less than 0.05. In patients given lumbar analgesia, there were no significant differences among the plasma vasopressin values. Neither in the anesthesia nor in the epidural group was there a significant difference in blood pressure or plasma osmolality. It is concluded that the main cause of vasopressin release after vaginal operations lies in nerve impulses originating at the operative site. PMID- 6857459 TI - Temporal variations of temperature of the breast by cholesteric liquid crystal contact plate thermography. AB - Thermography of the breast is considered by some to be a risk marker for the presence of abnormalities of the breast. Circadian variations in the temperature of the skin of normal and cancerous breasts have been documented. A temporal study was undertaken to verify whether or not thermograms obtained at different hours of the day are sufficiently similar to be clinically useful. Eleven healthy women underwent four serial thermographic evaluations each at three to four hour intervals. Significant differences were observed between the early morning results and subsequent evaluations. Reproducible thermograms were obtained for all studies done from 12 noon onward. This is a possible indication that the timing of thermographic examinations has to be standardized to ensure that reliable comparisons are being made. PMID- 6857461 TI - The next big question in the treatment of carcinoma of the breast. PMID- 6857460 TI - The multidisciplinary team approach to exenteration of the pelvis. AB - The experience of a newly formed, multidisciplinary, pelvic exenteration team is presented which consists of a gynecologic oncologist, a general surgeon and a urologist. The first 20 exenterations performed by this team are reviewed. Nine patients had no postoperative problems, and of the 11 patients who did have complications, all but two, which resulted in death, were corrected without resultant debilitation. Fourteen of the 18 patients who survived the operation are tumor-free for as long as three years postoperatively. Operative proficiency as well as operative mortality and morbidity have certainly improved quite significantly as the team has gained experience. PMID- 6857462 TI - A simplified method of transverse loop colostomy. PMID- 6857464 TI - The real one-handed tie. PMID- 6857463 TI - Removal of a thrombosed graft. AB - In the present report, a procedure for the removal of a late occluded graft which is firmly attached to the surrounding tissues is described which consists of disrupting mechanically the perigraft fibrous capsule by means of an external metal ring passed around the graft and, thus, allowing its easy removal. PMID- 6857465 TI - A technique for catheter fixation for continent ileostomy. PMID- 6857466 TI - The surgical management of acute and chronic injuries of the thoracic aorta. AB - The clinical diagnosis of traumatic descending thoracic aortic aneurysm is not obvious but is usually suggested on a roentgenogram of the chest. The diagnosis, therefore, is based upon a high index of suspicion and confirmed by an angiogram. Femoral-femoral bypass is a safe approach, assuring adequate distal perfusion and, thereby, avoiding problems of ischemia. By assuring adequate distal perfusion and preserving all possible intercostal arteries, spinal cord injury was avoided in this series. PMID- 6857467 TI - Operative risk factors of cholecystectomy-choledochotomy in the elderly. AB - To assess the relation between old age and mortality and morbidity in associated diseases, 789 patients older than 65 years who underwent operations for biliary lithiasis are presented in this study. It has been shown that, although mortality and morbidity are related to the age of the patient and to the presence of associated diseases, it is also affected by operative findings, such as dilation of the common bile duct, the incidence of bile infection, pathologic changes in the biliary tree and the type of supplementary procedure in instances of choledochotomy. It was possible to demonstrate that, irrespective of the clinical presentation, infected bile is associated with a higher mortality and morbidity than is sterile bile. Moreover, mortality and morbidity were higher after cholecystostomy-choledochotomy than after cholecystectomy only; it has been shown that there was a higher mortality and morbidity after t-tube drainage than after choledochoduodenostomy in patients who, after choledochotomy, underwent the foregoing supplementary procedures. The aforementioned features demonstrate that, in the presence of infected bile, associated with dilation of the common bile duct, due to advanced pathologic changes in the histology of the biliary tree, t tube drainage has to be avoided. Indeed, in this series of patients, t-tube drainage failed to achieve adequate decompression of the biliary tree and initiated exogenous acquisition with environmental microorganisms which are associated with an increase in the mortality and morbidity. PMID- 6857468 TI - Microlithiasis of the gallbladder. AB - Patients with microlithiasis represent a small group compared with the general population of patients with gallstones. However, it is a group which deserves particular attention because of the risk of acute pancreatitis. For this reason, cholecystectomy should be advocated in patients considered to be at low anesthetic risk in which echography or roentgenography detects the presence of minute stones in the gallbladder, even in the absence of biliary disorders. PMID- 6857470 TI - Tar burns in the southwest. AB - The burns which result from contact of human skin with hot tar may be quite serious in proportion to the body surface area involved. Although tending toward partial thickness burns, patchy areas of full thickness skin loss are commonly observed. The use of petrolatum-based ointments on the burn initially to dissolve the tar into the dressings seems like the most efficient and humane method of tar removal. Subsequently, care of the wound is like that of any other burn. Tar burns involving greater than 10 per cent of the body surface area are likely to be the most serious and require intravenous fluid resuscitation. Many tar burns appear to be preventable. PMID- 6857469 TI - The application of real-time ultrasound imaging during surgical procedures. AB - Operative ultrasound using real-time high resolution B-mode ultrasound scanning is a practical and useful diagnostic aid. At operations upon the biliary tract, pancreas and blood vessels, ultrasound had a favorable impact upon surgical management. When similar operative roentgenographic studies were available, operative ultrasound compared favorably with both operative cholangiography and arteriography. Problems with the lack of familiarity of the surgeon with the performance and interpretation of imaging ultrasound and lack of specifically dedicated ultrasound instruments need to be resolved to increase and improve the use of this potentially helpful aid to surgical diagnosis during operation. PMID- 6857471 TI - The influence of diabetes mellitus upon peripheral vascular disease. AB - The treatment of 332 consecutive patients referred to a peripheral vascular unit with rest pain, ulceration or gangrene of the lower limb has been studied. Ninety seven (20 per cent) of the patients had diabetes mellitus. Although diabetes was related to adverse limb salvage and patient survival rates, this could be accounted for by the influence of initial presenting clinical features and treatment upon survival time. The influence of these factors upon survival time was still strong even when the data were stratified for diabetric status. Thus, an extensive amputation carries the worse prognosis, with a less extensive amputation intermediate between an extensive amputation and any other form of therapy. Patients with both rest pain and ulceration or gangrene have a poor prognosis when assessed by either limb salvage or mortality. The majority of the patients with less extensive amputations are diabetic. This is related to the high incidence of localized ulceration among those in the diabetic group. In diabetics, a less extensive amputation, if clinically indicated, is worthwhile because of the low incidence of a subsequent extensive amputation after a less extensive amputation and the better survival rate for those patients with less extensive amputations as compared with those with extensive amputations. PMID- 6857472 TI - Technique of peritoneal dialysis cannulation in neonates. AB - A safe method for introducing a catheter for conducting peritoneal dialysis in neonates has been used successfully in 12 cannulations and has resulted in easy inflow and outflow of solutions without pericatheter leakage through the quite thin abdominal wall of the neonate. No significant complications have occurred. PMID- 6857473 TI - Computed tomographic mammography directed biopsy of the breast. AB - Computed tomography of the breast has been demonstrated to identify nonpalpable carcinoma of the breast at an early stage. It has been found possible to do an accurate biopsy of these small tumors using azimuth and distance data provided by the radiologist. PMID- 6857474 TI - Oblique incision of the groin for vascular reconstruction at the femoral level. AB - Exposure of the common femoral artery and its branches for vascular reconstruction has most often been accomplished with a vertical or hockey stick incision which crosses the inguinal folds. An oblique skin incision placed parallel to, and slightly above, the inguinal ligament affords adequate exposure, possesses better healing characteristics and, in the obese, avoids a potentially inflamed inguinal skin crease. PMID- 6857475 TI - Topical therapy and the development of silver sulfadiazine. AB - Topical therapy is a selective approach to the prevention and treatment of infection in burns and other surgical wounds. Effective compounds possess certain chemical and physical properties. Prerequisites include low solubility, slow absorption, nonreactivity with wound exudates, proteins and ions and ability to achieve prolonged antimicrobial activity in the wound. These compounds yield much higher levels in the zone of infection than can be achieved by diffusion into the wound after systemic administration. The wide spectrum of antibacterial activity, the low toxicity, minimal tissue reaction, ease of application suggest that topical silver sulfadiazine therapy can safely be extended to other wound infections, wound covers and certain transplant materials. PMID- 6857476 TI - Dynamic computed tomography and functional imaging in cerebral vascular anomalies. AB - Dynamic computed tomography was performed on patients with cerebral vascular anomalies, the density-versus-time curves were derived, and the gray-scale functional images demonstrating the pixel-by-pixel distribution of several flow parameters were processed. This noninvasive method was found to be useful not only in delineating the vascular anomalies with their afferent and efferent vessels, but also in detecting the abnormal flow patterns within and outside the vascular anomalies. Limitations and distinct advantages of this technique are briefly discussed. PMID- 6857477 TI - Computed tomographic imaging in cervical vertebral fractures. AB - Spinal computed tomography scanning was performed in five patients with different types of cervical fractures. Computed tomography scanning was superior to plain x ray studies in determining the narrowing of the spinal canal by bone fragments or soft tissues and in determining the involvement of the intervertebral joints. The value of computed tomography was clearly demonstrated in scanning those regions that are difficult to be examined by conventional radiologic methods. A disadvantage of computed tomography scanning is the impossibility of functional diagnostic investigations and examinations after surgery of patients who underwent stabilization with plates and wires. PMID- 6857478 TI - Positional variability in redundant lumbar nerve-root syndrome. AB - A case of redundant lumbar nerve roots associated with lumbar canal stenosis is described. At myelography, the redundant nerve roots proximal to a site of blockage were noted to disappear on flexion and extension while similar redundancy developed distally. The etiology of this condition is discussed along with the differential diagnosis. PMID- 6857479 TI - Trigeminal pain caused by a parapontine epidermal cyst. AB - A case of trigeminal neuralgia caused by a parapontine epidermal cyst is reported. The trigeminal inlet zone at the pons was completely surrounded by the tumor. No vascular element was detected around the trigeminal nerve root. Neurological symptoms were completely normal except for typical tic douloureux. Pain was controlled initially by carbamazepine, later by radiofrequency trigeminal nerve coagulation, and finally by microsurgical decompression. Review of the literature suggested the importance of lesions of the middle fossa as another etiological factor. When surgery is performed by the posterior route, the possibility of overlooking these lesions may exist. PMID- 6857480 TI - Subtemporal decompressions for shunt-dependent ventricles: mechanism of action. AB - The literature suggests that subtemporal decompression is an effective treatment for the syndrome of shunt-dependent ventricles because it allows the ventricle to enlarge around the shunt catheter tip. Pre- and post craniectomy ventricular areas were measured from computed tomography scans with a computer digitizing technique in three patients with this syndrome who had undergone four surgical procedures. All patients improved symptomatically following craniectomy. A significant decrease in total ventricular area was noted in all instances. The results suggest that subtemporal craniectomy causes the ventricles to become smaller, not larger. Other possible explanations for the effectiveness of the procedure are discussed. PMID- 6857481 TI - Asymmetrical hydrocephalus following ventriculitis from rupture of a thalamic abscess. AB - Ventriculitis developed suddenly in a patient with an undiagnosed abscess and was accompanied by obtundation, fever, meningismus, and hemiplegia. Aspiration of a streptococcal thalamic abscess and high doses of intravenous penicillin produced marked improvement. Increasing dysphasia 5 weeks later was accompanied by ventricular dilatation, most marked on the left, with no evidence of recurrent abscess. The left foramen of Monro was demonstrably patent. Shunting relieved the symptoms of aphasia; they recurred with one episode of malfunction of the shunt. This case lends support to the belief that parenchymal characteristics are important in hydrocephalus and demonstrates how asymmetrical ventricular dilatation can produce focal symptoms. PMID- 6857482 TI - Computed tomographic findings of vacuum phenomenon in cervical intervertebral disks. AB - A gaseous collection in the intervertebral space, or the vacuum phenomenon, was observed on computed tomograms in as many as 30% of the patients with cervical disk disease. The condition most frequently occurred at the level of C5-6. The gas tended to accumulate more often at the marginal region of the intervertebral disks, the level at which marked degeneration was seen; thus, it may be related to cracks within not only the nucleus pulposus, but also in the annulus fibrosus. PMID- 6857483 TI - Computed tomographic demonstration of the effect of proximal parent artery ligation for giant intracranial aneurysms. AB - Four patients with giant intracranial aneurysms, which measured over 2.5 cm in diameter, were treated by ligation of the proximal parent artery. The location of the aneurysms were intracavernous in two patients, paraophthalmic in one patient, and vertebral in the other patient. The effect of ligation was followed by repeated computed tomography scans with angiographic correlation. The aneurysms thrombosed soon after ligation, and with time, gradually organized with a reversal of the mass effect. Five years after the ligation, one aneurysm thrombosed completely and lost its mass effect upon the adjacent structures. For giant aneurysms treated with ligation of the proximal parent artery, computed tomography scans are a useful method for continuing review, producing precise information concerning actual size, thrombus formation, and various pathological changes. PMID- 6857484 TI - Unusual penetrating craniocerebral injury. AB - We report a 29-year-old patient who was operated on for a penetrating craniocerebral injury caused by an underwater fishing harpoon. It had penetrated through the roof of the left orbit, upward toward the calvaria. The patient was immediately operated upon and the foreign body was easily removed through a small left parietal craniectomy. In spite of the spectacular appearance of the injury on admission to the hospital, neurological impairment before and after the operation was minimal. PMID- 6857486 TI - Parinaud's syndrome in hydrocephalus due to a basilar artery aneurysm. AB - A 65-year-old woman appeared with a progressive dementia, gait disturbance, and Parinaud's syndrome. A computed tomography scan, an angiogram of the vertebral artery, and metrizamide ventriculography demonstrated a marked hydrocephalus. A giant aneurysm at the termination of the basilar artery projected into the third ventricle producing partial obstruction of the aqueduct. The symptoms were resolved by a ventriculoperitoneal shunt; but after a month, the patient again showed the upward-gaze palsies concomitant with occurrence of shunt malfunction. The possible mechanisms of Parinaud's syndrome observed in the patient are discussed. PMID- 6857485 TI - Circular enlargement of the optic canal caused by paranasal sinus mucocele. PMID- 6857488 TI - Availability of neurosurgical care in Canada and the United States. PMID- 6857487 TI - "Confusion tomography". PMID- 6857489 TI - Incomplete spinal cord injury. PMID- 6857490 TI - Bioadhesives. PMID- 6857491 TI - The monocular shimmers--your patient isn't deluded! PMID- 6857492 TI - Hepatic uptake of synthetic human gastrin I (1-17) in humans. AB - The hepatic uptake of unlabeled synthetic human gastrin I (1-17) was determined in four unanesthetized patients who did not have hepatic or gastroduodenal disease. The hormone was given by brief infusion and at rates producing concentrations of immunoreactive gastrin within the physiologic range. We estimated the first-pass fractional hepatic uptake by comparing the results after a portal and a peripheral infusion in each patient. It was -0.01 +/- 0.14 (mean +/- SD), demonstrating lack of hepatic uptake of gastrin I (1-17) in humans. PMID- 6857493 TI - The effect of halothane anesthesia on platelet aggregation in vivo: decreased deposition on polytetrafluoroethylene arterial grafts in dogs. AB - The technique of gamma-imaging can be used to study the deposition of 111In labeled platelets onto synthetic arterial grafts in vivo. Recent results suggested that platelet uptake on polytetrafluoroethylene (PTFE) grafts might depend on the choice of anesthetic. To evaluate the effect of anesthesia a series of experiments was performed in seven dogs wherein each animal served as its own control. The first of paired femoral or carotid PTFE grafts was inserted with the animal under pentobarbital anesthesia, and the graft was imaged for 90 minutes. A second graft was then inserted after at least 1 hour of halothane anesthesia. The mean activity ratio (describing platelet deposition) in the grafts inserted when only pentobarbital anesthesia was used was 7.04 +/- 0.55, compared to 1.20 +/- 0.07 in the grafts inserted with halothane anesthesia (P less than 0.01). Halothane anesthesia led to significantly decreased platelet uptake on canine PTFE arterial grafts. This effect was reversible, though not immediately, with no significant difference in graft activity noted by the day following surgery. PMID- 6857494 TI - Direction of flow in superficial veins as a guide to venous disorders in lower limbs. AB - Clinical methods and directional Doppler velocimetry applied to superficial veins have been used to study 527 patients with venous disorders in the lower limbs. Phlebography assisted by the image intensifier has been carried out in 80 of these patients. All examinations have been done with the patient upright, exercising, and without use of any artefact, such as a tourniquet. By these combined means Doppler flow patterns in the superficial veins of five groups of patients have been identified: (1) a highly distinctive downward flow in the upright exercising patient (retrograde circuit) in simple incompetence of the superficial veins (82.1%); (2) a characteristic pattern of upward flow accentuated by exercise, indicating collateral function past deep veins impaired by previous thrombosis (postphlebitic syndrome) (5.7%); (3) a surge back and forth on exercise in patients with valveless deep veins, probably of cogenital origin (8%); (4) sustained upward flow, accentuated by exercise, in veins acting as collaterals to occluded iliac veins (1.5%); (5) a variety of flow patterns in congenital states, including Klippel-Trenaunay syndrome (2.7%). Approximately one half of patients with venous stasis were in the first group and therefore probably had curable conditions; the remainder had the deep vein problems. The incidental role of the "perforator" is discussed and attention drawn to the significance of the retrograde circuit based upon the foot. The directional Doppler flowmeter provides an important screening test that positively identifies simple superficial vein incompetence, suitable for treatment, or gives clear warning of unsatisfactory deep veins that should be investigated further. PMID- 6857495 TI - Thyroid hormone responses in hemorrhagic shock: study in dogs and preliminary findings in humans. AB - One hour of hemorrhagic shock in the dog produces alterations in thyroid hormone metabolism far exceeding those seen after elective surgery or thermal injury. The changes in plasma thyroid hormone levels cannot be fully explained by carrier protein loss. Plasma concentrations of total thyroxine (T4) and triiodothyronine (T3) were significantly decreased after only 20 minutes of shock, continued to decrease throughout shock and resuscitation, and remained depressed for several days thereafter. Both hormones reached nadirs during volume replacement of 42% and 17% of baseline, respectively. The total T4 level normalized by the fifth postshock day, but the T3 concentration was still depressed on the ninth day. Plasma albumin, the principal canine thyroid hormone carrier, was significantly reduced 20 minutes after hemorrhage and remained low throughout convalescence. Concentrations of free T4 and T3 decreased during shock, but not as much as the total T4 and T3 concentrations. Reverse T3 levels, corrected for albumin loss, and T3 uptake values were increased during shock and resuscitation. Similar alterations in circulating thyroid hormone concentrations were seen in three patients with major traumatic injury and/or shock. The thyroid hormone changes in shock may represent another example of the "euthyroid sick syndrome." PMID- 6857496 TI - Emergency hemipelvectomy in the control of life-threatening complications. AB - Emergency hemipelvectomy (HP) is a rare procedure. Only three incidents have been previously reported. This paper describes six additional cases, analyzes our results, and sets forth criteria for patient selection. There were five men and one woman. The median age was 38.5 years. Primary underlying diseases were sarcoma (three cases), peripheral vascular disease (one), deep vein thrombosis (one), and drug abuse (one). Life-threatening peripelvic sepsis and hemorrhage were indications for emergency HP. All six patients had multiple procedures prior to definitive HP. Four classical and two modified HPs were performed. The mean operative time was 3.5 hours, the mean blood loss 2292 ml. There were no intraoperative complications. The median duration of hospitalization was 56 days. Five of six patients were saved. Life-threatening peripelvic sepsis or hemorrhage associated with tumor recurrence, radiation, or failed vascular reconstruction is an indication for emergency HP. Neither age nor physical condition should be a deterrent. The patient should not be allowed to advance to a premorbid state before HP is considered, although concomitant intra-abdominal disease is a contraindication. HP is recommended in lieu of hip disarticulation. We anticipate that the need for emergency HP will increase as limb salvage procedures for extremity sarcomas and dysvascular disease become more frequent. PMID- 6857498 TI - Balloon embolectomy catheters in small arteries. IV. Correlation of shear forces with histologic injury. AB - Experiments were performed in 18 dogs to evaluate the character and time course of arterial injury caused by balloon embolectomy catheters. Injury was correlated with balloon-artery shear forces. Shear forces were regulated intraoperatively. Thirty gram force caused no injury in 14 specimens. Sixty gram force stripped the intimal endothelium in two of four specimens examined at 2 days. Repair consisted of myointimal hypercellularity with return to normal one-cell thickness within 28 days. Ninety and 120 gram force stripped the intimal endothelium in 32 specimens with no medial injury. Repair again consisted of myointimal proliferation, which returned to normal in most vessels at 28 days. All vessels appeared normal at 6 months. This indicates that balloon embolectomy catheters can be a safe operative tool provided excessive shear forces are not imposed. This is quite feasible, for usual embolectomies were found to require about 60 gm shear force. Two hundred gram initial force caused intimal injury and fracturing of the internal elastic lamina, with the latter injury persisting even after 6 months. PMID- 6857497 TI - Correlation of release and actions of cholecystokinin in dogs before and after vagotomy. AB - Pancreatic secretion of enzymes and gallbladder contraction in response to intestinal stimulants are thought to be mediated through the vagus nerve and by means of release of cholecystokinin (CCK). The effect of truncal vagotomy on the release of CCK, pancreatic protein secretion, and gallbladder pressure (all stimulated by intraduodenal instillation of oleate) was studied in five dogs. Each dog was prepared with chronic pancreatic and gastric fistulas and catheter cholecystostomies. Simultaneous measurements were made of plasma CCK (by radioimmunoassay), pancreatic protein secretion, and gallbladder pressure (by perfused catheter technique) before and during intraduodenal administration of oleate. Before truncal vagotomy, intraduodenal oleate caused increases in plasma CCK (from 82 +/- 6 to 208 +/- 32 pg/ml), pancreatic protein secretion (from 83 +/ 8 to 165 +/- 15 mg/15 min), and gallbladder pressure (from 11 +/- 2 to 27 +/- 2 cm H2O) (all measured from basal state to 120 minutes). Truncal vagotomy caused a 45% decrease in the output of pancreatic protein in response to oleate and completely abolished the increase in gallbladder pressure, but it caused no change in release of CCK. The correlations between plasma CCK and pancreatic protein secretion before truncal vagotomy (r = 0.86) and after truncal vagotomy (r = 0.77) were highly significant. The correlation between plasma CCK and gallbladder pressure was highly significant before (r = 0.91) but not after (r = 0.42) truncal vagotomy. This study demonstrates that truncal vagotomy inhibits pancreatic protein secretion and gallbladder pressure in response to fat but does not interfere with release of CCK. The effects may be due to interruption of vagus-mediated reflexes between the intestine and the pancreas and gallbladder. The good correlation between plasma concentrations of CCK and both pancreatic protein secretion and gallbladder pressure provides evidence that the radioimmunoassay measures biologically active CCK. PMID- 6857499 TI - Management of the occluded aortofemoral graft limb. PMID- 6857500 TI - Correlation of immune and nutritional status with wound complications in patients undergoing vascular operations. AB - The acquired failure of host immunocompetence that may result from significant protein and caloric malnutrition has been associated with an increased incidence of septic complications in patients undergoing operation. Wound infection in patients undergoing vascular surgical procedures may lead to exposure or contamination of a vascular graft, with the subsequent risk of hemorrhage, limb loss, or death. The present study was undertaken to correlate the immune and nutritional status of patients undergoing vascular surgical procedures with the development of significant wound complications. Seventy-nine patients undergoing a variety of vascular operations were subjected to comprehensive nutritional assessment, including anthropometric measurements (height, weight, midarm circumference, triceps skin fold), serologic testing (albumin, transferrin, lymphocyte count, serum zinc), cutaneous assessment of delayed hypersensitivity (anergy battery), and neutrophil functional analysis. After operation the patients were observed for the development of delayed wound healing or wound infection. Statistical analysis of measured variables was performed to identify immune and nutritional markers with prognostic value. Patients with serum albumin levels above 3 gm/dl were much more likely to have uncomplicated wound healing (P less than 0.001). Similarly, patients with serum transferrin levels above 150 mg/dl had significantly fewer wound problems (P less than 0.01). Only 29% of patients with cutaneous anergy had normal wound healing, while 56% of those with intact cutaneous reactivity healed primarily; this difference, however, was not statistically significant. Diabetics in this series were more likely to develop wound problems (P less than 0.05). Anthropometric measurements provided no predictive information regarding the likelihood of uncomplicated healing. Similarly, measurement of total lymphocyte count and serum zinc yielded no significant prognostic information. The urgent nature of many vascular surgical procedures may preclude preoperative immune and nutritional assessment; however, the outcome of these procedures may ultimately depend upon intact host defense. The contribution of protein and caloric malnutrition to immunocompromise can be easily assessed in these patients. The detection and subsequent reversal of immunoincompetence through the use of enteral or parenteral alimentation should provide a significant reduction in operative morbidity and mortality. PMID- 6857501 TI - Progression of atherosclerosis in diabetics. AB - Two hundred seventy-four diabetic patients were studied over a 2-year period to evaluate the progression of lower extremity atherosclerotic occlusive disease (ASO). At initial evaluation, ASO was noted in 98 patients (36%). Incidence of new or more severe disease was noted in 92 patients (34%) at follow-up. Increased age, longer duration of diabetes, lower percent ideal body weight, elevated systolic blood pressure, and elevated serum cholesterol levels were all significantly associated with disease progression. Patients with disease progression were found to have significantly lower nerve motor velocities and sensory conduction, higher serum creatinine levels, and a higher prevalence of retinopathy, proteinuria, and carotid artery disease (perhaps indicating concomitant neuropathy and microvascular disease). Diastolic pressure, race, fasting and postprandial glucose, fasting and postprandial insulin, fasting and postprandial C peptides, and glycosylated hemoglobin levels did not correlate with disease progression. The strongest prognostic indicator of disease progression appeared to be preexisting disease. Significant disease progression over a relatively short period indicates that treatment of the diabetic patients who have symptoms should be early and aggressive. PMID- 6857503 TI - Synthetic vascular graft infections. II. Graft-enteric erosions and graft-enteric fistulas. PMID- 6857502 TI - Recruiting. PMID- 6857504 TI - Cutaneous anergy and marrow suppression as complications of gastroplasty for morbid obesity. AB - Although serious morbidity from gastric restriction for morbid obesity is rare, outflow tract dilation after gastroplasty has become a well-recognized complication, and reoperation to decrease outflow tract size has become increasingly common. We report the case of a patient who developed outflow tract obstruction with subsequent malnutrition, recurrent infections, and marrow suppression. Extensive immunologic evaluation revealed impaired cutaneous reactivity to a battery of recall antigens. Other in vitro T cell functions, B cell functions, neutrophil respiration, and quantification of complements were within normal limits. The patient's immunodeficiency was attributed to protein calorie malnutrition and was corrected with total parenteral nutrition. Recovery of immune function with renutriture was demonstrated, and coincident resolution of infection and marrow suppression also occurred. Because of the reversibility of the immunologic abnormality with appropriate nutritional therapy, it is important to consider and treat malnourishment in connection with any operation in which oral intake is severely limited. PMID- 6857505 TI - Durability of carotid endarterectomy. AB - Carotid endarterectomy is the preferred treatment for patients with transient ischemic attacks and carotid stenosis. Although clinically these patients do well, the long-term fate of the operated carotid artery has not been well documented. To address this question, repeated noninvasive testing has been employed to follow our carotid endarterectomy patients since 1976. Supraorbital Doppler examination, oculoplethysmography-Kartchner, carotid phonoangiography and, later in this series, spectral analysis of the carotid Doppler velocities were performed after 193 endarterectomies. One hundred fifty-eight patients were initially tested within 3 months of operation, and 35 were initially tested 3 or more months after operation. Twenty-four arteries, four of which were symptomatic, had an initial abnormal test and are excluded from this study of carotid artery durability. Of the 169 patients with normal carotid tests, 36 had no further evaluation. Among the 133 patients who returned for serial testing from 1 to 60 months (mean 20 months), 115 carotid arteries continued to test normal at late follow-up but 18 subsequently developed test abnormalities. Ten had more than 75% stenosis, eight had 50% to 75% stenosis. Eight of these patients had contrast studies: three had normal findings; the five that had abnormal findings underwent reoperation. Interestingly, only two patients presented with symptoms appropriate to the abnormal test. The findings suggest that carotid endarterectomy is a reasonably durable operation. Recurrent stenosis was presumed or proven in 10% of 133 serially tested carotid arteries. This threat of restenosis makes long-term follow-up of these patients mandatory. PMID- 6857506 TI - Right atrial thrombus secondary to peritoneovenous shunt: successful removal with use of cardiopulmonary bypass. AB - A patient who had had a functioning peritoneovenous (LeVeen) shunt for 10 months presented with recurrent ascites and the superior vena cava syndrome. He was found to have a thrombus occluding the superior vena cava and extending into the right atrium. The thrombus was removed and the shunt was declotted during cardiopulmonary bypass. PMID- 6857508 TI - Above-knee polytetrafluoroethylene femoropopliteal bypass graft: Is it a reasonable alternative to the below-knee reversed autogenous vein graft? AB - To determine whether an above-knee polytetrafluoroethylene (AK-PTFE) femoropopliteal bypass graft might be an acceptable alternative to a below-knee reversed autogenous saphenous vein (BK-ASV) bypass graft, we compared 51 AK-PTFE grafts to 39 concurrently performed BK-ASV grafts. All patients were staged by preoperative noninvasive vascular laboratory criteria into limiting claudication or limb salvage groups and by intraoperative arteriography according to degree of runoff. There was no significant difference in the primary graft patency at 36 months between the AK-PTFE group (63%) and the BK-ASV group (72%). Secondary graft patency among the AK-PTFE group was improved by minor distal graft revision to 88% at 36 months. The preoperative noninvasive hemodynamic evaluation status was an influential factor; the graft patency rate among the patients with limiting claudication was superior to that among the limb salvage group, but the degree of runoff as shown by intraoperative angiography did not appear to have an effect on cumulative patency. Resting Doppler ankle/brachial artery pressure ratios did not predict subsequent occlusion of AK-PTFE grafts. Atherosclerosis is a progressive and systemic disease that frequently involves both the coronary and tibial vessels. AK-PTFE spares autogenous saphenous vein so that it can be reserved for use in coronary artery bypass or in subsequent treatment of more distal tibial vessel disease. PMID- 6857507 TI - Intermittent sequential pneumatic compression of the legs and thromboembolism deterrent stockings in the prevention of postoperative deep venous thrombosis. AB - One hundred fifty patients over the age of 30 who had undergone major abdominal operations were stratified according to the risk of deep venous thrombosis and randomized into three groups to receive different prophylactic regimens: group A, electrical calf stimulation; group B, low-dose subcutaneous heparin; group C, intermittent sequential compression and thromboembolism-deterrent (TED) stockings. All the patients were scanned with the 125I-fibrinogen test for the whole stay in hospital. The incidence of 125I-fibrinogen detected deep venous thrombi was 18% in group A, 9% in group B, and 4% in group C. The results indicate that the regimen of intermittent sequential compression and TED stockings is as effective as low-dose subcutaneous heparin. Electrical calf stimulation is less effective. PMID- 6857509 TI - Achalasia of the cardia associated with pulmonary sarcoidosis. AB - The case of a patient with sarcoidosis and symptoms suggestive of achalasia cardia is presented. Because of increasingly severe dysphagia, cardiomyotomy was performed and biopsy specimens of the esophageal wall were obtained. Light and electron microscopy revealed lesions of the nerves in Auerbach's plexus consisting of an inflammatory process and demyelinization of the nerve fibers. Since the operation, the patient has been swallowing without difficulty. Although previous reports have described dysphagia in patients with sarcoidosis, presumably secondary to mechanical compression by adjacent lymph nodes or infiltration of the esophageal wall by sarcoid granulomata, this report documents for the first time that dysphagia can also be caused by direct involvement of the innervation of the esophagus by sarcoidosis. PMID- 6857510 TI - Radionuclide diagnosis of diaphragmatic rupture with hepatic herniation. AB - Seven surgically proven cases of a traumatic rupture of the right hemidiaphragm with a hepatic herniation were preoperatively diagnosed by radionuclide liver spleen imagings, and they were retrospectively analyzed. All injuries resulted from blunt traumatic injury including automobile accidents, and there were associated pelvic and rib fractures in five cases. All patients developed some degree of dyspnea in the relatively immediate phase. All chest radiographs showed an apparent elevation of right hemidiaphragm. Radionuclide liver-spleen imaging with 99mTc sulfur colloid characteristically demonstrated a distortion of liver configuration with superior and posterior displacement of the right lobe. Four patients had a large tear in the central tendon of the right hemidiaphragm, and none had a tear in the anterior part or in left lobe of the liver. The differential diagnosis of elevated right hemidiaphragm is briefly discussed. It is concluded that the correct preoperative diagnosis of the diaphragmatic rupture with liver hernia could be made with an awareness of this condition following trauma and radionuclide liver-spleen imaging. PMID- 6857511 TI - Hypertonic sodium lactate versus lactated ringer's solution for intravenous fluid therapy in operations on the abdominal aorta. AB - Fifty-eight patients who were to undergo aortic reconstruction were prospectively randomized into two groups to compare the effects of perioperative fluid replacement with isotonic and hypertonic crystalloid solutions. Blood loss was replaced with packed red blood cells, and additional fluid was given as either Ringer's lactate solution (RL, 130 mEq sodium/L, 274 mOsm/L) or a hypertonic balanced salt solution (HSL, 250 mEq sodium/L, 514 mOsm/L). Fluid was administered to maintain the cardiac filling pressure within 3 torr of the preoperative level and the cardiac output (CO) at or above the preoperative level. The groups were similar with respect to age, preexisting disease, duration of operation, and operative blood loss. During the operation, the RL group required 9.5 +/- 0.8 L of fluid, whereas the HSL group required 4.5 +/- 0.3 L (P less than 0.001). Pulmonary, cardiac, and renal functions were adequately maintained in both groups. There were no significant differences between the groups with regard to CO, urine output, or creatinine clearance during the operation and early postoperative period. Postoperatively, the intrapulmonary shunt was 20 +/- 1% in the RL group and it was 16 +/- 1% in the HSL group (P less than 0.05). The amount of sodium infused and the cumulative sodium balance at the completion of the study period were similar in both groups. Serum sodium and osmolarity were significantly greater in the HSL group (P less than 0.001), reaching a maximum of 151 +/- 1 mEq/L and 305 +/- 2 mOsm/L, respectively. Two patients in the HSL group had a persistent elevation in serum osmolarity (greater than 320 mOsm/L) during operation, for which they received RL for the balance of the resuscitation. There were no complications that could be attributed to the hypertonicity of the solution. HSL is effective for resuscitation of patients with extracellular fluid deficit and is safe provided that the serum sodium and osmolarity are monitored during periods of large volume administration. PMID- 6857512 TI - An ischemic basis for biliary strictures. AB - Three case reports reflecting a probable ischemic basis for biliary strictures are presented. A stricture occurring after biliary-enteric anastomosis following low division of the bile duct and another after relatively low division of the bile duct are explained on the basis of the tenuous blood supply to the supraduodenal bile duct from above. It is postulated that these strictures could have been avoided had the bile duct been divided at a higher level originally and had adequate back-bleeding from the transected upper bile duct been checked prior to performing the anastomosis. The stricture in the third patient probably occurred because the damaged duct segment was used for the anastomosis. The stricture could probably also have been avoided by higher transection of the duct. PMID- 6857514 TI - Achieving ileostomy continence with a prestomal ileal pouch and a stomal occlusive device. AB - To determine whether an artificial, indwelling, stomal occluding device could provide reliable continence for persons with an ileostomy and a prestomal ileal pouch, the device was tested first in four dogs and then in humans. After initial assessment of pouch volume and pressure-volume relationships in the dogs, the animals underwent progressively longer periods of stomal occlusion with the artificial device, such that 4 weeks later, they were tolerating occlusion for periods of 8 hours. The device achieved complete continence for gas and stool without discomfort in every dog. The pouch capacity rapidly increased, so that infusion of 500 ml of water at 4 weeks elicited less than a 10 cm H2O increase in intrapouch pressure. These encouraging canine results prompted use of this approach in a 55-year-old obese man undergoing proctocolectomy for chronic ulcerative colitis. The device achieved continence in the patient for 4- to 6 hour periods by 2 months after operation without discomfort or adverse sequelae. We concluded that the artificial device rapidly increased pouch capacity and effectively maintained leakproof fecal continence in dogs and humans with an ileostomy and a prestomal ileal pouch. PMID- 6857513 TI - Proximal gastric vagotomy and mucosal antrectomy: a possible operative approach to duodenal ulcer. AB - Our aim was to develop proximal gastric vagotomy with mucosal antrectomy as an operative approach to duodenal ulcer. We performed mucosal antrectomy in four dogs by excising the antral mucosa via a circular corporal myotomy, removing a circumferential band of corporal seromuscularis, anastomosing the corporal and pyloric mucosas endoantrally, and reapproximating the corporal and antral seromuscularis. Gastric emptying and serum gastrin were assessed before and 4 weeks after operation. A second operation, proximal gastric vagotomy, was then done, and the tests were repeated 4 weeks later. The concentration of gastrin in the serum during fasting was lower after mucosal antrectomy than before operation, as was the postprandial concentration; the values remained low after proximal gastric vagotomy. Gastric emptying of liquids and indigestible solids was unaltered by mucosal antrectomy or mucosal antrectomy plus proximal gastric vagotomy. The emptying of digestible solids was slowed somewhat by mucosal antrectomy to 75% of the control rate, but no further change was found after proximal gastric vagotomy. We concluded that mucosal antrectomy eliminated the gastrin-producing antral mucosa and, in combination with proximal gastric vagotomy, did not greatly alter gastric emptying of liquids or solids. The combined operation might have a role in the surgical treatment of duodenal ulcer. PMID- 6857517 TI - Male hypoplastic infrarenal aorta and premature atherosclerosis. AB - Hypoplasia of the abdominal aorta distal to the origin of the renal arteries may be a contributing factor in the development of early atherosclerosis. The abnormal aortic configuration and resultant increased stress forces may account for the localization of the disease to the aortoiliac segment. The increased frequency of single bifurcating lumbar arteries at the L4-L5 level, easily demonstrable on conventional arteriograms, suggests that the aortic hypoplasia may result from excessive fusion of the paired dorsal aortas during embryonic life. Hypoplasia of the infrarenal aorta is present in 9% of females with aortoiliac disease, and it is believed to be uncommon in males. A review of 408 peripheral arteriograms of males revealed 18 cases (4.4%) of hypoplasia of the abdominal aorta. Males with hypoplastic aortas develop symptoms 10 years earlier than those with normal-sized aortas and 10 years later than females with similar narrowing of the distal aorta. PMID- 6857518 TI - Aspiration pneumonia: treatment with pulmonary vasodilators. AB - Experimental aspiration pneumonia induced in the isolated perfused ventilated canine pulmonary lobe by the intrabronchial instillation of hydrochloric acid is characterized by pulmonary edema, intrapulmonary shunting, and loss of lung compliance. In addition, pulmonary artery pressure increases. In an attempt to modify the injury response, we restricted the increase in pulmonary artery pressure in the isolated lobe model by administering vasodilator drugs. In control lobes perfused for 4 hours there was minimal weight gain (14 gm), pulmonary artery pressure remained stable (13 mm Hg), and intrapulmonary shunting did not occur. Following intrabronchial instillation of 0.2 ml of 0.1N HCl/gm of lobe weight, lobe weight tripled (183 gm), pulmonary artery pressure (20 mm Hg) was significantly increased, and significant intrapulmonary shunting (32%) developed. When sodium nitroprusside (2 micrograms/min/kg of dog body weight) was infused into the pulmonary artery 3 minutes after HCl instillation, the pulmonary artery pressure was significantly reduced (13 mm Hg) compared to that in untreated acid lobes. This was accompanied by a significant reduction in mean weight gain (100 gm) and intrapulmonary shunting (15%) compared to untreated acid lobes. Similarly, when isoproterenol (0.04 micrograms/min/kg dog body weight) was infused into the pulmonary artery following acid instillation, the pulmonary artery pressure (12.5 mm Hg) was significantly reduced compared to that in untreated acid lobes. This was also accompanied by a significant reduction in weight gain (60 gm) and intrapulmonary shunting (6%) compared to untreated acid lobes. These data demonstrate that the increase in pulmonary artery pressure following acid injury can be lowered pharmacologically and that a significant decrease in injury response follows. This suggests that the magnitude of the injury response is in part a function of pulmonary artery pressure. PMID- 6857516 TI - Definition of human melanoma-associated cell surface antigens by hybridoma monoclonal antibodies. AB - Many human melanoma cell lines express HLA-D antigens in addition to HLA-A, -B, and -C specificities. Hybridoma antibodies produced after sensitization with melanoma cells are directed not only against tumor-associated antigens but against HLA and Ia-like specificities. Paired human melanoma cell lines and autologous lymphoblast lines were used to identify those monoclonal hybridoma antibodies that define human melanoma-associated antigens. Autologous lymphoblast lines were used to exclude hybridoma antibodies directed against HLA and Ia-like specificities. Using this method, we have identified several cell surface antigens that are expressed on the majority of human melanoma cell lines tested. PMID- 6857515 TI - Effects of low-dose warfarin on antithrombin III levels in morbidly obese patients. AB - Morbid obesity has been associated with increased risks for thrombotic diseases. Patients with morbid obesity are shown to have decreased activity and decreased concentration of antithrombin (AT) III. This deficit can be corrected by giving the patients low doses of the oral anticoagulant warfarin. The same beneficial effect was not observed in normal lean control volunteers in whom the levels of AT III were normal at all times. Thus, it may be possible to offer prophylactic protection against the effects of having depressed levels of AT III in patients at increased risk for thrombotic diseases without using full anticoagulant doses of warfarin, including morbidly obese patients. PMID- 6857519 TI - [Work of breathing curves in different forms of lung pathology]. PMID- 6857520 TI - [Characteristics of the course of pulmonary artery thromboembolism]. PMID- 6857521 TI - [Classification, clinico-pathophysiological characteristics and treatment principles in pancreatogenic complications of the respiratory tract]. PMID- 6857523 TI - [Role of indices in noninvasive methods of studying the lesser circulation in mitral stenosis]. PMID- 6857522 TI - [Tuberculosis of the breast]. PMID- 6857525 TI - [Physical work capacity and its limiting factors in hypertension patients]. PMID- 6857524 TI - [Dose-effect dependence after taking calcium antagonists in exertion stenocardia patients]. PMID- 6857526 TI - [Development of Ayerza's syndrome with pronounced arteriosclerosis of the pulmonary artery branches in postinfarct cardiosclerosis and muscular mitral failure]. PMID- 6857527 TI - [Crohn disease with damage to the duodenum, jejunum and large intestines]. PMID- 6857529 TI - [Immunocorrective therapy of patients with a severe form of infectious-allergic bronchial asthma]. PMID- 6857531 TI - [Role of psychotherapy in the treatment of bronchial asthma taking into account the "internal picture of the disease"]. PMID- 6857530 TI - [Corticosteroid dependence of bronchial asthma patients with a background of quantum hemotherapy]. PMID- 6857532 TI - [Effect of processes of free-radical oxidation and phospholipase activity on the course and outcome of acute pneumonia]. PMID- 6857528 TI - [Immunological manifestations of bronchial asthma in chemical industry workers]. PMID- 6857534 TI - [Diagnosis and treatment of pulmonary forms of ornithosis]. PMID- 6857533 TI - [Phagocytic activity of the alveolar macrophages in patients with acute and chronic nonspecific lung diseases. The effect of levamisole]. PMID- 6857535 TI - [Fiber bronchoscopy in the diagnosis and treatment of endobronchitis]. PMID- 6857538 TI - [Blood kinin system of patients with chronic nonspecific lung diseases]. PMID- 6857536 TI - [Characteristics of the microcirculation in chronic bronchitis patients and their relation to laboratory data]. PMID- 6857537 TI - [Changes in the blood plasma lipid and lipoprotein levels in chronic obstructive bronchitis]. PMID- 6857539 TI - [Erythrocyte morphology in nonspecific lung diseases (an electron microscopy study)]. PMID- 6857540 TI - [Long-aspirated foreign bodies in the bronchi as a cause of inflammatory lung diseases]. PMID- 6857542 TI - Cesarean section: 1983. PMID- 6857543 TI - Critical issues confronting public teaching hospitals in Texas. PMID- 6857541 TI - [Medico-economic effectiveness of dispensary care for patients with chronic nonspecific lung diseases using a sanatorium set-up in southwestern Siberia]. PMID- 6857544 TI - Cardiothoracic surgery in the United States Air Force. PMID- 6857545 TI - Qualitative behavior of a selectively neutral allelic model. AB - A model of Fleming and Viot for describing frequency distributions for selectively neutral allelic populations and for multidimensional numerical genetic traits is studied, with specific attention given to two qualitative aspects that are derived: the coherence of the random wandering distribution and the tendency to cluster at microscopic scales. A new quantity, called the clustering or occupation index, is introduced to measure relative patchiness of the distribution in terms of a limiting subcell occupation frequency. Results of one- and two-dimensional computer-generated simulations are presented which provide an estimate of the theoretical expected distribution of allelic types. Evidence of the robustness of the model, in the sense that it arises from a variety of assumptions about the reproductive mechanism, is presented in the Appendix. PMID- 6857546 TI - Assortative mating and the segregation variance. AB - Feldman and Cavalli-Sforza (Theoret. Pop. Biol. (1979), 15, 276-307; (1981), 19, 370-377) have emphasized the role of the segregation variance in models of assortative mating for continuous characters. This note examines its behavior in the context of a general additive model. Using known results concerning the effects of assortative mating and selection on genic variance and correlations among uniting gametes it is shown that the effects of these processes on segregation variance wil be small if the effective number of loci is large. Thus models in which the segregation variance remains constant are approximate descriptions of the behavior of characters determined by many loci. PMID- 6857547 TI - Distribution of mutants in aggregates of cultured cells. AB - The analysis of the distribution of mutants in an exponentially growing culture of cells that are aggregated into clumps of homogeneous size is described, given the mutation rate and a random process by which clumps divide to produce progeny. The mean and standard deviation of the proportion of clumps with a given number of mutant cells at a particular time are calculated. Since the standard deviation tends to be much smaller than the mean, the following conclusions can be drawn. Aggregation lowers the number of mutant-containing clumps in cultures grown to a standard number of cells, but raises the number of mutant-containing clumps in cultures grown to a standard number of clumps. In the absence of mutation, or at low mutation rates, clumps tend to become pure types (normal or mutant). The probability of finding pure, nonmutant-containing clumps, however, is approximately the initial fraction of nonmutant cells (given realistic forward and back mutation rates). Also, in terms of the given process, it is possible to compute the probability that all the cells in an aggregate descend from a single, common parent cell within a given number of generations, and thus to calculate the probability that all the cells in a clone grown from an aggregate descend from a single cell within a known number of generations. PMID- 6857548 TI - Simulating allele frequencies in a population and the genetic differentiation of populations under mutation pressure. AB - A method is developed for simulating the allele frequencies in an equilibrium or transient population under the effects of neutral mutation and random drift. The method is based on diffusion theory and is fast so that it can be used to study in detail the distribution of heterozygosity or any quantity that can be expressed as a function of allele frequencies. It has been applied to study the distribution of heterozygosity and the distribution of the frequencies of the first three most frequent alleles in a population. It also has been applied to study the distribution of the number of alleles shared by two populations that were derived from a common stock. PMID- 6857549 TI - The probability that related individuals share some section of genome identical by descent. AB - A formal mathematical framework is presented for the study of linkage in man and the concept of chromosome pedigree is defined for both autosomes and X chromosomes. It is shown that, assuming no interference, all the crossover processes in the pedigree may be viewed jointly as a continuous-time Markov random walk on the vertices of a hypercube, the time parameter being map distance along the chromosome. The event that two individuals have a segment of chromosome in common, thus proving them to be related, corresponds to the random walk hitting a particular set of vertices. The probability of this happening is calculated for various types of relationship, making use of the symmetry of the situation to partition the vertices into a very much smaller number of orbits and render the computation manageable. The probability that an individual with n children passes on all his or her genes to them is also calculated in this way. PMID- 6857550 TI - Sexual selection and fertility. AB - Genetic models are analyzed in which sexual selection is combined with fertility selection. In these models, the sexual selection acts on males, the fertility selection on either males, females or both sexes. The phenotypes thus selected may be determined either by dominant and recessive alleles or by each homozygous and heterozygous genotype. Polymorphisms of dominant and recessive phenotypes can be maintained in equilibrium by a balance between sexual and fertility selection. Generally fertility selection has a greater effect than viability selection in determining the point of equilibrium. The dominant phenotype is maintained at a lower frequency when at a fertility disadvantage than when at a viability disadvantage. When about 20% or more of the females mate preferentially, the models show that equilibria will be established at very different frequencies depending on whether fertility selection acts on males, females or both sexes. These results, applied to data of preferential mating of melanic two-spot ladybirds, predict differences in fertility which can be use to test the models. Symmetric models of preferences for each genotype also give rise to polymorphisms if the heterozygotes obtain an overall advantage. PMID- 6857551 TI - Variance of actual inbreeding. AB - The variances of actual inbreeding and coancestry in terms of their corresponding identities by descent were studied for finite populations. For inbreeding at a single locus, the total variance sigma 2 equal F(1-F) (F is the inbreeding coefficient) is comprised of a component sigma 2w within populations and a component sigma 2b between replicate populations. These variances increase in time to a maximum at about 1.1Ne generations for sigma 2w, about 2.3Ne generations for sigma 2b, and about 1.4 NE generations for sigma 2, and decrease thereafter (Ne is effective population size). The ratio sigma 2b/sigma 2 is ever increasing to an asymptote in the range 0.4-0.5 depending on Ne and the mating system. For finite populations with variation in pedigree F's, there are contributions sigma 2wF within and sigma 2bF between populations. The component sigma 2bF is insignificant except for very small populations, and sigma 2wF is largest in the early generations and then decreases roughly as (1-F)2/KNe where K is formulated in terms of the mating strategy and the degree of avoidance of mating relatives. An additional degree of avoidance increases K by a factor of 4. In a large population at equilibrium with respect to mixed self and random mating, sigma 2wF accounts for one-half to two-thirds of sigma 2w. Bringing in more loci leads to decomposition of the total variance into four components whose values are affected by linkages among the loci. The relationships between these components and sigma 2w, sigma 2wF, and sigma 2bF are elaborated in terms of tight and loose linkage. The exact computations of sigma 2wF and sigma 2bF require the use of two locus descent measures without linkage. The variances of various averages of actual identities by descent, such as the proportions for individuals or populations, are formulated for a sample of individuals. PMID- 6857552 TI - [Vaccines: immunologic principles]. PMID- 6857553 TI - [Vaccination schedule for routine preventive vaccinations]. PMID- 6857554 TI - [Vaccination for foreign travel]. PMID- 6857555 TI - [Vaccination reactions and complications]. PMID- 6857556 TI - [Diphtheria and tetanus]. PMID- 6857557 TI - [Whooping cough vaccination]. PMID- 6857558 TI - [Prevention of poliomyelitis]. PMID- 6857559 TI - [Vaccination against measles]. PMID- 6857560 TI - [Vaccination against mumps and vaccination against rubella]. PMID- 6857561 TI - [Significance of BCG vaccination in the current epidemiologic and therapeutic situation in the field of tuberculosis]. PMID- 6857563 TI - [Influenza and preventive influenza vaccination]. PMID- 6857562 TI - [Preventive hepatitis B vaccination]. PMID- 6857564 TI - Pneumococcal vaccine. PMID- 6857565 TI - [Typhoid: evaluation of prevention by vaccination]. PMID- 6857566 TI - [Passive immunization with immunoglobulins]. PMID- 6857567 TI - [Seroconversion following vaccination with a new measles vaccine strain]. PMID- 6857568 TI - How many blows really make an FEV1, FVC, or PEFR? AB - We have collected peak expiratory flow rates, one-second forced expiratory volumes, and forced vital capacities in sets of 10 or 20 values at one-minute intervals from 30 normal, 49 asthmatic, and 26 bronchitic subjects. Analysis shows that the derivatives are compatible with a normal distribution of the values in the sets, so that the true value is best represented by the arithmetic mean of all valid attempts. One-third of all subjects showed skewness in one or more indices but these were equally divided between positive and negative directions. There is no sign of the dominant negative skewness that would result if the true value was indeed a maximum, which could be approached or equalled but never exceeded. There is no sign that repetition worsens performance. Seventy-two subjects showed no regression in any index and those of the remainder who deteriorated were balanced by equal numbers in all categories who improved. There is a significant tendency for both the highest and the lowest values to occur in the earlier part of any series. Probability theory suggests that this is a statistical phenomenon. The best estimate of the true value of these indices is probably the mean of as many observations as can be conveniently obtained and the data can be treated statistically as if they were a sample from a normally distributed population. PMID- 6857569 TI - Interstitial lung disease and asthma in hard-metal workers: bronchoalveolar lavage, ultrastructural, and analytical findings and results of bronchial provocation tests. AB - Five patients with respiratory disorders associated with hard metal exposure are described. In four patients electron microprobe analysis of bronchoalveolar lavage cells or lung tissue was used to show tungsten and other hard-metal components. Three patients had interstitial pneumonia and fibrosis with unusual multinucleate giant cells. Electron microscopy showed that the giant cells comprised both type II alveolar epithelial cells and alveolar macrophages. The multinucleate macrophages formed a distinctive feature of the bronchoalveolar lavage material but the multinucleate alveolar epithelial lining cells were evident only in lung tissue. The other two patients both suffered from work related asthma, one of whom also had pulmonary opacities. Bronchial provocation tests in these patients supported the diagnosis of hard-metal-induced asthma and implicated cobalt as the agent responsible. PMID- 6857570 TI - Congenital broncho-oesophageal fistula in the adult. AB - The case of a 46-year-old man with congenital broncho-oesophageal fistula is presented. The patient had had recurrent chest infections since childhood and a recent history of heartburn and flatulence. A barium-swallow examination showed a small sliding hiatal hernia and an oesophageal diverticulum communicating via a fistula with the apical and posterior segmental bronchi of the left lower lobe. Bronchography showed bronchiectasis in this lobe. At thoracotomy resection of the broncho-oesophageal fistula and left lower lobectomy were performed. The patient's recovery was uneventful. Twenty published cases are reviewed. The classification of congenital broncho-oesophageal fistulae should take account not only of the type of fistula but also of the type and size of the bronchus with which the fistula communicates, the age of the patient at the first appearance of symptoms, and the duration of symptoms. PMID- 6857571 TI - Fatal intrathoracic sepsis associated with neck space infection. PMID- 6857574 TI - Primary bronchopulmonary amyloid tumour with massive hilar lymphadenopathy. PMID- 6857573 TI - Massive amyloidosis of mediastinal lymph nodes in a patient with multiple myeloma. PMID- 6857572 TI - Usefulness of transbronchial biopsy in immunosuppressed patients with pulmonary infiltrates. AB - In a retrospective study of thirty-one immunosuppressed patients with new pulmonary infiltrates transbronchial biopsy provided a specific diagnosis in 11 of the 31 (36%) patients. In a further five patients, whose biopsy showed non specific interstitial pneumonitis, a specific diagnosis was established by other means. Overall a specific diagnosis was obtained in 52% of patients. Twelve patients were left with a diagnosis of non-specific interstitial pneumonitis. In three out of 31 (10%) patients insufficient tissue was obtained. The seven patients who had metastatic carcinoma of the lung did poorly. The nine with other specific diagnoses did better in that five of them were alive after more than 11 months of follow-up. Patients with non-specific pneumonitis did well; eight out of 12 (67%) were alive after an average follow-up of 13.4 months. In 27 of the 31 (87%) patients the procedure was felt to have influenced therapeutic decisions. This was true whether the biopsy yielded a specific or a non-specific diagnosis. In our series making a specific diagnosis did not improve the patients' survival. Those with non-specific pneumonitis who were treated empirically did well, as did patients with specific diagnoses other than metastatic carcinoma of the lung. PMID- 6857575 TI - Endobronchial mass lesion due to sarcoidosis: complete resolution with corticosteroids. PMID- 6857577 TI - Penetrating cardiac injuries in the United Kingdom. PMID- 6857578 TI - Oxygen in the home. PMID- 6857576 TI - Bilateral pneumothoraces and pleural effusions complicating rheumatoid lung disease. PMID- 6857580 TI - Breast cancer and thoracic metastases: review of 119 patients. AB - Review of the case notes of 660 patients with a diagnosis of breast cancer during a five-year period showed that in 119 cases there had been thoracic metastases. These were recorded as pleural or extrapleural metastases (79 patients), mediastinal tumour (46 patients), lymphangitic carcinoma (41 patients), pulmonary nodules (34 patients), and solitary pulmonary nodule (nine patients). Endobronchial metastases were present in seven patients and multiple pulmonary tumour emboli in two. The thorax was often the initial site of tumour recurrence. Most of these recurrences were present in several locations (intrathoracic or both intrathoracic and extrathoracic) simultaneously, facilitating the clinical diagnosis of metastatic breast cancer. Histopathological confirmation of metastasis was mandatory for the 10 patients who had a solitary intrathoracic abnormality without evidence of disease elsewhere. The median survival after diagnosis and treatment of a solitary thoracic metastasis was 42+ months and three of 10 patients are currently in remission (at 44, 87, and 121 months). The small tumour burden and early diagnosis giving lead time may explain the long survival in this group of patients. PMID- 6857579 TI - Surgical management of native valve endocarditis. AB - From 1972 to 1981 40 patients have required urgent valve replacement for left sided bacterial endocarditis. The aortic valve was replaced in 31 patients, the mitral valve in four, and both in five patients. Twenty-six patients (65.5%) were in functional class IV heart failure according to the New York Heart Association criteria, and 13 patients (32.5%) were in class III heart failure at the time of operation. One patient in class II was operated on urgently for multiple cerebral embolism but died of fatal cerebral haemorrhage. In 22 patients (55%) there were no pre-existing valvular lesions and these patients were found to be more liable to develop severe haemodynamic failure. Premature closure of the mitral valve, documented by M-mode echocardiography, was a useful diagnostic aid and successfully determined the best timing of surgery in 14 out of 20 patients with severe aortic regurgitation. Cardiac arrest before operation appeared to be a significant risk factor (p = 0.0015) unless followed by immediate cardiopulmonary bypass. There were eight operative deaths (20%). Of 26 patients who were in functional class IV heart failure, 19 were operated on within four days of their haemodynamic deterioration and all survived. The operation was delayed in the remaining seven patients and none of them survived (p = 0.000003). There were no operative deaths among the patients in class III heart failure. There was only one episode of reinfection in the 16 patients followed up for at least three years. The duration of postoperative antibiotic treatment (four to six weeks in our patients), rather than any preoperative antibiotic regimen, seems to be important for preventing reinfection. At present there are 28 survivors, of whom 24 are in functional class I and four in class II. PMID- 6857581 TI - Localisation of a low-molecular-weight bronchial protease inhibitor in the peripheral human lung. AB - The localisation of a low-molecular-weight bronchial protease inhibitor (LMI) in human peripheral lung tissue was studied by an immunohistochemical method. This inhibitor was found exclusively in a part of the non-ciliated cell population of the bronchiolar epithelium. An inverse relationship was observed between the number of LMI-positive non-ciliated cells per millimetre of basement membrane and the bronchiolar diameter. These findings may have a bearing on the protease antiprotease theory of the development of pulmonary emphysema, LMI possibly playing a part in the protection of peripheral lung tissue against proteolytic destruction by enzymes liberated from granulocytes or migrating alveolar macrophages. PMID- 6857582 TI - Blood lactate and respiratory muscle fatigue in patients with chronic airways obstruction. AB - Blood lactate concentrations were measured in five patients with chronic airways obstruction after 10 minutes' sustained maximal voluntary ventilation (SMVV) with end-tidal carbon dioxide tension kept constant and after a 12-minute walk. No patient showed a significant rise in blood lactate after SMVV but all showed evidence of low-frequency fatigue of the sternomastoid muscle. After a 12-minute walk three patients showed a significant rise in blood lactate and two of them also had evidence of low-frequency fatigue of the sternomastoid muscle. The absence of a rise in blood lactate after SMVV may be due to the fact that in patients with chronic airways obstruction ventilation is limited by airflow obstruction to a level where only a small muscle mass is used, or where the aerobic capacity of the respiratory muscles is not exceeded. PMID- 6857583 TI - Prostaglandins and the control of airways responses to histamine in normal and asthmatic subjects. AB - Inhalation histamine challenges were performed in groups of normal and asthmatic subjects. On each occasion a regression line for the descending part of the log cumulative dose-response curve was computed. The dose of histamine causing a 20% fall in specific conductance (sGaw) was taken as an index of "sensitivity." The slope gave the "reactivity". In a double-blind, randomised study the potent inhibitor of prostaglandin synthesis indomethacin (50 mg four times per day for three days) was associated with a small but significant bronchodilatation in the normal but not the asthmatic subjects. Sensitivity to histamine was considerably decreased in the asthmatic patients (p less than 0.005) but unchanged in the normal subjects. In both groups reactivity was significantly increased (p less than 0.01). The study was repeated after several weeks of regular salbutamol treatment. In both groups salbutamol caused a decrease in sensitivity (p less than 0.001) but no change in reactivity. After indomethacin had been reintroduced while salbutamol was continued most of the effects of chronic salbutamol treatment were reversed in the normal subjects, with a similar trend in the asthmatic patients. In both groups the dose-response curves after indomethacin treatment were little affected by pretreatment with salbutamol. Beta-adrenergic stimulation induces changes in the airways that may be dependent on prostaglandin production. PMID- 6857584 TI - Effect of inhibition of prostaglandin synthesis on induced bronchial hyperresponsiveness. AB - Two groups of normal subjects were immunised with live attenuated influenza virus given by the intranasal route. One group was then treated with placebo capsules for 48 hours. At the end of this time an increase in sensitivity to inhaled histamine was found but with a coincident decrease in reactivity. The other group was treated with indomethacin (50 mg four times daily). The increase in sensitivity associated with influenza vaccination was prevented but there was a significant increase in reactivity. It is proposed that prostaglandins released as part of the inflammatory response in the airways after viral infection may be concerned in induction of the changes in response to histamine observed under these conditions. PMID- 6857585 TI - Pathogenic significance of Klebsiella oxytoca in acute respiratory tract infection. AB - A retrospective study of all Klebsiella isolations from patients admitted to hospital with acute respiratory tract infections over a 27-month period was carried out. Ten of the Klebsiella isolations from sputum and one from a blood culture were identified as Klebsiella oxytoca. The clinical and radiological features of six patients are described. Four of these patients had lobar pneumonia, one bronchopneumonia, and one acute respiratory tract infection superimposed on cryptogenic fibrosing alveolitis. One of the patients with lobar pneumonia had a small-cell carcinoma of the bronchus. We concluded that Klebsiella oxytoca was of definite pathogenic significance in these six patients and of uncertain significance in the remaining five patients. Klebsiella oxytoca has not previously been described as a specific pathogen in the respiratory tract. Close co-operation between clinicians and microbiologists in the management of patients with respiratory infections associated with the Enterobacteriaceae is desirable. PMID- 6857586 TI - Plasma DNA in the diagnosis of pulmonary embolism. AB - To assess the diagnostic value of measuring free plasma deoxyribonucleic acid (DNA) in patients suspected of having pulmonary embolism, we prospectively assayed the plasma of 40 consecutive patients who underwent pulmonary angiography for the presence of free plasma DNA. Fifteen of them had angiographic evidence of pulmonary embolism. Of these 15 only two (13%) had a positive result in the test for free double-stranded plasma DNA. We concluded that measuring free double stranded plasma DNA is of no value in the diagnosis of pulmonary embolism. PMID- 6857588 TI - Aortic valve avulsion after proximal aortic dissection in the Marfan syndrome: echocardiographic features and management. PMID- 6857587 TI - Clinical assessment of a rebreathing method for measuring pulmonary gas transfer. AB - A rebreathing method for measuring carbon monoxide transfer factor (TLCO) and transfer coefficient (KCO) is evaluated. The test was performed on 42 subjects. Seventeen of these had normal lung function while the remainder suffered from various conditions, most having fibrosing alveolitis. No patients with severe airways obstruction were included in the group. The results were compared with single-breath measurements and close correlations were found between single breath KCO and rebreathing KCO (r = 0.78, p less than 0.001) and between single breath TLCO and rebreathing TLCO (r = 0.97, p less than 0.001). The reasons for discrepancies between single-breath and rebreathing values are discussed. It is concluded that measurement of rebreathing gas transfer is a useful supplement to routine tests of lung function, particularly in breathless patients with a small vital capacity. PMID- 6857589 TI - A new bleeding disorder: lack of platelet aggregatory response to adrenaline and lack of secondary aggregation to ADP and platelet activating factor (PAF). AB - A bleeding disorder, probably familial, with absent adrenaline-induced platelet aggregation and lack of secondary aggregation response to ADP and platelet activating factor (PAF), is described. The laboratory findings do not fit any hitherto recognized hemorrhagic disease. The disorder was not caused by alpha adrenergic receptor deficiency, but the ultimate defect has not yet been unraveled. This patient illustrates that a normal response to more than one aggregating stimulus is necessary for normal hemostasis, and indicates a physiopathological role for adrenaline not hitherto recognized. Whether this also applies to PAF remains to be proven. PMID- 6857591 TI - Effects of peptides cleaved from human fibrinogen by plasmin on rabbit kidney cells in culture. AB - Low molecular weight fibrinogen degradation products (LMW-FDP) containing a mixture of dialysable peptides cleaved from human fibrinogen by plasmin are cytotoxic to an established line of rabbit kidney cells and to primary cultures of rabbit kidney cells. The presence of LMW-FDP in a concentration of 50 micrograms/ml during the cell cultivation caused a considerable release of 51Cr from prelabelled cells and inhibited 3H-thymidine and 86Rb uptake. Among three isolated peptides of established primary structure only one, 6D: Ser-Gln-Leu-Gln Lys-Val-Pro-Pro-Glu-Trp-Lys, induced a significant effect, i.e. it enhanced 3H thymidine incorporation. Two others, 6A: Ala-Arg-Pro-Ala-Lys and 6E: Thr-Ser-Glu Val-Lys, did not influence the examined parameters. Hence other components of LMW FDP must be assumed to be responsible for the cytotoxic effect on kidney cell cultures. PMID- 6857595 TI - Warfarin anticoagulation prevents experimental arterial thrombosis in rats without inducing haemorrhage. PMID- 6857593 TI - Neutralization of heparin activity by binding to human histidine-rich glycoprotein. PMID- 6857594 TI - Separation and purification of rat fibrinogen degradation products D1 and E by chromatofocusing. PMID- 6857590 TI - Warfarin-induced factor VII deficiency and the bleeding time. AB - The effect of warfarin-induced factor VII deficiency on the skin bleeding time was investigated in 10 consecutive patients with mean prothrombin times of 33 sec and factor VII levels of 7%. Bleeding times in all but one subject were entirely within the normal range. We conclude that warfarin administration, even to the point of prolonging the prothrombin time beyond the therapeutic range, is not associated with an abnormal bleeding time. Furthermore, from the above evidence and a review of the literature, it is considered doubtful that factor VII plays a major role in primary hemostasis. PMID- 6857592 TI - L-asparaginase induced antithrombin III deficiency: evidence against the production of a hypercoagulable state. AB - L-asparaginase, a chemotherapeutic agent employed in the treatment of acute lymphocytic leukemia (ALL), is known to depress the synthesis of numerous plasma proteins. The plasma concentration of the major protease inhibitor of the coagulation mechanism, antithrombin III, is substantially decreased in patients receiving this drug. This observation has generated speculation that L asparaginase may induce a hypercoagulable state in humans. To examine this hypothesis, we studied ten patients with ALL in remission who were being treated with the above chemotherapeutic agent. Our data revealed that infusion of this enzyme leads to a marked decrease in the plasma concentrations of prothrombin as well as antithrombin III. However, we have also observed a constant level of thrombin generation during the same period of time as monitored by plasma levels of prothrombin activation fragment (F1 + 2) and thrombin-antithrombin complex (TAT). Based upon these findings we suggest that administration of L-asparaginase does not usually lead to the induction of a hypercoagulable state. PMID- 6857596 TI - Antagonism of platelet aggregation by 13-azaprostanoic acid in acute myocardial ischemia and sudden death. AB - The effects of 13-azaprostanoic acid (13-APA) were studied during acute myocardial ischemia in cats and in rabbit sudden death induced by sodium arachidonate (Na-Ar). To more clearly define the mechanism of action of 13-APA, we also examined its effects on isolated cat and rabbit coronary arteries, in vitro aggregation of cat and rabbit platelet-rich plasma (PRP) and circulating rabbit platelet count measured in vivo. 13-APA provided minimal protection during myocardial ischemia in cats, partially reversing ischemia-induced ST segment elevations by 3-5 hours after coronary artery occlusion. However, 13-APA was ineffective in inhibiting the rise in plasma creatine kinase (CK) activity or the loss of CK from ischemic myocardial tissue. 13-APA (1.0 - 100 microM) did not inhibit contraction of cat coronary arteries produced by a stable thromboxane A2 analog. However, 13-APA (100 microM) inhibited aggregation of cat PRP induced by AA (1.0 microM). 13-APA also provided significant protection against sudden death induced by Na-Ar in rabbits. While this agent was ineffective in reducing vasoconstriction of rabbit coronary arteries or inhibiting platelet aggregation in response to 500 microM AA, aggregation of rabbit PRP by 250 microM AA was completely inhibited. AA injection produced a significant decrease in circulating platelet count in vehicle-treated rabbits. However, 13-APA reduced the decrease in circulating platelet count in rabbits which survived AA injection during the 13-APA infusion. These results indicate that antagonism of thromboxane A2 receptors in platelets may be an important feature in protecting against sudden death. The difference in sensitivities of vascular and platelet thromboxane receptors as well as the accessability of 13-APA to these receptors may explain the lack of protection of 13-APA in myocardial ischemia. PMID- 6857598 TI - Continuous recording of red cell interactions. PMID- 6857597 TI - Effects of sodium and lithium salts on the conformation of human alpha-thrombin. AB - Chemical modification studies have demonstrated that the ultra-violet difference spectrum of alpha-thrombin produced in the presence of sodium is due primarily to changes in the environment of tyrosine residues. This is based on the observation that the spectrum could be abolished by treatment of alpha-thrombin with tetranitromethane but not with dimethyl-(2-hydroxy-5-nitrobenzyl) sulfonium bromide. Although lithium produces similar (UV) difference spectrum, circular dichroism studies indicate that sodium and lithium induce different conformational transitions. alpha-Thrombin tends to assume a more ordered structure in the presence of sodium whereas lithium has the reverse effect. This inverse behavior is consistent with the effects of these cations on the autolysis rate and thermal stability of the activities of alpha-thrombin. PMID- 6857600 TI - Effect of dipyridamole on experimental disseminated intravascular coagulation in rats. AB - Experimental disseminated intravascular coagulation (DIC) can be induced by 4-h sustained infusion of endotoxin in a dose of 100 mg/kg in rats. The experimental model of DIC in rats was used to study the preventive effect of dipyridamole against DIC. Before the infusion of endotoxin, 0.5, 5.0 or 50.0 mg/kg of dipyridamole was injected intraperitoneally. The preventive effect against DIC was noted in all the parameters, such as fibrinogen and fibrin degradation products, fibrinogen level, prothrombin time, partial thromboplastin time, platelet count, and the number of renal glomeruli with fibrin thrombi, in rats treated with 5.0 or 50.0 mg/kg of dipyridamole. From these results, it was shown that dipyridamole inhibited the aggravation of endotoxin-induced experimental DIC in rats. PMID- 6857601 TI - Plasma hypercoagulability after termination of oral anticoagulants. AB - The effect of discontinuation of a long term oral anticoagulant therapy with phenprocoumon on blood clotting parameters has been evaluated in patients in a controlled prospective trial. After termination of phenprocoumon the prothrombin time normalized within 15 days and the thrombotest coagulation value within 57 days. Fibrinopeptide A (FPA) increased significantly during the observation period. FPA release in vitro also rose after discontinuation of anticoagulants. In control patients on a phenprocoumon maintenance therapy no alterations of the above mentioned parameters occurred within the same period. The data indicate that plasma hypercoagulability is found in many patients, orally anticoagulated because of myocardial infarction, when the anticoagulant therapy is discontinued. PMID- 6857599 TI - Influence of fibrinogen fragments on human lymphocyte thymidine uptake. AB - Fragments of human fibrinogen were tested for ability to suppress activation of human blood lymphocytes by the lectin phytohaemagglutinin (PHA). Measurement of cellular 14C-thymidine uptake was used as an indicator of DNA synthesis and cell proliferation. The tested fragments were obtained by plasmin digestion or by CNBr fragmentation of fibrinogen. Inhibition of uptake, with good dose response relationship, was demonstrated for the plasmic fragment PL-3 and for the CNBr fragment Hol-DSK. Digests of the latter with trypsin and plasmin gave the same effects as the intact fragment. However, reproducibility was poor with PL-3. Hol DSK gave better reproducibility, but with pronounced interbatch variations. Other fragments of fibrinogen were tested, but gave no effect in the studied concentrations. The reason for the poor reproducibility is discussed. PMID- 6857602 TI - Cyclic amides of N alpha-arylsulfonylaminoacylated 4-amidinophenylalanine--tight binding inhibitors of thrombin. AB - Variation of the potent thrombin inhibitors derived from N alpha-arylsulfonyl-4 amidinophenylalanine was carried out by interposition of an omega aminoalkylcarboxylic acid between the N alpha-arylsulfonyl residue and the 4 amidinophenylalanine part. The use of glycine as spacer renders the compounds tight binding inhibitors of thrombin. The Ki of the most potent inhibitor reaches the nmol/l range. The inhibitory effect is specifically directed against thrombin, the Ki values for inhibition of trypsin, plasmin and factor Xa are some orders of magnitude higher than those for thrombin inhibition. PMID- 6857603 TI - Isolation and characterization of a monoclonal antibody specific for fibrinogen and fibrin of human origin. AB - A hybridoma cell line secreting a monoclonal antibody directed against human fibrinogen has been isolated. The antigenic determinant recognized is present on both the fibrinogen and fibrin molecules but is apparently absent from the D and E fragments and from fibrinopeptides A and B. The antibody seems to recognize a conformational structure present in native fibrinogen and in which several or possibly all the fibrinogen polypeptide chains may participate. PMID- 6857605 TI - Stimulus-response coupling in human platelets. Evidence against a role of PAF acether in the "third pathway'. PMID- 6857604 TI - Evaluation of clotting and amidolytic activities of alpha-thrombin complexed with antithrombin III. PMID- 6857606 TI - Further evidence against the validity of using an ADP-removing enzyme system (CP/CPK) for demonstrating the role of secreted ADP in platelet activation. AB - The ADP-removing enzyme system creatine phosphate-creatine phosphokinase (CP/CPK) selectively inhibited primary aggregation in response to the thromboxane receptor agonist, U46619, in mouse aspirin-treated platelet-rich plasma. Inhibition by CP/CPK has become accepted as evidence for mediation by secreted ADP, yet primary aggregation is not usually attributed to secreted ADP. Hence these results throw doubt on the assumed mechanism by which CP/CPK inhibits aggregation. The possibility that such inhibition was due to removal of extracellular ADP released prior to platelet stimulation and exerting a potentiating influence was investigated. Ths explanation appeared unlikely as further additions of creatine phosphokinase to platelet-rich plasma preincubated with CP/CPK caused further inhibition of primary aggregation. Moreover, low concentrations of CP/CPK that reduced responsiveness to U46619 had no effect on collagen-induced aggregation, which ADP is known to potentiate. The evidence presented is consistent with CP/CPK exerting a direct inhibitory effect on platelet membranes and so inhibiting a facet of platelet aggregation not mediated by secreted ADP. These data support the conclusion of a previous study (Huang, E.M. and Detwiler, T.C., J. Lab. Clin. Med.,95, 59-68, 1980) that inhibition by CP/CPK cannot be taken as evidence for the involvement of secreted ADP. PMID- 6857607 TI - [Diet therapy of essential hypertension]. PMID- 6857608 TI - [Severe meningococcal disease studied from hospital records]. PMID- 6857609 TI - [Formaldehyde gas from laminated wood boards in the air of dwellings. Effect of the gas on children with bronchial asthma]. PMID- 6857610 TI - [The meconium aspiration syndrome]. PMID- 6857611 TI - [Interaction between neurological and psychological control mechanisms]. PMID- 6857612 TI - [Balloon occlusion of the renal artery. Use of percutaneous approach in nephrectomy]. PMID- 6857614 TI - [Endometriosis in infertility]. PMID- 6857615 TI - [Drug non-compliance. After thoughts on a case]. PMID- 6857613 TI - [Sickle cell anemia--a rare disease in Norway]. PMID- 6857616 TI - [The effect of 5-hydroxytryptamine(5-HT) on blood pressure]. PMID- 6857617 TI - [The hopeless patient]. PMID- 6857618 TI - [Physical activity for health and well-being. Goals and means]. PMID- 6857619 TI - [Improvement of fertility status in dairy farms by using the milk progesterone test]. AB - On nine farms comprising a total number of 370 cows, studies were done for two years to determine whether the reproductive status (RS) could be improved by systematic performance of the milk progesterone test. Milk samples were taken on the day of insemination (day 0), day 8 and day 21 to verify oestrus detection, the observation of ovarian dysfunction and the early diagnosis of (non )pregnancy. The RS on these nine farms increased from thirty-six to fifty-four, which was mainly due to the reduction of the number of inseminations required for each conception (from 2.1 to 1.7). On ten farms selected by a similar method, on which reproduction was supervised by the veterinary practitioner, the RS increased from forty-seven to fifty-five, which increase was particularly due to inseminations carried out sooner after calving. The RS of ten herds which served as controls, increased from forty-one to forty-seven. An analysis of costs showed that the costs using the progesterone test were estimated to be equivalent to the expense of supervising a reproductive dairy herd health programme. A diagnosis negative for pregnancy based on three milk samples tested was correct in 98 per cent of the cases. A diagnosis positive for pregnancy was correct in 90 per cent of the cases. When a death rate of 8 per cent of the embryos within three weeks after conception is taken into account, the proportion will also be 98 per cent. Summarizing, it is concluded that systematic performance of the milk progesterone test provides an attractive method of improving reproduction on those farms which do not take part in veterinary supervision of reproductive dairy herd health programmes. PMID- 6857620 TI - [Degradation of cereal straw with lye]. AB - Straw is a plentiful agricultural waste product. It cannot be used as the sole feed for ruminants and it cannot even serve to satisfy maintenance requirements. The rumen microbes are not capable of breaking down the cell walls in cereal straw rapidly enough or to a sufficient extent. To improve the utilization of straw, efforts were made to treat this material by physical, chemical and biological methods. Some of these procedures will only improve the intake of straw by the animal, whereas the primary object continues to be the improvement of digestibility. Alkali treatment of straw is the most suitable method for this purpose. The mode of action of alkali on the cell walls of straw is described in the present paper. PMID- 6857621 TI - [Negative destructive behavior in young retarded children]. AB - Twenty percent of a population of mentally retarded children, who underwent clinical observation because of behavior problems, demonstrated serious aggressive, destructive, negativistic and hyperactive behavior patterns. According to the parents this type of behavior developed between two and four years of age. It remains unclear whether this behavior is caused by a differential rate of maturation of certain brain structures or by unfavorable emotional and environmental variables. A psychotherapeutic approach to the treatment of these children led to positive results. It is supposed that if left untreated, a symptom shift can occur towards neurotic, depressive or aggressive behavior when the child gets older. PMID- 6857622 TI - [Pheochromocytoma in a 14-year-old boy]. PMID- 6857623 TI - [Aspects of energy metabolism in low birth weight children]. PMID- 6857625 TI - Negative linkage disequilibria. PMID- 6857626 TI - The Muckle-Wells syndrome and the major histocompatibility complex. PMID- 6857627 TI - Statistical aspects of measuring the strength of associations between HLA antigens and diseases. AB - It will be demonstrated that the delta measure (attributable risk) of Bengtsson & Thomson (1982) can be used in a wide variety of cases to determine which of a number of HLA antigens associated with a particular disease allele has the strongest genetic association. Tests of significance and confidence intervals for the delta measure will be discussed. PMID- 6857624 TI - [Medical experiments on children]. PMID- 6857628 TI - Fine structure of the integumental glands of a termite soldier. AB - The ultrastructure of some integumental glands occurring in the head, thorax and abdomen of K. flavicollis soldiers is described. The secretory units consist of two cells, the canal cell and the secretory cell (this latter filled with secretion granules). A cylindrical and distorted extracellular space, or reservoir, with an irregular outline is lined by short microvilli. The end apparatus is made up of small overlapping cuticular laminae which in section resemble small wavy rods. The ample distribution of the units has led the authors to consider them dermal glands. Scanning electron micrographs confirm that the glands' activity consists in the secretion of material which then spreads over the surface of the integument. The dissimilar appearance of the secretion granules present in glands of different soldiers suggests that the electron-lucid granules and the granules with fibrils are two completely different secretions at different ages of the animal. The authors do not therefore rule out the hypothesis that these integumental glands may later produce or release pheromones. PMID- 6857629 TI - Ultrastructural and histochemical study of the gallbladder epithelia of rainbow trout and tench. AB - The simple, high columnar gallbladder epithelia of the rainbow trout (Salmo gairdneri, Rich.) and the tench (Tinca tinca, L.) are composed of light and dark cells. Within the dark cells two types must be distinguished: less hydrated, but normal epithelial cells and degenerating cells. The latter seem to be eliminated from the epithelium through phagocytosis by monocytes and macrophages, which possibly correspond with the 'basal regenerative cells' of earlier investigations. Since they are mainly found near the basement membrane, an hypothesis is put forth that they do not enter the gallbladder lumen, but migrate back into the subepithelial connective tissue after phagocytosis. Light and less hydrated dark cells are specialized for absorption of water and dissolved bile salts and for secretion of mucus, which mainly consists of acid glycoproteins. Interspecific differences are seen with regard to both functions. So, in the tench only single microvilli are developed apically, whereas a true brush border is seen in the rainbow trout. Thus, a higher absorptive rate can be assumed in the rainbow trout. Or, with respect to mucus secretion, in the rainbow trout the granular endoplasmic reticulum predominates, whereas in the tench the smooth endoplasmic reticulum, often associated with glycogen and even forming 'glycogen bodies', is better developed. In the rainbow trout fibrillar granules of highly condensed acid glycoproteins are seen to be secreted. In the tench only vesicles of flocculent content occur. Perhaps, these morphological and subsequent metabolic differences may be related to the various feeding habits of the predatory rainbow trout and the omnivorous tench. Seasonal variations as expected especially in the tench after winter rest could not be established. PMID- 6857631 TI - Multiplication of nucleolar fibrillar centres and absence of rDNA amplification in mouse oocyte during meiotic prophase I. AB - During meiotic prophase I the nucleolus of the mouse oocyte assumes a reticulate structure of 'nucleolonema' type. This change coincides with the appearance of several secondary fibrillar centres. The number of these centres at diplotene (97 113), largely exceeds that of nucleolar organizers (4c DNA = 20 NORs). The quantitative analysis of autoradiographs after hybridization in situ with 3H uridine labelled rRNA, enabled us to demonstrate that the multiplication of the fibrillar centres in mouse oocyte nucleolus during meiotic prophase I is not the result of an amplification of the rDNA. The number of silver grains in pachytene and diplotene nuclei was twice that counted for somatic cell and oogonium nuclei (2c DNA). PMID- 6857632 TI - A simplified method for the rapid isolation of cardiac intercalated discs. AB - A simple and rapid method for the isolation of intercalated discs from a single rat heart is described. The outstanding features of this method are (i) a large quantity of starting material is not necessary, (ii) ultracentrifugation and separating gradient steps are not required, (iii) the disc fraction is relatively pure as verified by electron microscopy, and (iv) the starting tissue is rapidly homogenized into buffer, reducing possible damage to membrane structures after animal death. The fraction is rich in intercellular junctions, with gap junctions, fasciae adherentes and maculae adherentes all appearing well preserved. It should prove a useful starting base for further purification of these junctions and of sarcolemma from a specific portion of the cell surface membrane, namely the major area of structural interaction between adjacent cardiac cells. PMID- 6857630 TI - Tyrosine storage vacuoles in insect fat body. AB - The watery vacuoles first described from larval insect fat body (Chironomus, Voinov, 1927; Aedes, Wigglesworth, 1942; Rhodnius, Wigglesworth, 1967) have been studied in 4th and 5th stage Calpodes larvae. The vacuoles arise at the beginning (E + 6-24 hr) of the 4th stadium from plasma membrane infolds that separate from the cell surface as provacuoles less than 1 micron in diameter. These provacuoles grow and fuse with one another through the intermolt until about half the volume of each fat body cell is occupied by a single, large vacuole. The vacuoles begin to disappear at molting. Their membrane is either incorporated into the plasma membrane by exocytosis or fragmented into vesicles that fuse to become lamellar bodies where the membranes are presumably digested. All the vacuoles have gone by a few hours after ecdysis. The tyrosine content of the fat body increases and decreases in proportion to the size of the vacuoles. As the vacuoles decrease at molting the titre of tyrosine in the hemolymph is transiently elevated at the time when there is most demand for phenolics for cuticle stabilization. Crystals having the form of tyrosine crystallize out from vacuoles separated from the fat body. In fat body extracts separated by thin layer chromatography, similar crystals occur only in the eluates from spots corresponding to tyrosine. The vacuoles are therefore presumed to be tyrosine stores used in cuticle stabilization at molting. They correspond to a type of aqueous storage compartment that is well known in plants but hitherto little recognized in animal cells. PMID- 6857633 TI - A freeze fracture and thin section study of intestinal cell membranes and intercellular junctions of a nematode, Ascaris. AB - The microvillar and lumenal plasma membrane P-face of Ascaris intestinal cells is shown to be covered by relatively large (13 nm) particles at a fairly high density (1000/microm2), while the E-face has virtually none. The P-face of the lateral cell membranes, those separating the cells, have fewer and smaller (8 nm) particles. The intestinal cells are also shown to be connected by an apical complex of smooth septate and tricellular junctions similar to those found between some insect midgut cells. A periodic layer of tannic acid staining material is found on the cytoplasmic sides of the smooth septate junction, and when the intercellular space is filled with lanthanum, smoothly curved, 10 nm wide septal walls can be seen. Below the belt of septate junctions are a large number of gap junctions. These have closely packed arrays of particles on the P face with some particle aggregates adhering to the closely packed pit arrays on the E-face. PMID- 6857635 TI - Ultrastructure of the branchial epithelium of an amphibious brackish-water crab. AB - The ultrastructure of the branchial epithelium of the amphibious brackish-water crab Uca mordax (Smith) was investigated in relation to adaptation to the salinity of the medium. No distinct differences were observed in the epithelial structure of animals adapted to either 100% sea water or to 1% sea water. Thus any interpretation of the significance of particular structures in relation to specific transport processes should be regarded with caution. Apart from strict epithelial cells, pillar cells and glycogen (presumed) storage cells were found. The epithelial cells showed very well-developed apical microvilli or lamellae and basal interdigitations with adjacent cells. Well-developed junctional complexes were seen (band desmosomes, septate desmosomes, gap junctions). The cells are extremely rich in mitochondria. Microtubules, peroxisome-like bodies, multivesicular bodies and near-nuclear Golgi complexes were present. PMID- 6857634 TI - Structure of the egg funiculus and deposition of embryonic envelopes in a crab. AB - The newly laid egg of Carcinus maenas is attached to a maternal ovigerous seta by a funiculus which consists of the two superimposed vitelline envelopes 1a + 1b, highly stretched and concurrently showing important structural alterations. The funiculus is glued to the specialized seta merely owing to the strong adhesiveness of its external face comprising the outermost vitelline envelope 1a, without any added adhesive. The subjacent envelope 2, originated from the cortical reaction, is not involved in such a funiculus elaboration. In the course of the embryonic development, four new coatings are successively secreted from the ectodermal embryonic cells, underneath the (1a + 1b + 2) fertilization envelope or embryonic capsule. They will remain until hatching in this concentric order, thus giving evidence of successive embryonic moulting cycles, with apolysis but without exuviation. In addition, the successive secretory phases, regarding to the embryonic envelope elaborations, happen in presence of high concentrations of the ecdysteroid ponasterone A which might be involved consequently in such secretory processes. PMID- 6857640 TI - [Cataract due to worms (eye diplostomatosis) in the grassfish (Ctenopharyngodon idella)]. PMID- 6857636 TI - Ultrastructure of the eye of a euphausiid crustacean. AB - The compound eye of the Antarctic euphausiid Euphausia superba is a spherical clear zone eye. The dioptric system consists of a hexagonally-faceted cornea, two corneagenous cells, two crystalline cone cells which form the bipartite crystalline cone, and two accessory cone cells. The dioptric system of each ommatidium is separated from that of adjacent ommatidia by six distal pigment cells and a basement membrane. The proximal tip of the crystalline cone is cupped by the distal ends of the seven retinula cells whose nuclei are arranged in a staggered array slightly distal to the middle of the clear zone. In the distal half of the clear zone, each narrow retinula cell column is surrounded by large proximal extensions of the six distal pigment cells. The pigment cells narrow more proximally and terminate at the proximal basement membrane. A specialized axial channel complex extends from the crystalline cone through the clear zone, and is continuous with a conical refractive element which caps the distal end of the rhabdom. The rhabdom is fused, and made up of alternating highly birefringent layers of orthogonally-oriented microvilli. It is surrounded by a narrow extra cellular space which is continuous with the distal refractive element and a second conical refractive element at the proximal end of the rhabdom. PMID- 6857637 TI - Fine structure of comparable synapses in a mature and larval lobster muscle. AB - Neuromuscular synapses from the single excitor axon to the proximal accessory flexor muscle (PAFM) was studied by serial section electron microscopy in a 1st stage larval (less than 0.1 g) and a large adult (6.8 kg) lobster. The adult innervation of a lateral and a medial fiber, physiologically identified as low- and high-output respectively, was similar in the number and mean size of synapses but had significantly larger pre-synaptic dense bars for the high-output synapses. This correlation between quantal transmitter output and pre-synaptic dense bars and the appearance of exocytotic profiles along the dense bars strongly implicates the bars as active sites of transmitter release. Moreover the mature innervation is differentiated on the basis that the percentage of dense bar area to synaptic area is 9% for the low-output type compared to 22% for its high-output counterpart. In the larval PAFM the excitatory axon has not proliferated many branches and the innervation is therefore localized to groups of fibers in the lateral, medial and central regions of the muscle rather than to individual fibers. The lateral and medial sites of innervation representing putative low- and high-output types respectively (because of their location) do not differ in the size and number of pre-synaptic dense bars thereby suggesting a similarity in quantal synaptic transmission. However, the percentage of dense bar area to synaptic area is 40% for the lateral site compared to 67% for the medial site. Since this is a trend mimicking the mature innervation it shows an early stage in the differentiation of low- and high-output synapses. Furthermore the main axon provides half of the total innervation in the larval PAFM but none in the adult thereby demonstrating a restructuring of multiterminal innervation. PMID- 6857639 TI - [Eye diseases in dogs and cats (9). Photographs]. PMID- 6857638 TI - [Experiences and recent data on Coxiella burnetii infection (Q fever). 1]. PMID- 6857641 TI - [Anatomy of the skull of red deer and roe-deer]. PMID- 6857642 TI - [Maintenance and breed-dependent lesions of the locomotive apparatus in farm animals]. PMID- 6857643 TI - [Fatal outcome of a massive Cysticercus tenuicollis infection in swine]. PMID- 6857644 TI - [Myelography in small domestic animals]. PMID- 6857645 TI - [Parvovirus infection in the dog]. PMID- 6857646 TI - Unusual monoclonal DNA binding immunoglobulin. AB - The monoclonal antibodies directed against DNA were produced by somatic cell hybridization with parental cells (SP-2) and spleen cells from nonimmunized autoimmune MRL/lpr mice. The immunoglobulins were recovered from the culture supernatant from hybridoma by a solid immunoadsorbent and antibody immunoprecipitation. The results from the specificities of DNA binding monoclonal immunoglobulins suggest that the antibodies to DNA have the antibody combining sites for both epitope of double stranded helix and base of DNA and support the concept of the multiple antigen binding potentials of the hybridoma autoantibodies. PMID- 6857647 TI - Progression of Wenckebach type A-V block to high degree A-V block in aged man. AB - This case report describes a 60 years old male with Wenckebach A-V block which progressed to high degree A-V block. Syncope and dizzy attacks were attributed to high degree A-V block in the study of ambulatory ECG (Holter). Wenckebach point was low; 90 bpm when the right atrium was paced. At 140 bpm, 2:1 A-H block with intermittent alternating and high degree A-H block were induced. Furthermore, a very wide His potential was recorded during the electrophysiological study. He received a permanent pacemaking. Since Wenckebach type A-V block is usually regarded as benign, this case seems to be rare. PMID- 6857648 TI - Thyroid stimulation test with urinary T3 concentration as an index of thyroid response. AB - Ten USP units of TSH (thytropar) were administered intramuscularly daily for three days to five euthyroid controls, to thirteen patients with chronic thyroiditis [four clinically euthyroid patients with normal serum TSH (Group I), five clinically euthyroid patients with elevated serum TSH (Group II) and four clinically hypothyroid patients with high serum TSH (Group III)], and to five patients with primary hypothyroidism. Effects of TSH on the thyroid 24-hr uptake of 131I, 24-hr urinary T3 excretion and serum T3 concentration were assessed: In euthyroid controls, basal urinary T3 excretion was 0.76 +/- 0.26 (mean +/- S.D.) micrograms/day, increased to 1.31 +/- 0.16 micrograms/day on the first day, to 2.33 +/- 0.75 micrograms/day on the second day, and to a maximum of 2.78 +/- 0.65 micrograms/day on the third day of TSH administration. In Group I, basal urinary T3 excretion was normal (0.58 +/- 0.16 micrograms/day). Following TSH administration, the value increased to 1.60 +/- 0.62 micrograms/day, but the rate of increase was less than that in euthyroid controls. In Group II, basal urinary T3 excretion was normal (0.71 +/- 0.37 micrograms/day), but did not increase following TSH administration. In Group III, basal urinary T3 excretion was significantly low (0.32 +/- 0.07 micrograms/day), and did not increase after TSH administration. In patients with primary hypothyroidism, basal urinary T3 excretion, 0.12 +/- 0.10 micrograms/day, was lower than that of Group III, and did not increase after TSH administration. Positive correlations were found between urinary T3 excretion and serum T3 concentration before and after TSH administration. In contrast to basal serum T3 concentration and urinary T3 excretion, mean basal thyroid uptake of 131I in patients with chronic thyroiditis was higher than that of euthyroid controls. However, a positive correlation was found between the increased rate of urinary T3 excretion and the increase in thyroid 131I uptake after TSH administration. These observations indicate that the changes in urinary T3 excretion are reliable indices of the thyroid response to TSH administration in various states of thyroid function. PMID- 6857649 TI - The effect of acute inflammation on iron metabolism in rats. AB - Iron metabolism in rats with acute turpentine-induced inflammation was evaluated. In acute inflammation, reduced plasma iron and total iron-binding capacity values, shortened plasma iron disappearance time and lower plasma iron turnover were observed. The administration of 59Fe chondroitin ferrous sulfate in order to evaluate the reticuloendothelial (RE) function revealed a significantly increased 59Fe retention in the liver and lower incorporation into red blood cells. Radioactivity in hepatic RE cells was higher in acute inflammation than in control. These results suggest the possibility of a block in the transfer of iron from RE cells to the plasma iron pool during acute inflammation. PMID- 6857650 TI - The course and prognosis of manic-depressive psychosis: a quantitative analysis of episodes and intervals. AB - A quantitative analysis of episodes and symptom-free intervals in the course of manic-depressive psychosis was attempted. 1,066 patients who visited Tohoku University Hospital between 1955 and 1965 were investigated by a mail questionnaire and subsequent review of records in their care hospitals. There was no difference between the reply group and non-reply group in terms of demographic status. About 6.2% of patients were chronically ill. Eighteen percent of patients were dead at the time of study. The number of episodes was about three in depression and about seven in bipolar type during twelve years of observation. The length of symptom-free interval between episodes was about five years in depression and two years in bipolar type. There was no difference in the number of episodes or in the length of interval between 1955-1959 group and 1960-1965 group. The change of length was not confirmed between early and late intervals. PMID- 6857651 TI - Effect of passive movements on reaction time of the rectus femoris in normal subjects and patients with paraparesis. AB - Electromyographic reaction times (EMG-RTs) of the right knee extension were examined in eight normal subjects and eight patients with paraparesis under three conditions; during passive knee flexion (PFLX), passive extension (PEXT) and no passive movements (STAT). EMG-RTs of the three conditions were not significantly different between the normal and the patient group. A two-way analysis of variance (condition x group) showed that the main effect of condition was significant, but that of group and the interaction were not. Both in the normal and the patient group the shortest EMG-RTs of all was obtained in PEXT, followed by that of STAT and PFLX. Effect of passive movements on EMG-RTs in the patients whose position sense of the knee and muscle strength of the knee extension were within normal range did not vary with the abnormality of tactile sense and/or myotatic reflexes. The results indicated that activities of the pyramidal tract neurons in carrying out a movement were directly influenced by kinesthetic information of the moving limb. PMID- 6857653 TI - Discrepancy between the renal pelvic fluctuations and the pacemaker discharges at the pelvi-calyceal border. AB - Experiments were performed in vitro to explore the influence of isoproterenol on the canine pelvi-ureteral system. The rhythmic changes of intrapelvic pressure became no longer manifest and simultaneously recorded electromyograms revealed disappearance of peristalsis at sites distal to the upper region of renal pelvis following application of isoproterenol, while the pacemaker at the pelvi-calyceal border continued to discharge with an enhanced pace. This result has demonstrated that the renal pelvic pressure recorded during treatment with isoproterenol did not reflect the pacemaker activity of the renal pelvis. PMID- 6857655 TI - [Effects of irradiated wheat flour in the AKR mouse. IV. Effects on reproduction]. AB - Mouse of AKR strain received in their diet, 50% of wheat flour irradiated at 75000 rads or 50% of non irradiated flour during their lifetime. In this part, were analyzed data obtained through 7 consecutive mating : size of litters, weight and growth of pups, lethality in the first days, number of still-born, sex ratio. It was any significant difference between the two groups although many data were better in the test group. PMID- 6857654 TI - [Effects of irradiated wheat flour in the AKR mouse. II. Effects on hematology and activity of a serum enzyme]. AB - Blood samples were collected all six weeks from the tip of the tail of AKR mice fed with irradiated or non irradiated wheat flour. Haematocrit, red and white blood cell counts and differential white cell counts were determined and the activity of p-phenylenediamine oxidase was measured in the serum. No effect attributed to the diet could be demonstrated. We propose a method to detect antemortem the appearance of the AKR leukemia. PMID- 6857652 TI - Usefulness of two-dimensional echocardiography for diagnosis of the sites of origin in myxoma. AB - Three patients with atrial myxoma, two in the left atrium and one in the right were studied using two-dimensional echocardiography. An analysis by four cross sections, long and short axis, subcostal and four chamber views of the left ventricle showed that the stalk of one left atrial myxoma adhered to the anterior commissure, the other to the left atrial wall underlying on the aortic posterior wall, and that of right myxoma to the free wall of the right atrium. The myxomas were successfully removed by surgical intervention in all cases, where the sites of stalk were verified to be identical with those diagnosed by echocardiography. PMID- 6857656 TI - [Minor and fatal complications due to treating polytetrafluoroethylene in an industrial environment: clinical observations and physicochemical measurement of the polluted atmosphere]. PMID- 6857657 TI - [Effects of irradiated wheat flour in the AKR mouse. I. Effects on longevity, morbidity and pathology]. AB - Mouse of AKR strain were fed with wheat flour irradiated at 75.000 rads or with nonirradiated flour during their lifetime. In this first part were analyzed : bodyweight, morbidity, mortality, organ's histology. Were established : higher bodyweight in all animals fed with irradiated flour, this increase is statistically significant only in males and a longer time life in all animals of this group, this last difference is significant in females and in animals together without distinction of sex. PMID- 6857658 TI - Nasal cavity deposition, histopathology, and cell proliferation after single or repeated formaldehyde exposures in B6C3F1 mice and F-344 rats. AB - Inhalation exposure for 2 years to 14.3 ppm formaldehyde (HCHO) induced a 50% incidence of squamous cell carcinoma in the nasal cavity of F-344 rats but only a 3.3% incidence in B6C3F1 mice. Since the response was concentration and species dependent, species differences in nasal cavity "dose" were examined as a possible mechanism for the differences in tumor incidence. Naive (nonpretreated) and HCHO pretreated (6 or 15 ppm, 6 hr/day, 4 days) mice and rats were exposed to HCHO for 6 hr during which respiratory rate and tidal volume were recorded to calculate the theoretical deposition (micrograms/min/cm2) of HCHO on the nasal epithelium. Species differences in delivered "dose" were further assessed by comparative autoradiography, histopathology, and cell turnover studies. Because mice were better able to reduce minute ventilation upon repeated exposures, they had less HCHO available for deposition than rats, resulting in less tissue damage and a lower rate of cell turnover in the nasal epithelium. The correlation between calculated "dose" and observed nasal toxicity, including nasal tumor incidence, demonstrates that by normalizing the dosimetry to nasal surface area, species differences in nasal toxicity may be better understood. PMID- 6857659 TI - Effects of hexafluoroacetone on testicular morphology and lipid metabolism in the rat. AB - Rats dosed dermally with 39 or 130 mg/kg/day hexafluoroacetone sesquihydrate (HFA) for 14 days developed moderate or severe testicular atrophy, respectively; rats dosed with 13 mg/kg/day HFA for 14 days did not. Histologic evaluation of the testes revealed that spermatids, followed by spermatocytes, were the germ cells most affected by HFA; spermatogonia and Sertoli cells appeared to be less vulnerable. Lipogenesis from [3H]acetate and[14C]glucose was investigated in vitro in testes from HFA-treated and pair-fed control rats. Triacylglycerol and phospholipid synthesis was increased whereas sterol synthesis was decreased in testes from HFA-treated rats. Vitamin A and zinc were measured in the testes of control and HFA-treated rats; no differences in the levels of these nutrients were observed between the two groups. The data support the hypothesis that altered lipid metabolism, in particular sterol metabolism, is associated with the development of HFA-induced testicular atrophy. PMID- 6857660 TI - The effects of organophosphate-induced cholinergic stimulation on the antibody response to sheep erythrocytes in inbred mice. AB - In a previous study, we demonstrated that parathion suppressed both the primary IgM and IgG response to sheep erythrocytes (SRC) in inbred and outbred mice (G. P. Casale, S. D. Cohen, and R. A. DiCapua, 1982, toxicologist 2, 94). Suppression occurred after a dosage which produced cholinergic effects but was absent after a lower dosage which did not produce cholinergic signs. This information suggested that immunosuppression might be mediated indirectly as a result of toxic chemical stress. The present study evaluated the relationship between the anticholinesterase action of parathion, malathion, and dichlorvos (DDVP) and their effects on the primary humoral response to SRC. Male C57Bl/6 mice were given a single dose of parathion (16 mg/kg, po), malathion (720 mg/kg, po), or DDVP (120 mg/kg, po) 2 days after immunization with SRC. Two days later, tissues were removed for cholinesterase (CHE) assay and enumeration of splenic antibody forming cells (PFC). All three compounds produced moderate to severe cholinergic poisoning. DDVP produced cholinergic signs beginning 1/2 hr after dosing and lasting 1/2 to 1 hr. This profile was associated with a rapid but transient inhibition of brain CHE activity. In contrast, malathion and parathion produced prolonged cholinergic poisoning (4 to 7 hr) and prolonged suppression of brain CHE activity. All three compounds suppressed the primary IgM response. However, when they were given as multiple lower doses, none of the compounds suppressed the primary IgG response. These latter treatments produced no cholinergic signs. The cholinomimetic agent, arecoline (65 mg/kg, ip) produced a short-lived cholinergic crisis but no IgM suppression. Sustained-release arecoline produced prolonged cholinergic poisoning (3 to 5 hr) and reduced the number of IgM PFC to 50% of control. These results demonstrated that organophosphate-induced immunosuppression was associated with severe cholinergic stimulation. The immunosuppression may result from direct action of acetylcholine upon the immune system or it may be secondary to the toxic chemical stress associated with cholinergic poisoning. PMID- 6857661 TI - Quantitation of cutaneous toxicity: an in vitro approach using skin organ culture. AB - A short-term (48 hr) organ culture system for maintaining metabolically viable and structurally intact mouse skin has been developed. With the culture system, the responses of skin to in vitro physical and chemical insults were assessed by histologic examination and selected biochemical measurements in an attempt to establish a quantitative basis for the evaluation of cutaneous toxicity in vitro. In studies with mouse skin in organ culture following either freeze-thaw treatment (physical insult) or a single in vitro topical application of tributyltin chloride (10 to 1000 nmole/cm2), deleterious morphologic changes were observed. The degree of cellular injury was reflected by inhibition of in vitro incorporation of [3H]thymidine and [14C]leucine into epidermal DNA and protein, respectively; there also was leakage of intracellular enzymes into the culture medium in a dose and time related manner. These biochemical parameters are sensitive indicators of cellular injury; as such they may offer a simple, sensitive, and quantitative measure for assessing cutaneous toxicity of chemicals in vitro. PMID- 6857662 TI - Interaction between ethanol and carbohydrate on the metabolism in rat liver of aromatic and chlorinated hydrocarbons. AB - Metabolic rates of eight hydrocarbons (benzene, toluene, styrene, chloroform, carbon tetrachloride, 1,2-dichloroethane, 1,1-dichloroethylene, and trichloroethylene) were measured in vitro with the livers from rats that had consumed ethanol for 3 weeks in combination with various diets. Ethanol and carbohydrate antagonized each other in connection with activity of hepatic drug metabolizing enzymes (mixed-function oxidases); the former increased and the latter decreased these enzymes. A decrease (increase) in carbohydrate intake augmented (suppressed) the action of ethanol in a dose-related manner. In particular, a combination of ethanol with a low-carbohydrate diet (DeCarli and Lieber diet) enhanced enzyme activity and potentiated carbon tetrachloride induced hepatotoxicity. Enhancement of metabolism and potentiation of toxicity were due to the combination rather than to ethanol per se. PMID- 6857664 TI - Immediate and long-term alterations in maximal electroshock seizure responsiveness in rats neonatally exposed to triethyltin bromide. AB - Neonatal rats were injected (sc) with 0, 0.25, 0.5, 1.0, 2.5, or 5.0 mg/kg triethyltin bromide (TET) in a 2% ethanol vehicle on Days 0, 5, 10, 15, and 20 postnatally. TET-exposed neonates exhibited a dose-dependent delay in the ontogenetic appearance of both the clonic and tonic maximal electroshock seizure (MES) responses which were apparent up to Day 45, as evaluated by the MES grade distributions and the durations of the individual phases of the MES. In marked contrast, adult rats (exposed to TET only as neonates) exhibited long-term increases in MES severity, as evaluated by the durations of the individual phases of the MES. At 75 days of age, a time when the 1.0 mg/kg developmentally TET treated group exhibited an increased seizure severity, a single challenge dose of 1.0 mg/kg TET (ip) produced a proportional decrease in MES severity in both developmentally treated and control rats. No changes in preweaning or postweaning body weight were observed in the animals in the 0.25, 0.5, 1.0, or 2.5 mg/kg groups. A 30% decrease in weaning weight and an approximate 15% decrease in postweaning weight were observed in the 5.0 mg/kg group. These seizure results demonstrate that developmental exposure to TET produces immediate and long-term alterations in central nervous system functioning, which are of an opposite character. Interesting, we have previously shown that developmental lead exposure produces a similar developmental/adult dichotomy of effects with regard to the MES severity; however, the two patterns are reversed (D. A. Fox, S. R. Overmann, and D. E. Woolley (1979). PMID- 6857663 TI - Triethyltin decreases maximal electroshock seizure severity in adult rats. AB - Acute and subacute treatment of adult rats with triethyltin bromide (TET) caused dose-dependent and time-dependent decreases in maximal electroshock seizure (MES) severity. This decrease in excitability was characterized by both a decrease in the percentage of animals exhibiting a maximal seizure and a corresponding decrease in the extension durations and an increase in the flexion durations. Acutely treated rats received (ip) 0, 1, or 5 mg/kg TET while subacutely exposed (po) received 0, 1, 5, or 10 ppm TET in the drinking water for 10 days. Experiments were designed so that the total consumed dose of TET, on a milligram per kilogram basis, equaled that in the acute experiment. No alterations in body weight were observed in either experiment. Acutely, the onset of action of TET was detectable within 0.5 hr. For the 1 mg/kg group, the effect peaked between 4 and 24 hr and completely recovered by 72 to 96 hr. For the 5 mg/kg group, the marked effect peaked at 4 hr, however, no recovery was observed. Subacute exposure for 1 to 2 days produced marked decreases in MES severity which were still present in the 5- and 10-ppm groups 14 days after cessation of exposure. Comparison of the onset and recovery data in the acute and subacute experiments revealed a close correspondence in similarly dosed rats. Comparison with other MES data from our laboratory revealed that adult rats were more sensitive to TET than adult mice or developing rats. Additionally, the MES test was able to detect subtle functional alterations in the central nervous system at lower doses of TET than previously reported neurobehavioral evaluation procedures. PMID- 6857665 TI - Nephrotoxicity of paraquat in the sheep and the associated reduction in paraquat secretion. AB - Paraquat was administered to sheep at doses of 1, 2, 4, and 8 mg/kg. Paraquat was nephrotoxic to sheep, producing glomerular and tubular defects. Glomerular filtration rate (GFR) fell in a dose-dependent manner. Secretion of paraquat into the tubule was inhibited at low doses prior to any influence of paraquat on GFR. Subsequently, GFR and paraquat clearance (ClPQ) fell in parallel. Inhibition of paraquat secretion by paraquat itself was dose dependent. Poisoning of the secretory component removed a large part of the excretory capacity for paraquat. PMID- 6857666 TI - Neurotoxicity and protein binding of 2,5-hexanedione in the hen. AB - Previous studies in this laboratory have demonstrated 2,5-dimethylpyrrole adduct formation during in vitro exposure of protein amino groups to the neurotoxic n hexane metabolite 2,5-hexanedione (2,5-HD). The present investigation reports in vivo pyrrole adduct formation in neural and nonneural protein from 2,5-HD-treated animals. Adult, White-Leghorn hens were given daily doses of either 200 or 70 mg 2,5-HD/kg, po, for up to 55 or 135 days, respectively. Additional animals were given 70 mg/kg for 63 days and then allowed to recover for 72 more days. Protein separation by gel electrophoresis followed by staining with a pyrrole-specific reagent yielded evidence of widespread adduct formation in protein from serum, liver, kidney, brain, and purified myelin. Binding was particularly strong in serum albumin nd myelin basic protein. Quantitation of the adduct in these tissues revealed that its formation reached peak levels at 20 days in high dose and 30 days in low-dose animals. Levels subsequently declined, suggesting the presence of a clearance mechanism capable of removing altered protein during continuing 2,5-HD exposure. Protein from animals on the recovery regimen contained no detectable pyrrole adduct. Pyrrole adduct formation was also detected in neurofilament protein preparations, although protein yields were too low to allow assessment of clearance. Hens at both dosages displayed clinical signs indicative of CNS and PNS neuropathy. Histologic findings included axonal swelling and degeneration in peripheral nerve and some spinal cord nerve tracts. A hypothesis is proposed involving differential clearance of pyrrole adduct from neural vs nonneural tissue to explain the mechanism of action and target organ specificity of 2,5-hexanedione. PMID- 6857668 TI - Pulmonary mechanics in conscious Fischer 344 rats: multiple evaluations using nonsurgical techniques. AB - An adaptation of the method reported by Amdur and Mead (1958, Amer. J. Physiol. 192, 364-368) was used to evaluate pulmonary mechanics in conscious rats, utilizing a flow plethysmograph and intraesophageal catheter to determine compliance, resistance, respiratory flow, thoracic pressure, tidal volume, frequency, and minute volume. The procedure did not require surgery, and repeat evaluations were made in conscious rats. Real time calculations of pulmonary parameters were accomplished with an analog computer interfaced with a digital computer for display and data storage. Multiple evaluations (1, 3, 6, 13, 18, 24, 30, and 36 weeks) in 40 rats are reported. The utility of the system in establishing a base line against which pulmonary impairment, related to the effects of known pulmonary toxicants, e.g., ANTU and NO2, could be measured, was evaluated. PMID- 6857667 TI - A 26-week inhalation toxicity study with formaldehyde in the monkey, rat, and hamster. AB - This inhalation study involved simultaneous exposure of five groups of 6 male Cynomolgus monkeys, 20 male and 20 female Fischer 344 rats, and 10 male and 10 female Syrian golden hamsters for 22 hr per day, 7 days per week for 26 weeks to formaldehyde gas. The cumulative mean exposure concentrations were 0, 0, 0.19, 0.98, and 2.95 ppm for the two control groups, low-, mid-, and high-level exposure groups, respectively. There was no treatment-related mortality during the study. In monkeys, the most significant findings were hoarseness and congestion and squamous cell metaplasia in the nasal turbinates of the 2.95-ppm exposure group. There were no signs of toxicity in the lower-level exposure groups. In the rat, the only observations of possible responses to exposure were found in the 2.95-ppm exposure group. These findings consisted of squamous metaplasia in the nasal turbinates, decreased body weights starting during the second week of the study, and decreased liver weights. In contrast to monkeys and rats, hamsters did not show any significant responses to exposure even at 2.95 ppm. It was concluded that nearly continuous exposure of monkeys and rats for six months at a level of 2.95 ppm of formaldehyde clearly elicited an effect while exposures below this level did not appear to demonstrate an effect. It further appeared that the monkey and rat were more sensitive to formaldehyde exposure than the hamster. PMID- 6857669 TI - The kinetics of urethane elimination in the mouse. AB - Data from several investigators suggest that the prevalence of urethane-induced lung adenomas in the mouse is more nearly linearly related to the square of the urethane dose than to the dose itself. However, the relationship between urethane dose and integrated internal exposure to urethane has not been established. Outbred male Swiss mice between 41 and 45 days old were injected ip with one of seven doses of urethane ranging from 0.4 to 1.8 mg/g. The rate of elimination of urethane from the blood was followed by assaying the ethanol liberated from urethane by alkaline hydrolysis. The results indicated that urethane elimination is saturable, and saturated at all doses used, with a Vmax of 0.087 mg/ml/hr. Thus, internal exposure to urethane, measured as the area under the blood concentration, time curve, is not linearly related to urethane dose. In the range of doses used in this study, the area under the curve is C0(2)/2Vmax or (D/VD)2 (1/2Vmax), where C0 is the initial concentration; D, the dose; and VD, the volume of distribution. This relationship can be used to predict internal exposure to urethane as a function of dose. PMID- 6857670 TI - Biliary excretion and enterohepatic circulation of 2,4-dinitrotoluene metabolites in Fischer-344 rats. AB - Technical grade dinitrotoluene (DNT) is hepatocarcinogenic when fed to rats. DNT is oxidatively metabolized by hepatic enzymes and reductively metabolized by rat intestinal microflora in vitro. The objectives of the present studies were to determine the importance of bile as a route of excretion for DNT metabolites and to investigate the role of enterohepatic circulation in the metabolism of DNT. The common bile ducts of male and female F-344 rats were cannulated with an uninterrupted cannula at the hepatic and ileal ends. After 24 hr, male rats were given a po dose of 35, 63, or 100 mg 2,4-[14C]DNT/kg; female rats received 35 mg 2,4-[14C]DNT/kg. Immediately prior to dosing, the cannula was snipped and bile was allowed to collect in a glass reservoir, surgically implanted in the peritoneal cavity, which could be sampled externally. In males, excretion of 14C in bile was linearly related to dose. From 9.2 to 29.2 mumol eq of [14C]DNT (approximately 25% of the dose) appeared in bile within 24 hr. Females dosed with 35 mg/kg excreted only 18% of the dose in the bile. Over 90% of the radioactivity in the bile was the glucuronide conjugate of 2,4-dinitrobenzyl alcohol (DNBAlc G). In comparison to control rats, in which bile flow to the small intestine was uninterrupted, collection of bile decreased the amount of 14C excreted in urine. In both males and females most of the 2,4-DNT dose excreted in the urine was in the form of the oxidized metabolites DNBAlc-G and 2,4-dinitrobenzoic acid. These results indicate that bile is an important route of excretion for 2,4-DNT metabolites and that metabolites excreted in the bile can be reabsorbed from the gut. PMID- 6857671 TI - Covalent binding of [14C]methoxychlor metabolite(s) to rat liver microsomal components. AB - [14C]Methoxychlor was incubated with NADPH-fortified liver microsomes from male rats, and covalent binding to microsomal components was determined. The binding process was markedly enhanced when microsomes from phenobarbital-treated rats were employed. However, when microsomes from methylcholanthrene-treated rats were used the level of binding was not significantly affected. Incubation in the presence of glutathione, cysteine, or ascorbate markedly diminished binding. Metyrapone and SKF 525-A, inhibitors of hepatic cytochrome P-450-linked monooxygenase activity, inhibited the binding. Also, ethylmorphine and hexobarbital, alternate substrates of the monooxygenase system, inhibited binding. There was no binding to microsomal components in the absence of NADPH or oxygen. TCPO (1,1,1-trichloropropane-2,3-oxide), an inhibitor of epoxide hydrase activity, failed to enhance the binding process. However, N,N'-diphenyl-p phenylenediamine (NDP) and n-propyl gallate (PG), both free radical scavengers, decreased binding at micromolar concentrations without altering the extent of formation of polar [14C]methoxychlor metabolites. It was concluded that methoxychlor undergoes a hepatic microsomal monooxygenase(s)-mediated activation and that the resultant reactive metabolites (possibly free radicals) bind covalently to microsomal components. By contrast, the binding resulting from the incubation of an impure mixture of polar [14C]methoxychlor metabolites with liver microsomes did not require NADPH and O2 and was not affected by NDP, Pg, ascorbate, or heat-treatment of microsomes. This finding suggested that the binding subsequent to the initial metabolic activation of methoxychlor does not require further enzymatic transformation. However, whether the binding with metabolites represents the same chemical species as the binding with [14C]methoxychlor remains to be established. PMID- 6857672 TI - Characteristics of the hepatic monooxygenase system of the goldfish (Carassius auratus) and its induction with beta-naphthoflavone. AB - Treatment of goldfish with beta-naphthoflavone (ip) resulted in induction of hepatic monooxygenase activity in a dose-dependent manner. Levels of 7 ethoxyresorufin-O-deethylase and mexacarbate NADPH-dependent oxidative metabolism as well as cytochrome(s) P-450 were increased. Other substrates which have been associated with 3-methylcholanthrene (3-MC)-type induction in mammals were unchanged as was delta-aminolevulinic acid synthetase. Enzyme activities were inhibited by carbon monoxide and piperonyl butoxide confirming their cytochrome P 450 nature. NADH was found to stimulate metabolism in a significant manner with NADPH. pH-dependent ethyl isocyanide binding characteristics were similar in control and induced preparations while mexacarbate binding to oxidized microsomes revealed a higher apparent affinity constant (Kapps) as well as greater overall binding in induced preparations. SDS-gel electrophoresis revealed an increased band with a molecular weight of approximately 56,000. PMID- 6857673 TI - Minimal role of metallothionein in decreased chelator efficacy for cadmium. AB - Chelator efficacy in Cd poisoning drops precipitously if therapy is not commenced almost immediately after exposure. Metallothionein (MT), a low-molecular-weight metal-binding protein with high affinity for Cd, may be important for this phenomenon. To more fully assess this role of MT in the acute drop in chelator efficacy following Cd poisoning, rats were injected iv with radioisotopic Cd (1mg/kg as CdCl2; 50 muCi/kg) followed by diethylenetriaminepentaacetic acid (DTPA; 90 mg/kg ip) at various times (0, 15, 30, 60, and 120 min) after Cd. Ther percentage of the Cd dose remaining in major organs 24 hr following Cd was determined. Although DTPA reduced Cd content in the various organs when given immediately after Cd, the chelator was ineffective at all later times. Increases in hepatic and renal MT did not occur until 2 hr after Cd, and did not coincide with the earlier drop in chelator efficacy. Blockade of MT synthesis by actinomycin D treatment (1.25 mg/kg, 1 hr before Cd) failed to prolong the chelators effectiveness. Furthermore, newborn rats have high levels of hepatic MT which had no effect on the time course of chelator effectiveness since DTPA still decreased Cd organ contents if given immediately following Cd but had no effect if given 2 hr after Cd. Therefore, if appears that MT does not have an important role in the acute decrease in efficacy of chelation therapy for Cd poisoning. The quick onset of chelator ineffectiveness may be due to the rapid uptake of Cd into tissues which makes it relatively unavailable of chelation. PMID- 6857674 TI - Non-selenium-dependent glutathione peroxidase activity in rat lung: association with lung glutathione S-transferase activity and the effects of hyperoxia. AB - To determine if non-selenium-dependent glutathione peroxidase (Non-Se GSH-Px) activity is present in rat lung, we fractionated rat lung soluble fractions from rats fed a selenium-deficient or control diet and measured glutathione peroxidase activity with both cumene hydroperoxide and hydrogen peroxide as substrates. We also measured glutathione S-transferase (GSH S-transferase) activity in the fractions with 1-chloro-2,4-dinitrobenzene as substrate. Non-Se GSH-Px activity was present (about 34% of total GSH-Px activity), and the peak present in the gel filtration chromatogram coeluted with the GSH S-transferase peak. We then measured GSH S-transferase activity in lung-soluble fractions from rats exposed to room air or 85% O2 for 5 days. Lung GSH S-transferase activity was increased in the oxygen-exposed animals when compared to the air-exposed controls. The increase in GSH S-transferase activity could represent the induction of lung non Se GSH-Px activity. PMID- 6857677 TI - Immunosuppressive effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin in strains of mice with different susceptibility to induction of aryl hydrocarbon hydroxylase. AB - Mouse strains with different susceptibility to aryl hydrocarbon hydroxylase (AHH) induction and with different levels and/or affinity for a specific cytosolic binding protein ("receptor") were used to investigate the immunosuppressive effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Humoral antibody production was strongly inhibited in C57Bl/6 and C3H/HeN mice (more susceptible strains) with very low, single doses of TCDD (1.2 micrograms/kg), while other strains (DBA/2 and AKR) required higher doses (at least 6 micrograms/kg) to be partially suppressed. Longer exposure (8 weeks) did not increase the sensitivity of DBA/2 mice. A good correlation between the degree of enzyme inducibility and immunosuppression was observed in studies with B6D2F1 mice and backcrosses. Similar results were obtained with 2,3,7,8-tetrachlorodibenzofuran (TCDF), the most powerful competitor for TCDD "receptor" in vitro and in vivo. TCDD immunotoxic effects appeared to be associated with the presence of a specific cytosolic binding protein which mediates AHH induction. PMID- 6857678 TI - Disposition of metals after portal and systemic administration to rats. AB - To determine if metals undergo significant hepatic presystemic elimination, male Sprague-Dawley rats were administered solutions of ionic 109Cd, 64Cu, 203Hg and CH3 203Hg, 210Pb, and 113Sn at 1.0 mumol metal/kg into either the ileocolic (portal administration) or femoral vein (systemic administration). Serial blood and bile samples were obtained for 90 min after administration. Whereas the area under the blood concentration vs time curve after portal administration was not less than that following systemic administration or any metal, route-dependent differences in distribution did occur. Portal, in comparison to systemic administration, resulted in a higher blood/plasma concentration ratio for mercury and lower ratio for lead. These data suggest that the liver may play a role in the distribution of these metals within the blood. In addition, the biliary excretion of mercury, methylmercury, cadmium, and lead was higher after portal than after systemic administration. These route-dependent differences in disposition suggest that some degree of hepatic presystemic elimination occurs for several metals. PMID- 6857676 TI - Inhalation toxicity of epichlorohydrin: effects on fertility in rats and rabbits. AB - The effects of inhaled epichlorohydrin (ECH) on the fertility of Sprague-Dawley rats and New Zealand white rabbits were studied. Groups of 10 male rabbits, 30 male rats, and 30 female rats were exposed to 0, 5, 25, or 50 ppm of ECH vapor for 6 hr/day, 5 days/week for 10 weeks, and were held for a 10-week postexposure females. Exposed male rats were mated with unexposed females at several intervals during and after the exposure period. In addition, female rats which had been exposed for the 10-week period were mated with unexposed males and allowed to deliver their young. Exposure to 50 ppm of ECH vapor for 10 weeks resulted in transient infertility in the male Sprague-Dawley rats; recovery of fertility in rats occurred during the second week after termination of exposure. Male rats exposed to 25 ppm of ECH were able to impregnate unexposed females; however, fewer implantations were observed in these females than in the females mated to control males suggesting that fertility was adversely affected in this group as well. This effect also was reversed by the second week following termination of exposure. The incidence of resorptions in the unexposed female rats which were bred to the exposed males was not adversely affected. Among female rats exposed to ECH, no adverse effects were observed on estrus cycle, pregnancy rate, parturition, or the number and viability of the offspring. No discernible effects were noted on the volume of the ejaculate or on the motility, viability, concentration, or fertility of spermatozoa from male rabbits exposed to up to 50 ppm of ECH. Histologic examination of tissues from an interim and final termination of the exposed animals indicated that the most severely affected organ following inhalation exposure to 25 or 50 ppm of epichlorohydrin in both rats and rabbits was the nasal turbinates. These lesions, interpreted to be a result of irritation from the test material, were no longer present in animals which were held for the 10-week postexposure period. No adverse effects were observed among rats or rabbits exposed to 5 ppm of ECH for 10 weeks. PMID- 6857675 TI - Ethylene glycol monobutyl ether: acute, 9-day, and 90-day vapor inhalation studies in Fischer 344 rats. AB - The acute 4-hr LC50 (with 95% confidence limits) for Fischer 344 rats was determined to be 486 (339 to 696) ppm of ethylene glycol monobutyl ether (EGBE) for males and 450 (315 to 645) ppm for females. Notable observations included loss of coordination, red stained urine, and enlarged discolored kidneys at 867 and 523 ppm. In a subsequent study, rats were exposed for 9 days (6 hr/day) to EGBE concentrations of 245, 86, 20, or 0 (control) ppm. There were significant depressions of red blood cell (RBC) count (approximately 20% below control values), hemoglobin (Hgb), and mean corpuscular hemoglobin (MCH) concentration and increases in nucleated erythrocytes, reticulocytes, and lymphocytes in males and females of the 245 ppm group. Decreased body weight gains and increased liver weights were also found. A 14-day postexposure recovery showed substantial reversal of the affected blood parameters. Similar, but less marked, hematologic effects were observed in rats exposed to 86 ppm of EGBE, while rats of the 20 ppm group were indistinguishable from controls. In a 90-day study, rats were exposed to EGBE concentrations of 77, 25, 5, or 0 ppm for 13 weeks (6 hr/day, 5 days/week). Slight, but statistically significant, decreases in RBC (13% below control) and Hgb, accompanied by an increase in MCH (11% above control) were observed in the 77 ppm-exposed females after 6 weeks. At the conclusion of the 90 day exposure regimen, the hematologic effects seen in the females had lessened (RBC was 7% below control) or returned to control value ranges. Furthermore, no treatment-related differences were found in body weight, organ weights, urine or serum chemistries, gross lesions, or microscopic lesions in males or females. There were no significant biological effects in rats exposed subchronically to 25 or 5 ppm. The subtle hematologic findings of these studies confirm the known RBC perturbations of EGBE. PMID- 6857679 TI - Behavioral effects of toluene are modulated by stimulus control. AB - Behavior that is strongly controlled by environmental stimuli is less susceptible to disruption by certain chemicals than is such behavior not under strong external control. To determine whether toluene's effects can also be minimized by environmental stimuli, two varieties of a fixed consecutive number schedule were studied. With one, a lever press response was reinforced with milk only if preceded by a minimum of eight consecutive responses on a second lever, no cues indicating that the minimum number had been reached. With the other, a combination of lights and a tone served as a discriminative stimulus signaling the completion of the minimum response number. In an experiment studying these schedules separately, rats were exposed to toluene concentrations up to 3000 ppm for 4-hr periods immediately before their performance was tested. Toluene reduced the accuracy of both types of behavior in a concentration-related fashion. Clear differential effects occurred, with the signaled behavior, i.e., that under stronger stimulus control, showing less disruption by toluene. Similar results were produced after 2-hr exposures with a multiple schedule in which the signaled and unsignaled performances alternated within a single session. Response rate changes were observed at 560 ppm, but changes in rate were independent of effects on the accuracy of performance. The EC50 for significant behavior disruption was 1081 ppm for the unsignaled component of the multiple schedule; the EC10 was 480 ppm. No performance disruption was observed in the signaled component below 1780 ppm. The finding of differential sensitivity could be useful in guiding the development of more sensitive tests of performance impairment. PMID- 6857680 TI - Pharmacokinetics and metabolism of inhaled methyl chloride in the rat and dog. AB - Methyl chloride (MeCl) metabolism and pharmacokinetics were studied in male Fischer 344 rats and male beagle dogs. Apparent steady-state blood MeCl concentrations were proportionate to exposure concentration in rats and dogs exposed to 50 and 1000 ppm. Furthermore, blood MeCl concentrations were similar in both species when they were exposed to the same concentration. A linear two compartment open model described the blood MeCl data: alpha and beta phase elimination half-times corresponded to approximately 4 and 15 min, respectively, in rats, and 8 and 40 min in dogs. Rats exposed for 6 hr to 0, 50, 225, 600, or 1000 [14C]MeCl were evaluated for tissue nonprotein sulfhydryl (NPSH), total 14C activity, nonextractable tissue 14C activity, and urinary metabolites. MeCl induced NPSH depletion was dose-related and was greatest in liver. Total 14C in liver and kidney was approximately proportionate to exposure concentrations. Relative concentrations of nonextractable 14C decreased at 600 to 1000 ppm MeCl suggesting a dose-dependent metabolic pathway for MeCl in the rat. Metabolites in urine included N-acetyl-S-methylcysteine, methylthioacetic acid sulfoxide, and N (methylthioacetyl)glycine. These metabolites are likely to be products of a reaction between MeCl and glutathione. A nonradiometric analysis of a putative MeCl metabolite (S-methylcysteine) was performed in dogs exposed to MeCl; this method was not a sensitive indicator of MeCl exposure. PMID- 6857682 TI - Does consumption of alcohol in the presence of disulfiram cause brain damage? AB - After blocking aldehyde dehydrogenase activity with disulfiram in rats, a single injection of ethanol or a single day of inhaling ethanol vapor resulted in neuronal degeneration in the cerebral cortex and elsewhere that was detected by a specific silver stain and by electron microscopy. Treatment of rats with alcohol alone and with disulfiram alone did not cause neuronal degeneration. The minimum blood alcohol levels and disulfiram doses administered to the rats which caused neural degeneration are not distant from those values described in a clinical case of abuse of disulfiram. PMID- 6857681 TI - Pharmacokinetics of nicotine in rats after multiple-cigarette smoke exposure. AB - The pharmacokinetics of nicotine and its major metabolites was evaluated in male rats after multiple-cigarette smoke exposure. A smoke-exposure apparatus was used to deliver cigarette smoke to the exposure chamber. The rats were exposed to smoke from a single cigarette every 8 hr for 14 days and to the smoke of a cigarette spiked with radiolabeled nicotine on the 15th day. Blood and urine samples were collected at timed intervals during the 10-min smoke-exposure period of the last cigarette and up to 48 hr thereafter. Nicotine, cotinine, and other polar metabolites were separated by thin-layer chromatography and quantified by liquid scintillation counting. The data were analyzed by computer fitting, and the derived pharmacokinetic parameters were compared to those observed after a single iv injection of nicotine and after a single-cigarette smoke exposure. The results indicated that the amount of nicotine absorbed from multiple-cigarette smoke was approximately 10-fold greater than that absorbed from a single cigarette. Also, unlike the single-cigarette smoke exposure experiment, nicotine plasma levels did not decay monotonically but increased after the 5th hr, and high plasma concentrations persisted for 30 hr. The rate and extent of the formation of cotinine, the major metabolite of nicotine, were decreased as compared with their values following a single-cigarette smoke exposure. It was concluded that nicotine or a constituent of tobacco smoke inhibits the formation of cotinine and may affect the biotransformation of other metabolites. Urinary excretion tended to support the conclusions that the pharmacokinetic parameters of nicotine and its metabolites were altered upon multiple as compared to single dose exposure. PMID- 6857683 TI - Hypolipidemic activity and toxicity studies of a styrl-hexahydroindolinol, 34 250. AB - 34-250 evoked hypocholesterolemic activity in the rat (14, 25, 31, 52, 112 mg/kg, po), dog (10, 20, 40 mg/kg, po), and monkey (30 mg/kg, po). Serum triglycerides were lowered in the rat and dog but not in the monkey. 34-250 increased [14C]acetate incorporation into liver cholesterol, but incorporation of 14C labeled acetate into serum cholesterol was decreased. Desmosterol or 7-dehydro cholesterol did not accumulate in serum of the three species, suggesting that inhibition of cholesterol biosynthesis by 34-250 possibly does not occur at a late stage. Normal fecal bile acid excretion was observed in rats, suggesting that cholesterol catabolism probably was not enhanced by 34-250. Compound 34-250 induced hypocholesterolemia may result from inhibition of hepatic release of this sterol into blood. The reversible hepatic lipidosis observed in rats is also possibly related to decreased hepatic transport and/or secretion of triglycerides. 34-250 did not cause a proliferation of hepatic microbodies; the lack of an increase in this fatty acid oxidizing organelle suggests that it may also have had a role in increased hepatic lipidosis. In dogs, a high incidence of severe cataracts with an early onset was induced by 20 and 40 mg/kg, po of 34-250 despite the lack of desmosterol or 7-dehydro-cholesterol in serum. The absence of these late stage intermediates of cholesterol biosynthesis in the serum of a test species does not preclude the occurrence of ocular toxicity. PMID- 6857684 TI - Cardiac physiologic and tissue metabolic changes following chronic low-level cadmium and cadmium plus lead ingestion in the rat. AB - Female Long-Evans hooded rats received Schroeder's rye-based diet and 0 or 1 microgram/ml cadmium, or cadmium plus lead in mineral fortified drinking water from weaning to 18 months. The heavy metal-fed rats were normal with respect to control, including growth rates and final body weights. Rats receiving added cadmium and cadmium plus lead in the diet were characterized by a persistent hypertension which was evident after 2 months. Cardiac conduction system excitability was depressed preferentially in cadmium-(atrioventricular nodal region) and cadmium plus lead-(His-Purkinje system) fed rats. Although heart rates were comparable to control, myocardial contractile activity (peak active tension and dT/dt) was significantly decreased in intact perfused heart preparations from both heavy metal-treated groups. In conjunction with the observed physiologic changes, various tissue-specific metabolic alterations were detected in heart, kidney, and liver. Generally, prolonged heavy-metal ingestion at these levels resulted in impaired energy metabolism (e.g., decreased ATP, PCr; increased Pj, ADP concentrations) and altered essential mineral composition (e.g., calcium, magnesium, zinc, and to a lesser extent, sodium and potassium; copper levels were unaffected) that varied in severity according to the tissue. The addition of lead to the cadmium diet had little additive effect on the cardiovascular system; however, renal and hepatic tissues did exhibit apparent additive effects further suggesting that cadmium and lead actions and interactions may be tissue dependent. These experimental findings and the biologic inferences derived are consonant with the hypothesis that chronic, life long cadmium exposure approximating environmental levels may have significant adverse effects on mammalian systems, that include effects on cardiovascular tissues. PMID- 6857687 TI - Comparative aspects of the reproductive toxicology by inhalation in rats of ethylene glycol monomethyl ether and propylene glycol monomethyl ether. AB - This study was designed to provide a rapid assessment of the effect of two glycol ethers on some aspects of reproduction in the rat. Exposure was by inhalation at 100 and 300 ppm (EGME) and 200 and 600 ppm (PGME) for 6 hr/day. The study was in two parts: (a) Pregnant females were exposed on Days 6 to 17 of gestation. Body weight gain was reduced in both EGME groups. No litters were delivered in the 300 ppm EGME group and only 9/20 rats in the 100-ppm EGME group produced litters where the number, weight, and viability of the pups were reduced, but the pups appeared normal externally. Exposure at 200 and 600 ppm PGME had no effect. (b) Male rats were exposed for 10 days. There was a reduction in testicular weight accompanied by semeniferous tubular atrophy in the 300-ppm EGME group. There were no effects at 100 ppm EGME or 200 and 600 ppm PGME. 300 ppm EGME caused significant reductions in white blood cell count, red blood cell count, hemoglobin concentration, hematocrit, and mean cell hemoglobin. The study design proved capable of demonstrating the effects of EGME on the testes and on fetal development and highlighted PGMEs lack of activity at the doses tested. PMID- 6857686 TI - Protection by paracetamol against various gastric irritants in the rat. AB - Four nonsteroid anti-inflammatory drugs (NSAID), indomethacin, phenylbutazone, ibuprofen, and glafenine, caused erosions in the rat stomach in a dose-dependent manner. Paracetamol, which has been shown to protect against the gastric erosive activity of aspirin, reduced the gastric toxicity of indomethacin but was ineffective against the erosive activity of phenylbutazone and glafenine. Only the high erosion score of a large dose of ibuprofen was partly decreased by paracetamol. The gastric damaging effects of necrotizing concentrations of ethanol and sodium hydroxide were strongly reduced by paracetamol, but the erosive activity of hydrochloric acid was only slightly decreased by paracetamol. Thus, although paracetamol protected the gastric mucosa against various noxious agents, this drug was not able to protect against every type of gastric damage. Paracetamol might be protective by stimulating the biosynthesis of prostaglandins in the stomach wall. PMID- 6857685 TI - The effects of acetaldehyde and acrolein on blood pressure in guanethidine pretreated hypertensive rats. AB - These experiments were undertaken to study the effect of the interaction of the antihypertensive agent guanethidine and two aldehydes possessing sympathomimetic activity on the blood pressure of spontaneously hypertensive rats (SHR). Acetaldehyde, when administered iv to acutely guanethidine-pretreated (15 mg/kg) SHRs under urethane anesthesia, caused a potentiated pressor response in the dose range of 3 to 40 mg/kg. When administered iv to chronically guanethidine pretreated SHRs, a pressor response was noted at low doses and a depressor response at high doses. Acrolein (0.05 to 0.5 mg/kg) produced a pressor response at low doses and a depressor response at high doses in both acutely and chronically guanethidine-pretreated SHRs. Pressor responses, particularly to acetaldehyde, may be due to an enlarged tyramine-releasable pool, hyperreactivity of alpha adrenergic receptors of SHRs, or guanethidine inhibition of norepinephrine reuptake. Depressor responses to high doses of aldehydes may be attributed to vagal stimulation or direct vasodilation. It is concluded that there is a significant interaction between the aldehydes and guanethidine which may have implications for someone undergoing treatment with guanethidine for hypertension while being exposed to acetaldehyde and related compounds from ethanol and tobacco smoke. PMID- 6857688 TI - Toxicity of ortho-substituted bromobenzenes to isolated hepatocytes: comparison to in vivo results. AB - In this study, freshly prepared isolated rat hepatocytes were exposed to various concentrations of bromobenzene and six ortho-substituted bromobenzenes. Toxicity was estimated by trypan blue dye exclusion and release of GPT and K+ over a 0- to 4-hr time course. In all cases a close correlation among these three indices was observed. The rate of response depended on the exposure level and the nature of the o-substituent. The relative toxicity followed the order C2H5 greater than CH3 greater than or equal to CF3 greater than Br much greater than H greater than OCH3 much greater than CN. This order does not correlate well with the in vivo toxicity data previously obtained in this laboratory (Toranzo E. G., Gillesse, T., Mendenhall, M., Traiger, G.J., Riley, P.G., Hanzlik, R.P., and Wiley, R.A. (1977). Toxicol. Appl. Pharmacol. 40, 415-425.); in fact an almost inverse relationship is indicated. Several possible reasons are proposed in order to rationalize the discrepancy between these two results. The results emphasize the need for caution when using isolated hepatocytes to screen new compounds for purposes of determining their potential in vivo toxicity, at least until the differences between hepatocytes in vivo and hepatocytes in vitro are more thoroughly understood. PMID- 6857689 TI - Tetrachloroethylene: balance and tissue distribution in male Sprague-Dawley rats by drinking-water administration. AB - While low levels of organic contaminants have been reported to occur in drinking water, often little information is available concerning the toxicological significance of ingestion by this route. For tetrachloroethylene, considerable animal toxicity data exist for gavage or inhalation exposure. Since extrapolation of toxicity between routes of administration implies similar pharmacokinetic disposition, the pharmacokinetics of tetrachloroethylene was examined in rats following administration in the drinking water. Tetrachloro[14C]ethylene was administered to adult, male Sprague-Dawley rats in saturated drinking water solutions (approximately 150 ppm) resulting in a mean dose of 8.1 +/- 3.1 mg/kg. Within 72 hr from termination of a 12-hr drinking exposure period, approximately 88% of the body burden was eliminated as unmetabolized parent compound in expired air. As much as 96% of the activity recovered in this form was excreted during the first 24 hr. The remaining 14C activity recovered was the result of metabolic conversion to 14CO2 (2.2%), nonvolatile metabolites in urine (7.2%) and feces (1.7%), and minor amounts (0.9%) in the carcass. Radioactivity in the carcass 72 hr following termination of the exposure period was distributed within liver, kidneys, fat, lungs, heart, and adrenals. Pulmonary elimination of unchanged tetrachloroethylene was monophasic with a calculated elimination half life of 7.1 hr. The elimination kinetics were consistent with results previously generated by both gavage and inhalation exposure. The fate of tetrachloroethylene following drinking-water administration was not substantially different from the disposition resulting from these two routes of administration. PMID- 6857690 TI - Protective role of dietary butylated hydroxyanisole against chemical-induced acute liver damage in mice. AB - Prior consumption of a diet containing the food antioxidant, butylated hydroxyanisole (BHA), by female mice prevented the development of or minimized the acute liver damage caused by monocrotaline, acetaminophen, or bromobenzene. In contrast, neither the incidence nor the severity of carbon tetrachloride induced hepatotoxicity was affected by dietary BHA. Hepatotoxicity was judged by plasma alanine aminotransferase and aspartate aminotransferase levels, hepatic cytochrome P-450 content, and liver histology. The protective effect of BHA against acetaminophen-induced hepatotoxicity was not demonstrated in male mice. The observed protection by dietary BHA against acetaminophen- and bromobenzene induced hepatotoxicity was associated with the increase of liver glutathione. It is concluded that the protective action of BHA is dependent upon the nature of the toxic agent. PMID- 6857691 TI - Enhancement of rifampin teratogenicity in cultured rat embryos. AB - The teratogenicity of the semisynthetic antibiotic rifampin (RIF) was investigated in rat embryos cultured from Days 10 to 11. Comparisons were made between the teratogenicity of RIF alone and RIF plus a rat liver fraction and cofactors for cytochrome P-450-mediated monooxygenation. Both groups were compared to vehicle controls. Rifampin without the metabolizing system caused significant retardation of growth but no significant increase in incidence of abnormalities (neural tube defects). Metabolism did not alter the growth retarding action of the drug but did significantly increase the frequency of neural tube malformation. Exposure to RIF at concentrations from 12.5 to 100 micrograms/ml medium in the presence of the metabolizing system resulted in concentration-dependent decreases in embryo length, somite number, and protein content. The addition of metyrapone, an inhibitor of cytochrome P-450 activity, failed to prevent growth retardation but did reduce the incidence of malformations to a rate equal to that produced by the unmetabolized drug. No significant increases in malformation incidence or growth retardation were observed when embryos were cultured with the RIF metabolites, 3-formyl rifamycin, 25-deacetyl rifampin, or rifampin quinone. PMID- 6857693 TI - Comparison of tissue distribution of cadmium in mice intravenously injected with metallothionein and a polymer of metallothionein. AB - Polymers of cadmium metallothionein I and II were prepared and used for distribution studies. Mice were intravenously injected with comparable doses of cadmium as chloride, metallothionein and metallothionein-polymer and were killed at 3 h and 24 h after injection. A considerably higher concentration of cadmium was found in the plasma and spleen of animals exposed to metallothionein-polymer than other groups, while the cadmium concentration in the kidney was less than, but in the liver was greater than those injected with cadmium-metallothionein. Gel filtration of liver and kidney cytosols showed that metallothionein is the most stable form of cadmium in the tissues. The injected polymer was degraded into the monomer within 24 h in tissues. The high concentration of polymer in plasma indicates a slow clearance of cadmium in this form. The increased antigenicity of metallothionein-polymer may be related to its slow clearance from blood and increased deposition in spleen. PMID- 6857694 TI - Disposition, elimination and metabolism of O-ethyl O-4-nitrophenyl phenylphosphonothioate after subchronic dermal application in male cats. AB - The metabolism, distribution, and excretion of the insecticide O-ethyl O-4 nitrophenyl phenylphosphonothioate (EPN) were studied in the male cat. Each cat was given a daily dermal dose of 0.5 mg/kg [14C]EPN for 10 consecutive days. Fifteen days after the last dose, the cats had excreted 62% of the cumulative dose in the urine and 10% in the feces. No 14CO2 was detected in the expired air. O-Ethyl phenylphosphonic acid (EPPA) was identified as the major urinary and fecal metabolite. Phenylphosphonic acid (PPA) was the second highest metabolite. Only traces of the intact EPN were recovered in the urine and feces. The disposition studies performed 1, 5, 10 and 15 days after the administration of the last dose showed that EPN was the major compound identified in the brain, spinal cord, sciatic nerve, adipose tissue, plasma and kidney. Most of the radioactivity in the liver was identified as EPPA followed by PPA. The time course of plasma EPN, determined after the 10th daily dose was biphasic. The slower process had a half-life of 17.0 days. After tissue distribution was completed, tissue elimination was adequately represented as a single first-order process. PMID- 6857692 TI - Toxicological evaluation of poison oak urushiol and its esterified derivative. AB - Poison oak urushiol was compared with its esterified derivative for toxicity after oral administration to rats and guinea pigs. No hematological or pathological changes were noted and there were no differences seen in clinical chemistry measurements when compared to clinical biochemical and hematological reference values of normal experimental animals. Comparative LD50 studies in mice and tissue reactivity studies in rabbits indicated that acetylated urushiols were substantially less toxic than free urushiols. However, neither poison oak urushiol or poison oak urushiol acetate appeared to produce any tissue toxicity not related to a direct irritant effect. The free urushiol produced a much greater degree of skin irritation than did the urushiol acetate. Whether or not an animal had been sensitized to urushiol apparently had no effect on organ toxicity. PMID- 6857695 TI - Hepta-, hexa-, tetra- and dichloronaphthalene congeners as inducers of hepatic microsomal drug-metabolizing enzymes. AB - Pretreatment of immature male Wistar rats with 1,2,3,4,5,6,7-hepta-, 1,2,3,4,5,6,8-hepta- and 1,2,3,4,5,6-hexachloronaphthalene resulted in the induction of several hepatic microsomal drug-metabolizing enzymes. The enzymic activities, reduced cytochrome P-450:CO and ethylisocyanide binding difference spectra and electrophoretic mobilities of the induced microsomal proteins were comparable to those observed after administration of the classical inducer of microsomal aryl hydrocarbon hydroxylase, 3-methylcholanthrene. The 1,2,3,4,5,6,7 heptachloronaphthalene congener, which is fully substituted in the lateral 2,3,6 and 7 positions, was more potent than the 1,2,3,4,5,6,8-hepta- and the 1,2,3,4,5,6-hexachloronaphthalene congeners which contain only 3 lateral chloro substituents. 1,2,3,4-Tetra- and several lower chlorinated naphthalenes were inactive as inducers of microsomal aryl hydrocarbon hydroxylase. The effects of structure on the induction activities of the polychlorinated naphthalenes were similar to those observed for other halogenated aryl hydrocarbons. PMID- 6857696 TI - Pulmonary toxicity of 2-methylnaphthalene: lack of a relationship between toxicity, dihydrodiol formation and irreversible binding to cellular macromolecules in DBA/2J mice. AB - Intraperitoneal doses of 2-methylnaphthalene (2-MN) have been shown to cause pulmonary toxicity in DBA/2J mice. Pretreatment with the monooxygenase inducers sodium phenobarbital and 3-methylcholanthrene (3-MC) failed to protect the DBA/2J mice from the toxic effect of 2-methylnaphthalene. Pretreatment of DBA/2J mice with the monooxygenase inhibitors, SKF 525-A and piperonyl butoxide also failed to enhance or attentuate the pulmonary lesions. Pulmonary and hepatic microsomes from DBA/2J mice metabolized 2-methylnaphthalene to three dihydrodiols, 2 naphthyl alcohol and other unidentified metabolites. Kidney microsomes produced 2 naphthyl alcohol but no detectable dihydrodiols. In comparison to control animals, hepatic microsomes from animals pretreated with sodium phenobarbital produced more of the least polar dihydrodiol, while amounts of the other two dihydrodiols were unaffected. 3-Methylcholanthrene, piperonyl butoxide and diethylmaleate failed to affect dihydrodiol formation in both pulmonary and hepatic microsomes. After the administration of a lung toxic dose (400 mg/kg, i.p.) of 2-MN, irreversible binding was highest in the liver, followed by the kidney, the lung and lastly skeletal muscle. Of the pretreatments given to the mice, only phenobarbital demonstrated a significant effect, and this elevation was apparent only in the liver. A pulmonary toxic dose of 2-MN (400 mg/kg, i.p.) administered to DBA/2J mice significantly depleted reduced GSH in the liver and lung and to a lesser extent, in the kidney. There appeared no good correlation between the pulmonary toxicity of 2-MN-dihydrodiol and/or alcohol formation or the in vivo irreversible binding to macromolecules. These results are compared with those reported previously in C57BL/6J mice. PMID- 6857697 TI - Maternal hepatic and embryonic effects of 1,2,3,4-tetrachlorobenzene in the rat. AB - To assess possible maternal hepatic and reproductive effects of this uncharged, low molecular weight, lipophilic chlorinated benzene 0, 100, 300 and 1000 mg/kg/day of 1,2,3,4-tetrachlorobenzene (TCB) was orally administered to pregnant rats on days 9-13 of gestation and the animals were killed on day 14 of pregnancy. Phenobarbital and beta-naphthoflavone were administered to other pregnant rats as positive hepatic controls. Maternal mortality (7/19 rats) was increased and body weight gain was greatly decreased in the 1000 mg/kg/day TCB group. Liver to body weight ratio and hepatic microsomal protein content were unaffected by any TCB treatment. On day 14 maternal NADPH-cytochrome c reductase activity was increased at 1000 mg/kg/day, while the maternal hepatic microsomal cytochrome P-450 content was significantly induced by both 300 and 1000 mg/kg/day of TCB. Microsomal N-demethylation of aminopyrine was increased from 2.6 to 4.0 and 4.5 nmol/mg protein/min at doses of 300 and 1000 mg/kg TCB, respectively. However, maternal hepatic microsomal ethoxyresorufin O-deethylase activity was not consistently increased by TCB. Hepatic glutathione S-transferase activity towards 1,2-dichloro-4-nitrobenzene was increased only by the 1000 mg/kg/day TCB treatment. The rate of microsomal p-nitrophenol and phenolphthalein glucuronidation was increased by TCB administration. Embryonic growth was adversely affected by TCB treatment. Yolk sac diameter, embryonic crown-rump length, and head length were all decreased by treatment with 300 mg/kg/day TCB. This TCB treatment did not significantly elevate the number of dead or abnormal embryos. PMID- 6857698 TI - Transfer of chromic chloride to embryonic mice and changes in the embryonic mouse neuroepithelium. AB - Transfer of CrCl3 to embryonic mice and changes in the embryonic mouse neuroepithelium associated with Cr-induced neural tube defects were studied. A single intraperitoneal injection of 51CrCl3 was administered on the 8th day of gestation and animals were killed at various intervals for measurements of radioactivity in the maternal blood and embryos. Radioactivity per gram of fetal tissues increased during the observed period, while those of maternal blood decreased. Pregnant mice were injected intraperitoneally with a single dose of CrCl3 (non-radioactive) on the 8th day of gestation. Animals were killed at specified times after injection and embryos were removed and examined histologically. At 4, 8 and 12 h after injection many pyknotic cells were observed on the neural plate, especially at 8 h after injection. These data suggest that CrCl3 may affect embryos directly and cause neural tube defects and that pyknotic cells on the neural plate may be an early pathological finding in cases of developing exencephaly. PMID- 6857700 TI - Reduced Cd2+ accumulation and elevated metallothionein levels in a Cd2+ and Zn2+ resistant clonal CHO-K1 cell line. AB - A clonal cell line, R40F, was selected from a heterogenous population of Cd2+ and Zn2+-resistant CHO-K1 cells. These R40F cells demonstrated resistance to 120- and 4-fold higher concentrations of Cd2+ and Zn2+, respectively, than did wild type CHO-K1 cells. When cultured in the presence of low concentrations of Cd2+ (0.5 1.0 microM), the accumulation of intracellular Cd2+ in R40F cells appears to be significantly less than in wild type cells. Since R40F cells maintained in medium containing high concentrations of Cd2+ (200 microM) retain levels of Cd2+ equivalent to the intracellular concentration observed in wild type cells exhibiting cytotoxicity, it is assumed that reduced Cd2+ transport alone is unlikely to account for the resistance to Cd2+ toxicity. Exposure of R40F cells to non-toxic (2 microM or 100 microM) or toxic (200 microM) Zn2+ levels resulted in an accumulation of Zn2+ equal to, or greater than, that observed in the wild type cell. When compared to the basal level in uninduced wild type cells, metallothionein levels were elevated 14- and 23-fold, respectively, in R40F cells cultured in the presence of 0.5 microM Cd2+ and 100 microM Zn2+. These results are consistent with the hypothesis that R40F cells express Cd2+ and Zn2+ resistance as a consequence of a reduction in unbound intracellular Cd2+ levels and an elevation of metallothionein synthesis. PMID- 6857699 TI - Temporal variations in chloroform-induced hepatotoxicity in rats. AB - There is increasing evidence to show that drug metabolism and effects are modulated by biological rhythms; therefore the possibility that chloroform (CHCl3) induced acute hepatotoxicity may also vary as function of time of administration was investigated in male Sprague--Dawley rats. The animals were given a single intraperitoneal dose of CHCl3 or saline, 0.5 ml/kg, at 09:00 h, 13:00 h, 17:00 h, 21:00 h or 03:00 h and killed 4 h after treatment. The hepatotoxicity induced by CHCl3 was determined by the serum glutamic-pyruvic transaminase (SGPT), serum glutamic-oxaloacetic transaminase (SGOT) and lactic dehydrogenase (LDH) activities and by the glucose-6-phosphatase (G6Pase) activity of the liver. The increases in SGPT, SGOT and LDH were minimal and maximal when the organic solvent was injected at 09:00 h and 21:00 h, respectively, whilst the activity of G6Pase was depressed significantly at 03:00 h and 13:00 h under similar conditions. Starving the rats for 16 h prior to the injection of CHCl3 at 09:00 h increased substantially the hepatotoxicity as measured by the above enzyme activities. These findings may be relevant in the toxicity of CHCl3 in industrial workers exposed to this solvent at various times of the day. PMID- 6857701 TI - Effect of halogenated vinyl cysteine conjugates on renal tubular active transport. AB - Addition of halogenated vinyl cysteine conjugates to isolated rabbit kidney tubule suspensions resulted in a decrease in the active transport of para aminohippuric acid (PAH) and tetraethylammonium bromide (TEA). At 10(-5) M vinyl cysteine conjugate, tubule to medium accumulation ratios (T/M) were similar to those of controls while at 10(-3) M the T/M values decreased to 1, indicating complete inhibition of active accumulation of PAH or TEA. The decreased active transport was not caused by inhibition of mitochondrial oxidation since incubations in the presence of 10(-3) M halogenated vinyl cysteine did not inhibit tubule O2 utilization or production of 14CO2 from [14C]glucose or [14C]succinate. A mechanism is proposed whereby toxicity may result from covalent binding of an active intermediate, produced by enzyme cleavage, to membrane associated nucleophilic groups thereby decreasing active transport. PMID- 6857702 TI - Absence of embryotoxic effects in rats with three quaternary ammonium compounds (cationic surfactants). PMID- 6857703 TI - Competition between paraquat and putrescine for accumulation by rat lung slices. AB - Slices from rat lungs actively accumulate both paraquat and putrescine, while endogenous polyamines inhibit the accumulation of each. The organic ions phenol red and tetraethylammonium, as well as cycloleucine, have little, if any, effect on either paraquat or putrescine transport. Double reciprocal plots indicate that paraquat and putrescine compete for the same transport system in lung slices. The affinity for the system is much greater for putrescine than for paraquat; thus, a transport system normally meant for accumulation of polyamines can be usurped by the exogenous compound paraquat. Furthermore, these data support the hypothesis that paraquat and putrescine are accumulated by the same cell type. PMID- 6857705 TI - Isolation and characterization of two toxins from the venom of the Malayan cobra (Naja naja sputatrix). AB - Two principal toxins of the Malayan cobra (Naja naja sputatrix) venom have been purified to electrophoretic homogeneity by successive SP-Sephadex C-25 ion exchange chromatography and Sephadex G-50 gel filtration chromatography. They are designated as sputa-neurotoxin 1 (SN1) and sputa-neurotoxin 2 (SN2), respectively. both toxins belong to the group of short neurotoxins which are composed of approximately 60 amino acid residues. The LD50 values following i.p. injection of the purified toxins are 91 (SN1) and 71 (SN2) micrograms/kg mouse. Amino acid compositions of the two toxins show close similarities to other postsynaptically acting curaremimetic cobra neurotoxins. PMID- 6857706 TI - Ethoxyformylation and guanidination of snake venom phospholipases A2: effects on enzymatic activity, lethality and some pharmacological properties. AB - Lysine residues in the basic and relatively toxic N. nigricollis phospholipase A2 and in the acidic and relatively nontoxic N. n. atra phospholipase A2 were modified by acylation with ethoxyformic anhydride (in the presence or absence of the substrate dihexanoyl lecithin) or guanidination with O-methylisourea. Ethoxyformylation gave rise to some protein fractions in which enzymatic activity was preserved to a greater degree than intraventricular lethality. Guanidination had little effect on the isoelectric point or catalytic activity of either enzyme or on the lethal potency of the N. n. atra enzyme. However, the intraventricular lethality of the N. nigricollis enzyme was decreased much more than was its intravenous lethality, direct hemolytic potency, anticoagulant activity or cardiotoxic action on rat atrium. These results are compared to those previously obtained when the lysines in these two enzymes were carbamylated with potassium cyanate, a procedure which markedly decreased the isoelectric point of the enzymes. It is concluded that charge alone does not account for differences in toxicity. The data also indicate that there are at least two distinct active sites in both enzymes, one being primarily responsible for enzymatic activity and the other(s) associated with lethal and pharmacological effects of the protein. Modification of lysines affects the latter site(s), while having little or no effect on enzymatic activity. PMID- 6857704 TI - Effect of D-penicillamine on glomerular basement membrane, urinary N-acetyl-beta D-glucosaminidase and protein excretion in rats. AB - The administration of D-penicillamine (450 mg/kg) to young rats resulted in an immediate increase in urinary NAG and volume, as well as mild proteinuria of a predominently low molecular weight type. Doses less than 400 mg/kg failed to alter the urinary profile. Analysis of glomerular basement membrane prepared from rats injected with D-penicillamine (450 mg/kg) failed to show any abnormalities in amino acid and sugar composition. In contrast, glomerular basement membrane prepared from D-penicillamine injected rats was more soluble than membrane prepared from normal rats in SDS and 2-mercaptoethanol. The solubilised components of the membrane were resolved on SDS-polyacrylamide gel electrophoresis. An increase in the low molecular weight, and a concomitant fall in the higher molecular weight components present in the membrane was demonstrated. D-penicillamine therefore affects glomerular basement membrane directly in young rats, possibly by interfering with cross-link formation. These studies may provide a further basis for the study of D-penicillamine toxicity in man. PMID- 6857707 TI - An attempt to identify amino groups of Naja naja siamensis neurotoxin that interact with acetylcholine receptor by a comparison of their reactivities in free and receptor-bound neurotoxin. AB - An attempt to identify amino groups of Naja naja siamensis neurotoxin that interact with acetylcholine receptor by a comparison of their reactivities in free and receptor bound neurotoxin. Toxicon 21, 219-229, 1983--Free Naja naja siamensis neurotoxin was acetylated with non-radioactive and acetylcholine receptor-bound neurotoxin with radioactive acetic anhydride. The toxins from the two experiments were combined and the monoacetyl derivatives isolated by chromatography on Bio-Rex 70. The yields were determined by spectrophotometry and scintillation counting. To localize the acetyl group, a radioactive monoacetyl toxin was oxidized with performic acid, digested with trypsin and a peptide with the radioactive acetyl group was isolated by gel filtration on Sephadex G-25 and high voltage paper electrophoresis. Amino acid analysis indicated from which part of the molecule the peptide was derived. In free toxin, Ac-Lys 23 and 49 account for 56% and 12%, respectively, of the monoacetyl derivatives, and in bound toxin for only 25% and 8%. Lys 49 is as reactive as Ile 1 in free toxin and 50-150% more reactive than Lys 69, 35 and 12, but it has the lowest reactivity in bound toxin, being only about half as reactive as any of these three residues. The large decrease in reactivity of Lys 23 and 49 indicates that they interact with the receptor. The proximity of the receptor makes them less accessible to acetic anhydride. The reactivities are compared to that of Lys 12, which in free toxin has the least reactive amino group. The yield of Ac-Lys 23 relative to that of Ac Lys 12 drops from 12.4 to 1.5, or by 88%, Lys 49, 2.6 and 0.5 (81%); Ac-Ile 1, 2.6 and 1.1 (58%); Ac-Lys 69, 1.9 and 0.9 (53%); Ac-Lys 35, 1.8 and 1.0 (44%). The drop in reactivity relative to that of Lys 12 indicates a real decrease, provided that Lys 12 does not become more reactive in bound toxin. This is unlikely, since sequence homology shows that Lys 12 corresponds to Lys 15 of the neurotoxin oxiana II of Naja naja oxiana, a residue known to interact with the receptor. Sequence homology also supports the conclusion that the drop in the reactivity of Ile 1 has the same cause. The receptor-binding region of the siamensis toxin is rather large, containing the residue Lys 23 and 49, Ile 1 and probably also Lys 69 and 35. PMID- 6857709 TI - Purification and properties of a lethal, hemorrhagic protein, "Mucrotoxin A", from the venom of the Chinese habu snake (Trimeresurus mucrosquamatus). AB - Mucrotoxin A was purified from the lyophilized venom of Trimeresurus mucrosquamatus using gel filtration on a Sephadex G-100 column, followed by chromatography on CM-Sephadex C-50 and DEAE-Sephadex A-50. By these procedures, 14 mg of purified preparation could be obtained from 1 g of crude venom. The purified preparation was homogeneous by disc electrophoresis on polyacrylamide gel at pH 8.3, isoelectric focusing and by the presence of one precipitin line on immunodiffusion. Mucrotoxin A possessed both lethal and hemorrhagic activities, but it did not show caseinolytic activity. Its molecular weight was approximately 94,000 and the isoelectric point was 4.3. Mucrotoxin A contains approximately 3 moles of Ca and 2 moles of Zn per mole of toxin. The amino acid composition of Mucrotoxin A was determined. No carbohydrate was present. PMID- 6857708 TI - The inactivating effect of Bothrops jararaca and Waglerophis merremii snake plasma on the coagulant activity of various snake venoms. AB - Plasmas of the poisonous snake Bothrops jararaca and of the non-poisonous snake Waglerophis merremii were not clotted by various snake venoms. These plasmas also inactivated venom clotting activity on human plasma. This effect was absent in snake serum and in heated snake plasma. The active fraction was isolated by gel chromatography from B. jararaca plasma and corresponded to the fibrinogen containing fractions. It is suggested that the inactivation by snake plasma of the venom coagulant activity might be due to a fibrinogen-bound complex or to fibrinogen itself. PMID- 6857710 TI - Isolation and characterization of toxic proteins from the venom of the Brazilian scorpion Tityus serrulatus. AB - Through gel filtration on Sephadex G-25 and chromatography on CM-cellulose-52 five toxic proteins, electrophoretically pure, were isolated from the venom of the Brazilian scorpion Tityus serrulatus and partially characterized, as follows: 1. Toxin T1 VIII, with 61 amino acid residues, mol. wt 6675 and amino terminal sequence Lys-Glx-Gly-Tyr-Leu-Met-Asx-His-Glx-Gly-Cys-Lys-; 2. Toxin T1VI with amino acid residues, mol. wt. 7549 and amino terminal sequence Gly-His-Phe-Gly Lys; 3. Toxin T2III(I), with 63 amino acid residues, mol. wt. 7216 and amino terminal sequence Lys-Lys-Asx-Gly-Tyr-Pro-Val-Cys-Cys-Ser-; 4. Toxin T2IV, which is apparently identical to toxin T1VIII above, since it showed the same elution volume in chromatography on CM-cellulose-52, the same N-terminal Lys and the same electrophoretic mobility as T1VIII; 5. Toxin T1IV, a not previously described toxin from the venom of T. serrulatus, with 45 amino acid residues, mol. wt. 5188 and amino terminal sequence Lys-Glx-Gly-Tyr-Leu-, identical to the first five residues of T1VIII, although with a lower molecular weight. The pharmacological study of T1VIII in guinea pig vas deferens showed a pre-junctional sensitizing action, evidenced by a decrease of the dose-response curves to adrenaline and acetylcholine, with no increase of the maximum. This effect may be due to the liberation of noradrenaline. PMID- 6857711 TI - Further studies on the mass of venom injected by Elapid snakes. AB - Further experimental studies to determine the mass of venom injected by medically significant Australian elapids are reported. The use of a modified enzyme immunoassay technique to measure venom injected during snake bite is presented. The feeding biting pattern of the Australian eastern brown snake (Pseudonaja textilis) is described. Using data from ten different snakes of this species, it is established that the mass of venom delivered in a first-bite is 4.69 +/- 0.85 mg (mean +/- S.E.) and a mean of 91% of the delivered venom is injected s.c. or into deeper tissues in a first-bite. For this species, the mass of venom delivered sequentially in a bite sequence falls to 1.32 +/- 0.94 mg in the third bite in such a sequence. For the Australian rough-scaled snake (Tropidechis carinatus), the mass of venom delivered in a first feeding bite is 6.15 +/- 2.23 mg, falling to a minimum of 1.92 +/- 0.61 mg in the third bite of a sequence. for the Australian death adder (Acanthophis antarcticus) the mass of venom delivered in a feeding bite is 41.95 +/- 16.13 mg for a first bite. Biting data is also presented for three species of the genus Pseudechis (the Australian mulga (king brown) and black snakes. PMID- 6857712 TI - Two-dimensional polyacrylamide gel electrophoresis of hymenoptera venom and venom sac extracts. AB - Hymenoptera venom and venom sac extracts were studied by two-dimensional polyacrylamide gel electrophoresis using non-equilibrium pH gradient electrophoresis in the first dimension and sodium sulfate electrophoresis in the second dimension. Pure Apis mellifera (honeybee) venom collected by electrical stimulation was resolved into five major and more than 20 minor components. Polistes (paper wasp), Vespula (yellow jacket), Dolichovespula (aerial hornet) and Vespa (old world hornet) venom sac extracts contained more than 40 components each. These results illustrate the complexity of the mixtures in current use for immunotherapy for stinging insect hypersensitivity. The degrees of similarity observed between the various aspects of Polistes and Vespula studied correlate with the phylogenetic classification of these species. PMID- 6857713 TI - Cell-free extracts of Salmonella inhibit protein synthesis and cause cytotoxicity in eukaryotic cells. AB - Cell-free, unconcentrated sonic extracts of several serotypes of Salmonella caused extensive detachment of intact Vero cells. Undiluted sonic extracts of these strains exhibited cell detachment in the range 20-50%. Upon dilution, the extract preparations caused a linear, dose-related cytotoxic effect on Vero cell monolayers. The heat-lability (100 degrees C for 30 min) of much of the cytotoxic activity in the extract ruled out the possible involvement of endotoxin in this toxic effect for eukaryotic cells and suggested that this toxic factor is probably a protein. It was demonstrated that these sonic extracts also inhibited the incorporation of 3H-leucine by Vero-cells and that the inhibitory events occurred 1-2 hr after exposure. When subjected to heating at 100 degrees C for 30 min, the ability of Salmonella extracts to inhibit protein synthesis of Vero cells was significantly but only partially destroyed. Because of Salmonella extract-treated Vero cells did not release 3H-uridine until 24-48 hr after addition of sonic extracts, cell lysis was considered to be a secondary event resulting from the early shutdown of protein synthesis, rather than a direct effect of the toxic factor on membrane integrity. Further studies are needed to determine if these two biological activities of Salmonella sonic extracts are due to a single toxic molecule or result from two distinct toxin molecules. PMID- 6857714 TI - Spermidine in the venom of the scorpion, Palamneus phipsoni. PMID- 6857715 TI - Effect of water restriction on the development of hypothalamic lesions in weanling rodents given MSG. I. Drinking behaviour and physiological parameters in mice (Mus musculus). AB - Deprivation of water overnight (ON: 19.00-09.00 h) induced approx. 20% haemoconcentration in weanling ICR strain mice and resulted in avid consumption of fluid offered for 30 min subsequently, with delayed restoration of serum osmolality and sodium to normal levels in those offered 8% w/v monosodium L glutamate monohydrate (MSG) aqueous solution. Neuronal necrosis of the arcuate nucleus of the hypothalamus was found in 12/180 dehydrated mice deprived ON and subsequently consuming 3.0 g or more MSG/kg body weight offered hypertonic MSG solution as the sole source of drinking water. The lesions were less severe than in mice given MSG s.c. or by forced intubation. Mice deprived ON and subsequently consuming MSG solution with water in a free choice experiment, and those deprived during daytime (DT: 07.00-21.00 h) and subsequently consuming MSG solution, with or without water, developed fewer and less severe lesions than did mice deprived ON and subsequently consuming MSG solution solely. The provision of other nutrients (e.g. glucose, arginine) reduced glutamate-induced hypothalamic lesions and elevation of plasma L-glutamate. The findings are in accord with earlier observations that hypothalamic lesions do not result even in this most susceptible species from the 'voluntary' consumption of MSG by physiologically normal animals. No lesions were produced even in mice deprived of food and water ON and subsequently consuming up to 7.3 g MSG/kg body weight in diet and in soup. PMID- 6857719 TI - An open-ended rat tracheal implant model: toxic effects of formaldehyde on the respiratory epithelium. AB - An open-ended rat tracheal implant model was developed to permit quantitative and repetitive exposure of respiratory epithelia to test substances of a variety of physical forms. To investigate the acute toxicity of formaldehyde with this new model, tracheas were exposed to formaldehyde solutions twice a week, for up to 12 weeks. At the higher formaldehyde concentrations (1.0, 0.6, 0.3%) the tracheal lumens became obstructed by granulation tissue. At the lower concentrations (0.2, 0.1, 0.01%), the appearance of flattened and atrophic epithelium as well as hyperplasia and squamous metaplasia were observed. The extent of these epithelial alterations was, for the most part, formaldehyde dose-dependent. PMID- 6857718 TI - Fasting increases the concentrations of carbon tetrachloride and of its metabolite chloroform in the liver of mice. AB - Fasting mice for 24 h strongly enhanced hepatic triglyceride concentrations as well as the hepatic levels of carbon tetrachloride (CCl4) and chloroform (CHCl3) after i.p. injection of 0.1 ml/kg CCl4. The ratio CHCl3:CCl4 was lower in the livers of the fasted than in those of the fed mice. Fasting-induced steatosis leading to an increased affinity of the liver to a lipophilic compound like CCl4 is considered to be the cause for the increase in CCl4 hepatotoxicity induced by fasting in mice. PMID- 6857720 TI - Effect of chronic herbicide intoxication on in vivo activities of certain enzymes in the liver of freshwater fish Nemachelius denisonii (day). AB - Effect of 120 days of continuous exposure of three sublethal concentrations (1/2, 1/4 and 1/8 fractions of 96 h LC50) of Basalin on alkaline phosphatase (Alk P), acid phosphatase (Acid P), lactic dehydrogenase (LDH), succinic dehydrogenase (SDH), glutamic oxaloacetic transaminase (GOT), and glutamic pyruvic transaminase (GPT) activities in the liver of Nemacheilus denisonii were studied. Alk P, Acid P, LDH, and GPT activities were significantly inhibited, but GOT activities were not significantly altered. More inhibition was observed with the higher concentration, but Acid P, LDH, and GPT activities were significantly inhibited in all three sublethal concentrations. PMID- 6857722 TI - Carcinogenicity and toxicity tests on p-phenylenediamine in F344 rats. AB - p-Phenylenediamine, an intermediate of oxidative-type hair dyes, was administered to groups of male and female F344 rats in their diet. A subacute toxicity test showed that 0.4% p-phenylenediamine was very toxic to both sexes, but that 0.2, 0.1 and 0.05% p-phenylenediamine induced no remarkable toxic changes in either sex. In a chronic toxicity test 0.1 and 0.05% p-phenylenediamine were given to both sexes in their diet for 80 weeks, but no carcinogenic effects were found in either sex. PMID- 6857716 TI - Effect of water restriction on the development of hypothalamic lesions in weanling rodents given MSG. II. Drinking behaviour and physiological parameters in rats (Rattus norvegicus) and golden hamsters (Mesocricetus auratus). AB - No hypothalamic lesions were found in weanling Sprague-Dawley (SD) rats or in golden hamsters deprived of water and/or food overnight (ON 19.00-09.00 h) and offered monosodium L-glutamate monohydrate (MSG) in up to 10% solution for 30 min subsequently. ON restriction of water resulted in haemoconcentration, with elevation of haematocrit, plasma protein, electrolytes and osmolality in SD rats. Water-restricted rats avidly consumed large volumes of concentrated MSG solution and showed further evidence of haemoconcentration, with delayed restoration of plasma sodium and with high plasma glutamate, but did not develop lesions at up to 5.4 g MSG/kg b.w. Hamsters deprived of water ON consumed smaller volumes of MSG in aqueous solution than did SD rats, and in them no hypothalamic lesions were observed. That SD rats and golden hamsters, which are susceptible to hypothalamic lesions from the parenteral administration of high doses of MSG, did not develop lesions following the voluntary intake of MSG in aqueous solution, even under conditions of severe thirst, is further evidence of the safety of MSG as a food ingredient. PMID- 6857717 TI - Loss of hepatic monooxygenase activities, glutathione, and 'green pigment' formation after the administration of vinyl-cyclooctane to mice. AB - Vinylcyclooctane, when administered to mice at 500 mg/kg, produced reduction of microsomal cytochrome P-450, heme, aminopyrine-N-demethylase and ethoxycoumarin-O deethylase activities with respect to control values; furthermore the hepatic reduced glutathione level was depleted suggesting that glutathione is involved in the vinylcyclooctane metabolism. The reduction of cytochrome P-450 and monooxygenase activities was accompanied by the formation of abnormal 'green pigments'. PMID- 6857723 TI - Placental transfer of the major caffeine metabolite in the rat using 6-amino-5[N formylmethylamino]1,3[Me-14C]-dimethyluracil administered orally or intravenously to the pregnant rat. AB - 6-Amino-5[N-formylmethylamino]1,3[Me-14C]dimethyluracil (1,3,7-DAU), the most important caffeine metabolite in the rat and a minor one in man was synthesized and administered p.o. or i.v. to pregnant rats. This study demonstrates the distribution of this metabolite in the animal and its transfer to the embryos and the fetus. The fetus was shown to be protected by a placental barrier which leads to a lower fetal tissue exposure 1 h after the administration, the equilibrium between fetus and pregnant rat being reached 4-5 h later. Future studies testing the fetotoxicity of this metabolite compared with caffeine must take into consideration that only about half of the oral dose is absorbed. In addition, similar fetal tissue exposure must be obtained when this metabolite is given orally or is produced from caffeine. PMID- 6857721 TI - Intraluminal hexadecane enhances large intestinal excretion of tissue hexachlorobenzene in rats. AB - In young adult female rats with a cecal stoma, administration of hexadecane into the stomach (750 or 500 mg) and into the ligated colon (250 mg) enhanced 2- to 3 fold the intestinal excretion of [14C]hexachlorobenzene. Apparent sites of increased transferral from the blood into luminal contents were (caudal) ileum, cecum and colon. Presence of nonabsorbed hexadecane in luminal contents seems to be a prerequisite for the effect. Results support previous reports that enhancement of intestinal excretion of lipophilic chemicals by liquid paraffins takes place in the large intestine. PMID- 6857724 TI - Acetone-induced potentiation of trihalomethane toxicity in male rats. AB - The acute hepato- and nephrotoxic potentials of two trihalomethane water contaminants, bromodichloromethane (BrCHCl2) and dibromochloromethane (Br2CHCl), were determined in male Sprague-Dawley rats. Br2CHCl possessed a greater hepatotoxic and lethal potential than BrCHCl2. However, both Br2CHCl and BrCHCl2 were weak hepatotoxicants as compared to a related trihalomethane, CHCl3. Br2CHCl and BrCHCl2 did not produce liver injury until near-lethal dosages were administered. Neither trihalomethane appeared to produce appreciable kidney injury during the 24-h challenge period. Pretreatment of rats with acetone (15 mmol/kg, p.o.) markedly potentiated the hepatotoxic response to BrCHCl2 and Br2CHCl. The potentiated response observed with acetone plus BrCHCl2 or Br2CHCl was equal to or greater than that observed with acetone plus an approximately equimolar dosage of CHCl3. That is, acetone appeared to convert these weak hepatotoxicants into strong hepatotoxicants. PMID- 6857725 TI - Relationship between the carbon skeleton length of ketonic solvents and potentiation of chloroform-induced hepatotoxicity in rats. AB - Previous studies have suggested that ketonic solvents potentiate the hepatotoxic action of CHCl3 in rats. In addition, the relative potentiating capacity of the ketones appeared to be related to the length of their carbon skeleton. To test this hypothesis CHCl3-induced liver injury was evaluated in male Sprague-Dawley rats pretreated (15 mmol/kg, p.o.) with acetone (Ac), 2-butanone (Bu), 2 pentanone (Pn), 2-hexanone (Hx) or 2-heptanone (Hp). After 18 h, a challenging dose of CHCl3, (0.50 or 0.75 ml/kg, i.p.) was given. Liver damage was evaluated 24 h after CHCl3 administration by determining elevations in plasma GPT and OCT activity. Neither Ac, Bu, Pn, Hx, Hp or the CHCl3 challenging dosages produced marked liver injury when given alone. However, each of the ketones potentiated CHCl3-induced liver damage. The severity of the potentiated hepatotoxic response was significantly (positively) correlated with the ketone carbon chain length. These observations suggest that carbon skeleton length may play a role in determining the relative potentiating capacity of ketonic solvents. PMID- 6857727 TI - Effects of gliadin-derived peptides from bread and durum wheats on in vitro cultures of human cell lines. Implications for coeliac disease pathogenesis. AB - A peptic-tryptic-cotazym digest, obtained from bread (hexaploid) wheat gliadins under experimental conditions mimicking in vivo protein digestion, was found to reduce in vitro viability of human embryo (MRC-5) and tumor cell (Hep-2) lines. Time of onset and extent of cytotoxic effects were largely dependent on initial peptide concentrations in the culture medium. The presence of 2% fetal calf serum was capable of delaying, but not of preventing, the onset of cytotoxic effects only in MRC-5 cultures. A peptic-tryptic-cotazim digest obtained from durum (tetraploid) wheat gliadins and tested under identical conditions did not show any cytotoxic activity on MRC-5 and Hep-2 cell lines. These results indicate that cell systems are useful to investigate pathogenetic mechanisms of coeliac disease (gluten-dependent enteropathy). PMID- 6857726 TI - Effect of organo-tellurium compounds on the enzymatic alterations in rats. AB - An attempt has been made to correlate early toxicity of organo-tellurium (Te) compounds with enzymic alterations in liver, kidney, brain and serum at 1 and 3 days following single i.p. injections of bis-(tetraphenyl phosphonium) tetracyanato-bis-p-methoxy p-phenyl tellurate(IV) (TTMT) and bis-(tetraheptyl ammonium) tetraiodocyclopentane tellurate(IV) (TACT). These compounds, at 2 and 1 mg Te/kg body weight as TTMT and TACT, respectively, produced cholinergic signs and caused death within 3 days. Administration at maximum tolerable doses of 0.5 mg and 0.1 mg Te/kg body weight as TTMT and TACT, respectively, resulted in significant reduction of acetylcholine esterase (AChE) and monoamine oxidase (MAO) in serum and brain and by a significant decrease in hepatic glutathione and in glutathione-S-transferase (GST) and alkaline phosphatase in liver and kidney. PMID- 6857728 TI - Comparative study of rat, dog and human liver microsomal arylamide N hydroxylases. AB - As compared to rat liver microsomal arylamide N-hydroxylase both the dog and the human enzymes have lower affinity but higher activity. SKF525A, a well known effector of cytochrome P-450 dependent mixed function oxidases, activates the hepatic N-hydroxylase of all three species. This effect is concentration dependent and tends to plateau at 50 X 10(-6)M. As previously demonstrated with rat liver microsomes, the ring-hydroxylated, non-toxic, metabolites of 2 acetylaminofluorene, interact with the N-hydroxylating enzyme. These interactions are both compound- and species-specific. The most striking differences are seen with the paraphenolic product which activates the rat, does not affect the dog and inhibits the human liver enzyme. In the liver of this last species, that compound is the main metabolite of 2-acetylaminofluorene (2-AAF). PMID- 6857729 TI - Acute and subacute toxicity of piperine in mice, rats and hamsters. AB - Piperine is acutely toxic to mice, rats and hamsters. The LD50 values for a single i.v., i.p., s.c., i.g. and i.m. administration of piperine to adult male mice were 15.1, 43, 200, 330 and 400 mg/kg body wt, respectively. The i.p. LD50 value was increased to 60 mg/kg body wt in adult female and 132 mg/kg body wt in weanling male mice. In adult female rats, the i.p. LD50 value was 33.5 mg/kg body wt whereas the i.g. LD50 value was increased to 514 mg/kg body wt. Most animals given a lethal dose died of respiratory paralysis within 3-17 min. In subacute toxicity studies, the rats died within 1-3 days after treatment. Histopathologic changes included severe hemorrhagic necrosis and edema in gastrointestinal tract, urinary bladder and adrenal glands. Death of these animals may be attributable to multiple dysfunctions in their organs. PMID- 6857730 TI - [Pathology of ovarian cancer]. AB - With respect to their pathomorphology, the ovarian tumors form a large scale of histogenetically different types presenting considerable variations in their biologic behavior and responsiveness to radiologic and cytostatic therapy. The WHO classification contains eight major groups of malignant tumors. About 70% of them are common epithelial tumors. These tumors are the prototype of the ovarian cancer. Progress in early diagnosis can be expected because of recent developments in medical technology. Imageproducing physical methods like ultrasonography and computed tomography are more and more applied in order to obtain an exact preoperative diagnosis and for posttherapeutic check-up. A detailed knowledge of the tumor morphology is necessary for the application of these methods. Due to the multitude of different tumor types, ovarian tumors are paradigmatic for a selective tumor therapy. This is only possible after pretherapeutic differentiated histologic clarification. PMID- 6857732 TI - [Analysis of morbidity from simultaneous 5-fluorouracil therapy and radiation therapy in advanced gastrointestinal tumors. Report of results]. AB - Simultaneous application of 5-fluorouracil and radiotherapy is generally accepted in the treatment of gastrointestinal tumours. However, in 10 patients with metastatic gastrointestinal tumours we observed intolerable toxicity during this combined treatment regimen. Because of gastrointestinal and haematological toxicity the combined modality was interrupted in all patients. Given sequentially, this regimen was tolerated. Our experience indicates that an intolerable high rate of toxicity has to be taken into consideration in case of the simultaneous combination of 5-fluorouracil and radiotherapy. PMID- 6857731 TI - Computed tomography measurements of the cervix and distances to the bladder and rectum in intracavitary radiation treatment of gynaecological cancer. AB - Improved knowledge of the topography of target and adjacent organs in intracavitary irradiation of gynaecological tumours is needed when a high dose rate afterloading system with good precision is used. To get this information, 16 patients with small carcinomas were examined by computed tomography scan with applicators inserted. The thickness of the vesico and rectovaginal septa was measured. In the ten cervical carcinomas the minimum thickness was 4 mm. In the six early corpus carcinomas the vesicovaginal septum thickness was 7 to 9 mm while the rectovaginal septum thickness was 5 to 7 mm. Measurement of the cervical diameter seems to be valuable and can give information about suitable intracavitary target dimensions. In this way overtreatment of the bladder and rectum can be avoided and a more precise dose can be delivered to the entire target volume. PMID- 6857733 TI - [Vertebral changes following irradiation of an esophageal cancer]. PMID- 6857734 TI - Adult intraventricular craniopharyngioma. AB - A case of craniopharyngioma with unusual location confined within the third ventricle is reported. The 56 years old adult presented with symptoms and signs of increased intracranial pressure. There were no characteristic findings of craniopharyngioma in X-ray examinations, but computed tomography scan showed a mass lesion in the third ventricle. Literature survey revealed nine cases of craniopharyngioma developed solely within the third ventricle. PMID- 6857735 TI - [Value of posttherapeutic scintigraphy for the demonstration of distant metastases of differentiated carcinomas of the thyroid gland]. AB - The value of posttherapeutic scintigraphy performed at discharge with the remaining radioactivity after an ablative radio-iodine therapy was studied in 190 patients with differentiated carcinomas of the thyroid gland (54% papillary and 46% follicular carcinomas). 163 patients (86%) had no signs of disease. 33 patients had distant metastases. In six out of them, the examination method allowed a first demonstration of metastases. In seven further cases, additional, hitherto unknown foci were found. There was a specificity of 100% and a sensitivity of 82% (no false positive findings, six false negative findings). Further to the usual image-producing examination methods (native X-ray diagnosis, sonography and CT), posttherapeutic scintigraphy furnishes early information about the formation of distant metastases. Therefore it is helpful to indicate a regional percutaneous X-ray therapy and to assess the prognosis. PMID- 6857737 TI - [Reduction of the radiogenic tumor incidence by stimulation with lyophilized fetal cells. Experimentation on animals]. AB - The effect of an immunization treatment with lyophilized xenogenic fetal cells was studied in 7 months old, female albino rats (strain Wistar). The tumor incidence was measured after a sublethal whole-body irradiation with 600 cGy. Furthermore, the spleen of the individual animals was histologically examined. 3,5 to 6 months after a whole-body irradiation with 600 cGy, the tumor incidence was 55%. The tumors found were tubular adenocarcinomas of the thyroid gland. A significant reduction of the tumor incidence can be achieved by an immunostimulation with xenogenic, lyophilized, fetal cells (connective tissue and bone marrow, respectively) administered twice, namely eight days before and four days after the whole-body irradiation. The tumor incidence measured after 3,5 months was 10% and 15%, respectively, and after 6 months 15% and 25%, respectively. No significant tumor protection is achieved, however, by a single stimulation before whole-body irradiation and by a stimulation performed one or two times after whole-body irradiation. Histologic examinations of the spleen show in the immunostimulized animals a strong regeneration of the immune system with a significantly increased number of follicles and a significant increase of lymphocytes in the red pulp. The authors stress the possible clinical importance for radio-oncology of an immunostimulation with lyophilized, xenogenic, fetal cells. PMID- 6857738 TI - Radioresponse of fetal testes of mice and its modification by MPG (2 mercaptopropionylglycine). AB - Radiosensitivity of the primordial germ cells and its protection was estimated from the surviving number of spermatids in the 6 weeks old testes of control and MPG-pretreated mice after intrauterine exposure to 0.5, 1.5 and 2.5 Gy60Co gamma rays during fetal growth period. Radiosensitivity of fetal testes was found to increase with the advent of embryonic age. Quantitatively, significant protection in testes weight and spermatids count was registered in the MPG-pretreated animals at all the 3 dose levels studied. PMID- 6857739 TI - Temporal and dose characteristics of nucleic acids reduction in the leucocytes of irradiated mice. AB - The kinetics of the changes of the nucleic acids level in the leucocytes of mice, as well as the leucocyte count were traced over a 30 day period, after a 2 Gy gamma irradiation. The changes of these parameters, which are dose-bound, were examined at the 24th and 72nd hour after irradiation with doses, belonging to the 0,1 to 6,0 Gy dose range. During the progress of the radiation damage the changes in the nucleic acids show a phase character that reaches its minimum on day 3 postradiation, with a recovery about day 30. The relation nucleic acids level/radiation dose is described with a logarithmic function. With both time intervals the nucleic acids level decreases with the logarithm of the dose, the reduction in the nucleic acids concentration being more clearly marked on day 3 postradiation. The rate of the nucleic acids level change is not adequate to that of the leucocyte count. PMID- 6857740 TI - [Pre- and postoperative irradiation of the mammary carcinoma]. AB - There are different indications for the pre-, per- and postoperative treatment of mammary carcinomas with certain or doubtful operability. Based on clinical examinations, the clinical effect of pre- and postoperative irradiation on the incidence of loco-regional recurrences and distant metastases is explained. The resulting therapy suggestions are discussed. Instead of radical surgery or modified radical surgery in case of subclinical and little carcinomas less than 3 cm, a simple ablation of the tumor with adequate subsequent irradiation is recommended. The therapy results of conservative treatments published hitherto are presented. PMID- 6857736 TI - [Fractionated irradiations of the normal rabbit lung with fast neutrons or photons]. AB - 115 rabbits were irradiated with our usual fractionation scheme, and the dose effect curves for fast neutrons and photons (60Co) were determined with respect to pneumonitis and pulmonary fibrosis, respectively. On comparison of the radiogenic alterations three months after therapy, the relative biological effectiveness calculated by means of these dose effect curves was 2,9 for the fast neutrons. Furthermore, the authors tested the conformity of some clinical examination methods such as X-ray, scintigraphy and computed tomography with histological findings of pneumonitis and pulmonary fibrosis, respectively. In this regard, computed tomography was superior to the other examination methods. PMID- 6857741 TI - [Late mucous membrane changes following exclusive radiotherapy of malignant epipharynx tumors]. AB - Long-term modifications of the mucous membrane after exclusive radiotherapy of malignant tumors are of great interest. Sixteen patients with malignant tumors of the epipharynx could be checked up after exclusive radiotherapy. The treatment had been passed for more than five years. The examinations showed that the essential troubles, i.e. the general xerostomia was due to long-term modifications of the mucous membrane in the nose and epipharynx. The endoscopic findings and the results of histological examination of tissue specimens are reported, compared to the indications of literature, and discussed. PMID- 6857743 TI - [Cytologic endometrial changes following high-dose iridium-192 radiation]. AB - By intrauterine exfoliative smear performed twice in each of seventeen patients, the cytomorphologic effect of an iridium-192 after-loading irradiation was demonstrated. The examinations showed that the cytologic findings were characteristic of the effect of ionizing radiation even in case of the histologically unchanged, not radiosensitive cylindrical epithelium. After the iridium irradiation of malignantly transformed cells of the cylindrical epithelium with 1000 rd, vacuolation and pseudoeosinophilia were the predominant lesions, while after 2000 rd this was above all the presence of macronucleoli. A marked cellular diathesis is a characteristic result of the irradiation with iridium-192. Although hyperchromasia is not an absolute sign of malignancy in case of the adenocarcinoma, it should be mentioned that chromatin concentrations are scarcely found after irradiation. PMID- 6857742 TI - [Results of radiotherapy in case of juvenile xanthogranuloma of the iris]. AB - The juvenile xanthogranuloma is a rare, benign, cutaneous disease occurring in infants and young children which can be situated in about 10% of the cases on the eye and preferentially on the iris. The reason for consulting an ophthalmologist is mostly a recurrent unilateral hyphemia which is typical for this disease. The diagnosis of the juvenile xanthogranuloma has to be established clinically, based on the characteristic alterations of the iris--heterochromia, vascularized tumor or diffuse thickening of the iris--and the possibly increased intraocular pressure. In order to avoid the deleting consequences of an uncontrollable secondary glaucoma, radiotherapy with a total dose of 300 to 400 cGy combined with a mild local steroid treatment has to be undertaken immediately, if possible. Taking into consideration the indications of literature, the value of a low-dose radiotherapy for this disease shall be demonstrated by five own cases in all of which the concerned eye could be healed and preserved. PMID- 6857747 TI - Technical basis for the application of localized hyperthermia. AB - Techniques of localized hyperthermia have been developed these last years. Very superficial tumors may be heated by infra-red radiation, radiative diathermy at high frequencies (2450 MHz) or even by techniques of contact hyperthermia. Superficial tumors (some cm deep) may be heated by radiative diathermy at lower frequencies (434 MHz or 915 MHz), inductive diathermy or ultrasound. Deeper tumors (about 10 cm deep) are the most problematic. They may be heated by capacitive diathermy at frequencies of 13.5 or 27 MHz under favourable conditions, or perhaps by ultrasound when multiple transducers are used. Hyperthermic extracorporeal perfusion (in limbs) and interstitial hyperthermia are efficient and promising techniques but their indications are limited. PMID- 6857749 TI - Intravesical instillation of formalin and its complications. PMID- 6857744 TI - Radiation effects on submandibular gland of the rat. Stereological and ultrastructural study. AB - The chronic effect of 2000 rd (20 Gy) of X-rays locally applied to the submandibular gland of Wistar young-adult male rats, was studied by stereology, and light and electron microscopic observations. They demonstrated that degenerative changes were observed during the first months after irradiation. Atrophic processes developed from 6 months onwards. In the acinar compartment, atrophy was progressive from the first months post-irradiation up to 9 months post-irradiation. Ductal cell membranes and mitochondrial damage were clearly detected at ultrastructural level. Nuclear fragmentation and secretory granules alterations were also frequently seen in the acinar compartment. PMID- 6857748 TI - [Weekly control measurement at the linear accelerator]. AB - Weekly control measurements taken at the linear accelerator of the Medizinisches Strahleninstitut der Universitat Tubingen are described which largely exceed those prescribed by the "Richtlinien Strahlenschutz in der Medizin" (instructions about radioprotection in medicine). Since the determination of the field homogeneity and the energy of electron and X-ray radiation is very time consuming, a largely automatized procedure has been elaborated which is presented in this study. PMID- 6857746 TI - [Comparison of different methods for the determination of the energy dose distribution of enclosed Cs-137 afterloading sources]. AB - A low-dose afterloading unit of the type "Curitron" with Cs-137 sources is available at the Radiologic Hospital of the Karl-Franzens-Universitat of Graz. The available sources are between 4.2 cm and 9.1 cm long. The corresponding activities of the individual sources are at present between 117 mCi and 383 mCi. The energy dose distributions around the sources were measured by means of an automatic dose measuring equipment and an additionally developed water phantom. Based on the measurement results, three rapid algorithms were developed and introduced as program modules into the existing therapy planning system which is running under RSX in a minicomputer of the type PDP 11/34. These algorithms are compared with regard to their precision and calculating speed, and the results are presented in form of energy dose distributions. PMID- 6857745 TI - [Therapeutic effect of fetal mesenchyma in acute radiation disease of mice]. AB - The effects of an intramuscular application of fetal mesenchym (Resistocell) in mice with acute radiation injury was investigated. A single dose of 80 mg/kg body weight one day after radiation exposure (LD70/30, 635 cGy) showed significant therapeutic effects. Further experiments are recommended in order to improve and explain the reported results. PMID- 6857751 TI - A non-surgical technique for the transcervical administration of physiological and pharmacological agents into rat uteri. AB - A technique for the instillation of solutions into the rat uterine lumen is described. The method has been tested by following the receptor depletion/replenishment cycle after oestradiol injection and by checking on the stoichiometry of hormone/receptor translocation from the cytoplasmic compartment into the nucleus. Both crude sediments from frozen uteri and nuclei purified by a novel procedure were analyzed and gave identical results. The limitations and the advantages of the technique are discussed. PMID- 6857750 TI - Characterization of estradiol receptors in brain cytosols from perinatal ferrets. AB - Studies were undertaken to characterize the binding of [3H]estradiol ([3H]E2) to blood plasma and to brain cytosols collected from perinatal ferrets of both sexes. A dialysis experiment showed that the binding capacity of plasma for [3H]E2 was low in neonatal ferrets. Saturable, high-affinity binding of [3H]E2 to cytosols prepared from ferret hypothalamus + preoptic area (H + POA), basal temporal lobe, and midbrain + brainstem (sexes pooled) was demonstrated 5 days prior to the date of expected parturition (42-day gestation), as well as on the day of birth and on postnatal days 5 and 10. The binding of E2 to cytosols prepared from H + POA and temporal lobe of newborn ferrets met established criteria for estrogen receptors: (a) it was saturable; (b) it had a high affinity (Kd approximately 10(-10) M); (c) it was apparently macromolecular since it migrated in front of a 4.7 S dansyl-bovine serum albumin marker on sucrose gradients of low ionic strength and eluted in the void volume of Sephadex LH-20 columns; (d) it was apparently proteinaceous since binding was destroyed by preincubation with pronase; and (e) it was steroid-specific. Previous research suggests that perinatal exposure to E2 causes neither behavioral defeminization nor masculinization in the developing ferret. The present findings raise the question of whether estrogens, acting via neural receptors, normally affect brain development in ferrets of either sex. PMID- 6857753 TI - Synthesis of 2'(3')-O-DL-alanyl hexainosinic acid using T4 RNA ligase: suppression of the enzymic reverse transfer reaction by alkaline phosphatase. AB - 2'(3')-O-DL-Alanyl (Ip)5I was synthesized by a new method. An alanine ortho ester of inosine 5'-phosphate was added to (Ip)4I using the ATP-independent reaction of T4 RNA ligase, and the product was converted smoothly to the desired ester. The enzymic reverse transfer reaction was conveniently suppressed by the dephosphorylation of the adenosine 5'-phosphate coproduct, catalyzed in situ by alkaline phosphatase. PMID- 6857752 TI - Inhibition by a 4-methyl-4-aza-steroid of NADPH: delta 4-3-oxosteroid-5 alpha oxido-reductase activity in cultured interstitial cells derived from immature rat testis. AB - Prepubertal rat testes have high 5 alpha-reductase (delta 4-3-oxosteroid 5 alpha oxidoreductase) activity and secrete various 5 alpha-reduced androgens. We demonstrate that Na-4-methyl-4-aza-3-oxo-5 alpha-pregnane-20 (S)-carboxylate, a potent inhibitor of the prostatic 5 alpha-reductase, competitively inhibits the microsomal 5 alpha-reductase of rat testis. The apparent Ki for testosterone is 3.5 nM. At a concentration of 5 X 10(-7) M this compound efficiently inhibits the 5 alpha-reductase in cultured interstitial cells derived from prepubertal rats. Testosterone and 4-androstene-3,17-dione are the major androgens produced by these cells in the presence of inhibitor. It is concluded that 4-methyl-4-aza steroids are a useful tool in the study of steroid secretion by prepubertal Leydig cells. PMID- 6857755 TI - A sensitive assay of sialidase activity with fluorogenic oligosaccharide derivatives. AB - Fluorogenic oligosaccharide derivatives, lactityl-aminopyridine and sialyllactityl-aminopyridines, were synthesized by reductive amination of lactose and sialyllactose with 2-aminopyridine in the presence of sodium cyanoborohydride. Lactityl-aminopyridine showed bluish-white fluorescence at 390 nm by excitation with ultraviolet light at 320 nm, and the intensity of the fluorescence was proportional to the concentration of lactityl-aminopyridine within a range from 20 to 9800 pmole/ml. Two isomers of sialyllactityl aminopyridine were enzymatically hydrolyzed to sialic acid and lactityl aminopyridine by the action of both microbial and mammalian sialidases, and their suitability as substrates for sialidase was investigated. The result showed that sialidase activity was determined with about 55-fold higher sensitivity than that of ordinarily used colorimetric methods. PMID- 6857754 TI - Role of the 1-amino group in aminocyclitol antibiotics: synthesis of 1 deaminogentamicin C2. AB - The synthesis of 1-deaminogentamicin C2 described here, uses 3,2',6',3"-tetrakis N-tert-butoxycarbonylgentamicin C2 (2) as intermediate. N-Formylation of 2 followed by per-O-acetylation and dehydration furnished the isocyanide 5. Radical induced deamination of the latter using tri-n-butylstannane and removal of the protecting groups afforded the target 1-deaminogentamicin C2 (7). Its in vitro antibacterial activity is less than that of the parent gentamicin C2. The behaviour of 7 towards aminoglycoside-inactivating enzymes was also examined; interestingly, it was found to be neither substrate nor inhibitor for such enzymes. These results strongly suggest that the substitution pattern of the 1 position determines the biological properties of the aminoglycoside antibiotics. PMID- 6857757 TI - Hemoglobin Rio Grande [beta 8 (A5) Lys leads to Thr] a new variant found in a Mexican-American family. PMID- 6857758 TI - [Side effects of anthralin and its 2 main impurities on healthy skin]. AB - In 20 volunteers, we were able to demonstrate experimentally that side-effects of anthralin application on healthy skin development of erythema and pigmentation, can be significantly reduced in a short contact therapy, in comparison to a longterm treatment. The oxydation products 1.8-dihydroxy-9.10-anthraquinone and 10.10'-dimer which are considered the main impurities of anthralin do not cause any irritation on healthy skin. PMID- 6857756 TI - Comparative study of central dopaminergic properties of RU 29717 (N-propyl-9 oxaergoline) and pergolide. AB - RU 29717, a 9-oxaergoline derivative, has been compared with pergolide in a variety of biochemical and behavioural tests indicative of dopaminergic (DAergic) activity. RU 29717 and pergolide have a similar affinity for DA receptors labelled by [3H]spiroperidol or [3H]dihydroergocryptine ( [3H]DHEC) by using striatal or anterior pituitary membranes respectively. Both compounds stimulate the striatal DA-sensitive adenylate cyclase and inhibit the activity of this enzyme in dispersed cells from the neurointermediate lobe of the pituitary gland. In anterior pituitary cells in primary culture, they decrease prolactin release with the same efficacy. In vivo, they exert a long-lasting inhibition of the reserpine-induced hyperprolactinemia. They equally retard the alpha-MPT-induced disappearance of striatal DA and increase striatal acetylcholine levels. In behavioural models, the similarity between RU 29717 and pergolide is also evident: they induce contralateral circling in animals lesioned unilaterally with 6-OHDA, produce stereotyped behaviour and have emetic activity within the same dose range. Therefore, RU 29717, like pergolide, is a potent direct acting DAergic agonist. In experimental models used to investigate this activity at the striatal or the anterior pituitary levels the compounds present a similar profile of action. PMID- 6857759 TI - Synthesis of two photoreactive heterobifunctional reagents derived from hexanoic acid. AB - The synthesis of two photoreactive heterobifunctional reagents derived from hexanoic acid is described. The compounds are succinimido 6-N-(4 azidobenzoyl)aminohexanoate (1c) and succinimido 6-mercapto-S-(4 azidothiophenyl)hexanoate (2c). Compound 1c was synthesized from benzyloxycarbonyl 4-aminobenzoic acid and 6-aminohexanoic acid benzyl ester. Compound 2c was obtained by disulfide exchange of dithiobis-4-aminobenzene with 6 mercaptohexanoic acid. The azido function was introduced by displacement of the corresponding diazonium salt and the active ester, by the mixed anhydride method. Both compounds were decomposed by ultraviolet irradiation. Phytohemagglutinin was modified by reaction with reagent 1c or 2c. Irradiation afforded polymeric lectin derivatives resulting from intermolecular cross-linking. Sodium dodecyl sulfate- polyacrylamide gel electrophoresis analyses revealed the presence of Coomasie positive bands of molecular weight 33000, 67000, 120000, 144000, and higher. Polymeric structures resulting from irradiation of phytohemagglutinin modified with compound 2c were cleaved by reduction with 2-mercaptoethanol or with dithiothreitol. Phytohemagglutinin modified by reaction with compound 1c or 2c retained its ability to stimulate pig spleen lymphocytes in vitro. Whereas the lectin treated with reagent 2c was active as the unmodified protein, the lectin treated with compound 1c was more active than unmodified lectin at nearly all the concentrations tested. PMID- 6857760 TI - Capillartemisin A and B, two new choleretic principles from Artemisiae Capillaris Herba. PMID- 6857762 TI - New metabolites of riboflavin appear in human urine. AB - By surveying compounds having isoalloxazine derived from flavins on a high performance liquid chromatogram with fluorescence detection, two new flavin derivatives were found in human urine. These two compounds were purified by partition chromatography on a cellulose column and by paper chromatography with several solvent systems, and their structures were determined to be 7 alpha hydroxyriboflavin and 8 alpha-hydroxyriboflavin. The relative distributions, measured by high performance liquid chromatography, of 7 alpha- and 8 alpha hydroxyriboflavin, riboflavin, and hydroxyethylflavin and its derivative were calculated to be 31.1, 5.0, 25.6, 4.9, and 21.9%, respectively, to total flavins in normal human urine obtained in early morning. The excretion of 7 alpha- and 8 alpha-hydroxyriboflavin in human urine indicates the occurrence of a metabolic pathway of the isoalloxazine ring of flavin at its 7 alpha and 8 alpha positions. PMID- 6857761 TI - Isolation and amino acid compositions of geographutoxin I and II from the marine snail Conus geographus. AB - The peptide toxins having inhibitory effects on the contractile response of the mouse diaphragm to direct stimulation, geographutoxin I and II, have been isolated from Conus geographus, and their amino acid compositions have been determined. PMID- 6857763 TI - Basement membrane changes in human breast tissue in explant culture: a morphometric and ultrastructural study. AB - Basement membrane has been studied in vitro using human mammary lobules maintained in explant culture for periods up to 4 weeks. Morphologic similarities with basal lamina in malignant tumors in vivo have been observed, such as decrease in numbers of hemidesmosomes as determined by morphometry, reduplication and multilayering of the basal lamina, and failure to produce basal lamina after migration to the surface of the explant. Light microscopy using special stains for basement membrane has shown increasing fragmentation and loss with time in culture. These findings suggest that basement membrane changes seen in malignant tumors in vivo may not be limited to malignancy, per se, but may also be the result of other conditions. PMID- 6857765 TI - Juvenile aponeurotic fibroma: an ultrastructural study. AB - The light and electron microscopic findings in a case of juvenile aponeurotic fibroma are described. The tumor was composed of fibromatosislike areas and cartilagelike islands with characteristic calcification. The ultrastructural study verified the cartilaginous nature of this tumor. The cartilagelike islands were made up of chondrocytic cells embedded in an abundant intercellular matrix containing fine fibrils, spherical granules, and pleomorphic membrane-bound vesicles. The chondrocytic cells had many microvilli, a well-developed granular endoplasmic reticulum, and a prominent Golgi complex. In the periphery of each cartilagelike island was a perichondriumlike structure exhibiting transitional features from fibroblastic cells to chondrocytic cells. The fibromatosislike areas consisted of spindle-shaped fibroblastic cells and occasional myofibroblasts. The morphologic pattern of the tumor somewhat mimics embryonal chondrogenesis, and the fibromatosislike areas may represent an overgrowth of the fibrous layer of the perichondrium. It is possible to regard this tumor as an organoid tumor having a capacity for bidirectional differentiation into cartilage and fibrous tissue. PMID- 6857764 TI - Carcinoidal tumor of the kidney. AB - Two cases of primary renal carcinoidal tumor are reported. One was discovered in a 32-year-old pregnant woman. The other tumor was retrospectively diagnosed 3 years after nephrectomy in a 65-year-old woman who was hospitalized with a metastatic lesion in her lumbar spine. Both tumors are compared with 5 other cases previously reported in the literature, and hypotheses about the cause of renal localization of this tumor are reviewed. PMID- 6857766 TI - Effect of IgA deposits on the glomerular mesangium in Berger's disease. AB - In mesangial IgA glomerulonephritis (Berger's disease), the immunoproteins appeared to gain access from the capillary lumen to the mesangium via endothelial fenestrae or via channels between the endothelial cells. The deposits are transported into the deeper mesangium by a process of inhibition or diffusion, with the matrix acting as the head. There are no true channels or grooves in the mesangial matrix for the transport of the immunoproteins. The contractility of the glomerular myoid fibrils may account for the movement of deposits to the hilus for possible removal. There was partial dissolution of the deposits in the mesangial matrix accompanied by loosening of the matrix. No evidence was found for any significant intracellular phagocytosis and digestion. The mesangial deposits directly or indirectly stimulated the cellular hypertrophy and hyperplasia and increased deposition of mesangial matrix. This was accompanied by formation of collagen fibrils within the thickened matrix and led to atrophy of the mesangial cells and sclerosis of the glomeruli. PMID- 6857767 TI - Electron micrographs in five minutes. PMID- 6857768 TI - [Preoperative localization of parathyroid tumors]. PMID- 6857769 TI - [Asthma and allergic rhinitis in general practice in Denmark. Prevalence and incidence of contacts]. PMID- 6857770 TI - [Stricture of the urethra treated by internal urethrotomy using the Sachse method]. PMID- 6857771 TI - [Results of urethroplasty for stricture]. PMID- 6857774 TI - [Dosage of intravenous theophyllamine]. PMID- 6857773 TI - [Successful drug therapy with methylxanthines in bronchial asthma]. PMID- 6857772 TI - [Legionnaires' disease complicated by acute renal failure]. PMID- 6857778 TI - [Neonatal polycythemia]. PMID- 6857776 TI - [Cancer incidence in Denmark 1973-1977. Cancer statistics 5]. PMID- 6857775 TI - [Psychiatric and sexual problems in adult women resulting from sexual abuse in childhood]. PMID- 6857779 TI - [Artificial intra-ocular lenses]. PMID- 6857777 TI - [Legionella infections in Denmark. Results of serological studies lasting 3 1/2 years]. PMID- 6857780 TI - [Correction possibilities following operation for cataract in the elderly]. PMID- 6857783 TI - [The bacterial contamination of the air in an orthopedic operating room before and after laminar air flow. A comparative study in relation to total hip alloplasty]. PMID- 6857782 TI - [Absorption of theophylline from an aminophylline mixture]. PMID- 6857781 TI - [92 implants of Worst medallion lenses in cataract operations]. PMID- 6857784 TI - [Etomidate (Hypnomidat). A new intravenous anesthetic]. PMID- 6857785 TI - [Mental retardation among Greenlanders]. PMID- 6857786 TI - [Diagnosis of incorrect nutrition in school children]. PMID- 6857787 TI - [Lithium clearance. A new method of measuring the output of water and sodium from the proximal kidney tubules]. PMID- 6857788 TI - [Q fever--a diagnostic possibility]. PMID- 6857789 TI - [Does the degree of reduction of gastric acid secretion change during cimetidine therapy of duodenal ulcer?]. PMID- 6857790 TI - [CT scanning of abdominal aortic aneurysms]. PMID- 6857791 TI - [Clostridium difficile in the feces in acute diarrhea, irritable colon and ulcerative colitis]. PMID- 6857792 TI - [Detailed mapping of vascular beds]. PMID- 6857793 TI - [Nail-gun accidents]. PMID- 6857794 TI - [The subclavian steal syndrome or arterial steal--a variant]. PMID- 6857795 TI - [Giant mucocele in the frontal sinus]. PMID- 6857797 TI - [Bilateral agenesis of the seminal vesicles, vas deferens and epididymis demonstrated by chemical sperm analysis]. PMID- 6857796 TI - [Aspiration of a foreign body into the trachea]. PMID- 6857799 TI - [Activity in the hospital service in 1981]. PMID- 6857798 TI - [What do we know about oral occupational diseases?]. PMID- 6857800 TI - [Psoradrate (dithranol) cream]. PMID- 6857801 TI - [Tasks and results of rehabilitation clinics under the Danish public health law]. PMID- 6857802 TI - [Social medicine as an academic discipline. Discussion of theory and methods]. PMID- 6857804 TI - [The significance of tobacco smoking for asthma and rhinitis]. PMID- 6857805 TI - [An individual computer-based index file for scientific literature]. PMID- 6857803 TI - [Exceptional people and exceptional eye diseases. Their significance for pediatric and social ophthalmology]. PMID- 6857806 TI - [What should be done for relatively young hyperlipidemic patients following myocardial infarction?]. PMID- 6857807 TI - [Impacted subcapital femoral neck fractures]. PMID- 6857808 TI - [Injuries of the knee ligaments. A prospective and gonylaxometric study of 100 patients]. PMID- 6857811 TI - [Stress fractures at the distal end of the fibula]. PMID- 6857809 TI - [Isolated paralysis of the serratus anterior muscle treated surgically]. PMID- 6857810 TI - [Sucking marks in a newborn infant]. PMID- 6857812 TI - [Granulomatous prostatitis. Differential diagnosis from cancer of the prostate]. PMID- 6857813 TI - [Acute interstitial nephritis following trimethoprim therapy]. PMID- 6857816 TI - [Subcutaneous blood flow in pressure areas while lying on water beds]. PMID- 6857817 TI - [Condition of 89 newborn infants of drug-addicted mothers]. PMID- 6857815 TI - [Subcutaneous blood flow in pressure areas while lying on an antidecubitus air mattress]. PMID- 6857814 TI - [Disseminated intravascular coagulation and rupture of the splenic vein following hysterotomy]. PMID- 6857820 TI - [Allergic alveolitis precipitated by microorganisms in the home environment]. PMID- 6857819 TI - [Systemic lupus erythematosus with initial symptoms resembling hepatitis]. PMID- 6857818 TI - [The elongated styloid process syndrome (Eagle's syndrome)]. PMID- 6857821 TI - [Bilateral rupture of the quadriceps tendon]. PMID- 6857822 TI - [Acute abdomen caused by necrosis of the falciform ligament of the liver]. PMID- 6857823 TI - [Illness behavior in elderly persons. I. Decision to react to signs of illness]. PMID- 6857824 TI - [Alcohol--an underestimated factor in traffic accidents. Based on medico-legal examinations of traffic deaths]. PMID- 6857825 TI - [Metal sensitivity in orthopedic surgery]. PMID- 6857826 TI - [Intravesical chemotherapy in superficial tumors of the bladder]. PMID- 6857827 TI - [Severe eepistaxis. Incidence, etiology and treatment]. PMID- 6857828 TI - [The value of x-ray examination of the paranasal sinuses following epistaxis]. PMID- 6857829 TI - [Protruding ears. A follow-up study of 159 patients operated on by the Stenstom/Warrer method]. PMID- 6857830 TI - [Protruding ears. A retrospective study of 83 patients]. PMID- 6857831 TI - [Chronic suppurative hidradenitis of the genito-femoral region]. PMID- 6857832 TI - [Carpal tunnel syndrome. A follow-up study of 153 surgically treated patients]. PMID- 6857834 TI - [Lipomatous hypertrophy in the atrial septum]. PMID- 6857833 TI - [Loss of consciousness during underwater swimming preceded by hyperventilation]. PMID- 6857835 TI - [Appendectomy in cecal malrotation]. PMID- 6857836 TI - [Mild hypertension--when is it appropriate to treat?]. PMID- 6857837 TI - [Social service net work for the aged with dementia, living at home, and the risk of placing them into nursing homes]. PMID- 6857838 TI - [Illness behavior in the elderly. II. Self-treatment and seeking medical advice]. PMID- 6857840 TI - Calculations of acoustic scattering from ellipsoidal voids: bends, krill and fish. AB - The T-matrix approach is used to calculate the scattering of sound waves by an ellipsoidal void in a fluid. Results are presented for the total cross-section of a sphere as a function of frequency; this is related to the detection of the onset of bends in divers. Results are also presented for the angular variation in scattered amplitude when a plane wave is incident on an ellipsoidal cavity in water; this is related to the target strength of euphausiids and teleostean. It is concluded that the model is a useful representation of the scattering from such marine organisms. PMID- 6857841 TI - Ultrasonic equipment for the measurement of backfat on unshorn live sheep. AB - Because of the ease of application to the animal's exposed skin, the measurement by A-scan ultrasonics of backfat on pigs is an established technique; but difficulties are experienced with unshorn sheep because the fleece presents an obstacle, as a parting of the wool offers only a limited aperture for insonification of the subcutaneous tissues. Also, movement of the typical nervous sheep usually provides somewhat intermittent return echo signals, rendering difficult an otherwise simple measurement. The present instrument has overcome these problems by an accumulator-averaging technique, implemented by a microprocessor, allowing estimation of live backfat thickness to the nearest 0.5 mm. This paper describes the instrument function, and presents results of a series of experiments which examined the correlation with the carcass backfat thickness. PMID- 6857839 TI - [Deliveries and abortions 1977-1981]. PMID- 6857842 TI - [Value of natural science and technic in accident surgery]. PMID- 6857843 TI - [Traumatic bladder perforation in pelvic ring fracture. Case report with differential diagnostic aspects]. AB - In the context to multiple traumata, a 19-year-old man suffered an extraperitoneal bladder rupture due to perforation by a fractured pubic ramus. Because of a rapid shock-induced decrease of hematuria and the misinterpretation of a bruise on the right flank as a renal contusion, the clinical diagnosis was not established. The patient died of head injuries and ruptures of the liver and diaphragm with hemothorax and intra-abdominal bleeding. The impressive bladder perforation was first documented at the postmortem examination. The diagnosis and differential diagnosis of hematuria are discussed. PMID- 6857844 TI - [New implants for chest wall stabilization]. AB - A new rib plate is presented in two models with identical physical properties, but different methods of fixation. By means of a decrease of the plate thickness for both the screw fixation and the claw fixation, a symmetrical distribution of the charge to the fixation points is achieved. Such, a high stability as well as the desired elasticity are attained. A loosening of the implant or necrosis of the clasped parts of cartilage were not observed, so primary bone healing without the typical ball-shaped callus is possible. The elasticity of the thorax is not restrained. PMID- 6857845 TI - [Diagnosis and therapy of capitulum humeri fractures]. AB - Report of four cases of fracture of capitulum humeri treated by operation. The necessity of an exact preoperative radiological diagnostic work-up including lateral tomography of the elbow is pointed out. It is described how difficulties occurring during and after surgery can be avoided by choice of an adequate approach and a suitable internal fixation. Presented is the radio-volar approach and temporary fragment fixation with K-wires from ventral to dorsal. Three cases treated in a similar way show the efficiency of the procedure. PMID- 6857846 TI - [Postoperative functional after-care of fresh and chronic lesions of the knee ligament]. PMID- 6857848 TI - [Necessary stability and biomechanics of fracture healing in external fixation osteosyntheses]. AB - In recent years, many investigators have concerned themselves with improving the construction of the external fixator in order to achieve even greater stability. Clinical observations demonstrate a moderate callus formation and an often considerably delayed fracture healing resulting from such an extreme rigid mounting of the external fixator. This report presents biochemical considerations which indicate that extreme rigidity in the external fixator is not only unnecessary, but may even interfere with fracture healing and the formation of functionally stable bone. PMID- 6857847 TI - [Intramedullary nailing as secondary intervention following prior use of external fixation]. AB - The external fixation has its clear indications. In some cases, however, healing up of the bone fails to appear. This is caused partly by the gravity of the primary injury, partly by biomechanical reasons. The failure of a perfect fracture healing can require a change of the osteosynthesis procedure. Under certain conditions nailing provides good success. By means of 13 own cases conditions, indications and results of secondary nailing after prior external fixation osteosynthesis will be discussed. PMID- 6857849 TI - [Initial results with the dynamic hip screw in comparison to other osteosynthesis procedures]. AB - 30 fractures of the proximal end of the femur were stabilised with so-called "dynamic hip screws" (AO/ASIF). This method seems to be more suitable for some inter-trochanteric fractures which pose problems questioning our usual treatment with Ender's elastic round nails. The dynamic hip screw system is also more stable for femoral neck fractures of type Pauwels III than 4 cancellous bone screws. One phenomenon which can not yet be fully explained is the slipping out of the screw to an extent unobserved in other procedures. PMID- 6857850 TI - [Diagnosis and therapy of chondral and osteochondral fractures in the upper ankle joint region]. PMID- 6857852 TI - [Computed tomography of hip dislocation fractures]. PMID- 6857853 TI - [Electron microscopic findings in macroscopically intact cruciate ligaments in hemarthrosis]. PMID- 6857854 TI - [Effect of joint immobilization on arthrosis development]. PMID- 6857851 TI - [An experimental study of fracture resistance of the hip bones]. PMID- 6857855 TI - [Variations of the collateral fibular ligament and the ligament tracts to the lateral tibial condyle]. PMID- 6857856 TI - [Stability studies of a ventral external fixation unit of the tibia. I. Axial loading]. PMID- 6857858 TI - [Expert testimony in social law. 2 typical mistakes]. PMID- 6857859 TI - [Combination of external fixation unit with a floating suspension splint in the treatment of open lower leg fractures and infected tibial pseudarthrosis]. PMID- 6857857 TI - [A personal method of treating chronic fibular ligament insufficiency. Experimental study on cadavers]. PMID- 6857863 TI - [The malaria trophy]. PMID- 6857860 TI - [Usefulness of 24-hour electrocardiographic monitoring in the treatment of patients with Prinzmetal's angina]. PMID- 6857862 TI - [Pulmonary capillary pressure studied with pulsed Doppler technic]. PMID- 6857865 TI - [Health policy in Quebec: a society's choice]. PMID- 6857861 TI - [Surgical treatment of cardiac arrhythmias: current status and future perspectives]. PMID- 6857864 TI - [Deep venous thrombosis in an extremity following transvenous pacemaker implantation]. PMID- 6857866 TI - Thoracoabdominal retroperitoneal lymphadenectomy for nonseminomatous testicular cancer. AB - Retroperitoneal lymphadenectomy remains a mainstay of the management of patients with nonseminomatous testicular cancer. The operation provides accurate information regarding stage and prognosis, which current preoperative staging studies cannot duplicate. The therapeutic value of lymphadenectomy has been demonstrated more clearly for testicular tumors than for any other cancer. Properly performed, the operation results in complete removal of all node-bearing tissue at significant risk of harboring metastases. Yet the morbidity and mortality are low in these young, generally vigorous patients. The only long-term sequela is loss of ejaculation. Efforts are currently underway to determine limits to the operation that will preserve ejaculation while maintaining the efficacy of the procedure. PMID- 6857867 TI - [Expediency of the preventive use of antibiotics after surgical treatment of urologic patients]. PMID- 6857868 TI - [Significance of urinary transamidinase, lactate- and malate dehydrogenases in the evaluation of renal function in children with glomerulonephritis and pyelonephritis]. PMID- 6857870 TI - [Stenosis of the distal part of the urethra and vesico-pelvic reflux in girls]. PMID- 6857869 TI - [Angiographic study of the kidneys in children with megaureter]. PMID- 6857871 TI - [Neurovegetative prostatopathy]. PMID- 6857872 TI - [Surgical treatment of impotence]. PMID- 6857873 TI - [Copulative and reproductive functions in men after gastric surgery]. PMID- 6857874 TI - [Erythrographic denaturation-osmotic indicators in patients with chronic renal failure]. PMID- 6857875 TI - [Multiple cancer of the urethra after excision of the bladder]. PMID- 6857876 TI - [Remote results of enteroplasty of the bladder in phthisiourological practice]. PMID- 6857877 TI - A reproducible model for chronic renal failure in the mouse. AB - Chronic renal failure was induced in mice using bilateral electrocoagulation of the renal cortex. Thermal injury via an angled point cautery was applied to the fully exteriorized right kidney. Following a 10-day interval the left kidney was injured in a similar fashion. The incidence of local complications was negligible and because of the limited blood loss, very small laboratory animals can be used. By restricting trauma to varying proportions of the visible cortex graded levels of injury were obtained. Thus this model can produce a uniform pattern of renal failure and will therefore facilitate the acquisition of information on the biological consequences of chronic uraemia. PMID- 6857878 TI - Continuous telemetric monitoring of bladder function. AB - Preliminary investigations with telemetric urodynamic equipment permit us to describe the following indications for this technique: (1) repeated pressure/flow studies, both in obstruction and in experimental work; (2) when urge incontinence is expected on the grounds of the patient's history but standard cystometry reveals a stable bladder; (3) enuresis nocturna and psychogenic voiding dysfunctions; (4) in the therapy of incontinence. Some examples are presented. PMID- 6857880 TI - The characteristics of post tur blood loss: a preliminary study. AB - Peroperative and postoperative blood loss was studied in 20 patients. Both peroperative and postoperative blood loss was found to correlate together (p less than 0.05) and with the weight of resected tissue (p less than 0.05). The characteristics of the postoperative blood loss demonstrated a strong negative correlation with time, and calculation of the t50 showed that a 50% reduction in postoperative blood loss occurred within 16 h. PMID- 6857881 TI - Evaluation of gleason classification system in prostate cancer. AB - To compare the relative prognostic accuracy of the Gleason classification, the Whitmore staging, and the Broder grading systems, 111 patients with prostate cancer undergoing radical surgery were assessed utilizing these systems. The assessments were correlated with the presence or absence of disease six months to eight years after surgery. Of the three systems the Gleason classification system was the least accurate. PMID- 6857879 TI - Evaluation of ileum interposition in ureterosigmoidostomy: experimental studies. AB - Experiments in juvenile house pigs with a valved uretero-ileosigmoidostomy were performed, and the advantages of this procedure as against common methods were assessed. Postoperative studies up to 6 months revealed encouraging results in respect of function, infection rate, kidney function, serum electrolyte pattern and as to macro- and microhistological appearances. The results were considered superior to those obtained by simple ureterosigmoidostomy as shown by control groups. PMID- 6857882 TI - Deep vein thrombosis and prostatectomy. AB - A research protocol to evaluate the prevention of deep vein thrombosis in sequential patients undergoing prostatectomy is presented. There is an overall incidence of deep vein thrombosis in 8 per cent of patients. There was no advantage with intermittent leg compression when compared with elastic stockings. PMID- 6857883 TI - Metastatic carcinoma of prostate and bladder causing intestinal obstruction. PMID- 6857884 TI - Radiation therapy in bulky seminoma. AB - Between 1969 and 1980, 17 patients with bulky retroperitoneal seminoma and 1 patient with bulky mediastinal seminoma were treated with radiation therapy. One patient had resection of gross retroperitoneal disease, and 1 patient had resection of gross mediastinal disease. Fifteen patients received adjuvant irradiation to the mediastinum and paraclavicular lymph nodes, and 1 patient received adjuvant chemotherapy. At last follow-up, 17 of 18 patients (94%) remain free of disease. No patient has sustained treatment-related morbidity or mortality. PMID- 6857887 TI - Total nephroureterectomy with ureteral intussusception and transurethral ureteral detachment and pull-through. AB - We describe a technique for nephroureterectomy that includes ureteral intussusception and transurethral ureteral resection and our method for transurethral ureteral pull-through. These adjuncts permit total nephroureterectomy through a single skin incision and are appropriate in all cases except in patients with known high-grade transitional cell carcinoma of the renal pelvis or ureter. In 18 cases, these techniques have been shown to be reliable, safe, and rapid; in the 14 patients under observation for five years or longer, there have been no local recurrences of tumor. PMID- 6857885 TI - Private practice experience with AMS 791/792 urinary sphincter in male incontinence. PMID- 6857886 TI - Dorsal curvature of penis. PMID- 6857888 TI - Renal trauma in multiple-injured child. AB - Between 1959 and 1981, 251 renal injuries occurred in 248 children up to the age of sixteen years. Of the 36 children with renal laceration, rupture, or pedicle injury, 35 (97%) had associated injuries; 31 of these children (89%) with associated injuries required an immediate laparotomy by general surgeons for intra-abdominal injury. Immediate surgical management was performed on 27 severe renal injuries and resulted in nephrectomy in 3 of 20 renal lacerations (15%), in 4 of 4 ruptures (100%), and in 1 of 3 pedicle injuries (33%). Two of the 3 pedicle injuries (67%) had immediate repair with salvage of the kidney. Conservative management was carried out in 10 severe renal injuries. Delayed renal surgery was required in 3 cases (30%) and total renal loss (nephrectomy plus main renal artery injury) occurred in 5 of the 10 cases (50%). The severe degrees of renal injury did not all settle by themselves. Immediate surgical management of the patient with a severe renal injury resulted in a nephrectomy rate comparable with that of conservatively managed renal injuries. PMID- 6857889 TI - Early combined hormonal and chemotherapy for metastatic prostatic carcinoma. AB - Twenty-four patients with confirmed Stage D carcinoma of the prostate were treated with a combination of bilateral orchiectomy, estrogens (diethylstilbestrol) and chemotherapy (5-fluorouracil), and cyclophosphamide soon after diagnosis was established. Patients were followed up between forty-two to seventy-two months. Seventy-five per cent of patients reported relief of bone pain after initiation of therapy, and 83.3 per cent reported relief of their urinary symptoms. The primary tumor shrank in all patients, and initial stabilization or partial disappearance of osteoblastic lesions on bone scans was noted in 79.1 per cent of patients. The cumulative survival rates at five and six years were 63.48 and 50.78 per cent, respectively. The combined therapy was well tolerated by the patients, and complications were not severe and of a transient nature. PMID- 6857890 TI - Determinants of progression and equilibrium in hydronephrosis. AB - Upper urinary tract urodynamic parameters were measured serially in 12 dogs subjected to partial ureteropelvic junction obstruction. Measurements of pressure volume relationships (pelvimetrics) and the physiologic capacity of the renal pelvis were important predictors of hydronephrotic equilibrium which occurred only in kidneys whose pelvic urine volume remained lower than the renal pelvic capacity. Because of acquired changes in compliance and renal function, the same degree of obstruction caused progressive hydronephrosis at low pelvic volumes but not at high volumes in some kidneys. Hydronephrosis can thus be viewed as a compensatory mechanism which protects the kidney against further dilation and elevated intrapelvic pressure. PMID- 6857891 TI - Transvaginal inversion of urinary bladder after concealment of box in vagina. PMID- 6857892 TI - Congenital hemihypertrophy with adrenal carcinoma and medullary sponge kidney. AB - About 230 cases of congenital hemihypertrophy have been reported. A significant number of genitourinary abnormalities have been described in association with this disorder. Among these are Wilms tumors, adrenal malignancies, and medullary sponge kidney. We report on a patient with congenital hemihypertrophy, medullary sponge kidney, and an adrenal carcinoma. A brief review of the literature is given. PMID- 6857894 TI - Fractured catheter: unusual complication of percutaneous nephrostomy. PMID- 6857893 TI - Primary vaginal stones. PMID- 6857895 TI - Primary spontaneous renocutaneous fistula. PMID- 6857896 TI - Single ectopic ureter: pull-through technique for removal of ureteric stump. PMID- 6857897 TI - Idiopathic calcinosis of scrotum. AB - A case of idiopathic calcinosis of the scrotum is presented. Clinical recognition is easy if one keeps in mind such a disease in differential diagnosis of scrotal lesions. The serum levels of parathyroid hormone, calcitonin, calcium ion, and 25 OH vitamin D were normal. Multiple nodules were removed successfully, and the cosmetic result was excellent. PMID- 6857898 TI - Infrapubic incision in operative andrology. PMID- 6857900 TI - Release of sutured Penrose drain by optical urethrotome. PMID- 6857899 TI - Urology cart. PMID- 6857902 TI - Heterotopic cartilage in prostate. PMID- 6857901 TI - Androgen, estrogen, and progesterone receptors in peripheral and central zones of human prostate with adenocarcinoma. AB - For this study a prostate gland was obtained by retropubic total prostatectomy performed on a seventy-six-year-old patient at Gunma University Hospital. A surgical pathologist separated the gland into peripheral and central portions which were clearly divided by a fibrous stroma. Histopathologic examination of each layer revealed different patterns of adenocarcinoma. The cytosol was incubated with [3H]R1881, [3H]estradiol, or [3H]R5020 in the presence or absence of 100-fold excess unlabeled competing, R1881, diethylstilbestrol, or R5020, respectively. In addition, to measure only androgen receptor all androgen tubes contained 1 X 10(-5) M triamcinolone acetonide. Using glycerol density gradient technique, concentrations of androgen, estrogen, and progestogen receptor were measured on both tissues. Specific receptor concentrations were determined by computation of the suppressible binding from the 8S region of the gradients. The ratio of the androgen receptor to progestogen receptor in the central zone was 1.5 to 2.0 while the same ratio in the peripheral zone was 0.3 to 0.5. Estrogen receptor could not be detected in either portion of this gland, possibly because the patient had received large amounts of diethylstilbestrol diphosphate prior to operation. This is the first report of varying hormone receptor profiles in different anatomic zones of the human prostate. PMID- 6857903 TI - Leydig cell tumor in patient on estrogen therapy. AB - The occurrence of a Leydig cell tumor in a sixty-nine-year-old man, who received estrogen therapy for approximately two and one-half years, is reported. No similar situation has been reported in the medical literature, although there has been a search for the cause of these tumors in man. Experimentally, the administration of estrogen has caused these tumors in mice. PMID- 6857905 TI - "Flip-flop" phenomenon on retrograde ureterography establishes diagnosis of ureteral tumor. PMID- 6857904 TI - Case profile: visualization of renal cyst via intravenous urography. PMID- 6857906 TI - Psoas abscess after operation on lumbar spine. AB - A case of pyogenic psoas abscess is reported. It was found many years after lumbar spine operation, although the patient had confusing symptoms during the whole period. The last presenting symptoms were fever, chills, back pain, and hematuria. Ultrasonography provided conclusive information about the abscess. PMID- 6857907 TI - Apical entry of single main renal artery. AB - Two cases of extrahilar entry of a single main renal artery are described. Selective renal angiography demonstrated arterial entry through the upper pole of the kidney and venous exit, adjacent to the arterial entry. Embryologic as well as some surgical aspects are presented. To our knowledge only one similar variation of arterial supply to the kidney has been reported previously. PMID- 6857908 TI - Modified J nephrostomy catheter for intravesical pressure measurement in urodynamics. AB - The influence of a transurethrally inserted 8.3-F modified J-nephrostomy catheter on urinary flow rate was investigated by both spontaneous uroflowmetry and pressure flow study in patients with almost identical bladder volumes. No statistically significant differences were found between maximum and mean flow rates obtained by spontaneous uroflowmetry and pressure flow study, respectively. Consequently, transurethral catheter placement is recommended in routine urodynamics. PMID- 6857909 TI - [Features of the course of stage I open-angle glaucoma]. PMID- 6857911 TI - [Condition of the posterior epithelium of the cornea after implantation of different models of artificial lenses]. PMID- 6857910 TI - [Prolapse of the vitreous body after cataract extraction with implantation of an intraocular lens]. PMID- 6857912 TI - [Method of orthokeratotomy in the surgical correction of myopia]. PMID- 6857913 TI - [Late results of intralaminar refractive keratoplasty in aphakia and severe hypermetropia]. PMID- 6857914 TI - [Indications for enucleation in the treatment of patients with intraocular melanoma]. PMID- 6857916 TI - [Incidence of retinoblastoma mutations]. PMID- 6857917 TI - [Concentration of corticosteroid hormones in the blood of children with uveitis]. PMID- 6857918 TI - [Optical-electronic methods of increasing the clinical informational value of ultrasonic scans of the eye]. PMID- 6857915 TI - [Selected data on the incidence of eye pathology among children]. PMID- 6857919 TI - [Acoustic radiofrequency visualization of pathology of the vitreous body]. PMID- 6857920 TI - [Use of a ferroprobe pole-detector during foreign body removal from the ocular cavity]. PMID- 6857921 TI - [Possibilities of a technic of fixation topokeratometry]. PMID- 6857922 TI - [Method of calculating optical systems with contact and intraocular lenses for correction of unilateral aphakia]. PMID- 6857923 TI - [Improvements in eyeglasses and prospects for further advances in the near future]. PMID- 6857926 TI - [Fluoresceinography of the drainage tracts of the eye after surgery on Schlemm's canal]. PMID- 6857925 TI - [Various aspects of the technic for enucleating the eye in melanomas of the choroid]. PMID- 6857924 TI - [Serologically documented case of congenital chorioretinitis caused by lymphocytic choriomeningitis virus]. PMID- 6857927 TI - [Age-related changes in ultrasonic auditory perception]. PMID- 6857928 TI - [Vestibular and optokinetic reflexes in sportsmen]. PMID- 6857929 TI - [Changes in the vegetative nervous system in various chronic diseases of the nasal mucosa]. PMID- 6857930 TI - [Principles of surgical treatment of malignant tumors of nasal cavity and paranasal sinuses]. PMID- 6857931 TI - [Clinical use of computer tomography in malignant tumors of the maxilla and nasal cavity]. PMID- 6857932 TI - [Use of focused megahertz ultrasonics in otology]. PMID- 6857934 TI - [Formation and elimination of experimental synechiae of the vocal cords by the laryngomicrosurgical methods]. PMID- 6857933 TI - [Method of studying various parts of posterior mediastinum through a neck incision (anatomical study)]. PMID- 6857936 TI - [Determination of the vocal field in singers with laryngeal diseases]. PMID- 6857935 TI - [Electron microscopy study of the vocal muscle in patients with median laryngostenosis]. PMID- 6857939 TI - [Osteomyelitis of the frontal bone in acute sinusitis]. PMID- 6857938 TI - [Early roentgenological signs in perforation of the cervical segment of the esophagus]. PMID- 6857940 TI - [Extensive necrosis of the external nose, nasal septum and maxilla in a patient with acute pancreatitis complicated by secondary diabetes mellitus]. PMID- 6857937 TI - [Dynamics of the aqueous humor in paranasal sinusitis]. PMID- 6857941 TI - [Case of congenital anhidrotic ectodermal dysplasia]. PMID- 6857942 TI - [2 cases of nasopharyngeal teratoma in newborn infants]. PMID- 6857943 TI - [Nasopharyngeal teratoma in infants under 1 year of age]. PMID- 6857944 TI - [Multiple teratoma of the nose]. PMID- 6857945 TI - [Stage IV cancer of the larynx in an adolescent boy]. PMID- 6857947 TI - [Injuries of the pleural cupula and lung apex during catheterization of the subclavian vein, and their prevention]. AB - In the clinic 1442 catheterizations were performed, 1156 of them being catheterizations of the subclavian vein. Dangerous complications such as punctures of the posterior wall of the subclavian vein in combination with injuries of the pleura cupola and apex pulmonis were observed three times. Hemo-, hydro- and pneumothorax accompanying these complications in different combinations are contraindications to repeated puncture and catheterization of the subclavian vein both in the left and in the right. Recommendations are given to reduced possible complications. PMID- 6857946 TI - [Case of prolonged apnea after removal of a foreign body under anesthesia]. PMID- 6857948 TI - [Thrombosis of the superior vena cava caused by catheterization of the subclavian vein]. PMID- 6857949 TI - [Injury of the thoracic aorta during transpleural reamputation of the left main bronchial stump]. PMID- 6857950 TI - [Surgical treatment of developmental defects of the lungs]. AB - Developmental defects of the broncho-pulmonary system made up 14,9% in relation to all the patients with chronic nonspecific diseases of the lungs. Operations were performed on 454 patients. Among them 327 patients had different kinds of hypoplasia, 45 patients had rare defects and 72 patients were with dysontogenetic malformations. Most patients with developmental defects of the lungs must be treated surgically. PMID- 6857951 TI - [Computer tomography in cranio-cerebral injuries]. PMID- 6857952 TI - [Osmometry as a method of control of homeostasis in acute suppurative destructive diseases of the lung and pleura]. AB - The osmolar status was studied in 63 patients with acute abscesses of lungs and empyema of pleura at different stages of the conservative and operative treatment. The hypoosmolarity syndrome was revealed at the acute stage of the disease against the background of a pronounced purulent intoxication. An increased excretion of nonidentified osmotically active metabolites with urine was registered at the height of pyodestructive process and postoperative disease. PMID- 6857954 TI - [Diagnosis and surgical treatment of the masses in the right cardiodiaphragmatic angle]. AB - One hundred and three patients with different formations of the right phrenocardial angle were studied. Parasternal lipomas and celomic cysts of the pericardium were diagnozed in 77 patients. In the operative treatment of parasternal lipomas the transrectal incision in the right hypochondrium was preferred, anteropericardial thoracotomy was preferred in cysts. Lateral thoractomy was used in doubtful diagnosis. The nearest results were good. PMID- 6857953 TI - [Selective phlebography of the thymus gland with pneumomediastinum in patients with myasthenia gravis]. AB - The authors describe the technique of selective phlebography of the thymus under conditions of pneumomediastinum. The investigation of the thymus in 40 patients with myasthenia enabled the authors to conclude that a preliminary administration of gas into the fatty tissue of the anterior mediastinum facilitated catheterization of the thymus veins and favoured a success of selective phlebography, elevated the reliability of differential diagnosis of tumorous and involutional changes of the thymus as well as tumors and portions of a dense fibro-fatty tissue of the anterior mediatinum. The method is characterized by a lower radiation load on the patient and is more economical. PMID- 6857955 TI - [Humoral nonspecific immunity in patients with post-burn cicatrical strictures of the esophagus]. AB - The authors have studied the significance of factors of the humoral non-specific defense (HND) in 37 patients with cicatricial constrictions of the oesophagus and stomach. The data obtained were used for choosing the optimum terms for gastrostoma and oesophagoplasty. In 14 patients treatment with lysozyme was performed due to decreased indices of HND. PMID- 6857956 TI - [Combined (radiation and surgical) treatment of esophageal cancer]. AB - The article gives an analysis of results of the combined (radiation and surgery) treatment of carcinoma of the oesophagus. The results are estimated on the basis of an analysis of postoperative complications and survival of the patients during 3 and 5 years. The authors consider that the combined treatment does not only not complicate the operative intervention and postoperative management of the patients but also improves the remote results. PMID- 6857957 TI - [Results of surgical treatment of the "minimal" forms of breast cancer]. AB - Results of the surgical treatment of 262 patients with "minimum" (less than 1 cm) forms of breast cancer are analyzed. The incidence of local relapses and late metatases of the tumor following mastectomy after Patey did not exceed their incidence after the Halsted mastectomy (8.1% and 10,4% correspondingly). After an "extended" sectoral resection (a lateral excision) along with the axillary subclavian fat local relapses were found to appear in 12,5% of patients, late metastases being noted in 25,0% of cases. When sectoral resections were fulfilled without an ablation of the axillary fat "regional relapses of carcinoma made their appearance in 21,0% of patients, late metastases---in 15,7% of patients. A conclusion is made that indications to organ-preserving operations must be restricted even in the "minimum" forms of carcinoma. PMID- 6857958 TI - [Unsolved problems and prospects in the surgical treatment of duodenal ulcer]. AB - Different variants of vagotomy in combination with pyloroantrumectomy or operations draining the stomach are regarded to be expedient for the treatment of duodenal ulcer instead of the classical resection of the stomach. The selective proximal vagotomy vagotomy is thought to be perspective when used without a drainage of the stomach as an intervention preventing the threat of the development of complications with a chronic course of the disease. In the surgery of complicated duodenal ulcers, specially with high operative risk, it is quite justifiable to use sparing operative interventions such as vagotomy combined with operations draining the stomach. An individual approach to choosing the operative method in the ulcer disease resulting in lower postoperative lethality and better remote results of the treatment may be ensured in specialized gastroenterological hospitals only. PMID- 6857959 TI - [Functional disorders and work capacity after selective proximal vagotomy in duodenal ulcer]. AB - Remote results within the terms of from 1 to 3 years in 60 patients and the working ability in 73 patients subjected to selective proximal vagotomy (SPV) or SPV with drainage of the stomach were studied. Functional disorders were observed much more rarely after the isolated SPV. The use of benzohexasonium and electrostitmulation of the stomach in the early postoperative period allows preventing the development of functional disorders. The SPV ensures an early recovery of the working ability. PMID- 6857960 TI - [Treatment of external biliary fistula]. AB - The main task in the treatment of external biliary fistulas is known to be the radical correction of the major bile outflow. The individual pathogenetic approach to the treatment of external biliary fistulas, an adequate preoperative preparation and rational postoperative management enabled the authors to reduce postoperative lethality to 4.7% and to get good and satisfactory results in the overwhelming amount of patients. PMID- 6857961 TI - [Possibilities of surgical treatment of large intestine cancer in patients over 70]. AB - The age older than 70 can not be regarded as a contraindication for the radical surgical treatment in patients with colon carcinoma and must not be a cause for giving the surgery up. In patients older than 70 the operation volume should not be reduced to the detriment of its radical character. Concrete indications to different operative interventions in this category of patients have been elaborated following the investigation performed. PMID- 6857962 TI - [Inflammatory complications in cancer of the colon]. PMID- 6857963 TI - [Morphological criteria in estimating the extent of amputation of the limbs in obliterative lesions of the blood vessels]. PMID- 6857964 TI - [Diagnosis of mycetoma]. PMID- 6857965 TI - [Classification of clinical manifestations of thyroglossal cyst]. PMID- 6857966 TI - [Removal of foreign bodies from the limbs]. PMID- 6857967 TI - [Plastic surgery of open defects of the palate with a lingual flap]. AB - The authors describe results of the plasty of defects of the palate by a tongue flap. Good phonetics, better conditions for prosthezing, less number of operations, shorter time of staying in the hospital and less expenditure of the patient's force are the main advantages of the tongue flap plasty. PMID- 6857968 TI - Isolation of Yersinia enterocolitica from pigs in the United Kingdom. AB - A survey of the incidence of Yersinia enterocolitica from pigs in the United Kingdom was carried out by two laboratories using pre-enrichment culture methods on colon/caecal contents, faeces and tonsil tissue. Altogether 1931 specimens were cultured and 112 strains of Y enterocolitica were isolated. Only two strains were related to biotype 4, human serotype O:3 and none to biotype 2, human serotype O:9. All other isolates belonged to biotype 1. Many serotypes were identified, the predominant ones being O:6 (30) and O:5 (15) but 41 strains could not be serotyped. Possible reasons for the low incidence of serotype O:3 are discussed. PMID- 6857969 TI - Treatment of racing pigeons naturally infected with Mycoplasma columborale and M columbinum. AB - A group of six racing pigeons naturally infected with Mycoplasma columborale and M columbinum were housed in isolation and treated with tiamulin hydrogen fumarate in the drinking water for 35 days. Swabs from the oropharynx, the oesophagus and the trachea were negative for mycoplasmas at the end of this period. Mycoplasmas were recovered from two of the birds after a further nine days, and 13 weeks after the cessation of treatment mycoplasmas were recovered from all six birds. PMID- 6857971 TI - Feeding cow's colostrum to lambs. PMID- 6857970 TI - Urinary formiminoglutamic acid in lambs. PMID- 6857974 TI - Treatment of parasitic bronchitis. PMID- 6857973 TI - Fluid therapy in pigs. PMID- 6857972 TI - Fixing epiphyseal fractures. PMID- 6857977 TI - Cholangiofibrosis in the Syrian golden hamster. PMID- 6857975 TI - Congenital structural brain defects in the deaf dalmatian. AB - Deafness in dalmatian dogs in known to be congenital. It has been reported that the condition is manifested in structural defects of the sensitive lamina of the organ of Corti. In a study of deaf puppies, examined as they became available, this was found to be in doubt. Moreover, a characteristic gross reduction of area was found in the structure of the acoustic cortex in affected puppies. Extension of the morphometric studies further showed that the acoustic pathways were generally attenuated in keeping with the changes in the cortex. Consideration is given to the probability that the condition develops centrally rather than peripherally. Thus instead of the central components failing to develop because of lack of evocative stimulus from the end organ it is envisaged that the peripheral organ regresses because of incomplete innervation by central outgrowth. PMID- 6857976 TI - Familial cerebellar ataxia with hydrocephalus in bull mastiffs. AB - A family of bull mastiff pups in which 16 animals developed certain neurological signs is described. It is probable that the disease is inherited in an autosomal recessive manner. Clinical and pathological examination of six animals revealed ataxia, behavioural abnormalities and a visual defect associated with symmetrical lesions in the cerebellar nuclei, lateral vestibular nucleus and inferior colliculus together with a communicating hydrocephalus. The cerebellar lesions consisted of vacuolation, gliosis and axonal degeneration. Evidence for both axonal and oligodendroglial abnormalities was present and these probably result from a genetically determined metabolic disturbance in the affected neurones. PMID- 6857978 TI - Salmonella panama: isolation from aborted and newborn canine fetuses. PMID- 6857979 TI - Abortion in sheep associated with Salmonella montevideo infection. AB - In the eight year period, 1974 to 1981, abortion associated with Salmonella montevideo infection was recorded in 16 flocks in south east Scotland. Two of these flocks experienced infection in each of two years making a total of 18 incidents. Apart from abortion, there was little evidence of ill health in ewes and lambs in affected groups. The number of ewes which aborted in any one flock was very variable. The worst affected had 130 abortions which represented 25 per cent of the animals at risk. On the other hand in 10 of the incidents 6 per cent or less of the pregnant ewes were affected. PMID- 6857980 TI - Bog asphodel (Narthecium ossifragum) as a cause of photosensitisation in lambs in Norway. AB - In a five year experiment, 195 lambs and their dam were kept on four plots of wet moorland rich in the plant Narthecium ossifragum. The plots were top-dressed with calcium and, or, phosphorus, or given no treatment. After three years, the plant disappeared from the plots to which phosphorus had been applied, but remained where calcium only had been used. The saponin content of the plant appeared to be uninfluenced by the type of top-dressing or time of year. Photosensitisation (alveld) occurred on all plots during the first three years. During the fourth year the disease occurred only where the plant persisted. In the fifth year the disease did not occur on any plot. Alveld was produced in two lambs by the repeated administration of large quantities of saponin preparations from N ossifragum. Lambs of haemoglobin type AA were significantly more resistant to the disease than lambs with type BB. In nearly half the cases, the bromsulphthalein liver function test indicated a susceptibility to alveld up to seven days before the appearance of clinical signs. Increased bromsulphthalein retention was more common amongst AA lambs than BB lambs, but nearly all the BB lambs developed alveld, and only a few of the AA lambs. The differences were significant. PMID- 6857981 TI - Pharmacokinetics and urinary excretion of sulphadimidine in sheep during summer and winter. AB - Pharmacokinetics and urinary excretion of sulphadimidine were investigated in sheep during summer and winter seasons. Average minimum and maximum environmental temperature in the summer ranged from 22.6 to 40.2 degrees C and in winter from 4.5 to 21.1 degrees C. The determination of plasma volume, plasma protein and packed cell volume during summer and winter revealed a significant decrease in plasma volume and a significant increase in plasma protein in the summer indicative of haemoconcentration. Packed cell volume did not differ significantly between the seasons. The pharmacokinetics of sulphadimidine were determined following a single intravenous injection (100 mg/kg) in summer and winter. Zero time plasma concentration of the drug was higher during summer than in winter. The elimination half-life of the drug was similar in summer and winter, but the apparent volume of distribution was lower in summer. Likewise, total body clearance was significantly lower in summer. Based on these studies a satisfactory intravenous dosage regimen might consist of 86 and 100 mg/kg for priming and 78 and 88 mg/kg as maintenance doses during summer and winter, respectively, the doses being repeated at 12 hour intervals. Twenty four hours after sulphadimidine administration 90 and 73 per cent of the dose was excreted in urine during summer and winter, respectively. The drug was excreted mainly as free amine. PMID- 6857982 TI - Use of cupric oxide needles in the prophylaxis of induced copper deficiency in lambs grazing improved hill pastures. AB - Cuprix oxide needles as a single oral dose were administered to ewes in the prepartum period, and to one member of each pair of twin lambs at between three and five weeks of age when grazing hill pastures improved by liming and reseeding. Lambs derived from dosed or undosed ewes and treated at three to five weeks of age were maintained in normocupraemia and showed no signs of ill-thrift. Lambs derived from dosed or undosed ewes but not themselves dosed showed hypocupraemia and ill-thrift. The lambs derived from the dosed ewes took longer to become hypocupraemic, but showed only a transient benefit from the ewe treatment. The dosed ewes showed a delay in the onset of hypocupraemia compared with the undosed ewes but there were no definable differences in performance between the two groups. PMID- 6857984 TI - Dermatitis in the horse caused by Acarus farinae. PMID- 6857983 TI - Influence of some sedative drugs on the appetite of red deer. PMID- 6857985 TI - Feeding cows' colostrum to newborn lambs. PMID- 6857986 TI - Endemic Balkan nephropathy, a slow virus disease? AB - Serum samples from patients with endemic Balkan nephropathy (EBN) were inoculated intraperitoneally to four species of laboratory animals. It was only in the guinea pig that a serially transmissible experimental disease occurred, after a long incubation period. The morphopathological features in the guinea pig were similar to those encountered in the terminal phase of human EBN. The hypothesis that EBN might be a slow virus disease is discussed. PMID- 6857987 TI - Detrimental effects of hepatitis B virus infection on the development of the product of conception. AB - Frequent reproductive casualties (spontaneous abortions, stillbirths, prematurity and low birth weight, congenital malformations) were recorded in a group of 264 women who had viral hepatitis (VH) during pregnancy. The proportion of such events was much higher in the HBsAg-positive women (80%) than in the seronegative ones (44%) and it varied according to the trimester when VH had occurred. Liver disease could be incriminated as the main cause of infant death in 20 out of 2110 cases investigated; 6 of the 20 mothers proved to be HBsAg-positive. Asymptomatic HBsAg carriage in a group of 3800 pregnant women was found to be of about 8%; the prevalence of HBsAg was higher in the subgroups of women with an unfavourable pregnancy evolution. PMID- 6857989 TI - Circulation of influenza virus A(H1N1) in Moldavia (Romania) during 1978-1982. AB - The influenza virus A(H1N1) subtype that reappeared after an absence of 20 years was incriminated as an etiological agent of acute respiratory disease outbreaks in Moldavia (Romania). There were three epidemics in the winter--spring of 1978, 1979, and 1982, that affected mostly school communities and young adults. In 1980 1981 the circulation of A(H1N1) virus was limited. In all the epidemics mentioned the A(H1N1) subtype caused mild influenza cases, with minimal complications and insignificant mortality. PMID- 6857990 TI - The action on mumps virus of several preparations obtained from human milk. Preliminary note. PMID- 6857988 TI - 4S component of influenza virion RNA represented by a set of tRNAs. AB - The aminoacceptor capacity of the 4S fraction of influenza virion RNA--strain A/Texas 1/77a (H3N2)--was studied in a cell-free system containing individual 3H amino acids and rat liver pH 5-enzyme preparation. The presence of at least 5 species of active tRNA was demonstrated. There were differences in the composition of the tRNA populations of influenza virus and of the chick embryo chorioallantoic membrane cells in which the virus had cultivated. These differences point to the selectivity of the process of incorporation of tRNA molecules from the host cells into the virions. The data obtained are discussed from the point of view of the functional role of the 4S fraction of influenza virion tRNA. PMID- 6857991 TI - H protein, a minor protein of TMV virions, contains sequences of the viral coat protein. AB - H protein, a minor protein found associated with virions of tobacco mosaic virus (TMV) at an average of about one copy per virion and previously believed to be host-coded (Asselin and Zaitlin, 1978, Virology 91, 173-181), has been shown to contain sequences of the viral capsid protein. Two-dimensional tryptic peptide maps of 125I-labeled H protein (Mr 26,500) and coat protein (Mr 17,500) from TMV strains U1 and Dahlemense show that the respective H proteins contain most if not all of the labeled peptides of the coat proteins in addition to 2-3 unique peptides. The H proteins also contain unique antigenic determinants, as antibodies can be isolated which react strongly with the H protein but not with the coat protein of Dahlemense TMV. Finally, amino acid composition analysis of the U1-TMV H protein has shown the presence of methionine and histidine, amino acids not present in the coat protein of that strain. H protein appears to contain the same NH2 terminus as coat protein, as there is an H protein tryptic peptide that both comigrates in a two-dimensional system and produces the same acid cleavage product as the NH2-terminal tryptic peptide of coat protein. H protein also seems to have the same COOH terminus as coat protein, as cyanogen bromide digestion of Dahlemense-TMV coat protein and H protein indicates that each has a methionine about 12 amino acids from one terminus (known to be the COOH terminus of the coat protein). Thus, H protein is not structurally equivalent to coat protein with an addition on either its NH2 or COOH terminus. However, H protein does not appear to be a noncovalent aggregate of coat protein and some other protein. Rather, the model we favor for H protein structure is that of a branched fusion product between coat protein and another polypeptide of host or viral origin. PMID- 6857992 TI - The H protein isolated from tobacco mosaic virus reassociates with virions reconstituted in vitro. AB - Virions of two strains of tobacco mosaic virus (U1 and Cc) have associated with them a small amount of a minor protein called H protein (A. Asselin and M. Zaitlin, 1978, Virology 91, 173-181), now known to be related to the viral coat protein (C.W. Collmer, V.M. Vogt, and M. Zaitlin, 1983, Virology 126, 429-448.). In the present study, a quantification technique involving disruption of virions followed by direct analysis of the component parts on SDS polyacrylamide gels was used to confirm an average of one molecule of H protein per virion for U1 TMV. H protein was separated from coat protein and purified by electrofocusing in a flatbed of granulated gel under stringent dissociating conditions. When assayed in the presence of urea, H protein has a pI of approximately 5.4, coat protein has a pI of approximately 4.9. Proteinase K-treated TMV RNA and H-protein-free TMV coat protein were reconstituted in vitro with or without H protein and the resulting virions were analyzed. A small amount of H protein reassociated with virions reconstituted in vitro (less than 10% of the amount found in native virions) and became resistant to degradation by trypsin, but such virions were no different from virions reconstituted without H protein in terms of yield of reconstituted particles or infectivity. In mixed reconstitution experiments with RNA and coat protein from strains U1 and Cc in all four possible combinations and with U1 H protein, the H protein always associated with the U1 coat protein. This demonstrated U1-H protein affinity for a specific coat protein rather than a specific RNA. It is unlikely that H protein functions in the early stages of viral infection, although the possibility of its having some other role in the life cycle of TMV remains. PMID- 6857993 TI - Pathogenicity reactivation of nonpathogenic influenza virus recombinants under von Magnus conditions. AB - The pathogenicity for the chicken of a number of nonpathogenic recombinants between fowl plague virus and various avian and mammalian influenza A viruses can be reactivated by passaging serially at high multiplicities (von Magnus conditions) at 41 degrees, which is the nonpermissive temperature of nonpathogenic recombinants. While the mechanism underlying this reactivation is unclear, it could be excluded that it was due to segregation of heterozygotes to the wild type homozygotes. PMID- 6857994 TI - Analysis of the genome of fish lymphocystis disease virus isolated directly from epidermal tumours of pleuronectes. AB - Virions of fish lymphocystis disease virus (FLDV), a member of the iridovirus family, were isolated directly from lymphocystis disease lesions of individual flatfishes and purified by sucrose and subsequent cesium chloride gradient centrifugation to homogeneity as judged by electron microscopy. The isolated FLDV DNAs appear to be heterogeneous in size. Contour length measurements of 43 DNA molecules gave an average length of 49 +/- 23 microns, corresponding to 93 +/- 44 X 10(6) D. Molecular weight estimations of FLDV DNA by restriction enzyme analysis resulted in only 64.8 X 10(6) D indicating an excess length of the DNA of about 50%. FLDV DNA was sensitive to lambda 5'-exonuclease and to E. coli 3' exonuclease III without preference of any one terminal DNA restriction fragment. Denaturation and reannealing experiments of FLDV DNA resulted in the formation of circular DNA molecules of 34.25 microns contour length (= 65.22 X 10(6) D). This result suggests that FLDV DNA contains directly repeated sequences at both ends and that it is terminally redundant. FLDV DNA is methylated in cytosine. FLDV DNA did not hybridize with frog virus DNA indicating that the two iridoviruses are not closely related to each other. Restriction enzyme analysis and Southern blot hybridizations revealed that FLDV isolates can be classified into two different strains: FLDV strain 1 occurs in flounders and plaice, whereas strain 2 is usually found in lesions of dabs. PMID- 6857995 TI - Inhibition of alfalfa mosaic virus RNA and protein synthesis by actinomycin D and cycloheximide. AB - Actinomycin D, added early after inoculation, reduces the production of infectious alfalfa mosaic virus in cowpea protoplasts by 90%. This reduction was associated with an inhibition of viral minus-strand and plus-strand RNA synthesis, suggesting the involvement of host factors in these processes. Coat protein production was less affected by the drug. Addition of cycloheximide throughout the growth cycle resulted in an immediate cessation of coat protein production and an enhanced degradation of viral RNA. This degradation obscured possible effects of the drug on viral RNA synthesis. PMID- 6857996 TI - A protein kinase activity in lymphocytic choriomeningitis virus and identification of the phosphorylated product using monoclonal antibody. AB - A cyclic AMP-independent protein kinase activity was found in purified preparations of the Armstrong CA 1371 strain of lymphocytic choriomeningitis virus (LCMV). Using the exquisite sensitivity of monoclonal antibodies to LCMV polypeptides, the internal nucleocapsid N protein was identified as the major virus-specific phosphorylated product of the endogenous protein kinase activity. This was accompanied by an increase in the electrophoretic mobility of N protein as detected by SDS-PAGE. After solubilization of the virus with 1% Nonidet P40 approximately 81% of the endogenous protein kinase activity remained associated with LCMV nucleocapsids recovered by equilibrium centrifugation at a density of 1.25 g/cm-3 in a linear renograffin gradient. Specific phosphorylation of N protein was reconfirmed in the purified nucleocapsid fraction and both phosphoserine and phosphothreonine found to be the phosphorylated products of the kinase reaction. Although the significance of this enzyme remains unclear, the presence of a protein kinase within LCMV may allow the regulation of LCMV replication and maturation by phosphorylation of virus-specific polypeptides. These events may in turn play a key role in determining the nature and outcome of LCMV infection. PMID- 6857997 TI - Regulation of transcription and DNA replication of bacteriophage phi 80. AB - Transcriptional mapping and DNA replication measurements have been used to characterize a series of phi 80 suppressor-sensitive mutants which are defective in genes 15, 14, 16, and 17. These genes are localized within the inner right arm of the vegetative phi 80 DNA genome. The sus326 mutation in gene 15 leads to a decrease in major leftward (pL-att80) RNA levels and to a marked pleiotropic reduction in major rightward RNA synthesis; however, phi 80 DNA synthesis is reduced only moderately (about two-fold). These findings are consistent with the gene 15 product being a positive control regulator that is essential for normal transcriptional development, in particular, beyond a termination signal(s) (tR) located between genes 16 and 17. The sus8 and sus258 mutations (in genes 14 and 16, respectively) lead to severe blockage of both major rightward RNA transcription and phi 80 DNA synthesis. The products of genes 14 and 16 appear to be required for both autonomous phi 80 DNA replication and the "late" transcriptional development. The sus121 mutation in gene 17 reduces the level of "late" major rightward transcription (gene 17-1-13-att'80 segment) by about 10 fold but does not have any apparent effect on the levels of phi 80 DNA synthesis. These profiles identify the product of gene 17 as a "Q-type" positive control regulator for the "late" major rightward RNA. These studies reveal the functional characterization of four genes, the products of which are necessary for the efficient expression of the "early" RNA transcribed segments, autonomous DNA replication, and the production of normal levels of "late" (17-1-13-att'80) RNA synthesis. PMID- 6857998 TI - Acylated simian virus 40-specific proteins in the plasma membrane of HeLa cells infected with adenovirus 2-simian virus 40 hybrid virus Ad2+ND2. AB - HeLa cells infected with the adenovirus 2-simian virus 40 (Ad2+SV40) hybrid virus Ad2+ND2 were labeled with either [35S]methionine or [3H]palmitate and fractionated into cytoplasmic, nuclear, and plasma membrane fractions. Analysis of these fractions by sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed that the SV40-specific proteins in the plasma membrane fraction were specificially acylated. PMID- 6857999 TI - Proteins encoded near the adenovirus late messenger RNA leader segments. AB - Small fragments of adenovirus 2 DNA cloned into the single-strand phage M13 were used to select adenoviral messenger RNAs transcribed from the R-strand between map positions 16 and 30. Cell-free translation of these mRNAs produced proteins of 13.5K, 13.6K, and 11.5K, respectively encoded between the first and second segments of the tripartite major late leader, within the "i"-leader segment, and immediately preceding the third leader segment. Partial sequence analysis of the 13.6K protein is consistent with the hypothesis that it is encoded within the i leader segment. PMID- 6858001 TI - Tick-borne viruses structurally similar to Orthomyxoviruses. AB - Members of the Orthomyxoviridae are characterized at the structural level as enveloped, negative sense, RNA viruses that bud from the outer plasma membranes of infected cells and have seven or eight species of single-stranded RNA. None of the three types of orthomyxoviruses (influenza A, B, C) has been shown to be transmitted by arthropods; rather, the viruses are transmitted directly or indirectly from one infected vertebrate to another. Analyses of the virion RNA species and polypeptides of the tick-borne Thogoto and Dhori viruses indicate that they have structural characteristics similar to accepted members of the Orthomyxoviridae. For example, the viruses have seven size classes of single stranded RNA with 3' end consensus sequences of HOUCGUUG (or U or A) UUGUUC. . . . The viruses contain 54-56 X 10(3) Da nucleocapsid protein, an internal 28 X 10(3) Da putative matrix protein plus minor 85-90 X 10(3) Da proteins, and a major outer 65 X 10(3) Da glycoprotein. In addition to their sensitivity to actinomycin D and alpha-amanitin the viruses morphologically and morphogenetically resemble orthomyxoviruses. PMID- 6858000 TI - Morphogenesis of filamentous bacteriophage f1: orientation of extrusion and production of polyphage. AB - Crosslinking reagents were used to interrupt the process of filamentous phage morphogenesis and investigate the orientation in which nascent virions are extruded through the host cell membrane. Infected bacteria with emerging phage particles were crosslinked with glutaraldehyde. Immunoferritin-labeling studies on these emerging phage using anti-A protein IgG suggested that extrusion begins with the C protein end. To confirm this, phage extruding from infected bacteria were frozen using the reversible crosslinker dimethyl 3,3'-dithiobis propionimidate and fragments of emerging phage were isolated by shearing. Protein analysis of these fragments showed them to be enriched in C protein relative to A protein, as predicted if phage extrusion begins with the C protein end. The production of multiple-length phage particles (polyphage) by nonpermissive bacterial hosts infected with amber mutant phage strains was also studied. Polyphage were produced upon infection with amber mutants in genes III, VI, VII, and IX which code for proteins found at the ends of the mature phage particle. No polyphage were produced by mutants in the other genes tested. Gene III amber mutants produce noninfective polyphage, but those produced by genes VII and IX are infective. Gene VI amber mutants appear to produce unstable, noninfective polyphage particles. PMID- 6858002 TI - Topological analysis of the reovirus type 3 hemagglutinin. AB - We previously showed that the reovirus type 3 hemagglutinin (HA) has distinct functional domains. For example, we identified one group of anti-HA monoclonal antibodies which only inhibited virus-mediated hemagglutination and another group which exclusively neutralized reovirus infectivity. Using competition radioimmunoassays, we now report that these functionally discrete domains on the reovirus type 3 HA correspond to discrete antigenic regions of the protein. PMID- 6858003 TI - Role of adenovirus types 5 and 12 early region 1b tumor antigens in oncogenic transformation. AB - Recently we have reported that the difference in oncogenic potential between adenovirus type 5 (Ad5)-and Ad12-transformed cells in athymic nude mice is specified by early region 1b. In order to determine which of the two early region 1b (E1b) tumor antigens is responsible for the observed difference in oncogenicity we have constructed two Ad5/Ad12 hybrid plasmids: one allowing expression of the Ad5 19kD and Ad12 54kD E1b proteins, the other of the Ad5 58kD plus Ad12 19kD E1b polypeptides. Both hybrid plasmids contain the intact E1a regions of both serotypes. The chimeric plasmids were used to transform primary cultures of baby rat kidney cells and the resulting transformed cells were tested for oncogenicity in athymic nude mice. It was found that the degree of oncogenicity is determined by the identity of the large E1b tumor antigen. Studies with cells transformed by an Ad12 region E1 plasmid in which the gene coding for the 19kD tumor antigen was mutated showed that expression of this protein is nevertheless required for manifestations of the oncogenic phenotype of the transformed cell. PMID- 6858004 TI - Dietary intake and cardiovascular risk factors, Part II. Serum urate, serum cholesterol, and correlates. PMID- 6858005 TI - [The long-term dialysis program in Czechoslovakia in 1981 and its perspectives in the 7th 5-year-plan]. PMID- 6858006 TI - [Selection criteria for treatment with continuous peritoneal dialysis]. PMID- 6858007 TI - [Ultrafiltration characteristics of peritoneal dialysis]. PMID- 6858008 TI - [A new surgical approach to the formation of an arteriovenous fistula in patients with regular hemodialysis therapy]. PMID- 6858009 TI - [Peritoneal clearance and transfer of proteins in continuous ambulatory peritoneal dialysis]. PMID- 6858010 TI - [Vitamin C and continuous ambulatory peritoneal dialysis]. PMID- 6858011 TI - [Vasodilation therapy]. PMID- 6858012 TI - [Activity of thrombocytes in patients with ischemic cerebrovascular disorders]. PMID- 6858013 TI - [The role of emotions in the systematic approach to treatment of chronic alcoholics]. PMID- 6858014 TI - [The effect of the mass of footwear on certain physiological parameters in walking and running]. PMID- 6858015 TI - [Psychosocial aspects of tattooing in soldiers]. PMID- 6858016 TI - [Rational therapy of angina-pharyngitis]. PMID- 6858017 TI - [Determination of lead in blood and urine with flameless atomic absorption spectrophotometry]. PMID- 6858018 TI - [Preoperative treatment of torpidity wounds]. PMID- 6858019 TI - [Contribution to the knowledge of nomenclature of medicinal substances and their preparation]. PMID- 6858020 TI - [The development and modern problems of immunization against measles with live vaccine]. PMID- 6858021 TI - [Solitary plasmacytoma]. PMID- 6858023 TI - [Fisher's syndrome. A rare variation of polyradiculoneuritis (Guillain-Barre)]. PMID- 6858022 TI - [Fibroplastic Loffler's endocarditis (a case report)]. PMID- 6858024 TI - [Results of medical treatment of stomach ulcers]. PMID- 6858025 TI - [Comparison of the changes in mitotic activity and in serotonin concentration in regenerating liver]. AB - Mobilization of serotonin in intestine and its accumulation in liver and spleen tissues were observed at the initial periods after partial hepatectomy. Later on, content of serotonin was gradually decreased in liver tissue, however, its dynamics exhibited a phasic pattern--the minimal level of the amine coincided in time with the maximal mitotic activity. A negative correlation was found between the content of endogenous serotonin and mitotic activity. Possible role of endogenous serotonin in proliferating processes is discussed. PMID- 6858026 TI - [Functional characteristics of two membrane-bound polysome fractions from chick embryos]. AB - Among various membrane-bound polyribosomes from chicken embryos the polyribosomes loosely bound with membranes proved to be highly active in synthesis of total proteins as well as of collagens in vitro. These data suggest that polyribosomes loosely bound with membranes were not an impurity of free polyribosomes in the total preparation of the membrane-bound polyribosomes. These polyribosomes constituted a definite class of polyribosomes active in the synthesis of secreted proteins (i.e. of collagen). In polyribosome fractions identified by their size (monosomes, light and heavy polyribosomes) all the three fractions of loosely bound polyribosomes as well as light and heavy fractions of tightly-bound polyribosomes were active in synthesis of total proteins. Differences between tightly-and loosely-bound polyribosomes were noted also in studies of cell-free synthesis of collagen proteins. Heavy fractions of tightly-bound polyribosomes were the most active in synthesis of these proteins, light fractions were less active and monosomes did not exhibit any collagen-synthesizing activity. Only monosomes of loosely-bound polyribosomes were responsible for the synthesis of collagen. Polyribosomes loosely-bound with membranes appear to participate at early steps of membrane-polyribosome complex formation. PMID- 6858027 TI - [Lipid composition of mononuclear and polymorphonuclear leukocytes from peripheral blood of patients with chronic ischemic heart disease]. AB - In patients with chronic heart ischemic disease increase in contents of total lipids, total, free and ester-bound cholesterol, phospholipids, free fatty acids and triglycerides was detected in mononuclear leukocytes; in polymorphonuclear leukocytes from peripheric blood of the patients increase in content of phospholipids with simultaneous decrease of free fatty acids and triglycerides were observed as compared with the similar patterns of lipid composition in the cells of healthy persons. PMID- 6858028 TI - [Analysis of lipid and phospholipid spectra in blood and erythrocyte membranes in childhood obesity]. PMID- 6858029 TI - [Polyamines in normal human blood cell proteins and in leukosis]. AB - Content of putrescine, spermidine and spermine was estimated in leukocytes of healthy persons and of patients with various forms of leukoses. Spermine was the main component of the polyamine fraction in leukocytes; only small amount of putrescine was found. In leukoses, as the cell population rejuvenated, content of polyamines increased with elevation in the ratio spermidine/spermine approaching the maximal value in blast cells of blood from patients with acute leukosis. PMID- 6858030 TI - [State of lipid metabolism in rats preferably consuming water or ethanol solution]. AB - Content of total lipid in blood plasma, liver, brain, heart and spleen tissues, concentration of total phospholipids and cholesterol in blood plasma and of triacylglycerides in brain and liver tissues were increased in rats consuming ethanol as compared with animals drinking water. In liver tissue of ethanol consuming animals a decrease in phosphatidylcholine content and increase in lysophosphatidylcholine and sphingomyelin were observed; in brain concentration of phosphatidylethanolamine was decreased and of phosphatidylcholine--increased. Incorporation of 2(-14)C-acetate into cholesterol, total phospholipids as well as into the lipid fractions studied was increased in liver tissue of ethanol consuming rats; at the same time, incorporation of the label into total phospholipids, sphingomyelin, phosphatidylcholine and phosphatidylethanolamine was decreased in brain tissue of these rats. PMID- 6858032 TI - [Differences in the secondary structure of thyroglobulin under normal conditions and in nodular goiter]. AB - Intact and iodine-treated thyroglobulin from normal thyroid gland and from nodular euthyroid goiter were studied by means of circular dichroism to detect differences in the protein secondary structure. Contents of alpha- and beta structures in thyroglobulins were differentiated only by several per cents but artificial iodination of the protein increased markedly the difference between thyroglobulins of various origin. Extrapolation of the data to "zero" content of iodine-containing amino acids demonstrated that the initial steps of thyroglobulin synthesis occurring before iodination "in vitro", appears to be also responsible for alterations in the protein secondary structure. PMID- 6858031 TI - [Characteristics of lipoprotein metabolism impairments in nephrotic syndrome]. AB - Hyperlipoproteinemia corresponding to the IIb type was developed in the most patients with diffuse chronic glomerulonephritis and nephrotic syndrome. In blood concentration of very low density lipoproteins (VLDL) was increased with simultaneous accumulation of cholesterol in the fraction. Under conditions of nephrotic syndrome most distinct increase of the Sf 20-12 fraction and content of triglycerides, as compared with the Sf 12-0 fraction, was found in lipoproteins of low density (LDL) Content of cholesterol in high density lipoproteins (HDL) was decreased as compared with donor blood. Activity of postheparin lipoprotein lipase decreased in the most patients. Inspite of cholesterol accumulation in VLDL, triglycerides containing in the Sf 400-100 fraction of the patients were hydrolyzed by rat lipoprotein lipase at the high rate; hence, alteration of VLDL composition should be considered as a factor responsible for impairment of lipoprotein metabolism in blood. Content of VLDL was increased in blood of the patients within the first week of dexamethasone treatment. Within the subsequent period the hormone exhibited distinct hypolipidemic effect. In presence of the hormone heparin-dependent lipoprotein lipase was activated. Increase of lipolytic activity was observed in urine of patients simultaneously with distinct proteinuria. PMID- 6858034 TI - [Metabolic consequences of kidney normothermic ischemia]. AB - Normothermic ischemia of kidney within 1 hr caused critical impairments in metabolic reactions of nephrons. Activities of glucose-6-phosphate and lactate dehydrogenases in erythrocytes may characterize the functional state of kidney tissue in ischemia. Amount of 2,3-glucose diphosphate in erythrocytes correlated with the diuresis level. Kidney tissue ischemia led to alteration in the ratio of young and old erythrocyte populations in circulation. Alterations in activity of glucose-6-phosphate and lactate dehydrogenases in urine occurred due to both an increase in kidney clearance and the impairment of kidney tissue. PMID- 6858033 TI - [Lipolytic activity in blood plasma of patients with ischemic heart disease after administration of heparin on an empty stomach and with simultaneous fatty loading]. AB - Effect of heparin on the lipoprotein lipase activity was studied after its administration into fasting and fat loaded patients with heart ischemic disease, exhibiting various lipoprotein spectrum of blood. Heparin activated more distinctly the lipolytic enzymes in the patients kept on fatty diet as compared with the fasting patients. The difference was maximal in the patients with the IIa type of hypolipoproteinemia and minimal--in the patients with the IV type of the disease. The hypotriglyceridemic effect of heparin was found in all the groups examined; however, the least decrease in the triglyceride content occurred in the IV type of hypolipoproteinemia. These data demonstrate the relative deficiency of lipoprotein lipolysis in the type of hypolipoproteinemia studied. PMID- 6858036 TI - [Alterations of carbohydrate-containing components in glycoproteins of blood serum and blood cells from hypothyroid rats]. AB - Effect of simultaneous treatment with various doses of 6-methylthiouracil and thyroidectomy on content of carbohydrate-containing glycoproteins was studied in blood serum and plasmatic membranes of rat erythrocytes and leukocytes. Doses and schedule of the thyrostatics administration determined their effect on concentration of the glycoproteins studied. Correlation of various degree and significance was found between the alterations in content of individual carbohydrate-containing components, especially in membranes of erythrocytes and leukocytes. The data obtained enabled to elucidate the mechanisms of alterations in content of the glycoproteins studied in blood serum and plasmatic membranes of blood cells. PMID- 6858035 TI - [Effect of nonionic detergents on the results of studies of dehydrogenase and cholinesterase activities under conditions of enzyme electrophoresis]. AB - Nonionic detergents of polyhydroxyethylene series were shown to catalyze the reduction of trinitrotetrazolium blue in reactions involving phenazinemethosulfate and other reducing agents. An approach of dehydrogenase fractions to the micells of nonionic detergents during enzyme gel electrophoresis led to an increase in colour intensity of individual isoenzymes and to redistribution of the isoenzyme spectrum as a result of catalytic effect of the detergents. PMID- 6858037 TI - [Biogenic monoamines and their precursors in rats with spontaneous arterial hypertension]. AB - Content of tryptophane, tyrosine, serotonin, noradrenaline, adrenaline and dopamine was studied in blood serum and various brain regions of rats with genetically determined spontaneous form of hypertension. The arterial pressure of these animals was shown to depend on activity of noradrenaline-, serotonin- and dopaminergic systems of brain. Oppositely directed alterations in content of dopamine and noradrenaline were observed in various brain regions apparently as a result of changes in activity of the enzymes involved in the amines synthesis and degradation. PMID- 6858038 TI - [Physiological mechanisms of the regulation of lipoprotein biosynthesis in liver during physical exercise and in different phases of the restoration period]. AB - Changes in serum lipoprotein pattern and in total content of low density lipoproteins (LDL) and very low density lipoproteins (VLDL) were studied in blood and liver tissues of rats during physical exercise and restoration. Physical training induced synthesis of liver lipoproteins, in particular of their protein components. An initial period of lipoprotein synthesis in the liver tissue was preceded by transient activation of lysosomes in hepatocytes and their translocation towards nuclei. When lysosome translocation was depressed by vinblastine or colchicine injected 1 h before the physical exercise, an increase in total amount of LDL and VLDL fractions in liver and blood could not be observed. The inhibition of lysosomal proteolytic activity by hordox also impaired an increase in blood and liver lipoproteins. The data obtained suggest that activation of lysosomes and their translocation towards nuclei are important for induction of lipoprotein synthesis in liver tissue during physical exercise. PMID- 6858039 TI - [Molecular mechanisms of interaction between blood serum albumin and dinitroorthocresol]. AB - Interactions of dinitroortocresol with human blood serum albumin were studied using equilibrium dialysis, spectrofluorimetry and polarography. Two classes of binding sites were found in the protein molecule: high-affinity site, binding 4 molecules of cresol and a low-affinity site, binding up to 12 molecules. Binding of dinitroortocresol occurred simultaneously with alteration in the albumin molecule conformation. PMID- 6858041 TI - [Effect of L-thyroxine on content of carbohydrate components of glycoproteins in subcellular fractions of liver, thyroid gland and blood cells of rats]. AB - Content of carbohydrate components of glycoproteins (sialic acids, hexosamines, hexoses bound with proteins and L-fucose), their correlation and normalization in subcellular fractions of liver and thyroid gland tissues as well as in blood cells were studied after administration of various doses of L-thyroxin. Various doses of the hormone caused a dissimilar effect on alterations of the carbohydrate components in the structural elements of the tissues studied. Within 24 days after the hormone administration its small doses increased generally the carbohydrate content, middle doses--decreased their content in mitochondria and microsomes but increased in homogenate, plasmatic, mitochondrial and microsomal membranes, high doses--decreased the carbohydrate components in all the preparations studied. The period of normalization in the level of carbohydrate containing components of glycoproteins from rat liver tissue depended on the dose of L-thyroxin administered. Quantitative impairments in carbohydrate-containing components of glycoproteins are discussed. PMID- 6858040 TI - [Normalization of impairments in deamination of nitrogen compounds in experimental hypercholesterolemia]. AB - Appearance of cadaverine deaminating activity in mitochondrial fractions of liver and kidney of rabbits with experimental alimentary hypercholesterolaemia was prevented by an antioxant diludin (2,6-dimethyl-3,5-diethoxycarbonyl-1,4 dihydropyridine) which also decreased the abnormally elevated AMP-deaminating activity and elevated the decreased monoamine oxidase activity (substrates: serotonin, benzylamine, tyramine). In heart and brain tissues as compared with liver and kidney the impairments caused by hypercholesterolaemia and the normalizing effect of diludin were less distinct. The effects of diludin could be reproduced by nucleophylic reagents sodium thiosulphate or ascorbate. The normalization of impairments in deamination of nitrogenous compounds in hypercholesterolaemia was accompanied by improvement in morpho-physiological manifestations of atherosclerosis (injury of aortal intima, alteration in heart rhythm, changes in content of cholesterol, triglycerides and lipoproteins in blood serum). The data obtained are in agreement with the hypothesis on the significance of qualitative alteration (transformation) in catalytic properties of mitochondrial monoamine oxidases in the mechanism of impairments in deamination of nitrogenous compounds in atherosclerosis. PMID- 6858043 TI - [Threshold of the action of carcinogenic factors]. PMID- 6858044 TI - [Current problems of primary prevention of cancer]. PMID- 6858042 TI - [On the article by Turusov and Parfenov, "Problems of threshold in chemical carcinogenesis"]. PMID- 6858046 TI - [The state of the epidermis and the morphometric evaluation of epithelial cells in nevi and skin melanomas]. AB - 9 nevi and 11 melanomas, identified in accordance with present-day classifications, were examined. The histological and morphometric peculiarities of epithelium in the growth zone of these lesions and adjacent areas were studied. A significant correlation was established between histological and biochemical indexes, on the one hand, and the biological characteristics of melanocyte proliferation, on the other. Hyperplastic processes in melanoma and adjacent zone were matched by a marked increase in the cell size (2.5-5 times that in nevus). Deep submerged epithelial vegetations in melanoma form the basis for tumor cell proliferation and subsequent invasion; hence, they may be regarded as possible pathway of tumor progression. This morphogenetic peculiarity should be taken into account in identification of melanoma and determination of tendencies of its growth. PMID- 6858045 TI - [Interspecific embryonic antigens in the blood serum of cancer patients]. AB - Synthesis of animal embryonic proteins in human tumors, i.e. a phenomenon of interspecific embryonal reversion is discussed. Two new interspecific embryonic antigens (IEA) with relative molecular weights of 80,000 +/- 10,000 dalton (IEA 1) and 36,000 +/- 10,000 dalton (IEA-2) were identified, using antisera obtained by immunization of rabbits with a protein fraction isolated from glycoproteins of amniotic fluid of cattle fetuses. These proteins were detectable in blood serum and amniotic fluid of cow, sheep and pig fetuses and were not in human fetus. An immunoenzymatic method was used to identify IEA-1 in blood serum in 14-20% of cancer patients and in 58% of melanoma cases. IEA-1 was not detected in blood serum of non-tumor patients. IEA-2 was identified in 21-22% of tumor and non tumor patients. PMID- 6858047 TI - [Basic paths of development of scientific trends in oncology and the training of a staff of scientific worker-oncologists (based on dissertations defended in 1976 1980)]. PMID- 6858048 TI - [Immunologic response in patients with melanoma of the skin]. AB - Immunologic vigor was studied in 108 patients with skin melanoma and 20 healthy subjects by time-delayed hypersensitivity skin and leukocyte adherence inhibition tests. A correlation between changes in immune response and the clinical picture of melanoma was established. During remission immunologic indexes became stabilized in most patients. As tumor progressed, immune response deteriorated markedly, blood serum developed a blocking effect and promoted leukocyte adherence. Healthy subjects who were in close contact with melanoma, showed positive reaction in leukocyte adherence inhibition test with melanoma tissue extract. PMID- 6858049 TI - [Correlation of the level of humoral cytotoxins and delayed hypersensitivity skin reactions with survival of patients with melanoma of the skin]. AB - The study was concerned with relationships between blood-humoral cytotoxin level, time-delayed hypersensitivity skin reaction to DNCB and 3- and 5-year survival in skin melanoma patients. Humoral cytotoxin level proved to be irrelevant for prognosis, although this index may be sometimes used as a supplementary criterion for evaluating immunocompetence. Skin reactions to DNCB provide a valuable prognostic means in skin melanoma patients: 3- and 5-year survival rates are significantly higher in patients showing positive reaction than in those with negative reaction. PMID- 6858050 TI - [X-ray pattern of metastatic tumors of subcutaneous fat]. AB - The results of X-ray examination of 33 cases of metastases of different malignant tumors into subcutaneous fat are analysed. Such metastases appear in radiographs as single or multiple nodes of a density comparable with that of muscular tissue. They have a homogenous structure and a regular round shape with contours which may be indistinct in some areas. There are dilated vessels at tumor poles. Differential diagnosis between sarcoma, benign tumor and non-tumor process is discussed. PMID- 6858051 TI - [Modern possibilities of the surgical treatment of lung cancer]. AB - The twenty-year experience gained in the surgical treatment of 1,100 cases of lung cancer at the Clinic of Thoracic Oncology and Reanimation Department of the Center is summarized. Surgical and anesthetic procedures, premedication and methods of postoperative intensive care following resection or removal of the lung are discussed. The paper contains a detailed description of age-associated and concommitant diseases. Factors contributing to extension of indications for surgical treatment of lung cancer are analysed. Prevention and treatment of postoperative complications are considered. PMID- 6858053 TI - [Effect of tumor antigens on receptors of T-and B-lymphocytes in patients with cancer of the stomach]. AB - The effect of tumor antigens and those of gastric mucosa on rosette-formation by T-lymphocytes of blood and sheep red blood cells was studied in 65 gastric cancer patients by means of a spontaneous E-rosette-formation variation test. Antigens of original tumor extracts stimulated rosette-formation in 55.4% of patients, more frequently in cases of stage I-II tumors than in those of stage IV. After antigens of normal mucosa were removed from tumor extracts the frequency of positive tests did not change significantly in gastric cancer group, whereas, in controls, it dropped from 26.4 to 7.5%. Tumor antigens tested did not produce the same effect on the rosette-formation by B-lymphocytes with mouse red blood cells. PMID- 6858052 TI - [Prognostic significance of the determination of carcinoembryonic antigen in the blood of patients with lung cancer]. AB - Correlation analysis of the results of examination of 86 lung cancer patients treated by surgery and methods other than surgery established an inverse relationship between life-span and carcinoembryonic antigen (CEA) level. An analysis using reagents supplied by CEA-IRE-Sorin Company showed that a CEA level in blood in excess of 10 micrograms/l is associated with the most unfavorable prognosis. The degree and rate of CEA excretion are in direct correlation with life-span and provide the most reliable criterion in evaluating the effectiveness of lung cancer treatment. PMID- 6858056 TI - [Determination of the indications for reconstructive surgery following the removal of extensive malignancies of the head and neck]. AB - The paper discusses the results of 132 operations for plastic reconstruction of large areas of the head and neck, following removal of tumor. High-speed procedures using skin-fat and skin-muscle flaps cut along superficial vessels were performed. Application of conventional methods of one- and two-stage cosmetic surgery is time-consuming and may be followed by complications in the postoperative period. Outlines of a procedure for computing the time when plastic surgery becomes indicated are suggested. PMID- 6858057 TI - [Plasmocytic granuloma of the lung]. PMID- 6858058 TI - [Combination of early stomach cancer with wide-spread cancer of the urinary bladder and prostate]. PMID- 6858059 TI - [Patent information studies in establishing and carrying out a research plan]. PMID- 6858055 TI - [Effect of carcinogenic 2-naphthylamine on organ cultures of the urinary bladder of the rat]. AB - Treatment with 2-naphthylamine was followed by an 1.5-3 fold increase in the frequency of hyperplastic changes in the organ culture cells of rat urinary bladder epithelium, as compared with intact control and cell cultures treated with a non-carcinogenic analog (30.8, 17.6 and 10.7%, respectively). It is suggested that this effect was associated with the initial specific blastogenic effect of 2-naphthylamine metabolites on rat urothelium, the latter being traditionally considered resistant to this agent. Some other factors absent in rats but present in humans and dogs are indispensable for further malignant transformation and tumorigenesis. PMID- 6858054 TI - [Microspectrophotometric study of the DNA content of the nucleus of cells from premalignant polyps and cancer of the rectum]. AB - 38 adenomatous polyps, 42 villous polyps with varying degree of proliferation and epithelial dysplasia, 34 polyps with preinvasive cancer components and 44 polyps containing invasive cancer elements were examined microspectrophotometrically. The analysis established an increased level of epithelial cells with ploidy varying 3c-5c to be a characteristic feature of the initial stages of malignant transformation of rectal polyps. The invasive cancer had similar peculiarities. PMID- 6858060 TI - [Diagnostic laparotomy with splenectomy in lymphogranulomatosis in children]. AB - Diagnostic laparotomy aimed at identification of the stage of the process and splenectomy were conducted in 370 children (aged 2.5-16 years) suffering from Hodgkin's disease. Preoperatively, the clinical stage distribution of patients was as follows: stage I-34 patients (9.2%), II-210 (56.8%), III-108 (29.2%) and IV-18 (4.9%). Postoperatively, morphological stage I was established in 26, stage II-132, stage III-182 and stage IV-in 30 cases (7.0, 35.7, 49.2 and 8.1%, respectively). Stage was revised in 126 out of 370 patients (34.1%), i. e. in more than a third of cases. Specific lesions of the spleen occurred in 172 cases (46.5%), hepatic lesions--in 22 (5.9%). Explorative laparotomy is of high diagnostic value in stage identification in pediatric Hodgkin's disease. It is instrumental in obtaining bioptates for morphological examination. Splenectomy was not followed by any changes in the frequency of infectious diseases in children patients with Hodgkin's disease. PMID- 6858061 TI - [Time periods of the occurrence of local recurrences and the late results of the treatment of skin melanomas following surgical excision of the primary tumor]. AB - An analysis of the clinical data on 175 cases of local recurrence of malignant melanoma of the skin after surgery established the rate of incidence of these lesions in primary patients at 5.4 +/- 0.7%. In 41.7 +/- 3.7%, local lesions co occurred with the development of regional, intransit and distant metastases. In 88.0 +/- 2.6%, local recurrences appeared within the first three years after excision of primary tumor. The rate of survival of such patients within five years after removal of recurrent tumor was 31.4 +/- 3.9% and 21.2 +/- 4.1%--after ten years. PMID- 6858062 TI - [Development of oncological research performed at the dissertation level 1976 1980]. PMID- 6858063 TI - [Combined treatment of cancer of the middle third of the esophagus]. AB - The results of combined treatment of carcinoma of the mid-third of the esophagus are discussed. Optimal radiation dose appeared to be 30-40 Gy. Surgery should be performed not later than three weeks after termination of radiation treatment. Preoperative irradiation may be followed by pulmonary complications. Due to application of combined treatment of esophageal cancer, percentage of operable cases is increased. However, no effect on 5-year survival was registered. PMID- 6858065 TI - [Light and electron microscopic study of the degree of differentiation of cancer of the large intestine]. AB - Two groups of human rectal tumors histologically identified as well- and poorly differentiated carcinomas were studied by means of electron microscopy. Some tumors of the former group consisted of undifferentiated cells only, while the others comprised chiefly differentiated cells (goblet cells, enterocytes, oncocytes and/or endocrine cells). Some tumors of the latter group consisted of undifferentiated cells only or partially. The remaining tumors were formed mostly of differentiated cells with organ-specific characteristics. It is inferred that a comparison of the results of identification of the degree of tumor cell differentiation by light and electron microscopy may be inconclusive. This conclusion may provide a plausible explanation of the difference in prognosis and response to treatment of rectal tumors of similar histological patterns. PMID- 6858064 TI - [Anatomy and topography of the regional lymph nodes of the liver and gallbladder]. AB - Regional lymph nodes of the liver and gallbladder were examined in the autopsies of 80 adults (aged 17-96) in whom deaths were caused by factors not associated with lymph or gastrointestinal tract lesions. Lymphatic vessels of the liver and gallbladder are discharged into the lymph nodes of ten groups in abdominal cavity and four groups--in thoracic cavity. Also, they are discharged into thoracic duct. All lymphatic vessels of the liver and gallbladder are discharged into hepatic and pancreato-duodenal nodes only. The size of regional lymph nodes of the liver and gallbladder varies within 1-75 mm. PMID- 6858066 TI - [Influence of the rhythm and route of 1,2-dimethylhydrazine administration on its carcinogenic effect in mice]. AB - Effects of route of administration (subcutaneous, intraperitoneal, by stomach tube and with drinking water) and dose fractionation on the carcinogenicity of 1,2-dimethylhydrazine (DMH) were studied in CBA and (C57B1/6j X CBA)F1 mice. Fractionation of DMH dose given subcutaneously exerted different effects on tumors at various sites: decrease of colon and anal tumor incidence, increase of vascular liver tumors and renal adenomas and no influence on hepatoma, lung adenoma and uterine sarcoma induction. When given with drinking water, DMH did not induce colon and anal tumors but produced high incidence of vascular neoplasms. No such effect was observed when DMH was administered weekly by stomach tube. Alteration of the organotropism of DMH given with drinking water is attributed by authors to the decrease of single DMH dose and not to peroral route of administration. PMID- 6858067 TI - [Microroentgenography of transplantable tumors]. AB - Ehrlich ascites tumors were transplanted into the soft tissue of albino mouse hind leg. It was found that vascularization in tumor tissue proceeds in step with relevant morphologic alterations. The formation of three patterns of blood circulation system in tumor is completed within 7 days. Tumor transplantation is followed by pronounced vascular dystonia development and venous plethora. These changes are particularly distinct in lymph nodes in the zone adjacent to tumor. PMID- 6858069 TI - [Nutrition sciences in the implementation of the USSR food program]. PMID- 6858068 TI - [Various indicators of metabolism and energy expenditure in inadequate nutrition]. AB - The authors studied energy, nitrous, lipid, carbohydrate, mineral and vitamin metabolism in subjects aged 18-21 years exposed during 8 days to high physical loads within 4540-8495 kkal/day and given the daily diet consisting of natural food with an energy value of 3220 kkal. During the observation period, the body weight losses amounted to 3.7 kg (5.3%) of the initial weight magnitude on the average, whereas the amount of fatty component dropped by 23.9%. The test subjects manifested a decrease in work fitness, a fall in the main metabolism by 23%, reduction of the respiratory ratio to 0.67, and considerable alterations in the majority of metabolic indices. The recovery of the body status till the attainment of the initial level lasted 3-5 days. The subjects with a good physical stature tolerated the period of inadequate nutrition fairly well. PMID- 6858071 TI - [Effect of iodine deficiency on the growth and formation of the bone tissue]. AB - The authors studied several groups of children in terms of the height in endemic goiter regions and in the regions with no goiter incidence. Subject to study were also processes of osteogenesis and phosphocalcium metabolism in animals with iodine deficiency in the diet. It was established that in goiter endemic regions, the number of children under medium and of low height was increased while that of medium and over medium height, and the number of tall children were reduced. It was also found that iodine deficiency in the diet of animals entailed abnormalities in the growth patterns, destructive alterations in the bones and bone marrow, a decrease in the content of hydroxyproline, hexosamines, and in the activity of phosphomonoesterase-I in animal bones, as well as disorders of phosphocalcium metabolism. PMID- 6858070 TI - [Effectiveness of the diet therapy program in patients with chronic renal failure]. AB - The authors developed diets 7A and 7B with varying supply of low-protein food for different therapeutic institutions. Sixty-four four patients with chronic renal failure (CRF) received an experimental diet according to an individual program with regard to the stage, the clinical pattern of CRF and the patient's tolerance to protein. The diet was given after the patients had been kept on the control standard, low-protein, and high-caloric diet. After 3 to 10 weeks of the preset dietetic management the patients showed a considerable improvement in the well being, an increase in the mean body weight accompanied by decreased edema, fat and hypertension. The time course of changes in the laboratory indicators attested to an improvement of nitrous, protein, lipid and carbohydrate metabolism, a decrease in electrolyte abnormalities, acidosis, and anemia. The deficiency of essential amino acids in the blood remained unchanged, but their ratio to replaceable amino acids slightly increased, while loss with urine declined. PMID- 6858072 TI - [Method of continuous quantitative recording of gastric acid levels in the stomach]. AB - The author describes a method for a quantitative recording of hydrochloric acid output in the stomach of an anesthetized rat in the course of gastric perfusion with a buffer solution. Describes in detail the design of an experimental set up, provides the magnitudes of basal and histamine- and pentagastrin-stimulated gastric secretion of acid. Discusses different schemes of applying the method to exploring the action of stimulants and inhibitors of acid secretion in the stomach. PMID- 6858073 TI - [Mechanism of the inhibitory effect of fat on gastric secretion]. AB - Experiments on dogs were made to demonstrate the importance of humoral factor for the inhibitory action of fat. The mechanism of the effect of fat and antidiuretic hormone on gastric secretion was found to be different. Fatty emulsion was discovered to produce an inhibitory action on gastric secretion when administered parenterally, while lipid secretion with bile to the duodenum to be of importance. The inhibitory effect of prostaglandin E2 on gastric juice secretion was studied. It has been demonstrated that this action is not removed by adrenoblockers. PMID- 6858074 TI - [Effect of small amounts of 2,4-dichlorophenoxyacetic acid derivatives on thiamine and riboflavin metabolism in the animal body]. AB - Administration of the herbicide 2,4-DN (amine salt of 2,4-dichlorphenoxyacetic acid) to weanling rats in a dose of 1/20.000 and 1/2000 of the LD50 for 3 months brought about a 40-50% reduction of thiamine content in the organs and tissues of experimental animals as compared with control. The herbicide was introduced into a balanced formula diet. In the liver of rats given 2,4-DA, there was a 2-fold decrease in the content of flavine adeninedinucleotide, whereas the content of flavine mononucleotide showed a 2-fold rise. Besides, the rats given a lesser herbicide dose manifested a reduced excretion of riboflavine with urine, and an inhibition of liver succinate dehydrogenase. The same animals demonstrated an increase in the relative mass of the adrenals with a concurrent diminution in them of ascorbic acid content. PMID- 6858076 TI - [Effect of partial starvation on blood coagulation and fibrinolysis]. PMID- 6858075 TI - [Method of quantitative determination of vegetable fats in the Malysh and Maliutka infant foods]. PMID- 6858077 TI - [Urinary excretion of free amino acids in rats given food with different protein contents]. PMID- 6858079 TI - Hepatitis-associated markers in the American Red Cross blood donor population. V. Prevalence of antibodies to core antigen in three blood services regions. AB - A total of 20,643 samples of blood donated to three American Red Cross Blood Service regions were tested for antibodies to hepatitis B core antigen (anti-HBc) in order to evaluate and understand its significance and implications. All 20,643 samples were non-reactive for hepatitis B surface antigen (HBsAg) when screened at the regions. Overall, 2.2% of all samples were found to have anti-HBc, and a total of 16 had anti-HBc in the absence of antibodies to surface antigen (anti HBs) activity. 1 of the 16 samples with anti-HBc in the absence of anti-HBs was found to have HBsAg when tested by a sensitive procedural modification of the Austria II test. Samples with low levels of anti-HBc activity were significantly more likely to be negative for anti-HBs. PMID- 6858078 TI - Is the use of the term 'posttransfusion hepatitis type B' in its conventional sense still justifiable? AB - We have investigated 8 cases of clinically manifest hepatitis type B said to be posttransfusion hepatitis that have become known in the years 1978-1981. Paired samples of serum from all 54 blood donors implicated have been drawn at the time of the donation in question as well as a few months later. Only 1 donor, negative for HBsAg but positive with high titer for anti-HBc, could have been a possible source of infection. There is strong evidence that this person is a chronic low level carrier. In the case of 2 other patients transmission of hepatitis by clotting factors from pooled plasma cannot be denied. Regarding the remaining 5 cases, there is no hint whatsoever for a causal connection between blood transfusion and hepatitis type B. PMID- 6858082 TI - [Characteristics of the clinical course of cervical osteochondrosis of the spine]. PMID- 6858080 TI - A Caucasian family with the i phenotype and congenital cataracts. PMID- 6858083 TI - [Effect of different doses of a UHF field on the morphofunctional state of the kidneys]. PMID- 6858081 TI - [Effect of a tonsillar infection on liver carbohydrate function in chronic cholecystitis patients]. PMID- 6858084 TI - [Clinico-epidemiological indices of viral hepatitis A]. PMID- 6858085 TI - [Cases of tularemia in Lvov Province]. PMID- 6858086 TI - [2 cases of Reiter's disease]. PMID- 6858087 TI - [Effect of social hygiene factors on morbidity with temporary work incapacity among the female workers of a chemical fiber plant]. PMID- 6858088 TI - [Diagnostic importance of determining lysozyme in the bile in biliary tract diseases]. PMID- 6858089 TI - [Improvement in the work of infectious disease departments]. PMID- 6858090 TI - [Current problems of the professional psychological training of medical personnel]. PMID- 6858091 TI - [7 questions on the postgraduate education of therapists]. PMID- 6858092 TI - [Improved advanced teacher education--an important link in improving the training of medical personnel]. PMID- 6858093 TI - [Intensity of kinin formation in chronic cholecystitis patients]. PMID- 6858094 TI - [Enzyme activity of the blood serum and of the liver and gallbladder tissues in experimental cholecystitis]. PMID- 6858095 TI - [Interrelation of the vascular system of the liver and biliary tracts in chronic cholecystitis patients]. PMID- 6858096 TI - [Changes in liver function after partial and complete removal of the pancreas]. PMID- 6858097 TI - [Clinico-enzymatic criteria for the differential diagnosis of hepatic and subhepatic jaundice]. PMID- 6858098 TI - [Immunological indices in chronic pancreatitis]. PMID- 6858099 TI - [Role of absorption in the pathogenesis and treatment of the dumping syndrome]. PMID- 6858100 TI - [Importance of endoscopic studies in the early detection of stomach and intestinal diseases in the polyclinic]. PMID- 6858101 TI - [Effect of alcohol on the lipid spectrum of the blood serum in patients with chronic persistent hepatitis]. PMID- 6858102 TI - [Effect of intensive gamma irradiation on the blood biochemical indices in colonic cancer patients]. PMID- 6858103 TI - [Method of diagnosing circulatory failure in the acute period of myocardial infarct]. PMID- 6858105 TI - [Characteristics of night sleep in different forms of ischemic heart disease]. PMID- 6858104 TI - [Lesion of the right heart ventricle in combined myocardial infarct]. PMID- 6858106 TI - [Intracardiac hemodynamics and the external work of the heart in patients with different manifestations of coronary arteriosclerosis]. PMID- 6858107 TI - [Effect of baralgin on the indices of hemodynamics and acid-base equilibrium in patients with occlusive lesions of the arterial vessels]. PMID- 6858109 TI - [Effect of alcoholic intoxication on regional cerebral blood flow and on local vascular reactivity in craniocerebral injury]. PMID- 6858108 TI - [Development of disseminated intravascular coagulation as a consequence of traumatic spinal cord injury]. PMID- 6858110 TI - [Genesis of hemangiomas]. PMID- 6858111 TI - [Complications of pulmonary heart failure]. PMID- 6858112 TI - [Blood coagulation in chronic lung disease patients with systemic arterial hypertension]. PMID- 6858115 TI - [Treatment characteristics of patients with tuberculosis and nonspecific lung diseases complicated by chronic cor pulmonale]. PMID- 6858114 TI - [Esophagus and cardial sphincter in chronic cholecystitis patients]. PMID- 6858117 TI - [Course and outcome of newly detected destructive pulmonary tuberculosis]. PMID- 6858116 TI - [Differential methods of treating chronic bronchitis using physical factors]. PMID- 6858113 TI - [Cardiovascular status of bronchial asthma patients]. PMID- 6858119 TI - [Clinico-immunological evaluation of the levamisole treatment of chronic glomerulonephritis patients]. PMID- 6858118 TI - [Clinico-microbiological evaluation of ketotsef]. PMID- 6858120 TI - [Case of the combined course of hemochromatosis and amyloidosis of the kidneys]. PMID- 6858121 TI - Role of Clostridium difficile and Campylobacter jejuni in relapses of inflammatory bowel disease. AB - Findings from recent studies on the role of Clostridium difficile and Campylobacter jejuni in exacerbations of inflammatory bowel disease are in conflict. We examined stool specimens from 32 patients who had inflammatory bowel disease in relapse for the presence of C difficile and C difficile cytotoxin. In the last 19 cases stool specimens were also cultured for C jejuni. C difficile was identified in one patient who was receiving antimicrobial therapy. In no patient was C difficile cytotoxin detected. All cultures for C jejuni were negative. Routine screening of stool specimens for C difficile cytotoxin and C jejuni was not clinically useful in our patients during exacerbation of their inflammatory bowel disease. PMID- 6858122 TI - Veterans' reactions to release of American hostages. AB - Soon after the return of the hostages from Iran, the staff of the Mental Health Clinic of the Veterans Administration Outpatient Clinic, Santa Barbara, California, began noting an unusual association between veterans' feelings and the attention given the returning hostages. Of 100 veterans referred at random for diagnosis and treatment, not one had positive feelings about the reception given the returning hostages; 34 viewed the festivities and proclamations of welcome as excessive and unfair, and 12 expressed violent feelings toward the hostages, media people or members of the government. Of these 100 veterans, 52 expressed anxiety and excessive irritability, 41 were having psychic symptoms of depression and 38 reported sexual disturbances. This unusual form of stress had activated long-dormant feelings in veterans of four different wars and several generations. PMID- 6858123 TI - Bronchoscopic diagnosis of pulmonary infections. Comparison of protected-specimen brush and cytology brush with lung aspirates. AB - In a recent study the use of a new plugged double-lumen protected-specimen brush with the flexible fiberoptic bronchoscope was advocated to isolate pathogens in lower respiratory tract infections while avoiding upper respiratory tract contamination. To compare the efficacy of this brush and a standard single-lumen cytology brush in identifying the etiologic agent in lower respiratory tract infections, we studied 18 patients with lung infections. Transthoracic lung aspiration was done in all but two patients in an attempt to identify the specific etiologic agent. In these two cases, cultures of specimens of blood or postmortem lung tissue yielded the causative organism. In 12 patients anaerobic or aerobic bacteria (or both) were identified, whereas one patient had a mixed bacterial and fungal infection. Using the cytology brush and the protected specimen brush we identified at least one pathogen in 10 of 12 and 10 of 13 cases, whereas both brushes missed one or more causative organisms in 8 of 12 and 8 of 13 cases, respectively. Nonetiologic organisms were found in 8 of 12 cases by the cytology brush and 8 of 13 cases by the protected-specimen brush. Quantitative culture techniques improved the specificity of the brush results in infections where aerobes predominated. Our data show that bronchoscopic cultures of lower respiratory tract infections do not consistently recover the causative agent and are frequently subject to contamination by nonetiologic organisms. There was no difference between the brushes in avoiding contamination. PMID- 6858124 TI - Theophylline-induced seizures: clinical and pathophysiologic aspects. AB - The clinical features and management of theophylline-induced seizures are not well appreciated in spite of their unique aspects. These seizures tend to occur in neurologically intact patients and leave no or only minor neurologic sequelae if controlled early. They begin with focal motor seizures with or without secondary generalization and are followed by stupor or coma. They are responsive only to adjustment of theophylline dosage. Should the motor phenomenon persist, it takes the form of epilepsia partialis continua. Extensive workup for a structural brain lesion may be unrewarding. The electroencephalogram typically shows periodic lateralized epileptiform discharges, which may provide a diagnostic clue. PMID- 6858126 TI - Real and perceived risks of medical radiation exposure. AB - There is almost no subject that elicits greater concern and less objective understanding than that of exposure of patients to radiation accompanying diagnostic radiologic procedures. One or more of the health effects (cancer, developmental abnormalties and genetic changes) attributed to low-level exposure to radiation are frequently misinterpreted as likely consequences rather than statistical risks following radiation exposure. Even less well understood is the small magnitude of the risks accompanying radiation exposure compared with those related to activities encountered during the daily routine. For this reason, the perception of risk associated with exposure to low-level radiation is inconsistent with the reality of the risk as estimated by even the most conservative models of radiation injury. PMID- 6858125 TI - Screening for chlamydial infections in women attending family planning clinics. PMID- 6858127 TI - Radiation and health. PMID- 6858129 TI - Low-dose propranolol therapy for aborting migraine. PMID- 6858128 TI - The 'Alice in Wonderland' experience. Ergot alkaloid therapy for prolactin secreting pituitary tumors. AB - This discussion was selected from the weekly Grand Rounds in the Department of Medicine, University of New Mexico School of Medicine and Veterans Administration Medical Center, Albuquerque. Taken from a transcription, it has been edited by Drs Charles Sherman, Resident in Medicine, and Maire T. Buckman, Associate Professor of Medicine and Chief, Endocrinology Section, Veterans Administration Medical Center, Alburquerque. PMID- 6858130 TI - Successful medical management of bilateral ureteral obstruction due to acute uric acid nephropathy. PMID- 6858131 TI - Late complications of tricyclic antidepressant overdose. PMID- 6858132 TI - More on video display terminals. PMID- 6858133 TI - Multiple causality: consequences for medical practice. AB - When a scientifically trained health professional is called upon to deal with patients holding differing causal views of illness, the resulting lack of communication is frustrating to both. This discussion traces some implications for medical practice of significant cultural differences in two aspects of causal paradigms of illness: (1) terms accepted and (2) dimension or level of causality typically sought. The second is the more pervasive and intractable problem, having distinctive consequences for the role of curer, symptomatology, diagnosis and treatment. PMID- 6858134 TI - The University of Southern California School of Medicine. PMID- 6858137 TI - [Changes in the maturation indicators in oral and vaginal cytological smears]. PMID- 6858136 TI - [Method of removing the saphenous vein in the surgical treatment of varicose veins and sensory disorders]. PMID- 6858135 TI - [Blood cholesterol and triglyceride concentration in older age groups of both sexes]. PMID- 6858138 TI - [Physiological and pathological pain]. PMID- 6858139 TI - [2-year observation of a patient with post-traumatic myocardial infarction]. PMID- 6858140 TI - ["Valvular" mechanism of central nervous system ischemia in dissecting aortic aneurysm]. PMID- 6858141 TI - [Coexistence of hypothyroidism and diabetes mellitus with unusual course]. PMID- 6858142 TI - [Acute renal failure in lupus nephropathy, treated with peritoneal dialysis]. PMID- 6858143 TI - [Beckwith-Wiedemann syndrome in an infant]. PMID- 6858144 TI - [Williams' syndrome in 2 children]. PMID- 6858145 TI - [Functional blepharospasm with headache syndrome]. PMID- 6858147 TI - [Kaposi-Juliusberg disease in a 13-month-old girl]. PMID- 6858146 TI - [Acute ethylene glycol poisoning treated with hemodialysis]. PMID- 6858148 TI - [Complications of arterial hypertension]. PMID- 6858149 TI - [Effect of ambulatory physical rehabilitation on the blood coagulation system in patients after myocardial infarction]. PMID- 6858151 TI - [Electrocardiographic studies of persons of very advanced age]. PMID- 6858150 TI - [Pulmonary emphysema in infants who died of acute pneumonia]. PMID- 6858152 TI - [Bacterial etiological factors in urinary tract infections in adults]. PMID- 6858153 TI - [Induction of labor with prostaglandin F2 alpha in prolonged pregnancy]. PMID- 6858154 TI - [Use of salbutamol in the treatment of threatened premature labor]. PMID- 6858155 TI - [Cytological studies in the diagnosis of lung cancer]. PMID- 6858156 TI - [Analytical and clinical aspects of polyamines]. PMID- 6858157 TI - [Pathological somnolence]. PMID- 6858160 TI - [Motor changes masking plasmacytoma]. PMID- 6858161 TI - [Early diagnosis of cancer of the lower esophagus and cardia and the possibilities of surgical treatment]. PMID- 6858159 TI - [Adenocarcinoma of the duodenojejunal segment of the digestive tract]. PMID- 6858158 TI - [Drug-induced hyperthyroidism and pancytopenia in a case of parorexia]. PMID- 6858162 TI - [Analysis of cases of breech presentation]. PMID- 6858164 TI - [Post-traumatic myocardial infarction]. PMID- 6858163 TI - [Usefulness of the Neo-Prognosticon test]. PMID- 6858165 TI - [Rare cause of jaundice in a patient with residual calculi of the bile ducts]. PMID- 6858166 TI - [Chondrosarcoma of the index finger of the right hand]. PMID- 6858168 TI - [Ulnar nerve compression syndrome]. PMID- 6858167 TI - [So-called cough- and exertion-induced headache]. PMID- 6858169 TI - [Pharmacokinetics and acute signs of cardiac toxicity during doxorubicin therapy]. AB - Doxorubicin (Adriamycin) has shown impressive activity in the treatment of a broad spectrum of malignant tumours. Chronic irreversible cardiac myopathy is the usual cumulative dose-limiting toxicity with this anthracycline antibiotic. In this study acute cardiac reactions following doxorubicin infusions (60 mg/m2) were registered by means of ECG Holter monitoring and measurement of systolic time intervals. The PEPI as well as the PEP/LVET ratio were found to be significantly increased, with a peak at 6 hours following drug infusion (p less than 0.001). This observation proves the occurrence of transient myocardial dysfunction during doxorubicin treatment. Pharmacokinetic data showed good correlation between the electrocardiographic changes and the tissue distribution of the drug. Doxorubicin-related ventricular arrhythmias were observed in only 2 out of 6 cases. Repeated acute myocardial damage by doxorubicin infusions is considered to be the cause of chronic cardiomyopathy with long-term administration. PMID- 6858170 TI - [Jopamidol, a non-ionic x-ray contrast medium--tolerance from a neurological viewpoint]. AB - A double-blind trial was carried out in 80 patients, whereby jopamidol, the first stabilized non-ionic contrast medium, and meglumine iodamine were compared in 40 patients undergoing cranial computed tomography and 40 patients subjected to cerebral angiography. There was no difference in the quality of the radiographs. Jopamidol was better tolerated and caused significantly fewer side effects or complications than meglumine iodamine. Our evidence suggests that jopamidol has significant advantages over currently employed contrast media for cranial computed tomography and cerebral angiography. PMID- 6858171 TI - [Substitution therapy with prothrombin complex concentrates in acquired coagulation disorders]. AB - Over the past 11 years two different plasma concentrates--Prothromblex500 (factor II, IX and X) and Prothromblex Total500 (factor II, VII, IX and X) have been used in the treatment of 246 patients with acquired coagulation disorders, in particular deficiencies of the prothrombin complex (factor II, VII, IX and X). Patients on oral anticoagulation or suffering from liver disease required substitute therapy for severe bleeding episodes, acute operations or invasive diagnostic procedures. Serial coagulation studies and analyses showed that both concentrates achieved adequate correlation of the abnormal coagulation, whereby better results were obtained in patients on oral anticoagulation than in patients with severe liver disease. All operations and diagnostic procedures were completed without haemorrhagic complications, whilst the patients admitted for a severe bleeding episode were rapidly brought under control. These plasma concentrates did not cause any side effects. No case of intravascular coagulation was observed following substitution therapy. PMID- 6858172 TI - [Danger to heart and circulation by improper sport practice]. PMID- 6858173 TI - [Experiences with continuous ambulatory peritoneal dialysis (CAPD) at the University Clinic for Internal Medicine in Innsbruck]. AB - First described by Popovich et al. in 1978 [7], and modified by Oreopoulos et al. [6], CAPD is accepted as a simple technique which offers chronic dialysis to patients who are either unsuitable for, or noncompliant with, haemodialysis (HD). The technique of CAPD is based on the theoretical basis which predicted that adequate dialysis could be obtained if 10 litres of dialysis fluid per day are allowed to equilibrate with body fluids [5]. In practice, 2 litres of peritoneal dialysis solution are present in the peritoneal cavity, continuously, except for the periods when the patient exchanges the dialysate for fresh solution via a permanent peritoneal catheter [3]. The patient is ambulant and independent of hospital and machine. In our experience, with good technology and careful patient selection CAPD is now a well-established procedure and the preferred method of dialysis for some patients. PMID- 6858174 TI - [Therapy of paroxysmal supraventricular tachycardias by rapid patient-activated atrial stimulation]. AB - Recurrent, drug refractory supraventricular tachycardia may present a therapeutic challenge. Following invasive electrophysiological study and the prospectively controlled therapeutic failure of all available drugs 3 patients were treated by permanent implantation of a system for atrial burst stimulation. The system consists of an implanted receiver with electrodes connected to the right atrium and a radiofrequency stimulator that requires patient activation for burst pacing. During a follow-up period of 6 to 39 months numerous attacks of recurrent tachycardia were successfully terminated without complication. The therapeutic approach which has allowed stoppage of all antiarrhythmic drugs and has obviated the need for frequent hospital admissions has met with patient approval and is highly regarded as providing an improvement in quality of life. PMID- 6858176 TI - [Surgical therapy of peptic ulcer]. PMID- 6858175 TI - [Successful treatment of a case of puerperal hemolytic-uremic syndrome using plasmapheresis]. AB - This article describes the successful treatment of a patient with postpartum haemolytic uraemic syndrome by means of plasmopheresis. Also discussed are problems of the differential diagnosis and current therapeutic concepts of this rare syndrome. PMID- 6858178 TI - [Epidemiology of drug consumption in Austria--recommendations for health counselling]. AB - A representative survey of the Austrian population showed these results: 31% (women 39%, men 23%) use pharmaceutical drugs on a regular basis; high consumption rates are observed among people of 50 years and above (50-59 years of age 49%, 60 years and above 64%), among people in bad health condition (68%), among overweight (38%) or people who report being under stress (46%). Another group with high consumption of pharmaceutical drugs are those who already have reduced consumption of tobacco or alcohol. On the basis of epidemiological findings a concept "how to use pharmaceutical drugs" is designed which stresses the differentiation between necessary (and often not applied) medication and abuse of pharmaceutical drugs. PMID- 6858177 TI - [Peptic ulcer]. PMID- 6858179 TI - [Characteristics of drug therapy in kidney and liver insufficiency, in infancy and old age, during pregnancy and lactation]. PMID- 6858180 TI - Traffic accidents and the legal drinking age in Wisconsin. PMID- 6858181 TI - Wisconsin physicians' response to child abuse and neglect (CAN) ... part II: how can it be improved? PMID- 6858182 TI - Religious limitations to medical care. PMID- 6858183 TI - The outcome of emergency operations in patients with metastatic malignancy receiving chemotherapy. PMID- 6858184 TI - Sporotrichosis in Wisconsin. PMID- 6858186 TI - Optometric identification and referral of patients needing medical care. PMID- 6858185 TI - Diaphragmatic defects with gastric volvulus in the neonate. PMID- 6858187 TI - Pulmonary embolus. PMID- 6858188 TI - Quality care--a continuing commitment. PMID- 6858190 TI - Sporotrichosis in Wisconsin. PMID- 6858189 TI - I can drive a tank. PMID- 6858191 TI - TB san. PMID- 6858192 TI - Anguish languish. PMID- 6858197 TI - Hydrolysis of the biliary glucuronic acid conjugate of phenol by the intestinal mucus/flora of goldfish (Carassius auratus). AB - 1. An investigation was carried out on the hydrolytic activity of the intestinal mucus/flora on phenylglucuronide in the bile of goldfish. 2. Approximately 79% of the total phenylglucuronide (3.4 mumol) in the bile was hydrolysed after 16 h incubation with the intestinal mucus/flora. 3. Of the total phenol in the aquarium water of goldfish exposed previously to phenol for 48 h, 41% was found to be phenylglucuronide when fish were placed in a phenol-free medium and were dosed hourly for 8 h with D-saccharic acid 1,4-lactone to inhibit beta glucuronidase activity in the intestine. PMID- 6858194 TI - Barrier ultrasound. PMID- 6858193 TI - Year of the Child minus 42,000 daily. PMID- 6858195 TI - To recognize our role. PMID- 6858196 TI - Irreversible binding of acrylonitrile to nucleic acids. AB - 1. [2,3-14C]Acrylonitrile was incubated with rat-liver microsomes, NADPH and either DNA, RNA or bovine serum albumin. Irreversible binding occurred to the macromolecular targets. Binding was lower when incubations were performed without microsomes. 2. Most of the 14C bound to DNA, RNA or polynucleotides (poly-A, poly C, poly-G, poly-U) after incubation of [2,3-14C]acrylonitrile with rat-liver microsomes and 'conventional' re-isolation of the nucleic acids was removed from the macromolecular target when subsequently chromatographed on hydroxyapatite. 3. Radioactivity attached to DNA after prolonged non-enzymic incubations with [2,3 14C]acrylonitrile was also removed from the DNA by chromatography on hydroxyapatite. 4. When [2,3-14C]acrylonitrile was administered to rats (i.p.), incorporation of 14C into the natural bases of hepatic RNA was observed. In contrast with previous experiments with [1,2-14C]vinyl chloride, no radioactive [1-N6]etheno-adenine could be detected in RNA. 5. After administration of [2,3 14C]acrylonitrile to rats, hepatic DNA was isolated and hydrolysed by a modified enzymic procedure. Chromatography on PEI-cellulose showed two 14C peaks which did not co-chromatograph with any known standard. The amount of 14C in these presumed alkylation products was too low to allow chemical identification. 6. It is concluded that acrylonitrile, either itself or its metabolites, can alkylate nucleic acids. However, the extent of irreversible nucleic-acid binding is quantitatively much less than that observed with vinyl halides. PMID- 6858198 TI - The identification of two new urinary metabolites of fenfluramine in man. PMID- 6858199 TI - Effect of perfluorodecalin on the microsomal mono-oxygenase system in perfused rat livers. AB - 1. An emulsion of perfluorodecalin was used as a substitute for erythrocytes in a synthetic medium in the perfusion of isolated rat livers. 2. The efficiency of this oxygen carrier in maintaining liver viability and function was compared with an erythrocyte-containing medium. 3. Activities of the microsomal mono-oxygenase system, secretion of bile and concn. of transaminases, potassium, glucose, urea, pO2 and pCO2 in the medium, and ATP and glycogen in the tissue, did not differ in the two experimental conditions. PMID- 6858202 TI - [Practical thoracic surgery (3) 1. Drainage in the thoracic region. 1.2. Pleural cavity]. PMID- 6858200 TI - Effect of carbon tetrachloride--alcohol-induced liver fibrosis on microsomal mixed-function oxidases and the cytosolic glutathione-conjugating system in rat liver. AB - 1. Subchronic treatment of male and female rats with CCl4 (0.2 ml/kg orally twice weekly) and drinking water containing 5% ethanol for four weeks led to a 20 to 40 fold increase in serum sorbitol dehydrogenase activity and to an augmentation of the liver triglyceride and hydroxyproline contents, indicating steatosis and fibrosis, respectively. Liver fibrosis was less pronounced in females than in male rats. 2. As a consequence of these alterations the hepatic microsomal mixed function oxidase activity as measured by aminopyrine demethylation was decreased with concomitant loss of cytochrome P-450 in both sexes. Aniline hydroxylation as well as the activity of the NADPH-cytochrome c reductase showed no significant alterations. 3. While the hepatic glutathione content remained unchanged, the cytosolic glutathione S-transferase activities towards both an aryl and an epoxide substrate were markedly decreased following the development of liver fibrosis both in male and female rats. PMID- 6858201 TI - The metabolism of salicylidene benzylamine, a pro-drug for salicylate, in rats and dogs. AB - 1. Oral doses of [14C]salicylidene benzylamine were well absorbed by rats and dogs and excreted mainly in the urine (92% dose by rat in 24 h and 84% by dog in 48 h). 2. After 50, 100 and 300 mg/kg oral doses to rats, peak mean plasma 14C concn. (mainly salicylic acid) of 77, 243 and 396 micrograms equiv./ml respectively were reached between 2 and 4 h and maintained at this level until about 7.5 h. 14C was cleared more rapidly from the plasma of male rats than from that of female rats. After 44, 85 and 300 mg/kg oral doses to dogs, peak mean plasma 14C concn. (mainly salicylic acid) of 114, 194 and 320 micrograms equiv./ml respectively were reached at 4 h and then declined with a half-life of 6-7 h. 3. Tissue 14C concn. in both species were greatest at the times of peak plasma 14C concn., but in general were lower than those in the corresponding plasma. 4. The major components in rat and dog urine were salicyl alcohol, salicylic acid and salicyluric acid, the first two being excreted partly as glucuronic acid/sulphate conjugates. After initial hydrolysis of salicylidene benzylamine to salicylaldehyde, approximately equal amounts were reduced and oxidized to the corresponding alcohol and acid respectively. PMID- 6858203 TI - [Current aspects of rheumatic fever (diagnosis, therapy, prevention of recurrence)]. PMID- 6858205 TI - [The concept of multiple injuries and lesions from the military medical and clinical viewpoint]. PMID- 6858206 TI - [Distribution of hospital germs in a urology ward through catheter material]. PMID- 6858204 TI - [Testicular torsion, an often unrecognized clinical picture]. PMID- 6858207 TI - [Problems of norm and an evaluation system from the psychological diagnostic and rehabilitation viewpoints]. PMID- 6858208 TI - [Thoughts on subspecialization of medical specialists]. PMID- 6858209 TI - [Current guidelines based on the revised eligibility regulations for automobile driving]. PMID- 6858211 TI - [Spore analysis, an important aid in the diagnosis of mushroom poisoning]. PMID- 6858210 TI - [Current value of psychoprophylactic prenatal care]. PMID- 6858212 TI - [Practical chest surgery (4). Drainage of the chest area]. PMID- 6858214 TI - [Criteria for sports-related endurance of untrained adults]. PMID- 6858213 TI - [Errors and hazards of external therapy with corticosteroids]. PMID- 6858215 TI - [The intrauterine device from today's perspective]. PMID- 6858216 TI - [Significance of the right heart catheter without roentgen follow-up in hypertensive patients]. PMID- 6858217 TI - [Practical thorax surgery. 5. Drainage of the thoracic area. The lung]. PMID- 6858219 TI - [Rehabilitation of enterostoma patients]. PMID- 6858218 TI - [Experiences from a sex-counseling and birth control practice for adolescents]. PMID- 6858221 TI - [Astatic seizures - neurotoxic side effects of Piavermit]. PMID- 6858220 TI - [Cardiotoxic side effects of adriamycin]. PMID- 6858222 TI - [Possibilities and limits of genetic counseling]. PMID- 6858223 TI - [Indication for roentgen examination of the stomach and duodenum]. PMID- 6858225 TI - [Roentgen examination or endoscopy of the stomach?]. PMID- 6858226 TI - [Practical thoracic surgery. 6. Drainage of the thoracic area. Pericardium]. PMID- 6858224 TI - [Current status and value of roentgen examination of the stomach and duodenum]. PMID- 6858227 TI - [Pediatric surgery and andrological aspects of varicocele testis]. PMID- 6858228 TI - [Pedophilic offenses of adolescents]. PMID- 6858230 TI - [Possibilities of reducing sick leave based on the length of leave from occupational accidents and the distribution of sick leave]. PMID- 6858229 TI - [Selected anthropometric parameters for the evaluation of the nutritional status of 11 to 13-year-old students in East Germany and Lithuania]. PMID- 6858231 TI - [Alcohol and hyperlipoproteinemia]. PMID- 6858233 TI - [Clinical significance of uteroplacental circulation and its determination in the total complex of monitoring risk pregnancy]. PMID- 6858232 TI - [Prognostic value of the electrocardiogram in the control of myocardial infarct]. PMID- 6858234 TI - [Practical thoracic surgery (7). 1. Drainage in the chest area. 1.6. The subphrenic region]. PMID- 6858236 TI - [Unusual location of a congenital retroauricular parotid fistula]. PMID- 6858235 TI - [Determination of accident sequelae of the already damaged spine]. PMID- 6858238 TI - [The course of neurosis and its prognosis from the epidemiologic viewpoint- results of the Schwedt study]. PMID- 6858239 TI - [Selected results of an empirical study on the supervision of medical students by public health employees during practical career education]. PMID- 6858240 TI - [Disease status of workers and work disabled persons]. PMID- 6858241 TI - [Current roentgenologic delay in bronchial carcinoma]. AB - The actual delaying of findings in roentgenograms is represented in 1000 cases of resected bronchial carcinoma from 1957 to 1972 and in 800 unresectable patients from 1973 to 1976. The delaying is analysed using the criteria as localization, site, diameter, histology, clinical delaying of symptoms, manner of discovering the tumour, original finding in the roentgenogram, prognosis, and sex distribution of the tumours. 1. In 40% of the 1000 resected patients a delay of findings in roentgenograms may be pointed out. 2. Lung cancer is the best discovered by x-ray examination. 69% of 1000 resectable patients, suffering from lung cancer, were discovered by the people's x-ray screening (VRRU). Nevertheless 45-50% of these VRRU-cases are showing a delaying of findings in roentgenograms by more than 6 months. Even in patients, discovered by clinical symptoms, a delaying of findings after x-ray examinations was found, 26% of these patients showing abnormal x-ray findings at the time of diagnosis existing but unheeded already for 6 or more than 24 months. 3. In 10-15% of the cases resection could not be done to delaying of findings in roentgenograms. 4. In most cases the focus of peripheral tumours in roentgenograms is delayed (in 50% for 6 to more than 24 months). 5. In 74% of cases in women a roentgenographic delay was found by 6 to more than 24 months. As a matter of fact, only 10% of all patients were women. 6. Among the central tumours with plain densities the squamous cell carcinomata had findings markedly longer before diagnosis than small cell carcinomata. Among the peripheral tumours alveolar cell carcinoma and adenocell carcinoma are the longest delayed, followed by small (oat) cell carcinoma, polymorph cell carcinoma and squamous cell carcinoma. 7. Positive unheeded x-ray screening series under 6 months remained unregarded in our analysis. But even these series might be still improved. As a conclusion is stated: the detection and prognosis of lung cancer might be improved a) by increasing the quality of reading and interpretation of the VRRU, b) by differentiating the x-ray-intervals according to the risk of lung cancer in each person, c) by a constant algorithm in the diagnosis of suspect findings in roentgenograms. PMID- 6858237 TI - [Exact marital diagnoses]. PMID- 6858242 TI - [Effectiveness of photofluorography screening studies in the early detection of bronchial carcinoma]. AB - Report on results of a prospective study for earlier detection of peripheral and central bronchial carcinoma by fluorography performed for 6 years. In 1972 41,532 men of the age groups 1907 to 1937 were enrolled in the study group examined every 6 months. They were compared statistically and clinically to a control group of 102,348 persons of about the same sex and age distribution examined every two years by mass-x-ray. 1. By fluorographic screening the detection and resection rate in the study group was significantly increased. The percentage of resections was double as high as in the control group. 2. The higher detection rate especially in the younger age groups (40 to 54 years) of the study group caused an increase of the resection rate being three times higher than in the corresponding age group of the control population. 3. 67.5% of the persons with resection in the study group and 49.5% in the control group came to a life expectancy of more than three years. A 5 years healing after resection was attained by 23 of 42 resected patients of the study group and by 15 among 46 of the control group (55% to 32%). 4. Fluorography in 6 months intervals led to an increase of lower tumor stages. 5. At present fluorographic examinations showed to be the only mode of detection with good chances of resection as well in the study as in the control group, case-finding with clinical methods offering only small chances. 6. Among the patients resected in the study group the histological type of adenocarcinoma was rather frequent in 26.0%, parvicellular carcinoma amounting to 13.5%, on the other hand in the control group these types could be found with the same frequency in 16.8%. 7. The own results are reviewed with national and international investigations. Fluorographic examinations of selected risk groups (males between 40 and 70 years) in short intervals have proved to be at present the only method of finding bronchial carcinoma in time with some effectivity. 8. The effectivity of mass-x-ray-examinations must be improved a) by aimed examinations of risk groups, b) by improving the operational approach of fluorography using a special data bank of inhabitants, c) by reducing the medical protraction still high up to diagnosing bronchial cancer, d) by using the computer controlled risk aimed x-ray-examination for a complex screening programme. PMID- 6858244 TI - [Pleural mesothelioma, asbestosis and silicosis following long-term exposure to talc dust]. AB - A case report with pleural mesothelioma, asbestosis and silicosis after long time exposure to talc dust has been given. Pathological findings, professional exposure, diagnostic aspects, and medical assessment of disablement are described. The relationship between the diseases of lungs and the professional exposure to talc dust as well as the possibility of cause-distinction by co working of pathologist and industrial hygienist are discussed. PMID- 6858243 TI - [Measuring the effectiveness of different variants of tuberculosis control using simulation models]. AB - Simulation and predictive models of tb epidemiological trends in the Czech Socialist Republic (CSR) for the 1949-2000 period were devised taking into account several variants of tb control measures. AZUMA'S simulation model from Japan was used as the basis for the mathematical processing and adapted in different parts to satisfy the conditions prevailing in the CSR. The initial conditions and parameters to go into the equations of the model were determined or estimated from statistical data for the whole of CSR or from the results of some of the more detailed partial studies. An Olivetti P 6060 minicomputer was used for calculations. Statistical data were found in satisfactory agreement with trends estimated from model simulations. The simulation models revealed that the epidemiological trends were most influenced by the treatment, less by the BCG vaccination and the least by the active case finding. As suggested by the predictive simulations, discontinuation of the programme of tb control would result in a major deterioration of the epidemiological situation. PMID- 6858245 TI - [Role, tasks and perspectives of the activities of the Polish Association of Phthisiopneumonology]. PMID- 6858247 TI - [Remarks on dermatotoxic tests of plant-protective agents and insecticides]. PMID- 6858246 TI - [Value of secretory eosinophilia in the evaluation of nasal allergen tests]. PMID- 6858248 TI - [Principles in experimental establishing of air hygiene limit values]. PMID- 6858249 TI - [Effect of different SO2 concentrations on growing goats]. PMID- 6858250 TI - [Drinking water contamination by nickel-containing galvanic sewage]. PMID- 6858251 TI - [Reduction of the number of features used in an epidemiological study of psychoneurotic diseases]. PMID- 6858252 TI - [Efficacy of health educational measures from the medico-sociological viewpoint]. PMID- 6858253 TI - [Effect of measuring errors in the determination of oxygen intake]. PMID- 6858254 TI - [Psychological loading and stressing studies of operators in a gas processing factory]. PMID- 6858255 TI - [Ergometric studies of workers in domestic trade]. PMID- 6858256 TI - [Aid and support to the co-workers of hospitals and polyclinics during the preparation to an occupationally active old age]. PMID- 6858257 TI - [Energy conservation measures in the hospital--important aspect of the administrative activity]. PMID- 6858258 TI - [Revaccination against measles]. PMID- 6858260 TI - [Contribution to the occupational toxicologic problems of fluorine exposure at the place of work]. PMID- 6858259 TI - [A slide test for the demonstration of phagocytosis-induced reduction of nitroblue tetrazolium chloride (NBT) in neutrophils]. PMID- 6858261 TI - [Gas chromatographic fluoride determination following adsorption of trimethylfluorsilane on Porapak P]. PMID- 6858262 TI - [Toadstool Amanita pantherina poisoning]. PMID- 6858263 TI - [Experimental studies of identification and purity testing of disinfectant solutions with C4 base]. PMID- 6858264 TI - [Foot temperature conduction from hygienic and construction physical viewpoint]. PMID- 6858265 TI - [Enforcing the wear of individual protective ear cover for tractor drivers]. PMID- 6858266 TI - [Comparative studies of the damming effect and the wearing properties of hearing protective devices at the place of work]. PMID- 6858267 TI - [Local muscle endurance in repeated isometric contractions of given length and defined additional rest periods]. PMID- 6858268 TI - [The relation of general to special pathology]. AB - As most important fundaments of the general pathology the theory of the mechanisms of pathogenesis, the close relations to the general biology and the theory of science are described more in detail. Moreover, every pathologist must deal with the conditions of general-pathological evidence concerning the theory of cognition. Finally it is extraordinarily important to show the significance of the general pathology and of the constituting it theoretical thinking for the pathologist, the physician and the student. Since medicine is more and more studied under theoretical scientific viewpoints, for every physician a scientific basis knowledge is necessary. PMID- 6858269 TI - [Rapid gas chromatographic diagnosis of anaerobic infections]. AB - The microbial culture for the isolation and identification of anaerobic causative organisms is very expensive with regard to material and time. By means of the gas chromatographic proof of short-chain fatty acids in the clinical material within a short time (30-45 minutes) the tentative diagnosis of an anaerobic infection can be made. In the present paper methods and advantages of this kind of determination are described. PMID- 6858270 TI - [Correlation of serum creatinine concentration, retinopathy and frequency of hypertension in relation to the age of long-term diabetics in a rural population]. AB - 274 diabetics with a duration of the disease between 15 and 54 years were examined regarding the relations between their renal function, the frequency of retinopathy and hypertension and their age. 41.6% of the patients showed an increased creatinine value, a retinopathy occurred in 59.5% of all diabetics. In the increase of creatinine as well as in the retinopathy there was a close correlation of the retinopathy and the duration of the disease, but the retinopathy was significantly more frequent in younger persons. It is nearly always accompanied by hypertension. The latter way found in 69.3% of the patients. The duration of diabetes seems to have no influence on the frequency of hypertension, but the level of creatinine in patients under 60 does. Increased creatinine values as well as a retinopathy and hypertension were preponderant in males of this age group. References to the reduction of the high frequency of hypertension, retinopathy and of increased creatinine are given. PMID- 6858271 TI - [Problem of adaptive hyperparathyroidism in chronic renal failure]. AB - It is reported on a case of adaptive hyperparathyroidism (HPT) with diffuse hyperplasia of the adrenal glands including formation of an adenoma, in which during the first 5 weeks of the dialytic therapy massive pulmonary, vascular and periarticular calcifications developed. The previously existing untreated HPT and factors specific for dialysis (composition of the dialysate, heparin therapy) are made responsible for this course of the disease. Within one year the parathyroidectomy led to the regression of the calcifications. Prophylactic and therapeutic possibilities in the adaptive HPT are shown. PMID- 6858272 TI - [Problem of lung aspergillosis]. PMID- 6858273 TI - [ECG mapping studies for optimal electrode placement for the detection of stress induced changes in R-amplitude in the diagnosis of chronic ischemic heart disease]. AB - The evidence on the clinical relevance of the behaviour of the R-amplitude under load for the non-invasive diagnosis of the chronic ischaemic heart disease is contradictory in literature. One of the causes for the variable estimation is possibly to be found in the different localization of the lead electrodes. With the help of the ECG mapping using 30 electrodes at the anterior thoracic wall 15 males were examined with typical syndrome of angina pectoris and a clearly pathological reaction of the ST-distance in a preceding usual bicycle ergometry. The ECG mapping was carried out before, during and after an ergometer load in lying position with 50 Watt. The most frequent pathological reactions of the R amplitude were found below the chest wall electrodes V4, V5 and V6 after Wilson. The estimation of the valency of this first observation must be performed in further examinations. PMID- 6858274 TI - [Modern aspects of cardiogenic shock]. AB - Since the introduction of coronary care units the in-hospital mortality decreased in acute myocardial infarction (AMI), but not the mortality which persisted at about 90% in cardiogenic shock (CS). the definition of CS is based on a cardiac index of greater than 2.2 1/min/m2 and an advancing lactate acidosis with lactate values of about 4.0 mmol/1 which leads to death in most cases by the so-called secondary ventricular fibrillation. Measurements of invasive haemodynamic parameters like cardiac index etc. were superseded by clinical parameters because of methodological problems in clinical routine. Forrester deals with clinical parameters and the pulmonary wedge pressure to separate 4 haemodynamically different subsets in the acute stage of AMI. The treatment of cardiogenic shock uses the manipulation of pre- and/or afterload. Nitrates reduce an increased PCV to normal values because of dilating the capacity vessels (preload) which leads to venous pooling. The cardiac index increases up to 20%. Vasodilators (Na nitroprusside, phentolamine, prazosin, hydralazine, captopril) also caused an increase of the cardiac index because of afterload reduction. This therapeutic strategy demands exact continuous arterial blood pressure monitoring. A perfusion pressure greater than 80 mm Hg on an average will extend the infarction area in narrowed coronary arteries. Positive inotropic drugs (dopamine, dobutamine, amrinone) increase the contractility of the injured myocardium. From the haemodynamic point of view the best results can be achieved by application of temporary intraaortic counterpulsation (IABP) by reducing afterload and increasing diastolic perfusion of the coronary arteries. Nevertheless IABP is of restricted value because of high rate of pump-dependence. PMID- 6858275 TI - [Effect of obesity on cardiovascular performance]. AB - On 55 healthy test persons with normal weight and 76 healthy middle-aged obese test persons the measurement of systolic time intervals was performed standing and lying. In 39 obese patients and 55 test persons with normal weight a load ergometry was carried out. No significant difference between persons with normal weight and extreme overweight was recognized with regard to the index of tension. However, there were clear differences between persons with normal and overweight as to the time of tension and left-ventricular ejection time lying and standing, independent of the behaviour of blood pressure. In persons with overweight a significantly lower cardiac output was found. The index of tension of obese persons with a degree of efficacy below 75 Watt was on an average 1.04. Only half of the persons with overweight reached a degree of efficacy of 100 Watt. In 32 obese persons with a degree of efficacy of more than 75 Watt the regulation of frequency and blood pressure did not differ from that of persons with normal weight. PMID- 6858276 TI - [Reactive dynamics of immunologic parameters in healthy humans and in patients with rheumatoid arthritis]. AB - Investigations of three immune components (IgG, CRP, alpha 1 sGP) in 500 patients with rheumatoid arthritis at the beginning and the end of a spa treatment lasting 4 or 6 weeks as well as in 29 healthy test persons in monthly intervals over 2 years make clear that these immune components represent biorhythmologically regulated functions which underly a different dynamics related to the initial value. By means of the so-called "cross-over-point method" the adequate conditions can be figured. In these cases under the influence of the spa therapy a significant decrease of the dispersion at the end of the significant decrease of the dispersion at the end of the cure develops for the parameters CRP and IgG. These findings as well as the typicality of the course of the empiric regression between the beginning of the cure and the end of the cure represent criteria which are of importance for the demarcation of the dependence of the initial value to a statistical a: (a-b) effect. It is shown that the pathologically reactive dynamics of the immune components can be demarcated from the biorhythmically undisturbed dynamics. PMID- 6858277 TI - [Roentgen diagnostic studies of peripheral joints, sacroiliac joints and the spine in psoriasis arthropathy]. AB - The secure diagnosis "psoriasis arthropathica" must always be the result of a clinical examination, paraclinical and radiological findings. In 150 patients with arthropathic psoriasis X-ray examinations of peripheral joints, of the sacroiliac joints and of the spine were performed. As a result of subtle evaluations of the findings X-ray-morphological criteria on the skeleton of hand and foot, on the sacroiliac joints and on the spine may be derived. On the basis of the experiences gathered recommendations for the practice in form of radiographic objects of an X-ray-diagnostic basic programme in primary diagnostics and in repeated examinations are proposed. An optimum diagnostics of the arthropathic psoriasis can be achieved only ba close co-operation and by constant mutual informations between rheumatologists, dermatologists and radiologists. PMID- 6858278 TI - [Early diagnosis of cancer in the area of the gastrointestinal system]. AB - The early recognition of carcinomas is also in the abdominal region the aim of our permanent effort in the improvement of the prognosis of this disease. Only by a timely diagnosis a permanent cure is possible. Endoscopy and radiology are the corner-pillars of the diagnostics. At the least suspicion of a tumorous disease these methods should be used with all consequence. Since the methods mentioned cannot be used as mass examinations the control of risk groups are of great importance. In these groups of patients an actual care is possible. With the help of the operative endoscopy in form of polypectomy a decrease of the frequency of carcinoma might be achieved. PMID- 6858279 TI - [Differential diagnosis of adrenal gland hemorrhage in adulthood]. PMID- 6858280 TI - [Lipid parameters in the perfusate of dog kidneys following hypothermic pulsatile preservation]. AB - The concentrations of the free fatty acids, the triglycerides, the glycerol, and the phospholipids were measured in the perfusate of 10 dog kidneys after hypothermic pulsatile preservation of 48 hours duration. The concentration in free fatty acids decreased in which the fatty acid pattern is unchanged essentially. The free glycerol and the total phospholipids increased. These characteristics of the perfusate refer to an increased lipolysis of neutral fats and a changed membrane composition of the kidney during the preservation. PMID- 6858281 TI - [Effect of potassium concentration of the perfusion solution on organ resistance of the perfused dog pancreas]. AB - The influence of different potassium concentrations in the perfusate on the perfusion pressure of isolated dog pancreas is reported. A potassium concentration above 30 mmol/l leads both under hypothermic and normothermic conditions to an increase of the vascular resistance, That's why organs with a small blood flow should be perfused with solutions poor in potassium also in the initial perfusion. PMID- 6858282 TI - [Frequency of the so-called "apple allergy" ("apple contact urticaria syndrome") in patients with birch pollinosis]. AB - Rhinitis, itching and tingling and other mild reactions on the oropharyngeal mucosa are the most common complaints after eating raw apples (in about 30% of patients with hypersensitivity to birch pollen). Angioedema, urticaria and shock are rare, but must be noticed. On the basis of three case reports we are illustrating the difficulties of reliable test procedures. 49 patients have been examined by means of "scratch-chamber" test method, RAST and peroral provocation tests. The nature of the actual allergens (lectins?) is still unknown. The term "contact urticaria syndrome" should be used. PMID- 6858283 TI - [Phenytoin therapy in recessive dystrophic epidermolyses (epidermolysis bullosa dystrophica type Hallopeau-Siemens and epidermolysis bullosa dystrophica inversa)]. AB - In epidermolysis bullosa dystrophica recessiva Hallopeau-Siemens, blister formation is due to an excessive synthesis and secretion of a genetically altered collagenase which, under mechanical trauma, becomes activated out of its pro enzyme and leads to the destruction of collagen in the papillary dermis. There is evidence that phenytoin can inhibit the production of collagenase in the fibroblasts. This paper reports on experiences with the treatment of 6 patients suffering from this epidermolysis bullosa type with phenytoin since 2 years and more. Problems of pharmacokinetics and dosage, possible signs of intoxication, interactions with other drugs as well as side effects of phenytoin are discussed and a therapy regimen schedule is proposed on the basis of these experiences. PMID- 6858285 TI - [Functions of psychologic intervention as its integrative principle]. AB - With a growing demand on psychological services went a proliferation of psychotherapeutic methods and systems. The differences between approaches, and the incompatibility of systems contradicts the unitary concept of psychotherapy. To facilitate an understanding of psychological treatment, a number of psychological intervention processes are assumed and discussed as support, information, interpretation, correction and growth and evaluation. These functions, independent of approaches and systems can be directed to the problem areas of the client. The arena for such problems is seen within five life aspects: emotional freedom, self-acceptance, emotional balance, flexibility and interpersonal relations. PMID- 6858286 TI - [The body in conversation with the patient]. AB - The experience of the living body as condition of the human existence is evaluated according to the concept of the anthropological-integrative psychotherapy of D. Wyss. General ways of behavior towards the own body specially in psychosomatic diseases are subjected to research, including the possibilities of the therapist reactions. Models of psychosomatic methods are criticized under this aspect but also positive ways of approach discussed. Lacking integration of a bodily experienced approach with patients of psychosomatic disorders is pointed out--notably in clinical institutions--and new directions developed. PMID- 6858284 TI - [Linear psoriasis?]. PMID- 6858287 TI - [Boredom--symptom of emotional stunting]. AB - Contrary to the fundamental importance of emotions for all psychological phenomena and functions, academy psychology in the study of the relationship between emotion and cognition shows a neglect for the phenomena of emotion. Indirectly, apathy shows that losing the potential for experiencing emotions is followed by a loss of reality and self identity. The scientific onesidedness of intellectualism with it's neglect of the reality of feeling supports the public suppression of emotionality. The reality of emotion, put aside in the name of science, show up as an urging problem in depth psychology and psychotherapy. The desolation of emotion: the death of the self in the time, revealed in boredom, manifests the "lost time", the loss of personal history. A main concern of all psychotherapy seems to be a regaining of the time unity of the biographical "Gestalt" of personal identity; in other words the client is led into a learning process that gives him the opportunity to deal effectively with his emotions again. PMID- 6858288 TI - [Psychiatric concept of health--its dialectic and reflective determination]. AB - The subjectivity of the subject of psychiatry calls for a specific method, which cannot be developed in analogy to objectifying methodologies. Taking the current discussion of normative methods as an example, it is suggested to integrate the method of Hegel's logic into psychiatric thinking. In the following study, this suggestion is explained with reference to the problem of the scientific approach and to the dialectical constitution of illness and health. PMID- 6858289 TI - [Dream interpretation: theory of the "psychological apparatus" as initial consciousness theory in Freud's metapsychology]. AB - In the "Interpretation of Dreams" (1900 a) Freud presents for the first time a purely psychologically founded theory of psychic functioning, in the centre of which stands the model of the "psychic apparatus". In the detailed reconstruction of the statements of the "Interpretation" the present study tries to elaborate the meaning of "consciousness" within a psychology of the unconscious, in order to transfer--with reference to the early writings of J.-P. Sartre--the critique of Freudian unconscious to the level of the underlying conception of consciousness. PMID- 6858290 TI - [Value of 2-dimensional echocardiographic diagnosis in complications of acute myocardial infarct]. PMID- 6858291 TI - [The angiocardiographic image following determination of axial-oblique projection with 2-dimensional echocardiography]. AB - A precise prediction of axial-oblique angulation in cineangiocardiography by noninvasive investigation is possible. A simple method is described using two dimensional echocardiography to determine the cross-sectional plane. The perpendicular X-ray beam presents the angiocardiographic feature related to the echocardiographically determined plane. The described method is most helpful in diagnosis of simple morphological changes (ASD, VSD) as well as in complex congenital heart defects. To our knowledge this is the first report of the application of two-dimensional echocardiography to cardioangiographic axial oblique angulation. PMID- 6858292 TI - [Separation of the left atrium from the right pulmonary artery in the suprasternal echocardiogram: a parameter of left atrial pressure]. AB - A separation of the left atrium from the right pulmonary artery during atrial contraction may be observed in the suprasternal echocardiogram. In 280 catheterized patients with sinus rhythm, we investigated whether left atrial separation is a parameter from which an estimate of the left atrial pressure can be obtained. In 239 of the 280 patients, the suprasternal echograms were of a quality such that it could be seen whether there was, a left atrial separation. In 182 patients, a normal left atrial pressure (greater than or equal to 12 mm Hg) was found; in 57 patients, the left atrial pressure was elevated. An atrial separation was observed in 183 patients, and in 56 patients it was lacking. Lack of left atrial separation indicates a left atrial pressure elevation with a sensitivity of 73.7% and a specificity of 92.3%. If a left atrial pressure above 18 mm Hg was considered elevated, the sensitivity of this echoparameter amounted to 90.3%, and the specificity was 86.5%. The study shows that the left atrial separation from the right pulmonary artery separation from the right pulmonary artery in the suprasternal echocardiogram is a parameter valuable in providing a rough estimate of the left atrial pressure. PMID- 6858294 TI - [Ventricular septal defect as a complication of myocardial infarct]. AB - Between 1978 and 1982 emergency closure of postinfarction ventricular septal defect was performed in 4 patients (51--74 years) on the 3rd-7th day after acute myocardial infarction. All patients had a large left-to-right shunt and were in intractable acute heart failure; all of them survived the operation (3 patients had additional aortocoronary bypass grafts), and follow-up (0.5--4.5 years) was uncomplicated. The favorable clinical and functional results of surgical therapy indicate that postinfarction ventricular septal defects should be operated on even in patients over 70 years of age. PMID- 6858293 TI - [Transmural anterior wall infarct with isolated disease of the anterior interventricular ramus. Long-term prognosis in relation to the degree of stenosis and location]. AB - We examined the long-term prognosis in 213 survivors of the acute phase of a transmural anterior myocardial infarction with single vessel disease. All patients (pts) had undergone coronary angiography ad exercise testing at a mean interval of 6 months after myocardial infarction. 117 pts had a single lesion in the proximal LAD; 96 pts had a lesion after the first septal branch. The mean follow-up time was 4.5 years. The annual mortality for the whole group was 1.3%; 77% of all deaths occurred in pts with a greater than or equal to 75% proximal LAD lesion. The annual mortality of this subgroup was 2.75%--significantly higher than the 0.5% annual mortality in the remainder (p less than 0.003). Exercise induced angina was of prognostic importance only in pts with greater than or equal to 75% proximal LAD lesions (annual mortality 7.25% in this small subgroup). None of the patients with angina and a lesion after the first septal branch died during follow-up. The degree and the location of the stenosis are of prognostic importance even after transmural myocardial infarction. Exercise induced angina In pts with 1-VD after transmural anterior myocardial infarction is associated with a poor prognosis if it occurs in those with a greater than or equal to 75% stenosis in the proximal LAD. These results may help in the decision making process for transluminal angioplasty or bypass surgery. PMID- 6858295 TI - [Ventricular arrhythmias before and after prosthetic aortic valve replacement]. PMID- 6858298 TI - [Transvenous atrial septal defect occlusion in an animal experiment]. AB - Preliminary results concerning the occlusion of experimental atrial-septal defects (ASDII) of the secundum type are reported. An occlusion element was inserted transvenously and its passage across the atrial-septal defect was controlled by open-heart surgery in dogs. Subsequently, the defect was occluded using a single-piece element. In all 5 surgical experiments the occlusion was possible without dislocation or embolism of the element during an atrial stimulation of the heart for more than 1 hour. In additional experiments without open-heart surgery, atrial-septal defects were produced in 7 dogs by transseptal punction and perforation under X-ray control. The atrial-septal defects could be closed for a short time in 2 dogs. In 1 of the 2 dogs the element embolized into the right pulmonary artery, and in the other into the abdominal aorta. Transvenous occlusion of experimental atrial-septal defects is possible, but more experimental work is necessary with respect to the technical problems. PMID- 6858296 TI - [Sound spectrographic studies in the diagnosis of dysfunctions of mechanical heart valve prostheses (Bjork-Shiley prostheses)]. AB - A newly developed real-time sound spectroanalyzer was found to be capable of diagnosing malfunction of prosthetic heart valves (Bjork-Shiley prostheses). Sound spectroanalysis was carried out 430 times on 257 patients with a prosthetic heart valve. The valvular click of prosthetic heart valves shows a typical sound spectroanalysis pattern in real time, with a high-frequency peak which diminishes beyond 25 kHz. Thrombosis of the prosthetic heart valve causes loss of the valvular click and reduction in the intensity of the high-frequency components, as shown in 4 patients. Thus the sound spectroanalysis appears to be a noninvasive technique which may allow early diagnosis of a thrombosed prosthetic heart valve. We believe this method to be superior to phonocardiography and echocardiography. PMID- 6858297 TI - [Effect of the calcium antagonist nisoldipine on electrophysiologic parameters in the human]. AB - We investigated the influence of nisoldipine, a new calcium antagonist, on sinus node function, intracardiac conduction times, and the refractoriness of different compartments of the heart. Three catheters were placed in the right heart: a quadripolar one in the high right atrium, a bipolar one in the His position, and one in the apex of the right ventricle. Nisoldipine given i.v. in a dose of 1.5 microgram/kg body weight shortened the sinus node cycle length and the sinus node recovery time by 10%. The rate corrected sinus node recovery time, the sinoatrial conduction time, and the intracardiac conduction times remained unaffected. The effective refractory period of the right ventricle decreased slightly but significantly. The refractoriness of the other compartments did not change significantly. Systolic blood pressure decreased by 6%, whereas diastolic blood pressure remained constant. Nisoldipine thus exhibits no major effects on electrophysiological parameters in man. The increase in heart rate is regarded as a sympathetic reflex mechanism due to the decrease of systemic resistance. PMID- 6858299 TI - [Changes in phospholipid concentrations of erythrocytes in patients with megaloblastosis before and after treatment with cobalamin]. PMID- 6858300 TI - [Succinylation - a method for preparing soluble gliadin]. PMID- 6858301 TI - [Hypoxanthine concentration in the blood of newborn infants]. PMID- 6858302 TI - Influence of random drift and selection on ABO blood group gene frequencies in Jewish populations. PMID- 6858303 TI - Genetic study of five population groups of Lahaul-Spiti and Kulu districts, Himachal Pradesh. PMID- 6858304 TI - [Population genetics of the polymorphisms of the enzymes acP, ADA, AK, EsD, GLO I, GPT and PGM1, in Xhosa-Bantus and Europeans from South Africa]. PMID- 6858305 TI - Consanguinity and inbreeding effects on fertility, mortality and morbidity in the Malas of Chittoor district. PMID- 6858306 TI - [Comparative cytogenetic, morphologic and psychologic research on prisoners and blood donors]. PMID- 6858307 TI - Anthropometry and the secular trend in growth of Canadians. PMID- 6858308 TI - [Psychophysical development among Bantu speaking school children in Kenya. I. Body measurements and intelligence tests]. PMID- 6858309 TI - Identification and distribution of Echinostoma lindoense, E. audyi and E. revolutum (Trematoda; Echinostomatidae). AB - The closely related Echinostoma lindoense, E. audyi and E. revolutum can be differentiated by morphological characteristics of their adults and cercariae. We have found E. lindoense and E. audyi in Southeast and Southwest Asia and Central Europe and the former species also in South America. However, using the morphological characteristics described by Beaver (1937) for E. revolutum which is assumed to be cosmopolitan, we did not find this species in these regions. PMID- 6858310 TI - The excretory ducts of Diphyllobothrium dendriticum (Nitzsch 1824) plerocercoids: ultrastructure and marker distribution. AB - An electron dense marker, lanthanum nitrate, was injected into the excretory ducts of living plerocercoids of Diphyllobothrium dendriticum and the observations made by electron microscopy. The contractions of the plerocercoid spread the marker into the excretory system, and the distribution was found to be irregular both within the ducts and from one duct to another. Communication between the smallest ducts and the rest of the excretory system was noted. The marker was also introduced from the surrounding medium, in this case the fixative. It was found to flush into the excretory ducts through the pore in the tail and to be distributed into the ducts in the same way as the injected marker. No other pores were observed through the tegument other than the excretory pore in the tail by either method. In ultrastructure the duct wall is similar to that of other cestodes. The distributive role of the excretory system is discussed, including a comparison between the tegument and the duct wall. PMID- 6858311 TI - Immune response and immunodepression in Hymenolepis diminuta infection in rats. AB - Maximum size range of Hymenolepis diminuta was found in rats 22 days postinfection (p.i.) with single or several (3-6) tapeworms. Immunologic reactions of the host were connected with the growth and development of parasites. Positive results of macrophage migration inhibition test (MMI) were recorded from 7 until 22 days p.i. in infection with a single and to 16 days p.i. in those with 3-6 H. diminuta. The negative results of the MMI test observed at later postinfection times are considered as a manifestatioin of immunosuppression caused by the presence of H. diminuta. The expulsion of tapeworm by anthelmintic treatment with Yomesan restored for a short time cell-mediated immunity, as demonstrated by MMI test. The level of antibodies, as determined by passive hemagglutination test (HA), varied during the infection; it was highest at 22 days p.i. The removal of tapeworms as a result of drug treatment caused a rise in titers. PMID- 6858312 TI - The mechanisms of amino acid uptake by Brugia pahangi in vitro. AB - The transcuticular uptake of L-glycine and L-arginine by adult female Brugia pahangi has been shown to involve both a saturable carrier transport system and diffusion. The uptake of L-glycine was competitive with regard to L-methionine, L valine, and L-phenylalanine but noncompetitive with L-arginine. It is suggested that at least two distinct loci are involved in the transcuticular movement of amino acids in this filarial nematode. PMID- 6858313 TI - Scanning electron microscopy examination of larval Linguatula serrata Frolich (Linguatulidae: Pentastomida). AB - The surface structure of larval Linguatula serrata recovered from the abdominal cavity of a slaughtered goat is described as seen by scanning electron microscopy. The subterminal, squarish mouth situated ventrally in the cone-shaped head, was enclosed by four hook pits in a trapezoidal shape in the first and second abdominal annuli, each pit containing a pair of main and accessory hooks. Three pairs of sensory papillae were observed in the first three abdominal annuli and one pair of male genital papillae in the fifth annulus. Except for the anal annulus each of the 80 abdominal annuli was provided with a single, posteriomarginal row of minute spines bearing fine denticles and a median row of fine surface pores containing deep inner-plugged pores. The functional morphology of the spines and pores is discussed. PMID- 6858314 TI - Activation of the peptidergic neurosecretory system in Diphyllobothrium dendriticum (Cestoda) at suboptimal temperatures. PMID- 6858316 TI - [How does bone behave when an immunologic reaction (caused by administration of antigen) is induced a long time after metal implantation]. AB - It has been ascertained that metal implantation in the femoral bone of rats with simultaneously induction of immunological reaction leads in all probability to intense bone damage. It is possible that the sum of all qualitative and quantitative haemodynamic and biochemical consequences from the bone injury (implantation) and the immunological reaction are responsible for this result. To investigate the above possibility, we carried out this study with a monthly delay of antigen administration after metal implantation. We found that: a) Bone alterations occur in approximately 50% of experimental animals which received antigen. b) These bone changes are shown radiologically as osteolysis of immunological reaction, respectically. c) These changes are of less intensity than those produced in simultaneous implantation and antigen administration, but of practical importance. d) None of the control animals (without antigen administration) showed any radiologically visible bone alteration. We discuss the clinical usefulness of these results. PMID- 6858315 TI - [Clinical experience with the implantation of collagen-apatite for local bone regeneration]. AB - After a short review of the problematic of bone substitution the possibility of bone regeneration induced by implantation of synthetic Apatite and reaffined heterogenic Collagen is displayed especially with an industrial manufactured mixed preparation called "Collapat". Firstly it is referred especially to the comparing animal experience and histological results by Nizard. According to this research fine dispersed Apatite powder has obviously a remarkable osteoinductive effect, which is inhenced by the Collagen component, used especially as a distribution medium. The tract mainly concerns the clinical experiences in human patients with Collagen-Apatite-implantation since October 1979 with the indication of larger bone defects. In 85 patients with totally 94 Collagen Apatite-implantations in different age groups no incompatibility was seen. In X ray controls a rapid reestablishment of natural bone structures was observed. The Collagen-Apatite product seems particularly to be apt for the reconstruction of defect cavities as well as for an additive to autologous bone transplantation which by this method can be limited as well in number as in quantity. PMID- 6858317 TI - [Primary tumorous amyloid in bone]. PMID- 6858319 TI - [Biomechanical analysis of locomotion patterns in the lower limb. II. Forces in joints]. AB - After the introduction of a tri-sectional schematic model of the human body it was possible to investigate the simple dynamic locomotion pattern (braking process after a free fall); from this, the effective weight force and the ground recoil forces could be calculated. Once the external forces and the locomotion pattern are known the forces in the knee and hip joint can be determined with simplified joint structures, both for static bending of the knee as well as for the braking process during locomotion. This general calculation of internal forces is performed according to the so-called cross-section principle, since even this permits a basic comparison to be made between the forces acting at rest and during movement. The calculations show that during movement there is a relatively slight increase in the forces in the hip joint; on the other hand, following a free fall from 1.5 m and up to a kneebending angle of 100 degrees, the bearing force in the knee joint during braking increases to 21 times body weight. Thus, there is a massive increase in the internal forces during movement owing to the need for transmission of torque. Conclusions can be drawn from this concerning the development o much greater than f gonarthrosis in cases where there has been relatively little previous damage (for example), recurrent effusions, slight defects of the leg axes, slight instabilities of capsular ligaments). PMID- 6858318 TI - [Methods for increasing fatigue strength of osteosynthesis plates]. AB - For years metal implants are used for osteosynteses with good success. But there have been always fractures of implants, which need reosteosynteses in most cases. In publications an inadmissible high mechanical stress in the implants is responsible for the early failure. This stress is preponderant a reversed bending stress and leads then to fatigue fracture. In the technical practice shot peening and coining are used with success to improve the fatigue behaviour of dynamic stressed parts. It was obvious to research the effect of this treatments on the fatigue behaviour of implants too. Therefore reversed bending experiments of implants were carried out in the original state, after coining and after definite shot peening to obtain statistical calculated S-N-curves. The reversed bending amplitude without fracture of the coining implants increased 37% in opposition to original state. After shot peening this value even increased 111%. PMID- 6858320 TI - [Our indications for the treatment of acetabular and pelvic fractures with acetabular participation]. AB - Our indicative position for treatment of acetabular and pelvic fractures with acetabular participation is constituted through the results of cases from our medical files from the years 1976-1981. In 21 of the total 32 patients reviewed, we could set the indicator for operative treatment. The remaining 11 were all treated conservatively. Our principles for treatment are demonstrated here through several of these examples. PMID- 6858321 TI - [Radiolucent spatulas for simplifying Chiari's surgical technic of pelvic osteotomy]. PMID- 6858323 TI - [The snapping hip. Enlargement of the iliotibial tract by Z-plasty]. PMID- 6858322 TI - [Chondrolysis with protrusion and stiffness of the hip in puberty]. AB - With reference to 5 recently observed cases, and after a review of the literature, the rare and hitherto inadequately clarified complex of stiffness of the hip in puberty is considered. The primary condition--chondrolysis, not necrosis of the head--is typified by destruction with subsequent layered fibrosis of the tissue at the cartilage/bone transition point, mainly at the head of the femur and the acetabulum. The clinical picture is an independent one, accompanied by synovitis and in severe cases leading to fibrous ankylosis. It is not only seen in females with deep and protruding acetabuli, beginning usually between the ages of 10 and 16; it also occurs as a complication of femoral head epiphysiolysis in boys and occasionally also after trauma and inflammations in the hip region. In severe cases the treatment of these events, which even occur occasionally on the "healthy" side, is unsatisfactory. Early relaxation surgery still seems to be the most effective treatment, by reducing the pressure on the base of the acetabulum which probably occurs in these cases. All treatment should be performed in carefully timed and measured stages, "sneaking up" on the irritation. PMID- 6858324 TI - [Innervation disturbances of the quadriceps muscle in chondropathia patellae. A critical appraisal of the current concept of chondropathia]. AB - In a group of patients with typical histories of chondropathy, but in whom no other criteria of selection were applied, evidence of neurogenic damage in the quadriceps muscle was found. Innervational damage was also found regularly in the corresponding segments of the paravertebral musculature. Only in three cases, in which horn cell damage was suspected, were there no changes in the paravertebral musculature. There were abnormal structural or functional findings in the lumbar spine in all the patients. A disequilibrium between the median and lateral vastus groups, attributable to innervation, was postulated and subsequently confirmed by electromyography. The nature of chondropathia patellae as an insertion tendopathy is discussed, taking the lack of concomitance of chondropathy and chondromalacia into consideration as well as the findings in the group of patients examined. Phenomena associated with chondropathy which have hitherto incongruous may be explained on the basis of an asymmetrical innervation disturbance. PMID- 6858325 TI - [Intraligamentary additive tibia-head osteotomy. Indication - technic - results]. PMID- 6858326 TI - [Experiences with lengthening the lower leg in dyplasia using the Wagner apparatus]. AB - We report on the elongation of three different dysplasiae of the lower leg by means of Wagner's apparatur. We enter into the particular problems of elongations during the time of growth. The technical procedure as well as the problems of an elongation of dysplastic lower legs are pointed out. The experiences and results gained for the sake of an optimized proceeding in similar cases are discussed in particular. PMID- 6858327 TI - [Osteoid osteoma of the talus]. PMID- 6858328 TI - [Bipartite lunate bone]. AB - A review on the existing literature shows that the os lunatum bipartitum is an rarely seen morphological variation of carpal bones. Clinical and radiological sings and the resulting treatment are demonstrated at a patient suffering from such an abnormality. The differential diagnostic problems as to the etiology of similar skeletal alterations are discussed. PMID- 6858330 TI - [Retroperitoneal vascular injuries following lumbar disk surgery]. PMID- 6858329 TI - [The Krukenberg plasty and the provision of additional prostheses and technical aids]. AB - In case of bilateral forearm stumps or anomalies the Krukenberg plasty is indicated on at least one side. It aims at creating a tactile grasping organ. The coordination of Krukenberg on one side and a myoelektric prosthesis an the other side is an optimal solution for the person without hands. A blind person without hands may not miss the Krukenberg arm. The operation technique and the different modifications are discussed together with the anatomic and physiological principles, and especially the technique modified by E. Marquardt is described in detail. Due to this technique the grasping surface and the ends of the branches can be covered with skin of tactile sensation preserving all forearm muscles. By this technique two branches are created which are strong and well supplied with blood and which have tactile and well padded grasping surfaces. The post operative physical and occupational treatment including self-help training are an important part of treatment and aim at providing the newly created grasping organ with the capability and skill that are always required for all tasks in daily life. For functional and cosmetic reasons we provide the Krukenberg arm with an electromechanical prosthesis; the advantages of this treatment compared with other possibilities are discussed. PMID- 6858332 TI - [Results of conservative treatment of scoliosis using the Milwaukee corset]. AB - The conservative treatment of scoliosis with Milwaukeebrace has been studied in 165 patients over a period of seven years. We have shown that good results were obtained as long as the initial did not exceed angle of 40 degrees according to COBB. When the curvature exceeds 50 degrees the progression of the scoliosis was not stopped by the MILWAUKEE-brace. In our experience the latter patients should undergo an operation. An improvement of the corrections with the conservative treatment using the MILWAUKEE-brace can only be expected when the treatment was initiated in an early state. To achieve this good propose a number of screening methods to evaluate the progressive character of the scoliosis in particular during puberty; an intensive physio-therapy and careful control of the brace are required for the success of the therapy. PMID- 6858333 TI - [Classification and subclassification of funnel and pigeon chest]. AB - The Willital's clinical classification of funnel- and pigeon-chest deformities can be subclassified by special measurements of the chest. This easy technique enables to differentiate between: Sternocranial, sternocaudal, infrasternal, symmetric and asymmetric marginal and parasternal deformities. This further classification includes deformities of the vertebral column and deviatory development as well. The exact analysis of the abnormal chest in three different planes can be performed by external chest wall measurements that have been developed in our hospital. PMID- 6858331 TI - [Anchoring experiments on human cadaver vertebrae using various types of screws]. AB - The firmness of the bone structure of vertebrae of human cadavers was investigated by turning screws of four different types into vertebrae T6 to L5 and subjecting them to axial tension up to the point of extraction. It was found that the cancellous bone screws (rather than the Zielke screw) had the best anchoring characteristics in bone tissue. The shearing fracture stress of the vertebral bone tissue was found to be approx. 1.80 N/mm2; the relation between the extraction forces and the individual vertebrae was also examined. In addition, the extraction forces were determined for screws inserted into vertebrae T6 to L4, as performed in Zielke's ventral spondylodesis procedure, as well as the lower tolerance limit for each vertebra in this segment of the vertebral column. PMID- 6858334 TI - [Bicycle ergometry in general practice. Symptom-limited maximal stress--method, normal values, evaluation, risk]. PMID- 6858335 TI - [Disorders of function in artificial heart valves. Recognition by auscultation and phonocardiographic findings]. PMID- 6858339 TI - [Coronary patients and skiing. Risks and limits]. PMID- 6858336 TI - [Ultrasound diagnosis in general practice]. PMID- 6858338 TI - [Emergency in general medicine (50). Acute life-threatening catatonia]. PMID- 6858340 TI - [How frequent are minor injuries in ski accidents?]. PMID- 6858337 TI - [Differential diagnosis of the pathologic blood picture (11). Acute leukemias and preleukemia]. PMID- 6858341 TI - [Typical ski injuries in certain age groups]. PMID- 6858342 TI - [Craniofacial fractures in skiing accidents. Frequently minimized and mistaken injuries]. PMID- 6858344 TI - [Sports for adolescents]. PMID- 6858343 TI - [Severe craniocerebral injuries in winter sports]. PMID- 6858345 TI - [Poisoning in general practice]. PMID- 6858347 TI - [Organ removal and organ replacement from the current viewpoint]. PMID- 6858346 TI - [Leg length inequality. Experiences of a general practitioner--typical roentgen pictures]. PMID- 6858350 TI - [Differential diagnosis of the pathologic blood picture (8). Thrombopenia]. PMID- 6858349 TI - [What is your diagnosis? Zieve syndrome with alcohol-induced hepatopathy]. PMID- 6858348 TI - [Obstipation, a permanent problem]. PMID- 6858352 TI - [Differential diagnosis of acute and chronic edema]. PMID- 6858351 TI - [The expectorant Solucampher: effect on the tracheal clearing velocity in chronic bronchitis]. PMID- 6858353 TI - [Differential therapy of acute and chronic edema]. PMID- 6858355 TI - [Drowning. Physiopathology and therapy]. PMID- 6858354 TI - [A leading symptom: complaints during urination]. PMID- 6858356 TI - [Modern drinking water hygiene]. PMID- 6858357 TI - [Water treatment and its mechanism of action]. PMID- 6858358 TI - Stroke mortality and salt ingestion in Eastern Virginia. PMID- 6858359 TI - Fallopian tube microsurgery. PMID- 6858360 TI - Can you diagnose this? PMID- 6858362 TI - Barney Clark: "Odysseus, off on a last adventure". PMID- 6858361 TI - Antiglobulins as diagnostic aids in endocarditis. PMID- 6858363 TI - [Achievements and prospects for functional diagnosis]. PMID- 6858365 TI - [Achievements of modern enzymology in the diagnosis and treatment of internal diseases]. PMID- 6858367 TI - [Enzyme spectrum of blood during pneumonia in children]. PMID- 6858366 TI - [Calmodulin--a new universal protein and Ca-regulation of cell metabolism]. PMID- 6858364 TI - [State and prospects for development of functional diagnosis of digestive organ diseases]. PMID- 6858368 TI - [Organization and activities of a photochemotherapy department]. PMID- 6858369 TI - [A case of Martorell's syndrome]. PMID- 6858370 TI - [Malherbe's calcifying epithelioma]. PMID- 6858371 TI - [Treatment of psoriatic arthritis with the delayed-action preparation kenalog 40]. PMID- 6858372 TI - [Mycotic flora and the incidence of mycoses in the tropics]. PMID- 6858373 TI - [Gonorrheal urethritis in a man with a double urethra]. PMID- 6858374 TI - [Clinico-psychological characteristics of men with gonorrhea]. PMID- 6858376 TI - [Clinico-immunological parallels in patients with syphilis complicated by alcoholism]. PMID- 6858375 TI - [Gonorrhea detection in puerperae]. PMID- 6858377 TI - [Changes in various indices of natural resistance in syphilis patients during treatment]. PMID- 6858378 TI - [Experience with preventive treatment of syphilis with penicillin and cobalt preparations]. PMID- 6858379 TI - [Repeated syphilitic reinfection]. PMID- 6858380 TI - The vascular endothelial system. Structure--function--pathology--reaction to endotoxin shock--methods of investigation. PMID- 6858381 TI - [Relation between the process of information processing during learning and the level of motivation]. AB - Adaptive behaviour of 58 male mice of BALB/c line was studied (10 experimental sessions) in a multialternative maze (180 positive decisions) at various levels of alimentary excitation, after 0--12--24--36 hours of starvation. It has been found that such characteristics of the brain integrative activity as power, speed and rate of the development of motor information processing (estimated by dynamics of formation of correct decisions) are in direct dependency on the level of alimentary excitation. The suggestion is discussed that the level of concrete physiological neens represents both an "energiator" of the brain activity and its directing and organizing determinant. PMID- 6858383 TI - [Interaction of forward and backward conditioned connections as the neurophysiologic basis of the motivation for behavior]. AB - Motivation is defined as a physiological mechanism of activation of traces, kept in memory (engramms) of those external objects which can satisfy the organism's need and those actions which can satisfy it. In the last years E. A. Asratyan advanced and substantiated the concept that the physiological mechanism of motivation is based on the interaction of forward and backward conditioned connections where the backward connection is an activating influence of reinforcing reflex on the structures receiving conditioned signal and achieving the action which was earlier followed by reinforcement. It is experimentally shown that the appearance and extent of the backward conditioned connections generalization depend on the degree of motivational excitation. The backward conditioned connection is a specialized Ukchtomsky's dominant in the functional structure of the consolidated conditioned reflex, which makes the behaviour goaldirected and active. Thus, fundamental phenomena lay in the basis of behaviour: dominant and conditioned reflex--discovered and introduced in the science by A. A. Ukchtomsky and I. P. Pavlov. In the individual adaptive behaviour the dominant and conditioned reflex play the same role as variability and selection in the process of evolutionary adaptation. That is why the suggestion made by K. Popper and J. Eccles (1977) to replace Pavlov's theory of conditioned reflexes by the hypotheses theory is unfounded. PMID- 6858382 TI - [Reverse temporary connections and their role in human cortical reactions]. AB - A number of experiments shows that the character of human cortical response to a conditioned stimulus is to a considerable degree determined by properties and significance of the second stimulus in the combined pair. In a combination of two stimuli differently expressed depression of cortical response to the first stimulus takes place. If the "reinforcing" stimulus is emotionally significant and is recognized then the changes of evoked cortical activity in response to conditioned stimulus are complex and of different signs; they result from simultaneous action on cortical structures of both inhibitory and activating "nonspecific" influences. In this case the facilitation of the cortical response is revealed by comparison with the tests of indifferent stimulus before pairing or with tests where association between two indifferent stimuli is formed. A considerable increase of evoked response after elimination of the "reinforcing" emotional stimulus testifies that this facilitation is merely relative, and along with activating influence via feedback has an inhibitory action on cortical structures which perceive the conditioned stimulus. PMID- 6858384 TI - ["Conditioned states" of cortical cells]. AB - Experimental data are presented on reorganizations of intra- and interanalyzer functional connections of neurones in the course of conditioning, by interval cross-histograms of two impulse series, and notions on neuronal organization of local and spread conditioned states are formulated. Numerous varieties of the analysis of systemic, interconnected activity of cortical neurones in the process of learning convince of the fact that individual and integrative neuronal functions characterize different qualitative levels of their activity. The integrative function of neurones shows various degrees of complicacy and specialization. The local conditioned state is considered to represent functional integration of neurones in cortical microregions, and the spread conditioned state--as neuronal integration between cortical projection zones. The interaction of neurones in the cortical projection of conditioned stimulus is more multiform and complex than that in the motor cortex. During the elaboration of inhibitory conditioned reflex there occurs a reorganization of the cortical systemic activity in the projection zone of the conditioned stimulus and a decrease of intensity of distant connections. PMID- 6858385 TI - [Participation of the neostriatum in mechanisms of instrumental behavior]. AB - The paper is devoted to the study of the neostriatum role in the mechanism of instrumental learning. In the experiments on cats with damaged dorsal segment of the caudate nucleus head, deficit of forming new instrumental reflexes and achieving complex tasks was revealed. Damage of the caudate neucleus had a most pronounced negative influence on the process of differentiation elaboration. High and low-frequency stimulation of this structure in dogs did not disturb solution of an instrumental task: the end result was achieved, but the characteristics of many parameters of the motor act--latency, amplitude, duration--were significantly changed. The presented facts suggest that the basal ganglia play functionally different roles in the period of formation of instrumental conditioned reflexes and in the period of realization of consolidated connections. Possible mechanisms of neostriatum participation in the processes of elaboration and realization of instrumental reflexes of various motivational value are discussed. PMID- 6858386 TI - [Formation of conditioned reflexes to number of sequential stimuli in the dog]. AB - The present experimental study deals with question, whether dogs are able to orient their behaviour to stimuli which differ only by the number of identical clicks presented in successive series with variable interstimulus interval. Some dogs elaborated alimentary or defensive motor conditioned reflexes nd differentiations to them being in classical conditions in experimental chamber. In other dogs running to the feeding trough was elaborated and a differentiation to it in response to series of clicks differing only by one signal. It was established that the parameters of conditioned positive and negative reactions (latency, rate and realization frequency) statistically depended on the number of clicks in the series and did not depend upon its temporal characteristics (interstimulus intervals and duration). The conclusion is made that in CNS of dogs, elementary form of counting a signals takes place, and that the integrated result of this count might serve as a key to evoke positive or negative conditioned reaction. PMID- 6858388 TI - [Changes in the excitability of the motor cortex during elaboration of conditioned reflex switching]. AB - In the process of elaboration of conditioned transswitching of classical and instrumental alimentary and acid defensive reflexes, there was a change of excitability in the cortical projection of dog's forepaw. When flexor reaction elicited by stimulation of the motor cortex is used as signal stimulus, the character of functional reorganization in its cortical projection proves to be principally the same as at special elaboration of the motor cortex was used as a signal stimulus the thresholds of flexor reaction increased approximately equally in both experimental situations. PMID- 6858387 TI - [Inhibitory conditioned reflex of the tonic type]. AB - Physiological parameters of dogs conditioned reactions were studied, elaborated in response to experimental situations stimuli: in one case the animals experienced painful electrocutaneous stimulation (defensive situation), in the other one--they did not (neutral situation). One of these reflexes, that appearing in the defensive situation, may be considered as positive, the other one (in neutral situation)--as inhibitory. In conditions of transswitching, positive tonic conditioned reflex (TCR) determines positive signal significance of phasic (trigger) stimulus and inhibitory TCR--the negative significance (of the same stimulus). By conditions of elaboration, the inhibitory TCR resembles two types of internal inhibition--differential and delayed inhibition. At the same time the inhibitory TCR differs in such an important property as long duration. It determines its special functional inhibition. It is assumed that in integral behaviour TCR (positive and inhibitory) is a conditioned mechanism of regulation of levels of wakefulness and emotional states. PMID- 6858389 TI - [Instrumental heterogeneous responses to 2 successive complex stimuli with a common initial stimulus in the dog]. AB - Formation and achievement of heterogenous instrumental reflexes to two consecutive complex stimuli was studied in dogs. Under the action of conditioned complex stimulus tone--Pause--tone, the dogs may be trained not to have a motor response to the first tone presentation, but perform alimentary instrumental reaction only to its repeated administration. Introducing into the experiment not only alimentary but also defensive complex stimulus stone-pause--light resulted in a change in animal's reactions in such a sequence: at first alimentary instrumental reaction was disinhibited under the action of the preparatory stimulus and during the pause, then bieffector responses appeared, further on in most of the dogs motor defensive reactions mainly took place. Trigger stimuli evoked the adequate instrumental reaction. PMID- 6858390 TI - [Interaction between motivational and reinforcement components of self stimulation zones]. AB - Interrelations between motivational and reinforcing components of self stimulation (SS) zones were studied under stimulation by rhythmic and direct current (RC, DC) of both one and the same zone of self-stimulation and during simultaneous stimulation of two distant SS zones. It was shown that the reinforcing component of SS zones, independently from the way of its activation, has an inhibitory influence on the motivational reactions evoked by a stimulation of the same zone as well as any other SS site. Motivational component depending on the way of its activation has either an enhancing (RC) or an inhibitory (DC) effect on the reinforcing component. The methodical advantage of DC over RC is that DC allows to reveal more distinctly competitory relations between motivational and reinforcing components (in the form of inhibition of SS reactions of other brain points) and synergic relations--between the reinforcing components (in the form of enhancing SS reactions of other brain points). PMID- 6858391 TI - [Compensation for disruptions of visual function in the dog after partial exclusion of the neocortex]. AB - The recovery of visual disturbances provoked by partial neocortical deafferentation was studied in dogs with two sets of visual patterns: figures and differently oriented lines. The disturbances were more prominent, when the dogs had to solve the most complex visual tasks (6 stimuli showed to a dog simultaneously). There was a distinct recovery of figure recognition in the process of compensation, i. e. in 4--6 months after the neocortical deafferentation. On the contrary, recognition of oriented lines did not improve. Probably the differences between the two sorts of recognition mentioned above may be explained by various changes of their mechanisms' properties in the process of compensation. PMID- 6858392 TI - [Effect of fenamin and haloperidol on conditioned activity of neurons of the motor cortex and striopallidal system]. AB - The activity of neurones in the motor cortex, caudate nucleus, putamen and globus pallidus was studied during elaboration of motor conditioned reflexes to time in rabbits, treated with 1-amphetamine and haloperidol. Mechanisms of reproduction of cells trace activity in the reflex to time at the omission of trials, reacted to 1-amphetamine by increasing the intensity of reactions in the motor cortex and inactivation in putamen cells. The curve of dynamics of intensity changes of trace discharges in the course of a series of trials omissions remained unaltered only in motor cortex; in the other structures it significantly differed from the norm of intact animals. Haloperidol depressed the mechanisms of reproduction of trace reactions of the globus pallidus cells, and made them almost fully inactive in the motor cortex; the putamen neurones reacted to haloperidol by an increase of trace reactions intensity. Against the background of the animal chronic 1 amphetamine intoxication, haloperidol normalized the dynamics and intensity of trace activity. "Therapeutic" effect of haloperidol was most distinctly expressed in the motor cortex and putamen cells, less--in the caudate nucleus and was completely absent in the globus pallidus. PMID- 6858393 TI - [Electrical activity of the brain during behavior directed at elimination of a dominant]. AB - The stage of dominant discontinuation (ending) was studied on the model of "polarization dominant". The dominant focus was created in rabbits at the site of forepaw projection in the cortex. On reaching the dominant optimum it was disrupted (DC was switched off) after summation (forepaw movement) in response to eye stimulation by an air puff. In the next tests the rabbit voluntarily disrupted the dominant by blinking of the corresponding eye after DC was switched on. The analysis of electrical brain activity by computer showed, that goal directed blinking is preceded by the rise in the estimation of power spectra in the range of delta-frequencies of potentials in the neocortical frontal zones and in subcortical structures connected with blinking function. In the latter the potentials change earlier than in the cortex. Goal-directed blinking is preceded by the appearance of hemispheric asymmetry and of readiness potentials in the electrical activity of the neocortical frontal zones. PMID- 6858394 TI - [Role of individual experience in early ontogeny in the formation of reinforcing systems in the rat brain]. PMID- 6858395 TI - [Spatial distribution of single oscillations of the theta range of the EEG in the cat during extinction of the orienting response to sound]. PMID- 6858397 TI - [Ability to solve extrapolation problems in mice selected for different brain weights]. PMID- 6858396 TI - [Relation between forward and feedback connections and level of motivation in drinking instrumental reflexes in the rat]. PMID- 6858398 TI - [Effect of unilateral damage to the hypothalamus on behavioral responses to stimulation of the contralateral hypothalamus]. PMID- 6858399 TI - [Neuronal activity of the medial group of thalamic nuclei in the monkey during conditioned reflex activity]. PMID- 6858400 TI - [Alimentary and defensive motivations in the rabbit after cycloheximide blockade of protein synthesis]. PMID- 6858401 TI - [Effect of cholecystokinin-pancreozymin on consumption of a sucrose solution and activity of the taste receptor system in the rat]. PMID- 6858402 TI - [Effect of antacids on intestinal motility]. AB - Disturbances of gut motility occur frequently under a highdose antacid regimen. Typical symptoms are diarrhea and constipation. They are due to the cations of the antacids. Aluminum causes constipation, magnesium induces diarrhea, and calcium has no definite motor effect. The following mechanisms of action have to be taken into consideration: effects of the cations on the smooth muscle of the gut, on the enteric nervous system and on the release of gastrointestinal hormones as well as alterations of the physiochemical properties of the intraluminal contents. Aluminum inhibits the motor activity of the stomach and intestine, magnesium stimulates muscle contractions; however, the simultaneous activation of the intrinsic nerves, which are predominantly inhibitory, by magnesium may conceal the muscular effects of this cation. The diarrhea under a highdose regimen of antacid combinations appears to be due predominantly to the osmotic-secretory effects of the antacids. PMID- 6858403 TI - [Effect of antacids on mineral metabolism]. AB - Side effects of antacid therapy are dose dependant and compound related. High dose antacid intake may lead to fluid retention in the body depending on the sodium content of the different antacid preparations. Sodium bicarbonate ingestion provokes metabolic alkalosis and alkaliuria, the "nonsystemic calcium and magnesium containing antacids" cause these changes too, but to a lower degree. Urinary pH elevation favours the precipitation of calcium and magnesium salts, predisposing to renal stone formation. In patients with renal insufficiency the calcium and magnesium absorption may lead rapidly to toxic serum concentrations. Calcium and magnesium containing acids may provoke an acid rebound, which is clinically not relevant following magnesium-hydroxide ingestion. Phosphorus depletion is an important side effect of aluminum hydroxide intake. The phosphorus depletion syndrome combined with skeletal demineralisation and osteomalacia may occur. As well as calcium and magnesium cations the tribasic aluminum will be absorbed from the gut in small amounts. In patients with renal insufficiency aluminum deposition in the brain grey matter following Al(OH)3 ingestion will occur and seems to be a co-factor for the development of a dialysis encephalopathy syndrome. The clinical relevance of aluminum absorption from gut in patients with normal renal function is unknown until now. PMID- 6858406 TI - [Principles for the development of antacids]. PMID- 6858405 TI - [Cytoprotection with antacids?]. AB - Prostaglandins in very low concentrations which do not inhibit acid secretion protect the mucosa of the gastrointestinal tract against a great number of noxious agents. The protective action of various antacids is likely to be related to its acid neutralizing capacity. Antacids do not prevent lesions evoked by direct necrotising substances such as concentrated ethanol etc. It remains to be established whether the endogenous prostaglandin system is involved in the antiulcerogenic action of some antacids. PMID- 6858407 TI - [In vitro determination of the neutralizing capacity of antacids]. AB - The in vitro evaluation of antacids provides information about their therapeutic effectiveness. By testing the ability of antacids to buffer acid in vitro, the dependency of the neutralization or buffer capacity from the pH of the endpoint of titration should be taken into consideration. Practical and physiologic reasons suggest to use pH 3.5 as the standard reference value. Furthermore antacids, mostly those containing aluminum hydroxide, loose a considerable percentage of the buffer capacity, if they are tested in a protein solution. Finally, with regard to other indications for antacid therapy besides peptic ulcer disease like biliary reflux or alkaline gastritis, the individual ability of an antacid to bind bile acids should be tested in vitro. PMID- 6858408 TI - [Intragastric determination of neutralization capacity of antacids]. PMID- 6858404 TI - [Metabolic effects of antacids and interactions with other drugs]. AB - The incidence of side effects from antacids is low, but patients with renal insufficiency are at risk to develop alkalosis with high doses of calcium carbonate or magnesium hydroxides, or to develop hypercalcemia due to insufficient calcium elimination by the kidneys.--A great potential exists for drug interactions with antacids. In most instances, the effectiveness of other drugs is decreased in the presence of antacids, but effectiveness may be increased for L-dopa (less degradation in stomach) or quinidine (renal elimination reduced). Interactions at the absorption level can be avoided by administering the antacid one hour after intake of the other drugs (one hour after meals) which is also the optimum dosing schedule to ensure good antacid effect. Interactions through changes of urine pH are not eliminated by observing special dosing time schedules, but by modifying the dose or by selecting alternative drug treatment. PMID- 6858409 TI - [Determination of neutralization capacity of antacids in gastric juice]. AB - Observations made during intragastric titration studies performed with antacids that have an identical neutralizing capacity but differ in their chemical compositions suggested that aluminum hydroxide loses a large portion of its neutralizing capacity when applied postprandially. To further elucidate the mechanism involved in-vitro studies were performed whereby the reactivity of magnesium hydroxide, aluminum hydroxide, and calcium carbonate was estimated either in aliquots of 10 ml of water or 10 ml of 5% oxo solution. The effectively available neutralizing capacity of the respective antacids was measured for the pH range of 1 to 5. The results revealed that magnesium hydroxide as well as calcium carbonate can fully react with acid whereby their theoretically available neutralizing capacity is fully available for the pH of 1 to 4.5, this in water as well as in 5% oxo solution. In contrast, aluminum hydroxide loses a large proportion of the theoretically available neutralizing capacity already in water but especially in oxo solution in a pH dependent manner. The loss far exceeds that calculated when one takes into account the pKa dependent hydrolysis of aluminum hydroxide. This loss of reactivity increased from 20% at pH 1 in a near linear fashion up to above 80% at pH 3.5. A food induced decrease of aluminum hydroxide solubility as well as stabilisation of the macromolecular aluminum hydroxide complexes through anions and organic acids are likely to be responsible for this loss of reactivity. PMID- 6858410 TI - [Intragastric utilization of antacids following meals in relation to stomach emptying]. AB - Gastric acid secretion and gastric emptying rate was measured using double marker method and continuous titration of a liquid peptone test meal. Titration rate was significantly reduced by 30 ml of an aluminiumhydroxide- and magnesiumhydroxide containing antacid compound (Maalox). Acidity of gastric contents was reduced over a period of 48.4 +/- 9.1 min (mean +/- SD; endpoint of titration pH 5.5) and 77.6 +/- 2.0 min (pH 3.5) (p less than 0.05). The histamine H2-receptor blocker Ranitidine (0.25 mg/kg b.w.) and the antimuscarinic agent Pirenzepine reduced titrable gastric acid secretion in a similar range, as far as the observation period of 90 min is concerned. Biosorbin MCT, a formula diet, stimulated gastric acid secretion half the amount of gastric acid secretion stimulated by the peptone meal. Gastric emptying rate was significantly reduced by formula diet, but not by either of the other compounds. PMID- 6858411 TI - [Therapy with antacids: dyspepsia with and without ulcer]. AB - 1. The effect of antacids on non-ulcer dyspepsia is difficult to assess because of the heterogeneity and complexity of this symptom. Nevertheless, antacids may be used in the treatment of dyspepsia because they have a pronounced placebo effect and they are cheap and harmless. 2. The effect of antacids on ulcer induced dyspepsia is difficult to prove either. However, it is justified to use antacids in ulcer dyspepsia because they induce ulcer healing and because of their symptomatic effect - be it as a drug or as a placebo. PMID- 6858412 TI - [Therapy of duodenal ulcers with antacids]. PMID- 6858413 TI - [The HLA system and the adult type of cystic kidney]. PMID- 6858414 TI - [Binding and desorption of heparin to DEAE-cellulose dialysis membranes]. PMID- 6858415 TI - [Spontaneous rupture of the kidney pelvis calix system--causes, diagnosis and therapy]. AB - The symptoms, diagnosis and management of the spontaneous non-traumatic rupture of the urinary collecting system are described. It is important to distinguish this frank rupture of the diseased renal pelvis from extravasation due to pyelosinusal or fornical backflow. Most cases of the latter variety are caused by acute calculous ureteral obstruction and observed during intravenous pyelogram with abdominal compression. They can be managed conservatively. Frank rupture of the renal pelvis are caused by an acute obstruction in a collecting system affected by infection, chronic obstruction, calculous erosion or tumor and is usually of grave significance and requires early surgical intervention. If the therapy is adequate, the prognosis seems to be favourable and nephrectomy seldom necessary. PMID- 6858416 TI - [Continuous ambulatory peritoneal dialysis (CAPD). 3 years' therapeutic experience in 100 patients]. AB - The pros and cons of CAPD are weighed up on the basis of a 3-year study on 100 patients with renal insufficiency (61 men, 36 women and 3 children). If equal groups are compared, the survival rate corresponds to that of haemodialysis. Continuous detoxication and dehydration lead to a good uraemic metabolic situation (creatinine 960 mumol/l, urea 24 mmol/l, haemoglobin 98 g/l, albumin 31 g/l. The serum electrolytes are well-balanced, anorganic phosphate is normal. The rise in cholesterol and triglycerides observed is a possible negative influence with regard to arterial sclerosis. The functioning of the kidneys is not affected by CAPD. The main risks of this method of therapy are peritonitis and loss of protein via the peritoneal dialysate, which can be favourably influenced by strictly antiseptic handling when changing the dialysate bag and a sufficient protein supply in the diet. In France 10-15% of all patients with terminal renal insufficiency will be treated with CAPD in future. PMID- 6858419 TI - [Coincidence of congenital heart defects and porencephaly]. PMID- 6858417 TI - [Experimental administration of di-N-butyl-nitrosamine (DBN) in rats. Carcinogenic activity in the urinary bladder]. AB - Di-N-butyl-nitrosamine (DBN) was administered in a suspension with dimethylsulfoxide (DMSO) to 80 rats in doses of 10 and 40 mg/kg/day. The carcinogen was given to the animals in groups of 40 either orally or subcutaneously. The animals were exposed to the carcinogen for a maximum of 320 days. In one group of animals, hypertrophia and hyperplasia affected the whole epithelium of the bladder. In the other group, hyperplasia was intense enough to be considered as carcinomatous. A third group developed papillomatous carcinomas, which occupied the whole interior of the bladder. PMID- 6858418 TI - [Pseudofollicles in chronic lymphatic leukemia]. AB - In chronic lymphatic leukemia lymph nodes show very often nodular aggregates of cells that are somewhat larger than small lymphocytes and that are less hyperchromatic and less closely packed. These aggregates appear histologically as light areas that are called pseudofollicles, pseudonodules or proliferation centers. However, it has not been substantiated as yet that a more active proliferation of cells indeed takes place within these areas. Therefore, in 10 cases of chronic lymphatic leukemia the DNA-content, the size of the nuclei, and the frequency of mitoses within and outside the pseudofollicles were assessed. It could be shown that the cells of the pseudofollicles are indeed more actively proliferating populations than the cells outside the pseudofollicles. This proves that pseudofollicles are proliferation centers. PMID- 6858420 TI - [Primary tumors of the heart and pericardium]. AB - Primary tumors of heart and pericardium are rare. In consequence of modern noninvasive diagnostic procedures, some of these tumors today can be detected intra vitam and become accessible to operative therapy, too. The authors describe 10 primary cardiac tumors (7 atrial myxomas, 1 endocardial endothelioma of the right ventricle, 1 papilloma of the pulmonary valve, 1 sarcoma of the right atrium) and 3 diffuse malignant mesotheliomas of the pericardium. On the basis of the own material the histomorphologic variability and the dangerous complications of these neoplasms are discussed. PMID- 6858422 TI - Stimulatory effect of acid glycopeptide of Ehrlich ascites tumour on cell multiplication. PMID- 6858421 TI - [Focal nodular hyperplasia of the liver]. AB - Report about 19 cases of focal nodular hyperplasia of the liver observed from 1971 to June 1981. The autopsy cases are 7 women between 19 and 62 years of age. The intake of oral contraceptives over a long time period was known in 4 cases; once a node was detected in a 19-year-old woman after a normal pregnancy (death from amniotic fluid embolism), once in a 62-year-old woman who had a longterm diabetes, and once in a 47-year-old woman who died from acute alcoholic intoxication; probably contraceptives had not been taken. The biopsy cases are 11 women between 27 and 50 years of age and a man 25 years of age. Ten times the nodes were found on occasion of cholecystectomy, once during gastric resection, and once during vagotomy. 4 women took oral contraceptives for 5 to 101/2, 2 others for about 2 years. A 34-year-old woman had 7 pregnancies one shortly after the other. 4 women did not use oral contraceptives. In 12 of 18 women a hormonal induction seems possible, in 10 cases by oral contraceptives and in 2 cases by pregnancies. Complications such as bleedings we did not find. PMID- 6858423 TI - [Cerebral glioblastoma with cerebellar metastasis. Report of 3 cases]. PMID- 6858424 TI - [Changes in the proximal axon segment in layer III pyramidal cells in the neocortex of aged humans. A Golgi study]. AB - In the neocortex (in area 11) of the non-demented aged humans (average age: 72.6 years) preferably the pyramidal cells of layer III are subjected to a conspicuous aged-related alteration in that they develop spindle-shaped enlargements of their proximal axon segment. We found different degrees of these enlargements. A slender process arises distally from the dilatation showing the morphological characteristics of the axon. In Golgi impregnations, such layer III pyramidal cells with an axon alteration do not display obvious changes in the ramification or spine density of their dendrites. PMID- 6858425 TI - [Incidence of liver cirrhosis in autopsy cases. A statistical autopsy study]. AB - In this study, data about frequency, age and sex distribution of cirrhosis in 10000 autopsies are summarized. There were 475 (4.75%) cirrhoses, among them 319 complete and 156 incomplete forms. The peak of age distribution was in the 8th decennium. There is a preponderance of males in a proportion of 1.44: 1. Etiological hints were found for hepatitis in 23% and for alcohol in 20% of the cases. Only 159 (33.4%) cases with cirrhosis were known intra vitam. The causes of death were related to the liver disease in 136 cases (28.6%) (bleeding from esophagical varices in 60 cases = 44% of cirrhosis, and coma hepatic in 48 cases = 35% of cirrhoses). Most of the cirrhotics died from cardiovascular and bronchopulmonary diseases. In 33 of 475 cirrhoses (7.2%) a primary liver carcinoma had developed. The results were compared with those obtained previously by other authors. PMID- 6858426 TI - [Induced intestinal tumor development in mice following truncal vagotomy]. PMID- 6858427 TI - [Liposarcoma of the gallbladder and the peritoneum. A case report]. AB - We report a case of a male patient who was cholecystectomized at the age of 79. We diagnosed an intramural myxoid liposarcoma of the gall bladder without signs of metastasis. Two years later at autopsy we found a diffuse spread of the same type of tumour on mesentery, omentum maius, parietal and visceral peritoneum. The unusual primary site of the tumour is pointed out referring to literature, the question of primary multicentric liposarcoma resp. diffuse peritoneal metastases is discussed. PMID- 6858428 TI - [Ultrastructural stability of experimental amyloid in mice]. AB - Various types of amyloid are known in human pathology. As shown by Romhanyi, they can be diagnosed morphologically by investigation of the ultrastructural stability of the amyloid deposits. Based on such an investigation the present study indicates that some chemical and topooptical features of the amyloid induced in mice are similar to human secondary amyloid, whereas some other features to those of human primary amyloid. PMID- 6858429 TI - Myocardial infarction, cardiac rupture, and coronary insufficiency in the industrialised Ruhr valley. An autopsy study. AB - A retrospective study of autopsies was performed on patients who died of ischaemic heart disease (IHD) in the industrialised Ruhr valley of West Germany. Groups were classified on the basis of the presence or absence of cardiac scar tissue, acute myocardial infarction and cardiac rupture. Severe coronary atherosclerosis was not a constant finding in IHD, and ranged from 57% of acute coronary insufficiency cases in women to 86% of recurrent infarction cases in men. During the period 1970 to 1979 recurrent infarction decreased in frequency, whilst hearts with scar tissue in the absence of fresh infarction (chronic progressive coronary insufficiency) became increasingly common. These two groups accounted for 72% of IHD deaths and were more common in men than in women. However, the incidence of first-time acute myocardial infarction and acute coronary insufficiency was higher in women than in men. The frequency of clinically known diabetes mellitus and/or hypertension was higher in women with IHD than in controls. Systemic hypertension was not commoner in cardiac rupture cases than in other cases of acute myocardial infarction. Cardiac rupture increased markedly in the latter half of the last decade so that since 1974 20% of all acute myocardial infarcts showed cardiac rupture. The incidence of first time infarction as well as anterior infarction was significantly higher in cases of cardiac rupture than in acute infarction without rupture. The incidence of recent coronary thrombosis was low in recurrent myocardial infarction (23%), higher in first-time infarction (39%) and highest in cardiac rupture (59%). In men, this finding was significantly higher in acute infarction with rupture than in acute infarction without rupture (p less than 0.001). The view of coronary thrombosis as a secondary phenomenon in acute myocardial infarction is supported. PMID- 6858430 TI - [The photographic paper X-ray procedure--a simple technic for the visualization of osseous norm variations and malformations]. PMID- 6858432 TI - [Histomorphological changes in the myocardium of experimental animals in long term exposure to intense industrial noise]. AB - An experiment with male white rats exposed to the influence of industrial noise in an intensity of 95 dbA in the course of 3 consecutive hours daily, for a period of 3 and 5 months resp., was made. The morphological changes in the myocardium of the test animals were studied by applying classical histological and histochemical methods. It was established that the chronic noise causes a spasticatonic state in the vessels. Some hypoxically dependent dystrophic changes occur in the cardiomyocytes. The changes persist for a month upon ceasing of treatment, while during the second month a substituting regeneration develops. PMID- 6858431 TI - [So-called malacoplakia of the testis and epididymis]. AB - We report on a case of malacoplakia involving testis and epididymis in 63-year old man. The lesion had a characteristic yellow nodular gross appearance and was composed of histiocytes, neutrophils and plasma cells. Calcospherules (Michaelis Gutmann bodies) are prominent. The findings are compatible with the generally accepted concept that malacoplakia represents a peculiar inflammatory process of unknown etiology. The relationship between testicular malacoplakia and granulomatous orchitis is discussed. PMID- 6858433 TI - [Mycotic prosthetic valve endocarditis]. AB - Five autoptically proven cases with mycotic prosthetic valve endocarditis are reported with special reference to morphologic findings. The clinical signs in such patients manifest in the early post-operative phase and are accompanied with a high mortality rate. At autopsy, there were in all cases thrombotic vegetations upon the prosthetic valves which often caused severe arterial and cerebral embolic events. Histologically, fungi are demonstrable within the thrombotic material without any difficulties, and after embolectomy intra vitam, too. In addition to pathological aspects, the author briefly summarizes the most important symptoms of this affection, its arduous diagnostic management, its possible mode of infection, and its treatment. PMID- 6858434 TI - [Alcoholism--a disease just like other diseases]. PMID- 6858435 TI - [Legal remarks on alcohol in the factory]. PMID- 6858436 TI - [Carcinogenic working materials exemplified by fibers]. PMID- 6858437 TI - [Experiences with fiber endoscopy sclerosing of esophageal varices with polidocanol]. AB - Endoscopic sclerosing of oesophageal varices is only a palliative measure, which should be performed when the bleeding came to a standstill. The aim of treatment is to sclerose all visible varices in the oesophagus. This can be done with intervals in 4 to 5 weeks. Anaesthesia is not necessary. We observed perforations in 1%, stenosis of the oesophagus in 10% (n = 414 cases), treated in the last 4 years. The results obtained until now confirm our impression that, at present, injection sclerotherapy is the method of choice. PMID- 6858438 TI - [Idiopathic spontaneous pneumothorax - a current problem]. AB - 134 patients suffering from spontaneous pneumothorax were seen at the Surgical Department of Granada-University. Most of the patients were of young age (average age 23 years), with men prevailing. Until today its aetiology is unknown. Conservative treatment will do for cases with only partial pnth. In all other cases a suction drainage (Bulau-type) is installed. Surgery is only performed in those cases where no complete re-expansion of the lung can be achieved by suction drainage. PMID- 6858439 TI - [Aneurysm of the membranous septum of the heart. A diagnostic and therapeutic challenge]. AB - Aneurysms of the membranous portion of the interventricular septum are considered to be rare cardiac lesions. Left ventricular angiography appears to be the only method to establish the specific intravital diagnosis. Rupture, infection, thromboembolism, and obstruction of the right ventricular outflow tract have been documented for complications of this malformation. Early resection should be performed before complications occur. 4 patients underwent successful open heart correction of the aneurysm. In another patient a bundle branch block was present and a pacemaker was implanted. PMID- 6858440 TI - [Traumatic rupture of the esophagus]. PMID- 6858441 TI - Abstracts of papers at the workshop of the Deutsche Gesellschaft fur Hygiene und Mikrobiologie, Section II, Mainz, Federal Republic of Germany, 23.-25. September 1982. PMID- 6858442 TI - [Evaluation of a new latex agglutination test for identification of staphylococcus aureus]. AB - 286 clinical isolates of staphylococci and 19 Micrococcus spp. were tested in a new latex agglutinating test to detect bound coagulase and protein A simultaneously. Coagulase-positive strains of staphylococci (n = 119) were all found to be latex-positive. Negative latex agglutination test results were obtained with 154 out of 167 coagulase-negative strains, the other 13 (7.8%) strains gave positive latex tests. Furthermore 3 out of 19 Micrococcus strains yielded positive agglutinating results. According to the results presented a negative latex test allows a rapid exclusion of S. aureus. A positive latex test requires the determination of further typical characteristics to differentiate among the staphylococcal isolates. PMID- 6858443 TI - Viability and ultrastructure of S. aureus treated with fosfomycin. AB - Fosfomycin was administered to logarithmic growing cells of S. aureus ATCC 12600 when the number of viable cells (CFU) was about 5 X 10(7) cells/ml. Within 240 min the CFU i) increased for about 70% when 6 micrograms fosfomycin/ml were administered, ii) decreased for about 91% when 25 micrograms glucose-6-phosphate (G-6-P) were administered in addition to 6 micrograms fosfomycin/ml, and iii) decreased for about 98% when 60 micrograms fosfomycin/ml and 25 micrograms G-6 P/ml were added. By means of turbidity measurements mainly a retardation in cell reproduction could be recognized. Contrary to Gram-negative bacteria, the reduction of viable cells for about 90% was not accompanied by a loss of cell integrity in the same range. In addition to the ATCC strain this could be shown for eight further strains of S. aureus. PMID- 6858444 TI - [Megasphaera elsdenii--occurrence in 2,255 fecal samples of humans, chimpanzees and mice]. AB - In human gnotobiotic studies the number of cfu/g feces expresses the interspecies specific relations within this biotop. In our study we tried to culture the resident anaerobe microflora diluting 1 g feces to 10(-6) - 10(-9), and using the cystein-blood-agar (Beerens mod. Werner) together with the dextrose-water-blue agar. M. elsdenii appear as big, smooth and yellow colonies, which may be recognised at "first sight" diagnosis. In a retrospective study of 2255 fecal samples we compared the isolation-rate of M. elsdenii in the range of greater than or equal to 10(7)/g feces from healthy people to that of persons with gastrointestinal troubles. M. elsdenii has not been isolated from fecal samples of healthy people but in 12% from those of adults and 7.4% from children, both suffering from gastrointestinal disorders. So we consider that M. elsdenii in the range of greater than or equal to 10(7)/g feces does not belong to the resident anaerobe flora of the intestine. Further studies have to establish wether its normal range may be 10(3)-10(4)/g feces like that of C. perfringens. Comparing the isolation-rate from patients with colon-carcinoma to that of patients with dermatological affections, we found a relation of 8% to 20%. The biochemical activities of our isolates were according to the Anaerobe Laboratory Manual. Additional tests e.g. API-Zym and others make us assume an activity inner the metabolism of fatty-acids and amino acids e.g. inner the aspartat and pyruvat family. PMID- 6858447 TI - [Corresponding behaviour of the epithelium and stroma of the cervix uteri]. AB - Different types of epithelium in the human cervix are regularly found within circumscribed areas and obviously respect predetermined borderlines. The determination theory may explain these findings and could in consequence lead to the hypotheses of stromal regulation of the epithelium. Corresponding morphological changes of epithelium and associated stroma are evaluated as another relevant aspect. More or less obvious borderlines between two morphologically different environments are found in the stroma underlying epithelium with distinct borders. Such stroma changes were seen to be correlated to benign and neoplastic alterations of both squamous and cylindrical epithelium. PMID- 6858445 TI - Temperature-dependent changes in the sugar and fatty acid composition of lipopolysaccharides from Yersinia enterocolitica strains. AB - Yersinia enterocolitica S and R strains change the pattern and the amount of their lipopolysaccharide-linked fatty acids with the respective growth temperature. As described also for other enterobacterial strains, saturated fatty acids are decreased, especially the amount of C14:0, when growth was done at 10 degrees C and unsaturated fatty acids, notably C16:1 (palmitoleic acid), appear, which are present in trace amounts only when bacteria are grown at 40 degrees C. In addition to these changes in the fatty acids, also the amount of O-specific sugars is temperature-dependent. 6-Deoxy-L-altrose which is the only main O specific sugar in the LPS investigated, amounts to 30-40% (based on LPS dry weight) when grown at 10 degrees C, but only to 13-20% when growth was done at 40 degrees C. The decrease in O-specific material at 40 degrees C can at least partly be explained by the finding of a high number of unsubstituted R core stubs in polyacryl gel-electrophoresis. PMID- 6858446 TI - [Effect of marking laboratory animals on the results of pertussis vaccine potency tests]. AB - White mice used for protection tests with pertussis vaccines when marked with fuchsin before challenge showed reduced survival rates compared with their equally treated but unmarked cage mates. The fuchsin used had been dissolved in denaturated alcohol. On account of the small amounts of marking material applied, there was probably no direct toxic effect. Further methods of marking have then been studied in this delicate test system. Contrary to expectations the marking with picric acid solution showed no adverse effect at all. The shearing of an area of the fur, however, resulted in an even more detrimental effect than the use of fuchsin. The clipping of the top of one ear rested below the level of significance. Most probably the marked mice were neither affected adversely by the handling when marked nor by an actual chemical or mechanical impairment, but by the initiation of stress induced by the majority of their unmarked cage mates. At any rate, a possible influence of the marking of animals on the result of test procedures should be carefully considered. PMID- 6858448 TI - [Detection of estradiol receptors in the cyclic endometrium]. AB - In 41 women the 17 beta-estradiol-receptors were determined in the cytosol fraction. The highest concentrations were found in cases of glandular-cystic hyperplasia, were as in the cyclic endometrium the highest concentrations were recognized before the date of ovulation at a rate of 189,8 +/- 80 fmol/mg protein. --During the treatment with contraceptive drugs only a small content of receptors was observed in midcycle. PMID- 6858449 TI - [Morphologic findings in the placenta in intrauterine fetal growth retardation]. AB - The placentas of 105 small-for-dates infants and 190 newborns of normal birth weight were investigated morphologically. Each of these two groups consists of premature newborns and mature newborns. Macroscopic and microscopic data were evaluated by means of a so called data bank. --The weight and the area of attachment were determined. The histologic findings were classified in two groups: 1. Disturbances of placental maturation, 2. Morphologic changes in consequence of reduced uteroplacental blood flow. A marked increase of hypoplastic placentas was found among immature and mature small-for-dates infants. Retarded placental maturity was found more frequently among mature small for-dates infants then among prematures. Among these, placentas with signs of a reduced uteroplacental perfusion were found more frequently. --It is assumed that the pathogenetic course is different in placentas of premature and mature small for-dates infants. PMID- 6858450 TI - [Similarities and differences in the behavior of birth weight and Apgar score in newborn infants of primiparous women]. PMID- 6858451 TI - [Changes in the serum level of methohexital (Brietal) in mothers and newborn infants during anesthesia and cesarean section]. AB - On the occasion of cesarean sections the concentration of Brietal was investigated in maternal and umbilical vein blood after administration of 1 mg/kg body weight to the mother. The mean serum level in the newborns 5 minutes after injection was 0,02 micrograms/ml. No side effects were observed. PMID- 6858452 TI - [Fatal outcome of visceral lupus erythematosus in pregnancy]. AB - After a short presentation of pathogenesis, clinical course of events, diagnosis, treatment and prognosis of lupus erythematodes visceralis in pregnancy a case of maternal death is reported. The relative necessity of avoidance of pregnancy in such cases is demonstrated in the discussion. Irreversible contraception is recommendable. PMID- 6858453 TI - [Characteristic features of the physiology of the oxygen supply in newborn infants]. AB - At the moment of birth, the integrity of a neonate's respiratory, cardiovascular and neurologic system has to be established to permit a healthy transition from fetal to extrauterine life.--Difficulties of the cardiorespiratory function during the first days of life are the most common causes of death or illnesses among premature and mature newborn infants. In a short survey the main pathophysiological aspects of the respiratory adaptation, the cardiovascular transition and the oxygen transport in the neonatal period are explained. PMID- 6858454 TI - [Modifications of embryo and oocyte transfer in humans and our initial experiences]. AB - The principal different readings of transplantation of human ova are explained: embryo transfer, artificial embryonation, extracorporal breeding and oocyte transfer. Our procedure of egg transfer is reported by means of 19 operations, consisting of implantation of preovulatory oocytes into the uterine tubes opened by microsurgery. One pregnancy only could be observed, but it was terminated by early abortion. PMID- 6858455 TI - [Maritogenic insemination - a contribution to the treatment of childless couples. Report on clinical experiences]. AB - We treated 34 couples who urgently wanted to have children by means of artificial maritogenic insemination. Indications for this were combined asthenospermia and oligozoospermia (in 27 cases), therapy-refactory impotentia coeundi of the husband (in 3 cases) and sterility of uncertain origin (4 couples). We achieved 7 pregnancies. Abortions did not occur. 9 additional pregnancies were registered in 8 couples following treatment. In special cases artificial maritogenic insemination availed to recover from marital sterility. Pregnancies obtained after unsuccessful maritogenic insemination are discussed. PMID- 6858456 TI - [Value of hydrotubation in the treatment of sterility]. AB - In the Department of Obstetrics and Gynaecology of the Wilhelm-Pieck-University Rostock 215 women were treated with altogether 510 hydrotubations because of tubar sterility. 154 patients with altogether 392 hydrotubations could be analysed. Hydrotubations were performed ambulatory, praeovulatory, using the pertubation device by means of double ballon cathether partly in combination with the Speck-test. 35 of the 154 patients treated because of tubar sterility by means of hydrotubation and conception may be suspected in 5 cases. The rate of complications following hydrotubation is 1.5%. The use of hydrotubation can be recommended because of the technically easy administration and the wide therapeutical scale (cleaning of the tube, fimbriolysis, antiphlogistic effect on the tubal mucosa, stimulation of ciliar activity, desobliteration, neuroreflective induction of ovulation) especially as an additional treatment in the field of diagnosis and therapy of the pathological tubal factor. PMID- 6858457 TI - [Experiences with the metroplasty]. AB - Report on 34 metroplasties between 1955 and 1980 at the women's hospital in Halle. 20 patients postoperatively delivered 24 children. One patient is pregnant at present. There were 6 abortions. A spontaneous delivery is possible if there are no additional indications for caesarean section. In 26 cases infertility was the indication to perform the metroplasty. In case of coexisting sterility past experience has shown to insist on an exact diagnostic procedure of sterility. PMID- 6858458 TI - [Ultrasonic diagnosis of a thoracopagus in the 16th gestational week--A case report]. PMID- 6858459 TI - [Epidural hematomas in the infant]. AB - A report is given on eight cases of epidural haematoma in children aged 0 to 2 (11 per cent of a total of 70 epidural haematomas found in children). The individual clinical phenomena and courses of the disease are shown on the basis of our own patients. The prognosis of epidural haemorrhages is more favourable for such children than for older children and adults. PMID- 6858460 TI - [Pathomorphologic findings in cervical vessels and cerebral complications following direct (percutaneous) carotid angiography]. AB - A report is given on pathomorphic local findings in the cervical vessels and cerebral complications after direct (percutaneous) carotid angiography (d.c.a.). The studies were based on 1345 d.c.a. in 1199 patients of our establishment carried out in the period from July 1966 to the end of 1981. 112 d.c.a. of 102 decreased and dissected patients were pathomorphically evaluated. Of these, 12 cases showed massive angiographically produced findings in the cervical vessels, five of them with verified cerebral complications. In the cervical vessels, both A. carotis communis and V. jugularis may be affected. Circulatory disturbances of the cerebrum manifest themselves in anaemic and/or haemorrhagic disturbances. The relative importance of complications after d.c.a., their frequency as well as possibilities of a reduction are discussed. PMID- 6858461 TI - Multiple spinal meningiomas. Report of 2 cases. PMID- 6858462 TI - [Primary malignant melanoma of the posterior cranial fossa originating from the arachnoid]. PMID- 6858463 TI - [Sacrococcygeal chordomas--peculiarities of their morphology, clinical aspects, diagnosis and therapy]. AB - Sacro-coccygeal chordomas are discussed with respect to particularities of their morphology, clinical aspects, diagnosis and therapy, including two cases treated by the authors. The consideration of almost always ignored or misinterpreted initial lumboischialgia is pointed out. Because of the primary benign growth of these tumours, early diagnosis and immediate radical surgical treatment would possibly increase the survival chance of their carriers or even--so far only a speculation--lead to permanent curing. PMID- 6858464 TI - [Tumors of the 3d ventricle, clinical aspects and treatment]. AB - Our last 30 patients, who were operated upon 3rd-ventricle-tumors, are discussed on symptomatology, diagnosis and therapy. Depending on the localization we classify oral, basal and caudal tumors. The peak of these tumors is found in the first ten years of life. They are distributed as followed: spongioblastomas, ependymomas, pinealoma and other rare tumors. Mainsymptom is the sudden diffuse headache depending on this skull's position. The three groups show different symptomatic features, the oral one sepecially that headache described above. The symptoms of the caudal group are due to signs of raised intracranial pressure and content the typical syndrome of the lamina-quadrigemina. Basal tumors lead to diencephalic disturbances. The CT scan should be done as the first diagnostic step, eventually connected with ventriculography or ventriculotomography. In any case therapy should be started by implantation of an atrio-ventriculare shunt. If the disease is progressing an invasive procedure has to be done. Irradiation therapy is bound to a clear histologic diagnosis or to a clear inoperability. Our 5-years survival was 40% in average. PMID- 6858465 TI - [Use of xeroradiography in cervical pneumomyelography]. AB - For diagnosing lesions of cervical intervertebral disks, pneumomyelography is carried out in addition to diskography in cases with an indication for surgery. The application of xeroradiography in pneumomyelography is discussed for the first time. In contrast to the conventional X-ray film technique, xeroradiograms yield shraper contours at the gas/tissue interface. PMID- 6858466 TI - [Continuous multiplication of Coxiella burnetii through persisting infection in buffalo-green monkey (BGM) cell cultures]. PMID- 6858467 TI - [Contribution to the epizootiology of swine dysentery--the rat as possible disease reservoir]. PMID- 6858468 TI - The incidence of trypanosomiasis in the cattle population situated along the peripheries of the Kainji National Park in Nigeria. PMID- 6858469 TI - Potentiation of proliferative responses of bovine peripheral blood lymphocytes to mitogens by trypsin. PMID- 6858470 TI - Studies on blood parasites of pigs in Nigeria: pathogenicity of Babesia trautmanni in experimentally infected pigs. PMID- 6858471 TI - [Tissue reaction of rats of different ages to xerophagia]. AB - Studies have been made on the ionic and osmotic indices of the blood, as well as on the content of water and electrolytes in different tissues of rats from 2 age groups (adult animals over 90 days and 18-24 days old ones) in the course of water deprivation within 7 days. It was demonstrated that concentration of sodium in and osmolarity of the blood plasma increased earlier and to a greater extent in young animals as compared to adult ones. In most of the tissues investigated, these changes were accompanied by the increase in the content of electrolytes and water. In the subcutaneous tissue, accumulation of cations and dehydration were observed. Adult rats exhibited mainly ion-accumulating processes in all the tissues investigated, whereas young animals showed mainly shifts in water content of the tissues. PMID- 6858472 TI - [Electrical activity of different formations of the forebrain in the hen during sleep and wakefulness]. AB - Comparative electrophysiological studies of neo- and archistriatal structures have been made during the awake state, as well as during slow wave and paradoxic phases of the sleep. The electrical activity of ancient formations of the forebrain exhibit characteristic peculiarities in all the functional conditions investigated. During slow wave sleep, groups of high amplitude waves of short duration are observed in the archistriatum which may be compared with spike-like activity during nocturnal rest in poikilotherms. PMID- 6858473 TI - [Succinate dehydrogenase activity in the mesonephros in the process of development of chick embryos]. AB - The activity of succinate dehydrogenase in the mesonephros tissue of chick embryos is rather high on the 6th day of embryonal development and is not subjected to significant changes up to the 17th day. The absence of wide variations in the activity of this enzyme during the period of degeneration of the mesonephros may be due to a parallel decrease in the organ's mass and in the number of its mitochondria. PMID- 6858474 TI - [Classification of multiple sclerosis]. AB - A classification of disseminated sclerosis summing up many years of follow up of 750 patients is proposed. According to this classification, the cerebral, spinal and cerebrospinal forms are distinguished. The cerebral form includes hyperkinetic and ocular disease varieties. Both childhood disseminated sclerosis and disease variety with a late debut are distinguished. Rare cases of familial disseminated sclerosis are marked. Acute disseminated sclerosis is considered only as a stage of chronic disease development. PMID- 6858475 TI - [Effect of exposure to different temperatures on the clinical manifestations of multiple sclerosis]. AB - Negative effect of thermal procedures (hot bath taking or intake of 1-2 glasses of hot water) was established while examining 105 patients with disseminated sclerosis. The patients' status worsening was marked also during sharp cooling, whereas improvement during moderate cooling without shivering. A definite diagnostic significance of thermal procedures in disseminated sclerosis is pointed out. PMID- 6858476 TI - [Pathogenetic therapy of multiple sclerosis]. PMID- 6858477 TI - [Pathogenetic interpretation of changes in cerebral somatosensory evoked potentials in multiple sclerosis]. AB - Somatosensory evoked potentials (SSEP) were studied in 13 healthy persons and in 15 patients with disseminated sclerosis (DS). The amplitude decrease of early components of SSEP (frequently till disappearance of these components), latent period prolongation, asymmetry both of the amplitude and latencies were revealed. Late components with latent periods lasting over 80 ms did not change significantly. In DS, demyelinization is supposed to lead mainly to impairment of well myelinized lemnisc fibers of the somatosensory system in disseminated sclerosis. PMID- 6858478 TI - [Clinical picture and histopathology of Viliuisk encephalomyelitis]. AB - Clinical and histological study of 8 cases of Vilyui encephalomyelitis (VEM), characterized by chronic and acute course has shown that all the features of local non-purulent encephalomyelitis with marked dystrophic and atrophic changes of neural tissue were characteristic of VEM. Immunomorphological reaction that manifested as perivascular and membrane lymphoplasmacytic infiltrations was observed in patients with a more acute VEM course or with exacerbation of chronic VEM. Hydrocephalus is considered as a serious aggravating factor that favours atrophic nervous changes during protracted and chronic VEM course. PMID- 6858479 TI - [Serous meningitis in patients with herpes zoster]. AB - CSF was studied in 110 patients with herpes zoster. The whole complex of symptoms helped to diagnose serous meningitis in 62% of cases and so-called "asymptomatic meningitis" in 18% of cases. CSF cells were characterized by lymphocyte transformation and the presence of antigen to Varicella zoster virus determined by the fluorescent antibody method. Specific antibodies titer appeared to be at zero or minimal level. The disease pathogenesis is discussed. PMID- 6858480 TI - [Humeroscapular periarthrosis in patients with post-stroke hemiplegia]. AB - Neuro-orthopedic and electrophysiological studies in 122 patients with post insult hemiplegia underlie the authors' conclusion of shoulder pains peripheral origin. According to the authors' data these patients have humeroscapular periarthrosis formed as a result of cerebral and peripheral damages, including neck osteochondrosis. Fixing shoulder adductors are shown to become originally "numb" because of constant tonic impulsation damages. The mechanisms of this state are supposed to be connected with trophic changes and demand further study. PMID- 6858481 TI - [Psychopathology and various mechanisms contributing to the formation of the Kandinsky syndrome in acute alcoholic hallucinosis]. AB - Forty patients with acute alcoholic hallucinosis associated with the Kandinsky syndrome were examined clinicopsychopathologically. Manifestation of the Kandinsky syndrome was limited by associative automatism in patients with stage II alcoholism with transient hallucinosis lasting 2-4 days. In patients with stage III alcoholism with more prolonged (6-9 days) psychoses, the non-extensive Kandinsky syndrome manifested itself in integrity. Psychopathological phenomena of the syndrome in the picture of acute alcoholic hallucinosis were notable for their descriptiveness, concreteness, extreme simplicity, and instability. Senestopathic and kinesthetic automatisms were localized at the sites of real painful disorders. Therefore, apart from cerebral disorders, the peripheral sensory mechanisms are considered to be of importance in the genesis of the Kandinsky syndrome. PMID- 6858482 TI - ["Simple-minded" personality variant among chronic alcoholic patients]. AB - The author describes a frequently encountered variant of alcoholic patients' personality with non-psychopathic premorbid features (phlegmatic kind heartedness, faultlessness, cordiality, conscientiousness, vulnerability). The "pivot" of these features is "simple-mindedness". The peculiarities of alcoholism hypnotic states ("obliterated" somnambulism) and treatment in these patients according to their individual protective-psychological mechanisms are shown. The clinical material covers 1315 cases. PMID- 6858483 TI - [Study of the relation between the clinical picture of alcoholism and the constitutional-morphologic profile of patients who have sustained delirium tremens and schizophrenia complicated by alcoholism]. AB - Two hundred and forty patients with psychotic alcoholism and 200 patients with paranoic schizophrenia (48 of them suffered from alcoholism too) were examined clinicoanthropometrically. A definite syndromotaxis in patients with psychotic alcoholism and the peculiarities of the disease manifestations in patients with schizophrenia complicated by alcoholism in discrete somatotypical groups (classified according to the Rees Eysenk index) were discovered. The constitutional morphophenotype is regarded as an additional differential diagnostic criterion of the disease clinical manifestations. PMID- 6858484 TI - [Principles for evaluating reactivity in the clinical picture of alcoholism and addiction during drug therapy]. AB - Eighteen patients with chronic alcoholism, stages II-III were examined during tisercin treatment and medicamental interval. In patients with stage II alcoholism, perversion of the central neuronal tisercin effect was shown. Phenothiazines efficacy during abstinence period appeared to be linked with the perversion observed. Individual constant control of blood pressure, heart rate, acetylcholinesterase serum level, sleep function etc. during drug treatment is considered to be a perspective trend for an increase of toxicomania treatment efficacy. PMID- 6858485 TI - [Beta-blockers in the complex treatment of alcoholic delirium]. AB - Seventy-two patients with acute alcoholic delirium were examined cliniconeurophysiologically. The Athena scale, neurovegetative indices as well as those of adrenaline, noradrenaline, dopamine, and DOPA excretion were used for delirium gravity estimation. Proceeding from these data an attempt was made to use the beta-blocking agent obsidan for combined delirium treatment. The data obtained allow using the pathogenetic drugs for differentiated search of delirium treatment. Application of obsidan, an agent blocking hyperactivity of central adrenergic mechanisms in abortive and typical delirium promoted the removal of affective disorders, normalized hemodynamics and prevented early exhaustion of adrenergic mechanisms. Thus, obsidan produces favorable therapeutic effects when used in a complex of measures for alcoholic delirium treatment. PMID- 6858486 TI - [Various aspects of current treatment of patients with alcoholic delirium]. AB - The study is based on the results of clinico-catamnestic evaluation of various methods (two kinds of placebo, antabuse, esperal, and a number of psychotropic drugs and their combinations) of treating 526 chronic alcoholics. Under study there were groups of the addicts comparable in the age, form and duration of the disease, and the degree of personality degradation. The data obtained show that it is preferable to individualize the application of the psychotropic means and combinations with regard to the changes in the addicts' psychics, characteristics of their premorbid personality, and the course of the disease in each particular case. PMID- 6858487 TI - [Use of anti-morphine antibodies to determine low concentrations of morphine in human blood]. AB - The authors have developed an immunochemical method for determining low concentrations of morphine in human serum based on using the reaction of passive hemagglutination inhibition. The method is highly sensitive and practical, does not require special equipment, expensive reagents, and preliminary treatment of the biological fluid. The method has already been used for determining the morphine level in narcomaniacs with the opium form of morphinism. PMID- 6858488 TI - [Clinico-psychopathologic features of schizophrenia with delusional hypochondriacal disorders]. AB - Clinical examination of 70 patients and epidemiological survey of 77 patients with schizophrenia, characterized by delirious hypochondriac disorders have shown these disorders to occur mostly at initial phases of attack-like progredient schizophrenia. In patients with delirious hypochondriac disorders, symptoms of rough deficiency are usually absent. Hypochondriac thinking determining the content of the following psychotic states is settled to be formed at initial phases of disease. PMID- 6858489 TI - [Age and infectious psychoses in children and adolescents]. AB - Infectious psychoses were studied clinically in 60 children divided into three age groups: 3-7 years, 7-12 years and 12-17 years. Acute respiratory diseases, influenza, tonsillitis, otitis were the etiologic factors of psychoses. Short term delirium states characterized by visual and tactile hallucinations prevailed in the first group. Affective-asthenic syndromes prevailed in the second group children. Their psychoses were characterized by both visual and acoustic illusions. Protracted or periodical disorders of the consciousness including psychosensory, senestopathic and depersonalization ones prevailed in the third group. PMID- 6858490 TI - [Pathomorphosis of progressive paralysis]. AB - The author analyses 34 cases of general paresis. All the cases had been verified by laboratory findings. Some peculiarities of the disease manifestation in present-day conditions were discovered. A prolongation of the life-span and the disease incubation period in treated patients, as well as an increase of the disease incidence among women and a rarity of the formerly "classical" expansive form of the disease are noted. Data on the time course of CSF findings are presented. PMID- 6858491 TI - [Nonpsychotic disturbances in the new American classification of mental disorders (DSM-III)]. PMID- 6858492 TI - [Dynamics of intellectual mnestic disorders in alcoholism]. AB - Thirty alcoholic patients with remissions and one hundred alcoholics with relapses were followed up for three years using cross-section and longitudinal psychological examinations. The development of the psychic defect was shown to be related to the degree of personality degradation and the character of organic cerebral pathology. The patients with remissions displayed a greater reversibility of intellectual and mnemonic derangements; there was improvement in their memory and concentration levels as well as combinative abilities; their personal attitude to the study situation changed favourably. The patients with relapses in the course of disease were characterized by deteriorated capacities for memorization, analytic and synthetic mental processes as well as by increased exhaustibility, anxiety, and affective instability. Intellectual and mnemonic disorders in patients with alcoholic dementia were the least reversible. PMID- 6858493 TI - [Clinical polymorphism of the neurocutaneous syndrome in children]. AB - The incidence of the neurocutaneous syndrome in children with organic brain lesions of varying origin was studied. It was shown that in reviewing the structure of this syndrome (along with the other extensively described pathological forms, such as Recklinghausen's disease, tuberous sclerosis, Sturge Weber disease, etc.), the neurocutaneous syndrome characterized by depigmented spots on the skin should be considered separately. The paper describes at full length the individual dermatoglyphic parameters and features of the neurological state of the patients suffering from the neurocutaneous syndrome with depigmented skin spots. PMID- 6858494 TI - [Heredoataxia-myatrophy-curly hair syndrome (clinico-genealogic and pathomorphologic description of a new syndrome)]. PMID- 6858495 TI - [State of mechanisms regulating muscle tone in amyotrophic lateral sclerosis (clinico-electromyographic study)]. AB - For studying the mechanisms of spasticity electromyographic examinations were carried out in 54 patients suffering from lateral amyotrophic sclerosis at various stages of the disease. At the beginning of the spasticity formation disturbances of the functions of the checking spinal mechanisms and the gamma system were revealed, while those of alpha-mononeurons (tested by the H-reflex) showed no statistically significant changes. In the late period (pronounced spasticity) disturbances of all the motor systems mentioned were noted. The role of various mechanisms in the development of muscular hypertonicity in lateral amyotrophic sclerosis is discussed. PMID- 6858497 TI - [Encephalitis related to influenza in adults]. AB - The results of clinical, virological, and pathomorphological examinations of 25 patients with nervous system involvement into the morbid process caused by influenza infection are presented. The influenza-associated encephalitis is regarded as a manifestation of an infectious-allergic process, in the pathogenesis of which the vascular factor plays the leading role. Therapy with vasoactive drugs combined with glucocorticoids has appeared to be the most efficacious. PMID- 6858499 TI - [Ultrasound tomography of extracranial vessels]. AB - The paper deals with the potentialities of visualizing the carotid and temporal arteries as well as jugular veins with the help of the non-invasive method for compound real-time ultrasound scanning. In 18, out of twenty healthy volunteers examined, the echotomograms exhibited reasonably clear-cut images of the above listed vessels. Their localization, size, and pulsation patterns are described, which enables one to differentiate the arterial and venous trunks. Visualization of the vertebral artery was also performed. The technique of ultrasound transducer orientation by means of Doppler sonography is presented. PMID- 6858496 TI - [Autoallergic reactions of leukocytes in nervous forms of epidemic parotitis]. PMID- 6858498 TI - [Clinico-biochemical parallels in neurotoxicoses in children]. AB - The authors present the results of examining the plasma lipids in 62 children with an infectious neurotoxic syndrome. The children were suffering from acute respiratory viral infections, lobular pneumonia, or intestinal infections. Hyperlipidemia and dysphospholipidemia were revealed: the former was due primarily to a rise of the content of non-saturated fatty acids and triglycerides, and the latter to a drop of the lecithin and cephaline levels. These changes correlated with the disease gravity. No substantial differences in the plasma lipid spectrum were revealed in the children with the neurotoxicoses due to the acute respiratory infections, pneumonias, and intestinal infections, however, in the latter cases a more marked rise of the triglyceride content was noted. PMID- 6858500 TI - [Headaches and their paroxysms in children and adolescents with arterial hypertension]. PMID- 6858501 TI - [Ultrastructural localization of cytochrome oxidase in human embryonic brain cells]. AB - The author studied ultrastructural localization of cytochromoxidase (CO) in neuroectodermic cells (young neurons and glioblasts) of the brain of human embryos and 7--10-week-old fetuses. Use was made of CO determination via cytochrome C with the aid of 3,3'-diaminobenzidine as an electron donor. Intracellular distribution of CO in young neurons did not differ from that in glioblasts. Ultrastructural localization of activity appears to depend on the time of embryonal development and may be settled by varying the histochemical reaction conditions. CO was shown to be detectable in mitochondria of 7-week-old embryos and in mitochondria, some parts of cytoplasmic membrane, and in the cytolemma, that forms primary cell contacts, of 8--10-week-old embryos and fetuses. Ten weeks of embryonal development are supposed to be a time for cytochrome system maturation in the most active parts of the cytoplasmic membranes relevant to specific activity in future. PMID- 6858503 TI - [Dynamics of immunoglobulin levels and neuroimmune processes in intellectually deficient children]. AB - The study of immunoglobulin levels and neuroimmune processes in younger schoolchildren with slightly retarded intellectual development revealed the deficiency of immunoglobulin A (either alone or in combination with other types of immunoglobulins). The neuroimmune processes identified were characterized by the presence of brain antibodies predominantly against interspecific antigens. During psychostimulant and general somatic therapy, the concentration of immunoglobulins tended towards normal and the intensity of neuroimmune processes declined. PMID- 6858502 TI - [Features of the convulsive activity in the EEG of patients with classic phenylketonuria]. AB - The problem of the genetic burden inherited by the human race represents one of the research priorities of modern medicine, with hereditary diseases of the nervous system, particularly oligophrenia, being a significant part of it. The author examined the EEGs of patients suffering from "classic" phenylketonuria, a hereditary defect of metabolism, and found a) constant presence of intensive convulsive activity in all regions; b) presence of involuntary motor activity; c) changes in the principal rhythms of the EEGs; d) monotonous pattern of responses in the form of delta-waves of a generalized nature or in the form of epileptiform activity of the "slow spike wave" type; e) presence of the most profound EEG changes in the frontal regions. PMID- 6858504 TI - [Metalloligand homeostasis in hepatocerebral dystrophy]. PMID- 6858505 TI - [Finger and palm prints of children with mild mental retardation]. AB - Studies of the digital and palmar dermatoglyphs in oligophrenic (79 boys and 59 girls) and normal (104 boys and 100 girls) children revealed statistically significant changes in the distribution of the papillary patterns among the fingers: this manifested itself in changed dactyloscopic indices, and increase of the total crest count, and asymmetry of the finger patterns in the oligophrenic children. The main palmar lines were shifted in those children (as compared with the normal ones) to the proximal edge of the palm, and the occurrence of the axial and intermediate triradii changed, this change being statistically significant. PMID- 6858506 TI - [1 of the variants of stable psychopath-like states in patients with slowly progressing schizophrenia (problem of residual schizophrenia)]. AB - The peculiarities of the clinical course and development of stable psychopathlike states formed during slow-progressive schizophrenia stabilization were studied in 111 patients. Clinically they were attributed to a group of pseudopsychopathy and could be regarded as residual states. Two forming mechanisms of pseudopsychopathy corresponding to the course of endogenic process were singled out: the first one was typified as a characterological shift in paroxysmal course of the disease; the second one as an "amalgamated type" in stagnant course of the disease. Clinical typology of pseudopsychopathies including schizoid, hypochondriac, hyperthymic, hypoparanoic states is presented. Social rehabilitation peculiarities in each case were marked out. The development of endogenic psychoses eventuating in the formation of psychopathlike states is reviewed. PMID- 6858507 TI - [Classification and formulation of the diagnosis of vertebrogenic (spondylogenic) diseases of the nervous system]. PMID- 6858508 TI - [Neurovascular syndromes of the neck, shoulder girdle and extremities]. AB - The author summarizes the data of his long-term studies concerning one of the areas of neuroangiology: the problem of neurovascular syndromes. The latter ones can be identified as symptom-complexes of combined affections of the nervous and vascular systems associated with the compression and reflex mechanisms. Involved in their genesis are vertebral pathologies and anomalies, atherosclerosis of the major vessels, tonic and dystrophic changes of the muscles, etc. The report presents the first attempt at a classification of neurovascular syndromes and their detailed semiologic characteristics. The principles of conservative and surgical treatments are demonstrated. PMID- 6858509 TI - [Neurohumoral correlations in lumbar pain syndromes]. AB - The hemostasis system, activity of opioid peptides, hormonal status, vegetative and emotional parameters were studied in patients with lumbar pains of a vertebrogenic nature. The results obtained revealed a whole series of generalized shifts determining the reaction of the body to a local pain syndrome. These shifts were shown to exert an unfavourable effect on the course of a local pathological process. It is suggested that the generalized neurohumoral changes should be corrected by anti- and deaggregation agents, vasodilators, and a combination of psychotropic drugs. PMID- 6858510 TI - [Vegetative disorders in brain stem gliomas at different levels]. AB - Sixty-six patients with gliomas of the cerebral trunk were examined clinically to reveal the features of vegetative disorders depending on tumor sites. Morphometric studies and mathematic simulation (made in 8 cases) of the time course of processes that occur in the cells of the paraventricular and supraoptic nuclei of the hypothalamus from their integral characteristics enabled one to notice the adaptation character of changes in the responsiveness of the hypothalamohypophyseal neurosecretory system. PMID- 6858511 TI - [Functional status of the adrenal cortex in patients with multiple sclerosis]. AB - The spectrum of daily urine C21-corticosteroids was examined in 50 patients by thin-layer chromatography on silica gel. There were 28 men and 22 women aged 16- 50 years with a disease standing from 1 to 26 years. Twenty-two healthy persons of the same age formed the control group. Appropriate indices were calculated to have a deeper insight into adrenocortical function. The dependence of gluco- and promineralocorticoid activity and of corticosteroid biosynthesis and metabolism on the disease course and acuity was revealed. The data obtained made it possible to elaborate the most rational treatment tactics in patients with disseminated sclerosis and to define the opportunities of glucocorticoid use taking into consideration the adrenocortical response to the pathological process. PMID- 6858512 TI - [Pathogenetic mechanisms of depressive states]. AB - Data on the changes in the EEGs, the tone of the vegetative system and peripheral vessels, the metabolism of biogenic amines (catecholamines and serotonin), and adrenal function in patients with depressions of both endogenous and exogenous genesis were analyzed. Considerable changes in the somatic status of patients with manic-depressive psychosis during its remission and, particularly, during its preparoxysmal period were shown to be associated with the activity of the vagoinsular and sympatheticoadrenal homeostatic mechanisms through a positive feed-back system between them and the phasic vegetative shifts in viscero endocrine changes. A recurrent psychotic attack develops in association with the sympathicotonic syndrome in various clinical forms; however, later on, it is marked by a homogeneous character of the cerebral and somatic changes in the patients. Some specific elements of the intercentral relationships in depression are demonstrated. In depressions of other origins, the central-peripheral regulatory relationships display a heterogeneous character. The role of involutional and menopausal changes in the pathogenesis of depressions in the advanced age is also analyzed. PMID- 6858514 TI - [Study of memory function in depressions in advanced age (problem of transient dementia)]. AB - Mnestic function was examined in 50 patients suffering from late-age endogenous depressions, as well as in 10 patients with pronounced vascular dementia. A deterioration of the memory for recent events was discovered in the patients with the late-age depression, this deterioration correlating with the degree of the depressive mood, the anxiety, and psychomotor inhibition. Dynamic (affective) components were revealed in the psychoorganic syndrome structure in patients with the initial vascular dementia. Patients with a pronounced vascular dementia showed gross and persistent intellectual and mnestic impairments. Administration of single doses of melipramine and diazepam seems to be justified and desirable for differential diagnosis of late-age depressions and dementias, as well as for discovering the dynamic components in the structure of a psychoorganic syndrome. PMID- 6858513 TI - [Emotional reactions in different types of depression]. AB - The substantive and structural aspects of emotional reactions were studied in 107 patients with melancholic, anxious, and apathic depression by using dialogue and the Rorschach test. In melancholic depression, a correlation between the actualization of higher values and a high controllability of affective manifestations was established; in anxious depression, there was a correlation between the actualization of lower values and a decreased controllability of affective manifestations; and in apathic depression, the breakdown of the scale of values was associated with the uncontrollability of affective presentations. PMID- 6858516 TI - [Clinico-epidemiologic characteristics of endogenous psychoses with depressive episodes]. AB - A randomized sample of patients with endogenous psychoses marked by depressive attacks was examined by the clinicoepidemiological method. A comparative analysis of the major clinico-statistical characteristics, constituting this group of diagnostic forms, was carried out, showing a considerable homogeneity of the underlying pathogenetic mechanisms. Such clinical signs as the premorbid personality make-up of the patients, the age at the onset of the disease, the character of the premanifest period, the structure of the depressive syndrome, and the sex of the patients were disclosed to be of prognostic value. PMID- 6858518 TI - [Mental disorders in achalasia of the cardia (cardiospasm) and principles for treating them]. AB - Data on clinico-catamnestic examinations of 50 patients with achalasia of the cardia are presented. An analysis of the premorbid features has made it possible to reveal three basic groups of psychopathological disturbances, and, namely, a group with prevalence of neurosis-like disturbances, a group with hysterical traits of the character, and a group of patients with affective swings. It is noted that as long as the achalasia develops, the pre-morbid features are transformed to neurosis-like, hysteriform, and depressive syndromes. The rightfullness of differentiation of those syndromes has been confirmed by psychological examinations (by the MMPI method). Therapeutic recommendations on using psychotropic means and psychotherapy for treating the cardia achalasia are presented. PMID- 6858517 TI - [Problem of identification of the mentally ill and community tolerance of them]. AB - The paper is concerned with one of the aspects of recognition of mental patients, namely with the community tolerance to them. Altogether 209 unregistered patients and the same number of analogous patients registered at the dispensary were examined to reveal factors that interfered with the formers' application for psychiatric aid. Apart from the clinical problems, the examination program included exploration of the parameters characterizing the patient's microsocial environment. It was established that the community tolerance to the patients was determined not only by the mental disease severity but also by factors such as material-household and occupational conditions, the educational and cultural level of the family members, etc. The relationships between the patients' not taking into sufficient account with less favourable conditions of microsocial environment suggests that the community tolerance to the mental patients should be primarily regarded as a negative phenomenon. PMID- 6858515 TI - [Clinico-genetic characteristics of psychoses with a clinical picture of involutional melancholia]. AB - The author examined 34 probands with late endogenous paroxysmal psychoses and a characteristic picture of involutional melancholy at a certain stage of the disease. The accumulation of schizophrenia and affective psychoses among the next kin relatives of these patients was significantly lower than in the families of patients with paroxysmal schizophrenia and manic-depressive psychosis of an early onset, but at the same time it was considerably higher than the risk of morbidity in the general population. No accumulation of psychoses of any other nosological nature (including those of a mentality deteriorating type) was observed. A possible genetic relationship between the disorder in the group of patients under study and the presence of "involutional" symptomatology with endogenous psychoses in the clinical picture of "the disease is discussed. PMID- 6858519 TI - [Clinico-epidemiologic study of favorable and unfavorable variants of the course of continuous paranoid schizophrenia]. PMID- 6858522 TI - Hemodynamics of critical arterial stenoses. AB - The mechanics and the physiological problems related to critical arterial stenosis have been investigated by mathematical, biological and clinical models in experimental and clinical conditions. The value of critical stenosis has been defined in many ways but all the previous report on this subject agree in defining critical stenosis a reduction in section of the artery that can alter the poststenotic flow and pressure. Experimentally appreciable changes in pressures and flow do not occur until the cross-sectional area of a vessel has been reduced by more than 75% and these data are comparable to clinical situations. The data of several reports on this subject are plotted and compared and the different experiences are analysed to evaluate the best criteria to define the critical value of one stenosis and the clinical utilizations. PMID- 6858520 TI - [Correlations among the main syndromes of chronic alcoholism]. AB - Alcohol addiction seen in alcoholics is shown to constitute a part of alcoholic psychic degradation; it is reflected in emotional and volitional derangements, and determines the nosologic specificity of this degradation. Intellectual and mnemic disturbances are regarded as nonspecific psychoorganic ones, and they are directly associated with the volume of alcohol consumed and the severity of intoxication. Similar relations were revealed between alcohol addiction and the alcohol abstinence syndrome: alcohol addiction is combined with nosologically neutral post-intoxication disturbances and imparts the nosological specificity to the entire symptom-complex. PMID- 6858521 TI - [Surgery in chronic uremia]. PMID- 6858523 TI - [Lung hernia or pneumocele. Literature study and case report]. AB - Case-report of a "spontaneous" rupture of intercostale muscles between the 7th and 8th ribs on the right side is presented. The case was combined with a herniation of the lung in the defect of the thoracic wall. Surgical treatment consisted of closure of the defect utilizing tissues in the immediate vicinity. Review of frequency, signs and therapy of lunghernia in literature. PMID- 6858524 TI - [The esophageal axis in the preoperative evaluation of the operability of cancer of the thoracic esophagus]. AB - The length and the esophageal axis, studied by barium swallow, were examined in 30 patients with carcinoma of the thoracic esophagus. All these patients underwent later esophageal resection. An histologic examination was performed in all cases and a correlation was established between these preoperative and postoperative parameters. We have noticed that the presence of abnormalities in the esophageal axis allowed us to predict that the cancer infiltrated markedly through the adventitia in 85.7% of cases. If a resection is performed in these cases, it cannot be a curative resection. On the opposite, when the axis showed no abnormality, 81.2% of the cancers were confined to the wall, permitting then a curative resection. Tumor length did not seem to be an adequate parameter on establishing the depth of infiltration in the esophageal wall. Finally there was no correlation between lymph node metastasis and depth of invasion. PMID- 6858525 TI - [Surgical experience in 48 cases of early gastric carcinoma]. AB - The authors are reporting their surgical experience of the early gastric carcinoma (EGC). In the last twenty-one years, 48 patients with 54 EGC were operated on: 30 men and 18 women. The proportion of early gastric carcinoma (EGC) among treated gastric carcinoma which was 8% during the first period has risen to 12.5% during the last six years and to 30% during the last year. The average age was 59 years. Symptoms and means of diagnose are analysed. Gastroscopy with multiple biopsies is the most important method of diagnose. The EGC were limited to the mucosa in 27 cases, in another 27 lesions the submucosa was invaded. Most lesions were type II c and III. There were five associations with another cancer. Distal gastric resection (subtotal) was employed in all cases except in one case of total resection. The over all operative mortality rate (30 days) was 6%. The five years survival rate (excluding operative mortality) is 85% (corrected 93%). The ten years survival rate is 75% (corrected 92%). PMID- 6858527 TI - Postoperative incidence of bile infection in patients with biliary lithiasis. Relation to the supplementary procedure after choledochotomy. AB - To assess the incidence of bile infection in patients undergoing elective biliary surgery for chronic calculous biliary disease, 737 patients with colecystolithiasis or choledocholithiasis are presented in this paper. It has been shown that the incidence of bile infection in those patients, despite the fact that they all underwent elective surgery, is not inconsiderable and is furthermore associated with a significant mortality and morbidity rate. These features were seen to occur in a statistically higher incidence in patients with common bile duct stones, where a relation has been shown to exist between the incidence of postoperative bile infection and the supplementary procedure which had to be carried out after choledochotomy. It was a striking finding to observe that 70% of those patients with initially sterile bile became infected during the postoperative period of exogenous contamination through the T-tube. It is postulated that T-tube drainage has to be used with great precaution, and that even then, should be avoided in patients in whom either a primary common bile duct closure, or an internal drainage can be carried out. PMID- 6858526 TI - Postvagotomy dysphagia necessitating surgical relief. AB - A case of severe dysphagia following transthoracic truncal vagotomy is reported. Stenosis of the esophagus was due to a periesophageal fibrotic band. Surgical treatment was mandatory and relief was brought by resection of the stricture and restoration of the continuity by colonic interposition. A review of the literature on the subject is presented. PMID- 6858528 TI - [Retrograde subtotal duodenopancreatectomy]. AB - A sub-total pancreatico-duodenectomy can be performed through a retrograde way, leaving a small pancreatic stump at the hilum of the spleen, and avoiding any Wirsung-jejunal anastomosis. This operation offers the possibility of a large excision, with a small incidence of postoperative complications: it has been successfully applied in a series of 20 consecutive patients with cephalo pancreatic carcinoma. PMID- 6858530 TI - [Current trends in the surgical treatment of chronic pancreatitis]. AB - Since May 1980, we started treating patients suffering from chronic pancreatitis with pancreatic duct obstruction. During surgery, prolamine, a alcoholic amino acid solution, was injected into the pancreas through the papil of Vater or directly into the pancreatic duct following pancreatic tail resection. So far thirteen patients were treated this way. Operative mortality was nil and complications were minimal. There were no clinical recurrences of pancreatitis after nearly two years of follow-up. PMID- 6858529 TI - Bovine graft and polytetrafluorethylene prosthesis as an access to circulation for haemodyalisis. AB - In this article results are compared of the bovine graft and the Goretex graft as a shunt from an artery to a vein in view of the access to the circulation for haemodialysis. Drawing conclusions would seem premature as yet, but there seems to be some indication that the Goretex graft stays open more easily. In our opinion the Goretex graft is easier to handle during the operation. We want to point out once again that, in all probability, our ample experience with the Goretex graft plays a role in the evaluation of the outcome. PMID- 6858531 TI - [Advances in maxillofacial surgery]. PMID- 6858532 TI - [Lymph node tumors of the neck]. AB - An overview of the neck node pathology is presented with on the one hand inflammatory diseases of various origins such as tuberculosis, viruses and parasites and on the other hand neoplasms involving nodes. These are either primary tumors such as lymphomas or metastatic carcinomas originating mostly from upper digestive and respiratory tract. Are also evoked diagnostic problems and treatment approach of the neck lymphadenopathy. PMID- 6858534 TI - [Cervicofacial extranodal non-Hodgkin lymphomas. Apropos of 82 cases]. AB - Eighty-two patients with a head and neck extranodal lymphoma were treated and followed up by the same medical team during the period 1952-1981. Most of these tumors, which frequently originated from the Waldeyer ring, evolved by nodal infiltration, first in the neck and later in the abdomen. Association of a GI tract lymphomatous process with a head and neck lymphoma is of particular interest specially regarding gastric localizations (7/82). The treatment of choice is irradiation which is able to control initial head and neck disease, but local recurrences are frequent and represent 25% of the cases. Considering 5 year survivals, it is 49% on the whole series, 57% for the 31 stage I, 41.5% for the 21 stage II; only one patient over the five stage III and IV survived 5 years. For patients with lymphoma of diffuse type, adjuvant polychemotherapy should be considered at the start of management. PMID- 6858533 TI - [Cervical adenopathies of malignant lymphomas and especially Hodgkin's disease]. AB - Cervical lymph nodes are frequently involved in malignant lymphomas, especially in Hodgkin's disease. The surgeon who performs a lymph node biopsy should be aware of the technical problems concerning fixation, conservation, and transport of the surgical specimen in order to allow special immunologic and histochemical techniques, if there is a high degree of suspicion of malignant lymphoma. Staging laparotomy should be considered only if non invasive diagnostic methods have been non contributory and if the potential change in staging involves a change in treatment. Radiotherapy is the main part of the therapeutic strategy in stage I/II whereas chemotherapy is primarily considered for stage III/IV. Stage I/II, with B symptoms, with massive mediastinal involvement, and/or with a large number of nodal sites, may benefit from the combination of chemotherapy and radiotherapy. On the other hand, irradiation of residual disease after chemotherapy should be considered in disseminated disease. PMID- 6858536 TI - [Are fixed cervical lymph node metastases always inoperable?]. AB - Between 1977 and 1980 22 head and neck patients with large fixed lymph node metastases were operated 3 to 8 weeks after preoperative radiotherapy to 60 Gray. Six tumor-free survivals of more than 3 years prove that the fixation of lymph nodes, though serious, does not automatically mean inoperability. When the primary tumor is under control, it is always worth while to explore the neck. The actual reconstruction of the soft tissue cover is no longer a problem. And since the carotid artery can either be ligated (under EEG control) or by-passed, the real danger comes from deep loco-regional invasion into the base of the skull, the intervertebral foramina and the suprahyoid muscles. A specialized and if necessary a polydisciplinary approach is advocated to give these patients a reasonable chance of operability with a quantitatively and qualitatively decent survival. PMID- 6858535 TI - [Diagnosis and surgical treatment of metastatic cervical adenopathies]. AB - Needle biopsy is preferable to open biopsy for several reasons; no tumor spread, no inconvenient scars hampering future surgical intervention, no delay between diagnostic procedure and definitive therapy as well as its simplicity. A conclusive histological diagnosis of malignancy is only made in 70 to 80% of the cases by this technic. In the other cases however, the macroscopic and microscopic aspect usually very strongly suggests the nature of the disease. When a definite diagnosis of malignancy cannot be made this way an open biopsy is mandatory and to be performed under general anesthesia by a surgeon who is able to proceed immediately with the appropriate surgical therapy as soon as a peroperatory positive histological diagnosis is obtained. The classical therapy consists of a unilateral or bilateral radical neck dissection with or without resection of the primary tumor. The postoperative follow-up is usually simple. The incidence of postoperative complications is higher when the cervical region has been irradiated with a dose equal or higher to 5,500 tumor rads or when the larynx, pharynx and/or buccal cavity have been entered. PMID- 6858537 TI - [1- or 2-stage bilateral radical neck dissection]. PMID- 6858538 TI - [Diverticular disease of the left colon. Belgian surgical experience. Multicenter study of 962 cases]. PMID- 6858539 TI - CEA radioimmunoassay. Clinical applications in colorectal cancer. AB - Since 1978 carcino-embryonic antigen determinations (CEA) have been used systematically in the preoperative as well as in the postoperative assessment of 139 patients operated for colorectal cancers. From these data results that CEA determination is of poor value for screening purposes, as 30% of the tumors don't produce the specific CEA antigen. High preoperative levels which normalize after operation, are equal to curative resection. The importance of CEA is emphasized in the postoperative follow-up of especially Dukes B and C lesions, where starting from normal base figures, increasing CEA levels are suggesting recurrences, long before their clinical evidence. Serial CEA determinations may show a slow rise, and in these cases a second look procedure can be considered. Clinical examination stays primordial; CEA is a good marker, and on account of the low cost, allows to be inserted in the postoperative follow-up scheme. PMID- 6858541 TI - [Diagnosis of bone tumors using arteriography-guided drill biopsy]. PMID- 6858540 TI - [The place of total pancreatectomy in cancer of the head of the pancreas]. PMID- 6858542 TI - The effect of glucagon on the glycosaminoglycan content of canine arteries. AB - Hypophysectomized young beagles were treated for 21 days with pharmacological doses of glucagon, administered intramuscularly in two daily injections of 0.5 mg each. Hyaluronic acid, heparan, dermatan and isomeric chondroitin sulphates were determined in aorta, carotid, iliac, renal, mesenteric and coronary arteries. In comparison with age-matched hypophysectomized controls, glucagon-treated dogs showed a reduction in the heparan sulphate concentration in their carotid arteries and thoracic aorta. These results indicate that glucagon has a very limited effect on arterial glycosaminoglycan content. PMID- 6858543 TI - The relationship between blood glucose concentration and beat-to-beat variation in asymptomatic subjects. AB - Very little is known about the presence of autonomic neuropathy in subjects with slight abnormalities of glucose metabolism. This study was carried out to investigate whether impaired glucose tolerance (IGT) is associated with abnormalities of beat-to-beat variation (BTBV). Sixty-two subjects, aged 40-59 years, with IGT (according to EASD criteria) and 124 normals, matched for age, sex and body mass index (BMI), were selected among the participants in a health examination survey and tested for BTBV. Among the possible factors influencing this test, sex did not shown any effect, while age and BMI were significantly and negatively correlated to BTBV in both groups. Glucose intolerance was not associated with any impairment of BTBV which was almost identical in the normal (15.8 +/- 6.3 beats/min) (mean +/- SD) and in the IGT group (16.7 +/- 7.0 beats/min). Similarly no significant difference was found in BTBV between subjects with constant IGT or normal results at OGTT, repeated on two occasions. All subjects were then stratified according to blood glucose values 2 h after an oral glucose load (after load): only those with blood glucose after load greater than 200 mg/dl displayed a significant decrease in BTBV (9.7 +/- 3.8 beats/min) compared to those found normal at the glucose tolerance test (p less than 0.025). They were also the only ones with an average HBa1 level significantly higher than in normal individuals (p less than 0.005). In conclusion, IGT is not associated with abnormalities of BTBV. PMID- 6858546 TI - Efficacy of continuous subcutaneous insulin infusion in unstable diabetes secondary to chronic pancreatitis: a case report. PMID- 6858545 TI - A study of cupremia in a group of elderly diabetics. AB - In diabetics, even in those without complications and/or alterations of lipid metabolism, higher levels of cupremia were found than in the controls; these increased levels were not correlated with the duration of the disease and the cupremia was more evident in the older patients and in those with complications. However, the increases were not dissimilar from those found in non-diabetic arteriosclerosis. Our findings favor the hypothesis that after some years and by affecting fatty acid metabolism, higher levels of cupremia enhance the appearance of diabetic vasculopathy. PMID- 6858544 TI - Hypoglycemic treatments and the fibrinolytic system in maturity-onset diabetes mellitus without thromboembolic manifestations. AB - The fibrinolytic system was investigated in 115 patients with maturity-onset diabetes mellitus in good metabolic control and without thromboembolic manifestations. The patients were divided into 7 groups according to the hypoglycemic therapy: diet alone, tolbutamide, glibenclamide, phenformin, combination of the last two drugs, insulin, combination of insulin and phenformin. Our results indicate that in maturity-onset diabetes both fibrinolytic activity and inhibitors of fibrinolysis are increased. The enhanced fibrinolytic activity was not affected by different hypoglycemic drugs, whereas the main antiplasmins showed wide variations in the different treatment groups. In particular, a significant reduction of alpha 2M was observed in patients on glibenclamide therapy. In conclusion, our study showed that the high fibrinolytic state seems to be a constant element in diabetes, and that the different behaviors of the fibrinolytic system, reported by various authors in patients taking different hypoglycemic drugs, could be explained by the wide range of plasmin inhibitor levels observed in these conditions. PMID- 6858547 TI - The endocrine control of the initiation and growth of antlers in white-tailed deer. AB - Five fawn and 5 adult white-tailed deer (Odocoileus virginianus) were maintained in individual pens, fed a complete diet, and bled bi-weekly for one year. Blood serum was analyzed for testosterone (T), androstenedione (A), thyroxine (T4), calcium (Ca), phosphorus (P) and alkaline phosphatase (AP). Adults grew velvet antlers from mid-April and shed their velvet in mid-September. Hardened antlers were cast in March. Fawns grew velvet antler buttons which hardened in February and cast in March, prior to the growth of the first antlers. Adults had higher (P less than 0.05) titres of T and A over the year. Fawns had higher T4 levels and AP activity (P less than 0.05), while Ca and P levels were not different between the groups (P greater than 0.05). In the adults, T peaked in December and April and was correlated with the periods of hard antlers and the initiation of antler growth. In the fawns, T peaked in November and April and was correlated with hardened buttons and the initiation of the first antlers. Adult A peaked in June but hit nadirs in May and July and generally was not correlated with the antler cycle. In the fawns, A was similar to the T cycle. Thyroxine was relatively constant over the year in adults, but was elevated in the winter in fawns during the period of hardened buttons. Calcium and P levels were relatively constant throughout the year in both groups. AP activity was elevated over winter in adults and then decreased sharply when antlers were cast. Activity increased gradually again as new antlers grew. AP activity in fawns was elevated over the winter and spring and gradually declined as the first antlers developed. PMID- 6858548 TI - Intralysosomal hydrolysis of thyroglobulin. I. Modulation by lysosomal membrane permeability and exogenous factors. AB - Intralysosomal hydrolysis of endogenous (125I in vivo labelled) thyroglobulin (Tg) inside thyroid phagolysosomes and its modulation by exogenous factors (external pH, activators and inhibitors of lysosomal proteinases) were studied during in vitro incubations. Tg degradation was followed as the time-dependent increase in TCA-soluble radioiodine (free iodoaminoacids). The results demonstrate that this hydrolysis is only partially pH-dependent, one component being abolished by pH 8 and a cathepsin B inhibitor (zinc) whereas the residual activity was pH-independent and insensitive to zinc. It would seem therefore that the total thyroid phagolysosome population contains lysosomes permeable to both incubation buffer and zinc and lysosomes impermeable to these compounds. Both classes are operational (degrade Tg) at acidic or neutral pHs, while only impermeable organelles function when incubated at pH 8. These impermeable lysosomes have an acidic internal pH (about pH 5) and resist alkalinization very efficiently due to the high impermeability of their membranes. Additional experiments are in progress to determine the physiological significance of these two classes of lysosomes which might be related to a functional maturation of thyroid phagolysosomes. PMID- 6858550 TI - Early post-operative growth hormone levels predict the result of transsphenoidal tumour removal in acromegaly. AB - Serum human growth hormone (hGH) measurements were performed during transsphenoidal microsurgery for acromegaly and in the early period afterwards. There were 14 patients of which 2 were operated on twice. In 11 patients (2 patients at reoperation) the serum hGH concentration was normalized to less than 5 micrograms/l within 3 h after completion of surgery. On five occasions only partial restoration of the hGH values was obtained and additional treatment was given in 2 patients by successful re-operation. The early post-operative hGH concentrations were consistent with the clinical evaluation of the patients and the hGH concentrations during follow-up for an average of 27 months. We conclude that early post-operative serum hGH measurement is of value for evaluation of the efficiency of the tumour removal and the need for further treatment. PMID- 6858549 TI - Effects of prolonged administration of thyrotrophin on serum concentration, release and synthesis of thyroid hormones in mice. AB - Mice were injected sc with TSH (0.5 U) at 12 h intervals for 5 days. Groups of mice were sacrificed daily to determine serum T4 and T3 concentrations, 4 h thyroidal 125I uptake, distribution of 125I among thyroidal iodoamino acids, and thyroidal content of T4 and T3. Serum T4 and T3 concentrations increased significantly after the initial injection of TSH and gradually decreased thereafter, reaching initial levels on the 3rd and 4th days, respectively. In contrast to serum hormone levels, thyroidal 125I uptake, incorporation of 125I into T4 and T3 increased significantly on the first day and remained elevated throughout the period of TSH-treatment. Thyroidal T4 content expressed as microgram/mg weight of tissue decreased significantly on the first day and thereafter remained constant. Thyroidal T3 content did not change significantly throughout the experimental period. The differences between thyroidal synthesis and thyroidal contents of T4 and T3 strongly suggest that thyroid hormone secretion is being continuously stimulated. Transient increases in serum T4 and T3 concentrations are probably due to a gradual increase in the rate of peripheral degradation of thyroid hormones. These results suggest that TSH induced refractoriness in thyroidal iodine metabolism does not appear to exist, at least when TSH is given in vivo for 5 days. PMID- 6858551 TI - Effects of hysterectomy and uterine extracts on growth hormone, somatomedin, prolactin, thyrotrophin and thyroid hormones in adult rats. AB - Plasma concentrations and anterior pituitary content of growth hormone (rGH), thyroid stimulating hormone (rTSH), and rat prolactin (rPrl) as well as the plasma concentrations of triiodothyronine (T3), thyroxine (T4) and somatomedin A (SM-A) have been determined in intact, castrated or hysterectomized adult rats with and without treatment with steroid-free, crude uterine extracts. Hysterectomy caused a significant increase in the plasma GH but decrease in the plasma TSH concentrations. Injection of crude, steroid-free uterine extracts for 14 days had the following effects: decreased plasma GH concentration of intact rat and anterior pituitary GH content of both intact and castrated animals; increased plasma TSH and T3 concentrations above the ovariectomized control; decreased pituitary content of prolactin in castrated rats. The plasma levels of immunoreactive somatomedins A were negatively correlated to the plasma GH concentrations but positively correlated to the body weight. It was concluded that the uterus is not only a target for different endocrine influences but contains biologically active, non-steroidal substances which have a complex effect on the endocrine system of adult, female rats. PMID- 6858552 TI - Dyslipoproteinaemia in hypothyroidism of pituitary origin: effects of L-thyroxine substitution on lipoprotein lipase, hepatic lipase, and on plasma lipoproteins. AB - We have studied the effects of L-thyroxine substitution on lipoprotein concentrations, on the activities of lipoprotein lipase (LPL) and hepatic lipase (HL), and on the elimination rate of exogenous triglyceride in a homogeneous group of patients with hypothyroidism of pituitary origin. All were deficient of sex hormones but not of corticosteroids during the observation period. Before treatment total plasma cholesterol, LDL cholesterol, and triglyceride levels were significantly higher than in a euthyroid control group but not as high as in patients with overt primary hypothyroidism. The activities of LPL and HL were also intermediate between those of euthyroid and overt primary hypothyroid subjects, and there was a significant reduction of the elimination rate of exogenous triglyceride. No changes were found for HDL cholesterol levels. When the patients with secondary hypothyroidism were compared to patients with primary hypothyroidism, matched for thyroid function levels, age, sex, and weight, there were no differences with regard to plasma lipoprotein concentrations or post heparin lipase activities. In 3 patients with secondary hypothyroidism the lipoprotein profiles were studied by zonal ultracentrifugation and found to agree well with changes observed in primary hypothyroidism. L-thyroxine substitution produced a normalization of lipase activities and lipoprotein concentrations in patients with secondary hypothyroidism. We conclude that there are no fundamental differences in the disturbances of the lipoprotein metabolism in primary and secondary forms of hypothyroidism. PMID- 6858553 TI - Uptake of triiodothyronine into cultured human muscle cells. AB - The uptake of T3 was measured in cultured human muscle cells at 37 degrees C and pH 7.4 in a medium containing albumin and glucose. The initial up]take increased linearly when the total T3 concentration was varied from 10(-9) to 10(-4) M. At prolonged incubation time the uptake decreased to virtually zero in about 30 min. These data indicate a rapid passive transport mechanism of T3 and a fast equilibration of the cellular T3 with the surrounding medium. In agreement with these conclusions the efflux of T3 was rapid and the initial uptake was not altered by pre-incubation in a T3-containing medium. PMID- 6858554 TI - Iodide enhances IgG synthesis by human peripheral blood lymphocytes in vitro. AB - Several studies have suggested that iodide may increase thyroiditis and autoantibody synthesis. We have investigated the effect of iodide in vitro at physiologically relevant concentrations on immunoglobulin synthesis by normal human peripheral blood lymphocytes stimulated with pokeweed mitogen. Both the number of cells which synthesised IgG and the amount of IgG released into the culture supernatant increased significantly after culture in a medium with added iodide compared to a medium with added chloride. No effect of increasing concentrations of the added iodide from 10(-3) mM to 10 mM was observed. These findings suggest that iodides may have a role in enhancing antibody synthesis which may be important when programmes of iodide supplementation are introduced into areas which are deficient. PMID- 6858555 TI - Suppression and stimulation of TSH and thyroid hormones in bulls during starvation and refeeding. AB - Sixteen bull calves were fasted during two periods, 31/2 and 7 months old. Blood samples were taken every 6 h during an experimental period of 9 days: 2 control days, 5 fasting days and 2 refeeding days. During the control days with ad libitum feeding, T3, T4 and TSH increased during the day. During the fasting period, T4 decreased with a half-life of 3.5 days and T3 with a half-life of 3 days. TSH decreased in a less regularly way to a mean of 60% of control mean. Six h after refeeding, TSH had increased to 300% of control mean. T3 and T4 had a maximum 12 h after refeeding. As the T4 decreased with a rate nearly similar to the T4 disappearance rate in starving bulls, the secretion of T4 from the thyroid gland must have been almost stopped during the starvation period. The morning values were below normal for all three hormones after 2 days of refeeding. PMID- 6858556 TI - Neonatal hypothyroidism: effect on the circadian variation of serum TSH in adult male rats. AB - Newborn rats were rendered hypothyroid during the first post-natal week and then studied as adults. At 80 days of age, groups of control and neonatally treated animals were sacrificed at the peak (13.00 h) and trough (07.00 h) of the serum thyroid stimulating hormone (TSH) circadian rhythm. Both control and treated animals showed the normal peak and trough fluctuation of serum TSH, although the animals made hypothyroid neonatally had serum TSH levels which were less than those of the control animals. Serum thyroxine (T4) levels of control and treated animals were similar at the trough of the serum TSH rhythm (07.00 h), but the (T4) levels of the neonatally hypothyroid animals were significantly lower than those found in the control animals at the peak of the TSH rhythm (13.00 h). The results of this experiment indicate that the central nervous system (CNS) regulation of the circadian pattern of serum TSH is maintained in adult animals made hypothyroid neonatally, and supports the results of previous studies which indicate an enhanced sensitivity of TSH secretion to feedback suppression by thyroid hormones. PMID- 6858558 TI - Concentrations of 2-methoxyoestrogens in human serum measured by a heterologous immunoassay with an 125I-labelled ligand. AB - A radioimmunoassay has been developed for the measurement of 2-methoxyoestrogens in samples of human serum without chromatography after solvent extraction. Antibodies raised against 2-methoxyoestradiol-17 beta-hemi-succinyl-BSA served as binding protein and 2-methoxyoestrone-17-cmo-[125I]iodohistamine served as 125I labelled ligand. A specific (little or no cross-reactivities to other oestrogens), sensitive (2.4 +/- 0.9 pg/tube) and precise (6.5% intra-assay; 9.1% inter-assay) assay was obtained by employing the heterologous bridge system. The following concentrations were found in serum samples of healthy subjects (median, range in parentheses): men (19-58 years): less than 10.3 (less than 10.3-35.5) pg/ml (n = 22); women follicular phase: 46 (18-63) pg/ml (n = 8); luteal phase: 70 (31-138) pg/ml (n = 8); post-menopausal women: 33 (21-76) pg/ml (n = 10); pregnant women 11th-16th week: 674 (216-1678) pg/ml (n = 46); 37th-40th week: 3768 (2035-10691) pg/ml (n = 34); newborn cord serum 1608 (575-3095) pg/ml (n = 41). PMID- 6858560 TI - A case of congenital nonspherocytic hemolytic anemia associated with glucosephosphate isomerase (GPI) deficiency-GPI 'Kinki'. PMID- 6858559 TI - Hematologic and immunologic aberrations in patients under diphenylhydantoin administration. PMID- 6858557 TI - Thyroglobulin-rich colloid goitres: a result of the combined action of lithium and methimazole on the rat thyroid. AB - Naturally occurring euthyroid goitres in man and goitres produced in experimental animals by iodine deficiency or goitrogen feeding both have in common a thyroglobulin of low iodine content. The latter experimental goitres are always depleted of colloid and thyroglobulin. In contrast, natural goitres often contain excessive amounts of colloid which may accumulate because of endocytosis becoming refractory to TSH. We tested the hypothesis that minute doses of goitrogens could lower the iodine content of thyroglobulin without colloid depletion. We then examined whether such a low-dose 'classical' goitrogen could induce excessive colloid storage rather than depletion if acting in concert with lithium, a cation which blocks endocytosis. Rats on an adequate iodine intake were fed minimal doses of methimazole either alone or combined with lithium chloride. Chronic minimal-dose methimazole treatment lowered the iodine content of thyroglobulin without changing thyroglobulin content and thyroid weight. In contrast, addition of lithium to methimazole, produced goitres containing supranormal amounts of poorly iodinated thyroglobulin. We conclude that borderline doses of goitrogens can lower iodination of thyroglobulin without causing hyperplasia and colloid depletion. Thyroglobulin-rich goitres can be obtained by adding a second goitrogen which inhibits endocytosis. As an alternative to Marine's hypothesis of colloid goitre formation we suggest that inhibition of endocytosis, e g by goitrogens of the lithium type, could cause colloid and thyroglobulin accumulation in human iodine deficiency goitre. PMID- 6858562 TI - Extraosseous plasmacytoma causing obstructive jaundice--a rare case of IgA myeloma. PMID- 6858561 TI - Tumorigenicity and immunogenicity of somatic cell hybrids between L1210 mouse leukemia cell and L-fibroblast. PMID- 6858563 TI - Hb E/beta 0-thalassemia in a Laotian refugee. PMID- 6858565 TI - Coagulation-fibrinolytic analysis in patients with lung cancer. PMID- 6858564 TI - Basic studies on oral and rectal administration of factor IX concentrate preparation. PMID- 6858566 TI - Minimal altered SDS-PAGE profile of erythrocyte membrane proteins in paroxysmal nocturnal hemoglobinuria. PMID- 6858569 TI - The mechanism of decreased red cell acetylcholinesterase activity in patients with paroxysmal nocturnal hemoglobinuria: Its relation to the membrane lipids. PMID- 6858567 TI - A case of hereditary spherocytosis associated with factor V deficiency. PMID- 6858568 TI - Hemopoietic changes in partial DiGeorge syndrome (partial thymic hypoplasia). PMID- 6858570 TI - Histometrical study on the aspiration bone marrow biopsy. PMID- 6858573 TI - The anesthetic implications of chemotherapy. PMID- 6858571 TI - Follow-up study of 34 children with autoimmune hemolytic anemia. PMID- 6858572 TI - Quantitative analysis of biopsied bone marrow tissue embedded in resin from hemopathic patients. I. Distribution of marrow adipose volume (MAV) and hematopoietic cells (HC) in certain part of the bone marrow biopsied specimen. PMID- 6858574 TI - The adrenal gland and the use of cortisone in the management of patients with Addison's disease and Cushing's syndrome. PMID- 6858575 TI - Anatomic and physiologic changes of pregnancy: anesthetic considerations. PMID- 6858576 TI - Propanidid, an intravenous anesthetic agent. PMID- 6858577 TI - Ethics and nurse anesthetists--Part I. PMID- 6858578 TI - Evaluation of clinical performance: Part I. AB - The literature review reveals there is a wide variation of approaches in applying the concepts of evaluation. In this first article, the principles of clinical evaluation have been discussed and subsequently applied to the unique educational situation involved in a nurse anesthesia educational program. The effectiveness of any evaluation program can be determined only after implementation, use for a period of time, and further evaluation as to its effectiveness. The summative evaluation of the evaluation program may assist in identifying areas which need improvement, redesign and reaccomplishment. However, it is evident that an individualized program such as a nurse anesthesia program demands considerable evaluative skills on the part of faculty members and clinical instructors. Specifying objectives and measuring student performance requires continual monitoring to ascertain student progress. PMID- 6858579 TI - "Locality rule" standard of care expands. PMID- 6858582 TI - Perioperative care of the patient with traumatic head injury. AB - In summary, although the prognosis for the severely head-injured patient may be poor, there are a multitude of techniques available to the anesthetist for minimizing the occurrence of secondary head injury. Aggressive resuscitative efforts toward maintaining homeostasis must be directed at cardiovascular and neurological systems. Sound knowledge of physiologic principles and the clinical application of these principles are essential to the safe management of a patient who has sustained traumatic head injury. PMID- 6858580 TI - Biphasic respiratory depression from neurolept anesthesia. PMID- 6858581 TI - The blood loss analyzer--a new way to estimate blood loss. AB - Regardless of the means used to estimate blood loss, clinical observation of the patient with frequent assessment of cardiovascular status is that basis of total management. It is very important that EBL be reported with some accuracy using a device that has the ability to weigh blood loss. Why? The overall mortality rate from blood transfusion has been reported to be as high as one death per 5000 units given. This is a highly subjective number. There are undoubtedly cases in which death has resulted from the administration of one unit of blood. However, the most common pattern would be one in which a patient received many units of blood and still died as a result of his primary disease. Until recently, blood loss determination was merely a function of estimation or clinical observation due to the previously mentioned drawbacks of manual scale systems. With new advances in computers, the ease at which blood soaked sponges can now be weighed and calculated can be as simple as a touch of a button. PMID- 6858583 TI - Marfan's syndrome. PMID- 6858584 TI - Anesthesia for the carcinoid syndrome. PMID- 6858585 TI - Ethics and nurse anesthetists: Part II. PMID- 6858586 TI - Evaluation of clinical performance: Part II. AB - Through the methodological approach used in designing the clinical curriculum of the Minneapolis School of Anesthesia, the author believes the results of this work will enhance the management of the clinical evaluation program, improve the clinical instruction, and provide the student with a more valid and reliable evaluation of clinical performance. To quote Miller: "The path has been long, but the circle is now complete. Evaluation begins and ends with the behavioral goal of education, not with the instruments used to measure it or the instruction used to encourage it. It is at once a continuous process designed to facilitate learning and an intermittent activity to determine whether an acceptable amount of learning has occurred. . . . Evaluation is a tool for education not merely an administrative device for the separation of those who falter from those who succeed." PMID- 6858587 TI - A case approach: regional anesthesia for the juvenile patient. PMID- 6858588 TI - The role of the health care practitioner when the patient poses a harmful threat to others. PMID- 6858590 TI - Wheel-running of rats in combination with a simple self-stimulation procedure. AB - LONG EVANS hooded rats with chronically implanted electrodes in the Area hypothalamica lateralis (AHL, group 1), the Nucleus linearis rostralis (LR, group 2) and the Nucleus centralis superior (CES, group 3) were offered the possibility to spontaneously perform wheel-running for one hour per session. The number of wheel revolutions per ten minutes and per hour were counted automatically. The rats were connected with a square wave generator by a smooth flexible cable and received stimulus series (50 imp./s; 0.5 ms imp. duration; 0.5 s series duration; 0-3 V intensity) triggered by each complete revolution of the wheel. The sessions took always place at the same time of the day and under the same experimental conditions -- except the change of stimulus intensity. The results with 0 V served as controls. The method has the following advantages: 1. Self-stimulation is induced spontaneously in the first stimulation session. 2. Negative emotional effects can be quantified by the decrease of the wheelrunning activity. -- AHL stimulation caused an increase in the wheel-running activity amounting to 300 350% with a maximum at 3 V. LR stimulation brought about an ambivalent effect with increase to 200% at 1-2 V and decrease to 56% at 3 V. During CES stimulation an increase to 166-240% with its maximum at 2 V was observed. Stimulation with the same parameters did not evoked locomotion in an open field situation. PMID- 6858591 TI - Hemispheric differences in VEP elicited by mental arithmetic and tachistoscopically presented spatial transformation tasks. AB - Recent studies have furnished evidence of hemispheric asymmetry in the EEG and event-related potentials in man. Face-validated tasks as verbal and nonverbal ones (A: mental arithmetic; B: detection of a target in the hand of a manikin in different positions) were tachistoscopically presented to check side differences of VEP parameters in 5 healthy right-handed subjects. The EEG was recorded from C3, C4, P3 and P4 referenced to linked ears. The mean peak latencies of averaged VEPs were P1: 107 ms, N1: 142 ms, P2: 203 ms, N2: 265 ms, P3: 357 ms. No consistent treatment effects were obtained for peak latencies. Regardless of side differences, the attention related VEP amplitudes P1-N1 and N1-P2 were higher in A. Rightleft differences were found to be higher for visual-spatial transformation, except P2-N2 amplitude. The asymmetry of amplitudes suggests a higher activity of the right hemisphere in B. A possible description of dynamic variations due to learning and changes of strategy during repetitive mental activity by means of changes in EP asymmetry will be of interest for further investigations. PMID- 6858589 TI - The effect of selective attention on pattern-specific visual evoked potentials. AB - In a complex choice reaction time experiment, patterned stimuli without luminance change were presented, and pattern-specific visual evoked potentials to lower half-field stimulation were recorded. Two experimental conditions were used. The first was the between-field selection, where square patterns were presented in either the lower or the upper half of the visual field. In a given stimulus run one of the half-fields was task-relevant, and the subjects' task was to press a microswitch to stimuli of higher duration value (GO stimuli), while they had to ignore shorter ones, i. e. stimuli of lower apparent spatial contrast (NOGO stimuli). They had to ignore the stimuli appearing in the irrelevant half-field (IRR stimuli). In order to ensure proper fixation, the subjects had to press another microswitch at the onset of a dim light at the fixation point (CRT stimuli). Our second experimental condition was the within-field selection, where the GO, NOGO, and IRR stimuli appeared in the lower half of the visual field. GO and NOGO were square patterns while IRR stimuli were constructed of circles, or vice versa. (The CRT stimuli were the same as in the previous condition.) Three pattern-specific visual evoked potential components were identified, i. e. CI (70 ms latency), CII (100 ms latency), and CIII (170 ms latency). There were marked selective attention effects on both the CI-CII and CII-CIII peak-to-peak amplitudes. In both experimental conditions, responses with the highest amplitude were evoked by the GO type of stimuli, while the IRR stimuli evoked the smallest responses. According to these results, attention effects on the pattern-specific visual evoked potentials in the first 200 ms cannot be attributed to a simple stimulus set kind of selection. PMID- 6858592 TI - Cholinergic enzyme activity during partial brain ischemia in the dog. AB - Activity of cholinacetyltransferase (ChAT. EC 2.3.1.6) and acetylcholinesterase (AChE, EC 3.1.1.7) was monitored during occlusion of arteria cerebri media dx. (MCA) in five areas of the brain cortex, in nucleus caudatus and in the thalamus of the ipsilateral and contralateral hemisphere. After 1 hour of MCA occlusion ChAT and AChE activity was reduced in the ischemised region of the hemisphere, i. e. in gyrus ectosylvius anterior and gyrus sylvius anterior, whereas after 4 hours of occlusion the differences were not significant. In nc. caudatus and thalamus the activity of enzymes during ischemia did not change much. PMID- 6858594 TI - Electrical activity in the rat amygdala in some behavioral situations. PMID- 6858593 TI - Effects of ethanol on after--discharges evoked by electrical stimulation of hippocampus in rabbits. AB - The influence of ethyl alcohol on the after-discharges provoked by electrical stimulation of dorsal hippocampus in rabbits was studied. The after-discharges were registered from frontal cortex reticular mesencephalic substance and contralateral hippocampus. The hippocampus was stimulated seven times every 30 min. in two sessions performed in a 7 days' interval. In the second session ethanol in doses 0.8 g/kg i.v. and 0.4 g/kg p. o. and i. v. was administered. Ethanol administered intravenously in a small dose increase, whereas in a larger dose prevented the increase of after-discharge duration during the session. The influence of ethanol on after-discharges correlated with its initial blood concentration. PMID- 6858595 TI - Polygraphic characteristics of daytime sleep during social adaptation of normal children less than three years of age. PMID- 6858596 TI - Correlation between osmotic resistance of leukocytes to the oxygen pyknotic index Qp. PMID- 6858597 TI - Correlation of DNA content in leukocytes with their cytochemical DNA index. PMID- 6858599 TI - Annular gap junctions of the equine hoof wall. AB - Incidental to studies of keratinization of the equine hoof wall, annular gap junctions were found in the stratum spinosum of the intertubular horn of the stratum medium. Adjacent cells of the stratum spinosum showed extensive gap junctions, and often local invaginations of one cell into another were bound by gap junctions. It is proposed that these invaginations become detached from the cell surface to form the annular gap junctions. Formation of annular gap junctions may be a means of disposing of plasma membrane in response to changes in cell volume or shape occurring in keratinization. Interiorization of gap junctions may also facilitate cell movement, and perhaps may act to reorganize desmosome-tonofibril arrangements by budding off appropriate interdesmosomal areas, thus drawing the desmosomes closer to one another. PMID- 6858600 TI - The mesencephalic root fibers of the trigeminal nerve in the dog. AB - The trigeminal nerve has motor, intermediate and sensory roots in the dog. The motor root is composed of two bundles: the medial and ventral. The ventral motor root emerges from the pons, forming the common root with the sensory, and then is separated from it to run along with the medial motor root which separately exits from the pons as the ordinary motor root. The mesencephalic root fibers of the trigeminal nerve are investigated in the dog, using the myelin sheath degeneration technique. Degenerated fibers are observed numerously in the ventral motor root and moderately in the medial motor root, and are traced to the mandibular branch of the trigeminal nerve. Some degenerated fibers are observed in the sensory root and they seem to pass through the Gasserian ganglion to enter the ophthalmic and maxillary branches. No degenerated fibers are found in the intermediate root. PMID- 6858598 TI - Influence of clonazepam on thalamocortical phenomena in rats. AB - The influence of clonazepam on thalamo-cortical phenomena was studied in acute experiments in 20 rats. Early components of cortical responses to electrical stimulation of either LA or VDM thalamic nuclei remained unchanged. Only the latency of the late N2 component was significantly shortened after CZP. CZP did not change the incidence of rhythmic after-discharge ("thalamo-cortical spindles") and tended to prolong them. Two types of self-sustained after discharges of an epileptic nature which could appear after the end of rhythmic thalamic stimulation were influenced differently: Spike-and-wave type was invariably suppressed, serrated wave type of SSAD was generally unchanged by CZP. This last finding speaks in favour of the hypothesis that these two types of SSADs could serve as models of two different epileptic seizures. PMID- 6858601 TI - Pattern of membranous and chondral bone growth. A roentgen stereophotogrammetric analysis in the rabbit. AB - To elucidate longitudinal tubular bone growth patterns in relation to craniofacial development, nine 4-week-old male New Zealand white rabbits received tantalum implants in the calvarial bones and in the proximal and distal tibial epiphyses. The animals were examined by roentgen stereophotogrammetry. The rapid growth rate deceleration pertained to all growth regions studied, except the sagittal suture. A brief period of under-nutrition highlighted the parallel in growth rates between the frontonasal suture (associated to the facial skeleton) and the tibia. The neurocranial coronal suture exhibited a different growth pattern, presumably related to neural tissue expansion, which was also observed to rapidly react to nutritional deficiency. Tibial growth was found to sensitively reveal influences of somatic development. Hence, it might be used to optimize growth evaluations. PMID- 6858603 TI - Blood vessels of the bovine chorioidea. A scanning electron microscopic study. AB - On corrosion casts of the bovine choroidal vessels, the vascular architecture was investigated by means of scanning and corresponding transmission electron microscopy. Complete filling of the vessels produced close-fitting replicas. Thus, based on different luminal structure, the arteries and veins in the lamina vasculosa could be easily distinguished. The branches of these vessels were followed to the choriocapillaris. The complete pattern of afferent and efferent vessels provided the opportunity to establish a scheme of choroidal microcirculation. The choriocapillaris in the bovine as a freely communicating network is subdivided into star-shaped areas of roughly hexagonal form. On the boundaries of these areas the afferent vessels (arterioles) - arranged at regular distances - join the choriocapillaris, whereas drainage of the choriocapillaris is effected by a single efferent vessel (venule) in the center of each area. PMID- 6858602 TI - Mechanisms of development of prolactin-induced adenomyosis in mice. AB - Ectopic (intrauterine and under the renal capsule) pituitary transplantation induced a high incidence of adenomyosis with subserous nodules in both SHN and SLN strains of mice. Early signs of the development were the invasion of stromal fibroblasts into the myometrium along the branches of blood vessels, followed by uterine gland invasion of the musculature to the serosa. Pituitary grafting did not modify the effects of carcinogens on the uterus. Mechanisms of the development of adenomyosis and hormonal milieu facilitating these pathological changes of the uterus are discussed. PMID- 6858604 TI - Crystal growth in matrix vesicles of permanent tooth germs in kittens. AB - Dentinogenesis of permanent tooth germs in kittens was examined in a transmission electron microscope. Crystals of various sizes (3-30 A in width) appeared in the matrix vesicles. Electron diffractional features revealed that crystal size in electron micrographs reflected various stages of crystal growth. Pairs of small crystals and dislocated crystals were observed in some crystal-containing matrix vesicles. However, these matrix vesicles were not observed in unmineralized matrix just adjacent to calcifying fronts and in mineralized dentin. Furthermore, long crystals were abundant in mature dentin. These findings suggest that crystal growth in matrix vesicles is due to fusion and that dentin maturation progresses through crystal growth along the long axis. PMID- 6858605 TI - Development of the human fetal auditory cortex: growth of afferent fibres. AB - The sequential development and growth of the subcortico-cortical fibres have been studied by means of acetylcholinesterase (AChE; acetylcholine acetylhydrolase; EC 3.1.1.7) histochemistry on the serial sections obtained from brains of human fetuses ranging from 10 to 28 weeks of gestation. It was found that thalamic and basal telencephalic fibres approaching the fetal auditory cortex have very strong AChE reactivity during a prolonged period of growth. In the youngest fetuses (10.5 weeks) a prominent fibre system was seen emerging from the ventroposterior thalamic territory while the auditory neopallium was free of AChE staining. In older fetuses (16-18 weeks) AChE-positive fibres originating in the ventroposterior thalamus and basal telencephalon penetrate the 'subplate layer' of the auditory cortex. On the basis of AChE reactivity of the 'subplate layer' the auditory cortex can be delineated from the surrounding neocortical areas. In the oldest fetuses (22-28 weeks) AChE-positive fibres of thalamic origin penetrate the developing cortical plate of the auditory cortex. PMID- 6858607 TI - Nerve sheaths in the leptomeningeal connective tissue. AB - In 2 cats nerves of the spinal pia mater were studied by means of electron microscopy. These nerves possessed no perineurium. However, it has been observed that flat cells of the surrounding connective tissue can form an incomplete covering for small nerve bundles. In addition the perivascular nervous plexus of subarachnoid arteries of the brain stem, which were examined in 1 animal, also showed no perineural sheath. These results are discussed with those reported in the literature dealing with the perineurium of other peripheral nerves. The observations concerning the distribution and the composition of leptomeningeal nerves are in accordance with those obtained by light microscopic investigations. PMID- 6858606 TI - Morphology and permeability of junctional complexes in maturing ameloblasts of rat incisors. AB - Thin sections of newborn rat incisors were examined by tracer experiments and freeze-fracture replication in order to clarify the morphology and permeability of ameloblast junctional complexes in the maturation stage. Ameloblast junctional complexes consisted of gaps and tight junctions at the proximal and distal ends. Whereas the proximal junctional complexes sealed extracellular spaces incompletely, the distal ones formed complete, belt-like barriers around the cell. Tight junctions of these junctional complexes, however, were composed of both continuous and discontinuous rows of particles with various spaces among them. Intravenously injected horseradish peroxidase (HRP) reached the enamel surface through the extracellular spaces among ameloblasts and was absorbed by ameloblasts of the ruffled borders. Pinocytosis and transcellular migration of HRP could not be demonstrated in maturing ameloblasts except in the ruffled border zone. PMID- 6858608 TI - Three-dimensional measurements of the occlusal surface of upper first molars in a modern Japanese population. AB - Moire photographs of the occlusal surface of first molars of Japanese children were taken by means of a specially designed moire contourograph apparatus. They were then used for three-dimensional measurements. The heights of 4 cusps and some other points were measured by counting contour lines. Distances and angles between them were also measured. Sex differences of these measurements are found mainly around the metacone and hypocone. There is no clear correlation of the four cuspidal heights to the distances between them. PMID- 6858612 TI - Evaluation of some coagulation parameters in cerebral ischemia. AB - In order to investigate some aspects of blood coagulation and of platelet function in cerebral ischemia, 18 healthy subjects, 24 patients with previous cerebral infarction and 12 patients with transient ischemic attacks were studied. All patients were in a non-active state of the illness. In all subjects, platelet count, prothrombin time, activated partial thromboplastin time and determination of the fibrinogen concentration were performed as routine. All subjects were tested for platelet adhesiveness, circulating platelet aggregates, factor VIII coagulant (VIII C), factor VIII-related von Willebrand factor (VII RWF), factor VIII-related antigen (VII RAg), antithrombin III (AT III) concentration and activity and euglobulin clot lysis time. No significant difference between patients and controls was found in routine tests, platelet function, AT III concentration or activity. Plasma levels of VIII C, VIII RWF, VIII RAg were significantly increased in both patient groups. The VIII RAg/VIII C ratio was significantly increased only in patients with previous cerebral infarction. Euglobulin clot lysis time was significantly increased in both patient groups. PMID- 6858609 TI - [Recurrent familial idiopathic facial paralysis]. PMID- 6858611 TI - Autonomic neuropathy: the diagnosis. AB - The diagnosis of autonomic neuropathy is often difficult to establish, since clinical symptoms generally appear late in the course of the disease, and may be non-specific. A number of recently developed quantifiable and reproducible autonomic nerve function tests are reviewed, with emphasis on the physiological basis of the tests and on practical applicability. Finally, diagnostic criteria, based on autonomic nerve function tests, are suggested. PMID- 6858613 TI - Thymidine uptake by lymphocytes in the presence of supernatants of polymorphonuclear leucocytes incubated with multiple sclerosis brain antigens. AB - The effects of factors secreted by polymorphonuclear leucocytes (PMNL) incubated with multiple sclerosis (MS) and control brain antigens (MSG2 and KG2 respectively) were evaluated by assay of thymidine uptake by lymphocytes from normal individuals and MS patients. It was found that the cellular uptake of thymidine of both MS and normals was significantly lower in the presence of MSG2 PMNL supernatants compared to that in the presence of KG2-PMNL or without antigen PMNL supernatant. The findings indicate that an inhibitor of lymphocyte proliferation either may be released from PMNL by the action of MSG2 or may be synthesized in response to challenge by MSG2. PMID- 6858614 TI - Morphological changes of erythrocytes in patients and carriers of Duchenne disease. AB - The morphology of erythrocytes was investigated in 7 patients with Duchenne dystrophy and in 6 carriers of the same disease. Upon immediate fixation, the erythrocytes showed significant stomatocytosis which was observed in a scanning electron microscope. The mean value of the % of stomatocytes was significantly different in carriers compared to healthy people (P less than 0.01). PMID- 6858610 TI - [Verbal abilities of normal adults submitting to an aphasia linguistic protocol]. AB - A language test protocol for aphasia in French-speaking patients was drawn up recently by workers in Toulouse and Montreal. The protocol has been applied to sixty hospitalized sciatica patients of the same age range and socio-cultural level as the average population of aphasics in our department. Only one of the normal patients passed the test without any mistakes. The number and nature of the mistakes are studied statistically in relation to age, sex and socio-cultural level. PMID- 6858615 TI - Increased enolase activity in erythrocytes in a family with cerebellar ataxia. PMID- 6858617 TI - Fertility prognosis after surgical treatment of pelvic endometriosis. AB - A total of 129 infertile patients with endometriosis were treated by surgery. The severity of endometriosis was estimated according to Acosta's classification. The mean pregnancy rate was 51.2%. The pregnancy rate of the patients with primary infertility was 48.9% and, for the secondary infertility group, 56.8%. Two-thirds of the women who became pregnant conceived within one year. The pregnancy outcome in mild endometriosis was 59.1%, in moderate 56.4% and in severe 40%. Eighteen male partners had deficient sperm in the group of 63 women who did not conceive within the follow-up period. In addition to the extent of the disease, factors such as duration of infertility prior to surgery and age at the time of surgery seemed to be important in the fertility prognosis. PMID- 6858616 TI - Estriol screening in pregnancy. Prognostic value of total estriol in serum (E3) in an obstetrical population. AB - One thousand six hundred and sixty pregnancies were recorded in this investigation. In 1 042 women with singleton pregnancies and known term, measurements of the total serum estriol (E3) were made exclusively for the present study. The study was prospective, and the clinicians had no knowledge of the E3 values. Within the screened group a low E3 value entailed a 42% risk of delivering an infant with perinatal complications and a 27% risk of an infant small for gestational age (SGA). 7% of the infants with perinatal complications and 19% of the SGA infants were detected at the screening. In a sub-group of 800 pregnancies considered normal according to given criteria, a low E3 level involved a 27% risk of perinatal complications and a 15% risk of an SGA infant. Of these cases 4% and 14% respectively had been detected at the screening. It is concluded that the E3 level should be measured on wide indications, but that this test is of little value in pregnancies that are clinically quite normal. Thus, the benefit of screening all apparently normal pregnancies depends upon the extent and thoroughness of the clinical antenatal care. PMID- 6858618 TI - Serial plasma oxytocin levels during pregnancy and labor. AB - Maternal plasma oxytocin levels during pregnancy and labor were measured by a sensitive and specific radio-immunoassay. The mean plasma oxytocin concentration in maternal peripheral plasma showed a gradual rise towards term, reaching 12.5 microU/ml in term subjects without labor contractions. This level was not significantly different from the mean value in the 1st stage of normal spontaneous labor (12.6 microU/ml). Brief fluctuations in plasma oxytocin levels of considerable degree, and sometimes spurt release, were observed in labor and at term, but not in the mid-trimester, in serial samples collected at short intervals (about 10 sec). In normal spontaneous labor, no obvious relation was observed between the plasma oxytocin level and the uterine contraction period, and no significant difference was found between the mean value in uterine contraction periods (12.1 microU/ml) and that in relaxation periods (11.5 microU/ml). PMID- 6858619 TI - Factors related to an improved outcome for twins. AB - We observed that perinatal mortality among the 220 twins born at our hospital in 1977-78 (3.6%) was significantly lower than for the 210 twins born in 1975-76 (11.0%). At the same time the frequency of postpartum asphyxia had decreased significantly. An analysis of factors related to the diagnosis and therapy revealed that during the later period both the diagnosis of twins and bed rest in hospital had been initiated significantly earlier than during the former period. The duration of pregnancy, length of stay in hospital, use of beta-adrenergic drugs or glucocorticoids, duration and type of delivery and birthweight of the infants were similar in both groups. Early diagnosis permits the greatest degree of readiness for both the mothers and the obstetrical and pediatric personnel in order to meet the possible complications commonly associated with a twin pregnancy and birth. PMID- 6858620 TI - The 24-hour rhythmicity of birth. A populational study. AB - The incidence of birth has been determined for each hour of the day for all births in Norway in 1968-1977 of fetuses of 16 weeks of gestation or older, with resident mothers. The 24-hour incidence variations of births (A) with spontaneous onset and parturition, (B) with spontaneous onset, but delivery intervention, (C) with induced onset, but spontaneous birth, and (D) with induced onset and delivery intervention, are all different. It is shown that the curve for the hourly incidence of birth category A coincides very well with previous results of other workers. When multiple births are excluded and category A is split into first and later births in Northern and Southern Norway, dissimilarities arise between the respective 24-hour incidence curves. The results indicate that the 24 hour birth incidence variation has an underlying endogenous, circadian rhythmicity - possibly synchronized by the sun. The 24-hour rhythmicities of birth categories B, C and D seem to be purely exogenous - reflecting the working activity rhythms of hospital obstetricians and midwives. PMID- 6858621 TI - Maternal and fetal serum prolactin levels in cases of premature rupture of membranes. AB - Serum prolactin levels were measured in maternal and fetal sera immediately post delivery in 20 cases of premature rupture of the membranes and in 20 controls. Fetal serum prolactin levels were 781 +/- 265 ng/ml in cases of PRM and 737 +/- 314 ng/ml in controls. Maternal serum prolactin levels were 504 +/- 264 ng/ml in cases of PRM and 731 +/- 361 ng/ml in controls. This difference is statistically significant (t = 1.81, p less than 0.05). A probable role of prolactin in maintaining fetal membrane integrity and the probable effect of the difference in maternal serum prolactin concentration in the two groups on the membranes' viscoelastic properties is discussed. PMID- 6858623 TI - Intra-uterine growth and fatal fetal abnormality. AB - To study intra-uterine growth in pregnancies complicated by fatal abnormality of the fetus, 73 pregnancies involving fetal or neonatal death caused by malformation, chromosomal aberration or Mendelian disease were evaluated. Small for-gestational age newborns were found in 45% of the patients, and this finding was typical of 18-trisomies, amnion adhesion syndrome fetuses and multimalformed fetuses. Pregnancies affected by a Mendelian disease or a single fetal malformation mostly presented normal intra-uterine growth. In 25% of the patients, the symphyseal-fundal growth was retarded; this retardation started on average in the 25th gestational week. Polyhydramnios was present in 30% of the patients and was expressed in growth acceleration of the symphyseal-fundal measurement from the 28th gestational week. In 45% of the small-for-gestational age fetuses the biparietal growth showed low profile type retardation. The brain sparing phenomenon in growth was found in 21%. To assess the prospects of the conceivable modes of treatment, the need for an exact diagnostic evaluation of all pregnancies complicated by intra-uterine growth retardation and a consideration of the need for diagnostic amniocentesis in cases of early growth retardation is emphasized. This also applies to the time after legal abortion. PMID- 6858622 TI - The results of cryosurgical treatment in young women with cervical intra epithelial neoplasia. AB - A review is given of results from a 3-5-year follow-up of 105 young women treated with cryosurgery for a histopathologically verified dysplasia or carcinoma in situ of the uterine cervix. The recovery rate was 88%, with a slightly higher figure in the dysplasia group compared with that of carcinoma in situ. No invasive carcinoma was diagnosed and cases of treatment failure, all diagnosed within one year after cryosurgery, did not develop into a more severe form of neoplasia than previously. No recurrence has been noted so far and very few complications have been recorded. It is concluded that cryosurgery is an easy and effective method of treating cervical intra-epithelial neoplasia in young women. We stress, however, the importance of correct histopathological diagnosis prior to therapy and that after treatment the status of the patient must be checked with vaginal smears over a long period of time. PMID- 6858624 TI - Percutaneous estrogen replacement therapy. Effects on circulating estrogens, gonadotropins and prolactin. AB - A percutaneous gel containing 0.6 mg/g of estradiol-17 beta was used for cyclic replacement therapy in 19 postmenopausal women. Significantly increased serum concentrations of estradiol-17 beta, unconjugated estrone, and total estrone were recorded during 6 months of treatment. In contrast to oral treatment the quotient of estrone/estradiol-17 beta was maintained and even reduced during therapy. Significant gonadotropin inhibition was recorded and the estrogenic potency of 3 mg percutaneous estradiol-17 beta was similar to that of oral estradiol-17 beta 2 mg and 2.5 mg oral estrone sulphate. Prolactin levels remained constant during treatment. Therapy was effective in abolishing hot flushes in 17 out of the 19 women treated. The therapy was well accepted by the volunteers. Seventeen out of 19 women stated that the gel was easy to use in everyday life. Topic application may develop into an alternative treatment for climacteric complaints and may even have some metabolic advantages over oral treatment. PMID- 6858625 TI - Legal teenage abortions in a Swedish population in the 1970s. AB - The number of teenage abortions increased sharply in the early 1970s but gradually decreased from 1975, in absolute numbers as well as in relation to population figures. Teenage abortions now constitute 15% of the total number of abortions. However, the percentage of teenage pregnancies that are terminated by legal abortion is constantly increasing. As the preservation of childbearing function is of paramount importance in teenagers, a low complication rate is essential. Complications occurred in 7% of the cases studies, and the effects of complications of legal abortion on the later obstetric history are discussed. In 14% of the cases a second pregnancy was also terminated artificially. The repeat abortion rate is discussed, with special reference to the contraceptive method used. PMID- 6858626 TI - Long-term clinical effects of ovarian wedge resection in polycystic ovarian syndrome. AB - Twenty-nine consecutive patients with polycystic ovary (PCO) syndrome (defined as hirsutism plus oligomenorrhea or secondary amenorrhea, and excluding Cushing's syndrome, an androgen-secreting adrenal or ovarian tumor or adrenocortical hyperplasia) were treated with ovarian wedge resection leaving normal-sized ovaries. Long-term follow-up from 2.3-9.5 years (mean 5.7 years) showed that 26 of 29 patients (90%) had established normal menstrual cycles. Fertility and normal pregnancies were achieved in all 10 patients (100%) with normal postoperative menstrual cycles who desired to conceive, but not in the 3 patients with remaining postoperative oligomenorrhea. Eight of 9 patients who were obese preoperatively and who had normal postoperative menstrual cycles showed a major weight loss after wedge resection. In contrast, none of the preoperatively obese patients, who remained oligomenorrheic after surgery, lost weight. Hirsutism was not cured by wedge resection. It is concluded that ovarian wedge resection should still be considered useful in patients with PCO. PMID- 6858627 TI - Ultrasound demonstration of the amniotic membrane. AB - Ultrasound scanning in the first trimester of pregnancy occasionally revealed a thin linear echo in the gestational sac. A total of 360 examinations, which had shown a live fetus with a crown-rump length of 7-82 mm, equivalent to a menstrual age of 6-14 weeks, were reviewed. The linear echo was seen in 51 of the examinations, at an ultrasound age of 6-12 weeks. Most frequently it was seen in the 9th week, where it was recorded in 28 of 61 (46%) of the examinations. The origin of the linear echo is believed to be the very thin amniotic membrane, which from the 8th to the 12th week is lined by fluid on both sides. Other intra uterine membranes which all give stronger echo reflections are listed. PMID- 6858628 TI - Positional factors of the uterus play a contributing part in IUD failure. AB - This study is based on a uniform material of 3 500 copper IUD insertions at the Family Planning Unit of Turku Health Center, including 72 cases resulting in pregnancy. Among the pregnant subjects there were significantly more women with a retroverted flexed or mid-positioned uterus than in the control material. Repeat IUD pregnancies were rather common. These observations should be taken into account in practice, especially regarding great care with the insertion technique and a close follow-up of these women. The predisposing factors and the outcome of accidental pregnancies are discussed. PMID- 6858629 TI - Norethindrone in serum after use of an oral contraceptive containing norethindrone acetate. AB - The availability of norethindrone (NET) in serum was studied in 8 women after daily administration of a combination oral contraceptive pill (MinovlarR) containing 1 mg norethindrone acetate (NETA) and 50 micrograms ethinyl estradiol (EE2) from day 5 to day 25 of the menstrual cycle. The pill was taken daily at 9:30 a.m. after a light breakfast and blood samples were collected at 3 hr on alternate days and at 24 hr on other days after ingestion of the pill. On day 12 or day 15 of the first treatment cycle, serial blood samples were also collected at 1/2, 1, 2, 4, 6, 8 and 24 hr after taking the pill. Serum NET levels were estimated by the radioimmunoassay (RIA) technique. The plot of serum NET concentration versus time (0-24 hr) profile showed a rapid absorption of steroid and a peak NET concentration (18.3 +/- 4.8 ng/ml) reached at 2 hr after ingestion of the pill. By linear regression analysis of data (y = 0.27 + 0.12x; r = 0.95), it was observed that the serum NET level was initially about 1 ng/ml. Thereafter, it increased by 0.12 ng/ml per day up to 3.5 ng/ml by the end of 21 days' treatment with oral pills. The serum NET concentration decay slope fitted a two compartment open model with an initial rapid decay (half-life of 1.2 +/- 0.1 hr) followed by a slower beta-phase with a half-life of 8.5 +/- 1.5 hr. The study revealed that there was an accumulation of norethindrone in plasma during the treatment period and this suggests the possibility of exploring a reduction in the dose of this preparation so as to achieve the optimum NET concentration for contraception, and thereby avoiding unwanted steroid accumulation in the plasma of women. PMID- 6858630 TI - Total estriol in capillary and venous serum during late pregnancy. PMID- 6858633 TI - Pregnancy in a non-communicating, rudimentary uterine horn with a successful outcome. PMID- 6858631 TI - Breast carcinoma metastatic to the vagina. PMID- 6858632 TI - Spontaneous uterine rupture in late pregnancy caused by placenta percreta. PMID- 6858635 TI - Rupture of retinal pigment epithelial detachment in senile macular disease. AB - Three eyes with senile detachment of the retinal pigment epithelium were complicated by tearing of the detached pigment epithelium with subsequent wrinkling or folding up of the pigment epithelium under the fovea. In all cases this only recently recognised complication of senile pigment epithelial detachment was documented before and after tearing by fluorescein angiography. In one eye pigment epithelial rupture was followed by rapid ingrowth of subretinal neovascularisation, and in one eye neovascularisation was suspected, although no definite new vessels could be observed. PMID- 6858634 TI - Prenatal ultrasound diagnosis of intestinal calcifications with imperforate anus. PMID- 6858636 TI - The effect of the prostaglandin-inhibitor naproxen on the endothelial cell-loss after cataract extraction. AB - The influence of the anti-inflammatory, prostaglandin-inhibitor naproxen on the endothelial cell-loss after cataract-surgery was studied. Twenty-six patients received the drug, and 27 comprised a control group. The cell-loss, estimated one year after surgery, was found to be significantly lower in the naproxen-treated group than in the control group. PMID- 6858637 TI - Variations of central corneal curvature during the first year of contact lens wear. AB - During hard, hydrophilic and silicone lens wear the variations of central corneal curvature in the 2 eyes of each individual were significantly correlated. Mean changes of principal radii of curvature were small in each lens group (-0.075 +0.068 mm). Hydrophilic lens wearers showed an initial mean flattening of corneal curvature, followed by a significant steepening. Hard lens wearers apparently showed the opposite sequence of mean changes. Silicone lens wearers showed a significant mean corneal flattening. Central corneal asphericity was reduced during hard lens wear. Considerable individual curvature changes occurred (-0.35 +0.30 mm), but none of these necessitated lens refitting. Changes of the central corneal thickness and curvature during hard lens wear were apparently inversely correlated, the ratio between the changes being about -0.08:1. Hard and silicone lenses probably exerted a mechanical moulding effect. The exact aetiology of curvature changes in hydrophilic lens wearers remains obscure. Corneal curvature changes appear less reliable than corneal oedema in the detection of lens-induced impairment. PMID- 6858638 TI - Variations of refractive error during the first year of contact lens wear. AB - The variations of refractive errors during both hard, hydrophilic and silicone lens wear were significantly correlated in the 2 eyes of each individual. In each lens group the mean changes of spherical and cylindrical refractive errors were small (-0.458D-+0.250D and -0.325D-+0.056D, respectively). Considerable individual refractive changes occurred (spherical change: -3.0D-+1.5D, cylindrical change: -2.5D-+1.0D). However, only 2 subjects noticed spectacle blur and a normal visual acuity was always obtained by spectacle refraction immediately after lens removal. This indicated that clinically significant distortion of the central cornea did not take place. Hydrophilic lens wearers showed an increasing myopia during lens wear. Otherwise the refractive changes were not significantly influenced by the duration of lens wear. Refractive changes appeared to be significantly correlated to changes of the central anterior corneal curvature, the ratio of dioptric changes being about 1:1. PMID- 6858639 TI - Lipid deposits subconjunctivally and episclerally. Number, location, relation to external degenerations, and blood pressure. AB - Examination of 1029 subjects disclosed 30-60 micron-sized frog's egg-like lipid deposits subconjunctivally and episclerally in 34%. The prevalence was found to rise steadily with increasing age to a maximum between 70 and 80 (52%). The prevalence declined after the age of 80. Both sexes were equally represented, except in the age groups over 70, where females predominated. In 48% lipid deposits were presented in both eyes, located nasally, temporally, inferiorly, and superiorly in decreasing order of frequency. Vertical location alone was found in 13%. The number of lipid globules was the greatest horizontally (median value nasally 20, temporally 30) and the smallest vertically (median value inferiorly 8, superiorly 15). The lipid deposits were generally found in relation to anterior ciliary arteries, most frequently off the upper corner of the horizontal muscles. In no more than 13% were such deposits seen as pads bearing no relation to vessels, and in 1% between tendon fibres, likewise non-related to vessels. No relation was noticed to presence of pinguecula, pterygium, and scleral plaques, nor to blood pressure or particularly thick conjunctiva. Lipid deposits were rarer in cases with an extraordinarily thin conjunctiva. Presence of lipid deposits may possible be accountable for by injuries of the arterial wall due to eye muscle movements with subsequent exudation of lipids into the surrounding episcleral connective tissue. PMID- 6858640 TI - A case of corneal amyloidosis. AB - An unilateral case of corneal amyloidosis, presenting the clinical appearance and histopathological findings of a gelatinous drop-like corneal dystrophy in a 59 year-old male was reported. In the specimen obtained by a penetrating keratoplasty, amyloid was confirmed with light and electron microscopy. On the basis of histopathological findings, the origin of amyloid appeared to be closely related to the fibroblasts. PMID- 6858641 TI - Changes in the juxtapapillary retinal pigment epithelium following intravenous injection of sodium iodate. A light and electron microscopic study using horseradish peroxidase as a tracer. AB - The effect of an intravenous injection of sodium iodate on the retinal pigment epithelium immediately surrounding the optic nerve head has been investigated using horseradish peroxidase as a morphological tracer. A sodium iodate injection leads to a necrotic reaction of practically the complete retinal pigment epithelium. The juxtapapillary pigment epithelium, however, showed only attenuation and depigmentation without any necrotic reaction 4 and 12 days after the injection. Twenty-six days following the injection the epithelium had almost normalized. The result of this study thus demonstrates a noteworthy resistance of the juxtapapillary retinal pigment epithelium against the sodium iodate effect. At no stage was there a clear indication of a breakdown of the permeability barrier constituted by the juxtapapillary retinal pigment epithelium. Horseradish peroxidase moved into the peripapillary sensory retina by lateral diffusion from the surrounding retina and diffused into the optic nerve head proper, confirming the presence of a diffusional pathway through the Kuhnt intermediary tissue. PMID- 6858642 TI - Routine ERG recording using medium frequency flicker stimulus. AB - A medium frequency flicker stimulus of 10 Hz is evaluated in routine clinical ERG recording in detecting cone disorders. Tested on a number of normal eyes and on eyes with confirmed or suspected retinal disease it appears to be very useful as a complement to the standard program with the Krakau-Ohman apparatus. It yields an easily recordable and quantified response. PMID- 6858643 TI - Retinopathy caused by treatment with tamoxifen in low dosage. AB - In 17 patients treated with tamoxifen in a low dosage (30 mg daily) ophthalmological examination was performed. This revealed 2 cases with possible retinotoxic effect. A 64 year-old woman treated with tamoxifen for 9 months for metastatic breast cancer developed retinopathy with transitory visual impairment. The retinopathy was morphological characterised by multiple yellowish-white dots in the posterior pole, a parafoveal haemorrhage and accumulation of reticular pigment changes in the periphery of the retina. By retinal fluorescein angiography multiple non-fluorescent dots and hyperfluorescent areas were seen in the posterior pole. The retinal lesions remained unchanged except for the haemorrhage after discontinuation of the tamoxifen treatment. In another patient some of these changes were also found. The retinotoxic effect of tamoxifen has been reported previously with tamoxifen in high dosage (greater than or equal to 180 mg daily, minimal total dosage of 90 g) used for long periods, but never from this drug in low dosage (30 mg daily, minimal total dose 8.1 g-12.0 g). PMID- 6858645 TI - Reliability of photometric measurements in the Zeiss fundus camera. AB - The authors test the hypothesis of systematic errors in photometric and/or densitometric measurements performed by Fundus camera equipment. By means of 2 different methods (reflection and transmission) the non-uniformity of light distribution on sample surfaces placed in front of the fundus camera is shown. The consequent point by point variability in retinal illumination can be defined as the 'retinal shading problem'. This conclusion must be taken into account when equidensitometric measurements are carried out on eye fundus images with fundus camera, by photographic, cinematographic or TV techniques. PMID- 6858644 TI - Clindamycin and sulphonamides in the treatment of ocular toxoplasmosis. AB - Eight patients with active toxoplasmic retinochoroiditis were treated with clindamycin and a triple sulphonamide combination for a period of up to 6 weeks. In addition systemic prednisone was administered when the optic nerve or the macula was involved (6 of the 8 cases). In all cases we observed clinical improvement within 2 weeks. Visual acuity improved in all cases. Side effects of the treatment were observed in 2 cases. The follow-up period ranged from 8 to 22 months. PMID- 6858649 TI - Contrast sensitivity in evaluation of visual impairment due to diabetes. AB - Spatial contrast sensitivity of 19 diabetics with different degrees of visual impairment was studied. It was found that contrast sensitivity at intermediate and low spatial frequencies may decrease without corresponding loss of visual acuity. In advanced cases of diabetes the opposite may be true: contrast sensitivity was better than expected on the basis of visual acuity. Thus both visual acuity and contrast sensitivity measurements are useful in the evaluation of the nature of visual impairment due to diabetic eye disease. PMID- 6858647 TI - Diagnosis of an isolated vertical muscle palsy. AB - The determination of a paretic vertical muscle may be made by prism cover test measurements in the 9 diagnostic positions of gaze or the 3-step test which relies on the Bielschowsky head tilt test. A series of cases with an isolated paretic vertical muscle was used to compare the 2 methods of examination. It was found that 1) the 3-step test (based on the Bielschowsky head tilt test) is non diagnostic as frequently as fielding out, 2) the 3-step test is much more likely to diagnose an oblique (especially the superior oblique) than any other muscle, 3) there is a statistically significant association between a loger duration of the paresis and the appearance of spread of comitance, and 4) the disagreement between the 3-step test and cardinal gaze measurements which occurs in 18% of cases can not be adequately explained by 'overspread of comitance' to the point where the deviation is maximum in the opposite field of gaze. The measurement of the deviation in the cardinal positions of gaze was felt to more accurately indicate the paretic muscle when the two tests were in conflict. PMID- 6858646 TI - Visual outcome and complications in 287 intraocular lens implants (Federow) compared with 290 intracapsular cataract extractions. AB - In 287 consecutively intracapsular cataract extracted eyes with a Federow intraocular lens implant (IOL) and 290 eyes with consecutively performed intracapsular cataract extractions (ICCE) the final visual outcome and complications were examined in a retrospective study. The average observation time was 31 months in the IOL group and 37 months in the ICCE group. Seventy-five per cent in the IOL group and 77% in the ICCE group achieved a visual acuity greater than or equal to 0.5. The main cause of a visual acuity less than 0.5 was maculopathy pre-operatively recognized. A visual acuity less than 0.5 due to post operative complications occurred more frequently in the IOL group (28 eyes) compared with the ICCE group (13 eyes) - P less than 0.01. Twelve intraocular implants (4.3%) had to be removed. The most important cause was dislocation of the IOL (9 eyes). During our first 12 months of IOL implantation 8 dislocations occurred out of 56 implanted eyes (14.3%). The remaining 6 dislocations occurred among the last 231 IOL eyes (2.6%). It is concluded that complications are few, but often serious in intraocular lens implant surgery. Careful pre-operative examination and surgical experience are mandatory. PMID- 6858648 TI - Pathology of iridectomy specimens in gyrate atrophy of the retina and choroid. AB - Gyrate atrophy of the retina and choroid is an autosomal recessive disease characterized by progressive retinal degeneration and ornithine aminotransferase deficiency. We report here the new histological findings and ultrastructural changes in 3 iridectomy specimens from 2 Finnish patients with gyrate atrophy. The iridectomy specimens were removed during routine cataract extraction and studied with a transmission electron microscope. The dilator muscle showed atrophy, abnormal mitochondria, and tubular aggregate type structures similar to those found in skeletal muscle. Degenerative changes such as extracted cellular matrix, dropout of cellular organelles, and dilated intercellular spaces were observed in the pigmented posterior epithelium and the anterior iris epithelium. PMID- 6858652 TI - Experimental ankle injuries. Analysis of the traumatology of the ankle ligaments. AB - On 32 osteoligamentous ankle preparations forced movements were performed in varying, accurately defined directions. The sequence in which this caused rupture of the individual ligamentous structures of the ankle is described. Dorsiflexion traumas predominantly injured the posterior part of the deltoid ligament, while in plantar flexion traumas the injuries primarily involved the anterior capsule and the anterior talofibular ligament. Internal rotation traumas injured the anterior talofibular ligament and the short, anterior fibres of the posterior talofibular ligament before the calcaneofibular ligament was damaged, whereas in adduction traumas the calcaneofibular ligament ruptured first. Forced external rotation primarily caused rupture of the deep structures of the deltoid ligament, while conversely abduction traumas first caused rupture of the superficial part of this ligament. PMID- 6858651 TI - Fractured neck of femur. Pattern of incidence and implications. AB - Projected figures for the 1975 incidence of fracture neck of femur in Dundee are compared with the actual figures. Analysis of the incidence in 1952, 1975 and 1980, relating it to age and other factors, shows both an increase in the true incidence and a marked rise in the total number over the period. The length of stay in an Orthopaedic ward is considerably increased if the patient then has to be admitted to a long-stay bed. This length of inpatient stay and the increased incidence continues to raise the demand on acute Orthopaedic female beds. PMID- 6858650 TI - Treatment of soft-tissue sarcoma should be centralised. AB - New concepts regarding surgical margins and new modalities of preoperative examination make centralized care advantageous for patients with soft-tissue sarcomas. This study describes how the organizational level of surgical service and surgical technique have changed with time in southern Sweden. After reviewing all cases of soft-tissue sarcoma in the trunk and extremities registered during 1964-81, 261 patients remained for analysis. The material was divided into patients treated within or outside the Orthopaedic Oncology Group (OOG) for southern Sweden, which started in 1970. Patients treated by the OOG were separated into patients referred before and after surgery. In 1964-69, one-third (25/73) of the patients had a wide or compartmental excision at final surgery of the primary tumour compared with two-thirds (126/188) in 1970/81. Further, four fifths (111/142) of the patients treated by the OOG finally had wide or compartmental excisions, whereas only one-third (15/46) of the patients treated outside the OOG over the same time period had obtained this type of surgery. When recorded, the tentative pre-operative diagnosis was a benign lesion in more than one-half of the patients treated outside the OOG. In two-thirds of the patients referred before surgery the biopsy and treatment, a wide or compartmental excision, were combined into one surgical procedure. Over the years the number of patients referred increased. During 1980-81, 35 of 38 patients with soft-tissue sarcomas were referred to the OOG: 11 before any biopsy, 14 after a malignant cytodiagnosis and 10 following marginal excisions. PMID- 6858653 TI - Effect upon longitudinal growth of femur by intramedullary nailing in rats. AB - In an experimental study using rats it was found that intramedullary nailing through the distal femoral growth plate resulted in a significant retardation of longitudinal growth. Drilling only and pin removal after 7 weeks also gave significant inhibition of growth after 14 weeks, while drilling only with immediate removal of the pin gave no growth disturbance during the first 7 weeks. The investigation indicates that damage to the central portion of the epiphyseal growth plate in rats leads to inhibition of longitudinal growth. PMID- 6858654 TI - Fracture healing after rigid intramedullary nailing in rats. AB - Rigid intramedullary nailing of the right tibia after osteotomy with resection of the fibula was performed on 48 male Wistar rats weighting 300-400 g. Nailing was performed with 1.4-mm nails after reaming. Nail stiffness was similar to that of intact tibias. The left leg remained unoperated as control. The animals were sacrificed after 4, 8, 12 or 16 weeks, and both tibiae were tested in a 3-point bending test. Of the 35 animals with the nail in situ, nine animals showed non union at the time of testing. At 8 weeks stiffness had reached normal values, while strength and deflection showed about half of normal values. Poor strength and small deflectability combined with near normal stiffness may be taken as evidence that Wolf's law is valid also in newly formed tissues of fracture healing; the protection given by a rigid nail makes normal strength and pliability unnecessary. PMID- 6858655 TI - Operative treatment of severe proximal humeral fractures. AB - Results after the operative treatment of 41 severe proximal fractures of the humerus are reported. The fractures were classified according to Neer (1970a). The aim of treatment was accurate reduction and stable fixation of the fracture with screws or with screws and a plate. When scored according to Neer's (1970a) functional assessment, results in the 31 patients re-examined more than 1 year postoperatively were excellent or satisfactory in 23 patients. Results were excellent or satisfactory in 14/15 patients with type III fractures, in 7/11 with IV, and 2/4 with type VI. In the only re-examined patient with a type V fracture the result was unsatisfactory. The most common technical error was a too high positioning of the AO plate and persistent varus deformation of the head of the humerus. High positioning of the plate caused post-operative restriction in the movements of the glenohumeral joint because the implant impinged under the acromion during abduction. No aseptic necrosis of the humeral head was observed. Of the patients of working age all but one returned to their preoperative occupations within a mean of 3.5 months after surgery. PMID- 6858656 TI - Regional scintimetry in scaphoid fractures. AB - A quantitative scintigraphic method was introduced to examine the proximal, middle and distal third of the carpal scaphoid bone. 99mTc-Sn-pyrophosphate scintimetry was obtained by the use of a gamma camera equipped with a pinhole collimator. Of six patients in whom a unilateral fresh fracture of the scaphoid was clinically suspected, radiology showed a fracture of the scaphoid in four and no fractures in two. The method may be suitable in early diagnosis and further localization of clinically suspected fractures with initially non-diagnostic radiographs. PMID- 6858657 TI - Age, diabetes and smoking in lower limb amputation for arterial occlusive disease. AB - The increased number of amputations for arterial occlusive disease noted in western countries is only partly explained by increasing numbers of the elderly. A prospective analysis of the influence of diabetes and smoking habits was therefore carried out. In 1978-81, 188 lower limb amputees in Lund were examined and classified as non-smokers, ex-smokers, light smokers and heavy smokers. These figures were compared with corresponding figures among age-correlated controls and to a group of hip fracture patients. The material was divided into men and women and into non-diabetics and diabetics. Smokers had much lower mean age at amputation. Out of 188 amputees only 23 were not either a diabetic, a smoker or 80 years or more. The population study indicates a correlation between smoking and amputation for ichaemia. The coincident increase in cigarette consumption in Sweden is illustrated and it is suggested that smoking should be noted as routinely as diabetes at amputations. PMID- 6858658 TI - Localized bone resorption in the femur in mechanical failure of cemented total hip arthroplasties. AB - In 70 total hip arthroplasties exchanged because of mechanical loosening of the stem prosthesis, localized bone resorption or scalloping was found in 33 cases. In 19 of the 33 cases the process started at the level of the tip of the stem, which in 15 cases was found to be in direct contact with cortical bone as observed in the radiographs obtained immediately after the primary surgery. In 37 failures without scalloping this metal-to-bone contact was less common. It is concluded that localized bone resorption may occur as a result of mechanical stress and in the absence of deep infection. It is also suggested that the phenomenon might be avoided by proper cementing technique and centering of the tip of the stem, perhaps with the help of a centering device. PMID- 6858659 TI - Migration of the tibial component in successful unicompartmental knee arthroplasty. A clinical, radiographic and roentgen stereophotogrammetric study. AB - Migration of the tibial component in unicompartmental Marmor knee arthroplasty was measured by conventional radiography and roentgen stereophotogrammetry during a 2-year follow-up of six patients operated on for femoro-tibial arthrosis. The clinical course was satisfactory for all six patients. A radiolucent zone developed in all cases, the width of which was greater than 2 mm in one case. By radiography movements of two of the six prosthetic components could be detected. Roentgen stereophotogrammetry showed significant rotational and translatory movements in all six tibial components. In four cases these movements were small not exceeding 1 mm for translation and 1.5 degrees for rotation. The remaining two components showed larger migrations with maximum values of 2.7 mm for translation and 12.6 degrees for rotation. Five of the components tilted backwards about the transverse axis, four tilted away from the centre of the knee about the sagittal axis, and four rotated with the anterior part away from the centre of the knee about the vertical axis. The small movements of the four tibial components may be due to a semi-rigid fixation by connective tissue in the bone-cement interface. Since all knees were asymptomatic, neither the zones nor the minor movements seemed to have any clinical significance within the follow-up period. PMID- 6858660 TI - Conservation of metatarsal heads in surgery of rheumatoid arthritis of the forefoot. AB - A new method of forefoot reconstruction for rheumatoid arthritis in 79 patients is described in which the metatarsal heads are preserved. The first metatarsophalangeal joint is fused and the bases of the proximal phalanges of only those rays involved with disease excised together with cysts and synovium. Post-operatively traction is used to maintain the length of the operated lateral toes. The results in 71 patients followed for 3-5 years after operation are reported. Excellent pain relief, improved stability and feet of normal length are achieved. PMID- 6858662 TI - Radiographic joint space in normal acromioclavicular joints. AB - The acromioclavicular joint space in standard antero-posterior images of 151 normal subjects was measured. The joint space was significantly wider in men. There was a highly significant reduction of the joint space with age in both men and women and in persons past 60 a joint space of 0.5 mm or less is not pathological. A joint space wider than 7 mm in men and 6 mm in women is abnormal. The measuring technique described is useful in population studies. In individual cases a simple measurement with a ruler serves the same purpose. PMID- 6858661 TI - Total hip replacement in juvenile chronic arthritis. AB - Fifty total hip replacements in 33 patients with juvenile chronic arthritis were performed over a 10-year period with good pain reduction, increased hip motion but only a moderate increase in walking capacity. The average age at operation was 26 years and the average follow-up time 77 months. Six hips (patients) have been reoperated, one for infection, one for suspected infection and four due to mechanical loosening. Loosening was revealed radiographically in 10 hips at follow-up. Lack of cement cover and varus position was the main reason for loosening of the femoral stem. Considering the high loosening rate it is probable that at least one revision arthroplasty will be necessary in the future. PMID- 6858663 TI - Degeneration of the acromioclavicular joint. A morphological study. AB - One hundred and sixty-eight acromioclavicular joint dissections were performed on 85 cadavera, 46 men and 39 women, with an average age of 69, ranging from 18 to 92. The intra-articular discs and the joint cartilages were scrutinized and degenerative changes were graded macroscopically. An age related disintegration of the disc and the joint cartilages was found. After the age of 70 maximum degeneration was very common. PMID- 6858664 TI - Indication for weight relief and containment in the treatment of perthes' disease. AB - Fifty-four cases of Perthes' disease each suffering from total involvement of the femoral head were investigated to establish the relative merits of total weight relief and containment in management. It was found that using Catterall's criteria, once the femoral head is "at risk", containment is the only treatment of value; but when the head is "not at risk" a combination of containment and total weight relief produces a near perfect result in every case. PMID- 6858666 TI - Use of instillation-suction technique in treatment of chronic osteomyelitis. AB - Willenegger's closed instillation-suction technique for the treatment of chronic bone infection is described in which infected bone is first exposed and all sequestra removed. Two drainage tubes are perforated, inserted and brought out through the skin between 3 and 4 cm from the wound. The perforated portions of the tubes are laid close to the infected area and the wound closed in layers. One tube is connected to a drip bottle containing antibiotic solution and the second to a continuous suction pump. Closed continuous steady flow instillation-suction is thus established. The results of 28 cases are presented out of which 26 cases showed clinical resolution of the infection. PMID- 6858665 TI - Osteomyelitis caused by Mycobacterium avium. AB - Osteomyelitis due to M. avium is extremely rare and frequently fatal. The successful cure of an 11-year-old patient with multiple mycobacterial lesions in the pelvis and right humerus is reported. Although the mycobacteria were in vitro resistant to most antituberculous drugs a five-drug regimen was given over a total of 2 1/2 years. The accumulated streptomycin dose was 160 g but no adverse effects were noted. Streptomycin therapy was judged of major importance for the favourable outcome. PMID- 6858667 TI - Secretion of parathyroid hormone after surgical trauma. AB - Parathyroid hormone was measured in nine patients subjected to surgery under general anaesthesia not involving operative bone trauma. Total calcium concentration, ionized serum calcium and serum albumin was also analyzed pre- and post-operatively. An increase in serum parathyroid hormone was registered postoperatively without any accompanying decrease in ionized serum calcium. The measured changes are at present unexplained, but can be caused by other mechanisms than bone trauma. PMID- 6858668 TI - Effects of salmon calcitonin on mechanical properties of healing and intact bone and skin in rats. AB - Mechanical properties of healing femoral fractures, intact femora, healing skin wounds and intact skin, have been studied in young male rats during treatment with salmon calcitonin (CT) (3 MCR-U/kg body weight/day). Serum ionized calcium was reduced after each CT injection, and served as a control of the biological activity of the administered hormone. CT did not influence mechanical properties of healing fractures, intact bones or skin wounds. Neither did it change bone growth or body weight of the treated rats. In contrast, injections of the hormone impaired mechanical properties of intact skin Thus, the tensile strength and the ultimate elongation of skin specimens from CT treated rats were reduced by about 20 and 10 per cent respectively compared to controls after 30 days of treatment. The results of the present study do not support the use of salmon CT in the treatment of fractures. PMID- 6858670 TI - Abstracts of proceedings of Scandinavian orthopedic associations 1981 and 1982. PMID- 6858669 TI - Effects of salmon calcitonin on synthesis and mineralization of collagen in rats. AB - The effects of salmon calcitonin (CT) on collagen metabolism and mineral deposition in fractures and intact femora, and on collagen metabolism in healing skin wounds and intact skin have been studied in young male rats. Serum calcium and serum phosphorus were reduced 3 h after the daily subcutaneous CT injection (3 MRC-U/kg body weight), whereas a rebound increase in the serum levels of both minerals was observed at 24 hours after the injection. CT had an early transient inhibitory influence on the collagen synthesis, and this resulted in a reduced total content of collagen in bones and skin specimens from treated rats compared to controls. The concentration of collagen in bone and skin was, however, increased in treated animals compared to controls after prolonged CT administration. Following an early transient increase, the incorporation of strontium-85 into the fractured bones was impaired after 30 days of CT treatment. This resulted in a reduced mineral concentration in the fractures of treated rats compared to controls in the last part of the experiment. The recorded effects of CT treatment, which were most pronounced in healing fractures and intact skin specimens, may be interpreted as an inhibitory influence of CT both on synthesis, mineralization and degradation of collagen. PMID- 6858671 TI - Left ventricular systolic time intervals in preterm infants with patent ductus arteriosus. AB - Left ventricular systolic time intervals were recorded by a non-invasive technique, from the axillary artery, in 13 preterm infants with patent ductus arteriosus. At the onset of clinical symptoms, consistent with a large left-to right ductal shunt, the preejection intervals were shorter than in a control group of nine preterm infants without a patent ductus. The most pronounced difference was found in the shortening of the isovolumic contraction time, 10.7 msec in the ductus group compared with 22.4 msec in the control group. Ductal closure normalized the isovolumic contraction time to 22.1 msec. The very short preejection intervals, associated with a large ductal shunt, are suggested to reflect a combination of reduced aortic diastolic pressure and increased left ventricular filling pressure. In spite of increased volume load to the left ventricle there were no detectable changes in the systolic time intervals indicating impaired left ventricular function. The left ventricle seems to be competent to handle increased volume load in the presence of reduced afterload in preterm infants with symptomatic left-to right ductal shunts. PMID- 6858672 TI - Initial systolic time intervals as predictors of the severity of transient tachypnea in term neonates. AB - 42 term neonates with transient tachypnea (TTN) underwent echocardiography and determination of systolic time intervals before the age of 4 hours. Based on initial measurement of right ventricular systolic time intervals (RVSTIs) the patients were divided in two groups: neonates with RVSTI ratios less than or equal to 0.50 (Group I) (n = 35) and neonates with RVSTI ratios greater than 0.50 (Group II) (n = 7). Group II neonates also had significantly more prolonged left ventricular systolic time intervals (LVSTIs) than Group I neonates. Group II neonates developed markedly more severe form of TTN than Group I neonates. Initially prolonged RVSTI was best predictor of the development of severe TTN (relative risk ratio 17.5, p less than 0.001): clinical characteristics and oxygen requirements at the admission had limited predictive value. PMID- 6858673 TI - Surgical treatment of ulcerative colitis in children. PMID- 6858675 TI - Perceptual, motor and attentional deficits in seven-year-old children. Paediatric aspects. AB - 42 children representative of Swedish urban seven-year-olds with a combination of various minor neurodevelopmental deficits in the form of so-called minimal brain dysfunction (MBD) syndromes were compared with 51 children of the same age without such problems as regards general health data from parents' interviews and questionnaires and from paediatric examinations. The findings at the physical examination revealed only few and small differences concerning minor physical anomalies that, in part, is dealt with in a separate report. Children with MBD had experienced simple febrile convulsions significantly more often than controls, and an abnormal EEG was a common finding in these cases. So-called psychosomatic complaints were not overrepresented in the MBD group, but enuresis and encopresis was somewhat more common. The parents' answers to a set of 6 questions (concerned with late speech development, late motor development, gross motor clumsiness, fine motor clumsiness, "shuffling" and difficulties to concentrate) were found to have a high discriminating capacity detecting for MBD syndromes. The possibility of a clinical application of this finding is discussed. PMID- 6858674 TI - Perceptual, motor and attentional deficits in seven-year-old children. Neurological screening aspects. AB - In an extensive neuropsychiatric study of seven-year-old children, operational criteria for diagnosing minimal brain dysfunction (MBD) syndrome were used. Detailed behavioural assessment and meticulous neurological examination provided the basis for the MBD diagnosis. The time-consuming specialist examination by the child neurologist was considered too sophisticated for use in everyday clinical practice. Therefore, the results obtained at a short neurodevelopmental screening assessment performed by a child psychiatrist were analysed with the aim of finding a limited set of neurological examination items with high discriminating capacity detecting for MBD syndromes. A set of six such items (diadochokinesis, hopping on one leg, standing on one leg, cutting out a paper circle, associated movements when walking on lateral sides of feet and the labyrinth test of the WISC) produced a minimal rate of misclassified cases. It is argued that this discriminant set may be useful in everyday child psychiatric and pediatric assessment of children who raise suspicion of suffering from MBD. PMID- 6858676 TI - The effect of corticosteroids on the male fetal and neonatal reproductive organs. PMID- 6858678 TI - Thrombocytopenia in small-for-gestational-age infants. PMID- 6858677 TI - Immunologic components in human milk during weaning. PMID- 6858679 TI - Intestinal aganglionosis in the Smith-Lemli-Opitz syndrome. PMID- 6858681 TI - Effect of porcine calcitonin therapy on vitamin D metabolism and clinical response in a patient with osteogenesis imperfecta. AB - A 1 11/12-year-old girl with osteogenesis imperfecta was treated with porcine calcitonin. Eight bone fractures occurred in the previous 20 months before therapy, but none occurred during eight months of therapy. There was also a significant improvement in linear growth and radiographic bone density. This is the first study of the effect of calcitonin on vitamin D metabolism in a human. The high plasma levels of 1,25 dihydroxy-vitamin D (1,25-(OH)2-D) and 24,25 dihydroxy-vitamin D (24,25-(OH)2-D) before calcitonin therapy decreased after therapy. Plasma 25 hydroxy-vitamin D (25-OH-D) concentration, which normal in level before calcitonin therapy, was normal or slightly decreased during administration. It is concluded that calcitonin probably influences vitamin D metabolism in a patient with osteogenesis imperfecta. PMID- 6858680 TI - Transient congenital hypothyroidism in an infant with congenital nephrosis of Finnish type. PMID- 6858682 TI - Bcg vaccination as a cause of multifocal osteomyelitis in a 12-year-old girl. AB - A 12-year-old girl with multifocal skeletal sclerosis has been investigated. She was BCG vaccinated at birth and developed regional lymphadenitis in her left groin at two months of age. She was healthy until approximately 10 years of age, after which deficient height and weight gain occurred. BCG-itis was diagnosed in skeleton lesions. No evidence of immunodeficiency was found in the patient. After antituberculous treatment, the skeleton lesions, previously seen at bone scan, had disappeared. There has been a dramatic effect on her weight gain, growth and general well-being. PMID- 6858683 TI - Effect of physical training on exercise-induced bronchoconstriction. AB - A 6-week period of physical training of 28 asthmatic children reduced the exercise-induced percentage fall in peak expiratory flow (from baseline) from 44 +/- 4% (mean +/- SE) to 30 +/- 4%. Resting pulmonary function was unchanged. Resting and maximum heart rate (submaximal treadmill running) and postexercise plasma lactate were all lowered by training. The individual values for exercise induced bronchoconstriction and postexercise plasma lactate correlated positively before and after training. Furthermore, the training-induced reduction in these parameters correlated. In 14 asthmatic children, who served as controls, exercise induced bronchoconstriction and physical fitness remained unchanged during a comparable period. The study demonstrates a beneficial effect of endurance training on exercise-induced bronchoconstriction and working capacity. PMID- 6858684 TI - Respiratory syncytial virus infection in young hospitalized children. Identification of risk patients and prevention of nosocomial spread by rapid diagnosis. AB - Detection of RSV by immunofluorescence was used for rapid confirmation of the diagnosis in 89 infants during an epidemic. This made it possible to plan the care of the patients and use the personnel in an optimal way in order to maintain nosocomial infection at a low level. Somatic and environmental risk factors connected with serious disease were also identified. The course of the disease was more severe in children with chronic illnesses or those who had had perinatal complications. Allergy was more frequently reported by these families. Breast feeding for at least two months was practised in most families. PMID- 6858685 TI - Seasonal variation in serum-25-OH-D3 in mothers and newborn infants in northern finland. AB - Two groups, each consisting of twenty Finnish mother-neonate pairs and ten non pregnant controls were studied for serum calcium, serum phosphate, serum alkaline phosphatase, parathormone index (PTHind) and S-25-OH-D3. The first series was collected in winter and the other in summer. The serum samples were taken on the third day after delivery. The concentrations of S-25-OH-D3 were significantly lower in the mothers than in the non-pregnant controls in winter, but the difference was not significant in summer. The concentrations of S-25-OH-D3 in the serum of the mothers were similarly significantly lower in winter than in summer, ten mothers exhibiting a value below the detection line in winter, but only two in summer. The concentrations of S-25-OH-D3 in the mothers and their newborn infants showed a close relationship, but when extremely low values existed in the mothers, the infant concentrations were slightly higher. The seasonal variation in S-25-OH-D3 was also significant in the neonates. Although calcium was decreased and alkaline phosphatase elevated when compared with the non-pregnant controls in the mothers in both groups, these values showed no seasonal variation, and the mean levels of serum calcium, phosphate, alkaline phosphatase and PTHind in the neonates also remained unaltered between the two groups. The results indicate that additional vitamin D should be supplied during pregnancy in the winter months at this latitude. PMID- 6858687 TI - Gastrin production following antrectomy. A study on the occurrence of gastrin producing cells and the serum gastrin response to feeding. AB - Fifteen patients were studied 3 to 35 years after antrectomy, with a gastroduodenal (Billroth I (BI)) anastomosis in 8, and a gastrojejunal (Billroth II (BII)) anastomosis in 7. The investigations included gastric acid secretion, serum gastrin response to feeding and immunohistochemical search for gastrin producing cells in gastric remnant mucosal biopsies. All of the patients had hypochlorhydria. The gastrin response to feeding was minimal. Apart from a significantly higher value of serum gastrin 3 hours post-prandial in BI operated as compared to BII operated patients, no greater differences were found in the gastrin production between the two groups of patients. No gastrin-producing cells could be identified in the gastric remnant, not even in areas of pseudopyloric metaplasia. It is concluded that the gastrin production following antrectomy is caused by extragastric G-cells; these cells are poorly stimulated by food, and do not respond to hypochlorhydria with hypergastrinaemia. PMID- 6858686 TI - Renal function and biopsy changes during the course of Henoch-Schonlein glomerulonephritis. AB - Renal function studies were performed in 18 subjects in different stages of Henoch-Schonlein glomerulonephritis (HS GN). Nine children were serially investigated, and nine adolescents or young adults, who were considered to have clinically recovered, were investigated only once, 10.5-14 years after the onset. Inulin and PAH clearance, as well as sodium excretion, were determined during hydropenia (HP) and 3% volume expansion (VE) with isotonic saline. In most patients in the former group a renal biopsy was performed during the first investigation and again one year later. The early disturbances in renal function resembled those we have found in other types of GN. The GFR was normal during HP or after VE in most cases one year after the onset. The natriuretic response to VE was decreased in most patients initially, and this was found to persist in half of the patients 2-3 years after the onset. Pathological urinalyses then indicated disturbances in the renal handling of sodium. A reduced capacity to excrete sodium, however, did not seem to be of prognostic significance since all patients, except one who developed renal insufficiency and hypertension, had normal urinalyses and blood pressure six years after the onset. This study provides no evidence that subjects with previous HS GN will later develop impaired renal function or be predisposed to hypertension. PMID- 6858688 TI - Submucous lymphatic cysts of the small intestine. An autopsy study. AB - In 150 consecutive autopsies, submucous lymphatic cysts of the small intestine were demonstrated histologically in 35 cases (23%). The mean age of these 35 cases was 74 years. Lymphatic cysts were found in none younger than 55 years. A solitary lesion was observed in 9 cases, whereas more than 10 cysts were encountered in 14 autopsies. The diameter of the lesions never exceeded ca. 1 cm, and histological examination disclosed cystically dilated lymph spaces only in the submucosa. Studies of the clinical records and the autopsy reports revealed no case with symptoms from the lymphatic cysts, and no case with other diseases of the lymphatic system. PMID- 6858689 TI - Hyperplasia and growth of the true mesentery in the diabetic rat. AB - The true mesentery was studied in rats 4 weeks after they had been rendered diabetic with streptozotocin. The diabetic animals showed elongation and enlargement of the small intestine despite reduced body growth compared with controls of the same age. The mesentery in diabetic animals showed increased total area and contained an increased number of "windows", but the increment of total protein, DNA, and histamine (a marker of mast cells) was non-uniform and less than the increase in area. There appeared to be a close relationship between hyperplasia of the small intestine and its mesentery. The number of mast cells yielded by peritoneal lavage was increased in the diabetics. We suggest that our observation of the hyperplastic mesenteric reaction in diabetic rats may make a useful model for the study of growth, profiferation, and function of the mesentery available. PMID- 6858690 TI - [Tanshinones: antimycobacterial agents--its bile excretion and biotransformation in rat liver]. PMID- 6858691 TI - [Effect of time of administration of bis-A-TDA on its teratogenic actions in pregnant Wistar rats]. PMID- 6858693 TI - [Studies on Chinese drug Aconitum spp. XIX. The alkaloids of Aconitum pendulum and their chemical structure]. PMID- 6858694 TI - [The isolation and structural elucidation of liconeolignan from G. uralensis]. PMID- 6858692 TI - [Structure-activity relationships of sesquiterpenoid antitumor agents using molecular orbital method]. PMID- 6858695 TI - [Analysis of the main foreign steroids in prednisone acetate by HPLC]. PMID- 6858696 TI - [A method for the screening of anti-cerebral anoxia drugs]. PMID- 6858697 TI - [Histological and histochemical changes of Schistosoma japonicum and host liver caused by artemether]. PMID- 6858698 TI - Endurance training reduces the susceptibility of mouse skeletal muscle to lipid peroxidation in vitro. AB - Selected estimates of the lipid peroxidative capacity were assayed in the red and white skeletal muscles of control and endurance-trained mice. Endurance training decreased the lipid peroxidation rate in vitro in both muscle types. The concentration of lipids susceptible to Fe2+-induced lipid peroxidation was greater in the red than in the white skeletal muscle and increased after endurance training in the red muscle. Endurance training, however, decreased highly significantly the sensitivity of red muscle to in vitro stimulated lipid peroxidation. The activity of catalase and the concentration of vitamin E were considerably higher in the red muscle, whereas the activity of glutathione peroxidase was slightly higher in the white muscle. Endurance training caused no changes in these antioxidants. Endurance training increased the concentrations of reduced and total non-protein glutathione in the red skeletal muscle but not in the white muscle. The total sulfhydryl group contents were unaffected. Our results suggest that endurance training may increase the resistance of skeletal muscle to injuries caused by lipid peroxidation. PMID- 6858699 TI - Distribution of different fibre types in human skeletal muscles. 2. A study of cross-sections of whole m. vastus lateralis. AB - In order to determine the total number of fibres and the extent to which the relative occurrence of different fibre types varies within m. vastus lateralis, 15 micrometers thick cross-sections of whole muscles were prepared. The total number of type 1 and type 2 fibres was determined in every 48th square millimetre of the section, and the results thus obtained were analysed using a computer program allowing an assessment of bivariate data in the form of contour plots. The total number of fibres varied both in proximal to distal direction in the same muscle and between individuals. No obvious correlation existed between the mean fibre area and the muscle cross-sectional area. The proportion of type 1 fibres in the whole muscle varied between individuals (from 44% to 57%) with a mean value for all five of 52%. The distribution of different fibre types varied within the muscle, mainly as a function of depth, with a predominance to type 2 fibres at the surface and type 1 fibres in deeper regions of the muscle. Thus, the fibre type distribution in m. vastus lateralis is not random. This must be taken into consideration when data on fibre type composition are compared with functional variables. PMID- 6858700 TI - Importance of molecular charge for the passage of endogenous macromolecules across continuous capillary walls, studied by serum clearance of lactate dehydrogenase (LDH) isoenzymes. AB - Electrostatic capillary barrier characteristics was studied in the isolated maximally vasodilated rat hindquarter by use of a modified "tissue uptake" technique (Rippe et al. 1979). The hindquarters were artificially perfused with oxygenated horse serum at isogravimetry. As tracers two isoenzymes of lactate dehydrogenase (LDH) were used, having identical size (41 A, Mw approximately 140 000) but with differing molecular charge and labelled with two separable isotopes. LDH-H4 (125I) is negatively charged and LDH-M4 (131I) slightly positive, at physiological pH. The negatively charged protein LDH-H4 was more retarded in its transcapillary passage than LDH-M4. Net clearance of H4 was 0.0242 +/- 0.0045 ml/min X 100 g and that of M4 was 0.0748 +/- 0.0092 ml/min X 100 g (n = 11, p less than 0.001). This difference is suggested to be due to an interaction of the polyanionic tracer with a barrier of negative molecular charge, most effective at the small pore equivalent. Clearance data for H4 and for albumin (Rippe et al. 1979) are compatible with an equivalent large pore radius of 520 A. Neither vesicular transport (Palade 1953) nor the impact of fibre pore matrix (Michel 1980) is considered to be involved in the transcapillary passage of proteins. Negatively charged proteins probably pass through the large pore equivalent exclusively, while neutral macromolecules also utilize part of the small pore equivalent, for their transcapillary passage. PMID- 6858701 TI - Ultrasound study of the cranial venous system in the human new-born infant and the adult. AB - A pulsed doppler ultrasound technique has been used to measure changes in blood velocities in the superior sagittal sinus, the jugular veins and intracranial and extracranial arteries in 13 neonates, and in the jugular veins and an extracranial artery in 13 adults, during unilateral and bilateral jugular venous compressions. The results have enabled us to determine how the subject under examination functionally uses his cranial venous drainage system in the resting state, and whether or not he can shunt obstructed venous flow through other cranial venous channels. We have found great variability between the subjects. In the resting situation the range of possibilities from total dependence on one jugular vein alone to usage of both jugular veins and the vertebral veins exists. Shunting of blood on jugular compression from either or both jugular veins to the vertebral veins may occur, and contralateral shunting between the jugular veins may be possible in both directions, in one direction or not at all. PMID- 6858702 TI - Validity of the stop-flow method for estimating glomerular capillary pressure. PMID- 6858704 TI - The effect of heating and central cooling on serum TSH, GH, and norepinephrine in resting normal man. AB - The effects of central cooling and exterior heating on serum concentrations of thyrotropin (TSH), growth hormone (GH), and norepinephrine were studied in 10 normal males under resting conditions. Cooling was induced by ingestion of ice while the subjects were immersed in water of a temperature prone to elicit only minor cutaneous thermal reflexes. TSH and thyroid hormones changed neither during cooling nor during heating. Cooling induced a virtually complete suppression of GH-secretion whereas heating had the opposite effect: pronounced increase, also without previous cooling. Plasma norepinephrine rose by a factor of 2.5 and 1.7 during cooling and heating, respectively. It is concluded that the pituitary thyroid system does not take part in short-term thermoregulation in man--as opposed to the situation in some smaller mammals. The mechanisms and the physiological role of the GH-responses to cooling and heating are as yet unknown, but the latter stimulus is an advantageous tool in clinical and pathophysiological studies of pituitary function as it is both safe and convenient. PMID- 6858705 TI - Mechanical properties of rat cerebral arteries as studied by a sensitive device for recording of mechanical activity in isolated small blood vessels. AB - A sensitive device for recording of mechanical activity in isolated small blood vessels with calibres down to 100 microns is described. This equipment was used to examine the mechanical properties of rat cerebral arteries. The ultrastructure of the preparations was investigated by light-, transmission, and scanning electron-microscopy. In general the walls of the middle cerebral and basilar arteries consisted of 3 layers of smooth muscle cells, which occupied approximately 80% of the total wall thickness. The present technique preserved the integrity of the vessel wall and caused no observable damage to the smooth muscle or endothelial cells. Neither the basilar nor the middle cerebral arteries developed spontaneous phasic contractions under standard conditions. Potassium excess (124 mM) induced a biphasic contractile response characterized by a fast and partly transient increase in tension (phase A), followed by a slowly developing sustained contraction (phase B). The responses to K+ were strong, highly reproducible and not influenced by pH changes in the range 6.9-7.8, making K+-stimulation suitable for testing of vascular contractility. Length-tension measurements were performed on relaxed and K+-activated basilar arteries. The mechanical behaviour of the vessels conformed to a sliding-filament model of muscular contraction. Using the "Maxwell model" of a muscle, the length at which the contractile element produced maximum active tension was established. The passive wall tension at this length (approximately 1 mN/mm) averaged only about 20% of the total wall tension the arteries were capable of producing when activated by K+. Under isometric conditions the K+-contracted basilar artery developed a maximum active wall stress of approximately 240 mN/mm2. In the light of the mechanical data obtained from the length-tension measurements, the optimum resting wall tension for registration of vascular responses is discussed. It appears that the present in vitro system can be of great value in investigations of the smooth muscle function in small blood vessels. PMID- 6858707 TI - Adrenergic and pressure-induced modulation of carotid sinus baroreceptors in rabbit. AB - The sympathetic control of the carotid sinus baroreceptor activity was studied in rabbits. Stimulation of the cervical sympathetic trunk (10 Hz, 1 ms, 4-12 V) elicited an increase in discharge frequency of the non-medullated baroreceptor afferents but not of the medullated fibers. An isolated carotid sinus area preparation was used to examine the influence of noradrenaline perfusion on baroreceptor activity. Non-medullated baroreceptor afferents, but not the medullated afferents, responded to noradrenaline perfusion (10(-6) g/ml) with a significant increase in firing rate. Short-term resetting of the baroreceptors was also studied with the same preparation. After perfusing the sinus at a hypertensive level for 30 min the pressure-response curves of both the non medullated and the medullated baroreceptor afferents shifted to the right with increased thresholds and decreased maximal discharge frequencies. The extent of the short-term resetting was greater in non-medullated afferents than in medullated ones. It is concluded that the carotid sinus baroreceptors with non medullated afferents are under the sympathetic control. The physiological significance of this is discussed. PMID- 6858703 TI - Comparison of urinary and plasma catecholamine responses to mental stress. AB - 8 subjects were exposed to the Stroop mental performance test in a design with alternating hourly periods of rest and stress. During each period one urine sample and several venous plasma samples were obtained. Heart rate responded rapidly to initiation and termination of the stress exposure with increases and decreases respectively. Both urinary and plasma adrenaline increased significantly during stress. The plasma response was immediate and sustained. Neither urinary, nor plasma noradrenaline were significantly increased by the test. Plasma noradrenaline, however, increased significantly on termination of the exposure to stress. It was suggested that the latter effect may be due to muscle sympathetic nerve activity decreasing during stress and increasing following stress. The sample-to-sample variation was more than 20% of the mean for both catecholamines, indicating the need for frequent sampling to reliably reflect plasma levels. The mean intraindividual plasma/urine correlation was r = 0.70 (p less than 0.001) for adrenaline and r = 0.40 (p less than 0.05) for noradrenaline. When only resting periods were considered, no significant correlations remained, apparently due to a reduced range of variation and accompanying reduced signal-to-noise ratio. It is concluded that both urinary and plasma adrenaline may be useful in the evaluation of changes in sympatho-adrenal activity during stress. PMID- 6858706 TI - Activation of the tubuloglomerular feedback mechanism in dehydrated rats. AB - To study the influence of the tubuloglomerular feedback control (TGF) on the regulation of glomerular filtration rate (GFR) during dehydration, micropuncture experiments were performed on surface nephrons of dehydrated rats. Dehydration was achieved by withdrawal of food and water for 24 h. The urine flow rate decreased to 1.5 microliters/min (controls 2.9 microliters/min) and GFR decreased in these rats to 0.80 ml/min (controls 1.22). TGF was studied by two different micropuncture procedures. With the first technique the changes in proximal stop flow pressure in response to changes of the late proximal microperfusion rate were measured. With this technique the perfusion rate necessary to induce a half maximal stop-flow pressure response, the turning point, was also determined. An increased TGF sensitivity was found in dehydrated rats, as indicated by increased stop-flow pressure responses (35 versus 26%) and decreased turning points (16 versus 21 nl/min). With the second micropuncture technique the single nephron GFR (SNGFR) was measured at distal and proximal tubular sites, in the same nephron. Distal SNGFR was decreased during dehydration to 32.2 nl/min, versus 42.7 nl/min in controls. A significant difference between paired SNGFR measurements in the same nephron was observed during dehydration, the proximal value being 5.3 nl/min higher than the distal, whereas this difference was not seen in control rats. This finding indicates that activation of the feedback mechanism takes place to reduce SNGFR. It is concluded that the decrease in whole kidney GFR is partly caused by the observed increase in feedback activity. The present results are also in agreement with our earlier hypothesis that the hydrostatic and oncotic pressure conditions within the interstitial space surrounding the macula densa cells modulate the sensitivity of the tubuloglomerular feedback mechanism. PMID- 6858708 TI - Resetting of aortic baroreceptors with non-myelinated afferent fibers in spontaneously hypertensive rats. AB - The phenomenon of resetting and the possible mechanisms responsible for it were investigated in aortic baroreceptors having unmyelinated axons. Recordings were obtained from 31 aortic baroreceptor C-fibers in 20 normotensive Wistar Kyoto rats (WKY) and 37 baroreceptor C-fibers in 11 spontaneously hypertensive rats (SHR). The recordings were obtained from the left aortic nerve of an in vitro aortic nerve-aortic arch preparation. The thresholds for activation of baroreceptor C-fibers were not different between SHR's and WKY's at 16 weeks of age (139 +/- 7 and 133 +/- 5 mmHg, respectively). However, the thresholds for activation in SHR at 36 weeks of age were considerably higher (163 +/- 4 mmHg) indicating resetting of the receptors in the older rats. The pressure-discharge curves were not different between SHR's and WKY's at 16 weeks of age and WKY's at 35 weeks of age, but were shifted to the right for SHR's at 36 weeks of age. The receptors showed greater responses to pulsatile pressures than to steady state pressures at the same mean level of pressure. We found that aortic C-fibers were not reset during the early established phase of hypertension in SHR's because of enhanced receptor strain sensitivity. This is likely to be of importance for tonic vasomotor control at this time. In later stages of hypertension and despite enhanced strain sensitivity the endings were reset to higher pressures probably due to an increased collagen content in the aortic wall. PMID- 6858709 TI - Capillary transport of H2 gas generated locally in renal tissue. AB - Previous measurements by microspheres have shown a higher blood flow in outer cortex and a lower blood flow in inner cortex than found by diffusible tracers. During vasodilation microspheres have indicated a disproportionate increase in deep cortical blood flow, whereas diffusible tracer distributions remained unchanged. These discrepancies could possibly be explained by a variable net inward transport of diffusible tracers in postglomerular vessels, the transport existing in control, but disappearing during vasodilation. To test this hypothesis H2 gas was produced electrolytically for 1 s at a platinum electrode in midcortex and the resulting gas concentration curve measured polarographically at two electrodes placed above and below the source. Analysis of a mathematical model showed that the ratio of the curve maxima at the two electrodes (Cmo/Cmi) would best reveal a radial net transport. Average Cmo/Cmi at 25 positions in 7 clamped dog kidneys was close to unity, but rose to 1.24 at control flow. During acetylcholine infusion Cmo/Cmi rose to 1.68. Local washout rates at the two electrodes increased equally. Calculations indicated a small outwardly directed net transport in control (3 X 10(-4) cm/s), becoming slightly reinforced during vasodilation (5 X 10(-4) cm/s). Thus the control transport direction is opposite to the hypothesis, and the change during vasodilation was estimated to be too small to explain the disparity between diffusible tracer uptake and microsphere distribution in control. H2 concentration maximum was obtained earlier under control flow than in the clamped kidney, indicating an increase in apparent D of the gas in tissue from 3 X 10(-5) cm2/s to 5 X 10(-5) cm2/s, probably due to mixing of H2 gas in the capillary net work. PMID- 6858710 TI - Hallucinations in Kenyan schizophrenic patients. AB - Eighty Kenyan 'psychotic' patients were screened using the New Haven Schizophrenic Index (NHSI) and were all studied for hallucinations using standardised definitions. Fifty-one of the patients were NHSI positive and the rest NHSI negative. Sixty-one percent of the NHSI positive had hallucinations in one or more modalities as compared with 31% of the NHSI negative group. Of the NHSI positive 51% had auditory hallucinations directly to the patient, 43% had visual hallucinations and 25% had olfactory hallucinations. These results are compared and contrasted with the very few similar observations made elsewhere. PMID- 6858711 TI - Schneider's first rank symptoms of schizophrenia in Kenyan patients. AB - Eighty 'psychotic' patients admitted to Mathare Psychiatric Hospital, Nairobi, were screened using the New Haven Schizophrenic Index (NHSI). Fifty-one (64%) of these were positive and the rest negative. Of those positive 73% had First Rank Symptoms (FRS) of schizophrenia as opposed to only 24% in the group negative for schizophrenia. This difference is highly significant (P less than 0.001). The commonest individual FRS were thought echo, thought insertion, delusional mood and auditory hallucinations in third person. The frequency distribution of FRS had no relation to sex or age. These results are compared and contrasted with the findings of similar studies in various cultures. PMID- 6858712 TI - Psychometric evaluation of an inventory for assessment of parental rearing practices. A Dutch form of the EMBU. AB - The EMBU, an instrument which was designed to assess one's memories of parental rearing behaviour, was psychometrically evaluated. Principal component factor analysis of data of a mixed sample of 841 non-institutionalized phobic individuals revealed four factors which were termed Rejection, Emotional warmth, Over-protection and Favouring subject, thereby contributing to the convergent (cross-national) reliability and validity of the structural model of perceived parental behaviour. Besides the utilization of data from aforementioned phobic sample, the scales' internal consistency was assessed in data of five additional samples, which consisted of 277 'normals', 40 agoraphobics, 29 social phobics, 21 height phobics and 38 obsessive-compulsive neurotics, and found to be very satisfactory. In the normal and mixed phobic sample, validity measures were shown to be acceptable and to be independent of the parent's sex. Furthermore, findings suggested that the fact that retrospective data is being measured with the scales does not threaten the reliability and validity of gathered information due to faulty recall or falsified accounts. PMID- 6858713 TI - Platelet monoamine oxidase activity and trace acid levels in plasma of agoraphobic patients. AB - Platelet monoamine oxidase activity and plasma trace acid levels in 29 patients classified as agoraphobics was estimated. MAO activity towards p-tyramine and beta-phenylethylamine was found to be significantly higher in agoraphobics than in non-agoraphobic depressed patients and healthy controls. In addition plasma p hydroxyphenylacetic acid levels were low in both agoraphobic and depressed patient groups. All patients were also assessed by Spielberger State Anxiety and the short form of the Beck Depression Inventory scales. No significant correlations could be found between platelet MAO activity or plasma trace acid levels and the psychological scores. PMID- 6858714 TI - A three-dimensional treatment programme for chronic pain. AB - The treatment of chronic pain contains several problems such as ineffectiveness, side effects and drug dependence. The concepts of respondent and operant pain are introduced, together with a general operant learning model for analysis and treatment of psychological problems. To make a psychological analysis of pain, evidence for learned pain behaviour must be assessed, reinforcers for treatment revealed, goal behaviours set up, and support in the environment secured. In the further analysis, account must be taken to a) time pattern of pain, b) pain behaviour, c) reactions from the environment, d) pain activators, e) pain reducers, f) the effect of tension versus relaxation on pain, and g) changes in the family structure necessary because of the pain problem. A three-dimensional operant treatment programme for chronic pain is presented. It consists of 1) reduction of medication, 2) increase of activity, and 3) reduction of pain behaviour. Results, supporting the efficacy of the model, are presented. PMID- 6858716 TI - Primary and secondary affective disorders in adolescents and young adults. AB - The concepts of primary and secondary affective disorders have become widely accepted by researchers of adult psychiatric disorders. They are based on the chronological development of certain specified major affective disorders in relation to diagnosable, nonaffective psychiatric disorders. Despite potential etiological implications, little data are currently available on the primary secondary classification applied to cases with early onset adolescent and young adulthood affective disorders. This study reports on the application and clinical implications of the primary-secondary classification in a sample of 65 adolescent and young adult inpatients who meet Research Diagnostic Criteria (RDC) for an index episode of Major Depressive Disorder. PMID- 6858717 TI - Outcome of pregnancy in women treated at an alcohol clinic. AB - The studies in man concerning foetal alcohol damage have mostly covered skid row female alcoholics, and no study has described the outcome of pregnancy of a larger group of women receiving inpatient care for alcoholism. In another study we have described the medical and social characteristics of such a group (n = 92) of women, as well as those of an age-matched control group. This article reports retrospectively on the pregnancies and the infants of these women. The pregnancies and deliveries were normal in both groups. There was no significant difference in rate of stillbirths, neonatal mortality, perinatal asphyxia or neonatal distress. In infants born to alcoholic mothers after established regular alcohol consumption (n = 31), a significant reduction of mean placental weight, birth weight, length at birth and head circumference at birth, was found compared with control infants (n = 170). In the former group 12.9% of the infants were small for gestational age, in the latter 1.3%. Congenital malformations were significantly increased in the former group. Thus, in female inpatients at an alcohol clinic a history of increased risk for adverse neonatal outcome was found. PMID- 6858718 TI - Drug careers in perspective. AB - This paper reports the results of a 10-year follow-up of a pioneer group of 36 opiate addicts treated at a detoxification unit at St Lars Hospital in Lund in the years 1971-72. Sixteen of them are now ex-addicts. Their way out of addiction is described. The results show that there exists a turning process during which some kind of therapeutic action could be of considerable value. The ex-addicts go through a period in which they show signs of an identity conflict. During this period women seem more inclined to relapse than men. This stresses the importance of long-term therapeutic strategies. PMID- 6858715 TI - Carbamazepine, a possible adjunct or alternative to lithium in bipolar disorder. AB - The effect of carbamazepine in bipolar disorder has been studied by several groups. According to these studies carbamazepine appears to exert a "lithium like" effect. Twelve patients with lithium-resistant bipolar disorder and without epilepsy were prophylactically treated for 3 years with carbamazepine in an open study. In most patients carbamazepine was added to lithium, neuroleptics and/or antidepressants. Four patients did not complete the minimum treatment period of 6 months required for evaluation. In the remaining eight patients carbamazepine seemed to be effective in four patients, had a possible or slight effect in two, and no effect in the remaining two. It is concluded that carbamazepine can be safely combined with lithium, and that carbamazepine, eventually combined with lithium, can be effective in lithium(-alone)-resistant bipolar disorder. PMID- 6858719 TI - [Individuals and families]. PMID- 6858720 TI - Effects of intravenous administration of antigen on lymphocyte localization and blood flow into the mouse spleen. PMID- 6858721 TI - Side-to-side choledochoduodenostomy in the management of choledocholithiasis and/or associated pathology--facts and fiction. PMID- 6858723 TI - [Intracranial subdural empyema. Clinical and therapeutic aspects]. PMID- 6858722 TI - [Effects of thyroidectomy and repeated administration of L-thyroxine on the dehydrogenases of the pentose-phosphate pathway of rat erythrocytes]. PMID- 6858724 TI - [Efficiency and equity of the Portuguese health system]. PMID- 6858726 TI - Clinical and experimental morphological study of depressed skull fracture. AB - Ninety-eight cases of depressed skull fractures, caused by various accidents, were treated. The morphological structures of the fractures were studied. Thirty four depressed fractures were established experimentally, and a comparable study was performed. Clinically and experimentally I confirmed the same morphological reactions, that is, that the fractures of the inner region were always larger than those of the outer side, as a result of the direction of the impacting forces. The human skull suffers depressed fractures only because it has "HSH" (hard-soft-hard) histological structures. It is naturally disadvantaged. PMID- 6858727 TI - Proceedings of the 34th annual meeting of the Deutsche Gesellschaft fur Neurochirurgie in Mannheim, April 27-30, 1983. PMID- 6858725 TI - Modification of the effect of dimethyl sulfoxide on intracranial pressure, brain water, and electrolyte content by indomethacin. AB - Albino rabbits with experimental brain oedema produced by a combined cryogenic left hemisphere and a metabolic 6-aminonicotinamide lesion were given indomethacin (20 mg/kg) fifteen minutes prior to dimethyl sulfoxide (DMSO) treatment (1 g/kg bolus). Intracranial pressure (ICP), systolic arterial pressure (SAP), central venous pressure (CVP), and EEG were continuously measured while the animals were being mechanically ventilated at a constant PaCO2 (38-42 torr). At the end of the run, brain H2O and electrolytes were measured. There was no significant reduction in ICP at 5 minutes and 15 minutes after DMSO. This was strikingly different to what occurred when DMSO alone was administered, when a significant reduction was noted (p less than 0.05). At 30 minutes there was a reduction in ICP in both the DMSO and the DMSO/indomethacin groups, but in the former it was 50% of the pretreatment values while in the latter it was only 24%. Because indomethacin is a proven prostaglandin inhibitor, these results suggest that these substances may play a role in the mechanism of action of DMSO. PMID- 6858730 TI - Subarachnoid haemorrhage and meningiomas. Report of two cases. PMID- 6858728 TI - Micro-abscesses and presumptive inflammatory nodules of the brain. AB - Sixteen cases of micro-abscesses and presumptive inflammatory nodules of the brain are analyzed. The increasing frequency of cortico-subcortical small nodular lesions diagnosed by CT scan, as well as the number of cases successfully treated with antibiotics, are stressed. In the authors opinion, initial antibiotic treatment with a high possibility of a cure is indicated in patients with a presumptive inflammatory cortico-subcortical nodular lesions diagnosed by CT scan. PMID- 6858729 TI - Multiple meningiomas. Report of nine cases. AB - Multiple meningiomas are a seldom encountered neoplasm. Most authors report an incidence ranging from 1 to 3% of all meningiomas. The routine use of CT has resolved diagnostic problems involved with multiple meningiomas; nevertheless, they still present several nosologic problems. In fact, it may be difficult to differentiate "true multiple meningiomas", defined as a distinct entity by Cushing in 1938, from simple recurrences or the special variant (forme fruste) of von Recklinghausen's disease. Our report deals with nine cases of multiple meningiomas selected from a series of 372 meningiomas operated from 1968 to 1981 at our hospital. Cases were divided into a) multiple simultaneous meningiomas (five cases), b) multiple meningiomas successively detected at different localizations (two cases), and c) multiple meningiomas associated with neurofibromatosis (two cases). Only five of these nine cases, four from the first group and one from the second, were true multiple meningiomas. Pathogenetic factors related to true multiple meningiomas are discussed in relation to the literature reports. However, the different hypotheses proposed do not offer a definite explanation of the multicentricity of these tumours. PMID- 6858731 TI - Pseudopsammoma bodies in meningotheliomatous meningioma. A histochemical and ultrastructural study. AB - A case of meningioma arising from the right sphenoidal ridge is presented. Histologically, the tumour was composed of whorls of meningotheliomatous cells and many tumour cells containing intracellular inclusions were PAS positive, but diastase and neuraminidase resistant. The inclusions were named pseudopsammoma bodies by Kepes in 1961. The meningioma with pseudopsammoma bodies are a very rare entity and have been described in only 7 previous reports. We had an opportunity to examine one case of a meningioma with pseudopsammoma bodies. Electron microscopically, these substances were located in the intracellular spaces lined by microvilli. In earlier reports, the substances were said to be secretory products and a possibility of meningioma cell differentiation to secretory cell was postulated. Using the Concanavalin A staining method, the results of our present study strongly support this opinion. PMID- 6858735 TI - "Epilepsia arithmetices". Clinical and EEG study of a case and characteristics of precipitating factors. PMID- 6858734 TI - Intracranial pressure oscillations (B-waves) caused by oscillations in cerebrovascular volume. AB - In experiments during stepwise increases in intracranial pressure, B-waves could be provoked synchronously with pial vascular diameter oscillations. The vascular oscillations are known to be a sign of myogenic cerebrovascular regulation. An increase in their amplitude indicates vessel wall relaxation and impending failure of myogenic autoregulation. Therefore, vascular oscillations provoked during intracranial hypertension can be ascribed to a fall in transmural pressure and vessel wall tension. The resulting oscillations in the cerebral blood volume are reflected by ICP oscillations and lead to synchronous variation in ICP, the so-called "B-waves" with a frequency of 0.5 to 2 per minute. PMID- 6858733 TI - Effect of increased intracranial pressure on the blink reflex in cats. AB - During an acute increase in ICP produced by balloon inflation three different phases could be observed. In the first phase (ICP 40-50 mm Hg) the latencies of R 1 and R 2 showed an initial decrease followed by increase in latency. In the second phase (ICP 50-70 mm Hg) R 2 disappeared, whereas R 1 showed marked alterations, prolongation of the latency and duration, and a decreasing amplitude. In the third phase no response could be evoked. The pathophysiological observations correlated with the morphological alterations. Two ischaemic zones with BBB damage which "transsected" the mesodiencephalic and pontomesencephalic border were found. The results suggest that the disappearance of R 2 depends on rostral damage, whereas alteration of R 1 is caused by a pontomesencephalic lesion. PMID- 6858736 TI - Arachnoid cysts of the posterior fossa. Report of three cases. PMID- 6858732 TI - Omental transposition or transplantation to the brain and superficial temporal artery--middle cerebral artery anastomosis in preventing experimental cerebral ischaemia. AB - Transposition of lengthened omentum to the brain surface, transplantation of an omental graft, or superficial temporal artery--middle cerebral artery anastomosis were performed in dogs prior to transcranial occlusion of the ipsilateral middle cerebral artery at its origin, including the bifurcation of the internal carotid artery. Both omentum and by-pass were able to reduce the changes in cerebral blood flow, somatosensory evoked responses, cerebral water and electrolyte content, consequent to the ischaemic insult. In the experimental conditions adopted in this study, the effect of omental transposition in maintaining high levels of flow throughout the entire occluded hemisphere was more marked compared to that resulting from the other methods, while the onset of ischaemic cerebral oedema was affected approximately at the same degree by all procedures. The results point to the role of the transposed omentum in providing an effective collateral circulation to the ischaemic brain. PMID- 6858737 TI - Computed tomography in hepatolenticular degeneration. PMID- 6858738 TI - Pure optic ataxia. A case report. PMID- 6858739 TI - Abstract of the International Congress of General Hospital Psychiatry, Madrid, 23 37 January 1983. PMID- 6858741 TI - Attitudes among adolescents in a Swedish city toward some sexual crimes. AB - Using data from a representative sample of adolescents in grade ten in Uppsala, the fourth largest city in Sweden, attitudes toward a number of (criminal) sexual acts are studied. These data are contrasted with those from a sample of patients at a school gynecological clinic. It is found that for both samples, only a very limited number of the eight discussed acts are considered to be criminal by the adolescents. Although at least seven or eight acts are criminal in Swedish law, only two acts are considered criminal by about half of the respondents. These acts are pedophilia and rape after petting. The same questions were used by Kutchinsky in 1969 when on behalf of the U.S. Congress Commission on Obscenity and Pornography he studied inhabitants in Copenhagen, Denmark. When comparing data from Uppsala Sweden 1978 with data from Copenhagen, Denmark 1969 we find that Swedish adolescents in the late seventies, on the whole are much less likely to call the discussed acts criminal. The only exception is rape after petting, which in Copenhagen in the late sixties was the act least often seen as criminal but in the Uppsala study in the late seventies it was one of the two acts most often claimed to be criminal. Finally, the effects of coital experience and the effect of sexual knowledge on the percieved criminality of the acts are considered. PMID- 6858742 TI - Identity status and academic achievement in female adolescents. AB - Theories of Erikson and Marcia were applied to assess the relation between identity status and academic achievement in female adolescents. The differences in identity status between bright high achieving vs. underachieving students were ascertained separately for occupational planning, attitudes toward religion, and peer relations. It was hypothesized that the component of identity most closely linked to high achievement in school is having made commitments to certain goals and values. It was found instead that experiencing and working through crises in beliefs and values are more closely associated with successful academic achievement and formation of identity among adolescent girls than having made specific commitments to career or ideology. PMID- 6858740 TI - Hub Group: an innovative approach to group therapy in a short-term inpatient adolescent unit. AB - Two and one-half years of Hub Group have shown that short-term, ward-based, heterogeneously mixed adolescent groups can work. Backed by a behaviorally based privilege system, Hub Group contracting methods facilitate rapid investment in group therapy, are flexible enough to accommodate change, and provide a meaningful ritual that involves all group members in promoting change for the individual. Hub Group's method of self-rating and rewards promotes objectivity in self-evaluation. The contracts' images are compact, but all encompassing, providing a continuum along which to move in developing greater responsibility and productive functioning for the adolescents. There are distinct advantages and disadvantages to mixed levels of functioning within the same group. The nurturance and tolerance for others fostered by Hub Group is a primary advantage. Despite the obvious disadvantages of rapid turnover, common issues such as acceptance, attachment, and separation are ever present to be addressed. Leadership must be either supportive or confrontive, but always active in these groups. Hub Groups have shown that with the support and supervision of IDTU's administrative staff, diversely trained staff can comfortably perform multiple roles within the unit and be effective as group leaders. PMID- 6858743 TI - Relationship between preferences for part-time work and characteristics of unemployed youths. AB - Using data from the March 1979 Current Population Survey, the relationship was examined between preferences for part-time work and the personal characteristics of 2,087 unemployed 16- through 24-year olds in the civilian, noninstitutional population of the United States. Age and school enrollment were found to be the strongest correlates of desire for part-time work. Gender, race, veteran status, marital status, and educational attainment were related only slightly to part time job preferences. These data support the notion that most unemployed youths searching for part-time work are 16 to 19 years old and enrolled in school; on the other hand, knowing merely this does not indicate that youth unemployment has little economic significance, as some analysts have suggested. Additional research on the consequences of teenage labor market problems on subsequent adult well-being is needed to determine the significance of youth unemployment. PMID- 6858744 TI - Empowerment for role alternatives in adolescence. PMID- 6858745 TI - A limited population of unmarried adolescent fathers: a preliminary report of their views on fatherhood and the relationship with the mothers of their children. AB - Although much has been documented regarding adolescent childbearing (Juhasz, 1974; Furstenburg, 1976; Card & Wise, 1978; Russ-eft, 1979; Chilman, 1980; Earl & Siegel, 1980), little is known about the attitudes of unmarried adolescent fathers toward fatherhood and their relationship with the mothers of their children. Most of what is known about this relationship has been learned from the young mothers (Sauber, 1966; Bernstein, 1971; Pope, 1971; bemis, 1976; Lorenzi, 1977; Clapp & Raab, 1978). With the exception of a few investigators (Pannor et al., 1968; Pannor, 1971, Hendricks, 1981), virtually no accounts can be found in the literature documenting unmarried adolescent fathers' perceptions of fatherhood and their relationship with the mothers of their children. This paper attempts to bridge this gap in the literature by reporting on how two select populations of black unmarried adolescent fathers view fatherhood and their relationship with the mothers of their children. PMID- 6858746 TI - Minimal brain dysfunction in adolescent and young adult psychiatric inpatients. AB - This paper presents data on a study of 100 consecutive young adult psychiatric admissions to Horsham Hospital, to determine the incidence of minimal brain dysfunction in this population, to define the subcategories of common psychiatric presentation, and to compare these data with those from the companion study conducted by our research group of fifty consecutive adolescent psychiatric admissions, reported by Horowitz, 1981. PMID- 6858749 TI - Adolescent loneliness. AB - The purpose of this study was to investigate the phenomenon of loneliness in delinquent adolescents with regard to types of delinquency offenses committed, demographic characteristics, and personality characteristics in the areas of interpersonal needs for inclusion, control, and affection. The types of delinquency offenses were categorized as burglary, runaway, drugs, assault, and incorrigible. The demographic variables examined were age, sex, race, family rank or birth order, family structure in terms of parental presence, family income level, religion, and geographic locale. A sample of 98 adolescents was obtained from juvenile detention facilities in three metropolitan areas in the United States. Subjects ranged in age from 12 to 18. Subjects were asked to complete the Loneliness Questionnaire as a self-reported measure of loneliness. Subjects also provided information about themselves relative to demographic characteristics and completed the FIRO-B Questionnaire, which measured interpersonal needs for inclusion, control, and affection. The results revealed no significant differences with regard to any of the demographic variables when the effect of each was considered alone. However, there was a significant effect on loneliness by income when considered jointly with other demographic variables. Adolescents from the middle income group expressed more loneliness than those from the upper and lower income groups. No significant differences were observed with regard to personality characteristics related to interpersonal needs for inclusion and affection, but delinquent adolescents with medium to high needs for control indicated significantly more feelings of loneliness than delinquent adolescents with low needs for control. PMID- 6858748 TI - Active interventions in clinical practice: contributions of Gestalt therapy. PMID- 6858747 TI - Factors related to the self-concept of institutionalized, white, male, adolescent drug abusers. AB - The main purpose of this research was to examine the relationship between selected drug-related, familial, and demographic variables and the self-concepts of institutionalized, white, male, adolescent drug abusers in a large midwestern city. In addition, the self-concepts of the subjects in the study were compared with the self-concepts of Pulliam et al.'s (1971) non-drug using adolescent sample. The TSCS, a family questionnaire, an index of socioeconomic status, and an interview were used to collect data from 140 subjects. The mean self-concept score of this sample was significantly lower than the mean self-concept score of Pulliam et al.'s sample. Results of a stepwise multiple regression yielded four statistically significant predictors of the subjects' self-concepts: both mother/adolescent relationship and father/adolescent relationship when the adolescent was between age thirteen and his present age; the number of the subject's prior status offenses and the subject's preference for non-depressant drugs. These variables were positively correlated with the subjects' self concepts. This study demonstrated the importance of differentiating among institutionalized adolescents' self-concepts based on type of drug abused, prior criminal record, and parent/adolescent relationships. PMID- 6858750 TI - Family relationships of "problem" and "promising" youth. PMID- 6858755 TI - A combined spectroscopic study of the solution conformation of bradykinin. AB - CD, NMR and laser Raman spectroscopy have been used in a complementary fashion to study the conformation of bradykinin and related peptides. The results are interpreted to mean that the secondary structure of bradykinin in aqueous solution is a time average of two interconverting structures - one disordered and the other partially ordered. The peptide evidently spends a maximum of about 20% of its time in the partially ordered conformation which features a hydrogen bonded structure at the C-terminus, most likely a gamma-turn with Pro7 as the second residue. Bradykinin and its analogs enjoy considerable conformational adaptability in terms of response to changes in temperature and solvent composition. Thus, dioxane favors the hydrogen-bonded structure, while aqueous NaCl0(4) and methanol favor the trans Pro7 isomer. The pronounced CD changes caused by increasing the temperature are attributed to a conformational transition, which is reflected in the CD of the Phe residues and possibly also the Arg-Pro-Pro moiety. The magnitude of the thermodynamic functions for the presumed transition are interpreted to mean that the structure of water plays a dominant role in determining the conformation of the peptide. PMID- 6858752 TI - Demonstration of a complex subunit composition of a unitary dopamine receptor: effects of lesions and proteolytic enzymes on stereospecific binding. PMID- 6858753 TI - Specific binding of cysteine sulfinic acid to synaptic membrane fractions. PMID- 6858751 TI - Identification and localization of the recognition binding subunit of the D1 dopamine receptor. PMID- 6858754 TI - Immunochemical studies of human kininogen. AB - Antisera directed against the isolated heavy and light chains of high MW kininogen were used for immunochemical studies of high MW and low MW kininogens. The heavy chain region of high MW kininogen share identical immunologic determinants indicating similar structures. The light chain region of high MW kininogen is immunologically distinct from low MW kininogen and is therefore unique to high MW kininogen. Consequently the anti-heavy chain antibody could be used in radioimmunoassays to quantitate total kininogens antigens, whereas the anti-light chain antibody could be used as specific tool to quantitate high MW kininogen. PMID- 6858756 TI - Cyclokinins. PMID- 6858757 TI - Bradykinin potentiator from a casein peptone preparation. PMID- 6858762 TI - Bradykinin generation in clinical blood samples: a novel index of intravascular coagulation activation. PMID- 6858760 TI - Inhibition of the formation of angiotensin III. PMID- 6858758 TI - Haemodynamic effects of bradykinin in rats. AB - The intravenous infusion of bradykinin (20 micrograms/kg X min) induced an initial fall in blood pressure and total peripheral resistance in anaesthetized rats. These changes were accompanied with an increase in cardiac output and stroke volume. These effects were transient and after 20 min of infusion blood pressure and total peripheral resistance were much less decreased than initially. Cardiac output and stroke volume had completely normalized. Lower doses of bradykinin (1 microgram/kg X min), which did not affect blood pressure, induced a reduction in mesenteric and renal vascular resistance. After higher doses (4 or 20 micrograms/kg X min) mesenteric vascular resistance was further decreased but renal vascular resistance was unchanged or markedly increased. This renal vasoconstrictor response was almost absent in rats which were pretreated with indomethacin (4 mg/kg i.v.). Hence the increase in renal vascular resistance was most probably due to the stimulation of the synthesis of prostaglandins, which act as renal vasoconstrictors in the rat. PMID- 6858759 TI - Kinins, endothelial cells and calmodulin. PMID- 6858764 TI - Suppressive effect of bradykinin to cellular immune responses in vivo and in vitro. AB - Bradykinin, as well as histamine, one of the mediators in IgE mediated immediate type allergic reactions or acute inflammation, may affect the in vitro and in vivo cell-mediated immune reactions of the immunized animals. It was demonstrated in our present experiment that the appearance of delayed type hypersensitivity (DTH) skin reaction in the immunized guinea pig was remarkably suppressed by treatment of bradykinin or histamine and the suppression of cutaneous DTH by bradykinin was inhibited by H-2 antagonist (burimamide) but not by H-1 receptor blocker (chlorpheniramine). It was also clearly demonstrated that bradykinin suppressed the production of antigen-induced macrophage migration inhibitory factor (MIF) of the immune guinea pig peritoneal exudate cells (PECs) and the production of MIF was blocked by H-2 antagonist (burimamide) or H-2 agonist (tolazolin) but not by H-1 antagonist (chlorpheniramine). Antigen-induced lymphocyte proliferation of the immunized mice, one of the indicators of the cellular immune response, was also suppressed by treatment of bradykinin. These results indicate that bradykinin as well as histamine may have some role in the subsequent expression of cellular immune reactions. PMID- 6858765 TI - Metabolism of bradykinin by endothelial cells in culture. PMID- 6858761 TI - A biochemical study on the kinetics of kininogen in asphyxiated newborn. PMID- 6858763 TI - Components of KKKK system in plasma and edematous fluids of patients with nephrotic syndrome (NS): compensatory and pathogenetic role of kinins in nephrotic syndrome. PMID- 6858766 TI - A radioassay for carboxypeptidase N. PMID- 6858767 TI - Experimental therapeutics of movement disorders. PMID- 6858768 TI - Methods for evaluating treatment in Parkinson's disease. AB - Objective measurements of movement time, reaction time, and gait were compared with a clinical rating performed at the same times on several occasions in 10 patients with Parkinson's disease (PD). Positive correlations between objective measures and clinical evaluation were demonstrated. Movement time was the single most useful index of motor deficit, but no objective tests were more sensitive than clinical evaluations in the detection of motor disorder. It is concluded that there is at present no effective substitute for clinical procedures, although the convenience and future potential of objective measurement justify the further development of such systems for use in the experimental study of PD. PMID- 6858769 TI - Lisuride and pergolide in Parkinson's disease. PMID- 6858770 TI - The effects of pergolide on the cardiovascular system of 40 patients with Parkinson's disease. AB - The effect of pergolide, a semisynthetic ergot alkaloid, on the cardiovascular system of 40 patients with Parkinson's disease (PD) was evaluated. The mean daily dose of pergolide was 2.4 mg (range, 0.1 to 10 mg). The mean duration of follow up was 6 months (range, 2 weeks to 20 months). The 40 patients were selected only on the basis of severe PD. All 13 patients in the first part of the study underwent 1 to 5 days of Holter monitoring before starting pergolide. Monitoring was then carried out for an additional period of between 2 and 10 weeks while the patients were on pergolide. Seven of the 13 patients manifested repetitive ventricular rhythms. These were isolated and unassociated with increases in premature ventricular contractions. The dose at which the RVRs occurred was a function of the presence or absence of heart disease. The changes occurred below 3 mg/day in patients with heart disease and above 3 mg/day in patients without heart disease. Pergolide was discontinued in three of the patients with heart disease. It was concluded that pergolide may, in the diseased heart, predispose to RVRs. In the second part of the study, Holter monitoring was carried out only at the discretion of the cardiologist, and five patients were so monitored. None of these patients was rejected from the study. Only one patient (with heart disease) of the 27 patients in the second part of the study experienced an arrhythmia. This consisted of an increase in PVCs on 4 mg/day of pergolide. Pergolide was discontinued. Eight of the 40 patients in these early dose-ranging studies experienced orthostasis, two with syncope, immediately on addition of pergolide (0.1 to 0.4 mg) to levodopa. The orthostasis could be eliminated in all but two patients by reducing or discontinuing levodopa. PMID- 6858771 TI - Sustained bromocriptine therapy in 50 previously untreated patients with Parkinson's disease. AB - The progress of 50 previously untreated patients with idiopathic Parkinson's disease taking maximum tolerated doses of bromocriptine is described. Twenty eight showed sustained benefit, defined as a 25% improvement in disability scores for at least 1 year, and in five this improvement persisted for longer than 5 years. However, there was a tendency for deterioration to occur after about 2 years of bromocriptine. Fewer of the late complications associated with levodopa therapy were seen in those taking bromocriptine, and drug-induced dyskinesia was seen in only one patient. Fourteen early bromocriptine failures subsequently responded well to levodopa, but the addition of levodopa to patients showing late deterioration on long-term bromocriptine was unsuccessful. These results indicate that the total duration of effective drug treatment for Parkinson's disease cannot be extended by giving bromocriptine before commencing levodopa. PMID- 6858772 TI - Double-blind evaluation of trihexyphenidyl in dystonia. PMID- 6858773 TI - Surgical therapy for blepharospasm. AB - Over the past 3 1/2 years, 28 patients with blepharospasm have undergone, bilaterally, staged percutaneous thermolytic fractional destruction of branches of the facial nerve. This series consisted of 20 women and eight men ranging in age from 40 to 79 years, with symptoms for from 1 to over 10 years. At the time of follow-up, 12 patients had undergone one operation, 12 had had two operations, and four had had three to five operations. Sixteen of the 28 patients obtained excellent to good relief of symptoms for 1 to 3 1/2 years. The procedures performed using local anesthesia and intravenous analgesia allow the immediate recognition of any facial muscle weakness or asymmetry. The findings indicate that this procedure, in many patients with minimal complications, can significantly relieve the incapacitating symptoms of blepharospasm. PMID- 6858774 TI - Serotonergically active agents in levodopa-induced psychiatric toxicity reactions. PMID- 6858775 TI - Some therapeutic observations in Wilson's disease. PMID- 6858776 TI - Long-term treatment of tardive dyskinesia with presynaptically acting dopamine depleting agents. AB - Fourteen patients with TD, all but one also having tardive akathisia, were evaluated on presynaptically acting dopamine-depleting drugs, reserpine, TBZ, and AMT. Initially, the drugs were evaluated individually, but later AMT was used in combination with reserpine and with TBZ, since their different mechanisms of action allowed for increased potency when they were used in this combination. All but one patient responded to this therapeutic approach. Parkinsonism was easily induced, however. Most patients varied during the day between mild parkinsonism and mild dyskinesia-akathisia. It was difficult to have patients at the normal level between these two conditions. The addition of carbidopa/levodopa in one patient not only relieved the side effect of parkinsonism but may have also accelerated a remission from TD and akathisia. Although postural hypotension was a common adverse effect in patients receiving reserpine, especially in combination with AMT, it did not develop in patients taking TBZ, either alone or in combination with AMT. This observation suggests that TBZ may be less effective depleting monoamines in the periphery than in the central nervous system. Since reserpine is available commercially in the United States whereas TBZ is not, reserpine may be the drug of choice in treating patients with TD or tardive akathisia. The addition of AMT will increase the potency of this form of treatment. PMID- 6858778 TI - Levodopa-free periods ("drug holidays") in the management of parkinsonism. PMID- 6858777 TI - Abnormal involuntary movements: a study of dopaminergic receptor interaction. AB - Abnormal involuntary movements caused by chronic levodopa treatment in Parkinson's disease, tardive dyskinesia resulting from long-term treatment with neuroleptics, and Huntington's disease all seem to be related to functional alteration and/or derangement of the DA/ACh systems. Recent data show the presence of different types of DA receptors D1 and D2, which seem to be involved in the pathogenesis of AIM: an alteration of their mutual equilibrium could account for movements disorders. In addition, hypofunction of the ACh system also seems to play a role in the pathogenesis of AIM. The purpose of this study was to verify an alteration of DA/ACh relationships by evaluating the clinical responses to pharmacological stimuli in patients affected by AIM secondary to chronic levodopa and chronic neuroleptic treatment. The following drugs were used to evaluate the DA receptors: lisuride (0.007 mg/kg i.v.) and tiapride (2.85 mg/kg i.v.) as agonist and antagonist, respectively, at D2 receptors; oxopentphylline (2.85 mg/kg i.v.) and alpha-flupenthixol (.057 mg/kg p.o.) as agonist and antagonist, respectively, at D1 receptors. Levodopa plus carbidopa (250 mg + 25 mg) was also used. The ACh system was studied using orphenadrine (1.1 mg/kg i.v.) as an antagonist and physostigmine (0.014 mg/kg i.v.) and neostigmine (0.26 mg/kg i.v.) as agonists. Our results suggest an involvement mainly of D1 receptors in the pathogenesis of TD, whereas D2 receptors seem to be important in the onset of AIM after chronic levodopa treatment in Parkinson's disease. PMID- 6858779 TI - The effect of lithium on the "on-off" phenomenon in parkinsonism. PMID- 6858780 TI - Pergolide treatment in parkinsonism. PMID- 6858781 TI - Sustained low-dose levodopa therapy in Parkinson's disease: a 3-year follow-up. AB - Forty-four previously untreated patients with early idiopathic Parkinson's disease were treated from the time of diagnosis with submaximum doses of levodopa (mean 420 mg) in combination with a peripheral dopa decarboxylase inhibitor and followed for a minimum period of 3 years. Forty-one gained initial worthwhile improvement, and 17 achieved a reduction in pretreatment disability scores of more than 50%. After 3 years of sustained therapy, only 14 had completely maintained their initial response, and 12 patients were experiencing end-of-dose deterioration; 13 patients had mild peak-dose dyskinesias, but none developed the on-off phenomenon, hypotonic freezing, or end-of-dose dystonia. Retrospective comparison with patients matched for duration of disease and pretreatment severity who had been given maximum tolerated doses of levodopa (a comparable mean dose of 950 mg) showed that the smaller dose regimen reduces peak-dose dyskinesias but not waning of response or end-of-dose deterioration. PMID- 6858782 TI - Comparative efficacy of pergolide and bromocriptine in patients with advanced Parkinson's disease. AB - Treatment with pergolide was compared with bromocriptine in 25 patients, all of whom were also receiving levodopa and in all of whom the response to levodopa had diminished. All 25 patients had "on-off" phenomena. At the time bromocriptine was added to levodopa, the mean age of the patients was 61.8 years, mean duration of disease was 9.0 years, and mean duration of levodopa treatment was 6.1 years. For the group as a whole, disability as determined in the "on" period decreased by 36%, from 28.7 to 18.5; and 11 patients improved at least one stage. Disability as determined in the "off" period decreased by 25%, from 59.5 to 44.4. The number of hours in which patients were "on" increased by 62%, from 7.1 to 11.5. All of these changes were significant (p less than or equal to 0.05). Bromocriptine had to be discontinued in nine patients (eight because of mental changes). In the remaining 16 patients, bromocriptine was eventually discontinued because of diminishing efficacy. Mean dose of bromocriptine was 50 mg (range, 10-100 mg), and mean duration of treatment was 23 months (range, 2-65 months). At the time of their treatment with pergolide, the patients were older, 65.5 years, had the disease longer, 12.7 years, and were more disabled. Nonetheless, for the group as a whole, disability score as determined in the "on" period decreased significantly by 40%, from 43.5 to 26.3, and 14 patients improved at least one stage. Disability as determined in the "off" period decreased significantly by 21%, from 69.0 to 54.8. The number of hours in which patients were "on" increased significantly by 224%, from 3.4 to 11.0 hr. The mean dose of pergolide was 2.1 mg (range, 0.1-10.0 mg), and the mean duration of treatment was 6.2 months (range, 0.5-20 months). Pergolide was discontinued in eight patients: three because of asymptomatic tachyarrhythmias of unknown clinical significance (detected only by Holter monitoring); two because of orthostatic hypotension; and two because of mental changes. Although pergolide appears to be more potent than bromocriptine because of its greater effect in a larger number of patients at a more advanced stage of their disease, both drugs are useful, and both enhance our ability to manage patients with PD. PMID- 6858783 TI - Diphenhydramine blocks the leukotriene-C4 enhanced mucus secretion in canine trachea in vivo. AB - Leukotrienes (C4, D4) have been shown to enhance mucus secretion in both isolated human airway tissue and intact canine trachea in vivo. They also have been implicated as putative mediators in several airways diseases. In previous canine studies the mucus enhancing effect of leukotriene-C4 was blocked by atropine, FLP 55,712, and hexamethonium but not by cutting the superior laryngeal and vagus nerves. We anesthetized mongrel dogs with chloralose (100 mg/kg) and urethane (500 mg/kg) and ventilated them on a pump. To visualize the secretions from submucosal glands, we exposed the mucosa of the upper trachea and coated its surface with powdered tantalum. Secretions from the glands formed elevation in the tantalum layer (hillocks) with time: the number of tracheal hillocks (an index of mucus secretion) was measured at one or more of the four time points on six dogs after each treatment of the treatment sequence: no LTC4, LTC4, no LTC4 + blocker, and LTC4 + blocker. The potential blocker was diphenhydramine, an H1 antagonist for histamine. LTC4 was injected into the cranial thyroid artery which directly feeds the tracheal segment. We observed hillocks through a dissecting microscope, and the number of hillocks per 1.2 cm2 were counted for a 1-4 min interval. In 6 dogs with 12 responses, LTC4 (10 micrograms) gave a positive response that was significantly different from control (p less than 0.01-0.05) at 2-4 min. Diphenhydramine (n = 6), 0.5 mg/kg, a dose which blocked a histamine challenge without blocking an acetylcholine challenge of secretion, gave a statistically significant (p less than 0.01-0.05) reduction in mucus secretion at 1-4 min. These results support the conclusion that leukotriene C4 induces mucus secretion in dogs that is blocked by prior diphenhydramine administration. This would indicate histamine has a role, but as yet an unknown mechanism in the action of leukotriene-C4 in enhancing mucus. PMID- 6858784 TI - Studies on histamine-induced cutaneous flare in the guinea pig. AB - Evidence for the involvement of both H1- and H2-receptors in histamine-induced cutaneous flare reactions has been obtained. The guinea pig ear was used as the site of histamine injection since, unlike virtually all other skin areas in non humans examined to date, it displays a similar response to that which occurs in human skin, namely the Lewis triple response. The flare reaction to histamine in the guinea pig ear was established as an indirectly mediated, neurovascular phenomenon by demonstrating that the vascular changes which occur in the region of the flare are incompatible with histamine directly stimulating the cutaneous vasculature and also by showing that histamine-induced cutaneous flare reactions are reduced by local anaesthesia. Having verified the authenticity of the flare reaction in the guinea pig ear, the role of H1- and H2-receptors in histamine induced flare reactions was examined. Mepyramine and Cimetidine both significantly reduced the flare reaction produced by histamine. In addition, 2-(2 aminoethyl) pyridine, a selective H1-receptor agonist, was found to elicit a dose dependent flare response. PMID- 6858785 TI - Segmental and age-dependent changes of histamine's affinity in the rabbit aorta. AB - Affinities of contractile responses to histamine and H1-receptor agonists thiazolylethylamine (TEA) and pyridylethylamine (PEA) were evaluated in three segments of rabbit aorta and increase of affinity in the caudal direction was found. alpha-adrenergic affinity of noradrenaline did not possess such differentiation. Evaluation of the data with histamine receptor agonists and antagonists suggested H1-receptor liability of the phenomena. Affinities of histamine and noradrenaline were also investigated in relation to body weight which reflects age. Histamine's affinity was found to be age dependent, decreasing with the increase of age, while no correlation was found for noradrenaline between two parameters. Results are suggesting the presence of histamine specific vascular function in the rabbit which is receded by the advance of age. PMID- 6858787 TI - Effects of urethan on lymphokine-producing activity of lymphocytes and on some functions of peritoneal macrophages in rats. AB - Effects of urethan on some functions of blood lymphocytes and peritoneal macrophages (PMs) of rats were studied in in vivo and in vitro experiments. The in vitro lymphokine (LK) producing activity of lymphocytes in the presence of specific antigen was depressed by urethan administered 1-5 days before the BCG sensitization. However, the drug injected after the BCG sensitization was not effective on the LK production. Urethan added to the cultures of previously BCG primed lymphocytes did not influence the LK production. The sensitivity of glycogen-provoked PMs (pPM) to LK-induced activation and, at the same time, the 125I-IgG2a binding capacity as well as the EA rosette formation of the provoked PMs were depressed by urethan administered 1-5 days before the lavage of PMs. These functions of resident PMs (rPM) were not altered by the drug treatment. Urethan added to the cultures of resident or provoked PMs proved to be ineffective. These results led to the conclusions that urethan, after its in vivo metabolic conversion, causes an impairment of the macrophage functions in the inductive phase of the immune response and this event may be the crucial point in the immunosuppressive effect of urethan. PMID- 6858786 TI - Comparison of adhesion to glass and aggregation of human leucocytes. AB - C5adesArg-induced leucocyte aggregation and neutrophil adhesion to glass were compared using the same cell separation technique and identical chemicals for preparing the media. Human serum albumin decreased adhesion to glass but had no effect on leucocyte aggregation induced by C5adesArg. In contrast, C5adesArg in Gey's solution with or without HSA, in serum or plasma stimulated leucocyte aggregation in a dose-dependent fashion. However, it did not alter neutrophil adhesion to glass. This indicates that leucocyte aggregation and neutrophil adherence to glass do not necessarily represent equivalent responses taking place on different substrata. Thus they may be mechanistically distinct. PMID- 6858788 TI - The effect of X-ray irradiation on the adjuvant syndrome and the inflammatory response to urate crystals. AB - In rats, X-ray irradiation reduced the number of circulating leucocytes at different rates: mononuclears were depleted in 24 h, granulocytes were numerically reduced only 72 h after irradiation. The injection of adjuvant 24 h after exposure to X-rays resulted in inhibition of primary reactions at the injection site into one of the hind paws. Secondary reactions did not develop. Injected 72 h after irradiation, adjuvant evoked primary responses the severity of which was comparable to those of controls. Secondary lesions in the contralateral paw, forelimbs, ears and tail were detected which were less severe and developed at a later time than in controls. In contrast, normal responses to urate crystals were observed by injecting the irritant 24 h after irradiation. Injected 72 h after irradiation, urate crystals induced decreased inflammatory responses. Irradiation seemed to have interfered with the development of the response to adjuvant administered 24 h afterwards, by affecting lymphocyte subpopulations: the inhibition of the primary reaction presumably resulted from the numerical reduction of lymphoid cells characteristically distinct from B- and T-lymphocytes; reduced subpopulations of T and B-cells apparently accounted for the inhibition of secondary reactions. With the partial recovery from lymphocytopenia which started 4-5 days after irradiation, the animals could again respond with fully developed primary reactions to adjuvant injected 72 h after exposure to X-rays. Since secondary lesions in this group were less severe and developed at a later time than in controls, it is plausible that recovery from depletion of B- and T-lymphocyte subpopulations proceeded at a slower rate than recovery from depletion of non-B, non-T lymphoid cells responsible for the development of primary reactions. The experiments with urate crystals indicated that granulocytes were essential for the development of the acute oedematous response to this irritant. It is concluded that the relative contribution of lymphocytes and granulocytes for the development of inflammatory responses largely depend on the nature of the irritant employed. PMID- 6858791 TI - Metal binding by pharmaceuticals. Part 3. Copper (II) and zinc (II) interactions with isoniazid. AB - Formation constants for copper(II) and zinc(II) complexes of isonicotinoylhydrazine (isoniazid) and guanosine-5'-monophosphate have been measured potentiometrically at 37 degrees C, I = 150 mmol dm-3 [NaCl]. These constants have been used in computer models to assess the extent of complex formation by the drug in vivo. The simulations indicate that the predominant complexes existing in blood plasma are ternary species formed with histidinate. However, at clinical levels of isoniazid, it seems unlikely that these complexes are physiologically significant. On the other hand, ternary complex formation with nucleosides may be involved in the binding of isoniazid to viral RNA. PMID- 6858790 TI - Platelet activation by endogenous 5-hydroxytryptamine and histamine released by mast cell degranulation with compound 48/80 in the rat. AB - The intravenous injection of the mast cell degranulator C 48/80 (1 mg/kg) in rats did not produce thrombocytopenia nor circulating platelet aggregates but sensitized the platelets to aggregate upon turbulence challenge. Such turbulence induced platelet aggregation was not accompanied by formation of thromboxane B2. Electron microscopy revealed absence of platelet degranulation. Turbulence induced platelet aggregation was completely prevented by pre-treatment of the rats with cyproheptadine, dipyridamole and VK 774, partially with ketanserin (5HT2-receptor antagonist), but not with methysergide (antiserotonergic drug), pyrilamine (antihistaminic drug), suprofen, aspirin (cyclo-oxygenase inhibitors), phentolamine, propranolol, flunarizine, lidoflazine, oxycoumarin or Trasylol. Combined treatment with the anti-histaminic drug pyrilamine and the 5HT2-receptor antagonist ketanserin resulted in a dose-related inhibition for ketanserin of the turbulence-induced platelet aggregation. These experiments point to an interaction between histamine and 5-hydroxytryptamine in the platelet activation by mast cell released mediators. PMID- 6858789 TI - Study of platelet aggregation induced by platelet activating factor (PAF) after administration of ticlopidine or aspirin. AB - Platelet aggregation induced by platelet activating factor (PAF) was studied in 95 subjects: 39 controls, 23 patients receiving aspirin and 33 receiving ticlopidine. Potentiation of aggregation by concentrations of adrenaline unable to induce aggregation when used alone was also assessed. The 33 patients treated with ticlopidine showed a highly significant fall of platelet aggregation (p less than 0.001) at the three concentrations of PAF used. The 23 subjects receiving aspirin showed a diminution of platelet aggregation induced by PAF due to inhibition of ADP release. In these last two groups, adrenaline often potentiated platelet aggregation. However, this phenomenon was absent in subjects having taken aspirin in the hours before blood was drawn. This study demonstrates ticlopidine's inhibitory action on PAF-induced aggregation and confirms ticlopidine's role in reducing platelet aggregation by ADP, which has previously been demonstrated. PMID- 6858795 TI - [Cytofluorometry and tumors of the bladder]. PMID- 6858796 TI - [Value of bladder lavage in the follow-up of urothelial pathology]. PMID- 6858792 TI - Activity of cyclosporin A in experimental influenza virus infection in mice. AB - Oral administration of the immunosuppressive fungal metabolite cyclosporin A increased the mortality of Balb/c mice infected intranasally with influenza A/Hong Kong/1/68 (H3N2) virus. Cyclosporin A also increased the amount of virus that could be recovered from the lungs of infected mice and delayed the rate at which it was eliminated. Treatment with cyclosporin A did not, however, prevent the appearance of haemagglutination inhibiting antibody in the sera of animals that had been infected with a sub-lethal concentration of virus. PMID- 6858793 TI - [Conservation or loss of membrane antigens of the ABH blood group and their precursor substance. Prognostic importance for tumors of the bladder]. PMID- 6858794 TI - Current practice of urinary cytology. A four-year-practice review with 3,995 cytological specimens examined. PMID- 6858797 TI - [Value of urinary cytology and cytology of bladder lavage in the diagnosis and observation of bladder cancer]. PMID- 6858798 TI - [Prostatic cytology. Value of the technic in the diagnosis and surveillance of prostatic carcinomas; viewpoint of the urologist]. PMID- 6858799 TI - The role of urine cytology in urological practice. PMID- 6858800 TI - [Experience with prostatic aspiration cytology at Bordet Institute, from 1977 to 1981]. PMID- 6858801 TI - [Test of penetration of human spermatozoa into hamster eggs in vitro]. PMID- 6858802 TI - [The spermogram in urologic practice]. PMID- 6858803 TI - Evaluation of long-term oral administration of a sustained release theophylline preparation in children with chronic asthma. AB - Over a one-year-period 23 children with chronic asthma were given an oral sustained-release theophylline preparation in twice-daily doses. Constant therapeutic theophylline levels were maintained in 18 children for the whole period, while in 5 subjects the values were in almost all instances below the therapeutic range. In both groups, however, a good clinical effect from the preparation was observed. Only two children reported nausea and mild abdominal pains, whereas other two children had serum theophylline levels above 20 micrograms/ml with no side effects. It is concluded that oral sustained-release theophylline preparation is effective in providing therapeutic drug concentrations on a 12 hr dose schedule, thus avoiding the risk of lower compliance observed in children given normal theophylline tablets. PMID- 6858804 TI - Epsilon-amino-caproic acid in the treatment of Osler's hereditary angioneurotic edema. AB - This clinical entity described for the first time by Osler in 1888 presented a great therapeutic problem during many decades because of its severity. Landerman and later on Donaldson and Evans established the pathogenic mechanisms of this disease finding a deficiency in the inhibitor of the first activated component of complement, an alpha 2 aminoglycoprotein, to be the mechanism responsible of the same. More concretely, alterations in the plasmin, kinin and kallikrein systems are those that will lead to a change in vascular permeability with resultant tissue alterations. Four cases of hereditary angioneurotic edema are studied in female patients aged between 15 and 50 years and with family history consistent with angioneurotic familiar edema in which there were six cases of death due to edema of the glottis. Once the diagnosis had been made the patients were subjected to treatment with EACA at doses of 2.5 gm every 6 hours. The determinations of complement were similar in the four cases, with marked decreases in C4 and C1 inhibitor with a decrease in total complement in three cases. Regarding secondary effects, vomiting was found only in one cases, which as the dose was reduced did not necessitate termination of treatment. In summary, considering the results obtained in the cases above, we believe that due to its good tolerance and moderate cost, epsilon-amino-caproic acid at the abovementioned dosage is an excellent pharmacological agent in the treatment of Osler's hereditary angioneurotic edema. PMID- 6858805 TI - Atopic dermatitis and delayed hypersensitivity. AB - Studies of patients with atopic dermatitis show both clinical and laboratory evidence of a depression of cellular immunity. In order to study one aspect of this disease in vivo we studied 40 patients with atopic dermatitis of both sexes, aged 2-30 years and 40 supposedly healthy subjects with similar characteristics in regard to age and sex who served as the control group. Both groups were subjected to tests of delayed hypersensitivity with Candidin, Trycophytin and Tuberculin. Candidin response was negative in 72.5% and 85% at 48 and 72 hours respectively. Trycophytin response was negative in 77.5% and 87.5% of the readings at the same time intervals, and Tuberculin response was negative in 85.5% of the patients with atopic dermatitis studied. The results are shown to be statistically significant. It is concluded that, cellular immunity should be evaluated in patients with atopic dermatitis. PMID- 6858806 TI - Natural and antibody-dependent cellular cytotoxicity in patients with active sarcoidosis. AB - Lymphocyte surface markers, natural killer activity, antibody-dependent cellular cytotoxicity and lymphocyte binding to target cells were evaluated in a group of 16 subjects with active sarcoidosis. A reduction of E-RFC and a relative increase of EA-RFC were observed. At the same time, ADCC activity was similar to that of normal controls, while NK cytotoxicity was significantly decreased. On the other hand, the percentage of conjugates between lymphocytes and target cells was lower than in controls. These observations account for a selective defect of NK activity, suggesting that the NK assay might be an useful tool to support the impairment of cellular immunity in active sarcoidosis. PMID- 6858809 TI - Reproducibility of tethered swimming in exercise rehabilitation research. PMID- 6858807 TI - Cross-reactions between DNCB and DNFB. PMID- 6858808 TI - Balance ability and reflex maturation among normal, learning disabled and emotionally handicapped populations. PMID- 6858811 TI - Stress, social support and depression. PMID- 6858810 TI - A message from the president. Directions and dollars. PMID- 6858812 TI - Sunlight and protection of the skin. AB - Sunburn, wrinkling and malignancies are the frequent results of excessive sun exposure. Photosensitivity and photoallergic or phototoxic reactions are less commonly observed. Sunscreens containing para-aminobenzoic acid (PABA), PABA esters and benzophenones offer substantial protection, allowing even fair-skinned persons to participate freely in outdoor activities. These products are now rated and assigned a sun protection factor (SPF). Their routine use should be encouraged. PMID- 6858813 TI - Hyperactivity and the attention deficit disorder. AB - The attention deficit disorder is a clinical syndrome manifested by inattention, impulsivity and hyperactivity beginning before age seven and persisting for at least six months. The family physician plays a key role in consolidating the observations of parents and teachers with the findings on medical evaluation. The physician also initiates the comprehensive treatment program with counseling and stimulant medication, and coordinates the use of special education, mental health and other resources as needed. PMID- 6858814 TI - Emphysematous cholecystitis. PMID- 6858815 TI - Obstetric anesthesia. PMID- 6858817 TI - Acute toe strangulation. PMID- 6858816 TI - Poisoning by cholinesterase-inhibiting insecticides. PMID- 6858818 TI - Phenylpropanolamine. PMID- 6858819 TI - Differentiation of constrictive pericarditis from restrictive cardiomyopathy by computed tomographic imaging. PMID- 6858820 TI - Drug toxicity in patients receiving digoxin and quinidine. PMID- 6858821 TI - Serum creatine kinase isoenzyme MB in acute and chronic alcoholism. PMID- 6858822 TI - Echocardiographic findings in ruptured chordae tendineae of the tricuspid valve. PMID- 6858823 TI - Agranulocytosis due to new sustained-release procainamide. PMID- 6858824 TI - Absence of ventricular tachyarrhythmias in massive pulmonary embolism. PMID- 6858825 TI - Methyldopa and retroperitoneal fibrosis. PMID- 6858826 TI - QRS vector changes with rapid reduction of blood pressure in accelerated hypertension. PMID- 6858827 TI - Primary pulmonary hypertension improved by long-term oral administration of nifedipine. PMID- 6858829 TI - Amrinone therapy in congestive cardiomyopathy. PMID- 6858830 TI - Vasotonic angina: epicardial versus resistance vessel spasm. PMID- 6858828 TI - Pathologic study of echocardiography and coronary atherosclerosis. PMID- 6858831 TI - Intercostal muscle tic simulating ECG U waves. PMID- 6858833 TI - The qualitative effects of laser irradiation on human arteriosclerotic disease. AB - To determine the effects of laser irradiation upon human coronary atherosclerotic disease, coronary plaques were extracted from fresh human cadaver hearts. Seventy four diseased artery samples were sectioned either transversely or longitudinally and subjected to laser treatment from argon-ion and carbon dioxide sources. The laser beam affected vaporization and patency in fibrous, lipoid, and calcified plaques as observed histologically. Calcified blockage showed greater extent of charred remnants following controlled thermal injury than did fibrous or lipoid obstructions. The area and depth of penetration varied directly with intensity and duration of photoirradiation and inversely with the density of the atherosclerotic tissue. This study supports further research work on the use of lasers to effect relief of atherosclerotic obstructions. PMID- 6858832 TI - Prinzmetal's variant angina: is it transmitted genetically? PMID- 6858834 TI - Exercise training improves lipoprotein lipid profiles in patients with coronary artery disease. AB - The effects of endurance exercise training on plasma lipoprotein lipids were determined in 10 men, ages 46 to 62 years, with coronary artery disease (CAD). Patients maintained body weight, health-related behaviors, and stable diets throughout the program. Training was at 50% to 85% of maximal oxygen consumption (VO2 max) for 40 to 60 minutes, 3 to 5 days/week for 29 +/- 7 weeks. Training increased VO2 max (31 +/- 19%, p less than 0.001), reduced plasma cholesterol (C) (-8 +/- 4%, p less than 0.01), low-density lipoprotein-C (LDL-C) (-9 +/- 9%, p less than 0.01), and triglyceride (TG) (-13 +/- 32%, p less than 0.05) concentrations, and increased high-density lipoprotein-C (HDL-C) levels (11 +/- 13%, p less than 0.05) and HDL-C/LDL-C ratios (25 +/- 20%, p less than 0.01). Changes in LDL-C and VO2 max were correlated (r = -0.73, p +/- 0.01), while the changes in LDL-C and HDL-C each correlated inversely with pretraining lipoprotein levels (rLDL-C = -0.77, p less than 0.01; rHDL-C = -0.68, p less than 0.05). Thus potentially "antiatherogenic" benefits of exercise seem to be due to a training effect, since they correlate best with changes in VO2 max and are maximal in patients with initially low VO2 max, high LDL-C, and low HDL-C levels. PMID- 6858835 TI - Arterial and coronary sinus catecholamines in the course of spontaneous coronary artery spasm. AB - We studied plasma catecholamine levels in 10 patients with frequent spontaneous episodes of coronary artery spasm to evaluate the role of the sympathetic nervous system. Peripheral venous norepinephrine in supine and upright postures, urinary excretion of catecholamines, and functional testing of the sympathetic nervous system did not differ from the same measurements in control subjects. Arterial and coronary sinus levels of norepinephrine and epinephrine drawn early in ischemia were not elevated over baseline; coronary sinus norepinephrine levels were higher than those in arterial samples and rose from 315 +/- 32 (pg/ml +/- SE) at the onset of ST elevation to 490 +/- 49 pg/ml late in ischemia (p less than 0.05). Plasma epinephrine levels, higher in arterial than coronary sinus samples, also rose significantly only late in ischemia, from 44 +/- 14 pg/ml to 148 +/- 35 pg/ml (p less than 0.05) in arterial blood and from 33 +/- 10 pg/ml to 108 +/- 29 pg/ml in coronary sinus samples (p less than 0.05). Generalized sympathetic nervous system activation is not likely to be the sole cause of coronary artery spasm. PMID- 6858837 TI - Determinants of arrhythmic death during coronary artery reperfusion: effect of perfusion bed size. AB - To further our understanding of the factors determining the consequences of transient episodes of ischemia, we studied the influence of the size of the ischemic bed on the incidence of ventricular fibrillation (VF). The circumflex coronary artery (CFX) was occluded at various locations in 19 dogs. After 20 minutes of occlusion followed by 10 minutes of reperfusion the dogs were killed. The portion of the left ventricle (LV) at risk of infarcting (R/LV) was defined as the region supplied by the occluded CFX and determined by simultaneous perfusion of the CFX with saline solution, just beyond the occlusion site, and of the aorta with Evan's blue. Bread loaf slices of the heart were photographed and projected, and the normal (blue) and risk regions (unstained) traced. The product of area and slice weight yielded mass of normal and risk regions. The R/LV of dogs that died of reperfusion VF (n = 6) was 42.3 +/- 5.0%, larger (p less than 0.001) than R/LV in all surviving dogs (n = 13), 24.2 +/- 9.4%. Twelve of the 13 survivors had R/LV less than 35%, whereas all dogs that died had R/LV greater than 35% (p = 0.0005). As is true for VF occurring during coronary artery occlusion, the incidence of reperfusion VF is related to the size of the ischemic insult. PMID- 6858838 TI - Relationship between the extent of the hypoperfused zone of the myocardium and the occurrence of ventricular fibrillation. AB - Ventricular fibrillation and subsequent death frequently occur so soon after coronary artery occlusion that infarct size cannot be determined; thus the systematic study of their relationship is impossible. Recently, however, a technique has been developed that permits the assessment, in vivo, of the extent of the myocardial hypoperfused zone (HZ). Accordingly, in 55 open-chest dogs, 99mTc-labeled (8 mCi) albumin microspheres (15 microns in diameter) were injected into the left atrium 1 minute after coronary artery occlusion. The zone of hypoperfusion was analyzed in 28 dogs that had ventricular fibrillation (group A) and 27 dogs that had no ventricular fibrillation (group B). In group B, the HZ was 26.3 +/- 1.7% of the left ventricle vs 31.6 +/- 1.3% of the left ventricle in group A (p less than 0.05), showing that ventricular fibrillation occurred in dogs with larger zones of hypoperfusion. PMID- 6858836 TI - Effects of oral dipyridamole on coronary dynamics and myocardial metabolism at rest and during pacing-induced angina in patients with coronary artery disease. AB - The effects of oral dipyridamole administration (150 mg) on coronary hemodynamics, myocardial metabolism, and pacing threshold were studied in 10 patients with significant coronary artery disease (CAD). Following dipyridamole through 120 minutes, there was no significant change in resting heart rate, arterial pressure, coronary venous flow, coronary resistance, myocardial lactate extraction, or myocardial oxygen consumption. Rapid atrial pacing performed before and at 60, 90, and 120 minutes after dipyridamole failed to demonstrate any significant reduction in pacing threshold or evidence of increased ischemia after dipyridamole. Blood dipyridamole levels showed variable and slow absorption which probably explains the difference between intravenous and oral dipyridamole on coronary dynamics and myocardial response to pacing. PMID- 6858839 TI - Electrophysiologic studies in survivors of late cardiac arrest after myocardial infarction. AB - Nine patients resuscitated from life-threatening ventricular arrhythmias (VA) within 3 months of an acute myocardial infarction (AMI) underwent electrophysiologic studies (EPS) with clinical follow-up for at least 12 months. Neither reinfarction, drug therapy, nor electrolyte imbalance was a precipitating factor. VA was induced by ventricular pacing in six of nine patients. Five patients were prescribed empiric drug therapy, while the four other patients had repeated EPS to select optimal drug therapy. One patient remained unstable and died of VA in the hospital. No patient was discharged and successfully maintained on a drug known to prevent induction of VA, yet only two patients (25%) had a further recurrence of VA, one fatal. Our findings suggested that either drug therapy that is determined empirically or found not to suppress the induction of VA during EPS can be associated with a successful outcome in some of these patients, or the natural history of VA after myocardial infarction is that they are self-limiting in the absence of a new ischemic event. PMID- 6858840 TI - Angiographic correlates of recurrent sustained ventricular tachycardia in chronic ischemic heart disease. AB - We report the angiographic studies of 53 consecutive patients with angiographic coronary artery disease (CAD) and recurrent sustained ventricular tachycardia occurring at least 6 weeks remote from an acute myocardial infarction. Triple vessel disease was present in 25 patients (47%), double-vessel disease in 19 patients (36%), and single-vessel disease in nine patients (17%). All patients with single-vessel disease had left anterior descending coronary artery obstruction. Patients under 50 years old had significantly fewer diseased vessels than those over 50 years old (1.4 vs 2.4 vessels diseased; p less than 0.025). Left ventricular ejection fraction ranged from 0.15 to 0.61 (mean 0.34 +/- 0.11) and was 0.25 or less in 14 patients (26%). All patients had regional wall motion abnormalities. There was akinesia and/or dyskinesia in 49 patients (92%). Akinesia or dyskinesia was inferior in 17 patients (32%), anteroapical in 14 patients (26%), inferoapical in 10 patients (19%), and anteroapicoinferior in 6 patients (11%). Involvement of the septum was noted in 19 patients (36%) and of basal segments in 26 patients (49%). An average of 2.7 (out of seven) segments per patient were dyskinetic or akinetic. Thus multivessel disease, markedly reduced ejection fraction, and severe and extensive regional wall motion abnormalities are generally present. These findings have pathophysiologic as well as clinical and therapeutic implications. The nautral history of these patients as well as the results of therapy should be related to the underlying coronary anatomy and left ventricular function. PMID- 6858841 TI - Studies of arrhythmias by 24-hour polygraphic recordings: relationship between atrioventricular block and sleep states. AB - The relationship between AV conduction disturbances and sleep states was investigated using continuous polygraphic recordings for one full night. The results were as follows: (1) In the case of first-degree AV block, the phasic shortening of the PQ interval was observed during rapid eye movement (REM) sleep. (2) In the case of second-degree AV block (Wenckebach type), the conduction ratio increased transiently during REM sleep and significant relationships were observed between the number of nonconducted P waves and the mean heart rate in each sleep stage. (3) In the case of advanced AV block, complete AV block was observed less frequently during REM sleep and the period of falling asleep. Since the reproducibility of these results from night to night has not yet been investigated, additional evaluation is required. PMID- 6858842 TI - Pulmonary blood volume: relationship to changes in left ventricular end-diastolic pressure during atrial pacing. AB - Little data exist about the relationship between changes in cardiac end-diastolic pressure and changes in pulmonary blood volume. To assess this relationship, we studied 11 patients with coronary heart disease during atrial pacing in an attempt to produce multiple pressure-volume points. During catheterization, we obtained Millar pressure recordings of end-diastolic pressure along with equilibrium radionuclide angiograms. Cardiac output, ejection fraction, and pulmonary blood volume were obtained by means of recently validated radionuclide techniques. During pacing, substantial changes in pulmonary blood volume occurred only with marked increase in end-diastolic pressure volume (greater than or equal to 15 mm Hg) and rarely exceeded 15% of control pulmonary blood volume. Cardiac output did not change, while ejection fraction declined during pacing. There was a fair correlation between the absolute change in pulmonary activity (or pulmonary blood volume) or the percentage of change in pulmonary activity over the control value with end-diastolic pressure when all the data points were evaluated (n = 74, r greater than 0.70). However, the scatter in the data precluded making accurate estimates of pressure changes from changes in radionuclide volume changes. We conclude that large changes in cardiac filling pressure must occur during atrial pacing, where cardiac output does not change, before visible pulmonary blood volume changes occur. This may limit the extrapolation of presumed pressure changes from known pulmonary blood volume when changes are small. PMID- 6858843 TI - Pulmonary hypertension in isolated secundum atrial septal defect: high frequency in young patients. AB - Out of 709 consecutive patients with isolated secundum atrial septal defect, the pulmonary artery systolic pressure was greater than 50 mm Hg in 118 patients (17%). Pulmonary hypertension was present in 13% of patients under 10 years and in 14% aged 11 to 20 years. The Eisenmenger reaction was present in 9% of the 709 patients. The frequency of the Eisenmenger reaction was high in young patients and was not significantly different in patients in the first and second decades as compared to older patients. None of our patients with pulmonary hypertension resided at high altitude. The high frequency of pulmonary hypertension in our young patients cannot be satisfactorily explained. Autopsy studies suggest that in some, pulmonary hypertension is due to the persistence of the fetal pulmonary vascular pattern. PMID- 6858844 TI - Relationship between sympathetic neural activity, coronary dynamics, and vulnerability to ventricular fibrillation during myocardial ischemia and reperfusion. AB - The relationship between neural sympathetic discharge and vulnerability to ventricular fibrillation during myocardial ischemia and reperfusion was studied in 26 chloralose-anesthetized dogs. Preganglionic cardiac sympathetic impulse activity and ventricular fibrillation thresholds were separately determined before and during a 10-minute period of left anterior descending coronary artery occlusion and during release-reperfusion. Within 2 minutes of occlusion the ventricular fibrillation threshold was significantly decreased (from 25 +/- 1.3 to 16 +/- 2.3 mA, p less than 0.05) corresponding with the period of maximal activation of cardiac sympathetic preganglionic fibers (from 4.4 +/- 0.2 to 6.3 +/- 0.5 impulses/sec). Coronary sinus blood flow and oxygen tension decreased significantly. All these changes persisted for 5 to 6 minutes, thereafter returning to control levels despite continued obstruction of the coronary artery. A transient but significant reduction in ventricular fibrillation threshold also occurred with release of the occlusion but was unaccompanied by increases in sympathetic neural discharge. Bilateral stellectomy completely prevented the ventricular fibrillation threshold changes observed during coronary artery occlusion. However, there was no change in coronary sinus oxygen tension or blood flow. During reperfusion, stellectomy increased rather than decreased vulnerability to ventricular fibrillation. Stellectomy augmented the reactive hyperemic response to release-reperfusion. These findings indicate that enhanced cardiac sympathetic neural activity contributes to ventricular vulnerability associated with coronary artery obstruction. An opposite action results during release-reperfusion. Cardiac sympathetic neural discharge, by reducing the magnitude of reactive hyperemic response through influence on coronary vascular tone, exerts an antifibrillatory effect. PMID- 6858845 TI - Electrophysiologic effects of bretylium on canine ventricular muscle during acute ischemia and reperfusion. AB - Electrophysiologic effects of bretylium were assessed on a recently developed animal model for analysis of conduction of premature impulses and excitation threshold. Bretylium was administered intravenously 10 mg/kg over 10 minutes followed by 2 mg/min of infusion immediately after coronary ligation. Conduction of the premature impulse was recorded in the epicardial and endocardial sites both in the base-to-apex and apex-to-base directions, in the normal, in the center, and across the border of ischemic myocardium. Compared to the control group of animals, bretylium did not cause any significant change in the conduction characteristics in the ischemic myocardium; however, it delayed the conduction of premature impulses in the normal myocardium. Thus the disparity in conduction times between the normal and the ischemic myocardium was lessened by bretylium. Further, conduction of impulses from normal tissue across the border of ischemia was also delayed. Bretylium also decreased the excitability threshold in the ischemic myocardium, although the normal myocardial excitation threshold was unaffected. These unique effects of bretylium on conduction and excitability in the normal, in the center, and across the border of ischemic myocardium, when a therapeutic dosage of the drug is used, further validate its antiarrhythmic potential and offer an insight into its mechanism of action in the setting of acute myocardial ischemia. PMID- 6858846 TI - Electrophysiologic testing of bretylium tosylate in sustained ventricular tachycardia. AB - We used programmed ventricular stimulation to test intravenous bretylium tosylate in 10 consecutive patients with inducible sustained ventricular tachycardia (usually refractory to type I antiarrhythmic agents). These 10 patients had previously documented sustained ventricular tachycardia and/or ventricular fibrillation complicating stable heart disease. Following control inductions of sustained ventricular tachycardia, bretylium 10 mg/kg was infused over 30 minutes. Thirty minutes after this infusion, sustained ventricular tachycardia could be induced in 9 of the 10 patients (one of these nine patients also had bretylium-potentiated spontaneous ventricular tachycardia). Tachycardia induced in the nine patients after bretylium was similar to control tachycardia with respect to morphology and cycle length (333 +/- 16 msec after bretylium versus 330 +/- 16 msec during control). However, five of the nine patients tolerated induced tachycardia less well after bretylium (exacerbated hypotension). In one patient, ventricular tachycardia could not be induced after intravenous bretylium. PMID- 6858848 TI - Etchells-Fuller laboratory Hood Index. PMID- 6858847 TI - Influence of the pericardium on left ventricular diastolic pressure-volume curves in dogs with sustained volume overload. AB - The pericardium is largely responsible for displacement of the left ventricular diastolic pressure-volume curve observed after acute volume loading in dogs. Likewise the pericardium has been considered likely to play a role in displacement of the curve in patients with acute cardiac failure and in shifts following manipulation of afterload. This study was designed to examine the influence of the pericardium on the diastolic pressure-volume relation of the left ventricle when volume load is more sustained, a setting relevant to observations made in patients with heart failure. We measured left ventricular pressure and volume in six conscious dogs with sustained volume overload (mean left ventricular end-diastolic pressure 21 mm Hg, left ventricular end-diastolic volume 149% of the upper limit of normal for our laboratory) produced by aortocaval shunt created 7 to 29 days earlier. Simultaneous left ventriculograms and pressures were obtained before and during nitroprusside infusion with the pericardium intact and in four dogs the studies were repeated 7 to 15 days after pericardiectomy. In all six dogs with intact pericardium, nitroprusside displaced the entire pressure-volume curve downward whereas after pericardiectomy, the pressure-volume data points obtained before and during nitroprusside infusion fell on a single curve. These results were similar to those previously reported for acute volume overload. Nitroprusside did not alter the time course of left ventricular pressure fall during the isovolumic period of diastole either before pericardiectomy (28.8 +/- 10.2 sec,-1, 28.4 +/- 11.9 sec-1) or after (28.8 +/- 6.7 sec-1, 26.1 +/- 7.2 sec-1). These data indicate that in dogs subjected to volume overload sustained for periods of up to 29 days, the pericardium affects the left ventricular diastolic pressure-volume curve and contributes to the elevation of left ventricular filling pressure through upward displacement of this curve. PMID- 6858849 TI - Effectiveness of employee training and motivation programs in reducing exposure to inorganic lead and lead alkyls. PMID- 6858850 TI - Toxic products from fires. PMID- 6858851 TI - Developing and managing an industrial hygiene program. AB - Establishing a comprehensive industrial hygiene program at a major manufacturing location can be a formidable task, even when many of the basic elements are available. The growth of a manufacturing location often requires a change in industrial hygiene operational methods, as well as an increase in staff size. A successful six-step approach used at a major manufacturing location is described. The steps include: 1) learning the management system; 2) defining IH concerns; 3) establishing IH priorities, goals and objectives; 4) defining the business needs; 5) communicating the business needs; and 6) managing the program and measuring progress. PMID- 6858852 TI - Reproducibility and quality control in the analysis of biological samples for lead and mercury. AB - A simple statistical calculation was applied to 8 years of data on routine control sample and duplicate analyses from a laboratory quality control program. This provided standard deviations truly representative of this laboratory at no additional analytical expense, and accurate information on how they varied with concentrations. From these, the detection limit of the method, upper warning limits, and upper control limits for differences between duplicate analyses were calculated. These values were conveniently used for quality control in determinations of lead in blood and of mercury in urine. PMID- 6858853 TI - Seasonal effects on concentrations of monomethylformamide in urine samples. AB - Eleven du Pont operators participated in a special dimethylformamide metabolite (monomethylformamide, MMF) urine monitoring study to investigate a possible seasonal influence on urine metabolite concentrations. Variables considered included urine volume, MMF concentration, MMF mass, urine specific gravity, and ambient temperature. Statistical analysis revealed a 13% reduction in urine volume under hot weather conditions as a cause of increased MMF concentrations. A correction for this change in urine volume should be made subjectively. PMID- 6858854 TI - Respirable dust from lignite coal in the Victorian power industry. AB - The results from a 12-month program of static sampling for respirable dust in various work sites of the Victorian power industry are presented. Lignite coal is the major source of dust in this industry. The data appear to be nearly lognormal in distribution and are similar in magnitude to levels reported from North American surface mines and surface work sites. Average 8-hour, time-weighted average dust concentrations of 0.3 mg/m3 (SD = 0.3) were found in open areas. In enclosed coal handling areas, average concentrations of 0.7 mg/m3 (SD = 0.6) were found. PMID- 6858855 TI - Monitoring real-time aerosol distribution in the breathing zone. AB - A prototype air sampling, data recording, and data retrieval system was developed for monitoring aerosol concentrations in a worker's breathing zone. Three continuous-reading, light-scattering aerosol monitors and a tape recorder were incorporated into a specially designed and fabricated backpack for detailed field monitoring of both temporal and spatial variability in aerosol concentrations within the breathing zone. The backpack was worn by workers in a beryllium refinery. The aerosol which passed through each monitor was collected on a back up filter for later chemical analysis for Be and Cu. The aerosol concentrations were recorded on magnetic tape as a function of time. The recorded signals were subsequently transcribed onto a strip chart recorder, then evaluated using a microcomputer with graphics capability. Field measurements made of the aerosol concentration at the forehead, nose, and lapel of operators during the melting and casting of beryllium-copper alloy demonstrated that there is considerable variability in concentration at different locations within the breathing zone. They also showed that operations resulting in worker exposure can be identified, and the precise time and duration of exposure can be determined. PMID- 6858856 TI - Health, safety and environmental criteria for siting of laboratory facilities. AB - The development of applicable criteria for assessing the suitability of a site for construction of full and partial containment laboratories for the analysis of unknown and highly toxic chemicals is described. The criteria, based on considerations of health, safety and environmental factors, are used to define critical considerations in site selection to minimize the risk to non-laboratory personnel and the surrounding environment. Criteria are synthesized from several sources using the assumption of a worst-case chemical release. Mechanical failures, human failures, critical events and social/legal limitations are investigated, as are the characteristics of a site which may limit construction of such a facility. A detailed description is made of the various types of laboratories and the types of samples analyzed in them. The final recommendations are summarized for five typical laboratory settings; they are based primarily on the potential impacts on people, property and natural resources. A single occupancy building in a rural setting is recommended as the most suitable site for a full containment laboratory. A single occupancy building in an industrial park setting is acceptable, while multiple occupancy buildings and sites which are more highly developed are unacceptable. Similar recommendations are made for partial containment and conventional laboratories. PMID- 6858857 TI - Quantitative standard for exposure chamber integrity. PMID- 6858858 TI - Solutions for the ICRP gastrointestinal activity from inhaled radioactive aerosols. AB - The International Commission on Radiological Protection (ICRP) has developed linear differential equations to define the movement of the fraction of inhaled radioactivity that goes to the gastrointestinal tract. These equations are based on assumed biological removal constants for each of three aerosol classes. The graphical method presented here allows the determination of the total number of nuclear transformations that occur in each gastrointestinal compartment when a given class aerosol is inhaled. The method takes into account the radioactive half-life of the isotope, the intestinal absorption fraction, and the aerosol size. PMID- 6858859 TI - The "TWAp" in the lead standard. AB - This paper analyzes current OSHA practice for adjusting the permissible exposure limit (PEL) for inorganic lead to accommodate unusual work schedules. Depending on the work schedule, the PEL adjustment procedure can allow substantially higher exposure or require substantially lower exposure, as compared to the exposure permitted by the lead standard for a normal work schedule. In addition, the procedure allows compliance with the standard by manipulation of the work schedule alone, without reduction in lead exposure. The paper describes how calculating exposure on a weekly basis using the procedure outlined in the OSHA Field Operations Manual would eliminate the seven-fold range of allowed exposure. PMID- 6858862 TI - Prevalence and prognosis after a first nontransmural myocardial infarction. AB - Prevalence, prognosis, and coronary anatomy associated with nontransmural myocardial infarction (MI) were prospectively assessed in 458 consecutive men admitted to our coronary care unit with a first MI. Cardiac catheterization was performed in 402 of the 436 survivors within 1 month of the acute event. Mean follow-up was 33 months (range 5 to 72). Nontransmural MI was diagnosed in 28 patients (6%). These patients were younger (46 +/- 10 versus 51 +/- 7 years, p less than 0.001) and had lower peak creatine kinase values (601 +/- 319 versus 1,141 +/- 923 U, p less than 0.01) and better ejection fraction (63 +/- 8 versus 46 +/- 14, p less than 0.001) than did their counterparts. Survivors of nontransmural MI also had fewer affected arteries (p less than 0.001) and a lower prevalence of total or subtotal occlusion (greater than 90%) in the involved artery (p less than 0.01). Mortality in the acute phase and long-term survival at 4 years (Kaplan-Meier) in patients with nontransmural MI (94%) were similar to those in patients with transmural MI (90%). The occurrence of new nonfatal coronary events was also similar in both groups of MI survivors. Thus, in the absence of symptoms, more aggressive management to improve survival does not seem warranted after nontransmural MI. PMID- 6858861 TI - Dynamic evaluation of prognosis from time-dependent variables in acute myocardial infarction. AB - For predicting the 3 endpoints death, cardiac arrest, and cardiogenic shock within 44 days after admission for acute myocardial infarction (MI), a competing risk variant of the Cox multivariate model was developed. The population consisted of 1,140 patients with definite MI admitted within 24 hours of onset of symptoms. Prognostic variables from the entire hospitalization period were assessed. The time-dependent variables (occurrence of complications) were evaluated with occurrence up through the day before the actual prediction period started. The important prognostic variables for the endpoint death were ventricular fibrillation, age, congestive heart failure, and asystole. Variables for the endpoint cardiac arrest were congestive heart failure, ventricular premature beats, supraventricular tachycardia, extension of MI, and age. Variables for the endpoint cardiogenic shock were cardiac arrest, age, congestive heart failure, previous MI, and nodal rhythm. By using a hazard function for each endpoint and the coefficients for the variables entered, it is possible to estimate a total risk of death, cardiac arrest, or cardiogenic shock for the individual patient. This prediction can be updated during the course of hospitalization according to the occurrence of the new complications. The model can be directly utilized to assess risk. PMID- 6858860 TI - Intracoronary thrombolysis in acute myocardial infarction: an attempt to quantitate its effect by comparison of enzymatic estimate of myocardial necrosis with left ventricular ejection fraction. AB - The quantity of myocardium was estimated that can be salvaged by reperfusion of acute transmural myocardial infarction (MI). Serial analysis of serum creatine kinase (CK) activity was carried out in 41 consecutive patients with acute MI who underwent intracoronary thrombolysis. Enzymatic estimate of MI size was calculated using an average (method A) and an individually determined elimination constant (method B). Left ventricular ejection fraction 4 weeks after successful thrombolysis (cineangiogram) correlated inversely with MI size (method A: r = 0.85, method B: r = -0.76; both p less than 0.001). Patients with recanalization within 4 hours after the onset of symptoms were assembled in group A1 (n = 13, early reperfusion), and patients with successful recanalization after 4 hours in group A2 (n = 16, late reperfusion). Group B consisted of 12 patients without reperfusion. MI size in group A1 was 21 CK-g-Eq (method A) and 23 CK-g-Eq (method B), in group A2 50 CK-g-Eq (method A) and 54 CK-g-Eq (method B), and in group B 73 CK-g-Eq (method A) and 63 CK-g-Eq (method B). Mean values in group A1 were lower than in group A2 and group B (p less than 0.05). It is concluded that MI size was significantly reduced to about one third after early reperfusion as compared with no reperfusion. In contrast, MI size was not significantly reduced after late reperfusion. PMID- 6858863 TI - Symptomatic, electrocardiographic, metabolic, and hemodynamic alterations during pacing-induced myocardial ischemia. AB - Atrial pacing has been used to assess the physiologic impact of coronary artery disease (CAD). Several variables have served as markers of pacing-induced myocardial ischemia, but their specificities and sensitivities are unknown. Accordingly, in 28 patients, incremental atrial pacing was performed. Of the 28, 10 had no CAD. The left ventricular ejection fraction (LVEF) (by gated equilibrium blood pool scintigraphy) increased in this group (0.60 +/- 0.11 [mean +/- standard deviation] before pacing to 0.67 +/- 0.13 at peak-pacing, p = 0.002). In no patient did left ventricular end-diastolic pressure increase by greater than 5 mm Hg. No patient had lactate production, and 2 (20%) had electrocardiographic S-T segment depression greater than or equal to 0.1 mV. Four (40%) had chest pain with atrial pacing. In the remaining 18 patients with CAD, atrial pacing caused a decrease in LVEF greater than or equal to 0.05 (0.46 +/- 0.10 to 0.33 +/- 0.09, p less than 0.001) and new segmental wall motion abnormalities in all, indicating pacing-induced myocardial ischemia. Only 8 (44%) had an increase in left ventricular end-diastolic pressure of greater than 5 mm Hg, and only 9 (50%) had lactate production. Ten (56%) had ischemic electrocardiographic changes, and 12 (67%) had chest pain. Thus, the electrocardiographic, metabolic, and hemodynamic alterations that may accompany pacing-induced ischemia are specific but relatively insensitive markers of ischemia. In contrast, chest pain during atrial pacing is a nonspecific occurrence, appearing with similar frequency in normal subjects and patients with CAD and pacing-induced ischemia. PMID- 6858864 TI - Prolonged angina pectoris and persistent negative T waves in the precordial leads: response to atrial pacing and to methoxamine-induced hypertension. AB - In 18 consecutive patients without a history of myocardial infarction (MI), prolonged angina pectoris with persistent negative T waves in the precordial leads was associated with a high frequency of in-hospital spontaneous angina (14 of 18, 78%), usually accompanied by S-T segment elevation, and occasionally in hospital MI (4 of 18, 22%). Angina and MI always involved the electrocardiographic leads with negative T waves. Coronary arteriography, performed in 16 patients, revealed greater than or equal to 90% proximal diameter reduction of the left anterior descending (LAD) coronary artery in 14 patients. No patient had severe narrowing of all 3 major coronary arteries, but the 3 who had 100% LAD occlusion lacked collateral circulation. The ejection fraction was greater than or equal to 50% in 13 patients. Atrial pacing performed in 11 patients at an average rate of 142 beats/min produced a 1.0 mm S-T segment change in only 5 patients (45%), 3 of whom had an associated lactate production. Arterial systemic hypertension induced by methoxamine in 14 patients caused reversal of negative T waves without significant S-T segment shifts or chest pain and failed to elicit lactate extraction abnormalities in each of the 5 patients in whom it was determined. Thus, prolonged angina with persistent negative T waves in the precordial leads is almost invariably associated with a critical and proximal LAD obstruction, severe narrowing of 1 or 2 coronary arteries, and poor or absent collateral vessels. The relatively preserved coronary reserve in 55% of our patients suggests that negative T waves do not represent active myocardial ischemia. The study also suggests that transient "positivization" of the negative T waves may not necessarily relate to myocardial ischemia when associated with acute systemic hypertension. PMID- 6858865 TI - Clinical evaluation of the internal automatic cardioverter-defibrillator in survivors of sudden cardiac death. AB - An R-wave synchronous implantable automatic cardioverter-defibrillator (IACD) was evaluated in 12 patients with repeated episodes of cardiac arrest who remained refractory to medical and surgical therapy. Seven men and 5 women, average age 61 years, surgically received a complete IACD system. Coronary artery disease was found in 11 and the prolonged Q-T syndrome in 1. The average ejection fraction was 34%, and 6 patients had severe congestive heart failure (New York Heart Association class III or IV). The IACD is a completely implantable unit consisting of 2 bipolar lead systems. One system uses a lead in the superior vena cava and on the left ventricular apex through which the cardioverting pulse is delivered. The second system employs a close bipolar lead implanted in the ventricle for sensing rate. After the onset of ventricular tachycardia or fibrillation, the IACD automatically delivers approximately 25 J. Postoperative electrophysiologic study in 10 and spontaneous ventricular tachycardia in 1 patient demonstrated appropriate IACD function and successful conversion in all with an average of 18 +/- 4 seconds. The induced arrhythmias were ventricular tachycardia (160 to 300 beats/min) in 9 and ventricular fibrillation in 1. These data demonstrate that ventricular tachycardia, not ventricular fibrillation, was the predominant rhythm induced during programmed ventricular stimulation in these survivors of cardiac arrest and that the IACD effectively responded to a wide range of ventricular tachycardia rates as well as ventricular fibrillation. Use of the IACD offers an effective means of therapy for some patients who otherwise may not have survived. PMID- 6858866 TI - Efficacy of verapamil in chronic, recurrent ventricular tachycardia. AB - Verapamil, 0.25 mg/kg, was given to 24 patients with chronic, recurrent ventricular tachycardia (VT) whose clinical tachyarrhythmias were reproduced at electrophysiologic study. Seven patients (29%) responded acutely to verapamil: VT was not inducible in 5 and spontaneously terminated within 5 seconds of induction in 2 patients in whom it was previously sustained. Four of the 7 responders had no identifiable structural heart disease, and 3 had coronary artery disease. Responders were younger and had better left ventricular function than did nonresponders. Long-term therapy with verapamil, attempted in 5 of the 7 responders, was effective in 3, ineffective in 1, and of uncertain efficacy in 1. Verapamil therapy was discontinued because of worsened congestive heart failure in 2 patients. The short-term efficacy of verapamil in these patients compares favorably with the efficacy of other antiarrhythmic agents against VT induction in patients with long-term, recurrent, drug-refractory VT. The short-term efficacy of verapamil correlated with its long-term efficacy. These observations provide preliminary evidence that verapamil may be useful in the treatment of some patients with recurrent VT. When standard drugs are not effective, verapamil should be given a trial, especially in young patients with good left ventricular function. PMID- 6858867 TI - Electrophysiologic effects of lorcainide on the accessory pathway in the Wolff Parkinson-White syndrome. AB - The electrophysiologic effects of lorcainide, a class I antiarrhythmic agent with local anesthetic properties, were studied in 20 patients with the Wolff-Parkinson White syndrome. After intravenous administration of lorcainide (2 mg/kg), the sinus cycle length decreased in all patients from 705 +/- 117 to 636 +/- 94 ms (p less than 0.001). The atrioventricular conduction time lengthened from 84 +/- 22 to 94 +/- 22 ms (p less than 0.01) and the QRS duration increased from 92 +/- 19 to 120 +/- 29 ms (p less than 0.001). The effective refractory period of the atrium increased from 230 +/- 27 to 243 +/- 35 ms (p less than 0.05), whereas the ventricular refractoriness was unaffected. Retrograde conduction over the accessory pathway was blocked in 5 of 18 patients after lorcainide; in the remaining 13 patients a prolongation from 107 +/- 32 to 162 +/- 57 ms (p less than 0.001) was found. Anterograde conduction over the accessory pathway was blocked in 6 patients, and in all other patients it increased considerably. Circus movement tachycardia could be induced in 14 patients before and in 10 patients after the drug. The shortest R-R interval during tachycardia lengthened from 326 +/- 40 to 364 +/- 67 ms (p less than 0.05). The tachycardia zone was unaffected by lorcainide. In 15 patients atrial fibrillation was induced. After lorcainide anterograde conduction during atrial fibrillation was blocked (n = 5). The shortest R-R interval over the accessory pathway during induced atrial fibrillation increased from 228 +/- 35 to 304 +/- 103 ms (p less than 0.05). Intravenous administration of lorcainide produced a pronounced negative dromotropic effect on the conduction properties of the accessory pathway. Lorcainide appears to be a promising new antiarrhythmic agent in patients with the Wolff-Parkinson-White syndrome. PMID- 6858869 TI - Long-term recording of monophasic action potentials from human endocardium. AB - In 36 patients undergoing routine cardiac catheterization, a new "contact electrode" catheter technique was used to record monophasic action potentials (MAPs) from right atrial and right and left ventricular endocardial sites without the application of suction. Although of smaller amplitude, typically ranging from 15 to 40 mV, and of different reversal ratio (33 +/- 3%), MAP recordings closely resembled transmembrane action potentials in configuration and duration. Continuous MAP recordings of stable amplitude and, during regular pacing, of constant duration (+/- 1% at 90% repolarization) could be made from the same endocardial site for test periods of 1 hour (n = 4), permitting direct evaluation of the effect of cycle length alterations on local myocardial repolarization. A linear relation was found between MAP duration and basic cycle length varying from 350 to 700 ms. These rate-dependent changes in MAP duration were caused by a change in the slow phase of repolarization (phase 2), whereas the slope of rapid repolarization (phase 3) was unaltered. Single premature MAPs or MAPs after a pause showed changes in both phases. No MAPs could be recorded in areas of infarcted, aneurysmal myocardium, indicating that local viable myocardium is a prerequisite for the generation of the monophasic signal. Thus, in human subjects this catheter permits safe, long-term recording of MAPs which, although of smaller amplitude than transmembrane action potentials, bear appropriate and predictable phase relations. Such recordings may be useful in evaluating changes in local myocardial electrical activity induced by pacing or resulting from myocardial disease, or both. PMID- 6858868 TI - Electrophysiologic testing in the management of patients with the Wolff-Parkinson White syndrome and atrial fibrillation. AB - Twenty patients with the Wolff-Parkinson-White (WPW) syndrome and 1 or more episodes of symptomatic atrial fibrillation (AF) due to rapid anterograde bypass tract conduction underwent electrophysiologic testing. The mean ventricular rate during spontaneous AF was 242 +/- 56 beats/min (+/- standard deviation) and the shortest preexcited R-R interval was 194 +/- 40 ms. Six patients underwent surgical bypass tract ablation and 14 were treated medically, based on the results of electropharmacologic testing. Over a mean follow-up period of 35 +/- 19 months (+/- standard deviation), only 1 patient treated medically had a recurrence of minimally symptomatic AF. The successful chemoprophylaxis of symptomatic AF was associated with the inability to induce AF and atrioventricular reciprocating tachycardia during drug testing (7 patients) or with the induction of AF with a ventricular rate less than 200 beats/min and a shortest preexcited R-R interval of greater than 250 ms (7 patients). Electrophysiologic testing can identify a subgroup of patients with WPW and AF in whom medical therapy is a suitable alternative to bypass tract ablation. PMID- 6858870 TI - Conduction disturbances related to the site and severity of mitral anular calcification: a 2-dimensional echocardiographic and electrocardiographic correlative study. AB - To investigate an apparent association of mitral anular calcium (MAC) and electrocardiographic abnormalities, the relation between location of 2 dimensional (2-D) echo-quantified MAC and conduction disturbances was studied in 140 patients with MAC (MAC group) and in 135 age- and sex-matched patients without MAC (control group). The MAC group was subclassified regarding site and severity of calcium in the mitral anulus. The site of MAC was defined as Type I, near the primary conduction system--MAC located in the medial segment and/or extending to the anterior mitral leaflet; and Type II--MAC located at the central and/or lateral segments away from the primary conduction system. The severity of MAC was graded on 2-D echocardiography as mild (localized within 1 segment) and moderate to severe (greater than 1 segment). Seven patients with MAC, and only 1 control subject, had pacemakers in place. Conduction disturbances were present in 44 (31%) of 140 patients with MAC, and in 37 (27%) of 135 control patients (difference not significant). But there were more conduction disturbances in patients with Type I MAC (53%) than in those with Type II MAC (26%) (p less than 0.01). Specifically, complete left bundle branch block and intraventricular conduction delay were more prevalent when MAC was near the conduction system. Conduction disturbances also were more prevalent in patients with Type I MAC than in the control group: intraventricular conduction delay (Type I, 12% versus control, 4%; p less than 0.05) and total conduction disturbances (53 versus 28%; p less than 0.01). These data suggest that moderate to severe degrees of MAC located near the conduction system are associated with conduction disturbances, especially intraventricular conduction delay. PMID- 6858871 TI - Analysis of surgical versus medical therapy in active complicated native valve infective endocarditis. AB - From 1972 to 1980, 23 patients (Group A) with native valve infective endocarditis underwent surgical intervention, often for multiple indications, during the active stage of the infective process because of progressive class III and IV (New York Heart Association) heart failure (12 patients), persistent severe hypotension (3 patients), uncontrolled infection for over 21 days (11 patients), aortic root abscess (2 patients), and pericarditis (1 patient). Eighty-five patients (Group B) with active native valve endocarditis, matched for severity of illness, were treated medically. Two patients (9%) in Group A and 43 patients (51%) in Group B died during the hospital admission (p less than 0.001). Any difference in long-term cumulative survival rate between the 2 groups was largely due to the beneficial impact of surgical management on the hospital mortality. Of 23 patients in Group A, 11 (48%) had an entirely uncomplicated postoperative course. Long-term mortality rates in those with aortic valve endocarditis treated medically (79%) were significantly higher than in those with mitral valve involvement (47%) (p less than 0.05). Patients with aortic valve involvement treated surgically had a better hospital (p less than 0.005) and long-term (p less than 0.0005) survival rate than those treated medically. Two groups at risk for postoperative complications were identified; 3 of 11 patients (27%) with uncontrolled infection had an early postoperative recurrence, and 4 of 7 patients (57%) with an aortic root abscess had postoperative prosthetic paravalvular regurgitation. Surgery therefore effects a substantial reduction in hospital mortality in patients with complicated active infective endocarditis (9% versus 51%), but patients with preoperative prolonged periods of uncontrolled infection or with aortic root abscess are liable to postoperative complications. PMID- 6858872 TI - Coronary dilatory capacity in idiopathic dilated cardiomyopathy: analysis of 16 patients. AB - Hemodynamic function and overall coronary blood flow (argon technique) were measured in 16 patients with idiopathic dilated cardiomyopathy (IDC) and in 12 patients without detectable heart disease (control subjects) referred for precordial pain. In patients with IDC, coronary blood flow was normal at rest (78 +/- 17 ml/100 g-min versus 78 +/- 9 in control subjects). During maximal inducible coronary vasodilation (dipyridamole, 0.5 mg/kg), coronary blood flow was significantly reduced (142 +/- 38 ml/100 g.min versus 301 +/- 64 in control subjects; p less than 0.001). Consequently, obtainable minimal coronary resistance was increased in IDC (0.54 +/- 0.20 mm Hg/ml/100 g.min versus 0.23 +/- 0.04 in control subjects; p less than 0.001). In patients with IDC, left ventricular (LV) end-diastolic pressure was significantly increased (19 +/- 11 mm Hg versus 6 +/- 3 in control subjects; p less than 0.005), and the LV ejection fraction was diminished (36 +/- 11% versus 72 +/- 3% in control subjects; p less than 0.001). In patients with IDC, LV end-diastolic pressure correlated significantly with the obtained minimal coronary resistance after application of dipyridamole (r = 0.85; p less than 0.001). LV catheter biopsy specimens revealed no alterations in myocardial microvasculature. Thus, coronary dilatory capacity is impaired in patients with IDC, due partially to an increase in extravascular component of coronary resistance. PMID- 6858873 TI - Prevalence and significance of an abnormal S-T segment response to exercise in a young athletic population. AB - Treadmill stress electrocardiography is employed widely to detect underlying cardiovascular disease in asymptomatic persons. To determine the frequency and significance of an abnormal S-T segment response to exercise in young athletes with increased left ventricular (LV) mass induced by physical conditioning, 75 male isometrically trained athletes without evidence of heart disease (mean age 21 years) and 48 nonathletic young normal subjects were studied by M-mode echocardiography and exercise electrocardiography. Ventricular septal and posterior free wall thicknesses and calculated LV mass were significantly greater in athletes than in control subjects. An abnormal S-T segment response to exercise was present in 7 (9%) of the 75 athletes, all of whom had a LV mass greater than 275 g and in 5 the LV mass was above the 95th percentile of that of the control subjects. An abnormal treadmill exercise test result also was present in 3 (6%) of 48 control subjects. Seven of the 10 subjects with abnormal exercise test results had radionuclide angiograms at rest and with exercise, each of which was normal. It is concluded, therefore, that (1) abnormal exercise test results occur commonly in both athletes and non-athletes; (2) almost 10% of isometrically trained athletes have "false-positive" exercise electrocardiograms, suggesting that this test has major limitations in screening for underlying cardiovascular disease in athletes; and (3) in athletes, a relation was present between "physiologically" increased LV mass and false-positive exercise test results. PMID- 6858874 TI - Heterogeneity of left ventricular segmental wall thickening and excursion in 2 dimensional echocardiograms of normal human subjects. PMID- 6858875 TI - Cardiac disease after radiation therapy for Hodgkin's disease: analysis of 48 patients. AB - Occult or overt but delayed cardiac disease after thoracic radiotherapy for Hodgkin's disease may be common. Detailed cardiac evaluations were performed in 48 patients with Hodgkin's disease at risk a mean of 97 months after radiotherapy. The study protocol included echocardiography, gated radionuclide ventriculography, and cardiac catheterization. Cardiac disease was found in 46 patients (96%) and included constrictive or occult constrictive pericarditis (24 patients), an abnormal hemodynamic response to a fluid challenge (14 patients), coronary artery disease (6 patients), and left ventricular dysfunction (2 patients). Most patients (53%) had normal echocardiograms. Gated blood pool radionuclide angiocardiography was performed in 42 patients. Excluding patients with occlusive coronary artery disease, the left ventricular ejection fraction at rest (mean 59%) and during exercise (mean 69%) was within normal limits. Congestive heart failure occurred in 2 patients. Six patients had pericardiectomy for constrictive pericarditis and 3 patients had coronary artery bypass surgery for coronary artery disease. Thus (1) delayed cardiac disease after radiotherapy is common, (2) chronic pericardial disorders are the most frequent manifestations of this disease, and (3) the prognosis for patients who have radiation-induced cardiac disease is generally favorable. PMID- 6858876 TI - Reoperation for isthmic coarctation of the aorta: follow-up of 26 patients. AB - Twenty-six patients underwent reoperation for coarctation of the aorta (C of A) between 1972 and 1980. Most patients (73%) had undergone primary repair in infancy. The interval to reoperation was 5 months to 18 years (mean 8.2 years). Indications for reoperation included symptoms in 4, exercise systemic hypertension in 1, electrocardiographic changes of left ventricular strain in 1, arm hypertension in 21, and a C of A gradient at rest greater than 30 mm Hg in all. Surgical procedures included patch aortoplasty (16 patients), bypass graft (6 patients), left subclavian angioplasty (3 patients), and end-to-end anastomosis (1 patient). There were no operative complications or mortality. There was 1 late death from aortic valve disease. Duration of follow-up in the remaining 25 patients was 2 weeks to 7 years (mean 2.5 years). All patients are asymptomatic. C of A gradients were significantly reduced from 30 to 132 mm Hg (mean 56) preoperatively to 0 to 48 mm Hg (mean 15) postoperatively. Right arm systolic blood pressure also was significantly improved from 120 to 237 mm Hg (mean 153) preoperatively to 100 to 160 mm Hg (mean 124) postoperatively. Systemic systolic hypertension persisted in 5 of 25 (20%). It is concluded that C of A reoperation is a low risk procedure that improves symptoms and reduces C of A gradient and arm blood pressure. However, systolic hypertension does not always resolve postoperatively. Patch aortoplasty appears to be a safe and effective surgical approach. PMID- 6858877 TI - Subxyphoid 2-dimensional echocardiographic identification of left ventricular papillary muscle anomalies in complete common atrioventricular canal. AB - Mitral valve dysfunction is probably the major cause of operative mortality from total repair of complete common atrioventricular (AV) canal in infancy. The presence of a solitary left ventricular (LV) papillary muscle appears to be 1 anatomic factor influencing the success of mitral reconstruction because suturing of the cleft between the superior and inferior components of the anterior mitral leaflet creates a parachute mitral valve deformity, which may result in stenosis or in unduly high tension on the components of the repair. This study reports on (1) the 2-dimensional (2-D) echocardiographic appearance of the LV papillary muscle architecture in patients with complete common AV canal compared with that in normal subjects, and (2) the incidence of solitary LV papillary muscle in patients with complete common AV canal. Two-dimensional echocardiography was performed in 31 infants with complete common AV canal, 14 normal infants, and 9 infants with a large ventricular septal defect not involving the AV canal region. Of 31 infants with complete common AV canal, 26 (80%) had 2 LV papillary muscles on 2-D echocardiography, 3 (10%) had 3 LV papillary muscles, and 3 (10%) had 1 LV papillary muscle. In patients with 2 LV papillary muscles, the anterolateral papillary muscle was displaced posteriorly compared with that in normal subjects and in patients with ventricular septal defect, whereas the posteromedial papillary muscle was in its normal location. Among the 25 patients with complete common AV canal with 2 LV papillary muscles, there was 1 operative death. Among the 6 infants with complete common AV canal with LV papillary muscle anomalies, 5 underwent surgical repair with 4 early deaths. Subxyphoid 2-D echocardiography is a useful technique for evaluating LV papillary muscle architecture in complete common AV canal and permits identification of patients who may be at higher risk for unsuccessful mitral reconstruction. PMID- 6858878 TI - Anatomic obstruction of the right ventricular outflow tract in transposition of the great arteries. AB - In 126 hearts with transposition of the great arteries (TGA), morphologic features of the right ventricular (RV) outflow tract were analyzed. Distinct anatomic outflow tract obstruction was found in 15 of the 55 hearts with a ventricular septal defect (VSD) (27%): 12 had a perimembranous defect (predominantly extending into the infundibulum), 2 had an inlet, and 1 had an infundibular defect. In 12 hearts, outflow tract obstruction was caused by anterior displacement of infundibular septum and ventriculoinfundibular fold; in 3 hearts, it was caused by bulging of the trabecula septomarginalis or ventriculoinfundibular fold, or both. Of 71 hearts with an intact ventricular septum, only 2 (3%) had RV outflow tract obstruction: 1 had a trabecula in front of the aortic ostium and in the other an aberrant hypertrophic muscle bundle crossed the RV cavity, obstructing the entrance to the infundibulum. Associated malformations included aortic arch malformations (6 cases) and tricuspid valve anomalies (6 cases). Thus, anatomic RV outflow tract obstruction may constitute a complicating factor in TGA, notably in cases with VSD. A systemic RV blood pressure may trigger hypertrophy, resulting in progression of the obstruction; establishing normal RV pressure by a "switch" procedure might prevent this progression. PMID- 6858879 TI - Quantitative angiographic and morphologic aspects of aortic valve atresia. AB - Quantitative angiographic measurements were performed in 15 infants aged 1 to 35 days who had aortic valve atresia with intact ventricular septum and hypoplastic left ventricle. Thirteen infants had similar measurements performed at autopsy. The latter measurements were smaller than those found at angiography (because of shrinkage), but their relationship was predictable. Angiographic right ventricular (RV) volumes were 2 and 4 times normal in diastole and systole, respectively. The RV volume measured at autopsy was greater than 3 times normal. Mean RV ejection fraction was 0.40; it was below normal in 10 infants. Maximal right atrial volume was greater than 2 times normal, and mean left atrial maximal volume was two-thirds normal. The relation between circumferences of the aortic arch and ascending and descending aorta was similar at angiography and autopsy. PMID- 6858880 TI - Diagnostic accuracy of indium-111 platelet scintigraphy in identifying left ventricular thrombi. AB - This study defines the optimum imaging time window after injection of labeled platelet suspension for detection on left ventricular (LV) thrombi, identifies the most useful imaging views, and determines the reproducibility of this technique. A total of 662 images obtained from 64 patients were analyzed retrospectively on 2 separate occasions by 3 observers blinded as to patient identity, view (right anterior oblique, anterior, left anterior oblique, and left lateral), and time after injection of the platelet suspension that the images were obtained (0 to 2, 3 to 4, and 5 to 6 days). Images were categorized as either positive or negative. In every case surgical or autopsy verification of the presence or absence of LV thrombus was possible. The best combination of sensitivity, specificity, and diagnostic accuracy was found in the 3- to 4-day period in the left anterior oblique view and was 54 +/- 5% (mean +/- standard deviation), 98 +/- 1%, and 85 +/- 2%, respectively. Sensitivity, specificity, and diagnostic accuracy were not enhanced by adding additional views (right anterior oblique, left lateral, and anterior) to the left anterior oblique view in the 3- to 4-day time period. However, using multiple views, localization of thrombi to the left ventricle was facilitated. In a second retrospective analysis, a comparison of day 0 with day 3 to 4 images enhanced sensitivity and accuracy to 65 (p less than 0.001) and 90% (not significant), respectively. Specificity was unchanged at 99%. Mean intra- and interobserver agreement was 91 and 88%, respectively. Thus, (1) indium-111 platelet scintigraphy is a reproducible and specific technique for identifying LV thrombus, and (2) we advise imaging on day 0 and again 3 to 4 days after injection of the platelet suspension in right anterior oblique, left anterior oblique, left lateral, and anterior views to maximize accuracy and to facilitate localization of LV thrombus. PMID- 6858881 TI - Tissue digoxin concentrations during the quinidine-digoxin interaction. PMID- 6858882 TI - Effect of atrial fibrillation on atrial blood flow in conscious dogs. AB - This study was undertaken to examine the independent effects of atrial tachycardia, ventricular tachycardia, and atrial fibrillation (AF) on atrial and ventricular blood flow in conscious, heart-blocked dogs using radioactive microspheres. Atrial blood flow averaged 0.54 +/- 0.08 ml/min/g during the control period at an atrial rate of 124 beats/min and a ventricular rate of 90 beats/min. Atrial flow increased to 0.72 +/- 0.12 ml/min/g during atrial pacing at 236 beats/min, but was not significantly altered by ventricular pacing at 200 beats/min. AF at a ventricular rate of 90 beats/min resulted in atrial flow values of 0.91 +/- 0.08 ml/min/g. The ratio of atrial flow to left ventricular flow during AF averaged 1.18 +/- 0.08. Administration of a maximal vasodilating dose of adenosine during AF further increased atrial flow to 2.18 +/- 0.16 ml/min/g. Atrial tachycardia or AF did not significantly affect ventricular blood flow. These data indicate (1) that atrial blood flow increases significantly during AF, reaching flow values per gram of tissue comparable to those of the left ventricle, and (2) that this flow is regulated by the metabolic needs of the atrial tissue and does not represent maximal vasodilation. PMID- 6858883 TI - Quantitative detection of regional left ventricular contraction abnormalities by 2-dimensional echocardiography. Comparison of myocardial thickening and thinning and endocardial motion in a canine model. AB - Myocardial infarction (MI) was produced in 27 dogs by ligation of the left anterior descending coronary artery. Two-dimensional (2-D) echocardiograms were performed through the closed chest before and serially after coronary ligation, in both the acute and healing stages of MI. Two-dimensional echocardiographic studies performed before the animals were killed were analyzed for left ventricular (LV) contraction defects by 2 algorithms--1 involving systolic myocardial thickening and thinning and the other by determining the extent of endocardial motion to derive cavity area shrinkage. Using the thickening algorithm, myocardial dysfunction was detected in 93% of the animals with MI; with the area shrinkage method, contraction abnormalities were detected in 96% of the animals with MI. When the heart was divided from base to apex into 3 short axis sections, the thickening algorithm showed a trend toward better identification of normal regions than the area shrinkage algorithm. However, in predicting the circumferential extent of MI, the thickening-thinning method of analysis showed no advantage over the endocardial motion method (r = 0.77, standard error of the estimate = 0.16 versus r = 0.76, standard error of the estimate [SEE] = 0.16; p = not significant [NS]). These observations support the concept that either algorithm can be used effectively to detect the presence and quantify the circumferential extent of MI. PMID- 6858884 TI - Pharmacologically induced changes in wall thickening dynamics and mid-ventricular volumes in dogs assessed by prospectively gated computed tomography. PMID- 6858885 TI - End-systolic dimension-wall thickness relations during myocardial ischemia in conscious dogs. A new approach for defining regional function. AB - Overall and regional left ventricular (LV) function was studied during progressive coronary stenosis in conscious dogs by determining the relations at end-systole between LV pressure, chamber dimensions, and regional LV wall thickness. An index of regional wall stress was also analyzed. Using ultrasonic dimension gauges, measurements were made of LV wall thickness in control and ischemic regions, and the external long- and short-axis LV diameters were determined; an implanted micromanometer measured LV pressure. Internal LV diameters were obtained from the external diameters by subtraction of wall thickness, and the index of regional wall stress employed a thick-walled ellipsoidal model. During regional ischemia, the LV long axis at end-systole did not change, whereas the short-axis diameter progressively increased (from 24 +/- 7 mm [standard deviation] to 30 +/- 9 mm, p less than 0.001, indicating a more spherical LV shape during ischemia). The end-systolic pressure did not change, and therefore the end-systolic pressure-diameter relation shifted progressively, suggesting a global decrease in LV contactility. The end-systolic points relating LV wall thickness in the ischemic region to the end-systolic LV pressure revealed the regional nature of the abnormality, showing a progressive displacement to the left, whereas there was no significant displacement of this relation in the control region. The application of this index over a range of loading conditions during partial vena caval occlusion was illustrated. Thus, the regional end systolic wall thickness-pressure relation provides a new index for defining the regional contractile state of the LV myocardium which is potentially load independent and offers the possibility for echocardiographic application. PMID- 6858886 TI - Sympathetic denervation limited to a region of acutely ischemic canine myocardium increases excitability threshold and duration of bipolar electrograms. AB - This study determines the direct effects of sympathetic denervation on excitability threshold and bipolar electrograms in acutely ischemic myocardium. Regional denervation was performed by application of phenol to the epicardium surrounding the ischemic zone in order to eliminate the possible hemodynamic effects that global cardiac denervation may exert on the ischemic zone. Data were obtained during serial occlusions (less than or equal to 6 minutes in duration) of left anterior coronary artery in open-chest dogs with sympathetic denervation performed before the last occlusion. Late diastolic threshold was measured every 5 seconds by a constant voltage pacemaker which automatically registered threshold in stimulus duration. During ischemia, regional denervation (n = 9) increased peak excitability threshold from 240 +/- 51 (standard error of the mean) to 552 +/- 182 mus (p less than 0.05) and prolonged electrographic duration in epicardium from 19 +/- 3 to 25 +/- 4 ms (p less than 0.025) and in endocardium from 20 +/- 3 to 25 +/- 4 ms (p less than 0.01). Phenol application did not alter aortic pressure, ischemic wall motion (sonomicrometer technique), or ischemic zone blood flow (microsphere technique). Thus, acute sympathetic denervation when limited to ischemic myocardium increases the peak excitability threshold and concomitantly prolongs duration of bipolar electrograms. PMID- 6858887 TI - Transvenous ablation of the atrioventricular conduction system in dogs: electrophysiologic and histologic observations. AB - The correlation of histologic and electrophysiologic findings in dogs undergoing transvenous ablation of atrioventricular (AV) conduction has not been described. The creation of complete AV block in 10 dogs was attempted by delivering a direct current shock transvenously through a standard tripolar electrode catheter. The catheter was positioned to record the largest unipolar atrial and His bundle electrograms. A 280 J shock was delivered to the recording electrode by a standard cardioversion unit. After 1 shock, all dogs were in complete AV block refractory to isoproterenol (1 to 4 micrograms/min) and atropine (0.5 to 2.0 mg). Four weeks later, 5 dogs remained in complete AV block, 1 had first-degree block, and 4 had resumed normal AV conduction. Each dog with complete heart block had histologic evidence of severe damage to the AV node, His bundle, or both. On gross examination, these dogs were found to have discrete scars at the base of the septal leaflet of the tricuspid valve. Of the 5 dogs that had resumption of AV conduction, only 1 had histologic evidence of significant damage to the AV conduction system. That animal manifested a marked increase in the P-R interval (100 to 210 ms). Although temporary heart block occurred in each animal, chronic interruption of AV conduction was more difficult. Catheter location, atrial and His bundle electrogram relations, and the electrode used for delivery of energy were factors determining the effectiveness of this technique. PMID- 6858888 TI - Myocardial reperfusion after acute occlusion of the left main coronary artery. PMID- 6858889 TI - Prinzmetal's variant angina unresponsive to calcium channel-blocking drugs but responsive to combined calcium channel- and beta-blocking drugs. PMID- 6858892 TI - Noninvasive diagnosis of interrupted inferior vena cava: gated pulsed Doppler application. PMID- 6858890 TI - Cysts in left atrial myxomas identified by transesophageal cross-sectional echocardiography. PMID- 6858891 TI - Structural changes in ventriculoaortic porcine valved conduit implanted in a child. PMID- 6858893 TI - Congenital absence of pulmonary valve associated with tetralogy of Fallot: diagnosis by 2-dimensional echocardiography. PMID- 6858894 TI - False aneurysm of mitral-aortic intervalvular fibrosa: diagnosis by 2-dimensional contrast echocardiography at cardiac catheterization. PMID- 6858895 TI - Platypnea and interatrial right-to-left shunting after lobectomy. PMID- 6858896 TI - Compression of the superior vena cava and right atrium in cardiac tamponade. PMID- 6858897 TI - Familial aggregation of coronary heart disease and its relation to known genetic risk factors. PMID- 6858898 TI - Cardiovascular effects of breathing 95 percent oxygen in children with congenital heart disease. AB - The hemodynamic effects of breathing 95% oxygen were evaluated in 26 children with congenital heart disease. Aortic, pulmonary arterial, right atrial, and pulmonary arterial wedge pressure, aortic and pulmonary artery oxygen saturation, and blood gas, cardiac index, and heart rate were measured in room air and after each patient had breathed 95% oxygen for 10 (n = 26) and 20 (n = 5) minutes. Measurements were repeated with the patient again breathing room air for 10 (n = 11) and 20 (n = 6) minutes. After 10 minutes of 95% oxygen, arterial partial pressure of oxygen increased from 85 +/- 13 to 420 +/- 89 torr (p less than 0.001). Aortic mean pressure increased from 80 +/- 10 to 83 +/- 10 mm Hg (p less than 0.01), and systemic vascular resistance increased from 20 +/- 7 to 26 +/- 8 U (p less than 0.001). The cardiac index decreased by 21% from 3.96 +/- 0.94 to 3.12 +/- 0.74 liters/min/m2 (p less than 0.001) and the stroke index decreased by 11% (p less than 0.001). A 23% decrease in oxygen consumption (p less than 0.001) was observed, and oxygen transport decreased from 763 +/- 179 to 600 +/- 161 ml O2/min/m2 (p less than 0.001). Cardiac index, stroke index, and systemic vascular resistance did not return to normal until 20 minutes after cessation of oxygen breathing. To determine whether reflex bradycardia is responsible for these oxygen-induced hemodynamic changes, heart rate was kept constant by atrial pacing in a second group of 5 patients. In these children, significant decreases in cardiac index, stroke index, and oxygen consumption, and increases in systemic vascular resistance also occurred with 95% oxygen. Thus, in children with acyanotic congenital heart disease, hyperoxia increases aortic pressure and systemic vascular resistance and decreases cardiac index, stroke index, oxygen consumption, and oxygen transport. PMID- 6858900 TI - Two-dimensional echocardiographic assessment of caval and pulmonary venous pathways after the senning operation. AB - This study reports the 2-dimensional echocardiographic appearance of the caval and pulmonary venous pathways after the Senning procedure in 28 patients and establishes normal values for the caval and pulmonary venous pathway dimensions. Eighteen patients had no caval or pulmonary venous obstruction or tricuspid regurgitation at catheterization; 2 had isolated superior vena caval obstruction, 3 had isolated pulmonary venous obstruction, 4 patients had severe tricuspid regurgitation, and 1 had a large residual ventricular septal defect. The caval and pulmonary venous pathways were imaged in modified 4-chamber and transverse views, and the narrowest dimension of each pathway in each view was measured by 2 independent observers. Dimension measurements were then normalized to the cube root of body surface area. Caval and pulmonary venous pathway "dimension products" were obtained by multiplying the normalized dimension in the 4-chamber view by the normalized dimension in the transverse view. All patients with catheterization-proven caval or pulmonary venous obstruction or tricuspid regurgitation had caval or pulmonary venous pathway dimension products outside the normal range, defined by our measurements in the 18 patients with no caval or pulmonary venous obstruction or tricuspid regurgitation. Thus, 2-dimensional echocardiography can provide both quantitative and qualitative information about the caval and pulmonary venous pathways after the Senning procedure. PMID- 6858899 TI - Altered baroreceptor function in children with systolic hypertension after coarctation repair. AB - To determine whether altered baroreceptor function may contribute to systemic hypertension after coarctation of the aorta (C of A) repair, baroreceptor function was evaluated in 6 children with repaired C of A mild arm systolic hypertension. Data were compared with those from 7 normotensive control children with hemodynamically mild heart disease. Age at C of A repair averaged 9.9 +/- 3.1 years (mean +/- standard deviation [SD]). Arm systolic pressure was 143.8 +/- 2.9 mm Hg in the C of A repair group, compared with 118.3 +/- 9.9 for control subjects (p less than 0.001). At catheterization, steady-state sigmoidal baroreceptor function curves relating mean arterial pressure to R-R interval were derived by increasing and decreasing mean arterial pressure with small injections of phenylephrine and nitroprusside. Compared with control subjects, the baroreceptor function curves of children with repaired C of A (1) are reset about a higher baseline mean arterial pressure (108.8 +/- 6.6 versus 90.3 +/- 8.6 mm Hg, p less than 0.01), (2) have a decreased slope (7.9 +/- 3.7 versus 17.4 +/- 3.6 ms/mm Hg, p less than 0.001), and (3) have a diminished R-R interval range (246.7 +/- 81.5 versus 535.7 +/- 97.2 ms, p less than 0.001). Thus, in children with hypertension after C of A repair, the baroreflex is reset to an elevated mean arterial pressure level and has a diminished sensitivity to changes in arterial pressure. PMID- 6858901 TI - Cardiac amyloidosis causing cardiac dysfunction: analysis of 54 necropsy patients. PMID- 6858902 TI - Cardiac thrombosis and thromboembolism in chronic Chagas' heart disease. AB - A retrospective study of Chagas' heart disease was carried out by a review of 1,345 autopsy reports, with special reference to cardiac thrombus and thromboembolic phenomena. The incidence of cardiac thrombus was higher in cases of heart failure (36%) than in cases of sudden death (15%), higher in heavier hearts, and unrelated to age or sex. The left- and right-sided cardiac chambers were equally affected by thrombus. Endocarditis and blood stasis were considered important factors in the pathogenesis of cardiac thrombus. Thromboembolic phenomena were more common in the systemic circulation but caused relatively more deaths by pulmonary embolism. Fourteen percent of patients with thromboembolic phenomena died from them. Patients with multiple thromboembolic phenomena had a higher risk of death from embolism. Cardiac thrombosis or thromboembolic phenomena, or both, were present in 44% of the cases studied. Prophylactic measures should be taken for these important complications of Chagas' heart disease. PMID- 6858903 TI - Aortic valve closure and cardiac vibrations in the genesis of the second heart sound. AB - Simultaneous M-mode echocardiograms and external phonocardiograms were recorded in 15 healthy subjects to evaluate the genesis of the second heart sound. The onset of the second sound was found synchronous with the coaptation of the aortic valve cusps and a sharp vibration on the aortic wall. The closed valve was oscillating for 30 to 45 ms after the coaptation of the cusps. Magnified echocardiographic studies of the interventricular septum revealed a consistent, momentary quiver across the septal myocardium a mean of 4 ms after the onset of the second sound. In most subjects, a transient myocardial vibration was observed in temporal association with the first heart sound as well. The present observations suggest that the aortic valve closure initiates the production of the second heart sound, the main audible component resulting, however, from vibrations in the cardiac structures after the valve closure. PMID- 6858904 TI - Analysis of the amount of tricuspid valve anular dilatation required to produce functional tricuspid regurgitation. AB - To determine the critical anular dilatation required for functional tricuspid regurgitation (TR) and the role of systolic anular shortening in the severity of TR, 67 patients in whom right ventriculography had been performed were studied. These patients were classified into group I, control (n = 12), and the group II, patients with rheumatic valvular disease (n = 55). Group II patients were subclassified as follows: IIa, without TR (n = 19); IIb, with mild TR (n = 22); and IIc, with moderate to severe TR (n = 14). The angiographic maximal early systolic and minimal end-systolic diameters were measured. The shortening of the tricuspid anulus was expressed as percent reduction of the maximal diameter. The average maximal diameter (mm/m2) was: group I, 21 +/- 2; group IIa, 24 +/- 2; group IIb, 31 +/- 4; and group IIc, 37 +/- 4. The average minimal diameter (mm/m2) was: group I, 15 +/- 2; group IIa, 18 +/- 2; group IIb, 23 +/- 2; and group IIc, 31 +/- 3. The average percent shortening was: group I, 30 +/- 7%; group IIa, 25 +/- 7%; group IIb, 26 +/- 5%; and group IIc, 15 +/- 3%. The rheumatic patients had a larger maximal diameter than did those in the control group. Anular shortening was reduced only in the group with moderate to severe TR and preserved in the other groups, including those with mild TR. The critical diameter was determined to be between the maximal diameter in the rheumatic patients without TR and the minimal diameter in the patients with moderate to severe TR, or 27 mm/m2. Thus this easily measured parameter can determine the presence and significance of functional TR, adding objectivity to the angiographic diagnosis of TR. PMID- 6858905 TI - Effect of pericardiocentesis on right and left ventricular function and volumes in pericardial effusion. AB - To assess the effects of pericardial effusion on ventricular performance and volumes, electrocardiographically gated blood pool cardiac scintigraphy was performed immediately before and after 14 pericardiocenteses in 10 patients, 7 men and 3 women, aged 28 to 73 years (mean 50). Cardiac tamponade was present in 5 patients. After removal of 140 to 1,100 ml of pericardial fluid (527 +/- 305 ml [mean +/- standard deviation]), left ventricular (LV) ejection fraction increased from 63 +/- 5 to 64 +/- 4% (p greater than 0.05) and right ventricular (RV) ejection fraction decreased from 47 +/- 4 to 46 +/- 2% (p greater than 0.05). LV end-diastolic and end-systolic volumes increased (p less than 0.01) by 28 and 33%, and RV volumes by 40 and 43%, respectively. There were 8 patients with normal LV function (ejection fraction greater than 60%) and 6 patients with subnormal LV function. Changes in ejection fraction were nonsignificant in the 4 subgroups. LV end-diastolic volume changes were more marked (p less than 0.01) in patients with cardiac tamponade (+ 56%) than in those without tamponade (+ 17%), and in those with normal LV function (+ 36%) than in those with subnormal LV function (+ 21%). RV end-diastolic volume increased more markedly (p less than 0.05) in patients with tamponade (+ 72%) than in those without tamponade (+ 23%), but were similar in patients with normal (+ 38%) and abnormal (+ 43%) LV function. After pericardiocentesis, RV volume increased more markedly than did LV volume. Thus, hemodynamic and clinical improvement after pericardiocentesis may be related only to an increase in stroke volume. RV and LV ejection fraction, a measure of myocardial contractility, was not affected significantly by the presence of pericardial effusion, even in those patients who had cardiac tamponade. PMID- 6858906 TI - Acute effects of phlebotomy on right ventricular size and performance in polycythemic patients with chronic obstructive pulmonary disease. AB - To assess the acute effects of phlebotomy on right ventricular size and performance, gated equilibrium radionuclide angiography was used to evaluate 10 patients with severe chronic obstructive pulmonary disease and erythrocytosis (hematocrit greater than 55%). The mean right ventricular ejection fraction was abnormal before (0.38) but not after (0.43) phlebotomy, and the increase was highly significant (p less than 0.001). Similarly, the right ventricular end diastolic area decreased significantly from 588 to 505 pixels (p less than 0.02). No significant changes occurred on the left side. Cardiac output was unchanged or slightly increased. Thus, assuming that afterload was unchanged, as reported by other investigators, the data herein are consistent with the hypothesis that a normalization in preload shifts the Starling curve, resulting in improved right ventricular performance with preservation of the cardiac output. PMID- 6858907 TI - Left ventricular performance during exercise: response of ear densitogram derivative. AB - The peak derivative of the ear densitogram (PD) has been shown to track left ventricular (LV) function during exercise. Measured as percent change in amplitude from resting control, PD in normal subjects slowly and consistently increased throughout exercise and to 2 minutes of recovery, followed by return to control level. In contrast, PD in patients with coronary artery disease rapidly increased only to 1 minute of exercise, with no significant subsequent increase. Expressed as a percent change from control, the response of normal subjects differs significantly from that of patients with coronary artery disease at 1 and 4 minutes of exercise, and 2 minutes of recovery. The PD increase in normal subjects from end-exercise to 2 minutes of recovery may be attributable to the heart rate decreasing faster than venous return, associated with LV ejection time, which is significantly shorter than heart rate-predicted values 2 minutes after exercise. PMID- 6858908 TI - Effect of cimetidine on the pharmacokinetics and pharmacodynamics of quinidine. AB - The influence of cimetidine (1.2 g/day for 7 days) on the disposition and pharmacodynamic effects of a single oral dose of quinidine was studied in 6 normal volunteers. Cimetidine reduced the mean apparent oral clearance of quinidine (+/- standard error of the mean) from 25.5 +/- 2.7 to 16.2 +/- 1.4 liters/h (p less than 0.05). This was reflected in a 55% (range 30 to 109) increase in the mean half-life from 5.8 +/- 0.2 to 9.0 +/- 0.6 hours (p less than 0.05). Peak quinidine plasma concentrations and times to peak were also increased (p less than 0.05). Plasma protein binding and urinary excretion of quinidine were unchanged by cimetidine treatment. Alterations in the pharmacokinetic variables of quinidine were mirrored in simultaneously measured electrocardiographic parameters. Changes in Q-T, rate-corrected Q-T, QRS, and R-R intervals after a single oral dose of quinidine sulfate (400 mg) were significant. Treatment with cimetidine potentiated these pharmacodynamic changes, but failed to achieve significant differences from quinidine alone. Thus, cimetidine impairs the elimination of oral quinidine in normal volunteers. This interaction may lead to quinidine toxicity in patients in whom cimetidine is concomitantly administered. PMID- 6858909 TI - Nuclear magnetic resonance imaging of acute myocardial infarction in dogs: alterations in magnetic relaxation times. AB - Nuclear magnetic resonance (NMR) imaging was used to study 24-hour-old acute myocardial infarctions in 8 dogs. Images and measurements of excised hearts were obtained in a 6.5 ml bore-resistive NMR imager (0.35 Tesla). Spin echo NMR imaging in each instance demonstrated the area of infarction as a region of increased signal intensity compared with that in normal myocardium. The T1 and T2 values of the area of infarction were greater than those of normal myocardium in all dogs. For each dog the T1 value was greater for the infarct region; however, the group mean value for T1 (ms) of the infarct region (728 +/- 94) was not significantly greater than that for the normal region (650 +/- 87). The T2 value (ms) was discriminate for all dogs, and the mean value for the infarct region (48 +/- 2) was significantly different (p less than 0.01) from the value for normal myocardium (42 +/- 1). The percent water content of the infarct (79 +/- 1%) was significantly greater (p less than 0.01) than that of normal regions (76 +/- 1%). The linear relationship between T2 value and percent water content showed a good correlation coefficient (r = 0.90; p less than 0.01). NMR imaging detects acute myocardial infarction as a positive image without contrast media. Increased signal intensity of the infarct is related to increased hydrogen density and increased T2 relaxation time. PMID- 6858910 TI - Effects of coronary occlusion on flow in the distribution of a neighboring stenotic coronary artery in the dog. PMID- 6858912 TI - Roles of the right ventricular free wall and ventricular septum in right ventricular performance and influence of the parietal pericardium during right ventricular failure in dogs. AB - The roles of the right ventricular (RV) free wall and ventricular septum in RV performance were studied in the canine heart. The parietal pericardium was kept intact. Acute ischemia of the RV free wall from right coronary ligation decreased the RV stroke work index more than did that of the ventricular septum from the septal branch of the left coronary artery ligation (41 and 23%, respectively, p less than 0.01). The response of the RV stroke work index to acute volume loading was also decreased. Left ventricular dysfunction was detected only with ventricular septal ischemia. Combined RV free wall and ventricular septal ischemia produced more severe and predominant RV dysfunction with disproportionate elevation of RV end-diastolic pressure. After combined ischemia, pericardiotomy improved the RV stroke work index as well as the left ventricular stroke work index (40 and 27%, respectively, p less than 0.05), although the increase in RV stroke work index was greater than in left ventricular stroke work index (p less than 0.05). The results of this study suggest that (1) the RV free wall has a more important role than the ventricular septum in RV performance, (2) predominant RV failure can be induced experimentally after combined RV free wall and ventricular septal ischemia, and (3) the pericardium has a restrictive effect on the damaged and dilated right ventricle. PMID- 6858911 TI - Ventricular tachyarrhythmias in Prinzmetal's variant angina: clinical significance and relation to the degree and time course of S-T segment elevation. AB - Fifty-six patients with active Prinzmetal's variant angina were studied to determine the incidence and clinical significance of ventricular tachyarrhythmias and the correlation between arrhythmias and degree and time course of S-T segment changes during the ischemic attacks. Twenty-nine patients (Group I) had no ventricular arrhythmias in any of the 1,083 recorded episodes, while 27 patients (Group II) developed arrhythmias in 18% of the attacks. No significant differences in clinical, electrocardiographic, angiographic, or hemodynamic findings could be found between the 2 groups. In 23 of the 27 Group II patients, ventricular arrhythmias developed during maximal S-T segment elevation (occlusion arrhythmias), while in 10 they occurred during resolution of S-T segment changes (reperfusion arrhythmias); 6 of the latter patients also had occlusion arrhythmias. Eight of the 23 patients with occlusion arrhythmias and 6 of the 10 with reperfusion arrhythmias had ventricular fibrillation or ventricular tachycardia. Maximal S-T segment elevation was significantly greater (p less than 0.001) in patients with occlusion arrhythmias than in those without arrhythmias. The episodes with reperfusion arrhythmias were significantly longer (p less than 0.001) and showed a significantly greater S-T segment elevation (p less than 0.001) than those without arrhythmias in Group I patients. This study shows that significant ventricular tachyarrhythmias develop during ischemic attacks in about 50% of patients with active variant angina; clinical and angiographic features are not useful in distinguishing patients with arrhythmias from the others. Our findings suggest that in variant angina ventricular arrhythmias may be due to the effects of both coronary artery occlusion and reperfusion; both types of arrhythmias are correlated with the severity of ischemia, as measured by the degree of S-T segment elevation. Reperfusion arrhythmias also appear to be correlated with the duration of ischemia. PMID- 6858913 TI - Effect of fluocarbon exchange transfusion on myocardial infarction size in dogs. AB - Fluosol DA (20%), a perfluocarbon with high oxygen solubility, was administered by concurrent exchange transfusion (30 ml/kg) to anesthetized open-chested adult greyhounds (n = 9) 1 hour after left anterior descending coronary ligation. Mechanical ventilation using 100% oxygen was used throughout the experiment. A second similar group (n = 9) received 0.9% normal saline solution (30 ml/kg), and a third group (n = 9) received no further intervention. Systemic, right atrial, and left atrial pressures were not altered by the exchange transfusion. Monastryl blue dye was injected through the left atrial line at 6 hours after ligation to define the area of myocardium at risk (AR); the animals were then killed and the heart was excised. The left ventricle was sliced at 5 mm intervals and stained using triphenyltetrazolium chloride, defining areas of necrosis (AN). The ratio of AN/AR and total left ventricular mass were then compared with the use of planimetry. The results were as follows: the AN/AR ratio in the 9 control animals was 90 +/- 2 (mean +/- standard error of the mean); in the 9 animals who received saline solution it was 88 +/- 2; and in the animals who received Fluosol it was 67 +/- 4 (p less than 0.01 compared with control; p less than 0.001 compared with the saline group). Fluocarbon exchange transfusion may reduce infarct size when administered after coronary occlusion. PMID- 6858915 TI - Delayed thrombolysis of streptokinase-resistant occlusive thrombus: documentation by pre- and postmortem coronary angiography. PMID- 6858914 TI - Fibronectin: cardiovascular aspects of a ubiquitous glycoprotein. PMID- 6858917 TI - Contrast echocardiography to reduce ionizing radiation associated with cardiac catheterization during pregnancy. PMID- 6858918 TI - Prolonged survival (62 years) with single ventricle. PMID- 6858916 TI - Pulsus alternans after valve replacement for aortic regurgitation. PMID- 6858919 TI - Histiocytoid cardiomyopathy: a cause of sudden death in apparently healthy infants. PMID- 6858920 TI - Amiodarone distribution in human tissues after sudden death during Holter recording. PMID- 6858921 TI - Severe mitral regurgitation immediately after mitral valve replacement with a parietal pericardial bovine bioprosthesis. PMID- 6858922 TI - Long-term responses to nifedipine in patients with coronary spasm who have an initial favorable response. AB - Twenty-six patients with angina and coronary spasm participated in a randomized crossover trial comparing nifedipine with isosorbide dinitrate. Eighteen patients had a short-term beneficial response to nifedipine, and 14 of these were followed up for an average period of 9.4 months. During follow-up study, nifedipine was the primary therapy in these 14 patients, but other drugs were added when clinically necessary to control angina. There was an overall 86% beneficial response rate (greater than 50% decrease in angina frequency). However, 2 patients had a large increase (greater than 10 times) and 4 patients had a slight increase (transient) in angina frequency over the long term compared with the short-term response. The other 8 patients had a similar angina frequency compared with the short-term response. Of the 12 patients with a good response (transient slight increase or no change), 8 (67%) required additional drug therapy to maintain angina control. Nifedipine was discontinued in 2, and the dose was decreased in 3 of the 14 patients because of adverse effects. Three patients had a marked increase in angina at 9, 14, and 3 months, requiring hospitalization; 1 patient had coronary bypass for symptom control. Thus, patients with coronary spasm selected because of a favorable short-term response to nifedipine were effectively treated over the long term with nifedipine; however, additional therapy was often needed to control symptoms. Adverse effects were common, but simple reduction of nifedipine dose usually diminished the unwanted effects of the drug. PMID- 6858923 TI - Prognostic value of resting and submaximal exercise radionuclide ventriculography after acute myocardial infarction in high-risk patients with single and multivessel disease. AB - In patients who survive the acute phase of myocardial infarction, those with multivessel coronary artery disease generally have a worse prognosis than those with single-vessel disease. However, some patients with significant multivessel stenoses have a good prognosis, whereas some with a significant single-vessel stenosis have a poor prognosis. Thus, although definition of coronary anatomy may be helpful, it is a not a fail-safe prognosticator. In this retrospective analysis, the association of abnormalities at rest and during submaximal exercise testing with radionuclide ventriculography after acute myocardial infarction with major cardiac complications (death, recurrent infarction, severe angina or congestive heart failure) in the ensuing 6 months was assessed in patients with single and multivessel disease. Coronary angiography and submaximal exercise testing with radionuclide ventriculography were performed within 3 months of each other in 42 patients. Eleven of the 16 patients with single-vessel coronary stenosis had major cardiac complications. The subsequent course of these 16 patients was correctly predicted by left ventricular ejection fraction (LVEF) less than or equal to 0.40 in 8 patients, by LVEF less than 0.55 in 7 patients, by failure of LVEF to increase by 0.05 units in 13 patients, and by an increase in left ventricular end-systolic volume index (LVESVI) during exercise greater than 5% above baseline in 11 patients. Of the 26 patients with multivessel coronary artery disease, 24 had major cardiac complications. The subsequent course of these 26 patients was correctly predicted in 13 by LVEF less than or equal to 0.40, in 20 by LVEF less than 0.55, in 25 by a failure of LVEF to increase by 0.05 units during exercise, and in 20 by an increase in LVESVI by greater than 5% during exercise. Thus, submaximal exercise testing with radionuclide ventriculography may provide valuable prognostic information concerning the occurrence of major cardiac events after myocardial infarction not only in patients with multivessel disease, but also in those with single-vessel disease. Exercise-induced abnormalities of left ventricular function may have greater prognostic importance than the delineation of coronary arterial anatomy or the assessment of residual left ventricular function at rest. PMID- 6858924 TI - Evaluation of a QRS scoring system in acute myocardial infarction: relation to infarct size, early stage left ventricular ejection fraction, and exercise performance. PMID- 6858925 TI - Multiform accelerated idioventricular rhythm in acute myocardial infarction: electrocardiographic characteristics and response to verapamil. AB - Thirteen patients with acute myocardial infarction with multiform accelerated idioventricular rhythm (AIVR) occurring during the first 12 hours of monitoring in the coronary care unit are described. This arrhythmia, similar to the more common uniform AIVR, was intermittent, did not cause hemodynamic compromise, and was not related to more serious ventricular arrhythmias. There was no correlation between the bundle branch block pattern of the multiform AIVR and the electrocardiographic location of the myocardial infarction, but there was a perfect correlation between the frontal plane electrical axis of the multiform AIVR and the electrocardiographic location of the myocardial infarction. The presence of fusion beats between the different forms of AIVR suggests multifocality rather than multiformity. Intravenous verapamil (3 to 5 mg bolus) was administered to 6 patients with multiform AIVR in whom the arrhythmias were persistent enough to allow the evaluation of the effect of verapamil on the arrhythmia. Verapamil caused no change in the rate of AIVR in 1 patient, but in a second patient it decreased the rate by 20 beats/min. In 4 patients, verapamil abolished the arrhythmia: in 2 patients carotid sinus pressure (induced sinus slowing) allowed the emergence of the AIVR at a lower rate, and in the remaining 2 patients the arrhythmia was not observed. PMID- 6858926 TI - Subcostal 2-dimensional echocardiographic imaging of peripheral left coronary artery aneurysms in Kawasaki disease. AB - Our previous study provided a new 2-dimensional echocardiographic technique to detect peripheral right coronary artery aneurysms in Kawasaki disease, with use of the subcostal approach. An additional study was performed to detect peripheral left coronary artery aneurysms. Because the left anterior descending artery runs along the anterior interventricular sulcus and the left circumflex artery along the mitral valve ring, these regions were searched for coronary aneurysms by use of the subcostal imaging approach. Among 143 patients with Kawasaki disease, 44 left coronary aneurysms were visualized in 22 patients. Three aneurysms at the origin of the obtuse marginal artery and 1 in the further peripheral site of the left circumflex artery were observed in 3 patients. Two aneurysms at the origin of the second diagonal branch of the peripheral left anterior descending artery were detected. These echocardiographic studies were done prospectively, and their features coincided well in size, shape, and anatomic location with confirmatory angiographic appearances. PMID- 6858927 TI - Prolongation of the Q-T interval in man during sleep. AB - Parasympathetic blockade shortens the duration of the Q-T interval and ventricular effective refractory period independent of heart rate change. Since relative parasympathetic effect increases during sleep, it was determined whether sleep was associated with a change in the Q-T interval. Fifteen patients receiving no drugs underwent 3 to 6 days of continuous electrocardiographic recordings. Tracings were sampled every 30 minutes and recorded at a paper speed of 25 mm/s. This provided 12,000 Q-T and R-R intervals that were measured. Comparison of R-R intervals that had similar durations during sleep and awake states revealed that the duration of the Q-T interval was longer during sleep in all 15 patients (p less than 0.001). Eight patients had sufficient range of overlap of R-R intervals to compare linear regression lines of Q-T intervals recorded while awake with Q-T intervals recorded while asleep. The regression lines during sleep exhibited a mean intercept change of 38 +/- 37 ms and mean slope change of -0.021 +/- 0.040 ms when compared with the regression lines during the awake state. The difference in Q-T interval between awake and sleep states was 19 +/- 7 ms when calculated at a heart rate of 60 beats/min. These statistical comparisons of the relationship of the Q-T interval to R-R interval indicate that the Q-T interval is longer during sleep than during the awake state at the same heart rate. Prolongation of the Q-T interval during sleep may reflect increased vagal tone or sympathetic withdrawal. These changes in repolarization may be related to the diurnal variation of some ventricular arrhythmias. PMID- 6858928 TI - Relation of mode of induction and cycle length of ventricular tachycardia: analysis of 104 patients. AB - One hundred four consecutive patients with ventricular tachycardia (VT) were examined to correlate the cycle length with the mode of initiation of VT (single, double, and triple extrastimuli and rapid pacing). Tachycardias induced with a single extrastimulus were slower (342 +/- 72 ms, mean cycle length) than those induced with double (295 +/- 60 ms) or triple (282 +/- 56 ms) extrastimuli or rapid pacing (293 +/- 40 ms). There were no differences among the last 3 groups. In 38 patients who had endocardial catheter mapping to determine the site of origin of VT, distance from stimulation site to the site of origin was estimated and correlated with mode of initiation. There was no difference in mode of initiation when the stimulation site was close (less than 3 cm), intermediate (3 to 5 cm), or distant (greater than 8 cm) from the site of origin. To address the issue of distance from stimulation site to the site of origin somewhat differently, mode of initiation was correlated with site of previous myocardial infarction in 69 patients with VT initiated from the right ventricular apex. Again, mode of initiation did not differ among patients with septal, inferior, lateral, or multiple myocardial infarctions. Thus, cycle length of VT initiated with a single extrastimulus was slower than that initiated with double or triple extrastimuli or rapid pacing and the mode of initiation of VT was unrelated to site of myocardial infarction or distance between stimulation site and site of origin of VT. PMID- 6858929 TI - Cardiac arrest in young, ostensibly healthy patients: clinical, hemodynamic, and electrophysiologic findings. AB - This study examines the clinical, hemodynamic, and electrophysiologic findings in a unique group of 11 young (aged 15 months to 29 years) survivors of a cardiac arrest. All patients were previously in good health, and cardiac arrest was the initial manifestation of cardiac disease in all. Overt clinical and hemodynamic abnormalities were not as common as previously reported, and in some instances apparent cardiac abnormalities failed to provide a link to cardiac arrest. No patient had congenital heart disease or hypertrophic cardiomyopathy. However, during multicatheter electrophysiologic study, sustained tachyarrhythmia was reproducibly initiated in 8 of 11 patients (73%). Young, ostensibly healthy patients who survive cardiac arrest form a diverse group. Diligent programmed intracardiac electrical stimulation may demonstrate life-threatening tachycardias in these patients. Treatment to prevent recurrence of cardiac arrest is difficult in this group of patients. However, the ability to initiate tachycardia in the electrophysiologic laboratory may be useful in the management of these patients. PMID- 6858930 TI - Comparison of high-dose and medium-dose propranolol in the relief of exercise induced myocardial ischemia. AB - The effects of medium-dose (160 mg/day) and high-dose (480 mg/day) oral propranolol were compared in 22 patients who had typical angina pectoris and objective evidence of myocardial ischemia during exercise. Left ventricular (LV) ejection fraction (EF) and wall motion score (WMS) (an index of regional LV dysfunction) were assessed by radionuclide angiography both at rest and during exercise to the pretreatment maximum work load. Functional class improved in 11 of the 22 patients during medium-dose propranolol therapy. Medium-dose propranolol reduced mean resting heart rate from 71 to 55 beats/min, exercise heart rate from 122 to 93 beats/min, and exercise systolic blood pressure from 183 to 162 mm Hg (p less than 0.001 for each). The incidences of exercise-induced chest pain and S-T segment depression were reduced from 19 to 9 patients (p less than 0.001), and from 20 to 10 patients (p = 0.002), respectively. Medium-dose propranolol had no effect on mean EF or WMS at rest, but improved function in ischemic regions during exercise; WMS decreased (p = 0.001), and mean exercise EF increased from 0.51 to 0.56 (p = 0.025). Compared with the medium dose, high-dose propranolol improved functional class in 3 additional patients, and further reduced mean resting heart rate (from 55 to 52 beats/min, p = 0.001) and mean exercise heart rate (from 93 to 86 beats/min, p = 0.001). Exercise-induced chest pain and S-T segment depression were abolished in a further 7 and 6 patients, respectively. Exercise EF and WMS improved further in several patients, but the changes were not statistically significant for the group (p = 0.095 and 0.082, respectively). Thus, in patients with coronary artery disease and exercise induced ischemia, propranolol reduced heart rate and blood pressure and the incidence of exercise-induced chest pain, electrocardiographic changes, and ischemic LV dysfunction. Although most of these effects were seen with medium dose propranolol, higher doses provided additional relief of chest pain and S-T segment depression, and further improved global and regional LV function in several patients. PMID- 6858931 TI - Value of the ajmaline-procainamide test to predict the effect of long-term oral amiodarone on the anterograde effective refractory period of the accessory pathway in the Wolff-Parkinson-White syndrome. AB - In patients with the Wolff-Parkinson-White syndrome, intravenous ajmaline (50 mg administered over 3 minutes) or procainamide (10 mg/kg body weight administered over 10 minutes) is helpful in defining the duration of the anterograde effective refractory period of the accessory pathway. In this study the value of the ajmaline-procainamide test to predict the effects on the anterograde effective refractory period of the accessory pathway of long-term oral amiodarone were assessed. Thirty-six patients with the Wolff-Parkinson-White syndrome were studied. Twenty-four (Group A) had a negative result of the ajmaline-procainamide test and a mean duration of the anterograde effective refractory period of the accessory pathway of 237 +/- 24 ms. Twelve (Group B) had a positive result in the ajmaline-procainamide test (disappearance of preexcitation during sinus rhythm after administration of ajmaline and procainamide) and a duration of the anterograde effective refractory period of the accessory pathway of 284 +/- 25 ms (p less than 0.05 versus values in Group A). Amiodarone prolonged the anterograde effective refractory period of the accessory pathway by 53 +/- 35 ms in patients in Group A to 290 +/- 37 ms (p less than 0.001) and by 100 +/- 85 ms in patients in Group B to 384 +/- 94 ms (p less than 0.001). The difference in mean increase between both groups was not significant. In most patients (83%) in Group A amiodarone prolonged the anterograde effective refractory period of the accessory pathway to 260 to 330 ms. However, in most patients (83%) in Group B, amiodarone prolonged the anterograde effective refractory period of the accessory pathway to greater than or equal to 330 ms (p less than 0.01). Thus, an ajmaline procainamide test is of value in predicting the results of oral amiodarone on the anterograde effective refractory period of the accessory pathway. PMID- 6858933 TI - Syncope and ventricular tachycardia in patients with ventricular preexcitation. AB - Four patients with ventricular preexcitation whose syncope initially was attributed to an arrhythmia utilizing the accessory pathway are presented. At electrophysiologic study, the electrophysiologic characteristics of the accessory pathways were considered unlikely to support a tachycardia of a rate sufficient to result in syncope. Programmed stimulation of the right ventricle, however, reproducibly induced ventricular tachycardia to which the syncope was subsequently attributed in 3 patients. The importance of identifying ventricular tachycardia as the cause of syncope in these patients is emphasized. PMID- 6858932 TI - Evaluation of metoprolol in suppressing complex ventricular arrhythmias. AB - This study documents the extent of suppression of premature ventricular beats which can be achieved with metoprolol, a semiselective beta-adrenergic blocking agent, at doses of 100 to 200 mg daily, utilizing a single-blind placebo controlled 10-day protocol with continuous ambulatory electrocardiographic recording of 20 patients with cardiac disease and complex ventricular arrhythmias. Metoprolol (200 mg/day) resulted in suppression of 60% of total premature ventricular beats, with couplets (pairs) and ventricular tachycardia decreased 84% and 94%, respectively (all p less than 0.01). Exercise-induced premature ventricular beats, especially ventricular tachycardia, were effectively suppressed. The peak plasma metoprolol level to achieve these results was 72 +/- 34 ng/ml (mean +/- 1 standard deviation). At this plasma concentration, the mean 24-hour heart rate during normal activity was reduced from 78 +/- 8 beats/min (placebo) to 62 +/- 4 (metoprolol 200 mg/day) (p less than 0.001). Beta blockade also was demonstrated by a 20% reduction in heart rate during maximal Bruce exercise testing with metoprolol 200 mg/day. Although resting left ventricular function was not affected by metoprolol, pulmonary function tests show a statistically significant decrease in forced vital capacity, forced expiratory volume in 1 second, and forced expiratory flow rates (25-75) reversible with a beta-2 agonist. PMID- 6858934 TI - Efficacy, safety, and pharmacokinetics of a concentration-maintaining regimen of intravenous pirmenol. AB - A 3-stage, concentration-maintaining intravenous infusion regimen of pirmenol, a new antiarrhythmic agent, was tested for efficacy and safety in 8 subjects with chronic, stable premature ventricular beats. The regimen, which consisted of (1) a priming bolus of 50 mg over 2 minutes, followed by (2) a rapid loading infusion of 2.5 mg/min for 1 hour, and (3) a maintenance infusion of 0.25 mg/min, rapidly achieved and maintained stable plasma pirmenol levels from 0.94 to 2.75 micrograms/ml, during infusions lasting up to 48 hours. Therapeutic efficacy was evaluated during 4-hour infusions in 5 patients utilizing a randomized, double blind, placebo-controlled study design. Pirmenol suppressed average premature ventricular beat frequency 93 +/- 6% compared with control values (p = 0.03). Pirmenol infusions were unassociated with toxicity. There were slight but significant increases in diastolic blood pressure, QRS duration, and corrected Q T interval. No significant changes occurred in systolic blood pressure, heart rate, P-R interval, or laboratory variables. Pirmenol is a promising therapeutic agent that warrants further evaluation. The 3-stage infusion satisfactorily achieves and maintains therapeutic plasma pirmenol levels. PMID- 6858936 TI - Left ventricular function at rest and during exercise in congenital complete heart block: a radionuclide angiographic evaluation. AB - This study evaluates intrinsic cardiac performance during upright exercise in patients with congenital complete heart block. Left ventricular ejection fraction and volume were measured at rest and peak upright exercise with radionuclide angiography in 5 patients aged 11 to 39 years with congenital complete heart block: 4 were in New York Heart Association class I and 1 was in class II. The resting cardiac output was maintained at a normal level by an increase in end diastolic volume rather than by a decrease in end-systolic volume. The left ventricular ejection fraction was normal at rest in all patients, but an abnormal response to exercise was noted in 3 patients. There was no appreciable change in the end-diastolic volume during exercise. Thus, patients with congenital complete heart block utilize the Starling mechanism to maintain normal resting cardiac output, but the response to exercise is usually abnormal even in the absence of symptoms. PMID- 6858939 TI - The equine spleen: an electron microscopic analysis. AB - The capacity of the equine spleen to store and rapidly release as much as half the circulating blood volume after adrenergic stimulation depends upon the size of the spleen, its muscular capsule, and the distinctive structure of its red pulp. The unit, or lobule, of red pulp is a cylinder of pulp spaces organized in a reticular meshwork, supplied by a peripheral ring of arterial capillaries, and drained by a central venule. Reticular cells, which make up the meshwork of the pulp, contain an extraordinarily large complement of microfilaments and intermediate filaments and are richly innervated by nerves containing both dense and lucent core vesicles typical of adrenergic nerves. The wall of the pulp venule contains large apertures. The capacious red pulp would thus appear capable both of large-scale blood storage and, by the contractile adrenergic innervated reticulum and open venous vasculature, of rapid expression of stored blood into the circulation. Antigen-presenting cells are present not only in B and T cell zones in white pulp but in the periarterial macrophage sheath of red pulp as well. The periarterial macrophage sheath is one of the first sites of antigen capture, and the presence of these cells confers on it an immunological role. PMID- 6858935 TI - Current physiologic pacemakers: a serious problem with a new device. AB - Twenty adults underwent implantation of an automatic (DDD) pacemaker (Medtronic model 7000, Versatrax I) for treatment of symptomatic bradyarrhythmias. Only 9 patients had optimal DDD mode pacing during 78 paced months. In 3 patients, the DDD mode was changed to atrioventricular (AV) sequential (DVI) early because of risk imposed by sustained tachycardia upon underlying myocardial ischemia. The remaining 8 had had tachycardia due to pacemaker reentry, and 7 had neurologic and cardiovascular symptoms. DDD pacing was abandoned in 5 when reentry could not be interrupted by digitalis administration or reprogramming. Three continue to be paced in DDD mode despite intermittent reentrant tachycardias, with digitalis diminishing episodes of reentry in only 1. Mean ventriculoatrial conduction time was 229 +/- 34 ms. Reentrant pacemaker tachycardia developed in 7 of 12 with normal or nearly normal AV conduction, but in only 1 of 5 with complete heart block. Preimplantation electrophysiologic study did not reliably detect and initial postoperative Holter monitoring did not predict reentrant tachycardia. The risk of reentry caused by a short, fixed atrial refractory period combined with the high occurrence of slow retrograde AV conduction, particularly in patients with normal or nearly normal anterograde conduction, renders the Versatrax I and other similar pacemakers unsuitable for DDD mode pacing in many patients. PMID- 6858937 TI - Idiopathic paroxysmal ventricular tachycardia with a QRS pattern of right bundle branch block and left axis deviation: a unique clinical entity with specific properties. AB - Electrophysiologic evaluation before and after the serial administration of verapamil, lidocaine, propranolol, and procainamide was undertaken in 4 young, asymptomatic patients with recurrent, sustained ventricular tachycardia (VT). No patient had obvious organic heart disease. The electrocardiogram during sinus rhythm showed S-T depression and T-wave inversion over the inferior and lateral precordial leads in 3 patients. QRS morphologic characteristics during episodes of VT showed a pattern of right bundle branch block and left axis deviation. In all 4 patients, VT could be both induced and terminated with electrical stimulation. Verapamil terminated VT and prevented the induction of sustained VT in 3 patients, and markedly slowed the rate of VT in 1 patient. Procainamide effectively prevented the induction of sustained VT in 2 patients, and although ineffective in preventing induction in 2 patients, it slowed the rate of tachycardia in both. Lidocaine and propranolol did not prevent the induction of VT in any patient. These findings suggest that slow-response tissues may be involved in the genesis of VT in these patients, and that VT in these patients may represent a unique clinical entity with distinct electrocardiographic, electrophysiologic, and electropharmacologic properties. PMID- 6858938 TI - Studies on the organization and regeneration of bone marrow: origin, growth, and differentiation of endocloned hematopoietic colonies. AB - Hematopoietic colonies were studied by light microscopy in the marrow of alternate fraction x-irradiated mice (C576J/B1) to investigate the microenvironmental organization of marrow and identify early hematopoietic cell stromal cell interactions. Undifferentiated colonies (UC) were detected at 3 days postirradiation, showed a marked predilection for bone surfaces, and disappeared as differentiated colonies developed. Some UC occurred along marrow arteries. Neutrophilic granulocyte colonies (GC) occurred in all areas at 3 days but grew rapidly only subosteally. Few eosinophilic colonies (GCe) occurred. Erythrocytic colonies (EC) appeared at 4 days as dispersed populations of motile cells within a localized area of marrow; these tended to proliferate initially in intermediate and central marrow zones. Macrophage colonies (M phi C) of two "subtypes" were detected, peaking in relative frequency at 4 days. These appeared active in stromal repair and monocytopoiesis. Megakaryocyte colonies (MC) originated along bone and differentiated away from bone. From 3-5 days, the frequency of GC greater than UC greater than M phi C much greater than MC approximately equal to GCe. All colony types except UC, M phi C, and central GC increased in size and became mixed in differentiation by 12-14 days. For several weeks, however, erythropoiesis concentrated toward central areas, whereas granulopoiesis and thrombopoiesis concentrated along bone. Some mixed colonies showed an abrupt transition from erythrocytic, centrally, to granulocytic, subosteally. These results were interpreted as evidence that in x-irradiated marrow: (1) hematopoietic microenvironments (HMs) for stem-cell proliferation and commitment to differentiation, with the possible exception of HMs determining erythroid differentiation, occur in endosteal and periarterial regions; (2) a proliferative and/or chemotactic stimulus to erythroid progenitors exists in intermediate and central marrow regions; and (3) some subosteal regions may exclude erythropoiesis, or preferentially support nonerythroid differentiation. Elaborate associations occurred between macrophages and early UC, GC, and EC, but not MC hematopoietic cells. UC and GC often associated with osteoclasts. Reticular and other fibroblastic cells associated with the cells of all colony types. PMID- 6858940 TI - Preantral follicle development during the menstrual cycle in the Macaca mulatta ovary. AB - Ovaries obtained from 18 adult, regularly cycling rhesus monkeys were evaluated to determine the status of preantral follicle development at various stages throughout the menstrual cycle. The ovaries were serially sectioned, and all preantral follicles on every 20th section were classified as developing or atretic, counted and/or measured, and grouped according to size. Results from this study revealed (1) that a significant increase (P less than 0.05) occurred in the mean percentage of developing preantral follicles greater than 100 microns in diameter during the periovulatory period, suggesting that follicles in this size range had developed a sensitivity to the unique hormonal milieu present during that stage of the cycle; (2) that similar numbers of primordial and developing preantral follicles were present in the right and left ovaries of a pair, showing that neither ovary had a predominance over the other; (3) that the mean number of developing preantral follicles varied directly with the size of the primordial follicle pool; (4) that atresia was minimal with no significant differences between the various stages of the cycle in any size group; and (5) that polyovular follicles were abundant in certain pairs of ovaries, but could not be related to age or stage of cycle. PMID- 6858941 TI - Contributions of placodal and neural crest cells to avian cranial peripheral ganglia. AB - The method of embryonic tissue transplantation was used to confirm the dual origin of avian cranial sensory ganglia, to map precise locations of the anlagen of these sensory neurons, and to identify placodal and neural crest-derived neurons within ganglia. Segments of neural crest or strips of presumptive placodal ectoderm were excised from chick embryos and replaced with homologous tissues from quail embryos, whose cells contain a heterochromatin marker. Placode derived neurons associated with cranial nerves V, VII, IX, and X are located distal to crest-derived neurons. The generally larger, embryonic placodal neurons are found in the distal portions of both lobes of the trigeminal ganglion, and in the geniculate, petrosal and nodose ganglia. Crest-derived neurons are found in the proximal trigeminal ganglion and in the combined proximal ganglion of cranial nerves IX and X. Neurons in the vestibular and acoustic ganglia of cranial nerve VIII derive from placodal ectoderm with the exception of a few neural crest derived neurons localized to regions within the vestibular ganglion. Schwann sheath cells and satellite cells associated with all these ganglia originate from neural crest. The ganglionic anlagen are arranged in cranial to caudal sequence from the level of the mesencephalon through the third somite. Presumptive placodal ectoderm for the VIIIth, the Vth, and the VIIth, IXth, and Xth ganglia are located in a medial to lateral fashion during early stages of development reflecting, respectively, the dorsolateral, intermediate, and epibranchial positions of these neurogenic placodes. PMID- 6858942 TI - Follicular growth and kinetics during the estrous cycle, pregnancy and postpartum in the Indian mole rat (Bandicota bengalensis). AB - Follicular growth and kinetics were studied in detail in the ovaries of the Indian mole rat (Bandicota bengalensis) during various stages of the estrous cycle; days 7, 12, 15, 19, and 21 of pregnancy; and day 2 postpartum. The sizes of follicles, oocytes, nuclei, and nucleoli were measured. In all rats, regression coefficients, a, and intercepts, b, were calculated in oocyte/follicle, oocyte nucleus/follicle and oocyte nucleus/oocyte regressions. The oocyte reached its maximum size when the average follicle diameter was 117 microns in nonpregnant rats and 131 microns in pregnant rats. The oocyte nucleus attained maximum size when the follicle diameter was 110 microns during the estrous cycle and 111 microns during pregnancy and postpartum. Maximum values of the diameter of the largest antral follicle and average diameter of the four largest antral follicles were observed during proestrus (473 and 442 microns, respectively) and on day 21 of pregnancy (611 and 538 microns, respectively). Chi 2 analysis showed that distribution of various types of follicles was not independent of the stage of the estrous cycle and pregnancy. In estrus and metestrus most of the follicles were between stages I and V. However, by diestrus and proestrus, follicles of all size groups developed. The numbers of stage I and II follicles did not differ as pregnancy advanced. More stage V follicles were present on day 12 than on day 7 of pregnancy; however, their numbers decreased by day 15. Afterwards, progressive increase of stage V and (VI + VII) follicles was observed until day 21. This was accompanied by the shift of follicles from stage (III + IV) on days 19 and 21 of pregnancy and even of stage II on day 2 postpartum. Wherever possible, the results have been compared with previous observations in various rodent species. PMID- 6858946 TI - Dietary intake and nutrient supplement use in a Southern California retirement community. AB - Dietary histories and information concerning the use of nutritional supplements were obtained from 51 randomly selected residents of an Orange County, CA, retirement community. The nutrients for which dietary intakes were most apt to fall below 100% of the 1980 Recommended Dietary Allowance were: calcium, in both sexes; energy, in males; and iron, thiamin, riboflavin, and niacin in females. With the exception of calcium, few subjects had intakes below two-thirds of the Recommended Dietary Allowances. These findings are similar to those reported in previous dietary surveys of the elderly. Vitamin and mineral supplements were consumed by 72% of the subjects; such consumption was unrelated to dietary intake. Supplemental vitamin C was consumed by 67% of the subjects in amounts ranging from 30 to 5200 mg daily; supplemental vitamin E was taken by 51%, with amounts ranging from 8 to 1000 IU daily. Supplement use by this population is one of the highest reported among the elderly, an effect that may result from the affluence of the community, its geographic location, and from a high level of nutritional consciousness among its residents. PMID- 6858943 TI - CSF-contacting pinealocytes in the pineal recess of the Mongolian gerbil: a correlative scanning and transmission electron microscope study. AB - The pineal recess of the Mongolian gerbil was studied using correlative scanning and transmission electron microscopy. The surface of the pineal recess can be subdivided into three distinct zones: (1) central, (2) transitional, and (3) peripheral. In the gerbil, the deep pineal gland is located deep to the central and transitional zones. The ependyma of the peripheral zone is densely ciliated and resembles that of the main ventricular lining. Ependymal cells of the transitional zone are sparsely ciliated but possess numerous microvilli on their apical surfaces. Supraependymal neurons were identified in the transitional zones. These cells appear to make a synaptic-like contact with the underlying ependymal cells. Of the three zones, the central zone demonstrated the greatest amount of morphological variability. Although a number of supraependymal structures could be identified in the central zone, the most remarkable feature was the presence of protruding cells that possessed no significant surface features. Employing correlative transmission electron microscopy, the protruding cells were shown to be CSF-contacting pinealocytes. The number of CSF-contacting pinealocytes present in the central zone varied from one cell to large clusters that covered the entire zone. The results of this investigation demonstrate the presence of a direct contact and the potential for interaction between the deep pineal gland and the CSF of the pineal recess in the gerbil. PMID- 6858945 TI - The iron status of Black and white female adolescents from eight Southern states. AB - Hb, hematocrit, plasma iron, and transferrin saturation were measured in approximately 1000 girls aged 12, 14, or 16 yr in eight southern states. The iron status parameters did not differ significantly among the three age groupings or between menstruating and nonmenstruating girls. Blacks had significantly lower mean Hb (p less than 0.0001), hematocrit (p less than 0.0001), and transferrin saturation (p less than 0.05) levels than whites and a greater proportion of Blacks exhibited low Hb (p less than 0.05) and low hematocrit levels (p less than 0.01). Adjusting for dietary iron intakes and per capita income levels did not adequately account for significant race differences for iron status parameters. These findings support the contention that genetic as well as environmental factors are responsible for the frequently reported Black-white differences in Hb and hematocrit levels. PMID- 6858947 TI - Nutrition survey in Tabasco, Mexico: patterns of infant feeding. AB - Information on infant feeding was collected from 149 mothers of 744 children born over a period of 25 yr in an area of Tabasco, Mexico which has experienced rapid economic development. From 1953 to 1978, there was an increase in bottle-feeding, primarily as a supplement to breast-feeding, while the proportion of infants exclusively breast-fed declined from 69 to 48%. This trend was accompanied by a decrease in the average duration of lactation: the percentage of infants breast fed 12 months or more declined from 73 to 45%. Mothers living within the area of an agricultural development project completed in 1973 were more likely to bottle feed than mothers outside the project. The consequences of supplemental bottle feeding for continued lactation, infant health, and child spacing require further investigation. PMID- 6858944 TI - Dietary zinc intake and zinc concentrations of plasma, erythrocytes, and breast milk in antepartum and postpartum lactating and nonlactating women: a longitudinal study. AB - The zinc status of a group of 23 lactating and 13 nonlactating women was assessed longitudinally from 37-wk gestation through 6 months postpartum. Dietary zinc intake was determined by chemical analysis of 3-day duplicate plate food composites. In addition, zinc concentrations were measured in plasma, erythrocytes, and breast milk. The mean dietary zinc intake of both groups of postpartum women as determined by direct analyses was 42% of the Recommended Dietary Allowances or less. The plasma and erythrocyte zinc concentrations were not significantly different between the lactating and nonlactating women. Plasma zinc concentration increased from the time of delivery to one month postpartum for both groups and did not significantly increase further through 6 months postpartum. Erythrocyte zinc decreased from delivery through 6 months postpartum for both groups. Breast milk zinc concentration decreased with the duration of lactation. The calculated zinc intake of infants from breast milk was less than 50% of the Recommended Dietary Allowances. There was no correlation of maternal dietary zinc intake or maternal plasma and erythrocyte zinc with the concentration of zinc in breast milk. PMID- 6858948 TI - Graphical displays of growth data. AB - An informative and visually pleasing way of displaying growth information on groups of children is presented. The technique allows for simultaneous comparisons of subgroups of children from a particular survey or study with international growth standards and with other subgroups within the study or the survey. The technique consists of showing, in the form of a boxplot, the median, 5th, 25th, 75th, and 95th percentiles of the distribution of growth parameters. These are characteristics little affected by extreme or deviant values. The plots also show the upper and lower extremes and the mean value of the distribution. Boxplots representing age-specific distributions may be shown on a single graph using the abscissa labeled as the "age" axis. Anthropometric indices for different groups of children may then be compared with one another for specific age intervals and over time. This graphical method also enables establishing local anthropometric norms without the considerable expense and difficulty of generating local growth standards. PMID- 6858949 TI - "Advice of today . . . the discarded or derided dogma of tomorrow"? PMID- 6858950 TI - Maternal anthropometry and birth weight. PMID- 6858951 TI - Breast milk intake: variations in breast-feeding practices. PMID- 6858953 TI - The relation between freely chosen meals and body habitus. AB - By bomb calorimetry, we conducted a 7-day study of the energy contents of the freely chosen meals of 11 male subjects under their ordinary living conditions. Their body weights ranged from 60 to 99 kg and Quetelet indices ranged from 211 to 271 X 10(-5). Despite the wide range of body weight, there was no relation between daily energy intake and body weight, height, or Quetelet index. However the thickset subjects took diets and meals with higher energy density than the lean subjects (p less than 0.05 one-tailed for diets, p less than 0.025 one tailed for meals). On average, the energy of lunch and dinner contributed 26 and 44% of daily energy, respectively. There was a significant negative relation between the energy of lunch and that of dinner (p less than 0.01), but no significant association between weight of lunch and that of dinner (p greater than 0.1). PMID- 6858952 TI - A high protein, low calorie liquid diet in the treatment of very obese adolescents: long-term effect on lean body mass. AB - The use of Optifast-70, a high protein liquid diet, when used in the range of 500 to 700 cal over 5 months in very obese adolescents, was associated with weight loss of 20 to 25% of initial weight of which 70 to 75% of the loss was due to fat. No significant side effects were noted. Twenty-four hour electrocardiographic monitoring showed no significant changes, and linear growth continued. Lean body mass loss was 36% of the weight lost during the first 5 wks, but was only 10% of the weight lost during the next few months. Two adolescent males had negative phosphorus and nitrogen balances over the first 4 wk, implying that males may have slightly higher phosphorus, nitrogen, and calorie requirements. PMID- 6858954 TI - Evaluation of body composition and nitrogen content of renal patients on chronic dialysis as determined by total body neutron activation. AB - Total body protein (nitrogen), body cell mass (potassium), fat, and water were measured in 15 renal patients on maintenance hemodialysis (MHD). Total body nitrogen was measured by means of prompt gamma neutron activation analysis; total body water was determined with tritium labeled water; total body potassium was measured by whole body counting. The extracellular water was determined by a technique utilizing the measurement of total body chloride and plasma chloride. When compared with corresponding values of a control group of the same age, sex, and height, the protein content, body cell mass, and total body fat of the MHD patients were within the normal range. The only significant change was an increase in the extracellular water/body cell mass ratio in the male MHD patients compared to the controls. The lack of significant difference of the nitrogen values of the MHD patients compared to matched controls suggests that dialysis minimizes any residual effects of uremic toxicity or protein-calorie malnutrition. These findings further suggest that there is a need to reevaluate the traditional anthropometric and biochemical standards of nutritional status for MHD patients. It was concluded that it is particularly important to measure protein stores of MHD patients with low protein intake to ascertain nutritional status. Finally, in vivo measurement of total body nitrogen and potassium for determination of body composition provides a simple, direct, and accurate assessment of the nutritional status of MHD patients. PMID- 6858956 TI - Developmental changes in serum ferritin and erythrocyte protoporphyrin in normal (nonanemic) children. AB - We studied 4039 children who were 6 months to 12 yr of age to characterize developmental variations of serum ferritin and erythrocyte protoporphyrin. Age related descriptive statistics were derived. The -2 SD value for serum ferritin was found to increase progressively from 12 to 21 micrograms/1 with increasing age, while the +2 SD value for erythrocyte protoporphyrin was found to decrease progressively from 65 to 42 micrograms/dl whole blood with increasing age. While the mean serum ferritin value was found to continue to rise throughout the first 12 yr of life, erythrocyte protoporphyrin values were highest at 1 to 2 yr of age, then fell to essentially constant levels after 4 to 6 yr of age. These relationships, as well as the linear relationship of increasing hematocrit and serum ferritin with increasing age, suggest that the rise of hematocrit with age, as previously observed, is associated with improving storage and availability of iron for heme synthesis. PMID- 6858957 TI - Effect of maternal malnutrition during the reproductive cycle on growth and nutritional status of suckling rat pups. AB - To assess the impact of maternal malnutrition imposed at various stages of the reproductive cycle on pup growth and nutritional status, rats were fed 50% of the intake of control animals fed ad libitum either before pregnancy (R-B), before and during pregnancy (R-BP), during lactation (R-L), or throughout the experimental period (R-BPL). Regardless of the prior nutritional status of their dams, at 14 days of age pups nursed by restricted dams (R-L, R-BPL) were smaller and had less carcass fat and lower plasma albumin, plasma and liver vitamin A, and liver pyridoxine 5'-phosphate oxidase values than those nursed by dams fed ad libitum (C, R-B, R-BP). Pups nursed by chronically underfed dams (R-BPL) had lower Hb and plasma vitamin A values than those nursed by acutely malnourished (R L) dams. The nutritional status of pups suckled by previously malnourished dams refed during lactation (R-BP) was similar to those suckled by controls except for plasma albumin and vitamin A values. We conclude that maternal nutritional status influenced pup growth and nutritional status and that permitting voluntary intake of an adequate diet during lactation was effective in preventing malnutrition in suckling young. PMID- 6858955 TI - Comparison of animal and vegetable protein sources in the dietary management of hepatic encephalopathy. AB - Theoretical considerations based on amino acid metabolism in patients with hepatic encephalopathy as well as some limited patient studies had led to the proposal that dietary protein derived from a vegetable source may be better tolerated and more efficacious in such patients. However, studies in normal humans have revealed that vegetable protein is not as nitrogen sparing as animal protein. This prompted us to study under metabolic ward conditions the effects of vegetable and animal protein sources in patients with hepatic encephalopathy with respect to mental status, nitrogen balance, and plasma amino acids. No significant differences regarding any of the parameters studied was observed in relationship to the source of dietary protein, but compliance to the regimen was more difficult with the vegetable protein diet. PMID- 6858958 TI - Green algal infection in a human. AB - Infection by unicellular green algae has not been described in humans. A case is reported in a 30-year-old woman who developed persistent infection of a healing operative wound on the dorsum of the right foot, after possible contamination by river water while canoeing. The wound was debrided 2 months later. Histologically, infected tissues contained mixed suppurative and granulomatous inflammation associated with endosporulating, round to oval microorganisms, ranging from 6-9 microns in diameter. Many of these organisms contained multiple, strongly periodic acid-Schiff, Gomori methenamine-silver, and Gridley fungus positive granules in the cytoplasm. The organisms in tissue did not stain with fluorescent antibody conjugates specific for the two known pathogenic Prototheca species. In some organisms, electron microscopy revealed membranous cytoplasmic profiles considered to be remnants of degenerated chloroplasts. These findings are consistent with the presence of a green algal infection. PMID- 6858959 TI - Vitamin B6-dependent Streptococcus mimicking fungi in a patient with endocarditis. AB - A patient was referred to our hospital with a tentative diagnosis of fungal endocarditis based upon clinical symptoms, suggestive travel history, and microscopic visualization in blood cultures of gram-negative bulbous filaments that appeared to be fungal elements. Subcultures of the blood culture bottles were unsuccessful on all media with the exception of blood agar plates, which had been cross-streaked with Staphylococcus aureus. These plates grew vitamin B6 dependent streptococci. This nutritionally variant organism was determined by biochemical tests to be Streptococcus mitis (mitior). It had a penicillin MIC and MBC of 0.015 micrograms/mL and 0.03 micrograms/mL, respectively and streptomycin MIC and MBC of 0.78 micrograms/mL and 1.56 micrograms/mL, respectively. The patient was treated with these two agents and recovered. We stress the importance of suspecting vitamin B6-dependent streptococci, even when gram stains may suggest presence of other microorganisms. PMID- 6858960 TI - Tinea Pedis caused by Trichophyton violaceum. AB - This, to authors' knowledge, is the first report in the United States of Tinea pedis caused by Trichophyton violaceum in a recent Southeast Asian immigrant. Because of the recent entry into this country of refugees from an area of the world where T. violaceum is endemic, this anthropophilic dermatophyte may become a significant cause of dermatophytosis in the United States. PMID- 6858962 TI - Thalassemia minor: routine erythrocyte measurements and differentiation from iron deficiency. AB - The clinical differentiation of the causes of microcytosis is difficult because of the lack of a method for the diagnosis of alpha thalassemia. A number of laboratory tests have been proposed for the differentiation of alpha thalassemia from iron deficiency, including decision functions based on the red blood cell indices generated by electronic cell counters. The accuracy of these screening methods was assessed in 93 patients with microcytosis known to be secondary to either iron deficiency or beta thalassemia minor and, prospectively, in 26 patients with microcytosis in whom globin chain synthesis ratio was used to diagnose thalassemia. The functions evaluated were: RBC volume distribution curve; osmotic fragility; erythrocyte count; discriminant function = MCV - (5 X Hgb) - RBC - 8.4; ratio of MCH/RBC; ratio of MCV/RBC; and 0.01 X MCH X (MCV)2. A simplified method of measuring anisocytosis using the RBC volume distribution curve was significantly more accurate (P less than 0.01) in distinguishing iron deficiency from thalassemia than any of the other decision functions. Analysis of red blood cell volume distribution, although not sufficiently accurate for definitive diagnosis, appears to be a useful technic in the initial screening of patients with microcytosis and in determining which additional testing should be done. PMID- 6858961 TI - The ABCs of HPX. PMID- 6858963 TI - A new low ionic strength test for assessment of pretransfusion compatibility. Studies in vitro and in vivo. AB - A new simple low ionic strength antiglobulin test (LIS-AGT) is presented for use in the antibody screening phase of pretransfusion tests. The ionic strength during the incubation phase of LIS-AGT is held between 15-17% of that of indirect AGT, and 8 mM EDTA is added to serum to inhibit false-positive tests. The prevalence of false-positive LIS-AGT was determined to be approximately two times higher than that observed with the indirect AGT. The new test was superior to the indirect AGT in detecting antibodies specific to Rh, Duffy, Kidd, and MNSs antigens, while the indirect AGT was superior in detecting antibodies specific to K and Lewis antigens. On the basis of three 51Cr red blood cell (RBC) survival studies, it was shown that antibodies reactive with LIS-AGT only decreased the long-term survival of incompatible erythrocytes, although the one-hour recovery was not affected. It appeared that antibodies reactive by LIS-AGT only can cause delayed rather than acute hemolytic transfusion reactions. The data shown indicate that the LIS-AGT is a simple and valuable addition to the pre transfusion antibody screening test. PMID- 6858964 TI - Detection of platelet antibodies using the platelet migration inhibition assay. AB - We evaluated the usefulness of the Platelet Migration Inhibition (PMI) assay in detecting antibody to platelets in patients receiving platelet transfusions. Forty-one PMI assays were performed on pretransfusion sera from 19 patients. After each transfusion, each patient was evaluated clinically and by transfusion response for alloimmunization. Prevalence of antiplatelet antibody, the predictive value of positive and negative results, and efficiency of the PMI assay were calculated. The 41 PMI assays yielded true-positive, true-negative, false-positive, and false-negative results of 18, 14, 5, and 4, respectively. The sensitivity and specificity of the PMI assay were calculated at 81.8% and 73.7%. The PMI assay was comparable in sensitivity and specificity to immunofluorescence and superior to platelet aggregation and lymphocytotoxicity for detecting platelet (inhibition) antibodies. This test is simple and less costly than immunofluorescence; however, it lacks speed and efficiency for crossmatching purposes. It is useful as a clinical test in screening potential platelet pheresis donors and patients receiving platelet transfusions every other day. It may prove useful in research as a functional test to understand alloimmunization and restricted alloimmunization. PMID- 6858967 TI - Reticulocytopenic, coombs' positive anemia induced by procainamide. AB - A case of Coombs' positive anemia in a man who had procainamide-induced lupus erythematosus syndrome is reported. The patient had a hemoglobin of 4.3 gm/dl and reticulocytopenia (3.1% corrected). Serum lactate dehydrogenase and haptoglobin levels were normal, and total bilirubin was only slightly elevated. Two other reported cases of procainamide-induced hemolytic anemia have demonstrated similar findings. Apparently, procainamide occasionally may induce a reversible, reticulocytopenic, Coombs' positive anemia that is not associated with laboratory evidence of acute hemolysis. PMID- 6858965 TI - A predictive value model for quality control: effects of the prevalence of errors on the performance of control procedures. AB - A predictive value model has been developed to describe the usefulness of results from quality control tests or procedures. The model shows that the critical parameters are the probability for false rejection, probability for error detection, and prevalence or frequency of occurrence of analytical errors. When prevalence is low, control procedures should have a low probability for false rejection. When prevalence is high, control procedures should have a high probability for error detection. The predictive value model for a quality control (QC) test is analogous to the predictive value model for a diagnostic test, thus suggesting new strategies for optimizing the performance of QC tests. PMID- 6858966 TI - Aspiration does not influence interpretation of bone marrow biopsy cellularity. AB - Alterations of hematopoietic cellularity have been described in preaspirated marrow biopsy specimens. In this study, the extent of aspiration-induced artifacts was evaluated by comparing preaspirated and nonaspirated marrow biopsy specimens obtained from individual patients. Fourteen patients (28 specimens) were studied. One specimen, containing only cortical bone, was not evaluable. Of the remaining specimens, estimation of hematopoietic cellularity was not disturbed by preaspiration. Provided an adequate sized biopsy specimen is obtained, this study demonstrates that aspiration can be performed immediately before biopsy without altering the interpretation of hematopoietic cellularity. This makes a simple one-step aspiration-biopsy technic possible, without loss in diagnostic accuracy. In addition, without the need for repositioning to a different site on the iliac crest, patient tolerance should be improved. PMID- 6858968 TI - Diffuse nonsecretory osteosclerotic myeloma with extensive erythrophagocytosis. AB - A 51-year-old, black man presented with severe anemia and weakness. X-ray studies showed diffuse osteosclerosis involving most of his skeleton. He was documented to have similar bone changes on x-ray 5 years previously. Peripheral blood findings were suggestive of a myelophthisic anemia. Open biopsy of the iliac bone showed osteosclerotic myeloma. Secretion of abnormal protein could not be demonstrated through many examination of serum or urine. A unique finding at the autopsy was the presence of extensive erythrophagocytosis by the neoplastic plasma cells and macrophages. PMID- 6858970 TI - Nephrogenic metaplasia of the ureter. AB - We present what, to our knowledge, is the first reported case of nephrogenic metaplasia of the ureter. Nephrogenic metaplasia involves the transitional epithelium of the urinary tract and results in the formation of epithelial tubules, which are histologically similar to renal tubules. Special stains demonstrated both intracellular and intraluminal mucin. Ultrastructurally, the lesion consisted of epithelial cells with sparse microvilli and a thick basal lamina. The criteria for diagnosis and differentiation from carcinoma are discussed. PMID- 6858971 TI - Cunninghamella: a newly recognized cause of rhinocerebral mucormycosis. AB - Cunninghamella, a zygomycete in the order Mucorales, is an extremely rare cause of human infection. Of the five reported cases of human disease caused by this fungus, none involved rhinocerebral infection. Here, the authors document what appears to be the first case of rhinocerebral mucormycosis caused by Cunninghamella bertholletiae in an elderly man who had diabetes with sideroblastic anemia and hemochromatosis. The disease was rapidly fatal. The mycology and classification of this organism are presented, and the previous case reports in the literature are reviewed. PMID- 6858969 TI - Pre-elastofibroma and elastofibroma (the continuum of elastic-producing fibrous tumors). A light and ultrastructural study. AB - A fibroproliferative lesion arising anterior to the lower end of the scapula and containing polymorphic often fiberlike deposits of weakly elastinophilic fibrillary material is described. It is compared on the light and ultrastructural level to a typical elastofibroma. The fibrillary material seen in this tumor strongly resembles that which surrounds the strongly elastinophilic deposits in the typical elastofibroma and from which the elastin is thought to be derived. It is concluded that elastin-producing tumors form a continuum; at one end of which lies the tumor we have designated pre-elastofibroma and at the other, the typical elastofibroma. PMID- 6858972 TI - On writing medical articles. PMID- 6858973 TI - Clinical reactions and antibody responses to influenza vaccines. A comparison of split or subunit vaccines in children and young adults. AB - The reactogenicity and immunogenicity of a trivalent split-product influenza vaccine and a trivalent subunit influenza vaccine were studied in 67 children and young adults. Subjects received two doses of either vaccine given one month apart. The reactogenicity of the two vaccines was similar. After the second dose of the split-product vaccine, the prevalence of hemagglutination-inhibiting (HAI) antibody titers of 20 or more was as follows: A/Brazil/78, 73%; A/Bangkok/79, 100%; and B/Singapore/79, 73%. Similar data for the subunit vaccine recipients were 78%, 100%, and 74%, respectively. The HAI antibody responses to the A/Brazil/78 and B/Singapore/79 antigens of both vaccines were relatively poor in those subjects who were initially seronegative (HAI antibody titer less than 5) to the specific antigen. PMID- 6858974 TI - Selective hypoaldosteronism in infancy. Report of a case. AB - A 10-week-old female infant had anorexia, failure to thrive, and dehydration. Hyponatremia and hyperkalemia were found, along with urinary salt loss and increased plasma renin activity. Plasma deoxycorticosterone, corticosterone, and urinary 18-hydroxycorticosterone levels were increased. The plasma aldosterone levels were inappropriately reduced given the degree of sodium depletion present, while urinary aldosterone concentrations were persistently low. These are characteristic findings of an enzymatic defect in the synthesis of aldosterone involving 18-dehydrogenase, also known as methyl oxidase defect type 2. The infant responded to therapy with fludrocortisone acetate, including catch-up growth in both length and weight. The disease is transmitted by an autosomal recessive gene. PMID- 6858975 TI - Childhood subgaleal hematoma following minor head trauma. AB - Subgaleal hematoma developed one to eight days after minor head trauma in four children and in two infants, one with presumed trauma. These six children had no evidence of fracture or abnormality of coagulation. Hemorrhage into the subgaleal space resulted most likely from either radial or tangential forces applied to blood vessels within the subgaleal space. PMID- 6858976 TI - Kingella (Moraxella) kingae infections in children. AB - Kingella (Moraxella) kingae occasionally colonizes the nasopharynx and rarely causes serious infections. Three children with K kingae infections treated over a two-month period were studied. Epidemiologic investigation concluded that infection was community acquired, not pseudoinfection or nosocomial infection. Except for prompt laboratory recognition of the organism, no identifiable factors explained the observed prevalence. Five additional K kingae infections were reviewed. Affected sites included blood (two), valves (two), bone (two), joint (one), and disk space (one). Three patients had underlying disease; one was immunosuppressed. Kingella kingae resembles other members of the Neisseriaceae family and causes similar infections except meningitis. It is differentiated by colonial characteristics and standard biochemical tests. Treated infections responded to penicillin G potassium. Gram-negative bacteria uncommonly are implicated in endocarditis, arthritis, osteomyelitis, and diskitis; K kingae deserves recognition as a pathogen in these pediatric infections. PMID- 6858978 TI - Effect of a weight-reducing high-protein diet on the body composition of obese adolescents. AB - The effect of a three-month period on a high-protein reducing diet on body composition was studied in 17 obese adolescents, aged 12.5 to 17.4 years. Body composition was assessed by estimating fat-free body mass from four skin-fold thicknesses, total body potassium by natural potassium 40 abundance, and total body nitrogen by prompt gamma ray analysis. Weight loss was 15% of initial body weight. Total body nitrogen loss was only 4.8% (not significant), while total body potassium fell by 13.2%. Change in fat-free body mass estimated from skin fold thicknesses constituted approximately 44% of the total weight lost. There was no correlation between changes in total body potassium and total body nitrogen, suggesting that total body potassium cannot be used to predict total body nitrogen in a changing nutritional state. PMID- 6858977 TI - Effects of weight loss on fitness in obese children. AB - The relationship between weight and fitness change was established in 113 obese preadolescents participating in a six-month behavioral weight control program. Results showed significant improvements for both weight and fitness. Program success was strongly related to changes in exercise heart rate. Children who were most successful in the program decreased their maximal and recovery heart rates by 10.1 and 17.8 beats per minute, children with medium success had decreases of 4.9 and 11.8 beats per minute, and least successful children had decreases of 3.9 and 6.4 beats per minute. Analyses revealed that the combination of effective weight loss and an initially moderate degree of overweight (40% to 50%) combined to produce the greatest fitness changes. Children who entered treatment more than moderately overweight achieved comparable fitness improvements only if their weight loss was dramatic. PMID- 6858979 TI - Types I and III choledochal cyst. Preoperative diagnosis by ultrasound. AB - The presence of a choledochal cyst can be determined ultrasonographically. In two cases, the specific diagnosis of a choledochal cyst was made by identifying a bile duct that entered directly into a large cystic mass that was separate from the gallbladder. PMID- 6858981 TI - Congenital absence of the vagina. AB - Congenital absence of the vagina is the second leading cause of primary amenorrhea. Three patients had Mayer-Rokitansky-Kuster-Hauser syndrome or congenital absence of the vagina. We discuss the clinical, diagnostic, psychosocial, and therapeutic features of these patients and the syndrome. The lack of diagnosis until after puberty of this syndrome in many patients demonstrates the need for more careful genital examination in prepubertal and pubertal girls. PMID- 6858982 TI - Hepatic hemangiomatosis of infancy. AB - A 2-month-old female infant with congestive heart failure secondary to hepatic hemangiomatosis was treated with prednisone for five weeks without clinical improvement. She then underwent acute cardiac decompensation and required assisted ventilation. The hepatic artery was ligated to decrease the blood supply to the hemangiomata. Although the engorged liver softened dramatically, she continued to require mechanical ventilation for cardiac failure. Ten days postoperatively, she underwent digitalization with significant improvement in cardiac function, and she was then weaned from the respirator. Although, at 2 1/2 years of age, her liver has remained somewhat enlarged, her cardiovascular function has been normal. Our experience indicates that hepatic hemangiomatosis can be successfully treated via hepatic artery ligation and that cardiotonic measures might sometimes be required for recovery from coexisting congestive heart failure. PMID- 6858980 TI - The effect of early meconium evacuation on early-onset hyperbilirubinemia. AB - Delayed passage of meconium has been associated with hyperbilirubinemia. To determine if early evacuation of meconium is effective in reducing total serum bilirubin level, 84 term healthy neonates were randomly assigned to a suppository group or a nonsuppository group. Use of suppositories resulted in earlier evacuation of meconium as measured by the appearance of transitional stool. No significant effect was noted, however, on total serum bilirubin levels in the first three days of life. Routine use of suppositories to decrease total serum bilirubin level cannot be recommended for term healthy neonates. PMID- 6858983 TI - Colloid osmotic pressure at birth. Effect of sample site, type, and mode of delivery. AB - Colloid osmotic pressure was measured at birth in 102 newborns. Umbilical vein plasma colloid osmotic pressure correlated with total serum protein, birth weight, and gestational age. Mean colloid osmotic pressure of 11 infants who were small for gestational age was less than, and that of seven infants who were large for gestational age was more than, that of average-sized infants of similar gestation. For infants weighing 1,501 to 3,000 g, mean (+/- SD) colloid osmotic pressure following cesarean section (15.1 +/- 1.6 mm Hg) was lower than that following vaginal delivery (18.4 +/- 2.2 mm Hg). This may reflect the fact that use of maternal fluid therapy preceding cesarean section was greater than before vaginal delivery. The definition of normative values for neonatal plasma colloid osmotic pressure makes it possible to investigate changes in relation to disease, therapy, and subsequent outcome in sick neonates. PMID- 6858984 TI - Obstetric events and risk of periventricular hemorrhage in premature infants. AB - The relationships between selected obstetric factors and the occurrence of periventricular-intraventricular hemorrhage (PIH) was studied in a group of 77 infants weighing 1,200 g or less at birth. The diagnosis of PIH was made using ultrasonography or at autopsy in 42 (55%) of these infants. Univariate associations between PIH and gestational age (less than 30 weeks), duration of labor (greater than or equal to six hours), and vaginal delivery were found. Multivariate analysis, however, did not substantiate an association between PIH and any single obstetric factor. Log-linear analysis of multiway frequency tables showed significant second-order associations of PIH with gestational age and presentation during delivery and with duration of labor and presentation. A model for the risk of PIH based on gestational age, presentation, and duration of labor was derived using stepwise logistic regression. This model correctly predicted PIH in 70% (55) of the infants. Although obstetric factors may have a role in the pathogenesis of PIH, the interactions among factors, rather than single factors alone, are important. PMID- 6858986 TI - Education of residents. Results of a survey of pediatric training programs. PMID- 6858987 TI - Picture of the month. PMID- 6858985 TI - Surgical mortality and morbidity in extremely low-birth-weight infants. AB - Twenty extremely premature infants (birth weight, less than 1,100 g) underwent 49 surgical procedures for acquired conditions, including necrotizing enterocolitis, other forms of gastrointestinal perforation, gastroesophageal reflux, patent ductus arteriosus, and hydrocephalus. Few congenital anomalies requiring operation were encountered in this group. The overall survival rate was 58%. Using a computerized data base to compare surgical patients with a weight-matched group of nonsurgical patients, it was shown that survival was similar and that adverse prenatal and perinatal influences were equally distributed between both groups. Surgery per se did not adversely influence survival in extreme low-birth weight infants, and surgical patients are not a preselected group of stronger infants. PMID- 6858988 TI - Apathy as an early manifestation of intussusception. PMID- 6858990 TI - Intraosseous infusion. PMID- 6858992 TI - Well-child visits. PMID- 6858991 TI - Distended gallbladder appearing as abdominal mass in full-term neonates. PMID- 6858993 TI - Toxicology and forensic pathology--an interaction (chemical)? PMID- 6858989 TI - Severe hypernatremia in cystic fibrosis. PMID- 6858994 TI - Current conundrums facing forensic pathologists and toxicologists. PMID- 6858995 TI - Vitreous humor magnesium in alcoholics. AB - Postmortem vitreous humor magnesium concentrations were determined in 27 alcoholics and in 27 nonalcoholics who died of various causes. No significant differences in magnesium values were present between these two groups. The concentrations in those dying with alcohol withdrawal syndrome or in those with postmortem findings limited to hepatic fatty change did not differ significantly from those in the nonalcoholic group or from those of the alcoholics dying of other causes. There was no correlation between vitreous humor magnesium concentrations and postmortem interval in any group. We conclude that vitreous humor magnesium determination is not helpful in the postmortem evaluation of suspected alcohol-related deaths or in determining postmortem interval. PMID- 6858997 TI - Fatal retropleural hematoma complicating internal jugular vein catheterization. A case report. AB - This report describes a case of fatal retropleural hematoma complicating percutaneous insertion of a central vein catheter. The patient was a 55-year-old female undergoing surgery for severe rheumatic mitral valve disease. Factors responsible for this catastrophic incident are the anticoagulation of the patient, the edematous state of the soft tissues, and the multiple punctures of the wall of the jugular vein. PMID- 6858999 TI - Injuries sustained from high-velocity impact with water after jumps from high bridges. A preliminary report of 10 cases. AB - Autopsy findings in 10 cases of high-velocity impact with water--all suicides- are demonstrated. The injuries vary from no lesion at all to severe injuries, the fatal injuries predominately located to the thorax and the spine. All but one victim fell 35-37 meters; the last one fell 51 meters. The cause of death was drowning in six cases; in four cases, injuries were responsible for the fatal outcome. Head and neck injuries of any importance were not observed in the present investigation. PMID- 6858996 TI - Histopathological changes in selenium-exposed fish. AB - Redear sunfish (Lepomis microlophus) were collected from Martin Lake in east Texas. For at least 8 months, 1 year earlier, aqueous selenium-laden effluent from man-made sources was released into this 5,000-acre reservoir (unpublished data). Redear sunfish from a reference lake, 8 km upstream, were collected for comparison to Martin Lake fish. The hepatopancreas (i.e., liver and associated, disseminated exocrine pancrease), mesonephros (i.e., kidney), gonads, heart, spleen, stomach, and gill arches were preserved for histopathological examination using optical and/or transmission electron microscopy. Livers from Martin Lake redear sunfish (which had accumulated approximately 20 ppm selenium in the liver) showed central necrosis, reduced quantities of rough endoplasmic reticulum and glycogen particles, and increased numbers of lysosome-like structures. Kidneys showed proliferative glomerulonephritis, and exocrine pancreas showed marked hypertrophy at the optical level. Ultrastructurally, architectural disorganization, reduced rough endoplasmic reticulum, increased cisternal space, and proliferation of smooth endoplasmic reticulum were evident. The stomach, spleen, gill, heart, and gonads showed no abnormalities. PMID- 6858998 TI - Homicide in childhood. Distinguishable patterns of risk related to developmental levels of victims. AB - To study the characteristics of homicide in childhood, a review was done of the 29 medical examiner-autopsied children under 10 years of age who died under suspicious circumstances in Cook County in the first half of 1981 (17 by homicide, 12 by manner undetermined). Eleven cases occurred in January. The city victims came from neighborhoods characterized by poverty and female-headed households, consistent with the ecological model of child abuse. Eleven victims were infants: seven female, five white. The older victims were increasingly male and black with increasing age. Mean ages differed markedly for different types of injuries, with CNS and miscellaneous injuries typical in infancy, arson and beatings in toddler/preschool ages, and gunshot and pedestrian injuries in the school years. The data suggest that there are three clinically distinguishable types of homicide in childhood--infanticide, fatal child abuse and neglect after infancy, and murder in the community--related to developmental characteristics of the victims. PMID- 6859000 TI - Determination of ABO(H) blood group specific substances from fingernails. PMID- 6859001 TI - Intoxication by aspirin and alcohol in a child. A case of child abuse by medical neglect. AB - Investigation of child abuse deaths is often hindered by meager or unusual autopsy findings. Circumstantial factors are crucial in such investigations for a thorough understanding of the mechanism and manner of death. We present a case of childhood poisoning from aspirin and alcohol to demonstrate the medical neglect by the parents and the blatant discrepancies between the history provided by the parents and the actual facts preceding the child's death. PMID- 6859003 TI - Lead poisoning from hair spray ingestion. AB - A 37-year-old alcoholic woman was poisoned by lead from drinking hair spray mixed with water. Laboratory and pathologic findings showed changes due to lead poisoning. Further analysis by Scanning Electron Microscopy (SEM) and Energy Dispersive X-Ray Analysis (EDXA) confirmed the presence of lead in both the tissues and the hair spray. The significance of these findings is discussed. PMID- 6859004 TI - A fatal case of lead poisoning due to a retained bullet. AB - Lead poisoning from a retained bullet or missile is rare and is usually dependent on the location of the missile in a bone or immediately adjacent to a joint. A review of the literature revealed only 14 cases in which there was adequate laboratory documentation of plumbism caused by a retained bullet or missile. Only one of these previously reported cases resulted in death. We report a second death due to lead poisoning from a retained bullet with elevated blood lead levels documented by toxicologic analysis. PMID- 6859002 TI - Accidental death by gasoline ingestion. Case report and toxicological study. AB - A case of death following accidental ingestion of gasoline is described. Toxicological study, carried out by gas-liquid chromatography head space technique, permitted the identification and quantification of several hydrocarbons in all the viscera and biological fluids. The mechanism of death is discussed on the basis of the anatomopathological findings and quantitative toxicological results. PMID- 6859005 TI - Questionable traumatic deaths and their assessment. AB - It is often difficult to assess cases in which the circumstances strongly indicate traumatic cause of death, while the autopsy reveals no life-threatening injuries. Such cases can be divided into three groups: 1) death explained by heart disease and emotional stress and/or physical exertion; 2) deaths by suspected traumatic vagal inhibition in which another cause of death is found or the cause of death remains obscure, sometimes depending on incomplete postmortem investigation; and 3) death established by autopsy, but difficult to ascertain if there is a connection between the cause of death and the trauma. PMID- 6859006 TI - Two bite marks on assailant. Primary link to homicide conviction. AB - Two distinctly different bite marks occurred on the same individual, the perpetrator of a single homicide. The bite marks were produced by different teeth in the upper arch of the decedent on two separate areas of the perpetrator's body. While either injury demonstrated the points of identity with the decedent's dental arch, the pair considered together allowed conclusive identity of the perpetrator. The bite mark evidence led to a plea of guilty to second-degree murder by the accused. PMID- 6859008 TI - Detection of marihuana use by GC/MS analysis of mouth swabs. AB - A relatively simple and rapid test for detection of the components of Cannabis sativa (marihuana) after smoking consists of swabbing the exposed areas with an alcohol-containing swab, then concentrating the extract from the swab for direct analysis by Gas Chromatography-Mass Spectrometry. This test is now performed in several medical examiner's offices. This study was performed to evaluate this test using volunteer marihuana-smoking subjects. Caution must be used in interpreting the results obtained because of the transient nature of the intoxication, and because of the possibility of obtaining false-positive results. The time response and other parameters concerning the procedure are also discussed. PMID- 6859007 TI - Boot top fractures in pedestrians. A forensic masquerade. AB - Fractures of the legs are characteristic injuries in automobile-pedestrian collisions. Typically these occur at the level of the bumper; measurement of the height of these fractures may be used to reconstruct the events surrounding the collision. We report two cases in which the lower leg fractures did not correspond to the bumper, but rather to the top of the boots worn by the pedestrians. In both cases the decedents were wearing boots with lugged soles which provided fixation of the foot and support for the foot and ankle. The mechanism of these injuries is analogous to boot top fractures which occur in skiing accidents. PMID- 6859009 TI - Agent Orange. PMID- 6859010 TI - Gastric carcinoid: two unusual presentations. AB - We report two cases of gastric carcinoid that presented as benign-appearing polyps. One presented with multiple, benign-appearing polyps--a particularly unusual presentation for an uncommon tumor. The second patient had a single polypoid gastric carcinoid and atropic gastritis with pernicious anemia. These atypical presentations and uncommon association of gastric carcinoid are discussed. PMID- 6859011 TI - Angiographic, radiographic, and computed tomographic findings in tuberculosis of the jejunum. AB - Tuberculous involvement of the jejunum with thickening and infiltration of the bowel wall and subsequent gastrointestinal hemorrhage from multiple bleeding points was encountered. Bleeding could not be controlled by intra-arterial vasopressin infusion. To our knowledge this is the first report of angiographically demonstrated and treated tuberculous gastrointestinal hemorrhage. PMID- 6859012 TI - Concurrent malignant lymphoma of the jejunum and multiple synchronous colon cancers. AB - This paper describes a unique case of combined malignant lymphoma of the jejunum and multiple synchronous carcinomas of colon and rectum. The jejunal tumor developed obstructive growth without regional lymph node involvement. Histologically, it was a malignant lymphoma corresponding to medium-sized cell type of follicular lymphoma, suggesting B cell origin in the bowel wall. In the colon and rectum, except for the transverse segment, there were three encircling, annular infiltrative tumors, and six polyps with malignant change. They developed independently, separated by an intact mucosa suggesting multiple synchronous cancers. Histologically they showed adenocarcinoma with or without mucus production, adenosquamous cell carcinoma, and villotubular adenocarcinoma. A case report is presented with a brief review of the incidence and pathogenesis of both jejunal and colonic tumors. PMID- 6859013 TI - Ileal varices revealed by recurrent hematuria in a patient with portal hypertension and Mekong Schistosomiasis. AB - This present report describes a unique case of a patient with ileal varices revealed by recurrent bleeding from vesical varicosities. Ileal varices were associated with portal hypertension secondary to portal thrombosis. An unusual ileovesical shunt was demonstrated by the venous phase of the superior mesenteric arteriogram. This shunt was favored by adhesions between an abnormal ileal loop, which was infiltrated with ova of schistosoma mekongi, and the superior vesical wall. The patient was treated successively by lysis of adhesions and ileal resection. No portacaval shunt was performed. PMID- 6859014 TI - Ultrastructural pathology of Crohn's disease: correlated transmission electron microscopy, scanning electron microscopy, and freeze fracture studies. AB - The mucosa of the ileum or colon from 16 patients with active Crohn's disease was studied using transmission electron microscopy of thin sections, scanning electron microscopy, and freeze fracture electron microscopy. Electron micrographs of diseased tissue, as well as of grossly normal resection margins, were studied. Correlations of mucosal disease, as seen with the various ultrastructural techniques, were made and compared to controls. Alterations of epithelial cell tight junctions in freeze fracture replicas correlated with a decrease in the number of pinpoint contacts between adjacent cells in transmission electron microscopy preparations. Gap junctions in Crohn's disease did not vary with respect to structure or number, when compared to controls. Mucosal microulcerations, affecting 1 to 6 cells, were observed in transmission and scanning electron microscopy preparations. Possible freeze fracture electron microscopy correlates of microulcers consisted of replicas of cells completely devoid of tight junctional structures. "Aphthoid" type ulcers were studied with the various ultrastructural tools and were remarkable for several abnormalities of villi bordering the aphthoid ulcers, as well as surrounding villi. Transmission, scanning, and freeze fracture electron microscopy each provide unique and confirming data that may be used to construct a model for the pathophysiology of Crohn's disease. PMID- 6859015 TI - Reye's syndrome in the adult: case report and review of the literature. AB - A 22-year-old male presented with a brief history of progressive encephalopathy. One week previously, he had developed an upper respiratory infection that resolved spontaneously and was followed by intractable vomiting. He had taken salicylates for several days during the viral syndrome. The diagnosis of Reye's syndrome was confirmed by hepatic histology. Aggressive conservative management was followed by complete metabolic and neurological recovery. There are fewer than 10 reported cases of Reye's syndrome in adults but this disease may be more common than is generally suspected. The diagnosis should be considered in patients presenting with emesis and obtundation, who have recently had a viral illness and exhibit elevated blood ammonia and transaminases with normal cerebrospinal fluid. Confirmation is achieved by liver biopsy. Therapy is directed toward aggressive reduction of increased intracranial pressure. PMID- 6859017 TI - Steatohepatitis in obese children: a cause of chronic liver dysfunction. AB - Adult obese patients have been reported to present with hepatic abnormalities characterized by fatty hepatitis, fibrosis, and cirrhosis. These abnormalities however, have not been reported to occur in children. We report three obese children with steatohepatitis that presented with nonspecific abdominal pain and abnormal liver-function tests. Obese children should have a thorough investigation of their liver function even in the absence of symptoms or signs. PMID- 6859019 TI - Thoracic osteophyte producing dysphagia in a case of diffuse idiopathic skeletal hypertrophy. PMID- 6859016 TI - Sonographic evaluation of patients with portal hypertension. AB - The availability of real-time sonography has facilitated its use in the assessment of patients suspected of portal hypertension. Dilatation of the portal venous system may occur in portal hypertension, and a portal vein diameter greater than 13 mm is indicative of portal hypertension with a sensitivity of about 50%. Sonographic demonstration of lack of caliber variation of the portal system has a sensitivity of about 80%. The presence of venous collaterals can be demonstrated in about 90% of patients suitable for sonography. The coronary gastroesophageal varices can be seen in 90% when they are large sized, and in 65% when they are small sized. Other collaterals such as umbilical vein, duodenal varices, and gastrorenal and splenorenal varices can be detected. Sonography is a valuable screening procedure in the evaluation of portal hypertension and provides valuable information regarding the size and morphology of the liver and spleen, caliber and patency of the portal venous system, and the existence and location of the varices. PMID- 6859018 TI - Hepatitis on high dose isoniazid: reintroduction of the drug in severe tuberculous meningitis. AB - Hepatitis developed in two patients treated with high doses (1000 mg/day) of isoniazid for severe tuberculous meningitis. Isoniazid was discontinued and later readministered in gradually increasing intrathecal and subsequently oral doses, up to the final dose of 400 mg/day. Transaminases remained normal, during 12 months on this dose, suggesting dose dependence of hepatotoxicity or a metabolic adaptation to the injury. Continued isoniazid treatment can be important in similar cases and it may become possible, if oral or intrathecal doses significantly lower than the initial hepatotoxic ones, are used. PMID- 6859020 TI - Cigarette smoking, relative weight, and menopause. AB - To examine the interrelationships of cigarette smoking, relative weight, and the occurrence of natural menopause, the authors prospectively evaluated the experience of 66,663 female US registered nurses who were premenopausal in 1976. Over a two-year period, 5004 women became post-menopausal. Current smokers were more likely than past or never smokers to develop menopause, although the effects of smoking diminished with age. The rate ratios of menopause for current smokers vs. never smokers (with 95% confidence limits) for women aged 30-39, 40-44, 45 49, and 50-55 years were 1.90 (1.10-3.28), 2.16 (1.73-2.69), 1.53 (1.41-1.67), and 1.20 (1.12-1.28). These rate ratios were not appreciably affected by adjustment for relative weight. Median ages at menopause were 52.4 for never smokers and 51.9, 51.0, 50.7, and 50.4 years for women who currently smoked 1-14, 15-24, 25-34, and 35 or more cigarettes per day. A crude linear relationship between relative weight and occurrence of menopause was observed. Comparing the leanest and heaviest quintiles, rate ratios for menopause among women aged 30-39, 40-44, 45-49, and 50-55 years were 1.42 (0.74-2.75), 1.26 (0.95-1.69), 1.25 (1.13 1.41) and 1.08 (0.99-1.19). The effect of relative weight was in part explained by the tendency of current smokers to weigh less than nonsmokers. After adjustment for current cigarette consumption a weak linear relationship between relative weight and menopause remained among women who smoked, although no such association was seen among nonsmokers. PMID- 6859021 TI - Diabetic retinopathy in Nauruans. AB - An epidemiologic survey of the whole adult Micronesian population of Nauru in the Central Pacific conducted in 1982 has confirmed that Nauruans, along with Pima Indians, suffer the highest rate of abnormal glucose tolerance yet recorded. To establish the morbid effects of hyperglycemia in this population, all responders to the diabetes survey were concurrently examined for diabetic retinopathy. In diabetic subjects, the crude prevalence of retinopathy was 24%. Specific rates were determined at various levels of the following characteristics: age, two-hour post-load plasma glucose, body mass index, duration of diabetes, and systolic blood pressure. Prevalence was found to rise with increasing two-hour plasma glucose and duration, to fall with increasing body mass index, and to have a quadratic relationship with age and systolic blood pressure. The multiple logistic regression model was used to determine whether the selected characteristics were significant in increasing the risk of retinopathy. Body mass index and systolic blood pressure did not contribute significantly to this risk after controlling for age. Increasing two-hour plasma glucose significantly increased the risk of retinopathy, and duration of disease was the strongest predictor variable. This study shows that the consequences of hyperglycemia in this Micronesian population are comparable to those already documented in European and American Indian communities. PMID- 6859022 TI - Change in observed birth weight associated with change in maternal cigarette smoking. AB - Using data collected by the National Collaborative Perinatal Project of the National Institute of Neurological and Communicative Disorders and Stroke, the author paired on characteristics of their first study pregnancy 319 white women who reported a change in smoking habits for two successive pregnancies with 319 women who reported no change in smoking behavior. Matching was based upon similar birth weight, interval between births, smoking behavior, sex, and parity of the first of two study births. Divergent smoking behavior for each pair by the time of the second study birth allowed assessment of smoking as a treatment effect. Members of each pair who started smoking prior to the second birth while not smoking for the first, had infants with an average birth weight of 67 g less than infants of their controls who did not start smoking and 36 g less than their previous infant. Among infants whose mothers reported smoking prior to the first study birth, a significant increase in birth weight was observed over infants of controls for women who quit smoking prior to the second study birth (average, 169 g). Taken at face value, this rebound in birth weight is not consistent with an immutable, innate predisposition to lower birth weight among those disposed to smoking. PMID- 6859024 TI - The geography of gonorrhea. Empirical demonstration of core group transmission. AB - The pattern of reported gonorrhea in Upstate New York (exclusive of New York City) in the years 1975-1980 is one of intense central urban concentration, with concentric circles of diminishing incidence. The relative risk for gonorrhea in these central core areas, compared to background state rates, is 19.8 for men and 15.9 for women, but as high as 40 in selected census tracts. Prevalence appears to approach 20% in some areas, the level postulated by current epidemiologic models for continuing endemic transmission. These core areas are characterized by high population density, low socioeconomic status and a male to female case ratio of one or lower. Contact investigation data suggest that sexual contact tends to exhibit geographic clustering as well. These observations provide support for narrow focusing of epidemiologic resources as a major disease control strategy. PMID- 6859023 TI - Four urinary cations and blood pressure. A population study in two Belgian towns. AB - The relationship between blood pressure and the 24-hour urinary excretion of four cations (Ca, Mg, K, Na) was investigated in a random sample of 688 inhabitants of two Belgian towns. In 160 youths aged 10-19 years, systolic/diastolic blood pressure averaged 118 +/- 12.6/65 +/- 8.6 mmHg (mean +/- standard deviation) and the urinary excretion of the four urinary cations was broadly similar in both sexes. Adjusting for body weight removed the strong relationship between blood pressure and age, but a positive relationship between systolic pressure and pulse rate emerged. The only association between blood pressure and a urinary constituent was with calcium excretion, and this correlation was no longer apparent after adjusting for weight. In 528 adults aged greater than or equal to 20 years, systolic/diastolic pressure averaged 130 +/- 14.4/77 +/- 9.8 (p less than 0.001) higher in male than in female subjects. In these adults, both systolic and diastolic pressure were strongly and independently correlated with age and body weight. Systolic pressure in women was also significantly and positively related to pulse rate (r = +0.20; p less than 0.001). After adjusting for age and body weight, systolic and diastolic pressure in men were significantly and negatively correlated (p less than 0.001 and p less than 0.01, respectively) with urinary potassium excretion. Diastolic pressure in men was weakly but positively correlated with calcium excretion (p less than 0.05 after adjusting for body weight, age and urinary potassium excretion). The present study indicates that urinary potassium is a consistent and negative predictor of both systolic and diastolic pressure in adult men, whose diastolic pressure was also weakly and positively associated with urinary calcium. In youths and female subjects, the single 24-hour urinary excretion of the four cations did not contribute to the prediction of blood pressure. PMID- 6859025 TI - Hepatitis A associated with a hardware store water fountain and a contaminated well in Lancaster County, Pennsylvania, 1980. AB - In August-October 1980, a sudden increase occurred in the number of cases of jaundice reported among residents of a rural, agricultural section of Lancaster County, Pennsylvania. Investigation confirmed the cases as hepatitis A and showed that the outbreak was associated with consumption of water from a water fountain in a hardware store and water from the adjacent family home, both of which came from a well contaminated with feces. A total of 49 cases occurred from August 11 to October 21 in store customers, employees, family members, and persons visiting the family residence. Unusual features of the outbreak included an epidemic curve with two peaks, a very high attack rate in susceptibles at highest risk (greater than 90%), a high proportion of cases with jaundice (85%), absence of asymptomatic cases, and a high male to female ratio due to the makeup of the group at risk. PMID- 6859026 TI - Lung cancer among long-term steel workers. AB - A case-control study in an industrialized area of eastern Pennsylvania involving interviews with the next of kin of 335 men who died of lung cancer and of 332 controls who died of other causes revealed a significantly increased risk associated with employment in the steel industry, the area's major employer. The excess was primarily among long-term employees, particularly those who began work before 1935. Adjusted for cigarette smoking, the odds ratio associated with career employment was 1.8 (p = 0.01, 95% confidence interval, 1.2, 2.8). The increase was higher among steel workers who worked in foundry operations, but was seen for broad categories of jobs within the industry. No significant associations were found for other industries, although a 60% increase (p = 0.27, 95% confidence interval, 0.7, 3.7) was noted for zinc smelter workers employed at least 15 years. The findings help clarify the role of occupation as a risk factor for lung cancer in the area, and suggest that exposures in the steel industry contribute to an extent greater than previously recognized. PMID- 6859027 TI - Ethnic differences in health knowledge and behaviors related to the prevention and treatment of coronary heart disease. The San Antonio Heart Study. AB - From a public health perspective, Mexican Americans are widely recognized as an understudied population. Available evidence suggests that Mexican Americans shared equally with non-Hispanic Caucasians (Anglo Americans or "Anglos") in the national decline in coronary heart disease (CHD) mortality during 1970-1976. This finding is somewhat unexpected in view of Mexican Americans' relatively lower socioeconomic status, and it suggests that studying this ethnic group may be strategic in understanding which factors have operated to produce the decline in general. Data obtained from a random sample of Mexican Americans and Anglos residing in three socioeconomically and culturally distinct neighborhoods in San Antonio, Texas, indicated that Anglos were significantly more informed than Mexican Americans about CHD prevention and generally reported engaging in more behaviors specifically aimed toward prevention than did Mexican Americans. Levels of knowledge were not particularly high in either ethnic group; moreover, reported behavior lagged considerably behind knowledge. While Mexican Americans were significantly less likely than Anglos to volunteer knowledge about major heart attack symptoms, there were negligible ethnic differences in awareness of the need for prompt utilization of medical treatment resources when a heart attack actually occurs. Awareness of the need for prompt action was notably high among both ethnic groups. Although limitations in the nature and scope of the data dictate that these findings should be interpreted with caution, the results tend to argue in the direction that prompt access to medical treatment when coronary emergencies occur may have made a relatively greater contribution to the CHD mortality decline in both Mexican Americans and Anglos than did changes in life-style. Much additional data are needed, however, before a definitive explanation of the decline will be possible. PMID- 6859028 TI - The relationship of the U wave to the 10-year incidence of myocardial infarction. AB - The relationship between the baseline electrocardiogram and 10-year incidence of myocardial infarction was examined in a cohort of 1013 men. The men were participants in the Normative Aging Study, a longitudinal study of aging initiated in 1963 at the Veterans Administration Outpatient Clinic in Boston, Massachusetts. Absence of the U wave among these men yielded a relative risk estimate of myocardial infarction of 2.7 as compared to men with a U wave present (95% confidence interval, 1.4-5.2). This association persisted when standard coronary risk factors (cholesterol, blood pressure, and cigarette smoking) were taken into consideration in a multivariate analysis. The results support the conclusion that an abnormality in the electrocardiogram considered to be of little importance indicates an increased risk of myocardial infarction independent of known coronary risk factors. PMID- 6859029 TI - Determinants of change in blood pressure during childhood. AB - The determinants of change in blood pressure during childhood were studied in 596 Dutch children, aged 5-19 years. The children were randomly selected from a general population in Zoetermeer, near the Hague, the Netherlands, and this report deals with 462 children (78%), who had three to seven annual measurements of blood pressure between 1975 and 1982. The rate of change in blood pressure was obtained by least-squares regression of blood pressure on time for each subject. Initial level of blood pressure was associated negatively with subsequent change in systolic and diastolic pressure, even after adjustment for regression toward the mean. Parental blood pressure and initial body weight were related positively, but weakly, to the rate of blood pressure change. Initial serum uric acid was associated positively with change in blood pressure in girls only. Vascular reactivity, as measured by the cold pressor test, was not related to the rate of change in blood pressure. The same applied to pulse rate and the use of tobacco, coffee, and oral contraceptives. The finding that children with the highest initial levels of blood pressure did not have the largest subsequent increase suggests that there is no "horse-racing" of blood pressure during childhood. There is some evidence that the relation between initial level and subsequent change in blood pressure is modified by age. PMID- 6859030 TI - Short-term temporal cycles in the frequency of suicide. United States, 1972-1978. AB - Vital statistics data for the United States for the years 1972-1978 have been analyzed for variation in frequency of suicide by month, day of the week, day of the month, and phase of the lunar cycle. Frequency of suicide showed a peak in the spring months, a lesser peak in the fall and was lowest in December. Suicide was most frequent on Mondays and declined during the week to a trough on Saturdays (in the summer) or Sundays (in the winter). There was a previously unreported cycle by day of the month, of comparable magnitude to that seen by month and day of the week; suicides were most frequent around the 5th of the month and least frequent in the last days of the month. February was the only month which failed to exhibit this within-month cycle. There is no satisfactory explanation for any of these temporal cycles. There was no relationship between number of suicides and phases of the lunar cycle. PMID- 6859033 TI - Mechanism of defibrination in humans after envenomation by the Eastern diamondback rattlesnake. AB - We prospectively studied the hemostatic system of ten persons bitten by the Eastern diamondback rattlesnake (Crotalus adamanteus) during 1978-1980. Blood was drawn when the patients arrived in the emergency room and every 6 hr thereafter. All envenomated victims developed incoagulable blood (defined by a thrombin time greater than or equal to 120 sec, normal less than 20 sec). Platelet counts and plasma levels of antithrombin III and factors II and VIII were not drastically altered, which distinguished this disorder from classic disseminated intravascular coagulation. Fibrinogen levels were markedly decreased (mean coagulable level of 0 mg/dl and antigenic levels of 99 mg/dl). Plasminogen levels were 20% of normal, alpha-2-plasminogen inhibitor was 17% of normal, and plasminogen activator was 20 times normal. Levels of fibrin degradation products peaked at a mean of 7,680 micrograms/ml. The magnitude and duration of the coagulopathy were proportional to the clinical severity of envenomation. Treatment with antivenin blunted the coagulopathy. Because venom from the Eastern diamondback rattlesnake does not directly activate plasminogen, we conclude that coagulopathy following envenomation by that reptile appears to be due to partial proteolysis of fibrinogen with secondary activation of plasminogen by released plasminogen activator, probably of endothelial origin. PMID- 6859031 TI - Unique sensitivity of Hb Zurich to oxidative injury by phenazopyridine: reversal of the effects by elevating carboxyhemoglobin levels in vivo and in vitro. AB - Phenazopyridine (PAP) causes a hemolytic anemia in normal individuals who receive an overdose or in patients with decreased renal function given therapeutic doses. There are no reports of PAP-induced hemolysis in individuals with unstable hemoglobins. Therapeutic doses of PAP administered to a subject with Hb Zurich (His E7 (63) beta leads to Arg) caused a severe hemolytic anemia with many large Heinz bodies appearing in the red cells. Incubation of whole blood from three asymptomatic Hb Zurich subjects with PAP at a molar ratio of PAP/Hb of 1.3/1 produced a moderate to marked increase in methemoglobin (MHb) and Heinz body formation accompanied by a slight to moderate decrease in levels of reduced glutathione. The rates of MHb formation were proportional to the concentration of PAP. In two of the subjects the rates of formation of Heinz bodies and MHb were substantially higher than in the third subject. Red cells from five normal adults were not affected. In Hb Zurich red cells the affinity of the abnormal beta chain for carbon monoxide is much greater than that of the normal alpha and beta chains. The two subjects with higher rates of MHb and Heinz body formation were nonsmokers with in vivo carboxyhemoglobin (HbCO) levels of 4-6%. The third subject with low rates of MHb and Heinz body formation was a smoker with in vivo HbCO levels of 15-18%. Increasing levels of HbCO from 8.2% to 14.3% by the in vitro addition of CO caused a marked reduction in the rate of Heinz body formation and a moderate decrease in MHb formation. Rates of MHb formation similar to those observed in normal red cells occurred at HbCO percentages of 89.2 and 99.2. Red cells containing Hb Zurich are extremely sensitive to oxidative injury by PAP, either in vivo or in vitro. The degree of oxidative injury diminishes as the level of HbCO increases, a phenomenon that is enhanced by preferential binding of CO to the abnormal beta subunit of Hb Zurich. PMID- 6859034 TI - Lymphocytotoxic antibody is a predictor of response to random donor platelet transfusion. AB - The transfusion records of 189 patients with acute leukemia were analyzed to correlate lymphocytotoxic antibody (LCTAb) levels with response to a series of random-donor platelet transfusions (Tx). Twenty-one patients were studied twice at times of different LCTAb levels. All transfusions were given when patients were clinically stable without disseminated intravascular coagulation, bleeding, temperature greater than 101 degrees F, or splenomegaly. The mean 1-hr and 24-hr corrected count increments (CCI) for all patients with negative LCTAb were 16,100 and 12,000, and values for patients with positive LCTAb were 5,600 and 2,600 (P less than 0.0005). Thirteen patients had intermediate LCTAb (10-20%) and a variable response to Tx. Of the 137 patients with negative LCTAb levels 106 (77%) had good mean CCI of greater than 10,000 at 1 hr and greater than 7,500 at 24 hr following transfusion. In contrast of 60 patients with positive LCTAb (greater than 20% cytotoxicity), 53 (88%) had poor CCI of less than 10,000 at 1 hr and less than 7,500 at 24 hr after transfusion. Only 4 patients with positive LCTAb had a good response to random donor platelets at both 1 and 24 hrs. Eighteen patients had negative LCTAb with a high 1-hr and low 24-hr CCI. Thirteen of these had a history of positive LCTAb and in 9 there was an anamnestic rise following transfusion. Nine of 137 patients had negative LCTAb with low 1-hr and 24-hr CCI. LCTAb is highly predictive of response to random donor platelets. Cytotoxicity to greater than 20% of tested lymphocytes virtually precludes a good CCI at 1 and 24 hr. PMID- 6859032 TI - Biochemical characterization of three mutant isozymes of erythrocyte pyruvate kinase: PK-"Gainesville," PK-"San Juan," and PK-"Cape Canaveral". AB - Pyruvate kinase was partially purified from erythrocytes of three unrelated, nonconsaguineous patients with chronic hemolytic anemia of differing clinical severities. Characterization of the defective PK isozymes by internationally standardized criteria indicated that one (PK-"Gainesville") had severely impaired substrate affinity, another (PK-"San Juan") had markedly reduced residual activity, and the third (PK-"Cape Canaveral") had a combination of milder defects. Each appears representative of subsets emerging from the heterogeneous molecular defects that make up pyruvate kinase deficiency. PMID- 6859036 TI - Percentages of abnormal hemoglobins in adults with a heterozygosity for an alpha chain and/or a beta-chain variant. AB - The author reviews quantitative data from blood samples involving more than 700 simple and compound heterozygotes for one of 21 types of alpha-chain and 36 types of beta-chain variants. All samples were analyzed during the past few years by the same analytical procedure. Various factors influencing the percentages of the different abnormal hemoglobins are discussed; these include the variability of the method, the number of active alpha-chain genes, the location of the substitution, the type of substitution, the effect of the loss of a critical amino acid residue, and the introduction of a new residue on the physiochemical and/or functional properties of the protein. The use of a single accurate method is promoted; it may well be that high-pressure liquid chromatographic procedures will be the recommended methods for future analyses. PMID- 6859035 TI - Aging of the erythrocyte. 23. Changes in the permeation of spin-labeled electrolytes. AB - The transport of spin-labeled anions and cations was studied in bovine erythrocyte fractions of various ages. Permeation of a spin-labeled anion, 3 carboxy-2,2,5,5-tetramethylpyrrolidine-1-oxyl into the cells was found to be significantly slower in older cells, suggesting a functional impairment of the band 3 protein of the erythrocyte membrane during red cell aging in vivo. PMID- 6859037 TI - Absence of cross-reacting material in isolated propionyl CoA carboxylase deficiency: nature of residual carboxylating activity. AB - Fibroblast extracts and fetal liver homogenates from patients with propionic acidemia due to inherited deficiency of propionyl CoA carboxylase (PCC) were analyzed for the presence of immunologically cross-reactive PCC protein. Using several rabbit antisera raised against homogeneous human liver PCC, homogeneous pig heart PCC, or the individual non-identical subunits of the human liver enzyme, we found no detectable cross-reacting material by direct or competitive immunotitration in several cell lines from patients in either major complementation group (pcc A; pcc C) with isolated PCC deficiency. In contrast, cells of a patient from the bio complementation group contained normal amounts of immunoreactive PCC. Further analysis of the pcc A and pcc C mutants revealed that their residual propionyl CoA carboxylating activity varied greatly depending on the concentration of extract or homogenate protein used in the PCC assay. When propionyl CoA carboxylation was assayed at high protein concentration in a fetal liver homogenate from a pcc C patient, the apparent PCC activity was comparable to that found in normal human fetal liver. Significantly, the specific activity in the mutant, but not in the control, extract declined steeply as protein concentration was lowered, and this loss could not be prevented by adding PCC substrates, bovine serum albumin, glycerol, or 2-mercaptoethanol. Moreover, detailed analyses of immunotitration curves of control fibroblasts extracts showed that fresh extracts contained an amount of nonimmunotitratable carboxylating activity corresponding to the residual activity present in fresh extracts of mutant cell lines. We conclude that the residual propionyl CoA carboxylating activity found in isolated PCC deficiency represents another carboxylase that can utilize propionyl CoA as a substrate rather than a mutant form of PCC with markedly different immunochemical and physicochemical properties. PMID- 6859038 TI - Maternal smoking and trisomy among spontaneously aborted conceptions. AB - In a study of spontaneous abortions, we found an apparently robust association of trisomy with smoking that varies with maternal age. Among women under age 30, smoking either before or at the time of conception is less common in women aborting trisomic conceptions than in controls delivering at 28 weeks or later. Among older women, smoking is more common in women aborting trisomic conceptions than in controls. Our results point to an effect of smoking on the frequency of trisomic abortions that varies with age, and they suggest that the causes of recognized trisomic abortions differ in younger and older women. PMID- 6859039 TI - Heritable fragile sites on human chromosomes. X. New folate-sensitive fragile sites: 6p23, 9p21, 9q32, and 11q23. AB - Four new folate-sensitive fragile sites are documented at 6p23, 9p21, 9q32, and 11q23. These have all been shown to be heritable except for the one at 9p21, which has been seen only in a single individual. As with the other autosomal fragile sites, these appear to be innocuous in heterozygotes. PMID- 6859040 TI - Alzheimer disease: evidence for susceptibility loci on chromosomes 6 and 14. AB - We report the transmission of HLA haplotypes and Gm allotypes in 97 members of a single kindred containing 257 individuals, 45 of whom were determined by clinical examination, autopsy, or historical data to have had Alzheimer disease (AD). Extensive inbreeding suggests that more than one gene may contribute to susceptibility to AD in this family, despite the apparent vertical transmission of illness. The distribution of HLA haplotypes and of Gm allotypes to affected and unaffected siblings is consistent with the possibility that genes in the HLA region of chromosome 6 and perhaps also in the Gm region of chromosome 14 are determinants of susceptibility. Further studies are needed to investigate whether susceptibility to AD may result from an interaction between (immune response?) genes on these two chromosomes. PMID- 6859041 TI - Familial predisposition to cancer and age at onset of disease in randomly selected cancer patients. AB - Incidence of malignancy among close relatives was used to evaluate the relationship of early age at diagnosis and familial cancer predisposition in a general population of cancer patients. The occurrence of cancer and other conditions in families of more than 1,350 randomly selected patients with a wide variety of malignancies was ascertained. Each patient was assigned to one of four study groups based on comparison of his age at diagnosis with the distribution of ages at diagnosis for his cancer site compiled by the Third National Cancer Survey. These groups consisted of patients whose ages at diagnosis were in: (1) the lowest decile, (2) the median decile, (3) above the median decile, and (4) between the lowest and median deciles. Person-years and calendar time at risk were calculated for first-degree relatives in each group. The numbers of cancers expected among these relatives were calculated using age- and time-specific incidence rates of a standard population. Statistical analysis of (1) the numbers of reported vs. expected cancers in relatives and (2) the numbers of families reporting cancer in parents or siblings of patients showed that a familial tendency to develop cancer exists in this randomly selected population of cancer patients, regardless of age at onset of malignancy in the proband. Conversely, early age at diagnosis of cancer may indicate genetic predisposition to malignancy only in exceptional cases. PMID- 6859045 TI - Incidence of Friedreich ataxia in Italy estimated from consanguineous marriages. AB - The frequency of consanguineous marriages up to second-cousin degree has been carefully established in the past for each of the 95 Italian provinces using the Archive of about 500,000 dispensations given by the Catholic church for such marriages over a 55-year period. It has therefore been possible to compare the frequency of consanguineous marriages observed among 83 couples of parents of Friedreich patients with the frequency of consanguineous marriages of the same degree in the different Italian provinces during the same years. From these data, an estimate of the incidence of the disease has been obtained for the whole nation (between 1/22,000 and 1/25,000). In Southern Italy, where 16 out of the 18 consanguineous marriages among Friedreich parents are concentrated, the incidence of the disease is similar (between 1/25,000 and 1/28,000). This study indicates that the Archive of consanguinity existing in Italy allows a reliable comparison of the frequency of consanguineous marriages among parents of patients with that of the general population. The same method can therefore be applied to the study of incidence of other autosomal recessive disorders in Italy. PMID- 6859046 TI - BrdU-sensitive fragile site on long arm of chromosome 16. PMID- 6859042 TI - Heterogeneity between populations for multifactorial inheritance of plasma lipids. AB - A general linear model was described for multifactorial inheritance of the two plasma lipids, total cholesterol (CH), and triglyceride (TG). Analyses of two separate studies, the Honolulu Heart Study (HHS) and the Cincinnati Lipid Research Clinic (LRC), indicated some heterogeneity. Whereas the sibling environmental effect (b) was the only source of heterogeneity between the two studies for TG, the correlation between marital environments (u) may also be considered as a source of heterogeneity for CH. Under parsimonious hypothesis, intergenerational differences in heritabilities were not found to be significant for either trait (y1 = y2 = z1 = z2 = 1). Maternal effects were significant for CH but not for TG. Correlations between marital environments (u1 and u2) were not significant for TG, and may be considered nonsignificant for CH also under parsimonious hypotheses. In any case, the genetic (h2) and cultural (c2) heritabilities cannot be considered to be heterogeneous between the two studies. Based on pooled data, parsimonious hypothesis yields: h2 = .594 +/- .041 and c2 = .035 +/- .008 for CH, and h2 = .259 +/- .034 and c2 = .108 +/- .014 for TG. PMID- 6859044 TI - H-deficient blood groups of Reunion Island. III. alpha-2-L-fucosyltransferase activity in sera of homozygous and heterozygous individuals. AB - Small amounts of H-enzyme activity (from 500 to 1,280 counts per minute [cpm]) were detected in sera of white H-deficient individuals (h/h; Reunion phenotype), while no significant H activity (less than 500 cpm) could be detected in sera of Indian H-deficient individuals (h/h; Bombay phenotype). The H-enzyme levels of the unaffected members of H-deficient pedigrees showed an H-related dosage effect. Heterozygous H/h individuals had only half as much H activity in sera (17,000 +/- 3,400 cpm) compared with homozygous H/H individuals (31,600 +/- 3,700 cpm). Data suggesting interactions between the H enzyme and the other gene specified glycosyltransferases working on the same oligosaccharide chains carrying combined ABH and Lewis antigens are analyzed in terms of their possible genetic or biochemical origin. PMID- 6859043 TI - H-deficient blood groups of Reunion island. II. Differences between Indians (Bombay Phenotype) and whites (Reunion phenotype). AB - Two variants of recessive, H-deficient nonsecretor individuals (h/h, se/se) were identified on Reunion Island: (1) H-negative individuals corresponding to the classical Bombay phenotypes (OhO, OhA, OhB, OhAB) who lack completely the H antigen on their red cells; all of them were Indian and had strong anti-H antibodies reacting with normal O and Oh red cells from whites; and (2) H-weak individuals (Oh, Ah, Bh, ABh). This phenotype represented the majority (85%) of the H-deficient phenotypes on Reunion Island, and all of them were white. They had only a weak expression of the H antigen and showed small but detectable amounts of ABH antigens on their red cells. Their anti-H antibodies reacted with normal O erythrocytes, but failed to react with Oh red cells, regardless of the ethnic origin of the donor. They were all from the same geographical area on the Island (Cilaos) and showed homogeneous titers of anti-H antibodies in sera. We propose to call this particular variant of weak H phenotype, belonging to the so called para-Bombay series, Reunion. PMID- 6859047 TI - Misconceptions in "Trials of Structured Exploratory Data Analysis". PMID- 6859048 TI - Placebo therapy and the law: prescribe with care. AB - The use of placebos by physicians for therapeutic purposes is a common part of clinical medical practice. This Article examines the legal and ethical ramifications of placebo prescription. In particular, ethical concerns are related to substantive legal theories that may be advanced to attack or defend the practice of placebo therapy in particular cases. The author concludes that, under certain strictly defined circumstances, the use of placebos in patient care is ethically and legally justifiable. However, from any perspective, the rights and duties inherent in the physician-patient relationship must be respected by the physician when considering the clinical use of placebos. PMID- 6859049 TI - "Dr. Death" and the case for an ethical ban on psychiatric and psychological predictions of dangerousness in capital sentencing proceedings. AB - Psychiatric and psychological predictions of dangerousness are used in a number of American jurisdictions to convince a judge or jury that a convicted murderer should be sentenced to death. Empirical research has demonstrated, however, that psychiatric and psychological predictions of dangerousness generally are inaccurate. This Article describes the current use of such predictions in capital sentencing hearings and examines their status under existing professional codes of ethics. It argues that the rendering of these predictions by psychiatrists and psychologists is contrary to the scientific and healing traditions of their professions and urges psychiatrists and psychologists to adopt an ethical ban on predictions of dangerousness in the capital sentencing context. PMID- 6859050 TI - Age discrimination in retirement: in search of an alternative. AB - American employers have traditionally relied on age as the criterion for mandatory retirement. Yet advances in medicine indicate the inadequacy of age as a measure of job competence and suggest the potential for a more reliable measure. With current social and economic conditions pressing many employees to seek to work beyond mandatory retirement ages set by their employers, transition to more reliable measures has become a vital matter. This Note explores the potential for implementing medically-based alternatives to the age proxy. It initially addresses problems of medical feasibility and economic practicality, and considers how the divergent interests of employees and employers can be accommodated. The balance of the Note examines the present roles of Congress, agencies, and courts in facilitating age-blind mandatory retirement policy. It suggests the need for reform of the federal Age Discrimination in Employment Act and recommends a more effective distribution of roles among governmental institutions. PMID- 6859051 TI - The Massachusetts malpractice plaintiff's new hurdles: the expanding role of the medical malpractice screening tribunal. AB - The medical malpractice crisis of the early and mid-1970s prompted many states to enact legislation creating medical malpractice screening tribunals. This legislation often failed to define clearly the role and jurisdiction of the tribunals. The lack of statutory definition is particularly apparent where a claim before a tribunal raises primarily nonmedical issues. The changing doctrines of hospital liability, involving both medical and nonmedical determinations, illuminate this jurisdictional difficulty. This Note examines the Massachusetts courts' attempts to define the tribunal's role when the tribunal is confronted with issues of hospital liability and other unsettled areas of the substantive law of medical malpractice. The Note suggests that tribunals should be limited to deciding issues concerning medical treatment and the professional conduct of physicians and hospitals. PMID- 6859052 TI - Vigorous supplementation of a hypocaloric diet prevents cardiac arrhythmias and mineral depletion. AB - We have previously demonstrated that a hypocaloric, nutritionally deficient, liquid protein diet is associated with potentially life-threatening cardiac arrhythmias, which increased in frequency and complexity over the duration of the study. The present investigation was designed to evaluate the metabolic and cardiac changes associated with a hypocaloric, but otherwise nutritionally complete, diet. Six healthy, obese females from 154 to 182 percent of ideal body weight were evaluated in a metabolic ward for 48 days. The subjects ingested a weight maintenance diet during an eight-day period, which was followed by 40 days of an experimental diet containing 472 kcal of a mixture of protein (60 percent of calories), carbohydrate (25 percent), and fat (15 percent). This diet equaled or exceeded the recommended daily allowances for minerals, trace elements, vitamins, and essential fatty acids. The subjects were monitored for balances of nitrogen and minerals, as well as for the appearance of cardiac arrhythmias by 24 hour electrocardiographic recordings. Nitrogen balance was positive, and the previously demonstrated negative balances for potassium, sodium, calcium, magnesium, and phosphorus were either reversed or markedly decreased. In contrast to our previous study, no arrhythmias were observed in subjects ingesting the present experimental diet, and no significant change in cardiac rhythm was found in 13 obese, but otherwise healthy, outpatients. The data, based on a limited number of subjects, suggest that a hypocaloric diet vigorously supplemented with essential elements, micronutrients, and vitamins appears to be safer than the once popular, incomplete liquid protein preparation. PMID- 6859053 TI - Risk factors for pulmonary embolism. The Framingham Study. AB - To assess potential long-term risk factors for major pulmonary embolism, 46 subjects from the Framingham Heart Study with autopsy-confirmed and clinically significant pulmonary embolism were identified in whom age, systolic blood pressure, cholesterol level, cigarette use, glucose level, Metropolitan relative weight, and varicose veins were ascertained at entry into the Study. These variables were compared among these 46 subjects, all 3,470 subjects in whom these variables were measured at the inception of the Study, and the 998 of these subjects who died within 26 years of follow-up. In multivariate analysis of subjects with autopsy-confirmed major pulmonary embolism and all subjects who died, only Metropolitan relative weight was significantly and independently associated with pulmonary embolism and only among women (p less than 0.001). These findings indicate that, in this cohort, increased adiposity in women is an important long-term factor for significant pulmonary embolism at autopsy. This raises the possibility that weight reduction in obese women may decrease the chances of pulmonary embolism. PMID- 6859055 TI - Numbers are better than words. Verbal specifications of frequency have no place in medicine. AB - We were concerned about the precision (i.e., consensus as to meaning) of adjectives and adverbs used to express frequency in the medical literature. We asked 103 physicians and 106 nonphysicians to assign to each of 22 such modifiers a percentage representing their understanding of the term. As indexed by the standard deviations, the degree of imprecision for 17 terms was so great for both physicians and for laymen as to make their use unacceptable. Consensus was significantly less among laymen than among physicians for 10 of the terms. Greater consensus was shown by native English-speaking physicians than by those with other native languages. Our data suggest further that American graduates of American medical schools show more consensus than American graduates of foreign medical schools. Board-certified physicians did not show greater consensus than physicians who were not board-certified. Verbal expressions of frequency should be eliminated from medical communications; failing that, the author should specify numerically the frequency he intends when he uses any such expression. PMID- 6859056 TI - Primary Sjogren's syndrome and autoimmune hemolytic anemia in sisters. A family study. AB - Familial primary Sjogren's syndrome is infrequently reported despite a strong association with a genetically determined factor, HLA-DR3. Although autoimmune hemolytic anemia occurring with secondary Sjogren's syndrome has been well documented, its association with primary Sjogren's syndrome has not previously been well-recognized. Thus, the unique occurrence of primary Sjogren's syndrome and autoimmune hemolytic anemia in two sisters prompted investigation of other family members for autoimmune diseases and serologic phenomena and their relationships to HLA genotypes. Serologic analysis (antinuclear antibodies, anti single-stranded DNA, biologic false-positive result for syphilis, and rheumatoid factor) and HLA-A, B, C, and DR typing were performed in 19 relatives in the kindred. Although HLA-DR3 occurred in those affected with Sjogren's syndrome and thyroid disease, there was no consistent segregation of HLA haplotype with serologic abnormalities in other relatives. These data suggest that there are other, non-HLA-linked, factors contributing to the autoimmune diseases in this family. PMID- 6859057 TI - Cerebrospinal fluid rhinorrhea as a complication of malignant lymphoma. AB - A 53-year-old woman with a three-year history of recurrent stage IV diffuse aggressive lymphoma involving the nasopharynx presented with fever, chills, and the sudden onset of drainage of clear, colorless fluid from the left nostril. This woman had no history of trauma or physical activity that might increase intracranial pressure. Subarachnoid instillation of 111indium resulted in the accumulation of radioactivity in a cotton stint placed in the left nares, documenting cerebrospinal fluid rhinorrhea. Computed tomography of the head revealed bony erosion of the cribriform plate by lymphoma. Defervescence occurred in the patient 48 hours after treatment with antibiotics was begun, and systemic chemotherapy directed against the lymphoma resulted in resolution of the cerebrospinal fluid rhinorrhea within a month without surgical intervention. PMID- 6859054 TI - Microangiopathic anemia and disseminated intravascular coagulation in an elderly woman. PMID- 6859058 TI - Stiff-man syndrome and dementia. AB - Stiff-man syndrome is characterized clinically by fluctuating muscular stiffness and spasm, and electromyographically by continuous motor unit activity at rest, which is abolished by sleep, general anesthesia, nerve block, curare, and several centrally-acting medications. A spinal or supraspinal origin has been proposed for this disorder. Some clinical and electrophysiologic features, along with an occasional association with encephalopathy, may support a proposed supraspinal cause. An elderly man with progressive dementia and concomitant development of stiff-man syndrome is described. He had not had stiff-man syndrome one year earlier, when he had only mild dementia. An association between stiff-man syndrome and dementia has not been previously described. Increased muscle tone and muscular rigidity is frequently encountered in patients with dementia, however, and pathologic reflexes involving neck and proximal musculature have been described in dementia. It is possible that this patient represents an exaggerated form of such motor disturbances in dementia, and that clinical and electromyographic features of stiff-man syndrome may be present with increased incidence in patients with dementia. PMID- 6859060 TI - Portal and pulmonary hypertension with microangiopathic hemolytic anemia. AB - Marked pulmonary hypertension developed in a 40-year-old man with known cirrhosis and a previous portosystemic shunt. Terminally, he also showed signs of microangiopathic hemolytic anemia. At postmortem examination, he had severe plexiform dilatation lesions in the pulmonary vasculature, with deposition of fibrin in the vasculature channels. It is suggested that the site of microangiopathic red cell damage was the pulmonary microvasculature. PMID- 6859059 TI - Severe aortic insufficiency in juvenile chronic arthritis. AB - Valvular heart disease is rare in patients with juvenile chronic arthritis. We describe a 27-year-old woman with the systemic-onset form of juvenile chronic arthritis in whom aortic insufficiency necessitated valve replacement. Nodules were seen on both the aortic and anterior mitral leaflets at surgery, and histopathologic evaluation of the excised aortic leaflets demonstrated nonspecific changes similar to those described in rheumatoid valve disease causing aortic insufficiency in adults with rheumatoid arthritis. We believe that this is the first reported case of aortic insufficiency in systemic-onset juvenile chronic arthritis in which the pathologic condition of the valve can be attributed to the underlying disease. PMID- 6859061 TI - The diagnostic consultant. PMID- 6859063 TI - Relation of menstrual cycle phase to symptoms of rheumatoid arthritis. AB - Since progesterone and estrogen have been shown to exhibit anti-inflammatory/anti arthritic activity, women with rheumatoid arthritis might be expected to have a reduction of some symptoms of rheumatoid arthritis during the postovulatory phase of the menstrual cycle when the plasma concentrations of these hormones increase. Daily examination of symptoms during 69 menstrual cycles in 14 patients with rheumatoid arthritis revealed that rheumatoid arthritis was significantly reduced during the postovulatory phase of the menstrual cycle. This reduction was clinically and statistically significant. The data presented in this report indicate that some of the "spontaneous" fluctuations in rheumatoid arthritis symptoms may be the result of changes in plasma concentrations of estrogen and progesterone. PMID- 6859062 TI - Uninformed consent and terms without definitions. PMID- 6859064 TI - Use of hemoperfusion for treatment of theophylline intoxication. AB - We review our experience in the management of patients with plasma theophylline concentrations of 30 micrograms/ml or greater. Over a two-and-a-half-year period, 22 patients (Group 1) had plasma theophylline concentrations of 37 +/- 1 micrograms/ml (mean +/- SE) and experienced no severe toxicity (i.e., ventricular extrasystoles or tachycardia, seizures, cardiovascular collapse, or death). Six patients (Group 2) took overdoses of theophylline (92 +/- 12 micrograms/ml) and one died. Eight patients (Group 3) were iatrogenically intoxicated (48 +/- 6 micrograms/ml) and three died. Six patients from Groups 2 and 3 underwent hemoperfusion and did well, except for one patient, in whom seizures developed before hemoperfusion was initiated. We conclude from this experience that charcoal hemoperfusion is a useful procedure for the treatment of theophylline intoxication because of: (1) the serious morbidity and mortality of theophylline intoxication, (2) the prevention of complications with hemoperfusion, and (3) the relative safety of the procedure. We provide tentative guidelines for the initiation of hemoperfusion for the treatment of theophylline intoxication. PMID- 6859065 TI - Inheritance of the mitral valve prolapse syndrome. Discussion of a three dimensional penetrance model. AB - The families of 12 probands with classic mitral valve prolapse were studied for evidence of mitral valve prolapse. Seventy parents, sibs, and progeny were included in the analysis. Forty-seven percent (16 of 34) of progeny were affected compared with 30 percent (3 of 10) of parents. Thirty-eight percent (10 of 26) of sibs were affected. A three-compartmental penetrance model was devised to account for the variation in expression with age. This includes a latent stage (time before onset of signs), an affected stage, and a stage in which the subjects are withdrawn (because of treatment, regression, or death). The implications of this model are discussed. PMID- 6859066 TI - Effect of pregnancy on immune complexes and rheumatoid factors in patients with rheumatoid arthritis. AB - Rheumatoid arthritis is associated with circulating and intra-articular immune complexes and rheumatoid factors. The clinical activity of rheumatoid arthritis improves during pregnancy in the majority of women, with exacerbation following delivery. Concentrations of immune complexes, as detected by the Clq-binding assay, the Clq-solid phase assay, and the monoclonal rheumatoid factor-solid phase assay, decreased during gestation, with elevations following delivery. Concentrations of IgM-rheumatoid factor and IgG-rheumatoid factor, analyzed by radioimmunoassay, changed variably during pregnancy, increasing in some patients and decreasing in others. When examined serially before, during, and following pregnancy, changes in the concentration of circulating immune complexes and/or rheumatoid factors corresponded with the clinical changes in three patients. These observations document the significant effect of gestation on the concentration of circulating immune complexes in patients with rheumatoid arthritis. They also support the role of these laboratory tests in monitoring the clinical course of rheumatoid arthritis. PMID- 6859067 TI - Mural thrombi in myocardial infarctions. Prospective evaluation by two dimensional echocardiography. AB - Fifty-four consecutive patients with acute anterior myocardial infarctions were studied to determine the incidence and natural history of mural thrombus formation. Two-dimensional echocardiography was performed in the immediate postinfarction period. Multiple views were utilized. Standard criteria for defining mural thrombus formation and minimizing false-positive readings were adhered to. Correlation with clinical data was obtained in all patients to define a subgroup at high risk for the development of a mural thrombus. Follow-up was obtained for all patients to assess the natural history of mural thrombus formation, treated and untreated, with regard to peripheral embolization. Seventeen patients (32 percent) had mural thrombus formation. Statistically significant (p less than 0.001) correlation for mural thrombus formation was found with markedly elevated creatine kinase and lactate dehydrogenase levels and with apical dyskinesis. Ten patients with mural thrombi received anticoagulation therapy. None has had clinically evident emboli at a mean of 10.8 months follow up. Resolution of the mural thrombus was demonstrated with serial two-dimensional echocardiography in eight patients (80 percent). Six of seven patients who did not receive anticoagulation therapy (86 percent) had embolic events within three months (p less than 0.001). None of the 36 patients without a mural thrombus has had a spontaneous clinical embolus. Thus, the presence of a mural thrombus can be accurately identified in patients with acute myocardial infarction and predicted in a subgroup of those patients. Such patients should be considered for anticoagulation to prevent systemic embolization and should be followed with serial two-dimensional echocardiography. PMID- 6859069 TI - New perspectives on aspirin therapy. Proceedings of a symposium co-sponsored by the Aspirin Foundation of America, Inc. and Tulane University Medical Center. PMID- 6859068 TI - Patients surviving 10 years of hemodialysis. AB - Experience with 37 patients surviving 10 years of hemodialysis therapy was reviewed. These patients were compared with 103 patients who began hemodialysis between 1967 and 1971 and who subsequently died. Males had an excess risk of death. Patients with polycystic kidneys survived longer. There was more uncontrolled hypertension among a control group than in 10-year survivors. In survivors, the hematocrit level increased over time and averaged 30.4 percent at 10 years. Over 10 years, many complications arose including parathyroidectomy (24), pericarditis (13), gastrointestinal bleeding (11), myocardial infarction (10), septicemia (eight), and active tuberculosis (six). Despite complications, most patients are now stable. Between their eighth and 10th years they required an average of only one hospitalization with a mean stay of 9.7 days. Eighteen patients were not hospitalized. Excluding housewives, 67 percent of patients between ages 20 and 59 years are employed full-time and 10 percent part-time. Patients surviving 10 years are not progressively deteriorating and may look to the future with cautious optimism. PMID- 6859070 TI - Aspirin, prostaglandins, and peripheral gangrene. PMID- 6859071 TI - Distribution of salicylate in lens and intraocular fluids and its effect on cataract formation. AB - Retrospective studies on cataract development in patients with rheumatoid arthritis or osteoarthritis revealed a retardant effect of aspirin on diabetic and non-diabetic cataracts. The effect of aspirin is dose-dependent. The correlation coefficient between years delay for various cataracts subcategories versus aspirin taken (in tablets per day X years of intake) was 0.69. The ocular pharmacokinetics of 14C acetylsalicylic acid or salicylate were determined after intravenous or intraperitoneal administration to rabbits. 14C acetylsalicylic acid penetrates rapidly into rabbit lens and aqueous humor after intravenous administration. After intraperitoneal administration, salicylate levels in rabbit plasma, similar to those of humans receiving four to six aspirin tablets (325 mg each), result in accumulation of salicylate by lens (mean +/- SD) of 405 +/- 72 mumoles/g and 620 +/- 30 mumoles/g at two and four hours, respectively. At those dosages, salicylate is cleared in 24 hours from rabbit plasma and intraocular fluids, but retained by lens. Penetration of salicylate into rabbit lens and rat lens is dose-dependent. The retardant aspirin effect in diabetic cataracts is linked to inhibition of tissue aldose reductase and lens protein glycosylation. Deceleration of galactose cataract formation in rats occurs after daily salicylate intraperitoneal injections of 100 mg/kg a day. PMID- 6859072 TI - Pathogenesis of angina pectoris and role of nitrates in relief of myocardial ischemia. AB - The pathophysiologic mechanism of angina of effort has been understood for one and three-quarter centuries. However, the mechanisms underlying angina at rest are still largely unknown. Coronary spasm, whatever its mechanism, clearly causes Prinzmetal's variant angina. However, evidence that spasm is the cause of all angina at rest is wanting. Rather than spasm, it is suggested that most attacks may be the result of normal fluctuations in the tone of conductive coronary arteries in the presence of critical levels of organic obstruction. The nitrates both relieve coronary spasm and diminish normal coronary tone. They also affect the systemic circulation, so as to favorably influence the level of energy demand. PMID- 6859073 TI - New perspectives on therapeutic application of nitrates as vasodilator agents for severe chronic heart failure. AB - Although nitrates produce marked decreases in ventricular filling pressures in patients with severe heart failure, their therapeutic value has long been believed to be limited because they were thought to exert minimal arterial dilating effects. Recently, however, new conceptual approaches to vasodilator drugs have been developed that have challenged this traditional view. These new perspectives indicate that nitrates exert dilator actions on both the arterial and venous circulations, and reduce both preload and afterload; such balanced circulatory responses are particularly evident when large doses of these drugs are used. Cardiac output increases markedly with nitrates in patients with a greatly increased systemic vascular resistance before treatment or with significant mitral regurgitation. The major reason for the limited increases in cardiac output noted in previous studies is the inclusion of patients with heart failure whose pretreatment values for cardiac output were within normal limits; in these persons nitrates markedly activate neurohumoral vasoconstrictor mechanisms that counteract the arterial dilating actions of these drugs. Long term nitrate therapy attenuates exercise-induced increases in pulmonary venous pressures, which permit patients to undergo repeated submaximal exercise with fewer symptoms; this improves physical conditioning and exercise capacity, even in the absence of drug-related changes in cardiac output. The long-term hemodynamic and clinical benefits of nitrates in heart failure have been confirmed by two independent randomized double-blind placebo-controlled clinical trials. PMID- 6859074 TI - Tolerance to organic nitrates: clinical and experimental perspectives. AB - The initial efficacy of long-acting nitrate preparations in the management of angina pectoris and congestive heart failure is well established. A high priority has been placed on determining whether tolerance to the early beneficial effects develops after long-term nitrate therapy. Experimentally, tolerance has been documented in in vitro studies and in intact animals, and the available evidence suggests that tolerance is a cellular phenomenon occurring in target tissue. From a critical review of the published literature and an analysis of our own clinical and experimental work, we conclude that partial tolerance to some of the hemodynamic effects of nitrates occurs after long-term administration. However, this class of drugs remains an important and effective therapeutic option in the treatment of patients with angina pectoris and congestive cardiac failure. PMID- 6859075 TI - Acute hepatic insufficiency of the chronic alcoholic--revisited. PMID- 6859077 TI - Metadiagnosis. An epistemologic model of clinical judgment. AB - For convenience, clinical findings are often artificially forced into finite pigeonholes such as "positive" or "negative." This convention obscures much of the inherent uncertainty in diagnosis and can result in serious misinterpretation of the significance of certain observations. Unhappy past experience with the poor predictive accuracy of electrocardiographic stress testing in asymptomatic patients is one such example. As an aid to understanding the limitations of clinical diagnosis, an epistemologic model of judgment was developed. According to this model, judgments are viewed as existing on three separate dimensional levels, each of which is rigorously defined and unambiguously quantified. The first dimension expresses diagnostic belief in terms of a numeric probability; the second quantifies the degree of confidence in the probability estimate; and the third defines the information that derives from the probability and confidence. The practical clinical relevance of this conceptual model is illustrated by applying it to a common clinical problem: the interpretation of a "positive" electrocardiographic stress test result in an asymptomatic man. This process--termed herein "metadiagnosis"--provides a new perspective by which the art of diagnosis might be made more accurate and explicit. PMID- 6859078 TI - Abdominal catastrophe in a 66-year-old man. PMID- 6859076 TI - General medicine consultation. Lessons from a clinical service. AB - The 564 consultations performed by a general medicine consultation service during its first year were analyzed in order to provide a concrete definition of this new academic domain. Of the consultations, 52 percent were for patients on the surgical service. Among these patients, the most common reason for consultation was the preoperative management of chronic illness, specifically, hypertension, diabetes, and angina; 47 percent of such patients had two or more chronic illnesses. The service recommended cancellation of planned surgery in 2 percent and postponement in 9 percent of the 210 patients seen preoperatively. Patients on the psychiatric service accounted for 47 percent of the consultations. In this group, diagnostic issues were the most common reasons for consultation, that is, abdominal pain, dementia, and the suspicion of thyroid disease. Only 12 percent of the patients were seen for prognostic reasons, usually related to the planned use of electroconvulsive therapy or tricyclic antidepressants. The service was evaluated by the referring physicians who rated the service favorably on its "mechanics," as well as on its qualitative performance. However, complaints of triviality were voiced when the average length of the list of recommendations seemed disproportionate to the complexity of the problems. The service was also evaluated by the residents who had provided consultations. From their perspective, the service was more successful in teaching the "art" of consultation than the "science." This experience provides an operational definition of the work facing a general medicine consultation service as well as data useful in focusing future educational programs and research efforts. PMID- 6859079 TI - Rapid healing of diabetic foot ulcers with continuous subcutaneous insulin infusion. AB - Two patients with inadequately controlled diabetes mellitus had chronic foot ulcers that were refractory to repeated attempts with conventional treatment. In both patients, complete healing of the foot lesions occurred six to eight weeks after continuous subcutaneous insulin infusion was instituted and blood sugar levels had become normal. This suggests that good control of diabetes, as obtainable with continuous subcutaneous insulin infusion, stimulates healing of foot ulcers. Possible reasons for this finding are reviewed. PMID- 6859081 TI - Complications of therapeutic apheresis, including a fatal case with pulmonary vascular occlusion. AB - A high incidence of anaphylactic reactions has been observed in patients undergoing therapeutic plasma exchange. In three of 22 patients who underwent multiple exchanges, urticaria, bronchospasm, and hypotension developed during a course of plasma exchange that responded to treatment with steroids, antihistamines, and epinephrine. Fatal pulmonary microvascular occlusion with platelets and granulocytes developed in an additional patient eight hours following an apheresis procedure involving albumin replacement. The mechanism for the latter complication is not known but did not appear to invoke complement activation. This unexpectedly high risk of potentially fatal complications must be considered when a course of therapeutic apheresis, particularly involving treatment of a chronic disease, is planned. PMID- 6859080 TI - Hypertension and hyperparathyroidism. Inverse relation of serum phosphate level and blood pressure. AB - In a retrospective study of 120 patients with surgically proved primary hyperparathyroidism, 71 patients who were normotensive and 49 patients (41 percent) who were either hypertensive at the time of parathyroidectomy or had a history of hypertension were compared. The mean serum calcium levels in the normotensive and hypertensive patients were very similar (11.6 +/- 0.1 [SEM] mg/dl, and 11.8 +/- 0.1), ruling against the hypothesis that hypercalcemia per se is the dominant cause of the hypertension of hyperparathyroidism. The mean serum creatinine levels in the two groups were also very similar (1.02 +/- 0.05 and 1.09 +/- 0.05 mg/dl), indicating that the hypertension of hyperparathyroidism is not the consequence of advanced renal parenchymal damage. The hypertensive patients did not have a significantly higher prevalence of urolithiasis. A review of the data in this and related studies leads to the conclusion that the hypertension of hyperparathyroidism is heterogeneous in origin. The mean serum phosphate level in the hypertensive patients was significantly lower than that in the normotensive patients (2.20 +/- 0.06 mg/dl versus 2.69 +/- 0.09 mg/dl, p less than 0.02), which may be due to a decrease in renal tubular phosphate reabsorption secondary to hypertension. PMID- 6859084 TI - Physician distribution--will it get worse instead of better? PMID- 6859082 TI - Comparison of wire-guided percutaneous insertion and conventional surgical insertion of intra-aortic balloon pumps in 151 patients. AB - Over a 25-month period, percutaneous wire-guided balloon catheter insertion was attempted in 51 patients, and intra-aortic balloon pump insertion was attempted by conventional surgical method in 100 patients. The success rate in the group undergoing percutaneous insertion was 90.2 percent (46 of 51) and 90 percent in the group undergoing surgical insertion (90 of 100). The indications for intra aortic balloon counterpulsation were diverse in both groups. The major complication rate in the patient population undergoing percutaneous intra-aortic balloon pump insertion was 15.2 versus 15.6 percent for the surgical group, and there were no cases of leg amputation or aortic dissection in the percutaneous group; however, two cases of leg amputation and one case of aortic dissection resulting in death occurred in the surgical group. The percutaneous intra-aortic balloon pump insertion technique was successfully employed in conjunction with percutaneous transluminal coronary angioplasty in six cases. It is concluded that the wire-guided percutaneous balloon catheter method is a highly successful and rapid means of instituting intra-aortic balloon counterpulsation in a wide variety of clinical situations. However, because of the significant associated complication rate, the decision to institute balloon counterpulsation must weigh the benefit-to-risk ratio, and this procedure must still be evaluated on a case by-case basis. PMID- 6859083 TI - Safety and efficacy of intravenous quinidine. AB - The safety and efficacy of intravenous quinidine were evaluated in a patient population with a high prevalence of left ventricular dysfunction and intraventricular conduction delays. Quinidine gluconate (mean dose 9.1 +/- 1.6 mg/kg) was administered during electrophysiologic study to 100 patients with ventricular or supraventricular tachyarrhythmias. Clinical heart failure was present in 68 percent of the patients. Left ventricular end-diastolic pressure, cardiac index, and left ventricular ejection fraction were abnormal in 62, 48, and 70 percent, respectively. Major intraventricular conduction delays (QRS of 120 msec or more) were present in 27 percent, and the H-V interval was prolonged (over 55 msec) in 28 percent. Despite the prevalence of these abnormalities, quinidine was discontinued because of hypotension in only 10 patients. Saline solution was infused to maintain preload in 37 percent, and hypotension responded promptly to saline solution infusion or discontinuation of quinidine infusion in all subjects. Hypotension was not more common in patients with more severe left ventricular dysfunction. QRS duration, H-V interval, QTc, and right ventricular effective refractory period increased significantly (p less than 0.001) after quinidine administration. Heart block or QRS widening of 50 percent or more did not occur. Quinidine prevented arrhythmia induction in 26 percent of patients who received full doses. Ventricular tachycardia cycle length increased in all 41 patients in whom identical forms were induced before and after quinidine (287 +/- 71 msec versus 361 +/- 93 msec, p less than 0.001). Intravenous quinidine may be administered safely to patients with intraventricular conduction delays and moderate heart failure. When antiarrhythmic efficacy is assessed by electrophysiologic study, quinidine compares favorably with other antiarrhythmic agents. PMID- 6859085 TI - Clinical utility and management impact of M-mode echocardiography. AB - To determine the clinical utility and management impact of M-mode echocardiography, 182 echocardiograms were analyzed at a university teaching hospital. The physicians who ordered the echocardiograms said that 12 percent provided crucial information that was not available from other tests and that 26 percent resulted in a change in patient management. According to two independent board-certified cardiologist-reviewers, 86 percent of echocardiograms were appropriately ordered, but only 15 echocardiograms (8 percent) were actually needed for a change to a new and appropriate management. According to the reviewers, the 77 Group I M-mode echocardiograms (those ordered to evaluate left ventricular function, left atrial size, potential cardiac sources of emboli, or the possibility of bacterial endocarditis, or those ordered in patients who, according to the ordering physician, had undergone or would undergo catheterization regardless of the results of echocardiography) were less likely than the 105 Group II M-mode echocardiograms (those ordered to evaluate possible mitral valve prolapse, hypertrophic cardiomyopathy, valvular function, or the pericardium) to be ordered appropriately, to provide helpful information, or to provide crucial results. Group I echocardiograms had reviewer-assessed appropriate management impact in only one case (1 percent) compared with a 13 percent rate of management impact for Group II M-mode echocardiograms (p less than 0.01). Although echocardiography can be accurate and valuable with yields similar to those of other noninvasive procedures, 77 (42 percent) of 182 M-mode echocardiograms in this hospital could be predicted at the time of ordering to be in a low-yield group. PMID- 6859086 TI - Relation of therapeutic response to nifedipine to coronary anatomy and motion of S-T segment during unstable angina pectoris. AB - Of 77 patients hospitalized for unstable angina pectoris and failure of oral, dermal, or intravenous nitrates and/or beta blockade, 81 percent with negligible or single-vessel disease and 55 percent with two- or three-vessel disease showed response (p less than 0.05) to nifedipine therapy. Patients with either S-T elevation or no change during pain responded better (31 of 45) than those with any S-T depression (16 of 32; p less than 0.05). Patients with negligible or single-vessel disease had a higher prevalence of S-T elevation (13 of 16) than patients with two- or three-vessel disease (15 of 31; p = 0.004). S-T motion did not predict response in patients with two- or three-vessel disease, but did predict response in patients with negligible or single-vessel disease. On follow up study at 9 +/- 8 (range one to 33) months, 39 of 42 who had shown response were free from pain. Three died from infarction without unstable angina. (range one to 33) months, 39 of 42 who had shown response were free from pain. Three died from infarction without unstable angina. Five who showed response had elective bypass surgery. The addition of nifedipine abolished or reduced pain episodes by more than 50 percent in 61 percent of patients with refractory unstable angina pectoris. Patients with negligible or single-vessel disease with S-T elevation benefit most. In patients with two- or three-vessel disease, the type of S-T motion did not predict response. Follow-up of all those with response indicated sustained amelioration by nifedipine therapy. Failure of nifedipine therapy should not be accepted until a dose of 120 mg per day has been achieved, or until intolerable side effects appear. PMID- 6859088 TI - The generalist: a jaundiced view. PMID- 6859087 TI - Prevalence and clinical correlates of pulmonary arterial hypertension in progressive systemic sclerosis. AB - Forty-nine patients with progressive systemic sclerosis who had undergone extensive studies including pulmonary artery catheterization as part of an ongoing prospective study of the natural course of progressive systemic sclerosis were evaluated. The overall prevalence of pulmonary arterial hypertension in this population of patients with progressive systemic sclerosis was 33 percent, and among 10 subjects with the CREST syndrome the prevalence of pulmonary hypertension was 50 percent. The relation between pulmonary arterial hypertension documented at catheterization and abnormal results of noninvasive studies suggesting pulmonary hypertension, including physical examination, chest x-ray, electrocardiography, echocardiography, single-breath diffusing capacity, and vital capacity, was studied. Diffusing capacity was significantly lower in those patients with definite pulmonary hypertension (mean pulmonary artery pressure of 22 mg Hg or more) compared with those with a normal mean pulmonary artery pressure, and a diffusing capacity below 43 percent of predicted showed the greatest sensitivity (67 percent) of any single diagnostic test in detecting definite pulmonary hypertension. Chest x-ray suggesting pulmonary hypertension was the least sensitive of the tests evaluated, but showed the greatest specificity (100 percent) in identifying patients with pulmonary hypertension. A classification matrix based on discriminant function analysis utilizing the combination of diffusing capacity below 43 percent of predicted and chest x-ray and electrocardiographic findings correctly identified 75 percent of patients with definite pulmonary hypertension and 97 percent of patients with a normal pulmonary artery pressure, but failed to identify correctly patients with mild pulmonary hypertension (mean pulmonary artery pressure of 20 mm Hg). These findings indicate that specific noninvasive studies are helpful in assessing the likelihood of normal or definitely elevated pulmonary artery pressures in patients with progressive systemic sclerosis, but patients with mild pulmonary hypertension are not likely to be identified by these noninvasive studies. PMID- 6859089 TI - Fasting-enhanced immune effector mechanisms in obese subjects. AB - Acute nutritional deprivation occurs frequently in clinical practice, yet little data exist on its effect on immune host defenses. To investigate this question, various immune parameters were studied in 15 obese subjects before and after a 14 day fast. Blood monocyte bactericidal activity and natural killer cell cytolytic activity were enhanced by fasting: monocyte killing increased in 12 of 14 subjects (p less than 0.05) and natural killer cell activity increased an average of 24 percent in 13 subjects tested (p less than 0.02). Starvation also enhanced parameters of humoral immunity as evidenced by increases in serum concentrations of IgG, IgA, and IgM (p less than 0.01). By contrast, lymphocyte blastogenic responses to the mitogen phytohemagglutinin were modestly decreased. Peripheral blood leukocyte counts, including neutrophils, T cells, and B cells, did not decrease significantly. These results indicate that fasting has differential influences on immune function rather than a uniformly deleterious effect. Of potential import, this nutritional alteration appears to actually enhance certain effector functions of the host defense system. PMID- 6859090 TI - Infection among 210 patients with surgically staged Hodgkin's disease. AB - To determine the incidence and types of infections in Hodgkin's disease, particularly those related to the overwhelming pneumococcal sepsis syndrome, 210 consecutive patients with previously untreated Hodgkin's disease who underwent staging laparotomy with splenectomy from March 1968 to October 1979 were reviewed. For 178 patients (85 percent) alive at the end of the study, the mean follow-up time was 68.1 months. Eighty-two serious infections occurred among 59 (28 percent) of the patients; 47 (57 percent) serious infections were microbiologically documented and 35 (43 percent) were clinically documented. Forty-seven microbiologically documented serious infections occurred in 34 patients and consisted of 23 episodes of pneumonia, 10 cases of bacteremia, seven wound infections, two cases of disseminated herpes zoster, one subphrenic abscess, and four miscellaneous infections. Microbiologically documented serious infections occurring during initial treatment or remission had lower incidences of leukopenia (29 versus 58 percent) (p = 0.09) and death (11 versus 53 percent) (p = 0.005) than those occurring after relapse of Hodgkin's disease. Of the microbiologically documented serious infections, 76 percent were associated with a predisposing factor(s) (leukopenia, postoperative state, steroids, peripheral neuropathy, leukemia), of which 34 percent were fatal. Microbiologically documented serious infections unassociated with a predisposing factor were never fatal, including the only episode of pneumococcal sepsis in the series. In contrast to microbiologically documented serious infections, only 14 percent of clinically documented serious infections (versus 38 percent) were fatal. The overwhelming pneumococcal sepsis syndrome and other infections thought to be associated with the asplenic state are uncommon problems in patients with Hodgkin's disease after splenectomy. PMID- 6859091 TI - The trial of God. PMID- 6859092 TI - Survival and spectrum of anomalies in the Meckel syndrome. AB - We present two sisters whose malformations (hydrocephalus, cystic dysplasia of the kidneys, polydactyly, and cleft palate) are consistent with a diagnosis of the Meckel syndrome. Diagnosis in case 1 was delayed because of two factors: 1) prolonged survival (28 mo), and 2) the absence of severe craniofacial malformations. These two factors may create difficulties in making this diagnosis and result in uncertainty regarding the medical prognosis of the infant and the genetic prognosis for the parents. PMID- 6859093 TI - Brief clinical report: familial neonatally lethal syndrome of hypoplastic left heart, absent pulmonary lobation, polydactyly, and talipes, probably Smith-Lemli Opitz (RSH) syndrome. AB - Two siblings, one a male pseudohermaphrodite and the other female, died on the first day of life. In both instances pregnancy was complicated by polyhydramnios. At autopsy each was found to have multiple abnormalities, some concordant, others discordant. The concordant ones were hypoplastic left-heart complex, absent pulmonary lobation, polydactyly, bilateral talipes, and, on microscopic examination, some large atypical cells in the pancreatic islets. Chromosome cultures failed to grow. As far as is known parents were unrelated. Autosomal recessive inheritance is considered a possible cause, and the infants are thought to have the most severe form of the so-called Smith-Lemli-Opitz (RSH) Syndrome. PMID- 6859094 TI - Editorial comment: variability in the Smith-Lemli-Opitz syndrome: overlap with the Meckel syndrome. PMID- 6859095 TI - Cranial defects in the Goldenhar syndrome. AB - Four patients are presented with the Goldenhar syndrome (GS) and cranial defects consisting of plagiocephaly, microcephaly, skull defects, or intracranial dermoid cysts. Twelve cases from the literature add hydrocephalus, encephalocele, and arhinencephaly to a growing list of brain anomalies in GS. As a group, these patients emphasize the variability of GS and the increased risk for developmental retardation with multiple, severe, or unusual manifestations. The temporal relation of proposed teratogenic events in GS provides an opportunity to reconstruct biological relationships within the 3-5-week human embryo. PMID- 6859096 TI - Brief clinical report: short rib-polydactyly syndrome, Majewski type. AB - We describe a baby with external and internal anomalies of the Majewski form of the short rib-polydactyly (SRP) syndromes. Previously unreported abnormal vertebral bodies, delayed ossification of the sternum and fibulae, and a diencephalic hamartoma are noted. These abnormalities and minimal histologic abnormality at the chondro-osseous junction suggest that this syndrome may be heterogeneous or more variable than previously known. PMID- 6859097 TI - First report of mosaic trisomy 12 in a liveborn individual. AB - Trisomy 12 mosaicism was found in a 36-year-old woman with minor anomalies, neuromuscular abnormalities, and moderate mental retardation. Trisomy 12 was present in 13% of the lymphocytes but not in skin fibroblasts. Previous reports of dup (12p) and dup(12q) are reviewed. To our knowledge this is the first report of a "complete" trisomy 12 in a liveborn individual. PMID- 6859098 TI - Fryns syndrome: a new variable multiple congenital anomaly (MCA) syndrome. AB - We report a brother and sister who died neonatally with a distinctive but variable multiple congenital anomaly (MCA) syndrome. Anomalies in both included similar facial changes, cleft palate, distal digital hypoplasia, lung hypoplasia, and urogenital abnormalities. They were discordant for cleft lip, diaphragmatic hernia, and Dandy-Walker anomaly. These sibs resemble three recently reported stillborn children and support the existence of a "new" autosomal recessive MCA syndrome with variable expressivity. PMID- 6859099 TI - Brief clinical report: unilateral partial tibia defect with preaxial polydactyly, general micromelia, and trigonomacrocephaly with a note on "developmental resistance". AB - We report a boy with predominantly unilateral severe tibia defect with a high grade of preaxial polydactyly. Family history suggests the possibility of autosomal dominant inheritance with reduced penetrance and quite variable expressivity. The boy's phenotype and other previously reported examples of predominantly unilateral involvement in autosomal dominant and autosomal recessive limb mutations strongly suggest a hypothesis of developmental resistance in the uninvolved parts. PMID- 6859100 TI - Autosomal dominant duplication of the renal collecting system, hearing loss, and external ear anomalies: a new syndrome? AB - We report two families in which propositi had severe bilateral sensorineural hearing loss, a preauricular pit or tag, and duplication of the ureters or bifid renal pelvices. Other relatives had one or more of these anomalies in a pattern suggesting autosomal dominant inheritance with reduced penetrance and variable expressivity. We suggest the term "branchio-oto-ureteral syndrome" to designate this condition. PMID- 6859101 TI - Hereditary lecithin-cholesterol acyltransferase deficiency and Bloom syndrome in the same individual. AB - A couple who were first cousins had three children: an older son with Bloom syndrome (BLS) and homozygous lecithin-cholesterol acyltransferase (LCAT) deficiency; the second child (a son) and the parents are LCAT deficiency and the youngest child (a daughter), is homozygous for LCAT deficiency. The use of genetic markers gave no evidence of linkage of BLS and LCAT loci. PMID- 6859102 TI - Extensions to pedigree analysis. IV. Covariance components models for multivariate traits. PMID- 6859103 TI - Changes of serum hexosaminidase for the presumptive diagnosis of type I Gaucher disease in Tay-Sachs carrier screening. AB - Although reduced acid beta-glucosidase activity appears to be the primary enzyme defect in type I Gaucher disease, patients with this disorder also have marked elevation of serum acid phosphatase and beta-hexosaminidase activities but with a normal level of lactic dehydrogenase activity. Moreover, there is a characteristic alteration in the hexosaminidase isozyme distribution with a striking increase in hexosaminidase B. Since these changes appear to be consistent and unlike those associated with other disorders or the hormonally induced alterations associated with pregnancy, routine serum testing for the Tay Sachs carrier state may offer a useful approach for the presumptive diagnosis and screening for Gaucher disease. Unlike the changes in affected homozygotes, there are no characteristic alterations of acid phosphatase or hexosaminidase in heterozygotes for Gaucher disease. PMID- 6859104 TI - Brief clinical report: the syndrome of Yunis and Varon--report of a further case. PMID- 6859105 TI - Chromosome studies of patients with Alzheimer disease. AB - Ten patients with either the familial or sporadic form of Alzheimer disease (AD) were studied cytogenetically to confirm reports of aneuploidy and "long acentric fragments" associated with the disease. Findings in leukocytes of patients were compared with those in eight unaffected relatives and seven persons of similar age. Observations from encoded slides involving 3,800 conventionally stained and 1,396 G-banded metaphases (one patient) showed no significant increase in aneuploidy. The frequency of cells with hypermodal counts, a reliable measure of aneuploidy, was 4.2% and 1.1%, respectively, in women and men with familial AD and 4.0% and 2.3%, respectively, in women and men with the sporadic form of the illness. Similar frequencies of hypermodal cells occurred in female (2.6%) and in male (2.0%) control subjects. In contrast to the lack of aneuploidy, a small but significant number of false "long acentric fragments" was found in cells of women with AD (P less than .05). These aberrations are thought to represent premature centromere division (PCD) in intact chromosomes, primarily supernumerary Xs. Often in multiple copies, PCD occurred in 2.8% of their cells and in 0.6% of cells from control women. PCD occurred in 3.6% of cells of women with the familial form and in 1.7% of cells of women with the sporadic type of dementia. Among unaffected relatives PCD increased with age. The rarity of PCD in G-banded metaphases from an affected female (3/1,396) suggests that metaphase spreading techniques also may affect observable frequency. Thus PCDs occur more frequently in, but are not unique to, AD and may represent an epiphenomenon of aging, a process also characterized by the occurrence of neurofibrillary tangles and senile plaques in the cerebral cortex. PMID- 6859106 TI - Craniotelencephalic dysplasia in sisters: further delineation of a possible syndrome. AB - We describe two sisters with a complex of anomalies involving the cranium and brain. The changes in the former are consistent with those previously described as craniotelencephalic dysplasia and those in the latter indicate primary developmental abnormalities of the central nervous system including septo-optic dysplasia, absent olfactory nerves, agenesis of the corpus callosum, and lissencephaly. Per se, these cerebral malformations are causally heterogeneous, but their occurrence in association with craniotelencephalic dysplasia suggests that this combination is a distinct, probably autosomal recessive, syndrome. PMID- 6859107 TI - Ullrich-Turner syndrome associated with interstitial deletion of Xp11.4 leads to p22.31. AB - The full phenotype of the Ullrich-Turner syndrome (UTS) is thought to be due to loss of the short arm of X. We report a 16-year-old girl with lack of secondary sexual development, amenorrhea, and short stature. She had thyroiditis and numerous other UTS manifestations and was found to have a non-mosaic 46,X,del(Xp) chromosome abnormality. Breakpoints occurred at p11.4 and p22.31, with a loss of the intervening segment. PMID- 6859108 TI - Dicentric i(Yq) chromosome and azoospermia. PMID- 6859109 TI - Absence of the axial triradius. PMID- 6859110 TI - Oculogastrointestinal muscular dystrophy. AB - The author reports on four patients (one male, three females) from the same kindred with a newly recognized autosomal recessive condition involving striated and smooth muscle that has been designated oculogastrointestinal muscular dystrophy. It is characterized by ptosis, ophthalmoplegia, and progressive intestinal pseudo-obstruction leading to malnutrition and death before 30 y. Autopsy studies in two cases showed a severe primary myopathy of smooth muscles of the stomach and intestine with intact myenteric plexus and vagus nerves. The proposita notably had myopathic changes of striated muscles but also involvement of the peripheral nerves and central nervous system characterized by demyelinating and axonal neuropathy and focal spongiform degeneration of the posterior columns. PMID- 6859111 TI - Autosomal dominant recurrent encephalopathy of childhood. AB - Recurrent encephalopathy affecting cerebellar and extrapyramidal structures was observed in five members of two families. The syndrome is characterized by sudden onset of truncal ataxia, occasionally accompanied by lethargy and impairment of speech. Choreic and athetoid movements were present, and there was loss of deep tendon reflexes with presence of pathological reflexes. Onset of the disease was early in childhood. Attacks lasted for days to weeks; residual symptoms comprising speech impairment and incoordination were seen in some patients. Both sexes were affected. The pedigrees suggest autosomal dominant inheritance. Pathogenesis remains unexplained by the laboratory studies done; metabolic or immunological processes predisposed by genetic factors are suggested. Similar reports from the literature are discussed; no identical family could be found. PMID- 6859112 TI - Dominantly inherited syndrome of microcephaly and cleft palate. AB - Two sisters and their mother had a syndrome of microcephaly, cleft palate, and variable anomalies such as unusual facial appearance, hypotelorism, abnormal retinal pigmentation, maxillary hypoplasia, goiter, camptodactyly, mild mental retardation, and abnormal dermatoglyphics. This is an evidently dominantly inherited trait, either autosomal or X-linked. PMID- 6859113 TI - Brief clinical report: cebocephaly-holoprosencephaly in a newborn girl with a terminal 7q deletion [46,XX,del(7)(pter leads to q32:)]. AB - Cytogenetic study of a day-old infant showed a terminal del(7q): 46,XX,del(7)(pter leads to q32:). This infant had cebocephaly with holoprosencephaly. These clinical findings are atypical for the 7q - syndrome, in which patients usually have growth and mental retardation with few facial abnormalities. PMID- 6859114 TI - Chromosome Abnormalities in infants with prune belly anomaly: association with trisomy 18. AB - Two infants are described with "prune belly anomaly" (PBA) and concomitant trisomy 18. Severe abdominal distention was detected prenatally in one by ultrasonographic study, and in the second child at birth. Other chromosome abnormalities previously associated with PBA also are reviewed. The prune belly anomaly constitutes a malformation sequence that is causally nonspecific and which may occur in diverse aneuploidy syndromes. Aneuploidy is important to detect in prenatally diagnosed cases in which intrauterine fetal treatment is being considered. PMID- 6859116 TI - Autosomal-recessive aplasia cutis congenita--report of two affected sibs. PMID- 6859117 TI - Cerebral gigantism, intestinal polyposis, and pigmentary spotting of the genitalia. PMID- 6859118 TI - Nuchal cystic hygroma in a fetus with presumed Roberts syndrome. PMID- 6859115 TI - Serum pyruvate-kinase (PK) activity during pregnancy in potential carriers for Duchenne muscular dystrophy. PMID- 6859119 TI - Chromosome studies in hemifacial microsomia with radial ray defect. PMID- 6859120 TI - Maternal age in Duchenne muscular dystrophy. PMID- 6859122 TI - Goldenhar association and cranial defects. PMID- 6859123 TI - Lymphocyte capping in limb-girdle muscular dystrophy. PMID- 6859124 TI - Brachymesomelia-renal syndrome. AB - We have studied a male Japanese infant with severe upper limb brachymesomelia, glomerulocystic renal dysplasia, abnormalities of the cranium and face, corneal opacities, and a possible congenital heart defect. He was born at term and died on the 10th day of heart and kidney failure. Review of the literature failed to show a similar case. Glomerulocystic renal dysplasia has been reported in association with a variety of the nonskeletal malformations but has not previously been described in association with bony malformations. PMID- 6859125 TI - Trichoodontoonychial dysplasia--a new meso-ectodermal dysplasia. AB - We describe a hitherto apparently undescribed ectodermal dysplasia in four siblings. The condition combines severe hypotrichosis, hypoplasia of enamel leading to secondary anodontia, dystrophic nails, supernumerary nipples, nevus pigmentosus, bone deficiency of the fronto-parietal region, and other anomalies. This condition is probably due to an autosomal-recessive gene. ? PMID- 6859126 TI - Previously undescribed syndrome of craniofacial, hand anomalies, and sensorineural deafness. AB - We describe in a mother and her infant daughter a previously unreported syndrome of unusual craniofacial, hand, and digital anomalies. Both mother and child have a flat facial profile, hypertelorism, hypoplastic nose with slit-like nares, and a sensorineural hearing loss. Common radiographic manifestations include small maxilla, absent or small nasal bones, and ulnar deviation of the hands. This is either an autosomal dominant or X-linked trait. PMID- 6859127 TI - Inheritance of Bartter syndrome. AB - The Bartter syndrome is regarded as an autosomal recessive trait because of sib occurrence, equal sex ratio, and normal parents. Recently, obligatory carriers were shown to have the same pattern of platelet aggregation inhibition as their affected children, possibly a reflection of altered prostaglandin action. We investigated eight patients, and their parents and sibs, and found that all persons included in the study had impaired thrombocyte aggregation. These aggregation studies support the hypothesis that the Bartter syndrome is an autosomal recessive trait. PMID- 6859121 TI - Familial extragonadal germ cell tumors. PMID- 6859128 TI - Segregation of HLA in families with oral clefts: evidence against linkage between isolated cleft palate and HLA. AB - In an earlier study of families with two or more sibs affected with a cleft of the lip with or without clefts of the palate, we found no evidence for close linkage of HLA with this malformation. In the present study, we confine our attention to isolated cleft palate, an entity that is genetically distinct from cleft palate associated with cleft lip. In 15 sibships with two or more affected sibs, cleft palate, and parental HLA haplotypes assorted independently in the affected sibs, providing evidence against close linkage of this phenotype. PMID- 6859129 TI - Intracranial aneurysms: a report of a large pedigree. AB - We report on the occurrence of intracranial aneurysms in several individuals of a large French-Canadian family. Recurrence risk from 22 previously reported families (each with at least two affected first degree relatives) and the present family does not allow any firm conclusion about the mode of inheritance of the trait. PMID- 6859130 TI - "And, having writ, moves on". Presidential address. PMID- 6859133 TI - Board certification: past, present, and future. PMID- 6859132 TI - Recurrent endometriosis: incidence, management, and prognosis. AB - The rate of recurrence of endometriosis after treatment has varied from 2% to 47% in published reports. In order to determine whether a meaningful prognosis for recurrence can be rendered, 423 patients treated with conservative surgical procedures from 1967 to 1982 were followed as outpatients. From among these, 62 patients underwent reoperation. Annual rates of recurrence based on findings at reoperation ranged from 0.9% in the first postoperative year to 13.6% in the eighth postoperative year. The cumulative 3- and 5-year recurrence rates were 13.5% and 40.3%, respectively. Severity of disease was not predictive of recurrence. Pregnancy did not preclude, but did delay, recurrence. Forty-seven percent of infertile patients with recurrent endometriosis conceived after a second conservative operation. Of 20 patients who had a second conservative operation for endometriosis, 20% required a third laparotomy. This is the first study of postoperative recurrent endometriosis to utilize a control group and the first to report annual rates of recurrence and reoperation. PMID- 6859131 TI - Transient tachypnea of the newborn: the relationship to preterm delivery and significant neonatal morbidity. AB - Early studies suggest that transient tachypnea of the newborn is a benign disease of uncertain etiology. Consequently, prevention of this complication has not been a primary concern of obstetricians. In this study of amniotic fluid phospholipids, 55 pregnancies in which the neonate developed transient tachypnea were compared to 355 pregnancies after which respiratory distress did not occur. Thirteen neonatal complications and procedures, often associated with prematurity, were significantly increased in the infants who developed transient tachypnea. Potential risk factors for transient tachypnea were examined by stepwise discriminant analysis. Negative amniotic fluid phosphatidylglycerol, prematurity (less than 38 weeks), and 1-minute Apgar score less than 7 all made an independent contribution to the overall characterization of infants at increased risk for transient tachypnea. These findings suggest that mild fetal lung immaturity may be a factor in the pathophysiology of this syndrome, and that the relationship of perinatal factors associated with transient tachypnea of the newborn in previous studies, including maternal diabetes mellitus and cesarean birth, may be partially mediated through a neonatal surfactant deficiency. PMID- 6859134 TI - Vaginal delivery following previous cesarean birth. AB - Because of the rising cesarean birth rate in the United States, renewed interest in vaginal delivery after prior abdominal operation has been evident. In a prospective collaborative study 789 patients were evaluated for inclusion into this investigation. Of the 717 subjects who entered the study 162 chose to attempt vaginal birth and 101 were successful. Desire for tubal sterilization and the lack of prior vaginal delivery were significant correlates of the group selecting repeat abdominal birth and of those who were unsuccessful when vaginal delivery was attempted. There were eight dehiscences and three uterine ruptures among the 717 patients and none was related to catastrophic outcome for the mother or neonate. Perinatal losses (12) were not related to uterine rupture or method of delivery. There were no significant differences in uterine disruption between patients selecting either route of delivery. Likewise ancillary factors such as a prior febrile puerperium (endometritis), number of prior cesarean births, low-vertical uterine incisions, recurrent operative indications, the use of epidural anesthesia, or oxytocin administration were not discriminating factors in whether women chose to attempt or were successful in completing vaginal delivery after prior abdominal birth. From our data vaginal birth after cesarean section appears to be safe if conducted in a carefully selected population that is closely monitored in a prospective manner. PMID- 6859135 TI - Diabetes in pregnancy, Northwestern University series (1977-1981). I. Prospective study of anomalies in offspring of mothers with diabetes mellitus. AB - Offspring of mothers with diabetes mellitus were examined prospectively with the use of a detailed checklist. Diabetic women were usually identified in the late first or early second trimester and thereafter rigorously managed in hopes of achieving euglycemia. The frequency of infants with major anomalies was higher (9/106, 8.5%) in White Classes B to F than in either the general population or in a small group of concurrently gathered control subjects (1/41, 2.4%). The frequency of anomalies in Class A diabetes was 3/76 (3.9%), a rate that may or may not be increased. Of the 12 major anomalies observed in diabetic offspring, six involved the heart and three involved the skeletal system. No pattern of minor anomalies appeared to exist. Limited data failed to reveal a specific HLA type that conferred increased risk for anomalies, and chromosomal abnormalities were not increased in frequency. If hyperglycemia is indeed the mechanism responsible for anomalies in offspring of mothers with diabetes mellitus, our observations suggest that rates will be reduced only by achieving optimal control in the first trimester. PMID- 6859136 TI - Oligohydramnios: clinical associations and predictive value for intrauterine growth retardation. AB - Intrauterine growth retardation (IUGR) is difficult to diagnose before birth. Sonographically diagnosed oligohydramnios has been reported to be highly sensitive and reliable in detecting IUGR in carefully prescreened patients. To evaluate the clinical associations of oligohydramnios and its usefulness as a method of antenatal screening for IUGR on a large obstetric service, the consecutive ultrasound examinations of 2,453 viable singleton pregnancies with intact membranes were surveyed. The 96 (3.9%) pregnancies found to be complicated by oligohydramnios were compared with 96 with the same biparietal diameters, but with normal volumes of amniotic fluid. Mothers with oligohydramnios were younger, of lower parity, and at increased clinical risk for IUGR. Of 96 infants from oligohydramnios-complicated pregnancies, 38 (40%) were small for gestational age (SGA), compared with eight (8%) infants from pregnancies without oligohydramnios. Of 46 SGA births, 38 (83%) were preceded by sonographically diagnosed oligohydramnios (p less than 0.0001). IUGR associated with oligohydramnios tended to occur in young hypertensive gravid women, whereas non-oligohydramnios associated IUGR tended to occur in gravid women with low prepregnancy weight. With correction for the incidences of oligohydramnios and IUGR in the unselected population, it is shown that four in 10 cases of oligohydramnios would result in SGA births (40% predictive value of an abnormal test), but that only 16% of SGA births would be preceded by sonographically diagnosed oligohydramnios. Eighty four percent of the cases would be missed. These results suggest that, although the presence of oligohydramnios should increase the clinician's index of suspicion for IUGR, routine sonographic screening to detect oligohydramnios is not warranted. PMID- 6859137 TI - Maturation of vaginal and cervical epithelium in women exposed in utero to diethylstilbestrol (DESAD Project). AB - A total of 452 women with documented exposure in utero to diethylstilbestrol (DES) with epithelial findings present at the time of their initial examination have been evaluated prospectively to determine whether these findings changed over a period of 3 years. The examinations were all performed according to a strict protocol. Findings present at the time of the third annual examination were verified at a fourth examination. A verified decrease in the extent of epithelial findings occurred in 29.2% of these women and a verified increase in 6.6%; 53.1% had no change in the extent of epithelial findings, and 11.1% had a change that could not be verified at the time of the fourth visit. Analysis of many variables failed to identify a strong association between any variable and a decrease in the extent of the findings. It appears that the most important factor in the occurrence of changes in DES-associated findings is the passage of time. PMID- 6859138 TI - The selective use of vaginal hysterectomy in the management of adenocarcinoma of the endometrium. AB - Vaginal hysterectomy was performed in 56 patients with Stage I adenocarcinoma of the endometrium who were selected because of obesity or major medical problems that placed the patient at high risk for morbidity and death with an abdominal operation. Seventy percent of the patients were hypertensive and 29% were diabetic. The median weight for the 56 patients was 211 pounds. Ten patients who were age 40 or younger were included, and all showed signs of polycystic ovary syndrome. This subgroup of patients was significantly more obese, with a median weight of 331 pounds. Adjuvant radiation therapy was used in 32 of the 56 patients. There was one postoperative death from a pulmonary embolus, but there were few other major complications. The actuarial survival probability was 94% for all patients. With grade 1 tumors, the 5-year survival rate was 98%; with grade 2 tumors, it was 78%; and with grade 3 tumors, it was 84%. Although we do not recommend that vaginal hysterectomy become routine, it has cure rates comparable to those with abdominal hysterectomy and should be considered in patients who are a poor surgical risk, particularly patients with grade 1 tumors. PMID- 6859139 TI - Factors influencing the outcome of microsurgical tubal ligation reversals. AB - Seventy-three patients who underwent a microsurgical tubal reversal were reviewed in an effort to determine what factors influenced outcome. A 64% intrauterine pregnancy rate was achieved 6 months to 4 years postoperatively. There was a 4.4% incidence of ectopic pregnancies in this group. On the basis of a preoperative laparoscopy, no reversals were performed unless a total tubal length of 4 cm or more could be obtained. The final tubal length, the time interval from sterilization to reversal, and the site of reanastomosis did not influence the eventual outcome. The reversals were then evaluated by the type of sterilization procedure performed (Pomeroy, coagulation, falope ring, and Irving). The pregnancy rate was not statistically different in each group. Sterilizations performed by coagulation, however, were only reversible 58% of the time compared to 91% for the noncoagulation procedures because of extensive tubal destruction (p less than 0.001). It also took longer for the coagulation patients to conceive, with the average conception occurring in 13.0 months compared to 6.7 months for the noncoagulation group (p less than 0.001). A higher incidence of ectopic pregnancies occurred in the thermal burn patients as well. The longer interval for conception and the higher ectopic pregnancy rate may represent mucosal damage in coagulation patients beyond the anastomotic site. PMID- 6859140 TI - Cytoplasmic estrogen and progesterone receptors in primary cervical carcinoma: clinical and histopathologic correlates. AB - From 1977 to 1981, 39 cases of primary cervical carcinoma were assayed for the presence or absence of cytoplasmic estrogen (ERc) and progesterone (PRc) receptors by a saturation point dextran-coated charcoal assay. The levels of ERc and PRc were compared with clinical stage, histologic type, histologic grade, menstrual status, age, and survival. Carcinomas were divided into positive and negative receptor groups with the use of greater than 5 fmol/mg of cytosol protein for ERc and 10 fmol/mg of cytosol protein for PRc as discrimination points. Survival of the patients studied was computed by means of the product limit analysis according to Kaplan-Meier. A statistically significant difference in survival in the PRc + group versus the PRc - group in the total group of patients was noted with the Mantel-Cox test (P = 0.049). When patients were stratified according to menopausal status, a statistically significant difference in survival was noted between the PRc + group versus the PRc - group in the premenopausal patients only. PMID- 6859142 TI - Long-term effect of megestrol acetate in the treatment of endometrial hyperplasia. AB - Fifty-two postmenopausal women who were poor surgical risks and had histologically proved adenomatous hyperplasia, atypical hyperplasia, or adenocarcinoma in situ of the endometrium were treated with megestrol acetate, 40 mg per day, continuously for 9 to 104 months (mean, 42 months). More than 90% of these women had complete remissions of the hyperplasia. Three women with carcinoma in situ were followed up for 57, 65, and 104 months, without recurrence of the disease. Four women required hysterectomy; none had invasive adenocarcinoma. No adverse side effects of the drug were observed. Thus, we conclude that the continuous use of megestrol acetate is an effective, safe, alternative form of therapy for endometrial hyperplasia in postmenopausal women. PMID- 6859141 TI - Eclampsia. III. Neonatal outcome, growth, and development. AB - Infants of 72 recently managed women with eclampsia before delivery were studied. Infants with gestational age of 36 weeks or less (56%) were analyzed separately from those infants of more than 36 weeks' gestation (44%). In addition, premature infants of eclamptic mothers were compared with 40 premature infants whose mothers did not have any medical complications. Intrauterine growth retardation was symmetrical in all seven infants whose mothers had eclampsia prior to 32 weeks. All neurological abnormalities were associated with abruptio placentae or intrauterine growth retardation. Among the preterm infants of eclamptic mothers and those of normotensive mothers, there was no significant difference in any commonly acquired laboratory data. Neonatal complications in premature infants of eclamptic mothers were frequent. However, neonatal complications of the low-birth weight infants were strikingly similar regardless of the presence of eclampsia. It is possible that most neonatal complications are consequence of prematurity, instead of a sole consequence of eclampsia. Observations from follow-up data (up to 4 years of age) suggest normal growth and development for infants of mothers with uncomplicated eclampsia. PMID- 6859144 TI - Porphyria cutanea tarda and pregnancy. PMID- 6859143 TI - Vitamin B12-binding proteins in human amniotic fluid: an index to fetal maturity. PMID- 6859145 TI - Postpartum vulvar edema associated with birthing chair. PMID- 6859146 TI - Recurrent chorioamnionitis and maternal septicemia: a case of successful in utero therapy. PMID- 6859147 TI - Childhood dermatomyositis and pregnancy. PMID- 6859148 TI - Estriol in saliva as an index of fetoplacental function. PMID- 6859149 TI - Hypergonadotropism with pregnancy. PMID- 6859150 TI - Subcutaneous partial symphysiotomy. PMID- 6859151 TI - Reproductive outcome after amniocentesis for genetic indications. PMID- 6859152 TI - Characteristics of cells of cervix. PMID- 6859153 TI - Laparoelytrotomy. PMID- 6859154 TI - Effect of progestins on high-density lipoproteins. PMID- 6859155 TI - Maternal hypoglycemia and intrauterine growth retardation. PMID- 6859156 TI - Fetal and maternal effects of sodium nitroprusside. PMID- 6859158 TI - Rapid onset of cervical cancer in an upper socioeconomic group. AB - In this series of 130 patients with cervical cancer, 25% had a short interval of less than 3 years from negative cytologic screenings to finding of cancer. In the short interval group, the peak age was 30 to 35 years, but lesions also developed in younger women and in women aged 60 years and older. The majority of lesions were still in situ, a lesser number had microinvasion and two had invasive squamous carcinoma. The usually accepted risk factors, low socioeconomic group, multiparity, and poor hygiene, did not prevail in all cases. Some patients had no history of pregnancy. They were not considered to be in a low socioeconomic group and poor hygiene was not an apparent feature. In view of the rapid onset of cervical cancer in some patients, even those not considered to be at high risk, annual screening is recommended for all age groups. PMID- 6859157 TI - Isolation guidelines for obstetric patients and newborn infants. AB - Available isolation guidelines for use in hospitals have often overlooked the infectious diseases and unique interactions of obstetric patients and their newborn infants. To help fill this void, we present our hospital's isolation policies for obstetric and neonatal patients and guidelines for maternal-infant contact and breast-feeding. These policies represent a multidisciplinary consensus of opinion and available epidemiologic data and have been found useful and practical in a single large teaching hospital. Other institutions should be able to adapt these guidelines to their own patient populations, personnel, and physical facilities. PMID- 6859159 TI - A scanning and transmission electron microscopic study of the surfaces of intrauterine contraceptive devices. AB - We studied 10 intrauterine contraceptive devices by scanning and transmission electron microscopy. All the devices had material adherent to them. The amount of this material varied considerably. Many different morphologic types of bacteria were observed adherent to the devices, often buried in a thick biofilm. Occasionally a microcolony containing only a single bacterial morphotype was observed. Electron microprobe analysis revealed the presence of calcium in the biofilm formed by bacterial colonization. Very few types of bacteria were recovered by our cultural technique, suggesting that material must be scraped from the surface of the device, homogenized, and then cultured by means of selective media. An understanding of the mechanisms of adherence of bacteria to these devices could lead to the development of a device which will resist bacterial colonization. PMID- 6859160 TI - Management of premature rupture of membranes: the risk of vaginal examination to the infant. AB - Presented are the results over a 4-year period of the conservative management of cases of premature rupture of the membranes. Perinatal mortality in infants delivered more than 24 hours after rupture of the membranes is not higher than that in infants delivered within 24 hours of rupture of the membranes, if these results are based on pregnancies of comparable gestational age. Two independent factors influence the risk of infection: the duration of gestation, and the interval between vaginal examination and delivery. If corrections are made for these two factors, there appears to be no clear correlation between the incidence of infection and the period of time the membranes have been ruptured. Conservative management is justified if vaginal examination is avoided until delivery within 24 hours is expected to occur. PMID- 6859161 TI - Left ventricular function in preeclamptic patients: an echocardiographic study. AB - To examine left ventricular function in pregnancy complicated by preeclampsia, echocardiographic dimensions and left ventricular performance indices were determined in 42 preeclamptic patients, 25 normotensive third-trimester patients, and 25 nonpregnant patients. The performance of the left ventricle in normal third-trimester pregnant patients was unchanged as compared to that in nonpregnant patients. Three patients (7%) in the preeclamptic group had diminished values of echocardiographic contractility indices. However, in only one of these patients were there clinical signs of left heart failure; two other patients had latent myocardial dysfunction. Our conclusion is that left ventricular function in most preeclamptic patients is well preserved despite significant volume and pressure overload. PMID- 6859162 TI - The development of a profile scoring system for early identification and severity assessment of pregnancy-induced hypertension. AB - Two commonly encountered problems in the management of patients with pregnancy induced hypertension (PIH) or pregnancy-aggravated hypertension (PAH) are (1) a delay in early recognition of disease, and (2) imprecise assessment of the severity of the disease. Gravid women suffering from PIH may present in a protean manner which can be misleading to the clinician who relies strictly upon classic clinical parameters in the management of the patient. Many hematologic changes associated with PIH have been documented. However, a comprehensive evaluation of these changes, as depicted by simultaneous laboratory testing, has not been reported. The purpose of this study was twofold: (1) to formulate a profile scoring system in which clinical parameters and laboratory tests were utilized in concert, not as a predictor, but as a standardized method of early recognition of PIH, and (2) to evaluate the profile scoring system's accuracy in assessing the severity of the disease. Empirically, a "profile" was developed that included five clinical parameters (rollover test, mean arterial blood pressure, ocular arteriolar vasospasm, hand and facial edema, patellar reflexes) and eight laboratory tests (urine protein, serum urate, urea nitrogen, creatinine, albumin, total proteins, platelet count, and plasma fibrinogen). Values for each parameter and test were categorized into the accepted normal and abnormal ranges for pregnancy. On the basis of the degree of abnormality, weighted numerical scores of increasing magnitude were arbitrarily assigned to the respective value ranges. For a given patient, the sum of the individual parameter and test scores constituted the profile score. The sample population consisted of 108 patients with "at risk" characteristics or clinical manifestations of PIH. From one to six profile scores per patient were obtained between 24 weeks' gestation and the onset of labor. Simultaneously, the clinical status of the patient was evaluated and assigned to one of four categories: (1) no PIH, (2) incipient PIH, (3) mild PIH, and (4) severe PIH. Of the 108 sample patients, 14 did not develop clinical PIH (no PIH), 17 developed mild gestational or intrapartum hypertension only (incipient PIH), 45 manifested mild preeclampsia (mild PIH), and 32 demonstrated severe preeclampsia (severe PIH), four of whom were eclamptic. Profile scores +/- standard error of the mean (SEM) relative to the patient's clinical status were as follows: no PIH = 7.1 +/- 0.5, incipient PIH = 10.7 +/- 0.4; mild PIH = 15.5 +/- 0.4; and severe PIH = 28.3 +/- 0.9. On the basis of our study data, we believe that profile scoring is an effective system for the early identification of PIH. Also, we believe that, when patients with clinically overt PIH are evaluated, this approach enhances our ability to quantitate the severity of the disease objectively. PMID- 6859164 TI - Neonatal deaths in Alabama. II. Policy and research implications derived from a comparison of birth weight-specific state and medical center neonatal mortality rates. AB - An analysis of Alabama's recent neonatal mortality rate was performed to answer questions pertaining to projected changes in the neonatal mortality rate in the next decade. With current technology these questions include: (1) Can the current decline in the neonatal mortality rate continue? (2) Which infants not now surviving are potentially able to be saved? (3) What types of new programs may further reduce the neonatal mortality rate? (4) For which infants may research provide technology leading to further reductions in the neonatal mortality rate? In this analysis, birth weight-specific neonatal mortality rates for Alabama were compared with the lowest birth rate-specific neonatal mortality rates achieved in perinatal centers. Specific causes of neonatal death for each birth weight group were determined. Data suggest that 20% of current neonatal deaths would be preventable with available technology through expanded regionalization of perinatal care for infants born weighing less than 2,500 gm. Since lethal congenital anomalies cause the majority of neonatal deaths in infants born weighing greater than 2,499 gm, there is apparently little room for an improved neonatal mortality rate in this group. Without successful research leading to a reduction in preterm delivery rates, a reduction in lethal congenital anomalies or better survival of low-birth weight infants. Alabama's neonatal mortality rate is likely to level off at five to six per 1,000. PMID- 6859166 TI - Adjusted-dose heparin therapy by continuous intravenous infusion for recurrent pulmonary embolism during pregnancy. PMID- 6859165 TI - The autonomic nervous system and fetal heart rate variability. AB - Although it is often assumed that fetal heart rate variability reflects simple "push-pull" interactions between the parasympathetic and beta-sympathetic limbs of the autonomic nervous system, there has been little direct experimental evidence to support this view. We used autonomic blocking agents to investigate heart rate variability in chronically catheterized fetal lambs, and an on-line computer to make measurements of heart rate and of the higher and lower frequency components of its variability. beta-sympathetic blockade alone had no effect on variability. Parasympathetic blockade alone reduced it, but did not abolish it. Even after double blockade, some 35% to 40% of variability remained, thus implying that there is a major nonneural component to heart rate variability. There was evidence that the fetus, unlike the adult, is subject to a resting cardioacceleratory drive. PMID- 6859163 TI - Ketamine, catecholamines, and uterine tone in pregnant ewes. AB - Blood levels of ketamine, measured in both mother (1,230 ng/ml at 1 minute) and fetus (470 ng/ml at 1 minute) illustrate not only rapidly decreasing levels of the drug after its intravenous administration but also its transplacental passage. Concentrations of norepinephrine, epinephrine, and dopamine did not change in the mother or fetus after ketamine, with the exception of maternal levels of epinephrine, which were significantly higher at 45 minutes than control values (p less than 0.05). Maternal effects of ketamine consisted of increases in mean arterial pressure (7% p less than 0.05), cardiac output (16% p less than 0.01), and respiratory acidosis, all of which were slight and transitory. Although resting uterine tone increased (39% p less than 0.01), the uterine blood flow remained constant. None of the physiologic alterations could be correlated with changes in catecholamine levels. Therefore, the cardiovascular and uterine stimulating properties of ketamine at a dose of 0.7 mg/kg are small and are not the result of increased catecholamine levels in plasma. Further studies are necessary to elucidate the mechanism. PMID- 6859168 TI - Left ventricular dysfunction in a patient with toxic shock syndrome. PMID- 6859169 TI - Umbilical vein thrombosis at 32 weeks' gestation with delivery of a living infant. PMID- 6859167 TI - Failure of ultrasonic placental grading to predict severe respiratory distress in a neonate. PMID- 6859170 TI - Failure of serial echocardiographic studies to predict aortic dissection in a pregnant patient with Marfan's syndrome. PMID- 6859171 TI - The use of gallium scanning and determination of human chorionic gonadotropin to evaluate resorption of an abdominal placenta. PMID- 6859172 TI - Detection of gonorrhea by limulus lysate assay. PMID- 6859174 TI - Breast aspiration cytology: a neglected gynecologic procedure. AB - Presented is a retrospective review of 1,196 breast aspiration cytologic procedures done during 1973 through 1981, at the Straub Clinic and Hospital, Inc., Honolulu, Hawaii. Aspirations which yielded clear fluid are not included. Of all the patients who had breast aspirations, 204 subsequently underwent open biopsy, and a definitive histologic diagnosis was made. Of the 204 open biopsies, 23% proved the existence of malignancy. Thus, 4% of the 1,196 breast aspirations proved the presence of carcinoma. Office aspiration cytologic examination of breast lesions is an efficient and cost-effective technique which is available to every gynecologist, and for which there are no medical contraindications. Complications are rare and usually not significant. If clear fluid is obtained, a clinical diagnosis of benign cystic disease can be made with a high degree of reliability. If the findings of breast aspiration cytologic examination are reported to be suspicious or to disclose malignancy, the patient should be referred as soon as possible for a definitive open biopsy and appropriate surgical treatment. PMID- 6859173 TI - Clinical applications of techniques used in human in vitro fertilization research. AB - Human in vitro fertilization-embryo transfer not only provides an opportunity for pregnancy in women who were previously considered to be sterile, but also provides a unique method by means of which basic reproductive physiology can be investigated. From September, 1981, to September, 1982, 71 women with normal cycles who elected to attempt in vitro fertilization-embryo transfer underwent timed laparoscopy for recovery of oocytes. Oocytes were recovered in 60 patients, with embryo transfer resulting in 50 patients, and normal implantation occurred in nine patients. There was a significant correlation between ultrasound observation of follicle size and serum estradiol levels, thus making ultrasound monitoring of follicular growth during stimulation with clomiphene citrate or human menopausal gonadotropin in anovulatory women clinically useful. The technique of sperm washing employed for in vitro fertilization has now been used with good results for intrauterine insemination in patients with infertility due to a cervical factor or oligospermia. Therefore, the techniques used in human in vitro fertilization-embryo transfer are now clinically applicable for couples with infertility due to causes other than tubal disease. PMID- 6859176 TI - The medical antigravity suit for management of surgically uncontrollable bleeding associated with abdominal pregnancy. AB - Three patients with abdominal pregnancy have been treated at Stanford University Hospital in recent years. Common to each was surgically uncontrolled hemorrhage for which circumferential pneumatic compression (supplied by a medical antigravity suit) was used to stop the bleeding. In each patient, the hemostatic effect of treatment was dramatic. In published accounts of the use of the garment in other severely hemorrhaging patients, the effects have been similarly dramatic and equally successful. These observations lead to a compelling consideration in regard to optimum management of patients with abdominal pregnancy. If our experience is confirmed by others, optimum management in abdominal pregnancy hereafter should regularly and routinely include removal of the placenta at the primary operation. This approach would anticipate use of the medical antigravity suit to provide hemostasis if surgically uncontrollable bleeding is encountered. Theoretically, the complications and long-term morbidity associated with retention of the placenta would be eliminated by this means while the previous disadvantage of placental removal, the potential for exsanguinating hemorrhage, would be circumvented. PMID- 6859175 TI - Treatment variables in the management of endometrial cancer. AB - A review was made of 240 women with endometrial carcinoma who were treated at the University Hospital in Seattle, Washington, between 1961 and 1979. The most common predisposing factor was a history of exogenous hormones, elicited in 46.7%. As predicted, such patients exhibited a more favorable outcome. Twelve percent of patients developed recurrent disease, and the vagina was the most common site of recurrence. However, 85% of patients with vaginal recurrence had received preoperative radiation therapy. Nodal sampling was a phase of the primary surgical treatment of the disease in 41 of the 240 patients. An effort to focus on this issue was made by including in a separate review 26 additional patients similarly managed in 1980 and 1981, thereby raising to 67 the total number of patients with nodal sampling. Fifty-nine of these patients had Stage I endometrial cancer. In these patients, histologic grade of tumor and depth of invasion determined at the time of operation appear to serve as reasonable predictors of nodal involvement. PMID- 6859177 TI - Survey of men and women residents entering United States obstetrics and gynecology programs in 1981. AB - In July 1981, questionnaires were distributed to 1,128 residents entering the field of obstetrics and gynecology throughout the United States; 546 (48%) were returned and evaluated, 229 from women (42%) and 317 from men (58%). Factors that related to the choice of the specialty showed a universal interest in the birthing process and the surgical aspects of the specialty, with a large majority also interested in health education, endocrinology, primary care of young people, and achievement of a greater understanding of sexuality. Private partnership practice was favored by most of the respondents. Men attributed a greater importance to income than did women, who were more interested in a salaried practice and less irregularity of hours. Women tended to be more liberal on questions that were related to controversial medical and ethical issues in the field of obstetrics and gynecology. Role models, half of whom were teachers, were equally common to men and women (66%). PMID- 6859178 TI - Vaginal ulcers caused by tampons. PMID- 6859179 TI - The fetus determines circadian oscillation of myometrial electromyographic activity in the pregnant rhesus monkey. AB - Uterine electromyographic activity in the pregnant rhesus monkey showed two types of episodic electrical events, defined on the basis of duration of the episodes. One of these (designated type I in this report) was characterized by frequent bursts of electrical activity that lasted from 0.5 to 1.2 minutes (mean duration, 0.64 +/- 0.007 [SE] minutes) and occurred at frequencies of 10 to 45 per hour. The other type of electromyographic activity observed (type II) consisted of fragmented series of discharges that lasted 2 to 15 minutes (mean duration, 5.45 +/- 0.12 [SE] minutes) and occurred at frequencies of 0 to 6 per hour. The frequency of type I electromyographic events showed a circadian pattern of low amplitude with a maximum at night in animals with minimal uterine manipulation (electrodes only). This daily pattern was amplified during the 8 to 10 days that preceded delivery. Hysterotomy and fetal catheterization induced a circadian increase in the frequency of type I electromyographic events akin to that observed during the predelivery period. Fetal death abolished the high-amplitude circadian variation of type I electromyographic events both postoperatively and in the predelivery period. These data indicate that the fetus plays a role in the regulation of uterine type I electromyographic activity in the rhesus monkey. PMID- 6859180 TI - Clinical applications of the altered iron kinetics of toxemia of pregnancy. AB - The previously reported elevation of serum iron in association with toxemia of pregnancy was evaluated to determine if this chemical test could be clinically useful. When patients with toxemia and pregnant women with chronic hypertension were compared, a serum iron value greater than 100 micrograms/dl or an increase greater than 70% above baseline was a sensitive and specific indicator of toxemia. The predictive value is high and exceeds that of other commonly available tests. The clinical value of this model is discussed. PMID- 6859181 TI - Experience with the carbon dioxide laser in gynecologic microsurgery. AB - The value of the carbon dioxide laser in gynecologic microsurgery remains controversial. Initial reports on the success of the laser in infertility surgery were not supported by substantial patient data. The majority of researchers involved with laser microsurgery agree that the technique has numerous advantages, including excellent hemostasis, decreased tissue destruction, exacting precision of dissection and shortened operating time. There are, however, relatively small numbers of patients treated with this modality who have been followed up for a sufficient period of time to determine the ultimate effect the laser will have on pregnancy rates. Since our first laser microsurgical procedure in November, 1980, we have performed more than 150 such procedures. The procedures have included neosalpingostomy, tubal reanastomosis, vaporization of adhesions, and removal of endometriosis. The technique is safe as shown by the absence of any laser-related complication in our cases. We now have 69 patients who have been followed up for more than 1 year since the time of the procedure. The following work is a presentation of pregnancy data and patency rates from this patient group. These results are presented in an effort to offer some objectivity to the comparison of laser microsurgery and standard microsurgery. PMID- 6859182 TI - Visual acuity and motor characteristics in congenital nystagmus. AB - Improvement in visual acuity at near fixation in patients with congenital nystagmus has been explained on the basis of nystagmus damping, caused by superimposed convergence innervation. However, an electronystagmographic study of 13 patients with congenital nystagmus and improvement in visual acuity at near fixation failed to show a consistent decrease of nystagmus intensity at near fixation. Visual acuity at near fixation improved regardless of whether the nystagmus intensity decreased or increased. Factors other than nystagmus amplitude or frequency may be modified by convergence innervation and cause an increase in visual acuity at near in patients with congenital nystagmus. PMID- 6859183 TI - Ocular torsional movements in normal humans. AB - We conducted three studies of compensatory ocular torsional movements in normal human subjects, using changes in the axis of astigmatism, afterimages, and direct observation with cinematography. Measurements of changes in the axis of astigmatism and the subjects' subjective perception of afterimages with a superimposed Maddox rod showed a partial compensatory intorsion on head tilt to the ipsilateral side and extorsion on head tilt to the contralateral side. Cinematography demonstrated that the eye lags behind the head in a slow rolling movement as the head is tilted. Periodic rotary movements in the direction of the head tilt partially correct the lag and result in a partial compensatory torsion. A fourth experiment excluded false torsion as an artifact in these studies. PMID- 6859184 TI - Depth of strabismic amblyopia determined with neutral density filters. AB - We used a neutral density filter to assess motor responses in the fixation patterns of 25 patients, ranging in age from 5 to 54 years, with strabismic amblyopia. Shifts of fixation back to the preferred eye occurred when the visual acuity of the preferred eye through the filter was marginally better than that of the amblyopic eye. Thus, we were able to correlate the level of the filter at which this shift occurred with the level of amblyopia. This technique may be particularly helpful in the examination of preliterate children and in monitoring the progress in the treatment of amblyopia. PMID- 6859185 TI - Extraocular muscle surgery for dysthyroid myopathy. AB - A series of 45 patients underwent extraocular muscle surgery for diplopia induced by dysthyroid myopathy. Two thirds (31) of the patients were female and age distribution showed a peak (47%) in the sixth decade of life. The most common deviation was pure hypotropia; a combination of hypotropia and esotropia was also frequent. Initial surgical intervention restored binocularity in primary position in 30 patients and in reading position in 27 patients. After further surgery in some cases, 40 patients eventually achieved satisfactory alignment in primary position and 36 achieved it in reading position. PMID- 6859186 TI - Ocular motility testing in the evaluation of visual hallucinations. AB - Distinguishing organic visual hallucinations from those caused by hysteria or malingering is important but difficult. We found that ocular motility testing is helpful in making the distinction in some patients who allege that their hallucinations move. A 9-year-old girl thought to have organic hallucinations, possibly caused by an occipital lobe neoplasm, was unable to generate smooth pursuit movements when she attempted to follow the movements of the hallucinations. Instead, she executed a series of small downward saccades. Her hallucinations were presumably stress-induced. Conversely, a 62-year-old man with hypertension, arteriosclerotic heart disease, and depression, whose hallucinations were thought to be hysterical, was able to execute smooth pursuit movements when he attempted to follow the hallucinations. Detection of a previously unrecognized visual field defect helped to establish that the hallucinations were organic. Thus, patients with moving organic hallucinations may produce smooth pursuit movements when attempting to follow the hallucinations, but patients with feigned or hysterical hallucinations, who lack a fixation target, are likely to execute a series of saccades. PMID- 6859187 TI - Aqueous humor dynamics in Fuchs' uveitis syndrome. AB - We studied aqueous humor dynamics in ten subjects (four men and six women, ranging in age from 19 to 72 years) with unilateral Fuchs' uveitis syndrome. The unaffected fellow eyes served as controls. In two patients, the affected eye also had glaucoma. Fluorophotometry showed the blood-aqueous barrier to be abnormally permeable in the affected eyes. The calculated coefficient of exchange of fluorescein across the blood-aqueous barrier was 30.7 X 10(-4) min-1 in the affected eyes and 5.7 X 10(-4) min-1 in the unaffected eyes. The anterior chamber elimination coefficient of fluorescein, corneal endothelial permeability to fluorescein, and anterior chamber volume did not differ significantly in affected vs unaffected eyes. The rate of aqueous humor flow through the anterior chamber in the affected eyes appeared to be normal, as did the apparent resistance to the outflow of aqueous humor. PMID- 6859188 TI - A histopathologic study of 716 unselected eyes in patients with cancer at the time of death. AB - To determine the frequency of ocular metastases in the general population, we conducted a prospective histopathologic study of 716 eyes obtained from patients who had malignant neoplasms at the time of death. Fifty-two patients had ocular metastases; all of these individuals had widespread metastases that contributed to their deaths. The overall incidence of ocular metastases among all fatal cases of cancer was 9.3%. Thirty-three of the 117 patients with various types of leukemia and four of the 60 patients dying with lymphoma had ocular involvement. The total incidence of ocular metastases in patients dying of all types of carcinoma was 4.0%. In the nine patients dying of sarcoma, no ocular metastases were detected. We estimate that about 22,000 patients who will die of cancer in the United States during 1983 will have ocular metastases. PMID- 6859189 TI - Capsulectomy and membranectomy with the argon laser. AB - Using the argon laser photocoagulator, I created openings in opacified posterior capsules and secondary membranes in ten eyes with resulting improvement in visual acuity. Eight of these eyes had implanted intraocular lenses. There was no evidence of damage to the intraocular lens or to the ocular structures. All openings remained patent during the follow-up period. PMID- 6859190 TI - Effects of the Shearing posterior chamber intraocular lens on the corneal endothelium. AB - A consecutive group of 67 patients (70 eyes) with senile cataract underwent extracapsular cataract extraction and implantation of a Shearing posterior chamber intraocular lens. After two years of follow-up, there was an 11% +/- 2% decrease in central cell density (P less than .001), a 20% +/- 2% decrease in superior cell density (P less than .001), and a 5% +/- 3% decrease in inferior cell density (P less than .005). Complications included corneal edema requiring a corneal transplant (one patient), a sterile nonhealing ulcer that required a conjunctival flap (one patient), and secondary glaucoma (one patient). Nine patients had visual acuities poorer than 20/40 but none had cystoid macular edema. Primary or secondary capsulotomy did not significantly increase endothelial cell loss. Central endothelial cell loss from extracapsular cataract extraction with Shearing posterior chamber intraocular lens implantation was correlated with age, as well as with preoperative superior endothelial cell density (P less than .05). PMID- 6859191 TI - The transconjunctival oxygen monitor. AB - The transconjunctival oxygen monitor, mounted on a polymethylmethacrylate conformer, continuously measures the tissue oxygen tension of the palpebral conjunctiva. It is preferable to transcutaneous monitors because it requires no heat and correlates arterial oxygen in cerebral blood flow by monitoring a tissue bed vascularized by the internal carotid artery. We used it on 19 adult patients. The monitor was valuable in correlating arterial oxygen in hemodynamically compromised and uncompromised patients. However, the measurements decreased abruptly when the conjunctival temperature fell below 33 C in the compromised patients. The only ocular complications were conjunctival chemosis and mild punctate keratopathy in some patients; these resolved within 48 hours. This device may be useful in monitoring tissue oxygen tensions in critically ill patients and neonates at risk for retinopathy. PMID- 6859192 TI - Early equatorial cataracts in workers exposed to trinitrotoluene. AB - Twelve workers (nine men and three women with a mean age of 39.5 +/- 8.9 years) with occupational exposure to trinitrotoluene had a mean duration of exposure of 6.8 +/- 4.7 years. The general physical findings were minimal, but ophthalmologic examinations showed bilateral peripheral cataracts in six of the 12 workers. Cataracts were visible only with maximal mydriasis and were continuous or annular opacities at the equator. The cataracts did not interfere with visual acuity or visual fields. Only one worker with and one without cataracts had increased serum alanine aminotransferase and bilirubin levels, possibly associated with trinitrotoluene exposure. PMID- 6859194 TI - A visual acuity chart with geometric gradation and logarithmic notation. PMID- 6859193 TI - An anterior surgical approach to aphakic cystoid macular edema. AB - Fifteen consecutive eyes in 14 patients (six men and eight women, ranging in age from 43 to 75 years) underwent anterior vitrectomy for chronic cystoid macular edema documented by fluorescein angiography. All eyes had either vitreous adhesions to the cataract incision with pupillary distortion, or adherence of vitreous strands to the iris. Anterior vitrectomy via the corneoscleral limbus was performed in each case to remove vitreous from anterior segment structures. Thirteen of the 15 eyes showed visual improvement, with 12 of the 15 showing improvement of two Snellen lines or more. There was no direct correlation between the duration of aphakic cystoid macular edema and final visual acuity. PMID- 6859196 TI - Cause of enophthalmos secondary to maxillary sinus mucocele. PMID- 6859195 TI - Observation on transsynaptic changes in acquired Horner's syndrome. PMID- 6859197 TI - Unilateral systemic lupus erythematosus retinopathy. PMID- 6859198 TI - Reduction of retinal venous tortuosity after detachable balloon occlusion of carotid-cavernous fistula. PMID- 6859199 TI - Demodex infestation of the sebaceous gland. PMID- 6859200 TI - Pediatric migraine. PMID- 6859204 TI - Eyewash mistaken for contact lens soaking solution. PMID- 6859201 TI - Conjunctival involvement in primary systemic nonfamilial amyloidosis. PMID- 6859203 TI - Cover slip lens. PMID- 6859202 TI - Carcinomatous retrobulbar neuropathy disclosed by cytologic study of cerebrospinal fluid. PMID- 6859205 TI - Soft contact lenses and clinical disease. PMID- 6859206 TI - President's 1981 report to the American Academy of Optometry. PMID- 6859207 TI - President's 1982 report to the American Academy of Optometry. PMID- 6859208 TI - A model to explain the effect of soft lens design specifications on movement. AB - A model is presented which explains the movement of a contact lens in terms of its primary design specifications. The model is supported by clinical evidence. The interrelation between lens thickness, sagittal depth, and diameter is explained. The model explains why fewer base curves are needed as lens thickness is reduced. PMID- 6859209 TI - Validation of a model describing soft lens movement as a function of lens specification. AB - The authors fitted 12 subjects with 30% water-content, soft contact lenses. The sagittal depth of the lenses was varied in five steps while diameter was held constant. In a second study, diameter was varied from 12 to 14 mm in five steps. Regression analysis was used to analyze the data. Lens movement can be decreased by increasing lens thickness, reducing lens diameter, or flattening the base curve of the lens. PMID- 6859210 TI - Speculations on the direction of the optic nerve. AB - A theory is proposed to explain the direction of the optic nerve on the basis of differing embryonic growth of axons on opposite sides of the nerve head. Several ophthalmoscopic indicators of the direction of the optic nerve are discussed. Some clinical implications are presented. PMID- 6859211 TI - Lack of effects of anesthetic on measurement of intraocular pressure by Goldmann tonometry. AB - Intraocular pressure (IOP) was measured in humans by Goldmann tonometry. Pressures were compared with either benoxinate or proparacaine as the anesthetic. It was found that the values obtained did not differ depending upon the choice of anesthetic. PMID- 6859212 TI - Optical prophylaxis for environmental myopia: an epidemiological assessment of short-term effects. AB - The biologically plausible concept that relief of accommodation may reduce myopic progression, although not confirmed and not universally accepted, has nevertheless strongly influenced the practice of preventive optometry. Yet, no quantitative estimates of the strength of this postulated effect were found in the literature. From a cohort study of 120 young (18 to 20 years of age) male military students with low initial refractive error (less than or equal to +/- 1D, spherical equivalent), estimates were made of the short-term (5 months) effect of two forms of optical treatment to prevent school-related myopia. The cumulative incidence of clinically significant (greater than 0.25 D, spherical equivalent) myopic progression was less [standardized morbidity ratio (SMR) = 0.45] among those prescribed monofocal convex lenses (+1.25 D over far Rx) and prisms (2 delta base-in OU) and even more reduced (SMR = 0.32) among those prescribed bifocals (+1.5 D near adds) compared with those receiving sham treatment (no. 1 pink tint). Placebo-treated patients were more than twice [rate ratio (RR) = 2.2, 1.5] as likely as the monofocal group, and more than three times (RR = 3.2, 1.7) as likely as the bifocal patients, to suffer myopic progression during the period of follow-up. Etiologic fractions (EF, increase in myopic progression if treatment were eliminated) of 37 and 47% and preventive fractions (PF, decrease in myopic progression attributable to the treatment) of 27 and 32% were estimated for the monofocal and bifocal treatments, respectively. These findings suggest that while both modes of therapy are efficacious, the bifocal form is 20% (32/27 = 1.2) more preventive. PMID- 6859213 TI - Use of an ophthalmoscope for objective refraction of noncooperative patients. AB - Refractive ophthalmoscopy was performed on 16 subjects aged 5 to 27 years. Subjective refractions were performed on both eyes of the subjects followed by an ophthalmoscopic determination performed under cycloplegia by the authors. A 0.94 correlation was found between the subjectively determined "dry" refractive error and the refractive error determined ophthalmoscopically under cycloplegia by both examiners. The results of the two procedures differed by 1 D or less 82% of the time. The results indicate that refractive ophthalmoscopy is an alternative method for objectively determining refractive error in non-cooperative patients with poor fixational stability. PMID- 6859214 TI - Characteristics of a video-type pupillometer. AB - In using a video-type pupillometer, the adjustment of the clipping level, the illumination of the target, the focus of the camera, and the viewing angle have been shown to affect the measurement. The focus of the camera and the viewing angle are the most important variables. The precision of this instrument can be as good as 0.01 mm. The accuracy of the instrument is good with regard to clinical standards; however, all measurements vary slightly from the known value. Interexaminer variation appears to be small. PMID- 6859215 TI - Reversible glaucomatous cupping of the disc. AB - A nine-year-old girl under medical treatment for uveitis was brought for optometrical examination. In addition to a low grade anterior uveitis she was found to have high intraocular pressures, a reduced light sense, pulsation of the arteries on the disc and extensive optic disc cupping. The most probable diagnosis was juvenile rheumatoid arthritis. Photographs show reversal of the cupping over a four-month period during which intraocular pressures were brought into the normal range. Optometrists are cautioned that they should assess not only the progress of treatment of an established eye disease but should also review the entire ocular status of patients coming under their care. PMID- 6859217 TI - Coronary arterial ectasia, a predominant type of coronary sclerosis in aged captive rhesus monkeys (Macaca mulatta). AB - In hearts from aged rhesus monkeys, ranging from 20 to over 30 years, marked coronary arterial ectasia, dilatation, and tortuosity of the entire vessel were observed in 18 animals. Another 7 animals showed a moderate degree of ectatic changes. Dilated arteries showed remarkable thinness of the tunica media with atrophy and attenuation of the muscle cells and increased fibrous tissue. Diffuse or focal intimal fibrous thickening was present in the ectatic arterial wall, but cholesterol deposit, calcification, or the presence of lipid-laden foam cells in the intimal and medial wall was not observed. A focal degeneration and fibrosis of the myocardium were seen in the hearts of 11 cases. Clinically, 2 cases had either spontaneous diabetes mellitus or cardiac decompensation with mitral insufficiency, but the others had no abnormal metabolic or cardiovascular histories. Coronary arterial ectasia accompanied with medial fibrosis appears to be a predominant type of coronary arterial lesion in aged rhesus monkeys under long-term captivity. PMID- 6859216 TI - Altered growth patterns in vitro of human papillary transitional carcinoma cells. AB - In vitro growth patterns and morphologic characteristics of five low-grade human papillary transitional cell carcinomas (TCCs) were compared and contrasted with those of normal human urothelial cells in culture. Biopsies of TCC were performed by transurethral resection. Specimens of normal human ureters were obtained surgically. Singly dispersed TCC cells grew in 0.3% agarose semisolid medium with a cloning efficiency ranging from 0.02% to 0.71%. Singly dispersed normal ureteral urothelial cells under the same conditions did not form colonies in 0.3% agarose. Neither singly dispersed TCC nor normal urothelial cells formed colonies when plated on collagen-gel substrates. In primary explant culture, normal human urothelial cells grew rapidly, to form tightly adherent flat sheets of apparently nonmotile cells. Autoradiographic labeling with 3H-thymidine of growing cultures of normal urothelial cells showed cell division primarily in the zones of growth near the explant. Outgrowth of TCC from primary explants was loosely adherent. One TCC explant culture gave rise to a continuous suspension culture. Numerous multilayered cellular formations of fronds, nodules, and "walls" were seen around the periphery of TCC explant colonies. Autoradiography showed that these multilayered areas of TCC growth contained actively dividing cells. The altered ability of papillary TCC to form superficial multilayered formations in vitro distinguishes them from normal human urothelium and reflects the morphologic characteristic of this tumor type in vivo. PMID- 6859218 TI - Human serum induces maturation of human monocytes in vitro. Changes in cytolytic activity, intracellular lysosomal enzymes, and nonspecific esterase activity. AB - The dependence of human monocyte maturation in vitro on autologous serum was examined. If autologous serum was present during the monocyte culture, cytolysis of K562 target cells increased, intracellular levels of three lysosomal enzymes increased, and the fluoride-inhibitable esterase staining of the monocytes changed into a fluoride-resistant esterase stain (characteristic of more mature extravascular mononuclear phagocytes). Monocytes cultured in the presence and in the absence of serum also assumed different shapes. All of these changes were dependent on the concentration of autologous serum present (0-10%) and the length of time the monocytes were in culture (0-7 days). Lack of development by monocytes cultured in the absence of serum was not due to a general loss of the ability of these cells to function, because phagocytosis of antibody-coated erythrocytes was not lost following 7 days in culture in the absence of serum. PMID- 6859219 TI - Phenobarbital pretreatment protects against morphologic changes in rat bronchiolar epithelium caused by an impurity of malathion. AB - Oral administration (20 mg/kg) of O,O,S-trimethyl phosphorothioate (OOS) causes delayed toxicity in rats; ie, death occurs as late as 28 days after treatment. OOS-treated rats show morphologic changes in the bronchiolar epithelium of the lung; nonciliated (Clara) cells are fewer but larger 3 days after treatment. We have now found that pretreatment with the P-450-dependent mixed-function oxidase inducer, phenobarbital, protects against the morphologic changes caused by OOS. These results support the view that the lung is a target organ of the delayed toxicity caused by OOS and that OOS detoxification is mediated by P-450-dependent metabolism. PMID- 6859220 TI - The effects of heparin treatment on vascular permeability and vessel wall damage in acute hypertension in the rat. AB - The experiment was designed to test whether the ability of heparin to prevent vascular "fibrinoid" necrosis in severe hypertension is related to its effects on vascular permeability. Hypertension was produced by infusion of angiotensin II into rats for 1 or 4 hours; some rats were treated with heparin and others not. Native ferritin was used as a tracer, and small arteries of the intestine were examined by light and electron microscopy. Rats not subjected to angiotensin II were used as controls. Half were treated with heparin, and half were not. Arteries from normotensive animals showed no signs of permeability to ferritin, damage to the vessel wall, or irregularities in caliber. Vessels from hypertensive rats had alternating zones of constriction and dilatation. Ferritin penetration and vessel wall damage were found only in dilated zones; these were focal in the 1-hour experiments and more extensive in the 4-hour experiments. No differences were observed between heparin-treated and non-heparin-treated rats with respect to permeability to ferritin or to vessel wall damage. However, in the 4-hour experiments, non-heparin-treated animals had occasional fibrinlike deposits at sites of severe medial damage; these were never found in heparin treated animals. The findings suggest that although heparin does not appear to affect vascular permeability or medial damage during acute hypertension, it may prevent polymerization of fibrin in damaged vessel walls--presumably a result of the drug's anticoagulant properties. PMID- 6859221 TI - Stimulation of human monocyte/macrophage-derived growth factor (MDGF) production by plasma fibronectin. AB - Culture supernatants from human peripheral blood monocytes, isolated free of platelet contamination and cultured in the absence of serum, stimulate DNA synthesis and cell growth in Balb/c 3T3 fibroblasts and bovine aortic smooth muscle cells. Monocytes cultured in serum-free medium for 24 hours with plasma fibronectin, added as either a surface-attached or soluble molecule, secrete significantly increased amounts of growth-promoting activity. Fibronectin also stimulates an increase in intracellular growth factor content and in protein synthesis by monocytes. Both the enhanced growth-promoting activity and protein synthesis are inhibited by cycloheximide. Thus, fibronectin-monocyte interactions may influence the production of growth-promoting activity by monocytes and contribute to fibroblast and smooth-muscle replication in wound healing, chronic inflammation and atherosclerosis. PMID- 6859222 TI - Effect of antihypertensive therapy on the vascular changes of spontaneously hypertensive rats. AB - The effect of antihypertensive therapy on vascular morphologic characteristics was studied in spontaneously hypertensive rats (SHRs). Starting at either 7 or 22 weeks of age, SHRs were given a combination of hydralazine, chlorothiazide, and reserpine, which reduced the blood pressure significantly below the level of untreated animals. Rats were sacrificed at either the 22nd or the 42nd week of age along with age-matched untreated SHRs and normotensive Wistar-Kyoto controls. The following treatment groups were thus obtained: a) treated from the 7th to the 22nd or 42nd week, b) treated from the 22nd to the 42nd week, and c) treated from the 7th to the 22nd and left untreated until the 42nd week. Ultrastructural and morphometric studies were carried out on the aorta and intrarenal vessels. The expansion of the subendothelial space and medial thickening in the aorta as well as the increase in external to luminal diameter ratios and wall thickness of intrarenal vessels were prevented in SHRs treated continuously from the 7th week on. The severity of vascular lesions was markedly reduced in animals treated from the 22nd to 42nd week. Discontinuation of therapy resulted in rapid reestablishment and progression of both aortic and renal vascular disease to a degree identical to that of untreated SHRs. The results indicate that hypertensive vascular changes are preventable by early treatment and, depending on their nature, can be arrested or reversed by delayed treatment. PMID- 6859223 TI - The twitcher mouse. A model of human globoid cell leukodystrophy (krabbe's disease). PMID- 6859225 TI - The pulmonary vascular lesions of the adult respiratory distress syndrome. AB - Specimen arteriography, morphometry, and light and electron microscopy were used for examination of the pulmonary vasculature of 22 patients who died with the adult respiratory distress syndrome (ARDS), for the purpose of defining the lesions that contribute to pulmonary hypertension in this setting. The different lesions correlated with the duration rather than the cause of ARDS. Thromboemboli occurred in 21 patients, and macrothrombi found at autopsy correlated with the number of filling defects on antemortem angiography. Acute endothelial injury was documented ultrastructurally even in intermediate and late-stage patients. Fibrocellular intimal obliteration of arteries, veins, and lymphatics and infective vasculitis were prominent in those surviving beyond 10 days. In long term survivors, tortuous arteries and irregularly dilated capillaries were striking features. Peripheral extension of vascular smooth muscle and a significant increase in the percentage of medial thickness of muscular arteries with duration of ARDS were noted. The pathogenesis and clinical significance of these lesions is discussed. PMID- 6859224 TI - Ultrastructural studies of the interaction between liposome-activated human blood monocytes and allogeneic tumor cells in vitro. AB - Human blood monocytes were activated to become tumoricidal by incubation with liposomes containing muramyl tripeptide-phosphatidylethanolamine, a lipophilic derivative of muramyl dipeptide. The interaction of both tumoricidal and control monocytes with target melanoma cells was analyzed by means of light microscopy and scanning and transmission electron microscopy. The authors found increased clustering around the melanoma cells by tumoricidal monocytes as compared with the control monocytes. The initial clustering of the tumoricidal monocytes around the tumor cells was followed by the establishment of numerous focal points of contact (binding), some of which actually exhibited areas of discontinuous membrane, a finding confirmed by stereophotography. By 24-48 hours of cocultivation, many of the target cells exhibited zones of vacuolation in the immediate vicinity of the tumoricidal monocytes, suggesting target cell damage. (This finding was confirmed by time-course cytotoxicity assays.) The authors conclude that tumor cell lysis mediated by activated human blood monocytes occurs as the final step in a process that includes the establishment of a direct cell cell contact, damage to the target cell membrane, and the development of areas of vacuolation in the target cells. PMID- 6859227 TI - Accelerated rate of mononuclear phagocyte production in vitro by splenocytes from autoimmune motheaten mice. AB - The rapidly fatal autoimmune disease accompanied by pneumonitis in the mutant mouse known as motheaten is caused by an autosomal recessive gene. The proliferative capacity and production rate of splenic mononuclear phagocytes at different maturational stages, defined by morphologic criteria, were examined by two in vitro tritiated thymidine administration protocols and radioautography. The replicative rate of splenic promonocytes from 3-week-old normal mice was found to approximate that of adult bone marrow cells. Monocytes, macrophages, and previously described macrophagelike cells from motheaten mice had an accelerated rate of maturation in vitro, compared with similar cells from normal mice. These differences in the production rates could be attributed to the shorter period of time that promonocytes from the mutant mice are in the S phase of the cell cycle. Evidence, also, verified that the macrophagelike cells were derived from promonocytes via the monocyte-macrophage compartment. The unusual in vitro growth characteristics of the splenic mononuclear phagocytes from motheaten mice could be a manifestation of an in vivo abnormality of this lineage that could contribute to the development of pulmonary disease in these animals. PMID- 6859226 TI - Experimental model of ischemic bowel necrosis. The role of platelet-activating factor and endotoxin. AB - This report deals with the experimental production of ischemic bowel necrosis in rats by the administration of combined bacterial lipopolysaccharide (LPS) and platelet-activating factor (PAF). Neither LPS alone, nor PAF at a low dose, caused ischemic intestinal necrosis when administered intraaortically. With these two compounds in combination, necrotizing lesions of the gastrointestinal tract developed consistently. The lesions showed marked morphologic similarity to human necrotizing enterocolitis (NEC). There were no thrombi in mesenteric arteries or necrotic lesions in other organs to which these bioactive compounds were delivered. These findings suggest a possible synergistic involvement of PAF and LPS in the pathogenesis of NEC and other forms of ischemic bowel necrosis. The authors further suggest that the pathogenesis of experimental NEC in rats is independent of platelet aggregation. PMID- 6859229 TI - Correlation of regional disease and in vivo PO2 in rat mammary adenocarcinoma. AB - A knowledge of the distribution of oxygen tension (PO2) and vascularization in neoplasia has been fundamental to understanding relationships between tumor growth, hypoxia, and therapy. We have combined recessed oxygen microcathode and freeze-substitution techniques to correlate in situ PO2 profiles and morphologic features in 7,12-dimethylbenz(a)anthracene (DMBA) tumors in rats. Overlying connective tissue of transplanted tumor was exposed by a 1-2 mm incision and a cross-stitch pattern demarcated electrode puncture sites for histologic reference. Three buffered salt solutions (BSS) with different PO2 were each allowed to flow through a well over the tumor where electrodes were placed for calibration. Zero electrode oxygen current was recorded from a buffered yeast agar mixture of zero torr. PO2 was recorded at 5-mu intervals to approximately 1 2 mm. Atmospheric contamination was eliminated by continuous well flow of BSS, 30 torr. Finally, the tumor and surrounding tissues were quick-frozen in vivo with Freon 22 and liquid nitrogen. The tissue block was freeze-substituted and sectioned. PO2 profiles were superimposed onto correspondingly scaled photomicrographs. A viable periphery with a PO2 range of 50-82 torr and a transition to necrotic areas of PO2, 2-13 torr were observed. This transition was characterized by PO2 gradients within distances of 50-300 mu at variable puncture depths. This technique should be useful in further studies of growth, necrosis, and therapy. PMID- 6859228 TI - Potentiation of the anaphylatoxins in vivo using an inhibitor of serum carboxypeptidase N (SCPN). I. Lethality and pathologic effects on pulmonary tissue. AB - Carboxypeptidase N (EC 3.4.12.7) (SCPN) is a plasma enzyme that efficiently inactivates the anaphylatoxins C3a and C4a and significantly reduces C5a spasmogenic activity by removing the C-terminal arginyl residue from each of these factors. The arginine analog DL-2-mercaptomethyl-3 guanidinoethylthiopropanoic acid (SCPN-INH) is a potent competitive inhibitor of SCPN with a Ki for this carboxypeptidase in serum of 2 x 10(-9) M. Therefore, we have used the SCPN inhibitor to potentiate biologic activity of the anaphylatoxins in vivo. Infusion via the carotid artery of about 40 mg of SCPN INH into each of 8 adult guinea pigs inactivated the SCPN for at least 3 hours and caused no measurable toxic effects. When cobra venom factor (CVF) is infused into guinea pigs, it activates the alternative pathway of complement, thereby generating the anaphylatoxins C3a and C5a. Ordinarily, infusion of CVF is nonlethal, because the generated anaphylatoxins are rapidly converted to C3a des Arg and C5a des Arg by SCPN. However, CVF (200 micrograms) plus SCPN-INH delivered intravenously in 5 animals induced a lethal reaction in less than 5 minutes. The authors conclude that the lethal effect is due largely to the anaphylatoxins. Histologic sections of the lungs from treated animals show dramatic structural changes consistent with peripheral small airway constriction, bronchial constriction, and vasoconstriction of small muscular arteries. Also, cell aggregates are present in blood vessels. Other histologic changes include severe congestion, pulmonary edema, and an interstitial infiltrate of mononuclear cells. Large doses of chlorpheniramine prevent this lethal reaction. Lethality is apparently attributable to asphyxia and is dependent on the level of CVF administered: eg, 100 micrograms CVF was not lethal in 4 animals given SCPN inhibitor, although signs of respiratory distress were observed. On histologic examination of lungs from guinea pigs given CVF and SCPN-INH, the features are similar to those described when anaphylatoxins are instilled into guinea pig lungs. Intravenous application of purified C3a plus SCPN-INH also proved lethal in 3 of the 6 animals challenged. This is the first evidence that the C3a anaphylatoxin can elicit a lethal response. PMID- 6859233 TI - Controversies in otosclerosis. PMID- 6859230 TI - Induction of a reversible cardiac lipidosis by a dietary long-chain fatty acid (erucic acid). Relationship to lipid accumulation in border zones of myocardial infarcts. AB - Previous studies have demonstrated that cardiac myocytes in the border zone of acute myocardial infarction become markedly overloaded with neutral lipid during the transition from reversible to irreversible injury. To examine directly the role of these changes in neutral lipid metabolism in the development of irreversible cellular injury and associated increases in tissue Ca2+ content, the authors fed rats large amounts of a fatty acid (erucic acid) that is poorly oxidized by the heart and that subsequently accumulates as neutral lipid. Rats fed a high erucic acid (C22:1) diet in the form of 20% rapeseed oil for 3-5 days had a fourfold increase in triglyceride (49.5 +/- 3.8 SEM mg/g wet wt versus 13.6 +/- 13, n = 4) and a 60% increase in long-chain acyl CoA content (166.0 +/- 21.9 versus 91.5 +/- 9.0 nM/g wet wt, n = 4), compared with controls. However, there was no change in long-chain acyl carnitine or total phospholipid content. Histochemical studies showed accumulation of numerous lipid droplets in the myocytes, and electron microscopy revealed localization of lipid vesicles in direct contact with mitochondria, thus mimicking the lipid-laden cells in the border zone regions of acute myocardial infarcts. The acute lipidosis was reversible with either continued feeding of erucic acid for several weeks or conversion to a normal diet. It was not associated with an increased tissue Ca2+ content, nor with cell necrosis. However, continued erucic acid intake for 3 months was associated with focal myocardial degeneration and loss of myocytes. These results suggest that acute increases in neutral lipids, as found in the border zone of acute myocardial infarction, may not be the cause of progression to irreversible damage during acute myocardial injury, but that the persistent presence of similar lipid material over months may result in focal myocardial degeneration. PMID- 6859231 TI - Ultrastructural changes in bronchoalveolar lavage cells in sarcoidosis and comparison with the tissue granuloma. AB - The authors undertook this study to determine whether there were any morphologic changes in bronchoalveolar lavage lymphocytes and macrophages in sarcoidosis and, in particular, to determine whether changes described previously in the mononuclear phagocytes of sarcoid granulomas were also evident in such cells obtained by lavage. Lavage cells from 28 sarcoidosis patients were studied by transmission electron microscopy and compared with lavage cells from 17 control subjects and with lung tissue granulomas from 5 sarcoidosis patients. Interactions between mononuclear phagocytes, especially subplasmalemmal linear densities, and between these cells and lymphocytes were observed in both the tissue granulomas and lavage specimens from sarcoidosis patients. Subplasmalemmal linear densities were never observed in control lavage specimens. Fully developed epitheloid cells were not identified in lavage specimens, but differences were nevertheless found between the lavage cells from sarcoidosis patients and control subjects: in particular, alveolar macrophages in sarcoidosis were larger and showed better developed pseudopodia, more marked polarity, less nuclear heterochromatin, and lysosomes that were larger and more numerous but less electron-dense than normal. Lymphocytes were also enlarged and contained more lysosomes. It is concluded that although there are only a few similarities between the cells of the granuloma and those obtained by bronchoalveolar lavage in sarcoidosis, there are noticeable differences between the lavage cells of sarcoidosis patients and control subjects. In sarcoidosis, a variable proportion (10-70%) of the lavage cells show morphologic features of "activation." PMID- 6859234 TI - Complications of stapedectomies. AB - The authors consider the consequences and treatment of any error during and after stapedectomy, and present the usually less developed complications of stapedectomies: postoperative cochlear drops, tinnitus, vertigo. They also mention the other complications of stapedial surgery, and they particularly advocate the half-posterior stapedectomy technique, associated with a sufficiently large venous interposition. The authors had no cases of severe permanent cochlear loss during the first postoperative month in a series of more than 4000 stapedectomies. PMID- 6859232 TI - Acute lung inflammation induced in the rabbit by local instillation of 1-0 octadecyl-2-acetyl-sn-glyceryl-3-phosphorylcholine or of native platelet activating factor. AB - The intratracheal instillation into rabbits of 1-0-octadecyl-2-acetyl-sn-glyceryl 3-phosphorylcholine (AGEPC) or native platelet-activating factor (PAF) was shown to induce a dose-dependent acute pulmonary inflammation characterized by accumulation of macrophages in the alveolar space, degenerative and necrotic changes of alveolar epithelium, and accumulation of polymorphonuclear leukocytes (PMNs) and platelets in the alveolar capillary lumens with degenerative changes of endothelial cells. Infiltration of alveolar septa by inflammatory cells and, in a later stage, pulmonary fibrosis were also observed. Intrabronchial instillation of lysoglyceryl ether phosphorylcholine (lyso-GEPC) produced no inflammatory changes or only mild ones. In comparison with acute inflammation induced by intratracheal instillation of C5a des Arg, which is mainly characterized by the presence of neutrophils, red blood cells, and fibrin in the alveolar space, AGEPC and native PAF seem to induce a more severe accumulation of macrophages in the alveolar space and septa and of platelet and PMNs in the lumens of alveolar capillaries. These results are compatible with the concept that during inflammatory reaction an intraalveolar release of PAF contributes to the development of pulmonary injury. PMID- 6859235 TI - Audiologic test selection in the detection of eighth nerve disorders. PMID- 6859236 TI - Auditory brain stem response measurement in the assessment of pseudohypoacusis. AB - In the evaluation of patients with pseudohypoacusis, a test that gives at least a suggestion of the patient's true auditory sensitivity is of great value. This report is an evaluation of the application and contribution of auditory brain stem response (ABR) measurement in pseudohypoacusis through a case study approach. Four patients suspected of having pseudohypoacusis on the basis of their histories and initial audiometric results were tested with the ABR procedure. In all cases the auditory sensitivity suggested by ABR was considerably better than the voluntary thresholds obtained on the initial audiograms. Following ABR measurement, all four patients showed marked improvement in voluntary threshold responses, and two gave responses that were within normal limits. Although auditory brain stem response measurement is not a test of hearing, it can be a powerful tool in the identification and quantification of nonorganic hearing loss. PMID- 6859237 TI - Differential uptake of H3-amino acids in the cat cochlear nucleus. AB - A fresh brain-slice preparation that allows simultaneous characterization of the anatomic localization of radioactively labeled substances in a variety of different auditory brain stem areas has been used to examine localization patterns for a number of putative neurotransmitter amino acids in the anteroventral and dorsal cochlear nuclei of the cat. Following incubation of fresh brain sections in oxygenated salt solutions containing micromolar amounts of the tritiated amino acids, differences in the pattern of label localization are revealed by light microscopic autoradiography. Electron microscopic autoradiography of the same material demonstrates that the label is restricted to different synaptic terminal populations. In the dorsal cochlear nucleus, gamma aminobutyric acid (GABA) and glutamic acid incubations label two different terminal populations in the molecular layer. Glycine incubation labels a population more uniformly distributed among the molecular, fusiform cell, and deep layers. In the anteroventral cochlear nucleus the pattern after GABA and glycine incubations is similar, with multiple endings on all spherical cells labeled. Studies are underway to characterize fully the different labeling patterns and the conditions under which they occur. PMID- 6859238 TI - Qualitative and quantitative analysis of otoconia in the normal and in the genetically deaf inner ear. AB - By using the energy dispersive x-ray microanalysis technique the elemental composition of otoconia was analyzed in the normal fetal and normal adult, Shaker 1 and Shaker-2 mouse. There are no statistically significant differences in Ca concentration between otoconia seen in normal nineteenth gestational day (CBA/CBA) fetuses and that seen in 2-month-old animals. However, the standard deviation is almost three times larger in fetal than in adult otoconia. In all analyses, in both normal and mutant species, the following, elements were identified: Na, Mg, P, S, Cl, K, and Ca. The present findings strongly indicate a calcite composition of otoconia in both normal and mutant species. Significant differences in Ca concentration (p less than 0.05) occurred between the central and peripheral parts of large otoconia in normal mice. No difference in the elemental composition of otoconia in adult normal and Sh-2 mutants was detected. Differences occurred between adult normal and Sh-1 otoconia (Na--p less than 0.05; Mg--p less than 0.001; K--p less than 0.001; Ca--p less than 0.02). It is, however, unlikely that the shaking-waltzing behavior of Sh-1 and Sh-2 mutants derives from a minimal derangement of the elemental composition of otoconia. PMID- 6859239 TI - Objective tinnitus: a case report. AB - Objective tinnitus is a rather rare condition that may be due to myoclonus of certain muscles, such as the palate, or to arteriovenous communications, either congenital or acquired. In cases of palatal myoclonus the diagnosis of the causative factor is not always easy, but the use of tympanometry, EMG, and EEG may help in establishing the diagnosis. In cases of arteriovenous communications a pulse synchronous tinnitus is present. It may be temporarily obliterated by applying pressure over the mastoid area or over the carotid artery on the affected side. Audiometric and tympanometric studies are not diagnostic, and very careful angiographic studies are necessary because routine tests may not show the lesion. The case presented suggests another etiologic possibility for vascular objective tinnitus: a stenosis of certain branches of the external carotid artery. The treatment for myoclonic causes of objective tinnitus has been for the most part unsatisfactory, whether it be medical or surgical. On the other hand, surgical treatment of arteriovenous communications results in complete amelioration of signs and symptoms--hence the necessity for an accurate diagnosis. PMID- 6859240 TI - Benign osteoblastoma of the temporal bone. AB - Benign osteoblastoma is an uncommon tumor in the skull and particularly rare in the temporal bone. This article presents the clinical, radiologic, and pathologic findings of the fifth case known to involve the temporal bone, and only th second case limited to the temporal bone itself. Subtotal removal was performed following embolization of the tumor. The patient currently has no evidence of disease eighteen months following therapy. Benign osteoblastoma is rarely synchronously or metachronously associated with its malignant counterpart, osteosarcoma. Treatment should be conservative. Subtotal curettage is acceptable and often results in long-term resolution. Radiotherapy is not recommended unless the removal is incomplete and the consequences of local recurrence are serious, as in vertebral lesions. This lesion may be highly vascular, and preoperative embolization should be considered to minimize blood loss at surgery. PMID- 6859241 TI - The effect of stapedectomy on hearing of patients with otosclerosis and Meniere's disease. AB - To determine new guidelines for stapedectomy in patients with both Meniere's disease and otosclerosis, we studied the position of the saccular membrane and Reissner's membrane in relation to the stapes footplate in eight temporal bones from patients with Meniere's disease. We also reviewed charts of four patients with both otosclerosis and Meniere's disease who had stapedectomy. Histologic and clinical findings were compared with preoperative bone conduction levels at 500 Hz and at high frequencies. We found that the saccular and Reissner's membranes did not contact the stapes footplate ain bones of patients with preoperative bone conduction levels of 35 dB or better at 500 Hz and no high-frequency loss. We also found that stapedectomy was successful in patients with the same criteria. We therefore conclude that stapedectomy does not increase the risk of sensorineural hearing loss for patients with otosclerosis and Meniere's disease who have bone conduction levels of 35 dB o better at 500 Hz and no high-tone loss, but it is contraindicated for patients with 45 dB at 500 Hz or worse and with high-tone loss. PMID- 6859242 TI - Improvement of middle ear disease following septoplasty. PMID- 6859243 TI - Pitfalls in defending malpractice suits. PMID- 6859244 TI - Diagnosis of middle ear disease and acoustic neuroma. PMID- 6859245 TI - Management of hemifacial spasm and synkinesis following acute Bell's palsy. PMID- 6859246 TI - Fatigue considerations of muscle contractile force during high-frequency stimulation. AB - In a model for control of muscle force, wherein an induced background tetanus is attenuated by concurrent indirect stimulation at frequencies in the 0.6- to 10 kHz range, evaluation was made for effects on muscle fatigue of differing rates of the tetanic and high-frequency stimuli. Relatively little fatigue, and yet nearly the complete range of attenuation, were favored by lower frequencies of both these stimuli, e.g., tetanic stimulation at 50 Hz and a blocking frequency of 600 Hz. PMID- 6859247 TI - Changes in duration and amplitude of the evoked muscle action potential (EMAP) over distance in peroneal, median, and ulnar nerves. AB - Standard nerve conduction techniques measure the conduction of the fastest conducting axons. Slower conducting axons determine the amplitude, duration, and configuration of the EMAP. Normal data showing the change in amplitude and duration of the evoked EMAP over a length of nerve segment as well as the change per centimeter of that nerve segment has been lacking. This study supplies this data for the peroneal, median and ulnar nerves (tables 2-5) and gives examples of clinical application of these techniques in the diagnosis of compression syndrome and peripheral neuropathies with demyelination. Emphasis is also placed on potential sources of error which may affect the results obtained using these techniques. Further study of the application of these techniques in the diagnosis of neuropathies is indicated. PMID- 6859248 TI - Simple method to determine sincerity of effort during a maximal isometric test of grip strength. AB - The purpose of this study was to establish a simple method to determine the legitimacy of a maximal voluntary grip contraction (MVGC). To achieve this, 36 subjects were randomly assigned to either a sincere (S) or faker group (F) and asked without investigator knowledge to execute either a MVGC or 75% MVGC on a specially designed grip dynamometer. The dynamometer was attached to a load cell with analog output obtained from a strip chart recorder at 50 mm X sec.-1. The force curves were evaluated empirically and also analyzed according to the following components: rate of force application (SLP), peak force (PK), average force divided by peak force (DEV) and peak force divided by body weight (WTRATIO). Average values for S and F subjects respectively were; SLP 2217 vs 1642 n X s-1, PK 499 vs 387 n, and DEV 0.91 vs 0.72. When all variable were transformed to z-scores, summed for each subject and categorized by sum into upper and lower 50% groups by gender, 87.5% of the females (N = 16) and 80% of the males (N = 20) were correctly classified as S or F subjects. Based upon a discriminant analysis performed by gender, DEV was found to be the only significant predictor for females with DEV, SLP and WTRATIO being significant predictors for the males. It was concluded that S and F subjects can be determined from the results of a maximal isometric grip strength test based upon a simple configuration analysis of an isometric force curve. PMID- 6859249 TI - Steroid secretion by mouse testes perfused in vitro. AB - We determined the concentration of steroids in blood plasma of CBF1 male mice and the steroidogenic potential of the mouse testis. Steroid secretion rates are based on measuring selected C18, C19, and C21 steroids in the venous effluent of testes perfused with a defined medium containing luteinizing hormone. Steroids were isolated by thin-layer and/or column chromatography and quantified by radioimmunoassay. These include pregnenolone, 17 alpha-hydroxypregnenolone, dehydroepiandrosterone, androstenediol, progesterone, 17 alpha hydroxyprogesterone, androstenedione, testosterone, dihydrotestosterone, 3 alpha androstanediol, and 3 beta-androstanediol. Testosterone is the primary steroid secreted by mouse testes perfused in vitro and is the chief androgen present in blood plasma. Pregnenolone, an obligatory intermediate in steroid synthesis, is converted to testosterone via two separate steroidogenic pathways in approximately equal proportions. This is unlike other species in which testosterone biosynthesis proceeds preferentially via either the delta 4 or the delta 5 pathway. Our results, taken together, provide the first comprehensive assessment of Leydig cell steroidogenic activity in the mouse, demonstrate putative enzymatic pathways subserving androgen biosynthesis, and establish the predominant steroids in the peripheral circulation of adult mice. PMID- 6859250 TI - Evidence for an inhibitor of renal urate and PAH secretion in rabbit blood. AB - Results of previous studies of urate secretion in isolated perfused S2 segments of the rabbit proximal tubule suggested that a bath of rabbit serum may inhibit urate transport in comparison to a synthetic medium. In the current study we tested for a urate transport inhibitor by determining the steady-state tissue-to medium ratio (T/M) of [14C]urate in nonperfused S2 segments during incubation in synthetic medium (BSA-Burg) and commercial rabbit serum (RS-PF). With 80-120 microM urate in the bath the T/M ratio was 7.66 +/- 0.53 (n = 29) in BSA-Burg and 5.29 +/- 0.40 (n = 29) in RS-PF. RS-PF decreased the influx of urate into the cells but had no effect on urate efflux. Freshly drawn rabbit serum and plasma also inhibited urate accumulation, and the inhibition was reversible. p Aminohippurate accumulation was inhibited by RS-PF, but tetraethylammonium bromide uptake was not. RS-PF inhibited transepithelial secretion of urate and PAH, but net fluid absorption was not decreased. The inhibitory material in rabbit serum could not be removed by extensive dialysis (14,000-dalton exclusion), by ultrafiltration (50,000-dalton exclusion), or by charcoal or ethanol extraction. Inhibitory activity was detected in both albumin and globulin fractions of rabbit serum. The relation between bath and intracellular urate concentrations of nonperfused tubules in rabbit serum was sigmoidal, whereas the relation in the BSA-Burg medium was more nearly hyperbolic. We conclude that organic anion transport in rabbit S2 segments is inhibited or suppressed by normal serum and suggest that urate secretion and excretion may be subject to allosteric modification by serum proteins. PMID- 6859251 TI - Effect of acute potassium infusion on loop segment chloride reabsorption in the rat. AB - To assess the effect of acute potassium loading on proximal tubule and loop chloride handling, chloride transport was examined in superficial cortical nephrons in control rats and after infusion with either 0.3 M KNO3 (KVE) or 0.3 M NaNO3 (NaVE) using micropuncture techniques. Infusion with either salt increased plasma volume, single nephron glomerular filtration rate (SNGFR), and delivery of fluid and chloride out of the proximal tubule. Plasma volume, tubule fluid-to plasma inulin ratio, proximal transepithelial chloride ratio, and absolute and fractional proximal chloride delivery, however, were not different in the NaVE and KVE groups. Early distal tubule fluid flow rate, SNGFR, and fluid reabsorption were greater than control values following either infusion but these were not different between KVE and NaVE. Early distal tubule chloride concentration and transepithelial chloride gradient were greater and fractional chloride reabsorption was less in KVE than in either control or NaVE groups. Calculated fractional loop segment chloride reabsorption was less in KVE animals. These data suggest that potassium loading reduces fractional chloride reabsorption in the loop segment of rat superficial cortical nephrons. PMID- 6859253 TI - Specificity and modes of the anion exchanger in dog renal microvillus membranes. AB - The transport of various organic anions via the pathway that mediates the exchange of urate or p-aminohippurate (PAH) for OH- or Cl- in dog renal microvillus membrane vesicles was investigated. The pH gradient-stimulated uptakes of tracer urate and PAH were significantly inhibited by 5 mM PAH, n valerate, lactate, beta-hydroxybutyrate, pyruvate, acetoacetate, maleate, succinate, alpha-ketoglutarate, oxaloacetate, and cis-aconitate but not by 5 mM acetate, malate, oxalate, or citrate. the pH dependence of inhibition suggested that it was in their monovalent forms that these acid anions interacted with the urate exchange pathway. Outwardly directed gradients of succinate, lactate, and PAH stimulated uphill urate accumulation. Imposition of an inside-alkaline pH gradient stimulated the uphill accumulation of lactate and succinate. Na+ cotransport pathways for lactate and succinate were also present. In the presence of an inwardly directed Na+ gradient, lactate stimulated the uphill accumulation of urate, indicating that the pathways mediating Na+-lactate cotransport and lactate-urate exchange coexisted in at least some membrane vesicles. We conclude that the anion exchange pathway for urate in dog renal microvillus membrane vesicles has affinity for additional organic anions and can function in multiple exchange modes. Exchange of luminal urate or Cl- for intracellular organic anions or OH- is a possible mechanism for effecting uphill anion reabsorption in the proximal tubule. PMID- 6859252 TI - Glomerular filtration dynamics during renal vasodilation with acetylcholine in the dog. AB - The reason for the failure of glomerular filtration rate (GFR) to exhibit plasma flow dependency during pharmacologic vasodilation remains unclear although it has been suggested on the basis of experiments in rats that vasodilators may lead to a reduction in the glomerular filtration coefficient (Kf). To evaluate the applicability of this hypothesis to the dog, the effects of vasodilation with acetylcholine on glomerular dynamics and Kf were evaluated in two groups of dogs. One group (n = 19) was studied at spontaneous arterial pressures to allow maximum vasodilation to occur. In the other group (n = 5), renal arterial pressure was reduced and maintained at approximately 89 mmHg. Glomerular filtration rate and single nephron glomerular filtration rate were not altered significantly during acetylcholine infusion in either of the two groups. Both whole kidney and superficial filtration fractions decreased significantly. At spontaneous arterial pressures, transglomerular hydrostatic pressure was not altered significantly because of equivalent increases in proximal tubule pressure and in glomerular pressure. In the dogs studied at reduced renal perfusion pressure, glomerular capillary pressure did not change, but proximal tubule pressure increased slightly. Average effective filtration pressures and Kf were not significantly altered during the infusion of acetylcholine either at spontaneous or reduced renal perfusion pressures. These observations indicate that Kf in the dog is not significantly decreased by acetylcholine and that GFR is not affected during infusion of this agent because the effective filtration pressure is not significantly altered. PMID- 6859254 TI - Urea transport in nephron segments from medullary rays of rabbits. AB - To evaluate possible routes of urea delivery to the renal medulla, urea transport was studied in cortical thick ascending limbs and proximal straight tubules dissected from inner cortical medullary rays of rabbit kidneys. Urea was measured colorimetrically in the perfused, collected, and bath fluids. No evidence for active transport of urea was found in either segment. With imposed urea concentration differences between perfusion and bath fluids, there were significant passive fluxes of urea in both segments. The magnitude of the flux was independent of the direction of the concentration difference. Apparent permeability coefficients (X10(-5) cm/s) for urea were 2.0 for the cortical thick ascending limbs and 1.5 for the proximal straight tubules. Based on the measured permeability in the cortical thick ascending limb, substantial passive absorption of urea is predicted in vivo. This will contribute to the dilution of tubular fluid in this segment. The results in proximal straight tubules are compatible with passive urea secretion but not with a significant degree of active secretion. PMID- 6859255 TI - Barium inhibition of basolateral membrane potassium conductance in tracheal epithelium. AB - Addition of barium ion, Ba2+, to the submucosal bathing solution of canine tracheal epithelium reversibly decreased the short-circuit current and increased transepithelial resistance. The decrease in short-circuit current represented a decrease in the net rate of Cl secretion with no change in the rate of Na absorption. Intracellular microelectrode techniques and an equivalent electrical circuit analysis were used to localize the effect of Ba2+ to an inhibition of the permeability of the basolateral membrane to K. Ba2+ (2 mM) doubled basolateral membrane resistance, decreased the equivalent electromotive force at the basolateral membrane, and decreased the magnitude of the depolarization of basolateral membrane voltage produced by increasing the submucosal K concentration. The inhibition of the basolateral K permeability depolarized the negative intracellular voltage, resulting in both a decrease in the driving force for Cl exit and an estimated increase in intracellular Cl concentration. These studies indicate that there is a Ba2+-inhibitable K conductance at the basolateral membrane of tracheal epithelial cells and that the K permeability plays an important role in the generation of the negative intracellular electrical potential that provides the driving force for Cl exit from the cell. PMID- 6859257 TI - Renal nerve responses to cardiac receptor stimulation with bradykinin in monkeys. AB - Previous data from our laboratory demonstrated a species difference between the cat and dog in the arterial blood pressure (ABP) and renal nerve activity (RNA) responses to epicardial bradykinin (BK) applications. The present study was carried out to determine the ABP and renal nerve responses to chemical activation of cardiac afferents by BK in the intact and sinoaortic-denervated and vagotomized (SAD + VX) nonhuman primate. Seven Macaque monkeys (fascicularis and nemestrina) anesthetized with pentobarbital or chloralose were used in this study. The heart was exposed and suspended in a pericardial cradle. A left atrial (LA) catheter was inserted through the appendage. Changes in ABP and RNA (percent change from control) were determined when 1 and 10 micrograms/ml BK (in 1-ml volume) were applied to the anterior surface of the left ventricle or injected into the LA (0.3 and 3.0 micrograms/kg BK) in the intact and SAD + VX state. In both the intact and SAD + VX monkeys, ABP and RNA were significantly reduced with epicardial BK. In the intact state, LA injections of BK produced a significant decrease in the % delta of RNA and a depressor response. In the SAD + VX monkey, significant hypotensive responses were also observed with LA injections of BK concomitant with significant reductions in RNA. These results show the existence of a depressor response and inhibition of renal sympathetic nerve activity in the nonhuman primate mediated by the action of bradykinin on cardiac sympathetic afferents. PMID- 6859256 TI - Glomerular ultrafiltration dynamics during increased renal venous pressure. AB - The effects of unilateral partial renal venous ligation on whole kidney and single nephron function were determined in anesthetized euvolemic Munich-Wistar rats using clearance, blood flow, and micropuncture techniques. Increased venous pressure (4-22 mmHg) reduced glomerular filtration rate (GFR) and renal plasma flow (RPF) to 60% of control values; filtration fraction (FF) was constant. Similar responses occurred in the superficial cortex, as evidenced by a 40% fall in SNGFR determined while intratubular pressure was maintained at the elevated precollection level. Fractional reabsorption by the proximal convoluted tubule remained constant, indicating maintenance of glomerulotubular balance. The contralateral kidney exhibit a diuresis and natriuresis while GFR and RPF were stable. In the experimental kidney single nephron glomerular plasma flow decreased by 35% due to increments in preglomerular and efferent arteriolar resistance. The transcapillary hydrostatic pressure gradient was unchanged since there were similar 7- to 8-mmHg increases in glomerular capillary and Bowman's space pressures. Filtration pressure disequilibrium was observed in control and experimental periods. Mean effective ultrafiltration pressure was similar in both periods. Specific values for the ultrafiltration coefficient (Kf) fell from 0.023 to 0.015 nl . s-1. mmHg-1. Accordingly, partial renal venous ligation produces ipsilateral vasoconstriction and a fall in GFR that is primarily due to a proportional decline in Kf. PMID- 6859258 TI - Furosemide action on collecting ducts: effect of prostaglandin synthesis inhibition. AB - The effect of furosemide on inner medullary collecting duct chloride reabsorption has not been determined, and the blunting of furosemide action by drugs that inhibit prostaglandin synthesis, while known to occur, has not been examined in detail. The effect of indomethacin and meclofenamate on furosemide diuresis was studied in the rat using clearance and collecting duct microcatheterization methods. Furosemide-treated control animals showed complete inhibition of chloride, sodium, and water reabsorption in the inner medullary collecting duct. Rats given indomethacin or meclofenamate before and during furosemide administration showed marked reduction of the chloriuresis, natriuresis, and diuresis. Reduced delivery of sodium and chloride to the beginning of the inner medullary collecting duct, associated with a decrease in glomerular filtration rate and increased reabsorption in more proximal nephron segments, was largely responsible for the reduced natriuresis and chloriuresis during inhibition of prostaglandin synthesis. In addition, indomethacin increased collecting duct NaCl reabsorption toward normal, but meclofenamate showed no such effect. The results indicate that furosemide inhibits medullary collecting duct reabsorption of chloride, sodium, and water in the rat. The blunting of diuretic action seen with inhibition of prostaglandin synthesis is largely, although not entirely, due to effects of indomethacin and meclofenamate on furosemide action at nephron sites proximal to the collecting duct. PMID- 6859259 TI - Furosemide-sensitive Cl transport in embryonic chicken retinal pigment epithelium. AB - Retinal pigment epithelium- (RPE) choroid-sclera preparations from embryonic chickens were mounted in an Ussing chamber. A spontaneous transepithelial voltage (Ve) of 5.1 mV (retinal side positive) and a resistance of 114 omega . cm2 can be attributed to the RPE. Furosemide and ouabain inhibited the Ve without affecting the resistance when applied to the retinal surface of the preparation but had no effect when applied to the scleral surface. Acetazolamide and amiloride were without effect when applied to either surface. The Ve fell by 100% in Na-free medium, by 70% in Cl-free medium, and was unchanged in HCO3-free medium. When Na and Cl were returned to the medium, the Ve recovered. Dilution potentials and unidirectional flux studies indicated that the RPE is more permeable to Na than to Cl. Isotope flux studies performed under open-circuit conditions showed a net retina-to-choroid flux for both Na and Cl with the net Cl flux abolished by furosemide. Analysis of the Na+ and Cl- electrochemical gradients and the Na permeability across the RPE suggests that the net retina-to-choroid Na+ flux is largely passive, whereas the net retina-to-choroid Cl- flux results from active transport. These results indicate that embryonic chicken RPE possesses furosemide sensitive Cl transport function. A model of embryonic chicken RPE transepithelial transport is presented. PMID- 6859260 TI - Citrate uptake by basolateral and luminal membrane vesicles from rabbit kidney cortex. AB - The mechanisms of tubular transport of citrate in renal basolateral and luminal membrane vesicles were studied under various experimental conditions. Both membrane preparations take up citrate by a Na+-dependent transport system, although with different characteristics. The uptake of citrate by basolateral membrane vesicles was insensitive to changes in membrane potential, which is indicative of electroneutral transport of the anion. The Na+-dependent uptake of citrate by luminal membrane vesicles was influenced by the presence of Na+salt anions of different permeabilities in the order: chloride greater than sulfate greater than gluconate. Furthermore, addition of citrate to membrane vesicle potential-sensitive dye suspensions resulted in optical changes of the dye, indicative of electrogenic transfer of this compound. The apparent affinity of the citrate transport system located in luminal membrane vesicles, in contrast to basolateral membrane vesicles, was sensitive to changes in medium pH and was higher than that of basolateral membrane vesicles in the pH range studied. On the basis of these results a model for the transport of citrate by rabbit kidney proximal tubule is proposed. PMID- 6859261 TI - Effect of osmotic shocks on rabbit kidney cortex slices. AB - Rabbit kidney cortex slices behave an osmometers when withstanding hyperosmotic or hyposmotic shocks of amplitude up to pi 1/pi 2 = 1.25. For hyposmotic shocks of amplitude larger than or equal to pi 1/pi 2 = 1.50, the maximum swelling achieved is less than what can be expected on the basis of the van't Hoff relation, thereby indicating that a volume regulation process is taking place. Volume regulation in kidney slices can be dissociated into two distinct phases. The first one, of swelling limitation, is very rapid and keeps maximum cell volume at values lower than expected when the tissue is considered as an osmometer. This phase is followed by a slow volume readjustment process during which volume progressively decreases towards control values. The major intracellular osmotic effector loss during both swelling limitation and volume readjustment is Na+. The overall volume regulation process is insensitive to furosemide, vanadate, and bumetanide. Swelling limitation is blocked by addition of ouabain. Contrary to what has been believed previously, there is, however, no need to implicate control of the activity of a ouabain-sensitive, Na+/K+ pump in the Na-dependent volume regulation mechanism. PMID- 6859262 TI - Presence in normal human urine of a hypotensive and platelet-activating phospholipid. AB - Urine from normotensive volunteers and patients with systemic lupus erythematosus glomerulonephropathy was sequentially concentrated by negative-pressure ultrafiltration, dialyzed against distilled water, and extracted into the chloroform phase of a mixture of organic solvents(chloroform:methanol:water, 1:1:0.9 vol/vol). The lipid fraction was further purified by thin-layer chromatography on silica gel plates using neutral, acidic, and basic mixtures of organic solvents and it was then tested for its ability to induce the release of [3H]serotonin from rabbit platelets. All of the samples contained a platelet activating moiety similar to a synthetic platelet-activating factor (PAF-acether) on the basis of its chromatographic behavior, resistance to the pretreatment of platelets by 10(-6) M indomethacin, and loss of activity by alkaline methanolysis or treatment by phospholipases A2, C, and D. Cross-densensitization experiments between synthetic PAF-acether and the urine factor showed that both compounds act on platelets through the activation of the same putative receptor. Further, the urine factor induced hypotension when intra-arterially injected in normotensive rats, and this activity was also abrogated by alkaline methanolysis. In summary, these data provide evidence of the presence in normal human urine and, probably, of the release by the kidney of a lipid factor with platelet-activating and hypotensive activity whose general structure seems to be alkyl-acyl-glyceryl phosphorylcholine and, therefore, is similar to the structure of the inflammatory mediator PAF-acether and the antihypertensive polar renomedullary lipid. PMID- 6859263 TI - Evidence for bidirectional net movement of creatinine in the rat kidney. AB - Although the clearance of endogenous creatinine is used in many physiologic and metabolic studies in the rat as an index of glomerular filtration rate, there is no evidence that creatinine is a reliable test substance. Studies were therefore performed in anesthetized and conscious rats to determine the creatinine-to inulin clearance ratio (CCr/CIn). In anesthetized animals the CCr/CIn ratio was 0.5 and in conscious rats it was 0.7 at normal basal plasma creatinine levels. After an increase in plasma creatinine to 1.9 mg/dl induced by the intravenous infusion of creatinine, the CCr/CIn ratio was 1.2. Accordingly, these data indicate that net creatinine transport across the renal tubule is bidirectional and that transport is influenced by the plasma creatinine level. At normal plasma levels creatinine is extensively reabsorbed along the nephron, whereas net secretion is associated with elevated plasma creatinine. The results demonstrate that creatinine is not a reliable marker of glomerular filtration rate in the rat. PMID- 6859264 TI - Analyzing tracer disappearance curves to study hepatic transport kinetics. AB - This paper is devoted to a discussion of recent developments in the compartmental analysis of hepatic transport, especially the interpretation of tracer disappearance curves recorded from the reservoir of an isolated perfused liver preparation. The emphasis is on the advantages that this approach enjoys over other mathematical models, and a critical review of alternative methods is therefore included. The mathematical equations are largely suppressed, however, having appeared elsewhere in detail. PMID- 6859265 TI - Functional and anatomic heterogeneity in the liver acinus: impact on transport. AB - The site of solute exchange between blood and hepatocytes is the liver acinus, the structural and functional unit of hepatic parenchyma. Because the perfusion of acinar hepatocytes occurs in a sequential manner, differences in solute concentration between hepatocytes located at the inlet (zone 1) and at the outlet (zone 3) of the acinus are predictable. However, the distribution and transport of solutes by hepatocytes of each acinar zone also seem to be influenced by factors other than the sequential perfusion of blood. The concentration of receptors in hepatocytes at each zone, the presence of specific chemical groups on the incoming molecules, and the binding of the solutes to plasma protein are all factors that modify the interaction with, and the cellular concentration attained by, solutes in each acinar zone. Therefore, solute concentration in hepatocytes of each acinar zone may produce a profile of decreasing solute concentration from cells in zone 1 to those in zone 3, a reverse profile from zone 3 to zone 1, or a similar concentration in all hepatocytes. PMID- 6859266 TI - Saturation kinetics in hepatic drug removal: a statistical approach to functional heterogeneity. AB - Extraction of drugs and other substrates from blood passing through the intact liver (or other capillary beds), inferred from samples taken at the organ inlet and outlet, is influenced by two kinds of heterogeneity of capillaries: transverse and longitudinal with respect to the direction of blood flow. The transverse heterogeneity is exemplified by arteriovenous shunts of the extracting system; the longitudinal one by zones of liver function. These two clinically interesting examples are among transverse and longitudinal distributions of capillary properties that can be inferred from the way the organ transforms the influx of a substance (or of a pair of substances interacting via liver cells) into the outflux over a range of input concentrations or of rates of blood flow. Mathematical and statistical ideas recently developed to implement this program in terms of saturation kinetics of uptake are reviewed and elucidated in relation to key experiments, data analysis, and statistical hypothesis testing. PMID- 6859268 TI - Effects of cardiac tamponade on colonic hemodynamics and oxygen uptake. AB - The local hemodynamic response of the innervated but vascularly isolated colon to decreased systemic perfusion induced by cardiac tamponade was studied in anesthesized dogs as a model of nonocclusive mesenteric ischemia. Increasing levels of pericardial pressure caused progressive decreases in colonic blood flow associated with substantial increases in colonic vascular resistance. These increases in local colonic resistance were proportionately larger than concurrent increases in systemic resistance. The disproportionate response of the colonic resistance vessels was not diminished by colonic (sympathetic) denervation. Reductions of blood flow to 30 ml . min-1 . 100 g-1 resulted in compensatory increases in colonic oxygen extraction such that colonic oxygen consumption remained constant (flow independent) at about 1.5 ml . min-1 . 100 g-1. At blood flows below 30 ml . min-1 . 100 g-1 colonic oxygen consumption was markedly dependent on blood flow. This fundamental relation of colonic oxygen consumption to blood flow was the same whether ischemia was induced by cardiac tamponade, partial mechanical arterial occlusion, or vasoconstrictor (norepinephrine or digoxin) infusion. Furthermore, this relationship was not altered by vasodilation with isoproterenol after the induction of ischemia by any of the above means. PMID- 6859269 TI - Mucosal calcium uptake by rat cecum: identity with transcellular calcium absorption. AB - Unidirectional intestinal calcium uptake (JCame) at the mucosal surface of rat cecum was investigated in vitro with intact tissue. Uptake is linear for 2-3 min with no indication of rapid calcium binding. Kinetic parameters reveal a maximal velocity of 333 nmol . cm-2 . h-1 with a half-maximal concentration of 0.98 mM. High-calcium diet decreased JCame by more than 60% with respect to both control and low-calcium diets; 1 mM N-ethylmaleimide caused a similar reduction. The activation energy of JCame is significantly less than that of transepithelial mucosal-to-serosal calcium absorption. Mucosal uptake was compared with transepithelial calcium fluxes in rat cecum and revealed a 1:1 correlation over a wide range of transport rates. These results are interpreted to implicate a feedback control system between basolateral calcium efflux and brush-border calcium influx. PMID- 6859267 TI - Adaptation of intestinal muscle in bypassed loops after jejunoileal bypass in rat. AB - The function and structure of intestinal smooth muscle in the bypassed intestine of rats with 70% intestinal bypass were compared with the function and structure of muscle from equivalent areas of intestine from transected and nontransected controls. Muscle function was assessed by evaluating changes in intestinal transit. At all times studied after operation, transit in transected controls was identical to that seen in nontransected controls. In the bypassed intestine at 3 days after operation, transit in fasted animals was significantly slower than intestinal transit in either control group. Over a period of 14-35 days, transit in the bypassed intestine of fasted animals returned toward control values. In fed animals, on the other hand, transit was delayed when measured at both 3 and 35 days after bypass operation. These findings demonstrate a persistent change in muscle function in bypassed intestine in response to the ingestion of a meal. No changes in intestinal structure were found when bypassed intestine was compared with tissue from transected controls. Thus there were no indications of mucosal or muscular atrophy in the bypassed intestine. The weights of the combined submucosal, muscular, and serosal layers in the study segments were increased at 35 days after either bypass or transection compared with tissue from nontransected controls. These changes appear to be a nonspecific result of operation. PMID- 6859271 TI - Quantitative determination of macromolecular transport rate across intestinal Peyer's patches. AB - We used horseradish peroxidase (HRP) (mol wt, 40,000) to compare in vitro, in Ussing chambers, the rates of protein transport across segments of piglet jejunum with and without Peyer's patches. The mean HRP transport rate across intestinal segments with a patch, 25.2 +/- 4.2 SE ng . min-1 . cm-2 (22 animals), was increased threefold (P less than 0.0005) compared with control (no patch) tissue, 7.9 +/- 1.0 ng . min-1 . cm-2 (n = 29). Neither rate showed saturation with increasing concentrations of HRP; both were inhibited 75-95% by a temperature drop from 37 to 15 degrees C. Transport across patch-containing tissue was inhibited 48 +/- 6% (n = 5, P less than 0.0025) by 1 mM NaF, but NaF had no consistent effect on the transport across tissue without Peyer's patches. We conclude that HRP transport is increased across Peyer's patches. This transport is dependent on metabolism and does not involve specific receptors. These findings support the concept that the Peyer's patch serves an antigen-sampling function in the gut. PMID- 6859270 TI - Uptake of iopanoic acid by isolated rat hepatocytes in primary culture. AB - Uptake of iopanoic acid (IOP) was studied in 3-day primary cultures of rat hepatocytes isolated by the collagenase perfusion method. 125I activity of cells after incubation with 125I-IOP (1.0-100 microM) was used as a measure of uptake. At each IOP concentration uptake was linear for the first 45 s. The initial uptake velocity was directly proportional to IOP concentration and was nonsaturable up to 100 microM. The calculated uptake rate constant was 0.67 nmol . mg prot-1 . min-1 . microM-1. Uptake was only slightly reduced when the incubation was performed at 4 degrees C and was independent of sodium concentration. Albumin in the medium reduced IOP uptake. Uptake, however, was always greater than that predicted from the unbound IOP concentration alone. The data indicate that the hepatocyte uptake of IOP occurs by both a passive process and a saturable process. The saturable uptake component depends on an albumin-IOP hepatocyte interaction. The influence of albumin on uptake occurs possibly by an undefined specific cell surface phenomenon of albumin that promotes uptake of IOP or by enhancement of the diffusibility of IOP across the unstirred layer. PMID- 6859273 TI - Bombesin-induced tachyphylaxis markedly enhances gastrin response to a meal. AB - This study was designed to determine whether a bombesinlike peptide mediated the gastrin response to food. Tachyphylaxis of gastrin release was induced in six dogs by prolonged infusion of bombesin (500 ng X kg-1 X h-1) before ingestion of a meal. An impaired postprandial gastrin response during bombesin tachyphylaxis would be indirect evidence that a bombesinlike peptide mediated the gastrin response to food. Serum gastrin concentrations peaked (74 +/- 18 pM) 1 h after commencement of the bombesin infusion and then fell significantly (P less than 0.01), reaching a nadir of 15 +/- 1 pM at 4 h. Dogs were then fed the standard meal (15 g/kg Prime dog food), and the serum gastrin response was compared with that observed in response to the meal ingested during saline infusion. There was sixfold enhancement (P less than 0.01) of meal-stimulated gastrin release during bombesin infusion compared with saline infusion. Stopping the bombesin infusion before ingestion of the meal still resulted in significant (P less than 0.05) enhancement of the meal response. Although pancreatic polypeptide responses to bombesin also exhibited tachyphylaxis, prolonged infusion of bombesin did not enhance the pancreatic polypeptide response to food. We conclude that a bombesinlike peptide does not mediate the gastrin response to food in dog. We speculate that bombesin stimulates both secretion and synthesis of gastrin but that only secretion is subject to tachyphylaxis. The enlarged secretory pool produces an enhanced response when the G cell is exposed to stimulants other than bombesin. PMID- 6859272 TI - Distribution of surfactants in the canine gastrointestinal tract and their ability to lubricate. AB - Surface-active phospholipids, chemically similar to pulmonary surfactants, have been identified by thin-layer chromatography in gastric juice and on the mucosal lining of five tissues along the canine gastrointestinal tract. These included esophagus, oxyntic tissue, midduodenum, midjenunum, and midcolon. The mucosal phospholipid composition did not change appreciably along the length of the gastrointestinal tract, with the most prominent species being phosphatidylcholine (PC) (34-45%) and phosphatidylethanolamine (PE) (18-32%). The gastrointestinal mucosal surface also contained lesser amounts (5-10% each) of sphingomyelin (Sp), lysophosphatidylcholine, phosphatidylinositol (PI), and phosphatidylserine (PS) and small but detectable quantities of phosphatidylglycerol (PG) and phosphatidic acid. Both the lipid extracts of all six gastrointestinal sources as well as commercially available phospholipids identified in these samples (PC, Sp, PE, PI, PS, and PG) proved to be good boundary lubricants. Each reduced the coefficient of friction by greater than 75% between glass and carboxylated yarn when tested by a standard method for evaluating textile "sizes." The results are discussed in relation to the possible role of the surface-active molecules in imparting properties conducive to lubrication and acid protection onto the gastrointestinal epithelium. PMID- 6859274 TI - Measuring rates of O2 uptake in periportal and pericentral regions of liver lobule: stop-flow experiments with perfused liver. AB - Rates of oxygen uptake in periportal and pericentral regions of the hemoglobin free perfused rat liver were measured successfully for the first time with a miniature oxygen electrode (tip diameter, 50-60 microns) by stopping the flow of perfusate and measuring the rate of decrease of oxygen concentration on the surface of the liver. Rates of oxygen uptake in periportal and pericentral areas were 131 +/- 9 (mean +/- SD) and 56 +/- 14 mumol X g-1 X h-1 in livers from fed, phenobarbital-treated rats, respectively. In livers from fasted rats, rates of O2 uptake of 141 +/- 12 and 89 +/- 11 mumol X g-1 X h-1 were observed in periportal and pericentral regions, respectively. Similar data were obtained in livers from normal rats. Thus, periportal hepatocytes have higher rates of oxygen uptake than pericentral cells in both the fed and fasted states. Rates of oxygen uptake were not affected in periportal regions by fasting. In contrast, rates of oxygen uptake by hepatocytes in pericentral areas were significantly (P less than 0.001) greater in livers from fasted than from fed rats. This significant increase in oxygen uptake in pericentral hepatocytes as a result of fasting is consistent with the hypothesis that glycolysis occurs predominantly in pericentral regions of the liver lobule. PMID- 6859275 TI - Intestinal transudation, secretion, and lymph flow during volume expansion in the rat. AB - The effect of volume expansion by intravenous infusion of saline on the rate of intestinal lymph flow (JL), serosal surface transudation (JT), and secretion (JS) from upper jejunum was determined. During saline infusion there was a large increase in JS and JT but a small increase in JL due to increased capillary filtration. About 20% of JL from the main intestinal lymph duct originated from the intestine and the rest from the mesenteric pedicle. JL (corrected for pedicle lymph flow), JT, and JS were estimated to account for 10, 30, and 60% of capillary filtrate from the intestine, respectively. Neither lymph nor secretion contained measurable protein, but transudation had a high protein concentration about half of that in the plasma. From these findings it is inferred that probably both JL and JS were derived from the capillary filtrate of mucosa and submucosa vascular beds and JT from that of muscular vascular bed and that capillaries and venules in the mucosa restricted the passage of protein molecules while those of the intestinal muscular tissue were highly permeable to protein. PMID- 6859276 TI - Methods for analyzing gastric emptying. PMID- 6859277 TI - Fetal oxygen uptake, oxygenation, and acid-base balance as a function of uterine blood flow. AB - The rate of O2 delivery to the pregnant uterus (FaO2) was decreased in chronic sheep preparations by mechanical occlusion of uterine blood flow. The relationship of uterine venous O2 saturation (SVO2) to FaO2 was curvilinear with convexity toward the SVO2 axis. As SVO2 decreased, there was a decrease in uterine and umbilical venous O2 tension (PO2), with no appreciable reduction of the PO2 difference between the two veins and a decrease in the umbilical vein O2 delivery rate. Fetal O2 uptake and base excess remained normal as the umbilical vein O2 delivery rate was reduced from 1.1 to 0.6 mmol . min-1 . kg-1 but decreased markedly at an O2 delivery rate less than 0.5. Umbilical venous CO2 tension (PCO2) was higher than, and strongly correlated with, uterine venous PCO2 (R = 0.954). These observations support a venous equilibration model of ovine placental exchange and demonstrate that under normal physiological conditions the O2 supply to the fetal lamb is approximately twice the value necessary to maintain an adequate fetal O2 uptake and a normal fetal base excess. PMID- 6859279 TI - A nonsurgical canine model of chronic left ventricular myocardial dysfunction. AB - A simple technique of producing left ventricular myocardial damage accompanied by chronic complete heart block in dogs is described. The method is accomplished by repetitive transmyocardial DC shock with a guide wire introduced percutaneously and positioned in the left ventricle along the intraventricular septum and an external paddle at the left ventricular apex. Twelve weeks after the procedure significant hemodynamic changes included a fall in heart rate from a control of 76 +/- 19 (SD) to 43 +/- 9 beats/min (P less than 0.001), a rise in left ventricular filling pressure from 9 +/- 4 to 28 +/- 10 mmHg (P less than 0.001), and a fall in cardiac output from 3.1 +/- 1 to 2.3 +/- 0.6 l/min (P less than 0.05). Weekly echocardiography revealed a progressive increase in left ventricular end-diastolic diameter from 3.56 +/- 0.72 to 4.84 +/- 0.47 cm (P less than 0.01). Survival rate was 70%. Therefore, this relatively noninvasive technique is an effective means of producing chronic left ventricular myocardial dysfunction in the dog. PMID- 6859278 TI - Effect of hypoxia on ouabain inhibition of sodium pump in newborn rabbit myocardium. AB - The effects of hypoxia and reoxygenation on the inotropic effect of ouabain and sodium pump were studied in the isolated, arterially perfused newborn rabbit heart. Myocardial 86Rb+ active uptake was used as a marker of the sodium pump activity. During reoxygenation after mild hypoxia, 86Rb+ active uptake and ouabain effect were not significantly different from control. After severe hypoxia (with glucose) and reoxygenation, the inotropic effect of ouabain was not different from control, but mechanical toxicity occurred sooner. Severe hypoxia (with glucose-free solution) and reoxygenation caused an increase in tissue calcium, an attenuated inotropic effect of ouabain, and earlier mechanical toxicity. 86Rb+ active uptake was similar in all severe hypoxia groups and was significantly less than control values. Ouabain inhibition of 86Rb+ uptake in the severe hypoxia groups was not significantly different from control. These data indicate that severe hypoxia and reoxygenation depress the sodium pump but the effect of ouabain on the sodium pump in these muscles is similar to control. The decreased inotropic effect and increased toxicity of ouabain during reoxygenation after severe hypoxia may be due to an increase in cytoplasmic calcium and decreased tissue ATP. PMID- 6859280 TI - Vagal modulation of adrenergic effects on canine sinus and atrioventricular nodes. AB - Vagal stimulation modulates adrenergic neurotransmission at pre- and postjunctional sites. The purpose of this study was to test whether such multilevel cholinergic inhibition depressed sinus nodal automaticity and atrioventricular (AV) nodal conduction (A-H interval) in open-chest dogs anesthetized with chloralose. We compared the inhibitory effects of vagal stimulation when sinus nodal automaticity and AV nodal conduction were enhanced by bilateral stellate ganglia stimulation with comparable degrees of enhanced automaticity and conduction achieved by infusing norepinephrine and isoproterenol. We found that vagal stimulation prolonged in a frequency-dependent fashion sinus nodal cycle length and A-H interval more during stellate ganglion stimulation than during norepinephrine or isoproterenol infusion. Atropine eliminated all effects of vagal stimulation. These data provide functional evidence to support the concept that muscarinic modulation of adrenergic effects on sinus nodal cycle length and AV nodal conduction occurs at site(s) in addition to the postjunctional effector cell. PMID- 6859281 TI - Cycle length effect on restitution of action potential duration in dog cardiac fibers. AB - Electrical restitution of action potential duration (APD) was determined in Purkinje (n = 8) and ventricular muscle (n = 6) fibers at two different basic cycle lengths (BCL, 1,500 and 500 ms). Restitution curves, normalized for the longest APD (the plateau of restitution), fitted the sum of a fast (T1) and a slow (T2) exponential component. The T1 was shorter in ventricular muscle than Purkinje fibers (89 +/- 5 and 143 +/- 9; mean +/- SE, P less than 0.05), whereas the T2 did not differ (1,448 +/- 231 and 1,439 +/- 211). The BCL altered the APD value during the plateau of restitution but did not change the two exponential components. In both fiber types, the relation between APD and BCL during steady state fitted a hyperbolic curve that predicts the achievement of the maximum APD at long BCL. The restitution curves crossed the steady-state curve at two points outlining three different zones of APD intervals: early premature, late premature, and postmature. The APD during restitution was longer than the steady state in the late premature zone and shorter than the steady-state APD in the post-mature and early premature zones. The APD per se, independent of BCL, did not influence the kinetics of restitution in Purkinje fibers. PMID- 6859282 TI - Electrical stimulation causes endothelium-dependent relaxation in lung vessels. AB - Ring segments of blood vessels were isolated from the lungs of rabbits, cats, and monkeys. After constriction with norepinephrine, electrical field stimulation caused smooth muscle relaxation in these segments. Mechanical removal of the endothelial layer, verified by scanning electron microscopy, abolished or greatly attenuated the relaxation. The response could be restored in part by apposing the endothelial surface of another vessel segment and the denuded inner surface of the constricted vessel segment. Incubation with tetrodotoxin, procaine hydrochloride, guanethidine, propranolol, atropine, metiamide, indomethacin, quinacrine hydrochloride, 5,8,11,14-eicosatetraynoic acid, aminophylline, and verapamil failed to block or enhance the relaxation response to field stimulation. We conclude that the vascular endothelium in the larger pulmonary arteries and veins studied contains a diffusible substance that inhibits smooth muscle contraction. Its release by electrical field stimulation in vitro does not involve classic neuronal transmitter release or metabolism of arachidonic acid by cyclooxygenase or lipooxygenase. PMID- 6859283 TI - Consistent substrate utilization despite reduced flow in hearts with maintained work. AB - Assessments of myocardial metabolism based on external detection of accumulation of radiolabeled substrates may be influenced, as a result of alterations in flow, by altered substrate delivery as well as altered work (with concomitant changes in metabolic requirements). To determine whether reduced delivery limits substrate utilization under defined conditions of reduced perfusion, an isolated rabbit heart preparation was employed in which flow was reduced but myocardial oxygen consumption (MVo2) and work were kept constant by adjustment of left ventricular end-diastolic pressure and heart rate. Flow was reduced from 1.5 to 0.5 ml . g-1 . min-1, while work was maintained constant in hearts functioning at either low or high levels of MVo2. Consumption of palmitate remained constant (48.8 +/- 11.6 and 68.8 +/- 23.3 nmol . g-1 . min-1), because the proportion of palmitate extracted increased (8.8 +/- 4 to 29.1 +/- 7.2% and 10.3 +/- 3.4 to 21.0 +/- 6.1%). The results indicate that, despite reduction of flow, hearts at constant work loads can extract increasing proportions of delivered substrates such that net utilization remains constant until flow is reduced below the level required to maintain cellular function. They suggest that, under conditions of low flow, impaired extraction of substrates reflects either primarily or secondarily depressed myocardial metabolism rather than simply decreased delivery of substrate. PMID- 6859284 TI - Rat muscle blood flows as a function of time during prolonged slow treadmill exercise. AB - The purpose of these experiments was to follow blood flows (BF) within and among rat hindlimb skeletal muscles as a function of time during prolonged low-speed treadmill locomotion. Male Sprague-Dawley rats were chronically instrumented with two Silastic catheters, one in the ascending aorta via the right carotid artery for microsphere infusion and one in the left renal artery for arterial reference blood sample withdrawal. BFs were measured, using the radio-labeled microsphere technique, within and among 23 major skeletal muscles of rats before exercise and during treadmill locomotion at 15 m/min at 0.5, 1, 5, 15, 30, 54, and 71 min of exercise. During preexercise, BF was highest to deeply situated slow-twitch muscles (210 ml . min-1 . 100 g-1 in vastus intermedius) in the antigravity extensor muscle groups. During the 1st min of exercise each of the hindlimb muscles displayed one of four general BF patterns. 1) Many muscles had an "overshoot" in BF during the first 30 s of exercise; 2) some muscles attained steady-state exercise levels in the first 30 s of exercise; 3) others showed a decrease below preexercise levels; and 4) some muscles showed no change from preexercise. Most muscles showed a gradual increase in BF from 5 min through 54 min of exercise. The elevations in BF over preexercise were primarily directed to fast-twitch oxidative muscle fibers in the antigravity extensor muscles, and BFs to extensor muscle groups were generally higher than those to flexor muscle groups. The data demonstrate that BFs within and among rat muscles are heterogeneous, both before exercise and during prolonged low-intensity treadmill walking to fatigue. Mechanisms regulating the distribution of flow to the muscles remain to be elucidated. PMID- 6859285 TI - Different cardiac and renal inhibitory and excitatory areas in rabbit hypothalamus. AB - The hypothalamic area was stimulated in anesthetized rabbits at a large number of selected points, and the effects on the simultaneously recorded right cardiac sympathetic nerve activity (CSNA) and renal nerve activity (RNA) were analyzed quantitatively. Four characteristic patterns of CSNA and RNA responses could be observed. The most striking finding was the presence of opposite responses of CSNA and RNA at many hypothalamic stimulus points, in addition to the conventionally observed CSNA and RNA responses in the same direction. By a new method, we drew hypothalamic maps for CSNA and RNA response magnitudes. These maps show that the excitatory areas of CSNA and RNA are surrounded by respective inhibitory areas. Although the excitatory areas of CSNA and RNA correspond with each other on the right side, they are not identical on the left side. These data suggest that the heart and kidney are controlled by sympathetic nerve activities originating from different hypothalamic neural groups in the rabbit. PMID- 6859286 TI - Evidence for a central role for vasopressin in cardiovascular regulation. AB - Central vasopressin (VP) may modulate the functional activity of specific neuronal systems involved in cardiovascular regulation. To test this hypothesis we compared cardiovascular (CV) responses to electrical stimulation of the anteroventral region of the third ventricle (AV3V) in Brattleboro rats homozygous for diabetes insipidus (DI), in heterozygous DI rats (DI-HZ) and in normal Long Evans rats (LE). We also studied the effects of peripheral and intracerebroventricular (ivt) treatment of DI rats with VP and treatment of LE rats with an antipressor blocker of VP on cardiovascular responses to AV3V stimulation. Stimulation of the AV3V region in anesthetized LE rats produced a frequency-dependent increase in renal (RVR) and mesenteric vascular resistance (MVR), a decrease in hindquarter vascular resistance (HQVR), and a decrease in arterial pressure (AP) and heart rate (HR). DI and DI-HZ rats showed significantly greater decreases in AP and HR and lesser changes in RVR, MVR, and HQVR. The deficiency in vasoconstriction in DI rats appeared to be centrally mediated inasmuch as vascular responses to peripherally administered phenylephrine and nerve stimulation were comparable in LE and DI rats. Treatment of DI rats with VP peripherally improved CV responses to AV3V stimulation. An even greater improvement in CV responses to AV3V stimulation was obtained when DI were given ivt infusion of VP. Finally, following intravenous administration of an antipressor VP blocker LE rats showed a greater decrease in AP and HR and lesser resistance changes in response to AV3V stimulation. Our data suggest that cardiovascular responses elicited from stimulation of the AV3V region may depend, in part, on a central vasopressin mechanism. PMID- 6859287 TI - Thermodynamics of living matter: physical foundations of biology. AB - All major functions of life are exerted by reversible conformational changes of living matter, the genetically coded, giant molecules of proteins, polynucleotides, and biological membranes. Only thermodynamics can answer the questions why these reversible actions occur, why they are inevitable, and what the physical foundations may be on which biology rests. Classical Gibbs-Helmholtz thermodynamics was found to be inapplicable to the interpretation of reactions in living matter, because copious flows of heat without exchange of work obscure the subtle bond-forming or bond-breaking energy transformations that are driving the actions of living matter. An alternative thermodynamic formulation that is universally applicable was developed and applied to numerical examples: formation of a diatomic molecule from the elements, and two conformational changes, a protein folding and the winding of a polynucleotide helix. The subtle energy transformations, bond-forming or bond-breaking, that were causing the two reactions of living matter to proceed in vitro forward or in reverse have been identified as the thermal work function delta Wto(T) and the chemical bond energy delta Ho0. Since the chemical bond energies and the heat capacities delta CoP(T) between reaction temperature and the absolute zero, unchangeable attributes of matter, were the only ingredients used for the treatment, the complexity of the reactions has been reduced--as far as effects and ultimate causes are concerned- to the simplicity of low temperature physics, a solid physical foundation for all biological and medical sciences. PMID- 6859288 TI - Hypothalamic lesions abolish cardiovascular responses to chronic saline ingestion. AB - In rats made to drink isotonic saline solution instead of water for 5 wk, systolic pressure and heart rate, whether recorded indirectly from the tail or directly from femoral catheters, rose slightly. When the ventromedial hypothalamus was stimulated electrically, increases in arterial pressure and sympathetic neural firing were larger in saline-drinking than in water-drinking rats. By contrast, pressor responses to injections of norepinephrine or tyramine were unaltered. Following bilateral destruction of the ventromedial hypothalamus in other rats, none of the effects of chronic saline ingestion was elicited. Although neither the site nor the mechanism causing sympathetic overactivity has been determined, our results are in accord with the interpretation that salt loading elevates blood pressure, at least in part, by stimulating the ventromedial hypothalamus to increase sympathetic activity. PMID- 6859290 TI - Influence of heating rate on control of heat loss from the tail in mice. AB - Although heating rate is important for stimulating thermoregulatory reflexes, it is not known if the control system differentiates between total heat gain and rate of heat gain. Exposing animals to microwaves inside a waveguide permits continuous monitoring of whole-body heat absorption. Tail skin temperature of restrained mice was recorded during whole-body exposure to 2,450-MHz microwave radiation at specific absorption rates (SAR) of either 11.5, 21.7, or 43.5 W . kg 1 and whole-body heat loads of 0.3-14 J . g-1. The integration of tail skin temperature with time, defined as the skin temperature index (STI), was measured as a function of absorbed heat load. At ambient temperatures of 20 and 25 degrees C the STI, averaged with respect to heat load, increased significantly with SAR. Depending on SAR, the sensitivity of heat loss from the tail to microwave exposure increased 32-71% per 1 degree C elevation in ambient temperature. The data indicate that heat loss from the tail increases with the whole-body heat load accrued from microwave exposure. When heat loss is averaged with respect to heat load, the rate of heat absorption and ambient temperature increase the sensitivity of thermoregulatory centers that control peripheral heat loss from the tail of mice. PMID- 6859289 TI - Calorigenic effect of glucagon and catecholamines in king penguin chicks. AB - The calorigenic action of glucagon and catecholamine infusion was evaluated in winter-acclimatized king penguin chicks at 20 and 0 degrees C ambient temperature (Ta). At Ta = 20 degrees C the mean increase in metabolic rate was 0.73 W . kg-1 for epinephrine (80 micrograms . kg-1), 0.42 W . kg-1 for norepinephrine (150 micrograms . kg-1), and 1.16 W . kg-1 for glucagon (0.75 micrograms . kg-1); i.e., respectively 30, 17, and 47% of the control value. The maximum response to glucagon reached 89% over control. At Ta = 0 degrees C, for the same glucagon infusion, the mean increase in specific metabolic rate was 0.84 W . kg-1, 27% of control rate. In the cold, glucagon infusion inhibited shivering and substituted its calorigenic action, resulting in a less apparent effect. In contrast with the negligible effect of catecholamines, glucagon infused at low doses exerted a powerful calorigenic action in young king penguins and could be considered as a possible nonshivering thermogenesis mediator. PMID- 6859291 TI - Simultaneous determination of net uptake of 16 amino acids by a marine bivalve. AB - High-performance liquid chromatography was used to measure the simultaneous transport of 16 amino acids from seawater into the mussel Mytilus edulis. All the substrates, including representative neutral, basic, and acidic amino acids, were accumulated from ambient concentrations as low as 5 nM. Influx of four radioactively labeled amino acids was compared with their net flux. In each case the influx of the 14C-labeled substrate, determined from the removal of isotope from test solutions, accurately represented the net flux of that substrate as measured by direct chemical analysis. Ammonia was the only compound observed to be routinely lost from these animals. Rates of uptake of individual amino acids, each at concentrations of 10 nM, ranged from 2.4 to 7.0 nmol . g dry flesh wt-1 . min-1. The studies show that M. edulis is capable of a net uptake of dissolved amino acid from the very low concentrations characteristic of seawater. Moreover, net accumulation can occur against chemical gradients calculated to be in excess of one million to one. The rates of amino acid uptake may contribute significantly to the animals' energy requirements. PMID- 6859292 TI - Circadian pacemakers in lizards: phase-response curves and effects of pinealectomy. AB - Phase-response curves (PRCs) for 6-h fluorescent light pulses are described for both intact (sham-pinealectomized) and pinealectomized iguanid lizards (Sceloporus occidentalis). Although strongly diurnal in habit the PRC for intact lizards is more typical of those seen in nocturnal rodents. Other "nocturnal" characteristics of this lizard include the fact that the average free-running period (tau) is less than 24 h and the average tau in continuous light is longer than that observed in continuous darkness. The PRC for pinealectomized lizards is greatly distorted relative to that obtained from intact lizards. This "distortion" is discussed in terms of the role of the pineal as a coupling device or as a pacemaker within a multioscillator circadian system. In some individuals pinealectomy was also associated with 1) increased instability in free-running activity rhythms or arrhythmicity and 2) nocturnal entrainment to LD 12:12. PMID- 6859293 TI - Umbilical glucose and lactate extractions during maternal hyperglycemia in sheep. AB - Umbilical glucose and lactate extractions were determined in previously instrumented pregnant ewes into some of which D-glucose was infused to produce graded levels of maternal hyperglycemia as great as 20 mM. While fetal arterial glucose concentration continued to increase linearly as a function of maternal arterial glucose concentration during maternal hyperglycemia, the umbilical venoarterial difference in blood glucose concentration did not, and umbilical glucose extraction approached a plateau at approximately 0.063 mmol X min-1 X kg fetus-1 at maternal glucose concentrations greater than approximately 8 mM. The observed plateau in glucose extraction is consistent with saturation at high maternal glucose concentrations of the carrier mechanism for transport of glucose from the maternal to the fetal aspects of the trophoblast. The observed value of the plateau in umbilical extraction of glucose is slightly less than the maximum extraction predicted from previously published equations for this species, but the maternal blood glucose concentration at which the observed maximum occurred agrees closely with the value predicted by those equations. Umbilical lactate extraction, 0.031 +/- 0.021 mmol X min-1 X kg fetus-1, was independent of maternal arterial blood glucose and lactate concentrations and was independent of umbilical glucose extraction. PMID- 6859294 TI - Electrophysiological study on nervous pathway from splanchnic nerve to vagus nerve in rat. AB - Action potentials evoked by the stimulation of the hepatic branch of the splanchnic nerve were recorded from the peripheral cut end of the dorsal celiac branch of the vagus nerve in the rat. Action potentials were clearly demonstrated after averaging over 100 times by a computer. The observations indicate the existence of a nervous pathway from the hepatic branch of the splanchnic nerve to the dorsal celiac branch of the vagus nerve in the rat. PMID- 6859295 TI - Systems thinking in psychiatry: some theoretical and clinical implications. AB - The author discusses the theoretical and pragmatic value of systems thinking in psychiatry. An awareness of the pluralistic, multifactorial origins of psychopathology broadens the psychiatrist's understanding and increases his or her therapeutic potential. The psychiatrist who thinks in systems terms is a true generalist in medicine, and to practice that way is the most effective way of treating people. PMID- 6859296 TI - Guilt and conscience in major depressive disorders. AB - The authors propose definitions of guilt as a self-critical feeling state and of conscience as a set of standards, to permit independent assessment of their prevalence in a sample of 93 depressed, 29 schizophrenic, and 43 normal subjects. Patients with feelings of guilt tended to have a more severe conscience and lower self-esteem. While guilt is prominent in a moderate percentage of depressed patients, negative self-esteem may form one of the cornerstones for depressed patients of all types. The authors propose that the operational definition of psychoanalytic concepts such as guilt and conscience permits a valid and more rigorous test of clinical generalizations. PMID- 6859297 TI - Major depression in the elderly: DSM-III criteria and the dexamethasone suppression test as predictors of treatment response. AB - Twenty-seven elderly individuals with DSM-III diagnoses of major depression who demonstrated a nonsuppressor response to the dexamethasone suppression test had higher pretreatment levels of mood disturbance, required higher dosages of antidepressant medication, and had poorer responses to treatment than 17 clinically similar individuals with a suppressor response. However, when data on the outcomes of suppressors and nonsuppressors were combined, over half of the entire group sustained significant improvement, which supports the practical value of DSM-III criteria for depression in the elderly. PMID- 6859299 TI - Muddling through mental health policies. AB - This study reports the process and outcome of a mental health policy change designed to relieve overcrowding in the 10 municipal adult psychiatric inpatient units in New York City. The authors describe the strategies used to achieve a limited change in admission policies and analyze the effect of this change on the municipal hospitals. Comparison of conditions before and after the policy change suggests its positive impact. Results are discussed in reference to the model of incrementalism in policy making, emphasizing the need for comprehensive rational planning, the training of mental health professionals in policy making, and further research on this important area of psychiatry. PMID- 6859298 TI - Mortality in the era of deinstitutionalization. AB - The authors examined the 3 1/2-year mortality rate of 1,033 psychiatric patients who had received inpatient treatment during a 1-year period, using standardized mortality ratios to identify heightened risk. Deaths due to accidents or suicides and pneumonia occurred more frequently than expected. Deaths due to cancer occurred primarily among alcoholics; nonalcoholic patients had a significantly lower cancer mortality risk. The risk associated with age was greatest for young patients in general, but male schizophrenic patients and female alcoholics died at particularly young ages. The highest mortality risk associated with diagnosis was for male patients with affective disorders. The authors discuss the implications of these findings. PMID- 6859300 TI - Is treatment for alcoholism effective in persons on methadone maintenance? AB - A randomized prospective study of 625 drug addicts on methadone maintenance revealed that 105 (17%) were active alcoholics, 47 (8%) were inactive alcoholics, and 473 (76%) were not alcoholics. The active alcoholics were randomly assigned to abstinence therapy, controlled drinking with behavior modification, or a control group receiving the usual clinic services. There were no differences between treatment and control groups at baseline and during follow-up of up to 2 1/2 years, and there was no relation between remission and treatment, suggesting that the effectiveness of currently employed specific interventions for alcoholism in active alcoholic addicts maintained on methadone cannot be demonstrated. PMID- 6859301 TI - The deliberate self-harm syndrome. AB - Recent research has differentiated several distinct classes of self-destructive behavior. This paper describes the clinical characteristics of one class, the deliberate self-harm syndrome. Analysis of 56 published case reports of self-harm revealed a typical pattern of onset in late adolescence, multiple recurrent episodes, low lethality, harm deliberately inflicted upon the body, and extension of the behavior over many years. Since the clinical characteristics of the deliberate self-harm syndrome differ substantially from those of other classes of self-destructive behavior, the authors propose that DSM-IV classify deliberate self-harm as a separate diagnostic syndrome. PMID- 6859302 TI - Mental health policy and the political process. PMID- 6859303 TI - The dexamethasone suppression test in suicidal patients with unipolar depression. AB - Of 49 newly hospitalized patients who met Research Diagnostic Criteria for primary unipolar depression and were given the dexamethasone suppression test (DST), significantly more patients admitted for suicide attempts than nonsuicidal patients had abnormal DSTs. All five patients who made subsequent suicide attempts (one completed) within 6 months after admission had had abnormal DSTs. These findings suggest that the tendency of endogenously depressed patients to attempt suicide is exacerbated by an underlying neurobiological disorder reflected by limbic-hypothalamic dysregulation and that depressed suicidal patients with abnormal DSTs represent a high-risk group for recurrence of suicidal behavior. PMID- 6859305 TI - Sexual violence in the United States and the role of season. AB - An analysis by the cosinor method of over 50,000 rapes in 16 different locations in the United States revealed statistically significant annual rhythms in 14 locations, with maxima in the summer. Changes in numbers of rapes and assaults showed similar seasonal patterns, suggesting that rape comprised a subcategory of aggressive behavior. In contrast, there was a virtual absence of seasonal changes in numbers of murders. A close relation emerged between assaults and rapes, on the one hand, and temperature, on the other, in different geographical locations. The authors hypothesize that human violence, just like aggression in nonhuman primates, is influenced by exteroceptive environmental factors. PMID- 6859304 TI - Anxiety disorders and depression: contradictions between family study data and DSM-III conventions. AB - The authors report data from a case-control family study of lifetime psychiatric diagnoses among the relatives of individuals with major depression. Specifically, they address the relationship between anxiety disorders and major depression. The findings indicate that relatives of individuals with major depression plus an anxiety disorder are at greater risk for major depression, as well as anxiety disorders; than are the relatives of individuals with major depression without an anxiety disorder. This increased risk appears to be present whether or not the anxiety disorder occurs solely in association with episodes of major depression or is temporally separate. The nosological implications of these findings are discussed. PMID- 6859306 TI - Diagnosis of antisocial personality disorder in two prison populations. AB - The author presents data on the incidence and reliability of the DSM-III diagnosis of antisocial personality disorder in 246 male inmates of two prisons, comparing this diagnosis with assessment procedures that have proven useful in the study of psychopathy. He found good agreement between the diagnosis of antisocial personality disorder and assessments of psychopathy, although DSM-III did not readily identify individuals who fit the classic picture of psychopathy but avoided early contact with the judicial system. Nevertheless, DSM-III may be useful for differential diagnosis in criminal populations. PMID- 6859307 TI - Is the "live patient" interview on the boards necessary? AB - Study of American Board of Psychiatry certification examinations over a 2-year period revealed differences between audiovisual and "live patient" interview grades. Of 2,236 psychiatrists examined in psychiatry, 1,367 (61%) received concordant scores on their audiovisual and "live patient" examination hours and 1,165 (52%) received identical grades. Agreement about pass/fail decisions was even higher (80%). Where scores were not identical, two out of three candidates scored higher on the audiovisual section, prompting the conclusion that the two examination formats may test somewhat different skills or carry a different weight in the judgment of most examiners. It is therefore reasonable to conclude that these differences must continue to be tested for. PMID- 6859308 TI - The emergency room as a clerkship site. AB - The psychiatric emergency room of a county hospital is one of five clinical placement sites for the authors' medical school junior clerkship. The students assigned to the emergency room share the same core didactic work as students who are placed at more traditional sites, but the emergency room students have additional seminars in crisis intervention, aspects of emergency psychiatry, and orientation to social agencies. Analysis of data measuring the achievement of behavioral objectives common to all five clinical sites shows that emergency room students, in comparison with their peers at other sites, averaged more patient contact, more direct observation, and more supervisory experiences. PMID- 6859310 TI - Conflicts associated with physicians' pregnancies. AB - The authors surveyed clinical faculty and residents in one medical school to assess perceived stress related to working with a pregnant colleague. The majority acknowledged stress to themselves and their departments yet indicated that pregnancy had a humanizing effect on the work environment. Although most felt that the pregnant physician maintained her professional interests and efficiency, one-third reported women of childbearing age to be a hiring risk. A higher percentage of faculty than residents favored special considerations for pregnant physicians. The authors explore age, sex, and departmental differences and suggest that pregnancy in a physician generates conflicts in her colleagues. PMID- 6859309 TI - Administrative relationships between state hospitals and academic psychiatry departments. AB - To review administrative relationships between academic departments of psychiatry and state hospitals the authors sent a questionnaire survey to chairmen of the 115 psychiatry departments in the United States with approved residency programs, receiving responses from 98 (85%). They discuss three types of relationships and examine the nature of the training of university residents in state hospitals, providing suggestions for integrating service-oriented settings such as state hospitals into an academic psychiatry program. PMID- 6859311 TI - Suicide by burning. AB - Of 164 patients admitted to a university hospital burn unit, 15 (9%) had attempted suicide, and 5 of the 15 died. The use of a flammable liquid was the most common method of attempted suicide; the most common psychiatric diagnosis was schizophrenia. PMID- 6859312 TI - Effect of multiple time point sampling on the sensitivity of the dexamethasone suppression test. AB - Dexamethasone suppression test sensitivity in 188 patients was 61.6% when cortisol was measured at six time points and 48.5% when cortisol was measured twice. More patients had abnormal cortisol levels at 8:00 p.m. than at 4:00 p.m. or 10:00 p.m. PMID- 6859313 TI - Imipramine-induced vasospasm: a case report. PMID- 6859314 TI - Urinary tract abnormalities due to chronic psychogenic polydipsia. AB - Of 10 patients who excreted urine with low specific gravity and had chronic psychogenic polydipsia, five had urinary tract abnormalities, ranging from large bladders with large postvoid residuals to severe hydronephrosis, renal back pressure atrophy, and renal failure. PMID- 6859315 TI - Dexamethasone suppression tests in patients with panic disorder. AB - Dexamethasone suppression tests were given to 10 patients with panic disorder and 22 depressed patients. All patients with panic disorder were normal suppressors, and nine depressed patients were nonsuppressors. The mean cortisol levels of the two groups differed significantly. PMID- 6859316 TI - Is serum cholesterol a biological marker for major depressive disorder? AB - An abnormally high serum cholesterol level has been suggested as a biological marker for major depression. However, in 192 depressed and normal subjects, age and sex influenced serum cholesterol level, but the diagnosis of major depression did not. PMID- 6859317 TI - Agranulocytosis associated with amoxapine. PMID- 6859319 TI - The dexamethasone suppression test with mildly to moderately depressed outpatients. AB - In 66 depressed outpatients given the 1-mg dexamethasone suppression test (DST), the overall rate of nonsuppression was 14%. There was little difference in the rates for patients with endogenous and nonendogenous depression and no overlap between baseline cortisol hypersecretion and DST abnormality. PMID- 6859322 TI - Therapeutic response of a schizophrenic boy to a methylphenidate-chlorpromazine combination. AB - Methylphenidate in combination with chlorpromazine proved effective in the treatment of a boy with schizophrenia. Neuroleptics alone had not caused sufficient improvement to maintain him outside the hospital. PMID- 6859321 TI - Post-ECT confusional states associated with elevated serum anticholinergic levels. AB - Of 20 patients receiving ECT, those with high anticholinergic drug levels after ECT were at greater risk for developing post-ECT confusional states than were patients with low levels. PMID- 6859318 TI - ECT-induced delirium and further ECT: a case report. AB - The authors report the occurrence of a severe confusional state (DSM-III delirium) in a patient who received bilateral sinusoidal ECT. Unilateral brief pulse ECT was then used to successfully treat the patient's depression without the redevelopment of delirium. PMID- 6859323 TI - Successful treatment of paranoia with trazodone. PMID- 6859320 TI - ECT for major depression in a patient with acute brain trauma. AB - A woman with depression and cerebral cortical laceration caused by a self inflicted gunshot wound received ECT 3 weeks after wounding herself and had no untoward effects. The authors discuss relative contraindications to ECT based on head injury and posttraumatic seizures. PMID- 6859324 TI - Reversible cardiac conduction abnormality associated with trazodone administration. PMID- 6859327 TI - "Paranoid" in DSM-III. PMID- 6859325 TI - Vasopressin-8-lysine in prevention of ECT-induced amnesia. PMID- 6859326 TI - A note on sociosyntonic psychopathology. PMID- 6859328 TI - DSM-III diagnosis of dementia. PMID- 6859330 TI - Deanol treatment of tics in a 10-year-old girl. PMID- 6859329 TI - Low dopamine and serotonin levels in anorexia nervosa. PMID- 6859331 TI - Impairment of the gag reflex in schizophrenic patients. PMID- 6859332 TI - Response to isocarboxazid and the DST. PMID- 6859333 TI - Use of the cortisol suppression index for adolescents. PMID- 6859334 TI - Effects of d-amphetamine withdrawal in rats and man. PMID- 6859335 TI - Incest is not helpful. PMID- 6859336 TI - Doxepin as a potent H2 and H2 antihistamine for epigastric distress. PMID- 6859337 TI - Hindsight in Behcet's disease. PMID- 6859338 TI - An update on the West Virginia School of Medicine. PMID- 6859339 TI - Type II error in diagnosing borderline patients. PMID- 6859340 TI - All doctors don't marry women. PMID- 6859341 TI - Effects of the therapist's character structure. PMID- 6859343 TI - Lithium for delusional depression. PMID- 6859342 TI - A holistic approach to child psychiatry. PMID- 6859344 TI - Drs. Lidz and Blatt on Dr. Kety's review. PMID- 6859345 TI - The Ponzo illusion without suggested depth. PMID- 6859346 TI - Control of pigeons' matching-to-sample performance by differential sample response requirements. AB - Pigeons were trained on a matching-to-sample task in which sample hue and required sample-specific observing behavior provided redundant, relevant cues for correct choices. On trials that involved red and yellow hues as comparison stimuli, a fixed-ratio 16 schedule (FR 16) was required to illuminate the comparisons when the sample was red, and a differential-reinforcement-of-low rates 3-sec schedule (DRL 3-sec) was required when the sample was yellow. On trials involving blue and green hues as comparison stimuli, an FR 16 schedule was required when the sample was blue and a DRL 3-sec schedule was required when the sample was green. For some pigeons, a 0-sec delay intervened between sample offset and comparison onset, whereas other pigeons experienced a random mixture of 0-sec and 2-sec delay trials. Test trial performance at 0-sec delay indicated that sample-specific behavior controlled choice performance considerably more than sample hue did. Test performance was independent of whether original training involved all 0-sec delay trials or a mixture of 0-sec and 2-sec delays. Sample-specific observing response requirements appear to facilitate pigeons' matching-to-sample performance by strengthening associations between the observing response and correct choice. PMID- 6859347 TI - The effect of sound on visual apparent movement. AB - Twelve subjects found the longest possible interstimulus interval (ISI) at which they perceived continuous apparent motion of one light instead of partial motion or succession between two lights. In the visual condition, two lights only were presented. In the bimodal conditions, binaurally presented tones were presented synchronously with the lights, and the lights and tones were either spatially congruent (in phase) or incongruent (180 degrees out of phase). Bimodal presentations lowered the upper ISI threshold for the perception of visual apparent motion, and the reduction was greater when the tones and lights were spatially congruent. The threshold reduction may be caused by a perceptual inference about localization of the lights in space or by a change in visual persistence. PMID- 6859348 TI - Emotional conflicts of the career woman: women in medicine. PMID- 6859349 TI - Narcissism and the narcissistic personality: a holistic reappraisal. PMID- 6859350 TI - Clinical indicators of structural change. PMID- 6859351 TI - Psychodynamics of limit setting with the borderline patient. PMID- 6859352 TI - Depression as pseudo self-repair in a case of blocked mourning. PMID- 6859353 TI - Will the growth of health and welfare services be resumed? PMID- 6859354 TI - Medical data and injuries. PMID- 6859355 TI - The role of treponemal tests in therapeutic decision making. AB - As part of process evaluation of a syphilis control program, the predictability of serologic tests was assessed by reviewing the primary care case records (containing serology findings on 5,643 sera) of all individuals in six aboriginal communities. The direct relationship of predictability to positivity of treponemal test was influenced by the Venereal Disease Research Laboratory (VDRL) titre and when results were stratified by this variable, an inverse association of predictive value with levels of positivity of treponemal test was demonstrated. The predictive values positive of the FTA-ABS-IgM test for untreated disease was 0.31 for VDRL titres of 1:4 and increased to 0.84 for VDRL titres exceeding 1:16. The predictive value of treponemal tests would be increased by more restrictive criteria for their performance, and optimum interpretation demands concurrent assessment of VDRL titre, and clinical and epidemiological background of the individual patient. This type of evaluation on individual control programs is encouraged because the quantitative findings will vary with disease prevalence, testing criteria, and the individual laboratory testing performance. PMID- 6859356 TI - Northeastern Ohio trauma study: I. Magnitude of the problem. AB - This study measured the incidence of cause-specific trauma in the Cleveland and Lorain-Elyria Standard Metropolitan Statistical Areas (SMSAs), population 2.2 million, as reported to hospital emergency departments (ED). Cases were selected according to a stratified probability sampling plan (N = 9268). The participating hospitals accounted for 97.6 per cent of 903,346 ED visits in 1977; 52 per cent of these visits were for trauma (ICDA-8 E800-E999). The trauma incidence rate was 197 per 1,000 population. The six leading causes of injury were: falls, 24.4 per cent; cut/piercing injury, 14.2 per cent; striking or struck by object, 13.8 per cent; motor vehicle collisions (MVC), 11.6 per cent; overexertion/strain, 8.2 per cent; and assault, 4.3 per cent. Only falls, MVCs, and assaults were leading causes of both injury and death. The injury incidence rates for vehicular crashes and assault were 1.4 and 3.8 times higher, respectively, than the official incidence rates for these SMSAs. These differences point to a significant underreporting of data needed for public health decision making. Because data were not collected on cases treated outside the participating hospitals, the incidence rates reported here represent a conservative estimate of the magnitude of the problem. PMID- 6859357 TI - Spontaneous abortions after the Three Mile Island nuclear accident: a life table analysis. AB - A study was conducted to determine whether the incidence of spontaneous abortion was greater than expected near the Three Mile Island (TMI) nuclear power plant during the months following the March 28, 1979 accident. All persons living within five miles of TMI were registered shortly after the accident, and information on pregnancy at the time of the accident was collected. After one year, all pregnancy cases were followed up and outcomes ascertained. Using the life table method, it was found that, given pregnancies after four completed weeks of gestation counting from the first day of the last menstrual period, the estimated incidence of spontaneous abortion (miscarriage before completion of 16 weeks of gestation) was 15.1 per cent for women pregnant at the time of the TMI accident. Combining spontaneous abortions and stillbirths (delivery of a dead fetus after 16 weeks of gestation), the estimated incidence was 16.1 per cent for pregnancies after four completed weeks of gestation. Both incidences are comparable to baseline studies of fetal loss. PMID- 6859358 TI - Reassurance through prenatal diagnosis and willingness to bear children after age 35. AB - This study reports on a survey of 2,209 women age 25-45; most were married. Respondents were asked about their reproductive plans and whether prenatal reassurance might influence their reproductive intentions. For almost two-thirds of the age 35-45 respondents, either the woman or her husband had already chosen sterilization; of those able to bear children, but with uncertain plans, 25 per cent of 35-39 year olds and 12.8 per cent of 40-45 year olds indicated an increased willingness to have children if they were reassured that their baby had none of the birth defects detectable by amniocentesis. PMID- 6859359 TI - Assessing the impact of copayment on family planning services: a preliminary analysis in California. AB - A legislatively mandated copayment system for California state-funded family planning services was evaluated after the first six months of experience. Most clients reportedly could make their payments, but three times as many providers suggested lowering the fees as suggested raising them, and one-third reported a decrease in client donations. While the majority of providers did not report a decrease in clients, 22 per cent did so. For these drop-outs, it is estimated that the State would pay approximately $3 million in costs associated with unintended pregnancies, or one and a half times the amount cut from the Family Planning budget. PMID- 6859360 TI - The survival benefit of bystander cardiopulmonary resuscitation in a paramedic served metropolitan area. AB - We investigated the survival benefit bystander cardiopulmonary resuscitation (CPR) for out-of-hospital emergencies in a paramedic served area of metropolitan Los Angeles. Clinical information for all events occurring between January 1 and December 31, 1978 was obtained from paramedic report forms and hospital medical records. Bystander CPR was performed for 93 cases and, of these, 20 (22 per cent) survived to hospital discharge, as compared to 7 (5 per cent) of the 150 patients not receiving bystander CPR (p less than 0.001). Twelve (27 per cent) of the 45 patients in ventricular fibrillation (VF) who had bystander CPR survived, as compared to 4 (6 per cent) of 70 VF patients without bystander CPR (p less than 0.01). We conclude that bystander CPR, initiated prior to arrival of paramedics, produced a fourfold improvement in survival. Overall there was a 10 per cent survival rate at hospital discharge. Survival rates reported from Seattle may not necessarily be generalized to larger cities. PMID- 6859361 TI - Traveler's diarrhea at sea: two multi-pathogen outbreaks caused by food eaten on shore visits. AB - In 1976 and 1981, two outbreaks of gastrointestinal illness aboard cruise ships occurred within 24 hours following onshore visits to Haiti and Mexico, respectively. Three hundred eighty-six of 600 (64 per cent) and 98 of 260 (38 per cent) passengers became ill following luncheons in Port-au-Prince, Haiti, and Cozumel, Mexico. No increase in illness was observed among those passengers who did not attend the onshore luncheons. In both outbreaks, unrefrigerated seafood dishes served at outdoor buffets were epidemiologically incriminated as the vehicles of transmission. Several species of Vibrion, Salmonella, and toxigenic Escherichia coli were recovered from stool specimens of ill passengers in both outbreaks. In addition, invasive Escherichia coli and Shigella were isolated from stool specimens of ill passengers who ate at the Haitian buffet. Previous investigations of outbreaks of gastrointestinal illness aboard cruise ships have implicated exposures on board as the source and have involved only a single pathogen. PMID- 6859362 TI - Patterns of vitamin C intake from food and supplements: survey of an adult population in Alameda County, California. AB - Use of vitamin C in food and pills and its association with health habits and health status were investigated in a random sample of 3,119 adults in Alameda County, California. Vitamin C intakes of nearly 80 per cent of respondents met or exceeded Recommended Daily Dietary Allowances. Fourteen per cent or fewer appeared to have inadequate vitamin C intake. Vitamin C supplements were taken daily by 29 per cent, occasionally by 21 per cent. Most respondents obtained 100 mg or less of vitamin C daily; 2 per cent had more than 2000 mg. Proportionately, more women than men took vitamin C pills daily. Men aged 16 to 44 were the most likely to have neither vitamin C foods nor pills. Persons 45 years and older tended to take vitamin C pills daily, younger persons to take them occasionally. Respondents who did not eat breakfast or who smoked cigarettes had lower vitamin C intakes. People in poor health took more vitamin C than those in good health. Health status may have influenced vitamin C intake rather than vitamin C intake influencing health status. PMID- 6859363 TI - The effect of retirement on physical health. AB - This prospective study compared pre- to post-retirement changes in physical health among male retirees with changes among age peers who continued to work. The 229 retirees and 409 workers aged 55-73 at follow-up were all participants in the Veterans Administration Normative Aging Study. Physical health at baseline and follow-up (three to four years apart) was rated on a four-point scale according to the findings of medical examinations. Although physical health declined generally over time, regression analyses showed no significant difference between eventual retirees and continuing workers on health change, after controlling for age and excluding men who retired due to illness or disability. Among retirees alone, pre- to post-retirement health change was also not significantly associated with several circumstances which purportedly make the retirement transition more stressful, such as mandatory retirement or retirement to a reduced standard of living. The results of this study of physical health, which corroborate those of other studies based on self-reported health measures and mortality data, support the conclusion that the event of retirement does not influence the risk of health deterioration. PMID- 6859364 TI - Paraquat and marijuana: epidemiologic risk assessment. AB - In March 1978, 13 (21 per cent) of 61 marijuana samples from the southwestern United States were found to be contaminated with the herbicide paraquat, a pulmonary toxin, in concentrations from 3 to 2,264 parts per million. The source of the contamination was an aerial spraying program in Mexico, supported indirectly by United States funds. To evaluate US exposure, a nationwide survey of the paraquat content of confiscated marijuana was conducted. The survey found 33 (3.6 per cent) of 910 marijuana specimens to contain detectable paraquat. In states adjacent to Mexico (Census Region VI), 23 (12.8 per cent) of 180 specimens were contaminated. Combustion testing indicated that approximately 0.2 per cent of paraquat on marijuana passes into smoke. From these data, we projected that 100-200 marijuana smokers in Census Region VI would be exposed by inhalation to 500 micrograms or more of paraquat per year, a dose judged to represent a health hazard; nationally, between 150 and 300 smokers were projected to have such exposure. Another 6,000 persons in Region VI and 9,000 nationally were projected to be at risk of exposure to between 100 and 499 micrograms of paraquat annually. The risk of paraquat exposure was greatest among those smokers who make one large purchase of marijuana per year. No clinical cases of paraquat poisoning were recognized among marijuana smokers during these studies, but no systematic national search for such cases was undertaken. PMID- 6859365 TI - Comparison of an active and passive surveillance system of primary care providers for hepatitis, measles, rubella, and salmonellosis in Vermont. AB - Between June 1, 1980 and May 31, 1981, the Vermont Health Department telephoned a randomly chosen half of the state's primary care offices for surveillance reports of hepatitis, measles, rubella, and salmonellosis. No reports were actively solicited from the other half of the primary-care practices in the state. Active surveillance units made more reports and more complete reports of diseases and had twice the number of reports per patient seen by the practice than did passive surveillance units. (Am J Public Health 1983; 73:795-797.) PMID- 6859366 TI - Tetanus and diphtheria immunity in an elderly population in Los Angeles County. AB - Fifty-four per cent of 246 subjects attending senior citizen centers (mean age 69), and 29 per cent of 111 convalescent hospital subjects (mean age 82) had protective levels of tetanus antitoxin (greater than or equal to 0.01 units/ml). Age-specific immunity levels were lower for females than males, and generally decreased with age. Forty-eight and one-half per cent of the senior citizen center subjects and 55.9 per cent of the convalescent hospital subjects had protective levels of diphtheria antitoxin (greater than or equal to 0.01 units/ml). PMID- 6859368 TI - How effective are daytime motorcycle headlight use laws? PMID- 6859367 TI - The epidemiology of heat-related deaths, Texas--1950, 1970-79, and 1980. AB - A study of the deaths during a 1980 heat wave in Texas revealed death rates that were highest in males, the elderly, Blacks and those engaged in heavy labor, the latter two factors perhaps reflecting socioeconomic status. The data suggest that persistent high temperatures were related to death to a greater degree than the temperature peaks reached. Higher heat death rates in earlier years are believed to be attributable to the limited availability of air conditioning in those years. PMID- 6859369 TI - Boxing: atavistic spectacle or artistic sport? PMID- 6859370 TI - On obesity and weight control in children. PMID- 6859371 TI - Health policy agenda for the American people. PMID- 6859372 TI - The effects of sperm antibodies on fertility after vasectomy reversal. AB - Antisperm antibodies have been measured in serum and in seminal plasma in 130 males before and after vasectomy reversal, and the occurrence of pregnancy has been analyzed in those partners who were trying to produce a pregnancy. All patients have been followed for at least one year. Sperm-agglutinating antibodies were found in the serum of 79% of patients; seminal plasma antibodies were present in only 9.5% before reversal, and this rose to 29.5% afterwards. Overall, pregnancies occurred in the partners of 44.6% of those men who were trying to produce children. Production of pregnancy was significantly less likely when the preoperative serum antisperm antibody titer was 512 or more, but no decrease in fertility was seen with titers below this. Similar numbers of pregnancies were produced by patients with or without seminal plasma antibodies in titers of up to 16; there are too few patients with titers above this level to permit further analysis. A randomized controlled trial of perioperative steroids showed that they produced no benefit. It appears that the antisperm antibodies associated with vasectomy reversal may differ fundamentally from those occurring in naturally subfertile males. PMID- 6859373 TI - Studies of the normal human placental syncytiotrophoblast membrane: a combined immunological and physiochemical approach. AB - In view of the importance of the syncytiotrophoblast in the immunobiology of human pregnancy, the composition of this interface between fetus and mother was further studied by a combination of physicochemical and immunological approaches. Trophoblast membranes were solubilized using three classes of detergents: zwitterionic (sulfobetaine14), non-ionic (Triton X-100), and anionic (deoxycholate). Quantitative studies of protein released demonstrated the importance of dispersion of membranes into detergent, and optimum solubilization was then obtained at detergent:protein ratios of 1.3:1 for sulfobetaine, 2.5:1 for Triton X-100, and 4.4:1 for deoxycholate. Analysis of chaotrope-treated detergent-solubilized membrane components was performed by preparative isoelectric focusing followed by combined physiocochemical and immunological methods. The results revealed three major proteins which were identified as placental alkaline phosphatase, albumin, and transferrin. Certain additional low molecular weight proteins were also evident; one of these components displayed physicochemical properties similar to those of actin, but none appeared to be recognized by conventional heteroantisera raised to trophoblast membrane. These findings and the results of further immunological analysis by affinity chromatography are consistent with the concept that human trophoblast may express limited immunogenicity due in part to the presence of large amounts of absorbed maternal serum components and limited expression of fetal proteins. PMID- 6859374 TI - Smooth muscle antibodies in complicated early pregnancies. AB - The titer, immunoglobulin class, and staining pattern of smooth muscle antibodies (SMA) were assayed by indirect immunofluorescence in 15 patients with threatened abortion, 46 patients with spontaneous abortion, and 45 normal pregnant women in the first trimester to investigate possible abnormality of humoral immunity. An increased incidence of moderate and high titer SMA was found in both abnormal groups. SMA were mainly of the IgG class and gave a "vessel wall" staining pattern in immunofluorescence. This staining pattern suggests non-actin specificity of SMA. The more precise characterization of the antigen specificity of SMA in complications during pregnancy requires further investigation. PMID- 6859375 TI - Placental immunology. PMID- 6859378 TI - Developmental immunology. PMID- 6859377 TI - The immunology of reproduction. PMID- 6859376 TI - Idiopathic spontaneous abortions. PMID- 6859380 TI - Fertility and infertility. PMID- 6859379 TI - "Membrane-associated" immunoglobulins in cyst and ascites fluids of ovarian cancer patients. AB - A new column chromatography technique, utilizing peroxidase-labeled antihuman immunoglobulins, is described, which can measure the binding of specific antibodies to membrane fragments containing relevant antigens. Using this assay, the presence of bound immunoglobulin is demonstrated on membrane fragments isolated from ascites fluids, but not from tumor tissues. In this study, two populations of immunoglobulins were examined: 'free' immunoglobulins and immunoglobulins bound to ascites fluid-derived membrane fragments. Immunoglobulins eluted from membrane fragments of the ascites fluids were capable of binding to the tumor. These were specific for binding to tumor membrane preparations, in that there was two orders of magnitude greater binding of these immunoglobulins at a given concentration than 'free' immunoglobulins at the same concentration. PMID- 6859381 TI - Fetal H-Y typing using human amniotic fluid. AB - The H-Y (male) antigen is phylogenetically conserved among vertebrate species, including the species man. Previous studies have indicated the presence of a "soluble" H-Y antigen in male serum and culture fluids of male cells. We examined over 50 samples of amniotic fluid from male and female fetuses to determine if H Y typing could be correlated with the sex of the fetus. Samples of amniotic fluid were tested to inhibit the reactivity of monoclonal antibodies in a standard H-Y assay with protein A sheep red blood cells. We found that amniotic fluids from male fetuses inhibited 40% of the reactivity and that amniotic fluids from female fetuses inhibited 0.5% of reactivity. We could also correctly identify the sex of 90% of male fetuses and 100% of female fetuses. We have not yet identified the exact nature of the inhibiting antigen(s) in the amniotic fluids, but our results clearly indicate the feasibility of fetal H-Y typing. PMID- 6859384 TI - The presence of oncofetal antigens on ultraviolet light--induced and methylcholanthrene--induced murine tumors which are common to placental and fetal tissues. PMID- 6859383 TI - The value of the mixed antiglobulin reaction (MAR test) as an addition to routine seminal analysis in the evaluation of the subfertile couple. AB - A mixed erythrocyte-spermatozoa antiglobulin reaction (MAR test) for IgG antibodies has been done on semen specimens supplied by the male partners in 720 subfertile couples during a two-year period. The test was possible in all except 69 patients (9.5%). Antisperm antibodies were detected in 48 (10%) of 484 men with normal sperm counts, 18 (23%) of 78 with low sperm motility, and 19 (15%) of 128 with low counts. In 204 patients, antisperm antibodies were also measured by serum sperm-agglutination tests: The results showed a highly significant correlation with the results of MAR testing. It is concluded that the MAR test should be a routine part of seminal analysis, since the presence of IgG antisperm antibodies can be established in about 10% of men who might otherwise be passed as normal, and such antibodies can be positively excluded in a further 78% of the male partners of infertile marriages. PMID- 6859385 TI - Detection of an early pregnancy factor-like substance in sera of patients with testicular germ cell tumors. AB - Early pregnancy factor (EPF) is produced by both maternal and fetal tissue1,2 and has been detected previously only during pregnancy.3,4 The present report describes the detection of EPF, or an EPF-like substance (tEPF), in serum from patients with germ cell tumors of the testis. tEPF, or its free components, tEPF A and tEPF-B, were detected in all 11 patients with nonseminomatous tumors and in 5 of 10 patients with seminoma. It was not detected in serum from healthy male controls nor in patients with non-germ cell tumors or benign testicular disease. It is suggested that tEPF may be an additional serum marker for germ cell tumors and may expand the group already detectable by such markers. PMID- 6859382 TI - Effects of long-term immunization against the beta-subunit of ovine luteinizing hormone on circulating immune complex formation and on arterial changes in rhesus monkeys. AB - A major safety issue of contraceptive methods based on long-term immunization is the possible effect of circulating immune complexes (CIC) on the arterial wall. We have measured CIC's in 24 monkeys, immunized against the beta-subunit of ovine luteinizing hormone (oLH beta), emulsified with Freund's complete adjuvant, and in 7 nonimmunized controls by Raji assay, Clq assay, and an assay for rheumatoid factor. Eleven of the 24 immunized monkeys had CIC concentrations that were more than two standard deviations above the mean for controls in at least one of the assays. There was no correlation between antibody titer and CIC. Nine immunized and eight control animals on low-fat diets were killed to evaluate the effects of immunization on the artery wall. The cross-sectional intimal area was measured at several sites from projected microscopic images using a sonic digitizer. No statistically significant differences between test and control groups were found. However, when we compared the upper half of the distribution of test and control animals, we found that the mean intimal area of the thoracic aorta of immunized monkeys was twice that of controls and that that of the abdominal aorta was three times as large. These data indicate that long-term immunization against oLH beta induced CIC's in rhesus monkeys. Small increases in the intimal area were found in about half of the immunized animals. The results of this study suggest the need for a larger, more definitive study in which the diet is manipulated so that plasma lipids mimic those of human females in Western society. PMID- 6859386 TI - Necrotizing lymphadenitis. A study of 30 cases. AB - Thirty patients with necrotizing lymph-adenitis, a disorder initially described in Japan and commonly misdiagnosed as malignant lymphoma, have been studied, in addition, stains for immunologic markers were performed. The patients included 21 United States residents and most commonly were young women with a subacute illness characterized by persistent, painless cervical adenopathy with or without fever. The excised lymph nodes were moderately enlarged and typically showed focal, well-circumscribed, paracortical, necrotizing lesions, and abundant karyorrhectic debris, scattered fibrin deposits, aggregates of large mononuclear cells, and a paucity of plasma cells and neutrophils. Immunohistochemical stains on frozen tissue sections were positive for 63D3 and Leu-2a, indicating an admixture of of histiocytes/macrophages and cytotoxic/suppressor T-lymphocytes in the necrotizing lesions. The etiology of necrotizing lymphadenitis and its distinction from other causes of reactive lymphadenitis are discussed. To our knowledge, this disorder has not previously been reported in the United States. PMID- 6859387 TI - Ovarian tumors of probable wolffian origin. A report of 11 cases. AB - The clinical and pathological features of 11 ovarian tumors of probable wolffian origin are reported. The age of the patients ranged from 28 to 64 years (average 50 years). The presenting manifestation was abdominal swelling in five cases; in the remaining six cases the tumors were discovered on physical examination. Ten of the tumors were Stage Iai; the 11th, which contained foci of undifferentiated carcinoma, was Stage III. On gross examination the specimens were either solid or solid and cystic. Microscopical examinations revealed epithelial cells that lined cysts, lined or filled tubules, or grew in a diffuse pattern. Mitotic activity was low in the tumors of nine patients, eight of whom were known to be alive and free of disease from 1 to 15 years postoperatively (average 5 years); the ninth patient has been lost to follow-up. One patient whose tumor had a high mitotic rate (13/10 high-power fields) has bilateral pulmonary metastases 8 years postoperatively. The final patient, whose tumor was Stage III and contained foci of undifferentiated carcinoma, has been lost to follow-up. PMID- 6859388 TI - Microglandular adenosis. A benign lesion simulating invasive mammary carcinoma. AB - Microglandular adenosis (MGA) is a benign mammary disease in which small uniform acinar structures seem to grow haphazardly in the mammary parenchyma. While most often an inconspicuous microscopic lesion, MGA can cause a palpable tumor. This report is based on a review of 13 patients who presented with palpable tumors which were composed in part or entirely of MGA. The mean age was 53 years. In two cases, the mass was painful; a third patient described changes in the size of the tumor with menstrual cycles. Four patients had carcinoma associated with MGA. Two women had MGA coexistent with in situ lobular and intraductal carcinoma, respectively, when the carcinoma was diagnosed. Two other patients developed invasive carcinoma at intervals of 6 and 18 years subsequent to a biopsy of MGA. Both patients had hyperplastic foci in the MGA prior to developing carcinoma. These findings suggest that complete excision of MGA is appropriate and that it is prudent for patients with MGA to seek regular clinical follow-up. PMID- 6859389 TI - Interfollicular Hodgkin's disease. AB - An unusual pattern of focal involvement of lymph nodes by Hodgkin's disease is described which we have named "interfollicular Hodgkin's disease." It is characterized by florid reactive follicular hyperplasia which overshadows involvement of the interfollicular zones by Hodgkin's disease. The pattern can be mistakenly diagnosed as one of the many causes of reactive follicular hyperplasia. The seven cases studied did not appear to differ clinically from other more recognizable forms of Hodgkin's disease. The importance of this pattern of lymph node involvement by Hodgkin's disease rests on its misdiagnosis as a benign lesion and not on any unusual clinical features. PMID- 6859390 TI - Crohn's colitis with carcinoma and dysplasia. Report of a case and review of 100 small and large bowel resections for Crohn's disease to detect incidence of dysplasia. AB - A patient who developed invasive adenocarcinoma of the cecum after a 20-year history of Crohn's enterocolitis is reported. Histologic examination of the resected specimen showed widespread severe dysplasia in addition to the invasive carcinoma. An additional 100 randomly selected bowel resection specimens removed for Crohn's disease were reviewed to determine the frequency of epithelial dysplasia. Applying rigorous criteria, we found a 2% incidence of mild dysplasia; no instance of severe dysplasia was identified. PMID- 6859392 TI - Association between neuroendocrine (Merkel cell) carcinoma and squamous carcinoma of the skin. AB - Among 32 neuroendocrine carcinomas of the skin, 11 were from patients with previous or concomitant squamous carcinoma. The medical records and pathologic material for these 11 cases were reviewed, and the diagnosis of neuroendocrine carcinoma was confirmed in each instance by electron microscopy. In two cases, the squamous and neuroendocrine carcinomas were admixed, but each preserved its identity and transition between the two was not identified. Despite the lack of evidence for origin from a single cell, the observations nevertheless indicate a common carcinogenetic influence for squamous and neuroendocrine carcinomas of the skin. PMID- 6859391 TI - A clinicopathologic review of 25 cases of chordoma (a pleomorphic and metastasizing neoplasm). AB - A clinicopathologic study of 25 cases of chordoma revealed that this tumor occurs principally in (68%), with a predominance for the sixth decade of life (seven patients--28%), and shows a predilection for the sacrococcygeal region (52%). The symptomatology was intimately related to the location of the tumor. Histologically, chordoma showed an extremely wide range in its cellular composition and pattern, not only from tumor to tumor, but also often in different portions of the same tumor. In addition to the large physaliferous cells in a lobular arrangement, large cells with apparently degenerating nuclei (ghost cells) were commonly seen; cells arranged in concentric spherical formations were observed in two cases, whereas small, round cells predominated in another case. A sarcomatous pattern was prominent in two cases. Large pink cells were frequently seen and in one case were arranged in epithelial-like columns. Whether these neoplastic components can be related to different degrees of tumor differentiation is difficult to establish. Histologic features of five cases in which metastasis occurred were compared to previously described metastasizing cases. These appear to be few reliable features helpful in suggesting the metastatic potential of this neoplasm. PMID- 6859393 TI - Midline granulomas. PMID- 6859394 TI - The role of pharmaceuticals in the total health care of developing countries. PMID- 6859395 TI - Timing of stages and changes in numbers of multiply-infected erythrocytes during the asexual cycle of Plasmodium cynomolgi bastianellii. AB - Previous evaluations of the timing of developing stages in the erythrocytic cycle of the simian malaria parasite, Plasmodium cynomolgi, a frequently used model for relapsing malaria in man, have depended on procurement of blood samples at 4- or 6-hourly intervals. This brief report describes the blood cycle as determined from hourly bleedings, thus providing a more discriminating sequence usable for immunochemical or biochemical study of specific stages. The approximate timing of development for five defined stages in the asexual cycle was determined to be 12 14 hours for young trophozoites, 22-24 hours for developing trophozoites, 5-7 hours for mature trophozoites, 5-6 hours for early schizonts, and 3-5 hours for late schizonts. It was also demonstrated that the rate of erythrocytic multiple infection declined in proportion to the maturity of the parasite. Young and developing trophozoites presented the most numerous cases of multiple infection whereas very few schizonts were seen multiply infecting a host cell. PMID- 6859396 TI - The in vitro cultivation of Plasmodium gonderi. AB - Plasmodium gonderi, one of the vivax-type simian parasites, has been cultured in vitro by the candle jar method and by the sealed flask method. It showed a 48 hour asexual cycle and maintained its morphologic integrity. The effect of different sera (human, rabbit, and horse) was tested in culture and compared with results using rhesus serum. Growth was lower in rabbit and horse serum, but higher in human serum. Compared with individual human and rhesus serum, the multiplication rate in combined rhesus and human sera (1:1) was greater. In addition, human erythrocytes proved refractory to invasion by P. gonderi in vitro. PMID- 6859397 TI - Quantitation of amastigotes of Leishmania donovani in smears of splenic aspirates from patients with visceral leishmaniasis. AB - During a 20-month period, more than 500 splenic aspirations were performed in 89 patients with suspected or proven visceral leishmaniasis. The two complications which occurred (intra-abdominal bleeding and penetration of the intestine in one patient each) both resolved with conservative management. Parasite density in splenic aspirate smears was graded on a logarithmic scale from 0 (no parasites in 1,000 microscopic fields) to 6+ (greater than 100 parasites per microscopic field). Among 46 newly diagnosed and 17 relapsed or drug-resistant patients with visceral leishmaniasis, the average initial parasite grade was 4.35 +/- 0.92 (mean +/- SD) and 4.15 +/- 1.37, respectively. The grading system was useful in measuring the speed of response to treatment, and in distinguishing slow responders from nonresponders. This was especially valuable for managing patients with drug-resistant visceral leishmaniasis. The system also provided a means of comparing the efficacy of different treatment regimens, and for calculating the optimum duration of treatment. PMID- 6859398 TI - Fatal case of multiple liver abscesses caused by adult Ascaris lumbricoides. AB - The present report describes a recent fatal case of multiple liver abscesses caused by adult Ascaris lumbricoides in a 21-month-old child. Most abscesses contained a large number of adult worms and one ruptured into the peritoneal cavity, causing purulent peritonitis. PMID- 6859399 TI - Onchocerca volvulus: detection of circulating antigen by monoclonal antibodies in human onchocerciasis. AB - A monoclonal antibody of the IgM class recognizing Onchocerca volvulus circulating antigen (COA) was obtained. This monoclonal antibody was used in a radioimmunoprecipitation-PEG assay (RIPEGA) to detect circulating antigen in onchocerciasis patients' sera. COA could be detected in 63 (80%) of the 79 African patient sera tested, and in 126 (76%) of the 164 Indian (Venezuela) sera studied. There was no direct correlation between the presence of COA detected in the patient serum and the level of microfilarodermia. The RIPEGA using this monoclonal antibody detected COA in 91% of children under 10 years old, whereas the microfilarodermia in this group was positive in only 52% of the cases. The specificity of this test is improved compared to the results obtained with polyclonal antibodies. Immunofluorescence studies suggest that the COA might be located in the microfilaria cuticle. PMID- 6859400 TI - Differences in adult Schistosoma mansoni worm burden requirements for the establishment of resistance to reinfection in inbred mice. II. C57BL/KsJ, SWR/J, SJL/J, BALB/cAnN, DBA/2N, A/J, B10.A(3R), and B10.A(5R) mice. AB - Eight strains of mice (C57BL/KsJ, SWR/J, SJL/J, BALB/cAnN, DBA/2N, A/J, B10.A(3R), and B10.A(5R) were studied in regard to the development of resistance to secondary challenge with Schistosoma mansoni following a primary infection. Also analyzed were the number of eggs recoverable from the livers of these strains after primary infection and the size of the hepatic, schistosome egg focused granulomas newly formed at various times after infection. As previously observed by us and others, most often the degree of resistance conferred by an acute primary infection is related to the number of adult worms harbored due to the initial infection. The mean levels of protection observed in the different strains were seen to cover a spectrum from moderate to strong resistance, rather than demonstrating high or low resistance strains. There was no observable effect of the major histocompatibility complex on this resistance state. The number of eggs recoverable from the livers of the various strains was calculated on a total liver, per female worm basis, and was seen to be less in C57BL/KsJ, SWR/J and SJL/J mice. Granulomatous reactivity also varied considerably in a strain dependent manner. These data are compared with previously reported strain differences in S. mansoni infections. Although some similarities are observed between laboratories certain strain-related discrepancies also exist and are discussed. PMID- 6859402 TI - Crossed immunoelectrophoresis for the detection of split products of the third complement in dengue hemorrhagic fever. I. Observations in patients' plasma. AB - Crossed immunoelectrophoresis was applied to detect the products of the third component of complement (C3) activation in plasma of patients suffering from dengue hemorrhagic fever (DHF), using inulin-treated normal human sera as positive control. In DHF, C3 split products were demonstrated in severely ill patients classified as having Grade III and Grade IV disease. These split products rapidly disappeared during the convalescent phase. The appearance of C3 activation products in DHF correlated well with signs of shock. This electropherogram of C3 activation could be used as a parameter reflecting immunologic activity in dengue hemorrhagic fever. PMID- 6859401 TI - Development of an enzyme-linked immunosorbent assay using arabinomannan from Mycobacterium smegmatis: a potentially useful screening test for the diagnosis of incubating leprosy. AB - A carbohydrate antigen composed predominantly of arabinomannan has been purified from Mycobacterium smegmatis and used in an enzyme-linked immunosorbent assay to detect anti-mycobacterial antibodies in human sera. Sera from 117 controls, 25 tuberculosis patients, 124 leprosy patients and 256 household contacts of leprosy patients were tested. When compared with the control group, 56% of tuberculosis patients, 27% of patients with tuberculoid leprosy, 77% of borderline leprosy cases, and 95% of patients with lepromatous leprosy had elevated titers. Nine percent of the household contact group had abnormally high levels of antibody. The relevance of these findings to the serodiagnosis of incubating leprosy and the management of household contacts of leprosy patients is discussed. PMID- 6859403 TI - RNA fingerprinting as a method for distinguishing dengue 1 virus strains. AB - Virion RNAs of 12 geographically distinct dengue type 1 (DEN-1) virus isolates were clearly unique by RNA fingerprinting. Isolates from the same geographic area were very similar but differed from those of other areas, allowing us to establish three geographical groupings based upon percent shared oligonucleotides. Three Caribbean strains were virtually identical (85-91% homologous oligonucleotides) whereas Pacific/S.E. Asian strains exhibited considerably less homology to one another (44-49%). The Pacific/S.E. Asian strains exhibited little relationship (20-30%) to the Caribbean and African strains. A Sri Lankan isolate displayed a relatively high degree of homology to Nigerian isolates (60-66% homologous oligonucleotides), suggesting that the Sri Lanka DEN-1 infection originated from Africa. A 1978 Nigerian DEN-1 isolate and the 1969 Sri Lankan strain each exhibited greater than 50% homology with a 1977 Jamaican strain. The similarities observed between the African/Sri Lankan and Jamaican strains suggest that the DEN-1 virus which caused the 1977 Jamaican epidemic may have originated from Africa or Sri Lanka. The RNA fingerprint is a unique characteristic of DEN-1 strains from a particular geographic region, suggesting this technique as a useful tool for dengue epidemiological investigations. PMID- 6859404 TI - Transovarial transmission of dengue 2 virus by Aedes aegypti in nature. AB - Dengue 2 virus was recovered from three of 123 pools of naturally infected Aedes aegypti larvae (6,200 insects) collected from water containers in Rangoon. The virus was also isolated from two of 76 pools (7,730 mosquitoes) of male Ae. aegypti, collected as larvae and reared in the laboratory to adults. Minimum field infection rates among these two groups of mosquitoes were 1:2,067 and 1:3,865, respectively. Insect pools were inoculated into Toxorhynchites splendens mosquitoes and dengue viral antigen was subsequently detected in headsquash preparations by direct fluorescent antibody technique. Identification of the dengue serotype was done by complement-fixation test. This is the first report of dengue virus isolation from naturally infected mosquito larvae. These findings suggest that transovarial transmission of dengue virus occurs in nature. PMID- 6859405 TI - Surveillance for California encephalitis group virus illness in Wisconsin and Minnesota, 1978. AB - During the summer and fall of 1978, active surveillance for encephalitis in southwestern Wisconsin and southeastern Minnesota resulted in the detection of the largest number of cases of California encephalitis group (CEG) virus infections ever documented in that region, where CEG virus is known to be endemic. A total of 75 laboratory-confirmed and eight presumptive cases of CEG virus infections were identified as a result of serologic testing completed in the Wisconsin and Minnesota State Laboratories. Cases included 46 residents of Wisconsin, 25 of Minnesota, 10 residents of Iowa and two from Illinois. The outbreak peaked during the last half of August and the first half of September. Eighty percent of patients were less than 10 years of age; only one case was documented in an adult (greater than or equal to 18 years). The clinical picture in patients ranged from mild aseptic meningitis to encephalitis with coma; convulsions occurred in 31% (22/72) of patients. One patient, a 3-year-old girl, died. The high incidence of infection detected in this investigation may be representative of the endemic incidence of CEG illness in the region and suggests that CEG infections in children residing in endemic areas in Wisconsin and Minnesota may be a greater public health problem than previously recognized. PMID- 6859406 TI - Mastomys (rodentia: muridae) species distinguished by hemoglobin pattern differences. AB - Hemoglobin electrophoresis patterns were found to be reliable markers for distinguishing two species of Mastomys in Sierra Leone having 32 and 38 chromosomes. All 32-chromosome animals exhibited a single hemoglobin pattern, whereas those with 38-chromosomes had four distinguishable patterns. Both karyotypes were present throughout Sierra Leone. The 38-chromosome species was more prevalent in the Guinea savanna zone to the north, while the 32-chromosome species was most dominant in human-modified high forest areas of the eastern and southern parts of the country. In almost all situations the 32-chromosome species was more common in houses than in bush habitats; the reverse was true for Mastomys having 38 chromosomes. Analysis of hemoglobin patterns thus becomes useful for species identification, and is necessary to understand the roles of the different Mastomys forms as reservoirs of human diseases, such as Lassa fever in West Africa. PMID- 6859407 TI - Spaceflight and the telltale heart. AB - Cardiac arrhythmias have not been a common occurrence during manned spaceflights. Cardiovascular deconditioning, on the other hand, is a universal finding both during and after exposure to microgravity. Exercise capability is reduced only in the immediate postflight period as is cardiac output. These adaptive changes do not impair crew health or their ability to perform effectively in weightless flight. We believe that these effects are mediated by a decreased effective circulating blood volume and that they are completely reversible. In any case, an effective countermeasure is available to obviate or mitigate any untoward deconditioning effects on deorbit and return to Earth's gravity. PMID- 6859408 TI - Treatment of cardiac arrhythmias in patients with acute myocardial infarction. AB - Cardiac arrhythmias and conduction disturbances are commonly observed in patients with myocardial infarction. The available data suggest the administration of prophylactic lidocaine, either through a large intramuscular dose (300 mg), which is particularly suited for out-patient situations, or through intravenous loading doses followed by a constant lidocaine infusion. Patients with ventricular arrhythmia should be treated with direct-current countershock if hemodynamic deterioration is present. Drug therapy for patients with ventricular arrhythmias who are resistant to lidocaine include procainamide, bretylium, or intravenous amiodarone (experimental drug). Treatment of atrioventricular block in acute infarction depends on the site of atrioventricular block, the infarct location, and the hemodynamic status. Generally, atrioventricular block associated with inferior infarction and normal hemodynamic states generally does require insertion of a pacemaker. In contrast, patients with anterior myocardial infarction and Mobitz II or third degree atrioventricular block should be treated with emergent temporary insertion of a pacemaker. In addition, prophylactic pacing is clearly indicated for those with acute myocardial infarction complicated by the bifascicular block pattern of first degree atrioventricular block and new onset bundle branch block. PMID- 6859409 TI - When is surgery indicated for the control of supraventricular tachycardia? AB - The surgical treatment of supraventricular tachycardias, if the experience with the ones caused by Kent bundles is excluded, is only now developing. Recent reports have described eight patients who had ablation, excision, or exclusion of an area of myocardium that contained an automatic focus. One instance of partial atrioventricular node interruption has been reported for correction of an atrioventricular nodal reentry tachycardia. The largest group of patients subjected to a direct operation had interruption of atrioventricular conduction. Twenty-seven patients, most of whom had enhanced atrioventricular nodal conduction, had either His bundle ablation or division. Experiments on the supraventricular conduction system have been outlined; they may point the way to extension of the indications for direct operations for supraventricular tachycardia. PMID- 6859410 TI - Recurrent ventricular tachycardia: how effective is surgical management? AB - Previous "blind" surgical intervention for recurrent, sustained ventricular tachycardia has been disappointing. Successful surgical intervention requires that a local arrhythmia circuit be interrupted, ablated, or disengaged from the adjacent healthy myocardium while incurring minimal injury to the remaining functional heart. Evidence is accumulating in both animals and human beings that myocardial ischemic damage may yield all the requisite substrates for a sustained reentrant ventricular arrhythmia. Ninety consecutive patients with recurrent, sustained ventricular tachycardia which was refractory to medical therapy underwent electrophysiologically directed surgical therapy. There were eight operative deaths (9 percent surgical mortality within 30 days after operation). In 65 of the 80 patients who underwent postoperative electrophysiologic studies, programmed ventricular stimulation was unable to replicate the clinical arrhythmia. Eight of the 17 patients with postoperatively inducible tachycardia were successfully treated with drugs. PMID- 6859411 TI - When is myocardial mapping clinically valuable? AB - All cardiac arrhythmias are either automatic or reentrant. Automatic arrhythmias occur in the periinfarction or perioperative period. Chronic, recurrent arrhythmias are typically reentrant. By definition, reentrant arrhythmias are inducible with programmed electrical stimulation. When a malignant cardiac arrhythmia is identified, the patient is taken to the electrophysiologic laboratory for study. Reentrant ventricular tachyarrhythmias are induced with programmed electrical stimulation. Pharmacologic suppression is guided by electrophysiologic testing. When antiarrhythmic suppression fails, surgical intervention may be an effective alternative. Endocardial catheter mapping before surgery may serve as an important guide to the surgeon. Myocardial mapping is clinically valuable only when all antiarrhythmic therapy has failed, and the patient is considered to be a candidate for surgical intervention. When surgical intervention is planned, we consider preoperative catheter mapping desirable and intraoperative electrophysiologic localization mandatory. PMID- 6859413 TI - Effectiveness of surgical management of the Wolff-Parkinson-White syndrome. AB - In this report, the surgical experience with the treatment of Wolff-Parkinson White syndrome in 190 patients who had 210 Kent bundles has been summarized. The patients with reentry tachycardia caused by the Kent bundle were relieved by Kent division or by His division, the latter being used only in 10 percent of the patients. A malignant ventricular arrhythmia was found in 25 percent of the patients and was due to a Kent bundle that conducted an atrial flutter fibrillation 1:1 to the ventricle. This arrhythmia was corrected by Kent interruption, since the Kent bundle alone participated in the arrhythmia. Other unusual manifestations of Kent bundles were found, such as multiple pathways, unidirectional conducting pathways, and pathways causing incessant junctional tachycardia. Other cardiac problems were frequently present, such as hypertrophic cardiomyopathy and Ebstein's anomaly. Even in such a multifaceted problem caused by a minute congenital abnormality, careful application of sophisticated electrophysiologic measurements followed by appropriate surgical methods have proved to be effective in correcting the two arrhythmias associated with Wolff Parkinson-White syndrome. PMID- 6859412 TI - Automatic defibrillation in man: is it feasible? AB - Twenty-eight patients who survived multiple arrhythmic cardiac arrest refractory to medical therapy underwent implantation of the automatic defibrillator without additional antiarrhythmic surgery. Lateral thoracotomy was used for implantation in 14 patients and the subxiphoid technique was used in 14. There was no operative mortality and surgical complications were minimal. The longest follow up was 29 months and the average was 14 months. The implanted device correctly identified and reverted 50 episodes of spontaneous malignant ventricular tachyarrhythmias in six hospitalized patients. After discharge, 20 episodes of automatic out-of-hospital resuscitations occurred in eight patients. Kaplan-Meier survival curves, based on the assumption that out-of-hospital defibrillations would otherwise have been lethal, indicated an expected 1 year mortality of 60 percent. Seven deaths were in fact observed in this period for an actual mortality rate of 30 percent. We conclude that automatic defibrillation is clearly feasible in man and appears to increase survival in selected high-risk patients. PMID- 6859414 TI - Carcinoids and the carcinoid syndrome. AB - The many manifestations of carcinoids will continue to puzzle and intrigue surgeons. Because these are dynamic tumors which produce multiple hormones with many potential side effects, an aggressive surgical debulking of them is advocated. Even in the presence of metastatic disease, some long-term survival can be anticipated. The most debillitating aspect of this tumor to the patient is the carcinoid syndrome. The symptoms occur erratically and are often not well controlled by presently available medication. Although metastatic disease present at diagnosis is most commonly seen with jejunoileal carcinoids, colorectal carcinoids appear to be the most lethal tumors. However, they are rarely associated with the symptoms of carcinoid syndrome. Carcinoids may often be associated with other types of tumors, some of which are known to produce their own hormones. Survival of the patients seems to be related to their other tumor type rather than the primary carcinoid. The clinician should be aware of the strong association of carcinoids with peptic ulcer disease. The ulcer diathesis is probably related to ectopic histamine production and can usually be controlled by cimetidine and antacids, although surgical intervention may be required. PMID- 6859416 TI - Postoperative deep venous thrombosis in Japan. Incidence and prophylaxis. AB - The incidence of postoperative deep venous thrombosis was investigated using the iodine-125-fibrinogen method in 256 patients undergoing major surgery. Deep venous thrombosis was found in 49 patients (15.3 percent), and nonfatal pulmonary embolism developed in one of seven patients in whom the thrombus extended to the popliteal vein. The same investigation was performed in 110 patients who wore a graduated compression stocking on one leg, with the other leg serving as a control. Deep venous thrombosis was found in 4 of 110 stockinged legs (3.6 percent) and in 16 of 110 control legs (14.5 percent). The incidence of deep venous thrombosis decreased significantly in patients who wore the stocking. An increase in femoral venous flow velocity was found in the stockinged legs by the Doppler method. The mean velocity of venous return by xenon-133 clearance was significantly greater in the stockinged legs than in the control legs. These findings were considered to support the efficacy of graduated compression stockings for the prevention of deep venous thrombosis. PMID- 6859418 TI - Breaking strength of small intestinal anastomoses. AB - The breaking strength of standardized small bowel anastomoses at different times after surgery was studied in the rat. The anastomotic strength with sutures in place successively decreased during the first 3 postoperative days to approximately 15 percent of the immediate postoperative value. This indicates a rapid decrease in the suture holding capacity of the gut wall in the early postoperative course. From the fourth day onward a rapid increase in strength was recorded. This could be due not only to deposition of collagen in the tissue bridging the anastomosis but also to the regained capacity of the gut wall to withstand tearing forces. After 14 days the strength of the anastomosis was due mainly to healing, and the relative contribution from the sutures was negligible. It may be that tearing of sutures through the tissue is more important than defective healing for anastomotic complications. PMID- 6859422 TI - Isolated cystic dilatation of the cystic duct. AB - Presented was an unusual case of congenital cystic dilatation of the extrahepatic biliary tract in which the cystic changes were confined solely to the cystic duct. There was concomitant common bile duct obstruction secondary to inflammation and mass effect from the cyst. Management consisted of cholecystectomy, excision of the cyst, common bile duct exploration, examination of the ampullary region by duodenotomy, and choledochoduodenostomy. PMID- 6859419 TI - Biliary stricture as a complication of chronic relapsing pancreatitis. AB - To assess our results in the treatment of patients who present with obstructive jaundice due to distal common bile duct stricture after chronic relapsing pancreatitis, 25 patients were seen and operated on for this disease between 1974 and 1981. Our results have demonstrated that provided the diagnosis of the disease is accurate, the management for a large proportion of patients can be simple, safe, and effective. Indeed, choledochoduodenostomy, which has been carried out in combination with either gastrojejunostomy and vagotomy in the presence of duodenal obstruction or with pericystojejunostomy for the treatment of pancreatic pseudocyst, has been shown to be the treatment of choice. PMID- 6859420 TI - Safety of incidental appendectomy. AB - Reports in the surgical literature are conflicting as to whether appendectomy "in passing" during laparotomy for trauma or for some other disease state does or does not significantly increase patient morbidity or mortality. A chart survey of all appendectomies (342 for acute appendicitis and 146 as incidental procedures) performed on the trauma service of Grady Memorial Hospital over a 40 month period appeared to indicate that the wound infection rate (6.8 percent) was the same as that for acute simple or suppurative appendicitis (6.7 percent), whereas the intraabdominal sepsis rate (17.5 percent) paralleled that for more advanced gangrenous or perforative appendicitis (18.6 percent). Since the validity of a retrospective review is always open to question, a prospective, randomized trial was carried out only on patients with a negative abdominal exploration for trauma over a 22 month interval at the same trauma service. An odd second from the last digit hospital number dictated appendectomy, provided the appendix was readily accessible; an even digit in the same locus dictated retention of the appendix. In no patient did intraperitoneal sepsis develop, regardless of the procedure chosen. Wound infection rates were 1.8 percent for appendectomy (1 of 56), if local anatomic considerations precluded an easy appendectomy (0 of 45), and 3.6 percent for the control subjects without appendectomy (3 of 83). There were no deaths. These data cast considerable doubt on the reliability of retrospective reviews and support the generally accepted dictum that incidental appendectomy, especially in the trauma patient, can be a relatively innocuous procedure. PMID- 6859423 TI - Metastatic melanoma presenting as obstructive jaundice with hemobilia. AB - Metastasis of melanoma to gastrointestinal organs are common and have been well documented. Metastasis to the common bile duct with a clinical presentation of obstructive jaundice and hemobilia, as encountered in our patient, is a heretofore unreported clinical problem. This diagnosis was not suspected before operation but was established after a successful pancreaticoduodenectomy. The patient had an uneventful recovery and has shown no signs of recurrence. The causes of obstructive jaundice and hemobilia have been presented and discussed. PMID- 6859421 TI - Spontaneous pneumothorax. AB - Spontaneous pneumothorax in the apparently healthy individual is a reasonably common occurrence. In a military hospital serving a large population in the age range most at risk for this entity, we have gained a wide experience with this problem. A review of our 10 year experience with spontaneous pneumothorax and its surgical treatment has been presented. In our series, a decreased male to female ratio was noted. This may reflect the increased incidence of female smokers. A total of 9.4 percent of our patients had complications of their tube thoracostomy treatment and an additional 10 percent required surgery for resolution of their problem. Our indications for pleural abrasion have been discussed. Pleural abrasion remains our mainstay of surgical therapy for treatment of recurrent spontaneous pneumothorax with acceptable morbidity. PMID- 6859415 TI - Intraoperative ultrasonography for detecting the renal vein during a distal splenorenal shunt procedure. AB - We have used intraoperative ultrasonography to find the left renal vein when performing distal splenorenal shunt procedures in six consecutive patients. Immediate discovery and exposure of the renal vein was possible in all cases. This method prevents unnecessary tissue injury, thus preventing troublesome hemorrhage and lymphorrhea from the retroperitoneum. PMID- 6859417 TI - Rectal trauma. A retrospective analysis and guidelines for therapy. AB - Twenty patients seen at Boston City Hospital required general or spinal anesthesia for rectal injuries, and 17 required laparotomy. Findings on sigmoidoscopy were falsely negative in 4 of 13 patients examined. Diagnosis was delayed in two patients. Associated injuries occurred in 55 percent, with the lower genitourinary tract being the area most frequently injured. Complications occurred in eight patients (40 percent). Abscess formation and bacteremia were the most common, but iatrogenic complications occurred in four patients. Pulmonary embolism occurred in two patients and was suspected in a third patient. Routine treatment included diverting colostomy with distal irrigation and adequate drainage. Repair of the injury was performed when possible. Two of the 20 patients (10 percent) died, one after a prolonged septic course and one from recurrent pulmonary embolism. Rectal trauma continues to be a challenging injury. PMID- 6859424 TI - [Characteristics of the course of pregnancy and labor in adrenal hyperandrogenism]. PMID- 6859426 TI - [Residual manifestations of poliomyelitis and their effect on the course of pregnancy and labor]. PMID- 6859425 TI - [Indices of metabolic processes and their value in the prognosis of the outcome of pregnancy and labor in obese women]. PMID- 6859427 TI - [Role of catecholamines and corticosteroids in body adaptive reactions in acute massive blood loss in labor]. PMID- 6859428 TI - [Clinico-experimental characteristics of uterine contractile activity and fetal status in the process of labor induction by acupuncture]. PMID- 6859429 TI - [Characteristics of uterine contractile function in the preliminary period and the methods for its regulation]. PMID- 6859431 TI - [Fibrinolytic activity of the blood in normal and pathological pregnancies]. PMID- 6859433 TI - [Use of echography for studying the dynamics of uterine involution in the physiological course of the puerperal period]. PMID- 6859435 TI - [Specific pregnancy proteins obtained from human decidua]. PMID- 6859432 TI - [Acid-base status of healthy women during physiological pregnancy]. PMID- 6859430 TI - [Obstetrics injuries to the pelvic symphyses]. PMID- 6859434 TI - [Technic of perineotomy in labor]. PMID- 6859436 TI - [Neurotic states in the early puerperium]. PMID- 6859437 TI - [Characteristics of the lipid composition of the blood serum in the mother, newborn infant and placenta in the physiological course of pregnancy and labor]. PMID- 6859439 TI - The peripheral blood smear in heat stroke. An aid to diagnosis. PMID- 6859438 TI - [Determination of the lymphocytes capable of spontaneous thymidine-3H incorporation in the peripheral blood of women in the dynamics of pregnancy, labor and the puerperium]. PMID- 6859440 TI - Psychosocial factors in the completion of a drug abuse program. PMID- 6859441 TI - The Sparkman Center: a pragmatic concept in public health training in developing countries. PMID- 6859442 TI - The role of health education in meeting international public health needs. PMID- 6859443 TI - Public health training in Peru: the Sparkman Center's initial venture. PMID- 6859444 TI - The international dimension at UAB. PMID- 6859445 TI - The financial pain of chest discomfort. PMID- 6859446 TI - Neurotic excoriators: advantages of an interdisciplinary treatment approach. PMID- 6859448 TI - Perspectives/radiology rounds. Soft tissue mass. PMID- 6859447 TI - Perspectives/medical grand rounds. Hepatitis B virus vaccine. PMID- 6859449 TI - Perspectives/noninvasive cardiology. New trends in permanent cardiac pacing. PMID- 6859450 TI - Organization and activities of local public health department in Alabama. PMID- 6859451 TI - Car restraint activities--1982. PMID- 6859454 TI - Meningitis in patients with sickle cell anemia: normocellular CSF at initial diagnosis. PMID- 6859453 TI - Cost of affiliation: menace or myth? PMID- 6859452 TI - The creation of the Cystic Fibrosis Research Center from research lab to the clinic. PMID- 6859455 TI - Terminating chemotherapy: another stage in coping with childhood leukemia. AB - As physicians become increasingly capable of managing the physical aspects of cancer, the psychological responses of patients and their families take on growing importance. The present study sought to assess the psychological experience of parents whose leukemic children are finishing chemotherapy. Nineteen mothers and one father of children whose chemotherapy had been discontinued were interviewed. The results suggested that negative reactions including anxiety and fears relating to relapse may be a normal emotional response. This paper discussed aspects of the experience of caring for a leukemic child that contribute to this fear and anxiety and possible ways of easing parents' discomfort. PMID- 6859456 TI - Attitudes and practices of families of children in treatment for cancer. A cross cultural study. AB - A follow-up study was made of the prevalence of the use of unproven treatment methods by families of children being treated for cancer at UT M.D. Anderson Hospital. Information was also obtained about parental attitudes toward conventional and alternative treatments and their understanding of them, as well as the physicians' awareness of the use of alternative treatments. Cross-cultural comparisons were made to assess the differences between Hispanics and Anglos in their perceptions of treatment. Sixty-six parents responded to questionnaires (34 Anglo, 30 Hispanic, and two others), and the results in terms of prevalence of use were comparable to those obtained in an earlier study (less than 10%) at the same institution, as well as to those recently reported by investigators at another institution in northwestern U.S. No parents reported the use of Laetrile. Significant differences were found between the Anglos and Hispanics in their perceptions of the treatment administered at the hospital. A significant number of parents expressed a desire for more information from their physicians about all types of treatment. This study serves as a pilot project for a nationwide, multihospital study to be conducted in 1982. PMID- 6859457 TI - Effect of subcutaneous desferrioxamine on iron balance in young thalassemia major patients. AB - In this study we evaluated the effect of 1-year, subcutaneous desferrioxamine daily infusion on iron balance in 23 thalassemia major children, aged 8-74 months, with transfusional iron accumulation less than 3.8 g at the outset of the trial. Statistical analysis showed a significant correlation between transfusional iron accumulation and percentage of transfusional iron eliminated. Confidence limits analysis of these data indicated that over 3.5 g of transfusional iron load, 95% of the patients may achieve balance. The appropriate time to begin desferrioxamine infusion, therefore, seems to be after about 30 transfusions of packed red blood cells when iron accumulation of approximately 3 g is reached. As we found a statistically significant correlation between transfusional iron eliminated and serum ferritin levels, the evaluation of serum ferritin alone can also predict when balance can be obtained. PMID- 6859458 TI - Severe congenital hypoplastic anemia. Transmission from a healthy female to opposite sex step-siblings. AB - Congenital hypoplastic anemia (CHA) is a rare entity characterized by selective depression of erythropoiesis. The disease was first described in 1938, in four patients reported by Diamond and Blackfan, followed by a number of longitudinal studies and reviews of approximately 175 well-documented cases and/or unpublished records. The typical patient presents in infancy (median 1 month of age) with pallor. In as many as 30% of the patients there is an inconsistent pattern of congenital anomalies of the heart, integument, musculoskeletal system, and kidneys. Although its congenital nature is firmly established, the pathophysiology is still unknown, and it is likely that there are multiple biochemical or cellular defects producing the same clinical syndrome. That the disease is genetically determined is suggested by some cases accompanied by congenital anomalies, by racial differences--only a few blacks and one Asian have been described--and by multiple occurrences in some families. The number of such families is small, and the mode of inheritance appears inconsistent. The purpose of this report is to emphasize the apparently variable genetics of a disease which is undoubtedly variable in its clinical expression. We describe the unique occurrence of CHA in half-siblings of opposite sex, both with moderately severe disease, transmitted by a healthy female. PMID- 6859459 TI - Secondary syphilis. Clinical morphology and histopathology. AB - Twenty-four biopsy specimens of skin were taken from 23 patients with several types of lesions of secondary syphilis. In macular and maculopapular lesions, the histological changes were not specific. No or few plasma cells were observed in specimens at this stage. In early papular lesions, the histological appearance was more diagnostic. A lymphohistiocytic bandlike infiltrate was present in the upper part of the dermis and extended around blood vessels of the deep plexus. In nearly two-thirds of the cases, plasma cells were present in early papular lesions. The epidermis, too, was frequently involved in these lesions of the disease. In late papular lesions, the pathologic features were distinctive. The infiltrate was dense, diffuse, and, in some instances, nearly completely plasmocytic. In nummular syphilides, many neutrophils were present in a hyperplastic epidermis, whereas in corymbiform lesions, the epidermis was not involved at all. PMID- 6859460 TI - A tongue is stayed, a scream is stifled. PMID- 6859461 TI - Onycholysis in psoriatic nails. PMID- 6859462 TI - Wayward words. PMID- 6859465 TI - Forensic dermatopathology. An introduction. PMID- 6859463 TI - Chronic infection with cutaneous herpes simplex in a patient with systemic lupus erythematosus. AB - A 68-year-old black woman with systemic lupus erythematosus being managed by systemic corticosteroids developed large ulcerated lesions in a dermatomal distribution on the flank and abdomen. Subsequently, large ulcers developed progressively in the perianal region, the buttocks, the perivaginal region, and the thighs. The clinical diagnosis was vasculitis of systemic lupus erythematosus. Biopsy from the margin of an ulcer showed changes in the epidermis that are specific for infections by herpesvirus. Electron microscopy revealed viral particles of herpesvirus. Cultures from the perianal lesions grew Herpesvirus hominis. This is the first report to our knowledge of "chronic cutaneous herpes infection" in a patient with systemic lupus erythematosus. PMID- 6859464 TI - Is a pathologist liable for a dermatologist's mistake? PMID- 6859467 TI - [Audiometric study of retarded children]. PMID- 6859466 TI - [Evoked auditory potentials in geriatrics]. PMID- 6859468 TI - [Meniere's vertigo. III. Relative frequency of the various symptoms and other clinical aspects deduced from a statistical study of standardized clinical histories]. PMID- 6859469 TI - [The esophageal speaker and his new life]. PMID- 6859470 TI - The monitor of the future? PMID- 6859471 TI - Postoperative dreaming. A comparison of the incidence following pentazocine and morphine premedication. AB - The incidence of postoperative dreaming following the use of morphine and pentazocine as premedicants in an otherwise standard anaesthetic sequence is compared in healthy volunteers. No statistically significant difference was demonstrated between the two drugs. The causes of psychotomimetic problems in the postoperative period and the difficulty of precise definition of hallucinations are discussed. PMID- 6859474 TI - The application of cricoid pressure. An assessment and a survey of its practice. AB - A simple test rig was developed to assess the force applied during the application of cricoid pressure. Anaesthetists and paramedical personnel familiar with Sellick's manoeuvre were tested yielding results which indicate an unacceptably wide variation in performance in each group. The mean force was 46.4 N but 47% failed to reach a force of 44 N. In addition a survey was undertaken of trained anaesthetic staff to identify the current status of the manoeuvre. Of those sampled 78% routinely employed Sellick's manoeuvre and over 70% had experienced a problem with its application which exposed the patient to the risk of regurgitation. PMID- 6859473 TI - The radiological characteristics of bronchopleural fistula following pneumonectomy. PMID- 6859472 TI - Pituitary cryoablation. The results of treatment using a transphenoidal cryoprobe. AB - Pituitary ablation by the injection of alcohol through a transphenoidal needle has been practised for a number of years. In order to reduce the complications resulting from the spread of alcohol to neighbouring structures, a cryoprobe has been constructed which can be passed up through the needle into the gland and a series of localised lesions produced. The degree of pain relief is as good if not better than that obtained with alcohol. Only one instance of temporary blurring of vision resulted and hormonal disturbances were not seen. No difference was observed between the results obtained from the treatment of hormone-dependent and hormone-insensitive tumours. Pain caused in one patient by a benign tumour was unsuccessfully treated. PMID- 6859475 TI - The determination of an effective cricoid pressure. AB - A study of cricoid pressure was undertaken to relate the applied cricoid force with the resulting intraluminal cricopharyngeal (or oesophageal) pressure. The results indicate that whilst there was a wide range in normal adults a cricoid force of 44 N was judged to be effective in protecting the majority of adult patients from regurgitation. PMID- 6859476 TI - Emergency extracorporeal oxygenation for an intratracheal foreign body. PMID- 6859478 TI - Bypassing a problem airway. AB - A case of cancrum oris is described. Airway control was difficult at three different stages of treatment. The use of transtracheal ventilation allowed the problem airway to be bypassed on each occasion, avoiding the dangers of blind nasal intubation, tracheostomy and guided intubation techniques. PMID- 6859477 TI - The urinary catheter as a bronchial blocker. AB - Two cases are described in which problems with double lumen bronchial tubes occurred during thoracic surgery. A urinary catheter inserted down one lumen of each of the tubes enabled one lung anaesthesia to be continued without disturbing the surgery. This technique should be considered before abandoning one lung anaesthesia in those few cases where double lumen tubes fail to function as desired. PMID- 6859479 TI - Restricted spread of analgesia following epidural blood patch. Case report with a review of possible complications. AB - A complete restriction of upward spread of local analgesic solution in the epidural space is reported in a patient who three years earlier had received an epidural blood patch for post-spinal headache. Organisation of the blood clot with fibrous tethering of the dura to the wall of the spinal canal is suggested as the most likely cause of this apparent obstruction to spread. Other potential complications of epidural blood patch are presented. It is concluded from the literature on the subject that there is a need for a multi-centre analysis of the factors which might influence the incidence of inadvertent dural tap with an epidural needle. PMID- 6859480 TI - Recessive dystrophic epidermolysis bullosa. The anaesthetic management of a case for major surgery. PMID- 6859481 TI - Rapid and safe withdrawal of intravenous papaveretum after prolonged continuous infusion. AB - A case is reported in which papaveretum was administered to a patient by continuous intravenous infusion for 60 days. Complete and rapid withdrawal of the narcotic analgesic at the end of that period, despite a massive established daily requirement, was relatively simple and apparently safe. Aspects of narcotic analgesic dependence as they pertain to the case are discussed and the prolonged administration of intravenous opiates with greater confidence by clinicians involved in the intensive therapy of similar patients is suggested. PMID- 6859482 TI - Pituitary cryoablation. AB - Transphenoidal ablation of the pituitary gland by the injection of alcohol is used for the relief of wide-spread cancer pain. A technique is described in which a cryoprobe is passed through a transphenoidal needle and a number of lesions produced within the gland. It is suggested that this method of pituitary ablation may prove to be as effective but accompanied by fewer complications than the injection of alcohol. PMID- 6859483 TI - Unilateral computerised tomography guided coeliac plexus block: a technique for pain relief. AB - Twelve patients have undergone unilateral coeliac plexus block using needle localisation by computed tomography and the technique is described. Computed tomography has the advantage that the needle route to the coeliac axis can be accurately planned, avoiding damage to other organs. In this study nine out of twelve patients had significant pain relief. Most success was achieved in patients with carcinoma of the pancreas. PMID- 6859484 TI - Pentazocine-induced pulmonary oedema. PMID- 6859485 TI - Etomidate-overdose by continuous infusion. PMID- 6859486 TI - Spinal cord injuries. PMID- 6859487 TI - Anaesthesia in first-degree atrioventricular block. PMID- 6859488 TI - Early recognition of a possible Althesin reaction. PMID- 6859489 TI - Surgery under regional analgesia with narcotics as single agents. PMID- 6859490 TI - The 'induction' dose of thiopentone. PMID- 6859491 TI - Anaesthesia for carcinoid syndrome. PMID- 6859492 TI - Anaesthesia for pharyngolaryngectomy with extrathoracic oesophagectomy and gastric transposition. PMID- 6859493 TI - [Effect of surgery and anesthesia on the plasma catecholamine level and rate of urea production in severely burned patients]. AB - The influence of anaesthesia and operation on plasma catecholamine level (Group A) and on the production of urea (PU) (Group B) was investigated in two groups of severely burned patients. Plasma catecholamine levels increased at every operation. The increase of noradrenaline however was always higher than that of adrenaline. The elevation of NA in operations performed during the first week was significantly higher than in all later operations. The production of urea (PU) was chosen as a parameter of protein catabolism. The PU was measured on the day before the operation, on the operation day and on the 1st, 2nd and 3rd postoperative day. The highest mean values of the PU could be found on the 2nd and 3rd postoperative day, but the increase was less than expected. There was no difference in plasma catecholamine levels in PU between the different methods of anesthesia. The advantages and disadvantages of the methods of anaesthesia studied are discussed. PMID- 6859494 TI - [Spontaneous motility of the human taenia coli under morphine, thiopental and dehydrobenzperidol]. AB - Intestinal dysfunction is well known after narcotic analgesics and anaesthetics. The site and extent of this action is not really known in man. We investigated the direct effect of morphine, thiopentone and droperidol on human taenia libera in vitro. The spontaneous motility of strips of fresh resected human taenia libera induced by a suitable preload was observed by isometric measurement of developed tension. Cumulative doses of morphine 1 X 10(-8) - 3.89 X 10(-6) g/ml, thiopentone 2.5 X 10(-6) - 9.75 X 10(-5) g/ml or droperidol 2.5 X 10(-8) - 9.72 X 10(-6) g/ml were added to the bath solution. The following parameters were analysed: amplitude, frequency and performance (Montevideo Units MU) of the spontaneous contractions and also the basal tone between contractions. Morphine showed no effects. Thiopentone reduced basal tone to 45.5% of the initial value and frequency to zero. The amplitude of contractions and the MU decreased with thiopentone more than 22.5 X 10(-6) g/ml. All effects are reversible. Droperidol has no significant effects with the exception of a light increase of frequency in high doses. The well known in vivo effect of morphine is therefore not induced by direct action on the smooth muscle of human intestine. Thiopentone in high dose can reduced intestinal motility by direct action on the smooth muscle. Droperidol in the dose used is probably without clinical relevance. PMID- 6859495 TI - [Recovery after ketamine-diazepam and thiopental-fentanyl-infusion anesthesia with jet-ventilation for laryngomicroscopy]. AB - Using two infusion anaesthesiamethods for laryngomicroscopy in 187 non-selected patients we studied the recovery phase with the aid of a special questionnaire filled in by the recovery room nurse. Premedication was with Thalamonal and atropine. Muscle relaxation was achieved by a succinylcholine drip. Induction doses: fentanyl 0.05-0.1 mg and thiopental 3-5 mg/kg bodyweight (Th-group) or diazepam 10-20 mg and ketamine 1 mg/kg bodyweight (K-group). Infusion doses: Thiopental 11.7 mg/min. (Th-group) or diazepam 0.2 mg/min. and ketamine 2 mg/min (K-group). Anaesthesia lasted for 20-30 min. We observed and noted during recovery: Breathing, cough-frequency and -quality, alertness, reaction to speech and stimulation, orientation, motor behaviour and well-being. Anaesthesia was sufficient in both groups. The patients of the K-group woke up earlier and their laryngeal reflexes seemed to stabilize quicker than in the Th-group. Because of the elevation of blood pressure caused by the stimulation of the laryngoscopy both methods are not recommended for patients at risk from high blood pressure. PMID- 6859496 TI - [Cyanosis as a result of drug-induced methemoglobinemia. A case report]. AB - A 39-old, anaemic woman, admitted to hospital because of a fistula between bladder and bowel, developed a moderate degree of methaemoglobinaemia (19% of total haemoglobin) after prescription of 3 X 200 mg/die phenazopyridine (Pyridium) for 4 weeks. She showed a greyish discoloration of the skin; lips and nailbeds were cyanosed. On the basis of a glucose-6ph-dehydrogenase deficiency (71 mU/10(9) RBCs instead of 131 +/- 13 mU/10(9) RBCs - the normal value for adults) the medication with phenazopyridine induced methaemoglobinaemia. The coincidence of anaemia (8.7 g/dl Hb) and methaemoglobinaemia (19%) caused mild signs of hypoxia (fatigue, headache, feebleness and dyspnoea on exertion). PMID- 6859498 TI - [Anesthesiological care in a field hospital in Thailand with special regard to ketamine (Ketanest)]. AB - From mid-May to mid-July 1980, 363 anaesthesias were carried out in the refugee camp Khao I Dang on the border between Thailand and Kambodia. These were done in a tropical climate under difficult conditions. The patients were refugees, mostly injured in the war. Regional anaesthesias were generally preferred as they are safer for the patients and not so much surveillance is necessary. For general anaesthesia ketamine combined with diazepam and in most cases assisted respiration by a combination of nitrogen oxide - oxygen and halothane were selected. Anaesthesia was induced by thiopental or diazepam on patients with eclampsia or head injuries or toxic goitre. Apart from a laryngospasm no other severe complication occurred. To reduce pain after an operation, ketamine infusion was successfully employed in isolated cases. PMID- 6859499 TI - [Continuous thoracic peridural anesthesia for intra- and postoperative analgesia]. PMID- 6859497 TI - [Effect of anesthesia and surgery on the postoperative course in multiple sclerosis]. AB - Multiple sclerosis is the most frequently occurring neurologic disease in our area. The common opinion is that a stress situation such as a surgical procedure or general anaesthesia may lead to an amelioration of this disease. No really convincing evidence exists to support this opinion. The observation of the postoperative course of two patients, who underwent a total of three surgical procedures under general anaesthesia suggests a short-lived temporary deterioration of their symptoms. An amelioration of the disease however was not observed. PMID- 6859500 TI - [Clinical experiences with a new infusion system]. AB - Fifty samples of an infusion system with a spherical drop chamber were tested and were found to function normally. The system's greatest advantage is that it can be applied in any position when used with flexible containers with pressure cuffs. While complications certainly are possible, they can be avoided. The system is particularly suitable for use in emergencies outside the clinic and while transporting patients. PMID- 6859501 TI - [Glycopyrrolate (Robinul), a new anticholinergic substance]. AB - Glycopyrrolate is a quaternary ammonium compound with indications for use similar to those for atropine. Because of the quaternary nature, it is poorly absorbed when taken orally and penetrates neither placental nor blood-brain barriers. When given by the parenteral route, the cardio-vagal blocking action of glycopyrrolate is twice that of atropine while inhibition of salivation is 5-6 times greater. The use of glycopyrrolate for premedication provides a therapeutic margin 2-3 times wider than that of atropine. Glycopyrrolate administered with neostigmine to antagonise the residual neuromuscular blockade of non-depolarising relaxants has advantages over atropine because the pharmacodynamic profile is more suited to that of neostigmine. The abrupt changes in cardiac rate, therefore, become minimal. If glycopyrrolate, 5 micrograms/kg-1, is injected intravenously just before the induction of anaesthesia, severe bradycardia is inhibited when repeated doses of succinylcholine are used. Although the alkalinising effect on gastric secretions has not been substantially verified, glycopyrrolate does provide long lasting bronchodilatation from its blocking action on smooth muscle. Only a few studies with glycopyrrolate in children have yet been published. However, it appears that this drug provides no real advantages over atropine when used in paediatric anaesthesia. PMID- 6859503 TI - Plasma lignocaine concentrations following topical laryngeal application. AB - Lignocaine 4%, 4 mg/kg, was sprayed onto the larynx and subglottic area of 96 children aged from 2 weeks to 12 years and plasma lignocaine concentrations were measured. While the majority were well within the accepted safe range (4.5 micrograms/ml) occasional concentrations over 8 micrograms/ml appeared in all groups. Simultaneous arterial and venous sampling showed a small but significant difference in the first 10 minutes. PMID- 6859502 TI - Plasma bupivacaine concentrations in children during caudal epidural analgesia. AB - Plasma bupivacaine concentrations were measured in 45 children, whose ages ranged from 4 months to 12 years, following administration of caudal epidural analgesia. Using 3 mg/kg of bupivacaine 0.25%, mean blood levels of 1.2-1.4 microgram/ml were reached, which are well within the limits of projected toxic levels. Simultaneous arterial and venous sampling showed a small but significant difference between these two sampling sites fo the first fifteen minutes. PMID- 6859504 TI - Postoperative analgesia for haemorrhoid surgery. AB - Seventy patients undergoing haemorrhoidectomy under general anaesthesia were randomly allocated to one of five treatment groups in order to compare the effectiveness of various caudal agents in the control of postoperative pain. Four groups were given a caudal injection of either 2% lignocaine, 0.5% bupivacaine, 2% lignocaine + morphine sulphate 4 mg or normal saline + morphine sulphate 4 mg, while the fifth (control) group did not receive an injection. The number of patients requiring postoperative opiates was significantly higher in the lignocaine group than in the morphine (p less than 0.05) and morphine-lignocaine (p less than 0.05) groups. No agent significantly reduced the number requiring opiates. In those who received opiates, the mean analgesic period was 228 minutes in the control group, and was significantly longer following bupivacaine (577 min, p less than 0.01), morphine-lignocaine (637 min, p less than 0.05) and morphine (665 min, p less than 0.0). The mean analgesic period following lignocaine (349 min) was not significantly different from control. The incidence of catheterisation was lowest in those patients who did not receive caudal analgesia. PMID- 6859505 TI - An evaluation of body temperature measurement. AB - The accuracy of routine body temperature measurements, the suitability of various sites for such measurements, and the performance and practicality of various temperature measuring devices were studied. Oral and axillary temperature measurements made by the nursing staff were within 1 degree C of a reference value (within 0.5 degree C in 67%). Both sites were suitable for routine ward temperature measurement. Mercury-in-glass thermometers are recommended for routine ward use. Electronic and disposable chemical thermometers cost more but the latter are suitable in uncooperative patients and children. Forehead skin temperature measurements using liquid crystal plastic discs were unreliable. Pulmonary artery and rectal temperature measurements were satisfactory in operating theatre and intensive care unit; however, electronic thermometers should be subjected to routine checks. The bladder temperature measuring device proved unsuitable for clinical use. When oesophagus, nasopharynx and tympanum sites are used careful placement is necessary to minimise trauma and obtain reliable measurements. PMID- 6859506 TI - The management of headache following accidental dural puncture in obstetric patients. AB - The progress and management of fifty-eight obstetric patients who received an accidental dural puncture is described. Headache attributable to dural puncture occurred in 85% of patients managed conservatively. Epidural infusion or repeat epidural bolus injections of saline after delivery reduced the incidence to 65%. A therapeutic autologous blood patch using 8-10 ml of blood was performed in 28 patients at least 24 hours after the accidental puncture. Dramatic and permanent relief occurred in 75% following this procedure. A repeat blood patch was effective in four patients and ineffective in the remaining two. Mild and temporary back stiffness and one case of moderately severe radicular pain for three days were the only complications noted after the procedure. The pathophysiology and treatment of dural puncture headache is reviewed. Reduction of pressure differential across the dural puncture site is most useful in the first 24-48 hours. Persistent and severe headache occurring after this should be treated with blood patch. PMID- 6859507 TI - Femoral nerve block--the anatomical basis for a single injection technique. AB - A technique for blocking the femoral nerve using a single needle placement is described. It depends on an appreciation of the anatomy and the need to feel loss of resistance twice as two fascial layers are penetrated during insertion of the needle just lateral to the femoral artery. A single injection of bupivacaine 0.35 0.5 per cent of at least 0.3 ml/kg will produce a satisfactory block. PMID- 6859508 TI - Neurolytic lumbar sympathetic blockade: a modified technique. AB - A modification of the traditional method of lumbar sympathetic blockade is described. A semi-prone patient position, combined with vertical X-ray screening, are employed to facilitate determination of the level and angle of needle insertion. PMID- 6859509 TI - The effects of lignocaine spray on the laryngeal mucosa of the cat. AB - The laryngeal mucosa of cats which had been treated with a lignocaine aerosol spray prior to endotracheal intubation was examined histologically. A degree of oedema and cell damage was apparent. When one side of the larynx was sprayed before intubation and the other side protected in the same cat, cellular damage was greater on the side which received the lignocaine spray. In no cat were the changes considered severe enough to constitute a post-anaesthetic hazard. PMID- 6859511 TI - Tracheo-oesophageal fistula caused by blunt chest injury. PMID- 6859510 TI - Failed intubation in a patient who had previously undergone jaw fixation. PMID- 6859512 TI - Cholinesterase deficiency. PMID- 6859513 TI - Throat packing in oral surgery. PMID- 6859514 TI - Boyle's machine. PMID- 6859515 TI - Safety device or patient hazard. PMID- 6859516 TI - Pyogenic granuloma of the vocal cord. PMID- 6859518 TI - Histone fractionation by high-performance liquid chromatography. AB - A method for the rapid chromatography of histones by high-performance liquid chromatography (HPLC) using a reverse-phase mu Bondapak C18 column containing a packing of octadecylsilane chemically bonded to silica and a linear elution gradient running from water to acetonitrile is described. Two conditions were found to be necessary to achieve histone fractionation: (i) silylation of the active groups of the silica solid support, and (ii) trifluoroacetic acid (TFA) in the eluting solvents. Greater than 90% of the total [3H]lysine-labeled protein applied to the column was eluted from the column. The fractionation of the histones appears to be based on the hydrophobic properties of the proteins. The HPLC histone fractions (identified by their electrophoretic mobilities) were eluted from the column in the following order: H1, H2B, (LHP)H2A, (MHP)H2A + H4, (LHP)H3, and (MHP)H3 (where LHP and MHP refer to the less hydrophobic and more hydrophobic histone variants). Phosphorylated histone species were not resolved from their unmodified parental species. The volatile nature of the water/acetonitrile/TFA eluting solvent facilitated the recovery of salt-free histones from the eluted HPLC fractions by simple lyophilization. This system is very useful for the rapid isolation of the lysine-rich histones, H1 and H2B, and the variants of histone H3. With further development, this system is expected to extend the advantages of HPLC to the fractionation of histone H4 and the variants of histone H2A as well. PMID- 6859517 TI - Ca2+-binding proteins: a comparative study of their behavior during high performance liquid chromatography using gradient elution on reverse-phase supports. AB - Reverse-phase high-performance liquid chromatography has been shown to be applicable to the isolation of Ca2+-binding proteins, specifically parvalbumins, from tissue extracts or from preparations first purified by "conventional" chromatography. Through an investigation of the behavior of a series of Ca2+ binding proteins as a function of buffer composition, pH, and organic eluant it has been possible to define mild conditions allowing for chromatography of the proteins in their native states. The elution positions of parvalbumins were not observed to correlate with the "overall" protein hydrophobicity, calculated using hydrophobicity values for the individual amino acids, thus indicating that factors such as hydrophobic/hydrophilic surface areas are important in determining the degree of association with the support. The usefulness of reverse phase chromatography as an analytical tool for determining protein homogeneity is illustrated. Samples which had been isolated via "conventional" chromatography methods, and thought to be homogeneous, were observed to contain multiple species of the same protein. PMID- 6859519 TI - An improved method for isolation of the C-terminal fragment of proteins. AB - An efficient and easily realizable method for the isolation of the C-terminal fragment is described. Proteins are esterified by methanolic HCl and subsequently digested with pepsin. The peptide mixture is submitted to paper electrophoresis in pH 2.1 buffer. The identification of the C-terminal peptide is performed by preparing a guide peptide map, using pH 5.5 buffer in the second dimension. The C terminal fragment appears as an on-diagonal spot. It can be isolated by a pH 5.5 run of the corresponding band from the first (pH 2.1) electrophoretogram. Since the C-terminal peptide is the fastest moving component, there is no need for its further purification. The expected yield is about 40%. PMID- 6859520 TI - A critical reappraisal of Waddell's technique for ultraviolet spectrophotometric protein estimation. AB - Waddell's method of estimating protein concentration by the difference between spectrophotometric absorptions (215-225 nm) has been reexamined. Over limited ranges of total protein, a linear relation was found for ten purified proteins; the narrowest range was between 5 and 25 micrograms/ml. Using published extinction coefficients at 280 nm for these ten proteins, protein concentration at 280 nm correlated closely with the 215 nm/225 nm difference measurements (mean difference of 2.6%). Waddell's method also accurately determined the total protein in a mixture of proteins with widely varying individual 280-nm extinction coefficients. Biuret estimates of total protein in plasma or serum gave poor correlation with measurements by Waddell's method. Within protein concentration limits, Waddell's method was linear, narrow, and more variable, both for individual proteins and for protein mixtures, than previously reported. Within these limits, the method is probably as accurate a measure of total protein as measurement by nitrogen analysis, with the advantage of being nondestructive. PMID- 6859522 TI - Measurement of biosynthetic rates and intracellular transit times for a cell surface membrane glycoprotein, alkaline phosphatase in HeLa cells. AB - The techniques for measurement of biosynthetic rates and intracellular transit times of an integral membrane protein isoenzyme have now been validated. Thus, induction of placental alkaline phosphatase in cultured HeLa cells by prednisolone and by butyrate is shown to result in its increased biosynthesis as measured by uptake of [35S]methionine into immunoprecipitated cell-surface placental alkaline phosphatase. The cell-surface placental alkaline phosphatase is liberated from the cells by proteolytic cleavage by bromelain, which results in a decrease of the placental alkaline phosphatase subunit mass from 64,000 to 62,000 daltons. The time of transit of new placental alkaline phosphatase molecules from their ribosomal site of synthesis to their terminal cell-surface, bromelain-sensitive site is approximately 55 min. This system may be useful in studies of regulation of intracellular protein processing and transport to the cell surface of proteins destined to become integral membrane proteins. PMID- 6859521 TI - An analytical method for the selective retrieval of iminobiotin-derivatized plasma membrane proteins. AB - An analytical method for the selective retrieval of surface plasma membrane proteins which have been covalently "tagged" with the low-molecular-weight ligand 2-iminobiotin has been developed. Retrieval is based upon the specific interaction between the 2-iminobiotin molecule, avidin, antiavidin antibody, and insoluble protein A from Staphylococcus aureus. Conditions for the reaction include moderately basic pH (8.0-9.0) and moderately high ionic strength (300 mM NaCl). The retrieval reaction is insensitive to 4% (w/v) Triton X-100, NP-40, and Lubrols PX and WX and is inhibited by octyl-beta-D-glucopyranoside and Ammonyx LO. Large numbers of samples can be processed quickly and simultaneously. Immunoprecipitated proteins can be readily released into solution by incubation in the presence of either low pH, biotin, or sodium dodecyl sulfate. PMID- 6859523 TI - Anomalous electrophoretic migration of oligodeoxynucleotides with terminal -OH groups: applications for DNA exonuclease characterization. AB - Oligodeoxynucleotides with a terminal -OH group on both the 5' and 3' ends migrate anomalously in 23% polyacrylamide-7 M urea gels. This migration anomaly can be exploited to characterize nuclease digestion products. Thus, using specific substrates and the methods described, several types of DNA exonuclease activity can be readily distinguished. PMID- 6859524 TI - Validity of the continuous spectrophotometric assay of Kalckar for adenosine deaminase activity. AB - Both adenosine and inosine obey Beer's law to 1.0 mM at 265 nm and pH 7.4 at 25 degrees C. Murphy et al. (1) claimed serious deviation from Beer's law above 200 microM for both substances, and concluded that the assay of adenosine deaminase activity based on recording spectrophotometric change at 265 nm as originally suggested by Kalckar produces anomalous results. The data herein presented show that this is not so, and that the large number of published studies of adenosine deaminase activity assayed by this method are indeed valid and should not be dismissed as artifactual as suggested by Murphy et al. PMID- 6859525 TI - Ion-exchange high-performance liquid chromatography of oligodeoxyribonucleotides using formamide. AB - The superiority of buffer systems containing formamide for the ion-exchange high performance liquid chromatographic separation of oligodeoxyribonucleotide mixtures generated in solid-phase syntheses is illustrated. The resolutions achieved are compared to those achieved with the same mixtures in other eluting solvents. The use of formamide systems is recommended for oligodeoxyribonucleotide purification in general and is particularly valuable where the oligonucleotide of interest is highly self-complementary and/or rich in deoxyguanosine residues. PMID- 6859527 TI - Improved methods for calculating formation constants for nucleotide--cation complexes. AB - Two data reduction methods that can be used to calculate formation constants for nucleotide-cation complexes are described. Both methods are used to analyze data obtained by an anion-exchange resin method, and either method can improve the accuracy of the calculated formation constants by more than 50%. The key to this significant improvement in accuracy is the realization that the equation for the mathematical model describing such systems is always nonlinear in terms of the formation constants and, in the general case, is higher order in the cation concentration. There are two major reasons for the improved quality of the results associated with the new model. First, successive linear extrapolations are eliminated, and error propagation is reduced. Second, all of the data are used for the simultaneous calculation of all formation constants, and the uncertainty due to random experimental errors is minimized. PMID- 6859528 TI - Barbiturate N-demethylase activity in isolated rat hepatocytes. AB - The isolated hepatocyte preparation has become an increasingly popular system for studying xenobiotic metabolism, and there is a need for methods of determining metabolic activity. Described here is a simple and sensitive radiometric assay for barbiturate N-demethylase activity in the isolated hepatocyte suspension. The demethylation of 1,3-dimethylphenobarbital is determined by measuring the formation of its only significant metabolite, N-methylphenobarbital. The reaction is a typical P-450-mediated dealkylation. PMID- 6859529 TI - Electrophoresis of small proteins in highly concentrated and crosslinked polyacrylamide gradient gels. AB - A high concentration (40%) of acrylamide plus N,N'-methylenebisacrylamide combined with a high level of crosslinking (12.5%) yielded clear gels capable of restricting the passage of small proteins. This gel composition was chosen in preference to other combinations, in particular those producing opaque gels which have larger pore sizes and which provide a reduced sieving effect. Gradient gels were prepared in which the gel concentration rose from 3 to 40% and the degree of crosslinking increased from 4 to 12.5%. Such gels were suitable for fractionating crude, unreduced, and uncharacterized extracts containing proteins ranging in molecular size from 10,000 to several million daltons under conditions where all proteins are retained on the gel even after prolonged electrophoresis. The gels yielded zones which were of improved sharpness and resolution compared with gels of lower concentration and degree of crosslinking, and can be used to provide an estimate of molecular size. Examples of the use of HX gradient gels included both anodic and cathodic electrophoresis at pH 8.3 and 3.1, respectively, of serum and cereal-grain proteins and a partial enzymic hydrolysate of serum albumin. PMID- 6859526 TI - A multichannel fraction-collection system designed for the use in DNA-damage studies via the alkaline-elution technique. PMID- 6859530 TI - A versatile apparatus for electrophoresis including isoelectrofocusing and its performances. AB - A new versatile electrophoresis apparatus with a circulating cooling plate for analytical, preparative, and two-dimensional electrophoresis, including isoelectrofocusing, was designed and constructed. The apparatus consists of six main separable blocks and two removable bar electrodes. Each block in the apparatus usually has more than two roles and can easily be assembled with paper clips. Various combinations of the blocks and electrodes enable one to assemble not only an apparatus for horizontal (flat-bed), vertical slab, disc gel, and preparative electrophoresis, but also preparative isoelectrofocusing. PMID- 6859531 TI - Applications of high-performance liquid chromatography to the characterization of the interactions of heparin with antithrombin III and thrombin. AB - A rapid method for differentiating active heparin from inactive components by high-performance liquid chromatography is described. Additionally, the procedure allows for the distinction of heparin fractions with different molecular weights. The methodologies were extended to investigations on the effects of heparin in the interaction between thrombin and antithrombin III. The product formed in the presence of heparin has a characteristic retention time that is ascribed to the binding of heparin to the protein-protein complex. PMID- 6859534 TI - A simple method for the estimation of amino groups on insoluble matrix beads. AB - A method for the determination of free amino groups on solid supports is proposed. The method is based on the reaction of the matrix with excess 2,4,6 trinitrobenzenesulfonic acid (TNBS) and subsequent quantitative determination of unreacted TNBS by reaction with glycine. The method is simple and reproducible and does not require the solubilization of the matrix, therefore proving suitable even for crosslinked insoluble supports. PMID- 6859532 TI - A latex agglutination test for lectin binding. AB - Blood group A + H substance purified from hog gastric mucin was fixed to polystyrene particles by physical absorption to produce a lectin-agglutinable latex. Agglutination of this latex by soybean agglutinin, concanavalin A, and wheat germ agglutinin is specifically inhibited by the respective monosaccharide haptens and is not affected by known noninhibitory sugars. The sensitivity of the assay, a function of particle loading and latex concentration, approaches that of the hemagglutination test. NaCl, NaHCO3, NH4CO3, NH4-acetate, and Tris-HCl up to a concentration of 1 M do not interfere with the test. The latex suspension is stable for several months and can be stored in freeze-dried form. PMID- 6859533 TI - Rapid polyacrylamide slab drying using a microwave gel dryer. PMID- 6859535 TI - Activated carbon beads for the removal of highly albumin-bound species. AB - Activated carbon beads in which 5% activated carbon powder was embedded in 4% agarose were prepared by the emulsion technique. The column of the beads was demonstrated to effectively remove salicylic acid, warfarin, and long-chain fatty acids from solutions containing albumins by either zonal or frontal analysis under the condition of 0.1 M NaCl, pH 3.0 (HCl). The beads were also demonstrated to purify a commercial human serum albumin preparation from residual fatty acids. The beads would be of value in many biochemical purification processes in which activated carbon is employed. PMID- 6859536 TI - Fluorimetric determination of carbamoyl phosphate. AB - A simple fluorimetric assay for the determination of carbamoyl phosphate in tissue extracts is described. In the assay, production of ATP from carbamoyl phosphate and ADP by carbamate kinase is coupled to the formation of NADPH, using glucose, hexokinase, NADP+, and glucose-6-phosphate dehydrogenase. Production of NADPH in this system proved to be equal to the amount of carbamoyl phosphate present. PMID- 6859537 TI - Dry reagent chemistries in clinical analysis. PMID- 6859538 TI - Determination of chlorinated pesticides in urine by molecular neutron activation analysis. PMID- 6859539 TI - Determination of bromine in blood serum by epithermal neutron activation analysis. PMID- 6859540 TI - Breath analysis by atmospheric pressure ionization mass spectrometry. PMID- 6859543 TI - Dividing and newly produced cells in the corpus callosum of adult mouse cerebrum as detected by light microscopic radioautography. AB - New cell production in the corpus callosum and subependyma of 4 month old mice was analysed by light microscopic radioautography after 3H-thymidine injections. In the subependymal region of the lateral ventricle, about 10% of cells were labeled in mice examined 2 h after 3H-thymidine, and 40 to 50% of cells were labeled after 7 d of isotope infusion. In corpus callosum of mice 2 h after precursor injection, the few cells (0.1 to 0.2%) that were labeled had the appearance of "immature cells", and were presumably incompletely-differentiated neuroglial precursor cells which were preparing to divide. After 7 d of continuous 3H-thymidine administration, more labeled neuroglia (about 2%) were detected in corpus callosum; these newlyproduced cells included several astrocytes and some oligodendrocytes, as well as immature cells. Since the immature cells were the most frequently observed type of dividing cell within the normal adult corpus callosum, it is probable that the new astrocytes and oligodendrocytes were the products of divisions of their respective precursor cells. PMID- 6859542 TI - Sympathetic innervation at the apex of the cat's canine tooth - a quantitative analysis. AB - Superior cervical ganglia were removed unilaterally from 6 adult cats. 2 animals were sacrificed at 2, 4 and 7 d and the innervation of the canine apex examined quantitatively. The number of non-myelinated axons was lower on the operated side 4 and 7 d after sympathectomy. The number of degenerating axons was always greatest on the operated side and highest 2 d after operation. By combining the proportion of axons lost with those in the process of degenerating it is estimated that between 4.8 and 12.5% of the axons (52-88 axons) entering the apex of the cat's canine are sympathetic. Degenerating axons were often within the same Schwann cell as intact, presumably sensory, axons and were sometimes in contact with them. This contact may be the anatomical basis for the modulation of nociceptive input by sympathetic activity. PMID- 6859541 TI - The relationship of proteoglycans to developing transalveolar fibres in the alveolar bone of the mouse. AB - Proteoglycans are of interest because of their complex role in the development and maintenance of connective tissues. The present study demonstrates changes in the distribution of proteoglycans in the developing alveolar bone of the mouse using techniques of light and high-voltage electron microscopy. In early development proteoglycans are uniformly distributed throughout the interdental septum. By day 25 there is a loss of proteoglycans, probably as a result of mineralization and the maturation of the collagen of transalveolar fibres. By day 45 proteoglycans are distributed only in tissues adjacent to transalveolar fibres. These proteoglycans occupy the channels surrounding transalveolar fibres and the adjacent bone matrix. It is proposed by the authors that these proteoglycans are involved in the maintenance of the collagen of the transalveolar fibres. Because of the absence of fibroblasts adjacent to transalveolar fibres, proteoglycans are thought to be essential carriers of tropocollagen to these large fibres. PMID- 6859544 TI - Prenatal loss in the rat following moderate consumption of alcohol incorporated in a liquid diet. AB - The teratogenic potential of alcohol in humans has now been confirmed, and a characteristic pattern of anomalies (Fetal Alcohol Syndrome) is found in infants born to mothers who are chronic alcoholics. The pathogenesis of the fetal alcohol syndrome is unclear: very little is known about the way alcohol acts during pregnancy and alters fetal growth and morphogenesis. The objective of this investigation was to determine the effects of a widely used ethanol liquid diet in the pregnant rat. The ethanol liquid test diet is based on the Lieber-De Carli formula. 20 Sprague-Dawley rats were matched closely by weights and assigned in pairs to either an alcohol treated or a pair-fed control group. Control animals received the same amount of the liquid diet with maltose-dextrins substituted isocalorically for the ethanol. Graduated tubes were used for the oral delivery of the diets. Ethanol was gradually introduced into the diet as follows: 100 Kcal/l, days 1-2; 200 Kcal/l, days 3-5; 350 Kcal/l, days 6-12. Following this initial treatment period, all animals were then given rodent pellets and tap water ad libitum. The mothers showed no overt signs of gross toxicity. The mean maternal weight gain of the ethanol treated animals did not differ significantly from the controls. The incidence of fetal resorptions was increased, intrauterine growth was not affected and the offspring at term appeared normal. The results indicate that moderate alcohol consumption during early gestation in the rat led to significant prenatal loss but proved to be non-teratogenic. PMID- 6859545 TI - The normal peak of electromyographic activity of the quadriceps femoris muscle in the stair cycle. AB - The quadriceps femoris muscles of 18 subjects with no history of knee joint pathology were analysed climbing stairs. Temporal data was obtained from bilateral contact closing footswitches. Knee joint data was measured using a specially constructed flexible linkage-bar electrogonimeter. Electromyographic activity was obtained from bipolar Beckman surface electrodes placed on four components of the quadriceps femoris, vastus medialis oblique, vastus medialis longus, vastus lateralis and rectus femoris. Results showed that within the stair cycle, stance occupied 60% and swing 40%. Cadence values were greater during descending than ascending stairs. Joint angle data demonstrated 2 changes in direction of the angular motion of the knee joint in both ascending and descending. Electromyographic analysis identified a peak of EMG activity for each component of the quadriceps femoris in both ascending and descending stairs. Results identified the location of peak EMG activity at specific knee joint angles. The quadriceps components also demonstrated a regular sequence of recruitment. EMG amplitude levels obtained were higher in ascending than descending stairs. The results have clinical implications in the design of lower extremity prostheses and in the application of functional electrical stimulation. PMID- 6859546 TI - Ultrastructural observations of the fetal rat heart during prolonged gestation. AB - The ultrastructure of myocardial cells was examined from fetal rat hearts during experimentally induced prolonged gestation (GD 23, 24 and 25), and compared to those from term fetuses (GD 22) and newborn animals (N1, N2, N3). Gestation was prolonged by daily subcutaneous injections of 5 mg progesterone to gravid females on days 20 through 24. The 4 chambers of the heart were assessed individually for structural differences by morphometric analysis. Comparison between the 2 atria at each stage revealed no differences as was the case between the 2 ventricles. At term and throughout the newborn period, atrial and ventricular cells were characterised by numerous mitochondria, moderate amounts of glycogen, few lipid droplets and membrane-bounded granules, which, moreover, were peculiar to atrial tissue. During prolonged gestation (GD 24 and 25), there was a statistically significant increase in the size of mitochondria in both atria and ventricles and a reduction of membrane-bounded atrial granules. Whole heart glycogen content was also assessed, biochemically, and found reduced on GD 24 and 25. In addition to the morphological and biochemical findings, fetal rat heart weights were obtained from each designated day of prolonged gestation and compared to newborn rat hearts of comparable age. A statistically significant increase in heart weight was noted on GD 24. Meconium staining, which is indicative of fetal distress was also observed on GD 24 and 25. The morphological and biochemical changes observed suggest a response by the fetal heart to stressful conditions, namely hypoxia and hypoglycemia, which are known to exist during prolonged gestation. PMID- 6859547 TI - [Morphometric and histochemical studies of the masticatory muscles in growing white rats following ligation of the right common carotid artery]. AB - White Wistar rats served for examinations to the masticatory muscles after ligature of the a. carotis communis dextra on the 42nd d after birth. Gravimetric determinations of the dry substance of the muscles were performed in a total of 229 animals. In 65 animals casts of the vessels in synthetic resin (Kallocryl M) were made and the inside diameters of the blood vessels of the corresponding vascular regions measured. Histological, histochemical and muscle-fibre morphometric observations of the masticatory muscles were made in 10 animals. Due to processes of adaption the a. carotis communis sinistra with an enlarged cross section supplied the head with an increased blood volume. However, the anatomical and physiologic conditions of the collateral blood vessels conveying blood to the right side of the head prevented the entry of same share of blood into that side. Obviously there is a causal connection between this circumstance and the reduction in the dry substance of the right-side masticatory muscles. Histologic investigations revealed an increase in the capillaries by 10 percent in the animals operated on. The reduction in the diameters of the muscle fibres on the right side of the head was accompanied by a change in the normal combination of fibre types. 2 out of 5 animals which had been operated on showed a fairly homogeneous distribution of the fibre types in the masticatory muscles. Fibres of type 2 tended to be more vulnerable than fibres of type 1. Pathogenetically, the reduction in the dry substance of muscles and the reduction in the diameters of the muscle fibres are caused by nutritive disturbances in connection with restricted circulation. The neuronal-trophic sphere and the mechanism which is responsible for the differentiation of the muscle-fibre types seem to be affected as well. The myokinetic synapses are not affected. PMID- 6859548 TI - The anatomical basis for the inguinal hernia. AB - The inguinal regions of 100 adult cadavers were dissected. 20 male cadavers had inguinal hernia. The pubic arch was in a low position in 80 percent of the cases, a very large percentage and much greater than in any other population. The origin of internal oblique muscle from the inguinal ligament was away from the pubic tubercle and its lower fibres did not cover the deep inguinal ring in the indirect inguinal hernia cases. Most of the inguinal hernias were noticed on the right side. PMID- 6859549 TI - [Weight growth of the tunny (Thunnus thynnus) as a function of time and length]. AB - Weight growth according to the dates of SELLA (1929) was first investigated by Kruger (1973) with the Gompertz-, Bertalanffy- and Reciprocal Function. Results showed significant differences due to the lack of values after 14 years of the tunny's development. In this contribution the work of Kruger is carried on based on a much broader scale of growth functions with infinite or restricted time of weight increase. Moreover relations between the length and original and modified weights are established giving results seldom obtained in such unity with other species. PMID- 6859550 TI - [Topochemistry of aminopeptidase A (angiotensinase A) in the kidney cortex of the golden hamster]. AB - The localization of aminopeptidase A (APA; E.C. 3.4.11.7) in the kidney cortex of the golden hamster was demonstrated by histochemical means (simultaneous azo coupling technique; alpha-L-Glu-MNA as substrate and HNF as coupling agent). APA was shown in the renal corpuscle (mainly podocytes and epithelium of the Bowman's capsule), the brush border of the proximal tubule, the perivascular tissue and some peritubular capillaries.--The demonstration of APA in the perivascular tissue of the juxtaglomerular apparatus (JGA) appears to have bearing on the regulation of angiotensin effects in the JGA for APA is an angiotensin degrading enzyme. PMID- 6859551 TI - Association of centromeric heterochromatin with the nucleolus in mouse Sertoli cells. AB - In adult Sertoli cells of most strains of mice, all the centromeric heterochromatin is condensed in two chromocenters, one on each side of a single, large nucleolus. In a random-bred Swiss OF-1 strain, however, the nucleus has a different structural organization. Part of the heterochromatin Is seen as chromocenters in contact with the nucleolus; the rest of it is dispersed in granules of unequal size in the nucleoplasm. Such an unusual spatial arrangement of heterochromatin in interphase nucleus cannot be explained either by a difference in the nucleolar organizing regions or by a polymorphism of the C banding of metaphase chromosomes. PMID- 6859552 TI - Spermatogenesis in the vasectomized monkey: quantitative analysis. AB - The seminiferous epithelium in mature vasectomized Macaca fascicularis was examined quantitatively to assess spermatogenesis. Monkeys were bilaterally vasectomized and controls were bilaterally sham operated. At postoperative periods of 10 and 18 months, groups of monkeys were castrated and their testes prepared for morphologic analysis. Diameters were measured in 100 cross sections of seminiferous tubules from each animal. Numbers of spermatogonia (Ad and Ap), preleptotene spermatocytes, pachytene spermatocytes, and step 7 spermatids, relative 10 Sertoli cell nucleoli, were counted in stage VII tubules. Tubule diameter and germ cell numbers per Sertoli cell nucleoli were not altered by vasectomy. Our study demonstrates quantitatively that spermatogenesis in the monkey is not inhibited up to 18 months following vasectomy. PMID- 6859553 TI - Organization and structure of branches in the rat pulmonary arterial bed. AB - Pulmonary arteries were fixed by perfusion under constant pressure and filled with rubber. The hardened rubber cast delineated the arterial bed, permitting dissection of axial vessels and all branches. Each segment was prepared for scanning electron microscopy and transmission electron microscopy. Branches arising at acute angles from the axial artery and the first two generations of its branches, regardless of diameter, had the same concentric muscle layer structure as parent vessels. Endothelial cells of the parent vessel were oriented into the ostia of these branches. Branches that came off the axial vessel or its branches at right angles had spiral muscle bundles and led to nonmuscular precapillary vessels. Right angle branches also had similar wall structure regardless of diameter. Near the ostia of right angle branches, endothelial cells of the parent vessels did not show orientation of their long axis into the branch lumens. It was concluded that branch arteries arising at acute angles are conduit which carry blood to distant parts of the lung while right angle branches are a histologically different group which distribute the blood to local capillary beds. PMID- 6859554 TI - Freeze-fracture studies of neonatal mouse incisors. AB - Differentiation of preodontoblasts to odontoblasts and preameloblasts to ameloblasts during development of the mouse mandibular incisor proceeds in a gradient from the area of the odontogenic organ, where undifferentiated ectomesenchymal and epithelial cells proliferate, toward the incisal tip where mature tooth tissues, dentin and enamel, are present. The freeze-fracture technique has been used in the work presented here to study cell membrane ultrastructure of preodontoblasts and preameloblasts at several stages of differentiation. At early stages of differentiation, cuboidal preameloblasts are joined together distally by numerous gap junctions. Relatively fewer junctions occur elsewhere on the lateral plasma membranes, but gap junctions frequently occur proximally between preameloblasts and stratum intermedium cells. As differentiation proceeds and the cells become columnar, distal and proximal junctions persist. Tight junctions, however, were not observed at any of the stages studied. Intramembrane particle concentration of the lateral preameloblast plasmalemma appears to increase as differentiation proceeds. Odontoblasts are also joined distally by numerous gap junctions which persists through later stages of differentiation. Although odontoblast cell processes were observed to project toward the preameloblast layer, no clear points of cell to cell contact or defined intercellular junctions between the two cell types were observed. PMID- 6859555 TI - Quantitative assessment of neural development in human premolars. AB - The number of nerve fibers entering a tooth gives an indication of the tooth's capacity to perform a sensory function. Nerve fiber development was quantitated from cross sections of the apical portions of 49 erupted human premolars at various stages of root development and in subjects up to 71 years of age. Neural development was incomplete in immature teeth, greatly variable in young mature teeth, and complete in older teeth. Myelinated axons changed in number but not in size during tooth development. There were significantly fewer myelinated axons in teeth with open and parallel apical foramina than in older teeth. Unmyelinated axons did not change significantly in number with development but fewer large axons were found in older teeth. The number of unmyelinated axons enclosed in a single boundary lamina tended to be lower in older teeth. As a physiologic correlate, threshold responses to electrical stimulation were also determined prior to premolar removal. Threshold stimulation decreased significantly with apical foramen maturation. A significant negative correlation was found between the threshold stimulus and the number of myelinated axons in fully developed teeth, but not in immature teeth. PMID- 6859556 TI - Suppression of adrenal cortical growth and differentiation in fetal rats exposed to dexamethasone. PMID- 6859557 TI - Autoradiographic location of sensory nerve endings in dentin of monkey teeth. AB - We have used the autoradiographic method to locate trigeminal nerve endings in monkey teeth. The nerve endings were labeled in two adult female Macaca fascicularis by 20 hours of axonal transport of radioactive protein (3H-L proline). We found a few labeled axons in contralateral mandibular central incisors and one mandibular canine. In ipsilateral teeth, numerous myelinated and unmyelinated axons were labeled; they formed a few terminal branches in the roots but primarily branched in the crown to form the peripheral plexus of Raschkow and to terminate as free endings in the odontoblast layer, predentin, and as far as 120 micrometers into dentinal tubules. Electron microscopic autoradiography showed that the radioactive axonally transported protein was confined to sensory axons and endings; odontoblasts and dentin matrix were not significantly labeled. Labeled free nerve endings were closely apposed to odontoblasts in dentin but did not form distinctive junctions with them. Nerve endings were most numerous in the regular tubular dentin of the crown adjacent to the tip of the pulp horn, occurring in at least half of the dentinal tubules there. Reparative dentin was poorly innervated, even near the tip of the crown, and it had a different tubular structure and adjacent pulpal structure from the innervated dentin. Radicular dentin was not innervated in most areas but did contain a few labeled axons where the predentin was wide and the odontoblasts were columnar, as at the buccal and lingual poles of some roots. Our results show tha dentinal sensory nerve endings in primate teeth can be profuse, sparse, or absent depending on the location and structure of dentin and its adjacent pulp. When dentin was innervated, the tubules were straight and contained odontoblast processes, the predentin was wide, the odontoblast cell bodies were relatively columnar, and there was an adjacent cell-free zone and pulpal nerve plexus. PMID- 6859559 TI - Na-tartrate in the treatment of chronic nonbacterial prostatitis. AB - In an open investigation 20 patients with a history of chronic abacterial prostatitis (24 month duration) and of multiple therapies were treated by 0.07 0.15/kg Na-tartrate. Na-tartrate, a known inhibitor of the prostatic fraction of acid phosphatase in laboratory studies, was given orally for 12 weeks after dissolution in fluids and well tolerated. 13 patients completed the study and 3 spermiograms at 6 weeks interval were performed. 11/13 patients demonstrated increased sperm count (44.5 +/- 26.4 leads to 55.06 +/- 34.7) elevated seminal prostatic phosphatase (727 +/- 114.7 leads to 810.8 +/- 55.7) and improved seminal testosterone (2.86 +/- 1.6 leads to 4 +/- 1.4) while seminal y-GT was not significantly changed. Polyamine excretion showed a distinct elevation for putrescine 17.7 +/- 5.3 leads to 28.5 +/- 6.8. Clinically the 11 from 13 patients presented with marked improvement in a 4 months follow-up. PMID- 6859558 TI - Study on human spermatozoal motility: preliminary report on newly developed multiple exposure photography method. AB - We have developed a multiple exposure photography (MEP) method for objectively evaluating the spermatozoal motility. The semen specimen placed in a 10-microns chamber was photographed through the phase-contrast microscope. Light pulses were generated with the aid of a multipulser using a xenon stroboscope (pulse interval: 160 msec., exposure: 1 sec.). In the photomicrographs, motile spermatozoa produced images of six-ringed chains, while nonmotile spermatozoa appeared as brighter images which clearly visualized spermatozoa from the head to the tail. When 30 semen specimens from fertile males were analyzed 1 hour after their collection, the mean spermatozoal concentration was found to be 79 x 10(6) per ml the mean rate of motile spermatozoa 39.7% and the mean spermatozoal velocity 29.3 microns per sec. The rate of motile spermatozoa estimated by the MEP method (39.7%) was lower than that estimated by the direct observation method (60% or more) by ca. 20%. The MEP method enables concurrent accurate estimation of the spermatozoal concentration, the rate of motile spermatozoa and the velocity of individual spermatozoa. PMID- 6859560 TI - Unconjugated 5 alpha-androstan-3 alpha, 17 beta-diol and 5 alpha-androstane-3 beta, 17 beta-diol in normal and pathological human seminal plasma. Comparison with testosterone, 5 alpha-dihydrotestosterone and testosterone-glucosiduronate. AB - By means of specific RIA unconjugated 5 alpha-androstan-3 alpha, 17 beta-diol (3 alpha-diol) and 5 alpha-androstane-3 beta, 17 beta-diol (3 beta-diol) have been estimated for the first time in normal and pathological human seminal plasma. Testosterone, 5 alpha-dihydrotestosterone and testosterone-glucosiduronate (T, DHT, TG) have been determined simultaneously. On average a significant decrease of both diols was established in seminal plasma obtained from males suffering from oligozoospermia, azoospermia, asthenozoospermia and teratozoospermia. The decrease of 3 beta-diol was more pronounced. A significant diminution in DHT concentrations was found only in severe oligozoospermia. Significantly lowered concentrations of testosterone were detected in severe oligozoospermia and in teratozoospermia. However, DHT levels in teratozoospermia were found on average within normal ranges. TG exhibited no significant deviations. PMID- 6859561 TI - C-reactive protein in semen and serum of men with chronic prostatitis. AB - Qualitative determination of C-RP in semen and serum of men with and without prostatitis showed that, the protein is present mostly in semen only in cases with prostatitis and with a significantly higher percentage incidence in the infertile than the fertile. PMID- 6859563 TI - Post-coital test in subfertile men. AB - Twenty-two patients with border-line spermiograms (moderate oligoasthenozoospermia or asthenozoospermia) were studied by the post-coital test (PCT) to determinate the behaviour in vivo of semen with modest dysspermia (spermatozoa counts between 10 and 20 million/ml, with 20-40% forward motility). All the female partners were normal morphologically and functionally. The PCT were always carried out when the cervical mucus was favorable (mean score 12.2 12.3) and the endocervical pH was 7.25-7.30. The positive results for the asthenozoospermic semen samples were 6.75% and for the oligozoospermic one 10%, when the classification were based on the W.H.O. criteria. When the semen samples were classified according to Kremer's criteria positive results were found in 37.5% and 40% of the cases respectively. The effects of both cervical mucus properties and pH on the results of the PCT were found to be important. The high percentage of the favorable results emphasizes the usefulness of completing studies of border-line spermiograms with an in vivo test, since it is difficult to define normality and predict the fertility potential from semen examination alone. PMID- 6859562 TI - Between and within subject correlations and variances for certain semen characteristics in fertile men. AB - Between subject and within subject variances and correlations for different semen characteristics have been determined for a population of 315 fertile men who provided one or more ejaculates within an abstinence period of 1 to 5 days. The semen characteristics measured were sperm count, semen volume, pre-freeze motility and post-thaw motility. An approach via a decomposition of the variance or via a decomposition of correlation leads essentially to the same conclusions i.e. the within subject factors are not negligible but are less important than the between subject ones. Thus there is broad evidence for overall differences in the quality of the ejaculate from one subject to the other but not for different ejaculates of the same subject. PMID- 6859564 TI - [Basic questions on andrological appraisals in a court of law. Procreative ability in the past]. AB - In a court of law the andrological appraisal towards the assessment of the procreative ability of a man is concerned with the degree of procreative ability during the legal time of conception (181st to 302nd day prior to the date of birth including both of these days BGB Section 1592). The andrological expert is a servant of the court, not a judge. Each finding deviating from the norm must be controlled at least twice. Preliminary diagnoses must be fully considered. In the case of oligozoospermia manifested at the present point in time, whereby anamnestic data regarding any past sicknesses are lacking, it must be assumed that during the legal time of conception a condition similar to that now detected also existed. This means that the present finding was already in a state of effect in the past. PMID- 6859565 TI - Narcotics are not expected to produce unconsciousness and amnesia. PMID- 6859567 TI - An experimental study of urodynamic effects of epidural morphine and of naloxone reversal. AB - Urinary retention after epidural morphine is a distressing and troublesome complication. This study was undertaken to determine the effects of morphine (epidural, intramuscular, and intravenous) on urinary bladder function and possible reversal by naloxone. Thirty male volunteers (aged 20-28 years) were studied; the doses studied were 2, 4, and 10 mg of epidural morphine, 10 mg intramuscular morphine, and 10 mg intravenous morphine. The urodynamic study consisted of measurements of urine flow rate, strength of detrusor contraction, bladder capacity, and urethral pressure. Irrespective of dose, all subjects receiving epidural morphine showed marked relaxation of the detrusor shortly after injection. There was a corresponding increase in the maximal bladder capacity leading to urinary retention. These effects lasted an average of 14-16 h. Urethral pressures remained unchanged. Urodynamic changes after intramuscular and intravenous morphine were minimal. Treatment using a single intravenous injection of 0.8 mg naloxone promptly reversed the effects of epidural morphine on the bladder. Prevention of urinary retention was achieved with an intravenous infusion of naloxone started before administration of epidural morphine. The possible mechanisms of urinary retention following epidural opiates are discussed. PMID- 6859568 TI - A pharmacokinetically designed etomidate infusion regimen for hypnosis. AB - An etomidate infusion regimen for hypnosis as part of balanced, totally intravenous anesthesia was designed to maintain plasma etomidate concentrations above the awakening concentration of 300 ng/ml while avoiding dose-related side effects. The etomidate infusion regimen of 0.1 mg/kg/min for 3 min, 0.02 mg/kg/min for 27 min, and 0.01 mg/kg/min for the remainder of the anesthesia was used together with intravenous bolus doses of fentanyl, droperidol, and pancuronium. This was evaluated in 11 patients and the kinetics of etomidate were reexamined. The anesthetic technique seemed clinically satisfactory for the infusion periods of 30-109 min. The average time and plasma concentration at the end of the infusion was 59.5 min and 583 ng/ml, at awakening was 9.3 min and 307 ng/ml, and at alertness was 19.5 min and 227 ng/ml. The main difference between the kinetics observed in the present study and those of previous studies is in the elimination clearance. The average plasma elimination clearance of the present study was 1210 ml/min and the whole-blood clearance was estimated to be 1357 ml/min, giving an apparent hepatic extraction ratio of approximately 0.90. The negative correlation of patient mass and elimination clearance normalized for body mass suggests that the terminal infusion should not be adjusted to body mass. PMID- 6859566 TI - Succinylcholine-induced increases in plasma catecholamine levels in humans. AB - Given the hypothesis that interaction of succinylcholine with nicotinic receptors releases endogenous catecholamines, plasma levels of epinephrine and norepinephrine were determined in anesthetized and manually ventilated patients immediately before and 2 min after intravenous administration of succinylcholine. Anesthesia was induced with intravenous thiopental (3-4 mg/kg) followed by the administration of nitrous oxide and oxygen (1:1) and 0.5-1.0% halothane. Stimulation of the patients was avoided. Succinylcholine (1 mg/kg) or metocurine (0.3 mg/kg) was injected intravenously and ventilation was controlled without intubation. Plasma norepinephrine levels increased from 301 pg/ml to 491 pg/ml (SEM = +/- 19 pg/ml, P less than 0.01, N = 5) 2 min after the injection of succinylcholine; the increase in plasma epinephrine was not statistically significant. The time course of catecholamine elevation was studied in three additional patients. The increase of norepinephrine occurred immediately after the injection of succinylcholine, peaked (647 +/- 67 pg/ml) around the third minute, and disappeared by the 10th min. The increase in epinephrine was less marked. Plasma levels of catecholamines did not change after the injection of metocurine (N = 2). The possibility that succinylcholine stimulates nicotinic receptors on the postganglionic sympathetic terminals is discussed. We propose that the elevation of plasma norepinephrine might contribute to the development of early adverse cardiovascular reactions to succinylcholine. PMID- 6859569 TI - Blood pressure response and plasma fentanyl concentrations during high- and very high-dose fentanyl anesthesia for coronary artery surgery. AB - We examined whether different plasma fentanyl concentrations could maintain hemodynamic stability during coronary artery surgery. Two randomly selected groups of 10 patients were studied. Patients in group 1 received a single 75 micrograms/kg intravenous dose of fentanyl; patients in group 2 received the same dose but it was followed by an infusion of fentanyl at a rate of 0.75 micrograms/kg/min. The total dose of fentanyl in group 2 was 162 +/- 6.5 micrograms/kg (mean +/- SEM). At some point during surgery, all 10 patients in group 1 and 7 of 10 patients in group 2 had a hypertensive response. Plasma fentanyl concentrations in the two groups were not significantly different in the period 10-45 min after induction of anesthesia. At 60 min, corresponding to the time of aortic root dissection, mean plasma fentanyl concentration was statistically significantly lower in group 1 than in group 2 (13.5 +/- 1.4 ng/ml and 24 +/- 2.3 ng/ml, respectively, P less than 0.01). However, no significant difference was observed in the frequency of hypertensive response between the two groups in the period before cardiopulmonary bypass. During cardiopulmonary bypass, plasma fentanyl concentrations in group 1 were 2-3 times lower than those in group 2, and hypertension was observed in all 10 patients in group 1 but in only 2 patients in group 2 (P less than 0.05). Patients in group 1 were ventilated for 16.6 +/- 1.5 h, and those in group 2 for 19.1 +/- 1.8 h, postoperatively (P greater than 0.05). Six patients in group 1 required vasodilating drugs, whereas eight patients in group 2 required alpha-adrenergic agonists. Although the plasma fentanyl concentrations achieved were not successful in totally suppressing a hypertensive response, this study suggests that a plasma fentanyl concentration might be attainable to effect this. PMID- 6859570 TI - Epidural morphine for the relief of postoperative pain after cesarean delivery. AB - To determine the safety, efficacy, and dose response of epidurally administered morphine for analgesia after cesarean delivery, 40 healthy women who underwent cesarean delivery with epidural anesthesia were randomly assigned to receive one of four regimens for relief of postoperative pain: intramuscular administration of morphine, 7.5 mg (N = 10); or epidural administration of morphine, 2 mg (N = 10), 5 mg (N = 10), or 7.5 mg (N = 10). Evaluations were made of intensity and relief of pain, time to administration of additional analgesic medications, changes in vital signs and blood-gas tensions, and adverse effects. Intramuscular administration of 7.5 mg of morphine effectively relieved pain for only a short time. When morphine was administered epidurally, 2 mg proved ineffective whereas both 5 mg and 7.5 mg provided substantial pain relief for approximately 24 h. There were no significant changes in vital signs or blood-gas tensions. Side effects included pruritus and nausea, which occurred frequently but were usually mild and easily treated. We concluded that either 5 mg or 7.5 mg of morphine epidurally administered was effective and safe in providing prolonged analgesia after cesarean delivery. PMID- 6859571 TI - Maternal and fetal effects of prophylactic hydration with crystalloids or colloids before epidural anesthesia. AB - Prophylactic intravenous hydration decreases the incidence and severity of hypotension due to obstetric epidural anesthesia. This study assesses whether infusion of normal serum albumin (NSA) offers any advantages over Ringer's lactate (RL) solution. Sixty patients scheduled for elective cesarean sections were divided into three equal groups. Group 1 received 1200 ml of RL; group 2, 700 ml of RL plus 500 ml of 5% NSA; and group 3, 1000 ml of RL plus 200 ml of 25% NSA. In group 1, the concentrations of serum albumin (SA) decreased from 3.5 +/- 0.3 (mean +/- SD) to 3 +/- 0.2 g/dL (P less than 0.01) and plasma oncotic pressure (POP) from 20 +/- 3 to 17 +/- 3 torr (P less than 0.005) immediately after hydration. In group 2, SA remained unchanged, but POP decreased from 21 +/- 2 to 19 +/- 2 torr (P less than 0.005). In group 3, SA increased from 3.6 +/- 0.5 to 3.9 +/- 0.3 g/dL (P less than 0.01) and POP from 19 +/- 2 to 21 +/- 2 torr (P less than 0.0025). Neither SA nor POP levels differed among the groups 24 h later; however, both SA and POP were significantly lower than preinfusion values in all groups at 24 h. The incidence of maternal hypotension, neonatal Apgar scores, and acid-base status also were comparable among the groups (X2 analysis). Because low POP may predispose to postoperative pulmonary morbidity, the incidence of this complication was studied in the mothers by using a point scoring system (based on the presence of symptoms and physical signs) and also by measuring AaDO2 gradients. Neither pulmonary morbidity scores nor AaDO2 gradients differed significantly in the three groups. It is concluded that both crystalloid and colloid prehydration produce equally satisfactory maternal and fetal outcomes. PMID- 6859572 TI - Fiberoptic nasotracheal intubation--incidence and causes of failure. PMID- 6859574 TI - Hazardous anesthesia machine malfunction occurring after routine preventive maintenance inspection. PMID- 6859573 TI - Intraoperative awareness and hypertensive crisis during high-dose fentanyl diazepam-oxygen anesthesia. PMID- 6859576 TI - Hemodynamic monitoring. PMID- 6859575 TI - Localizing the axillary artery. PMID- 6859577 TI - Migration of physicians to and from anesthesiology. PMID- 6859578 TI - Acquired immunodeficiency syndrome (AIDS) and blood products. PMID- 6859579 TI - Inhibition of gamma-aminobutyric acid release from synaptosomes by local anesthetics. AB - The effects of local anesthetics on the synthesis, release, and degradation of gamma-aminobutyric acid (GABA) in rat brains were investigated. The addition of procaine, lidocaine, cocaine, or tetracaine did not alter either glutamic acid decarboxylase (GAD) activity or GABA transaminase (GABA-T) activity in vitro. Neither did the enzyme activities in rats with local anesthetic-induced convulsions differ from control values. Tetracaine inhibited high K+-evoked [2,3 3H]GABA release from synaptosomes of rat brain in a dose-dependent manner with a minimal effective concentration of 10(-4) M. Cocaine, lidocaine, and procaine also reduced the release, although they were less potent than tetracaine. The GABA release inhibitors in order of potency are tetracaine, cocaine, lidocaine, and procaine which correlates well with their relative toxicity as convulsants. These results suggest that local anesthetics reduce GABAergic activities by inhibiting the release of the neurotransmitter from the nerve terminals, and that inhibition of the GABA system may be involved in the mechanism of local anesthetic-induced convulsions. PMID- 6859580 TI - Variations in pancuronium requirement, plasma concentration, and urinary excretion induced by cardiopulmonary bypass with hypothermia. AB - To determine the effects of cardiopulmonary bypass (CPB) and hypothermia on the neuromuscular blockade produced by pancuronium, this relaxant was infused intravenously into 10 anesthetized patients to produce and maintain 90% depression of the twitch tension of the adductor pollicis muscle following supramaximal ulnar nerve stimulation. Infusion rates, plasma concentration of pancuronium, and adductor pollicis temperature were measured every 15 min. During the normothermic period preceding the start of CPB, the pancuronium requirement, the pancuronium plasma concentration, and muscle temperature were mean (mean +/- SEM): 238 +/- 12 micrograms . m-2 . 15 min-1, 0.31 +/- 0.01 microgram/ml, and 33.9 +/- 0.1 degrees C, respectively. At the beginning of CPB, the pancuronium infusion rate increased to 362 +/- 32 micrograms . m-2 . 15 min-1 (P less than 0.001) despite a decrease in the muscle temperature to 29.2 +/- 0.9 degrees C (P less than 0.001) and in pancuronium plasma concentration to 0.22 +/- 0.02 microgram/ml. During sustained muscle hypothermia to 28.3 +/- 0.4 degrees C the pancuronium plasma concentration remained constant at 0.22 +/- 0.01 micrograms/ml (P less than 0.001) while the requirement decreased to 94 +/- 15 micrograms . m-2 . 15 min-1 (P less than 0.001). After the muscle temperature was returned to 34 +/- 0.6 degrees C, the plasma pancuronium concentration and requirements increased to 0.35 +/- 0.05 microgram/ml and 392 +/- 32 micrograms . m-2 . 15 min 1 (P less than 0.001), respectively. After CPB, these values were 0.39 +/- 0.04 microgram/ml and 239 +/- 25 microgram . m-2 . 15 min-1. These results demonstrate that pancuronium requirements are increased at the beginning of CPB because of circulatory volume changes and again during rewarming of the patient once muscle temperature reaches about 34 degrees C. PMID- 6859581 TI - Dose-response suppression of noxiously evoked activity of WDR neurons by spinally administered fentanyl. AB - The present study examined the influence of spinally administered fentanyl on the spontaneous and noxiously evoked activity of wide dynamic range (WDR) neurons in the dorsal horn of decerebrate, spinal cord-transected cats. This work was performed in order to evaluate the dose-response relationship, time course, and naloxone reversibility of fentanyl suppression of neurons that are involved with the transmission of information about pain. Extracellular single neuron recordings were obtained from 18 WDR neurons in the lumbar enlargement. These neurons were activated by a radiant heat stimulus on the footpads of the hindpaw. Fentanyl (10, 15, 25 micrograms in 0.5 ml of physiologic saline) was placed on the spinal cord following control studies of each neuron and the effect was observed. In 12 cats, 31 min after fentanyl administration, naloxone (0.1 mg) was administered intravenously, and its effect on the fentanyl suppression was determined. All three doses of fentanyl suppressed both the spontaneous and evoked activity of all the neurons studied. Thirty minutes after fentanyl the mean evoked activity was reduced to 47, 23, and 11% of control values by 10, 15, and 25 micrograms, respectively. The spontaneous activity was reduced to similar levels. Intravenous naloxone (0.1 mg) caused a significant reversal of the fentanyl suppression. The results of the present study indicate that fentanyl causes a naloxone-reversible, dose-dependent suppression of noxiously evoked WDR neuron activity. Such results support the concept that fentanyl is acting through a specific drug-receptor interaction. The onset of neuronal suppression occurred more rapidly, and the duration of the suppression was longer following fentanyl than that seen following spinal morphine. The onset and duration of this suppression correlates well with human clinical data, providing further evidence that alterations of WDR neuronal activity may be important in the production of spinal opioid analgesia. PMID- 6859582 TI - Hypothermia and barbiturates: individual and combined effects on canine cerebral oxygen consumption. AB - Following establishment of total spinal anesthesia, the cerebral metabolic effects of progressive hypothermia (37, 28, 18, and 14 degrees C) were studied initially in six awake dogs. The EEG became isoelectric at temperatures below 18 degrees C. At 14 degrees C, CMRO2 was reduced to 7% of control. Thereafter, 40 mg/kg thiopental, iv, was given and the dogs were rewarmed while an isoelectric EEG was maintained by a continuous thiopental infusion. The CMRO2 was then compared at the different temperatures with and without thiopental. The CMRO2 was unaffected by the barbiturate at 14 and 18 degrees C. At 28 and 37 degrees C the CMRO2 was significantly reduced by the barbiturate (at 37 degrees C to 55% of the 37 degrees C value without thiopental). The change in CMRO2 with temperature in the absence of EEG activity (due to barbiturates) closely approximated an Arrhenius curve (relating log CMRO2 to the reciprocal of absolute temperature). In the presence of EEG activity (no barbiturates) such a simple relationship was less apparent. The results support the following conclusions: barbiturates only affect CMRO2 in the presence of neuronal electrical activity; the combined effect of hypothermia and barbiturates on CMRO2 cannot be expressed as a simple additive relationship; and in the presence of electrical activity, the relationship between temperature and CMRO2 cannot be defined by any simple mathematical function. PMID- 6859584 TI - Pharmacokinetic aspects of epidural morphine analgesia. AB - Twenty patients undergoing thoracotomy were given 2, 4, or 6 mg morphine epidurally in a double-blind, randomized study for postoperative analgesia. Administration at T12-L1 or L1-L2 resulted in a dose-related analgetic duration (514 +/- 118 min, 778 +/- 207 min, and 938 +/- 155 min; means +/- SEM, respectively, for the groups). For the three groups, peak plasma morphine concentrations (range 19-34 ng/ml) were reached within 15 min. The plasma curves had a similar appearance as after an intramuscular injection and pharmacokinetic calculations showed an elimination half-life (mean +/- SEM) of 173 +/- 24 min, 200 +/- 60 min, and 213 +/- 57 min for the groups, respectively. The morphine concentrations in the CSF were considerably higher compared with plasma (45-100 times the plasma concentration at 1 h, 100-250 times at 3 h, and 125-175 times at 5 h) but the elimination half-life of morphine in the cerebrospinal fluid (CSF) was similar to that in plasma. The lumbar approach was used with similar efficacy as reported for thoracic administration. Side effects were few and nonsignificant. The authors conclude that epidural morphine administration results in a dose-dependent analgesia, as well as concentrations in the CSF that are considerably higher than in plasma. With similar elimination half-lives for morphine in CSF and plasma, the long analgetic duration probably depends on the locally high morphine concentrations achieved. For safety purposes, one may use the lumbar approach to the epidural space even for thoracic pain without reducing the efficacy. PMID- 6859583 TI - Relationship between cerebral blood volume and CSF pressure during anesthesia with halothane or enflurane in dogs. AB - Cerebral blood volume (CBV) and intracranial pressure (ICP) were examined in dogs during 3.5 h anesthesia with halothane (0.8%) or enflurane (2.2%), and after decreasing the concentration of halothane to less than 0.1% or enflurane to less than 0.2%. As compared with animals breathing N2O and O2, halothane (0.8%) increased CBV 11-12%, while ICP remained increased (4-5 cmH2O) for 3.5 h. Both at 0.8% and less than 0.1% ICP correlated positively with changes in CBV. Enflurane (2.2%) increased CBV by 8-10%, and while ICP correlated with changes in CBV during the initial 30 min, ICP increased independently of CBV thereafter. PMID- 6859585 TI - Potentiation of succinylcholine phase II block with isoflurane. AB - To determine the effect of isoflurane upon phase II block 20 patients were given succinylcholine by infusion at a rate which maintained the twitch tension of the adductor pollicis muscle at 10% of control for 2 to 4 h. The patients were assigned randomly to either nitrous-oxide-isoflurane (0.75-1.5% inspired) or nitrous-oxide-fentanyl for maintenance of anesthesia, and neuromuscular activity was monitored using train-of-four stimulation. Tachyphylaxis to succinylcholine was observed in both groups but this was followed, in the isoflurane group but not in the fentanyl group, by a decrease in succinylcholine requirement. This decrease was related to the extent of phase II block present. It is concluded that isoflurane potentiates succinylcholine phase II block although the mechanisms involved are not necessarily the same as in the potentiation of nondepolarizing neuromuscular blocking drugs. PMID- 6859587 TI - Attenuation of fentanyl-induced truncal rigidity. PMID- 6859588 TI - Acute pulmonary embolism during therapeutic arterial embolization with silicone fluids. PMID- 6859590 TI - Appraisal of epinephrine administration to patients under halothane anesthesia for closure of cleft palate. PMID- 6859586 TI - Comparison of isoflurane and halothane safety margins in rats. AB - In rat experiments, the dose-effect curves for three different end points of anesthesia [loss of righting reflex (RR), prevention of movement (PM), and heart rate response (HR) to noxious stimuli] and for the lethal effect (LE) due to cardiovascular depression were determined with isoflurane and halothane. The obtained data were used to calculate LD50/ED50 ratios and standard safety margins (SSM) for assessment of each agent's safety. It was found that isoflurane provides an equal degree of separation between dose-effect curves for different end points of anesthesia as halothane does. However, isoflurane provides greater margins of safety. The margin between the highest of anesthetic doses--the loss of HR response--and the lethal dose for isoflurane was twice that for halothane (LD50/HR ED50 4.3 vs. 2.2, P less than 0.01). The standard safety margin for the loss of HR response was also greater with isoflurane (142 vs. 43, P less than 0.05). These results agreed that isoflurane may provide greater cardiovascular safety for anesthesia than halothane does. PMID- 6859589 TI - Pulmonary barotrauma resulting from a faulty Hope II resuscitation bag. PMID- 6859591 TI - Ammonia toxicity resulting from glycine absorption during a transurethral resection of the prostate. PMID- 6859593 TI - Dinamap adaptation for neonatal blood pressure determination. PMID- 6859592 TI - High-dose fentanyl for neuroanesthesia. PMID- 6859594 TI - Permanent paralysis of the accessory nerve after cannulation of the internal jugular vein. PMID- 6859595 TI - Potentially fatal machine fault. PMID- 6859596 TI - Yet another machine fault. PMID- 6859599 TI - Anesthesia and neuroradiology: considerations regarding metrizamide. PMID- 6859598 TI - Pulmonary artery catheters in Eisenmenger's syndrome: many risks, few benefits. PMID- 6859600 TI - Neutralizing capacity of particulate antacids. PMID- 6859597 TI - Technique is the critical variable. PMID- 6859602 TI - Intraoperative somatosensory-evoked potentials. PMID- 6859601 TI - A not so apparent cause of intraluminal tracheal tube obstruction. PMID- 6859603 TI - A lung model for testing respiratory quotient measurements. PMID- 6859604 TI - Beware of sharp edges in metal endotracheal tubes. PMID- 6859605 TI - Bupivacaine cardiotoxicity in a pregnant patient with mitral valve prolapse. PMID- 6859606 TI - Cerebral cortical extracellular fluid H+ and K+ activities during hypotension in cats. AB - Cerebral cortical blood flow, electrical activity, and extracellular fluid (ECF) pH and K+ ion activities were measured in anesthetized cats (0.7% halothane 65% N2O in O2) subjected to hypotension (mean BP 30-32 and 26-28 mmHg), induced by either practolol and trimetaphan (TMP) or practolol and nitroprusside (NTP). Limited blood withdrawal was also necessary to achieve these blood pressure (BP) levels. Cerebral cortical blood flow during hypotension was greater with NTP than with TMP, and hyperemia occurred in the recovery phase after NTP but not TMP. Electrical activity also was maintained better with NTP. ECF K+ increased in five of six TMP experiments but in only one of six NTP experiments. Values of K+ greater than 15 mM were only seen in the TMP group. Release of K+ into the ECF space occurred at values of cerebral cortical oxygen delivery below 3 ml 100 g-1 min-1. ECF K+ partially recovered after the end of hypotension in all except the experiment with the highest value. A progressive and severe cerebral acidosis was seen in all experiments during induced hypotension, and values below pH 6.50 were present at the stage of K+ increase in the ECF space. It is concluded that the ability of cell membranes in the cat's cortex to maintain normal ionic gradients is depressed by hypotension to these levels with TMP, but not with NTP, and that this difference is related to better-maintained oxygen supply values during NTP hypotension. PMID- 6859607 TI - Effect of thiopental induction on sympathetic activity. AB - Several recent studies with different anesthetic agents have reported increases in plasma norepinephrine concentration during induction. To determine if induction with intravenous injection of thiopental also is associated with initial sympathetic activation, 24 ASA class I patients were assigned randomly to receive one of the following anesthetics: Group I, thiopental 3 mg/kg, iv, followed by inhalation of 100% oxygen and a continuous intravenous infusion of thiopental 0.2-0.3 mg X kg-1 X min-1; Group II, thiopental 3 mg/kg followed by inhalation of halothane (1.5% end-tidal concentration) in oxygen; and Group III, thiopental 3 mg/kg followed by inhalation of 70% nitrous oxide in oxygen. After thiopental injection, ventilation was controlled to maintain PCO2 near control levels. In Group I, plasma norepinephrine concentration decreased with continued administration of thiopental. This decrease became statistically significant (P less than 0.05) 10 min after injection. Plasma epinephrine concentration did not change. For Groups II and III, both plasma norepinephrine and epinephrine concentration did not change. For Groups II and III, the stability of the catecholamine concentrations during induction may have been caused by the circumvention of the second stage of anesthesia, equal depression of both inhibitory and excitatory synapses, or the combined effects of the agents. Regardless of the cause, the use of a modest induction dose of thiopental appears to allow the induction of anesthesia without sympathetic activation. When it is important to prevent sympathetic activation, administering a modest dose of thiopental before the inhalation of halothane or nitrous oxide may be preferable to inducing anesthesia with inhalation agents or narcotics alone. PMID- 6859608 TI - The cerebral metabolic effects of isoflurane at and above concentrations that suppress cortical electrical activity. AB - The effects of 1.4-6.0% end-expired isoflurane on cerebral metabolism and hemodynamics were examined in dogs. A dose-related decrease in cerebral oxygen consumption (CMRO2) occurred until there was suppression of cortical electrical activity as reflected by the onset of an isoelectric electroencephalogram. This occurred at an end-expired concentration of 3% isoflurane when the mean CMRO2 was 2.02 ml X 100 g-1 X min-1. Thereafter, increasing concentrations of isoflurane to 6% had no further effect on the CMRO2. Brain biopsies taken at the end of the study revealed normal concentrations of ATP and phosphocreatine and a normal energy charge. Despite a normal cerebral energy state, there was a mild, dose related, cerebral lactic acidosis (up to 2.84 mumol/g) that accompanied a mild systemic acidosis. It is concluded that the cerebral metabolic changes produced by isoflurane are secondary to an effect on cortical electrical activity, that abolition of this activity can be produced in dogs by a clinically relevant concentration of isoflurane (3%) without marked systemic hemodynamic effects, and that concentrations of isoflurane necessary to abolish cortical activity have no direct toxic effect on cerebral metabolic pathways. PMID- 6859609 TI - Cerebral protection by isoflurane during hypoxemia or ischemia. AB - The cerebral metabolic effects of isoflurane suggest that it may provide a degree of cerebral protection similar to that demonstrated for barbiturates. Accordingly, the possible cerebral protection afforded by isoflurane against hypoxemia and ischemia was studied in mice and dogs, respectively. In mice breathing 5% oxygen survival time was increased significantly over control in groups exposed to 1.0% and 1.4% isoflurane. At higher concentrations (2.0% and 3.0%) it is presumed that cardiorespiratory depression contributed to shorter survival times. In six dogs the effects of 3% isoflurane on the rates of cerebral ATP and phosphocreatine depletion and lactate accumulation during incomplete global ischemia were compared with six control dogs exposed to N2O. Incomplete global ischemia was produced by acute hemorrhagic hypotension to 30 mmHg for 9 minutes, a situation that does not abolish cortical electrical activity (active EEG). In the dogs exposed to isoflurane, the cerebral energy stores of ATP and PCr and the cerebral energy charge were sustained at significantly higher levels than in dogs exposed to N2O, and the cerebral lactate accumulation was significantly less in the initial 7 minutes of hypotension. It is concluded that in the circumstances of oxygen deprivation insufficient to abolish cortical electrical activity, isoflurane, like the barbiturates, can provide some cerebral protection presumably by depressing cortical electrical activity and cerebral metabolism. PMID- 6859610 TI - Hemodynamic predictors of myocardial ischemia during halothane anesthesia for coronary-artery revascularization. AB - The authors undertook a prospective study of 30 patients undergoing halothane anesthesia for coronary-artery revascularization to ascertain which clinically monitored hemodynamic variables--or combination of variables--associated with myocardial oxygen supply and demand best predict myocardial ischemia. Simultaneous recordings of electrocardiogram (lead II and V5), systemic, central venous, pulmonary artery, and pulmonary artery occluded pressures were analyzed for correlation with ischemic episodes. Ischemia occurred with significant increases (P less than 0.0001) in heart rate, central venous pressure, and pulmonary artery occlusion pressure and with significant decreases (P less than 0.0001) in systolic and mean arterial blood pressure and in coronary perfusion pressure (mean arterial minus pulmonary artery occluded pressure). There was no correlation between ischemia and either hypertension (systolic blood pressures up to 200 mmHg) or the rate-pressure product. Systemic systolic blood pressure, systemic mean arterial blood pressure, and coronary perfusion pressure as single determinants were the most useful to monitor in avoiding myocardial ischemia. A combination of systemic arterial blood pressure (systolic or mean) and filling pressure (central venous or pulmonary artery occluded) was generally as useful but not more so than the preceding single variables in avoiding ischemia. Rate pressure product was not of value in this regard. Patients were divided into three groups according to preoperative left ventricular (LV) function to determine whether pulmonary artery occluded pressure (PAOP) was more useful than central venous pressure (CVP) as either a predictor of ischemia or an index of cardiac filling: normal LV function (Group I), moderately abnormal LV function (Group II), and markedly abnormal LV function (Group III). PAOP offered no advantage over CVP for either purpose, except in some Group III patients. PMID- 6859611 TI - On the safety of radial artery cannulation. AB - The frequency of complications following radial artery cannulation for monitoring purposes was determined in 1,699 cardiovascular surgical patients and in 83 patients in whom cannulation was performed in another artery after failure at the radial site. Patients were examined and radial artery flow determined by a Doppler technique 1 day and 7 days after decannulation. Although partial or complete radial artery occlusion after decannulation occurred in more than 25% of the patients, no ischemic damage to the hand or disability occurred in any patient. Neither duration of cannulation nor the size or material of the cannulas were determinants of abnormal flow. Abnormal flow was significantly related to female sex, the presence of hematoma, and to the use of extracorporeal circulation. The radial arteries of 16 patients whose results of Allen's test were abnormal were cannulated and no abnormal flow or ischemia followed. In 22 patients, the ulnar artery was cannulated after multiple punctures of the ipsilateral radial artery and no ischemia followed. We conclude that in the absence of peripheral vascular disease, the Allen's test is not a predictor of ischemia of the hand during or after radial artery cannulation, that when decreased or absent radial artery flow follows cannulation it is of no clinical consequence, and that radial artery cannulation is a low-risk high-benefit monitoring technique that deserves wide clinical use. PMID- 6859612 TI - An elevated pulmonary wedge pressure resulting from an upper respiratory obstruction in an obese patient. PMID- 6859613 TI - Anesthetic management of a pregnant patient with scleroderma. PMID- 6859616 TI - Collapse after epidural injection following inadvertent dural perforation. PMID- 6859614 TI - Prolonged neuromuscular blockade following succinylcholine in a patient homozygous for the silent gene. PMID- 6859615 TI - Clonidine withdrawal complicated by amitriptyline therapy. PMID- 6859617 TI - Pseudoarterialization of the CVP by an infusion pump. PMID- 6859618 TI - Another way to insert a Macintosh blade. PMID- 6859621 TI - [A model of cockroach control in a large area. II. Occurrence and distribution of Blattella germanica and Blatta orientalis in the district of Potsdam (GDR)--an infestation analysis]. AB - Blattella germanica and Blatta orientalis occur in the district of Potsdam (German Democratic Republic). B. germanica is the real cause of plague. Up to now 2,734 building properties have been infested with cockroaches. B. germanica was found in 2,644 properties; B. orientalis was found in 20 properties and both were found in 70 properties. Infestation with cockroaches increases with urbanisation. Infestation is especially frequent in works canteens and similar rooms. Outdoor distribution of cockroaches takes place passively in food transports. Inside buildings cockroaches spread through cracks in walls, through pipings, lift shafts etc. 70 to 80% of the properties infested by cockroaches are works canteens, shops, restaurants, hotels and bakeries. B. germanica was found in 82% of the larger hospitals and outpatients' clinics, in about 72% of the works canteens, in about 26% of the restaurants and hotels, in about 20% of the bakeries and the enterprises manufacturing beverages, in 17% of the shops, in 8.8% of the nurseries and creches and in a smaller percentage in flats and newlybuilt residential areas. PMID- 6859619 TI - Celozoic myxosporidians (Myxidium spp. and Chloromyxum spp.) of cyprinids from the river Esla (Leon, NW Spain). I. Description of the species. AB - In the examination of 417 Cyprinids, belonging to 7 species, caught in the Esla river from April 1977 to December 1979, the following celozoic myxosporidians were found: Myxidium macrocapsulare Auerbach, 1910 in Leuciscus cephalus cabeda and Chondrostoma polylepis polylepis; Myxidium carinae n. sp. in Barbus barbus bocagei; Chloromyxum complicatum n. sp. in B. barbus bocagei and L. cephalus cabeda; Chloromyxum chondrostomi n. sp. in Ch. polylepis polylepis; and Chloromyxum cyprini Fujita, 1927 in B. barbus bocagei. All of them were found in the gall bladder, except Chl. cyprini that also parasitizes the liver. The myxosporidians are described and drawings and photomicrographs are presented. Data on the prevalence and intensity of their infections are also given. PMID- 6859620 TI - [Strobila periodicity of Spirometra (Cestoda: Diphyllobothriidae)]. AB - The non-induced, endogeneous periodic destrobilation in Spirometra is conceived as an extreme of pseudapolysis. The patent time of S. erinaceieuropaei and S. sp. with single or with simultaneous infestations is arranged in separate patent periods marked off from each other by negative phases. This phenomenon is due to a periodicity of the strobila. In dissections during the negative phase only the scolex and neck alone or provided with a very short strobila could be found in the intestine. There were no striking differences between single and simultaneous infestations. The periodicity altogether, however, showed a great variability. A synchronization of the periodicity of egg shedding and destrobilation is concluded from one simultaneous infestation with demonstrably at least 2 tapeworms. After successive superinvasion, however, the periodicity evidently does not become synchronous, the periodicity of egg shedding is masked. PMID- 6859622 TI - [Contribution to the parasitic fauna of the GDR (German Democratic Republic). 7. Occurrence of Gasterophilus larvae (Diptera: Gasterophilidae) in horses]. AB - Observations were carried out from May 1977 to May 1980 on occurrence, fauna, and seasonal dynamics of Gasterophilus spp. in 2,539 horses for butchering from all districts of the German Democratic Republic and also in 79 horses after control against gasterophilosis. 99.98% of the 13,742 second and third instar larvae of horses for butchering were Gasterophilus intestinalis, only 0.02% Gasterophilus nasalis. Out of 7,765 larvae passed after control measures Gasterophilus intestinalis dominated with more than 96%. Only in four districts of the German Democratic Republic Gasterophilus nasalis was found. The mean extensive invasion from 1977 to 1980 was 8.7%, the mean intensive invasion 33.4 +/- 3.16 larvae/infected horse, the number of larvae ranging between 2 and 576 per horse. From 1977/78 to 1979/80 the intensive invasion increased from 25.8 +/- 2.74 to 58.6 +/- 3.49 larvae/infected horse. Peaks of extensive invasion appeared in April, May and October. From October to February the horses harboured both second and third instar larvae of Gasterophilus spp. The occurrence of gasterophilosis is concentrated in the northern parts of the German Democratic Republic. PMID- 6859623 TI - Analysis of biometrical characters of two mallophagan species treated with a phosphoorganic insecticide. AB - On the basis of biometrical analysis of various parts of the body in M. gallinae and E. stramineus treated with insecticide (Polwet 5) it was found that only the sizes of abdomen were differently changed in both species. The differentiation of these changes depends on the Polwet 5 concentration used and on the specific morphological features of both species. PMID- 6859624 TI - Haematophagous behaviour of Menacanthus eurysternus (Mallophaga, Amblycera). AB - Haematophagous nature of some mallophagan species is of great concern to the scientists working in the field. Such species cause harm to the host directly by reducing vitality and productivity and indirectly by acting as reservoir and transmitter of pathogenic strains of infectious diseases. Menacanthus eurysternus infesting common myna Acridotheres tristis feeds exclusively on host blood obtained by piercing the quill of pin feathers and by gnawing through the epidermis. As much as 88.56% adults, 73.91% third instar nymphs, 66.66% second instar nymphs and 83.21% first instar nymphs were found feeding on the host blood, when examined microscopically. This mallophagan species does not harbour any triturating agent and is not involved in cannibalism or predation. PMID- 6859625 TI - Rhinopharyngoscopy for the evaluation of allergic-immunologic disorders. AB - We have developed fiberoptic rhinopharyngoscopy as an important procedure for the evaluation of allergic and immunologic disorders. The procedure is useful for office practice, well tolerated and without serious complications. This paper outlines the technique for fiberoptic rhinopharyngoscopy, the pathology which can be identified, instruments available and our experience in nearly 100 patients. PMID- 6859626 TI - Histamine inhalation challenge in children: a comparison of two methods. AB - Airway reactivity in children is often assessed using a histamine inhalation challenge test. The bronchoconstrictor agents are usually delivered by five slow inspiratory capacity (IC) maneuvers, the IC method. We compared the IC method with a tidal breathing (TB) method in 30 children; 11 were normal, six were under investigation for asthma and 13 were known asthmatics. None of the normal children responded to either method, whereas 18 out of the 19 (95%) known or suspected asthmatics responded to the TB method while only 13 out of 19 (68%) showed a significant reduction in FEV1 when the IC method was used. The concentration of histamine necessary to cause a 20% reduction in FEV1 was less for the TB method, suggesting that in children the TB method will produce airway reactivity more quickly than the IC method. PMID- 6859628 TI - Clinical evaluation of the antishock trouser: retrospective analysis of five years of experience. AB - A retrospective study of five years of experience in using pneumatic antishock trousers was undertaken to provide data for analysis of clinical response and complications associated with use of the suit. Of 1,120 patients who received pneumatic antishock trousers, 821 (73.3%) survived more than 24 hours, and their response and clinical course were analyzed. Response was not uniform: most exhibited blood pressure response, and some showed changes in only pulse rate or evidence of improved tissue perfusion. Different responses were noted for different shock etiologies. Of all the potential complications theoretically possible, a prevalence of only 4% for ischemic skin changes (none requiring grafting) and 0.97% for renal perfusion failure were noted. The pneumatic antishock trouser is thought to be beneficial and safe. PMID- 6859627 TI - Comparison of nebulized terbutaline (TERB) and subcutaneous epinephrine (EPI) in the treatment of acute asthma. AB - The purpose of this study was to compare nebulized terbutaline 5 mg vs. subcutaneous epinephrine (1/1000, 0.3 cc) in the treatment of acute exacerbations of asthma in adult patients. Patients with a known diagnosis of asthma, who presented to the investigators in acute respiratory distress, without any previous adrenergic agents for six hours, were the subjects for this study. There were 33 patients enrolled in the study between 16 and 64 years of age. The results indicate both treatment groups gave significant increases in pulmonary function at all times when compared to baseline (p less than 0.001). Nebulized terbutaline and subcutaneous epinephrine appeared equally effective in the treatment of acute exacerbations of asthma, without significant differences in bronchodilator effectiveness or side effects. PMID- 6859629 TI - Comparative hemodynamic effects of antishock suit and volume expansion in normal human beings. AB - The effects of pneumatic antishock trousers on central venous pressure (CVP) and mean arterial pressure (MAP) were compared with those of volume expansion with normal saline in a group of healthy young men. CVP increased from 4.8 +/- 1.9 to 7.3 +/- 2.5 mm Hg (P less than .001) with the suit and from 4.7 +/- 1.9 to 7.3 +/ 2.2 mm Hg (P less than .001) with volume expansion. During suit use, MAP increased from 85 +/- 6.7 to 93 +/- 6.8 mm Hg (P less than .001), while during volume expansion it did not change. Therefore, despite equivalent increases in CVP, the pneumatic antishock suit significantly increased MAP while volume expansion did not. The data suggest that the increased blood pressure produced by the suit may be at least in part dependent on mechanisms other than increased preload from an "auto transfusion" of blood into the central circulation. PMID- 6859630 TI - Rupture of the right hemidiaphragm due to blunt trauma. AB - Five cases of right-sided rupture of the diaphragm are reviewed. Orthopedic injury, head injury, and shock were the most common associated findings. Apparent elevation of the right hemidiaphragm was seen initially in all cases, but two were misdiagnosed. An algorithm that includes modified peritoneal lavage, CT scan with contrast, and intraperitoneal Tc sulfur colloid is suggested for patients with suspected right diaphragmatic trauma. PMID- 6859632 TI - Medical consequences of the New Mexico State Penitentiary riot. AB - On February 2, 1980, a riot broke out among the 1,157 inmates at the New Mexico State Penitentiary and 139 people were injured. Of these, 33 died. Survivors had a variety of problems resulting from blunt or penetrating trauma, acute intoxication with drugs, or smoke inhalation. Fourteen percent of the casualties arrived at local hospitals in serious or critical condition. A study of the injury patterns revealed a significant difference (P less than .001) in the incidence of severe head trauma in those who had died compared to those who survived. Most of the seriously or critically ill survivors suffered from acute poisoning or from penetrating wounds. PMID- 6859631 TI - Open treatment of fingertip amputations. AB - Twenty-five patients with fingertip injuries at or distal to the distal interphalangeal joint were treated with a thorough cleansing of the wound with application of bacitracin and a sterile dressing. Warm soaks were begun 48 hours after injury. Crush injury was the most common type of trauma, followed by cutting injuries. Bone involvement was present in six cases. The average healing time was 29 days. At the time of complete healing, sensation was normal in 22 patients (88%). Systemic antibiotics were not administered routinely. No patient developed a wound infection. Our study documents that fingertip amputations can be successfully treated by nonoperative methods that result in preservation of finger length and contour, retention of sensation, and healing without infection. PMID- 6859633 TI - Acute care of severe tooth fractures. AB - Teeth that are severely fractured and demonstrate vital tissue at the fracture line may be treated acutely by extirpating the pulp. This technique leaves the patient free of pain until secondary care is available. PMID- 6859634 TI - Depression of respiratory function by pneumatic antishock trousers in traumatic quadriplegia. AB - A case of mild hypoventilation associated with an incompletely inflated pneumatic antishock suit in traumatic quadriplegia is presented. Pulmonary function studies were performed on the same patient 23 days later. Base line studies were performed and then repeated with the antishock suit inflated to 40 and then 100 mm Hg. Measurements were made of tidal volume (Vt), inspiratory reserve volume (IRV), expiratory reserve volume (ERV), forced vital capacity (FVC), forced vital capacity in one second (FEV1), and maximum voluntary ventilation (MVV). With increasing suit pressures, all parameters decreased with the exception of the ERV, which was initially zero. Traumatic quadriplegia must be added to the list of disorders in which caution must be used when considering the use of the abdominal compartment of the pneumatic antishock suit. PMID- 6859635 TI - Thigh compartment syndrome without lower extremity trauma following application of pneumatic antishock trousers. AB - Reported are two cases of thigh compartment syndrome following application of a pneumatic antishock trouser suit. Both patients developed compartment syndromes after prolonged antishock suit use in the absence of any apparent leg trauma. We recommend that suit compartment pressures be no more than required to restore adequate blood pressure. The duration of application should be no longer than is clinically necessary. Patients with prolonged application (greater than 120 minutes) should be closely monitored for the development of compartment syndromes. PMID- 6859636 TI - Atraumatic panmural rupture of the esophagus: Boerhaave syndrome. AB - Three cases of spontaneous rupture of the distal esophagus are presented. All three patients presented in acute distress, exhibiting epigastric pain and signs of cardiovascular collapse. They all underwent surgery for repair of the lesion. One died postoperatively, and the other two patients recovered after a complicated postoperative period. Because Boerhaave syndrome has a high mortality rate and its diagnosis can be elusive, a high index of suspicion should be maintained by the attending physician. PMID- 6859640 TI - Muscle strength grading. PMID- 6859641 TI - Pupillometry and confrontation measurements: a simple and rapid technique. PMID- 6859637 TI - Complete heart block in meningococcemia. AB - A 41-year-old man died of meningococcemia after presenting with skin rash, fever, and bradycardia. Electrocardiograms demonstrated intermittent complete heart block, and necropsy showed myocarditis with focal necrosis of the conduction system. This syndrome should be recognized as typical for meningococcemia, and all patients with meningococcal disease should be observed carefully for the development of bradycardia. PMID- 6859639 TI - Undiagnosed myasthenia gravis in emergency psychiatric referrals. AB - The diagnosis of myasthenia gravis is difficult to make in the emergency department. Reported are two cases in which myasthenia was not suspected and the patients were referred to the emergency psychiatrist. In both cases, when appropriate medical treatment was instituted, the psychological symptoms disappeared. PMID- 6859638 TI - Diquat intoxication. AB - Reported is the case of a 23-year-old man who ingested 300 mL of Reglone. He developed vomiting five to 10 minutes after ingestion. Shortly thereafter, he developed renal and central nervous system manifestations of toxicity, followed by cardiovascular collapse and death 14 hours after admission. Autopsy findings revealed esophagitis, tracheitis, gastritis, and ileitis. Prompt, aggressive therapy that included fluid replacement and removal of the toxin was unsuccessful. PMID- 6859642 TI - New technique for field intubation. PMID- 6859643 TI - Acid phosphatase in rape victims. PMID- 6859645 TI - Electrical injuries. PMID- 6859646 TI - Emergency C-section. PMID- 6859647 TI - Unsuspected tension pneumothorax as a hidden cause of unsuccessful resuscitation. PMID- 6859644 TI - Verapamil and digitalis toxicity. PMID- 6859648 TI - Carotid massage in the elderly. PMID- 6859649 TI - Calcium blockers and bronchoconstriction. PMID- 6859650 TI - Modification of allergic bronchoconstriction by a calcium antagonist: mode of action. AB - Because both degranulation of mast cells and contraction of airway smooth muscle are dependent upon the influx of calcium, a calcium blocking agent might modify allergic bronchoconstriction by at least these two mechanisms. We treated sheep allergic to Ascaris suum antigen with the calcium antagonist Verapamil prior to airway challenge with an aerosol of Ascaris suum antigen and also investigated the response without pretreatment. Aerosolized Ascaris suum antigen increased mean pulmonary resistance (RL) to 530% of baseline (n = 6). Pretreatment with intravenously administered Verapamil (150 micrograms/kg) increased mean RL to 225% of baseline but bronchoconstriction produced by subsequent antigen challenge was completely prevented. Verapamil did not modify bronchoconstriction produced by aerosols of histamine and carbachol, agents that act upon airway smooth muscle. Further, it did not reverse the increase in RL induced by an intravenous infusion of carbachol. These results suggest that verapamil, at the dosage used, did not prevent allergic bronchoconstriction by a direct action on smooth muscle and therefore was effective by inhibiting the release of mast cell mediators. PMID- 6859651 TI - Importance of airway inflammation for hyperresponsiveness induced by ozone. AB - We studied whether ozone-induced airway hyperresponsiveness correlates with the development of airway inflammation in dogs. To assess airway responsiveness, we determined increases in pulmonary resistance produced by delivering acetylcholine aerosol to the airways. To assess airway inflammation, we biopsied the airway mucosa and counted the number of neutrophils present in the epithelium. Airway responsiveness and inflammation were assessed in anesthetized dogs before ozone exposure and then 1 h and 1 wk after ozone (2.1 ppm, 2 h). Airway responsiveness increased markedly at 1 h after ozone and returned to control levels 1 wk later in each of 6 dogs, but it did not change after ozone in another 4 dogs. Furthermore, dogs that became hyperresponsive also developed a marked and reversible increase in the number of neutrophils in the epithelium, whereas dogs that did not become hyperresponsive had no change in the number of neutrophils. For the group of dogs, the level of airway responsiveness before and after ozone exposure correlated closely with the number of epithelial neutrophils. The results suggest that ozone-induced airway hyperresponsiveness may depend on the development of an acute inflammatory response in the airways. PMID- 6859652 TI - The physiologic consequences of saline lobar lavage in healthy human adults. PMID- 6859653 TI - The pathogenesis of the low pleural fluid pH in esophageal rupture. AB - To determine the possible mechanisms responsible for the low pH pleural effusion associated with esophageal rupture we evaluated the following possibilities: (1) gastric acid reflux, (2) bacterial metabolism, and (3) leukocyte metabolism. Neither elimination of gastric hydrogen ion contribution by distal esophageal ligation nor elimination of bacteria with antibiotics prevented the progressive fall in pleural fluid pH after esophageal rupture. Only elimination of polymorphonuclear leukocytes from the pleural space by rendering animals leukopenic with nitrogen mustard, prevented a low pH effusion after esophageal rupture. It appears that pleural fluid leukocyte metabolism is primarily responsible for the low pH effusion associated with esophageal rupture. PMID- 6859654 TI - Acute effects of volcanic ash from Mount Saint Helens on lung function in children. AB - To evaluate the acute effects of volcanic ash from Mt. St. Helens on the lung function of children, we studied 101 children 8 to 13 yr of age who were attending a 2-wk summer camp for children with diabetes mellitus in an area where about 1.2 cm of ash had fallen after the June 12, 1980, eruption. The outcome variables used were forced vital capacity, forced expiratory volume in one second, their ratio and mean transit time. Total and respirable dust levels were measured using personal sampling pumps. The children were tested on arrival and twice (early morning [A.M.] and late afternoon [P.M.]) every second or third day during the session. A within-day effect was measured by the P.M./A.M. ratio for the lung function variables; a between-day effect was measured by the change in the P.M. measurements over the 2 wk of camp. We found no strong evidence of either a within-day or a between-day effect on lung function, even in a subgroup of children who had preexisting lung disease or symptoms, despite daytime dust/ash levels that usually exceeded the Environmental Protection Agency's significant harm level for particulate matter. PMID- 6859655 TI - Spirometry in children. Methodology for obtaining optimal results for clinical and epidemiologic studies. AB - Spirometric methodology for clinical and epidemiologic use in children was evaluated in 123 third and fourth grade school children 8 and 9 yr of age. They performed spirometric testing in the middle of October and again in the middle of November 1979. The results demonstrated that spirometric standards developed from adult studies can be applied to children. In addition, a minimum of 5 and a maximum of 8 maneuvers should be attempted to provide at least 3 acceptable tracings. In children, the allowable difference between the 2 best acceptable tracings of 5% or 100 ml, whichever is greater, was demonstrated to be a reasonable guideline. The results are equally reproducible when the maximal values, the mean of the 2 or 3 best values, or the values from the "best sum" tracing (the tracing with the highest value for the sum of the FVC and FEV1) are used. PMID- 6859656 TI - Changes in the normal maximal expiratory flow-volume curve with growth and aging. AB - On the basis of their answers to a self-administered questionnaire, 697 nonsmoking healthy subjects were chosen from a randomly selected sample representative of the white non-Mexican-American population of Tucson, Arizona, enrolled in a longitudinal study of respiratory health. For each subject, the first satisfactory set of flow-volume data obtained during the first 3 consecutive surveys was selected for analysis. For forced vital capacity (FVC) and forced expiratory volume in one second (FEV1), the single best value for each subject was selected. Other flow-volume measurements were derived from the single test with the best sum FEV, plus FVC. These data were used to derive improved prediction equations for each sex by age group for 5 spirometric and flow-volume variables. The resulting predicted values demonstrate the effects of development, maturation, and senescence on ventilatory function. "Normal" limits are proposed that take into consideration the between-subject variability and non-Gaussian distribution of the various measurements. PMID- 6859657 TI - Continuing education in pulmonary disease for primary-care physicians. AB - A continuing medical education program was implemented and evaluated in 16 community hospitals. It was targeted at primary-care physicians and used physicians identified by their peers as being educationally influential for the dissemination of information. Self-study materials were used, followed by an intensive 2-wk preceptorship that resulted in a significant increase in physician knowledge. Inpatient chart audits identified a series of changes in the management of chronic obstructive pulmonary disease in the intervention hospitals that were not noted in the control hospitals. These included the increased use of intravenously administered fluids, loading doses of intravenously administered bronchodilators, aerosolized and single agent bronchodilators, and respiratory therapy services. Continuing medical education, delivered through community-based educationally influential physicians, is an effective way of changing physician behavior in small communities with no prior ongoing educational programs. This approach should improve patient care and may reduce the need for participation of academic faculty in traditional continuing education programs. PMID- 6859658 TI - Proliferation of alveolar interstitial cells during postnatal lung growth. Evidence for two distinct populations of pulmonary fibroblasts. AB - In order to define the origin and fate of lipid-filled interstitial cells (LIC) in the neonatal rat lung, 4- and 11-day-old rats were injected with tritiated thymidine (3H-T) and killed 1 to 96 h later. Thymidine-labeled lung cells were identified in autoradiographs and analyzed ultrastructurally. Interstitial cells accounted for 61% of 3H-T-labeled cells at 4 days but only 26% at 11 days. The LIC had a different labeling index than did nonlipid interstitial fibroblasts (NLIC) at each age, and also had distinct morphologic characteristics. At no time point did labeled LIC lose their lipid and become NLIC or vice versa. These results suggest that at least 2 separate populations of interstitial fibroblasts exist in the neonatal rat lung, probably with distinct functions. This supports the concept of tissue fibroblast heterogeneity. PMID- 6859659 TI - Patterns of pulmonary perfusion scans in normal subjects. III. The prevalence of abnormal scans in nonsmokers 30 to 49 years of age. AB - The prevalence of abnormal pulmonary perfusion (Q) scans in persons without cardiopulmonary disease has not been well defined; this prevalence could impact on the current diagnostic approach to those in whom pulmonary embolic disease is suspected. In prior studies, we found that Q scan defects, particularly lobar or segmental defects, are rarely present in normal young smokers and nonsmokers. To determine if normal nonsmokers of an older age group have a higher prevalence of Q defects, we performed 6-view Q scans in 40 subjects 32 to 49 yr of age who had no known cardiopulmonary disease. Each subject had undergone a history, physical examination, electrocardiogram, spirometry, and posteroanterior chest roentgenogram prior to scanning. All Q scans were interpreted blindly and independently by 2 experienced readers. No subject demonstrated a lobar or segmental defect on 2 views. One subject with scoliosis had a subsegmental defect corresponding to a prominent aortic arch on the chest roentgenogram. We conclude that abnormal Q scans are extremely uncommon among normal nonsmokers 30 to 49 yr of age. PMID- 6859660 TI - Macrophage function in pulmonary alveolar proteinosis. AB - We studied the lavage fluid recovered from a symptomatic patient with pulmonary alveolar proteinosis using in vitro assays for macrophage function. The alveolar macrophages from this patient had reduced phagocytic capacity. The particulate fraction from the cell-free lavage fluid (20,000 X gravity pellet) induced a pronounced phagocytic defect in normal mouse peritoneal macrophages but did not impair intracellular degradative activity. These results suggest that the lipoproteinaceous debris in patients with alveolar proteinosis can induce a phagocytic defect in alveolar macrophages, which probably increases the accumulation of more debris and may contribute to the increased risk of pulmonary infection. PMID- 6859661 TI - Do neutrophils play a major role in elastin turnover of normal tissues? AB - Urinary desmosine excretion (a quantitative measure of endogenous elastin breakdown) was monitored in 2 patients with cyclic neutropenia. In the first one, measurements were carried out over 2 complete 25-day cycles (nonconsecutive), whereas in the second, measurements were limited to selected urine specimens obtained on days when circulating neutrophils were at undetectable levels. Desmosine excretion remained in the normal range in both patients during neutropenic episodes, suggesting that endogenous elastin breakdown was not dependent on neutrophil-mediated elastinolysis. Thus, in alpha 1-antitrypsin sufficient subjects, any lung elastin turnover caused by neutrophils is probably intermittent and limited to times and foci marked by acute inflammatory changes in the lung. PMID- 6859662 TI - The respiratory inductive plethysmograph: bands versus jerkins. AB - The respiratory inductive plethysmograph (RIP) is used to measure ventilation from body surface movements. We have compared the accuracy of the two versions of inductance coils used with this instrument. The early version consists of rib cage and abdominal coils sewn into a one-piece jerkin, whereas the new version consists of similar coils attached to two separate bands. Following overnight studies in 12 subjects, we found that less than 50% of separate band RIP tidal volumes were accurate when compared with simultaneously measured spirometric values. The jerkin RIP, however, was accurate in 87% of the breaths measured. Therefore, we advocate the use of the jerkin RIP for prolonged studies because the separate bands appear to move more easily. PMID- 6859663 TI - Aspiration and lung abscess in cystic fibrosis. AB - Large abscess cavities are not commonly encountered in patients with cystic fibrosis (CF). One such patient is reported in whom an abscess developed secondary to aspiration of sand and salt water. Material obtained at bronchoscopy revealed anaerobes as well as the aerobic organisms previously cultured from her sputum. Rapid improvement occurred after institution of antibiotic therapy specifically directed against the anaerobic organisms. PMID- 6859664 TI - Respiratory function after paralysis of the right hemidiaphragm. PMID- 6859665 TI - Mycobacterium simiae. PMID- 6859666 TI - Treatment of tuberculosis and other mycobacterial diseases. PMID- 6859667 TI - President's address: the Pandora's box of antenatal surgery. PMID- 6859669 TI - Effects of altered tidal volume on oxygen dynamics in shock lung. PMID- 6859668 TI - Cardiovascular performance and myocardial infarction following aortic surgery. AB - A review of all patients who had undergone aortic reconstruction for aortoiliac occlusive disease and aneurysm over the previous five years demonstrated that fatal myocardial infarctions occurred most frequently two or three days remote from surgery. The most outstanding hemodynamic finding was sustained tachycardia which displayed a maximum risk on the second postoperative day. The peak coincided with the period of maximum incidence of fatal myocardial infarction. We suggest that the degree of postoperative tachycardia, which is a major determinant of myocardial oxygen consumption, contributes significantly to the risk of acute myocardial ischemia. PMID- 6859670 TI - The role of fine needle aspiration cytology in the management of solid breast tumors. AB - The value of fine needle aspiration cytology in patients with breast masses has found limited acceptance in the United States. When employed consistently, however, it has been reliable and has facilitated patient management. A positive cytological diagnosis of cancer has always been confirmed by histology, while "atypical," "suspicious," and "abnormal" categories represent cancer in varying degrees of frequency and open biopsy is usually necessary. The method is quick, easy, and causes no morbidity. The critical aspects for its success are those of interested surgeons and cytopathologists, and appropriate sampling and processing technique. In our experience with fine needle aspiration cytology in 38 patients with breast tumors, all 23 patients with cytological diagnosis of cancer, three of four with suspicious, and one of three with atypical smears proved to have cancer. Two of four patients with unsatisfactory smears had carcinoma on biopsy, both of the infiltrating lobular variety. Based on this limited experience, as well as on information in the available literature, fine needle aspiration cytology is strongly recommended in the evaluation and management of patients with breast tumors. PMID- 6859672 TI - Pitfalls of the Doppler examination for venous thrombosis. AB - In a prospective study comparing Doppler ultrasound and contrast venography in 112 patients, we identified all false-negative and false-positive results obtained by Doppler and are reporting those errors that we believe are commonly occurring pitfalls of this technique. There were 21 false-negative and nine false positive examinations. False-negative examinations were caused by the following factors: thrombi isolated to the veins of the calf (13 patients); nonocclusive clot involving or proximal to the popliteal vein (3); incorrect interpretation of examinations done by inexperienced personnel (2); acute thrombosis masked by changes of severe chronic disease (1); misinterpretation of increased saphenous flow in the presence of an occluded superficial femoral vein (1); and bilateral clot with one leg having significantly more evidence of venous obstruction than the other (1). Factors in the nine false-positive examinations were chronic disease interpreted as acute thrombosis (3), interpretation of weak signals in the calf as thrombosis (3), weak signals due to obesity (2), and excess Doppler probe pressure distorting venous flow (1). We conclude that results of the Doppler examination should be questioned when there is a suspicion of thrombus in the deep veins of the calf, the question of a nonocclusive thrombus, or the presence of chronic venous changes related to previous deep venous thrombosis. PMID- 6859673 TI - Successful autotransplantation of parathyroid adenomas in seven patients. AB - The autotransplantation of normal as well as adenomatous parathyroid tissue is currently being used with increasing frequency. In the present report, we describe our experiences with the successful transplantation of adenomatous or hyperplastic parathyroid tissue in seven patients. Prior to transplant surgery, six of these patients had recurrent or persistent primary hyperparathyroidism. The last patient was on hemodialysis for chronic renal failure and was presumed to have tertiary hyperparathyroidism. A large superior mediastinal parathyroid adenoma was found at a second neck exploration. In all patients, the only remaining parathyroid tissue was either adenomatous or hyperplastic. A total of 30 to 75 mg of this parathyroid tissue was diced and transplanted into single subfascial pockets of the forearm muscles (6) or sternocleidomastoid muscle (1). Following transplantation, all patients required transient calcium and vitamin D supplements for six to 12 weeks. In follow-up studies of ten months to 12 years, all patients have remained eucalcemic with normal parathyroid hormone levels. The use of a single subfascial pocket (versus the popular method of multiple implants) may explain the lack of recurrent hyperparathyroidism in our small population. PMID- 6859671 TI - A new look at the multifactoral etiology of gallbladder disease in children. AB - The etiology of gallbladder disease in children is multifactoral. Seven of these factors are fairly well known: obstruction of biliary ductal system, hemolytic disease, estrogen effect, obesity, familial, metabolic, and stress related. Our biggest group of patients, 19 out of the total 61 or 31 per cent, were found to have had prior abdominal/renal surgery or partial bowel obstruction. It has been shown that ileal resections result in gallstones due to loss of bile salt absorption; however, volvulus and partial obstruction from adhesive bands have never been incriminated before. A number of teenagers appear to develop acalculous cholecystitis and have symptoms a good many months before stones develop. These patients who have delayed (greater than 36 hours) excretion of oral cholecystogram dye also have positive duodenal drainage studies after cholecystokinin. Gallbladder disease in children is not a rarity as surgical textbooks would lead one to believe. PMID- 6859675 TI - Musculoepithelial flaps in the management of acute duodenal defects. PMID- 6859674 TI - Resident ratings of surgical faculty. Improved teaching effectiveness through feedback. AB - This study was designed to test the effect on teaching effectiveness of providing regular feedback to the faculty of a general surgery residency. A faculty evaluation rating scale was developed as one aspect of an overall "Code of Teaching Responsibility" process. This study compares two cohorts of surgery teaching staff--one during 1980 and the other during 1982 with respect to resident ratings of teaching effectiveness. Thirty-nine identical surgical faculty were in each cohort--19 general surgeons and 20 subspecialty surgeons. The results show that those faculty receiving the lowest ratings in 1980 show the greatest significant improvement in ratings in 1982--even after a statistical artifact was eliminated. Those in the middle range of ratings in 1980 did not change significantly in 1982. The highest rated faculty in 1980 showed a slight decrease in 1982 ratings. There was no difference between mean ratings of general and subspecialty surgeons. These results suggest that negative feedback to surgical residency faculty who are performing least effectively has a more powerful impact than does positive feedback to those teaching staff who are performing satisfactorily. PMID- 6859676 TI - Long-latency somatosensory evoked potentials during carotid endarterectomy. AB - Scalp recorded somatosensory evoked cortical responses (SSEP) may be measured under general anesthesia to assess the electrical responsiveness of the brain. Such potentials were measured in 25 patients undergoing carotid endarterectomy without shunt. Electrical unresponsiveness occurred bilaterally in one patient and unilaterally in one patient. The patient with unilateral electrical silence developed a perioperative stroke, the only stroke in this series. Analysis of the SSEPs recorded from these patients suggests that profound ischemia produces electrical silence: that intermediate degrees of ischemia produce prolonged interpeak latencies and decreasing amplitudes in the SSEP. This modality seems to offer promise as an intraoperative monitor during cerebrovascular surgery. PMID- 6859677 TI - Multiple identities and psychological well-being: a reformulation and test of the social isolation hypothesis. PMID- 6859678 TI - Mental health and the interpersonal environment: a reexamination of some effects of social structure on mental health. PMID- 6859679 TI - Causes and consequences of sex-role attitudes and attitude change. PMID- 6859680 TI - Paranoia and the structure of powerlessness. PMID- 6859681 TI - Curriculum tracking and delinquency: some observations. PMID- 6859682 TI - On purple emperors, pulmonary embolism, and venous thrombosis. PMID- 6859683 TI - Progress against osteoporosis. PMID- 6859684 TI - Fluoride treatment of osteoporosis: a new look at an old drug. PMID- 6859685 TI - Haiti and the acquired immunodeficiency syndrome. PMID- 6859686 TI - Alcohol and the heart. PMID- 6859688 TI - Fine-needle aspiration biopsy of the thyroid gland. PMID- 6859687 TI - Erroneous plasma norepinephrine levels with radioimmunoassay. PMID- 6859694 TI - Hemochromatosis and pruritus. PMID- 6859690 TI - Metoclopramide and secondary hyperaldosteronism. PMID- 6859691 TI - Gallium scanning and melanoma. PMID- 6859689 TI - Levamisole and chronic delta hepatitis. PMID- 6859692 TI - Cold urticaria and an oral contraceptive. PMID- 6859693 TI - Cimetidine and eosinophilic fasciitis. PMID- 6859695 TI - Urinary erythrocytes and glomerular disease. PMID- 6859696 TI - Amiodarone and pulmonary effects. PMID- 6859697 TI - Cotton dust and the lung. PMID- 6859698 TI - Mycobacterial culture in acquired immunodeficiency syndrome. PMID- 6859699 TI - Neutropenia and hemolytic anemia in a homosexual man. PMID- 6859700 TI - Campylobacter enteritis. PMID- 6859701 TI - Endobronchial miconazole for pulmonary aspergilloma. PMID- 6859702 TI - Human blastomycosis from dog bites. PMID- 6859703 TI - Schistosomal egg viability and treatment decisions. PMID- 6859704 TI - Physical signs of rejected treatment. PMID- 6859705 TI - Pulmonary angiography, ventilation lung scanning, and venography for clinically suspected pulmonary embolism with abnormal perfusion lung scan. AB - Inherent contradictions in current diagnostic recommendations for pulmonary embolism have created considerable confusion and controversy. To resolve these contradictions, we did a prospective study of ventilation-perfusion scanning, pulmonary angiography, and venography in consecutive patients with clinically suspected pulmonary embolism and abnormal perfusion scans. Ventilation scanning increased the probability of pulmonary embolism in patients with large perfusion defects and ventilation mismatch, but a ventilation-perfusion match was not helpful in ruling out pulmonary embolism. Small perfusion defects with mismatch had neither sufficiently high nor low probability to be of diagnostic value. The observed frequency of proximal vein thrombosis (19% to 51%) and its association with the range of ventilation-perfusion defects have important implications for management of pulmonary embolism. Pulmonary angiography is required in combination with venography in most patients with perfusion abnormalities because the probability of pulmonary embolism is neither sufficiently high nor low to confirm or exclude pulmonary embolism. PMID- 6859706 TI - Skin tags: a cutaneous marker for colonic polyps. AB - The relation between adenomatous colonic polyps and the development of adenocarcinoma of the colon is well established. An association between skin tags and colonic polyps in patients with acromegaly has also been reported. To ascertain if skin tags are a cutaneous marker for colonic polyps independent of the presence of acromegaly, 100 men referred for colonoscopy were studied. Forty six patients had colonic polyps and 37 also had skin tags; the correlation was highly significant (p less than 0.005). The sensitivity and specificity of the presence of skin tags serving as a cutaneous marker for adenomatous colonic polyps were both greater than 75%. Thus, at least in this population, skin tags may serve as a means for identifying patients at increased risk for having colonic polyps. PMID- 6859708 TI - Enflurane hepatotoxicity. A clinicopathologic study of 24 cases. AB - Analysis of 24 cases of enflurane anesthesia-associated hepatic injury shows that the clinical, biochemical, and histologic features are similar to those seen with halothane- and methoxyflurane-related hepatitis. Postoperative fever was the presenting symptom in 19 patients. Jaundice occurred in 19 patients after a mean latent period of 8 days. Sixteen patients had been previously exposed to enflurane or halothane, and the latent period from exposure to the onset of symptoms or jaundice was shortened in these patients. There were five fatalities among the entire group. Liver biopsy most characteristically showed centrilobular necrosis, occasionally with ballooning degeneration and fatty change. The presumed mechanism of injury is metabolic idiosyncracy, and prior exposure to a haloalkane anesthetic may increase the risk of hepatic injury after enflurane administration. PMID- 6859709 TI - Ticks and Lyme disease in the United States. PMID- 6859707 TI - Infection with parvovirus-like virus and aplastic crisis in chronic hemolytic anemia. AB - From 1980 to 1982 seven adults with chronic hemolytic anemia were admitted to Cook County Hospital, Chicago, with aplastic crisis. Six of these patients had sickle cell anemia, the seventh patient had beta thalassemia intermedia. Virologic studies showed that six patients had acute infection with the human parvovirus-like virus; in the remaining patient the lack of appropriate specimens precluded viral diagnosis. We describe the features of the virus infection and accompanying erythroid aplasia, and discuss the role of parvovirus-like virus as the etiologic agent in the arrest of erythrocyte production. PMID- 6859710 TI - La Vie Medicale en France: 1983. PMID- 6859711 TI - Hepatitis B virus markers in homosexual men. PMID- 6859713 TI - Campylobacter thrombophlebitis. PMID- 6859712 TI - Penicillin G for anaerobic lung abscess. PMID- 6859715 TI - Immunologic abnormalities in Wegener's granulomatosis. PMID- 6859716 TI - Trazodone and liver toxicity. PMID- 6859714 TI - Euthyroid hyperthyroxinemia. PMID- 6859717 TI - Aortic insufficiency unmasked by a peritoneovenous shunt. PMID- 6859718 TI - Medicine in Zambia. PMID- 6859719 TI - A radioimmunoassay index for allergic bronchopulmonary aspergillosis. AB - Differentiating patients with allergic bronchopulmonary aspergillosis from those with asthma who have immediate cutaneous reactivity to Aspergillus fumigatus may be difficult. Both groups have IgE and IgG antibodies against aspergillus antigen. We describe methods for establishing IgE and IgG antibody indices using sera from asthmatic patients as a control serum pool. The IgE and IgG antibody indices are usually both positive and at least one index was positive in all patients during the acute stage. The indices had diagnostic value in individual patients during the other four stages, but were not consistently positive in patients in any other stage. In a patient with a suspected case, serodiagnosis should be attempted before corticosteroid therapy is started; thus, acute-phase serum should be obtained and stored before therapy. PMID- 6859720 TI - Transition from systemic lupus erythematosus to common variable hypogammaglobulinemia. AB - A 34-year-old man had polar extremes of B cell dysfunction: systemic lupus erythematosus evolving into common variable hypogammaglobulinemia. He presented in 1974 with seizures and six other criteria for systemic lupus erythematosus; his antinuclear antibody titer was 1:1024 and IgG level, 2870 mg/dL. After 5 months of immunosuppressive treatment, a 79% decrease in serum IgG and 95% decrease in IgA levels occurred and manifestations of systemic lupus erythematosus disappeared. Six years later, he developed panhypogammaglobulinemia, had recurrent sinopulmonary infections, and showed nodular lymphoid hyperplasia on rectal biopsy. For comparison, serum immunoglobulin concentrations were measured serially in 13 other patients with systemic lupus erythematosus. Three developed severe depressions of these levels, two with IgG levels less than 300 mg/dL and one with an IgA level of 8 mg/dL. These decreases were transient, related to treatment, and not associated with infections. Daily high-dose prednisone therapy (60 mg/d) rather than treatment with cytotoxic drugs correlated with decreased immunoglobulin concentrations. PMID- 6859721 TI - Absence of the seventh component of complement in a patient with chronic meningococcemia presenting as vasculitis. AB - A previously healthy 40-year-old man presenting with fever, arthritis, and cutaneous vasculitis was found to have chronic meningococcemia. Evaluation of his complement system showed an absence of functional and antigenic C7, compatible with a complete deficiency of the seventh component of complement. Study of the patient's family spanning four generations showed heterozygous deficiency of C7 in five members. Chronic neisserial infection can be associated with C7 deficiency and must be distinguished from other causes of cutaneous vasculitis. PMID- 6859723 TI - Metronidazole lowers serum lipids. PMID- 6859722 TI - Campylobacter enteritis from untreated water in the Rocky Mountains. AB - During the summers of 1980 and 1981 Campylobacter jejuni was isolated from 23% and Giardia lamblia was isolated from 8% of persons with diarrheal disease acquired in the area of Grand Teton National Park, Wyoming. Campylobacter enteritis occurred most frequently in young adults who had been hiking in wilderness areas and was significantly associated with drinking untreated surface water in the week before illness (p less than 0.02 in 1980; p less than 0.005 in 1981). Penner serotype 4 was the commonest serotype isolated from humans and the only serotype isolated from an implicated mountain stream. These studies show that backcountry surface water can be an important source of C. jejuni and that infection with Campylobacter, as well as G. lamblia, should be considered as a cause of diarrhea in those who have recently returned from wilderness areas. PMID- 6859724 TI - Identification of peritoneal dialysis catheter tunnel infection by scanning with Indium-111-labeled leukocytes. PMID- 6859725 TI - Suspected obstructive jaundice: a decision analysis of diagnostic strategies. AB - Clinical decision analysis and a computer model were used to evaluate ten diagnostic strategies for the diagnosis of extrahepatic obstructive jaundice. The sensitivity, specificity, complications, and costs of currently used individual tests were used to determine the overall sensitivity, specificity, complications, and costs of each strategy at different disease prevalences. In patients with a low probability of extrahepatic obstructive jaundice (less than or equal to 20%), the optimal strategy begins with ultrasonography, followed by a cholangiogram when dilated ducts are present. When dilated ducts are not present, patients may be observed clinically and endoscopic retrograde cholangiopancreatography is done if the jaundice does not resolve. In patients with a higher probability of extrahepatic obstructive jaundice, a cholangiogram is needed for an accurate diagnosis. In patients with a low probability of extrahepatic obstructive jaundice, the optimal strategy has an overall sensitivity of 92% and a specificity of 99%. About 40% of patients need a cholangiogram at an average cost of $1000 per patient. In patients with a higher probability of extrahepatic obstructive jaundice, the optimal strategy has an overall sensitivity of 97%, specificity of 98%, and cost of $1000 to $1200 per patient. PMID- 6859726 TI - The early clinical manifestations of Lyme disease. AB - Lyme disease, caused by a tick-transmitted spirochete, typically begins with a unique skin lesion, erythema chronicum migrans. Of 314 patients with this skin lesion, almost half developed multiple annular secondary lesions; some patients had evanescent red blotches or circles, malar or urticarial rash, conjunctivitis, periorbital edema, or diffuse erythema. Skin manifestations were often accompanied by malaise and fatigue, headache, fever and chills, generalized achiness, and regional lymphadenopathy. In addition, patients sometimes had evidence of meningeal irritation, mild encephalopathy, migratory musculoskeletal pain, hepatitis, generalized lymphadenopathy and splenomegaly, sore throat, nonproductive cough, or testicular swelling. These signs and symptoms were typically intermittent and changing during a period of several weeks. The commonest nonspecific laboratory abnormalities were a high sedimentation rate, an elevated serum IgM level, or an increased aspartate transaminase level. Early Lyme disease can be diagnosed by its dermatologic manifestations, rapidly changing system involvement, and if necessary, by serologic testing. PMID- 6859728 TI - [Charcot's blue edema, a case]. AB - The case of an 18 year old Algerian girl with acrocyanosis of the four extremities since childhood and presenting a with 6 months history of oedema of the left hand resulting in severe functional handicap, is reported. Clinically, the oedema suggested a lymphatic origin. However, its localised, strictly unilateral distribution, the normality of vascular investigations, the absence of pain and regression of the oedema during the period of hospitalisation suggested autoaggression. The discovery of tourniquet marks on the skin of the thigh confirmed the diagnosis of Charcot's blue oedema. The patient has a hysterical personality, was of higher than normal intelligence but immature, and could only express herself through her functional handicap, a cry for affection in a rigid family environment only concerned by her scholastic achievements. To our knowledge, there have been 27 other reports of this condition since Charcot's first description in 1890. The majority concerned young intelligent women. Diagnosis is difficult and can only be confirmed by the finding of tourniquet marks on the skin. Psychotherapy is often useful as an underlying neurotic or psychotic personality is commonly found. PMID- 6859727 TI - [Spanish toxic syndrome. Anatomo-clinical report of the 1st case studied in France]. PMID- 6859729 TI - [Rheumatic pelvispondylitis associated with acute disseminated lupus erythematosus. A case]. PMID- 6859730 TI - [Miliary tuberculosis in an alcoholic associated with inappropriate secretion of antidiuretic hormone]. PMID- 6859731 TI - [Gonococcal endocarditis. A new case]. AB - The authors report the case of a 35 year old female hospitalised for gonococcal endocarditis with mitral valve vegetations infecting pre-existing asymptomatic rheumatic mitral incompetence. Apyrexia was rapidly obtained with antibiotic therapy; the valvulopathy was well tolerated from the hemodynamic viewpoint; the echocardiographic appearances of the vegetations were stable. However, the patient died during the third week of a cerebral haemorrhage, probably due to rupture of a mycotic arterial aneurysm. The authors suggest that the difficulties encountered in the fight against sexually transmitted diseases may result in a recrudescence of this type of disseminated gonococcal infection. PMID- 6859732 TI - [Anatomo-clinical conference. Pitie-Salpetriere Hospital. Case no 1--1983. Recurrent hemoptysis in a 22-year-old girl]. PMID- 6859733 TI - [Hemangiopericytomas of the buccal cavity. Anatomoclinal and ultrastructural study. 9 cases]. AB - Hemangiopericytoma, an unpredictable tumour, is not rare in the buccal cavity. Nine cases, most of which have been followed-up over a long period, show that, in this localisation, this neoplasm shows the unpredictable nature, though to a lesser degree (recurrences and metastases) of those situated in other parts of the body. Histological and ultrastructural analysis shows, apart from its characteristic perivascular features, much cellular polymorphism responsible for the diagnostic problems. A variety of cells, endothelial, fibroblastic and smooth muscle are observed next to the pericytes. The predominance of one or another cell type significantly affect the prognosis; immature forms with an endothelial predominance have a recurrent course, whilst fibrous forms have a much better prognosis. This diversity tends to support the histogenetic concept of one blastomatous cell responsible for the variable maturative possibilities. PMID- 6859736 TI - [Early results of the use of a new method of evaluation of fetal movements in the third trimester]. PMID- 6859734 TI - [Hemolytic disease of the newborn due to rare maternal alloantibodies (7 years of experience)]. PMID- 6859738 TI - [Irresponsibility of systematic recourse to cesarean section for breech presentation]. PMID- 6859737 TI - [Hypertension in pregnancy: analysis of case studies in 1979-80]. PMID- 6859735 TI - [Medical motives for induced abortion in hospital]. PMID- 6859739 TI - Functional neck dissection. Anatomical grounds, surgical technique, clinical observations. AB - The anatomical grounds of and surgical technique for functional neck dissection are described in detail in order to demonstrate that the radicalism of this procedure, from the viewpoint of surgical anatomy, is by no means less than that of the classical (so-called radical) neck dissection. From 1972 to 1978, 476 operations were performed (211 patients treated bilaterally and 54 unilaterally). The percentage of false negatives (ie, histologically proven metastases in clinically unsuspected nodes) was 14%, while the percentage of false positives (histological negativity in clinically suspected nodes) reached 53%. The total number of local recurrences in a three-year follow-up was nine (3.5%). PMID- 6859740 TI - Perception of sound through direct oscillation of the stapes using a piezoelectric ceramic bimorph. AB - An ossicular vibrator of original design made from a piezoelectric ceramic bimorph was described. To test its effectiveness, the vibrator was temporarily implanted during tympanoplasty in four selected patients who had suffered extensive damage to the middle ear. By use of a special applicator, the vibrator was connected to either the stapes or the columella and was then excited by pure tone and speech signals. The subjects could hear well with the vibrator and distinguish speech signals. Thus a vibration threshold curve and a vibratory speech discrimination score were obtained. Comparing these with the results of conventional audiometry, the vibrator proved to be a highly efficient sound conducting device. This study furthermore calls attention to some practical applications of this device, particularly to the possibility of implanting the vibrator as part of an implantable hearing aid. PMID- 6859741 TI - Esophageal dysfunction in patients with contact ulcer of the larynx. AB - Vocal abuse is the best-known etiological factor in contact ulcer. Other factors, such as hiatus hernia and gastroesophageal reflux have been discussed. A 12-year study of 58 male patients (mean age 52 years) with present or previous contact ulcers, is reported. Forty-three patients were investigated with esophageal function tests, ie, esophageal manometry including pH monitoring, acid-perfusion test, and acid-clearing test. Esophageal dysfunction was found in 74% which is significantly higher than the 30% found in the general population. PMID- 6859742 TI - Auditory brainstem responses in children with early recurrent middle ear disease. AB - Auditory brainstem responses were recorded from an experimental group of 15 children with early histories of recurrent middle ear disease for the purpose of examining the effects of reduced auditory input on auditory brainstem function. The responses from these children were analyzed in terms of absolute latencies, interwave latencies and latency shifts across sensation level. Comparisons were made to a control group of children with no history of middle ear disease. Results indicated significant differences between the groups. The experimental group demonstrated greater absolute latencies for waves III and V as well as greater interwave latencies. These findings support the interpretation of an association between early recurrent middle ear disease and brainstem function. PMID- 6859743 TI - Topographic arrangement of motoneurons innervating the suprahyoid and infrahyoid muscles. A horseradish peroxidase study in cats. AB - The topographic arrangement of motoneurons innervating the muscles which participate in the rostrocaudal movement of the larynx was studied in cats by means of the horseradish peroxidase (HRP) method. After HRP injection into these muscles, all labeled neurons were found in the nuclei of the brainstem and cervical nerves (C1, C2) ipsilaterally. The mylohyoid and anterior digastric motoneurons were seen in a cluster in the medial part of the rostrocaudal area of the motor trigeminal nucleus. Within the medial part of the nucleus, the mylohyoid motoneurons were located ventrally and the anterior digastric motoneurons dorsally. The posterior digastric neurons were situated in the accessory facial nucleus, the stylohyoid neurons in the ventral aspect of the facial nucleus, the geniohyoid motoneurons in the ventral aspect of the hypoglossal nucleus, and the thyrohyoid motoneurons in the lateral aspect of the hypoglossal nucleus and the dorsomedial part of the ventral horn cells of C1. The HRP-labeled neurons of the sternohyoid and sternothyroid muscles were observed in the central portion of the ventral horn cells of C1 and C2. PMID- 6859744 TI - Frequency selectivity and temporal processing in Friedreich's ataxia. Clinical aspects in two patients. PMID- 6859745 TI - Laser vidian neurectomy. PMID- 6859746 TI - Thymopharyngeal duct cyst: a form of cervical thymus. AB - The various types of cervical thymus may present as a neck mass, usually laterally, from the angle of the mandible to the manubrium. Since it is rare to diagnose the entity preoperatively, the differential diagnosis includes the more common branchial cleft cyst, thyroglossal duct cyst, cystic hygroma, cystic dermoid, and lesions of the salivary gland, thyroid, parathyroid, and cervical lymph nodes. Because cervical thymic tissue in various forms has been reported so frequently, we feel the entity should be considered in the clinical differential diagnosis of lateral neck mass, especially in the younger age group. PMID- 6859747 TI - Primary squamous cell carcinoma of the middle ear invading the cochlea. A histopathological case report. AB - This report describes the histopathological changes in the temporal bone of a 71 year-old man who died of meningitis and epidural abscess complicated by primary squamous cell carcinoma of the middle ear. The present case is unusual and differs somewhat from previously reported cases of the primary squamous cell carcinoma of the middle ear in three respects: 1) an extensive invasion of the cancer into the membranous labyrinth, 2) cholesterol deposits in the cochlear spiral canal, and 3) presence of ossifying labyrinthitis. Among these findings, extensive involvement of the inner ear by cancer destroying the lower part of the otic capsule is particularly unusual. It is assumed that squamous cell carcinoma overcame the biological resistance to neoplastic infiltration which probably exists in the otic capsule and the membranous labyrinth. PMID- 6859749 TI - X-ray study of the month. Metastatic carcinoma of the thyroid to the sphenoid sinus. PMID- 6859748 TI - Secretory immune response in patients with oropharyngeal carcinoma. AB - The secretory immune system is a unique, local immunological mechanism which appears to be independent of systemic immunity. Secretory immunoglobulin A (SIgA), a major component in this mucosal immune system, is structurally different from the IgA immunoglobulin in serum and has a function as a first line of defense against the uptake of macromolecules and against infectious agents in the intestine, respiratory tract and genitourinary system. However, its relationship to the development and control of neoplasia is not well understood despite the fact that the major portion of human malignancies are of the epithelial type and located where the secretory immune system is vigorously functioning. In this study, the amounts of SIgA and secretory component (SC) in oral secretions and sera were measured in 20 patients with oropharyngeal carcinoma and 22 appropriate control subjects in order to elucidate the involvement of the secretory immune system as it related to oropharyngeal carcinoma. Cancer patients had increased IgA levels in oral secretions (561 +/- 161 micrograms/ml) compared to normal subjects (166 +/- 18 micrograms/ml, p less than 0.02) and to a smoker/drinker subgroup of controls (229 +/- 8.7 micrograms/ml, p less than 0.05). The elevated IgA levels in cancer patients appear to be unrelated to local inflammation or the patient's history of smoking or drinking. Density gradient analysis demonstrated that the IgA measured in oral secretions migrates at the 11S position, confirming that it is of the secretory type and indicating that the increased levels of IgA in oral secretions of patients with oropharyngeal carcinoma are not due to nonspecific leakage of 7 SIgA from sera. Secretory component levels in sera also revealed highly significant differences between cancer patients (1.65 +/- 0.73 micrograms/ml) and all control subjects (0.85 +/- 0.12 micrograms/ml, p less than 0.002). The data suggest that the increased SIgA concentration in secretions and SC level in sera accompany the existence of oropharyngeal carcinoma. The biological significance of these findings and their possible clinical application are discussed. PMID- 6859750 TI - Pathology consultation. Plasma cell tumors of the head and neck. AB - Neoplastic plasma cell disorders, multiple myeloma, extramedullary plasmacytoma and solitary plasmacytoma affect the head and neck with different manifestations. Multiple lytic lesions of the jaws and infrequent soft-tissue lesions characterize multiple myeloma's presence. The solitary plasmacytoma of bone is infrequent in the jaws. Wherever it occurs, it is a precursor lesion to multiple myeloma. Extramedullary plasmacytoma has several clinical and biologic forms. The most benign is the local upper airway lesion that is amenable to surgery or radiotherapy and manifests no recurrences. Approximately 40%, however, terminate in osseous and soft-tissue dissemination. The distant involvement has more characteristics of metastases than the diffuse axial skeletal involvement of multiple myeloma; to acknowledge this distribution and the apparently better prognosis, the disseminated form is called myelomatosis. PMID- 6859751 TI - [Value of periungual capillaroscopy in the early diagnosis of systemic scleroderma]. PMID- 6859752 TI - [Tolerability of an aromatic retinoid (RO 10 9359, etretinate, Tigason, Roche). Research on its toxicity on hematopoietic, renal and thyroid functions. Interactions with the metabolism of natural retinoids]. AB - 59 patients with keratinisation diseases have been received RO 10 9359. There is a clinical medicum tolerance. Biologic controls have been carried out before and after a 3 month treatment. There is a good biological tolerance for the hematopoietic, glucidic, renal and thyroid functions. Thus the hepatic tolerance is poor for the patients with a predisposition for hepatic diseases (plethorics, alcoholics). PMID- 6859753 TI - [Multicentric pigmented Bowen's disease associated with cancer of the uterine cervix]. PMID- 6859754 TI - [Non-epidermotropic malignant cutaneous lymphoma and sarcoidosis]. PMID- 6859755 TI - [Postphotochemotherapeutic eruptive lentigines]. PMID- 6859756 TI - [The child, the image and the pediatrician]. PMID- 6859759 TI - [Transfontanellar cerebral ultrasonography]. PMID- 6859757 TI - [Techniques, indications and results of transcutaneous centesis of the urinary tract in children]. PMID- 6859758 TI - [Radiologic exploration of epidermoid cysts of the spleen in children]. PMID- 6859761 TI - [Embolization and intra-vascular therapy in thoracic, abdominal and peripheral pediatric diseases]. PMID- 6859760 TI - [The silent kidney in children]. PMID- 6859762 TI - ["Efficacy" of the scanography in convulsions and epilepsy in children]. PMID- 6859763 TI - [Emergency indications for computer tomography examination of the brain in pediatrics]. PMID- 6859764 TI - [The esophagus and respiratory diseases in pediatrics. Techniques and indications of radiological investigations]. PMID- 6859766 TI - [Indications for scanography of the thorax in children]. PMID- 6859765 TI - [Retroperitoneal tumors in children]. PMID- 6859767 TI - [Significance of 99mTc-diethyl-IDA scintigraphy in the diagnosis of biliary duct atresia]. PMID- 6859768 TI - [Pulmonary ventilation-perfusion scintigraphy in pediatric respiratory pathology. Experience with 157 studies, paired in 130 children]. PMID- 6859769 TI - [Echographic aspects of pulmonary hydatid cysts in children. Apropos of 7 case reports]. PMID- 6859770 TI - [Rupture of a dissecting aneurysm of the ascending aorta 10 years after coarctation therapy. Apropos of a case report of a 10-year-old girl]. PMID- 6859771 TI - [Hypoderma bovis meningitis. Apropos of new pediatric case]. PMID- 6859772 TI - [Temporary epiphysiodesis of the lower limbs in children using blount's technic. Experience with 160 cases. Experimental study]. PMID- 6859773 TI - [Auditory screening in kindergarten schools. Apropos of a survey]. PMID- 6859775 TI - Presentation and prognosis of malignant tumours of the thyroid gland in the West Riding of Yorkshire. AB - Fifty cases of malignant tumours of the thyroid gland presenting over a 15 year period (1963 1978) in a large district general hospital are reviewed. The distribution of histological types, presenting symptoms and the outcome of treatment are discussed. PMID- 6859774 TI - The microflora of the oesophagus. AB - A study of the oesophageal microflora was undertaken in 51 normal adults and in 50 patients with carcinoma of the oesophagus. Aerobic organisms were present in every case. Anaerobic organisms were cultured from 41 (80%) of normal controls and 48 (96%) of patients with carcinoma. The isolation rate of all species of aerobic and anaerobic bacteria was similar in both groups. The antibiotic sensitivities of the oesophageal microflora were examined to determine appropriate antibacterial therapy for patients undergoing oesophageal surgery and for the treatment of oesophageal perforation. PMID- 6859777 TI - The future of inhalation anaesthesia. PMID- 6859776 TI - Is the undeniably palpable liver ever 'normal'? AB - A study of whether the lower border of the normal liver, if it extended below the costal margin, could be reliably identified by clinical examination was undertaken in 42 patients in whom there was no clinical, biochemical or scintographic evidence of liver disease. Two clinical observers independently agreed that in 10 of these patients the liver extended infracostally. However, scintiscanning demonstrated that 30 patients had livers extending below the costal margin and that 2 of the 10 livers clinically identified did not in fact lie infracostally. Thus whilst the normal liver commonly extended below the costal margin, recognition of this extension by clinical methods occurred no more frequently than would be expected by chance. It is concluded that the confident clinical finding of a liver projecting below the costal margin should suggest that the organ is abnormal. PMID- 6859778 TI - A simple stoma wafer cutter. PMID- 6859779 TI - Urodynamic investigation in a district general hospital. AB - In patients with disorders of micturition there is a poor correlation between clinical diagnosis and urodynamic findings. Thirty-three out of 82 patients studied in a Urodynamic Unit had their treatment plan altered as a result of the investigation. PMID- 6859780 TI - Experience with the 'Triple Test' in pancreatic disease. AB - The results of the secretin-pancreozymin test, duodenal aspirate cytology and hypotonic duodenography (the Triple Test), performed during a single duodenal intubation in patients with pancreatic or ampullary carcinoma, chronic pancreatitis and non-pancreatic disease were analysed retrospectively. Thirty five of 36 carcinoma patients and all 11 chronic pancreatitis patients had an abnormal result. One hundred and sixteen of 170 non-pancreatic disease patients had a normal result. It would appear that the Triple Test (TT) may be a useful screening test for pancreatic disease. PMID- 6859781 TI - A prospective study of radionuclide biliary scanning in acute pancreatitis. AB - Early surgery for biliary pancreatitis has resulted in a need for an accurate method of gallstone detection in acute pancreatitis. Fifty patients with acute pancreatitis were studied prospectively to assess the diagnostic value of Radionuclide Biliary Scanning (RBS) performed within 72 hours of an attack. To assess the general accuracy of RBS a further 154 patients with suspected acute cholecystitis or biliary colic were similarly studied. There were 34 patients with biliary pancreatitis and 18 (53%) had a positive scan (no gallbladder seen). There were 16 patients with non-biliary pancreatitis and 5 (31%) had a positive scan. All 51 patients with acute cholecystitis had a positive scan, as did 82% of the 51 patients with biliary colic. There were 52 patients with no biliary or pancreatic disease and none of these had a positive scan. RBS is highly accurate in confirming a diagnosis of acute cholecystitis or biliary colic. However, it cannot be relied on to differentiate between biliary and non-biliary pancreatitis and should certainly not be used as the basis for biliary surgery in these patients. PMID- 6859782 TI - The transduodenal per-ampullary approach to common bile duct calculi. AB - A method of management of 212 patients whose common bile duct calculi were removed through the Ampulla of Vater across the duodenum is described. One patient died from haemorrhagic pancreatitis directly related to the procedure and 11 others died from causes related to the need for a major procedure in people relatively late in life: an overall mortality of 5.7% and of 0.5% for directly related causes. Ten patients suffered non-fatal complications. Ninety three left hospital within 14 days after operation and 79 within 21 days. Although one patient, for a special reason, continued to form stones and discharged them without any difficulty, no others have formed stones that have been recognised symptomatically or clinically. No patient has had cholangitis or common duct stenosis. PMID- 6859784 TI - The anatomical relationship between the retropancreatic part of the bile duct and the main pancreatic duct. AB - The main pancreatic duct lies posteriorly within the head of the pancreas and adjacent to the retropancreatic part of the common bile duct. In 17 out of 25 (68%) autopsy specimens which were studied, the two ducts ran within 5 mm of each other for a mean distance of 3.9 cm. The pancreatitis which sometimes develops as a complication of instrumentation of the bile duct could be a result of damage to the main pancreatic duct. PMID- 6859783 TI - Proximal gastric vagotomy: a district general hospital experience. AB - A district general hospital experience with proximal gastric vagotomy over a nine year period is reported. One hundred and eight patients undergoing the operation for chronic duodenal ulcer were assessed. The follow-up period was 1-9 years (mean 4 years and 7 months). The results were graded using a modification of the classification of Visick (1948). Over 85% of our patients were satisfied with their results. (Visick 1 and 2). Recurrent ulceration was noted in 3.9% of our series (4 cases). There were no deaths and few complications. The technique used by us is described briefly and the role of proximal gastric vagotomy in a district general hospital is discussed. PMID- 6859785 TI - A proposed new method for the treatment of dry mouth. PMID- 6859786 TI - British urology 1982. PMID- 6859788 TI - Prolonged access to the venous system using the Hickman right atrial catheter. PMID- 6859789 TI - Viral aetiology in schizophrenia? PMID- 6859787 TI - Oesophageal varices: evaluation of injection sclerotherapy without general anaesthesia using the flexible fibreoptic gastroscope. PMID- 6859790 TI - An evaluation of the effect on resting and exercise blood pressure of some first line treatments in hypertension. AB - Eighteen patients with idiopathic hypertension were studied to assess the anti hypertensive control, both at rest and during exercise of increasing doses of hydrochlorothiazide, metoprolol and a combination of hydrochlorothiazide and metoprolol. Each active treatment period was given for four weeks with an intervening four week placebo period, with assessments made at 2 to 4 hours and 22 to 24 hours following tablet intake. The results show that the resting systolic and diastolic values for all active treatment periods were significantly different from placebo. During exercise, the systolic blood pressure levels were significantly reduced by all active treatments with the greatest overall reduction being achieved by either metoprolol or the metoprolol hydrochlorothiazide combination. However, the exercise induced increase in systolic blood pressure was reduced by approximately 25% by both metoprolol and the combination product, when compared to placebo, but not by the diuretic alone. PMID- 6859791 TI - 99mTc-nuclear venography in elective hip surgery. PMID- 6859792 TI - Serologic titres to micro-organisms in systemic lupus erythematosus: a family study. AB - Serologic titres were measured to a number of micro-organisms in patients with systemic lupus erythematosus, their consanguineous and nonconsanguineous relatives and a group of control subjects. There was no significant difference in titres observed for any of the organisms in the different subject groups. The significance of these results is discussed. Despite the negative results, an infective aetiology for systemic lupus erythematosus remains a viable hypothesis. PMID- 6859793 TI - Advances in dermatology in the past decade. PMID- 6859794 TI - The significance of type B hyperlactataemia in infective encephalopathy. AB - A disordered sensorium, a cardinal sign of lactic acidosis, is commonly attributed to the acidosis resulting from increased production and decreased utilization of lactate. We report hyperlactataemia in 22 children with encephalopathy following viral, rickettsial and bacterial infections. On admission there was normoglycaemia together with anion gap acidosis (p less than 0.02), hyperlactataemia (p less than 0.003), fatty acidaemia (p less than 0.004) and increased serum creatinine (p less than 0.0004) when compared to the results in convalescence. Management with two types of hyperglycaemia-producing infusions, one of them containing lactate, resulted in hyperglycaemia (p less than 0.002) from the 2nd to 4th days of admission. This was associated with a decrease in lactate, creatinine and acidosis and with clinical recovery. Infusions of either glucose or lactate would normally result in hyperlactataemia, more so if there was difficulty with lactate utilization. The fall in lactate supports the hypothesis that the hyperlactataemia is probably due to an adaptive increase in lactate production as an alternative cerebral fuel which is consequent on poor glucose utilization by brain, the cause of the encephalopathy. Additionally it leads to increased Cori cycle activity. Hence the clinical and metabolic recovery with such management. PMID- 6859795 TI - A preliminary report of the significance of electroencephalographic changes in children with viral infections. PMID- 6859796 TI - Dermatophytosis in Thailand. PMID- 6859797 TI - Malignant lymphomas of the skin. PMID- 6859798 TI - Current trends in the treatment of psoriasis. AB - New treatment modalities are now available in the management of psoriasis. We report our local studies on these new modalities. Application of dithranol for 1/2 hour is just as effective as when applied for 24 hours. This means less staining of the skin, clothes and no more burns. Oral retinoids gave more than 70% improvement in six of the seven patients with recalcitrant psoriasis. Oral retinoids produced more than 75% improvement in all eight patients with pustular psoriasis. PUVA therapy gave a complete clearance rate of 77% with an average of 25 sessions of treatment and an average total UVA dose of 346 J/cm2. However REPUVA (retinoids and PUVA) produced a complete clearance rate of 73% with an average of 18 sessions of treatment and an average total UVA dose of 142 J/cm2. The newer forms of treatment together with the established therapies have tremendously improved the total management of patients with psoriasis. PMID- 6859799 TI - The use of photochemotherapy (PUVA) in the initial clearance phase of psoriasis- the local experience. AB - 35 patients with extensive psoriasis were treated with meladinine and ultra violet A photo-chemotherapy. 77% cleared requiring 25 episodes of treatment, 42 days and an average total UVA dose of 346 J/cm2. The results are compared with other European and American studies. PMID- 6859800 TI - Dermatomyositis in a skin clinic. AB - 12 cases of dermatomyositis were seen in the Middle Road Hospital over a five year period. 2 cases were childhood dermatomyositis. Of the 10 adult patients, the majority (7) were in the younger age group between 21 to 40 years old. The incidence of underlying malignancy was 60% in adult patients and of all the malignancies, 66.7% were nasopharyngeal carcinoma. 4 of the 6 patients with underlying malignancy were in the younger age group of 21-40 years old which was previously reported as uncommon. PMID- 6859802 TI - Bacterial infections of the skin. I: primary and secondary infections. AB - Bacterial skin infections are important to recognize because we have the means to eradicate almost all of them. Primary skin infections are mainly caused by staphylococci or streptococci. Staphylococci infections present as furuncles and carbuncles, superficial folliculitis, impetigo or rarely the Scalded Skin Syndrome. Streptococcal infections present as impetigo, ecthyma, erysipelas or cellulitis. Corynebacteria causes erythrasma, trichomycosis or pitted keratolysis. Gram-negative primary skin infections, although uncommon, may occur; bacterial cultures are generally necessary for diagnosis. Secondary bacterial infections of pre-existing wounds, burns, dermatitic skin, or retention cysts are common events. PMID- 6859801 TI - An approach to urticaria. AB - As the problem of chronic urticaria is frustrating both to the physician and patient, an attempt to study its aetiology was made. 100 cases of chronic urticaria was studied in 1979. Patients having daily urticaria for more than 6 weeks, were included. There were 52 males and 48 females. A detailed history of the pattern of urticaria, drugs, physical causes, diet and illnesses were asked for, followed by physical examination. Each were then screened through a Diagnostic Tray including basic haematological tests, urinalysis, stools analysis, physical allergy tests, food provocation battery and further special tests. 17 patients had physical urticaria, cold (6), pressure (5), delayed dermographism (1), cholinergic (4), solar (1). 4 patients had severe reactions with aspirin, one with tetracycline; one had undiagnosed thyrotoxicosis. 36 of all the patients had a positive test on provocation with the food battery: aspirin (13), preservatives (3), colour dyes (6), yeast (1) and others (15). It has been suggested that these are not the immediate cause but are aggravating factors. 48% of patients showed dermographism. The number of idiopathic cases about 77% is consistent with the findings of others. We feel that an attempt to exclude treatable causes has brought reassurance to many of the patients. Long term antihistamine therapy was given in these cases. PMID- 6859803 TI - Bacterial infections of the skin. II: cutaneous clues to systemic infections. AB - Systemic bacterial infections often produce skin signs which are of help in the elucidation and evaluation of these diseases. This paper reviews some of such cutaneous clues, their occurrence, recognition and value. The following conditions are discussed: bacterial endocarditis, pseudomonas septicaemia, disseminated gonococcal infection, meningococcemia, clostridia infections, leptospirosis and typhoid fever. Bacterial causes of erythema nodosum are also considered. PMID- 6859804 TI - Alkaline phosphatase as tumor marker. AB - Applications and limitations of alkaline phosphatase as a tumor marker are discussed. This review focuses on three characteristic isoenzymes that have been found in the serum of cancer patients: (1) the Regan isoenzyme in bronchogenic carcinoma; (2) the Nagao isoenzyme in pleuritis carcinomatosa; and (3) the hepatoma alkaline phosphatase. Tumor variants of alkaline phosphatase are classified based on their heat stability properties resembling or differing from the placental isoenzyme. They can also be differentiated in their behavior to specific inhibitors. The presence of electrophoretic variants and enzyme immunoglobulin complexes in other cancers are also described. PMID- 6859805 TI - Lipid-bound sialic acid as a tumor marker. AB - Significant elevations in plasma/serum lipid bound sialic acid (LSA) concentrations have been documented in patients with malignant diseases. Initial studies indicate that LSA may be a useful marker in cancer of the prostate, bladder, breast, lung, colon, ovary and in leukemia, lymphoma, Hodgkins disease and melanoma. The data suggest that the LSA test lacks the required sensitivity and specificity for routine cancer detection but may be a valuable adjunct in the clinical evaluation of the cancer patient. PMID- 6859807 TI - Oncogenes: an overview. PMID- 6859806 TI - Problems in crossmatching blood from cancer patients. AB - The term "cancer" is an umbrella for a large number of malignant diseases which vary in severity and type. Therefore, many problems are associated with crossmatching a patient with this diagnosis. Blood use may vary greatly in amount and in the urgency of its need. The diseases themselves may cause cold reactive auto agglutinins to appear. The diseases and their treatments may cause red cell antigenic structure to be modified or antibodies to decrease in strength. Multiple transfusions may induce the formation of multiple antibodies. A few blood groups have been associated with a higher incidence of carcinoma in the patients possessing them. All of these possibilities must be considered by the blood bank when a transfusion request for a patient with "cancer" is received. PMID- 6859808 TI - Changes in the fatty acid patterns of brain phospholipids during development of rats fed peanut or rapeseed oil, taking into account differences between milk and maternal food. AB - The nature and amount of essential fatty acids in dietary fat play a leading part in the repartition of brain polyunsaturated fatty acids (n-3 and n-6). In order to determine precisely the respective roles of linolenic and linoleic acids in the diet on rat brain development, we used two diets in which the percentage of linolenic acid (18:3 n-3) was different. The animals were fed peanut oil (group A) or rapeseed oil (group B) during pregnancy and throughout lactation. The study of the fatty acid composition of gastric milk showed that the levels of linoleic acid (18:2 n-6) and more so linolenic acid (18:3 n-3) were much lower than in dietary fats. In group B, the 18:3 n-3 level of gastric content was about four times lower (2.4%) than in the maternal diet (8.5%) at the beginning of the suckling period and significantly increased until weaning. Analysis of the fatty acid composition of ethanolamine phosphoglycerides showed that docosapentaenoic acid delta 7-10-13-16-19 (22:5 n-3) and docosahexaenoic acid delta 4-7-10-13-16 19 (22:6 n-3) levels increased in group B in relation to group A and, on the other hand, the docosapentaenoic acid delta 4-7-10-13-16 (22:5 n-6) level decreased in group B. The sum of (n-3 + n-6) fatty acids did not change in either group B or group A. In our experimental conditions, we found no marked effect of diet composition upon conversion of linoleic acid to arachidonic acid. In summary, linolenic acid can be utilized in the brain (rather than linoleic acid) to provide long-chain polyunsaturated fatty acids and the amount of n-3 fatty acids would correlate with the desaturation activity of docosatetraenoic acid delta 7-10-13-16 (22:4 n-6) to docosapentaenoic acid delta 4-7-10-13-16 (22:5 n 6). PMID- 6859809 TI - Restoration effects of glucose refeeding on reduced synthesis of albumin and total protein and on disaggregated polyribosomes in liver of starved rats: evidence of a post-transcriptional control mechanism. AB - Previous studies demonstrated that fasting is accompanied with a reduction of liver protein and albumin synthesis. A protein-deficient diet also leads to a marked change in liver RNA and protein metabolism. Although the reduction of protein synthesis and the disaggregated polyribosomes during fasting can be corrected by a single feeding of protein or a complete amino acid mixture, no or little changes of amino acid concentrations were found in portal blood and liver cytosol of fasted animals as compared to those of the fed group. To determine the effect of glucose on the reduced rate of protein and albumin synthesis of fasted rats, free and membrane-bound polyribosomes were isolated quantitatively from liver of starved rats (42-66 h) at different intervals after a single feeding of glucose and after giving glucose ad libitum for 24 h. (1) The yield of polyribosomal RNA decreased dramatically after a 42- to 66-hour starvation. A glucose refeeding did not change the RNA content. However, the restoration of polyribosome size could be observed rapidly. (2) At various levels of RNA, there was a decreased protein synthesis in fasted animals. However, the synthesis was enhanced after glucose refeeding. The albumin synthesis was also proportionately increased (10-12% of total protein synthesis of membrane-bound polyribosomes). (3) Glucose refeeding had no influence on the content of albumin mRNA sequence and liver RNA. These findings suggest that the effect of glucose on the restoration of protein and albumin synthesis is a sole post-transcriptional event. PMID- 6859810 TI - [Changes in blood levels of haptoglobin and ceruloplasmin in vitamin A deficiency in Sprague-Dawley rats]. AB - The aim of the present study was to find out whether the elevation of the serum ceruloplasmin level, previously described in vitamin-A-deficient rats, is a specific phenomenon. Quantitative variations of serum ceruloplasmin, albumin and haptoglobin (whose concentration increased during inflammation) were determined in normal and vitamin-A-deficient rats. Concentrations of ceruloplasmin, haptoglobin, and the value of the haptoglobin to albumin ratio are increased in the serum of vitamin-A-deficient rats compared to normal rats. The results suggested that the increased serum level of ceruloplasmin in vitamin-A-deficient rats was due to the presence of inflammation. PMID- 6859811 TI - [Supplementary feeding of 38 Senegalese infants]. AB - A food consumption survey by weighing has been carried out for 3 days in 38 Senegalese infants aged from 6 to 12 months living in the suburbs of Dakar in order to assess the importance of complementary food to cover their nutritional requirements. The recommended dietary allowances in energy and in proteins are satisfied to 49 and 74%, respectively. The other nutritional requirements are covered to the following levels: calcium 38%, iron 24%, vitamin A 39%, B1 51%, B2 43%, PP 82%, C 54%, folates 8%, B12 263%. If we take into account the estimated nutrient intake of breast milk, the recommended dietary allowances in energy and in proteins were satisfied during the survey. PMID- 6859812 TI - Further studies on intestinal accumulation of glycine during fasting in rainbow trout (Salmo gairdneri Richardson). AB - Using the sliced intestine method, we studied in vitro the effects of long-term fasting (4 and 8 weeks) on the accumulation of 0.5 and 10 mM glycine in the mid- and hindgut of the trout. Increased glycine accumulation during fasting was noted when accumulation was calculated per gram of intestinal dry weight, per milliliter of cellular water, but especially per gram of mucosal tissue. The glycine tissue to medium ratios are also higher in fasted intestines, revealing an enhancement of the active pathways of the amino acid transport. After 4 weeks of fasting, the increased glycine accumulation is greater in hindgut, especially for the lowest glycine concentration (0.5 mM). With the highest concentration (10 mM), the effects of fasting similarly decrease in intensity and affect in the midgut and hindgut. After 8 weeks of fasting, the differences between fed and fasted intestines tend to be fewer, probably because of a progressive attenuation of the effect of fasting on the active pathways of glycine accumulation. PMID- 6859814 TI - Influence of zinc status on postprandial plasma zinc changes in pigs. AB - In growing castrated pigs changes in the postprandial plasma zinc values were found to be inversely related to the zinc status of the animals. In pigs prefed with a moderate zinc diet (25 ppm) postprandial plasma zinc values increased, whereas in pigs prefed with a high zinc diet (150 ppm) values decreased after intake of a meal containing 150 ppm of zinc. It is considered that the presence of metallothioneine in the liver, which depends upon the zinc status, is responsible for this effect. PMID- 6859813 TI - [Adrenal catecholamines and their metabolism in the vitamin A deficient rat]. AB - The adrenal catecholamines (norepinephrine and epinephrine) and their conversion enzymes (PNMT, COMT) were comparatively investigated in: (1) rats fed a diet deprived of vitamin A, inducing a rapid and severe deficiency; (2) rats fed another diet leading to a more progressive deficiency (rats supplemented with retinol served as controls for these two types of diet), and (3) rats fed a whole industrial diet. The first diet induced a strong accumulation of adrenal catecholamines and increased the activity of PNMT and COMT. The second diet only increased the adrenal content of norepinephrine and epinephrine. PMID- 6859816 TI - Lymphatic transport of cholesterol from exogenous and biliary origins in nonfasting rats after intraduodenal infusions of triolein. AB - Labelled thoracic-duct lymph was collected from nonfasting rats with a bile fistula after simultaneous intraduodenal infusions of bile labelled with [1-2 3H] cholesterol and a nutritive mixture containing [4-14C] cholesterol. The gastrointestinal tract, feces, chylomicrons and infranatants were analysed. Both biliary and exogenous cholesterol were absorbed by lymphatic way but the recovery of 3H labelling in total lymph was markedly higher than that of 14C activity. This fact might be due to different rates of cholesterol exchanges from the two origins with the nonlabelled cholesterol present in the enterocytes and further exchanges of the enterocytes cholesterol with plasma cholesterol. Most of radioactivity was detected in chylomicrons. The relative [3H] and [14C] cholesterol specific activities were always low; thus when a little exogenous cholesterol is brought the major part of lymph cholesterol had an endogenous- other than biliary--source. PMID- 6859815 TI - [Effect of the linolenic acid content of the mother's diet on the polyunsaturated fatty acid composition of subcellular fractions in brain development in the rat]. AB - In order to determine precisely the respective roles of linolenic acid and linoleic acid in the maternal diet on rat brain subcellular fractions during development, we used two diets with different percentages of linolenic acid (18:3 n-3). The animals were fed peanut oil (group A) or soybean oil (group B) during pregnancy and throughout lactation. Nature and amount of essential fatty acids had no incidence on saturated and monounsaturated fatty acid distributions in myelin, synaptosomal, mitochondrial and microsomal fractions. In adult rats, all subcellular fractions are marked by an increase of n-3 fatty acid and a decrease of n-6 fatty acid levels in group B compared to group A. In 15-day-old animals, on the contrary, only the synaptosomal fractions are significantly affected by the diet. Independent of diet, brain development is marked by a decrease of n-6 fatty acids in all subcellular fractions; on the other hand, the n-3 fatty acid level is increased in the synaptosomal and mitochondrial fractions, and decrease in the myelin and microsomal fractions. The sum of (n-3 + n-6) fatty acids remains constant in group B and in group A in all subcellular fractions. Finally, under our experimental conditions, we found no marked effect of diet composition upon linoleic acid conversion to arachidonic acid; only the delta 4-7-10-13-16 docosapentaenoic acid (22:5 n-6) level decreased in group B. delta 7-10-13-16-19 Docosapentaenoic acid (22:5 n-3) seemed to be a better substrate for delta 4 desaturase than delta 7-10-13-16-docosatetraenoic acid (22:4 n-6). PMID- 6859817 TI - Functional activities of alveolar macrophages in rat exposed to hyperoxia (normobaric O2). AB - Pulmonary alveolar macrophages (PAM) from rats exposed to 100% normobaric oxygen for 24, 48 and 65 h were collected by bronchoalveolar lavage. The cell yield was not modified by a 24 h exposure, but after 48 h, the number of PAM decreased and polymorphonuclear leucocytes were found in the lavage liquid. These modifications were amplified after a 65-h exposure. The percentage of uptake of Staphylococcus aureus after 30 min of incubation with PAM from rats exposed for 24 h and 48 was unchanged. No impairment of intracellular bactericidal activity toward S. aureus could be demonstrated in PAM from rats exposed to O2 for 24 h. After 48 h of O2 exposure, a slightly significant decrease in intracellular bactericidal activity was found only after 120 min of incubation. Nitroblue tetrazolium reduction and chemiluminescence were measured in PAM from O2-exposed and control rats: no modification could be demonstrated after 24 and 48 h of exposure. These results suggest that the PAM is relatively resistant to oxygen toxicity. PMID- 6859818 TI - [Action of erythromycin on its own producer in cultivation on broth media]. AB - The effect of erythromycin on the growth, morphogenesis and antibiotic production capacity of the organism producing it or Str. erythreus was studied. Erythromycin was added to the medium in concentrations comparable to the productivity of the organism. It was shown that at the cell level Str. erythreus was highly resistant to its own antibiotic. Still, erythromycin had a significant effect on the developmental cycle of the culture. It inhibited the growth of the mycelium capable of the antibiotic production and induced an increase in reproduction. On long-term subculturing or in the presence of erythromycin the culture showed a pronounced tendency for fragmentation similar to that in proactinomycetes, whereas under the usual conditions the mycelial growth was not disturbed. However, the structure of the septa in Str. erythreus is typical of the streptomycetes. It is concluded that Str. erythreus occupies an intermediate position between Nocardia and Streptomyces. PMID- 6859819 TI - [Distribution of kanamycin and cefazolin in the body of dogs with various types of small intestine infarcts]. AB - Study of the pharmacokinetics of kanamycin and cefazolin in various types of experimental infarction of the small intestine showed their satisfactory penetration capacity with respect to the body fluids (blood, lymph, peritoneal exudate) and tissues (small and large intestine, parietal peritoneum, small intestine mesentery, gastrocolic omentum). This capacity was also shown with respect to the small intestine and its mesentery affected by infarction. Tissues traumatized during surgical operations were saturated with the antibiotics in concentrations equal to those in the control animals. The maximum concentrations of the antibiotics in the biosubstrates studied were observed by the 1st hour from the moment of their intramuscular injection. For prophylaxis of postoperative infections it is recommended that the antibiotics be applied not later than 1 hour before operation. This time is considered to be optimal. PMID- 6859821 TI - [Effect of antibiotic therapy and vaccine therapy on the phagocytic reaction in mice infected with Staphylococcus]. AB - The time course of changes in the activity, intensity and completeness of phagocytosis with leukocytes of the peritoneal exudate was studied on mice with experimental staphylococcal infection treated with rifampicin, lincomycin and inactivated staphylococcal vaccine used alone or in combination. It was shown that immunization of the animals with inactivated staphylococcal vaccine promoted stimulation of the phagocytic defense. Rifampicin and lincomycin applied therapeutically induced a decrease in the activity, intensity and completeness of phagocytosis. It should be noted that rifampicin had a less pronounced inhibitory effect than lincomycin. The combined use of vaccine and antibiotics with therapeutic purposes promoted an increase in phagocytosis as compared to the use of the antibiotics alone. The combined therapy sometimes resulted in completeness of phagocytosis making it reach the control values (the 10th and 15th days, rifampicin and vaccine). It should be noted that a more pronounced stimulation of the activity, intensity and completeness of the phagocytosis was observed with the use of the combination of rifampicin and the vaccine. PMID- 6859820 TI - [Determination of the biological activity of antibiotics by using dry nutrient media]. AB - The possibility of using available dry nutrient media Nos. 5 to 12 in assays of antibiotic biological activity with the agar diffusions method was studied with respect to benzylpenicillin, gramicidin S, kanamycin sulfate, kanamycin B, oleandomycin, novobiocin, tetracycline and erythromycin. The dry media were used instead of the respective media prepared with meat hydrolyzate. Optimal conditions of the assays on such media were determined. PMID- 6859822 TI - [Effect of a biostimulant formed by yeastlike fungi on the dynamics of the accumulation of CoA, biotin and levorin in the process of growth of S. levoris]. AB - Regularities of the effect of a biostimulator produced by years-like fungi on accumulation of CoA, biotin and levorin in a developing culture of S. levoris were studied. It was shown that addition of the biostimulator to the fermentation medium resulted in increased accumulation of CoA and biotin in the mycelium of the levorin-producing culture within the first 48 hours of the growth and in their more intensive consumption at the final stages of the fermentation process. The rate of the levorin synthesis in the medium with the biostimulator markedly exceeded that in the control. PMID- 6859823 TI - [Search for new antibiotics of the cyclosporin group]. AB - A total of 160 fungal cultures belonging to Trichoderma were isolated from soil samples collected in various regions of the USSR. The cultures were tested for production of antibiotics of the cyclosporin group, having a narrow antifungal spectrum. It was found that 7 cultures produced substances having a selective inhibitory effect on Asp. niger and no activity against gram-positive and gram negative organisms. An antibiotic substance close by its physicochemical properties to cyclosporins was isolated from T. viride 122. PMID- 6859824 TI - [Quantitative determination of the antibiotic tobramycin using high-performance liquid chromatography]. AB - Separation of the main components of the nebramycin complex of apramycin, kanamycin B and tobramycin was achieved in the form of their 2,4-dinitrophenyl derivatives. A chromatograph SR 8000 of 'Spectra-Physics" and a column 'Sperisorb C6" (4.6 X 250 mm) with the granule size of 5 micrometers were used in the study with the mobile phase of acetone-trisbuffer, pH 7 in a ratio of 65 to 35, the flow rate of 1 ml/min, a temperature of 35 degrees C and detection at lambda 350 nm. Quantitative determination of the tobramycin purity level was performed with an equation developed for the given conditions. The purity levels of the reference tobramycin base and its sulfate were estimated. The results of the estimation corresponded to the data of biological titration. PMID- 6859825 TI - [Effect of antibiotic resistance on the appearance of mutants in a culture of Streptomyces cremeus subsp. tobramycini producing an aminoglycoside complex]. AB - Possible formation of auxotrophs and changing of the antibiotic production property connected with resistance to antibiotics of different modes of action were studied in Streptomyces cremeus subsp. tobramycini producing the nebramycin complex of 2-desoxystreptamine derivatives. Four hundred and five spontaneous and 1800 gamma-radiation induced antibiotic resistant mutants of the culture were studied. The frequency of the auxotrophs was shown to be increasing. Correlation between formation of strains producing monocomponent aminoglycosides and antibiotic resistance was observed. The frequency of mutants with preferable synthesis of the tobramycin component among strr-, rifr- and rubr-mutants was 3- 10 times higher than among the sensitive portion of the population when total selection was used. Therefore, the spontaneous mutation of antibiotic resistance is selective with respect to both isolation of auxotrophs and strains producing separate aminoglycoside antibiotics. PMID- 6859826 TI - [R plasmid distribution in S. typhi isolated on the territory of the left coast of the Ukraine in 1970-1982]. AB - A total of 373 strains of S. typhi isolated in 1970-1982 were tested with respect to their sensitivity to 9 antibiotics active against gram-negative bacteria. It was shown that about 1/3 of the isolates were resistant to 1-3 antibiotics. Among the resistant isolates the number of strains resistant to 4-5 and more antibiotics amounted to 12.5 per cent. The plasmid nature of the antibiotic resistance in the isolated strains of S. typhi was shown. Transmissive R plasmids were detected in 13 per cent of the strains studied. Within the last 5 years there was an increase in the proportion of strains with transmissive R plasmids in patients with sporadic typhoid fever or especially in groups of patients with the disease. PMID- 6859827 TI - [Experimental study of the dynamics of the biochemical indices of the lymph after kefzol and amphotericin B administration]. AB - Antibiotics belonging to different groups i. e. amphotericin B of the neoaromatic group of heptaene antibiotics and kefzol, a cephalosporin antibiotic were studied with respect to their effect on some biochemical indices of the lymph and blood serum of experimental animals. Amphotericin B was administered intravenously in a dose of 1000 unit/kg once or daily for 5 days. Kefzol (sodium cephazoline) was administered intramuscularly in a single dose of 100 mg/kg. When the antibiotics were used in single doses, the lymph samples were collected from the thoracic duct 1 and 24 hours after the administration. On the repeated use of the antibiotic the samples were collected 24 hours after the last injection. The following biochemical indices were determined: the level of total protein, the ratio of the protein fractions (albumins, alpha 1-, alpha 2, beta- and gamma globulins), the contents of urea, urea nitrogen, residual nitrogen, total, free and bound cholesterol. The esterification and albumin-globulin coefficients were estimated. The study revealed an analogy in the character of the changes in the above indices of the lymph and blood serum of the rabbits. However, there were also less pronounced changes in the above indices of the blood serum as compared to those in the lymph of the same animals. PMID- 6859828 TI - [Action of levorin on the incorporation of labelled amino acids into the proteins of Ehrlich ascitic cancer cells]. AB - A polyenic antibiotic levorin had a significant damaging effect on the amino acid transport in the cells of Ehrlich's ascites carcinoma by inhibiting the incorporation and increasing the release of 14C-glycine and 14C-arginine. Inhibiton of incorporation of the radioactive amino acids into protein was observed on both simultaneous addition of the antibiotic and the label into the medium and addition of previously labeled cells into radioinactive medium with the antibiotic. Since in the latter case levorin had probably no effect on the specific radioactivity of the precursor, it was suggested that the decrease in the label incorporation into protein was an evidence of the real antibiotic inhibition of the rate of the synthesis of the polypeptide chain. PMID- 6859829 TI - [Toxicity, pharmacokinetics and pharmacodynamics of Soviet-made doxorubicin]. AB - The LD50 of doxorubicin, prepared at the Institute of New Antibiotics of the Academy of Medical Sciences of the USSR was 4.6, 12.5, 13.5 and 570 mg/kg for single intraperitoneal, intravenous, subcutaneous and oral administrations to albino mice, respectively. When used intravenously in a single dose, it had an inhibitory effect on the blood system of albino mice and rats. The cumulative properties of doxorubicin were somewhat higher than those of rubomycin or carminomycin. At an average 30 and 96 per cent of doxorubicin were bound with the proteins of rabbit blood serum and the organ homogenates, respectively. The antibiotic levels in organs were high and persisted for prolonged periods. About 10 and 13 per cent of doxorubicin were excreted with 24 hours with urine and bile, respectively. In doses close to the therapeutic ones (1 mg/kg) doxorubicin had no significant effect on the arterial pressure and respiration of anesthetized cats. a 5--10-fold increase of the dose resulted in a marked decrease of the arterial pressure and in excitation of the respiration. The amplitude of the ECG did not change significantly. The effect of doxorubicin on the heart rate was inconclusive. PMID- 6859830 TI - [Experience with the use of kanamycin in gastroenterology]. PMID- 6859831 TI - Membrane potential in anaerobically growing Staphylococcus aureus and its relationship to gentamicin uptake. AB - The electrical potential (delta psi) across the cytoplasmic membranes of Staphylococcus aureus cells growing under aerobic and anaerobic conditions was determined by measuring the equilibrium distribution of [3H]tetraphenyl phosphonium. In conjunction, gentamicin uptake and killing were studied in the same cells under identical conditions. Under aerobic conditions, delta psi was 169 mV, gentamicin uptake was readily demonstrable, and the number of viable cells decreased by almost four orders of magnitude in the presence of antibiotic. In contrast, delta psi was -142 mV anaerobically, gentamicin uptake was essentially nonexistent, and the aminoglycoside had no effect on viability. Remarkably, when the ionophore nigericin was added under anaerobic conditions, delta psi increased to the level observed aerobically, gentamicin uptake tripled to about 18% of the aerobic level, and viability decreased by one order of magnitude. The results are consistent with other observations (Mates et al., Proc. Natl. Acad. Sci. U.S.A. 79:6693-6697, 1982), indicating that the relationship between delta psi and gentamicin uptake is gated, and suggest that diminution of delta psi may be an important factor in aminoglycoside resistance under anaerobic conditions. PMID- 6859832 TI - Relationship between structure and antiplaque and antimicrobial activities for a series of bispyridines. AB - A series of bispyridines were examined for their bactericidal activities against in vitro, preformed, pure-culture plaques of selected oral plaque-forming bacteria. The antimicrobial activities of these agents were examined in relation to their molecular configurations. These studies demonstrated that the length of the interpyridine polymethylene group bridge and the length of the alkyl side chain were important determinants of antiplaque and antimicrobial efficacy. The most potent compounds of the bispyridine series were studied to determine the minimal conditions (concentration, duration, and frequency) of treatment required for likely clinical efficacy. PMID- 6859834 TI - Antibiotic resistance and serotypes of Streptococcus pneumoniae from patients with community-acquired pneumococcal disease. AB - From August 1978 to December 1981, 200 Streptococcus pneumoniae strains isolated from adult patients with pneumococcal disease were tested for susceptibility to penicillin G, erythromycin, clindamycin, tetracycline, and chloramphenicol by disk diffusion. Minimal inhibitory concentrations (MICs) were determined by agar dilution and broth dilution. The sources (numbers) of these isolates were blood (111), cerebrospinal fluid (30), sputum (26), pleural fluid (16), and miscellaneous (17). Of the 200 strains, 18 were partially resistant (MIC, 0.1 to 1 micrograms/ml) and 2 were resistant to penicillin. A total of 144 (72%) strains were tetracycline resistant, 87 of which had MICs of greater than or equal to 64 micrograms/ml. Ninety (45%) isolates exhibited various degrees of chloramphenicol resistance, with MICs ranging from 16 to 64 micrograms/ml. Five strains were resistant to erythromycin and clindamycin. Eleven penicillin-resistant strains were also resistant to chloramphenicol and tetracycline. Twenty-one different serotypes were encountered among the 120 typed strains studied. The most prevalent serotypes, in order of frequency, were 3, 1, 5, 19, 8, 6, 9, and 4, representing approximately two-thirds of the total number of isolates serotyped. These findings clearly indicate the need to perform antibiotic susceptibility testing in all cerebrospinal fluid isolates and other clinical significant isolates. PMID- 6859833 TI - Susceptibility of the Bacteroides fragilis group in the United States in 1981. AB - The minimal inhibitory concentrations of nine antimicrobial agents was determined for over 750 clinical isolates of the Bacteroides fragilis group of anaerobic bacteria collected from nine centers in the United States during 1981. High resistance rates were documented for cefoperazone, cefotaxime, and tetracycline. Cefoxitin had the best activity of the beta-lactam antibiotics, whereas moxalactam and piperacillin had good activities. The resistance rate for clindamycin was 6%. There were no metronidazole- or chloramphenicol-resistant isolates encountered. There were significant differences in susceptibility among the various species of the B. fragilis group, particularly with moxalactam, cefoxitin, and clindamycin. Clustering of clindamycin-, piperacillin-, and cefoxitin-resistant isolates was observed at different hospitals. The variability of resistance rates with the beta-lactam antibiotics and clindamycin indicates that susceptibility testing of significant clinical isolates should be performed to define local resistance patterns. PMID- 6859835 TI - In vitro activity of rifampin in combination with oxacillin against Staphylococcus aureus. AB - The in vitro activity of rifampin alone and in combination with oxacillin was determined for 75 Staphylococcus aureus strains (64 susceptible and 11 resistant to oxacillin). Minimal inhibitory concentrations (MICs) and minimal bactericidal concentrations (MBCs) were determined by broth microdilution; antibiotic combinations were evaluated by microdilution checkerboard and time-kill studies. The 90% MIC of rifampin was less than or equal to 0.015 micrograms/ml after both 24 and 48 h of incubation. The 90% MBC of rifampin was less than or equal to 2.0 micrograms/ml on subculture at 24 h of incubation and less than or equal to 0.5 micrograms/ml on subculture at 48 h. MIC checkerboards with oxacillin-susceptible strains revealed an additive or indifferent effect in 35 strains (55%) and antagonism in 29 strains (45%). MBC checkerboards performed by subculture at 24 h demonstrated antagonism for all but one of the oxacillin-susceptible strains, with sub-MBCs of rifampin impairing the bactericidal activity of oxacillin. MBC checkerboards performed by 48-h subculture revealed antagonism with 37 strains (58%); in 26 additional strains (40%), a synergistic, additive, or indifferent effect was observed at low antibiotic concentrations, but antagonism was seen at higher concentrations. Time-kill studies tended to show indifference rather than antagonism with oxacillin plus rifampin. In checkerboards performed with oxacillin-resistant strains, the addition of rifampin did not improve oxacillin inhibitory or bactericidal activity to a clinically significant extent; however, the addition of oxacillin improved the bactericidal activity of rifampin at easily achievable serum concentrations. PMID- 6859837 TI - Effects of cloned interferon alpha 2 in normal volunteers: febrile reactions and changes in circulating corticosteroids and trace metals. AB - Six healthy volunteers were given single intramuscular injections of an ascending dose schedule of human interferon alpha 2 (Hu IFN alpha 2) from Escherichia coli. At a dose of 3 X 10(6) U, all of the volunteers had febrile reactions with influenza-like symptoms as previously described for purified natural leukocyte interferon. Significant rises in serum 11-hydroxycorticosteroids and falls in plasma zinc levels were observed at this highest dose. Although there was a reduction in the febrile reaction complex, the simultaneous administration of indomethacin with a "toxic" dose of interferon did not alter the changes in white cells, corticosteroids, or trace metals. Nonspecific effects must be considered in the therapeutic activity of interferon. PMID- 6859836 TI - Reduction in fever and symptoms in young adults with influenza A/Brazil/78 H1N1 infection after treatment with aspirin or amantadine. AB - During an outbreak of influenza A/Brazil/78 H1N1 infection, 47 volunteers with clinical and virological influenza of less than 2 days duration were treated in a randomized double-blind fashion for 5 days with 100 or 200 mg of amantadine daily or with 3.25 g of aspirin daily. The aspirin treatment group defervesced more rapidly (10.3 h versus 21.5 h and 23.6 h; P less than 0.01), but by the second daily follow-up visit, both groups of amantadine recipients exhibited greater symptomatic improvement. Bothersome side effects resulted in discontinuation of therapy by 35% of the aspirin treatment group but only 3% of the amantadine treatment group (P less than 0.05). Individuals who present to a physician during an influenza A epidemic with characteristic symptoms will experience symptomatic benefit from amantadine treatment, with negligible toxicity. PMID- 6859838 TI - Sulfur metabolism in the biosynthesis of monobactams. AB - We studied the biosynthesis of monobactams with respect to sulfur metabolism in Chromobacterium violaceum, Acetobacter sp., and Agrobacterium radiobacter. All three organisms used inorganic sulfur for monobactam production. When sulfur containing amino acids were assayed as a source of sulfur for monobactam production, C. violaceum used cystine but not cysteine or methionine, Acetobacter sp. used all three compounds, and A. radiobacter used none. 35S from cysteine, methionine, and sodium sulfate was incorporated into monobactam by Acetobacter sp. Cell-free extracts of all three organisms were shown to possess cysteine desulfhydrase activity. In Acetobacter sp., this activity was constitutive, required pyridoxal phosphate, and had a pH optimum of 9.5. Extensive loss of 3H from L-[3-3H]cysteine was seen upon desulfhydration; no evidence of serine formation was found. Active sulfate was formed in cell-free extracts of A. radiobacter, and, since inorganic sulfur was used by all three organisms, it is likely that the sulfamate group of monobactams is produced via active sulfate. PMID- 6859840 TI - Isolation of trimethoprim-resistant, sulfonamide-susceptible Enterobacteriaceae from urinary tract infections. AB - The isolation of trimethoprim-resistant, sulfonamide-susceptible Enterobacteriaceae causing urinary tract infections is reported. The appearance of these strains followed the introduction of trimethoprim alone for use as treatment. Trimethoprim resistance was attributable to plasmids or transposons less frequently in sulfonamide-susceptible Escherichia coli isolates than in sulfonamide-resistant strains. PMID- 6859839 TI - Effects of hepatic function on vancomycin clinical pharmacology. AB - Using a recently developed radioimmunoassay, we performed 15 vancomycin pharmacology studies in cancer patients with infections. Vancomycin (500 mg) was infused intravenously for 30 min every 6 h for up to 7 days. The plasma disappearance curve was biphasic, with an initial half-life of less than 30 min. The second half-life (t1/2 beta), not dose related, varied from 1.4 to 231 h among the patients. In six studies of patients with normal hepatic functions, the t1/2 beta was 2.6 h; the rate of total clearance was 162 ml/min. In contrast, nine studies of patients with impaired liver function had a much longer t1/2 beta (37 h) and a decrease in the rate of total clearance to 48 ml/min. These factors resulted in an increase in the value of area under the concentration-time curve from 59 to 3,434 micrograms X h/ml. These results have demonstrated the importance of the effects of liver function on vancomycin disposition. The vancomycin dose and schedule should be adjusted for patients with liver impairment. PMID- 6859841 TI - Comparative in vitro activity of semisynthetic penicillins against Proteeae. AB - The in vitro susceptibilities of 181 isolates of precisely identified Proteeae species to five semisynthetic penicillins were determined with low and high inocula. Significant differences in susceptibility patterns among various Proteeae species to the penicillins examined were demonstrated. Providencia stuartii was clearly distinguished from Providencia alcalifaciens by its greater resistance to the antibiotics tested. PMID- 6859842 TI - Bacteriological studies of the enteric flora of patients treated with bicozamycin (CGP 3543/E) for acute nonparasitic diarrhea. AB - During a therapeutic trial of bicozamycin (BI) for traveler's diarrhea, aerobically grown, gram-negative bacteria, predominantly Escherichia coli, were decreased by 2 to 3 logs per g of stool; the number of BI-resistant gram-negative bacteria did not increase. Resistant species were most often Citrobacter freundii, Klebsiella pneumoniae, and Morganella morganii, and few BI-resistant E. coli strains were isolated. Cross-resistance between BI and other antimicrobial agents was not found. Resistance to BI could not be transferred or mobilized to an E. coli K-12 recipient. PMID- 6859843 TI - Formation of (4R)- and (4S)-4-hydroxyochratoxin A and 10-hydroxyochratoxin A from Ochratoxin A by rabbit liver microsomes. AB - Three metabolites were formed from ochratoxin A in the presence of rabbit liver microsomal fractions and NADPH. They were isolated by extraction, thin-layer chromatography, and high-pressure liquid chromatography. Two of them were identified as (4R)- and (4S)-4-hydroxyochratoxin A. It is suggested on the basis of mass and nuclear magnetic resonance spectroscopy that the third metabolite is 10-hydroxyochratoxin A. The formation of the metabolites was inhibited by carbon monoxide and metyrapone and was stimulated when microsomes from phenobarbital treated animals were used. The results suggest that cytochrome P-450 catalyzes the formation of these metabolites. PMID- 6859844 TI - Effects of storage on microbial loads of two commercially important shellfish species, Crassostrea virginica and Mercenaria campechiensis. AB - The effects of storage on the microbial load in two commercially important species of shellfish were examined. Oysters (Crassostrea virginica) were stored as shellstock, shucked meats, and fully processed meats at four temperatures for up to 21 days, and clams (Mercenaria campechiensis) were stored only as shellstock. The concentrations of most microbiological groups of organisms increased with the duration and temperature of storage in both shellfish species, although the increases were significantly lower in claims. Concentrations of Vibrio cholerae rose by approximately 1 log in oysters stored as shellstock after 7 days at 2 degrees C, and Lac+ vibrios increased 2 logs at 8 degrees C. Total counts of bacteria, fungi, coliforms, fecal streptococci, Aeromonas hydrophila, and clostridia were significantly higher in shucked oysters than in those stored as shellstock. Fecal coliforms were statistically the same, but V. cholerae, Vibrio parahaemolyticus, and the Lac+ vibrios were higher in oysters stored as shellstock. The concentrations of all microbial groups were higher in fully processed oysters than in shucked meats, with the exception of the vibrios, which showed no significant difference among the treatments. The results showed that although traditional methods of storing shellfish resulted in an overall increase in the microbial load, vibrio levels increased only in oysters stored as shellstock. Although fecal coliform and total bacterial counts did not correlate with those for vibrios in fresh oysters, strong correlations were observed in oysters stored for 7 days, suggesting that these indicators may be useful in monitoring oyster quality when meats are stored for a limited time as shellstock. PMID- 6859845 TI - Microbial transformation of nitroaromatic compounds in sewage effluent. AB - The transformation of mono- and dinitroaromatic compounds was measured in sewage effluent maintained under aerobic or anaerobic conditions. Most of the nitrobenzene, 3- and 4-nitrobenzoic acids, and 3- and 4-nitrotoluenes and much of the 1,2- and 1,3-dinitrobenzenes disappeared both in the presence and absence of oxygen. Under anaerobiosis, 2,6-dinitrotoluene and 3,5-dinitrobenzoic acid disappeared slowly, but no loss was evident in 28 days in aerated sewage. Aromatic amines did not accumulate during the aerobic decomposition of the mononitro compounds. They did appear in nonsterile, but not in sterile, sewage incubated aerobically with the dinitro compounds and anaerobically with all the chemicals. Analysis by gas chromatography and combined gas chromatography-mass spectrometry showed that aniline was formed from nitrobenzene, toluidine was formed from 3- and 4-nitrotoluenes, and aminobenzoic acid was formed from 3- and 4-nitrobenzoic acids under anaerobiosis, and that nitroaniline was formed from 1,2- and 1,3-dinitrobenzenes, aminonitrotoluene resulted from 2,6-dinitrotoluene, and aminonitrobenzoic acid was a product of 3,5-dinitrobenzoic acid under both conditions. The isomeric forms of the metabolites were not established. Aniline, 4-toluidine, and 4-aminobenzoic acid added to sewage disappeared from aerated nonsterile, but not from sterile, sewage or sewage in the absence of oxygen. 2 Nitroaniline, 2-amino-3-nitrotoluene, and 2-amino-5-nitrobenzoic acid added to sewage persisted for at least 60 days in aerobic or anaerobic conditions. Gas chromatographic and gas chromatographic-mass spectrometric analyses demonstrated that acetanilide and 2-methylquinoline were formed from aniline, 4 methylformanilide and 4-methylacetanilide were formed from 4-toluidine, 2 methylbenzimidazole was a product of 2-nitroaniline, and unidentified benzimidazoles were formed from 2-amino-3-nitrotoluene in the absence of oxygen, and that 2-nitroacetanilide and 2-methyl-6-nitroacetanilide were formed from 2 nitroaniline and 2-amino-3-nitrotoluene, respectively, in the presence or absence of oxygen. It is suggested that the transformations of widely used nitroaromatic compounds should be further studied because of the persistence and possible toxicity of products of their metabolism. PMID- 6859847 TI - Adaptation of mesophilic anaerobic sewage fermentor populations to thermophilic temperatures. AB - Thermophilic (50 degrees C) and obligately thermophilic (60 degrees C) anaerobic carbohydrate- and protein-digesting and methanogenic bacterial populations were enumerated in a mesophilic (35 degrees C) fermentor anaerobically digesting municipal primary sludge. Of the total bacterial population in the mesophilic fementor, 9% were thermophiles (36 x 10(6)/ml) and 1% were obligate thermophiles (4.5 x 10(6)/ml). Of these 10%, the percentages of bacteria (thermophiles and obligate thermophiles, respectively) able to use specific substrates were further enumerated as follows: bacteria able to digest albumin, casein, starch, and mono- and disaccharides, 30 and 10%; pectin degraders, 10 and 0.2%; cellulose degraders, 2 and 0.06%; methanogens that grow with H2 and CO2, methanol, and dimethylamine, 9 and 1%; methanogens that grow with formate, 8 and 5%; and methanogens that grow with acetate, 25 and less than 0.8%. Shortly after the temperature was elevated from 35 to 50 or 60 degrees C, the digestion of albumin, casein, starch, and mono- and disaccharides was detected, and methane was produced from H2 and CO2. Methane produced from acetate was not delayed at 50 degrees C, but was delayed by 29 days at 60 degrees C. Methane produced from formate was delayed by 3 days, from methanol by 7 days, and from dimethylamine by 5 days at 50 and 60 degrees C. A 10- and 20-day acclimation period was required for hydrolysis of pectin and cellulose, respectively, at 50 degrees C. Digestion of pectin required 20 days and cellulose longer than 85 days when the temperature was elevated abruptly from 35 to 60 degrees C. The acclimation period for the digestion of pectin and cellulose at 60 degrees C was shortened to 3 and 15 days, respectively, by seeding with a small amount of a culture acclimated to 50 degrees C. The data suggest that enrichment of cellulolytic, pectinolytic, and acetate-utilizing bacteria is crucial for the digestion of sewage sludge at 60 degrees C. PMID- 6859848 TI - Net positives: conservative approach to measurement of proportions positive in substerilization process studies. AB - A method (designated the net positive approach) is described for scoring results of sterility tests done with more than one recovery condition on product items treated with inactivating agents at levels less than those used in sterilization processes proper (subprocess treatments). Three tests of sterility, one per recovery condition, constitute a single sample. A growth in one or more recovery conditions is scored as a net positive for that sample. The net positive approach reduces the occurrence of false-negatives and assigns a value to the proportion of items reported as nonsterile (proportions positive) that is conservative. PMID- 6859846 TI - Susceptibilities of algae and Legionella pneumophila to cooling tower biocides. AB - Nine algal strains and nine Legionella pneumophila strains were tested in laboratory culture for their susceptibility to inhibition by a variety of commercially available microbiocides. The responses ranged from ineffective to effective at 1/100 the manufacturers' recommended pulse doses. Tests were also performed to determine whether the action of the microbiocide was bacteriostatic or bacteriocidal. PMID- 6859850 TI - Transformations of halogenated organic compounds under denitrification conditions. AB - Trihalomethanes, carbon tetrachloride, 1,1,1-trichloroethane, 1,2-dibromoethane, chlorinated benzenes, ethylbenzene, and naphthalene at concentrations commonly found in surface and groundwater were incubated under anoxic conditions to study their transformability in the presence of denitrifying bacteria. None of the aromatic compounds showed significant utilization relative to sterile controls at initial concentrations from 41 to 114 micrograms/liter after 11 weeks of incubation. Of the halogenated aliphatic compounds studied, transformations of carbon tetrachloride and brominated trihalomethanes were observed after 8 weeks in batch denitrification cultures. Carbon from the decomposition of carbon tetrachloride was both assimilated into cell material and mineralized to carbon dioxide. How this was possible remains unexplained, since carbon tetrachloride is transformed to CO2 by hydrolysis and not by oxidation-reduction. Chloroform was detected in bacterial cultures with carbon tetrachloride initially present, indicating that reductive dechlorination had occurred in addition to hydrolysis. The data suggest that transformations of certain halogenated aliphatic compounds are likely to occur under denitrification conditions in the environment. PMID- 6859849 TI - Transformations of 1- and 2-carbon halogenated aliphatic organic compounds under methanogenic conditions. AB - Several 1- and 2-carbon halogenated aliphatic organic compounds present at low concentrations (less than 100 micrograms/liter) were degraded under methanogenic conditions in batch bacterial cultures and in a continuous-flow methanogenic fixed-film laboratory-scale column. Greater than 90% degradation was observed within a 2-day detention time under continuous-flow methanogenic conditions with acetate as a primary substrate. Carbon-14 measurements indicated that chloroform, carbon tetrachloride, and 1,2-dichloroethane were almost completely oxidized to carbon dioxide, confirming removal by biooxidation. The initial step in the transformations of tetrachloroethylene and 1,1,2,2-tetrachloroethane to nonchlorinated end products appeared to be reductive dechlorination to trichloroethylene and 1,1,2-trichloroethane, respectively. Transformations of the brominated aliphatic compounds appear to be the result of both biological and chemical processes. The data suggest that transformations of halogenated aliphatic compounds can occur under methanogenic conditions in the environment. PMID- 6859853 TI - Cloning of total mRNA populations from adult and embryonic mice. AB - Total clone banks of cDNAs synthesized from poly(A)-RNA obtained from three stages of the developing mouse were constructed. The stages chosen were 13-day old embryo, neonatal, and fully grown adult. To have as complete a bank as possible, large numbers of individual clones were generated approximately 400,000 for the 13th day embryo and neonatal mouse and approximately 610,000 for the adult bank. In each case the clone bank was constructed by inserting double stranded cDNA into the PstI site of pBR322 by the "G-C tailing" method. Sequences cloned in this way could be separated from the plasmid host DNA by treatment of the resultant total chimeric plasmid population with PstI. Aliquots of the cloned cDNA material were labeled with 32P by "nick translation" using Escherichia coli DNA polymerase I for the preparation of hybridization probes. Back-hybridization of these probes to the total clone banks allowed the determination of the sequence diversity among the above three very different developmental stages. The use of such clone banks should allow the identification of developmental stage specific mRNAs. PMID- 6859852 TI - Purification and properties of a factor from rat liver cytosol which stimulates vitamin K epoxide reductase. AB - Two protein type factors which stimulate the reduction of vitamin K1-2,3-epoxide to vitamin K1 have been separated from the 105,000g-supernatant fraction (cytosol) of rat liver homogenates. One of these factors is rather labile. However the other factor was sufficiently stable to permit 900-fold purification following sequential column chromatography on DEAE-Sephacel, QAE-Sephadex, CM Sephadex, and Sephacryl S-200. Four milligrams of this purified material were obtained in 32% yield from 11 g of soluble cytosolic protein. This factor appeared to be homogeneous as determined by gel electrophoresis and has a molecular weight of about 38,000 as determined by gel filtration. The final preparation had no vitamin K epoxide reductase activity in the presence or absence of either NADH or dithiothreitol. The results of kinetic studies using this factor were consistent with its acting as a nonessential activator of the microsome catalyzed reduction of vitamin K1-2,3-epoxide. The factor did not cause a large change in the apparent Km (2.2-2.5 microM) of vitamin K epoxide reductase, but the apparent Vmax was increased about fourfold. PMID- 6859854 TI - Post-translational processing reactions involved in the biosynthesis of lysosomal alpha-N-acetylgalactosaminidase in cultured human fibroblasts. AB - The synthesis and processing of alpha-N-acetylgalactosaminidase and its oligosaccharides were studied by metabolic labeling of human skin fibroblasts with [2-3H]mannose or 32Pi, immunoprecipitation of the enzyme, gel electrophoresis of the immunoprecipitates, and examination of the radioactive oligosaccharides recovered from protein bands excised from the gels. The data suggest that the enzyme was first synthesized as a Mr = 65,000 precursor which was then processed to a mature Mr = 48,000 enzyme; only the Mr = 65,000 precursor was immunoprecipitated from the culture medium. The oligosaccharides were separated into two chromatographic species by Bio-Gel P-4 fractionation. The more retained species were determined to be high-mannose oligosaccharides containing 7 to 9 mannose residues. A portion of the more highly excluded oligosaccharides from the Mr = 65,000 band was hydrolyzed by alkaline phosphatase, and the resulting oligosaccharides migrated with the same mobility as Man8-9GlcNAc. This alkaline phosphatase-sensitive peak could also be labeled with 32Pi. These observations indicate that alpha-N-acetylgalactosaminidase was synthesized as a higher molecular weight precursor which contained phosphorylated high-mannose oligosaccharides. PMID- 6859851 TI - Use of magnesium to increase sensitivity of Limulus amoebocyte lysate for detection of endotoxin. AB - Increased sensitivity of the Limulus amoebocyte lysate (LAL) assay for the detection of endotoxin was attained by the reconstitution of commercially available LAL reagent with a magnesium-containing solution. As little as 2 to 6 pg (0.002 to 0.006 ng) of Escherichia coli O127:B8 endotoxin per ml was detected, an increase in sensitivity of 10 to 30 times. The optimum magnesium concentration range for the LAL reagent used and the optimum pH range were approximately 50 to 65 mM and pH 6.0 to 8.0, respectively. Reconstitution of five commercially available brands of LAL with a solution containing magnesium resulted in greater assay sensitivity than the identical LAL reconstituted with pyrogen-free water. Use of LAL reconstituted with a solution containing magnesium is crucial for the assay of some parenteral products, wherein increased sensitivity is essential to meet the requirement for the maximum valid dilution criteria. The mode of action of magnesium for enhanced sensitivity of LAL has been postulated. PMID- 6859856 TI - Histone H1: ultracentrifugation studies of the effects of ionic strength and denaturants on the solution conformation. AB - The conformation of histone H1 has been examined under native and denaturing conditions in the absence of DNA or chromatin. Sedimentation coefficients were determined for Histone H1 in 0.1 M KCl and in 6 M guanidine hydrochloride solutions at pH 7.4. The influence of ionic strength on the conformation of histone H1 has been determined by measurement of the sedimentation coefficient in tetramethylammonium chloride solutions of up to 2.5 M and extrapolated to infinite ionic strength. Results from these experiments suggest that the native conformation of histone H1 is very asymmetric in shape. The molecule is best described as a prolate ellipsoid with axes of 312 A (2a) and 16 A (2b) in low ionic strength media and also as a prolate ellipsoid with axes of 202 A (2a) and 20 A (2b) at high ionic strength or when associated with polyanions, e.g., DNA. Denaturation of histone H1 by guanidine hydrochloride was found to be completely reversible. In 6 M guanidine hydrochloride, the H1 molecule collapses to a sphere but the original extended conformation of the protein is readily restored on dialysis. This suggests rigid conformational requirements for the H1 molecule as incorporated into chromatin. The shape and dimensions for the H1 molecule at high ionic strength are not sufficiently conclusive to locate H1 in the chromatin structure. It is proposed, however, that viable models for chromatin architecture must be consistent with the histone H1 solution dimensions obtained here. PMID- 6859857 TI - Effect of modification of membrane phospholipid composition on the activity of phosphatidylethanolamine N-methyltransferase of Tetrahymena. AB - The activity of phosphatidylethanolamine N-methyltransferase is less than 10% of control levels in microsomes prepared from the ciliate protozoan Tetrahymena thermophila whose phospholipid composition had been altered by being cultured on media containing phosphonic acids. The primary modification obtained is decreased levels of phosphatidylethanolamine (J.D. Smith and D.A. Giegel, Arch. Biochem. Biophys., 206, 420-423 (1981) and 213, 595-601 (1982)). The enzyme protein is present in these cells at normal levels since addition of the substrate phosphatidylethanolamine to the assay system restores enzyme activity of the lipid-modified microsomes to control levels, while the enzyme from control microsomes is not affected by added phosphatidylethanolamine. The microsomal enzyme is inhibited by the anionic phospholipids cardiolipin, phosphatidylglycerol, and phosphatidylinositol and by lysophosphatidylethanolamine while it is activated only by phosphatidylserine in addition to the substrates phosphatidylethanolamine and phosphatidyldimethylethanolamine. The added phosphatidylethanolamine acts directly as a substrate for the methyltransferase rather than acting by merely stimulating utilization of endogenous lipid since added phosphatidyl[14C]ethanolamine is directly converted to phosphatidylcholine. The results suggest that the technique of phosphonic acid-induced modification of lipid composition will be useful for the study of other membrane-bound enzymes. PMID- 6859858 TI - Chromophoric derivatives of coenzyme MF430, a proposed coenzyme of methanogenesis in Methanobacterium thermoautotrophicum. AB - Factors F430 are nickel tetrapyrroles from methanogenic bacteria. Two methods are described to extract these compounds from cells of Methanobacterium thermoautotrophicum, namely, by boiling with 40% ethanol and by treatment of disrupted cells with HClO4 at pH 2 and 0 degrees C. The subsequent purification procedures involving column chromatography are outlined. Ethanol extraction yielded one yellow compound which will be denoted coenzyme MF430 (CoMF430). Extraction with HCIO4 yielded a yellow derivative, called Factor F430II, and a red component (F560). In addition, a number of derivatives were prepared by preparative thin-layer chromatography, acid hydrolysis, and methanolysis of acid hydrolyzates. On the basis of ultraviolet-visible light absorption and mass spectral data, it was concluded that the methylated chromophores obtained by treatment of acid hydrolyzates are derivatives of Ni(II)sirohydrochlorin and its pi-cation radical. Reduction studies and ultraviolet-visible light, 1H-NMR, and mass spectroscopy indicate that the chromophoric derivatives of CoMF430 differ from the native compound with respect to the reduction level of the tetrapyrrole and the structural elements that are attached to the chromophore. PMID- 6859859 TI - The biosynthesis of crustacean chitin. Isolation and characterization of polyprenol-linked intermediates from brine shrimp microsomes. AB - The biosynthesis of crustacean chitin appears to involve the participation of a lipid-linked intermediate. A microsomal preparation from larval stages of the brine shrimp Artemia salina was found to catalyze the glycosylation of exogenous [3H]dolichol phosphate, yielding a product which was insoluble in chloroform:methanol (2:1) but soluble in chloroform:methanol:water (10:10:3). Artemia microsomes catalyze the transfer of N-acetylglucosamine from UDP-N acetylglucosamine to a lipid acceptor. After extraction of labeled lipids with either chloroform:methanol (2:1) or chloroform:methanol:water (10:10:3), labeled compounds could be purified by ion-exchange chromatography on DEAE-Sephacel. Mild acid hydrolysis of 3H-N-acetylglucosamine labeled material soluble in chloroform:methanol:water (10:10:3) yielded a series of oligosaccharides ranging from 2 to about 8 glycosyl units in size. The larger components were shown to be sensitive to chitinase digestion but resistant to treatment with alpha mannosidase. Such 3H-N-acetylglucosamine containing compounds, prepared by both in vivo and in vitro procedures, appear to be chitin oligosaccharides. Brine shrimp microsomes also catalyze the transfer of mannose from GDP-mannose to a lipid acceptor. Mild acid hydrolysis of mannosyl lipids soluble in chloroform:methanol:water (10:10:3) yielded oligosaccharides which were sensitive to alpha-mannosidase digestion and resistant to treatment with endochitinase. The results suggest 3H-N-acetylglucosamine-labeled oligosaccharide-lipids are distinct from the mannose-labeled fraction and may participate in the formation of an endogenous primer for chitin synthesis after their transfer to a protein acceptor. PMID- 6859855 TI - Antioxidant activity of uric acid and 3-N-ribosyluric acid with unsaturated fatty acids and erythrocyte membranes. AB - Uric acid and 3-N-ribosyluric acid have been proposed to be important antioxidants in human plasma and in the bovine erythrocyte, respectively. In this study both of these compounds at 0.2 mM protected linolenate and arachidonate from air oxidation in the presence of 5 microM copper sulfate. The unsaturated fatty acids were protected when the urates were added at the beginning of the incubation or at 12 and 24 h of incubation for linolenate and at 3, 6, and 12 h for arachidonate. Both urates protected human and bovine erythrocyte membranes from peroxidation by t-butylhydroperoxide. These data support the proposal that urates are important antioxidants and free radical scavengers. PMID- 6859860 TI - Decrease of renal phosphoenolpyruvate carboxykinase RNA and poly(A)+ RNA level by ochratoxin A. AB - Ochratoxin A, a nephrotoxin produced by Aspergillus ochraceus, decreases the activity of phosphoenolpyruvate carboxykinase (GTP) (EC 4.1.1.32) (PEPCK) in the cytosol of rat kidneys, as well as inhibits renal gluconeogenesis (Meisner, H., and Meisner, P. (1981) Arch. Biochem. Biophys. 208, 146-153). Ochratoxin A greatly reduces the level of translatable mRNA for PEPCK in kidneys of rats fed the toxin for 2 days, while the efficiency of translation of poly(A)+ RNA is not affected. A species of poly(A)+ RNA coding for a 72,000 Mr protein is increased in relative amount. Although similar in molecular weight to PEPCK, this protein is not precipitated by an antibody to PEPCK, and has a different peptide map. The sequence abundance of PEPCK mRNA, as measured by either Northern blotting or the dot blot technique, is reduced, while the hepatic level of PEPCK mRNA is not changed. The total poly(A)+ RNA level is reduced 50% in kidneys, but not livers, of rats fed a standard dose of ochratoxin A for 3-5 days. In nuclei isolated from toxin-fed rats, the rate of transcription of total RNA or PEPCK mRNA, as measured by incorporation of [32P]UTP, is not reduced by the toxin. Ochratoxin A therefore lowers total renal mRNA concentration, and certain species, notably PEPCK, are reduced to a greater extent than the bulk of the RNA pool. PMID- 6859861 TI - Biochemistry and physiological role of methionine sulfoxide residues in proteins. PMID- 6859864 TI - Analysis of catalytic subunit microheterogeneity in ribulosebisphosphate carboxylase/oxygenase from Nicotiana tabacum. AB - Urea isoelectric focusing of dissociated, carboxymethylated Nicotiana tabacum ribulose-1,5-bisphosphate carboxylase/oxygenase reveals catalytic subunit microheterogeneity. Aggregated or nonaggregated sucrose gradient-purified preparations and the crystalline protein displayed essentially identical large subunit multiple polypeptide patterns. Various pretreatments which fully dissociate the holoenzyme did not alter catalytic subunit microheterogeneity. Direct comparison of the carboxymethylated and noncarboxymethylated crystalline and sucrose gradient-purified proteins demonstrated that the large subunit multiple polypeptide pattern was not an artifact of carboxymethylation. The inclusion of the seryl protease inhibitor phenylmethylsulfonyl fluoride during purification of the holoenzyme did not affect the large subunit multiplicity. However, the addition of leupeptin, a potent thiol proteinase inhibitor, to all solutions during purification of the native protein markedly reduced large subunit polypeptide L3 and increased the staining of polypeptide L2, suggesting that L3 is a leupeptin-sensitive proteinase degradation product of L2. Polypeptide L1 also appeared to be a purification-related artifact, but derived from a modification of L2 other than that which yielded L3. We conclude that polypeptide L2 is the single, native isoelectric form of the catalytic subunit of tobacco ribulosebisphosphate carboxylase/oxygenase. PMID- 6859862 TI - Structure of a bacterial photosynthetic membrane. Isolation, polypeptide composition, and selective proteolysis. AB - A procedure for the isolation of highly purified bacterial photosynthetic membranes from Rhodopseudomonas viridis is described. The purity of the final membrane fraction has been confirmed by electron microscopy. Seven major polypeptide bands are associated with the photosynthetic membranes, and all seven are resistant to solubilization in Triton X-100 detergent. Two pigmented bands with apparent molecular weights of 44K and 41K are thought to be cytochromes. The three polypeptides with apparent molecular weights of 38K, 32K, and 28K have been reported in reaction center preparations of other laboratories. Two low-molecular weight (16K and 11K) bands bind bacteriochlorophyll b and may represent light harvesting bacteriochlorophyll-protein complexes. The structures that were isolated seem to represent complete photosynthetic membranes, consisting of reaction center, electron transport, and light-harvesting components, all arranged in the regular lattice characteristic of viridis. Selective proteolysis of these membranes indicates that all membrane components are accessible to digestion by trypsin and pronase, except for the light-harvesting complexes. PMID- 6859863 TI - Immunochemical studies on the binding specificity of the blood group Leb specific lectin Griffonia simplicifolia IV. PMID- 6859867 TI - Further characterization of the heat-stable factor in the alpha-hydroxylation and oxidation of lignoceric acid in brain: effect of acidic amino acids and hexose phosphates on brain fatty acid metabolism. AB - Lignoceric acid and other very long-chain fatty acids are converted to alpha hydroxy fatty acids and ceramide in brain. These fatty acids are also oxidized and produce glutamic acid and other water-soluble products. All of these metabolic conversions are catalyzed by a rat brain particulate fraction and require NADPH, heat-labile factor, and heat-stable factor. The heat-stable factor was prepared from calf cerebellum. Glucose 6-phosphate and N-acetylaspartic acid have previously been identified as active components of the heat-stable factor. We report in this manuscript that glutamic acid, glutamine, aspartic acid, and gamma-aminobutyric acid as well as inorganic phosphate and adenosine nucleotides are also active components of the heat-stable factor. When the amino acids, glucose 6-phosphate, AMP, and phosphoric acid were combined, full activity of the heat-stable factor for the formation of cerebronate (by alpha-hydroxylation) and glutamate (presumably by beta-oxidation) from lignoceric acid was recovered. The role of the acidic amino acids in the metabolic conversion of lignoceric acid in brain appears to be their conversion to the corresponding alpha-keto acids and then incorporation into the TCA cycle. Glucose 6-phosphate is also likely to be involved in the TCA cycle through the Emden-Meyerhof pathway. Inorganic phosphate and AMP seemingly are used to produce ATP. However, the addition of up to 20 mM ATP alone did not replace the heat-stable factor. PMID- 6859866 TI - Na+, K+, H+ and Cl- permeability properties of rabbit skeletal muscle sarcolemmal vesicles. AB - The ion permeability properties of rabbit skeletal muscle sarcolemmal vesicles were investigated by means of radioisotope flux, membrane potential, and light scattering measurements. An enriched sarcolemmal fraction was obtained from the 22-27% region of sucrose gradients after isopycnic centrifugation. The presence of contaminating sarcoplasmic reticulum was assessed with the use of a purified sarcoplasmic reticulum vesicle fraction. 22Na+, 86Rb+, 36Cl-, and [3H]sucrose flux measurements indicated that the sarcolemmal fraction possessed isotope spaces ranging between 1.5 and 4 microliters/mg protein. Membrane potential measurements using the voltage-sensitive fluorescent probe 3,3'-dipentyl-2,2' oxadicarbocyanine iodide (diO-C5-(3)) indicated that sarcolemmal vesicles were impermeable to H+ and Na+ but that 10-15% of the vesicles were permeable to K+. Light-scattering measurements indicated a small fraction of sarcolemmal vesicles were permeable to both K+ and Cl-. Whether the low permeability of sarcolemmal vesicles to Na+, K+, and Cl- is the result of a low concentration of ion channels or the inactivation of these channels during isolation is at present uncertain. PMID- 6859869 TI - Transport of methotrexate in Chinese hamster ovary cells: a mutant defective in methotrexate uptake and cell binding. AB - The uptake of several folate compounds has been investigated in wild-type and one class of methotrexate-resistant Chinese hamster ovary cells. The wild-type cells can take up methotrexate, folic acid, and 5-methyl tetrahydrofolate. The uptake of methotrexate is characterized by a KT of 1.9 +/- 0.2 microM and a Vmax of 1 +/ 0.8 pmol/min/mg protein, is competitively inhibited by folic acid and 5-methyl tetrahydrofolate, and is sensitive to p-hydroxymercuriphenyl sulfonic acid. The resistant cells are unable to take up methotrexate, folic acid, and 5-methyl tetrahydrofolate. In addition, the resistant cells are unable to bind methotrexate specifically, whereas the wild-type cells bind the drug with an apparent KD of 2 +/- 0.4 microM and a Vmax of 1.3 +/- 0.3 pmol/mg protein. These data indicate that the resistant cells are resistant because of an inability to take up the drug resulting from a defective membrane-binding component. The data also suggest that both methotrexate and folic acid are transported by the same system in Chinese hamster ovary cells. PMID- 6859868 TI - Paracatalytic inactivation of pig heart pyruvate dehydrogenase complex. AB - The phenomenon of paracatalytic inactivation has been demonstrated and characterized with the pig heart pyruvate dehydrogenase complex. The enzyme became progressively inactive when it was preincubated in the presence of pyruvate, thiamine pyrophosphate, and extrinsic oxidative agent, 2,6 dichloroindophenol. Not only the overall reaction of enzyme complex but the individual reactions catalyzed by enzyme components, pyruvate dehydrogenase, and dihydrolipoamide acetyltrasferase, were reduced after preincubation. The observed inactivation is due to two factors: (i) covalent incorporation of the pyruvate atoms, and (ii) formation of a thiamine pyrophosphate analog. (i) A covalent incorporation of radioactivity from [2-14C]pyruvate into the enzyme complex, which was proportional to the inhibition of overall reaction was observed. Seventy-eight percent of the radioactivity incorporated into the dihydrolipoamide transacetylase but not into the lipoic acid. Thus, modification of the dihydrolipoamide acetyltransferase component can be attributed to the covalent incorporation of pyruvate atoms. (ii) During inactivation, the enzyme-bound thiamine pyrophosphate underwent a modification resulting in the formation of a thiamine pyrophosphate analog, presumably thiamine thiazolone pyrophosphate, which inhibited exclusively the pyruvate dehydrogenase component. PMID- 6859865 TI - Comparison of glycerophosphate acyltransferases from Euglena chloroplasts and microsomes. AB - The acylation of sn-glycerol 3-phosphate is a common reaction in the pathways leading to the biosynthesis of glycerol-derived phospholipids, galactolipids, and sulfolipids. Enzymes catalyzing this reaction have been solubilized from Euglena chloroplasts, microsomes, and mitochondria (B. A. Boehler and M. L. Ernst-Fonberg (1976) Arch. Biochem. Biophys. 175, 229-235; L. V. Grobovsky, S. Hershenson, and M. L. Ernst-Fonberg (1979) FEBS Lett. 102, 261-264). Some characteristics of the reactions catalyzed by the acyl-CoA:sn-glycerol-3-phosphate O-acyltransferases (EC 2.3.1.15) solubilized from chloroplasts and microsomes of Euglena have been compared. Although the two enzymes have some common features, including stimulation by bovine serum albumin and phosphatidyl choline and sensitivity to sulfhydryl-binding reagents, they differ in their stabilities and responses to salt and glycerol. They exhibit different acyl-CoA substrate dependency curves. The proportions of monoacyl sn-glycerol-3-phosphate acyltransferase activity differ in the two solubilized enzyme preparations, and different products are produced by each of the glycerophosphate acyltransferases solubilized from chloroplasts and microsomes, respectively. Neither glycerophosphate acyltransferase will use palmitoyl- or myristoyl-acyl carrier protein (ACP) as a substrate whereas both use the corresponding CoA esters. Neither is inhibited by ACP, but the enzyme from microsomes is inhibited by CoA. PMID- 6859870 TI - The influence of phospholipase A2 and glutathione peroxidase on the elimination of membrane lipid peroxides. AB - The relationship between release of membrane lipid peroxidation products and phospholipase action was examined. Rat liver microsomes and phosphatidylcholine liposome-phospholipase A2 preparations were subjected to iron ascorbate-induced lipid peroxidation. Peroxidation products were characterized by measurement of malondialdehyde and lipid peroxides. Experiments were designed to demonstrate phospholipase dependent removal of peroxidation products origination in the membrane. Increased lysophosphatidylcholine formation was evident following lipid peroxidation in phospholipase A2-containing liposomes which was inhibited by p bromophenacyl bromide and mepacrine. Lipoxygenase-dependent oxygen consumption, as well as peroxide transfer from microsomes to the incubation medium, was largely dependent on phospholipase and could be diminished by phospholipase inhibitors. Furthermore, lipid hydroperoxides formed by subjecting phosphatidylcholine liposomes to iron ascorbate-induced peroxidation, or those present in aged liposomes, were effectively reduced by glutathione peroxidase when phospholipase A2 was present in the assay. Low level glutathione peroxidase activity was observed in the absence of phospholipase A2. PMID- 6859871 TI - Configurational, conformational, and solvent effects on the reduction of a Schiff base by reduced pyridine nucleotide analogs. AB - The rate of reduction of the Schiff base, delta 1-pyrroline-2-carboxylic acid, by beta-NADH has previously been shown to be 6.8 times smaller than that calculated from the substituent effects in 1-substituted 1,4-dihydronicotinamides. The factors governing this anomalous rate have been studied by measuring the reduction rate with a number of reduced pyridine nucleotides in water and water methanol mixtures. The beta-configuration for the nicotinamide-ribosidic linkage was found to be responsible for 75% of the anomaly; the same reduced coenzyme with alpha-linkage, however, behaves normally. It was also shown that the low reactivities of the reduced coenzymes with beta-configuration are entirely the result of their abnormal thermodynamic stabilities. Conformational effects (the folding of beta-NADH) account for only 20% of the reduction rate anomaly. Addition of organic solvents causes only a modest decrease in the overall rate. These solvent effects are interpreted in terms of the opposing effects of solvents on the basicity of the Schiff base and on the reduction step itself. Specific solvation effects appear important in controlling the reduction rates. PMID- 6859872 TI - Isolation of mitochondria, lysosomes, and microsomes from the rat ventral prostate with a note on inverted microsomal vesicles. AB - A procedure is presented for the isolation of lysosomes, mitochondria, and microsomes from the rat ventral prostate with relatively good yield. Homogenization was performed with a Polytron homogenizer or in combination with the Potter-Elvehjem device. Reasonably pure mitochondria and lysosomes could only be obtained using a Metrizamide gradient, whereas it was possible to prepare pure microsomal fractions by differential centrifugation in sucrose. The purity of the lysosomes and mitochondria was 90 and 85%, respectively, as judged by the presence of different marker enzymes. These findings were confirmed by ultrastructural analyses. Electron micrographs of the isolated lysosomes showed intact lysosomes surrounded by a single membrane. The lysosomes contained intramatrical vesicles with lipid-like material. Vesicles derived from the endoplasmic reticulum in the microsomal fraction ranged from 70 to 90% depending on the centrifugal force used to sediment the mitochondrial fraction. Electron micrographs of the microsomal fraction showed that about 40% of the vesicles were inverted and turned "inside-out", i.e., having their ribosomes attached to the inside of the vesicles. By fractionation of ethylenediaminetetraacetate treated microsomes on a sucrose gradient a partially purified fraction was isolated which consisted of 65% of inverted microsomes. PMID- 6859873 TI - Characterization of brain phosphatidylserine decarboxylase: localization in the mitochondrial inner membrane. AB - A membranous fraction from calf brain, sedimenting at 10,000g, catalyzes the decarboxylation of exogenous phosphatidyl[14C]serine presented in an aqueous dispersion in detergent. The product formed by the enzymatic decarboxylation reaction is chemically and chromatographically identical to phosphatidyl[14C]ethanolamine. The calf brain decarboxylase activity: (1) did not require divalent cations; (2) was optimally active at neutral pH; (3) exhibited maximal activity in the presence of 0.1% Cutscum or sodium taurocholate; (4) was inhibited by hydroxylamine or p-hydroxymercuribenzoate; and (5) has an apparent Km = 2.4 mM for the phospholipid substrate. When this fraction was further separated by metrizamide density centrifugation, 90% of the phosphatidylserine decarboxylase activity was associated with the mitochondria. Resolution of the inner and outer membranes of the mitochondria revealed that greater than 99% of the decarboxylase activity was bound to the inner membrane. In contrast to this result, diacylglycerol ethanolaminephosphotransferase, another enzyme responsible for phosphatidylethanolamine biosynthesis in brain, was greatly enriched in the microsomal fraction. The highest level of phospholipid N-methyltransferase activity was also localized in the microsomal fraction. Thus, phosphatidylethanolamine formation via cytidine diphosphate ethanolamine in brain occurs at a membrane site where it should be available for the biosynthesis of phosphatidylcholine by stepwise methylation. In order for phosphatidylethanolamine formed by the decarboxylation reaction to be available for N-methylation, translocation from mitochondria to the microsomal site would be required. PMID- 6859874 TI - Ketomethylthiobutyric acid formation from methylthioadenosine: a diffusion assay. AB - Typical enzyme kinetics were observed when 5'-methylthioadenosine was used as substrate with extracts of malignant murine cells in a diffusion assay. The volatile product was measured after diffusion into a solution of the sulfhydryl reagent, 5,5'-dithiobis(2-nitrobenzoic acid), which it reduced to a yellow chromophore. Cysteine was required in the system. The volatile product was identified as H2S derived from the cysteine. The yield of H2S was similar to the amount of 2-keto-4-methylthiobutyric acid (KMTB) formed from methylthioadenosine when the KMTB was measured simultaneously in an ether extraction assay. KMTB could replace methylthioadenosine as a substrate capable of causing the formation of the diffusible product from cysteine. It is concluded that the following sequence of reactions takes place in the diffusion assay system: (1) 5' methylthioadenosine + Pi leads to adenine + 5-methylthioribose-1-P, (2) 5 methylthioribose-1-P leads to KMTB, (3) KMTB + cysteine leads to methionine + 3 mercaptopyruvate, (4) 3-mercaptopyruvate + excess R-SH leads to pyruvate + H2S, (5) H2S + 5,5'-dithiobis(2-nitrobenzoic acid) leads to 5-mercapto-2-nitrobenzoic acid. Thus, the diffusion assay measures the amount of KMTB formed. The key enzyme, cysteine aminotransferase, EC 2.6.1.3, was partially purified from malignant cells and from liver and several of its characteristics are described. The diffusion assay using this enzyme is useful in measuring de novo synthesis of alpha-keto acids and it is applicable to crude enzyme preparations. The sensitivity is about 5 nmol of keto acid and the accurate range is 5 to 100 nmol. PMID- 6859875 TI - Evidence for a carbanion intermediate in catalysis by spinach ribulose-1,5 bisphosphate carboxylase/oxygenase. AB - Spinach ribulose-1,5-bisphosphate (RuBP) carboxylase/oxygenase (EC 4.1.1.39) showed marked reactivity towards tetranitromethane in the presence of RuBP, when the enzyme was in the fully activated state. The inactivated enzyme did not catalyze substrate-dependent nitroform production. Nitroform production was proportional to the concentration of the enzyme and tetranitromethane at optimal substrate concentrations. The pH optimum for nitroform production was similar to that for carboxylation. The effects of bicarbonate, ribulose-1,5-bisphosphate, and temperature on partition of the intermediate between production of phosphoglycerate and nitroform indicate that both routes share a common intermediate. Data on stoichiometry of the reaction imply that the intermediate is not oxidized by tetranitromethane but instead is nitrated. The data are compatible with a carbanion intermediate in the reaction catalyzed by ribulose 1,5-bisphosphate carboxylase. PMID- 6859876 TI - Malate synthase: aggregation, deaggregation, and binding of phospholipids. AB - Octameric malate synthase is located in the glyoxysomes of cucumber cotyledons. The enzyme is predominantly confined to the organelle's membrane and can be solubilized with Mg2+. Separation of cell structures in a zonal rotor afforded, besides glyoxysomes, two other zones with malate synthase activity, viz., in the gradient supernatant and in the range of the endoplasmic reticulum (ER). Malate synthases of these three fractions were purified to apparent homogeneity and classified according to their molecular weight. Differences in subunit molecular weight, however, could not be detected when malate synthases from the three fractions were compared. Mature malate synthase, as well as malate synthase prepared from fractions sedimenting similarly to the ER, exhibited the following behavior with respect to aggregation and deaggregation: at low salt concentrations and in the absence of Mg2+, the enzyme shifted to aggregated forms (approx 100 S); with 2 mM Mg2+, malate synthase deaggregated and occurred predominantly as an octamer (19 S). By changing buffer conditions, mature forms of malate synthase could be interconverted repeatedly between octameric and aggregated forms, whereas a monomeric form (5 S), prepared from soluble fractions assigned to the cytosol, did not oligomerize. The amphipathic properties of malate synthase were demonstrated by the enzyme's capacity for binding phospholipids. PMID- 6859878 TI - The reaction of arachidonic acid epoxides (epoxyeicosatrienoic acids) with a cytosolic epoxide hydrolase. AB - Epoxyeicosatrienoic acids, formed during the cytochrome P-450-catalyzed oxidation of arachidonic acid, react with a liver cytosolic epoxide hydrolase to form vicinal diols of eicosatrienoic acid. The role of this cytosolic enzyme, rather than a microsomal bound type, explains previous results illustrating the ability to accumulate epoxides during the in vitro aerobic steady state of oxidative metabolism of arachidonic acid by liver microsomes. The inability of the 5,6 epoxyeicosatrienoic acid to serve as a suitable substrate for this enzyme is discussed in light of recent studies concerning possible unique physiological functions for this metabolite. PMID- 6859877 TI - Oligomerization of malate synthase during glyoxysome biosynthesis. AB - The octameric malate synthase, found in glyoxysomes of plants, is synthesized as monomeric precursor in the cytoplasm. The precursor form does not possess a different subunit molecular weight than the mature organellar enzyme, but differs from the organellar protein by not oligomerizing and aggregating. This was shown by synthesis in a cell-free reticulocyte lysate system programmed with cucumber poly A+-mRNA followed by immunoprecipitation of the radiolabeled translation products. The precursor form of malate synthase was also detected in vivo in the cytosol of pulse-labeled cucumber cotyledons after immunoprecipitation of the radiolabeled polypeptide. At low salt concentrations, mature malate synthase can be converted into aggregated forms. However, the precursor form obtained either by in vitro translation or by extraction from the cytosol after short pulses of radioactive methionine, could neither be oligomerized into the octameric form nor aggregated into the 100-S form. Processing of malate synthase, assumed to be a requisite for oligomerization, took place rapidly in the glyoxysomes, but proceeded only slowly in the cytosol. This was demonstrated both by the uptake of in vitro-translated malate synthase into glyoxysomes, and by analysis of newly synthesized malate synthase detectable in glyoxysomes in vivo. In both cases the octamer was by far the predominant form. PMID- 6859879 TI - Turnover of cytoplasmic and mitochondrial aspartate aminotransferase isozymes in mouse liver and transplantable hepatomas. AB - Activities of the cytoplasmic and mitochondrial isozymes of aspartate aminotransferase (aspartate:2-oxoglutarate aminotransferase, EC 2.6.1.1, AAT) in transplantable mouse hepatomas BW7756 and H-4 are reduced when compared to normal adult liver. Both proteins have been purified to homogeneity from a single preparation of mouse liver and monospecific antibodies raised to each isozyme. By quantitative immunotitration analysis, the activity of each isozyme in liver and hepatoma has been shown to correlate with levels of immunoprecipitable protein. Furthermore, for each isozyme, the liver versus hepatoma species is indistinguishable by heat inactivation kinetics, Km's for substrates, and molecular weights. Thus, the reduction of mitochondrial and cytoplasmic AAT activities in hepatoma tissue is due not to alterations in the catalytic activity of the enzyme molecules, but to a decrease in the number of enzyme molecules present. Turnover of the isozymes was studied in liver and hepatoma tissue using in vivo radiolabeling and specific immunoprecipitation techniques. The cytoplasmic isozyme has a similar rate of degradation in liver and hepatoma, while the rate of synthesis of this isozyme in hepatoma is approximately tenfold less than in liver. The mitochondrial isozyme is also degraded at a similar rate in both tissues, but the rate of synthesis is sixfold greater in normal liver tissue than in hepatoma. It is concluded that decreased amounts of both isozymes in hepatoma as compared to liver are the result of a reduction in the rate of synthesis of each isozyme without any change in the rate of degradation. PMID- 6859881 TI - Hailey-Hailey disease: response to vitamin E therapy. PMID- 6859880 TI - Toxic reaction to methotrexate in a patient receiving penicillin and furosemide: a possible interaction. PMID- 6859883 TI - Granuloma annulare treated with chlorambucil: an 18-month follow-up. PMID- 6859882 TI - Lipoma on the shoulder in site of chronic trauma. PMID- 6859884 TI - Call level I (in situ) malignant melanoma. What it is. PMID- 6859885 TI - Favorable prognosis for malignant melanomas associated with acquired melanocytic nevi. AB - In a clinicohistopathologic study of 557 patients with primary cutaneous malignant melanoma, there were fewer metastases and/or deaths from melanoma when histologic evidence of a coexisting acquired melanocytic nevus was found. A total of 130 patients with melanocytic nevus and 427 cases of melanoma without histologic evidence of a nevus (denovo) were studied. Clinical follow-up evaluation for evidence of metastases and/or death was obtained. Only ten of the patients (7.7%) with nevus-associated melanoma had metastases and/or death v 78 (18.3%) with de novo melanoma. When stratified by lesion thickness, the logrank test for survival revealed a statistically significant difference between the two groups. An overall favorable outcome seen in patients with malignant melanomas associated with acquired melanocytic nevi was found, therefore, to be independent of lesion thickness as well as six other variables reported to be related to the biologic behavior of malignant melanoma. Thus, the presence of nevus cells in a specimen of malignant melanoma portends a better prognosis and may have important implications in the biology of this neoplasm. PMID- 6859886 TI - Pyoderma gangrenosum and monoclonal gammopathy. AB - The records of eight patients with pyoderma gangrenosum and monoclonal gammopathy showed that all patients except one had an IgA paraproteinemia. To date, seven patients have had a benign course and multiple myeloma has developed in one. In seven patients, the onset of the pyoderma gangrenosum preceded the detection of the monoclonal gammopathy. The monoclonal gammopathy did not seem to influence the morphologic findings, course, or therapy of the pyoderma gangrenosum. In the one patient with myeloma, treatment of the myeloma caused accelerated healing of the skin lesions. PMID- 6859887 TI - Trichophyton mentagrophytes granulomas. Unique systemic dissemination to lymph nodes, testes, vertebrae, and brain. AB - A man had Trichophyton mentagrophytes infection that ultimately involved the lymph nodes, testes, vertebrae, and CNS. It was associated with anergy and defective lymphocyte transformation to T mentagrophytes antigen. The patient was also anergic to repeated delayed skin testing with PPD and dinitrochlorobenzene. His lymphocyte responsiveness, as demonstrated by lymphocyte transformation to phytohemagglutinin and PPD, was substantially decreased. However, the results of an in vitro leukocyte migration inhibition assay showed that his lymphocytes were responsive to T mentagrophytes antigen as well as to PPD. The patient's serum IgE level was increased, but serum transferrin levels were persistently abnormal. Therapeutic attempts, including the systemic administration of griseofulvin, amphotericin B, clotrimazole, and transfer factor failed, and the patient died five years after systemic disease onset. PMID- 6859888 TI - Childhood systemic lupus erythematosus. Association with pancreatitis, subcutaneous fat necrosis, and calcinosis cutis. AB - Pancreatitis developed in a 12-year-old girl with a one-year history of systemic lupus erythematosus. The pancreatitis was first manifested by panniculitis of the lower extremities. Calcinosis cutis subsequently developed, both in areas of panniculitis and in areas free of panniculitis. The patient's medications at the time of onset of pancreatitis included prednisone, hydrochlorothiazide, and azathioprine, all of which have been reported to be causes of pancreatitis. We wish to alert physicians that pancreatitis associated with cutaneous panniculitis and calcinosis cutis may develop in children with systemic lupus erythematosus. PMID- 6859889 TI - Pyoderma gangrenosum. Response to cyclophosphamide therapy. AB - A 46-year-old woman had a 17-year history of intermittently severe pyoderma gangrenosum without identifiable associated systemic disease. Her condition had become unresponsive to corticosteroid and sulfone therapy given for systemic effect, but responded completely to 150 mg/day of cyclophosphamide. Immunosuppressive therapy should be considered in patients with severe, recalcitrant pyoderma gangrenosum, even in the absence of associated systemic disease. PMID- 6859890 TI - Induction of actinic lichen planus with artificial UV sources. AB - A fair-complected woman had an episode of actinic lichen planus (ALP) following natural sunlight exposure. The occurrence of ALP in the Netherlands, with its temperate summers, is highly unusual. Phototests with repeated doses of UV-B radiation successfully induced lichen planus-like skin lesions, while UV-A irradiation had no effect. Histologic examination of both the naturally occurring ALP lesions and the artificially induced lesions disclosed features characteristic of lichen planus. PMID- 6859891 TI - Psychosomatic concepts in dermatology. A dermatologist-psychoanalyst's viewpoint. AB - Few experienced clinicians remain unimpressed both by the influence of psychological and social factors on the physical state and by our relative inability to deal adequately with this aspect of the practice of dermatology. This article reviews the historical development of psychosomatic concepts, describes some theories concerning the process whereby somatization takes place and why a particular disease is "chosen," reviews some of the relevant basic science findings, offers a working classification of psychocutaneous disease, and, finally, makes some suggestions as to how we may become more effective in handling this important part of our clinical practice. PMID- 6859892 TI - Effect of "aminopterin" on epithelial tissues. AB - The folic acid antagonist, 4-aminopteroyl glutamic acid ("aminopterin"), is a potent inhibitor of growth and of connective tissue proliferation. The present study indicates that the suppressive effects of "aminopterin" on epithelial structures are more striking than on connective tissue, as revealed by observation of interference with wound healing and epithelization, atrophy and ulceration of mucosa, alopecia, and prompt suppressive effects in such dermatologic disorders as psoriasis and chronic indurative dermatoses. "Aminopterin" was administered orally in daily doses of 1.5 to 2.0 mg. to thirteen patients with psoriasis (of whom six had associated arthritis) and to five patients with chronic indurative dermatoses. The latter included one patient with chronic atopic eczematoid dermatitis with associated asthma, one with chronic eczematoid seborrheic dermatitis, one with chronic discoid lupus erythematosus involving the face, and two with scleroderma. In all patients there were remissions in cutaneous lesions, which appeared most commonly between the 5th and 10th day of "aminopterin" therapy. Treatment was interrupted in most patients after an initial course of 14 to 28 mg. because of the regular occurrence of shallow ulceration of the buccal mucosa and frequent development of abdominal cramps. Remissions persisted for periods ranging from two weeks to several months, after which lesions returned which responded to further courses of "aminopterin." The therapeutic response was more complete in the seven patients with psoriatic arthritis than in in six subjects with uncomplicated psoriasis. In four patients with psoriatic arthritis in whom the responses to "aminopterin" and cortisone were compared, arthritic manifestations were considerably more relieved by cortisone, but improvement in psoriasis was consistently more complete and more sustained with "aminopterin." No evidence of a summative effect of cortisone and "aminopterin" on psoriasis was observed when the two were employed concomitantly, although amelioration of arthritic symptoms was more complete than when cortisone was given alone. Topical application of "aminopterin" in a 1% ointment was found to be ineffective. "Aminopterin" is a toxic drug, and its administration must be carefully supervised. The citrovorum factor has proved useful in overcoming "aminopterin" toxicity but interferes with its therapeutic effects. It is suggested that "aminopterin" may prove useful in other dermatologic disorders and in cutaneous manifestations of some systemic diseases which, in certain instances, have been temporarily benefited by cortisone. PMID- 6859893 TI - Commentary: three decades of folic acid antagonists in dermatology. PMID- 6859895 TI - Failure of human growth hormone to benefit dystrophic epidermolysis bullosa. PMID- 6859894 TI - Tinea capitis in the New York City area. PMID- 6859896 TI - Variegate porphyria and porphyria cutanea tarda. PMID- 6859897 TI - Cutaneous remnants of the omphalomesenteric duct. PMID- 6859898 TI - Disseminated North American blastomycosis. PMID- 6859900 TI - Granuloma faciale. Treatment with the argon laser. AB - Three patients with granuloma faciale were successfully treated by argon laser therapy. The intense blue-green laser light is readily absorbed by these inflammatory lesions, resulting in resolution of the clinical and microscopic abnormalities. There were no recurrences during follow-up periods of 23, 21, and 5 months, respectively. Argon laser therapy appears to be an important addition to the treatment armamentarium for this uncommon, but difficult to treat, entity. PMID- 6859899 TI - Anticentromere and anticentriole antibodies in the scleroderma spectrum. AB - We studied serum samples from 106 patients, including 80 in the scleroderma spectrum, by indirect immunofluorescent microscopy, using PtK1 rat kangaroo tissue culture cells as substrate. Anticentromere (Kinetochore) antibodies were present in 28 patients, and anticentriole antibodies were present in four patients. Anticentromere antibodies were usually present in patients with a benign, chronic form of systemic scleroderma, which has been termed the CREST (Calcinosis, Raynaud's phenomenon, esophageal involvement, sclerodactyly, and telangiectasia) syndrome. The four patients with a previously undescribed anticentriole antibody were all in the scleroderma spectrum. Possibly, these antibodies may have diagnostic and prognostic importance. Further, they will be useful in studying the structure and function of these cellular organelles. PMID- 6859901 TI - Metastasizing basal cell carcinoma originating in a stasis ulcer in a black woman. AB - A case of basal cell carcinoma originated in a long-standing stasis ulcer on the lower extremity and then metastasized to the dermis and subcutaneous tissue of the thigh. The literature on metastasizing basal cell carcinoma is reviewed. PMID- 6859902 TI - Cutaneous sarcoidosis associated with sarcoidosis of the upper airway. AB - The diagnosis of laryngeal sarcoidosis is frequently delayed because it is rare and often develops insidiously. A 24-year-old woman with the annular scarring form of cutaneous sarcoidosis later contracted laryngeal sarcoidosis. Despite a two-year history of upper respiratory tract symptoms, the patient's progressive respiratory distress was attributed to sarcoidal pulmonary involvement. Dermatologists should be aware of the risk of airway obstruction from laryngeal granulomas in patients with cutaneous sarcoidosis. Although most commonly associated with the lupus pernio form of sarcoidosis, upper airway granulomas also develop in patients with other cutaneous manifestations of sarcoidosis. PMID- 6859903 TI - Febrile ulceronecrotic Mucha-Habermann's disease. AB - A patient with febrile ulceronecrotic Mucha-Habermann's disease manifested the characteristic features of this entity. These include a polymorphous eruption with histopathologic findings of Mucha-Habermann's disease, large ulceronecrotic skin lesions, intermittent high fever, and constitutional symptoms. The patient was unique in that he also had malabsorption and eosinophilia. This disease may represent a hypersensitivity reaction. To our knowledge, there are five previous cases of febrile ulceronecrotic Mucha-Habermann's disease reported in the world literature. PMID- 6859904 TI - White piedra. AB - White piedra, a fungal infection caused by Trichosporon cutaneum, has been reported in Europe, South America, and the Orient. A few cases have also been reported in the United States, all of them acquired as well in this country. A patient whose condition was diagnosed in California apparently contracted white piedra while visiting Panama, demonstrating that tropical diseases may occasionally be found at great distances from their point of origin. Therapy with topical clotrimazole and removal of infected hairs by shaving failed to produce a clinical or culturally confirmed cure in this patient. PMID- 6859905 TI - Eruptive lipofibromata. AB - Patients with increased circulating levels of adrenocorticosteroids or with diabetes mellitus are described as having a predilection for skin tags. These cutaneous outgrowths are usually filiform papules in the axillae and on the neck or eyelids. I saw the unusual development of broad-based lipofibromas on the legs of a diabetic woman with Cushing's syndrome. These tumors were multiple, soft, sessile, and hyperpigmented. PMID- 6859906 TI - Possible discoid lupus erythematosus in newborn infant. Report of a case with subsequent development of acute systemic lupus erythematosus in mother. AB - Cases of a newborn infant with an eruption clinically and histologically consistent with lupus erythematosus and of his mother developing acute disseminate lupus erythematosus 11 months after delivery are presented. It is urged that in the future in cases of death of a fetus of a mother who has lupus erythematosus of any type or who gives a history of this disease, the fetus be examined for stigmata of lupus erythematosus. The possibility of a transmittable etiological agent of lupus erythematosus from mother to fetus is suggested. PMID- 6859907 TI - Acute paronychia after high-dose methotrexate therapy. PMID- 6859908 TI - Fetal surgery. PMID- 6859909 TI - The incidence of coeliac disease and early weaning. PMID- 6859910 TI - The nerve deaf child--intrauterine rubella or not? AB - We describe a laboratory test which is useful in determining whether deafness is due to intrauterine rubella. The study group consisted of 8 deaf patients with proved intrauterine rubella, 12 patients with familial deafness, and 17 controls. Blood was taken at time 0 from all of them. All the deaf children and 5 controls were immunised and further blood samples taken at 2 and 6 weeks. Each blood sample was analysed for the lymphocyte response to rubella in vitro and for the presence of rubella haemagglutination inhibition. All the rubella-affected patients had antibody titres to rubella at time 0 and there was no notable change after immunisation. None of these patients had a significant lymphocyte response to rubella antigen at any time. Eight of the familial deaf patients and 13 of the controls had positive antibody titres. With the exception of one patient whose results were equivocal, all the familial deaf patients and controls in whom antibodies were detected had lymphocyte responses to rubella. In those with undetectable antibodies the lymphocytes failed to respond in vitro to rubella antigen. PMID- 6859911 TI - Duodenal microflora in infants with acute and persistent diarrhoea. AB - The duodenal bacterial population was determined qualitatively and quantitatively in 3 groups of infants with diarrhoeal disease of varying duration. Infants with acute self limiting diarrhoea (group 1) had an abnormal overgrowth of organisms in the upper small bowel which was similar to that found in infants whose diarrhoea persisted after 4 days in hospital (group 2). The total duodenal organism count in infants with diarrhoea persisting after 7 days in hospital (group 3) was almost 100 times greater than either of the other groups. The findings may have important implications in preventing persistent diarrhoea from becoming protracted. PMID- 6859914 TI - Ultrasonography of the pelvic organs in prepubertal and postpubertal girls. AB - Reference curves for the growth of the uterus and ovaries were established for prepubertal and postpubertal girls by examining 34 healthy schoolgirls of age 7, 10, 13, and 17 years by grayscale ultrasound. Uterine volume increased from mean 0.9 cm3 at 7 years to 53 cm3 at 17 years. The ovaries could not be detected by ultrasound in girls of 7 years, but ovarian volume increased from mean 0.7 cm3 at 10 years to 5.8 cm3 at 17 years. There was good correlation between the Tanner score and uterine and ovarian volumes (r = 0.91 and 0.82 respectively). To test the reference curve, the uterine volume was assessed in 10 girls with abnormal sexual development. Five girls with precocious puberty had values greater than mean + 2 SD and 5 girls with primary amenorrhoea had values less than mean - 2 SD. Good reference values for ovarian and uterine size are necessary before ultrasound can be used to evaluate these organs in children with abnormal development of the reproductive system. PMID- 6859913 TI - Sodium homeostasis in term and preterm neonates. II. Gastrointestinal aspects. AB - Eighty five 24 hour balance studies were performed on 70 healthy newborn infants of gestational age 27-40 weeks; dietary intake and stool losses of sodium were measured. There was a relation between gastrointestinal sodium absorption and conceptional age (the sum of gestational and postnatal age), whether expressed as absolute stool sodium losses or as the ratio of stool sodium to dietary sodium intake. The stool K:Na ratio rose appreciably with maturation, although stool content of potassium was not greatly increased. These findings suggest that intestinal sodium absorption is inefficient in immature babies and that the degree of malabsorption is inversely related to conceptional age. PMID- 6859915 TI - Growth status and the risk of contracting primary tuberculosis. AB - A case of open tuberculous infection in a member of staff at a primary school resulted in an outbreak in which nearly a quarter of the children in the school contracted a primary infection. The growth status of these children was compared with that in the non-infected children before the outbreak and on two occasions after the outbreak. The children with tuberculous infection were taller and fatter than the controls before and after the outbreak but differences were not always statistically significant. Among children with a good nutritional status the thin and small child is at no greater risk of contracting primary tuberculous infection than other children. PMID- 6859912 TI - Sodium homeostasis in term and preterm neonates. I. Renal aspects. AB - Eighty five 24 hour sodium balance studies and creatinine clearance measurements were performed in 70 infants of gestational age 27-40 weeks and postnatal age 3 68 days. The kidney's capacity to regulate sodium excretion was a function of conceptional age (the sum of gestational age and postnatal age) and an independent effect of postnatal age was also observed--extrauterine existence increased the maturation of this function. The sodium balance was negative in 100% of infants of less than 30 weeks' gestation, in 70% at 30-32 weeks, in 46% at 33-35 weeks, and in 0% of greater than 36 weeks, and the incidence of hyponatraemia closely paralleled that of negative sodium balance. Despite a low glomerular filtration rate (GFR) urinary sodium losses were highest in the most immature babies but fractional sodium excretion (FENa) was exponentially related to gestational age. An independent effect of postnatal age could be identified on FENa but not in GFR. These findings indicate that in infants of greater than 33 weeks' gestation sodium conservation is possible because of a favourable balance between the GFR and tubular sodium reabsorption, but that below this age GFR exceeds the limited tubular sodium reabsorption capacity. The rapid increase in sodium reabsorption in the first few postnatal days seems to be due to maturation of distal tubular function, probably mediated by aldosterone. We suggest that the glomerulotubular imbalance for sodium is a consequence of the immaturity of the tubuloglomerular feedback mechanism, and we estimate that the minimum sodium requirement during the first 2 weeks of extrauterine life is 5 mmol (mEq)/kg/day for infants of less than 30 weeks' gestation and 4 mmol (mEq)/kg/day for those born between 30 and 35 weeks. PMID- 6859916 TI - Partial galactose disorders in families with premature cataracts. AB - Minor and major deficiencies of enzymes affecting galactose metabolism may be associated with cataracts of early onset. Results are presented for 10 such families with minor enzymatic disorders. Expression of the major disorders probably involves galactitol accumulation and osmotic lens damage but this mechanism is not obviously associated with minor disorders. The observed incidence of minor incomplete enzymatic disorders of galactose metabolism in families with an incidence of cataracts of early onset may be at least partly incidental. PMID- 6859918 TI - Face mask resuscitation: does it lead to gastric distension? AB - Inflation and oesophageal pressures were recorded simultaneously during bag and mask resuscitation of 9 asphyxiated babies. After half a minute of standard inflation pressures, higher pressures were applied for at least 5 inflations by occluding the blow-off valve. No air entered the oesophagus until a high mean inflation pressure of 5.4 kPa was exceeded. These findings were confirmed in 4 fresh stillborn babies studied similarly. We conclude that resuscitation using bag and mask, applying pressures less than 3.5 kPa, should not lead to gastric distension. PMID- 6859919 TI - Hand and ECG tremor in spinal muscular atrophy. AB - The presence of hand and electrocardiogram (ECG) tremor was studied in 31 children with severe, intermediate, or mild form of spinal muscular atrophy. Clinical tremor of the hands was seen in 16 (59%) of 27 patients, all with benign forms of the disease. Nineteen patients had ECG tremors, of whom 17 had the mild or intermediate form. With the exception of one, all patients in the mild or intermediate group had hand or ECG tremor. Hand and ECG tremor are valuable in the diagnosis of the benign forms of spinal muscular atrophy; they are of no value in diagnosis of the severe infantile type. PMID- 6859917 TI - Comparison of the B vitamin composition of milk from mothers of preterm and term babies. AB - Samples of milk were taken at intervals during lactation from 35 mothers of term and 26 mothers of preterm infants and assayed for 8 B complex vitamins. Both term and preterm milks varied widely in vitamin content between mothers. Mean concentrations of thiamin, vitamin B6, nicotinic acid, pantothenic acid, biotin, and folic acid increased progressively over several weeks after parturition but vitamin B12 concentrations declined generally and riboflavin values showed little change. Preterm milk was not richer in vitamins than term milk of the corresponding stage of lactation and it appeared that intake of B vitamins differed widely among preterm infants given their own mothers' milk. These infants may have meagre body reserves and an increased need for vitamins, and breast milk whether from their own mother or from the milk bank may not meet their needs. There is a strong case for supplementing breast milk given to preterm babies with the B complex vitamins. PMID- 6859920 TI - Effects of smoking on breast feeding. AB - Infant feeding methods used by mothers who smoke and by mothers who do not, who delivered in one maternity hospital, were compared to determine if smoking affected breast feeding. Significantly more of the smoking group chose either to bottle feed from delivery or, having been discharged from the hospital breast feeding, changed to bottle feeding before the baby was 6 weeks old. This pattern was seen in each socioeconomic group and, as the smoking and non-smoking mothers were otherwise comparable, suggests that smoking may have a direct effect on breast feeding. PMID- 6859921 TI - Testicular feminisation syndrome presenting in the newborn. AB - Testicular feminisation syndrome in a neonate was confirmed by cytogenetic studies. Karyotype analysis in 2 phenotypically female siblings showed the presence of the disorder in the 2 year old sibling. Subsequently a fourth phenotypically female sibling showed the disorder. PMID- 6859922 TI - Umbilical cord serum creatine kinase BB in the diagnosis of brain damage in the newborn: problems in interpretation. AB - Raised values of creatine kinase BB (CKBB) in umbilical cord serum were obtained with some normal babies and those with fetal distress. Further investigation showed that the umbilical artery and vein tissue contain high CKBB activity, indicating that some cord blood samples may not solely reflect CKBB liberated from the brain. PMID- 6859923 TI - Obstructive jaundice secondary to chronic midgut volvulus. AB - A case of progressive extrahepatic biliary obstruction due to chronic midgut volvulus secondary to malrotation in a 5-month-old girl is presented. The obstruction to the bile duct was relieved after correction of the malrotation and division of the obstructing bands. PMID- 6859924 TI - Hyponatraemia caused by repeated cerebrospinal fluid drainage in post haemorrhagic hydrocephalus. AB - Three hyponatraemic infants had post-haemorrhagic hydrocephalus which was treated by repeated drainage of cerebrospinal fluid. Each required oral sodium supplements. The concentration of sodium in the cerebrospinal fluid was such that as much as 3 mmol of sodium could have been removed with each ventricular tap. Serum sodium concentrations should be monitored closely in any infant requiring regular drainage of cerebrospinal fluid. PMID- 6859926 TI - Guidance of ventricular tap by ultrasound. PMID- 6859925 TI - Special and intensive care baby units and nurse staffing in the UK. AB - A review of neonatal special and intensive care units in the UK in 1980-81 shows that although the number of cot/incubator units provided for special care conforms with current recommendations, there is a contrasting shortfall of 40% in cot/incubator units for intensive care. Admission policies are vague, vary considerably, and not all units are engaged in the type of care for which they are officially intended. Many units would admit fewer babies if the number and level of expertise of nursing staff in postnatal wards was improved. Rationalisation and redistribution of facilities seems advisable. The number of trained nurses falls far short of those recommended. Almost 21% of units had no formal staffing establishment, and of those that did less than half were filled. The total number of nurses of all ranks and experience failed to reach recommended levels, as did the ratio of trained staff to 'others'. Recruitment of nurses to this specialty is slow and the high turnover rate endangers maintenance of high standards and continuity of patient care. PMID- 6859927 TI - Percutaneous alcohol absorption and skin necrosis in a preterm infant. PMID- 6859928 TI - Rickets in low birthweight infants. PMID- 6859929 TI - Nuclear magnetic resonance imaging of the brain. PMID- 6859930 TI - Phototherapy for neonatal hyperbilirubinaemia: the importance of dose. AB - The management of neonatal jaundice can be made much easier using simple methods that increase the radiant energy in the range 420 to 480 nm. Two groups of infants being treated for physiological jaundice during a period of 6 months were compared. The first group received treatment from two unmodified phototherapy units and the second from two units in which the horizontal frames housing the tube lights were lowered, thus providing a higher 'dose' of phototherapy. Measurements of irradiance from the four units were compared. An improvement in treatment was noted in the group receiving the higher dose with a decrease in duration of treatment and a greater rate of fall in the level of serum bilirubin. A dose response relationship was thus confirmed. Comparisons between previous studies are hindered by failure to recognise the varying contribution of background irradiance, the use of radiometers with differing spectral responses, and the use of different units for expressing results. Failure to appreciate the importance of dose must largely be responsible for the present wide variability in the effectiveness of phototherapy. PMID- 6859931 TI - Pyridoxine dependent seizures--a wider clinical spectrum. AB - We report 4 infants with pyridoxine dependent seizures who had clinical features that led to diagnostic uncertainty. Their clinical course was unusual in 1 or more of the following: later onset of initial seizures; a seizure free period after taking of anticonvulsants, but before taking of pyridoxine; a long remission after withdrawal of pyridoxine; and atypical seizure type. This report illustrates a broader range of clinical features and highlights the need to consider the diagnosis of pyridoxine dependent seizures in any infant with intractable epilepsy, regardless of the pattern of seizures and the response to anticonvulsant medications. In such a case, 100 mg intravenous pyridoxine should be given and, if a definite clinical response is established, oral pyridoxine should be continued indefinitely. PMID- 6859932 TI - Sensorineural hearing loss in sporadic congenital hypothyroidism. AB - Hearing acuity was assessed in 45 children with sporadic congenital hypothyroidism during adequate long-term treatment. Otoscopy was performed in each and additional tympanometry in some of them. Secretory otitis media was found in 6 and was treated medically or by inserting grommets in the eardrum. In these children, hearing acuity was assessed after the otitis had been cured. Hearing acuity was measured either by conventional monoaural pure-tone audiometry (125-8000 Hz) or by binaural free field testing depending on the child's age (above and below 4 years respectively). Hearing was normal in 36 (80%) children. In the remaining 9, sensorineural hearing loss to some degree was detected affecting the higher frequencies in particular. Perceptive deafness required the use of a hearing aid in 4 children. No relationship could be found between hearing acuity and chronological age or bone age at diagnosis of congenital hypothyroidism or type of hypothyroidism. Sensorineural hearing loss is common in children with congenital hypothyroidism and should be searched for carefully and systematically to avoid difficulties related to speech and language development. PMID- 6859933 TI - Prediction of infant hospital admission risk. PMID- 6859935 TI - Evaluation of the trace metal supplements for a synthetic low lactose diet. AB - A trace element supplement used with a synthetic low lactose milk (Galactomins 17 and 18) has been evaluated by means of metabolic balance studies in 4 infants with dissacharide intolerances. The supplement was considered satisfactory for iron and manganese but increases in its zinc and copper content are probably necessary to ensure adequate retentions of these metals. PMID- 6859934 TI - Nutritional survey of Bangladeshi children aged under 5 years in the London borough of Tower Hamlets. AB - The main deficiencies in the diet of Bangladeshi infants and children are vitamin D, iron, and later, calories. Protein intake is a little low in some, but in general is satisfactory. Calcium and vitamin C intakes are adequate. The proportions of food are often inappropriate, mainly because of a high carbohydrate intake. Weaning tends to be late, with predominant milk drinking, even into the second year of life. Convenience baby foods, containing mainly carbohydrate are the major components of the diet until well into the second and third years of life, without the conversion to family food seen in white children. Vitamin D is given to fewer than half the children. It may be given to fewer still if the observation that bottles were often unopened is true for many families. PMID- 6859937 TI - Behavioural management of sleep problems. AB - The outcome of 19 consecutive children referred with sleep disorders and managed by behavioural methods is described. An 84% success rate is reported, which was maintained at 6 months' follow up. Successful outcome was associated with absence of marital discord and attendance of both parents at treatment sessions. PMID- 6859936 TI - Iron deficiency anaemia with hypoproteinaemia. AB - Forty two children were admitted to this hospital between 1975 and 1980 with severe iron deficiency anaemia and 8 of them also had oedema caused by a low concentration of serum proteins. These 8 patients, aged 8-24 months, and 13 age matched controls were investigated. The patients had excessive faecal loss of 59FeCl or 51Cr-albumin, or both; their jejunal biopsy specimens showed little decrease in the ratio of villous height to crypt depth; and they had fewer intraepithelial lymphocytes and cells containing IgA than controls. They were all treated with an oral ferrous iron preparation and the oedema, hypoproteinaemia, and low haemoglobin concentrations rapidly resolved. These results show that immunologically mediated hypersensitivity is not implicated in iron deficiency anaemia associated with hypoproteinaemia. PMID- 6859938 TI - Drug treatment of juvenile dermatomyositis. AB - A series of 29 children with dermatomyositis has been reviewed and the outcome compared between cases treated by us initially with a low dosage short duration course of corticosteroids, and those referred late and having had various different therapeutic regimens and usually more active and higher dosage drug schedules. There were fewer relapses and less morbidity in the low dosage short term group. It was noted also that there was no relation between the initial mode of onset or severity and the eventual outcome or course of the disease. However, pronounced skin vasculitis appeared to reflect severity of disease. PMID- 6859940 TI - Age of appearance of circadian rhythm in salivary cortisol values in infancy. AB - Samples of saliva (4 in 24 hours), collected at monthly intervals for the first 6 months of life in 8 term infants by their mothers, were analysed for cortisol by radioimmunoassay. Values in the first month were more variable, daily mean values were greater, and amplitudes of variation were greater than in subsequent months. The circadian rhythm appeared by the third month. PMID- 6859939 TI - Clinical pharmacology of netilmicin in the newborn. AB - The plasma peak, trough, and peak-trough concentrations of netilmicin given to preterm and term infants were measured after different regimens to determine which dosage would provide satisfactory peak and trough concentrations. In infants aged less than 7 days, dosage regimens of 3.0 or 2.5 mg/kg every 12 hours gave satisfactory peak levels (range 5.2-12.0 micrograms/ml) but troughs were above the desirable maximum level of 3 micrograms/ml in more than half the preterm infants. Subsequently a dosage regimen of 3.0 mg/kg immediately followed by 2.0 mg/kg every 12 hours resulted in trough levels that exceeded 3 micrograms/ml in only 2 of 25 preterm determinations and never in term infants, yet gave satisfactory peak levels (range 4.5-7.4 micrograms/ml). In preterm infants aged 4 to 7 weeks a dosage of 3 mg/kg every 8 hours gave satisfactory peak and trough levels. PMID- 6859941 TI - Management of the extrapyramidal manifestations of phenylketonuria with L-dopa. PMID- 6859942 TI - Long term phototherapy in Crigler-Najjar syndrome. AB - A 10 year old girl with type 1 Crigler-Najjar syndrome has been treated with daily phototherapy from birth. Her general physical and neurological development are normal. PMID- 6859943 TI - Compliance problems in the dietary management of eczema. AB - We have reviewed the progress of 40 children with severe eczema associated with food intolerance. Even with highly motivated parents and patients the emotional and financial burdens resulted in many finding the diets impossible to maintain. Three of 14 children (21%) under 3 years of age, and 12 of 26 children (46%) over 3 years gave up diets, with a subsequent relapse of their eczema. PMID- 6859944 TI - Side effects of verapamil in infants. AB - Two infants with supraventricular tachycardia were given intravenous verapamil and subsequently suffered life threatening bradycardia and hypotension. As there were no predisposing factors, direct drug action is implicated and other reports of the adverse effects of verapamil are noted. Supraventricular tachycardia in neonates and young infants may be safely treated with digoxin and cardioversion, and intravenous verapamil should be avoided. PMID- 6859945 TI - Sudden unexpected infant death. I Paediatric counselling. PMID- 6859946 TI - Sudden unexpected infant death. II Home monitoring. PMID- 6859948 TI - [Bone marrow pathology in 5 cases of systemic mastocytosis. Pseudomyelomatous forms with dysglobulinemia and benign polyclonal bone marrow plasmacytosis. Hamazaki-Wesenberg bodies associated with mast cell granulomas]. PMID- 6859947 TI - Alcohol consumption in pregnancy. PMID- 6859950 TI - [Some basic or alleged facts about germinal tumors]. PMID- 6859949 TI - [Hepatic cholesterosis. Histological, histochemical and ultrastructural study of 2 cases]. PMID- 6859952 TI - [Systemic calcific emboli in calcified aortic valve diseases. Apropos of an anatomical case]. PMID- 6859953 TI - [Diffuse eosinophilic fasciitis (Shulman's syndrome). Apropos of a case disclosed by spinal cord compression]. PMID- 6859951 TI - [Renal onchocytoma with giant mitochondria. Light and ultrastructural study apropos of 2 cases]. PMID- 6859954 TI - [Idiopathic pulmonary hemosiderosis, Anatomoclinical study of a case]. PMID- 6859955 TI - [Malignant histiocytosis. An anatomical study of 6 cases with atypical clinical manifestations]. PMID- 6859956 TI - The British Society for Rheumatology. PMID- 6859957 TI - Vascular mortality in patients with gout and in their families. AB - A mortality study was performed to determine death rates from coronary and cerebrovascular pathology in 180 patients with gout and their families. Lipid profiles were also analysed. Neither male nor female gout patients after presentation to hospital nor their male or female first-degree relatives were found to have an increased risk of dying from coronary artery or cerebrovascular disease. Families of hyperlipidaemic gout patients had a slightly increased incidence among males of death from coronary artery disease, a finding which may reflect the hypercholesterolaemia found among these relatives. It could have influenced the vascular mortality rate in families of hyperlipidaemic gout patients without any relationship to the diagnosis of gout itself. PMID- 6859958 TI - Prognostic value of the type of onset of rheumatoid arthritis. AB - The type of onset in 235 patients with rheumatoid arthritis (RA) was acute in 69, subacute in 55, and gradual in 111 patients. The radiological destruction of the hands and feet after 7 years from the beginning of the disease was the same in all patient groups. Thus the nature of the onset of RA seems not to have any significant influence on the outcome of the arthritis. PMID- 6859959 TI - Avascular necrosis of bone complicating corticosteroid replacement therapy. AB - Two patients who developed widespread severe avascular necrosis of bone while on steroid replacement therapy are described. One, a diabetic, underwent yttrium-90 pituitary ablation for retinopathy and developed avascular necrosis within 18 months of starting prednisolone. The other, who had Addison's disease, developed avascular necrosis within 14 months of starting cortisol replacement therapy. Both cases came to bilateral total hip replacement. PMID- 6859960 TI - Osteoarthritis and articular chondrocalcinosis in the elderly. AB - One hundred consecutive admissions to an acute geriatric unit were examined for clinical and radiographic evidence of osteoarthritis (OA) and articular chondrocalcinosis (ACC). Thirty-four patients had ACC. This was age related, the prevalence rising from 15% in patients aged 65-74 years to 44% in patients over 84 years. The commonly involved joints were the knee (25%), public symphysis (15%), and wrist (9%). No other aetiological factors predisposing to ACC were found. Of the 25 patients with ACC in the knee 7 had no symptoms or signs and no radiographic evidence of OA at that site. However, the combination of ACC and radiographic OA was characterised by an increase in clinical joint disease. Features of inflammation (joint swelling and joint line tenderness) involving the knee, wrist, and elbow were particularly common in ACC. It is concluded that ACC is common in the elderly and is associated with an increased incidence of joint disease. PMID- 6859961 TI - Evidence for an association between rheumatoid arthritis and autoimmune endocrine disease. AB - Evidence is presented for the first time of a significantly increased prevalence of type 1 (insulin-dependent) diabetes in the close relatives of patients with rheumatoid arthritis. Thirty-nine (13%) of 295 patients with classical or definite rheumatoid arthritis had a first or second degree relative with type 1 diabetes and 38 (13%) had a close relative with autoimmune thyroid disease. These findings could be compatible with a possible common genetically determined mechanism of susceptibility to both diseases. PMID- 6859963 TI - A new specific assay for the detection of DNA immune complexes: its relevance in SLE. AB - Double-stranded DNA immune complexes (DNA-ICs) were assayed by millipore filtration and deoxyribonuclease digestion in 40 patients with both active and inactive systemic lupus erythematosus (SLE). The assay is superior to the double stranded DNA antibody (ds ADA) as an indicator of active disease, and, when combined with the total haemolytic complement (CH50) and ds ADA levels it increases the prediction of the relative risk of active disease. A good correlation between actual levels of DNA-ICs and the degree of activity was also shown. We conclude that measurement of DNA-ICs is of value as an additional monitor in the assessment of activity in SLE. PMID- 6859964 TI - Inhibition of cartilage breakdown by hydrocortisone in a tissue culture model of rheumatoid arthritis. AB - Bovine nasal cartilage discs cocultured with human rheumatoid synovial membrane or synovial-membrane-conditioned media release proteoglycan largely as a result of cartilage breakdown. We assessed the effects of hydrocortisone on proteoglycan distribution between cartilage and culture medium, and on cartilage breakdown expressed as the release of either proteoglycan or 35S-products from prelabelled discs. The presence of synovial membrane inhibited the capacity for net proteoglycan synthesis, preventing its accumulation in cartilage; this was little affected by hydrocortisone. The major response to pharmacological concentrations of hydrocortisone was suppression of both spontaneous and synovial-membrane induced cartilage breakdown. The autolysis of synovial protein that normally occurred during culture was similarly prevented by comparable doses of corticosteroid. Changes in chromatographic distribution of the 35S-labelled degradation products released from cartilage conformed with a corticosteroid induced inhibition of endogenous lysosomal or related proteinase activity. Additionally, inhibition of the early events in synovial membrane that are responsible for chondrocyte-mediated breakdown of cartilage may contribute significantly to the overall corticosteroid effect. PMID- 6859965 TI - Native type II collagen-induced arthritis in the rat. III. Relationship between the cellular immune response to native type II collagen and arthritis. AB - The relationship between cell mediated immunity to collagen and arthritis was studied with lymphocytes from arthritic and nonarthritic rats after immunisation with native bovine type II collagen. With the in-vivo radiometric ear assay arthritic rats gave a significantly higher response to native type II collagen than did nonarthritic rats. However, there was an overlap of values, and some arthritic rats gave no response to collagen even on the day of onset of arthritis. There was no difference in the response of lymphocytes from arthritic and nonarthritic rats with in-vitro transformation to native type II collagen, responses being found in both groups. All rats which developed arthritis had serum antibodies to native type II collagen, but not all responded to the tests for cell mediated immunity. These findings suggest that antibodies to collagen are more associated with the development of arthritis than is cell mediated immunity to collagen. PMID- 6859962 TI - Relationship of angiogenesis factor in synovial fluid to various joint diseases. AB - A low-molecular-weight freely dialysable angiogenesis factor has been isolated from 49 synovial fluids obtained from patients with various joint diseases. An analysis of disease type and incidence of freely dialysable angiogenesis activity showed that the osteoarthrotic group had a significantly higher incidence than all the other groups (p = 0.0332). Angiogenesis factor has also been detected in a bound form in the retentates of fluids which gave positive results for dialysable factor. The possibility that an imbalance between carrier-bound and free factor may have a causative role in disease is discussed. PMID- 6859966 TI - Uric acid effects on in vitro models of rheumatoid inflammatory and autoimmune processes. AB - A neutrophil monolayer system was used to study the effects of uric acid on neutrophil-aggregate interactions important in rheumatoid inflammation. No effect on immunoglobulin G aggregate phagocytosis was seen, but hyperuricaemic levels of uric acid were associated with an enhancement of phagocytosis-induced release of the azurophilic granular enzyme beta-glucuronidase. A trinitrophenyl-coupled mononuclear leucocyte rheumatoid factor plaque-forming assay was utilised to study uric acid effects on polyclonal activation of immunocompetent cells. Low levels of uric acid enhanced and high levels suppressed this system. Hyperuricaemia may enhance some aspects of rheumatoid inflammation, while uric acid may modulate an important component of rheumatoid autoimmunity. PMID- 6859967 TI - A case of sarcoid arthritis in a child. AB - An 8-year-old girl presented with dyspnoea, weight loss, erythema nodosum, and an arthritis. A diagnosis of sarcoidosis with joint involvement was made. The clinical features of this unusual arthritis in a child and the response to corticosteroid therapy are described. PMID- 6859969 TI - Haptoglobin phenotypes. PMID- 6859970 TI - The susceptibility of gamma-irradiated Glossina palpalis palpalis at different ages to infection with Trypanosoma congolense. PMID- 6859968 TI - Spondylodiscal erosions due to gout: anatomico-radiological study of a case. AB - The necropsy of an 84-year-old woman with painful polyarticular gout showed a severe erosion of the L2 vertebral body due to sodium urate deposition. The radiological signs of this tophus had existed for many years; it had caused recurrent pain but no neurological complications. A small tophus and a Schmorl's node on 2 neighbouring thoracic vertebrae permitted the differentiation between vertebral plate erosion in the first, which was of bone origin, and vertebral plate remodelling in the second, which originated in the cartilaginous tissue of the disc. PMID- 6859971 TI - [Current status of leishmaniasis in Tunisia]. PMID- 6859972 TI - Ultrastructural aspects of childhood nephrotic syndrome in Northern Nigeria. PMID- 6859973 TI - [Treatment of intestinal nematode infections]. PMID- 6859974 TI - [Organoleptic aspects and levels of 3,4 benzopyrene in smoked fish traded in Maroua (North Cameroon)]. PMID- 6859976 TI - The stomach after surgery. An endoscopic perspective. AB - Twenty-five per cent of the authors' total upper endoscopy experience since 1974 has been in patients who have had upper gastrointestinal tract surgery. The observations from 617 examinations in 400 of these patients is reviewed. Pain or nausea and vomiting was a common presenting symptom. Multiple complaints were frequent. Gastritis was the most common endoscopic finding present in 127 patients (32%). Biopsy yielded an 89% histologic confirmation of the endoscopic perception. Coexisting mucosal pathology was common, with 39% of the patients having two or more abnormalities. X-ray in 190 patients had only a 30% accuracy rate and a frequent occurrence of false negatives (46%). Bezoars and intraluminal sutures were seen commonly and endoscopy provided a therapeutic choice for enzyme injection of the bezoar and removal of the sutures. Endoscopy provided a method of evaluation of our highly selective vagotomy technique; 96% of our patients with ulceration at the time of surgery were healed by endoscopy and 93% had active antral-pyloric function. PMID- 6859975 TI - [Acquired immune deficiency syndrome in 3 patients from Zaire]. PMID- 6859978 TI - Venous insufficiency of the lower limb and stasis ulceration. Changing concepts and management. AB - In a group of patients studied for venous insufficiency, the incidence of deep venous insufficiency was much higher than previously suspected. Insufficiency of the superficial system, when present, was associated invariably with deep venous insufficiency, suggesting a leading role for the latter condition. Evidence is presented to show that in many instances, such reflux is probably non-thrombotic. The results of various types of direct venous valve surgery in a group of patients are presented. PMID- 6859977 TI - Extrahepatic biliary obstruction associated with pancreatitis. AB - A total of 40 patients with pancreatitis had associated extrahepatic biliary obstruction. Eighteen had biliary-induced pancreatitis. Comprehensive correction of the biliary tract disease, including cholecystectomy, common duct exploration and, when indicated, transduodenal sphincteroplasty, resulted in a high recovery rate (83%) with no recurrence of pancreatitis. Twenty-two patients had chronic pancreatitis with involvement of the terminal biliary tract by a long tapering stenosis. Nineteen of these patients had chronic fibrocalcific pancreatitis secondary to chronic alcohol abuse. In five patients, the stenosis produced a high grade obstruction which required biliary bypass with choledochoduodenostomy (four) or cholecystoduodenostomy (one). The remaining 14 patients maintained patency of the biliary tract following correction of the underlying pancreatic pathology. The latter consisted of drainage (nine) or resection (five) of 14 associated pseudocysts (present in 64% of the 22 patients), combined with side-to side pancreaticojejunostomy to decompress an obstruction of the major pancreatic duct. In assessing the degree of terminal bile duct stenosis, calibration of the duct with Bakes dilators or rubber catheters was a useful aid. Two of the 22 patients ultimately proved to have carcinomas, producing obstruction of the pancreatic duct in the head of the gland. Both were treated initially with choledochoduodenostomy. This possibility must be considered in the management of these patients. PMID- 6859979 TI - Aortic saddle embolus. A twenty-year experience. AB - Clinical experience with aortic saddle embolus (ASE) is not extensive due to the relative infrequent lodging of emboli at the aortic bifurcation. During the period 1962-1982, 26 patients (mean age, 56 years) were treated at the UCLA Medical Center for ASE and followed from 2 to 158 months (mean, 45 months). These cases were reviewed in order to identify features of diagnosis, anticoagulation, and operation which impact on results. All 26 patients presented with bilateral lower extremity ischemia with or without extension of clot to the iliac bifurcation. Ninety-six per cent of emboli were of cardiac origin and one-third occurred in patients who had previous symptoms of chronic lower extremity ischemia. Rest pain and motor/sensory deficits were main complaints in 92% of the patients, but did not become manifest until more than 6 hours, unlike more distal emboli which have an earlier presentation. Preoperative angiography, even in the patient with a history of claudication, has a small role in planning the surgical approach to patients with ASE and, although performed in 11 patients, it influenced operation in only two. Operation within the "golden period" of 6 hours after embolization did not significantly influence outcome after ASE, since 20 patients were operated on more than 6 hours after embolization, with results similar to six patients who were operated on less than 6 hours after embolization. Early high-dose heparinization, used in all patients and maintained for a mean of 12 days, may have contributed to this effect. In 22 patients (85%) Forgarty catheter extraction via bilateral groin approaches was used with a mortality of 14%; only one death was directly attributed to the catheter embolectomy. In 15% of patients, a direct approach on the aorta was selected with a zero mortality rate. Postoperative functional result was excellent with an amputation rate of only 2% (one limb). Re-embolization occurred in seven patients (27%) after discharge, five of whom had not been maintained on Coumadin and two who were not anticoagulated adequately. The authors conclude that the keys to successful treatment of ASE include high dose heparin which is maintained through the perioperative period, embolectomy without preoperative angiography, and maintenance of long-term oral anticoagulation. PMID- 6859981 TI - Lung abscess revisited. A survey of 184 cases. AB - One hundred eighty-four patients with lung abscess, admitted to the Hospital of the University of Mississippi between 1960 and 1982, were studied with respect to sex (149 men and 35 women), age (mainly fourth to sixth decades), location of abscess(es) (RLL, RUL, and LLL mainly), predisposing factors (aspiration in sensorium disorders, obstruction, gingivo-dental suppuration, immunoincompetence) and nonoperative (89%) and operative (11%) therapy, usually lobectomy. Data from the different decades were compared, but there were few major differences. Mortality rate was 22% in the 1960s, 25% in the 1970s, and 28% in 1980-1982. Major management problems involved massive pulmonary hemorrhage, impaired immune defenses, old-age debility, bronchopleural fistula with empyema, or very large cavity. Anaerobic bacteria predominate and penicillin is the treatment of choice. Incidence of operation is declining, but cases are more often complicated. Prognosis is good in the uncomplicated case. PMID- 6859980 TI - Routine electroencephalographic (EEG) monitoring during carotid endarterectomy. AB - Controversy continues concerning the advisability of routine shunting, no shunting, or selective shunting during carotid endarterectomy. Because of its reflection of the physiologic state of the end organ, the authors chose routine 18 lead EEG monitoring as a guide to selective shunting and as an indication of adequate shunt function during all carotid endarterectomies performed from December 1977 through July 1982. In that period, 200 patients underwent 219 endarterectomies under general anesthesia and EEG monitoring. Ischemic EEG changes at the time of carotid cross clamping suggested the need for intraluminal shunts in 16% of patients. Insertion of shunts restored the EEG pattern to normal in all instances, although in two patients, adjustment of the shunt was required to maintain this results. EEG changes requiring shunting occurred in 10% of patients with unilateral disease, in 27% of patients with bilateral disease, and in 42% of patients with unilateral stenosis and contralateral occlusion. Twenty seven patients had small fixed neurologic deficits before operation. Surgery was not delayed in these individuals who demonstrated no increased requirement for shunts and no new postoperative neurologic deficits. In the group of 150 endarterectomies performed as separate procedures, there was one (0.7%) fixed neurologic deficit after operation, one transient deficit (0.7%), and one death (0.7%). Sixty-nine endarterectomies were performed simultaneously with open heart surgery and were associated with one fixed neurologic deficit (1.4%) and two transient deficits (2.9%). All four deaths in this group were attributable to the cardiac surgical procedures. These results indicate that selective shunting based on EEG monitoring permits the safe performance of carotid endarterectomy, even in patients considered to be at high risk for postoperative neurologic deficit. PMID- 6859982 TI - Properly conducted fundoplication reverses histologic evidence of esophagitis. AB - Little is known about the fate of histologic changes of esophagitis following an antireflux procedure. In a widely quoted paper (Gastroenterology 1979; 76:1393), initial healing of esophagitis was reported, but it was noted that normal biopsies reversed to abnormal in a small number of patients who were followed for up to 69 months. The authors studied esophageal histology in 21 patients undergoing a Nissen fundoplication by a standardized technique. All patients underwent biopsy after operation from 5 to 96 months (mean, 39 months). Nineteen of 21 patients had esophagitis typified by leukocytic infiltration shown on preoperative biopsy. Only two patients had these changes after operation, and one subsequently returned to normal. No patient had evidence of worsening of his esophageal mucosa over time, but several persisted with epithelial changes that included basal cell hyperplasia and papillary elevation. The authors conclude that the Nissen fundoplication, when performed by a standardized technique, leads to reversal of histologic evidence of esophagitis, even for follow-up periods of 96 months, and that the symptomatic status of a patient correlates well with the histologic level of esophagitis. PMID- 6859983 TI - Surgical treatment of recurrent peptic ulcer disease. AB - One hundred twenty patients in whom recurrent peptic ulcer developed after various surgical procedures for primary duodenal ulcer were operated on at the Mayo Clinic between 1970 and 1975. The postoperative mortality rate was 3.3% for all cases, 0.9% for elective cases, and 23% for the 13 patients who required emergency surgical care. The mean hospital stay was 13 days, and postoperative complications developed in 25 patients (20%). Approximately 70% of the patients had excellent or good results, whereas the rest had significant postoperative sequelae, including 8.4% (9 patients) in whom rerecurrent ulceration developed. When remedial surgery for recurrent ulcer consisted of vagotomy and distal subtotal gastrectomy (35 patients) after previous vagotomy and drainage procedure (21 patients), subtotal gastrectomy (three patients), vagotomy and hemigastrectomy (eight patients), or gastroenterostomy alone (three patients), there were no operative deaths, 74% of 27 patients available for at least a 5 year follow-up had excellent or good results, and rerecurrent ulceration developed in only one patient. These results indicate that vagotomy and resection is a satisfactory operation for recurrent peptic ulcer and that the long-term results after this operation compare favorably with those reported for cimetidine therapy. PMID- 6859985 TI - Lack of correction between activated clotting time and plasma heparin during cardiopulmonary bypass. PMID- 6859984 TI - Tomographic gallium-67 citrate scanning. Useful new surveillance for metastatic melanoma. AB - Conventional gallium scans are not useful to evaluate patients with metastatic melanoma. We evaluated a new method of tomographic gallium imaging. One hundred fourteen tomographic scans were obtained in a prospective surveillance study of 67 patients over a 3-year period. Scans were evaluated and compared to findings of independent clinical evaluations. Sensitivity of gallium identification of tumor involving peripheral lymph nodes and soft tissues, abdomen, mediastinum, and osseous sites was 68% to 100%; overall sensitivity of this technique is 82% with specificity of 99% in 570 organ system assessments. Analysis of discordant findings when a site was clinically occult but gallium-positive showed gallium uptake to be true-positive in six of seven lymphatic sites, three of three lung and mediastinal sites, six of six abdominal sites, but in no brain or bone sites. Gallium lesions identified by computed tomographic scans proved to be false positive at one lymphatic and one bone site, and false-negative at four otherwise clinically evident lymph node and soft tissue sites, seven pulmonary sites, and four brain sites. Gallium tomographic scanning provides a composite assessment of melanoma and may eliminate the need for other studies. PMID- 6859986 TI - Effect of chest physical therapy on the prevention of atelectasis in children following cardiac surgery. PMID- 6859987 TI - Simplified method for obliterating an arteriovenous fistula. PMID- 6859988 TI - Adjuvant postoperative radiation therapy for Dukes C adenocarcinoma of the rectum. AB - This study was designed to explore the effects of adjuvant postoperative radiation therapy on the course and survival of patients with Dukes C adenocarcinoma of the rectum. Moderate dose radiotherapy was offered to 64 patients. Twenty-four accepted and were treated, while the remainder refused. With a mean follow-up of 32.3 months, the overall survival rate was 63% (40/64) and the mean disease-free survival rate at the time of this report was 45%. The following variables were analyzed separately: operative procedure, distance of the tumor from the anal verge, tumor size, and transmural, vascular, lymphatic and perineural invasion of tumor. The most significant differences between irradiated and non-irradiated patients were found in the group of patients whose lesions were 6 cm or less from the anal verge. Of the 19 such patients with an average follow-up of 36.4 months, ten patients were irradiated and nine were not irradiated. The irradiated group had a 90% (9/10) survival rate and 70% (7/10) of them were disease free; the non-irradiated group had a 44% (4/9) survival rate and 22% (2/9) of them disease free. It is concluded that patients with adenocarcinoma of the rectum metastatic to lymph nodes, whose lesions' lower border is measured 6 cm or less from the anal verge, benefit significantly from adjuvant postoperative radiotherapy. PMID- 6859991 TI - Ulcer surgery made less expensive. A cost-development study: 1963, 1973, and 1978. AB - The cost for operative treatment of duodenal ulcer disease over a 15-year period was studied by carefully measuring on a day-to-day basis each cost item separately for every individual. All prices were transformed into 1975 cost level. Statistical analysis revealed a 42% reduction in the cost for operative treatment. This decrement in cost coincided with a change from partial gastrectomy to highly selective vagotomy as the routine procedure. Further refinement of highly selective vagotomy did not result in a further cost decrement. PMID- 6859989 TI - Percutaneous transhepatic biliary drainage. Complications due to multiple duct obstructions. AB - The medical histories of fifty-three consecutive patients who were scheduled for percutaneous transhepatic biliary drainage (PTBD) were reviewed for incidents of sepsis. Among the 52 patients who were successfully catheterized, there were 14 incidents of sepsis, three incidents of abscess and sepsis, and two incidents of sepsis following a pulled catheter (a total incidence of 36.5%). In 14 instances, the sepsis was attributed primarily to the presence of enteric bacteria combined with bile stasis caused by multiple duct obstruction from disseminated malignancy. The presence of bacteria in the bile of well-drained patients did not necessarily lead to sepsis. This series highlights the importance of medical alert for signs of sepsis in biliary drainage patients and suggests that external drainage is preferable in patients with incomplete emptying of the biliary system during PTBD. PMID- 6859990 TI - Management of spontaneous umbilical hernia disruption in the cirrhotic patient. AB - Umbilical hernia is a common finding in cirrhotic patients with ascites. Spontaneous disruption of the hernia and attendant discharge of ascitic fluid is an unusual and rarely reported complication in these patients and is associated with an overall mortality rate of nearly 30%. During the 5-year period 1977-1982, nine patients with hepatic cirrhosis and ascites were treated for spontaneous rupture of an umbilical hernia. Ascites was attributed to alcoholic cirrhosis in all cases and was present for an average of 21 months prior to rupture. In two cases, failed peritoneovenous shunts resulted in reaccumulation of massive ascites. Initial management included sterile occlusive dressings, fluid repletion, and intravenous antibiotic administration. Hernia repair was performed an average of 4.2 days after rupture. General anesthesia was used in eight cases and local anesthesia in one case. In one instance, the hernia became incarcerated and required urgent repair. Postoperative complications, including wound infection and colonic dilatation, occurred separately in two patients (22%). One patient died of hepatic failure 28 days after operation, for an overall mortality rate of 11%. Surviving patients have been followed for an average of 8 months, and most have done well. Spontaneous rupture of umbilical hernia in patients with ascites occurs uncommonly. Operative management is indicated uniformly and can be conducted safely when the patient's condition has stabilized. The prognosis is favorable for patients with good hepatic reserve. PMID- 6859993 TI - Metastasis and death in patients with thin melanomas (less than 0.76 mm). AB - Experience with melanomas measuring less than 0.76 mm was reviewed. Over a 10 year period, of more than 400 patients with thin melanomas, 12 melanomas were found to have metastasized, with 11 resulting in death. Patients with thin melanomas should be carefully followed. PMID- 6859992 TI - Preferential activation and depletion of the alternative complement pathway by burn injury. AB - Complement levels of eight adult burn patients (25% to 90% body surface area) were studied upon admission to a burn unit and sequentially for one week. Mean classical pathway titers (CH50) were 49% below the normal mean, while hemolytic C4 titers were reduced by 53% and C3 by 43%. However, the alternative pathway titer was reduced by more than 90%, suggesting preferential depletion of this pathway. This depletion was associated with sepsis, pneumonia, and "shock lung." Alternative pathway deficiency was still present one week postburn, and may contribute to the susceptibility of burn patients to bacterial sepsis. PMID- 6859994 TI - Local and in-transit metastases following definitive excision for primary cutaneous malignant melanoma. AB - A total of 672 consecutive patients with clinical stage I and stage II primary cutaneous malignant melanoma were treated by excision of 3.0 to 5.0 cm of surrounding skin down to and including the underlying fascia when the lesion exceeded 0.5 mm thickness (Breslow measurement). More conservative margins were taken in locations where such excisions would result in significant cosmetic or functional morbidity and for thinner lesions (less than 0.5 mm). Seven of 658 patients with clinical stage I disease (1.1%) and three of 14 patients with clinical stage II disease (21.4%) developed histologically verified local metastases within 5 cm of the primary excision scar or skin graft. Fifteen patients with stage I disease developed in-transit metastases (2.3%) at a site more than 5.0 cm proximal to the surgical scar or skin graft but not beyond the regional nodal group. Two patients with stage II disease who had developed local metastases also developed in-transit metastases (14.3%). No patient with a lesion less than 1.0 mm thick has had a local recurrence. Nine of the ten patients (90%) who developed local metastases and 12 of the 17 patients (70.6%) who developed in transit metastases have also developed systemic metastases to date. Local and in transit metastases following such definitive excision is a significant indicator of disseminated systemic metastatic melanoma. PMID- 6859995 TI - Fine needle aspiration biopsy of thyroid nodules. AB - The clinical value of the fine needle aspiration of thyroid nodules was evaluated by comparing preoperative cytology to subsequent pathology in 109 patients undergoing thyroidectomy. Preoperative cytology was reported as insufficient cellular material (31 patients), benign goiter (27 patients), follicular neoplasm (22 patients), thyroiditis (12 patients), suspicious for papillary carcinoma (nine patients), Hurthle cell neoplasm (five patients), medullary carcinoma (one patient), lymphoma (one patient), and metastatic adenocarcinoma (one patient). Operative findings demonstrated that the overall sensitivity of fine needle aspiration in diagnosing thyroid neoplasia (carcinoma or adenoma) was 88% and its specificity was 80%. Operation verified the cytologic diagnosis of medullary carcinoma, lymphoma, metastatic adenocarcinoma, and seven of nine papillary carcinomas. Of the five patients with an aspiration biopsy diagnosis of Hurthle cell neoplasm, three patients had carcinoma and one had an adenoma. Four carcinomas and 12 follicular adenomas were found in patients with a cytologic diagnosis of follicular neoplasm. Thyroiditis was confirmed at operation in all 12 patients with this diagnosis on fine needle aspiration. One carcinoma was found in the 27 patients with benign goiter diagnosed on cytology. Fine needle aspiration is a valuable tool that can lead to earlier diagnosis and treatment of thyroid cancer. However, a negative aspiration does not supplant good clinical judgement in determining the need for thyroidectomy. PMID- 6859996 TI - The role of oxygen-free radicals in ischemic tissue injury in island skin flaps. AB - The contribution of free radical-mediated reperfusion injury to the ischemic damage caused by total venous occlusion of island skin flaps was investigated in a standardized rat model. Control flaps subjected to 8 hours of total venous occlusion showed complete, full thickness necrosis when followed for 7 days following release of the vascular occlusion. Treatment with superoxide dismutase, a scavenger of superoxide radicals, prior to and immediately following the onset of reperfusion, significantly enhanced island flap survival from 0/11 (0%) to 8/15 (53%), p less than 0.005, and from 0/9 (0%) to 6/12 (50%), p less than 0.02, respectively. These findings are consistent with the hypothesis that oxygen free radicals generated at the time of reperfusion following a period of ischemia contribute significantly to the ultimate damage caused by ischemic injury. Such findings are consistent with similar reported observations on other tissues and suggest a means by which ischemic tissue injury might be therapeutically modified, even after the period of ischemia. PMID- 6859997 TI - Gastric carcinoma. A ten-year review. AB - Data on 164 patients treated at the Cleveland Clinic with gastric adenocarcinoma during the ten year period 1970 to 1980 was analyzed. Fiberoptic esophagogastroduodenoscopy was introduced as a routine diagnostic modality during this time and yielded a positive tissue diagnosis in 86% of patients in this series. Laparotomy was performed on 150 patients; 49 patients (30%) were biopsied only, 19 (12%) were bypassed for palliation, and 82 (58%) underwent gastrectomy. Of the latter group, only 45 patients (27%) were resected for cure. The overall operative mortality rate was 6%. All patients were staged according to the International TNM classification (stage I--10%, II--24%, III--12%, and IV--53%). Survival at 5 years was influenced by tumor location and extent of gastric resection but was most significantly related to stage of disease at operation (stage I--65%, II--22%, III--5%, and IV--0%; p less than 0.0001) and to the status of regional nodes (positive--17%, negative--56%; p less than 0.005). Despite the routine use of fiberoptic endoscopy, the majority of gastric cancers were advanced at diagnosis and their prognosis remains discouraging. Improvement of results will require a more aggressive approach to the endoscopic investigation of upper gastrointestinal symptoms and earlier surgical intervention. PMID- 6859998 TI - Ascites-induced LeVeen shunt coagulopathy. AB - Ten of 11 patients undergoing peritoneovenous (LeVeen) shunt placement for intractable ascites had disseminated intravascular coagulation (DIC) following the shunt procedure. Intraoperative ascitic fluid specimens revealed fibrin split products (FSP) in high titer (1:100-1:1600) in all patients. Endotoxin was found in 6 of 11 ascitic fluid samples but in no plasma samples. Activated clotting factors, clot inhibitors, excess protein, and fibrinolytic activity were not found in ascitic fluid. Clotting factor levels were much lower than in plasma. Bleeding occurred after operation in two patients; this appeared to be related to the severity of liver dysfunction as demonstrated by elevations of bilirubin, serum glutamic oxalocetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), and preoperative DIC. It is concluded that the LeVeen shunt coagulopathy is DIC, and may be related to exposure of the systemic circulation to FSP-rich ascitic fluid that may activate the coagulation mechanism. Bleeding complications do not appear to be related to the severity of the post shunt coagulopathy, but rather to the severity of liver dysfunction and presence of preoperative DIC (probably caused by the liver disease). PMID- 6859999 TI - The effects of hemodilution during pulmonary edema in dogs. AB - Because of their multiple medical problems, patients with the adult respiratory distress syndrome (ARDS) often develop anemia. In order to determine the effects of a low hemoglobin concentration on gas exchange in such patients, the authors studied the effects of isovolemic hemodilution in the dog oleic acid model of ARDS. Twelve splenectomized dogs with oleic acid-induced pulmonary edema and a consequent venous admixture of 31% +/- 5% (mean +/- SEM) (FIO2 = 0.21) underwent two-stage isovolemic hemodilution with Hetastarch followed by retransfusion of the withdrawn red cells. This resulted in hemoglobin levels at each stage of 12.7 +/- 0.7 g/100 ml, 9.1 +/- 0.6 g/100 ml, 6.5 +/- 0.5 g/100 ml, and 10.1 +/- 0.5 g/100 ml (mean +/- SEM). Oxygen transport fell from 363 +/- 25 ml/kg/min to 219 +/- 17 ml/kg/min (p less than 0.001) at maximum hemodilution during air ventilation and from 383 +/- 79 ml/kg/min to 292 +/- 91 ml/kg/min (p less than 0.001) during oxygen ventilation. Since oxygen consumption remained constant throughout the hemoglobin range studied, decreased hemoglobin resulted in declines in P-VO2. Hemodilution with Hetastarch did not affect intrapulmonary shunt or venous admixture despite the significant increase in cardiac output associated with hemodilution. PMID- 6860000 TI - Concerning the Pancoast tumor: what is the superior pulmonary sulcus? PMID- 6860001 TI - Bypass grafting and aneurysmorrhaphy for aortic arch aneurysms. AB - The technique of permanent aortic arch bypass grafting combined with simultaneous aneurysmorrhaphy, excision or exclusion of the aneurysm without the use of systemic heparinization, cardiopulmonary bypass, or external bypass shunting has been used successfully in treating 5 patients with aneurysms of the aortic arch. There were no complicating cerebral vascular accidents, bleeding diatheses, or signs of distal embolization. There were 2 deaths; 1 patient died early (10 days postoperatively) of myocardial infarction, and the other died over one year later of unrelated causes. Follow-up has extended to an interval of seven years. The early death subsequent to myocardial infarction in 1 patient prompted the routine use of preoperative carotid and coronary angiography for assessment of these systems. Severe occlusive disease in these vessels requires a staged or simultaneous reconstruction prior to management of the aortic aneurysm. PMID- 6860002 TI - Results of reoperation for periprosthetic leakage. AB - Between 1961 and 1978, 6,602 valves were replaced in 5,660 patients. Reoperation for periprosthetic leakage was performed in 105 patients (1.6% of the valves); early mortality was 5.7%. At reoperation, 52% of patients were in New York Heart Association Classes III and IV, whereas 72% had been in Classes III and IV prior to the primary valve replacement. Seventy-five patients had aortic periprosthetic leaks, which were distributed equally around the annulus. Among these patients, 41 (55%) had aortic valve rereplacement and 34 (45%) had suture repair. At 5 years, the survival was 94% and the event-free survival was 71%. Seventeen patients had multiple aortic valve reoperations. Hospital mortality for the second reoperation was 5.8%. At late follow-up, 19 patients had murmurs of residual or recurrent aortic periprosthetic leakage. Twenty-nine patients had mitral periprosthetic leaks, most often near the anterior leaflet. Eight patients had mitral valve rereplacement, and 21 had suture repair. At 5 years, the survival was 75% and the event-free survival was 52%. Four patients underwent multiple reoperations. At late follow-up, 5 of the 29 patients in the mitral valve group had murmurs of residual or recurrent periprosthetic leakage. One patient had tricuspid valve rereplacement. The low hospital mortality and the good late results have encouraged us to recommend an aggressive approach in the correction of periprosthetic leakage in all symptomatic and selected asymptomatic patients. PMID- 6860003 TI - Long-term results of pulmonary resection for atypical mycobacterial disease. AB - From 1967 through 1981, 40 pulmonary resections were performed in 37 patients with Mycobacterium intracellulare infection. The patients ranged in age from 24 to 67 years, and 86% were men. Smoking and alcohol abuse seemed to be predisposing factors. Localized atypical mycobacterial infection unresponsive to chemotherapy was the operative indication for 38 of the 40 resections. All patients had cavitary disease. Mean length of preoperative drug treatment was 22 weeks. Sensitivity studies showed a very high incidence of in vitro drug resistance. Twenty-five patients were converted to sputum-negative status preoperatively; however, 23 of these had positive smears or cultures from their resected specimens. Resections performed included upper lobectomy in 31 patients, upper and middle lobectomy in 2 patients, upper lobectomy plus superior segmentectomy in 3, left completion pneumonectomy in 2, and wedge resection in 2. Two patients underwent staged bilateral upper lobectomies. There were no perioperative deaths. Complete follow-up in 33 patients (mean, 94 months) revealed only two reactivations at 3 and 5 years postoperatively. One of these patients is well following completion pneumonectomy 9 years after his first operation; the second patient responded to reinstitution of three-drug chemotherapy and is well 5 years later. Thirty-one patients have remained entirely free of disease. Excisional surgery remains the treatment of choice for localized M. intracellulare pulmonary infection. PMID- 6860004 TI - The optimal temperature for preservation of the myocardium during global ischemia. AB - To determine the myocardial temperature that provides maximal preservation of the heart during global ischemic arrest, five groups of dogs were studied (6 per group). In all animals, the aorta was cross-clamped for 120 minutes. Serial biopsies were done for determination of adenosine triphosphate and creatine phosphate, and study by electron microscopy. Starling curves were derived prior to cardiopulmonary bypass and 60 minutes after bypass. Mitochondrial changes were graded on a scale of 0 to 4. In the control group (Group 1), the aorta was clamped when the rectal temperature reached 25 degrees C (myocardial temperature, 18 degrees to 22 degrees C). In Groups 2, 3, 4, and 5, myocardial temperature was maintained at 6 degrees C, 10 degrees C, 14 degrees C, and 18 degrees C (all +/- 2 degrees C), respectively, by the use of systemic and topical hypothermia and repeated injections of cold cardioplegic solution into the aortic root. All groups showed a depression of left ventricular stroke work index, particularly Group 1 (no survivors), Group 2, and Group 3. The high-energy phosphate stores were well preserved in all groups except Group 1. The mitochondrial ultrastructure showed significant changes in all groups, especially Groups 1 and 5. These data indicate that satisfactory preservation of mitochondrial ultrastructure and high-energy phosphates was achieved at myocardial temperatures lower than 18 degrees C. Extreme hypothermia (Groups 2 and 3) was associated with significant reduction in ventricular function under the experimental conditions employed. PMID- 6860005 TI - Calcium-channel blockade as an adjunct to heterogeneous delivery of cardioplegia. AB - The clinical situation of heterogeneous cardioplegia was simulated in a canine model by temporary ligation of the circumflex coronary artery during a three-hour interval of cardioplegic arrest. Nifedipine and lidoflazine, administered prior to aortic clamping, were evaluated as adjuncts to cold (2 degrees C) crystalloid cardioplegia. Assessment was made of regional function (sonomicrometer systolic shortening) and of global function by measuring left atrial (LA) pressure at constant cardiac output (CO), aortic pressure, and heart rate, and by measuring stroke work at constant LA pressure, aortic pressure, and heart rate. Among 14 control dogs, only 7 could achieve a CO of 5 liters per minute following cardioplegic arrest. Left anterior descending coronary arterial systolic shortening recovered to only 86% of prearrest values (p less than 0.05), circumflex coronary arterial systolic shortening recovered only 28% (p less than 0.01), stroke work recovered 59% (p less than 0.01), and LA pressure was 6.7 mm Hg higher (p less than 0.01) than prior to cardioplegic arrest. Lidoflazine provided no statistically significant benefit in these animals (N = 4). However, dogs given nifedipine (N = 6) had very little change in left anterior descending coronary arterial systolic shortening (99% recovery), stroke work (93% recovery), and LA pressure (delta = 0.4 mm Hg). None of these changes was statistically significant. There was some deterioration in circumflex coronary arterial systolic shortening (56% recovery; p less than 0.05). All 6 dogs given nifedipine achieved a CO of 5 L/min following cardioplegic arrest. Clinical cardioplegia is typically heterogeneous cardioplegia. Calcium-channel blockade appears to be useful in this situation. PMID- 6860006 TI - Use of a pacing pulmonary artery catheter during cardiac surgery. AB - The Swan-Ganz Pacing TD Catheter with cardiac pacing capabilities was evaluated in 65 patients who underwent a cardiac operation. The catheter was inserted quickly and easily with minimal patient discomfort. Before initiation of cardiopulmonary bypass, atrial pacing was achieved in 89.2% of the patients, ventricular pacing in 93.8%, and sequential pacing in 87.7%. After termination of bypass, atrial pacing was achieved in 84.6% of the patients, ventricular pacing in 93.8%, and sequential pacing in 81.5%. Pacing thresholds were well within the current outputs of commercially available external pulse generators. No complications that could be attributed to the Swan-Ganz Pacing TD Catheter occurred in this series of patients. PMID- 6860007 TI - Hemodynamic effects of intraaortic administration of protamine. AB - Seventy-nine consecutive patients were given protamine rapidly into the ascending aorta during neutralization of heparin at the end of cardiopulmonary bypass. Simultaneously left atrial, diastolic pulmonary arterial, or right atrial pressures were maintained constant by appropriate infusion of oxygenated blood into the aorta. The systemic and pulmonary vascular resistances did not change, mean arterial blood pressure increased slightly, and cardiac output increased significantly (p less than 0.001). It seems that this method of heparin neutralization is safe provided that the intravascular volume can be maintained constant. PMID- 6860008 TI - The hemodynamic effect of phentolamine and dobutamine after open-heart operations in children: influence of the underlying heart defect. AB - The hemodynamic effects of phentolamine alone and in combination with dobutamine were studied in the immediate postoperative period in two groups of children. Group 1 (N = 6; mean age, 152 months) had open-heart operation for acquired mitral valve disease. Group 2 (N = 6; mean age, 60 months) had intracardiac repair for tetralogy of Fallot. Before drug administration, cardiac index did not differ between groups, but patients with tetralogy of Fallot had a higher heart rate and smaller stroke volume index; systemic vascular resistance was high in both groups. With phentolamine (10 micrograms/kg/min), cardiac index and stroke volume index increased similarly in both groups (+ 13% for cardiac index in Group 1, +9% in Group 2), while systemic vascular resistance, pulmonary vascular resistance, and pulmonary wedge pressure decreased. When dobutamine (5 micrograms/kg/min) was added, there was a further increase in cardiac index in both groups, but it was greater in Group 1 (+17% vs +12%, p less than 0.01, compared with phentolamine alone; +33% vs +22%, p less than 0.01, compared with control). Systemic vascular resistance remained unchanged and heart rate increased in both groups, so that the left ventricular stroke work index increased. Although stroke volume index increased significantly with dobutamine in Group 1 (+11%, p less than 0.01), it remained unchanged in Group 2 (+3%, not significant). Thus in Group 2, dobutamine increased cardiac index only by increasing heart rate. This suggests that the relatively small, noncompliant left ventricle in patients with tetralogy of Fallot cannot further respond to inotropic drugs by increasing stroke volume index. PMID- 6860009 TI - Intrapericardial teratoma in a newborn infant: use of fetal echocardiography. AB - The case of an infant with intrapericardial benign teratoma, which was suspected in utero after fetal echocardiography, is reported. This new approach permitted very early diagnosis and surgical treatment before cardipulmonary distress appeared. The tumor was excised completely, and the patient was asymptomatic three months postoperatively. PMID- 6860010 TI - Left atrial-left ventricular bypass for congenital mitral stenosis. AB - The case of a patient with congenital mitral stenosis successfully treated by insertion of a left atrial-left ventricular valved conduit is presented. After insertion of the conduit, pulmonary artery pressure was normal, persistent pulmonary edema and ascites disappeared, and the child's rate of growth and level of activities returned to normal. PMID- 6860011 TI - Management of aneurysms in segments of saphenous vein grafts. AB - A technique to manage aneurysmal dilatation of a segment of saphenous vein is presented. A vein sleeve is used to cover the dilated segment. Avoidance of subsequent venovenous anastomosis and the ease of application justify its clinical use. PMID- 6860012 TI - Primary repair of acute traumatic aortic disruption. AB - A technique that facilitates primary repair of acute traumatic aortic disruption is described. With this technique, primary repair has been possible in 5 of our most recent 9 patients with this injury, whereas all 46 of our previous patients were treated by insertion of a prosthetic graft. Primary repair of traumatic aortic disruption is feasible in many more patients than we initially thought possible and should always be considered, particularly in the young patient with a healthy, elastic aorta that is only partially transected. PMID- 6860013 TI - Tricuspid annuloplasty: a modified technique. AB - A modification of the de Vega semicircular annuloplasty for tricuspid regurgitation is presented. This technique has been used successfully in 48 patients since January, 1979. PMID- 6860014 TI - Cardioplegia techniques. PMID- 6860016 TI - Coronary vein graft marking. PMID- 6860015 TI - Cardioplegia with transvenous pacing. PMID- 6860017 TI - Infusion of vasoactive and inotropic drugs. PMID- 6860018 TI - The EJV approach. PMID- 6860019 TI - Operation for aortic atresia. PMID- 6860020 TI - Current management of transposition of the great arteries: immediate septostomy, occasional prostaglandin infusion, and early Senning operations. AB - Between January, 1979, and September, 1982, 30 infants with dextro(D) transposition of the great arteries were managed with the Senning procedure for transposition of ventricular inflow. In 11 infants under 6 months of age, there were no associated cardiac malformations and no hospital deaths. Among 17 infants operated on between the ages of 6 and 12 months, 6 had associated cardiac malformations, and there were 2 hospital deaths. Two infants in the series were over 12 months of age; 1 had an associated malformation, and there were no hospital deaths. Analysis of cardiac rhythms in the postoperative period demonstrates that the first 2 patients operated on continue to have persistent junctional escape rhythm, while the remaining 26 survivors are in sinus rhythm. Twenty-four-hour Holter monitoring performed in 24 patients showed only 9 patients to be in sinus rhythm throughout the entire recording period. Seven patients had occasional atrial and ventricular premature contractions; the remainder had episodes of sinus arrest with junctional escape rhythm. Evidence of pulmonary caval or pulmonary venous obstruction has not appeared in any patient. Recently introduced technical modifications to the Mustard procedure have improved the results of that operation in regard to rhythm disturbances and baffle obstruction to venous return. This series, therefore, does not demonstrate superiority of the Senning procedure over the Mustard procedure. However, since results comparable to those of the Mustard procedure can be obtained in very young infants using the Senning operation along with deep hypothermia and circulatory arrest, the Senning procedure is deemed preferable to the Mustard procedure for this age group because of the ease with which it can be performed and because the procedure eliminates surgical judgment, and thereby surgical error, in the location of suture lines. PMID- 6860021 TI - Portable suction device for use in patients with postoperative pleural air leaks. PMID- 6860023 TI - Pannus ingrowth on a Bjork-Shiley prosthesis. PMID- 6860022 TI - Breakage of prolene suture. PMID- 6860024 TI - Removal of percutaneous intraaortic balloon. PMID- 6860025 TI - The evolution of the surgical methods for interruption of right free wall Kent bundles. AB - In 17 patients with right free wall accessory pathways of conduction of the Kent type, three different operations were used that evolved as the surgical experience increased. Localization was by intraoperative electrophysiological methods in 16 patients and by preoperative study in 1. The types of operation were an epicardial ventricular approach in 2 patients, an endocardial atrial approach in 14, and an epicardial approach without atriotomy using cryothermic ablation in 1. The most important surgical principle was extensive separation of the coronary sulcus fat from the atrium, annulus fibrosus, and ventricle. All pathways were interrupted, although 1 patient had to have a second operation. There were no deaths or serious complications. The success of operation in Patient 1 in our series of 17 patients with right free wall pathways proved that Kent bundles cause the arrhythmia in Wolff-Parkinson-White syndrome. It is concluded that the principles on which are based the surgical treatment of arrhythmias due to right free wall Kent bundles are well established and that in selected patients, the operation may be done without cardiopulmonary bypass. PMID- 6860026 TI - Cardiac pacing under hyperbaric conditions. AB - Temporary external pacemakers have been reported to fail under hyperbaric conditions. In this study we investigated cardiac pacing under hyperbaric conditions. Permanent hermetically sealed pacemakers were found to function well under hyperbaric conditions, while several models of temporary external pacemakers failed. The electrical characteristics of pacing leads did not change under hyperbaric conditions. External pacing under hyperbaric conditions may be accomplished safely by using a permanent pacemaker attached to the patient's temporary external leads. PMID- 6860028 TI - Esophagitis secondary to ingestion of caustic material. AB - The records of 176 patients admitted to Grady Memorial Hospital over a 10-year period with a history of ingestion of corrosive material were reviewed. Esophagoscopy was performed in 168 patients an average of 15 hours after ingestion. In 94 patients, no esophageal burn was found. Seventy-four others had injury of the esophagus of varying degree; 3 of these had no evidence of oropharyngeal burn. The patients with esophageal injury were treated with steroids for two weeks and antibiotics for 5 days. No complications resulted from esophagoscopy or steroid therapy in any patient. Stricture did not develop in any of the patients in whom esophagoscopy was negative. Documented stricture occurred in 29 patients with esophagoscopic evidence of esophageal burns, 7 of whom did not respond to periodic esophageal dilation and subsequently underwent esophageal bypass. Three patients had symptoms and signs of gastric perforation on the first, sixth, and eighth days after ingestion, respectively, and at laparotomy all of them were found to have severe gastric injury. One of these patients died on the postoperative day 28; this was the only death among all patients seen with history of ingestion of corrosive material. This study suggests that with early esophagoscopy, approximately 55% of patients who ingest corrosive material can be spared the agony and prolonged treatment of possible esophageal injury. Appropriate management will result in preservation of the esophagus in most patients. PMID- 6860027 TI - Hemodynamics of pacing after aortic valve replacement and coronary artery surgery. AB - The cardiovascular effects of atrial, ventricular, and sequential pacing at PR intervals of 175, 150, 125, and 100 msec were studied immediately following cardiopulmonary bypass in patients with aortic stenosis, aortic insufficiency, or coronary artery disease. Atrial pacing increased the cardiac output and mean arterial blood pressure only in the patients with coronary artery disease. Ventricular pacing consistently was associated with the lowest cardiac output and mean arterial blood pressure. Hemodynamic response to changing PR intervals was variable. Our results suggest that if augmentation of heart rate is required in the period immediately after bypass, atrial pacing should be used in preference to ventricular pacing. In the presence of second- or third-degree heart block when atrial stimulation is ineffective, sequential pacing with an individualized PR interval becomes the therapeutic choice. PMID- 6860030 TI - Segmental replacement of superior vena cava with spiral vein graft. AB - Following resection of a leiomyosarcoma, the superior vena cava (SVC) was successfully replaced by means of a spiral graft constructed from autogenous saphenous vein. This technique has previously been applied only as a bypass operation in patients with total occlusion of the SVC causing SVC syndrome. Our patient had mild SVC obstruction and absence of venous hypertension in the upper body before the operation in which segmental SVC replacement was employed. She has remained free from signs or symptoms of SVC obstruction, and graft patency was demonstrated ten months after operation. The literature concerning use of the spiral graft is reviewed, and our operative technique is described. Use of a spiral vein graft should be considered whenever large veins must be replaced. PMID- 6860032 TI - Demonstration of pleural tube track tubularity. AB - The inflammatory reaction that is caused by the placement of a tube in the pleural space persists after tube removal and may be observed on chest roentgenograms. One radiological presentation of this reaction is a lucent stripe, which represents localized iatrogenic pneumothorax in the track of the tube. The possibility that this stripe may represent a tubular track is not generally appreciated. We report two instances in which the three-dimensional tubular nature of the tracks is demonstrated. Failure to correlate such a stripe with roentgenograms showing the previous placement of the chest tube at the site of a track may lead to confusion and potentially serious misinterpretation. PMID- 6860029 TI - Advantages of a new polyvinyl chloride double-lumen tube in thoracic surgery. AB - Double-lumen endobronchial tubes offer many advantages during thoracic operations. However, technical problems with tube placement and potentially life threatening complications have discouraged widespread use of standard double lumen tubes. Some of these problems may be reduced with a new polyvinyl chloride (PVC) double-lumen tube. A total of 214 intubations were undertaken in 204 patients using one of three endobronchial tubes. The cases of these patients were reviewed to determine differences in the complications associated with the Carlens, Robertshaw, and PVC tubes. Complications included unsuccessful or difficult intubation, tube dislodgment, unsatisfactory lung deflation, tube malposition, and hypoxemia. In 8 of 16 intubations with the Carlens tube and in 14 of 62 intubations with the Robertshaw tube, there were complications. In all, 22 of 78 intubations (28%) using conventional double-lumen tubes were complicated compared with 5 of 136 (4%) using the PVC tube. The technical problems and risks of endobronchial intubation were reduced significantly with the PVC double-lumen tube. PMID- 6860031 TI - Special considerations in ventricular pacing in patients with tricuspid valve disease. AB - In patients who have undergone prosthetic tricuspid valve replacement or tricuspid annuloplasty and in whom the pericardial space is obliterated by adhesions from previous operations, the need for ventricular pacing may be met by lead placement in the venous tributaries of the coronary veins. This approach avoids compromise of prosthetic tricuspid valve function and injury to bioprosthetic valves and natural valves repaired by annuloplasty. Although acute stimulation thresholds are slightly higher than those for short-term endocardial implants, stable long-term ventricular pacing has been observed in patients reported in the literature in whom such lead placement was inadvertent and in the 2 patients in the present paper in whom such replacement was deliberate. This method appears to be a safe alternative to standard ventricular pacing techniques under the special circumstances reported here. PMID- 6860033 TI - Male mouse accessory sex glands in organ culture. AB - Explants of epididymis, vas deferens, seminal vesicle, and coagulating gland from 10-12-week-old and 7-8-month-old male Swiss Webster mice were maintained in synthetic media without serum or hormones for up to 28 days. Differences were observed in the survival and responses of each gland and the behavior of the principal and basal cells. Epithelial cell migration was pronounced in the vas, moderate in the epididymis, and low in the seminal and coagulating gland. The incidence of basal cell proliferation, hyperplasia, and squamous metaplasia usually was positively related to the frequency of basal cells in the zero-time explants. Few differences were observed between the survival or responses of explants from young and old animals; however, explant culture appears useful for exploring fundamental properties of each accessory sex gland, especially the properties of basal cells. PMID- 6860034 TI - Seminiferous epithelium cycle in the armadillo. PMID- 6860035 TI - Influence of cations and albumin on human spermatozoa. AB - The effects of potassium, calcium and magnesium cations, and albumin on motility of spermatozoa, were tested after 15 min, 4 hr, and 24 hr of incubation using laser Doppler velocimetry. The optimal concentration of K+ was found to be 11 mM; higher values decreased motility more severely than did lower ones, even when K+ was completely removed. Motility was increased in the presence of small amounts of calcium (from 0.8-1.7 mM) but was depressed by magnesium concentrations above 0.8 mM. Moderate concentrations of albumin (0.5-1%) improved motility, but the protecting effect of this compound--leading to a best sperm survival--appeared with higher concentrations (4%). In conclusion we observed that optimal ionic conditions presently found were corresponding well to the tubal environment in preovulatory phase. PMID- 6860036 TI - Effect of long term administration of ovine prolactin on hypothalamic-pituitary testicular axis in rat. AB - The effect of hyperprolactinaemia on testicular morphology and on hypothalamic pituitary-testicular axis was studied in adult male Wistar rats. Animals received ovine prolactin (oPRL) 200 micrograms twice daily s.c.) for 24 and 36 days and were killed by exanguination. Blood was collected for hormonal determinations and sex accessory glands were removed for histological studies. Circulating testosterone (T) and luteinizing hormone (LH) levels showed a significant reduction after 36 days of treatment whereas plasma follicle-stimulating hormone (FSH) levels were unchanged in all animals. No macroscopic or light microscopic histological modifications were observed in the testes. The present results, while excluding a direct effect of hyperprolactinaemia on seminiferous tubules, suggest that LH suppression is the consequence of a central effect of the ovine PRL long-term administration. The increased DA turnover in the hypothalamus suggested as inhibitory on GnRH neurons could account for this effect. The reduction of T levels seems to be mediated by the LH suppression, even though a direct effect of oPRL on Leydig cell receptors could be hypothesized. PMID- 6860038 TI - Deoxyribonuclease activity in human seminal fluid. AB - Deoxyribonuclease (DNase) activity was examined in the whole and two split fractions of human seminal fluid from normospermic, oligozoospermic, and azoospermic origins as well as in sonicates of isolated sperm after freezing and thawing of samples and at various pH values of substrates. The method consisted in the measurement of digested areas in plates containing herring sperm deoxyribonucleic acid (DNA). No correlation was found between DNase activity (875 +/- 22 (SE) ng/ml) and seminal fluid quality. The enzyme activity was significantly lower in the second split portion (764 +/- 43 ng/ml) as compared to the first (971 +/- 41 ng/ml). Sonicates of washed sperm were inactive. It is suggested that DNase activity derives from the epididymis and possibly from the vas deferens where it participates in the decomposition of DNA from dead cells. PMID- 6860039 TI - Teaching andrology in U.S. and Canadian medical schools: a questionnaire. AB - Based on the questionnaires answered by 60 of the 140 schools surveyed, it is apparent that the teaching of andrology receives little emphasis in the schools' curricula. The lack of support given to the teaching of andrology is more evident at the postgraduate than at the undergraduate level. Although andrology is relatively new as an independent biochemical specialty, it is suggested that increased availability of information on andrology to students and physicians would have a positive impact on the quality of health care. PMID- 6860040 TI - Effects of stress on the reproductive system of male rats and mice. AB - Male rats were immobilized for 2 hr/day, 5 days a week, for varying periods of time (7-31 days) to assess the effects of stress on the reproductive system. Mice were immobilized for 25-38 days. The effectiveness of the stress was demonstrated by assessing the adrenal and body weight. Adrenal weights were significantly increased (p less than .05--t-test) compared to controls. Body weights were decreased compared to controls. No consistent change was noticed in the testicular weight and progressive motility of the spermatozoa drawn from the cauda epididymis and vas deferens. There were no deleterious effects of immobilization stress on the morphology of the differentiating germ cells, peritubular wall, and the interstitial tissues of the testis. PMID- 6860037 TI - Temperature-induced alterations in rabbit testicular contractility in vitro. AB - Rabbit testicular contractions and intratesticular pressure were recorded in vitro as temperature was increased from 33 to 38 degrees C. The response of the testicular capsule to several physiological agents was quantified at 35, 37 and 38 degrees C. A corresponding increase in intratesticular pressure was observed with each contraction. Uniform intratesticular pressures developed in normal spontaneous autorhythmic testicular preparations. The force of capsular contractions increased slightly from 33 to 35 degrees C, but decreased markedly with temperatures above 35 degrees C. Intratesticular pressure increased linearly with increased force of contractions to a maximum of 143 mg of tension. As intratesticular pressure increased, the amplitude of contractions decreased. Marked irregularities in force and frequency of contractions occurred with temperatures above 38 degrees C. Increasing testicular temperature from 35 to 37 degrees C and from 37 to 38 degrees C both markedly reduced the effectiveness of acetylcholine by 58 and 71%, serotonin by 52 and 71%, epinephrine by 41 and 45%, PGF2 alpha by 37 and 54%, histamine by 33 and 54% and bradykinin by 29 and 43%, respectively, in their ability to increase tone of the capsule. PMID- 6860041 TI - Melanoma linked with chromosome 6 genes. PMID- 6860042 TI - Documenting suspected drug-induced thrombocytopenia. PMID- 6860044 TI - Identification of risk for renal insufficiency from nonsteroidal anti inflammatory drugs. AB - Risk for renal insufficiency (RI) resulting from nonsteroidal anti-inflammatory drugs (NSAID) exists in cirrhosis with ascites, nephrotic syndrome, decompensated congestive heart failure, and chronic renal disease. We saw seven cases of NSAID RI that demonstrate important additional clinical risk factors. These include advanced age (mean, 76 years), use of diuretic drugs (6/7 patients), and evidence of renal vascular disease as suggested by long-standing hypertension, diabetes, or atherosclerotic cardiovascular disease (7/7 patients). Analysis of past case reports of NSAID RI also showed these features. Treatment of acute gouty arthritis was the most common precipitating event. Evolving NSAID RI was suggested by rising serum urea nitrogen, serum creatinine, and serum potassium levels, and body weight gain associated with low fractional excretion of sodium. We conclude that since NSAID RI is preventable and reversible, it is important to recognize and monitor the conditions of those patients at risk. PMID- 6860043 TI - The value of the peripheral blood smear in anemic inpatients. The laboratory's reading v a physician's reading. AB - Since physicians are routinely taught to review the peripheral blood smear results of all anemic patients, we analyzed the diagnostic value of the laboratory's blood smear reading and the incremental value of a physician's personal reading in anemic inpatients. Blood smear abnormalities, as reported by the laboratory and two hematologists, were poorly reproducible, with only five of the 11 types of abnormalities being more reproducible than could be expected by chance. The blood smear performed no better than RBC indices in detecting probable iron deficiency or low serum levels of folate or vitamin B12. In anemias not caused by deficiency states, the blood smear reading performed by the hospital laboratory provided unique information in 6% of the cases and helpful information in another 25%, but the additional reading performed by a hematologist never provided unique information and provided incremental helpful information in only 4% of the cases. The peripheral blood smears of all anemic inpatients should be read by the hospital laboratory, but in our hospital, a routine additional personal reading by a physician had limited incremental value and could be reserved for selected cases. PMID- 6860045 TI - Effects of guanabenz therapy on renal function and body fluid composition. AB - Guanabenz acetate is a new centrally acting alpha 2-adrenergic agonist. Seventeen hypertensive men, in whom BP was normalized with guanabenz, underwent assessment of renal function, renal hemodynamics, and body fluid composition following short term (three to six weeks), long-term (five to six months), and withdrawal (two weeks) therapy. Guanabenz therapy caused a modest but reversible reduction in glomerular filtration rate (12% to 18%), effective renal plasma flow (9% to 17%), and renal blood flow (12% to 20%). Renal vascular resistance was unchanged. Guanabenz therapy had no significant natriuretic or antinatriuretic effects in patients with an effective BP decrease, although it had the ability to produce and sustain a water diuresis. Guanabenz therapy was not associated with salt and water increases within body fluid compartments. Guanabenz, in some patients, is an effective monotherapy for the treatment of hypertension. PMID- 6860046 TI - Quinine-induced thrombocytopenia following intravenous use of heroin. AB - Profound thrombocytopenia developed in a 22-year-old man after intravenous use of heroin. A high-titer, quinine-dependent, platelet-specific antibody was detected in his serum using lysis of normal platelets labeled with chromium 51 and an electroimmunoassay for measurement of platelet-associated IgG. The antibody was specific for quinine and failed to react with platelets in the presence of quinidine hydrochloride or two structural analogues of heroin. Quinine, a common adulterant found in heroin, was detected in the patient's blood and urine. On the basis of these observations, the patient was judged to have quinine-induced immunologic thrombocytopenia. To our knowledge, this report is the first to confirm that quinine used as an adulterant can induce immunologic thrombocytopenia following an injection of heroin. PMID- 6860047 TI - Disseminated aspergillosis complicating hepatic failure. AB - Disseminated aspergillosis is not generally known as a complication of hepatic failure. Three patients with subacute hepatic necrosis died of clinically unrecognized disseminated aspergillosis. All of the patients had pulmonary aspergillosis and Aspergillus infections of the CNS. Focal neurologic deficits were clinically misconstrued as intracerebral hemorrhages caused by the coagulopathy of liver failure. Signs of invasive pulmonary aspergillosis were ascribed to refractory bacterial pneumonia. Each patient had a hospital course of longer than three weeks and each received treatment with corticosteroids and intravenous antibiotics. Invasive aspergillosis should be considered as a cause of refractory pneumonia and of new focal neurologic deficits in patients with hepatic failure. PMID- 6860048 TI - Survey of very-low-calorie weight reduction diets. I. Novelty diets. PMID- 6860049 TI - Nutrition and the health of the elderly. A growing concern for all ages. AB - At a recent symposium, presentations were made summarizing current knowledge relating the dietary intake of six nutrients, calcium, vitamin D, iron, zinc, folate, and thiamin to health and disease in the elderly. The nutritional concerns of the elderly are becoming Increasingly Important as this population segment grows in size. In evaluating the nutritional status of the elderly, dietary calcium deficiency is emerging as a widespread problem. Alcoholism and the chronic use of certain medications appear to be major causes of specific vitamin and mineral deficiencies. Preventive measures to be maximally effective probably have to be started earlier in life. More research is clearly needed concerning the habits, lifestyles and nutritional requirements of various segments of the elderly population. PMID- 6860050 TI - Informed consent in research and practice. Similarities and differences. PMID- 6860051 TI - Acute polyuric renal failure after aspirin intoxication. AB - Reversible acute polyuric renal failure was observed in a patient after the ingestion of an unusually large toxic (125 g) dose of aspirin. Renal dysfunction occurred in the absence of volume depletion or underlying renal impairment. These observations emphasize the need for careful monitoring of renal function in all patients with aspirin intoxication. PMID- 6860052 TI - Impotence during therapy with verapamil. PMID- 6860053 TI - Primary polydipsia. Syndrome of inappropriate thirst. AB - A patient with lifelong severe polyuria and polydipsia had normal serum antidiuretic hormone (ADH) levels and responded to water deprivation with a prompt increase in urine osmolality and maintenance of normal plasma osmolality (less than 290 mOsm/kg), despite extreme thirst. When treated with desmopressin acetate and allowed free access to water, she was able to reduce plasma osmolality below 270 mOsm/kg, and her compelling thirst disappeared. The disorder is interpreted to be the result of excessive fluid intake in response to a thirst stimulus that was not inhibited by normal plasma osmolality. This study indicates that osmoreceptor control of ADH secretion is normal. Continued administration of vasopressin has relieved the symptoms and has not resulted in water intoxication. PMID- 6860055 TI - Pulmonary dirofilariasis and transitional cell carcinoma. Benign lung nodules mimicking metastatic malignant neoplasms. PMID- 6860054 TI - Disseminated intravascular coagulation and hypotension after intravasation of barium. AB - Prolonged hypotension and disseminated intravascular coagulation were seen in a patient after intravasation of barium sulfate contrast medium during a barium enema examination. High endotoxin levels were measured in the contrast material. In vitro, this material induced generation of bradykinin. The clinical features observed may be explained by contact activation of the Hageman factor-dependent pathways caused by the contrast material and/or by circulating endotoxins. Treatment of this rare but severe complication occurring during a barium enema procedure should be directed against the endotoxic shock. PMID- 6860056 TI - Pyoderma gangrenosum associated with primary biliary cirrhosis. PMID- 6860057 TI - Hearing loss and erythromycin pharmacokinetics in a patient receiving hemodialysis. AB - A left upper lobe pneumonia developed in a patient who was receiving hemodialysis; he was treated intravenously with 1 g of erythromycin lactobionate every six hours. After five doses, hearing loss was noted; this was later documented by audiogram. Erythromycin serum concentrations as high as 100 mg/L and a half-life more than three times longer than normal were observed. To our knowledge, this represents the first report of reversible hearing loss associated with elevated serum erythromycin concentrations and prolonged serum half-life. PMID- 6860058 TI - Pancytopenia in mannosidosis. AB - A case of autoimmune pancytopenia is described in a patient with mannosidosis who developed anti-platelet and anti-neutrophil antibodies and a low haptoglobin level. Bone marrow biopsy and 111InCl3 bone marrow scanning demonstrated hypoplasia of the marrow with a paucity of "storage cells." Pathogenic mechanisms and implications for other inborn errors of metabolism are discussed. PMID- 6860060 TI - Clinical manifestations in cardiac sarcoidosis. PMID- 6860059 TI - Fulminant hepatitis associated with disulfiram. Report of a case. AB - Disulfiram is used commonly as reinforcement in the treatment of chronic alcoholism. Although the drug is generally considered safe, there are reports of side effects including psychosis and hepatitis. We report a case of fatal fulminant hepatitis caused by the use of disulfiram in a man with previously normal hepatocellular function. PMID- 6860061 TI - Central sleep apnea and acetazolamide therapy. PMID- 6860062 TI - Hyperthyroidism. PMID- 6860063 TI - Patient-physician accommodation. PMID- 6860064 TI - Physician's responsibility. PMID- 6860065 TI - [Apolipoproteins and glycosylated hemoglobin in the young insulin-dependent diabetic]. AB - Apolipoproteins A and B, total cholesterol, triglycerides, HDL, LDL, VLDL cholesterol and glycosylated hemoglobin levels were measured in 81 children and adolescents with juvenile-onset diabetes. There were 41 males and 40 females aged 7 to 22 years. They were separated into 3 groups depending on severity: G1 (well controlled diabetes), G2 (partly controlled diabetes), G3 (poorly controlled diabetes). In boys, triglycerides levels were significantly high in group G1, apolipoprotein B, total cholesterol, triglycerides, VLDL cholesterol levels and Alc glycosylated hemoglobin were raised in group G3. Furthermore, there was a positive correlation between the percentage of Alc glycosylated hemoglobin and LDL cholesterol level. In girls, triglycerides levels were significantly high in group G1, as were apolipoprotein B, triglycerides and VLDL cholesterol levels in group G2 and apolipoprotein B, triglycerides, LDL cholesterol, VLDL cholesterol levels and the percentage of Alc glycosylated hemoglobin in group G3. A positive correlation between the percentage of Alc glycosylated hemoglobin and LDL cholesterol level was also found. PMID- 6860066 TI - [Neuroblastomas treated at the Gustave-Roussy Institute from 1975 to 1979. 173 cases]. AB - From 1975 to 1979, 173 children with neuroblastoma were treated according to the same protocol at the Institut Gustave-Roussy. They were classified according to the site of the primary tumor (abdominal: 122; thoracic: 29; others: 22) and according to TNM staging (stage I: 8; stage II: 24; stage III: 35; stage IV: 99; stage V: 2). Depending on stage and age, treatment consisted of surgery and radiotherapy associated with cyclic multiagent chemotherapy (vincristine, Adriamycin, cyclophosphamide). It resulted in a significant improvement of prognosis in stage III patients, especially those with abdominal tumors. In the latter group, prognosis depended mainly on the possibilities of resection of the tumors. Therefore, making these tumors operable remains the major goal of therapy in such patients. Radiotherapy is quite efficient in sterilizing the small post surgical residual tumors. Prognosis in children over 1 year of age with metastases still remains very poor, even though the quality of the survival is improved. PMID- 6860067 TI - [Food consumption of children eating lunch in school restaurants]. AB - In order to study the dietary intakes of children having lunch at school, 150 children were observed: 60 aged 5-6 years, 60 aged 9-10 years and 30, aged 5-13 years, attending 5 different schools (4 in town, 1 in the country). The estimation of spontaneous ingesta was made according to the weighing method. Energizing rations, the percentages of caloric intakes, the amounts of total, animal and vegetal lipids, of total carbohydrates and pure carbohydrates, of total, animal and vegetal proteins were estimated for each meal and each child. The analysis of these ingesta suggests that the dietary habits of children at school is a major factor of nutritional lack of balance, much more important than that related with the quality of the proposed food. PMID- 6860068 TI - [Rhabdomyolysis and acute encephalitis in coxsackievirus infection]. AB - We report the case of a 6 year-old boy with rhabdomyolysis involving only the inferior limbs. It was complicated by renal failure with anuria and intravenous coagulopathy and associated with encephalitis. Virologic investigations showed a recent infection due to Coxsackie B5 virus. Full recovery was observed after symptomatic treatment with peritoneal dialysis, exchange transfusion and heparin therapy. PMID- 6860069 TI - [Neurologic manifestations in rheumatoid purpura]. PMID- 6860072 TI - [Hospitalization of foreign children in the Paris area]. AB - In 1980, within a 29 day-period, we studied all the hospitalizations of children in 14 departments of the "Assistance Publique" in Paris. The survey included 940 children and 978 hospitalizations. We compared French children with foreign children, living in France and born to 2 foreign parents. The rate of foreign children among the hospitalized children is abnormally high. This high rate is partly explained by social factors but remains high after adjustment of those factors. The 2 groups of children are not hospitalized for the same kind of diseases: French children are more frequently hospitalized for congenital malformations, foreign children for accidents and infections. Foreign children are hospitalized longer than French children for a same disease. The length of hospitalization is not connected with the father's type of work but rather with the occupation of the mother. The child's hospitalization is shorter when the mother has a professional occupation, and that influence of the mother's work is independent of the other factors. PMID- 6860070 TI - [Multiple synostosis disease. Study of the variation of symptoms within the same family]. PMID- 6860071 TI - [Intracranial ependymoma in children. Prognosis and therapeutic perspectives]. AB - The authors report 47 cases of intracranial ependymomas occurring in children less than 15 years of age, who were operated on from 1969 to 1979. The aim of the study was to study the incidence of intraspinal metastases and to suggest a logical protocol for postoperative radiotherapy. The operative mortality rate was 17%. The 5 year survival rate, after exclusion of postoperative mortality, was 51%. Recurrences developed in 41% of cases and metastases in 20%. Among these, intraspinal metastases occurred in 14.5% and were found only in infratentorial ependymomas, whether benign or malignant. The results and those in the literature suggest that a protocol of irradiation adapted to the site and the histological grading of these tumors should be discussed with the teams of radiotherapy; in infratentorial ependymomas, the irradiation should include the whole craniospinal axis. PMID- 6860073 TI - Brain electrical activity mapping (BEAM) in schizophrenic patients. AB - A new topographic approach, brain electrical activity mapping, summarizes EEG and evoked potential data as color maps. Eleven drug-free and 14 medicated schizophrenic patients and 11 normal controls were studied with this technique. Compared with controls, both schizophrenic groups had more slow activity (delta, 0 to 3.5 Hz), greatest in frontal regions, and more fast activity (beta, 20 to 31.5 Hz) in postcentral regions. Both schizophrenic groups were different from controls late in the visual evoked potential and in the middle of the auditory evoked potential. Overall, using multivariate discriminant analysis, a very significant group separation effect was found, and retrospective classification was 95% successful in discriminating both schizophrenic groups from controls. To estimate the ability of our features to assign subjects prospectively to control or patient groups, we employed "jackknifing," which resulted in overall classification success rates of 84.0% for medicated schizophrenic patients v controls and 81.8% for drug-free schizophrenic patients v controls. PMID- 6860076 TI - Plasma phenylalanine, tyrosine, and tryptophan in schizophrenia. AB - Plasma phenylalanine, tyrosine, and tryptophan concentrations were measured in chronic schizophrenic patients, normal controls, and heterozygotes for phenylketonuria. Schizophrenic patients' plasma concentrations of these amino acids could not be distinguished from those of normal controls, either when fasting or following oral or intravenous (IV) phenylalanine challenge. No neuroleptic effect was observed. Plasma phenylalanine-tyrosine ratios following IV phenylalanine challenge could easily distinguish heterozygotes from schizophrenic and normal control subjects but could not distinguish schizophrenic subjects from normal control subjects. No overlap between heterozygotes' values and those of the schizophrenic and normal subjects was observed. These studies find no evidence of abnormal phenylalanine metabolism in schizophrenic persons. Phenylalanine challenge did not affect the abstraction or judgment capacities of the subjects. PMID- 6860075 TI - Computed tomographic scans in patients with schizophrenia, schizoaffective, and bipolar affective disorder. AB - Computed tomographic (CT) scans of 28 chronic schizophrenic patients, 15 chronic schizoaffective patients, and 19 patients with bipolar affective disorder were compared on three measures: ventricular size, sulcal prominence (cortical atrophy), and cerebellar atrophy. Because the patients with bipolar disorder were older, measures were adjusted by controlling for age statistically or excluding patients over age 50 years. After age correction, there were no significant differences across diagnostic groups. Each group contained some subjects with enlarged ventricles, sulcal prominence, and/or cerebellar atrophy. The similarity of CT scan results across the three groups argues against ascribing these abnormalities to any one psychiatric disorder or to a specific drug effect. Sampling effects and the possibility of differential causes of the findings in the different diagnostic groups must be considered. Examination of the correlations of these three CT scan measures found them to be significantly related to each other. Age correlated with all measures when patients over age 50 years were included in the analysis, but not for patients aged 50 years and younger. PMID- 6860074 TI - Altered P300 topography in schizophrenia. AB - The spatiotemporal evolution of the P300 waveform was topographically mapped in a group of ten male chronic schizophrenics, using the technique of brain electrical activity mapping. Group-average P300 waveforms were constructed for the schizophrenic group and a group of matched controls. The control group's P300 showed a concentric development about a maximum in the centroparietal area, slightly displaced toward the left. In contrast, the schizophrenic group's P300 maximum was more anterior and to the right, with a deficiency in left temporal activity. Using the technique of significance probability mapping, it was demonstrated that the maximum between-group difference was localized to the left middle and posterior temporal regions, where the schizophrenic group was deficient in activity. PMID- 6860078 TI - Thinking disorder in depression. AB - This experiment demonstrated abstract reasoning deficits in depressed patients and detailed some of the components of cognition that may determine such deficits. Subjects were given a discrimination learning problem in which possible solutions had to be formulated and tested against new information. Depressed subjects performed more poorly on the task than controls. Two types of errors- inability to narrow down the set of possible solutions (poor "focusing") and perseveration on disconfirmed hypotheses--hampered the performance of depressed but not control subjects. While logic, memory, and attention were intact at an elementary level, the inability to coordinate these functions in a complex task appeared to be an important feature of the depressive impairment. PMID- 6860077 TI - Disordered thinking. AB - To evaluate formulations that thought disorder at the posthospital phase identifies a subgroup of nuclear schizophrenics with poor outcomes, 77 patients from a longitudinal project were followed up on major dimensions of psychopathology linked to nuclear schizophrenia. The data indicate that (1) schizophrenics were more thought disordered than were nonschizophrenics at the posthospital phase; (2) thought-disordered schizophrenics had only slightly poorer scores on classic prognostic indicators associated with poor outcomes; (3) a subgroup of early chronic schizophrenics were not severely thought disordered; (4) almost all severely thought-disordered schizophrenics demonstrated clear evidence of delusional activity at follow-up; and (5) thought-disordered schizophrenics had poorer outcomes. The overall results fit in with formulations that a severe thought disorder is one of several major features of schizophrenia. The data suggest that posthospital thought disorder identifies a subgroup of poor outcome schizophrenics, although some non-thought-disordered schizophrenics also show poor outcomes. PMID- 6860079 TI - Personality attributes of depressive patients. AB - Three groups of depressive patients (endogenous bipolar, endogenous unipolar, and nonendogenous) and one nondepressive control group displayed statistically significant differences on several personality variables when the patients were in a depression-free interval. Each of the depressive groups had stronger autodestructive-neurotic tendencies than the control group. The nonendogenous patients were overautonomous and aggressive, the endogenous unipolar patients lacked autonomy, and the endogenous bipolar patients had a hypomanic drive toward success and achievement and were anancastic and aggressive. These results were controlled for the influence of persisting symptoms of depression. They rectify generally accepted views and represent a basis for further clinical research. PMID- 6860080 TI - Assortative mating, social adjustment, and course of illness in primary affective disorder. AB - Fifty-six married inpatients with primary affective disorders and their spouses participated in a 12- to 36-month follow-up study in which the relationship of assortative mating to social adjustment and course of illness was examined. At follow-up, the patients who were concordant with their spouses for psychiatric illness had poorer social adjustment than the group of patients with well spouses. This finding was confirmed by both relatives' ratings and clinicians' ratings of the patients' social adjustment. Measures of relapse since the target hospitalization and self-rated symptoms at the time of follow-up were not different for the two groups. The divorce rate, however, was significantly greater for the couples who were concordant for psychiatric illness when compared with the discordant couples. PMID- 6860081 TI - Cerebral blood flow in schizophrenia. PMID- 6860082 TI - The Mini-Mental State Examination. PMID- 6860083 TI - Warburg's cancer theory revisited: a fundamentally new approach. AB - Warburg's cancer theory was based on cell injury at the bioenergetic system level. Posteriorly done research work on cell membrane biology, and on the role of calcium in the multifunctional capabilities of the cell (respiration, protein metabolism, membrane physiology, mitosis, etc.) has been used to corroborate another years ago stated hypothesis on carcinogenesis. The consequently new theory states that a cell injury at the cell membrane level is the event triggering a massive influx of calcium ions, and as the result of which some cells die by toxic death (necrosis) while, in order to survive others must adapt themselves to a changed intracellular ionic environment. This adaptation process leads to a more primitive way of life (neoplasia) where the cells appear to be independent of biological signals, specially those calcium-dependent. The increased intracellular calcium concentration seems also to be the cause of increased cell glycolysis (Warburg's observation), and of the preneoplastic hyperplasia by uncontrolled translational mRNA activity. PMID- 6860084 TI - Establishment of slowly growing lung tumor cell model by aspiration of tumor cells. AB - In male BDF1 mice, aspiration of suspended Lewis lung tumor cells at a certain concentration leads to the occurrence of lung carcinomas after 30 days. Under the chosen experimental conditions tumor incidence is about 70%. Within 20 days, animals die from this slowly growing tumor. Furthermore, the experimental conception offers a model which seems suitable for investigations into growth regulation of lung tumors. PMID- 6860085 TI - [Carminomycin in combination with some cytostatics. 1. Efficacy in leukemia L1210]. AB - Additive an synergistic therapeutic effects are demonstrable in the murine L 1210 model following combined application of CRM with CTX. Cytostasane, 5-FU, DTIC and CCNU, while combinations of CRM with L-PAM, BLM, DBD, CLB or MTX gave no such effects. PMID- 6860087 TI - [Prognostic factors for differentiation of melanoma patients with and without relapse]. AB - In a retrospective analysis histopathologically determined high risk factors were registered in 150 melanoma patients. In addition immunological tests were carried out in 119 of these patients. Relapses were shown to occur so far only in melanoma patients with one ore more of the following high risk factors: Maximal tumour thickness greater than or equal 3 mm, level V according to Clark, very high mitotic activity, evidence of metastasis, and reduced PHA stimulation in the LTT. PMID- 6860086 TI - Multiple myeloma associated with Kaposi sarcoma: a case report. AB - An Italian woman affected by multiple myeloma (MM) associated with Kaposi's sarcoma (KS) has been studied. MM appeared to be at stage II, A, according to Durie & Salmon (3) (quantitative staging); KS spread out two and a half years after MM had been diagnosed, and showed only a pharyngeal involvement. The patient was still alive two and a half years after KS had been discovered, showing a benign clinical course, though several infectious complications had occurred. The observed patient is compared with the other ten cases reported in the world literature. The long lasting observed survival is thought to be related to the low MCM and the length of successful therapy. PMID- 6860088 TI - [The value of the granulocyte phagocytic test in oncology follow-up care]. AB - This work represents the results of the granulocyte phagocytic test in tumor effected individuals by observing the course over a period up to three years. In tumor patients, which could be operated radically, a normal phagocytosis activity of granulocytes indicates the undisturbed course. In patients with progressive carcinoma growth the average of phagocytosis is lowered obviously. These results revealed information for the prognosis of malignant diseases and the nonspecific accompanying diseases. PMID- 6860089 TI - [Radiodiagnosis of pathologic processes of the stomach using EDP as a diagnostic aid]. AB - The use of EDP makes it possible to increase the accuracy of the radiodiagnostics of the stomach. The retrospective study is based on 540 X-ray examinations of benign and malignant processes of the stomach which had been diagnosed histologically. It can be proved by means of examination findings that the use of the multivariate discriminatory analysis allows a reliable analysis of the manifold interrelations between the various classes of diagnosis on the one hand and diagnostically usable sign patterns on the other hand so that, in the majority of the classes of diagnosis, the degree to which the diagnostic information issued will increase in comparison to the empirically established radiodiagnoses. The reclassification resulted in the following correct assignments to the various classes: ulcus ventriculi, benign 87 per cent; ulcus ventriculi, malignant - 78 per cent; exulcerated carcinoma - 82 per cent; polyp, benign - 85 per cent; polyp, malignant - 75 per cent; polypoid carcinoma - 91 per cent; stenosis, benign - 85 per cent; stenosis, malignant - 79 per cent; infiltrating carcinoma - 63 per cent. Preconditions for the practical application of EDP in the radiodiagnostics of the stomach are an examination technique and method which exhaust all the available technical possibilities, and an exact interpretation of the radiographic signs. PMID- 6860091 TI - [Antimycotic agents, 13. Halophenoxy-1,3,5-triazines]. PMID- 6860090 TI - Influence of vitamin A on the formation of ethylnitrosourea (ENU)-induced leukemias. AB - In mice, administration of ethylnitrosourea (120 mg/kg body weight) on day 14 of pregnancy leads to a transplacentally induced and transplantable leukemia in a high percentage of the offspring. Moreover, 100% of the offspring develop, later on, adenomas of the lung. Application of retinol palmitate (daily dose 170,000 IU/kg) reduces leukemogenesis up to 50%, yet without influencing formation of lung adenomas. PMID- 6860092 TI - [2-(1H-Tetrazol-5-yl)-4,5-dihydroindeno[1,2-b]pyran-4-one]. PMID- 6860093 TI - Functional comparison of upper extremity amputees using myoelectric and conventional prostheses. AB - Upper extremity amputees were tested on a standardized series of tasks using a myoelectric hand, a conventional prosthesis (cable-controlled hook), and their normal hand (unilateral amputees only). They answered also a questionnaire on activities of daily living (ADL) and provided other prosthetic information. Amputees who had been fitted only with a conventional prosthesis, and used their prosthesis regularly, tended to wear the prosthesis more hours per day (14 hours) than amputees fitted with a myoelectric hand (9.6 hours), some of whom continued to use a conventional prosthesis for some jobs. However, the amputees with myoelectric prostheses had a greater functional range of motion (ROM) than those with a conventional prosthesis, and many regular wearers of a myoelectric prosthesis had long since rejected a conventional prosthesis. Amputees took about 2.5 times as long to complete the tasks tested with a conventional prosthesis and about five times as long with a myoelectric prosthesis than with their normal hand. Despite the slower function, more than 60% of below-elbow (B-E) amputees accepted the myoelectric prosthesis in preference to a conventional prosthesis, which they had all been fitted with previously. Others preferred to continue using a conventional prosthesis to which they had become accustomed (13%) or no prosthesis (26%). The combination of function, ROM, and cosmetic appearance of a myoelectric prosthesis is preferred by most B-E amputees, despite its slower performance at the present time. PMID- 6860094 TI - Arm crank vs handrim wheelchair propulsion: metabolic and cardiopulmonary responses. AB - The handrim propulsion system of most manual wheelchairs has been shown to be inefficient and stressful to the cardiovascular and pulmonary systems. Arm crank propulsion has been suggested to reduce these stresses. In order to compare conventional handrim wheelchair propulsion to arm crank type wheelchair propulsion, 16 volunteers (9 able-bodied, 7 wheelchair-dependent) operated both wheelchairs over level tiled and carpeted test courses at 3km.hr-1. The arm crank propelled wheelchair was operated in 3 gear ratios: low, medium and high. Exercise bouts were 5 minutes in duration. During the final minute of each test, oxygen uptake (VO2), net locomotive energy cost (NLEC), pulmonary ventilation (VE) and heart rate (HR) were monitored. Subjects exhibited significantly lower magnitude of these physiologic responses during arm crank wheelchair propulsion relative to handrim wheelchair propulsion for all gear drive ratios. Average percent differences were 30% and 32% for VO2; 50% and 50% for NLEC; 27% and 34% for VE; and 16% and 19% for HR on the tiled and carpeted test surfaces, respectively. From these data we conclude that arm crank wheelchair propulsion is less strenuous than conventional handrim wheelchair propulsion and that arm crank propulsion systems should be considered as a possible means to improve wheelchair design. PMID- 6860096 TI - Functional ability indices: measurement problems in assessing their validity. AB - This study examines measurement problems which must be considered in assessing the validity of alternative measures of functional ability. Threats to meaningful evaluation of validity include problems of: (1) assessing the impact of aids, adaptations and helpers; (2) controlling for situational variation and motivational factors; (3) controlling for the professional perspective of the rater; and (4) controlling for the role expectations of the patient in the performance of certain functions. These problems were investigated using validity comparisons from the St. Thomas' Hospital elderly study in which questionnaire based assessments of functional status were compared with assessments of physicians and visiting geriatric nurses. Clinician and questionnaire-based measurements were compared for 92 elderly (age 75 years and older) primary-care patients in terms of performance of 13 mobility and self-help functions. Trichotomous measures of performance controlled more adequately for the compensating effect of aids, adaptations, and helpers, and rater/questionnaire agreement was highest for more basic mobility and self-help functions. Test retest reliability comparisons indicated that motivational factors and situational variation were minimized by reassessing the subjects in their own homes using members of their primary-care team. Levels of concordance between questionnaire ratings and clinical ratings show systematic variation indicating differences in the clinical perspectives of physicians and visiting nurses. Finally, variations in the reported and clinically-evaluated performance of male and female subjects appear to reflect the culturally determined role expectations of men and women as they relate to self-care. PMID- 6860097 TI - Patient profiles: utilization in functional performance assessment. AB - A computerized XY graphic plotted profile has been developed as a method of displaying patient progress and goals using the Patient Evaluation Conference System (PECS) as the data source. Each profile is a bar graph of functional status and goal scores for specific contact-evaluation points. Contacts are represented by different colors so that one color is superimposed on the other. Individual functional items are plotted on the X-axis at the appropriate level of independent or dependent function, as indicated by the 0 to 7 scale which appears on the Y-axis. The profile is used in goal-oriented team conferences, and provides a focus on particular problems of low status or discrepencies between status and goals. This visual aid can provide a display of rehabilitation progress useful to the patient, family, and staff. PMID- 6860098 TI - Stress and personal attitudes in chronic illness. AB - The possible relation of two stressor types (life events and illness experience) to three sets of attitudes (personal life satisfaction, self-assessed coping, and satisfaction with treatment personnel/facilities) was examined within a sample of 97 outpatients having multiple sclerosis. In addition, potential moderators of hypothesized relationships were examined (trait anxiety, age, social class, and knowledge of the disease). When attitudes were regressed on stressors and moderators, both sets of stressors exerted significant influence, though their impacts were mitigated by the moderators. This study's findings support the position that the association of attitudes with stressor exposure in chronic disease populations is contingent on demographic and psychological moderating factors. PMID- 6860095 TI - Oxygen consumption of elderly persons with bilateral below knee amputations: ambulation vs wheelchair propulsion. AB - Elderly bilateral below knee (BK) amputees were tested for oxygen consumption (VO2), heart rate (HR) and velocity (V) during ambulation on a 40m walkway and a stationary wheelchair ergometer. Values obtained from amputees were compared to values obtained from a control population of the same age group. On test day 1 bilateral amputees and normal subjects ambulated at their natural pace on a walkway for approximately 5 minutes. On test day 2 each subject propelled a stationary wheelchair ergometer at their natural rate for the same distance that they ambulated. Measurements of VO2 (ml/m/kg), HR (beats/min), and V (m/min) were obtained during both sessions. Results show that the bilateral BK group required significantly more VO2 (ml/m/kg) (123%), had higher HR (26%), and slower V (36%) than the normal group during ambulation. The energy cost in terms of ml/min/kg during ambulation was similar, suggesting that the amputees ambulated at the same power cost as normals but at lower velocities. During wheelchair propulsion the BK group and normal group showed no significant difference in the 2 criteria. Results suggest that wheelchair propulsion is a more energy efficient mode of mobility for elderly bilateral BK amputees than ambulation. Energy cost and heart rate determinations may be valuable in choosing the course of mobility training and recommended activity levels. Cosmetic, psychosocial, and other clinical factors must be considered in prescribing rehabilitation. PMID- 6860099 TI - Wheelchair transfer training for right cerebral dysfunctions: an interdisciplinary approach. AB - A 44-year-old patient with cerebrovascular accident and resulting total occlusion of the right internal carotid artery and severe cognitive impairments was seen as an inpatient. Impulsivity, general inattention, left side neglect, decreased concentration and visual-spatial-perceptual difficulties were clinically evident. A conventional approach to training this patient in wheelchair transfer skills met with little success. An individualized training program based on the patient's specific cognitive strengths and deficits was developed. The major elements of the program were (a) careful observation of task performance, (b) task analysis of the skill to be taught, (c) utilization of the patient's learning strengths to guide performance, (d) small step hierarchical programming to meet the desired goal, (e) intense repetition of the skill and (f) data collection procedures to monitor change and program adjustments. Six weeks after the program was implemented the patient was able to complete safe transfers, and was discharged home. At follow-up, two weeks after discharge, inconsistency in transfers was noted; the written program was immediately reestablished, and the patient continued safe wheelchair transfers at every subsequent check. This study suggests that treatment outcome in patients with right hemisphere damage may not be as bleak as has been previously suggested. A treatment strategy that includes an optimal utilization of a patient's verbal skills to cue and monitor performance and judgment, along with systematic data collection to guide program modifications, can lead to a more successful rehabilitation outcome. PMID- 6860100 TI - Dysphagia: predicting laryngeal penetration. AB - Fifteen patients with pharyngeal stage dysphagia were studied clinically and by motion fluoroscopy. Eleven patients demonstrated laryngeal penetration during swallowing. There was high incidence of impaired pharyngeal gag and wet-hoarse voice quality among this group. Other observations were found to correlate poorly with penetration. Cough was an unreliable indicator of laryngeal penetration. Penetration was most likely when liquids were swallowed and least likely when semisolids were swallowed. Motion fluoroscopy of swallowing was necessary for detecting penetration reliably, identifying that dysphagia depends, in part, on bolus qualities, and planning a feeding approach consistent with remaining swallowing functions. PMID- 6860103 TI - Gait analysis in cerebral palsied and nonhandicapped children. AB - The gait patterns of 39 nonhandicapped children and six children with cerebral palsy (CP) were evaluated using computerized high-speed cinematography. Variability of gait was measured during 10 nonconsecutive cycles for each subject. Gait in normal 9-year-old children was found to be similar to that observed in adults. Children with CP demonstrated greater intrasubject variations in individual gait components compared to their nonhandicapped peers. Stride length, gait velocity, and range of motion were related to the severity of physical handicap. Intraindividual variability was greater among subjects with CP classified as mildly spastic than in those considered to have only moderate neurologic impairment. This may signify that less handicapped children are capable of varying the components of their walking pattern to a larger extent than those more severely affected, but at the same time do not possess the same degree of automatic motor control as nonhandicapped children. Computerized gait analysis can be valuable in supplementing routine clinical gait analysis in CP. PMID- 6860101 TI - Contour donor chair: device to maximize effects of overhead cervical traction. PMID- 6860102 TI - Undergraduate curricula in PM&R: implications for resident recruitment and general image of the specialty. AB - Comprehensive data on undergraduate curricula in Physical Medicine and Rehabilitation were obtained in a 1980 questionnaire survey of approved residency programs. Survey parameters included curriculum content (type and duration per academic year), teaching format and educational methodologies, academic exposure and student enrollment, faculty characteristics, and curriculum impact on resident recruitment. Of 53 responding programs 44 reported undergraduate education activities in PM&R. Curriculum content was predominantly clinical in all programs. The teaching format used by 70% of respondents consisted of a combination of lectures, clinical case presentations, conferences, demonstrations and clinical clerkships. Seventy-two percent of this sample were either compulsory or contained a compulsory component. An academic exposure to PM&R of two or more years and a curriculum duration of more than four weeks per academic year was reported by 81% and 75% of respondents respectively. Compulsory programs were offered most frequently in the first two years, while electives were offered mostly in the last two years of study. A low enrollment in electives (less than 50% of class) is reported, regardless of year of study. A teaching faculty of more than five was reported by 63% of programs. A positive curriculum impact on resident recruitment was reported by 72% of the respondents. Positive and negative implications of these findings for the PM&R specialty image and for a career choice in PM&R are discussed. PMID- 6860104 TI - Anterior tibial compartment pressures during running with rearfoot and forefoot landing styles. AB - Elevated compartment pressure is the central feature of exercise-induced anterior tibial compartment syndrome. The compartment pressures of 17 legs of 14 subjects were continuously monitored with the solid state transducer intracompartmental (STIC) catheter system while they ran on a treadmill. The subjects ran with relaxed, rearfoot and forefoot landing styles, confirmed with videotape records and wafer footswitches at heel and toe. In 24 of 34 comparisons, anterior tibial compartment systolic pressures were significantly influenced by landing style. The changes were consistent in direction and magnitude within, but not among, subjects. These findings may have implications for the design of footwear and for the training regimens of patients with exercise-induced anterior tibial compartment syndrome. PMID- 6860105 TI - Energy expenditure in hip disarticulation and hemipelvectomy amputees. AB - Energy expenditure was measured using a metabolic measurement cart (MMC) for 8 patients with hip disarticulation (HD, group 1), 10 patients with hemipelvectomy (hp, group 2), and 11 able-bodied subjects (group 3). Velocity and O2 consumption of comfortable, fast, and slow walking speeds were measured with a MMC. Comfortable walking speeds with HD and hp were 51% to 61% of controls (p less than 0.001), but there was no difference in O2 uptake per minute among the three groups. Fast walking speeds for groups 1 and 2 was 70% to 75% of comfortable walking speeds in group 3 (p less than 0.01), and the mean O2 uptake of fast walking speeds in groups 1 and 2 was 40% to 50% more than that of group 3 at comfortable speeds. Energy cost per unit distance (work) was 80% to 125% greater with patient groups than with able-bodied subjects. The difference between the pre- and immediate postexercise pulse rates for comfortable walking speeds were higher in groups 1 and 2 than in group 3. PMID- 6860106 TI - Amyotrophic lateral sclerosis: a comprehensive rehabilitation approach. AB - A clinic was established at The Mount Sinai Medical Center and staffed by a multidisciplinary team to assess the feasibility of caring for the patient with amyotrophic lateral sclerosis (ALS) through an outpatient facility. Three hundred ALS patients were evaluated and followed in a 3-year period. Each patient was viewed as an individual, and the establishment of four clinical neurologic scales (or stages) proved helpful in tracking declining functional performance and in the establishment of suggestions for care. A rehabilitation program can be effective in helping the ALS patient maximize functional abilities while minimizing disabilities and complications at every stage of the disease. Such a program can be implemented through an outpatient clinic with regularly scheduled follow-up visits. PMID- 6860107 TI - Hysterical conversion reactions: some patient characteristics and treatment team reactions. AB - Paralysis due to an hysterical conversion reaction may require an active rehabilitation program to prevent complications such as contractures and adhesions. The delivery of this care can create an emotional burden on the rehabilitation staff due to their awareness of the psychiatric etiology of this condition. Good patient care may be undermined by the thought that the patient is malingering. This paper explores features of hysteria--its relation to emotional stress, absence of organic pathology and symbolism--and contrasts it to malingering. The impact of this condition on the treatment staff is explored with two case studies. An understanding of hysteria could make the delivery of proper care to these troubled patients less stressful. PMID- 6860108 TI - Urinary tract care: improvement through patient education. AB - The purpose of this study was to determine if a special program of patient and family education in urinary tract care would result in improved control of urinary tract infection (UTI) by spinal cord injury patients at home. The Williamson Functional Impairment Scale, modified to measure outcomes of impairment due to UTI, was applied to 54 patients in 1975 and to 21 in 1979. Patients in the latter group had completed a special urinary tract care education program of classes, reading material, written examinations, and demonstrations of acquired skills. At follow-up, only 32% of the patients in the 1975 group were asymptomatic of UTI, compared with 71% of the 1979 group. Only 5% of the patients in the 1979 group lost time from their usual daily activities, compared with 23% of the 1975 group. The improvements in impairment outcomes were not related to a reduction in the incidence of confirmed or suspected UTI (found in 63% of patients in the 1975 group and 62% of patients in the 1979 group). It is concluded that the 1979 group recognized symptoms earlier and took definitive action which resulted in less impairment and time lost due to UTI. The patient education program did result in improved urinary tract care after discharge. PMID- 6860109 TI - Micturition monitor as an aid to management of neurogenic bladder. AB - A portable, battery-operated micturition monitor has been developed for use by patients with spinal cord injuries. The monitor, when integrated into the external urinary collection device for a male with a spinal cord injury, provides an accurate measure of the elapsed time in minutes since the patient last voided. This measure greatly reduces the efforts required by the medical staff to obtain a reliable residual urine volume measurement. PMID- 6860110 TI - Sagittal movements of the human lumbar vertebral column: a quantitative study of the role of the posterior vertebral elements. AB - The influence of the posterior vertebral ligamentous and bony elements on the sagittal range of motion of the lumbar spine has been investigated by observing the effects of sectioning ligaments and pedicles in 17 cadavers of both sexes with an age range from 14 to 78 years. The main investigation showed that the apophyseal joints provide a greater restraint to flexion and extension movements than do the lumbar ligaments. It also showed that the age changes which most severely affect movement in elderly persons occur in the intervertebral discs rather than in the posterior elements. PMID- 6860111 TI - Voluntary anterior dislocation of the shoulder: case study. AB - Anterior shoulder dislocation can be willfully produced by a subject through abnormal unbalanced muscle contraction at the shoulder joint. It may be associated with pathologic lesions at the shoulder. Treatment consists of vigorous shoulder strengthening exercises and/or surgery to increase anterior stability at the joint. For any treatment approach to be successful the subject must avoid dislocation of the shoulder. A psychologic component frequently associated with this condition is its use as a mechanism for attention, sympathy or defense--a factor that has a significant negative effect on response to treatment. PMID- 6860112 TI - Sling support during pregnancy after hemipelvectomy: case report. AB - A 32-year-old woman delivered a normal male infant by the vertex 14 years after hemipelvectomy. During pregnancy she remained ambulatory with forearm crutches and wore a specially designed sling that she felt provided support and comfort. It is suggested that such external support to the uterus of the pregnant woman after hemipelvectomy may enhance presentation by the vertex. PMID- 6860113 TI - Reversibility of neurological deficits in vitamin B12 deficiency. AB - A female patient with subacute neurological deficits secondary to an hereditary vitamin B12 deficiency was repeatedly examined clinically and neurophysiologically. It is concluded that neurological normalization after treatment with vitamin B12 also occurs within the CNS. Such normalization takes place soon after initiating treatment and probably reflects other neuronal mechanisms that remyelination, i.e. recovery from conduction block in fast somatosensory pathways and/or improvement of synaptic transmission. PMID- 6860114 TI - [Chronic trichinosis and neuromuscular diseases. Morphologic and pathogenetic aspects]. AB - Muscle biopsies were carried out on five patients affected by a chronic neuromuscular disorder, mostly in the form of a spinal muscle atrophy. All patients had suffered from acute trichinellosis many years before, the interval between acute parasitic infection and the appearance of the slowly progressive neuromuscular syndrome being of 21, 13, 35, 26 and 16 years respectively. In biopsy specimens, morphological and enzyme-histochemical changes typical of a progressive neurogenic muscular atrophy were present; in addition, encapsulated but still living, enzyme-positive parasites and signs of focal myositis were detected. The possible pathogenetic correlations between the "chronic" trichinellosis and the "degenerative" neuromuscular disorder are discussed. PMID- 6860115 TI - [The effect of alcohol withdrawal syndrome on the self concept of alcoholics in the Freiburg Personality Inventory (FPI) at admission and in the course of therapy]. AB - Looking through the items of the FPI the hypothesis was proposed that the FPI determines aspects of the alcohol-withdrawal-syndrome. Greater deviations from standard norms found on admission and greater changes during inpatient treatment can be attributed to the occurrence of withdrawal symptoms and their improvement. Alcoholics without withdrawal symptoms seem to describe themselves quite normally on personality dimensions. PMID- 6860116 TI - Psychiatric research in Medical Perspective. PMID- 6860117 TI - Changes in electroretinogram and serum potassium during L-DOPA treatment in parkinsonism. AB - The relationship of L-DOPA plasma level, parameters of ERG and severity of extrapyramidal symptoms after a single dose of L-DOPA was investigated in 11 patients suffering from parkinsonism of idiopathic or arteriosclerotic origin. After a drug-free night, each patient received his/her usual morning dose of L DOPA. In the subsequent 3 h, the ERG recordings, blood levels and clinical ratings of extrapyramidal symptoms significantly dropped after a delay of 60 min in relation to the occurrence of the peak plasma L DOPA level. The initial "b" wave amplitudes as well as initial serum potassium values were abnormally high. There was a statistically significant correlation between the decrease of "b" wave amplitude (delta "b") and the potassium "normalization index" (i.e. the ratio between the observed decrease of serum potassium and the pretreatment difference from the middle normal potassium value). A definite interpretation of the data cannot be provided until more knowledge about the origin of "b" wave of ERG is available. It can be concluded tentatively that dopaminergic processes influence electrophysiological reactivity of the retina. PMID- 6860120 TI - [Primary unrecognized severe craniocerebral injuries in psychiatry]. AB - Among 11,136 psychiatric patients admitted between 1977 and 1982 14 cases of initially unrecognized severe head injuries were originally admitted for psychiatric disorders in connection with alcohol abuse. While the overall incidence at 0.13% was low, this figure increased for the 1310 alcoholic patients of this period to 1.06% and 2.1% respectively, depending on the ready availability of computerized tomography. Plain skull X-rays showed fractures in only 2 patients and in 6 cases trivial head injuries indicated a more severe trauma. In the lucid period 2 patients talked of having fallen. Information from relatives revealed in 10 cases that the patients had had a fall, the majority during an epileptic fit in a predelirant state. Five patients underwent surgery on the day of diagnosis, 4 patients died before a correct diagnosis could be made. The avoidable factors contributing to death included above all, the failure to recognize an extracerebral hematoma. PMID- 6860118 TI - Defects of elastic lamina in middle cerebral artery. A possible cause of a primary intracerebral hemorrhage in a young woman. AB - Circumscribed defects in the elastic lamina as a possible cause of intracerebral hemorrhage are reported. The abnormality was present in the right middle cerebral artery of a 24-year-old women. The patient died of large intracerebral hemorrhage which extended into the lateral ventricle on the same side and to the subarachnoid space. In the absence of vascular malformation and secondary degenerative changes attributed to hypertension these defects of the internal elastic lamina associated with the rise of the blood pressure appear to lead ultimately to bleeding. PMID- 6860121 TI - Evoked potential monitoring during acute occlusion of the basilar artery and selective local thrombolytic therapy. AB - Neurophysiological examinations of brainstem functions before, during and after selective interventional neuroradiology i.e. selective intraarterial thrombolytic therapy of an acute occlusion of the basilar artery are reported. The success of the therapy was demonstrated by the reappearance of normal somatosensory potentials and of the blink reflex immediately after the thrombolysis. The BAEPs were continuously recorded during the thrombolysis. Normalization of the latencies and of the interpeak latencies at a very early stage of the therapy indicated the improvement of brainstem functions. PMID- 6860119 TI - Lactate and pyruvate content of the human cisternal cerebrospinal fluid. Normal values, age and sex dependency, correlations with glucose concentrations. AB - Cisternal CSF specimens were obtained from 144 fasted individuals free from organic brain disease (42 males and 102 females; mean age 41 +/- 10.3 years, range 16-69 years). In 30 cases a simultaneous lumbar puncture was also performed. The concentration of CSF glucose (G1) was measured by the o-toluidine method, and that of lactate (La) and pyruvate (Py) by enzymatic tests. No significant difference was found between the mean G1 and Py values of the lumbar and cisternal CSF but the lumbar La was somewhat higher than the cisternal one (P less than 0.10). In the cisternal CSF the frequency distribution of G1, La and Py samples was a Gaussian one (P less than 0.05). The normal ranges, as mean +/- 2SD, were for La 0.680-2.100 mM/1, and for Py lower limits of the range (between mean +/- 2 SD and mean +/- 1 SD) are considered to be potentially pathological. No significant difference was found between the mean G1, La and Py values in males and females. Consistent age-related changes could not be detected either in the G1 or Py levels, however, a tendency for La increase was observed in the oldest-age-group (over 54 years). A negative correlation was found between the G1 and La concentrations of the cisternal CSF (r = 0.375; P less than 0.001). PMID- 6860123 TI - [Standardization of the electromyographic tetany test in the diagnosis of normocalcemic tetany: the 10-minute Trousseau test in patients and healthy humans]. AB - Eighteen adult patients with typical history and signs of normocalcemic tetany (hyperventilation syndrome) and 18 age- and sex-matched controls were submitted to a provocation test for tetany. This consisted of 10-min ischemia of the right arm produced by suprasystolic cuff compression at the upper arm (Trousseau test) and a postischemic electromyographic recording from the right interosseous I muscle. Postischemic repetitive discharges were found in all patients and predominantly consisted of multiples of 5 times and more. These discharges lasted 8 min on the average. Of the normal controls, as many as 16 subjects (88.8%) also exhibited tetanic discharges. However, these preferred a lower number of repetitions, such as doublets or triplets. Both number of repetition and duration of postischemic tetanic activity were significant parameters discriminating between patients and controls (2P less than 0.001), as was the cumulative total number of spontaneous potentials, amounting, on the average, to 10,266 in the group of patients and to only 320 in the controls (2P less than 0.001). The investigation has shown that the occurrence of postischemic tetanic spontaneous activity per se does not help to discriminate between cases of latent tetany and healthy controls. However, a normocalcemic tetanic condition may be assumed if multiples occur with a complexity of quadruplets or more, if these multiples last at least 2 min, and if they appear in a rhythmic order and in groups. PMID- 6860122 TI - [Polyneuropathy caused by disulfiram poisoning]. AB - Disulfiram is known to produce toxic encephalopathy and peripheral neuropathy. The case of a 37-year-old alcoholic who attempted to commit suicide by taking 22.5 g disulfiram is described. During the first 6 days after the intoxication he was stuporous and had cerebellar ataxia and dysarthric speech. Then he became comatose, and as he recovered from coma, he showed peripheral neuropathy including diplegia faciei and severe tetraparesis. Denervation potentials were detected in both facial muscles and distal muscles of the upper and lower limbs, while conduction velocity was normal. Axonal degeneration was verified by sural nerve biopsy. In addition neurofilamentous axonopathy was documented. The recovery from his paresis lasted 2 years. PMID- 6860124 TI - Clinical investigations into antidepressive mechanisms. I. Antihistaminic and cholinolytic effects: amitriptyline versus promethazine. AB - It is assumed that established antidepressants exert their clinical efficacy by potentiation or decrease of central noradrenergic and serotonergic neurotransmission. However, recent experimental work suggests that antihistaminic and/or cholinolytic effects may also be involved. This double-blind controlled study compared amitriptyline (catecholamine potentiating, antihistaminic, cholinolytic) with promethazine (antihistaminic, cholinolytic) in 50 severely depressed inpatients over a 30-day treatment period. Analysis of the Hamilton depression rating scale revealed significant clinical superiority of amitriptyline over promethazine in such major depressive symptoms as depressed mood, suicidal ideation, psychic anxiety, and sleep disturbances. No significant difference was evident as far as autonomous side effects were concerned. Similar results were found by analysis of the AMP rating system. It is concluded that antihistaminic or cholinolytic effects per se do not explain the antidepressants' efficacy. However, potentiation of noradrenergic neurotransmission by cholinolytic activity might be the major antidepressive mechanism. PMID- 6860125 TI - [Results of a training program to improve the speed of visual perception and concentration in brain-damaged patients]. AB - A program for the training of perceptual speed and attention with a duration of four weeks was developed and given to thirty brain damaged patients. In order to evaluate a possible generalization effect of the training all subjects were tested three times, i.e. at the beginning of the training, after four and after eight weeks with a series of 16 standardized psychometric tests. These comprised tasks which closely resembled the training procedures as well as tasks testing psychomotor functions in a broader sense and even tasks of reasoning and other intellectual functions. To test the different effects of training, spontaneous recovery and test repetition an experimental design with two groups of patients and two control groups was necessary. Only the groups of patients showed a significant and marked improvement in all tests which could neither be explained by spontaneous recovery nor by test repetition. The training effect proved to be stable after four weeks. The most marked improvement, however, was seen with those tasks most closely resembling the training procedures; in no case the performance level of the control groups was reached. PMID- 6860127 TI - Late recurrence of cutaneous melanoma. AB - Most patients treated for cutaneous melanoma who have recurrent disease do so within the first ten years after primary diagnosis. This report covers seven patients with clinical stage I disease in whom local or regional recurrence developed 11 to 23 years after first treatment. Six of the seven patients were premenopausal at the time for primary diagnosis, suggesting that gonadal steroids may affect the natural history of cutaneous melanoma by lengthening the disease free interval. The seventh patient was male. All seven of the patients had regional recurrence that was definitively treated by further surgery. Lymph node metastases occurred in six of these seven patients. After surgical retreatment, all patients lived for at least 2.5 years. Four remain alive, three disease free, and one with partially controlled systemic and regional disease free, and one with partially controlled systemic and regional disease. This study underlines the importance of continued long-term follow-up in patients treated for cutaneous melanoma. PMID- 6860126 TI - Postoperative toxic shock syndrome. AB - Previously, most cases of the toxic shock syndrome (TSS) have been described in a menses-related clinical setting. Recently, however, cases have been described in nonmenses-related clinical settings, in particular, in association with postoperative wound infections. Three cases of TSS occurred as a complication of surgical procedures. Toxic shock syndrome complicated the postoperative course of one patient undergoing routine inguinal herniorrhaphy, to our knowledge the first reported case of this syndrome directly resulting in the patient's death in the postoperative setting. In another case, TSS, with recurrence, resulted from a Staphylococcus aureus wound infection after unilateral salpingo-oophorectomy, to our knowledge the first reported case of recurrence in a nonmenses-related setting. PMID- 6860128 TI - Postoperative choledochoscopy. A five-year experience. AB - In a five-year period postoperative choledochoscopy was used in 85 consecutive patients for therapeutic or diagnostic interventions in the biliary tract. Seventy-three patients underwent postoperative choledochoscopy for removal of retained biliary stones; 67 (92%) had successful removal of 94 retained stones; in 11 stones were located in the intrahepatic ducts; in six postoperative choledochoscopy failed; and in 12 postoperative choledochoscopy was performed for diagnostic or other therapeutic reasons. No serious complications were encountered in this series. The advantage of this simple and effective technique over other instrumental or so-called radiologic techniques is discussed. In our opinion, postoperative choledochoscopy is now the method of choice for diagnostic and therapeutic (re)interventions in the biliary tract by patients with a T tube still in situ. PMID- 6860129 TI - Preoperative and postoperative assessment of nutrient intakes in patients who have undergone gastric bypass surgery. AB - The study of 25 morbidly obese patients who had undergone gastric bypass surgery was undertaken to determine the fat, carbohydrate (CHO), protein, and total caloric intake before and at 1, 3, 6, and 12 months postoperatively. No postoperative complications occurred, and all patients lost weight appropriately. The nutrient intakes were estimated from dietary recall. Dramatic decreases occurred in average total caloric intake from a preoperative value of 3979.4 to 351.6 kcal at 1 month, 471.3 kcal at 3 months, 932.7 kcal at 6 months, and 1091 kcal at 12 months. Fat, CHO, and protein intake decreased equally until 12 months when fat intake had reached a plateau while CHO and protein intake continued to rise. Weight reduction after gastric bypass surgery is related to decreased caloric intake, predominantly in the fat component. PMID- 6860130 TI - Congenital arteriovenous malformations. The role of transcatheter arterial embolization. AB - We treated 11 patients with congenital arteriovenous malformations (AVMs) with staged transcatheter arterial embolization of their lesions. In nine patients, the AVM involved an extremity. One patient had multiple pulmonary AVMs, another an AVM of the pancreas. Embolization was performed using polyvinyl alcohol sponge (Ivalon) particles and Gianturco-Wallace colls. Nine patients had a systemic response to embolization, characterized by pain, fever, leukocytosis, and elevated enzyme levels. Complications (three major, two minor) developed in five patients. A total of 28 staged embolizations were performed, with follow-up to 36 months. We found transcatheter embolization a useful palliative therapy in treating congenital AVMs. It should be considered as a therapeutic alternative for patients with unresectable AVMs, those for whom amputation would be required, and those who are otherwise poor surgical candidates. PMID- 6860131 TI - Immunosuppression with cyclosporine. A new approach to improve patency of venous allografts. AB - In cases in which an autogenous vein is not available, the venous allograft still represents an interesting alternative; however, early occlusion of the allograft is the rule. Forty-five mongrel dogs received jugular allografts transplanted into the carotid artery. Group 1 (n = 6) received no immunosuppression; group 2 (n = 5) received systemic azathioprine (2.5 mg/kg/day). In group 3 (n = 10) the grafts were pretreated with cyclosporine at 4 degrees C, and in group 4 (n = 9) the grafts were cryopreserved in a solution of 15% dimethyl sulfoxide and cyclosporine (50 mg/L) at -196 degrees C prior to implantation. Groups 3 and 4 received azathioprine as in group 2. Group 5 received cyclosporine systemically (15 to 20 mg/kg/day). Patency rates at one month (groups 1 and 2, 0%; group 3, 57.1%; groups 4 and 5, 100%) indicate that cyclosporine improves venous allograft survival both when used systemically and as a graft pretreatment modality. PMID- 6860135 TI - Fine-needle aspiration of palpable breast masses. A program for staged implementation. AB - Fine-needle aspiration (FNA) can provide a morphologic diagnosis of palpable breast masses in an accurate, efficient, inexpensive, and safe manner. However, how one acquires the skill to perform the FNA and interpret the resulting smears, while protecting the patient from the risk of false-positive or false-negative results, is scarcely considered. We used a three-phase program to acquire experience with FNA while providing services for 205 patients over a 16-month period. We performed FNA sequentially in vitro, in vivo, and finally in vivo for clinical use. With available literature and this graduated implementation program, physicians totally inexperienced with FNA can achieve results similar to those of medical centers having experience with thousands of patients. PMID- 6860134 TI - Subcutaneous mastectomy. Indications, technique, and applications. PMID- 6860133 TI - Plasma colloid oncotic pressure-pulmonary artery occlusion pressure gradient. A poor predictor of pulmonary edema in surgical intensive care unit patients. AB - Because Starling's equation contains four factors that theoretically influence fluid movement across the pulmonary capillary bed, we prospectively examined the relationship between the plasma colloid oncotic pressure (PCOP) minus the mean pulmonary artery occlusion pressure (PAOP) (the only two presently available clinically for measurement) and pulmonary edema determined in terms of percent venous admixture (Qs/Qt) and roentgenographically in 17 consecutive patients in a surgical intensive care unit to determine whether this PCOP-PAOP gradient could accurately predict the presence of pulmonary edema. The PCOP-PAOP gradient proved to be a poor predictor of pulmonary edema determined by these means. We believe this resulted from the inherent insensitivity of the PCOP-PAOP gradient as an estimate of the net intravascular filtration pressure, and Qs/Qt and roentgenograms as measurements of lung edema, as well as the multiplicity of variables involved in the genesis of pulmonary edema in the clinical situation. PMID- 6860132 TI - Elevated levels of peripheral serum creatine phosphokinase with strangulated small bowel obstruction. AB - Experimental arterial bowel infarction can cause elevations in levels of peripheral serum creatine phosphokinase (CPK), lactic dehydrogenase (LDH), and their isoenzymes. To test whether these changes would occur in strangulated small bowel infarctions, 18 dogs were placed under general anesthesia and randomized to one of three categories: laparotomy alone, simple mechanical small bowel obstruction, or strangulated small bowel infarction induced by incarcerating bowel in a surgically created ventral hernia. Serum samples were drawn for 48 hours postoperatively. Total CPK and LDH activity were determined by automated spectrophotometry; isoenzyme levels were determined by agarose gel electrophoresis. Levels of peripheral serum CPK and each of its isoenzymes became significantly elevated in the dogs with strangulated infarction. Such elevations did not occur with LDH. The findings suggest that changes in peripheral serum CPK could prove helpful in evaluating bowel viability in cases of intestinal obstruction. PMID- 6860136 TI - Cervical distribution of iodine 131 following total thyroidectomy for thyroid cancer. AB - The use of postoperative radioiodine thyroid scanning has questioned whether total thyroidectomy is surgically possible. Similar to earlier studies, we have found functioning iodine 131 (131I)-avid thyroid tissue in our patients following total thyroidectomy for thyroid cancer. Preoperative and postoperative thyroid scans were compared in 24 patients to study the cervical location of postthyroidectomy residual thyroid tissue. Thyroid scanning detected 44 distinct sites of uptake. Thirty-eight of these foci were located either at the extremes of the upper poles of the thyroid gland (24) or along the embryonic thyroid descent tract (14). We conclude that these foci of 131I uptake represent incomplete resection of normal thyroid tissue, and that surgical attention to these areas should result more frequently in extirpation of the entire thyroid gland. PMID- 6860138 TI - Adult duodenal webs. A difficult diagnosis. AB - Intestinal obstruction in adults caused by congenital duodenal webs is uncommon. Roentgenographic and endoscopic diagnosis is difficult owing to frequently nonspecific roentgenographic findings and the obliteration of normal pyloric endoscopic anatomy. The ultimate diagnosis of this lesion is likely to be made at the time of cellotomy for suspected obstructing peptic ulcer disease with the observation of an unobstructed pylorus. We studied three recent cases and reviewed the pertinent literature, which demonstrated problems associated with preoperative and surgical diagnosis and management. Diagnosis of duodenal webs should be suspected in all patients with gastric or high duodenal obstruction and investigated by digital duodenal exploration at the time of surgery. PMID- 6860137 TI - Granulocyte transfusion as adjunctive therapy for qualitative granulocytopenia. Multiple liver abscesses in a patient with chronic granulomatous disease. PMID- 6860139 TI - Investigations on the pancreatic and stomach secretion in pigs by means of continuous infusion of 14C-amino acids. PMID- 6860140 TI - Electrophysiologic changes associated with chronic administration of organophosphates. AB - Changes in the electrophysiologic activity of the rat sciatic nerve were examined after repeated dosing with either of two organophosphate insecticides, parathion, and trichlorfon. Although the parathion treated animals showed overt signs of systemic toxicity, there were no significant changes in any of the measured parameters of sciatic nerve excitability. Trichlorfon, on the other hand, produced dose-dependent changes in the duration, rise time, relative area, and refractory period of the sciatic nerve compound action potential. The observed changes indicated an increased excitability of the nerve. During the early development of these electrophysiologic changes there were no accompanying histologic changes in the nerve. This suggests that changes in nerve excitability may be a sensitive indicator of neurotoxicity, and that continued trichlorfon exposure may lead to a cumulative alteration in nerve function. PMID- 6860141 TI - Chronological relationship between neurological signs and electrophysiological changes in rats with methylmercury poisoning - special reference to selenium protection. AB - In order to see chronological relationship between electrophysiological changes and "early" neurological sign (tail rotation) elicited in rats poisoned with methylmercury, we made serial measurements of amplitude of compound action potential and sensory nerve conduction velocity of the tail nerve in rats with five dose schedules [methylmercury vs selenium, (1)20 ppm:0.1 ppm, (2)20: 0.3, (3)20: 0.6, (4)10: 0.1, (5)10: 0.6]. We observed the following sequence in the onset of neuro-electro-physiolo-somatic signs: fall in compound action potential greater than decrease in sensory nerve conduction velocity greater than tail rotation greater than weight loss. Protective potency of dietary selenium against neurotoxicity of methylmercury was observed with regard to both electrophysiological changes and neurological signs. PMID- 6860142 TI - Mechanism of formation of mercapturic acids from aromatic aldehydes in vivo. AB - Male adult Wistar rats dosed i.p. with o-substituted benzaldehydes (o-F, o-Cl, and o-Br = V, VI, and VII) excreted mercapturic acids in urine. These acids were identified as N-acetyl-S-(ortho-substituted benzyl)cysteines (I, II, III). The total mercapturic acid excretion as % dose (2.0 mmol/kg, n = 4) was 1.2 +/- 0.4, 6.8 +/- 0.9, and 10.4 +/- 2.0 for V, VI, and VII. p-Cl-benzaldehyde administered in the same dose showed a non-significant urinary thioether excretion. The aim of the investigation was to prove in vivo a postulated metabolic pathway of substituted benzaldehydes via sulphate esters to mercapturic acids. After a single administration of the sodium salts of o- and p-Cl-benzylsulfuric acid a significant increase in mercapturic acid excretion of 21.2 +/- 1.8% and 14.5 +/- 1.2% of dose (2.0 mmol/kg, n = 4) was found. By pretreatment with pyrazole the mercapturic acid excretion increased after administration of o-Cl-benzyl alcohol (IX) whereas a significant decrease was found after administration of o-Cl benzaldehyde (VI). After simultaneous administration of ethanol with IX and VI an increase in mercapturic acid excretion was observed. After previous administration of pentachlorophenol a significant decrease in urinary mercapturic acid excretion for IX and VI was found. These findings are in accordance with a metabolic pathway of substituted benzaldehydes via benzyl alcohols, subsequently sulphate esters to the corresponding benzylmercapturic acids. PMID- 6860143 TI - On the histopathogenesis of rat forestomach carcinoma caused by aristolochic acid. AB - The histopathogenesis of rat forestomach carcinoma induced experimentally with aristolochic acid was investigated. The intragastric administration of 10 mg/kg/day caused extensive necrosis of the squamous epithelium, followed by regeneration and hyperplasia, papilloma formation and ultimately by invasive squamous cell carcinoma. PMID- 6860144 TI - Cytokinetic and cytogenetic effect of agricultural chemicals on human lymphoid cells in vitro. II. Organochlorine pesticides. AB - Human lymphoid cells of LAZ-007 cell line, incubated with 10(-4) to 10(-6) molar of eight different organochlorine pesticides had dose related cytotoxicity, mitotic depression and cell cycle traverse inhibition. In cultures incubated with 10(-4) M concentrations, M1 metaphases were as high as 13% (Dicofol) as compared to less than 1% in the controls. The frequency of M3 metaphases in cultures incubated with 10(-6) M concentrations ranged from 11% (Chlordane) to 15% (Endosulfan) compared to 17% in control cultures. Statistically significant increase in SCE frequency was seen in cells exposed to Chlordane, Dicofol, Endosulfan and Toxaphene. On metabolic activation with rat liver microsomal S-9 enzymes, Chlordane, Dicofol and Tetradifon induced SCE frequency was higher than that of nonactivated cultures. PMID- 6860145 TI - Effect of adrenalectomy, pretreatment with SKF 525-A, phenobarbital and diethyl maleate on the acute toxicity of fenitrothion in male rats. AB - The effect of adrenalectomy (Adx), SKF 525-A, phenobarbital (PB), and diethyl maleate (DEM) on the acute toxicity of fenitrothion was investigated in male rats by assessing the degree of plasma cholinesterase activity. PB, 60 mg/kg/day for 3 days, exerted no protective effect on the toxicity of fenitrothion (100 mg/kg, p.o.) given 24 h after the last injection. In adrenalectomized and SKF 525-A pretreated rats, the toxicity of fenitrothion was lower than that of the controls. Fenitrothion toxicity was increased by administration of DEM (1 ml/kg), which depletes hepatic glutathione (GSH) levels. In vitro, the rates of fenitrothion decomposition and fenitrooxon formation by microsomes were markedly affected by PB, SKF 525-A and Adx. The decomposition of fenitrooxon by the microsomal fraction and GSH-dependent decomposition of fenitrooxon by the soluble fraction were not affected by PB, SKF 525-A and Adx pretreatment. The GSH dependent decomposition of fenitrothion and fenitrooxon was increased by addition of GSH to the incubation mixture. The present results indicate that the GSH dependent metabolic pathway plays an important role in the detoxication of fenitrothion. PMID- 6860146 TI - A new pathway of acrolein metabolism in rats. AB - The excretion of metabolites of acrolein in rat urine after single oral administration of 10 mg/kg was investigated. S-Carboxyethylmercapturic acid (S carboxyethyl-N-acetyl-cysteine), or S-(propionic acid methyl ester)mercapturic acid, was found as the major metabolite. An unidentified metabolite was found in expired air. Acrylic acid and methyl acrylate are suggested as intermediates in the metabolism of acrolein. PMID- 6860147 TI - Anti M-protein antibody response to type A or B natural influenza detected by solid phase enzyme linked immunosorbent assay and by complement fixation. AB - Anti M-protein antibody response has been looked for in sera from individuals with serological evidence of A or B influenza infection using pure M-protein (M) in complement fixation tests (CF), in IgG and in IgA specific enzyme linked immunosorbent assays (ELISA). Mp ELISA (IgG specific) antibodies are not restricted to people with history of recent respiratory infection. Individuals under 15 years are less prone than those older to display M ELISA activity. Most M ELISA positive individuals are also nucleoprotein (NP) positive. There are more M than NP ELISA positives in the influenza A series whereas the reverse is observed in the influenza B series. Most of the M ELISA positives are also S CF (standard soluble antigen CF) positive indicating that M ELISA IgGs are related to recent infections. Some sera exhibit M ELISA activity with no other evidence of influenza experience than V CF (viral antigen CF) or HI (haemagglutination inhibition), suggesting that some recent influenza infections are better traced with M ELISA than with S CF. Amongst chronic bronchitis patients with V CF or HI antibodies to A2 influenza virus but no type A S CF activity, the proportion of M ELISA positives averages 40 per cent. This fact as well as two other features of that group i.e. cases with long lasting S CF activity and occasional virus isolation several months after the initial acute infection, suggest that influenza virus might cause prolonged infection in some patients with chronic bronchitis. PMID- 6860149 TI - Low genetic mixing between avian influenza viruses of different geographic regions. AB - The degree of genetic relatedness of vRNA segments 1, 2, and 3 of avian influenza A viruses was investigated by molecular hybridization. The results indicate that avian influenza A viruses isolated within a given geographic region are genetically more closely related than strains from different regions, irrespective of the year of isolation and the species from which the virus was isolated. Studies on RNA segment 4 of viruses within the subtype H7 isolated in different regions gave similar results. Thus the genetic composition of avian influenza A viruses appears to be maintained to a rather high degree within a given geographic region and the intrusion of genes from "foreign regions" appears to be taking place with low frequency. The results are discussed with respect to the worldwide distribution of influenza virus genes by migrating birds. PMID- 6860150 TI - Leakage of cellular enzyme during replication of oncogenic and nononcogenic adenoviruses. AB - Leakage of glutamic-oxalacetic transaminase was monitored as an indicator of cell damage during a 48-hour period in which maximum virus replication occurred. There was increased leakage of the enzyme from HEp-2 cells infected with highly oncogenic adenovirus type 12. Leakage from cells infected with adenovirus types 18 and 31 (highly oncogenic), types 3,7 and 14 (weakly oncogenic), and types 1, 2 and 5 (nononcogenic) was similar to that from uninfected HEp-2 cells, even after the appearance of advanced virus-induced cytopathology. PMID- 6860151 TI - [The effect of gold on natural killer activity]. PMID- 6860148 TI - Replication of virulent and attenuated strains of yellow fever virus in human monocytes and macrophage-like cells (U937). AB - Virulent and attenuated strains of yellow fever virus were compared for their ability to grow in cultures of unstimulated leucocytes and monocytes derived from human peripheral blood, and of a macrophage-like cell line of human origin, U937. The extent of virus growth in leucocyte cultures varied depending on the strain of virus, multiplicity of infection, presence of diluted antibody in the culture medium but independently of the flavivirus immune status of the donor. The same pattern of differential growth was observed in the three types of cultures used. Although strain related variation in growth occurred within both virulent and attenuated strains, most of the attenuated strains produced higher virus yields than the virulent ones, suggesting that replication in this cell system is not related to the expression of virulence for the host. Replication in human monocytes as an in vitro marker of immunogenity for substrains of 17 D vaccine virus is discussed. PMID- 6860152 TI - [Effect of H1- and H2-receptor antagonists on late asthmatic responses]. PMID- 6860153 TI - Public health management of tuberculosis. PMID- 6860154 TI - Pulmonary tuberculosis: control of transmission. PMID- 6860155 TI - Atypical Mycobacteria. PMID- 6860156 TI - Renal tuberculosis. PMID- 6860157 TI - Tuberculous infections of the central nervous system. PMID- 6860158 TI - Skeletal tuberculosis. PMID- 6860159 TI - Modern issues in the therapy of tuberculosis. PMID- 6860160 TI - Chemoprophylaxis of tuberculosis. PMID- 6860161 TI - [Nonclostridial anaerobic soft tissue infections]. AB - Fourteen cases of nonclostridial anaerobic infections of soft tissues caused by peptococci, peptostreptococci, bacteroids or their combinations with E. coli, Proteus, and Staphylococcus aureus were studied. They are characterized by a rapid spread of serous-suppurative inflammation and the causative agents in loose fibrous connective tissue of subcutaneous adipose tissue (cellutitis), surface fascia (fasciitis), or skeletal muscles (myositis). Dissolution of intercellular structures of the connective tissue, extensive necroses, mild leukocyte reaction, and a wide peripheral zone of toxic edema are observed in the focus of inflammation. This is due to a high toxicity and enzymatic activity of the causative agents. Gas formation is observed when anaerobes are combined with E. coli. PMID- 6860162 TI - [Hamman-Rich syndrome]. AB - An analysis of 29 observations of the Hamman-Rich syndrome was carried out. Histological, histochemical, and electron microscopic studies showed the earliest changes to consist in edema of the interstitial connective tissue of the lungs followed by the development of crude lesions of alveolar elasticity and increase in the number of argirophilic and collagen fibers leading to disorders in the aerohematic barrier. The chronic course of the disease leads to pulmonary microcystosis. Hormone therapy slows down the development of the pathologic process. PMID- 6860163 TI - [Electron microscope study of pigmented villonodular synovitis]. AB - The ultrastructure of pigmented villonodular synovitis was studied on the operation material from 5 patients. Differences in the cell composition of villous and nodular formations typical of the disease were found. Different functional conditions of foamy cells was noted. Since foamy and fibroblastic cells were most numerous the possibility of accumulation of mononuclear phagocytes capable of excreting a proliferation factor in response to the primary local disturbance of lipid metabolism in fibroblast cells in pigmented villonodular synovitis is discussed. PMID- 6860164 TI - [Fibroplastic reactions in liver pathology]. AB - The results of a study of fibrosis in acute and chronic diseases of the liver are presented. Different forms of liver fibrosis (intralobular, portal, and septal) were shown to occur with various frequency in liver diseases and to be of dissimilar significance in diagnosis, clinical manifestation and evolution of the disease, and evaluation of its prognosis. PMID- 6860165 TI - [Characteristics of kidney involvement in disseminated intravascular coagulation (morphogenesis of cortical necrosis)]. AB - Morphological examinations of 72 autopsy observations of the disseminated intravascular blood coagulation (DIVBC) syndrome (a combination of microthrombosis in renal glomeruli, adrenals, gastrointestinal tract and other organs with the hemorrhagic syndrome) led to a conclusion on the role of DIVBC in the formation of cortical renal necroses. All the observations presented capillary thrombosis of the renal glomeruli the extent and dissemination of which had influenced the size of cortical necroses. Cortical ischemia in early stages is manifested by nephrothelium dystrophy followed at 3-5 days by the development of necrosis of the tubules, glomeruli, and stroma. The formed cortical necroses of the kidneys (CNK) are demarkated, their healing occurs at the expense of the interstitial tissue, whose cells proliferate, and later collagen genesis is observed. Scars from CNK have been shown to contain tubules with an undifferentiated epithelium. PMID- 6860166 TI - [Structural basis of functional heart failure during the postresuscitation period]. AB - Light and electron microscopic study of the myocardium of dogs two weeks after clinical death caused by the loss of blood was carried out and showed that the structural bases of the myocardium contractile function insufficiency during the postresuscitation period included the damage of the contractile apparatus of cardiomyocytes (microlysis and fragmentation of myofibrils, deformation of Z bands, relaxation of sacromeres) and marked lysis of the sacrotubular system leading to the violation of the excitation-contraction coupling. Cardiomyocyte damages are associated with changes in the microcirculatory channel causing the worsening of transcapillary exchange that provides the tissue homeostasis. PMID- 6860167 TI - [Changes in the myocardium and coronary vessels during the postoperative period in aged and elderly patients]. AB - Data of morphological examinations of 65 hearts of patients dying at the ages of 45 to 89 years in the early postoperation period after cavity operations are presented. Apart from routine histological and histochemical examinations, morphofunctional analysis of the intraorgan vascular architectonics was done using a macro-microroentgen contrast examination of the heart and determinations of volumetric density and location of focal lesions of the myocardium by the histostereometric method. An analysis of the pattern and distribution of myocardial lesions as well as of the elements of structural-functional adaptation and dysadaptation of the heart of senile patients under extreme conditions of operational trauma and early postoperation period is presented. A direct correlation was established between the volumetric density of focal myocardial lesions, the age of the patients and the duration of the stress situation (operational intervention). PMID- 6860169 TI - [Hamman-Rich syndrome]. PMID- 6860168 TI - [Stereological characteristics and enzymatic activity of myocardial capillaries in different variants of pathology and death (data from immediate autopsies)]. AB - Parallel stereo- and cytospectrophotometric examinations of human myocardial capillaries, 20-60 min after biological death were carried out. The activity of alkaline phosphatase, adenosine triphosphatase, lactate dehydrogenase and NAD diaphorase in the capillary wall in relation to the sex and age in cardiovascular pathology, renal diseases and leukemias were studied. The permeability and level of energy supply of transendothelial transport were found to depend on the kind of the main pathological process and type of death. According to the parameters under study, the functional state of the capillary network of the myocardium in atherosclerosis with or without its combination with hypertension and also in secondary renal hypertension is described. PMID- 6860170 TI - [Hypoplasia of the thymus gland in children]. AB - Morphological changes of the thymus, tonsils, lymph nodes, spleen, and other organs in two observations of severe combined insufficiency (SCIN) in infants of the first year of life are described. In both cases there was hypoplasia of the thymus with the lack or occasional thymic bodies and poor content of thymocytes in the lobules. In one infant, hypoplasia of the thymus was combined with intestinal angiomatosis which suggested the syndrome of ataxia-teleangiectasia. In the other infant, SCIN was associated with severe granulocytopenia of the Kostman type. In this case epithelial cells of the lobules formed adenomatous structures. Both infants died with sepsis developing against the background of SCIN. PMID- 6860173 TI - Multiple sclerosis susceptibility. Interaction between sex and HLA. AB - The sex of patients with multiple sclerosis (MS) in relation to the sex, number, and relationship of affected relatives indicates an interaction between sex and autosomal genes in determining susceptibility to MS in some persons. This conclusion is confirmed by the observation that the proportion of laterally related affected female pairs (siblings or cousins) who share the maximum possible number of HLA haplotypes is greater than that proportion in corresponding unlike-sex pairs. PMID- 6860171 TI - [Principles of pathological diagnosis in children with congenital abnormalities]. AB - The features of establishment of pathological diagnosis in children with congenital malformations (CM) are discussed. An analysis of 1058 autopsy records of the centralized department of pathology of the Children's Clinical Hospital No. 1, Moscow, was carried out. CM were found in 236 cases (22.3% of the total number of autopsies). In 117 cases (49.6% of all CM observations) CM was the main disease, in 82 (34.7%) observations CM were combined with other diseases. In the establishment of pathological diagnosis in cases of combined diseases, the epidemiological situation, the importance of one or another process for statistical generalizations should be taken into consideration. In our opinion, preference should be given to cases of intrauterine, highly contagious, and nosocomial infections. In 37 (15.7%) observations CM exerted no effect on the course of the disease and was classified as the background condition. PMID- 6860172 TI - The CNS in Guillain-Barre syndrome. PMID- 6860174 TI - Supranuclear eye movement disorders in Fisher's syndrome of ophthalmoplegia, ataxia, and areflexia. Report of a case and literature review. AB - Eye movements in a patient with Fisher's syndrome were examined clinically and documented photographically when palsies were most severe and on repeated occasions during the recovery period. Two recordings of horizontal eye movements were made using the infrared reflection method. Particular attention was paid to signs indicating supranuclear eye movement disorders. We also reviewed cases in which signs suggesting brain-stem involvement were reported. Mild ptosis in the presence of severe ophthalmoplegia, preservation of Bell's phenomenon despite paralysis of voluntary upward gaze, conjugate palsies of vertical gaze, and horizontal dissociated nystagmus have been found relatively often. Convergence spasm was reported only once, however, and there were no prior reports of rebound nystagmus or vertical vestibulo-ocular reflex disorder. PMID- 6860176 TI - Quantitative CSF IgG measurements in multiple sclerosis and other neurologic diseases. An update. AB - To compare four ways of measuring CSF IgG levels in diagnosing multiple sclerosis (MS), we analyzed CSF samples of 106 patients with clinically definite, probable, or possible MS and 127 patients with other diseases. The IgG synthetic rate and IgG index were the most sensitive tests at 0.88 and 0.94, respectively; IgG alone and IgG-albumin ratio, at 0.53 and 0.59, were less valuable. The IgG synthetic rate (0.87) was more specific than the IgG index (0.73), making it the quantitative measure that best correlated with a clinical diagnosis of definite MS. However, combining these four methods showed an even higher correlation. Quantitative CSF IgG elevations occurred much less frequently in patients with clinically definite MS receiving immunosuppressives and in those with clinically probable and possible MS. We did not perform qualitative CSF IgG measurements, but our methods' sensitivity and specificity were comparable with those attributed to oligoclonal IgG bands by others. We also found numerous other diseases where elevations of CSF IgG occurred by all four methods. PMID- 6860177 TI - Carpal tunnel syndrome. Complication of toxic shock syndrome. AB - Peripheral nerve complications occurred in four patients with toxic shock syndrome. Each patient had an acute carpal tunnel syndrome develop that was verified by nerve conduction studies. Recovery was rapid in two cases, but delayed in two others. Decompressive procedures were required in only one patient, with eventual recovery. Another condition, the toxic shock syndrome, must now be added to the long list of possible causes of compression of the median nerve in the wrist. PMID- 6860178 TI - Signs and symptoms from a cerebral lesion that suggest cerebellar dysfunction. AB - Lesions of the cerebral hemispheres can produce signs and symptoms very similar to those produced by cerebellar lesions. I studied a case that demonstrated the signs of dysmetria and intention tremor; it resulted from an infarct of areas 5, 7, and, to a lesser extent, 40, of the contralateral cerebral hemisphere. PMID- 6860175 TI - Epstein-Barr virus infection and antibody synthesis in patients with multiple sclerosis. AB - We studied infectious and immune mechanisms in demyelinating disease. The clinical diagnosis in this study of 313 consecutive cases of multiple sclerosis (MS) was based on the clinical conclusions of two or more neurologists and definite abnormalities in CSF IgG. Measurement of antibodies to six microbial agents was compared in 313 patients with MS and 406 controls in the same age range. Using a standardized immunofluorescent antibody (IFA) technique, we found a significantly higher prevalence of Epstein-Barr virus (EBV) infection and a higher level of serum viral capsid antigen IgG antibody titer in the MS population than in the controls. The MS population had a lower cytomegalovirus (CMV) infection rate and lower CMV complement fixing antibody production than controls. Except for the higher measles infection rate and antibody titer in patients with MS, data on the other viruses did not differ from controls. PMID- 6860179 TI - Perineural spread of cutaneous basal and squamous cell carcinomas. The clinical appearance of spread into the trigeminal and facial nerves. AB - Five patients were studied in whom a trigeminal or facial neuropathy resulted from perineural spread of basal or squamous cell carcinomas arising in the skin of the face. The cause of the neuropathy was not immediately apparent because there was no evidence of local skin recurrence in any of the patients after the onset of their neurologic symptoms. Pain was a prominent feature in those patients with trigeminal involvement. Radiologic investigations were helpful in only one patient. The diagnosis should be suspected when symptoms and signs are confined initially to superficial branches of the trigeminal or facial nerves and later extend to more central branches in the order in which they arise. Confirmation can be made by microscopic examination of the nerves involved. PMID- 6860181 TI - Delayed neurologic sequelae in carbon monoxide intoxication. AB - Of 2,360 victims of acute carbon monoxide intoxication examined between 1976 and 1981, delayed neurologic sequelae were diagnosed in 65 (2.75% of the total group, 11.8% of those admitted). There were 25 men and 40 women. Ages ranged from 34 to 80 years (mean, 56.1 years), with the peak incidence in the sixth and seventh decades. The lucid interval before appearance of neurologic sequelae varied from two to 40 days (mean, 22.4 days). The most frequent symptoms were mental deterioration, urinary or fecal incontinence, gait disturbance, and mutism; the most frequent signs were masked face, glabella sign, grasp reflex, increased muscle tone, short-step gait, and retropulsion. There were no important contributory factors except age and the severity of anoxia. Previous associated disease did not hasten the development of sequelae. Of 36 patients followed up for two years, 27 (75%) recovered within one year. PMID- 6860180 TI - Reflex sympathetic dystrophy (causalgia) treatment with guanethidine. AB - Three cases of reflex sympathetic dystrophy (causalgia) were associated with cervical spondylosis. Two of them were related to sudden cervical trauma. Patients showed burning pain, hyperalgesia in a segmental distribution, and edema of the arms, hands, and fingers bilaterally. Oral administration of guanethidine sulfate was effective in all cases. Our results support the hypothesis that hypersensitivity to norepinephrine plays a role in reflex sympathetic dystrophy. PMID- 6860182 TI - The characterization of an amnesic syndrome following hypoxic ischemic injury. AB - We used clinical analysis and criteria derived from the experimental studies of classic amnesic syndromes to characterize the amnesia that follows hypoxic ischemic brain injury from cardiac or respiratory arrest. The results show that patients with hypoxic ischemic amnesia have several neuropsychological features in common with other amnesics, including intact short-term memory, severely depressed free recall, and less depressed recognition of visual and verbal material. Unlike amnesics with alcoholic Korsakoff's syndrome, they are oriented and do not confabulate. Hypoxic ischemic brain injury is a common hospital occurrence, and a study of the characteristics of the amnesia that can occur after such injury should enlarge our understanding of the amnesic syndromes. PMID- 6860183 TI - Subacute bilateral malignant exophthalmos due to orbital medulloblastoma metastases. AB - A 26-year-old woman complained of subacute bilateral exophthalmos, one year after the extirpation of a cerebellar medulloblastoma. The clinical picture and the orbital computed tomographic scan suggested orbital pseudotumor or endocrine ophthalmopathy rather than orbital medulloblastoma metastases. The latter diagnosis was confirmed by histologic examination. The occurrence of extraneural medulloblastoma metastases including bilateral orbital involvement is discussed. PMID- 6860184 TI - Myelopathy after herpes zoster. AB - A 73-year-old woman with a remote history of carcinoma of the ovary had herpes zoster involving several lumbosacral dermatomes. There subsequently developed a progressive myelopathy with normal myelographic findings and CSF pleocytosis. Vidarabine (15 mg/kg/day) was given for ten days. No further progression occurred. The syndrome of progressive myelopathy following herpes zoster is rare; direct viral invasion of the cord with subsequent necrosis appears to be the pathogenic mechanism. Antiviral therapy may have halted progression, but it did not lead to recovery of function. PMID- 6860185 TI - Subacute toxic delirium following nitrous oxide abuse. AB - Nitrous oxide (N2O) abuse has been associated with myeloneuropathy, but significant mental status changes rarely have been described. We treated a patient in whom a subacute delirium developed after heavy N2O abuse; symptoms slowly cleared over three weeks after removal of the neurotoxin. PMID- 6860186 TI - Abducens nerve palsy due to spontaneous dissection of the internal carotid artery. AB - A patient had angiographic and computed tomographic features of a dissecting aneurysm of the extracranial internal carotid artery, with intracranial extension into the cavernous sinus. Isolated abducens nerve palsy resolved without treatment, within a two-month period. PMID- 6860188 TI - Hearing loss as an initial symptom of meningococcal meningitis. PMID- 6860187 TI - Ataxic hemiparesis from lesions of the corona radiata. AB - Ipsilateral cerebellar and pyramidal signs suddenly developed in three patients. Computed tomography revealed small infarcts of the corona radiata in two patients and a small infarct in the posterior limb of the internal capsule in the third. Ataxic hemiparesis can result from lesions of the corona radiata as well as many other points along the corticopontine pathways. PMID- 6860190 TI - Supratentorial, suboccipital, subdural hematoma. PMID- 6860192 TI - Seizures secondary to thyrotoxicosis and high-dosage propranolol therapy. PMID- 6860189 TI - Chronic pain syndrome in amyotrophic lateral sclerosis. PMID- 6860191 TI - Infarction in a meningioma after cardiac arrest. Computed tomographic and pathologic findings. PMID- 6860193 TI - Migrainous olfactory aura in a family. PMID- 6860194 TI - Primary lateral sclerosis. PMID- 6860195 TI - Enophthalmos and Horner's syndrome. PMID- 6860197 TI - Posterior retinal holes secondary to diabetic retinopathy. AB - Pars plana vitrectomies were performed on 85 diabetic eyes with preoperative posterior retinal holes. Six months following vitrectomy, 27 of the eyes had substantial visual improvement. Additional retinal holes were a frequent operative complication, occurring in 35 (41%) of the eyes. Of those postvitrectomy irides that could be visualized, 25 had rubeosis involving the peripheral iris or angle. Neovascular glaucoma occurred during the follow-up period in 18 eyes. The vitreous cavities were clear in 53 eyes, and the macula was attached in 47 (55%) of the eyes, but opacities of more anterior structures prevented visualization of the fundi in many cases. PMID- 6860196 TI - Visual, refractive, and keratometric results of radial keratotomy. AB - Prospective evaluation of radial keratotomy was conducted on 156 consecutive eyes of 101 patients. Before surgery, mean spherical equivalent (SE) was -5.0 diopters and uncorrected distance acuity was 20/200 or worse in 96% of eyes. All eyes were examined six months after surgery. Overall six-month postoperative distance acuity was 20/20 in 43% and 20/40 or better in 73% of eyes; 51% of eyes were within 1.0 D of emmetropia; mean change in SE was +4.8 D. When preoperative myopia was less than 6.0 D, six-month uncorrected acuity was 20/20 in 53% and 20/40 or better in 84% of eyes; 63% were within 1.0 D of emmetropia. Visual, refractive, and keratometric findings appeared stable at six months. Predictability appeared best when preoperative myopia was less than 6 D. Complications were few, none resulted in reduced best-corrected acuity, and most were transient and/or well tolerated. In this series, radial keratotomy appeared safe short-term. Ongoing evaluation is being conducted to determine long-term safety and efficacy. PMID- 6860198 TI - Vitreous fluorophotometry in patients with hypertension. AB - Vitreous fluorophotometry performed on 22 patients with moderate to severe hypertension showed that patients with active retinopathy, as manifested by retinal hemorrhages, cotton-wool spots, retinal exudates and edema, or disc edema, generally had elevated values (20/28 eyes). Control of the BP resulted in a decrease in the values toward the normal range. Patients with only arteriolar sclerosis, even some with particularly high BP, generally had normal fluorophotometric values (14/16 eyes). The two exceptions showed minimal elevations. Vitreous fluorophotometry is a useful tool to quantitate the blood retinal barrier in patients with moderate to severe hypertension and may be a sensitive indicator of treatment efficacy. PMID- 6860199 TI - Case-control study of ocular hypertension. AB - A retrospective case-control study compared 100 ocular hypertensive patients with 100 ocular normotensive patients matched for sex and age. Interviews were conducted and charts were reviewed to explore demographic, personal, and environmental factors, as well as medical history and refractive error. Multiple logistic regression analyses assessed which factors were independently related to the presence or absence of ocular hypertension. The variables significantly associated with the presence of ocular hypertension were family history of glaucoma, myopic refractive error, absence of liquor intake, history of nonocular surgery, high income, and history of high BP. PMID- 6860200 TI - Early and late failures of argon laser trabeculoplasty. AB - Sixty-five eyes in 52 patients with open-angle glaucoma were treated with argon laser trabeculoplasty (ALT). Although a majority of the eyes showed a decrease in intraocular pressure (IOP) of 5 mm Hg or more, eight eyes required filtering surgery within one year of treatment, and extensive peripheral anterior synechiae and persistent elevation of IOP developed in an additional two eyes that did not undergo surgery. In four of six eyes with juvenile glaucoma that were treated with ALT, complications developed and/or filtering surgery was required. A rise in IOP more than a year after treatment was noted in two eyes that had shown an initial satisfactory response to ALT. Although ALT seems to be a valuable addition to glaucoma therapy, the potential exists for both early and late complications and failures. PMID- 6860202 TI - Hematoporphyrin phototherapy for experimental intraocular malignant melanoma. AB - Administration of a hematoporphyrin derivative (HpD) followed by photoradiation with red light completely or partially destroyed Greene hamster melanoma developed in the anterior chamber of rabbit eyes. Tumor-bearing eyes were divided into two groups. Twenty-two eyes received an HpD injection followed by exposure to red light from a slide projector with a 500-W quartz halogen lamp and a red filter (intensity to the tumor was about 4.0 mW/sq cm). In the control group (six eyes), eyes were exposed either to red light only or to HpD injection only. Local complications after therapy included edema and congestion of the conjunctiva, clouding of the cornea, and hemorrhage on the iris surface. The HpD itself has no cytotoxic effect, is preferentially retained in tumor cells, and causes a destructive photodynamic effect as a result of the production of cytotoxic singlet oxygen in the tumor. Accordingly, it may be a safe and potentially therapeutic procedure in the treatment of uveal melanoma. PMID- 6860201 TI - Use of betaxolol in the reduction of elevated intraocular pressure. AB - Forty eyes in 20 patients with elevated intraocular pressure were treated with either a 0.125% betaxolol ophthalmic solution or a placebo. After 2, 4, and 6 weeks of twice-daily therapy, the eyes receiving the betaxolol had a mean percent reduction in IOP greater than that in the eyes treated only with the drug vehicle (placebo). Both solutions were well tolerated. PMID- 6860203 TI - Cryotherapy for intraepithelial conjunctival melanocytic proliferations. Ultrastructural effects. AB - A double freeze-thaw cryoapplication to the conjunctiva was used to treat the flat intraepithelial proliferation of atypical melanocytes in five patients. Electron microscopy of six paired biopsy specimens taken before and after cryotherapy showed in all specimens rupture of plasmalemmas of intraepithelial melanocytes and release of cytoplasmic debris into the intercellular space. In four patients the plasmalemmas of the squamous cells (keratinocytes) generally remained intact after nitrous oxide treatment (temperatures reaching -20 degrees C by thermocouple monitoring), but these cells frequently displayed dissolution of intercellular desmosomes and hemidesmosomal contacts with the basement membrane. In one patient treated with liquid nitrogen, both the squamous cells and the melanocytes were irreversibly damaged at temperatures of -40 degrees C. These ultrastructural data establish that there is a selective sensitivity of atypical intraepithelial conjunctival melanocytes to freezing at temperatures below -20 degrees C. PMID- 6860204 TI - Corneal endothelium in herpetic keratouveitis. AB - The corneal endothelium underwent changes in 15 patients with unilateral herpetic keratouveitis. Study with both noncontact and wide-field specular microscopes showed that six patients had mild and nine patients severe keratouveitis. Transient endothelial changes indicating endotheliitis were observed in all eyes affected by severe keratouveitis. In three cases nonreflecting areas were observed with the specular microscope one to two days earlier than the conventional signs of anterior uveitis. This finding suggests direct herpes simplex virus invasion into endothelial cells that could be followed by an inflammatory cell attack against the endothelium. The eyes that had experienced severe keratouveitis showed marked pleomorphism of the endothelial cells and a 15% lower central endothelial cell density on average than the healthy fellow eyes. In the eyes with mild keratouveitis, the endothelial mosaic showed only a 1.4% lower endothelial cell density. PMID- 6860205 TI - Prognostic factors in corneoscleral lacerations. AB - Of 122 patients with corneoscleral lacerations repaired during a four-year period, 21 (17%) underwent enucleation primarily or within ten days of injury, 85 (70%) had at least six months of follow-up, and 16 (13%) were unavailable for follow-up. The most significant predictors of enucleation were poor initial visual acuity, the amount of hyphema, the presence of posterior uveal prolapse or vitreous hemorrhage, the extent of lens damage, and the length of laceration. The most significant predictors of a good visual outcome were good initial visual acuity, absence of hyphema, absence of posterior uveal prolapse or vitreous hemorrhage, and length of laceration. Final astigmatism was greater if the corneal wound was 4 mm or longer. Delaying the initial repair up to 36 hours had no effect on outcome. PMID- 6860206 TI - Laser interferometric visual acuity in senile macular degeneration. AB - Twenty-nine eyes from 15 patients were affected by senile macular degeneration and had clear ocular media. Tests with retinal interference fringe patterns produced by a low-energy helium-neon laser and Snellen's charts showed that in 13 eyes, interferometric and Snellen's acuities were within one line. In the remaining 16 eyes, laser interferometric acuities were notably better than Snellen's acuities. Our results suggest that laser interferometric visual acuities, prior to lens extraction, will prove inconsistent in accurately predicting postoperative Snellen's acuities in patients with senile macular degeneration. PMID- 6860207 TI - Visual field testing with red targets. AB - Ten patients with partial temporal visual field defects were examined with a modified tangent screen projection perimeter (Auto-Plot). Defects demonstrated with an isopter for chromatic recognition of a 3-mm red stimulus could always be reproduced with an isopter for achromatic recognition of a dim, 3-mm white stimulus. The red-white intensity ratio producing equivalent fields remained constant for a given patient but varied from subject to subject (range, 3.0 to 7.5; mean, 5.7; SD, 1.8). Thus, red functioned as dim white, but no single fixed ratio of intensities was applicable to all subjects. Visual field testing with 1 foot-candle of tangent screen illumination permitted subjects to adapt to dark. As retinal sensitivities increased, the corresponding visual field steadily enlarged for 30 minutes. This effect was greater in the pathologic temporal fields, which increased relatively more than intact nasal fields. The result was poor visual field reproducibility with time. PMID- 6860208 TI - Effect of binocular variations of Snellen's visual acuity on Titmus stereoacuity. AB - Thirty normal subjects were tested with the Titmus stereotest varying the binocular Snellen's visual acuity from 20/20 to 20/200. From the 36 possible combinations, a nomogram describing the relationship of binocular variations of Snellen's visual acuity and stereoacuity was constructed. The nomogram provides a useful reference for comparing expected and achieved clinical results of the Titmus stereotest in normal subjects. The effects of various pathologic conditions of the eye on the relationship between Snellen's visual acuity and stereoacuity needs to be studied. PMID- 6860211 TI - Tarsal-conjunctival advancement flaps for upper eyelid reconstruction. AB - For subtotal or total upper eyelid reconstruction, a technique combining tarsal conjunctival advancement flaps from the upper and lower eyelids was used. A tarsal-conjunctival flap was begun just inside the lower lid margin, and was brought into the upper eyelid so that the tarsus formed the new upper eyelid margin. The remaining tarsus and conjunctiva from the upper eyelid were brought forward to join the lower lid flap. On this conjoined tarsal-conjunctival flap, a full-thickness skin graft was placed. Four weeks later, the conjunctival flap from the lower eyelid was separated. The main advantage of this technique is that it provides stability and support for the new upper eyelid margin while keeping the skin and hair from turning in against the globe. PMID- 6860209 TI - Mucolipidosis I. AB - A case of mucolipidosis I had clinical and histopathologic features that were a combination of changes found in both mucopolysaccharidoses and sphingolipidoses. Corneal clouding, spokelike cataracts, tortuous conjunctival and retinal vessels, and strabismus were clinical findings. Histopathologically, there were inclusion vacuoles similar to those seen in mucopolysaccharidoses; lamellar bodies typical of sphingolipidoses were rare. These vacuoles were seen in conjunctival and corneal epithelium and fibrocytes, conjunctival and retinal vessel endothelium, and all retinal cell layers. PMID- 6860212 TI - A method to predetermine the correct photocoagulation dosage. AB - Relative absorbance in different locations on the retina has been studied by measuring the relative reflectance. Using this measurement it is possible to predetermine the correct dosage of light power in any new location on the retina by comparing the new reflectance with the reflectance in the test location. It is important to measure the reflectance with the aiming beam in its actual setting for application because the absorbance is affected by the angular orientation of the beam. A method is proposed for measuring, when needed, the relative concentration of blood and melanin at different points of the retina. PMID- 6860210 TI - Intracorneal lens implantation. AB - In previous experiments, we found that a high-water-content hydroxyethyl methacrylate (Permalens) hydrogel implant was not only well tolerated within the rabbit corneal stroma but also would successfully alter the anterior radius of curvature, and thus the refractive state, of the rabbit eye. The same lens material implanted in the cornea of a patient with aphakic bullous keratopathy was tolerated for six months and decreased epithelial edema but did not alter the refractive state. This cornea, containing the intrastromal lens, was obtained at subsequent penetrating keratoplasty and studied by light and transmission electron microscopy. Morphologically, the epithelium and anterior stroma were not edematous, whereas the stroma posterior to the lens remained edematous. Minimal fibroblastic activity was evident at the lens-stroma interface. There were no signs of inflammation, ulceration, or neovascularization. PMID- 6860213 TI - Time and location analysis of lesion formation in photocoagulation. AB - Fourteen eyes from seven owl monkeys were used for study of the time and location within the retinal layers of the formation of the white reactions produced by photocoagulation with green (530.9 nm), yellow (568.2 nm), or red (647.1 nm) krypton wavelengths. Locations on the retina with equivalent conditions of absorbance were chosen. The white reaction formed in the first 100 ms of application. The depth at which the most damage occurred depended on the wavelength used. The final shape of the lesion depended on the location (in depth) of the white reaction first formed and on the power of the laser beam. The cauterizing power of the krypton yellow was evident. PMID- 6860214 TI - Ocular infection with herpes simplex virus in nonimmune and immune mice. AB - In a detailed study of ocular infection by herpes simplex virus (HSV) type 1 in mice, the course and signs of eye disease were investigated and compared in primary and secondary infection using slit-lamp examination, culture of the tear film, and monitoring of the blink reflex. Response to primary inoculation ranged from subclinical infection to severe keratitis. Compared with conjunctival scarification, corneal scarification resulted in more frequent and severe eye disease and signs of CNS infection. Previous infection in the skin of the contralateral ear considerably modified subsequent infection of the eye so that signs of disease occurred earlier, were limited to dendritic keratitis with some stromal involvement, and were largely reversible. The mouse seems to be a suitable animal for studying ocular infection with HSV. PMID- 6860215 TI - Comparison of empirically derived and theoretical aphakic refraction formulas. AB - A formula for predicting aphakic refraction from axial length and keratometry measurements was derived from 120 cases, using linear regression analysis, as follows: Psp = 80.4 - 1.65L -0.7K, where P indicates aphakic spectacle power in diopters; L, axial length in millimeters; and K, result of keratometry in diopters. The prediction accuracy of this simple formula was compared with that of a complex theoretic formula based on geometric optics in 205 additional cases. The prediction accuracy of the theoretic and linear regression-derived formulas was virtually identical despite their differences in complexity and derivation. The differences and similarities between theoretic-derived and regression-derived aphakic and pseudophakic prediction formulas are discussed. PMID- 6860216 TI - Clinical application of the laser Doppler technique for retinal blood flow studies. AB - The newly developed laser Doppler technique was used to measure retinal blood flow characteristics in patients with forms of central retinal venous occlusive disease. The measurements were consistent with the expected reduced retinal blood flow in these disease processes. PMID- 6860218 TI - Deep facial osteology as revealed by coronal sections of the dried skull. AB - An understanding of the bony framework and relationships of the face is essential to the facial reconstructor. A dried human skull was immersed in a hardening agent to preserve the ethmoidal labyrinth and then cut in the coronal plane to produce six sections. The anterior and posterior surface of each section was photographed and landmarks were labeled. Since the thick anterior bony structures were removed with the first slice, the normal delicate laminae of the deep face, within the deeper sections, were exposed for study. PMID- 6860217 TI - Implants of Gore-Tex. AB - Pieces of an expanded, fibrillated, polytetrafluoroethylene material (Gore-Tex), were evaluated as implants for application in facial plastic augmentation and reconstructive surgery. The Gore-Tex cylinder material, which has an average internodal spacing of 30 microns, became permeated with viable connective tissue. Few histiocytes and giant cells accumulated at the implant site, a sign that little chronic inflammation and foreign-body reaction were present. Mature connective tissue around the implant appeared to form a strong supporting envelope for the material, yet the implant could be easily dissected from the subcutaneous tissue and could be removed en bloc without difficulty. Gore-Tex is a versatile material that seems to have a favorable future in facial plastic and reconstructive surgery. Clinical studies will define that potential more clearly. PMID- 6860219 TI - Retrospective analysis of surgically treated Le Fort fractures. AB - Craniofacial suspension, in conjunction with intermaxillary fixation (IMF), is the time-honored method of Le Fort fracture repair. However, several patients with maxillary fractures treated at the Medical Center Hospital of Vermont in Burlington by the oral surgery and otolaryngology services have been managed with IMF alone. Twenty-one of these patients were examined retrospectively through comprehensive dental and otolaryngologic clinical analyses. Traditional concerns for facial elongation and nonunion were among the key questions addressed by this study. There was no evidence of nonunion in any patient examined. A comparison of each patient's lateral cephalometric roentgenogram with computerized norms suggested that facial elongation did not occur when IMF alone was the principal method of repair. PMID- 6860220 TI - Techniques to enhance utilization of advancement flaps. AB - Utilization of advancement flaps to cover facial defects is potentially limited by the secondary distortion of adjacent anatomical landmarks, expansion of any residual lesion, and the vascular embarrassment of wound closure under tension. In this study, advancement flaps are raised in piglets, and the first stage in the serial excision of a hypothetical skin lesion is simulated. It is demonstrated that undermining of the lesion-bearing skin results in expansion of the lesion and is counterproductive. If, however, a separate layer of hypodermis and fascia is mobilized deep to the lesion and sutured to the advancing flap, skin closure can be accomplished with minimal tension. This results in maximal recruitment of the advancement flap and minimal expansion of the residual lesion as the defect is bridged. PMID- 6860221 TI - Laser Doppler velocimetry and fluorescein dye in the prediction of skin flap viability. A comparison. AB - Laser Doppler velocimetry provides a quantitative and noninvasive measurement of cutaneous blood flow. Piglets were used to compare laser Doppler velocimetry and fluorescein with each other and as predictors of flap viability. Twenty-five random pattern rectangular skin flaps were studied with both techniques. Eighteen of the flaps were observed for two weeks and the length of viable flap documented. A reading of 100 mV on the laser Doppler corresponded with full fluorescence after dye injection. Both fluorescein and the laser Doppler underestimated flap surviving length slightly. Laser Doppler readings taken 24 hours postoperatively predicted the length of surviving flap exactly. The laser Doppler correlated well with fluorescein dye. PMID- 6860223 TI - Platysma myocutaneous flap for intraoral defects. AB - The use of myocutaneous flaps has resulted in improved methods for reconstruction involving the head and neck area. The platysma myocutaneous flap offers an excellent alternative for reconstructing appropriate oral cavity defects resulting from tumor ablation. It has certain advantages over other local or distant pedicled flaps and has been proved to be a reliable alternative for single-stage repair of these defects. The technique of this flap is described and a review of its use in six cases, including complications, is discussed. PMID- 6860222 TI - Serial fluorometric assessment of experimental neurovascular island flaps. AB - Quantification of tissue sodium fluorescein delivery was used to monitor neurovascular island flaps subjected to various manipulations of the vascular pedicle. In 20 anesthetized rats, inferior epigastric neurovascular island flaps were studied during transient arterial or venous occlusion and presumed vascular spasm. During clamping, there was no substantial fluorescein uptake by the flaps. Reinjection of fluorescein after removal of the clamps resulted in adequate fluorescein uptake and elimination in those flaps that remained viable. Three of the flaps with presumed vascular spasm eventually evidenced an increase in fluorescence with subsequent injections and remained viable; one flap did not show adequate fluorescence after any of the four injections and subsequently necrosed. It is concluded that documentation of tissue fluorescein delivery following serial injections of dye permits accurate monitoring of the functional status of the vascular pedicle at close-time intervals during the critical hours immediately after flap construction. PMID- 6860224 TI - The growth potential of autograft cartilage. An experimental study. AB - Does free transplanted autologous cartilage grow? Clinical studies by Peer and Dupertuis have produced variable observations. If free cartilage autografts in infancy and childhood do increase in size, the need for additional procedures, such as overgrafting or successive allografting as the child grows, would be obviated. There is a need for an experimental model to determine the presence and magnitude of cartilage growth as well as the contributions of appositional and interstitial growth toward overall growth. PMID- 6860225 TI - Management of nasal cutaneous malignant neoplasms. An interdisciplinary approach. AB - Standard methods of managing large or recurrent cutaneous nasal malignant neoplasms are often inadequate, leaving extensions of the tumor that are clinically invisible. Conventional methods may also allow considerable amounts of normal tissue to be sacrificed in an attempt to ensure the removal of all carcinoma. Through partnership of the dermatologic surgeon and the reconstructive surgeon, a more effective method of curing and rehabilitating patients with nasal skin cancer can be achieved. The dermatologic Mohs' surgeon can perform microscopically controlled excision of malignant neoplasms, providing the highest cure rates obtained by any method. This method is particularly suited for basal cell carcinomas that are recurrent, larger than 1 cm in size, or are of the morpheaform histologic subtype. Total microscopic excision allows nasal reconstruction to proceed with the highest degree of confidence of tumor control. The location and extent of the malignancy dictate the surgical approach for nasal reconstruction. PMID- 6860226 TI - Conjoint hyoid bone segments for the repair of severe laryngeal stenosis. AB - We discuss and show by illustrations a surgical technique for the management of severe combined laryngeal and subglottic stenosis using multiple pieces of hyoid bone. No serious problems resulted from the removal of the entire hyoid bone. All patients have maintained a good airway, despite the possibility of absorption of a free bone graft. Although it is reasonable to try to use the hyoid bone with a strap muscle pedicle, it is impossible to reconstruct the subglottic and laryngeal area without multiple pieces. Our experience encourages us to use multiple pieces of free hyoid bone for laryngotracheal reconstruction. PMID- 6860228 TI - Complication of septorhinoplasty. Benign or malignant? AB - Routine septorhinoplasty on an unchanging nasal hump and deflected nasal septum resulted in subcutaneous respiratory epithelium, possibly surgically misplaced with a fibrotic host response. Progressive growth of the lesion over midface resulted in severe cosmetic deformity. Findings from repeated early biopsy specimens were benign. Removal of entire mass (44 g) failed to definitely resolve a tentative diagnosis of mucoepidermoid carcinoma, grade 1. A study will be made from a nationwide sample. Prevention, treatment, and final diagnosis are the ultimate objectives. PMID- 6860227 TI - Free osteocutaneous groin flap in the reconstruction of large mandibular defects. A case study. AB - Multiple tissue transfers are being used more and more in head and neck reconstruction. With the development of microvascular surgery, free flaps have been used as one such method of reconstruction. We have found that the use of the osteocutaneous groin flap, a free flap, is an excellent choice for filling all the requirements of reconstruction of massive oral defects in which large segments of the mandible are resected. This flap is not to be used routinely as a first-choice flap, and it should only be used in patients who are healthy enough to tolerate the prolonged anesthesia necessary to complete such a procedure and in the patient who has a good prognosis from his disease. PMID- 6860229 TI - Pathologic quiz case 2: cutaneous leishmaniasis. PMID- 6860230 TI - Hamartoma of the hypopharynx. PMID- 6860231 TI - Experimental microsurgical utero-ovarian and tubal transplantation. PMID- 6860233 TI - Endometrial cancer detected 31 months after childbirth--a case report. PMID- 6860232 TI - Study on role of oxytocin in lactating rats by passive immunization. PMID- 6860235 TI - Prenatal fetal heart structures identified by two-dimensional echocardiography. PMID- 6860234 TI - Cervical cancer in association with intrauterine contraceptive devices. PMID- 6860236 TI - Myomectomy: a reappraisal and post-operative reproductive performance. PMID- 6860237 TI - Re-evaluation of measurements of maternal serum hCG, hPL and progesterone as prognostic markers of abortion in early pregnancy. PMID- 6860238 TI - Rokitansky-Kuster--Hauser syndrome with fibromyoma arising in rudimentary buds. PMID- 6860239 TI - Outcome of pregnancy and follow-up of children conceived by ovulation induction. PMID- 6860240 TI - Clinical implication of hyperprolactinemias, especially with prolactinoma and luteal insufficiency. PMID- 6860241 TI - The effect of maternal glucose administration upon fetal myocardial glycogen change during acute blood loss in the term pregnant dog. PMID- 6860243 TI - Neurological disorders due to metastases. PMID- 6860242 TI - Adolescent health-1. Coping with cancer. PMID- 6860244 TI - Abdominal paracentesis. PMID- 6860245 TI - How to succeed in practice by really trying. Guidelines for the care of dying patients. PMID- 6860246 TI - Clinical presentations of metastatic carcinoma. PMID- 6860248 TI - Metastatic spread of cancer. PMID- 6860247 TI - Living with one's mistakes. PMID- 6860249 TI - Radiotherapeutic management of metastatic carcinoma. PMID- 6860251 TI - Phenylketonuria (PKU) and the single gene: an old story retold. PMID- 6860250 TI - Can recovery from stuttering be considered a genetically milder subtype of stuttering? PMID- 6860253 TI - Chromosomal and behavioral studies of Mexican Drosophila. I. Vagility characteristics of three populations of D. pseudoobscura. PMID- 6860252 TI - The association between phenylthiocarbamide (PTC) tasting ability and psychometric variables. PMID- 6860254 TI - Movers and stayers: genetic analysis of mobility and positioning in hybrids of lake charr, Salvelinus namaycush, and brook charr, S. fontinalis (pisces, salmonidae). PMID- 6860255 TI - A histochemical study of lipoid pigment storage in chronic granulomatous disease (CGD). AB - The presence of large pigmented, lipid-laden histiocytes throughout the reticulo endothelium is a typical feature of CGD. They have been studied histochemically in specimens of spleen, liver and lymph nodes of a 17-year-old female with CGD. The results of such a study indicate that in CGD histiocytes contain a ceroid pigment. The typical autofluorescence of the pigment is related to lipid peroxidation-derived fluorescent compounds, which seem to be directly involved in the PFAS-positivity of ceroid. This suggests that PFAS stain can be considered not only a technique for the demonstration of unsaturated lipids, but also a useful histochemical method in the study of lipid peroxidation. The finding of ceroid storage, which always indicates an excess of free-radical reactions in vivo, is particularly intriguing in CGD, known to be characterized by the failure of a free-radical generating enzymatic system in phagocytes. PMID- 6860256 TI - Fluorescence histochemical patterns of Purkinje cell layer in rat cerebellum after long-term phenytoin administration. AB - The effects of long-term Phenytoin (DPH) administration were studied on the cerebellum Purkinje layer of Sprague-Dawley rats. Histochemical qualitative studies were performed in order to investigate fluorescence patterns linked to degenerative pigment storage and to changes in biogenic amines. Specific tests for Falck's method and the microspectrofluorometric analysis of fluorescent bodies showed: a) an increase in storage lipopigment which, generally referred to in the literature as lipofuscin, partially exhibit a more complex structure due to the simultaneous presence of lipofuscin and ceroids in the same granular body; b) a change in neurotransmitter patterns. This change must be typically related to an altered metabolism of biogenic amines and/or to degenerative phenomena causing the accumulation of biogenic amines in nerve terminals. The morphological and histochemical pictures support the idea of a generalized Purkinje cell damage. PMID- 6860257 TI - Neutral mucins in coeliac disease. AB - Neutral mucins in duodeno-jejunal biopsies of coeliac infants were studied. Subtotal villous atrophy was observed in 22 untreated patients whereas 18 patients, after a gluten-free diet for twelve months, had an histologic pattern of partial villous atrophy. The results showed a different distribution of neutral mucosubstances along the crypts and villi; in mucosae with subtotal villous atrophy, some goblet cells producing only neutral mucins were evident at various levels in deep crypts, when compared to those observed in partial villous atrophy. The possible correlation between epithelial cell differentiation and neutral mucins secretion was discussed. PMID- 6860258 TI - Nuclear DNA content distribution in five parotid gland tumors. A preliminary report. AB - Quantitative cytophotometric evaluations of nuclear DNA content were made on epithelial cells obtained from five cases of parotid gland tumors. The measurements were performed on sections stained with Feulgen reaction and, as control of diploid value, adventitious small lymphocytes as well as normal epithelial cells were considered. A fairly good correlation between the type of histogram of DNA values and a progressive degree of atypia was found since particularly high levels of hyperdiploidy were found in more severe tumors. PMID- 6860260 TI - Organ and species specificity in chemical carcinogenesis. Proceedings of a symposium, March 1981, Raleigh, North Carolina. PMID- 6860259 TI - The nature of organ specificity in chemical carcinogenesis. PMID- 6860262 TI - Chemical carcinogenesis studies in nonhuman primates. PMID- 6860261 TI - Organ and species specificity in nickel subsulfide carcinogenesis. AB - In summary, dose-response relationships have been demonstrated for Ni3S2 carcinogenesis in rats and hamsters and for transformation of Syrian hamster fetal cells by Ni3S2 in vitro. Absolute species specificity has not been observed in Ni3S2 carcinogenesis, although rats are apparently more susceptible than mice, hamsters, or rabbits. Also, significant variations have been reported in susceptibilities of rat strains to Ni3S2 carcinogenesis. Most organs of rats have been found to be susceptible to Ni3S2 carcinogenesis following direct exposure by injection or inhalation; intraocular and intramuscular routes of administration have yielded the highest tumor incidences. Finally, an experiment in hamsters has indicated that Ni3S2 may be noncarcinogenic by the oral route; further studies are needed to confirm or refute this speculation. For discussions of molecular mechanisms that may be involved in carcinogenesis by Ni3S2 and other nickel compounds, readers are referred to recent review articles (8-10). PMID- 6860263 TI - Organ specificity and tumor promotion. PMID- 6860264 TI - Species differences in response to aromatic amines. PMID- 6860265 TI - Liver as a model system for analyzing mechanisms of tumor initiation and promotion. PMID- 6860266 TI - Promotion of urinary bladder carcinogenesis. PMID- 6860267 TI - Species and organ differences in the biotransformation of chemical carcinogens. PMID- 6860268 TI - Multiple effects and metabolism of alpha-naphthoflavone in induced and uninduced hepatic microsomes. PMID- 6860269 TI - Cell-mediated mutagenesis, an approach to studying organ specificity of chemical carcinogens. PMID- 6860270 TI - The activation of carcinogens by mammary cells: inter-organ and intra-organ specificity. PMID- 6860271 TI - Tissue-specific sister chromatid exchange analyses in mutagen-carcinogen exposed animals. PMID- 6860272 TI - Introduction: DNA damage and repair. PMID- 6860273 TI - DNA modification and repair in vivo: towards a biochemical basis of organ specific carcinogenesis by methylating agents. PMID- 6860274 TI - Modification of DNA repair processes induced by nitrosamines. PMID- 6860275 TI - Repair of alkylated DNA by cell extracts from various organs and species. PMID- 6860276 TI - Cell specificity in DNA damage and repair. PMID- 6860278 TI - Species specificity in nitrosamine carcinogenesis. PMID- 6860277 TI - DNA adduct formation and removal in N-acetoxy-2-acetylaminofluorene-exposed cultured cells and in organs from rats fed 2-acetylaminofluorene. PMID- 6860279 TI - Trans-species and trans-tissue extrapolation of carcinogenicity assays. PMID- 6860280 TI - Carcinogenic risk assessment--the consequences of believing models. PMID- 6860281 TI - Organ specificity and interspecies differences in carcinogenesis by metabolism independent alkylating agents. PMID- 6860282 TI - [Extension apparatus for the operating table]. PMID- 6860283 TI - [Statistical study of the age at delivery of mothers of patients with congenital hip dislocation]. PMID- 6860286 TI - [Effect of meniscus surgery on the knee joint--a study of late results]. PMID- 6860287 TI - [Late results of the surgical treatment of lateral ligament ruptures of the upper ankle joint]. PMID- 6860284 TI - [Possible applications of photogrammetry in orthopedics]. PMID- 6860285 TI - [Femoral neck fractures following radiation therapy]. PMID- 6860288 TI - [Thom's surgical technic in the treatment of spastic contractures of the knee in children]. PMID- 6860289 TI - [Surgical treatment of the late stages of Koehler's disease II by implantation of a silicone rubber prosthesis]. PMID- 6860290 TI - [Syndrome of the narrow lumbar spinal canal caused by a benign osteochondroma]. PMID- 6860291 TI - Hypoxanthine-guanine phosphoribosyltransferase in human erythroid cells: properties of the isozymes. AB - We have previously given evidence that the hypoxanthine-guanine phosphoribosyltransferase (HGPRT; EC 2.4.2.8) isozymes in human erythroid cells result from posttranslational modifications of a single gene product [Johnson, G. G., et al. (1982). Biochemistry 21: 960]. In the present work we compare the properties of the unmodified and two major modified isozymes, which collectively account for 90% of the HGPRT enzyme activity in cell lysates. The modified isozymes differ from the parent molecule in the pH dependence of activity and in the relative utilization of the two purine base substrates, hypoxanthine and guanine. In contrast to the changes in the catalytic properties of the enzyme, the modifications have no detectable effects on the heat stability or on the equilibrium between enzyme dimers and enzyme tetramers. PMID- 6860294 TI - Genetics of esterases in Drosophila. VII. Genetic control of the activity level of juvenile hormone (JH)-esterase and heat resistance in D. virilis at high temperatures. AB - The heat-resistant subline 147S was obtained in Drosophila virilis by selecting for viability individuals of heat-sensitive stock 147. It was shown that in the heat-treated 147S pupae the activity of juvenile hormone (JH)-esterase is decreased and, consequently, the titer of juvenile hormone is increased compared with those in the control pupae. These changes are consistent with those observed earlier for resistant stock 101. Heat-resistant stocks 101 and 147S were crossed with heat-sensitive stock 147, whose heat-treated larvae show earlier activation and higher activity of JH-esterase than control larvae. The viability and electrophoretic esterase patterns were analyzed in the F1 and F2 hybrids at different temperatures. It was found that the F1 hybrid is resistant to the effect of high temperature and its activity level of JH-esterase is lower compared with controls. In the F2 hybrid, there was a 3:1 segregation of viability and a 1:2:1 segregation of the activity level of JH-esterase at high temperatures. It is concluded that the activity level of JH-esterase and heat resistance in D. virilis are monogenically controlled at high temperatures. PMID- 6860293 TI - Physiological effects of an allozyme polymorphism: glutamate-pyruvate transaminase and response to hyperosmotic stress in the copepod Tigriopus californicus. AB - In order to regulate cell volume during hyperosmotic stress, the intertidal copepod Tigriopus californicus, like other aquatic crustaceans, rapidly accumulates high levels of intracellular alanine, proline, and glycine. Glutamate pyruvate transaminase (GPT; EC 2.6.1.2), which catalyzes the final step of alanine synthesis, is genetically polymorphic in T. californicus populations at Santa Cruz, California. Spectrophotometric studies of homogenates derived from a homozygous isofemale line of each of the two common GPT alleles indicated that the GPTF allozyme has a significantly higher specific activity than the GPTS allozyme. Under conditions of hyperosmotic stress, individual adult copepods of GPTF and GPTF/S genotypes accumulated alanine, but not glycine or proline, more rapidly than GPTS homozygotes. When young larvae were subjected to the same hyperosmotic conditions, GPTS larvae suffered a significantly higher mortality than GPTF or GPTF/S larvae. These results suggest that the biochemical differences among GPT allozymes result in specific physiological variation among GPT genotypes and that this physiological variation is manifested in differential genotypic survivorships under some naturally occurring environmental conditions. PMID- 6860292 TI - Hypoxanthine-guanine phosphoribosyltransferase in human erythroid cells: degradation of the enzyme. AB - In a previous report we provided evidence that the three major hypoxanthine guanine phosphoribosyltransferase (HGPRT; EC 2.4.2.8) isozymes in human erythroid cells are derived by posttranslational modification of a single enzyme [Johnson, G. G. et al. (1982). Biochemistry 21: 960]. In the experiments reported here we provide further evidence that the modified isozymes have a catalytic activity that is at least as great as that of the unmodified enzyme. However, we also show that the total HGPRT activity decrease with red-cell age, by a factor of approximately 4, and that this decrease in activity is paralleled by a loss in HGPRT immunoreactive protein. We estimate that the loss of HGPRT activity and immunoreactive protein as well as the changes in the relative abundances of the major isozymes occur early in the cell's life. PMID- 6860295 TI - Protoplasmic incompatibility and the genetic control of stable messenger RNAs. AB - In Podospora anserina, protoplasmic incompatibility due to the combination of nonallelic genes is suppressed by the addition of a recessive mutation in the modA gene to a dominant mutation in the modB gene. The effect of the modA and modB mutations on several features of protoplasmic incompatibility was investigated. Results show that the modA mutation suppresses two of them: the shutoff of RNA synthesis and the inhibition of synthesis of normal proteins. The suppression of a third feature of protoplasmic incompatibility, i.e., the synthesis of specific proteins, involves both the modA and the modB mutations. Employing the dihydrostreptomycin sensitivity of the modA gene product, it is shown that the modA gene controls the synthesis of one of these proteins (laccase III) at a posttranscriptional level. Concerning the modB gene, its effect was studied by means of a thermosensitive recessive mutation in this gene. It is demonstrated that the presence of this mutation results in the occurrence, in the cell extract, of enzyme activities (laccase III and its associated activities) and polypeptides specific to protoplasmic incompatibility. Furthermore, it could be deduced that the modB gene operates on these syntheses at a posttranscriptional level. PMID- 6860296 TI - Ribosomal RNA gene number and sequence divergence in the diploid-tetraploid species pair of North American hylid tree frogs. AB - Hyla chrysoscelis (2n = 24) and H. versicolor (2n = 48) are a diploid-tetraploid species pair of tree frogs. Hybridization saturation of isolated 125I-labeled ribosomal RNAs (rRNAs) with filter-immobilized DNA shows that there are twice as many rRNA genes in the tetraploid as in the diploid. For the diploid, saturation occurs at 0.037%, from which it is calculated that there are about 618 copies of the (18 S + 28 S) rRNA genes per haploid genome. Analysis of the extent of hybridization and also the thermal stability of homologous and heterologous hybrids shows that considerably more base substitutions have occurred in the tetraploid rDNA genes than in the diploid since their divergence. This is interpreted to reflect either a relaxation of the gene regulatory "correction" mechanism hypothesized to be responsible for the maintenance of identical tandem rRNA genes in the tetraploid or a release of one gene set from the normal selective constraints. PMID- 6860297 TI - The chimpanzee M blood-group antigen is a variant of the human M-N glycoproteins. AB - Chimpanzee erythrocytes express strong M but weak, occasional N blood-group activity, as detected by anti-M and anti-N reagents. We have found that the M activity is carried by a major membrane glycoprotein that is similar but not identical to the human MM glycoprotein (glycophorin A). We have isolated and characterized this glycoprotein from erythrocyte membranes of four individual chimpanzees. The purified glycoproteins strongly inhibited agglutination of M cells by rabbit anti-human M sera and only weakly inhibited the agglutination of N cells by rabbit anti-human N sera. They also displayed medium-to-strong inhibitory activity against chimpanzee iso- and crossimmune antisera tested with chimpanzee erythrocytes of various V-A-B-D and Wc specificities, which are known as chimpanzee extensions of the human type M-N system and the Miltenberger counterpart, respectively. Each glycoprotein was cleaved with CNBr into three fragments, whose size, solubility, and composition were analogous to those obtained by similar treatment of the human M-N antigens. The amino-terminal fragment was found to be a glycooctapeptide whose amino acid composition and partial sequence indicated that it is an intermediate form of the human M and N glycooctapeptides. Its carbohydrate content comprised two threonine-linked saccharide units that, although similar in composition to the human threonine linked units, were fewer in number than the three units found in the corresponding human glycooctapeptides. Structural similarities to the human antigens strongly suggest that the amino terminus bears the major antigenic determinants of the molecule, and the occurrence in this region of numerous, albeit rare, variants among humans and in chimpanzees indicates that the corresponding coding sequence of the structural gene is particularly susceptible to mutational events. We conclude that the chimpanzee M gene product is a variant of the human type and that the chimpanzee gene is an allele of the human polymorphic M-N locus. PMID- 6860298 TI - Characterization of superoxide dismutase (SOD-1 and SOD-2) activities in inbred mice: evidence for quantitative variability and possible nonallelic SOD-1 polymorphism. AB - Liver Cu/Zn (SOD-1) and Mn (SOD-2) superoxide dismutase activities were determined in 12 inbred mouse lines. SOD-2 activity varied from 5 to 8 U/mg protein but was never more than 5% of the total. SOD-1 activity varied from 112 (SJL/J) to 155 (RF/J) U/mg protein, with the 12 strains falling into three activity classes. No correlation between SOD-1 activity and H-2 histocompatibility phenotype was observed, i.e., these two loci do not appear linked as previously suggested [Novak, R., Bosze, Z., Matkovics, B. and Fachet, J. (1980). Science 207:86]. Several tissues in all strains exhibited three SOD-1 charge electromorphs which did not differ in relative proportions between strains or tissues. The pI values of these three isozymes were 4.0, 4.5, and 5.0, respectively. The pI value of SOD-2 was 7.7. Both SOD-1 and SOD-2 were sensitive to CHCl3/EtOH extraction, but this sensitivity was not electromorph specific. Quantitation of the SOD-1 isozymic pattern indicated that the electromorphs were present at a ratio of 1:6:23 in order of increasing pI. Fitting of these data to a binomial distribution showed that they were consistent with the presence of two SOD-1 subunits (chains) of unequal pI. The mole fractions of the two chains were calculated to be 0.14 (lower-pI chain) and 0.86 (higher-pI chain). Since the mice used were highly inbred, this pattern could be due to unequal rates of transcription of linked, nonallelic SOD-1 loci, although other explanations are possible. The activity differences between SJL/J and RF/J appear large enough and the data precise enough to make genetic studies on the control of SOD-1 expression in the mouse practicable. PMID- 6860299 TI - Molecular weight differences in acid phosphatases of stem homogenates from L and S flax genotrophs. AB - Anionic acid phosphatase (AP) isozymes in stem homogenates of flax genotrophs L and S were examined electrophoretically. The banding pattern was similar in both genotrophs. Relative mobility (Rm) was faster in each band of L than in the corresponding band of S. These Rm shifts did not result from differences in the sample concentration or from differential rates of development. AP activity was the same in both genotrophs. The banding pattern of F1 hybrids resembled the parental pattern. No multiple banding was observed in any of the F1 bands. The Rm in the F1 hybrids showed a dominance of L. Plots of loge (Rm) against gel concentration were constructed. While the Y intercepts of the plots indicated some differences in free electrophoretic mobility, molecular conformation was the major factor underlying both the Rm differences between bands and the Rm shifts between L and S, for corresponding bands. Estimates of apparent molecular weight (MW) for the different bands ranged from 25,000 to 250,000, with a strong possibility that some bands were oligomeric forms of others. Apparent MW was, on average, 17% higher in S than L. PMID- 6860300 TI - Glutathione S-transferase activities in the yellow-fever mosquito [Aedes aegypti (Louisville)] during growth and aging. AB - Our previous findings [Hazelton & Lang (1978) Fed. Proc. Fed. Am. Soc. Exp. Biol. 37(6), 2378 (abstr.)] demonstrated aging-specific changes in glutathione concentrations in the yellow-fever mosquito [Aedes aegypti (Louisville)]. A possible mechanism could be increased utilization via glutathione S-transferase. Thus glutathione S-transferase activities were measured in mosquito samples from the entire life span, including growth, maturity and senescence. Methods were validated for the quantitative determination of transferase activities with 1,2 dichloro-4-nitrobenzene (DCNB) and 1-chloro-3,4-dinitrobenzene (CDNB) as second substrates. Marked changes occurred during the life span, and the profiles for both DCNB and CDNB activities were identical. The activities increased throughout larval development and reached a maximum in the metamorphosis stage. The activities decreased at the end of metamorphosis in the 5-day-old adult, reached a plateau during maturity (5-20 days), and then decreased 31% (P less than 0.007) during senescence (after 33 days). This senescence-specific decrease occurred in both sexes and was localized in the abdominal region. Further kinetic analyses indicated that the lower enzyme activities were most likely due to lower amounts of active enzyme rather than a change in kinetic properties. These findings indicate that the capacity for GSH utilization via glutathione S-transferase is diminished with aging. This does not explain our previously observed decreases in GSH, but the results suggest that GSH-linked detoxification would be impaired during senescence. PMID- 6860301 TI - Glutathione biosynthesis in the aging adult yellow-fever mosquito [Aedes aegypti (Louisville)]. AB - Our previous findings [Hazelton & Lang (1978) Fed. Proc. Fed. Am. Soc. Exp. Biol. 37(6), 2378 (abstr.)] demonstrated a senescence-specific decrease in glutathione (GSH) concentration in the yellow-fever mosquito Aedes aegypti (Louisville)]. As a possible mechanism for this change, GSH biosynthesis was investigated in adult mosquitoes of different ages through the life-span. Biosynthesis was measured as the incorporation rate of [14C]glycine or [14C]cystine into glutathione. Essential information to validate the procedure was also obtained on the precursor-amino-acid pool sizes and kinetic parameters such as lag-time and time course of incorporation. Also, synthesis de novo rather than exchange was verified using buthionine sulphoximine, a specific inhibitor of GSH biosynthesis. The synthetic rates with either amino acid precursor varied throughout the adult life-span, but the patterns for both precursors were essentially identical. Biosynthesis was high in the newly emerged adult and decreased 62-70% (P less than 0.005) to a plateau during maturity. From the mature value there was a decrease of 36-41% (P less than 0.005) to a new plateau during senescence. Glutathione biosynthesis and concentration were correlated throughout maturity and senescence (r = 0.982) and thus biosynthesis was proportional to glutathione content. On this basis we concluded that impaired biosynthesis is the major and perhaps sole mechanism for the aging decrease in glutathione content. PMID- 6860303 TI - Plasma clearance and endocytosis of cytosolic malate dehydrogenase in the rat. AB - 1. Pig heart cytosolic malate dehydrogenase was radiolabelled with O-(4-diazo-3,5 di-[125I]iodobenzoyl)sucrose and intravenously injected into rats. Enzyme activity and radioactivity were cleared from plasma identically, with first-order kinetics, with a half-life of about 30 min. 2. The tissue distribution of radioactivity was determined at 2 h after injection. All injected radioactivity was recovered from the tissues. A high percentage of the injected dose was found in liver (37%), spleen (6%) and bone including marrow (19%). 3. Radioactivity in liver and spleen increased up to 2 h after injection and subsequently declined, with a half-life of about 20 h. 4. After differential fractionation of liver, radioactivity was largely found in the mitochondrial and lysosomal fraction. 5. Liver cells were isolated 1 h after injection of labelled enzyme. We found that Kupffer cells, endothelial cells and parenchymal cells had endocytosed the enzyme at rates corresponding to 2725, 94 and 63 ml of plasma/day per g of cell protein respectively. 6. Radioautography indicated that in spleen and bone marrow the enzyme is mainly taken up by macrophages. 7. Internalization of the enzyme by liver, spleen and bone marrow was saturable. This indicates that the enzyme is taken up in these tissues by adsorptive endocytosis. 8. The present results closely resemble those obtained previously for the mitochondrial isoenzyme of malate dehydrogenase and for lactate dehydrogenase M4. Since those enzymes are positively charged at physiological pH, whereas cytosolic malate dehydrogenase is negative, net charge cannot be the major factor determining the rate of uptake of circulating enzymes by reticuloendothelial macrophages, as has been suggested in the literature [Wachsmuth & Klingmuller (1978) J. Reticuloendothel. Soc. 24, 227 241]. PMID- 6860302 TI - Isolation of a plasma-membrane fraction from gastric smooth muscle. Comparison of the calcium uptake with that in endoplasmic reticulum. AB - 1. A plasma-membrane fraction was isolated from the smooth muscle of the pig stomach by using differential and sucrose-density-gradient centrifugations. When the centrifugation was carried out after preloading the crude microsomal fraction with Ca2+ in the presence of oxalate, the contamination of the plasma-membrane fraction by endoplasmic reticulum was decreased and a fraction enriched in endoplasmic reticulum vesicles filled with calcium oxalate crystals was obtained. 2. The plasmalemmal and endoplasmic-reticulum membranes could be distinguished by differences in the activity of marker enzymes and in the cholesterol content and by their different permeability to oxalate and phosphate. Oxalate and phosphate stimulated the Ca2+ uptake in the endoplasmic reticulum much more than in the plasmalemmal vesicles. In the plasma-membrane vesicles 40 mM-phosphate was more effective for stimulating the Ca2+ uptake than was 5 mM-oxalate, but the reverse was seen in the endoplasmic reticulum. 3. The high cholesterol/phospholipid ratio of the crude microsomal fraction are of the majority of the vesicles present in the crude microsomal fraction are of plasmalemmal origin. 4. The Ca2+ pump of the plasmalemmal and endoplasmic-reticulum vesicles could be differentiated by their different sensitivities to calmodulin. However, the two Ca2+-transport ATPases did not differ by their sensitivity to vanadate nor by the energization of the Ca2+ transport by different nucleoside triphosphates. PMID- 6860306 TI - Abnormal phosphocreatine metabolism in perfused diabetic hearts. A 31P nuclear magnetic-resonance study. AB - 31P n.m.r. analysis of control and diabetic hearts perfused for 1 h with a glucose buffer showed constant and normal levels of phosphocreatine and ATP. Supplementing the buffer with 0.5, 1.2 or 2.0 mM-palmitic acid had little or no effect on high-energy-phosphate levels in control hearts. In contrast, increases in palmitate concentration produced significant decreases in ATP in diabetic hearts, despite normal and constant levels of phosphocreatine. This 31P n.m.r. study suggests a defect in phosphocreatine metabolism in the perfused diabetic heart that might be related to creatine kinase kinetics. PMID- 6860304 TI - Arteriovenous differences for amino acids across control and acid-secreting rat stomach in vivo. AB - 1. A method is described for measuring arteriovenous differences across the rat stomach in vivo. 2. Notable results were the uptake of branched-chain amino acids, the uptake of arginine, which was approximately balanced by an output of ornithine, and the output of alanine. 3. The fractional extraction of glutamine from the blood by the stomach wall of pentagastrin-stimulated rats was 4.7%. 4. The arteriovenous differences for ammonia depended upon the blood ammonia concentration. 5. Arteriovenous differences were not affected by the stimulation of acid secretion with pentagastrin. 6. It is concluded that the high activity of branched-chain-amino-acid aminotransferase (EC 2.6.1.42) in the gastric mucosa is associated with metabolism of these amino acids, but that the stomach wall is a less avid user of glutamine than is the small intestine. PMID- 6860305 TI - Nucleoside transport in human erythrocytes. A simple carrier with directional symmetry in fresh cells, but with directional asymmetry in cells from outdated blood. AB - Kinetic characteristics of the transport of uridine, a non-metabolized permeant in human erythrocytes, have been compared in erythrocytes from fresh and outdated stored blood. Uridine transport kinetics in fresh cells conformed to the predictions of a simple carrier model operating with directional symmetry, but in erythrocytes from outdated blood the kinetic characteristics of uridine transport were those of an asymmetric system. The latter result agrees with earlier reports by others. The mobility of the loaded and empty carriers differed by about 6- and 12-fold in fresh and outdated blood, respectively. PMID- 6860309 TI - Induction by growth factors of polysaccharide synthases in bean cell suspension cultures. AB - Suspension cells of bean subcultured into medium that maintains the culture and stimulates cell division but not differentiation brings about an increase in arabinan synthase activity. Subculture into a medium that induces both cell division and xylogenesis brings about in addition an increase in xylan synthase. Both synthases are membrane-bound and are concerned with the formation of neutral pectin or hemicellulose of the cell wall respectively. During the rising phase of the induction of these activities in the appropriate culture medium, the increases in activities were inhibited by either actinomycin D (an inhibitor of transcription) or D-2-(4-methyl-2,6-dinitroanilino)-N-methylpropionamide (an inhibitor of translation). Thus the control for the induction of the enzyme activities involves transcription and possibly translation. Subculture of the cells brought about an increase, probably non-specific, in total membrane-bound translation, as indicated by increased amounts of bound polysomes and incorporation of [35S]methionine into membrane proteins. If the control of the appearance of specific mRNA molecules is partially effected by growth factors then these are probably operative during the period of the cell cycle that is stimulated by subculture and it is probably at this time that the growth factors act to bring about the changes necessary for differentiation. PMID- 6860307 TI - Interaction of bilirubin with human erythrocyte membranes. AB - The kinetics of [3H]bilirubin binding to human erythrocyte ghost membranes was investigated. The binding occurred rapidly and was saturable with respect to [3H]bilirubin and membrane concentration. The apparent dissociation constant (Kd) and maximum binding (Bmax.) for bilirubin of the membranes were 2.3 microM and 0.93 nmol/mg of protein respectively. Low-affinity binding, non-saturable at 400 microM, was observed. Thermal dependency of the saturable binding showed a U shaped curve with the lowest value around 37 degrees C. Affinity labelling of the membrane proteins using [3H]bilirubin-Woodward's reagent K complex did not define individual proteins. The Kd (12 microM) and Bmax. (4.4 nmol/mg of protein) for bilirubin of the tryptic membranes increased 5.0 and 5.2 times the respective control values (2.4 microM and 0.85 nmol/mg of protein). Heat-treatment of the membranes for 3 min at 100 degrees C increased the saturable binding as much as by 222%. These results indicate that there exist saturable bilirubin-binding sites on the erythrocyte membranes and also suggest that they are not composed of proteins. PMID- 6860308 TI - Arabinan synthase and xylan synthase activities of Phaseolus vulgaris. Subcellular localization and possible mechanism of action. AB - Membrane fractions from bean hypocotyl or suspension cultures incorporated arabinose from UDP-beta-L-arabinose into arabinan and xylose from UDP-alpha-D xylose in vitro; the level of each activity was dependent on the state of differentiation of the cells. These activities may be due to single transglycosylases, since no lipid or proteinaceous intermediate acceptors were found in either case. Subcellular fractionation studies showed that enzyme activity in vitro was localized in both Golgi-derived membranes and endoplasmic reticulum in similar amounts. However, incorporation into the polymers in vivo in suspension culture cells incubated with [1-3H]arabinose was considerably greater in the Golgi-derived membranes. Thus, although these enzymes may be translated and inserted at the level of the endoplasmic reticulum, their activities are under other levels of control, so that most of the activity in vivo is confined to the Golgi apparatus. Initiation of glycosylation in the endoplasmic activity may, however, occur. PMID- 6860310 TI - Characteristics of the beta-adrenergic adenylate cyclase system of developing rabbit bone-marrow erythroblasts. AB - After fractionation of rabbit bone marrow into dividing (early) and non-dividing (late) erythroid cells, the adenylate cyclase activity of membrane ghosts was assayed in the presence of guanine nucleotides ((GTP and its analogue p[NH]ppG (guanosine 5'-[beta, gamma-imido]triphosphate))), the beta-adrenergic agonist L isoprenaline (L-isoproterenol) and the antagonist L-propranolol. Both GTP and p[NH]ppG increased the adenylate cyclase activity of early and late erythroblasts, whereas the stimulating effect of the beta-adrenergic drug L isoprenaline was limited to the immature dividing bone-marrow cells. The effect of L-isoprenaline was completely inhibited by the antagonist L-propranolol, confirming that the response was due to stimulation of beta-adrenergic receptors on the plasma membrane. The lack of response of non-dividing erythroblasts to beta-adrenergic stimuli is not due to loss of beta-receptors, since both dividing and non-dividing cells bind the selective ligand [125I]iodohydroxybenzylpindolol with almost equal affinities, the apparent dissociation constants, Kd, being 0.91 X 10(-8)M and 1.0 X 10(-8) M respectively. The number of beta-adrenergic receptors per cell was 2-fold higher in the dividing cells. No significant change in binding affinity for GTP and p[NH]ppG during erythroblast development was observed: the dissociation constants of both guanine nucleotides were almost identical with early and late erythroblast membrane preparations [2-3 (X 10(-7) M]. With dividing cells, however, in the presence of L-isoprenaline the dissociation constants of GTP and p[NH]ppG were lower (6 X 10(-8) M). The dose response curves for isoprenaline competition in binding of [125I]iodohydroxybenzylpindolol by dividing cells showed that the EC50 (effective concentration for half maximum activity) value for isoprenaline was higher in the presence of p[NH]ppG. With non-dividing cells the EC50 value for isoprenaline was equal in the presence and in the absence of p[NH]ppG and similar to that observed with dividing-cell membranes in the presence of the nucleotide. Thus differentiation of rabbit bone-marrow erythroid cells seems to be accompanied by uncoupling of the beta-adrenergic receptors from the adenylate cyclase catalytic protein as well as by a decrease in the number of receptors per cell, but not by changes in the catecholamine and guanine-nucleotide-binding affinities. PMID- 6860311 TI - NADPH-dependent reduction of 2,6-dichlorophenol-indophenol by the phagocytic vesicles of pig polymorphonuclear leucocytes. AB - NADPH-dependent 2,6-dichlorophenol-indophenol (DCIP) reductase activity in the homogenate of phagocytosing pig polymorphonuclear leucocytes was twice that of the resting cells and the activity in the phagocytic vesicles corresponded to the activity increment due to phagocytosis. The apparent Km value of the reductase activity in the vesicles for NADPH was 30 microM, which is similar to that of the NADPH-dependent superoxide (O2-) formation. Increasing the DCIP reductase activity by increasing the DCIP concentration caused a decrease in the O2- forming activity, the NADPH oxidation rate being constant and independent of the dye concentration. p-Chloromercuribenzoate and cetyltrimethylammonium bromide at low concentrations inhibited the O2- -forming activity of the vesicles without inhibiting the DCIP reductase. Quinacrine inhibited both O2- formation and DCIP reduction. The DCIP reductase activity could be extracted with a mixture of deoxycholate and Tween-20, which extracts the O2- -forming activity. The reductase activity in the extract was enhanced 2-fold by the addition of FAD, and its apparent Km was 0.085 microM. These results indicate that the NADPH-dependent DCIP reductase activity of the phagocytic vesicles is catalysed by a flavin containing component of the O2- -forming system. PMID- 6860312 TI - Photosynthetic electron transport in thylakoid preparations from two marine red algae (Rhodophyta). AB - Thylakoid membrane preparations active in photosynthetic electron transport have been obtained from two marine red algae, Griffithsia monilis and Anotrichium tenue. High concentrations (0.5-1.0 M) of salts such as phosphate, citrate, succinate and tartrate stabilized functional binding of phycobilisomes to the membrane and also stabilized Photosystem II-catalysed electron-transport activity. High concentrations (1.0 M) of chloride and nitrate, or 30 mM Tricine/NaOH buffer (pH 7.2) in the absence of salts, detached phycobilisomes and inhibited electron transport through Photosystem II. The O2-evolving system was identified as the electron-transport chain component that was inhibited under these conditions. Washing membranes with buffers containing 1.0-1.5 M-sorbitol and 5-50 mM concentrations of various salts removed the outer part of the phycobilisome but retained 30-70% of the allophycocyanin 'core' of the phycobilisome. These preparations were 30-70% active in O2 evolution compared with unwashed membranes. In the sensitivity of their O2-evolving apparatus to the composition of the medium in vitro, the red algae resembled blue-green algae and differed from other eukaryotic algae and higher plants. It is suggested that an environment of structured water may be essential for the functional integrity of Photosystem II in biliprotein-containing algae. PMID- 6860313 TI - The effect of malonyl-CoA on overt and latent carnitine acyltransferase activities in rat liver and adipocyte mitochondria. AB - 1. Carnitine palmitoyltransferase and carnitine octanoyltransferase activities were measured in mitochondria at various acyl-CoA concentrations before and after sonication, thus permitting assessment of both overt and latent activities. 2. Overt carnitine palmitoyltransferase in liver and adipocyte mitochondria and overt carnitine octanoyltransferase in liver mitochondria were inhibited by malonyl-CoA. None of the latent activities were affected by this metabolite. 3. 5,5'-Dithiobis-(2-nitrobenzoic acid) stimulated latent hepatic carnitine palmitoyltransferase at low [palmitoyl-CoA]. 4. Starvation (24 h) decreased overt carnitine palmitoyltransferase activity in adipocyte mitochondria, but did not alter the sensitivity of this activity to malonyl-CoA. PMID- 6860314 TI - Non-metabolizable amino acids are potent stimulators of hepatic and renal ornithine decarboxylase activity. AB - The non-metabolizable amino acids alpha-aminoisobutyric acid (AIB) and cycloleucine and the poorly metabolizable amino acid D-alanine potently stimulated hepatic ornithine decarboxylase (ODC) activity in starved rats. The stimulation by AIB was shown to have several of the characteristics of stimulation by a protein meal and occurred in hypophysectomized animals. AIB also stimulated renal, but not brain or heart, ODC activity. PMID- 6860315 TI - Coupling ratio of electrogenic Na+-alanine cotransport in isolated rat hepatocytes. AB - Na+-alanine cotransport across the cell membrane in isolated rat hepatocytes was studied. Changes in the cell membrane potential associated with the transport of alanine interfere with determination of the Na+-alanine coupling ratio of the cotransport. With valinomycin present to 'clamp' the cell membrane potential, a coupling ratio of 1:1 for the Na+-alanine influx was obtained. PMID- 6860316 TI - Glycine uptake by erythrocytes in iron deficiency anemia. AB - Glycine uptake by erythrocytes from cases of iron deficiency anemia, megaloblastic anemia, and anemia of chronic renal failure and hypothyroidism has been studied. Concentrative uptake, characteristically observed only in iron deficiency, is dependent on a favorable Na+ gradient and is inhibited by p chloromercuribenzoate. Transport appears to be mediated by a carrier whose possible relation to iron deficiency is discussed. PMID- 6860317 TI - The urinary excretion of ethylmalonic acid: what level requires further attention? AB - The urinary excretion of ethylmalonic acid was studied in various patients, including children with glutaric aciduria type II and with beta-ketothiolase deficiency. An increased excretion at a modest level was found in 20 out of 5000 children who were referred for screening of inherited metabolic disease. Two children were studied longitudinally, but no clue to the origin of ethylmalonic acid was found in these cases. It is concluded that follow-up investigation of abnormal ethylmalonic acid excretion is only indicated when additional organic acids such as dicarboxylic acids are excreted in large amounts. PMID- 6860318 TI - NADP-linked isocitrate dehydrogenase from beef liver: a new method of purification and the effect of metal ion cofactor on its stability. AB - 1. A more rapid and efficient method of purification of beef liver NADP-linked isocitrate dehydrogenase is reported. The method involves gel filtration, ion exchange, and affinity chromatography techniques. The enzyme is obtained in pure form with a recovery of 33%. The specific activity is 43 U/mg at 25 degrees C in the presence of Mn2+ ions and 31 U/mg under previously reported conditions and assuming a specific absorption coefficient of 1.29 cm2/mg at 280 nm. Both the yield and the specific activity are higher than the previously reported values. The apparent Km values for isocitrate and NADP+ are 1.7 and 7.3 microM, respectively, in the presence of 0.2 mM MnCl2, from the initial rate data obtained with a sensitive fluorimeter. 2. The stability of the enzyme at 25 degrees C is investigated. The enzyme is rapidly inactivated when preincubated with isocitrate and NADP+, in the absence of metal ion, and it cannot use free isocitrate as substrate. PMID- 6860319 TI - Protein turnover and physical fitness in man. AB - The whole-body flux and protein-synthesis rates were determined in two groups of adult males aged 20-30 years who were matched for height and weight. [15N]Glycine was used as a tracer. Flux and synthesis rates were calculated from the urinary ammonia 15N excretion enrichment. Group I consisted of international competition level oarsmen, while Group II engaged in no exercise program. Measurement of the urinary nitrogen excretion rate showed that the oarsmen excreted more than twice as much nitrogen as the control group (P less than 0.05). RESULTS: flux and synthesis were 21.3 +/- 3.2 gN/9 hr and 188.7 +/- 59.9 g protein/day for the oarsmen and 16.4 +/- 2.1 g N/9 hr and 201.7 +/- 33.0 g protein/day for the controls. Data are +/- 1 SD for the eight oarsmen and eight controls. The flux values were different at the P less than 0.05 level. We concluded that (i) an exercise program does not lead to an increase in the basal protein turnover rate in adequately nourished individuals. PMID- 6860320 TI - Effects of cholesterol feeding on primate serum lipoproteins. III. The change in high density lipoprotein components. AB - Sooty mangabey (Cercocebus atys) monkeys had a lower serum HDL cholesterol concentration than any other Old World monkey species reported. In addition, they had a higher serum Lp(a) concentration than other species. The mangabeys were fed a cholesterol-fat diet for 5 weeks. HDL2 and HDL3 amounts were determined from the two peaks apparent upon analytical ultracentrifugation. In the first 1-3 weeks, 13 of the 14 mangabeys increased 30% (mean) in total HDL, this increase occurring only in the HDL2 fraction. After 5 weeks, HDL and HDL2 decreased markedly. During the cholesterol feeding, HDL3 continually decreased in flotation rate, indicating it was either smaller and/or denser. HDL2 and HDL3 separated well on molecular sieving agarose columns during the diet period, whereas a single symmetrical elution peak was found for chow-fed HDL. Thus on a cholesterol fat diet, HDL2 and HDL3 increased in difference in molecular size. PMID- 6860321 TI - Effect of vitamin E on adjuvant arthritis in rats. AB - Adjuvant arthritis was induced in rats fed a diet deficient in or supplemented with vitamin E, and its severity was scored according to the macroscopic findings of their legs, tails, and ears. The average score so obtained was higher in the vitamin E-deficient diet group than in the group of rats supplemented with vitamin E. Whereas the A/G ratio remained depressed in vitamin E-deficient rats, rats on a vitamin E-supplemented diet showed a fast recovery from A/G-ratio depression. The serum levels of beta-glucuronidase and acid phosphatase were elevated after administration of an adjuvant. The serum levels of these lysosomal enzymes showed a remarkable increase in rats fed a vitamin E-deficient diet, while the elevation in lysosomal enzyme levels in rats fed a vitamin E supplemented diet was inhibited. The levels of thiobarbituric acid (TBA) reactants in the synovia were elevated at 2 weeks after exposure to the adjuvant and were decreased thereafter. In rats maintained on a diet supplemented with vitamin E, on the other hand, the increase in synovial level of TBA reactive substances was inhibited. These observations suggest that the aggravation of adjuvant arthritis may be associated with lipid peroxidation and that antioxidants, such as vitamin E, may be beneficial for arthritis. PMID- 6860323 TI - Factors affecting the exchange of apoproteins between human high density lipoprotein subclasses in vitro. AB - We have presented evidence that apoproteins may exchange, in vitro, between all HDL subclasses tested, including HDL2b, HDL2a, HDL3, and HDL4. This exchange process is influenced by various factors including the concentrations of the subclasses and the presence of added apoprotein. This exchange process should be considered when designing experiments using HDL subclasses in vitro, and the importance of exchange in the in vivo situation should be a subject of further investigation. PMID- 6860324 TI - In vitro absorption of [14C]leucine during inflammation and the effect of antiinflammatory drugs in the jejunum of rats. AB - 1. Inflammation was induced in the hindlegs of rats by formalin injection and the in vitro absorption of [14C]leucine was studied. 2. Treatment of rats with formalin caused a reduction in the in vitro absorption of leucine from the mucosa of jejunum. 3. Oral administration of oxyphenbutazone or a herbal anti inflammatory drug (Withania somnifera) prior to formalin injection resulted in no alteration in the jejunal absorption of [14C]leucine. PMID- 6860322 TI - Effect of Intralipid-infusion on erythrocyte membrane in rabbits. AB - Through Intralipid infusion in rabbits, the phospholipids derived from Intralipid were incorporated into erythrocytes, although Intralipid is mainly composed of triglycerides. This is supported by the increase in oleic acid and the compensatory decrease in linoleic acid of the phospholipids in the erythrocyte membrane, corresponding to the content of linoleic acid in the phospholipids from Intralipid. The excess phospholipid rendered the membrane more fluid, probably by overwhelming the rigidifying effect of the increased cholesterol content. Furthermore, the shape of erythrocytes was changed from biconcave to spur, dose dependently. The morphological alterations in erythrocyte membranes could not be completely elucidated by the changes in lipid. These results suggested that the alteration in lipid metabolism in Intralipid-infused rabbits caused various effects on the erythrocyte membrane, through the elevation of triglyceride, cholesterol, and phospholipid contents in plasma. PMID- 6860325 TI - Monoclonal antibodies against the human acetylcholine receptor. AB - Monoclonal cell lines synthesizing antibodies against partially purified acetylcholine receptor from human muscle (H.AChR) were produced. Eleven clones secreted antibodies against H.AChR. Four were obtained in ascitic form. Two of them have been exhaustively studied. Specificity and affinity for H.AChR were demonstrated. Cross-reactivity with mouse AChR was shown but not with torpedo or porcine AChR at the same concentration. Purified IgG injected intravenously provoked an obvious muscular weakness. Inhibition experiments on myasthenia gravis sera binding have demonstrated that monoclonal antibody specificity is directed against an antigenic determinant shared by human and mouse AChR. PMID- 6860326 TI - The backbone and side chain conformations of the cyclic tetrapeptide HC-toxin. AB - A study of the conformational parameters of HC-toxin and its diacetyl derivative in chloroform solution has been carried out. Two-dimensional NMR spectroscopy and the nuclear Overhauser effect have been used in order to determine connectivities (assignments and sequence) and approximate torsion angles and interproton distances. The results are consistent with a bis-gamma-turn conformation previously reported for dihydrochlamydocin. Model building based upon NMR data supports a D configuration for Ala2 and Pro4 residues. PMID- 6860327 TI - Fluorescence excitation profiles of beta-carotene in solution and in lipid/water mixtures. AB - Intrinsic fluorescence from all-trans beta-carotene molecules in solution and embedded in lipid/water mixtures has been observed under laser excitation and its excitation profiles measured. The profiles closely correspond to the absorption spectra. The observations can be explained in terms of a low-lying 1Ag excited state. PMID- 6860328 TI - Saturation behavior of the manganese-containing superoxide dismutase from Paracoccus denitrificans. AB - A pulse radiolysis study of the Mn-superoxide dismutase from Paracoccus denitrificans has shown that, at concentration of 0(2)-. below 0.8 x 10(-4)M, the catalyzed dismutation of 0(2)-. is a first order reaction with regard to 0(2)-.. At concentration of 0(2)-. above 0.8 x 10(-4)M, the Mn-superoxide dismutase is shown to catalyze superoxide dismutation with a mechanism which exhibits saturation kinetics. This behavior was previously found in the bovine Cu/Zn superoxide dismutase and in the Fe-superoxide dismutase from Photobacterium leiognathi. Two parameters of catalysis were determined from pH 5 to pH 11: the rate constant k was pH independent at basic pH. The variation of Km with pH indicated that the enzyme possessed an ionizable group with pK 9.8 which participates to the substrate binding. PMID- 6860329 TI - A 400 MHz 1H NMR study of fortuitin, a natural linear lipopeptide. AB - Fortuitin is a linear acyl nonapeptide methyl ester in which all the peptide residues are hydrophobic. Its 400 MHz 1H NMR spectrum in pyridine-d5 has been assigned. In this solvent, its conformation is not random and seems to form a hairpin. Conformational equilibria exist in pyridine as well as in less polar solvents such as CDCl3 and CD2Cl2. As for other lipopeptides, conformation and self-association properties strongly depend on the polarity of the environment. These properties should be related to the interactions of lipopeptides with membranes and to their capacity to induce pore formation. PMID- 6860330 TI - The effect of copper chelating drugs on liver iron mobilization in the adult rat. AB - To test the hypothesis that ferroxidase I (ceruloplasmin) activity is essential for iron mobilization, adult rats were fed a copper sufficient diet with or without the chelating drugs D-penicillamine and triethylenetetramine for 120 days. By day 6 of treatment and for the remainder of the experiment the drug-fed rats showed low plasma copper concentration and low ferroxidase I activity. Plasma ferroxidase II activity in the DPA and TETA groups tended to be slightly lower than that of controls. No animals became anemic. Therefore, persistent low plasma ferroxidase I does not necessarily cause anemia in the adult rat. PMID- 6860331 TI - Mono (ADP-ribosyl)ation of hen liver nuclear proteins suppresses phosphorylation. AB - The phosphorylation of nuclear proteins from hen liver nuclei was suppressed under conditions of incubation with NAD. The reconstituted protein kinase assay system containing heat-treated and subsequently ADP-ribosylated nuclei and NI type protein kinase revealed that the ADP-ribosylated nuclear proteins are poor acceptors for the phosphorylation reaction. Therefore, mono(ADP-ribosyl)ation may contribute to the regulation of phosphorylation reaction in nuclei. PMID- 6860332 TI - Induction of endoreduplication in Chinese hamsters V79 cells by cytosine arabinoside. AB - Endoreduplication (ER) could be induced very effectively in Chinese hamster V79 cells exposed to cytosine arabinoside (1-beta-D-arabinofuranosylcytosine; Ara-C). Cells were cultured for 48 hours in Ara-C containing medium. ER frequency increases rapidly after Ara-C release. About 60% of metaphase cells were endoreduplicated at 8-10 hours after release from Ara-C (5 micrograms/ml). Induction of ER also depends on Ara-C concentrations. PMID- 6860335 TI - [3H]nimodipine specific binding to cardiac myocytes and subcellular fractions. AB - [3H]Nimodipine binding was studied in isolated myocytes from rat heart and in partially purified sarcolemma, sarcoplasmic reticulum and mitochondrial fractions from dog heart. In isolated myocytes, the density of [3H]nimodipine specific sites (10(6) per cell) was close to density of [3H]QNB sites (0.8 x 10(6) per cell) and higher than that of [3H]DHA sites (0.2 x 10(6) per cell). During subcellular fractionation, [3H]nimodipine binding did not copurify with plasma membrane markers. The highest densities were found in fractions enriched in sarcolemma or in sarcoplasmic reticulum. No specific binding was found in mitochondria. These results indicate that the localization of [3H]nimodipine sites is not restricted to areas of the plasma membrane rich in beta adrenoceptors, muscarinic receptors and sodium pump sites. PMID- 6860333 TI - 31P NMR and viscometric studies of the interaction of meso-tetra(4-N methylpyridyl) porphine and its Ni(II) and Zn(II) derivatives with DNA. AB - The interactions of meso-tetra(4-N-methylpyridyl) porphine (TMPyP) and its Zn(II) and Ni(II) derivatives with DNA have been investigated by 31P NMR and viscometric titrations. TMPyP and its Ni derivative increase the viscosity of linear DNA, cause unwinding and reverse coiling of superhelical DNA, and induce a separate downfield peak in the 31P NMR spectrum of DNA. The Zn derivative slightly decreases the viscosity of linear DNA, does not unwind superhelical DNA, and does not give a downfield NMR peak. The main DNA 31P NMR signal is shifted slightly upfield on either the addition of TMPyP or the Ni compound. These results indicate that TMPyP and the Ni(II), but not the Zn(II), derivative bind to DNA by intercalation. PMID- 6860334 TI - Oxygen-induced inhibition of light-dependent uptake of tetraphenylphosphonium ions as a probe of a direct interaction between photosynthetic and respiratory components in cells of Rhodopseudomonas capsulata. AB - Light-generated and oxygen-dependent membrane potentials by heterotrophycally grown cells of Rhodopseudomonas capsulata have been investigated by using a tetraphenylphosphonium ion-selective electrode. The results show that respiratory electron transport affects the magnitude of photogenerated membrane potential while photosynthesis seems to either inhibit or stimulate respiration in coupled or uncoupled cells, respectively. These observations have been considered as evidence that the intracytoplasmic membrane system of R. capsulata contain respiratory and photosynthetic apparatuses which are strictly intermingled. PMID- 6860336 TI - Exit of proteins and fragments thereof from mitochondria is accelerated by the import of cytosolic synthesized proteins. AB - Most mitochondrial proteins are synthesized on cytosolic ribosomes and imported into mitochondria. Incubation of 35S-methionine labeled mitochondria from rat hepatocytes with proteins synthesized in a cell-free system, using messenger RNA from rat liver, dramatically increased the release of mitochondrial proteins and fragments thereof into the medium. Since the synthesized proteins include cytosolic precursors of mitochondrial proteins, our results strongly suggest that import of proteins from the cytosol into mitochondria influences the half-life of proteins in these organelles. The use of this simple approach--i.e. combining the study of protein import and exit with mitochondria--to further clarify intracellular protein turnover and its regulation is suggested. PMID- 6860337 TI - Reconstitution of the dicarboxylate exchange activity by incorporation into liposomes of a Triton-extract of mitochondrial rat-liver inner membranes. AB - The exchange between external [14C] malonate and internal malate or phosphate was reconstituted in liposomes prepared by incorporation of a Triton-extract of mitochondrial rat-liver inner membranes. The conditions of transport were investigated and the kinetic parameters of malonate-malate and malonate-phosphate exchanges were determined. The exchange was sensitive to butylmalonate and to organomercurials. Sulfate and phosphate decreased the rate of malonate-malate exchange and phosphate inhibition was found to be competitive. This report demonstrates the possibility to reconstitute a functional dicarboxylate transport and to use the system for further purification and for studies at the molecular level. PMID- 6860338 TI - Isolation and sequence of a non-opioid peptide derived from proenkephalin. AB - A non-opioid peptide derived from adrenal proenkephalin has been isolated and sequenced. The sequence of this peptide is Ser-Pro-His-Leu-Glu-Asp-Glu-Thr-Lys Glu-Leu-Gln (Proenkephalin 168-180). This sequence represents the portion of Peptide I that is cleaved to yield Peptide E. This peptide is processed in a similar manner to the opioid peptides and is present at approximately the same level as Peptide E. PMID- 6860339 TI - Chronic ethanol administration induced an increase in phosphatidylserine in guinea pig synaptic plasma membranes. AB - Chronic ethanol administration to guinea pigs via intragastric intubation elicited a specific increase (50%) in phosphatidylserine in the synaptic plasma membrane. The ethanol-treated group also showed a 53% increase in synaptosomal (Na,K)-ATPase activity. Analysis of the acyl group composition of individual phospholipids in the same membrane fraction revealed only small changes which varied depending on the type of phospholipids. Since the (Na,K)-ATPase is known to be specifically activated by phosphatidylserine, the adaptive increase in enzyme activity during chronic ethanol treatment may be related to the increase in this type of negatively charged phospholipid. PMID- 6860340 TI - Isolation of fatty acids covalently bound to the gastric mucus glycoprotein of normal and cystic fibrosis patients. AB - Covalently bound fatty acids were found in strictly purified and delipidated gastric mucus glycoprotein of normal and cystic fibrosis individuals. The susceptibility of this linkage to methanolic KOH and hydroxylamine treatment indicated the ester bond between fatty acids and glycoprotein. On the average, 2.9 nmol fatty acid/mg glycoprotein were found in normal samples, and 12.2 nmol/mg glycoprotein in samples derived from cystic fibrosis. In normal gastric mucus glycoprotein the covalently linked fatty acids consisted of hexadecanoate (47.0%), octadecanoate (22.0%), tetracosanoate (5.9%), octadecenoate (14.5%) and tetracosenoate (6.0%). In cystic fibrosis mucus glycoprotein the covalently bound fatty acids were comprised mainly of hexadecanoate (36.5%), octadecanoate (48.7%) and octadecenoate (8.6%). These data indicate that cystic fibrosis gastric mucus glycoprotein is highly acylated and perhaps this is the major defect of glycoproteins in this disease. PMID- 6860341 TI - Correlation between protein phenotype and gene expression in adult rabbit fast twitch muscles undergoing a fast to slow fiber transformation in response to electrical stimulation in vivo. AB - In this report we have defined three distinct stages of the fast to slow transformation of muscle in terms of the myosin isoenzyme pattern in a non denaturing gel system. In phase I a rearrangement of fast isoenzymes with no increase in slow isoforms took place. Phase II is characterised by a complex pattern of fast and slow isoenzymes and of isoenzymes of intermediate mobility. Phase III shows full conversion to the slow isoform with residual traces of fast and intermediate components. Changes in myosin light chains, as revealed by two dimensional gel analysis, showed good correlation with their corresponding mRNAs as determined by translation of extracted total RNA in a nuclease treated reticulocyte lysate cell-free system. This suggests that in the fast to slow transformation gene expression is regulated at the level of transcription. PMID- 6860342 TI - 2-fluoro-ATP: a toxic metabolite of 9-beta-D-arabinosyl-2-fluoroadenine. AB - Murine P388 cells incubated in vitro with the anticancer drug arabinosyl 2 fluoroadenine accumulate its 5'-triphosphate, F-araATP, as the major phosphorylated metabolite. A new chromatographically separate metabolite that accumulated to levels 10% of that of F-araATP was identified as 2-fluoro-ATP, by the following criteria. 1. The metabolite coeluted with the authentic compound on anion-exchange HPLC. 2. Dephosphorylation of the metabolite yielded a compound that was chromatographically identical to 2-fluoroadenosine. 3. The compound was sensitive to NaIO4 oxidation. Cellular incubation experiments indicated that 2 fluoroadenine, but not arabinosyl 2-fluorohypoxanthine, was the likely intermediate in the formation of 2-fluoro-ATP. PMID- 6860343 TI - Presence of low molecular weight polypeptides in human brunescent cataracts. AB - Microdissected sections from opaque & brunescent lens nuclei contain low molecular weight (4,000-8,000 dalton) polypeptides not found in microdissected sections of transparent lens nuclei. Tryptic digestion of these polypeptides from different cataracts reveal similar peptide maps. Together, these results support the involvement of proteolysis in human cataractogenesis, and suggest the possibility of similar molecular mechanisms occurring in cleavage of lens polypeptides during formation of the opaque & brunescent human cataract. PMID- 6860344 TI - alpha-Fluoromethyl histidine. Inhibition of histidine decarboxylase in pylorus ligated rat. AB - alpha-Fluoromethyl histidine is an irreversible inhibitor of histidine decarboxylase. The injection of a single dose to pyloric-ligated rats inhibits gastric mucosal histidine decarboxylase in a dose-dependent manner but does not modify histamine content and gastric acid secretion even at the highest dose used. Administration of cimetidine increases histidine decarboxylase activity, decreases histamine level in gastric mucosa and inhibits gastric acid secretion. The co-administration of alpha-fluoromethyl histidine blocks the augmentation in enzyme activity, maintains lowered histamine level and prolongs the antisecretory action of cimetidine. PMID- 6860345 TI - Kinetics of in vitro O-deethylation of phenacetin and 7-ethoxycoumarin by rat intestinal mucosal cells and microsomes. The effect of induction with 3 methylcholanthrene and inhibition with alpha-naphthoflavone. AB - A novel, sensitive (0.5 ng) assay for acetaminophen, using HPLC with selective electro-chemical detection, enabled us to study rat small intestinal O deethylation of phenacetin and compare it with corresponding 7-ethoxycoumarin-O deethylation. Two in vitro systems, i.e. isolated intestinal mucosal cells and microsomal fractions thereof, were used to study kinetics for the O-deethylation of both substrates. Kapp m- and Vmax-values are similar for 7-ethoxycoumarin- and phenacetin-O-deethylation. Apparent Km-values varied between 50 and 70 microM in control rats and decreased after 3-methylcholanthrene pretreatment to 20-45 microM. Vmax-values were increased by 3-methylcholanthrene pretreatment. O Deethylation was inhibited equally in cells and microsomes by alpha naphthoflavone, but is inhibited more markedly in intestinal preparations after pretreatment with 3-methylcholanthrene. It is suggested that 7-ethoxycoumarin and phenacetin are O-deethylated by different forms of cytochrome P-450 with almost identical Kapp m and that these enzymes have a different distribution along the villus. PMID- 6860346 TI - Use of pentachlorophenol as long-term inhibitor of sulfation of phenols and hydroxamic acids in the rat in vivo. AB - Inhibition of sulfation of the phenolic compound harmol (7-hydroxy-1-methyl-9H pyrido[3,4-b]indole) by pentachlorophenol (PCP) was studied in the Wistar rat: PCP was administered in various ways to find a convenient method for long-term inhibition of sulfation. High doses of PCP or sodium pentachlorophenolate (NaPCP) in the diet (350 ppm) or NaPCP in the drinking water (1.4 mM) of Wistar rats for one week inhibited the sulfation of harmol by 30-45%. The plasma concentration of PCP in rats with NaPCP (1.4 mM) in their drinking water was highest (270 microM) in the period that the animals were kept in the dark and consumed food and water. This is explained by a rapid elimination: the elimination of PCP from plasma, after intravenous administration, showed a biphasic disappearance curve with half lives of 2.17 and 7.24 hrs, respectively. This is much faster than in Sprague Dawley rats. A log-linear correlation was found between the plasma concentration of pentachlorophenol and the inhibition of harmol sulfation. Although administration of NaPCP to rats in their drinking water inhibited the sulfation of harmol only by 45%, it inhibited the sulfation of the carcinogenic arylhydroxamic acid N-hydroxy-2-acetylaminofluorene by 70-75%. PMID- 6860347 TI - Influence of hypoxia on the metabolism and excretion of misonidazole by the isolated perfused rat liver--a model system. AB - The isolated perfused rat liver was evaluated as a model system for the characterization of misonidazole metabolism under hypoxic conditions. Misonidazole metabolism by livers perfused under aerobic conditions was also examined. The clearance of misonidazole was more than three times greater under anaerobic compared to aerobic conditions (4.94 +/- 1.56 vs 1.27 +/- 0.22 ml/min; means +/- S.D., N = 3). Misonidazole metabolites were detected only in the bile. Analysis of these metabolites by reverse-phase high performance liquid chromatography (HPLC) demonstrated that misonidazole metabolism was also qualitatively changed when anaerobic conditions were employed. Misonidazole beta glucuronide was the major metabolite detected under aerobic conditions, but it was a minor metabolite in anaerobically perfused livers. The three major metabolites produced under anaerobic conditions were not characterized, but desmethyl misonidazole (RO-07-9963) and the 2-amino-imidazole derivative of misonidazole (1-[2-aminoimidazol-1-yl]-3-methoxy-2-propanol) were excluded as possible structures. PMID- 6860349 TI - Delayed biliary excretion of indocyanine green in rats with glycerol-induced acute renal failure. PMID- 6860348 TI - Carbon tetrachloride and bromotrichloromethane toxicity. Dual role of covalent binding of metabolic cleavage products and lipid peroxidation in depression of microsomal calcium sequestration. AB - We have investigated the importance of covalent binding and lipid peroxidation on the depression of microsomal calcium sequestration associated with in vitro metabolism of 14CCl4. Studies with CBrCl3 are also reported. In aerobic systems, promethazine was used to block lipid peroxidation, measured as malondialdehyde (MDA) generation. Effects of low levels of lipid peroxidation were tested in Fe2+ supplemented systems free of halogenated hydrocarbons. The results indicate that microsomal calcium sequestration can be depressed significantly by metabolism of either CCl4 or CBrCl3 in the absence of MDA generation, or by lipid peroxidation occurring in the absence of halogenated hydrocarbons. PMID- 6860352 TI - Reactivation of soman inhibited acetylcholinesterase in vitro and protection against soman in vivo by bispyridinium-2-aldoximes. PMID- 6860350 TI - Cultured human adult hepatocytes: a new model for drug metabolism studies. PMID- 6860351 TI - Cholinesterase and carboxylesterase activities in soman poisoned rats treated with bispyridinium mono-oximes HI-6 and HS-6. PMID- 6860353 TI - Uptake of [3H]nitrendipine into cardiac and smooth muscles. PMID- 6860354 TI - Time-dependent uptake and metallothionein-binding of gold, copper and zinc in the rat kidney. AB - In rats, in which the whole body burden of Au decreases rapidly, but biphasically, maximum kidney concns are not attained until 10-15 days after a single intraperitoneal dose of either Au(I) or Au(III). The concn of metallothionein-bound Au and of total kidney Cu, which also increases after the administration of the Au compounds, however, reach maxima at 5 days. Between at least 6 and 24 hr after Au treatment, the increases in the concn of Au and Cu in the metallothionein fraction are highly correlated. Measurements on the kidneys of animals at early times (15 min-6 hr) after dosing with Au(III) indicate that the Zn content of the (endogenous) metallothionein is depressed during the first hour, shows a transient increase at 2 hr and then falls to a minimum at 6 hr. Subsequent (6-24 hr) changes in metallothionein-bound Zn parallel those of metallothionein-bound Au and Cu. It seems, therefore, that Au and Cu are incorporated simultaneously into rat kidney metallothionein and this incorporation may be mediated by an initial displacement of Zn. In rats exposed to five doses of Au(III) the half-times of total and metallothionein-bound Au in the kidneys are appreciably longer than those in animals given a single dose. In both groups, the concns of Cu and Zn in the renal metallothionein do not decrease in parallel with that of Au, but change roughly in proportion to their whole kidney concns. In consequence, the metal composition of the metallothionein fraction, which remains above the endogenous concn in the normal kidney throughout an experimental period of 90-140 days, alters considerably with time. PMID- 6860356 TI - Effects of media of low osmolarity on the dense bodies of human platelets. AB - Exposure of human platelets to buffer at 30 milliosmoles (mOs) caused marked swelling of the cells (a volume increase of almost 300% as estimated from electronic sizing) without a statistically significant loss of dense bodies or a change in the measured diameter of the dense-body core (as examined electron microscopically in air-dried whole mounts). Even biochemically isolated dense bodies maintained the integrity of their electron-opaque cores in 30 mOs buffer. However, exposure of platelets to 30 mOs buffer reduced the platelet content of cytoplasmic 14C-labeled nucleotides and the vesicular content of [3H]5 hydroxytryptamine (5-HT) by 90%. It thus seems likely that the dense-body membrane displays a sufficiently low permeability to water to prevent swelling and dissolution of the core, but that exposure to hypotonic media allows stored 5 HT to cross the vesicular membrane. Impermeability of this membrane to 5-HT under normal conditions may, therefore, play an important role in the maintenance of vesicular 5-HT stores, rather than the presence of an intact dense-body core. The data also suggest that an "osmotic lysis" or "chemiosmotic" model of secretion may not account for the exocytotic release of human platelet dense bodies. PMID- 6860355 TI - The inhibition of catechol-O-methyltransferase by 2,3-dihydroxypyridine. AB - Despite its structural similarity to catechol, 2,3-dihydroxypyridine is not a substrate but a "dead-end" inhibitor of purified pig liver catechol-O methyltransferase. It inhibits the methylation of 3,4-dihydroxyphenylacetic acid competitively with an inhibitor constant of 15 microM. Against the methyl donor, S-adenosyl-L-methionine, it is an uncompetitive inhibitor (Ki = 85 microM). Clearly, although 2,3-dihydroxypyridine interacts with the catechol-binding site of the enzyme, the presence of a nitrogen in the ring alters its susceptibility to O-methylation. PMID- 6860357 TI - Depletion in vitro of mitochondrial glutathione in rat hepatocytes and enhancement of lipid peroxidation by adriamycin and 1,3-bis(2-chloroethyl)-1 nitrosourea (BCNU). AB - Treatment of isolated rat hepatocytes with 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) and adriamycin (ADR) produced a complete depletion of cellular glutathione accompanied by a significant increase in lactate dehydrogenase (LDH) leakage. Separation of the mitochondrial and cytoplasmic pools of glutathione by digitonin disruption showed that, although BCNU, a specific inhibitor of glutathione, completely depleted the cytoplasmic pool of glutathione, the mitochondrial supply was not entirely expended and LDH leakage was only moderately stimulated. Only after depletion of the mitochondrial supply of glutathione by ADR and BCNU did LDH leakage increase markedly. Measurement of lipid peroxidation, by monitoring malondialdehyde through the thiobarbituric acid procedure, showed that malondialdehyde accumulated more extensively and at a rate mirroring release of LDH from ADR/BCNU treated cells. The time of increase in LDH leakage and malondialdehyde production corresponded to the time of depletion of mitochondrial glutathione to less than 10% of the initial pool size. No such increase in LDH leakage was observed with BCNU or ADU treatment alone or when aminopyrine, an inhibitor of lipid peroxidation, was included. Aminopyrine was found to prevent, in a dose-dependent manner, both LDH leakage and malondialdehyde production stimulated by ADR/BCNU treatment. The protective effect peaked at 5 mM aminopyrine, and higher concentrations produced significant LDH leakage exhibiting LDH release kinetics different than those observed with ADR/BCNU. Although aminopyrine had no effect on the rate or extent of cytoplasmic glutathione depletion by ADR/BCNU treatment, the mitochondrial pool was conserved significantly in those cells protected by aminopyrine. These data suggest that enhanced hepatocyte damage observed after treatment with a combination of ADR and BCNU versus BCNU or ADR alone is due to the extensive depletion of mitochondrial glutathione supported by ADR after glutathione reductase inhibition. Further, enhancement of lipid peroxidation is strongly implicated in the mechanism of adriamycin toxicity. PMID- 6860358 TI - Identification and partial purification of hamster microsomal cytochrome P-450 isoenzymes. AB - We have identified and partially purified three forms of cytochrome P-450 from hamster liver microsomes. Phenobarbital (PB) treatment induced three major polypeptides with relative mobilities (Mr) of 47,000, 50,000 and 51,500. The 47,000 polypeptide was assigned as epoxide hydrolase, since it was also enhanced by trans-stilbene oxide (TSO) treatment. Two polypeptides (Mr = 48,500 and 53,500) were induced by both 3-methylcholanthrene (3-MC) and beta-naphthoflavone (BNF) treatments. Treatment with Aroclor 1254 induced three polypeptides (Mr = 48,500, 50,000 and 53,500), indicating the induction of both drug- and carcinogen inducible cytochrome P-450s. Liver microsomal benzo[a]pyrene hydroxylase activity was not affected significantly by any of these inducers. In contrast, it was induced 2- to 3-fold in lung microsomes by 3-MC, BNF or Aroclor 1254 treatment. Benzphetamine N-demethylase and 7-ethoxycoumarin O-deethylase activities, expressed as nmoles of product formed per min per mg of liver microsomal protein, were increased 3- to 4-fold by either PB or Aroclor treatment. The activity of 7 ethoxycoumarin O-deethylase was the only one enhanced significantly by 3 methylcholanthrene or beta-naphthoflavone treatment in liver microsomes. Pregnenolone-16-alpha-carbonitrile (PCN) and TSO did not alter any of these activities. The major polypeptides induced by PB (Mr = 50,000) and 3-MC (Mr = 48,500 and 53,500 respectively) were partially purified, to a specific content of 6-10 nmoles P-450/mg of protein and were active in catalyzing N-demethylation of benzphetamine, hydroxylation of benzo[a]pyrene, and O-deethylation of 7 ethoxycoumarin with different substrate specificity. None of these isoenzymes immuno-cross-reacted with antibodies prepared against rabbit cytochrome P-450LM2 or P-450LM4. PMID- 6860359 TI - S-adenosylhomocysteine hydrolase activity, deoxyadenosine triphosphate accumulation, and competence of thymocyte and spleen leucocyte response to mitogens in coformycin-treated mice. AB - The inhibition of S-adenosylhomocysteine hydrolase and accumulation of dATP in thymus, spleen and other tissues of mice treated with the adenosine deaminase inhibitor coformycin were studied in parallel with the competence of thymocytes and spleen leucocytes to undergo mitogen-induced transformation. Newborn mice were lethally sensitive to daily injections of coformycin, 0.2 mg/kg, whereas adult mice were not. Developmental profiles of enzymes of nucleoside metabolism showed adenosine deaminase and purine nucleoside phosphorylase to be greatest in thymus around day 20 and to decrease for animals older than 60 days. The most notable change was a 3-fold increase in spleen leucocyte adenosine deaminase activity between days 10 and 30. Adenosine deaminase activity was reduced to less than 10% of normal in tissues of newborns treated with coformycin for 12-14 days. S-Adenosylhomocysteine hydrolase was also reduced to 5-40% of normal with no evidence of tissue specificity. Both thymocytes and erythrocytes of coformycin treated mice accumulated dATP whereas spleen leucocytes did not. For coformycin treated mice, spleen leucocyte and thymocyte response to concanavalin A (Con A) was reduced to 20 and 60% of controls respectively. Coformycin, 3.6 microM, also potentiated the in vitro toxicity of adenosine and deoxyadenosine toward thymocytes or spleen leucocytes by approximately an order of magnitude. Our observations are consistent with dATP being involved in impairment of thymocyte responsiveness; however, it appears unlikely that either dATP elevation or S adenosylhomocysteine hydrolase inhibition is involved in the mechanism of impairment of spleen leucocyte response by coformycin. PMID- 6860360 TI - Effect of pretreatment with sodium phenobarbital on the toxicity of soman in mice. AB - Pretreatment with sodium phenobarbital induces hepatic microsomal enzymes which are responsible for the metabolic breakdown of a large number of endogenous and exogenous chemical compounds. A previous study [K. P. DuBois and F. K. Kinoshita, Proc. Soc. exp. Biol. Med. 129, 699 (1968)] reported that phenobarbital pretreatment reduced the toxicity of various organophosphorus anticholinesterases; however, the exact mechanism for the increased detoxification was not investigated. In this study, the effect of phenobarbital pretreatment on the toxicity of soman was investigated. Male mice were injected daily for 4 days with sodium phenobarbital (100 mg/kg, i.p.) and used in the various experiments 24 hr after the last injection. Phenobarbital pretreatment produced a significant increase in liver weight and decreased the sodium pentobarbital (75 mg/kg, i.p.) induced sleep-time to 41 min compared to 141 min in controls. The lethality of soman was reduced following phenobarbital pretreatment. In control mice, the soman 24 hr LD50 values (microgram/kg) were 130, 393 and 42 following s.c., i.p. and i.v. administration, respectively, whereas in phenobarbital-pretreated mice the soman 24 hr LD50 values (microgram/kg) were 261, 746 and 63 following s.c., i.p. and i.v. administration respectively. Acetylcholinesterase activity was increased in the plasma (90%) but not in brain or diaphragm following phenobarbital pretreatment. Liver somanase activity was not affected. Liver aliesterase and serum aliesterase were both increased significantly following phenobarbital pretreatment. An increase in the amount of nonspecific binding sites for soman (esterases in liver and plasma) and not an increase in the metabolism of soman in vivo probably accounts for the protection afforded by phenobarbital pretreatment in mice. PMID- 6860361 TI - On the mechanism of covalent binding of butylated hydroxytoluene to microsomal protein. AB - The structures of cysteine conjugates of 3,5-di-tert-butyl-4-hydroxytoluene (BHT) and the binding sites of BHT metabolites on microsomal protein were investigated by 13C nuclear magnetic resonance (13C-NMR) and gas-liquid chromatography/mass spectrometry. The cysteine conjugates of 2,6-di-tert-butyl-4-hydroxymethylphenol (BHT-alcohol) and 2,6-di-tert-butyl-4-methylene-2,5-cyclohexadienone (quinone methide), which are metabolites of BHT found in rat liver and specifically reacts with thiol compounds, were prepared as alcoholic aqueous solutions. The molecular structure of the cysteine conjugate of BHT-alcohol agreed completely with that of quinone methide in 13C-NMR spectra or mass spectra. These spectra of both conjugates further showed that the conjugates are due to thioether binding between the 4-methyl group of metabolites and the sulfhydryl group of cysteine. When [14C]BHT-bound microsomes prepared in vitro were enzymatically hydrolyzed with Pronase E, the major radioactive material that eluted with methanol from a column of Amberlite XAD-2 and gave a positive ninhydrin reaction was identified as a cysteine conjugate of BHT by comparing its Rf values on TLC and mass spectrum. On the basis of the results, it was apparent that the binding site of activated substituents of BHT on protein was mainly the sulfhydryl group of cysteine residue. PMID- 6860362 TI - Depression of human sperm motility by inhibition of enzymatic methylation. AB - Alteration of membrane fluidity during enzymatic methylation of membrane phosphatidyl-ethanolamine (PE) and neutralization of negative charges of membrane proteins due to methylation of carboxyl groups may contribute to sperm motility. Therefore, enzymatic phospholipid methylation and carboxymethylation, and the consequences of their inhibition on motility, were studied using human sperm. These studies gave the following results. Human sperm homoganates contained two phospholipid N-methyltransferases (PMT) which converted PE to phosphatidylcholine (PC) in the presence of S-adenosylmethionine (SAM). The first PMT converted PE to phosphatidyl-N-methylethanolamine (PME). In had a Km of 4.0 microM and a pH optimum of 8.0. The second PMT converted PME to phosphatidyl-N,N dimethylethanolamine and PC. It had a Km of 71 microM and a pH optimum of 10.0. Spermatozoa also contained protein carboxymethylase (PCM) and methyl aceptor protein (MAP). The intracellular levels of S-adenosylhomocysteine (SAH), an inhibitor of SAM-mediated methylations, were increased by adding adenosine (100 microM), L-homocysteine thiolactone (L-HCT, 10 microM), and erythro-9-(2-hydroxy 3-nonyl)-adenine (EHNA, 10 microM), an inhibitor of adenosine deaminase, to human sperm ejaculates that had been diluted with sodium phosphate buffer at pH 7.4 and 25 degrees. The motility index of each sperm suspension was determined every hour for 4 hr. In the presence of the mixture of adenosine, L-HCT and EHNA, the motility index was depressed by 57%. Under similar conditions, phospholipid methylation was depressed by 48%. Similar experiments were also conducted in the presence of 3-deazaadenosine (Deaza, 80 microM), a selective inhibitor of SAH hydrolase. In the presence of adenosine and L-HCT, Deaza depressed the motility index by 60% and phospholipid methylation by 86%. The potencies of SAH in the inhibition of phospholipid methylation and protein carboxymethylation in sperm homogenates had the following order: PMT I greater than PCM greater than PMT II. These observations indicate that the PMT system and/or the PCM-MAP system play a significant role in the regulation of human sperm motility. PMID- 6860363 TI - Direct quenching of adriamycin radicals by coenzyme Q10 and tetrazolium salts. PMID- 6860364 TI - Identification of a tetrahydroprotoberberine as a metabolite of trimetoquinol in the rat. PMID- 6860365 TI - Use of vaccinia, a DNA virus, to study the role of DNA incorporation in the mechanism of action of 6-thioguanine. PMID- 6860367 TI - Effect of quinidine on membrane properties. Depression of the lipid phase transition temperature and changes in the permeability of the lipid bilayer. AB - The influence of an antiarrhythmic drug, quinidine, on the physical state of membrane phospholipids was investigated using model membranes, liposomes. Turbidimetric measurements on liposomes prepared from neutral (dipalmitoyl phosphatidylcholine) and acidic (dipalmitoyl phosphatidic acid) phospholipids showed that quinidine reduces the temp of the gel to liquid-crystalline phase transition and broadens the temp range of the transition. The effect of quinidine on the thermal behaviour of model membranes depends on both the pH and the type of phospholipids used. It is markedly stronger for acidic than for neutral phospholipids, suggesting the importance of electrostatic effects in drug membrane interaction. The ability of quinidine to interact with the lipid bilayer was confirmed by permeability measurements with the use of a self-quenched fluorescent compound, calcein. It is suggested that quinidine-phospholipid interaction may contribute to the mechanisms by which the drug exerts its physiological and pharmacological effects. PMID- 6860366 TI - The influence of thyroid hormones and propylthioracil on salicylate hepatotoxicity in monolayer cell cultures. PMID- 6860368 TI - Formation of inactive cytochrome P-450 Fe(II)-metabolite complexes with several erythromycin derivatives but not with josamycin and midecamycin in rats. AB - The effects of some macrolides (4 mmoles . kg-1 p.o. daily for 4 days in vivo; 0.3 mM in vitro) on hepatic drug-metabolizing enzymes in rats were compared. One group of macrolides including previously studied compounds (oleandomycin, erythromycin and troleandomycin), as well as several other erythromycin derivatives, showed induction of microsomal enzymes and formation of inactive cytochrome P-450-metabolite complexes in vivo; this formation increased in the order: oleandomycin, erythromycin ethylsuccinate, erythromycin stearate, erythromycin itself, erythromycin propionate, erythromycin estolate and troleandomycin. Troleandomycin and, to a lesser extent, erythromycin and oleandomycin formed cytochrome P-450-metabolite complexes when incubated in vitro with 1 mM NADPH and microsomes from rats pretreated with troleandomycin or phenobarbital, but not with microsomes from control rats or rats treated with 3 methylcholanthrene. In contrast, two other macrolides, josamycin and midecamycin, showed no induction of microsomal enzymes and no detectable formation of cytochrome P-450-metabolite complexes in vivo. In vitro, these macrolides failed to form detectable complexes even with microsomes from rats pretreated with troleandomycin or phenobarbital. Hexobarbital sleeping time was unaffected by preadministration of josamycin or midecamycin (4 mmoles . kg-1 p.o.) 2 hr earlier; the in vitro activity of hexobarbital hydroxylase was not inhibited by 0.3 mM josamycin or midecamycin. We conclude that, unlike several erythromycin derivatives, josamycin and midecamycin do not form inactive cytochrome P-450 metabolite complexes in rats. PMID- 6860369 TI - Occurrence of 6-hydroxy-1-methyl-1,2,3,4-tetrahydro-beta-carboline in tissues and body fluids of rat. AB - A capillary column gas chromatographic-mass spectrometric method was used to identify and quantitate 6-hydroxy-1-methyl-1,2,3,4-tetrahydro-beta-carboline (6OMTHBC) in rat. The excretion rate in urine was 0.73 +/- 0.20 nmoles per 24 hr and in faeces 0.18 +/- 0.03 nmoles per 24 hr. In urine, about 90% of the 6OMTHBC was in a conjugated form, whereas in faeces most (approximately 75%) of the 6OMTHBC was in a free form. The compound was detectable in liver (11.1 +/- 3.6 pmoles/g), kidney (2.1 +/- 0.9 pmoles/g) and plasma (0.52 +/- 0.15 pmoles/ml), but not in brain (less than 0.3 pmoles/g). When 6OMTHBC was injected to rats, 75% of the injected amount was excreted in urine during the first 10 hr. The plasma level of 6OMTHBC declined with a half-life of 1.5 hr. PMID- 6860370 TI - Potentiation of the biochemical effects of beta-phenylethylhydrazine by deuterium substitution. AB - The concentrations of dopamine (DA), m-tyramine (mTA), p-tyramine (pTA) and serotonin (5-HT) in the striata of rats 18 hr after the administration of three different doses (5, 50, or 100 mg/kg) of beta-phenylethylhydrazine (phenelzine, PEH) were measured. These concentrations were compared to those following the administration of the same doses of 1,1,2,2-tetradeutero-PEH (d4PEH). In general, PEH and d4PEH caused dose-dependent increases in the levels of mTA, pTA and 5-HT. The lowest dose of d4PEH caused greater increases than PEH in the levels of all four monoamines. The concentration of 5-HT was increased more by d4PEH than PEH at all three doses. The inhibition of mitochondrial MAO obtained from rat striatum by PEH or d4PEH in vitro revealed no differences. However, the inhibition of striatal MAO obtained from rats injected with d4PEH was found to be greater than that from rats injected with PEH. It was concluded that deuteration of PEH potentiates its ability to inhibit MAO following its administration to the rat by slowing its degradation in vivo. PMID- 6860371 TI - Identification of the cyanopregnenolone-inducible form of hepatic cytochrome P 450 as a catalyst of aldrin epoxidation. AB - In light of recent suggestions that hepatic microsomal aldrin expoxidation activity selectively reflects the phenobarbital (PB)-inducible form(s) of cytochrome P-450 (P-450PB), we tested the effect of pregnenolone-16 alpha carbonitrile (PCN), a synthetic steroid that induces P-450PCN, a form of the cytochrome biochemically and immunochemically distinguishable from P-450PB. In hepatic microsomes prepared from rats receiving PB, 3-methylcholanthrene (3-MC), or PCN, the latter compound produced a greater increase in aldrin epoxidation activity relative to control than did PB, whereas 3-MC decreased enzyme activity. Moreover, the aldrin epoxidation activity in microsomes prepared from PCN- or PB pretreated rats was selectively inhibited by form-specific antibodies directed against P-450PCN or P-450PB, respectively, whereas anti-P-450MC antibodies gave no inhibition with microsomes prepared from induced or control animals. We conclude that P-450PCN, P-450PB, and probably other cytochromes P-450 catalyze aldrin epoxidation, precluding use of this enzyme as a specific marker of a single form of the cytochrome. PMID- 6860372 TI - Toward an understanding of patient outcome measurement. PMID- 6860373 TI - Gold therapy in the elderly rheumatoid arthritis patient. AB - Forty elderly (greater than or equal to 60 years old) and 101 young (less than 60 years old) rheumatoid arthritis patients receiving injectable gold therapy were followed prospectively between April 1971 and April 1982. The mean total gold compound received was 1,392 mg in the young group and 1,861 in the elderly group. Besides age, the only significant difference between the two groups was the increased gold compound received by the elderly. To determine efficacy and toxicity within and between certain age groups, the 141 patients were divided into 4 arbitrary age groups: group A (less than 30 years), group B (30-44 years), group C (45-59 years), and group D (greater than or equal to 60 years). The elderly responded to the gold therapy as well as the young patients did, at any time frame examined after 3 months of therapy. There was no difference in clinical benefit among groups A, B, C, and D. Nine patients in the elderly group and 15 in the young group had therapy discontinued because of no response. This difference was not significant among the groups A, B, C, and D. There was no difference in outcome of individual toxicity between the elderly and the young groups, and no difference in frequency of toxicity between the age groups A, B, C, and D. Serious hematologic toxicity occurred only in patients over 47 years of age, and nephrotic syndrome occurred only in patients over 52. In this study, gold therapy was found to be as clinically beneficial in the elderly as in the young patients, and the toxicity and drug failure rates were not significantly different. PMID- 6860374 TI - Arthropathy of Lowe's (oculocerebrorenal) syndrome. AB - We describe 3 children with Lowe's syndrome who developed joint manifestations--a previously rarely recognized feature. Two children had swelling and contractures of large and small joints; the third child had a small joint effusion and hypermobile joints. None of them had antinuclear antibody or rheumatoid factor; synovial effusions and biopsies showed no evidence of inflammatory cell infiltration. By light microscopy, profuse fibrous tissue and sparse synovial lining cells were found. Electron microscopy of the synovium of 2 patients showed large amounts of normal appearing collagen, unidentified thin fibrils, and focal profuse granular and fibrillar basement membrane-like material around small vessels, similar to findings described in other tissues in this syndrome. Whether these clinical and pathologic findings are results of the still incompletely understood basic metabolic defect or not, they should be recognized as features that may be seen in patients with Lowe's syndrome. PMID- 6860375 TI - Decreased complement mediated binding of antibody/3H-dsDNA immune complexes to the red blood cells of patients with systemic lupus erythematosus, rheumatoid arthritis, and hematologic malignancies. AB - The complement mediated binding of prepared antibody/3H-dsDNA immune complexes to the red blood cells obtained from a number of patient populations has been investigated. Patients with solid tumors have binding activity similar to that seen in a normal group of individuals. However, a significant fraction of patients with systemic lupus erythematosus, rheumatoid arthritis, and hematologic malignancies have lowered binding activity compared with normal subjects. Quantitative studies indicate the lowered activity probably arises due to a decrease in complement receptors on the respective red blood cells. The potential importance and implications of these findings are briefly discussed. PMID- 6860376 TI - Spinal fractures complicating ankylosing spondylitis. A long-term followup study. AB - Twenty-two spinal fractures in 20 patients with chronic ankylosing spondylitis are reported. Nineteen fractures occurred in the cervical region. Fourteen of the fractures were caused by minor falls, 3 by falls down steps, 4 by motor vehicle accidents, and 1 by cardiopulmonary resuscitation. Long-term followup (mean 3.2 years) of 9 fractures diagnosed early and managed conservatively showed bony union of all fractures. No patient deteriorated neurologically and 3 patients made major recovery. Long-term followup is also reported on 6 patients in whom the diagnosis was delayed. The difficulties in diagnosis and management are discussed. PMID- 6860378 TI - Hyaluronate synthesis by synovial villi in organ culture. AB - Individual canine synovial villi were used to establish short-term synovial organ cultures. These villi incorporated 3H-glucosamine into highly-polymerized 3H hyaluronic acid (3H-HA), which was the only 3H-glycosaminoglycan identified in the culture medium. Some 3H-HA, and larger amounts of other 3H glycosaminoglycans, were recovered from cultured tissues. Culture medium 3H-HA content was proportional to the surface area of cultured villi. Organ cultures of nonvillous synovium were compared with villi; nonvillous cultures synthesized less 3H-HA per mm2 of their synovial intimal surface than villi. These cultures complement cell culture techniques for in vitro studies of synovial lining cell function. PMID- 6860377 TI - The radiographic diagnosis of sacroiliitis. A comparison of different views with computed tomograms of the sacroiliac joint. AB - Conventional radiography is the standard method of objectively identifying sacroiliitis. Single views of the sacroiliac joints can be unequivocally interpreted in 70-80% of patients with low back pain. A series of views usually correctly resolves the ambiguity in the remaining 20-30% of patients (67% correct). Computed tomography will be helpful in the few patients in whom a series of views produces equivocal interpretation. PMID- 6860380 TI - Sternocostoclavicular hyperostosis: case report with a 31-year followup. PMID- 6860379 TI - Benoxaprofen stimulates proteoglycan synthesis in normal canine knee cartilage in vitro. AB - Several nonsteroidal antiinflammatory drugs which are cyclooxygenase inhibitors (e.g., salicylates, fenoprofen, ibuprofen) have been shown to suppress proteoglycan synthesis by normal joint cartilage in vitro. We examined the effect of benoxaprofen, a long-acting proprionic acid derivative which inhibits lipoxygenase in addition to causing moderate cyclooxygenase inhibition. When added to the culture medium in concentrations comparable with those obtainable in serum of patients treated with the drug (e.g., 10 and 50 micrograms/ml), benoxaprofen increased proteoglycan synthesis in slices of normal canine knee cartilage to 126% and 135%, respectively, of control levels. These concentrations of the drug augmented net protein synthesis to 154% and 123%, respectively, of control levels. Incorporation of 3H glucosamine into 9-aminoacridine precipitable material was increased by benoxaprofen, showing that it stimulates net proteoglycan synthesis, and not merely sulfation. At concentrations of either 10 or 50 micrograms/ml, the drug had no effect on proteoglycan catabolism or on the ability of proteoglycans to interact with cartilage hyaluronic acid to form macromolecular aggregates. Nordihydroguaiaretic acid, a free radical scavenger which, like benoxaprofen, inhibits the lipoxygenase as well as cyclooxygenase pathways of arachidonic acid metabolism, also increased 35S glycosaminoglycan synthesis in cartilage slices. The stimulation of glycosaminoglycan and protein synthesis by benoxaprofen suggests that its action on the chondrocyte may be different from that of most other nonsteroidal antiinflammatory drugs. PMID- 6860381 TI - Nifedipine treatment for pulmonary hypertension in a patient with systemic sclerosis. PMID- 6860382 TI - Bladder malignancy in a patient receiving low dose cyclophosphamide for treatment of rheumatoid arthritis. PMID- 6860383 TI - Mcleod syndrome (hemolysis, acanthocytosis, and increased serum creatine kinase): potential confusion with polymyositis. PMID- 6860384 TI - Nifedipine in digital ulceration in scleroderma. PMID- 6860385 TI - Central nervous system manifestations after pulse therapy for systemic lupus erythematosus. PMID- 6860386 TI - Diffuse idiopathic skeletal hyperostosis in a patient with situs inversus. PMID- 6860388 TI - Rheumatoid synovial cyst of the hip. PMID- 6860387 TI - Pyoderma gangrenosum and seronegative erosive polyarthritis. PMID- 6860389 TI - Rehabilitation of severe hip damage in juvenile arthritis. PMID- 6860390 TI - Control of susceptibility of F344 rats to adjuvant arthritis: an alternative interpretation. PMID- 6860391 TI - Clinical use of ANSi hearing aid measurements. PMID- 6860392 TI - Assistive listening devices... Part I: New responsibilities. PMID- 6860394 TI - I'd rather tell a story than be one: Joysa Gale Post with William R. Leith. PMID- 6860393 TI - Assistive listening devices... Part II: Large area sound systems. PMID- 6860395 TI - The prevalence of hearing impairment. PMID- 6860396 TI - Deinstitutionalization: the data demythologized. AB - Many past studies of data on deinstitutionalization have used an overly simplistic and often misleading approach, which has led to a number of "myths" of deinstitutionalization. The authors present data on the changing mental health service system collected by the Division of Biometry and Epidemiology of the National Institute of Mental Health, and they analyze the data to reveal trends that disprove a number of the commonly accepted myths. Through their analysis they show that outpatient care has not replaced inpatient care, that public institutions, particularly state mental hospitals, have not been replaced by community-based facilities, and that private resources have not replaced public ones as the bearer of the cost of caring for the mentally ill. They conclude that the availability and quality of mental health services and the effect of these services on patients and their communities are difficult issues for future research. PMID- 6860397 TI - Praise for article on financial exploitation. PMID- 6860399 TI - Case management. PMID- 6860398 TI - Establishing cost centers within libraries of medical centers. AB - Medical centers that educate students, treat patients, and perform medical research usually adopt accounting methods for separating those functions financially--designating each function as a cost center. Faculty members who participate in more than one of the separately charged activities have their salaries apportioned accordingly. Cost-shared services, such as a computer facility or a power plant, may also be apportioned among the cost centers. Given this approach to accounting, the shared services of the medical center's library should be included in such an apportionment. Whether such is the case, why the matter is of concern, and how such accounting can be performed were recently studied. PMID- 6860400 TI - Comparative observations of mucus transport velocity in health and disease. AB - The present study evaluated mucus transport velocity (MTV) in different areas of the tracheobronchial tree in vitro in normal, acute and chronic bronchitic animals. The average MTV in normal animals ranged from 11.5 mm/min in the trachea to 0.64 mm/min in the pre-terminal bronchus. Chronic bronchitic animals showed mucus hypersecretion, areas of ciliary abnormality and mucus stagnation. The mean transport velocities ranged from 21.2 mm/min in the trachea to 4.1 mm/min in the pre-terminal bronchus. In the acutely ill animals, MTV ranged from 2.5 mm/min in the trachea to zero below the upper lobar bronchus. It is postulated that the higher than normal values in chronic bronchitis are due to altered mucus rheology, increased peristalsis and linear acceleration; whereas those in acute bronchitis were attributed to an early phase of viral or bacterial infection. PMID- 6860401 TI - Visuo-motor behaviour in pre-school children in relation to sex and neurological status: an experimental study on the effect of 'time-pressure'. AB - A detailed analysis was made of the visuo-motor behaviour of 139 pre-school children during a spatial-constructive task with and without time-pressure. The study focused mainly on sex differences and the implications of minor neurological dysfunctions for children's visuo-motor behaviour. Between sexes only minor differences in behavioural organization and efficiency were found. Between neurological groups only differences within the girls were found, those with lower neurological optimality scores showing more signs of 'lack of motor inhibition' and distraction in the prestress condition, seemingly related to differences in motivation. No effect was found for time-pressure for groups with a different neurological status. PMID- 6860402 TI - Diagnosis and classification of myocarditis by endomyocardial biopsy. AB - Myocarditis was diagnosed by endomyocardial biopsy in 34 patients with otherwise unexplained heart failure. On the basis of both clinical and histologic findings these patients were divided into three groups. Seven patients had acute myocarditis (mean age, 20 years; mean ejection fraction, 22 per cent) characterized by an interstitial inflammatory infiltrate and extensive, acute cell damage. Five of these patients died after a mean duration of illness of eight weeks. Eighteen patients had rapidly progressive myocarditis (mean age, 35 years; mean ejection fraction, 19 per cent) characterized by patchy acute and healing cell damage and fibrosis; 17 of them died after a mean duration of illness of 23 months. Nine patients had chronic myocarditis (mean age, 31 years; mean ejection fraction, 31 per cent) characterized by focal inflammation and cell damage. All nine were alive after a mean follow-up period of 39 months. In four of these nine, clinical and hemodynamic improvement occurred after one month of immunosuppressive therapy. Our study suggests that a clinically useful classification of myocarditis can be accomplished by endomyocardial biopsy. PMID- 6860403 TI - [Significance of sensitization to tissue antigens in various forms of obstetric pathology]. PMID- 6860406 TI - [Incidence of pregnancy and labor complications in hypertension depending on the state of peripheral hemodynamics]. PMID- 6860407 TI - The neuropathology of propionic acidemia. AB - The neuropathology in two biochemically documented cases of propionic acidemia is presented. While spongiform changes in white matter were seen in the infant who died at 12 days, no such changes were evident in an older patient who died at age 23 months. These findings are compared with other aminoacidemias. PMID- 6860404 TI - [Current tropical dermatoses. Tungiasis, tropical ulcer, leishmaniasis. Observations from general practice]. PMID- 6860405 TI - [Characteristics of the course of pregnancy and labor depending on the location of the placenta]. PMID- 6860408 TI - Dopamine-B-hydroxylase: suicide inhibition by the novel olefinic substrate, 1 phenyl-1-aminomethylethene. AB - Dopamine-B-hydroxylase [E.C.1.14.17.1] plays a key role in the biosynthetic interconversion of neurotransmitters. It is now demonstrated for the first time that dopamine-B-hydroxylase also catalyzes the oxygenation of an olefinic substrate, 1-phenyl-1-aminomethylethene, producing 2,3-dihydroxy-2 phenylpropylamine after acid workup. This reaction gives the normal oxygenase stoichiometry of electrons to O2 to product of 2:1:1, and is kinetically comparable to other oxygenase activities of dopamine-B-hydroxylase, with a kcat value of 10 sec-1 and a KM of 8.3 mM. 1-Phenyl-1-aminomethylethene is also a time dependent, first-order inactivator of dopamine-B-hydroxylase. The inactivation process exhibits the characteristics of mechanism-based, irreversible inactivation, giving a KI value of 13 mM and a kinac of 0.04 min-1. The central role of dopamine-B-hydroxylase in catecholamine metabolism suggests possible pharmacological uses for olefinic inhibitors of this enzyme. PMID- 6860409 TI - Arsenic in the forest environment after thinning with MSMA and cacodylic acid. PMID- 6860410 TI - [Pancreatic heterotopy in the choledochus. Apropos of a case]. PMID- 6860412 TI - Random scaling: an extension of Kraepelin's combined method. AB - Kraepelin combined the constant method and the method of limits to avoid the inconvenience of the former and the response bias of the latter. The use of this approach together with Guttman scaling provides a method that requires few observations, is easy to administer and score, and can be applied to a variety of measurement situations. Examples are given of its use for point of subjective equality, aesthetic preference, and thresholds. PMID- 6860411 TI - High performance liquid chromatographic determination of malondialdehyde in vegetable oils. AB - A simple high performance liquid chromatographic (HPLC) method has been developed for determining malondialdehyde (MDA) in vegetable oils. MDA was reacted with dansyl hydrazine in an acidic medium, and the product, 1-dansyl-pyrazole, was determined by HPLC, using a Zorbax sil column with mixed mobile phase of n-hexane methylene chloride. MDA can be determined as 1-dansyl-pyrazole by fluorometric detection at a level of 0.01 ppm in vegetable oils. PMID- 6860413 TI - [Physical basis of ultrasonography]. PMID- 6860415 TI - [When should bronchial carcinoma be irradiated?]. PMID- 6860414 TI - [Association of CRST syndrome, Gougerot-Sjogren syndrome, thyroid hyperplasia and chronic persistent hepatitis]. PMID- 6860416 TI - Once-daily vs. continuous aminoglycoside dosing: efficacy and toxicity in animal and clinical studies of gentamicin, netilmicin, and tobramycin. AB - The dosing frequency of aminoglycoside antibiotics may alter efficacy and toxicity independent of total daily dose. Once-daily tobramycin dosing was compared with continuous infusion in three models of efficacy. Acute pneumonia due to Pseudomonas aeruginosa in guinea pigs responded better to once-daily dosing, and chronic pneumonia in rats and endocarditis in rabbits responded equally to both regimens. Dogs given gentamicin, tobramycin, or netilmicin once daily, with maximum serum concentrations of greater than 100 mg/liter, had less nephrotoxicity than dogs given continuous infusions. Tobramycin was given once daily or continuously to 52 patients with cystic fibrosis who in 10 days had no change in creatinine clearance or hearing despite maximum serum tobramycin concentrations of 40 mg/liter. Intermittent dosing of aminoglycosides, causing infrequent large maximum serum concentrations, may be less toxic and equally efficacious as frequent dosing. PMID- 6860417 TI - Multiple lutein cysts in an uncomplicated pregnancy. Case report. PMID- 6860418 TI - Clinical hepatitis B in two infants born to asymptomatic hepatitis B surface antigen carrier mothers. PMID- 6860419 TI - Critical study of staging in multiple myeloma. AB - 130 patients with multiple myeloma were reviewed for a retrospective study of their classification according to Durie & Salmon. No significant difference was found in survival between patients in stages I, II and III (median survival 24.8, 32.1, and 17.3 months, respectively). Of the classical criteria affecting survival, only the Hb level showed any significant influence (P less than 0.04). In accordance with this finding, the survival time was much shorter (P less than 0.001) in patients with renal failure than in patients without (median survival 7.4 and 24.8 months, respectively); in addition, thrombopenia, fever, old age, and above all, the % of bone-marrow plasmocytes present, were shown to be decisive factors. PMID- 6860420 TI - [Immune thrombocytopenia]. PMID- 6860422 TI - Apolipoprotein B subspecies in chylomicrons isolated from a patient with chyluria. AB - The diagnosis and the clinical course of a 17-year-old white male with chyluria are reported. Cloudy, milky urine appeared spontaneously, in the absence of edema or any signs or symptoms of parasitic infection. Pedal lymphangiography demonstrated the presence of a lymphatic renal fistula, and digital subtraction angiography showed aneurysmal dilatation of the aorta at the level of the renal arteries. This case provided an opportunity to ascertain which of the forms of apolipoprotein B were present in lymph chylomicrons. Apolipoprotein B is needed for chylomicron secretion. It exists in several forms--B-100, B-74, B-48, and B 26. After a meal consisting of fat, chylomicrons in which apolipoprotein B-48 was virtually the only apolipoprotein B present appeared in the urine, while apolipoprotein B-100 was the only apolipoprotein B present in the plasma very low density lipoproteins. Chyluria disappeared two weeks after institution of a low fat diet. This case illustrates an interesting, rare cause of chyluria. Because of the presence of chyluria, it was also demonstrated that chylomicrons in which apolipoprotein B-48 is virtually the only apolipoprotein B present are a physiologically normal product of the intestine. PMID- 6860421 TI - Atypical familial dysbetalipoproteinemia associated with apolipoprotein phenotype E3/3. AB - Familial dysbetalipoproteinemia has been reported to be associated uniquely with an apolipoprotein E phenotype (E2/2) that occurs in approximately 1% of all persons. We have observed the typical clinical and biochemical characteristics of this disorder in five members of a family, in all of whom the apolipoprotein E phenotype, as determined by isoelectric focusing electrophoresis, is E3/3. The disorder is present in three generations of the family: the proband, her mother, and three of the proband's five children. The proband's husband, father of all five children, also has apolipoprotein E phenotype E3/3, as do his two unaffected children. As in normal persons with phenotype E3/3, the apolipoprotein E of affected members appears to have a single residue of cysteine. When incorporated with egg lecithin into discoidal complexes, the apolipoprotein E from affected members was taken up normally into perfused livers of estradiol-treated rats, in which a high level of LDL receptors is expressed. When isoelectric focusing electrophoresis was carried out over a narrow range of pH (5-7), each of the apolipoprotein E isoforms of affected members was observed as a doublet, even after reduction of dimers of the protein with 2-mercaptoethanol and treatment with neuraminidase to minimize the content of sialylated forms of the protein. Doublets were also observed in the apolipoprotein E-2 of patients with classical dysbetalipoproteinemia, but only in the affected members of the family with atypical dysbetalipoproteinemia were the components of the doublets equally prominent. As in classical dysbetalipoproteinemia, both apolipoprotein B-100 and B-48 were present in the very low density lipoprotein fraction of plasma obtained in the postabsorptive state, indicating that remnantlike lipoproteins of both hepatic and intestinal origin accumulate. This observation, together with available evidence on the structural and functional heterogeneity of human apolipoprotein E, lead us to suggest that the disorder in this family is caused by one or two structurally abnormal forms of apolipoprotein E that contain a single residue of cysteine. PMID- 6860423 TI - Physical fitness. Its contribution to serum high density lipoprotein. AB - The effects of exercise conditioning on serum high density lipoprotein cholesterol (HDL-C) were studied using 20 members of a regular joggers club and other healthy non-member subjects of varying degrees of habitual physical activity (253 males and 391 females). Both the HDL-C and HDL-C/serum total cholesterol (TC) levels were significantly higher with the 20 regular joggers than with the sedentary controls matched for age, TC, serum triglycerides (TG) and weight index (WI). A significant correlation was found between HDL-C/TC and the exercise conditioning value obtained by using the results of the 12-min performance test as an index among the non-member subjects. In order to ascertain the relative significance of exercise conditioning in influencing HDL-C/TC, a multiple regression analysis was conducted using HDL-C/TC as the variable criterion. The results showed that TG affected HDL-C/TC the most among both males and females, while exercise conditioning affected it second among males and fourth among females. PMID- 6860424 TI - Unscheduled DNA synthesis and DNA repair studies of peroxyacetic and monoperoxydecanoic acids. AB - Peroxyacetic (PAA) and monoperoxydecanoic (MPDA) acids were assayed for induction of unscheduled DNA synthesis (UDS) by liquid scintillation counting of hot-acid extractable DNA and by light microscope autoradiography. Both compounds were also assayed for induction of DNA repair synthesis by differential density labeling ultracentrifugation. Uniformly negative results were obtained for MPDA. Conflicting results were obtained for PAA using the UDS techniques. Negative results were consistently obtained, however, in three separate assays using two different PAA samples with the more definitive differential density DNA repair synthesis technique. Hydrogen peroxide, which is present as a contaminant in the PAA samples, was also assayed for induction of UDS by autoradiography and for induction of DNA repair synthesis by differential density labeling. Our results with this compound are in agreement with published data and were consistently positive using both techniques. We conclude that neither MPDA nor PAA induce DNA repair synthesis and suggest that the conflicting PAA results may be due to the presence of hydrogen peroxide in commercial samples of PAA. PMID- 6860425 TI - Monoamine oxidase inhibition in healthy volunteers by CGP 11305 A, a new specific inhibitor of MAO-A. PMID- 6860426 TI - Conformation of Asn-Ala-Gly-Ala-Asn and its derivatives in solution--a CD spectra analysis. AB - The CD method has been used to study the conformation of the pentapeptide Asn-Ala Gly-Ala-Asn (NAGAN) and the tetrapeptides Asn-Ala-Gly-Ala (NAGA) and Asn-D-Ala Gly-Ala-NH2 (NDAGA) in solution. At low pH the far UV CD spectra of aqueous solutions of NAGAN show a positive extremum at 215 nm and a negative extremum at 232.5 nm. Under this condition, the molecule of NAGAN may assume a beta-turn structure. In the solution of 90% ethanol or tri-fluoroethanol at pH 5.8, NAGAN reveals CD spectra with a negative 218 nm extremum. The[theta]218 values are independent of the concentration of NAGAN. Au intramolecular beta-pleated sheet like structure is suggested to explain the negative peak. The CD spectra of NAGA show a single positive band at around 215 nm. The possibility of forming a beta turn by NAGA has been discussed. Only the 196 nm negative extremum can be seen in the spectra of NDAGA. It seems as if NDAGA is in the form of a random coil. According to the report made by Pan et al. all these peptides possess analgesic activity. Therefore, it seems that the analgesic activity is not related to the special conformation of the peptides. PMID- 6860427 TI - The formation and metabolism of N-hydroxymethyl compounds--III. The metabolic conversion of N-methyl and N,N,-dimethylbenzamides to N-hydroxymethyl compounds. AB - The stability of metabolically-generated N-(hydroxymethyl) compounds was investigated using a series of N-methylbenzamides as model substrates. N (Hydroxymethyl)-benzamide was characterized as a major metabolite of N methylbenzamide in vitro, and was also identified as a urinary metabolite of N methylbenzamide. N-(Hydroxymethyl) compounds were also found as metabolites of 4 chloro-N-methylbenzamide and 4-t-butyl-N-methylbenzamide in vitro. Thus substitution in the 4-position of the phenyl ring of derivatives of N (hydroxymethyl)-benzamide did not affect their stability sufficiently to cause degradation to formaldehyde under the conditions used. N-(Hydroxymethyl)-N methylbenzamide was identified as a metabolite of N,N-dimethylbenzamide in vitro. However, N-(hydroxymethyl)-N-methylbenzamide was less stable than N (hydroxymethyl)-benzamide under alkaline conditions. Furthermore, N (hydroxymethyl)-N-methylbenzamide, unlike N-(hydroxymethyl)-benzamide and its 4 substituted derivatives, was positive in the colorimetric assay for formaldehyde, presumably because of its degradation to produce formaldehyde. Thus substitution on the nitrogen atom which bears the methyl group in N-methylbenzamide markedly affected the stability of the N-methylol produced during oxidative metabolism. N Formylbenzamide was identified as a metabolite of N-methylbenzamide in suspensions of mouse hepatocytes and also in vivo. The mechanism for its production probably involves the generation of N-(hydroxymethyl)-benzamide. PMID- 6860428 TI - Hb Albany-GA or alpha 2(11)(A9)Lys leads to Asn beta 2. AB - A fast-moving alpha chain abnormal hemoglobin (Hb J) was observed in a black teenager from southern Georgia. Its quantity, i.e. the sum of Hb J and Hb J2, was 23.8%. Its presence did not cause any hematological or clinical abnormalities. Tryptic peptides from a digest of the alpha-J chain were separated by HPLC. Amino acid analysis of these peptides and sequence analysis of the abnormal T-2,3 nonapeptide identified a Lys leads to Asn substitution at position alpha 11(A9). PMID- 6860429 TI - DC-52, a novel antitumor antibiotic. 1. Taxonomy, fermentation and biological activity. AB - A novel antitumor antibiotic, DC-52 was found in the culture broths of Actinomycete DO-52. The producing organism was subsequently determined to be a new species and named Streptomyces melanovinaceus nov. sp. For the production of the antibiotic, soluble starch served as a good carbon source and soybean meal was a good nitrogen source tested. The antibiotic DC-52 is active against Bacillus subtilis, Staphylococcus aureus and Klebsiella pneumoniae, but not active against most Gram-negative bacteria. The antibiotic is also active against mouse leukemia P388. PMID- 6860430 TI - Studies on WF-3161, a new antitumor antibiotic. AB - WF-3161 is an antitumor antibiotic produced by a strain of fungus, Petriella guttulata. The antibiotic was purified by solvent extraction and a combination of silica gel and reverse phase column chromatography. The chemical structure of the antibiotic (C31H44N4O6, mp 181-183 degrees C) was found to be a cyclic tetrapeptide consisting of phenylalanine, leucine, pipecolinic acid and 2-amino-8 oxo-9,10-epoxydecanoic acid. WF-3161 inhibited the growth of Trichophyton asteroides. It prolonged survival period of mice bearing leukemia P-388 with a high therapeutic index. PMID- 6860431 TI - Factors affecting expression of glycolipid tumor antigens: influence of ceramide composition and coexisting glycolipid on the antigenicity of gangliotriaosylceramide in murine lymphoma cells. AB - Gangliotriaosylceramide (Gg3Cer) was previously described as a tumor-associated antigen in murine L5178Y lymphoma [Young, W. W., Jr., and Hakomori, S., Science (Wash. D.C.), 211: 487-489, 1981]. This paper describes the major factors affecting the expression of Gg3Cer at the surface of various clones of L5178Y lymphoma. Of 26 sublines that were recloned, six cell lines showing different degrees of Gg3Cer expression at the cell surface were used for analysis of the glycolipid composition as related to its cell surface antigenicity. Three remarkable correlations between glycolipid composition and the antigenicity of Gg3Cer have been found: (a) high-expressor sublines were characterized by a large proportion of a unique molecular species of Gg3Cer having alpha-hydroxypalmitic acid in its ceramide moiety in striking contrast to low expressors which did not contain this molecular species; (b) low expressors contained a large quantity of ganglio-N-tetraosylceramide (Gg4Cer) and NeuAc alpha 2 leads to 3Gal beta 1 leads to 3GalNAc beta 1 leads to 4Gal beta 1 leads to 4Glc beta 1 leads to 1 Cer (GM1b) gangliosides, whereas these glycolipids were almost absent in high-expressor clones; and (c) nonexpressors, which were converted from the high expressors in vivo through immunotherapy with the monoclonal antibodies to Gg3Cer, contained a large quantity of ganglio-N-tetraosylceramide and NeuAc alpha 2 leads to 3Gal beta 1 leads to 3GalNAc beta 1 leads to 4Gal beta 1 leads to 4Glc beta 1 leads to 1Cer. The nonexpressors should have an induced enzyme system to metabolize Gg3Cer to ganglio-N-tetraosylceramide and NeuAc alpha 2 leads to 3Gal beta 1 leads to 3GalNAc beta 1 leads to 4Gal beta 1 leads to 4Glc beta 1 leads to 1Cer. Three factors, i.e., ceramide composition, coexisting glycolipids, and an antibody dependent glycolipid change, are therefore important in determination of glycolipid antigenicity and antigen modulation by antibodies. The ceramide composition may affect glycolipid organization in membranes, and the coexisting glycolipid having a longer carbohydrate chain may mask the accessibility of antibody to the antigenic glycolipid. The antigenic modulation by the action of the antibody in vivo may be based on activation of a new glycosyltransferase. PMID- 6860432 TI - Chimeramycins: new macrolide antibiotics produced by hybrid biosynthesis. PMID- 6860433 TI - [Laxative action of a new anthraquinone glycoside from rhubarb roots]. PMID- 6860434 TI - Design and analysis methods for longitudinal research. PMID- 6860435 TI - Deinstitutionalization: health consequences for the mentally ill. PMID- 6860437 TI - Self-care in health. PMID- 6860436 TI - Appropriate uses of multivariate analysis. PMID- 6860439 TI - The public health implications of abortion. PMID- 6860440 TI - Critical issues in the conduct and interpretation of clinical trials. PMID- 6860438 TI - Health effects of indoor pollutants. PMID- 6860441 TI - Improving the health of children: must the children be involved? PMID- 6860443 TI - Environments, people, and health. PMID- 6860442 TI - Schistosomiasis control: past, present, and future. PMID- 6860444 TI - Cadmium. PMID- 6860447 TI - Biological assays for mutagens in human samples. PMID- 6860445 TI - Mercury. PMID- 6860446 TI - Respiratory assessments--expired air and ventilatory performance. PMID- 6860449 TI - Application of cytogenetic methods for biological monitoring. PMID- 6860448 TI - Dosimetry of electrophilic compounds by means of hemoglobin alkylation. PMID- 6860450 TI - Land use planning and health. PMID- 6860451 TI - Health consequences of the experience of migration. PMID- 6860452 TI - [Surveillance and prevention of whooping cough. Simplified guidelines]. PMID- 6860454 TI - [The well baby clinic]. PMID- 6860453 TI - [The rhinopharyngeal crossroad]. PMID- 6860455 TI - [Congenital nephrotic syndrome, pseudohermaphroditism and congenital hip dysplasia]. PMID- 6860456 TI - [A case of sexual identification disorder]. PMID- 6860458 TI - Long-term memory for contextual attributes: dissociation of amygdala and hippocampus. AB - Rats were given passive avoidance training within a distinctive environment followed by subseizure level stimulation of the hippocampus or amygdala. The animals were then tested for retention of the aversive experience using a partial cue (subset of the original training environment) and a complete cue (the original training environment). Post-trial hippocampus stimulation produced a retention deficit in both the partial and complete cueing conditions, while post trial amygdala stimulation produced an intermediate retention deficit in the partial, but no deficit in the complete cueing condition. It is proposed that the hippocampus, but not the amygdala, is involved in processing of the environmental context utilizing spatial temporal attributes. PMID- 6860459 TI - The development of inhibitory learning and memory in hooded and albino rats. AB - A special kind of passive avoidance was elaborated which made it possible to study inhibitory conditioning in hooded (Long-Evans) and albino (Wistar) rat strains from day of birth to 10 or 11 days of age. Remaining on the safe platform for 60 sec, thus avoiding an electrified grid, for the 1st and 2nd time were the criteria. Passive avoidance was established from the first postnatal hours in both strains. A general developmental trend was demonstrated by a decreasing number of trials to both criteria and increase of average latencies. A temporary inversion of this trend in hooded rats took place at the age of 2 days, and in albinos at the age of 3 days. Habituation or fatigue were excluded by control experiments without noxious stimulation, and the associative character of the reaction was further proved by sensitization experiments. Evidence of memory retention was obtained as early as between the day of birth and the next day. The animals which served on the day of birth as controls needed, on the following day, significantly more trials than naive animals or pups which had been taught, one day before, to avoid the electrified grid. This phenomenon was called 'learned safety' for the previously control animals behaved as if they had learned that descent to the grid was safe. The 24-h memory of the learned inhibitory reaction--withholding movements towards the grid--was first observed in hooded rats between 1 and 2 days of age. Thus the capability to learn an inhibitory reaction has been proved in the neonatal rat which is born less mature than many other altricious mammals. Though learning and memory in both rat strains improved with age, there were small differences in favor of their earlier development in pigmented animals. PMID- 6860457 TI - Brain 5-hydroxytryptamine and learned resistance to punishment. AB - Rats can learn to persist in making a response that is punished. Brain 5 hydroxytryptamine (5-HT) systems are known to mediate acute responding to punishment. This work investigates 5-HT involvement in learned resistance to punishment. Forebrain 5-HT was depleted by intracerebral injection of 5,7 dihydroxytryptamine. Lesioned rats were fully able to learn resistance to punishment, although acute responding to punishment was impaired. Forebrain 5-HT does not mediate learned resistance to punishment. PMID- 6860460 TI - Angular acuity in normal and commissure-sectioned rabbits. AB - Both normal and commissure-sectioned rabbits were examined over a variety of visual discrimination tasks. The visual displays were projected at various distances within the frontal visual field of the rabbit. The learning of either a black-white or a vertical-horizontal problem was found to be normal in commissure cut animals. Furthermore, no deficit in angular acuity was observed. However, when they were tested with the patterns displayed at 25 cm distance, large impairments were found in the commissure-sectioned animals. PMID- 6860461 TI - Distractibility following simultaneous bilateral lesions of the superior colliculus or medial frontal cortex in the rat. AB - Hooded rats with bilateral lesions of the superior colliculus or medial frontal cortex were compared with controls for locomotor guidance in shuttling back and forth between goal-doors at two opposite ends of a large arena. Colliculectomized rats accomplished this with great accuracy. When flashing distractor lights were introduced midway down the runway, frontal corticals and controls were severely disrupted but colliculars continued to run normally. This result was obtained both when all training occurred postoperatively (Experiment 1) and when runway performance had been stabilized preoperatively (Experiment 2), thus after a long or short postoperative recovery interval. The results offer support for previous studies with rats which have demonstrated sensory 'neglect' but good locomotor guidance after collicular ablation. Frontal corticals differed from controls only in terms of their elevated rate of repeat door-pressing upon postoperative resumption of testing in Experiment 2. Despite the similarity between effects reported elsewhere of collicular and frontal lesions made unilaterally, bilateral deficits clearly demonstrable after collicular ablation were absent here after frontal lesions. The results imply that the functional responsibilities of superior colliculus and frontal cortex in the rat are separable; at least, they have different rates of functional recovery. PMID- 6860462 TI - Grating acuity of the Mongolian gerbil (Meriones unguiculatus). AB - The grating acuity of the Mongolian gerbil was measured using a two-alternative forced-choice task in a jumping stand. Frequency-of-seeing curves generated by a modified method of limits indicated that the acuity of the gerbil for a horizontal square-wave grating is about 1.5-2.0 cycles/degree (c/deg) at 70 cd/m2, using the 70%- and 80%-correct levels of performance as criteria for defining acuity. The acuity for horizontal gratings is reliably better than that for vertical gratings, and this difference does not appear to be luminance dependent. A corresponding orientation anisotropy is not seen in acquisition scores, nor is an 'oblique effect' evident. The acuity of the gerbil continues to increase with luminance into the (human) photopic range, suggesting the existence of a functional cone system. The gerbil visual system appears to be well adapted for detail vision in a diurnal lifestyle. PMID- 6860464 TI - EBBS abstracts. Abstracts of the annual general conference of the European Brain and Behaviour Society, Parma, Italy, September 2nd-4th, 1982. PMID- 6860463 TI - The inability of squirrel monkeys to localize sound after unilateral ablation of auditory cortex. AB - The ability of squirrel monkeys to localize brief sounds was tested before and after unilateral ablation of auditory cortex. Results indicated that, after unilateral ablation of auditory cortex, monkeys could no longer localize sound accurately in the hemifield opposite to the side of lesion. These data demonstrate that contralaterally-directed functioning of auditory cortex occurs in primates. PMID- 6860466 TI - [Smoking and cardiovascular disease]. PMID- 6860465 TI - [Combined study of central hemodynamics and microcirculation in circulatory failure patients]. AB - The status of the central hemodynamics and microcirculatory bed was studied in 50 patients (aged 25-60 years) with coronary heart disease complicated by circulatory failure. The local tissue blood flow was investigated by the H clearance method with an automatized apparatus made in the USSR, the capillaroscopic picture was observed with a TM-1 telecapillaroscope. The paper presents a discussion of the fact that with an increase in circulatory failure the changes in the central hemodymamics are accompanied by functional and morphologic disturbances in the microcirculatory bed. PMID- 6860467 TI - [All-Union cooperative program to control hypertension in a selected population]. PMID- 6860470 TI - [Development of cooperative research programs in the epidemiology and prevention of ischemic heart disease and arterial hypertension]. PMID- 6860472 TI - [Method of detecting the early stages of heart failure in arterial hypertension patients in prophylactic studies in an unselected population]. AB - A total of 569 subjects (91.2% response rate) were examined from a 5% random sample of 40 to 64 year-old men and women in the framework of a prophylactic program on hypertension control. There are 181 patients (31.8%) suffering from arterial hypertension (blood pressure 160/95 mm Hg and above). In 111 of them cardiac insufficiency was diagnosed by standard clinical methods and in 60 patients by bicycle spiroergometry. Two-stage bicycle spiroergometry has some advantages over one-stage test: work load volume, physical adaptation coefficient, time of heart rate recovery were increased by 202.7%, 124.4% and 220%, respectively, the exercise tolerance being improved. Cardiac insufficiency was found in 35.3% of cases, latent IA stage, diagnosed by bicycle spiroergometry, being revealed in 18.3%, IB stage in 10.0%, IIA stage in 3.4% and IIB in 3.6% of cases. PMID- 6860468 TI - [Incidence of arterial hypertension and its relation to basic risk factors in women 20-69 years old (based on the data from a simple epidemiological study)]. AB - The incidence of arterial hypertension in 1247 women (74% of response rate) has been studied. It accounted for 26.2% in women, aged 20-69, and increased with age. The incidence of systolic hypertension is significantly greater in women 50 years of age or older, diastolic hypertension occurring more often in women 20-49 years of age. The incidence of arterial hypertension in women is associated with lipid metabolism disturbances and excessive body weight. The level of blood pressure in blue-collar women is somewhat higher than in white-collar women. PMID- 6860471 TI - [Determination of the thresholds of taste sensitivity to table salt in a population study]. AB - The study of an organized population has revealed three types of gustatory sensitivity to sodium chloride: low, medium and high. A certain dependence of salt sensitivity threshold on sex and age has been found. The examination of hypertensive patients in hospitals has revealed that patients with low gustatory sensitivity to salt are characterized by sodium and water retention. High gustatory sensitivity suggests sodium deficiency and corresponds to salt appetite. High salt sensitivity threshold may serve an indication for the administration of diuretics and for dietary salt restriction necessary for hypertension prevention and treatment. PMID- 6860469 TI - [Tolerance for physical loading in relation to arterial hypertension and excess body weight in a population of 11 to 17-year-old schoolchildren]. AB - In a cross-sectional epidemiologic study of schoolchildren aged 11-17 years, the cardiac work index at exercise was found to be higher in schoolchildren with arterial hypertension (AH) and excess body weight than in the control group. The duration of an exercise test was similar in the two groups. The higher cardiac work index at exercise may be explained by considerably higher systolic blood pressure in schoolchildren with AH and by higher heart rates in those with excess body weight. PMID- 6860474 TI - [Multifactorial prophylaxis of ischemic heart disease (a cooperative study)]. AB - The examination of 40-59 year-old males in Moscow, Kaunas, Minsk, Tashkent, Frunze in the framework of a cooperative study on multifactorial prophylaxis of coronary heart disease has shown that the disease and its risk factors such as arterial hypertension, smoking, hypercholesterolemia, excessive body weight and low physical activity are wide-spread among the male population of all the five cities, 75-83% of all the subjects examined thus being in need of preventive measures. Preventive measures against risk factors carried out in Moscow, Kaunas and Minsk already in the first 2 years have shown the possibility of reducing the incidence of arterial hypertension in the population (in Moscow by 7.8%, in Kaunas by 6.1%, in Minsk by 9.8%), smoking (in Moscow by 7.9%, in Kaunas by 8.1%, in Minsk by 14.8%), hypercholesterolemia (in Moscow by 4%, in Kaunas by 4.9%, in Minsk by 8.4%). PMID- 6860473 TI - [Prognostic significance of arterial pressure, blood plasma lipids, Ketle's index and smoking in relation to the possible development of arterial hypertension]. AB - A prospective study of 40-59 year-old males from one of the Moscow districts has shown the correlation between newly developed cases of arterial hypertension and blood pressure level, blood lipids, body weight, smoking. Complex informative index of the above parameters for possible hypertension development is being analyzed. The most informative criteria have been stated and the prognostic value of the index for possible hypertension development has been established. PMID- 6860476 TI - [Characteristics of the blood plasma lipid spectrum in a population of 11- to 17 year-old schoolchildren (based on epidemiological study data)]. PMID- 6860477 TI - [Lipid concentration in the blood plasma of women 20 to 69 years old (based on epidemiological study data)]. PMID- 6860475 TI - [Incidence, in Moscow schoolchildren 11 to 17 years old, of combinations of risk factors for ischemic heart disease]. AB - A total of 1276 schoolchildren aged 11-17 from a Moscow district have been examined. 1172 subjects underwent a complete program examination including biochemical investigation of blood (78.9% of all the children to be examined or 95% of all the schoolchildren examined). The occurrence of combined basic indices, known as adult risk factors of coronary heart disease has been studied in each age and sex group of this population. The data obtained can be used in the differential approach to the planning of preventive measures at the population level. PMID- 6860479 TI - [Excess body weight as a risk factor in ischemic heart disease]. AB - Men aged 40-59 from one of the Moscow districts were subjected to a randomized study. 3908 men (about 78% of subjects to be studied) were examined. 1021 men underwent repeated examinations. The incidence of coronary heart disease increased with the increase of body weight, whatever the levels of systolic and diastolic blood pressure, and blood plasma cholesterol, triglycerides, alpha lipoprotein cholesterol and with no risk factors present. PMID- 6860480 TI - [Arterial pressure in adolescents. The 1st prospective study (International Collaborative Study of Juvenile Hypertension)]. PMID- 6860481 TI - [Bicycle ergometry test results in persons with ischemic heart disease detected in mass screening]. AB - Bicycle ergometry in 40-59 year-old male patients with coronary heart disease, identified during mass prophylactic examination on the basis of epidemiological criteria, has shown that in patients with angina pectoris of effort and no myocardial infarction in history positive exercise tests are observed in 20,8% of cases, while in patients with painless CHD forms positive results are observed in 15.4% of cases. Positive exercise tests are the most often in patients with daily anginal attacks and in those with ST depression and flat negative T waves. PMID- 6860478 TI - [Nutrition and the incidence of ischemic heart disease]. AB - The analysis of the correlation between diet and coronary heart disease (CHD) incidence in 40-59 year-old men from one of the Moscow districts has demonstrated dietary differences between subjects with and without CHD. Food and calories consumption reduces with age, however this is accompanied by an obvious increase in body weight and CHD incidence. Besides energy disturbance, consumption of essential polyunsaturated fatty acids also reduces with age. Patients with CHD show energy disturbance and lower, as compared to persons without CHD, consumption of polyunsaturated fatty acids. PMID- 6860482 TI - [Physical load tolerance examined in epidemiological studies]. AB - The work presents the results of the study of tolerance to exercise test in 677 men aged 40-59, carried out during a cross-sectional epidemiologic study. Persons with positive electrocardiographic results of the test were shown to be characterized by a diminished tolerance to exercise, the duration of the test and cardiac index being informative indicators together with such IHD risk factors as blood serum cholesterol level and age. PMID- 6860483 TI - [Results of a carbohydrate tolerance study in prospective epidemiological research on ischemic heart disease]. AB - There are presented the results of a prospective study aimed at establishing the incidence of impaired carbohydrate tolerance in a nonorganized population of middle-aged males, which in a 6.5-year follow-up accounted for 42.2 and 40.3%, respectively. The incidence of diabetes mellitus increased drastically with age (3.1% and 9.8% in 50-54 and 60-64 year-old men, respectively). Men with borderline impaired carbohydrate tolerance combined with glucosuria require the most thorough dispensary follow-up, for they were found to develop diabetes mellitus in 6.3% of cases during the following 6.5 years. PMID- 6860484 TI - [24-hour ECG monitoring of patients with different clinical forms of stenocardia]. AB - A total of 60 patients with coronary heart disease were examined and divided into 2 groups: (I)53 patients with classical angina pectoris at rest and of effort; (II)7 patients with variant angina pectoris. The results of 24-hour ECG monitoring, bicycle exercise test and coronary angiography were studied. By giving an objective ECG pattern during myocardial ischemia attack. 24-hour ECG monitoring enabled one to differentiate various clinical forms of angina pectoris, establish their connection with heart rhythm disturbances, thus forming the basis for the differential approach to the treatment. PMID- 6860485 TI - Analysis of cell kinetics, chromosome aberration frequency and sister chromatid exchanges in lymphocyte "in vitro" cultures of patients irradiated by 131I. Preliminary note. AB - In the present note we analyse the possible effect of 131I administration on lymphocyte cultures or patients previously subjected to thyroidectomy because of carcinoma. Three parameters were taken into consideration: cell kinetics, SCE frequency and chromosome aberrations frequency before and after treatment. It is possible to point out only an increase of chromosome aberrations. Our data stress the importance of considering several variables at the same time when we are faced with the problem of evaluating possible DNA damage. PMID- 6860486 TI - [Circadian changes in somatotropic hormone and prolactin during a balanced normocaloric diet and after a high protein diet in 16 normal subjects]. PMID- 6860487 TI - [Blood testosterone levels before and after races of various duration]. AB - The blood testosterone levels have been measured in nine middle-distance runners seven walkers and in eighteen marathon runners before and after races of different duration. Most of the athletes (24 out of 34, 70,6% of the population) have shown an increase in testosterone levels soon after physical exercise. The values varied from an average of 5,83 to 7,72 ng/ml in middle distance runners, from 4,70 to 6,70 ng/ml in walkers, and from 5,00 to 6,82 ng/ml in marathon runners. The Authors hypothesize that prolonged physical activity in well-trained athletes may determine an augmented incretion of testosterone. PMID- 6860488 TI - Influence of bromocriptine on glucose-3-H3 metabolism in vivo. AB - The dopaminergic agonist Bromocriptine has been perfused in vivo in normal Wistar rats to control its activity on Glucose-3-H3 metabolism. Bromocriptine shows a rapid influence on glucose production rate (Ra) and glucose utilization rate (Rd). Both rates increase, but since Bromocriptine effects on glucose production rate is more significant than the ones on glucose utilization, the final results is an increase in plasma glucose levels. Since glucose production rate in normal animals is practically equal to hepatic glucose output, the most logical explantation of Bromocriptine activity is the activation of glycogenosis with a rise of plasma glucose levels. PMID- 6860489 TI - The effects of a load of phenilalanine on glucose metabolism. AB - The clinical and experimental hyperphenylalaninemic conditions seem associated with disorders of carbohydrates metabolism. Examples are the increased liver glucose turnover and the glycogen depletion under Phenylalanine load and the hyperexcretion of glucose in the urine of PKU children. We studied the effects of an acute load of Phenylalanine on Glucose-3-H3 kinetics and plasma glucose levels in adult male Wistar rats. The effects of the load were very slow and after 40 minutes we observed an increase in the rate of plasma glucose production (Ra), that in normal animals in an almost exclusive liver function. As result of this glucose production there was a modest increase in plasma glucose levels. PMID- 6860490 TI - Modulation of presynaptic cholinergic receptors by adrenergic drugs. AB - Some adrenergic drugs were tested for their ability to interact with the stimulatory activity of scopolamine on Ach output from brain cortex. The noradrenergic neurotoxin DSP4 was the most potent in depressing the effect of the anticholinergic drug and behaved like a potent alpha 2-agonist and alpha 1 antagonist on nervous peripheral structures. This finding supports the view of a connection between presynaptic adrenergic and muscarinic receptors. PMID- 6860491 TI - [Effect of adrenaline on blood glucose and glycogen in catfish tissues]. AB - The effects of epinephrine injected intraperitoneally (5 mg/kg body weight) on the catfish carbohydrate metabolism were studied. Epinephrine caused a very high and persisting hyperglycemia, the highest value of which was 340 +/- 21 mg/100 ml of blood (control value: 75 +/- 6 mg/100 ml) at 24th hour after the administration. Moreover, epinephrine caused glycogenolysis in liver: from 127 +/ 10 to 95 +/- 8 mg/g of tissue. In white muscle the lowering of glycogen happened just after the epinephrine injection and reached the lowest value (1,6 +/- 0,3 mg/g) at 2,5 hours after the administration (control value: 2,9 +/- 0,4 mg/g). A glycogen decrease took place in red muscle with a great delay, but was still present 48 hours after administration (control value: 17,5 +/- 1,8 mg/g; sample value: 11,2 +/- 3,2 mg/g). The increase of glucose level in blood could be referred to glycogenolytic processes in liver. As far as musculature is concerned, red muscle probably plays a role in recovering the glycogen level in white muscle. PMID- 6860492 TI - [Vascular microanastomoses in the experimental and clinical transplantation of tube and ovary]. AB - This work offers a review of the progresses achieved in both experimental and clinical fields about internal genital organs grafting. The Authors refer their own experience on the vascular microanastomosis and the grafting in rats. They particularly point out the difficulties and the problems they have met during their study. Microsurgical technic has allowed to achieve the viability of the microanastomosis controlled by hystological observations after 10 and 30 days. PMID- 6860493 TI - Presence of delta antigen in liver biopsies of HBsAg positive patients with chronic liver diseases living in the Naples area. AB - In a study of the presence of delta-Ag in liver biopsies of HBsAg positive patients with chronic liver diseases living in the Naples area, delta-Ag has been found only in patients with HBsAg positive chronic active hepatitis and in none of HBsAg positive patients with other liver diseases including those with chronic persistent hepatitis. The data obtained support the hypothesis that the simultaneous infection with HBV and delta-agent, and superinfection with delta agent in HBsAg positive patients predispose the outcome of chronic hepatitis. PMID- 6860494 TI - [Interaction of the 3rd component of complement (C3) with the surface of LS murine fibroblasts]. AB - LS fibroblasts grown in suspension culture fix C3 on their surface when they are incubated with human or guinea pig complement as shown by reacting te cells with FITC-labelled anti C3c sera or immunoglobulins. At the same time the lytic activity of complement is lowered and aliquots of C3 are subtracted from the sera following incubation with the cells. EDTA - EGTA experiments and other observations suggest that C3 fixation requires activation, which proceeds via the alternative pathway, in much the same manner as it has been reported for limphoid cells and thymocytes. PMID- 6860496 TI - [HDL2 and HDL3 in beta-thalassemia]. PMID- 6860495 TI - [HDL2 and HDL3 cholesterol in hepatic cirrhosis]. AB - In order to further investigate plasma lipoproteins abnormalities secondary to serious liver damage, we studied plasma lipids and lipoproteins, and in particular HDL subfractions (HDL2, HDL3), in 12 patients with cirrhosis of the liver and in 12 sex, age and weight matched healthy volunteers. Enzymatic methods were used to determine total cholesterol and triglycerides, while the extractive method of Abell et al. was used for the determination of HDL-cholesterol levels after LDL and VLDL precipitation with polyanions (MnCl2 and Na-heparin) and of HDL3-cholesterol values after HDL2 precipitation with dextran-sulphate 15,000 m.w. Total cholesterol and HDL-cholesterol levels were significantly lower in cirrhotic patients compared to normal subjects. We must emphasize that only HDL3 cholesterol was decreased in cirrhotics, whereas HDL2-cholesterol values were normal or high. We suggest that a diminished activity of hepatic triglyceride lipase might account for the decrease in HDL3-cholesterol in liver cirrhosis. PMID- 6860497 TI - [Growth and doubling time of the L1210 ascites tumor in DBA/2 mice after electrothermocoagulation of the tuberoinfundibular region of the hypothalamus]. PMID- 6860498 TI - Cyclic adenosine-3':5'-monophosphate binding proteins in human mammary tumor cytosol and their relation to estrogen and progesterone receptors. A preliminary study. AB - A method for determining cAMP-binding activity in human mammary tumor cytosol is described and the results of routine assay on 57 tumor samples are presented in relation to the estrogen and progesterone receptor levels. Results show that the values of each single parameter are very largely dispersed. The estrogen receptor/cAMP-binding protein ratio distributes in a very interesting way, in view of a retrospective clinical trial now in progress. PMID- 6860499 TI - [Kinetics of sulphur compounds decrease in liver homogenates during in vitro incubation in experimental conditions modifying lipid peroxidation rate]. AB - Low values of pH are known to increase lipid peroxidation during "in vitro" incubation of rat liver homogenates. Non protein sulphydryl compounds decrease more rapidly when the pH of the homogenate is lower. The increase in incubation temperature stimulates the production of TBArs. At high temperature values the SH groups content of liver tissue falls quickly; the rate of this fall, at the same temperature values, shows differences at different pH. In all experimental conditions the decrease of -SH groups precedes the stimulation of TBArs production and it is mainly due to GSH oxidation, being the decrement of total glutathione very low. Total homogenate from Yoshida AH-130 hepatoma shows no production of GSSG even when incubate for 2 hours at 40 degrees C and at pH 6. The importance of the role played by carbonyl compounds arising from peroxidative decomposition of unsaturated fatty acids on GSH decrement in liver homogenates is discussed and the difference between Yoshida hepatoma and normal liver, as far as GSH decrease is concerned, is discussed. PMID- 6860500 TI - [Clinico-electroencephalographical significance of small sharp spikes]. AB - Clinical and electroencephalographical investigations were made on the 234 patients with neuropsychiatric disorders, showing small sharp spikes (sss) on EEG. Incidence of sss was significantly higher in patients with epilepsy (8.6%) than in the non-epileptic cases (2.5%), especially in early age groups (11-35 years). Some differences in clinical features and in characteristics of sss were found between the epileptic patients and the non-epileptic patients; namely, 1) In majority of the subjects (97%), sss were observed exclusively in stage 1 and 2 of sleep, however, 8 epileptic patients exhibited sss in deep sleep (stage 3) or in awake state, as well as in light sleep. 2) In the non-epileptic group, females (3.4%) showed significantly higher incidence of sss than males (1.7%), while there was no sex difference in the epileptic group. 3) Of the non-epileptic patients, 45% had autonomic symptoms, such as headache, dizziness, tinnitus, nausea and vomiting, while there was no significant correlation between particular neuropsychiatric diagnosis and the EEG pattern. Among the non epileptics, 72% showed normal EEG except for sss and in 89% sss appeared bilaterally but commonly bilaterally independently. 4) As to relation of sss to seizure types of epilepsy, complex partial seizures showed significantly higher incidence of sss (25.2%) than simple partial seizures (7.5%) and generalized tonic-clonic seizures (6.5%). In the patients with epilepsy, sss were often observed unilaterally predominantly (49%), especially in the patients with complex partial seizure (57%). In complex partial seizure, unilateral sss coincided with laterality of anterior-temporal seizure discharges in 68%. According to the results, the authors suggested that sss has some electroencephalographical significance, probably on mechanisms relating to epileptogenic dysfunction, particularly that of complex partial seizures. PMID- 6860502 TI - [Intracranial lipomas--report of six cases]. AB - Intracranial lipoma is a very rare tumor, and infantile lipoma has been reported quite scarcely. The authors recently have encountered six cases of intracranial lipoma, five are infants and one is adult, on which the results of neuroradiological examinations, especially CT findings are reported. Two of six cases had lipoma of the corpus callosum associated with cranium bifidum at the midline of frontal region. Two of six cases had lipoma occurred at the quadrigeminal cistern. To one of them showing advanced enlargement in circumference of the head in the postnatal period, the V-P shunt was conducted for obstructive hydrocephalus. Another case had agenesis of the corpus callosum associated with interhemispheric cyst. One case out of six had lipoma originating from the left sylvian fissure and the remaining adult patient had lipoma located in the interpeduncular cistern. Four cases out of those six were associated with agenesis of the corpus callosum. Based on published reports, the etiology, neuroradiological features, clinical symptoms and signs, differential diagnosis and surgical indication were discussed. PMID- 6860501 TI - [Moyamoya disease associated with persistent primitive trigeminal artery-Report of two cases]. AB - Two cases of Moyamoya disease associated with persistent primitive trigeminal artery (PTA) are reported. Case 1: A 44 year-old man had sudden severe headache and found to have a subcortical hematoma in the left temporo-parietal lobe by CT scans. Four vessel study revealed the right PTA and Moyamoya disease. Case 2: A 56 year-old woman suffered sudden severe headache and was diagnosed as subcortical hematoma in the right temporo-parietal lobe by CT scans. The left PTA and Moyamoya disease were revealed by four vessel study. In the previously reported 232 cases with PTA, we couldn't find out any case associated with Moyamoya disease. There are also no cases associated with Moyamoya disease in 93 cases of persistent primitive hypoglossal artery (PHA) whose vascular anomaly is essentially similar to that of PTA. In the 907 cases of Moyamoya disease collected by Japanese cooperative study, there were no cases in which PTA or PHA was associated by. The period when PTA or PHA disappears at the embryonic stage (5-14 mm) almost corresponds to the period (11-14 mm) in which the vascular state is similar to Moyamoya phenomena. From this point of view, two cases of Moyamoya disease associated with PTA suggest that there is a close relationship between Moyamoya disease and PTA. On the other hand, it seems that Moyamoya disease is associated with PTA by mere chance, because their combination is very rare and Moyamoya vessels changes frequently and dynamically, while PTA does not change. PMID- 6860503 TI - [Electrophysiological findings in patients with hemifacial spasm--effect of neurovascular decompression on synkinesis]. PMID- 6860504 TI - [Experimental study of cerebral protective substances in ischemia--effect of vitamin E]. AB - Using the "Canine model of complete ischemic brain regulated with a perfusion method", the effects of vitamin E which acts as an antioxidant on cerebral ischemia were investigated. After pretreatment with vitamin E by oral or intravenous administration, cerebral blood flow was reduced to 1/10 the normal state and one hour later, return to a normal state allowed. Subsequent changes in electrical activity were observed and the effects of the vitamin E were evaluated. In the control group, no recovery of electrical activity was seen. While in the group of vitamin E administration, the survival time was not prolonged but the recovery time was shortened statistically in the dogs given 30 mg/kg of vitamin E intravenously. Furthermore, in the group treated with vitamin E, distinct recovery of EEG potentials at three 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 indicated that administration of vitamin E is effective in protecting the brain from cerebral ischemia. PMID- 6860505 TI - Cross-sectional echocardiographic findings of anomalous origin of left coronary artery from pulmonary artery. AB - Anomalous origin of the left coronary artery and left ventricular myocardial hypokinesis were visualised by cross-sectional echocardiography. Significant dilatation of the right coronary artery was another important finding. Cross sectional echocardiography appears to be useful for evaluating patients with anomalous origin of the left coronary artery from the pulmonary artery. PMID- 6860506 TI - Haemodynamic effects of intravenous amrinone in patients with impaired left ventricular function. PMID- 6860507 TI - Subcostal M-mode computerised echocardiography. An alternative or complementary approach to parasternal echocardiography? AB - Subcostal M-mode echocardiography has been suggested as a method for assessment of left ventricular size and function. Parasternal and subcostal measurements (direct and derived) of left ventricular function were compared in 30 healthy young subjects. We calculated instantaneous left ventricular diameter and wall thickness every 10 ms for both the subcostal and parasternal approaches using a computer program for echocardiographic digitisation and compensation. All variables were filtered to calculate instantaneous first derivative (velocity) and logarithmic derivative (normalised velocity). The program provided normal values for computerised variables of left ventricular function from the subcostal approach. It was found that there was no identity and no correlation or a poor one between subcostal and parasternal left ventricular internal diameters and volumes. The parietal wall thickness was significantly greater using the subcostal approach, and the comparative velocities study showed striking variations between the two approaches, especially in diastole, where the peak lateral wall thinning rate was 20% lower than the posterior thinning rate. We conclude that for a normal and young population, the subcostal and standard parasternal data cannot be used interchangeably for precise studies of left ventricular function. The subcostal approach, however, provides useful complementary information about lateral wall motion. PMID- 6860508 TI - Indomethacin treatment in small versus large premature infants with ductus arteriosus. Comparison of plasma indomethacin concentration and clinical response. AB - An analysis of clinical response and plasma indomethacin concentration was performed on 10 small (less than or equal to 1000 g) and 12 large (greater than 1000 g) premature infants who had symptomatic ductus arteriosus and required intravenous indomethacin therapy (0.3 mg/kg per day). The postnatal age, daily fluid intake, and cardiopulmonary status of the two groups at time of study were comparable, The small premature infants had a significantly lower peak plasma indomethacin concentration and lower concentration in the first four hours after infusion, and lower plasma concentration X time integral than that of the larger premature infants. There was a significant difference between the groups in proportion of response (2/10 vs 9/12) after one dose of indomethacin; this difference was not seen after two to three doses. The results of the study suggest that small premature infants do respond to indomethacin treatment, but compared to the larger infants may require repeated doses. PMID- 6860509 TI - Congenital absence of pulmonary valve leaflets. AB - Congenital absence of pulmonary valve leaflets is an uncommon condition usually associated with ventricular septal defect and an obstructive pulmonary valve ring. Twenty-one patients with these malformations are described. Twenty had an associated ventricular septal defect with ventriculoarterial concordance, and one also had transposition of the great arteries, ventricular septal defect, and obstructive pulmonary valve ring. The clinical features, cardiac catheterisation findings, and angiocardiographic results are presented. Twelve patients underwent cardiac surgery. Three patients died, one in the early, and the other two in the late postoperative period. The results, according to the surgical technique employed and postoperative cardiac catheterisation findings, showed that patients in whom the bioprostheses were implanted in the pulmonary position had a better late follow-up. PMID- 6860510 TI - Open mitral valvotomy: fourteen years' experience. AB - During the period 1968 to 1980, 222 patients with mitral valve disease in which stenosis was the dominant lesion were admitted under the care of the senior author. All patients presented with severe dyspnoea (NYHA grades 3 or 4). One hundred and fifty seven (71%) patients were treated by open mitral valvotomy. One patient died within 30 days of operation (0.6% hospital mortality) and one suffered a transient cerebrovascular accident. One hundred and twenty four (70%) patients were followed up for one to 14 years (mean 7.5 years). There were seven late deaths. Actuarial curves predict the 90.2% 10 year survival after open mitral valvotomy. Eight patients required mitral valve replacement for restenosis corresponding to 16% at 10 years. The remaining patients are in NYHA grades 1 and 2. PMID- 6860511 TI - Exercise induced pulmonary vasoconstriction. AB - Pulmonary vascular resistance normally falls or remains unchanged during exercise. Seven children with pulmonary hypertension were exercised during cardiac catheterisation after operative correction of ventricular septal defect (6) and truncus arteriosus (1). Except for the presence of moderate pulmonary hypertension, resting haemodynamics in these seven children were similar to those of normal children of equal age, but during exercise the postoperative patients showed a rise rather than a fall (+2% vs -18%) in total pulmonary vascular resistance. Two of the seven children had a substantial increase in pulmonary arteriolar resistance during exercise (from 509 to 715 dyne s cm-5 in one patient and from 606 to 828 dyne s cm-5 in the other). These two patients did not differ from normal children in respect of arterial or mixed venous oxygen saturations or of pH with exercise, nor was left atrial pressure related to the rise in pulmonary resistance. These two patients, however, had only a small rise in cardiac output during exercise (6.8% and 43.1%) in spite of a substantial increase in oxygen consumption (121% and 373%). One of the patients with exercise induced pulmonary vasoconstriction had an 82% increase in resting pulmonary vascular resistance over a five year period subsequent to her first exercise study. Analysis of these data, and those previously reported, suggests that exercise induced pulmonary vasoconstriction may occur in 10 to 25% of patients who survive correction of certain congenital cardiac defects. The vasoconstriction cannot be attributed to abnormal changes in blood gases or left atrial pressure, and may be an early sign of progressive pulmonary hypertension. PMID- 6860512 TI - Serum creatine kinase and creatine kinase MB isoenzyme responses of post infarction patients after a graded exercise test. AB - The response of total creatine kinase (CK) and the creatine kinase isoenzyme (CK MB) was studied in 22 male post-infarction patients (three to six months after myocardial infarction) after a functional graded exercise test, before entering a rehabilitation programme. Eleven subjects (group A) completed the test without developing significant electrocardiographic abnormalities. Eleven subjects (group B) showed changes that necessitated premature termination of the test. No significant differences were observed before the functional graded exercise test between the groups in serum concentration of CK, CK MB, and the percentage of CK MB to CK (MB/ CK%). The two groups were significantly different (p less than 0.01) 24 hours after the graded exercise test in CK MB and MB/CK%, but not in CK. In group B, CK and CK MB rose significantly after the graded exercise test (p less than 0.05) as did MB/CK% (p less than 0.01). In group A only CK showed a significant rise (p less than 0.05). It is probable that increases in CK MB after exercise arise from myocardial tissue efflux, reflecting reversible ischaemia. It is concluded from this study that CK MB appears to be a specific indicator of myocardial ischaemia and could, therefore, be of significant assistance in the clinical and functional assessment of the post-infarction patient. PMID- 6860513 TI - Limitation of enzymatic models for predicting myocardial infarct size. AB - The possibility of predicting myocardial infarct size from early enzyme measurements was studied using a physiological two compartment distribution model. Based on this the time dependent appearance function in plasma was calculated for creatine kinase, aspartate aminotransferase, and lactate dehydrogenase in 29 patients suffering from acute myocardial infarction. On average, the appearance function of the three enzymes started four hours after the onset of symptoms, and the maximum was reached after 12 hours for creatine kinase, 13 hours for aspartate aminotransferase, and 22 hours for lactate dehydrogenase. The cumulated appearance function was used as an acceptable estimate of infarct size. The prediction of infarct size from defined points of the appearance function curve for each of the three enzymes was attempted according to a set schedule during the first 25 hours after the onset of myocardial infarction. The prediction using creatine kinase was superior to the other enzymes. Even so, a reliable prediction could only be established at the very earliest from nine hours and this is too late, as irreversible loss of myocardium occurs rapidly after the onset of symptoms. This, together with the fact that other models have unacceptable variability of the prediction, lead to the conclusion that enzymatic predictive models are of no practical value in clinical intervention studies to reduce infarct size. PMID- 6860515 TI - Atrioventricular discordance. Cross-sectional echocardiographic--morphological correlative study. PMID- 6860514 TI - Sinus node electrogram recording in 59 patients. Comparison with simultaneous estimation of sinoatrial conduction using premature atrial stimulation. AB - Directly measured sinoatrial conduction time was compared with sinoatrial conduction time assessed simultaneously by the single premature atrial stimulus technique in 59 patients: 20 with normal sinus function, 35 with sinus dysfunction, and four with sinus bradycardia but negative indirect methods. In patients with normal sinus function direct sinoatrial conduction time was 102.5 +/- 34 ms (mean +/- 2 SD) and was identical to indirect sinoatrial conduction time. Neither direct sinoatrial conduction time in the basal and return cycle, nor post-return and basal cycle lengths were different. Sinoatrial and atriosinus conduction durations were similar. In sinus dysfunction direct sinoatrial conduction time (average 160 +/- 47 ms) was longer than in normal sinus function. Prolonged direct sinoatrial conduction time may therefore be considered as a criterion of sinus dysfunction. In sinus dysfunction no significant correlation was observed between direct and indirect sinoatrial conduction times. Direct sinoatrial conduction time was equal to (17 patients), longer than (12 patients), or shorter than (six patients) indirect sinoatrial conduction time. These differences can be explained by delayed or incomplete premature depolarisation penetration into the sinus node rather than by the classical pacemaker shift. PMID- 6860516 TI - Simultaneous recording of continuous arterial pressure, heart rate, and ST segment in ambulant patients with stable angina pectoris. AB - Simultaneous and accurate recording of arterial blood pressure and ST segment changes is fraught with technical difficulties. We have developed a new system to enable accurate reproduction of the electrocardiogram and intra-arterial blood pressure, using a transducer/perfusion unit conventionally used to study hypertensive subjects, linked to a frequency modulated tape recorder. Detailed methods of digital analysis have been developed to process the data. This system has been used to study 22 patients with arteriographically proven severe obstructive coronary artery disease who suffered frequent attacks of angina. Control data from quantified dynamic exercise in the laboratory were used for comparison with the effects of normal daily activities outside the hospital and to test the hypothesis that "double product" (heart rate X systolic blood pressure) is relevant to the onset of angina in such patients. The most important finding was that both angina and asymptomatic episodes of ST segment depression were invariably accompanied by an increase in heart rate, whereas there was considerable variation in blood pressure changes ranging from an increase to a substantial fall. This suggests that heart rate changes are more important in determining ischaemic episodes than blood pressure. Furthermore, the "double product" was not reproducible during repeated episodes of angina and asymptomatic ischaemia and did not appear to have an important role in the pathogenesis of intermittent myocardial ischaemia in this group of patients. PMID- 6860517 TI - Determinants of recurrent atrial flutter after cardioversion. AB - Eighteen male patients (mean age 59 years) who were electrically cardioverted for pure atrial flutter were retrospectively studied to determine those factors influencing the maintenance of regular sinus rhythm or reversion to atrial flutter. Six months after successful cardioversion, 10 patients (55%) had recurrent atrial flutter and eight patients (45%) were still in sinus rhythm. The two groups were not significantly different with respect to age, symptomatology, abnormalities on the 12 lead electrocardiogram (during sinus rhythm), or the administration of digoxin and a class Ia antiarrhythmic agent (after cardioversion). There was a trend for those patients with recurrent atrial flutter to have a higher incidence of underlying heart disease and previous episodes of atrial flutter than the non-recurrent group. There were statistically significant differences between the recurrent and non-recurrent groups with respect to echocardiographically determined left atrial size and left ventricular ejection fraction. Patients with a left atrial size greater than 45 mm or with an ejection fraction less than 45% were all at high risk for recurrent atrial flutter after successful cardioversion. PMID- 6860519 TI - Bridging the gap. PMID- 6860518 TI - Familial occurrence of mitral valve prolapse: is this related to the straight back syndrome? AB - Familial prevalence of mitral valve prolapse in a Chinese population was determined in 22 propositi of whom 10 had straight back (group A), three had abnormally high metacarpal index (group B), and nine had neither (group C). Of 71 (32 male and 39 female subjects) first degree relatives screened, mitral valve prolapse was found in 19 (seven male and 12 female subjects) (26.8%). The familial prevalence among groups A, B, and C was 20%, 30%, and 38.5%, respectively. Our study indicates that the familial occurrence of mitral valve prolapse does not depend on its association with the straight back syndrome. PMID- 6860520 TI - Continuous intercostal nerve blockade for pain relief following cholecystectomy. AB - Continuous intercostal nerve blockade was used to provide analgesia after cholecystectomy. The blockade was maintained by the insertion of a single extradural catheter into an appropriate intercostal space and by "topping-up" with local anaesthetic on demand. Of the patients studied, 92%, and 76%, required no additional analgesia in the first 24 h and first 48 h following operation, respectively. Measurements of peak flow were obtained on the 1st day after operation. A mean improvement of 37% on pre- "top-up" peak flows, was found. It is suggested that continuous intercostal analgesia is a a safe, reliable and powerful form of analgesia which may improve respiratory function after cholecystectomy. PMID- 6860521 TI - Evaluation of creatinine phosphokinase screening as a predictor of malignant hyperthermia. A prospective study. AB - The efficiency, sensitivity and specificity of measurements of serum creatinine phosphokinase in the screening of malignant hyperthermia-susceptible patients in routine clinical practice has been examined. Although the overall efficiency of this screening method was high, the predictive value of a positive test in the ambulatory surgical population was poor. PMID- 6860522 TI - Effect of antacids on the plasma concentration of phenoperidine. AB - The effect of antacids on the plasma concentration of phenoperidine was studied in six volunteers. All subjects received the same dose of phenoperidine (15 micrograms kg-1) on different occasions in the presence, and absence of, an antacid preparation. In control studies, secondary peaks in the plasma concentration of phenoperidine were invariably observed; these were entirely eliminated, or modified substantially, by the concurrent administration of antacids. In the latter conditions, plasma concentrations of phenoperidine were greater during the first 20 min, and the area under the plasma concentration- time curve between 0 and 20 min was significantly greater than in control studies. In contrast, the plasma clearance of the drug was almost identical in control conditions and during treatment with antacids. After the oral administration of phenoperidine to two subjects, the systemic bioavailability of the drug was 9.9% and 13.9% respectively. PMID- 6860523 TI - Potentiation of nerve block in vivo by physiological adjuvants in the solution. AB - One hundred and seventy-four rats received a standardized 0.4-ml injection into the left infraorbital nerve and all solutions contained lignocaine 0.25 g dl-1. In groups 1-4, the solutions were isoosmotic and contained, besides sodium chloride, potassium chloride 0 or 4 mmol litre-1 and glucose 0 or 20 mmol litre-1 (0 or 360 g dl-1). For groups 5-8, the solutions were hypoosmotic, containing sodium chloride to 0.6 of normal tonicity but were otherwise identical to solutions 1-4. Presence and duration of sensory block were determined from the reflex sublingual electromyographic response to periodic homolateral and contralateral electrical stimulation of the upper lip. In groups 1-4, the presence of potassium chloride 4 mmol litre-1 approximately doubled the duration of blockade (P less than 0.001). Groups 5-8 showed that hypoosmolarity also doubled the duration of block (P less than 0.001), but hypoosmolarity and potassium chloride did not have additive effects. It is concluded that addition of potassium- chloride 4 mmol litre-1 to isotonic solutions of lignocaine is likely to enhance their clinical effectiveness. PMID- 6860524 TI - Cryogenic damage to peripheral nerves and blood vessels in the rat. AB - The effects of cryogenic injury on femoral blood vessels and nerves were studied in 28 rats. The femoral neurovascular bundles were dissected out bilaterally and the vessels and nerves subjected to cryogenic injury. The rats were sacrificed at intervals of up to 2 weeks. Damage to the nerves and to a number of femoral vessels was severe and included necrosis and thrombus formation. The results indicate that significant vascular damage can occur during cryotherapy, and the possible complications of this should be considered. PMID- 6860525 TI - Pulse polarography and intravascular oxygen electrodes. AB - The membranes covering standard polarographic in vivo PO2 electrodes were modified with a view to altering their response times. Their performance was examined under constant and pulsed polarization. Pulse polarization diminished the under-reading of the PO2 signal which occurred at low flow rates. The stability of the electrode signal was greatly improved by integrating the electrode current over the pulse period. The combination of thin membranes and pulsed polarography will provide a PO2 electrode with a fast time response without under-reading the true in vivo PO2. PMID- 6860526 TI - Postoperative ileus, pregnancy-related cholinesterase deficiency and suxamethonium after-pains. A case report. AB - An account is presented of a patient who developed ileus, of greater or lesser severity, after each of seven operations (including two extra-abdominal and three Caesarean sections). During her most recent pregnancy, reviewed here, her plasma cholinesterase activity was found to be decreased and it remained low until at least the 6th day post-partum. However, as the normal activity had been gained by 6 weeks after delivery, the phenomenon had evidently been pregnancy-related. Despite receiving suxamethonium by infusion to completion of her Caesarean section, she did not show an abnormally prolonged response, although she did suffer considerable suxamethonium "after-pains". The question is posed of a possible relationship between the postoperative ileus, muscle pains and the decrease in cholinesterase activity. PMID- 6860529 TI - Comparison of the effects of single doses of atenolol and labetalol on airways obstruction in patients with hypertension and asthma. AB - 1 The effects of atenolol (100 mg), a cardioselective beta-adrenoceptor blocking agent, and labetalol (300 mg), a combined alpha- and non-selective beta adrenoceptor blocking agent given in single doses were examined in a double-blind placebo controlled study in 11 asthmatic patients with hypertension. Changes in forced expiratory volume in one second (FEV1) were measured. 2 There were no significant differences between the effects of the active drugs, approximately half the patients having higher FEV1 values during each of the two active treatments. When compared with placebo, labetalol significantly reduced the effect of inhaled salbutamol on FEV1. 3 Whilst beta-adrenoceptor blockings drugs cannot be recommended in patients with airways obstruction, should they inadvertantly be given, labetalol like atenolol may be considered relatively safer then pure non-selective beta-adrenoceptor blocking drugs. PMID- 6860528 TI - A clinical pharmacological comparison of diclofensine (Ro 8-4650) with nomifensine and amitriptyline in normal human volunteers. AB - 1 Ten healthy male volunteers participated in a double-blind placebo-controlled crossover comparison of the pharmacodynamic profiles of single oral doses of diclofensine 25 mg and 50 mg, nomifensine 75 mg and amitriptyline 50 mg. 2 Diclofensine did not influence salivary flow or consistently affect pupil diameter and had no significant effect on subjective measurements of sedation and mood. It had no effect on reaction time, or on critical flicker frequency. 3 By contrast, amitriptyline significantly reduced salivary flow, produced significant sedation and impairment of mood, prolonged reaction time, and appeared to decrease (but not significantly) critical flicker frequency. 4 Nomifensine significantly reduced (i.e. improved) reaction time, and inhibited salivary flow. 5 Diclofensine did not significantly influence heart rate, blood pressure, systolic time intervals or high speed electrocardiogram. 6 No significant treatment-related differences were observed in serum prolactin, cortisol or growth hormone levels. PMID- 6860527 TI - The pharmacodynamics and pharmacokinetics of conventional and long-acting propranolol in patients with moderate hypertension. AB - 1 The effects on heart rate and blood pressure after single and multiple dosing (1 month) of a long acting formulation of propranolol 160 mg daily, and conventional propranolol, 80 mg twice daily, or 160 mg daily were compared in 11 moderately hypertensive subjects previously shown to respond to propranolol. 2 After acute dosing all three treatments produced significant reduction in blood pressure. After multiple dosing all three treatments maintained significant reductions in lying, standing and exercise heart rate and blood pressure throughout the 24 h. At 24 h, after multiple dosing, the fall in resting and standing systolic BP was significantly greater with LA propranolol than with conventional propranolol 80 mg twice daily or conventional propranolol 160 mg once daily (P at least less than 0.05). 3 The plasma propranolol concentration time curve after LA propranolol showed slowed absorption, and the area under the curve was significantly lower than after conventional propranolol (acute dosing; LA propranolol 160 mg 560 mg ml-1 h, conventional propranolol 80 mg twice daily 1135 mg ml-1 h, conventional propranolol 160 mg daily 1414 mg ml-1 h). PMID- 6860530 TI - Dystonic reactions and the pharmacokinetics of metoclopramide in children. AB - The pharmacokinetics of metoclopramide have been studied in nine children receiving the drug as prophylaxis for cytotoxic induced vomiting. Plasma concentrations of metoclopramide have also been studied in three children with dystonic reactions to the drug. The pharmacokinetics in children were similar to those reported in healthy adults. There was no difference in the plasma concentration of metoclopramide of children with dystonia when compared to those without this adverse effect. Kinetic differences in childhood do not explain the occurrence of dystonia, which in the individual appears to be related to factors other than plasma drug concentrations. PMID- 6860531 TI - The effect of hyoscine butylbromide on the swallowing of capsules. AB - Hyoscine butylbromide (20 mg) given intravenously to 48 patients with normal oesophageal motility significantly reduced oesophageal transit of hard gelatin capsules when swallowed in the erect and supine positions with 15 ml and 60 ml water when compared to an age/sex matched group. Delayed capsule transit and possible failed or slowed drug absorption occurring as a consequence of anti cholinergic drugs on the oesophagus, constitutes a new drug interaction. PMID- 6860532 TI - Use of a bioassay in healthy men to evaluate diuretic-spironolactone combinations. AB - The plasma potassium responses to 1 week's treatment with metolazone 0.625 mg, 1.25 mg and 2.5 mg in combination with spironolactone 50 mg, and metolazone 2.5 alone were examined in a double-blind, crossover study in twelve healthy subjects. Spironolactone attenuated the hypokalaemia induced by metolazone- addition of spironolactone 50 mg to metolazone 2.5 mg raised plasma potassium by 0.18 mmol/l (P less than 0.025). In the presence of spironolactone, a linear log metolazone dose-plasma potassium response relationship (P less than 0.01) was demonstrated. Spironolactone was unable to compensate fully for metolazone's hypokalaemic effect although in combination with metolazone 0.625 mg and 1.25 mg, plasma potassium concentration was maintained close to pretreatment levels. The human bioassay employed provided conveniently quantitative information which allows the rational development of a fixed dose diuretic-spironolactone combination tablet. PMID- 6860533 TI - Evidence for a dual action of sulphinpyrazone on drug metabolism in man: theophylline-sulphinpyrazone interaction. AB - The effects of sulphinpyrazone administration on the metabolic and renal clearances of theophylline in man were investigated. Sulphinpyrazone increased total plasma theophylline clearance by 22%. This was the sum of increases in metabolic clearances by 3-demethylation (32%), 1-demethylation (30%) and 8 oxidation (22%) and of a decrease in renal clearance (27%). It is proposed that sulphinpyrazone has differential effects on at least two forms of cytochrome P 450 inhibiting one enzyme or group of enzymes which metabolises tolbutamide, phenytoin and S(-)warfarin and inducing a form (or forms) which metabolises theophylline, antipyrine and R(+)warfarin. PMID- 6860534 TI - Oral verapamil does not affect glucose tolerance in non-diabetics. AB - Verapamil, a calcium antagonist used to treat angina pectoris, inhibits insulin release in vitro and, when administered intravenously to humans, decreases glucose tolerance. Oral verapamil, 120 mg/day for 1 week increasing thereafter to 240 mg/day in divided doses, was given to nine non-diabetic patients with angina pectoris for 4 weeks. The glucose and insulin responses to a standard glucose load showed no significant difference before and after verapamil. Oral verapamil in the doses used in this study had no significant effect on glucose tolerance in non-diabetics. PMID- 6860535 TI - No significant effect of cimetidine on the pharmacokinetics of misonidazole in man. PMID- 6860536 TI - The effect of indoramin infusion on apparent liver blood flow in man. PMID- 6860537 TI - Atenolol reduces plasma melatonin concentration in man. PMID- 6860538 TI - Symptomatic gastro-oesophageal reflux in pregnancy. A comparative study of white Europeans and Asians in Birmingham. PMID- 6860539 TI - Do anal abscesses lead to fistulae-in-ano? PMID- 6860540 TI - An initial assessment of augmentin for the treatment of paediatric infections in general practice. PMID- 6860542 TI - Scleroderma and carcinoma of uterus. PMID- 6860541 TI - Long-term control of hypertension with Diumide-K. PMID- 6860543 TI - Primary carcinoma of the fallopian tube following hysterectomy. PMID- 6860546 TI - Prognostic significance of serum prolactin levels in advanced breast cancer. AB - Serum prolactin concentrations were measured in 135 postmenopausal patients with advanced breast cancer prior to their treatment with one of 3 endocrine therapies: aminoglutethimide (AG), tamoxifen (T) + AG, or T + AG + danazol. The mean level of prolactin was higher, and there were more individuals with levels of prolactin greater than or equal to 500 mIUl-1, in the group of patients who did not respond to treatment. Of the patients whose disease progressed, those with prolactin levels greater than or equal to 500 mIUl-1 had a significantly shorter survival. It appears that high prolactin levels indicate a poor prognosis to endocrine therapy and the probability of a shorter than average survival time. PMID- 6860545 TI - Reproductive factors in the aetiology of breast cancer. AB - An interview study of 1,362 breast cancer cases and 1,250 controls identified through a multi-centre screening project allowed an evaluation of reproductive determinants of breast cancer. Risk increased linearly with age at first livebirth; women with a birth after age 30 showed 4-5-fold excess risks compared to those with a birth prior to 18, while the risk for nulliparous women resembled that for women whose first birth was in their late twenties. The protection conferred by an early first pregnancy prevailed for pregnancies that ended in a livebirth or stillbirth, but not for those that terminated in other outcomes. Among parous women, a first trimester abortion prior to a livebirth was not associated with an elevated risk, except in the event of multiple miscarriages (RR = 2.2, 95% Cl 0.9-5.1). Although numbers were limited, women who reported an induced abortion in the absence of ever having a livebirth showed some elevation in risk. Age at first livebirth explained most associations, but some residual reduction in risk was noted for multiparous women and those with several births at an early age. There was evidence that delays in birth after marriage increased risk, but this did not explain the high risk associated with late age at first birth. PMID- 6860544 TI - The epidemiology of endometrial cancer in young women. AB - A case-control study was conducted in Los Angeles County, California, of 127 endometrial cancer cases aged 45 years or less at diagnosis, to investigate the role of fertility, obesity and exogenous oestrogens in the development of the disease in young women. Use of sequential oral contraceptive (SOCs) or oestrogen replacement therapy (ERT) for greater than or equal to 2 years was strongly associated with increased risk of endometrial cancer. After excluding these cases, since the SOC or ERT use was probably the cause of their disease, we were left with 110 case-control pairs for further study. Among these remaining case control pairs increasing parity was strongly associated with decreased risk (relative risk of 0.12 for women of parity 3 compared to nulliparous women, P less than 0.001). Current weight was associated with increased risk (relative risk of 17.7 for women weighing greater than or equal to 190 lbs compared to women weighing less than 130 lbs, P less than 0.001). Combination oral contraceptive (COC) use was associated with a decreased risk, which decreased with duration of COC use (relative risk of approximately 0.28 at 5 years of use, P less than 0.001), but the estimate of the protective effect was reduced and became statistically non-significant when allowance was made for weight and parity. The protective effect of COC use was only clearly evident in women who had less than 3 live-births and weighed less than 170 lbs. These results provide further support for the "unopposed" oestrogen hypothesis of the aetiology of endometrial cancer. PMID- 6860547 TI - Enhanced Fc receptor expression by a sub-population of murine intra-tumour macrophages following intravenous Corynebacterium parvum therapy. AB - Intravenous injection of Corynebacterium parvum (C. parvum) 4 days after s.c. inoculation of 5 X 10(5) cells derived from the immunogenic fibrosarcoma FSA/R induced tumour growth inhibition over a period of 21 days in syngeneic C3H/Buf mice. This was not accompanied by a change in the proportions of host cells within the tumour, but the activation state of tumour-infiltrating macrophages was increased following C. parvum therapy. Two macrophage subpopulations were identified in FSA/R tumours after fractionation by unit gravity velocity sedimentation. After i.v. C. parvum therapy the tumour-infiltrating macrophage subpopulation which sedimented between 1 and 6 mm h-1 was consistently activated as determined by measurement of Fc receptor avidity. Other intra-tumour macrophages were generally unaffected by C. parvum treatment. We have previously shown that the host cell fraction sedimenting between 1 and 6 mm h-1 is enriched with monocytes and the data presented in this paper suggest that these cells may enter the tumour in a pre-activated state following intravenous C. parvum therapy. PMID- 6860548 TI - Activities of free radical metabolizing enzymes in tumours. AB - The activity of enzymatic defences against free radical attack including superoxide dismutase (SOD), catalase, glutathione peroxidase and glutathione reductase have been compared in some experimental animal tumours with the corresponding normal mouse tissues. The activity of SOD in PC6 plasmacytoma and P388 lymphocytic leukaemia was lower than in normal lymphocytes and the activity in a mouse bladder carcinoma (MB) was one-half of that of the normal bladder tissue. Similarly PC6, P388, TLX5 lymphoma and MB showed lower catalase activity than the corresponding normal tissues. The activity of glutathione peroxidase in tumours was in general comparable with that of the normal tissues with the exception of MB, while TLX5, PC6 and P388 contained much lower glutathione reductase activity than normal lymphocytes. The results suggest that it may be possible to selectively destroy certain tumours by peroxidative attack, and that P388 leukaemia would be much more sensitive than L1210 leukaemia to free radical production. PMID- 6860549 TI - Clonal variation in the arrest, survival and growth of RIF-1 mouse sarcoma cells in the lungs of C3H mice. AB - The relationship between the long term retention of 125IUdR-labelled tumour cells in the lungs and the formation of pulmonary lesions, has been examined for six in vitro isolated RIF-1 clones. Following i.v. injection, the initial number of cells trapped in the lungs was close to 100% in all cases. However, the rates at which individual clones were subsequently cleared from the lungs and the fraction of persistently retained cells varied considerably. Whilst clones also differed markedly in their lung colony formation efficiency (L.C.F.E.) there was no clear correlation between the long term retention of tumour cells in the lungs and subsequent metastasis formation, even when the retention of one clone was artificially increased in the lungs by admixture with microspheres. The fate after injection of clone 16 which is retained well in the lungs but which is of low L.C.F.E. has been compared with that of clone 19 which is retained poorly in the lung but which is of high L.C.F.E., using in vitro clonogenic capacity as a measure of cell viability in the lungs. Our findings show that clone 16 cells arrested in the lungs are in a viable, albeit "dormant", state some 26 days post i.v. injection. In contrast, arrested clone 19 cells proliferate rapidly in the lungs. These data may indicate varying significance of tumour cell and host properties in the metastatic success or failure of individual RIF-1 clones. PMID- 6860551 TI - The occurrence of multiple lymphoreticular and hematological malignancies in the same households. PMID- 6860550 TI - Response to X-radiation and cytotoxic drugs of clonal subpopulations of different ploidy and metastatic potential isolated from RIF-1 mouse sarcoma. AB - Clonal subpopulations of different ploidy values and metastatic capacities, isolated from the RIF-1 mouse sarcoma, have been tested for in vitro X-radiation sensitivity, for in vitro sensitivity to adriamycin and for in vitro and in vivo sensitivity to melphalan and CCNU. Following X-radiation, no consistent differences in the survival curve characteristics (Do and n) of diploid, tetraploid and octoploid cells were observed. In addition no relationship between radiation response and metastatic capacity was observed. For drug response, no marked differences were found in the dose response curves of RIF-1 clones treated in vitro with adriamycin. However, a wide variation in the responses of RIF-1 clones to in vitro melphalan treatment was observed which was independent of both ploidy and metastatic capacity. Although the responses of RIF-1 clones to in vitro CCNU treatment were similarly independent of metastatic capacity, a clear relationship between CCNU sensitivity and ploidy was observed. Thus, all diploid RIF-1 clones were markedly more sensitive to CCNU treatment than either tetraploid or octoploid RIF-1 clones. For both melphalan and CCNU treatment the relative sensitivities in vitro correlated with in vivo sensitivities as assayed by clonogenic cell survival. PMID- 6860552 TI - Cancer incidence in patients with psoriasis. PMID- 6860553 TI - Vascular changes in early TSH-induced thyroid tumours in the rat. PMID- 6860554 TI - Electron microscopy of hypertensive pulmonary vascular disease. AB - Hypertensive pulmonary vascular disease secondary to chronic alveolar hypoxia is the result of vasoconstriction and then muscularization of the terminal portions of the pulmonary arterial tree. Ultrastructurally these two phases are characterized respectively by muscular evaginations and the hyperplasia of smooth muscle cells. Plexogenic pulmonary arteriopathy secondary to congenital cardiac shunts, primary pulmonary hypertension or rare cases of cirrhosis of the liver are characterized by concentric-laminar proliferation of myofibroblasts. Later there is a development of plexiform lesions which consist of vascular channels separated by a matrix of proteoglycan containing fibrillary cells and myofibroblasts. Fibrinoid necrosis results from the passage of fibrinogen from the vascular lumen into the arterial wall. PMID- 6860555 TI - Does the lung work? 6. Pictures in the mind. PMID- 6860556 TI - Acute severe asthma: factors that influence hospital referral by the general practitioner and self-referral by the patient. AB - We describe a prospective study of 261 consecutive episodes of acute severe asthma occurring in 232 patients in 1 year. Sixty-seven episodes were treated at home by a selected group of 34 general practitioners, 148 episodes were treated in hospital following referral from general practitioners and 46 episodes were treated in hospital after self-referral, not having been seen by a general practitioner. All patients recovered fully. Comparisons between these groups of patients showed that those selected for hospital admission had higher pulse rates, lower peak expiratory flow rates and more severe grades of attack than those treated at home. Children were more likely to be admitted to hospital, as were patients living near to hospital, or those who were already receiving hospital outpatient supervision. There were self-referrals in all age groups. Several factors which influence the decision on admission, including the speed of onset and severity of the episode, justify some shift of the primary care role from the general practitioner to the hospital. If self-referral is to be encouraged there is a need for agreement on the types of patient and the nature of the attack that are best suited to this type of management. PMID- 6860558 TI - Retained secretions in the bronchoscope: a source of material for cytology. PMID- 6860557 TI - The effect of established diabetes mellitus on the presentation of infiltrative pulmonary tuberculosis in the immigrant Asian community of an inner city area of the United Kingdom. PMID- 6860559 TI - Unusual pulmonary reactions to oily propyliodone (Dionosil) in bronchography. AB - Severe reactions to oily propyliodone are rare. Side-effects are usually mild and self-limiting. Three cases are reported of early pulmonary reactions, the cause of which may be a chemical pneumonitis or possibly an allergic response to one of the components of the contrast medium. There was a good response to corticosteroid therapy in all three patients. PMID- 6860560 TI - Metabolic changes at the margin of the spreading psoriatic lesion. AB - Keratotome slices were cut across the margins of rapidly-spreading psoriatic plaques. Each slice was divided into eight sections and in each section we measured the percentage cells in S phase and the levels of glucose-6-phosphate dehydrogenase (both related to epidermal proliferation), acid phosphatase (associated with keratinization) and alkaline phosphatase (a marker for dermal capillaries). Disturbances in the epidermis extended only 2 to 4 mm into the 'uninvolved' skin, whereas the capillaries were metabolically abnormal for a distance of about 2 cm ahead of the advancing edge of the plaque. This implies that changes in the capillary may precede those in the epidermis during the spread of the psoriatic lesion. PMID- 6860561 TI - Sweat gland disturbances in granuloma annulare and necrobiosis lipoidica. AB - We studied sweat gland distribution, density and activity in thirteen cases of granuloma annulare and ten cases of necrobiosis lipoidica, using a combination of the plastic impression and starch-iodine methods. The pattern of sweat gland disturbance in the two diseases was entirely different. In necrobiosis lipoidica an intense and uniform hypohidrosis was detected throughout the lesion, whereas in granuloma annulare the disturbance followed the morphology of the lesion (the papular border showed complete anhidrosis, whereas the flat central part of the lesion showed only moderate hypohidrosis or normal sweating). The method assigns numerical values to the 'relative density' and the 'relative activity' of the functioning sweat glands compared with normal skin, thus permitting statistical evaluation of the results. PMID- 6860562 TI - Merkel cell tumour: report of a case. AB - We report the case of a 75-year-old lady with recurrent primary cutaneous Merkel cell tumours. The condition can be misdiagnosed as lymphoma or anaplastic carcinoma, and the definitive diagnosis can be made only by electron microscopy of fresh tissue. This is the first reported case in the British literature. PMID- 6860564 TI - Skin collagen content. PMID- 6860563 TI - Acute urticaria due to alcohol. AB - A patient with urticaria caused specifically by alcohol is described. The reaction could be blocked by indomethacin and naloxone, indicating that the eruption was mediated by endogenous opiates and prostaglandins. Sodium cromoglycate blocked the reaction completely and consistently. PMID- 6860565 TI - Altered polymorphonuclear leukocyte responses in psoriasis: chemotaxis and degranulation. AB - Chemotactic activities of circulating polymorphonuclear leukocytes (PMN) were determined in twenty patients with psoriasis and twenty healthy control persons. After serial dilution of the complement split product C5a and the formylated tripeptide f-met-leu-phe (FMLP), chemotaxis profiles showed that PMN migration toward both chemotaxins was significantly increased in psoriasis. In addition, PMN from psoriatic patients responded to chemotaxins at much lower concentrations compared with controls. The liberation of (lysosomal) beta-glucuronidase was also determined in cytochalasin B-treated cells confronted with increased concentrations of the chemotaxins. Secretion of this marker enzyme started at lower concentrations in PMN derived from psoriatic patients. Our observations demonstrate migratory and secretory hyper-responsiveness of PMN from psoriatic patients. This may play a role in perpetuating the psoriatic tissue reaction. PMID- 6860567 TI - Generalized pustular psoriasis precipitated by phenylbutazone and oxyphenbutazone. AB - We describe two patients who developed generalized pustular psoriasis after taking phenylbutazone and oxyphenbutazone respectively, and discuss the possible pharmacological mechanism of this effect. PMID- 6860566 TI - Is Dowling-Degos disease the same disease as Kitamura's reticulate acropigmentation? AB - A patient is described with the clinical and histopathological features of both Dowling-Degos disease and Kitamura's acropigmentatio reticularis. The possible identity of the two genodermatoses is discussed on the basis of the similarity of their clinical and histopathological features and of the presence of the two diseases in the family of the propositus. PMID- 6860568 TI - Type C retrovirus-like particles in mycosis fungoides. PMID- 6860569 TI - Mandibular resorption in systemic sclerosis, and its possible association with Scl-70 antibody. PMID- 6860570 TI - Retinoids and the gastric mucosa. PMID- 6860571 TI - Treatment of cutaneous lymphoma with etretinate. AB - Twelve patients with various types of lymphoma were treated with etretinate. The diagnosis included parapsoriasis en plaque, epidermotropic lymphoma (diffuse chronic erythroderma with atypical mononuclear cells, Sezary syndrome or MF tumours) and non-epidermotropic lymphoma. The patients received etretinate in a dose of 0.8 to 1.0 mg/kg/day for 2 to 14 months. No additional therapy was given. Patients with epidermotropic lymphomas stage I and II had a favourable clinical and histological response whereas those with deeply infiltrating tumours remained unresponsive. Patients with parapsoriasis en plaque and poikiloderma showed little response. Of the four patients who discontinued the treatment, three had recurrences after 3 to 4 months but one remained clear. The results obtained with etretinate may equal those obtained with more aggressive treatments. PMID- 6860572 TI - Dapsone in the treatment of miliary lupus of the face. PMID- 6860574 TI - CIRD symposium: Advances in skin pharmacology III: mechanisms and mediators of skin inflammation. 23-24 October 1982, Sophia Antipolis, France. PMID- 6860573 TI - Photochemotherapy (PUVA) in the treatment of urticaria pigmentosa. AB - Eight patients received PUVA for mastocytosis. Five women had typical adult-onset urticaria pigmentosa, without evidence of systemic disease. Another woman had suspected hepatic involvement while the remaining female had early-onset familial urticaria pigmentosa with morphologically atypical mast cells. The only male patient had cirrhosis with hepatic deposits of mast cells in addition to polycythaemia rubra vera. In all patients, except the man with systemic disease, there was reduced pruritus and wealing and partial to almost complete fading of the macules. The manifestations of urticaria pigmentosa recurred after treatment was discontinued. In both lesional and uninvolved skin there was no significant change in either the mean mast cell counts or mast cell ultrastructure after an average of twenty-seven PUVA exposures. In addition, PUVA did not cause a significant alteration in the histamine content of the skin. The beneficial effect of PUVA in urticaria pigmentosa therefore does not appear to be directly related to a change in mast cell numbers or morphology, or to the histamine concentration in the skin. PMID- 6860575 TI - Continuous monitoring of plasma protein extravasation and cell accumulation in vivo. PMID- 6860576 TI - Skin inflammation induced by hypomagnesaemia in the rat. AB - Hairless rats fed a hypomagnesaemic diet developed an inflammatory dermatosis characterized by papular erythematous plaques. The dermatosis was long-lasting and could be observed for up to 6 months. It was inhibited by intraperitoneal injection of magnesium or dexamethasone but not by mepyramine, cimetidine, theophylline, aspirin or indomethacin. Analysis of semithin sections only showed oedema in the epidermis and superficial dermis with occasional intra-epidermal splitting. Direct immunofluorescence did not detect immunoreactant deposits within epidermis or dermis. Hypomagnesaemic dermatosis in hairless rats is proposed as a model for the pharmacological study of skin inflammation. PMID- 6860578 TI - An attempt to evaluate the relative clinical potencies of various diluted and undiluted proprietary corticosteroid preparations. AB - Two series of tests have been performed in order to assess the vasoconstrictor potency of several diluted and undiluted proprietary corticosteroid preparations. Results showed that differences in concentration of a particular corticosteroid were not always reflected as significant differences in vasoconstrictor potency. A previous finding that Eumovate ointment exhibits early vasoconstrictor activity similar to that of Betnovate ointment was confirmed. The extemporaneous dilution of proprietary corticosteroid preparations remains a widespread but controversial habit. In addition, several proprietary products are represented by a range of dilutions of the same corticosteroid with each concentration targeted at a different segment of the market place. Recent work by our group has revealed some interesting results concerning the vasoconstrictor potency of both diluted and undiluted preparations (Gibson et al., 1982). The aim of this study was to extend the investigation to cover a number of widely used preparations. PMID- 6860577 TI - Kinetics of UV-erythema in normal subjects. AB - In the expanding field of clinical dermatopharmacology we standardized an erythema model for testing drugs with effects on UV-induced inflammation in normal male Caucasian subjects. Using a light source with fibre-optic transmission and precise radiation characteristics, some of the shortcomings of conventional UV-application could be overcome. The radiation geometry during the various experiments was kept constant by a tube, permitting a defined area of exposure. Up to eight skin areas of the backs of normal volunteers were radiated with 86.2% UV-A and 13.8% UV-B. After exclusion of hyporeactive and hyperreactive subjects a good intrasubject reproducibility was obtained repeatedly over at least 3 months. According to the definition of bioavailability, our method allows the measurement of the rate and extent of UV-induced erythema. This model has been used for testing topical steroids, non-steroidal antiphlogistics in a variety of pharmaceutical formulations. PMID- 6860579 TI - Anthralin inflammation versus UV-erythema in psoriatics. AB - Anthralin has been applied in low and high concentrations with and without UV irradiation in the treatment of psoriasis (Schauder & Mahrle, 1982a,b). We have studied the relationship between the sensitivity to anthralin and UV-irradiation which might possibly help us to give a more individually adapted therapy. PMID- 6860580 TI - The effect of leukotrienes C4 and D4 on microcirculatory flow in humans. AB - By quantifying the flare response, leukotrienes LTC4 and LTD4 were shown to increase the microcirculatory flow in a sigmoidal dose-response relation over the dose-range of 6.25-800 pmol. LTD4 was found to be more potent than LTC4 after 5 min, but not after 15 min, as estimated by this method. Laser-Doppler flowmeter studies confirmed that LTD4 is a more potent vasodilator than LTC4. PMID- 6860581 TI - Photochemical reactions of Heracleum laciniatum. Influence of dimethyl sulphoxide and corticosteroids. AB - Phytophotodermatitis of Heracleum laciniatum is quite common in Tromso during the summer months. The clinical picture varies from mild to severe erythematous reactions with or without vesicles or bullae on the exposed parts of the body. Phototoxic reactions of Heracleum laciniatum are reported. The influences on phototoxic reactions by bergapten (5-methoxypsoralen) and UV-A by treating the skin with a membrane labilizing agent, dimethyl sulphoxide (DMSO), and a membrane stabilizing agent, the steroid desoximethasone, are evaluated. PMID- 6860582 TI - Epidermal phospholipase A2 activity is raised in the uninvolved skin of psoriasis. AB - In uninvolved epidermis from nine psoriatic subjects, the mean phospholipase A2 activity was significantly greater (P less than 0.01) than in nine controls. The increased activity of this enzyme could lead to an increase in the concentration of free arachidonic acid which, in turn, could lead to increased concentrations of inflammatory mediators. PMID- 6860583 TI - Sensitivity and specificity of eicosanoid radioimmunoassays: new strategy. PMID- 6860584 TI - Langerhans cell--mononuclear cell contacts are not specific for allergy in patch tests. AB - Langerhans cell-mononuclear cell contacts in the epidermis were analysed in minimum positive allergic and toxic patch tests after 6, 12, 24, 48, and 72 hours. No differences between allergic and toxic patch tests were observed in the appearance of Langerhans cells or in the number of Langerhans cell-mononuclear cell contacts. Thus, Langerhans cell-mononuclear cell contacts are not specific for contact allergic reactions, as has previously been suggested. PMID- 6860585 TI - Quantitation of sensitization and responsiveness to dinitrochlorobenzene in normal subjects. AB - Dinitrochlorobenzene (DNCB) has been used widely to assess cell-mediated immunity in man. However, previous workers have evaluated response qualitatively and subjectively. Such methods cannot elucidate the quantitative relationships between stimulus and response essential to an understanding of the functional components of the system. We have developed quantitative techniques to explore the dose-response relationships of both afferent and efferent limbs of the response, and used this method to examine changes in reactivity to DNCB after exposure to UV radiation and in people with contact allergies. PMID- 6860586 TI - The structure and dynamic function of the dermal lymphatic capillaries. AB - Intraluminal valves are present in dermal lymphatic capillaries. It is postulated that, according to the phase of filling or emptying, new valves can be formed by the connective tissue and the endothelial cells which extend into the lumen. They might be called helper-valves. PMID- 6860587 TI - Pure red cell aplasia. PMID- 6860588 TI - Measurement of the density of human platelets and its relationship to volume. AB - New methods are described for platelet isolation and buoyant density determination using low-speed centrifugation in continuous density gradients of Percoll. The conditions used do not induce loss of granule or cytoplasmic markers and enable reproducible platelet frequency distributions to be obtained in linear density gradients. Such frequency distributions are normal with a mode of 1.0645 +/- 0.0015 g cm-3 (mean +/- SD, n=20). Platelets fixed in 0.1% glutaraldehyde show a modal density of 1.0712 +/- 0.0005 g cm-3. Content of protein, lactate dehydrogenase, beta-thromboglobulin and 3H-serotonin correlate closely with platelet numbers throughout the density distribution. The frequency distribution of platelet volume between 2.2 and 21 fl fits a log normal model and cell volume in density subfractions from the most dense to the least dense also approximate log normality. There is a positive correlation between mean platelet volume and buoyant density with a small increment between the least and the most dense extremes. Platelet subfractions separated by volume using a FACS II cell sorter differ substantially from each other in cell volume but the difference in mean density of four different volume fractions in negligible. In discontinuous density gradients of Stractan factors other than platelet density must influence the separation of platelets, as rebanding of platelets from interfaces shows a wide variation in buoyant density when analysed in continuous gradients. It is concluded that analysis of platelet buoyant density in continuous Percoll gradients supports the view that platelet density, like platelet volume, is determined primarily during thrombocytopoiesis and that volume and density are largely independent elements of platelet heterogeneity. PMID- 6860589 TI - Transition from granulocyte to macrophage predominance in bone marrow cultures. AB - These studies examine the mechanisms underlying the transition from granulocytes to macrophages that characterizes cultures of bone marrow cells. Normal mouse marrow was cultured for several weeks in diffusion chambers (DCs) implanted in previously irradiated host mice. Previous studies with this system have shown that there is a period of logarithmic cell growth for 7 d following by a plateau in both total cell number and the numbers of CFU-S and CFU-C. The present studies show that this plateau in cell growth is associated with high cycling rates of both CFU-S and CFU-C. The plateau phase ends with a rapid decrease in the numbers of these progenitor cells. This is associated with a decline in the number of granulocytes, whereas macrophages persist at approximately the plateau level for the entire 48 d of culture. Transplantation of plateau phase cells into secondary DC cultures leads to a more rapid decline in the numbers of CFU-S and CFU-C followed by the total disappearance of granulocytes; in contrast, macrophage number undergoes a small increase which is maintained thereafter. When regular injections of 3H-thymidine are given to host mice bearing late phase secondary cultures, macrophage labelling rises to a plateau of only 30-40%, indicating that most macrophages at this stage of culture are long-lived cells. The kinetics of the stem cell changes implicate the CFU-C as the immediate precursor of granulocyte development in DC cultures but suggest that the CFU-S is the major determinant of overall cell renewal in this system. Macrophages doubtless also originate from CFU-C but, unlike granulocytes, these are often long-lived cells probably with some capacity for continuing cell division. These properties account for the often observed propensity of macrophages to repopulate bone marrow cultures from which stem cells and granulocytes have been depleted. PMID- 6860590 TI - Inhibition of the pentose phosphate shunt by 2,3-diphosphoglycerate in erythrocyte pyruvate kinase deficiency. AB - Pentose phosphate shunt activity was studied by the release of 14CO2 from 14C-1 glucose and 14C-2-glucose in the red cells of five patients with pyruvate kinase deficiency and found to be significantly decreased after new methylene blue stimulation when compared to high reticulocyte controls. Incubated Heinz body formation was increased and the ascorbate cyanide test was positive in blood from these patients. The activity of glucose-6-phosphate dehydrogenase (G6PD) as well as that of 6-phosphogluconate dehydrogenase (6PGD) was inhibited to 20% of baseline in normal red cell haemolysate by 4 mM 2,3-diphosphoglycerate at pH 7.1. 2,3-Diphosphoglycerate was a competitive inhibitor with 6-phosphogluconate (Ki=1.05 mM) and a noncompetitive inhibitor with NADP (Ki=3.3 mM) for 6PGD. Since the intracellular concentrations of glucose-6-phosphate, 6-phosphogluconate and NADP are below their Kms for G6PD and 6PGD, the kinetic data suggest that increased concentrations of 2,3-diphosphoglycerate in pyruvate kinase deficient red cells are sufficiently high to suppress pentose phosphate shunt activity. This suppression may be an additional factor contributing to the haemolytic anaemia of pyruvate kinase deficiency, particularly during periods of infection or metabolic stress. PMID- 6860591 TI - Disappearance of alpha-methyldopa induced red cell autoantibodies despite continuation of the drug. PMID- 6860592 TI - The sequential structure of odour mixture component intensity judgements. PMID- 6860593 TI - Genetics, law and obstetric practice. PMID- 6860594 TI - The malformed fetus and stillbirth: whose patient? PMID- 6860596 TI - Problems and pitfalls of risk assessment in antenatal care. AB - Current obstetric risk-scoring systems do not make a precise prediction of the chances of an abnormal outcome and so cannot be used in formal decision analysis. We examine here the feasibility of using Bayes' theorem to provide an accurate assessment of fetal risk and conclude that two severe limitations effectively exclude this approach as a useful contribution to antenatal care: (1) inaccuracy of the data base: geographical variations and the 'treatment paradox' conspire to reduce the reliability on which any assessment may be made; (2) 'dependency' of the risk factors: most obstetric variables are interdependent and are not therefore amenable to analysis by means of Bayes' theorem. Although fetal risk will be assessed subjectively for the foreseeable future, obstetricians should be aware of the essentially mathematical nature of decision-making. PMID- 6860597 TI - Maternal blood levels of human placental lactogen in the prediction of fetal growth retardation: choosing a cut-off point between normal and abnormal. AB - Single estimations of serum human placental lactogen (hPL) were made in 527 unselected women between 36 and 40 weeks gestation. The association between decreased serum levels of hPL and intrauterine growth retardation was confirmed. The effect of changing the cut-off point between normality and abnormality on the sensitivity, specificity and predictive value was determined. When the 10th centile of hPL values was used, 29% of all growth-retarded fetuses were identified and 91% of all 'normal' fetuses were excluded. The 15th and 25th centiles yielded improved sensitivities of 37 and 50% respectively, but specificity was reduced. It is suggested that the 10th centile provides a good compromise between sensitivity on the one hand and specificity and predictive value on the other. PMID- 6860598 TI - A comparative assessment of an automated blood microprocessor for fetal blood pH measurements in the labour ward. AB - A new fully automated, self-calibrating, blood pH analyser was compared with a standard reference instrument for the measurement of pH of fetal scalp and umbilical cord blood samples. The new instrument is reliable and simple to operate, the volume of blood needed for analysis is small and it does not require the availability of trained laboratory technicians for its use. PMID- 6860595 TI - Fetal anatomical abnormalities and other associated factors in middle-trimester abortion and their relevance to patient counselling. AB - Fetuses present in 91 consecutive spontaneous or missed middle-trimester abortions were studied anatomically and tissue karyotyping was attempted. Anatomical abnormalities were found in 32 fetuses, two of these also had chromosomal abnormalities, six of these abortions were associated with other possible aetiological factors. In a further 23 pregnancies there were probably significant aetiological factors associated with the abortion and in 10, where the fetus had arrested growth, there were two with other possible factors. From a prospective analysis of subsequent pregnancies it would appear that if all the factors relating to middle-trimester abortion, including fetal autopsy, are analysed, better patient counselling and realistic prognoses can be given for subsequent pregnancy. PMID- 6860601 TI - Multicentric carcinoma of the female lower genital tract. AB - The clinical history and treatment of 17 patients with multicentric primary carcinomas of the cervix and vulva is presented. There is a significant association between vulval intraepithelial neoplasia and cervical neoplasia. The concept of multicentricity in relation to invasive and intraepithelial neoplasia of the cervix and vulva is critically reviewed. PMID- 6860600 TI - Plasma progesterone levels as an index of ovulation. AB - Plasma progesterone levels were measured in three groups of untreated women. (1) Nine women with follicle rupture, proved by laparotomy or laparoscopy, had values of greater than or equal to 40 nmol/l on days 18-24 (days-10- -5 from the next period); thus a value of less than 40 nmol/l should not be taken as evidence of ovulation. (2) Nineteen healthy women with normal menstrual histories had hormone assays on alternate days during one cycle. In five of them all values were less than 38 nmol/l. (3) Forty women had a single progesterone assay on days 20-29 of a conceptual cycle. Eight of them had a level less than 40 nmol/l. Ovulation had certainly occurred in all of them, but it is difficult to assess whether the sample timing was optimal since there was no following menstrual period. Progesterone levels in drug-induced conceptual cycles were in general higher than those in spontaneous pregnancy cycles. Women with luteinization of the unruptured follicle frequently had values of greater than 40 nmol/l. Conversely, a secretory endometrium was not uncommon in cycles with values of less than 38 nmol/l. PMID- 6860599 TI - Metabolic inactivation of noradrenaline in human placenta, umbilical cord and fetal membranes. AB - Metabolic inactivation of noradrenaline (NA) was studied in human placenta, umbilical vessels, Wharton's jelly and fetal membranes. Highest degradation capacity was observed in the placenta and fetal membranes, where the NA was inactivated by both monoamine oxidase (MAO) and catechol-O-methyltransferase (COMT). No MAO and COMT activity was found in the cord jelly and the activities in umbilical vessels were very low. PMID- 6860602 TI - Fetal cardiovascular dynamics during cardiac dysrhythmia. Case report. PMID- 6860603 TI - Haemolytic-uraemic syndrome during the first trimester of pregnancy. Case report. PMID- 6860604 TI - Endometriosis with Turner's syndrome treated with cyclical oestrogen/progestogen. Case report. PMID- 6860605 TI - Wernicke's encephalopathy induced by hyperemesis gravidarum. Case reports. PMID- 6860606 TI - Sex ratio of births resulting from artificial insemination. Sex ratio of live born Hausa infants. PMID- 6860607 TI - Changed prognosis of breech-presenting low birthweight infants. PMID- 6860608 TI - Rod and cone activity in patients with dominantly inherited retinitis pigmentosa: comparisons between psychophysical and electroretinographic measurements. AB - Extended electroretinographic (ERG) testing has been carried out in a series of patients with retinitis pigmentosa, dominantly inherited. In 36 of 57 cases only cone b waves were evoked. In 20 of these, psychophysical tests showed only cones mediated vision (Massof class I), while in 16 statis scotopic perimetry demonstrated residual rod function (class II). In the remaining cases, where rod ERGs were seen, the light intensities required to evoke responses were not greatly elevated. A computer model was constructed to relate psychophysical threshold measurements to ERG data. This analysis of the results suggests that in one subgroup of patients the scotopic ERG is smaller than expected from the losses of visual field and that in another the psychophysical elevation of rod visual threshold is greater than expected from ERG measurements. PMID- 6860609 TI - A modified ERG technique and the results obtained in X-linked retinitis pigmentosa. AB - An electroretinographic (ERG) technique is described in which the relationship between scotopic b wave amplitude and stimulus light intensity is determined. The relative amplitude of scotopic to photopic responses is assessed by means of red light and flicker. The method is applied to the detection of ERG abnormalities in heterozygotes for X-linked retinitis pigmentosa. These have been found in only a proportion of cases. The ERG results can be used to suggest the nature of the retinal abnormality. PMID- 6860610 TI - An automated statis perimeter/adaptometer using light emitting diodes. AB - An automated static perimeter/adaptometer is described which measures thresholds with lights of 2 wavelengths. The instrument uses light-emitting diodes to produce the stimuli and is controlled by a small computer, making it very suitable for clinical testing of large numbers of patients. The use of 2 LEDs with different peak emission wavelengths (530 and 660 nm) permits an assessment of the relative state of rod and cone mechanisms in a particular region of the retina either during dark adaptation or when the eye is fully dark adapted. PMID- 6860611 TI - A genetic analysis of retinitis pigmentosa. AB - Genetic analysis of 457 patients with retinitis pigmentosa (RP) included categorisation of families by recognised mendelian pattern of inheritance and formal segregation analysis of all informative sibships. Of the 368 probands a surprisingly high 18% (68) had significant congenital loss of hearing and were diagnosed as having Usher syndrome. The RP probands were categorised as: 21.7% autosomal dominant, 9.0% X-linked, 16.0% autosomal recessive, 3.3% genetic type uncertain, and 50.0% simplex. Segregation analysis reflected this high proportion of simplex cases, accounting for reduced penetrance in dominant families; only 20% remain classified as sporadic (possibly nongenetic). In the matings between normal persons estimates of the segregation ratio also indicate lower values than expected. Unlike in RP sibship, segregation in the Usher syndrome is consistent with the hypothesis of recessive inheritance. Therefore RP with significant hearing loss segregates as expected, while even if a proband is classified as a dominant or recessive the recurrence risk for the RP phenotype may be below mendelian expectation. PMID- 6860612 TI - Acute retinal necrosis. AB - We treated 2 patients with unilateral acute retinal necrosis in association with uveitis. The disorder began as anterior uveitis, secondary glaucoma, and retinal vasculitis, and then developed into retinal necrosis within a few months. The aetiology was obscure and the appropriate treatment debatable. We also review reports of patients showing the same clinical characteristics, termed Kirisawa type uveitis and bilateral acute retinal necrosis, and believe the disorders to be identical. PMID- 6860613 TI - Keratoprosthesis: a long-term review. AB - A keratoprosthesis (KP), is an artificial cornea which is inserted into an opacified cornea in an attempt to restore useful vision or, less commonly, to make the eye comfortable in painful keratopathy. Results o a retrospective study of 35 patients, with 55 KP insertions, are reviewed with regard to visual acuity, length of time vision is maintained, retention time, and complication. Overall there were a number of long-term real successes, eith retention of the KP and maintenance of improved vision in eyes not amenable to conventional treatment. Careful long-term follow-up was needed, with further surgical procedures often being necessary. PMID- 6860615 TI - Sustained release of carmustine (BCNU) for treatment of experimental intraocular malignancy. AB - Sustained release of carmustine (1,3-bis[2-chloroethyl]-1-nitrosourea, or BCNU) via an episcleral implanted silicone device was used to treat Greene hamster melanoma implanted in the anterior chamber of rabbit eyes. Group 1 animals received carmustine intravenously; group 2 received the drug by local sustained release via an episcleral implanted silicone device; group 3 received the drug by both local sustained release and intravenous injection (a total dosage more than twice that in group 1); and group 4 was not treated. The effectiveness of the various administration routes was compared by clinical observation of tumour size and systemic and local toxic reactions, and by histopathological examination. Carmustine delayed the growth of Greene melanoma in all 3 treated groups, but was most effective when a lower dose of the drug administered intravenously was combined with an additional higher dose administered by local sustained release. Local side effects included corneal clouding and conjunctival oedema and congestion at the early stage of local drug delivery via the episcleral implanted device. PMID- 6860616 TI - Cyst of accessory lacrimal gland. AB - We present a case of an epithelial cyst of the conjunctiva caused by the dilatation of an accessory lacrimal gland. The case is peculiar in regard to the size of the cyst and the absence of traumatic or inflammatory factors to explain the retention of fluid. PMID- 6860614 TI - Conjunctival excision or lamellar scleral autograft in 38 Mooren's ulcers from Sierra Leone. AB - Ulcus rodens corneae (Mooren's ulcer) was studied in 30 patients with 38 corneal ulcers. Although the clinical picture resembled Mooren's description, the West African type of ulcus rodens is different in that it has a higher prevalence, a tendency towards perforation, is most frequent in the age group 20-40 years, and is often associated with ankylostomiasis. Conjunctival excision with thermocoagulation gave some relief at the site of the ulcers, but recurrences at other places occurred in at least 52% of cases. Six eyes with a progressive iris prolapse and a flat anterior chamber were reconstructed with lamellar scleral autografts in the absence of donor corneas. PMID- 6860617 TI - Steroid responsiveness in connective tissue diseases. AB - Thirty-four patients with connective tissue disease used dexamethasone drops 0.1% in one eye for 6 weeks. There was a higher incidence of positive steroid response than would be expected in a normal population. Most of the male patients were responders. Care should be exercised when prescribing local steroids for these patients. Males should be offered regular screening for glaucoma. PMID- 6860618 TI - Urinary 3-methylhistidine excretion in man: the role of protein-bound and soluble 3-methylhistidine. AB - The influence of dietary meat and meat stock intake on urinary excretion of 3 methylhistidine (3MH) was examined in human adults. In the absence of 3MH ingestion for 48 h, the study subjects adjusted to an intrinsic urinary 3MH: creatinine value. If the meat and meat stock-free diet was maintained on subsequent days, only minute diurnal variations occurred, and the values of random urine samples during the day were representative of the 24 h 3MH: creatinine value. The mean 3MH: creatinine value (SD) for a group of adults (n 7) was 0.105 +/- 0.023 (mumol of 3MH/mg creatinine), which is approximately 35% lower than the corresponding value in healthy growing infants (0.148 +/- 0.039) (Seashore et al. 1981). Ingestion of meat soup and meat causes different patterns of urinary excretion of 3MH which are consistent with the finding that meat extracts, such as soup and stock, contain considerable amounts of 3MH. The 3MH contents of beef, chicken and turkey were 3.8 +/- 0.15, 3.0 +/- 0.09 and 2.3 +/- 0.29 mumol/g dry wt meat respectively. All three meats contained a water-soluble 3MH-fraction (% total 3MH: beef 8, chicken 21, turkey 23). Amino acid analysis of the soluble fraction with or without hydrochloric acid hydrolysis demonstrated free 3MH in chicken and turkey (5.2 and 2.8% of the total respectively) but not in beef. Patients undergoing urinary 3MH measurements should maintain a diet that is free not only of solid meats, but also of meat stock. The ingestion of commercial food products (e.g. frozen or canned meals, sauces, pizza, etc.) may impair the validity of such measurements because of their meat-stock content. A dietary regimen is presented which is based on a shorter 12 h urine collection. The shorter collection time is satisfactory in the light of the steady rate of 3MH-excretion after 2 d of a diet free of meat and meat stock. PMID- 6860620 TI - The influence of cooked kidney beans (Phaseolus vulgaris) on intestinal cell turnover and faecal nitrogen excretion in the rat. AB - Male Wistar rats were fed on semi-synthetic diets containing cooked white kidney beans (Phaseolus vulgaris) or equivalent levels of protein and carbohydrate. No change was observed in over-all nitrogen balance in animals fed on the bean diet, but there was a two- to three-fold increase in their faecal excretion, compared with control rats. This was compensated by a decrease in urinary-N excretion. Homogenized small intestinal mucosa, prepared from bean-fed animals, showed a 28% increase in protein content compared with control material. Measurements of 3H labelled thymidine turnover indicated that mucosal cell exfoliation was increased by approximately 35% in the small intestines of bean-fed rats compared with controls. It is concluded that though a diet rich in cooked P. vulgaris leads to some increase in mucosal cell turnover in the small intestine of rats, the consequent increase in mucosal protein loss could not account for the increased faecal-N excretion seen in these animals. PMID- 6860621 TI - The effects of organic acids, phytates and polyphenols on the absorption of iron from vegetables. PMID- 6860619 TI - Dietary intake of fluoride ashed (total fluoride) v. unashed (inorganic fluoride) analysis of individual foods. AB - Fluoride content in ninety-three individual food items from a hospital in a fluoridated area was determined by ashing (total fluoride) v. unashing (inorganic fluoride) analysis. No discrepancy between the two methods was found by food group but two dry cereals and black pepper did show significantly more fluoride after ashing. The reason for the unavailability before ashing was not determined. Daily fluoride intake was estimated at 1.783 mg which is midway between the 1.211 and 2.201 mg reported from studies in which composite diets were analysed. Daily intake from food at 0.4 mg was one-quarter of the daily total intake 1.8 mg; a ratio consistent with those previously reported in serum, urine and bone between residents from a non-fluoridated v. fluoridated community. PMID- 6860622 TI - Effect of zinc deficiency on the pregnant ewe and developing foetus. AB - Mature Merino ewes were given either a low-zinc diet (4 mg/kg) or an adequate-Zn diet (50 mg/kg) for all or part of pregnancy. The ewes consuming the low-Zn diet consumed 25% less feed than those given the adequate-Zn diet during the last 115 d of pregnancy. Zn concentration in the plasma of Zn-deficient pregnant ewes declined from 0.7 to 0.3 mg/l. The lambs born to Zn-deficient ewes weighed less and had reduced concentrations of Zn or less total Zn, or both, in the whole carcass, liver and pancreas. A reduction in activity of alkaline phosphatase (EC 3.1.3.1) in the liver and a slight reduction in thymidine kinase (EC 2.7.1.21) activity in the thymus was also observed in Zn-deficient lambs. The Zn-deficient ewes deposited approximately 63 mg Zn into each single-born lamb; this indicates that during the last third of pregnancy the developing foetuses were accumulating the equivalent of 35% of the total dietary Zn intake of the ewes. PMID- 6860623 TI - Methionine requirement of kittens given amino acid diets containing adequate cystine. AB - Six purified amino acid diets containing 6.0 g cystine/kg and the following levels of L-methionine (g/kg diet): 2.1, 2.7, 3.3, 3.9, 4.5, 9.0 were presented to twelve weanling kittens (six male and six female) for six periods of 10 d each. Kittens were assigned to the diets in accordance with a 6 x 6 balanced Latin-square design. Body-weight gains of males and females attained apparent plateaux at 3.3 g methionine/kg diet and were respectively (mean +/- SEM) 22 +/- 4 and 18 +/- 2 g/d. Daily food intakes attained apparent plateaux at 2.7 g methionine/kg diet for male and female kittens and were 63 +/- 10 and 49 +/- 4 g/d respectively. Nitrogen retentions (calculated as dietary-N intake minus faecal- and urinary-N excretion) attained apparent plateaux at 3.9 g methionine/kg diet for both male and female kittens and were 0.85 +/- 0.15 and 0.65 +/- 0.05 g/d respectively. Previous work has shown that the kitten's L methionine requirement, in a diet lacking cystine, is 7.5 g/kg diet. Our results indicate that the kitten's L-methionine requirement is 3.9 g/kg diet when 6.0 g cystine/kg is provided, thus approximately 50% of the animal's sulphur amino acid requirement can be met by cystine. PMID- 6860624 TI - The effect of zinc deficiency on glucose metabolism in meal-fed rats. AB - The incorporation of uniformly-labelled [14C]glucose into fatty acids and glycogen of adipose tissue and liver was used to assess the effects of zinc deficiency on glucose metabolism in meal-fed rats. Throughout the study, identical feeding regimens were maintained between each of the Zn-deficient groups and their appropriate controls. The feeding regimens were either meal feeding or ad lib. feeding. Zn deficiency reduced [14C]glucose incorporation into fatty acids of epididymal fat pads of meal-fed rats by 75% when compared with meal-fed controls. Zn deficiency caused a slight but significant decrease in [14C]glucose incorporation into liver fatty acids of meal-fed fats when compared with meal-fed controls. Zn deficiency significantly increased [14C]glucose incorporation into liver glycogen of meal-fed rats in Expt. 2 but not in Expt 1. Some effects of Zn deficiency on glucose metabolism were shown to be independent of the feeding regimen when a single daily meal was given to both Zn deficient and control groups. This method of feeding may be a useful approach to study the effects of Zn on glucose metabolism in the rat. PMID- 6860625 TI - Kinetics of [103Ru]phenanthroline and dysprosium particulate markers in the rumen of steers. AB - Two rumen cannulated steers consuming 5.5 kg air-dry lucerne (Medicago sativa) hay/d given at two-hourly intervals were used to study the kinetics in the rumen of the two particulate markers, 103Ru-labelled Tris-(1, 10-phenanthroline) ruthenium II chloride ([103Ru]P) and dysprosium (Dy). Provision of markers was achieved by allowing the steers to eat separated stems of the hay on to which had been sprayed solutions of the markers. The intake of large-particle (retained by a 3.2 mm mesh screen) dry matter (DM) in boluses and the rumen large-particle pool size measured by emptying the rumen were used to calculate the turnover rate constant of this pool (1.02 and 1.19/d for steers A and B respectively). The decline with time of both [103Ru]P and Dy associated with large-particle DM in raft digesta was best described by two-compartmental kinetics. The first compartment apparently reflected a combination of the processes of mixing of labelled particles throughout the rumen contents, physical migration of marker from the labelled hay, and physical breakdown of large particles to small particles. The disappearance with time of [103Ru]P and Dy associated with small particles from the raft, ventral digesta and faeces from 3 to 8 d was well described by a single kinetic compartment with a rate constant similar to that of the second compartment of the large particles from the raft. [103Ru]P was rapidly distributed through both the raft and ventral digesta of the rumen. This observation, taken together with measurements of migration of [103Ru]P, suggested that on entering the rumen much of the [103Ru]P did not remain associated with the original feed material. The majority (63-64%) of Dy entered the raft digesta and mixed only slowly through the rumen contents. Some Dy (18-27%) apparently migrated rapidly from large particles and to small particles immediately after ingestion and there was also evidence for some slow migration from small to large particles. When used under the conditions described for this experiment neither [103Ru]P nor Dy was satisfactory as a marker to trace the passage through the rumen of a particular meal. PMID- 6860626 TI - The effect of 1 alpha-hydroxycholecalciferol on the placental transfer of calcium and phosphate in sheep. AB - The calcium and phosphorus concentrations in foetal tissue or the placental transfer of 45Ca and 32P, or both, were studied in fifty-five control or 1 alpha hydroxycholecalciferol (1 alpha-(OH)D3)-treated (0.1 micrograms/kg body-weight per d for 12 d) ewes between 77 and 140 d of gestation. Treatment resulted in a significant increase in the concentration of Ca and P in foetal tissues at all stages of gestation except at 140 d when, it is suggested, foetal mineralization may approach a maximum value. This increase in Ca and P concentration in foetal tissues was associated with an increased placental transfer of Ca, though at 111 and 120 d gestation this increase was not significant. P transfer, which was only measured at 140 d gestation, was also significantly higher in treated animals. The concentrations of Ca and P in both maternal and foetal plasma were increased significantly by the 1 alpha-(OH)D3 treatment. Whereas the concentration of Ca in the plasma of foetuses was always greater than in their dams, the concentration of plasma P in treated animals, unlike controls, was lower in foetuses than dams. This suggests that the increased placental transfer of P, unlike that of Ca, may be a passive rather than an active process. PMID- 6860627 TI - Blood flow and nutrient exchange across the liver and gut of the dairy cow. Effects of lactation and fasting. AB - The rate of blood flow in the portal and hepatic veins, and the net exchange across the gut and liver of volatile fatty acids (VFA), glucose, lactate, pyruvate, amino acids, ketone bodies, glycerol, non-esterified fatty acids (NEFA) and oxygen, were measured in lactating and non-lactating cows (a) in the normal, fed state and (b) before, during and after 6 d of fasting. Blood flow rate through the liver was 52% higher in normal, fed, lactating cows as compared with non-lactating cows, and was decreased by fasting in both groups of cows. Portal blood flow rate increased with an increase in metabolizable energy (ME) intake. Lactating, as compared with non-lactating, cows exhibited lower arterial concentrations of glucose and lactate, higher net portal outputs of VFA and ketone bodies, a higher net hepatic output of glucose, and higher net hepatic uptake of propionate and lactate. The splanchnic outputs of acetate, glucose and hydroxybutyrate were all apparently greater in the lactating cows. Fasting caused a rapid decrease in the blood concentrations of the VFA and an increase in those of glycerol and NEFA. The portal, i.e. gut, outputs of VFA, lactate, ketone bodies, alanine and (serine + threonine), and the portal uptake of O2, were all decreased by fasting. Fasting for 6 h also decreased the hepatic output of glucose and acetate by 77 and 95% respectively, increased the hepatic uptake of pyruvate, glycerol and NEFA, and doubled hepatic ketone-body output. The splanchnic output of acetate and glucose and the splanchnic uptake of O2 were also decreased by fasting. The net portal outputs of VFA, lactate and hydroxybutyrate, and the net hepatic output of glucose, were all correlated with ME intake in fed and fasted cows. Hepatic glucose output was also correlated with milk yield. The net hepatic uptake of gluconeogenic precursors measured in this study could account for net hepatic glucose output in the fasted cows, but not in the fed cows. The net hepatic uptake of the ketogenic precursors butyrate and NEFA was sufficient to account for the hepatic output of ketone bodies in both fed and fasted cows, but it is unlikely that the hepatic uptake of ketogenic precursors could also account for the observed hepatic output of acetate. PMID- 6860628 TI - Growth and development of rats artificially reared on a high or a low plane of nutrition. AB - In order to exclude the possibility of differences in maternal care which are known to result from typical methods of undernutrition during the suckling period, rat pups were reared artificially on different planes of nutrition away from their mothers. Artificial rearing was accomplished by fitting infant rats with a gastric cannula through which a milk substitute was infused intermittently. Rats were fed thus from 4 to 21 d on a high (ARHI) or a low (ARLO; 44% of ARHI level) plane of nutrition. Underfeeding of the ARLO group was continued till 25 d, after which all rats were given a good-quality pelleted diet qd lib. Compared with mother-reared (MR) litter-mates, ARHI rats showed advanced eye-opening and, at 21 and 25 d, they resisted restraint more strongly. Growth in body-weight of ARHI and MR rats was similar but, when autopsied at 32 weeks, the ARHI rats were shorter (nose-rump length) and had lighter gastrocnemius muscles, adrenals and brains, but heavier epididymal-fat pads. ARLO rats had deficits at 32 weeks compared with ARHI rats in whole body, kidney and epididymal-fat-pad weights, and in tibia length. In a second experiment, ARHI and MR rats were killed at 21 d. All the differences found at 32 weeks were already present at 21 d. In addition, the ARHI pups had enlarged livers and intestines but shorter tibias. The milk substitute, which is one commonly used in such studies, has a low protein and high carbohydrate content compared with rats' milk. This difference probably caused the abnormal organ growth of ARHI rats. PMID- 6860629 TI - Energy and nitrogen metabolism of lactating rabbits. AB - Twelve crossbred does (New Zealand White x California) were offered a diet of high protein and metabolizable energy content (249 g/kg dry matter (DM) and 13.6 MJ/kg DM respectively) throughout a 32 d lactation at one of four feeding levels (240, 280, 320 or 360 g/d). Each feeding level was replicated three times. Milk output was measured by weighing the does before and after their one daily suckling period. The lactation was divided into four consecutive 8-d periods. Each doe was placed in a direct calorimeter for 48 h around the mid-point of each of these periods and measurements of energy exchange were made. Nitrogen balance was also measured throughout the study period. Milk samples were taken from a parallel group of animals and the estimates of milk composition were applied to the main group of does. From the second period of lactation onwards nearly all does mobilized body tissue to support milk energy secretion, although there was no loss of weight. Multiple regression analyses were used to examine the apparent efficiency with which metabolizable energy and body-tissue energy were utilized for milk production. Overall, the relationship was described by the equation: (formula; see text) where Milk E is the milk energy output, ME intake is the metabolizable energy intake and Body ER is the body energy retention, all expressed in kJ/kg body-weight0.75 per d. All does appeared to be in positive N balance throughout lactation on this high-protein diet. PMID- 6860630 TI - Cadmium-113 nuclear magnetic resonance studies of proteolytic fragments of calmodulin: assignment of strong and weak cation binding sites. AB - Proteolytic fragments of bovine testis calmodulin were obtained by limited proteolysis with trypsin or thrombin. Cadmium-113 NMR studies showed that the tryptic fragment encompassing Ca2+ binding domains III and IV (TR2C) gave rise to a spectrum identical with that of the native protein. Two thrombic fragments containing either domains I, II, and III [TM1-(1-106)] or the single domain IV [TM2-(107-148)] both gave rise to one broad resonance only. These data indicate that domains III and IV comprise the two high-affinity Ca2+ binding sites in intact calmodulin and that disturbance of the structural relationship between domain III and domain IV markedly reduces the affinity of these two sites for Ca2+ ions. These observations are discussed with respect to other published accounts concerning the sequence in which the four calcium domains in calmodulin are filled. PMID- 6860631 TI - 3-hydroxy-3-methylglutaryl-CoA lyase: catalysis of acetyl coenzyme A enolization. AB - 3-Hydroxy-3-methylglutaryl-CoA lyase, which performs the cleavage of 3-hydroxy-3 methylglutaryl-CoA (HMG-CoA) to acetoacetate and acetyl-CoA by a Claisen-type reaction, also catalyzes enolization of acetyl-CoA. The rate of detritiation of methyl-labeled acetyl-CoA is proportional to enzyme concentration and is diminished by an antiserum that also inhibits the cleavage reaction. The tritium exchange reaction requires both divalent cation and acetoacetate. An analogue of HMG-CoA, 3-hydroxyglutaryl-CoA, was prepared by reaction of acetonedicarboxylic anhydride with CoASH and reduction of the ketoacyl-CoA product with cyanohydridoborate. While 3-hydroxyglutaryl-CoA does not appear to be a substrate for HMG-CoA lyase, it competitively inhibits both the cleavage reaction (Ki = 50 microM) and the tritium exchange from acetyl-CoA (Ki = 95 microM). Agreement between the Ki values measured for cleavage and for tritium exchange supports the hypothesis that the slow tritium exchange is a lyase-dependent reaction. Initial attempts to demonstrate complete reversibility of the cleavage reaction have not been successful. However, the data suggest that the cleavage of HMG-CoA is at least partially reversible and indicate that enolization of acetyl-CoA may be dependent upon a conformational change of HMG-CoA lyase, induced by binding of acetoacetate, in a manner analogous to the keto acid dependent tritium exchange catalyzed by malate synthase and citrate synthase. PMID- 6860632 TI - Effect of changes in the phospholipid composition on the enzymatic activity of D beta-hydroxybutyrate dehydrogenase in rat hepatocytes. AB - The phospholipid composition of primary rat hepatocytes was manipulated by supplementing the medium with choline analogues. The unnatural analogue l-2-amino 1-butanol was incorporated into membrane phospholipids to the largest extent, whereas the natural choline analogues ethanolamine, N-methylethanolamine, and N,N dimethyl-ethanolamine were methylated to yield phosphatidylcholine. When cells were supplemented with [14C]ethanolamine, greater than 25% of the total phosphatidylcholine contained radiolabel in the polar head group after 2 days of supplementation. The extent of phospholipid methylation was reduced by depriving the cells of serine and methionine. Under these conditions, N-methylethanolamine and N,N-dimethylethanolamine were incorporated into phospholipids and were not further metabolized to phosphatidylcholine. After 3 days of supplementation with N-methylethanolamine, the content of phosphatidyl-methylethanolamine went from essentially 0 to 40% of the total phospholipids and surpassed the extent of incorporation of all other analogues. The formation of the new phospholipid species was primarily at the expense of phosphatidylcholine and phosphatidylethanolamine. D-beta-Hydroxybutyrate dehydrogenase, which requires phosphatidylcholine for activity, was assayed in submitochondrial membranes isolated from supplemented cells. For cells supplemented with either l-2-amino-1 butanol or N-methylethanolamine, the Km for NADH increased relative to choline supplemented cells while the Km for acetoacetate remained the same. For example, after 3 days of supplementation with N-methylethanolamine, the Km for NADH was 3 fold higher than the value for the choline-supplemented control cells. The change in the Km was due to the change in the lipid environment with no alteration in the enzyme itself. The results suggest that the phosphatidylcholine molecules necessary to activate the enzyme exchange with the other phospholipids in the membrane so that the Km of the enzyme reflects the overall content of phosphatidylcholine as well as other properties of the membrane phospholipids. PMID- 6860633 TI - Relationship between histone H1 poly(adenosine diphosphate ribosylation) and histone H1 phosphorylation using anti-poly(adenosine diphosphate ribose) antibody. AB - The chromatin-associated enzyme poly(ADP-Rib) polymerase catalyzes the posttranslational modification of histones. Antibody to poly(ADP-Rib) has been coupled to Sepharose, and the resultant immunoadsorbent was used to fractionate, specifically, histone H1 subpopulations undergoing this nuclear protein modification. When this method of separation was used, it was additionally observed that poly-(ADP-ribosylated) H1 species were highly accessible to in vitro phosphorylation by nuclear protein kinase. Phosphorylated H1 molecules were retained by the anti-poly(ADP-Rib)-Sepharose column due to the presence of endogenous poly-(ADP-Rib) components. Degradation of the latter moieties on phosphorylated H1 reversed their adsorption to the column. PMID- 6860634 TI - Fate of an intervening sequence ribonucleic acid: excision and cyclization of the Tetrahymena ribosomal ribonucleic acid intervening sequence in vivo. AB - In previous studies of RNA splicing in vitro, we have shown that the intervening sequence (IVS) of the Tetrahymena rRNA precursor is excised as a unique linear RNA molecule and subsequently cyclized. In the present work, we have investigated the occurrence and stability of these RNA species in vivo. RNA was separated by gel electrophoresis, transferred to diazotized paper, and hybridized with 32P labeled DNA probes. RNA molecules containing the IVS were found to reside within the nucleus and not in the cytoplasm. The species found in nucleus include both the linear and circular forms of the excised IVS RNA, as well as the unspliced precursor. On the basis of quantitation of the hybridization, the half-lives of the IVS-containing pre-rRNA and the excised IVS RNA in rapidly growing cells were estimated as 2 and 6 s, respectively. We conclude that splicing is not a rate limiting step in rRNA maturation and that the IVS RNA is quickly degraded after its excision. When the deproteinized nuclear RNA was incubated at 37 degrees C in a Mg2+-containing solution, a substantial portion of the linear IVS RNA was converted to the circular form. Autocyclization, previously characterized with IVS RNA produced by splicing in vitro, is therefore also a property of IVS RNA produced in vivo. PMID- 6860635 TI - Condensed form of (dG-dC)n X (dG-dC)n as an intermediate between the B- and Z type conformations induced by sodium acetate. AB - Circular dichroism and laser Raman spectroscopy reveal that the synthetic DNA polymer (dG-dC)n X (dG-dC)n undergoes a cooperative transition induced by sodium acetate from a right-handed B-form to a left-handed Z-type conformation with a midpoint at 2.05 M. However, at concentrations only slightly higher than the end point of this transition (above approximately 2.2 M) and up to approximately 2.65 M, the Z-form is not stable in solution but aggregates to form highly condensed DNA. A manyfold increase of positive ellipticity in the range 340-250 nm is observed which is indicative of a psi (+)-type structure. At even higher concentrations (greater than or equal to 2.7 M), the Z-form is stable without condensation, and there is no change in the inverted CD spectrum. All structural transitions are reversible except that it is not possible to redissolve the highly condensed psi (+)-form by further increasing the salt concentration to greater than or equal to 2.7 M. The very high cooperativity of these transitions enables the DNA polymer to adopt three distinctly different structures (B-, Z-, and psi-forms) within a narrow range of sodium acetate concentration (approximately 200 mM). The Raman spectra of the condensed form and the Z-form in very concentrated sodium acetate show that the psi (+)-type state forms without substantial changes of the secondary conformation of the DNA. This indicates that the left-handed Z-helix of (dG-dC)n X (dG-dC)n can form psi-type aggregates with an ordered superstructure similar to those observed for natural right-handed DNA helices. PMID- 6860636 TI - Interactions of porphyrins with nucleic acids. AB - The interactions of tetrakis(4-N-methylpyridyl)-porphine (H2TMpyP-4) and its copper(II), nickel(II), zinc(II), cobalt(III), iron(III), and manganese(III) derivatives with several nucleic acids have been investigated. Spectrophotometric titrations of H2TMpyP-4 and Cu(II)TMpyP-4 with the synthetic polymer poly(dG-dC) could be analyzed by a nearest-neighbor exclusion model leading to n approximately equal to two base pairs and equilibrium constants of 7.7 X 10(5) M 1 and 8.0 X 10(5) M-1, respectively. The other metal derivatives [except for the nickel(II) porphyrin] do not provide sufficiently large color changes with poly(dG-dC) to allow analysis. In contrast, all of these porphyrins interact with poly(dA-dT) and DNA. For those porphyrins investigated, the binding profiles are not adequately fit by a nearest-neighbor exclusion model but have profiles suggesting that cooperativity effects are important. Spectral and circular dichroic experiments both suggest base specificity. With calf thymus DNA, the copper(II) and nickel(II) derivatives show prominent negative circular dichroism (CD) features and large red shifts and hypochromicity of the Soret absorption band characteristic of GC specificity, as demonstrated with the synthetic polymer. The other metal derivatives show prominent positive induced visible CD features with small red shifts and hypochromicity of the absorption bands in the Soret region characteristic of AT specificity. Only the metal-free derivative has a conservative CD spectrum suggesting distribution among GC and AT sites. PMID- 6860637 TI - Resonance energy transfer between cysteine-34 and tryptophan-214 in human serum albumin. Distance measurements as a function of pH. AB - The single cysteine residue (Cys-34) of human serum albumin was modified with the organic mercurial [4-[p-(dimethylamino)phenyl]azo]phenyl]mercuric acetate. Introduction of this chromophore into the protein results in the quenching of the protein tryptophan fluorescence spectrum due to energy transfer from the tryptophan residue to the mercurial. Since human albumin contains only a single tryptophan, it was then possible to calculate distances between the mercurial bound at Cys-34 and Trp-214 under various conditions. This distance contracted during the course of the N leads to F transition, being 34-35 A in the N conformation (pH 6-7.5) and 29.9 A in the F conformation (pH 3.6). The distance increased substantially during the course of the F leads to E transition occurring between pH 3.6 and pH 1.9 and was found to be nearly 37 A at pH 1.9. The distance between Cys-34 and Trp-214 was found to undergo a slight contraction during the N leads to B transition occurring between pH 7.0 and pH 9.0. At pH 8.5 9 where the protein is predominately in the B form, the distance was found to be slightly more than 31 A. PMID- 6860638 TI - Resonance energy transfer between cysteine-34, tryptophan-214, and tyrosine-411 of human serum albumin. AB - Reaction of p-nitrophenyl anthranilate with human serum albumin at pH 8.0 results in esterification of a single anthraniloyl moiety with the hydroxyl group of tyrosine-411. The absorption spectrum of the anthraniloyl group overlaps the fluorescence emission of the single tryptophan residue at position 214. This study complements that of the preceding paper [Suzukida, M., Le, H. P., Shahid, F., McPherson, R. A., Birnbaum, E.R., & Darnall, D. W. (1983) Biochemistry (preceding paper in this issue)] where an azomercurial group was introduced at cysteine-34. Anthraniloyl fluorescence was also quenched by the azomercurial absorption at Cys-34. Thus measurement of resonance energy transfer between these three sites allowed distances to be measured between Cys-34 in domain I, Trp-214 in domain II, and Tyr-411 in domain III of human serum albumin. At pH 7.4 in 0.1 M phosphate the Trp-214 leads to Tyr-411, Tyr-411 leads to Cys-34, and Trp-214 leads to Cys-34 distances were found to be 25.2 +/- 0.6, 25.2 +/- 2.1, and 31.8 +/- 0.8 A, respectively. PMID- 6860639 TI - Interaction of bovine blood clotting factor Va and its subunits with phospholipid vesicles. AB - Thrombin-activated factor Va and factor Va subunit binding to large-volume vesicles was investigated by a technique based on the separation by centrifugation of phospholipid-bound protein from the bulk solution. This technique allows the direct measurement of free-protein concentration. It is concluded that the phospholipid binding site on factor Va is located on a basic factor Va subunit with Mr 80 000 (factor Va-LC). The effects of phospholipid vesicle composition, calcium concentration, pH, and ionic strength on the equilibrium constants of factor Va- and factor Va-LC-phospholipid interaction were studied. Factor Va and factor Va-LC binding to phospholipid requires the presence of negatively charged phospholipids. It is further demonstrated that the following occur: (a) Calcium ions compete with factor Va and factor Va-LC for phospholipid-binding sites. (b) The dissociation constant of protein-phospholipid interaction increases with the ionic strength, whereas the maximum protein binding capacity of the phospholipid vesicle was not affected by ionic strength. (c) The dissociation constant for factor Va-phospholipid interaction depends on pH when the vesicle consists of phosphatidic acid. It is concluded that factor Va phospholipid interaction is primarily electrostatic in nature, where positively charged groups on the protein directly interact with the phosphate group of net negatively charged phospholipids. The results suggest that factor Va, like factor Xa and prothrombin, has the characteristics of an extrinsic membrane protein. PMID- 6860640 TI - Circular dichroism spectroscopy of the intermediates that precede the rate limiting step of the refolding pathway of bovine pancreatic trypsin inhibitor. Relationship of conformation and the refolding pathway. AB - Circular dichroism spectra of the partially folded trapped intermediates were measured in order to aid in the elucidation of the conformational forces which determine a nonrandom, nonsequential pathway of disulfide bond formation upon refolding of bovine pancreatic trypsin inhibitor. Whatever conformation was responsible for the kinetic rates of the intermediates should be stabilized by the presence of their trapped disulfide bonds. The near-ultraviolet spectra provide considerable information about the environments of the aromatic and disulfide side chains. The predominant single-disulfide intermediate has significant nonrandom conformation not present in the fully reduced protein, with aromatic rings and the disulfide bond in stabilized asymmetric environments. Forming either of the two nonnative, but kinetically important, second disulfides in this intermediate does not produce unequivocably different conformations. Forming a second native, but kinetically unproductive, disulfide produces a substantial decrease in randomness, which may hinder formation of the third disulfide. The largest conformational changes occur upon disulfide rearrangement to the stable, correctly refolded, two- and three-disulfide species. Interpretation of the far-ultraviolet spectra in terms of the secondary structure of the intermediates is uncertain, due to the atypical spectra of the folded forms of the protein. Consequently, we are unable to determine unambiguously the secondary structure of the intermediates. However, all the spectra show that nonrandom conformations of the polypeptide chain gradually appear as disulfide bond formation progresses, as expected from the nonrandom pathway of the latter. PMID- 6860641 TI - Structural organization of filamentous proteins in postsynaptic density. AB - Actin is one of the major protein constituents of the postsynaptic density (PSD), a characteristic structural entity subjacent to the postsynaptic membrane in excitatory synapses of the vertebrate central nervous system. In isolated purified PSD preparations, it is present to the extent of 29 +/- 2 micrograms/mg of total protein, 90% of which is in the filamentous (F-actin) form. Iodination by a discriminatory labeling technique demonstrates that actin is located on the surface of the PSD from which it can be stripped by treatment with a mixture of strong anionic detergents, leaving behind an insoluble core held together by disulfide bridges, consisting in part of tubulin and "PSD protein". PMID- 6860642 TI - Purification, characterization, and assembly properties of tubulin from unfertilized eggs of the sea urchin Strongylocentrotus purpuratus. AB - Tubulin was purified from unfertilized eggs of the sea urchin Strongylocentrotus purpuratus by chromatography of an egg supernatant fraction on DEAE-Sephacel or DEAE-cellulose followed by cycles of temperature-dependent microtubule assembly and disassembly in vitro. After two assembly cycles, the microtubule protein consisted of the alpha- and beta-tubulins (greater than 98% of the protein) and trace quantities of seven proteins with molecular weights less than 55 000; no associated proteins with molecular weights greater than tubulin were observed. When analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis on urea-polyacrylamide gradient gels, the alpha- and beta-tubulins did not precisely comigrate with their counterparts from bovine brain. Two-dimensional electrophoresis revealed that urchin egg tubulin contained two major alpha tubulins and a single major beta species. No oligomeric structures were observed in tubulin preparations maintained at 0 degrees C. Purified egg tubulin assembled efficiently into microtubules when warmed to 37 degrees C in a glycerol-free polymerization buffer containing guanosine 5'-triphosphate. The critical concentration for assembly of once- or twice-cycled egg tubulin was 0.12-0.15 mg/mL. Morphologically normal microtubules were observed by electron microscopy, and these microtubules were depolymerized by exposure to low temperature or to podophyllotoxin. Chromatography of a twice-cycled egg tubulin preparation on phosphocellulose did not alter its protein composition and did not affect its subsequent assembly into microtubules. At concentrations above 0.5-0.6 mg/mL, a concentration-dependent "overshoot" in turbidity was observed during the assembly reaction. These results suggest that egg tubulin assembles into microtubules in the absence of the ring-shaped oligomers and microtubule-associated proteins that characterize microtubule protein from vertebrate brain. PMID- 6860643 TI - Localization of the second calcium ion binding site in porcine and equine phospholipase A2. AB - At alkaline pH porcine pancreatic phospholipase A2 is known to bind two Ca2+ ions per protein molecule. One Ca2+ ion is strongly bound to the active site and is essential for enzyme activity. A second Ca2+ ion binds more weakly to the protein and improves the affinity of the enzyme for lipid-water interfaces severalfold at high pH values. A group having a pK around 6 controls enzyme binding to lipid water interfaces in the absence of Ca2+. By use of proton titration techniques this group is now identified to be a carboxylate having an abnormally high pK. Its pK shifts to a value around 4.5 in the presence of high Ca2+ concentrations, suggesting that the carboxylate is involved in binding the second Ca2+ ion. The carboxylate was identified to be Glu71 by comparing proton titration experiments on porcine pancreatic phospholipase A2 and an isoenzyme. The isoenzyme differs by only four residues from the most abundant enzyme, lacking the carboxylate at position 71 (Asn for Glu). The isoenzyme also appeared to be devoid of an abnormal carboxylate. Identification of Glu71 as the abnormal carboxylate in the porcine enzyme was substantiated by comparison with enzymes from other sources. Kinetic experiments on the various phospholipases finally demonstrated that enzyme species containing Glu71 bind a second Ca2+ ion to the low-affinity site, whereas enzymes lacking Glu71 also lack this second site. These experiments confirm the suggestion that Glu71 is one of the ligands for Ca2+ in the low affinity site. PMID- 6860644 TI - Deuterium nuclear magnetic resonance studies of bile salt/phosphatidylcholine mixed micelles. AB - Mixed micelles of deoxycholate (DOC) and 1-palmitoyl-2-oleoylphosphatidylcholine (POPC) have been prepared in which the POPC was specifically deuterated in the 2 , 6-, 10-, or 16-position of the palmitoyl chain or in the N-methyl position of the choline head group. The deuterium nuclear magnetic resonance (2H NMR) spectrum of each of these specifically deuterated mixed micelles consists of a singlet whose line width depends upon the position of deuteration. Spin-spin relaxation times indicate a gradient of mobility along the POPC palmitoyl chain in the mixed micelle, with a large increase in mobility on going from the 10- to the 16-position. Spin-lattice relaxation times (T1's) demonstrate a similar gradient of mobility. Both trends in NMR relaxation behavior are consistent with a bilayer arrangement for the solubilized POPC. 2H T1 times for DOC/POPC micelles are significantly shorter than those measured in other bilayer systems, indicating unusually tight phospholipid acyl chain packing in the mixed micelle. PMID- 6860645 TI - Separate sites of low and high affinity for agonists on Torpedo californica acetylcholine receptor. AB - We have studied alkylation of the membrane-bound acetylcholine receptor (AcChR) from Torpedo californica electric organ by the cholinergic agonist bromo acetylcholine (BrAcCh). Following reduction of the AcChR with dithiothreitol (DTT) under strictly controlled conditions, a single class of binding sites was covalently labeled by BrAcCh. The extent of alkylation was dependent on the concentration of both DTT and BrAcCh and reached a maximum when a number of sites equivalent to the number of alpha-bungarotoxin (alpha-BTx) binding sites were labeled. The reaction with BrAcCh was completely inhibited by saturating concentrations of alpha-BTx. On the contrary, complete alkylation of the AcChR with [3H]BrAcCh consistently inhibited only approximately 50% of alpha-BTx binding. The effects of DTT reduction and subsequent BrAcCh alkylation on the cation-gating properties of the AcChR were investigated in rapid kinetic experiments. DTT reduction resulted in a slight decrease in the maximum cation flux and a small shift in the effective dissociation constant to higher acetylcholine (AcCh) concentration. The flux response was completely inhibited by maximal alkylation of the membrane vesicles by BrAcCh. A low-affinity binding site for AcCh, which is likely to be important in AcChR activation, has been revealed for T. californica AcChR by studying the effects of cholinergic ligands on the fluorescence of a probe, 4-[(iodoacetoxy)ethylmethylamino]-7-nitro-2,1,3 benzoxadiazole (IANBD), covalently bound to the AcChR protein. Maximal labeling by BrAcCh did not affect the binding of AcCh to the low-affinity binding site, as monitored by changes in the fluorescence of this probe. This low-affinity binding site must therefore be distinct from the site labeled by BrAcCh. The results strongly support the notion that the nicotinic AcChR contains multiple binding sites for cholinergic ligands. PMID- 6860646 TI - Photoaffinity modification of delta 5-3-ketosteroid isomerase by light activatable steroid ketones covalently coupled to agarose beads. AB - In order to identify the minor site(s) of photoattachment of unsaturated steroid ketones to delta 5-3-ketosteroid isomerase from Pseudomonas testosteroni, we have developed a solid-state photoaffinity labeling technique. Two solid-state reagents, O-carboxymethylagarose-ethylenediamine-succinyl-17 beta-O-19 nortestosterone and O-carboxymethylagarose-ethylenediamine-succinyl-17 beta-O-4,6 androstadien-3-one, have been synthesized. Under anaerobic conditions, isomerase bound to these resins is photoinactivated by UV light (lambda greater than 290 nm) whereas isomerase bound to O-carboxymethylagarose-ethylenediamine deoxycholate or isomerase in the presence of O-carboxymethylagarose ethylenediamine-acetate is almost completely stable to irradiation under the same conditions. Photoinactivation under anaerobic condition promoted by the resin bound steroid ketones results from a reaction at the active site since the competitive inhibitor, sodium cholate, which does not absorb light above 290 nm, provides protection toward photoinactivation. Preliminary analysis of isomerase that has been photolyzed in the presence of O-carboxymethylagarose ethylenediamine-succinyl-17 beta-O-4,6-androstadiene-3-one has established that the enzyme is converted to at least two different forms. One form binds more tightly to the resin than does the native enzyme. This form can be eluted by a sodium dodecyl sulfate containing buffer. The second form is not eluted by this buffer but can be released from the resin by cleavage of the ester bond linking the steroid to the derivatized agarose. We presume that the latter form is covalently coupled to the resin-linked steroid. In the presence of oxygen, additional nonspecific inactivation reactions occur, but these can be suppressed by the singlet oxygen trap, L-histidine. The application of solid-state photoaffinity reagents to some areas of receptor isolation and characterization is discussed. PMID- 6860647 TI - Kinetics of RNA replication. AB - The reaction kinetics of single-stranded RNA replication were investigated by means of analytical and computer simulation methods. A model reaction mechanism is proposed that is in accord with the extensive experimental data available for the replication of various templates by the enzyme Q beta replicase. Despite the complexity of this mechanism, conventional concepts of steady-state and dynamic enzyme catalysis and plausible values of the rate and stability constants for the elementary reactions suffice to provide detailed understanding of RNA replication kinetics. The main features can be described with simple formulas that are analogous to traditional descriptions of enzyme kinetics. PMID- 6860648 TI - Nuclear magnetic resonance studies on calmodulin: spectral assignments in the calcium-free state. AB - The 400-MHz proton magnetic resonance spectra of calcium-free scallop testis calmodulin (CaM) and pig brain CaM were observed. Detailed spectral assignments were made by resolution enhancement, spin decoupling, and nuclear Overhauser enhancement (NOE) experiments as well as pH titration. Comparison between spectra of scallop testis CaM and pig brain CaM were also utilized for the assignment. Previous assignments for tyrosine-99, histidine-107, epsilon-trimethyllysine-115, and tyrosine-138 [Seamon, K. B. (1980) Biochemistry 19, 207; Krebs, J., & Carafoli, E. (1982) Eur. J. Biochem. 124, 619] were confirmed. Phenylalanine-99 and threonine-143 of scallop testis CaM were identified. Sixteen methyl resonances from one isoleucine, two valines, nine methionines, and the amino terminal acetyl group were identified. First-stage assignments were made of resonances arising from seven phenylalanines. The uniquely high field shifted phenylalanine resonance previously reported by Seamon was found to consist of two doublets from the two pairs of delta protons of two phenylalanines. The NOE experiments showed that the two phenylalanines are located closely to each other. The large high-field shifts of these phenylalanines were accounted for the ring current effects due to their proximity. An isoleucine and a valine of which methyl resonances appear at high fields were found to be situated closely to each other. It was found that two delta protons and two epsilon protons of almost all aromatic residues are magnetically equivalent, suggesting that the local structure of aromatic residues is so flexible as to permit the rapid flipping motion of the ring. PMID- 6860649 TI - Dimeric half-molecules of human fibrinogen are joined through disulfide bonds in an antiparallel orientation. AB - Human fibrinogen is a dimer composed of two identical halves. Each dimeric half contains three peptide chains (alpha, beta, and gamma) linked by disulfide bonds. The two half-molecules are joined by three disulfide bonds, one between the two alpha-chains (residue alpha-28) and two between the two gamma-chains (residues gamma-8 and gamma-9). In the absence of any difinitive experimental evidence, it has been presumed that the joined halves were aligned in a parallel orientation similar to the situation found in immunoglobulins. We have now determined that the two gamma-chains--hence, the dimeric halves--are connected in an antiparallel manner. A tryptic peptide containing gamma-chain residues 6-14 was isolated as a disulfide-linked dimer from CNBr-treated fragment E. Synthetic peptides corresponding to this sequence were prepared, from which parallel and antiparallel dimers were constructed. During the syntheses, cysteine thiol groups were protected as p-methoxybenzyl and acetamidomethyl sulfides; the peptides were dimerized by selective deprotection and disulfide bond formation. First, the p methoxybenzyl groups were removed by liquid hydrogen fluoride and the newly exposed thiols oxidized in the presence of potassium ferricyanide. Then the monocystine compound was converted to the double-cystine product by iodolytic cleavage of the acetamidomethyl group with concomitant disulfide bond formation. This selectivity was used to prepare peptide dimers which modeled both parallel and antiparallel arrangements. The antiparallel-oriented synthetic peptide was indistinguishable from the native tryptic peptide as judged by elution from reverse-phase high-performance liquid chromatography and circular dichroism spectroscopy. The parallel-oriented synthetic peptide differed from the native material by both criteria. PMID- 6860650 TI - Stereospecific binding of diastereomeric peptides to salmon sperm deoxyribonucleic acid. Further evidence for partial intercalation. AB - A series of diastereomeric dipeptide amides, containing an N-terminal L-lysyl residue and a C-terminal L- or D-amino acid with a derivatized aromatic ring on the side chain, was synthesized to determine the dependence of (1) the chirality of the N-terminal amino acid alpha-carbon and (2) the length of the N-terminal amino acid side chain for intercalation of the aromatic ring. The nature of the complex between the peptide and DNA (i.e., electrostatic, intercalative, or a combination of these) was determined by UV and CD studies, viscometric titrations, and 1H NMR studies. The results of these studies reveal distinct differences in the binding site of the aromatic rings of the various peptides. In particular, the results suggest that the alpha- and epsilon-amino groups of the lysyl residue bind electrostatically to adjacent phosphates on the DNA backbone in a stereospecific manner. As a result of this stereospecificity, the aromatic rings of the peptides with the L-L designation point toward the DNA helix, while those of the peptides of the L-D designation point away from the helix. This is completely consistent with previously reported work [Gabbay, E.J., Adawadkar, P. D., & Wilson, W. D. (1976) Biochemistry 15, 146; Gabbay, E. J., Adawadkar, P. D., Kapicak, L., Pearce, S., & Wilson, W. D. (1976) Biochemistry 15, 152]. The results also indicate a great dependence on the length of the side chain for intercalation of the aromatic ring. Specifically, if the side chain is long enough, and flexible enough, the aromatic ring can fully or partially intercalate, regardless of the chirality of the N-terminal amino acid alpha carbon. However, if the side chain is too short, only partial intercalation is observed for peptides of the L-D designation, and no intercalation is observed for peptides of the L-D designation. PMID- 6860652 TI - Hydroxamates and aliphatic boronic acids: marker inhibitors for aminopeptidase. PMID- 6860651 TI - Role of indole and amino groups in the structure and function of Naja nigricollis toxin alpha. PMID- 6860653 TI - 2',5'-Oligoadenylates and related 2',5'-oligonucleotide analogues. 2. Effect on cellular proliferation, protein synthesis, and endoribonuclease activity. AB - A number of the new enzymatically synthesized 2',5'-oligonucleotide trimers, namely, those containing the nucleosides 8-azaadenosine, toyocamycin, sangivamycin, formycin, 8-bromoadenosine, tubercidin, and guanosine, were found to inhibit protein synthesis and cellular proliferation after uptake into intact L and HeLa cells. 2',5'-Oligonucleotide trimers containing cytidine, inosine, uridine, and 1,N6-ethenoadenosine had some effect while those containing 2 chloroadenosine, 3-ribosyladenine, ribavirin, and 2-beta-D-ribofuranosylthiazole 4-carboxamide had no detectable effect on protein synthesis or cellular proliferation after uptake into L or HeLa cells. All of these 2',5' oligonucleotide analogues inhibited protein synthesis in the in vitro rabbit reticulocyte lysate system except for the trimer containing ribavirin. Such nucleoside substitutions have further defined the substrate-specificity requirements for the endoribonuclease and/or the inhibitors for the 2',5' phosphodiesterase. Most of the 2',5'-analogues were degraded in L-cell extracts so the endogenous nucleases are not very specific. The 2',5'-trimers containing tubercidin and 2-beta-D-ribofuranosylthiazole-4-carboxamide were quite stable in comparison to the 2',5'-A trimer. The inhibition of protein synthesis and cellular proliferation observed correlated well with the degradation of rRNA and polyadenylated mRNA observed after uptake of the 2',5'-analogues into intact L cells. The degradation of the polyadenylated mRNA appeared to be a more sensitive test than inhibition of cellular protein synthesis for determining biological activities of the 2',5'-oligonucleotide analogues. PMID- 6860654 TI - B to Z transition of double-stranded poly[deoxyguanylyl(3'-5')-5 methyldeoxycytidine] in solution by phosphorus-31 and carbon-13 nuclear magnetic resonance spectroscopy. AB - The B to Z transition of poly(dG-m5dC) . poly(dG-m5dC) has been monitored by 31P nuclear magnetic resonance (NMR) spectroscopy as a function of concentration of several salts. In 5 mM Tris- [tris(hydroxymethyl)amino-methane] HCl buffer two peaks of equal area (0.27 ppm separation) are observed at -4.2 ppm (upfield from trimethyl phosphate), indicating an alternating (right-handed) B conformation. Upon addition of NaCl, CsF, MgCl2, or Co(NH3)6Cl3, a signal arises at -3 ppm that is characteristic of the left-handed Z form. This signal is half of a doublet (1.3-2.1 ppm separation) and is tentatively assigned to the tg+ phosphodiester conformation in the Z form. The midpoints of the cooperative B to Z transitions with these salts are in good agreement with the values reported from circular dichroism (CD) studies for this copolymer. The 13C NMR spectra at natural abundance of poly(dG-m5dC) . poly(dG-m5dC) in the alternating B conformation in low salt show a broad resonance for the C2' and no clear resonance for the C3'. This is in contrast to the alternating B form of poly(dA-dT) . poly(dA-dT) under similar conditions, which exhibits a well-resolved doublet for both C2' and C3' that is presumed to derive from alternating C2'-endo and C3'-endo deoxyribose conformations. In the 13C NMR spectrum of the Z form of poly(dG-m5dC) . poly(dG m5dC), two major peaks are observed for the C2', which may also indicate an alternating sugar conformation. PMID- 6860655 TI - Granular pneumocytes in primary culture secrete several major components of the extracellular matrix. AB - Primary cultures of rat alveolar type II epithelial cells (granular pneumocytes) produced several components of the pulmonary extracellular matrix. Fractionation by ion-exchange chromatography of radiolabeled protein secreted into the culture medium resulted in the partial purification of two of these components: fibronectin and type IV procollagen. Identification of these proteins by sodium dodecyl sulfate-polyacrylamide gel electrophoresis was confirmed by radioimmune precipitation studies with affinity-purified antibodies. Thrombospondin, a platelet alpha-granule protein that was recently shown to be secreted by endothelial and other mesenchymally derived cells and may be involved in platelet aggregation, was, in addition, purified by elution from diethylaminoethylcellulose with 0.5 M NaCl. The levels of these secreted proteins were measured by radioimmune precipitation. Of the total radiolabeled culture medium protein secreted during a 24-h period by the granular pneumocytes, fibronectin, type IV procollagen, and thrombospondin represented 3-15%, 2%, and 3%, respectively. The biosynthesis, by alveolar epithelial cells, of proteins that constitute or are closely associated with the alveolar basement membrane implies that this structure is at least partially derived from the cells themselves. Furthermore, it suggests that the type II epithelial cell is involved in pulmonary cytodifferentiation, in lung morphogenesis and repair, and in certain interstitial lung disorders in which derangement of the extracellular matrix occurs. PMID- 6860656 TI - Conformational effects of volatile anesthetics on the membrane-bound acetylcholine receptor protein: facilitation of the agonist-induced affinity conversion. AB - The rate of the carbamylcholine-induced affinity conversion of the membrane-bound acetylcholine receptor protein from Torpedo californica is enhanced by pretreatment of the membranes under an atmosphere of 3% halothane or 1% chloroform. The enhancement is much more pronounced in the presence of low rather than high concentrations of carbamylcholine since the volatile anesthetics alter the apparent dissociation constant for carbamylcholine from 17 to 3 microM without affecting the first-order rate constant for the ligand-induced conversion (0.07 s-1). These results indicate that the acetylcholine receptor is assuming a conformational form with intermediate affinity for carbamylcholine in addition to the previously described low- and high-affinity forms. The dissociation constants for carbamylcholine obtained from kinetic studies of the carbamylcholine-induced transition are 3-15-fold lower than those obtained as inhibition constants from the rate of 125I-labeled alpha-bungarotoxin binding to the low-affinity conformer of the acetylcholine receptor protein. This pattern, observed in both the presence and absence of anesthetic, provides further evidence that the acetylcholine receptor has nonequivalent ligand binding sites for carbamylcholine. PMID- 6860657 TI - Interactions of monovalent cations with phosphatidylserine bilayer membranes. PMID- 6860658 TI - Abolition of the thermotropic transition of charged phospholipids induced by a cardiotoxin from Naja mossambica mossambica as detected by fluorescence polarization, differential scanning calorimetry, and Raman spectroscopy. AB - The effects of a Naja mossambica mossambica cardiotoxin on the thermotropic properties of charged phospholipids have been studied by fluorescence polarization, differential scanning calorimetry, and Raman spectroscopy. The binding of the toxin is only governed by the net charge at the interface and is not affected by the polar head group structure of the phospholipids or by the acyl chains physical state, degree of insaturation, or length. The effect of the toxin on the phospholipid structure is drastic. In all cases, the gel to liquid crystalline phase transition monitored by fluorescence and Raman spectroscopies is progressively abolished without notable shift in temperature as the proportion of toxin is increased. The endothermic peaks detected by differential scanning calorimetry decrease in intensity as the toxin content is increased but always remain sharp. All the techniques used give complementary results, and none of them reveals the presence of secondary transitions at higher or lower temperatures. We thus believe that the lipid molecules that are perturbed by the toxin, approximately 10 +/- 2 molecules, do not undergo a phase transition. Raman results demonstrate that these "boundary" lipids display a population of gauche rotamers that is as high as the one found in the liquid-crystalline phase of the pure phospholipid and this even well below the phase transition temperature. On the other hand, fluorescence results are interpreted as due to a partial immobilization of the lipids in contact with the toxin above the transition temperature. Thus, even though the interaction is governed by electrostatic forces, the toxin penetrates at least partially into the bilayers, inducing a disorganization of the aliphatic chains and changes in their mobility; this could explain their lytic activity. PMID- 6860659 TI - Molecular flexibility in microtubule proteins: proton nuclear magnetic resonance characterization. AB - Bovine microtubule protein preparations have been examined by proton nuclear magnetic resonance (1H NMR) spectroscopy at 270 MHz. Sharp resonances have been identified as deriving from microtubule-associated proteins. These resonances persist after self-assembly of microtubule protein. Brief tryptic treatment of assembled microtubules, specifically cleaving the microtubule-associated protein HMW2 (Mr = 270 000), releases the pendant portion of HMW2 (Mr = 240 000), three quarters of which is in a flexible conformation. Isolated tau protein and HMW2 protein both show substantial flexibility; on recombination with tubulin dimer, tau shows considerable decrease in flexibility whereas HMW2 is unaffected. The observations may have important implications for the interactions between microtubules and other cytoskeletal structures. PMID- 6860660 TI - Kinetic evidence for a monomer activation step in actin polymerization. AB - We measured the time course of skeletal muscle actin polymerization at different actin concentrations. In 0.1 M KCl with 1 mM Mg2+, log/log plots of the rate of the early, slow phase of polymerization vs. actin concentration were linear with slopes from 1.0 to 1.3. Computer-assisted calculations of similar curves from theoretical models with different sizes for the nucleus showed that no simple model gave a log/log plot with a slope less than 1.5. Addition of a first-order, monomer activation step before nucleation allowed models of any reasonable nucleus size to have a slope of 1. This is the first evidence that such a step is part of the kinetic pathway for actin polymerization. In 0.1 M KCl with 0.2 mM Ca2+, log/log plots of the rate of the slow phase vs. actin concentration were linear with slopes from 2.0 to 2.5. Monomer activation was not necessary to account for this slope. However, fits of kinetic curves calculated from theoretical models to experimental kinetic curves showed that filament fragmentation was important to achieve a good fit, confirming the finding of Wegner and Savko [Wegner, A., & Savko, P. (1982) Biochemistry 21, 1909-1913]. Our fit procedure also allowed us to estimate the size of the nucleus and the rate constants for activation, nucleation, and fragmentation. In 0.1 M KCl with 1 mM Mg2+, the nucleus was a dimer or trimer, and nucleation was fast. In 0.1 M KCl with 2.0 mM Ca2+, the nucleus was a trimer, and nucleation was slow. PMID- 6860662 TI - Interaction of aromatic amino acids in D and L forms with 3,4 dihydroxyphenylalanine decarboxylase from pig kidney. PMID- 6860661 TI - Effect of inorganic phosphate on the reverse reaction of bovine brain hexokinase. AB - Kinetic studies were used to investigate the mode of brain hexokinase (EC 2.7.1.1, ATP:D-hexose 6-phosphotransferase) regulation by glucose 6-phosphate (glucose-6-P), ADP, and inorganic phosphate (Pi). A model for regulation of brain hexokinase by glucose-6-P and Pi had been proposed from initial-rate studies and binding experiments [Ellison, W. R., Lueck, J. D., & Fromm, H. J. (1975) J. Biol. Chem. 250, 1864-1871]. The results of the present investigation demonstrate that Pi is an activator of the brain hexokinase reaction when the reaction is studied in the nonphysiological direction. Evidence is presented which indicates that the back-reaction substrates and Pi can bind the enzyme simultaneously, and the suggestion is made that Pi binds to an allosteric site on the enzyme. These findings are in marked contrast to results obtained in the absence of ADP which convincingly demonstrate that glucose-6-P and Pi are mutually exclusive binding ligands for brain hexokinase. The kinetic data can be reconciled with the model for hexokinase regulation within the context of the well-established kinetic mechanism for brain hexokinase. PMID- 6860663 TI - Interaction of chick oviduct progesterone receptor with the 2',3'-dialdehyde derivative of adenosine 5'-triphosphate. AB - Avian oviduct progesterone receptor was treated with the 2',3'-dialdehyde derivative of ATP (oATP) in an attempt to demonstrate the presence of nucleotide binding sites on the receptor. oATP, when added to cytosol, inhibited binding by transformed receptor to ATP-Sepharose, DNA-cellulose, phosphocellulose, or isolated nuclei in an irreversible manner. oATP did not disrupt the steroid receptor complex, but it did alter the ionic properties of the receptor. This was demonstrated by an increased affinity of receptor for DEAE-cellulose and for hydroxylapatite. oATP mimicked the effect of ATP on progesterone receptor with regard to two properties: it altered the rate of receptor inactivation that occurs in the absence of progesterone, and it promoted receptor conversion from an 8S complex to lower sedimenting forms (4-6 S). The action of oATP on the receptor could be blocked by the addition of pyridoxal 5'-phosphate, which has been shown previously to interact with the progesterone receptor. A partial interference of oATP action was also observed when ATP was added. These results indicate that oATP interacts with the progesterone receptor and may be used as an affinity-labeling agent for receptor characterization. PMID- 6860664 TI - Action of lipoprotein lipase on phospholipid monolayers. Activation by apolipoprotein C-II. PMID- 6860665 TI - Evidence for carrier-mediated transport of glucocorticoids by human placental membrane vesicles. AB - Glucocorticoid uptake by isolated placental membrane vesicles has been studied in an attempt to identify a membrane-mediated carrier mechanism. A preliminary communication from this laboratory has reported that uptake of the glucocorticoid corticosterone by these vesicles was a time-dependent, saturable, osmotically sensitive process (Fant, M.E., Harbison, R.D. and Harrison, R.W. (1979) J. Biol. Chem. 254, 6218-6221), but did not conclusively demonstrate a carrier mechanism. Further studies of labeled corticosterone uptake by placental vesicles are described herein which indicate that steroid uptake by these vesicles is a carrier-mediated process. We found that corticosterone uptake was temperature sensitive, and an apparent phase-transition effect on the rate of uptake was seen to occur at approximately 16 degrees C. Treatment of the vesicles with phospholipase A2 and the sulfhydryl group attacker, p chloromercuriphenylsulfonate, inhibited corticosterone uptake. In contrast to our previous findings in intact cells, neuraminidase treatment of membranes did not inhibit steroid uptake, perhaps indicating a species variation. Lastly, it was possible to show that corticosterone movement across the membrane exhibited countertransport, a phenomenon common only to carrier-mediated transport mechanisms. These studies show that placental vesicles accumulate corticosterone by a carrier-mediated mechanism. PMID- 6860666 TI - Differential effect of neuraminidase-treatment on the surface charge-associated properties of rat reticulocytes and erythrocytes. Studies by partitioning in two polymer aqueous phases. AB - Rat reticulocytes undergo charge-associated surface changes, detectable by cell partitioning in charged dextran-poly(ethylene glycol) aqueous phase systems, as they become mature erythrocytes. Young reticulocytes have a lower partition coefficient, i.e., quantity of cells in the top phase as a percentage of total cells added, than do mature erythrocytes. Sialic acid is the main charge-bearing group on red blood cells and, in the case of the rat, most of the sialic acid can be removed by treatment of the cells with neuraminidase (Vibrio cholerae). By combining isotopic 59Fe-labeling of reticulocytes with countercurrent distribution of the entire red blood cell population in charged dextran poly(ethylene glycol) aqueous phases we have now studied the relative effect of neuraminidase-treatment on rat reticulocytes and mature erythrocytes. It was found that neuraminidase-treatment (a) does not eliminate surface differences, detectable by partitioning, between rat reticulocytes and erythrocytes and (b) reduces the partition coefficient of mature erythrocytes to a greater extent than the partition coefficient of reticulocytes indicating a differential effect of this enzyme on the two cell populations. PMID- 6860667 TI - Selective inactivation of rabbit reticulocyte initiation factor eIF-3 by helenalin. AB - Helenalin, a sesquiterpene lactone which reacts primarily with exposed sulfhydryl groups, was shown to be an effective inhibitor of protein synthesis in rabbit reticulocyte lysates. Optimal inhibition required a 30 min preincubation in the absence of any added thiol compound. Beta-Mercaptoethanol was more effective than reduced glutathione in protecting enzyme sulfhydryl groups from inactivation by helenalin. Using partially fractionated systems, it was possible to show that helenalin had no effect on the elongation reactions or on the formation of the ternary initiation complex. However, the conversion of the ternary complex to the 48 S initiation complex was strongly inhibited. In this assay, only the initiation factor(s) were sensitive to helenalin. Using an assay system which requires all the initiation factors for optimal activity it was possible to show that the 0-40% ammonium sulfate cut of initiation factors (containing eIF-3 and eIF-4B) was sensitive to helenalin, while the 40-50% ammonium sulfate cut (containing eIF-2 and eIF-5) was not. Both ammonium sulfate cuts were equally sensitive to inhibition by the sulfhydryl reagent N-ethylmaleimide. Three purified rabbit reticulocyte initiation factors were then tested in the same assay system. Only eIF-3 showed appreciable sensitivity to helenalin, while eIF 2, eIF-3 and eIF-4B were all sensitive to inactivation by N-ethylmaleimide. These data suggest that helenalin may possess a relatively high degree of specificity as a sulfhydryl reagent. PMID- 6860668 TI - Effects of thyrotropin on thyroid chromatin. Enhanced sensitivity to micrococcal nuclease and increased nuclear protein phosphorylation. AB - Thyroid slices were incubated with or without TSH for 2 or 5 h. Nuclei were then prepared, subjected to mild digestion with micrococcal nuclease, and centrifuged at 1200 X g. The amount of DNA in 1200 X g supernatants was increased by TSH at 5 h, but not at 2 h. In parallel studies, thyroid slices were incubated with 32Pi and labeling of acid-soluble nuclear proteins was examined. TSH-dependent increases in labeling of histones H1 and H3, and of the high mobility group protein HMG 14, were observed at 2 h; however, there were no apparent changes in TSH-dependent labeling between 2 and 5 h, in nuclease-sensitive or in bulk chromatin. These results suggest that the observed TSH-dependent changes in the micrococcal nuclease-sensitivity of thyroid nuclear chromatin were not induced directly by changes in the phosphorylation of the histones or HMG 14. PMID- 6860669 TI - Determination by fluorescence quenching of the environment of DNA crosslinks made by malondialdehyde. AB - DNA crosslinks made by malondialdehyde are fluorescent. The fluorescence is quenched by collision or intercalation. A 3.3-fold higher concentration of the external (collision) quencher KI was required to cause 50% quenching of the fluorescence of the interstrand-DNA crosslinks than to cause 50% quenching of the fluorescence of the model compounds Val2MDA and the malondialdehyde-crosslinked heterodimer of GMP and CMP. Thus, the crosslinked nucleotide dimers in the DNA were shown to be 70% shielded from the solvent. Similarly, DNA-protein crosslinks made by malondialdehyde were shown to be 55% shielded. The internal (intercalation) quencher Ag+ enhanced the fluorescence of the DNA crosslinks at concentrations below 0.3 mM; higher concentrations quenched the fluorescence. Concentrations of Ag+ below 10 mM did not affect the fluorescence of the model compounds. The calculated dissociation constant for Ag+ was much less at pH 5 than at pH 7 or 9. The observed binding of Ag+ and its pH dependence suggest that pi-stacking of adjacent bases strengthens the binding of Ag+ to the crosslinks. These results indicate that the crosslinks are in the interior of the DNA, so they may not easily be recognized by a repair system. PMID- 6860670 TI - Differential in vitro translation and independent in vivo regulation of mRNA's for subunits of ligandin. AB - Synthesis of both subunits (Ya and Yb) of ligandin in equal amounts was observed when poly(A)+ mRNA isolated from the post-mitochondrial fraction was translated in an in vitro wheat-germ system and the products were immunoprecipitated by monospecific antibody to ligandin and analyzed by SDS-polyacrylamide gel electrophoresis and fluorography. When the Mg2+ or K+ concentrations were increased in the in vitro wheat-germ system the ratio of synthesis of Yb/Ya subunits was 3. With a mRNA-dependent reticulocyte lysate, the synthesis of Ya subunits was 20-30% higher than Yb subunits. At a fixed K+ and Mg2+ concentration, the ratio of incorporation of [35S]methionine into Yb/Ya subunits remained 1 and 0.7 in wheat-germ and reticulocyte lysate systems, respectively, up to 60 min. When poly(A)+ mRNA was fractionated on a 5-20% sucrose gradient, ligandin mRNA was present in fractions having a peak sedimentation value of 11 S. When poly(A)+ mRNA was fractionated by gel electrophoresis, fractions enriched in mRNA for each subunit were obtained. By administration of [3H]leucine followed by determination of radioactivity in ligandin and total proteins by immunoprecipitation and trichloroacetic acid precipitation, respectively, synthesis of the Ya subunits was selectively stimulated by phenobarbital administration. When poly(A)+ mRNA from liver of rats administered phenobarbital was translated in vitro a selective increase in the mRNA content of Ya subunits was observed. When poly(A)+ RNA from testes was translated in the wheat-germ system and products analyzed, Yb subunits were the predominant subunit (greater than 90%) synthesized, reflecting the subunit composition of testicular ligandin. These results suggest that in spite of the close sequence homology between the two subunits of ligandin, there are separate mRNA's for each subunit which are independently regulated. PMID- 6860671 TI - Metabolism and non-random occurrence of nonnascent short chains in the DNA of Ehrlich ascites cells. AB - The DNA of Ehrlich ascites cells was labeled with radioactive thymidine using different labeling schedules: Incubation periods between 15 s and 4 h; pulse/pulse-chase experiments with pulses in the range of a few minutes; longtime incubation followed by a longtime chase (both in the range of 1 cell generation). From the purified DNA of the labeled cells a fraction (0.3-0.4%) of short chains was separated and partially fractionated by means of a hydroxyapatite thermochromatography procedure. The evaluation of the labelling patterns of the short chains indicated that less than 5% of them can be regarded as replication intermediates ('Okazaki pieces'). The rest, termed nonnascent pieces, exhibited a slow turnover. The life span of the nonnascent pieces was estimated to be about 1 cell generation. On helical DNA, nonnascent pieces were distributed in a non random manner. Their preferential localisation was nearby sites which caused binding of the DNA, after purification, to nitrocellulose and which occurred about every 60-80 microns on the nuclear DNA of the cells. PMID- 6860672 TI - Tissue-specific differences in DNA methylation in various mammals. AB - The only naturally occurring modified base in vertebrate DNA is 5-methylcytosine. Using a precise high-performance liquid chromatographic analysis of DNA enzymatically digested to deoxynucleosides, we have shown that rats, mice and four types of monkey display tissue-specific as well as species-specific differences in the extent of methylation of their cytosine residues. Several similarities in the patterns of tissue-specific DNA methylation in these mammals and in the previously studied human samples were observed. Compared to most other types of DNA examined, brain and thymus DNAs were hypermethylated which suggests that this hypermethylation is a determinant or a necessary byproduct of mammalian differentiation. In all of the studied rodents and primates, the highly repeated DNA sequence fraction was more methylated than the moderately repetitive or single copy fractions. The tissue-specific differences in overall DNA methylation showed no correlation with what is known about average cell turnover rates nor with the percentage of the genome that is transcribed. Liver regeneration in the rat following partial hepatectomy did not detectably alter 5-methylcytosine levels in liver DNA. A considerable increase in the extent of methylation of total liver DNA was observed during normal development of the rat. The latter phenomenon may be due to a major change in the cellular composition of the liver. PMID- 6860673 TI - Different effects of subunit association upon absorption and circular dichroism spectra of methemoglobin. AB - Absorption and circular dichroism (CD) spectra of the Soret band, assigned as a pi-pi transition of the porphyrin pi-electron system, showed a great difference between alpha and beta subunits in the ferric state (alpha +, beta +). The nonequivalence of the spectra between alpha + and beta + subunits partly originates from the difference in the strength of the bond between heme iron and the proximal histidine. The peak positions for absorption and CD spectra of the ferric derivatives associated with F-, H2O, N-3 and CN- of the isolated subunits qualitatively correlate with the spin state of the ferric heme. The Soret absorption spectra obtained by simple addition of those for alpha + and beta + subunits are very similar to those for methemoglobin A (metHb A). On the other hand, the arithmetic means for the Soret CD spectra of alpha + and beta + subunits are different from those for metHb A. These differences were not observed between the Soret CD spectra of alpha 1 beta 1 dimer, which is predominantly present in metHb Hirose (beta 37Trp-Ser), and those of tetrameric metHb A. Therefore, the interaction between alpha 1 and beta 1 subunits to make the alpha 1 beta 1 dimer may strongly affect the CD spectral properties of alpha + and beta + subunits. The effect of the interaction between two homogeneous dimers, alpha 1 beta 1 and alpha 2 beta 2, forming a tetramer, on the Soret CD spectral properties, if any, is very small compared with that between alpha 1 and beta 1 subunits. PMID- 6860674 TI - The interaction of an ionizing ligand with enzymes having a single ionizing group. Implications for the reaction of folate analogues with dihydrofolate reductase. AB - Binding theory has been developed for the reaction of an ionizing enzyme with an ionizing ligand. Consideration has been given to the most general scheme in which all possible reactions and interconversions occur as well as to schemes in which certain interactions do not take place. Equations have been derived in terms of the variation of the apparent dissociation constant (Kiapp) as a function of pH. These equations indicate that plots of pKiapp against pH can be wave-, half-bell- or bell-shaped according to the reactions involved. A wave is obtained whenever there is formation of the enzyme-ligand complexes, ionized enzyme . ionized ligand and protonated enzyme . protonated ligand. The additional formation of singly protonated enzyme-ligand complexes does not affect the wave form of the plot, but can influence the shape of the overall curve. The formation of either ionized enzyme . ionized ligand or protonated enzyme . protonated ligand, with or without singly protonated enzyme-ligand species, gives rise to a half-bell-shaped plot. If only singly protonated enzyme-ligand complexes are formed the plots are bell-shaped, but it is not possible to deduce the ionic forms of the reactants that participate in complex formation. Depending on the reaction pathways, true values for the ionization and dissociation constants may or may not be determined. PMID- 6860675 TI - Guanidinium- and temperature-induced conformational changes in glucose dehydrogenase. AB - The conformational changes in glucose dehydrogenase are studied as a function of temperature and guanidinium chloride (GdmCl) concentration. The data were analyzed assuming a two-conformer model which gave similar results using either circular dichroism or enzyme activity. The free energy of denaturation was 0.94 kcal/mol from specific activity and 1.64 kcal/mol from circular dichroism measurements. The mid-point of the denaturation curve was 0.65 or 0.63 M GdmCl, as determined by specific activity or circular dichroism, respectively. The transition temperature, 6.4 degrees C, is close to that of a microsomal membrane phase change, a result that is consistent with the fact that glucose dehydrogenase contains lipid materials when isolated with a non-ionic detergent such as Triton X-114. As the temperature increased, the amount of beta-pleated sheet increased, and the alpha-helical content decreased, suggested that glucose dehydrogenase contains a stable core of beta-pleated sheet. PMID- 6860676 TI - Purification and properties of a brain enzyme which deiminates proteins. AB - The deimination of guanidyl groups of peptides, proteins and other arginine containing compounds is catalyzed by enzymes found in mammalian brain and epidermis. In cow, the brain and epidermal enzymes differ kinetically and physically, but both may be quantitated by measuring the production of benzoyl citrulline ethyl ester from benzoyl-arginine ethyl ester. The brain enzyme has been purified to apparent homogeneity, as judged by the presence of only one 85,000 dalton band in purified preparations when examined by SDS-polyacrylamide gel electrophoresis. An antibody raised to this band precipitates pure and partially purified brain enzyme but not partially purified epidermal enzyme, using the Ouchterlony technique. The antibody bound to an insoluble matrix removes brain enzyme activity from solution but not epidermal enzyme activity. The Km of the brain enzyme for benzoyl-arginine ethyl ester is about 0.33 mM. PMID- 6860677 TI - Consecutive beta-turn conformation of a synthetic model peptide corresponding to the active site of thioredoxin. AB - A synthetic model peptide, (formula; see text) which mimics the active-site disulfide loop of thioredoxin has been prepared. 270 MHz 1H-NMR studies establish that Cys-4 and methylamide NH groups are solvent-shielded, using hydrogen deuterium exchange, solvent and temperature dependence of chemical shifts and nitroxide radical-induced broadening as diagnostic criteria. Infrared measurements provide supporting evidence for intramolecularly hydrogen-bonded conformations. The related peptide in which Gly-2 is replaced by alpha aminoisobutyric acid has been shown to adopt a similar backbone conformation based on NMR and CD data. Based on the known stereochemical preferences of alpha aminoisobutyric acid residues, a consecutive beta-turn conformation involving two intramolecular 4 leads to 1 hydrogen bonds is proposed for both disulfides. Vicinal coupling constants and CD data are discussed with reference to the side chain conformation of the cysteine residues. Large structural differences have been established between the thioredoxin active-site model disulfide and its acyclic precursor. PMID- 6860679 TI - The divergent metabolic fate of ether analogs of cholesteryl and retinyl esters after injection in lymph chylomicrons into rats. PMID- 6860678 TI - Spontaneous and protein-catalyzed transfer of 1-alkyl-2-acetyl-sn-glycero-3 phosphocholine (platelet-activating factor) between phospholipid bilayers. AB - 1-Alkyl-2-acetyl-sn-glycero-3-phosphocholine (platelet-activating factor or alkylacetyl-GPC), a bioactive phospholipid that possesses hypotensive, platelet aggregating and inflammatory properties, is known to be secreted by a variety of cell types. The biological activity of alkylacetyl-GPC is related to a precise chemical structure that implicates interaction with proteins. We have studied the spontaneous and protein-catalyzed transfer of alkylacetyl-GPC between phospholipid vesicles and have demonstrated the following: 1. There are at least two transferable pools of alkylacetyl-GPC in sonicated phospholipid vesicles. 2. These two pools differ in the rate at which they dissociate from the vesicles; one pool equilibrates between donor and acceptor vesicles instantaneously while the other pool is transferred much more slowly. 3. Dialysis of alkylacetyl-GPC between phospholipid vesicles through the aqueous phase is slow. 4. A protein fraction derived from rat lung cytosol catalyzes the transfer of the nonequilibrating pool of alkylacetyl-GPC between phospholipid vesicles; this transfer is superimposed on the spontaneous transfer and is unchanged in experiments using vesicles from which the rapidly equilibrating pool has been removed. PMID- 6860680 TI - The outer carnitine palmitoyltransferase and regulation of fatty acid metabolism in rat liver in different thyroid states. AB - The activity of the outer carnitine palmitoyltransferase (EC 2.3.1.21) and the carnitine-dependent oxidation of palmitoyl-CoA was increased 3-4 fold in liver mitochondria from hyperthyroid rats as compared with hypothyroid rats. The inhibitory effect of malonyl-CoA on carnitine-dependent fatty acid oxidation was preserved in all thyroid states, but decreased in hyperthyroid mitochondria. Fasting for 24 h increased the activity of the outer carnitine palmitoyltransferase about 50% in hypothyroid liver mitochondria, whereas it had no significant effect in hyperthyroid mitochondria. The thyroid state had no significant effect on total carnitine palmitoyltransferase in liver mitochondria. Fasting stimulated fatty acid oxidation 3-4-fold in isolated hepatocytes from hypothyroid rats, whereas it had no effect in hyperthyroid rats. Feeding 0.3% clofibrate to euthyroid rats about doubled the activity of the total carnitine palmitoyltransferase, whereas it had no effect on the outer transferase. The regulation of fatty acid oxidation in the liver is discussed. PMID- 6860681 TI - Lipids of gastric secretion in patients with cystic fibrosis. AB - Lipids were investigated in gastric secretions of patients with cystic fibrosis and of normal individuals. Organic extracts from dialyzed and lyophilized samples were fractionated on silicic acid columns into neutral lipids, glycolipids and phospholipids. The lipids contained in each fraction were separated into individual components by thin-layer chromatography and quantitated. The gastric secretions of patients with cystic fibrosis contained 80-140% more lipids than those of normal individuals, exhibited an elevated level of neutral lipids and contained alkylglycerols and alkylacylglycerols. The level of glycolipids was higher in normal gastric secretions. The phospholipids of cystic fibrosis secretions exhibited about 50% lower content of lysophosphatidylcholine, lysophosphatidylethanolamine and lysophosphatidylserine. The glycosphingolipids of both types of samples contained mono-, di- and trihexosylceramides. The major glyceroglucolipid of normal gastric secretions was tetraglucosyl glyceroglucolipid, whereas hexa- and octaglucosyl glyceroglucolipids were predominant in cystic fibrosis samples. The sulfated glyceroglucolipids in cystic fibrosis samples were lower than those of normal secretions and represented only 4-37% of total glyceroglucolipid, whereas in normal secretion sulfated glyceroglucolipids averaged 50-62%. PMID- 6860682 TI - The effect of triiodothyronine on fatty acid synthetase activity and content in differentiating ob17 preadipocytes. AB - The effect of triiodothyronine on the activity and amount of the key lipogenic enzyme fatty acid synthetase was studied in differentiating preadipocyte cells (ob17) isolated from ob/ob mouse epididymal fat pad. In the presence of physiological concentrations of insulin, the acquisition of adipose morphology was accompanied by a parallel increase (10--15-fold) in synthetase specific activity and radioimmunoassayable amount relative to soluble cellular proteins. Inclusion of T3 at confluence significantly enhanced synthetase activity and content, with a maximum of 1.5--2-fold above controls at the physiological 1.5 nM concentration, whether insulin is present or not. During adipose conversion, T3 increased the development of enzyme activity and after a longer lag period, the accumulation of the synthetase. Our results suggest that the stimulating effect of T3 upon synthetase activity could involve as a first step the activation of preexisting inactive synthetase molecules and as a second one an increased accumulation of activable synthetase. After longer culture periods, inactive radioimmunoassayable synthetase accumulated. PMID- 6860683 TI - Hepatic retention and elimination of cholesteryl linoleyl ether after injection of labeled acetylated LDL or chylomicrons. AB - Rat mesenteric duct chylomicrons labeled with [3H]cholesteryl linoleyl ether and human acetylated low density lipoproteins labeled with [14C]cholesteryl linoleyl ether were injected simultaneously into rats. 3 h after injection 80-90% of the injected radioactivity were recovered in the liver and the ratio of 3H/14C in the liver was the same as in the injected material. The 3H/14C ratio declined gradually over a period of 18 days due to loss of [3H]cholesteryl ether which had been injected with the chylomicrons, and retention of the same compound injected bound to acetylated LDL. The loss from the liver of the chylomicron-bound cholesteryl linoleyl ether was shown to occur through the bile, and its elimination from the body was verified by monitoring fecal excretion. The present results provide evidence that hepatic persistence of a nonhydrolyzable analog of cholesteryl ester is a function of the cell type which has ingested the lipid. Thus, the uptake of labeled chylomicrons by hepatocytes results in a slow but progressive excretion of the nonhydrolyzable lipid through the bile, while the preferential uptake of acetylated LDL by nonparenchymal cells of liver and by the spleen leads to persistence of the lipid in the organ. PMID- 6860685 TI - Application of prostaglandin-profiling techniques to study the release of prostaglandins from the fetal lamb ductus arteriosus. AB - Through gas chromatographic techniques with capillary columns and electron capture detection which allow the resolution of prostaglandins F2 alpha, D2, E2, thromboxane B2 and 6-ketoprostaglandin F1 alpha and their 15-keto-and 15-keto 13,14-dihydro metabolites, we have studied the release of these products from the ductus arteriosus in vitro. 6-Ketoprostaglandin F1 alpha was the major product in the incubation fluid while 15-keto-13,14-dihydro prostaglandin F2 alpha was the major product in the tissue. Prostaglandin E2 was almost undetectable in the fluid and tissue. Prostaglandin I2 formed in major proportions by the tissue is released mostly as 6-ketoprostaglandin F1 alpha, although minor amounts of its 15 keto-13,14-dihydro metabolites were detected. These results show differential release of prostaglandin types by this tissue, demonstrating formation and metabolism of endogenous prostaglandins at the same time. PMID- 6860684 TI - Transfer of cholesteryl linoleyl ether from phosphatidylcholine and phosphatidylethanolamine liposomes to cultured cells catalyzed by lipoprotein lipase. AB - Unilamellar liposomes prepared from purified phospholipids (phosphatidylcholine, phosphatidylethanolamine or sphingomyelin) and labeled cholesteryl linoleyl ether were used to study lipoprotein lipase-catalyzed transfer of cholesteryl ester into cells in culture. In mesenchymal rat heart cell cultures, the transfer of cholesteryl linoleyl ether and cholesteryl linoleate was similar and related to the activity of endogenously produced lipoprotein lipase. In human skin fibroblasts transfer of labeled cholesteryl linoleyl ether was proportional to the concentration of milk lipoprotein lipase added to the incubation medium. Liposomes prepared from phosphatidylcholine or phosphatidylethanolamine were much better donors of cholesteryl ether to normal and apolipoprotein E-B receptor negative fibroblasts and to endothelial cells than those prepared from sphingomyelin. Lysophosphatidylcholine was formed during incubation with milk lipoprotein lipase but was not considered to be directly responsible for the lipoprotein lipase-catalyzed transfer of cholesteryl ether. This conclusion was drawn because in the absence of lipoprotein lipase addition of lysophosphatidylcholine to liposomes, or almost complete phospholipolysis by phospholipase A2, did not result in the transfer of cholesteryl linoleyl ether from liposomes to cells. Attachment of lipoprotein lipase to the cell surface was mandatory for the transfer of cholesteryl ether and could be prevented by heparin. High density apolipoprotein reduced also the transfer of cholesteryl linoleyl ether, even though it did not interfere with the binding of labeled milk lipoprotein lipase to cultured fibroblasts. The present results provide evidence that lipoprotein lipase, and not the products of phospholipid hydrolysis, is the ligand for the non-apolipoprotein E-B receptor-mediated transfer of cholesteryl ester to cells. PMID- 6860686 TI - Liver cytosolic fatty acid-binding proteins. Effect of diabetes and starvation. AB - The binding of [1-(14)C]oleate to rat liver cytosol was studied, using gel filtration on Sephadex G-75 and G-50. In liver cytosols from control rats, most of the high-affinity oleate binding was in the region of 12 000-dalton proteins. In liver cytosols from diabetic and starved rats, a second peak of radioactivity appeared in the void volume. This peak was shown to be associated with a component having the molecular weight of 400 000. Evidence suggesting that a change in the composition of cytosolic binding proteins is involved is presented. PMID- 6860687 TI - Evolutionary studies on pancreatic colipase. AB - In this evolutionary study the following criteria have been used to prove the existence of colipase: 1. It restores the activity of human and porcine pancreatic lipase inhibited by bile salt. 2. It cross-reacts with antisera to human and porcine colipases. 3. Its restoration of lipase activity, inhibited by bile salt, in the tributyrin assay system, is prevented by antiserum to colipase. 4. It is a heat-stable, low-molecular-weight protein (molecular weight about 10 000 by gel-filtration). The occurrence of colipase has been verified in the exocrine pancreatic cells from hagfish (Myxine glutinosa), ratfish (Chimaera monstrosa), rayfish (Raja radiata). Greenland shark (Somnius microcephalus) and dogfish (Squalus acanthius). No colipase activity could be found in the gastric juice of crayfish (Pacifastacus leniusculus). These results indicate that colipase envolved in the vertebrates before the organized exocrine pancreatic gland and occurred simultaneously with the bile salts/bile alcohols. PMID- 6860688 TI - Neutral lipid precursors for gangliosides are not formed by rat liver homogenates or by purified cell fractions. AB - As part of an ongoing investigation into the ganglioside and neutral glycosphingolipid biosynthetic pathways in rodent liver, the synthesis of ceramide, glucosylceramide and lactosylceramide was examined in homogenates and purified membrane fractions of rat liver. Ceramide synthesis and its stimulation by exogenously added D-sphingosine was demonstrated in homogenates and isolated membrane fractions, with activity concentrated in the endoplasmic reticulum. In contrast, significant D-sphingosine- or ceramide-dependent formation of glucosylceramide, or glucosylceramide-dependent formation of lactosylceramide (in the presence of labelled UDP-[14C]glucose and UDP-[14C]galactose, respectively,) could not be demonstrated. The possibility is raised that liver may be dependent on extra-hepatic sources of neutral glycosphingolipids to support ganglioside biosynthesis. PMID- 6860689 TI - High-energy diets produce different effects on fatty acid synthesis in brown adipose tissue, white adipose tissue and liver in the rat. AB - The influence of feeding rats a high-energy diet for 7 days on fatty acid synthesis in brown adipose tissue, white adipose tissue and liver of the rat was investigated. The incorporation of 3H2O and [U-14C]glucose into fatty acid was measured in vivo. The rats fed the high-energy diets had higher rates of fatty acid synthesis in white adipose tissue than the controls fed on chow, while fatty acid synthesis in brown adipose tissue and liver was either decreased or unchanged relative to that of controls fed on chow. After an oral load of [U 14C]glucose the incorporation of radioactivity into tissue fatty acid was several fold higher in brown adipose tissue than in white adipose tissue in rats fed on chow. In rats fed the high-energy diets, incorporation of radioactivity into fatty acid in brown adipose tissue was decreased while that into white adipose tissue was either increased (Wistar rats) or unchanged (Lister rats). PMID- 6860690 TI - Phosphatidylcholine biosynthesis in rabbit kidney tubule suspensions. Effect of metabolic substrates on precursor incorporation. AB - To gain insight in the mechanisms that regulate phosphatidylcholine (PC) biosynthesis we studied the incorporation of [14C]choline and 14C-labelled fatty acids into PC of tubule suspensions of rabbit kidney cortex and outer medulla, in vitro. Moreover, the influence of renal substrates on these incorporation rates were examined. When incubated with saturating concentration of 1 mM [14C]choline tubules incorporated 4.40 +/- 0.36 mumol choline per g protein per h. Addition of fatty acids such as palmitate and oleate led to a significant increase in [14C]choline incorporation into PC. Further addition of renal substrates such as glucose, propionate, proline, glutamine and glutamate further enhanced this stimulated incorporation significantly. Maximal rates of [14C]choline incorporation were found to be 9.94 mumol per g protein per h in presence of choline, oleate and glucose. In tubules of the outer medulla only glucose showed a stimulatory effect. On the other hand, 14C-labelled fatty acids were incorporated into tubular PC to a similar extent as was found for [14C]choline incorporation (4.54 +/- 0.62 and 5.52 +/- 0.77 mumol/g protein per h for oleate and palmitate, respectively). Addition of choline or renal substrates increased fatty acid incorporation in an additive manner. Maximal rates of 14C-labelled fatty acid incorporation were found to be 17.7 mumol per g protein per h in presence of oleate, choline and propionate. In contrast to isotope studies, net PC content decreased rather than increased under all experimental conditions, indicating that results may represent membrane lipid turnover. The observed rates are sufficient to replace total renal membrane PC in 1 day. PMID- 6860691 TI - Comparative metabolism of free and esterified fatty acids by the perfused rat heart and rat cardiac myocytes. AB - Studies have been conducted on the uptake and metabolism of unesterified oleic acid and lipoprotein triacylglycerol by the perfused rat heart, and of oleic acid, free glycerol and lipoprotein triacylglycerol by rat cardiac myocytes. The perfused heart efficiently extracted and metabolized unesterified fatty acid and the fatty acid released during lipolysis of the recirculating triacylglycerol. The released glyceride glycerol, however, was largely accumulated in the perfusion media. Cardiac myocytes also extracted and rapidly metabolized unesterified fatty acid. As with the intact heart, free glycerol was poorly utilized by cardiac myocytes. Although the cells appeared to extract a small amount of available extracellular triacylglycerol presented as very low density lipoprotein, this was shown to be unmetabolized, suggesting adsorption rather than surface lipolysis and uptake of the released fatty acid. The data suggest that myocytes are unable to metabolize triacylglycerol fatty acids without prior lipolysis by extracellular (capillary endothelial) lipoprotein lipase. PMID- 6860692 TI - Cholesteryl ester and apolipoprotein E transfer between human high density lipoproteins and chylomicrons. AB - The transfer of cholesteryl esters and apolipoprotein E has been studied between plasma HDL and chylomicrons isolated either from ascitic fluid or from the plasma of a patient with type V hyperlipoproteinemia. Whereas apolipoprotein E transfer was rapid and occurred at low temperature, cholesteryl ester transfer was suppressed at 4 degrees C. Apolipoprotein E transfer did not depend upon the presence of cholesteryl ester transfer protein and was in fact inhibited by the partially purified preparation of this protein. Apolipoprotein E transfer was not increased by reduction with dithiothreitol. The transfer of cholesteryl esters increased sharply at a chylomicron to HDL ratio of cholesteryl ester above 1/10, a value which may be of physiological significance at the peak of postprandial lipemia. At this ratio, the transfer of apolipoprotein E was minimal and increased only at ratios above 2/1. From these results, it is concluded that there is no connection between apolipoprotein E and cholesteryl ester transfer from HDL to chylomicrons. It is, therefore, proposed that whereas chylomicron apolipoprotein E is acquired rapidly and mostly in the lymphatic system, the concentration of chylomicron cholesteryl esters increases significantly and independently in the circulation. PMID- 6860693 TI - Hepatic microsomal composition studies in the Gunn rat. AB - The homozygous jaundiced (jj) Gunn rat exhibits hepatic microsomal enzyme activities which vary from markedly decreased to normal when compared with the non-jaundiced (JJ) Gunn rat. In order to determine if an alteration in microsomal lipid might be related to these observations, cholesterol, phospholipid, fatty acid and fluorescence polarization determinations were carried out in Gunn rats of both genotypes. Significant differences in microsomal palmitic, stearic and arachidonic acid composition were present, but these were not striking. Fluorescence polarization data best fit a two-phase linear model for both genotypes with no significant differences in breakpoint temperatures. In jj rats, the anisotrophy parameter ((r0/r)-1)-1 was significantly greater than that seen in JJ rats at both 25 and 37 degrees C, indicating a decreased membrane fluidity in the jaundiced animals. Alterations in enzyme microenvironment due to subtle changes in lipid composition may be related to the different enzyme activities observed in Gunn rats. PMID- 6860695 TI - The role of the acyl-CoA pool in the synthesis of polyunsaturated 18-carbon fatty acids and triacylglycerol production in the microsomes of developing safflower seeds. AB - Microsomes isolated from the developing cotyledons of the seeds of the safflower varieties, very-high-linoleate, Gila and high-oleate, were capable of exchanging the acyl groups in acyl-CoA with the fatty acids in position 2 of phosphatidylcholine. The specificity of the 'acyl-exchange' towards the acyl moiety in acyl-CoA was selective in the order: oleate greater than linoleate greater than linolenate. Stearoyl-CoA was completely selected against when presented in a mixed substrate with unsaturated 18-carbon acyl-CoAs. Microsomes, of the very-high-linoleate safflower variety, rapidly desaturated in situ labelled [14C]oleoylphosphatidylcholine in the presence of NADH. Little oleate desaturation, however, was observed in the microsomes of the high-oleate variety. Microsomes of the Gila and high-oleate varieties of safflower rapidly synthesised phosphatidic acid by the acylation of glycerol 3-phosphate with acyl-CoA. The phosphatidic acid was metabolised to diacylglycerol, which was further acylated to triacylglycerol. A strong selectivity for linoleoyl-CoA was found for the acylation of glycerol 3-phosphate in both the Gila and high-oleate microsomes. On the basis of these results, we propose that the pattern of 18-carbon unsaturated fatty acids in the triacylglycerols of all 'oil'-producing seeds is a direct reflection of the fatty acids in the acyl-CoA pool. This, in turn, is governed by: A, the rate and specificity of the acyl exchange between acyl-CoA and phosphatidylcholine; B, the rate of oleate (and linoleate) desaturation in phosphatidylcholine; and C, the rate and specificity of the glycerophosphate acyltransferase. PMID- 6860694 TI - A novel transformation of 13-LS-hydroperoxy-9,11-octadecadienoic acid. AB - 13-LS-Hydroperoxy-9,11-octadecadienoic acid (13-HPOD) was incubated with human hemoglobin. Apart from monoketo-, monohydroxy- as well as a number of hydroxy epoxy acid derivatives earlier identified (Hamberg, M. (1975) Lipids 10, 87-92) a small conversion (1-2%) of 13-HPOD into 8-LR, 13-LS- and 8-DS, 13-LS-dihydroxy 9trans,11trans-octadecadienoic acids was demonstrated. An unstable intermediate, i.e., 12,13-epoxy-8,10-octadecadienoic acid, was detected in the conversion of 13 HPOD into the two dihydroxy-octadecadienoates by trapping experiments. It was concluded that compounds structurally related to the leukotrienes may be formed nonenzymatically from 13-HPOD. PMID- 6860696 TI - Distribution of C apolipoproteins between the vascular and lymph compartments of the rat. AB - This study has investigated the kinetics of transfer of C apolipoproteins between the vascular and lymph compartments of the rat. Very-low-density lipoprotein, labeled with [125I]apolipoprotein C, was injected intravenously into lymph duct cannulated rats and the redistribution of radioactivity between lymph and plasma followed at frequent intervals for 3 h. Equilibration between the two compartments was rapid (10-15 min), and thereafter removal from both compartments continued at similar rates. Specific radioactivity determinations showed that lymph C-III-0, C-III-3, and C-III-2,1 apolipoproteins rapidly reached values identical to those of corresponding plasma C apolipoproteins and the interrelationship between the curves were consistent with precursor-product relationships in which all, or most, of the product (lymph apolipoprotein C-III) was derived from the precursor (plasma). However, the specific radioactivity curves for C-II peptide did not cross; the lower value for lymph C-II apolipoprotein suggests that, unlike C-III apolipoproteins, a substantial proportion (approx. 40%) of lymph C-II peptide is not derived from the plasma compartment. The most likely source of the unlabeled lymph apolipoprotein C-II is synthesis and secretion from the intestine. PMID- 6860697 TI - Effect of cholesterol and bile acids on the regulation of cholesterol metabolism in hamster. PMID- 6860699 TI - Lipid peroxidation of human erythrocyte ghosts induced by organic hydroperoxides. AB - Isolated human erythrocyte ghosts perform lipid peroxidation, measured as malondialdehyde, induced by cumene hydroperoxide and t-butyl hydroperoxide but not by H2O2. In contrast to Ames et al. (Ames, B.N., Cathcart, R., Schwiers, E. and Hochstein, P. (1981) Proc. Natl. Acad. Sci. 78, 6858-6862), no inhibition is found by uric acid, only an increase in lag-time of the malondialdehyde production. In parallel with the malondialdehyde production, fluorescent chromolipids are also formed. Both processes are blocked by the addition of desferal, a potent iron chelator. The malondialdehyde production is also inhibited by the OH radical scavenger, thiourea, and by the anti-oxidant, butylated hydroxytoluene. Treatment of erythrocyte ghosts with cumene hydroperoxide or t-butyl hydroperoxide leads to the genesis of high-molecular weight protein, but not with H2O2. The appearance of high-molecular-weight proteins is accompanied by disappearance of protein bands, e.g., the alpha- and beta-spectrin band, the anion-exchanger and some other smaller bands. Furthermore, a protein band is formed in the lower-molecular-weight region. 4. The addition of desferal does not reveal any blockade of the high-molecular weight protein genesis. In contrast, a marked diminution of high-molecular-weight proteins is observed by the addition of thiourea, accompanied by a protection of the protein bands which would otherwise disappear. Similar results are obtained with butylated hydroxytoluene. 5. It is concluded that under oxidative stress the process of high-molecular-weight protein genesis can occur independently of the lipid peroxidation process, measured as the revealing of malondialdehyde. PMID- 6860698 TI - Beta-oxidation of polyunsaturated fatty acids having double bonds at even numbered positions in isolated rat liver mitochondria. AB - beta-Oxidation of polyunsaturated fatty acids was studied with isolated rat liver mitochondria in state 3 or uncoupled conditions. 1. Incubation of mitochondria with docosahexaenoyl-, linolenoyl- or gamma-linolenoylcarnitine resulted in an increase of the absorbance at 340 minus 385 nm. This increased absorbance was due to an accumulation of beta-oxidation intermediates of the polyunsaturated fatty acids, and not to the reduction of nicotinamide nucleotides. 2. Experiments carried out with soluble fractions of liver mitochondria incubated with docosahexaenoyl-CoA and gamma-linolenoyl-CoA indicated that this ultraviolet light-absorption was at least partly caused by acyl-CoA esters having a 2,4(,7) di(tri)enoyl-CoA structure. 3. The addition of glutamate to mitochondria oxidizing gamma-linolenoylcarnitine decreased the absorbance at 340 minus 385 nm, and simultaneously stimulated respiration. With liver mitochondria isolated from fasted rats, 6 mM glutamate increased the rate of acetoacetate production from gamma-linolenoylcarnitine by 130 and 210% under state 3 and uncoupled conditions, respectively. Glutamate did not have any significant effect on the degradation of oleoylcarnitine. The proposed explanation for these findings is that the glutamate dehydrogenase reaction can function as a source of NADPH for 2,4 dienoyl-CoA reductase. 4. The degradation of gamma-linolenoylcarnitine to ketone bodies was augmented in mitochondria isolated from rats treated with clofibrate or partially hydrogenated marine oil. 5. We conclude that 2,4-dienoyl-CoA reductase is an important auxiliary enzyme in the beta-oxidation of polyunsaturated fatty acids. Induction of this enzyme by clofibrate or by certain high-fat diets increases mitochondrial capacity for the degradation of polyunsaturated fatty acids. PMID- 6860701 TI - In vitro studies of the adrenal metabolism of halogenated side-chain analogues of cholesterol. AB - The cholesterol side-chain cleavage enzyme system of rat adrenal mitochondria and rat adrenocortical carcinoma cells was found to metabolize three halogenated side chain cholesterol analogues to pregnenolone. The analogues were 26 bromocholesterol, 26-nor-25(RS)-bromocholesterol and 26-iodocholesterol. The addition of Ca2+ to rat adrenal mitochondria did not produce an increase in the rate of metabolism of the halogenated sterol to pregnenolone. The brominated sterols suppressed the de novo sterol biosynthesis of rat adrenocortical carcinoma cells. The experimental findings are supportive of the notion that a halogen atom at such a position in a sterol is analogous to a hydroxyl group but unlike a proton. ACTH, therefore, may not be a requirement for the uptake and utilization of such sterols. The halogenated sterols may have a use as probes in the study of sterol transfer into and within cells. PMID- 6860700 TI - Possible involvement of 1-acyl-glycerophosphorylinositol acyltransferase in arachidonate enrichment of phosphatidylinositol in human platelets. AB - Microsomes isolated from human platelets synthesize phosphatidylinositol by the action of acyl-CoA: 1-acyl-sn-glycerol-3-phosphorylinositol(1-acyl-GPI) acyltransferase. The properties of 1-acyl-GPI acyltransferase were compared with those of 1-acyl-glycerophosphorylcholine (1-acyl-GPC) acyltransferase. Apparent Km values of 1-acyl-GPI and 1-acyl-GPC acyltransferases for the corresponding acyl acceptor (lysophospholipid) were 22 and 20 microM, respectively, in the presence of arachidonoyl-CoA as fatty acyl donor. However, the Km value (1.3 microM) of 1-acyl-GPI acyltransferase for arachidonoyl-CoA was much lower than that (5.0 microM) of 1-acyl-GPC acyltransferase. Under optimal conditions, the acylation rate of 1-acyl-GPI with arachidonoyl-CoA was 2-6 times higher than with oleoyl-CoA and linoleoyl-CoA, and was very low with saturated fatty acyl-CoAs. The acylation rates with various acyl-CoAs for 1-acyl-GPI were different from those for 1-acyl-GPC. These results suggest that the reacylation pathway of 1 acyl-GPI participates in the incorporation of arachidonic acid to phosphatidylinositol in platelet microsomes. Furthermore, there were no significant effects of thrombin-activation on acyl-CoA specificity for 1-acyl-GPI and 1-acyl-GPC acyltransferase in human platelets. PMID- 6860702 TI - Deacylation and uptake of the fatty acyl chain from enantiomeric dialkylacylglycerol by intact rat fat cells. AB - Isolated rat fat cells hydrolyze the ester bond in position 3 of enantiomeric dialkyl[3H]acylglycerol added as triester-analogue substrate. This lipolytic system constitutes an integrated model which allows, in the absence of di- and monoesters, specific determinations of both the rate-limiting step in triacylglycerol breakdown and the uptake of acyl residues in cell lipids. Splitting of the ester bond was catalyzed by a cell-bound acylhydrolase which exhibited the characteristic properties of lipoprotein lipase. About 70% of the total amount of 3H-labelled fatty acid released during hydrolysis were concomitantly taken up by the cells and reesterified, mainly as triacylglycerol, in cell lipids. The acyl residues appeared to penetrate the cells directly after lipoprotein lipase hydrolysis, without entering the extracellular compartment. This, along with previous finding of a high positive correlation between rates of lipolytic activity and fatty acid uptake (Verine, A., Salers, P. and Boyer, J. (1982) Am. J. Physiol. 243, E175-E181), suggests that the uptake process is directly related to enzyme action. These results are consistent with the concept that lipoprotein lipase, besides being an acylhydrolase, could also function as acyltransferase. PMID- 6860704 TI - Gangliosides of hog skeletal muscle. AB - The ganglioside content of hog skeletal muscle was 27 nmol/g wet weight when calculated as lipid-bound sialic acid. The elution profile on DEAE-Sephadex A-25 column chromatography showed that the monosialoganglioside fraction (61% of total lipid-bound sialic acid) contained at least seven major gangliosides and that the disialoganglioside fraction (25%) contained four major ones. These gangliosides were purified by latrobeads column chromatography, and from the results of sugar analysis, specific enzymatic hydrolysis, a permethylation study and CrO3 oxidation, the structures of these gangliosides were determined to be as follows: A, GM3(NeuAc); B, GM3(NeuGc); C, sialosylparagloboside(NeuAc); D sialosylparagloboside (NeuGc); E, GM1(NeuAc); F, GM1(NeuGc); G, sialosyllactosaminylparagloboside(NeuAc) (monosialogangliosides) and H, GD1a(NeuAc, NeuAc); I, GD1a(NeuAc, NeuGc); J, GD1a(NeuGc, NeuGc); K, GD1b(NeuAc, NeuAc) (disialogangliosides), where NeuAc is N-acetylneuraminic acid and NeuGc is N-glycolylneuraminic acid as sialyl groups. The major fatty acids of gangliosides A, D and G were mainly C16:0, but those of the others, E, F, H, J and K, were C16:0, C18:0, C22:0 and C24:0. The long-chain bases were predominantly C18:1 sphingosine in all gangliosides. PMID- 6860703 TI - Neonatal changes in fatty acid profile of phospholipids in rat heart muscle. AB - The fatty acid composition of rat heart phospholipids was examined during the neonatal and postnatal period. The rats were killed on days 1, 7, 14 and 21 after birth and at the ages of 2 and 6 months. The fatty acyl chain composition of the two major phospholipids, phosphatidylcholine (PC) and phosphatidylethanolamine (PE) changed significantly during the first 2 months. In PC there was a marked and immediate increase in stearic acid, a significant but transient increase in arachidonic acid and late increase in linoleic acid content. In PE there was an immediate increase in stearic acid and docosahexaenoic acid, followed by a late increase in linoleic acid content. The observed alterations in fatty acid composition of heart muscle phospholipids resemble changes induced by repeated administration of norepinephrine and subsequent recovery. Neonatal stress and increased cardiac function play an important role in the modification of the fatty acid composition of rat heart muscle phospholipids during early development. PMID- 6860705 TI - The effect of dietary fat on bile salt synthesis in rat liver. AB - The effect of dietary fat on conjugated cholic, chenodeoxycholic and tauro-beta muricholic acid synthesis was studied using hepatocytes isolated from rats given a low-fat diet, or a low-fat diet mixed with 10% olive oil or 10% corn oil. The rats were totally biliary drained for 48 h prior to preparation of the cells in order to raise bile salt synthesis to a level which was measurable by radioimmunoassay. Synthesis of both conjugated cholic and chenodeoxycholic acid was raised in hepatocytes from rats given a fat supplement (either corn oil or olive oil) in the diet as compared to that in cells from low-fat-fed animals. Tauro-beta-muricholic acid synthesis, however, was unaffected by corn oil feeding. Production of conjugated cholic acid was increased to a greater extent when rats were given olive oil as opposed to corn oil, but these differences were not statistically significant. The conjugated cholic, chenodeoxycholic, and tauro beta-muricholic acid and cholesterol content of bile collected at 2-h intervals during the biliary drainage of the same groups of rats was also determined. The pool size of both conjugated cholic and chenodeoxycholic acid in the enterohepatic circulation was found to be significantly decreased in rats given olive oil as compared to those given corn oil or the low-fat diet only. The pool size of tauro-beta-muricholic acid was also decreased in the olive oil-fed rats compared to the other two groups, but this difference was not statistically significant. After the pool had been drained out, animals which had received fat in the diet secreted more conjugated cholic and chenodeoxycholic acid into the bile than rats which had received the low-fat diet only. This effect was more marked when the fat given was olive oil rather than corn oil. Secretion of tauro beta-muricholic acid into bile at this stage of biliary drainage was not changed by dietary fat supplements. Biliary cholesterol excretion was also increased in rats on diets containing 10% fat, with olive oil again having a greater effect than corn oil. The results show that supplementing the diet with fat leads to increased synthesis of conjugated cholic and chenodeoxycholic acids and biliary cholesterol secretion in the rat. The relatively more saturated fat, olive oil (85% oleate), gave a consistently larger increase than the more unsaturated, corn oil (50% linoleate), but the type of fat appeared less important than the presence of fat in the diet. PMID- 6860706 TI - Properties and distribution of phosphatidylinositol-specific phospholipase C in human and horse platelets. AB - Phospholipase C has been studied in homogenates, total particulate and soluble fractions of horse and human platelets. This enzyme, assayed with exogenous L-3 phosphatidyl[14C]inositol, is predominantly localized in the soluble fraction and its distribution parallels that of lactate dehydrogenase. A small percentage of activity present in the particulate fraction seems to be due to contamination with soluble enzyme. Enzyme from horse and human platelets appears identical, having a Km of 0.10-0.15 mM, acid pH optimum (pH 5.5) and showing Ca2+-dependency and weak inhibition by deoxycholate. Analysis of the reaction products shows the formation of myo-inositol 1,2-cyclic phosphate and myo-inositol 1-phosphate in almost equal amounts. Platelet stimulation with thrombin does not seem to induce association of the cytosolic activity to the membranes. The cytosolic activity is not affected by pretreatment of the intact platelets with prostacyclin or thrombin. Degradation of phosphatidylinositol present in a membrane fraction isolated from platelets by cytosolic phospholipase C requires addition of deoxycholate. Our information suggests that the degradation of phosphatidylinositol in stimulated platelets is mainly achieved by exposure of the substrate to the cytosolic enzyme and by an increase of the free Ca2+ concentration needed for optimal phospholipase C activity. PMID- 6860707 TI - NADH and NADPH inhibit lipid peroxidation promoted by hydroperoxides in rat liver microsomes. AB - Lipid peroxidation induced through cytochrome P-450 activation of cumene hydroperoxide, linolenic acid hydroperoxide and peroxidized phosphatidylcholine in rat liver microsomes is markedly inhibited by either NADH or NADPH. This inhibition is not due to an antioxidant effect. Conversely, cumene hydroperoxide decomposition is stimulated by the reduced pyridine nucleotides but not by some modifiers of cytochrome P-450 (SKF-525A, metyrapon and aniline). The mechanism by which NADH and NADPH prevent lipid peroxidation may involve a reduction of the hydroperoxides mediated by cytochrome P-450 and occurring without formation of free radical forms that are usual sparkers of lipid peroxidation. PMID- 6860708 TI - Adipose tissue and skeletal muscle lipoprotein lipase and hepatic lipase activities in cholesterol-fed guinea pigs. AB - In control and in cholesterol-fed (1%) guinea pigs, the lipoprotein lipase activities of adipose tissue and skeletal muscle and the hepatic lipase activity were assayed after elution of the enzymes from tissues by heparin. The lipoprotein lipase activities were similar in the two groups of animals; the hepatic lipase activity was found be significantly increased in the animals fed cholesterol. PMID- 6860709 TI - Iron-binding proteins in vitreous humour. AB - The soluble protein composition of Macaque monkey vitreous humour was studied in order to understand its iron-binding properties. The protein content of vitreous humour was 217 micrograms/ml +/- 4.6%, 40% of which was serum albumin and 30% an iron-binding protein of hydrodynamic properties identical to that of transferrin or lactoferrin. Relative to serum, the vitreous humour contained a 13-fold excess of this protein(s). Isoelectric focusing, iron-binding and immunoelectrophoretic studies indicated that both vitreous humour and aqueous humour contained lactoferrin as well as serum transferrin. The iron-binding capacity of these proteins in vitreous humour was equivalent to the mass of haemoglobin iron contained in at least 570000 monkey erythrocytes. It was concluded that the intraocular lactoferrin originated from within the eye. These iron-binding proteins may play a protective role in ocular disturbances such as vitreous haemorrhage, iron foreign body toxicity and infection. PMID- 6860710 TI - Activation of bronchial mucin proteolysis by 4-aminophenylmercuric acetate and disulphide bond reducing agents. AB - High molecular weight bronchial glycoproteins, as nearly native as possible, were treated with either 2-mercaptoethanol or 4-aminophenylmercuric acetate (APMA): analytical electrophoresis revealed that a decrease in molecular weight of glycoproteins coincided with the disappearance of some proteins associated with high molecular weight bronchial glycoproteins. These modifications were not observed if high molecular weight bronchial glycoproteins were incubated with paramethylsulphonyl fluoride and EDTA, two synthetic protease-inhibitors, prior to 2-mercaptoethanol or APMA action. These data suggest that protease antiprotease complexes are associated with bronchial mucins and that reducing agents or APMA activate proteases. PMID- 6860711 TI - Characterization of oligosaccharide units of p-N-collagen type III from dermatosparactic bovine skin. AB - p-N-collagen type III was extracted from dermatosparactic and normal fetal bovine skin and purified by ion-exchange chromatography using DEAE- and CM-cellulose. Asparagine-linked sugar chains were fractionated by high voltage paper chromatography from the products obtained after hydrazinolysis and reduction with NaB3H4. These oligosaccharides composed of neutral and acidic components are mannose-containing oligosugars of the complex type. Their abundance is much higher in dermatosparactic p-N-collagen type III. PMID- 6860713 TI - [Analysis of the associative properties of visual cortex neurons in the local joint action of mediators]. AB - The neuronal spike activity in the visual cortex of awake nonanesthetized rats during paired local action of glutamate and acetylcholine has been investigated. In some neurons the specific associative activity modifications were recorded in form of chemosensitivity changes to the analog of conditioned stimulus (1 glutamate) mainly. The initial reactivity of neurons to the paired stimuli is not enough to form the associative effects. PMID- 6860714 TI - Alpha 1-acid glycoprotein in the neonate with and without infection. AB - In a study of early neonatal infection, 278 babies had a blood culture and an alpha 1-acid glycoprotein (alpha 1-AGP) determination. There were significant differences between the mean (+/- SEM) levels of alpha 1-AGP in infants who were noninfected (26 +/- 1.3 mg/dl, n = 244), infected (81 +/- 11 mg/dl, n = 12) and proved to have sepsis (66 +/- 10 mg/dl, n = 22). In the 'noninfected' group, alpha 1-AGP levels increased with postnatal age. Increasing levels were seen on the 1st day with both increasing gestational age (15-34 mg/dl from less than 30 to greater than or equal to 38 weeks) and birth weight (17-42 mg/dl from less than 1,000 to greater than or equal to 4,000 g), irrespective of the infant's sex. Among the sepsis group, infants who died had lower levels than those who survived (19 mg/dl vs. 90 mg/dl). PMID- 6860712 TI - [Isolation of biologically active halves of the long tail fibers and whiskers of bacteriophage T4]. AB - The following substructural elements of bacteriophage T4 have been isolated in homogeneous and biologically active state: the whole long tail fibrils, distal and proximal halves of the long tail fibrils and whiskers. It has been shown that during the infection of Escherichia coli with T4 amber-mutants (defective in the genes coding for heads and tails), the major part of distal and proximal fibril halves found within the cell appears to be unassociated. The interaction of distal and proximal fibril halves with the bacteriophage particle is necessary for the whole tail fibril formation to proceed effectively. PMID- 6860715 TI - Functional residual capacity and sleep states in the premature newborn. AB - Functional residual capacity (FRC) variations in relation to sleep state changes were studied in 11 premature infants with birth weights of 1.68 +/- 0.48 kg and gestational ages of 32.7 +/- 2.2 weeks (mean +/- SD). Helium dilution was used to measure FRC, and sleep states were identified using neurophysiologic criteria. No significant difference in FRC could be demonstrated between data collected during active sleep (AS) and quiet sleep. However a relationship was shown between AS and paradoxical breathing (p less than 0.02) and between AS and irregular breathing (p less than 0.05). Several factors are discussed which might explain the discrepancy between the present data in premature infants and the previously published data in term infants. (1) Neurophysiologic identification of sleep states does not include breathing pattern whereas behavioral identification does. It is therefore possible that lung volume changes are related to breathing pattern changes and not to sleep state changes per se. (2) Maturational changes may occur among the mechanisms which control FRC, leading to a progressive stabilisation of FRC, the variation of which could become related to sleep state changes. PMID- 6860716 TI - Functional development of adrenergic uptake mechanisms in the human fetal heart. AB - The uptake of 3H-NA into human fetal heart tissue was low during the first half of gestation, only one-fifth of that observed in the mouse heart. A gradual increase in uptake was seen during the second trimester of gestation. A drop in temperature resulted in inhibition of 3H-NA uptake in all samples, but most distinctly in the mouse heart and in the human fetal heart at 14-20 weeks of gestation. Cocaine and desipramine reduced the uptake of 3H-NA in human fetal atria after 14 weeks of gestation but not before that. Nialamide showed no such effect. The functional development of the noradrenergic nervous system in the human fetal heart was found to be very slight during the first trimester of pregnancy. After that a gradual maturation of noradrenergic mechanisms was seen. At the end of the first half of gestation the noradrenergic neurons in the human fetal heart may be held to function qualitatively similarly to those in the mature mouse heart. PMID- 6860717 TI - Free thyroid hormone levels during the postnatal period in the pig. AB - Sequential observations on serum concentrations of dialyzable (DFT4,%) and absolute free thyroxine (FT4), free triiodothyronine (FT3) and free reverse triiodothyronine (FrT3) were conducted in piglets (n = 10) from birth to 21 days of age. Mean FT4 and FT3 were found to be significantly raised during the first 3 days of life, with the highest value (0.520 +/- 0.070% DFT4, 551 +/- 0.1 pmol/l and 0.965 +/- 0.020% DFT3, 18.8 +/- 1.2 pmol/l) between 0 and 12 h after birth. Later, a decrease was observed until the end of the first week followed by a steady and relatively low level during the second and third postnatal weeks. Dialyzable fraction of rT3 increased to a peak value of 48 h of age (0.621 +/- 0.044%) and then decreased til day 7, showing a steady level during the second and third weeks of life. Absolute FrT3 concentration remained low and relatively constant except for a higher value (3.76 +/- 0.44 pmol/l) between 12 and 24 h after birth. The FT4:FT3 and FT4:FrT3 ratios were high between 0 and 6 h of age. The FT3:FrT3 ratio reached the highest value (about 11.0) between the second and fifth days, followed by a fall to 4.7-7.5 during 2-3 weeks after birth. PMID- 6860718 TI - Hypnosis and lateral cerebral function as assessed by dichotic listening. AB - In a replication of Frumkin et al. we investigated the hypothesis that hypnosis may facilitate a shift in brain hemispheric dominance, as assessed by right-ear dominance shifts in a dichotic listening paradigm. Eight low, 13 medium, and 8 high hypnotizables, as assessed by the Stanford Hypnotic Susceptibility Scale, Form C, were given the Berlin et al. dichotic tape during two waking conditions and following an alert hypnotic induction. Results contradicted Frumkin et al. In contrast, low hypnotizables showed a significant reduction in right-ear dominance, suggestive of greater participation of the right cerebral hemisphere following hypnotic induction. Highs and mediums did not change. Discussion centers around procedural differences between the two studies (particularly type of hypnotic induction and instructions to attend to one or both ears) and the possible influence of relaxation/anxiety levels upon lateral shifts in cerebral function. PMID- 6860719 TI - Acute exacerbation of paranoid psychotic state after long-term abstinence in patients with previous methamphetamine psychosis. AB - From a population of 111 patients with chronic methamphetamine (MAP) psychosis, who were treated at ten mental hospitals during the past 3 years, 21 patients were selected for study. Sixteen patients who experienced MAP psychosis again used MAP one or more times after long-term abstinence and experienced acute exacerbation of a paranoid psychotic state which was almost identical to the initial psychotic episode. Four of these patients relapsed following a single MAP reuse of an amount less than that initially used, and one relapsed without evidence of MAP reuse. In eight patients, small doses of neuroleptics, e.g., 3 mg per day of haloperidol, prevented the acute provocation of a psychotic state by MPA reuse. Subsequently, three of these relapsed into a psychotic state following MAP reuse without concurrent haloperidol medication. The clinical data were compared with animal experiments which indicate that chronic MAP use can induce a long-term susceptibility to sensitization to MAP. The positive prophylactic effect of small doses of haloperidol on the acute exacerbation may suggest the participation of dopaminergic supersensitivity as a mechanism for the paranoid psychotic state. PMID- 6860721 TI - A cholinergic role in the mechanism of lithium in mania. AB - Based on evidence that mania may include an alteration of cholinergic function, we have previously investigated the effects of various monovalent ions on the muscarinic cholinergic receptor from human caudate nucleus utilizing the radio labeled antagonist (3H)quinuclidinyl benzilate (QNB). In this study we observed that Li+ at 1 mM was unique in its ability to specifically reduce the affinity of 3H-QNB for the muscarinic receptor (increasing the QNB dissociation constant from 35.9 pM to 72.4 pM). The sodium-specific induction of positive cooperativity (nHill) at the muscarinic cholinergic receptor was inhibited in the presence of Li+. Both observations achieved statistical significance at p less than 0.05. A Li+-related decrease in specific QNB binding sites (Bmax) by 23% (from 2480 to 1900 pmole/g protein) was additionally manifest, albeit only achieving a statistical trend (p less than 0.10). The exact mode of Li+ action in the management of major affective illnesses remains speculative. The observations that this cation specifically mediates a reduction of muscarinic receptor affinity and number of binding sites within the human caudate suggests further consideration of the association between muscarinic cholinergic activity and mania as it relates to Li+. PMID- 6860720 TI - The dexamethasone suppression test in patients with alcoholism. AB - It is unknown whether the dexamethasone suppression test (DST) can be used to help identify patients with major depressive disorder if they have recently been abusing alcohol. We evaluated 38 male alcoholics with Research Diagnostic Criteria (RDC), the Beck Depression Inventory (BDI), and the standardized overnight 1-mg DST, administered after 3-4 weeks of detoxification. Eighty-two percent had a normal suppressive DST response. The DST may be useful in aiding identification of patients with a profile of major depressive disorder and continued depression after alcohol detoxification. The test might facilitate a rational selection of alcoholics who may benefit from antidepressants. However, the possibility of false positive results must be further investigated. PMID- 6860723 TI - A comparison of the behavioral properties of (+/-)-, (-)-, and (+)-5-methoxy alpha-methyltryptamine. PMID- 6860724 TI - d-Amphetamine response and dexamethasone suppression test as predictors of treatment outcome in unipolar depression. PMID- 6860725 TI - Use of the dexamethasone suppression test using DSM-III criteria on an inpatient psychiatric unit. PMID- 6860726 TI - Temporal association between depression-dependent dyskinesias and high urinary phenylethylamine output. PMID- 6860722 TI - A comparison of human muscarinic cholinergic receptor properties subsequent to alcohol abuse and senescence. AB - Neuropsychiatric impairment during senescence and consequent to alcohol abuse demonstrates several parallels in the areas of short-term memory and sensorimotor skills. In this study high-affinity binding of the muscarinic cholinergic antagonist quinuclidinyl benzilate (QNB) was determined with post-mortem human brain tissue from normal young adults, age-matched ethanol abusers, and nondemented senior adults without histories of substance abuse. Hippocampus was chosen because of its high-density cholinergic innervation and probable role in the mnemonic process. A statistical significance emerged between nonalcoholic young adults and both ethanol abusers and seniors in reference to cooperative binding interactions (Hill coefficient, nH) amongst the latter two groups. Analysis of the respective receptor affinities (KD) revealed a significant difference between each group. A trend toward an increased KD occurred from nonalcoholic young adults to alcoholic young adults to nonalcoholic seniors. Concerning the density of receptor sites (Bmax) no difference emerged between alcoholic or nonalcoholic young adults. However nonalcoholic seniors manifest a statistically significant reduction in Bmax; this feature is consistent with the reports of several other investigators. Amongst subjects with a pathologic history of ethanol abuse, a premature senescence along parameters of nH and KD emerged, albeit not including the apparent age-dependent decline in Bmax. PMID- 6860727 TI - More on celiac disease as a model for schizophrenia. PMID- 6860728 TI - Cerebrospinal fluid prostaglandin E in depression, mania, and schizophrenia compared to normals. PMID- 6860729 TI - Symptom profile of patients with positive DST: a pilot study. PMID- 6860730 TI - Clinical response of aggressive schizophrenics to oral tryptophan. PMID- 6860731 TI - Prolactin levels in schizophrenia: relation to platelet monoamine oxidase, plasma amine oxidase, plasma dopamine-beta-hydroxylase, and erythrocyte catechol-O methyltransferase activity. PMID- 6860732 TI - Neuropsychiatric disturbances associated with idiopathic calcification of the basal ganglia. AB - A patient with idiopathic calcification of the basal ganglia (ICBG) manifested a schizophrenialike psychosis beginning at age 17 and later developed a complex movement disorder and mild dementia. Extensive calcification of the basal ganglia was demonstrated by computerized tomography. Review of reported cases of ICBG suggests that patients who become symptomatic early in adulthood are more likely to present with psychosis, whereas those presenting later in life typically manifest dementia and a motor system disorder. ICBG, like other conditions affecting subcortical structures, can produce schizophrenialike symptoms that may precede the onset of intellectual deterioration and extrapyramidal motor disturbances. PMID- 6860734 TI - Violence and episodic behavioral dyscontrol. PMID- 6860733 TI - Psychiatric disorder in myotonia. PMID- 6860735 TI - Dynamics of ovarian blood supply to periovulatory follicles of the ewe. AB - Radioactive microspheres were injected into the ovarian artery ipsilateral to the ovary containing the dominant (preovulatory) or postovulatory follicle of the ewe to estimate the distribution of ovarian blood to those follicles throughout the periovulatory period. The follicle of interest was excised from the ovary at the first sign of estrus (4-h heat checks), or 4, 8, 12, 16, 20, 24, 28 and 32 h later. Blood samples to be analyzed for serum luteinizing hormone (LH) were taken at each observation for estrus. Follicles were partitioned into basal tissue, apical tissue and fluid (preovulatory follicles) constituents. Radioactivity was determined within the residual ovary and in each follicular component. Follicular data were normalized to the ascending limb of the preovulatory surge of serum LH (first detected increase in LH = O h). The supply of ovarian blood to the wall (apex + base) of follicles was elevated after the rise in LH was initially ascertained (0-12 h). The distribution of blood to the follicular wall began to decline from 12 to 16 h, and subsequently continued to decrease (20 h) until after ovulation had occurred (greater than or equal to 24 h after the LH increase). Blood supply was less to the wall of follicles in the 20-h group and to ruptured follicles than that to the wall of follicles collected before the initiation of the surge of LH. There was no evidence that blood supply to either the basal or apical portion of the follicular wall was altered preferentially. Radioactivity was not detectable within follicular fluid. PMID- 6860736 TI - Effects of gossypol on the seminiferous epithelium in the rat: a light and electron microscope study. AB - This study was undertaken to determine the effects of 10, 20 and 30 mg/kg per day of gossypol for 2-11 weeks on the rat testis. At the light microscope level, the most striking effect of gossypol treatment is the presence of severely damaged and entirely normal seminiferous tubules adjacent to one another in the same section. Affected tubules exhibit intraepithelial vacuoles of varying size, exfoliation, and atrophy. With the electron microscope, the intraepithelial vacuoles are found to consist of intercellular spaces and intracellular vacuoles occurring primarily, though not exclusively, in the Sertoli cells. Severely affected Sertoli cells exhibit many large vacuoles as well as an overall decrease in cytoplasmic ground substance, rough and smooth endoplasmic reticulum and Golgi apparatus. There is an overall increase in the frequency of occurrences of vacuolated tubules with time and dose but in no group of animals were more than 46% of the tubules affected. At the electron microscope level, the most striking specific effect of gossypol treatment is the production of ultrastructural defects exclusively in the mitochondrial sheath of Stage 18 and 19 spermatids; these changes are evident in small numbers as early as 2 weeks after 20 mg/kg per day of gossypol and increase with dose and time. No other significant differences between germ cells or Leydig cells of control and gossypol-treated rats are observed under the experimental conditions employed. The significance of these observations is discussed in relation to the possible mechanisms of action of this new experimental male contraceptive. PMID- 6860737 TI - Reproductive cycle of the Asian elephant (Elephas maximus) in captivity. PMID- 6860738 TI - Mechanisms of amino acid uptake in cumulus-enclosed mouse oocytes. AB - The nutritional role of mouse granulosa cells on antral dictyate mouse oocytes has been studied by measuring the transfer of different amino acids through gap junctional channels between somatic and germ cells. When present in the incubation medium at concentrations resembling in vivo conditions, glycine, alanine, proline, serine, tyrosine, glutamic acid and lysine entered cumulus enclosed oocytes cooperatively, while valine, leucine and phenylalanine did not. However, cooperative uptake of leucine and phenylalanine was observed at higher external precursor concentrations. We conclude that in vivo antral mouse oocytes depend on surrounding granulosa cells for amino acid uptake, with the exception of amino acids carried by the leucine exchange transport system, and propose that amino acid transfer between granulosa cells and oocytes is dependent on precursor concentrations in the coupled cells. PMID- 6860739 TI - Steroid metabolism by the bovine uterine endometrium and conceptus. PMID- 6860740 TI - Assay for characterization of human follicular oocyte maturation inhibitor using Xenopus oocytes. AB - Human follicular fluid from healthy mature Graafian follicles and from pathologic ovarian cyst fluid was found to be inhibitory to progesterone-induced meiotic maturation of oocytes from the South African clawed toad, Xenopus laevis. Human follicular fluid but not human serum, collected from the same individuals, demonstrated a linear dose-response inhibition on the maturation of oocytes in the Xenopus assay system. These findings indicate that the human follicular and cyst fluids contain oocyte maturation inhibitor (OMI). This human OMI was inactivated when subjected to a boiling water bath for 2 min. The OMI action was shown to be reversible in its inhibitory action. The fact that OMI can act directly on the oocyte was demonstrated by its inhibitory action on maturation in defolliculated oocytes. The findings demonstrate that the inhibitory action of human OMI is not species-specific. Xenopus oocytes provide a simple, readily available, year-round bioassay material for testing follicular oocyte maturation inhibitor. PMID- 6860741 TI - Modulation of the estrous cycle by pheromones from pregnant and lactating rats. AB - Female rats were exposed to odors from females that went through a birth cycle of pregnancy, birth and lactation. The estrous cycle was shortened by odors from pregnant rats and lengthened by odors from lactating rats and their pups. Changes in estrous cycle length were accompanied by changes in the length of the luteal phase (metestrus-early diestrus). A log survivor plot demonstrated that variation in cycle length was the result of different rates of ovulation within the population under each condition. Neither pregnancy nor lactation odors affected the intensity or timing of the lordosis reflex. These odors could modulate fertility and coordinate birth cycles within a group of rats. PMID- 6860742 TI - Serotonin-induced disruption of implantation in the rat: I. Serum progesterone, implantation site blood flow, and intrauterine pO2. AB - Serotonin, administered on the day after the initiation of implantation, promptly terminates pregnancy in the rat. Consequently, the effects of serotonin on serum progesterone levels, implantation site blood flow, and intrauterine oxygen tension were determined to see whether the disruption of implantation is related to altered corpus luteum and/or uterine vascular function. Animals received a subcutaneous injection of physiological saline (C: control) or serotonin (S: 20 mg/kg) on Day 5 of pregnancy. Serotonin did not alter the number of blastocysts implanting (C: 6.02 +/- 0.52 vs. S: 6.29 +/- 0.46, sites/cornu) but did cause subsequent implantation site resorption (C: 0.08 +/- 0.07 vs. S: 5.46 +/- 0.44/cornu; P less than 0.001). Progesterone levels in serotonin-treated rats did not differ from those of controls at 6 h postinjection or on Days 6 through 10 of pregnancy. Implantation site blood flow was reduced at 30 min (C: 0.76 +/- 0.12 vs. S: 0.25 +/- 0.02 ml/min per g; P less than 0.01) and remained suppressed at 2 h after serotonin injection. A prompt and sustained reduction in intrauterine oxygen tension (C: 48.9 +/- 3.7 vs. S: 25.9 +/- 4.5 mmHg; P less than 0.005; 120 min) accompanied the reduced uterine perfusion. Thus, disruption of implantation is not a result of impaired corpus luteum function but is associated with marked and protracted reductions in uterine blood flow and intraluminal oxygen availability. PMID- 6860743 TI - Mice selected for age of puberty: reverse selection and reproductive characteristics. AB - Previous investigations have hypothesized a link between regulation of population size in various rodent species and changes in allele frequencies for certain loci that exert their effects on particular behaviors or processes related to reproduction. Drickamer (1981a) has shown that age of first vaginal estrus can be shifted by artificial selection and that there is a relatively high heritability for this trait in laboratory Mus. This paper reports on two related experiments, one a test of reverse selection on strains of mice previously selected for early and late first vaginal estrus, and the other a compilation of data for a variety of traits related to reproduction for the original base stock and four artificially selected stocks. The original selection for early and late onset of puberty did not result in fixation of the trait-enough residual variation remained so that in eight generations of selection it was possible to significantly reverse the timing of first estrus. Traits related to reproduction including litter size, pup weight, survival of pups to 21 days, weight at 21 days, fertility and birth intervals all were not affected by the selection process across all five stocks tested. These results are discussed with regard to changes in puberty and generation time in Mus as a factor in population regulation. PMID- 6860744 TI - Progesterone and estrogens in the pregnant and nonpregnant dolphin, Tursiops truncatus, and the effects of induced ovulation. AB - Baseline serum levels of progesterone and total immunoreactive estrogens were determined for intact and ovariectomized captive female Atlantic bottlenose dolphins (Tursiops truncatus), as well as newly captured wild adult females. Stimulation of ovarian follicular growth and ovulation was attempted by intramuscular injection of pregnant mare's serum gonadotropin (PMSG). High doses of PMSG were required to increase serum estrogen levels. When PMSG was followed by an injection of human chorionic gonadotropin (hCG), ovulation was presumed to have occurred as indicated by subsequent high levels of serum progesterone. From these observations, it appears that 1) females with progesterone levels greater than 3000 pg/ml over an extended period are pregnant, 2) Tursiops truncatus is capable of spontaneous ovulation in captivity without gonadotropin therapy, 3) captive female dolphins, although relatively resistant to PMSG, can be induced to ovulate using a combination of high intramuscular-injected doses of PMSG followed by hCG, and 4) spontaneous ovulation is likely to follow an induced ovulation. PMID- 6860745 TI - Pubertal development of the boar: age-related changes in testicular morphology and in vitro production of testosterone and estradiol-17 beta. AB - The responsiveness of testicular tissue, in terms of testosterone (T) and estradiol-17 beta (E2) production, to human chorionic gonadotropin (hCG) stimulation in vitro was assessed during pubertal development of the boar. A morphometric investigation was conducted concurrently to quantitate Leydig cell and seminiferous tubule changes in the testes of developing boars. Testicular volume percentage of seminiferous tubules increased from 36% at 40 days of age to a maximum of 72% at 190 days of age. Increases in tubular diameter were from 65 micrometers at 40 days of age to 236 micrometers at 250 days of age. Testicular volume percentage of Leydig cells decreased from 40% at 40 days of age to 10% at 250 days of age. Leydig cell number increased rapidly to 130 days of age, remained constant through 160 days, and then increased steadily to 220 days of age. Volume per Leydig cell changed little from 40 to 130 days of age, increased by 75% at 160 days, and declined thereafter. Total Leydig cell weight increased steadily from 40 to 160 days of age and then declined slightly. The capacity of Leydig cells for T production and testicular tissue for E2 production was greatest (P less than 0.05) after hCG stimulation in boars that were 130 and 160 days of age. In addition, sensitivity, as judged by the regression coefficient of T or E2 production per Leydig cell on log dosage of hCG was greater (p less than 0.05) for T at 130 days of age and for E2 at 160 days of age. The data presented support the hypothesis that one factor in pubertal development of boars is an increased capacity and sensitivity of the testes to gonadotropin stimulation. PMID- 6860747 TI - Prolactin in the cat: I. Pseudopregnancy, pregnancy and lactation. PMID- 6860748 TI - Effects of ethanol on superovulation in the immature rat following pregnant mare's serum gonadotropin (PMSG) or PMSG and human chorionic gonadotropin treatment. AB - We sought to determine whether superovulation could occur in immature rats on a 5% ethanol diet and treated with pregnant mare's serum gonadotropin (PMSG) alone or with human chorionic gonadotropin (hCG). Holtzman female rats were divided into five groups at 20 days of age. Six rats (Group I) were killed at that age. Ten rats (Group II) were placed on an ad libitum laboratory chow diet and killed on Day 33. Twenty-four rats (Group III) were placed on an ad libitum laboratory chow diet. Twenty-four rats (Group IV) were placed on 5% ethanol liquid diet, while 24 rats in Group V were pair-fed with the animals in Group IV. At 30 days of age, 12 rats from each Group, III, IV, and V, received 25 IU of PMSG s.c. and were killed 74-76 h later. The remaining 12 rats from each Group, III, IV and V, received 25 IU of PMSG and 54-56 h later received 10 IU of hCG and were killed 20 h later. Ovulation occurred in all the rats of Groups III and V that received PMSG alone or with hCG. In the ethanol-treated rats that received PMSG alone, 75% ovulated, while 92% ovulated that received PMSG and hCG. The number of ova shed in the ethanol-PMSG-treated rats was significantly less than in the ethanol-PMSG hCG-treated animals and in the controls. The uterine weights and morphology of the animals in Group IV were similar to those in Groups III and V. The study indicates that ethanol does not have a direct gonadotoxic effect on the ovary but indicates that ethanol has an effect on the hypothalamus and/or the pituitary, thereby disrupting the synthesis and/or release of luteinizing hormone releasing hormone (LHRH) or luteinizing hormone (LH). PMID- 6860749 TI - Urinary estrogens during pregnancy of the ruffed lemur (Lemur variegatus). AB - Pregnancy in the ruffed lemur (Lemur variegatus) was monitored by analyses of urinary estrogens. Urine samples were collected weekly throughout pregnancy (gestation: 100 +/- 1.6 days) from ten females analyzed for total immunoreactive estrogen (Et) and indexed by creatinine (Cr). Maternal urinary total estrogen excretion remained low until the last half of gestation at which time excretion increased steadily, reaching values 1000 times greater than those observed at estrus. Chromatographic separation after enzyme hydrolysis of lemur urine indicates that estrone is the major estrogenic component of pregnancy in the ruffed lemur, with the remaining components consisting of equal amounts of estradiol-17 alpha and -17 beta. PMID- 6860750 TI - Anticoagulant activity of amino acid modified polystyrene resins: influence of the carboxylic acid function. AB - In previous papers, we have described the preparation and heparin-like properties of insoluble modified polystyrene resins. We now report results obtained with amino acid sulphamide resins that are virtually devoid of sulphonate groups and with resins bearing both sulphonate groups as well as amino acid sulphamides with spacers of various lengths. The absence of sulphonate groups does not affect the anticoagulant activity of the former type of resin. The biologic activity of the latter type of resin is dependent upon the length of the spacer between the amino and carboxylic acid functions. Maximal anticoagulant potency is attained with a spacer consisting of three methylene groups. Biologic activity is reduced with spacers that are less than or greater than this critical size. PMID- 6860751 TI - Fracture toughness of acrylic denture base. AB - This paper describes the application of two fracture toughness tests, the compact tension (CT) and the double torsion (DT) to homogenous poly(methyl methacrylate) and two-phase acrylics. Materials were tested in air as processed and after saturation for one month in water. Most materials gave stable crack propagation with these tests, allowing accurate measurement of crack velocity. Modulus and un notched fracture strength (sigma f) were determined at an identical strain rate in bending to that used in the fracture toughness tests, allowing accurate calculation of the flaw size (a) for a material and an assessment of how applicable Linear Elastic Fracture Mechanics are to these materials. PMID- 6860746 TI - Male vomeronasal organ mediates female-induced testosterone surges in mice. PMID- 6860752 TI - Evaluation of infusion sets by biological and chemical testing. AB - Some of the biological and chemical tests used in toxicological evaluation of synthetic polymers were correlated. The individual tests (sperm cell motility, tissue culture inhibition, intracutaneous test, optical absorption at 220-360 nm, reducing impurities) did not mutually correspond. The final estimation of the tested device is assessed as a sum of these units. Therefore, it is necessary to evaluate the results of the individual tests in arbitrary units. PMID- 6860753 TI - Morphological demonstration of direct deposition of bone on human aluminium oxide ceramic dental implants. PMID- 6860755 TI - Bioerodible polyanhydrides for controlled drug delivery. PMID- 6860754 TI - Porous acrylic cement for the correction of craniofacial deformities and repair of defects, animal experimentation and two years of clinical application. PMID- 6860756 TI - The influence of various carbon fibre braiding techniques and methods of fixation on the extensibility of ligament prostheses. AB - An alloplastic ligament prosthesis with carbon fibres should not only be biocompatible but should also restore the biomechanical function of a natural system, which includes restoring its elasticity. Tests with new types of braided carbon fibre strands showed their elastic extensibility to increase with increasing number of filament tows and increasing braid angle. The best results were obtained with 32 tows and a 43 degrees braid angle. This strand type was tested in vitro as a medial collateral ligament prosthesis with two methods of fixation in human knees and, in like manner, in vivo in sheep knees. Biomechanical tests in vitro using human cadaver knees and sheep knees after 12 weeks' implantation showed an elasticity similar to that of normal natural ligaments. PMID- 6860757 TI - Experiences with Al2O3--ceramic middle ear implants. AB - The excellent tolerance of bio-inert aluminium oxide ceramic after being implanted into the middle ear has been shown by our electron microscopic studies and clinical experience over 4 years. Our implants developed for ossicular chain reconstruction were covered by a delicate middle ear mucosa within a few weeks. We have observed no foreign body reactions. The ceramic implants are distinguished by the almost unlimited number of forms or shapes into which they can be ground quickly and precisely during operation. We value Al2O3 ceramic implants because there is no bony fixation with the surrounding bone but rather a joint-like connection with the remaining parts of the ossicular chain. PMID- 6860758 TI - Scanning electron microscopy examination of a porous alumina prosthetic heart valve. PMID- 6860759 TI - The binding of corroded metallic ions to salivary-type proteins. AB - Employing equilibrium dialysis, the binding ability of nickel, copper, and chromium from the corrosion of Biobond, Sybraloy, and Vitallium dental alloys in an inorganic saliva to glycoprotein, mucin, amylase, and lysozyme is reported. Binding was highest with copper to glycoprotein at 5.0 M Cu/M protein, followed by nickel at 1.2 M Ni/M protein, and by chromium at 0 M Cr/M protein. Tin products did not succumb to dialysis. The binding to all types of proteins exhibited molar ratios of about equal magnitudes except in lysozyme where binding was very low, most likely due to its high isoelectric point. Protein--protein interactions for amylase were higher, which hindered the nickel binding at lower protein concentrations. Peaks in glycoprotein binding vs pH behaviour occurred for copper at pH = 6 and for nickel at pH = 7. For glycoprotein and mucin, binding is taken to occur via the sialic acid carboxylate groups and for amylase via the imidazole groups of the histidine residues. It is thought that in order for copper to bind with the same number of sites as does occur with nickel, ligands of the form CuCl-CuCl2 are generated. The size of hexahydrate ligands of chromium are large which may not permit attachment onto binding sites. PMID- 6860760 TI - Tissue reactions to the separate implantation of individual constituent phases of dental amalgam, including assessment by energy dispersive X-ray microanalysis. AB - Soft tissue degradation of the 3 principal amalgam phases have been investigated in relation to their role in the formation of the amalgam tattoo. Each phase, finely powdered, was implanted subcutaneously into the submandibular region of guinea-pigs for periods ranging from 1 week to 1 year. The rates of breakdown were assessed radiographically and the final lesions were examined by light and electron microscopy and X-ray microanalysis. gamma 2 (Sn7Hg) phase degraded rapidly, mainly extracellularly, and did not produce a tattoo. Both mercury and tin disappeared from the lesion. gamma 1 (Ag2Hg3) phase degraded less rapidly, both extra and intracellularly, and produced a small tattoo. Mercury was lost from the lesion. gamma (Ag3Sn) phase degraded slowly, intracellularly, and produced a large tattoo. Tattoos always resulted from persistence of minute particles of silver and sulphur associated with basal lamina and connective tissue. PMID- 6860761 TI - Bioglass composites: a potential material for dental application. AB - Bioglass, a promising material for dental applications, can be reinforced with ductile stainless steel fibres. Three aspects of the fibre-reinforced bioglass composites are discussed. They are the interface between the glass and the metal fibres, the mechanical properties of the composites and their in vivo bonding behaviour. The importance of a good interfacial bond between the glass and the metal fibres is outlined. The improvement in strength and toughness, due to the fibres, is explained. The in vivo bonding behaviour of the bioglass composite is checked under statically loaded conditions. PMID- 6860762 TI - Dental polyelectrolyte cements. III. Effect of additives on their rheology. AB - As part of a series of investigations of dental polyelectrolyte cements, the influence of additives was studied by viscometry. At low concentrations, tartaric acid was found to exert an accelerating influence on glass ionomer cements but to retard the reaction by complex formation at high concentrations. When dissolved with the liquid component, NaF accelerated some glass ionomer cements and retarded others. NaCl was found to accelerate the zinc polycarboxylate cements, possibly through its reduction in the electrical potential between powder and liquid phases. Neutralization of the polyacids retarded the reactions but not enough to indicate that hydrogen ions were directly involved in the rate determining step. PMID- 6860764 TI - Selection of acrylic bone cements for use in joint replacement. AB - Commercial acrylic bone cements have been compared in terms of their mechanical, thermal and rheological properties. Significant differences have been found between the tensile strengths, shear strengths and peak polymerization temperatures of the cements tested. Large differences have been found between the viscosities of different formulations and the duration of their working periods during polymerization. Optimum cement selection is found to depend critically upon ambient conditions within the operating theatre considered in combination with the characteristics of the cements themselves. It is proposed that, at present, the only differences between commercial bone cements of relevance to successful joint replacement lie in the area of rheological properties during polymerization. PMID- 6860765 TI - [10 Years experience of test criteria for fracture-resistant stems in hip joint prostheses]. PMID- 6860763 TI - Studies on dental fluoride-releasing polymers. IV: Fluoridation of human enamel by fluoride-containing sealant. AB - An experimental fluoride-containing acrylic sealant was prepared using methacryloyl fluoride-methyl methacrylate copolymer as powder component. The in vitro fluoride acquisition by human enamel coated with the sealant after 11, 21, 41 and 84 days of incubation in a phosphate buffer of pH7 at 37 degrees C was determined. Fluoride penetration and uptake were increased by prolonging the exposure time of enamel to the sealant. Most of the fluoride retained in enamel was found to be present as fluorapatite. The discharge of fluoride in the sealant was about 12% of initial load after 84 days of immersion. PMID- 6860766 TI - [Studies on the stress behavior in the interface of total hip prosthesis]. PMID- 6860767 TI - [Mathematical studies on particle paths in an aneurysm]. PMID- 6860768 TI - [Problems in hemodynamic monitoring from the viewpoint of intensive care medicine]. PMID- 6860769 TI - [Distortion of blood pressure values in inadequate adaptation of the dynamic response to the catheter-transducer system]. PMID- 6860770 TI - Brain function monitoring: a new method for simultaneous recording and processing of EEG-powerspectrum and brainstem potentials (BAEP). PMID- 6860772 TI - Ferritin as a label for high-gradient magnetic separation. AB - In three model systems, particles the size of cells or smaller have been surface labeled with ferritin to make them slightly paramagnetic, by virtue of the iron in the ferritin. In each case it was possible to show that labeled particles could be magnetically removed from a flowing suspension by the high-gradient magnetic separation (HGMS) technique. The first system of particles consisted of small (1 micron) carboxylate-modified latex spheres to which ferritin was covalently bound to create stable paramagnetic particles analogous to a ferritin labeled subcellular membrane preparation. In the second system polyacrylamide beads that more closely approximated whole cells in size (5-50 microns) were labeled with immunoferritin. The third system was a biomembrane preparation: erythrocyte ghosts labeled with a ferritin-lectin conjugate. A field of 7 T (tesla) (70 kG) was used in each case, along with buffer flow rates through the HGMS column in the range 0.1-1.0 ml/min. PMID- 6860771 TI - Theory of the electrokinetic behavior of human erythrocytes. AB - We develop a theory of electrophoresis of human erythrocytes that predicts mobilities significantly smaller than those based on the classical Smoluchowski relation. In the classical treatment the charge is assumed to be spread uniformly on the hydrodynamic surface. The present model takes into account that most of the charge, due mainly to sialic acid, is contained in the glycocalyx. The glycocalyx is modeled as a permeable layer of polyelectrolyte molecules anchored to the cell membrane. The charge is assumed to be uniformly distributed throughout this layer. The fluid flow in the layer is treated as being dominated by Stokes friction arising from idealized polymer segments. The Navier-Stokes equations are solved to give the dependence of electroosomotic velocity with distance from the cell surface. An expression for the electrophoretic mobility is obtained which contains two parameters (a) the thickness of the glycocalyx and (b) the mean polymer segment radius. The best fit to experimental data is obtained if these are given the values 75 A and 7 A, respectively. Deviation from experimental data at low ionic strength (less than 0.05 M) occurs. However, this deviation is in the direction one would expect if at low ionic strength the polyelectrolyte layer expands slightly due to decreased charge shielding. PMID- 6860773 TI - A theoretical study on the sucrose gap technique as applied to multicellular muscle preparations. III. Methodical errors in the determination of inward currents. AB - The analysis of errors associated with saline-sucrose interdiffusion in sucrose gap experiments on multicellular muscle preparations described in two previous papers (Lammel, E., 1981, Biophys. J., 36:533-553, 555-573) is extended to the determination of current-voltage relations that contain an activated inward current component. The membrane current-voltage (i(t)-V(m)) relation used in the computations was N-shaped and consisted of two components, an outward (background) current (i(bg)) with properties of anomalous (inward-going) membrane rectification, and an inward current (i(s)) resembling the slow inward current of cardiac muscle. Reconstruction of current-voltage relations, which simulate those determined experimentally, indicates that in the potential range in which the total membrane current (i(t)) is outward, i(t) is measured too high, whereas it is measured too low in the range of net inward current. Reversal potentials of the inward and outward components are both shifted to more negative values, that of the inward current being more affected. Simulation of the experimental approach to evaluate i(s) as the difference between i(t) and i(bg) shows that errors that produce values too high for i(bg) are partly compensated by errors that lead to values of the net inward component that are too low. The basic features of the distorting effects analyzed are independent of different assumptions made on the selectivity of the slow inward current channels. They are related to currents emerging from the sucrose compartment (local circuit as well as externally applied currents). PMID- 6860774 TI - DNA and protein lattice-lattice interactions in the filamentous bacteriophages. AB - The relations between the protein coats and DNAs of the four filamentous bacteriophages fd, Xf, Pf1, and Pf3 are considered. These viruses have similar morphologies, yet show a diversity of detailed structure, having different protein coat symmetries (helical and rotational), different coat protein sizes (44-50 amino acids per subunit) and sequences, different nucleotide axial translations (2.3-5.5 A), and different ratios of nucleotides per coat protein subunit (integers 1.0 and 2.0, and nonintegers approximately 2.4). These divergences are all reconciled quantitatively by means of two theoretical concepts: the pitch connection and the restricted pitch connection. The pitch connection relates protein and DNA surface lattices with arbitrary, nonintegral nucleotide/subunit ratios in a nonrandom way. The restricted pitch connection selects a preferred set of n/s values. Both relations are derived formally in a mathematical appendix. The available structural data are explained, including the fd DNA pitch indicated by x-ray diffraction photos and the similar DNA morphologies of Xf and fd. Predictions are made for the existence of nonclassical inverted DNA structures (I-DNA) in Pf1 and Pf3. PMID- 6860778 TI - Sedimentation coefficients of self-associating species. II. Tests with a simulated example and with beta-lactoglobulin A. AB - If sedimentation equilibrium and sedimentation velocity experiments are performed on a self-associating solute under the same solution conditions, it is possible to evaluate the sedimentation coefficients (si) of the self-associating species and the usual concentration dependence parameter (g or gs). We have tested some of these methods with simulated examples. A more critical test is to use real data. Sedimentation equilibrium experiments with beta-lactoglobulin A at 20 degrees C in 0.2 M glycine buffer (pH 2.46) indicated that a nonideal monomer dimer association was present. Sedimentation velocity experiments were performed on beta-lactoglobulin A under the same conditions. Using data from both sets of experiments we were able to evaluate s1, s2, g and gs using two different models for swa, the apparent weight average sedimentation coefficient. The empirical model for swa developed by Weirich et al. [1] gave better variance than did the model for swa developed by Gilbert and his co-workers [2-5]. Using a simulated monomer-dimer association mimicking a system having higher sedimentation coefficients than beta-lactoglobulin A did, we were able to show that one could not obtain s2 from tangents to the plot of 1/swa vs. c in the high concentration region. The methods developed here for sedimentation coefficients can be applied to other experiments in which a weight average property (or its apparent value) of a self-associating solute is measured, provided the appropriate thermodynamic experiments are done under the same solution conditions. PMID- 6860777 TI - Liquid membrane phenomena in chlorpromazine action. AB - Chlorpromazine has been shown, in the present study, to generate a liquid membrane at an interface in accordance with Kesting's hypothesis [5]. The specific orientation of chlorpromazine molecules in a liquid membrane with hydrophobic ends facing the permeable substances has been found to reduce the permeability of catecholamines and neurotransmitter amino acids. This observation is discussed in the light of the orientation of receptor proteins in general. The data on transport of catecholamines and neurotransmitter amino acids are discussed in the context of the mechanism of action of chlorpromazine. PMID- 6860776 TI - Spontaneous oscillation of electrical potential across organic liquid membranes. AB - An artificial membrane was studied consisting of an oil layer, nitrobenzene containing picric acid, imposed between two aqueous phases, one of which contained 5 mM hexadecyltrimethylammonium bromide (CTAB) and 5% ethanol. It was found that this system shows rhythmic and sustained oscillation of the electrical potential within the range 150-300 mV with an interval of 2-3 min. In the absence of CTAB or ethanol, no oscillation was observed. It is indicated that in this experiment the concentrations of the solutes are far-from-equilibrium, i.e., the hydrophilic substance, picric acid, was dissolved in the organic phase and the hydrophobic substance, CTAB, was dissolved in the aqueous phase. In addition, the presence of an unstirred layer was suggested to be essential for generating such electrical oscillations. PMID- 6860780 TI - Reduced lipogenesis in cafeteria-fed rats exhibiting diet-induced thermogenesis. AB - Fatty-acid synthesis has been measured in vivo with 3H2O in cafeteria-fed rats exhibiting diet-induced thermogenesis. Synthesis was decreased in brown adipose tissue, the liver, white adipose tissue, and the carcass of the cafeteria-fed animals compared to rats fed the normal stock diet. Whole-body synthesis was also decreased in the cafeteria-fed group. Diet-induced thermogenesis, in contrast to cold-induced non-shivering thermogenesis, does not lead to increased fatty-acid synthesis and this is presumably due to the inhibitory effects on lipogenesis of the high dietary fat intake characteristic of cafeteria diets. The results also indicate that the energy cost of body fat deposition in cafeteria-fed rats is lower than in animals fed a low-fat/high-carbohydrate stock diet. PMID- 6860775 TI - Fluorescence monitoring of electrical responses from small neurons and their processes. AB - To improve the sensitivity of fluorescence measurements of electrical responses from small cells and their processes, we have optimized the optical measuring system. The fluorescence intensity from a stained cell was increased 40-fold relative to our previous apparatus. The increased fluorescence intensity permits the use of an inexpensive photodiode (or a photodiode array) that has a approximately 10-fold higher quantum efficiency relative to a photomultiplier. Utilizing the improved apparatus, we optically recorded an action potential of a 2 microns wide neuronal process with a signal-to-noise ratio of approximately 50 (root mean square noise) without averaging. We also report the design of an improved fluorescence voltage-sensitive probe; the fractional change of the fluorescence signal under optimal conditions was 21%/100 mV. PMID- 6860779 TI - Identification of an acidic metabolite of N-nitrosodiethanolamine isolated from rat urine. AB - N-Nitrosodiethanolamine metabolism was studied in order to clarify the mechanism(s) by which this compound elicits its carcinogenic effect. Samples of 24 h urine from rats given a single dose of N-nitrosodiethanolamine were collected. Gas chromatographic thermal energy analyses showed the presence of only one compound containing the nitroso moiety besides N-nitrosodiethanolamine. This compound was identified as the acidic derivative N-(2-hydroxyethyl)-N carboxymethylnitrosamine by comparison with an authentic standard by means of gas chromatographic mass spectrometric analysis of the trimethylsilyl or pentafluorobenzyl esters. The amount of N-(2-hydroxyethyl)-N carboxymethylnitrosamine excreted in the 24 h urine was about 6% of the N nitrosodiethanolamine administered. PMID- 6860782 TI - Studies on glutathione metabolism in ventral prostate and chemically induced prostatic carcinoma in rats. AB - Glutathione content and the activity of glutathione reductase were examined in ventral prostate and chemically induced 11095 squamous-cell prostatic carcinoma in rats. Castration produced a significant reduction in the levels of reduced (GSH) and oxidized (GSSG) glutathione and glutathione reductase activity in the prostate. Replacement of testosterone (50 mg/kg) daily for 7 days to castrated animals elevated the reduced glutathione level and the activity of glutathione reductase almost to normal limits. Squamous-cell carcinoma was implanted in castrated and intact animals. Tumor growth in normal rats produced a decrease of almost 30% in the weight of the ventral prostate at 21 days post-implantation, although the glutathione levels remained unaffected. Much greater activity of glutathione reductase was detected in the tumor in comparison to the values noted for the normal tissue. The tumor also showed significantly higher values for the GSH/GSSG ratio. No apparent difference could be found in the rate of the growth of tumors whether implanted in normal or castrated animals. The levels of reduced and oxidized glutathione and glutathione reductase activity also seemed identical in tumors obtained from both groups of animals. Administration of testosterone (50 mg/kg) or beta-estradiol (2 mg/kg) daily for 11 days to tumor-bearing castrated animals did not alter the levels of glutathione and glutathione reductase activity. A significantly higher level of blood reduced glutathione was found in tumor-bearing rats in comparison to that seen for the normal subjects. Our results demonstrate that androgen depletion and replacement therapy influence the metabolism of glutathione in rat ventral prostate. Squamous-cell carcinoma of the prostate appears to differ from the normal tissue with respect to the observed androgen effects. There is dissimilarity in the metabolism of glutathione in the two tissues since greater activity of glutathione reductase and lower values of reduced glutathione were seen in the tumor as compared to those of the ventral prostate. Treatment with beta-estradiol, an antiprostatic agent, does not seem to influence the growth or glutathione metabolism of squamous-cell carcinoma of the prostate. The observed changes in blood glutathione levels might prove to be useful as an index of rapid growth of the neoplastic tissue. PMID- 6860781 TI - Direct demonstration of increases in cytosolic free Ca2+ during stimulation of pancreatic enzyme secretion. AB - The Ca2+-activated photoprotein aequorin has been incorporated into intact, isolated rat pancreatic acini by a hypotonic swelling method. The isolated acini retained normal secretory responses after loading with aequorin. Increases in cytosolic Ca2+ concentration in response to a physiological secretagogue, carbamylcholine, and to divalent-cation ionophore A23187 have been demonstrated. Simultaneous measurement of the dynamics of enzyme secretion and changes in cytosolic Ca2+ concentration has been achieved using a newly developed apparatus. PMID- 6860784 TI - Effect of some hormones on the rate of the triacylglycerol/fatty-acid substrate cycle in adipose tissue of the mouse in vivo. AB - A method is described for the measurement of the rate of the triacylglycerol/fatty-acid cycle in adipose tissue of the mouse in vivo, which depends upon the incorporation of tritium from [3H]H2O into the glycerol and fatty-acid moieties of triacylglycerol. The rate of the cycling is increased two fold by feeding, an effect that is completely abolished by the beta-adrenergic blocker propranolol. The beta-adrenergic agonist fenoterol increased the rate of cycling five-fold in white adipose tissue and three-fold in brown adipose tissue. Cold exposure had no effect on the rate of cycling in white adipose tissue but increased the rate almost two-fold in brown adipose tissue. The increased rate of cycling during feeding, which may be due to increased sympathetic nervous activity, is consistent with the view tha the role of cycling is to increase sensitivity of metabolic control systems when required. PMID- 6860783 TI - Thrombin, a stimulator of bone resorption. AB - It is shown that thrombin (0.1-7 units/ml) stimulates calcium mobilization and bone matrix degradation, as indicated by release of [3H]proline, from cultured calvarial bones. The second finding in this paper, that indomethacin blocks the stimulating effect of thrombin on bone resorption, is consistent with the concept that prostaglandin synthesis may be involved in this process. It is suggested that thrombin is a potential mediator of bone resorption associated with inflammatory and malignant processes. PMID- 6860785 TI - An analysis of amino acid composition of a few oxidoreductases by different methods. PMID- 6860786 TI - A membrane-bound human placental protein kinase activated by endogenous polypeptides. AB - A protein kinase (PPdPK) was purified from plasma membranes of human placenta. Phosphorylation of casein, but not of phosvitin or lactalbumin, by [gamma-32 P]ATP in the presence of PPdPK was stimulated about 10-fold by naturally occurring polypeptides prepared from a variety of sources similar to the procedure of Roberts et al. (Proc. Natl. Acad. Sci. U.S.A. 77, 3494-3498, 1980). The amino acid phosphorylated on casein was serine. According to gel exclusion chromatography the mol.wt. of PPdPK was 95 000. In autoradiograms, following polyacrylamide-gel electrophoresis, the autophosphorylation of PPdPK was greatly enhanced by the polypeptide activators. PMID- 6860788 TI - Inhibition and recovery of DNA synthesis in PHA-stimulated u.v.-irradiated lymphocytes from patients with actinic keratosis. AB - The recovery, after inhibition by u.v.-irradiation, of phytohaemagglutinin stimulated DNA synthesis is impaired in lymphocytes from patients with multiple actinic keratoses (AK) compared to the recovery in lymphocytes from age-matched, control individuals. This shows that the reduced level (50%) of DNA repair activity in AK cells is sufficiently different from that in normal cells to significantly affect cellular activity. PMID- 6860787 TI - Trypsin digestion of core chromatin. AB - Chicken erythrocyte core chromatin was digested with trypsin for 18 h. Five major limit peptides were produced with mol.wts. from 10 800 to 8000 which arose from the central regions of each core histone. The basic amino- and carboxyl-terminal regions of each core histone were digested to small peptides having an average size of less than six amino acids. The small basic peptides, 25% by weight of the total histone, dissociated from the complex and could be removed by dialysis. The five major limit peptides remained bound to the DNA and contained all the secondary structure originally present in the native histones. Trypsin digestion decreased the supercoiling of the DNA in the complex and perturbed the tertiary structure of the histones. By contrast, there were no changes in the secondary structure of the large degraded histone fragments. However, when these were dissociated from the DNA, the secondary structure, which is predominantly alpha helix, decreased by 50%. It is concluded that DNA binds strongly to the central regions of the core histones via alpha-helical segments on the polypeptide chains. PMID- 6860789 TI - The effect of monocytes in the peripheral blood CFU-C assay system. AB - The effect of cellular interactions in the in vitro assay of myeloid progenitor cells in peripheral blood (PB CFU-C) was investigated. Ficoll-Paque-separated peripheral blood mononuclear cells (PB MNC) from 7 healthy subjects were cultured at cell concentrations from 10 to 0.625 X 10(5) MNC/plate in doubling dilutions. The number of colonies per 10(6) lymphocytes plated (corrected colony count, CC) was significantly higher when 2.5 X 10(5) or less PB MNC were cultured than when 5 or 10 X 10(5) cells were cultured. This decrease in CC when large numbers of cells were cultured was not present when the nonadherent cells only were cultured. The inhibition was reproduced when adherent cells were added back to the nonadherent cells. The inhibition appeared to be proportional to the number of monocytes present. A model depicting the role of monocytes in the PB CFU-C assay system is presented. The increased understanding of cellular interaction represents an important step towards the standardization of the PB CFU-C assay. PMID- 6860790 TI - Development of pluripotent hematopoietic progenitor cells in the human fetus. AB - Pluripotent hematopoietic progenitor cells (CFU-GEMM), myeloid progenitor cells (CFU-GM), and erythroid progenitors (BFU-E) were studied in midtrimester human fetuses using the mixed colony assay. All three progenitor cell populations were detected at high levels in the fetal liver from 12 to 23 wk of gestation. Stem cells were first observed in the bone marrow at 15-16 wk of gestation, although bone marrow cultures from earlier fetuses showed heavy growths of stromal cells. Spleen cultures first showed growth of stem cells at 18-19 wk, but fetal thymus showed no hematopoietic activity. Peripheral blood from four fetuses aged 13, 18, 20, and 21 wk showed very high levels of all 3 progenitor cells. The results demonstrate that hematopoietic development in the human fetus parallels that of the mouse. The observation that stromal cell development in the bone marrow precedes the appearance of hematopoietic progenitor cells suggests that they may be closely involved in stem cell growth. PMID- 6860791 TI - Properties of NADH-cytochrome-b5 reductase from human neutrophils. AB - An NADH-ferricyanide reductase activity of ca. 170 nmole ferricyanide reduced/min/10(7) cells is present in the membrane fraction of human neutrophils. This membrane-bound activity constitutes ca. 85% of the total NADH-ferricyanide reductase activity that is present in these cells. The enzyme(s) readily utilize(s) purified cytochrome-b5 from beef liver as an electron acceptor. No other physiologic electron acceptors tested (e.g., ubiquinone-30, menadione) were active. The specificities of electron donors (e.g., NADH congruent to deamino NADH much greater than NADPH) and acceptors (e.g., Fe(CN)6-3 greater than 2,6 dichlorophenol-indophenol much greater than O2) for the enzyme(s) in unfractionated membranes, along with action of inhibitors (e.g., ADP, p chloromercuribenzoate) and the pH optimum, indicate that virtually all of the membrane-bound ferricyanide reductase activity in these cells is NADH-cytochrome b5 reductase. This reductase, however, is only slightly solubilized (ca. 10%) by a phosphate buffer extraction procedure that is effective with the liver enzyme. PMID- 6860792 TI - Lithium enhancement of megakaryocytopoiesis in culture: mediation via accessory marrow cells. AB - To examine the effect of lithium (Li) on early megakaryocytopoiesis, murine marrow megakaryocytic (CFU-M) and granulocyte-macrophage (CFU-C) progenitors were assayed in vitro with and without addition of lithium chloride (LiCl) to culture. At 2 mM LiCl, the numbers of CFU-M- and CFU-C-derived colonies were increased to 146% +/- 8% and 128% +/- 6% of controls, respectively (p less than 0.005). Enumeration of megakaryocytes per colony showed a 78% increase of colonies (p less than 0.05) containing from 6 to 22 cells, suggesting an increased proliferative capacity of CFU-M in the presence of LiCl. Conditioned media from spleen cells cultured in the presence of both pokeweed mitogen (PWM-SCM) and 2 mM Li increased the numbers of CFU-M and CFU-C to 157% +/- 8% and 183% +/- 8%, respectively (p less than 0.025), compared to control cultures stimulated by PWM SCM alone. Since the production of active colony-stimulating activities (CSA) from mitogen-stimulated conditioned media requires T lymphocytes, we hypothesized that the enhancement of the growth of early hematopoietic progenitors in marrow cultures was due to a Li-induced CSA production by accessory marrow cells, rather than a direct effect of Li on stem cells. To test this, cyclosporin-A (CyA), a T lymphocyte function inhibitor known to suppress CSA production in PWM-SCM, was added to marrow cultures in the presence of 2 mM Li. CyA (3 micrograms/ml) abrogated the Li-induced enhancement of CFU-M and CFU-C growth, but had no effect on colony formation when added alone. The data suggest that the Li-induced enhancement of early megakaryocytopoiesis and granulocytopoiesis is due to local production of CSA(s) by an accessory cell population and requires the integrity of T-lymphocyte function. PMID- 6860793 TI - Red blood cell size is important for adherence of blood platelets to artery subendothelium. AB - The hematocrit is one of the main factors influencing platelet adherence to the vessel wall. Raising the hematocrit causes an increase of platelet accumulation of about an order of magnitude. Our studies concern the role of red cell size. We have studied this effect using an annular perfusion chamber, according to Baumgartner, with human umbilical arteries and a steady-flow system. Normal human red blood cells (MCV 95 cu mu) increased platelet adherence sevenfold, as the hematocrit increases from 0 to 0.6. Small erythrocytes from goats (MCV 25 cu mu) caused no increment in adherence in the same hematocrit range. Rabbit erythrocytes (MCV 70 cu mu) caused an intermediate increase in adherence. Red blood cells from newborns (MCV 110-130 cu mu) caused a larger increase in platelet adherence than normal red cells at hematocrit 0.4. These results were further confirmed with large red blood cells from two patients. Experiments with small red cells (MCV 70 cu mu) of patients with iron deficiency showed that platelet adherence was similar to normal red cells, provided the red cell diameter was normal. Small red blood cells of a patient with sideroblastic anemia caused decreased adherence. These data indicate that red cell size is of major importance for platelet adherence. Red cell diameter is more important than average volume. However, for size differences in the human range, the hematocrit remains the dominant parameter. PMID- 6860794 TI - Genetic evidence for fetal origin of transcobalamin II in human cord blood. AB - Phenotypes of transcobalamin II (TC2) were determined in 95 maternal-cord serum pairs in order to identify the origin of TC2 in human cord blood. Unsaturated (apo) TC2 in serum was labeled with radioactive (57Co) cobalamin (CbI) and separated into isoproteins by polyacrylamide gel electrophoresis and autoradiography. Discordancy between the maternal and the cord serum type was observed in 45% of the pairs. The results demonstrated that, at the end of pregnancy, the fetus is capable of TC2 synthesis and that there is no detectable transplacental passage of maternal apo-TC2. Presence of maternal saturated (holo) TC2 in cord serum could be excluded in 9 informative discordant pairs by exchanging endogenously bound CbI with 57Co-CbI. Our finding that TC2 in human cord serum is of fetal rather than maternal origin suggests an essential role for fetal TC2 in CbI utilization and appears to contradict the hypothesis that transplacental passage of maternal TC2 may explain the normal fetal development in cases of congenital TC2 deficiency. The total immunoreactive TC2 content in 23 maternal serum samples collected at the end of pregnancy (812 +/- 175 pM CbI equivalent) was significantly higher than in the corresponding cord sera (605 +/- 148 pM; p less than 0.001) and did not significantly differ from the value in a control group of healthy male and female adults (841 +/- 192 pM). At the end of pregnancy, the apo-TC2 content in 12 maternal serum samples (760 +/- 347 pM) was significantly higher than in the corresponding cord sera (501 +/- 254 pM; p less than 0.05) and did not significantly differ from the value in the control group (747 +/- 137 pM). PMID- 6860795 TI - Kinetics of platelet adhesion and thrombus growth. AB - Epifluorescent microscopy was used to monitor the adhesion of platelets and the growth of platelet aggregates on collagen-coated glass tubes perfused with whole blood. The maximum basal length and width of the aggregate size increased linearly with time, growing symmetrically transverse to the direction of flow and asymmetrically in the plane longitudinal to the direction of flow. Aggregates had elliptical bases, with the major axis parallel to the direction of blood flow. These studies provide an experimental approach to studies of the kinetics of platelet interaction with artificial surfaces and give further support to the concept that blood flow has a major effect on the development of platelet thrombi. PMID- 6860796 TI - Does treatment with ARA-C in low dosage cause differentiation of leukemic cells? AB - A series of 21 patients (5 refractory anemias with an excess of blasts in transformation and 16 acute leukemias) were treated with small doses of ARA-C (10 mg/sq m/12 hr for 15-21 days). Improvement was noted in 15 cases (71%) and complete remission observed in 12 (57%). Complete remission was obtained after one course of treatment in 8 cases. The fact that these patients entered remission relatively slowly and did not suffer marrow aplasia suggests that low dose ARA-C may function in vivo as it does in vitro, i.e., by inducing differentiation of leukemic blasts. PMID- 6860797 TI - Acute megakaryoblastic leukemia in early childhood. AB - Two girls, each less than 2 yr of age, developed acute megakaryoblastic leukemia (malignant myelosclerosis). Both presented with anemia, severe thrombocytopenia, and a low percentage of blasts in their peripheral blood. Their marrow showed marked reticulin fibrosis with an increase in blasts and immature megakaryocytes. The blasts stained negatively for myeloperoxidase and Sudan Black B, but showed acid phosphatase (ACP) and alpha-naphthyl acetate esterase (ANAE) activity inhibitable by sodium fluoride. They were identified as megakaryoblasts by the platelet peroxidase reaction. Cytogenetic studies showed multiple chromosomal abnormalities in both cases. Chemotherapy with vincristine, prednisone, and L asparaginase was without effect, while daunorubicin and cytosine arabinoside induced a complete remission in one case. The second case responded to a combination of cytosine arabinoside, daunorubicin, and 6-thioguanine. This article documents that acute megakaryoblastic leukemia occurs in early childhood and describes its clinical, pathologic, and cytogenetic features. Previous reports of childhood "myelofibrosis" are reviewed, and their possible relationship with acute megakaryoblastic leukemia is discussed. PMID- 6860798 TI - Red cell membrane stiffness in iron deficiency. AB - The purpose of this study was to characterize red blood cell (RBC) deformability by iron deficiency. We measured RBC deformability to ektacytometry, a laser diffraction method for determining the elongation of suspended red cells subjected to shear stress. Isotonic deformability of RBC from iron-deficient human subjects was consistently and significantly lower than that of normal controls. In groups of rats with severe and moderate dietary iron deficiency, RBC deformability was also reduced in proportion to the severity of iron deficiency. At any given shear stress value, deformability of resealed RBC ghosts from both iron-deficient humans and rats was lower than that of control ghosts. However, increase of applied shear stress resulted in progressive increase in ghost deformation, indicating that ghost deformability was primarily limited by membrane stiffness rather than by reduced surface area-to-volume ratio. This was consistent with the finding that iron-deficient cells had a normal membrane surface area. In addition, the reduced mean corpuscular hemoglobin concentration (MCHC) and buoyant density of the iron-deficient rat cells indicated that a high hemoglobin concentration was not responsible for impaired whole cell deformability. Biochemical studies of rat RBC showed increased membrane lipid and protein crosslinking and reduced intracellular cation content, findings that are consistent with in vivo peroxidative damage. RBC from iron-deficient rats incubated in vitro with hydrogen peroxide showed increased generation of malonyldialdehyde, an end-product of lipid peroxidation, compared to control RBC. Taken together, these findings suggest that peroxidation could contribute in part to increased membrane stiffness in iron-deficient RBC. This reduced membrane deformability may in turn contribute to impaired red cell survival in iron deficiency. PMID- 6860799 TI - Holey red cells: a brief note. PMID- 6860800 TI - Holey red cells: A brief note. A commentary. PMID- 6860801 TI - Cystathionase: a potential cytoplasmic marker of hematopoietic differentiation. AB - Cysteine auxotrophy and absence of cystathionase (CSE) has been associated with certain human and rodent leukemic cell lines. To determine whether this state was a marker of malignant transformation or of cellular differentiation, CSE content was measured in 16 well characterized human leukemia-lymphoma cell lines. Enzyme was easily detected in several lines but its level did not correlate with a proposed scheme of differentiation based on cell-surface markers. However, the apparent absence of enzyme in human bone marrow CFU-C determined by growth experiments suggests reduced levels of CSE may be a marker of cytoplasmic immaturity. PMID- 6860803 TI - Behavioral response of mallards to contaminated drinking water. PMID- 6860804 TI - Acclimation of channel catfish (Ictalurus punctatus) to nitrite. PMID- 6860805 TI - Effects of Grays Harbor Estuary sediment on the osmoregulatory ability of coho salmon smolts (Oncorhynchus kisutch). PMID- 6860802 TI - A new family with classical factor X deficiency as demonstrated by electroimmunoassay. AB - A new family with classical factor X deficiency is described. The proposita is a 6 year old girl who presented with occasional epistaxis and a hematoma after an intramuscular injection. The main laboratory features consisted in a prolongation of partial thromboplastin, prothrombin and Stypven clotting times corrected by the addition of normal serum. Factor X activity varied between 3 and 6%. Factor X amydolytic activity was 15% of normal. Electroimmunoassay failed to show the presence of factor X antigen. No inhibitor was found in the proposita plasma. Parents and other family members showed intermediate levels of factor X activity and antigen and were considered to be heterozygotes. No consanguineity was found in the family. PMID- 6860807 TI - Histopathologic effects of JP-4 aviation fuel on fathead minnows (Pimephales promelas). PMID- 6860806 TI - Distribution of polycyclic aromatic hydrocarbons in the surficial sediments of Casco Bay, Maine. PMID- 6860808 TI - Effect of copper, cadmium, and zinc on percent spore germination of the cinnamon fern (Osmunda cinnamomea) and the sensitive fern (Onoclea sensibilis). PMID- 6860809 TI - Synergistic and antagonistic responses of fern spore germination to combinations of copper, cadmium, and zinc. PMID- 6860810 TI - Seasonal variation in the accumulation of radionuclides of the uranium series by yellow pond-lily (Nuphar lutea). PMID- 6860811 TI - Effect of calcium and aluminum concentrations on the survival of brown trout (Salmo trutta) at low pH. PMID- 6860812 TI - Trace element concentrations in the liver, kidney, and muscle of Queensland cattle. PMID- 6860813 TI - Chlorobenzene residues in human fat and milk. PMID- 6860814 TI - Survival and condition of rainbow trout (Salmo gairdneri) after acute exposures to methyl parathion, triphenyl phosphate, and DEF. PMID- 6860815 TI - Adsorption of fenitrothion and 3-methyl-4-nitrophenol on soils and sediment. PMID- 6860816 TI - Toxicity of fluometuron and diuron on the intermediate snail host (Lymnea spp.) of Fasciola hepatica. PMID- 6860817 TI - Frequency composition of auditory middle responses. AB - Power spectral analysis and digital filtration were performed on the auditory middle responses (AMR) to click stimuli in six subjects with normal hearing. The spectral analysis revealed that the main power of the AMR was located at frequencies between 30 and 50 Hz with a peak at 40 Hz. A small elevation of power observed in the spectrum between 90 and 180 Hz was considered to be due to the ABR and the earliest part of the AMR. Typical AMR components, namely Na, Pa, Nb and Pb, were constantly recognised with digital high-pass (HP) filtration at 30 Hz. With increasing cut-off frequencies up to 50 Hz, the peak latencies of Na and Pa remained unchanged, while their magnitudes markedly decreased. On the other hand, Pb completely disappeared with 40 Hz filtration, forming two distinct positive peaks at about 55 and 80 ms after the stimulus onset. In some cases, three small positive peaks were seen following Pa with HP filtration at 50 Hz. With 60 Hz HP filtration, main components of the AMR substantially disappeared. PMID- 6860818 TI - Illuminance and recording of eye movements by electro-oculography. AB - The fluctuation of the d.c. potential of the eye following changes in the ambient level of illuminance is well recognised in the field of ophthalmology. However, the influence of this factor in the recording of eye movements in the oto neurological clinic has been little investigated. In this study the variation in the d.c. potential was measured for fixed periods of time after subjects entered a clinic environment of known illuminance and after entering the dark. In the short term (3-4 min), the variation in d.c. potential was less than 20% in the 22 subjects tested. Suggestions are made to minimise these fluctuations in the recording of nystagmus and other eye movements. PMID- 6860819 TI - The acceptability of spectrum-preserving and spectrum-destroying transposition to severely hearing-impaired listeners. AB - Various devices have been constructed to lower the frequency of speech sounds to make them accessible to those with hearing in the low frequencies only. In the present experiment two such devices are compared. One device, the FRED (frequency recoding device) maps the 4-8 kHz region on to the 0-4 kHz region in a way that preserves the spectral pattern of transposed signals. The other device, the Oticon TP 72, converts signals in the 4-8 kHz region into low frequency noise (below 1.5 kHz). Both devices combine transposed information with conventionally amplified speech. It was found that untrained adults with acquired sensory-neural hearing losses opted to supplement conventional amplification with FRED transposition on 365 out of 576 occasions, to improve the clarity of speech sounds. Under the same conditions they opted to use Oticon transposition on significantly fewer (32 out of 576) occasions. Subjective preferences for FRED as opposed to Oticon transposition were also highly significant. It was concluded that for the subject group in question a transposition which preserves the relative spectrum of transposed sounds is initially more acceptable than one which uses high-frequency signals to modulate low-frequency noise. PMID- 6860820 TI - The cupped hand as an aid to hearing. AB - The acoustic effects of cupping the hand behind the ear were measured by means of a miniature microphone placed at the entrance to the ear canal. Pure tone signals from 0.2 to 10 kHz, at 1/3-octave intervals, were used. Amplification was produced when subjects were facing the sound source, mainly in the mid-frequency range, where there was a peak of 8 dB around 1.6 and 2 kHz. When the subjects had their backs towards the sound source, the effect produced was attenuation, the maximum being 9.5 dB at 2.5 kHz. PMID- 6860821 TI - A comparison of behind-the-ear high-fidelity linear hearing aids and two-channel compression aids, in the laboratory and in everyday life. AB - Eight patients suffering from sensorineural hearing losses with recruitment took part in a trial comparing their own hearing aids (or no aid if they did not normally wear one) with 'high-fidelity' linear aids and with aids incorporating two-channel syllabic compression. All aids were worn behind the ear. Speech intelligibility was measured both in quiet and in noise, and the patients were given questionnaires enquiring about the effectiveness of the aids in everyday situations. Both the intelligibility tests and the questionnaires indicated that the linear aids were substantially better than own/no aid, and the compressor aids were substantially better than the linear aids, allowing good speech discrimination over a wide range of sound levels. Six out of the eight patients derived significant benefit from being fitted with two aids rather than one. The use of directional microphones in the linear and compressor aids allowed a significant improvement for speech intelligibility in noise when the speech and noise were spatially separated. PMID- 6860822 TI - Loudness adaptation, when induced, is real. AB - In two recent articles, Hood and Wade (1982) and Weiler et al. (1981) have argued that the loudness of a steady tone does not appear to decline over time unless listeners are given a reference sound by which to judge loudness. The present experiments show, by the method of successive magnitude estimation, that listeners do not need a reference sound in order (1) to track accurately the decline in the loudness of a tone slowly decreasing from 60 to 40 dB SPL or (2) to track the loudness decline of a constant-intensity tone under special conditions that lead to adaptation. Since a reference sound is not needed by listeners to track a decline in loudness, and since Hood and Wade and Weiler et al. have found a decline with a reference but not without, it follows that adding a reference sound to a sustained sound must induce adaptation that otherwise does not occur. In support of that interpretation, the present measurements show that when subjects are told to ignore the same reference sound as used by Hood and Wade and by Weiler et al.--an increment every 30 s to a steady tone--loudness still declines. The bigger the increment (20 dB v. 5 dB) and the longer (5 s v. 1 s), the more loudness declines. Thus, loudness adaptation may be induced not only by a contralateral intermittent sound (Botte et al., 1982) but also by an ipsilateral intermittent sound. However, under normal listening conditions at levels above about 30 dB SL, loudness does not adapt. PMID- 6860823 TI - Auditory middle responses in young children. AB - In order to ascertain if any substantial difference exists in the auditory middle responses (AMR) between adults and young children, a digital high-pass (HP) filtering technique was applied to the responses in 26 young children aged 1-7 years and nine adults with normal hearing. Two significant differences were found between the HP-filtered responses in children and those in adults. Pa in the responses from adults was consistently recognized with HP filtering up to 50 Hz, while Pa in young children was effectively detected only with 20 Hz HP filtering. It was mostly eliminated when the HP filter was set at 30 or 40 Hz. Pb was identified in most of the adult responses, particularly with HP filtering at 30 Hz. On the other hand, it was not visually distinguished in the responses from young children with any HP filter setting. PMID- 6860824 TI - Auditory perceptual function in relation to phonological development. AB - Auditory perceptual functioning, specifically auditory memory and discrimination, has been historically considered related to linguistic development, in particular phonological development. This fact has resulted in therapy for children with delayed/deviant phonological development being focused on improving auditory memory and discrimination. A number of studies have been carried out over the past few decades to establish whether or not this relationship exists. These studies are reviewed and reasons for the diversity of results discussed. The phonological development of 60 children in relation to their auditory memory and discrimination is described, together with a test of auditory discrimination designed for the purposes of the study. PMID- 6860825 TI - OCTANET--an electronic library network: I. Design and development. AB - The design and development of the OCTANET system for networking among medical libraries in the midcontinental region is described. This system's features and configuration may be attributed, at least in part, to normal evolution of technology in library networking, remote access to computers, and development of machine-readable data bases. Current functions and services of the system are outlined and implications for future developments in computer-based networking are discussed. PMID- 6860826 TI - The NEOUCOM Cooperative Cataloging Service: development and review of the first four years. AB - The Basic Medical Sciences Library of the Northeastern Ohio Universities College of Medicine (NEOUCOM) provided a Cooperative Cataloging Service to fourteen of its affiliated hospitals' libraries since March 1978, using the OCLC system. Analysis of the first four years of service showed that the hospital libraries spent almost $30,000 to catalog more than 18,000 titles. Personnel expenses and other costs eclipsed the savings from a 31.3% duplication rate. Centralized bibliographic control control and the principal by-product of the service, a uniform, machine-related data base, provided the foundation for an on-line integrated library system to serve the consortium. The hospital libraries contributed 44% of the unique titles in this data base, which emphasis the need to share resources and continue cooperation. PMID- 6860827 TI - Medical book reviewing. AB - The large number of medical books published complicates selection by medical librarians. Book reviews are a potentially useful aid to selection. How available medical book reviews are to medical librarians, as well as how timely and accessible they are, were studied. Book reviews appearing in 1981 in a select group of medical journals were studied, and questionnaires sent to book publishers and the book review editors of the journals in the study. PMID- 6860828 TI - The role of basic-unit librarians in RML decision making: an evolutionary process. AB - Representatives of basic-unit libraries (one per state) with full voting rights were included on the Executive Committee of the Kentucky-Ohio-Michigan Regional Medical Library (RML) Network in 1978, after a three-year effort initiated by hospital librarians in Franklin County, Ohio. This article describes the process that resulted in hospital library participation at all levels of Region V governance, focusing on stages of development, action between the advocate and the administrative structure, and outcome. PMID- 6860829 TI - OCLC book interlibrary loan in a basic-unit hospital library: one year's experience. AB - Methodist Medical Center of Illinois Medical Library, a "basic-unit" medical library (i.e., not a resource library) in the Regional Medical Library Program recently completed one year of borrowing and lending books using OCLC. Of the books successfully borrowed through OCLC, 79% were obtained from nonmedical libraries. Forming cost-sharing OCLC clusters among basic units makes OCLC an affordable alternative to borrowing books from overburdened medical resource libraries. PMID- 6860830 TI - The hospital library as a focus of patient education activities and resources. PMID- 6860831 TI - A psychodynamic view of character pathology in Vietnam combat veterans. PMID- 6860833 TI - The benefits of integrating treatment evaluation and clinical practice in a long term hospital setting. PMID- 6860834 TI - History and principles of graphology. PMID- 6860832 TI - Self and object representations and the "evil eye". PMID- 6860835 TI - Some observations on recurrent dreams. PMID- 6860836 TI - Equine herds as sentinels for Venezuelan Equine encephalitis virus activity, Nicaragua 1977. PMID- 6860837 TI - Ecological strategies for the prevention and control of health problems. PMID- 6860838 TI - Lead concentrations in the blood of children from pottery-making families exposed to lead salts in a Mexican village. PMID- 6860839 TI - Merolicos and health education. PMID- 6860840 TI - Primary health care workers: the rural health aide program in El Salvador. PMID- 6860842 TI - Approach to the patient with myopathy. PMID- 6860844 TI - Open and closed abdominal injuries. PMID- 6860841 TI - Changing concepts of health and health services: new opportunities for nutrition promotion. PMID- 6860843 TI - Eye injury. AB - Many of the ocular injuries could be prevented by simple measures: in industry by wearing protection for the eyes, in road traffic accidents by wearing seat belts, and in sport by wearing protective clothing. From this article it is apparent that the surgical approach to many cases of trauma has changed within the last few years and the results have improved quite considerably. PMID- 6860845 TI - Immediate management of spinal injury. PMID- 6860846 TI - Investigation of hypertension. AB - Ferguson (1975) calculated that if 5 per cent of the estimated 20 million patients with hypertension in the USA had a secondary cause, the cost of their investigation would amount to $2 billion at 1975 prices. For the majority of patients a careful clinical appraisal together with simple biochemical screening tests and a baseline ECG and chest film are adequate before embarking on therapy. For those patients in whom there are clinical or other grounds to suspect a treatable secondary cause, a wide range of modern investigative techniques are available. Even if there are no clues to a secondary cause initially, the possibility of such a cause is occasionally suggested by failure of response to triple therapy with, for example, a thiazide, a beta blocker, and a vasodilator. Whether the hypertensives are being treated in general practice or in hospital, a careful initial assessment together with regular supervision is essential to allow the identification of those with potentially curable disease. PMID- 6860847 TI - Local management of surgical sepsis. AB - The most important aspect of the prevention of infection in traumatic wounds is early and thorough debridement. In elective surgery there is no substitute for meticulous technique. The successful treatment of established infection depends on early diagnosis and accurate localization of the sepsis, followed by incision and adequate drainage or, in the case of an infected viscus, excision. PMID- 6860848 TI - Pregnancy-related psychiatric disorder. PMID- 6860849 TI - Medicine and the media. Problems in medical ethics. PMID- 6860850 TI - Postgraduate diplomas. FRCR Part I. PMID- 6860851 TI - Small oxygen analysers. AB - Analysers using a polarographic electrode had a tendency to react to nitrous oxide, which was considered dangerous with one analyser. However, they had cheaper running costs and a faster response time than the galvanic-cell analysers. These latter analysers were slightly cheaper initially but their sensors were expensive and had a reduced life in the presence of nitrous oxide. Details of accuracy tests have been presented and opinions expressed with regard to the most satisfactory analysers for clinical use. PMID- 6860852 TI - A new suction-irrigation device: uses in microsurgery and plastic surgery. PMID- 6860853 TI - The trapezoid flap for the correction of burn scar contractures. AB - A trapezoid flap, which includes scarred skin in its substance, has been designed to allow correction of burn scar contractures. The method is widely applicable in many areas of the body and appears to overcome many of the shortcomings of traditional methods of scar release. The design and use of the flap is illustrated. At the time of writing this technique has been used on five patients. The results are encouraging and all the patients have retained full release of their scar contractures. PMID- 6860855 TI - Early cleft palate repair completed before the age of 16 weeks: observations on a personal series of 100 children. AB - This paper is a review of a series of 100 children on whom the author carried out a cleft palate repair at or before they reached the age of 16 weeks. The children had tympanometry tests done before and after surgery. In the case of clefts of the primary and secondary palate, dental casts were taken. The author's personal technique of cleft palate repair is presented. Some of the early results are discussed along with thoughts on the effects on jaw development, speech and hearing of such early surgery. PMID- 6860854 TI - The assessment of middle ear function and hearing by tympanometry in children before and after early cleft palate repair. AB - Tympanometry has been carried out to assess middle ear function in cleft lip and cleft palate children from birth. All these children had normal aeration of the middle ear at birth, and remained normal until complications began to appear at 17 weeks. Closure of the palatal defect is known to reduce middle ear complications and its seems that closure at, or before, 4 months of age significantly reduces these complications. PMID- 6860856 TI - Stress fracture of the iliac bone with subfascial femoral neuropathy: unusual complications at a bone graft donor site: case report. AB - Two unusual complications following removal of a large iliac bone graft are reported: a stress fracture of the iliac bone with a subfascial haematoma that produced a femoral neuropathy. The aetiology of these complications is discussed and certain recommendations made to avoid their repetition. PMID- 6860857 TI - Inferiorly-based gastrocnemius muscle flap in the treatment of war wounds of the middle and lower third of the leg. AB - Over the last 2 years we have treated several hundred severe lower limb injuries due to shells or high velocity missiles. Often these injuries involved extensive loss of the soft tissues and bone. We have been very impressed with the versatility of the inferiorly-based gastrocnemius muscle flap in the safe closure of these defects. PMID- 6860859 TI - Dog bites of the face: a 15 year review. AB - Over a period of 15 years, 109 patients with 148 dog bites of the face were treated in one Plastic Surgery Unit. In this retrospective review the patterns of injury and treatment are defined with particular reference to specialised anatomical structures involved and the problems of repair. In this study, 87 patients (80%) were under 15 years of age. PMID- 6860858 TI - Upper eyelid retraction treated by cross-face free muscle graft: case report. AB - Upper eyelid retraction can be an early sign of Graves' disease. In a patient with no obvious endocrinological disturbance first the left and later the right upper eyelid became retracted. Since there was no exophthalmos it was decided to counteract the levator over-activity with free muscle grafts as used in the correction of paralytic lagophthalmos. PMID- 6860860 TI - The use of a vastus lateralis muscle flap to repair a gluteal defect. AB - The vastus lateralis flap offers a simple method of repair of gluteal defects in the paraplegic patient. The details of the surgical technique and the advantages of the vastus lateralis flap are described. PMID- 6860861 TI - The forehead flap: minimising the secondary defect by preservation of the frontalis muscle. AB - The most frequent objection to the use of the forehead flap for intraoral reconstruction is that it leaves an unsightly secondary defect, an adherent shiny skin graft and an expressionless forehead. However, it is possible to raise the flap superficial to the frontalis muscle leaving its structure and innervation intact. Expressive movement is preserved and the secondary defect minimised. The technique is described and illustrative cases are presented. PMID- 6860862 TI - De-epithelialised "turn over" axial-pattern flaps in the lower extremity. AB - Leonard (1981) has reported the successful use of a de-epithelialised "turn over" deltopectoral flap for a chest wall defect. This paper presents the application of the principle of a de-epithelialised " turn over" type of flap to the fasciocutaneous flap described by Ponten (1981) and the dorsalis pedis flap described by O'Brien and Shanmugam (1973) and McCraw and Furlow (1975) for defects of skin and subcutaneous tissue in the lower extremity. The reason for their choice and the alternatives are briefly discussed and some general comments are added on the use of de-epithelialised "turn over" flaps. PMID- 6860863 TI - A multifocal extra-abdominal desmoid tumour. AB - The literature on multifocal aggressive fibromatosis is reviewed and the fifth case recorded is reported. It conforms with the histopathological criteria for aggressive fibromatosis. Conservative local excision and radiotherapy have controlled the disease with preservation of a functioning limb. PMID- 6860864 TI - Intracranial complications of rhinoplasty. AB - The practicing plastic surgeon acquires a wide experience of the complications of rhinoplasty. These range in severity from minor imperfections of contour to the more dramatic but re complications of haemorrhage and infection. While causing alarm to patient and surgeon alike, they rarely pose a threat to life. We wish to bring to the attention to our colleagues three potentially lethal intracranial complications of rhinoplasty which they may not have previously experienced: cerebrospinal fluid rhinorrhea, meningitis and cavernous sinus thrombosis. These three unusual cases have occurred in the author's practice over a period of 20 years. PMID- 6860865 TI - Experimental microarterial grafts: freeze-dried allografts versus autografts. AB - A segment of the femoral artery from a Sprague-Dawley rat was removed and freeze dried. It was then used as a graft for a defect in the femoral artery of another rat. The femoral artery on the other side of this recipient rat had a similar grafting procedure using a segment of its own femoral artery, thus acting as a control. The patency rate, histopathology and scanning electron microscopy studies showed that freeze-dried allografts behave in the same way as autografts in this experimental model. They were easy to preserve, readily available on rehydration and were somewhat easier to handle because of their mild rigidity. PMID- 6860866 TI - Micro-lymphatic bypass in the treatment of obstructive lymphoedema of the arm: case report of a new technique. AB - A report is presented of a case of secondary lymphoedema of the upper limb successfully treated by microlymphatic bypass with a composite graft containing three lymphocollectors from the lower limb to bypass the ablated portion of the pathway. To ensure success the surgery must be carried out before the peripheral lymphatics have been damaged or destroyed by increasing pressure and recurrent infection. Pre-operative lymphangiography is mandatory to assess suitability for the bypass procedure. Other methods of treatment are reviewed. PMID- 6860867 TI - Interstitial fluid pressure as a circulatory monitor in skin flaps. AB - Intradermal interstitial fluid pressure (IFP) in the rat epigastric flap has been measured under varying conditions of blood flow. Pressure changes were not as expected. An attempt has been made to explain these anomalous results using radiolabelled isotopes. PMID- 6860868 TI - Use of the Yarsagil aneurysmal clamp for end-to-side microvascular anastomosis: an experimental study in rats. AB - The use of an aneurysmal microclamp for end-to-side microvascular anastomosis is described. It is atraumatic, can be applied easily and does not require complete mobilization of the recipient vessel. PMID- 6860872 TI - Some anatomical observations on the human placenta as applied to microvascular surgical practice. AB - The human placenta has many vessels traversing its foetal surface. A variety of sizes is available down to vessels of diameter 1 mm. Selection of a suitable artery can provide a vessel that can be satisfactorily used for microsurgical practice. Where other preparations are not available, the human placenta appears to offer a reasonable, cheap and readily available alternative. PMID- 6860869 TI - Comparison of microscope and loupe magnification: assistance for the repair of median and ulnar nerves. AB - A retrospective study of the results of repair of complete divisions of median and ulnar nerves in 31 patients was carried out to compare those operations in which microscope magnification had been used with those in which loupe magnification had been used. A comprehensive set of clinical parameters was applied to assess the patients. It included motor performance of the intrinsic muscles of the hand, tests of protective sensation, discriminatory sensation, sudomotor function and vibration sensation. The results are comparable with previously published series with children notably showing a greater degree of recovery of function than adults. Because this is a relatively small retrospective series, it does not lend itself to statistical analysis. However, the results suggest that the type of magnification assistance used in peripheral nerve repair is not as significant in the achievement of good results as other factors which should be considered. PMID- 6860870 TI - The effect of temperature on blood flow in island and free skin flaps: an experimental study. AB - Skin blood flow is especially susceptible to temperature change, as the skin has an important role in body thermoregulation. The effect of temperature on blood flow in an experimental skin flap model in the dog has been measured using an electromagnetic flowmeter. the flap blood flow varied directly with temperature. In the range 22 degrees C-38 degrees C, this relationship was linear, the increase in the flap blood flow being 3.41% per degree Celsius. However, outside this temperature range the change was much greater. PMID- 6860873 TI - Cartilaginous choristoma of buccal mucosa: a case report. AB - A rare and possibly the first case of a cartilaginous choristoma of the buccal mucosa is presented. Careful examination at follow-up for over 11 months has revealed no clinical evidence of any recurrence. PMID- 6860871 TI - The effect of blood viscosity on blood flow in the experimental saphenous flap model. AB - A study has been made of the effect of lowering blood viscosity with ancrod (Arvin) on blood flow in an experimental island skin flap. Blood flow was measured directly using an electromagnetic flowmeter. It was observed that blood flow into the flap increased significantly (p less than 0.02) as a result of lowering blood viscosity. PMID- 6860874 TI - Microphallic hypospadias: testosterone therapy prior to surgical repair. AB - The surgical repair of hypospadias may be more difficult in boys with microphallus than in those with a penis of normal size. Temporary enlargement of the abnormally small penis can be achieved by local application or systemic administration of testosterone. We have studied the effect of local application of testosterone cream in seven boys with microphallic hypospadias. Serum testosterone levels and penile size were measured before, during and after treatment. The relative advantages and disadvantages of local testosterone application in comparison with injection are discussed. PMID- 6860875 TI - Dreaming: The functional state-shift hypothesis. A neuropsychophysiological model. AB - The different brain functional states during sleep and wakefulness are associated with differences in processing strategies, memory stores, and EEG patterns. Shifts of functional state occur spontaneously or as orienting reactions to processed information, and cause the formal characteristics of dreams. Forgetting of dreams is a function of the magnitude of the difference between states during storage and recall. Based on EEG similarities between sleep stages and developmental stages, brain states during sleep in adults are proposed to correspond functionally with waking states during childhood. Repeated functional regressions occur during sleep, with access to earlier memory material and cognitive strategies unavailable during waking life, so that earlier experiences can be used for current problems. This dream work constitutes the biological significance of sleep. PMID- 6860876 TI - Depression and the accessibility of memories. A longitudinal study. AB - A group of depressed patients and a group of normal subjects were assessed on two occasions. On each they were required to recall past real life experiences associated with a series of stimulus words. Subjects were subsequently required to rate each experience for happiness and pleasantness. The depressives showed an increased probability of recalling sad memories; within this group there was a significant relationship between severity of depressed mood and the percentage of sad memories recalled. The extent of reduction in depressed mood from occasion 1 to occasion 2 was significantly related to the increase in accessibility of happy memories and the decrease in recall of sad memories. For those patients who improved between the two occasions there was a significant reduction in the probability of recall of a very unhappy memory. The results extend the previous findings on the effect of mood state on the accessibility of memories of differing affective tone. The findings are discussed in terms of context specific encoding and retrieval. PMID- 6860877 TI - Comparison of research diagnostic systems in an Edinburgh community sample. AB - Four research diagnostic schemes are compared in one community sample. The prevalence of psychiatric disorder ranged from 8.7 per cent (ID-Catego, threshold and definite) through 13.7 per cent (RDC, probable and definite) to 20.3 per cent (Bedford, borderline and definite). The main comparison made is between the PSE/ID/Catego and SADS/RDC systems. Sixty-one per cent of cases are identified as such by both these schemes. There is poor agreement about labelling; only 56 per cent of cases of depression and 16.7 per cent of cases of anxiety are so diagnosed by both systems. A post hoc check list was used to identify Bedford cases; all bar one were found to fulfil RDC and PSE case criteria. The results are compared with those from other centres which have used the same diagnostic criteria in community studies. PMID- 6860878 TI - Factor analysis and validation of the general health questionnaire in women: a general practice survey. PMID- 6860880 TI - First rank symptoms as predictors of ECT response in schizophrenia. AB - First rank symptoms (FRS) in association with affective features predict improvement on ECT. When affectivity was disregarded in 142 schizophrenic probands given ECT and the relationship between FRS alone and ECT response examined, those without FRS had a significantly better ECT outcome score than those with FRS. In various schizophrenic sub-samples, defined in terms of hypothesized predictive abilities of different sets of FRS, no differences came to light. PMID- 6860879 TI - The effect of unilateral non-dominant ECT on memory and perceptual functions. PMID- 6860881 TI - Corpus callosum thickness in chronic schizophrenia. AB - In an effort at replication of the original report (Rosenthal and Bigelow, 1972) of increased callosal thickness in schizophrenic brains, the corpus callosum was measured in a blind study of 64 brains autopsied between the years 1972 and 1976. Diagnosis was established by independent chart review. The mean corpus callosum mid sections of 21 early onset chronic schizophrenic brains were found to have a significantly greater thickness when compared with 8 subjects with late onset schizophrenia, 13 patients with neurological diagnoses, or 14 patients with other psychiatric diagnoses. These studies, if independently confirmed, should provide an impetus for testing the hypothesis that some chronic schizophrenic patients have an illness associated with a pathological process in the corpus callosum. PMID- 6860882 TI - The clinical description of forty-eight cases of sexual fetishism. AB - This study surveys the discharge register of a large London teaching hospital over 20 years and presents data on its 48 cases of clinical sexual fetishism. An attempt was made to answer two questions: (1) What are the clinical problems these patients present? They have more to do with the perception of fetishes as personally or socially unacceptable than with 'objective' restrictions placed on sexual activity. (2) What is the classification used to describe? The data have not enabled any conclusions to be drawn about the existence of particular fetishist syndromes. Certainly, a fifth or more of the sample had fetishes for clothes or rubber or rubber items, or wore or stole a fetish or fetishes; but this information is insufficient to allow one to assume that these patients had something significant in common, and leaves open the question of what more precisely each individual was attracted to. PMID- 6860884 TI - Cancer and depression. PMID- 6860883 TI - Dopa dose-dependent sexual deviation. PMID- 6860886 TI - Community screening for mental illness. PMID- 6860885 TI - Paranoia and dysmorphophobia. PMID- 6860887 TI - Social intervention in the families of schizophrenics: addendum. PMID- 6860888 TI - Dead souls: crisis intervention in geriatrics. PMID- 6860889 TI - Is tardive dyskinesia commoner in Jews? PMID- 6860890 TI - Ultrasonic diagnosis of posterior urethral valve in neonates. AB - The availability of real time ultrasound units with small transducer heads has made perineal ultrasonography a practical proposition in infants. The findings of a dilated posterior urethra and bladder obstruction in a male infant indicate the high probability of a posterior urethral valve. The features seen in the urethra as well as those in the bladder and kidneys are demonstrated. PMID- 6860891 TI - CT evaluation of paranasal sinus tumours for cranio-facial resection. AB - Twenty-two patients with tumours of the paranasal sinuses had computerised tomography performed prior to cranio-facial resection. The findings of CT, histology and operative appearances are compared and a 78% correlation found. The radical approach offered by cranio-facial resection allows more accurate confirmation of CT findings than hitherto possible. The particular importance of CT scanning in relation to tumours of paranasal sinuses is discussed. PMID- 6860892 TI - Liver cadmium concentrations in metal industry workers. AB - In vivo neutron activation analysis of liver cadmium concentration was performed in 285 metal workers, 130 of whom had been exposed to cadmium in the workplace. Only two workers showed pathological levels in excess of 50 ppm. However, mean liver, urine and blood cadmium levels were significantly different as between the exposed and the unexposed workers. In vivo neutron activation analysis of liver cadmium concentration is easy to perform and can readily be used for industrial screening whenever a hazard is suspected. PMID- 6860893 TI - Enhancement of computed tomographic scanner based digital radiographic images. AB - Scanned digital radiographs are one of the imaging facilities available on the EMI 7070 scanner. The images offered by the system were found to be clinically poor and the reason for this was that the round shape of the patient was forming the major component of the image. Two empirical methods to account effectively for patient shape have been investigated and are now in clinical use. The first method assumes that the patient shape is approximated to a second-order polynomial of the picture element position. For each line of the image a second order polynomial function is fitted to the image data, then removed from the image data. The second method involves using the existing CT wedge as an average compensation wedge to remove the majority of the effect of the patient shape. The relative merits and clinical application of both techniques are discussed. PMID- 6860894 TI - A system for dual-energy radiography. AB - A system has been developed and theoretically analysed for the generation of chemical information from conventional radiography. A specially modified cassette has enabled dual-energy radiographs to be taken during a single exposure. A simple theoretical model has demonstrated that the concept of an optical density "standardised" to the local surroundings allows adequate quantification of the dual-energy radiographs. Using this method, data can be obtained relating to the effective atomic number of a radiographed material provided some estimate of its physical density is known. Simulated in vivo analysis of gall-stone composition has been demonstrated using these techniques. PMID- 6860895 TI - Blood flow changes in transplanted mouse tumours and skin after mild hyperthermia. AB - The influence of moderate hyperthermia on the vascular perfusion of four different tumour types and of normal mouse skin was investigated. The 86Rb extraction technique was used to measure changes in perfusion relative to total cardiac output, both during and after a one hour heat treatment at 42.5 degrees C. Perfusion of the SA FA tumour increased slightly during the first 30 minutes of heating but had returned to control values by the end of a 1 hour heating period. After heating, the relative perfusion of all four tumour types fell significantly below control values by 24 hours and remained low for 1-2 days (SA FA tumour) before returning to control values. Relative perfusion of normal skin was progressively increased during heating and remained elevated for 24 hours after the end of treatment before returning to control levels. PMID- 6860897 TI - Fracture of the radial neck with medial displacement of the shaft of the radius. PMID- 6860896 TI - Sesamoid fracture of the thumb. PMID- 6860898 TI - Radiological gastric filling defect due to penetration into the spleen by a large gastric ulcer. PMID- 6860899 TI - Inaccessible stone in the cystic duct remnant--a cause of failure of percutaneous extraction. PMID- 6860900 TI - Dose response curves for organ function or cell survival. PMID- 6860901 TI - A simple technique for quantitative cholecystokinin--HIDA scanning. PMID- 6860903 TI - SI units of exposure in radiology. PMID- 6860902 TI - Defining clinical radioresistance and radiosensitivity. PMID- 6860904 TI - The hazards of acupuncture. PMID- 6860905 TI - The effect of breast biopsy on reactive changes in the axillary lymph nodes. AB - The reactive changes in the axillary lymph nodes of 50 breast cancer patients treated by mastectomy immediately following frozen section diagnosis have been compared with the changes in the nodes of 50 patients whose biopsy preceded mastectomy by between 2 and 5 days. The frequency of sinus histiocytosis was significantly greater in those patients who had been subjected to previous biopsy. This finding suggests that prior breast biopsy may negate the prognostic significance of sinus histiocytosis in breast cancer. PMID- 6860907 TI - Axillofemoral and femorofemoral grafts: a 6-year experience with emphasis on the relationship of peroperative flow measurement to graft survival. AB - Over a 6-year period 64 axillofemoral bypass and femorofemoral crossover grafts have been performed in 58 patients, most of whom were considered unfit for intra abdominal surgery. Indications were peripheral ischaemia in 78 per cent and disabling claudication in 22 per cent. The limb salvage rate at 3 years was 75 per cent. No claudicants lost limbs, but only one-third of patients presenting with forefoot gangrene or ulceration avoided amputation. Most patients presenting with ischaemic symptoms at rest had associated femoropopliteal and distal disease, confirmed by the ankle pressure index measurements, and this influenced graft patency. Although the cumulative patency at 3 years for all grafts combined was 57 per cent with similar patencies for both the axillofemoral and femorofemoral grafts, early occlusion was more common in axillofemoral grafts and this may be reduced in bifemoral grafts by the increased flow rate in the vertical limbs. Peroperative electromagnetic flowmeter measurements were made after reconstruction on 55 femoral arteries in 46 of the patients and graft flow velocities were derived from these measurements. Comparison between velocities from those grafts remaining patent and those subsequently occluding showed a high incidence of occlusion in grafts with a maximal velocity after distal vasodilatation of less than 8 cm/s. Graft occlusion after the first postoperative month was more commonly associated with other factors such as continued smoking, severity of distal disease and perigraft infection. PMID- 6860906 TI - Causes and clinical significance of gastritis following Billroth II resection for duodenal ulcer. AB - Billroth II resection was carried out in 1000 duodenal ulcer patients in the period 1948-1956. Twenty-two to thirty years later, gastroscopy and biopsy was performed in 196 of 423 survivors. Chronic atrophic gastritis appeared in 93 per cent of the cases, 47 per cent showed slight and 46 per cent severe changes. Seven per cent had normal mucosa. The microscopic grade of gastritis proved to be independent of age, alcohol and tobacco consumption and serum gastrin. No correlation between clinical status, such as dumping, diarrhoea, vomiting and pain, haematological parameters and the microscopic grade of gastritis, could be found. It is suggested that gastritis might be caused by reflux of bile, pancreatic and intestinal juices, and that postgastrectomy symptoms and anaemia do not depend on the microscopic grade of gastritis. PMID- 6860908 TI - Carcinoma of the anus in Crohn's disease. AB - The incidence of gastrointestinal cancer in patients with Crohn's disease may be slightly increased. We report 2 cases of squamous cell carcinoma of the anus occurring in patients with distal Crohn's disease. PMID- 6860909 TI - A clinical evaluation of postoperative peritoneal lavage in the treatment of perforated appendicitis. AB - In a comparative investigation, 369 patients operated upon for perforated appendicitis were studied retrospectively. During the period 1973-1979 181 patients with perforated appendicitis, treated at Sundsvall Hospital, were all given postoperative peritoneal lavage, whereas 188 patients with the same diagnosis treated at Skovde Hospital received no such treatment. Appendicectomy was performed in all patients and all were given systemic antibiotic therapy. Complications recorded were postoperative deaths, intra-abdominal abscesses, wound infections, postoperative ileus and lavage catheter complications. Postoperative peritoneal lavage did not diminish the frequency of these postoperative complications. PMID- 6860910 TI - Symptoms and signs of operable breast cancer 1976-1981. AB - The symptoms and sings of operable breast cancer in 1205 women are reviewed, and in a considerable proportion classic signs are absent. Of the patients 73 per cent were postmenopausal and 76 per cent of cancers presented as discrete lumps. Pain as a presenting symptom was rare (5 per cent), but when questioned 33 per cent of women admitted that the lump was painful. Some 42 per cent of patients had skin tethering or fixation, only 22 per cent had nipple retraction of displacement, and 42 per cent had lesions which appeared to have well-defined edges. Only 2 per cent of the lesions were clinically T0 or T1, the majority (56 per cent) being T2, and 12 per cent were T3. PMID- 6860911 TI - In situ femoropopliteal and distal vein bypass for limb salvage--experience of 50 cases. AB - The aim of this paper is to assess the in situ technique of saphenous vein femoropopliteal (and femorotibial) bypass for limb salvage, and to compare it with the reversed vein method of bypass. In our 3-year study, we have operated on 50 cases resulting in a graft patency and limb salvage rate of 78 per cent at 18 months and 72 per cent overall. There was a 2 per cent perioperative and 10 per cent overall mortality. Graft thrombosis was associated with a variety of factors, mostly notably a small vein (les than 4 mm), a low calf vessel anastomosis, wound sepsis and progressive proximal (inflow) disease. However, the strongest correlation was that between graft thrombosis and the extent of distal disease, as 11 of 12 cases with thrombosed grafts had grade 2 or 3 run-off. In our experience the in situ technique offers haemodynamic and technical advantages over the reversed vein method of performing straightforward femoropopliteal bypass. Moreover, the in situ technique has wider application in that it allows a smaller vein (greater than 2.5 mm) to be used and also makes anastomosis to a small calf vessel easier. In this series, 16 per cent of cases would have been considered unsuitable for the reversed vein method if 4 mm was accepted as the lower limit of size for a reversed vein graft. PMID- 6860912 TI - Dynamic preoperative assessment of cardiac reserve in elective aortic surgery. AB - Myocardial infarction accounts for over 50 per cent of mortality following elective abdominal aortic surgery. Previous history of ischaemic heart disease and abnormal ECGs, common in vascular patients, are unreliable parameters for predicting myocardial response to stress. Exercise ECGs are often valueless, as claudication may mask myocardial insufficiency. Myocardial performance was studied preoperatively in 29 consecutive patients undergoing elective aortic bifurcation grafting, using a Swann-Ganz catheter to measure the rise in pulmonary artery wedge pressure (PAWP) produced by rapid intravenous infusion of plasma (200-400 ml). A Frank-Starling Curve was obtained by plotting LVSWI against PAWP. Two important values were obtained: (a) 'Upslope' or gradient of the ascending portion of the curve. Low values identify patients most at risk from cardiac complications. Six patients who suffered from postoperative cardiac complications had a mean 'upslope' value of 1.568 +/- 0.681 (1 s.e.m.), whereas the 23 who did not, had a mean value of 7.094 +/- 0.745 (1 s.e.m.), a significant difference (P less than 0.001); (b) 'PAWPmax', the ventricular filling pressure above which work output dropped. Infusion beyond this may precipitate pulmonary oedema. PAWP was observed at levels greater than PAWPmax in all 6 patients who developed either pulmonary oedema or myocardial infarction. The myocardial performance curve can reliably identify high risk patients and permit control of intravenous therapy within individual safety limits, thereby preventing pulmonary oedema. PMID- 6860913 TI - Cranial and cervical nerve damage associated with carotid endarterectomy. AB - Carotid endarterectomy may be complicated by damage to the adjacent cranial and cervical nerves. The true incidence and severity of these complications is rarely reported. In a prospective study of 43 carotid endarterectomies there was a 25 per cent incidence of temporary vocal cord palsy, 5 per cent incidence of hypoglossal nerve damage and anaesthesia of the greater auricular and transverse cervical nerves was found in 60 per cent and 69 per cent of patients respectively 1 week postoperatively. There was some recovery of these nerve injuries over a 6 month period. PMID- 6860914 TI - Adjuvant distal arteriovenous shunt with femorotibial bypass for critical ischaemia. AB - In a series of 59 femorotibial bypass operations for critical ischaemia an arteriovenous (A-V) shunt was constructed at the distal anastomosis in 36 patients whose pedal angiograms showed an occlusion in the primary pedal arch. Mean blood flow recorded in the grafts without the shunt in the patients whose primary pedal arch was occluded was 83.6 +/- 9.9 ml/min (mean +/- s.e.m.) compared with 152 +/- 16.2 ml/min in those patients whose primary pedal arch was intact (P less than 0.01). This increased to 236 +/- 20.5 ml/min with the shunt open (P less than 0.001). Twelve months after operation the cumulative patency rate for grafts with an A-V shunt was 46.5 per cent compared with 40.5 per cent for grafts in the better risk patients with a patent primary pedal arch who did not receive a shunt. No side effects were observed due to the presence of a shunt. The importance of the primary pedal arch and the rationale of adjuvant distal arteriovenous shunt are discussed. The results indicate that the addition of an arteriovenous shunt at the distal anastomosis of a long femorotibial bypass is of benefit when blood flow through the graft is limited by occlusive disease in the pedal arteries. PMID- 6860915 TI - The diagnosis and treatment of peri-aortic fibrosis ('inflammatory' aneurysms). AB - A proportion of abdominal aortic aneurysms are found at laparotomy to have thick white walls and extensive peri-aneurysmal adhesions. Graft replacement in these patients is often difficult and associated with an increase in morbidity and mortality. In this study 103 patients with a clinical diagnosis of aortic aneurysm were scanned with computerized tomography to determine whether this condition could be diagnosed preoperatively. Of these, 15 showed diagnostic radiological criteria of peri-aortic fibrosis. Laparotomy revealed no false negatives and only one false positive. Clinical, serological and pathological findings have been compared to those with 'normal' aneurysms. In view of the similarities between this condition and retroperitoneal fibrosis, 5 patients were treated with Prednisone 5 mg twice daily for up to 18 months and a CAT scan technique developed to monitor the degree of thickening quantitatively. Abdominal pain disappeared rapidly, and sequential scanning showed a decrease in peri aortic fibrosis. Measurements showed the fibrosis only to disappear, with no increase in the diameter of the aortic lumen. In some cases, the lumen was only minimally dilated, although clinical examination suggested an aneurysm. Consequently we suggest that the term peri-aortic fibrosis is a better description of this condition whose aetiology is still obscure, and in which aneurysm formation, when present, may simply be consequent upon the fibrotic reaction in the wall. PMID- 6860917 TI - Does local treatment affect the outcome of breast cancer?-an alternative view of the Manchester Regional Breast Study. PMID- 6860916 TI - ERCP in the diagnosis of unexplained abdominal pain. PMID- 6860918 TI - Salmonellosis. PMID- 6860919 TI - The effect of calcium infusion on the electrocardiogram of parturient paretic cows. PMID- 6860920 TI - Comparison of Haemophilus equigenitalis (contagious equine metritis organism) and other Haemophilus species by disc electrophoresis of acid-phenol-soluble proteins. PMID- 6860921 TI - Unilateral testicular hypoplasia in a white Fulani bull: case report. PMID- 6860922 TI - Spray vaccination with an improved F Newcastle disease vaccine. A comparison of efficacy with the B1 and La Sota vaccines. PMID- 6860923 TI - Scrotal onchocerciasis in a bull in Nigeria. PMID- 6860925 TI - The effect of road transportation on the blood constituents and behaviour of calves. I. Six months old. PMID- 6860924 TI - Uptake of fenbendazole by grazing sheep with access to feed-blocks containing fenbendazole. PMID- 6860926 TI - Some aspects of gastric secretory tests in dogs for diagnostic purposes in two selected cases of stomach disease. PMID- 6860928 TI - Role of serum enzymes in evaluating flukicidal action of disophenol in Fasciola affected buffaloes. PMID- 6860927 TI - Plasma progesterone, oestrone and oestrone sulphate levels during the first half of gestation in swamp buffaloes. PMID- 6860929 TI - Gastrodiscus aegyptiacus in horses in Guyana. PMID- 6860930 TI - Fundamental frequency, language processing, and linguistic structure in Wernicke's aphasia. AB - Five Wernicke's aphasics and five normal control subjects were tested in order to assess several aspects of fundamental frequency (F0) in speech production. The clinical impression of normal prosody in Wernicke's aphasia is correct inasmuch as these patients generally exhibited F0 declination. However, F0 declination ranged over shorter domains than in normal speech. Moreover, the increased use of F0 continuation rises by the Wernicke's aphasics indicated their inability to maintain a single F0 contour over constituents which are normally integral. The hypermelodic quality of F0 in the speech of Wernicke's aphasics further supported the notion that speech prosody was not strictly normal. F0 attributes tended to be normal when they corresponded to the global linguistic variable of sentence length, while they were abnormal when they corresponded to the processing of syntactic structure. No evidence was found that paraphasias and neologisms directly affected the programming of F0. The results are discussed in terms of speech processing abilities and limitations in Wernicke's aphasia. PMID- 6860932 TI - Word production and comprehension in Alzheimer's disease: the breakdown of semantic knowledge. AB - Relatively mildly impaired patients with suspected Alzheimer's disease (N = 14; Verbal IQ = 96) and normal controls of similar age and education (N = 11) were administered tests requiring production (naming and fluency) and comprehension of single words. Word comprehension was assessed on a superordinate level (rating words for degree of "pleasantness") and on a more specific level (matching abstract pictorial representations with printed words denoting objects, action, emotions, and modifiers). Performance on standardized measures of semantic knowledge (Vocabulary and Similarities subtests of the WAIS) was also evaluated. The naming and fluency abilities of the Alzheimer's patients were found to be highly correlated (r = .80) and impaired. Naming errors often consisted of semantic field errors which were either hierarchically or linearly related to the target name. In comparison with normals, verbal fluency was characterized by a tendency to generate proportionally more category names concurrent with reduced production of items within a category. Single-word comprehension was also impaired, except when judgments of affective meaning were required. It was argued that these results suggest that Alzheimer's disease may lead to a specific disruption in semantic knowledge characterized by a difficulty in differentiating between items within the same semantic category concurrent with the relative preservation of broader categorical information. PMID- 6860931 TI - Mirror writing in right-handers and in left-handers. AB - To determine whether normal left-handers were more adept than were normal right handers at mirror writing, we tested right-handers and left-handers for their ability to mirror write. Independent of hand used, left-handers wrote mirror words (but not normal words) faster than did right-handers, which suggest that left-handers may be better able to reverse directions (left leads to right to right leads to left). Although when using their preferred hand, left-handers made fewer errors than did right-handers (using their preferred hand), the left hand both in right- and in left-handers was superior to the right hand. That the left hand was superior to the right is compatible with the hypothesis either that the right hemisphere contains mirror engrams or that movements away from the body are more accurate than movements toward the body or both. PMID- 6860934 TI - Writing nonwords to dictation. AB - Two experiments show that the spelling of a nonword that is heard (i.e., /prein/) is influenced by the spelling of a word that is heard earlier (i.e., "brain" greater than prain and "crane" greater than prane). This is a robust effect and inspection of the pattern of results suggests that, under these conditions, both words and nonwords are lexically analyzed. A patient with an aquired reading disorder characterized as surface dyslexia was unaffected by such lexical influences in his spelling of nonwords. Moreover, his spelling suggested a defective ability to generate phonemically acceptable spellings of nonwords. Taken together with other reports of neurologically caused spelling impairments these results suggest that skill at assigning letters to sounds never becomes independent of lexical skill in adult readers. An analogical, lexically based parsing system for the reading and spelling of new (nonwords, as suggested by Marcel (1980) appears to be the best fit to these data. PMID- 6860933 TI - Further study of the electrophysiological correlates of lexical decision. AB - Discriminations were required between words, pseudohomophones, and visually matched nonwords. Two tasks were employed, one which could be accomplished on the basis of a visual code (the REAL task, involving discrimination between words and both types of nonword) and another necessitating the use of a phonological code (the REAL/PSEUD task, words and pseudohomophones vs. non-words). ERPs were recorded from three midline sites and from left and right inferior parietal sites. Two principal results were observed, (i) the peak latency of a late positive component, P637, covaried with RT, with variations in latency of around one half the corresponding RT variations, and (ii) the peak-to-peak amplitude of N100-P187 interacted with stimulus and task, such that it was larger for nonwords in the REAL task and words in the REAL/PSEUD task. No task- or stimulus-dependent asymmetries were observed in any ERP component. The P637 latency data support a model of RT variation based on the interaction of changes in parallel response preparation and stimulus evaluation processes. The observations with respect to N100-P187 suggest that ERPs are sensitive to factors related to the early processing of words and word-like visual material. PMID- 6860935 TI - An assessment of cerebral dominance in language--disordered children via a time sharing paradigm. AB - A time-sharing paradigm was used to assess language lateralization in language disordered and normal children aged 4-7 years. Several expressive language tasks as well as a vocal, but nonlinguistic, task were administered concurrently with unimanual finger tapping. Dependent variables were percent disruption scores and number of syllables produced per concurrent trial. All language concurrent tasks produced tapping reductions for both hands for both groups. This result contrasts to similar time-sharing studies claiming asymmetrical interference and hence language lateralization in children (N. White & M. Kinsbourne, 1980, Brain and Language 10, 215-223; J. Obrzut, G. Hynd, A. Obrzut, & J. Leitgeb, 1980, Brain and Language 11, 181-194). A multiple regression analysis revealed a significant interaction effect differentiating language-disordered from normal children. Normals exhibited a parallel response pattern for speech and tapping (both increased or decreased in rate) under all lateralization conditions. Language disordered children exhibited an inverse response pattern (e.g., if speech output increased, tapping rate decreased) only under left-hemisphere time-sharing. PMID- 6860936 TI - Contrasting cases of Italian agrammatic aphasia without comprehension disorder. AB - Two patients with agrammatic speech and unimpaired comprehension are presented and contrasted. Case 1 had an infarction involving precentral gyrus, subjacent white matter, and posterior and superior aspects of the insula, largely sparing Broca's area. His speech was slow and dysarthric, consisting of short disconnected phrases with some omission of lexical verbs. Case 2 had an unusual transient aphasia of acute onset without hemiplegia; speech rate, articulation, and sentence length and complexity appeared normal. Both patients tended to omit function words and finite verb inflections, but Case 2 did so much more than did Case 1. Neither patient showed impairment in any other area of language performance. Tentatively, Case 2 is described as being more morphologically impaired but less syntactically impaired than Case 1, while neither has damage to a central language processor. PMID- 6860937 TI - Participation of cortical recurrent inhibition in the genesis of spike and wave discharges in feline generalized penicillin epilepsy. AB - Cortical recurrent inhibition (RI) evoked in pericruciate cortex by antidromic stimulation of the cerebral peduncle (CP) was studied in normal cats and in cats exhibiting the signs of feline generalized penicillin epilepsy (FGPE) following the i.m. injection of penicillin. Two measures of RI evoked by antidromic CP stimulation were used: (i) the averaged focal potential in the pericruciate gyrus; and (ii) the duration of the suppression or diminution of extracellularly recorded action potential (ap) discharge of antidromically activated pericruciate neurons measured in peristimulus time histograms (PSTHs). After i.m. injection of 350,000 IU/kg of penicillin RI remained preserved as long as only generalized spike and wave (SW) discharges appeared in the EEG, although in 5/17 neurons a modest to moderate reduction in the duration of RI occurred once SW discharges had appeared in the EEG. This inconstant reduction was probably not caused by a direct anti-inhibitory action of penicillin, but is a consequence of the increased number of ap discharges curtailing RI. At the small concentrations of penicillin existing in brain in FGPE its anti-inhibitory action evident with larger concentrations cannot be demonstrated. When focal or generalized tonic clonic (T-C) seizures occurred, RI was reduced in slightly more than half of the instances for a few minutes before the onset of these seizures. This suggests that the transition from SW discharge to T-C seizure may be caused by a breakdown of RI. PMID- 6860938 TI - Excitation by dopamine of putative oxytocinergic neurones in the rat supraoptic nucleus in vitro: evidence for two classes of continuously firing neurones. AB - Neurones from the supraoptic nucleus in the rat hypothalamic slice preparation in vitro have been recorded from using conventional extracellular techniques. Neurones which fired in a slow continuous manner (putative oxytocinergic cells) increased their firing pattern in response to dopamine applied in the perfusate or pressure ejected onto the slice. Of these neurones, 85% were inhibited by spiperone, haloperidol or cis-flupenthixol applied in the bath. A small proportion (approximately 15%) of neurones excited by dopamine (DA) were not affected by these DA antagonists but were inhibited strongly by (+/-)-sulpiride. Similar results were also obtained on a small number of cells recorded from an 'island-slice' preparation, utilized to isolate the observed responses to an area immediately adjacent to the supraoptic nucleus. These results may be relevant to earlier work on in vivo anaesthetized preparations using intracerebroventricular injections of DA and antagonists, and indicate that such substances may act directly on a synapse(s) within the magnocellular nucleus in addition to other possible actions within the neurohypophyseal tract. The differential response to the dopamine antagonists indicate that the majority of continuously firing neurones in the supraoptic nucleus are of the DI receptor class, but the presence of possible D2 receptors on a small proportion of these neurones suggests that a second type of continuously firing neurone may exist in this nucleus. PMID- 6860940 TI - Enhanced growth and morphological differentiation of isolated adult rat oligodendrocytes in vitro: use of a naturally produced extracellular matrix. AB - Attachment, growth and morphological differentiation of isolated adult rat oligodendrocytes cultured on a naturally produced basement membrane-like extracellular matrix (ECM) occurred much faster than on poly-L-lysine (PLL) coated tissue culture dishes. In each individual trial the cells cultured on ECM exhibited, within 3-5 days in culture, a massive outgrowth of long and branched cytoplasmic processes. Outgrowth to such an extent, using PLL or plastic tissue culture dishes, was not observed even after 2 weeks in culture. The successful high plating efficiency, rapid growth and network formation as well as its resemblance to the in vivo environment of cells make this naturally produced substrate a superior substitute for PLL and therefore more attractive for studying the behavior and function of oligodendrocytes in vitro. PMID- 6860941 TI - Influence of catecholamines on reward-related neuronal activity in monkey orbitofrontal cortex. AB - Reward-related neuronal activity and its regulation by catecholaminergic input were investigated in the orbitofrontal cortex of the behaving monkey by means of extracellular unit recording and microiontophoretic application of drugs. Neuronal activity was modulated by reward situations and catecholamines. The activity of a majority of the noradrenaline-sensitive cells decreased and of the dopamine sensitive cells increased during food acquisition behavior. The results suggest that catecholamines could be involved in reward-related neuronal activity in the monkey orbitofrontal cortex. PMID- 6860939 TI - Opioid and non-opioid mechanisms of footshock-induced analgesia: role of the spinal dorsolateral funiculus. AB - Exposure to inescapable footshock causes either an opioid or non-opioid mediated analgesia in the rat depending on the temporal parameters of its administration. Lesions of the spinal dorsolateral funiculus significantly reduce both the opioid and non-opioid forms of this footshock-induced analgesia. Thus, these two neurochemically discrete pain-inhibitory systems appear to depend on the integrity of the same descending path, one known to be activated by morphine and by analgesic brain stimulation. PMID- 6860942 TI - Strain-dependent and stress-induced changes in rat hippocampal cholinergic system. AB - The study demonstrates that in the hippocampus of inbred Wistar-Kyoto (WKY) rats [3H]choline uptake is 38% higher than in Brown-Norway (BN) rats. In contrast, the maximum binding capacity of [3H]quinuclidinylbenzilate (QNB) is 28% lower in WKY than in BN rats. After immobilization stress there is a reduction in [3H]choline accumulation which is more pronounced in WKY rats. Furthermore, maximal QNB binding after stress is increased only in WKY rats. Choline acetyltransferase activity, which was 83.5% higher in WKY rats, was not altered after stress in both strains. We conclude that: (1) choline accumulation is directly related to choline acetyltransferase activity in hippocampal synaptosomes; (2) maximum cholinergic muscarinic binding capacity is inversely related to the above two presynaptic activities and (3) immobilization stress results in a decreased choline accumulation and may lead to an increased QNB binding. The results imply that reduction in choline accumulation may be a compensatory mechanism of cholinergic synapses during adaptation to lengthly periods of neuronal activity. PMID- 6860943 TI - Continuous light paradoxically reduces catecholamine-induced melatonin production. AB - Exposure of rats to continuous light for 14 days reduced the stimulation of melatonin content in the pineal gland produced by either isoproterenol administration or exposure to darkness. Since continuous light has been reported to enhance many intermediate biochemical events leading to the synthesis of melatonin, these results demonstrate the importance of examining the endproduct of an organ when evaluating the physiological significance of biochemical changes in model biological systems. PMID- 6860945 TI - Changes in brain chemistry produced by dopaminergic agents: in vivo electrochemical monitoring reveals opposite changes in anesthetized vs unanesthetized rats. AB - Semidifferentiated voltammograms were recorded using graphite paste electrodes in the striatum of the anesthetized and unanesthetized rat treated with the dopamine agonist, pergolide. The first peak in the voltammogram, which represents mainly ascorbic acid (AA) and lesser amounts of dopamine and 3, -4-dihydroxyphenylacetic acid, was decreased in the anesthetized rat and increased in the unanesthetized rat. Spiperone but not alpha-methyltyrosine pretreatment prevented the pergolide induced rise. Thus, if the first faradaic peak is mainly AA, the release of AA is a postsynaptic dopaminergic event and may be important in dopaminergic neurotransmission. PMID- 6860944 TI - Chronic D-amphetamine and phencyclidine: effects on dopamine agonist and antagonist binding sites in the extrapyramidal and mesolimbic systems. AB - Dopamine agonist and antagonist binding to rat striatal and mesolimbic region tissue was examined in rats chronically treated with D-amphetamine or phencyclidine. In striatum, D-amphetamine produces a down-regulation of [3H]spiroperidol binding but an increase in [3H]ADTN bound (measured in the absence of ascorbate). This suggests that [3H]spiroperidol and [3H]ADTN bind to distinct, separate sites which can be independently regulated. PMID- 6860946 TI - Further evidence for a strong depressive effect of low doses of morphine on VB thalamic neuronal responses (a study on arthritic rats). AB - The effects of various i.v. morphine doses (30, 100 and 1000 micrograms/kg) were studied upon unitary ventral basal (VB) neuronal responses elicited by joint stimulation in 24 Freund's adjuvant induced arthritic rats. The depressive effect of morphine was significantly dose-related and generally naloxone-reversible; however there were sometimes some difficulties to reverse morphine effect with the lowest dose of naloxone (10 micrograms/kg). The effect of morphine was not significantly different from that obtained in normal rats upon responses of specific nociceptive VB neurons. Although these results do not explain enhancement of morphine analgesia in arthritic rats by comparison with normal rats, they do confirm efficiency of low doses of morphine upon VB neuronal responses elicited by stimuli which induce nociceptive reaction in freely moving animals. PMID- 6860948 TI - Adaptive plasticity in the spinal stretch reflex. AB - Monkeys can change the amplitude of the spinal stretch reflex without change in initial alpha motor neuron tone, as measured by EMG, or in initial muscle length. Change is apparent in 5-10 days, continues to develop over weeks, and persists during inactive periods. Spinal stretch reflex change may be a valuable system for studying the neuronal and synaptic bases of an adaptive change in primate CNS function. PMID- 6860947 TI - Neonatal handling selectively alters the phosphorylation of a 47,000 mol. wt. protein in male rat hippocampus. AB - Beginning on postnatal day 1, rat pups were handled for 7 min daily for 23-30 days. This treatment diminished the in vitro phosphorylation of phosphoprotein F 1 [mol. wt. approximately 47 K daltons, protein B-50] in the hippocampus of male rats. Other major phosphoproteins (D-1-2. mol. wt. 80-86 K daltons: E-2-3. mol. wt. 50-55 K daltons) were not influenced by handling. These findings confirm and extend the results of Holmes et al. who observed a decrease in ECS-induced protein kinase activity subsequent to handling. PMID- 6860949 TI - Neuronotrophic activity in brain wounds of the developing rat. Correlation with implant survival in the wound cavity. AB - Neuronotrophic activity accumulates in a wound cavity created in the entorhinal/occipital cortex of developing rats. These trophic factors support the survival of neurons in monolayer cultures of chick embryo spinal cord, ciliary ganglion, sympathetic ganglion and dorsal root ganglion, as well as of mouse dorsal root ganglion. Trophic activity was very low both in non-injured brain tissue and in the wound cavity 1 day post-lesion, but it increased 15- to 300 fold during the subsequent 2-5 days. Together with the trophic activity in the wound fluid were other substances which interfered with the survival of spinal cord neurons. The neuronotrophic factors appeared to be proteins immunologically distinct from mouse submaxillary nerve growth factor. Fragments of rat embryo corpus striatum placed in the cortical wound cavity immediately after its formation showed very poor subsequent survival and no innervation of the host hippocampus. However, if implantation was delayed by 3 or 6 days with respect to the time at which the receiving cavity was made, the survival was greatly improved and innervation of the host took place. The time course for the accumulation of the trophic factors in the cavity paralleled the delay leading to increased survival of brain grafts. It is suggested that the neuronotrophic activity accumulating in the wound cavity during the delay period may be responsible for the increased survival of the implants. PMID- 6860950 TI - Endogenous and exogenous factors support neuronal survival and choline acetyltransferase activity in embryonic spinal cord cultures. AB - Dissociated 4-day (stage 23) chick embryo lumbar cord cells were cultured at low or high cell densities for 1 or 5 days in the presence or absence of added spinal neuronotrophic factor (supplied as RN22 Schwannoma conditioned medium, RCM). In low density, 1-day cultures neuronal survival was dependent on added RCM whereas by 5 days no neurons survived, even in the presence of RCM. In high density 1-day cultures a substantial neuronal population could survive even without added RCM and a large proportion of this neuronal population would survive for 5 days. When conditioned media from high density lumbar cord cultures was supplied to low density unsupplemented cultures, a similar level of 5-day neuronal survival resulted. However, no neurons survived in RCM-supplemented 5-day high density cultures, indicating the presence in RCM of a material toxic for the neurons. Both the RCM and the high density lumbar culture-conditioned medium supported considerable choline acetyltransferase activity indicating the presence within these cultures of motoneurons. PMID- 6860951 TI - Visually guided reaching and tactile discrimination performance in the monkey: the effects of removals of parietal cortex soon after birth. AB - Unilateral removals of parietal cortex were made soon after birth in 5 monkeys. The inferior parietal lobule was removed alone or together with the superior parietal lobule; the second somatosensory area (SII) was removed alone or together with posterior parietal surface cortex. Neurological changes were observed; and the animals were assessed quantitatively for their accuracy of reaching for visual targets and for their ability to discriminate between objects by palpation in the dark. Each hand was evaluated separately. Disorders of reaching (confined to the contralateral hand) were found to persist longer than in animals with comparable removals made at a later age; whereas the ability to make tactile discriminations was not more severely impaired after an early than a late ablation. PMID- 6860952 TI - Unmyelinated nociceptive units in two skin areas of the rat. AB - Responses of unmyelinated afferent fibres were investigated in two skin nerves of Sprague-Dawley rats. The units were tested as to whether they responded to mechanical probing of the skin, to controlled radiant heat stimulation, and/or to cooling of the skin (to less than or equal to 5 degrees C). Ninety-six units in a n. saphenaus and 129 units in a n. coccygealis were studied, which were identified as afferents by means of the above-mentioned stimuli. In both nerves mechano- and heat-sensitive units (CMHs) were most frequent (56% in n. saphenaus and 74% in n. coccygealis). There were, however, significantly more purely mechanoceptive units (CMs) in n. saphenaus than in n. coccygealis (30% vs 5%). In contrast cold-sensitive units (CCs) were more frequent in n. coccygealis. They constituted 25% of the afferent C-fibres in this nerve. When testing heat sensitivity of CMHs with ramp stimuli raising the temperature to 55 degrees C at a rate of 0.8 degree C/s, heat thresholds had a wide range of between 30 and 55 degrees C. Since CMHs with low heat thresholds had the highest discharge rates and the greatest dynamic sensitivity in the range of noxious temperatures, they most probably also had nociceptive functions. It was shown that the low heat thresholds of some CMHs were not due to sensitization by preceding heat stimuli. It is argued that low-frequency discharges (less than or equal to 2 Hz) observed in some nociceptive CMHs of the rat at non-noxious temperatures are insignificant for nociception. When comparing discharges during a first ramp heat stimulus to 50 degrees C (rise time 1 degree C/s) with those during a second stimulus of identical time course delivered 5-10 min later, 44% of the CMHs were sensitized, 24% were desensitized and the remainder were not clearly influenced. We did not find a significant correlation between initial heat thresholds and tendency to sensitization or desensitization. PMID- 6860953 TI - Role of GABA in the control of thyrotropin secretion in the rat. AB - Various doses of GABA from 0.25 to 5 mumol injected into the third ventricle decrease serum TSH rapidly. The same effect was observed with GABOB (10 mumol), the hydroxylated form of GABA. The inhibitory effect of both of these drugs was prevented by picrotoxin injection (1 microgram). Peripheral injection of GABAergic drugs such as GABOB or AOAA also decreased serum TSH. In vitro, the addition of GABA (from 6.7 . 10(-6) to 6.7 . 10(-4) M) to the incubation medium of hemi-anterior pituitary did not modify the liberation of TSH. To test the physiological role of GABA in the regulation of thyrotropin function the circadian TSH rhythm was used as a model. Both GABAergic inhibitors, picrotoxin (10 microgram/kg b.w.) as well as semicarbazide (150 mg/kg b.w.), induced an increase of the low basal nocturnal level of TSH (centered on the 02.00 h time point) without altering the diurnal peak of TSH. We conclude that GABA has an inhibitory effect on central thyrotropin control via an inhibition of TRH release from the hypothalamus and might be, at least partly, responsible for the low nocturnal levels of serum TSH observed during the circadian physiological rhythm. PMID- 6860954 TI - Action of neurotensin on spinal cord neurons in the rat. AB - Histochemical, biochemical and pharmacological data suggest that the tridecapeptide neurotensin (NT) may play a role as an intercellular messenger in the spinal cord of rats. In the present study the response of spinal cord neurons to NT was investigated employing conventional extra- and intracellular recording techniques in combination with iontophoresis or a microperfusion system which permits the control of the maximal concentration of NT reached near the neuron. Recordings were obtained from motoneurons, interneurons and from neurons in the dorsal horn receiving synaptic input from low and high threshold mechanoreceptors activated in their peripheral cutaneous receptive fields. The most commonly observed action of NT applied by either mode was an excitation after a dose dependent delay. The response was dose-dependent, repeatable and reversible. The intracellular recordings revealed that these excitatory responses were due to a depolarizing action of NT associated with an increase in input resistance, not attributable to non-linearities in the current-voltage relationship. The present data are in agreement with most previous investigations reporting excitatory actions of NT on neurons in various neuronal structures in the peripheral and central nervous system. It seems unlikely that these excitatory effects are indirect actions mediated by an inhibition of other neurons in the vicinity. PMID- 6860956 TI - Optically induced strabismus results in visual field losses in cats. AB - Kittens were reared using goggles containing a prism that simulated a convergent strabismus. A bilateral loss of 30 degrees of the contralateral monocular visual field resulted, indicating that the components of the visual pathways representing the nasal visual field are more sensitive to spatially conflicting visual inputs than the components representing the temporal field. Differences in the extent of binocular visual fields occurred, with alternating fixators demonstrating a full field and unilateral fixators demonstrating a binocular field reduction ipsilateral to the deviating eye. PMID- 6860955 TI - Studies on the release by somatic stimulation from rat and cat spinal cord of active materials which displace dihydromorphine in an opiate-binding assay. AB - Using the spinal superfusion procedure, in anesthetized rats and cats, the presence of active factors which displace dihydromorphine in brain opiate binding studies, has been observed. Separation of this activity on a Sephadex G-10 column reveals the presence of two fractions which occur before (Fraction I) and after (Fraction II) the salt peak which account for over 70% of the observed dihydromorphine-displacing activity. The ratio of activity in Fraction II/Fraction I is 33 and 21, in the resting spinal perfusates of the rat and cat, respectively. High intensity, bilateral stimulation of the sciatic nerve in cats, results in a 30- and 5.4-fold increase in the levels of Fraction I and Fraction II, respectively, over pre-stimulation levels. In rat, bilateral stimulation of the hind paws, resulted in a frequency-dependent increase in the levels of Fraction I (1.9- and 3.2-fold at 5 and 50 Hz, respectively). Dynorphin 1-13 fragment elutes at least partly in Fraction I. With regard to Fraction II, the peak co-chromatographs with hexapeptide derivatives of enkephalin. Met- and Leu enkephalin (Fraction III), elute off the column at a point where opiate receptor displacing activity is relatively small. Electrophoretic separation of Fraction I radioreceptor activity of alkaline and acid pH on agarose columns revealed two principle peaks which co-migrated with alpha-neoendorphin and dynorphin 1-13. Fraction II activity appeared primarily in a single peak which was isographic with enkephalin hexapeptides. Using radioimmunoassays, detectable levels of dynorphin and Met-enkephalin were observed and sciatic nerve stimulation resulted in significant increases. Neither column-coupled radioreceptor assays nor radioimmunoassays revealed the presence of beta-endorphin. The present experiments demonstrate the releasability by high intensity somatic stimulation of a variety of opioid peptides present in spinal terminals. Significantly, however, the majority of this activity appears to be found in fractions different from those of the pentapeptide enkephalins. PMID- 6860957 TI - Representations of the body surface in areas 3b and 1 of postcentral parietal cortex of Cebus monkeys. AB - The somatotopic organization of postcentral parietal cortex was determined with microelectrode mapping methods in a New World monkey, Cebus albifrons. As in previous studies in macaque, squirrel and owl monkeys, two separate representations of the body surface were found in regions corresponding to the architectonic fields 3b and 1. The two representations were roughly mirror-images of each other, with receptive field locations matched for recording sites along the common border. As in other monkeys, the glabrous digit tips of the hand and foot pointed rostrally in the Area 3b representation and caudally in the Area 1 representation. Both representations proceeded in parallel from the tail on the medial wall of the cerebral hemisphere to the teeth and tongue in lateral cortex along the Sylvian fissure. Compared with the other monkeys, the tail of the cebus monkey, which is prehensile, was represented in a very large region of cortex in Areas 3b and 1. Like its close relative, the squirrel monkey, the representation of the trunk and parts of the limbs were reversed in orientation in both Area 3b and Area 1 in cebus monkeys as compared to owl and macaque monkeys. The reversals of organization for some but not all parts of the representations in cebus and squirrel monkeys suggest that one line of New World monkeys acquired a unique but functionally adequate pattern of somatotopic organization for the two adjoining fields. PMID- 6860958 TI - The mode of cerebellar activation of neurons in the cat motor cortex: an intracellular HRP study. AB - Intracellular recordings and morphological identification of neurons by using intracellular HRP staining were performed in the cat motor cortex. By cerebellar stimulation, stellate cells in layers II-III, pyramidal cells in layer III and fast pyramidal tract neurons (PTNs) were activated with short latency and fast rising EPSPs, while pyramidal cells in layer II and slow PTNs showed a wide range of latency and slow rising EPSPs. This difference may be related to activation through the deep and superficial thalamocortical projections. PMID- 6860960 TI - Binding sites for the glutamate-analogue [3H]AMPA in cultured rat brainstem and spinal cord. PMID- 6860959 TI - Depression of benzodiazepine binding and diazepam potentiation of GABA-mediated inhibition after chronic exposure of spinal cord cultures to diazepam. AB - Cultures of fetal mouse spinal cord were exposed to 12.6 microM (3.6 micrograms/ml) diazepam for 7 days. After drug removal, benzodiazepine receptor binding was assayed on intact cells and intracellular recordings of diazepam effects on GABA-mediated inhibitory responses were obtained. The biochemical and electrophysiological data revealed significant and parallel reductions in both receptor binding and pharmacological action on GABA responses which did not return to control levels until 3-4 days after removal of diazepam. The results indicate that chronic exposure of spinal cord cultures to diazepam results in a reversible down-regulation of diazepam binding and function. PMID- 6860961 TI - Fasting and feeding-associated changes in cyclo(His-Pro)-like immunoreactivity in the rat brain. PMID- 6860962 TI - Antagonism of opiate-like, lanthanum-induced analgesia by naloxone, 2 mg/kg, in rats. PMID- 6860963 TI - The inactivity of brain phospholipid transfer protein toward phosphatidylinositol 4-phosphate. AB - Bovine brain phosphatidylinositol transfer protein catalyzes the transport of phosphatidylinositol and, to a lesser extent, phosphatidylcholine between model phospholipid membranes. To investigate the transport of phosphorylated phosphatidylinositol derivatives, 32P-labeled lipids were isolated from guinea pig brain, separated by chromatography on a column of neomycin-coated glass beads, and incorporated into single bilayer vesicles. Under conditions where significant transfer of phosphatidylinositol was observed, no protein-catalyzed transport of phosphatidylinositol 4-phosphate was detected. Thus, the substrate specificity of the brain phospholipid transfer protein cannot be extended to phosphatidylinositol 4-phosphate. PMID- 6860964 TI - Reinnervation of the partially deafferented hippocampus by compensatory collateral sprouting from spared cholinergic and noradrenergic afferents. AB - The cholinergic and adrenergic afferents innervating the hippocampal formation in the rat reach the target region via three distinctly separate routes, two dorsal and one ventral one. Partial deafferentation of the hippocampus obtained by destruction of the dorsal routes (through the fimbria-fornix and the supracallosal striae) resulted in removal of 90% and 60% of the cholinergic and adrenergic innervations, respectively, within one month. By 6-10 months after lesion, the remaining cholinergic and adrenergic inputs, reaching the target via the ventral route, had expanded more than two-fold, resulting in a significant recovery in the original cholinergic and adrenergic innervation patterns. Because of its slow and protracted time-course and its ability to re-establish innervation also in initially denervated areas, this compensatory collateral sprouting phenomenon may be of particular interest for the understanding of the long-term, protracted functional recovery that is seen both after experimental brain lesions as well as in patients with severe brain injuries. PMID- 6860965 TI - Functional correlates of compensatory collateral sprouting by aminergic and cholinergic afferents in the hippocampal formation. AB - Selective lesions of discrete aminergic and cholinergic afferent pathways to the hippocampal formation have been studied as an experimental model of behavioral recovery after partial hippocampal deafferentation in adult rats. The noradrenergic, serotoninergic and cholinergic afferents reach the hippocampal formation along three routes: a supracallosal pathway, a subcallosal pathway (along the fimbria-fornix), and a ventral pathway (along the ansa lenticularis and the ventral amygdaloid pathway). Bi-lateral lesion of the supracallosal pathway resulted in significant reductions in biochemical markers of the hippocampal noradrenergic, serotoninergic and cholinergic innervations. Within 6 weeks following lesion these markers were found to have recovered to levels close to normal. A more substantial deafferentation, obtained by a bilateral lesion of both dorsal pathways, resulted in a more profound initial decrease in the biochemical marker levels, and a less complete recovery in the long-term animals. Concomitant with the initial phase of deafferentation, rats with lesions of one or both of the dorsal afferent pathways exhibited an equally profound behavioral deficit in acquisition of a forced choice alternation learning task in a T-maze. However, while rats subjected to the combined supracallosal-fimbria-fornix lesion remained impaired, the ones with lesions of the supracallosal pathway alone exhibited a significant recovery of the capacity to perform the maze task. The correlation between behavioral recovery and recovery of the biochemical markers in the supracallosal pathway-lesioned group was significant for the serotoninergic innervation of the hippocampus. The present results suggest that reinnervation of the partially deafferented hippocampus through compensatory collateral sprouting is a valuable new experimental model system within which to analyze mechanisms underlying functional recovery after lesions in the CNS. PMID- 6860966 TI - Reinnervation of mechanoreceptors in the human glabrous skin following peripheral nerve repair. AB - The technique of percutaneous microneurography was used to record single unit activity from 65 reinnervated and 24 normally innervated mechanoreceptors in the glabrous skin of the human hand. The results were obtained from 20 patients and 5 control subjects. The patients had suffered complete traumatic transsection, with subsequent repair, of the median or ulnar nerves. Three types of mechanoreceptors (RA, SAI, SAII) and many unidentified units located in deep tissues were found to become reinnervated. No reinnervated PC units could be identified. Response thresholds, discharge characteristics and receptive field properties of reinnervated receptors were comparable to normal, with the exception that reinnervated SA I units had slower static discharge rates and smaller receptive fields. No evidence was found for multiple peripheral innervation by a single afferent fiber. The reinnervated mechanoreceptors were predominantly located in the palm and the proximal fingers with few in the finger tips, contrary to normal. The locations and frequency of occurrence of the different types of receptors could be correlated with the goodness of sensory recovery. It is suggested that these differences result from misguidance of regenerating fibers and from poor reinnervation, and that they account for reduced sensitivity and poor tactile discrimination in patients with peripheral nerve injuries. PMID- 6860967 TI - Estrogenic maintenance of lordotic responsiveness: requirement for hypothalamic action potentials. AB - Studies were conducted to determine the requirement for hypothalamic, sodium current-based action potentials in the performance of a stereotypic, estrogen dependent reflex, the lordosis response. Intrahypothalamic infusion of local anesthetics (50% procaine or 0.5% bupivacaine) into conscious rats had no effect on lordotic responsiveness, and, in a separate group of urethane-anesthetized rats, depressed multiunit electrical activity temporarily. Intrahypothalamic infusion of tetrodotoxin into conscious rats, however, resulted in a dose dependent, reversible decline in lordotic responsiveness. The first significant drop in lordotic responsiveness occurred 40 min after infusion; the minimum was reached 2-4 h after infusion. Recovery of lordotic responsiveness to preinfusion levels was complete by 12-24 h after infusion. Electrophysiological studies in a separate group of urethane-anesthetized rats revealed that intrahypothalamic tetrodotoxin infusion in most cases suppressed multiunit activity completely usually within 6 min, and this suppression lasted for at least several hours. These data indicate that large, prolonged decreases in electrical activity in the hypothalamus, where estrogenic action is necessary and sufficient to induce lordosis, result in a gradual, reversible decline in lordotic responsiveness. These data are consistent with a 'tonic' rather than a 'mount-by-mount' role of hypothalamic neurons in lordosis. Furthermore, since lordotic responsiveness declined only when hypothalamic electrical activity had been disrupted severely for at least 40 min, it is postulated that the neuroactive products released by lordosis-relevant, hypothalamic neurons may have a duration of action of at least several minutes. PMID- 6860969 TI - Origin of cingulate cortex cholinergic innervation in the rat. AB - The relative contribution of the n. diagonal band and thalamic nuclei to the cholinergic innervation of the cingulate cortex was examined. Lesions were placed in the n. diagonal band, anterior thalamus, and medial thalamus of rats, and changes in choline acetyltransferase in discrete regions of the cingulate cortex were determined. The n. diagonal band lesion produced a large decrease in choline acetyltransferase activity while the thalamic lesions produced no significant change in activity. PMID- 6860968 TI - Intrinsic neurons are involved in lateral hypothalamic self-stimulation. AB - The recent technique of using ibotenic acid to lesion selectively local neurons while sparing fibers of passage permitted us to answer a long-standing question: is lateral hypothalamic self-stimulation supported by fibers of passage or are the intrinsic hypothalamic neurons involved? Three groups of adult male Sprague Dawley rats were used. In a normal group, electrodes were bilaterally implanted in the lateral hypothalamus and self-stimulation (ICSS) was obtained separately with the right and left electrodes, at various current intensities, using a nose poke response. In the experimental group, the intrinsic neurons of the lateral hypothalamus were destroyed unilaterally by local injection of ibotenic acid (4 or 6 micrograms in 0.5 microliter); the other side served as the sham-lesion control. Ten days later ICSS electrodes were implanted bilaterally, one in the lesioned area, the other in the contralateral hypothalamus. As in the case of the normal animals, the rate of nose-poking (ICSS) was then determined separately for each electrode. In the normal rats, ICSS rates were the same with stimulation on either side and the increase in ICSS rate as a function of the increase in current intensity was the same on each side. In the experimental rats, ICSS of the lesioned side was decreased in all cases; moreover, after lesion with the 6 micrograms dose, ICSS was totally suppressed. Self-stimulation of the sham lesioned side was not significantly different from that observed in the normal rats. In 6 rats sampled from the lesioned groups as well as in 3 additional unimplanted animals, biochemical assays compared dopamine and serotonin contents of the two striata and noradrenaline and serotonin contents of the two hippocampi. No difference was observed for these two structures between the side ipsilateral to the lesion and the contralateral side. Moreover, none of these monoamine levels differed from those seen in the unimplanted rats. These results, taken together, suggest that intrinsic lateral hypothalamic neurons are involved in ICSS. PMID- 6860970 TI - Choline acetyltransferase activity in the nucleus tractus solitarius: regulation by the afferent vagus nerve. AB - The influence of nodose ganglionectomy or transection of the peripheral branches of the afferent vagus nerve on choline acetyltransferase (ChAT) activity in the nucleus tractus solitarius (NTS) was studied. ChAT activity was reduced in the microdissected caudal and intermediate portions of the NTS in vagotomized as well as ganglionectomized rats. However, only the ganglionectomy resulted in the degeneration of medullary nerve fibers. These results suggest that the changes in ChAT activity in the NTS are independent of neuronal degeneration and may be due to transynaptic modulation of ChAT activity by afferent vagal impulses. The presence of ChAT in the sensory nodose projection to the NTS, however, cannot be ruled out. PMID- 6860971 TI - Effects of electrical stimulation on acetylcholine synthesis in cat caudate nucleus. AB - The concentration of endogenous- and deuterium-labeled acetylcholine (ACh) in the cat caudate nucleus was determined after stimulation of either the substantia nigra or the precruciate cortex. In this procedure the caudate nucleus is exposed surgically, and a coring device is used to obtain biopsy specimens which are immediately frozen in liquid nitrogen. Samples are collected at rest, 5 min after stimulation, and again 5 min after a resting period. An infusion of 2H9-choline is maintained during these manipulations to provide a label for ACh synthesis. Electrical stimulation of the substantia nigra, which increases the release of dopamine, produced a decrease in endogenous ACh and the newly synthesized deuterium-labeled ACh. Stimulation of the precruciate cortex produced no significant effect on the levels or synthesis of ACh, but attenuated the effect of subsequent nigral stimulation. These preliminary results indicate that stimulation of the substantia nigra has a net excitatory effect on ACh synthesis in the caudate. This stimulation apparently is modulated by input from the cortex. PMID- 6860974 TI - Effects of noradrenaline applied iontophoretically on rat superior collicular neurons. AB - In rats anesthetized with urethane effects of iontophoretically applied noradrenaline (ejection currents, less than 20 nA) were examined on spontaneous and/or photically evoked discharges of neurons in the superior colliculus (SC). In a given SC neuron NA acted either to facilitate or to inhibit both spontaneous and evoked discharges. Though the inhibition was more frequently observed than the facilitation in all layers of the SC, the ratio of the facilitated neurons to the inhibited ones increased as one advanced through the SC from superficial to deep. These findings are in line with those obtained when SC neurons were subject to repetitive electrical stimulation of the locus coeruleus. PMID- 6860972 TI - Gastric mucosal damage induced by lateral hypothalamic lesions in rats: the potential contribution of bile. AB - The present study was conducted to investigate the potential contribution of bile to gastric mucosal damage induced by lesions of the lateral hypothalamic area in rats. In two separate experiments it was found that (1) lateral hypothalamic lesions did not alter the rate of bile flow in the acute preparation, but (2) bile duct ligation significantly reduced the incidence of gastric mucosal damage. Based on these and previous findings it is suggested that the reflux of bile interacts with the weakened gastric mucosal barrier to elicit ulceration. PMID- 6860973 TI - Effects of 5,7-dihydroxytryptamine on HRP retrograde transport from hippocampus to midbrain raphe nuclei in the rat. AB - The combination of horseradish peroxidase (HRP) retrograde tracing and specific lesioning using 5,7-dihydroxytryptamine (5,7-DHT) was applied to the midbrain raphe-hippocampal system. Serotonergic fibers from the median raphe nucleus (MRN) of the rat reach the dorsal hippocampus (HIPP) through the cingulum bundle (CB) and the fornix-fimbria (FF). Intracerebral microinjections of 5,7-DHT in these two bundles were made at various times before HRP injections into the dorsal HIPP. After both CB and FF lesion, the number of labeled cells in MRN is reduced to 49.6% at zero time (HRP injected immediately after 5,7-DHT) and to 6.5% after 2 days. There was no significant effect on the number of labeled cells in the locus ceruleus. Selective lesioning of 5-HT fibers in the CB or the FF revealed that raphe-CB-HIPP neurons and raphe-FF-HIPP neurons have a similar distribution pattern in the MRN, but that a dorsal group of neurons at the junction of MRN and dorsal raphe nucleus took the CB route exclusively to innervate the HIPP. The CB pathway was used by more neurons (55% of total number of labeled neurons) than was the FF (21%). An appreciable number of fibers (23%) appear to have branches in both pathways. Our findings are discussed with regard to the recovery of HIPP function seen after long term destruction of 5-HT fibers in the CB. PMID- 6860975 TI - Action of estrogen and mechanical vaginocervical stimulation on the membrane excitability of hypothalamic and midbrain neurons. AB - The effect of vaginocervical stimulation (VCS) and estrogen iontophoresis on the electrical activity recorded in urethane-anesthetized female rats from medial preoptic-septal (MPO-S) and midbrain central gray (MCG) neurons was studied during two phases of the estrous cycle, namely metestrus (M) and late proestrus estrus (LP-E). The spontaneous discharge rate of both MPO-S and MCG neurons varied over the two stages of the estrous cycle. The spontaneous electrical activity of the MPO-S neurons was higher during M than during LP-E whereas MCG unit activity was low during M and higher during LP-E. The VCS-evoked changes in unit activity were specific, in that they were observed in response to mechanical genital stimulation and not in response to painful stimuli and/or nonspecific arousal. These responses were not dependent on the stage of estrous cycle. Finally, the iontophoresis of 17 beta-estradiol hemisuccinate evoked electrophysiological responses from MPO-S and MCG neurons. More MPO-S neurons were responsive to estrogen in LP-E than in M, while fewer MCG neurons were responsive to estrogen in LP-E than in M. The results clearly show that ongoing electrical activity of hypothalamic and midbrain nerve cells can fluctuate between M and LP-E phases of the estrous cycle and change with vaginocervical probing as well as iontophoretically applied estrogen. Furthermore, the results suggest the existence of a reciprocal relationship between the membrane activity of MPO-S and MCG neurons which may be related CNS control of reproductive activities. PMID- 6860976 TI - Cytoarchitecture of the nucleus of the lateral olfactory tract: a Golgi study in the rat. AB - Examination of Golgi-impregnated rat brains reveals that three main cell types can be distinguished in the nucleus of the lateral olfactory tract (NLOT). Class A neurons, by far the predominant cell type seen in NLOT, are spiny projection neurons that differ in form and orientation in each of the three layers of the nucleus. In layer I, the superficial plexiform layer, and in layer III, the deepest layer of NLOT, most class A neurons have a stellate or semi-pyramidal shape. In layer II, the intermediate layer of NLOT, class A neurons are pyramidal cells that have one or two apical dendrites that extend ventrally through layers II and I, and numerous basal dendrites which arborize in the vicinity of the cell. Axons of class A neurons in layers II and III are directed towards the commissural bundle of the stria terminalis and emit collaterals that appear to arborize in the layer of origin. Class B neurons are spine-sparse stellate cells that are found in all three layers of NLOT. Their axons, when well-impregnated, are seen to form dense local arborizations in the vicinity of the cell. Class C neurons, which have been observed only in layer III, are small neurogliaform cells with numerous, short, varicose dendrites that branch profusely. Axons branch several times in the vicinity of the cell. PMID- 6860977 TI - Nucleus accumbens inhibits specific motor but not nonspecific classically conditioned responses. AB - A classical leg flexion conditioning paradigm was used to elicit specific motor responses, as well as nonspecific responses requiring less involvement of the motor system, in cats. Stimulating and lesioning the nucleus accumbens differentially affected these two types of responses. The specific conditioned responses, leg flexion and vocalization, were suppressed by stimulation and enhanced by lesions of the nucleus accumbens. The nonspecific responses, changes in respiration rate and amplitude, and in heart rate, were affected inconsistently or not at all. This suggests a role for the nucleus accumbens in the inhibition of motor components of learned emotional responses, and is consistent with hypotheses holding that the nucleus accumbens gates the access of the limbic system to motor systems. PMID- 6860978 TI - Prolactin increases the activity of tuberoinfundibular and nigroneostriatal dopamine neurons: prolactin antiserum inhibits the haloperidol-induced increases in dopamine synthesis rates in median eminence and striatum of rats. AB - The role of PRL in mediating the haloperidol-induced increase in tuberoinfundibular dopamine synthesis rate was assessed by studying the effects of administration of PRL antiserum. Antiserum to PRL generated in rabbits and not cross-reacting with other anterior pituitary hormones was administered IV to adult, male rats which received haloperidol 2.5 mg/kg or tartaric acid vehicle SC 22 hr and 12 hr before measurement of dopamine turnover. Comparable groups of haloperidol or vehicle-treated animals received normal rabbit serum as control. Dopamine synthesis or turnover rate was estimated by measurement of accumulation of L-dihydroxyphenylalanine following inhibition of L-aromatic amino acid decarboxylase with m-hydroxybenzylhydrazine. Haloperidol increased median eminence dopamine synthesis rate, and PRL antiserum completely prevented this effect, supporting the thesis that the haloperidol-induced increase in tuberoinfundibular dopamine turnover is mediated by PRL. PRL antiserum did not alter basal median eminence dopamine synthesis rate in male rats. In addition to its effect in median eminence, PRL antiserum blunted the haloperidol-induced increase in striatal dopamine synthesis rate, suggesting that the haloperidol induced increase in nigroneostriatal dopamine turnover is mediated in part by PRL. Neither haloperidol nor PRL antiserum altered serotonin synthesis rate in mediobasal hypothalamus or striatum. The data provide further support for a mechanism by which PRL can regulate its own secretion. They also suggest that prolactin alters the activity not only of tuberoinfundibular but also of nigroneostriatal neurons. PMID- 6860980 TI - Ultrastructure of HRP-labelled neurons: a comparison of two sensitive techniques. AB - Rat sciatic nerves were transected and placed in a solution of HRP. Following perfusion, L4-6 spinal segments and sensory ganglia were cut into 60 micron sections. Alternate sections were processed with the glucose oxidase (GOD) or the benzidine dihydrochloride (BDHC) procedure. Sections were then either mounted on glass slides for light microscopic (LM) examination or embedded in epoxy resin for sequential light and electron microscopic (EM) analysis. At the LM level, GOD reaction product was granular and confined to the soma and proximal dendrites of motoneurons, while BDHC reacted tissue was characterized by a diffuse labelling of the cytoplasm, extending as far as tertiary dendrites. At the EM level, neurons in tissue processed with the GOD technique contained lysosomal and vesiculotubular elements that were extremely electron dense. Label in BDHC reacted tissue appeared as dense patches of reaction product dispersed throughout the cytoplasm. Possible reasons for the qualitative differences in the reaction product provided by the two techniques as well as suggested applications of the techniques are discussed. PMID- 6860981 TI - Circadian pineal modulation of pituitary effect on murine corticosterone in vitro. AB - An old controversy is resolved as a novel effect: In a rhythmic fashion, aqueous pineal homogenate (APH) enhances, attenuates or leaves unaffected the production of corticosterone by mouse adrenals incubated with pituitary media. All glands stem from the same circadian stage in these (isophasic) studies on 72 female CD2F1 mice, standardized for two weeks in L 0600-1800 and D 1800-0600. Every 4 hours during a 24-hour span, 12 mice were killed. Pineals were removed for the preparation of APH and stored at 4 degrees C. Hypothalami, pituitaries and adrenals were removed, bisected and placed in wells containing 1 ml Krebs-Ringer buffer (K), at 4 degrees C, until incubation. At each circadian stage, bisected adrenals were incubated with 95% O2 and 5% CO2 at 37 +/- 1 degree C for 5 hours, with K only or with the addition of 0.05 IU ACTH 1-17 or APH or with isophasic pituitary or hypothalamic preincubation media with and without APH or muscle. Media were stored at -20 degrees C until corticosterone RIA. A circadian rhythm (p less than 0.05) characterized corticosterone production after stimulation by the pituitary alone or with APH. The overall modulatory effect of APH is an increased circadian amplitude of adrenal corticosterone production, in response to the isophasic pituitary. PMID- 6860979 TI - Neuropathological studies of experimental toxocariasis in lead exposed mice. AB - Binghamton Heterogeneous stock mice intubated with embryonated eggs from the common parasite of dogs, Toxocara canis, display dramatic alterations in behavior. Many of these behavioral changes are markedly attenuated if mice are maintained also on a drinking solution containing lead acetate. The data presented here, however, show that the extensive neural degeneration of the CNS occurs after T. canis infection and that the nature and extent of this degeneration is similar, regardless of whether mice had been administered parasites alone or in combination with lead. Thus the neuropathological data reported in detail here cannot account for the striking interactive influence of T. canis and lead on behavior. PMID- 6860982 TI - Model studies for brain dialysis. AB - A dialysis cannula suitable for perfusing deep brain structures in animals is described and characterized in a series of model experiments. The effects of flow rate, concentration, variations in cannula construction, barriers to diffusion and pumping technique on the recovery of tryptophan from aqueous solutions at 37 degrees C were examined. The 200 micron diameter dialysis cannula gave good recoveries which varied from about 8% at 6 microliter/min to almost 90% at 0.15 microliter/min. Prepurification of the extracellular fluid by dialysis allows the sample loop of a high performance liquid chromatograph to be incorporated in the outflow line of the cannula for direct injection of dialysates. PMID- 6860983 TI - A dual moveable stimulating electrode and its application to the behavioral version of the collision test. AB - The construction and testing of a dual moveable electrode for chronic stimulation in small mammals are described. The assembly is lightweight (0.9 g), its components are completely re-usable, and the two electrodes may be independently advanced in steps as small as 80 microns over a maximum vertical excursion of 6 mm. The unit performed as well as fixed electrodes do in daily behavioral tests conducted over a 3 month period. Ipsiversive rotation was elicited by stimulation of 15 pontine-mesencephalic sites in a single rat. Behavioral evidence for the collision of heterodromic action potentials in circling-relevant fibers was obtained in 4 position sets. PMID- 6860984 TI - [Circadian rhythm of gastric mucosa enzymes in man]. PMID- 6860985 TI - [Study of the mechanical properties of the dentoalveolar articulation (articulatio dentoalveolaris)]. PMID- 6860986 TI - [Glycosylation of hemoglobin in rats]. PMID- 6860987 TI - [Hemodynamic changes after smoking in humans]. PMID- 6860988 TI - [Changes in the clinical condition and pulmonary function in patients with chronic bronchitis after 10 years]. PMID- 6860989 TI - [Theoretical study of the hippuran nephrogram]. PMID- 6860993 TI - [What is new in the etiopathogenesis, diagnosis, therapy and prognosis of chronic active hepatitis? (In the context of a study trip to the USA)]. PMID- 6860991 TI - [Use of physiologic pressure in postoperative cholegraphy]. PMID- 6860992 TI - [Muscle afferents mediating cardiovascular and respiratory responses to work]. PMID- 6860990 TI - [Hexabrix - a new contrast medium in angiology]. PMID- 6860996 TI - Potent vasoconstriction of the isolated perfused rat kidney by leukotrienes C4 and D4. AB - Chemically synthesized leukotriene C4, D4, and E4 have been compared for their effects on the isolated Krebs-perfused rat kidney, rat stomach strip, and guinea pig ileum. C4 was more potent than D4 or E4 at all concentrations tested in contracting the rat stomach strip and in constricting the isolated rat kidney, while D4 was more potent than C4 or E4 in contracting the guinea pig ileum. While the effect of leukotrienes on the isolated kidney was blocked dose dependantly by FPL 55712, a blocker of leukotriene action, it was not blocked by the presence of either indomethacin, a cyclooxygenase blocker, or OKY-1581, a blocker of thromboxane synthesis. These results indicate that leukotriene action in the kidney is of a direct nature and is not mediated via activation of the prostaglandin pathway, especially thromboxane A2 synthesis. PMID- 6860995 TI - Drug-induced changes in fetal breathing activity and sleep state. AB - Drugs reported to stimulate fetal breathing (FB) were injected into a femoral vein of near-term fetal lambs during rapid eye movement (REM) and non-REM (NREM) sleep. The primary response to NaCN, 0.25-0.5 mg, a dose which did not flatten the electrocorticogram, was a brief burst of gasping in any sleep state. When injected during REM sleep, NaCN caused the cessation of spontaneous FB and the onset of gasping. Stimulation of FB was observed infrequently. Caffeine (10 mg) and doxapram (3 mg) frequently caused an immediate change in sleep state or arousal. The incidence of FB increased concomitantly with a change to REM sleep or wakefulness (W), but FB still ceased with the onset of NREM sleep. When administered during an episode of spontaneous FB during REM sleep, both caffeine and doxapram caused stimulation of the frequency and depth of breathing. Pilocarpine (4 mg) caused arousal and gasping followed by prolonged vigorous breathing that was dependent on intact carotid sinus nerves. Indomethacin (120 mg over several hours) did not affect sleep states but induced FB in both NREM and REM sleep. In summary, in the fetus the primary effect of NaCN is to suppress spontaneous FB and induce gasping and the effects of pilocarpine, caffeine, and doxapram are intimately related to sleep states or arousal. Indomethacin causes the conversion from episodic fetal to continuous postnatal-type breathing. These data indicate the importance of assessing fetal state of consciousness in interpreting the respiratory response to drugs. PMID- 6860994 TI - Acute effects of amiodarone in the isolated dog heart. AB - Direct injection of amiodarone (10-1000 micrograms) into the sinus node artery of the isolated blood-perfused dog atrium produced dose-dependent negative inotropic and chronotropic responses that were unaffected by atropine. Intraarterial amiodarone also had a negative inotropic action on isolated left ventricular muscle preparations electrically paced at 1.5 to 2.0 Hz. A continuous infusion of 100 micrograms/min of amiodarone significantly suppressed the positive chronotropic effect of norepinephrine whether expressed in percent change or in absolute values; its positive inotropic effect expressed in percent change was not suppressed but rather enhanced by amiodarone. Calcium chloride induced positive chronotropic and inotropic effects expressed in percent change were, respectively, slightly suppressed and enhanced by amiodarone. Intravenous injection of amiodarone (5 mg/kg) decreased the heart rate and blood pressure of the support dog and produced a negative inotropic response in the isolated left ventricular muscle preparation perfused with arterial blood from the support dog. These results suggest first, that amiodarone has direct negative inotropic and chronotropic effects that are not mediated by cholinergic mechanisms and second, that it has a depressive action on norepinephrine and calcium-induced positive chronotropic effects and an enhancing action on their positive inotropic effects. PMID- 6860997 TI - Periodicities in respiration and heart rate in newborns. AB - Periodic breathing is common in normal infants, but may be associated with prolonged apnea leading to crib death. The mechanisms of periodic breathing and its relation to normal breathing patterns are unclear. We recorded respiratory and heart rate (HR) patterns of 11 healthy newborn infants during quiet sleep, in both normal and periodic breathing. Spectral analysis of the respiratory pattern revealed a low-frequency (LF) periodicity in normal breathing approximately equal to the frequency of periodic breathing when this occurs. Periodic breathing thus appears to be an exaggeration of an underlying slow amplitude variation which is present in regular breathing. LF periodicity also appeared in the HR pattern in both normal and periodic breathing, suggesting an LF modulation of cardiovascular control as well. The lack of a definite phase relation between HR and ventilation at LF may indicate dominant peripheral, rather than central, interactions between HR and respiration at these frequencies. PMID- 6860998 TI - Failure of delta-aminolaevulinic acid and porphobilinogen to alter renal salt and water excretion in the dog. AB - We tested the hypothesis that the hyponatremia commonly observed in patients with acute hepatic porphyria is mediated by the presence of aminolaevulinic acid (ALA) and (or) porphobilinogen (PBG) at the level of the renal tubule to alter water handling, or at the level of the nervous system to release antidiuretic hormone (ADH). When these substances were infused intravenously into hydropenic dogs, there was no effect on systemic hemodynamics or renal function. Neither ALA or PBG, when infused directly into the renal circulation of water-loaded dogs, could effect a decrease in urinary flow, osmolar clearance, or renal perfusion. Similar results were obtained when these substances were infused directly into the renal circulation of hydropenic dogs. When ALA was administered directly into the carotid artery of nine water-loaded dogs and eight hydropenic dogs, there was again no effect on systemic hemodynamics or renal function. These data suggest that ALA (and PBG) have no effect on the renal excretion of sodium or water, and ALA does not cause the release of ADH. The hyponatremia of porphyria may be related to factors other than the elevated plasma levels of ALA and PBG. PMID- 6860999 TI - Monosaccharide transport and hexokinase activity in leg muscles from cardiomyopathic hamsters. AB - The facilitated diffusion system for monosaccharides was studied with nonmetabolized 3-O-methyl-D-glucose (3-O-MG) and hexokinase activity was determined with 2-deoxyglucose (2-DG) in extensor digitorum longus (EDL) and soleus muscles from BIO 14.6 (dystrophic) hamsters. Motor activity was recorded at 2 months of age. F1B (normal) hamsters were controls. In EDL (fast-twitch) muscle, sugar transport was unaltered at 6 weeks; at 2 to 5 months the normal decrease in sugar transport with time was reduced, decreasing stimulation of the facilitated diffusion system by anoxia. Phosphorylation in EDL muscles, measured at 2 months, probably was decreased. In soleus (slow-twitch) muscle, 3-O-MG transport was unaltered with age but hexokinase activity, determined at 2 months, was greatly increased in the quiescent state and during stimulation at 2 Hz. Motor activity was less, but not significantly, in the dystrophic hamsters. The results indicate that the alterations in glucose metabolism depend upon both muscle type and age. We interpret the changes in dystrophic fast- and slow-twitch muscles as reflecting compensatory mechanisms to increase the generation of energy. PMID- 6861000 TI - The acute hypocalcaemic effect of ethanol and its mechanism of action in the rat. AB - The hypocalcaemic action of ethanol (3 g/kg body weight) was investigated in intact, thyroparathyroidectomized and antrectomized rats. It was found that ethanol administered either intraperitoneally or orally reduced plasma calcium concentrations within 30 min and that this response lasted for 8 h. Additional studies performed in antrectomized and thyroparathyroidectomized rats indicated that neither gastrin nor the hormones parathormone and calcitonin had any effect on the hypocalcaemic effect of ethanol. Investigation of the mechanism of action of ethanol-induced hypocalcaemia involved measurements of calcium efflux from and influx into the plasma pool. Ethanol did not have any effect on the disappearance from plasma of 45Ca administered intravenously at 0 min. In contrast, ethanol was found to enhance the disappearance of 45Ca administered intraperitoneally 17 h prior to the experiment. The interpretation of 45Ca studies was discussed and it was concluded that ethanol-induced hypocalcaemia resulted from a decrease in calcium influx into the plasma. Additional in vitro studies did not indicate the suppressive action of ethanol on the release of calcium from tibias. In conclusion, our results show that the mechanism of hypocalcaemia caused by ethanol is the suppression of calcium release from some tissue(s) into the plasma. PMID- 6861002 TI - The fate of orally administered [4-14C]phenytoin in two healthy male volunteers. AB - A recovery study was conducted to determine whether phenytoin (DPH), like the barbiturates, is metabolized via the recently discovered N-glucosidation pathway. Virtually 100% of the ingested 14C-labelled doses in two subjects could be accounted for in the excreta within 5 days, with 35% in feces and 65% in urine. Radioactivity in the urine was entirely due to free and conjugated 5-(4-hydroxy phenyl)-5-phenylhydantoin (p-HPPH) and the dihydrodiol, and that in the feces mostly due to the unmetabolized drug. There was no indication of phenytoin N glucoside being excreted in either the urine or feces of either subject, although one of the subjects was known to possess a particularly strong N-glucosidation capacity for barbiturates. The other subject was a poor metabolizer of debrisoquine and sparteine. Nevertheless, the DPH disappearance from serum and the DPH metabolite excretion in urine were virtually alike in these two subjects, indicating that the debrisoquine 4-hydroxylating and DPH hydroxylating capacities may be separable entities. PMID- 6861001 TI - Effects of mixed-function oxidase inducers and inhibitors on cytochrome P-450 content, gel electrophoresis profiles, and 3-methylindole-induced lung toxicity in goats. AB - Effects of mixed-function oxidase inducers and inhibitors on cytochrome P-450 content, gel electrophoresis profiles, and 3-methylindole-induced lung injury were studied in goats. In the first experiment, goats were pretreated with phenobarbital (PB), 3-methylindole (3MI), 3-methylcholanthrene (3MC), or SKF 525 A. Liver, lung, and kidney microsomes were used for cytochrome P-450 and gel electrophoresis studies. Although pulmonary cytochrome P-450 was not affected by any of the pretreatments, hepatic cytochrome P-450 significantly increased (P less than 0.05) after PB and 3MC pretreatment. All pretreatment resulted in changes in liver gel profiles in the 43,000 to 68,000 molecular weight region, but only PB and 3MI pretreatment altered gel profiles in the lung. In the second experiment, pretreated goats were infused with 3MI. The relative severity of lung injury in these animals, based on clinical signs, lung lesions, lung weight, and mean survival time was as follows: SKF 525-A pretreated group greater than PB pretreated group = unpretreated group greater than 3MI-pretreated group greater than or equal to 3MC-pretreated group. The results indicate that changes in 3MI induced lung injury are accompanied by changes in gel profiles in the molecular weight region of 43,000 to 68,000. PMID- 6861003 TI - Changes in cerebrospinal fluid and plasma vasopressin in the febrile sheep. AB - Plasma and cerebrospinal fluid (CSF) concentrations of vasopressin (AVP) were measured in conscious sheep during fever induced by iv endotoxin. Body temperature and blood pressure were also measured. AVP concentrations increased in both CSF and plasma although increases were not parallel. AVP concentrations in CSF were significantly correlated to increases in body temperature whereas plasma AVP concentrations were not. Neither CSF nor plasma AVP concentrations were correlated with changes in blood pressure. These data indicate that there may be independent regulation of AVP release into plasma and CSF compartments and supports the idea that AVP may have several physiological functions to perform during fever. PMID- 6861004 TI - Specificity of hepatic aldehyde dehydrogenase inhibition by calcium carbimide (calcium cyanamide) in the rat. AB - Acute, oral administration of 7.0 mg/kg calcium carbimide (calcium cyanamide) to rats, 2 h before sacrifice, produced complete inhibition of hepatic, low-Km (less than 1 microM acetaldehyde) mitochondrial and cytosolic aldehyde dehydrogenase enzymes and significantly inhibited high-Km (approximately 1 mM acetaldehyde) mitochondrial, cytosolic, and microsomal aldehyde dehydrogenase isozymes. Calcium carbimide had no effect on several other hepatic enzyme activities including mitochondrial glutamate dehydrogenase and monoamine oxidase, cytosolic alcohol dehydrogenase, microsomal NADPH-cytochrome c reductase, benzo[a]pyrene hydroxylase and aminopyrine N-demethylase activities, and microsomal cytochrome P 450 content. It is concluded that calcium carbimide is a more specific inhibitor of hepatic aldehyde dehydrogenase enzymes than disulfiram. PMID- 6861005 TI - The effects of "dead space" and urine flow changes on measurements of glomerular filtration rate by clearance methods. PMID- 6861007 TI - The murine ependymoblastoma: growth pattern and survival in C57Bl/6J mice. AB - The murine ependymoblastoma is a transplantable tumor of cerebral origin. The growth pattern and survival times of the murine ependymoblastoma implanted peripherally and intracranially in non nude C57Bl/6J mice have been found to be predictable and consistent when examined by means of Tumor Cell Dose Assessment (end point solution), Tumor Growth and Survival Assessment. The results suggest that a greater tumor cell dose is required to generate peripheral tumor take than brain tumor take. This difference may result from a greater immunologic response to tumor implanted peripherally than into the immunologically privileged brain. PMID- 6861009 TI - Neurology and neurosurgery in Nepal. PMID- 6861008 TI - Sensorineural deafness in early acquired syphilis. AB - A 36 year old male developed bilateral sensorineural deafness as the chief manifestation of secondary syphilis. Cerebrospinal fluid showed pleocytosis. Treatment with penicillin and prednisone resulted in good recovery of hearing. Initial recovery seemed dependent on corticosteroids. Deafness can complicate acquired syphilis in both early and late stages of the disease and may be its sole manifestation. Early acquired syphilitic deafness is usually the result of a meningitis affecting the eighth nerve and responds well to treatment. These features are contrasted with those of late acquired syphilitic deafness. PMID- 6861006 TI - Life effects of narcolepsy: relationships to geographic origin (North American, Asian or European) and to other patient and illness variables. AB - A recent questionnaire survey of the life-effects of narcolepsy in 180 patients, 60 each from North American, Asian and European populations, compared to similarly distributed age and sex matched controls, documented multiple and marked effects on work, education, driving, accidents, recreation, personality, memory and other parameters. The data have now been further analysed according to the patients' geographic (culturo-genetic) origin and to a number of other patient and illness variables. The three different geographic populations showed few significant differences for the some 160 life-effects items in the questionnaire. This strongly indicates that these are an integral part of the disease or of the human reactions to it. Most of the few significant population differences appeared cultural in origin (e.g., concerning driving records, personality changes), although a few may possibly reflect genetic differences (e.g., visual problems). Analysis of the pooled data according to respondees' age, sex, age at illness onset, duration of illness and treatment led again to relatively few significant findings. It is concluded that, in general, once the disease has been diagnosed, all the major life effects are present and remain so. The results strongly support the contention that most life-effects are not related to the diagnostic 'tetrad' symptoms themselves but rather to excessive daytime sleepiness, the symptoms most resistant to ant-narcoleptic treatment. PMID- 6861012 TI - Optic neuritis and multiple sclerosis. PMID- 6861010 TI - Rhabdomyosarcoma of the head and neck in children. PMID- 6861011 TI - Hemispherectomy for seizures revisited. AB - The serious, late complication of superficial cerebral hemosiderosis, which appears after several years in 1/4-1/3 of patients who have undergone hemispherectomy, has resulted in recent years in a considerable reluctance to carry out this operation despite the fact it has proved to be highly effective in patients with medically refractory seizures associated with hemiplegia. Preservation of a small portion of the hemisphere, usually the frontal or occipital pole, has proved to be effective in preventing this late complication, but at the cost of a significant reduction in the effectiveness of the operation in reducing the patients' seizure tendency. Preserving the frontal and occipital poles but disconnecting them from the rest of the brain, resulting in a functional complete but anatomical subtotal hemispherectomy, retains the therapeutic effectiveness of a complete hemispherectomy while still protecting adequately against the serious late postoperative complication of superficial cerebral hemosiderosis and its associated neurologic deterioration, hydrocephalus and sometimes death. PMID- 6861013 TI - Bromocriptine in the long-term management of advanced Parkinson's disease. AB - Thirty-seven patients with advanced Parkinson's disease who initially tolerated, and responded to bromocriptine therapy were followed for 12 to 50 (mean 28) months. Using a method of gradual increase of bromocriptine, with concomitant levodopa reduction, the peak effect of the drug was apparent by three months, at which time the mean daily dose of bromocriptine was 23.9 mg and Sinemet (levodopa + carbidopa) had been reduced by 34 percent. Eight patients had sustained improvement without further drug changes for an average of 29 (range 14-50) months. After periods of improvement varying between 3 and 30 months, 29 patients had a fall-off from peak effect. Peak effect was regained in 21 of these 29 patients for an average of 16 additional months by initially increasing bromocriptine or Sinemet, or by eventually increasing both drugs. The main adverse effect was a confusional state which necessitated late withdrawal of bromocriptine in four patients. The best results were in younger patients with end-of-dose deterioration and levodopa induced dyskinesias. With cautious introduction, and intermittent dosage adjustment, bromocriptine can be of long term benefit to patients with advance Parkinson's disease. The majority of patients have a gradual late fall-off in effect which can frequently be reversed with dosage adjustment. PMID- 6861014 TI - Epilepsy from cerebral arteriovenous malformations. AB - Twenty-seven patients with epilepsy as the only manifestation of a cerebral AVM were seen at the MNI/MNH from 1973 to 1981. The nine females and eighteen males between the ages of fourteen and fifty-four years (mean 25.2 years) had epilepsy for an average of 3.5 years prior to the diagnosis of AVM. Seven patients had primarily generalized seizures, ten patients had partial seizures with complex symptoms, fourteen patients had partial seizures with elementary symptoms, and thirteen patients had secondarily generalized seizures. Although there was no history of intracranial hemorrhage, seven patients had negative hemispheric signs (hemiatrophy, hemianopia, dysphasia, hemiparesis), two had impaired mentation, and two were ataxic. The EEG, normal in ten cases,showed non-epileptiform activity in six cases, and focal epileptiform activity in eleven cases. Angiographic and/or histological examination revealed eight small (less than 2 cm in diameter) and nineteen large lesions. Fifteen AVMs involved the frontal lobe, ten the temporal lobe five the parietal lobe, and one the occipital lobe. Angiography failed to demonstrate three frontal and three temporal AVMs. Plain CT scanning demonstrated a high or low density lesion without a mass effect in sixteen cases, enlargement of the ipsilateral ventricle or Sylvian fissure in seven cases, and diffuse ventricular enlargement in three cases. CT scanning was performed after the intravenous injection of contrast material in nineteen cases and demonstrated vascular enhancement in fifteen cases and an abnormal blood vessel in six cases. Two angiographically occult AVMs demonstrated vascular enhancement with infusion CT scanning, thereby demonstrating the vascular nature of the lesion where angiography had failed to do so. PMID- 6861015 TI - Perforated peptic ulcer. PMID- 6861016 TI - Controversy in the surgical management of melanoma. PMID- 6861017 TI - Treatment for localized carcinoma of the prostate. PMID- 6861018 TI - A modified technique for long-term transverse colostomy. PMID- 6861020 TI - Surgical management of malignant melanoma. PMID- 6861019 TI - Actinomyces and the IUD. PMID- 6861021 TI - Embolization of arteriovenous fistulas and aneurysms with detachable balloons. AB - The authors describe their technique of embolization, using detachable balloons to produce endovascular occlusion in three patients with multiple pulmonary arteriovenous fistulas and in one patient with a large peripheral aneurysm. The results were satisfactory. The clinical presentation and treatment course in each of the four patients are described and the role of this form of therapy is discussed. This method of endovascular occlusion is particularly appropriate for treating pulmonary arteriovenous fistulas and aneurysms because placement of the balloon is precise, permanent and localized and the flow of the balloon in the fistula or aneurysm can be directed. PMID- 6861022 TI - Effect of femoral profundaplasty on blood flow. AB - The effect of femoral profundaplasty on blood flow in the lower limb was examined. In 15 patients with signs and symptoms of femoropopliteal artery occlusion, the following measurements were made before and after profundaplasty with vein-patch graft: ankle pressure index, muscle blood flow at rest and with maximal exercise (xenon clearance technique), and blood flow in the calf and in the great toe (venous occlusion plethysmography). No significant change was found in resting muscle blood flow, or in the results of calf or toe plethysmography. Muscle blood flow was significantly (p less than 0.01) increased 1 minute after maximal ischemic exercise (6.3 +/- 2.0 ml/100 g X min-1 before operation and 10.4 +/- 3.9 after) and the time to reach peak muscle blood flow after tourniquet release was significantly reduced (p less than 0.01) after operation, from 149 +/ 52 to 102 +/- 46 seconds. Ankle pressure index was unchanged by profundaplasty (0.63 +/- 0.17). All of the six patients with claudication were subjectively improved, and in seven of the nine patients with foot ischemia the limb was saved. The changes in blood flow help to explain the clinical improvement noted after profundaplasty. PMID- 6861023 TI - Graft infections in aortoiliac arterial reconstructions. AB - Twenty-four patients with 25 infected prosthetic grafts have been treated at the Health Sciences Centre in Winnipeg over the past 20 years. Nineteen primary operations were done for aortoiliac occlusive disease and 6 for abdominal aortic aneurysms. The patients presented from 2 weeks to 9 years after the first operation. In 16 of the graft infections there was a groin abscess, a draining sinus or a false aneurysm. The commonest method of treatment was excision of the entire graft with immediate extra-anatomic arterial reconstruction. Six patients died. Early diagnosis and aggressive surgical treatment are emphasized. PMID- 6861024 TI - Why remove an infected aortofemoral graft? AB - The radical treatment of infected vascular grafts is a major procedure with a high mortality and loss of limb. The authors review their experience with 13 consecutive cases of infected aortofemoral grafts treated conservatively during an 11-year period. The treatment consisted of wide incision and drainage of the infected area followed by assiduous irrigation with an antiseptic or antibiotic solution. In 10 patients the inguinal wound healed and the prosthesis was reincorporated; 8 of the 10 had a patent prosthesis and the treatment was considered successful, while 2 needed further surgery. Three patients died of hemorrhage or sepsis. Follow-up ranged from 8 to 144 months (mean 77 months). Two patients had a false aneurysm 3 and 7 years after wound healing. The results compare favourably with those of radical treatment. The authors believe a conservative approach must always be tried as the first step in the management of infected vascular prostheses. The gratifying results observed in their series, in both the short and long term, support this conservative approach, which is a satisfying alternative to radical operations with their high mortality and morbidity. PMID- 6861025 TI - Extra-anatomic bypass grafting in the lower extremity. AB - Between January 1975 and December 1980, 104 extra-anatomic bypasses were performed on 102 patients. Of these, there were 81 femorofemoral bypasses on 80 patients and 23 axillofemoral bypasses on 22 patients. Those who underwent femorofemoral grafting were divided into three groups: group 1 - 18 patients who had undergone previous aortofemoral bypass grafting with occlusion of one limb of the graft, group 2 - 17 patients who were considered to be at high risk and group 3 - 45 patients who could have tolerated a conventional reconstructive procedure. Our results indicate that the cumulative patency rate of the femorofemoral bypass at the end of 1 year and 5 years is good and that this operation is an excellent first choice procedure in cases of unilateral iliac disease, to relieve severe ischemia or disabling claudication, whether the patient is a poor or good operative risk. On the other hand, axillofemoral grafting has a lower patency rate and should be reserved for high-risk patients and for the relief of severe ischemia only. PMID- 6861026 TI - A prospective study of lower limb amputations. AB - Most leg amputations are performed for vascular disease. A mortality of 30% was associated with above-knee amputations in this study. Healing by primary intention took place in 59% of patients, 31% had delayed healing and 10% required a revision. Only 10% of above-knee amputees used a prosthesis and 48% required total bed care. Below-knee amputations in which a rigid dressing was used had slightly better healing than when soft dressings were used but the difference was not significant. The overall reamputation rate was 15%, the mortality was 7.2% and 57% were fully ambulatory with a prosthesis. Amputation at either the transmetatarsal or digital level was carried out in 25% and 80% healed. The mortality was 11%. Clinical observation is still the best determinant of the level of amputation; below-knee amputation should be strived for in every patient who is a candidate for rehabilitation. Use of a rigid dressing is recommended. PMID- 6861027 TI - Revision of total hip arthroplasty. AB - Between September 1978 and December 1980, 28 revision procedures were carried out at the Wellesley Hospital, Toronto, for biomechanical failure of total hip arthroplasties. Twenty-six patients were personally reviewed and assigned a Harris hip rating. Seven patients had major complications intraoperatively or postoperatively; three of them required further surgery. Twenty-four patients had satisfactory results and none were worse. The mean Harris score preoperatively was 36.3. At a minimum follow-up of 1 year after revision, the mean Harris score rose to 79.9 (p less than 0.01). Revision of total hip arthroplasty is a difficult and demanding procedure but can produce satisfactory results. PMID- 6861029 TI - Bilateral interstitial cell tumour of the testes. AB - The authors report a case of bilateral interstitial cell tumour of the testes. A 64-year-old man presented with painless testicular swellings of many years' duration. No hormonal disturbance was manifested but the patient was achondroplastic and diabetic. Bilateral orchiectomy was performed. The patient remained well. This is a rare tumour and bilateral involvement is extremely unusual. PMID- 6861028 TI - [Predictive value of preoperative acidity tests in ulcer recurrence after supraselective vagotomy]. AB - The authors have analysed the predictive value of the basal and peak gastric acidity levels, measured preoperatively, in a series of 27 supraselective vagotomies. They recommend care in the choice of this operation for hypersecretors and they propose criteria for the preoperative selection of the candidates. They suggest determination of the preoperative basal gastric acidity level and a cimetidine suppression test to identify patients at high risk for recurrence of the ulcer. PMID- 6861030 TI - Should oral amiodarone be used for sustained ventricular tachycardia in patients requiring open-heart surgery? AB - A patient with sustained ventricular tachycardia was operated on after an unsuccessful trial of amiodarone. Profound myocardial depression and low cardiac output became evident as he was weaned from cardiopulmonary bypass. Despite inotropic support, use of the intra-aortic balloon pump and left heart assist device, he died. Because of this experience, the authors developed a canine model to determine the effects on left ventricular function of amiodarone given orally. Left ventricular stroke work, cardiac output, ventricular contractility (maximum dP/dt) and peripheral vascular resistance were measured in 12 mongrel dogs at a heart rate of 150 beats/min and at a constant preload of 10 mm Hg. Six animals received the drug orally and the remaining animals were used as sham-operated controls. Maximum dP/dt decreased from 2855 mm Hg/s to 1291 mm Hg/s (p less than 0.01) and left ventricular stroke work was reduced from 48.7 g-m/beat to 21.8 g m/beat (p less than 0.05) after the administration of amiodarone. Cardiac output and peripheral vascular resistance did not differ significantly. Amiodarone severely depressed left ventricular function in this experiment. The prolonged half-life of this antiarrhythmic combined with its adverse effect on myocardial function suggests that it should not be used in patients with refractory life threatening ventricular tachycardia who are good candidates for electrophysiologic evaluation and endocardial resection. PMID- 6861031 TI - Gastroduodenal Crohn's disease: diagnosis and selection of treatment. AB - Crohn's disease of the stomach and duodenum is uncommon and difficult to diagnose. This study reviews 23 patients with this condition seen at the Toronto General Hospital between 1970 and 1981. In 12 patients the major symptoms were due to coexisting lower intestinal Crohn's disease (primarily distal disease). Diarrhea and crampy abdominal pain were the primary presenting complaints. None had obstructive symptoms. Nine of the 12 were treated medically, 7 with success; 1 required surgical intervention and 1 continued to have pain but no evidence of ulceration. In the remaining 11 patients, the major symptoms were due to their gastroduodenal Crohn's disease (primarily proximal disease) even though 10 had coexisting disease of the intestine. Their symptoms included postprandial vomiting, upper intestinal bloating, hematemesis and epigastric pain. Only one patient was successfully treated medically; the others required surgical intervention. At the time of writing, 9 of the 11 patients had no symptoms. The authors conclude that response to medical therapy occurs only in patients whose gastroduodenal disease is relatively mild and whose symptoms come from distal intestinal disease. In contrast, patients whose main symptoms are from gastroduodenal involvement usually require surgical treatment. Vagotomy with gastroenterostomy is the procedure of choice. PMID- 6861032 TI - Colles' fracture: end results in relation to radiologic parameters. AB - Thirty-seven patients with unilateral Colles' fractures were examined clinically and roentgenographically at least 1 year after fracture. Statistical analysis of the data, comparing roentgenographic parameters with clinical results, showed that loss of volar tilt directly affected the final results by decreasing grip and pinch strength. But regardless of radiologic appearance, all patients had similar levels of activity, pain and range of motion. PMID- 6861033 TI - Interstitial radiotherapy for localized carcinoma of the prostate. AB - Forty-two patients with localized carcinoma of the prostate have been treated with interstitial implantation of iodine 125 seeds after a thorough staging process. The procedure was well tolerated and carried acceptable morbidity and no mortality. Of major concern, however, was the failure of local control of the tumour in a high proportion (88%) of patients at 1 year. Combined interstitial and external beam radiotherapy may overcome this. PMID- 6861034 TI - Aortoiliac arteriovenous fistula simulating iliac vein thrombosis following intervertebral disc surgery. AB - This report describes an unusual presentation of arteriovenous fistula secondary to intervertebral disc surgery. A 61-year-old obese woman underwent operation for a herniated intervertebral disc. One month later she was readmitted with painful swelling of the left calf. The condition progressed to include pigmentation of the whole extremity with varicosities and ulcerations. The femoral vein was found to be occluded and there were multiple collateral vessels in the thigh. Initially, phlebitis was diagnosed, then iliac vein thrombosis. Her symptoms improved slightly with rest and anticoagulant therapy. Finally, after 2 years, an arteriovenous fistula was suspected because of a bruit in the presacral region and oxygen saturation of venous blood in the thigh. The diagnosis was confirmed by aortography. The fistula was transected and the artery and vein individually sutured, producing immediate improvement. The patient was symptom-free 3 years later. When chronic venous obstruction, unusual distribution of collateral circulation and pigmentation of a lower extremity are found after disc surgery, an arteriovenous fistula should be suspected. The diagnostic procedures should include auscultation of the abdomen and back, venography, measurement of blood oxygen levels in the collateral venous circulation and aortography. PMID- 6861035 TI - The dysvascular amputee: multidisciplinary management. AB - The authors describe 8 years of experience in the care of amputees with dysvascular diseases using a multidisciplinary team approach. They compare this method of amputee rehabilitation with one using similar personnel but no team approach. In the hospital using the team approach, there were many more below knee amputees, a higher number of prosthetic fittings in a shorter period and more fittings in older patients than in the control hospital. PMID- 6861036 TI - Septic complications of perforated peptic ulcer. AB - The septic complications of peptic ulcer perforation have not been adequately described in the literature because the sparse microflora usually present in the upper gastrointestinal tract is generally believed to represent a minimal risk. One hundred and eighty-two peptic ulcer perforations (150 duodenal, 32 gastric), seen over 15 years, are reviewed. The septic complications relating to intestinal perforation included intra-abdominal abscess (22 cases), wound infection (26 cases) and generalized bacterial peritonitis (18 cases). The incidence of postoperative abscesses was significantly (p less than 0.05) greater in patients with gastric than with duodenal perforation. In both groups, abscesses were much more frequent when perforation occurred more than 24 hours before operation. The risk of intra-abdominal sepsis following acute peptic perforation is substantial. In such cases, routine anaerobic and aerobic cultures should be done of fluid taken from the peritoneal cavity at operation. PMID- 6861037 TI - Familial polyposis coli: an unusual family. AB - Familial polyposis is an autosomal, dominantly inherited disorder. Usually less than 50% of siblings are affected because of incomplete penetrance by the responsible gene. The family described in this paper was unusual in that all seven siblings of one son had the disorder. The chances of this occurring, assuming complete penetrance, is 1 in 128. Moreover, several members of his family had Gardner's syndrome with associated extracolonic manifestations, including a rarely associated papillary carcinoma of the thyroid. There was no evidence of a cosanguineous marriage. Patients with familial polyposis are advised to adopt children, otherwise surveillance of their children must be lifelong, beginning at puberty. PMID- 6861038 TI - Intrauterine intussusception: case report and literature review. AB - Intussusception in the newborn is a unique clinical entity, and one of the most unusual causes of intestinal obstruction in infants. Its cause can be idiopathic, secondary to a local lesion or a complication of disease. Early diagnosis and treatment are important, because survival depends on them. The authors report a case of jejunal atresia secondary to intrauterine intussusception, followed by a literature review. Less than 30 cases have been adequately documented in the world literature. Eight reports from the literature are selected to highlight clues for early diagnosis, such as vomiting, with or without bile, abdominal distension and bloody stools, because of their prognostic implications. Intussusception is rare under the age of 3 months; the incidence is 0.3% in the neonatal period. Previous reports indicate that a confusing clinical picture has led to a delay in operation and a high mortality. The ultimate outcome depends on an acute awareness of the condition in the presence of the diagnostic clues in a newborn. PMID- 6861039 TI - Effects of ionizing radiation. PMID- 6861040 TI - An objective social reason to reconsider abortions. PMID- 6861041 TI - Children's exercise centre a break from tradition. PMID- 6861042 TI - Radioimmunotechnology for cancer diagnosis and treatment. PMID- 6861046 TI - How breast cancer presents. AB - A study of 501 new breast cancers in patients seen in a consulting surgical practice revealed that 87% were in patients 45 years of age or older. The patients had found 83% of the cancers. The distributions of size and stage were the same for the tumours found by the patients and those found by the referring physicians. Two thirds of the cancers had an associated visible clinical sign, demonstrating the importance of inspection in the examination of the breast. Dimpling, sometimes apparent only on manipulation of the tumour, was present with 264 of the cancers and was often associated with "minimal" lesions. Mammography was done for 63 of the breast cancers but it missed 27. Of the physician-found cancers 15 were in patients who had already had breast cancer, 4 were in patients presenting with symptomatic metastases and 14 were in women presenting with other disorders. Of the 52 cancers found by periodic examination 3 were locally advanced and 21 had axillary metastases, while among the 28 "early" cancers 12 were in women who were senile, mentally defective or psychotic. Only four of the cancers found by the physicians were in women under age 45; two were rapidly fatal, one had an axillary metastasis, and the fourth was in a woman who had had cancer of the opposite breast. The remaining 284 lesions found by periodic or routine examination in women under age 45 were benign. Thus, periodic or routine examination for unsuspected breast cancer in women under age 45 seems unjustified except in those who have already had breast cancer. PMID- 6861047 TI - Who should manage your investment portfolio? PMID- 6861043 TI - Self-harm: 1. Suicide. AB - Although suicide rates have remained relatively stable, the risk of suicide has increased among 25- to 35-year-old men. Attempts to understand suicide fall into three major frameworks: sociologic theories, psychologic theories and the relation of suicide to psychiatric illness. The risk of suicide can be assessed by means of a relatively simple clinical interview. Since most suicide victims consult their family doctors within the month before their death, physicians are in a unique position to prevent suicide. Routine assessment of the risk of suicide among patients who appear depressed or are undergoing an emotional crisis can lead to accurate diagnosis and effective intervention. Similarly, the appropriate use of psychotropic medication can lead to effective treatment while minimizing the risk of a lethal overdose. PMID- 6861044 TI - Pharmacists and their relationship with elderly patients. AB - A survey of 60 randomly selected pharmacists explored their relationship with elderly patients, including their information storage systems, dispensing practices and the major problems they encounter with these patients. Nearly all the pharmacists kept a medication profile for each elderly patient, and one third used a computer, which facilitated recording of additional information. However, few recorded the age of the patient. Many pharmacists counselled their elderly patients on the correct use of medications, but few provided counselling on the use of nonprescription drugs. Most of the pharmacists reported using techniques to improve compliance among elderly patients. More than 80% of the pharmacists reported apparently inappropriate prescribing by physicians at least occasionally. PMID- 6861045 TI - Hemodynamic effects of pacing-induced tachycardia in valvular aortic stenosis. AB - The hemodynamic effects of tachycardia were studied in 13 patients with valvular aortic stenosis. Observations were made during sinus rhythm (average heart rate 80 beats/min) and two periods (P1 and P2) when atrial pacing increased the heart rate to 109 and 131 beats/min respectively. The cardiac index did not change, but the left ventricular stroke work index fell from 61.8 to 39.5 g X m/m2 (p less than 0.001) as the heart rate increased. The left ventricular end-diastolic pressure averaged 18 mm Hg during sinus rhythm and fell to about 11.5 mm Hg at P1 and P2 (p less than 0.001). The brachial arterial systolic pressure did not change during pacing, but the left ventricular systolic pressure fell from 208 mm Hg to 201 mm Hg during P1 (p less than 0.05) and 193 mm Hg during P2 (p less than 0.001). The mean systolic aortic valve gradient averaged 64 mm Hg during sinus rhythm and fell to 51 mm Hg during P2 (p less than 0.001), and the peak aortic valve gradient fell from 82 to 69 mm Hg during P2 (p less than 0.001). The left ventricular ejection time fraction increased from 26.9% during sinus rhythm to 31.9% during P1 (p less than 0.05) and 34.7% during P2 (p less than 0.005). Because of the prolonged left ventricular ejection time fraction and smaller stroke volume, a smaller pressure gradient developed across the stenosed valve at higher heart rates. The pacing test was of little value in assessing left ventricular function and thus is not useful during invasive investigations of valvular aortic stenosis. PMID- 6861048 TI - Principles of involuntary commitment. PMID- 6861049 TI - Preoperative electrocardiography. PMID- 6861050 TI - Rubella vaccine: recommendations for use. PMID- 6861051 TI - Rubella vaccination: a course becomes clear. PMID- 6861052 TI - Preventing the congenital rubella syndrome by vaccinating women at risk. PMID- 6861053 TI - Consent to randomized treatment: a reply to Brewin. PMID- 6861054 TI - Self-harm: 2. Deliberate nonfatal self-harm. AB - The incidence of deliberate acts of self-harm, such as drug overdoses, has greatly increased in the past two decades. The term "suicide attempt" is really a misnomer. For most people who harm themselves the primary motivation is rarely to die. As well, there are many differences between self-harm patients and patients who have committed suicide. The former tend to be characterologically disturbed and socially disadvantaged. Intervention narrowly focused on suicide prevention will lead to lengthy hospital stays in high-risk cases and ineffective treatment for most self-harm patients, who tend not to comply with outpatient treatment. Crisis-oriented intervention with a brief hospital stay in all cases of self-harm may provide more effective assessment and management. PMID- 6861055 TI - Hypokalemic metabolic alkalosis caused by surreptitious vomiting: report of four cases. AB - Four women, aged 22 to 40 years, presented with severe hypokalemia and metabolic alkalosis. Three had related neuromuscular symptoms. All four patients denied vomiting or diuretic ingestion, and a diagnosis of Bartter's syndrome was entertained. A diagnosis of surreptitious vomiting was suspected from the characteristic urine electrolyte pattern: high values for sodium and potassium, and a chloride concentration of less than 5 mmol/l. Three patients excreted sodium and potassium primarily with bicarbonate and had an alkaline urine; the fourth patient excreted these cations primarily with an organic anion and had an acid urine (pH 5.5). Since self-induced vomiting may be a common method of weight reduction in young women, recognition of this characteristic urine electrolyte pattern will assist in the rapid diagnosis of hypokalemia and metabolic alkalosis of obscure cause. PMID- 6861056 TI - Solitary penile ulcer associated with infections mononucleosis. AB - Determining the cause of genital ulcers requires extensive laboratory investigation, particularly if there is no history of sexually transmitted disease. In a patient with a solitary penile erosion who was tired, weak, sweaty and febrile, hematologic and serologic tests suggested infectious mononucleosis, and bacteriologic and serologic studies, along with attempts at virus culture, ruled out syphilis and herpes simplex. The erosion healed soon after the other signs and symptoms resolved. It therefore appears that solitary penile erosions may be a presenting feature of infectious mononucleosis. PMID- 6861057 TI - Health information industry: pushing patient education. PMID- 6861060 TI - How to become comfortable talking about sex to your patients. PMID- 6861058 TI - Diazepam withdrawal syndrome. PMID- 6861059 TI - The paradox of family violence. PMID- 6861061 TI - Localized hirsutism following Colles' fractures. PMID- 6861062 TI - Use and abuse of psychoactive drugs in the elderly. AB - The elderly are susceptible to many psychiatric symptoms caused by the vast array of drugs they may take. Therefore, history-taking demands a very careful look at all their medicines. In this paper some dangers of over-the-counter drugs are described, and the paradox of psychotropic drugs sometimes causing psychiatric side effects is discussed. Several types of drugs and their side effects are outlined, and suggestions are made for appropriate drug treatment in this age group. PMID- 6861063 TI - Spontaneous rupture of the quadriceps tendon and patellar ligament during treatment for chronic renal failure. AB - The quadriceps tendon and patellar ligament rupture rarely, even when under great stress or trauma, but can rupture spontaneously in patients with chronic diseases such as gout, rheumatoid arthritis and renal disease. Several factors probably combine to weaken the tendon, including an impoverished local vascular supply, repeated microtrauma and secondary hypoparathyroidism with osteodystrophy. In the three cases reported here, one of which was bilateral, the patients were being treated for chronic renal disease; surgical repair of the tendons led to sound healing and a return to normal function of the joints. PMID- 6861064 TI - CMA abortion survey. AB - Responses to the question as to whether abortions should be performed at the woman's request during the first trimester of pregnancy were evenly divided. There was support for abortion on socioeconomic grounds, during the first trimester, from 61.5% of the respondents. Termination of pregnancy beyond the first trimester was supported by a majority of the respondents only in cases in which the woman's life is in danger (73.9%) or in which there is evidence of a severe physical abnormality in the fetus (70.6%) or in cases in which the woman's physical health is in danger (55.5%). Those who said they would not support abortion under any circumstances constitute, at most, 5.1% of the respondents. Support for the maintenance or the elimination of therapeutic abortion committees was addressed in two questions and in both cases the respondents were evenly divided. The responses to these two questions were compared and found to be logically consistent. Only physicians should perform abortions, and they should be performed in hospitals with the woman either as an inpatient or, during the first trimester, as an outpatient. The performance of first-trimester abortions in provincially approved abortion clinics was supported by 47.3% of the respondents. Of the 885 respondents who wished to see some amendment to the Criminal Code, 409 stated that the term "health" as used in the Criminal Code relative to the legal grounds for therapeutic abortion should be defined. PMID- 6861065 TI - Should you tell your patients the truth? PMID- 6861066 TI - Ethics and the physician-nurse relationship. PMID- 6861067 TI - Early changes in human myocardial nuclei after doxorubicin. AB - Ten nuclei from the endomyocardial biopsies for each of the following 32 patients were examined by electron microscopy: seven patients before and then four and 24 hours after treatment with first-dose doxorubicin; seven patients before and four and 24 hours after treatment with first-dose doxorubicin plus N-acetyl cysteine; nine patients with doxorubicin induced cardiomyopathy; and nine patients with idiopathic congestive cardiomyopathy. Five criteria were used to semiquantitatively compare nuclei and nucleoli from each group. The most dramatic changes in nuclear and nucleolar morphology were seen four hours after doxorubicin administration. Nucleoli were smaller, contracted or segregated and contained fewer fibrillar centers and a collapsed or fragmented nucleolonema. The addition of N-acetylcysteine to treatment did not alter these results. By 24 hours, nuclei had returned to the pre-treatment status. Long-term doxorubicin therapy produced increased chromatin clumping and slightly contracted nucleoli. The idiopathic congestive cardiomyopathic nuclei differed significantly from these doxorubicin cardiomyopathic nuclei in the decreased amount of chromatin clumping and the increase in fibrillar centers and nucleonema pattern. It is concluded from this study that: (1) doxorubicin markedly alters the morphology of the human myocardial nucleus and nucleolus four hours after treatment, but these changes diminish by 24 hours; (2) N-acetylcysteine treatment fails to prevent these changes; and (3) the nuclei and nucleoli of chronic doxorubicin-induced cardiomyopathy differ significantly from other congestive cardiomyopathies, but do resemble changes seen four hours after the first dose of doxorubicin. PMID- 6861068 TI - Two cases of acute leukemia following treatment of malignant glioma. AB - Two female patients, 42 and 30 years old, respectively, died of acute nonlymphocytic leukemia 43 and 38 months, respectively, after a subsequent treatment: chemotherapy for one and irradiation and chemotherapy for the other, following excision of a malignant glioma. At the time of death, both seemed to be in complete remission of their brain tumor. Both had been treated with procarbazine and nitrosoureas. The latter were responsible for severe myelosuppressive episodes and seem to have played an essential role in the induction of the leukemia. In one case, a myelodysplasia was observed before the onset of the AL and the diagnosis of refractory anemia with excess of blasts seemed warranted. Secondary acute leukemias are rare in the evolution of malignant gliomas and the usefulness of subsequent radiochemotherapy cannot be questioned at the present time. The risks involved in this therapy are minor when compared to the short-term fatal prognosis of this type of tumor. PMID- 6861069 TI - The dedifferentiation of prostate carcinoma. AB - Fifty-four patients with prostate carcinoma, each having 2 TURP (transurethral resection of the prostate) procedures separated by 3 to 11 years, were studied to determine whether the histologic appearance of prostate carcinoma remains the same for the life of the host or whether the histological appearance changes with time. Using the M. D. Anderson (MDAH) method of grading prostate carcinoma, 19 of 26 (73%) Grade 1 lesions, 9 of 12 (75%) Grade 2 lesions, and 7 of 8 (88%) Grade 3 lesions dedifferentiated into another grade at the time of the 2nd TURP. Eight cases that were Grade 4 at the time of the 1st TURP, remained Grade 4 lesions at the time of the 2nd TURP. Although 10 Grade 1, Grade 2, and Grade 3 lesions did not change grades, 8 of these 10 cases were less differentiated at the time of the second TURP than they were at the time of the first TURP. Furthermore, no Grade 1 lesions demonstrated evidence of metastases, but 19% of Grade 2 lesions, 55% of Grade 3 lesions, and 80% of Grade 4 lesions demonstrated evidence of metastases. This study suggests that the usual course of prostate carcinoma is dedifferentiation and that with dedifferentiation, the likelihood of metastases increases. PMID- 6861070 TI - Concanavalin A binding histiocytes in Hodgkin's disease and their relation to clinicopathologic features of the disease. AB - The occurrence and staining patterns of Concanavalin A (Con A) binding histiocytes were studied in diagnostic lymph node specimens of 133 patients with Hodgkin's disease. Varying numbers of Con A binding histiocytes were present in all tumors. Two distinct cytoplasmic staining patterns of the Con A binding histiocytes were noted: diffuse, and a pattern termed "globular" which represents a dense, solitary paranuclear aggregate of binding sites. The diffuse binding pattern was seen in the majority of histiocytes with no apparent nuclear atypia, but was also occasionally seen in Reed-Sternberg cells. Globular binding was present in both benign and malignant-looking histiocytes, including rare Reed Sternberg cells. Based on the number of histiocytes in which globular binding of Con A (G-cells) was observed, tumors were grouped in the following three categories: Group 1: tumors with large numbers of G-cells (42 cases); Group 2: tumors with a small number of G-cells (16); and Group 3: tumors with rare or no G cells (75). Tumors with large numbers of G-cells were seen more frequently in patients with disseminated disease than in those with localized (69.0% versus 31.0%; P less than or equal to 0.002), and more often in patients with B-symptoms than in those without (73.8% versus 26.2%; P less than or equal to 0.001). Large numbers of G-cells were present in most tumors of the lymphocyte depletion type (14/16), whereas rare or no G-cells were seen in the majority of the nodular sclerosis type (46/59). These observations suggest that the G-cells may represent an abnormal variant of histiocytes, the occurrence of which is associated with unfavorable clinical and pathologic features of Hodgkin's disease. PMID- 6861071 TI - Peripheral lung carcinoid tumor producing predominantly gastrin-releasing peptide (GRP). Morphologic and hormonal studies. AB - A carcinoid tumor of the peripheral lung producing gastrin-releasing peptide (GRP), a peptide hormone known to be present in the endocrine cells of fetal bronchial epithelium, is reported. Brain-gut peptide hormones in this tumor were assayed by radioimmunoassays, localized by immunohistochemistry and characterized by gel filtration. Electron microscopic study revealed that tumor cells resembled P-cells of normal human fetal bronchial epithelium. While GRP-containing cells were predominant in this tumor, calcitonin-containing cells were also found in some areas. Difference in distribution of hormones according to histologic features was noted in the tumor. A greater portion of the tumor showed spindled cells that predominantly contained GRP, and a smaller portion of the tumor showed cells arranged in tubular or trabecular patterns that mainly contained calcitonin. The gel-filtration pattern of the tumor extracts consisted of two peaks, one of these corresponded to the synthetic replicate of porcine GRP, and another was considered to correspond to C-terminal fragments of the peptide. PMID- 6861072 TI - Paravertebral malignant rhabdoid tumor in infancy. In vitro studies of a familial tumor. AB - Two female siblings died within three months after presenting with paravertebral tumors in the first year of life. The pathology of the two tumors was identical and characteristic of a malignant rhabdoid tumor. There were no identifiable tumor patterns within the kindred which have been associated with any hereditary cancer or precancer syndromes. Fibroblasts were cultured from skin biopsies obtained from the second patient and both parents. Assays of growth kinetics associated with cellular transformation revealed that fibroblasts from the affected sibling can be distinguished from those of the parents and age-matched controls by increased in vitro occurrence of tetraploidy. Such evidence suggests that increased in vitro tetraploidy occurring spontaneously in cultured fibroblasts is an expression of a cancer-prone gene. Increased in vitro tetraploidy has previously been demonstrated in some kindreds with heritable colon cancer syndromes, and may extend our understanding of the genetic etiology of some childhood cancers. PMID- 6861073 TI - Glassy cell carcinoma of the cervix. Cytologic and clinicopathologic analysis. AB - A clinicopathologic analysis of 15 patients with glassy cell carcinoma confirmed that this is a rare disease, having an incidence of 1.2%. It is a rapidly progressive and biologically aggressive disease with early extrapelvic metastasis. The five-year survival and the median survival in our series were 28% and 14 months, respectively. The majority of patients (87%) were understaged, which may have played a role in the poor prognosis. Four of 12 patients (33%) were initially diagnosed as having a benign disease (false-negatives). Defining of cytologic characteristics and differential features of this tumor may facilitate an early and more accurate diagnosis to improve prognosis. PMID- 6861074 TI - Angioimmunoblastic lymphadenopathy. Long-term follow-up study. AB - The clinical course of 41 previously reported patients with angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) on whom follow-up information has been obtained for five or more years is described. Of the 41 patients, 27 achieved a complete remission (CR). The durations of the CR ranged from two to 214 months, with a median of 48 months. Nine of these 27 complete responders are still alive and well without evidence of disease, whereas the remaining 18 patients have died of pneumonia, septicemia, immunoblastic lymphoma, or unrelated causes. These 27 patients had a significantly longer median survival (51 mos) than did the 14 patients who had partial or no response (9 mos) (P = 0.0006). Only two of these 14 patients who did not initially achieve a CR are alive (survivals, 66 months and 70 months). There was a trend suggesting that patients who received combination chemotherapy which included prednisone had a slightly longer survival than did the remaining patients (P = 0.087). Lymphocytopenia was evident in a higher proportion of dead patients than in those who remained alive (P = 0.089). PMID- 6861075 TI - Unexplained pulmonary infiltrates in the compromised patient. An invasive investigation in a consecutive series. AB - A series of 51 consecutive unexplained pulmonary infiltrates were reviewed retrospectively, in a group of 48 patients in whom invasive procedures were performed. Fifty-two percent of these patients had leukemia or lymphoma and 40% had solid tumors. All patients had lung tissue obtained premortem either by transbronchial biopsy through the flexible fiberoptic bronchoscope or by open lung biopsy. There was a 27% complication rate in these invasive procedures including bleeding, pneumothorax, and ventilatory support. Infectious agents were found in only 13 cases (25%) with a mortality rate of 62%. The pathologic finding of the underlying malignant disease or organizing pneumonia portended a poor prognosis with 100% and 80% mortality, respectively. Twenty-one patients had biopsy tissue revealing only nonspecific pathologic changes and were associated with the lowest mortality (19%). It was found that 50% of the solid tumor patients with unexplained pulmonary infiltrates had nonspecific pathologic changes. The biopsy findings resulted in a change in the therapy in 29% of the cases and in 19% of the cases the subsequent change in therapy resulted in marked improvement. The lung biopsy is useful to diagnose treatable infectious disease, as well as for prognostic guidance in caring for critically ill compromised patients. PMID- 6861076 TI - Propionibacterium shunt nephritis in two adolescents with medulloblastoma. AB - The anaerobic diphtheroid Propionibacterium acnes was identified as the organism responsible for "shunt" nephritis in two adolescents with ventriculoatrial shunts inserted previously for the management of medulloblastoma. Only three cases of "shunt" nephritis secondary to infection with this common skin commensal organism are known to have been reported. The rarity of such reports may be related to the lack of good anaerobic laboratories, the length of time necessary for cultures to show growth, the poor ability of certain blood culture media to support growth of this organism, and the failure of physicians to consider Propionibacterium acnes as a true pathogen in certain clinical situations. PMID- 6861078 TI - Time trend in the prevalence of intestinal metaplasia in Japan. AB - In connection with the recently commenced decline of death rate for gastric cancer in Japan, the time trend of intestinal metaplasia of the stomach among the Japanese is investigated. Otherwise normal stomachs from autopsies, and stomachs removed for gastric or duodenal ulcer or for early gastric carcinoma, each collected from two different periods at intervals of 10 to 20 years, are compared histologically. The results show that the prevalence of intestinal metaplasia in those stomachs generally remains high, but that there is a regular downward tendency of the prevalence of confluent intestinal metaplasia in all of those stomachs, except for the stomachs with gastric ulcer. The fall in prevalence is conspicuous among the individuals of middle age groups, especially of patients aged in their 40s, and it is minimized toward old age. The decrease of intestinal metaplasia among the Japanese is considered to have been started only recently. There is no evidence verifying the antecedence of the fall in prevalence of intestinal metaplasia to the decline of death rate for gastric cancer in Japan. Evidence does not suggest a precancerous nature of intestinal metaplasia per se. PMID- 6861077 TI - Pain in metastatic breast cancer. AB - The pain experiences of 86 women with metastatic carcinoma of the breast were systematically evaluated over a period of one year. Fifty-six percent of the sample reported experiencing pain, and the intensity of pain was not significantly related to site of metastasis. Multiple regression analysis revealed that 50% of the variance in the pain experience was accounted for by: (1) the amount of mood disturbance as measured by the Profile of Mood States (POMS); (2) the patients' belief that the pain indicated worsening of the illness; and (3) the use of analgesic medication. The nature of family support, social functioning, and coping responses were not significantly associated with pain intensity, nor was mortality during the one-year follow-up period. These data document the significance of psychological factors in accounting for differences in pain experience and document the interaction between pain and mood disturbance. These findings suggest that treatment of metastatic pain should include attention to the patient's mood and adjustment to the illness. PMID- 6861079 TI - Taste thresholds of patients with cancer of the esophagus. AB - Twelve patients with untreated cancer of the esophagus and 14 control subjects matched for age, smoking, and alcohol consumption were tested for taste thresholds. Taste acuity for the four basic tastes was evaluated by three stimulus forced choice techniques (Henkin). There were no significant differences between the groups for detection and recognition thresholds for sour, salty, sweet, or bitter taste stimuli. Comparison of patients' detection and recognition thresholds with those of eight young healthy nonsmokers showed marked differences. Salivary urea nitrogen concentration was not different between patients and matched controls and did not correlate with bitter taste thresholds. Variable results have been reported for taste sensitivity in patients with malignant disease. In view of the results of this study and the many factors which influence taste acuity, it appears that a general statement regarding taste alterations in cancer patients cannot be made. Choice of appropriate control groups to correct for factors known to affect taste but not related to cancer per se is important for proper interpretation of taste testing results. PMID- 6861080 TI - Leiomyosarcoma arising in an arteriovenous fistula. AB - The case of a man who developed a leiomyosarcoma in association with a surgically created arteriovenous fistula is reported. This unusual complication of a dialysis fistula is the first reported case of a leiomyosarcoma occurring in a surgically created fistula. PMID- 6861083 TI - Fat necrosis of the breast simulating recurrent carcinoma after primary radiotherapy in the management of early stage breast carcinoma. AB - Between March 1973 and December 1980, 76 patients with Stage I or II breast carcinoma were treated by biopsy and definitive radiation therapy at Stanford University Medical Center. There were 78 treated breasts since two patients had bilateral carcinomas at presentation. During a median follow-up period of 29 months, eight patients developed discrete masses in the treated breast. In four of these patients biopsied tissue revealed recurrent carcinoma yielding a local control rate of 95%. Four additional patients had lesions which were clinically indistinguishable from recurrent cancer. Biopsy specimens, however, revealed fat necrosis of the breast. The clinical and pathologic features of this entity are described. It is imperative that clinicians be aware of this treatment sequelae so that conservative diagnostic procedures may be used and breast deformity minimized. If postirradiation fat necrosis is considered, mastectomy for suspected persistent or recurrent disease may be avoided. PMID- 6861082 TI - Chemohormonal therapy of metastatic prostate cancer. A pilot study. AB - Combined chemohormonal therapy of metastatic prostate cancer has not been previously evaluated in patients failing primary hormones (estrogens and/or orchiectomy). The combination of Adriamycin and high-dose diethylstilbestrol diphosphate (Stilphostrol) was studied in 19 heavily pretreated patients, to document toxicity and patient acceptability. Major toxicity was myelosuppression, cardiac failure and venous thrombosis. Clinical improvement was noted in 10/16 (63%) of evaluable patients. Patients with pre-existing cardiac disease or venous thrombosis are not suitable for this therapy. PMID- 6861081 TI - Isolated lung perfusion with Adriamycin. A preclinical study. AB - Isolated in vivo single-lung perfusion with an Adriamycin-containing whole-blood perfusate was performed in three groups of dogs after establishing adequate controls. The procedure, performed through a left thoracotomy, was followed two weeks later by a contralateral pneumonectomy. Survival following pneumonectomy was used as the ultimate end point in assessing perfusion toxicity. Groups I and II had high mortality rates but provided valuable information concerning perfusion methods, venous drainage techniques, drug dosage schedules, and perfusate flow rates. The group III study consisted of five dogs perfused for 45 minutes at flow rates sufficient to maintain mean pulmonary artery pressure at 12 15 mm Hg. An initial Adriamycin (Adr) dosage of 0.5 micrograms/ml in the plasma perfusate resulted in mean peak Adr lung tissue levels of 3.8 +/- 1.06 micrograms/g. All animals survived right pneumonectomy 19 +/- 4 days later. Three dogs have been killed and histologic examination showed only mild focal pleural and subpleural interstitial fibrosis. Based on these studies it is concluded that isolated single-lung perfusion is a reproducibly safe technique and that a dosage of Adr has been identified which produces no apparent toxity in a large animal model. A clinical trial is currently in progress. PMID- 6861084 TI - Low-dose preoperative irradiation, surgery, and elective postoperative radiation therapy for resectable rectum and rectosigmoid carcinoma. AB - A regimen of low-dose preoperative radiation therapy (RT), surgery, and elective postoperative RT for resectable carcinomas of the rectum and rectosigmoid is presented. Initial results in a group of 36 patients is discussed. In four patients clinically silent metastatic disease was discovered. Of 16 patients without indications for postoperative RT, only one died with disease. Indications for postoperative irradiation were found in 15 patients and four relapses (26%) subsequently occurred. Since the surgicopathologic stage of the tumor is the best prognostic predictor for rectal cancer, this regimen allows for the delivery of high-dose adjuvant irradiation only to those at high risk of local recurrence. Thus, this combination selects patients likely to benefit from postoperative RT while preserving the advantages of preoperative RT. PMID- 6861085 TI - Hyperparathyroidism following irradiation of benign diseases of the head and neck. AB - In a series of 73 consecutive patients with hyperparathyroidism (HPT) eight patients gave a history of irradiation of head and neck because of benign diseases. The average interval between irradiation and definite diagnosis was 34 years. Intermittent hypercalcaemia was found in three patients. Microscopic examination of pathologic parathyroid glands of three patients showed a predominance of oxyphil cells. Thyroid abnormalities occurred more frequently in irradiated patients than in nonirradiated patients with HPT. Reviewing clinical and experimental data an etiologic role of irradiation in the pathogenesis of HPT appears present. PMID- 6861086 TI - Adenosquamous carcinoma of the thyroid after radiotherapy for Hodgkin's disease. A case report and review. AB - This is a case report of a patient who had received radiation therapy for Hodgkin's disease and 48 years later developed adenosquamous carcinoma of the thyroid gland. Radiation associated thyroid carcinoma is usually of differentiated variety and carried no different prognosis than one not related to radiation. Coexisting adenocarcinoma and squamous cell carcinoma is a very rare event, but makes the prognosis of patients with thyroid carcinoma much poorer. As a result, this kind of patient requires early recognition and aggressive therapy. PMID- 6861087 TI - Variation in receptor status between primary and metastatic breast cancer. AB - Steroid hormone receptors for oestradiol (ER) and progesterone (PR) have been measured sequentially in primary and metastatic breast cancer to determine whether receptor status remains concordant in individual patients. Serial receptor measurements from the same tumor site showed a change from receptor positive to receptor-negative tissue with time in some patients. Receptors were measured in primary tumor and later metastatic disease or tumor of the contralateral breast in 28 patients. Concordant results were found in 46% of cases. Six of nine patients with ER-positive primary tumors developed ER-negative metastases and four of five PR-positive primary tumors were associated with PR negative secondary deposits. Nine of 19 patients with ER-negative primary tumors later had ER-positive metastases, and three of 15 PR-negative primary tumors were associated with PR-positive secondary deposits. Possible false-negative ER measurements (ER-, PR+) in primary tumors, and interval treatment with chemotherapy or hormonal manipulation between biopsies may have contributed to these changes in receptor status. Six patients changing from receptor-negative primary tumors to receptor-positive metastases underwent hormonal therapy of metastatic disease, and four had objective responses to treatment. Care should be taken when using receptor measurements from primary breast tumors to help decide treatment for later metastatic disease. PMID- 6861088 TI - A comparative study of trace elements in normal and cancerous colorectal tissues. AB - Quantitative study of the Zn, Cu, K, Rb, Mn, Pb and Ni trace elements by the x ray fluorescence method in normal and cancerous tissue samples, obtained from 18 patients suffering from cancer of the colon and rectum, shows that cancerous tissues exhibit statistically higher K, Rb, and Cu concentration than corresponding normal tissues. There are evidences that also Ni and Pb are elevated in cancerous tissues. Finally Zn and Mn do not show any appreciable difference in normal and cancerous tissues. PMID- 6861089 TI - Carcinoma in situ of the urinary bladder with and without associated vesical neoplasms. AB - Of 99 patients who had carcinoma-in situ (TIS) at least once between 1970 and 1980, 84 were subjected to detailed analysis and pathologic review. They may be classified into four groups: (Group 1) 14 patients, who presented with invasive bladder carcinoma (TCC) associated with TIS; (Group 2) 15 patients who, subsequent to the diagnosis of TIS with or without another superficial TCC developed muscle invasion (12 patients) or metastases without muscle invasion (three patients); (Group 3) 29 patients who underwent cystectomy for superficial TCC (Ta or T1, or TIS alone). Twenty (69%) had extravesical superficial extension. Two patients developed metastases subsequent to undergoing cystectomy; and (Group 4) 26 patients with TIS proven at least once who have not developed muscle invasion, metastases nor have undergone cystectomy. Nineteen had previous non-TIS superficial TCC. All patients in Groups 2 and 4 were treated conservatively (TUR +/- intravesical chemotherapy) when the initial diagnosis of TIS was made. Twelve patients in Group 3 underwent cystectomy within a month of the diagnosis of TIS. When 38 patients found to have TIS in association with the first diagnosis of superficial transitional cell carcinoma of the bladder were compared with 32 patients who had TIS diagnosed subsequent to their initial diagnosis of transitional cell carcinoma, the former group fared significantly worse (P less than 0.01) in regard to muscle invasion, metastases, or clinical indications for cystectomy. PMID- 6861090 TI - Mesenchymal chondrosarcoma of bone and soft tissues. AB - Mesenchymal chondrosarcoma of bone and soft tissues treated at the Istituto Ortopedico Rizzoli are reviewed. The skeletal locations were prominent in five cases. Only two cases were in the soft tissues. Radiographic picture in the bone shows an aggressive osteolysis, with soft tissues invasion. Histologic picture is the same in bone and soft tissues, and is highly distinctive: islands of well differentiated chondrosarcoma embedded in undifferentiated mesenchymal cells with high malignancy characteristics. The cases showed a poor prognosis, and no patient survived more than four years. PMID- 6861091 TI - Acinic cell adenocarcinoma. A clinicopathologic analysis of 294 cases. AB - Two hundred and ninety-four cases of acinic cell adenocarcinoma were reviewed for the purpose of defining the clinical parameters and determining the distribution of the four histomorphologic tissue patterns and five cell types for correlation to biologic behavior. The vast majority occurred in the parotid gland. There was a male predominance and a peak incidence in the third decade of life. The tumors were usually less than 3 cm in diameter and were slow growing. Pain was a common symptom, but was not indicative of prognosis. Nearly one half of the neoplasms exhibited multiple tissue growth patterns, and three fourths of the tumors displayed more than one cell type. The microcystic pattern was seen most frequently, regardless of the biological behavior of the tumors. The well differentiated acinic cell was the most prevalent cell type except in cases with metastases, where the intercalated-duct cell type was slightly more frequent. Follow-up of 244 cases revealed a recurrence rate of 12%, a metastatic rate of 7.8%, and death rate of 6.1%. Since all histomorphologic patterns and cell types were manifest in tumors which recurred, metastasized, or caused the death of the patients, it seems appropriate to consider these neoplasms as low-grade adenocarcinomas rather than essentially benign with occasional unpredictable malignant behavior. PMID- 6861092 TI - Chest X-rays and full lung tomograms in gynecologic malignancy. AB - Four-hundred-seventy-one patients with gynecologic malignancy were studied. All of these had chest x-rays at the time of staging and 323 had concurrent full lung pleuridirectional tomography performed. In no instance were pulmonary parenchymal metastases identified by tomograms when the chest x-ray was negative and tomography led to more equivocal readings than did the chest x-ray. The current study indicates that there is extremely low diagnostic yield of full lung tomography in gynecologic malignancies. Full lung tomography was poor in assessing the presence of small pleural effusions. The yield of positive chest x ray at varying follow-up times was also examined. The yield has been expressed by site of origin of the tumor as well as by stage at initial diagnosis. Some of these yields are quite high. There is a very poor prognosis when pulmonary findings become evident, regardless of the site of origin of the tumor. More than one half of the patients who develop pulmonary abnormalities will be dead within one year. PMID- 6861093 TI - Urologic imaging and correlation with serum laboratory determinations in staging gynecologic malignancies. AB - The records of 526 patients with gynecologic malignancies were reviewed to determine the correlation of urologic imaging modalities with serum renal function studies in detecting ureteral obstruction at the time of initial staging. Three hundred and forty-three of these patients had excretory urograms and 305 patients had concurrent serum urea nitrogen and creatinine determinations and 261 patients had concurrent radionuclide bone scans. Twenty-six patients had concurrent sonograms. Hydronephrosis (either unilateral or bilateral) was demonstrated at urography in 11% of patients with carcinoma of the cervix and ovary, but in only two percent of patients with carcinoma of the endometrium (the latter probably due to anatomic differences and an earlier stage of disease at the time of presentation). Serum urea nitrogen and creatinine determinations were abnormal in only 30% of the patients with urinary obstruction. Although only a small proportion of patients with hydronephrosis had bone scans and sonography, these appeared to be sensitive methods of detecting obstructions, but were more expensive than urography. PMID- 6861094 TI - Liposarcoma occurring in children. An analysis of 17 cases and review of the literature. AB - Liposarcoma, one of the most common malignant mesenchymal neoplasms affecting adults, has rarely been documented to arise in children. Therefore, in this retrospective study, the clinicopathologic features of 17 liposarcomas retrieved from the files of the Armed Forces Institute of Pathology (AFIP) which occurred in patients between the ages of eight months and 15 years were analyzed. In contrast to the slight male prevalence verified in most studies of adult liposarcoma, this group of 17 cases disclosed a distinct female majority (65%). The tumor had a predilection for the lower extremity (41%), particularly the thigh; the remaining examples, which included cases from the neck, back, axilla, buttock, and forearm, reflected a seemingly random anatomic distribution. The retroperitoneum, a very common primary location for adult liposarcoma, accounted for only one example in the group. The histologic variants of liposarcoma coincided with the types delineated in most generally accepted classifications employed for liposarcoma in adults, but their distribution varied considerably from that found in most extensive series of adult liposarcomas. Specifically, there were 13 myxoid liposarcomas, two well-differentiated liposarcomas, and one each of the round cell and mixed variants. Follow-up information, obtained for 15 cases, revealed local recurrence in three patients, one of whom eventually died as a result of direct tumor extension into the pleural cavity. PMID- 6861095 TI - Prognostic parameters in recurrent malignant melanoma. AB - In 361 patients with recurrent malignant melanoma, the clinical stage was the strongest determinant of subsequent survival (P less than 0.01). In Stage IV, the number of initial, distinct lesions was important. Patients presenting with a single metastatic nodule had median survival ten months, whereas those with two or more metastatic nodules had median survival 6.9 months (P less than 0.05). The length of disease-free interval from excision of the primary to recurrence correlated consistently with subsequent survival in patients with regional lymph node metastases. Those with disease-free interval less than one year had median survival 15.8 months with 16% surviving at five years, while those with interval one year or longer had median survival 23.7 months with 30% surviving at five years (P less than 0.05). In Stage IV, the correlation of survival with disease free interval became significant only with 24 months as the demarcation point of length of disease-free interval. Age and sex affected the disease-free interval, but not survival after recurrence. PMID- 6861096 TI - Survival from preinvasive and invasive malignant melanoma in Western Australia. AB - The crude and relative survival rates from malignant melanoma of the skin were evaluated in 528 patients diagnosed in Western Australia in 1975-1976. Follow-up of patients to December 31, 1980 was 96% complete. For invasive malignant melanoma the relative five-year survival rates were 85% in men and 89% in women, while in cases of preinvasive melanoma both sexes experienced 100% relative five year survival. The effects on prognosis of sex, anatomic site, clinical stage, level of invasion and tumor thickness were examined. Invasive melanomas of less than 0.76 mm in thickness also were associated with 100% relative survival. The variation in survival of melanoma patients with geographic location and the relative contributions of early diagnosis and biologic nature to the favorable outcome of melanoma in Australia are discussed. PMID- 6861097 TI - Metastasis of an optic glioma through a ventriculoperitoneal shunt. AB - Metastatic spread of an optic glioma through a ventriculoperitoneal shunt resulted in the accumulation of malignant ascites in a young boy. Chemotherapy with vincristine, CCNU, and prednisone resulted in regression of the ascites and no further tumor progression. Extracranial metastasis of such a slow growing tumor is a rare occurrence; however, in this case, the spread through the shunt further emphasizes the need for protective filters in the shunts. PMID- 6861100 TI - The use of a tumor colony assay in predicting chemotherapeutic drug response in murine bladder cancer. AB - A tumor colony assay (TCA) was evaluated for its ability to predict anticancer drug responses in an N-[4-(5-nitro-2-furyl)-2-thiazolyl]-formamide (FANFT) induced murine bladder tumor (MBT) model. Ten anticancer drugs were evaluated in vivo and in vitro using four MBT cell lines (40 drug responses). Using the optimum criteria for drug response, the TCA accurately predicted drug responses in the murine model 65% of the time with a true-positive predictive rate of 54% and a true-negative predictive rate of 70%. Drug testing tumor cells immediately on removal from the mouse resulted in a true-positive predictive rate of 77% and a true-negative predictive rate of 100%. The authors conclude that the TCA can predict response to chemotherapy in the MBT model and may be useful in screening investigation compounds for the subsequent evaluation in this murine bladder tumor model. PMID- 6861098 TI - Assessment of response of bone metastases to systemic treatment in patients with breast cancer. AB - Seventy-one patients with breast cancer and bone metastases, together with other assessable sites of disease, were monitored by radiologic skeletal survey, bone scanning, pain charts, bone marrow aspirate, serum calcium, alkaline phosphatase and urine hydroxyproline/creatinine ratio. On the basis of UICC criteria of response in nonosseous sites, 37 were classed as responders and 34 as nonresponders. Responding patients with osteolytic disease frequently showed sclerosis, but only at 6-8 months, whereas patients with mixed lytic/sclerotic or sclerotic metastases frequently showed no change or further sclerosis. Nonresponders most frequently showed progressive lysis. Bone scanning showed clear evidence of improvement or deterioration in 7/21 responders and 8/23 nonresponders who showed no definite evidence of progression or response on skeletal radiography. Pain assessment was also useful in these patients. Neither the bone marrow aspirate nor other biochemical tests were useful in assessing response to therapy. This study concludes that bone scanning and pain assessment are both useful in assessment of response of bone metastases to treatment in some patients and incorporation into a standard criteria of response is recommended. PMID- 6861099 TI - A Phase I study of the combination N-(phosphonacetyl)-L-aspartate (PALA, NSC 224131) and L-alanosine (NSC-153353) in patients with advanced cancer. AB - This article reports a Phase I study of combined therapy with N-(phosphonacetyl) L-aspartate (PALA) and L-alanosine in 26 patients with advanced cancer. Each agent exhibits antitumor effect by enzyme inhibition: PALA blocks pyrimidine biosynthesis by impeding aspartate transcarbamylase and L-alanosine depletes purine nucleotides by interfering with adenylosuccinate synthetase. These agents were selected for clinical investigation in light of synergistic cytotoxicity in vitro against human tumor cell lines and in vivo against P-388 murine leukemia resistant to cytosine arabinoside. Dose-limiting toxicities were stomatitis and diarrhea to a lesser extent. There was no substantial myelosuppression. The authors recommend either of two intravenous regimens for studies of therapeutic activity in selected patients with neoplastic diseases: a one-day treatment repeated of PALA, 5.0 g/m2 and L-alanosine, 3.0 g/m2, repeated every 3 weeks; or a monthly program of PALA, 500 mg/m2/d 1-5 and L-alanosine, 60 mg/m2/d 1-5. PMID- 6861101 TI - Adjuvant postoperative radiation therapy for colorectal carcinoma above the peritoneal reflection. II. Antimesenteric wall ascending and descending colon and cecum. AB - From 1970 to 1981, 50 patients had curative surgery for carcinoma of the cecum, ascending, or descending colon and were Stage greater than or equal to B2. In 15 cases, the lesion originated on the antimesenteric (posterolateral) bowel wall. Of seven cases (with minimum three-year follow-up) not receiving adjuvant postoperative regional irradiation, four recurred in the tumor bed/abdominal wall versus 0/3 irradiated patients. Similarly, the five-year survival was improved in the irradiated group (2/3) versus only 2/9 in the unirradiated group. Patients with transmural extension of right or left colon cancers originating on the anti mesenteric (posterolateral) bowel wall may have a high incidence of postoperative regional failure which may be decreased by adjuvant postoperative regional irradiation. PMID- 6861102 TI - Pseudomyxoma peritonei: preoperative diagnosis by ultrasound and computed tomography. A case report. AB - Pseudomyxoma peritonei is an unusual condition caused by rupture of a mucinous neoplasm. Correct preoperative diagnosis can now be made by use of ultrasound and computed tomography. PMID- 6861103 TI - Clinical application of a whole blood assay for human natural killer (NK) cell activity. AB - A whole blood assay for assessment of spontaneous or NK-cell activity has been proposed in order to avoid many of the problems encountered with the conventional methods involving cell separation procedures. Normal subjects and patients with cancer of the kidney or bladder were investigated with the new method. Cancer patients were found to exhibit significantly lower levels of reactivity when compared to normal subjects; furthermore, the results were consistent with the common belief that tumor burden and NK activity were inversely related. The whole blood assay appears useful in monitoring cancer patients, particularly those treated with immune modulators. PMID- 6861104 TI - Results of a uniform histopathologic review system of lymphoma cases. A ten-year study from the Southeastern Cancer Study Group. AB - To determine the usefulness of a consulting panel for histopathologic review in lymphoma cases, a comparative study of the histopathologic diagnosis of the local pathologist was done and compared with the final diagnosis by an expert pathologist in 1088 cases of lymphoma studied by the Southeastern Cancer Study Group (SECSG) during the implementation of five protocols during the last ten years. The following conclusions were reached: (1) In 44 cases (4%), the material sent for review was judged inadequate to make a diagnosis; (2) In 82 cases (8%), the local pathologist's diagnosis was judged incorrect; (3) In Hodgkin's Disease (HD), the diagnosis was confirmed in 545 of 595 cases (92%). However, using the Lukes and Butler classification by subtype of HD, the expert pathologist judged only 289 of 595 cases as correct (49%). The least agreement was found in the lymphocytic predominance (LP) subtype, in which only six of 34 (18%) cases were correct. The best correlation was found in the nodular sclerosis (NS) type of HD where agreement occurred in 161 of 186 (87%) cases; and (4) In the non-Hodgkin's lymphomas (NHL) the diagnosis was confirmed in 428 of the 493 cases studied (87%). Subclassification using the Rappaport system revealed agreement in 274 of 493 (56%) cases. Subtypes associated with good prognosis were judged correct by the expert pathologist in 105 of 139 instances (76%). Likewise, agreement in subtypes of poor prognosis occurred in 254 of 351 cases (72%). These data again confirm the need for an uniform consulting panel system especially for cases involved in cooperative group trials. This has even become more important now with the increasing complexity of the different classifications currently in use. PMID- 6861106 TI - Second malignant tumors detected by needle aspiration cytology. AB - Between 1967-1980, 14 second primary cancers were detected by needle aspiration cytology in patients treated for malignant tumors. The interval between the first cancer and the occurrence of the second cancer varied from six months to 21 years. In all 14 cases, the cytologic diagnosis of the second cancer was later confirmed by histopathologic examinations. In 13 patients, the second cancer was dissimilar from the first one, and in one patient the two cancers were subtypes of lymphoproliferative tumors. In three patients the cytologic diagnosis falsely defined the subtype of the second cancer. Malignant lymphoma was the predominant tumor either as the first cancer (50%) or as the second cancer (43%). Thyroid cancer occurred as the second cancer in three patients. Needle aspiration cytology of all newly appearing lesions can be performed routinely during follow up examinations to discriminate between relapsed disease and new malignant tumors. PMID- 6861105 TI - Cytologic examination and CEA measurement in aspirated pancreatic material collected by percutaneous fine-needle aspiration biopsy under ultrasonic guidance for the diagnosis of pancreatic carcinoma. AB - Diagnostic accuracy of the cytologic examination or CEA measurement in pancreatic fluid obtained by percutaneous fine-needle aspiration biopsy under ultrasonic guidance, was investigated in 26 patients with histologically proven carcinoma of the pancreas, and the incidence of positive results of cytology and CEA assay were compared in pancreatic fluid obtained by percutaneous fine-needle aspiration biopsy and by endoscopic cannulation of the ampulla of Vater in the same 19 patients. Positive cytologic findings were observed in the fluid obtained by percutaneous aspiration biopsy of 88.5% of the patients with pancreatic carcinoma. The location of the cancer had no influence on the cytology, but positive results were more frequent in patients with distant metastases than in those with localized tumor or locally invasive carcinoma. Positive cytologic results were obtained in the pancreatic fluid obtained by endoscopic cannulation from the ampulla of Vater of only 15.8% of the patients examined by both methods, but percutaneous fine-needle aspiration biopsy significantly increased the diagnostic rate. In the specimens obtained by aspiration biopsy, tumor cells were much more abundant and easily recognizable. When cytologic examination does not provide any evidence of malignancy, measurement of CEA levels in pancreatic fluid is probably useful. Combination of the cytology and CEA assay of the specimens obtained by percutaneous fine-needle aspiration biopsy of the pancreas increased the diagnostic rate to 100%. PMID- 6861107 TI - Adrenal cortical carcinoma. A study of 77 cases. AB - Seventy-seven patients with histologically proven adrenal cortical carcinoma seen at the University of Texas M. D. Anderson Hospital (1950-1981) were studied. Thirty-nine were women (mean age at diagnosis, 36.6 years), and 38 were men (mean age at diagnosis, 48.3 years). On presentation, 41 of 74 had abdominal symptoms (55.4%) and 25 of 74 had an abdominal mass (33.8%). Twenty-six patients (33.8%) were found to have clinically functional disease (18 women, 8 men). At diagnosis, 26 (33.8%) had clinical or radiologic signs of distant metastases. Preoperative radiologic studies yielded an abnormal intravenous pyelogram in 42 of 51 (82%), an abnormal abdominal ultrasound in eight of nine (88.9%), abnormal computerized tomography in 10 of 10 (100%), and abnormal arteriogram in 18 of 19 (94.7%). Surgery for localized or regional disease was associated with a disease-free interval of at least 2 years in 16 of 34 patients (47%). The use of op'DDD, abdominal radiotherapy, and systemic chemotherapy produced demonstrable effects in nine of 47 (19.1%), two of nine (22.2%), and three of 26 (11.5%), respectively. Distant metastases occurred in 60 patients, commonly in lung, liver, peritoneal and pleural surfaces, lymph nodes, and bone. Analysis of survival data showed a 5-year survival of approximately 30%. The authors concluded that early diagnosis and radical surgery offer the only prospects of long-term survival and the possibility of cure. PMID- 6861108 TI - Sclerosing variants of follicular center cell lymphomas presenting in the retroperitoneum. AB - A study of 22 patients with sclerosing variants of follicular center cell lymphoma (FCCL) presenting as a retroperitoneal mass is reported. These FCCL variants comprise 74% of retroperitoneal non-Hodgkin's lymphoma presentations. A partial intranodal follicular growth pattern was present in each case, and marked sclerosis of a distinctive pattern was associated with extensive perinodal lymphomatous infiltration. Small cleaved cells (SCC) predominated in five cases, large cleaved cells (LCC) in 14, and large noncleaved cells (LNCC) in three. Eighty percent of patients with SCC predominance were Stage I-II, compared to 50% of those with LCC predominance; all three LNCC cases were Stage IV. High stage was attained primarily by renal invasion or infiltration out the mesenteric root into gut or omentum; only three patients had biopsy proven extraabdominal disease. Combined modality therapy achieved an 88% complete or partial remission rate in patients with SCC and LCC predominance; all three LNCC patients died. PMID- 6861109 TI - A statistical approach to an individualized prognostic index (IPI) for breast cancer survivability. AB - The authors present 611 and 262 case histories of patients with breast cancer, studied 5 and 10 years after mastectomy, respectively; 27 clinical and 10 histologic parameters were considered for the statistical evaluation, in order to define an Individualized Prognostic Index (IPI) for breast cancer survivability. The probability of survival was estimated by a Bayesian formula using selected prognostic parameters, these parameters were placed in order of discriminant resolution and, for the calculation of the IPI, were selected according to their importance, as it follows: 5 years after surgery: percent affected nodules, dermal infiltration, TNM phase, Scarff-Bloom index and evolutive outbreak (PEV); 10 years after surgery: TNM phase, dermal infiltration, percent affected nodules and Scarff-Bloom index. The current information considers that out of several parameters, the selected prognostic parameters used for the IPI are sufficient to establish probability tests and a reliable estimation of life expectancy following breast cancer surgery. PMID- 6861110 TI - Parametrial implant in Stage III B cancer of the cervix. III. A five-year study. AB - Since 1975, the Department of Radiation Therapy, University of Maryland Hospital initiated a policy of supplementing the dose to the affected parametrium by using radium needles implants in conjunction with a protruding tandem preferably, or Manchester ovoid in the case of absence of the lower segment of the uterus. The authors have noted a remarkable improvement in local control as well as an improved three-year survival rate with minimal immediate complications. Additional Stage IIIB (FIGO) cases were collected and they were treated by the same technique and have a close follow-up since 1975. Forty-nine cases studied, 32 (65%) survived with disease-free status for a minimum of five years with no loss to follow-up. Local control was excellent, as expected, at the level of 84% (41/49). There were 8% major complications as a consequence of radiation treatment and the majority of them required surgical intervention with excellent success. Paraaortic metastasis remains a major problem and requires further study. The current plan will include retroperitoneal exploratory laparotomy and para-aortic node sampling with extension of the external beam portals to include the positive node region and followed by interstitial and intracavitary brachytherapy. PMID- 6861111 TI - Paraganglioma of the cauda equina. AB - The authors present two cases of paraganglioma located in the cauda equina. Diagnosis was suspected by light microscopy and confirmed with the identification of characteristic neurosecretory vesicles. The presence of cytoplasmic filaments in both of our cases and of cilia in one case are very unusual findings in paraganglioma and seem to be characteristic of this location. The cauda equina is a extremely rare location for this type of tumor and, as far is known, only ten other cases have been reported. Paraganglioma should be considered as a diagnostic possibility in order not only to make a correct diagnosis, but also to prepare tissues for special stains and biological and electronmicroscopic studies. PMID- 6861112 TI - Cutaneous malignant melanoma in Alberta: 1967-1976. AB - The records of 519 patients with cutaneous malignant melanoma (CMM) were analyzed for the period 1967 to 1976 from the population-based cancer registry of the Province of Alberta in Canada. During this period, the incidence of CMM rose more rapidly in men (especially those older than age 50 years) than in women. Five year survival rates were 59% and 74% for men and women, respectively. Women survived longer mainly because of a longer disease-free interval. Once the disease recurred, however, the mean time to death was similar for both men and women. Primary lesions were most frequent on the trunk, and head and neck in men, and on the lower limbs in women. The proportion of trunk lesions is increasing in both sexes, especially in persons younger than age 50 years. The lack of a consistent upward trend for lesions on the lower limbs in women was unexpected. The data predict a growing contribution of trunk lesions is young men to the increasing incidence and mortality of CMM in Alberta. PMID- 6861113 TI - Normal bone marrow karyotype in paroxysmal nocturnal hemoglobinuria--a cooperative European study. AB - Sixteen patients with paroxysmal nocturnal hemoglobinuria (PNH) from five European centers have been submitted to chromosome analysis. All of them had a normal bone marrow karyotype. The associations between some chromosomally abnormal cases reported in the literature and "typical" PNH or PNH phenomenon during the course of other hematological disorders are discussed. PMID- 6861114 TI - Acute nonlymphocytic leukemias and dysmyelopoietic syndromes in patients treated for Hodgkin's lymphoma. AB - The clinical, hematological, and cytogenetical features of six patients with hematological disorders secondary to Hodgkin's lymphoma (HL), are described. Three patients developed a dysmyelopoietic syndrome (DMS); three, an acute nonlymphocytic leukemia (ANLL). Chromosomal analyses showed a normal karyotype in one case and an abnormal one in five cases: one with a 53-chromosome clone, two with a pseudodiploid pattern plus hyperdiploid subclones, and two with a hypodiploid pattern. Trisomy 21 was observed in two cases, tetrasomy 21 in one case, monosomy 5 and monosomy 7 in two cases. The correlations of chromosomal changes with hematological abnormalities or clinical aspects are discussed. PMID- 6861117 TI - Chromosome analysis of human neuroblastoma cell line TR14 showing double minutes and an aberration involving chromosome 1. AB - The chromosomal analysis of a human neuroblastoma cell line derived from a pediatric patient is presented. The cell line has a modal chromosome number of 64 and contains large numbers of double minutes (DMs). The DMs are stable over many passages in vitro. A consistent feature of the karyotype is an abnormality involving the short arm of chromosome 1, which is consistent with previous reports from human neuroblastomas. The region distal to band 1p31 has homogeneously staining characteristics and as such this cell line represents a rare example where DMs and HSRs are constitutive features of the same cells. The possibility that such regions could arise from chromosome rearrangements is discussed. PMID- 6861115 TI - 5q- anomaly in a patient with disseminated teratoma. AB - A 5q- anomaly associated with other chromosome anomalies was found in the infiltrated bone marrow of a patient with a highly malignant teratoma originally located in the mediastinum. There was no evidence of a second malignancy, and it is likely that the 5q- anomaly was, indeed, associated with the malignant teratoma cells. PMID- 6861116 TI - Induction and reduction of sister chromatid exchange by CCNU in human lymphocytes in vitro. AB - Sister chromatid exchange (SCE) was studied in human lymphocytes treated with 1 (2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) in vitro. A dose-dependent increase of SCE was observed in cells exposed to 10(-5) - 10(-4) M CCNU. The maximal increase was 25-35 SCEs/cell over the control level, which is similar to the increase found in patients treated with CCNU in vivo. In the presence of rat liver microsomes (S-9 fraction) the frequency of CCNU-induced SCE was slightly higher than in parallel cultures without S-9, suggesting that microsomal metabolism may enhance the rate of decomposition of CCNU into reactive products. The CCNU-induced increase of SCE was greater in cells treated for longer time periods (up to 70 hr) than in cells subjected to a 1-hr treatment. This effect was most pronounced at higher concentrations of the drug (5 X 10(-5) M). The frequency of CCNU-induced SCE was also found to be dependent on the time of treatment in the cell cycle. A treatment for 1 hr during early G1-phase (about 20 hr before the first S-phase) gave rise to a higher increase of SCE than a 1 hr treatment immediately before or during the first or second S-phase. Thus, the CCNU-induced DNA damage leading to SCE seems to persist and may even increase during the prereplicative phase of the cell cycle. After replication in BrdUrd free medium, the frequency of CCNU-induced SCEs decreased to the control level. The present results, taken together with other studies of strand break and cross link formation by CCNU in mammalian cells in vitro, suggest that the major SCE inducing damage by CCNU is DNA interstrand cross-links. These lesions then appear to be slowly removed, if at all, during the prereplicative phase of the cell cycle, and to disappear during or after replication in BrdUrd-free medium in vitro. PMID- 6861119 TI - Cells with double minutes divided into two categories. PMID- 6861118 TI - Sister chromatid exchange: variation by age, sex, smoking, and breast cancer status. AB - Variation in sister chromatid exchange (SCE) frequency in lymphocytes of 125 persons was compared using a multivariate general linear model. The study was performed to determine whether SCE frequency differs with respect to age, sex, smoking, and breast cancer status. Study subjects were divided into: members of two branches of families having an excess of cancer (primarily breast) including a brother and sister in one family who developed nonbreast malignancies within 1 yr of the study; women in both families successfully treated for breast cancer (all at least 5 yr posttreatment); and women from the general population with confirmed breast cancer. Controls consisted of spouses who married into the high risk kindreds, hospital personnel, and others (primarily tradesmen without history of occupational exposure). Results show that: (1) Women with active breast cancer have a significantly higher mean SCE frequency than control women or women greater than 5 yr posttreatment for breast cancer; (2) Cigarette smokers show a significantly higher number of SCEs than was observed in nonsmokers; (3) The increase in SCE level in smokers is dose-related to exposure as measured by cumulative pack-years; (4) SCE values in both high-risk families are not significantly different from controls; (5) Neither the age nor sex of the individual affects SCE frequency; and (6) The observed distribution of exchanges agrees with that expected based on the proportion of the genome represented by each chromosome group. PMID- 6861120 TI - Chromosome abnormalities in acute leukemia: a higher incidence than previously assumed. PMID- 6861121 TI - Ketone body, glucose, lactic acid, and amino acid utilization by tumors in vivo in fasted rats. AB - Arteriovenous differences for acetoacetate, beta-hydroxybutyrate, glucose, lactic acid, and glutamine and other amino acids were measured across Morris hepatomas 5123C, 7777, and 7288CTCF and Walker sarcocarcinoma 256 in vivo in rats fasted for 2 days. The acetoacetate and beta-hydroxybutyrate concentrations in arterial whole blood of fasted tumor-bearing rats were 0.52 +/- 0.06 and 1.82 +/- 0.19 mM (S.E., n = 38), respectively. Both ketone bodies were utilized by the tumors, and the rates of utilization were directly related to the rates of supply. The mean utilization rates for acetoacetate and beta-hydroxybutyrate were 13.9 +/- 2.9 (range, 0 to 64; n = 30) and 24.7 +/- 4.4 (range, 0 to 145; n = 38) nmol/min/g tumor wet weight, respectively. Eight of the tumors produced acetoacetate, presumably from utilized beta-hydroxybutyrate. An average of 52% of the acetoacetate and 30% of the beta-hydroxybutyrate carried in the arterial blood was removed during one pass through the tumors. The concentrations of glucose and glutamine in the arterial whole blood of fasted tumor-bearing rats (n = 38) were 6.55 +/- 0.3 and 0.76 +/- 0.02 mM, respectively; both of these substrates were utilized at rates that were directly proportional to the rates of supply. The mean rates of glucose and glutamine utilization for all tumors in fasted rats were 101 +/- 11 (range, 3 to 313) and 8.2 +/- 1.1 (range, 0 to 25.1) nmol/min/g tumor wet weight, respectively. Thirty-six % of the glucose and 25% of the glutamine supplied to the tumors was utilized. Comparison (by linear regression and analysis of covariance) of the rates of supply and utilization of glucose and glutamine in tumors growing in fasted versus fed rats indicated that these substrates are utilized more efficiently by tumors growing in fasted animals. Lactic acid was either produced or utilized, depending on the arterial whole blood concentration. Production or utilization occurred, respectively, when the arterial lactate concentration was less or greater than 1 to 3 mM. The arterial whole-blood amino acids (except glutamine) were utilized at rates that ranged from 1 to 4 nmol/min/g tumor wet weight. The results indicate that energy production for tumor growth in fasted rats is supported, in part, by an increased availability of ketone bodies, by an increased efficiency of utilization of glucose and glutamine, and, under certain circumstances, by utilization of lactic acid. PMID- 6861123 TI - Demonstration of immunogenicity with the poorly immunogenic B16 melanoma. AB - Animal tumors of spontaneous origin have consistently been found to be less immunogenic than are tumors induced by chemical carcinogens or oncogenic viruses. Spontaneous tumors rarely demonstrate significant immunogenicity in classical transplantation rejection tests. This study demonstrates a novel approach to the question of tumor immunogenicity using viable tumor cells in diffusion chambers. Classical transplantation rejection was induced to the poorly immunogenic, spontaneous B16 murine melanoma by implantation of diffusion chambers containing viable B16 melanoma tumor cells. Implantation of B16 chambers i.p. for at least 4 weeks induced specific, long-term resistance to subsequent live B16 tumor cell challenge. In contrast, immunization with irradiated tumor cells for the same time interval resulted in a delay of tumor growth but had no effect on survival. These studies demonstrate the possibility that a significant anti-tumor immune response against the B16 melanoma may be induced without the presence and negative regulatory influences of a progressively growing B16 tumor. In addition, the diffusion chamber sensitization technique may detect the antigenicity of some tumors which are not detectable by classical transplantation rejection tests. Thus, the diffusion chamber technique provides another avenue for testing the immunogenicity of tumors, especially those of spontaneous origin. PMID- 6861122 TI - Toxicity of methyldopa (Aldomet) to mouse neuroblastoma cells in vivo. AB - The adrenergic blocking agent methyldopa (Aldomet) is toxic to C-1300 neuroblastoma cells in vivo. Four injections of Aldomet at a dose of 7.5 mg/injection were given over a period of 24 hr to C-1300 neuroblastoma-bearing mice. This treatment killed a significant proportion of the C-1300 neuroblastoma cells. Flow cytometric data suggest that sensitivity of tumor cells to Aldomet is not related to the cell cycle. PMID- 6861124 TI - Effects of extreme hypoxia on the growth and viability of EMT6/SF mouse tumor cells in vitro. AB - The purpose of this study was to characterize a model system in which to study hypoxic cell biology in vitro as a function of time under extremely hypoxic conditions. EMT6/SF cells that were maintained at 37 degrees under hypoxic conditions showed no increase in cell number for up to 70 hr. The mitotic index of hypoxic cultures was less than 0.1%, compared to 2.3 to 3.0% in aerated cultures. The plating efficiency of hypoxic cells decreased with time to 20 to 30% of control values by 70 hr. Aerated cultures consumed glucose more rapidly than did hypoxic ones, due to increasing cell number in air. But, on a per cell basis, hypoxic and aerated cells consumed glucose at equal rates (congruent to 1.2 X 10(-4) micrograms/cell/hr). Virtually 100% of the glucose consumed was converted into lactic acid in both aerated and hypoxic cultures. The labeling index and rate of incorporation of [3H]thymidine decreased exponentially with time in hypoxia. However, the percentage of cells with S-phase DNA content remained nearly constant for up to 72 hr. The rate of protein synthesis was suppressed in hypoxic cultures to between 20 and 50% of control (aerated) rates. When cultures were reaerated following 45 hr of hypoxia, congruent to 12 hr was required for resumption of DNA synthesis and cell division. The application of this system to further study of hypoxic cell biology is discussed. PMID- 6861125 TI - Relationship of adriamycin concentrations to the DNA lesions induced in hypoxic and euoxic L1210 cells. AB - Exponentially growing L1210 mouse leukemia cells were incubated with Adriamycin (ADR) under hypoxic (95% N2:5% CO2) or euoxic conditions (95% air:5% CO2) for 1 hr at 37 degrees at a drug concentration ranging from 2.8 X 10(-8) to 2.8 X 10( 4) M, i.e., from levels attained clinically by bolus delivery to the high levels used as an i.p. drug dwell or experimentally, in in vitro conditions. High pressure liquid chromatography analyses showed diminishing efficiency in drug uptake by the cells as the dose was increased. There were no significant differences between hypoxic and euoxic cells in drug uptake and metabolism. The frequency of DNA protein-associated single-strand breaks and DNA-protein cross links per 10(6) nucleotides, detected by the alkaline elution technique, increased with the dose in the range of 2.8 X 10(-8) to 2.8 X 10(-6) M in both euoxic and hypoxic cells and declined thereafter. However, the number of DNA lesions relative to a normalized drug level declined steadily, starting with the 2.8 X 10(-7) M concentration. Concentrations greater than 2.8 X 10(-6) M of ADR induced still another type of lesion, direct DNA strand breaks, only in euoxic cells. The results indicate that a common mechanism of interaction between drug and DNA is present in hypoxic and in euoxic cells at low ADR, while an O2 dependent mechanism becomes operational in euoxic cells at high ADR levels. PMID- 6861127 TI - Time-dose relationships for simultaneous misonidazole and 1,3-bis(2-chloroethyl) 1-nitrosourea exposures in vitro. AB - The effect of incubating KHT-iv tumor cells with 1,3-bis(2-chloroethyl)-1 nitrosourea (BCNU) alone or in simultaneous combination with the radiation sensitizer misonidazole (MISO) was determined for aerobic and hypoxic incubations. Relative to aerobic exposures, the cytotoxicity of BCNU was significantly enhanced when KHT-iv cells were exposed under hypoxic conditions for 1 hr. This effect was apparently related to a trypsin effect and was absent in experiments with cells trypsinized immediately prior to treatment. In contrast to 1-hr exposures, treatment for 4 hr to the same total BCNU exposure doses resulted in equivalent cell killing under aerobic and hypoxic conditions. The addition of 3 mM MISO to the 1-hr treatment protocol did not significantly modify the toxicity of BCNU toward aerobic or hypoxic cultures of KHT-iv cells. However, the cell-killing efficiency of BCNU during a 4-hr hypoxic exposure was significantly enhanced by the addition of MISO doses as small as 0.5 mM. Addition of sensitizer did not modify the 4-hr aerobic toxicity of BCNU. The decay of BCNU was not significantly altered by MISO or by low oxygen tensions, effectively eliminating the role of altered pharmacokinetics in this example of in vitro chemosensitization. These results suggest that prolonged exposure times and hypoxia are prerequisites for the expression of chemosensitization when MISO is combined simultaneously with certain chemotherapeutic agents in vitro. By comparison to the doses of MISO used in preincubation experiments, it was possible to produce enhanced cytotoxicity by relatively small MISO doses. PMID- 6861126 TI - Reduction of estrogen receptor concentration in MCF-7 human breast carcinoma cells following exposure to chemotherapeutic drugs. AB - To study the effects of commonly used chemotherapeutic drugs on estrogen receptor (ER) of human breast cancer, we investigated the specific binding of [3H]estradiol within intact MCF-7 human breast cancer cells after 1 to 4 hr of exposure to methotrexate (0.5 to 50 micrograms/ml), 5-fluorouracil, and vincristine in serum- and hormone-free medium. Intracellular [3H]estradiol binding was either slightly increased (methotrexate and 5-fluorouracil) or not changed (vincristine) during the first 2 hr of drug exposures at 37 degrees, but slightly decreased at the third hr. After 4 hr of drug treatments, [3H]estradiol binding within MCF-7 cells was reduced by 30 to 70%; the response was dose dependent. Most (80 to 83%) of the intracellularly bound [3H]estradiol was found within the nuclei, and the drug-induced reduction of ER was reflected by a depleted nuclear uptake of [3H]estradiol. The Scatchard plot showed a large decrease of receptor number per cell with no apparent alteration in the binding affinity. The reduction of ER was reversible; regeneration of receptors to the control level occurred at either 4 hr (methotrexate and 5-fluorouracil) or 8 hr (vincristine) after removal of these drugs. The restoration was followed by an increase of ER beyond the control level. The dose-dependent depletion of ER by these cytotoxic drugs was also detectable in a second ER-positive cell line, MDA MB-134. These data indicate that the cytotoxic drugs may cause a dose-dependent, reversible depletion of ER in human breast cancer, and the effect seems to be due to inhibition of receptor synthesis rather than inhibition of the binding of estradiol to its receptors. PMID- 6861128 TI - Biological effects and structure-activity relationships of 1,2-dihydropyrido[3,4 b]pyrazines. AB - The effects of a number of 1,2-dihydropyrido[3,4-b]pyrazines (1-deaza-7,8 dihydropteridines) upon the proliferation and the mitotic index of cultured L1210 cells and upon the survival of mice bearing P388 leukemia were determined. The 1,2-dihydrostructure and amino groups or masked amino groups at positions 5 and 7 were necessary for activity, and various substituents at positions 2 and 3 had considerable influence upon the activity. A number of these pyrazines had significant activity against i.p. P388 leukemia in mice, and several pyrazines were more active than the corresponding oxazines or thiazines in both the in vitro and the in vivo systems. The effects of the pyrazines upon the cultured cells were reversible, and the rate and degree of reversibility were influenced by the substituents at positions 2 and 3. Tests performed with two of the pyrazines yielded results that indicate that these compounds, like the known agent nocodazole, might compete with colchicine for binding to tubulin. Synergistic killing of cultured L1210 cells was obtained with combinations of one of the pyrazines and vincristine. PMID- 6861129 TI - Metabolic activation of styrene by erythrocytes detected as increased sister chromatid exchanges in cultured human lymphocytes. AB - Styrene induces sister chromatid exchanges (SCEs) in human whole-blood lymphocyte cultures without exogenous metabolizing systems, which indicates that styrene is metabolically activated in this in vitro system. Whole-blood lymphocyte cultures from 11 male donors showed a clear increase in SCEs after a 48-hr treatment with styrene (2 mM) or with the reactive metabolite styrene 7,8-oxide (0.15 mM). Styrene (0.5 to 4 mM) induced a distinct dose-dependent increase of SCEs in whole blood cultures (with 200 to 400 million red blood cells/ml) but only a slight effect in purified lymphocyte cultures (with 20,000 red blood cells/ml). SCE induction by styrene (2 mM) depended on the amount of red blood cells (0.02 to 2000 million/ml) added to the purified lymphocyte cultures. Cyclophosphamide, studied for comparison, clearly increased SCEs irrespective of the presence of erythrocytes. The results show that erythrocytes are essential for the activation of styrene in the lymphocyte test system. This activation probably results from the conversion of styrene into styrene 7,8-oxide by oxyhemoglobin. PMID- 6861130 TI - Effects of tamoxifen on human breast cancer cell cycle kinetics: accumulation of cells in early G1 phase. AB - We have studied the effects of tamoxifen on the cell cycle kinetics of the endocrine-responsive MCF-7 human breast cancer cells. Tamoxifen inhibits proliferation of MCF-7 cells. The tritiated thymidine labeling index is markedly reduced by tamoxifen, indicating a reduction in the fraction of cells in S phase. Flow cytometry of mithramycin-stained cells reveals that cells accumulate in G1 phase, with a concomitant depletion of S- and G2-M-phase cells with tamoxifen. Mapping of G1-phase cells by morphology of prematurely condensed chromosomes demonstrated that tamoxifen-treated cells accumulate in early G1. These studies indicate that tamoxifen inhibits proliferation of MCF-7 human breast cancer cells by invoking a transition delay early in the G1 phase of the cell cycle. PMID- 6861131 TI - Effects of vincristine on cell survival, cell cycle progression, and mitotic accumulation in asynchronously growing Sarcoma 180 cells. AB - The effects of vincristine (VCR) on cell survival, cell cycle progression, DNA synthesis, and metaphase accumulation were studied in relation to drug concentration and drug exposure duration in Sarcoma 180 cells in vitro. VCR was found to affect cells in interphase, producing a transient G2 block at all drug concentrations and drug exposure durations studied. VCR did not affect DNA synthesis directly. Increases in the metaphase index were delayed and always peaked at approximately 8 hr after drug removal, regardless of the duration of drug exposure. Increases in the metaphase index of sufficient magnitude to be commensurate with VCR lethality were observed only with prolonged drug exposure. VCR produced both nuclear fragmentation and polyploidy. The proportion of cells undergoing polyploidy increased progressively with increasing drug exposure duration. Interference with cytokinesis during prolonged VCR exposure may represent a lethal effect of VCR that is separate from its short-term effects. This could serve as the basis for the clinical study of the antitumor effects of prolonged VCR infusions. PMID- 6861132 TI - Schedule dependence of vincristine lethality in Sarcoma 180 cells following partial synchronization with hydroxyurea. AB - The effects of exposure to 0.1, 0.5, or 2 microM vincristine for 4 hr were studied in Sarcoma 180 cells at various times after synchronization with 5 mM hydroxyurea for 1 hr. Maximum sensitivity to the lethal effects of vincristine was observed at 10 to 14 hr after hydroxyurea exposure at the higher vincristine concentrations, compared to a period of a maximum sensitivity to a second dose of hydroxyurea at 8 to 12 hr. Serial flow cytometry studies indicated that the apparent decrease in sensitivity to vincristine at 14 to 18 hr was due to the division of cells in the leading segment of the synchronized wave and their entry into the relatively resistant G1 phase prior to vincristine exposure. Synchronized cells that had not divided at the time of vincristine exposure were blocked transiently in G2. Serial metaphase index studies suggested that the G2 cells closest to the end of the cell cycle at the time of vincristine exposure were likely to exhibit the greatest degree of mitotic disorganization when they overcame the G2 block and entered metaphase. The present studies suggest that sensitivity to vincristine increases progressively as cells approach mitosis. The molecular mechanisms underlying this phenomenon are considered in relation to the increase in cell tubulin content during the course of cell cycle progression. PMID- 6861133 TI - Rapid and reversible inhibition of junctional communication by tumor promoters in a mouse cell line. AB - HEL-37 cells rapidly transferred microinjected fluorescein between contacting cells. This transfer was strongly inhibited by tumor-promoting phorbol esters and mezerein but not by non-promoting derivatives. The onset of the inhibition occurred after 5 to 10 min of exposure to the test compound and was complete within 20 min. Using a wash-off procedure, it was demonstrated that inhibition of dye transfer by phorbol-12, 13-dibutyrate was fully reversed by 100 min, after a lag of 40 to 60 min. The recovery of dye transfer competence was blocked by puromycin. Both 12-O-tetradecanoylphorbol-13-acetate and monensin caused elevated Na+ levels in HEL-37 cells, but the latter compound did not inhibit dye transfer. It was concluded that the promoter inhibition of transfer was not a consequence of Na+-induced increase in cytoplasmic Ca2+ concentration. PMID- 6861134 TI - Effect of pyran copolymer on activation of murine macrophages: evidence for incomplete activation by use of functional markers. AB - The degree of activation of peritoneal macrophages elicited by pyran copolymer (MVE-2) was studied in C57BL/6J mice. When cytotoxicity was examined under endotoxin-free culture conditions, the pyran-elicited macrophages could not complete cytolysis of tumor target cells. The macrophages, however, completed cytolysis when pulsed with endotoxin. These results were obtained when either the interval between injection of the pyran copolymer and harvest of the macrophage or the dose of pyran was varied. The pyran-elicited macrophages expressed five markers considered to be typical of inflammatory macrophages, and bound tumor cells to an augmented degree. The pyran-elicited macrophages were capable of secreting a potent cytolytic proteinase when pulsed with endotoxin, but did not secrete cytolytic proteinase spontaneously. The pyran-elicited macrophages, in contrast to inflammatory macrophages, could effect cytostasis of tumor cells; their cytostatic potential was also augmented by addition of endotoxin. Taken together, the results indicated that pyran copolymer elicits primed but not fully activated murine macrophages. PMID- 6861135 TI - Energy metabolism in nongrowing mice with sarcoma. AB - The time course of energy metabolism has been studied in weight-stable and nongrowing mice with a transplantable methylcholanthrene-induced sarcoma. Daily oxygen consumption and carbon dioxide production were measured in relation to the tumor growth from the time of tumor implantation. The time course of energy dynamics was related to the end-state changes in body composition. Freely fed sarcoma-bearing mice decreased their whole-body energy expenditure in proportion to the tumor growth. This was due to the accompanying anorexia. The alteration in oxygen consumption and carbon dioxide production was continuously evident 24 hr/day in sarcoma-bearing mice. The tumor-bearing mice lost body fat and had decreased respiratory quotient, while pair-fed controls maintained their body composition, and their respiratory quotients agreed with the food respiratory quotient. Loss of body lipids in freely fed sarcoma-bearing mice reflected a negative energy balance, accompanied with increased fat oxidation, while maintenance of body composition in pair-fed controls reflected a decreased metabolic rate. Sarcoma-bearing mice showed a significantly higher energy expenditure in relation to their food intake compared to that of pair-fed controls. Estimates of partition of oxygen uptake in sarcoma-bearing mice support that both the host and the tumor account for the elevated energy expenditure. This study has confirmed a small but significantly increased energy expenditure in sarcoma-bearing mice, which was continuously present 24 hr/day in spite of unlimited availability of food. This illustrates the fatal outcome of experimental cancer. PMID- 6861136 TI - Genetic control of susceptibility of rats to gastric carcinoma. AB - Genetic control of the induction of gastric tumors by N-methyl-N'-nitro-N nitrosoguanidine (MNNG) was studied in susceptible ACI rats, resistant Buffalo rats, and their F1 and F2 offspring. Both sexes of all strains, initially 7 to 9 weeks old, were given MNNG at a concentration of 83 micrograms/ml in their drinking water for 32 weeks and were sacrificed at experimental Week 72. The incidence of gastric adenocarcinoma in ACI rats was 80% in males and 47% in females; in Buffalo rats, the incidence was 18% in males and 0% in females. F1 hybrids showed the same resistance to MNNG as did Buffalo rats; the incidence of gastric adenocarcinoma was 17% in males and 8% in females. These results suggest that resistance to induction of gastric adenocarcinoma by MNNG is a dominant characteristic. The incidence of gastric adenocarcinoma in the F2 generation was 36% in males and 14% in females, which is close to the 3:1 ratio expected from the segregation of a single resistant gene. In ACI and Buffalo strains and their hybrids, males were more susceptible than females to induction of gastric carcinoma by MNNG. Intestinal tumors were observed mainly in the duodenum and jejunum in both strains and their hybrids, and the incidences were as follows: ACI: males, 67% and females 42%; Buffalo: males, 12% and females, 18%; F1: males, 18% and females, 15%; and F2: males, 15% and females, 19%. Thus, there seems to be a common genetic basis for both gastric and intestinal carcinogenesis by MNNG. PMID- 6861137 TI - Differential response of an ovarian-responsive mouse mammary tumor to androgenic and estrogenic agents. AB - An ovarian-responsive mammary tumor subline, T4-OR26, was isolated from an outgrowth of a progressed TPDMT-4 pregnancy-dependent mammary tumor in a virgin DDD mouse. T4-OR26 tumors were characterized by significantly faster growth in virgin mice than in ovariectomized mice. Both estrogen and progesterone were important for growth of the subline, as they were for that of the parent. Tamoxifen (TAM), with estrogenic activity, and epithiostanol (EPI) and testosterone propionate, with androgenic activity, which all caused TPDMT-4 tumors to regress, were compared for antitumor potency against the new subline by 3 s.c. injections weekly in virgins. EPI at 300 micrograms and testosterone propionate at 1000 micrograms elicited immediate tumor growth suppression with subsequent slight regression as did ovariectomy. TAM at 1000 micrograms caused tumor growth suppression after 2 weeks without subsequent regression. At 600 micrograms, EPI but not TAM significantly inhibited 17 beta-estradiol plus progesterone-induced tumor growth; at 400 micrograms, neither had any significant effect on the tumor growth induced by 17 beta-estradiol alone. With regard to their effect on hormone receptors, it was noted that EPI and testosterone propionate treatments with tumor regression caused significant reduction in cytoplasmic progesterone receptor, but TAM treatment, which does not influence tumor growth, did not cause such reduction. The results provide evidence that hormone-dependent mammary tumors may acquire greater resistance to estrogenic than to androgenic therapeutics with progression. PMID- 6861138 TI - Effect of the preestrogen 4-androstene-3,17-dion-19-al on the Dunning R3327 prostatic adenocarcinoma. AB - The purpose of this pilot study was to determine if biogenetic precursors of estrone such as 4-androstene-3,17-dion-19-al, which is virtually devoid of thrombotic potential as well as androgenic and uterotrophic activity, could replace estrogen in the treatment of the hormone-sensitive Dunning R3327 prostatic adenocarcinoma in the male Copenhagen rat. If such were the case, the way would be open to an improved form of palliative therapy of prostatic cancer with the potential for decreased estrogenic side effects and cardiovascular complications. To this end, the R3327 tumor was transplanted (Day 0) into the flank of 10-week-old male Copenhagen rats, and treatment was begun 20 weeks later at which time the tumors reached a mean volume of 2160 cu cm. In addition to 4 androstene-3,17-dion-19-al (1 and 10 mg/day), diethylstilbestrol (33 micrograms/day) and 17 beta-estradiol (3.3 and 33 micrograms/day) were studied (daily for 60 days). At 1 mg/day, 4-androstene-3,17-dion-19-al produced a 43% inhibition of tumor growth (Day 203) while, in the 10 mg/day group, a 72% inhibition of tumor growth was measured on Day 196 (roughly equivalent to that produced by estradiol at 3.3 micrograms/day), with a 50% inhibition on Day 231. It is concluded that the tumor-inhibiting activity of 4-androstene-3,17-dion-19 al, coupled with its very low thrombotic potential, indicated that orally active analogues of this steroid may offer advantages over estrogens in the palliative treatment of prostatic cancer. PMID- 6861139 TI - Inability of cytoplasmic or nuclear androgen receptor content or distribution to distinguish benign from carcinomatous human prostate. AB - We used exchange saturation analysis at 15 degrees to quantitate total cytoplasmic and nuclear androgen receptor content of 70 patient specimens. Cytoplasmic androgen receptor contents (fmol/mg DNA) for eight specimens of clinically benign hyperplasia, 14 specimens of histologically hyperplastic prostate obtained at cystoprostatectomy, and carcinomatous and noncarcinomatous prostate obtained at radical prostatectomy for prostatic carcinoma, 48 specimens, respectively, were 830 +/- 165 (mean +/- S.E.), 890 +/- 445, 955 +/- 240, and 750 +/- 95. Nuclear androgen receptor contents of these same specimens, respectively, were 275 +/- 40, 235 +/- 30, 345 +/- 25, and 350 +/- 30; whereas, the values of the cytoplasmic/nuclear receptor content, respectively, were 3.25 +/- 0.55, 3.05 +/- 0.80, 2.50 +/- 0.50, and 2.80 +/- 0.40. Multiway analyses of variance of these cross-sectional data showed that there was no significant difference (p greater than 0.05) between group mean values. This result principally reflects the fact that the families of values for the four tissue groups were highly heterogenous with broad overlap. The results would not appear to be unduly influenced by carcinomatous epithelial cell content of the specimens, because cytoplasmic and nuclear androgen receptor content were not related to specimen carcinomatous epithelial cell content. Paired analyses of receptor content in carcinomatous and noncarcinomatous prostate specimens from the same prostate showed enhanced or unchanged receptor content in 58% (cytoplasmic) and 62% (nuclear) of specimens. Our studies show that cross-sectional analyses of androgen receptor content fail to distinguish carcinomatous prostate from noncarcinomatous prostate. However, paired analyses of these tissues from the same gland identify distinguishing differences. The clinical relevance of these observations remains to be examined. PMID- 6861140 TI - Enhancement of sensitivity to adriamycin in resistant P388 leukemia by the calmodulin inhibitor trifluoperazine. AB - Resistance to the cytotoxic effects of daunomycin and Adriamycin (ADR) in sublines of Ehrlich ascites and P388 mouse tumors has been demonstrated to be due to reduced cellular accumulation and retention of drug. In this study, the effect of the calmodulin inhibitor trifluoperazine on the cellular accumulation, retention, and cytotoxic effects of ADR in ADR-sensitive (P388/S) and ADR resistant (P388/R) P388 mouse leukemia cells was determined. In cells treated in suspension culture for 24 hr or for 1 hr followed by plating in soft agar, a noncytotoxic concentration of 4 microM trifluoperazine, enhanced the sensitivity to ADR 2- to 6-fold in P388/R but not in P388/S cells. A marked enhancement in cellular retention rather than accumulation of ADR in only P388/R cells was obtained with trifluoperazine treatment. This study suggests the possible novel use of phenothiazines to improve drug sensitivity of tumors resistant to ADR treatment. PMID- 6861142 TI - Flow cytometric and morphological studies of ovarian carcinoma cell lines and xenografts. AB - Human ovarian cancers of four different histological types have been cultured in vitro and in nude mice. Nineteen tumor specimens (11 solid tumors and eight malignant effusions) were obtained from 14 patients. Tumor lines from ten of these patients were established after several subpassages, and six xenograft lines have been grown, all of them from tumors of which a cell line exists in vitro. In all, 14 lines have been successfully cultured from the 19 tumor specimens. The morphology (studied by light and electron microscopy) of the established lines in vitro and in vivo resembles that of the original tumors in all cases. Flow cytometric studies of DNA content of the original tumor specimens and the cell culture and xenograft lines were performed. In all lines in both culture systems, aneuploid cells became predominant after the first to fourth passages, despite an aneuploid peak having been evident in only nine of the 19 initial specimens. Four of the original tumor specimens contained measurable estrogen receptors and five progesterone receptors, but none of the established cell lines expressed these hormone receptors. These results indicate that, while morphological features are similar in the initial tumor specimens and in the established lines in vitro and in vivo, flow cytometric and steroid hormone receptor data suggest selection of aneuploid and receptor-negative cells. PMID- 6861141 TI - Kinetics of N- and C-hydroxylations of 2-acetylaminofluorene in male Sprague Dawley rat liver microsomes: implications for carcinogenesis. AB - The metabolism of 2-acetylaminofluorene (AAF) has been studied in male Sprague Dawley rat liver microsomes over a concentration range of 0.02 to 300 microM, and kinetic parameters have been determined for five oxidative pathways. The N hydroxylation of AAF was best described by a single enzyme system with a mean Km of 0.033 microM and a mean Vmax of 3.63 pmol/mg/min. Pretreatment of animals with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) caused a marked induction of N hydroxylase activity while phenobarbital had no effect. Biphasic kinetics for the 7-hydroxylation of AAF were observed in both control and TCDD- and phenobarbital induced microsomes. The high-affinity Km [0.051 +/- 0.015 (S.E.) microM; n = 3] in control microsomes was 3 orders of magnitude lower than the low-affinity Km (103 +/- 16 microM; n = 3) indicating that each isoenzyme predominated at vastly different substrate concentrations. The mean Vmax values for the low- and high affinity enzymes were 3.5 and 1351 pmol/mg/min, respectively. TCDD pretreatment markedly induced the activity of the low-capacity enzyme and reduced the activity of the high-capacity enzyme. Phenobarbital caused a significant induction of both enzyme pathways. Biphasic kinetics were also observed for the 5-, 3-, and 1 hydroxylations of AAF in control and phenobarbital-induced microsomes, but in TCDD-pretreated microsomes only 1-hydroxylation exhibited biphasic kinetics. TCDD caused a marked induction of these metabolic pathways while phenobarbital had no effect. Nonclassical kinetics were observed for the 9-hydroxylation of AAF, and at high substrate concentrations detoxification via this pathway and 7 hydroxylation predominated. However, at low concentrations, metabolic activation of AAF via N-hydroxylation was a major pathway. These data indicate that multiple forms of cytochrome P-450 are involved in AAF metabolism and that the balance between metabolic activation and detoxification of this substrate is dependent on both concentration and previous exposure to inducers. PMID- 6861143 TI - A new bioactive form of human calcitonin. AB - Distinct immunoreactive forms of calcitonin (CT), extracted with 2 M acetic acid from two pancreatic tumors, were characterized and identified by gel permeation chromatography and by reverse-phase high-performance liquid chromatography. The extracted CT forms were compared to CT obtained from medullary thyroid carcinoma and from normal thyroid glands, and were, furthermore, analyzed in a rat hypocalcemic bioassay. On gel filtration analysis, two broad peaks coeluting with synthetic human CT-(1-32) and extracted dimeric CT, respectively, were found in variable amounts. An acetonitrile gradient high-performance liquid chromatography system revealed two to three predominant CT peaks. Biologically active monomeric and dimeric CT and the biologically inactive sulfoxide form of human CT-(1-32) have been identified. Moreover, we have detected for the first time a new biologically active CT-like component which was most prominently recognized in a benign pancreatic tumor. PMID- 6861144 TI - Regional [14C]misonidazole distribution in experimental RT-9 brain tumors. AB - Regional [14C]misonidazole-derived radioactivity (MISO) was measured by quantitative autoradiography in experimental RT-9 brain tumors 0.5, 2, and 4 hr after an i.v. bolus (25 mg) and constant infusion (10 mg/hr). Misonidazole (MISO) concentration in plasma and brain was also measured by high-pressure liquid chromatography; the brain/plasma MISO ratio ranged between 0.5 and 0.7. MISO equivalents were calculated from tissue or plasma 14C radioactivity and [14C]MISO specific activity data. The MISO/MISO equivalents ratio, which represents the nonmetabolized fraction of [14C]MISO, fell gradually in plasma (0.89 at 4 hr) and more rapidly in brain (0.67 at 4 hr) and tumor (0.30 at 4 hr). MISO distributed uniformly throughout the brain at all three time periods. In contrast, MISO distribution in tumor was variable, and tumor concentrations relative to that in brain increased with time. The average tumor/brain MISO ratio was 1.3, 1.7, and 2.6 at 0.5, 2, and 4 hr, respectively, which suggests tumor uptake and binding of MISO or, more likely, MISO-derived 14C-labeled metabolites. In addition, MISO distribution in tumor tissue was strikingly heterogeneous at 4 hr, resulting in an average high/low tumor activity ratio of 4/1 and an average high tumor/brain ratio of 5/1. Tumor regions with high MISO activity correlated in part to viable appearing cells around necrotic foci. PMID- 6861145 TI - Shedding and immunoregulatory activity of YAC-1 lymphoma cell gangliosides. AB - YAC-1 lymphoma cells, both when cultured in vitro and when passaged in ascites form in vivo, synthesize gangliosides (means of 22.1 and 14.7 nmol lipid-bound sialic acid isolated per 10(8) cells, respectively) with potent inhibitory effects on mitogen- and antigen-induced lymphoproliferation: 10 to 30 nmol highly purified YAC-1 gangliosides/ml caused greater than 90% inhibition of proliferative responses of murine lymphocytes to concanavalin A, lysozyme (a soluble specific antigen), and allogeneic cells (mixed-lymphocyte response). Measureable quantities of these gangliosides were shed by the tumor cells in vitro and also were recovered from the ascites fluid in vivo. Furthermore, the gangliosides isolated from ascites fluid (mean of 15.3 nmol/ml) had inhibitory activity of a magnitude similar to that of the gangliosides isolated from the tumor cells. Therefore, significant inhibition of normal lymphoproliferative responses by tumor-derived gangliosides occurred at ganglioside concentrations which are actually present in the fluid surrounding the tumor cells in vivo. These results support the hypothesis that shedding of gangliosides may serve to protect tumor cells from host immune destruction. PMID- 6861146 TI - Aneuploidy induction and cell transformation by diethylstilbestrol: a possible chromosomal mechanism in carcinogenesis. PMID- 6861147 TI - Characterization of two metastatic subpopulations originating from a single human colon carcinoma. AB - Two separate cell lines originating from distinct metastatic deposits in a patient with a primary colonic carcinoma have been established both in vivo and in vitro. One metastasis, OM-1, was found in the omentum, and the other, HOT-3, was located on the ovary. These two metastases differ in several significant characteristics, including growth kinetics and the production of carcinoembryonic antigen by the cultured cells. OM-1 xenograft tumors contain about 8-fold more colonic mucin antigen than do HOT-3 heterografts. Similarities also exist. Both cell lines contain extra chromosomes in the A group, and both are missing chromosomes in Pair 14 of the D group and in Pair 18 of the E group. Xenograft tumors from these two metastases contain equivalent amounts of carcinoembryonic antigen and nonspecific cross-reacting antigen. These metastases developed through a process of progression and natural selection that occurred during the course of the patient's disease. Thus, the cell lines established from them provide material which may be used to study functional intraneoplastic diversity. PMID- 6861148 TI - Glycoprotein exhibiting immunological and enzymatic activities of human prostatic acid phosphatase. AB - A glycoprotein (GP) which is immunochemically and biologically related to human prostatic acid phosphatase (PAP) has been isolated from human seminal plasma by ammonium sulfate precipitation followed by sequential concanavalin A:Sepharose 4B column, anion-exchange chromatography and gel filtration. The purified GP was shown to be homogeneous by disc- and sodium dodecyl sulfate: polyacrylamide gel electrophoresis. The apparent molecular weight of purified GP was estimated to be 50,000 by gel filtration and 45,000 by sodium dodecyl sulfate: gel electrophoresis. In gel diffusion against antiserum to purified PAP, a partial immunological identity was shown between GP and PAP. This was further confirmed by an inhibition reaction between GP and antiserum to purified GP by PAP. Significantly, 30% of PAP enzyme activity was inhibited by anti-GP antiserum, while only 5% was inhibited by anti-PAP antiserum. Purified GP was shown to exhibit a weak, but significant, acid phosphatase activity by hydrolyzing alpha naphthyl phosphate at pH 5.6. The Km and Vmax for GP are 1.6 X 10(-4) M and 0.056 mumol/min/microgram protein, respectively, using alpha-naphthyl phosphate as the substrate. In the presence of anti-PAP antibody, the enzyme activity of GP was enhanced severalfold. Furthermore, the acid phosphatase activity of GP also was inhibited by tartrate, which is the most commonly used inhibitor for PAP. GP and PAP were found to have different carbohydrate content, amino acid composition, amino-terminal sequence, and peptide map. Thus, GP represents a newly identified protein. The significance of these results at molecular and clinical levels is discussed. PMID- 6861150 TI - Unilateral chromatid damage: a new basis for 6-thioguanine cytotoxicity. AB - Using the technique of premature chromosome condensation, which permits the visual inspection of interphase chromatin, we have shown previously that 28 hr after exposure to 6-thioguanine (TG) specific and drastic morphological changes in the chromosomes of Chinese hamster ovary fibroblasts in the G2 phase of the cell cycle become evident. In this paper, we demonstrate that this damage is a dose-related effect, appearing as sharp curling or "kinking" at lower TG concentrations and as unilateral chromatid damage and gross chromosome disruption at higher TG concentrations. With the use of a scoring system for quantitating the severity of this specific damage, the threshold concentrations for the appearance of unilateral chromatid damage and for loss of colony-forming ability were shown to be identical. Since the appearance of unilateral chromatid damage paralleled the appearance of TG-induced cytotoxicity in terms of time and dose, and since the severe disruption of G2 prematurely condensed chromosomes is consistent with TG-induced G2 arrest seen in this and other systems, we conclude that unilateral chromatid damage is centrally involved in the delayed cytotoxicity of TG in Chinese hamster ovary cells. PMID- 6861149 TI - Glucocorticoid receptor levels in mouse skin after repetitive applications of 12 O-tetradecanoylphorbol-13-acetate and mezerein. AB - Female Sencar mice were given twice weekly topical applications of 0.2 ml of acetone, 4 micrograms of 12-O-tetradecanoylphorbol-13-acetate (TPA), 2 micrograms of mezerein, or 4 micrograms of TPA followed by 2 micrograms of mezerein. Whole skin cytoplasmic glucocorticoid receptor content and dissociation constants were determined at various times after the last application of the agents. After four to 12 applications of acetone, the mean glucocorticoid receptor level was 0.49 +/ 0.02 pmol/mg cytosol protein, and the dissociation constant was 6.0 +/- 0.17 nM. The glucocorticoid receptor level was markedly reduced and remained low for at least 72 hr after repetitive applications of TPA. The mean receptor level was 0.113 +/- 0.011 (S.E.) pmol/mg cytosol protein, and the Kd was 2 to 4 times the control value. In contrast, the glucocorticoid receptor level was not significantly reduced after repetitive applications of mezerein. If four applications of mezerein were preceded by four applications of TPA, then the glucocorticoid receptor level was similar to that after TPA alone. It was also demonstrated that the glucocorticoid receptor level in papillomas was extremely low (0.022 pmol/mg cytosol protein) but was much higher in newborn skin (0.52 pmol/mg cytosol protein). PMID- 6861151 TI - Immunohistological study of precancerous mucus modification in human distal colonic polyps. AB - The M1 antigens associated with gastric fucomucins, oncofetal markers of the distal colonic mucosa, were demonstrated to be more closely associated with adenomas [92 of 139 (66%)] than with invasive adenocarcinomas [27 of 218 (12%)]. They were always expressed in tumors containing the M3 antigen normally associated with the intestinal mucus. The M1 antigens, present in 100% of hyperplastic polyps (30 of 30), were not specific for a particular histological type of adenoma but were found to be more closely associated with those showing a villous differentiation [41 of 47 (87%)] than with those having a tubular pattern [51 of 92 (55%)]. The presence of these M1 antigens depended neither on the size nor on the degree of cytological atypia of the nodular adenomas. However, M1 antigens were found in 94% of the adenomas (35 of 37) concomitant with adenocarcinomas; in contrast, only 56% of adenomas (55 of 102) observed on noncancerous mucosa contained these M1 antigens. As already demonstrated during rat colonic carcinogenesis, mucus modification characterized by the presence of M1 antigens could represent early molecular changes occurring before malignant transformation related to a chemical carcinogen. These M1 antigens might be regarded as early precancerous markers of an oncofetal type, associated with human distal colonic mucosa. PMID- 6861152 TI - Epidemiology of coffee and pancreatic cancer. AB - The association between pancreatic cancer and putative risk factors was examined using 275 incident cases and 7994 controls interviewed in six United States cities for a major study of tobacco-related diseases. From the comparison population were excluded patients with other diseases postulated to be associated with pancreatic cancer (e.g., other pancreatic diseases and diseases of the gallbladder) and those admitted for disorders known to be associated with smoking. After carefully controlling for age, the data failed to indicate an association between coffee consumption and pancreatic cancer (odds ratio congruent to 1.0). This was true both before and after adjustment for cigarette smoking and in both males and females. There was a statistically significant association between pancreatic cancer and smoking in both males and females (odds ratio 3.0 for males who smoked more than 1.5 packs/day and 2.0 for females who smoked more than 1 pack/day). PMID- 6861153 TI - Transcription of hematopoietic-associated oncogenes in childhood leukemia. AB - We have examined the transcriptional expression of the cellular homologues of several retrovirus-associated oncogenes, myc, rel, rasH, myb, src, and erb, in uncultured childhood leukemia and normal hematopoietic cells, as a first step in determining their normal function and possible association with human neoplasia. Cellular myc-specific RNA was detected in all 30 samples of hematopoietic tissue examined, including 18 leukemias of both the lymphoid and myeloid series, three lymphomas, five normal leukocytes, and four cell lines. Although the level of expression varied over a 25-fold range, no general pattern based on cell type or disease state was evident. In addition, in all cell types examined, a single molecular-weight myc-specific RNA species was observed. Transcriptional expression of the rel and rasH genes showed a similar lack of specificity, with the rasH gene being expressed at a low uniform level in all cell types examined. myb expression was marginally detectable in most samples, although the myeloid leukemia cells possessed approximately 4-fold higher levels. The expression of src was relatively low in most samples, with markedly elevated levels in a few diverse leukemia samples. erb expression was undetectable in all but two acute myelogenous leukemia samples. Analysis of one patient who had high levels of myc, erb, and src expression before therapy revealed a dramatic reduction in erb and src expression but not myc expression while the patient was in remission. These results indicate that primary human leukemia cells, as well as normal leukocytes, do express the cell homologues to several retrovirus-associated oncogenes, that some leukemia cells express high levels of several oncogenes, and that some of these genes are differentially expressed in specific subpopulations of cells. PMID- 6861154 TI - Mitoxantrone in patients with acute leukemia in relapse. AB - Twenty-six patients with acute leukemia in relapse were treated with mitoxantrone (dihydroxyanthracenedione dihydrochloride). The drug was given as a rapid i.v. infusion for 5 days, and doses were escalated from 8 mg/sq m daily for 5 days to 20 mg/sq m daily for 5 days. Five of 12 patients with acute lymphoblastic leukemia were induced into complete remission; one patient was induced into complete remission twice. The marrow response lasted from 3 to 50+ weeks. Among 12 patients with acute myelogenous leukemia, there was one complete and one partial remission, with response duration lasting 8 and 2 weeks. One patient with chronic myelogenous leukemia in blastic crisis also had a partial remission lasting 17 weeks. Remissions occurred at doses ranging from 8 to 14 mg/sq m daily for 5 days. All responders had been treated previously with anthracyclines. Drug induced side effects included dose-limiting oral mucositis, sporadic nausea and vomiting, and transient elevations of the hepatic enzymes. Approximately one third of the patients had septic complications during the myelosuppressive phase following treatment. We believe that mitoxantrone has definite utility in the treatment of acute leukemia in relapse. PMID- 6861155 TI - Production and molecular size heterogeneity of immunoreactive gastrin-releasing peptide in fetal and adult lungs and primary lung tumors. AB - Gastrin-releasing peptide (GRP) is known to be a bombesin-like peptide present in mammalian tissues. Using GRP radioimmunoassay specific for carboxyl-terminal portion, the immunoreactive GRP (IR-GRP) content of 5 fetal lungs, 38 adult lungs, and 131 primary lung tumors was determined. All fetal lung extracts contained IR-GRP ranging from 31 to 140 ng/g, wet weight. IR-GRP was present in 7 to 21% of normal adult lungs and lung carcinomas other than small-cell carcinoma; the amount was not very large except in two cases of adenocarcinoma, in which 110 and 140 ng/g of IR-GRP were detected. In the case of small-cell carcinoma, IR-GRP was found in 23 of the 31 cases examined (74%), and nine (29%) of these contained large amounts of IR-GRP (100 to 14,000 ng/g). As for carcinoid tumors, IR-GRP was found in five of the 12 cases examined (42%), and large amounts of IR-GRP were detected in two cases (5,100 to 130,000 ng/g). Immunohistochemically, IR-GRP was found in the neuroendocrine cells of fetal lungs and in the tumor cells of primary lung tumors. When these tissue extracts were examined by bombesin radioimmunoassay that recognizes bombesin but not GRP, they did not contain immunoreactive bombesin, suggesting that IR-GRP in these tissues is more similar to GRP than to bombesin. Sephadex G-50 gel filtration always revealed two peaks of IR-GRP in both fetal lungs and IR-GRP-producing tumors. One was eluted at the position corresponding to that of porcine GRP (Peak 1) and the other, at the position just behind that of porcine GRP (14-27) (Peak 2). In the five fetal lungs, Peak 2 comprised more than 83% of the total IR-GRP. In the 12 IR-GRP producing tumors examined, the ratio of these two peaks differed from case to case. Our data indicate that IR-GRP, which is present in fetal lung, is often produced by primary lung tumors, especially by small-cell carcinoma and carcinoid tumor, with molecular size heterogeneity. PMID- 6861156 TI - Circadian rhythmicity of polyamine urinary excretion. AB - Polyamines are small, highly charged, organic cations of possible regulatory importance in RNA-dependent protein synthesis, the production of which reflects cellular growth and division. The cytokinetics of normal cell populations is circadian rhythmic. This is reflected by a circadian rhythmicity undescribed previously in urinary monoacetylputrescine and the ratio of N1-acetylspermidine to N8-acetylspermidine in healthy individuals. Patients harboring advanced cancers sometimes excrete abnormal quantities of certain acetylated polyamines, and their urine samples may exhibit an abnormally high ratio of N1 acetylspermidine to N8-acetylspermidine. Changes in polyamine production and excretion associated with cancer may be best perceived by rhythmometric analysis of carefully timed samplings. PMID- 6861157 TI - Tamoxifen-induced fluorescence as a marker of human breast tumor cell responsiveness to hormonal manipulations: correlation with progesterone receptor content and ultrastructural alterations. AB - The fluorescent binding of tamoxifen to eosin is used on Papanicolaou-stained smears as a marker of cell responsiveness to the antiestrogen molecule. Forty-two cases of human breast carcinomas were submitted to tamoxifen treatment between first diagnosis and surgery (4 to 30 days). Tamoxifen-induced fluorescence is observed in 17 of 42 cases (40%). There is a highly significant correlation between progesterone receptor content of the tumor and cellular fluorescence (0.01 greater than p greater than 0.001). Ultrastructural changes of such tumors (820 cells observed in 28 treated patients and 840 cells in 32 untreated controls) are observed in 42% of treated cells versus 10% of untreated cells. These ultrastructural alterations can be significantly correlated with cellular fluorescence induced by tamoxifen treatment and with progesterone receptor content of human breast cancers. These data suggest that a short pretreatment with tamoxifen before surgery can give useful additional information at the biochemical, cytochemical, and ultrastructural levels regarding cell responsiveness to hormonal manipulation. PMID- 6861159 TI - Depression of high-affinity rosette formation in dysplasia and carcinoma in situ of the uterine cervix: mediation by serum factors. AB - High-affinity erythrocyte rosettes (HA-RFC) have been shown previously to be depressed in patients with dysplasia and carcinoma in situ of the uterine cervix. The effect of serum from these patients on HA-RFC in normal lymphocytes was studied to further elucidate the nature of immunological changes in early cancer. Sera from patients with dysplasia and carcinoma in situ significantly decreased HA-RFC in normal lymphocytes as compared to control serum (p less than 0.001). Serum inhibitory activity correlated well (p less than 0.001) with HA-RFC in the patients' lymphocytes and was postulated to represent the presence of a serum factor in these patients. Liquid chromatography studies showed this factor to have a molecular weight of approximately 50,000. Additional factors with molecular weights of 73,000 and 88,000 were present in patients with carcinoma in situ but not in patients with dysplasia. Serum inhibitory activity was not observed in Stage I squamous cell carcinoma. These factors may represent antigen specific suppressor factors produced in response to the expression of neoantigens by premalignant cells and may be involved in "sneaking through" of developing tumors. PMID- 6861158 TI - High-affinity erythrocyte rosette formation and inhibition in premalignant disease of the uterine cervix. AB - Total lymphocyte counts, total rosette formation, high-affinity rosette formation, and the rosette inhibition titer were studied in 104 patients with dysplasia, carcinoma in situ, or Stage I squamous cell carcinoma of the uterine cervix. Although no changes were detected in total lymphocytes or total rosette formation, a significant decrease (p less than 0.001) was observed in high affinity rosette formation in patients with moderate and severe dysplasia and carcinoma in situ. The rosette inhibition titer was significantly increased (p less than 0.001) in all stages of dysplasia and carcinoma in situ; incubation of patients' serum with normal lymphocytes did not reproduce this change but significantly decreased the rosette inhibition titer of the patients' lymphocytes (p less than 0.001). No change in high-affinity rosette formation or the rosette inhibition titer was observed in patients with Stage I squamous cell carcinoma as compared to controls. These changes are postulated to represent alterations in the normal balance of T-cell differentiation during the early stages of tumor development. PMID- 6861160 TI - Kaposi's sarcoma: a new staging classification. AB - Reports of an unusual form of Kaposi's sarcoma in young homosexual men in North America have demonstrated that previous classification systems for this disease are incomplete. We describe the clinical characteristics of 49 homosexual men with Kaposi's sarcoma and propose a new staging for the disease. There appear to be four clinically distinct forms of Kaposi's sarcoma: stage I--the more typical locally indolent lesions occurring predominantly in elderly males in North America and Europe; stage II--a locally invasive and aggressive form seen almost exclusively in equatorial Africa; stage III--a disseminated mucocutaneous form, often with lymph node involvement, seen primarily in African children and North American male homosexuals; and stage IV--a disseminated, mucocutaneous form with visceral involvement also seen in African children and North American male homosexuals. These stages are further subtyped as to the presence or absence of the systemic signs of unexplained fever and/or weight loss. Further longitudinal follow-up of these recently diagnosed cases will hopefully document that this proposed staging system correlates with survival data and is useful in the evaluation of treatment regimens for uniformly defined patient groups. PMID- 6861161 TI - Activity and pharmacokinetics of teniposide in Lewis lung carcinoma-bearing mice. AB - The antitumor activity of teniposide (VM26) was investigated in Lewis lung carcinoma (3LL) of the mouse after a single dose of 20 mg/kg iv (given 8 or 14 days after tumor transplant) or after three doses of 6.5 mg/kg iv (given on Days 8, 11, and 14 after tumor transplant) (total dose, 19.5 mg/kg). The single dose resulted in only 25% primary tumor reduction but had marked antimetastatic activity. The repeated doses (6.5 mg/kg x 3) were much more effective, with 85% primary tumor reduction and the apparent disappearance of all metastatic deposits. The pharmacokinetics of VM26 was investigated in 3LL-bearing mice by a high-performance liquid chromatographic assay. At both of the above doses VM26 disappeared from mouse plasma biphasically, with an elimination half-life of about 70 mins. The concentrations in metastases were higher than in primary tumor, where very low levels were found. The highest VM26 levels were found in liver, small intestine, and kidney, and the lowest levels were found in the brain. Excretion of VM26 in urine amounted to less than 5% of the dose. PMID- 6861162 TI - Preclinical re-evaluation of benzaldehyde as a chemotherapeutic agent. AB - Benzaldehyde (BA), an agent extracted from figs, is reported to have antitumor activity in vitro against a variety of experimental tumors and in vivo against refractory human neoplasms. We employed recently developed in vitro techniques to examine the effect of BA on growth of malignant human cells, and examined its effects in vivo against two human tumor xenografts established from primary specimens. BA showed dose-dependent inhibition of HL60 promyelocytic leukemia cells and normal human granulocyte/macrophage colonies. It showed no in vitro activity against either KG-1 myeloid leukemia cells or chronic lymphocytic leukemia cells grown in colony culture. BA failed to inhibit growth of either HL60 or KG-1 cells in liquid culture, and did not induce differentiation of HL60 cells. When tested against human tumor colony-forming cells from 30 patients with solid tumors, inhibition of colony growth greater than 70% was seen in six patients (20%). BA failed to inhibit the in vivo growth of either the T222 epidermoid carcinoma xenograft or the T380 ovarian carcinoma xenograft. We conclude that BA lacks significant activity against most human tumors tested in these experimental systems. PMID- 6861164 TI - Phase I evaluation of semustine in a weekly schedule. AB - A phase I study of weekly semustine was conducted in 32 patients with advanced cancer. Doses were escalated from 18 to 36 mg/m2/week. At a dose of 36 mg/m2/week, 43% of the patients developed platelet counts less than 100,000/mm3 after a median of 20 weeks on study, and 25% developed wbc counts less than 3000/mm3 after a median of 16 weeks on study. Drug-related nausea was reported by only one patient and was the only subjective toxic effect reported. Tumor regressions were noted in patients with adenocarcinoma of the colon, melanoma, and mixed adenocarcinoma and squamous cell lung cancer. A reasonable starting dose for phase II studies is 36 mg/m2/week, with dose adjustments based on platelet and wbc counts. PMID- 6861163 TI - Vincristine in advanced bladder cancer: a European organization for research on treatment of cancer (EORTC) phase II study. AB - Thirty-seven patients with measurable deposits or primary lesions arising from transitional cell carcinoma of the bladder were treated with 1 mg/m2/week of vincristine. One complete response lasting 7 months was seen among the 23 patients with metastatic disease. Two partial responses were seen among the 14 patients with persistent primary tumor. Vincristine is not recommended for further evaluation as a single agent in transitional cell carcinoma of the bladder. PMID- 6861165 TI - Treatment of metastatic carcinoid tumor with dactinomycin or dacarbazine. AB - We studied the effect of two single drugs on patients with metastatic carcinoid tumors. All patients had symptomatic and measurable disease and all had elevations of urinary 5-hydroxy indole acetic acid excretion. Seventeen patients were treated with dactinomycin at a dose of 12-15 micrograms/kg/day for 5 days repeated every 4-5 weeks. One partial response was achieved. Fifteen patients were treated with dacarbazine (DTIC) at a dose of 250 mg/m2/day for 5 days every 4-5 weeks. Two partial responses were achieved. The median times to tumor progression were 10 weeks with dactinomycin and 18 weeks with DTIC. Median survival times were 28 and 47 weeks, respectively. Dactinomycin given by this schedule appears to have only limited activity as a single-agent treatment in malignant carcinoid tumor. DTIC, although showing only a slightly better response rate, perhaps warrants further investigation in view of our more favorable interval to tumor progression and survival experience and in view of this drug's more established activity in the closely related islet cell carcinoma. PMID- 6861166 TI - Phase II study of hycanthone in patients with advanced colorectal carcinoma. PMID- 6861167 TI - Phase II evaluation of phenesterin in patients with advanced ovarian cancer. PMID- 6861168 TI - [Medical biophysics and nuclear medicine at the School of General Medicine of Charles University in Prague]. PMID- 6861169 TI - [Positive scintigraphy of tumors using labelled antibodies]. PMID- 6861171 TI - [Radioisotope tests in patients with hairy cell leukemia]. PMID- 6861170 TI - [Significance of the determination of tissue polypeptide antigens in malignant tumors]. PMID- 6861173 TI - [The decision-making value of clinical studies]. PMID- 6861172 TI - [Lung visualization in bone marrow scintigraphy using 99mTc-labelled sulfur colloid]. PMID- 6861176 TI - [Decrease in sperm velocity in relation to the morphologic quality of the ejaculate]. PMID- 6861175 TI - [Laboratory methods for the regulation of estrogen therapy in patients with prostatic carcinoma]. PMID- 6861174 TI - [Pharmacologic urography in the diagnosis of disorders of the upper urinary tract]. PMID- 6861178 TI - [The effect of azosemide and furosemide on the renal excretion of amino acids]. PMID- 6861177 TI - [The significance of serum ferritin in the evaluation of iron reserves during pregnancy]. PMID- 6861180 TI - [Computerized clinical records in malignant lymphogranuloma]. PMID- 6861179 TI - [An analysis of pathologico-anatomic findings in patients who died from malignant lymphogranuloma]. PMID- 6861181 TI - [Possibilities of evaluating the Gamma-11 system for heart studies]. PMID- 6861182 TI - [Changes in the number of vascular endothelia in the plasma of rats and guinea pigs subjected to whole-body irradiation]. PMID- 6861183 TI - [An attempt at early diagnosis of tumors using nucleolar changes in lymphocytes in circulating blood]. PMID- 6861185 TI - [Fevers of unknown origin]. PMID- 6861184 TI - [Observations on mother and child care in Sweden]. PMID- 6861186 TI - [Method for determining the activity of natural killer cells (NK cells)]. PMID- 6861187 TI - [HLA antigens and the immune response in atopy]. PMID- 6861188 TI - [Immunologic findings in children in relation to tonsillectomy and adenectomy]. PMID- 6861189 TI - [Cerebral cysticercosis]. PMID- 6861191 TI - Kinetics of DNA synthesis in feeding-dependent and independent hepatocyte populations of rats after partial hepatectomy. AB - The effects of food consumption on the kinetics of hepatic DNA synthesis after partial hepatectomy (PH) have been studied in rats. Short-term (4-24 hr) fasting before or after PH resulted in depression and/or delay of DNA synthesis on days 1, 2 and 3 of regeneration. This depression was found in hepatocytes and, to a lesser extent, in littoral cells. Re-feeding resulted in an increase of DNA synthesis within 3-8 hr. The results suggest that two different hepatocyte subpopulations exist in regenerating rat liver: one which proceeds to DNA synthesis without apparent exogenous signals, and another one which needs, in addition to the specific mitogenic action of PH, food intake as a secondary permissive signal in order to initiate DNA synthesis. In the latter population food consumption appears to be required at two different stages: (1) in G0 or the early pre-replicative phase (PRP); (2) in the late PRP 3-8 hr before initiation of DNA synthesis. In the latter stage dietary protein is needed, but no so in the former. The dependence on feeding in the late PRP increases relatively with time after PH. No evidence was found to suggest a different distribution of the two cell populations throughout the liver acinus. The findings support the hypothesis that the known effects of the light-dark rhythm on the timing of DNA synthesis after PH are mediated by the natural feeding rhythm of rats fed ad libitum. In addition they offer a means for improving the synchrony of hepatocyte proliferation in regenerating rat liver. PMID- 6861190 TI - Autoradiographic study of colchicine inhibition of DNA synthesis and cell migration in hairless mouse epidermis in vivo. AB - In vivo effects of colchicine on mitotic counts, DNA synthesis, and cell migration time were investigated in hairless mouse epidermis. [H3]TdR was used to examine DNA synthesis and measure the transit time. We found that colchicine (at a dose of 50 micrograms/25 g body weight) caused mitotic arrest, but had no effect on the number of cells in S phase during the first 4 hr after injection. Colchicine reduced the number of cells in S phase in normal epidermis during the 16-30 hr after injection, but the effect was no longer seen at 42 hr post injection. A similar depression in S-phase cell counts appeared in UVR-stimulated hyperplastic epidermis by 48 hr after injection of colchicine. In addition, migration of [H3]TdR-labelled cells from the basal layer to the superficial layers in UVR-stimulated hyperplastic epidermis was disturbed by colchicine injection. The delay in movement was not seen during the first 24 hr, but appeared by 48 hr after injection. PMID- 6861192 TI - Rat serum factors inhibiting the G1-S transition in hepatocytes. II. Properties of the low molecular weight factor. AB - The properties were investigated of low molecular weight factors acting on the G1 S transition of baby rat hepatocytes. These factors were produced by incubating adult rat serum with trypsin or a 100,000 g liver microsomal fraction, and isolated by ultrafiltration. Enzyme degradation assays indicated that the active compound was in both cases a glycopeptide sensitive to pronase and papain and to the combination of neuraminidase and beta galactosidase. No loss of hepatocyte G1 S inhibitory activity was observed after heat treatment at pH 7.0. G50 gel filtration showed that both the G1-S inhibitory factors were collected in the last fractions eluted. The elution volume was slightly larger for the trypsin than for the microsomal-induced factor, suggesting a small difference between their molecular weight. These factors are believed to be glycopeptides with a molecular weight around 1400. They might be composed of a 3-sugar polysaccharide chain with a galactose preterminal and a neuraminic acid terminal, linked to a polypeptide chain of 6 to 8 amino acids. PMID- 6861193 TI - Mouse epidermal cell proliferation after a single application of dimethyl sulphoxide (DMSO). AB - Hairless mouse epidermis was treated topically with a single application of undiluted DMSO. Epidermal cell proliferation during the following 72 hr was examined by means of DNA flow cytometry, [3H]TdR autoradiography, and a stathmokinetic method with colcemid. Topical application of DMSO was followed by perturbations in the epidermal cell proliferation that were in general similar to those observed in epidermal regeneration due to sudden cell loss. In contrast to such regenerative reactions, no hyperplasia could be detected after DMSO treatment, in spite of a consistently increased mitotic rate the first 3 days after DMSO treatment. The augmented epidermal cell production following exposure to DMSO therefore appears to be balanced by a correspondingly increased cell loss. PMID- 6861195 TI - In vivo studies on the regeneration kinetics of enriched populations of haemopoietic spleen colony-forming cells from normal bone marrow. AB - Functional properties of mouse haemopoietic spleen colony-forming cells, enriched 40- to 80-fold, from normal bone marrow were studied. It was found that: (1) the number of partially purified CFU-s (colony forming unit-spleen) required to rescue lethally irradiated mice was similar to the number of normal unfractionated bone marrow CFU-s giving the same level of protection; (2) the homing of partially purified CFU-s was similar to that of CFU-s from unfractionated bone marrow; (3) the regeneration of CFU-s in spleen was similar for enriched and unfractionated cell populations between 4 and 11 days after transplantation. In contrast, the rate of regeneration of CFU-s in femur was slower with enriched progenitor cells than with unfractionated bone marrow. The growth rate in femur, however, could be restored to normal by injecting freshly isolated syngeneic thymocytes with the enriched CFU-s population. The results indicate that the partially purified CFU-s are by themselves functionally normal and show that the rate of CFU-s repopulation in bone marrow can be affected by cell types other than spleen colony-forming cells. PMID- 6861194 TI - Cloning and frequency analysis of haemopoietic stem cells producing CFC over weeks in long-term marrow cultures. AB - Using adherent marrow cell layers devoid of stem cells, in vitro cloning and the determination of the frequency of murine haemopoietic stem cells were performed by means of limiting dilution. The presence of stem cells in individual microcultures was indirectly proven by the sustained presence of in vitro colony forming cells (CFC). These cells increased in number as a function of the culture period, which seems to indicate that the CFC were, de novo, produced in vitro. Although stem cell frequencies comparable to the in vivo spleen colony assay were determined in some experiments, most of our frequency estimates suggested stem cell frequencies ranging from 5/10(6) to 90/10(6). After a period of approximately 4 weeks, the stem cell activity in the microcultures declined rapidly. This may have been caused either by an increased differentiation pressure governed by CSF and/or similar factors or by sub-optimal culture conditions. PMID- 6861196 TI - Autoradiographic studies of glial proliferation in different areas of the brain of the 14-day-old rat. AB - Cell cycle parameters, as well as the mode of proliferation of glial cells, in four different areas of the brain of the 14-day-old rat (cortex, corpus callosum, nucleus caudatus putamen and commissura anterior) were studied using different cell kinetic methods after injection of [3H]TdR and/or [14C]TdR. The duration of the S phase (tS) was found to be about 10 hr and that of the cycle time (tC) about 20 hr, tG2 is less than 2 hr and t(G2 + M) about 4 hr. These values are valid for glial cells in all four brain areas studied. However, the labelling index (LI) of the glial cells differs by a factor of 3, between 1.8 and 5.4% in the different brain areas. Accordingly, the growth fraction of the glial cell population in the four areas varies between 0.04 and 0.12. Glial cells (astrocytes as well as oligodendrocytes) proliferate according to a steady state system. Furthermore, the proliferation of glial cells is associated with continuous cell loss. After each mitosis about 3% of the daughter cells become pyknotic and die. In addition, a permanent exchange of glial cells occurs between the proliferating and non-proliferating pool. PMID- 6861197 TI - Infection in prosthetic arterial grafts. PMID- 6861199 TI - The development of community care in psychiatry. PMID- 6861198 TI - Amoebic liver abscess in infancy. A case report. PMID- 6861201 TI - A major epidemic of anthrax in Zimbabwe. Part II. PMID- 6861200 TI - The aetiology of illness as determined by divination and methods of treatment by Zimbabwean N'anga. Review of 100 consultations with township n'anga. PMID- 6861202 TI - 5.8S ribosomal RNA. PMID- 6861203 TI - Dictyostelium mutants lacking DIF, a putative morphogen. AB - DIF is an endogenous extracellular signal that may control differentiation of D. discoideum cells. It is a dialyzable, lipid-like factor that induces stalk cell formation among isolated amebae incubated in vitro with cAMP. To examine the consequences of DIF deprivation, we have isolated several mutant strains that are impaired in DIF accumulation, and whose inability to make stalk cells in vitro and during normal development on agar can be corrected by the addition of exogenous DIF. Little DIF is made by the mutants, and morphological development on agar stops after the cells have aggregated, but before a slug forms. In these DIF-deprived conditions, prespore cells can differentiate, but prestalk cells cannot. PMID- 6861204 TI - Analysis of the hemagglutinin glycoprotein from mutants of vaccinia virus that accumulates on the nuclear envelope. AB - We isolated mutants whose vaccinia hemagglutinin (HA) accumulates on nuclear envelopes and the rough endoplasmic reticulum. Mutant HA must be blocked at a pre Golgi step because it has high-mannose-type carbohydrates but no fucose. Neither N- nor O-glycosidically linked carbohydrates are involved in the transport defect of the mutant HA, because tunicamycin, an inhibitor of N-type glycosylation, has no effect, and O-type glycosylation takes place in the Golgi organelle. The unglycosylated form of the mutant HA synthesized in the presence of tunicamycin is 3000 daltons larger than the wild type. This higher molecular weight is related to the transport defect. HAs translated in vitro also show this difference, evidence that it reflects mutation in the HA structural gene. Portions of HAs that project into the cytoplasm seem to account for this weight difference. Thus the cytoplasmic tail of glycoprotein has an important function in transport out of the rough endoplasmic reticulum. PMID- 6861205 TI - Suppression of contact sensitivity and cell-mediated lympholysis by oral administration of hapten is caused by different mechanisms. AB - Oral administration of 2,4,6-trinitrobenzene sulfonic acid (TNBS), a water soluble analog of trinitrochlorobenzene (TNCB), causes suppression of contact sensitivity (CS) to picryl chloride. We wished to determine what effect oral administration of TNBS (10mg), 10-12 days prior to sensitization, caused significant suppression of CS to picryl chloride. However, mice had to be fed at least three times at weekly intervals to cause suppression of the CTL response. CS was inhibited both at the afferent (induction) as well as at the efferent (effector) phase of the response. The unresponsiveness for CS was readily transferrable with cells from spleen, Peyer's patches, and mesenteric lymph node cells from fed mice. In contrast, although the hapten specific CTL response was significantly suppressed in mice fed three times. suppression could not be transferred with any of the aforementioned lymphoid populations. Furthermore, spleen cells from fed mice showed a significantly enhanced in vitro CTL response after stimulation with hapten-modified syngeneic stimulator cells. The results indicate that suppression of CS and of the CTL response in TNBS fed mice is probably caused by different mechanisms. PMID- 6861207 TI - Syngeneic sensitization of mouse lymphocytes on monolayers of thyroid epithelial cells. IV. Correlation with H-2 haplotypes. AB - In vitro primary syngeneic sensitization on monolayers of thyroid epithelial cells was performed with 21 inbred strains of mice representing 11 original H-2 haplotypes. Significant differences in the proliferative responses, assessed by thymidine uptake, were found to be related to the major histocompatibility complex haplotype. This result was further confirmed using congenic resistant strains of mice. In comparison with the experimental autoimmune thyroiditis induced by syngeneic thyroglobulin and adjuvant, primary syngeneic sensitization on monolayers of thyroid epithelial cells appeared to be under the same genetic control (H-2k strains being good responders, while H-2b mice are poor responders). PMID- 6861206 TI - Protection of mice against influenza virus infection: enhancement of nonspecific cellular responses by Corynebacterium parvum. AB - Groups of C57BL/6J, BALB/c, BALB/c, nu+/nu+ mice, inoculated intranasally with Corynebacterium parvum (350 micrograms/mouse) were protected from death by an otherwise lethal dose of influenza virus, A/WSN (H1N1) inoculated 3 days later. The lungs of C. parvum-treated, virus-infected C57BL/6J, BALB/c, or BALB/c nu+/nu+ mice contained significantly less infectious virus than did controls, and this reduction was apparent as soon as 24 hr after virus inoculation. The maximum protective effect correlated with increased lung interferon levels. C. parvum treatment caused an increase in the lung cell number which was in part due to a large increase (ca. 10-fold) in macrophage content, and the natural killer cell activity was also enhanced, though not as markedly as occurred 3 days after infection. Most (greater than 85%) of the resident macrophages in normal lungs were susceptible to infection by virus (as indicated by hemadsorption), whereas most of those recovered from the lungs of C. parvum-treated mice resisted infection. Despite the increase in macrophage content, the level of specific immune responses to infection, such as cytotoxic T-cell activity, DTH reaction, and antihemagglutinin antibody, remained unchanged by C. parvum treatment so that the major if not only effect of this treatment was on the level of the less specific components of the immune system. PMID- 6861208 TI - Protective effects of differentiation inducers on natural killer sensitivity of K 562 cells: Analysis at a single-cell level. AB - K 562 cells induced to differentiate by sodium butyrate (SB) or 12-O tetradecanoyl-phorbol-13-acetate (TPA) were studied for their capacities to be bound and killed by large granular lymphocytes (LGL) in a single-cell cytotoxicity assay in agarose. After SB treatment, K 562 cells were less efficient in binding to LGL, whereas the frequency of killer cells among bound LGL was unaffected. When TPA was used to induce K 562 differentiation, the binding of LGL to their target and the lytic efficiency of the bound LGL were both diminished when compared to control K 562 cells. It has been demonstrated that the expression of structures involved in the binding of natural killer (NK) effectors to their targets could be correlated with the target-differentiation stage. It is shown that phorbol-ester treatment can also affect NK target structures involved in the killing step. PMID- 6861209 TI - Involvement of interferon in virus-induced lymphopenia. AB - Intraperitoneal injection of vesicular stomatitis virus (VSV) into mice causes marked and rapid changes in leukocyte distribution. The virus induces an increase in peripheral blood (PB) granulocytes and an extensive decrease in the lymphocyte count which reaches a nadir of less than 10% of preinfection values, 12 hr after virus inoculation. In the lymph nodes and spleen extensive lymphocyte translocation and granulocyte infiltration are observed. Most changes abate 48 hr following virus inoculation. Injection of poly(rI):(rC) causes similar changes to those observed with VSV. The lymphocyte changes observed after injection of VSV or poly(rI):(rC) coincide with high levels of interferon (IFN) in the serum. We have examined the effects of anti-IFN antibody on those changes and investigated whether they can be mimicked by injecting IFN. Our findings suggest that the IFN induced by VSV or poly(rI):(rC), rather than those agents themselves, causes the observed lymphopenia as well as some of the changes observed in the spleen. On the other hand, the effects of VSV on granulocyte localization do not appear to be mediated by IFN. PMID- 6861210 TI - Mechanism of augmentation of the antibody response in vitro by 2-mercaptoethanol in murine lymphocytes. II. A major role of the mixed disulfide between 2 mercaptoethanol and cysteine. AB - Five thiol compounds including 2-mercaptoethanol (2-ME) were examined for their augmenting effects on in vitro antibody response to sheep erythrocytes. Three compounds were effective with the following order of activity; 2-ME greater than dithiothreitol greater than cysteamine. Glutathione and thioglycollate failed to enhance the response. The same order or effectiveness was seen in the stimulation of [35S]cystine uptake by murine lymphocytes by these thiols. Murine lymphocytes took up cysteine five to six times more rapidly than cystine. It is, however, unlikely that 2-ME stimulation of cystine uptake is solely due to the reduction of cystine into cysteine, because 2-ME was still stimulatory after free thiol groups had disappeared in the medium containing 2-ME and [35S]cystine. The mixed disulfide of cysteine with 2-ME (Cys-2-ME) was found to be an only product after free thiols had been oxidized. [35S]Cys-2-ME was taken up by the lymphocytes with a comparable rate to cysteine via a transport system common to that of leucine and phenylalanine. Cysteine was, however, transported via a different route. It was observed that Cys-2-ME was readily metabolized to cysteine and glutathione after the uptake. Cys-2-ME added to cystine-free RPMI 1640 medium could support the antibody response as efficiently as cystine plus 2-ME. These observations strongly suggest that 2-Me stimulates cystine uptake and, therefore, enhances the antibody response through the formation of the mixed disulfide with cysteine. PMID- 6861212 TI - Rapid kinetics of lysis in human natural cell-mediated cytotoxicity: some implications. AB - The entire lytic process of natural cell-mediated cytotoxicity against sensitive target cells can occur rapidly, within minutes. This was demonstrated by 51chromium release and in single-cell assays. At the cellular level, most of the target cell lysis occurred within 15-30 min after binding to effector cells. The enriched natural killer cell subpopulation of lymphocytes obtained Percoll density gradient centrifugation (containing greater than 70% large granular lymphocytes (LGL)) was the most rapidly lytic population by 51chromium release. However, in the single-cell assay, the rate of lysis of bound target cells was quite similar for the LGL-enriched effector subpopulation and the higher density subpopulation of effector cells recognized previously. Both the light and dense effector cells contained similar numbers of target binding cells. Therefore, that the light subpopulation effected lysis more rapidly and to a greater extent than the dense subpopulation suggested that the low-density effector cells probably recycled more rapidly than those of higher density. This was corroborated by the finding that when conjugates were formed at 29 degrees C for the single-cell assay, a significant number of dead unconjugated targets could be observed only on the slides made with the LGL-enriched effector cells but not on those made with dense effector cell. Lysis continued to increase in the chromium-release assay probably because of recycling, recruitment, and/or heterogeneity of the effector cells, and/or because of heterogeneity or delayed death of the target cells. PMID- 6861211 TI - Mechanism of augmentation of the antibody response in vitro by 2-mercaptoethanol in murine lymphocytes. III. Serum-bound and oxidized 2-mercaptoethanol are available for the augmentation. AB - The fetal calf serum (FCS) that was incubated with 2-mercaptoethanol (2-ME) followed by the removal of free 2-ME could support the antibody response to sheep erythrocytes in vitro as effectively as native FCS plus 2-ME. The supporting activity of 2-ME-pulsed FCS was reversibly abrogated by the treatment with dithiothreitol followed by dialysis. In addition, iodoacetamide-treated FCS did not acquire the supportiveness by 2-ME pulsing. These observations suggest that the activity of 2-ME-pulsed FCS would be due to the mixed disulfide between 2-ME and FCS components. On the other hand, the disulfide form of 2-ME (2-MEox) could also augment the antibody response as effectively as fresh 2-ME (the reduced form). These derivatized forms of 2-ME as well as fresh 2-ME was found to stimulate the transport of [35S]cystine into murine lymphocytes when the uptake was examined by the long-term experiments (24 hr). These stimulations were thought to be mediated by the formation of the mixed disulfide between 2-ME and cysteine because the lymphocytes promoted the reaction of [35S]cystine with 2 MEox- or 2-ME-pulsed FCS to produce the mixed disulfide that had been shown to be taken up by the lymphocytes four to five times more rapidly than cystine. Therefore, it was suggested that 2-MEox, and 2-ME-pulsed FCS could augment the antibody response in a similar fashion to 2-ME by stimulating the uptake of cystine, an essential amino acid. PMID- 6861213 TI - Comparison of stem-cell recovery in autoimmune and normal strains. AB - The capacity of NZB stem cells to proliferate in vivo was evaluated in two systems which required repopulation of peripheral organs. In both types of depletion systems, stem-cell repopulation after cyclophosphamide treatment or adoptive transfer repopulation in lethally irradiated hosts, it was found that NZB stem cells were hyperproliferating. The increase in proliferating cells was most pronounced in the spleens of NZB mice treated with high-dose cyclophosphamide and in lethally irradiated F1 mice reconstituted with NZB T-cell depleted bone marrow. Thus, upon a stimulus to repopulate, NZB marrow stem cells will hyperproliferate in peripheral organs resulting in an increase in cell number. The abnormality in the marrow cells can be observed in young NZB mice when their marrow cells are in an environment which requires recovery and division. PMID- 6861215 TI - [Diagnosis and treatment of esophageal perforations]. PMID- 6861216 TI - [On the question of the etiology of bulbitis. An immunohistochemical study]. PMID- 6861214 TI - [Disorders of glycoregulation in chronic pancreatic disease]. PMID- 6861217 TI - [Late consequences of the surgical treatment of gastrointestinal diseases]. PMID- 6861218 TI - [The dependence of the hypolipemic effect of pectins on their chemical composition]. PMID- 6861220 TI - [Ascorbic acid and disorders of glycoregulation]. PMID- 6861219 TI - [PTC and drainage of the biliary tract in postoperative strictures of the hepatocholedochus]. PMID- 6861221 TI - [Endocrine ophthalmopathy from the viewpoint of the endocrinologist]. PMID- 6861222 TI - [Orbital decompression]. PMID- 6861223 TI - [Orbital rhabdomyosarcoma in a newborn infant]. PMID- 6861225 TI - [Amiodarone keratopathy]. PMID- 6861224 TI - [Diagnosis and therapeutic outlooks on meningiomas affecting the orbit]. PMID- 6861227 TI - [Orbitology. Contemporary trends in the diagnosis and therapy of orbital diseases]. PMID- 6861226 TI - [Isolated paralysis of ocular accommodation in both eyes in a young man]. PMID- 6861228 TI - [Intermittent syndromes in pediatric neurology]. PMID- 6861230 TI - [Electroencephalographic and radiographic follow-up microanastomoses]. PMID- 6861229 TI - [The first years of a neurologic intensive care unit]. PMID- 6861231 TI - [Dose rehabilitative balneotherapy affect the work capacity of patients after intervertebral disk surgery?]. PMID- 6861232 TI - [Epileptogenicity of various parts of the cerebral cortex in a model group of intracranial meningiomas]. PMID- 6861233 TI - [Studies on sleep drunkeness. II. Polygraphic findings]. PMID- 6861234 TI - [EEG tracings of workers exposed to vinyl chloride]. PMID- 6861236 TI - [Cytology of the cerebrospinal fluid in acute focal ischemia of the brain]. PMID- 6861235 TI - [Lipids in the cerebrospinal fluid. Personal experience]. PMID- 6861238 TI - [Lay and professional attitudes in psychiatry]. PMID- 6861237 TI - [Levels of lactate dehydrogenase isoenzymes in the serum and cerebrospinal fluid and the degree of malignancy of brain tumors]. PMID- 6861239 TI - [Modern possibilities of determining lithium in serum from its level in saliva]. PMID- 6861240 TI - [Structural elements in reactive disorders]. PMID- 6861241 TI - [Problems of diagnosis in psychiatry]. PMID- 6861242 TI - [A comparison of the effectiveness of 3 therapeutic preventive programs for neurotics. IV. Risk index for an unfavorable prognosis of the neurosis. Report on Program P 17]. PMID- 6861243 TI - [Theory of microstructures in functional psychoses of a hypothetical viral etiology]. PMID- 6861244 TI - [Versatile emergency psychiatric care in Eastern Slovakia]. PMID- 6861245 TI - [Tasks and goals in the teaching of social medicine as part of world outlook training (experience in teaching at the Pediatric Department of Charles University in Prague]. PMID- 6861246 TI - [Relationships and connections in health care systems from the spatial aspect]. PMID- 6861247 TI - [Bibliometric analysis in social medicine]. PMID- 6861249 TI - [The physician as a socially concerned person]. PMID- 6861252 TI - [Problems in teaching social medicine in the 6th year at the Comenius University Medical School in Bratislava]. PMID- 6861248 TI - [Development of wages in the health services]. PMID- 6861250 TI - [Quality and effectiveness of health care]. PMID- 6861251 TI - [Regulation of the health status of the population from a cybernetic viewpoint]. PMID- 6861254 TI - [The role of health education in the creation of a healthy life style]. PMID- 6861253 TI - [Final standardization work in the health services and its role in the management of standardization]. PMID- 6861255 TI - [Possibilities of changing from selective to mass dispensarizaton]. PMID- 6861256 TI - [Geriatrics as a medical discipline]. PMID- 6861257 TI - [Modern trends and tasks in the areas of hematology and transfusion services]. PMID- 6861258 TI - VP16-213 and cyclophosphamide in advanced breast cancer. A phase II study. AB - Twenty-seven patients with histologically proved advanced breast cancer were given VP 16-213 and cyclophosphamide. Twenty-one had shown resistance to other chemotherapy schedules and six had experienced relapse during adjuvant chemotherapy. There were four complete responses (15%) and seven partial responses (26%). Median survival was 61 weeks and median duration of response was 31.4 weeks. All patients experienced gastrointestinal toxicity and 22 patients (81%) showed bone marrow toxicity. This regimen is effective in advanced breast cancer resistant to other chemotherapy regimens. PMID- 6861261 TI - Determination of the antitumor agent SOAz (1,3,3,5,5 pentakis(aziridino)-1 lambda 6,2,4,6,3 lambda 5, 5 lambda 5 thia-triazadiphosphorine-1-oxide) by a gas chromatographic assay suitable for pharmacokinetic studies in man. AB - A sensitive method, based on capillary gas chromatography using a thermionic detector, has been developed for the new antitumor agent pentakis(aziridino) thiatriazadiphosphorine-oxide, (NPAz2)2NSOAz ('SOAz'), in order to obtain pharmacokinetic data from patients receiving this drug IV in clinical trials. A structural analog of SOAz, (NPAz2)2NSOPh ('SOPh'), was used as an internal standard. The detection limit of SOAz with this method was 0.01 mg/l for serum and 0.04 mg/l for urine. The coefficient of variation (n = 10) was 6,0% at 1.5 mg/l in serum and 1.6% at 75.0 mg/l in urine. Analytical recoveries averaged 89.9% from serum and 86.7% from urine. In two patients treated with subtoxic doses of SOAz (55 mg/m2), serum levels were found ranging from 3.0 to 0.16 mg/l at 10 min and 12 h, respectively, after administration. This assay seems to be useful for determining SOAz in samples from patients receiving subtoxic doses of SOAz. PMID- 6861259 TI - Trilostane in the treatment of advanced breast cancer. AB - The combination of trilostane 960 mg daily and either dexamethasone 0.5 mg b.d. or hydrocortisone 10 mg b.d. has been used to treat advanced metastatic breast cancer in post-menopausal women. Twenty-three patients had assessable disease and received treatment for a minimum of 8 weeks. Six (26%) showed an objective response and three (13%), stabilisation of previously progressive disease, sustained for at least 3 months. Side-effects were mainly gastrointestinal. Biochemical studies suggest that the mechanism of action may be inhibition of conversion of androstenedione to oestrone. PMID- 6861260 TI - Interactions of human leukocyte interferon with vinca alkaloids and other chemotherapeutic agents against human tumors in clonogenic assay. AB - Purified human leukocyte interferon produced by recombinant techniques (IFN-alpha A) was tested in vitro with chemotherapeutic drugs, vinblastine (VLB), vincristine (VCR), vindesine (VDS), vinzolidine (VZL), cis-platinum (PLAT), doxorubicin (DOXO), etoposide (VP-16), and melphalan (MEL). The activity of these agents alone or in combination was tested against various human tumor cell lines, using a modified soft agar clonogenic assay. Three human tumor cell lines (myeloma, RPMI 8226; breast, MCF-7; and colon, WiDR) showed sensitivity to these agents at clinically achievable drug concentrations. Statistically significant synergistic activity against in vitro colony formation was observed with the combination of VLB and IFN-alpha A. An additive or sub-additive effect was usually observed with the other agents tested. Continuous exposure of the 8226 myeloma cell line to both IFN-alpha A and PLAT showed evidence of a more significant potentiation. It is hypothesized that the synergistic effect observed between VLB and IFN-alpha A is due to some of their common mechanisms of action. PMID- 6861262 TI - Clinical pharmacokinetics of (NPAz2)2NSOAz: 'SOAz'. AB - Pharmacokinetic studies of 1,3,3,5,5 pentakis (aziridino)-1 lambda 6,2,4,6,3 lambda 5,5 lambda 5 thiatriazadiphosphorine-1-oxide ('SOAz'), a new antineoplastic agent containing an inorganic ring system and five aziridino groups, were performed in six patients who took part in a phase I clinical trial of the agent. The drug was administered as a rapid IV infusion. Serum decay curves could be fitted to an open two-compartment model of drug disappearance. After a short initial phase with a t 1/2 (+/- SD) of 7.8 +/- 4.2 min a terminal phase with a dose-independent half-life of 203 +/- 17 min occurred. The coefficient of apparent distribution was 0.71 +/- 0.13. The renal clearance was 75 +/- 11 ml/min and the total body clearance 162 +/- 23 ml/min. A percentage of 46.5 +/- 6.6 of the administered drug could be recovered unchanged in the urine within 24 h. It is concluded that in view of concentrations known to be effective in vitro, administration in large single doses may be advantageous. Dose adjustments should be made for patients with impaired renal function. PMID- 6861263 TI - Phase I clinical trial of (NPAz2)2NSOAz: 'SOAz'. AB - (NPAz2)2NSOAz ('SOAz') is the first of a new class of cytotoxic agents containing an inorganic heterocyclic ring system to enter clinical trial. It was used to treat 31 patients with advanced cancer by IV infusion over 30 min on days 1, 2, 3, and 4 of a 21-day cycle, which was postponed if necessary to allow for hematological recovery. A total of 46 courses evaluable for toxicity was given and the tumor response was evaluable in 21 patients. Seven dose levels, ranging from 25 mg/m2 to 300 mg/m2, were studied, with three to six patients at each level. The only major toxicity was myelosuppression, especially thrombocytopenia, which was dose-limiting. Platelets decreased from the 14th day onward, with a nadir 4-5 weeks after administration. Leukopenia was less predictable and reached a nadir 3-5 weeks after administration. In most patients recovery was complete after 6-9 weeks. Myelosuppression was clearly cumulative in succeeding courses and proved irreversible in three patients. Anemia also occurred, but otherwise SOAz was remarkably well tolerated. There were no responses and no therapy related deaths. The highest tolerated dose for patients who had received no or only minor chemotherapy prior to treatment with SOAz was 300 mg/m2, and that for heavily pretreated patients, 175 mg/m2. Because of cumulative myelotoxicity phase II studies with SOAz are not recommended. PMID- 6861264 TI - Decreased plasma half-life of cyclophosphamide during repeated high-dose administration. AB - Cyclophosphamide was given as IV doses of 50 mg/kg/day on each of four successive days as treatment for ovarian and lung cancer. Blood samples were taken at regular intervals and analysed for cyclophosphamide by gas liquid chromatography. The plasma half-lives (t 1/2) and volumes of distribution (V D) were calculated for each of the treatment days; t 1/2 was found to decrease with subsequent doses whereas V D was not significantly changed. PMID- 6861266 TI - Pharmacokinetics of melphalan in children following high-dose intravenous injection. AB - The pharmacokinetics of high-dose IV melphalan (140 or 220 mg m-2) were studied after 12 administrations in 10 children (aged 2.5-16 years) undergoing chemotherapy for either neuroblastoma or Ewing's tumour. To assess whether a simpler and less expensive nitrobenzylpyridine (NBP) spectrophotometric assay for alkylating activity was a satisfactory alternative to high-pressure liquid chromatography (HPLC), the plasma melphalan concentration was estimated by both methods in five cases. Analysis of the disposition of melphalan gave a mean half life of 1.3 +/- 1.0 (SD) h, clearance 18.4 +/- 9.4 l X h-1 X m-2, and apparent volume of distribution 26.3 +/- 18.0 l X m-2. These pharmacokinetic parameters were similar to those found in adults: no correlation was found between any parameter and age or glomerular filtration rate. NBP alkylating activity determinations yielded consistent results and good correlation with plasma melphalan concentration. However, concordance analysis indicated a consistent bias, the NBP assay always giving lower estimates of plasma melphalan concentration: HPLC assay therefore remains the method of choice for determining plasma melphalan pharmacokinetics. PMID- 6861265 TI - Flow-cytometric analysis of DNA distribution after VP16-213 treatment of Lewis lung carcinoma. AB - The two dosage schedules of VP16 that gave the least and the greatest efficacy in Lewis lung carcinoma of the mouse were selected for evaluation of the cytokinetic effects observable in vivo at different intervals after treatment (schedule A: 40 mg/kg IV, on day 8 after transplant; schedule B: 13 mg/kg IV, repeated on days 8, 11, and 14 after transplant). After the single dose and after each repeated dose there was a marked increase in the percentage of cells in the LS-G2-M phases, with a corresponding decrease in the percentage of cells in G0-G1. The number of neoplastic tetraploid cells compared with normal diploid cells in the tumor was reduced after the single IV dose, and more markedly so after repeated doses. This study suggests that the more marked delay of cancer cell growth and greater effectiveness observed with schedule B is related to repeated blockage of the LS G2-M phases. PMID- 6861267 TI - Continuous intravenous infusion of vinca alkaloid using a subcutaneously implanted pump in a canine model. AB - A major drawback of infusions of the vinca alkaloids is the lengthy period of hospitalization which is often required for this novel technique of cancer therapy. A potentially useful system to deliver outpatient therapy has been investigated in a preclinical study. A self-contained infusion pump powered by a self-charging fluorocarbon system has been implanted SC in three dogs. The performance of two pumps which had been factory-calibrated to deliver 2.5 and 4.5 ml/day, respectively, was evaluated during 22 infusions of the vinca alkaloids (vincristine, 7; vinblastine, 7; and vindesine, 8). Infusions were given over a 5 to 7-day period and were repeated at 3-week intervals. No malfunctioning of the pumps occurred in over 500 cumulative days of use. The flow rates of the pumps were quite stable except in one animal whose increased flow rate was probably a consequence of fever due to self-induced inflammation about the pump pocket. No local or distant tissue reactions to the pump were observed. Decomposition of vincristine and vinblastine in the infusate at the end of 5- or 7-day infusions was minimal as determined by high-pressure liquid chromatography. The amount of decomposition of vindesine in the infusate was variable. Steady-state concentrations of vincristine during infusion were always greater than 10(-9) M, and were similar to those previously determined in our clinical infusion trials using a dosage of 0.5 mg/m2/day. Clinical evaluation of this system for prolonged infusions of vincristine and other vinca alkaloids appears to be warranted. PMID- 6861268 TI - Therapeutic effect of vincristine, adriamycin and prednisolone (VAP) in angioimmunoblastic lymphadenopathy (AIL). AB - Five patients, three males and two females, with angioimmunoblastic lymphadenopathy (AIL) are described. The two who received steroids had no response and died 2 and 6 months later. The three patients who received vincristine, adriamycin and prednisolone (VAP) went into remission early and are still in remission with a follow-up of 22-35 months. It is concluded that VAP is effective therapy in AIL. PMID- 6861269 TI - Copper levels and the adriamycin inhibition of proliferating cells. PMID- 6861270 TI - Methotrexate metabolism. PMID- 6861271 TI - Membrane potentials of urinary bladder epithelium in F344 rats treated with N butyl-N-(4-hydroxybutyl)nitrosamine or sodium saccharin. AB - Membrane potentials of the urinary bladder epithelium in F344 male rats treated with N-butyl-N-(4-hydroxybutyl)-nitrosamine (BBN) or sodium saccharin were measured. In experiment 1, membrane potentials were measured sequentially in the early stage of their change on treatment with 0.05% BBN in the drinking water or with basal diet containing 5% sodium saccharin. Membrane potentials were measured with microelectrodes in weeks 1, 2, 4 and 8 of the experiment. The potential of the group treated with BBN was significantly higher than that of the controls from as early as week 1 until the end of the experiment. In experiment 2, the dose-dependence of the effects of BBN and sodium saccharin on the membrane potential was examined. F344 male rats were treated with 0.05, 0.01, 0.005 or 0.001% BBN in the drinking water, or 5, 1, 0.2 or 0.04% sodium saccharin in basal diet. Clear dose-dependence was observed in the effect of BBN on the potential, but of the doses of sodium saccharin used, only 5% saccharin caused a significantly higher potential than in the control group. These findings suggested that in the early stage of urinary bladder carcinogenesis induced by BBN, the Na+ channel located in the apical membrane may be inactivated. PMID- 6861272 TI - Influence of tumor-promoting phorbol esters on the phosphorylation of membrane proteins in lymphocytes. AB - Treatment of bovine lymphocytes with 12-O-tetradecanoyl-phorbol-13-acetate (TPA) (10(-8) M) for as little as 5 min significantly alters the ability of membrane particulate fractions to phosphorylate proteins using in situ protein kinases and exogenous [gamma-32P]ATP. After 20 min of treatment, the phosphorylation of two proteins with mol. wts. of 65K and 74K in the isolated membrane-particulate fraction is increased approximately 30-35%, whereas the phosphorylation of a 130K protein is almost completely suppressed. The ability of different phorbol esters to alter membrane protein phosphorylation correlates well with their potency as tumor promoters in mouse epidermis and as comitogens in phytohemagglutinin treated lymphocytes. This phorbol ester response appears to have a low temperature coefficient since cells treated with TPA at 4 degrees C also responded, although at a slower rate. This action of TPA is neither mimicked nor antagonized by dibutyryl cAMP (1 mM); moreover, it is not affected by retinoic acid, an agent which blocks several other phorbol ester effects in these cells. Inhibition of protein synthesis with cycloheximide also fails to influence this response. In contrast, trifluoperazine, an inhibitor of calmodulin function and certain lipid-dependent protein kinases, depressed the phosphorylation of the 65K and 74K proteins to below the control level. PMID- 6861273 TI - Epidermal polyamine profiles after multiple exposures to ultraviolet radiation. AB - In experimental studies of u.v.-skin-carcinogenesis u.v.-radiation is usually given in discrete amounts over a protracted period of time. Epidermal polyamine profiles were investigated in hairless mice after single and multiple exposures to ultraviolet-B (u.v.B). Hairless mice were irradiated with u.v.B from FS40 sunlamps and sacrificed after 1, 5, 10 or 20 days of daily irradiation with 0.9 kJ/sq m u.v.B at 6, 24 or 48 h after the final irradiation. Epidermis was analyzed for ornithine decarboxylase (ODC) activity, and for its putrescine, spermidine and spermine content. Skin biopsies were examined for histological changes. As previously reported epidermal ODC activity was induced 6 h after one irradiation with u.v.B and reached a maximum activity at approximately 24 h. In contrast after 5, 10 or 20 daily irradiations with u.v.B the epidermal ODC activity was maximal at approximately 6 h after the final irradiation and by 24 h had returned towards control levels. The magnitude of the ODC activity measured 6 h after irradiation increased with the number of irradiations. A similar pattern was seen with epidermal putrescine levels where a marked shift from a peak at approximately 24 h after one irradiation with u.v.B to a peak at approximately 6 h after 20 days of irradiation with u.v.B occurred. Spermidine levels increased as the number of u.v.B exposures was increased and spermine levels tended to decrease. The spermidine/spermine ratio increased most rapidly during the first 5 exposures, and remained elevated through to 20 days of daily irradiation. Chronic irradiation with u.v.B results in rapid induction of ODC activity and putrescine accumulation in the epidermis, events also elevated by chemical or viral transformation. PMID- 6861274 TI - Kinetic evidence for the involvement of multiple forms of human liver cytochrome P-450 in the metabolism of acetylaminofluorene. AB - The kinetics of 2-acetylaminofluorene (AAF) metabolism have been studied in liver microsomes from four human subjects over a substrate range of 0.02-200 microM. The N-hydroxylation of AAF was best described by a single enzyme system with a mean Km of 1.63 microM and a mean Vmax of 61 pmol mg-1 protein min-1. Biphasic kinetics for the 7-hydroxylation of AAF in all four subjects were observed and a two enzyme system best described the data. The mean Km and Vmax for the high affinity, low-capacity enzyme were 0.69 microM and 30 pmol mg-1 protein min-1, respectively, while for the low affinity, high capacity enzyme the mean Km was 75 microM and the mean Vmax was 286 pmol mg-1 protein min-1. In one of the four subjects studied the 5-hydroxylation of AAF was similarly resolved into a two enzyme system. The 1-hydroxylation of AAF in human microsomes was a major reaction and was best described by a single enzyme system. The 3- and 5 hydroxylations of AAF were minor metabolic pathways. Non-classical Michaelis Menten kinetics were observed for the 9-hydroxylation of AAF and at high substrate concentrations this was the major metabolite formed. These data demonstrate the involvement of at least two forms of human cytochrome P450 in the metabolism of AAF. PMID- 6861276 TI - Increased DNA content as an early marker of transformation in carcinogen-exposed rat tracheal cell cultures. AB - To determine if abnormal cellular DNA content, suggestive of aneuploidy, is an early indicator of transformation by chemical carcinogens, we exposed primary cultures of rat tracheal epithelial cells to N-methyl-N' -nitro-N nitrosoguanidine (MNNG), 12-O-tetradecanoylphorbol-13-acetate (TPA), MNNG followed by TPA, or solvent as a control. After 40 and 60 days in culture suspensions of the cells were made, fixed, stained with DNA-dye Hoechst 33342, and the fluorescence per cell measured with a flow cytometer. The DNA histogram showed that freshly isolated rat tracheal epithelial cells, and control cells at days 40 and 60 had predominantly diploid DNA content values. The late primary (day 40) and early passaged (day 60) control cells commonly show increased numbers of cells with tetraploid DNA contents. TPA induced aneuploidy in few cultures by day 40, but by day 60 all samples tested had significant numbers of cells with aneuploid DNA content. In contrast a single MNNG treatment or MNNG followed by TPA regularly caused extensive aneuploidization by day 40. Multiple cycling subpopulations with aberrant DNA contents appear. These dramatic changes in cellular DNA content suggestive of drastic ploidy changes in MNNG and MNNG + TPA exposed cultures are early events, preceding other evidence of neoplastic transformation by many cell generations. Our results suggest that aneuploidy is an early event in the transformation of rat tracheal epithelial cell cultures by chemical carcinogens. PMID- 6861277 TI - An oncogenic cell line inducing transplantable metastasizing adeno-carcinomas in Xenopus borealis. AB - Three epithelioid cell lines were initiated from stage 35 tadpoles of Xenopus borealis. Cell strain XB693-M1 was obtained by incubation of one of these cell lines in MNNG. The strain is hypotetraploid with a modal chromosome number of 62. It is tumorigenic when 4 X 10(6) cells are injected into hosts belonging to a partially histocompatible family. The tumors are very invasive, metastasizing adenocarcinomas that kill the host within 5 to 38 weeks. The tumor can be propagated in vivo by serial transplantation. PMID- 6861275 TI - Factors influencing the promotion of transformation in chemically-initiated C3H/10T1/2 Cl 8 mouse embryo fibroblasts. AB - Treatment of low density asynchronous cultures of C3H/10T1/2 Cl 8 mouse embryo fibroblasts with N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) initiates the process of transformation and produces significant numbers of transformed foci only when treated cultures are subsequently exposed to the tumor promoter 12-O tetradecanoylphorbol-13-acetate (TPA). Cell culture variables which influence the outcome of this initiation and promotion system were studied. A TPA concentration of 0.25 micrograms/ml was found to be optimal for the promotion of focus production and the presence of TPA was required both during logarithmic growth and throughout confluence. The lot of fetal calf serum used to cultivate the cells also played a determining role in focus production. Of nine serum lots purchased from four different suppliers, only two were suited for initiation and promotion studies with MNNG and TPA. In contrast, seven of these lots were adequate for transformation studies with 3-methylcholanthrene. Factors which adversely influenced focus production included the use of fungizone or the use of high passage stock cultures. These studies demonstrate that cell culture variables which influence promotion in these cells can be controlled and that this system can be successfully used in studies of the cellular mechanism of in vitro promotion and for the detection of genotoxic substances. PMID- 6861278 TI - Alkyldiazohydroxides are stable intermediates in the degradation of n-nitroso (acetoxyalkyl)-alkylamines in rat serum. AB - The decomposition in rat serum of N-nitroso-(acetoxyalkyl)-alkylamines 14C labelled in different positions, was monitored. The determination of radioactivity of individual fractions permitted the determination of the rate limiting step in their degradation scheme. From the primary nitroso-acetoxy compounds the alkyldiazohydroxide shows the highest stability. Furthermore, it was shown that the alpha-hydroxy compounds of the secondary nitrosamines seem to be more stable than the hydroxylated primary ones. PMID- 6861279 TI - Fluoro-substituted N-nitrosamines. 6. carcinogenicity of N-nitroso-(2,2,2 trifluoroethyl)-ethylamine in rats. AB - N-Nitroso-(2,2,2-trifluoroethyl)ethylamine (F-3-NDEA) was tested for carcinogenic activity in male Sprague-Dawley rats at 4 dose levels. The compound was given by gavage twice weekly. Treatment related tumors were observed in all experimental groups and appropriate dose-response relations were seen. The main tumor localisations were the esophagus and the nasal cavity. F-3-NDEA therefore is carcinogenic in rats after oral administration, a biological effect to be expected since it had been shown earlier that this compound is enzymatically activated by dealkylation and is weakly mutagenic in bacterial assay systems. A change in organotropism is observed when comparing carcinogenicity of F-3-NDEA with the predominantly hepatocarcinogenic activity of parent N nitrosodiethylamine. PMID- 6861281 TI - Formation of N-nitrosomorpholine in isolated rat lungs during nitrogen dioxide ventilation. AB - An isolated rat lung preparation was ventilated with NO2 while being perfused with a medium containing morpholine. After 60 min of ventilation-perfusion, N nitrosomorpholine was detected in both lung tissue and perfusate. PMID- 6861280 TI - Pretreatment of normal human fibroblasts and human colon carcinoma cells with MNNG allows chloroethylnitrosourea to produce DNA interstrand crosslinks not observed in cells treated with chloroethylnitrosourea alone. AB - Chloroethylnitrosoureas (CNU) are antitumor agents which produce DNA interstrand crosslinks. We have proposed that crosslinks are produced in DNA via monoadduct formation at the guanine-O6 position, followed by a delayed reaction with the opposite DNA strand. Human cells are known to differ in their capacity to repair the O6-methylguanine lesion. One example of this repair capacity is the ability of cells to reactivate adenovirus which has been damaged by in vitro treatment with N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). Cells that repair the virus are designated Mer+ and deficient cells Mer-. In a recent report, we showed a clear correlation between CNU-induced DNA interstrand crosslinking and the Mer phenotype. Mer- cells produced consistently higher levels of interstrand crosslinks than did Mer+ cells. In the present study we have measured the CNU induced DNA interstrand crosslinking in IMR-90 normal human fibroblasts (Mer+), HT-29 human colon carcinoma cells (Mer+), and VA-13 SV-40 transformed human cells (Mer-) following pretreatment with MNNG. Cells were treated for 1 h with MNNG, then for an additional 1 h with CNU. Comparable levels of CNU-induced DNA interstrand crosslinking were observed in all cell lines. This crosslinking has been previously undetected in the IMR-90 and HT-29 cells. Cytotoxicity studies showed that MNNG pretreatment greatly enhanced the killing of IMR-90 and HT-29 cells by CNU, however, in VA-13 cells the increase in cell kill was smaller. These data suggest that in Mer+ cells a DNA repair system may remove chloroethyl monoadducts before the lethal DNA interstrand crosslinks can form. However, pretreatment of cells with MNNG may saturate this repair system rendering it inoperable. PMID- 6861282 TI - A gene involved in action of tumor promoters is identified and mapped in Caenorhabditis elegans. AB - We isolated mutants of the nematode Caenorhabditis elegans resistant to 12-O tetradecanoylphorbol-13-acetate (TPA). The TPA-resistant mutants, although they grew somewhat smaller than normal, reproduced well and behaved normally in TPA; they also did similarly in another phorbol ester tumor promoter, phorbol-12,13 didecanoate (PDD), thus proving they are also resistant to PDD. All the mutations defined by these TPA-resistant mutants were semidominant to the wild-type allele. The 15 independently isolated mutants all fell into the same complementation group, defining a single gene, tpa-1. The gene tpa-1 mapped near the marker gene dpy-9 on chromosome IV. PMID- 6861283 TI - Dynamic vagal control of pacemaker activity in the mammalian sinoatrial node. AB - Dynamic heart rate control by parasympathetic nervous input involves feedback mechanisms and reflex bursting of efferent cardiac vagal fibers. Periodic vagal bursting induces phasic changes in sinoatrial cycle length and can entrain the pacemaker to beat at periods that may be identical to those of the vagal burst. We investigated the electrophysiological basis of these phenomena in isolated sinus node preparations (rabbit, cat, and sheep). In the presence of propranolol (3.9 X 10(-6)M), relatively brief (50-150 msec) trains of stimuli, applied onto the endocardial surface of the preparation, activated postganglionic vagal terminals and induced a brief hyperpolarization of sinoatrial pacemaker cells. This vagally mediated hyperpolarization could alter the pacemaker rhythm by an amount that depended on its duration and its position in the cycle, as well as on the duration of the free-running pacemaker period. When the free-running period was sufficiently long and the hyperpolarization was induced sufficiently early in the spontaneous cycle, a "paradoxical" acceleration of the pacemaker rhythm ensued. Phasic changes were plotted on phase-response curves, constructed by scanning systematically the sinoatrial pacemaker period with single or repetitive vagal trains. These phase-response curves enabled us to predict the entrainment characteristics and the levels of synchronization of the pacemaker to the vagal periodicity. The overall data explain the cellular mechanisms involved in the phasic effects of brief vagal discharges on sinoatrial periodicity, and provide conclusive evidence for the prediction that repetitive vagal input is capable of forcing the cardiac pacemaker to beat at rates that can be faster or slower than the intrinsic pacemaker rate. These data should improve our knowledge of the dynamic control of heart rate by neural reflexes and aid in our understanding of rhythm disturbances generated by the interaction of the cardiac pacemaker with vagal activity. PMID- 6861284 TI - Phasic effects of repetitive vagal stimulation on atrial contraction. AB - The vagus nerves of anesthetized dogs were stimulated once each cardiac cycle with a brief burst of pulses, and the timing of the stimulus bursts was changed by a fixed increment on successive cardiac cycles. The effects of such vagal stimulation on atrial contraction depended on the number of pulses per stimulus burst, on the interval between pulses within the burst, and on the timing of the stimulus bursts within the cardiac cycle. The vagal stimulus bursts had the least negative inotropic effect when they were given less than 100 msec before the next atrial depolarization, and they were most effective when given about 330 msec before the next atrial depolarization. This dependence of the inotropic response on the timing of the vagal activity within the cardiac cycle indicates that the following conditions must prevail with respect to the vagal innervation of the atrium: (1) the acetylcholine released from the vagal nerve endings is hydrolyzed at a critically rapid rate in the atrial tissues, (2) the neurally released acetylcholine must exert its major influence on atrial contraction during some preferential fraction of the cardiac cycle (presumably, during depolarization), and (3) after a vagal stimulus of a given strength, the concentration of acetylcholine in the region of the myocardial cells will attain its maximum value during this critical phase of the cardiac cycle when the vagal stimuli are given at the optimal time in the cardiac cycle. PMID- 6861285 TI - Tissue PO2 in the intestinal muscle layer of rats during chronic diabetes. AB - Chronic diabetes mellitus induced in rats by streptozotocin or of genetic origin in Db/Db mice is associated with a loss of capillaries, arteriolar constriction, and a decrease in resting and maximum blood flow. As a result of these vascular changes, as well as glycolysation of hemoglobin, it is possible that tissue Po2 is reduced at rest and cannot be substantially increased during dilatation. Tissue Po2 in the intestinal muscle layer was measured at rest and during maximal dilation. In addition, the spacing between capillaries with active flow and the velocity of red blood cell flow in capillaries were measured at rest and at maximum dilation. These measurements were made in normal and diabetic rats (streptozotocin) at age 26-30 weeks; the diabetic animals had been hyperglycemic (greater than 350 mg/100 ml) for 12-15 weeks. Tissue Po2 at a distance of about 15 microns from the arterial, mid-point, and venous end of capillaries in normal rats was 24.8 +/- 1.1 (SE), 23.1 +/- 1.2, and 22.4 +/- 0.9 mm Hg, respectively, compared with 25.8 +/- 0.9, 24.1 +/- 1.2, and 22.4 +/- 1.1 mm Hg, respectively, in diabetic rats. The maximum mid-capillary tissue Po2 during dilation was 27.7 +/- 1.3 mm Hg in normal rats and 29.7 +/- 1.5 mm Hg in diabetic rats. The average distance between capillaries was 37.6 +/- 2.0 microns in normal rats and 46.8 +/- 2.9 microns in diabetic animals; vasodilation did not change the capillary spacing in either group of animals. Capillary red cell velocity in normal rats increased from 0.98 +/- 0.11 mm/sec at rest to 2.1 +/- 0.4 mm/sec during dilatation. For comparable conditions in diabetic rats, the velocities were 0.41 +/- 0.07 and 1.06 +/- 0.19 mm/sec. The data presented indicate that the diabetic animals have tissue Po2 equivalent to those in normal rats, both at rest and during maximum vasodilation. The loss of capillaries and decreased resting and maximum capillary red cell velocity in diabetic rats would decrease the delivery of oxygen, but, apparently, a decrease in oxygen consumption occurred that allowed the intestinal tissue to have a normal Po2. PMID- 6861286 TI - The effects of isoproterenol and ouabain on oxygen consumption, lactate production, and the activation of phosphorylase in coronary artery smooth muscle. AB - In previous work, oxidative metabolism in vascular smooth muscle was found to be correlated with isometric force; aerobic lactate production, however, was found to be substantial and correlated with Na-K transport processes (Paul et al., 1979; Paul, 1980). In this work, the role of glycogen phosphorylase in this unusual functional compartmentalization of of vascular energy metabolism was investigated. Isometric force, oxygen consumption, lactate production, and the level of phosphorylase activity were measured in porcine coronary arterial segments. For comparison with previous studies, phosphorylase activity was also measured in rabbit aorta. Added potassium chloride induced a contracture in which oxygen consumption, lactate production, and phosphorylase activity all increased. Ouabain also induced a contracture, and an increase in oxygen consumption and phosphorylase activity. However, lactate production was inhibited. Isoproterenol, when added to a potassium chloride-induced contracture, elicited a relaxation in isometric force, and oxygen consumption returned to basal levels; however, lactate production and phosphorylase activity remained at the previously elevated levels. Isoproterenol alone had only marginal effects on all parameters studied. The results indicate that the role of phosphorylase in vascular metabolism is complex and unlikely to be a rate-limiting factor for the observed aerobic glycolysis. The high levels of phosphorylase activity observed in the absence of actomyosin interaction support a mechanism of beta-adrenergic relaxation in which the sensitivity of actin-myosin interaction to calcium ion is decreased. PMID- 6861287 TI - Influence of perfusate PO2 on hypoxic pulmonary vasoconstriction in rats. AB - The purpose of these studies was to evaluate the influence of perfusate oxygen tension on hypoxic pulmonary vasoconstriction and to identify the site at which both alveolar and perfusate gas tensions stimulate hypoxic pulmonary vasoconstriction. Lungs from adult rats were ventilated and perfused in vitro at constant temperature, PCO2, and pH, with a perfusion circuit incorporating a membrane oxygenator that allowed independent control of the alveolar and perfusate gas tensions. Blood flow to the lung was constant (0.06 ml per g body weight per min), and pulmonary vascular resistance was therefore proportional to pulmonary artery pressure. In study 1, the pulmonary artery pressor response to zero or 22 mm Hg alveolar oxygen was measured when the perfusate oxygen tensions were approximately 8, 26, 41, 64, or 128 mm Hg. The pressor response as a percent of the maximum pressure change was progressively reduced as perfusate oxygen tension increased. For alveolar oxygen tension of zero; the pressor response = 128 -39 (Log PPO2) and r = 0.8 (P less than 0.01), the effect of perfusate gas tension on the response to alveolar gas tension of 22 mm Hg was similar. These results demonstrate that the stimulus for hypoxic pulmonary vasoconstriction is a function of both alveolar and perfusate oxygen tension. In study 2, the response to alveolar oxygen tension of 42 mm Hg was measured with mean perfusate oxygen tensions of 130, 52, and 17 mm Hg. In six animals with forward perfusion, the responses decreased with increasing perfusate oxygen tension, as in study 1. In another six animals, with retrograde perfusion, the responses to alveolar hypoxia were not altered when perfusate oxygen tension was increased. These results demonstrate that the sensor region for hypoxic pulmonary vasoconstriction is precapillary. These studies confirm and extend previous hypotheses that alveolar and perfusate oxygen tensions together, determine the PO2 at a precapillary site to stimulate hypoxic pulmonary vasoconstriction. PMID- 6861288 TI - Potential fields on the ventricular surface of the exposed dog heart during normal excitation. AB - We studied the normal spread of excitation on the anterior and posterior ventricular surface of open-chest dogs by recording unipolar electrograms from an array of 1124 electrodes spaced 2 mm apart. The array had the shape of the ventricular surface of the heart. The electrograms were processed by a computer and displayed as epicardial equipotential maps at 1-msec intervals. Isochrone maps also were drawn. Several new features of epicardial potential fields were identified: (1) a high number of breakthrough points; (2) the topography, apparent widths, velocities of the wavefronts and the related potential drop; (3) the topography of positive potential peaks in relation to the wavefronts. Fifteen to 24 breakthrough points were located on the anterior, and 10 to 13 on the posterior ventricular surface. Some were in previously described locations and many others in new locations. Specifically, 3 to 5 breakthrough points appeared close to the atrioventricular groove on the anterior right ventricle and 2 to 4 on the posterior heart aspect; these basal breakthrough points appeared when a large portion of ventricular surface was still unexcited. Due to the presence of numerous breakthrough points on the anterior and posterior aspect of the heart which had not previously been described, the spread of excitation on the ventricular surface was "mosaic-like," with activation wavefronts spreading in all directions, rather than radially from the two breakthrough points, as traditionally described. The positive potential peaks which lay ahead of the expanding wavefronts moved along preferential directions which were probably related to the myocardial fiber direction. PMID- 6861289 TI - Effect of exercise on the relationship between myocardial blood flow and systolic wall thickening in dogs with acute coronary stenosis. AB - Relationships between regional myocardial perfusion and transmural function, both during treadmill exercise and at rest, were examined in conscious dogs with varying degrees of coronary stenosis produced by a hydraulic occluder. In 13 dogs we measured myocardial blood flow with microspheres (10-12 microns in diameter) and regional systolic wall thickening (%). During exercise with coronary stenosis, myocardial blood flow was characterized by nonuniform distribution, and associated with regional dysfunction. The relationships between normalized myocardial blood flow and normalized %wall thickening during exercise with coronary stenosis were linear, with significantly different slopes (mean myocardial blood flow: y = 1.23x - 0.16, r = 0.93; subendocardial myocardial blood flow: y = 1.50x - 0.02, r = 0.86; subepicardial myocardial blood flow: y = 0.83x - 0.18, r = 0.87). To fill the gap between available subendocardial and subepicardial data during exercise with coronary stenosis and control points, however, would require nonlinear components. In 10 of the dogs, coronary stenosis at rest was also produced to compare regional myocardial blood flow - %wall thickening relations at rest with those during steady state exercise. The absolute mean myocardial blood flow - %wall thickening relation during exercise with coronary stenosis (y = 11.6x - 1.9, r = 0.90) was significantly shifted rightward from the resting relation (y = 25.3x -2.1, r = 0.80). However, when changes in %wall thickening were plotted vs. myocardial blood flow per beat, the relationships at rest and exercise were nearly superimposable. Likewise, relations between normalized myocardial blood flow and changes in %wall thickening at rest and exercise were not significantly different. We conclude: %wall thickening during exercise is directly related to changes in mean myocardial blood flow but is related in nonlinear fashion to changes in subepicardial and subendocardial myocardial blood flow; %wall thickening may provide a reliable index of the relative transmural flow distribution during exercise as well as at rest; during brief bouts (5-8 minutes) of exercise with coronary stenosis, the relationship between stabilized regional contractile dysfunction and level of myocardial blood flow per beat is the same as that during coronary stenosis at rest. PMID- 6861290 TI - Fetal blood volume responses to acute fetal hemorrhage. AB - The purpose of this study was to explore the changes in fetal blood volume that occur after fetal hemorrhage. Fifteen unanesthetized, chronically catheterized fetal sheep averaging 130 +/- 3 (SD) days gestation were studied 4 to 6 (average 5) days after catheter implantation. The fetuses were hemorrhaged by continuous withdrawal from an arterial catheter over 5 minutes. On the average (n = 15), 13.9 +/- 5.3% of the initial volume was removed. Fluid gradually entered the fetal circulation during and after the hemorrhage. Thirty minutes after hemorrhage had been initiated, 53.0 +/- 22.0% restitution of the lost volume occurred. Thus, short-term fetal blood volume restitution after fetal hemorrhage averaged about twice that of the adult. Hemorrhages averaging 7.3 +/- 2.3% (n = 3), 12.9 +/- 1.0% (n = 8), and 21.0 +/- 3.3% (n = 4) were followed by 55.7 +/- 13.3%, 54.7 +/- 26.4%, and 47.7 +/- 19.9% restitution, respectively. Thus, fractional volume replacement appears independent of the shed volume over the range of 5-25% volume loss. The protein concentration in the fluid which entered the fetal vasculature averaged 53% of the plasma protein concentration, suggesting that the fetal interstitium was the primary source of the fluid. In summary, the data suggest that the fetus is able to replace rapidly about half of the volume lost due to rapid hemorrhage, and appears considerably better at controlling its blood volume immediately after rapid hemorrhage than the adult. PMID- 6861292 TI - Metabolism of circulating adenosine by the porcine isolated perfused lung. AB - Adenosine uptake was studied in the piglet isolated perfused lung by means of the single-circulation paired-tracer dilution technique. Adenosine was efficiently taken up from the pulmonary vascular bed, and the process was potently inhibited by dipyridamole. Following uptake, adenosine was incorporated into intracellular nucleotides, and at low perfusate concentrations, little or none of the incorporated radioactivity returned to the circulation. At higher concentrations, cellular uptake was saturable and products of intracellular catabolism (inosine and hypoxanthine) were returned to the circulation. Perfusion of low concentrations of adenosine after inhibition of pulmonary adenosine kinase led to a proportional decrease in the retention of nucleotides and to a release of inosine and hypoxanthine. A small proportion of adenosine was metabolised extracellularly by adenosine deaminase; this activity was not released from perfused lungs and is apparently an ecto-enzyme. PMID- 6861291 TI - Developmental changes in the cardiac effects of amrinone in the dog. AB - Amrinone, a bipyridine compound, has been shown to exert a positive inotropic effect on the heart, without producing cardiac arrhythmias. Because of preliminary observations suggesting that the actions of amrinone might change significantly with growth and development, we studied its effects on the contractility and electrophysiology of isolated cardiac muscle of 0- to 96-day old beagles and Purkinje fibers of 5-year-old beagles. Amrinone's effects on ventricular muscle contractility were age-related. A significant decrease in contractility of right ventricular trabeculae and papillary muscles (not associated with changes in action potential characteristics) was observed in the 0- to 3-day newborn, whereas, by day 4-10, amrinone increased contractility. The magnitude of the increase became greater through day 96 of life. The negative inotropic effect of amrinone is unassociated with changes in the action potential plateau, suggesting that the slow inward current is not involved in this mechanism. PMID- 6861294 TI - Phenytoin reduces calcium current in the cardiac Purkinje fiber. AB - We have investigated the effects of phenytoin on the electrical and mechanical activity of isolated calf and dog cardiac Purkinje fibers. Phenytoin (5-100 microM) lowers and shortens the plateau phase of the Purkinje fiber action potential and reduces twitch tension. We studied the ionic basis of these effects by combining a conventional two-microelectrode voltage clamp procedure with pharmacological techniques that allow separation of time-dependent plateau membrane currents. We find that phenytoin reduces voltage-dependent calcium current in the Purkinje fiber. In addition, this drug slightly reduces two time dependent outward currents. These effects of phenytoin on membrane current account, at least in part, for its influence on the action potential and twitch tension. PMID- 6861293 TI - Toxic effects of silver-silver chloride electrodes on vascular smooth muscle. AB - We found that silver, either as silver metal or silver chloride, exerted toxic effects on the smooth muscle of isolated cannulated hamster cheek pouch arterioles. Silver initially stimulated the smooth muscle, producing a marked vasoconstriction. The vessels then dilated back to control diameters. Once the arterioles began to dilate, they became refractory to norepinephrine or potassium stimulation. We caution the use of silver in the presence of smooth muscle, especially when tissue mass is small or free protein concentration is low. PMID- 6861295 TI - Renal responses of the cardiac-denervated nonhuman primate to blood volume expansion. AB - Experiments were performed to determine whether total, specific cardiac denervation affects the renal responses of the nonhuman primate to acute intravascular volume expansion. Adult male Macaca fascicularis monkeys underwent chronic intrapericardial cardiac denervation or sham surgery. After a 14- to 30 day recovery period, each animal was anesthetized with sodium pentobarbital and estimated blood volume was volume-expanded 20% with 6% dextran in isotonic saline. Control renal excretory function did not differ between the two groups, and both groups had similar increases in urine flow, sodium and potassium excretion, osmolar clearance, free water clearance, and renal plasma flow after volume expansion. The times to peak diuresis and natriuresis also were similar in both groups. These results demonstrate that the cardiac-denervated monkey shows unattenuated renal excretory responses to volume expansion. This could indicate that either cardiac receptors do not play a major role in eliciting these responses in the primate or that eliminating a role of cardiac afferents is compensated for by redundant afferents from arterial baroreceptors. PMID- 6861296 TI - Role of adenosine in the maintenance of coronary vasodilation distal to a severe coronary artery stenosis. Observations in conscious domestic swine. AB - The purpose of this study was to test the hypothesis that adenosine is required to maintain arteriolar vasodilation distal to a severe coronary stenosis. Eight closed-chest conscious pigs were prepared by placing a 7.5-mm long stenosis (82% lumenal diameter reduction) in the proximal left anterior descending coronary artery. Regional myocardial blood flow (microsphere technique) was measured at control 1, after 10 minutes of intracoronary infusion of adenosine deaminase (7 10 U/kg per min) distal to the stenosis, and 20-30 minutes after stopping adenosine deaminase infusion. Studies with 125I-labeled adenosine deaminase were conducted in six additional pigs to document the extent to which infused adenosine deaminase penetrated the interstitial space. 125I-labeled adenosine deaminase was infused for 10 minutes (10-11 U/kg per min) into the left anterior descending coronary artery. Calculated interstitial fluid concentrations of adenosine deaminase ranged between 71 and 272 U/ml and were at least one order of magnitude greater than that required to deaminate all the adenosine which would be released into the interstitium in response to 15-30 seconds of coronary occlusion. In the primary group of animals (n = 8), endocardial flow (ml/min per g) distal to stenosis at control 1 (1.15 +/- 0.33) was reduced vs. endocardial flow in the nonobstructed circumflex zone (1.59 +/- 0.38, P less than 0.05). Flows in epicardial layers were comparable at control 1 (distal zone = 1.40 +/- 0.36 vs. circumflex zone = 1.45 +/- 0.41). Distal zone endocardial and epicardial flows did not change vs. control 1 in response to infusion of adenosine deaminase. However, the distal: circumflex epicardial flow ratio declined vs. control 1 (0.98 +/- 0.14) during adenosine deaminase infusion (0.87 +/- 0.17, P less than 0.05). The distal:circumflex endocardial flow ratio during adenosine deaminase (0.72 +/- 0.20) was unchanged vs. control 1 (0.76 +/- 0.22) but was less than control 2 (0.80 +/- 0.18, P less than 0.05). Thus, destruction of all or most interstitial adenosine caused only slight relative reduction in regional myocardial blood flow distal to a severe coronary artery stenosis. Accordingly, adenosine contributes only modestly to maintenance of arteriolar vasodilation in this setting or else its absence is almost fully compensated for by another mechanism(s). PMID- 6861298 TI - Endocardial pacing site affects left ventricular end-diastolic volume and performance in the intact anesthetized dog. AB - We investigated how pacing from different endocardial sites affects the left ventricular three-dimensional contraction pattern and performance in intact anesthetized dogs. We used data from the motion of radiopaque markers implanted in the left ventricular endocardium in an analysis based on the polar decomposition theorem to determine the left ventricle's three-dimensional principal directions and magnitudes of deformation, and its axis and angle of rotation during the cardiac cycle. This paper also derives a new procedure that permits statistical comparison of different left ventricular cavity deformation patterns. During normal sinus rhythm and pacing from the right atrium, left ventricular septum, left ventricular apex, and right ventricular apex, the principal directions of left ventricular deformation remained relatively fixed with respect to the left ventricle's anatomy, independent of heart rate and pacing site. These directions were oriented in septum-free wall, anterior posterior, and apex-base directions. End-systolic pressure and volume did not vary significantly among pacing sites. End-diastolic volume varied significantly among pacing sites, with right ventricular apical pacing producing the smallest end-diastolic and stroke volume. These results reveal that beats produced by right ventricular apical pacing eject less blood compared with beats produced by right atrial, left ventricular septal, or left ventricular apical pacing. PMID- 6861297 TI - Hyperreactivity of coronary arterial smooth muscles in response to ergonovine from rabbits with hereditary hyperlipidemia. AB - This study was undertaken to examine the response to ergonovine, an agent used to provoke spastic constriction of large epicardial coronary arteries, to elucidate the responsible underlying mechanism, and to determine the impact of endogenous hyperlipidemia on contractile properties of isolated vessels from different beds. The isolated arteries from both control and Watanabe hereditary hyperlipidemic rabbits (WHHL rabbits) were suspended for recording isometric force in oxygenated Krebs buffer and exposed to agonists and antagonists. In atherosclerotic aortas from WHHL rabbits, the concentration-response relations for ergonovine and serotonin exhibited a marked leftward shift with significantly depressed constrictor threshold concentration and lowered one-half maximally effective concentration values. In coronary arteries with no atherosclerotic lesions detectable macroscopically from WHHL rabbits, the concentration-response relations showed a leftward shift for ergonovine but not serotonin. Coronary contraction evoked by ergonovine was remarkably inhibited by 0.1 microM cyproheptadine and 0.3 microM methysergide, serotonergic antagonists, in both groups. alpha-Adrenergic blockade with 0.1 microM prazosin was effective in inhibiting ergonovine-induced contraction of aortas from control rabbits, but not that of atherosclerotic ones. The constrictor response to ergonovine of atherosclerotic aortas was inhibited by cyproheptadine. The responsiveness to ergonovine of both carotid and femoral arteries from WHHL rabbits with no sclerotic lesions, which was suppressed by prazosin was not different from that of control rabbits. In contrast, the concentration-response relations for phenylephrine in the four different types of arteries did not differ appreciably between the two groups, and the constrictor responses to 20 mM KCl were virtually identical. Thus, aortas and coronary arteries exposed to endogenous hyperlipidemia appear to be hyperreactive to ergonovine mediated by a serotonergic mechanism. PMID- 6861299 TI - The effects of cardiac sympathetic nerve stimulation on perfusion of stenotic coronary arteries in the dog. PMID- 6861300 TI - Blood pressure and heart rate variabilities in normotensive and hypertensive human beings. PMID- 6861301 TI - Predictors of systolic blood pressure response to treadmill exercise: the Lipid Research Clinics Program Prevalence Study. AB - We used multiple linear regression to study predictors of systolic blood pressure response (SBPR), i.e., the increase in pressure above baseline after 3, 6, and 9 min of treadmill exercise, in 4262 men and women. Predictors considered were usual SBP, the difference (delta SBP) between resting SBP and SBP immediately before exercise, age, education, obesity index, alcohol consumption, cigarette smoking, preexercise heart rate and, in women, gonadal hormone use. In men, age, obesity index, and cigarette smoking were positively associated with SBPR and in women 20 to 49 years old, age, obesity index, and alcohol consumption were positively associated with SBPR. In women 50 years old or older, usual SBP was negatively associated with SBPR. In both men and women a larger delta SBP was associated with a smaller SBPR. These results help explain the considerable variation in SBPR, and the delta SBP results suggest that potential SBPR may, to certain extent, have a specific, finite range. The similarity of predictor variables for SBPR to predictor variables for hypertension is concordant with the previous observation that a high SBPR may foreshadow subsequent hypertension. PMID- 6861302 TI - Reduced aortocoronary sinus extraction of epinephrine in patients with left ventricular failure secondary to long-term pressure or volume overload. AB - Heart failure is associated with a reduction in tissue norepinephrine concentration, catecholamine fluorescence, and tyrosine hydroxylase activity. We hypothesized that this attrition of sympathetic nerve function might also be associated with a reduction in the ability of the neuronal membrane to sequester catecholamines. Since the heart does not release epinephrine, the cardiac extraction of epinephrine should be an index of the membrane uptake system. In 12 patients with documented left ventricular failure (pulmonary edema) secondary to mechanical overload and in 10 patients with no history of heart failure, we measured simultaneous plasma catecholamine concentrations in the aorta, coronary sinus, and femoral vein. The aortocoronary sinus extraction of epinephrine was 43 +/- 17% in the group with no evidence of heart failure but 0 +/- 14% in the group with failure. Net norepinephrine outflow (release minus extraction) was significantly higher in the group with failure, possibly because of reduced extraction. There was neither a reduction in the ability of the lower limb to extract epinephrine nor an increased norepinephrine outflow from the limb. These findings suggest that the sympathetic neuronal membrane uptake system is also depressed in the failing heart and that if the mechanism of catecholamine sequestration in the heart is related to that in the lower limb, the ablation of sympathetic nerve function is specific to the heart and is not a result of a generalized depression of the peripheral sympathetic nervous system. PMID- 6861306 TI - Ventricular vulnerability assessed by programmed ventricular stimulation in patients with and without late potentials. PMID- 6861304 TI - Arrhythmogenic right ventricular dysplasia: a generalized cardiomyopathy? PMID- 6861305 TI - Cyclic changes in arterial pulse during respiratory support. PMID- 6861303 TI - Exercise conditioning in middle-aged men after 10 days of bed rest. AB - Of 12 healthy men with a mean age 50 +/- 4 years who had been at bed rest for 10 days, six were randomly assigned to perform individually prescribed physical exercise daily for 60 days after bed rest (exercise group) and six simply resumed their customary activities (control group). Exercise group subjects were significantly more active than control subjects during this interval (p less than .05). Two classic training effects observed in the 60 days after bed rest were significantly larger among exercise than among control group subjects; compared with values immediately after bed rest, heart rate at a constant submaximal workload declined by 36 +/- 11 beats/min in the exercise group vs 16 +/- 8 beats/min in the control group and peak oxygen consumption increased by 4.8 +/- 4.2 vs 2.2 +/- 5.0 ml/kg/min (both p less than .05). Despite these differences in the cardiovascular response to exercise, peak oxygen consumption in both groups returned to before-bed rest levels by 30 days after bed rest, and this was accompanied by significant (p less than .05) and similar increases in resting left ventricular end-diastolic and stroke volumes in both groups. Simple resumption of usual physical activities after bed rest was as effective as formal exercise conditioning in restoring functional capacity to before-bed rest levels. PMID- 6861308 TI - Noninvasive evaluation of pulmonary hypertension by a pulsed Doppler technique. AB - We used a pulsed Doppler technique to examine the flow velocity pattern in the right ventricular outflow tract in 33 adults. In the patients with normal pulmonary artery pressure (mean pressure less than 20 mm Hg, 16 patients), ejection flow reached a peak level at midsystole (137 +/- 24 msec, mean +/- SD), producing a domelike contour of the flow velocity pattern during systole. In contrast, the flow velocity pattern in patients with pulmonary hypertension (mean pressure greater than or equal to 20 mm Hg, 17 patients) was demonstrated to accelerate rapidly and to reach a peak level sooner (97 +/- 20 msec, p less than .01); in 10 of the pulmonary hypertensive patients a secondary slower rise in flow velocity was observed during a deceleration, resulting in the midsystolic notching. The time to peak flow (acceleration time, AcT) and right ventricular ejection time (RVET) were measured from the flow velocity pattern. Either AcT or AcT/RVET decreased with increase in mean pulmonary artery pressure, and a very high correlation (r = -.90) was found between AcT/RVET and log10 (mean pulmonary artery pressure). The use of this technique permitted the noninvasive estimation of the pulmonary artery pressure. PMID- 6861309 TI - Relationship between segmental thallium-201 uptake and regional myocardial blood flow in patients with coronary artery disease. AB - The relationship between the spatial distribution of thallium-201 in myocardial perfusion scintigrams and the distribution of left ventricular regional myocardial blood flow was examined in 25 patients undergoing coronary arteriography. Thallium-201 myocardial scintigrams were obtained after symptom limited exercise and after a 4 hr delay. Regional myocardial blood flow was measured by the xenon-133 clearance method in patients at rest and during rapid atrial pacing to a double product comparable with that achieved during exercise stress testing. Patterns of regional thallium-201 activity and regional myocardial blood flow, recorded in similar left anterior oblique projections, were compared for left ventricular segments supplied by the left anterior descending (LAD) and left circumflex (CIRC) arteries. In 11 patients without significant lesions of the left coronary artery (group 1), thallium-201 was homogeneously distributed in the LAD and CIRC distributions in scintigrams taken during peak exercise; these scintigrams correspond to homogeneous regional myocardial blood flow in the LAD and CIRC regions during pacing-induced stress. In 14 patients with significant lesions of the left coronary artery (group 2), ratios of regional thallium-201 activity in the LAD and CIRC distributions of exercise scintigrams correlated well (r = .84) with ratios of regional myocardial blood flow measured during rapid pacing. Background subtraction altered the relationship between relative thallium-201 uptake and regional myocardial blood flow, causing overestimation of the magnitude of flow reduction on exercise scintigrams. These data indicate that: (1) in patients with normal left coronary arteries, thallium-201 is homogeneously distributed to the left ventricle, reflecting the homogeneous distribution of regional myocardial blood flow over a wide range of mean left ventricular flow rates and (2) in patients with significant lesions of the left coronary artery, the relative spatial distribution of thallium-201 activity in exercise perfusion scintigrams reflects the distribution of regional myocardial blood flow. PMID- 6861307 TI - Hydrodynamic compression of the right atrium: a new echocardiographic sign of cardiac tamponade. AB - The relationship of right atrial inversion, a previously undescribed cross sectional echocardiographic sign, to the presence of cardiac tamponade was examined. We studied 127 patients with moderate or large pericardial effusions. Cardiac tamponade was present in 19 and absent in 104. Four patients with equivocal tamponade were excluded from analysis. Right atrial inversion was present in 19 of 19 patients with cardiac tamponade and 19 of 104 without cardiac tamponade (sensitivity, 100%; specificity, 82%; predictive value, 50%). The degree of inversion as quantitated by the area-corrected curvature did not improve the ability to discriminate between patients with and without cardiac tamponade. However, consideration of the duration of inversion by the right atrial inversion time index (duration of inversion/cardiac cycle length) and an empirically derived cut-off of 0.34 did improve the specificity and predictive value (100% and 100%, respectively) without a significant loss of sensitivity (94%). We conclude that right atrial inversion, particularly if prolonged, is a useful echocardiographic marker of cardiac tamponade that may be of particular diagnostic value when the clinical picture is unclear. PMID- 6861311 TI - Assessment of the opening angle of implanted Bjork-Shiley prosthetic valves. AB - A method has been developed in which cineradiography is used for the assessment of the opening angle of implanted Bjork-Shiley prosthetic valves. The method is based on the fact that the ring and the disc, which are known to be circular, appear to be elliptical on x-ray films. The spatial position of the valve can be retrieved from the characteristics of these ellipses when vectoranalysis is applied. The method's accuracy does not depend on the position of the patient with respect to the direction of the x-ray beam. The accuracy of the method was demonstrated with the use of a phantom valve. The difference between the measured and the real opening angle was -0.7 +/- 1.8 degrees (mean +/- SD). Results were reproducible in patients to within -0.1 +/- 1.8 degrees. In 18 patients with normally functioning valves it could be demonstrated with frame-by-frame analysis (interval between frames 20 msec) that the valves opened very rapidly up to about 60 degrees. Closing patterns varied. In one of our patients with valvular thrombosis insufficient valvular opening could be demonstrated by our method before the patient's complaints drew attention to the valvular dysfunction. PMID- 6861310 TI - Prediction of cardiac events after uncomplicated myocardial infarction: a prospective study comparing predischarge exercise thallium-201 scintigraphy and coronary angiography. AB - The ability of predischarge quantitative exercise thallium-201 (201T1) scintigraphy to predict future cardiac events was evaluated prospectively in 140 consecutive patients with uncomplicated acute myocardial infarction; the results were compared with those of submaximal exercise treadmill testing and coronary angiography. High risk was assigned if scintigraphy detected 201T1 defects in more than one discrete vascular region, redistribution, or increased lung uptake, if exercise testing caused ST segment depression greater than or equal to 1 mm or angina or if angiography revealed multivessel disease. Low risk was designated if scintigraphy detected a single-region defect, no redistribution, or no increase in lung uptake, if exercise testing caused no ST segment depression or angina, or if angiography revealed single-vessel disease or no disease. By 15 +/- 12 months, 50 patients had experienced a cardiac event; seven died (five suddenly), nine suffered recurrent myocardial infarction, and 34 developed severe class III or IV angina pectoris. Compared with that of patients at low risk, the cumulative probability of a cardiac event was greater in high-risk patients identified by scintigraphy (p less than .001), exercise testing (p = .011), or angiography (p = .007). Scintigraphy predicted low-risk status better than exercise testing (p = .01) or angiography (p = .05). Each predicted mortality with equal accuracy. However, scintigraphy was more sensitive in detecting patients who experienced reinfarction or who developed class III or IV angina. When all 50 patients with events were combined, scintigraphy identified 47 high-risk patients (94%), whereas exercise-induced ST segment depression or angina detected only 28 (56%) (p less than .001). The presence of multivessel disease as assessed by angiography identified nine more patients with events than exercise testing (p = .06). However, the overall sensitivity of angiography was lower than that of scintigraphy (71% vs 94%; p less than .01) because three patients who experienced reinfarction and 10 who developed class III or IV angina had single-vessel disease. Importantly, 12 (92%) of these 13 patients with single-vessel disease who had an event exhibited redistribution on scintigraphy. These results indicate that (1) submaximal exercise 201T1 scintigraphy can distinguish high- and low risk groups after uncomplicated acute myocardial infarction before hospital discharge; (2) 201T1 defects in more than one discrete vascular region, presence of delayed redistribution, or increased lung thallium uptake are more sensitive predictors of subsequent cardiac events than ST segment depression, angina, or extent of angiographic disease; and (3) low-risk patients are best identified by a single-region 201T1 defect without redistribution and no increased lung uptake. PMID- 6861312 TI - Value of QRS alteration in determining the site of origin of narrow QRS supraventricular tachycardia. AB - To determine the value of alternation of QRS morphology in determining the site of origin of sustained narrow QRS supraventricular tachycardia (SVT), we retrospectively studied 163 distinct tachycardias in 161 patients (ages 4 to 91 years) in whom the site of origin of SVT was proven by intracardiac electrophysiologic study. Sustained SVT was defined as lasting longer than 30 sec. Narrow QRS was defined as QRS width less than 0.12 sec. Atrial fibrillation and flutter were excluded. The presence or absence of QRS alternation was judged at least 10 sec after initiation of SVT. Circus movement tachycardia with anterograde AV node conduction and a retrograde accessory AV pathway was seen in 89 patients (58 with Wolff-Parkinson-White syndrome, 31 with concealed accessory pathway); intra-AV nodal reentrant tachycardia (AVNT) was present in 57 cases, and 17 tachycardias were atrial in origin. QRS alternation was present in 36 of 163 cases (22%). In only eight of these 36 did RR interval length alternation accompany alternation in QRS morphology. Thirty-three of 36 (92%) tachycardias with QRS alternation were circus movement tachycardias. Two were atrial in origin and one was AVNT. We conclude that the presence of QRS alternation during sustained narrow QRS SVT is highly indicative of a retrograde accessory AV pathway in the tachycardia circuit. PMID- 6861315 TI - Prognostic significance of the number of induced ventricular complexes during assessment of therapy for ventricular tachyarrhythmias. AB - We analyzed 255 long-term trials of antiarrhythmic therapy, each of which had been evaluated at electrophysiologic study, to identify the maximum number of induced ventricular complexes consistent with the long-term efficacy of antiarrhythmic therapy. All patients had spontaneous and inducible sustained ventricular tachycardia or ventricular fibrillation. The incidence of therapeutic efficacy at 1 month and throughout follow-up was similar for trials in which zero, one, two, three, four, five, six to 10, and 11 to 15 complexes were induced, but significantly lower (p less than .001) for trials in which 16 or more complexes were induced. The cumulative incidence of efficacy at 1 year was 75 +/- 5% for 0 to 5 induced complexes, 72 +/- 11% for six to 10 complexes, 83 +/ 15% for 11 to 15 complexes, 42 +/- 10% for 16 complexes to 15 sec, and 48 +/- 6% for sustained ventricular tachycardia. At 1 year, the incidence of "sudden death free" survival was higher for patients in trials that prevented initiation of sustained ventricular tachycardia than for those in trials that permitted initiation of sustained ventricular tachycardia (91 +/- 3% vs 75 +/- 6%; p = .01). The duration of the arrhythmia induced at therapy assessment was in the range of 11 to 20 complexes for only 4% of trials. Antiarrhythmic therapy is likely to be effective if as many as 15 complexes are induced at therapy assessment. The best cutoff, between 11 and 20 complexes, is difficult to identify because of the small fraction of trials in this range. Patients in whom initiation of sustained ventricular tachycardia is not prevented are at high risk for arrhythmia recurrence and sudden death. PMID- 6861313 TI - Electrophysiologic actions of O-demethyl encainide: an active metabolite. AB - Differences between the electrophysiologic actions of the antiarrhythmic agent encainide have been reported after short-term intravenous and oral administration. Only prolongation of the HV interval and QRS duration have been described immediately after short-term intravenous administration of encainide in dogs and man. However, during oral therapy or more prolonged infusions, prolongation of the AH interval and atrial and ventricular effective refractory periods have also occurred. In most patients receiving encainide therapy, metabolites (O-demethyl encainide and 3-methoxy-O-demethyl encainide) accumulate during prolonged therapy to concentrations greater than those of the parent drug. We compared the electrophysiologic action of O-demethyl encainide with that of saline in anesthetized dogs to determine if this metabolite has pharmacologic activity and whether its electrophysiologic effects could account for the disparities noted between effects of intravenous and oral encainide therapy. An initial pharmacokinetic evaluation allowed design of a series of loading and maintenance infusions that produced plasma concentrations similar to those seen during encainide therapy in man (concentration after first maintenance dose, 149 +/- 27 ng/ml [+/- SE] and after second maintenance dose, 230 +/- 45 ng/ml). Significant increases in atrial effective refractory period and ventricular refractoriness, and prolongation of AH interval and HV conduction time were observed. These effects are similar to those reported after prolonged oral encainide therapy but are substantially different from those seen after short term infusions of encainide. These findings indicate that the difference between the electrophysiologic actions of intravenous and oral encainide may be due to pharmacologic effects of at least one encainide metabolite, O-demethyl encainide. PMID- 6861314 TI - Comparison of the electrophysiologic effects of intravenous and oral lorcainide in patients with recurrent ventricular tachycardia. AB - The electrophysiologic effects of intravenous lorcainide (2.2 mg/kg) in 10 patients were compared with the electrophysiologic effects of oral lorcainide (mean dose 400 mg/day for 8 days) in 11 patients, all with recurrent ventricular tachycardia that could be induced with programmed stimulation. Intravenous and oral lorcainide resulted in similar prolongation of the QRS, QT, and HV intervals, but only oral lorcainide resulted in prolongation of the AH interval and atrial and ventricular effective refractory periods. After both oral and intravenous lorcainide, ventricular tachycardia could still be induced, but the arrhythmia was slower and better tolerated hemodynamically. The mean plasma lorcainide level during a maintenance intravenous infusion was 1254 +/- 662 ng/ml compared with a lorcainide level of 562 +/- 41 ng/ml and a norlorcainide level of 1212 +/- 653 ng/ml after oral dosing. No norlorcainide was detected in plasma after intravenous lorcainide. These data suggest that the short-term electrophysiologic effects of intravenous lorcainide may be different from those of short-term therapy with the oral drug. These differences should be considered during short-term studies of lorcainide. PMID- 6861318 TI - Effect of hydralazine on perfusion and metabolism in the leg during upright bicycle exercise in patients with heart failure. AB - The aerobic exercise capacity of patients with chronic heart failure is frequently impaired because of inadequate O2 transport to working skeletal muscle. To determine whether hydralazine improves O2 transport to working muscle, we examined the effect of intravenous hydralazine on blood flow (measured by thermodilution) and metabolism in the leg during maximal upright bicycle exercise in 10 patients with chronic heart failure. Hydralazine increased maximal exercise cardiac output (5.6 +/- 0.7 to 6.7 +/- 0.6 l/min; p less than .01) and decreased systemic O2 extraction (79 +/- 3% to 65 +/- 2%; p less than .01) but did not alter maximal O2 uptake (787 +/- 105 vs 779 +/- 82 ml/min). Leg blood flow at maximal exercise increased from 1.6 +/- 0.2 to 2.1 +/- 0.4 l/min (p less than .03); the proportion of cardiac output delivered to the leg remained unchanged (59 +/- 3% vs 57 +/- 9%). This increase in flow was associated with a decrease in O2 extraction in the leg (84 +/- 2% to 79 +/- 2%; p less than .01) and no change in peak femoral venous lactate (59.1 +/- 7.4 vs 54.1 +/- 5.3 mg/dl), suggesting that there is functional or anatomic shunting of the augmented limb flow rather than delivery to metabolizing muscle. These data suggest that hydralazine augments flow to the exercising limb in patients with heart failure but that this augmented flow does not increase oxygen availability within working muscle. PMID- 6861317 TI - Significance of systemic vascular resistance in determining the hemodynamic effects of hydralazine on large ventricular septal defects. AB - The hemodynamic effects of hydralazine were studied in 17 infants and young children with ventricular septal defects to clarify the significance of systemic vascular resistance (SVR) in determining these effects. Patients with peak pulmonary arterial pressures greater than 75% of systemic pressure were placed in group I, which was further divided into group Ia (n = 6), consisting of those with a control SVR of 20 U.m2 or higher, and group Ib (n = 8), consisting of those with a lower SVR. Group II consisted of three patients with lower pulmonary arterial pressures. Intravenous injection of hydralazine (0.3 mg/kg) reduced SVR in all but two patients. The magnitude of reduction correlated with prehydralazine (control) SVR (r = .66, p less than .01). Systemic blood flow (Qs) increased from 3.7 +/- 0.7 to 5.0 +/- 0.8 l/min/m2 (p less than .005). The mean systemic arterial pressure for all patients decreased from 69 +/- 2 to 65 +/- 2 mm Hg (p less than .01) and the mean pulmonary arterial pressure decreased from the control value by 9 +/- 4% (p less than .01) in group I and by 17 +/- 1% in group II. Pulmonary blood flow (Qp) did not change significantly in either group. The Qp/Qs ratio was reduced from 3.6 +/- 0.4 to 2.4 +/- 0.2 (p less than .02) in group Ia. In sharp contrast, however, it increased from 2.6 +/- 0.3 to 3.3 +/- 0.5 (p = .06) in group Ib. The posthydralazine Qp/Qs ratio, expressed as percent of the control value, inversely correlated with the control SVR (r = -.61, p = .02) in group I. The response was not different in the group II patients. Thus, we conclude that control SVR is important for prediction of the hemodynamic effects of afterload reduction by hydralazine in infants and young children with large ventricular septal defects, and that this drug may be beneficial in patients with high control SVRs since a high SVR brings about a decrease in the Qp/Qs ratio. PMID- 6861316 TI - Electrocardiographic changes after streptokinase-induced recanalization in patients with acute left anterior descending artery obstruction. AB - ECG changes were assessed in 15 patients in whom intracoronary streptokinase recanalized a totally occluded left anterior descending artery during acute myocardial infarction. These results were compared retrospectively with those in 22 comparable conventionally treated patients who underwent catheterization during the acute stage of infarction. Before angiography no significant differences were found in the sum of ST elevation (sigma ST increase V1-V6), the sum of R waves (sigma RV1-V6), or the number of Q waves (nQV1-V6) in leads V1 through V6. sigma ST increase V1-V6 was significantly lower in the streptokinase group than in control patients at all times after angiography. sigma RV1-V6 declined and nQV1-V6 increased in both groups during the first 12 hr, but there was no further change in the control group, whereas in the streptokinase group a significant increase in sigma RV1-V6 and decrease in nQV1-V6 followed. There was a significant correlation between long-term electrocardiographic (sigma RV1-V6; nQV1-V6) and angiographic findings (ejection fraction, akinetic segment length). Thus, the Q wave regression and increase in sigma RV1-V6 after streptokinase suggest, in accordance with angiographic findings, that jeopardized myocardium was salvaged by reperfusion. PMID- 6861319 TI - Factors determining the loss of ductus arteriosus responsiveness to prostaglandin E. AB - The ductus arteriosus of the newborn infant varies in its ability to dilate when doses of prostaglandin E (PGE) are administered. We infused PGE2 into 15 late gestation newborn lambs to determine which factors regulate the ability of the ductus arteriosus to respond to PGE. PGE2 dilated the ductus in 10 lambs (responders); in five other lambs, despite similar PGE2 concentrations, there was no effect (nonresponders). The measured ductus resistance after the PGE2 infusion was directly related to the ductus resistance before the infusion. Responders had a larger left-to-right shunt through the ductus before the PGE infusion than nonresponders. Ductus that were isolated and studied in vitro from lambs that were nonresponsive to PGE2 (in vivo) were limited in their ability to relax with PGE2 as well as to actively contract with oxygen and indomethacin. This generalized loss of ductus responsiveness was directly related to the amount of the left-to-right shunt through the lumen of the ductus. These observations are consistent with the hypothesis that the constriction of the ductus arteriosus after birth limits the ability of the ductus to respond to PGE therapy. PMID- 6861320 TI - A two-dimensional Doppler echocardiographic method for calculation of pulmonary and systemic blood flow in a canine model with a variable-sized left-to-right extracardiac shunt. PMID- 6861321 TI - Dose-dependent effects of short-term methylprednisolone on myocardial infarct extent, scar formation, and ventricular function. PMID- 6861322 TI - Computerized image analysis for quantitative measurement of vessel diameter from cineangiograms. AB - Subjective estimates of the angiographic severity of coronary artery stenoses show variability and inaccuracy. We therefore tested the accuracy of a newly developed computerized image analysis system for quantitating vessel diameter from cineangiograms. Fourteen cylindrical phantoms of known diameter were filled with contrast medium and filmed over a wide range of clinically relevant radiographic conditions in order to develop regression equations that related computer-derived to anatomic diameters. Computer measurements of vessel diameter were unaffected by vessel size, magnification, focal spot size, thickness of scattering medium, kilovolt peak, or location within the radiographic field, but a correction factor was necessary for a small but significant (p less than .01) linear dependence on contrast medium concentration. The accuracy of computerized vessel diameter measurements ranged between +/- 59 and +/- 137 mu for all conditions except for rapid vessel motion and contrast medium concentrations of 50% or less meglumine diatrizoate (Renografin 76), both of which resulted in reduced accuracy as well as in the inability to locate lumen edges of vessels less than 1 mm in diameter. PMID- 6861324 TI - Limitation of infarct size with thrombolytic agents. PMID- 6861323 TI - Overview of thrombolysis. PMID- 6861325 TI - Factors involved in salvaging ischemic myocardium: effect of reperfusion of arterial blood. PMID- 6861326 TI - Changes in left ventricular ejection fraction after intracoronary thrombolytic therapy. Results of the Registry of the European Society of Cardiology. AB - Changes of left ventricular ejection fraction (delta EF) determined by monoplane contrast angiography before intracoronary streptokinase infusion and in the chronic stage of infarction before hospital discharge were assessed in 125 patients. Preintervention EF was .49 +/- .136 and chronic EF was .025 +/- .118 higher (p = .02) in the total group. Some subgroups had an improved EF: patients with collaterals (delta EF = .046 +/- .106, p less than .01, n = 42), patients with incomplete obstruction before intervention (delta EF = + .076 +/- .141, p = .03, n = 19) and patients in whom complete obstruction was permanently recanalized (delta EF = .024 +/- .113, p = .04, n = 89). A continuous model relating delta EF to both duration of infarct symptoms before hospital admission and to preintervention EF showed a decline in EF improvement over time in the subgroup that was admitted within less than 6 hours after the onset of chest pain and successfully recanalized (n = 72). PMID- 6861327 TI - The coronary arteries in acute myocardial infarction. AB - The coronary arteries in patients who die of an acute myocardial infarction may be anatomically normal or they may have a combination of lesions. They may show only marked atherosclerosis, with or without special features such as intramural hemorrhage or plaque rupture. There may also be thrombotic occlusion of the lumen of the artery. Whether this thrombotic process usually occurs before the myocardial infarction or whether it sometimes follows and results from the infarct is not known. PMID- 6861328 TI - The international registry to support approval of intracoronary streptokinase thrombolysis in the treatment of myocardial infarction. Assessment of safety and efficacy. AB - The data from 224 cases of acute myocardial infarction treated with intracoronary streptokinase plus standard coronary care unit management and 178 cases of acute myocardial infarction treated solely with standard coronary care unit management were reviewed to assess the efficacy and safety of the intracoronary administration of streptokinase during evolving myocardial infarction. Successful recanalization of the occluded infarct-related coronary artery was achieved in 176 of 224 streptokinase-treated cases (79%). The incidence of in-hospital postinfarction complications was lower and the mean left ventricular ejection fraction was improved in the successfully reperfused group. The in-hospital cardiac mortality in the reperfused patients was 4.5%. The intervention with coronary angiography and intracoronary streptokinase was generally well tolerated. Adverse reactions were relatively infrequent and were controlled with standard treatment. PMID- 6861329 TI - Myocardial imaging with thallium-201 for assessment of regional myocardial perfusion and viability after intracoronary thrombolytic therapy. AB - Whereas coronary arteriography demonstrates success of reflow or recanalization after intracoronary thrombolysis, myocardial perfusion imaging with thallium-201 (201Tl) permits assessment of viability of reperfused myocytes. The initial distribution of 201Tl in the myocardium immediately after intravenous injection is the result of both blood flow delivery of the radionuclide to the heart and the extraction fraction for 201Tl. If 201Tl is administered during a period of coronary occlusion, a scintigraphic defect will be observed in the territory of the occluded vessel. If, subsequently, blood flow is restored, as with reperfusion, and cellular kinetics transport of 201Tl returns to normal, myocardial regions initially deprived of 201Tl will demonstrate delayed redistribution and the defect will tend to normalize within several hours. In a sustained coronary occlusion, the defect will persist after 201Tl injection. Specific imaging protocols that have been or can be used to assess thrombolytic therapy are reviewed. If intracoronary streptokinase infusion is associated with a substantial enhancement of perfusion and preservation of cellular integrity in the ischemic zone, delayed 201Tl images obtained several hours after intravenous injection of the radionuclide will demonstrate significantly more 201Tl activity than the images before reflow. Direct intracoronary injections of 201Tl down the infarct vessel have also been used to evaluate the benefit of thrombolytic therapy by the demonstration of increased 201Tl uptake after reperfusion in the ischemic zone. Finally, computer methods for subtracting serial images obtained after two separate intravenous 201Tl injections administered before and after streptokinase infusion might be used to derive a "functional image" of the ischemic region that would quantitatively be proportional to the amount of myocardial salvage achieved. PMID- 6861331 TI - Studies of experimental coronary artery reperfusion. Effects on infarct size, myocardial function, biochemistry, ultrastructure and microvascular damage. AB - The present report is a review of recent experimental studies in a canine model of acute coronary occlusion. The questions addressed were: (1) Does coronary reperfusion reduce myocardial infarct size? (2) What is the relationship between microvascular damage and hemorrhage and the development of myocardial necrosis? (3) What are the biochemical, functional and ultrastructural characteristics of reperfused tissue salvaged from necrosis? Coronary occlusion followed by reperfusion in the dog resulted in significant subepicardial salvage of myocardium if reperfusion was instituted before 6 hours of ischemia. Because ultrastructural evidence of microvascular damage was found only after irreversible damage to myocytes, and because gross hemorrhage after coronary reperfusion was confined to zones of myocardium that were already necrotic, it does not appear that hemorrhage should serve as a deterrent to reperfusing reversibly injured myocytes. Severely ischemic myocardium that had been salvaged by coronary reperfusion required several days before it returned to normal from biochemical, functional and ultrastructural standpoints. PMID- 6861334 TI - Pepsinogen Group I radioimmunoassay and total serum pepsinogen colorimetric determination: a comparative study in normal subjects and in peptic ulcer patients. AB - Pepsinogens, proteolytic enzymes produced by peptic cells of the stomach and discharged into the gastric lumen as well as into the blood have been divided into two groups: PG-I, originating from chief cells, and PG-II, mainly from antrum peptic cells. Both total serum pepsinogen (s-Pg) and PG-I have been separately reported as being significantly increased in gastric (GU) and duodenal ulcer (DU) patients and related to maximal acid output. In order to ascertain the relationship between s-Pg measured by means of the colorimetric Uete method, and PG-I determined by RIA method, these were assayed in 72 control subjects, 35 GU and 95 DU patients. s-Pg was found to be significantly increased both in GU and DU patients in comparison with control subjects. Likewise PG-I was significantly enhanced in GU and DU patients as compared with controls. A significant direct correlation between s-Pg and PG-I was found in all the subjects studied (r = 0.732). PMID- 6861332 TI - Enzymatic estimation of infarct size during reperfusion. AB - Infarct size estimated enzymatically is an objective end point for assessing interventions in patients with acute myocardial infarction and correlates with acute and long-term morbidity and mortality. However, there is concern whether such estimates are reliable in the setting of reperfusion. Reperfusion during experimental infarction and clinically with streptokinase is associated with higher plasma creatine kinase (CK) levels that peak much earlier than with sustained occlusion, indicating a more rapid release rate. In this report, experimental derivation of the parameters for estimating infarct size--myocardial CK distribution and content, CK depletion, plasma CK disappearance rate and the release ratio--are presented, together with the experimental and clinical validation of these estimates. The close correlation between myocardial CK depletion and morphometric estimates of infarct size (r = .92), which provides the basis for enzymatic estimation of infarct size, remains valid during experimental reperfusion. Plasma CK activity (100-5000 IU/l) assayed before and after incubation of streptokinase (5000 U/ml for 30 minutes at 37 degrees C) showed less than 5% variation. Plasma CK disappearance (kd) in the conscious dog before and during infusion of streptokinase (20,000 U/hour) were identical. The CK release ratio has not been determined during streptokinase therapy or experimental reperfusion, but in the experimental animal during early reperfusion, infarct size was overestimated by the plasma CK method compared with histologic estimates. Despite the overestimation, enzymatic estimates still correlate closely with histologic estimates (r = .90). The presence of a close correlation despite sudden complete early restoration of flow suggests that with the appropriate experimentally determined correction factors, one can obtain reliable enzymatic estimates of infarct size to assess the efficacy of streptokinase. PMID- 6861333 TI - Developmental aspects of immunologically characterized proteins. AB - The spectrum of clinical tests for proteins characterized by their antigenic rather than by their enzymatic properties has been very limited, and still is today. This is mainly due to technical problems in the development of tests for such "antigens". The recently developed hybridoma technology has supplied us with the urgently needed new approach to overcome these problems. It is now possible to develop specific monoclonal antibodies against any determinant on antigens in any tissue, membrane or extract without the need to prepare antigens of high purity. Diagnostically valuable tissue marker molecules without known biological activity have become accessible, and can be detected and quantitated in tissues and body fluids with the new reagents. In most of the tests that will become available now or in the near future, polyclonal antisera will be substituted by monoclonal antibodies. Future developments, however, will exploit the advantages of the new technology to their full extent. In this paper, the advantages and disadvantages of monoclonal antibodies are evaluated and illustrated by the example of monoclonal antibodies to human kidney tissue antigens. Future developments comprising all fields of clinical diagnosis as well as applications in therapy are discussed. PMID- 6861330 TI - Limitation of infarct size with thrombolytic agents--electrocardiographic indexes. AB - Forty-four patients with acute transmural myocardial infarction underwent cardiac catheterization 4.7 +/- 1.3 hours (+/- SD) after the onset of persistent chest discomfort. Thirty-nine patients had total occlusion of infarct-related vessels; 27 of these 39 had successful intracoronary thrombolysis. Twenty of these 27 patients (74%) had reperfusion arrhythmia. Accelerated idioventricular rhythm was most often observed with reperfusion of all myocardial zones, while sinus bradycardia and hypotension accompanied reperfusion of the inferoposterior left ventricle. Three patients with spontaneous accelerated idioventricular rhythm had patient, stenosed, infarct-related vessels on the initial coronary angiogram. Patients with unsuccessful intracoronary thrombolysis did not demonstrate these specific arrhythmias. While there is rapid control of injury current with successful intracoronary thrombolysis, Q waves develop rapidly after reperfusion; however, in the days after intracoronary thrombolysis, there is a decline in Q wave with partial regrowth in R wave amplitude in some patients. Thus, specific arrhythmias, most notably accelerated idioventricular rhythm, are useful markers for the occurrence and timing of successful coronary arterial recanalization. In addition, rapid control of injury current and partial regrowth of R waves are electrocardiographic markers of myocardial salvage. PMID- 6861336 TI - Solid-phase direct immunoassay for serum intestinal and placental alkaline phosphatase. AB - Antibodies against placental alkaline phosphatase (PAP) share antigenic determinants with the intestinal isoenzyme (IAP) and vice versa. Both isoenzymes can be found as part of the total activity of alkaline phosphatase (AP) in the serum. Using antibody-coated polystyrene tubes, a simple and sensitive immunoassay was developed which allows the quantitative determination of IAP or PAP without interference of the cross-reacting isoenzyme. The presence and amount of IAP depends on the ABO blood group, secretory status and the oral fat intake. The serum IAP in healthy fasted individuals was found up to 8 U/I in secretors of blood group O and B and below 1 U/I in non-secretors and blood group A donors. In screening tests of various pathological sera. IAP was found elevated up to 100 U/I in idiopathic hyper-AP-aemia and some liver cirrhosis patients. PMID- 6861335 TI - Clinical usefulness and methodology of immunological assay of pancreatic enzymes. AB - Radioimmunoassays for plasma pancreatic enzymes, especially cationic trypsin, are good tools to diagnose pancreatic pathology. The trypsin assay is very sensitive. Its detection limit is 300 pg/ml. The plasma level of this enzyme appears to be representative of pancreatic function. This assay was shown to be valuable in the diagnosis of acute pancreatitis, and to follow the course of the disease. In chronic pancreatitis, it enables assessment of residual function of the organ. In the terminal stage of this disease, very low values were found. Used as a screening test, the assay allowed early detection of cystic fibrosis. PMID- 6861337 TI - Enzymological aspects of disorders in purine metabolism. AB - Congenital enzyme defects of purine synthesis de novo and the salvage pathway are responsible for excessive uric acid production and are often associated with hyperuricemia and gout. On the other hand, defects of enzymes essential for the purine nucleotide cycles are the biochemical basis of dysfunction of the immune system. The influence of several congenital enzyme deficiencies on the regulation of biosynthesis de novo, on the regulation of purine nucleotide concentrations, and on adenosine concentration, as well as the effect on purine transport through cell membranes are discussed. The determination of enzymes involved in purine metabolism in noncongenital diseases seems to be of diagnostic importance. As examples, enzyme activities in lymphocytes of leukemic patients, and the determination of serum guanase activity in patients with liver dysfunction are described. PMID- 6861338 TI - Enzymes of purine metabolism in cancer. AB - In cancer cells, a marked imbalance in the enzymic pattern of purine metabolism is linked with transformation and/or progression. In chemically-induced, transplantable hepatomas in rat, the specific activities of the anabolic enzymes, IMP dehydrogenase, GMP synthetase, adenylosuccinate synthetase, adenylosuccinase, AMP deaminase and amidophosphoribosyltransferase, increased to 13.5-, 3.7-, 3.1-, 1.8-, 5.5- and 2.8-fold, respectively, of those in normal liver. Activities of the catabolic enzymes, inosine phosphorylase, xanthine oxidase and uricase, decreased to 19, 10 and 4%, respectively. This enzymic imbalance was specific to hepatic neoplasia, since no similar pattern was observed in differentiating or regenerating liver. Most enzymic alterations were present also in chemically- and virus-induced animal tumors, in human kidney, liver and colon carcinomas, and in human colon carcinoma xenografts. The molecular correlation concept applies to purine biochemistry and an important segment of neoplastic gene expression was identified in the behavior of key purine-metabolizing enzymes. PMID- 6861339 TI - Determination of nifedipine in serum or plasma by reversed-phase liquid chromatography. AB - Therapeutic concentrations of nifedipine in serum or plasma were measured by reversed-phase liquid chromatography, with detection by ultraviolet absorbance at 235 nm. In the procedure a disposable reversed-phase extraction column is used. A 1-mL sample is required. The method is sensitive to 3 micrograms of nifedipine per liter and the standard curve is linear to at least 400 micrograms/L. Coefficients of variation at 100 micrograms/L were 2.2% within-run, 2.8% between run. The method has been used to determine nifedipine in patients involved in a test of its efficacy in treating muscular dystrophy. PMID- 6861342 TI - New "on-line" sample-pretreatment procedure for routine liquid-chromatographic assay of low-concentration compounds in body fluids, illustrated by triamcinolone assay. AB - In this fully automated technique for sample cleanup before chromatographic or other quantitation steps, analytes in body fluids are enriched and semi-purified on a first column. After their selective elution, analytes are "transformed" by admixing appropriate solvents in such a way that they are focused on the top of a second column. By backflush, they then are transferred to an analytical liquid chromatographic column (or simply eluted for quantification by other techniques). This technique is illustrated by the liquid-chromatographic assay of triamcinolone from a 1-mL urine sample, with ultraviolet detection. Because analytical recovery is almost complete and precision high, no internal standardization is necessary. Interference is eliminated as well as or better than with manual techniques. Chief advantages of this technique are online operation, processing of samples of larger volume, low cost with respect to extraction devices, and nearly universal applicability for exogenous or endogenous compounds of clinical relevance. It potentially may be widely applied. PMID- 6861341 TI - Metabolism of creatinine in vivo. AB - Two forms of radiolabeled creatinine were used in this study, [carbonyl-14C]- and [amidino-14C]creatinine, the latter being synthesized in this laboratory. These labeled compounds were given intravenously to rabbits. Specimens of plasma, urine, feces, and selected tissues were collected. These were liquid chromatographed and the separated components compared for radioactivity and identity. This first use of amidino-labeled creatinine revealed the metabolic conversion of small amounts of creatinine to an unidentified non-basic compound and guanidinobutyrate in normal rabbits and to guanidinopropionic acid and arginine in a rabbit that had a low creatinine clearance. A mechanism is suggested for this metabolic process. The proposed pathway may be a major route of elimination of creatinine in renal failure. PMID- 6861340 TI - Specific micro-radioimmunoassay for prednisolone in serum. AB - Use of an 125I radioimmunoassay involving antiserum coupled to magnetizable cellulose, after prednisolone-21-phosphate interference is removed by dichloromethane extraction at pH 7.4 and endogenous glucocorticoid interference is removed by selective chemical derivatization with Girard's Reagent T [(carboxymethyl)trimethylammonium chloride hydrazide], allows determination of prednisolone in 10 microL of serum. Results correlate well with those of an established liquid-chromatographic method for separating prednisolone from its metabolites. PMID- 6861343 TI - Detection of morphine in urine by hemagglutination inhibition, with use of lyophilized reagents. AB - We describe a modified test of hemagglutination inhibition for the detection of morphine in urine, similar to the well-known test for pregnancy. The reaction takes place in test tubes or ampoules containing carefully matched amounts of lyophilized morphine antiserum and tanned human erythrocytes coated with morphine conjugated to rat serum albumin. The reagents are reconstituted by adding 100 microL of urine and 400 microL of water, and the result is read after 60 min. The detection limit, tested with the method of Gorodetzky (Clin Chem 19:753, 1973), was about 200 ng of total morphine per milliliter of urine. For more than 2000 samples, results by our test agreed satisfactorily with those obtained by an accepted RIA method. The test is suitable for rapid screening in field work, monitoring subjects during detoxication, and use in nonspecialized laboratories. Confirmatory analysis is needed for quantitative measurements, forensic purposes, and discrimination between morphine and cross-reacting opiates. PMID- 6861344 TI - The succinonitrile triple-point standard: a fixed point to improve the accuracy of temperature measurements in the clinical laboratory. AB - In an investigation of the melting and freezing behavior of succinonitrile, the triple-point temperature was determined to be 58.0805 degrees C, with an estimated uncertainty of +/- 0.0015 degrees C relative to the International Practical Temperature Scale of 1968 (IPTS-68). The triple-point temperature of this material is evaluated as a temperature-fixed point, and some clinical laboratory applications of this fixed point are proposed. In conjunction with the gallium and ice points, the availability of succinonitrile permits thermistor thermometers to be calibrated accurately and easily on the IPTS-68. PMID- 6861345 TI - Radioimmunoassay for human corticosteroid-binding globulin. AB - We isolated corticosteroid-binding globulin from human plasma and used the isolated protein as the antigen in raising antibodies in rabbits. The resulting antiserum was used to develop an RIA with which we can determine the globulin in as little as 0.007 microL of serum, although we routinely use, after appropriate dilution, 0.02 microL. The mean concentration of corticosteroid-binding globulin in the serum of 40 normal subjects was 32.4 (SD 4.2) mg/L. The correlation (r) between results with this RIA and those by an established binding assay was 0.94. PMID- 6861346 TI - A nonlinear regression-kinetic method for quantification of serum triglycerides. AB - We report a new kinetic approach to the quantification of triglycerides (triacylglycerols) in human sera. The new approach combines a commercially available enzyme-reagent system with a multiple-linear-regression data-processing method. Values of absorbance collected at 3-s intervals between 20 and 305 s are fitted to a pseudo-first-order model to compute the total change in absorbance expected if the reaction were to proceed to equilibrium. The computed absorbance change varies linearly with triglyceride concentration between 3 and 20 mumol/L (after 250-fold dilution of sample). The pooled relative standard deviation was 7.2% for 23 serum samples with triglyceride concentrations between 3 and 20 mumol/L. Comparison of kinetic (y) and equilibrium (x) absorbance changes for the 23 sera gave a least-squares equation of y = 0.994x + 0.00066, confirming good agreement between the methods. The temperature coefficient is less than 0.2% per degree Celsius. PMID- 6861347 TI - "Unbound analog" radioimmunoassays for free thyroxin measure the albumin-bound hormone fraction. AB - We have assessed the influence of albumin-bound thyroxin (T4) on apparent free T4 values obtained by two "unbound analog" free T4 methods (AmerlexR Free T4 and Clinical Assays one-step Free T4). We evaluated sera showing three different albumin anomalies: total hereditary analbuminemia, partially corrected analbuminemia, and familial dysalbuminemic hyperthyroxinemia, where abnormal albumin-binding of analog tracer is associated with high apparent free T4 values by these methods. In hereditary analbuminemia, free T4 was almost undetectable by both assays; in contrast, free T4 by equilibrium dialysis was normal. After addition of T4-free human serum albumin, the apparent free T4 concentration in total hereditary analbuminemia became normal by the analog methods. Immunoprecipitation of [125I]T4 and the unidentified labeled kit analogs by antiserum to human albumin was negligible in untreated total hereditary analbuminemia and approximately twice normal in familial dysalbuminemic hyperthyroxinemia. Therefore, alterations in tracer binding to albumin correlate with the apparent free T4 concentrations obtained by the analog methods. The interactions of the unidentified analog tracers and T4 with albumin are such that these techniques principally reflect the albumin-bound T4 moiety. PMID- 6861348 TI - Effect of Fluosol-DA on radioimmunoassay results. AB - Fluosol-DA, an emulsion of perfluorocarbons, is used as a blood substitute. Its presence in samples affects results of certain radioimmunoassays routinely done in our laboratory. In several, added Fluosol-DA caused an upward displacement of the standard curve, the extent of which depended on the structure and quantity of the assayed antigen, the concentration of Fluosol-DA, and the nature of the immunoreagents. Fluosol-DA markedly affected results of assays for triiodothyronine, thyroxin, and digoxin (by one method), but assays for aminoglycosides and protein hormones were unaffected. We determined that Fluosol DA interacts with unbound labeled (and, presumably, with unlabeled) antigen to form a complex that coprecipitates with the bound antigen-antibody fraction during the separation step. In comparison with the idealized condition we observed an apparent increase in antibody-bound labeled antigen and consequently an apparent underestimation of the measured antigen. Depending on the nature of the immunoreagents, antibodies can extract more or less of their respective antigens from particles of Fluosol-DA emulsion. PMID- 6861349 TI - The Kodak Ektachem 400 Analyzer evaluated for automated enzymic determination of plasma creatinine. AB - We have evaluated an automated creatinine iminohydrolase procedure for plasma creatinine analysis, as used in the Kodak Ektachem 400 Analyzer. The correlation with kinetic and end-point (equilibrium) alkaline picrate procedures is generally excellent. The enzymatic procedure has the advantage of being unaffected by bilirubin, cephalosporins, and acetoacetate, all of which interfere in alkaline picrate procedures. Its accuracy, however, greatly depends on calibration values provided by the manufacturer. Storage of samples at -20 degrees C produced little change in measured creatinine. The Ektachem procedure has a greater range of linearity (140 mg/L) than the alkaline picrate procedures, but it shares with them the disadvantages of suboptimal precision in the normal range. The increased specificity, ease of performance, and other advantages of this use of creatinine iminohydrolase make it an attractive procedure. PMID- 6861350 TI - Sample preparation with ion-exchange resin before liquid-chromatographic determination of plasma catecholamines. AB - Estimation of plasma catecholamine concentrations by "high-performance" liquid chromatography, although increasingly used, still presents difficulties. We describe a method for clean-up of plasma samples on cation-exchange resin before they are extracted with alumina. This procedure eliminates many of the interfering compounds often present in plasma extracts prepared with the alumina treatment alone. The method can be adapted to use commercially available disposable cation-exchange columns. PMID- 6861351 TI - Nonaqueous reversed-phase liquid chromatography and fluorimetry compared for determination of retinol in serum. AB - A new assay for retinol in human serum, based on nonaqueous reversed-phase liquid chromatography, is presented. Sample preparation includes addition of the internal standard, retinyl propionate, deproteinization of 100 microL of serum with acetonitrile, and extraction with hexane. The standard curve is linear up to 2 mg/L. The assay is characterized by excellent sensitivity (detection limit, 15 micrograms/L) and good within-run and between-run precision (CVs of 2.6 and 2.7%, respectively), and results compare favorably with those by fluorimetry. We assayed 135 samples from hospitalized patients by both methods. Although the two sets of values correlated well (r = 0.955) the fluorimetric method occasionally suffers from interferences. In practice, fluorimetry proves valuable as a routine method, while liquid chromatography meets the criteria of a potential reference method. PMID- 6861352 TI - Densitometry of phosphatidylcholine and sphingomyelin in high-density lipoproteins. AB - We describe the quantitative densitometric determination of phosphatidylcholine (PC) and sphingomyelin (SP) in human serum after precipitation with phosphotungstic acid/MgCl2 and use of thin-layer chromatography. After development, chromatographic plates were charred with methanolic sulfuric acid and MnCl2 and scanned by direct reflectance densitometry in an automated densitometric system interfaced to a basic programmable computing integrator. The method is sensitive enough to detect abnormally low concentrations of PC and SP in high-density lipoproteins. The accuracy of the method was tested either with the Bartlett phosphorus assay or with enzymatic methods for PC and SP; correlations of the described method with the enzymatic determinations were r = 0.93 and 0.88, respectively. Day-to-day precision (CV) for the phospholipid determination was 8.6% for PC and 12.2% for SP. The major advantage of this inexpensive technique is that native plasma or serum or the serum supernate after precipitation can be used without prior delipidation. With this technique serum high-density lipoproteins had PC values of 1.08 (SD 0.32) mmol/L in men (n = 158) and 1.12 (SD 0.37) mmol/L in women (n = 192); similarly, SP values were 0.23 (SD 0.07) mmol/L in the men and 0.23 (SD 0.08) mmol/L in the women. The differences by sex are not significant. PMID- 6861353 TI - Vitamin B12 assays: call for a definitive method. PMID- 6861354 TI - Creatine kinase MB-isoenzyme evaluated by cellulose acetate electrophoresis. PMID- 6861355 TI - Lactate dehydrogenase isoenzyme 6 with increased creatine kinase BB isoenzyme. PMID- 6861356 TI - Influence of minicolumn procedure on apparent hemoglobin A1 in the presence of hemoglobin J-Baltimore. PMID- 6861357 TI - Origin of anodally migrating alkaline phosphatase isoenzyme in transient hyperphosphatasemia of infancy. PMID- 6861358 TI - Faster analysis for total and direct bilirubin in the Cobas-Bio analyzer. PMID- 6861359 TI - An alternative to receiver-operating characteristic curves. PMID- 6861360 TI - Previous work overlooked. PMID- 6861362 TI - Determination of [K+] in blood serum with a valinomycin-based silicone rubber membrane of universal applicability to body fluids. PMID- 6861363 TI - Some factors affecting the determination of glycosylated hemoglobin by electrophoresis on agar gel. PMID- 6861364 TI - Falsely negative values for creatine kinase isoenzyme MB by the isomune CK-MB assay, and a solution to the problem. PMID- 6861361 TI - Comments on the proposed selected method for electrophoresis of lactate dehydrogenase isoenzymes. PMID- 6861365 TI - A Coomassie blue dye-binding method for determining urinary protein is dilution dependent. PMID- 6861366 TI - Nuclear binding and cellular metabolism of thyroxine in a euthyroid patient with hyperthyroxinaemia. AB - The receptor mechanism and intracellular T4 deiodination were studied in a patient, who was euthyroid despite high T4 levels. Serum T3 and serum reverse T3 levels were normal and the TRH tests produced a normal rise in TSH. Protein binding capacities for T4 in serum were found to be normal. The T4 bound to a single set of binding sites in the patient's lymphocyte nuclei with a Ka which was depressed as compared with that of normals (Ka = 2.8 x 10(10) 1/mol) and a maximum specific binding capacity (MSBC = 1.9 fmol T4/10 micrograms DNA) which was increased as compared with normals (msbc = 1 x 10(-16) mol/1 T4/10 micrograms DNA). The cellular deiodination of T4 was found to be normal, whereas T3 accumulation was increased and the nuclear T3 concentration raised. In conclusion, these results suggest that in this patient the syndrome of peripheral tissue resistance to thyroid hormone action is due to a defect at the level of the nuclear receptor and not to a defective intracellular T4 to T3 conversion. PMID- 6861367 TI - Effect of metoclopramide on the secretion of aldosterone and other adrenocortical steroids. AB - The aim of this study was to determine the effect of metoclopramide, a dopamine antagonist, on the secretion of aldosterone and other adrenocortical steroids in normal subjects. An i.v. bolus injection of 10 mg of metoclopramide significantly increased the plasma PRL, plasma aldosterone and 18-hydroxycorticosterone, but the plasma renin activity, plasma deoxycorticosterone, corticosterone and cortisol remained unchanged. The changes in plasma aldosterone induced by metoclopramide were significantly correlated with the basal levels of plasma aldosterone and renin activity. These results suggest that the response of plasma aldosterone to metoclopramide in normal subjects is influenced by the basal activity of renin-angiotensin-aldosterone system and the late step of aldosterone synthesis is stimulated by metoclopramide. PMID- 6861368 TI - The place of PRL in human lactation. AB - Plasma PRL levels were measured during an episode of breast feeding in fourteen women on the eighth and 42nd post-partum days. The results show that as lactation continues so the importance of absolute values of PRL diminishes, but the capability to secrete PRL in response to the suckling stimulus is maintained. PMID- 6861369 TI - Induction of secondary antibody responses to Plasmodium chabaudi in vitro. AB - Spleen cells and peripheral blood mononuclear cells (PBMC) from mice, which had recovered from infection with Plasmodium chabaudi, were induced to produce anti P. chabaudi antibody by incubating the cells with P. chabaudi parasitized red cells in Marbrook cultures. The anti-malarial antibody was assayed using the indirect fluorescent antibody test. Spleen cells and PBMC from mice infected 2-4 months previously gave higher antibody titres in culture than similar cells from mice infected a year previously. There was a good correlation between the ability of spleen cells or PBMC to be stimulated to produce antibody in vitro and the ability of mice similar to the cell donors to resist a challenge infection. Some immunity can be adoptively transferred with both spleen cells and PBMC. PMID- 6861370 TI - Specific lysis of Plasmodium yoelii infected mouse erythrocytes with antibody and complement. AB - An assay for complement-dependent antibody-mediated cytolysis of Plasmodium yoelii infected mouse erythrocytes was designed. By means of a rat hyperimmune serum to P. yoelii the presence of parasite associated antigens was demonstrated on erythrocytes from P. yoelii infected mice. Tests with such erythrocytes fractionated on Percoll gradients showed that the target antigens for the cytotoxic antibodies were confined to the surface of only infected erythrocytes containing late stages of the parasite. The cytotoxic antibodies were of IgG class. PMID- 6861371 TI - IgG and IgE circulating immune complexes, total serum IgE and parasite related IgE in patients with mono- or mixed infection with Schistosoma mansoni and/or S. haematobium. Influence of therapy. AB - IgG and IgE containing circulating immune complexes (CIC), total serum IgE and parasite related IgE were determined in monoinfected patients with Schistosoma mansoni or S.haematobium and in patients with a mixed infection. IgE- and IgG-CIC and total serum IgE were significantly higher in the mixed infection group. There is considerable cross-reactivity between the crude S.haematobium and S.mansoni antigen preparations. The level of IgE-CIC is correlated to the levels of total serum IgE and parasite related IgE respectively. Furthermore IgE-CIC levels were related to the intensity of infection. Twelve out of 21 patients suffering from a monoinfection were reinvestigated 1-4 months after specific chemotherapy. Parasitological cure is followed by a significant decrease of total serum IgE and IgE-CIC, whereas parasite related IgE did not change significantly. The importance of the disappearance of IgE-CIC is discussed. PMID- 6861372 TI - Meningococcal meningitis associated with persistent hypocomplementaemia due to circulating C3 nephritic factor. AB - Two teenage patients who presented with meningococcal meningitis were found to have persistently low C3 levels even after recovery. This was accompanied by circulating C3 nephritic factor, which persisted for more than 12 months in each case. Neither patient had evidence of partial lipodystrophy or of glomerulonephritis initially, although one patient subsequently developed mesangioproliferative glomerulonephritis following a second admission with pneumococcal pneumonia. It is possible that the generation of the nephritic factor was initiated during the presenting illness. PMID- 6861375 TI - The specific in vitro antibody-mediated retention of bovine serum albumin by porcine hyaline articular cartilage. AB - Porcine hyaline articular cartilage (HAC) has been used to investigate the interaction of bovine serum albumin (BSA) and anti-BSA with articular collagenous tissues in vitro. There was a marked retention of 125I-labelled BSA by plugs of HAC (a) exposed to rabbit anti-BSA for 1-2 h at 37 degrees C prior to a similar incubation with the antigen, or (b) exposed to the antigen and then to antibody. The specifically retained radiolabelled BSA was localized in or at the articular surface of the plugs. In the absence of specific antibody a relatively small amount of the antigen was retained. Exposure of HAC to multiple cycles of antibody and antigen treatment resulted in an increased retention of the 125I BSA. There was a concomitant increase in the retention of the anti-BSA and the capacity of the treated plugs to fix complement. The forces that maintained the labelled antigen in the tissue were not readily reversed by excess unlabelled BSA. Pre-formed, soluble BSA/anti-BSA complexes did not appear to penetrate the tissue unless the HAC was first exposed to anti-BSA. The results suggest that the antibody-mediated, surface oriented retention of 125I-BSA results from the formation of immune complexes in the tissue. PMID- 6861374 TI - Non-specific suppression of antigen-induced lymphocyte blastogenesis in Onchocerca volvulus infection in man. AB - Lymphocyte blastogenic responses to O. volvulus antigen (Oncho Ag), SKSD, and the mitogen PHA were tested in three groups of persons: light to moderately infected persons (INF); previously exposed but uninfected persons (EXP) and normal controls (NC). The exposed group showed significant responsiveness to Oncho Ag (delta ct/min = 6,002 +/- 1,375), while the infected (delta ct/min = 943 +/- 418) and normal control (delta ct/min = 428 +/- 418) groups did not. The mean blastogenic response to SKSD were EXP, 8,644 +/- 5,249; NC 6,039 +/- 2,880; INF, 2,619 +/- 1,012. The reduced reactivity in the INF group to Oncho Ag showed a significant correlation with reactivity to SKSD (P less than 0.05). To elucidate the mechanism of hyporesponsiveness in the infected group rigorous adherent cell depletion, by adherence to plastic followed by a nylon wool column, was utilized. When 20% plastic adherent cells were added back to the T cells prepared in this fashion, the mean blastogenic response to SKSD was significantly augmented (P less than 0.01). In contrast, the responsiveness to Oncho Ag was not significantly altered. The addition of indomethacin (1 microgram/ml) or autologous plasma had no significant effect on reactivity to either SKSD or Oncho Ag. There were no significant differences in the mean reactivity of the three groups to PHA-M (delta ct/min EXP 78,514 +/- 12,564; INF 62,393 +/- 14,447; NC 61,423 +/- 4,465). These results suggest that O. volvulus infection is associated with decreased lymphocyte reactivity to both parasite related and unrelated antigens, and imply that the mechanism for the two types of hyporesponsiveness may be distinct. While a weakly adherent suppressor cell may account for non specific hyporesponsiveness, the mechanism of parasite specific decreased reactivity remains unknown. PMID- 6861373 TI - IgA and IgM rheumatoid factors in serum, saliva and other secretions: relationship to immunoglobulin ratios in systemic sicca syndrome and rheumatoid arthritis. AB - Paired serum and saliva samples from seven patients with systemic sicca syndrome (SSS), 15 patients with rheumatoid arthritis and a positive Schirmer's test (RA+), 15 patients with rheumatoid arthritis and negative Schirmer's test (RA-) and 14 normal individuals were analysed for albumin and immunoglobulin concentration as well as IgA and IgM rheumatoid factor (RF) activity. Protein levels in saliva were higher in SSS and RA+ but, when corrected for serum concentration and salivary flow rate, only the IgG ratio remained significantly elevated in SSS (P less than 0.01) and RA- (P less than 0.05) and the IgM ratio was reduced in RA- (P less than 0.05) compared to controls. Although IgM RF activity in serum and saliva was strongly correlated (P less than 0.001) in all three patient groups, the activity in saliva was considerably lower than serum activity. In the two (RA) patients tested, IgM RF in saliva contained secretory component. Mean salivary IgA RF activity varied between 34% (RA-) and 84% (SSS) of serum activity and correlated with serum activity in SSS (P less than 0.001) and RA- (P less than 0.01). IgA RFs in saliva, but not in serum, contained secretory component. Additional demonstration of IgA RF activity in nasal and duodenal secretions in SSS may be related to involvement of the common mucosal immune system. PMID- 6861376 TI - Radioimmunoassay for antibodies to human skeletal muscle myosin in serum from patients with polymyositis. AB - Antibodies to human skeletal muscle myosin were detected in 90% of sera from patients with polymyositis by radioimmunoassay using purified human myosin as antigen, and the mean titre was 4.24 X 10(-10)M. The incidence and the mean titre of anti-myosin antibodies were significantly higher than in patients without polymyositis. Anti-myosin antibody titres correlated with steroid therapy in polymyositis patients. Titres in untreated patients with polymyositis correlated with the severity of muscle weakness. Radioimmunoassay for anti-myosin antibodies should prove to be useful in the diagnosis of polymyositis and the evaluation of clinical state. PMID- 6861378 TI - IUIS/WHO notice. Appropriate uses of human immunoglobulin in clinical practice. AB - There is a consensus amongst clinical immunologists that an effort should be made to define, for non-specialists, criteria and indications for administering immunoglobulin (gammaglobulin, immune serum globulin [ISG]) to patients. In addition to the well established immunoglobulin preparations for intramuscular injection, preparations rendered suitable for intravenous administration have recently become available, opening new prospects for the use of this material. The present report has been prepared by members of the Clinical Immunology Committee of the International Union of Immunological Societies in collaboration with the World Health Organization. It aims to delineate current recommendations for the use and dosage of immunoglobulin in the prophylaxis of viral and bacterial infections and in replacement of antibodies in immunodeficient patients. It is a further aim of this report to point out clearly those situations where immunoglobulin is not deemed to be useful or is contraindicated. Inappropriate use of this valuable material results in excessive and unnecessary costs for health services, carries some risk and is wasteful. This report also summarizes current knowledge on adverse reactions to immunoglobulin injections and those qualities which would be most desirable, if not essential, for safe and useful immunoglobulin preparations. PMID- 6861377 TI - The late reaction following bronchial provocation with house dust mite allergen. Dependence on arachidonic acid metabolism. AB - The involvement of arachidonic acid metabolism in early and late bronchial reactions has been studied in four asthmatic subjects sensitive to Dermatophagoides pteronyssinus. Pre-treatment with either indomethacin (an inhibitor of the cyclo-oxygenase pathway) or benoxaprofen (an inhibitor of both cyclo-oxygenase and lipoxygenase pathways) failed to affect the amplitude, but did produce some foreshortening of the early response to allergen. If benoxaprofen is an effective inhibitor of SRS-A formation in vivo, then these observations question the role of SRS-A as a spasmogen in allergen-induced bronchospasm. Both drugs were effective inhibitors of the late reaction, implying involvement of cyclo-oxygenase products (endoperoxides, prostaglandins or thromboxanes) in the genesis of a late response to allergen. PMID- 6861380 TI - The hindfoot. PMID- 6861379 TI - Incidence of antibodies against rabbit liver specific lipoprotein (RLSP) in chronic active hepatitis. AB - In chronic active hepatitis (CAH) evidence exists that circulating autoantibodies against liver specific lipoprotein (LSP) could play a role in the development of hepatocellular injury. We evaluated the presence of autoantibodies in CAH against LSP using rabbit LSP, as antigen in a radioimmunoprecipitation test. Fifty-one patients with histologically diagnosed CAH were investigated. Among these 16 were HBsAg+, 15 were HBsAg-/anti-HBc+, 10 were non-A, non-B, 10 were autoimmune CAH. Anti-LSP were detected in six of 16 (37%) HBsAg+ (mean titre of 1:198); four of 15 (33%) HBsAg-/anti-HBc+ (mean titre of 1:246); two of 10 (20%) non-A, non-B (mean titre of 1:185); seven of 10 (70%) autoimmune CAH (mean titre of 1:307). No correlation was evident between the titre of anti-LSP and the values of AST, bilirubin or IgG. The findings seem to be consistent with the following conclusions: (a) CAH patients develop an humoral immune response to determinants in LSP which are not species specific. This is further evidence that rabbit LSP could be considered a suitable alternative to the human preparation in evaluation of autoimmunity in CAH and (b) the different behaviour of anti-LSP in patients with viral CAH (B, non-A, non-B) in respect of patients with autoimmune CAH suggests a variable importance of these antibodies in the mechanism of ongoing liver cell injury according to the various types of CAH. PMID- 6861381 TI - A new method of manual reduction for intra-articular fracture of the calcaneus. AB - Eleven typical cases are reported to demonstrate a bimanual traction-bending reduction technique for the calcaneal fracture associated with fracture dislocation of the subtalar joint. The method reported is recommended for the initial treatment of calcaneal fractures. PMID- 6861382 TI - The dilemma of painful old os calcis fractures. AB - This study of 16 patients (17 amputations) draws attention to intractable pain as a rare, but not previously emphasized, sequela of os calcis fracture. The fracture remained painful despite, in many cases, exhaustive measures to relieve symptoms. The majority of patients still had pain even after amputation and revision, suggesting the development of a regional (phantom) pain syndrome. Patients should be advised that severe os calcis fractures may not heal sufficiently to stabilize the foot for 18-24 months. Patients who continue to complain of pain following treatment of a fracture of the os calcis should be carefully evaluated in a pain management clinic. Since in some patients the pain may not be entirely organic in origin, amputation would not solve the problem. In the present series amputation did not always relieve pain and also made prosthetic fitting difficult. PMID- 6861383 TI - Pathologic hindfoot conditions in the athlete. AB - Millions of people run in the United States, both for competitive reasons and for basic conditioning. Unfortunately, many runners develop cumulative (overload) stress syndromes, a number of which occur in the hindfoot. Among the most common are Achilles tendinitis and its associated conditions, plantar fasciitis, and tendinitis of the posterior tibial and flexor hallucis longus tendons. Most of these conditions respond well to conservative treatment, but in some instances surgery is needed. Surgery frequently can help patients who have not responded to conservative therapy to return to active and even competitive athletic lives. PMID- 6861384 TI - Bilateral subtalar dislocations. A case report. AB - A 29-year-old man with bilateral subtalar dislocations demonstrated that neurologic damage can accompany subtalar dislocation. Neurologic injury, among other well known risk factors, produces poor final results. Serial 99mTc bone scans with a pin-hole collimator are useful for evaluating the vascularity of the talar body. PMID- 6861386 TI - Pes planovalgus in children. AB - Postural valgus hindfeet in children, so-called "flat feet" or floppy feet, are not new to orthopedics. A small number of these patients have significant symptoms requiring surgical treatment. Many patients are adequately controlled without operation by Rose-Swartz insoles worn during the growing period. In this series of 17 children and one adult with severe pes planovalgus, both parents and children testified to considerable and lasting functional improvement at examinations performed several years after surgery. The hindfoot shape as judged by shoe wear and on radiographs may not be vastly different before and after surgery; however, function is gained, and symptoms decrease markedly, justifying the surgical intervention. PMID- 6861385 TI - Cavus, cavovarus, and calcaneocavus. An update. AB - Cavus, cavovarus, and calcaneocavus deformities are often related to neuromuscular disorders that result in intrinsic and/or extrinsic muscle imbalance in the foot. A careful search for intraspinal causes should be made, particularly in progressive cavus deformity in children. Plantar release is the most common procedure performed for correction of cavus feet and its variants. The choice among available surgical procedures is dictated by the age of the patient, the flexibility and cause of the deformity, an analysis of the deformity, and appropriate standing roentgenograms. Soft tissue procedures, including plantar fasciotomy and tendon transfers, are usually done in younger patients. Bony procedures, including calcaneal, midtarsal, and forefoot osteotomies, are performed in mature feet and are tailored to the apex of the deformity. Triple arthrodesis is a salvage operation for correcting cavus and its variants. PMID- 6861387 TI - Tibialis posterior tendon rupture. AB - Rupture of the tibialis posterior (TP) tendon occurs most commonly in adult women. It evolves as an insidious, painful, and progressive flatfoot deformity. Watching for such deformities as too many toes and including the single heel rise test in the examination will facilitate an accurate diagnosis. The treatment rationale should consider the site and extent of tendon disruption, as well as the presence of secondary deformity. Early treatment will help to prevent long term functional impairment. PMID- 6861389 TI - Dislocation following total hip arthroplasty. Management by special brace in selected patients. AB - Dislocation after total hip arthroplasty (THA) occurs in 1%-3% of the cases reported in the literature. Recurrent dislocations due to malpositioned components should be treated by revision arthroplasty. Dislocated hips that have optimally positioned components but weak abductors can be treated by a special brace that prevents extremes of flexion, adduction, and rotation. Two hundred and eighty-nine total hip arthroplasties were performed from 1975 to 1981. Nine patients, all of whom had optimal position of components and the brace treatment, had dislocations. In one patient who had a spastic muscle disorder the brace was used as prophylaxis. The short chair-back brace has a lateral joint with thigh cuff. The joint can be locked at a particular position to give the desired movement of the hip joint. The brace, applied after the second dislocation, is worn for six to nine months. Excellent results were obtained in nine patients. One patient is still using the brace. The brace is light and can be worn under normal clothing; ordinary activities are easily performed by patients wearing the brace. Patients should be trained to avoid positions and activities that predispose to dislocation. PMID- 6861388 TI - Survival of patients and prostheses after total hip arthroplasty. AB - The survival statistics of 695 patients who had 803 total hip arthroplasties (THA) were correlated with the incidence of aseptic loosening using standard actuarial methods. Follow-up periods ranged from three to 11 years. High patient mortality was associated with factors that lower physical fitness: old age, bilateral hip disease, excessive obesity, diagnosis of rheumatoid arthritis, and post-traumatic changes. Patients in whom revision procedures were done due to prosthetic failure experienced a very low mortality. The factors associated with aseptic loosening were unilateral hip disease, defective surgical technique, and excessive body weight (greater than 80 kg). The increased rates of aseptic loosening that have been observed during the later years of follow-up evaluation were attributable to higher survival rates of the more physically fit individuals in the population at risk. PMID- 6861390 TI - Radiographic anatomy of the hindfoot. AB - Lead markers were placed on various osseous structures of the talus and calcaneus in fresh amputation specimens to analyze the radiographic anatomy of the hindfoot. Analysis of the talocalcaneal articulations revealed that only the central one-third of the posterior subtalar joint can be visualized on the lateral projection, whereas the axial view profiles only the anterior one-third of the joint. The anterior two-thirds of the middle subtalar joint is profiled on the lateral projection, whereas no portion of the middle articulation can be visualized on the axial view. The anterior subtalar joint can not be identified on either lateral or axial radiographs. In addition, nine extra-articular osseous landmarks on the talus and calcaneus were investigated. The identification of these structures is helpful in the diagnosis of pathologic disorders affecting the adult hindfoot. PMID- 6861391 TI - Comparative study of pinning in situ and open epiphysiodesis in 105 patients with slipped capital femoral epiphyses. AB - One hundred five patients were treated for slipped capital femoral epiphyses during the period from 1964 to 1976. Attempts were made to evaluate the differences in results of multiple pinning and open epiphysiodesis performed to treat this problem. Pinning in situ was performed in 61 hips, and open epiphysiodesis was performed in 33 hips. The average follow-up period was seven years four months for pinning in situ and six years seven months for open epiphysiodesis. The average slippage was 22 degrees for patients treated by pinning in situ and 30 degrees for patients treated by open epiphysiodesis. At follow-up evaluation 91.7% of the patients treated by pinning in situ had good or excellent results, as compared with 71.6% of the patients treated by epiphysiodesis. For the patients treated by pinning in situ, 5% had poor results, and 3.3% were considered failures. For the patients treated by epiphysiodesis, 3.4% had poor results, while 25% were considered failures. Pinning in situ is the treatment of choice. It is more predictable, has less complications, and provides better long-term results. PMID- 6861392 TI - Chronic compartmental syndrome in the tensor fasciae latae muscle. AB - Chronic compartmental syndromes have been reported in various locations in the upper and lower extremities, but to the best of the authors' knowledge it has not been described in the tensor fasciae latae muscle. Two patients, men of about 60 years of age, complained of pain on exertion and sitting associated with swelling of the tensor muscle. In both cases CT scans showed muscle enlargement. Intracompartmental pressure values were high both at rest and during exercise. After fasciotomy the patients were relieved of pain, and intracompartmental pressure values were normalized. PMID- 6861394 TI - Anteromedialization of the tibial tuberosity for patellofemoral malalignment. AB - Anteromedialization of the tibial tuberosity is a new and highly effective technique for transferring the tibial tuberosity when anteriorization is desired in addition to medial shift of the patellar tendon insertion. Prompt primary bone healing can be achieved, allowing rapid rehabilitation with substantially improved patellofemoral mechanics. No bone grafting is necessary to achieve anteriorization, although only slight to moderate anteriorization is possible in most cases. Realignment of the patellofemoral mechanism and relief of patellofemoral contact stress can be achieved in one procedure. PMID- 6861395 TI - Avulsion fractures of the tibial tubercle in adolescents. A report of bilateral fractures and a review of the literature. AB - Avulsion fractures of the tibial tubercle prior to epiphyseal closure are being treated with greater frequency. Watson-Jones Types I and III fractures are the most common; both require open reduction and internal fixation. Type II fractures respond to closed reduction and plaster immobilization. The authors have found only 76 fractures reported in the literature since 1935. Four cases were bilateral. Fifty-nine patients were boys, and two were girls; the sex was not reported for 11 patients. Type III fractures occurred most often in older adolescents. Types I and II fractures occurred in younger patients. No reports of growth disturbance of the proximal tibial epiphysis occurring after a Type III fracture were found. PMID- 6861393 TI - Salvage of bilateral knee arthroplasties with Pseudomonas infection. A case report. AB - The treatment of infection after knee arthroplasty presents difficult medical and technical problems. Adequate control of the infection by appropriate antibiotic treatment and arthrodesis is no longer the only alternative to surgical management of the infected implant. Successful reimplantation can be achieved, although the quality of arthroplasty is often inferior to that of noninfected per primam arthroplasty. PMID- 6861396 TI - Ligament injuries associated with physeal fractures about the knee. AB - A retrospective study of 29 cases of epiphyseal plate fractures about the knee revealed 14 patients with ligament instability at follow-up evaluation an average of 66 months after injury. Distal femoral physeal fractures had occurred in 16 of the 29 patients. Six of these patients had ligament insufficiency, which was recognized by positive anterior drawer and Lachman tests in all six and laxity to valgus stress in one. Proximal tibial physeal fractures were noted in 13 of the 29 patients. Eight of these patients had ligament laxity; anterior drawer and Lachman tests were positive in five, and laxity with valgus stress was present in four patients. It is concluded that because 14 of 29 patients (48%) had ligament insufficiency at follow-up evaluation, physeal fracture about the knee does not exclude ligament damage and, in fact, is associated with a high incidence of ligament injury. Furthermore, a complex proximal tibial physeal fracture associated with medial collateral ligament rupture is described for the first time. This resulted in medial collateral ligament insufficiency, genu valgus, and early degenerative changes. A treatment plan of primary ligament repair, fracture reduction, and follow-up evaluation to skeletal maturity is suggested for this unique fracture. PMID- 6861397 TI - Screw fixation of closed oblique and spiral fractures of the tibial shaft. AB - The difficulty of reducing and holding fractures of the tibial shaft, especially those of oblique configuration, is well known. A high incidence of malalignment after closed treatment of fractures of the distal third of the tibial shaft, as compared with fractures in more proximal sites, has also been reported. In 29 of 37 fractures in the present study treatment by closed methods had failed. In highly selected cases of closed tibial shaft fractures, notably those in the distal third and at the middle third-distal third junction with an oblique or a spiral configuration and an unacceptable position after closed reduction, simple screw fixation followed by plaster immobilization provides an effective treatment alternative. PMID- 6861398 TI - Supracondylar fractures of the humerus in children treated by closed reduction and percutaneous pinning. AB - During the period from 1973 to 1978, 38 children with displaced supracondylar fractures of the humerus were treated at The Children's Hospital of Philadelphia by closed reduction and percutaneous pin fixation. The technical details of the procedure include (1) reduction under general anesthesia with adequate relaxation; (2) insertion of crossed pins from the medial and lateral side with the elbow in acute flexion; (3) and intraoperative clinical and roentgenographic examination of the pinned fracture with the elbow in extension to determine the adequacy of the reduction, with particular attention to the carrying angle. By Flynn's criteria acceptable results were obtained in 19 of the 25 patients studied. Three results were unacceptable due to cubitus varus of 2 degrees, 5 degrees, and 10 degrees, respectively, and three to loss of flexion. Although rotational malalignment occurred in 19 patients, as manifested by a change in shoulder rotation, in no patient was it clinically significant, either cosmetically or functionally. There were no neurologic or vascular complications from the treatment. This is a safe and reliable technique for obtaining and maintaining an excellent reduction in this difficult fracture while preserving vascular function. PMID- 6861399 TI - Lymphangiomatosis and massive osteolysis of the cervical spine. A case report and review of the literature. AB - On the basis of clinical, radiographic, and pathologic evidence, massive osteolysis can be divided into two forms: Gorham's disease and angiomatosis. The present case is the first report of massive osteolysis of the lymphangiomatosis type involving the cervical spine but without visceral involvement. Originally, plain lymphangiomatosis was diagnosed, but the diagnosis was changed to massive osteolysis. Only one other case of lymphangiomatosis with cervical involvement was found, but in that case the viscera were also involved. Both cases exemplify a prolonged progressive pattern, recalcitrant to treatment and with a devastating outcome. Diagnosis by biopsy is difficult, and incremental radiation therapy early in the disease process should be considered. PMID- 6861400 TI - Biomechanical analysis of foot function during gait and clinical applications. AB - Temporal and distance gait factors, foot-switch contact patterns, ankle/subtalar joint motion, and center of foot pressure distribution have been used to evaluate normal and abnormal foot mechanics. A normal control group and selected patients with well defined pathologic conditions were studied to examine the effectiveness of this method. Biomechanical observations reflect the clinical pathologic condition. Abnormalities involving the forefoot, midfoot, and hindfoot are most suitable for analyzing center of foot pressure. Ankle and subtalar problems are studied by motion analysis, with the subject walking on different ground conditions. PMID- 6861401 TI - Tourniquet hemostasis. A clinical study. AB - A clinical study was undertaken to evaluate the pneumatic tourniquet setting required for adequate hemostasis in extremity surgery. After induction of anesthesia, the pneumatic tourniquet pressure at which the peripheral pulse disappeared was determined using a Doppler stethoscope. For upper-extremity procedures 50 mm Hg was added to this setting to allow for collateral circulation and blood pressure changes. An average pressure of 189.9 +/- 24.1 mm Hg was used for the upper-extremity group (44 patients), and an average of 231.0 +/- 26.5 mm Hg was used for the lower-extremity group (40 patients). Maximum pressures utilized were 255 mm Hg in the upper extremity and 305 mm Hg in the lower extremity. This simple, noninvasive technique uses tourniquet pressure settings well below those recommended in standard reference texts without sacrificing the adequacy of hemostasis to obtain a "bloodless field." PMID- 6861402 TI - Dependence of electrical conductivity on fixed charge density in articular cartilage. AB - A new system for measuring the resistivity of articular cartilage is based on the four-point probe technique. The system measures resistivity as a function of depth from the articular surface. The measurements obtained showed that the conductivity, kappa, of articular cartilage equilibrated in Ringer's solution (pH, 7.4) is constant in all zones, with a value of 6-10 X 10(-3) mho/cm. Conversely, kappa of articular cartilage equilibrated in distilled water varies distinctly, being low in the superficial zone (about 0.7 X 10(-3) mho/cm) and high in the middle to deep zone (about 3 X 10(-3) mho/cm). This is almost the same variation shown by the fixed charge density, FCD, which was measured by the tracer cation method; a linear correlation between kappa and the FCD was found (correlation coefficient, 0.88). These observations were well understood based on the Donnan equilibrium; the mobility of Na+ in cartilage was thought to be independent of FCD. PMID- 6861403 TI - Acetabular cement compactor. An experimental study of pressurization of cement in the acetabulum in total hip arthroplasty. AB - To improve cement fixation of acetabular components for total hip arthroplasty, a new instrument, the acetabular cement compactor, was devised. Measurements in human cadaveric acetabula show that the cement intrusion pressure is significantly and substantially increased by the acetabular cement compactor. The depth of cement intrusion is greatly improved when the compactor is used, as compared with finger packing. The impression casts of the acetabular cement are superior when the cement is inserted using the acetabular cement compactor. Occlusion of the orifice of the keying holes permits generation of high pressure in the cement within them. This can be achieved by using the keying-hole seal. Pressurization of the acetabular cement used in the dough stage by the acetabular cement compactor substantively improves acetabular cement fixation. PMID- 6861404 TI - Solubility of spinal ligament collagen in idiopathic and secondary scoliosis. AB - Supraspinous and interspinous ligaments from patients with infantile and adolescent idiopathic scoliosis and from patients with secondary scoliosis were investigated for collagen content and cross-linking. No differences were demonstrated in the collagen content of ligaments from the idiopathic and secondary scoliosis groups. Collagen solubility studies were used to test for cross-linking defects. Similar amounts of neutral salt-soluble and acetic acid soluble collagen were extracted from the ligaments of all diagnostic groups. Investigation of the normally insoluble collagen pool extracted from the ligaments of different diagnostic groups after "lyotropic relaxation" revealed no differences in the amount of collagen extracted or in its stability to alkaline denaturation. Control experiments using rat skin collagen showed that the lyotropic procedure solubilized undegraded alpha- and beta-polypeptide chains from the tissue. Reports from other laboratories have suggested the presence of a collagen defect in the skin of patients with adolescent idiopathic scoliosis. The results of the present investigation show that it is unlikely that a generalized defect of collagen cross-linking, or a specific defect of ligament collagen cross linking, occurs in either infantile or adolescent idiopathic scoliosis. PMID- 6861407 TI - Rigid painful flatfoot secondary to tarsal coalition. AB - Rigid flatfoot secondary to tarsal coalition requires proper clinical and roentgenographic evaluation. In patients with limited subtalar motion and pain in the tarsal area, a coalition should be suspected. Proper roentgenographic evaluation with standard anteroposterior, lateral, and oblique views is essential. Calcaneonavicular coalition, as visible on an oblique film, may be a solid bony fusion or, more often, a cartilaginous coalition, which is characterized by flattening of the calcaneus and navicular at their junction. Axial (Harris) views demonstrate coalition in the middle and posterior facets, which may be cartilaginous or osseous. Lateral tomography is used to demonstrate irregularities of the anterior facet or the undersurface of the talar head. When symptomatic, a calcaneonavicular coalition with no degenerative changes of the tarsal joints is treated by resecting the bar and inserting the extensor digitorum brevis into the area from which the coalition is excised. An osseous bar is resected, or, if degenerative changes are noted, a triple arthrodesis is performed. Talocalcaneal coalition is first treated conservatively by a regimen of Plastizote shoe inserts, short-leg casts, or an ankle-foot orthosis. If conservative treatment fails to alleviate pain, a triple arthrodesis is indicated. PMID- 6861405 TI - Computerized tomography (CT) scanning technique for the hindfoot. AB - Radiographic sections of the hindfoot were obtained using a computerized tomographic (CT) scanning unit. The standard examination consists of a series of coronal sections 4 mm thick at 4-mm intervals of the plantigrade foot, from the posterior talocalcaneal facet through the navicular. The coronal plane provides the best view of the facets of the talocalcaneal joint. Occasionally, the transverse plane is used to examine the talonavicular joint, calcaneocuboid joint, and talar neck. Minor modifications in the scanner help to produce optimal CT studies of the hindfoot. PMID- 6861408 TI - Surgical treatment of the accessory navicular. AB - Surgical management of the accessory navicular or navicular beak using the Kidner procedure was indicated in 29 feet. Pain was present in all feet; difficulty with shoe fit and flat feet were other complaints. The patients were followed up for two to ten years (mean, 4.5 years) after operation. Eleven results were excellent, 15 good, and 3 poor, all in boys with a navicular beak. Only one complication occurred. Excision of the accessory navicular or navicular beak, together with suturing the fibers of the posterior tibial tendon (inserting on the accessory navicular or navicular beak) to the inferior surface of the navicular, is effective treatment. PMID- 6861409 TI - Implant arthroplasty in the adult hindfoot. AB - In patients with mild to moderate valgus deformity and localized pain due to lateral impingement, the subtalar implant has been effective in controlling position and relieving localized pain. When used in conjunction with a talonavicular resurfacing prosthesis in the absence of talonavicular subluxation, the implant has been effective in relieving pain and maintaining the foot in a normal or nearly normal position. In feet with valgus deformity and talonavicular subluxation, both the subtalar implant and the talonavicular prosthesis with a built-in stop must be used. Use of these implants requires that the foot be supple and correctable to at least neutral position at surgery. The valgus hindfoot with a subluxated but otherwise normal talonavicular joint presents a greater problem. In this condition correction can be maintained only if the subtalar implant is used in conjunction with the modified talonavicular joint with a built-in stop. External supports in the shoe have not been routinely used in all patients after operation for a variety of reasons (mostly nonmedical). It may be advisable in patients who have had correction of a deformity to continue to use some sort of support in the shoe for most ambulation. Arthroplasty early in the disease course, before severe deformities develop, may prevent progression of the disorder, but more experience is necessary to validate clinical impressions. PMID- 6861406 TI - The hindfoot and its relation to rotational deformities of the forefoot. AB - The movements occurring at the various joints of the foot are complex, and since deformities can arise at each joint, classification of the deformities of the foot can be confusing. The position of the hindfoot can be conveniently described using the relationship of the long axis of the calcaneus to the long axis of the tibia. The position of the forefoot can then be related to that of the hindfoot. Rotation of the forefoot occurs as a result of relative movements of the talus and calcaneus and is a noticeable feature of the valgus or flat foot. Various types of valgus foot are recognized, e.g., calcaneovalgus, equinovalgus or "vertical talus," and so-called "postural" valgus. A variation is described in which the hindfoot is valgus by definition, when the patient is standing, but in which after correction the talus moves into an abnormally horizontal position relative to the calcaneus and the forefoot assumes a position of marked supination, almost appearing to stand on its lateral edge. This deformity has been observed in paralytic conditions and also in an idiopathic form. It may be correctable if detected early but if allowed to progress may result in a persistent deformity, producing discomfort and excessive shoe wear. In the late stage correction of the hindfoot may, if the rotational component is not recognized, result in an unacceptable forefoot position. PMID- 6861410 TI - Supramalleolar osteotomy in the management of the rheumatoid hindfoot. AB - Supracondylar osteotomy is an alternative to other procedures for realignment of the rheumatoid hindfoot. Of 64 hindfoot operations performed since 1964, 12 were supracondylar osteotomies. The specific indication for this procedure was an ankylosed rheumatoid foot with equinovarus deformity and limited range of tarsal motion. Conventional triple arthrodesis in such circumstances creates a rigid foot, further compromising an already damaged ankle. Of the nine feet available for evaluation one to ten years after operation, seven were relieved of pain and two had anterior metatarsalgia from recurrence of equinus deformity. Correction of varus deformity was maintained in all. Ankle motion diminished from a mean of 17 degrees before operation to 7 degrees when reviewed. Five of the eight ankles had bony fusion. Mean rotatory tarsal motion was improved in two and diminished in seven; mean rotation remained constant, at approximately 13 degrees. Whereas ankle joint motion fared badly under the combined onslaught of disease and osteotomy, the preservation of tarsal motion, correction of deformity, and relief of pain make supramalleolar osteotomy a worthwhile alternative procedure under the specific circumstances cited. PMID- 6861411 TI - Pain and impairment considerations following treatment of disruptive os calcis fractures. AB - Closed reduction and/or acceptance of os calcis fracture in its injured state appears to be a reasonable treatment plan. The results of surgical treatment using the Palmer procedure should be considered in some cases and weighed against the shortcomings expected with any choice. Open reduction is preferred in some cases to develop better bone stock and more height for a possible future arthrodesis. PMID- 6861412 TI - Reduction of calcaneal fractures by the McReynolds medial approach technique and its experimental basis. AB - Most calcaneal fractures are of the joint depression type or the tongue type, both of which are amenable to reduction by the medial approach technique. This procedure is based on the principle of restoring the medial wall of the calcaneus, which must be done from the medial side. An accurate reduction produces stability, restores length and height, and partially restores width. The joint depression- or tongue-type fragment is reduced to restore the articular surface of the posterior facet. Many of these fractures can be reduced from the medial side. However, if necessary, a lateral incision should also be made for accurate replacement of these fragments. The final restoration of calcaneal width is accomplished by reducing the lateral bulge of the tuberosity by applying direct pressure over the lateral heel. This deformity, which produces morbidity, must be completely reduced. The medial approach technique offers an opportunity to reduce each of the deformities of the depressed calcaneal fracture. The method is recommended. PMID- 6861413 TI - Anatomy and biomechanics of the hindfoot. AB - Hindfoot function involves eccentric loading of the subtalar joint and repetitive strain of the calcaneal soft tissues. Both are induced by the serial pattern of foot support. The subtalar joint experiences rapid eversion following heel strike and subsequent inversion during terminal stance. Although these actions reduce the rotatory strain on the ankle joint, they also challenge the local soft tissues and controlling muscles. Compression and traction of the soft tissues about the heel are normal events during each walking cycle. Loading the limb at the onset of stance causes heel pad compression. Conversely, the plantar fascia and tendo Achillis are subjected to significant traction as body weight is transferred onto the forefoot during the latter half of the single limb support period. The intensity of hindfoot stress increases with the vigor of activity. Running creates symptoms that do not arise with ordinary walking. Microtrauma is cumulative. Also, the aging process reduces the ability of tissue to accommodate repetitive force. PMID- 6861414 TI - [A case of multiple tumor-cell embolism to the central nervous system simulating neoplastic angioendotheliosis]. PMID- 6861415 TI - [A experimental study of pyrithiamine-induced encephalopathy in the rat III. Determination of the concentrations of ATP and P-creatine in various regions of pyrithiamine-treated rats following rapid tissue fixation with microwave irradiation]. PMID- 6861416 TI - [A neuropathological study of the hypoglossal nucleus in amyotrophic lateral sclerosis]. PMID- 6861417 TI - [Increased sympathetic nervous activity in motor neuron disease--a hemodynamic study]. PMID- 6861418 TI - [Anatomical study on the nucleus accumbens. With the special reference to dopaminergic projection from the midbrain]. PMID- 6861419 TI - [A case of thalamic hemorrhage associated with cheiro-oral syndrome with hyperkinesies volitionnelles]. PMID- 6861420 TI - Predicting the need for exchange transfusion in newborn infants. A comparison of five methods. AB - The need for exchange transfusion was analyzed retrospectively using several different methods (total bilirubin binding capacity, birth weight, plasma protein level, and two published charts). These predictive methods were applied to 175 jaundiced infants for whom all the data were available and to 19 infants who were actually exchanged. Most of the patients were sick, premature infants. This study demonstrates the lack of agreement among the predictive methods. PMID- 6861421 TI - The effect of early feeding on plasma glucose levels in SGA infants. AB - Plasma glucose levels were measured during the first day of life in 24 small-for gestational-age (SGA) infants who began formula feedings within two hours of birth. In contrast to the high incidence of low blood sugar seen previously in fasted SGA infants, no infant had a plasma glucose below 30 mg/dl; after the first feeding, no values below 40 mg/dl occurred. Mean plasma glucose levels were lower in infants born to mothers with preeclampsia (57.2 +/- 2 vs 69.7 +/- 2.3 mg/dl, p less than .005). The results indicate that hypoglycemia (plasma glucose less than 40 mg/dl) can be easily avoided in SGA infants simply by providing adequate calories without delay after delivery. PMID- 6861422 TI - The asymmetric tonic neck reflex. Its presence and significance in the newborn. AB - Asymmetric tonic neck reflex (ATNR) is an easily elicited reflex in the immediate newborn period and should not be considered pathologic unless it is obligatory. Although bidirectional responses are normally encountered, unidirectional responses are not uncommon. The majority of infants display the complete reflex, however, the lower extremities are the most consistent participants. PMID- 6861423 TI - Transient solitary diastolic murmurs in the newborn. AB - Three newborn infants were observed to have murmurs restricted to diastole. None was considered ill, and none has exhibited symptoms or findings of cardiopulmonary disease throughout follow-up. Localization of the diastolic timing and absence of a significant systolic component of the murmur were confirmed by phonocardiography. The transient nature of the finding was established by serial phonocardiography. Essentially normal cardiac anatomy was determined by routine chest radiograms, electrocardiograms, and echocardiography in both M and two-dimensional modes. Suggestive evidence for left-to-right shunting was present in each case. Invasive studies were not performed. An anatomic cause for the diastolic murmur was not discovered, suggesting it could be related to the ductus arteriosus or mild pulmonary insufficiency. PMID- 6861424 TI - An analysis of physician-parent communication in pediatric prenatal interviews. AB - Thirty-three prenatal interviews done in the offices of four practicing pediatricians were audio-recorded, transcribed, and analyzed for content by two separate methods. Interviews with the individual pediatricians varied markedly in length and were significantly longer if the father was present. Pediatricians took charge of the interviews by asking more questions than parents and by talking twice as much as parents. A relatively small number of topics (medical care of the infant, infant feeding, business aspects of the pediatrician's practice, and history of the current pregnancy) occupied a majority of the interview time. Although interviews with individual pediatricians tended to include a standard set of topics, any given visit was individualized to address parents' issues. Follow-up interviews with mothers showed that they were highly satisfied with the visits and perceived the doctors as having been warm and friendly. Mothers' highly favorable reactions were achieved in spite of the fact that interview style was generally doctor-active/parent-passive, indicating that, in some medical settings, this approach may be quite appropriate. PMID- 6861425 TI - Perinatal management of major gastrointestinal anomalies diagnosed by maternal ultrasound. PMID- 6861428 TI - An unusual twist to umbilical artery catheterization. PMID- 6861427 TI - Female child circumcision in Ilesha, Nigeria. The present and the future. AB - In February 1981, the external genitalia of 578 female children were examined at the child welfare clinic, Wesley Guild Hospital, Ilesha, Nigeria. Of these children 96.5 per cent were under five years of age, and 66.3 per cent were circumcised. Of the circumcisions, 75.5 per cent had been done in the first month of life. "Traditional" surgeons performed 68.7 per cent of the circumcisions, and private clinic personnel, 21.1 per cent. In 49.6 per cent, circumcision had been done to prevent the head of any future baby from touching the clitoris at parturition, an event believed to result in early death of the neonate. In 48 per cent, circumcision had been done just to conform with custom. Of 175 mothers questioned, 82 per cent believed that an uncircumcised lady was more likely to be promiscuous than a circumcised lady. PMID- 6861429 TI - Malnutrition and hypernatremic dehydration in two breast-fed infants. PMID- 6861426 TI - Circumcision. A study of current practices. AB - The purpose of this study was to investigate the current incidence of circumcision, the reasons governing parental decisions regarding circumcision, the immediate and later complications from the procedure, as well as genital problems occurring in uncircumcised boys. The incidence of circumcision was found not to have changed over the past five years despite the recommendations of the American Academy of Pediatrics Task Force on Circumcision. The reasons given for circumcision reflected mostly the strength of tradition, rather than a medical approach. Four per cent of newborns experienced early complications from the procedure, whereas 13 per cent experienced later, minor complications. Problems reported in uncircumcised infants were probably variants of normal. While the results of this study and evidence for discontinuing neonatal circumcision, we strongly recommend that, if physicians dissuade parents from having their infants circumcised, they must give adequate information concerning hygiene and the slow, natural separation of the foreskin from the glans. PMID- 6861430 TI - Postmarketing studies of drug efficacy: when must they be randomized? PMID- 6861432 TI - Tobramycin kinetics during continuous ambulatory peritoneal dialysis. AB - To establish therapeutic guidelines for tobramycin use in patients receiving continuous ambulatory peritoneal dialysis (CAPD), we studied tobramycin single dose kinetics in CAPD patients. Tobramycin was studied after a 1.5-mg/kg dose given either intravenously (TOB-IV) or intraperitoneally (TOB-IP). TOB-IV provided a plasma concentration above 3 mg/l at 12 hr with a t 1/2 of 39.5 hr. When tobramycin was given intraperitoneally, 52% of the dose was absorbed; peak plasma concentrations were only 1.8 mg/l, and the t 1/2 was 35 hr. CAPD accounted for only 15% to 20% of total body clearance in both groups. The kinetic principle of superposition was used to predict plasma concentrations after repeated TOB-IP. A model using once-a-day dosing predicted that a loading dose of 4 mg/kg followed by 1.5 mg/kg would achieve steady-state plasma concentrations of 2.8 to 4.2 mg/l. Another model using tobramycin in each exchange predicted that a loading dose of 3 mg/kg followed by 0.3 mg/kg would provide steady-state plasma concentrations of 2.8 to 3.1 mg/l. These data should be useful in treating CAPD patients with tobramycin who have nonperitoneal gram-negative aerobic bacterial infections, as well as those who require the drug for peritonitis. PMID- 6861431 TI - Ibuprofen and sulindac kinetics in alcoholic liver disease. AB - Ibuprofen and sulindac kinetics after oral doses were compared in 15 patients with alcoholic liver disease and 29 normal subjects. The patients with alcoholic liver disease were divided into a group with fair hepatic function (FHF) and a group with poor hepatic function (PHF) based on elimination rates of indocyanine green. The effects of alcoholic liver disease on the ibuprofen kinetics were minimal. The absorption of the drug appeared to be delayed in some of the PHF patients, and slight differences were noted in the serum AUC and the elimination rate constant for ibuprofen. The absorption of sulindac was delayed in both PHF and FHF groups of patients, as was the appearance of the active metabolite, sulindac sulfide, and the inactive metabolite, sulindac sulfone. The plasma AUC for sulindac sulfide in patients with poor hepatic function was four times that in normal subjects. The kinetics of sulindac, a pro-drug that relies on the liver for conversion to an active metabolite, were markedly affected by alcoholic liver disease. PMID- 6861433 TI - Intraindividual and interindividual variability in 8-methoxypsoralen kinetics and effect in psoriatic patients. AB - Our purpose was to investigate the origin of intraindividual variation in comparison with interindividual variation of 8-methoxypsoralen (8-MOP) kinetics in different body fluids. The clinical test in therapy with psoralens and ultraviolet A (PUVA), expressed as the minimal phototoxic dose (MPD), was performed to establish a possible connection between biologic effect and kinetics of 8-MOP. The MPD and 8-MOP kinetics in serum and suction blister fluid (sbf) were determined in 18 psoriatic patients on PUVA therapy in 4 test days spread over a 7-mo period. Evidence showed that interindividual fluctuations are caused by differences in intrinsic clearance (Cl). Interindividual variations are large in comparison with intraindividual variations. A correlation was found among maximal serum concentrations, Cls, MPDs, and concentrations in sbf. In clinical practice the maximal serum concentration, determined in blood samples taken at 1, 2, and 3 hr after 8-MOP ingestion, is indicative of the rate of 8-MOP metabolism and thus of the biologic effect in the patient. PMID- 6861434 TI - Plasma levels, protein binding, and elimination data of lidocaine and active metabolites in cardiac patients of various ages. AB - The serum and urine levels of lidocaine and two active dealkylated metabolites, monoethylglycinexylidide (MEGX) and glycinexylidide (GX), were determined by HPLC in 33 cardiac patients receiving lidocaine for more than 1 day. Clinical assessment of nervous system toxicity was carried out at the time of blood drawing. The ratios in serum of MEGX to lidocaine and of GX to lidocaine were 0.36 +/- 0.26 (mean +/- SD) and 0.11 +/- 0.11. Lidocaine and MEGX binding to serum proteins from seven patients 2 days after their myocardial infarctions were 55.4 +/- 5.9% and 14.3 +/- 3.0%. After correction for this difference in protein binding, the MEGX/lidocaine ratio in serum water was 0.68 +/- 0.49. MEGX levels in serum water were 80% or more of the lidocaine levels in 11 of the 33 patients. GX binding was 5 +/- 4%. Even after correction for protein-binding differences, GX levels in serum water were low compared to lidocaine levels. The steady-state serum GX concentration normalized for lidocaine infusion rate declined with age. Of 27 patients without toxicity, six had serum lidocaine levels above 8 micrograms/ml. Five of six patients with toxicity had levels less than 8 micrograms/ml. The renal clearance of lidocaine, MEGX, and GX was less than creatinine clearance in most patients. We conclude that MEGX, but not GX, contributes to the pharmacologic activity of lidocaine therapy in a substantial fraction of patients. We also suggest that the concept of a single value for the upper limit of the therapeutic level of lidocaine in serum is an oversimplification because it does not take into account individual differences in drug-protein binding or accumulation of active metabolites. PMID- 6861436 TI - Oral methadone self-administration: effects of dose and alternative reinforcers. AB - We examined the efficacy of oral methadone as a reinforcer by offering methadone maintenance patients the chance to self-administer extra doses of methadone occasionally in addition to their regular dose. Seven maintenance patients received twice-weekly choices between methadone doses or money. Doses were 0, 1, 5, 10, 25, or 50 mg methadone; the alternative money option was $1 or $5. Extra methadone doses were reliably self-administered by maintenance patients, and percent of dose choices rose as the size of the dose offered increased. Thus extra methadone doses functioned as reinforcers in this situation. Further, across the entire dose range, more dose choices were selected when $1 was offered than when $5 was offered as an alternative. Thus methadone self-administration was influenced by the alternative reinforcers available for drug refusal. Neither reports of subjective withdrawal symptoms nor reduction of symptoms after extra methadone predicted methadone self-administration, but dose selections were more likely when urinalysis results indicated recent illicit opiate use. The reinforcing effects of oral methadone in methadone-tolerant patients may be an important factor in the popularity of this treatment among drug abusers and in the long-term treatment retention generally observed during methadone maintenance. PMID- 6861435 TI - Effect of pregnancy on the relationship between concentration and anticoagulant action of heparin. AB - The anticoagulant effect of heparin, as reflected by the slope of the relationship between heparin concentration and the logarithm of the activated partial thromboplastin time (APTT), was determined in citrated plasma of seven women in the third trimester of pregnancy and in 10 nonpregnant women of comparable age. Factors II, V, and VII to XII, albumin, individual globulins, antithrombin III, fibrinogen, alpha-1-acid glycoprotein, alpha-1-antitrypsin, alpha-2-macroglobulin, prothrombin time, and hematocrit were also determined. Baseline APTT (i.e., APTT without heparin) was 30.2 +/- 3.0 sec (mean +/- SD) in the pregnant women and 29.6 +/- 4.7 sec in the controls (NS). The heparin slope value was 1.68 +/- 0.46 ml/U in the pregnant women and 2.33 +/- 0.49 ml/U in the controls, showing that the anticoagulant effect of heparin is decreased in pregnancy. The prothrombin time was also decreased in pregnancy (19.1 +/- 0.8 vs 23.1 +/- 0.5 sec; P less than 0.01). Pregnancy was associated with a significant increase in the activity of factors VII, VIII, IX, and X and in the concentrations of fibrinogen, alpha-1-globulin, and alpha-1-antitrypsin. The plasma albumin concentration was decreased in the pregnant group. In both the pregnant and nonpregnant women (considered separately), the heparin slope value correlated negatively with factor XI activity (r = -0.85 and -0.71; P less than 0.05). Baseline APTT, which was consistently found to correlate with heparin slope value in previous reports on men and nonpregnant women, also showed such correlation in the nonpregnant group of the present study (r = 0.85; P less than 0.05) but not in the group of pregnant women (r = -0.54; NS). The relative heparin resistance in pregnancy in this investigation is consistent with clinical reports of increased heparin requirements during pregnancy. PMID- 6861438 TI - Hemodynamic effects of dobutamine in patients with alcoholic cirrhosis. AB - The effects of dobutamine infusion on cardiac output, hepatic blood flow, and the gradient between wedged and free hepatic venous pressures were studied in 14 patients with alcoholic cirrhosis. Cardiac output rose from 5.8 +/- 1.2 l/min (mean +/- SD) to 7.1 +/- 1.5 l/min. Hepatic blood flow and the gradient between wedged and free hepatic venous pressures did not change significantly during the dobutamine infusion (1.360 +/- 0.510 l/min to 1.446 +/- 0.502 l/min and 17.7 +/- 4.9 mm Hg to 17.9 +/- 3.7 mm Hg). We conclude that in alcoholic cirrhotic patients, dobutamine increased cardiac output as a result of increased heart rate and that there were no significant changes in percentage of cardiac output distributed to the liver. PMID- 6861437 TI - Effects of oral contraceptive steroids on acetaminophen metabolism and elimination. AB - Plasma acetaminophen elimination was examined in women taking low-dose estrogen oral contraceptive (OC) steroids and in age-matched control women. Fractional rates of elimination and fractional clearances were calculated for each of the metabolic pathways, including oxidation, sulfation, and glucuronidation. The cysteine adduct and mercapturic acid derivative of acetaminophen were used as an index of oxidative biotransformation, a potentially toxic route of metabolism for acetaminophen. Plasma acetaminophen clearance rose from 287 +/- 13 ml/min to 470 +/- 51 ml/min in women taking OC steroids, whereas elimination t1/2 decreased from 2.40 +/- 0.14 hr to 1.67 +/- 0.16 hr. The fractional clearance and rate of elimination of acetaminophen by glucuronidation increased in women taking OC steroids, whereas the clearance and elimination by sulfation did not differ significantly from values in control subjects. Fractional clearance of the cysteine adduct also increased significantly, but clearance of acetaminophen mercapturic acid did not change. These data suggest that the increased clearance of acetaminophen from plasma in women taking OC steroids results from increased glucuronidation of the drug, although the mechanism is not known. PMID- 6861440 TI - Effects of ibopamine on serum prolactin and growth hormone levels in hyperprolactinemic and acromegalic subjects. AB - The effects of oral doses (100, 200, and 400 mg) of a dopamine derivative, ibopamine, on serum prolactin (PRL) and growth hormone (GH) levels were evaluated in hyperprolactinemic patients, some of whom also were acromegalic. There was dose-related lowering of PRL levels. The highest dose was as effective as 500 mg L-dopa, although the duration of action was shorter, with a decrease to below 50% of basal PRL values in all patients. Serum GH did not rise in nonacromegalic subjects, but it fell after 400 mg ibopamine in the L-dopa-sensitive acromegalic patients. These data suggest, but do not prove, that ibopamine is able to directly stimulate pituitary dopamine receptors. PMID- 6861439 TI - Theophylline kinetics in a geriatric group. AB - The influence of age, sex, and smoking on theophylline disposition was studied in 38 healthy subjects ranging in age from 26 to 81 yr. There were 8 young (less than 60 yr) and 30 geriatric (greater than 60 yr) subjects, including 28 men (8 smokers) and 10 women (3 smokers). A crossover experimental design was used. A single dose of theophylline elixir (5 mg/kg lean body weight [LBW]) was given as a reference product to all subjects. One week later a sustained-release (SR) theophylline tablet (8 and 6 mg/kg LBW) was given to the young and the geriatric subjects. Serum theophylline concentrations were determined by HPLC. Theophylline elimination (t1/2 beta) is shorter in the geriatric group (6.93 and 8.14 hr); total body theophylline clearance is greater in the geriatric group (44.39 and 32.97 ml/kg/hr), and the apparent volume of distribution is also greater in the geriatric group (26.29 and 22.97 l). Sex and smoking did not influence any of the parameters studied. In 93% of the geriatric subjects, serum theophylline levels of 8 to 20 micrograms/ml were reached at steady state with the SR tablet. Theophylline dose reduction based on an arbitrary age limit is not, therefore, invariably indicated. PMID- 6861441 TI - Sites of action of tripamide. AB - Tripamide is a new diuretic derived from a sulfonamide nucleus that has both antihypertensive and natriuretic properties. We assessed its renal site of effect with standard clearance techniques. Studies during water loading indicated a 47% increase in fractional free water clearance (an effect opposite that of thiazide diuretics) and a simultaneous 75% increase in fractional delivery of solute to the diluting segment. Consequently, when free water clearance was assessed relative to delivery of solute, tripamide induced a decrease from 0.86 +/- 0.03 to 0.75 +/- 0.01. This indicated an inhibitory effect on solute reabsorption at the cortical segment of the thick ascending limb of Henle's loop. Studies during hydropenia indicated increased free water reabsorption. When factored for delivery of solute, however, free water reabsorption decreased from 0.66 +/- 0.02 to 0.61 +/- 0.02, indicating a site of effect of tripamide at the medullary segment of the thick ascending limb of Henle's loop. Tripamide also increased calcium excretion. No effects on renal hemodynamics or indices of effect at the proximal tubule were observed. The data indicate that tripamide is a loop diuretic that may also affect more proximal nephron sites. PMID- 6861442 TI - Verapamil-induced changes in digoxin kinetics and intraerythrocytic sodium concentration. AB - Verapamil increases plasma digoxin concentration by about 60% to 80%. To explore the clinical consequences of this interaction, we evaluated single-dose digoxin kinetics along with repeated measurements of intraerythrocytic sodium concentration in eight healthy subjects before and during verapamil coadministration. Verapamil reduced mean total body clearance of digoxin from 4.68 +/- 0.41 to 3.29 +/- 0.26 ml/min/kg and prolonged digoxin biologic t1/2 from 33.5 +/- 2.4 to 41.4 +/- 2.3 hr. These kinetic changes were associated with a greater elevation of intraerythrocytic sodium concentration than controls. Verapamil had no effect on intraerythrocytic sodium content. In vitro experiments revealed no influence of verapamil on the number of glycoside receptors on human lymphocytes. Since intracellular sodium concentration has proved to correlate closely with clinical signs of digoxin toxicity, our indicate that verapamil is likely to increase the risk of digoxin-induced arrhythmias. PMID- 6861443 TI - Pharmacokinetics of ibuprofen in man. I. Free and total area/dose relationships. AB - Ibuprofen kinetics were studied in 15 subjects after four oral doses. Plasma levels of both total and free ibuprofen were measured for 12 hr, and urine was collected for 48 hr after the doses. All subjects showed a nonlinear relationship between dose and total ibuprofen plasma AUC. Free ibuprofen plasma AUC, however, was linearly related to the dose, suggesting that oral clearance based on free drug was dose independent. Urinary recovery data indicated that efficiency of absorption was dose independent. PMID- 6861446 TI - The effects of cardioselective and non-selective beta-adrenoceptor blockade on the hypokalaemic and cardiovascular responses to adrenomedullary hormones in man. AB - Adrenaline was infused intravenously in nine normal volunteers to plasma concentrations similar to those found after myocardial infarction. This study was undertaken on three occasions after 5 days' treatment with placebo or the beta adrenoceptor antagonists, atenolol or timolol. Adrenaline increased the systolic pressure by 11 mmHg, decreased the diastolic pressure by 14 mmHg, and increased the heart rate by 7 beats/min. These changes were prevented by atenolol. However, after timolol the diastolic pressure rose (+19 mmHg) and heart rate fell (-8 beats/min). Adrenaline caused the corrected QT interval (QTc) to lengthen (0.36 +/- 0.02 s to 0.41 +/- 0.06 s). No significant changes were found in the QTc when subjects were pretreated with atenolol or timolol. The serum potassium fell from 4.06 to 3.22 mmol/l after adrenaline. Serum potassium fell to a lesser extent to 3.67 mmol/l after atenolol and actually increased to 4.25 mmol/l after timolol. Adrenaline-mediated hypokalaemia appears to result from the stimulation of a beta 2-adrenoceptor linked to membrane Na+/K+-ATPase causing potassium influx. PMID- 6861448 TI - Uptake of L-leucyl-L-leucine and glycylsarcosine by hamster jejunum in vitro. PMID- 6861444 TI - Blood pressure response to chronic low-dose intrarenal noradrenaline infusion in conscious rats. AB - Sodium chloride solution (0.9%) or noradrenaline in doses of 4, 12 and 36 micrograms h-1 kg-1 was infused for five consecutive days, either intrarenally (by a new technique) or intravenously into rats with one kidney removed. Intrarenal infusion of noradrenaline caused hypertension at doses which did not do so when infused intravenously. Intrarenal compared with intravenous infusion of noradrenaline caused higher plasma noradrenaline concentrations and a shift of the plasma noradrenaline concentration-blood pressure effect curve towards lower plasma noradrenaline levels. These results suggest that hypertension after chronic intrarenal noradrenaline infusion is produced by relatively higher levels of circulating noradrenaline and by triggering of an additional intrarenal pressor mechanism. PMID- 6861447 TI - The effects of nutrition and trauma on whole-body protein metabolism in man. AB - Whole-body protein metabolism was determined by a primed constant-rate infusion of L-[ 1-14C ]leucine in patients before and after elective surgery, the nutritional intake being carefully controlled and the surgical stress in individuals being assessed. Pre-operatively, whole-body protein flux (P less than 0.05) and synthesis (P less than 0.05), along with amino acid oxidation (P less than 0.01), increased with nutritional intake whereas protein breakdown remained unaltered. Whole-body protein balance also correlated with intake (P = 0.001). Postoperatively, whole-body protein metabolism was determined with patients either fasted (group 1) or fed (group 2) and the change in metabolism in each individual from a pre-operative study, carried out in the fed state, was calculated. Whole-body protein breakdown increased in both groups (group 1, + 0.91 +/- 0.74 g day-1 kg-1; mean +/- SD, n = 7: group 2, + 0.47, + 0.63 and + 1.01 g day-1 kg-1, n = 3), the change being significant in those fasted after surgery (P less than 0.05). However, the pattern of change in whole-body protein synthesis was entirely different in each group, rising in those fed throughout (+ 0.32, + 0.41 and + 0.66 g day-1 kg-1, n = 3) but falling in those fasted after surgery (-0.38, -0.80 and -1.33 g day-1 kg-1, n = 3). The changes in metabolism appeared more marked in those undergoing greatest surgical stress. Some of the factors involved in the calculations are discussed and their effects on the overall conclusions are considered. A concept of whole-body protein metabolism in the metabolic response to trauma is advocated whereby protein breakdown is largely obligatory to the response, whereas synthesis responds to substrate availability. PMID- 6861449 TI - Assessment of gall-bladder storage function in man. PMID- 6861445 TI - Calcium transport in synaptosomes and subcellular membrane fractions of brain tissue in spontaneously hypertensive rats. AB - The uptake of Na+ and Ca2+ by synaptosomes and uptake of Ca2+ by the mitochondria and microsomes of brain tissue of rats with spontaneous hypertension (SH rats) and normotensive Kyoto-Wistar rats (WKY rats) were studied with an isotope exchange method. By means of inhibitor analysis it has been shown that calcium influx into the synaptosomes during depolarization of their plasma membrane takes place only through the potential-dependent channels in both groups of animals. Basal Ca2+ uptake by the synaptosomes of hypertensive rats was increased, apparently by partial depolarization of the synaptosome membrane caused by the increased membrane permeability to Na+ (basal Na+ uptake by synaptosomes was found to be increased in hypertensive rats). Ca2+ uptake by mitochondria of hypertensive rats was increased, and the Ca2+ uptake by microsomes was decreased in these rats compared with controls. The increment of the maximal Ca2+ transport rate in microsomes after the addition of calmodulin was decreased in spontaneously hypertensive rats compared with normotensive animals. Thus alterations in the interaction of calmodulin with the Ca2+-transporting systems of the plasma membrane are an important part of the widespread membrane defect observed in spontaneous hypertension. PMID- 6861450 TI - Release of intracellular enzymes from an isolated mammalian skeletal muscle preparation. AB - An isolated skeletal muscle preparation is described which has been used to study the efflux of enzymes in response to contractile activity, metabolic poisons and detergent treatment. In both fast and slow muscles contractile activity caused a release of lactate dehydrogenase and creatine kinase that reached a peak 1-2 h after the end of stimulation. There was very little release during the 30 min stimulation period whether the muscles were under aerobic or hypoxic conditions. Incubation of the muscles with cyanide and iodoacetate caused a similar delayed release of enzyme. Disruption of cell membranes with detergent treatment caused an entirely different and very rapid pattern of enzyme release. Enzyme release from the fatigued isolated muscle preparations appears to be initiated as a consequence of phosphorylcreatine or ATP depletion. The relevance of this to release of muscle enzymes after activity in vivo is discussed. PMID- 6861451 TI - [Non-steroidal anti-inflammatory drugs (NSAID): how many? which ones?]. PMID- 6861452 TI - [Validity of anti-influenza vaccination]. PMID- 6861453 TI - [Clinical pharmacology of amebicides]. PMID- 6861454 TI - [Treatment of polycystic ovary syndrome]. PMID- 6861455 TI - [Reflections on aging]. PMID- 6861456 TI - [Psychosomatic aspects of liver and biliary tract pathology. Clinical course and therapy]. PMID- 6861457 TI - [The effects of ticlopidine on platelet aggregation: study on 13 atherosclerotic patients]. PMID- 6861458 TI - [Gangliosides: a new prospective therapy of uremic neuropathy]. PMID- 6861459 TI - [Short term treatment of essential arterial hypertension with atenolol: effect on the renin-angiotensin-aldosterone system and on hemodynamic parameters]. PMID- 6861462 TI - [The concept of risk and prevention in occupational medicine]. PMID- 6861460 TI - [Liver role in the metabolism of non-steroid antiinflammatory drugs (NSAID)]. PMID- 6861461 TI - [Prostaglandins in the therapy of arterial hypertension]. PMID- 6861463 TI - [Possibility and limits in the research of the efficiency for the therapeutic use of warm medicinal springs]. PMID- 6861464 TI - [Refractory obesity in menopause: therapeutic results in a span of 10 years]. PMID- 6861465 TI - [Therapeutic efficacy of pentoxifylline in peripheral artery diseases: its clinical value]. PMID- 6861466 TI - [Zinc: recent findings on the subjects of physiopathology, clinical aspects and therapy]. PMID- 6861468 TI - [Anatomo-functional aspects of respiratory rehabilitation in chronic bronchopneumopathy]. PMID- 6861467 TI - [Prescription of dietetic products for the weight loss]. PMID- 6861469 TI - [Therapy of gastric and duodenal ulcer]. PMID- 6861470 TI - Comparative progesterone concentrations in two Peromyscus species. AB - 1. Plasma progesterone concentrations were measured by radioimmunoassay in the oldfield mouse (Peromyscus polionotus) and the deermouse (P. maniculatus) at estrus and at 5-day intervals during pregnancy. 2. P. polionotus had significantly higher progesterone levels, both at estrus and during gestation. 3. The level was markedly less in female P. polionotus bearing interspecific (P. polionotus x P. maniculatus) hybrid conceptuses than in those with conspecific conceptuses. 4. It is postulated that the reduced progesterone level in females bearing hybrid fetuses may be responsible for reproductive failure which regularly occurs when this cross is attempted. 5. An endocrine difference of this magnitude could represent an incipient reproductive isolating mechanism. PMID- 6861471 TI - Partial purification and characterization of DNA-dependent RNA polymerases I and II from cherry salmon (Oncorhynchus masou). AB - 1. DNA-dependent RNA polymerases I and II were purified approx 3900- and 13,000 fold, respectively, from sonicated nuclear extract of cherry salmon (Oncorhynchus masou) liver by DEAE-Sephadex, heparin-Sepharose and DNA-cellulose column chromatography. 2. The purified RNA polymerases exhibited a requirement for four kinds of ribonucleoside 5'-triphosphates, an exogeneous template and divalent cation. 3. The activities of RNA polymerases I and II were inhibited by Actinomycin D (24 micrograms/ml) but not by Rifampicin (200 micrograms/ml). 4. RNA polymerase I preferred native DNA as template, while polymerase II preferred single-stranded DNA. 5. RNA polymerase II was inhibited by a low concentration of alpha-amanitin (0.02 micrograms/ml). RNA polymerase I was also inhibited by the relatively high concentration of alpha-amanitin (IC50 = 100 micrograms/ml and IC70 = 750 micrograms/ml). 6. RNA polymerases from cherry salmon exhibited a higher activity at low temperature than from rat liver. PMID- 6861472 TI - Lactate dehydrogenase isozymes in the genus Xenopus: analyses of complex isozyme patterns. AB - 1. Previous work showed that seven out of 13 Xenopus species and subspecies possess a simple pattern of 5 LDH isozymes as it is common to most vertebrates. 2. The remaining six species with more complicated patterns are further analyzed in the present paper. 3. X. l. laevis, X. vestitus and X. wittei are characterized by the appearance of an anodal "sixth band". Two explanations are given. 4. A comparison of organs in X. borealis reveals the bands additional to the five banded pattern as secondary isozymes. 5. The five bands in the A4 region in X. ruwenzoriensis, combinations of A subunits in nature as demonstrated by treatment with antibodies against the purified A4 homopolymer, must be considered as being the result of a duplicated A. locus. 6. The same is possibly true for the closely spaced cathodal bands in X. fraseri. 7. The occurrence of only few expressed duplicated loci among the genus Xenpus indicates progressed diploidization within this genus. PMID- 6861473 TI - Quantitative protein synthetic rates in various tissues of a temperate fish in vivo by the method of phenylalanine swamping. AB - 1. A single high-dose injection of 14C- (or 3H-) phenylalanine was used for measurement of protein synthetic rates in tissues of toadfish, Opsanus tau, in vivo. 2. Average rates at 20 degrees C, as per cent of tissue protein synthesized per day, were as follows: liver, 14; head kidney, 15; gill, 7.7; spleen 5.0; heart, 2.3; testis, 1.4; epaxial and pectoral muscle, 0.20-0.23. Elevated rates in muscle (0.71%/day) were found in fed fish. 3. Temperature dependency (Q10) in the 10-20 degrees C range averaged 6-7 for tissues with high rates of protein turnover, and 3-4 in heart and muscle after two-weeks acclimation. PMID- 6861474 TI - Effects of fasting, noradrenaline and glucose tolerance test on free fatty acids and blood glucose in thyroid-deficient pigs. AB - 1. This experiment was carried out to study the effects of thyroidectomy or treatment with an anti-thyroid drug (Methimazole) on the lipolytic and glycogenolytic responses to fasting, noradrenaline and glucose tolerance test in young growing pigs. 2. Male and female crossbred pigs weighing 15-30 kg were used. 3. Fasting caused a slight hypoglycemic response but without statistical differences between euthyroid and thyroid-deficient animals. 4. Free-fatty acids mobilization was significantly different between euthyroid and thyroid-deficient pigs and, the lipolytic effect of NA was lower in thyroidectomized animals than in treated or euthyroid pigs. 5. Glucose tolerance test was not different among the groups. However, FFA mobilization during the GTT was significantly different. 6. The results suggest that the interaction between catecholamines-thyroid hormones play an important role in the FFA mobilization in vivo. PMID- 6861475 TI - Lactate dehydrogenase activity and lactate/pyruvate ratio in muscle of thermally acclimated goldfish. AB - 1. Some glycolytic metabolites were determined for red muscle (RM) and white muscle (WM) of goldfish acclimated to 10 and 25 degrees C. 2. Lactate/pyruvate (L/P) was higher in RM than in WM. 3. Lactate dehydrogenase (LDH) of RM was slightly more susceptible to inhibition by lactate than WM-LDH. At L/P found in vivo under resting conditions, RM-LDH was about three times as inhibited as WM LDH. 4. When 25 degrees C-fish were forced to swim at 25 degrees C, the increase of L/P in WM was mainly due to increased lactate level and that in RM was ascribed to decreased pyruvate level. These changes were obscure in 10 degrees C fish. PMID- 6861476 TI - Some comparative properties of pyruvate kinase in haematopoietic cells and erythrocytes from rainbow trout (Salmo gairdneri R). AB - 1. Temperature acts as a pyruvate kinase regulator in haematopoietic cells and erythrocytes. 2. Fructose-1,6-biphosphate and alanine act as allosteric modulators of pyruvate kinase in haematopoietic cells, while in erythrocytes although fructose-1,6-biphosphate exerts also allosteric effect, alanine appears to be a competitive inhibitor. ATP (1.0 mM) does not exert any clear effect on pyruvate kinase of both cellular populations. 3. The level of specific activity of pyruvate kinase in haematopoietic cells is 40-fold that of PK from erythrocytes. PMID- 6861478 TI - Respiratory effects of normobaric oxygen toxicity in awake guinea-pig. AB - We studied the time course of the respiratory events in awake guinea-pigs catheterized with a chronic arterial cannula, exposed to 100% O2 during 48 hr and after air return breathing. 2. The oxygen toxicity has a pulmonary and respiratory expression: clinical, histological and biochemical data show that death is related to the asphyxia generated by acute pulmonary edema. 3. The O2 toxicity respiratory effects show striking differences in rats and guinea-pigs; the differences belong to a specific and particular lymphatic system in the rat. 4. Rat and guinea pig offer two different models of pulmonary edema, (the first is characterized by absence of arterial hypoxemia) and in consequence two different models of lung oxygen toxicity. PMID- 6861480 TI - Contact allergy to petrolatums. (I). Sensitizing capacity of different brands of yellow and white petrolatums. AB - 46 yellow and white petrolatums were screened for their skin sensitizing properties in 3 subjects with known histories of contact sensitivity to yellow petrolatum. Patch testing revealed that all the petrolatums examined contain sensitizing substances in varying amounts. The results were analyzed with regard to origin, color, purification procedures involved in the production of pharmaceutical grade petrolatum, and pharmacopoeial requirements satisfied. Allergenicity correlated positively with these parameters, but only among petrolatums of the same brand. Petrolatum sensitivity may sometimes account for false positive patch test reactions to substances diluted in it. A petrolatum which causes no reaction on healthy skin may cause eczematous reactions on damaged skin. PMID- 6861477 TI - Proteins and glycoproteins of monkey and human platelets. Comparison by high resolution two-dimensional gel electrophoresis. AB - 1. The protein and glycoprotein composition of the blood platelets of six primate species have been compared by high resolution two-dimensional polyacrylamide gel electrophoresis. 2. Only minor differences have been observed in the protein patterns of all six species. 3. The glycopeptide patterns of the monkey platelets five species) were rather uniform, but clearly different from the human pattern. PMID- 6861479 TI - Comparison of carbohydrate and lipid metabolism in mice and rats during fasting. AB - 1. Swiss albino mice and Sprague-Dawley derived rats, 6-8 weeks in age were compared in the fed condition and after a fast of 24 and 48 hr. 2. Plasma glucose was significantly higher in mice than rats in the fed state but this difference disappeared after the 48 hr fast. 3. In the fed condition, plasma FFA and glycerol levels were significantly higher in mice than rats yet did not change during fasting. With starvation, there was a progressive increase in plasma FFA in the rat but no change in plasma glycerol. 4. The content of triacylglycerols in the plasma and liver was comparable in mice and rats in the fed state. Plasma triacylglycerols declined to a similar extent in both species during a fast of 48 hr. In mice, hepatic triacylglycerols increased markedly during fasting but declined in rats. 5. Heart triacylglycerols were higher in mice than rats in the fed state and increased still further during a fast of 48 hr during which time little change was observed in the rat. Myocardial glycogen was comparable in mice and rats in the fed state. With fasting, cardiac glycogen content decreased in the mouse but remained unchanged in the rat. 6. Distinct differences in certain of the parameters of carbohydrate and lipid metabolism were found with mice and rats in the fed and fasted condition. PMID- 6861484 TI - Elbow eruptions in nickel and chromate dermatitis. AB - In 7 patients with nickel or chromate allergy and dyshidrotic hand eczema, we observed symmetric hyperkeratotic lesions on the elbows which ran a similar course to the hand dermatitis. Histopathological examinations show findings suggestive of lichen simplex chronicus and subacute-chronic dermatitis, but exclude psoriasis. We conclude that these elbow lesions are a characteristic of systemic allergic contact dermatitis. PMID- 6861482 TI - Phototoxic and contact toxic reactions of the exocarp of sweet oranges: a common cause of cheilitis? AB - Irritant skin reactions were produced within 1 h after application of the exocarp of sweet oranges or alcoholic extracts therefrom. Such reactions faded within 48 h. The exocarp, or extracts thereof, induced phototoxic reactions which were strongest at 72 h after exposure. The phototoxic reactions were only induced in natural blondes and only with some oranges. The in vivo phototoxic reactions were confirmed in vitro, causing a slight but clear photo-inhibition of Candida albicans. Only some oranges inhibited growth. PMID- 6861481 TI - Is Cytox 3522 (10% methylene-bis-thiocyanate) a human skin sensitizer? AB - Methylene-bis-thiocyanate is an antimicrobial agent in Cytox 3522 (American Cyanamid Corporation) and Nalco 206 (Nalco Chemical Company). Both are wide spectrum industrial biocides. Cytox 3522 showed a strong sensitization potential in guineau pigs using the Guinea Pig Maximization Test and the Open Epicutaneous Test procedures. In spite of this, human sensitization has not been reported. This may be explained by several factors such as limited exposure, low-use concentration and a lack of diagnostic patch tests in selected patients. PMID- 6861483 TI - Allergic contact dermatitis from ethylene thiourea. AB - A case of allergic contact dermatitis to the rubber additive material ethylene thiourea (ETU) is presented. Testing for cross-sensitivity gave a positive reaction to the fungicide Maneb, manganous ethylenebisdithiocarbamate, but this reaction was probably due to ETU which was detected in Maneb by thin-layer chromatography. Different sources of ETU are reported. PMID- 6861485 TI - Persistent contact dermatitis from the insecticide dichlorvos. PMID- 6861486 TI - Phytophotodermatitis due to common rue (Ruta graveolens). PMID- 6861488 TI - Contact allergy to dibrompropamidine cream. PMID- 6861487 TI - Contact dermatitis from clindamycin. PMID- 6861489 TI - Patch testing with oak moss extract. PMID- 6861490 TI - Formaldehyde in a hypoallergenic non-woven textile acrylate tape. PMID- 6861491 TI - Soggy stratum corneum. PMID- 6861492 TI - Facial psoriasis caused by contact allergy to linalool and hydroxycitronellal in an after-shave. PMID- 6861493 TI - Is topical erythromycin base non-allergenic? PMID- 6861496 TI - Helping your patient comply to a diet prescription. PMID- 6861494 TI - Diet and cardiovascular disease: an introductory statement. PMID- 6861495 TI - The relationship of hyperlipoproteinemia to atherosclerosis. PMID- 6861497 TI - Correlation of spontaneous respiration and neurologic damage in near-drowning. AB - Twenty-six near-drowning children were assessed for neurologic damage with the Glasgow Coma Score, and for spontaneous respirations after CPR. All children had a Glasgow Coma Score of 3 or 4; after resuscitation, 13 children had spontaneous respiration and 13 were apneic. The 13 children with spontaneous respiration suffered little or no residual neurologic impairment. Those children with apnea had severe neurologic impairment or died despite treatment. It appears that the present of spontaneous respirations correlated with surviving a near-drowning episode with minimal or no neurologic deficit and may be of benefit as a prognostic indicator. PMID- 6861498 TI - Central venous catheterization in the emergency setting. AB - To determine the appropriateness and rate of complications from central venous catheterization (CVC) in the emergency department of a university teaching hospital, criteria for justifiability were established and all such catheterizations during a 1-yr period were reviewed. Of 61 catheterizations in 57 patients, 41% could not be justified according to the criteria established. Eight (14%) patients had serious complications from catheter placement. This complication rate is higher than that in any previously published study, but no other study has examined only emergent catheter placement. These findings underline the importance of adhering to a limited set of indications for CVC in emergency departments. PMID- 6861499 TI - Cardiac injury after chest trauma. AB - Fifty consecutive patients with severe chest trauma were studied prospectively to evaluate the frequency of significant cardiac injury and to determine what diagnostic studies were useful. Forty-nine of 50 patients had elevated cardiac enzymes and 26 of 50 had abnormal ECGs on admission. No patient had complications associated with myocardial infarction, including 15 who underwent general anesthesia. We found persistent (greater than 48 h) ECG changes in only 3, 2 of these 3 also had markedly elevated MB fraction of CPK. Significant pericarditis occurred in 5 patients, 2 of whom never had ECG abnormalities. We conclude that minor cardiac injury is common in severe chest trauma, but only rarely causes myocardial contusion. Myocardial isoenzymes may be useful in making that important distinction. Clinically significant traumatic pericarditis may occur in the absence of ECG changes and must be considered in every patient with chest injury and unstable hemodynamics. PMID- 6861500 TI - Inappropriate secretion of antidiuretic hormone in a postsurgical pediatric population. AB - Twenty-four pediatric patients undergoing corrective posterior spinal fusion surgery for idiopathic scoliosis were studied to determine the frequency with which the syndrome of inappropriate antidiuretic hormone secretion (SIADH) developed. We measured arterial blood gases, serum and urine electrolytes and osmolalities, CVP, and urine output during and after surgery. The 20 patients receiving hypotonic iv salt solution in the immediate postoperative period experienced a significant drop in serum sodium values (6.2 +/- 2.9 mEq/L) and 5 (25%) developed SIADH as diagnosed by routine laboratory procedures. Four patients were treated with iv isotonic salt solution. No patient developed hyponatremia (serum Na+ less than 130 mEq/L) and the decrease in serum sodium (3.0 +/- 0.8 mEq/L) was not statistically significant. We conclude that SIADH occurs commonly in patients undergoing corrective vertebral surgery and that vigilant attention must be paid to their fluid and electrolyte management in the postoperative period. PMID- 6861501 TI - Heart rate and blood pressure in infants of pre-eclamptic mothers during the first hour of life. AB - Neonatal heart rate (HR) and arterial blood pressure (BP) were recorded continuously for the 1st hour of life in term newborn infants of normotensive (control group) and pre-eclamptic (study group) primiparous mothers. Infants were matched for gestational age, birth weight, method of delivery, and Apgar scores. In infants of pre-eclamptic mothers, the HR was significantly lower for the 1st 50 min of life, and their mean arterial blood pressure (MAP) was significantly higher during the 1st 20 min of life. PMID- 6861503 TI - Designing the critical care unit: a multidisciplinary approach. AB - Planning for the physical facility of an ICU has not kept pace with the dramatic technologic improvements in the care of critically ill patients. Specific guidelines for planning of critical care units must be generated by combined input from physicians, nurses, and architects in order to avoid inconsistency of planning. Because most critical care is delivered in the community facility, planning must be directed toward this type of institution, and adapted as necessary for the university or research center. The 4-yr planning and building of a 40-bed critical care center is described for a community hospital. PMID- 6861504 TI - Rapid emergency testing using blood plasma. AB - A method of blood analysis, using plasma instead of serum, is very valuable in shortening the time for reporting an emergency test by about 50-60%, by eliminating the serum separation step. Good correlation between plasma and serum was obtained for common chemical analyses. PMID- 6861502 TI - Treatment of portal hypertension with isosorbide dinitrate alone and in combination with vasopressin. AB - Experimental animal studies have suggested that certain vasodilators could minimize the adverse cardiovascular effects of vasopressin. We investigated the hemodynamic effects of isosorbide dinitrate, alone and in combination with vasopressin, in patients with liver cirrhosis. In 10 patients, isosorbide dinitrate, 5 mg sublingually, reduced portal pressure by 21% as assessed by the gradient between wedged and free hepatic venous pressure, but also decreased mean arterial pressure (MAP) by 20%, pulmonary artery wedge pressure (WP) by 50%, and oxygen delivery (DO2) by 13%. In 6 other patients, isosorbide dinitrate, 5 mg sublingually, combined with vasopressin, 0.4 U/min iv, reduced portal pressure by 37%, increased MAP by 13%, and mean pulmonary artery pressure (MPAP) by 70%, and decreased DO2 by 32%. Thus, isosorbide dinitrate reduces effectively portal hypertension in patients with liver cirrhosis, but also decreases DO2 to the tissues as a consequence of a fall in cardiac output due to decreased preload. At the dosage used in this study, isosorbide dinitrate does not prevent the adverse hemodynamic effects of vasopressin. PMID- 6861505 TI - A comparison of continuous wave Doppler ultrasonography with microsphere measured left-to-right shunt through the patent ductus arteriosus. PMID- 6861506 TI - Induced barbiturate coma: methods for evaluation of patients. AB - Seven patients treated with deep sustained barbiturate narcosis to protect the brain and control intracranial hypertension underwent extensive monitoring. The epidural intracranial pressure (EDP) and arterial blood pressure (BP) were recorded continuously; serial records of the EEG, somatosensory evoked potential (SEP) and internal carotid artery (ICA) flow velocities by pulsed Doppler technique were obtained. Serum barbiturate levels leading to full suppression of the EEG did not change the central conduction time nor the configuration of the evoked responses. Monitoring the intracranial pressure (ICP), BP, and thereby, the cerebral perfusion pressure (CPP) gave valuable information on the patients' state and served as a guide for dosage and timing of barbiturate therapy, and facilitated supervision of adequate ventilation. Recording of EEG and SEP, monitoring of the CPP and ICA Doppler investigation offer prognostic information in these cases. When clinical deterioration occurs, these methods can predict and, in combination, give ample evidence for development of brain tamponade. Premature as well as unnecessarily deferred 4-vessel angiography, therefore, can be avoided. PMID- 6861508 TI - Present status of high frequency ventilation. PMID- 6861507 TI - Right coronary artery occlusion after acute proximal dissection (hematoma). AB - A known hypertensive presented to the hospital with sudden onset of chest pain and shock. ECG, cardiac enzymes, aortogram and echocardiogram were normal. Hemodynamic monitoring and radionucleotide angiogram demonstrated a severely dyskinetic right ventricle. Autopsy revealed proximal aortic dissection with extramural compression of right coronary artery, resulting in right ventricular dysfunction. PMID- 6861509 TI - Organophosphate poisoning. PMID- 6861510 TI - Topically applied alcohol as a cause of contact dermatitis. PMID- 6861511 TI - Ethylenediamine: systemic eczematous contact-type dermatitis. PMID- 6861512 TI - Update on chancroid. PMID- 6861513 TI - Pyogenic granuloma simulating a cutaneous horn. AB - A cutaneous horn is a keratotic, usually conical tumor, consisting of a spire of accumulated, cohesive stratum corneum. A number of primary lesions underlying the horny material are known to cause this condition. We present an unusual case of pyogenic granuloma clinically mimicking a cutaneous horn and suggest that it be included in the initial differential diagnosis as a rare cause of this entity. We also review various known causes of cutaneous horn. PMID- 6861514 TI - Reversible, Cushing-induced generalized dermatophyte infection. AB - A patient with an extensive, chronic dermatophyte infection unresponsive to griseofulvin was found to have Cushing's disease. After correction of the chronic hypercortisolism, the dermatomycosis cleared without further therapy. PMID- 6861516 TI - Photodermatitis multiformis acuta. AB - A condition precipitated by acute sun exposure, occurring primarily in women, and having all the characteristics of erythema multiforme is reported. PMID- 6861515 TI - A case of pantaloon obesity. AB - A 79-year-old woman presented with an unusual form of obesity limited to the lower half of the body from the waistline down but sparing the lower legs and feet. The patient was massive (360 lbs) and symmetrical. The superior half of the body was normal with no morbid obesity or lipoatrophy. These findings do not correspond to any classic form of lipodystrophy. The fat distribution is reminiscent of a pair of knickers and qualifies for the name "pantaloon obesity." PMID- 6861517 TI - Solar urticaria in cystic fibrosis. AB - Solar urticaria, to the best of our knowledge, has not been previously reported in association with cystic fibrosis. We present a 10-year-old atopic child with cystic fibrosis who developed hives in areas exposed to sunlight. PMID- 6861518 TI - Simultaneous occurrence of intradermal nevus and syringoma. AB - A 59-year-old white woman presented with two lesions on her face. A clinical diagnosis of intradermal nevus was made and the lesions were excised. In each lesion, histopathologic examination showed an intradermal nevus associated with syringoma. The unusual association of syringoma and intradermal nevus in two lesions forms the basis of this report. PMID- 6861519 TI - Bowen's disease of the palm. AB - Bowen's disease is a squamous cell carcinoma characterized by isolated, grouped or confluent nodules, either flat, scaling, or crusted, with an arcuate or serpiginous configuration. Malignant dyskeratosis throughout the epidermis, the bowenoid hallmark, is not sufficient by itself to identify a lesion as Bowen's disease. It has been suggested, but not proven, that arsenic has a role in the etiology of Bowen's disease. A case of Bowen's disease affecting the palm, an unusual location, is reported. PMID- 6861520 TI - Topical therapy for perioral dermatitis. AB - Six patients with perioral dermatitis were successfully treated with a combination of 1.5 percent erythromycin topical solution twice a day and topically applied hydrocortisone valerate cream. Application of erythromycin solution seems to be an effective topical therapy. Hydrocortisone valerate cream, when used in a controlled, tapered regimen seems to prevent acute rebound flare of perioral dermatitis from previous high-potency steroid use or abuse. PMID- 6861521 TI - The origin of multiple sex chromosomes in the gerbil Gerbillus gerbillus (Rodentia: Gerbillinae). AB - The sex chromosomes of the partly sympatric species of gerbils Gerbillus pyramidum and G. gerbillus (Mammalia: Gerbillinae) were investigated by a variety of light- and electron-microscope methods, including DNA replication banding and synaptonemal complex (SC) techniques. The sex-chromosome mechanism of G. pyramidum is of the maleXY:femaleXX type, whereas that of G. gerbillus is of the less common maleXY1Y2:femaleXX system. The results include the demonstration that the X chromosomes of both species are compound. One segment is added to the X chromosome of G. pyramidum, leading to an increase in length from the standard 5% to approximately 7.3%, whereas two different extra segments increase the length of the X chromosome of G. gerbillus to approximately 11% of the length of the haploid genome. In both cases the extra material is autosomal and is also represented in the respective Y chromosomes. Classifying heterochromatin by the variation in staining quality was helpful in elucidating the possible origin of the different chromosome segments, including the pericentromeric regions. Observations on meiotic chromosome pairing and chiasma formation have confirmed the homologies established by band comparisons. The occurrence of chiasmata between the sex chromosomes supports the autosomal origin of the pairing segments. These and other findings have been interpreted in the framework of a multistep evolutionary model. This sequence starts from a hypothetical pair of sex chromosomes, the X element of which amounts to 5% of the haploid genome, and leads through three translocations involving two pairs of autosomes and one pericentric inversion to the most complex situation of this series, manifested in G. gerbillus. The adaptive value, if any, of autosome incorporation into the sex chromosomes repeatedly occurring here is unknown. It is, however, a remarkable fact that in one species, G. gerbillus, the complex sex-chromosome constitution is conserved over vast geographic distances, and in the other, G. pyramidum, the compound X and Y chromosomes withstand change in the face of extreme autosome restructuring. PMID- 6861522 TI - Chromosome changes in 6-TG-resistant mutant strains derived from a karyotypically stable human line, C32. AB - Karyotypes of the human C32r16 line and its HPRT-mutant derivatives were compared. All three HPRT-mutant strains (TG-A, TG-E1, and TG-E2) studied were hypotetraploid and arose by genomic duplication. TG-A and TG-E had distinct karyotypes, reflecting their independent clonal origins. Both TG-E1 and TG-E2 were similar karyotypically, except that TG-E2 differed from TG-E1 by the presence of two new sets of balanced translocations and a significantly higher number of new markers, viz., 24 new markers in 14 TG-E2 cells as compared to 2 new markers in 13 TG-E1 cells. Comparison of the hypothetical 2s karyotype of C32r16 with the modal karyotypes of the mutants revealed (1) that chromosome changes occurred more frequently among marker chromosomes (57.1%) than among normal chromosomes (18.1%) and also more frequently among tetrasomic (28.6%) than among disomic (3.3%) normal chromosomes, and (2) that one member of a group of paired marker chromosomes tended to be eliminated very frequently, whereas disomic normal chromosomes retained their disomic condition. Chromosome 7 was involved in the formation of new marker chromosomes twice as much as any other chromosome, and even increased to pentasomy in TG-E1. Chromosome changes associated with 6-thioguanine treatment are briefly discussed. PMID- 6861523 TI - Karyotypic kinship between the blue fox (Alopex lagopus Linn.) and the silver fox (Vulpes fulva Desm.). AB - A karyotypic comparison between the blue fox and the silver fox revealed conservation of the chromosome arm as a unit, except for large heterochromatic blocks in 10 pairs of blue fox chromosomes and the complete absence of a common metacentric autosomal pair. This finding seems to indicate that their karyotypes evolved from a common ancestral karyotype, characterized by 70-76 acrocentric autosomes, mainly through a series of independent centric fusions. PMID- 6861524 TI - Heterochromatin heterogeneity in Chinese hamster sex bivalents. AB - The heterochromatin of the Chinese hamster sex chromosomes was analyzed by different banding techniques. Combined results obtained after differential Ba(OH)2 treatment, BrdU incorporation, Giemsa 11, and staining with quinacrine permitted the characterization of different regions in the heterochromatic portions of the X and Y chromosomes. In the light of these observations, the chiasma observed in the sex bivalent of Chinese hamster spermatocytes was localized within specific heterochromatic regions. The homologous segments consist of the entire short arm of the Y and the distal end of the long arm of the X up to band q21. These regions are probably not rich in highly repetitive DNA sequences, which are more resistant to alkali denaturation, or in satellite DNA, which is stained by Giemsa 11. Thus the heterochromatin in the homologous regions of the sex chromosomes allows the formation of a chiasma. The heterogeneity found in these heterochromatic regions may help to establish a more precise relationship between heterochromatin and recombination. PMID- 6861525 TI - The ancestral karyotype of Carnivora: comparison with that of platyrrhine monkeys. AB - The karyotypes of six species of Carnivora (Mungos mungo, Paradoxurus hermaphroditus, Potos flavus, Mustela furo, Felis serval, and Halichoerus grypus), representative of five different families, were studied and compared. Correspondence between almost all chromosome segments was found, and a presumed ancestral karyotype of Carnivora is proposed. Analogies to human chromosomes are also given, and the results obtained are in excellent agreement with previously published gene mapping data on man and the domestic cat. PMID- 6861526 TI - Modes of inheritance of X-Y dissociation in inter-subspecies hybrids between BALB/c mice and Mus musculus molossinus. AB - Genetic analysis of the high frequency of X-Y chromosome dissociation found in primary spermatocytes of F1 hybrids between Japanese wild mice (Mus musculus molossinus) and inbred laboratory mice (BALB/c) was attempted. The frequency of X Y dissociation (X//Y) in both BALB/c and M. m. molossinus was lower than 30% (Low X//Y), while the value was more than 70% (High X//Y) in their F1 hybrids. Two types of progeny (High X//Y and Low X//Y) appeared in the backcross between BALB/c and High X//Y males, although the frequency of Low X//Y progeny decreased with increasing numbers of backcross generations (26.5% at N2, 13.2% at N3, 5.3% at N4, and 0% at N5). Low X//Y sires produced only Low X//Y mice. We hypothesize that at least one heritable factor which is responsible for the end-to-end association of the sex chromosomes (temporally symbolized as Sxa) is located on the common part of the X and Y chromosomes. The Sxa allele of BALB/c is Sxaa and that of M. m. molossinus is Sxab. The genotype expected in High X//Y males is Sxaa/Sxab and in Low X//Y males and their parental stocks either Sxaa/Sxaa or Sxab/Sxab. The repeated segregation of Low X//Y progeny from High X//Y sires is interpreted simply by assuming that crossing-over has occurred between the X and Y chromosomes. The gradual decrease in the recombinant type mice (Low X//Y) during sequential backcrosses suggests the presence of some autosomal factors that suppress the crossing-over of the sex chromosomes and that do not seem to function in the inter-subspecies hybrids. PMID- 6861527 TI - Evolution of chromosomal variation in cottontails, genus Sylvilagus (Mammalia: Lagomorpha): S. aquaticus, S. floridanus, and S. transitionalis. AB - The banding patterns of mitotic chromosome from three cottontail species, Sylvilagus aquaticus (2n = 38), S. floridanus (2n = 42), and S. transitionalis (2n = 46), are presented and compared with those of the proposed leporid ancestral karyotype, the latter being reflected in a species of hare, Lepus saxatilis (2n = 48). The differences in the diploid numbers of the cottontail species are primarily due to the fixation of Robertsonian fusions which have occurred during the evolution of their respective genomes. Of the eight fusion products identified, seven were species specific, while one, which is thought to reflect their more recent common ancestory, is shared by both S. aquaticus and S. floridanus. Other karyotypic differences include interspecific variation in the amount and distribution of constitutive heterochromatin, as well as the presence of two autosomal pairs in S. transitionalis which do not have apparent banding homologies either with the chromosomes of other cottontails or with those of the Lepus genome. The tendency for certain chromosomes in the ancestral karyotype to show a predisposition to undergo fusion events within the Leporidae is discussed. PMID- 6861528 TI - Identification of cell surface polypeptides encoded by human chromosomes 2 and 5 in human-mouse somatic cell hybrids. AB - Iodinated cell surface polypeptides of human-mouse somatic cell hybrids were analyzed by one-dimensional sodium dodecyl sulfate polyacrylamide gel electrophoresis and high resolution two-dimensional gel electrophoresis in an effort to identify human gene products. Expression of two cell surface polypeptides was positively correlated with retention of specific human chromosomes: a polypeptide of molecular weight 250,000 and isoelectric point 8.3 with the human 5, and a polypeptide of molecular weight 250,000 and isoelectric point 7.0 with the human 2. PMID- 6861529 TI - Instruments for human in-vitro fertilization and embryo transfer. PMID- 6861530 TI - Further studies of the concentration of magnesium ion (Mg++) in blood from patients with autoimmune diseases. PMID- 6861531 TI - Erectile function in men with occlusive arterial disease in the legs. PMID- 6861533 TI - IX Scandinavian Congress of Cardiology. June 3-4, 1983, Copenhagen, Denmark. Abstracts. PMID- 6861532 TI - Natural course of a raised Yersinia enterocolitica antibody titre in an unselected, adult population followed during one year. PMID- 6861534 TI - Pulmonary alveolar proteinosis. Specific or nonspecific response? PMID- 6861535 TI - Nondominant right coronary artery disease. A source for right ventricular infarction, anginal pain, and a positive exercise electrocardiogram. AB - A patient is described who presented with isolated episodes of typical angina pectoris. Subsequent exercise electrocardiogram was positive, and cardiac catheterization revealed a 90 percent lesion of a nondominant right coronary artery supplying only the right ventricular (RV) myocardium. The left coronary artery was normal. Stress gated equilibrium radionuclide angiograms (RNA) revealed a normal left ventricular exercise response and a markedly abnormal RV response (RV ejection fraction decreased from 31 percent at rest to 27 percent at peak stress). Nondominant right coronary artery lesions can be a source of angina pectoris, RV infarction, and a positive ECG response to exercise. Stress RNA can be useful in evaluating the functional significance of these lesions. PMID- 6861537 TI - Pressurized aerosol bronchodilator instruction. PMID- 6861536 TI - Endocarditis caused by B fragilis. AB - A 54-year-old man had had an acute anterior myocardial infarction nine years prior to this hospital admission. Since that time he had been asymptomatic with the exception of occasional episodes of precordial chest pain. The patient died from septic shock on the tenth day after the present admission. On autopsy there was an old myocardial infarct with aneurysmal dilatation of the left ventricle which contained a large thrombus with multiple abscesses. Septic infarcts were also found in the left kidney and the left temporal lobe of the brain. PMID- 6861538 TI - Disseminated tuberculosis caused by Mycobacterium intracellulare (update) PMID- 6861539 TI - Optimum steroid dosage in status asthmaticus. PMID- 6861540 TI - Antitussive effect of guaifenesin. PMID- 6861541 TI - Correct height measurement for pulmonary function testing parameters. PMID- 6861542 TI - Acute thrombophlebitis following IV amiodarone administration. PMID- 6861543 TI - On the analysis of left ventricular volume from gated radionuclide ventriculograms. PMID- 6861544 TI - Pregnancy in 20 patients with bioprosthetic valve replacement. AB - We studied twenty women who became pregnant after porcine bioprosthetic valve replacement. Six patients had aortic valve, seven mitral, and seven aortic plus mitral valve replacement. All women were treated with aspirin (1 g daily or 500 mg every 48 hours) during pregnancy, delivery, and the postdelivery period. Thirteen patients experienced atrial fibrillation. There were 27 pregnancies with three ending in abortion. Twenty five normal babies were delivered. There was no maternal mortality or morbidity from thromboembolism or hemorrhage. Comparison of the pregnancy course of these women and the general population shows no difference with respect to fetal or maternal morbidity and mortality. Pregnant women with bioprosthetic valve replacement treated with aspirin had normal pregnancies without the risk of thromboembolism. Fetal and perinatal morbidity and mortality was also within normal limits. PMID- 6861545 TI - Respiratory muscle tone and the control of functional residual capacity. PMID- 6861546 TI - Clinical evaluation of a simple demand inhalation MDI aerosol delivery device. AB - Inhalation of medication is the preferred method for treating reversible airway obstruction; however, difficulties in the use of pressurized canisters frequently lead to suboptimal results. The Aerochamber (Monoghan Medical Corp) is a portable breath-actuated device that attaches to a metered-dose inhaler (MDI) and is designed to overcome many of the problems of aerosol delivery encountered by some patients. The attachment of this breath-actuated device to an MDI reduced pharyngeal deposition of aerosol 14-fold, but delivery of aerosol to intrapulmonary airways in normal subjects and patients with bronchitis remained unchanged. In a group of nine patients with stable asthma, inhalation of a bronchodilator aerosol using the breath-actuated device (Aerochamber) achieved effective bronchodilation similar to an optimally administered MDI. Advantages of the breath-actuated device (Aerochamber) include (1) aerosol delivery of medication whether or not the discharge of aerosol is synchronized with inhalation, (2) effective therapeutic response compared with optimally administered MDI; (3) greatly reduced deposition of aerosol in the upper airways, which might be expected to reduce adverse effects of steroids; and (4) universal application to all bronchodilator and steroid MDIs. PMID- 6861548 TI - When should respiratory muscles be exercised? AB - 1. Normal respiratory muscles have a large functional reserve. 2. Muscles have a tremendous capacity for adaptation. Adaptation is task-specific (eg, muscles use similar motor units for the same tasks). 3. Muscular fatigue results when motor units are required to perform an unaccustomed task. Continued effort in the face of fatigue, especially high-tension low-repetition effort, may produce a reversible "use atrophy" (eg, fiber damage, splitting, and regeneration). 4. Exercising damaged or regenerating muscle may produce irreversible damage. 5. Exercising the respiratory muscles of some patients may make them more susceptible to fatigue or, at least, produce no further improvement in function. Alternating rest and exercise improves pulmonary function tests in some patients. 6. Retraining a weak or damaged muscle requires that it first be "shut down" and rested before attempting retraining. 7. Training a rested muscle to different tasks--before these tasks are needed--may be the critical step in successful rehabilitation. 8. Resistance breathing probably improves both respiratory muscle strength and respiratory muscle endurance. 9. There are at least three immediate tasks for clinicians to define: Where in the present natural history of COPD should respiratory muscles be rested? How long should they be rested? How best can they be retrained? PMID- 6861547 TI - Diagnosis of bronchial asthma by clinical evaluation. An unreliable method. AB - To determine the predictive value of wheeze compared to methacholine inhalation challenge (MIC) in diagnosing asthma, we prospectively evaluated 34 patients considered to be difficult diagnostic problems, referred with a history of wheeze. On the basis of MIC results, 12 patients had hyperreactive airways consistent with asthma, while 22 had airways that were no more reactive than those of normal controls. Compared to MIC, a history of wheeze was predictive of hyperreactive airways 35 percent of the time, a prior clinical diagnosis of asthma 62 percent, and scattered monophonic expiratory wheeze 43 percent. We conclude that: (1) a history of wheeze, a prior clinical diagnosis of asthma, and expiratory wheezing on physical examination are much less reliable than MIC in predicting the presence or absence of asthma; (2) these parameters cannot be used as reliable epidemiologic markers for asthma; and (3) the clinical suspicion of asthma should be confirmed by bronchoprovocation challenge or the demonstration by spirometry of reversible expiratory airflow obstruction. PMID- 6861549 TI - Gastrobronchial fistula secondary to a subphrenic abscess. PMID- 6861550 TI - Should the FVC be considered in evaluating response to bronchodilator? PMID- 6861551 TI - Concealed Wenckebach phenomenon in a 3:1 atrioventricular block. Conduction disturbances within the His bundle. PMID- 6861552 TI - Diffuse epithelial pleural mesothelioma presenting as a solitary lung mass. AB - We report the occurrence of a malignant pleural epithelial mesothelioma which presented radiographically and at surgery as a localized solitary mass, but was found microscopically to involve grossly normal pleura. Clinically diffuse mesothelioma recurred 19 months later. Localized malignant mesothelioma has been associated with the same poor prognosis as the diffuse form and, as suggested by this case, may represent an early phase of diffuse disease. PMID- 6861553 TI - Parents' and medical student therapists' perceptions of child mental health services: a teaching program in prevention and early intervention. PMID- 6861554 TI - Maternal perception of child temperament and observed mother-child interaction. PMID- 6861555 TI - A consideration of abortion survivors. PMID- 6861556 TI - The integration of the emotional and surgical treatment of children hospitalized on a pediatric-surgical ward. PMID- 6861557 TI - Measuring mothers' perceptions about the influences of infant caregiving practices. PMID- 6861558 TI - Permanency planning: a redefinition. PMID- 6861560 TI - One residential center's model for working with families. PMID- 6861561 TI - A protective posture toward emotional neglect and abuse. PMID- 6861562 TI - Weekend only: an alternate model in residential treatment centers. PMID- 6861559 TI - Staff development for a therapeutic environment. PMID- 6861564 TI - [Ruptures and traumatic aneurysms of the aorta]. PMID- 6861565 TI - [Cardiac pacemaker implantation]. PMID- 6861563 TI - [Heart injuries and their delayed sequelae]. PMID- 6861567 TI - [Arterial circulation of the extrahepatic bile ducts]. AB - The blood supply of the extrahepatic bile ducts was investigated in 15 human specimens. Human embryology explains the origin of the main blood supply in this area by the a. pancreaticoduodenalis posterior superior, the a. cystica and the a. hepatic propria. Other arteries are inconsistent and functionally unimportant. 2 or 3 marginal arteries are predominant in the arterial system surrounding the common bile duct. Surgery of the extrahepatic bile ducts should be performed with respect to this particular arterial network. PMID- 6861566 TI - [Circular stapling anastomosis (EEA) following gastrectomy]. AB - After total gastrectomy because of gastric malignancies 31 oesophagojejunostomies performed in end-to-side fashion using a standard manual technique were compared with oesophagojejunostomies performed in end-to-end fashion by mechanical stapling (EEA). After manual suturing there was a leak in 29% and 25.8% out of all patients died. After automatic mechanical suturing anastomotic failure was seen in 12.9% with a postmortality rate of 3.2%. These results show, that by mechanical stapling a secure oesophagojejunostomy is possible and the risk of gastrectomy can be reduced. PMID- 6861568 TI - [Transgenicular amputation: an alternative to thigh amputation?]. AB - Since 1976 we attempted to avoid an above-knee (AK) amputation in favor of a knee disarticulation. From 1976 to 1979 83 patients with an average age of 72 years could be amputated through the knee and 55 patients with average age of 73 years had to be submitted to an AK-amputation. As compared to the AK-amputation the transgenicular (TG) resection has the following advantages: 1) Lower postoperative mortality (TG 10%, AK 33%). --2) Higher prosthetic fitting rate (TG 77%, AK 61%). --3) Significantly improved rehabilitation of the patient (walking with artificial limb: TG 67%, AK 20%). --The results of a TG-amputation may be impaired by disturbances of wound healing with subsequent necrosis and/or infection. Among our patients every forth amputation stump following TG-resection had to be reamputated at above-knee level. PMID- 6861570 TI - [Instrumental stomach tube formation. Use of Yamagishi's stapling instruments]. PMID- 6861569 TI - [Saddle embolism of the aortic bifurcation caused by parts of a cardiac myxoma]. PMID- 6861571 TI - [The federal court on the demand to view medical records]. PMID- 6861572 TI - Surgical management of diverticulitis. The role of the Hartmann procedure. AB - Presented is the authors' experience with 182 patients treated primarily by the one-stage primary resection or two-stage resection. (Hartmann operation). One hundred thirty five patients undergoing primary resection had an associated mortality rate of 2.2 per cent. Of 44 patients operated upon using the Hartmann operation for complicated diverticulitis (obstruction, perforation, abscess formation, or fistula formation) the mortality rate was 4.5 per cent. Primary resection in an elective setting is associated with the lowest mortality and morbidity; however, marked inflammation, obstruction and/or peritonitis preclude primary anastomosis. In the urgent setting the staged operation is associated with acceptable morbidity and mortality. PMID- 6861574 TI - The prevalence of hemorrhoids. AB - The clinical records of 835 patients were reviewed. Five hundred ninety four had symptoms of hemorrhoids (symptomatic group) and 241 had no symptoms (asymptomatic group). Eight-six per cent of the entire group had hemorrhoids, 88 per cent among the symptomatic group and 82 per cent among the asymptomatic group. It was felt that if the prevalence rate of hemorrhoids in the symptomatic and asymptomatic groups is similar or close to similar in every age, it is likely that a certain number of people will have hemorrhoids in every age group irrespective of the presence or absence of symptoms. If the prevalence rate is high, it would seem to support the theory that hemorrhoids are normal parts of the human body, not a disease but a sign of aging. Although the difference in the prevalence rate overall in the symptomatic and asymptomatic groups, 88 versus 82 per cent was mathematically significant, this was due to the large sample size and it was small enough to be without clinical importance. No significant differences in the prevalence rate between symptomatic and asymptomatic patients within age groups were found. PMID- 6861575 TI - Cathartic colon. Reversibility of roentgen changes. AB - Cathartic colon is an infrequent and severe manifestation of chronic irritant laxative abuse. Little is known of its natural history after cathartics are stopped. Previous reported cases have shown residual roentgen abnormalities on follow-up examinations. A case is presented of cathartic colon caused by more than 70 years of laxative abuse that demonstrated complete reversal of the roentgen changes four months after stopping the medication. Some pathophysiologic correlates of this dramatic reversibility are discussed. PMID- 6861573 TI - Peripheral blood lymphocyte levels in large-bowel cancer. AB - The relationship between peripheral blood lymphocyte levels and monitoring and assessment of prognosis of patients with large-bowel cancer has been assessed. There does not appear to be a correlation between the absolute lymphocyte count and the state of disease. Furthermore, the preresection and postresection lymphocyte levels do not accurately predict the likelihood of recurrent cancer subsequently developing, and the serial monitoring of patients with peripheral blood lymphocyte levels adds no important new information to clinical follow-up. PMID- 6861576 TI - Ischemic colitis associated with systemic lupus erythematosus. AB - A case of colonic ischemia, infarction, and perforation secondary to systemic lupus erythematosus (SLE) is described in a 37-year-old woman. The incidence and significance of gastrointestinal complications in SLE are discussed. PMID- 6861577 TI - An unusual hamartomatous malformation of the rectosigmoid presenting as an irreducible rectal prolapse and necessitating rectosigmoid resection in a 14-week old infant. AB - A 14-week-old female infant presented with an irreducible rectal prolapse and a large polypoid tumor at the tip of the prolapsed mucosa. The tumor and prolapsed rectum were resected. Four weeks after the operation, profuse rectal bleeding occurred and a second similar tumor was diagnosed by endoscopy in the sigmoid colon. Laparotomy, rectosigmoid resection, and endorectal pull-through were performed. At operation, the serosal surface showed ragged polypoid lesions and an abnormal angiomatous vascularization. The postoperative course was uneventful. The histology suggested a congenital mucosal malformation. This pathology is unique in our experience and we have been unable to find anything resembling it in the literature. At age two years a Sertoli cell tumor developed in the girl with pubertas precox and a recurrent colonic polyp of the Peutz-Jeghers type. PMID- 6861579 TI - Genetic aspects of multiple polyposis coli. AB - Questions on this topic that concern the clinician are addressed: whether it is inherited and, if so, whether Mendelian; what the segregation ratios will be; whether it is heterogeneous; how its high frequency can be accounted for; and what preventive measures are available. In several cases the question has to be reworded in order to make it sufficiently precise for it to be used in practice without misleading the patient. Framed in this fashion applicable answers are relatively easily available although many genetic puzzles remain. To date, no antenatal diagnosis is available. PMID- 6861580 TI - In vitro studies on heritable colonic cancer. AB - Some properties of in vitro growth associated with transformation, varied between and within the clinically defined colonic cancer syndromes. None of these differences, nor any grouping of them, permitted identification of specific genotypes. Such differences did support the concept, long assumed on the basis of differences in extracolonic lesions in some colonic cancer syndromes, that they are not all due to the same mutation but represent distinct genetic entities, these genetic differences not being detectable in vivo, but rather in vitro. PMID- 6861581 TI - Special table and instrument rack as used in the lithotomy-Trendelenburg position for anterior resection by stapling and abdominoperineal excision of the rectum. PMID- 6861578 TI - Oxygen therapy in pneumatosis coli. What is the minimum oxygen requirement? AB - Breathing high concentrations of oxygen at atmospheric pressure has been effective in achieving prompt objective and subjective relief in pneumatosis coli. A 22-year-old man was treated with 40% oxygen--a smaller concentration than used by previous physicians--supplied through a nonrebreathing mask. During meals, oxygen was given at 5 1/minute by nasal cannula. Oxygen therapy was maintained for seven days. A year after treatment the patient was still asymptomatic and free from disease. Using this therapeutic measure the benefit/risk ratio of oxygen therapy could be increased. PMID- 6861582 TI - Giant duodenal ulcers. Successful healing with medical therapy. AB - Giant duodenal ulcers (GDU) have been associated with a high incidence of morbidity and mortality unless early operative intervention is undertaken. There are few published reports of successful medical management of GDU. Therefore, we reviewed 14 consecutive patients with GDU at our institution. Excluding the following cases: Two patients who had elective surgery, two patients who died from unrelated causes, and one patient who initially presented with a complication of GDU, complete healing was accomplished in eight of nine patients with cimetidine, antacids, and close observation. We conclude from our review that uncomplicated GDU can be successfully treated with medical therapy. PMID- 6861583 TI - Oral administration of spermine inhibits gastric acid secretion in rats. AB - Administration of spermine by oral route inhibits the histamine-stimulated gastric acid secretion in pylorous ligated rats. The extent of both the acid and volume of secretion is dependent on the dose of spermine. The polyamine is completely ineffective when injected by the intravenous route. A single oral dose of spermine suppresses acid secretion for at least 6 hr. An inverse relationship between the efficacy of oral spermine and age of the animals was observed. These data suggest a therapeutic potential for the naturally occurring polyamine compounds. PMID- 6861586 TI - Double-blind assessment of therapeutic efficacy in clinical trials. PMID- 6861585 TI - Species and strain differences in mepirizole-induced duodenal and gastric lesions. AB - Species and strain differences in mepirizole-induced duodenal and gastric lesions were studied. Mepirizole at 200 mg/kg given orally induced deep duodenal ulcers and gastric erosions in nonfasted Sprague-Dawley, Fisher, Wistar, and Donryu rats at an incidence of over 75%. Mepirizole at 300 mg/kg given orally also induced penetrating duodenal ulcers in nonfasted rabbits at an incidence of 50%. There was little or no damage to the duodenum and stomach in mice and dogs given 200 300 mg/kg of mepirizole orally or subcutaneously. The stomachs of fasted guinea pigs given 200 mg/kg of mepirizole had superficial erosions at a high incidence (93.3%). Mepirizole at 200 mg/kg given intraduodenally significantly reduced the volume of gastric juice but increased the acidity and pepsin activity in both pylorus-ligated and acute fistula rats. In chronic fistula rabbits, however, the agent at 200 mg/kg given orally reduced the volume and acidity, but increased the pepsin activity. The mechanism of duodenal ulceration by mepirizole differs slightly in rats and rabbits. PMID- 6861587 TI - Pseudomembranous colitis secondary to metronidazole. PMID- 6861584 TI - In vitro effects of pancreatic polypeptide and motilin on contractility of human gallbladder. AB - In vivo studies have indicated that pancreatic polypeptide induces gallbladder relaxation, whereas motilin initiates contraction of the gallbladder. To determine if these two polypeptides act directly on the gallbladder muscle, their effect on strips of human gallbladder was studied in vitro. Preparations were suspended in an organ bath and the isometric tension recorded. Dose-response curves to cholecystokinin and acetylcholine were first established. The ability of pancreatic polypeptide to cause relaxation under basal conditions and during 50% maximal stimulation by cholecystokinin-octapeptide (2 X 10(-8) M) was assessed on four strips at approximate physiological concentration (300 pmol/liter) and on four additional strips at 10(3) higher concentration. Pancreatic polypeptide did not have any effect on the basal or the cholecystokinin-generated tension at either concentration. The response to motilin was evaluated on four gallbladder strips at concentrations ranging from 10(-11) to 6.7 X 10(-7) M. Although the highest concentration was more than 10(5) greater than levels reported in fasting serum, motilin did not initiate any gallbladder strip contraction. Whereas the preparation was unresponsive to pancreatic polypeptide and motilin, it was capable of contracting in a dose related fashion to the known agonists cholecystokinin and acetylcholine, and the response was blocked by the respective antagonists dibutyryl cyclic GMP and atropine. It thus seems that pancreatic polypeptide and motilin exert their respective actions as sites remote from the gallbladder without directly affecting gallbladder muscle. PMID- 6861589 TI - A monolayer culture of human gastric epithelial cells. AB - Our aim was to develop a fibroblast-free monolayer culture of human gastric mucosal cells, using the specimens obtained by routine endoscopic biopsy. Human gastric mucosa obtained from normal volunteers by endoscopic biopsy was dissociated from collagenase and hyaluronidase. Dissociated cells were cultured in supplemented Coon's modified Ham's F-12 medium. Within 24 hr of inoculation, the cells were attached to the culture dishes. This was followed by cellular outgrowth. On phase-contrast microscopy, all cells had epithelial characteristics and fibroblasts were not observed. Ninety percent of cells contained periodic acid Schiff reaction-positive mucous granules after diastase digestion consistent with mucous epithelial cells. Two percent of the cells gave a strong reaction for succinic dehydrogenase activity (parietal cells). Immunohistochemical staining for pepsinogen in cultured cells was negative. On EM, microvilli-like projections, junctional complexes, Golgi apparatus, and mucous granules were apparent in the majority of cells. Mitotic figures were observed by day 3 with Giemsa staining. Autoradiographically, these cells were able to incorporate [3H]TdR into the nuclei. Cells were capable of synthesizing DNA, and this function was inhibited by cycloheximide. Cells could be cultured for up to two weeks without fibroblast contamination. A method of primary monolayer culture of human gastric mucosa obtained by a routine endoscopic biopsy has been successfully developed. PMID- 6861588 TI - Depressed hepatic glutathione and increased diene conjugates in alcoholic liver disease. Evidence of lipid peroxidation. AB - The role of lipid peroxidation in the pathogenesis of alcoholic liver disease has been a subject of controversy. In order to study this question we measured hepatic glutathione and diene conjugates in liver biopsies from 16 alcoholics with different stages of liver injury and 8 nonalcoholics with liver disease. Patients with alcoholic liver disease were found to have decreased hepatic glutathione compared to patients with liver disease unrelated to alcohol (22.1 +/ 2.5 vs 33.5 +/- 4.6 nmol/mg protein, P less than 0.05). The decrease in glutathione was accompanied by an increase in diene conjugates in hepatic lipids (3.37 +/- 0.14 vs 2.26 +/- 0.21 OD at 232 nm/mg lipid, P less than 0.001). The changes were present in all stages of alcoholic liver damage including fatty liver but unrelated to nutritional status in these patients. They support the concept that lipid peroxidation may be an important mechanism in the pathogenesis of alcoholic liver disease. PMID- 6861591 TI - Experimental hepatic iron overload in the baboon: results of a two-year study. Evolution of biological and morphologic hepatic parameters of iron overload. AB - Four baboons receiving intramuscular iron for 15 months were compared with two control baboons. From the overall two-year observation period the following data emerge: (1) The baboon is a suitable animal for obtaining a massive and chronic iron overload. Liver iron concentrations reached very high levels (ranging from 41.3 to 180.6 mumol/100 mg dry weight vs 1.7 +/- 0.5, mean +/- SEM, in controls), and a major liver iron overload (ie, with concentration values greater than or equal to 18) was present in all four animals for an average period of 16.5 months (range 14-19). (2) When compared with human hepatic iron-overload disorders, iron distribution was similar to that observed in secondary (transfusional) hepatic siderosis since iron deposits were found primarily in sinusoidal cells. However, a marked parenchymal siderosis was also obtained close to that observed in primary (genetic) siderosis. Iron toxicity was present biologically as indicated by an increase in serum transaminases. Histologically, a slight fibrosis was observed in the most heavily iron-overloaded baboon. On the whole, this study of subhuman primates brings new evidence that iron per se has only a minor hepatic damaging effect. It also suggests that the iron-overloaded baboon liver provides a promising tool for the study of liver cell disturbances in human iron overload. PMID- 6861592 TI - Volume accommodation by distension of gastric fundus (rabbit) and gastric corpus (cat). AB - In attempts to identify the structures of the proximal stomach responsible for volume accommodation, the dimensions of a herbivore (rabbit) were compared to those of a carnivore (cat) stomach at various degrees of filling. The total gastric surface area was similar in both species, but the proximal stomach of cats consisted primarily of the segment between the incisura angularis and the cardia (gastric corpus), while the proximal stomach of the rabbit was represented largely by the true fundus (segment orad to cardia). In both species, the muscle coat of the proximal stomach was thinner than that of the distal stomach, but this difference was more prominent in rabbits than in cats. In both species, the length and the angulation of the lesser curvature were little affected by filling of the stomach. Most length increases of the greater curvature occurred proximal to the cardia in the rabbit and proximal to the incisura angularis in the cat. Filling the stomach increased the length of the gastric circumference more steeply in the cat than in the rabbit. In both species, the stomachs shortened in their longitudinal axis in response to a drug that excites gastric smooth muscle (carbachol). A drug that inhibits gastric smooth muscle (isoproterenol) gave the stomach a more elongated shape. Cat stomachs ruptured at higher volumes and intragastric pressures than rabbit stomachs. In the cat, volume accommodation takes place in the transverse axis of the stomach, and parallel to the circular muscle fibers of the gastric corpus. In the rabbit, volume unfolds the gastric fundus in the longitudinal and transverse axes in parallel to the radiating course of the oblique muscle fibers. PMID- 6861590 TI - Effect of chronic ethanol ingestion on zinc absorption in rat small intestine. AB - The effect of chronic ethanol ingestion on the ability of the small intestine to absorb zinc was examined in male Sprague-Dawley rats. Six rats were fed the Lieber-Decarli liquid rat diet for 1 month during which 36% of their total calories were provided as ethanol, while their pair fed controls received these calories as carbohydrate. Zinc absorption was then examined simultaneously in duodenal and ileal segments by in vivo perfusion. Net absorption of zinc in the ileum was reduced by 16% following chronic ethanol feeding. Duodenal absorption of zinc was significantly less than in the ileum and was unaffected by chronic ethanol ingestion. These results demonstrate that chronic ethanol ingestion significantly impairs net zinc absorption in the ileum of the rat, the most active area of zinc uptake as measured by in vivo perfusion, and suggest that malabsorption of zinc may contribute to the zinc deficiency seen following chronic ethanol ingestion. PMID- 6861593 TI - A canine model for the study of gastric secretion and emptying after a meal. AB - Our aim was to develop a chronic canine model that would serve for the simultaneous measurements of postprandial gastric secretion and emptying by a double-marker dilution technique without artificially interfering with intragastric pH. A constant duodenal perfusion of a nonabsorbable marker allowed determination of luminal flow and total recovery of a second marker ingested with a meal. By calculating the amount of meal marker remaining in the stomach and its dilution (by repeat gastric sampling), we could determine the volume of gastric contents. Acid concentration in gastric samples was measured by titration ex vivo, and gastric acid content was calculated by multiplying the volume of gastric contents by titratable acidity. In this model, net acid gain at each sampling interval indicates acid output. Acid and volume losses are equivalent to duodenal acid load ad emptying rate, respectively. The method has been validated by virtually abolishing the endogenous secretion of acid (by intravenous infusion of cimetidine) and the calculation of known volumes and concentrations of acid exogenously instilled in the animal's stomach. Our results indicate that this is an accurate and practical method for the physiologic measurement of postprandial gastric function in dogs. Further, these studies substantiate the validity of the assumptions upon which the human double-marker method was based. PMID- 6861594 TI - Topical 16,16-dimethyl-prostaglandin E2. Effects on gastric morphology, hydrogen ion loss, and bicarbonate secretion. AB - Using a canine chambered stomach preparation, the effects of topical 16,16 dimethylprostaglandin E2 (dmPGE2) on gastric mucosal morphology, H+ loss and HCO3 secretion were assessed. Compared to control studies in which acid alone (100 mM HCl) bathed the epithelium, dmPGE2 (1 or 4 micrograms/ml), when applied to gastric mucosa in acid medium, significantly (P less than 0.01) enhanced H+ loss from the bathing solution in a dose-related fashion. These effects, however, were independent of any injury to the epithelium as confirmed by both light and electron microscopy. In other studies in which dmPGE2 was applied to gastric mucosa in neutral solution (150 mM NaCl, pH 7.0) using identical doses, a dose related increase (P less than 0.01) in HCO3-secretion was observed. When the net HCO3-output (microEq/15 min) for each dose of dmPGE2 employed was compared with the net H+ loss (microEq/15 min) for each dose of PG used, no differences were noted. The correlation between H+ loss and HCO3-secretion was highly significant (r = 0.87; P less than 0.01). We conclude that with the doses studied, dmPGE2 is not damaging to gastric mucosa and that the apparent increase in H+ loss elicited by dmPGE2 in acid medium is due to acid neutralization secondary to HCO3 secretion. PMID- 6861595 TI - 16,16-dimethyl PGE2 and HCO3- efflux. PMID- 6861596 TI - Drug binding to plasma proteins during human pregnancy and in the perinatal period. Studies on cloxacillin and alprenolol. AB - Plasma protein binding of one acidic drug, cloxacillin, and one basic drug, alprenolol, was determined by equilibrium dialysis at +37 degrees C during pregnancy and the 1st postnatal week in 12 women and their newborn infants and in 7 nonpregnant women (controls). A significant increase in fraction free cloxacillin in maternal plasma occurred during pregnancy already from the 2nd trimester compared to the controls (p less than 0.01) and was most pronounced at delivery (median values 0.126 and 0.069, respectively). A similarly increased fraction free cloxacillin was found in cord blood (median value 0.108) which further increased during the 1st postnatal week (range 0.112-0.164). In maternal plasma the binding capacity returned to the values of the controls during the same time period. The binding of cloxacillin was significantly correlated with the concentration of albumin (p less than 0.01). High correlation was also found between binding of the basic drug alprenolol and concentration of orosomucoid (p less than 0.005). This was most obvious in the newborn infants with low concentrations (range 0.1-0.3 g/l) and in the mothers during the puerperium with high concentrations of orosomucoid (range 0.7-2.5 g/l). On the basis of plasma protein binding data in the mother and her child, a maternal to fetal plasma concentration ratio was calculated. For cloxacillin this ratio was close to unity (1.03), while it was significantly above unity for alprenolol (1.72). At equilibrium, therefore, the total plasma concentration of alprenolol in the mother can be expected to exceed the concentration in her infant. PMID- 6861597 TI - Parental methadone treatment: a multigenerational study of development and behavior in offspring. AB - After 60 days of treating both sexes with daily oral doses of 15 mg/kg methadone hydrochloride, Wistar rats were mated. Drug treatment of females continued until the weaning of their pups. The body weight of pups was reduced compared to controls up to weaning, and viability was significantly decreased. Ontogeny of reflexes was delayed, and exploration in an open-field arena was reduced up to 2 weeks of age, but then increased above controls. Defecation in the open-field arena was lessened. When only the sire received methadone, only the increase in exploratory behavior and the decrease in defecation occurred. Breeding offspring (F1) of which both parents had methadone treatment gave F2 generation offspring for which neonatal mortality was significantly elevated and defecation in the open-field arena was lessened at 21 days. No changes clearly traceable to methadone were found in the subsequent F3 generation. Some F3 generation rats were treated with methadone and bred in the same manner as the original parental generation. The resulting pups, having the genealogy twice-exposed to methadone, were not significantly different from those whose immediate parents only received the drug. PMID- 6861598 TI - Use of amiodarone in the therapy of primary ventricular arrhythmias in children. AB - 4 children, ages 11-14 years, were diagnosed as having primary ventricular arrhythmias (3 ventricular tachycardia, 1 multifocal premature ventricular contractions) without underlying heart disease. All 4 patients were treated initially with standard antiarrhythmic drugs (quinidine, propranolol, procainamide) and either did not respond (3 patients) or experienced drug toxicity (quinidine - 1 patient) necessitating withdrawal of antiarrhythmic therapy. Amiodarone, a new antiarrhythmic agent, was initiated in a single oral daily dose of 10 mg/kg/day. All patients have shown a significant clinical response to oral amiodarone with either complete suppression of ventricular tachycardia in 2 patients, near complete suppression in 1 and abolition of multifocal premature ventricular contractions in the fourth patients. 2 patients have had corneal microdeposits detected by slitlamp examination and are receiving methylcellulose eye drops; no other adverse reactions have been encountered during the follow-up of 6 months to 3 years. PMID- 6861599 TI - Regulation of monooxygenation during development of chick embryo liver: role of cytochrome P-450 isozymes and NADPH. AB - The endoplasmic reticulum of the liver cell, supplied with molecular oxygen and NADPH, can monooxygenate a variety of lipid soluble compounds including steroids and many drugs. The essential enzymatic steps are carried out by cytochrome P-450 and NADPH cytochrome P-450 reductase. There are several molecular forms (isozymes) of cytochrome P-450 in liver, and it has been shown that their relative concentrations change during development and in response to phenobarbital. Because substrate specificities of the isozymes differ to some extent, changes in the isozyme pattern should alter the pattern of substrate utilization if the isozymes are controlling the rates of monooxygenation. We found that the rates of testosterone hydroxylation and the oxidative N demethylations of benzphetamine, codeine, and ethylmorphine were equal in endoplasmic reticulum isolated from chick embryo liver on day 11 of egg incubation, and this equality was unaffected by age or phenobarbital. Thus, monooxygenation rates do not appear to be controlled by the isozymes of cytochrome P-450. A factor that might affect the pattern of steroid and drug utilization by endoplasmic reticulum may be the availability of reducing equivalents. Lowering the concentration of NADPH to one half-optimum values in our reaction mixtures (0.5 to 0.25 mM) diminished the monooxygenation rate of benzphetamine by 8%, of testosterone by 40%, and of codeine and ethylmorphine by 60%. These differential effects were independent of age and phenobarbital. Thus, the pattern of substrate utilization by the monooxygenase system in vivo is probably altered by changes in the tissue concentration of NADPH. PMID- 6861600 TI - Age-related changes in electrophysiological properties of canine Purkinje fibers: effect of ouabain. AB - Transmembrane potentials were recorded in Purkinje fibers obtained from dogs aged 1 day, 1 week, 2 weeks, 4 weeks and more than 1 year. After the initial impalements there was a time-dependent increase in diastolic potential. This hyperpolarization was more pronounced in the younger Purkinje fibers. Maximum diastolic potentials from 1-day-old puppies (-78.0 +/- 1.2 mV), after 10 min of continuous impalement, were significantly less negative than those for adults ( 84.2 +/- 1.9 mV). Fibers from neonates exposed to ouabain do not depolarize as much as fibers from adults. PMID- 6861601 TI - Normal serum 25-hydroxyvitamin D levels in phenobarbital-treated toddlers. AB - Serum 25-hydroxyvitamin D (25-OHD) levels were measured in 74 children randomly treated in a double-blind fashion with either 5 phenobarbital/kg/day or placebo after a single febrile seizure. Phenobarbital treatment for a period from 5 to 12 months had no effect on the 25-OHD levels. However, both in the phenobarbital and the placebo groups, vitamin D supplementation raised the circulating 25-OHD concentration (p less than 0.05). Whether it has a protective effect remains thus to be seen. PMID- 6861602 TI - Pentazocine and tripelennamine ('T's and blue's'): effects on the fetus and neonate. AB - Three groups of women enrolled in a comprehensive perinatal addiction program were studied. Group I (n = 13) were addicted to pentazocine and tripelennamine (T's and blue's), group II were low-dose methadone-maintained women (n = 46) and group III women were drug-free controls (n = 27). No differences were seen in maternal age, gravidity, obstetrical complications, gestational age or neonatal Apgar scores. Significant differences were observed between drug-exposed and drug free neonates in birth weight, length and head circumference. An evaluation of neonatal behavior using the Brazelton Neonatal Behavioral Assessment Scale revealed that infants of mothers who used T's and blue's throughout pregnancy demonstrated interactive deficits and withdrawal similar to methadone-addicted newborns. PMID- 6861603 TI - Lipid peroxidation in the newborn rat: influence of fasting and hyperoxia on ethane and pentane in expired air. AB - The rate of lipid peroxidation, as determined by expired air pentane and ethane measurements, was assessed in suckled or fasted newborn rats exposed to air or hyperoxia (FIO2 greater than 0.95). Pentane and ethane production in suckled newborn rats did not significantly change with exposure to hyperoxia after birth. Pentane production averaged over a 3-day exposure period was 2.8 pmol/100 g/min in hyperoxia versus 2.5 pmol/100 g/min in air. However, significant increases in ethane production occurred in fasted newborn rats over the first 18 h of life (less than 2.5 pmol/100 g/min increasing to greater than 6 pmol/100 g/min), which were not observed in suckled animals. Although hyperoxia did not cause an increase in pentane or ethane production above air-exposed controls, nutritional deprivation in newborn rats appeared to accelerate lipid peroxidation events and resulted in high mortality in newborn rats exposed to hyperoxia. PMID- 6861605 TI - Treatment of anaerobic infections in children with metronidazole. AB - The tolerance and efficacy of metronidazole were studied in 15 pediatric patients who had anaerobic infection. 5 had soft tissue abscess, 4 had aspiration pneumonia, 3 had intracranial abscess and 3 had chronic sinusitis. 45 bacterial isolates were recovered (3 isolates per patient). 40 were anaerobes and included 17 Bacteroides sp. (8 sp.), 16 anaerobic cocci and 6 Fusobacterium nucleatum. Metronidazole was given intravenously at the dose of 30 mg/kd/day or orally in the dose of 40-50 mg/kg/day. The length of therapy was between 14 and 52 days (average 26 days). 7 of the patients received initial parenteral therapy for 5-21 days (average 11.6 days), and subsequently received oral therapy. The minimal inhibitory concentration of 38 of the 41 anaerobic isolates (93%) was equal or less than 2 micrograms/ml. The mean peak concentration of metronidazole on the third day of therapy was 24.2 micrograms/ml range 15.2-30 micrograms/ml) and the mean trough was 7.2 micrograms/ml (range 4-11.6 micrograms/ml). No local or systemic adverse reaction as noted. A good response to therapy with a complete cure occurred in 14 of the 15 children. A fair response was achieved in 1 patient. Metronidazole appears to be effective and safe in the treatment of serious anaerobic infection in children. PMID- 6861606 TI - Effect of propranolol on the acid base balance and hemodynamics of 'chronically instrumented' pregnant sheep. AB - Maternal and fetal responses to i.v. admission of propranolol (4 mg/4 min) were investigated in 10 'steady-state' sheep experiments performed on 5 ewes and their fetuses at 101-128 days of gestation. Observations were made at 0, 5, 15, 30, 45, 60, 75, 90 and 120 min from the start of infusion. Transient decrease in fetal heart rate (p less than 0.05) was observed at 15 min, accompanied by fetal acidosis, which persisted throughout the experiment. Mean fetal pCO2 increased significantly at 5, 15 (p less than 0.025) and 75 min (p less than 0.05). Fetal pO2 decreased at 15 min (p less than 0.025). Oxygen saturation (O2%) decreased at 15 (p less than 0.001) and 60 min (p less than 0.025). Concomitant decreases in O2 content were noted at 15 (p less than 0.005), 30 (p less than 0.05), 60 (p less than 0.025) and 90 min (p less than 0.05). Mean fetal base excess decreased at 30 min (p less than 0.05). Mean maternal heart rate decreased at 15 (p less than 0.010) and 30 min (p less than 0.005), followed by an increase at 75 (p less than 0.05) and 90 min (p less than 0.05). Mean uterine blood flow remained unchanged during infusion and up to 90 min. However, it increased at 105 (p less than 0.025) and 120 min (p less than 0.05). It is suggested that propranolol causes definite fetal adverse effects and its usage during pregnancy must be limited to absolutely indicated situations. PMID- 6861604 TI - Acute cardiovascular effects of indomethacin in anesthetized newborn dogs. AB - Cardiac output and regional blood flow distribution were measured in 14 newborn dogs before and 90 min following 0.3 mg/kg of indomethacin and in 4 control animals who received buffer alone using the Radioactive Microsphere Reference Organ Technique. Indomethacin produced no significant change in cardiac output or blood flow to the gastrointestinal tract or kidney. There were no changes in cerebral blood flow in animals over 4 days of age. However, in 3 of 8 puppies less than 3 days of age, indomethacin resulted in a 47% fall in cerebral blood flow. In newborn dogs, indomethacin in the dose employed had no deleterious effects on cardiac output and, with the possible exception of the cerebral circulation, on blood flow distribution. PMID- 6861607 TI - [Calorimetric approach to the study of the effect of radio-frequency range electromagnetic radiation on the erythrocyte plasma membrane]. PMID- 6861608 TI - [In vitro comparison of 2 sodium transport pathways across the wall of the small intestine in the rat]. PMID- 6861609 TI - [Endocytosis in the dendrites as a compensatory function of the nerve cells in extreme exposures]. PMID- 6861610 TI - [Transplantation of frozen embryonic brain tissue into the brain of adult rats, intact and after hypoxia]. PMID- 6861611 TI - [Nature of the long-wave absorption band of reaction centers in Rhodopseudomonas viridis in relation to the process of primary charge separation]. PMID- 6861612 TI - [Ca2+-induced fusion of bilayer lipid membranes not containing a solvent]. PMID- 6861613 TI - [Complete stoichiometry of free NADP-H oxidation in liver microsomes]. PMID- 6861614 TI - [Neutral lipids of the nuclei of liver and tumor cells in the growth process]. PMID- 6861615 TI - [Action of hormones and N-nitroso-N,N-dimethylurea in a concentration not causing mutations on the binding of nonhistone nuclear proteins with chromatin DNP]. PMID- 6861616 TI - Alcohol withdrawal syndromes - prediction from detailed medical and drinking histories. AB - The predictability of the withdrawal syndrome on the basis of the drinking history immediately prior to detoxification was investigated in 43 patients admitted to an inpatient Alcoholism Service; a pilot study consisted of 17 patients and a subsequent definitive study of 26. After obtaining informed consent, blood alcohol concentrations were measured. Each subject was extensively interviewed to obtain a medical and dietary history and to determine alcohol and drug intake in the past week and months. The levels of intoxication and withdrawal signs/symptoms were assessed on admission and daily for at least 3 days. Urine and blood toxicology screens were also performed for 19 subjects. Contrary to widespread impressions, most of the patients were able to give a detailed account of their drinking and drinking-related behavior in the 3 days prior to admission and 73% could do this for the previous 7 days. Subjects were consistent in their reporting; 85% gave drinking histories consistent among interviews conducted independently by the medical, research and counseling staff. A significant correlation (r = 0.55; P less than 0.01) was found between the severity of withdrawal and the total alcohol intake in the days immediately prior to admission. No significant correlation was evident between withdrawal severity and the number of years of heavy drinking. Amounts of benzodiazepines (diazepam and flurazepam) administered by the medical staff during the first 3 days of withdrawal and for the total hospital stay were also found to be significantly correlated with withdrawal severity (r = 0.58; P less than 0.01 for both). Regression analyses of these data also confirmed the statistically significant relationships between alcohol intake and withdrawal severity and between withdrawal severity and amounts of benzodiazepines used for detoxication. Of special interest was the finding that 50% of the subjects reported no hangovers within he past year or more and 23% reported that they had never experienced a hangover, despite very heavy drinking. In addition, only 50% of the patients had regularly consumed coffee or any caffeine-containing substance; this low incidence of caffeine intake was statistically significantly less than that found in extensive surveys of the general population in which only 3-10% eschew caffeine-containing beverages. It is concluded that the severity of alcohol withdrawal can be related to a cluster of variables among which is recent alcohol intake. The present results are, at the same time, consistent with previous observations of the appreciable differences among individuals in the consequences of abrupt cessation of chronic alcohol consumption. PMID- 6861617 TI - Serum folic acid levels and antipyrine clearance rates in smokers and non smokers. AB - Serum folic acid (FA) levels and antipyrine clearance rates were determined in 15 healthy male subjects who had not been administered any drug and alcohol for a month preceding the study. Eight of the 15 subjects smoked cigarettes daily while the remaining seven did not. The serum FA levels were measured by Lactobacillus casei bioassay. The antipyrine clearance rates were estimated in plasma or saliva obtained after oral administration of antipyrine for evaluating the activity of hepatic microsomal oxidase. The serum FA levels in the smokers were significantly lower than those in the non-smokers and the antipyrine clearance rates were significantly higher in the smokers compared with the non-smokers. The increase of the antipyrine clearance rates in the smokers was supposed to be caused by an increase in the activity of hepatic microsomal oxidase since it has been established that polycyclic aromatic hydrocarbons contained in cigarette smoke induce these enzymes. The association of the decrease in the serum FA levels and the increase of the antipyrine clearance rates was investigated. PMID- 6861618 TI - Diary gives more accurate information about alcohol consumption than questionnaire. AB - In a population of 49 male volunteers, mean daily alcohol consumption was measured first by a questionnaire and then twice by a diary. The reliability of the diary method was estimated to be at least 90%. The mean daily consumption reported in the questionnaire was on the average 60% of that revealed by the diary. The difference between the two methods in measuring alcohol consumption did not depend either on age, the level of alcohol consumption, the percentage of drinking days or on the percentage of days when the subjects felt intoxicated by alcohol. This shows that the ranking of subjects according to questionnaire data is not biased in a group of subjects motivated to give accurate answers. PMID- 6861619 TI - A taxonomy of small hostels for alcoholics. PMID- 6861620 TI - Steroids pulse therapy in systemic lupus erythematosus. PMID- 6861621 TI - Steroids and avascular bone necrosis. PMID- 6861622 TI - Prevention of Giardia in drinking water. PMID- 6861624 TI - Interaction of penicillins with the components of plasma expanders. AB - The interaction of penicillin with high molecular components of plasma expander such as dextran, 6-hydroxyethylstarch, and polygeline were studied. The formation of penicilloyl polysaccharides and smaller amounts of penicilloyl polygeline during incubation were confirmed by ultrafiltration and gelfiltration. The ultrafiltration through Collodion-Bags SM 13 200 was found to be a rapid and convenient method for the determination of macromolecular penicilloates. The accelerated degradation by the formation of penicilloyl esters with glucose and lactic acid was also suggested. PMID- 6861623 TI - Recommendations for monitoring lithium therapy. PMID- 6861625 TI - Intravenous streptokinase in acute myocardial infarction. AB - Intracoronary streptokinase has been reported to be successful in producing coronary recanalization and lowered morbidity and mortality in acute myocardial infarction patients, when administered shortly after the onset of chest pain. However, intracoronary administration of streptokinase is not practical for most hospitals at present, and intravenous administration would enable treatment of larger numbers of patients and enable the drug to be administered earlier than by the intracoronary route. Available studies have suggested benefits of the intravenous route and results of randomized clinical trials indicate an approximately 20-percent decrease in mortality after intravenous use. Intravenous streptokinase after acute myocardial infarction warrants further investigation. PMID- 6861626 TI - Decrease in theophylline clearance after the administration of erythromycin to a patient with obstructive lung disease. AB - It has been demonstrated previously that erythromycin can inhibit the total body clearance of theophylline, resulting in elevated serum theophylline concentrations. The overall incidence of this interaction and the population at risk have not been elucidated fully. Recent investigations have suggested that such an interaction is doubtful and that patients in whom this occurrence was suspect developed alterations in theophylline disposition secondary to worsening pulmonary function, not from erythromycin therapy alone. This case report shows that the interaction between theophylline and erythromycin can be clinically significant, producing as much as a 50-percent reduction in the total body clearance of the bronchodilator. The magnitude and time course of this interaction in patients with congestive heart failure and chronic obstructive pulmonary disease may differ considerably from that reported in healthy volunteers. PMID- 6861627 TI - Treatment of chlorpropamide overdose with diazoxide. AB - A patient who took a chlorpropamide overdose was treated for several hours with concentrated glucose solutions, with little success in maintaining adequate serum glucose concentrations. Intravenous diazoxide administration was begun with the hope of decreasing pancreatic insulin release. After diazoxide was begun, glucose requirements decreased dramatically, and serum glucose was supranormal for most of the period of diazoxide administration. The case was complicated by the fact that the patient had taken three agents that can cause hypoglycemia- chlorpropamide, alcohol, and aspirin. Drug interactions potentiating the hypoglycemic effect of the chlorpropamide were also possible. Glucose infusion is the mainstay of therapy for a sulfonylurea overdose. However, glucose acts as a further stimulus of insulin release from a sulfonylurea-primed pancreas. Administration of concentrated glucose solutions is technically difficult because of damage to veins. Metabolic consequences of high rates of glucose infusion to hyperinsulinemic patients include hypokalemia and hypophosphatemia. Diazoxide appeared to decrease the glucose requirement in this patient, as it did in three other reported cases. Diazoxide is approved for certain hypoglycemic, hyperinsulinemic conditions. Sulfonylurea overdose represents a hypoglycemic, hyperinsulinemic condition; diazoxide appears to be an effective treatment. PMID- 6861628 TI - Acute overdose of bromocriptine. PMID- 6861629 TI - Comment on aminoglycoside program. PMID- 6861630 TI - Ethylene glycol toxicity and treatment. PMID- 6861631 TI - Drug prescribing and use among elderly people in Spain. AB - As a result of the lack of an adequate regulation, the supply and the use of medicines is irrational in Spain. In order to know the characteristics of the prescription and use of drugs among the elderly, two drug utilization studies were carried out. The first study was an analysis of 981 prescriptions from an outpatient clinic of the Spanish Social Security. The results show that a high proportion of fixed-dose combinations were prescribed and that drugs without any demonstrated therapeutic value are often prescribed for the elderly. The second study was a survey of 389 individuals randomly chosen among people affiliated with a pensioners' club. The results show that drug use is highly prevalent among the elderly, that many medicines without any demonstrated benefit are being taken, and that potentially harmful drugs were being used by a high proportion of patients without medical follow-up. The prevalence of the use of some particular groups of drugs is also presented. PMID- 6861632 TI - Comparative effects and analgesic efficacy of the agonist-antagonist opioids. AB - Pentazocine, butorphanol, nalbuphine, and buprenorphine are mixed agonist antagonist opioids that are effective analgesics, with less abuse potential than the agonists morphine, propoxyphene, and codeine. The dual properties of the agonist-antagonists are largely explained by their varying actions at the postulated three types (mu, chi, and sigma) of opioid receptors. The agonist antagonists are classified as either morphine-like or nalorphine-like, based on their acute effects and withdrawal symptoms after chronic dosing. Buprenorphine is morphine-like, while the other drugs are nalorphine-like. These agents vary in the duration of analgesia, with pentazocine having a mean action of three hours and buprenorphine greater than six hours. The hemodynamic effects of nalbuphine and buprenorphine generally resemble those of morphine, while pentazocine and butorphanol increase cardiac workload, blood pressure, and pulmonary artery pressure. The agonist-antagonists have ceilings for respiratory depression, whereas the agonists produce dose-dependent depression. Agonist-antagonists generally produce less increase in biliary ductal pressure than does morphine. The major clinical limitations are that agonist-dependent patients may experience unpleasant subjective effects, when treated with the agonist-antagonists, and the nalorphine-like agents can produce psychotomimetic effects. More clinical experience is needed to rank the abuse potential within this group of opioids. The newer agents are being studied for oral use in acute and chronic pain. PMID- 6861633 TI - Gentamicin and tobramycin dosing guidelines: an evaluation. AB - The provision of pharmacokinetic dosing services has become a cornerstone of clinical pharmacy practice in many institutions. As these services expand, more pharmacists will become involved, and the need for a structured, uniform approach to the provision of these services may be necessary. Therefore, this article discusses specific approaches (i.e., guidelines) to the most common clinical conditions that the pharmacist may encounter. The goal is to promote consistent interpretation and application of clinical and kinetic data by the members of our aminoglycoside dosing service. The guidelines provide a structured yet adaptive approach to the clinical use of gentamicin and tobramycin. The major areas of controversy that were encountered in developing these guidelines are discussed, and the guidelines are presented. These guidelines currently are used to standardize our pharmacokinetic dosing service and as a tool for educating new pharmacists to their role and responsibilities as members of the pharmacokinetic consultation team. Additionally, these guidelines are being used as criteria for the assessment of quality assurance in the area of clinical pharmacokinetics. PMID- 6861635 TI - Phenytoin-induced lymphadenopathy. AB - Various lymph node abnormalities have been associated with phenytoin therapy. Four distinct categories of lymphadenopathy have been described: lymphoid hyperplasia, pseudolymphoma, pseudo-pseudolymphoma, and lymphoma. These presentations vary from a benign symptom complex, with enlarged lymph nodes, that is reversible upon drug discontinuance to a true malignant lymphoma that is progressive and ultimately fatal. Benign lymph node hyperplasia and pseudolymphoma may result in erroneous diagnosis and treatment of malignant lymphoma if phenytoin-associated lymphadenopathy has not been considered. We describe a patient who developed enlarged inguinal lymph nodes while receiving chronic phenytoin therapy. An initial diagnosis of malignant lymphoma was made, and recurrent hospitalizations and treatment with cytotoxic drugs ensued. Repeat biopsy, as well as reexamination of the removed nodes, later revealed phenytoin associated hyperplasia. Patients who develop enlarged lymph nodes while receiving phenytoin should be evaluated carefully so that phenytoin-induced lymphadenopathy may be differentiated from true malignant lymphoma and appropriate treatment may be given. PMID- 6861634 TI - Nifedipine: two new uses. AB - Nifedipine, a calcium channel blocker currently indicated for vasospastic and chronic stable angina, undoubtedly will have many other uses because of its potent peripheral vasodilatory activity and minimal effects on cardiac contractility. These effects of the drug have proved beneficial in treatment of malignant hypertension and Raynaud's phenomenon. Single oral doses of nifedipine 10-20 mg have rapidly and smoothly reduced blood pressure in malignant hypertension, suggesting its use in the emergency room or office setting. Continuous monitoring of the patient is not required. Studies also have demonstrated the efficacy of nifedipine in Raynaud's phenomenon, and the drug should be considered as an initial agent of choice. PMID- 6861637 TI - The pharmacist as a member of the CPR team: evaluation by other health professionals. AB - Physician and nurse evaluation of the pharmacist's participation on the cardiopulmonary resuscitation (CPR) team was studied, in an attempt to justify the pharmacist's role. A pharmacist-evaluation questionnaire was prepared, based on the Likert Method. This questionnaire contained ten statements related to organizational and mechanical contributions, drug information contributions, and overall contribution and desire, by other health professionals, for continuance of this service. Pharmacists attended all CPRs during a six-month period and distributed a questionnaire to one physician and one nurse in attendance. Verification was obtained that these individuals had attended previous arrests where pharmacists were not in attendance. Only those evaluations that were completed and returned by the physician or the nurse, to the Department of Pharmaceutical Services, were evaluated. Results indicated that physicians and nurses are in agreement with the pharmacist's organizational and mechanical contribution. Both physicians and nurses tended toward agreement with the pharmacist's drug information contribution. Finally, physicians and nurses are in agreement with the pharmacist's overall contribution to the CPR team and desire continuance of this service. PMID- 6861636 TI - Prolonged diarrhea secondary to methyldopa therapy. PMID- 6861638 TI - Effect of probenecid on the pharmacokinetics of aminophylline. AB - The authors investigated the effect of probenecid on the pharmacokinetics of aminophylline. Seven normal volunteers served as their own controls in a crossover study. In the first phase, subjects received an oral dose of aminophylline after an overnight fast. In the second phase, probenecid was given orally 30 minutes prior to the administration of aminophylline. Serum and urine theophylline levels were determined by high performance liquid chromatography. Statistical analysis showed that probenecid had no significant effect on any of the pharmacokinetic parameters measured. Probenecid appears to have little or no influence on the liver metabolism of theophylline. PMID- 6861641 TI - When are shampoos worth prescribing? PMID- 6861640 TI - Irritable bowel syndrome and its treatment. PMID- 6861639 TI - Use of anticholinergics in the nursing home: an empirical study and review. AB - The Medicare Utilization Review Committee conducted a survey to determine the use of drugs with anticholinergic effects in confused elderly nursing home patients. Twenty-nine patients (34.5 percent) were receiving anticholinergic drugs, predominantly from the antidepressant and antipsychotic class. Thioridazine (Mellaril) was the most frequently used antipsychotic. No patients received higher than the equivalent recommended daily dose of atropine when calculated in terms of relative anticholinergic potency. No statistically significant correlation could be found between the presence of confusion and the amount of anticholinergics administered. Confusion and cognitive deterioration frequently are encountered when caring for aged patients. Clinical experience and recent studies suggest that anticholinergics may increase the risk of or exacerbate existing confusion, and this possible effect of anticholinergic activity should be considered when prescribing for elderly patients. PMID- 6861642 TI - Long-term oral anticoagulant therapy. PMID- 6861643 TI - Oxatomide--a new H1-antihistamine. PMID- 6861644 TI - Relationship between chemical structure and allergenicity: aromatic amines. AB - This review utilizes current clinical and experimental contact sensitization data with aromatic amines to hypothesize on the relationship between chemical structure and allergenicity. The available data suggests: 1. A Primary amino group in the ring induces sensitizing properties; 2. aromatic amine allergenicity is related to basicity, resulting from the action of substituents in the ring; 3. electron donor substituents enhance whereas electron acceptor substituents attenuate the activity. PMID- 6861645 TI - [Contact allergy to cetylstearylalcohol (Lanette O) as a therapeutic problem in stasis dermatitis and leg ulcer]. AB - Contact allergic investigations in 2064 patch tested patients (1977-1981) showed that 3,9% had a contact allergy from cetylstearylalcohol (Lanette O). 453 of these patients suffered from stasis dermatitis and leg ulcer. 15% of these 453 patients had a contact allergy from Lanette O, whereas 85% of all patients with Lanette allergy suffered from stasis dermatitis with and without leg ulcers. A closer association between this contact-allergy and these diseases is therefore indicated. Further problems arise due to the presence of cetylstearylalcohol in numerous topical preparations (examples are given) and the often incomplete declaration of the bases and ingredients. PMID- 6861646 TI - Skin vapour loss as a method for measuring the influence of soaps and detergents on human skin. (Part 1). AB - The influence of a number of liquid soaps and detergents on the barrier function of the human skin was investigated by means of skin vapour loss (S.V.L.) measurements. Five liquid cleansers for body use and two liquid dish-cleansers were assayed on the volar side of the forearm. The measurements were performed on 20 healthy volunteers before and after the application of 1 ml of 2 vol.% solution. Five testpersons had to be excluded from the group because of theoretical reasons. The effect on the skin by the applied soaps and detergents was expressed in the average increase of S.V.L. X C. A considerable intra- as well as inter-subject variation of S.V.L. after the application of the test substances could be noted. Each person showed his own pattern of susceptibility. Skin reactions to soaps and detergents as measured by S.V.L. depend not only on the nature of the tested substances but also differ considerably from one person to another. The osmolarity of a test solution may play a role of importance in the irritant effects of soaps and detergents. PMID- 6861647 TI - [Muscular carnitine-palmityl-transferase deficiency]. AB - Deficiency in carnitine-palmityl-transferase (CPT) was demonstrated in a 20-year old man with paroxysmal myoglobinuria, after failure to discover another cause. It is concluded that muscular CPT deficiency must be excluded before a recurrent myoglobinuria is classified as "idiopathic". PMID- 6861648 TI - [The importance of somatosensory evoked potentials in neurologic diagnosis]. PMID- 6861649 TI - [Caution in prescribing non-steroidal antiphlogistics for geriatric patients]. PMID- 6861651 TI - [The current diphtheria situation]. PMID- 6861650 TI - [Gallbladder torsion]. PMID- 6861652 TI - [Diphtheria immunity and its epidemiological significance]. AB - Indirect haemagglutination test for antitoxic diphtheria antibodies was performed on 3503 sera of persons of all age groups. The results demonstrate that a high percentage of juveniles and adults with less than 0.01 IU/ml has either no (48.9% for juveniles, 35.6% for adults) or at 0.01-0.09 IU/ml only insufficient immunological protection (30% and 41%, respectively) against diphtheria and its toxic effects. But even among children up to 14 years of age, 28.5% are completely without and 20.5% without reliably protective antitoxic immunity, despite a high rate of immunization. There is thus a dangerously high epidemic potential of susceptible persons in the population of the Federal Republic of Germany. To erect a barrier of immunity against epidemic spread requires not only immunization of all children, but also re-immunization every five to six years, plus immunization of juveniles and young adults among a selected group with, at present, highest risk of infection. For this purpose there is a diphtheria toxoid of Behringwerke for adults with only 5 IU toxoid/0.5 ml, which, however, after single application produced an antitoxic immunity (greater than or equal to 0.1 IU/ml) in previously sensitized subjects (17 of 49). Of 32 primary seronegative persons 14 reacted to two injections, while a further 18 (36.7%) had no immune response within six weeks even after second injection. PMID- 6861653 TI - [Uterine bleeding in the elderly after long-term application of oestrogen containing hair lotion]. AB - Long-term use of a widely available oestrogen-containing hair lotion caused specific systemic oestrogen effects with proliferation of the endometrium in two patients aged 66 and 82 years. Uterine bleeding was the cardinal sign. These findings confirm the possible percutaneous absorption of externally applied oestrogen-containing substances. They probably also explain an oestrogen effect on uterine epithelium, which is not rarely seen during cancer-preventive gynaecological examination and has no other explanation. PMID- 6861654 TI - [Cholesterol content of bile-duct stones]. AB - The cholesterol content of bile-duct stones from 40 patients after cholecystectomy was compared with 22 gall-bladder stones. There were 18 (82%) cholesterol-rich stones (cholesterol content more than 60% of dry weight) among gall-bladder stones, but only 12 (30%) among bile-duct stones. Eight bile-duct stones (20%) contained fibrous material, a further seven (18%) had a cholesterol rich nucleus and cholesterol-poor outer layer. These findings indicate that residual fibres or small migrated gall-bladder stones can form the nidus for the growth of choledochal stones. The cholesterol content of bile-duct stones did not correlate with the age of the patient, time since cholecystectomy or cholesterol saturation of hepatic bile. PMID- 6861655 TI - [Local fibrinolysis therapy in subtotal stenosis of the median cerebral artery]. AB - In a 60-year-old female patient with clinical symptoms of progressive left-sided apoplexia and subtotal stenosis of the middle cerebral artery local fibrinolysis via a floating balloon catheter was successfully used for recanalisation of the vessel leading to marked clinical improvement. PMID- 6861656 TI - [Bronchopulmonary infiltrates in chronic inflammatory bowel disease]. AB - High temperatures, night sweat, chest pain, cough and dyspnoea suddenly occurred in a 54-year-old patient. The serious disease was accompanied by variable pulmonary infiltrations. Chemical pathology showed maximally increased sedimentation rates, slight leucocytosis and anaemia. Complete serology was negative. The occurrence of large intestinal ileus required laparatomy and after commencement of treatment with steroids the overall state improved, pulmonary symptoms disappeared, and radiographically demonstrable infiltration were clearly regressing. Histology revealed presence of acute ulcerative colitis. Lung infiltrates probably represented extraintestinal manifestation of the chronic inflammatory bowel disease. In contrast to experience from the literature lung infiltrations in this case preceded clinical manifestations of the underlying disease. PMID- 6861657 TI - [Diagnosis of the inverted nasal papilloma]. PMID- 6861659 TI - [Reduced incidence of the causes of death in chronic alcoholism]. PMID- 6861658 TI - [New concept of the origin of essential hypertension. Genetically conditioned salt sensitivity as a consequence of heightened noradrenergic sensitivity and heightened proximal sodium re-resorption]. PMID- 6861660 TI - Subchronic and reproductive toxicology studies on acrylic acid in the drinking water of the rat. AB - In the subchronic study acrylic acid was incorporated in the drinking water of Fischer 344 rats (15 per group) for three months at dosage levels of 0.75, 0.25, 0.083 or 0 g/kg/day. No deaths occurred during the study but several treatment related effects were observed. At 0.75 g/kg/day dosage level, body weight gain was reduced as were food and water consumption. Changes in organ weights and clinical chemistry parameters were observed along with increases in urine specific gravity and protein concentration. Similar, though less profound, changes occurred at 0.25 g/kg/day. At 0.083 g/kg/day, the only effect was a reduction of water consumption by male rats. There were no significant treatment related histopathologic changes. Many of the effects observed may have been the result of decreased water and food consumption rather than specific toxic effects of acrylic acid. In the reproduction study, the same dosages of acrylic acid were given to groups of 10 males and 20 females for 90 days after which the animals were mated. Treatment was continued throughout gestation and lactation. Treatment related effects included decreased body weight gain, and reduced food and water consumption in F0 rats at the 2 highest dosage levels. Organ weight changes occurred in both F0 and F1 animals and reduced body weight gain was seen in the F1 pups at the highest level. No statistically significant changes in reproductive indices were observed, perhaps because of an atypical control group. PMID- 6861661 TI - The toxicologic evaluation of marcellomycin--an antineoplastic anthracycline antibiotic. AB - Dose-related toxicologic effects of marcellomycin, an antineoplastic anthracycline antibiotic, were observed in single-dose studies in mice iv (43.05 67.65 mg/m2) and dogs iv (41.0-90.2 mg/m2), and in multiple-dose studies in dogs iv (9.8-29.6 mg/m2 2X/week for 6 weeks) and rats sc (9 weekly doses at 26.2-72.2 mg/m2). Toxicity was primarily manifested by suppression of myeloid tissue, especially the erythrocytic and thrombocytic series, and lymphoid tissues. Initially a neutrophilic leukocytosis was observed in dogs and rats, which was considered possibly to be due to mobilization of the marginal and bone marrow neutrophil pools. In dogs, this was followed by a marked, dose-related neutropenia; and, in rats that died, there was marked depletion of bone marrow cells. Other toxicities observed included enteropathy, severe subcutaneous serofibrinous inflammatory edema and necrosis at injection sites, prostate and seminal vesicle atrophy, uterine hypoplasia, testicular and pancreatic degeneration, thyroid follicular proliferation and hemorrhage in various organs. In general, these toxicities were reversible in surviving animals during recovery periods. Significant cardiotoxicity was not demonstrated. PMID- 6861662 TI - Developmental toxic effect after subcutaneous injections of methadone in Charles River CD-1 mice. AB - Four groups of Charles River CD-1 pregnant mouse dams were dosed subcutaneously daily with 5, 10, 20, and 28 mg/kg of methadone during day 6 to 15 of gestation. Prenatal and postnatal studies were conducted in the offspring and mouse dams. Caesarean sections were performed on some of the females from each group on day 19 of gestation and fetuses evaluated by routine teratologic methods. All females remaining were allowed to deliver, and several postnatal signs were recorded from the pups during the lactation period. Maternal mean body weight gains and food consumption were reduced. No apparent alteration in the food efficiency index was detected, thus maternal malnutrition may not have been a factor in producing adverse effects on offspring. The incidence of external and visceral malformations was neither dose-related nor significantly different from those of the controls. However, administration of methadone decreased ossification of the digits, sternum, and skull of the offspring. Adverse effects of methadone on reproduction were apparent at doses of 20 mg/kg/day and above, and characterized by an increase in resorptions and a decrease in the number of live fetuses per litter. Methadone was found not to be teratogenic to the CD-1 mice. However, adverse effects on intrauterine growth, fetal ossification, neonatal growth, development, and survival rate were seen among weaned pups. PMID- 6861664 TI - Ultrastructural characterization of lymphocytes in head and neck cancer. PMID- 6861663 TI - Hepatic polysubstrate monooxygenase activities in different strains of rats fed cabbage (Brassica oleracea). AB - Weanling male Fischer (F), Long-Evans (LE), and Sprague-Dawley (SD) rats were fed a semi-purified basal diet or a 20% cabbage diet for 3 and 4 weeks. Hepatic polysubstrate monooxygenase (PSM) activity was measured. Significant strain differences were found in aniline hydroxylase and p-nitrophenol O-demethylase activities. Aniline hydroxylase and NADPH cytochrome c reductase activities were significantly decreased in all strains after 4 weeks of cabbage dietary treatment. F and LE rats consuming the cabbage diets also had significantly reduced O-demethylase activity after 4 weeks. Except in LE, aminopyrine N demethylase activity tended to be elevated in the strains consuming the cabbage diets. Cabbage diets increased testes weight in SD and thyroid weights in LE rats. All strains showed decreased thymus weights in the cabbage dietary treatments. This study with rats shows that hepatic PSM activities, as well as some organ changes due to dietary cabbage are strain dependent. PMID- 6861665 TI - Sarcoidosis of the external nose. PMID- 6861666 TI - Nonendemic Burkitt's lymphoma. PMID- 6861667 TI - Thyroglossal cyst in the elderly patient. PMID- 6861669 TI - Management of head and neck cancer in general practice. PMID- 6861668 TI - Dental surgery's role in head and neck cancer management. PMID- 6861670 TI - Cancer therapy in the continuing care unit. PMID- 6861671 TI - Duties of the medical social worker in cancer treatment. PMID- 6861673 TI - The contribution of the community to the care of the cancer patient. PMID- 6861672 TI - Caring for the cancer patient: a friend's perspective. PMID- 6861674 TI - [Training needs for health and nutrition personnel in developing nations]. AB - This paper examines some of the factors related to the training of health and nutrition personnel in developing countries in general and in Latin America in particular. It addresses both professional and technical level staff responsible for the formulation of plans and programs, and auxiliary personnel responsible for the delivery of services. Using the systems analysis model, the need for training human resources in research techniques and decision-making on a scientific basis is taken as an example for a discussion of aspects of the diagnosis, planning, execution and evaluation of health and nutrition programs. Various ways are indicated of giving training in research techniques, using the personnel available and employing simple instructions and methods, currently under-used, such as gathering anthropometric data. The authors stress that if an effort were to be made in the countries, the risk factors influencing health and nutrition, particularly among the maternal-child group, might well be identified quickly and without great cost. The case of the height census in Costa Rica is reviewed as a practical example of programs that have originated in developing countries and that make maximum use of auxiliary personnel in obtaining reliable, valid information for decision-making purposes. This census included children in the first grade of the primary cycle at the national level. The contents of the tutorial training program of the Institute of Nutrition of Central America and Panama (INCAP) are also described. PMID- 6861675 TI - [The mission of the Pan American Health Organization]. PMID- 6861676 TI - [Training in psychiatry for health teams in Colombia]. AB - About 90% of the 40 million victims of mental disorders in the developing countries receive no treatment, and little progress is being made in this respect. This article examines the use of new strategies for solving the problem. It is obvious that the traditional methods of mental health care have been ineffective and that new programs should now be undertaken that can ensure proper service within the coming decades for those being neglected. Based on the results of a practical experiment carried out in Colombia, the authors, without making any definitive recommendations, point to the usefulness of training auxiliary staff of urban and rural health centers to work as a team (under the supervision of a physician or a graduate nurse) in the care and management of psychiatric patients. They enumerate the advantages offered by training programs on various aspects of mental health for general practitioners (who usually have little interest in psychiatry), psychiatry residents, nurses, and auxiliaries. PMID- 6861677 TI - [Training of human resources for medicine in the year 2000]. AB - During the 17 years that remain till the year 2000, by which it is aspired to have achieved the goal of Health for All, medical manpower training will have to be redesigned to meet the purposes of that goal and to prepare the health service team for the challenges that await it in that no longer so distant future. The writer analyzes the Region's demographic, socioeconomic, technological and health situations and trends, and the parts played by the physician and the health services, and comes to the conclusion that, in addition to rationalizing the utilization of resources, primary care involves a profound transformation of the physician's social function and working situation; in other words, that the function of the physician, how services are used, and the technologies to be applied will have to be redefined for the year 2000. In relation to the outlook for professional practice, the article stresses that, to provide primary care to the entire population, the health services will need multiskilled and multidisciplinary personnel and the full participation of the community, and the preponderant role will fall to the general practitioner. Accomplishing all this will require greater emphasis on training the general practitioner (or family doctor), though without neglecting the specialist, a thoroughgoing and independent review of the study programs of the Latin American medical schools carried out by themselves in a spirit of self-criticism with a view to arriving at their own solutions, and the promotion of a closer physician-patient relationship, in a manner consistent with the political and social structure of each country. PMID- 6861679 TI - [Epidemiology in clinical medicine]. AB - Today, epidemiology is no longer confined to the study of outbreaks of infectious contagious diseases, but is shifting its focus to the chronic-degenerative diseases, and it is becoming increasingly necessary to train the clinician to apply its principles and methods in his medical practice. In his argument to this effect, the writer stresses the importance of bedside clinical work as a means to discovery and to the confirmation--or refutation--of hypotheses propounded in the experimental laboratory and in public health studies. As the prescriber of procedures for diagnosis and treatment, the clinician, it is asserted, is better placed than the epidemiologist to provide guidance for the solution of salient health problems. While of value in clinical research and the choice and analysis of preventive and curative methods, clinical epidemiology is also important for elucidating the natural history and causative factors of diseases, determining the effectiveness of new procedures, assessing the benefits to be gained from them, and evaluating the efficiency of the very health services that make them available to the population. Giving the clinician a basic understanding of epidemiology as an analytical instrument for the selection of methods of diagnosis and treatment, it is maintained, is the way to enhance his capacity for critical evaluation. PMID- 6861678 TI - [Training of personnel for the goal of health for all in the year 2000 and primary care strategy: a methodologic proposal]. AB - As a result of health-related resolutions at world and regional level, the training of personnel to implement health activities has become a major factor in meeting the commitments assumed by the countries. The authors describe an alternative training methodology, beginning with an analysis of the problems to be addressed and setting forth some fundamental factors and basic premises to be considered as a prior step in the planning and execution of training activities. The need to fit the training to the particular functions and characteristics of the various staff levels is stressed, with special emphasis on the desirability of building the training around actual jobs and adapting it to the specific nature and characteristics of service in the national context of each country. It is important that this training be perceived as a continuous, ongoing process. With this in view, the authors suggest a number of ways of furthering the training of adults involved in the process, using these approaches as alternatives to the traditional modes, which are based on courses and seminars with a predetermined duration and accordingly create the impression that the education ends when the required number of hours and activities in the course have been completed. The ideas and opinions expressed in this article are validated at the end by a preliminary report on an experiment begun by the Community Health Training Program of Central America and Panama (PASCCAP), a joint activity of the Ministries of Health of the six area countries, that serves as a training facility of the Pan American Health Organization. Subsequent phases of the process will be the subject of later reports. PMID- 6861680 TI - [Meeting of the Assessment Committee of the Program of Education in Health Administration in Latin America and the Caribbean]. PMID- 6861683 TI - Motor reaction time and stereotyped pattern of the EMG activities in ballistic elbow extension. PMID- 6861682 TI - Diagnostic use of H-reflex from vastus medialis muscle. PMID- 6861681 TI - Single mother unit control and variations of recruitment order of motor units in human m' abductor pollicis brevis and m' interosseus dorsalis I. PMID- 6861684 TI - The diagnostic value of late responses in radiculopathies due to disc herniation. PMID- 6861686 TI - Electromyographic study of the bulbo-cavernosus muscle in women according to parity and during labor. PMID- 6861685 TI - Inhibition from radial group I afferents of H-reflex in wrist flexors. PMID- 6861687 TI - [Early electrophysiologic diagnosis of alcoholic polyneuritis]. PMID- 6861688 TI - EMG parameters changes in the effort pattern at various loads in diseased muscle. PMID- 6861689 TI - Interference electromyogram processing Part I: Influence of the motor unit action potential shape on the interference electromyogram spectra. PMID- 6861690 TI - Production of growth factor activity by cultured bovine calf anterior pituitary cells. AB - Primary cultures of bovine calf anterior pituitary cells were observed to proliferate for at least eight doublings in a serum-free defined medium without the addition of mitogens or hormones. Insulin caused minor increments both in the rate of proliferation of cells from a doubling time of 31 h to 26 h and in the saturation density from 1 X 10(5) to 1.4 X 10(5) cells/cm2. To determine whether the pituitary cells could secrete a growth factor, medium conditioned by the pituitary cells was tested for mitogenic activity. Conditioned medium caused a dose-dependent increase in 3T3 fibroblast DNA synthesis indicating that it contained the equivalent mitogenic activity of either 2.5 X 10(-9) M epidermal growth factor (EGF) or 250 ng/ml fibroblast growth factor (FGF). 3T3 cell proliferation was also stimulated to a greater extent by conditioned medium than by EGF or FGF. Y1 adrenal cortical tumor cells were also stimulated by conditioned medium to synthesize DNA and proliferate. The mitogenic activity in the conditioned medium was heat and acid stable unlike pituitary FGF. No EGF could be detected in the conditioned medium by a RIA using antimouse EGF serum and a RIA for multiplication-stimulating activity was also negative. None of the classical pituitary hormones were mitogenic under the test conditions indicating that the mitogenic activity could not be attributed to the known pituitary hormones. Although these results indicate that pituitary cells secrete a growth factor(s), its identity is not established. PMID- 6861691 TI - Specific estradiol binding in embryonic Mullerian ducts: a potential modulator of regression in the male and female chick. AB - The total content of putative estradiol-specific cytosolic type I and nuclear type I and II estradiol-specific binders was measured in 8- and 9-day-old male and female chick embryo Mullerian ducts. Cytosolic and nuclear type I estradiol specific binding levels were similar in males and females, and no significant differences were noted among right vs. left and 8-day-old vs. 9-day-old embryo Mullerian ducts. The levels of nuclear type I estradiol binder were consistently higher than the cytosolic type I binder, but this difference was not significant. Nuclear type II estradiol-specific binding, however, was significantly higher in the left Mullerian ducts of both male and female embryos. The significance of these findings in relation to the regression of Mullerian ducts in male and female chick embryos is discussed. PMID- 6861692 TI - Diethylstilbestrol metabolism by the fetal genital tract. AB - Oxidative metabolism of diethylstilbestrol (DES) was measured in both the male and female genital tracts of the fetal mouse in organ culture. The major oxidative metabolite formed was Z,Z-dienestrol, whose formation appeared to be time dependent in the isolated fetal genital tract of both sexes. This peroxidative metabolite, which has been previously linked to bioactivation of DES in adult target tissues, was not detected in the fetal liver cultures. In addition, fetal genital tracts were capable of O-methylation of DES. In fact, a new metabolite, 4'-O-methyl-DES, was formed in fetal genital tissues but not in liver cultures. On the other hand, conjugation of DES occurred extensively in the fetal liver and placenta but not in the fetal genital tissues; conjugated DES was found primarily in the media. Thus, the fetal genital tract, which is the primary target for the transplacental carcinogenicity of DES, has the capacity to metabolize this compound. PMID- 6861693 TI - Analysis of the effect of progesterone in vivo on estrogen receptor distribution in the rat anterior pituitary and hypothalamus. AB - An acute injection of estradiol is known to cause a rapid redistribution of estrogen receptors in responsive cells, measurable as depletion of the cytosol receptor content with accompanying accumulation in the nucleus. We have examined the effects of progesterone on this process in the anterior pituitary and hypothalamus using an animal model in which sensitivity to steroidal feedback control of gonadotropin secretion has been defined. Ovariectomized immature rats were administered low dose estrogen replacement for 4 days. On the morning of the fifth day, groups of animals were injected according to one of the following protocols: 1) vehicle alone; 2) 5 or 10 micrograms estradiol; and 3) 0.8 or 3.2 mg progesterone, followed 1 h later by vehicle or 5 or 10 micrograms estradiol. All animals were killed 1 h after estradiol (or vehicle) injection, and levels of cytosol and nuclear estrogen receptors were measured. The only change occasioned by progesterone treatment was a decrease in anterior pituitary nuclear estrogen receptor levels. At the 5-microgram dose of estradiol, 0.8 and 3.2 mg progesterone were equally effective in diminishing nuclear estrogen receptor binding. When 10 micrograms estradiol were used to cause receptor redistribution, only the higher 3.2-mg dose of progesterone significantly depressed nuclear receptor binding. If ovariectomized animals were maintained in the absence of estrogen replacement, progesterone at either the 0.8- or 3.2-mg dosage was completely ineffective in altering the patterns of estradiol-induced cytosol or nuclear estrogen receptor levels. The results demonstrate a tissue-specific inhibitory action of progesterone on estrogen-induced enhancement of nuclear estrogen receptor binding. This inhibition can be partially overcome by increasing the level of estrogen used to effect receptor redistribution. The requirement for maintenance of a background level of estrogen suggests that the inhibitory action of progesterone is mediated through progesterone receptor interactions. PMID- 6861694 TI - Identification of aromatase activity in rodent pituitary cell strains. AB - To date, biochemical evidence has been presented for hypophysial aromatization in only one species, a teleost fish, although the pituitary glands of several mammals have been reported to be aromatase negative. To reinvestigate this problem, established clonal strains of rodent pituitary cells (GH3, GH4C1, and AtT20/D16) were incubated at 37 C for 6-48 h in serum-less medium containing [7 3H]androstenedione. Radiolabeled metabolites were isolated by solvent extraction, thin layer chromatography, and phenolic partition. The authenticity of the estrogenic products in both cells and incubation medium was verified by methylation and recrystallization to constant specific activity. Measurement of androgen metabolites was also validated by recrystallization of selected samples. Authentic estrone and 17 beta-estradiol were identified in cultures of the two PRL- and GH-secreting clones, and there were strain differences in the quantity of estrogen produced (GH3 greater than GH4C1). Under the same conditions, aromatization was not detectable in the ACTH-secreting line (AtT20/D16). A time yield analysis of androgen metabolism in GH4C1 cells showed that aromatization was linear for 12 h after labeling, but that substrate was diverted mainly to 5 alpha-reducing pathways. Large amounts of highly polar metabolites accumulated 24 and 48 h after the addition of [3H]androgen, and subsequent hydrolysis revealed that these were sulfo- and glucuronoconjugates. The metabolic fate of estrogen in GH4C1 cultures was investigated indirectly by adding a radioinert estrone trap together with the radiolabeled androgen substrate and was also tested in separate cultures by adding [3H]estrone and [3H]estradiol directly. Although the two estrogens were interconverted, there was no evidence that formed or added estrogen was extensively metabolized or conjugated. We conclude that the expression of aromatase activity in hypophysial cells is not a property of all transformed lines but may be dictated by the secretory cell type. Although low relative to other metabolites, estrogen yields in cultured GH cells resemble production in primary cultures derived from other tissues known to be estrogen targets, including the hypothalamus. PMID- 6861696 TI - A study of the interaction between progesterone and membrane lipids. AB - The ability of progesterone to associate with phospholipid was examined in a model membrane system. Molecular interaction was assessed by measuring the enthalpy of the phase transition of dipalmitoylphosphatidylcholine liposomes by differential scanning calorimetry. The response was compared to cholesterol, a constituent of cellular membranes. Unlike cholesterol, progesterone caused minimal disruption of the phospholipid bilayer phase properties at concentrations ranging from 5-33 mol %. However, it interacted with the phospholipid to a greater degree when cholesterol was included in the liposomes. These results indicate that progesterone can intercalate into phospholipid bilayers containing cholesterol, and raise the prospect that there may be some diffusion of the hormone across the plasma membrane. PMID- 6861695 TI - Parathyroid function and magnesium depletion in the rat. AB - Hypocalcemia is characteristically observed in magnesium deficiency in a number of animal species. Previous studies demonstrated impaired release of PTH in magnesium-depleted hypocalcemic humans. However, an enigma remains in that, unlike in other animals, hypercalcemia, rather than hypocalcemia, accompanies magnesium deficiency in the rat. Because intact parathyroids are necessary for the development of this hypercalcemia, it has been postulated that magnesium depletion stimulates, rather than impairs, PTH secretion in the rat. In an effort to more directly evaluate this thesis, sequential measurements of circulating immunoreactive PTH (iPTH) were made over a 30-day period in rats maintained on a magnesium-deficient diet and in match-fed controls. In the control rats, serum calcium, magnesium, and iPTH remained relatively constant throughout the study. By contrast, during the first 4 days of a low magnesium diet, serum magnesium decreased to 1.0 mg/dl, serum calcium increased moderately, while serum iPTH increased to a mean level that was twice that in controls. After 5 days, when serum magnesium progressively fell to levels less than 0.6 mg/dl and serum calcium continued to rise, serum iPTH fell to levels significantly lower than the control value. In a second set of experiments, the effect of hypocalcemia on circulating iPTH in magnesium deficiency was evaluated. Circulating iPTH was greatly increased and not significantly different in magnesium-deficient and magnesium-replete animals who were rendered chronically hypocalcemic by diets deficient in either calcium or vitamin D. The results of this study indicate that: 1) in the rat, an increase in PTH secretion occurs early in the genesis of magnesium deficiency in the presence of a modest increase in serum calcium; however, the subsequent further increase in serum calcium counteracts the stimulatory effect of hypomagnesemia on PTH secretion; 2) unlike the human parathyroid gland, the rat parathyroid gland responds appropriately to both hypo- and hypercalcemia in magnesium deficiency; and 3) the hypercalcemia that occurs in the magnesium-deficient rat is not due to increased PTH secretion and must be accounted for by another mechanism. PMID- 6861697 TI - Inhibition of implantation and termination of pregnancy in the rat by a human chorionic gonadotropin antagonist. AB - Administration of varying doses (10-50 micrograms) of deglycosylated human CG (DG hCG) which was previously shown to be a potent hormonal antagonist in vitro, to pregnant rats inhibited implantation and terminated gestation. When administered between days 1-5 implantation was inhibited as seen on day 10. Serum progesterone levels were also suppressed. Similar doses administered between days 8 and 11 resulted in complete fetal resorption when examined on day 16. This was also accompanied by a dramatic reduction in serum progesterone. A dose of 50 micrograms DG-hCG given during the second half of pregnancy between days 13 and 16 had no deleterious effect on pregnancy including the day of parturition but the number of pups delivered was reduced by 26% as compared to 3% loss in control groups. It is concluded that DG-hCG can successfully antagonize hormone action in vivo by blockade of ovarian receptor sites for LH in the pregnant rat. PMID- 6861698 TI - Effects of dansyl-arginyl-(4'-ethyl)piperidine amide on gonadotropin binding to rat tissues. AB - The effects of dansyl-arginyl-(4'-ethyl)-piperidine amide (DAPA) on the binding of gonadotropins has been investigated. The compound inhibited the binding of hCG, human LH, and porcine LH to rat luteal membranes with an ED50 of 70 microM and the binding of human FSH to rat testicular membranes with an ED50 of 350 microM. Alteration of the substitution at the 4 carbon of the piperidine moiety altered the effect for hCG binding to luteal tissue, the ED50 being lowered with increased chain length (ED50 for H greater than methyl greater than ethyl greater than propyl = isobutyl) and shifted approximately half an order of magnitude for each carbon added. Analysis of equilibrium binding data for hCG to rat luteal membranes showed a decrease in the Ka with increasing DAPA concentrations (2.2 X 10(10), 1.0 X 10(10), and 0.4 X 10(10) M-1 for 0, 50, and 150 microM DAPA, respectively), with little or no effect on the number of sites. At a concentration of 50 microM, the compound did not affect the initial rate of association of the hormone and its receptor, but did change the dissociative behavior. After a short period of association, dissociation was followed in the absence and presence of DAPA. In all cases a biphasic dissociation was observed. The presence of DAPA slowed the rate constant for the fast phase (DAPA-treated, 4.7 X 10(-3) min-1; control, 7.6 X 10(-3) min-1) and reduced the fraction of total hCG undergoing the slow phase of dissociation (DAPA-treated, 60.6%; control, 77.4%). After a long period of association, the dissociation of hCG was monophasic, and the presence of DAPA increased the rate constant from 2.0 X 10( 4) to 4.4 X 10(-4) min-1. The results show that DAPA acted as an inhibitor of gonadotropin binding. The kinetic data suggest a sequential model of hormone binding in which the compound affected a step subsequent to the initial interaction. PMID- 6861699 TI - Suppression of cultured bovine adrenocortical zona glomerulosa cell aldosterone synthesis by steroids and its prevention by antioxidants. PMID- 6861700 TI - Testosterone-responsive mouse kidney glycosphingolipids: developmental and inbred strain effects. AB - Mouse kidney and urinary glycosphingolipids from developing C57BL/6J and adults of several other inbred strains were analyzed by high performance liquid chromatographic techniques. Glycosphingolipids from male and female C57BL/6J kidneys were similar until the fifth week of age. Galactosylceramide containing nonhydroxy fatty acids and galabiglycosylceramide containing nonhydroxy fatty acids first appeared in male kidneys, followed by an increase in galabiglycosylceramide containing hydroxy fatty acids. Galabiglycosylceramide was observed in male urine from the earliest collection period (26 days of age). At 5 weeks, globotriglycosylceramides were present in male urine, and by 6 weeks, they became the major glycolipid species. Analysis of the glycosphingolipids from adult male and female DBA/2J, CBA/J, C3H/HeJ, and AKR/J kidneys revealed that galactosylceramides and galabiglycosylceramides which contain nonhydroxy fatty acids were absent in all females and present in all males. The globotriglycosylceramides were elevated in male kidneys of all strains. Galabiglycosylceramides and globotriglycosylceramides were present in male urine of all strains. Each strain exhibited a characteristic pattern of urinary glycosphingolipids which varied not only in the different levels of di- and triglycosylceramides but also in the ratio of components that are distinguished by their fatty acid and long chain base composition. These data provide evidence that in several inbred strains of mice, testosterone induces the production of specific di- and triglycosylceramides, which are components of lysosomal organelles that are normally excreted in the urine. PMID- 6861701 TI - Studies of the biological effect and degradation of glucagon in the rat perifused isolated adipose cell. AB - The time relationships between glucagon-stimulated lipolysis and hormonal degradation are incompletely understood. These studies were designed to examine the rat adipocyte response to hormonal stimulation in the perifusion system. The perifused isolated adipocyte responded to glucagon concentrations as low as 10( 11) M, with maximum lipolysis at 10(-7) M glucagon. The lipolytic response corresponded in timing with exposure to glucagon. At lower concentrations, there was an appreciable lag between exposure to hormone and initiation of lipolytic response. Termination of response occurred with removal of hormone from the perifusion medium. The percentage of undegraded glucagon in the perifusate fractions (as determined by precipitability with trichloroacetic acid) remained above 80% until the point where free hormone was cleared from the system and lipolysis had ceased. The adipocytes continued to release both intact and degraded glucagon into the medium, the latter increasing with time. Release showed first order kinetics for both undegraded and degraded glucagon, with rate constants of 0.0656 +/- 0.0053 and 0.0716 +/- 0.0073 min-1, respectively. These perifusion studies provide a mechanism for assessing the time relationship between glucagon stimulation of lipolysis and its removal and degradation. Furthermore, the increased sensitivity of the fat cell to glucagon demonstrated herein with perifusion suggests that the importance of glucagon as a physiological regulator of lipolysis may have been underestimated by earlier researchers. PMID- 6861702 TI - Cleavage of parathyroid hormone to the 1-34 and 35-84 fragments by cathepsin D like activity in bovine parathyroid gland extracts. AB - We have obtained a crude enzyme preparation from bovine parathyroid gland homogenates which when incubated with PTH, cleaves the hormone into two major fragments. Isolation and chemical analysis has led to the identification of these peptides, the 1-34 fragment and the 35-84 fragment. Digestion of PTH was totally inhibited by the inclusion of the cathepsin D inhibitor, pepstatin, in the enzyme digest. A comparison of the digest obtained using the crude enzyme fraction vs. digestion of PTH by purified bovine cathepsin D led to the findings that the same peptide products were formed in each case. The natural 1-34 hormone fragment derived from the procedure has been determined to be fully biologically active in a bone resorption system. PMID- 6861703 TI - Progestin receptors in female rat brain and hypophysis in the development from fetal to postnatal stages. AB - The fetal and postnatal development of the progestin receptors in the intact female rat brain was investigated by means of the in vitro cytosol binding and the nuclear exchange assay using 3H-R5020 ([17 alpha-methyl-3H] 17 alpha-,21 dimethyl-19-nor-4,9-pregnadiene-3,20-dione). A large 7S peak of progestin binding in the cerebral cortical cytosols was observed at days 7-14 with less evident binding in the hypothalamus-preoptic area (HPOA). The cortical cytosol receptors, first detectable at day 0, rapidly increased at days 1-7, reaching a maximum at day 10, then gradually declined thereafter. The receptors in the HPOA and other brain areas appeared at day 1, increased during the first week, then remained constant at days 10-28. Hypophysial cytosol receptors, first detectable at day 10, increased at day 28. Nuclear progestin binding was low in the HPOA and cortex of the neonates at days 1-3. Interestingly, despite the low level of serum progesterone, the cortical nuclear binding suddenly increased at days 7-10, then remained high at days 14-21. A similar, though less pronounced, pattern was seen in the HPOA. Diethylstilbestrol injection caused an increase in the cytosol binding capacities in the HPOA, but did not in the cortex. These results suggest the appearance of the brain progestin receptor system immediately after birth, and differential patterns of their postnatal development in the intact female rat. The onset of increased nuclear translocation of endogenous progestin receptor complex may occur in the cortex, and possibly HPOA, at around days 7-10. Progestin receptors in the postnatal rat HPOA are estrogen inducible, but not in the cortex. PMID- 6861704 TI - The suppression of pineal melatonin content and N-acetyltransferase activity by different light irradiances in the Syrian hamster: a dose-response relationship. AB - The purpose of this study was to test the influence of various irradiances of cool white fluorescent light on the suppression of pineal N-acetyltransferase activity (NAT) and melatonin content in hamsters. Groups of animals were exposed to light irradiances ranging from 0.00-1.86 microwatts (microW)/cm2 for 20 min during the night. Both pineal NAT and melatonin were similarly depressed by the light irradiances in a dose-related manner. The shape of the resultant dose response curves and the calculated ED50 for NAT (0.066 microW/cm2) and melatonin (0.058 microW/cm2) were remarkably similar. These findings may be relevant to the physiological control of the pineal by natural illumination. PMID- 6861705 TI - Role of the pineal gland in ovine photoperiodism: regulation of seasonal breeding and negative feedback effects of estradiol upon luteinizing hormone secretion. AB - In this study we determined whether the pineal is required for the photoperiodic control of reproduction in ewes and, if so, whether its effect is mediated via negative feedback effects of estradiol on LH. Two groups of Suffolk ewes were pinealectomized and challenged with 90-day alternations between long (16 h of light, 8 h of darkness) and short (8 h of light, 16 h of darkness) photoperiods for 2 yr. One group of pinealectomized ewes had intact ovaries; the other was ovariectomized and implanted with estradiol to monitor feedback inhibition of LH. Reproductive effects of pinealectomy were correlated with elimination of the nighttime rise of serum melatonin. In pineal-intact control ewes, reproductive function was readily manipulated by photoperiod. Long days inhibited ovarian cyclicity and increased the negative feedback potency of estradiol regardless of time of year; short days had stimulatory effects on both variables. In most animals, pinealectomy abolished both the inductive effects of short days and the inhibitory effects of long days, and eliminated the nighttime rise in serum melatonin. Although seasonal changes in reproductive function persisted after pinealectomy, the timing of these changes coincided most closely with that of pineal-intact animals housed outdoors. With the passage of time after pinealectomy, however, these seasonal fluctuations became progressively damped. These results document pineal mediation of the photoperiodic control of seasonal breeding in ewes and indicate that the pineal exerts its effect, at least in part, by changing the capacity of estradiol to inhibit LH secretion. Furthermore, the pineal mediates the response to both stimulatory and inhibitory photoperiods. Finally, ewes that are unresponsive to photoperiod remain seasonal, either in response to other environmental cues or owing to the expression of an endogenous circannual rhythm of reproduction. PMID- 6861706 TI - Vasopressin-induced antinociception: an investigation into its physiological and hormonal basis. AB - Systemically administered lysine-8-vasopressin (LVP; 16-128 micrograms/kg) was found to induce a potent and dose-dependent antinociceptive effect, as measured by the tail-flick test in the rat. This effect could be seen in the absence of any significant change in general activity, indicating that it was not due to sedation or general motor debilitation. The antinociceptive effect of LVP does not appear to be mediated by endogenous opiates or other pituitary hormones, as evidenced by: 1) the lack of antagonism by the opiate receptor blocker naloxone, 2) the lack of cross-tolerance with morphine, and 3) its persistence after hypophysectomy. Des-glycinamide-LVP, a vasopressin analog with no appreciable pressor or antidiuretic action, showed no antinociceptive activity (128 micrograms/kg), and des-amino-arginine-vasopressin, a vasopressin analog with minimal pressor activity but greatly enhanced antidiuretic activity, was also relatively ineffective (128 micrograms/kg). These results suggest that the antinociceptive activity of vasopressin may be related to receptor types similar to those mediating its pressor effects. Nevertheless, the antinociceptive action of vasopressin does not appear to be secondary to its pressor activity, since phenylephrine failed to induce an antinociceptive effect at a dosage that mimicked the pressor response to vasopressin. These results are in concert with a growing body of evidence suggesting that vasopressin may be one of several nonopiate peptides that play a role in the modulation of pain sensitivity. PMID- 6861707 TI - Selective down-regulation of adrenergic receptor subtypes in tissues from rats with pheochromocytoma. AB - We have used an animal model of pheochromocytoma and radioligand-binding techniques to examine the effects of high levels of circulating norepinephrine and dopamine on adrenergic receptor subtypes in several peripheral tissues. New England Deaconess Hospital rats with transplanted pheochromocytomas were hypertensive and had levels of plasma norepinephrine and dopamine 50-fold greater than those of controls. The number of beta-adrenergic receptors in membranes prepared from the renal cortex and the left ventricle from these rats was decreased about 50%, but the animals had no significant decrease in the overall number of beta-adrenergic receptors in pulmonary membranes. beta-Receptor affinity was unaltered in animals with pheochromocytoma. Competition for [125I]iodocyanopindolol binding to beta-receptors by subtype-selective agents indicated a selective decrease of about 80% in the number of beta 1-adrenergic receptors in renal cortical and pulmonary membranes, without a decrease in beta 2 adrenergic receptor number. Rats with pheochromocytoma also had about a 70% decrease in the number of alpha 1-adrenergic receptors in membranes from renal cortex and lung, but no significant decrease in the number of alpha 1-adrenergic receptors in hepatic membranes and no decrease in the number of alpha 2 adrenergic receptors in renal cortical and hepatic membranes. These results indicate that rats in which pheochromocytomas are transplanted show adrenergic receptor subtype- and tissue-specific down-regulation. Although the selective down-regulation of alpha 1- and beta 1-adrenergic receptors may reflect a response to the preponderance of norepinephrine in these animals, the results indicate that different tissues and different adrenergic receptor subtypes may have varying susceptibility to down-regulation in response to increased circulating catecholamines in vivo. PMID- 6861708 TI - Mechanism of action of thioureylene antithyroid drugs in the rat: possible inactivation of thyroid peroxidase by propylthiouracil. AB - We have previously shown that the thioureylene antithyroid drugs 6-propyl-2 thiouracil (PTU) and 1-methyl-2-mercaptoimidazole (MMI) can inactivate thyroid peroxidase (TPO) in a model iodination system containing relatively high concentrations of iodide. The purpose of the present study was to determine whether these drugs may also inactivate TPO in vivo in rats. Assays for total TPO activity after injection of PTU or MMI did not prove to be a valid approach. As TPO inactivation might be expected to result in a relatively prolonged inhibition of enzyme activity, most of our experiments involved measurement of the duration of the inhibitory effect of a single injection of drug. Young rats were injected with low doses of PTU or MMI, and the effect on thyroidal organic iodine formation was determined at intervals after injection, either by 1-h pulse labeling with 131I- in vivo or by incubation of excised thyroid lobes in a medium containing 131I-. Results of both types of experiment demonstrated that the inhibitory effect of a small dose of PTU (1 mumol/100 g BW) was still very marked 17-18 h after injection. Moreover, an inhibitory effect of this small dose of PTU on the metabolism of [35S]MMI could also be demonstrated. Administration of MMI to rats, on the other hand, did not show the prolonged inhibitory effect observed with PTU. This is most likely attributable to the much lower thyroidal uptake of MMI than of PTU in rats. Intrathyroidal metabolism of [35S]PTU and [35S]MMI was also investigated. In contrast to the rapid disappearance of 35S from plasma, both drugs showed accumulation and retention of 35S in the thyroid. However, we obtained no evidence that thyroidal accumulation of PTU or one of its metabolites could explain the prolonged inhibitory effect of this drug. It seemed more likely that this was attributable to TPO inactivation. The clinical implications of our findings are discussed with relation to the dosage schedule commonly employed in the treatment of Graves' disease with antithyroid drugs. PMID- 6861709 TI - Effects of ouabain on [3H]ouabain binding, 86Rb uptake, cellular sodium and potassium, and parathyroid hormone secretion in dispersed bovine parathyroid cells. AB - We have compared the effects of the cardiac glycoside ouabain on [3H]ouabain binding, 86Rb uptake, cellular sodium and potassium, and PTH secretion in dispersed bovine parathyroid cells. [3H]ouabain binds reversibly to a single class of binding sites with an affinity of 6.1 X 10(-8) M and a binding capacity of 5.8 X 10(5) sites/cell. Ouabain also inhibits the uptake of 86Rb, an analog of K, by 90% with half-maximal inhibition at 7.2 X 10(-8) M. There is a concomitant, ouabain-induced increase in cellular sodium and a reduction in cellular potassium. The half-maximal effect on cellular monovalent cations takes place at 1.4 X 10(-7 M ouabain. Finally, ouabain causes a dose- and time-dependent inhibition of low calcium-stimulated PTH secretion. This inhibition does not require extracellular calcium; half-maximal inhibition occurs at 1.1 X 10(-7) M ouabain. These results show that dispersed bovine parathyroid cells contain abundant binding sites for ouabain, a known inhibitor of Na+-K+-ATPase. Moreover, the ouabain-induced reduction in 86Rb uptake and alterations in cellular sodium and potassium support an inhibition of this enzyme in parathyroid cells by the cardiac glycoside. Finally, the close correspondence between ouabain binding and effects on Rb uptake, cellular monovalent cations, and PTH release suggest a role for Na+-K+-ATPase per se or for monovalent cations in PTH secretion. A change in sodium-calcium exchange due to the elevation in cellular sodium is a potential mechanism by which ouabain might inhibit PTH secretion. PMID- 6861710 TI - Superfusion of normal and neoplastic mouse mammary tissue with estrogens. AB - Slices of normal mammary tissue from pregnant and lactating mice and slices of neoplastic (MXT) mouse mammary tissue were superfused with estradiol (E2) and estrone (E1) each labeled with a different isotope. Isotope concentrations in tissue and perfusate at the steady state were used to calculate fractions and rates of uptake, metabolism and release of estrogens by the tissue perfused. Both E2 and E1 entered equally well and were concentrated to the same extent by normal and neoplastic mammary tissue. However, much smaller tissue to medium ratios and larger diffusible fractions of estrogens were found in tumor slices as compared to mammary tissue from both pregnant and lactating mice, the uptake being the highest in pregnancy mammary glands. The interconversion between E1 and E2 was found to favor the formation of E2 in normal mammary tissue, the metabolic activity being the highest in lactating glands. In the MXT tumor slices the conversion of E1 into E2 was predominant as well but in contrast to the almost negligible metabolism of E2 in normal mammary tissue, a large fraction of E2 was converted into E1. The observed differences in estrogen uptake and metabolism between pregnant and lactating mammary glands were in concordance with the functional characteristics of the tissues. Furthermore, E1 was shown to play an important role in the mouse mammary gland as a metabolic precursor of E2. A different metabolic pattern was found in neoplastic mammary tissue. PMID- 6861711 TI - 3H-vasopressin binding to the rat mesenteric artery. AB - We investigated the binding of 3H-Arg8-vasopressin to membranes from rat mesenteric arteries. Specific binding of 3H-vasopressin was 60-75% of total binding. Binding at 22 C achieved a plateau at 30 min whereas at 4 C binding was significantly slower. Binding was reversible upon addition of 1 microM Arg8 vasopressin after 30 min of incubation. Scatchard analysis indicated a single class of high-affinity binding sites with an equilibrium dissociation constant of 5.1 +/- 0.6 nM and a total binding capacity of 91 +/- 12 fmol/mg protein. Competitive inhibition of 3H-Arg8-vasopressin binding showed an IC50 of 3 nM for Arg8-vasopressin, 14 nM for [I-(beta-mercapto-beta-beta-cyclopentamethylene propionic, 4-valine, 8-D-arginine]-vasopressin, 31 nM for oxytocin, 52 nM for I deamino-8-D-arginine-vasopressin, 0.1 microM for [I-deamino-penicillamine, 4 valine, 8-D-arginine]-vasopressin, and 0.8 microM for desglycinamide-deamino-Arg8 vasopressin. Unrelated peptides did not displace 3H-Arg8-vasopressin. We conclude that these binding sites possess characteristics of physiologically relevant vasopressin receptors in vascular smooth muscle of a resistance type vessel. PMID- 6861712 TI - Purification of an estrogen-regulated breast cancer protein by monoclonal antibody affinity chromatography. AB - An estrogen-regulated cytoplasmic protein has been purified from MCF-7 human breast cancer cells with anion exchange and monoclonal antibody affinity chromatographies. The purified protein has a monomeric mol wt of 28,000 and isoelectric species with pI's between 5.9 and 6.0. Amino acid analysis indicates the protein is acidic, is probably hydrophilic, and contains unusually low amounts of methionine and half cystine. This rapid, two-step procedure produces purified protein in high yield and demonstrates the power of monoclonal antibodies in protein purification. PMID- 6861713 TI - Effects of extracellular Ca++ and Mg++ on cytosolic Ca++ and PTH release in dispersed bovine parathyroid cells. AB - We studied the effects of varying extracellular concentrations of Ca++ and Mg++ on cytosolic Ca++ concentration and PTH release by incorporating the Ca++ sensitive, fluorescent dye "QUIN 2" into dispersed bovine parathyroid cells. Increasing extracellular Ca++ from 0.5 to 2.0 mM led to a dose-dependent increase in cytosolic Ca++ from 179 +/- 8 to 646 +/- 68 nM (mean +/- SE, N = 13; P less than 0.01), which correlated closely (r = -.987, P less than .001) with the suppression of PTH secretion by the same Ca++ concentrations. Raising extracellular Mg++ from 0.5 to 3 mM also caused a dose-related increase in cytosolic Ca++ from 176 +/- 10 to 277 +/- 15 nM (N = 12, P less than 0.01) which correlated (r = -.959, P less than .01) with inhibition of PTH release. These results show a close inverse relationship between cytosolic Ca++ and PTH release with alterations in extracellular Ca++ or Mg++. Cytosolic Ca++ may, therefore, act as a second messenger mediating the effects of these divalent cations on PTH release. PMID- 6861714 TI - Influence of shifts in dietary calcium on postprandial renal calcium excretion in thyroid-intact and thyroidectomized rats as affected by vitamin D deficiency. PMID- 6861715 TI - The inhibition of phosphatidylinositol turnover: a possible postreceptor mechanism for the prolactin secretion-inhibiting effect of dopamine. AB - We studied the association between the inhibition of phosphatidylinositol (PI) turnover and the inhibition of PRL secretion in the presence of dopamine. The incorporation of radiolabeled phosphate into anterior pituitary gland PI as well as serum PRL levels were significantly (P less than 0.01) greater in female than in male rats. No significant sex-related difference was found in the incorporation by pituitary tissue of 32P into phosphatidylcholine (PC) or phosphatidylethanolamine (PE). Dopamine decreased the incorporation of 32P into PI, but not into PC or PE, by female rat pituitary glands; this effect was reversed by two dopamine receptor-blocking agents, haloperidol and pimozide. After dopamine was removed from the incubation medium, basal 32P incorporation into PI was restored within 10 min. The administration of bromocriptine (500 micrograms/kg, ip, 4 h earlier) significantly reduced pituitary PI turnover. Conversely, in vivo injection of alpha-methyl-p-tyrosine (alpha MpT; 200 mg, ip, 2.5 h before death), an inhibitor of catecholamine biosynthesis, dramatically increased serum PRL levels. In vitro incorporation of 32P into PI, but not into PC or PE, increased (+130%) when these glands were incubated for 30 min with radiolabeled phosphate. The in vitro addition of 0.5 microM dopamine to glands from alpha MpT-treated rats counteracted the stimulation of 32P incorporation into PI produced by alph MpT treatment. In rats bearing the transplantable PRL secreting tumor MtTW15, the hyperprolactinemia produced by the tumor stimulates hypothalamic turnover of dopamine, with a consequent inhibition of pituitary gland PRL secretion. 32P incorporation into PI, but not into PC or PE, was significantly (P less than 0.01) inhibited (-41%) in pituitary glands from these rats. The injection of alpha MpT (200 mg/kg, ip) or haloperidol (2 mg/kg, ip) 12 and 3 h before death into MtTW15 tumor-bearing rats abolished the inhibition of 32P incorporation into pituitary PI. Dopamine also decreased PI turnover in the 7315a PRL-secreting pituitary tumor. Our data indicate that the PI cycle may be an intracellular mechanism controlling PRL release in the rat and that the changes in its cleavage and turnover may be an early postreceptor event responsible for the inhibition of PRL secretion produced by factors such as dopamine. PMID- 6861717 TI - Melatonin-induced increase in cytoplasmic estrogen receptor activity in hamster uteri. AB - The pineal gland hormone, melatonin, has been shown to influence the growth and metabolism of uterine tissue in the Syrian hamster. Because the uterus is an estrogen-responsive target tissue, we studied the effect of melatonin on the unoccupied estrogen receptor (ER) activity of immature hamster uteri in vivo and in vitro. A single sc injection of 2.5 micrograms melatonin increased the ER activity of uterine cytosol (Rc) 30% within 60 min [from 147.4 +/- 14.1 (SE), to 191.8 +/- 18.5 fmol/mg protein]. Scatchard analysis showed the induced population of receptor to be homogeneous and of high affinity, with an equilibrium dissociation constant (Kd = 0.08 nM) similar to that for uteri for vehicle treated animals. The induction of Rc by melatonin persisted for 90 min, but Rc returned to control levels by 2 h after injection. Scatchard analysis of unoccupied nuclear receptor showed no significant differences either in the quantity of receptor (vehicle = 379.7 +/- 46.7, melatonin = 396.9 +/- 76.7 fmol/mg protein) or in the Kd (vehicle = 0.75 nM, melatonin = 0.60 nM) between these two groups. In vitro incubation of fresh whole uteri for 60 min in media containing 10(-5) M melatonin increased Rc by 83% (from 41.3 +/- 10.7 to 75.4 +/- 11.0 fmol/mg protein), supporting a direct effect of melatonin on uterine tissue. The Rc induced by melatonin both in vivo and in vitro was sensitive to the degree of homogenization used in preparation of the cytosol. Whereas conservative homogenization (two 10-sec bursts with an intermittent 40-sec cooling period) of uteri from melatonin-treated animals was associated with a significant increase in Rc, homogenization for 60 sec without intermittent cooling showed a significant decrease (from 251.1 +/- 17.4 to 182.7 +/- 5.8 fmol/mg protein) as compared with uteri from vehicle-treated animals. Whole organ analysis of uteri from animals injected with melatonin followed by [3H]estradiol, in which no homogenization was used, demonstrated a 26% increase in Rc specific binding, confirming induction as the primary response to melatonin. These findings demonstrate the ability of melatonin to modulate ER activity in hamster uteri, and may help explain the effects of melatonin on uterine growth and metabolism. PMID- 6861719 TI - Morphologic and phenotypic analysis of an outcross line of blotchy mouse. AB - Blotchy is an X-linked recessive mutation at the "Mottled" locus in the mouse. The affected blotchy male (Blo/Y) mouse from an inbred genetic background demonstrates morphologic and physiologic abnormalities consistent with emphysema in adult life. Breeding of Blo/Y mice has been difficult because the inbred Blo/Y males are sterile. We report the successful development of a line of outbred Blo/Y male and Blo/Blo female nice by the controlled outcross mating of the inbred heterozygous Blo/+ female with the Argonne hybrid B6CF1 male mouse. The subsequent outcross Blo/Y progeny breed vigorously with the outcrossed Blo/+ female. The lungs of the outbred Blo/Blo female and inbred Blo/Y male mice demonstrate mild to moderate panacinar emphysema with a significant decrease in internal surface area (p less than 0.005) and an increase in mean linear intercept (p less than 0.005). In contrast, the lungs of the outbred Blo/Y is structurally normal. Despite the absence of emphysema-like changes in the outbred Blo/Y males, there were phenotypic features that suggest inherited abnormalities in connective tissue proteins including 1) high incidence of aortitis leading to premature death from aneurysmal rupture, and 2) significant decrease in the morphometrically determined parenchymal elastic fiber length in the lung (p less than 0.01). The outbred blotchy strain may be a useful experimental animal model in determining the pathogenesis of emphysema. PMID- 6861718 TI - Changes in ribonucleic acid polymerase activities in gonadotropin-treated Leydig cells: an estradiol-mediated process. AB - The effects of desensitizing doses of hCG on the activities of Leydig cell DNA dependent RNA polymerases I, II, and III were investigated after optimization of the enzyme assay. Individual activities were obtained by taking advantage of their different sensitivities to alpha-amanitin. RNA polymerase III was a minor component of the alpha-amanitin-resistant activity at 0.10 micrograms/ml, and was therefore measured together with RNA polymerase I. In adult rats treated with 10 micrograms hCG, sc, RNA polymerases II and I plus III activities of Leydig cells rose within 45 min to 180 +/- 6% and 162 +/- 2% of the control value, and then decreased to control values at 60 min. The initial stimulation of polymerase activities was coincident with maximal increases in testosterone and estradiol levels in plasma. A second and more sustained increase in polymerases II and I plus III activities occurred between 12 and 24 h (212 +/- 12% and 180 +/- 10% of the control value) and was maintained until 48 h after hCG injection. The hCG induced rise in polymerase activities was due to activation of the enzymes, since chromatin template capacity was unaltered. In animals treated with the antiestrogen tamoxifen, stimulation of RNA polymerase activity by hCG was completely inhibited. Also, hCG did not stimulate polymerase activity in animals treated with aminoglutethimide, which blocks steroid synthesis from cholesterol, or in those treated with adrostatriendione, which inhibits aromatization of testosterone leading to estradiol. Increases in RNA polymerase activities were also achieved by the administration of lower doses of hCG (0.1 and 1 micrograms) and the administration of estradiol (2 micrograms), resembling the pattern seen with 10 micrograms hCG. These studies have indicated that the hCG-induced RNA polymerase activation in the Leydig cell is mediated through nuclear actions of estradiol, since stimulation of the enzymes was prevented by tamoxifen and inhibition of steroid biosynthesis, and was induced by estradiol administration. PMID- 6861716 TI - Hypothalamic integration of dopaminergic and opiate pathways controlling vasopressin secretion. AB - Lesions of the circumventricular organs were produced by administration of monosodium-L-glutamate to neonatal rats. At 16 weeks of age these rats were given different stimuli to vasopressin release. In control rats, morphine (50 micrograms) injected into the third ventricle resulted in a rapid increase in plasma vasopressin concentrations at 10 min, followed by a reduction at 20 min. The circumventricular organ-lesioned rats, however, showed a pronounced fall in vasopressin secretion both at 10 and 20 min after 50 micrograms morphine. A similar abolition of the morphine-elicited rise in plasma vasopressin could also be achieved by the iv infusion of small doses of dopamine in normal rats. Hypoxic stimuli, which result in a marked rise in vasopressin in normal rats, failed to elicit any increase in circumventricular organ-lesioned animals. Vasopressin release after stimulation with 9% saline, however, was augmented in the lesioned animals. These results suggest that circumventricular organs have an important role in controlling neurohypophyseal secretion and that they differentially control different stimuli to vasopressin release via dopaminergic and opiate pathways. PMID- 6861720 TI - The pleura: a combined light microscopic, scanning, and transmission electron microscopic study in the sheep. I. Normal pleura. AB - The structural features of the ovine pleura are described using light, scanning, and transmission electron microscopy. Extensive sampling of the visceral and parietal pleura revealed considerable variation in both surface morphology and pleural interstitial anatomy. Variations of mesothelial surface were encountered and these were due to microvillar density and length. The pleural interstitium varied considerably in thickness, being relatively sparse in the anterior lung lobes, where respiratory excursion is least, and much more robust in the caudal lung lobes, where respiratory excursion is greatest. A similar correlation was observed with regard to the abundance and extent of the elastic meshwork embedded in the interstitium. The parietal pleura had openings which connected directly with the lymphatics in the underlying interstitium, thus forming a direct channel between the pleural cavity and the lymphatic system. PMID- 6861722 TI - Tradescantia-Micronucleus (Trad-MCN) test on the genotoxicity of malathion. AB - The Tradescantia-Micronucleus (Trad-MCN) bioassay was utilized to determine the genotoxicity of Malathion, a common insecticide. Four different treatment procedures were applied: a) absorption of Malathion/water mixture (with or without DMSO and/or S-9) through the stem, b) spraying a Malathion/water mixture onto the plant cuttings in enclosed chambers, c) spraying a Malathion/water mixture on an open population of plants in the greenhouse, and d) absorption of Malathion fumes through the leaves and buds. Most treatments were administered for 6 hr, followed by a 24-hr recovery time. Slides were prepared from the samples and scored for micronucleus (MCN) frequencies. Results of 16 experiments indicated that the genotoxicity of liquid Malathion absorbed through the stem was very low and often masked by high toxicity, causing dead cells in the stem, leaves, and meiocytes. Malathion spray at the dosage of 0.435% in an enclosed chamber or on an open population of plants yielded negative responses. Malathion fumes at dosages of 0.15-0.25% induced significantly higher (0.05) MCN frequencies above the controls and altered the nuclear structure to form unequal sized nuclei and multiple breaks in each of the four cells of a tetrads. It also caused degeneration of nuclei, "protrusions on nuclei," and inhibition of cell growth. Higher dosages (above 0.25%) were toxic. PMID- 6861724 TI - The detection of viable heritable translocations by chromosome banding procedures. AB - Ethyl methanesulfonate was tested for its ability to induce viable heritable translocations in progeny of male rats given a single IP injection prior to breeding. Reproductively competent Wistar rats were used as the test animals. Males were treated with either 75 or 150 mg/kg EMS or vehicle control. Neonates were used for primary tissue culture; the fibroblasts were harvested for cytogenetic analysis of chromosomes banded by Giemsa banding procedures. Since the cells examined were somatic cells, it was necessary to karyotype only two to three per neonate to ascertain inherited translocations. A reduction in fertility was observed in males treated with EMS. A statistically significant (p less than 0.05) dose-related increase in heritable translocations was observed in the F1 generation of treated animals. PMID- 6861721 TI - Delayed pulmonary phosphatidylglycerol synthesis and reversal by prenatal dexamethasone in fetal rats of streptozotocin-diabetic mothers. AB - Lung slices from fetal rats of streptozotocin-diabetic mothers incorporated [3H]glycerol and [3H]choline into phosphatidylglycerol and disaturated phosphatidylcholine, respectively. When compared to age-matched fetuses from nondiabetic mothers, lung phosphatidylglycerol synthesis of 21-day fetuses of diabetic mothers was significantly diminished, although [3H]glycerol incorporation into other phospholipids was not impaired. Synthesis of disaturated phosphatidylcholine was not diminished in lungs of 20-, 21-, or 22-day fetuses of diabetic mothers. Prenatal dexamethasone partially reversed the diminished phosphatidylglycerol synthesis at 21 days of gestation; the degree of stimulation was the same as that seen in 21-day fetuses of normal mothers but the maximal rate of [3H]glycerol incorporation was about 60% of that in 21-day fetuses of normal mothers. Fetal lung disaturated phosphatidylcholine synthesis was not stimulated by dexamethasone in diabetic pregnancies, in contrast to that seen in nondiabetic pregnancies. These data suggest that maternal diabetes interferes with the ability of fetal lungs to synthesize phosphatidylglycerol, a finding consistent with the delayed appearance of phosphatidylglycerol in the amniotic fluid of human diabetic pregnancies. In addition, maternal diabetes impairs the responsiveness of disaturated phosphatidylcholine synthesis to dexamethasone. Since phosphatidylglycerol synthesis is enhanced by prenatal dexamethasone, this therapy may still be effective for reducing the adverse impact of maternal diabetes on fetal lung development. PMID- 6861725 TI - Review: putative mutagens and carcinogens in foods. II: sorbate and sorbate nitrite interactions. AB - Sorbic acid and potassium sorbate are widely used Generally Recognized as Safe (GRAS) food additives with an extremely high (25 mg/kg) acceptable daily intake level. Some children between the ages of 6-24 months may actually ingest this amount. While presently not permitted to be added directly to meat and poultry products in the US, potassium sorbate has been proposed as a preservative for bacon, as an additive in conjunction with nitrite and ascorbate or erythorbate. Sorbate and nitrite form several species of direct-acting mutagens and genotoxic agents when present together at pH's mimicking gastric conditions. Two of the mutagens have been identified as ethylnitrolic acid and 1,4-dinitro-2 methylpyrrole. Mutagen formation is blocked by ascorbate at low pH. Ascorbate at eightfold molar excess leads to inactivation of 1,4-dinitro-2-methylpyrrole near neutral pH but does not destroy the mutagenic nitro compound at low pHs. The combination of sorbate with nitrite represents a potential health risk in the absence of adequate inactivating levels of ascorbate (vitamin C). PMID- 6861727 TI - Operator's activities at CRT terminals: a behavioural approach. PMID- 6861728 TI - A physiological assessment of the rolling crutch. PMID- 6861726 TI - Cytogenetic evaluation of di-(2-ethylhexyl)phthalate and its major metabolites in Fischer 344 rats. AB - Di-(2-ethylhexyl)phthalate (DEHP) and its two major metabolites, mono-(2 ethylhexyl)phthalate (MEHP) and 2-ethylhexanol (EH), were evaluated for their ability to induce chromosomal damage in male Fischer 344 rats after oral administration. Dose levels, the highest of which represents one-tenth of the five-day LD50, were based on a preliminary five-day dose-finding study for each test material. The dose levels selected were 5.0, 1.7, and 0.5 ml/kg/day for DEHP; 0.14, 0.05 and 0.01 ml/kg/day for MEHP; and 0.21, 0.07 and 0.02 ml/kg/day for EH. All test materials and vehicle control (corn oil) were administered by gavage for five consecutive days. A triethylenemelamine (TEM)-positive control group received a single intraperitoneal injection of 0.5 mg/kg TEM one day prior to sacrifice. Of the 50 metaphase bone marrow cells examined from each animal, no significant increase in chromatid and chromosome breaks or structural rearrangements were noted for DEHP, MEHP, and EH. In addition, the mitotic index, determined from 100 cells per animal, was unaffected by DEHP, MEHP, or EH. The results of this investigation indicate that DEHP, MEHP, and EH, at these dose levels, did not induce detectable chromosomal aberrations after oral administration. PMID- 6861729 TI - A study of red and white light on the chart table for navigation at sea. PMID- 6861723 TI - Mutagens: some possible health impacts beyond carcinogenesis. AB - Considerable attention is currently being given to the roles of environmental and endogenous mutagens in tumor induction and in tumor progression through the abilities of mutagens to induce one or another kind of somatic mutation. It is proposed here that mutagens, also through induction of somatic mutations, initiate a spectrum of additional, much more common, focal lesions that are important to the human condition. While individually they are of relative insignificance and thus neglected by many clinicians, the functional attributes of these focal lesions have important impacts on human physiology and thus contribute substantially to the process of aging. Additionally, one individual focus may progress to an extent that it produces clinically recognizable symptoms and may even jeopardize the carrier's life. The ultimate and developed expression of these lesions is heterogeneous, is far removed in time from initial induction, and relies on additional host and environmental factors for expression; therefore, the possible role of somatic mutation is readily overlooked. The focal lesions reviewed are fibrous atherosclerotic plaques, senile cataracts, and metaplasias. Literature that implicates metaplasias as precursor or as predisposing lesions in the ultimate formation of gallstones, duodenal ulcers, and adenocarcinomas is summarized. PMID- 6861731 TI - A study of energy expenditure during manual and machine washing of clothes in India. PMID- 6861730 TI - A Trimix saturation dive to 660 m. Studies of cognitive performance, mood and sleep quality. PMID- 6861733 TI - Digitech: a microcomputer-digitizer facility for automated testing of motor performance during discrete positioning movements. PMID- 6861732 TI - A calculation and interference test apparatus for the simulation of mental stress. PMID- 6861736 TI - Isolation and identification of Yersinia enterocolitica requires incubation temperatures below 37 degrees C. PMID- 6861734 TI - Latex agglutination test for detection of Candida antigen in patients with disseminated disease. AB - A latex agglutination test has been devised which allows detection of a circulating antigen in patients with systemic infection due to Candida albicans, Candida tropicalis and Candida parapsilosis. Latex is sensitized with serum from rabbits immunized with whole heat killed Candida albicans blastoconidia. The active component of this serum is IgG. Control latex, used to differentiate non specific agglutination, is sensitized with the same dilution of serum from a rabbit without antibody to Candida species. Sera from a number of patient groups were tested. While none of the hundred normal controls had an antigen titer of greater than or equal to 1:4, 30 of 33 patients with documented disseminated candida infection had antigen titers of 1:4 to 1:32. Two of the 33 gave false negative results, and one caused nonspecific agglutination. In all patients who recovered after antifungal therapy antigen levels returned to within the range found in normal controls. PMID- 6861735 TI - Intestinal occurrence of Campylobacter jejuni in a French hospitalized population. PMID- 6861737 TI - Virulence of stock cultures of Staphylococcus aureus 248 beta H in poor soft nutrient agar. PMID- 6861738 TI - Perspectives and controversies in the prevention of infection in granulocytopenic patients. PMID- 6861740 TI - Salt-induced conformational transitions in chromatin. A flow linear dichroism study. AB - The chromatin structure in solution has been studied by the flow linear dichroism method (LD) in a wide range of ionic strengths. It is found that increasing the ionic strength from 0.25 mM Na2EDTA, pH 7.0 to 100 mM NaCl leads to a strong reduction of the LD amplitude of chromatin and inversion of the LD sign from negative to positive at 2 mM NaCl. Chromatin exhibits a positive LD maximum value at 10-20 mM NaCl. These data enable us to conclude that in very low ionic strength (0.25 mM Na2EDTA) the nucleosome discs are oriented with their flat faces more or less parallel to the chromatin filament axis. Increasing ionic strength up to 20 mM NaCl leads to reorientation of the nucleosome discs and to formation of chromatin structures with nucleosome flat faces inclined to the fibril axis. A conformational transition of that kind is not revealed in H1 depleted chromatin. The condensation of the chromatin filaments with increasing concentration of NaCl from 20 mM to 100 mM slightly influences the orientation of the nucleosomes. PMID- 6861739 TI - The diagnosis and treatment of toxoplasmosis. PMID- 6861741 TI - 9,10-Dihydrophenanthrenes as phytoalexins of Orchidaceae. Biosynthetic studies in vitro and in vivo proving the route from L-phenylalanine to dihydro-m-coumaric acid, dihydrostilbene and dihydrophenanthrenes. AB - Hydroxy derivatives of 9,10-dihydrophenanthrenes, orchinol and hircinol, were isolated from bulbs of Orchidaceae which had been induced to accumulate phytoalexins. Incorporation of radioactive precursors, L-phenylalanine and various hydroxycinnamic acids, has been investigated by feeding experiments in vivo. m-Coumaric acid and dihydro-m-coumaric acid were found to be efficiently incorporated into the dihydrophenanthrene derivatives. Dihydro-m-coumaric acid was not only converted into the dihydrophenanthrenes but was also formed from L phenylalanine in the same tissue; it was thus proved to be an intermediate. The role of dihydro-m-coumaric acid was substantiated by studies in vitro. An active stilbene synthase was detected in enzyme preparations from induced orchid bulbs and assayed with different CoA esters. The enzyme, characterized on the basis of its substrate specificity, selectively converted dihydro-m-coumaroyl-CoA plus malonyl-CoA into 3,3',5-trihydroxybibenzyl. The role of 3,3',5-trihydroxybibenzyl as physiological intermediate was further corroborated by investigations with intact plants. Both its formation from phenylpropanoids and its conversion into orchinol was demonstrated. The data provided evidence for a biosynthetic sequence originating from L-phenylalanine and leading to 9,10-dihydrophenanthrenes via m coumaric acid, dihydro-m-coumaric acid, and 3,3',5-trihydroxybibenzyl. PMID- 6861742 TI - A simple model for studies on the regulation of cholesterol synthesis using freshly isolated hepatocytes. AB - Rat hepatocytes isolated by the procedure described here showed 3-hydroxy-3 methylglutaryl-CoA reductase activity in the range of that reported for rat liver at the maximum of the circadian cycle, even if they were taken from rats at the time of the minimum. The enzyme was present in cells as both its active dephosphorylated (20 +/- 8%) and the inactive phosphorylated forms. The enzyme activity and the ratio between the two forms were unaltered during 3 h of cell incubation. 25-Hydroxycholesterol (50 microM) induced about 50% inhibition of 3 hydroxy-3-methylglutaryl-CoA reductase activity during 1 h incubation but the relative amount of the two forms was not modified by the sterol. Cells isolated by the described procedure may therefore be a useful tool in studies on the regulation of cholesterol neogenesis, both through the synthesis of the enzyme, which can be shown by measuring the activity after complete dephosphorylation of the enzyme, and via the rapid reversible shift of the inactive to the active form, resulting from the ratio between the two enzyme forms. The latter mechanism for the modulation of cholesterol synthesis cannot be tested in cell cultures because full activation of the enzyme occurs during hepatocyte plating. PMID- 6861743 TI - Ca2+ and Mg2+-dependent complex formation of tropomyosin with phosphotroponin (P1TI2C) or dephosphotroponin (TI2C). AB - The reduced viscosity of troponin and dephosphotroponin is independent of the protein concentration in both states, either metal-free or with troponin C saturated with Ca2+ or Mg2+; that of tropomyosin increases linearly as function of the protein concentration, indicating aggregation. Addition of troponin to tropomyosin increases the reduced viscosity over the expected value being maximal at a 1:1 molar ratio of both proteins. The reduced viscosity of a 1:1 molar mixture of phosphotroponin-Mg4 or dephosphotroponin-Mg3 increases in two phases as function of the total protein concentration, indicating the formation of two kinds of troponin-tropomyosin complexes. In the first phase, troponin and tropomyosin form a non-aggregating 1:1 complex, which is characterized by a value of 0.45 dl/g for the intrinsic viscosity and a sedimentation coefficient of 3.6 S. Employing these two values a molecular weight of 150 000 can be calculated, which is in the range of the sum of molecular weights for troponin and tropomyosin (156 000). In the second phase the troponin-tropomyosin complex aggregates further, a process described by:n (troponin-tropomyosin) leads to (troponin-tropomyosin)n. This further aggregation occurs upon saturation of the Ca2+-specific sites in troponin C. A model is discussed which explains the shortening of 1.5 nm per tropomyosin molecule upon the shift of tropomyosin from the periphery into the groove of the actin filament by tropomyosin aggregation. PMID- 6861744 TI - Polymorphism of alpha-actinin. Electrophoretic and immunological studies of rabbit skeletal muscle alpha-actinins. AB - Heterogeneity of alpha-actinins from rabbit skeletal muscles was studied. Polyacrylamide gel electrophoresis in the presence and absence of sodium dodecyl sulfate has made it possible to distinguish two closely related alpha-actinins from rabbit fast, white muscle. One isoprotein (designated type I alpha-actinin) appears to be preferentially located in the psoas muscle, while the other (designated type II alpha-actinin) appears to be preferentially located in the longissimus dorsi muscle. Electrophoretic analyses have further shown that the two isoproteins are present as mixtures in most rabbit white, fast-twitch muscles. A standard polyacrylamide gel--sodium dodecyl sulfate/polyacrylamide gel sequential electrophoretic procedure was developed to resolve the different alpha actinin dimers and to determine their subunit compositions. By this technique, both type I and type II alpha-actinins appeared to be homodimers. No heterodimeric species of alpha-actinin were detected. alpha-Actinin of red, slow twitch muscles was similar to type II alpha-actinin of fast, white muscle on one dimensional and two dimensional gels. However, slow, red muscle alpha-actinin was significantly different from fast, white muscle alpha-actinins in terms of one dimensional peptide mapping and immunological cross-reactivity. PMID- 6861745 TI - Metabolism of N8-monoacetylspermidine in rat hepatoma cells. Investigation of its effect on the activity of L-ornithine decarboxylase. AB - Recent evidence has indicated a role for the acetyl derivatives of polyamines, particularly N8-monoacetylspermidine, as activators of L-ornithine decarboxylase in rat hepatoma tissue culture (HTC) cells. This is in contrast with the well described negative regulatory control of ornithine decarboxylase exerted by their non-acetylated counterparts. Because of the possibility of a rapid extracellular and intracellular catabolism of the acetyl derivatives of polyamines, the metabolism of N8-monoacetylspermidine and its effect on HTC cell ornithine decarboxylase have been investigated, under conditions which eliminate its extracellular catabolism. Differing from previous reports, we demonstrate that N8 monoacetylspermidine does not elevate ornithine decarboxylase activity when added at low concentrations to the culture medium of HTC cells. Higher concentrations decrease ornithine decarboxylase activity in a dose-dependent manner. This effect cannot be unambiguously attributed to the effect of the acetyl derivative itself, because of the presence in situ of a very active N8-monoacetylspermidine deacetylase, which generates spermidine intracellularly. PMID- 6861746 TI - The amino-acid sequence of a purothionin from Triticum monococcum, a diploid wheat. AB - Purothionins were extracted and purified from the diploid wheat Triticum monococcum. Two proteins were obtained, one of which was present in only very small amounts. The major purothionin of T. monococcum was sequenced and it had an amino acid sequence identical with that of the beta-purothionin of Triticum aestivum (hexaploid bread wheat). It is known that T. monococcum contains the wheat A genome, so the structural gene coding for the beta-purothionin must comprise a part of the A genome. There have been no observable (as amino acid replacements) changes in the DNA comprising either the beta-purothionin gene of T. aestivum or the purothionin gene of T. monococcum, since T. monococcum (or its wild equivalent, Triticum boeoticum) hybridized with the diploid wheat B genome progenitor and started the evolution from diploid to allohexaploid wheat. All of the investigated characteristics of the purothionin-like protein isolated in small amounts suggested that it was essentially identical in amino acid sequence with the T. monococcum purothionin. It may be a dimerized form of beta purothionin. PMID- 6861747 TI - The precursor of rat liver mitochondrial glutamate dehydrogenase has enzymatic activity. AB - The cytosolic precursor for the mitochondrial glutamate dehydrogenase of rat liver was synthesized in a cell-free reticulocyte lysate using messenger RNA from rat liver. To check whether this precursor had enzymatic activity, a highly sensitive fluorimetric method, which can measure picogram quantities of enzyme, was used together with competitive dissociation of the precursor from an immunoprecipitate with inactive glutamate dehydrogenase. Glutamate dehydrogenase activity, corresponding to that estimated from incorporation of [35S]-methionine, was detected in the precursor. The significance of this finding is discussed. PMID- 6861748 TI - Hysteretic behaviour of citrate synthase. Alternating sites during the catalytic cycle. AB - Chemically and stereochemically pure (3S)-citryl-CoA was prepared enzymically and used as a substrate for citrate synthase to investigate the previously determined unexpectedly low rate of hydrolysis of the (3RS)-substrate. The unnatural R diastereomer of this mixture is not inhibitory. At low enzyme concentrations the rate of citryl-CoA hydrolysis was linear until the reaction went near to completion; the hydrolysis approached Michaelis-Menten kinetics at high enzyme concentrations. In between these concentration extremes a biphasic rate dependence was detectable, where a fast initial phase lasting a few seconds was followed by a slow steady-state phase. Citrate synthase was characterized as a hysteretic enzyme existing in two interconvertible forms, which were designated according to their functions as hydrolase E and ligase E'. The hysteretic behaviour originates in the cleavage of citryl-CoA to acetyl-CoA and oxaloacetate. This reaction occurs on the ligase form E', which represents a trap for enzyme form E, the hydrolase. The conclusions given above are strengthened by the ordinary hydrolysis kinetics of (2S)-malyl-CoA, a substrate that is not subject to cleavage of the C-C bond on the synthase. The results satisfy the kinetic criterion for citryl-CoA being an intermediate of the physiological synthase reaction and, therefore, establish the oscillation of the synthase between hydrolase and ligase states during the catalytic cycle. A disorganization of these oscillations can be achieved by limited tryptic proteolysis of the synthase. PMID- 6861749 TI - Porphyran primary structure. An investigation using beta-agarase I from Pseudomonas atlantica and 13C-NMR spectroscopy. AB - Porphyran, a highly substituted agarose from Porphyra umbilicalis was degraded by highly purified beta-agarase I from Pseudomonas atlantica. This enzyme cleaved at the reducing side of units of beta-neoagarobiose (3,6-anhydro-alpha-L galactopyranosyl-(1 leads to 3)-beta-D-galactopyranose). The oligosaccharides were divided into fractions of low and high molecular weight by dialysis. The permeate (23% of total starting carbohydrate) was separated by ion-exchange into neutral and anionic fractions. Gel filtration of the neutral fraction (19%) resolved two major oligosaccharides. These were shown by 13C-NMR spectroscopy to be 6(3)-O-methyl-neoagarotetraose and 6(3),6(5)-di-O-methyl-neoagarohexaose. Gel filtration of the anionic oligosaccharides (3.3%) revealed two novel monosulphated tetrasaccharides, 6-O-sulphato-alpha-L-galacto-pyranosyl-(1 leads to 3)-beta-D-galactopyranosyl-(1 leads to 4)-3,6-anhydro-alpha-L-galactopyranosyl (1 leads to 3)-D-galactopyranose and its 6(3)-O-methylated derivative. The 13C NMR data from the sulphated tetrasaccharides provided a novel reference which was used to characterise higher, partially sulphated fragments in the dialysis permeate. The fraction retained on dialysis (77%) had an average degree of polymerisation of 40 and was homologous with the high-molecular-weight anionic permeate. From 13C-NMR spectroscopy porphyran was found to comprise 49% sulphated disaccharide units and these were calculated to occur in stretches averaging 2.0 2.5 contiguous units. PMID- 6861750 TI - Brain proteolipids. Isolation, purification and effect on ionic permeability of membranes. AB - Proteolipid apoproteins have been isolated from a whole bovine brain homogenate by chloroform/methanol extraction, and fractionated by chromatography on modified (lipophilic) Sephadex, followed by ion-exchange chromatography on CM-Trisacryl. The various final, highly hydrophobic, fractions are homogeneous (sodium dodecyl sulfate/polyacrylamide gel electrophoresis). Transmembrane ion transfers were studied by 22Na + flux and electrical conductance measurements. Single channel events were observed at low protein concentrations, in particular with one of the final homogeneous apoproteolipids of molecular mass 24 kDa. PMID- 6861751 TI - The use of alginate ester films on solid supports in the preparation of water insoluble immunoadsorbents for purification of antigens. AB - A novel method developed for the preparation of immunoadsorbents is based on the technique of coating potential column supports with a propylene glycol alginate ester film created by emulsion polymerisation. The cross-linking of the film with 1,2-diaminoethane in alkaline solution resulted in a water-permeable but water insoluble film which was stable at high pH. Sheep anti-(human IgG) was subsequently coupled to the cyanogen-bromide-activated film and the resultant immunoadsorbents were used to purify IgG from whole human serum. The production of the film-coated supports, chemical coupling of antibody and the chromatographic characteristics of four alginate-film-coated supports are described. With the use of Sepharose--alginate-ester--sheep-anti-(human IgG) immunoadsorbent the overall yield for IgG from five serial adsorption-elution cycles was 94% of the adsorbed IgG. This immunoadsorbent proved to be of high binding capacity and allowed the elution of specific antigen in almost 100% yield and high purity with minimal non-specific interference from other serum proteins. PMID- 6861752 TI - Induction of differentiation in a rat mammary epithelial stem cell line by dimethyl sulphoxide and mammotrophic hormones. AB - Rama 25 is a clonal epithelial cell line derived from a dimethylbenzanthracene induced rat mammary adenocarcinoma. In the presence of the mammotrophic hormones, insulin, hydrocortisone, estrogen and prolactin, Rama 25 produces small amounts of casein and forms domes at a low rate. The rates of both these processes can be greatly increased by the addition of dimethyl sulphoxide or hexamethylenebisacetamide which are also known to induce the differentiation of Friend erythroleukemia cells. Other compounds which stimulate the differentiation of Rama 25 cells include linoleic acid and 6-thioguanine. The intracellular pathways triggering changes in the two markers of differentiation are partially separable using different combinations of hormones, prolactin and hydrocortisone being the most important for the production of casein and the formation of domes respectively. The kinetics of differentiation, as judged by the appearance of these two markers, are characterised by two phases, a fixed period of 8 h (lag phase), the length of which is independent of the dimethyl sulphoxide concentration and a second phase where their rates are dependent on the concentration of dimethyl sulphoxide. Rama 25 cells do not become committed to differentiate during this lag phase but increasing numbers of cells do so after this period. We suggest that the differentiation processes occur in two stages. The first stage, involving the inducer, commits Rama 25 cells to a new differentiated state. The second stage, involving the hormones, modulates the expression of different markers of this state. Both casein production and dome formation can be blocked by inhibitors of DNA synthesis and show reciprocal changes with the rates of cellular DNA synthesis. Thus, in its hormonal and DNA synthetic requirements for differentiation, Rama 25 cells appear to resemble some of the mammary epithelial cells of mature virgin rats. PMID- 6861753 TI - Purification and partial characterization of a highly immunogenic human leukocyte protein, the L1 antigen. AB - L1 is a major and highly immunogenic protein component of human granulocytes. It was purified from random samples of blood-donor leukocytes. An antiserum to L1 was initially raised in rabbits by immunization with protein fractions from preparative agarose gel electrophoresis. The main problem in purifying L1 was its poor stability when carried through multiple steps. Preparative isoelectric focussing was therefore adopted as an efficient one-step method. The isoelectric focussing pattern of L1 was greatly influence by the presence of EDTA or calcium ions in the sample buffer. With low EDTA concentrations or calcium excess, L1 focussed as seven protein bands in two regions, pH 6.1-6.5 and pH 7.6-8.4. Conversely, L1 was found only in the pH-6.1-6.5 region when excess EDTA was added to the sample. Irrespective of conditions, the bulk of L1 focussed at pH 6.3 and pH 6.5. Also the electrophoretic mobility of L1 was strongly influenced by calcium ions, suggesting uptake of calcium by the protein. In the presence of calcium, L1 adhered to glass surfaces and filters used for concentration of protein solutions. The latter problem could be prevented by addition of EDTA. The molecular mass of L1 was determined to be about 36.5 kDa. The molecule was shown to consist of three non-covalently linked 12.5-kDa subunits. PMID- 6861754 TI - Exchange of histones H1 and H5 between chromatin fragments. A preference of H5 for higher-order structures. AB - Histones H1 and H5 can exchange between an H1-containing chromatin fragment from rat liver and an H1, H5-containing fragment from chicken erythrocytes at ionic strengths from about 35 mM to 105 mM. The redistribution has reached equilibrium by ionic strength 75 mM in 1 h or less at 4 degrees C. After exchange at ionic strength 75 mM, long fragments, whether of rat liver or chicken erythrocyte chromatin, are recovered with a higher H5:H1 ratio than short fragments, suggesting a stronger preference of H5 than of H1 for higher-order structures which exist for long fragments at ionic strength 75 mM. Competition experiments between occupied H1 or H5 binding sites on chromatin fragments from rat liver or chicken erythrocytes and empty sites on H1-depleted rat chromatin show that rat H1 does not distinguish between the two types of site, whereas H5 discriminates in favour of sites on native chromatin, even when the chicken fragments are too short to form higher-order structures. (The behavior of the chicken H1, which may be bound less tightly than rat H1, depends on the length of the chicken fragment, in a manner suggesting that fragments of 15 nucleosomes and longer can form stable higher-order structures which have high-affinity binding sites for both H5 and H1.) We conclude that the affinity of sites for H5 is in the order:higher order structures greater than nucleosome filament much greater than H1-depleted chromatin. The same relative order of affinities may well apply for H1 but the discrimination is much lower. This difference between H1 and H5 seems likely to be relevant to the greater stability of H5-containing chromatin, and in turn its transcriptional inactivity, and indeed to the mechanism of replacement of H1 by H5 during the terminal stages of erythropoiesis. PMID- 6861755 TI - Characterization of cytochrome P2-450 (20-S) mRNA. Association with the P1-450 genomic gene and differential response to the inducers 3-methylcholanthrene and isosafrole. AB - Mouse liver cytochrome P2-450 is defined as the major isosafrole-inducible form of P-450 which is most specific for isosafrole metabolism. lambda AhP-1 represents a 15.5 X 10(3)-base-pair segment of mouse genomic DNA having the cytochrome P1-450 gene (approximately equal to 4600 base pairs) located in the middle portion. Using various subclones as probes, we investigated the differential expression of P1-450 mRNA and P2-450 mRNA induction as a function of association with the Ah locus, 3-methylcholanthrene or isosafrole dosage, tissue specificity, and developmental age. Both P1-450 (23-S) mRNA and P2-450 (20-S) mRNA induction processes are regulated by the Ah receptor. P2-450 mRNA is about 10-fold more sensitive than P1-450 mRNA to induction by either 3 methylcholanthrene or isosafrole. Phenobarbital pretreatment has no effect at all on either P1-450 mRNA or P2-450 mRNA. Whereas both P1-450 mRNA and P2-450 mRNA are induced by 3-methylcholanthrene in C57BL/6N liver, P1-450 (23-S) mRNA but not P2-450 (20-S) mRNA is induced by 3-methylcholanthrene in C57BL/6N kidney. P1-450 mRNA induction by 3-methylcholanthrene is measurable in C57BL/6N liver at day 15 of gestation, and the expression becomes enhanced with increasing age. P2-450 mRNA induction by 3-methylcholanthrene in C57BL/6N liver appears about 7 days later during development than 3-methylcholanthrene-inducible P1-450 mRNA. Both 3 methylcholanthrene-induced P1-450 mRNA and P2-450 mRNA are detectable in DBA/2N liver; their appearance is later in development, however, and at lower concentrations than that seen with C57BL/6N liver. P1-450 (23-S) mRNA and P2-450 (20-S) mRNA appear to hybridize to a common 5' fragment of the P1-450 gene. PMID- 6861756 TI - Identification of new sialic acids derived from glycoprotein of bovine submandibular gland. AB - Improvements in the isolation procedure and the analytical equipment enabled the detection of seven novel sialic acids in bovine submandibular gland glycoprotein: N-acetyl-8-O-acetylneuraminic acid, N-acetyl-8,9-di-O-acetylneuraminic acid, N acetyl-7,8,9-tri-O-acetylneuraminic acid, N-glycoloyl-7-O-acetylneuraminic acid, N-glycoloyl-7,9-di-O-acetylneuraminic acid, N-glycoloyl-8,9-di-O-acetylneuraminic acid, and N-glycoloyl-7,8,9-tri-O-acetylneuraminic acid. There are also indications for the presence of N-glycoloyl-8-O-acetylneuraminic acid. In addition, the sialic acids already known to occur in this tissue, namely N acetylneuraminic acid, N-acetyl-7-O-acetylneuraminic acid, N-acetyl-9-O acetylneuraminic acid, N-acetyl-7,9-di-O-acetylneuraminic acid, N glycoloylneuraminic acid, and N-glycoloyl-9-O-acetylneuraminic acid could be identified. Sialic acids were released from the mucin by mild acid hydrolysis and prefractionated on a Dowex 2X8 anion-exchange column (formate form) by elution with a 0-0.6 M gradient of formic acid. The four pools of sialic acids obtained in this way were each further fractionated by column chromatography on cellulose with n-butanol/n-propanol/water (1/2/1, v/v/v) as eluent. By this procedure, N acetylneuraminic acid, N-acetyl-7-O-acetylneuraminic acid, N-acetyl-9-O acetylneuraminic acid, N-glycoloylneuraminic acid, and N-glycoloyl-9-O acetylneuraminic acid were obtained in pure form. The other sialic acids could be enriched sufficiently in different fractions for structural identification. Analyses of sialic acids were carried out by one-dimensional and two-dimensional thin-layer chromatography, gas-liquid chromatography, and gas-liquid chromatography-mass spectrometry. PMID- 6861757 TI - The primary structure of subunit II of NADH dehydrogenase from bovine-heart mitochondria. AB - Subunit II (with a molecular mass of about 24000 dalton, approximately 24 kDA) of NADH dehydrogenase from beef heart mitochondria was [ 14C ]carboxymethylated and cleaved with CNBr and proteolytic enzymes. Sequence analyses of purified fragments suggest that the subunit is composed of a homogeneous polypeptide chain, containing just over 230 residues. The primary structure of this chain was established except for a 14-residue internal part which was only determined by composition. The amino acid sequence suggests that four cysteine residues are involved in the binding of an iron-sulfur cluster. The subunit contains no long hydrophobic segment, in contrast to structures often found in membrane proteins, but in agreement with a model where the functional unit of NADH dehydrogenase in the membrane is shielded by other intra-membrane proteins. The polypeptide has a weak similarity to the iron-sulfur binding region of ferredoxin and has interesting but possibly insignificant similarities to parts of previously compared flavin-linked enzymes. PMID- 6861758 TI - Comparative binding of ethidium and three azido analogs to dinucleotides: affinity and intercalation geometry. A 1H NMR and visible spectroscopy study. AB - Geometrical and thermodynamic information has been obtained from theoretical analysis of both visible and 1H-NMR spectroscopic binding isotherms of ethidium and three photoactivable derivatives (8-azido-ethidium, 3-azido-ethidium and 3,8 diazido-ethidium) to self-complementary ribodinucleosides. The following results have been obtained. 1. Interaction with pyrimidine(3-5')purine sequences is well accounted for by multicomponent equilibria involving self-association of the dyes in oligomers, formation of 1:1 and 2:1 (nucleoside:dye) complexes. This model provided evidence for intercalation of all dyes, though with weaker affinity in the case of diazido-ethidium (2 X 10(6) M-2 vs 6 X 10(7) M-2). Moreover 3-azido ethidium was shown to intercalate into cytidylyl(3'-5')guanosine (CpG) with its phenyl group lying in the major groove of the minihelix. This geometry is inverted with respect to that of all other compounds. It should be emphasized that visible and 1H-NMR techniques independently provided similar results (intercalation, affinity constants) therefore supporting this stepwise model. 2. Interaction of all dyes with purine(3'-5')pyrimidine sequences is not intercalative, even at low temperature (4 degrees C), but is well described by self-association of the dyes and formation of 1:1 (nucleoside:dye) complexes. Regarding the reversible DNA intercalation process, these studies show that 8 azido-ethidium is the only photoactivatable derivative which behaves exactly as ethidium. Therefore 8-azido-ethidium can be used as a covalent probe to investigate the DNA-related cytotoxic effects of ethidium. PMID- 6861759 TI - Structure of the mouse cytochrome P1-450 genomic gene. AB - Clone 46 was previously shown to represent mouse cytochrome P1-450 cDNA by both translation arrest experiments and segregation of induced P1-450 mRNA with induced aryl hydrocarbon hydroxylase activity among individual 3 methylcholanthrene-treated offspring of the (C57BL/6N)(DBA/2N)F1 X DBA/2N backcross. With clone 46 as a probe, a MOPC 41 mouse genomic-DNA library was screened. lambda 3NT12, a 16 X 10(3)-base-pair insert of genomic DNA grown in a recombinant Charon 4A lambda vector phage, was isolated and characterized. It was determined that clone 46 hybridizes to the extreme 5' end of lambda 3NT12. pMJE12, a 3.0 X 10(3)-base-pair fragment in the 5' region of lambda 3NT12, was subcloned in plasmid pBR322 and used as a probe to screen again the same mouse DNA library; recombinant phages lambda 3NT13, lambda 3NT14, and lambda AhP-1 were isolated and characterized. The relative orientation of each of the four genomic clones on the mouse chromosome was determined. Only lambda AhP-1 contains the entire P1-450 genomic gene, which by R-loop analysis spans about 46 X 10(2) base pairs and contains at least five exons. Clone 46 is shown to be a 3' unique sequence of the genomic P1-450 gene. The lambda AhP-1 genomic-DNA clone from the MOPC 41 plasmocytoma is shown by a series of restriction enzymes to be the same as genomic DNA from normal mouse liver. With a subclone in the 5' portion of the P1-450 gene, two and three hybridizable fragments are found with mouse genomic DNA that has been digested with EcoRI and BamHI, respectively. PMID- 6861761 TI - Synthesis of rat-liver lactate dehydrogenase and characterization of its mRNA. AB - Rat liver lactate dehydrogenase (LDH) has been synthesized in hepatocytes and in a cell-free translation system. The subunit synthesized in both systems displayed the same electrophoretic mobility upon sodium dodecyl sulfate/polyacrylamide slab gel electrophoresis. Sequence analysis of the subunits translated in vitro and synthesized in vivo indicated N-acetyl-alanyl-alanine for both N termini. Thus, the newly synthesized subunit does not exhibit an amino-terminal extension. The mRNA for the lactate dehydrogenase subunit was exclusively found in free polysomes. A size of 2120 +/- 240 nucleotides was estimated for the mRNA. Only about 50% of these nucleotides are needed to code for the polypeptide chain of the enzyme. PMID- 6861760 TI - The metabolism of chenodeoxycholic acid to beta-muricholic acid in rat liver. AB - 1. The synthesis of conjugated chenodeoxycholic acid and tauro-beta-muricholic acid in isolated rat hepatocytes was measured by radioimmunoassay. Production of tauro-beta-muricholic acid was linear over 4 h of incubation at 37 degrees C. The net synthesis of conjugated chenodeoxycholic acid was very much lower than that of tauro-beta-muricholic acid. 2. When hepatocytes were prepared from rats in which the enterohepatic circulation had been broken, either by feeding the bile salt sequestrant, cholestyramine or by total biliary drainage for 48 h, synthesis of tauro-beta-muricholic acid was increased compared to that in cells from control rats. Conjugated chenodeoxycholic acid accumulation during incubation of the hepatocytes was increased by cholestyramine feeding but not by total biliary drainage. These results suggest that there is a metabolic difference between the two methods of breaking the enterohepatic circulation with regard to chenodeoxycholic acid synthesis. 3. Hepatocytes prepared from rats given 1% cholesterol in the diet for at least 2 weeks synthesised significantly more tauro beta-muricholic acid than those from control rats. The total amount of conjugated cholic, chenodeoxycholic and tauro-beta-muricholic acids synthesised by cells from cholesterol fed animals, however was not significantly different from that produced by hepatocytes from normal rats. 4. Exogenous taurochenodeoxycholic acid was metabolised to tauromuricholic acid by isolated hepatocytes. Production of tauro-beta-muricholic acid reached a maximum at a concentration of 20 microM taurochenodeoxycholic acid. The total metabolism of taurochenodeoxycholic acid, however, increased linearly up to the highest concentration measured, 50 microM. 5. The biliary content of tauro-beta-muricholic acid during total biliary drainage fell rapidly in the first 10 h and thereafter continued to decline, reaching a minimum after about 24 h. No significant rise was observed during the remainder of the experimental period. 6. It is concluded that a large proportion of the conjugated chenodeoxycholic acid synthesised by isolated hepatocytes in vitro is metabolised to tauro-beta-muricholic acid, and therefore it is necessary to take this into account when using this system to study bile salt synthesis. PMID- 6861762 TI - Ganglioside biosynthesis in Golgi apparatus of rat liver. Stimulation by phosphatidylglycerol and inhibition by tunicamycin. AB - Golgi vesicles were isolated and purified from rat liver, in which the specific activities of glycosyltransferases (e.g. GM3:CMP-NeuAc sialyltransferase, GD3 synthase; GM3:UDP-GalNAc galactosaminyltransferase, GM2 synthase) were 50-60 times enriched relative to microsomes or total homogenate. Synthesis of gangliosides GM2 and GM1 in such Golgi vesicles is, in the absence of any detergents, stimulated 6-fold and 20-fold respectively by phosphatidylglycerol. Other phospholipids like phosphatidylethanolamine and phosphatidylserine are also significantly stimulatory. With 50 micrograms Golgi protein and 1 nmol UDP GalNAc, optimal stimulation of GM2 synthase was obtained with 20 micrograms of phosphatidylglycerol and 7.5 nmol of the lipid acceptor GM3. Under the same experimental conditions this stimulation exceeds (by about 40%) that obtained with optimal amount (200 micrograms) of the detergent octylglucoside. Phosphatidylglycerol, on the other hand, has virtually no stimulatory activity on the synthesis of ganglioside GD3 either in the presence of Mg2+ or Mn2+, indicating that facilitation by phospholipid of GM3 transport into Golgi vesicles was not the basis of stimulation of GM2 synthesis. Tunicamycin inhibits the synthesis of gangliosides GM2 and GM1 in isolated Golgi vesicles, but only in the absence of detergents. In the presence of phosphatidylglycerol, GM2 synthesis, for example, was inhibited by 60% by 2 micrograms tunicamycin and more than 85% by 10 micrograms tunicamycin, per 50 micrograms Golgi membrane protein. The inhibition was stronger on GM1 synthesis: 85% with 2.5 micrograms of the antibiotic. The dependence on phosphatidylglycerol and the degree of inhibition by tunicamycin of the synthetic activities are strictly dependent on the intactness of the Golgi vesicles: both phenomena become increasingly less evident when the vesicles are pelleted, and frozen and thawed several times, and completely disappear when the vesicles are solubilized by detergents or disrupted by ultrasonication. Furthermore, tunicamycin inhibition is reversible by increased concentration of phosphatidylglycerol. All these results indicate that phosphatidylglycerol does not stimulate, and tunicamycin does not inhibit, the transferases themselves; rather, the two opposing effects might relate to carrier mediated transport, e.g. of nucleotide sugars, across Golgi vesicles. PMID- 6861763 TI - Protein disulphide-isomerase activity in various cells synthesizing collagen. AB - A high correlation was found between the activities of protein disulphide isomerase and prolyl 4-hydroxylase when assayed in cells synthesizing various collagen types or the same type at markedly different rates. The highest activities of both enzymes were found in freshly isolated chick-embryo tendon and cartilage cells, intermediate activities in confluent cultures of human skin and lung fibroblasts and mouse 3T6 fibroblasts, and the lowest values in three human sarcoma cell lines, the difference in protein disulphide isomerase activity between the freshly isolated tendon cells and confluent simian-virus-40 transformed human lung fibroblasts being about 25-fold. All these differences are in good agreement with differences reported between the various cells in their rates of collagen synthesis. A great similarity was also found between the changes in the two enzyme activities measured per cell during the growth of 3T6 fibroblast cultures from the early logarithmic phase to the stationary phase. No correlation was found between protein disulphide isomerase activity and the type of collagen synthesized. The data suggest that protein disulphide isomerase may be involved in the formation of intra-chain and inter-chain disulphide bonds in procollagens, but there is no collagen type-related variation in this enzyme activity of a magnitude that would explain the marked differences in the rates of formation of inter-chain disulphide bonds between the various collagen types. PMID- 6861764 TI - Na+-dependent uptake of 4-azidophenylalanine by pig intestinal microvillus vesicles. Interaction with neutral amino acid uptake and labelling pattern. AB - A procedure for the synthesis of tritiated 4-azidophenylalanine in a radioactively homogeneous form is described. The characteristics of the 4 azidophenylalanine uptake by pig intestinal microvillar vesicles and its interaction with the neutral amino acid transport have been studied. 4 Azidophenylalanine is transported into an osmotically sensitive space and the transport is sodium dependent. It is demonstrated that 4-azidophenylalanine transport is inhibited by L-alanine and L-phenylalanine but not by L-lysine and D glucose. Likewise 4-azidophenylalanine inhibited the initial transport of L alanine and L-phenylalanine but the initial transport of L-lysine and D-glucose was unaffected. Treatment of microvillar vesicles with 4-azidophenylalanine in combination with photolysis irreversibly inactivated the L-alanine transport. Photolabelling in the presence of sodium using tritiated 4-azidophenylalanine resulted in labelling of 10 peptides, all found in the fraction insoluble in Triton X-100. Omission of sodium from the reaction mixture or addition of L alanine did not specifically abolish labelling in any of the labelled components. PMID- 6861765 TI - Heme P460 of hydroxylamine oxidoreductase of Nitrosomonas. Reaction with CO and H2O2. AB - Hydroxylamine oxidoreductase (HAO) of Nitrosomonas catalyzes the dehydrogenation of NH2OH and subsequent addition of oxygen to form nitrite. HAO contains c hemes and the CO-binding heme P460 in a 7:1 ratio; dehydrogenation of NH2OH involves passage of electrons to P460 and then c hemes. We now report that electrons rapidly pass from c hemes of HAO to the P460 center and then to H2O2. This conclusion is supported by (a) inhibition of c heme oxidation with CO and (b) loss of H2O2-oxidizability of ferrous c hemes following specific destruction of heme P460. Reaction of ferrous P460 with H2O2 is rate-limiting. Activation of dioxygen for N-oxidation by ferrous HAO may involve the two-electron reduction of O2 by P460. The reaction of ferrous HAO with H2O2 was studied as it may reveal aspects of the mechanism of activation of dioxygen. Reaction of ferrous heme P460 with CO is slow and with low affinity as compared with other hemoproteins. Values for reaction of CO with enzyme were: k1, 1.1 X 10(-3) M-1 s-1 and Kd, 12 microM. PMID- 6861768 TI - Anomalous systemic venous return: recognition by two-dimensional echocardiography. AB - The two-dimensional echocardiographic features of anomalies of systemic and coronary venous return are described as they were seen in 23 patients with this diagnosis proven at angiography. A left-sided superior vena cava draining to the right atrium via an enlarged coronary sinus was correctly identified in all 17 patients with this condition by observing a characteristically moving ovoid structure in the region of the posterior atrioventricular groove. This structure opacified before the right side of the heart following bolus injections of contrast material from a left arm vein. Injection from the right arm in 12 patients or femoral vein in four patients of this group produced contrast echoes within the right heart only. A left-sided superior vena cava draining directly to a left atrium in three patients, or left side of a common atrium in two patients with atrial situs inversus, was identified by the immediate opacification of the left-sided chamber following injection from the left arm. Two patients with hemiazygos inferior vena caval return to the left superior vena cava or left atrium were studied using injections of contrast from the femoral vein which successfully identified the venous abnormality. Two-dimensional echocardiography, when combined with peripheral venous injections of contrast will reliably demonstrate anomalies of systemic venous return, and thus provides important information before more invasive procedures. PMID- 6861766 TI - Right ventricular dysfunction and surgical outcome in postinfarction ventricular septal defect. AB - The data of 50 consecutive patients treated for postinfarction ventricular septal defect were reviewed. Cardiac catheterization was carried out in all patients and surgical repair was undertaken in 32 patients. The main factors affecting surgical outcome were the site of infarction and the extent of right ventricular damage. Anterior myocardial infarction carried a better hospital survival rate than inferior infarction (67 and 31%, respectively). Poor right ventricular free wall contraction, present in 44% of anterior infarctions and 71% of inferior infarctions carried a high mortality. Eighty per cent (12/15) of patients with good right ventricular contraction survived operation compared to only 24% (4/17) of patients with poor right ventricular contraction. Surgery within 24 h to 14 days of infarction carried a survival rate of 50% (7/14), similar to that in patients operated on more than two weeks following infarction (9/18). Seventeen out of 18 patients who did not undergo surgery either died suddenly before scheduled operation or were considered too poor a surgical risk. Of these, 12 patients died within one week of infarction and five patients survived between two weeks and three months. Early surgical repair should therefore be considered in all patients with postinfarction ventricular septal defect, the prognosis in patients with good right ventricular contraction being excellent. PMID- 6861767 TI - Efficacy of i.v. amiodarone in converting rapid atrial fibrillation and flutter to sinus rhythm in intensive care patients. AB - Twenty-six consecutive patients (14 males, 12 females--mean age 66.6) were admitted to an intensive care unit (ICU) because of a rapid ventricular response to atrial fibrillation (RAF). Fourteen of them had been unsuccessfully treated by drugs (other than amiodarone) and/or DC shock before admission. A loading dose of i.v. amiodarone was administered (repeated boluses of 3 mg/kg in 3 min, or 30 min infusions of 5 to 7.5 mg/kg), followed by continuous infusion, in order to reach a maximal total dosage of 1500 mg in 24 h. This treatment was considered efficacious if a reversion to stable sinus rhythm (SSR) occurred within 24 h and was maintained for more than 48 h. This was achieved in 21 out of 26 patients (80.8%). The mean time between the administration of therapy and the occurrence of SSR was 171 min. The total dose of amiodarone delivered to effect SSR was 6.9 +/- 2.3 mg/kg. No adverse reactions were encountered during the bolus injection but we recommend that continuous infusion be carried out through a central venous catheter to avoid phlebitis. The administration of 7 mg/kg of intravenous amiodarone delivered in 30 min proved a safe and successful first choice of management in atrial fibrillation with a rapid ventricular response. PMID- 6861771 TI - Late prosthetic valve endocarditis: review of 19 cases and treatment. AB - Eighteen out of 1606 patients treated by valve replacement between January 1971 to June 1979 were admitted in Brugmann University Hospital for late prosthetic valve endocarditis. Of the 19 episodes (one patient had two distinct episodes four years apart), nine (group I) were treated medically and 10 (group II) by combined medical and surgical therapy. The infective organism was Staphylococcus epidermidis in two-thirds of our cases. Two cases in group I (22.2%) were long term survivors. In group II, all 10 patients survived reoperation. There were four late deaths; six patients (60%) were still alive 1.8 to 4.4 years later (mean survival three years). Prompt prosthetic valve replacement is recommended in the presence of systemic emboli, evolving murmurs, uncontrolled sepsis or congestive heart failures (especially if the infective organism is a fungus or a staphylococcus), in late prosthetic valve endocarditis. PMID- 6861770 TI - Lack of influence of propranolol and metoprolol on walking distance in patients with chronic intermittent claudication. AB - Ten patients with chronic intermittent claudication were included in a double blind, randomized cross-over study of placebo, propranolol 80 mg b.i.d. and metoprolol 100 mg b.i.d., each given for two months. At the end of each treatment period, the patients were tested on a treadmill and the time to first claudication pain and to intolerable claudication pain was noted. There was no decrease in time to first claudication pain or to intolerable pain with either propranolol or metoprolol as compared to placebo. PMID- 6861769 TI - Diagnosis of acute aortic dissection by M-mode and cross-sectional echocardiography: a five-year experience. AB - During a five-year period, 26 cases of acute thoracic aortic dissection were studied by M-mode and cross-sectional echocardiography prior to cardiac catheterization and aortography. The diagnosis could be made non-invasively in 20 patients. Important information concerning the extent of the dissection, and the presence or absence of aortic regurgitation or a pericardial effusion could be obtained. Negative examinations were largely confined to cases where the distal thoracic aorta alone was involved. In a further 30 cases admitted to the coronary care unit during this period in which echocardiography was performed to rule out aortic dissection, two false-positive examinations led to aortography which demonstrated aortic dilatation and aortic regurgitation only. In the remaining 28 cases, echocardiographic examination was negative and none of these patients subsequently evidenced aortic dissection. Echocardiography using both M-mode and cross-sectional techniques is a rapid and highly effective method of making an early diagnosis of thoracic aortic dissection. Cross-sectional echocardiography is complementary to the M-mode technique, enhancing diagnostic accuracy by improving structural recognition in a condition where the normal anatomy is often severely distorted. PMID- 6861772 TI - Carcinoma of the vulva. AB - From 1966 to 1981 96 patients with carcinoma of the vulva received their primary treatment at the Frauenklinik of the Klinikum Mannheim. The average age was 69 years at the time of the diagnosis. Histologically keratinizing squamous cell carcinoma was found in 78.2% of all cases, non-keratinizing squamous cell carcinoma in 9.2% and atypical squamous cell carcinoma in 4.6%. Preferred localisation of the vulvar carcinoma were the labia majora and minora (55.1%) and the perineum (19.5%). 43.7% of all patients underwent vulvectomy or hemivulvectomy, followed by radiation in 47.4% of these cases. Electrorescetion was performed in 24.1% of all patients, followed by radiation in 71.4%. 16.1% underwent radical surgery, followed by radiation in 85.7% of patients. The 5-year survival rate was 44.4% when radical surgery was performed, and 38.5% when this was not the case. PMID- 6861776 TI - Cancer of the endometrium in the province of Trieste: epidemiological considerations. AB - The Authors examined the epidemiological behaviour of endometrial carcinoma in the Province of Trieste from 1969 to 1980. In this period a European standard incidence of 14.33(0)/0000 was recorded. The most affected age group is 60 to 69, and the average age is 64 years. A clear increasing trend of this kind of neoplasia was recorded. This increase mainly occurs in younger age groups than those which presently are most affected. PMID- 6861775 TI - Frequent atypical re-epithelialization in young patients. PMID- 6861774 TI - Role of second look laparotomy in multidisciplinary treatment and in the follow up of advanced ovarian cancer. AB - Surgical re-examination after first line surgery followed by chemotherapy is an absolutely necessary step in the course of integrated treatment of advanced ovarian epithelial tumours. Our personal experience of surgical re-staging and reductive surgery in 48 patients affected by ovarian tumours stage III and IV (FIGO), by laparotomic second look is reported. Repeated surgery succeeds in further reducing the neoplastic deposits or radicalizing the first intervention in 33% of the overall series; in 52% of the cases, the second look was negative for neoplasia; in 16% only, despite tumour finding no reductive surgery was possible. If only the cases presenting residual neoplasia after primary surgery are taken into account, tumour debulking was possible in 44% of the patients. The analysis of this series fully confirms the preliminary statement that the smaller the residual neoplasia after surgery, the greater the chances of success for chemotherapy in ovarian cancer. It confirms as well that the laparotomic second look is the only currently available way to usefully assess the full remission of the disease. PMID- 6861773 TI - Cone: its possible diagnostic and therapeutical role in microcarcinoma. PMID- 6861777 TI - Role of computed abdominal tomography (C.A.T. Scan) in the follow up of ovarian tumors. AB - This study evaluates the possible use of computed tomography not as an alternative diagnostic method but, rather, as a supplement to laparotomy in patients treated for ovarian cancer. The following conclusions can be drawn: in patients presenting no clinical evidence of persistent or relapsing disease C.T. Scan is not a mandatory but, rather, an optional test since it entails 25% false negatives, a 66.6% predictive value and because the involved patients will need, in any case, a further intervention. Conversely, C.T. Scan is clearly indicated in patients presenting clinical evidence of disease. It can prove helpful in detecting metastases in areas that prove difficult to be clinically examined; in assessing whether the retroperitoneal areas conceal neoplastic tissue or in planning the right operation for masses that have been palpated only before chemotherapy, and then in regression. When, despite chemotherapy, tumour progresses, surgery may became useless, and the C.T. Scan may therefore prove helpful in defining the condition and guiding non surgical treatment. Therefore, in the follow up of ovarian cancer the C.T. Scan may be performed on the basis of clinical course, instead than on a rigid aprioristic planning. PMID- 6861778 TI - Prophylaxis and prevention on gynaecologic oncology: new trends. From proceedings of IInd International Meeting of Gynaecologic Oncology. Venice-Lido (Italy) April 22nd-23rd-24th 1982. PMID- 6861779 TI - Tracheloscopically directed biopsy of the endocervical canal in stage II adenocarcinomas of the endometrium. AB - Endoscopic inspection of the endocervical canal (tracheloscopy) appears to be a rapid, reliable diagnostic technique to confirm the presence of endometrial neoplasms involving the endocervix found at fractional curettage. A series is presented in which 68% of patients with "positive" endocervical curettage were found to have no involvement of the endocervix by tracheloscopy and biopsy, which was confirmed by subsequent hysterectomy. The technique is discussed, and the use of this procedure in the staging of endometrial malignancies is recommended. PMID- 6861780 TI - A contribution to the therapy of cervicocarcinoma: remarks on 40 patients presenting paraaortic metastases (1970-1979). AB - The Authors report survival data concerning 40 patients affected by cervicocarcinoma who, between 1970 and 1979, underwent exploratory laparotomy after pelvic radiotherapy, with detection of paraaortic lymphnode metastases. The patients subjected to laparotomy only (21 cases) have a 9-month average survival, which increases to 24 months in those with lymphadenectomy and complete pelvic surgery. While all the patients in the first group have died, in the second 3 survive at 5 years and 3 show no evidence of disease at 52,46 and 35 months from surgery. Hysterectomy with pelvic and lomboaortic lymphadenectomy, whether therapeutical or palliative, seems to be in patients with paraortic metastases provided surgery is feasable. PMID- 6861781 TI - The influence of bilirubin, alcohol and certain drugs on the kinetics of 99mTc Diethyl IDA (EHIDA) in humans. AB - On the basis of the mathematical analysis of 99mTc-EHIDA hepatobiliary time activity curves of normal individuals two rate constants, one related to accumulation of radioactivity (uptake) and the other to excretion, were calculated indicating a two-compartmental model. By means of computerized fitting the rate constant of excretion (Kb), the time of maximum uptake (Tmax) and the rate constant of uptake (Ka) were calculated. In severely jaundiced patients (serum bilirubin concentrations greater than 140 mumol/l) a markedly decreased or absent uptake of 99mTc-EHIDA was observed. In moderately jaundiced patients a low Kb was invariably observed; in obstructive jaundice due to malignant disease--but not in jaundice of benign obstructive or hepatocellular origin--an increase in Ka was frequently present. This latter finding was not always present, however, and consequently kinetic studies do not unequivocally differentiate between jaundice of obstructive and hepatocellular origin. A markedly increased uptake (a high Ka) was noticed in alcoholics and patients taking phenobarbital and diphenylhydantoin possibly because of drug-induced membrane alterations. When the alcoholics developed hepatocellular injury the Ka converted to normal values. Thus, 99mTc EHIDA kinetics may be useful in the follow-up of patients with established or suspected alcoholism by virtue of the fact that it appears to be a sensitive monitor of functional changes in hepatocyte plasma membrane properties. PMID- 6861783 TI - Recurrent renal cell carcinoma following nephrectomy mimicking a normal kidney on bone scan. PMID- 6861784 TI - Renal sequential scintigraphy: unilateral clearance rate determination based on external measurements only. AB - A method of estimating the 131I-hippuran clearance of each kidney during renal sequential scintigraphy is presented. The clearance rates were obtained from the elaboration of the renal histograms and of a blood curve recorded on the precordium, directly compared with the injected dose. A function simulating the progressive deformation of the radioactive bolus as kidney perfusion is impaired was introduced into the computation. The method was tested on 23 patients who underwent simultaneous determination of the clearance rate with the Sapirstein method, the results being corrected to 1.73 m2 of body surface area. The correlation coefficient r between the obtained data (the sum of the clearance rates of the two sides) and the results of the Sapirstein method was 0.89. PMID- 6861785 TI - Influence of exercise on serum levels of myoglobin measured by radioimmunoassay. AB - To determine the influence of exercise on serum levels of myoglobin, serum levels of this protein were determined by RIA in 90 healthy men, divided as follows: (1) Basal control (no exercise) 25 cases; (2) Moderate exercise (after subject had been working for 12 h in Medicine Emergency Service) 19 cases, and (3) Intensive exercise: (a) football professional (45-min match) 10 cases; (b) football amateur (45-min match) 10 cases; (c) basketball professional (45-min match) 10 cases, and (d) basketball professional (90-min training) 16 cases. Our results led us to the following conclusions. (1) Moderate exercise, such as the usual daily work, does not modify myoglobin levels; (2) Myoglobin serum levels after exercise increase in nearly all individuals. They are higher in untrained people; (3) There seems to be a correlation between exercise intensity and increase of myoglobin serum levels, and (4) The detection of serum myoglobin by RIA may have a wide field of application for sport medicine. PMID- 6861782 TI - Perforation of the gallbladder diagnosed preoperatively. AB - A 69-year-old white male was admitted to the hospital for right upper quadrant pain, fever, and vomiting. Acute cholecystitis was not thought to be present because of a negative ultrasonogram and oral cholecystogram. A 99mTc-PIPIDA hepatobiliary study showed definite evidence of gallbladder perforation, with pockets of radiolabeled bile in the abdomen. Immediate surgery confirmed the scan diagnosis. In patients who are at high risk for gallbladder perforation the technetium-99m-labeled iminodiacetic acid hepatobiliary scan should be considered as a first procedure to rule out acute cholecystitis and possible gallbladder perforation. PMID- 6861786 TI - Physical requirements of a 59Fe bone marrow distribution digital scanning study. AB - A method is described to provide whole-body scannings of 59Fe bone marrow distribution using a tungsten-alloy collimator. The physical requirements of this method were determined by means of dedicated phantoms. As we were only interested in bounded 59Fe regions (sacral bone, liver and spleen), it was necessary to subtract the 59Fe activity in the blood. An estimate of this activity was obtained by means of 99mTc-labelled erythrocyte whole-body scanning to which a correction factor K was applied. The independence versus depth was performed by computing geometrical means of prone and supine images. The results of these experiments indicate the possible feasibility of a scanning method for a ferrokinetic study in place of the usual external counting. PMID- 6861787 TI - Comparative quality control of 99mTc-Pyrophosphate and 99mTc-diphosphonate radiopharmaceuticals. AB - The results of analysis of 99mTc-Pyrophosphate (99mPyP), taken as a representative of the group of compounds having an organic P-O-P bond, and of the three diphosphonate compounds: methylene diphosphonate (MDP), 2,3-dicarboxy propane diphosphonate (DPD) and ethane-1-hydroxy-1, 1-diphosphonate (EHDP), which differ in their chemical structure, are shown. Also, some physicochemical parameters such as chloroform-water apparent partition coefficient, the osmotic pressure and pH values in final preparations were studied. The radiochemical purity of these radiopharmaceuticals was determined by the two methods: Sephadex chromatography for separation of 99mTc-hydrolysate and TLC on silica gel with 85% methanol for the determination of free 99mTcO-4. The yield of labelling for both methods was over 90%. Also, pharmacokinetic parameters such as binding to the plasma proteins and to erythrocytes were determined. 99mTc-PyP binding to plasma proteins was higher than the binding of diphosphonate compounds. The quantitative distribution of preparations was determined in experimental animals. PMID- 6861788 TI - Gallium-67 imaging in carcinoma of the esophagus. PMID- 6861789 TI - The early follow-up of 131I-treatment of thyrotoxicosis. PMID- 6861792 TI - Dihydroergosine pharmacokinetic modelling and simulation. AB - For this study of dihydroergosine pharmacokinetic modelling and simulation, the data from our paper about 3H-DHESN plasma, bile, urine, and faeces concentrations after intravenous and oral administration were used (1). The model obtained with the identified parameters was in agreement with in vivo data. Certain special phenomena, such as the enterohepatic cycle and incomplete absorption, were taken into account. Analog-hybrid simulation and identification represents an effective tool for such studies. In spite of the limited validity of the available in vivo data, the work represents a first step in the introduction of DHESN into human medicine. PMID- 6861790 TI - Hepatic clearance of gitoxin: pharmacokinetic study on rabbit isolated liver. Influence of protein binding and comparison with digoxin. AB - Hepatic clearance of gitoxin has been studied in the rabbit and compared with that of digoxin using an isolated perfused liver technique. During 1.5 hour perfusions with a modified Krebs-Henseleit solution, gitoxin perfusate levels decreased biexponentially; the distribution and elimination half-lives were estimated to be 0.14 and 1.25 hour, Vd area to be 95.5 ml.g-1 and intrinsic metabolic clearance to be 1.98 ml.min-1.g-1. During 1.5 hour perfusions with modified Krebs-Henseleit solution containing 2.7% bovine serum albumin, gitoxin perfusate levels decreased monoexponentially. This is probably due to protein binding which moderates hepatic uptake so that distribution is not yet complete after 1.5 hour and it is therefore impossible to discriminate the two phases. This was confirmed by 5 hour perfusion experiments with an emulsion of perfluorocarbon in the modified Krebs-Henseleit solution also containing 2.7% bovine serum albumin, during which gitoxin levels decreased biexponentially. Distribution and elimination half-lives have been estimated to be 0.31 and 5.54 hours, Vd area to be 139 ml.g-1 and intrinsic metabolic clearance to be 1.36 ml.min-1.g-1. Gitoxin has been compared in these experimental conditions with digoxin, one of the most often used cardiotonic's. Distribution and elimination half-lives of digoxin were estimated to be 0.34 and 4.52 hours, Vd area to be 46.5 ml.g-1 and intrinsic metabolic clearance to be 0.17 ml.min-1.g-1. Other pharmacokinetic parameters (alpha, beta, V1, V2...) also have been calculated for these three types of perfusion experiments. PMID- 6861791 TI - Pharmacokinetics of dihydroergosine in rats after intravenous and oral administration. AB - Wistar rats received an intravenous dose of 20 micrograms/kg and an oral does of 40 micrograms/kg 3H-Dihydroergosine. Concentrations of radioactivity were measured in plasma, bile, urine, and faeces, and pharmacokinetical parameters of an open two compartment model were calculated. After intravenous injection and oral administration 3H-Dihydroergosine is rapidly lost from the central compartment with distribution rate constants alpha = 0.889 h-1 and beta = 0.722 h 1, respectively. Biological half life in the elimination phase after both application is nearly the same t 1/2 = 13.6 h. The volume of central compartment is Vc = 3.075 l/kg and the volume of distribution Vd beta = 30.75 l/kg. The fraction of 3H-Dihydroergosine absorbed after oral administration, calculated from areas under the curves upon oral and intravenous administration, is 31%. The percentage of 3H-radioactivity eliminated with bile was 98.3% of the dose within 72 hours after intravenous and 29.3% after oral administration. The main portion of the administered 3H-radioactivity was recovered in faeces -66.1% after intravenous and 81.3% after oral administration, while only 17.4% and 4.9% of the administered dose was eliminated in the urine within 120 hours, respectively. PMID- 6861793 TI - [14C]cadralazine: absorption, distribution and excretion in rat and dog. AB - Absorption, distribution and excretion of [14C]cadralazine in rat after oral and i.v. administration of 3 mg/kg were studied. Plasma levels after oral administration of 10 and 45 mg/kg were also evaluated. A direct relation between dose and plasma levels was demonstrated. The drug was well absorbed, disappeared very rapidly from plasma, and was distributed in all the organs examined, with the highest concentration in liver, kidney, and gastrointestinal tract. For more than 4 days excretion was essentially through the urine (75.6% after i.v. and 80% after oral administration), whereas faecal and biliary excretions were quite low. The total recovery was respectively 77.6% and 83.2% after i.v. and oral administration of 3 mg/kg, with the greatest amount (65-70% of the administered dose) appearing in the first 4 to 7 hours. Placental transfer and excretion of radioactivity with milk were demonstrated. Drug-protein binding was 25.9%. Elimination of 14CO2 was not observed. Plasma levels in dog, after oral and i.v. administration of 1 mg/kg of labelled compound, showed similar behaviour to that observed in the rat. Binding of the radioactivity to erythrocytes was found; the radioactivity values observed up to 24 hours were constant with time and not dependent on the decreasing plasma levels. The total recovery (urine and faeces) in the dog over 4 days was 71.1% and 82.1% after oral and i.v. dose, respectively. Preliminary metabolic approaches in rats showed that cadralazine was essentially excreted as unchanged drug in the presence of minor metabolites. PMID- 6861796 TI - A unique dydrogesterone metabolite in the rhesus monkey. PMID- 6861795 TI - Dydrogesterone: metabolism in animals. AB - The metabolic pattern of dydrogesterone was investigated in the rat, dog, mouse, rabbit and rhesus monkey. The drug was administered orally in 3H-labelled form. Following enzymatic hydrolysis of conjugates the radioactive metabolites were extracted from the urine, and in rat and dog also from bile. The separation method used for the development of the metabolite patterns was reversed-phase high performance liquid chromatography. Dydrogesterone and 4 derivatives, known or suspected to be metabolites, were used as marker substances. In all the species a substantial portion of the urinary or biliary radioactivity was too polar to be extracted, or it was not resolved in the chromatographic system used. The radioactivity which did develop into a pattern coincided with two or more of the marker substances. Only in the monkey, the pattern contained a peak of some substance which did not coincide with any marker. The urinary patterns of rat, dog, and mouse differed substantially, from each other as well as from those of rabbit and monkey. The patterns for the latter two animals showed certain similarities, both to each other and to the human urinary pattern as reconstructed from previous studies. It is concluded that with regard to the metabolic fate of dydrogesterone, the rabbit resembles man more than does any other species. PMID- 6861797 TI - Identification of the major urinary metabolites of (+)-catechin and 3-O-methyl (+)-catechin in man. AB - Following oral administration of (+)-catechin and 3-O-methyl-(+)-catechin to human volunteers the major urinary metabolites were shown to be the glucuronides of 3'-O-methyl-(+)-catechin respectively. Isolations from urine and from synthetic products have been carried out by semi-preparative high performance liquid chromatography; definitive elucidations of structures have been carried out by gas chromatography-mass spectrometry and nuclear magnetic resonance spectroscopy. PMID- 6861798 TI - Pharmacokinetics of disopyramide in patients with chronic renal failure. AB - The pharmacokinetics study of a single oral dose of 200 mg of disopyramide was performed in 22 normal control subjects and 33 patients with chronic renal failure (CRF). The latter were subdivided into 3 groups of 11 patients each as a function of the gravity of renal insufficiency. With the exception of maximum concentration (C max), which was only slightly modified, and of the apparent distribution volume which remained unchanged, all the other pharmacokinetic blood parameters (t max, concentration at 24th hour, elimination constant (ke h-1), elimination half-life, area under the curve and plasma clearance) were significantly modified in the CRF group; in particular, the elimination half-life was significantly increased (for 22 cases of CRF with mean plasma creatinine greater than 250 microM at 16.3 hours compared to 8.0 hours in controls). The urinary elimination of disopyramide was studied in 14 renal insufficiency patients and in 6 controls. The decreased rate of urinary excretion of disopyramide and its monodealkylated derivative (NMD), during the first 24 hours, was directly related to the severity of renal insufficiency. The ratio of urinary NMD/(disopyramide + NMD) was unchanged in CRF patients as compared to the controls. The results suggest that the dosage of disopyramide should be decreased when plasma creatinine values are greater than 250 microM, and creatinine clearance is less than 30 ml/min. The dose for a 70 kg subject would be 100 mg, administered every 12 hours. PMID- 6861800 TI - Recurrent alternating ophthalmoplegia with iridoplegia in a young diabetic. AB - Regressive painless left third nerve paralysis with pupillary involvement was followed 6 months later by a right painful complete ophthalmoplegia. The two attacks resolved without treatment. The patient, 22 years old, was recognized diabetic and no other cause was found. It is suggested that this clinical pattern is characteristic of the involvement of two different territories of third nerve vascularization. PMID- 6861799 TI - Pharmacokinetics-activity relationships of a new non-hormonal antifertility agent: 3-(2-ethylphenyl)-5-(3-methoxyphenyl)-1H-1, 2,4-triazole, in the rat and the hamster. AB - The pharmacokinetic profiles of a new non-hormonal anti-fertility agent, DL 111 IT, were studied in rats and hamsters given the 14C labelled compound parenterally dissolved in aqueous or oily vehicles. In both species, DL 111-It was rapidly metabolized and excreted when given intravenously or subcutaneously in aqueous vehicles (half-lives = 15-45 min.), whereas the kinetics were prolonged when it was administered in oily formulations (half-lives = 7-10 h). Binding studies revealed a high affinity of DL 111-IT for rat serum albumin (Ka = 6 X 10(5) 1/mole). The radioactivity concentrations in different tissues of pregnant rats appeared to be uniform with the excretory organs and lungs being the main target tissues. At the site of action, the utero-placental complex, the levels of total 14C were comparable to those in plasma, whereas the concentration of unchanged DL 111-IT was higher and remained so for a longer time. A comparison between the kinetic profiles and the activity data after single or multiple dose administration in different formulations, clearly indicates a close relationship between activity and plasma and tissue (utero-embryo placental complex) levels of DL 111-IT, and also makes clear the influence of the formulation and of the treatment schedule on the anti-fertility activity of the compound. PMID- 6861794 TI - Fate and disposition of bromocriptine in animals and man. II: Absorption, elimination and metabolism. AB - The disposition and biotransformation of bromocriptine were investigated in mouse, rat, dog, rhesus monkey and man following administration of the drug substance labelled with either tritium or carbon-14. The enteral absorption of bromocriptine was incomplete and amounted to 30-40% of the dose as estimated directly from the sum of biliary and urinary excretion of radioactive compounds in bile duct cannulated rats and monkeys. The main route of elimination was the bile (80-93% of the absorbed dose). Only 1 to 6% of the radioactive dose was recovered in urine of intact animals and man. Extensive biotransformation of bromocriptine is reflected by very complex metabolite profiles in all tested body fluids and by the almost complete absence of parent drug in urine and bile. Of the numerous drug-derived radioactive components seventeen could be identified. In animals the major urinary metabolites were 2-bromo-lysergic acid (7), its amide (3), and the respective isomers at position 8, metabolites 6 and 1. Bromolysergic acid (7) and bromoisolysergic acid (6) accounted for half of the radioactivity in human urine. In rat and monkey bile up to 40% of the radioactivity was associated with metabolites derived from the oxidation (hydroxylation, ring-opening) of the proline fragment (4, 5, 21-24, 29-31). The hydroxylated compounds were present in the form of conjugates with glucuronic acid. These were subsequently deconjugated in the intestine and recovered in the faeces as the free forms. The presence of the parent drug as a major component in rat plasma following intravenous administration and its absence after oral administration indicated that the elimination of bromocriptine proceeded almost entirely by metabolism in the liver. In vitro studies with isolated rat hepatocytes and 10.000 g supernatant of human liver confirmed the in vivo findings. Based on the structures of the identified metabolites it could be concluded that the biotransformation of bromocriptine in man occurred through the same principal pathways as in all investigated animal species. PMID- 6861803 TI - Incidence of abnormal EEG findings in patients with obstructions of the carotid artery and their prognostic value for the postoperative long-term course. AB - Between 1972 and 1980, a total of 706 patients were operated on at the Surgical Department of the University Hospital at Erlangen for chronic arteriosclerotic lesions, or kinking or coiling of the carotid artery; an evaluable preoperative EEG was recorded in 515 patients. Patients with an abnormal EEG revealed an increased early mortality rate, and a greater incidence of strokes in the long term. In patients with "controversial' indications for surgery, i.e., patients with asymptomatic carotid bruit, chronic cerebral ischemia, or nonhemispheric attacks, a low-grade increase in early mortality, the incidence of deaths, and the incidence of strokes in the long term, were established. Although an abnormal EEG cannot, by and large, be considered an absolute contraindication to surgery, it should, nevertheless, be a reason for carrying out a thorough internistic examination of the patient and for critically considering the surgical indications. PMID- 6861802 TI - Central conduction velocity (lumbar-vertex) in man calculated by means of a new method. Studies on variability, the effects of sex, age and different equipments. AB - Lumbar-to-scalp conduction velocity has been measured in 40 volunteers of both sexes, subdivided in two age groups, during uni- and bilateral peroneal nerve stimulation. It was calculated from the lumbar response to the main positive component of the simultaneously recorded, short latency scalp potentials (P3a). The mean value was 39.7 +/- 2.4 m/s (mean +/- SD). The mean side difference during unilateral stimulation was 2.08 +/- 1.6 m/s. It was extremely steady in a group of subjects repeatedly tested during a 14-month follow-up, even when different equipment was used. PMID- 6861801 TI - 100 cases of spontaneous intracerebral haematoma. Diagnosis, treatment and prognosis. AB - 100 consecutive cases of spontaneous intracerebral haematomas are reported, all examined by computerized tomography (CT). Exact siting of the haemorrhages was obtained, their expansion and volumes were calculated. 36 patients were operated upon. 63 survivors were followed up in respect of disablement and social rehabilitation. Almost half of the haematomas had volumes below 10 cm3 which, without CT would probably have escaped notice. The prognosis was predicted by the level of consciousness, the volume of the haematoma and its location. The total mortality was 37%, 35% returned to work, 6% required institutional care. Indications for operation are outlined, based on our observations. PMID- 6861804 TI - Combined partial temporal and secondary generalized status epilepticus. Report of a case with fear bouts followed by prolonged confusion. AB - A right-handed 32-year-old woman had recurrent combined partial temporal and secondary generalized epileptic states almost constantly related to menstruations. During such more or less prolonged episodes sometimes the patient presented right adversive attacks with short postictal dysphasia. The catamenial status epilepticus observed in this cas was manifested in two clear-cut behavioral phases. The first phase was characterized by frequently recurrent left temporal epileptiform discharges without tendency to diffusion, progressively more prolonged and pseudorhythmic associated with a signalized feeling of intense fear without apparent impairment of consciousness or speech disturbances. The electroclinical features of the first phase suggest a depth origin of the paroxysms, probably due to a primary epileptogenic focus in the left amygdaloid hippocampal complex. In the second phase the left temporal focal semirhythmic discharges associated with fear bouts became more frequent and prolonged and began to be followed by long-lasting generalized discharges resulting in a trance like state with severe impairment of consciousness. The diffuse paroxysmal activity regularly preceded by the left temporal focal discharges was interpreted as a form of secondary bilateral synchrony constantly triggered from a focal pacemaker represented by the primary epileptogenic focus. During the very short transient periods of sudden cessation of the epileptiform activity the patient returned immediately to an apparent normal mental state. Good correlation could be established between different seizure patterns and predominant clinical signs. Intravenous diazepam rapidly decreased and then completely stopped the catamenial status epilepticus. Some problems related to the classification of these rare epileptic events are discussed. PMID- 6861806 TI - Familial paroxysmal kinesigenic choreoathetosis. Report of a pharmacological trial in 2 cases. AB - 2 cases of familial paroxysmal kinesigenic choreoathetosis are described. The results of a pharmacological trial with phenobarbital, valproic acid, diazepam, iota-Dopa plus carbidopa, and haloperidol are reported. Phenobarbital is the only effective drug. On this basis the pathophysiological mechanisms of this rare disorder are briefly discussed. PMID- 6861808 TI - Second piroxicam symposium. PMID- 6861809 TI - Comparative study of piroxicam and indomethacin retard in osteoarthritis. AB - Indomethacin retard and piroxicam were compared in an open, randomized, parallel study in the treatment of osteoarthritis. Improvement of the symptoms of the disease was highly significant for both drugs. There was no statistical difference between the two drugs in terms of efficacy. Number and duration of side effects were significantly lower with piroxicam than with indomethacin retard. Piroxicam was administered once a day. Indomethacin retard was always (43% of the cases) or sometimes (14%) given twice daily. PMID- 6861805 TI - First results of immunotherapy with immunoglobulin G in multiple sclerosis patients. AB - 31 patients with multiple sclerosis were treated for an mean period of 4 years with high doses of human immunoglobulin. Overall, one third improved, one third showed no change and one third deteriorated. The effect of treatment was not related to any clinical or biological variable except perhaps the immunogenetic profile (HLA). The potential role of this symptomatic treatment is discussed. PMID- 6861807 TI - Eating seizures. AB - Three personal observations of "eating seizures' are described and similar cases in the literature considered. The authors conclude that eating seizures represent an unusual pathological event with complex physiopathological mechanisms, and prognosis may change in relation to the different clinical contexts. The role of intermittent prophylactic treatment with clobazam is discussed. PMID- 6861810 TI - Multicenter study of piroxicam in the treatment of acute musculoskeletal diseases involving 3011 patients. AB - An open non-comparative study was conducted to assess the efficacy and tolerability of piroxicam in patients with acute musculoskeletal disease. A total of 3011 patients of both sexes, aged between 18 and 70, were treated with piroxicam: 4 capsules (40 mg) after dinner, on the first two days and two capsules (20 mg) on the following days. Patients were evaluated for a maximum period of 14 days. Assessment of efficacy was made including local pain and limitation of mobility. The patients' self-assessment of pain was also analyzed. A clear improvement in each of the parameters analyzed was found by the third day of treatment. The general self-assessment of efficacy by the patients presented excellent and good results in 97.5%; very similar to the final assessment of efficacy made by the doctors, 91.1%. Adverse reactions were found in 368 patients (12.22%). PMID- 6861812 TI - The effect of piroxicam on neutrophil and monocyte-macrophage function. AB - The effect of piroxicam on neutrophil and monocyte chemotaxis was evaluated in vitro and in vivo. Piroxicam demonstrated a marked inhibitory activity on neutrophil chemotaxis and to a lesser extent on monocyte chemotaxis. The data here presented supports the notion that piroxicam interfere with the inflammatory process by affecting primarily neutrophil and to a lesser degree monocyte function. PMID- 6861811 TI - Use of piroxicam in the treatment of acute gout. AB - The authors carried out an open noncomparative study to evaluate the anti inflammatory therapeutic activity of piroxicam in 40 adult patients suffering from acute gout. The patients ranged in age from 28 to 68 years (the average age was 51.6 years) overall, 21 men and 19 women participated in the trial. All of the patients had their disease for more than one year and they were receiving treatment with Benziodarone, 100 mg per day when the drug was discontinued from clinical use in Brazil. All of these patients subsequently experienced aggravation of their disease and had an acute attack of gout. Each patient was given piroxicam, 40 mg, in a single dose on the first day and two divided doses of 20 mg for the following five days. The affected joints were: elbow, knee, ankle and hallux. Severity of pain at rest, severity of pain on movement, tenderness, swelling, redness, heat and restriction of movement were evaluated. By the sixth day of the trial, good or total remission was observed in all patients. Overall evaluation of efficacy showed excellent and good results in 81.6% of the patients. Tolerability was excellent and good in 92.5%. All adverse reactions that occurred during the use of piroxicam therapy were noted. Five patients showed mild side effects, such as pyrosis, nausea and headache, and two patients had severe side effects (skin rash, gastric disturbance) that necessitated withdrawal from therapy. Finally, statistical analysis demonstrates that piroxicam is highly efficacious in the treatment of acute gout. PMID- 6861813 TI - Pharmacokinetics of piroxicam in man. AB - Piroxicam is a potent antiinflammatory agent currently in widespread use for the treatment of various inflammatory conditions of man. Following single oral doses of 10 to 100 mg, piroxicam is rapidly and fully absorbed, and eliminated with a mean plasma half life of about 45 hr. Mean peak concentrations are about 2 micrograms/ml after single 20 mg doses and about 6 micrograms/ml at steady state with 20 mg daily. Multiple peaking suggests enterohepatic recirculation of drug. In accord with expectations, steady state is achieved within 7 to 12 days with no appreciable accumulation thereafter. Due to the long plasma half life, once daily dosing provides continuous exposure to drug, with concentrations fluctuating less than twofold. Coadministration of aspirin reduces piroxicam levels by about 20 percent; antacids have no effect on piroxicam plasma concentrations. PMID- 6861815 TI - Experience with piroxicam in general practice: results of a German multicenter study on 18,888 patients. AB - 18,888 patients with chronic or extra-articular rheumatic diseases were treated for an average period of 36.1 or 26.9 days with the new non-steroidal anti rheumatic agent piroxicam. In particular, piroxicam had a positive effect in terms of providing relief from pain. Side effects were relatively rare and seldom required discontinuation of treatment. In about 75% of the patients the maintenance dose was 20 mg piroxicam in a single daily dose. No influence on the laboratory values or accompanying diseases were observed. PMID- 6861814 TI - Clinical and laboratory changes produced by piroxicam in rheumatoid arthritis. AB - Twenty-five patients with active rheumatoid arthritis received treatment with piroxicam during 12 weeks in an open, non-comparative trial. In addition to improvement of clinical parameters, a significant diminution of the erythrocyte sedimentation rate and a decrease in rheumatoid factor titers was noted in both serum and synovial fluid. PMID- 6861816 TI - An epidemiological and therapeutic multicenter study involving 3,309 patients with osteoarthritis. PMID- 6861818 TI - Ureterosigmoidostomy in bladder exstrophy. AB - Experience with ureterosigmoidostomy (US) using a reflux prevention technique in 38 of 48 cases of bladder exstrophy is reviewed. During a follow-up period of 14 years, the results were excellent as to morphological changes of the upper urinary tract, incontinence, psychological development and social behavior. Within their families the patients are considered healthy. Even in children with benign disease, US with reflux prevention performed during the second year of life is the operation of choice for urinary diversion. In the postoperative follow-up it is recommended that sigmoidoscopy be performed once a year in addition to routine controls of the upper urinary tract and metabolic balance. PMID- 6861817 TI - Anorectal physiology after anterior resection and pull-through operation. AB - Sensory and motor investigations have been performed in normal subjects, in patients who had undergone low anterior resection of the rectum and in patients following Bacon-type pull-through operation. The electromechanical relationship has been clearly defined in the anal sphincter activity. The motor findings, the threshold for sensation and its quality in the patients following low anterior resection were similar to those of the controls. Following pull-through operation the anorectal inhibitory reflex is frequently replaced by a contraction of the sphincteric zone. But, sometimes, this reflex is preserved as well as a fine discriminatory sensation. These data suggest that at least some of the mechanisms of anal sphincter continence have been preserved even after complete excision of the rectum. PMID- 6861820 TI - Suprapubic transvesical sonography of the prostate: determination of prostate size. PMID- 6861819 TI - A prospective randomized study of preoperative irradiation with cystectomy or cystectomy alone for invasive bladder carcinoma. AB - Prognosis was studied in 44 patients with urothelial bladder tumors, WHO grades 2 or 3, invading the lamina propria or the muscular coat, without signs of distant metastases. The patients were preoperatively randomized into two groups according to treatment: total cystectomy with or without preoperative irradiation. The 3- and 5-year survival rates were 81 and 61%, respectively, in 22 patients not receiving preoperative irradiation. 22 patients preoperatively irradiated had 3- and 5-year survival rates of 81 and 75%, respectively. Individuals who were tumor free at cystectomy after preoperative irradiation had an excellent prognosis and tumor eradication was achieved in 80% when a cumulative radiation effect (CRE) above 1,400 reu was administered. Only 1 of 10 patients who received a CRE above 1,400 reu died from bladder tumor. This might indicate that preoperative irradiation improves the survival rate providing the CRE exceeds 1,400 reu. The presence of residual tumor after transurethral resection, aimed at resecting the tumor completely, seems difficult to evaluate since the surgeon was mistaken in believing the excision to be radical in more than 50% of the cases. The risk of error was especially high when the tumor infiltrated the muscular wall of the bladder. PMID- 6861821 TI - The challenging vesicovaginal fistula. AB - The authors report herein their experience in treating 75 cases of vesicovaginal fistulas. 80% were caused by gynecologic surgery and 20% were of obstetrical origin. The authors favor the transvaginal approach and describe in detail the two technics they recommend. The most commonly used method is the Chassar-Moir procedure. 70% of the patients were cured after one attempt with this procedure, and 93% after two operations. In complicated fistulas (irradiated or extended to the urethra) the Martius procedure was used. In this technic a flap formed from the fat tissue of one of the labia majora is interposed between bladder and vagina. 10 of 11 patients so treated were cured. PMID- 6861822 TI - Experience with 204 renal cell carcinomas. Management and operative approach. PMID- 6861823 TI - Papillary morphology in adult human kidneys and in baby and adult pig kidneys. AB - The morphology of the renal papillae was studied by inspection in a series of: (1) Hampshire/Duroc piglet kidneys; (2) Danish Landrace adult pig kidneys, and (3) kidneys obtained at necropsy from adult patients. In both man and pig two main types of papillae were found: (1) a single or 'simple' papilla which drains one renal lobe, and (2) a fused or 'compound' papilla which drains two or more renal lobes. Compound papillae were found most frequently in the Hampshire/Duroc kidneys and least frequently in the human kidneys. In all three groups compound papillae were found most frequently in the upper pole. Intrarenal backflow during retrograde pyelography in the piglet kidney at intrapelvic pressures of 30-35 mm Hg (moderate) and of 70-75 mm Hg (high) was related to the morphology of the individual papilla. Both types of papilla could be divided into an open type containing at least two round or oval orifices of the papillary ducts and a closed type with small, often slit-like orifices. At moderate intrapelvic pressure intrarenal backflow occurred mainly in the open compound papillae whereas at high intrapelvic pressure it occurred in nearly all open compound papillae and in about 50% of the open simple papillae. It is concluded that papillary morphology plays an important role in the predominant upper polar occurrence of intrarenal backflow/intrarenal reflux during micturition cystography and in the higher frequency of intrarenal backflow in the mid-zone than in the lower pole in adult human beings. PMID- 6861825 TI - Long-term survival with recurrence of hypernephroma. PMID- 6861824 TI - Percutaneous nephroscopy: a review of the physical properties, suitability and cost of the instruments. AB - The physical properties, suitability and cost of six instruments used for elective percutaneous renal endoscopy have been evaluated. Three were rigid and three were flexible. The optics, flow rate and accessories of the rigid instruments have been demonstrated to be superior to the flexible instruments. Flexible instruments, however, were used in 15% of our 70 elective percutaneous operations. The 21-Charr cystoscope was adequate for extracting smaller calculi, but it was necessary to use the Storz and Wolf rigid nephroscopes when ultrasonic disruption was required. Based on our data, improvements and modifications to both flexible and rigid instrument design are suggested. PMID- 6861826 TI - Hemangioma of the kidney. AB - A case of hemangioma in the lower pole of the right kidney is reported. Relapsing hematuria and a urographic filling defect were the principal findings. A vascular mass of thick uniform vessels with rapid shunting of contrast medium into the vein was seen in arteriography. The histologic appearance was highly dilated vessels with well-framed walls. Lower heminephrectomy was successfully performed. The main features of this rare tumor are discussed. PMID- 6861827 TI - Page kidney. Curable hypertension. PMID- 6861829 TI - Learning style and its relation to exceptionality at both ends of the spectrum. PMID- 6861828 TI - Research in reading and learning style: implications for exceptional children. PMID- 6861830 TI - Left/right brains, teammates in learning. PMID- 6861831 TI - Goal attainment scaling: a method for evaluating special education services. PMID- 6861832 TI - Sources and manifestations of occupational stress as reported by full-time special education teachers. PMID- 6861833 TI - A survey of special education teacher consultants. PMID- 6861835 TI - An animal model of age changes in short-term memory: the DRL schedule. AB - Eight mature (6 month old) and seven aged (24 month old) male Sprague Dawley rats were trained for 20, 30-min sessions on a differential-reinforcement of-low-rate 6 sec schedule. Responses were recorded according to their interresponse times (0 2 sec, 2-4 sec, 4-6 sec, 6-8 sec, 8-10 sec, and greater than 10 sec). Results indicated that the aged rats initially had difficulty in inhibiting short IRT responses, but with extended training this performance deficit was overcome and both age groups exhibited characteristic and effective patterns of responding. These data suggest that aged rats suffer from a temporary response bias and not a deficit in STM. PMID- 6861836 TI - A multidimensional scaling analysis of aging and the semantic structure of animal names. AB - Adult age differences in semantic structure were investigated using nonmetric individual differences multidimensional scaling. Similarity judgments of all possible pairs of 16 animal names were obtained from 20 adults in each of the following six age ranges: 20-29, 30-39, 40-49, 50-59, 60-69, 70-79. The overall scaling solution revealed a semantic space consisting of the features of size and predativity. Comparisons of the age groups revealed a small but statistically significant tendency for participants in the two oldest groups to emphasize the concrete dimension of size, in contrast with the middle-aged groups who emphasized the abstract dimension of predativity. This abstract-to-concrete trend of adult age differences is compared with the concrete-to-abstract trend for this same semantic domain which has been observed previously among young children. PMID- 6861834 TI - The role of pre-experimental knowledge in text processing in adulthood. AB - The present investigation was designed to examine the effects of pre-experimental knowledge on the text recall of younger (mean = 23.1 years), middle aged (mean = 44.2 years), and older (mean = 66.8 years) adults. The subjects were presented with biographical sketches of famous entertainment figures selected such that normatively differential levels of pre-experimental knowledge about the figures was possessed by the various age groups. Subjects recalled the texts immediately after input and again after a delay of one week. Analyses indicated that, at the immediate test, younger subjects remembered the texts better than the middle-aged and older subjects. However, at the delayed test, the performance of the younger subjects did not differ significantly from either older group. In addition, age interacted with story type. The pattern of results suggested that age differences in text processing may be present or absent depending on the level of pre experimental knowledge about the to-be-remembered topic possessed by the various age groups. PMID- 6861837 TI - Effects of dietary carnitine on myocardial palmitate oxidation in the aging rat. AB - Aging is associated with decreases in myocardial fatty acid oxidation and carnitine concentration. The purpose of this study was to investigate the effects of dietary carnitine manipulation on myocardial palmitate oxidation and carnitine content in young adult and middle-aged rats. Rats were fed either a carnitine free or a carnitine-supplemented diet for nine weeks and killed at ages 6.5 and 18 months. Myocardial carnitine content was unaffected by age or diet. However, in 18 months rats fed a carnitine-free diet, myocardial palmitate oxidation was 77% higher, carnitine palmitoyltransferase activity 39% higher, and lipid droplet volume density 55% higher compared to 18 month rats fed a carnitine-supplemented diet. In 6.5 month rats, dietary carnitine had no effect on these variables. These results indicate that dietary carnitine restriction increases myocardial fatty acid metabolism in middle-aged but not in young adult rats. PMID- 6861838 TI - The role of memory in personality continuity: a 25 year follow-up. AB - Several longitudinal studies have been published showing high retest coefficients in self-report personality inventories. While the data suggest stability in personality over long periods of adulthood, critics have argued that individuals may be motivated to present themselves in consistent fashion to the investigator. It has been suggested that respondents may remember how they answered the items previously. Thus, memory and the desire for consistency may be responsible for the high stability coefficients typically observed. In the present study 85 individuals who had completed the California Test of Personality as university students in 1944 were asked to complete it again 25 years later. Respondents were instructed to remember how they had answered the inventory as students and to fill it out in that manner (Retrospective condition) in addition to responding as they were in the present (Self condition). Results indicated high retest correlations between the 1944 and 1969 Self conditions, whereas the correlations between the 1944 Self and 1969 Retrospective conditions were much lower. Subjects describing their present selves obtained scores more highly correlated with their 1944 scores than scores created by attempting to describe themselves as they had been 25 years previously. These data indicate that memory for responses to a personality inventory taken years before is inaccurate, and that it cannot account for the observed consistency in personality test scores. PMID- 6861839 TI - Effects of age on some behavioral characteristics of novel auditory stimuli in the rat. AB - Low intensity novel auditory stimuli have two behavioral characteristics. First, such stimuli elicit exploratory behavior directed at the sound source. Second, novel stimuli gain control of responding in a discriminative task more rapidly than familiar stimuli. Experiments were carried out to investigate these two characteristics of novel stimuli. In the first experiment 3, 12 and 30 month old rats were given three sessions, 24 hours apart, of exposure to an initially novel low intensity series of noise pulses; the number of exploratory responses of the sounding speaker per session was counted. In the second experiment, 12 and 30 month old rats were trained in a sound location discrimination in which the stimuli were made familiar prior to discrimination training. Age had no effect on the amount, habituation and retention of habituation of exploration of the sounding speaker. In the second experiment, the 12 month and 30 month old animals acquired the discrimination at the same rate; again no age effect was found. PMID- 6861840 TI - Effects of protein, dietary restriction, and exercise on survival in adult rats: a re-analysis of McCay, Maynard, Sperling, and Osgood [1941]. PMID- 6861841 TI - Reward in the learning of older adults. PMID- 6861843 TI - A useless exercise. PMID- 6861842 TI - Contextual effects upon text memory for young, aged-normal, and aged memory impaired individuals. AB - The purpose of the study was to assess contextual effects upon text memory for young, aged-normal, and aged memory-impaired individuals. Subjects read short passages which differed in their contextual relatedness to target sentences, and then recalled those target sentences. It was found that large differences distinguished the performance of the young from the elderly on the free recall task; that cueing aided the performance of the young and the elderly-normal more than the aged-impaired; and lastly, that no differences were found in recognition performance between young and aged normals whereas the performance of the aged impaireds was significantly poorer than either the young or the aged-normal group. The results were interpreted in light of two hypothetical mechanisms; the first is labeled "normal" aging and the second, "pathological" aging. PMID- 6861844 TI - Ibopamine in very severe congestive heart failure: pilot haemodynamic invasive assessment. AB - The acute effects of ibopamine, a new, orally active dopaminergic agent, were assessed invasively in 8 patients with congestive heart failure (NYHA Class IV). The cardiac Index increased (P less than 0.01) and preload and afterload decreased (P less than 0.05) after a single mean dose of ibopamine 1.4 mg/kg. The peak effect occurred after 1 to 3 h and activity was still demonstrable after 4 to 6 h. There was no change in blood pressure, heart rate or rhythm. No clinical evidence of cardiac toxicity or side effects was noted. Oral ibopamine shows promise in the treatment of congestive heart failure, but more extensive studies after chronic treatment are desirable. PMID- 6861845 TI - Endralazine, a new peripheral vasodilator. Evaluation of safety and efficacy over a 3 year period. AB - Nineteen out-patients with moderate to severe essential hypertension were treated daily for 3 years, with an average dose of 13 mg endralazine, a new peripheral vasodilator, in free combination with pindolol 3 x 5 mg. The blood pressure showed a statistically significant reduction from 172/110 mmHg to 154/92 mmHg after treatment for 3 years. Tachyphylaxis was not observed during the 3 years period. Oedema was the most frequent side-effect, but it disappeared spontaneously. No difference in efficacy and tolerance between slow and fast acetylators was found. Only 2 patients developed a weak positive antinuclear antibody titre, which disappeared spontaneously from one during continued treatment. No clinical evidence of a systemic lupus erythematosus-like syndrome was noted. It is concluded that the differences between endralazine and hydralazine in dosage and metabolism may explain the lower immunogenic activity of endralazine. PMID- 6861846 TI - The effect of the calcium antagonist nifedipine on pressor and aldosterone responses to angiotensin II in normal man. PMID- 6861847 TI - Pharmacodynamic and pharmacokinetic interactions between ketamine and diazepam. AB - Anaesthesia with continuous i.v. ketamine and 65% nitrous oxide in oxygen was given to a total of 49 patients undergoing major abdominal surgery. A control group was premedicated with atropine and other groups received in addition rectal diazepam or clorazepate i.v. For further patients had been on oral diazepam or barbiturates for 1-14 years; as premedication they received atropine alone. The anaesthetic technique gave good operative conditions in the 4 groups of patients. The haemodynamic stimulation of ketamine was significantly reduced in patients premedicated with diazepam. Psychotomimetic side effects were not prominent in any of the groups. Patients premedicated with diazepam required a lower rate of ketamine infusion as compared to controls during the initial 30 min of anaesthesia. The patients in the other groups did not differ from the control group in this respect. There were large differences in metabolic pattern between the groups. As compared to the controls, the patients on long-term diazepam or barbiturates had high concentrations of hydroxylated metabolites, with levels higher than that of norketamine. The patients pretreated with diazepam had very low plasma levels of hydroxylated metabolites. Clorazepate premedication did not significantly affect the metabolism of ketamine. The biological half-life of ketamine was significantly increased in the diazepam-treated group, and it was shortened in those on long term treatment with barbiturates or diazepam. PMID- 6861848 TI - Pharmacokinetics of diltiazem after intravenous and oral administration. AB - The kinetic profile of diltiazem, a novel calcium antagonist, was studied in 12 volunteers following oral (60 mg) and intravenous (15 mg) administration. After i.v. administration biphasic elimination was observed, with a distribution half life of 0.3 +/- 0.2 h and an elimination half-life of 3.1 +/- 1.0 h; the apparent volume of distribution was 5.3 +/- 1.71/kg and the total clearance was 1.28 +/- 0.48 l/kg/h. After the oral dose the elimination had a half-life of 3.2 +/- 1.3 h. The absolute bioavailability of diltiazem ranged from 24 to 74% (mean 42 +/- 18%). The interindividual variation may be explained by a variable first pass effect. PMID- 6861849 TI - Bioavailability and pharmacokinetics of theophylline following plain uncoated and sustained-release dosage forms in relation to smoking habit. II. Multiple dose study. PMID- 6861850 TI - Plasma theophylline and caffeine and plasma clearance of theophylline during theophylline treatment in the first year of life. AB - Plasma concentrations of caffeine and theophylline were simultaneously determined in 17 preterm infants after oral administration of aminophylline for treatment of apnoea. The ratio of caffeine/theophylline concentration in plasma increased during the first 2 weeks of treatment, owing to the longer time required for caffeine than for theophylline to reach steady state. The caffeine/theophylline ratio at steady state was 0.57 +/- 0.03 (mean +/- SE). Thus, caffeine contributed significantly to the total methylxanthine load in the infants. The plasma clearance of theophylline was calculated from the plasma steady state concentrations. In 3 preterm infants treated with oral aminophylline, repeated sampling showed an approximately linear increase in clearance with time from 16.8 +/- 0.4 (mean +/- SE) at a postnatal age of 6-11 days to 30.9 +/- 2.5 ml/kg/h at 64-69 days. In 1 full-term infant treated with oral theophylline from 3.5 to 11.5 months of age, the plasma clearance of theophylline increased in a roughly linear manner, reaching a plateau of about 100 ml/kg/h at 6-7 months of age. This corresponds to the clearance found in 1-4 year old infants. PMID- 6861854 TI - Biological variability of multiple dose pharmacokinetics of netilmicin in man. PMID- 6861853 TI - Pharmacokinetics and clinical effects of cefuroxime in patients with severe renal insufficiency. AB - The pharmacokinetics and clinical effects of cefuroxime were investigated in 5 patients with severe impairment of renal function (creatinine clearance less than or equal to 23 ml/min), suffering from an urinary tract infection. Bolus i.v. injections of cefuroxime 750 mg b.i.d. or 750 mg once daily were given to the patients depending on the degree of renal impairment. The concentration of drug in serum and urine was measured during treatment, and pharmacokinetic parameters were evaluated on the second and last days; the parameters obtained on the 2 days did not differ significantly. Drug elimination half-life increased from 4.2 h (creatinine clearance 23.0 ml/min) to 22.3 h (creatinine clearance 5.0 ml/min) with decreasing renal function. The apparent volume of distribution ranged from 11.6 to 17.9 l, and showed a substantial increase to 29.6 l in the patient with the poorest renal function. A linear correlation was found between the total and renal clearance of cefuroxime and the creatinine clearance; the extrarenal clearance was 8.24 ml/min. Concomitant treatment with furosemide did not impair renal function and no evidence of nephrotoxicity was found. The clinical efficacy of the drug was good. Symptoms of infection subsided after 3-4 days and the isolated pathogens were eradicated. No relapse or episodes of reinfection were observed in a following-up period of 3 months. The drug was well tolerated and no side effects or changes in haematological or biochemical values were seen. PMID- 6861851 TI - Effect of dosage frequency of carbamazepine on drug serum levels in epileptic patients. AB - The effect of dosage frequency of carbamazepine (CBZ) (brand name Tegretol) on pseudo-steady state drug serum levels were studied in 14 male (16-18 years) epileptics. They had already been receiving CBZ (mean dose 13.7 mg/kg) for an average period of 2.3 years in combination with other antiepileptic drugs. During this investigation, total daily CBZ dose was kept unaltered, but they received medication in thrice, twice and once daily dosage regimes. Each treatment period lasted for 4 weeks. The profiles of 24 h serum drug levels as assessed at the end of each treatment period, were observed to be within the therapeutic range during these 3 regimes. However, as expected, there were higher fluctuations of serum CBZ concentrations during once daily medication than during divided dosage regimes. Other concomitant antiepileptic drugs were continued in 2-3 divided daily doses during these 3 treatment periods, and the serum drug levels were measured at 8 h prior to the morning dosing. The concentrations of other drugs remained unchanged apart from a slight decrease in the serum sodium valproate levels during once daily medication. No clinical or electroencephalographic adverse effects were observed and there was no significant change in the fit frequency. In view of this observation, CBZ (Tegretol tablet) is probably effective as a single daily dose, but further long-term controlled clinical trial is necessary. PMID- 6861852 TI - The effect of ethanol administration on the disposition and elimination of chlormethiazole. AB - Acutely administered ethanol has been shown to inhibit the hepatic metabolism of a number of drugs. Ethanol might be expected to decrease the first-pass extraction of chlormethiazole leading to higher blood levels of this high clearance sedative frequently used in the management of alcoholic patients. Chlormethiazole has a narrow therapeutic index and the unexpected deaths reported in alcoholics taking this drug may have been due to an effect of ethanol on the metabolism of chlormethiazole. However in this study, acutely administered ethanol maintained at levels around 22 mmol/l had no significant effect on the disposition or elimination of either daily or intravenously administered chlormethiazole. PMID- 6861855 TI - Pharmacokinetics and protein binding of prednisolone after oral and intravenous administration. AB - The pharmacokinetics of prednisolone after oral and intravenous administration of 10 and 20 mg have been studied. Serum protein binding of prednisolone was also measured after the i.v. injections. The bioavailability after oral administration was 84.5% after 10 mg and 77.6% after 20 mg (p greater than 0.05). Dose dependent pharmacokinetics were found, the VDss and Clt being significantly larger (p less than 0.01) after 20 mg i.v. than after 10 mg i.v. The protein binding of prednisolone in all subjects was non-linear, and is the most likely cause of the dose dependent pharmacokinetics, as there was no dose dependent variation in elimination half-time. PMID- 6861856 TI - Severe toxic reaction to tinidazole. AB - A physician aged 44 years participated as a volunteer in pharmacokinetic studies with tinidazole (FASIGYN, Pfizer). He received 1600 mg of the drug as an intravenous infusion over 80 min. Shortly afterwards, he fainted and was unconscious for about 10 s. The attack was followed by low blood pressure, nausea and tiredness for several h. The serum concentration of tinidazole was 35.4 mg/l when the attack started. Blood tests showed a normal immunoglobulin E level, and a transient fall in the concentration of complement factor C3 after the infusion. It is concluded that tinidazole caused an acute toxic reaction with subsequent activation of complement factors. PMID- 6861859 TI - Diuretic effect of slow-release furosemide in elderly patients. AB - To compare the natriuretic and diuretic effects of a slow-release and a standard formulation of furosemide, 18 elderly patients with stable congestive heart failure were hospitalized and treated with one of these formulations in a double blind randomized trial. Patients received placebo on the first 2 days, furosemide on the third day and placebo again on the last 2 days of the study. In patients receiving the standard formulation mean urine output was increased only on the day of active treatment. However, in patients who had received the slow-release preparation, increased urine excretion was seen both on the day of active treatment and on the subsequent day. The total diuresis (0-48 h) in the 2 groups was equal, but a peak diuresis (0-6 h) was seen only in patients on the standard formulation of furosemide. Sodium excretion followed the pattern of urine excretion. Furosemide in a slow-release formulation offers advantages in maintenance therapy in congestive heart failure, especially in elderly patients. PMID- 6861857 TI - Effect of fenoterol on small airways and regional lung function in asymptomatic asthma. AB - Lung function tests for small airways were performed before and after inhalation of fenoterol by 11 young asymptomatic asthmatics and in 8 control subjects. In the asthmatics, minimal impairment in the tests was found except for increased expansion of the lower part of the lung (133Xe regional lung volumes) and an "abnormal" distribution pattern of a bolus of Xe inhaled from the residual volume. This suggests enhanced airway closure, especially in the lower area of the lung. Usual therapeutic doses of fenoterol (0.4 to 0.6 mg in puffs) could not correct these abnormalities, but 1.2 mg given to 2 patients resulted in changes similar to those observed in normals. The results suggest that small airway impairment in asymptomatic asthmatics is not only related to enhanced bronchomotor tone, but also to anatomical changes located especially at the base of the lung. PMID- 6861858 TI - Trends in peptic ulcer related diseases from 1972 to 1980. Hospital activity analysis data and general practice cimetidine prescribing levels. AB - Between 1972 and 1980 Hospital Activity Analysis from 5 Northern Ireland Hospitals demonstrated a gradual increase in the number of patients discharged for all diagnoses whilst there was a decline in discharges for peptic ulcer related disease, (duodenal ulcer, gastric ulcer, gastrojejunal ulcer, peptic ulcer site unspecified and hiatal hernia). The mean number of peptic ulcer related disease discharges per year for 1977-80, when cimetidine became generally available, was 10% lower than that of 1972-76, mainly due to a decline in male patient numbers. The mean annual number of male patients with a duodenal ulcer fell significantly by 18% (U = 1, p less than or equal to 0.025) during the 1977 80 period, whereas female discharges decreased by only 4%. Between 1972-76 and 1977-80 the mean annual number of duodenal ulcer perforations decreased significantly by 21% in males but only by 4% in females. Surgery for peptic ulcer related disease was 47% less in 1977-80 period, with significant decreases in duodenal ulcer, gastric ulcer and hiatal hernia procedures. From 1977 to 1980 there was considerable growth in Northern Ireland general practice cimetidine prescribing with 300,000 prescriptions being dispensed over the period. Apart from male duodenal ulcer cases, hospitalisation for peptic ulcer related diseases did not decrease substantially after the introduction of cimetidine but duodenal ulcer perforation and conditions warranting surgery did decline. PMID- 6861860 TI - Delayed elimination of triamterene and its active metabolite in chronic renal failure. AB - The kinetics of triamterene and its active phase II metabolite were studied in 32 patients with various degrees of impaired renal function; the creatinine clearances ranged from 135 to 10 ml/min. The area under the plasma concentration time curves (AUC) for triamterene were not influenced by kidney function, but the AUCs for the effective metabolite OH-TA-ester were significantly elevated in renal failure, indicating accumulation of the metabolite. Urinary recovery of triamterene and its metabolite over a 48 h collection period was significantly reduced in renal failure. This is considered to be due to delayed urinary excretion, corresponding to reduced renal clearance. The renal clearance of the native drug exceeded that of the metabolite, because of their different protein binding, 55% for triamterene and 91% for the metabolite. The latter is eliminated almost exclusively via tubular secretion and extra-renal elimination is less important. Administration of this antikaliuretic is therefore considered hazardous in patients with impaired kidney function. PMID- 6861861 TI - Effect of zopiclone on the arousal level of healthy volunteers assessed by the averaged photopalpebral reflex. AB - The averaged photopalpebral reflex (PPR) represents the mean of summed reflex contractions of the orbicularis oculi muscle in response to periodic photic stimuli. The latency of PPR can be used to assess a drug effect on human arousal level, since it is prolonged if there is a reduction in the arousal level of the subject. In the present study of the clinical effects of zopiclone, healthy male volunteers aged 18-22 years were given zopiclone 5 mg and 10 mg, nitrazepam 5 mg and 10 mg, or placebo, in a double-blind, cross-over design. Changes in the latencies of PPR were examined from 0.5 to 4 h after medication. Both zopiclone and nitrazepam prolonged the latency in a dose-dependent manner, but the prolongation induced by zopiclone appeared more rapidly, was slightly more marked and lasted for a shorter period than that induced by nitrazepam. Zopiclone produced slightly fewer subjective changes, such as vagueness of thought and weakness, than did nitrazepam. From these results, it is suggested that zopiclone possesses a potent hypnotic action which appears more rapidly and is slightly more potent and shorter lasting than that of nitrazepam. In addition, zopiclone may also exhibit fewer side effects, such as vagueness of thought and weakness than nitrazepam, and it may cause less "hang over". PMID- 6861862 TI - Visual analogue scale and the analysis of analgesic action. AB - A double-blind randomized trial was carried out in 90 male patients suffering from pain after meniscectomy. The patients received a single dose of paracetamol 1000 mg plus codeine 60 mg, paracetamol 1000 mg, codeine 60 mg, or placebo. The tablets were taken when needed after surgery and the postoperative pain was recorded on a visual analogue scale. Over a period of 4 h the efficacy of the drugs was calculated in terms of pain intensity, pain intensity difference and percentage pain reduction. The greatest effect was obtained in patients taking the paracetamol plus codeine combination. Statistical analysis was carried out by use both of parametric and non-parametric procedures. The results suggest that pain reduction is a valuable measurement of analgesic efficacy and that non parametric assumptions are preferable in the statistical analysis of analgesic activity. PMID- 6861863 TI - Serum concentrations of amiodarone during long term therapy. Relation to dose, efficacy and toxicity. AB - In 17 patients on long term therapy with amiodarone, serum drug levels measured by HPLC were related to pharmacological effects. At steady state, serum levels were directly proportional to the dose, 5 mg/kg per day leading to an average serum level of approximately 2.5 mumol/l. The non-amiodarone level of iodine averaged 4-times higher than the level of amiodarone iodine. The elimination half life of amiodarone ranged from 21 to 78 days, and of non-amiodarone iodine from 24 to 160 days. Control of arrhythmias was satisfactory in all 12 evaluable patients, when the serum amiodarone level exceeded 1.5 mumol/l. Deterioration of vision and polyserositis occurred only at amiodarone levels above 4 mumol/l. Tentatively, a therapeutic range of 1.5 to 4 mumol/l is proposed. In contrast, thyroid dysfunction was observed at any amiodarone level. In view of the narrow therapeutic window, therapy with amiodarone may be optimized by monitoring its serum level and in addition, thyroid function should be regularly checked. PMID- 6861864 TI - Pharmacokinetics of prenalterol after single and multiple administration of controlled release tablets to patients with congestive heart failure. PMID- 6861866 TI - Bioavailability and saturation of the presystemic metabolism of oral lorcainide therapy initiated in three different dose regimens. AB - The feasibility of giving a supplementary starting dose of the antiarrhythmic drug lorcainide, in order to minimalize the impact of the extensive, but saturable first-pass metabolism, was evaluated. Twenty-five adult patients were given 100 mg lorcainide tablets according to one of 3 different dosage schedules: Eight patients took one tablet at 0, 12 and 24 h, 8 took 1 tablet at 0, 1, 12 and 24 h and 9 took 1 tablet at 0, 2, 12 and 24 h. Levels of lorcainide and its metabolite, nor-lorcainide, during treatment were determined by gas-liquid chromatography. The results show that giving a second tablet 1 or 2 h after the first may produce faster saturation of the pre-systemic metabolism of lorcainide in the liver. PMID- 6861865 TI - Pharmacokinetics in man of a new antiarrhythmic drug, cibenzoline. AB - The kinetics of cibenzoline (UP 339.01), a new antiarrhythmic drug, was studied after i.v. and oral administration to 5 healthy subjects. Cibenzoline levels in plasma and urine cibenzoline were measured by a GLC method. After i.v. administration, the total clearance was 826 ml . min-1. The fraction of cibenzoline excreted unchanged in the urine was 0.602 and it was correlated with the creatinine clearance. After i.v. and oral administration, the renal clearances were 499 ml . min-1 and 439 ml . min-1, and the half-lives were 4 h 01 min and 3 h 24 min, respectively. The differences were not significant. Availability by the oral route was 0.92, the maximum plasma concentration being observed at 1 h 36 min. The results were compared with those for other antiarrhythmic drugs. PMID- 6861867 TI - Pharmacokinetics of sotalol during pregnancy. AB - Sotalol, a beta-adrenoceptor blocking drug, was administered to 6 healthy pregnant volunteers between 32-36 weeks gestation and when at least 6 weeks post partum. On both occasions, each volunteer was given sotalol 100 mg intravenously and 400 mg orally in randomised order with at least a 1 week washout period between. Plasma samples were analysed for sotalol using a fluorometric method and the pharmacokinetic profiles investigated. The systemic clearance of sotalol was significantly greater in the antenatal period (2.4 +/- 0.3 ml/min/kg) than in the post-natal phase (1.5 +/- 0.1 ml/min/kg). The apparent volume of distribution was similar in the two periods: the elimination half-life was 6.6 +/- 0.6 h ante natally and 9.3 +/- 0.7 h post-natally after intravenous drug but the trend for faster elimination was not significant. The elimination half-life after oral administration (about 10 h) and bioavailability (about 90%) were not altered significantly by pregnancy. It is suggested that the more rapid clearance of sotalol in pregnancy may be due to increases in renal plasma flow and glomerular filtration rate. PMID- 6861868 TI - Lack of dose dependent kinetics of theophylline. AB - Oral theophylline was given to 6 adults with airways obstruction. The initial dose was 125 mg daily and this was increased by 125 mg each week. The final total daily dose reached was determined by side effects and ranged from 500 mg to 1125 mg. At the end of each week and before the next dosage increment steady state, trough plasma theophylline concentrations were measured. For each individual and for the group as a whole there was a highly significant linear correlation between theophylline dose and trough plasma concentration. This indicates that for oral theophylline, in adults, dose-dependent kinetics do not play a significant role and dose may be adjusted without fear of a disproportionate rise in plasma concentration. PMID- 6861869 TI - Relationships between plasma theophylline clearance, liver volume and body weight in children and adults. AB - The influence of liver volume and body weight on plasma theophylline clearance was investigated in asthmatic children and adults. A linear relationship (r = +0.99) was demonstrated between ideal body weight and liver volume estimated by an ultrasonic scanning technique. Age-related changes in liver volume-to-body weight ratio could account for only 30% of differences in plasma theophylline clearance (1/h/kg) between children and adults. It is summized that increased hepatic mixed function oxidase activity is the major contributor to the higher plasma theophylline clearance in children. PMID- 6861870 TI - Procaine hydrolysis defect in uraemia does not appear to be due to carbamylation of plasma esterases. AB - Procaine esterase activity in plasma from patients with renal failure is decreased by 40%. Since cyanate is formed from urea and readily carbamylates certain blood proteins, a possible role for cyanate in the depression of plasma esterase activity in uraemic patients was considered. However, in vitro carbamylation of normal plasma in a range similar to that detected in uraemic patients did not influence procaine esterase activity. Kinetic analysis of the reaction showed that the maximal hydrolyzing capacity but not the Km in uraemic plasma was diminished (5.0 +/- 0.3 X 10(-5) moles hydrolyzed per litre of plasma per minute and a Km of 3.9 +/- 0.2 X 10(-5) mol/l in plasma from normal volunteers as compared to 3.1 +/- 0.1 X 10(-5) mol/l/min and 3.5 +/- 0.2 X 10(-5) ml/l in plasma from patients with renal failure). Therefore, not carbamylation but rather a decrease in enzyme synthesis is the likely explanation for the lower rate of procaine hydrolysis in uraemic plasma. PMID- 6861871 TI - Steady-state kinetics and analgesic effect of oral morphine in cancer patients. AB - The steady-state kinetics of morphine given as tablets and solution were compared in 7 cancer patients with chronic pain. There was no accumulation of morphine (20 40 mg) when repeatedly administered every 4 to 6 h. The mean steady-state concentration of morphine during the dose interval varied between 5.9 and 68.4 ng/ml (20.7-240 nmol/l), and was linearly related to the daily dose of morphine. There were no significant differences between the tablets and the solution of morphine with regard to relative oral bioavailability or peak concentration. The time-to-maximum plasma concentrations was significantly longer for the tablets. The pain score profile, assessed by a visual analogue scale during a dose interval, showed a similar pattern after the two oral formulations of morphine. No significant linear relationship between the scores and the plasma concentrations of morphine was observed. PMID- 6861872 TI - Pharmacokinetics of biliary excretion in man V. Dibromosulfophthalein. PMID- 6861873 TI - Comparative multiple dose kinetics of two formulations of indomethacin. AB - The kinetics of a controlled release (CR) formulation of indomethacin 75 mg (Indocid-Retard) given once daily was compared with a conventional 25 mg indomethacin capsule (Indocid) given 3 times daily for 7 days, to 14 healthy volunteers, using a randomized, cross-over, multiple-dose study design. The following differences in plasma indomethacin profiles after the 2 treatments were observed: average peak concentrations (Cmax) for the CR regimen were higher and the time to peak (Tmax) was significantly delayed. Trough (pre-morning dose) plasma concentrations (Cmin) on Days 2, 5, 6 and 7 were significantly lower after the CR-formulation. No statistically significant differences between preparations for area under the plasma concentration time curve (AUC0-24 h) or for renal clearance were observed. Average steady-state plasma concentrations (Cssp) on Day 7 of the multiple dose regimens averaged 0.477 and 0.427 microgram/ml for the 75 mg CR once daily and the conventional 25 mg t.i.d. treatments, respectively. These results show that the bioavailability of the CR and conventional indomethacin formulations under these multiple-dose conditions was not significantly different. PMID- 6861874 TI - Agglutination of murine and guinea pig peritoneal cells by alpha-L-fucose-binding lectin: Evonymus europaea. AB - Among lectins from Lotus tetragonolobus, Ulex europaeus I and Evonymus europaea, agglutinating cells with blood group H determinants containing L-fucose alpha 1 leads to 2-linked to subterminal D-galactose, only the last lectin agglutinates thioglycolate- and paraffin oil-stimulated murine and guinea pig peritoneal exudate cells (PEC). The agglutination is inhibited by specific inhibitors of Evonymus lectin only: lacto-N-fucopentaose I and lactose. These results suggest the presence of a determinant on the surface of PEC, containing L-fucose alpha 1 linked at the nonreducing end which is different from blood group H determinants. Nonstimulated murine peritoneal cells (PC) are not agglutinated by the lectin but become agglutinable after neuraminidase treatment. Unstimulated guinea pig PC from different animals are agglutinated to a different extent by the same lectin concentration and show increased agglutinability after neuraminidase digestion. These results show that receptor for Evonymus lectin also exists on the nonstimulated PC but access to it is hindered by sialic acid. Trypsin- and pronase-digested PEC show increased agglutinability with Evonymus lectin. These results suggest that the lectin receptor is a glycolipid. Since alpha-linked L fucose has been suggested as a part of the macrophage receptor for migration inhibitory factor in the guinea pig (Remold, J. Exp. Med. 1973. 138: 1065), the effect of Evonymus europaea lectin on the migration of PEC was studied. It was found that lectin inhibits the migration of PEC in the capillary tube assay up to 80%. PMID- 6861876 TI - Calcium-dependent 86 Rb efflux and ethanol intoxication: studies of human red blood cells and rodent brain synaptosomes. AB - Effects of ethanol on calcium-dependent potassium efflux were investigated in red blood cells (RBC) from humans and brain synaptosomes from rats and mice. 86 Rb was used as a tracer for potassium. Synaptosomes and RBC were lysed and resealed with 86 Rb and calcium-EGTA buffers to regulate intracellular levels of ionized calcium. In vitro addition of ethanol (100 mM) stimulated the calcium-dependent 86 Rb efflux of synaptosomes. This stimulation was blocked by apamin, an inhibitor of the calcium-dependent potassium current of nerve cells. In addition, intracerebroventricular injection of apamin inhibited ethanol-induced narcosis in mice, providing behavioral evidence for the importance of calcium-stimulated potassium efflux in alcohol intoxication. In vitro addition of ethanol, propanol or butanol increased calcium-dependent 86 Rb efflux of human RBC at low concentrations of free calcium, but did not change the calcium-independent efflux of 86 Rb. These results suggest that the calcium-dependent 86 Rb efflux of nerve endings may have an important role in the pharmacological and toxicological effects of ethanol. PMID- 6861877 TI - In vivo interaction of gamma-type endorphins with dopaminergic ligands in rat brain. AB - The beta-endorphin (beta E) fragment des-Tyr1-gamma-endorphin (DT gamma E, beta E (2-17)) has been reported to interact with neuroleptic binding in vivo but not in vitro. We have attempted to replicate the in vivo experiments and extended the work to include conditions in which des-enkephalin-gamma-endorphin (DE gamma E, beta E-(6-17)) exhibited behavioral activity. Systemically administered haloperidol significantly elevated plasma and decreased striatal [3H]spiperone. DE gamma E significantly elevated plasma [3H]apomorphine when both substances were injected directly into the nucleus accumbens. gamma-type endorphins consistently but non significantly decreased brain spiperone or apomorphine binding. It is concluded that the interaction between gamma-type endorphins and dopaminergic binding sites may be either indirect or limited to a subset of these sites. PMID- 6861875 TI - Prevention and therapy with electrolectin of experimental autoimmune myasthenia gravis in rabbits. AB - Electrolectin (EL), an endogenous beta-D-galactoside-binding lectin from Electrophorus electricus, was found to have a prophylactic and therapeutic action on the experimental autoimmune myasthenia gravis (EAMG) in rabbits. EAMG is an autoimmune disease induced by immunization with the purified acetylcholine receptor protein (AChR) and is considered to be a good model for the human disease myasthenia gravis. Simultaneous immunization with AChR and EL completely prevented the onset of myasthenic symptoms. This preventive effect was accompanied by a decrease in the recognition of AChR by anti-AChR antibodies. The administration of EL to myasthenic rabbits led, in most cases, to a complete recovery which was not accompanied by any significant change in the level of circulating anti-AChR antibodies. No evidence for an action of EL at the muscular level could be obtained. EL, however, was found to bind to rabbit lymphocytes and to stimulate their mitosis. These results suggest that EL produces its effects on EAMG by acting at the level of the immune system. It is proposed that EL may play a role in the immunological regulation of the response to self-antigen, which could be one of the biological functions of this animal lectin. PMID- 6861880 TI - Ex vivo studies after oral treatment of the beagle with dihydroergotamine. AB - Plasma concentrations of unchanged dihydroergotamine (DHE) were measured in beagle dogs on days 1 and 7 of a 1 week treatment with daily oral doses of DHE. Responses to both 5-HT and noradrenaline were monitored isometrically on spiral strips from saphenous arteries and femoral veins removed 24 and 72 h after the last oral dosage of DHE. Femoral vein strips were removed from dogs treated for 1 week with daily doses of 0.60 mg/kg DHE p.o. and suspended in organ baths. When stretched to an initial tension of 500 mg, such strips relaxed significantly less than strips taken from control beagles. Furthermore, the vasoconstrictor potencies of both 5-HT and noradrenaline were significantly increased on strips from femoral veins but not on strips from saphenous arteries removed from DHE treated beagles. About 210 min after suspension in organ baths, femoral vein strips from DHE-treated dogs developed spontaneously an increase in basal tone, a phenomenon which was not observed with saphenous arteries. It is suggested that sensitization of venous smooth muscle to the constrictor activities of endogenous catecholamines and 5-HT contributes to the venoconstrictor activity of DHE. Moreover, the pharmacologic action of orally administered DHE, as assessed by the ex vivo measured changes in sensitivity of vein strips, requires peak plasma levels of more than 0.30 ng/ml. However, the duration and maintenance of the venoconstrictor response is largely independent from continuously elevated plasma DHE levels. PMID- 6861878 TI - Suppression of exploratory locomotor activity in the rat by the local application of 3-PPP enantiomers into the nucleus accumbens. AB - It was found that (-)-3-PPP, 5-160 microgram/side produced a statistically significant suppression of exploratory locomotor activity after application to the nucleus accumbens. The (+)-isomer was about 8 times less potent in suppressing exploratory activity. Except for suppression of the locomotor activity by 160 micrograms of (-)-3-PPP no statistically significant effects were produced by either isomer applied in the neostriatum. PMID- 6861881 TI - Effects of electric footshock on barbiturate sensitivity, nociception and body temperature in mice. PMID- 6861879 TI - Temperature-sensitive conformational changes in membrane-bound and solubilized [3H]imipramine binding sites. AB - [3H]Imipramine binding sites are located on serotonergic nerve terminals and on blood platelets. Previous studies on our laboratories have indicated temperature sensitive conformational changes in [3H]imipramine binding sites in hippocampal and cerebral cortex membranes. We now report that similar changes are observed in both membrane-bound and digitonin-solubilized [3H]imipramine binding sites of human blood platelets. This may indicate integrity of the solubilized binding site. PMID- 6861883 TI - Anticonvulsant action in mice with sound-induced seizures of the optical isomers of gamma-vinyl GABA. PMID- 6861884 TI - Calcium-independent release of [3H]dopamine by veratridine in pargyline- and reserpine-treated corpus striatum. AB - Veratridine produced a dose-dependent release of cytoplasmic [3H]dopamine in rat corpus striatal slices. Cytoplasmic [3H]dopamine was obtained by pretreating rats with reserpine to inhibit vesicular storage and incubating with pargyline and beta-thujaplicin to inhibit catabolism prior to incubation with [3H]dopamine. Release of [3H]dopamine by veratridine is absolutely calcium-independent and can be abolished by 10(-4) M tetrodotoxin and inhibited by 10(-5) M nomifensine. These results suggest that veratridine can release cytoplasmic [3H]dopamine by a carrier-mediated process. PMID- 6861882 TI - Selective DA2 versus DA1 antagonist activity of domperidone in the periphery. AB - Relative activity of domperidone as an antagonist of the two peripheral dopamine (DA) receptors, DA1 and DA2, was studied in pentobarbital-anesthetized dogs. Renal vasodilation produced by intra-arterial injection of DA into the phenoxybenzamine-pretreated renal vascular bed was the DA1-mediated response, while femoral vasodilation induced by dipropyl dopamine injected into the femoral artery with intact nerve supply was the DA2-mediated response. Domperidone, 0.5-5 micrograms/kg intravenously, inhibited the DA2 response by 15-75%. In contrast, doses up to 5 mg/kg had no effect on DA1-mediated or bradykinin-induced renal vasodilation. Domperidone has thus proved to be more selective than other DA2 antagonists, differentiating between the two peripheral DA receptors by a margin of greater than 10(4). Furthermore, domperidone was found to be selective as a DA2 versus alpha 2-adrenergic antagonist as studied on the dog cardioaccelerator nerve, thus, enhancing its value as a selective DA2 antagonist. PMID- 6861885 TI - Calcium uptake by intestinal smooth muscle: influence of alkylation. PMID- 6861886 TI - Ethyl-beta-carboline-3-carboxylate decreases [3H]GABA binding in membrane preparations of rat cerebral cortex. PMID- 6861887 TI - Failure of 3-PPP to activate dopamine autoreceptors in vitro. PMID- 6861888 TI - Differential effects of acute and chronic administration of haloperidol on homovanillic acid levels in discrete dopaminergic areas of rat brain. AB - After acute administration of haloperidol, homovanillic acid (HVA) levels were increased in the prefrontal cortex, anterior cingulate cortex, discrete limbic areas and A14 dopamine (DA) neurons. The maximal effect of haloperidol was attained more slowly in the prefrontal cortex and amygdala than in the other regions. The ED50 of haloperidol was 0.03 mg/kg in the prefrontal cortex, but was 0.06-0.07 mg/kg in other areas examined. After repeated administration of haloperidol, tolerance to the HVA increase was observed in the striatum and all limbic areas examined, the amygdala being the most susceptible to this tolerance. In contrast, no tolerance was found in the anteromedial and suprarhinal DA neurons of the prefrontal cortex and A14 DA neurons. These results suggest that the prefrontal cortex may be a possible site for the antipsychotic action of haloperidol. On the other hand, no change of HVA levels in the A12 and A13 DA neurons of the hypothalamus was observed after haloperidol treatments, suggesting a lack of neuronal feedback mechanism in the A12 and A13 DA neurons. PMID- 6861889 TI - Des-Gly-vasopressin improves acquisition and slows extinction of autoshaped behavior. AB - The effects of a vasopressin analog (DGAVP) with minimal endocrinological activity, were assayed on acquisition and extinction of a discrete trial, food reinforced, autoshaped lever touch response. Magazine-trained rats, maintained at 80-85% of free-feeding body weights, were injected s.c. with saline, 5 or 10 micrograms/kg of DGAVP 1 h before each of two sessions in which they learned to touch a retractable lever, presented on a 45 s random interval (RI 45) schedule. Retracted lever contacts (nose-pokes) and unconditioned rearing activity were simultaneously monitored. After acquisition of the extended lever touch response, rats were reassigned to treatment groups, and again injected with saline, 5 or 10 micrograms/kg of DGAVP 1 h before each of two extinction sessions. DGAVP facilitated acquisition (5 micrograms/kg) and slowed extinction (5 and 10 micrograms/kg) of conditioned behavior, while having no effects on the other behaviors, thus demonstrating the specificity of the effect of a vasopressin-like compound on both tasks (enhanced acquisition and retarded extinction) used to study learning. PMID- 6861890 TI - Behavioral evidence for the involvement of gamma-aminobutyric acid in the actions of ethanol. AB - Behavioral interactions between ethanol and GABA-mimetic and GABA antagonist drugs were evaluated by duration of narcosis and motor incoordination (inhibition of bar holding) in mice. Aminooxyacetic acid (AOAA), baclofen, and tetrahydroisoxazolopyridineol (THIP) (GABA mimetics) lengthened ethanol narcosis, while picrotoxin shortened ethanol narcosis. AOAA and baclofen also enhanced the incoordinating effects of ethanol, while picrotoxin and bicuculline (GABA antagonists) had the opposite effect. In addition, the incoordinating effects of AOAA and baclofen were potentiated by low doses of ethanol, while incoordination produced by bicuculline was antagonized by ethanol. Mice selected for genetic differences in neurosensitivity to ethanol (LS and SS strains) displayed corresponding differences in the incoordinating effects of baclofen and THIP. Furthermore, chronic ingestion of ethanol resulted in a decrease in the incoordinating effect of THIP. These results, together with electrophysiological, biochemical, and behavioral data from other laboratories, suggest that: (1) augmentation of GABA effects is involved in the incoordinating and soporific actions of ethanol; (2) one factor responsible for genetic differences in ethanol response is sensitivity to GABA; and (3) ethanol tolerance and dependence may be related to decreased sensitivity to GABA. PMID- 6861891 TI - Effects of chronic antidepressant treatment on serotonin receptor activity in mice. AB - The effect of acute and chronic treatments with conventional and atypical antidepressant drugs on serotonin receptor activity was assessed by the responsiveness of mice to the serotonin receptor agonist 5-methoxy-N,N dimethyltryptamine. Acute treatment with 10 mg/kg of amitriptyline, imipramine, trazodone, mianserin or viloxazine reduced the head twitch response measured 1 h following a challenged dose of the serotonin agonist. Acute iprindole and desmethylimipramine, however, had no effect on the serotonergic response. Chronic treatment with the clinically effective antidepressants amitriptyline, imipramine, desmethylimipramine, iprindole, and trazodone produced an enhanced responsiveness to 5-MeODMT. The enhanced responsiveness was first observed 24 h after cessation of treatment with most drugs. The effect lasted for at least 48 h. Chronic treatment with the neuroleptic haloperidol did not result in altered responsivity to the serotonin agonist. Brain accumulation of imipramine and amitriptyline and their deaminated metabolites were measured. Brain drug and metabolite levels peaked 1 h following both acute and chronic treatments. Brain accumulations of amitriptyline and its metabolite were much greater than those of imipramine and its metabolite. This pharmacokinetic data is consistent with an early (1 h) antagonism of the 5-MeODMT response and the emergence of hightened responsiveness to 5-MeODMT after chronic treatment, when brain drug levels are reduced. These findings are also consistent with the greater inhibitory effect found after treatment with amitriptyline than with imipramine. It is concluded that enhanced serotonin neurotransmission which develops during chronic treatment with antidepressant drugs may be related to the clinical action of these drugs. PMID- 6861894 TI - In vitro release of newly synthesized serotonin from superfused rat suprachiasmatic area--ionic dependency. PMID- 6861892 TI - Dual mechanism of ouabain action on noradrenaline output from guinea-pig vas deferens. AB - Isolated guinea-pig vas deferens was used to test the effects of varying the concentration of extracellular Na+, Ca2+ and Mg2+ and the influence of tetanic transmural stimulation and of tetrodotoxin on the ouabain-induced increase in noradrenaline output. The total amount of noradrenaline released by ouabain increased with increasing concentration of either Na+ (from 35 to 143 mM) or Ca2+ (from 0.3 to 2.5 mM). The rise in the ouabain-induced increase of noradrenaline output was retarded by increasing the concentration of either Ca2+ from 0.3 to 5 mM or Mg2+ from 1.2 to 20 mM. Tetanic transmural stimulation facilitated the occurrence of ouabain-induced noradrenaline output, while tetrodotoxin (5 X 10( 7) g/ml) greatly inhibited it. These results suggest that ouabain causes an increase in noradrenaline output through at least two different mechanisms, a tetrodotoxin-sensitive action potential and Na+-dependent Ca2+ influx resulting from the inhibition of the Na+-K+ pump. PMID- 6861895 TI - Blockade by glutamic acid diethyl ester of excitation of nucleus tractus solitarii neurons and vasodepressor responses reflexly elicited by vagal stimulation. PMID- 6861893 TI - Bronchopulmonary effects of clonidine on the bronchomotor responses of the guinea pig. AB - In conscious guinea pigs, clonidine (10 and 100 micrograms/kg i.v.) lowered diastolic (-7.9 +/- 3.5 and -12.4 +/- 5.2%) and systolic (-8.6 +/- 3.0 and -11.9 +/- 4.2%) arterial pressure and reduced heart rate (-14.5 +/- 3.9 and -27.7 +/- 3.8%), but did not significantly modify pulmonary airway resistance. Hypotension was suppressed by yohimbine and bradycardia was partially suppressed by atropine and yohimbine, which demonstrates in this animal an alpha 2-adrenergic effect for hypotension and a mixed cholinergic and alpha 2-adrenergic effect for bradycardia. Clonidine (10 and 100 micrograms/kg i.v.) enhanced the bronchoconstrictor effects of histamine 20 micrograms/kg (+80.0 +/- 22.5 and 89.1 +/- 26.5%), acetylcholine 25 micrograms/kg (+66.4 +/- 19.8 and +95.4 +/- 25.4%) and serotonin 15 micrograms/kg (+68.5 +/- 23.2 and +81.4 +/- 34.1%). The duration of this effect was comparable to that of the hypotensive and cardiac effects of clonidine. The effects of clonidine were suppressed after pretreatment with propranolol, reserpine or pentobarbitone, all drugs which enhance the bronchoconstrictor effect of ACh. Yohimbine (1 mg/kg), piperoxan (0.3 mg/kg) or prazosin in high dosage (0.3 mg/kg) inhibited the potentiation by clonidine of ACh-induced bronchoconstriction, whereas prazosin in lower doses (0.03 mg/kg) or AR-C 239 (0.05 mg/kg) had no action. A specific involvement of alpha 2 adrenoceptors stimulated by clonidine with subsequent reduction of the adrenergic activity associated with bronchospasm could therefore be demonstrated in the conscious guinea-pig during bronchomotor reactions. PMID- 6861897 TI - The effect of the dimeric and multimeric forms of fibronectin on the adhesion and growth of primary glomerular cells. AB - Primary glomerular cells placed in a chemically defined medium containing Waymouth's medium MB 752/1 supplemented with insulin, transferrin, fibroblast growth factor, nonessential amino acids, sodium pyruvate, and antibiotics showed rapid outgrowth of cells which morphologically resembled well differentiated visceral epithelial cells followed by outgrowth of poorly differentiated cells; morphologic evidence suggests these latter cells are precursor cells of the epithelial cell lineage. Whereas the well differentiated glomerular epithelial cells were never observed to divide by sequential phase microscopic observations, a chemically defined medium was developed for optimal growth of the poorly differentiated cell type. This serum-free medium contained Waymouth's medium MB 752/1 supplemented with insulin, transferrin, selenium, and fibronectin (plus non essential amino acids, sodium pyruvate, and antibiotics). Using this chemically defined medium, we have compared the effects of dimeric and multimeric fibronectin (high molecular weight disulfide-bonded fibronectin produced by incubation of dimeric fibronectin with 3 M guanidine followed by dialysis against 0.05 M cyclohexylaminopropane sulfonic acid (CAPS) buffer, pH 11) on the adhesion and growth of the poorly differentiated primary glomerular cell type. Dimeric fibronectin (FN) was twice as effective as multimeric FN in promoting glomerular cell adhesion, although both forms of FN promoted cell adhesion better than an uncoated substratum. In contrast, cell growth studies demonstrated that multimeric FN was a more potent growth stimulant than dimeric FN. The differential effects of dimeric and multimeric forms of FN in vitro suggests that these molecules may have different functions in vivo. PMID- 6861898 TI - Localization of a major nuclear envelope protein by differential solubilization. AB - The nuclear envelope (NE) is the interface of the two major compartments of the cell. We used differential solubilization in conjunction with ultrastructural visualization to localize components of the NE in the surf clam Spisula solidissima. The high salt-resistant NE fraction can be separated into a pore complex-containing supernatant (4 M urea extract) and a membrane pellet devoid of pore complexes or pore remnants. Urea extraction of the membrane pellet reveals two major proteins with an apparent molecular weight (MWapp) of 67 000 (clam lamin) and 200 000 that are also found in the high-salt and detergent-extracted NE containing pore complexes. Urea extraction of the clam NE under reducing conditions removes the clam lamin. The 200 000 D protein remaining in the NE after removal of the pore complex is not solubilized by detergent extraction and thus can be localized on the inner nuclear part of the NE. PMID- 6861896 TI - Demonstration of stimulatory effects of platelet-derived growth factor on cultivated rat arterial smooth muscle cells. Differences between cells from young and adult animals. AB - The effects of platelet-derived growth factor (PDGF) on DNA synthesis and proliferation in cultures of arterial smooth muscle cells obtained from young and adult rats, respectively, were measured. Addition of 10-20 ng/ml of PDGF to medium MCDB 104 induced DNA synthesis in quiescent cultures of cells from young animals to a similar extent as 10-20% whole blood serum (WBS). PDGF further stimulated proliferation of the cells in medium MCDB 104, although less markedly than 10% WBS. Antibodies against PDGF partially inhibited the growth response after stimulation with serum. This shows that PDGF is a major growth factor in serum for these cells and that PDGF can promote entrance into and passage through S phase and mitosis independent o plasma factors. Cells from adult animals were also found to respond to PDGF, although a higher concentration (25 ng/ml) was required to obtain a maximum effect. These cells, however, responded better than cells from young animals to stimulation with serum. Further, antibodies against PDGF did not inhibit the growth-stimulatory effect of serum to any appreciable extent. Thus, serum contains growth factors other than PDGF that stimulate preferentiaLly the proliferation of smooth muscle cells from adult animals. PMID- 6861899 TI - Hormone-induced parthenogenetic activation of mature starfish oocytes. AB - 1-Methyladenine, which has been previously shown to be the hormone responsible for meiosis reinitiation in starfish oocytes, triggers parthenogenetic activation when applied to matured starfish oocytes after emission of the second polar body and formation of the pronucleus. In Marthasterias glacialis and Asterias rubens oocytes parthenogenetic activation includes elevation of a fertilization membrane, cleavage and the formation of normal bipinnaria larvae. Activation is likely to result from 1-methyladenine interaction with the category of stereospecific membrane receptors involved in meiosis reinitiation, since structural requirements of this compound are identical for both biological responses. Appearance of oocyte responsiveness to 1-MeAde after, but not before emission of the second polar body cannot be accounted for by their increased sensitivity to intracellular Ca2+ at that time, although it is shown that Ca2+ mediates hormone effect in inducing parthenogenetic activation. Pretreatment of immature oocytes with the free hormone in excess strongly inhibits the 1 methyladenine-induced parthenogenetic activation of the oocytes when they have completed maturation. It is suggested that reappearance of 1-MeAde sensitivity when oocytes form a pronucleus depends either upon recruitment or new receptor units or on the reactivation of pre-existing inactivated receptors at this stage of oocyte maturation. PMID- 6861900 TI - Lymphoblastoid cell variant in contact-mediated cell spreading. AB - We have isolated a clone of human lymphoblastoid cells that is capable of undergoing the phenomenon of contact-mediated cell spreading in vitro. We have detected this behavior when using both transmission electron microscopy (TEM), and differential interference contrast microscopy. Upon cell-cell contact, cells become loosely adherent and then begin to extend cellular processes that contact other cells and the substrate. We have also selected a variant clone that has lost the capability for cell spreading. The adhesions-defective variant becomes adhesion-positive and appears morphologically identical with the adhesive cells only in response to specific amino sugars. In the presence of those sugars the adhesion response is correlated with a shift in the apparent molecular weight of an iodinatable component. We propose that contact-mediated cell spreading in lymphoblastoid cells is mediated by a non-transferable cell surface-associated glycoconjugate. The synthesis of that glycoconjugate is defective in the non adhesive clone, unless the cells are grown in glucosamine or mannosamine. PMID- 6861901 TI - Medium conditioned by feeder cells inhibits the differentiation of embryonal carcinoma cultures. AB - Non-dividing STO mouse fibroblasts have been used for some time as feeder cells for maintaining certain embryonal carcinoma cells in an undifferentiated state. We report here that medium conditioned by these feeders can inhibit embryonal carcinoma (ec) cell differentiation induced either by removal from feeders, or, in the case of cells not normally requiring a feeder layer, by retinoic acid treatment. PMID- 6861902 TI - Comparison of the growth of normal and neoplastic mouse mammary cells on plastic, on collagen gels and in collagen gels. AB - The growth of normal and neoplastic mouse mammary cells was compared in primary cultures on plastic, on rat tail collagen gels and in rat tail collagen gels. Cells on plastic grew for the first few days, then stopped with only a 1- to 3 fold increase in cell number after 2 weeks in culture. Cells grown on or in collagen gels grew continuously over the 2-week culture period with up to 10-fold increase in cell number for cultures on collagen gels and a 20-fold increase for cells embedded in collagen gels. The difference in growth rates between cells grown in collagen gel and those grown on collagen gels was due, in part, to the three-dimensional growth of the colonies in collagen gel their two-dimensional growth on collagen gel. Cells grown on and in collagen gel can produce an electron-dense basal lamina-like structure which is associated with collagen IV and laminin as judged by immunofluorescence. Cells grown on plastic do not form this structure. Cis-OH-proline blocks the production of collagen and inhibits the growth of the cultured cells indicating collagen production to be involved in growth. Rat tail collagen gels are a superior substratum for the growth of mouse mammary cells and this may be related to the cells' ability to form a collagen IV containing basal lamina-like structure. PMID- 6861903 TI - The orientation of fibroblasts and neutrophils on elastic substrata. AB - The reaction of fibroblasts to the elastic properties of the substratum was studied using elastic collagen films. These films were stretched in one axis to give a substratum which was anisotropic in its elasticity and deformability. Analysis of the orientation of fibroblasts cultured on these substrata showed that they oriented along the axis of stretch which was also the axis of fibre alignment. This orientation was significantly reduced when the films were made less elastic by attachment to a glass slide and chemical fixation. Neither of these procedures appeared to alter the surface shape of these films, which suggests that the elastic properties of the substratum markedly influence the orientation of fibroblasts. The orientation of locomotion of neutrophil leukocytes on elastic collagen films was also analysed and no bias along the axis of stretch was observed. This was compared with neutrophil locomotion in 3-D stretched collagen gels, in which a strong bias along the axis of stretch and of fibre alignment was observed. The possible reasons for the response of these two cell types is discussed. PMID- 6861904 TI - Microdissection of the mouse egg. AB - A rapid and efficient method for microdissection of the mouse egg is described. The dissection is carried out in hanging drops of medium surrounded by heavy liquid paraffin oil at room temperature. Eggs are first deformed into a cylindrical shape and then dissected at a predetermined site with a glass needle on a Leitz micromanipulator. The survival rate of the dissected fragments is 75 90% and between 20 and 30 eggs can be dissected in an hour. Development of the dissected eggs is at least as good as that described after other types of manipulation. Cytoplasts and karyoplasts of various sizes can be prepared, as well as gynogenetic and androgenetic eggs with different amounts of cytoplasm. This procedure may help to examine nuclear-cytoplasmic interactions in eggs reconstituted from a variety of fragments. PMID- 6861905 TI - Mg2+-dependent compactness of heterochromatic chromosome segments. AB - The stability of heterochromatic blocks in pachytene chromosomes of Tenebrio molitor (Insecta, Coleoptera) was analysed at the chromosomal level using a modified Miller spreading technique. Incubation of nuclei in solutions of different ionic strength and composition revealed that the characteristic compactness of heterochromatic segments was preserved in the presence of at least 0.6 mM MgCl2. The compactness of these segments was lost in solutions of different ionic strength and composition revealed that the characteristic compactness of heterochromatic segments was preserved in the presence of at least 0.6 mM MgCl2. The compactness of these segments was lost in solutions containing NaCl (0.1-100 mM), but no MgCl2. They then resembled the euchromatic segments. The decondensed heterochromatic segments could be recompacted by adding MgCl2 to a final concentration of 1.0 mM. The characteristic compactness of heterochromatin of pachytene chromosomes therefore depends on the presence of Mg2+, but is independent of Na+. PMID- 6861906 TI - Cell-cell contact promotes DNA synthesis in retinal glia but not in fibroblasts. AB - Contact among retinal glial cells in monolayer cultures of intermediate density stimulated DNA synthesis. The stimulation occurred in passaged cultures lacking neuronal elements and is, therefore, the first demonstration of growth promotion by contact among cells of the same apparent type. In contrast, low levels of association among dermal fibroblasts in cultures of similar density had no stimulatory effect. However, as few as three cellular contacts depressed fibroblast DNA synthesis. This latter observation suggests that the density dependent suppression of fibroblast proliferation observed in confluent cultures begins to be expressed at subconfluent cell densities. PMID- 6861907 TI - Nuclear maturation in pig and rabbit oocytes after interspecific fusion. AB - Porcine ovarian oocytes were fused with either homologous (porcine) or heterologous (rabbit) oocytes, both at different stages of maturation. The maturation-promoting factor (MPF) present in maturing porcine oocytes or ovulated rabbit oocytes induced rapid chromosome condensation of the oocytes with intact germinal vesicles (GVs). In the case of activation of ovulated rabbit oocyte, germinal vesicle breakdown (GVBD) of porcine oocytes was incomplete or did not occur. In the giant cells consisting of two immature porcine oocytes, meiotic maturation proceeded in the same manner as in unfused oocytes. However, in cells derived from fusion of immature porcine and rabbit oocytes, two metaphase groups of chromosomes were observed 6 h after fusion. It may be concluded that GVBD is governed after fusion by the cytoplasm originating from the oocytes of more advanced stages of maturation or from those which mature faster. PMID- 6861908 TI - Mitochondrial ultrastructural transformations in P. lividus eggs stimulated by ammonia. AB - In mitochondria of P. lividus eggs the transition from the condensed to the orthodox form is accomplished in about 45 min after fertilization. Similar ultrastructural transformations are induced by exposure to ammonia that is known to cause a partial egg activation. PMID- 6861910 TI - Altered structure of ribosomal RNA transcription units in hamster cells after DRB treatment. AB - The adenosine analog 5,6 dichloro-1-beta-ribofuranosyl benzimidazole (DRB) inhibits specifically mRNA production in eukaryotic cells, with concomitant alterations in pre-rRNA processing and nucleolar ultrastructure. We have focused our analysis on the effects of drug treatment on rRNA transcription through observations of spread ribosomal RNA (rRNA) transcription units from hamster cells. A significant increase in the size of ribosomal matrix units is paralleled by the appearance of abnormally large RNP structures containing elongating pre rRNA. These structures correspond to nucleolar perichromatin granules which are known to appear in various conditions of cell growth when rRNA processing is altered. It is proposed that DRB-induced impairments in rRNA maturation are largely determined by alterations in the rRNA transcription process. PMID- 6861909 TI - Adhesive responses of fibroblast and neuroblastoma cells to substrata coated with polyvalent or monoclonal antibody to fibronectin. AB - Both polyvalent and hybridoma-produced antibodies to fibronectin (Fn) were used to 'map' the immunoaccessible subsets of cell surface fibronectin on virus transformed murine fibroblast SVT2 and rat neuroblastoma B104 cells. As one approach to this end, attachment and spreading responses of cells were measured on tissue culture substrata coated with antibody or with plasma fibronectin to compare their adhesive responses. Both SVT2 and B104 cells adhere poorly to polyvalent anti-Fn-coated substrata over short time intervals, but within several hours changes occur which permit cells to attach and spread as well on anti-Fn as on Fn (post-adsorption of the anti-Fn with Fn also generates a maximal response). This adhesive response could be completely prevented by predigesting the cells with Flavobacterium heparanase, but not with chondroitinase ABC, indicating that the cell surface Fn responsible for antibody-mediated adhesion is associated with heparan sulfate proteoglycans on the cell surface. The compositions of the substratum-attached material (left bound after EGTA-mediated detachment of cells) from cells attaching to anti-Fn or Fn were analysed by SDS-PAGE and found to be identical within the same cell type for the two different substrata. Three hybridoma-produced antibodies, which recognize different determinants on Fn, generated different adhesive responses for SVT2 or B104 cells when adsorbed to the substratum. SVT2 cells adhered well to antibody no. 32-coated substrata but poorly to antibodies 92 or 136; on the other hand, B104 cells responded similarly to all three antibodies over short times of attachment but much better to no. 32 after a several hour incubation. These experiments indicate that (1) much of the cell surface fibronectin is complexed with heparan sulfate proteoglycan and is initially inaccessible to bind to polyvalent antibody on the substratum to promote adhesion; (2) the surface of neuroblastoma cells contains a fibronectin like molecule which is important in their substratum adhesion; and (3) monoclonal antibodies are valuable tools in 'mapping' the orientation of cell surface molecules like fibronectin by measuring adhesive responses to antibody-coated substrata. PMID- 6861911 TI - Growth-stimulatory effects of retinoblastoma-derived growth factors and other mitogens on Nakano mouse lens epithelial cells. AB - A polypeptide growth factor (RDGF) secreted by a human retinoblastoma cell line (Y-79) grown in serum-free defined medium stimulated DNA synthesis up to 36-fold and cellular proliferation by 100% upon 3 days of exposure to quiescent Nakano mouse lens epithelial cells (NKR-11) deprived of serum supplements. The stimulation of DNA synthesis produced by RDGF in the absence of serum could be further potentiated by the presence of 0.1 microgram/ml of insulin or 0.1 microgram/ml of arginine vasopressin. 12-O-tetradecanoyl-phorbol-13-acetate (TPA), on the other hand, produced a 30-40% decrease in RDGF activity at 0.01-1.0 microgram/ml of TPA. The stimulation of DNA synthesis produced by RDGF, and its potentiation by the simultaneous addition of insulin, could be sustained after transient exposure (30 min) to RDGF, or RDGDF plus insulin, respectively, whereas insulin alone as little effect after exposures of up to 6 h. Nerve growth factor (1.0 pg to 1.0 microgram/ml) did not stimulate DNA synthesis or cell division in NKR-11 cells, whereas fibroblast growth factor (FGF) produced an optimal 3-fold stimulation of DNA synthesis at 10 ng/ml. Epidermal growth factor (EGF) activity was optimal and showed a 5-fold increase in DNA synthesis at 100 pg/ml in NKR-11 cells. The early receptor-mediated events that might be responsible for the transition to a proliferative state in quiescent Nakano mouse lens epithelial cells are discussed. PMID- 6861912 TI - Differential transcription of early and late-replicating DNA in human cells. AB - Several studies suggest that most of the functional genes of mammalian cells are contained in the early-replicating sequences of DNA. There is little direct evidence, however, to support this view. To determine whether the extent of transcription of different DNA sequences is related to the order in which these sequences are replicated, I have selectively labelled early- and late-replicating DNA with [3H]thymidine ([3H[TdR) and determined the extent to which the 3H labelled non-repeated sequences of each DNA preparation are hybridized by increasing concentrations of RNA from exponentially growing KB cells. The fraction of DNA hybridized at infinite RNA concentration was then estimated by a plotting method which linearizes the data. Selective labelling of DNA was achieved by synchronizing a culture of KB cells by a double block of DNA synthesis and then labelling portions of the culture 0-3 h (early) or 6-9 h (late) after release of the cells from the second block. At all RNA concentrations tested, the fraction of early-replicating DNA hybridized was significantly greater than that of late-replicating DNA. At infinite RNA concentration the value for early-replicating DNA was 3-4 times as great as that of late-replicating DNA. If it is assumed that the fraction of DNA hybridized at infinite RNA concentration is proportional to the fraction of DNA which is transcribed, it can be concluded that 3-4 times as much early-replicating DNA is transcribed as late-replicating DNA in exponentially growing KB cells. PMID- 6861913 TI - Genome intermixing and sister chromatid exchange in newly-formed HeLa-3T3 Hybrid cells. AB - Mouse and human genomes occupy distinct regions within hybrid interphase nuclei following division of HeLa-3T3 heterokaryons. With subsequent cell division the proportion of interphase cells displaying separation of human and mouse genomes decreases. Examination of several hundred hybrid colonies revealed a linear relation between the log of the fraction of interphase cells with separated genomes and the log of clone size. This indicates that there is a constant probability that separated genomes will intermingle at each mitosis. Human and mouse chromosomes can also occupy distinct sectors in metaphase spreads derived from heterokaryons. Computer analysis of the distribution of chromosomes within 548 hybrid metaphases showed that mouse and human chromosomes are randomly intermixed within several divisions and before the onset of rapid chromosome loss. Sister chromatid exchange (SCE) rates were also measured in mass populations of newly-formed HeLa-3T3 hybrid cells. For most hybrid metaphases there was not significant change in SCE rates within the human chromosome set. In a small minority of hybrid metaphases, characterized by asynchronous condensation of chromosome sets, there was a 50-fold increase in SCE. However, chromosomes are progressively lost from all hybrid cells. Thus, the two processes examined in the present studies, the distribution of human chromosomes at metaphase and SCE, are not implicated in the preferential loss of human chromosomes from HeLa-3T3 cells. PMID- 6861914 TI - The diffusion of fluorescein in the stroma of rabbit cornea. AB - The diffusion rate and the distribution ratio of fluorescein in the stroma was studied in rabbit cornea. A strip of corneal stroma was mounted in a chamber and fluorescein in a phosphate buffer solution was circulated across the end of the strip for 24 hr. The change in fluorescence intensity was measured along the strip and the diffusion coefficient was calculated using Fick's diffusion equation. The mean coefficient of diffusion was 1.21 +/- 0.24 (+/- S.D.) X 10(-6) cm2/sec at 19 degrees C. The ratio of fluorescence between the stroma and the solution was 1.34 to 1.33 for the concentrations ranging from 0.1 to 10 g/ml. PMID- 6861915 TI - Early development of selenium-induced cataract: slit lamp evaluation. AB - The purpose of our research was to document early lenticular changes preceding cataract formation in rats receiving an elevated dose of selenium. The following stages were observed after selenium injection: Stage 1 (13-24 hr post-injection), formation of posterior equatorial subcapsular cataract (PESC); Stage 2 (24-72 hr), decline of the PESC, development of a prominent 'washer' shaped change in the refraction of the cortex, and first appearance of swollen fibers around the nucleus; Stage 3 (three to five days), appearance of bilateral dense central nuclear cataracts and further development of perinuclear swollen fibers; Stage 4 (five to 10 days), some nuclear cataracts became more opaque and/or angular. The results are consistent with the hypothesis that the initial site of action of selenium in nuclear cataract formation is not in the lens nucleus. Rather, selenium causes early changes outside the nucleus, which are followed by nuclear cataracts. PMID- 6861916 TI - Surface-replica topography of retinal pigment epithelium during phagocytosis. AB - The initial step in retinal phagocytosis may be mediated by complementary recognition molecules on the pigment epithelial microvilli and outer segment membrane surfaces. These molecules may display a surface morphology which is related topographically to phagocytic events. In order to explore this, we have developed a method for replicating the membrane surfaces of rat pigment epithelial explants during phagocytosis of latex beads. The explants are fixed in a mixed aldehyde and osmium fixative and the basal surface glued to a coverslip. After dehydration and critical point drying, the tissue is replicated with platinum and carbon in a freeze-fracture apparatus using either rotary or unidirectional coating and the replicas are examined by transmission electron microscopy. The membrane surfaces of the pigment epithelial cells and their microvilli are studded with numerous surface particles varying in size from 20 to 50 nm that are closely packed and give a cobblestone appearance to the membrane topography. During the early stages of phagocytosis, microvillous processes appear to spread over the beads and form branched processes as they contact bead surfaces. During bead engulfment the microvilli have shortened into flattened sheets with interdigitating processes overlapping the beads. These uptake sites resemble Venus' fly-traps, which as they close over the beads create craters in the membrane surfaces of the pigment epithelium. The crater-like uptake sites appear to flatten out in the later stages and form flattened membrane domains which are surrounded by crenulated membrane that displays an irregular particulate morphology. PMID- 6861917 TI - Effect of temperature and pH on release of enzymes from lysosomes of the bovine retinal pigment epithelium in vitro. AB - The effects of buffer concentrations, pH, and temperatures on the release of enzymes from lysosomes of the bovine retinal pigment epithelium were studied in vitro. Cathepsin D, arylsulfatase, and acid phosphatase were used as lysosomal marker enzymes. Elevation of temperature caused a marked increase in the release of cathepsin D and arylsulfatase from lysosomes, but little changes in the release of acid phosphatase. Acidic conditions accelerated the release of arylsulfatase and acid phosphatase. Different buffer concentrations had little effect on the release of these enzymes from lysosomes. PMID- 6861918 TI - 1983 annual meeting abstracts. International Society for Experimental Hematology. 10 - 14 July 1983. London, England, The United Kingdom. PMID- 6861919 TI - Occupational asthma secondary to low molecular weight agents used in the plastic and resin industries. AB - The rapid proliferation of complex plastic polymers and resins has led to a marked increase of work-induced asthma due to low molecular weight agents. Phthalates are frequently used in the manufacture of epoxy resins, plasticizers, adhesives and a wide variety of other materials. They have recently been identified as an important irritant and immunogen of at least four occupational respiratory syndromes, i.e., asthma/rhinitis, late respiratory systemic syndrome, pulmonary disease-anemia syndrome, and an irritant reaction. Isocyanates are extensively employed in the production of polyurethane foams, adhesives, paints and other plastic products. They have been incriminated in the causation of occupational lung disease since 1951. It appears that both specific IgE-mediated and non-specific irritant mechanisms are operative in isocyanate-induced asthma. Formaldehyde is a widely used irritating chemical, mainly employed as disinfectant or in the production of multiple resin products employed in the wood, shoe, and clothing industries. Several of these resin products can give off formaldehyde fumes causing occupational and non-occupational dermatitis, urticaria, bronchitis and reactive airway disease. Colophony pine resin used in virtually all soft soldering fluxes, and paraphenylene diamine used in the fur, paint and rubber industries have also been implicated in the generation of industrial asthma. Awareness of where such agents are likely to be encountered, together with patterns of respiratory disease induced, should facilitate earlier diagnosis. PMID- 6861920 TI - Cardiac output, pulmonary hypertension, hypoxaemia and survival in patients with chronic obstructive airways disease. AB - A prospective study of cor pulmonale in 74 patients relates pulmonary haemodynamics to survival. Mean arterial oxygen tension (PaO2) was 7.2 +/- 0.14 kPa and mean arterial carbon dioxide tension (PaCO2) 6.6 +/- 0.12 kPa at entry. Pulmonary artery pressure (PAP), pulmonary vascular resistance (PVR), and cardiac output (CO) sitting and supine and where possible on exercise, were measured every one or two years by a floating catheter technique. Survivors showed very little change in pulmonary artery pressure, pulmonary vascular resistance or cardiac output. Those who did not survive, showed a steady increase of PAP and PVR, whether or not they had received continuous oxygen therapy at home. Cardiac output remained normal or slightly elevated despite increasing pulmonary artery pressure. The relationship between VO2 (minute oxygen consumption) and cardiac output remained within the normal or greater than normal range, even on exercise. Although a deteriorating clinical situation may be paralleled by changes in pulmonary haemodynamics, it is questioned whether such changes are causally implicated in mortality. PMID- 6861921 TI - The effect of aminophylline on cardiac rhythm in advanced chronic obstructive pulmonary disease: correlation with serum theophylline levels. AB - The effect of IV aminophylline on cardiac rhythm of patients with advanced, stable chronic obstructive pulmonary disease (COPD) was evaluated with Holter monitoring in 38 males (average age 62 yrs). Serum levels ranged from 7.4 to 18.6 mg/l. Significant improvement in pulmonary functions and blood gases from baseline measurements were observed. New supraventricular tachycardia was seen only in three (8%) of 38 patients. Sixteen (76%) of the 21 patients with insignificant ventricular ectopy (VE) at baseline remained unchanged during therapy. Of the 17 patients who had significant baseline VE, nine (53%) had increased VE and eight (47%) had decreased VE. No symptomatic arrhythmia was observed. Whereas aminophylline in therapeutic dosage failed to provoke VE in arrhythmia-free COPD patients, the effect of aminophylline on pre-existent VE is variable. PMID- 6861922 TI - Extrinsic allergic bronchiolo-alveolitis: serology and biopsy findings. AB - Because the diagnosis of extrinsic allergic bronchiolo-alveolitis is usually on a clinical and serologic basis, recent histopathologic descriptions of the syndrome are rare. As the etiology may vary in different countries, so perhaps may the histopathology? Clinical and serological examination was combined with histopathology of open lung biopsy from 14 northern Finnish patients. All of them, after exposure to mouldy dust, had a typical clinical syndrome with cough and/or dyspnoea, some radiographic changes, and a reduced VC and/or DCO. Precipitating antibodies were demonstrated in 11 patients. Histopathologically, oedema, macrophages and granulomas were found in all patients, as were lymphocytic and plasmocytic infiltrates. Inflammatory changes were alveolar, interstitial and bronchiolar, including bronchiolar granulomas in all but one case. None of the patients had severe fibrosis or emphysema. There were no examples of clear-cut acute or chronic stages as described in previous studies. Instead, most of our specimens represented an "intermediate" stage, indicating differences in exposure or susceptibility of the population compared with other countries. PMID- 6861923 TI - Influence of corticosteroid treatment on the course of farmer's lung. AB - In this prospective study of farmer's lung disease 93 patients were subjected to a follow-up period of an average of 18.6 months. The patients were initially divided into three groups, each receiving corticosteroids either for four weeks, twelve weeks, or not at all, if the disease was less severe. Lung function, clinical findings and chest radiography were recorded at intervals of one, three, six and 12 months and every six months after that. Corticosteroid treatment seemed to have no marked influence on the course of lung function or the prognosis of working capacity. Twelve-week treatment did not produce better results than four-week. However, corticosteroids diminished the appearance of fibrotic changes in chest radiograms. It is concluded that corticosteroids should be given to severely ill patients to ameliorate symptoms, but no apparent benefit is derived from long-term treatment. Eighty-five per cent of patients continued farming and cattle-feeding after recovery. The severity of the initial attack and the occurrence of relapses were found to be the most important factors influencing respiratory performance, subjective symptoms and working capacity in patients with farmer's lung. PMID- 6861924 TI - Tuberculosis emerging in patients treated with corticosteroids. AB - Corticosteroid therapy is held to facilitate activity of tuberculous disease. This retrospective study is an analysis of 1355 patients suffering from tuberculosis who had been discharged from a chest hospital during a 9-year period starting in 1971. Those on corticosteroid therapy for the last 6 months prior to diagnosis, were included. There were no new cases of tuberculosis among these, but 40 patients or 3 per cent had reactivation of former disease. The findings should be representative of the national prevalence. Despite increasing use of corticosteroids, there is no indication that the number of reactivated cases associated with such treatment has increased during the years. A majority of our patients were suffering from serious corticosteroid-demanding diseases which might in themselves be as causative as the drug therapy in activating the tuberculosis. PMID- 6861925 TI - Nuclear DNA in carcinoid tumours of the lung. AB - Fluorescence cytophotometric DNA measurements on 15 carcinoid tumours generally yielded histograms with a prominent G1-phase peak and only low frequencies of S- and G2-phase nuclei. In 13 tumours the modal DNA value was near diploid (1.75 2.25). Three of these 15 tumours showed a much greater number of S- and G2-phase values than the others and in two of them there were also G1-phase peaks below the near-diploid range. Among 22 samples of small cell carcinoma of the lung (SCCL), the modal DNA value was hypodiploid in two, near diploid in seven and hyperdiploid in 13. The proportion of S-phase cells was higher in the SCCL samples than in the carcinoid tumours. It is suggested that the nuclear DNA distribution profile may facilitate morphological discrimination of a classical pulmonary carcinoid from small cell carcinoma. In a borderline case, the finding of a hyperdiploid DNA stem line and high proliferative activity will favour the diagnosis of SCCL. PMID- 6861927 TI - Amiodarone pneumonitis. PMID- 6861926 TI - Mechanism of phase V in the single breath washout curve. AB - The underlying mechanism of the occurrence of a downward phase V at the end of a bolus washout curve was investigated in three healthy subjects. Phase V appeared not to originate from apical zones with low concentration of tracer gas but from dependent lung zones, which were not pathological. Indeed: 1) a reversed, upward, terminal slope was obtained when the bolus had been directed to the lung base by imposing a transition of the body through 180 degrees between inspiration and expiration or by inhaling a bolus close to TLC; 2) phase V was also present on N2 washout curves and, thus, originated from zones with smaller RV/TLC than the apical ones. Phase V increased with flow rate. PMID- 6861929 TI - Optokinetic nystagmus deficits following parieto-occipital cortex lesions in monkeys. AB - Optokinetic nystagmus (OKN) was induced in six monkeys by rotation of a full field drum. After unilateral lesions of the inferior parietal lobule and prestriate cortex (IPL-PS lesion), three monkeys had diminished velocity of slow components when the drum rotated toward the side of the lesion. OKN slow components appeared normal when the drum rotated in the opposite direction, while fast components appeared normal in both directions. The severity of the slow component deficit was greater at higher rates of stimulus rotation than at lower ones. Recovery occurred within 7-10 days for two monkeys; no recovery was evident after 2 weeks for the third. Subsequent bilateral IPL-PS lesions in two of these monkeys reduced OKN slow phase velocity in both directions. Two monkeys with unilateral lesions limited to the inferior parietal lobule (IPL lesions) had only very mild and transient deficits lasting 1-3 days. Bilateral IPL lesions also produced only slight OKN deficits. One monkey had a lesion which destroyed most of the lateral striate cortex of one hemisphere and had no discernable OKN deficit. These results demonstrate that, in contrast to earlier reports, lesions of parieto-occipital cortex in monkeys produce deficits which are qualitatively similar to, although of shorter duration than, those OKN deficits which commonly are associated with posterior parietal damage in humans. PMID- 6861928 TI - Supraspinal cell populations projecting to the cerebellar cortex in the turtle (Pseudemys scripta elegans). AB - Neuronal cell populations giving rise to cerebellar projections in the turtle, Pseudemys scripta elegans, were analysed following injections of horseradish peroxidase into the cerebellar cortex. The most prominent retrograde cell labeling occurred bilaterally within the caudal rhombencephalon and especially in the ventral portion of the inferior reticular field. Based on the structural parameters of the labeled cells (size, dendritic tree), their location and laterality of projection, attempts were made to identify cell groups similar to the inferior olive, the lateral funicular (reticular) nucleus and the perihypoglossal complex of other vertebrates. There were some labeled neurons within the descending and principal trigeminal nuclei, but few if any within the dorsal column nuclear complex. Cerebellar projections on the other hand clearly arose from the n.vestibularis inferior and n.vestibularis dorsolateralis on both sides. While there was little evidence for labeled cells located in a similar position as the pontine nuclei of higher vertebrates, a conspicuous number of neurons were observed in meso-diencephalic regions. Confirming the findings of Reiner and Karten (1978) characteristic accumulations of cells were seen in the nucleus opticus tegmenti, in the ipsilateral mesencephalic tegmentum and lateral and ventral to the ipsilateral nucleus pretectalis. Additional neurons were found in the periventricular hypothalamus, the nucleus of the fasciculus longitudinalis medialis and in the n.interstitialis of flm on both sides as well as in the red nucleus. PMID- 6861930 TI - Functional role of association fibres for a visual association area: the posterior suprasylvian sulcus of the cat. AB - This paper reports on experiments in which the effect of disconnection of association fibres from Area 17/18 to the posterior suprasylvian cortex (PSSC) was investigated. In the control experiments, all neurons had large receptive fields in the central 5-10 degrees of the visual field without detailed retinotopy. In the medial bank of PSSC, receptive fields were located in the contralateral visual field, while receptive fields of neurons in the lateral bank were located ipsilaterally. Neurons in PSSC could be excited by electrical stimulation of the ipsilateral Area 17/18 boundary, of the medial pulvinar (N. lat. post., pars. lat.) and the lateral geniculate body. About 2/3 of all neurons could be excited from all these regions, although with varying latencies. After acute and chronic subpial undercutting of the representation of the central 5-10 degrees of the ipsilateral area 17/18, visual response properties including direction sensitivity, receptive field size and ocularity of PSSC-neurons in the medio-posterior bank did not change significantly. After ablation of the whole contralateral visual cortex (including PSSC and a wide region of the contralateral Clare-Bishop area) the input from the ipsilateral eye was considerably diminished, but other response properties did not change significantly. These essentially negative findings are discussed in relation to different findings of other authors, and it is argued that the subpial undercutting of only the central visual field representation may have prevented damage to the ipsilateral suprasylvian cortex and its afferents, which is difficult to avoid if the whole area 17 is ablated by suction. It is proposed, that association fibres may only "unspecifically" excite neurons in related association areas rather than impose onto them specific response features. These latter are derived, also in association areas, essentially from their thalamic afferents and their intracortical interaction. PMID- 6861931 TI - Topographical organization of the thalamic projections to the cortex of the anterior ectosylvian sulcus in the cat. AB - The thalamic afferents of the anterior ectosylvian sulcal region were studied in the cat using retrograde axonal transport of horseradish peroxidase. Following peroxidase injections in the cortex of both banks and fundus of the anterior ectosylvian sulcus, retrograde labeling was always very abundant in the ventromedial thalamic nucleus, whichever part of the sulcus was injected. Consistent numbers of labeled neurons were also identified in the lateral medial subdivision of the lateral posterior-pulvinar complex, suprageniculate nucleus, posterior thalamic nuclear group and magnocellular division of the medial geniculate nucleus. A smaller number of labeled neurons was found in the ventral part of the lateral posterior nucleus, and ventralis anterior, ventralis lateralis, medialis dorsalis and intralaminar nuclei. The quantity and topographical distribution of labeled neurons in these thalamic nuclei depended on the location of the injection in the banks and fundus of the sulcus. PMID- 6861932 TI - Uncrossed retinal projections to the accessory optic nuclei in rabbits and cats. AB - Retinal projections to the accessory optic nuclei of rabbits and cats were demonstrated with standard autoradiographic techniques following intraocular injections of [35S]methionine and [3H]proline. In the pigmented rabbit, albino rabbit, normally pigmented domestic cat and Siamese cat the medial, lateral and dorsal terminal nuclei (MTN, LTN, and DTN, respectively) of the accessory optic system were densely labelled on the side contralateral to the injected eye. An ipsilateral projection, while clearly present in all but the Siamese cat, varied in the number of nuclei involved. In the albino rabbit, the ipsilateral projection ended in the MTN, while in the pigmented rabbit, it ended in the MTN, LTN and DTN, and in the normally pigmented domestic cat it ended in the MTN and LTN. These results indicate that the accessory optic system in rabbits and cats is more extensive than previously reported and that differences exist in the accessory optic system which may be related to genetic differences in normally pigmented and hypopigmented animals. PMID- 6861933 TI - The distribution of posterior parietal fibers in the corpus callosum of the rhesus monkey. AB - The distribution of posterior parietal fibers in the corpus callosum of the rhesus monkey was analyzed using autoradiographic techniques. Posterior parietal fibers are located in the posterior half of the body of the corpus callosum. There is some segregation of fibers with respect to their place of origin within the posterior parietal lobe. However, there is also overlap, particularly between fibers coming from the caudal inferior parietal lobule and the medial parietal lobe. PMID- 6861934 TI - Adaptive change of the vestibulo-ocular reflex in the cat: the effects of a long term frequency-selective procedure. AB - Ocular movements of naive and adapted cats were recorded by classical electronystagmography techniques during: (1) sinusoidal vestibular stimulation, (2) sinusoidal optokinetic stimulation, (3) sinusoidal additive visual-vestibular stimulation, and (4) sinusoidal conflicting visual-vestibular stimulation. Adaptation of the horizontal vestibulo-ocular reflex (VOR) was produced in adult cats by sustained combined sinusoidal rotation of the cat and its surroundings (fixed-field conditions). This procedure was applied for four hours for four consecutive days. On the fifth day the VOR in darkness, the OKR, the VOR in the light and the visual suppression of the VOR were studied. VOR gain decreased from day to day and some relative frequency-specificity emerged. The gain of the visually inhibited VOR also diminished after training. This change was also frequency-specific. OKN gain, tested by a set of sinusoidal rotations, was found to be virtually unchanged. In the naive cat, VOR modified by the visual stimulus (fixed or moving) could be computed by an algebraic summation of the VOR and OKR eye movement compensations. After training, the gain of the VOR in situations where the VOR was interacting with the OKR remained easily predictable by the algebraic summation of the isolated VOR and OKR compensations. PMID- 6861935 TI - Rat somatosensory (SmI) cortex: I. Characteristics of neuronal responses to noxious stimulation and comparison with responses to non-noxious stimulation. AB - Single unit responses to noxious and non-noxious somatic stimulation were investigated in the somatosensory (SmI) cortex of rats under halothane-nitrous oxide anaesthesia. Four categories of neurons were observed: (1) neurons driven by non-noxious cutaneous stimulation, (2) neurons driven by non-noxious deep stimulation, (3) neurons driven by noxious stimulation only (nociceptive specific neurons), (4) neurons driven by noxious as well as non-noxious stimulation (convergent or nociceptive non-specific neurons). The receptive fields of the neurons driven by contralateral cutaneous non-noxious stimulation were small. These neurons responded phasically to cutaneous stimulation in the majority of cases. Neurons driven by stimulation of deep receptors (e.g. joint movement) could also be recorded in the same part of SmI cortex. Neurons driven by noxious stimulation had large receptive fields and were often tonically driven by noxious stimulation. Convergent (or nociceptive non-specific) neurons could often be inhibited from body parts not included in their excitatory receptive field. Some neurons driven by noxious stimulation were able to encode stimulus parameters such as temperature of a hot water bath or surface of the skin area stimulated. The different categories of neurons defined above could be successively recorded during a given electrode penetration. Evidence for the somatotopic organization of the different categories of inputs was obtained. These results strongly suggest that the first somatosensory (SmI) neocortex is involved in nociception. PMID- 6861936 TI - Rat somatosensory (SmI) cortex: II. Laminar and columnar organization of noxious and non-noxious inputs. PMID- 6861939 TI - Age-related morphologic differences in the rat cerebral cortex and hippocampus: male-female; right-left. AB - This paper is one of a series presenting right-left differences in the morphology of the rat forebrain, but this presentation differs from the previous ones by offering age-related changes in both sexes. Long-Evans rats were housed with the dam prior to weaning at 21 days of age and three to a cage thereafter. The ages of the animals studied were 6 to 7, 14, 21, 90, 180 to 185, 390 to 400, and 870 to 876 days. The thicknesses of the cerebral cortex and of the hippocampus were measured on microslide-projected images of thionin-stained sections. We learned that the cerebral cortex of the male rat was thicker on the right side than on the left at all ages in 41 of 42 measures, being statistically significant in 30 of 42 measures. Areas 10, 3 and 17 showed the most marked differences at all ages. In the female rat, laterality was not so well defined, but, in general, the left cerebral cortex was thicker than the right in 33 of 54 measures, but in only 5 of the 54 were statistically significant differences found. The right-left differences in the hippocampus followed the pattern of the cortical differences in the male and female rats. The right male hippocampus was thicker than the left at all ages, with greater differences noted in the younger than in the older groups. The female left hippocampus was thicker than the right, but only in the 90-day group was the difference significant. PMID- 6861937 TI - Visual cortical projections to the paraflocculus in the rat. An electrophysiologic study. AB - The visual cortex of the rat was electrically stimulated with monopolar tungsten electrodes to determine the response properties of single neurons in the parafloccular lobule of the cerebellum. Following stimulation of the contralateral visual cortex, mossy fiber (MF)-evoked responses were indicated in 80 of 91 cells (88%) by activation of single or double spike potentials at latencies of 6-16 ms followed by an inhibition in simple spike frequency. MF activations were further identified by the demonstration of graded responses with increasing stimulus intensity and by following stimulus frequencies up to 20 Hz. Fifteen percent (9/61) of identified Purkinje cells in the parafloccular lobule demonstrated activation by climbing fiber excitations, as identified by the characteristic all-or-none burst response, which were evoked at variable latencies between 15-31 ms and 68-115 ms. Experiments involving stimulation of the superior colliculus and lesioning of the cerebral peduncle suggest that the visual cortical projection to the paraflocculus is mediated by the cortico-ponto parafloccular pathway rather than relayed through midbrain nuclei. The electrophysiologic evidence suggests that the paraflocculus is a major receiving lobule of the cerebellum for inputs from the visual cortices. PMID- 6861940 TI - Misreaching in monkeys after combined unilateral occipital lobectomy and splenial transection. AB - Studies of the effects of lesions of the parietal cortex suggest that this region plays a critical role in visuomotor guidance, whereas experiments on the effects of disconnecting this region from visual input have been inconsistent in supporting this hypothesis. In the present experiment, monkeys with a unilateral occipital lobectomy and splenial transection initially showed marked misreaching by the hand contralateral to the lobectomy when tested informally with peanuts presented by hand. Although this severe misreaching recovered within a few weeks, there was a persistent deficit in the contralateral hand on two, more difficult, reaching tasks. One task allowed full vision of the reaching hand; the other limited vision by requiring the monkeys to reach under an opaque shelf. Misreaching persisted on these tasks for at least 200 days after surgery. Monkeys with only an occipital lobectomy did not show contralateral-hand misreaching on informal testing or on the limited-vision task, and only very minor misreaching in two of three animals on the full-vision task. Results indicate that geniculostriate visual information must reach posterior cortical regions for visually guided reaching by the contralateral limb to be fully accurate. PMID- 6861938 TI - The orbitofrontal cortex: neuronal activity in the behaving monkey. AB - Single unit recording of neurons in the orbitofrontal cortex of the alert rhesus monkey was used to investigate responses to sensory stimulation. 32.4% of the neurons had visual responses that had typical latencies of 100-200 ms, and 9.4% responded to gustatory inputs. Most neurons were selective, in that they responded consistently to some stimuli such as foods or aversive objects, but not to others. In a number of cases the neurons responded selectively to particular foods or aversive stimuli. However, this high selectivity could not be explained by simple sensory features of the stimulus, since the responses of some neurons could be readily reversed if the meaning of the stimulus (i.e. whether it was food or aversive) was changed, even though its physical appearance remained identical. Further, some bimodal neurons received convergent visual and gustatory inputs, with matching selectivity for the same stimulus in both modalities, again suggesting that an explanation in terms of simple sensory features is inadequate. Neurons were also studied during the performance of tasks known to be disrupted by orbitofrontal lesions, including a go/no go visual discrimination task and its reversal. 8.6% of neurons had differential responses to the two discriminative stimuli in the task, one of which indicated that reward was available and the other saline. Reversing the meaning of the two stimuli showed that whereas some differential units were closely linked to the sensory features of the stimuli, and some to their behavioural significance, others were conditional, in that they would only respond if a particular stimulus was present, and if it was the one being currently rewarded. Other neurons had activity related to the outcome of the animal's response, with some indicating that reinforcement had been received and others, that an error had been made and that a reversal was required. Thus, neurons in the orbitofrontal cortex possess highly coded information about which stimuli are present, as well as information about the consequences of the animal's own responses. It is suggested that together they may constitute a neuronal mechanism for determining whether particular visual stimuli continue to be associated with reinforcement, as well as providing for the modification of the animal's behavioural responses to such stimuli when those responses are no longer appropriate. PMID- 6861941 TI - Localization of motoneurons innervating deep and superficial facial muscles in the rat: a horseradish peroxidase and electrophysiologic study. AB - In the rat, distribution of the motoneurons supplying the deep facial muscles (DFM)--the posterior belly of the digastric (VP) and the stylohyoid (SH) muscles- and the superficial facial muscles (SFM) was studied using the horseradish peroxidase (HRP) method and the antidromic field-potential method. The HRP was injected individually into the VP or SH or applied directly to the central end of the facial nerve cut immediately before it enters the parotid gland. Electrical stimulation was administered to the common stem of the branches innervating the VP or SH and to the facial nerve trunk just before entering the parotid gland. Both VP and SH motoneurons were found not in the main but in the accessory facial nucleus, within which the VP motoneurons were more numerous and more dorsorostrally extended than were the SH motoneurons. Motoneurons supplying the SFM were confined within the main facial nucleus. Evidence was found that the distribution of antidromic field potentials evoked by stimulation at the above sites coincided with the distribution of motoneurons supplying either the DFM or SFM obtained from the HRP experiment. In the rat, the accessory and main facial nuclei can be considered to be the mass of motoneurons exclusively innervating the DFM and SFM, respectively. PMID- 6861943 TI - Restoration of functional continuity in dystrophic murine muscle after crushing. AB - The recovery of functional continuity after crush injury was measured by a simple electrophsiological technique in semitendinosus muscles of normal and dystrophic mice of the C57BL/6J(dy2Jdy2J) strain. In contrast to virtually complete restitution in normal muscles, only one-third of fibers regained continuity in dystrophic muscles. The study also confirmed the lower resting membrane potentials of dystrophic fibers and the presence of "functional" denervation in some of them. PMID- 6861944 TI - Early rapid and transient increase in ornithine decarboxylase activity within sympathetic neurons after axonal injury. AB - The activity of ornithine decarboxylase (ODC) was examined in the rat superior cervical ganglion during development and after postganglionic axotomy. During development the enzyme activity in the ganglion was transiently elevated at 19 days gestation (2 days before birth) and then declined to low adult activities by 5 days after birth. After axotomy the enzyme activity in the ganglion was rapidly increased. As early as 2 h after the injury the activity was increased to 200% and by 10 h it attained a peak of 453% above control values. The activity then rapidly declined to a lower value of about 200% above control by 24 h, where it remained as long as 5 days and then returned to control values by 10 days postoperative. The early increase in ODC activity was demonstrated by inhibitor cytochemistry to occur within neuronal cell bodies. The ODC activity was also increased after preganglionic nerve transection (denervation) (275%), end organ removal (60%), and 6-hydroxydopamine treatment (75%). We conclude that increased ODC activity is one of the earliest events in the reaction of the nerve cell body to axonal injury, and that increased ODC activity is a common feature of drastic metabolic alterations in neurons of the superior cervical ganglion. PMID- 6861945 TI - Effects of cholinergic and dopaminergic agents on pain and morphine analgesia measured by three pain tests. AB - The effects of several cholinergic and dopaminergic agents on pain and morphine analgesia were assessed using three pain tests. These tests--tail-flick, hot plate, and Formalin--allow comparison of the effects of different noxious stimuli and different motor responses. Each pain test yielded a unique constellation of cholinergic and dopaminergic influences, suggesting that variation of stimulus and response parameters can change the functional expression of cholinergic and dopaminergic systems related to pain processing. Significant analgesia was observed in the Formalin test, compared with the saline control, after administration of choline (30 or 60 mg/kg), atropine (2 mg/kg), mecamylamine (2 mg/kg or 10 mg/kg), or apomorphine (0.3 or 8 mg/kg). No analgesic effects in this test were observed after atropine (10 mg/kg) or pimozide (0.125 or 0.5 mg/kg). In contrast, there was no evidence of analgesia produced by any of these drugs, in the doses given, in the hot-plate test, and only apomorphine (8 mg/kg) produced analgesia in the tail-flick test. When these cholinergic and dopaminergic agents were administered to rats after an injection of 2.5 mg/kg morphine, which by itself has been shown not to produce analgesia in any of the tests, a general pattern of facilitation was observed in the Formalin test but not in the tail flick or hot-plate tests. Facilitation was produced by choline, atropine, mecamylamine, apomorphine, and pimozide (at 0.5 mg/kg but not 0.125 mg/kg). The data suggest that differences in the type of noxious stimulation and in the motor responses required in various pain tests are crucial in determining the observed pharmacologic profile of pain and opiate analgesia. PMID- 6861946 TI - Effect of interruption of bulbospinal pathways on lordosis, posture, and locomotion. AB - The effect of interruption of descending bulbospinal projections arising from (i) the medial medullary reticular formation: nucleus reticularis gigantocellularis (NGC) and nucleus reticularis magnocellularis (NMC), (ii) nucleus raphe magnus, and (iii) nucleus subceruleus on the lordosis reflex, posture, and locomotion was examined. After interruption of descending NGC-NMC fibers, time-dependent deficits in lordosis were observed during the first two postoperative weeks with subsequent reflex recovery. A syndrome of postural and locomotor deficits occurred after NGC-NMC lesions. Postoperatively, postural reflexes were dominated by increased extensor tone which resulted in limb hyperextension. Specific time dependent deficits in the control of extensor and flexor muscle groups involved in locomotion resulted in a motor syndrome that is detailed. After interruption of NMC fibers alone, no postural or locomotor deficits occurred and effects on lordosis were limited to the first few postoperative days. The NMC data suggested that the majority of the functional deficits seen after NGC plus NMC lesions were due to destruction of the NGC descending projections. Interruption of NSC bulbospinal fibers resulted in a significant depletion of spinal cord noradrenaline (NA) but not serotonin (5-HT). Functional deficits, when present, were limited to the first few postoperative days. Although interruption of descending NRM fibers resulted in a significant depletion of spinal cord 5-HT concentrations, greater depletions occurred in the NGC plus NMC group. No functional deficits were observed in the NRM group. These data suggest that interruption of NGC-NMC fibers destroyed the descending output from neurons which integrate the hormonal and sensory information necessary for lordosis. PMID- 6861947 TI - Alterations in apomorphine concentration in spinal cord and brain follow the time course of catalepsies induced by different treatments. AB - Because evidence for the neurotransmitter role of dopamine in the gray matter of the spinal cord is accumulating, a question arises of whether or not spinal dopamine receptors are also involved in the effects of dopaminomimetics which are believed to induce beneficial effects in Parkinson's disease through an action thought to be mediated mainly by striatal dopamine receptors. To test this hypothesis muscimol and picrotoxin were injected unilaterally into the posterior part of the substantia nigra of rabbits permanently implanted with stainless steel cannulae. Muscimol (a GABA-mimetic) enhanced locomotor activity, evoked a stereotyped behavior and contralateral rotations, and increased apomorphine induced gnawing. Picrotoxin, a substance which inhibits GABA transmission, induced ipsilateral rotations, evoked catalepsy and muscle rigidity, and inhibited locomotor activity. Picrotoxin abolished apomorphine-induced gnawing, and increased haloperidol-mediated catalepsy. The catalepsy induced by an intranigral injection of picrotoxin, and the picrotoxin-evoked blockade of the apomorphine-induced gnawing disappeared within 16 h after the intranigral injection. Alterations in the apomorphine concentration in brain structures (n. caudatus and cerebral cortex) and in spinal cord after picrotoxin injection followed the same time course as the behavioral changes, and returned to the control values 16 h after injection of picrotoxin. Apomorphine was always injected 30 min before the rabbits were killed. Moreover, the substantial increase (to 300%) in apomorphine concentration in the spinal cord probably reflects the antagonism between behavioral changes induced by picrotoxin and the haloperidol catalepsy, rather than the decreased apomorphine concentrations observed in the brain structures. We suggest, therefore, that there exists a correlation between the behavioral effects, which are generally accepted as laboratory models of Parkinson's disease, and the enhanced apomorphine concentration in the spinal cord. PMID- 6861948 TI - Effect of sagittal transections of the brain stem tegmentum on alumina cream induced focal motor seizures in cats. AB - The effect of extensive and circumscribed sagittal transections of the brain stem tegmentum on types B (epilepsia partialis continua) and C (contradversive tonic clonic seizures) alumina cream-induced focal motor seizures in cats was investigated. The neurological abnormalities of cats with transections and differences in the EEG-EMG patterns of types B and C seizures between operated and intact animals were statistically analyzed. Animals with either extensive or superior central nucleus transections showed bilateral neglect and internuclear palsy syndromes, no tonic type C seizures (contradversion), and a significant decrease in electromyogram multiple-unit activity (EMG MUA) from 0 to 10 s or more after the onset of EEG paroxysmal tonic-clonic discharges. Animals with rostral transections showed a unilateral neglect and internuclear palsy or ataxic syndromes with a concomitant partial reduction of contradversive seizures and a significant decrease in EMG MUA from 0 to 5 s or less after the onset of EEG tonic-clonic discharges; those with dorsal and caudal transections showed a transient neglect and insomniac syndromes with no differences in contradversion and EMG MUA at the onset of EEG tonic-clonic discharges in relation to intacts. Experimental and intact animals showed neither differences in types C and B EEG patterns nor in EMG MUA at the end of type C EEG tonic-clonic discharges and type B EEG spikes. These results support the idea that tonic and clonic muscular seizures are due to epileptic impulses originating in the cerebral cortex and mediated at the level of the brain stem by different pathways. PMID- 6861942 TI - Twitch potentiation after voluntary contraction. AB - Twitch potentiation was studied in human tibialis anterior (TA) and plantarflexor (PF) muscles after maximal voluntary contractions (MVCs). Potentiation was greater in TA and other dorsiflexor (DF) muscles than in PF and was dependent on the intensity of the voluntary effect. It was also observed that potentiation was maximal after MVCs of approximately 10-s duration; after longer voluntary contractions, the potentiation was partially suppressed by fatigue, especially in the TA. Potentiation was significantly larger when muscles were tested in a shortened position regardless of the position at which the preceding MVCs had been performed. PMID- 6861949 TI - Hippocampal lesions increase the severity of unilaterally induced audiogenic seizures and decrease their latency. AB - The effect of unilateral and bilateral lesions of the hippocampus was examined in unilaterally tested SJL/J mice. The data indicate that lesions of the hippocampus decrease the latency to and increase the severity of audiogenic seizures. PMID- 6861950 TI - Periaqueductal gray inhibition of trigeminal subnucleus caudalis unitary responses evoked by dentine and nonnoxious facial stimulation. AB - The possible pain inhibitory effects of periaqueductal gray (PAG) stimulation were investigated in cats anesthetized with Nembutal and immobilized with Flaxedil. Unitary responses evoked by electrical stimulation of the upper canine dentine and by cutaneous facial noxious and nonnoxious stimuli were recorded extracellularly from the trigeminal subnucleus caudalis. A bipolar electrode was introduced into the PAG to test the effects of PAG excitation on the trigeminal response to dentine (TRED) and cutaneous nonnoxious stimulation. In some experiments, a similar electrode was lowered into the contralateral posterior thalamus to study the antidromic activation of subnucleus caudalis cells and the effects of thalamic stimulation on the TRED. Dentine stimulation evoked brief (6- to 15-ms) bursts of 1 to 10 spikes with 3- to 25-ms latencies. Most units (88%) were also activated by cutaneous facial stimulation. Stimulation of the posterior thalamus had no effect on the TRED or on responses to cutaneous stimulation, but activated antidromically 10% of the units. In 71% of the units PAG stimulation inhibited the TRED. In some of those cases (12%), the inhibitory effect persisted 30- to 60 s. The PAG stimulation could produce paradoxical effects, potentiating the TRED evoked by threshold intensity and inhibiting the TRED elicited by suprathreshold stimulation. About one-half the PAG points evoked detectable effects. Their location had no clear topographical distribution, although ventral sites were more potent than dorsal sites. Responses evoked by nonnoxious facial stimulation were also inhibited by the PAG. PMID- 6861952 TI - Masseteric silent periods electrically evoked in normal subjects and patients with temporomandibular joint dysfunction. AB - The mean latency and duration of electromyographic silent periods were compared in normal subjects and patients with symptoms of temporomandibular joint (TMJ) dysfunction. The silent periods were evoked in the masseter muscle by electrical stimulation of the mental nerve area and recorded at 100% and 50% of maximum masseter EMG activity. Two silent periods were typically observed. The mean latency of the early silent period as well as the mean duration of both the early and late silent periods were shorter at 100% than at 50% of the maximal voluntary activity. In comparing the two groups, the mean latencies were shorter and the mean durations were longer for both silent periods in the TMJ group compared with the normal group. The prolonged silent periods in the TMJ group do not appear to be caused by a difference in stimulus intensity or level of voluntary activity in the masseter muscle. These results permit the speculation that the mechanism of the prolonged silent period in the TMJ patients might be central rather than peripheral. PMID- 6861951 TI - Sex differences in the phenotypic expression of avian dystrophy. AB - Although the gene for muscular dystrophy in chickens is not sex-linked, results from clinical tests suggest that it is expressed differently in males and females. As measurement of muscle contractile responses provides a quantitative index for the severity of the disease, the contractile properties of the extensor digitorum communis muscle were examined in normal and dystrophic chickens with respect to sex. Furthermore, these differences were examined in young (6 to 9 weeks) and old (greater than 6 months) chickens. Results showed that age-related sex differences were apparent for those mechanical parameters of the muscle (in particular the posttetanic potentiation and posttetanic contracture) known to distinguish normal and dystrophic birds. The sex differences observed in the younger group indicate that the female birds were more severely affected by the disease than were the male. In the older group, the male were affected by the disease more severely than age-matched female birds. If the inheritance pattern is truly autosomal then it is likely that one or more developmental factors interact with the dystrophic genotype and alter the dystrophic phenotype. PMID- 6861953 TI - The decerebrate human: associative learning. AB - Phasic changes in cardiac reactivity to innocuous stimuli, presented in a sensory disparity paradigm, were used to evaluate habituation and learning processes in five decerebrate subjects. Three subjects showed systematic changes over trials in the pattern of cardiac response to simple auditory or visual stimuli, indicative of habituation. In addition, tests for associative learning were given after repeated presentations of two paired stimuli. The appearance of a marked cardiac orienting response, to the unpredictable omission of the second stimulus, documented the development of a conditioned association in these same three subjects. One additional subject failed to show a consistent pattern of response to the stimuli, and another demonstrated a consistent response which was not subject to habituation. Overall, these findings support the view that learning processes are not solely the product of the cerebral hemispheres, but reflect general integrative features of the human neuraxis. PMID- 6861954 TI - Intracellular topography of immunoreactive gastrin demonstrated using electron immunocytochemistry. AB - Gastrin (G)-producing cells from the mammalian gastric antrum have been investigated using computer-assisted morphometry and a novel double colloidal gold-labeled-immunoglobulin electron immunocytochemical procedure. Correlation analysis of human antral G-cells indicates (p less than 0.001) that a single population of granules exists with small (160 nm) electron-dense and large (240 nm) electron-lucent forms representing the extremes. Non-crossreacting region specific antisera have been used to visualize G-17 and G-34 (progastrin) to the small electron-dense granules and G-17 to the other intermediate forms. From the results we propose a topographic segregation of immunoreactive gastrins within 2 apparently distinct granule subclasses and suggest that this may represent the pathway of granule maturation. PMID- 6861955 TI - Dermatomic distributions of hypopigmented macular lesions of leprosy: neural dependence of melanocytic functions. AB - Dermatomic analysis of the distribution of the hypopigmented patches of leprosy has revealed a pattern wherein patches are most frequent in dermatomes of the brachial plexus, decrease gradually in frequency in succeeding spinal segments and increase again in dermatomes of the lumbar plexus. The predilection of hypopigmented patches for certain dermatomes may be a reflection of easy vulnerability of the neural pigmentary mechanism and/or a reflection of selective multiplication of M. leprae in nerves of certain dermatomes, even though the organisms might have been seeded all over the body by hematogenous spread. These preliminary observations are discussed. PMID- 6861956 TI - Comparison of cutaneous hyperemia in cattle elicited by larvae of Boophilus microplus and by prostaglandins and other mediators. AB - Blood flow has been measured in bovine skin following the injection of tick antigens and a number of pharmacological mediators; including histamine, prostaglandins and slow reacting substance of anaphylaxis. The greatest increase in blood flow (20 times normal) was recorded with tick antigens and with prostaglandin F2. This mediator may therefore influence blood flow during immune reactions to ticks and during the rapid ingestion of blood by the ticks. PMID- 6861957 TI - Hepatic oxygen consumption, in vivo, in the rat. AB - A method is described that quantitates hepatic oxygen consumption, in vivo, in the rat. This method can evaluate hepatic oxygen consumption resulting from chronic conditions that may alter it. PMID- 6861958 TI - Release of vasoactive intestinal peptide from rat jejuno-ileum in vitro. Effect of various depolarizing agents. AB - Vasoactive intestinal peptide (VIP) can be released in vitro from intestinal slices under veratridine and batrachotoxin depolarization, whereas potassium depolarization has no effect. The lack of an effect of potassium observed in this peripheral preparation is different from the positive action described for it in the CNS. The present data suggest that VIP can be released through different mechanisms in the peripheral and central nervous system. PMID- 6861959 TI - Location of dopamine stores in rat kidney. AB - In normotensive and genetically hypertensive Wistar rats, chronic renal denervation reduces renal cortical levels of noradrenaline and dopamine by more than 90%. Non-neural stores of renal dopamine are therefore small or absent. PMID- 6861960 TI - Parallel increase of ascorbic acid and glutathione contents in brown adipose tissue during chronic cold exposure. AB - Spontaneous lipid peroxidation rate was found unchanged in the brown adipose tissue of rats chronically exposed to cold, although oxidative metabolism, ascorbic acid and poly-unsaturated phospholipid amounts increased. It is suggested that the concomitant increase in glutathione concentration may protect the tissue from a possible peroxidative process. PMID- 6861961 TI - Altered hyperemic response of the coronary arterial bed in alloxan-diabetes. AB - Reactive hyperemic responses of the coronary arterial bed, provoked by asphyxia or clamping of the coronary artery, were compared in alloxan-diabetic and metabolically healthy dogs. In alloxan-diabetic dogs the response of the coronary arterial bed lasted longer, and its reactivity to hypoxia was lower. Treatment with adenosine caused less vasodilation in diabetic animals than in controls. These changes may be due to the altered reactivity of diabetic vascular smooth muscle. PMID- 6861962 TI - Subcellular distribution and binding of heavy metals in the untreated liver of the squid; comparison with data from the livers of cadmium and silver-exposed rats. AB - In natural squid liver, about 30% of the total Cd present was found in the cytosolic fraction. A large portion of this Cd was bound to high molecular weight species (mol. wt greater than 70,000). In contrast to Cd, about 60% of the total Ag occurred in the cytosolic fraction; Ag was bound mainly to low molecular weight species (mol. wt less than 20,000). PMID- 6861963 TI - Free cholesterol not carried by lipoproteins in human serum. AB - Considerable amounts of nonesterified cholesterol were found in human serum freed from lipoproteins. This cholesterol, when incubated with synaptosomal plasma membranes of dog brain, evokes changes of the ouabain-sensitive ATPase activity, as the exogenously added cholesterol does. PMID- 6861965 TI - Bone marrow genotoxicity of N-methyl, N-nitrosourea (NMU): n-alkanols as sister chromatid exchange (SCE) anti-inducers. AB - The in vivo SCE test was used to demonstrate significant inhibition of NMU bone marrow genotoxicity by pretreatment of Chinese hamsters with n-alkanols. Our findings exclude a loss of intracellular DNA alkylation potential through a competitive direct reaction of NMU with the weakly nucleophilic polar end of the n-alkanols, but not through methylations of nucleophilic membrane sites possibly liberated by structural modifications which the membrane-active amphiphilics induce. PMID- 6861964 TI - Superoxide dismutase activity in the skin of rats irradiated by He-Ne laser. AB - The activity of the enzyme superoxide dismutase has been measured in the skin of rats irradiated by a low-power He-Ne laser. The irradiation was performed at the doses of 4, 8 and 20 J/cm2 in a single or repeated treatment. The increase in activity of superoxide dismutase in the skin of irradiated animals was not statistically significant. PMID- 6861967 TI - Failure of naloxone to modify the depth of hypnotic trance. PMID- 6861968 TI - Effect of specific and nonspecific immune complexes on injury of intact hepatocytes in vitro. AB - Immune complex (IC)-mediated cytotoxicity of hepatocytes was investigated in vitro, using antibodies against specific and nonspecific target cell surface membranes. The results indicated that neither specific, nor nonspecific IC evoked significant lysis of intact hepatocytes. Thus, the IC are unlikely to play an important role in the immune-associated injury of normal hepatocytes in acute and chronic liver diseases. PMID- 6861969 TI - Serum inhibitory activity on granulocyte-macrophage colony formation. AB - Normal and chloroform-extracted human sera, fractionated by Sephadex column chromatography, have been tested for inhibitory activity on granulocyte macrophage (GM) colony formation. It was found that this activity is connected with lipoproteins (inhibitors of granulocyte-macrophage colony stimulating factor) and low molecular weight substances (7000; 13,000) which can act as specific polypeptide chalones. PMID- 6861966 TI - Effects of bunaphtine on 45Ca movements in rat aortic smooth muscle. AB - The effect of bunaphtine (BNA, 5 X 10(-5)M) on La3+ -resistant 45Ca content and 45Ca efflux was studied on rat aortic smooth muscle. BNA decreased both control and norepinephrine-stimulated La3+-resistant 45Ca content and increased the 45Ca efflux. These effects could explain the inhibition of the contractile responses induced by BNA. PMID- 6861970 TI - The effect of blood storage on differential chromosome staining of human lymphocytes. AB - Human blood was stored for up to 3 days before 66-h culture with 3 concentrations of bromodeoxyuridine (BrdU) (10, 20 and 40 microM). In cultures containing 10 or 20 microM BrdU, the number of cells staining as first division metaphases (MI) increased with storage time. In addition, as the storage time was increased the staining quality deteriorated although this was less pronounced in cultures containing 40 microM BrdU. The implications of these results for routine fluorescence plus Giemsa staining as part of a cytogenetic radiation dosimetry service are discussed, with the recommendation that for accurate identification of M1 cells, the concentration of BrdU should be increased in cultures set up from blood that has been stored for more than 2 days. PMID- 6861972 TI - Cytogenetics of Xenopus laevis. I. G-banding pattern of Xenopus laevis chromosomes. AB - Although karyotype analyses by G-band staining have been used routinely in mammals, birds and reptiles, few have been reported in amphibia. We succeeded, however, in differential chromosome staining of some chromosomes of the African clawed toad, Xenopus laevis, by using the trypsin technique. PMID- 6861971 TI - Formation of the active antifertility metabolite of (S)-alpha-chlorohydrin in boar sperm. AB - The male antifertility agent (S)-alpha-chlorohydrin (I) is metabolized by boar sperm to (S)-3-chlorolactaldehyde (II) by an enzyme that is involved in the oxidation of glycerol to glyceraldehyde. The presence of glycerol decreases the activity of this enzyme towards (S)-alpha-chlorohydrin in vitro thereby preventing the formation of (S)-3-chlorolactaldehyde, an inhibitor of glyceraldehyde 3-phosphate dehydrogenase in boar sperm. PMID- 6861974 TI - Estimation of the odorous steroid, 5 alpha-androst-16-en-3-one, in human saliva. AB - The concentration of the urine-smelling steroid, 5 alpha-androst-16-en-3-one, has been measured by radioimmunoassay in the saliva of 9 men and 4 women. The lower limit of detection was estimated to be 0.725 nmoles/l. In six of the men the range of concentrations of the odorous steroid was 0.8-1.8 nmoles/l saliva (3 men had less than the estimated lower limit of detection). In only one of the women studied could the 5 alpha-androst-16-en-3-one be measured (0.83 nmoles/l) in the saliva. PMID- 6861973 TI - Effects of prednisolone and butyrate on agglutinability of HeLa cells by concanavalin A. AB - Agglutinability by concanavalin A was measured with HeLa65 cells grown with prednisolone or sodium butyrate, 2 compounds that increase the activity of the carcinoplacental form of alkaline phosphatase, an enzyme localized in membranes. Prednisolone enhanced concanavalin A agglutination approximately 3-fold while sodium butyrate had no effect. PMID- 6861975 TI - Norepinephrine level in the hypothalamus of the genetically hypertensive mouse. AB - The norepinephrine content of the hypothalamus of young mice with high blood pressure was statistically lower than that of mice with low blood pressure. The difference was not evident in older mice from these same strains. No differences in dopamine content were found suggesting a genetic difference in the activity of the converting enzyme. PMID- 6861977 TI - [Systematic generic chemico-toxicological testing in forensic toxicology. IV. Application of a computer in a generic survey of substances of toxicological interest]. PMID- 6861976 TI - A technique for the comparison of biological distribution and solvent partition of drugs. AB - A dialysis technique is described which allows the measurement of drug distribution between buffer and solvents as well as between buffer and biological preparations under identical experimental conditions. Partition and distribution coefficients of thiopental, pentobarbital, imipramine, and chlorpromazine were determined using octanol, other solvents, and tissue homogenates. PMID- 6861978 TI - [Pseudomorphism of chloramphenicol stearate and palmitate in relationship availability]. PMID- 6861979 TI - A programmable calculator procedure for parameter estimation according to the two compartment open model with first order absorption. PMID- 6861981 TI - [Pharmacokinetics of bilignost in the normal liver and in experimental pathology]. AB - In the first approximation the process of distribution of the radiographic contrast agent bilignost may be formalized with the aid of a linear two compartmental model, while generally, with the aid of a non-linear many compartmental perfusion model of the pharmacokinetics. Pharmacokinetic analysis of experimental data has shown that the decreased content of bilignost in the liver during acute carbon tetrachloride poisoning is largely determined by the impairment of radiographic contrast agent absorption by the liver. PMID- 6861980 TI - [Effect of antioxidants on lipid peroxidation in combined lesions of the liver]. AB - Experiments on white rats were made to examine the action of sodium selenite alone and combined with tocopherol acetate (vitamin E) as well as that of a tincture prepared from the grass of the selenium-containing plant astragal on lipid peroxidation during liver poisoning with carbon tetrachloride and tetracycline combined with ethyl alcohol. It was shown that carbon tetrachloride, ethanol and tetracycline are inducers of lipid peroxidation. Combination of carbon tetrachloride and tetracycline with ethanol leads to the potentiation of their prooxidant effect. Sodium selenite and the tincture from astragal grass inhibit free radical oxidation, which is evidenced by the reduction of the content of malonic dialdehyde and dienic conjugates in the whole blood and liver homogenates. PMID- 6861982 TI - [Pharmacological activity of drugs in nephrectomy in rats]. PMID- 6861983 TI - [Influence of antidepressants on the hypothermic effects of alpha-methyldopa and clofelin]. PMID- 6861984 TI - [Clinico-pharmacological study of neurotropic agents in neurogenic diseases of the cardiovascular system and stomach]. AB - It has been established in experiments that as visceral pathology arising during excess exposures advances, the deficiency of energy resources develops in the tissues of damaged organs. Application of the agents that normalize the function of the sympathetic nervous system (L-DOPA) and stimulate energy formation processes (ethimizol) accelerated reparative processes in damaged stomach and myocardium. Application of L-DOPA and ethimizol to the treatment of peptic ulcer patients produced a good therapeutic effect--an increase in the creatine phosphate content in the gastric mucosa and removal of the niche symptom in 80% of cases. PMID- 6861985 TI - [Reaction of the body to the effect of barbiturates and the activity of monoaminergic processes in the brain]. AB - The adaptive reaction to barbiturates was studied in the presence of a seasonally varying monoamine content and metabolism in the brain. The effectiveness of amobarbital and monoamine content in mouse brain were determined monthly during 5 years. It has been demonstrated that both adaptive reactivity of mice and monoamine content in the brain show a similar seasonal periodicity. The conclusion is made that adaptive reactivity determining the depth and duration of amobarbital anesthesia correlates mainly with the activity of serotoninergic processes. Activation of adaptive reactions caused by repeated administration of the barbiturate correlates with the activity of dopaminergic processes. PMID- 6861987 TI - [Effect of tranquilizers on myocardial function in stress injury]. AB - Experiments on rats were performed to evaluate the action of diazepam (1 mg/kg), phenazepam (1 mg/kg), meprotan (25 mg/kg), mebicar (500 mg/kg), and phenibut (25 mg/kg) on myocardial function under stress-induced injury. Diazepam, phenazepam and phenibut protected the myocardium from stress by raising the functional reserves of the heart. Meanwhile meprotan and mebicar produced no stress protective action on the heart under similar conditions. PMID- 6861986 TI - [Comparative characteristics of the pharmacological properties of novocaine and trimecaine at different periods after thermal, mechanical, radiation and combined lesions]. PMID- 6861988 TI - [Comparative study of the activity of anti-arrhythmia agents in calcium chloride induced arrhythmia in mice]. AB - Calcium chloride (280 mg/kg intravenously) provokes arrhythmia, heart fibrillation and death of mice. Pretreatment with isoptin, etmozine, lidocaine, trimecaine, quinidine and novocainamide prevents rhythm disorders and animals' death. Isoptin, etmozine, lidocaine and trimecaine have been found the most effective. Atropine does not produce any protective action. The simplicity and availability of the method described enables one to apply it as a model for search of new antiarrhythmic drugs. PMID- 6861989 TI - [Effect of armin on the microcirculation of the cerebral cortex of white rats]. AB - Experiments on white male Wistar rats with the use of the cinetelevision technique have shown that armine in a single LD50 provokes a 85-100% increase in the blood flow rate in the microvessels and a 45-50% elevation of the diameter of the pial arterioles. Administration of the drug in a dose of 1/2 of the LD50 brings about a 90% increase in the blood flow rate, whereas the diameter of the arterioles declines by 25%. The LD50 of armine lowers the cholinesterase activity in the brain and blood by 50-60%, while 1/2 of the drug LD50 by 20-30%. PMID- 6861991 TI - [Effect of strophanthin and celanide on the autoregulation of the cerebral blood flow]. AB - It has been demonstrated in acute experiments on anesthetized cats that the control group animals manifested (before glycoside administration) a comparatively steady brain circulation accompanied by changes in the arterial pressure (AP) within 60-150 mm Hg. Intravenous injection of strophanthine (0.05 mg/kg) and celanide (0.1 mg/kg) improved autoregulatory reaction of the brain vessels during AP falling to lower levels as compared to control. PMID- 6861990 TI - [Effect of euphylline and no-spa on microcirculation]. PMID- 6861992 TI - [Effect of peritol on the functional and morphological characteristics of the small intestine in rats]. AB - Experiments were made on 140 male Wistar rats with the use of morphological, biochemical and radiometric research methods. It was established that as soon as the treatment with the anabolic drug peritol was completed, there appeared the morphological signs attesting to an increase in functional activity of vasculostromal elements of the small intestine, and the absorption rate of vitamin B12 got intensified. Activity of enzymes responsible for parietal digestion (alkaline phosphatase, invertase), absorption of 59Fe-citrate and 131I albumin were unchanged. No substantial changes were revealed on the part of the morphology and function of the small intestine in the long-term period after peritol administration. PMID- 6861994 TI - [Effect of retabolil on the functional activity of thyroid hormones of athletes]. PMID- 6861995 TI - [Myelotoxic action of the new antitumor preparation spirobramin]. AB - Experiments on 110 white noninbred tumor-free rats were made to explore the myelotoxic action of a new antineoplastic drug spirobramine. A single (200 mg/kg) intravenous injection and a course of drug treatment (40 mg/kg 5 times every other day) produced monotypic changes in the peripheral blood and bone marrow hemopoiesis, primarily marked by inhibition of erythroid, eosinophilic and thrombocytic myeloid fibers followed by the development of moderate anemia, thrombocytopenia and aneosinophilia in the peripheral blood. A single injection of spirabramine in an MTD produced more pronounced changes in the blood than injection of the drug in divided doses. PMID- 6861993 TI - [Effect of hormonal preparations on lysosome enzyme activity in rat tissues]. AB - Experiments on white male rats were made to study and compare the action of hormonal drugs (testosterone propionate, retabolil and chorionic gonadotropin) on lysosomal enzymes of different tissues. There were differences in the changes in the activity of acid phosphatase, ribonuclease, cathepsins and beta-galactosidase after a single administration of testosterone and after a course of drug treatment. Retabolil and chorionic gonadotropin acted on lysosomal enzymes of spermatic vesicles similarly to testosterone given in a single dose. As far as the activity of liver cathepsins and beta-galactosidase is concerned retabolil was found to produce an opposite effect as compared to that of testosterone. PMID- 6861996 TI - [Effect of chronic fluorine poisoning on oxidative processes in body tissues]. PMID- 6861998 TI - Synthesis, acute toxicity and chemotherapeutic anti-cancer activities of a new tripeptidic mustard. AB - A new antitumor agent having the chemical composition of 3-(p-fluorophenyl) Lalanyl-3-[m-bis-(2-chloroethyl)aminophenyl]-L- alanyl-L-methionine ethyl ester hydrochloride (PTT 119) was synthetized. It fundamental toxicological data in mice and rats were assessed; its antitumor activity was investigated by establishing in mice, inoculated with L 1210 leukemia or in AKR mice with spontaneous leukemia of viral origin, a significant increase in Mean Survival Time as well as a percent increase of Increased Life Span and of the number of survivors. PMID- 6861997 TI - [Electromyographic characteristics of acute poisonings with chlorine derivatives of phenoxy acids]. AB - In acute poisonings with chlorine derivatives of phenoxy acids, the myotonic period of poisoning is marked electromyographically by the manifestations specific and non-specific for myotonia. The characteristic signs involve multiple electrical responses of muscle fibers stimulated by a single excitation impulse- potential or myotonic discharges. Non-specific alterations are characterized by prolongation of the latent period, decreased amplitude and shortening of the length of evoked action potentials, which indicates the suppression of muscle excitability. Electromyographic changes are a consequence of deranged muscle rather than of synaptic processes. PMID- 6861999 TI - Researches on antibacterial and antifungal agents. I. Analogs of nalidixic acid with a pyrrole moiety. AB - The synthesis and antibacterial activities of 4-hydroxyquinoline-3-carboxylic acid and 1,4-dihydro-1-ethyl-4-oxoquinoline-3-carboxylic acid containing a pyrrole or 2,5-dimethylpyrrole group at 6 position are reported. Reaction of 1-(4 aminophenyl)pyrrole or 2,5-dimethyl-1-(4-aminophenyl)-pyrrole with ethoxymethylenemalonate diethyl ester (EMME) afforded the related pyrroleanilinomethylenemalonates, which were subjected to thermal cyclization to give the required quinoline derivatives. These compounds on ethylation furnished at last the quinolonecarboxylic analogs of nalidixic acid. PMID- 6862000 TI - [Thiourea derivatives of naphtho [1,2-d] thiazole and their cyclization products]. PMID- 6862002 TI - N-monosubstituted urethanes and esters of 6-cis-dimethylamino-1,3,3-trimethyl-2 oxabicyclo-[2.2.2]octan-5-trans-ol with hypotensive and other activities. AB - The synthesis of 6-cis-dimethylamino-1,3,3-trimethyl-2-oxabicyclo[2.2.2]octan-5 trans-ol (III) starting from 1,3,3-trimethyl-6-nitrimino-2 oxabicyclo[2.2.2]octane is described. Starting from aminoalcohol (III), a series of N-substituted urethanes (IV) and esters (V), as well as the rigid analogue of acetylcholine (VII), were prepared. A number of compounds (V) and particularly (IV) showed remarkable hypotensive and bradycardic activities in rats, whereas the p-aminobenzoate (V h) showed infiltration anesthesia in mice comparable to that of lidocaine. Antiarrhythmic activity in mice and antiacetylcholine activity in vitro are also reported. PMID- 6862003 TI - [Tertiary aminoalkyl derivatives of 3-methyl-6- or -8-azaquinoxalin-2(1H)ones. Effect on acquisition and modification of a conditioned avoidance response in rats]. AB - Eight derivatives of 3-methyl-6-azaquinoxalin-2(1H)-one and of 3-methyl-8 azaquinoxalin-2(1H)-one were prepared. They bear on position 1 an aminoalkyl chain (dimethylaminoethyl, morpholinylethyl, dimethylaminopropyl and N methylpiperazinylpropyl). Three of these compounds exhibit a high degree of deconditioning activity on rats; compound (I) is particularly active on the acquisition of a conditioned avoidance response, while compound (II) is more active than chloropromazine on the modification of a C.A.R. Compound (II) is characterized also by low toxicity. PMID- 6862001 TI - Swelling and binding effects in a polymeric microfiber model for controlled drug release. AB - The diffusion of model molecules from water dispersions of ethylenevinyl-N,N diethylglycinate copolymer microfibers has been studied in different conditions. The influence of pH on diffusion rate has been related to water association and swelling effects following structural transitions induced in the copolymer by the acidic medium, rather than to difference in binding of the diffusing species to the macromolecule. PMID- 6862004 TI - [Non-steroidal anti-inflammatory agents. Stereoisomers of homologues of 2-(4 biphenylyl)-3-hydroxypropionic acid. XII]. AB - The synthesis of some homologues of 2-(4-biphenylyl)-3-hydroxypropionic acid, the separation of related diastereoisomers, their attribution to erythro and threo series, and resolution of the optical antipodes are described. The antiinflammatory activity--initially tested by carrageenin assay--proves generally influenced by steric configuration and is interesting for the isohexanoic derivative. PMID- 6862006 TI - Cell free translation of chicken calcitonin messenger RNA. AB - The primary step of calcitonin biosynthesis was studied in a normal organ: chicken ultimobranchial gland, a tissue particularly rich in calcitonin secretory cells. Poly(A)-rich RNA was extracted and purified from ultimobranchial organs and translated in a reticulocyte lysate in the presence of labelled methionine. Polyacrylamide gel electrophoresis of specific immunoprecipitates revealed a major band of Mr 14 500 and a band of Mr 13 300. Thus, in chicken the precursor of calcitonin is a Mr 14 500 polypeptide. The minor component of Mr 13 300 could represent limited processing by the reticulocyte lysate. PMID- 6862008 TI - Resistance of chromatin superstructure to tryptic digestion modulated by conjugated polyacrylamide. AB - Soluble polyacrylamide conjugates have been used to modulate tryptic digestion of chromatin. Digestion of histones H1/H5 and H3 are mutually dependent and relatively independent of that of the core histones which are not significantly digested until 50-60% of H3 is degraded. H1/H5 and H3 are most exposed, H3 behaves as a "non-core' histone, its destruction appears to be the critical factor in the collapse of the chromatin superstructure during tryptic digestions. The digestion kinetics are explained by proposing that the initial sites of attack are in cavities much larger than the diameter of trypsin (4-5 nm). Procedures for the preparation of soluble polyacrylamide and its conjugation to trypsin are described. PMID- 6862007 TI - 76-kDa poly(A)-protein is involved in the formation of 48 S initiation complexes. AB - In erythropoietic mouse cells induced by Friend leukemia virus, approximately 50% of non-polyribosomal globin mRNA is found in 48 S initiation complexes ready to be translated. EDTA releases 15 S globin mRNPs, homologous to polyribosomal globin mRNPs. The 76-kDa poly(A)-protein is one of its main protein components. The other 50% of non-polyribosomal message can be separated as 20 S 'free' mRNPs. Its protein composition is different, especially the 76-kDa protein is lacking. The role of this protein is discussed. PMID- 6862005 TI - [Molecular structure with potential inhibitory action on the biosynthesis of FAH4]. AB - Molecules formed by two pharmacophoric synthons--4-H2N--C6H4--SO2NH--and 2,4 diaminopyrimidine--were prepared. These structural units, with sulphamidic and antifolic action respectively, are bound without mutual electronic interaction, as demonstrated by their experimental electronic indices. The compounds were tested for activity on several bacterial strains and their biological activity was compared with that of molecular combinations formed by 4 aminobenzensulphonamide and substituted 2,4-diaminopyrimidines, to discover whether these two pharmacophoric synthons, so bound, are synergic. PMID- 6862009 TI - Intranucleosomal localization of the AP endodeoxyribonuclease of rat liver chromatin. PMID- 6862010 TI - Identification of a troponin-I like protein in platelet preparations as histone H2B. AB - A tropomyosin-binding protein (app. Mr 17000) was detected in equine platelet preparations by a gel overlay technique. Its isolation, amino acid and partial sequence analyses have shown it to be histone H2B. As with a similar protein from pig platelet preparations [der Terrossian et al. (1983) FEBS Lett. 152, 202-206], it inhibits Mg2+-dependent actomyosin S1 ATPase. This inhibition is partially reversed in the presence of calmodulin and Ca2+ but is not potentiated, unlike troponin-I, by tropomyosin. This protein, along with the other histones, is almost certainly derived from a low level of contaminating nucleated cells in most platelet preparations. PMID- 6862012 TI - Changes in lipid phase behaviour in human myelin during maturation and aging. Involvement of lipid peroxidation. AB - The biophysical properties of human myelin isolated from white matter of patients aged two months to 74 years were investigated using wide-angle X-ray diffraction. The myelin transition temperature increased from 13 degrees C to 65 degrees C as age increased from two months to 17 years, demonstrating an increase in the myelin lipid stability. Following this maturation period, the myelin transition temperature remained constant at 65 degrees C until age 50. Beyond age 50, the transition temperature of myelin decreased by 13 degrees C indicating that myelin stability decreased with aging. During this aging period, the levels of malondialdehyde and conjugated diene increased, indicating an increasing amount of lipid peroxidation. Although evidence is indirect, the results of this investigation strongly suggest that free radicals could be a primary factor in the acceleration of the aging processes in the human brain. PMID- 6862011 TI - Binding of optically pure (--)-[3H]nicotine to rat brain membranes. AB - With the recent availability of (--)-[3H]nicotine of high specific activity, binding studies were performed on rat brain membranes in the presence of a variety of nicotine analogues and cholinergic drugs. Both a higher affinity (Kd = 2 X 10(-10) M) and a lower affinity (2 X 10(-9) M) site were observed; the stereoselectivity of both sites being similar. A good correlation was observed between IC50-values and psychotropic potency of a series of N'-alkyl substituted nicotine analogues. PMID- 6862013 TI - Effect of cholesterol on phosphate uptake by human red blood cells. PMID- 6862014 TI - Phosphatidylserine decarboxylase is located on the external side of the inner mitochondrial membrane. AB - It is shown that the trypsin-treatment of rat liver mitochondria, depleted of the outer membrane, causes a strong inactivation of phosphatidylserine decarboxylase. This inactivation is dependent on trypsin concentration and the time of digestion in a similar manner as the inactivation of cytochrome oxidase. Under these conditions only a moderate inactivation of succinate dehydrogenase is observed. Phosphatidylserine decarboxylase is thus localized in the outer leaflet of the inner mitochondria membrane or, at least, is accessible from the outer surface of the inner membrane. PMID- 6862016 TI - Inhibition of protein synthesis by the cordycepin analog of (2'-5')ppp(Ap)nA, (2' 5')ppp(3'dAp)n3'dA, in intact mammalian cells. AB - The introduction of the cordycepin analog of (2'-5')An, (2'-5')ppp(3'dAp)n3'dA [referred to as (2'-5')p33'dAn], into mouse L929 cells and cultured human fibroblasts resulted in a dose-dependent inhibition of protein synthesis which was comparable to the inhibition observed by (2'-5')ppp(Ap)nA [referred to as (2' 5')p3An]. The inhibition of protein synthesis by (2'-5')p33'dAn was much more persistent than that of the naturally occurring (2'-5')p3An following prolonged incubation of cells. Furthermore, the (2'-5')p3An was cytotoxic to mammalian cells in culture, whereas the (2'-5')p33'dAn was not. PMID- 6862017 TI - Gossypol binds to a high-affinity binding site on human serum albumin. AB - The triterpene gossypol competes with bilirubin for a high-affinity binding site on human serum albumin. Similar competition between bilirubin and gossypol occurs in the binding of these ligands to the glutathione S-transferases from human liver and placenta. In each case, gossypol and bilirubin exhibit similar binding constants. The binding properties of gossypol may generally mimic those of bilirubin. PMID- 6862018 TI - Antioxidant properties of caeruloplasmin towards iron- and copper-dependent oxygen radical formation. AB - The antioxidant activity of caeruloplasmin can be mainly ascribed to its ferroxidase activity which effectively inhibits ferrous ion-stimulated lipid peroxidation and ferrous ion-dependent formation of hydroxyl radicals in the Fenton reaction. In addition, caeruloplasmin can prevent copper ions from stimulating lipid peroxidation. PMID- 6862015 TI - Presence in many mammalian tissues of an identical major cytosolic substrate (Mr 100 000) for calmodulin-dependent protein kinase. AB - Incubation of cytosol fractions from a variety of mammalian tissues (heart, liver, lung, adrenal, spleen and skeletal muscle) with Ca2+ (0.5 mM) in the presence of gamma-[32P]ATP resulted in the phosphorylation of a prominent substrate of Mr approximately 100 000 (100 kDa). One-dimensional peptide maps and two-dimensional tryptic fingerprints of the phosphoprotein from these sources were identical. A single major phosphopeptide was generated by trypsin and was determined to contain exclusively phosphothreonine. The 100 kDa substrate could be distinguished from glycogen phosphorylase (Mr approximately 97 000) by a number of criteria including phosphopeptide mapping and by its failure to bind either to glycogen or to a specific antiphosphorylase antibody. The Ca2+ dependent protein kinase responsible for phosphorylation of the 100 kDa protein appeared to be a calmodulin (CaM)-requiring enzyme in that it could be inhibited in cytosol extracts by trifluoperazine (IC50 6-16 microM) and that exogenous CaM was necessary for 100 kDa phosphorylation in CaM-depleted cytosol. These results suggest that a rise in intracellular Ca2+ resulting in an activation of CaM dependent protein kinase leads to the phosphorylation of a common 100 kDa substrate in many tissues. PMID- 6862020 TI - Rapid purification of bovine kidney branched-chain 2-oxoacid dehydrogenase complex containing endogenous kinase activity. AB - Branched-chain 2-oxoacid dehydrogenase complex has been purified to near homogeneity by a simple, rapid procedure. The final product contains endogenous kinase activity capable of phosphorylating and inactivating the complex. Phosphorylation continues after complete inactivation, indicating the possibility of several phosphorylatable sites. PMID- 6862019 TI - A rapid stimulation of phosphatidylinositol metabolism in rabbit leukocytes by pseudomonal leukocidin. AB - The time course experiments of 32Pi-labelling and breakdown of phospholipids in rabbit leukocytes exposed to leukocidin from Pseudomonas aeruginosa suggested that the initial action of this toxin was to stimulate phosphatidic acid production, presumably by causing a rapid metabolic change of phosphatidylinositol (PI response) correlating with phosphatidylinositol-specific phospholipase C and 1,2-diacylglycerol kinase. It appears that a rapid formation of phosphatidic acid and degradation of polyphosphoinositides in leukocytes treated with the toxin might be related a Ca2+-movement from extra- and intracellular spaces, resulting in the activation of Ca2+-dependent enzymes involved in the leukocidic process. PMID- 6862021 TI - Multi-site phosphorylation of bovine kidney branched-chain 2-oxoacid dehydrogenase complex. AB - The alpha-subunit of the E1 component of branched-chain 2-oxoacid dehydrogenase is phosphorylated at 3 sites by an endogenous kinase. Inactivation of the complex correlates with rapid phosphorylation of one of these sites. The similarities with the covalent regulation of pyruvate dehydrogenase complex are discussed. PMID- 6862022 TI - Association of tubulinyl-tyrosine carboxypeptidase with microtubules. PMID- 6862023 TI - Two galactose-specific receptors in the liver with different function. AB - In the rat liver both hepatocytes and macrophages have been shown to express on the surface lectins with similar binding specificity for galactose residues. Functionally the two lectins differ in the uptake of ligands. Whereas the hepatocytes ingest molecules and small particles (less than 10 nm), the macrophages take up particles only. Antisera raised against hepatic galactose specific receptor failed to react with the macrophage lectin but blocked ligand binding to the hepatocyte only, indicating either a different antigenic structure or membrane localization of the two lectins. PMID- 6862026 TI - Nuclease digestion patterns as a criterion for nucleosome orientation in the higher order structure of chromatin. AB - Nuclease digestion patterns have been used to discriminate between possible orientations of nucleosomes in the higher order structure of chromatin. Computer simulations were done assuming 3 basically different orientations of nucleosomes which include all proposed models for the '30 nm fibre'. It is found that only alternating exposure of consecutive nucleosomes can explain the DNase I and DNase II digestion patterns. PMID- 6862024 TI - Disappearance of paternal histocompatibility antigens from hybrid mouse blastocyst at the time of implantation. AB - Products of the major histocompatibility complex (H-2) are important in allograph rejection. In view of the close relationship between mother and foetus, we can consider the latter as an allograph which is however not rejected by an immunological reaction. We studied the presence of H-2 antigens on embryo membranes at the time of implantation, by immunochemical labeling using gold particles coupled with protein A. Results showed that the expression of H-2 antigens is different before and after implantation. It seems that after implantation, H-2 antigens disappear from trophoblastic membranes. This could explain the absence of immunological reaction of the mother against the foetus. PMID- 6862025 TI - Isolation and characterization of a 7 S RNP particle from mature Xenopus laevis oocytes. AB - Mature oocytes of Xenopus laevis contain a 7 S RNP particle consisting of two components, ribosomal 5 S RNA and a protein of Mr approximately 45000. The structure of the free 5 S rRNA and the 7 S RNP complex has been studied by diethylpyrocarbonate modification of adenines. A74, A77, A90, A100, A101 and A103 of the 5 S rRNA are protected upon association of the protein. PMID- 6862027 TI - Role of histones H1 and H3 in the maintenance of chromatin in a compact conformation. Study with an immobilized enzyme. AB - Chromatin polynucleosomes have been digested with trypsin immobilized on collagen membranes. This method allows the mild removal of the most accessible histone fragments simply by dipping the enzymatic membrane into the chromatin solution, without modification of its ionic and chemical composition. These results demonstrate that the removal of H1 does not affect the higher-order structure of chromatin and that only the elimination of the terminal regions of H3 leads to the unfolding of H1-depleted fibres. This observation suggests that structural changes reported in many previous works were not due to only the removal of H1 but to a concomitant unbinding from DNA of the N-terminal domain of H3. PMID- 6862028 TI - Further characterization of the bile salt-stimulated lipase in human milk. AB - Bile salt-stimulated lipase is a milk enzyme unique to the higher primates. Its molecular and kinetic characteristics differ greatly from other lipolytic enzymes; e.g., pancreatic lipase and lipoprotein lipase. It has a much higher app. Mr, 310000 on gel filtration and 100000 after denaturation. It requires primary bile salts for optimal activity and bile salts also protect the enzyme from proteolytic and heat inactivation. It may, due to its low substrate specificity, contribute to the utilization of a variety of milk lipids. Since it lacks positional specificity, digestion of milk triglycerides should be complete, which may explain why fat absorption is more efficient in breast-fed than in formula-fed infants. PMID- 6862029 TI - Phosphoenolpyruvate shuttle--transport of energy from mitochondria to cytosol. AB - Brown-adipose tissue mitochondria of hamster and rat contain phosphoenolpyruvate carboxykinase (EC 4.1.1.32). In the presence of ketoglutarate and malate, phosphoenolpyruvate is formed and exported from mitochondria. Phosphoenolpyruvate formation is inhibited by 1,2,3-benzenetricarboxylate. It is proposed that phosphoenolpyruvate carboxykinase together with pyruvate carboxylase and pyruvate kinase forms a phosphoenolpyruvate shuttle through which energy produced by the Krebs cycle in mitochondria may be exported to cytosol. PMID- 6862030 TI - Demonstration of a main immunogenic region on acetylcholine receptors from human muscle using monoclonal antibodies to human receptor. AB - Eleven cloned hybridomas which secrete antibodies to acetylcholine receptors from human muscle have been prepared. All of these monoclonal antibodies to have the same basic specificity as shown by competition for binding to the main immunogenic region on the receptor, but these antibodies differ in fine specificity as shown by reaction with denatured receptor subunits and interspecies cross-reaction. PMID- 6862031 TI - Hydrocortisone inhibition of ascorbic acid transport by chromaffin cells. AB - Adrenal chromaffin cells have been found to accumulate ascorbic acid by a saturable high affinity mechanism that is inhibited by hydrocortisone. The rate of ascorbic acid transport into cells was linear for at least 1 h and had a Km of 103 microM, a value approaching the reported concentration of ascorbic acid in the adrenal vein during stress. The uptake process itself, representing net accumulation rather than exchange, was inhibited by 0 degrees C, lack of sodium, ouabain, and by dinitrophenol and iodoacetate. Hydrocortisone but not the inactive analogue hydrocortisone hemisuccinate was found to inhibit ascorbic acid uptake in a reversible manner, with an ID50 of 62 microM. This value was within the reported steroid concentration in the adrenal portal system during a significant stress. Both ascorbic acid and hydrocortisone are secreted from cortical cells during stress into the adrenal portal system and thus contact medullary chromaffin cells. We suggest that the control of ascorbic acid uptake by hydrocortisone indicates the existence of a heretofore unanticipated biochemical aspect of the adrenal stress response. PMID- 6862034 TI - Effects of dietary factors on skeletal integrity in adults: calcium, phosphorus, vitamin D, and protein. PMID- 6862033 TI - Subunit heterogeneity in the structure and dynamics of hemoglobin. A transient Raman study. PMID- 6862032 TI - Reserpine labels the catecholamine transporter in synaptic vesicles from bovine caudate nucleus. AB - Tritiated reserpine binds to synaptic vesicles from bovine caudate with high affinity (Kappd = 1.25 nM, Bmax = 3.3 pmol/mg protein). This interaction is both ATP-dependent and sensitive to the protonophores CCCP and nigericin, suggesting that a proton electrochemical gradient is required for binding. Dopamine, epinephrine, norepinephrine and serotonin all inhibit reserpine binding at concentrations similar to those required for inhibition of dopamine uptake. Treatment with saponin to release vesicle contents results in complete loss of accumulated dopamine but retention of bound reserpine. These results indicate that reserpine binds to the catecholamine transport system of synaptic vesicles with high affinity and specificity. PMID- 6862036 TI - Angiotensinogen. AB - Human angiotensinogen has been purified from outdated blood bank plasma. The purified angiotensinogen has a specific angiotensin I (Ang I) content of 20.7 micrograms Ang I/mg protein and contains only one amino-terminal amino acid, aspartic acid. However, it exhibits two bands on sodium dodecyl sulfate polyacrylamide gel electrophoresis with apparent molecular weights of 61,400 and 65,400. It is concluded that these bands represent different forms of angiotensinogen because the specific Ang I content is equivalent to the theoretical Ang I content. Analysis of the purified angiotensinogen showed it to contain 14% carbohydrate. PMID- 6862035 TI - Blood pressure and left ventricular dysfunction in the spontaneously hypertensive rat. AB - The important role of the heart in the manifestation of systemic hypertension often becomes apparent with the development of left ventricular dysfunction. After a prolonged course of stable compensated left ventricular hypertrophy, spontaneously hypertensive rats (SHR) developed left ventricular dysfunction. A phase of overt left ventricular dysfunction and dilatation was present at an advanced age (24 months) in female SHR, a phase during which systemic hypertension was no longer manifest despite the maintenance of an increased vascular resistance. Similarly, when left ventricular dysfunction was induced after the experimental production of a myocardial infarction, the systemic arterial pressure levels of young SHR fell. This reduction in blood pressure was directly related to the extent of the histologic damage to the left ventricle. These studies underscore the important permissive role of the heart in the expression and maintenance of systemic hypertension. PMID- 6862038 TI - Tissue sources of protein kinase activities in human seminal fluid: studies of normal, oligozoospermic, and vasectomized men. AB - Protein kinase activities in seminal fluids of normo-, hypo-, and oligozoospermic and vasectomized men were measured using lysine-rich histones and partially dephosphorylated phosvitin as acceptor substrates. There was a significant relationship of histone kinase but not phosvitin kinase activities with the number of spermatozoa originally present in the semen. Histone kinase and phosvitin kinase activities were diminished 88% and 62%, respectively, in vasectomy seminal fluid. The sex accessory gland sources of seminal fluid protein kinase activities not associated with spermatozoa were examined in split ejaculates of vasectomized men. Histone kinase activity was greater in the first fractions, suggesting that the prostate is its predominant contributor; whereas the distribution of phosvitin kinase activity did not indicate any preferential accessory gland source of this enzyme. PMID- 6862037 TI - Effect of testosterone enanthate on hematopoiesis in normal men. AB - Testosterone enanthate, a commonly used depot form of androgen, was administered to normal men according to several dose schedules. This resulted in significant increments in serum testosterone levels despite the fact that testosterone concentrations remained within the normal population range in almost all instances. Mild but significant increases in white blood cell, red blood cell, hematocrit, and hemoglobin concentrations were noted. These effects correlated with the dose frequency schedules. Negligible changes in mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration were observed. Despite the significant individual increases in blood parameters, all values remained within the normal population range and no clinical manifestations were observed. PMID- 6862039 TI - Rabbit oviduct microvascular architecture after tubal ligation. PMID- 6862040 TI - Correlation of human in vitro fertilization with the hamster egg bioassay. AB - We compared fertility potential measurements by the zona-free hamster egg bioassay with the in vitro fertilization of human eggs. Sperm from 24 husbands participating in an in vitro fertilization-embryo transfer program were used in 27 inseminations of the wives' eggs and in simultaneous inseminations of hamster eggs. In seven cases, a positive fertility assessment was obtained in the absence of fertilization of the wives' eggs attributable to egg immaturity or in one case to equipment failure. In the remaining 20 cases, at least one egg was fertilized, for a level of 73%. In 90% of the husbands who fertilized their wives' eggs, a positive fertility assessment was obtained. Two husbands gave false-negative assessments. To account for these, alternative culture conditions were examined; sperm exposure to longer preincubations or at higher concentrations usually improved assessments. These results indicate that fertility assessment with this bioassay is highly correlated with the fertilization of human eggs in vitro. PMID- 6862041 TI - The diagnostic value of plasma free testosterone in non-tumorous and tumorous hyperandrogenism. AB - The clinical significance of total and free testosterone (T) estimates for the diagnostic approach to hirsute patients was assessed. Plasma T was measured by radioimmunoassay and its non-protein-bound fraction was determined by equilibrium dialysis, thus facilitating the calculation of apparent free T (AFT). The cases of 162 subjects were investigated; the subjects included 75 women in whom glandular androgen release had been defined by selective catheterization. A positive linear correlation was observed between both parameters over a wide range of concentrations (T, 153 to 10,700 pg/ml; AFT, 0.8 to 342 pg/ml; P less than 0.001). Significant differences of mean T and AFT levels were found between healthy control subjects (n = 8) and subjects with non-tumorous hyperandrogenism (n = 60; P less than 0.005). Individual values overlapped considerably; elevated T (greater than 640 pg/ml; 48%) or AFT (greater than 7.2 pg/ml; 52%) were present in only half the hirsute women. However, the upper 95% confidence limits of normal for both indices were exceeded in all patients with androgen-secreting ovarian tumors (n = 7). It is concluded that the indirect estimation of AFT in addition to T is time-consuming, costly, without practical value in selecting the proper treatment, and therefore not mandatory in the routine evaluation of androgenized women. PMID- 6862042 TI - Heritable aspects of uterine anomalies. I. Three familial aggregates with Mullerian fusion anomalies. AB - Familial aggregates of incomplete Mullerian fusion have been reported, but the role of genetic factors has not been elucidated. In the last several years, we have fortuitously encountered three families in which several members were affected with Mullerian fusion anomalies. In two families, several members had incomplete Mullerian fusion as traditionally described. In the third family, several members had the hand-foot-genital syndrome, a rare autosomal dominant disorder characterized not only by Mullerian fusion defects but also by skeletal (hand and foot) malformations. The etiologic heterogeneity of Mullerian fusion defects is considered. PMID- 6862043 TI - Heritable aspects of uterine anomalies. II. Genetic analysis of Mullerian aplasia. AB - The genetics of Mullerian aplasia (absent fallopian tubes, absent or rudimentary uterine corpus and cervix, absent upper vagina) has never been investigated systematically. Some investigators believe the disorder is inherited in female limited autosomal dominant fashion, males transmitting the mutant gene but, of course, not manifesting the trait. To investigate this possibility, we obtained pedigrees in 23 probands with Mullerian aplasia. None had an affected relative. The absence of affected individuals among 30 postpubertal sisters, 31 paternal aunts, and 40 maternal aunts makes it unlikely that a sex-limited autosomal dominant gene is a common cause of Mullerian aplasia in our population. Dominant genes might exist in other populations, and fresh dominant mutations cannot be excluded. However, polygenic/multifactorial inheritance is perhaps more plausible. PMID- 6862044 TI - Comparison of Doppler examination and retrograde spermatic venography in the diagnosis of varicocele. AB - The accuracy of the Doppler stethoscope is compared with that of retrograde spermatic venography in the diagnosis of varicocele in 39 subfertile men. In the 38 cases in which left-sided venography was successful, there was a good correlation between the radiographic and Doppler results in 33 cases (87%). The five failures were all false-negative results in patients without clinically diagnosed varicoceles. In the 33 cases in which right-sided venography was successful, there was a good correlation between the radiographic and Doppler results in 17 patients (52%). This low sensitivity on the right side appears to be a minor drawback, because right-sided reflux almost always occurs in conjunction with left-sided reflux, and therefore varicocele would be diagnosed in these patients despite the false-negative Doppler finding. Unlike venography, the Doppler study is noninvasive, inexpensive, and easy to perform. We conclude that it should be part of all studies of varicocele and infertility and that it may prove sufficiently accurate for use in controlled studies of the effectiveness of varicocelectomy and the role of subclinical varicocele in the pathogenesis of infertility. PMID- 6862046 TI - A model of stepwise evolution of higher eucaryotes. PMID- 6862045 TI - The use of Ti-plasmids as plant-directed gene vectors. PMID- 6862047 TI - The lethal recessive mutations of the mouse. Their origin, their nature and their use in developmental genetics. PMID- 6862048 TI - Stress as a factor of genetic variation and the problem of destabilizing selection. PMID- 6862049 TI - Alloreactive cytotoxic anti-H-2 antibodies in sera of the syngeneically immunized C57BL/10ScSnPh, BALB/cJPh, and B10.A/SnPh mice. AB - Mice of the inbred strains B10.A (H-2a), B10 (H-2b), and BALB/c (H-2d) were immunized with the syngeneic cells, and the sera obtained from individual animals on day 10 after the 8th immunizing injection were assayed for the presence of alloreactive cytotoxic antibodies. Anti-H-2Kk antibodies were present in the sera from 50% of the syngeneically immunized BALB/c mice. The syngeneic-immune B10 sera contained weak anti-H-2Dd antibodies in 14% of the immunized animals. B10.A mice produced no antibodies after syngeneic immunization. PMID- 6862051 TI - [Familial idiopathic hypoparathyroidism associated with progressive sensorineural deafness(1)]. AB - A 29-year-old man came to our hospital with tetany and sensorineural deafness. Routine laboratory testing revealed a serum calcium of 5.5 mg/dl and a serum phosphate of 6.1 mg/dl. The level of circulating immunoreactive parathyroid hormone was undetectable, and he showed hyperresponsiveness to the exogenous parathyroid hormone (synthetic hPTH (1-34), 100U). Thus, he was diagnosed as having idiopathic hypoparathyroidism. The other endocrine functions were normal. The parathyroid antibody was negative and no moniliasis was found. On the examination of his family, it was found that his male sibling and one of his female siblings also had hypocalcemia (6.4 mg/dl and 6.0 mg/dl) and undetectable levels of circulating immunoreactive parathyroid hormone, and all his siblings, his father and one of his nieces had sensorineural deafness, so he was diagnosed as as having familial idiopathic hypoparathyroidism and familial progressive sensorineural deafness. In addition to this case, we have experienced two siblings of another family having the same combination of these disorders (unpublished observation). Since familial idiopathic hypoparathyroidism is not common, it seems that the present combination of these disorders is not a chance association. PMID- 6862052 TI - [Normalization of exaggerated glucagon secretion in response to arginine loading in diabetic patients--application of an artificial endocrine pancreas]. PMID- 6862053 TI - [The development of a counterregulatory system for an artificial endocrine pancreas--invention of glucose and glucagon infusion algorithms]. PMID- 6862050 TI - [Thyroid antibodies and serum thyrotropin in a specific population group]. PMID- 6862054 TI - Asymptomatic hematuria and proteinuria in children. PMID- 6862055 TI - Heterotopic pregnancy: a case report. PMID- 6862056 TI - The confidentiality of occupational medical data. PMID- 6862059 TI - An analysis of variations in U.S. fertility and female labor force participation trends. AB - This study is based on time series data from 1947-1977 on fertility and female labor force participation, and examines (a) the effects of male relative income and female earnings on the level and timing of fertility and female labor force participation, and (b) the relative importance of variations in relative income and female wage rates in explaining the fluctuations in both fertility and female labor supply. The results suggest that relative income exerts a significant positive effect on fertility and a negative effect on female work effort. However, female wage rates appear to be the dominant factor in explaining variations in fertility and female labor force participation over the past two decades, with increases in female earnings leading to both depressed fertility and increased labor force participation of women. PMID- 6862058 TI - Interrelationships between fertility and marital dissolution: results of a simultaneous logit model. AB - Previous studies have failed to examine (a) the simultaneity of decisions to bear children and to dissolve a marriage and (b) the effects of the childbearing in the period just before dissolution on the likelihood of disruption. We attempted to resolve both problems by developing a simultaneous logit model of the interrelationship between the probability of separation and of having a birth during this period (when dissolution presumably is being considered). The model was estimated at successive durations of first marriage, using data for white women in the 1970 National Fertility Survey. The results indicate that childbearing patterns--number of children and age of youngest child at the beginning of the marital interval being studied and fertility during the interval -did not influence the likelihood of separation in simple or consistent ways over the marital life course, nor did marital strife (as indicated by separation) seem to affect childbearing throughout marriage. PMID- 6862057 TI - Do couples make fertility plans one birth at a time? AB - Criteria are specified for distinguishing one-decision from sequential-decision models of fertility. Sequential decisions are not demonstrated by parity-specific differences in fertility determinants. Sequential models must demonstrate the importance of unanticipated intervening events in changing fertility plans or fertility experience. They must demonstrate that the intervening events are not caused by the fertility. Two empirical tests are designed to determine which model best fits the data. One test predicts fertility plans, the other fertility events. Both tests provide some support for sequential models. PMID- 6862061 TI - Sex differences in life cycle measures of widowhood. AB - Using formulas which measure life cycle characteristics of widowhood as a function of life table survivorship and age at marriage, we illustrate changes in patterns of widowhood and widowerhood since 1950, as well as differences by race, by age of bride and of groom, and by age differences between spouses. Although the current inequality in the risks of widowhood and widowerhood for the average couple is mostly due to sex differences in mortality, a one year age difference between spouses has about the same impact as does a one year difference in life expectancy. Calculations based on current distributions of age of groom by age of bride indicate that the older the age of groom, the greater the age difference between spouses and the higher the likelihood of a woman outliving her husband: the typical groom who marries in his fifties faces a 4 to 1 chance that he will be outlived by his spouse. PMID- 6862060 TI - Industrial shifts, female employment, and occupational differentiation: a dynamic model for American cities, 1960-1970. AB - Sex-linked occupational differentiation has been seen as influenced by both the industrial structure of the economy and the sex composition of the labor force. Here, with a sample of 70 SMSAs, it was found (a) that the odds of men relative to women of joining professional and managerial occupations increased between 1960 and 1970, and (b) that this increase was dependent on the growth of tertiary industries and the greater number of women joining the cash economy. The observed effect of industrial shifts on sex-occupational differentiation, however, is argued to be a spurious consequence of the gender-composition of the work force. Specifically, the development of tertiary industries generates greater demand for female labor. Intensive recruitment of women to the labor force in turn increases occupational differentiation because females, in sex-typed labor markets, are likely to be channeled in disproportionate numbers away from upper-status occupations. The findings demonstrate that traditional modernization theory is unable to account for this. However, the results lend support to expectations derived from a labor market sex-segmentation approach. PMID- 6862062 TI - An integrated system for demographic estimation from two age distributions. AB - This paper presents a simple method for estimating a birth rate and a level of mortality for an intercensal period. The birth rate is estimated from the intercept of a line fitted to data and the level of mortality from the slope of that line. The formula that is developed is based upon a recent generalization of stable population relations. An estimate of childhood mortality level is an optional but significant piece of additional input. An important by-product of the procedure is an estimate of the true age distribution. PMID- 6862063 TI - A simple model for linking life tables by survival-mortality ratios. AB - Patterns of variation in mortality can be studied by measuring changes in selected life table functions. A model is proposed in which the rate of change over time in the life table survivorship probability at any age has been assumed as proportional to the product of its own value and its complementary probability or the probability of dying by that age, where the proportion is the same for all ages and depends only on the time duration between successive life tables. The end result is that the logit functions of the survivorship probabilities at two points in time are linearly related with a slope of one. The projecting power of the model has been tested by using U.S. life tables for the years 1950 and 1970 as well as Coale and Demeny's regional model life tables. In the latter case, the model produced surprisingly close matches even when the expectations of life differed by as much as 20 years. PMID- 6862064 TI - Improving the accuracy of migration age detail in multiple-area population forecasts. AB - Population projections are often required for many geographical areas, and must be prepared with maximal computer and minimal analytical effort. At the same time, realistic age detail forecasts require a flexible means of treating age specific net migration. This report presents a migration projection technique compatible with these constraints. A simplified version of Pittenger's model is used, where future migration patterns are automatically assigned from characteristics of historical patterns. A comparative test of age pattern accuracy for 1970-1980 indicates that this technique is superior to the commonly used plus-minus adjustment to historical rates. PMID- 6862065 TI - [Urticaria pigmentosa, multiple basilomas of the skin of the torso and ultraviolet irradiation. A case report]. PMID- 6862066 TI - [Suppression of the Jarisch-Herxheimer reaction by prednisolone]. PMID- 6862067 TI - [The modification of skin surface film by tensides. 1: Defatting as a function of concentration and constitution]. PMID- 6862069 TI - [Malignant melanoma of the skin]. PMID- 6862068 TI - [The modification of skin surface film by tensides. 2: Skin impedance changes as a function of concentration and constitution]. PMID- 6862071 TI - Maternal prolactin, cortisol, growth hormone and noradrenalin profiles during labor and following delivery. AB - Maternal prolactin, cortisol, growth hormone and noradrenalin levels were measured immediately before induced labor, during the expulsion stage and 60-90 min following delivery in 10 normal subjects between 38 and 41 wk of gestation. A significant reduction in prolactin levels was accompanied by a marked rise in cortisol and noradrenalin levels, indicating a paradoxical suppression of prolactin due to stress of labor. Growth hormone levels declined both during labor and following delivery, presumably as a result of anti-insulin actions of cortisol and noradrenalin. PMID- 6862072 TI - The significance of indirect electrocardiography in fetal cardiac arrhythmias. AB - A unique case in which a tentative diagnosis of congenital heart disease was made by fetal ECG is presented. A new averaging technique allowed an accurate analysis of the QRS complexes obtained from the maternal surface. This is the first case of fetal arrhythmias in which an early prenatal diagnosis of an anatomical lesion of the heart was suspected by reason of an abnormal fetal ECG and confirmed clinically at birth. PMID- 6862070 TI - L/S ratio, biochemical and clinical changes after ritodrine intravenous infusion. AB - The effects of ritodrine hydrochloride on the L/S ratio, the clinical and biochemical status of the mother, and the amniotic fluid were studied in a total of 46 women between the 28th and 35th wk of their pregnancy. An increase in the L/S ratio and creatinine levels in the amniotic fluid, significant changes in the maternal serum levels of potassium, sodium, alpha 1-antitrypsin and glucose were found, whereas the urea levels remained unchanged. Maternal hyperglycemia and hypokalemia in both maternal serum and amniotic fluid, were more pronounced when the ritodrine was infused in 5% dextrose. The findings from monitoring the cardiovascular systems of both mother and fetus, agreed with previous reports. It was concluded that ritodrine hydrochloride has a positive effect on the fetal lung maturation, probably by accelerating the release of surfactant. Its administration, however, should be under laboratory control. PMID- 6862074 TI - Classic illustration: neonatal respiratory distress syndrome. PMID- 6862073 TI - Dysgerminoma of the ovary in association with XY gonadal dysgenesis. AB - A case is reported of an adolescent presenting with primary amenorrhea. On pelvic examination a large unilateral ovarian tumor was palpated. Microscopic examination of the tumor removed at laparotomy revealed a pure dysgerminoma. Further gynecological-endocrinological investigations and chromosome analysis showed an XY gonadal dysgenesis. A review of current approaches to diagnosis, prognosis and especially to the controversial therapeutic modalities is presented. PMID- 6862075 TI - S-100 protein in adipose tissue. AB - 1. The nervous system-specific S-100 protein is present at high levels in adipose tissues of various animal species. 2. The adipose S-100 protein levels in beef and rat were 1.13 and 1.59 micrograms/mg protein, respectively, which were comparable to the brain levels (beef, 4.85 micrograms/mg; rat, 1.98 micrograms/mg). 3. Adipose tissues of rabbit, pig and human contained 0.222, 0.149 and 0.083 micrograms S-100 protein/mg, respectively. 4. The S-100 protein level in rat adipose tissue showed a developmental profile similar to that in the brain. PMID- 6862076 TI - Acylation of lysoglycerophospholipids by adrenal membranes. AB - 1. Substantial differences were found in the acyl donor and lyso-acceptor specificities among subcellular membranes and with respect to different regions of the adrenal gland. 2. In the presence of Mg2+-ATP and CoASH, adrenal microsomes were actively transferring arachidonate to lysophospholipids with acyl acceptor specificity in the order: 1-acyl-GPI greater than 1-acyl-GPC greater than 1-acyl-GP. However, when oleoyl-CoA was used, acyl acceptor specificity for the microsomal transferases was in the order: 1-acyl-GPC greater than 1-acyl-GP greater than 1-acyl-GPI. 3. Mitochondrial membranes had very low acyl transfer activity and they preferred 1-acyl-GPC over other lyso-acceptors. 4. The chromaffin granules were apparently lacking this type of activity. PMID- 6862077 TI - Labelled lipids distribution following [3H]glycerol injection to pregnant rabbits. AB - 1. The time dependent variation in specific activity of serum triglycerides and phospholipids has been studied following an intravenous pulse-labelling with 2 [3H]glycerol to pregnant rabbits. 2. The specific activity of triglycerides varied according to the gestation time and the maximal values of specific activity shifted to shorter times when gestation progressed to term. 3. The specific activity of serum phospholipids was higher in pregnant animals and increased with gestation time. 4. Concentrations and specific activities of both triglycerides and phospholipids were investigated in serum of pregnant and fetal rabbits at term. Concentrations of both lipid classes were notably higher in the fetal blood than in the maternal one. 5. The results were discussed on the basis of changes in hepatic biosynthesis of phosphatidic acid. Also, it was suggested a high drainage of either lipids or their degradation products by the feto placental unit at the end of pregnancy. 6. Levels and specific activities of maternal and fetal lipids from liver and lung were also examined. The different metabolic roles of the main tissues involved in triglyceride and phospholipid metabolism were discussed. PMID- 6862079 TI - Kinetic analysis of rat liver sorbitol dehydrogenase. AB - 1. A steady state kinetic investigation was performed on an improved preparation of rat-liver sorbitol dehydrogenase (L-iditol: NAD-oxidoreductase, EC 1.1.1.14). 2. Data analyses indicate the enzyme follows a rapid equilibrium random mechanism in the direction of sorbitol oxidation and a random mechanism in the direction of fructose reduction. 3. Kinetic constants were: K m NAD 0.082 mM; K m sorbitol 0.38 mM; K m NADH 67 microns; K m fructose 136 mM. 4. Evidence is adduced to indicate the more rapid reverse (fructose reduction) reaction is susceptible to metabolic control by formation of abortive enzyme fructose-NAD and enzyme-NADH sorbitol complexes. PMID- 6862078 TI - 5-methylcytosine content in different organs of the mouse and rat, several tumors and in mice embryos. AB - 1. The content of 5-methylcytosine of the DNA of 11-day old mice embryos was compared with that of the DNA of different plasmocytoms. 2. Furthermore the DNA content was determined in different transplantable tumors and normal organs of the rat and the mouse. 3. By the aid of liquid chromatography significant differences could be demonstrated in the content of 5-methylcytosine of the DNA of BALB/c-mice or NMRI-mice and the DNA of the plasmocytom MOPC 104 E and MOPC 141, but not in the case of MOPC 321. 4. Clear differences could be observed with restriction enzymes: the DNA of all the plasmocytoms studied is more digested with Hpa II and Hha I than the DNA of the embryos. This is not the case however with MSP I. 5. The DNA of three transplantable tumors tested contains less 5 methylcytosine than the one of the liver kidney of the mouse and the rat. This was confirmed with restriction enzymes too. PMID- 6862080 TI - Spectroscopic investigations on the interaction of the anthracycline antibiotic violamycin BI with deoxyribonucleic acid. PMID- 6862081 TI - Kinetic evidence for two active sites in beta-D-fucosidase of Helicella ericetorum. AB - 1. The kinetics of beta-D-fucosidase of the snail H. ericetorum have been studied. The enzyme shows beta-D-fucosidase, beta-D-glucosidase and beta-D galactosidase activities, all associated in a single peak in both DEAE-cellulose chromatography and isoelectric focusing (p1 4.35), having the same optimal pH (5.0). 2. With the corresponding p-nitrophenyl glycosides as substrates, beta-D fucosidase activity shows the lowest Km, the highest Vmax and the best Vmax/Km value; close activity values were obtained for beta-D-glucosidase, however, beta D-galactosidase activity is much lower in this enzyme. 3. All the kinetic evidence suggests that this enzyme has two active sites: a fuco-gluco site and a galacto site. 4. beta-D-fucosidase and beta-D-glucosidase activities have similar Km, Vmax, Vmax/Km and Ki values; these values are very different from those of beta-D-galactosidase activity. beta-D-fucosides and beta-D-glucosides completely compete for a common active site in mixed-substrate experiments, while beta-D galactosides only partially compete with both glycosides. 5. With delta-D gluconolactone, the enzyme shows a hyperbolic mixed-type inhibition, mainly competitive for beta-D-fucosidase and beta-D-glucosidase activities (with the same inhibition sub-type), and predominantly non-competitive for beta-D galactosidase activity (with different inhibition sub-type). With delta-D gluconolactone more inhibition of beta-D-fucosidase and beta-D-glucosidase activities was found, and with gamma-D-galactonolactone, more inhibition of beta D-galactosidase activity was detected. 6. The enzyme is activated by some carbohydrates, probably in relation with a transglycosylation mechanism. PMID- 6862082 TI - An approach to the elucidation of the quaternary structure role in the activity of pyruvate kinase studies on the immobilized enzyme. AB - 1. Studies on pyruvate kinase immobilized via -S-S- linkages showed that single subunits of this tetrameric enzyme are inactive. 2. Pyruvate kinase was coupled with different preparations of CNBr-activated Sepharose via one and more than one bond, and after removal of non-covalently bound subunits by denaturant treatment the subunit derivatives were obtained composed of different pyruvate kinase species. 3. Heat inactivation studies of immobilized enzyme derivatives suggested that not only tetramers of pyruvate kinase are active. 4. This idea is further supported by experiments with 2 M urea dissociation of immobilized tetrameric enzyme carried out in the presence of Mg2+ ions. PMID- 6862083 TI - Separation and properties of a "neutral" hexosaminidase from embryonic chicken brain. AB - 1. A "neutral" hexosaminidase has been separated from other hexosaminidase forms (I and II) by DEAE-cellulose chromatography and characterized in embryonic (16 days old) and 1-day old chicken brains. 2. Its properties differ from those of the forms I and II. It has optimum activity at about pH 6.0 and can be eluted from DEAE-cellulose with 0.25 M KCl only. 3. It has no N-acetylgalactosaminidase activity and cannot be successfully detected after isoelectric focusing since it is very acidic and completely unstable below pH 5.0. 4. "Neutral" hexosaminidase is heat-stable at pH 6.0 and is inhibited by chloride. 5. These properties, very different from those of forms I and II, suggest that this "neutral" form of hexosaminidase would be very similar to known hexosaminidase C separated from other materials. 6. We have found no significant differences for the above mentioned three forms in chick embryos (16-days old) in comparison with those from 1-day old chicken. PMID- 6862084 TI - Characterization of two thiol-dependent aminopeptidases partially purified from human placenta. AB - 1. Two thiol-dependent aminopeptidases (I and III) were partially purified from the soluble fraction of human placenta. 2. Aminopeptidase I preferred L-alanine beta-naphthylamide (AlaNA) as substrate at pH 7.0-7.5. It was sensitive to heat and some divalent metal ions (Co2+, Ni2+, Zn2+) but resistant to EDTA, and some amino acids. 3. Aminopeptidase III hydrolysed equally well AlaNA and ArgNA at pH 6.5-7.0. It was markedly suppressed by EDTA and reactivated by Co2+. It was inhibited by heat, some amino acids, benzamadine and puromycin. PMID- 6862085 TI - Unfolding processes of small globular proteins: the two-state vs multi-state model. AB - 1. The alcohol-induced unfolding of two homologous proteins, neurotoxin and cardiotoxin from Taiwan cobra (Naja naja atra) venom has been analysed. 2. It is postulated that the unfolding process for both proteins is a multi-state conformational transition. 3. It has been hypothesized that between the compact native state of the protein and its fully unfolded state there exists a quasi continuous spectrum of conformational metastates of protein species. 4. The population distribution of these metastates is partially dependent on the nature of unfolding factors as well as the amino acid composition and sequence. 5. The sum of all transient conformational states and the protein species being in the folded and unfolded states respectively, can be detected by means of circular dichroism spectroscopy since the absorption of circularly polarized light is rapid relative to the rate of fluctuations of the protein structure. PMID- 6862086 TI - Effect of heparin on the porcine lymphocyte chromatin--II. Comparative study of sedimentation of chromatin DNA and isolated DNA. AB - 1. Sedimentation of chromatin DNA and isolated deproteinized DNA was compared in neutral and alkaline sucrose density gradients after incubation of chromatin or DNA with various concentrations of heparin. 2. Irrespective of the molecular weight of DNA, an increase in the sedimentation constant of DNA was found with increasing concentration of the polyanion employed. PMID- 6862087 TI - Kinetics of rat brain soluble catechol-O-methyltransferase and its inhibition by substrate analogues. AB - 1. The initial rates and inhibition of rat brain catechol-O-methyltransferase were studied. Double reciprocal plots of initial rates versus either S-adenosyl-L methionine or 3,4-dihydroxybenzoic acid, in the absence of product, gave a series of lines intersecting to the left of the ordinate. 2. Inhibition in the presence of S-adenosyl-L-homocysteine was competitive but in the presence of vanillic acid was non-competitive if S-adenosyl-L-methionine was the varied substrate. 3. When 3,4-dihydroxybenzoic acid was the varied substrate, both S-adenosyl-L homocysteine and vanillic acid gave rise to a non-competitive inhibition. 4. The initial rate and product inhibition patterns were consistent with an ordered BiBi mechanism with S-adenosyl-L-methionine being the first substrate and 3,4 dihydroxybenzoic acid the second substrate to combine with the enzyme. 5. In addition, these results suggest that vanillic acid is the first product and S adenosyl-L-homocysteine the second product to dissociate from the enzyme. 6. The substrate analogues salsolinol and 3-carboxysalsolinol were competitive inhibitors with respect to 3,4-dihydroxybenzoic acid but were non-competitive with respect to S-adenosyl-L-methionine. For enzymes with an ordered mechanism an uncompetitive inhibition would be expected. 7. A possible explanation is that both substrate analogues can combine with either free enzyme with lower affinity or with an intermediary enzyme form with much greater affinity. 8. A scheme which is consistent with the data is presented. PMID- 6862088 TI - Zinc binding to tubulin. AB - 1. Zinc binding to tubulin was studied by incubating microtubules with 65Zn and measuring the 65Zn retained with tubulin on DEAE Sephadex. 2. Data showed two classes of binding site, one of very low affinity and a second class binding 0.86 g-atoms Zn/mol tubulin with a dissociation constant of approx. 110 microM. 3. Binding of zinc to the higher affinity site was 50% inhibited by 2 mM N-ethyl maleimide. PMID- 6862089 TI - Aging of the erythrocyte--XVII. Changes in the properties of superoxide dismutase. AB - 1. An increase in the sensitivity of superoxide dismutase (SOD) to the action of diethyldithio-carbamate and cyanide was observed in red cell fractions of greater age. 2. It suggests that SOD inactivation during erythrocyte aging is not an "all or none" process but involves transition(s) between enzyme forms of different properties. 3. An increase in the ratio of less mobile to the more mobile SOD bands was observed by polyacrylamide-gel-electrophoresis in older erythrocytes. PMID- 6862090 TI - Effect of prepartum blockade of microtubule formation on milk production and biochemical differentiation of the mammary epithelium in holstein heifers. AB - 1. Prepartum intramammary infusions of colchicine markedly reduced subsequent milk production compared with untreated mammary glands in the same animal. 2. After the first week postpartum, milk composition was similar in control and treated mammary glands. 3. Rates of fatty acid synthesis, CO2 production and protein synthesis at either 5 or 21 days postpartum were lower in mammary tissue slices taken from mammary glands treated prepartum with colchicine. 4. We conclude that an intact microtubule system is necessary for initiation of milk synthesis and secretion at parturition. PMID- 6862091 TI - Effect of prepartum blockade of microtubule formation on ultrastructural differentiation on the mammary epithelium in holstein heifers. AB - 1. Prepartum infusion of colchicine into mammary quarters of heifers inhibited normal development of bovine mammary secretory tissue. 2. In comparison with control, tissue from colchicine-infused quarters exhibited 22.6% less alveolar luminal area and 17.1% more interalveolar connective tissue area indicating a reduction in secretory activity. 3. Cytological analysis demonstrated that undifferentiated cells predominated in treated quarters whereas the majority of cells in control quarters were fully differentiated. 4. Although control quarters reached normal histological development by the third week postpartum, tissue from colchicine-infused quarters remained relatively immature. 5. Results suggest that (1) an intact microtubule system is necessary during the prepartum period if the mammary gland is to respond normally to lactogenic stimuli and (2) transient disruption of microtubule integrity during the prepartum period irreversibly suppresses differentiation of mammary epithelia during the subsequent lactation. PMID- 6862093 TI - Intranuclear localization of DNA polymerases alpha and beta in regenerating rat liver. AB - 1. Nuclei isolated from regenerating rat liver were digested with micrococcal nuclease and fractionated on glycerol gradients into soluble chromatin fragments and chromatin associated with the nuclear skeleton. 2. Distributions of DNA polymerases alpha and beta in these fractions were different. While beta polymerase followed closely the distribution of the chromatin fragments, alpha polymerase associated preferentially with the skeleton-chromatin complex. 3. At least 20% of total alpha polymerase in the nuclei was shown to be bound to the skeleton. In nuclei extracted with isotonic sucrose buffer containing 50 or 100 mM Tris-Cl the portion of the skeleton associated enzyme was increased to 40-50%. 4. These data show that the skeleton bound alpha polymerase was preferentially retained in the nuclei during salt extraction. 5. Contrary to the replicational DNA polymerase alpha, DNA polymerase beta did not show any affinity to the skeleton. PMID- 6862092 TI - Non-oxidative synthesis of pentose 5-phosphate from hexose 6-phosphate and triose phosphate by the L-type pentose pathway. AB - 1. Ribose 5-phosphate was non-oxidatively synthesized from glucose 6-phosphate and triose phosphate by an enzyme extract prepared from rat liver (RLEP). Analysis of the intermediates by GLC, ion-exchange chromatography and specific enzymatic analysis, revealed the presence of the following intermediates of the L type pentose pathway: altro-heptulose 1,7-bisphosphate, arabinose 5-phosphate and D-glycero D-ido octulose 8-phosphate. 2. With either [1-14C] or [2-14C]glucose 6 phosphate as diagnostic substrates, the distribution of 14C in ribose 5-phosphate was determined. At early time intervals (0.5-8 hr), [1-14C]glucose 6-phosphate introduced 14C into C-1, C-3 and C-5 of ribose 5-phosphate, at 17 hr 14C was confined to C-1. With [2-14C]glucose 6-phosphate as substrate, 14C was confined to C-2, C-3 and C-5 of ribose 5-phosphate during early times (0.5-8 hr), while at 17 hr 14C was located in C-2. 3. The transketolase exchange reaction, [14C]ribose 5-phosphate + altro-heptulose 7-phosphate in equilibrium ribose 5-phosphate + [14C]altro-heptulose 7-phosphate, was demonstrated for the first time using purified transketolase, its activity was measured and it is proposed to play a major role in the relocation of 14C into C-3 and C-5 or ribose 5-phosphate during the prediction labelling experiments. 4. The coupled transketolase-transaldolase reactions, 2 fructose 6-phosphate in equilibrium altro-heptulose 7-phosphate + xylulose 5-phosphate and 2 altro-heptulose 7-phosphate in equilibrium fructose 6 phosphate + D-glycero D-altro octulose 8-phosphate were demonstrated with purified enzymes, but are concluded to play a minor role in the non-oxidative synthesis of pentose 5-phosphate and octulose phosphate by (RLEP). 5. The formation of gem diol and dimers of erythrose 4-phosphate is proposed to account in part for the failure to detect monomeric erythrose 4-phosphate in the carbon balance studies. 6. The equilibrium value for the pentose pathway acting by the reverse mode in vitro was measured and contrasted with the value for the pathway acting in the forward direction. The initial specific rates of the pentose pathway reactions in vitro for the reverse and forward directions are measured. 7. The study which includes carbon balance, time course changes and 14C prediction labelling experiments reports a comprehensive investigation of the mechanism of the pentose pathway acting reversibly. PMID- 6862094 TI - Immunological relatedness of histidine ammonia-lyases from some species of Pseudomonas: taxonomic implication. AB - 1. Histidine ammonia-lyases (histidase EC 4.3.1.3) from Pseudomonas testosteroni NCIB 10808 and Pseudomonas putida NCIB 10807 were purified and specific antibody was raised to each separately in a rabbit. 2. Immunological cross-reactions of each antibody to histidine ammonia-lyases from various species of Pseudomonas were examined by the enzyme inhibition test. 3. The immunological data obtained suggest that these Pseudomonas species can be classified into three groups. These cross-reactions tend to indicate a certain degree of homology within species in a group but not between groups. PMID- 6862095 TI - Progesterone, glucocorticoid and estradiol receptors in MCF-7 cells bind to chromatin. AB - MCF-7 cells contain progesterone, estradiol and glucocorticoid receptors. Following addition of these hormones to the growth medium of the cells, hormone receptor complexes were found to sediment with chromatin fragments produced by trace digestion with micrococcal nuclease. The binding in all cases could be competed by excess unlabeled hormone. In each case the fragments with which the hormone-receptor complexes were associated tended to be smaller than the bulk chromatin fragments, indicating a greater sensitivity of those chromatin regions to the nuclease. The mononucleosomes released by more extensive digestion with micrococcal nuclease contained different amounts of each of the three hormone receptor complexes. Progesterone could usually be detected on mononucleosomes only after very brief sedimentation analyses, whereas glucocorticoid- and estradiol-labeled mononucleosomes were stable during long centrifugations. Comparison of glucocorticoid- and estradiol-labeled mononucleosomes indicated that their sedimentation rates differed from one another and from bulk nucleosomes. Estradiol nucleosomes from MCF-7 cells and rat uterus (Senior and Frankel, 1978) sediment significantly faster than bulk nucleosomes, while glucocorticoid nucleosomes from MCF-7 cells and rat hepatoma cells sediment with, or even fractionally slower than, bulk nucleosomes. PMID- 6862097 TI - Primary monolayer cell culture of bovine parathyroids: effects of calcium, isoproterenol and growth factors. AB - Cell aggregates of bovine parathyroid tissue were prepared by limited collagenase digestion and placed in culture in Weymouth's MB752/1 (calcium = 3.3 mg/100 ml) containing 5% fetal bovine serum and supplemented with insulin alone, or insulin, hydrocortisone, transferrin and epidermal growth factor. Only insulin was required for the maintenance of PTH secretion over a 9-day period. The cell aggregates spread to form monolayer in 3-5 days. The majority of the cells in monolayer were polygonal with well-defined borders. Nuclei were round and the cytoplasm was free of vacuoles. Cell cultures responded to secretory stimulation by low calcium or by isoproterenol with increases in the secretion of PTH and SP 1. At low calcium, about 18% of both the cellular PTH and SP-1 was secreted per hour, and up to 50% of the cell content of these proteins was released per hour upon stimulation by isoproterenol and low calcium combined. The responses to calcium and isoproterenol decreased as a function of time in culture, and calcium responses often disappeared completely by 10 days of culture. When cells were cultured in medium containing a higher (5 mg%) than standard concentration of calcium between days 3-6 of culture, the degree of secretory inhibition attainable with high calcium was greater than that of cells cultured in the standard medium. When secreted hormonal peptides were separated by SDS-gel electrophoresis prior to RIA, it was found that the secretion of intact hormone was sensitive to calcium. For every molecule of PTH secreted into the medium, 1.5 2 mole-equivalents of carboxyl fragments were also released. Calcium control of fragment release was not as stringent as that of PTH release. PMID- 6862096 TI - Effects of steroids on fibroblasts: identification of glucocorticoid-regulated proteins by two-dimensional gel electrophoresis. AB - Fibroblasts cultured from normal human forearm or genital skin were exposed to dexamethasone (DM) 10(-9)-10(-7) M, deoxycorticosterone (DOC) 10(-6)M, or vehicle for 4-16 h and [35S]methionine-labelled proteins compared by two-dimensional gel electrophoresis. No effects on cell number or [35S]methionine incorporation were seen with either steroid, nor any effects of DOC on patterns of protein synthesis. In contrast, after 4 h incubation DM consistently (24/24 gels) caused increased abundance of a protein spot designated k (kappa; Mr approximately 41 000, pKi approximately 6.5). After 16 h steroid exposure, levels of protein kappa remained elevated; abundance of a second protein spot omega (omega; Mr approximately 42 000, pKi approximately 5.4) was consistently (8/8 gels) lower than in control fibroblasts. We interpret these data as evidence for glucocorticoid-specific effects on human skin fibroblasts, and that (within the pKi and molecular weight range studied) the observed changes in abundance of proteins kappa and omega constitute the human fibroblast glucocorticoid domain. PMID- 6862098 TI - Rapid estrogen metabolism and vitellogenin gene expression in Xenopus hepatocyte cultures. AB - Male hepatocytes metabolized estradiol-17 beta, 17 alpha-ethinylestradiol and mestranol extremely rapidly (t 1/2 = 40, 60 and 300 min, respectively), whereas these were more stable in cultures of female hepatocytes (t 1/2 = 120, 150 and 640 min, respectively). Vitellogenin mRNA accumulated for only 12 h after a single addition of 10(-6) M estradiol to male hepatocyte cultures; mestranol, but not 17 alpha-ethinylestradiol or diethylstilbestrol, was more potent than the natural hormone. The level and rate of accumulation of vitellogenin mRNA were 5 15 times higher in female than in male hepatocytes, mestranol and estradiol being more potent than 17 alpha-ethinylestradiol and diethylstilbestrol. Ovariectomy, 60 days prior to cell culture, did not alter the metabolism of estradiol or the vitellogenic response of female hepatocytes. On the other hand, a single administration of estradiol in vivo to male Xenopus caused a long-lasting shift (at least 16 weeks) to the female pattern of its metabolism, although the enhanced inducibility of vitellogenin genes was partially reversed between 4 and 16 weeks after hormonal treatment. The addition of fresh estradiol every 4 h to male hepatocyte cultures to compensate for its rapid metabolism resulted in a continuous and sustained accumulation of vitellogenin mRNA at rates comparable to those attained in vivo. Our findings explain the requirement for high levels of estrogen to activate vitellogenin genes and establish Xenopus hepatocyte cultures as a reproducible system for analysing the expression of this multigene family. PMID- 6862099 TI - Lack of estradiol receptor in Kurloff cell cytosol. AB - The percentage of lymphoid cells containing Kurloff bodies is increased after estrogen treatment. Cytosolic fractions of pure Kurloff cells were incubated with tritiated 17 beta-estradiol. No measurable specific binding was observed under any of the different experimental conditions tested. Kurloff cells do not appear to be a target cell for estrogen. PMID- 6862100 TI - Timing and rates of synthesis of early histone mRNA in the embryo of Strongylocentrotus purpuratus. AB - The level of early histone mRNA in Strongylocentrotus purpuratus changes abruptly at 6 hr of development, increasing an average of 10-fold by 9-10.5 hr and then decreasing over 2-fold by 13.5-15 hr. These changes occur when the late embryonic mRNA is still a very minor component of histone gene transcription. The exact values of increase and decrease of mRNA level vary from experiment to experiment and may reflect the conditions of embryos at different times. The instantaneous rate of synthesis of histone RNA per embryo increases from at least 47 fg/min at 6 hr to 114 fg/min at 9 hr and then drops to 29 fg/min at 12 hr. The rate of mRNA accumulation is lower: 20, 43, and 12 fg/min, respectively. On a per cell basis, however, the rate of synthesis and accumulation is highest at 6 hr and continuously decreases to 1/20 the level per cell at 12 hr. The transcriptional rates and relative mRNA increases taken together predict an average increase from 0.16 to 0.24 pg/embryo (6-10 X 10(5) molecules) per mRNA species in the egg to 1.6 to 2.4 pg/embryo (6-10 X 10(6) molecules) at 10.5 hr. The transcription rates indicate that at the maximal values we obtained, about two to three molecules of each histone RNA are made per gene copy per minute. The half-life of the histone mRNAs in the period from 6 to 13.5 hr probably varies, with the maximal turnover at about the time histone RNA level peaks. A half-life of 1.5 hr at 12 hr of development is estimated. Change in transcriptional rate per nucleus, increase in cell number, and probably a change in mRNA stability as well are therefore involved in the control of histone mRNA levels in the early embryo. PMID- 6862101 TI - DNA synthesis and cell generation cycle during determination and differentiation of the metanephric mesenchyme. AB - Isolated metanephrogenic mesenchyme can be induced for epithelial differentiation and tubule formation by an embryonic spinal cord that is cultivated in a transfilter position to the target cells. Under such conditions, determination of the cells starts at 12 hr and is completed around 24 hr. To correlate this event to DNA synthesis, thymidine incorporation was followed in such cultures from 2 to 96 hr after setting up the transfilter explants. Controls were cultured under conditions which did not result in induction. Incorporation into both induced and noninduced mesenchymes dropped rapidly during the first 12 hr when the tissues were transferred to the in vitro conditions. During the subsequent critical 12- to 24-hr period, mesenchymes continuously exposed to an inductor showed a marked increase in their incorporation of thymidine. If induction was interrupted during the first 10 hr there was no stimulation of incorporation when measured at 24 hr. Similarly, isolated mesenchymes and those exposed to a tissue devoid of inducing capacity did not show stimulation, and their incorporation remained at a low level when measured at 24 hr. Parallel DNA measurements were made by flow cytometry of individual nuclei from mesenchymes exposed to the inductor from 0 to 46 hr. No major changes in the distribution of the various phases of cell generation cycle were detected nor could any synchronization be shown. Hence the changes in the incorporation rate of thymidine seem to be due to variations in the total length of the cell cycle. We conclude that induction of differentiation of the metanephric mesenchyme is accompanied by a contact-mediated stimulation of DNA synthesis. The stimulation may represent a permissive effect on a predetermined cell population in the metanephrogenic mesenchyme. PMID- 6862102 TI - Control of gap junction formation in early mouse embryos. AB - Intercellular communication via gap junctions begins in the eight-cell stage in early mouse embryos. We have studied the timing of this event in relation to compaction, and have begun to explore some of the possible control mechanisms underlying it. Gap junction formation was inferred by measuring ionic coupling as well as by observing the intercellular transfer of fluorescent dye. Embryos were obtained early on Day 3 of pregnancy by flushing the oviducts of HA/ICR mice that had been mated with CB6F1/J males. Gap junctions were detected only in those embryos which had achieved the fully compacted state. Inhibition of protein synthesis by cycloheximide treatment beginning as early as the late four-cell stage failed to block compaction or the acquisition of gap junctions, demonstrating that the necessary proteinaceous components are present in advance of these events. In order to test the possibility that gap junctions could be induced to form prematurely, fully compacted, communication-competent eight-cell embryos were aggregated with two- or four-cell embryos. Even after 10 hr of aggregation, no interembryonic gap junctions could be detected. Fully compacted eight-cell embryos when aggregated with each other, however, became ionically coupled within 3-5 hr. The number of interembryonic junctional channels was judged to be effectively small, since the aggregated embryos exhibited obvious ionic coupling but very weak dye coupling. In contrast to gap junction formation within embryos, junction formation between embryos was blocked by cycloheximide. These results demonstrate that gap junction formation in early mouse embryos is under precise temporal control, involving the assembly or mobilisation of preexisting components. This stockpile of components is either unavailable or insufficient to allow the formation of additional gap junctions between aggregated communication-competent embryos without new protein synthesis. PMID- 6862103 TI - An analysis of protein synthesis, membrane proteins, and concanavalin A-binding proteins during conjugation in Tetrahymena thermophila. AB - Conjugation in the ciliate Tetrahymena thermophila has been used as a system in which to analyze biochemical events associated with the execution of a complex cell-cell interaction. Two-dimensional electrophoretic analysis of [35S]methionine-labeled whole-cell proteins revealed major changes in protein synthesis correlated with costimulation and the onset of pairing; specifically, the major induced polypeptide was one of 80 kDa. A second change in the pattern of protein synthesis was associated with the onset of meiosis; the major induced product was another, perhaps related, 80-kDa polypeptide. An effort was made to detect changes in the patterns of membrane proteins and Con A-binding proteins during conjugation; no changes were found. These results are discussed in the context of earlier hypotheses regarding the distribution of Con A receptors on the surfaces of conjugating cells. PMID- 6862104 TI - Metabolism of sulfogalactosyl glycerolipids in the myelinating mouse brain. AB - The in vivo metabolism of sulfogalactosyl glycerolipids (SGG) was studied in the cerebrum and cerebellum of developing mice after intraperitoneal injection of [35S]sulfate. After correction for the specific radioactivity changes of blood sulfate the quantitative rates of biosynthesis and biodegradation of this lipid could be determined. In addition, the net accumulation of SGG was measured. Throughout development the rates of SGG biosynthesis and net accumulation were higher in the cerebellum than in the cerebrum. The developmental patterns of SGG net synthesis in both parts of the brain were closely related to those observed earlier for sulfatide. During development the rate of SGG biosynthesis in both parts of the brain showed a peak earlier than that of sulfatide (at 14 days versus 20 days). The in vivo patterns of SGG degradation followed those of biosynthesis in the cerebrum and cerebellum. During postnatal development 40 to 80% of the daily synthesized SGG disappeared within 24 hr, suggesting that degradation may also be involved in the regulation of SGG net synthesis during myelination, as previously indicated for sulfatide. PMID- 6862105 TI - Consequences of neural tube and notochord excision on the development of the peripheral nervous system in the chick embryo. AB - Notochordectomy and neuralectomy were carried out either in one- or in two-step experiments on the chick embryo. The aim of this operation was to study the influence of the axial organs (notochord and neural tube) on the development of the ganglia of the peripheral nervous system. The neural crest cells from which most peripheral ganglion cells arise were labeled through the quail-chick marker system and their fate was followed under various experimental conditions. It appeared that the development of the dorsal root and sympathetic ganglia depends on survival and differentiation of somite-derived structures. In the absence of neural tube and notochord, somitic cells die rapidly, and so do the neural crest cells that are present in the somitic mesenchyme at that time. In contrast, those crest cells which can reach the mesenchymal wall of the aorta, the suprarenal glands, or the gut survive and develop normally into nerve and paraganglion cells. Differentiation of the neural crest- and placode-derived sensory ganglia of the head which develop in the cephalic mesenchyme is not affected by removal of notochord and encephalic vesicles. These results show that the peripheral ganglia are differentially sensitive to the presence of the neural tube and the notochord. Among the various ganglia of the peripheral nervous system, spinal and sympathetic ganglia are the only ones which require the presence of these axial structures. The neural tube allows both the spinal and the sympathetic ganglia to develop in the absence of the notochord. In contrast, if the notochord is left in situ and the neural tube removed, the spinal ganglia fail to differentiate and only sympathetic ganglia can develop. PMID- 6862106 TI - Neurite extension by peripheral and central nervous system neurons in response to substratum-bound fibronectin and laminin. AB - Dissociated neurons from embryonic chick dorsal root and sympathetic ganglia (peripheral neurons) and from spinal cord and retina (central nervous system neurons) were cultured on plastic substrata treated with purified fibronectin and laminin. Both central and peripheral neurons attached to and extended neurites on laminin. In contrast, only peripheral neurons initiated neurites on fibronectin; central neurons cultured under identical conditions aggregated into clusters and did not extend neurites. Neurite length, number of neurites initiated, and extent of neurite branching on fibronectin- and laminin-treated substrata were evaluated and compared with similar measurements of neuronal response to poly-L-lysine treated plastic. Poly-L-lysine provides an adhesive surface for neurite elongation, but fibronectin and laminin appear to promote more rapid neurite elongation. Our observations suggest that neuronal interaction with these glycoproteins may involve neuron-specific cell surface components. These responses to laminin and fibronectin in vitro may be related to the presence or absence of these glycoproteins in specific extracellular environments during specific developmental stages. PMID- 6862107 TI - Cholinergic traits in the neural crest: acetylcholinesterase in crest cells of the chick embryo. AB - Previous work by our group has demonstrated that mesencephalic neural crest cells at an early stage of migration are able to synthesize acetylcholine (ACh). Acetylcholinesterase (AChE), the enzyme responsible for ACh degradation, was examined in neural crest cells of the chick embryo, using cytochemical and biochemical methods. Observations at the light microscope level showed that cholinesterase activity, identified as true AChE, was present at all axial levels in presumptive crest cells of the neural folds, soon after closure of the neural tube. Subsequently, AChE activity was found in cells of the individualized neural crest and in crest cells migrating at cephalic and trunk levels. Cell counts revealed that 88-94% of the total crest population was AChE-positive. Electron microscope observations indicated that the enzyme was confined to perinuclear and endoplasmic reticulum cisternae. The AChE of migrating mesencephalic neural crest cells was identified as the dimeric form (sedimentation coefficient 6.9 S) of the catalytic subunit. These results indicate that the specific AChE is present in the majority of neural crest cells all along the neural axis. Thus the ability to synthesize and degrade ACh is expressed at least in some neural crest cells at an early stage of development. PMID- 6862108 TI - The origin of the mesoderm in an anuran, Xenopus laevis, and a urodele, Ambystoma mexicanum. AB - We have investigated whether superficial cells of the blastula contribute to mesodermal structures in the anuran Xenopus laevis and the urodele Ambystoma mexicanum. The superficial cells alone of late blastulae of both embryos were labelled with Bolton-Hunter reagent and the embryos were allowed to develop. The progeny of the labelled cells were identified at later stages and the results demonstrate that superficial cells of Xenopus blastulae make no significant contribution to the mesoderm, whereas those of the axolotl Ambystoma always contribute. PMID- 6862109 TI - Effects of maternal diabetes on early embryogenesis. Alterations in morphogenesis produced by the ketone body, B-hydroxybutyrate. AB - The present study used the whole embryo culture technique to determine the effects of the ketone body, B-hydroxybutyrate (B-OHB), on organogenesis in mouse embryos. Embryos of two stages (3-4 and 5-6 somites) were exposed for 24 h to a racemic mixture of D-L B-OHB at levels of 8, 16, or 32 mM/L. An abnormal pattern of development resulted, consisting of growth reduction and inhibition or delay of neural tube closure in the cranial and/or caudal regions of the embryo. These effects were dose- and age-dependent, such that younger embryos were more frequently affected than older ones, and increasing doses produced a higher rate of malformation. Growth reduction as evidenced by embryonic protein showed similar relationships. Histologic analysis of embryos exposed to 32 mM/L B-OHB for 24 h revealed numerous cytoplasmic "vacuoles" widespread throughout the neuroepithelium, mesenchyme, and ectoderm. Ultrastructurally, these "vacuoles" proved to be mitochondria that had undergone high-amplitude swelling with a loss of matrix density and few identifiable cristae. No other consistent ultrastructural changes were noted, and the mitochondria of control tissues displayed a typical orthodox configuration. While this study does not conclusively limit the effects to the D-form of B-OHB, possible relationships exist between the ultrastructural alterations, ketone body metabolism, and abnormal morphogenesis. PMID- 6862110 TI - Developmental-stage-dependent teratogenic effects of maternal spontaneous diabetes in the chinese hamster. AB - The effect of maternal diabetes on teratogenesis was examined utilizing female Chinese hamsters with typical diabetic symptoms from our closed colony (CHA) and F13-F19 of the brother-sister mating generations of a diabetic strain (CHAD). Both groups were mated with nondiabetic males from CHA. Embryologic studies on day 2.5, 4.5, and 18.5 of gestation were performed with 30, 31, 71 diabetic females that were impregnated during a normal 4-day estrous cycle. The preimplantation embryos of day 2.5 and 4.5 were also karyotyped. The results indicated that: (1) There was no decrease in the number of ovulated ova, of collected embryos, and of implantation sites in the diabetic females. (2) As far as the preimplantation stages were concerned, there was no decrease in the cleavage activity and no increase in the incidence of developmental anomalies. (3) There was no increase of chromosomal aberrations in the preimplantation embryos. (4) With respect to the postimplantation development, however, there were significant increases in embryonic death (P less than 0.001), gross malformation (P less than 0.001), and fetal hypoplasia (P less than 0.001). Results (1), (2), and (3) indicated that in diabetic females capable of conceiving during a normal estrous cycle, the maternal diabetic milieu did not affect oogenesis, ovulation, fertilization, cleavage division, implantation, and chromosomal behavior. Result (4), however, showed definitely that maternal diabetes exerted deleterious effects on fetal development during the stage of organogenesis, and also markedly reduced fetal growth during later developmental stages. PMID- 6862111 TI - Resting and exercise hyperemic pulsatile arterial blood flow in insulin-dependent diabetic subjects. AB - Pulsatile arterial blood flow was studied in 20 normal (N), 20 short-term (STIDDM; mean: 5.17 yr), and 20 long-term insulin-dependent diabetic patients (LTIDDM; mean: 14.76 yr) between the ages of 18 and 30 yr with no clinically detectable peripheral vascular disease. Measurements were taken from waveforms obtained noninvasively using an electromagnetic flowmeter at rest and immediately after a 3-min isometric exercise challenge of the right leg. At rest, both groups of diabetics exhibited minute flow values similar to those in the normal group. This was achieved, however, by increased vasodilation in peripheral tissues as indicated by a difference in waveform configuration. Diabetic subjects showed a significantly smaller peak flow, a less steep ascending and descending slope, and a higher minute heart rate than normal controls. After 3 min of isometric exercise, the diabetic groups exhibited significantly less minute flow, flow/pulse, and a more vasodilated flow pattern similar to that recorded at rest. In addition, the LTIDDM group showed significantly less arterial elasticity than N or STIDDM groups as indicated by a shorter propagation time. These findings imply that apparent functional changes in pulsatile arterial blood flow occur early in the time course of diabetes and are independent of duration. PMID- 6862112 TI - Excessive nonenzymatic glycosylation of peripheral and central nervous system myelin components in diabetic rats. AB - The amount of nonenzymatic glycosylation present in normal and diabetic rat peripheral nerve myelin, whole brain, brain myelin, and individual myelin protein components was determined using NaB3H4 reduction followed by either boronic acid affinity chromatography or SDS-polyacrylamide gel electrophoresis (SDS-PAGE). Diabetic peripheral nerve myelin (PNS-M) showed a 5.2-fold increase over normal, indicating that myelin is the major peripheral nerve component undergoing excessive glycosylation in diabetes. SDS-PAGE of diabetic and normal PNS-M showed no differences in the pattern of protein bands or in the distribution of glycosylated adducts. However, in the diabetic, the amount of incorporated radioactivity was 3.74 times greater in the P0 protein and 2.8 times greater in the high-molecular-weight material that did not enter the gel. In whole brain, a 2.4-fold increase in the amount of nonenzymatic glycosylation was observed when diabetic was compared with normal, while diabetic brain myelin (CNS-M) was 3.8 times more glycosylated than normal brain myelin. SDS-PAGE of diabetic and normal CNS-M, like that of PNS-M, showed no differences in the pattern of protein bands or in the distribution of glycosylated adducts. The amount of incorporated radioactivity, however, was 3.18 times greater in the proteolipid region, 2.37 times greater for basic myelin protein, and 2.9 times greater for the high molecular-weight proteins that did not enter the gel. This excessive nonenzymatic glycosylation of the main peripheral and central nervous system myelin components may contribute to the functional abnormalities of myelinated neurons associated with diabetes. PMID- 6862113 TI - Splanchnic and peripheral disposal of oral glucose in man. AB - Oral glucose (92 g) was administered to 22 healthy, young volunteers undergoing hepatic vein catheterization, and net splanchnic glucose output (SGO) was measured during the basal period and for 4 h after glucose ingestion. In the basal state, SGO averaged 1.90 +/- 0.11 mg/min X kg. After glucose, SGO rose to a peak value of 6.65 +/- 0.83 mg/min X kg at 30 min and returned to baseline by 3 h. Total SGO over 4 h was 69 +/- 4 g; assuming complete absorption of the load, this amount represented 75% of the oral glucose. In a subgroup of six subjects, leg glucose uptake was simultaneously quantitated by femoral vein catheterization and leg blood flow measurement. In the postabsorptive state, glucose uptake by one leg was 24 +/- 8 mg/min and increased to a mean value of 76 +/- 7 mg/min during the 4 h after glucose ingestion. Overall, 18 +/- 2 g/4 h of glucose were taken up by one leg, which extrapolates to a total body muscle uptake of 65 +/- 4 g over 4 h. We conclude that in normal man, well over 2/3 of an oral glucose load escapes splanchnic removal, and that the peripheral tissues quantitatively play the dominant role in glucose disposal. PMID- 6862114 TI - A simplified real ear technique for verifying the maximum output of a hearing aid. AB - Real ear SPL (RE/SSPL90) produced by four different hearing aids was compared to the standard SSPL90 measurements for the same hearing aids on a 2-cc coupler. The effects of venting, location, and reliability for RE/SSPL90 were also studied. As expected, the real ear output level was greater than the coupler level. No systematic influence of earmold venting was found. An earmold that occludes an ear canal decreases the output in the high-frequency range so that only a small difference remains between RE/SSPL90 and 2-cc coupler levels above 2000 Hz. The difference seems to be affected slightly by the output impedance of the hearing aid receiver system. Individual variation for the RE/SSPL90 is as much as 10 dB. Finally, the saturated output levels measured were found to be insensitive to changes in actual microphone input levels caused by different procedures for calibrating ambient SPL. The RE/SSPL90 method is easy to use and reliability seems quite adequate for the typical clinical setting. PMID- 6862115 TI - Development of speech intelligibility in children with recurrent otitis media. AB - This study defined developmental functions for Pediatric Speech Intelligibility word and sentence materials presented in quiet and in competition for 25 normal children and 25 children with recurrent otitis media. Ages ranged from 24 to 56 mos. In normal children, developmental functions for Pediatric Speech Intelligibility speech materials showed earlier development of performance (1) in quiet than in competition and (2) for words than for sentences (competing condition). In children with otitis media, developmental functions were normal for both words and sentences in quiet and for sentences in competition. However, developmental functions were grossly abnormal for words in competition. PMID- 6862117 TI - Influence of cigarette smoking on extra-high-frequency auditory thresholds. AB - Twenty-five young adult nonsmokers and 18 smokers were studied with respect to differences in their extra-high-frequency (EHF) auditory sensitivity. Although no statistically significant differences were found between their EHF thresholds, there was some evidence that smokers have poorer EHF hearing. The implication of this finding, vis-a-vis the use of EHF auditometry as a predictor of atheromatous damage to blood vessel walls, is discussed with suggestions for future research. PMID- 6862118 TI - The collapsed earmold phenomenon. AB - This paper describes the collapsed earmold phenomenon resulting from a wide bore earmold. The collapse was alleviated by a simple modification of the earmold (cutting of its most medial 1/6 of an inch). PMID- 6862116 TI - The revised form of the Hearing Performance Inventory. AB - The revised Hearing Performance Inventory contains 90 items selected in part on a statistical basis and in part on clinical relevance from a previous experimental form. An analysis of the responses of 354 hearing-impaired subjects was used to evaluate the performance of each of the 90 items remaining in the Revised Form. Because the only items eliminated were either found or deemed to be too easy, too difficult or redundant, the Revised Form maintains the strength of the previous form while reducing significantly the time required for its administration. PMID- 6862119 TI - Reversible audiological results in a patient with an extra-axial brain stem tumor. AB - A case of a 32-yr-old patient with an extra-axial brain stem tumor is presented. Many postoperative audiological test results were reversed compared to the preoperative results. A variety of auditory measures were conducted to show which tests were sensitive to this patient's lesion. Also reported are some rather unique postoperative auditory changes which, in retrospect, provided an interesting view as to the extent of the lesion. PMID- 6862120 TI - I.V. therapy guidelines now in second printing. PMID- 6862121 TI - F-I-R-E! Evacuating St. Joseph's. PMID- 6862122 TI - Accident prevention--establish safety program. PMID- 6862124 TI - The human hospital. PMID- 6862123 TI - Security and confidentiality are everyone's business. PMID- 6862125 TI - Workload measurement systems: past, present and future. PMID- 6862126 TI - [Regrouping: the Joliette experience]. PMID- 6862127 TI - Avoiding the perils of quality circles. PMID- 6862128 TI - Hazards and complications of I.V. therapy. PMID- 6862129 TI - Epidemiology of type 1 (insulin-dependent) diabetes in Scotland 1968-1976: evidence of an increasing incidence. AB - A computer file of all Scottish hospital admissions in the period 1968-1976 was searched to identify the 2,505 children (aged less than 19 years) with a diagnosis of diabetes. The average annual incidence of the disease (based on first hospital admission) was estimated to be 13.8 per 100,000 children aged less than 19 years (boys 14.4 per 100,000; girls 13.2 per 100,000). The highest incidence, 20.0 per 100,000 was in the age group 10-14 years and the lowest 7.1 per 100,000 in those aged less than 5 years. It is estimated that during the study period there was an 80% increase in the annual incidence of juvenile diabetes, from about 10 per 100,000 in 1968 to about 18 per 100,000 in 1976. First admission rates showed seasonal variations for those aged 5 years or more, with peaks in October/November and January/February. Marked variation was found in the incidence rates in the different counties of Scotland. The central lowlands which includes the cities of Edinburgh and Glasgow was an area of low incidence. There appeared to be an inverse correlation between the incidence rate in each county and population density. In Glasgow, there was an inverse association between the incidence rate in each city ward and the average number of persons per room. There was no evidence of space-clustering of the disease in different years within the parishes (rural districts) of each county and there was no convincing evidence that the variation in the incidence of diabetes between parishes in the same county was more than might have been expected to arise by chance. The observations are compatible with the disease having a viral aetiology but it is difficult to explain the striking rise in incidence over the study period on this basis. PMID- 6862130 TI - Systolic time intervals in diabetes. AB - The systolic time intervals at rest of 16 Type 1 (insulin-dependent) and 30 Type 2 (non-insulin-dependent) otherwise healthy adult diabetic patients selected from primary health care clinics were compared with those of age- and sex-matched normal subjects by paired analysis. There was no significant difference in prevalence of smoking, body mass index, fasting serum cholesterol or mean blood pressure between the diabetic and control groups. Mean rate-corrected pre ejection period (diabetic patients: 132.7 +/- 2.1 ms, normal subjects: 134.6 +/- 3.5 ms (+/- SEM), left ventricular ejection time (diabetic patients: 413.9 +/- 3.0 ms, normal subjects: 421.5 +/- 4.7 ms) electromechanical systole (diabetic patients: 544.9 +/- 2.5 ms, normal subjects: 548.0 +/- 3.5 ms) and pre-ejection period/left ventricular ejection time ratio (diabetic patients: 0.36 +/- 0.01, normal subjects: 0.34 +/- 0.01) were not significantly different between the two groups (p greater than 0.05) and systolic time intervals did not correlate with duration of diabetes or type of treatment. Thus, we did not detect subclinical cardiomyopathy in healthy diabetic patients by this technique. However, a statistically significant skew in the distribution of systolic time intervals in the diabetic group (p less than 0.025) suggests the possibility of an 'at risk' population in which a more sensitive technique might demonstrate impaired ventricular performance. PMID- 6862131 TI - Respiratory sinus arrhythmia in diabetic neuropathy. AB - Heart rate variation was measured at different rates of regular deep breathing (2.5 to 13 breaths/min) in 11 normal subjects and 13 diabetic patients with neuropathy, defined clinically by the absence of both ankle jerks or the presence of autonomic symptoms. Subjects were divided into those above and below 30 years old. Normal subjects showed twofold changes in heart rate variation with maximum variation at mean breathing rates of 6.3 and 5.5 breaths/min. Heart rate variation was significantly smaller than normal in the diabetic patients with neuropathy, at all of the frequencies tested in the younger group and 7 of the 13 test frequencies in the older group; the maximum variation occurred at slower mean breathing rates of 4.5 breaths/min (p less than 0.005) and 4.1 breaths/min (p less than 0.01) respectively. Seven diabetic patients without neuropathy, with intact leg reflexes and less than 30 years old, had normal heart rate variation but the maximum responses occurred at a mean breathing rate of 5.4 breaths/min, significantly slower than normal (p less than 0.02). Measuring the breathing rate at which heart rate variation is maximal may be a sensitive way of detecting autonomic (vagal) neuropathy. PMID- 6862132 TI - A collaborative study of the measurement of glycosylated haemoglobin by several methods in seven laboratories in the United Kingdom. AB - A collaborative study compared methods for measuring glycosylated haemoglobin in seven laboratories in the United Kingdom. No satisfactory standard for general use was found. Satisfactory internal quality control systems were in use for each assay which allowed the maintenance of a normal range in each participating laboratory. No satisfactory quality control system suitable for general use could be identified. Costs and convenience of the assays are reported. The technical problems with each type of assay and precautions for their use were identified, such as the need for standardization in incubation times, the practicability of automation of colorimetric assays, and the precision of pH needed for buffers in column separation methods. The relevance of the technical problems to interpretation of measurements is also considered. It is concluded that laboratories measuring glycosylated haemoglobin should maintain a normal range, use 'in-house' quality controls to monitor assay performance and keep clinical colleagues informed of the findings and of any changes in methodology that might affect the interpretation of results. PMID- 6862133 TI - Does obesity explain excess prevalence of diabetes among Mexican Americans? Results of the San Antonio Heart Study. AB - Obesity and Type 2 (non-insulin-dependent) diabetes mellitus are common in the Mexican American population. It is not clear whether this is merely a specific instance of the more general phenomenon of excess Type 2 diabetes and obesity among poor people, or whether Mexican Americans have a discrete genetic susceptibility to Type 2 diabetes. The latter consideration arises because Mexican Americans are of mixed native American and European ancestry and native Americans may have a genetic predisposition to Type 2 diabetes which Mexican Americans could share. We studied 936 Mexican Americans and 398 Anglo-Americans randomly selected from three socially and culturally distinct neighborhoods in San Antonio, Texas. Three categories of obesity--lean, average, and obese--were defined using the Anglo-American distribution of the sum of the triceps and subscapular skinfold. Mexican Americans were two to four times as likely to fall into the obese category as Anglo-Americans, but within categories, the two ethnic groups were closely matched in terms of sum of skinfolds. The prevalence of Type 2 diabetes, however, was significantly greater in Mexican Americans than in Anglo Americans even when the comparisons were made within the three obesity categories. The summary prevalence ratio, controlling for obesity, was 2.54 for men (p = 0.004) and 1.70 for women (p = 0.036). Thus, lean Mexican Americans are still at greater risk of Type 2 diabetes than equally lean Anglo-Americans. Conversely, although Type 2 diabetes prevalence increases as expected with increasing obesity in both ethnic groups, obese Anglo-Americans are still relatively protected compared with equally obese Mexican Americans. Plasma glucose was significantly higher in Mexican Americans than in Anglo-Americans even after controlling for obesity. These results indicate that, although obesity contributes to Type 2 diabetes in Mexican Americans, it does not by itself explain the entire excess prevalence rate. PMID- 6862135 TI - Proteinuria in diabetes. PMID- 6862134 TI - The thermal stability of collagen in diabetic rats: correlation with severity of diabetes and non-enzymatic glycosylation. AB - The thermal stability of collagen fibres from rat tail tendon was studied in both normal and diabetic rats. Results were correlated with the age of the animals, glycosylated haemoglobin level and the degree of non-enzymatic glycosylation of the collagen. Age was found to be the most important single determinant of the thermal rupture time of collagen fibres (r = 0,87, p less than 0.005). Thermal rupture time was also increased in diabetes and showed good correlation with glycosylated haemoglobin (r = 0.69, p less than 0.005) and non-enzymatic glycosylation of collagen (r = 0.51, p less than 0.005). The correlation of glycosylated haemoglobin level and thermal rupture time was significant, independent of age and non-enzymatic glycosylation of collagen. Experiments in vitro showed that incubation of collagen fibres with glucose increased the thermal stability of collagen. These results demonstrated an independent effect of severity of diabetes on the physical properties of collagen. The role of non enzymatic glycosylation in causing the changes in collagen properties in diabetes remains to be fully elucidated. PMID- 6862136 TI - Antiplatelet/anticoagulant drug therapy in severely uncontrolled diabetes mellitus. PMID- 6862137 TI - [Experimental morphological study, using electron microscopy, of adriamycin induced cardiomyopathy]. PMID- 6862138 TI - [Thrombocytosis and rheumatoid arthritis]. PMID- 6862140 TI - [Autoimmune hemolytic anemia in healthy persons. A clinical contribution]. PMID- 6862139 TI - [Effects of isocaloric variations in a diet with simple and complex sugars on atherogenic risk factors. II: the effect on platelet aggregation]. PMID- 6862141 TI - [Obesity and cardiopathies in the aged: assessment of the metabolic and behavioral risk factors and of clinico-instrumental changes]. PMID- 6862142 TI - Regression of line-10 hepatocarcinoma with synthetic quinonyl muramyl dipeptide in strain-2 guinea pigs. AB - Multiple intralesional injections of quinonylmuramyl dipeptide-66, a new synthetic immunoadjuvant, with a vehicle oil such as squalene or squalane resulted in the regression of line-10 hepatocarcinoma in strain-2 guinea pigs. This chemically synthesized adjuvant should be a useful immunotherapeutic agent for cancer. PMID- 6862143 TI - Enhancement of thermal cell killing by methylglyoxal bis(guanylhydrazone) in Chinese hamster V-79 cells. AB - Using the method of colony formation, the modifying effect of methylglyoxal bis(guanylhydrazone) (MGBG) was examined on 44 degrees hyperthermia- and/or radiation-induced cell killing and on thermotolerance development after 44 degrees exposure in Chinese hamster V-79 cells. After exposure to MGBG (10 microM) for more than 6 hr, cells became more sensitive to 44 degrees hyperthermia. When an interval at 37 degrees (up to 24 hr) was interposed between MGBG and hyperthermic treatments, cell survival was not significantly increased, as compared with that for MGBG immediately followed by 44 degrees. Cells treated with MGBG remained more thermosensitive, even after a 24 hr interval. On the other hand, when cells were exposed to split dose 44 degrees hyperthermia in the presence of MGBG during an interval of 6 hr at 37 degrees, the development of thermotolerance was not inhibited. After the combined treatments of MGBG followed by X-ray irradiation and hyperthermia, cell survival was markedly decreased, as compared with that in the case of X-ray irradiation alone or in combination with hyperthermia. PMID- 6862144 TI - Difference in 3H-thymidine incorporation after irradiation between murine B16 melanoma and squamous cell carcinoma in vivo. AB - The tumor growth and cell proliferation kinetics of B16 melanoma and transplantable squamous cell carcinoma (BSC tumor) in C57BL/6 mice were studied after single-dose X-ray and fast-neutron (2 MeV) irradiations. From tumor volume change studies, B16 tumor showed a high relative biological effectiveness (RBE) value (5.5) compared to that of BSC tumor (3.5). The tissue characteristics of the two tumors were not significantly different, but the post-irradiation changes in mitotic index (MI) and lebeling index (LI) were dependent on the tumor and on the nature of the radiation. After irradation, mitosis was immediately inhibited (G2 block) but recovered within several hours in BSC and X-ray-irradiated B16 tumors. The neutron-irradiated B16 tumors showed no recovery up to the end of the observation period. After X-ray irradiation, of B16 tumors, LI showed an immediate reduction, while the reduction was delayed several hours (equal to G1 + M) in BSC tumors. The extent of reduction was dose-dependent, and its recovery was coincident with the recovery of mitosis. The change in LI of neutron irradiated BSC tumors was similar to that with X-rays, but no change in LI was observed in neutron-irradiated B16 tumors over 18 hr. From these results, it is assumed that the cell progression of B16 tumors is susceptible to ionizing radiation, and that G1 block is induced as a result of irradiation. PMID- 6862145 TI - Thromboplastic and fibrinolytic activities of cultured human gastric cancer cell lines. AB - Thromboplastic and fibrinolytic activities of 8 lines of cultured human gastric cancer cells were estimated both in cell lysate and serum-free supernatant fraction. Furthermore, cell lysates with differing levels of thromboplastic activity were injected intravenously into congenitally athymic nude mice and the role of this activity in thrombus formation was examined. Thromboplastic and fibrinolytic activities of the cell lysate and the serum free-supernatant fraction varied from one line to another. There was no apparent correlation between these activities and the degree of histological differentiation of the original tumor. The thromboplastic activity was factor VII-dependent and factor IX-independent, indicating that it was attributable to tissue thromboplastin, although some factor VII-independent thromboplastic activity was also included in the cell lysate of two lines. Intravenous injection of the cell lysate with high thromboplastic activity produced more thrombi in the lung than that with low thromboplastic activity. This suggests that thromboplastic activity of cancer cells might play a significant role in the development of the hypercoagulable state in patients with gastric cancer. PMID- 6862147 TI - Mechanisms of lectin and antibody-dependent polymorphonuclear leukocyte-mediated cytolysis. AB - The mechanisms of tumor lysis by polymorphonuclear leukocytes (PMNs) were investigated. In antibody-dependent PMN-mediated cytolysis (ADPC), sensitized tumor cells were specifically lysed via Fc receptors on PMNs. On the other hand, lectin-dependent PMN-mediated cytolysis (LDPC) caused nonspecific lysis of several murine tumors after recognition of carbohydrate moieties on the cell membrane of both PMNs and tumor cells. Both ADPC and LDPC depended on glycolysis, and cytotoxicity was mediated by reactive oxygen species; LDPC was dependent on superoxide and ADPC on the myeloperoxidase system. The participation of reactive oxygen species in PMN cytotoxicity was also demonstrated by pharmacological triggering with phorbol myristate acetate. These results indicate that reactive oxygen species have an important role In tumor killing by PMNs and that ADPC and LDPC have partly different cytolytic processes as well as different recognition steps. PMID- 6862146 TI - Induction of polymorphonuclear leukocyte-mediated cytolysis by wheat germ agglutinin and antitumor antibody. AB - The role of polymorphonuclear leukocytes (PMNs) as effector cells in tumor lysis was investigated in vitro. PMNs were obtained from the peritoneal cavity of C3H/He Mice injected ip with 2 ml of 12% casein sodium. These PMNs could lyse murine MM46 tumor cells in the presence of the plant lectin, wheat germ agglutinin (lectin-dependent PMN-mediated cytolysis). PMNs alone did not cause cytolysis. PMNs obtained 6 hr after casein injection were effective against tumor target cells but those obtained 3 hr after the injection were not. Other lectins, such as concanavalin A, phytohemagglutinin, pokeweed mitogen, soybean agglutinin, Ulex europaeus agglutinin, Lens culinaris hemagglutinin and Bauhinia purpurea agglutinin, did not cooperate with PMNs in tumor lysis. Antitumor antibody was another mediator that induced tumor lysis in cooperation with PMNs (antibody dependent PMN-mediated cytolysis). These results indicate that PMNs can lyse tumor cells in the presence of appropriate mediators. PMID- 6862148 TI - Combination therapy of murine tumors with lentinan, bacterial lipopolysaccharide and a Streptococcus preparation, OK432. AB - Combination therapy by intralesional injection of OK432 followed by intraperitoneal administration of lentinan and bacterial lipopolysaccharide caused almost complete regression of solid-type tumor MH134. All three components were needed for maximal antitumor activity. Mice in which MH134-tumor had regressed due to this combination therapy showed an augmented antitumor delayed hypersensitivity reaction (measured by the footpad test) and resistance to rechallenge with MH134, but they had no cytolytic antibodies in their serum detectable by the complement cytotoxicity test. The possible importance of local inflammation induced by OK432 in this combination therapy is discussed. PMID- 6862149 TI - Antitumor activity of 2-keto-3-deoxyoctonate-free lipopolysaccharide of Vibrio anguillarum in mice. AB - The antitumor activity of a marine bacterium, Vibrio anguillarum, against Ehrlich carcinoma cells in ddY mice was investigated. The aqueous layer obtained by the hot phenol-water procedure exhibited more antitumor activity than did the middle layer or the phenol layer. This finding indicates that lipopolysaccharide (LPS) derived from V. anguillarum exhibits significant antitumor activity. In fact, mice injected with LPS obtained by ultracentrifugation and treatment with RNase had a longer mean survival period than the control mice. V. anguillarum LPS also inhibited the growth of syngeneic fibrosarcoma induced by 3-methylcholanthrene in C57BL/6 mice. V. anguillarum LPS possesses no 2-keto-3-deoxyoctonate, a regular sugar component of the core region of most gram-negative bacterial LPS, suggesting that 2-keto-3-deoxyoctonate is unnecessary for the antitumor activity of LPS. PMID- 6862150 TI - Growth inhibitory activity of human lymphoblastoid and fibroblast interferons in vitro. AB - Growth inhibitory activities of both human fibroblast (HuIFN-beta) and lymphoblastoid (HuIFN-alpha) interferons against 17 human cultured cell lines derived from leukemias and lymphomas were measured quantitatively by regrowth assay. Daudi cells were the most sensitive to both interferons. Three B-cell lines, one T-cell line and one non-T, non-B cell line were moderately sensitive to both interferons. Although the levels of sensitivity of these cell lines to the interferons were different, cells could be killed by the interferons. Eleven other cultured cell lines including three B-cell lines, three T-cell lines, two non-T, non-B cell lines, two myeloid cell lines and one monocytoid cell line were not sensitive to these interferons. The results indicated that the growth inhibitory activity of interferons was not always cell lineage-specific and cell lines which were sensitive to the one interferon were always sensitive to the other interferon, although the level of sensitivity was different. Cytocidal action of interferons was analyzed by use of the most sensitive Daudi cells. The results indicated that both interferons had a time-dependent cytocidal action, but not a concentration-dependent one. Knowledge of the mode of the cytocidal action may be useful for the design of optional therapeutic schedules using the interferons. The prediction of clinical effectiveness of interferon against hematologic malignancies is discussed, based on the level of in vitro sensitivity of cultured leukemia and lymphoma cell lines. PMID- 6862151 TI - Influence of taurocholate on hepatic clearance and biliary excretion of asialo intestinal alkaline phosphatase in the rat in vivo and in isolated perfused rat liver. AB - We have used canine intestinal alkaline phosphatase, an asialoglycoprotein, as a tool to study the effect of taurocholate on hepatic asialoglycoprotein transport. After bolus injections of 20 U of alkaline phosphatase into anesthetized rats in vivo and isolated perfused rat livers, a biexponential disappearance pattern was observed; 6.2% of the dose and 0.8% of the dose was excreted in bile, respectively. Taurocholate infusion in vivo and in isolated perfused livers resulted in a virtually complete abolition of the plasma disappearance of alkaline phosphatase in the second slow phase of the curve, whereas the primary disappearance rate was not affected. Wash out experiments showed release of exogenous alkaline phosphatase from the liver, which was strongly increased by taurocholate. Liver perfusion experiments with two subsequent doses of alkaline phosphatase indicated that the taurocholate effect was completely reversible. It is concluded that taurocholate enhances exocytosis of interiorized alkaline phosphatase from liver into plasma. The taurocholate effect on hepatic exocytosis of the asialoglycoprotein may also occur when bile salt concentrations in the systemic or portal circulation, or both, are elevated due to certain liver diseases and postprandial bile salt absorption. PMID- 6862152 TI - Serum-ascites albumin concentration gradient: a physiologic approach to the differential diagnosis of ascites. AB - Serum-ascites albumin concentration gradient, a parameter of oncotic pressure gradient reflecting presence or absence of portal hypertension, was compared with the usual parameters of ascitic fluid analysis in the differential diagnosis of ascites. Twenty-nine patients with liver disease and 15 patients with malignant neoplasm were prospectively studied. The group with malignant neoplasm showed higher ascitic fluid total protein level (3.70 +/- 1.28 vs. 1.66 +/- 1.20 g/dl), ascites to serum ratio of total protein level (0.58 +/- 0.14 vs. 0.26 +/- 0.14), ascitic fluid lactic dehydrogenase level (756 +/- 693 vs. 151 +/- 125 U/L), ascites to serum ratio of lactic dehydrogenase level (1.13 +/- 0.79 vs. 0.35 +/- 0.22), and lower serum-ascites albumin gradient (0.72 +/- 0.30 vs. 1.85 +/- 0.45) (p less than 0.001 for all parameters). Results of the serum-ascites albumin gradient overlapped the least between the two groups: all but 1 patient with malignant ascites while only 1 patient with liver disease had a gradient lower than 1.1. We conclude that the serum-ascites albumin gradient offers the best diagnostic discrimination between ascites caused by liver disease and ascites caused by a neoplasm. PMID- 6862153 TI - Portal vein ligation selectively lowers hepatic cytochrome P450 levels in rats. AB - In rats, surgical creation of a portacaval shunt leads to hepatic atrophy and lowered levels of cytochrome P450, the key component of liver enzymes involved with drug metabolism. These effects are largely attributable to diversion of portal blood away from the liver and not to decreased hepatic blood flow. The present study has established a simpler model of portal blood diversion in order to examine the role of portal blood constituents in the regulation of hepatic cytochrome P450. Portal vein ligation was performed on male Wistar rats in which portasystemic anastomoses had been produced by subcutaneous transposition of the spleen. Portal vein ligation resulted in portal hypertension, as evidenced by splenomegaly, and in hepatic atrophy. In liver of rats with portal vein ligation, microsomal cytochrome P450 levels were significantly less than in sham-operated control rats, but cytochrome b5, NADPH-cytochrome c reductase, and glucose-6 phosphatase were unaltered. The activities of four mixed function oxidases also were reduced significantly in the liver of rats with portal vein ligation, the changes being greatest for ethylmorphine N-demethylase, a prototype substrate for the phenobarbital-inducible isoenzyme of cytochrome P450. In contrast, the activity of microsomal heme oxygenase, the rate-limiting step in catabolism of heme to bilirubin, was enhanced after portal vein ligation. Experiments in pair fed rats showed that the changes observed in liver from rats with portal vein ligation could not be attributed to caloric deprivation. Administration of phenobarbital increased liver mass, cytochrome P450 levels, and mixed function oxidase activities both in rats with portal vein ligation and in controls, indicating that the liver of the ligated rats retained considerable protein synthetic capacity. It appears that hepatic atrophy and lowering of cytochrome P450 levels that follow portal vein ligation are consequences of altered exposure of the liver to factors normally present in portal blood, and that the same alterations may also enhance heme oxygenase activity. PMID- 6862154 TI - Upper esophageal sphincter and pharyngoesophageal motor function in infants with and without gastroesophageal reflux. AB - Upper esophageal sphincter and pharyngeal motor function were assessed in 16 infants with gastroesophageal reflux and 11 age-matched control infants. Resting upper esophageal sphincter pressure in gastroesophageal reflux infants was 26.6 +/- 10.0 cmH2O (means +/- SD) and was similar to that of control infants (28.9 +/ 10.0 cmH2O). Pharyngeal contraction amplitude, duration, and velocity were the same in control and reflux subjects. A minor degree of incoordination between pharyngeal contraction and upper esophageal sphincter relaxation was noted in 2 control subjects and 2 infants with gastroesophageal reflux. Esophageal acidification produced an increase in mean upper esophageal sphincter resting pressure of 10.0 cmH2O in controls and 11.1 cmH2O in reflux patients. PMID- 6862156 TI - Centrally administered bombesin affects gastric emptying and small and large bowel transit in the rat. AB - The effects of intracerebroventricular bombesin on gastric emptying and small and large bowel transit were evaluated in female rats using radioactive marker techniques. Gastric emptying was studied by determining the rate of emptying of tritium-labeled polyethylene glycol from the stomach after intracerebroventricular saline or bombesin, while intestinal transit was determined after the direct instillation of radiochromium into the small and large bowels. Dose- and time-response studies were conducted. Bombesin (0.01-1.0 microgram, intracerebroventricularly) slowed gastric emptying in a dose-related manner. Time-course studies of gastric emptying after administration of the peptide concurrently with, or 10 or 20 min before the marker, showed maximum effects 20 min after bombesin. This effect was blocked by subdiaphragmatic vagotomy. Small intestinal transit was also delayed by intracerebroventricular bombesin (0.01-3.0 microgram); when studied by giving the peptide concurrently with, or 10 or 20 min before the marker, maximal effects were seen 20 min after bombesin. In contrast, transit in the large intestine was stimulated when bombesin (1 microgram, intracerebroventricularly) and the marker were given concurrently, while a small (nonsignificant) delay of transit occurred at 20 min after doses of 0.01-1.0 microgram. Fed rats showed a significant (p less than 0.05, Student's t-test) increase in fecal boli within the first 30 min after intracerebroventricular bombesin (1 microgram) (3.66 +/- 0.49, bombesin; 1.16 +/- 0.54, saline). Peripherally administered bombesin (20 micrograms/kg, intraperitoneally) had no effect on gastric emptying. These results indicate that bombesin exerts profound effects on the mammalian gastrointestinal tract via the central nervous system, probably through a vagally mediated motor pathway. Furthermore, the qualitatively different effects of this peptide on the small and large bowels emphasize that these different organs respond to drugs in different manners and with different time-courses. PMID- 6862157 TI - Effect of bombesin on serum immunoreactive trypsin in healthy subjects and in patients with chronic pancreatitis. AB - We studied the effect of bombesin (9 ng/kg X min for 30 min by intravenous infusion) on serum immunoreactive trypsin in healthy subjects and in chronic pancreatitis patients. Bombesin administration caused a marked and significant increase of serum immunoreactive trypsin concentration in healthy subjects. The increase occurred in the first 15 min after the beginning of bombesin infusion and persisted for the duration of the study (2 h). In patients with chronic pancreatitis, the increase was much less pronounced. In these patients, the integrated immunoreactive trypsin response to bombesin was significantly correlated with bicarbonate, lipase, and chymotrypsin outputs into the duodenum. The response of serum immunoreactive trypsin to bombesin stimulation seems to vary according to the degree of pancreatic exocrine dysfunction and to reflect the functional capacity of acinar cell mass. PMID- 6862155 TI - Esophageal acid perfusion in coronary artery disease. Induction of myocardial ischemia. AB - Although coronary artery disease and gastroesophageal reflux disease are common conditions which, therefore, may coexist, it is unknown whether or not the presence of one affects the other. We performed esophageal acid perfusion tests, with concurrent blood pressure, heart rate, and 12-lead electrocardiographic monitoring, in 37 patients, 25 with angiographically documented coronary disease and 12 with normal coronary arteries. Rate-pressure product, an index of myocardial work load, was calculated. In patients with coronary disease who developed chest pain during acid perfusion, rate-pressure product increased from 10.0 +/- 1.0 x 10(3) (mean +/- SEM) basally to 15.2 +/- 1.5 x 10(3) (p less than 0.001), and 3 of 9 patients showed concomitant electrocardiogram evidence of myocardial ischemia. In addition, in coronary disease, 64% of patients with infrequent or absent reflux symptoms by history had positive acid perfusion tests, and 56% of patients with coronary disease who developed pain during esophageal acid perfusion could not distinguish that pain from their usual angina. We conclude that in coronary disease, acid perfusion (and, presumably, gastroesophageal reflux) resulting in chest pain causes rate-pressure product elevation and can induce myocardial ischemia. The presence of esophageal acid sensitivity is not accurately predicted by clinical history in coronary disease, and pain of esophageal origin is often confused with angina. PMID- 6862158 TI - Muscarinic cholinergic receptors in the piebald mouse model for Hirschsprung's disease. AB - The contracted segment of terminal large intestine in both Hirschsprung's disease in humans and in the piebald-lethal strain of mice with congenital megacolon may result from muscarinic cholinergic receptor denervation supersensitivity. This hypothesis was tested by direct binding studies using the muscarinic receptor ligand, tritiated quinuclidinyl benzilate. There were no differences in either the receptor density, dissociation constant, or agonist/antagonist Hill coefficients in the proximal, middle, or distal colon of mice with congenital megacolon as compared with normal littermates. These data do not support the concept of denervation supersensitivity. The data support the suggestion that absence of the inhibitory neurons of the enteric nervous system accounts for the hyperexcitability of the musculature of the aganglionic terminal segment and the obstructive constriction of the segment. PMID- 6862159 TI - Natural history of benign esophageal stricture treated by dilatation. AB - Although bougienage is widely used to treat benign esophageal stricture, the rate of stricture recurrence and the long-term effectiveness of bougienage are unknown. We studied the natural history of esophageal stricture in 154 patients in whom bougienage was used as primary therapy. Dilatations were considered successful in terms of relief or major improvement of dysphagia in 84.5% of 103 patients followed 6 mo or longer (median, 26 mo). The risk of requiring esophageal dilatation after the initial episode was greatest in the first year of follow-up; thereafter, a smaller fraction of patients required dilatation each year. Forty-three percent of patients required no further dilatations, and a life table analysis showed that 36% of patients would require no further dilatation during a projected 4-yr follow-up. The median frequency of subsequent dilatation was less than once a year. We were unable to identify any significant factors, such as initial severity of stricture, cause of stricture, presence of active esophagitis, or initial caliber of dilatation, that could predict the need for subsequent dilatation. Our results suggest that patients with benign strictures fall into two groups. In one group, the natural history was to improve or become asymptomatic after an initial series of dilatations, and only a small proportion eventually developed recurrent symptoms. The second group (46% of patients) required further dilatations to treat dysphagia during the first year of follow up. Two-thirds of these patients needed regular dilatations in subsequent years. We conclude that bougienage is effective treatment for benign esophageal strictures, and should be utilized as primary therapy for most strictures. PMID- 6862160 TI - Chronic mild restraint protects the rat gastric mucosa from injury by ethanol or cold restraint. AB - The effects of chronic mild restraint on the susceptibility of the rat gastric mucosa to ethanol or cold-restraint injury were studied. Gastric mucosas of animals subjected to chronic mild restraint exhibited less damage when bathed with 40% ethanol than those of control animals. This reduced damage was observed with 2 days of mild restraint and was maximal (93% less damage; p less than 0.0005) when the animal was mildly restrained for 10 days. Pretreatment with indomethacin abolished the protection afforded by chronic mild restraint, suggesting a mechanism involving endogenous prostaglandin synthesis. Chronic mild restraint significantly (p less than 0.05) reduced the injury to the gastric mucosa caused by cold-restraint stress. This model of mild restraint may prove useful in future studies on the mechanism of stress-induced and other gastric mucosal lesions. PMID- 6862161 TI - Manometric findings during spontaneous chest pain in patients with presumed esophageal "spasms". AB - Nine patients with intermittent chest pain thought clinically to be secondary to esophageal "spasms" developed typical pain while being studied with an intraluminal transducer probe placed in the distal esophagus. Manometric changes from control periods were examined preceding and during pain episodes. No significant difference in distal esophageal wave duration or amplitude or in frequency of abnormal peristalsis was observed preceding or during pain episodes when compared with nonpain periods over a mean monitoring time of 227 min. No change from the nonpain periods in esophageal baseline pressure occurred during pain episodes, nor was there any other obvious manometric change by gross inspection of the tracings. We conclude that patients clinically suspected of having esophageal "spasms" as the source of chest pain frequently do not, regardless of the presence or absence of motility abnormalities on conventional esophageal manometric studies. PMID- 6862162 TI - Tubulointerstitial nephropathy associated with arteriohepatic dysplasia. AB - An infant with a variant of arteriohepatic dysplasia (characteristic facies, valvular and peripheral pulmonic stenosis, hypercholesterolemia, intrahepatic cholestasis) and a severe tubulointerstitial nephropathy is described. Liver biopsy at 2 mo and at 10 mo of age revealed marked hepatocellular cholestasis and a slight decrease in the number of interlobular bile ducts per portal triad. Severe fibrosis was noted at 10 mo. Renal findings included tubular atrophy, microcystic tubular dilatation, and interstitial fibrosis. Death at 10 mo was associated with renal failure and pneumonia. The case suggests an additional association between renal cystic disease and abnormalities of the biliary tree. PMID- 6862163 TI - Dimensions of gastroduodenal surface pH gradients exceed those of adherent mucus gel layers. PMID- 6862164 TI - And now pathophysiology of M cells--good news and bad news from Peyer's patches. PMID- 6862165 TI - Upper esophageal sphincter: does it care about reflux? PMID- 6862166 TI - Prolactin--thyroid interaction in Fundulus heteroclitus. AB - Injections of adult Fundulus heteroclitus with 0.2 IU of oTSH over 4 days caused an increase in serum T4, with no effect on serum T3. Administration of 12 IU of oPRL in conjunction with the same dosage of TSH prevented the TSH-induced rise in T4, without affecting serum T3 levels. The failure of TSH to cause T4 levels to rise in the presence of PRL may result from either inhibition of release or acceleration of metabolic clearance of T4. We therefore conducted three experiments to examine potential effects of PRL on the kinetics of peripheral clearance of thyroid hormones. 125I T4 was cleared from serum in a biphasic pattern that was unaltered by PRL. Clearance of labeled T3 followed a similar pattern that was also not influenced by PRL treatment. Generation of labeled T3 by deiodination of a dose of 125I T4 was quantified over a 24-h period. Again, PRL-treated fish showed no significant differences. Since PRL is without effects on thyroid hormone clearance patterns or deiodination rate, we conclude that PRL prevents TSH-induced increases in serum T4 in this species by directly affecting thyroid function. PMID- 6862167 TI - Histochemical distribution of peroxidase in ascidians with special reference to the endostyle and the branchial sac. AB - The histochemical distribution of peroxidase was studied in 10 species of ascidians. In the endostyle, strong peroxidase activity was found in zone 7 in Ciona intestinalis, Ascidia zara, Ascidia sydneiensis samea, Cnemidocarpa areolata, Styela clava, and Pyrura vittata. The activity in zone 7 was weak in Styela plicata and Halocynthia hilgendorfi. Pyura michaelseni and Halocynthia roretzi showed only faint activity in zone 7, but showed strong activity in zone 9 and in the transitional zone, respectively. Pyura vittata exhibited peroxidase activity in zone 5 as well as in zone 7. Zone 8 was negative for peroxidase, but the cilia of zone 8 cells were distinctly stained for peroxidase in Ciona intestinalis and Cnemidocarpa areolata. These results show that wide species differences exist in the distribution of peroxidase in the ascidian endostyle. Peroxidase activity was also detected in the branchial sac, although here again wide species differences were noted in terms of peroxidase-positive sites. Peroxidase activity was also found in the postpharyngeal alimentary canal, but not in the tunic. PMID- 6862168 TI - Histochemical distribution of peroxidase in amphioxus and cyclostomes with special reference to the endostyle. AB - The histochemical distribution of peroxidase was studied in amphioxus, ammocoetes larvae, adult lampreys, and hagfish. The endostyle of amphioxus displayed peroxidase activity in zone 5 and, in some individuals, in zone 1 as well. The endostyle of ammocoetes exhibited strong peroxidase activity in type 2c and type 3 cells. These peroxidase-positive regions coincide well with radioiodine-binding regions previously described. Thyroid follicles of adult lampreys stained strongly for peroxidase, but those of the hagfish did not. The branchial sac of amphioxus showed peroxidase activity, but the gill sac of cyclostomes did not. The intestine did not show peroxidase activity in amphioxus or in cyclostomes. PMID- 6862169 TI - Seasonal variations in circulating thyroxine and triiodothyronine concentrations in spotted munia Lonchura punctulata. PMID- 6862170 TI - Circannual and circadian variations in plasma levels of steroids (cortisol, estradiol-17 beta, estrone, and testosterone) correlated with the annual gonadal cycle in the catfish, Heteropneustes fossilis (Bloch). AB - Circannual and circadian variations in plasma levels of steroids were estimated by radioimmunoassay in the female and male catfish, Heteropneustes fossilis, over two consecutive annual reproductive cycles. In the female catfish, testosterone (T), estradiol-17 beta (E2), and estrone (E1) were detectable in the plasma only during the reproductively active (preparatory through spawning) period and their levels increased during vitellogenesis. In the fully gravid catfish, when vitellogenesis was nearly complete, levels of E2 declined but those of T continued to increase suggesting a product-precursor relationship between the two steroids. Plasma cortisol (F) was detectable throughout the year and exhibited three peaks coinciding with summer, monsoon, and winter; the first and second peaks coincided with vitellogenesis and spawning, respectively. In the male catfish, changes in plasma T and F levels closely paralleled the seasonal recrudescence and activity of testes and seminal vesicles. After spawning, gonads regressed and levels of sex steroids declined sharply. In the absence of natural spawning due to scanty monsoon rains, as during the second year of this study, gonadal regression was delayed and the sex steroids persisted in the plasma well beyond the normal spawning season. In addition, the first two peaks of F levels merged to form a plateau extending from the preparatory period until the late spawning period. The three sex steroids (T, E2, and E1) exhibited identical circadian rhythms; a major peak occurred at the onset of the dark phase (20:00 hr) and a minor peak was generally observed 4 hr after the onset of the light phase (12:00 hr). The amplitude of rhythms was greatest during the prespawning and the spawning periods. Cortisol peak levels generally alternated with those of sex steroids. Steroid rhythms show rather precise correlations with environmental factors such as photoperiod, temperature, and rainfall as well as with seasonal reproductive activity in both sexes of catfish. PMID- 6862171 TI - Functional development of the hypothalamic-adenohypophyseal-testicular (HAT) axis in the chick embryo. AB - Plasma testosterone concentrations in intact and surgically partially decapitated (hypothalamo-hypophyseoprivic) chick embryos were determined by radioimmunoassay for the incubation interval, Days 7.5-17.5. "Hypophysectomy" of male chick embryos at 33-38 hr of incubation resulted in plasma testosterone levels which were significantly lower than those of intact embryos on Days 13.5, 15.5, and 17.5. The addition of luteinizing hormone (LH) to the chorioallantoic membrane (CAM) of decapitated embryos increased plasma testosterone concentrations to normal levels by Day 13.5, while LH and pituitary transplants to the CAM elevated plasma testosterone to above normal values by Day 15.5. These observations, together with other findings, are interpreted as demonstrating that in the chick embryo the adenohypophyseal-testicular axis is functional by Day 13.5 of incubation. There are also indications that the hypothalamic-adenohypophyseal testicular complex is functional at this same embryonic time. PMID- 6862172 TI - Radioimmunoassay of arginine vasotocin and mesotocin in serum of the frog Rana ridibunda. PMID- 6862173 TI - Immunocytochemistry of gonadotropic cells in the pituitary of some teleost species. AB - An antiserum (anti-sGTH) raised against salmon gonadotropin (SG-G100) was tested on pituitary sections of Sarotherodon mossambicus, Carassius auratus, Anguilla anguilla (intact and estradiol-treated to induce the development of the gonadotropic (GTH) cells), Salmo trutta fario, and a protandric marine teleost (Sarpa salpa, Sparidae). Using an immunoenzymologic technique, anti-sGTH stained GTH and thyrotropic (TSH) cells in the species studied. Anti-sGTH stained the granulated GTH cells in S. trutta fario and S. salpa; the vacuolated cells remained faintly stained or unlabeled in most cases. The results are discussed in the light of cytological, ultrastructural, and biochemical data which suggest that two forms of GTH cells may be present in some teleost pituitaries. PMID- 6862174 TI - Morphological observations on the parathyroid of the opossum (Didelphis virginiana). AB - Parathyroid III of the opossum, Didelphis virginiana, lies on the medial surface of the internal carotid artery at its origin just above the bifurcation of the common carotid artery. It is limited externally by a capsule and is subdivided into lobule-like structures by connective tissue septae. The parenchyma consists solely of chief (principal) cells, arranged in irregular cords and clumps supported by a delicate vascular connective tissue. Ultrastructurally, the chief cells are polyhedral in shape and have centrally placed nuclei. The cytoplasm contains small, randomly distributed, rod-shaped mitochondria, scattered profiles of granular endoplasmic reticulum, free ribosomes, and small perinuclear Golgi complexes. Secretory granules are small, electron-dense, and appear to be limited by a delicate membrane. The granules are related both to the Golgi complex and the basal cell membrane. Capillaries that lie immediately adjacent to the chief cells show an extensively fenestrated endothelium. PMID- 6862175 TI - Immunocytochemical identification of the prolactin-secreting cells in the teleost pituitary with an antiserum to chum salmon prolactin. AB - An antiserum raised to highly purified chum salmon (Oncorhynchus keta) prolactin (sPRL) was used to identify prolactin-producing cells in the adenohypophysis of 15 species of teleosts by the immunocytochemical peroxidase-antiperoxidase method. In the chum salmon, the only pituitary cells that reacted with sPRL antibody were the PRL cells organized as follicular structures in the rostral pars distalis. When the antiserum was absorbed with sPRL, on the other hand, no immunoreactive cell was observed in the pituitary, indicating the specificity of the antiserum. Furthermore, the antibody to sPRL reacted only with PRL cells in the pituitaries of three species of salmonids, a plecoglossid, eel, carp, goldfish, killifish, tilapia, and five species of marine fishes, thus showing no species specificity of the antibody among the teleosts tested. The PRL cells of the eel decreased in number and also in immunoreactivity after adaptation to seawater for 1 month. On the other hand, highly immunoreactive PRL cells were observed in the pituitaries of marine fishes, although the cells were much fewer in number than in eels and in other fishes in fresh water. PMID- 6862176 TI - Corticosteroid receptors in the kidney of chick embryo. I. Nature and properties of corticosterone receptor. AB - Cytosol from kidney of chick embryo (age 16-18 days) contained a corticosterone binding site with the features of a putative receptor. This receptor was a thermolabile protein, readily digested by proteolytic enzymes, with a sedimentation coefficient of 7-8 S and with an apparent molecular weight greater than 100,000. Simultaneous studies with transcortin (CBG) revealed several differences between the renal- and serum-binding protein pertaining to the effect of temperature, the sedimentation coefficient, the charcoal "stripping" and, finally, the binding and competition of various steroids for the two proteins. Kinetic analysis showed a rapid association (10 min), which followed second-order reaction kinetics, and a dissociation of pseudo-first-order reaction kinetics with a t1/2 of 168 min at 0 degrees. The analysis of the Scatchard plot showed the presence of a single class of binding sites with an association constant (KA) of 1.3 X 10(8)M-1 and a binding capacity (nmax) of 500-700 fmol/mg protein. We obtained similar results when we used dexamethasone as a ligand. The association (ka) and dissociation (kd) rate constants were respectively 2.9 X 10(6)M-1 sec-1 and 6.86 X 10(-5) sec-1. From their ratio a KA value of 4.2 X 10(10) M-1 was obtained. Studies with various steroids demonstrated that only dexamethasone and, to a lesser degree, progesterone competed for the binding site. These data showed that the kidney of chick embryo possessed one type of receptor for the glucocorticoids, which was similar to the type II described in rat kidney. PMID- 6862177 TI - Corticosteroid receptors in the kidney of chick embryo. II. Ontogeny of corticosterone receptor and cellular development. AB - In this study the ontogeny of cytosol receptors for corticosterone in the chick embryo kidney was examined and then this ontogenic profile was compared with that of an index of cellular development, i.e., the enzyme ornithine decarboxylase (ODC). The corticosterone receptor concentration (nmax) increased by sevenfold from Day 12 to Day 15 of embryogenesis and then declined to its lowest level by the time of hatching (Day 21). Similar results were obtained when dexamethasone was used as ligand, except that the baseline values at Day 9 and 21 were higher than those found with corticosterone. An identical ontogenic profile was obtained when the results were corrected for the endogenous glucocorticoids present in the cytosol. This increase of the corticosterone receptor occurred simultaneously with the enhanced adrenal corticoid synthesis. The ODC also showed a marked increase and a rapid fall during chick embryogenesis, but the enzyme activity was at its maximum when the corticosterone receptor number was still low (Days 12 and 13) and quickly decreased by the time the receptors had reached their highest levels (Days 14 and 15). The lowest level of ODC was observed immediately before hatching. These results indicate that during chick embryogenesis adrenal corticoids may induce the development of the corticosteroid receptor and that such development may cause a suppression of ODC activity. This suppressive effect of glucocorticoids could represent a mechanism of hormonal action on the kidney. PMID- 6862178 TI - Seasonal variations of serotonin content in the pineal complex and the lateral eye of Lampetra planeri (cyclostoma, petromyzontidae). AB - Serotonin concentrations were measured by spectrofluorimetry in the pineal complex and the lateral eyes of Lampetra planeri, living in a natural environment, throughout two consecutive years. Large seasonal fluctuations with bimodal annual patterns of variations were observed in both the pineal complex and the lateral eyes. In the pineal complex, peak values occurred in February and August and low values in April and November. In the lateral eyes, peak values occurred in March and September. Comparison of the serotonin concentrations between the pineal complex and the lateral eyes showed that in ammocoetes the serotonin concentrations were similar in these organs, while in metamorphosing forms and adults the serotonin concentrations were significantly higher in the lateral eyes. The physiological significance of the seasonal variations of serotonin observed in both the pineal organ and the lateral eyes and the importance of environmental factors in their control remain to be determined and need further investigations. PMID- 6862180 TI - The development and integration of fine motor sequences in 12- to 18-month-old children: a test of the modular theory of motor skill acquisition. AB - According to the modular model, skill development proceeds through the development of stable units of action called subroutines. The development of these programmed units frees the child to attend to those parts of the action not yet mastered. Once consolidated they can be applied to many different contexts. Thus, complex skill sequences can be produced. The theory generates several predictions, most fundamental being an association between increasing proficiency and increasing consistency. Experiment 1 was a longitudinal study in which six 12 month-old children were observed over a period of eight months. Various manipulative tasks were used, notably the placement of rods in corresponding holes. Experiment 2 was a cross-sectional study of performance consistency in rod placement (N = 30). Results showed that consistency decreases as proficiency increases. It is concluded therefore that the programmed components of complex actions are not characterized by the invariance predicted by modular theory. PMID- 6862179 TI - An endocrine and histophysiological study of the testicular annual cycle in the hedgehog (Erinaceus europaeus L.). AB - The histophysiology of the testis was studied all year round in adult male hedgehogs living in middle-western France. Variations in Leydig and Sertoli cell populations were correlated to plasma testosterone levels and compared to variations in seminiferous tubule diameter and germ cell production. During the last part of the hibernating period, in winter, Leydig cell parameters and plasma testosterone levels increased and reached maximum values in February, 1 month before the maximum development of seminiferous epithelium. The numerous large sized Leydig cells in spring and summer corresponded to the maximum levels of plasma testosterone and maximum development of seminiferous tubules, spermatogenesis, and Sertoli cells. Regression occurred in August for Leydig cells and plasma testosterone levels, in September for seminiferous tubules and spermatogenesis. All the gonadal functions remained depressed from September to November. The relative frequency of the stages and duration of the seminiferous epithelium cycle were also studied. The same duration (10 days) was observed in hibernating animals in winter and active animals in spring. PMID- 6862181 TI - Effect of dietary aflatoxin concentration on the assessment of genetic variability of response in a randombred population of chickens. AB - The effect of graded levels of dietary aflatoxin on the assessment of genetic variability of body weight and gain and plasma protein response was tested utilizing the Athens-Canadian randombred population of chickens. Dietary aflatoxin was administered at levels of either 0, 1.25, 2.50 or 5.0 microg/g of diet ad libitum from 7 to 21 days of age to progeny from 58 sire families. Twenty one-day body weights, gain and plasma protein concentration were used to assess the variation in response.-The administration of increasing levels of aflatoxin resulted in a dose-related decrease of gains and plasma protein concentrations. Plasma protein concentrations were significantly higher among males than females within the control group; however, this difference was reversed as the severity of the aflatoxin challenge increased. Heritability estimates for all responses increased as the level of aflatoxin administered increased. This change was most notable for total plasma protein concentration. Phenotypic correlations for plasma protein concentration and growth measurements tended to diminish with increasing levels of aflatoxin. A similar trend was noted for the genetic correlations; however, a moderate correlation between growth responses and plasma protein response was detected in the 5.0-microg/g aflatoxin treatment group. Genetic correlations were calculated for the same characters between the different levels of aflatoxin. Regardless of which aflatoxin challenges were compared, a very high genetic correlation for 21-day body weight and 7- to 21-day gain was estimated. This variation in growth potential in the toxic environment paralleled that observed in the control environment but at a lower plane. Genetic correlations for plasma protein response across aflatoxin levels diminished as the difference between the levels of aflatoxin administered increased. Plasma protein concentration in the control environment was positively correlated with plasma protein response in groups fed a low level of aflatoxin, but negatively correlated when an aflatoxin challenge of 2.5 microg/g or more was given, suggesting that selection for aflatoxin resistance using plasma protein response as a selection criterion should be made under an aflatoxin stress environment. PMID- 6862184 TI - Abstracts of papers presented at the 1983 meeting of the Genetics Society of America. St. Louis, Missouri, June 12-16, 1983. PMID- 6862182 TI - Multiple-locus departures from panmictic equilibrium within and between village gene pools of Amerindian tribes at different stages of agglomeration. AB - A comparative analysis of departures from multiple-locus Hardy-Weinberg equilibrium is presented for a set of four tribal Indian groups (the Yanomama, Makiritare, Wapishana and Ticuna) from the lowlands of South America. These tribes span a range of agglomeration and acculturation from the most traditional, swidden horticulturalists to frontier townspeople. The small-group social organization typical of traditional horticulturalists leads to substantial departures from tribal panmixia, as manifested by the distribution of multiple locus genotypes both within and between villages. Within villages, the departures from single-locus Hardy-Weinberg equilibrium are small and nonsignificant, but the departures from gametic equilibrium (independence of loci) are substantial, even for the unlinked loci we have used to characterize these populations. The departures from single-locus homogeneity across villages are also substantial. One of the normal concomitants of increasing acculturation in this setting is an increase in agglomeration. As agglomeration increases, the departures from multiple-locus panmixia decrease, a process that can be very rapid. We discuss both the shifting balance theory of evolution and punctuated evolutionary rates in light of the small group social organization that must have obtained throughout most of human evolution. PMID- 6862183 TI - Should individual fitness increase with heterozygosity? AB - Natural selection influences not only gamete frequencies in populations but also the multilocus fitness structures associated with segregating gametes. In particular, only certain patterns of multilocus fitnesses are consistent with the maintenance of stable multilocus polymorphisms. This paper offers support for the proposition that, at stable, viability-maintained, multilocus polymorphisms, the fitness of a genotype tends to increase with the number of heterozygous loci it contains. Average fitness always increases with heterozygosity at stable product equilibria (i.e., those without linkage disequilibrium) maintained by either additive or multiplicative fitness schemes. Simulations suggest that it "generally" increases for arbitrary fitness schemes. The empirical literature correlating allozyme heterozygosity with fitness-correlated traits is discussed in the light of these and other theoretical results. PMID- 6862185 TI - Genetic variation of wild mouse populations in southern Germany. I. Cytogenetic study. PMID- 6862186 TI - Genetic variation of wild mouse populations in southern Germany. II. Serological study. PMID- 6862187 TI - The unreliability of subjective probe estimates of cyclofusional vergence performance. PMID- 6862188 TI - Recent developments in eye fundus imaging for clinical application: television fluoroangiography and new technologies. PMID- 6862189 TI - The EOG in unilateral eye disease: injuries. AB - In unilateral injuries, the tap to the eye by a penetrating foreign body is sufficient to depress the electro-oculogram (EOG). Total recovery is time consuming. During the recovery period, complications such as siderosis and detachment may arise, acting with predilection on the light-sensitive EOG component. Blunt traumata and possibly surgical opening of the eyeball predominantly decrease the light-insensitive component of the EOG. PMID- 6862190 TI - Rheologic findings in patients with acute central retinal artery occlusion. AB - The most important rheologic parameters were examined in six patients with acute occlusion of the central retinal artery. Blood samples were taken as part of the initial clinical examination on the day of the occlusion before the onset of therapy, and the following parameters were studied: (1) yield shear stress; (2) hematocrit; (3) plasma viscosity; (4) extent of erythrocyte aggregation; (5) erythrocyte deformability; (6) plasma fibrinogen concentration. A definite shear stress could be measured in all patients, something not possible in rheologically healthy volunteers. Hematocrit values were in the upper normal range; plasma viscosity was significantly increased. The extent of erythrocyte aggregation was greater than normal, erythrocyte deformability was markedly reduced, and the plasma fibrinogen was markedly higher than the normal level. Aside from the well known pathologic findings in the carotid arteries of many patients with acute retinal vascular occlusion, rheologic factors seem to be of great importance in this disease. PMID- 6862191 TI - Changes in alkaline and acid phosphatases of the rabbit cornea following experimental exposure to ethanol and acetone: a biochemical and histochemical study. AB - Alkaline and acid phosphatases were studied in the rabbit cornea following acetone and ethanol exposure to the eye. Changes in enzyme activities were investigated in homogenates of epithelium and stroma quantitatively and in frozen cryostat sections on days 1, 4, 7, 14, and 28. Biochemical and histochemical findings showed a remarkable increase in alkaline phosphatase of the epithelium beginning on day 7. This activation persisted until day 28 after instillation of both noxae with maximum activity on day 14. However, acetone was proved to be significantly more effective than ethanol. In addition, a different topochemistry of alkaline phosphatase was found in the epithelium of treated corneas, i.e., enzyme activity was observed not only superficially but in all epithelial layers of the cornea as compared to a normal one. The effect of acetone and ethanol on a regenerating corneal epithelium is discussed. PMID- 6862192 TI - [Nonspecific manifestations of inhalation exposure to magnesium oxide]. PMID- 6862194 TI - [The food program and the tasks of nutritional hygienists in the Ukraine]. PMID- 6862195 TI - [Bactericidal action of UV radiation on bacterial flora of the air in animal breeding quarters]. PMID- 6862193 TI - [Mutagenic activity of the combined action of the herbicides 2,4-D and 2,4,5-T]. PMID- 6862196 TI - [Joint work of the Moscow Erisman Research Institute of Hygiene with practical public health organs]. PMID- 6862197 TI - [Results of research on child and adolescent hygiene]. PMID- 6862200 TI - [Research on child and adolescent hygiene today]. PMID- 6862198 TI - [Experience in improving the organization of forms of health inspection]. PMID- 6862199 TI - [Method of processing data characterizing the sanitary status of water resources]. PMID- 6862201 TI - [Gas chromatographic determination of organic acids in the atmosphere]. PMID- 6862202 TI - [Photometric method of determining diphenyl(2-ethylhexyl) phosphate in the air]. PMID- 6862203 TI - [Combined action of hydrogen fluoride and sulfurous anhydride on the body of white rats]. PMID- 6862204 TI - [Method of recording the orientation and exploratory behavior of laboratory animals]. PMID- 6862205 TI - [Method of determining cobalt in biological substrates]. PMID- 6862207 TI - [Determination of the quantitative interrelations between the degree of atmospheric pollution and the health status of the population]. PMID- 6862206 TI - [Determination of nitrapyrin and its metabolite 6-chloropicolinic acid in the environment]. PMID- 6862208 TI - [Effect of hydrogen sulfide on the determination of phenol in the air]. PMID- 6862209 TI - [Data on establishing the maximum permissible concentrations of chloronitro- derivatives of benzoic acid in reservoir water]. PMID- 6862210 TI - [Establishment of the maximum permissible concentration of ethyl acetate in reservoir water]. PMID- 6862211 TI - [Data on the hygienic standard for magnesium chlorate in reservoir water]. PMID- 6862212 TI - [Effect of industrial-frequency electrical fields on the reproductive function of animals]. PMID- 6862213 TI - [Characteristics of the combined action on the body, of powder metals via inhalation uptake]. PMID- 6862214 TI - [Biological action of propionaldehyde and propionic acid on the body of experimental animals]. PMID- 6862215 TI - [Effect of chlorinated paratertiary butyltoluenes on kidney function]. PMID- 6862216 TI - [Hygienic standards for lighting for pupils in water color and drawing classes]. PMID- 6862217 TI - [Hygienic regulation of viral contamination of the environment]. PMID- 6862219 TI - Unstarted projects, unused paragraphs, and unfinished business. PMID- 6862218 TI - The Federal Council on Aging: new priorities. PMID- 6862220 TI - A peer educator approach to nutrition for the elderly. PMID- 6862221 TI - A management tool for evaluating the adequacy and quality of homemaker-home health aide programs. PMID- 6862222 TI - The Donald P. Kent memorial lecture. The aged as scapegoat. PMID- 6862223 TI - Frailty and strength: the dialectic in aging. PMID- 6862224 TI - Transportation for the elderly: Sec. 16(b)(2) in Massachusetts. PMID- 6862225 TI - Intergenerational financial support: retirement-age males, 1971-1975. PMID- 6862226 TI - Intergenerational relations and testamentary patterns: an exploration. PMID- 6862227 TI - The art of matchmaking: a case study in shared housing. PMID- 6862228 TI - Community services in small rural towns: patterns of use by older residents. PMID- 6862230 TI - The graying of the college classroom. PMID- 6862229 TI - Students as resources to the aging network. PMID- 6862232 TI - Crime and the elderly: the relationship between risk and fear. PMID- 6862231 TI - Predicting the outcomes of nursing home patients. PMID- 6862233 TI - [Work capacity and its improvement]. PMID- 6862234 TI - [Hygieno-physiological evaluation of major ergonomic characteristics of metal cutting machines]. PMID- 6862235 TI - [Hygienic evaluation of work conditions, health of parquet floor layers, and health-promoting measures]. PMID- 6862236 TI - [Benz(a)pyrene content in Soviet and Bulgarian anthophyllites]. PMID- 6862237 TI - [Functional state of the body and various specific functions in women engaged in construction work in hot climate]. PMID- 6862238 TI - [Prevention of environmental pollution with carcinogenic hydrocarbons during preparation of steel-pouring ingot molds]. PMID- 6862239 TI - [Effects of methylmethacrylate and vinyl chloride on the somatotropic function of the pituitary gland]. PMID- 6862240 TI - [Working conditions and various physiological parameters of workers in factories producing malt hops]. PMID- 6862241 TI - [Physiological functions in female workers engaged in work involving eyestrain and low motor activity]. PMID- 6862242 TI - [Approaches to the prevention of the local cooling of fish processors in ships]. PMID- 6862243 TI - [Optimization of the work of overhead electric crane operators in pellet calcination shops]. PMID- 6862244 TI - [Training of humans under hyperbaric conditions]. PMID- 6862245 TI - [Changes in various indices of the nervous system in workers exposed to phthalate plasticizers]. PMID- 6862246 TI - [Hygienic standards for carbocromen aerosol in the air of the workplace]. PMID- 6862247 TI - [Environmental monotony as a factor of the workplace in automated industrial facilities]. PMID- 6862248 TI - [Morphological changes in the organs of animals subjected to inhalation exposure to acrylonitrile]. PMID- 6862249 TI - [Physiological evaluation of the orthostatic factor in the weavers' trade]. PMID- 6862252 TI - [Echocardiographic evaluation of hemodynamics in tocolysis treated with Partusisten]. PMID- 6862250 TI - [Copper level of the erythrocytes during physiological pregnancy and in pregnancy complicated by EPH gestosis]. PMID- 6862251 TI - [Effect of the use of Partusisten in threatened premature labor after outflow of amniotic fluid depending on the method of administration]. PMID- 6862255 TI - [Socio-medical aspects of premature labor. IV. Premature labor in relation to the occupational problems of women]. PMID- 6862254 TI - [Additional gynecological operations performed during appendectomy]. PMID- 6862253 TI - [Habitual abortion in the light of cytogenetic studies]. PMID- 6862256 TI - [Removal of uterine adhesions with the use of the hysteroscope (description of 2 cases)]. PMID- 6862257 TI - [Reconstruction of the vagina with the pedicled flap from the bladder]. PMID- 6862258 TI - [Local immunologic secretory system in the female genital organs]. PMID- 6862259 TI - Height, body composition, biological maturation and training in relation to socio economic status in girl gymnasts, swimmers, and controls. AB - This study examined the height, body composition, prevalence of obesity, biological maturation and training in relation to socio-economic status of 78 female gymnasts (age 138 +/- 18 months), 52 girl swimmers (age 134 +/- 24 months) and 116 control girls (age 131 +/- 21 months). The female gymnasts are shorter and lighter than girl swimmers. They are also shorter than control girls comparing the growth percentiles. The weight to height ratio (w/h) and the Quetelet index are the same for the groups. The female gymnasts have less fat, and a later biological maturation than girl swimmers and controls. The socio economic status of girl swimmers is lower than that of the control group. Nevertheless the girl swimmers are taller and they have the same biological maturation as the controls. The girl swimmers are even more matured than the gymnasts. The gymnasts have the same socio-economic status as the controls, but they are shorter and less matured. Therefore, in the investigated groups no positive relationship between height and socio-economic status exists. Nor is a low socio-economic status accompanied by a late biological maturation or a higher prevalence of obesity. Training did not correlate with socio-economic status in gymnasts or controls, only in the swimming group a weak correlation was found. PMID- 6862260 TI - The effect of neonatal head-irradiation and subsequent fasting on the mechanisms of catch-up growth. AB - The heads of 2 day old male and female rats were X-irradiated with 600 rad. Non irradiated littermates served as controls. At 40 days of age groups of irradiated and non-irradiated rats were subjected to a 48 hour fast. Non-fasted groups of irradiated and non-irradiated rats were fed ad lib. and were used for comparative studies. Growth of body weight and tail length was recorded at intervals through 70 days of age. At sacrifice, pituitary weight, tibial length, and tibial epiphyseal width were also determined. The results confirm earlier findings that whole head irradiation produces reduced growth of body weight and of tail length which remains uncompensated by catch-up growth. After fasting and then refeeding normal catch-up growth acceleration occurred in both male and female irradiated and nonirradiated animals. The fasted non-irradiated animals caught up to the non irradiated control rat size for both body weight and tail length. Similarly, the fasted irradiated rats caught up to the irradiated, non-fasted rat size, but did not catch up to the size of the non-irradiated controls. Pituitary weight and tibial length were significantly reduced in irradiated males and females. At sacrifice, no significant difference existed between the fasted and non-fasted subgroups. The tibial epiphyseal growth plate was not narrowed in irradiated rats; fasted rats had increased epiphyseal width during recovery in only one group. We conclude that the catch-up growth control is intact in the head irradiated stunted rat. The findings suggest that the mechanism which recognizes normal body size (set-point for body size) and which determines the limit of catch-up growth acceleration is reset for a smaller body size by the head irradiation. PMID- 6862261 TI - Correlation among growth rate and organ weights of rats fed on diets containing Vicia faba L. or casein as sources of protein at different levels. AB - A significant impairment in the rate of growth, food efficiency and daily gain along with a decrease in the weight of skeletal muscle, carcass, viscera and liver was found in rats fed for a period of seven weeks on raw legume Vicia faba L. at different levels with respect to the controls on casein. Correlations between body weight and the weights of the structures were studied. PMID- 6862262 TI - Effects of preweaning and postweaning feed restriction on the development of polygenic obese mice. AB - Polygenic obese (M16) and control (ICR) mice were raised in litters of 8 (N8) or preweaning restricted in litters of 14 (N14). Mice were fed either ad libitum or postweaning restricted by automatic feeders from 4 to 10 weeks of age. All mice were fed ad libitum from 10 to 16 weeks. Preweaning restriction (N14) resulted in mice at 4 weeks with smaller body weights, fat percent, subcutaneous fat depot and adipocyte diameter than N8 mice. Most of the effects of preweaning restriction were overcome by 10 weeks. Obese mice, at 10 and 16 weeks, were heavier and had higher fat percent and larger fat depots with more and larger adipocytes than control mice. Postweaning restriction resulted in mice at 10 weeks with smaller body weight but greater fat percent, especially in the control line. Postweaning restriction of obese mice resulted in a higher percent of fat at 16 weeks. The change in eating pattern, stress or other factors associated with postweaning restriction, as imposed in this study, resulted in an altered metabolism that distributed a greater proportion of energy to fat storage than in the ad libitum fed mice. Ultimate body size and adipose tissue characteristics were determined primarily by genotype, whereas most effects of nutritional restriction were temporary. PMID- 6862263 TI - Accurate measurements of the lower leg length and the ulnar length and its application in short term growth measurement. AB - A new method of lower leg measurement for the determination of endochondral growth has been described quite different from the techniques commonly utilized. Endochondral growth of the lower leg can now be detected after one week (in provided case) the growth is at least 0.15 mm. The results of the lower leg measurement were compared with those of the ulnar length measurements in a four months lasting longitudinal growth study on twenty-one normal growing children. It appeared that the new lower leg length measuring technique with a margin of error in hundreds of millimeters is even more sensitive than the ulnar length measuring technique and a substantial improvement to conventional measuring methods in which the error fault is commonly expressed in millimeters. The new technique is especially suited for the assessment of short term growth in children whose ulnar length can not be measured accurately enough. Short term growth can now be followed in children from about the age of two years without using X-rays. This new technique permits: 1. Short term growth studies; 2. Studies of drug effects on tibia in single individuals within short time intervals; 3. Comparison of the growth in length of the lower leg and the ulna within time intervals as short as three weeks. 4. Studies in biorhythms of the lower leg length. PMID- 6862264 TI - Glucocorticoid hormone adversely affects the growth and differentiation of cartilage cells in neonatal mice. AB - Condylar cartilage of neonatal mice served as an experimental model to study the late in vivo effects of a single dose of a fluorinated synthetic analogue of cortisol on cartilage cell growth and development. Forty-eight hours after the administration of triamcinolone hexacetonide, the proliferative rate of chondroprogenitor cells decreased significantly. However, by the 6th day a marked recovery took place when the total number of 3H-thymidine labelled cells increased by 52.9%, and by 13 days hormone-treated condyles revealed an increase of 93.1% in the total number of labelled cells. At the same time, the magnitude of the chondroprogenitor zone increased by 194.4% and it was found to contain a large population of fibroblast-like cells. The latter were found to synthesize type I collagen and fibronectin, lacked any specific organization and occupied larger portions of the condylar head. Twenty days following the administration of the hormone the newly-formed mass of fibroblast-like cells penetrated the underlying cartilage, split it and formed a direct communication with the marrow cavity. Ultrastructural examination further substantiated the fibroblastic nature of the newly-formed cell population. Hence, it seems very possible that if a corticosteroid hormone is administered to newborn animals it possesses the capacity to affect the normal differentiative pathway of pre-chondroblasts and shift their developmental pathway toward the fibroblastic cell line. PMID- 6862265 TI - Crossbreeding channel catfish for improvement of body weight in earthen ponds. AB - Twelve experiments on intraspecific crossbreeding of channel catfish, Ictalurus punctatus, for improvement of body weight are compared and reviewed. Crossbred fingerlings resulting from matings of unrelated F1 crossbred populations did not show heterotic growth. Crossbreds resulting from pure strain P1 showed an average increase of 10.3 percent in growth above the fastest growing parent strain. Marion female X Kansas male, a crossbred from two rapidly growing domestic strains, was the fastest growing to fingerling size. Average increase in body weight (fingerling to harvest size) by crossbreds was 1.5 percent greater than the fastest growing parent strain. Marion X Kansas, Auburn X Kansas, and Auburn X Uvalde were the fastest growing crossbreds to harvest size (8-13 percent increase in growth rate). Six of nine crossbreds made from Pi generations expressed heterosis above both parent strains for body weight. Eight of nine crossbreds grew better than at least one of their parents. Reciprocal crossbreds did not grow at the same rate. Males and females of a specific strain had different combining abilities with other strains. There was a maternal effect for combining ability. All crossbreds made with Auburn females exhibited heterosis. PMID- 6862267 TI - [Initial experience with an operation for pulmonary artery narrowing in young children with patent common atrioventricular canal]. PMID- 6862266 TI - [Fistulae of the coronary arteries from the left ventricle]. PMID- 6862270 TI - [Evaluation of the physical adaptation of patients operated on for "pale"-type congenital heart defects]. PMID- 6862268 TI - [Bacterial endocarditis and bioprosthesis of the heart valves]. PMID- 6862269 TI - [Surgical treatment of patients with rheumatic heart defects complicated by subtotal thrombosis of the left atrium]. PMID- 6862271 TI - [Complications in operations on the major arteries in desmogenesis imperfecta]. PMID- 6862274 TI - [Treatment results in chronic nonspecific pleural empyema in children and adolescents]. PMID- 6862272 TI - [Osmotic balance in heart defect patients operated on under artificial circulation]. PMID- 6862273 TI - [Surgical treatment of pleural empyema in children]. PMID- 6862275 TI - [Effect of aortic catheterization on the regional blood flow in children under treatment for bacterial destructive pneumonias]. PMID- 6862276 TI - [Choice of treatment method in thromboembolism of the trunk and main branches of the pulmonary artery]. PMID- 6862277 TI - [Process of adaptation in the formation of a "small" lung after polysegmental resections and basic principles in its correction]. PMID- 6862278 TI - [Plastic operations on the tracheal bifurcation]. PMID- 6862279 TI - [Surgical procedure in severe and complicated forms of suppurative lung diseases]. PMID- 6862280 TI - [Changes in the hemodynamic indices in surgical interventions on the lungs in children]. PMID- 6862281 TI - [Diagnosis of anomalies of bronchial tree development by a contrast method using tantalum powder]. PMID- 6862282 TI - [Technic of esophagocardiomyotomy in cardiospasm and achalasia of the cardia]. PMID- 6862283 TI - Management of stones in the biliary tree. PMID- 6862284 TI - Serological markers in fulminant hepatitis B. AB - Serological markers for hepatitis B virus infection have been examined in 34 patients with acute hepatitis B, 17 of whom developed fulminant hepatic failure. Hepatitis B surface antigen concentrations were significantly lower and hepatitis Be antigen was less frequently detectable in patients with fulminant hepatic failure compared with those with acute hepatitis (median 0.64 micrograms, range 16-0 and median 32 micrograms and range 100-4 micrograms respectively, p less than 0.001; HBeAg detected in 12% and 88% respectively, p less than 0.001). The IgM component of hepatitis B core antibody was significantly higher in the patients with fulminant hepatic failure with median values of 500 IU/ml compared with those with uncomplicated hepatitis (median 202 IU/ml, p less than 0.05 Wilcoxon's rank test). Three patients who developed a fulminant course had detectable levels of either anti-HBs or anti-HBe. These results are consistent with enhanced antibody responses to all three hepatitis B virus antigens and more rapid clearance of the latter during fulminant hepatic failure. PMID- 6862285 TI - Hepatitis B virus DNA in children's liver diseases: detection by blot hybridisation in liver and serum. AB - Molecular hybridisation using cloned hepatitis B virus DNA (HBV DNA) was applied to liver and serum samples from 46 children (39 with liver diseases and seven controls) for detection of HBV DNA sequences, free and integrated into the liver cell genome. HBV DNA integration was observed in 10 children. The young age of some of these cases indicates that such integration can occur early in liver disease and is not related to the duration of viral infection. Thirteen children exhibited serological evidence of active viral multiplication. All but one had free HBV DNA in liver tissue and integrated HBV DNA sequences were found in four cases. Integrated HBV DNA sequences alone were also detected in three children with neither HBV-antigens nor HBV DNA in serum. One had inactive cirrhosis, and the two others, chronic active hepatitis. Consequently DNA hybridisation may be useful for diagnosis, in the absence of serological signs of HBV infection; its specificity was enhanced in the present investigation by negative results in six children with autoimmune chronic active hepatitis. Taken together, the above results imply that HBV-DNA integration can occur in both active and inactive liver disease. Integrated HBV DNA was also observed in the liver of three children with fatal hepatic failure who presented with antibodies to HBsAg and/or to hepatitis B core antigen in the serum. This finding raises the question of the relationship between the host immune factors and the state of HBV DNA. PMID- 6862289 TI - Estrogen and progesterone receptors in ovarian neoplasms. AB - The cytoplasmic receptors for 17 beta-estradiol (ER) and progesterone (PR) were measured in 39 malignant and 15 benign ovarian neoplasms. All eight endometroid carcinomas had positive ER sites, one-half contained PR. The number of ER binding sites decreased as tumor grade increased. Conversely, none of the 11 mucinous tumors contained either ER or PR receptors. One-half of the well-differentiated serous tumors had ER (57 +/- 23 fmole/mg protein) while none of the poorly differentiated tumors had measurable binding. In serous carcinomas, PR was only detected in well-differentiated lesions (447 +/- 240 fmole/mg protein). Only one of 15 benign neoplasms contained ER and PR receptors. Correlation of tumor grade and type may help to plan hormonal therapies in advanced ovarian malignancies. PMID- 6862288 TI - Single intubation test for investigation of malabsorption and diarrhoea. AB - A one session multipurpose intubation method for the investigation of diarrhoea and malabsorption is described. It enables tests for bacterial colonisation, infestations, and luminal cytology of the small intestine to be combined with a pancreatic exocrine function test and a jejunal biopsy during the same intubation. The technique has proved acceptable, reliable, diagnostically valuable, and convenient for use on outpatients. PMID- 6862290 TI - Steroid-receptor proteins in nonepithelial malignancies of the ovary. AB - Tissue samples from 20 patients with nonepithelial ovarian malignancies were assayed for cytosol estrogen (ERc) and in selected samples progestin-receptor (PRc) proteins. The nine germ cell malignancies assayed were low in ERc. One recurrent granulosa cell tumor had an ERc concentration of 36 fmole/mg cytosol protein (fmole/mg c.p.) while three other stromal tumors were low in ERc. Three of seven mixed mesodermal tumors had a high ERc concentration (34-91 fmole/c.p.). Two primary and one recurrent granulosa cell tumors and one endodermal sinus tumor had borderline to elevated PRc levels (18-254 fmole/c.p.). Four of seven mixed mesodermal tumors had borderline to slightly elevated PRc concentrations (13-22 fmole/c.p.). The low ERc in germ cell malignancies of the ovary is consistent with previous clinical observations that the growth of these tumors is not influenced by removal of the contralateral ovary. The high ERc levels detected in three of seven mixed mesodermal ovarian tumors and one of three granulosa cell tumors suggest that hormone-related therapy should be investigated in the management of patients with these malignancies. PMID- 6862287 TI - Reliability of routine double contrast examination of the large bowel: a prospective study of 2590 patients. AB - A total of 2590 consecutive patients referred for double contrast examination (DCE) of the large bowel were followed up radiographically, clinically, endoscopically, and histopathologically during a four year period. The patients were put into two groups on the basis of the presence or absence of radiographic evidence of colonic disease at the first--that is, index examination. By comparing the findings obtained at the index double contrast examination with those obtained during follow up, the sensitivity, specificity, and accuracy of the index double contrast examination were all calculated at 0.84. The predictive value of a positive report was 0.93 and that of a negative report 0.70. If, however, patients with normal double contrast examinations at the start of this series and not examined further during the follow up period were accepted as free from significant colonic disease, the predictive value of a negative report increased to 0.93. Double contrast examination is thus a reliable method for showing the presence of colonic lesions and therefore considerably helps the management of a given case. PMID- 6862286 TI - Comparison of cholesterol and beta-sitosterol: effects on jejunal fluid secretion induced by oleate, and absorption from mixed micellar solutions. AB - Jejunal fluid secretion induced by perfusion with oleic acid can be reduced by the addition of cholesterol. The present study was performed to test the specificity of this effect by comparing the effects of cholesterol with that of a plant sterol, beta-sitosterol during perfusion of the jejunum in healthy volunteers. In addition, we compared the solubilities of cholesterol and beta sitosterol in micellar solutions and their jejunal absorption rates. One millimolar beta-sitosterol was as effective as 1 mM cholesterol in reducing jejunal fluid secretion induced by 6 mM oleate (n = 7). In mixed micellar solutions consisting of 10 mM taurocholate and 6 mM oleate, solubility of beta sitosterol is about one third of cholesterol solubility. When cholesterol was gradually replaced by beta-sitosterol in the incubation mixture, beta-sitosterol reduced cholesterol solubility to a greater extent than would be expected from an equimolar replacement of cholesterol by beta-sitosterol. Absorption of beta sitosterol was limited by its solubility in mixed micellar solutions and both sterols were absorbed at equal rates as long as their solubility limits were not exceeded (n = 5). PMID- 6862292 TI - Prognostic factors in malignant epithelial ovarian tumors. AB - In a study of 494 patients with ovarian carcinoma all known factors that eventually influence prognosis were tested both separately and comparatively in a multivariate statistical analysis, using survival as the dependent variable. It was found that the histologic grade and the size of the residual tumor after surgery are the most important factors influencing survival. The histologic type affected prognosis only in Stage III patients with large residual tumors. The stage of tumor progression had prognostic value, although Stage IIa was found to have the same survival rate as Stage I of this disease. The state of the tumor capsules in Stage I had no prognostic effect. Ascites only affected survival in Stage III patients who had small or no residual tumor after surgery. Age was found to influence survival only in Stage III patients with small residual tumors, or no residual tumor, and in advanced Stage II cases. Continued chemotherapy seems to be of benefit in Stage III patients with small or no residual tumors following surgery. PMID- 6862291 TI - Laser miniconization in mild and moderate dysplasia of the uterine cervix. AB - Mass cytologic screening for cervical cancer often reveals only mild dysplasia not indicating conization but necessitating continual checkup. Such routine checkups are often insufficient, beside which the patients find them frustrating. Therefore a new method, called miniconization, for treatment of patients with vaginal smears showing mild or moderate dysplasia (cervical intraepithelial neoplasia/CIN/I-II), was developed. With the CO2 laser handpiece a 5-mm-thick disc of the cervix, including the whole transformation zone, was removed. This was followed by endocervical curettage. The advantage of the method over cryosurgery, electrocoagulation, and laser vaporization, for example, is that the tissue specimen as a whole disc including the transformation zone can be sectioned and examined histologically. Another advantage is the decreased risk of postoperative bleeding, which enables ambulant care. One hundred and fifty-one patients have hitherto been treated and carcinoma in situ has been found in 15.2% and microinvasive carcinoma in 1.3% of all these patients in whom vaginal smears showed mild or moderate dysplasia (CIN I-II). PMID- 6862294 TI - Sequential evaluation of general immunocompetence in gynecologic cancer. AB - A sequential evaluation of general immunocompetence was performed in 70 previously untreated patients with gynecologic cancer. Immunologic evaluations were made prior to any therapy and repeated every 3-4 months for 3 years or until patients died of disease. Cell-mediated immunity was investigated by delayed hypersensitivity to intradermal skin test antigens (STA) and by contact sensitization to 2,4-dinitrofluorobenzene (DNFB). Serum immunoglobulin determinations were performed to evaluate humoral immunity. Compared with age matched controls, there was impairment of cell-mediated response to both STA and DNFB in patients with locally invasive and disseminated cancer but not in those with preinvasive cancer. There was a progressively impaired reactivity with clinical progression of disease independently of histological type of neoplasm. Sequential evaluations revealed that variations in immune reactivity occurred that also correlated with the patient's clinical course. Significant changes in immunoglobulin levels, an increase in IgG and IgA, and a decrease in IgM, were observed in the cancer groups as compared with age-matched healthy female controls. However, neither initial values nor sequential determinations of immunoglobulins were related to the clinical course of gynecologic cancer. PMID- 6862293 TI - Phase II trial of galactitol 1,2:5,6-dianhydro (NSC 132313) in the treatment of advanced gynecologic malignancies: a Gynecologic Oncology Group study. AB - Dianhydrogalactitol was administered intravenously to patients with advanced or recurrent gynecologic malignancies on a weekly schedule. The initial dosage was 60 mg/m2 with escalation to 75 mg/m2 if there were no adverse effects. Forty-two patients with ovarian epithelial adenocarcinoma (OEA) and forty-one patients with squamous carcinoma of the cervix (SCC) were entered into this study. Of these, 39 patients with OEA and 36 with SCC were evaluable for toxicity and response. Seven patients (19.4%) with SCC had an objective response, while six patients (15.4%) with OEA had an objective response. Adverse effects were frequent but tolerable. There were no drug-related deaths, and only two patients suffered life threatening hematologic toxicity. Myelosuppression was observed more frequently among the patients with OEA. A higher percentage of OEA patients had received prior chemotherapy. The level of activity and frequency of adverse effects observed at this dose schedule warrant further studies of this drug in these two tumors. PMID- 6862295 TI - Epithelial carcinoma of the ovary in the reproductive years: clinical and morphological characterization. AB - In the 10-year interval from 1972 through 1981, 247 patients were treated for epithelial ovarian carcinoma at New York University Medical Center. Of this group, 31 patients (12.6%) were below age 40, and this group had distinctive features favoring longer survival. Of these patients 12 (38.7%) had borderline tumors, compared to 9 of 216 patients (4.2%) over 40 years of age (P less than 0.001). Stage I disease and well differentiated lesions were also common in the younger group. Early symptomatology and frequent gynecologic examinations during the childbearing years may also contribute to early detection of these tumors. The median survival in this group (7 years) was better than that reported for all ages. After careful evaluation, conservative surgical management can be considered for patients with Stage Ia disease which is either borderline or grade 1 carcinoma. PMID- 6862296 TI - Dermatomyositis and coexistent ovarian cancer: a review of the compounding clinical problems. AB - Although the nature of the relationship of dermatomyositis and malignancy is debated, the clinical implications of their coexistence is considerable. This review details the clinical and laboratory diagnostic features of the dermatomyositis (DM). Two case reports serve to focus on the unique management problems faced by the gynecologic oncologist when DM is associated with ovarian malignancy. Cricopharyngeal achalasia, an unusual aberration of DM, complicated the course of both patients. PMID- 6862297 TI - Modern trends in human leukemia V. New results in clinical and biological research including pediatric oncology. PMID- 6862298 TI - Monoclonal antibody therapy: "model" experiments with toxin-conjugated antibodies in mice and rats. PMID- 6862299 TI - In vitro cytodestruction of leukemic cells in human bone marrow using a cocktail of monoclonal antibodies. PMID- 6862300 TI - Viral oncogenes and cellular prototypes. PMID- 6862301 TI - The biology of an oncogene, based upon studies on neoplasia in Xiphophorus. PMID- 6862302 TI - Selective killing of leukemia cells by inhibition of TdT. PMID- 6862303 TI - Expression of retroviruses during early mouse embryogenesis. PMID- 6862304 TI - Induction of histiocytomas by pristane treatment of mice chronically infected with Moloney murine leukemia virus. PMID- 6862305 TI - Proliferation and maturation of hemopoietic cells from patients with preleukemia and aplastic anemia in agar and diffusion chamber cultures. PMID- 6862306 TI - The early stage of Friend virus erythroleukemias: mechanisms underlying BPA "independent" in vitro growth of BFU-E. PMID- 6862307 TI - Evidence for the origin of Hodgkin and Sternberg-Reed cells from a newly detected small cell population. AB - To clarify the origin of Hodgkin (H) and Sternberg-Reed (SR) cells, frozen sections of lymph nodes from 25 patients with Hodgkin's disease were immunostained with a large panel of monoclonal antibodies reactive with cells of lymphoid tissue and granulopoiesis. The results showed that (a) H and SR cells are devoid of markers specific to, or characteristic of B cells, macrophages, dendritic reticulum cells, or interdigitating reticulum cells, and (b) the vast majority of H and SR cells contain granulocyte-related antigens detectable with the monoclonal antibodies TU9 and 3C4, but constantly lack other granulocytic cell markers (such as peroxidase and chloroacetate esterase). Monoclonal antibodies raised against a Hodgkin's disease-derived cell line included one, Ki l, that was found to be selectively reactive with H and SR cells and a minute, but distinct, cell population in normal lymphoid tissue and bone marrow. The latter hitherto unknown cell population appears to be the normal equivalent of H and SR cells. PMID- 6862308 TI - Transfection as an approach to understanding membrane glycoproteins. PMID- 6862310 TI - Natural cellular defense activities against tumors--cytostasis and NK activity. PMID- 6862309 TI - Structure and expression of class I genes of the mouse major histocompatibility complex. PMID- 6862311 TI - The clinical pharmacology of cytosine arabinoside. PMID- 6862312 TI - Experimental infection of cat and chicken with Cryptosporidium sp. oocysts isolated from a calf. PMID- 6862313 TI - Human hydatidosis in South Bohemia. AB - Hydatid cysts were found on histopathological examination of liver from 9 patients at the age of 60-91 years in South Bohemia (Czechoslovakia). These findings suggest that human hydatidosis may occur in old people in Czechoslovakia. PMID- 6862315 TI - Transfer of delayed hypersensitivity through repeatedly sensitized peritoneal exudate cells during experimental ancylostomiasis in mice. AB - Current investigations using sensitized peritoneal exudate cells from mice infected repeatedly with Ancylostoma caninum larvae supply the evidence that these cells have the capability to transfer passive immunity to isogeneic recipients in contrast to normal cells from uninfected donors. High doses of sensitization to donors and a lapse of time between the expansion and proliferation of cells in the recipients provide a rather strong immunological readiness to expel/destroy the worm burden. The larvae bore through the gut reaching the peritoneal cavity but cannot enter the liver and/or lungs; they are thus misled (in the absence of normal guiding influences) to muscles where they undergo allergic death. PMID- 6862314 TI - Tissue reaction in experimental cysticercosis of sheep and goats caused by infection with Taenia saginata eggs. AB - In experimental infection of sheep with Taenia saginata eggs the intensity of infection may be influenced by the age of the animal at the time of infection, the height of the infection dose and the mode of infection (perorally in capsules or by means of an oesophagus tube). In non-adequate intermediate hosts of T. saginata (sheep, goats), the cellular reaction around the young cysticercus is very strong, but it differs from the reaction known in bovine cysticercosis: large macrophages, which migrate to the larva at the early phase of infection in cattle, are lacking in sheep and goats. Neither the new formation of collagen in the granulation tissue was observed in these hosts, but the demarcation of the mode was formed by a wide zone of connective tissue at the periphery. The development of the cysticercus was markedly retarded and already four weeks after infection a majority of cysticerci were dead. Nodular changes persisted still 40 days p.i., when the cysts are transparent in cattle. Neither cysticerci nor their remnants were found at that time. The results of indirect haemagglutination reaction are not constant in inadequate intermediate hosts (particularly in sheep) and only low titres of antibodies can be detected even in strong infections. PMID- 6862316 TI - Detection of Giardia intestinalis in duodenal aspirate and in the stool. AB - Compared was the detection of Giardia intestinalis in duodenal contents and in the stool. During endoscopic examination duodenal contents were recovered by means of a tube attached to the mucosa and by aspiration from the region of pars verticalis. In 102 persons, duodenal and stool examinations revealed four and five cases of Giardia infection, respectively. The results showed that both diagnostic methods are equivalent and demonstrated that parasitologic examinations of patients suffering from dyspeptic disorders are very useful. PMID- 6862317 TI - Changes in the blood picture of white mice experimentally infected with various species of ascarids. AB - The blood picture was studied in white mice experimentally infected with Ascaris suum, Toxocara cati, and Toxascaris leonina. In mice infected with A. suum, maximum number (17%) of eosinophiles occurred on day 28 p.i. In mice infected with T. cati, the eosinophilia increased already from the first day after infection, reaching the maximum (26%) on day 21 p.i. In mice infected with T. leonina, the eosinophilia increased from day 7 to day 28 p.i. and a slightly increased number of eosinophiles persisted during the whole experiment. PMID- 6862318 TI - Naegleria fowleri in cooling circuits of industrial and power plants in North Moravia. AB - Both nonvirulent (15 strains) and virulent (1 strain) variants of Naegleria fowleri were isolated from the cooling circuits in seven of ten examined plants in North Moravia. No amoebae were found in waters with a high salinity (electric conductivity more than 614 microseconds) and with a low content of phosphates (less than 0.37 mg . 1(-1)) and oxygen (less than 7.4 mg . 1(-1)). Other results of the physical, chemical and bacteriological examinations showed no direct bearing on the occurrence of N. fowleri. PMID- 6862319 TI - [The suppressive effect of melilotus extract on the thermal edema of rats]. AB - The effect of melilotus extract (ME) and Esberiven (ES) which contain coumarin on the thermal edema, which is one of high protein edema, was evaluated by both quantitative and qualitative assays. The intraperitoneal injection of ME immediately after burn greatly reduced the amount of swelling and effectively inhibited the occurrence of necrosis and induration in the injured leg-skin as compared with the saline controls in which a 3rd degree of thermal injury was observed. Administration of ES also induced a similar suppressive effect. Furthermore, either intraperitoneal or subcutaneous local injection of ME 4 hr before burn was effective in reducing the edema and thermal injury. No increase of the lymph flow and output of lymphocytes and protein from the thoracic duct lymph was observed in thermally injured rats given an injection of ME. The massive infiltration of neutrophils and macrophages 6 to 24 hr after the subcutaneous injection of ME was histologically observed in the dermal lesion of normal rats. Twenty-four hr later, macrophages, fibroblasts, and lymphocytes became predominant. The present data taken together suggest that ME exerts the suppressive effect on thermal injury by either prior or post administration, and these effects might be induced in an indirect manner, through the action of phagocytic cells accumulated in the injured lesion, not via lymphatic drainages of excess fluid and protein. PMID- 6862321 TI - Structural variability in primate vocalizations and its functional significance: an analysis of squirrel monkey chuck calls. AB - Sound spectrograms of vocalizations recorded from 'Gothic arch' squirrel monkeys were examined for shared structural characteristics. A rapidly descending element, the 'mast', was found to be diagnostic for a group of variable but structurally similar vocalizations called chucks. In addition to the mast, a variable FM element ('flag') and a terminal noisy element ('cackle') formed a basic 3-element structural unit. A review of functional studies suggests that this flag-mast-cackle structure is used by the squirrel monkey and a variety of other New World primates in circumstances involving close social contact. PMID- 6862322 TI - Use of the forest canopy by the agile gibbon. AB - Brachiation was the main form of locomotion and took place along branches and boughs in the upper canopy. The posture during feeding depended on the substrate, with the gibbons sitting on branches but hanging in twigs. During foraging the gibbons hung more, even on branches, but as only short stops were made this is probably to increase mobility. Feeding on fruit took place mainly in the middle canopy on small trees; feeding on leaves and foraging occurred evenly throughout the middle and upper canopies. Gibbons are light mobile animals with a rapid and direct form of locomotion that enables them to exploit dispersed food sources and to defend a large territory. PMID- 6862320 TI - [Experimental study of the effects of bromelain on the sputum consistency in rabbits]. AB - Effects of bromelain (BR) on rabbit sputum consistency were investigated in vitro and in vivo. On the sputum showing relatively low viscosity, BR and other enzymes such as serratiopeptidase (SP), the mixed preparation of pronase and pancreatin, and lysozyme exerted lowering effects; and the effect of BR was the most potent. However, bromhexine had virtually no effect. On the sputum showing relatively high viscosity, BR exerted more potent lowering effects on the viscosity and yield value of sputum than those of SP. Furthermore, 320,000 U/head BR and 120,000 U/head SP lowered the viscosity significantly and yield value of sputum in rabbits with oral administration for 3 days. The lowering effect on the yield value of BR was more potent than that of SP. BR also increased the sputum volume in rabbits. BR and SP showed tendencies to decrease the contents of acid glycoprotein and sialic acid in sputum. It can be considered that these results support the effectiveness of BR as an expectorant in clinical use. PMID- 6862323 TI - Inter-troop transfer of Lemur catta males at Berenty, Madagascar. AB - Lemur catta male exchange occurred throughout the reserve at Berenty and affected change in the composition of most, if not all, of the twelve troops in the reserve. Males migrate into troops with which they are already familiar. Inter troop encounters may serve to increase a male's knowledge of a potential new home. Extensive overlap in home ranges may facilitate this process. An important result of migration in L. catta is the avoidance of inbreeding in a species whose females form stable groups over long periods of time and do not breed out of their troop. PMID- 6862324 TI - Size and diet in the evolution of African ape craniodental form. AB - Interspecific differences in craniodental morphology among Pan paniscus, Pan troglodytes, and Gorilla gorilla are analyzed. These apes differ in both diet and body size, and thus present an excellent example in which to apply an allometric criterion of subtraction in order to determine morphological differences which might be related to divergent dietary specialization. The use of ontogenetic allometry in particular as a criterion of subtraction is discussed. Bivariate and multivariate results indicate that most of the variation in skull form among the species relates to the extension of a common growth trend to different sizes. Comparative analysis of growth trajectories reveals a number of differences, but none that appear to relate to a reorganization of skull proportions which might correspond to a dietary shift towards increased folivory. The dentition clearly exhibits non-allometric shape changes corresponding to the dietary differences, however. The meaning of these differences between cranial and dental patterns is discussed. PMID- 6862325 TI - Premaxillary-maxillary suture asymmetry in a juvenile Gorilla. Implications for understanding dentofacial growth and development. AB - A specimen of juvenile gorilla was found that had the premaxillary-maxillary suture coursing between the lateral deciduous incisor and deciduous canine on one side of the jaw, but between the central and lateral deciduous incisors on the other; in the latter, the suture also separates the alveolus of the lateral deciduous incisor from the crypt of the growing successional lateral incisor. Rather than dismiss this exception to the traditional dictum of tooth identification--which is based on the position to teeth relative to this suture- as some inconsequential anomaly, an attempt is made to understand how this can occur within the confines of present understanding of dentofacial growth and development and developmental theory. An hypothesis relating tooth and tooth class identification is presented in the context of ectomesenchymally predifferentiated stem progenitors and subsequent tooth class proliferation. PMID- 6862326 TI - Taxonomy and phylogeny of black-and-white colobus monkeys. Inferences from an analysis of loud call variation. AB - Field recordings of male loud calls (or roars) from each major form of black-and white colobus monkey have been analyzed spectrographically, and features of tempo and pitch measured. Considered together with data on cranial dimensions, coat pattern, and geographical distribution, the results of this analysis suggest that there are five species of black-and-white colobus: Colobus angolensis, C. guereza, C. polykomos, C. satanas, and C. vellerosus. C. guereza and C. vellerosus may have differentiated most recently during a major arid event prior to the last Pleistocene glacial maximum; they have an identical low-pitched roar which we consider to be a shared, derived character. The other species, of which C. satanas has the most distinct roar, may belong to older lineages. PMID- 6862329 TI - An anatomic study of the anterior superior process of the os calcis and its clinical application. AB - The anatomy of the anterior superior process of the calcaneus was studied from 15 fresh amputation specimens and from two cases of surgical intervention of fractures of this process. Specific anatomic relationship exist between the associated ligamentous attachments and the production of fractures of this process. It was found that both the anterior interosseus talocalcaneal and calcaneocuboid ligaments were tight on inversion and on inversion plus plantarflexion, suggesting that both of these ligaments may play a part in the production of avulsion fractures of the anterior calcaneal process. The relationship between the articular facets of the calcaneal process, including the inconstant anterior talocalcaneal facet, and the occasional unexpected poor results encountered with these fractures is described. Finally, the local anatomy is correlated with tarsal coalitions found in this area. PMID- 6862328 TI - Treatment of ingrown toenail. AB - A plan is presented which brings together three elements: the clinical stage of disease, the age of the patient, and the treatment regimes available. It is a practical and systematic yet flexible approach to the successful treatment of a given ingrown toenail. A general outline and specific detail of conservative and surgical technique are offered. PMID- 6862327 TI - McKeever arthrodesis for the painful hallux. AB - Three hundred nine McKeever arthrodeses for treatment of the painful hallux were performed on 234 patients at the Mayo Clinic from 1955 to 1980. Two hundred six cases were contacted, and 71 were personally examined and X-rayed. The average follow-up was 15 years (1 to 28 years). Ninety-one percent wore shoes within 2 months, 92% are painless, and 98% without other foot pathology are wearing dress shoes of their choosing. Complications, which consisted of failed fixation, infection, and recurrence of deformity, occurred in 8%. The screw fixation was removed in 30%. Eighty-six percent of the patients are satisfied. PMID- 6862332 TI - Bilateral tarsal tunnel syndrome caused by varicosities. AB - The authors present a case report of bilateral tarsal tunnel syndrome occurring in a 39-year-old, slightly overweight female with a long history of varicose veins of her legs. Symptomatology suggestive of tarsal tunnel syndrome was present over the left heel. Vein stripping was done on both legs. When the burning discomfort at the inner aspect of the left heel continued in spite of the strippings, she presented at our Foot Clinic. Surgery on the left heel revealed varicosities overlying the medial and lateral plantar nerves near their origin, and removal of these resulted in prompt relief of her complaints. Nine months later and 10 months following the venous stripping of her right leg, medial right heel pain, burning, paresthesias, and a positive Tinel sign appeared over the inner aspect of her right heel. There was prompt subsidence of these complaints when again varicosities were found and removed. PMID- 6862331 TI - Radiological aspects of the tarsometatarsal joints. AB - Considerable difficulty may be encountered in evaluation of the disrupted tarsometatarsal joint complex as seen in variations of fracture dislocations of the Lisfranc's joint. This report points out constant relationships between the tarsal and metatarsal bones as seen on the standard anteroposterior and medial oblique views. Awareness of these constant radiological relationships can help the operating surgeon reconstruct the normal anatomic alignment. PMID- 6862333 TI - Proximal diaphyseal fractures of the fifth metatarsal (Jones' fracture): two cases treated by cross-pinning with review of 106 cases. AB - Two young males with proximal diaphyseal fractures of the fifth metatarsal (Jones' fractures), one acute and one with delayed union, have been presented and healed with percutaneous cross-pinning, shortleg casting, and partial weightbearing. Both healed without complications in 7 and 11 weeks, respectively. Both were followed for more than 2 years. In the acute Jones' fracture the treatment of choice is a nonweightbearing shortleg cast for 8 weeks. In the symptomatic nondisplaced delayed union the author favors percutaneous cross pinning, shortleg cast, and partial weightbearing. Intramedullary screw fixation is an alternative. In the patient with symptomatic nonunion, bone grafting is the treatment of choice. Asymptomatic patients with radiographically unhealed fractures require no treatment. One hundred six cases of the Jones' fracture are reviewed. PMID- 6862330 TI - Impingement exostoses of the talus and fibula secondary to an inversion sprain. A case report. AB - Impingement exostoses of the talus and fibula following an inversion sprain is an uncommon sequela to the initial injury. Although a high frequency of symptomatic tibial and talar impingement exostoses have been reported, changes on the lateral side of the ankle are more subtle with significant roentgenographic findings rarely seen. The authors present a rare case of impingement exostoses involving both the talus and fibula simultaneously. Arthroscopy visualized the tibiotalar and talomalleolar articulations. It revealed opposing exostoses of the talus and fibula, necessitating surgical resection. Arthroscopy is recommended for difficult diagnostic problems of the ankle and an awareness of the condition of post-traumatic impingement exostoses of the talus and fibula. PMID- 6862335 TI - [Possibilities and advantages of automobile tourism]. PMID- 6862334 TI - Early epiphyseal fusion in Freiberg's infraction. PMID- 6862336 TI - [Still's disease in adults]. PMID- 6862337 TI - [Physostigmine as delirium-preventive agent in ambulatory alcohol withdrawal]. PMID- 6862340 TI - [Gene expression and protein synthesis in the normal heart muscle and in adriamycin cardiomyopathy]. PMID- 6862339 TI - [Functional methods of esthetic facial surgery]. AB - The subject "Funktionelle Methoden der Asthetischen Gesichtschirurgie' (Functional methods in facial aesthetic surgery) is described from the viewpoint of the otorhinologist. This surgical specialty is to care for the functions of 4 organs of sense, of the facial nerve, of ingestion, breathing and speaking. The accentuation in this publication lies on functional criteria. They are essential even in facial surgery with aesthetic motivations. 3 further papers refer to the surgical anatomy of the "isthmus pharyngis' and the problems of surgery of the velopharyngeal insufficiency and the nasopharyngeal atresia. The author describes his own surgical methods. PMID- 6862338 TI - [Inhalation and perfusion scintigraphy of the lung in comparison to clinical and roentgenologic findings]. PMID- 6862341 TI - [Psychosocial aspects in the third stage of life]. PMID- 6862342 TI - [Reducing the risk of anesthesia by preoperative preparation]. PMID- 6862343 TI - [Inhalation anesthesia today. 2: Special effect of inhalation anesthetics]. PMID- 6862344 TI - [Animals as causes and vectors of disease. 2: Arthropods or millipeds as vectors of disease]. PMID- 6862345 TI - [Postoperative changes in hemostasis by heparin/dihydroergotamine prevention]. AB - Coagulation studies and the J-125-fibrinogen-uptake-test for diagnosis of deep vein thrombosis were carried out in 244 and 288 patients resp. undergoing vaginal or abdominal hysterectomy. They were given a prophylaxis with 2 X 5000 IU calcium heparin (Calciparin) or 2 X 5000 IU sodium heparin with 0.5 mg dihydroergotamine (Heparin-Dihydergot). Control patients received acenocoumarol (Sintrom). The incidence of deep vein thrombosis was lowest in the heparin/dihydroergotamine group and was 5.9%. With calcium heparin prophylaxis it was 15.5%, and with acenocoumarol 12.2%. Plasma heparin levels and parameters of coagulation, fibrinolysis and platelet function showed that after 8 days of heparin prophylaxis with or without dihydroergotamine there is no change in hemostasis towards an increasing hypo- or hypercoagulability. Coagulation changes and the incidence of postoperative wound hematoma were identical using heparin alone or in combination with dihydroergotamine. Thus the improved effectiveness of heparin/dihydroergotamine in prevention of deep vein thrombosis which has been shown in the fibrinogen test cannot be explained by an effect onto the coagulation parameters studied. It is pointed out that a peridural anesthesia can be carried out in low-dose heparin and heparin/dihydroergotamine prophylaxis without the risk of bleeding and that the incidence of wound hematoma can be reduced by correct choice of the site of injection. PMID- 6862346 TI - [Current therapy: combined drug therapy of hyperuricemia, gout and alcohol induced fatty liver]. PMID- 6862347 TI - [Neuropsychologic contribution to the differentiation of the tranquilizing or sedative effect of a psychoactive drug]. PMID- 6862348 TI - [Primary malignant melanoma of the leptomeninx -- case report on a diffuse variant]. AB - The clinical findings of a female patient with a solitary diffuse invasion of a malignant melanoma into the leptomeninx are compared to the clinical findings of other cases described in literature. It is obvious that headache is the primary symptom. In the progress of the disease, the following symptoms occur: choked papilla, weakness or loss of vision and later on disturbance of consciousness. A common clinical development is hydrocephalus internus. To confirm the initial diagnosis it is necessary to identify specific pathological cells in the cerebrospinal fluid. PMID- 6862349 TI - [Studies on relationships between changes in myocardial blood flow, electrocardiographic alterations and serum creatine kinase and histologic extent of myocardial infarction in conscious dogs with permanent coronary occlusion and effects of diltiazem hydrochloride on these variables]. PMID- 6862350 TI - [Studies on central organization for circling behavior in rats]. PMID- 6862352 TI - [Practical application results of the Hirose's simple microdiffusion method for determining alcohol of body fluids]. PMID- 6862351 TI - [Early findings of diabetic retinopathy on fluorescein angiography]. PMID- 6862353 TI - Role of renal gluconeogenesis in the maintenance of glycaemia after L-tryptophan administration to rats. AB - The time-course of liver and kidney gluconeogenesis after L-tryptophan administration has been studied. Two and half hours after injection of L tryptophan (0.5 g/kg body wt) a 97% inhibition of hepatic gluconeogenesis in starved rats was observed. Twelve hours later, the inhibition remained 35%. Hepatic glycogen was almost completely depleted (97%) in fed rats after 5 hours. At this time there was a severe hypoglycaemia in fed and 48 h starved rats which gradually disappeared with time, the values going back to normal after 12 hours. Tryptophan treatment was associated with a significant increase in renal gluconeogenesis in fed and 48 h starved rats with a maximum at 5 h (165% and 190% respectively). When hepatic gluconeogenesis was constantly inhibited in fed rats by periodic injection (every 4 h) of L-tryptophan, renal gluconeogenic ability remained increased throughout the experiment while blood glucose concentrations did not change. These observations suggest that kidney contributes to maintain glycaemic homeostasis under these conditions of liver gluconeogenesis impairment. PMID- 6862354 TI - Response of human aldosteronoma cells in culture to the N-terminal glycopeptide of pro-opiomelanocortin and gamma 3-MSH. AB - Cells were isolated from one of two adenomas from the adrenal cortex of a hypertensive patient with primary hyperaldosteronism. A primary culture of these cells responded with increased aldosterone secretion to gamma 3-MSH and human (residues 1-76) and porcine (residues 1-80) N-terminal peptides of pro opiomelanocortin (POMC). EC50 was lowest for gamma 3-MSH, while maximal response was greater for both N-terminal peptides of POMC. We conclude that gamma 3-MSH derived from the N-terminal segment of POMC contains the active core of the aldosterone-stimulating activity of the N-terminal on these adrenal cells. PMID- 6862357 TI - Effect of hypophysectomy and administration of TSH on the activity of monoamine oxidase in the thyroid gland of rats. AB - The thyroid monoamine oxidase (MAO) activity was measured in rats after hypophysectomy and TSH treatment to find out whether the thyroid MAO activity can be modified with TSH. Hypophysectomy decreased MAO activity in the thyroid gland of rats. The administration of TSH (2.5 U kg-1 daily for 5 days) to hypophysectomized rats increased MAO activity and fully compensated the absence of the pituitary. These data suggest that the thyroid gland MAO activity is under the regulatory influence of TSH. PMID- 6862356 TI - Human medullary carcinoma of the thyroid in tissue culture. AB - Medullary thyroid carcinomas (MCT) were obtained from patients with Sipple's syndrome or non-hereditary MCT. Cultures of enzymatically dissociated cells showed that MCT cells were mostly free-floating cells of epithelial characters. These MCT cells preserved the ability to secrete calcitonin for a long period of in vitro maintenance. However, the MCT cells under the usual culture conditions were filled with numerous cytoplasmic granules and appeared to be extremely fragile. When MCT cells were cultured in a low-calcium medium, such granules were not observed. In addition, MCT cells in the low-calcium medium increased the amount of calcitonin in response to added calcium and tetragastrin. Therefore, the culture of MCT cells in the low-calcium medium appeared to be useful for studies about the biochemical and physiological characters of human MCT cells in vitro. PMID- 6862355 TI - The effect of vasopressin on LH release in baboons. PMID- 6862358 TI - Renal impairment in experimental hemochromatosis in rats. AB - Parenteral administration of iron as the complex with nitrilotriacetate resulted in moderate iron deposition in the renal cortex along with heavy deposition of iron in liver, heart, and exocrine pancreas. Iron treated rats exhibited slight but significant changes in serum chemistries consistent with mild renal insufficiency: increased chloride and creatinine and decreased sodium, calcium and CO2 content as a group with isolated increases in urea nitrogen (2/9) and phosphorus (3/9). Serum albumin was decreased and the normal correlation of serum calcium with serum albumin was abolished by iron overload. Although food intake/g body weight was similar in the two groups, both water intake and urine output relative to solute load were increased in iron-overloaded rats. We conclude that the renal insufficiency occasionally reported in human hemochromatosis may reflect a direct nephrotoxic action of iron. PMID- 6862360 TI - Changes of peripheric lymphocyte nucleoli in diabetes. PMID- 6862359 TI - Quantitation of apolipoprotein E-isoforms in diabetes mellitus. PMID- 6862362 TI - Metabolism of the inhibitory neurotransmitter gamma-aminobutyric acid in a rabbit model of fulminant hepatic failure. PMID- 6862361 TI - Lower calcitonin levels in young hypogonadic men with osteoporosis. PMID- 6862363 TI - Ground squirrel hepatitis virus infection. PMID- 6862365 TI - Spontaneous bacterial peritonitis: a prospective investigation in predominantly nonalcoholic cirrhotic patients. PMID- 6862364 TI - Hepatitis A infection in chronic carriers of hepatitis B virus. AB - By routine screening for serologic markers of hepatitis A and B in patients with acute hepatitis, 30 chronic carriers of hepatitis B virus with serologic evidence of acute hepatitis A and two patients with simultaneous acute infection with hepatitis A virus and hepatitis B virus were detected. For evaluation of clinical data, two major risk groups were distinguished. Nine patients were drug addicts and 17 were children and young adults from Mediterranean countries or southeast Asia. During the acute phase of illness, serum bilirubin and SGPT levels did not differ from those in other patients with acute hepatitis A. In three patients for whom follow-up sera were available, HBsAg concentration decreased during the acute stage of hepatitis A. PMID- 6862366 TI - Hemodynamic changes in patients with portal venous obstruction. AB - Splanchnic and systemic hemodynamics were evaluated in five adult patients with portal hypertension due to portal venous obstruction and were compared with those of patients with cirrhosis and those of a control group. In patients with portal venous obstruction, the gradient between wedged and free hepatic venous pressures ranged from 2 to 3 mm Hg, as in the control group, and was significantly lower than in patients with cirrhosis. Hepatic blood flow averaged 0.521 +/- 0.127 liter per min per m2 (mean +/- S.D.) and was significantly lower than that measured in cirrhotic and normal patients. Cardiac index averaged 3.788 +/- 0.629 liters per min per m2; this high value for cardiac index was not significantly different from that measured in cirrhotic patients, but was significantly higher than in patients of the control group. It is suggested that a hyperkinetic circulatory state may result from the development of portal-systemic venous collateral circulation in patients with portal venous obstruction having normal liver and hepatic venous pressures. PMID- 6862367 TI - Elevated plasma carnitine in hepatic cirrhosis. AB - Carnitine is essential for the oxidation of fatty acids. The liver is a major site of fatty oxidation. To determine if there are alterations in plasma carnitine in patients with alcoholic cirrhosis, we measured plasma carnitine and its metabolites by a specific radioenzymatic method in 20 men with hepatic cirrhosis and 30 healthy volunteers. We found total carnitine, free carnitine, short-chain acylcarnitines, and long-chain acylcarnitines to be significantly elevated in the cirrhotic subjects. The mean values for total carnitine, free carnitine, short-chain acycarnitines, and long-chain acylcarnitines for the cirrhotic patients and the control subjects were 73.1 vs. 46.1, 47.0 vs. 36.7, 17.9 vs. 5.7 and 8.2 vs. 3.7 microM, respectively. The greatest increases were noted in the acylcarnitines; 3-fold for short-chain acylcarnitines and over 2 fold for long-chain acylcarnitines. We conclude that alcoholic cirrhosis is a hypercarnitinemic condition. PMID- 6862369 TI - Detection of Regan variant type of alkaline phosphatase isoenzyme in liver tissue of Indian childhood cirrhosis. AB - Alkaline phosphatase (ALP) isoenzyme composition was studied in sera and liver from patients with Indian childhood cirrhosis (ICC). A typical pattern consisting of a fast-moving anodal preliver band with slower moving diffuse liver and placental bands followed by an intestinal band was consistently observed in sera of patients in all stages of ICC and in pregnant mothers of index ICC patients. ICC liver ALP was relatively heat-stable and inhibited by L-phenylalanine and L leucine. The isoenzyme also had similar immunological determinants to placental ALP and adult intestinal ALP isoenzymes. Total serum ALP isoenzyme and its heat stable component progressively increased in concentration from early to advanced stages of the disease suggesting that the diseased liver in ICC is the source of the abnormal isoenzyme. PMID- 6862368 TI - The role of fat-storing cells in Disse space fibrogenesis in alcoholic liver disease. AB - Liver biopsy samples from 40 chronic alcoholic patients, including 9 with minimal changes of the liver, 6 with mild hepatic fibrosis, 14 with moderate fibrosis, and 11 with severe fibrosis (cirrhosis) were studied by electron microscopy to assess fibrogenesis in the Disse space and the role of fat-storing cells in this process. In the Disse space of normal liver, collagen fibers are few, and while lipid droplets containing fat-storing cells exist, their rough endoplasmic reticulum (RER) is inconspicuous. In the course of progressive hepatic fibrosis, collagen in the Disse space increased. This was significantly associated with gradual development of RER in fat-storing cells, confirmed by morphometric analysis. It is likely, therefore, that the development of RER in the fat-storing cells is a morphological correlative of their activated fibrogenesis and transformation into fibroblasts. To further clarify this, the rate of collagen synthesis was measured by the method of in vitro incorporation of [3H]proline into collagen in 17 liver biopsy samples from alcoholic patients and compared with the degree of morphological changes of RER in fat-storing cells. In liver samples with well-developed RER in fat-storing cells, a significantly higher rate of collagen synthesis was observed. These results suggest that in alcoholic liver injury, fat-storing cells may play an important role in Disse space fibrogenesis. PMID- 6862370 TI - Extrahepatic biliary atresia in a rhesus monkey (Macaca mulatta). AB - Extrahepatic biliary atresia was observed in a 6-week-old female rhesus monkey. Jaundice and conjugated hyperbilirubinemia were detected at the age of 6 days and persisted throughout life. At 6 weeks of age, the diagnosis of extrahepatic biliary atresia was established at exploratory laparotomy, and bile duct remnants were biopsied. Histological examination of these specimens showed inflammatory and fibrosing lesions similar to those observed in humans with extrahepatic biliary atresia. Because of serologic evidence of Reovirus 3 infection in human patients with extrahepatic biliary atresia, serum of the affected monkey was tested for antibodies to this virus. Three sequential serum samples obtained during the course of illness showed persistently high Reovirus 3 titers which are consistent with but do not prove concurrent Reovirus 3 infection. This report represents the first documented case of spontaneous extrahepatic biliary atresia in a nonhuman primate and suggests that this species may be suitable for further investigation of the pathogenesis of this disease. PMID- 6862372 TI - Primary pulmonary hypertension: an unusual case associated with extrahepatic portal hypertension. AB - A patient with both extrahepatic portal hypertension and primary pulmonary hypertension is reported. The pulmonary hypertension developed without a surgical portal-systemic shunt, and at autopsy there was no evidence of a large spontaneous shunt. This association of pulmonary arterial hypertension and portal venous hypertension without either intrinsic liver disease or a large portal systemic anastomosis has not been reported previously. Our case supports the concept that portal hypertension with its attendant portal-systemic collateral circulation may be the major predisposing cause of pulmonary hypertension both in intrinsic liver disease and extrahepatic portal vein obstruction. PMID- 6862373 TI - 34. Mosbacher Kolloquium der Gesellschaft fur Biologische Chemie: Biological oxidations. April 14th to 16th, 1983. Abstracts. PMID- 6862374 TI - The analysis of a protein-polymorphism. Evolution of monomeric and homodimeric haemoglobins (erythrocruorins) of Chironomus thummi thummi (Insecta, Diptera). AB - The evolutionary history of 12 Chironomus thummi thummi (CTT) haemoglobins of known primary structures was reconstructed by the maximum parsimony method. This reconstruction demonstrates that the 12 CTT haemoglobin lineages originated monophyletically from a common ancestor within early Insecta and have the lineage to monomeric blood worm haemoglobin as their closest sister group. It can be further deduced that the earliest ancestral CTT haemoglobins were monomers and that a branch to all extant dimeric CTT haemoglobins emerged later in phylogeny near the base of Chironomidae, but perhaps still before Chironomus itself evolved. This ancient, pre-Chironomus history suggests that among insect taxa, now lacking expressed globins, remnants of globin genes might exist as unexpressed pseudogenes. By the parameter of base replacement frequencies, CTT haemoglobins appear as relatively slow-evolving proteins, showing a preponderance of guanine in equilibrium adenine transitions at the first nucleotide position of the codons but not at the second. The most conservatively-evolving amino acid positions are haem contacts; the next most conservative are in interhelical contacts and interior positions involved in stabilization of tertiary structure. Further elucidation of the phylogenetic origins and adaptive evolution of the multiple haemoglobins found in Chironomus will be possible by the maximum parsimony method once haemoglobins or, in their absence, haemoglobin pseudogenes are sequenced in species throughout Chironomidae and related taxa. PMID- 6862375 TI - The binding of deoxycholic acid to band 3 protein from human erythrocyte membranes and to bovine serum albumin. AB - The binding of a water-soluble steroid, deoxycholic acid, to solubilized band 3 protein from erythrocyte membranes was studied by equilibrium dialysis. At acid pH, a single high affinity binding site with an association constant K = 4 . 10(5)M-1 was found. In addition, the protein showed a large number of low affinity binding sites. High affinity binding of the steroid was not observed when the pH was made alkaline or when deoxycholic acid was substituted by cholic acid. The results support the suggestion previously derived from monolayer experiments that band 3 possesses a single cholesterol-binding site of high affinity and specificity (Klappauf, E. & Schubert, D. (1979) Hoppe-Seyler's Z. Physiol. Chem. 360, 1225-1235). Bovine serum albumin was also found to possess a single high affinity binding site for deoxycholic acid (K = 4 . 10(5)M-1). In contrast to band 3, this site is observed both at acid and alkaline pH. PMID- 6862371 TI - Morphologic and biochemical changes in dogs after portacaval shunt plus bile fistula or ileal bypass: failure of bile fistula or ileal bypass to prevent hepatocyte atrophy. AB - External biliary fistula (BF) or ileal bypass (IB) was performed in dogs at the time of or 2 weeks after portacaval shunt (PCS). The pathologic changes in the dog livers 2 to 4 weeks later were compared to those caused by PCS alone. Histopathologic differences between PCS alone vs. PCS plus BF or IB could not be found. Thus, the experiments did not confirm recent observations by others in rats that BF prevents or reverses the hepatic injury of PCS. As estimated by plasma mevalonic acid determinations, the increase in hepatic cholesterol synthesis that is characteristic after BF or IB was suppressed in animals with PCS. BF and IB reduced but did not eliminate the postprandial elevation in serum bile acid that occurs after PCS. The findings have possible relevance in planning the treatment of patients with familial hypercholesterolemia with the combined use of PCS and IB. PMID- 6862376 TI - Identification of a sperm receptor-glycoprotein from the porcine zona pellucida. AB - Porcine zona pellucida were solubilized by treatment with lithium 3,5 diiodosalicylate. Following further purification by phenol/water extraction, ethanol precipitation and high performance liquid chromatography a total of 11 fractions were obtained. Fractions in the molecular mass range, that were previously found to possess antigenic properties, were tested in a spermatozoa radio-receptor binding assay. One of the fractions with an N-terminal amino-acid residue of alanine was found to have spermatozoa receptor properties. This result might aid future studies on the spermatozoazona pellucida interactions at the molecular level. PMID- 6862377 TI - Influence of isolation media on the preservation of mitochondrial functions. AB - 1) In the present study the influence of sucrose and mannitol-based isolation media on the degree of functional preservation of rat liver mitochondria has been investigated. Apparently intact mitochondria conventionally prepared with a 0.3M sucrose medium displayed significantly lower rates of state-3 respiration, pyruvate carboxylation, ATP hydrolysis and thiol group production than mitochondria prepared from the same livers with mannitol. 2) Extracts from the latter, furthermore, showed a significantly higher activity of succinate dehydrogenase activity, whereas no difference in glutamate dehydrogenase activity was demonstrable. 3) The low activities apparent with the sucrose medium could be brought to the level of the mannitol medium by the addition of potassium phosphate (4mM). A similar effect was exerted by K2SO4, whereas KCl and the respective sodium salts were significantly less effective. 4) Sucrose-prepared mitochondria display decreased contents of metabolites such as ATP, glutamate, citrate and malate. 5) Comparative studies with a variety of carbohydrates indicated that isolation media based on disaccharides are inferior to those based on monosaccharides in the preparation of functionally intact mitochondria from rat liver. 6) The results reported herein appear to be of general interest as sucrose-prepared mitochondria have been employed in the past in a great number of studies and are still widely used at present. PMID- 6862378 TI - The importance of the intramolecular disulfide bridges in porcine somatotropin for its biological activity. AB - The dependance of the porcine somatotropin activity on the entireness of the intrachain disulfide bridges is investigated in three biological systems: bioassay in vivo, radioimmuno assay and receptor assay with rat liver membranes. Cleavage of the disulfide bridges is accomplished by reduction, oxidation and sulfitolysis, respectively. In no case is the hormone activity completely abolished with regard to measurements in the bioassay and radioimmuno assay. In the radioligand assay with rat liver membranes neither native porcine somatotropin nor the treated hormone preparations are bound by the receptors. PMID- 6862379 TI - Dynamics of the glutathione redox system in rat liver after partial hepatectomy. PMID- 6862380 TI - [The Erwin Riesch symposium on the occasion of 20 years of biochemical studies in Tubingen. In cooperation with the Society for Biological Chemistry--20-22 April 1983 in Tubingen. Abstracts]. PMID- 6862381 TI - Purification and characterization of two types of Laburnum alpinum anti-H(O) hemagglutinin by affinity chromatography. PMID- 6862385 TI - [Biosynthesis of phenylalanine and tyrosine in Streptomycetes]. AB - The biosynthesis of phenylalanine and tyrosine from prephenic acid may proceed via phenylpyruvic acid or p-hydroxyphenylpyruvic acid or via arogenate. The enzymes necessary for these biosynthetic steps have been tested in a variety of Streptomycetes. Tyrosine is synthesized exclusively via arogenate, while phenylalanine is synthesized via phenylpyruvic acid. The feedback inhibition pattern of the corresponding enzymes has been determined. The organisms may be divided into four groups according to the properties of the phenylalanine and tyrosine biosynthetic enzymes and their regulation patterns. PMID- 6862382 TI - Quantitation of immunoadsorbed flavoprotein oxidases by luminol-mediated chemiluminescence. AB - The detection of the flavoenzymes 6-hydroxy-L-nicotine oxidase and 6-hydroxy-D nicotine oxidase at the sub-femtomol level was achieved by coupling the reaction of the immunoadsorbed proteins to the peroxidase-catalysed oxidation of luminol. The H2O2-producing oxidases retained their full activity when bound to the respective immobilized antibodies. This fact allowed the concentration of the enzymes from very dilute solutions and the quantitative assay of their activities in the microU range. Due to strict stereoselectivity and the absence of immunological cross-reactivity, the two flavoproteins could be determined in the same solution. This method was used to measure the 6-hydroxy-D-nicotine oxidase and 6-hydroxy-L-nicotine oxidase activities in Escherichia coli RR1 and different Arthrobacter strains cultured under non-inducing conditions. The same activity ratio of 6-hydroxy-L-nicotine oxidase/6-hydroxy-D-nicotine oxidase as in D L nicotine-induced cells of A. oxidans was observed in non-induced wild type and in riboflavin-requiring (rf-) mutant cells of this aerob. PMID- 6862383 TI - Evidence for and separation of globular hydrophobic and non-hydrophobic forms of acetylcholinesterase from bovine caudate nucleus. AB - Almost complete removal of the detergent from a purified 10.7S complex consisting of acetylcholinesterase and [3H]Triton X-100 bound to an affinity gel was achieved by extensive washing and subsequent elution of the enzyme. Applying this procedure of detergent removal, the majority of the enzyme could be stabilized by self-aggregation forming soluble 16S and 20S aggregates, which contained small amounts of bound residual Triton X-100 in the range of 0.4-1.6 mol Triton X-100 per mol acetylcholinesterase. Besides these aggregates, a nearly detergent-free 10.5S form was observed, lacking the hydrophobic region responsible for detergent binding and self-aggregation. PMID- 6862384 TI - The metabolism of tryptophan and 7-chlorotryptophan in Pseudomonas pyrrocinia and Pseudomonas aureofaciens. AB - Pseudomonas pyrrocinia ATCC 15958 and a mutant strain (ACN) of Pseudomonas aureofaciens ATCC 15926 possess a mechanism for the degradation of the tryptophan side chain. Indole, indole-3-carboxylic acid, indole-3-acetic acid and the corresponding compounds chlorinated or brominated at position 7, as well as indole-3-pyruvate and 7-chloroindole-3-pyruvate, were isolated from bacterial cultures. The chlorinated indole derivatives were isolated after the addition of 7-chloro-DL-tryptophan to cultures of P. pyrrocinia whereas their bromo analogues were found in the culture medium of the mutant strain ACN of P. aureofaciens, grown in the presence of sodium bromide. Enzymatic studies show that tryptophan is transaminated to indole-3-pyruvate, which is transformed to indole-3 acetaldehyde. Dehydrogenation of indole-3-acetaldehyde leads to indole-3-acetic acid, which is further metabolized to indole-3-carboxaldehyde, and converted by dehydrogenation to indole-3-carboxylic acid. Indole is formed by the spontaneous decarboxylation of indole-3-carboxylic acid. PMID- 6862387 TI - Androgen control of male sex behavior in the crested newt (Triturus cristatus carnifex Laur.): castration and sex steroid administration. AB - Castration significantly lowers serum testosterone in sexually active male Triturus cristatus. Replacement therapy by implants of testosterone in silastic capsules elevates the serum testosterone level to higher values than normal. Sex behavior is depressed by castration and partially reinstated by replacement therapy with testosterone. 5 alpha-dihydrotestosterone was the only testosterone metabolite showing some behavioral effectiveness in castrates; estradiol and 5 beta-dihydrotestosterone failed to elicit sex behavior. PMID- 6862388 TI - Hormonal specificity and activation of sexual behavior in male zebra finches. AB - Castrated zebra finches receiving one of six hormone treatments were given three weekly tests with different females and their sexual behavior was contrasted with that of two control groups consisting of intact or castrated males given implants of cholesterol. The six hormone treatments were: two aromatizable androgens, testosterone (T) and androstenedione (AE); two nonaromatizable androgens, androsterone (AN) and dihydrotestosterone (DHT); an estrogen, estradiol (E); or a combination of E + DHT. Half the males receiving DHT received the 5 alpha-isomer, half received the 5 beta-isomer. Castration significantly reduced the proportion of males which courted females, total courtship displays, high-intensity courtship displays, beak wiping activity, and significantly increased the latencies to show these behaviors compared to intact males. Castrated males never attempted to mount a female. All of these measures of courtship and copulatory behavior were restored to normal levels only by treatments providing both estrogenic and alpha-androgenic metabolites (i.e., T, AE, E + alpha DHT). AE was clearly the most effective of these, raising behavior significantly above normal on several measures. AN treatment was more effective than alpha DHT on all measures and not significantly different from intact birds on some. Treatment with E, alpha DHT, beta DHT, or E + beta DHT was totally ineffective. Surprisingly, females only solicited males whose hormone treatments provided estrogenic metabolites. Not only did they solicit males given aromatizable androgens, which showed high rates of courtship activity, they also solicited males given E or E + beta DHT, some of which never even courted. Castration and hormone treatment also affected body and syringeal weight, but in opposite directions. Castration increased body weight while decreasing syringeal weight. Hormone treatments providing alpha-androgenic metabolites decreased body weight and increased syrinx weight. Treatments supplying estrogen as well were slightly more effective. PMID- 6862386 TI - Menstrual cycle patterns of hormones and sexual behavior in gorillas. AB - Oppositely sexed pairs of gorillas were tested behaviorally during the menstrual cycle to determine the relationship between hormone concentrations of the female and the frequency of sexual activity by the pair. Five females were tested individually during two cycles with each of two males, but serum samples for hormone assay were obtained from each female only during the first cycle of testing. There was no clear relationship between hormones and behavior for the single cycle in which the serum samples were obtained, with the exception that no copulations occurred after the early luteal phase, when progesterone was greater than 5 ng/ml. Normalized behavioral data from all four test cycles for all pairs suggested that female-solicited copulations were restricted primarily to the periovulatory period. Male sexual initiative (by one of the males) accounted for most copulations temporally dissociated from the periovulatory period. Normalized hormone data for all of the females suggested that (1) attractivity was associated with estradiol concentrations during the follicular phase, (2) proceptivity with estradiol and testosterone at midcycle, whereas (3) receptivity was not associated with hormone patterns or cycle phase. The data suggest that hormones are one of several variables that contribute to the regulation of sexual behavior in gorillas. PMID- 6862389 TI - Hysterectomy facilitates proceptive behavior in rats. AB - The effects of hysterectomy on proceptive behavior were investigated using several doses of estradiol benzoate (EB) and progesterone (P) in female rats. One week after surgery, ovariectomized (OV) and ovariectomized-hysterectomized (OH) rats were given three daily injections of 1.0 or 2.0 micrograms EB followed by 0.5 mg P or oil on the fourth day and were tested for solicitation 4 hr later. The same animals received 1.0 or 2.0 micrograms EB plus 0.1 mg P, or 4.0 micrograms EB plus oil on the same schedule a week following the first test and were tested again. Ovariectomized-hysterectomized animals receiving 0.5 mg P, regardless of the EB dose, showed significantly higher solicitation scores than OV animals, but the scores of the EB-primed OV and OH rats receiving 0.1 mg P or oil vehicle did not differ. PMID- 6862390 TI - Onset of the receptive and proceptive components of feminine sexual behavior in rats following the intravenous administration of progesterone. AB - The present study was carried out in order to assess the time course of action of progesterone (P) in the facilitation of complete feminine sexual behavior. Female rats (estrogen primed via 5% E2 Silastic capsules) were given 200 micrograms of P either intravenously (iv) or subcutaneously (sc), and tested for estrous behavior at 1/4, 1/2, 1, 2, and 4 hr after treatment. Among iv-treated animals, significant amounts of lordosis behavior were seen as early as 1/2 hr, and a dramatic rise in solicitation behavior was observed at 2 hr. Although sc-treated animals displayed significant amounts of lordosis and solicitation behavior at 2 hr, the behavior was not maximal until 4 hr. Intravenous administration of 400 micrograms P was equipotent to 200 micrograms P, whereas 50 micrograms of iv P was relatively ineffective. A dual mechanism hypothesis pertaining to progesterone's actions in the facilitation of both the receptive and proceptive components of feminine sexual behavior in rats is discussed. PMID- 6862391 TI - Androgenic regulation of chemoinvestigatory behaviors in male and female hamsters. AB - In male hamsters, chemosensory responsiveness to sexually relevant female odors is facilitated by testosterone (T). Some evidence suggests that this is not a sexually dimorphic response in that adult females can respond similarly to males following administration of T. This was evaluated and additionally, the hypothesis that facilitation of chemosensory responsiveness by T might be mediated by the conversion of T to aromatized or 5 alpha-reduced metabolites was tested. In 2-min tests, we measured the time adult males or females investigated female hamster vaginal secretion (FHVS). These animals were gonadectomized and administered T, 5 alpha-dihydrotestosterone (DHT), estradiol (E2), or a combination of DHT and E2, by subcutaneous implantation of Silastic capsules. FHVS tests were conducted either 2 and 4 weeks, or 4 and 6 weeks subsequent to gonadectomy and hormone treatment. Comparisons among groups receiving different hormone doses indicated that (1) males and females are not equally responsive to the attractant properties of FHVS, and that (2) neither DHT, E2, nor their combination, can duplicate the effects of T in facilitating responsiveness to FHVS in either sex. The copulatory behavior of males under the hormone conditions described was also tested and it was found that variations in the rate at which the test males sniffed or licked the receptive female's anogenital region correlated with variations in measures of the males' sexual performance. PMID- 6862392 TI - Intracerebroventricular administration of oxytocin and maternal behavior in rats after prolonged and acute steroid pretreatment. AB - The role of oxytocin in the initiation of maternal responsiveness in rats was reexamined. Oxytocin (400 ng in 4 microliters saline) or saline alone was infused into the cerebral ventricular system of ovariectomized steroid-primed virgin females. Subjects received 2 weeks of exposure to ovarian steroids via subcutaneously implanted Silastic capsules (Experiment 1) filled with 17 beta estradiol (1 mm; from Day 1) and progesterone (15 mm; Days 3-13), or they received a single injection of estradiol benzoate (100 micrograms/kg) 48 hr before intracerebral infusion (Experiment 2). Behavioral testing began immediately after oxytocin or saline administration. Latencies to retrieve, group, and crouch over foster young were scored. Contrary to previous reports, oxytocin did not stimulate a rapid onset of maternal responsiveness. The mean latencies to exhibit pup-oriented behaviors ranged from 2.8 to 5.1 days in all groups, regardless of treatment. PMID- 6862393 TI - Serum prolactin levels and crop-sac development in ring doves during a breeding cycle. AB - Using a turkey prolactin radioimmunoassay, the serum prolactin levels of male and female ring doves (Streptopelia risoria) during the breeding cycle were measured and their circulating prolactin levels were compared to crop-sac weight on a within-bird basis. During the early phase of the incubation period, crop weight showed a delayed response to prolactin stimulation and there was no correlation; during the midincubation period when prolactin and crop-sac weight were increasing, there was a strong positive correlation; around hatching, when prolactin was at its peak, there was no correlation. There were again strong positive correlations at later samples, when squabs were developing and both prolactin and crop-sac weight were declining. Thus, it appears that the correlation between the circulating prolactin level and crop-sac development depends on the stage of the breeding cycle. While males and females showed similar pattern of circulating prolactin during the period of incubation and parental care, only females consistently showed a postovulatory rise of prolactin. These results were discussed in the context of the role of prolactin in the breeding cycle. PMID- 6862394 TI - Testosterone and photoperiod interact to regulate locomotor activity in male hamsters. AB - Testicular size, plasma testosterone levels, copulatory behavior, and daily locomotor activity are reduced in male hamsters after 10 weeks of exposure to short days. The role of testosterone in the short day-induced decline in locomotor activity was investigated, determining whether or not photoperiod could alter the effect of testosterone on activity. Castrated adult hamsters were allowed to acclimate to running wheels (wired to digital counters) and then were kept on either long (L:D 14:10) or short (L:D 6:18) days for 60 days. On Day 60, half of the animals on each light cycle were implanted with 12-mm-long testosterone-filled Silastic capsules; half received empty capsules. Digital counting of wheel-running activity continued for another 140 days. Blood samples taken on Day 200 confirmed L:D 14:10 and L:D 6:18 testosterone-treated hamsters had equivalent plasma testosterone levels. After an initial decline in activity, L:D 14:10 animals exhibited a progressive rise in mean running activity (from approximately 2000 to approximately 5000 wheel revolutions per day) through 100 days after the initiation of testosterone treatment. In contrast, activity levels in testosterone-treated L:D 6:18 animals remained uniform (approximately 2000 wheel revolutions per day) during this time, indicating exposure to short days rendered the hamsters less sensitive to the stimulatory effect of testosterone on activity. Of further interest was a marked increase in activity after 160-200 short days in animals treated with either testosterone-filled or empty capsules. It appears the total amount of daily locomotor activity in the hamster is modulated by circulating testosterone levels in a manner which is dependent upon the environmental photoperiod. PMID- 6862395 TI - Genotype modulates testosterone-dependent activity and reactivity in male mice. AB - Adult castration significantly reduced the homecage locomotor activity of both inbred C57BL/6J and DBA/2J and outbred Rockland-Swiss (R-S) male mice. Castrated C57BL animals exhibited greater reductions in this behavior than did the other genotypes. Locomotor activity in a novel environment (reactivity) was also reduced by castration but only for inbred males. In both test situations, postcastration reductions in ambulation were prevented by implants of testosterone (T)-containing Silastic capsules. Thus, testicular hormones promote activity and reactivity in the male mouse in a genotype-dependent fashion. PMID- 6862396 TI - Burn victim faces impending divorce, potential job loss. PMID- 6862397 TI - On the possible prevention of sexual problems in adolescence. AB - The author contends that a primary cause of sexual problems is failure to teach children about sex before they reach adolescence. Physical and mental growth are nurtured and supported throughout infancy and childhood, while sexual development is stifled or distorted. As a result children reach adolescence with their natural eroticism maimed. The author pleads for a basic change in the attitudes of adults, so that parents will begin to teach their children about sexuality. By adolescence children should be prepared to understand and accept their capacity for sexual expression and be fully aware of when and how it might or might not be appropriate. PMID- 6862398 TI - The price of psychotropic drugs: a neglected factor. AB - Of the various factors that determine the choice of psychotropic drugs, economic cost to patients is often not adequately considered. The authors present results of a small survey of private pharmacy prices for psychopharmacologic agents, and compare these prices with wholesale prices and prices from alternative retail sources. They report a large degree of price variability, which sometimes even overshadows price differences between trade and generic preparations. Problems with bioequivalency among different preparations, the ramifications of prescribing the largest possible dose unit, and other issues related to drug cost are discussed. PMID- 6862400 TI - Cultural factors complicating diagnosis and treatment of an African college student. PMID- 6862399 TI - Chronic schizophrenic women's attitudes toward sex, pregnancy, birth control, and childrearing. AB - Interviews with 23 chronically institutionalized, schizophrenic women living on a chronic care unit indicated that the majority had a continuing interest in sex and engaged in sexual activity. Fourteen of the women wanted to become pregnant. Few seemed to recognize their limited potential to be adequate parents. Respondents often gave bizarre or inaccurate responses to the interview questions, indicating that their ideas about contraception, pregnancy, and childrearing were affected by psychopathology. The authors concede that the task of designing and implementing birth control programs for severely ill schizophrenic patients is formidable but encourage mental health professionals to openly discuss sex, birth control, and having children with their patients. PMID- 6862401 TI - The relationship between family violence and hospital recidivism. PMID- 6862402 TI - A partial hospitalization program for nursing home residents. PMID- 6862403 TI - Microcomputer mania: a new mental disorder? PMID- 6862404 TI - Lithium index. PMID- 6862405 TI - Assaults on nursing staff. PMID- 6862406 TI - Dangerous patients. PMID- 6862407 TI - National conference addresses the economic and strategic outlook for hospitals. PMID- 6862408 TI - This is supposed to be the decade of competition. Will it be? PMID- 6862409 TI - Technical hitches delay filmless radiology. PMID- 6862410 TI - Internship program exposes teenagers to hospital life. PMID- 6862412 TI - 'Marooned' hospital sustained by functional design. PMID- 6862411 TI - Health promotion package developed for rural hospitals. PMID- 6862413 TI - Microcomputers play a growing role in hospitalwide information systems. PMID- 6862414 TI - A U.S. Air Force Base Hospital is exploring microcomputers' potential. PMID- 6862415 TI - Human resources management data processing system helps reduce clerical records volume. PMID- 6862416 TI - Antitrust risks in salary surveys? Maybe not: reader. PMID- 6862417 TI - Limits will cut costs. PMID- 6862419 TI - Revenues, spending up at community hospitals. PMID- 6862418 TI - Spending moratoriums elicit mixed reviews. PMID- 6862420 TI - Three hospitals brave NMR marketplace in joint venture. PMID- 6862421 TI - Nuclear medicine put on wheels. PMID- 6862422 TI - AIDs cited as major administrative concern. PMID- 6862423 TI - Multi plans linkage of geriatric services. PMID- 6862424 TI - Pleasing the patient. Service departments strive to cushion 'customers from budget cuts'. PMID- 6862425 TI - Marketing new food services. PMID- 6862426 TI - Efficient engineering. PMID- 6862427 TI - Good housekeeping. PMID- 6862428 TI - Courts are unkind to malpractice reform laws. PMID- 6862429 TI - A process model of the pregnancy course. PMID- 6862430 TI - The autopsy, 1983: can it be revived? PMID- 6862432 TI - Non-Hodgkin's lymphoma in children. AB - Non-Hodgkin's lymphomas (NHLS) in children can conveniently be divided into four major types: lymphoblastic lymphoma, Burkitt's lymphoma, non-Burkitt's lymphoma, and large-cell lymphoma. This article reviews the clinical and histopathologic features of the different types. Recent studies have demonstrated that accurate diagnosis and histopathologic classification of NHL in children provide the optimal basis for selection of therapy. PMID- 6862431 TI - Diagnosis and behavior of juvenile rhabdomyosarcoma. AB - The main problems in the diagnosis of rhabdomyosarcoma are 1) distinction of undifferentiated examples from other small cell malignancies, especially soft tissue Ewing's tumor and lymphoma; 2) distinction of spindling examples from fibrosarcoma, leiomyosarcoma, malignant fibrous histiocytoma, polyhistioma, and other sarcomas; 3) recognition of minimal criteria on small samples such as needle biopsy specimens or frozen sections; and 4) recognition of rhabdomyosarcoma in uncommon sites such as bone (mandible), perineum, retroperitoneum, and chest. In 95 pediatric cases diagnosed and treated at Royal Alexandria Hospital for Children--45 after the introduction of combined therapy- minimal diagnostic criteria were assessed. Cross-striations were found in only one third of cases; longitudinal myofibrils were more common and more helpful. There was much overlap between histologic types, and the microscopic patterns had little bearing on prognoses in preadolescent children. Fourteen cases could not be further differentiated ("embryonal sarcoma, probably rhabdomyosarcoma")--nine small-cell tumors; four tumors from genitourinary tract or head for which very small biopsy specimens were available, and one spindling retroperitoneal neoplasm. In all, slight evidence suggested embryonal rhabdomyosarcoma; this evidence included oat-shaped nuclei and, in a few cells, deeply eosinophilic cytoplasm, small elongated processes, or myxoid or alveolar foci--features that exclude lymphoma and Ewing's tumor. In six cases that were originally classified as poorly differentiated or undifferentiated, later material confirmed the presence of rhabdomyosarcoma by showing a predominantly well-differentiated (pleomorphic) or alveolar pattern after therapy. In 14 remaining undifferentiated cases, immunoperoxidase staining with antihuman-myoglobin serum was positive in five. With combined therapy there was 100 per cent survival among patients with paratesticular, limb, and stage I and stage II tumors; considerably improved survival among patients with head and neck, pelvic, and stage III tumors; and 100 per cent mortality among patients with intra-abdominal and stage IV tumors. PMID- 6862433 TI - High-resolution chromosome analysis of phenotypically abnormal patients with apparently balanced structural rearrangements. AB - Thirteen phenotypically abnormal patients with previously identified de novo or familial, apparently balanced, chromosome rearrangements were reexamined with high-resolution techniques. No definite imbalance could be demonstrated in any of the cases. However, some breakpoints were reassigned to more specific sub-bands and others to totally different bands. The study confirmed translocation reciprocity in some cases in which metaphase banding techniques failed to allow such determination. In one patient an apparent extra dark band was observed which could be explained by limited uncoiling, intraband exchange or small band duplication. In two patients limited uncoiling was observed in one derivative chromosome. Tissue-limited mosaicism was discovered in cultured fibroblasts from one of the seven patients evaluated. PMID- 6862434 TI - Chromosomes from the epithelium of plucked human telogen hairs. AB - This study describes how chromosome preparations can be made from the epithelium associated with plucked hairs from various body sites, following culture in vitro. PMID- 6862435 TI - Sister chromatid exchanges and chromosome aberrations in fibroblasts from patients with retinoblastoma. AB - The frequencies of sister chromatid exchanges (SCEs) and chromosome breaks were investigated in five diploid fibroblast strains derived from three patients with deletion 13 [del(13)] retinoblastoma, one patient with a hereditary form of retinoblastoma, and one trisomy 13. The fibroblasts with del(13)(q14q22) showed slightly increased SCEs (at a P level of 5-10%), but the others, including del(13)(q12q14), the hereditary form of retinoblastoma, and trisomy 13, did not have increased SCEs as compared to normal controls. No increase in chromosome breaks was found in these fibroblasts. The results suggest that retinoblastoma is not associated with spontaneous increased chromosomal instability. PMID- 6862436 TI - Tandem translocation t(14;14) in isolated and clonal cells in ataxia telangiectasia are different. AB - In a patient affected by ataxia telangiectasia (AT), an invading clone with a t(14;14) was found in PHA-, but not in pokeweed-stimulated, lymphocytes. With high resolution R-banding, the proximal breakage was visualized at the junction of bands q11.1-q11.2. This breakpoint differs from that (q12) of noninvading rearrangements of chromosome 14 in AT and non-AT patients. These differences are discussed. PMID- 6862437 TI - Dicentric chromosome 13 and centromere inactivation. AB - The karyotype of a child with dysmorphic findings suggestive of both trisomy 13 and the 13q--syndrome was found to have cells with one of two different dicentric chromosomes: one bearing a duplication of chromosome 13q [46,XX,-13, + psu dic (13)t(13;13)(pter leads to cen leads to q34::q34 leads to pter)] and the other a deletion of 13q [46,XX,-13, + psu dic (13)t(13;13)(pter leads to cen leads to q22::q11 leads to pter]. Longitudinal cytogenetic studies in leukocytes demonstrated a loss of those cells possessing the small dicentric [psu dic(13)(q22;q11)], whereas fibroblasts from two separate skin biopsies contained only this marker. Q-band polymorphisms indicated that both dicentrics were of paternal origin, with the smaller dicentric derived from the larger via the bridge-breakage-fusion cycle. The presence of two active centromeres could not be confirmed in either dicentric. PMID- 6862438 TI - Familial fragility on chromosome 16 (fra 16q22) enhanced by both interferon and Distamycin A. AB - A family with a "fragile site" at 16q22, inducible by both interferon and Distamycin A, is reported. Immunological problems were found in the family. In a sibship of ten, eight children had died in infancy. Our study led to the conclusions that interferon and Distamycin A induce fragility at the same site, which has the same characteristics as the spontaneous fragile site; that a viral hypothesis for this fragility may be supported; and that immunoincompetence of one kind or another must be considered in families presenting a fragile site at 16q22. PMID- 6862439 TI - Chromosome segregation into the spermatozoa of two men heterozygous for different reciprocal translocations. AB - Sperm chromosomes from two human males, each heterozygous for a different reciprocal translocation, were examined. Chromosomally normal sperm were found in equal numbers to those carrying the translocation in the balanced form, in both males. Alternate segregation was more common than adjacent segregation in both translocations. Male W. G. had a greater proportion of sperm containing chromosome abnormalities unrelated to the translocation than did J.S., the second made studied. J.S. however, had a greater frequency of chromosomally unbalanced sperm. The great majority of unbalanced sperm in both males was due to adjacent I segregation. PMID- 6862440 TI - Efficient direct chromosome analyses and enzyme determinations from chorionic villi samples in the first trimester of pregnancy. AB - Chorionic villi were obtained by an aspiration technique which proved to be the best of four alternative procedures. We report in detail the series of experiments which led to (1) successful, rapidly growing cell cultures practically free of maternal cell contamination (the use of hormone-supplemented Chang medium greatly increased the growth rate); (2) an efficient direct method to obtain high quality metaphases from the Langhans cells of the cytotrophoblast tissue and with which the fetal karyotype is defined within a few hours of chorionic villi sampling; and (3) successful testing for the activity of eight enzymes directly from the villi samples, thus showing that this material is suitable for a rapid, direct diagnosis of the related metabolic diseases. PMID- 6862441 TI - Sister chromatid exchange in the centromere and centromeric area. AB - Central and peripheral sister chromatid exchanges (SCE) were evaluated separately in human phytohemagglutinin (PHA)-stimulated lymphocytes after culture for 72 h in 5-bromodeoxyuridine (BrdU) containing medium. At the same time, the length of chromosome No. 1 was measured in 10 metaphases per case and the mean value taken as a representative parameter for the contraction of chromosomes. The statistical analysis of regression revealed a close relationship between the percentage of SCE observed in the centromere and the contraction state of chromosomes (P less than or equal to 0.01). A statistically significant increase of central exchanges was seen in more condensed chromosomes, due to the difficulty in differentiating clearly between centric and pericentric exchanges. Consequently, if exchanges in the centromere are omitted from evaluation, this would lead to spuriously low SCE rates in more contracted chromosomes. In order to exclude the variable factor of chromosome contraction in SCE studies, we highly recommend inclusion of counts of central exchanges. Results obtained on chromosomes with twisted chromatids, a situation which tends to stimulate SCE, should be omitted. PMID- 6862444 TI - Human chromosomal polymorphism. VII. The distribution of chromosomal Q polymorphic bands in different human populations. AB - The distribution of chromosomal Q-polymorphic bands was studied in different human populations. The populations studied showed no differences in the relative amount of Q bands in all the 12 polymorphic loci of seven autosomes, but interpopulation differences did exist in the absolute amount of Q bands in all the 12 potentially polymorphic loci of seven autosomes, these differences consisting of uniform increases or decreases in this absolute amount. Comparisons of the mean number of Q-heterochromatin bands with fluorescence levels 4 and 5 per individual showed a consistent prevalence of this quantitative parameter of chromosomal Q polymorphism in females as compared to males in all the national groups. It is suggested that there is some dosage compensation of chromosomal Q heterochromatin material in females due to the absence of a chromosome in their genome, which is able to "compensate" for the large Q band in chromosome Y which is present only in the karyotype of males. PMID- 6862442 TI - Is there a general relationship between estimated chromosome distances in interphase and location of genes with related functions? AB - The problem of a possible clustering of human chromosomes containing genes with related functions was examined in the interphase nucleus of lymphocytes by a statistical comparison of distances between chromosomes containing such functionally related genes with all sets of chromosome distances. The gene locus assignments were taken from a recent review (McKusick 1982); the chromosomal distances were those estimated by Hager et al. (1982) from the frequencies of reunion figures between specific chromosomes as observed in chromosome instability syndromes (Fanconi anemia, Bloom syndrome) and after treatment with Trenimon. Chromosomal distances had been estimated by multidimensional scaling. There was no general tendency for closer location of chromosomes containing genes with related function. A few such chromosomes do show below average distances but this could easily be a chance result. PMID- 6862443 TI - Confirmation of a de novo duplication, dup(10)(q24 leads to q26), by GOT1 gene dosage studies. AB - A girl with mental retardation and the facies associated with the distal 10q duplication syndrome was found to have a tandem duplication of 10q24 to 10q26. This was confirmed by gene dosage studies of glutamic oxaloacetic transaminase 1. The clinical features of this patient are compared with those of other reported cases of the distal 10q duplication syndrome with duplication-deficiency karyotypes due to familial reciprocal translocations or inversions or with tandem duplication of a more proximal region of 10q. Reports of tandem duplications in man and possible mechanisms of origin are discussed. PMID- 6862445 TI - The distribution and interaction of haemoglobin variants and the beta thalassaemia gene in Liberia. AB - In a population survey in Liberia, West Africa, 12 major tribes were examined for the prevalence of Hb S, Hb C, and the beta thalassaemia (beta Thal) gene. Hb C is rare; Hb S and beta Thal occur in polymorphic frequencies. The distribution of both genes shows an inverse correlation. The beta Thal trait was diagnosed by quantitation of Hb A2 on DE 52-microchromatography. This method proved to be reliable and useful for mass screening. PMID- 6862446 TI - Selection against chromosomally abnormal sperm--fact or fiction? PMID- 6862447 TI - VDT workstation design: preferred settings and their effects. PMID- 6862448 TI - The perception of flicker and glare on computer CRT displays. PMID- 6862449 TI - Quantifying the thermal protection characteristics of outdoor clothing systems. PMID- 6862450 TI - Individual differences in multiple-task performance as a function of response strategy. PMID- 6862452 TI - Estimating the ascertainment probability from the number of ascertainments per proband. AB - Several methods of estimating the ascertainment probability from the distribution of the number of ascertainments per proband have been presented in the literature. Here these methods are compared. The Skellam often gives the best fit, but there are counter examples. The estimate from a Poisson distribution is generally close to the best solution. PMID- 6862451 TI - Compatibility and resource competition between modalities of input, central processing, and output. PMID- 6862453 TI - Polarity and sex effect in genetic transmission of affective disorders. The single major locus hypothesis. AB - A single major locus model of inheritance that incorporates polarity (bipolar unipolar distinction) and sex effect was applied to family study data on bipolar and unipolar affective disorders. In the model tested, clinical polarity and sex related thresholds determined a differential liability to major affective illness, whereby unipolar females and bipolar males represented two extremes on a genetic-environmental continuum. Bipolar males were more deviant, and unipolar females were less deviant genetically than bipolar females and unipolar males. The major locus hypothesis did not provide an acceptable fit to the data. The implications of these findings for genetic and biological research in affective disorders are discussed. PMID- 6862454 TI - Red cell antigen, plasma protein and red cell enzyme polymorphisms in the island of Tasmania. AB - Blood specimens from 651 blood donors registered with the Hobart division of the Red Cross Blood Transfusion Service of Tasmania were examined for six red cell antigen systems, as well as two plasma protein and three red cell enzyme polymorphisms. The most distinctive feature is the relatively high frequency of the Rh haplotype cde. Subdivision of the sample, permitted via questionnaire data, indicated that donors born overseas exhibited the greatest differences from those born in Tasmania, but none were significant at the 5% level. Overall gene frequencies in Tasmanian donors, except for the Rh system, were very similar to those reported for Melbourne donors, and clearly reflect the known predominance of British and Irish immigrants throughout the period of white settlement on the island. PMID- 6862455 TI - Hereditary hemoglobin disorders in a Brazilian population. AB - A survey of hereditary hemoglobin disorders in a mixed Brazilian population of the northeast of the State of S. Paulo revealed a 5.3% incidence of abnormal phenotypes among 400 schoolchildren, 4.5% among 602 mothers and 2.8% among 606 newborns. The most common findings were AS (1.9%), AC (0.8%) and beta-thalassemia (0.8%) heterozygotes, which amount to 3.5% of the sample. In a second selected population of 1,023 patients of the Hematologic Clinic of the University Hospital and their relatives, 471 cases of hemoglobinopathies were detected. The most frequent anomalies were heterozygous beta-thalassemia (35.2%) and Hb S (32.5%), followed by sickle-cell anemia (13.0%), homozygous beta-thalassemia (4.0%) and sickle-cell/beta-thalassemia (4.0%). Other defects detected were delta-beta thalassemia, Hb C, Hb Hasharon and Hb A2'. One family with alpha-thalassemia has been identified that included a girl with Hb H disease. The significance of these findings is discussed with regard to the racial origin of the population of this region. PMID- 6862456 TI - Sex ratio and natural selection at the human ABO locus. AB - Natural selective effects of ABO maternofetal incompatibility depend on age, sex and gene frequency. This study focuses on differences of fitness according to age and sex. Calculations of genotype frequencies weighted by fitness lead to the hypothesis that forces of natural selection would favor an association of excess males with type O. Studies of polymorphic populations and homogeneous O populations provide empirical support for the hypothesis. PMID- 6862457 TI - Alkaptonuria and ochronosis. A survey and 5 cases. AB - A survey of alkaptonuria and ochronosis is given, based on the literature and on 5 additional cases. The disease, which is autosomal recessive, results from a decreased amount of the enzyme homogentisic acid oxidase, due to which tyrosine and phenylalanine cannot be broken down via the normal pathway. The diagnosis is made by determination of urinary urinary homogentisic acid excretion, as the clinical and radiological findings are not pathognomonic. The symptoms, which extend over decades, result from the deposition of pigment in the extracellular macromolecules of the connective tissue, particularly of the skin and joints. PMID- 6862458 TI - Differences in the relative distribution of human gene diversity between electrophoretic and red and white cell antigen loci. AB - Gene frequency data for 25 loci (2 HLA loci, 9 blood group loci, and 14 electrophoretically detectable loci) were collected from the literature of 18 human populations from all over the world. The data were subjected to a hierarchical gene diversity analysis to provide an estimate of the relative distribution of genetic variation between and within populations and population groups for different types of loci. Two different ways of grouping the populations, i.e., according to anthropological criteria and to a cluster analysis based on gene frequency data, gave essentially the same results. For all loci combined approximately 86% of total gene diversity was found within populations, 3% was associated with differences between populations within groups, and 11% related to group differences. These results are very similar to those obtained in previous studies based on fewer loci and different sets of populations. The distribution of genetic variation is different for different types of loci. The HLA loci give a picture very similar to that of the electrophoretic loci while the blood group loci have a substantially larger fraction of the total gene diversity distributed between populations or population groups. PMID- 6862459 TI - Proceedings of the 10th International Congress of the European Association of Poison Control Centres held in association with the British Toxicology Society. Brighton, England, 3--6 August 1982. PMID- 6862460 TI - Haemodynamic studies in eight cases of acute colchicine poisoning. AB - 1 The authors performed haemodynamic studies in 8 cases of colchicine poisoning. The doses absorbed ranged between 9 and 160 mg (mean dose 39 mg). THe haemodynamic study was performed between the 6th and 72nd h after intoxication, before and after plasma infusion (370 ml over a period of 20 minutes). 2 Four patients had severe shock with decreased cardiac index (CI) and increased sytsemic vascular resistance (SVR). Four patients had a hyperkinetic state with increased CI and decreased SVR. The four patients with cardiac failure died, the others recovered. 3 Haemodynamic study of acute colchicine poisoning is of therapeutic and prognostic interest. Hypovolaemia is always present. An initial decrease of cardiac performance is an index of severity with a lethal outcome. PMID- 6862461 TI - Chemotherapy of Amanita phalloides poisoning with intravenous silibinin. AB - 1 A total of 18 cases of Amanita phalloides intoxication was treated by combined chemotherapy during 1980 and 1981. After attempted primary elimination of the toxin all patients received silibinin as basic therapy mainly by infusion and in two instances orally. 2 In order to evaluate the effect of silibinin therapy a retrospective study of the followed-up case records was made. The cases were arbitrarily classified into three groups according to the severity of liver damage (light, medium and severe). 3 There was found a close relationship between the severity of liver injury and the delay between mushroom ingestion and the onset of silibinin therapy. With the exception of one fatality in a particularly high dosage suicidal intoxication, all patients survived. 4 Administration of silibrinin even up to 48 h after mushroom ingestion appears to be an effective measure to prevent severe liver damage in Amanita phalloides poisoning. Contrarily, the onset of general supportive treatment together with penicillin therapy which was throughout several hours before silibinin administration did not correlate with the severity of liver damage. PMID- 6862462 TI - Myoglobinuric renal failure due to drug-induced rhabdomyolysis. AB - 1 Two cases of drug-induced rhabdomyolysis, one of them presenting with acute myoglobinuric renal failure are described. 2 The pathogenesis of rhabdomyolysis and renal failure in our cases is discussed with reference to work published by other authors. 3 Whereas there seems to be obvious evidence for direct toxic drug muscle interaction, the mechanism for the development of myoglobinuric renal failure remains unclear. PMID- 6862463 TI - In vitro and in vivo evaluation of two preparations of activated charcoal as adsorbents of aspirin. AB - 1 The adsorptive capacities of two preparations of activated charcoal have been studied both in vitro and in vivo using aspirin as a test compound. 2 The in vitro adsorptive capacities of the charcoal preparations were 477 mg of acetylsalicylic acid/g effervescent charcoal ('Medicoal'); 359 mg/g untreated standard charcoal ('Norit-A') and 482 mg/g reheated charcoal ('Norit A'). 3 In vivo both charcoal preparations significantly reduced peak salicylate concentrations and salicylate availability, to a similar extent (analysis of variance P less than 0.001). 4 Both charcoal preparations have similar capacities for adsorbing aspirin both in vitro and in vivo. PMID- 6862465 TI - An investigation of the role of the specific opioid antagonist naloxone in clinical toxicology. AB - 1 An assessment of the current role of naloxone in clinical toxicology has been made in a series of three separate epidemiological studies. 2 Through the National Poisons Information Service we found that the role of naloxone in opioid poisoning is often not appreciated by the enquirer and that toxicological screening is often requested before the diagnostic use of naloxone. 3 The recommended dose of naloxone (0.4--1.2 mg i.v.) is not always adequate. In 51 cases where naloxone was effective, doses of up to 3.2 mg were necessary (mean 1.8 +/- 0.3 mg SEM i.v.). 4 In 31 cases of non-opioid poisoning, naloxone in doses of 0.4--1.2 mg i.v. caused no deterioration, whilst six patients in whom no opioids were detected showed clinical improvement. 5 In 300 cases of suspected ethanol-induced coma, 49 showed reversal of coma with naloxone, and in 38 cases ethanol was the sole cause of coma (mean plasma concentration 3.54 +/- 0.62 g/l SEM). 6 These results suggest that the role of naloxone in clinical toxicology is not fully appreciated. There is a need for further education as to its indications in opioid poisoning, together with additional studies to define more accurately the dose/response relationship. In addition, the role of naloxone in coma induced by ethanol and certain other non-opioids needs to be evaluated further. PMID- 6862466 TI - Arterial perfusion for hydrofluoric acid burns. AB - The perfusion method is briefly summarised: 1 An arteriogram (under brachial plexus block) is carried out, and the radial, ulnar or brachial artery chosen as infusion site, according to the location and extent of the damage. 2 The infusion is administered over 4 h: Radial or ulnar artery 10 ml 20% calcium gluconate in 40 ml normal saline, or brachial artery: 20 ml 20% calcium gluconate in 80 ml normal saline. 3 Heparin 200 u per kg body weight as long as the arterial catheter is in pace. PMID- 6862464 TI - Effects of naloxone on ethanol-induced coma. PMID- 6862467 TI - Acute voluntary intoxication by ricin. AB - 1 A 21-year-old student ingested thirty ricin seeds in a suicidal attempt, some of which were masticated. Three hours later he developed severe diarrhoea with vomiting and abdominal cramps, followed by extracellular dehydration and circulatory collapse. 2 Biological changes included haemoconcentration. He recovered following symptomatic treatment by infusion of saline and glucose solutions. 3 Ricin was quantified by a radioimmunologic method using Iodine 125, and showed that only a small part of the ricin contained in the seeds was absorbed. PMID- 6862468 TI - Computers in poisons information. AB - Computers may be used by Poison Control Centres (PCCs) for literature retrieval, as answering aids and for case registration. Experience now shows that in each of these uses the computer may be valuable but many of these programs are still in their infancy and there is undoubtedly scope for further development both for service and research applications. The present debate about the role of computers in PCCs is of considerable importance since it must be hoped that it will be possible to make the best use of finances and develop an approach which assists rather than confounds international understanding. PMID- 6862469 TI - Computerised product information. A preliminary report from the Swedish Poison Information Centre. PMID- 6862471 TI - Childhood poisoning: perspectives and problems. PMID- 6862470 TI - Enquiries to the Danish Poison Information Centre 1970-1980. Results of a pilot project with standardization of data. PMID- 6862472 TI - Childhood poisoning in a paediatric hospital: the Luebeck experience. AB - 1 Case documentations in Poison Control Centres represent today probably the most useful source of information on actual trends. They are generally restricted to toxicologically relevant information, but they do not describe true incidence patterns. Population based analyses of incidence therefore generally consist of retrospective studies of hospital data. The regional and historical limitations of such studies restrict their usefulness in prevention and intervention. A solution could be prospective studies in defined regions. 2 Such a prospective registration of poisoning in children was started in 1982 in the Luebeck Medical School's Paediatric Hospital. This hospital is the only institution treating acute poisoning in the region, so that regional representation of the data can be expected. Based on the experiences of a previous retrospective analysis of 730 poisoning cases treated between 1976 and 1980, a documentation form was developed for the registration of clinically and epidemiologically relevant data. Information on the toxic substance and the poisoned child is complemented by data on the clinical treatment as well as on socio-demographic parameters. 3 The first months' experience with the documentation form, and the results of the registration of 95 cases are presented. Possibilities and limitations of such registration systems are discussed. PMID- 6862473 TI - The frequency of children's poisonings in different social groups. AB - 1 Social stress has been emphasised as one of the major aetiologic factors in childhood poisonings. The clinical records of 188 children treated for acute poisoning in Helsinki during a six month period in 1980 were investigated. 2 The ratios of the observed number of poisonings to the expected ones calculated on the basis of the social group distribution in Helsinki were as follows: (I) 1.9, (II) 0.7, (III) 0.8, and (IV) 1.2. With respect to the poisonings classified as severe, the corresponding ratios were 0.7, 0.6, 1.4 and 1.4. 3 There were more accidental and less serious poisonings in the highest social group than in the other social groups, and they were relatively more often caused by plants or tobacco. The delay from the poisoning to the treatment was the shortest among the children of the highest social group. The differences in poisoning incidence rates among various social groups could partly be explained by different patterns of health service utilization. PMID- 6862474 TI - Acute poisoning by ethylene chlorohydrin. Intoxication by ingestion of film cement in two children. PMID- 6862475 TI - Acute intoxication with nicotine alkaloids and cannabinoids in children from ingestion of cigarettes. PMID- 6862476 TI - Non-accidental paracetamol poisoning in an eleven month-old child. AB - 1 Although accidental poisoning of children with drugs and chemicals is a common precipitant for admission to hospital, the possibility of deliberate poisoning as an extension of 'the battered baby syndrome' is rarely considered. 2 Most children admitted following accidental ingestions require little active management other than induction of emesis. Report of relatively large overdoses in infancy are rare, and protocols for management of such cases largely untried. This case report demonstrates the successful application of a current treatment regimen to an infant who had ingested a substantial quantity of paracetamol. PMID- 6862477 TI - Poisoning with Veratrum-containing sneezing powders. AB - 1 Nine cases of accidental poisoning of children with sneezing powder are reported. Symptoms, besides sneezing, included gastrointestinal disturbances and syncope, whilst examination demonstrated bradycardia and hypotension. 2 The powder, as supplied, carried no information on its constituents but Veratrum alkaloids were identified on analysis. The signs and symptoms observed were compatible with poisoning from these compounds. 3 As a result of these observations, it was possible to trace the manufacturers and a change was made to a safer formulation. This example emphasises the value of toxic vigilance by Poison Control Centres. PMID- 6862478 TI - Short-term experience of the newly established poison control centre of Cairo. AB - 1 During the first 31 weeks of operation, the Cairo Poison Control Centre received 463 enquiries. 2 Accidental poisoning predominated with 54% of cases involving children under 5 years of age whilst attempted suicide was reported in only 21%. 3 When these early experiences are compared with the observations from the European Poison COntrol Centres, there are a number of marked differences including the types of drugs and chemicals involved. 4 Problems associated with drugs considered obsolete in Europe, inadequately labelled chemicals and inappropriate treatments have already been highlighted, and preventive measures are being considered. PMID- 6862479 TI - Carbon monoxide poisoning: poisons unit experience over five years. PMID- 6862481 TI - Review of enquiries made to the NPIS concerning Psilocybe mushroom ingestion, 1978--1981. PMID- 6862480 TI - The problem of the corrosiveness of products--a pilot study with a denture cleaner. PMID- 6862482 TI - Trazodone overdosage: experience from a poisons information service. PMID- 6862483 TI - Acute chlormethiazole poisoning in patients notified to the Poisons Unit, Guy's Hospital, 1978--1981. AB - 1 Out of 493 patients with suspected acute chlormethiazole poisoning notified to the Poisons Unit, Guy's Hospital during 1978--1981, the diagnosis was confirmed either analytically or by detailed clinical information in 108 patients, 40 of whom had ingested chlormethiazole alone. 2 The principal signs reported indicate that the clinical features of acute chlormethiazole poisoning resemble those of barbiturate poisoning, with deep coma (n = 66), respiratory depression (n = 26) and hypotension (n = 17) in the severe cases. Five patients died as a result of early, profound respiratory depression. 3 In 53 survivors in whom toxicological analyses were performed, poisoning with chlormethiazole alone had a better prognosis than when ethanol or other drugs were also present, except in patients with hepatic or pulmonary disease or in the elderly. 4 These results emphasise that although patients poisoned with chlormethiazole who survive to reach hospital generally have a good prognosis, fatal respiratory complications often occur before the patient can be treated. PMID- 6862484 TI - Acute poisoning with ibuprofen. AB - 1 Seventy five cases of ibuprofen overdose were recorded during a two year survey. 2 Details of the symptoms, treatment and the eventual outcome are known for 64% of the cases. The majority of the patients had no symptoms or only mild symptoms such as nausea or vomiting. 3 In the three cases where more serious symptoms were reported, the role of ibuprofen was not certain. 4 Laboratory analyses available for 13 cases demonstrate that plasma ibuprofen concentrations of up to 704 mg/l could be associated with no symptoms. 5 The data suggest that ibuprofen is of low toxicity in acute overdose and that therapy used should be supportive only. PMID- 6862486 TI - Determination of amphetamine and methylamphetamine by gas-liquid chromatography (head space). AB - 1 A method for determining amphetamine and methylamphetamine in urine by gas liquid chromatography is described. 2 Chromatography is performed on a 10% Apiezon L, 10% KOH column with alkali-flame detection (NPD). This method avoids the losses of these volatile substances which are known to occur when solvent extraction is used. An alkalinized urine sample (1 ml) is introduced into a sealed vial which is heated in a water bath at 70 degrees C for 20 min. A 1 ml portion of the gas phase in equilibrium with the liquid phase is chromatographed. 3 Amphetamine and methylamphetamine can be detected and measured in urine samples after single therapeutic doses of the drugs. PMID- 6862485 TI - Experience with a screening method for laxative abuse. AB - 1 Abuse of laxatives may lead to a variety of serious disorders which are usually difficult to recognize because of the heterogenicity of the toxic effects. 2 In order to facilitate the diagnosis of chronic laxative poisoning, a laboratory screening method for the detection of colonic stimulants in urine has been designed and has been applied in practice over a three-year-period. 3 During this period, 157 samples from 81 patients were sent to the laboratory. Fifteen patients (18.5%) were definitely shown to use self-prescribed laxatives. 4 Next to the diphenolic compounds: bisacodyl, phenolphthalein and bisoxatin, the anthraquinone derivative rhein, a metabolite of vegetable laxatives, was found in several cases. In the urine of three patients a substance resembling rhein was found, which was shown to be aloe-emodin. 5 It is concluded that chronic self poisoning with laxatives is a fairly common disorder than can easily be overlooked. Laboratory screening of the urine of suspected patients is an economic and reliable method for its diagnosis. PMID- 6862487 TI - Application of I.R. spectrophotometry in emergency analyses. AB - I.R. spectrophotometry has been applied in emergency toxicological analyses. Poisons and drugs are extracted into chloroform, potassium bromide is added to the extract and the solvent evaporated. Potassium bromide discs are prepared by compression and scanned in an I.R. spectrophotometer. A data bank of standard spectra has been prepared and computerized comparison of the spectral data of the sample extract with those of authentic compounds allows the identification of toxic agents in 'real time'. PMID- 6862488 TI - The mechanism of paracetamol-induced hepatotoxicity: implications for therapy. AB - 1 The reactive metabolite responsible for paracetamol-induced hepatotoxicity, postulated to be N-acetyl-p-benzoquinoneimine reacts with N-acetyl cysteine. 2 An adduct is formed by an SN2 mechanism and paracetamol is produced by a redox reaction. 3 The adduct produced is capable of further oxidation by N-acetyl-p benzoquinoneimine. 4 Methionine does not react with the reactive metabolite to any great extent. PMID- 6862490 TI - Spectral analysis of arterial blood pressure in the rat. PMID- 6862491 TI - Orthogonal surface lead recordings of His-Purkinje activity: comparison of actual and simulated waveforms. PMID- 6862492 TI - Adaptive control of blood pressure. PMID- 6862489 TI - A practical analysis of the electrical conductivity of blood. PMID- 6862493 TI - Theoretical considerations regarding the optimization of cardiac assistance by intraaortic balloon pumping. PMID- 6862494 TI - A multichannel event timer for real-time laboratory computer systems. PMID- 6862495 TI - Frequency limitations and optimal step size for the two-point central difference derivative algorithm with applications to human eye movement data. PMID- 6862496 TI - 1/f fluctuations in the spontaneous spike discharge intervals of a giant snail neuron. PMID- 6862497 TI - A preprocessor for on-line data reduction in accelerated playback of ECG's. PMID- 6862498 TI - Discrete time estimation of the mean Doppler frequency in ultrasonic blood velocity measurements. PMID- 6862499 TI - A low-noise low input impedance amplifier for magnetic measurements of nerve action currents. PMID- 6862500 TI - On the possibility to determine integral characteristics of the cardiac electric generator from extracardiac electric and magnetic measurements. PMID- 6862501 TI - Mechanical fatigue as a possible determinant of in vivo longevity of red blood cells. PMID- 6862503 TI - A learning filter for removing noise interference. PMID- 6862502 TI - A light-scattering apparatus for the study of cellular suspensions. PMID- 6862504 TI - The quantification and graphic display of correlations among three spike trains. PMID- 6862505 TI - SEER-I: the semantic EEG evaluation regimen. PMID- 6862506 TI - Pressure-derived flow: a new method. PMID- 6862507 TI - Vertical fusional response to asymmetric disparities. PMID- 6862508 TI - A computer algorithm to calculate P50 from a single blood sample. PMID- 6862509 TI - Prediction of temperature profiles in tumors and surrounding normal tissues during magnetic induction heating. PMID- 6862510 TI - Design considerations for a real-time ocular counterroll instrument. PMID- 6862512 TI - Some improvements in the measurement of variable latency acoustically evoked potentials in human EEG. PMID- 6862511 TI - Microwave-induced pressure waves in mammalian brains. PMID- 6862513 TI - Demodulation of amplitude modulated noise: a mathematical evaluation of a demodulator for pathological tremor EMG's. PMID- 6862517 TI - Xth International Complement Workshop. May 25-27, 1983 . Mainz. Abstracts. PMID- 6862514 TI - Technique for cloning bovine aortic endothelial cells. AB - A simple reproducible method is described for isolating pure clonal populations of bovine aortic endothelial cells in culture. Single cells exposed to conditioned medium grow rapidly (clonal cell doubling time approximately 20 h) until a confluent monolayer is reached. This method provides virtually 100% cloning efficiency. In addition, the cell population doubling level of endothelial cell cultures, when continuously exposed to conditioned medium, is increased 40% over controls in fresh medium. PMID- 6862518 TI - A study of cells present in lymph draining from a contact allergic reaction in pigs sensitized to DNFB. AB - Pigs were skin-painted with the contact sensitizing agent 1-fluoro 2,4 dinitrobenzene (DNFB) and lymph cells coming from the site were collected. Half the animals were sensitive to DNFB and half were normal controls. Special attention was paid to cells belonging to the veiled cell series. At 20 hr after DNFB application, some blast cells--on morphological grounds belonging to the veiled cell series--could be observed in the lymph of presensitized animals. But the most predominant finding in these pigs was that, approximately 30 hr after painting, the total cell output began to increase, reaching 10 times the normal level at 70 hr. The increase in the output of lymphoblasts was the most marked, suggesting peripheral sensitization. Such changes were not observed in normal animals. Here the most striking alterations were seen in the veiled cells. Some of these cells were moving ponderously about, apparently in pursuit of other lymph-borne cells, and this activity resulted in the formation of large cellular aggregates. Since it is known that veiled cells are involved in antigen handling, this behaviour probably facilitates the induction of the T-cell immune response. By contrast, the veiled cells from presensitized animals behaved in a more normal manner and the proportion found in aggregates was only briefly increased. In these animals lymphocytes were seen to interact with veiled cells in a manner reminiscent of peripolesis, apparently recognizing antigenic signals on the surface of the veiled cells. It is discussed that this might result in deletion of the antigen-presenting veiled cells, thus controlling the magnitude of the immune response. PMID- 6862516 TI - Amphibian cell culture: established fibroblastic line from embryos of the discoglossid frog, Bombina orientalis. AB - A new amphibian cell line, Bor II, is described. It was initiated from Stage 20 embryos of the discoglossid frog, Bombina orientalis. In early passages the cell line had an epithelioid morphology. Beginning at or around subcultivation 16, a more fibroblastic cell type emerged and rapidly became predominant. These later passage cells were able to proliferate in low (1.0%) serum, displayed frequent overlaps, and lacked postconfluent inhibition of cell division. The cell line was unable to survive at 37 degrees C, but grew vigorously within a temperature range of 20 degrees to 30 degrees C. The presence of two distinctive marker chromosomes in an otherwise diploid karyotype should make these cells useful for nuclear transplantation studies. PMID- 6862515 TI - Established cell lines from rat adipose tissue that secrete lipoprotein lipase. AB - A number of cell lines derived from the stromal-vascular fraction of rat adipose tissue have been established that represent a variety of morphologic types. Despite their differing morphology, all of these cell lines secrete lipoprotein lipase in response to heparin. Because lipoprotein lipase secretion has been attributed to the presence of preadipocytes in the stromal-vascular fraction, we examined these cell lines for adipocyte conversion. None of the cell lines converted to adipocyte morphology when held at confluency or when exposed to media supplemented with high concentrations of fatty acid or very low density lipoproteins. These cell lines therefore do not seem to be preadipocytes, despite the presence of lipoprotein lipase. Among these cell lines are several that display the "cobblestone" morphology of endothelial cells, although they lack angiotensin-converting enzyme activity, reactivity with Factor VIII antibodies, and Weibel-Palade bodies. A number of authentic endothelial cells were found to be negative for lipoprotein lipase secretion. These data suggest that the "endothelial-like" cell lines established from adipose tissue are not endothelial cells. PMID- 6862519 TI - Induction of syngeneic tumour-specific immunity by liposomes reconstituted with L2C tumour-cell antigens. AB - Liposomes composed of phosphatidylcholine and phosphatidylserine were reconstituted by detergent dialysis with 3 M K Cl extracts of L2C tumour cells. Liposomes containing L2C antigens were as antigenic as intact tumour cells in the elicitation of delayed-type hypersensitivity responses in strain-2 guinea-pigs previously immunized against L2C tumours. Soluble L2C antigens were devoid of immunoprotective activity, whereas the reconstituted liposomes were capable of protecting animals against up to approximately 100 times the minimal lethal dose of tumour cells. Moreover, the reconstituted liposomes were as antigenic and immunoprotective as viable (irradiated) cells. PMID- 6862520 TI - Autoimmune haemolytic disease in mice after exposure to a methylating carcinogen. AB - N-Methyl-N-nitrosourea (MNU) but not methyl methanesulphonate (MMS) induced both autoimmune haemolytic anaemia and thymic lymphoma in susceptible strains of mice, particularly the C57BL/6. These effects could be positively correlated with the formation of O6-methylguanine in target DNA. All murine lymphoid cells showed lack of ability to remove O6-methylguanine from their DNA, therefore the variation of responses between different mouse strains indicated that other host factors, probably genetic, must be involved. The results do indicate however that a potent pre-mutagenic DNA base modification can initiate the events leading to autoimmune disease in susceptible mice. PMID- 6862522 TI - A comparison of the effects of heat-aggregated and chemically cross-linked IgG on monocyte C2 production. AB - Heat or alkali-aggregated IgG was found to inhibit C2 production by monocytes, whereas chemically cross-linked IgG and antigen-antibody complexes stimulated C2 synthesis. Chemically cross-linked IgG was shown to inhibit monocyte EA-rosette formation presumably because it blocked monocyte Fc receptors. Furthermore stimulation of C2 synthesis was limited to polymers of the IgG1 and IgG3 subclasses. In contrast, heat-aggregated IgG failed to inhibit monocyte EA rosette formation significantly, and all the heat-aggregated IgG subclasses inhibited C2 production. It therefore appears that physically aggregated IgG does not bind effectively to Fc receptors. As the effects of physically aggregated IgG C2 production are similar to those of the hydrophobic proteins casein and alkali denatured human serum albumin (HSA), it is suggested that hydrophobic residues in the aggregates bind preferentially to the lipid component of the cell membrane. PMID- 6862521 TI - Immunological responses to fed protein antigens in mice. II. Oral tolerance for CMI is due to activation of cyclophosphamide-sensitive cells by gut-processed antigen. AB - Mice fed ovalbumin develop specific systemic hyporesponsiveness. This oral tolerance is abrogated by cyclophosphamide pretreatment, and the mechanism of abrogation could be either via T suppressor cells or via damage to the gut epithelium. A serum transfer protocol was used to examine the site of action of cyclophosphamide in this system. Serum was collected from ovalbumin-fed mice and transferred into recipients which were then parenterally immunized with ovalbumin in Freund's complete adjuvant. Serum transfer suppressed the delayed type hypersensitivity (DTH) responses but not the antibody responses of the recipients. Cyclophosphamide pretreatment (100 mg/kg) of recipients (but not of donors) abrogated this suppressor effect. Parenteral administration of ovalbumin in a range of doses did not induce immunological hyporesponsiveness. It is suggested that absorption across the gut mucosa leads to generation of fragments of ovalbumin that induce suppressor cells selective for DTH. PMID- 6862523 TI - The influence of gut function on lymphoid cell populations in the intestinal mucosa of lambs. AB - The number and type of lymphoid cells in the intestinal mucosa of lambs change during the first weeks after birth. The influence of gut function on these changes was examined by comparing the evolution of lymphoid cell populations in normal ileum with that in lengths of ileum which had been isolated surgically from the functional intestinal tract of the lamb before birth. The isolated lengths of ileum had a normal blood and nerve supply and they remained healthy throughout a period of at least 2 years, although they did not have a normal histological development. In comparison with normal ileum, the villi of the isolated ileal segments were much smaller and there were many fewer intraepithelial lymphocytes; the lamina propria had significantly fewer lymphocytes than the functional ileum and only a few plasma cells. When isolated ileal segments were reconnected into the intestinal tract after having been isolated from it for 1-3 months, the histology of the mucosa reverted to that of the normal gut, with the same number and types of lymphoid cells. Radiolabelled lymphoblasts collected from intestinal lymph and injected intravenously accumulated to only a small extent in isolated segments of ileum compared with either the normal or the reconnected segments of ileum. This suggested that the paucity of lymphocytes in the mucosa of the isolated segments was due to a reduced extravasation of these cells there. The influence which the gut contents exert on the lymphoid cell population in the mucosa is probably associated with antigenic stimulation but may also be related to other factors concerned in the normal digestive functions of the gut. PMID- 6862524 TI - The successful use of asialylated IgG as an immunogen and arthritogen in the rabbit. AB - Joint lesions, closely resembling the main features of those seen in rheumatoid patients, were produced by intra-articular injections of asialylated homologous IgG into presensitized rabbits. The inflammatory changes were characterized by areas of extremely dense chronic inflammatory cell infiltration, where the lymphocytes were often aggregated into lymphoid follicles. There were also signs of involvement of the contralateral, saline-injected knee. Formation of an experimental rheumatoid factor-like antibody, detected by its ability to agglutinate sheep erythrocytes sensitized with baboon IgG, was also demonstrated. In addition, the rabbits developed other manifestations associated with rheumatoid arthritis, namely increases in erythrocyte sedimentation rate, serum haptoglobin concentration and joint size. PMID- 6862525 TI - Studies on delayed-type hypersensitivity (DTH) reactions in the pleural cavity in mice: prolonged DTH reaction and its interruption by cyclophosphamide treatment. AB - DTH reactions to sheep erythrocytes (SRBC) and purified protein derivative (PPD) antigens were produced in the pleural cavity in mice. The profiles of the DTH reactions with respect to time course and cellular exudate reactions differed greatly according to the strains of mice. In particular, HY mice that were established in our laboratory displayed prolonged DTH reactions, characterized by macrophage followed by lymphocyte reactions. HY X C3H F1 mice showed a similar tendency. On the other hand, strains such as C3H, BALB/c, DBA/2 and B6 mice showed short-lived and macrophage-predominant DTH reactions. BALB/c nu/nu mice showed no DTH reactions. Characteristic features of the prolonged DTH reactions in HY mice were transferred with sensitized T cells. However, DTH reactions in HY mice treated with cyclophosphamide (CY) terminated in a short period, and mainly consisted of macrophages and polymorphs, although they were greatly enhanced. Such profiles of the reactions could also be transferred with sensitized T cells from CY-treated and SRBC-sensitized mice. Spleen cells taken from CY-treated and SRBC-sensitized HY mice, when injected intravenously into SRBC-sensitized HY mice just prior to challenge, could not interrupt prolonged DTH reactions. These results thus indicated various phenotypes of the DTH reactions in terms of time course and exudate cellular component involved might be carried by the specific effector T cells in each phenotype of the DTH reactions and could be induced using strains of mice and CY. PMID- 6862526 TI - Quantitative studies of Fc receptors on human monocytes: characterization by binding of homologous and heterologous monomeric IgG and soluble immune complexes of different composition. AB - The binding of 125I-labelled monomeric human and rabbit IgG (H-IgG, R-IgG) and rabbit IgG immune complexes (IC) to monocyte-enriched human peripheral blood cells had been investigated quantitatively. Scatchard plots at 4 degrees demonstrated that R-IgG bound to the same number of Fc receptors per cell (19,000) as H-IgG, but with a lower affinity (2.4 +/- 0.9 X 10(8)/l/mol and 3.5 +/- 1.1 X 10(8)l/mol, respectively). Inhibition studies demonstrated that the two ligands could mutually inhibit each other, H-IgG having higher inhibitory efficiency versus R-IgG than the reverse. It seems likely that R-IgG reacts with the Fc receptor for the homologous IgG, although with lower affinity. Binding of soluble R-IgG anti-bovine serum albumin (BSA) IC, prepared at molar antigen:antibody (Ag:Ab) ratio of 2:1 and 12:1, showed quite different behaviour, the IC binding with association constants almost 10-fold lower than the affinity of monomeric R-IgG, but binding six- to seven-fold as many IgG molecules per cell at saturation. PMID- 6862527 TI - NKP-15: a monoclonal antibody reactive against purified human natural killer cells and granulocytes. AB - A monoclonal antibody of the isotype IgG1,k, NKP-15, was produced by immunizing Balb/c mice with highly purified suspensions of human natural killer (NK) cells. By indirect immunofluorescence, NKP-15 reacted with 15 +/- 5.0% of the peripheral blood lymphocytes, 90 +/- 3.0% of the granulocytes and was non-reactive with T cells, B-cells, monocytes, platelets and erythrocytes. NKP-15 reacted with 90 +/- 6.0% of purified large granular lymphocytes (LGL), which displayed highly enriched NK cell activity. NKP-15, however, showed no reactivity with a panel of human tumor cell lines. Analysis of NK cell-K562 tumor cell conjugates and depletion by panning of NKP-15+ cells indicated that all functionally tumorlytic NK cells expressed the NKP-15 antigen. It was also determined by competitive blocking experiments that NKP-15 recognizes a new NK cell surface antigen not delineated by the NK-specific monoclonal antibody, Leu-7, and that the epitope for NKP-15 appears to be associated with the Fc-receptor of NK cells and granulocytes. PMID- 6862529 TI - Susceptibility to phenytoin-induced cleft palate in mice is influenced by genes linked to H-2 and H-3. AB - Pregnant female mice of various congenic strains were injected on days 11 through 14 of gestation with phenytoin, and the fetuses were examined for the occurrence of cleft palate. The pattern of susceptibility indicates that two genes in the H 2 complex and another gene linked to H-3 are involved in the determination of this trait. PMID- 6862528 TI - Revised rules for naming class I and class II antigenic determinants controlled by the mouse H-2 complex. PMID- 6862530 TI - H-Y antigen in XO mice. AB - We examined the expression of H-Y antigen in 14 XO female mice using three monoclonal H-Y-specific antibodies. We found that spleen and liver cells from XO mice removed the reactivity of these antibodies at the same efficacy as XY cells. However radiobinding assays on cultured XO cells suggested a qualitative or quantitative difference between XO and XY cells. In cell-mediated cytolysis (CMC), H-Y-specific reactivity was observed when XO fibroblasts were used as targets, but no reactivity was observed when XO concanavalin A (Con A) blasts were used as targets. We concluded from these studies that XO mice do express H-Y antigen, detected both by serologic assays and cell-mediated assays. PMID- 6862533 TI - Plasmid associated suppression of pathogenicity of wild-type strains of Vibrio cholerae from cholera patients. PMID- 6862531 TI - Genetic control of the expression of class I molecules on rat erythrocytes. AB - Class I major histocompatibility antigens of the rat and mouse are generally thought to be present on erythrocytes, and hemagglutination has frequently been used as a means of MHC typing in these species. Recent evidence suggests that there are genetic differences in the expression of class I molecules on the red blood cells of rats. We have confirmed and extended these findings with four monoclonal antibodies that define a minimum of three separate class I specificities. The lymphocytes of rats of the RT1b, RT1c, and RT1m haplotypes were killed by these antibodies, but their red blood cells were not agglutinated despite the fact that these antibodies had good hemagglutinating activity for the cells of other positive strains. By an indirect radioimmunoassay, it was shown that lymphocytes and erythrocytes of the hemagglutination-positive strains bound large amounts of antibody; lymphocytes of the RT1b, RT1c, and RT1m haplotypes also bound large amounts of antibody but their erythrocytes bound very little. Using the appropriate congenic strains and segregating populations, it was shown that there are a minimum of two genes that affect the red cell expression of these specificities. We have also used an anti-beta 2-microglobulin serum to quantitate independently the relative amounts of class I molecules on the cell surfaces, and have shown that the red cells of these three haplotypes express reduced amounts of available class I molecules, while their lymphocytes express quantities similar to those of other strains. PMID- 6862532 TI - Reevaluation of the evidence for the generation of new lethal t haplotypes by mutation. PMID- 6862534 TI - Salmonella serotypes prevalent in India during 1978-81. PMID- 6862536 TI - Dental fluorosis in Ledhupur and Rustampur villages near Varanasi. PMID- 6862535 TI - Renal function in long term lithium prophylaxis. PMID- 6862537 TI - Hypocholesterolemic and hypolipidemic activity of quercetin--a vitamin P-like compound in rats. PMID- 6862538 TI - Studies on adrenoceptors in the isolated perfused rat mesentery: effects of propranolol. PMID- 6862539 TI - Maximal oxygen uptake in young Indian asymptomatic smokers and nonsmokers. PMID- 6862540 TI - Placental changes in rat following experimental ischaemic hypoxia. PMID- 6862541 TI - Silastic foam elastomer wound dressing in wound management. PMID- 6862542 TI - Bacteriological spectrum of brain abscess with special reference to anaerobic bacteria. PMID- 6862544 TI - Direct gas liquid chromatography of clinical specimens for rapid diagnosis of anaerobic infections. PMID- 6862545 TI - Staphylococcal food poisoning by consumption of sweetmeat. PMID- 6862543 TI - Sero-immunity of normal Rhesus monkeys to tetanus and diphtheria. PMID- 6862546 TI - Enzymatic changes in experimental primary amoebic meningoencephalitis. PMID- 6862547 TI - Effect of caprine luteal extracts on progesterone secretion by goat granulosa cells in culture. PMID- 6862548 TI - Effect of streptolysin O on immunological cardiac lesions in rats. PMID- 6862549 TI - Functional and histological abnormalities of small bowel mucosa in giardiasis. PMID- 6862550 TI - Chlorinated pesticide residues in blood plasma and adipose tissue of normal and exposed human population. PMID- 6862551 TI - Prevention of certain biochemical changes in acute ischaemic rabbit heart by verapamil. PMID- 6862552 TI - Effect of dextroamphetamine and caffeine on single-trial passive avoidance response in rats. PMID- 6862553 TI - Comparison of the effect of ordinary and microfined aspirin on the DNA content of gastric aspirates. PMID- 6862554 TI - Preliminary study on the mechanism of dopamine action on rabbit myometrium. PMID- 6862555 TI - The effect of venous stasis on the fracture healing. PMID- 6862556 TI - Development and maturation of lateral geniculate body in man. PMID- 6862557 TI - Breeding habitats of phlebotomine sandflies in Bihar, India. PMID- 6862558 TI - Field trial of Bacillus thuringiensis H-14 (VCRC B-17) against Culex and Anopheles larvae. PMID- 6862559 TI - Evaluation of intramuscular 15 (S) 15 methyl prostaglandin F2 alpha for menstrual regulation and preoperative cervical dilatation. PMID- 6862560 TI - Antimicrobial resistance and R-plasmids of Salmonella paratyphi A isolated at Bombay. PMID- 6862561 TI - Energy intake of well-to-do preschool children in India. PMID- 6862563 TI - Effect of measles on cell mediated immunity. PMID- 6862562 TI - Immune deficiency in undernourished children and its correction by nutritional therapy. PMID- 6862564 TI - Circulating immune complexes in glomerulonephritis with special reference to minimal change disease. PMID- 6862565 TI - Drug resistant Salmonella serotypes in cases of infantile diarrhea in Bombay city. PMID- 6862566 TI - Serum electrolytes in schizophrenic patients. PMID- 6862567 TI - Impact of extra motivation among tuberculosis patients of the duration of their unbroken drug continuity--a multivariate approach. PMID- 6862569 TI - Cancer incidence in Singapore 1968-1977. PMID- 6862568 TI - Hydated disease of the spine with paraplegia. (Report of a case). PMID- 6862570 TI - Potassium infusion attenuates avoidance-saline hypertension in dogs. AB - Previous studies have shown that a combination of avoidance conditioning schedules and increased intake of salt and water results in progressive hypertension in dogs within 14 days. The present experiments investigated the effects of increasing potassium intake upon blood pressure and heart rate of dogs made hypertensive by avoidance conditioning and salt-water loading. Two daily 30 minute sessions of free-operant avoidance conditioning were presented for 36 days during which isotonic saline was continuously infused into the arterial circulation (1.2 liters/day; 185 mEq Na+). Daily mean levels of systolic (22 +/- 5 mm Hg) and diastolic (12 +/- 4 mm Hg) pressure increased progressively in each dog during Days 1-14. Infusion of potassium chloride (100 mEq/day) from Days 15 28 resulted in progressive decreases in daily mean levels of systolic (-11 +/- 2 mm Hg) and diastolic (-8 +/- 1 mm Hg) pressure in each dog over this period. From Day 29-36, systolic (8 +/- 1 mm Hg) and diastolic (5 +/- 1 mm Hg) pressure increased. Normotensive dogs not on the avoidance schedule showed no change in arterial pressure in response to 14 days of potassium chloride infusion. These experiments show that the level of potassium, as well as sodium, intake significantly determines blood pressure levels in this form of experimental hypertension. PMID- 6862571 TI - Thallium uptake by canine iliac arteries. AB - Most of the thallium uptake by canine iliac arteries (70%) was inhibited by ouabain. The component sensitive to ouabain was significantly increased by incubating tissues in K+-free solution and reduced by low temperatures, metabolic inhibitors, and loading with lithium. The apparent Km for thallium for the ouabain-sensitive uptake was 0.47 +/- 0.046 mM. External K+ inhibited thallium uptake and the apparent Ki was estimated to be 6.5 mM. Thallium thus appears to have a greater affinity for the ouabain-sensitive components. The residual component of thallium uptake was unaffected by maneuvers that affected the ouabain-sensitive uptake, which thus appears to be a suitable indicator of Na+ pump activity in vascular smooth muscle. PMID- 6862573 TI - Hypothalamic pressor responses and salt-induced hypertension in Dahl rats. PMID- 6862572 TI - Propranolol effects on hypertension and the arterial wall beyond the treatment period in turkeys. AB - To determine if the effects of propranolol on hypertension and the arterial wall persisted for a significant time after the medication was discontinued, various parameters were compared at 16 weeks in control turkeys (CC), in birds on the medication from 3 days to 16 weeks (PP), and in others that were treated only from 3 days to 10 weeks (PC). At 16 weeks, arterial blood pressure, maximum rate of pressure increase (dp/dt max), and aortic intimal hyperplasia were lowest in the PP group, intermediate in the PC birds, and highest in the CC turkeys. Likewise, the vascular wall constituted 61% of the radius of the coronary arteries in the CC group, but only 52% and 45% in the PC and PP groups, respectively. At 16 weeks, heart rate was lowest and aortic tensile strength highest in the group that was treated for the entire period, at the end of which the average plasma propranolol level was 97 ng/ml. At the same age, heart rate and aortic tensile strength were approximately the same in the CC and PC groups, and propranolol was not detectable in the plasma. It is concluded that the administration of propranolol to hypertensive turkeys early in life reduced blood pressure, aortic intimal hyperplasia, and arterial wall thickness and that these effects persisted to a significant degree for at least 6 weeks after the medication was discontinued. The higher aortic tensile strength that was produced by propranolol did not persist. PMID- 6862574 TI - Changes in paraventricular vasopressin and oxytocin during the development of spontaneous hypertension. AB - The potential role of central neuroendocrine changes in the development of spontaneous hypertension was evaluated. The developmental changes in blood pressure and hypothalamic and plasma levels of vasopressin (AVP) and oxytocin (OT) were determined in groups of SHR and WKY animals from 3 to 24 weeks of age. Hypothalamic OT content was significantly lower in 3-, 6-, and 12-week-old SHR rats compared to age-matched WKY animals. Hypothalamic AVP content was not different at 3 weeks of age, but was lower in the SHRs at 6 and 12 weeks. To localize strain differences in AVP and OT, specific hypothalamic nuclei were removed from 300 microns frozen brain sections, and hormone content measured. Paraventricular AVP and OT content was lower in the SHRs which had increased blood pressure (6, 12, and 24 weeks of age) but not in the prehypertensive groups (3 weeks of age). Neuropeptide content was unchanged in the supraoptic nucleus or median eminence. Plasma levels of AVP were increased in the SHR, while OT was unchanged. Thus, genetic hypertension is associated with specific and localized changes in hypothalamic AVP and OT. The fact that the peptide deficit occurred in the paraventricular nucleus, a region thought to be involved in the control of autonomic function, may have important implications in terms of the pathogenesis of hypertension. PMID- 6862575 TI - Longitudinal study of the hindquarter vasculature during development in spontaneously hypertensive and Dahl salt-sensitive rats. AB - The purpose of this study was to examine vascular structural alterations longitudinally in spontaneous and Dahl genetic hypertension. Hypertensive and control animals were studied at 5,9-11, and 17-19 weeks of age to permit analysis of prehypertensive, early and established hypertensive stages. Minimal and maximal resistance of the hindquarter vasculature was used as a functional assessment of structural alterations. At 5 weeks of age, the minimal vascular resistance of the spontaneously hypertensive rats (SHR) was elevated over Wistar Kyoto (WKY) (p less than 0.02) but there was no difference between Dahl salt sensitive (S) and resistant (R) rats. In both sets of animals, the minimal vascular resistance of the hypertensive group was significantly elevated over controls with age: p less than 0.001 in SHR; p less than 0.001 in Dahl S. The maximal vasoconstrictor response was significantly greater with age in SHR than in WKY, (p less than 0.001), but was not different in Dahl S compared to R. Thus, structural alterations, determined by assessing minimal vascular resistance, are present in both spontaneous and Dahl salt-sensitive hypertension, but the origin of the two differ. An increase in smooth muscle mass, assessed by maximal constriction, contributes importantly to the structural alterations in spontaneous hypertension; in Dahl S, other factors appear to contribute to structural alterations. Further, structural alterations precede frank hypertension in SHR but not in Dahl S hypertension. PMID- 6862576 TI - Kidney function and sodium handling in the pregnant spontaneously hypertensive rat. AB - Effects of gestation on volume homeostasis and renal function were studied in awake spontaneously hypertensive rats (SHR). Systolic blood pressure was similar to that of virgin littermates during most of SHR pregnancy but decreased near term (p less than 0.005). Plasma renin activity was lower in SHR than in age matched Wistar-Kyoto (WKY) rats (p less than 0.001), but values were similar in gravid and nonpregnant animals from each strain. Renal renin content and lipid volume fractions of papillary interstitial granules were significantly greater in pregnant animal of each strain and those of the gravid WKY were also greater than both pregnant and virgin SHR. Saralasin had no effect on mean arterial pressure in gravid and virgin rats from either group. Plasma volume increased significantly near term in animals of both strains. Kidney weight, glomerular filtration rate (GFR), and renal blood flow were lower in SHR compared to WKY, and the hypertensive rats failed to demonstrate an increase in GFR during gestation, unlike the WKY. All SHR and pregnant WKY excreted infused sodium better than the virgin WKY. Also, regular Wistar animals excreted a salt load better than the virgin WKY. Finally, uterine blood flow, pup number and conceptus weight were similar in SHR and WKY. We conclude that pregnancy induces a decrease in blood pressure in SHR, and that angiotensin II does not seem to play an important role in maintaining blood pressure during gestation in either SHR or WKY. Despite a lower GFR and its failure to increase during pregnancy, renal sodium handling is not impaired in the SHR. The virgin WKY has a decreased ability to excrete sodium which is ameliorated during gestation. PMID- 6862577 TI - Circulatory pressure-volume relationship and cardiac output in DOCA-salt rats. AB - We studied the total vascular pressure-volume relationship and cardiac output (CO) in conscious rats receiving DOCA-salt or sham treatment. The mean circulatory filling pressure (MCFP) was measured by briefly inflation an indwelling balloon in the right atrium, and the MCFP-blood volume (BV) relationship over +/- 10% of BV was determined by rapid blood infusion or withdrawal. CO was measured in separate experiments using Fick's principle. Arterial pressure-volume relationship was also determined in additional experiments on anesthetized rats. Compared with sham rats, the mean arterial pressure was unchanged at 1 week, increased at 2 weeks, and increased further thereafter in the DOCA-salt rats. The BV was unchanged at 1 week, expanded at 2 weeks, unchanged at 5 weeks, and contracted at 8 weeks. There were no significant changes in MCFP, total vascular compliance (the inverse of the slope), nor unstressed volume (extrapolated volume axis intercept) at 2, 5, and 8 weeks. Total vascular capacity, assessed as BV at MCFP of 7.6 mm Hg, increased at 2 weeks, was unchanged at 5 weeks, and decreased at 8 weeks. Arterial compliance decreased at 5 and 8 weeks. CO remained unaltered at 1, 2, 5, and 8 weeks. These results suggest that the altered total vascular capacity may serve to maintain a normal CO against a rising afterload in the conscious DOCA-salt hypertensive rats, and that the decreased total vascular capacity may be a secondary hemodynamic feature with progression of hypertension. PMID- 6862578 TI - Endogenous opioids and baroreflex control in humans. AB - We describe two studies designed to elucidate the role of endogenous opioids in blood pressure control in humans. In the first study, nine normal subjects received infusions of DAMME (a metenkephalin analog), naloxone, or saline, and blood pressure, heart rate, and plasma norepinephrine concentration were determined supine and following 5 minutes of 70 degrees head-up tilt at intervals for 6 hours. Blood pressure following tilt was significantly decreased by DAMME but not influenced by naloxone, the effect being most marked at 3 hours (placebo = 110 +/- 6/78 +/- 7 mm Hg; naloxone = 106 +/- 10/79 +/- 5 mm Hg; DAMME = 96 +/- 16/67 +/- 8 mm Hg (p less than 0.01). However, heart rate and plasma norepinephrine did not rise in response to this hypotension. Heart rates at 3 hours were: placebo = 87 +/- 16 bpm; naloxone = 88 +/- 19 bpm; DAMME = 89 +/- 23 bpm. Plasma norepinephrine levels (nmol/liter) at 3 hours were: placebo = 6.0 +/- 2.2; naloxone = 5.8 +/- 1.9; DAMME = 6.0 +/- 1.9. In the second study, seven normal subjects had blood pressure reduced by incremental infusions of sodium nitroprusside, and the effects of placebo, naloxone, and DAMME on the slope of the heart period/blood pressure relationship investigated. Naloxone significantly increased the slope by 90% and DAMME significantly reduced the slope by 30%. It is concluded that endogenous opioids modulate the baroreflex control of blood pressure in normal humans. PMID- 6862579 TI - Effects of withdrawing diuretic therapy on blood pressure in mild hypertension. AB - A 1-year double-blind placebo-controlled study on the effects of diuretic withdrawal was conducted on a group of 62 previously well-controlled, mildly hypertensive patients. Data were collected on blood pressure (BP), biochemical laboratory values, and subjective reports of side-effects. Twenty-six percent of placebo subjects and 3% of the active treatment subjects reached preset criteria for the return of hypertension (reverters). The average systolic and diastolic pressures of all placebo-treated patients who did not revert showed statistically significant increases. BP control was quickly reestablished in reverters by restarting diuretic therapy. No substantial differences in side-effects were reported between the groups, and laboratory changes were those consistent with known metabolic effects of thiazide and thiazide-like diuretics. This study showed a much lower reversion rate after treatment withdrawal than previously reported by other investigators. It also showed significant increases in BP of placebo patients who did not revert. Long-term diuretic therapy retains its effectiveness in responsive mild hypertensive patients, potentially offering protection against the increased risks of mortality and morbidity associated with even slight elevations of BP. Withdrawal of diuretics cannot be recommended for patients with mild hypertension without use of other equally effective interventions to maintain optimum BP control. PMID- 6862580 TI - North Karelia (Finland) hypertension detection project. Five-year follow-up of hypertensive cohort. AB - A 5-year follow-up study of a random sample of middle-aged hypertensives indicated that the North Karelia (Finland) Hypertension Detection Project was effective in reducing blood pressure levels. This analysis indicated that the intensification of drug treatment caused marked blood pressure reduction in the community, especially among individuals with previously undetected cases of hypertension. Reduction of blood pressure levels among nontreated persons was observed in this study and may reflect in part the importance of both active case finding and follow-up including health education and preventive services. The community approach used in this study reached and brought under control most of those people who were undetected at the beginning of the study and most of the hypertensives. On the basis of the results, it is concluded that a well-organized hypertension control program can meet the challenge of hypertension care and benefit millions of people throughout the world. PMID- 6862581 TI - Antihypertensive effectiveness of intravenous labetalol in accelerated hypertension. AB - Labetalol, an antihypertensive agent that blocks both beta- and alpha-adrenergic receptors, was administered intravenously to 19 patients with accelerated hypertension who required rapid lowering of blood pressure. Systolic blood pressure was lowered from 209 +/- 4 to 143 +/- 2 mm Hg; diastolic blood pressure was reduced from 140 +/- 2 to 93 +/- 2 mm Hg. Side-effects were minimal and included nausea, epigastric burning, rhinorrhea, and premature ventricular contractions. One patient became hypotensive and required treatment. Overall, the study demonstrates labetalol to be a safe and effective agent for the emergency lowering of blood pressure, with demonstrated results comparable to other parenteral agents. PMID- 6862582 TI - Effects of atenolol and hydrochlorothiazide on blood pressure and plasma catecholamines in essential hypertension. AB - The antihypertensive effects of atenolol and hydrochlorothiazide were compared with placebo in a randomized, double-blind crossover study, with the blood pressure responses related to sympathetic nervous system activity. Twelve patients with essential hypertension were given atenolol (100 mg), hydrochlorothiazide (50 mg), and placebo as single daily doses, each for 6 weeks. Mean supine, standing, and post-exercise blood pressures (mm Hg) on atenolol (155/94, 152/95, 177/93, respectively) and hydrochlorothiazide (154/99, 150/103, 172/96) were lower (p less than 0.01) than corresponding placebo values (172/109, 166/113, 204/111) at 6 weeks. The role of the sympathetic nervous system in the antihypertensive actions of atenolol and hydrochlorothiazide was examined. The supine plasma norepinephrine on placebo was used as an index of sympathetic activity to categorize each patient's "adrenergic status." The six "hyperadrenergic" patients with high resting norepinephrine values (mean, 302 pg/ml) exhibited a greater (p = 0.05) decrease in BP (-30/-20 mm Hg) on atenolol compared with the BP fall of -9/-11 mm Hg observed in the lower norepinephrine group (mean, 211 pg/ml). Resting plasma norepinephrine values did not predict the BP fall on hydrochlorothiazide. The "adrenergic status" of each patient as measured by the plasma norepinephrine concentration tended to be relatively constant regardless of therapy or the state of activity. In this study, atenolol was an effective antihypertensive agent comparable to hydrochlorothiazide in potency. Adrenergic status tended to predict the BP response to atenolol and was a relatively constant feature of the patients in all treatment phases. PMID- 6862583 TI - Training and certification of blood pressure observers. AB - Accurate, reproducible measurements of blood pressure (BP) were central to the goals and objectives of the Hypertension Detection and Follow-Up Program (HDFP), a multicenter clinical trial on the efficacy of pharmacological treatment of individuals with elevated BP. All potential BP observers with or without previous experience in measuring BP were required to undergo a defined training program and meet set performance criteria to be certified to take HDFP BP. Recertification was required twice a year. Originally an audiotape test was used to measure accuracy of BP readings. This approach was later replaced by a videotape test, which proved more realistic and an equally effective tool for long-term quality control. With this technique of certifications, 75% of the individuals taking the test passed on the first attempt and more than 95% passed with one or two attempts. Although agreement for blinded BP duplicates was generally good, the appearance of sound (systolic BP) was identified with greater reproducibility than was the disappearance (diastolic BP). These recertification procedures were of great value in assuring the continued high quality of our BP data. PMID- 6862584 TI - Calcium antagonists in the treatment of hypertension. PMID- 6862585 TI - Effectiveness of combined nifedipine and propranolol treatment in hypertension. AB - The long-term antihypertensive effect of combined nifedipine and propranolol therapy was assessed in an open trial in 26 hypertensive patients (19 men, seven women, mean age 53 years). On propranolol alone (160 to 240 mg/day), the patients' average sitting blood pressure was 192 +/- 5/114 +/- 2 mm Hg. Propranolol was continued in a fixed dose and nifedipine was added in a dose that was gradually increased from 30 to 90 mg/day to achieve blood pressure (BP) values below 160/95 mm Hg. Twenty-two patients remained on the combined regimen for 14 to 30 weeks. Their BP decreased to 136 +/- 3/84 +/- 2 mm Hg on an average daily dose of 59.5 mg nifedipine. Seventeen of the 22 subjects were subsequently treated sequentially with propranolol alone, combined therapy, and nifedipine alone, to assess the relative efficacy of each mode of therapy. The combined regimen was found to be more effective than either drug alone. Side effects occurred in 13 of 26 patients. Four dropped out 4 to 11 weeks after starting nifedipine because of either intolerable flushing (2), allergic rash (1), or headache (1). Nine subjects experienced mild reactions that were well tolerated. It is concluded that the combined use of propranolol and nifedipine is effective in the long-term treatment of moderately severe hypertension and offers an alternative therapeutic approach that deserves further evaluation. PMID- 6862586 TI - Pharmacokinetics and metabolism of nifedipine. AB - Nifedipine is almost completely absorbed from the gastrointestinal tract as shown by plasma levels after sublingual, oral, and rectal administration. Because of presystemic metabolism, the bioavailability is about 56% to 77%. After oral administration of 10 mg, the mean plasma concentration of nifedipine reaches maximum values of 160 +/- 49 micrograms/liter after 30 to 60 minutes. After 8 hours, the mean concentration drops to 3.4 +/- 1.2 micrograms/liter. After intravenous administration (0.015 mg/kg) biphasic elimination occurs, the half life of the alpha-phase being about 13 minutes and of the beta-phase 1.26 +/- 0.55 hours in healthy volunteers. After oral administration of higher doses (40 mg) and after continuous infusion over 24 hours, a third phase with a half-life of about 8 hours can be seen. The apparent volume of distribution of the central compartment (Vce) is 0.294 +/- 0.1 l/kg, and the total body clearance amounts to 0.45 +/- 0.1 liter/hr . kg. Nifedipine is eliminated from the body by hepatic metabolism to the major metabolites 2,6-dimethyl-4-(2-nitrophenyl)-5 methoxycarbonyl-pyridine-3-carboxylic acid (M I) and the corresponding 2 hydroxymethyl-pyridinecarboxylic acid (M II). Methods for the quantitative detection of unchanged nifedipine in the presence of the pyridine analog in plasma (HPLC) and of the main metabolites in plasma and urine (GLC) have been developed. A simple semiquantitative method for detecting metabolites in urine (HPTLC) can be used to monitor patient compliance. PMID- 6862587 TI - Epidemiological study of the relationship between calcium and blood pressure. AB - During an epidemiological survey of 9321 male Belgian subjects, a highly significant positive correlation was found between the serum calcium level and blood pressure. The slope of the equation relating serum calcium level to blood pressure was higher in subjects who restricted their sodium intake than in subjects who did not. The slope was also significantly higher in subjects who did not take medication for hypertension compared to those who did. There was a significant and positive correlation between urinary calcium measured from 24 hour samples and blood pressure, both in the Belgian study and in a further epidemiological survey in Korea. In the Korean study, no significant correlation was found between 24-hour urinary magnesium excretion and blood pressure. PMID- 6862589 TI - Nifedipine or verapamil as sole treatment of hypertension. An intraarterial study. AB - Intraarterial ambulatory blood pressures were recorded prior to and during therapy with two different calcium ion antagonists, nifedipine and verapamil, in two separate groups of patients. In the first group, nine patients were studied off therapy and following a minimum of 6 weeks of nifedipine treatment (dose range, 20 to 60 mg twice daily). A second group of 16 patients followed the identical protocol but were prescribed verapamil (120 to 160 mg, three times daily). During both studies, patients underwent standardized physiological tests including tilt, isometric handgrip, and dynamic bicycle exercise. Both verapamil and nifedipine caused a reduction in blood pressure over most of the 24 hours studied. Nifedipine did not affect heart rate whereas verapamil caused a reduction of approximately 10 bpm. Nifedipine and verapamil did not induce postural hypotension, and the absolute responses to dynamic and isometric exercise were reduced. These results show the efficacy of slow channel inhibitors in the management of essential hypertension. PMID- 6862588 TI - Acute hypotensive response to nifedipine. AB - Nifedipine, an effective hypotensive drug in severe hypertension, was investigated by invasive methods in 15 hypertensive patients while they were supine, erect, and exercising moderately. The effects of oral nifedipine 20 mg examined 45 minutes after the dose showed a reduced systemic arterial blood pressure via a reduction in peripheral resistance. Nifedipine reduced pulmonary arterial pressure and pulmonary wedge pressures (PWP) during exercise in patients with abnormally high values but did not alter them in patients with normal values. Heart rate and cardiac output increased by a reflex mechanism. The decreases in arterial blood pressure and PWP correlated with the initial values while the increases in heart rate and cardiac output did not correlate with the extent of blood pressure reduction. Since nifedipine decreases arterial blood pressure, pulmonary arterial pressure, and PWP in proportion to the pretreatment values, it is a useful drug in severe hypertension with and without elevated pulmonary pressures. PMID- 6862591 TI - Modulation of bacterial aggregation by PMN and platelet extracts. AB - Human parotid saliva contains agglutinins which bind to the surface of streptococci and induce the formation of bacterial aggregates. Bacterial aggregation can be blocked by proteins released from viable PMNs and platelets or by sonic extracts prepared from these cells. PMN and platelet inhibitors display characteristic differences in molecular weight, protease, and temperature sensitivity. The mechanism of action of the inhibitors appears to involve a direct interaction with the salivary agglutinins rather than with the bacteria. It is thus possible that PMN and platelet-derived products might modulate saliva mediated bacterial aggregation and thereby influence the course of infections in the oral cavity. PMID- 6862590 TI - Biochemical and morphologic changes in rabbit lung following endotracheal instillation of zymosan particles. AB - In order to establish a model of lung disease in which the usefulness of potential antiinflammatory compounds can be evaluated, we have analyzed the biochemical and cellular responses of rabbits to zymosan deposition in their lungs. A suspension of zymosan particles was instilled into the lungs of rabbits using an intratracheal catheter. Because the influx of leukocytes and the transudation of plasma into affected lungs was expected to contribute to the total cellular enzyme and protein levels, lungs were homogenized and assayed after various time intervals for six cellular enzymes and for protein content. After one day, alkaline phosphatase and neutral protease levels were elevated by 90% and 50%, respectively, above normal values. After two and three days, all of the pulmonary enzymes assayed displayed maximal two- to fourfold increases in their levels of activity. After seven days, only the alkaline phosphatase and neutral protease levels remained slightly elevated by 50% and 30%, respectively. Histologic analysis revealed focal and diffuse intraalveolar, interstitial, peribronchiolar, and perivascular accumulations of macrophages, granulocytes, and lymphocytes. Severe pulmonary edema, evident microscopically after one to three days, correlated well with 100% increases in both the wet weight and protein content of the lungs. In control experiments, the intratracheal infusion of saline solution minus zymosan particles resulted in a variety of enzymatic changes in the lungs after three days, which could be distinguished both enzymatically and histologically from those following zymosan deposition; histopathologic analysis revealed a pattern of intravascular congestion with erythrocytes, edematous thickening of alveolar septa, and focal intraalveolar hemorrhages, but with no inflammatory infiltration. In summary, this study demonstrates the time course of an experimental model for acute and chronic lung inflammation, the extent of which may be quantitatively evaluated using cellular enzymatic markers. PMID- 6862592 TI - Chemiluminescence response of equine alveolar macrophages during stimulation with latex beads, or IgG-opsonized sheep red blood cells. AB - Isolated equine alveolar macrophages were shown to generate a luminol-dependent light response when challenged with a phagocytic stimulus. The chemiluminescent response was not detected with luminol prepared at 1.0 x 10(-5) or 1.0 x 10(-4) molar concentrations, but was readily quantitated when used at a 1.0 x 10(-3) molar concentration. Challenge of the alveolar macrophages with latex particles or with equine IgG-coated sheep red blood cells elicited the luminol-dependent light response, whereas unchallenged equine alveolar macrophages or those challenged with unopsonized erythrocytes failed to emit light above background levels. Latex-bead-challenged macrophages released 8.06 times the total amount of light as those equine alveolar macrophages challenged with equine IgG-opsonized erythrocytes. This study represents the first investigation on chemiluminescence and equine alveolar macrophages. PMID- 6862593 TI - Aggregation of equine platelets by PAF (platelet-activating factor). AB - Platelet-activating factor (PAF), a lipid released as a result of immediate allergic reactions from basophils and mast cells as well as by a variety of other cell types and stimuli, is one of the most potent platelet agonists and hypotensive agents known. Equine platelets stimulated over a wide range of PAF concentrations aggregated in a time- and dose-dependent manner. Maximum aggregation was observed at concentrations of PAF as low as 3.58 x 10(-14) M with platelet-rich plasma (PRP) and 3.58 x 10(-16) M with washed platelets. Furthermore, the aggregation observed did not appear to be breed-dependent. Finally, the platelet arachidonate pathway appeared to play no role in PAF induced aggregation as exogenous arachidonate did not enhance the reaction, nor were equine platelets pretreated with 38 microM aspirin inhibited in their response to PAF. This level of aspirin totally inhibited the equine platelet aggregation response to arachidonate. PMID- 6862596 TI - A study of serum and hepatic copper in Indian childhood cirrhosis. PMID- 6862595 TI - Gut flora in breast and bottle fed infants with and without diarrhea. PMID- 6862594 TI - Thyroid hormones and TSH in normal children and hypothyroids. PMID- 6862597 TI - The rationale of levothyroxine therapy in hypothyroidism. PMID- 6862599 TI - Delivery of better maternal and child health (MCH) services through continuous monitoring of grades III and IV malnourished children in ICDS scheme. PMID- 6862600 TI - Malaria in newborn. PMID- 6862598 TI - Serum zinc, copper and protein levels in children of destitute homes. PMID- 6862601 TI - Congenital malformations in live born infants in a rural community. PMID- 6862602 TI - Presidential address. XIX National Conference of Indian Academy of Pediatrics, 5th December, 1982 Cuttack. PMID- 6862603 TI - Value of a peripheral blood smear examination in evaluation of systemic disease in childhood. PMID- 6862604 TI - Pattern of childhood malignancies in Rajasthan. PMID- 6862606 TI - Infective polyneuritis with complete external ophthalmoplegia. PMID- 6862605 TI - Congenital lymphedema (Milroy's disease). PMID- 6862607 TI - Epidermolysis bullosa simplex. PMID- 6862609 TI - High risk factors of blood transfusion for severe anemia in children. PMID- 6862610 TI - Yolk-sac tumor of sacrococcygeal region. PMID- 6862608 TI - Effect of tobacco chewing by mothers on fetal outcome. PMID- 6862611 TI - Sandhoff's disease GM2 gangliosidosis: Type-2. PMID- 6862613 TI - Opsoclonus-palatal myoclonus syndrome. PMID- 6862612 TI - The hypereosinophilic syndrome. PMID- 6862614 TI - Sex chromosomal aberration and their modes of presentation. PMID- 6862616 TI - Renal functions in small for gestational age new born infants. PMID- 6862618 TI - Placental morphology and fetal growth. PMID- 6862615 TI - Kocher-Debre-Semelaigne syndrome. PMID- 6862617 TI - Neonatal necrotizing enterocolitis. PMID- 6862619 TI - Incidence and causes of irreversible renal failure in children. PMID- 6862620 TI - [Changes in plasma amino acids during and following isolated liver perfusion in the human. Brief clinical report]. AB - Plasma amino acids have been analysed during isolated perfusion of the liver in dogs. Aromatic amino acids increased, also the branched chain amino acids showed a small rise. Thus no signs of hepatic failure could be detected. To evaluate early signs of hepatic failure in 2 patients scheduled for isolated liver perfusion, the plasma amino acids where analysed. Corresponding to the results obtained in animals, aromatic acids increased, whereas branched chain amino acids remained constant or rose. Even in the postoperative course no signs of deterioration of plasma amino acids could be detected. PMID- 6862621 TI - [A recent procedure for intraoperative autotransfusion]. AB - At the surgical unit of the University of Cologne a new system for autotransfusion (Solcotrans) was used in 18 patients. This system consists of a plastic case connected with a vacuum pump by an airtube. After filling the plastic case with 50 ml sodium citrate, 450 ml of blood can be aspirated by the surgeon and be reinfused by the anaesthesiologist. The system was used in shunt surgery at portal hypertension, at venous thrombectomy and at aneurysms of the aorta abdominalis. Through this, stored blood was not necessary in 13 operations. PMID- 6862622 TI - [Metabolic changes in a 3-week treatment with a low calorie protein-carbohydrate diet in massively obese adolescents]. AB - 8 massively obese adolescents (2 girls, 6 boys, mean age 12.6 +/- 2.1 years, mean overweight 74 +/- 14%) were treated for 3 weeks with a very low calory diet (VLCD), containing 240 kcal, 33 g protein, 25.5 g carbohydrates and 0.7 g fat. Mean weight loss after 3 weeks was 9.47 +/- 2.8 kg. The mean loss of total nitrogen was 232.4 +/- 73.2 g. Great individual variations in regard to the amounts of nitrogen loss occurred. The mean nitrogen loss over the period of 21 days was 113.3 +/- 71.2 g. Three patients reached positive nitrogen balance in the third week. No pathological changes could be shown for serum electrolytes and enzymes as well as for glucose, urea and creatinine. At the end of the first week serum uric acid values were elevated, but reached normal values at the end of the diet period. 3 patients were treated with Allopurinol 200 mg for 7 to 14 days. Serum protein concentrations fell significantly from 7.64 +/- 0.3 to 7.0 +/- 0.2 g/dl, whereas serum albumin concentrations remained constant. Cholesterol and LDL cholesterol fell significantly (p less than 0.001) to "supranormal" values, HDL cholesterol and triglycerides remained almost constant. 24-h-ECG investigations before, during and after the diet did not reveal any pathological findings. PMID- 6862623 TI - Cytopathic effect of whole cells and purified membranes of Mycoplasma hyopneumoniae. AB - Marked cytopathic effect was produced in both porcine lung fibroblasts and MRC-5 human lung fibroblasts with doses of 7.5 X 10(6) and 1.5 X 10(7) CFU of Mycoplasma hyopneumoniae J per ml, respectively. M. hyopneumoniae VPP11, at a concentration as low as 1.25 X 10(7) CFU/ml, was capable of causing cytopathic effect in MRC-5 monolayers also. The infected monolayers developed patches of detached or lysed cells within 48 h. At a protein concentration of 2 micrograms/ml, M. hyopneumoniae membranes, prepared from freeze-thaw lysed cells, were capable of inducing cytopathic effect in MRC-5 fibroblasts within 24 h. The cytoplasm did not contain any cytotoxic activity. This indicates that the cytopathic factor is located in the cell membrane. This factor appears to be protein in nature. It was heat labile (100 degrees C, 15 min) and was destroyed by pronase (1 mg of pronase per 1 mg of membrane protein). It appears to be antigenic, since rabbit anti-M. hyopneumoniae serum was capable of neutralizing its cytopathic activity. PMID- 6862624 TI - Role of granulocytes and monocytes in experimental Staphylococcus epidermidis endocarditis. AB - The role of granulocytes and monocytes during the induction and course of Staphylococcus epidermidis endocarditis was investigated by the selective depletion of monocytes with the drug VP16-213 and of both granulocytes and monocytes with nitrogen mustard. The induction of endocarditis was influenced only by the depletion of monocytes: the 50% infective dose differed significantly, being 3.4 X 10(5) CFU in control rabbits and 3.4 X 10(4) CFU in the monocyte-depleted rabbits, whereas no significant differences were found between the latter and those depleted of both granulocytes and monocytes. Also, control rabbits injected with 10(6) or 10(7) CFU had a significantly higher incidence of sterile vegetations than did rabbits selectively depleted of granulocytes or monocytes. Compared with baseline values, mean monocyte numbers at the time of bacterial inoculation were significantly increased in control rabbits whose vegetations remained sterile, whereas this effect was not seen in rabbits whose vegetations became infected. The course of the endocarditis appeared to be significantly influenced by both granulocytes and monocytes. Comparison showed that a decrease of the same numbers of these cells per microliter of blood was accompanied for the monocytes by an approximately fourfold higher increase of the number of staphylococci in the vegetations. The correlation between the number of granulocytes and of monocytes on the one hand and the number of staphylococci in the vegetations on the other was not substantially influenced by the duration of the disease or the number of staphylococci injected to induce the endocarditis. The number injected proved to be significantly correlated with the number of staphylococci in the vegetations. In rabbits with numbers of CFU per gram of vegetation exceeding 10(7), blood cultures were usually positive. This finding applied rarely to control rabbits, but generally to drug-treated rabbits. In the latter animals a significant correlation between the number of staphylococci in the vegetations and in the circulation was found. We conclude that only monocytes have a measurable effect on the induction of Staphylococcus epidermidis endocarditis but during its course both granulocytes and monocytes keep the endocardial infection in check. PMID- 6862625 TI - Interaction of human plasma fibronectin with cariogenic and non-cariogenic oral streptococci. AB - The interaction of purified human plasma fibronectin (Fn) with bacteria was studied with a variety of oral streptococci. Each of the strains of Streptococcus mutans, Streptococcus salivarius, Streptococcus sanguis, and Streptococcus mitis tested was aggregated by Fn to various degrees, depending on the concentration of Fn added to the test mixtures. Binding assays performed with radiolabeled Fn and various strains of streptococci demonstrated various capabilities to bind Fn, and the amount of Fn bound by each strain was paralleled by its Fn-induced aggregation, with S. mutans 6715 giving the highest values in both assays. Because of the avid binding of Fn by certain strains of potentially cariogenic streptococci, we investigated the possibility that Fn may be present in human saliva and may be adsorbed from saliva onto artificial tooth pellicles. Immunoreactive Fn was detected in paraffin-stimulated whole saliva by enzyme linked immunosorbent assays of saliva adsorbed onto gelatin-coated cuvettes and by immunoelectroblots (Western blots) of salivary components separated on sodium dodecyl sulfate-polyacrylamide slab gels. Furthermore, immunoreactive Fn was found to be present in artificial tooth pellicles formed by incubating hydroxyapatite beads with whole human saliva. These results demonstrate that certain strains of oral streptococci bind to and are aggregated by Fn. The presence of Fn in artificial tooth pellicles suggests that this macromolecule may play a role in the attachment of potentially cariogenic and other oral streptococci to dental tissues. PMID- 6862626 TI - Selenium and immune functions in humans. AB - Earlier animal experiments have shown that selenium depletion may decrease immune functions. In this human study, 40 volunteers from a population with low serum selenium concentrations were supplemented with selenium or placebo for 11 weeks. Blood samples were drawn at intervals for analysis of selenium status and immune function. At the end of the supplementation period, plasma selenium levels were 74 ng/ml in the placebo group and 169 ng/ml in the supplemented group. The improvement in selenium status was associated with a 57% increase in the activity of platelet glutathione peroxidase in the group supplemented with selenium, but there was no increase in the activity of this enzyme in the placebo-treated subjects. Immune function was measured in vitro by tests of lymphocyte and granulocyte activity. Intracellular killing of Staphylococcus aureus by granulocytes was slightly lower in the placebo group than in the selenium group at the end of the supplementation period (77.2 compared to 85.2%; P less than 0.05). No significant changes were observed in phagocytosis, chemotactic factor generation, antibody or leukocyte migration inhibitory factor production by lymphocytes, or proliferative responses to phytohemagglutinin or concanavalin A. These results suggest that the selenium deficiency of the order found in Finland and some other areas of the world has little, if any, influence on the immune functions measured in this study. PMID- 6862627 TI - Experimental pneumococcal meningitis: role of leukocytes in pathogenesis. AB - Two groups of rabbits with experimental meningitis induced by direct intracisternal inoculation of Streptococcus pneumoniae cells were studied. One group was rendered profoundly leukopenic by nitrogen mustard, and the other had normal leukocyte counts. The two groups had comparable bacterial growth rates (mean generation time, 60 versus 67 min) and ultimate bacterial populations in the cerebrospinal fluid (CSF) (mean log10 CFU, 9.1 versus 8.7); therefore leukocytes did not effectively slow or limit the growth of pneumococci in the CSF in vivo. Increased CSF protein, decreased CSF glucose, and increased CSF lactate levels were similar in both groups, suggesting that leukocytes are not essential for these changes to occur. Quantitative blood cultures revealed identical levels of pneumococcal bacteremia until 13 to 14 h after the initiation of infection, when the leukopenic rabbits showed a larger number of pneumococci in the blood, ultimately exceeding the number reached in nonleukopenic rabbits by 100-fold. Leukocytes therefore limit the extent of pneumococcal bacteremia after infection of the CSF despite their lack of effect on the course or the CSF manifestations of experimental meningitis. PMID- 6862629 TI - Binding of 18F by cell membranes and cell walls of Streptococcus mutans. AB - The binding of 18F to isolated cell membranes and cell walls of Streptococcus mutans GS-5 or other bacteria was assayed. The attachment of 18F to these cell envelopes proceeded slowly and reached equilibrium within 60 min. 18F binding was stimulated by Ca2+ (1 mM). The binding of 18F to cellular components was dependent upon the pH, as well as the amount of 18F and dose of the binder employed. The binding of 18F by cell walls prepared from fluoride-sensitive and fluoride-resistant cells of S. salivarius and S. mutans did not differ significantly. The pretreatment of cell walls or cell membranes for 60 min at 30 degrees C with 1 mg of RNase, DNase, or trypsin per ml did not influence the binding of 18F by the walls and membranes of S. mutans GS-5. However, prior exposure of cell membranes to sodium dodecyl sulfate caused a significant reduction in the number of 18F atoms bound by the membranes. In saturated assay systems, cell membranes of S. mutans GS-5 bound 10(15) to 10(16) atoms of 18F per mg (dry weight), whereas cell walls from S. mutans GS-5, FA-1, and HS-6 or Actinomyces viscosus T14V and T14AV bound 10(12) to 10(13) atoms of 18F per mg (dry weight). 18F in this quantity (10(12) to 10(13) atoms) cannot be detected with the fluoride electrode. The data provide, for the first time, a demonstration of 18F binding by cell membranes and walls of oral flora. PMID- 6862628 TI - Characterization of Toxoplasma gondii antigens that react with human immunoglobulin M and immunoglobulin G antibodies. AB - Studies were performed to define the nature of the Toxoplasma gondii antigens that are recognized by human immunoglobulin M (IgM) and IgG antibodies. Both IgM and IgG antibodies were found to be directed mainly against T. gondii membrane antigens in sera obtained from patients with acute toxoplasmosis. Treatment of the membrane preparation with DNase, RNase, or lipase had no apparent effect on the reactivity of the membrane antigens with IgM and IgG antibodies. Lipids isolated from tachyzoites were not recognized by either IgM or IgG antibodies. Exposure of T. gondii membranes to heat, proteolysis, or oxidation with sodium periodate decreased the reactivity of the membrane preparations with both IgM and IgG antibodies. A preparation of T. gondii proteins and polysaccharides were recognized by both immunoglobulin classes. T. gondii polysaccharides reacted with human IgG antibodies produced during both the acute and chronic phases of the infection. We concluded that, after infection with T. gondii, IgM and IgG antibodies are elicited in response to both protein and carbohydrate constituents of the invading parasite. PMID- 6862632 TI - Correlation between the presence of a fifty-megadalton plasmid in Salmonella dublin and virulence for mice. AB - All of the Salmonella dublin organisms isolated from cattle in Japan (20 strains) and in Europe (2 strains) harbored one plasmid of approximately 50 megadaltons (Mdal). The biochemical reactions of a derivative strain (5230P-) cured of the 50 Mdal plasmid were those of its parental strain 5230P+. However, the strain 5230P- proved to be 100- to 1,000-fold less virulent for mice compared with that of the strain 5230P+, suggesting that the virulent phenotypes of S. dublin may be mediated by the 50-Mdal plasmid. PMID- 6862630 TI - Local immune response to repeated topical antigen application in the simian labial mucosa. AB - Minor salivary glands of the oral mucosa in healthy monkeys (Macaca fascicularis and Macaca mulatta) contain organized structural units suitable for recognizing and processing antigens. A previous study of M. fascicularis monkeys provided experimental evidence of retrograde access of oral antigens deep into the minor salivary glands. The present study aimed at exploring the possible immune response of simian oral mucosa to repeated topical application of a chemically defined antigenic solution at the labial and gut mucosa. Ten female M. fascicularis animals were challenged topically at the lower lip mucosa at weekly intervals for a variable period of 4 to 8 weeks with a solution consisting of horseradish peroxidase, ferritin, and special India ink. Transmission electron microscopic examination of immunohistochemically treated sections of the labial glands revealed the presence of plasma cells containing specific anti-horseradish peroxidase antibody. These cells resided in the interacinar regions. Enteric and gut priming with the same antigen in four other monkeys, bypassing the oral mucosa, failed to reveal the presence of horseradish peroxidase-positive plasma cells in the labial mucosa of any of the four animals, although in one animal such cells could be identified in a mesenteric lymph node. This is suggestive of the existence, at least in primates, of a local immune response of the oral mucosa independent of systemic involvement. PMID- 6862631 TI - Demonstration of antibodies to Mycoplasma pneumoniae attachment protein in human sera and respiratory secretions. AB - Antibodies specific to the attachment protein of Mycoplasma pneumoniae were demonstrated in sera and respiratory secretions of human patients. The results indicate that the attachment protein is a major immunogen. PMID- 6862633 TI - Further comparisons of endogenous pyrogens and leukocytic endogenous mediators. AB - It was recently shown (Murphy et al., Infect. Immun. 34:177-183), that rabbit macrophages produce two biochemically and immunologically distinct endogenous pyrogens. One of these has or copurifies with substances having a molecular weight of 13,000 and a pI of 7.3. This protein was produced by blood monocytes or inflammatory cells elicited in 16-h rabbit peritoneal exudates. These acute peritoneal exudates were produced by the intraperitoneal injection of large volumes of saline containing shellfish glycogen. When the leukocytes in these exudates were washed and incubated at 37 degrees C in saline, they released an endogenous pyrogen. The injection of this pyrogen into rabbits, rats, or mice caused the biological manifestations which have been attributed to leukocytic endogenous mediator. These effects were increases in blood neutrophils, the lowering of plasma iron and zinc levels, and the increased synthesis of the acute phase proteins. The other rabbit endogenous pyrogen seems to be a family of proteins with isoelectric points between 4.5 and 5.0. These proteins are produced by macrophages in the lung, liver, or in chronic peritoneal exudates. In these experiments, the lower-isoelectric-point endogenous pyrogens were produced by macrophages from the peritoneal cavity of rabbits that had been injected 4 days earlier with 50 ml of light mineral oil. These rabbit pyrogens were found to have leukocytic endogenous mediator activity in mice but to be completely inactive in rats. When injected into rabbits, these proteins produced fever, lowered plasma iron, increased blood neutrophils, but failed to elevate plasma fibrinogen. PMID- 6862634 TI - Activation of caprine arthritis-encephalitis virus expression during maturation of monocytes to macrophages. AB - Lentiviruses, which cause arthritis-encephalitis and maedi-visna in goats and sheep, respectively, cause persistent infections in these animals. The viruses replicate productively at low levels in macrophages in diseased organs such as the "maedi lung" and nonproductively in other cell types such as leukocytes in peripheral blood. Nonproductive infections become productive during in vitro cultivation of the cells. This study showed that monocytes were the only cells in the peripheral blood leukocytes of an infected animal in which virus was detected and that virus activation occurred only when these cells matured into macrophages. Only a minute fraction of cultured monocytes matured into macrophages, and viral infectivity was associated exclusively with this fraction. Antiglobulin-coated glass wool fragments were lethal for monocyte macrophages because of toxic phagocytosis, but had no effect on B or T lymphocytes. The simultaneous addition of the glass fragments and leukocytes to culture dishes resulted in no macrophage maturation and no virus production. The addition of the fragments to virus-producing macrophages caused the death of the cells and a decline in virus production. Virus production in less avidly phagocytic cells was unaffected by the glass. Thus, although macrophages may be permissive for virus replication, one mechanism for restricted virus expression in vivo may be physiological factors controlling the maturation of these cells. PMID- 6862635 TI - Humoral immune response in Hepatitis B virus infections. PMID- 6862636 TI - Biological profile of Legionella longbeachae and Legionella jordanis. PMID- 6862638 TI - Lipid A antibody determinations using ELISA on patients at a children's hospital: a preliminary report. AB - Using the enzyme-linked immunosorbent assay (ELISA), we studied the IgG and IgM antibody titers in various groups of pediatric patients (n = 81) infected with gram-negative organisms. Unlike the control group (n = 12), IgG antibodies were detected in only five (all under four months of age) of 19 children with sepsis. We assume that either the IgG antibodies are used up during the infection, or the lack of IgG antibodies results in a disposition to sepsis; the latter is more probable. Seventeen of 18 patients with urinary tract infections and proven renal involvement were IgM-positive. This indicates a permanent antigen stimulus, possibly in the form of a fixed antigen complex. Because of the heterogeneity of the groups studied, no overall statements can be made for the 93 children studied, some of whom were studied repeatedly. These children included 17 with tracheal colonization, 17 with recurrent urinary tract infections without proven renal changes and six with wound infections. PMID- 6862639 TI - Blood sampling in sheep. PMID- 6862637 TI - The role of antibodies against alpha-toxin and teichoic acid in the diagnosis of staphylococcal infections. AB - An enzyme-linked immunosorbent assay (ELISA) was used with purified alpha-toxin and teichoic acid preparations to measure the IgG and IgM response in Staphylococcus aureus infections. After determining antibodies in a normal population, cut-off levels were set for all age groups. ELISA with alpha-toxin was more sensitive than the antistaphylolysin neutralization test (ASTA). Determining IgM antibodies with the two antigens was found to be of limited diagnostic value. Positive IgG titers against alpha-toxin were found in 21 of 27 patients (78%) with endocarditis, 11 of 14 (79%) with complicated septicemia, eight of 20 (40%) with uncomplicated septicemia and in 12 of 22 (54%) with chronic osteomyelitis. The IgG responses to teichoic acid and alpha-toxin were somewhat different when measured by ELISA, and the parallel performance of the two assays resulted in improved serological diagnostics. The number of positive patients increased to 89%, 86%, 65% and 64%, respectively, in the four groups with a diagnostic specificity of 93%. In septicemic staphylococcal infections, the diagnosis could be established in all patients (28 of 28) with adequately spaced paired samples. PMID- 6862640 TI - Neurological disorders of cattle and sheep. PMID- 6862641 TI - Restraint, anaesthesia and treatment of children's pets. PMID- 6862642 TI - Simultaneous effects of sinusoidal whole body vibration and broadband noise on TTS2's and R-wave amplitudes in men at two different dry bulb temperatures. AB - The aim of this study was to investigate the temporary hearing threshold shift (TTS2) and R-wave amplitudes in eleven healthy males when they were exposed to paired sinusoidal whole body (Z-axis) vibration (5 Hz--2.12 m/s2) and stable broadband A-weighted white noise at dry bulb temperatures of 20 degrees C and 30 degrees C. The intensity of noise in the exposure combinations was 75, 85 and 95 dB(A). The total number of tests was 66, and they were carried out in an exposure chamber. The subjects were dressed in standard clothing, and carried out simple tasks using a choice reaction time device during the test. According to the results, the means of the TTS2 values were usually higher at the dry bulb temperature of 30 degrees C than at 20 degrees C. Hearing threshold shifts were the greatest at frequencies of 4 and 6 kHz, and the smallest at 8 kHz. The more intense the noise in the paired combination of noise and vibration, the clearer the tendency for an increase in the ambient temperature to accelerate the increase in the hearing threshold. The effect of the ambient temperature on the temporary hearing threshold shifts also appeared to be slightly stronger during successive exposure cycles. Changes in the values for the R-wave amplitudes seemed to be connected with those in the hearing threshold. The decrease in the R wave amplitude was connected to the increase in the TTS2 values, especially when the subjects were simultaneously exposed to a 95 dB(A) noise and whole body vibration at the dry bulb temperature of 30 degrees C. This implies that an increase in the ambient temperature intensifies cardiovascular disturbances in the body, which accelerate the development of functional disturbance in the inner ear. PMID- 6862643 TI - Antimoniosis: a particular form of pneumoconiosis. II. Experimental investigation. AB - In a pilot experiment 0.5 ml of antimony oxide (Sb2O3 and Sb2O5) dust was injected intraperitoneally and endotracheally in two groups of "Wistar" type female albino rats. After two months, the rats were sacrificed and microtome slices were stained with hematoxylin-eosin and PAS. Morphology investigation revealed changes of pneumoconiosis of a noncollagenous nature. PMID- 6862644 TI - An experimental study on irritation and annoyance due to passive smoking. AB - Forty subjects were exposed to cigarette smoke produced by a smoking machine in a climatic chamber. The degree of air pollution due to cigarette smoke corresponded to 2.5 and 1.3 ppm delta CO. The concentrations of particulate matter, NO and NO2, were measured. The effects on subjective irritation, annoyance and eye blinking rate were determined. All measured effects increased with increasing smoke concentration as well as with exposure duration. Based on these effects, a tolerable limit in the range between 1.5 and 2.0 ppm delta CO is proposed. PMID- 6862645 TI - Mortality in an european cohort occupationally exposed to epichlorohydrin (ECH). AB - A study was undertaken on the mortality of workers exposed to ECH at four European sites with plants producing epichlorohydrin (ECH), epoxy resins, glycerin, and other specialty chemicals derived from ECH. The vital status of 606 individuals with at least one year of exposure to ECH, starting at least 10 years before the final date of the study on 31 December, 1978, were collected. Mortality was analysed for a subgroup with 10 or fewer years of exposure, and another subgroup with more than 10 years of exposure. Four deaths from different cancers were observed against five expected. No excess mortality from cancer was observed in either subgroup or the complete cohort, which could be related to ECH exposure. The small size of the cohort and the limited number of deaths due to low average age (42 years), as well as the short duration of the observation period, do not allow a firm conclusion to be reached regarding the potential carcinogenicity of ECH in man. Current exposure levels are low, but exposure in the early days of production occasionally reached levels high enough to be irritating. We recommend updating the study 5 years from the final date of the present study, i.e. on 31 December, 1983. Within their limitations this and other epidemiological studies so far provide no evidence for an association between occupational exposure to ECH and the occurrence of malignant neoplasms in man. PMID- 6862646 TI - Nailfolds capillary abnormalities in polyvinyl chloride production workers. AB - In an unselected group of 120 Polish employees of a PCV production plant, nailfold capillaroscopic as well as general medical examination and some laboratory investigations (serum paper electrophoresis, IgA, IgG, IgM immunoglobulin concentration) were performed. Capillary abnormalities were seen in 48 persons (40%). No correlation with the length of occupational exposure, age and immunoglobulin concentration was found. The most frequent capillary patterns were the following: spastic changes with atonic component (18X) with giant Raynaud's loops in 10 of them, discrete spastic abnormalities (15X), scleroderma like picture (12X) with a prevalence of short scattered capillaries and disarrangement of polarity. The percentage of persons with capillary abnormalities in this study (40%) is very similar to results described by Maricq (1976, 1978) in England (39.5%) and in the USA (36%). PMID- 6862647 TI - Glutathione reductase activity in skin exposed to 4-tertiary butyl catechol. AB - The effect of 4-tertiary butyl catechol (TBC), a potent depigmenting chemical, on glutathione reductase (GR) in pigmented ear skin of hairless mice was investigated. Three topical applications of TBC, which cause neither skin color changes nor melanocyte degeneration, induced an increase in enzyme activity. Since the same treatment resulted in pheomelanin formation as evidenced by electron microscopy, it is suggested that the GR increase correlates at least in part with changes in melanocyte metabolism. This enzyme generates a reduced form of glutathione which may be involved in the formation of glutathionedopas, substrates for hydrolytic enzymes to produce cysteinyldopas, and pheomelanin. Elevation of GR may be an indication of melanogenesis before clinical skin color changes due to TBC appear. It may be used for the early detection of occupational leukoderma. PMID- 6862648 TI - Urine chromium as an estimator of air exposure to stainless steel welding fumes. AB - Welding stainless steel with covered electrodes, also called manual metal arc welding, generates hexavalent airborne chromium. Chromium concentrations in air and post-shift urine samples, collected the same arbitrarily chosen working day, showed a linear relationship. Since post-shift urine samples reflect chromium concentrations of both current and previous stainless steel welding fume exposure, individual urine measurements are suggested as approximate although not exact estimators of current exposure. This study evaluates the practical importance of such measurements by means of confidence limits and tests of validity. PMID- 6862650 TI - The effects of ethanol on blood toluene concentrations. AB - The metabolism of toluene was found to be inhibited by a large dose of alcohol in seven volunteers exposed to 80 ppm of toluene under experimental conditions. When alcohol was taken during exposure, blood toluene concentrations were 42.5% greater on average than during exposure with no alcohol. This is probably due to competition for alcohol dehydrogenase which is required for the breakdown of both ethanol and toluene. In men exposed to toluene at work, it was found that blood toluene concentrations were lowest in those who drank regularly. These results suggest that continued alcohol intake increases the metabolism of toluene, presumably by inducing the microsomal oxidising enzyme system in the liver. PMID- 6862649 TI - Carbon monoxide exposure and information processing during perceptual-motor performance. AB - This study examined the influence of exposure to ambient carbon monoxide resulting in final carboxyhemoglobin (COHb) levels of approximately 5.0% on the ability to process information during motor performance. Subjects (n = 16) performed a primary reciprocal tapping task and a secondary digit manipulation task singly and/or concurrently during 2.5 h exposure to room air (0 ppm CO) or 100 ppm CO. Five levels of tapping difficulty and two levels of digit manipulation were employed. Tapping performance was unaffected when COHb levels were as high as 5%. However, at this level of COHb it was noted that CO exposure interacted with task difficulty of both tasks to influence reaction time on the digit manipulation task. It was concluded that motor performance was not influenced by exposure to CO leading to COHb concentrations of 5%. Task difficulty was a significant factor mediating behavioral effects of CO exposure. PMID- 6862651 TI - Reduction of nightwork by re-designing of shift-rotas. AB - The reduction of nightwork is an important preventive measure to limit possible negative effects of night shifts on well-being, health and social life. An example of a gradual reduction of nightwork in a group of transport workers at an airport is presented. After having carefully analysed the real number of persons needed during nighttime for loading and unloading aircrafts the number of shiftworkers who had to work between 02.00 and 06.00 h was reduced in a first step from 104 to 66 and in a second step to 38 persons. PMID- 6862653 TI - Transvascular fluid balance and capillary permeability in the lung. PMID- 6862654 TI - The assessment of ventricular function in acutely ill patients. PMID- 6862652 TI - Limited capacity of humans to metabolize tetrachloroethylene. AB - Personal monitoring of exposure to tetrachloroethylene (TETRA) with carbon felt dosimeters and analyses of urine for total trichloro-compounds (TTC) were carried out in two groups of workers (36 males and 25 females), one group (20 males and 19 females) in dry-cleaning workshops and the other (16 males and 6 females) engaged in the removal of glue from silk cloth. Comparison of the urinary TTC levels with TETRA in the environment revealed that, while the metabolite levels increased essentially linear to TETRA concentrations up to 100 ppm, leveling off was apparent in the metabolite excretion when the exposure to TETRA was more intense (e.g. more than 100 ppm), indicating that the capacity of humans to metabolize TETRA is rather limited, as previously discussed. From the set of the data thus obtained, screening levels of 30 and 61 mg TTC (as TCA)/l urine as the lower 95% confidence limits for a group mean were calculated for the biological monitoring, by means of urinalysis, of exposure to TETRA at 50 and 100 ppm (TWA), respectively. A tentative calculation with additional exhaled-air analyses indicated that, at the end of an 8-h shift with exposure to TETRA at 50 ppm (TWA), 38% of the TETRA absorbed through the lungs would be exhaled unchanged and less than 2% would be metabolized to be excreted into the urine, while the rest would remain in the body to be eliminated later. PMID- 6862655 TI - Oxygen-carrying blood substitutes. PMID- 6862656 TI - Psychosocial sequelae of intensive care. PMID- 6862657 TI - Hypoxemia due to drugs. PMID- 6862658 TI - Effect of catecholamines on pulmonary right-to-left shunt. PMID- 6862659 TI - Differential lung ventilation. PMID- 6862661 TI - Increase of mucosal mast cells in the jejunum of patients infected with Trichinella spiralis. AB - The mast cell response in the mucosa and connective tissue of 36 jejunal biopsies of patients with clinically diagnosed trichinellosis, teniasis and lambliasis has been studied. Biopsy material was fixed in standard formalin or Carnoy's fixative, enabling differentiation between mucosal mast cells (MMC) and connective tissue mast cells (CTMC). With both fixatives CTMC could equally well be recognized. With Carnoy's fixative an additional population of mast cells (MMC) could be visualized both in the mucosa and the connective tissue. In the mucosa small mucosal mast cells were observed as well. Compared to the numbers of mast cells in the mucosa and the connective tissue of teniasis and lambliasis patients, the number of mast cells in trichinellosis patients only visualized using Carnoy's fixative was markedly higher. It was concluded that also in man trichinellosis is accompanied by an increase of cells with MMC characteristics. Further studies are needed to clarify the morphological and histochemical features of these cells and their possible role in this parasitic infection. PMID- 6862660 TI - Specific antibody responses in rats and mice after daily immunization without adjuvant. PMID- 6862662 TI - Local and systemic factors regulating mucosal mast cells. AB - The contributions of local and systemic factors to the regulation of mucosal mast cells and globule leukocytes have been examined in the rat. Nippostrongylus brasiliensis has been used to provide a potent immunological stimulus for mucosal mast cell hyperplasia and the roles of intestinal and extraintestinal sensitization observed by comparison of the gut mast cell responses to larval and adult worm infestations. Systemic effects of adult worm infestations have been examined in isolated Thiry-Vella loops of intestine. It is concluded that the extraintestinal phase of larval infestation is not obligatory for a gut mast cell response and that mast cell hyperplasia and globule leukocyte formation are not dependent on direct contact with the parasite or its products. The dissemination of the mast cell response and the general significance of the results are discussed. PMID- 6862664 TI - Absence of complement activation in vitro by sodium meglumine ioxitalamate. AB - The effect of radiographic contrast media on proteins of the complement system in vitro was investigated using protein level measurement and crossed immunoelectrophoresis. Despite the 20% loss of total serum hemolytic activity (CH50) induced by sodium meglumine ioxitalamate (0.5 M), no significant changes in C3c, C3N or B were detected by radial immunodiffusion. These contrast media did not cause electrophoretic conversion of C3, as assessed by the absence of split product, and the small degree of spontaneous C3 conversion (loss of 20% C3N antigen and the presence of two peaks with C3c antigen) which occurred when serum was incubated in polypropylene tubes, was inhibited by the contrast media. The effects of sodium meglumine ioxitalamate and zymosan in vitro on complement activation were compared. PMID- 6862663 TI - Characterization of a very high density lipoprotein allergen, Dpt 4, from the house dust mite Dermatophagoides pteronyssinus. AB - The allergen Dpt 4 from the house dust mite Dermatophagoides pteronyssinus was shown to be a lipoprotein as judged by its Sudan black B staining properties. Ultracentrifugal studies confirmed this finding and showed that Dpt 4 was polydisperse, although the majority of the allergen belonged to a very high density lipoprotein class. Physicochemical studies using gradient polyacrylamide gel electrophoresis showed that Dpt 4 had an apparent molecular weight of 244,000 daltons and a particle diameter of 10.73 nm. Agarose gel electrophoresis showed that the allergen had an electrophoretic mobility 0.86 times that of human alpha lipoprotein. The observation that Dpt 4 is a lipoprotein is consistent with earlier studies which showed that the allergen was heterogeneous with regard to its molecular weight and that it contained the hapten phosphorylcholine. PMID- 6862665 TI - Correlation of leukocyte accumulation with chemotactic activity in the exudate of an allergic air-pouch inflammation. AB - Chemotactic activity at the site of an allergic air-pouch inflammation induced with azobenzene-arsonate-conjugated acetyl bovine serum albumin as an antigen was studied and a close correlation of the chemotactic activity with the intensity of leukocyte migration was demonstrated. In the period of vigorous leukocyte immigration into the fluid in the allergic air-pouch, chemotactic activity of the exudate was maintained at a high level, while no significant activity was detected after the number of leukocytes in the pouch fluid reached maximum. PMID- 6862666 TI - Quercetin inhibits anaphylactic contraction of guinea pig ileum smooth muscle. AB - Certain flavonoids inhibit antigen-induced release of histamine from mast cells and basophils and also inhibit contraction of guinea pig ileum induced by histamine, acetylcholine, and PGE2. We examined the effect of one flavonoid, quercetin, on anaphylactic smooth muscle contraction of ileum from guinea pigs sensitized to egg albumin. Quercetin inhibited both the phasic and tonic components of anaphylactic contraction in a concentration-dependent fashion (IC50 approximately 10 microM). Whether this is primarily an effect on mast cell mediator release or inhibition of mediator effects on smooth muscle has not been established. PMID- 6862668 TI - Treatment of infertility associated with auto-antibodies to sperm. PMID- 6862667 TI - Effect of diet on adjuvant-induced disease and mitogenic responses of Fisher rats. AB - Fisher rats from a inbred colony, when fed on a salt-free high-protein diet, developed only a mild arthritis after adjuvant injection. Their spleen cells failed to respond in vitro to concanavalin A (a T-cell mitogen), although they possessed a B-cell function of plaque formation to sheep red blood cells. When a full salt supplement was included in the diet, or magnesium or copper or zinc was included in the drinking water, adjuvant-induced arthritis was severe and the response to the T-cell mitogen was restored. The above results suggest that these trace elements may stabilize or activate certain cell populations needed for some immune responses in rats. PMID- 6862671 TI - Quantification of germ cells and seminiferous tubules by stereological examination of testicles from 50 boys who suffered from sudden death. AB - A stereological study of the development of testicular volume, the germ cell population and the seminiferous tubules was carried out on testes from 50 boys between 0 and 18 years of age who had suffered from sudden unexpected death. Semi thin sections (0.5 micrometer) of testicular tissue were prepared and examined by point and profile counting using a projection microscope. Testicular weight was recorded in 48 of the cases. Median volume of pairs of testes increased from 1.1 (range 0.3--1.9) to 3.0 cm3 (range 2.8--3.4) during the 0--10 year period, while the median of the total number of germ cells per boy was augmented from 13 x 10(6) (range 4.4--36 x 10(6)) to 83 x 10(6) (range 32--122 x 10(6)) during the same period. The median length of the seminiferous tubules per boy was 181 m (range 27--361) in the 0--1 year period and 411 m (range 277--660) in the group 5 -10 years. Mean tubular diameter was unchanged during the first 10 years of life, whereas the mean nuclear diameter of the germ cells showed significant negative correlation to age in boys less than 10 years. After the age of 10 years a more marked growth of testicular volume, an increase in the number of germ cells and the diameter as well as the length of the seminiferous tubules were observed. Thus, the study showed that testicular size, the number of germ cells and the total length of the seminiferous tubules per boy increased not only in puberty but also during the first ten years of life. PMID- 6862670 TI - Seminal plasma testosterone and dihydrotestosterone levels in men with varicoceles. AB - Testosterone (T) and dihydrotestosterone (DHT) were measured in the seminal plasma of men with varicoceles, azoospermic vasectomized men and men with normal seminal parameters. Testosterone levels were not different significantly in these groups of men. DHT concentrations and the DHT/T ratio were significantly lower than normal in men with varicoceles and sperm densities below 30 million/ml and the vasectomized men, but not different from normal in the men with varicoceles whose sperm densities were greater than 30 million/ml. In men whose sperm density and/or motility improved after varicocelectomy, there was an increase in seminal plasma DHT levels and the DHT/T ratio. When seminal parameters were not improved by varicocelectomy, there was no change in DHT levels or in the DHT/T ratio. It is concluded that men with varicoceles and sperm densities below 30 million/ml have a deficiency in the epididymal 5 alpha-reduction of testosterone. PMID- 6862669 TI - Effect of vasectomy on the steroid profile of human seminal plasma. AB - The effect of vasectomy on the steroid profile of seminal plasma was studied in 19 healthy men at 4-monthly intervals during a 2-year post-vasectomy period. The steroids analyzed by radioimmunoassays were: androstenedione (A), testosterone (T), dihydrotestosterone (DHT), oestradiol (E2) and the sulphoconjugated forms of pregnenolone (delta 5P-S), dehydroepiandrosterone (DHEA-S), testosterone (T-S), dihydrotestosterone (DHT-S), oestrone (E1-S) and oestradiol (E2-S). The quantitatively most important steroids present in the seminal plasma were DHEA-S, delta 5P-S and DHT-S. Vasectomy resulted in a significant but non-progressive reduction in DHT (40%) and T (23%) levels. The levels of E2, delta 5P-S and DHT-S also exhibited a smaller reduction following vasectomy. No significant changes were observed in the levels of the other steroids studied. The results are interpreted as suggesting that under normal conditions the bulk of the steroids present in the ejaculate is contributed by the accessory reproductive organs. In addition, a significant part of the DHT and T reach the ejaculate together with the sperm directly from the testis and/or epididymis. It is suggested that the normal steroid levels in seminal plasma established in this investigation could serve as reference values in the hormonal evaluation of male infertility. PMID- 6862673 TI - The influence of medium composition, osmolarity and albumin content on the acrosome reaction and fertilizing capacity of human spermatozoa: development of an improved zona-free hamster egg penetration test. AB - The influence of medium composition, osmolarity and albumin concentration on the ability of human spermatozoa to undergo the acrosome reaction and penetrate zona free hamster ova has been investigated. Raising the osmolarity but not the albumin concentration of the media was found to significantly increase the proportion of spermatozoa exhibiting an acrosome reaction and penetrating hamster ova, without influencing motility. There was, however, no correlation between the size of the acrosome reacted population and penetration rates between samples, suggesting that the zona-free hamster egg penetration test is more than just a measure of the availability of acrosome reacted cells. As a result of this study, a revised protocol for the hamster egg assay is described which is shorter and considerably more sensitive than conventional procedures. PMID- 6862672 TI - An analysis of the direct effects of gossypol on human spermatozoa. AB - The direct effects of gossypol and its acetic acid adduct, on the movement and functional competence of human spermatozoa were investigated employing exposure times of 1, 5 or 15 min and concentrations of 50 microM, 500 microM and 1000 microM. These compounds markedly reduced the motility, velocity, frequency of sperm head rotation and linearity of sperm progression, the most significant effects being observed with gossypol acetic acid on populations of 'capacitated' spermatozoa. Significant direct effects of gossypol on the ability of human spermatozoa to penetrate both cervical mucus and zona-free hamster ova were also observed, which were independent of any effects on motility. These results reinforce the notion that gossypol may serve a contraceptive role in the female as a 'spermicidal' agent, and suggest that this compound may also be of scientific value as a probe for identifying and isolating functionally important components of the human spermatozoon. PMID- 6862674 TI - Nuclear methods in agriculture. Papers from working group sessions of the European Society of Nuclear Methods in Agriculture. PMID- 6862676 TI - On the flow of medical information through a hospital registration post. AB - The health status of any inpatient of the Geneva hospital is appraised 3 times as follows: once before hospitalisation, then while registering, and last at discharge from hospital. Data about these 3 examinations were gathered in the registration post and then coded. The number of recorded ailments and their contents were statistically analysed. There is a notable increase in the number of diagnosed ailments and a large agreement about their nature. Simple models to describe the relations between those 2 variables were investigated, but turned up to be somewhat unsatisfying. Throughout the paper due allowance is made for a distinction between medicosurgical ailments and more specialised ones. PMID- 6862675 TI - Microcomputer-controlled plotting of environmental health data. AB - A general microcomputer program has been developed which facilitates the preparation of finished plots of geographical and temporal variations in such data as: the concentrations of suspended airborne particulate matter and of metallic and organic components detected in the particulate; the incidences of several kinds of respiratory illnesses and symptoms; epidemiological information obtained from physicians, hospitals, pharmacies, and schools. Examples of plots produced by the program, detailed explanations of how it works and a complete program listing are included. PMID- 6862677 TI - Digital analysis of RR intervals for identification of cardiac arrhythmias. AB - This paper describes a digital computer program for the automated detection and classification of persistent cardiac rhythms. The algorithm is based on dynamic mathematical models and state estimation. The method is based on the use of RR interval data and the development of simple models that describe the sequential behavior of such intervals characteristic of different persistent rhythms. The method involves the calculation of sufficient statistics for the data. The method was tested on the actual rhythm data; it provides a rapid and accurate identification of persistent cardiac rhythms. PMID- 6862678 TI - Breaches of computer security. PMID- 6862679 TI - A microcomputer program in Basic for iterative, non-linear data-fitting to pharmacokinetic functions. PMID- 6862680 TI - Spontaneous in vitro malignant transformation in a xeroderma pigmentosum fibroblast line. AB - This paper deals with a spontaneous malignant transformation in one of our XP fibroblast lines. This cell line, designated XP29MA, was derived from a 14-year old boy who did not show skin tumors or precancerous alterations either at the time of clinical examination or when the biopsy was taken. We have compared the following features in both the malignant and the benign cell line from which the malignant line developed: tumor formation in nude mice, repair capacity, cytogenetic status, light and electron microscopic characteristics. The benign cell line XP29MA had a doubling time of 4.3 d, did not form tumors in nude mice, showed a very low repair capacity (as determined by colony-forming ability, unscheduled DNA synthesis and alkaline elution) but exhibited a normal cytogenetic and ultrastructural status. In contrast, the transformed cell line XP29MAmal grew three times faster, formed colonies in methyl cellulose, gave rise to fibrosarcomas in nude mice, showed a drastically higher repair capacity, and was characterized by an extreme genetic imbalance, resulting from numerical and structural chromosome alterations of Nos. 1, 3, 4, 8, 12, 16, 17, 18, 20 and 21. Ultrastructural examination revealed fusiform and polygonal cells, the latter exhibiting large indented nuclei, vesicular dilatations of the endoplasmatic reticulum and numerous lysosomes. The higher repair capacity in XP29MAmal cells is tentatively explained in terms of reversion, enhancement of post-replication repair and/or expression of SOS-type functions. PMID- 6862681 TI - Age at any birth and breast cancer risk. AB - In an effort to assess the relative importance of age at first birth, age at subsequent births, and total parity to the occurrence of breast cancer, reproductive data from 4,225 women with breast cancer and 12,307 hospitalized women without breast cancer were analyzed by a multiple logistic regression model. Age at first birth was confirmed to be the most important reproductive risk indicator; it was associated with a 3.5% increase of relative risk for every year of increase in age at first birth (the 95% confidence interval of this estimate was 2.3 to 4.7% increase per year). However, age at any birth after the first was also an independent and statistically significant risk indicator; it was associated with a 0.9% increase of relative risk for every year of increase in age at any (and every) birth (the 95% confidence interval of this estimate was 0.4 to 1.5% increase per year). There is evidence that the age of approximately 35 years represents for every birth a critical point; before this age any full term pregnancy confers some degree of protection; after this age any full-term pregnancy appears to be associated with increase in breast cancer risk. The effect of parity is determined by the age of occurrence of the component pregnancies. While most pregnancies occur under the age of 35, the distribution varies from population to population, and this may account for the differences between populations in whether or not a protective effect is seen for births after the first, and if it is seen, its extent. PMID- 6862682 TI - Trends in malignant melanoma of skin in New Zealand. AB - Incidence and mortality rates for malignant melanoma of skin in the New Zealand non-Maori population over the past 30 years were analysed in relation to sex, age, birth cohort and time. In both sexes, the age-standardized incidence rates increased approximately exponentially with time, with an annual increment of 7.5%. The age-standardized mortality rates increased approximately linearly with time, resulting in a two- to three-fold increase over 30 years, as compared with an eight- to nine-fold increase in the incidence rates. Descriptive birth cohort analysis shows different patterns of increase for incidence and mortality rates. The main difference is that, whereas incidence rates have continued to increase in recent birth cohorts, mortality rates have stabilized. The explanation for this difference is uncertain. PMID- 6862683 TI - Site-directed chemotherapy with a drug bound to anti-idiotypic antibody to a lymphoma cell-surface IgM. AB - Xenogeneic antibodies against the cell-surface IgM of a B-cell lymphoma (38C-13) were coupled through a dextran bridge to the anti-neoplastic drug, daunomycin. The conjugate maintained both its antibody and its drug activity. The effectiveness of the conjugate was tested in vivo in mice challenged with the 38C 13 lymphoma. Drug conjugates of the idiotypic antibodies injected intraperitoneally 2 days after tumor transplantation almost completely inhibited tumor development. The controls, daunomycin-dextran-goat anti-DNP, free daunomycin, or the antibodies alone had no effect or only delayed the tumor development. PMID- 6862684 TI - Analysis of the growth characteristics of a primary BALB/c IgG plasmacytoma. AB - Spontaneously arising and chemically or virally induced tumors usually cannot be analyzed in the early stages of tumorigenesis. Growth characteristics of these tumors thus are not available and it is unknown whether their expansion at any stage is influenced by the immune system. We have developed the following strategy to evaluate possible deviations from exponential growth in initial stages when a tumor is not yet manifest and in order to overcome the two main objections against most experiments in tumor immunology: use of possibly selected transplantable tumors and high initial cell doses. BALB/c mice received 0.5 ml of Pristane intraperitoneally three times within 16 weeks. This treatment induces plasmacytomas in 58% of the animals within 1 year. Mice were bled twice a week beginning with the 5th week after the last injection and sera were stored. Guinea pig anti-idiotypic antibodies were raised against the IgG myeloma protein of a plasmacytoma developing in mouse 6-15 and a radioimmunoassay was set up. Sera of mouse 6-15 were then tested in retrospect for appearance and increase of the myeloma idiotype Id 6-15. We followed this idiotype thus for 19 weeks from a concentration of about 10 micrograms/ml up to 3 mg/ml serum. Plasmacytoma 6-15 cell growth was calculated from the Id 6-15 levels. In early phases wave-like fluctuations were found, possibly due to varying ratios of secretor to total plasmacytoma 6-15 cells. This phase was followed by an exponential increase in secretor cell number. At no time was there evidence for anti-idiotypic auto antibodies against Id 6-15. The data are discussed in connection with possibly early activation of cellular components of the immune system. PMID- 6862686 TI - Initiation of focal hyperplastic hepatic lesions by transplacental administration of ethylnitrosourea in rats of F1 generation, and no transmission of the effect to F2 and F3 generations. AB - Administration of ethylnitrosourea (ENU) to pregnant rats in the late stage of gestation has been known to have a mainly neurocarcinogenic action on the progeny. However, when transplacental administration of ENU was combined in postnatal life with a brief dietary exposure to 2-acetylaminofluorene (2-AAF) and a two-thirds partial hepatectomy, numerous focal hyperplastic lesions of gamma glutamyltranspeptidase (GGT)-positive hepatocytes emerged in the liver of the progeny. On the other hand, rats of F2 generation born of F1 parents and F3 rats born of F2 parents showed no increase in the incidence of hepatic lesions after treatment with the same dietary regimen. It was suggested that direct interaction between fetal liver cells and the carcinogen is important for occurrence of initiated hepatocytes and that the initiation effect on rat liver by ENU does not persist in the descendants of F2 and F3 generations. PMID- 6862685 TI - Homogeneously staining regions and tumorigenicity. AB - A homogeneously staining region (HSR), a chromosome abnormality associated with gene amplification, was found to increase in length coincident with an enhancement in tumorigenicity when cells from a human retinoblastoma cell line were serially passaged in athymic (nu/nu) mice. PMID- 6862687 TI - Persistence of methylated purines in the DNA of various rat fetal and maternal tissues and carcinogenesis in the offspring following a single transplacental dose of N-methyl-N-nitrosourea. AB - Formation and loss of methylated purines in DNA of various fetal and maternal tissues were measured up to 7 days following intravenous administration of N [14C]methyl-N-nitrosourea to rats on the 21st day of gestation. Methylation products were detected in all tissues examined, the level in maternal liver being higher than in other tissues. The concentrations of 7-methylguanine and 3 methyladenine decreased faster in fetal than in corresponding maternal tissues, due to a higher rate of DNA synthesis in fetal tissues, as determined by incorporation of labelled thymidine. Removal of the promutagenic DNA lesion O6 methylguanine was most efficient in maternal and fetal liver; but it was very poorly repaired in kidney and brain. The persistence of O6-methylguanine relative to 7-methylguanine was highest in the DNA of fetal brain. The principal targets for the transplacental carcinogenic effect of N-methyl-N-nitrosourea under these experimental conditions were fetal neurogenic tissue and kidney; and malignant tumors developed at these sites in 31-34% and 15-16% of male and female descendants, respectively. These results support the concept that a complex interaction between DNA alkylation, repair and replication is the molecular basis of initiation of carcinogenesis by alkylating agents. PMID- 6862688 TI - Diet and colorectal cancer: a case-control study in Greece. AB - A case-control study probing the role of diet on the incidence of colorectal cancer was undertaken in Athens, Greece, in a population characterized by ethnic homogeneity but substantial heterogeneity with respect to dietary habits. The case series consisted of 100 consecutive patients with histologically confirmed colorectal cancer admitted to two large hospitals of Athens during a 16-month period; the control series consisted of orthopaedic patients, admitted to the same hospitals during the same time period, individually matched to the index cases by age and sex. Dietary histories concerning the frequency of consumption (per month or per week) of about 80 food items were obtained by the same interviewer. Cases reported significantly less frequent consumption of vegetables (particularly beets, spinach, lettuce and cabbage) and, independently, significantly more frequent consumption of meat (notably lamb and beef). Between the two extremes (high-vegetable, low-meat diet versus high-meat, low-vegetable diet) a risk ratio of about 8 appears to exist, sufficient (in size and direction) to explain a substantial part of the international variation in the incidence of colorectal cancer. Significant associations were not found with beer or other alcoholic beverages, and significant interactions were not noted with respect to age, sex and anatomic localization (colon vs. rectum). PMID- 6862689 TI - In vitro production of rabbit macrophage tumor cell cytotoxin. AB - Rabbit pulmonary lavage cells, consisting mostly of macrophages (90-95%), cultured in the presence of LPS, secreted tumor cell cytotoxin that was similar to tumor necrosis serum cytotoxin. A similar cytotoxin was produced by phorbol ester-pretreated rabbit bone marrow cells and by blood mononuclear cells when cultured in the presence of LPS. All cytotoxins had molecular weights of approximately 48,000 daltons by gel filtration and eluted from DEAE-Sephadex between 0.28 and 0.32 M NaCl. All were stable to 56 degrees C for 60 min, but labile to 70 degrees C for 20 min. B16C3 melanoma cells and mouse embryo fibroblasts were resistant to the cytotoxins. By 3 h in culture, all effector cells secreted detectable cytotoxin levels. Kinetics of cytotoxin production differed for effector cells derived from the different tissues. No additional cytotoxin production could be demonstrated after 30 h in pulmonary lavage or bone marrow cell cultures, despite a change to fresh medium with LPS. Actinomycin D (I microgram/ml) added with LPS inhibited cytotoxin production (greater than 95%) by pulmonary lavage cells. Delaying addition of actinomycin D after LPS treatment demonstrated that messenger RNA production for cytotoxin was completed by 2 to 6 h. PMID- 6862691 TI - International variations and temporal trends in mortality from multiple myeloma. AB - Mortality statistics for multiple myeloma over the period 1960-1975 have been analysed for 23 countries. Attention has been focused on international variations, secular trends, and the male to female mortality ratio. The greatest percentage increases have been found in countries with low overall rates. The male:female ratio was generally higher in countries with high rates, and the national rates correlated more strongly with GNP per caput than with an index of medical care (hospital beds/10,000). Further analyses have been carried out over the period 1955-79 in Sweden, a country with high but relatively stable rates, and Japan, where the rates are very low but are increasing rapidly. An age, period, and cohort analysis of the trends in these countries is presented and criticized. The contributions made by increased diagnostic capability and by an increase in the true incidence of the disease are discussed. PMID- 6862690 TI - MHC imbalance and metastatic spread in Lewis lung carcinoma clones. AB - Imbalance in the Kb and Db region encoded molecules is observed in Lewis lung carcinoma clones. The uncloned metastatic population and the D122 high-metastatic clone show no expression of H-2Kb products, while the nonmetastatic A9 clone expresses Kb products. Twenty-nine new subclones of 3LL and A9 were analyzed for D-end and K-end membrane expression, primary growth rate and metastatic spread. We show that the imbalance in H-2Kb to H-2Db is correlated with metastatic properties of a given clone, but local tumor growth is not. A "low Kb/low Db" phenotype is nonmetastatic as is a "high Kb/high Db" phenotype; a "low Kb/high Db" is highly metastatic and a "medium Kb/high Db" is moderately metastatic. We find support for this notion of imbalance in experiments on MHC modulation by interferon and retinoic acid. Interferon increases both Kb and Db expression of A9 and D122 clones yet the net increase of Db was greater than Kb. This was associated with an increase in metastasis formation. Retinoic acid increases the expression of the Db gene product on the nonmetastatic A9, clone, without apparent changes in Kb expression. This treatment shifts the A9 to a high metastatic phenotype. The significance of this imbalance to the tumor--host relationship is discussed. PMID- 6862692 TI - Lysis of fresh human tumor cells by autologous large granular lymphocytes from peripheral blood and pleural effusions. AB - Human lymphocytes and their subpopulations from the peripheral blood and pleural effusions of cancer patients were tested for cytotoxicity against fresh tumor cells isolated from carcinomatous pleural effusions of the same patients. Fresh tumor cells were relatively resistant to lysis by autologous unseparated lymphocytes in a 4 h Cr-release assay. Positive reactions were recorded in 10 of 38 blood samples and 10 of 37 effusion specimens. Purification of large granular lymphocytes (LGL) by discontinuous Percoll gradient centrifugation resulted in enhancement of cytotoxic activity against autologous tumor cells and K562 cells, with no reactivity in LGL-depleted small T-lymphocyte populations. Significant lysis of effusion tumor cells by autologous LGL was observed in 15 of 22 blood specimens and 15 of 21 effusion samples. Further depletion of high-affinity sheep erythrocyte rosetting cells from Percoll-purified LGL populations gave an increase in autologous tumor-killing activity. Depletion of LGL/K562 conjugates from LGL populations decreased lysis of autologous tumor cells and K562 cells. Effusion tumor cells that were susceptible to lysis by allogeneic normal LGL were also killed by autologous LGL, and effusion tumor cells resistant to lysis by allogeneic NK cells were not lysed by autologous LGL. In a single-cell cytotoxicity assay in agarose, 4-26% LGL bound autologous tumor cells and 0.2-5% LGL killed these target cells, while 12-45% LGL bound K562 cells and 2-20% LGL lysed them. These results indicate that cytotoxic potential for autologous effusion tumor cells is present in the peripheral blood and pleural effusions of cancer patients; it is strongly associated with a minor proportion of LGL and restricted to the cell population that can lyse NK-sensitive K562 cells. PMID- 6862693 TI - Correlation of drug sensitivity on human colon adenocarcinoma cells grown in soft agar and in athymic mice. AB - A well-differentiated colorectal tumor T 219 which grows as a xenograft in athymic mice (human-tumor-nude-mouse system) and forms colonies in culture (soft agar colony-formation assay) has been used to test the correlation between the above two methods of exposure of human tumor cells to antineoplastic agents. In in vitro studies, two protocols were used: 1 h drug exposure and continuous drug exposure. In the 1 h drug exposure experiments six drugs, doxorubicin (DX), 4' deoxydoxorubicin (deoDX), 4'epidoxorubicin(epiDX), 4'-O-methyldoxorubicin (O-DX), N-trifluoroacetyldoxorubicin-14-valerate (AD-32) and 5-fluorouracil (FUra) were studied, while in continuous drug exposure experiments four of the above drugs (DX, deoDX, epiDX, O-DX) were studied. The survival of the tumor clonogenic cells (HC219) was determined by counting the number of colonies formed during 13-14 days of incubation and dose-response curves were obtained. In in vivo studies, the mice were treated with all of the drugs used in in vitro 1 h drug exposure experiments (DX, deoDX, epiDX, O-DX, AD-32 and FUra). To quantitate the chemotherapeutic effectiveness of the drugs, T/C% (relative tumor volume of treated group as percentage of the control group) values were calculated each time the tumors were measured. The experimental data suggest that in vitro 1 h drug exposure results are in good agreement with the in vivo results, while the continuous drug exposure results do not agree with the in vivo data. The most active drug in in vivo studies, deoDX, was found to be the most active drug in the in vitro 1 h drug exposure experiments as well. However, in continuous drug exposure experiments, O-DX, not deoDX, was found to be the most active drug. Activities of the other drugs tested also differed from their respective activities in in vivo studies. Although the relative effectiveness of various drugs can be compared by determining molar concentrations of the drugs producing 50% inhibition of colonies (ID50) the expression, PEI = LD10/ID50 X 1000, which takes into consideration toxicity of the drugs, is probably a better indicator of the in vitro drug activity. The results suggest that soft agar colony-formation assay (with established cell lines from the same tumor) may be used for the prediction of in vivo activity of potential antineoplastic agents against human tumor xenografts in nude mice. PMID- 6862695 TI - Liver-to-lung traffic of cancer cells. AB - Following the injection of B16 melanoma cells into the portal veins of mice, all animals developed liver tumors, but only 16% developed lung tumors. Portal vein injections of radiolabelled B16 and Walker 256 cancer cells into mice and rats, respectively, revealed that all of the cells were temporarily arrested in the liver and most were then slowly released. Bioassays indicated that of 8 X 10(4) B16 cells released from the liver over 24 h after portal vein injections of 10(5) cells, only approximately 1% were delivered to the lungs in a viable state. Experiments made with radiolabelled B16 cells showed that transit through either the liver or lungs following portal vein or tail vein injections, respectively, resulted in massive death of cancer cells. It is suggested that the death of most circulating cancer cells passing through the first organ encountered after leaving their primary tumor, serves to severely limit their further direct spread to other organs. It is therefore expected that metastases to these other organs would, to a large extent, be generated by cancer cells from metastases in the "first organs" as distinct from direct seeding from cancer cells released from the primary tumor. If the results of the present experiments have general application, they serve to emphasize the importance of metastasis of metastases in the natural history of the spread of cancer. In a previous publication (Weiss, 1980), studies of lung-to-liver traffic of cancer cells in rats revealed that, after tail vein injections, most Walker 256 cells were temporarily arrested in the pulmonary vasculature and then slowly released. A large proportion of the released cancer cells were dead or lethally injured on release from the lungs, and this "first organ processing" apparently accounted for the comparative rarity of extrapulmonary tumors following tail vein injections. In this communication, the concept of "first organ processing" of circulating cancer cells is further examined with respect to the liver-to-lung traffic of B16 melanoma and Walker 256 cells injected into the portal veins of mice or rats respectively. Both of these cell types grow well in the lungs following tail-vein injection. PMID- 6862694 TI - Modulation of K562 cells with sodium butyrate. Association of impaired NK susceptibility with sialic acid and analysis of other parameters. AB - Neuraminidase treatment of parental and butyrate-induced K562 tumor cells was associated with an increase in natural killer (NK) susceptibility of these target cells. The degree of enhancement with neuraminidase was significantly greater for the NK-resistant (NRR) butyrate-differentiated K562 cells so that the relative difference between the parental NK-sensitive (NKS) K562 line and its induced NKR variants, in terms of NK sensitivity, was no longer five- or six-fold but only two-fold. The predominant reason for the altered NK susceptibilities of the target cells after neuraminidase treatment was an increase in the target-cell binding ability of these cells as assessed by a direct conjugate-forming cell assay using Percoll-enriched NK cells and cold target competition assays. The enhancement did not appear to be due simply to an increased membrane-membrane attraction caused by a reduction of net negative cell surface charges since protamine sulphate, a positively charged molecule, had no effect on NK activity. Compared with the NKS parental K562 tumor cells, the NKR butyrate-induced cells had 3.6- to 4.0-fold higher sialo-transferase activities and were associated with significantly greater amounts of cell surface sialic acid detected both in sialyl glycoproteins (2.2- to 2.9-fold higher) and particularly within ganglioside extracts (6.2- to 13.6-fold higher). In conformity with the marked neuraminidase enhancement of NK-mediated cytolysis of the butyrate-induced targets, these NKR cells were associated with significantly enhanced levels of neuraminidase accessible sialic acid compared to the NKS parental K562 cell line. Other parameters such as sensitivity to superoxide radicals, intrinsic superoxide dismutase levels, altered membrane repair mechanisms and transferrin competition, were not significantly different between the NKS and NKR target phenotypes. Sugar inhibition studies demonstrated an enhanced inhibition against the butyrate induced cells with a variety of neutral sugars. The degree of inhibition with phosphorylated sugars was comparable between the parental and induced K562 tumor target cells and is consistent with our previous findings showing that these hexose phosphates may be inhibiting cytolysis at a step independent of target cell recognition. PMID- 6862696 TI - Period lengthening of human circadian rhythms by lithium carbonate, a prophylactic for depressive disorders. AB - The effect of lithium carbonate on the circadian system of man was studied. Four out of eight volunteers living without time cues in isolated huts in the arctic showed a lengthening of the periods of the body temperature rhythm, activity rhythm, and sleep/wakefulness rhythm by c. 1 h. Four of the participants did not show a change in the periods between the placebo and lithium ingestion phases. Two subjects who did not receive lithium salt showed internal desynchronization between the temperature rhythm and the sleep/wakefulness rhythm. Extreme isolation in bunkers is not necessary to allow free running of the circadian system in man. The sleep/wakefulness rhythm, which is very easy to record, was a reliable indicator of the circadian system in the internally-synchronized state. PMID- 6862697 TI - Altered circadian periodicities in oral temperature and mood in men on an 18-hour work/rest cycle during a nuclear submarine patrol. AB - A group of nuclear submariners was studied to examine whether an 18-h routine (6 h on, 12-h off watch) during a 10-week submerged patrol affected the 24-h circadian rhythm in oral temperature, Thayer's activation, Mood 'Activity' (MA) and Mood 'Happiness' (MH). They were observed during three phases of the patrol: Phase 1, the beginning 8-day period; Phase 2, the middle of the voyage; and Phase 3, the last 7-8 day period. The group-synchronized 24-h rhythm in oral temperature disappeared during Phase 3. The group-synchronized 24-h rhythms in Thayer's activation and in MA and MH disappeared during Phases 2 and 3. A group synchronized 18-h rhythm was not produced in any of the variables in any phase, except MH during Phase 2. Periodicity analysis of the individuals' data showed that a loss of 24-h rhythmicity in oral temperature was due not only to reduced circadian amplitude but also to a dispersion of Time of Peak (TOPs). Loss of 24-h rhythm in 'Activation', 'Happiness', and 'Activity' was predominantly due to a wider dispersion of TOPs. The 18-h routine did appear to exert a small modulating effect on rhythmic activity in the variables examined in this study. Since the sleep/wakefulness cycle was well entrained by the 18-h routine, the submariners experienced a spontaneous internal desynchronization between the activity cycle and the cycles or oral temperature and psychological states. The performance and health consequences of this chronic dyschronism have yet to be explored. We suggest further research to determine the usefulness of an index of synchronization among the physiological and psychological variables, and the relationship of the desynchronizing effects to performance. PMID- 6862698 TI - Alterations in circadian rhythmicity in calcium oxalate renal stone formers. AB - The circadian (circannual for oxalic acid) variations of 13 urinary variables (volume, creatinine, calcium, oxalic acid, glycolic acid, 17-ketosteroids, 17 hydroxycorticosteroids, phosphates, urea, uric acid, chloride, sodium, and potassium) have been documented in 7 calcium oxalate renal stone formers and 7 healthy men (control group). Urine was collected every 4 h over a period of 24 h. All subjects had the same synchronization: diurnal activity from 07(00) to 23(00) +/- 1 h and nocturnal rest; meals were given at fixed clock hours (08(00), 12(30) and 20(00) +/- 1 h). A statistically-significant rhythm (p less than 0.05) was validated for all variables except urea and calcium in healthy men. In renal stone formers, 6 variables (calcium, oxalic acid, and glycolic acid in particular) had no detectable circadian rhythm. However, a periodicity of c. 8 h (ultradian rhythm) was demonstrated for calcium and oxalic acid with peaks being located around 02(00), 10(00), and 18(00). No circannual variations in oxalic acid output could be observed. The present study shows an alteration of the periodicity of calcium and oxalic metabolisms, i.e. the loss of a circadian (24 h) rhythm and the occurrence of an ultradian rhythm of 8 h. The risk of calcium oxalate crystallisation appears thus greater at 02(00), 10(00), and 18(00). Furthermore, any study dealing with oxalic acid excretion should state the season of urine collection when comparing renal stone formers and healthy subjects, as significant differences in oxaluria may appear during the summer months and not during the rest of the year. PMID- 6862699 TI - Perhexiline: good for refractory angina but take care! PMID- 6862700 TI - Observer variability in coronary angiography. PMID- 6862701 TI - Diminutive pulmonary artery growth following right ventricular outflow tract enlargement. AB - We have assessed the clinical results and angiographic pulmonary artery growth following construction of the right ventricular outflow tract in 10 children with tetralogy of Fallot or pulmonary atresia. All cases were associated with diminutive pulmonary arteries and considered unsuitable for total corrective surgery. The mean age of the children was 34 months, mean weight 10 kg and mean body surface area 0.48 m2. The right ventricular outflow tract was constructed by insertion of a patch of dura mater (5 patients), pericardium (2 patients), homograft valved conduit (2 patients) and infundibulectomy (1 patient). The ventricular septal defect was not closed. Study of the patients between 13 and 37 months postoperatively revealed an increase in mean arterial oxygen saturation of 22% (P less than 0.01) and a fall in mean haemoglobin concentration of 1.6 g% (P less than 0.05). Overall change in pulmonary artery diameter compared to that of the trachea was insignificant although in individual cases a 50% increase in diameter was shown. Palliation of symptoms was equivalent to conventional shunting procedures. Closure of the ventricular septal defect was performed successfully in 2 patients at a later date. PMID- 6862702 TI - Right ventricular outflow enlargement. The best treatment for diminutive pulmonary arteries? PMID- 6862705 TI - Limiting factor for the initiation of reentrant tachycardia in concealed Wolff Parkinson-White syndrome. AB - We studied the limiting factor for the initiation of reentrant tachycardia in 14 patients with concealed Wolff-Parkinson-White syndrome by comparing atrial refractoriness and echo times. When relatively late atrial premature beats (A2) were not accompanied by an atrial echo (Ae), the echo times were estimated from the antegrade A2-V2 conduction time of A2, since the retrograde conduction time via the accessory pathway remained constant regardless of the degree of prematurity. Thus, A2-Ae curves including the minimal echo time and the longest A2-Ae without Ae could be drawn in all patients. Then the curve was compared with the atrial effective refractory periods and the functional refractory periods of A2 in each patient. Atrial refractoriness which might limit the occurrence of an Ae is not that of basic beats (A1) but that of premature beats (A2). In all patients the atrial effective refractory periods of A2 were much shorter than the minimal echo time and the longest A2-Ae without Ae, suggesting that the atrial effective refractory period is not responsible for limiting the initiation of an Ae. Also in 13 of 14 patients, the atrial functional refractory periods were shorter than the minimal echo time and the longest A2-Ae without Ae. In one patient, the atrial functional refractory period was sandwiched between the minimal echo time and the longest A2-Ae without Ae suggesting the atrial functional refractory period of Ae might be responsible for limiting the occurrence of an Ae in this patient. PMID- 6862704 TI - Cardiac prostheses: a twentieth century problem. PMID- 6862703 TI - The suprasternal approach to recording aortic valve prostheses: a comparison with the precordial and subxiphoid approaches. AB - We evaluated 56 consecutive patients echocardiographically 9 days to 104 months after aortic valve replacement by the precordial, subxiphoid and suprasternal approach. In 11 patients, the mitral valve had also been replaced. For comparison, a subjective grading system (score 1 up to 3) was applied to the records obtained from each approach. Disc valves (n = 41) were equally scored from the precordial and suprasternal approach (score 2.6). Ball prostheses (n = 6) were best imaged from the suprasternal approach (score 3.0), whereas bioprostheses (n = 9) were best visualized from the precordial (1.8). Simultaneous imaging of both valves was possible in 6 out of 11 patients with a double prosthesis using the suprasternal approach but not from precordial and subxiphoid approaches. Six patients presented prosthetic valve dysfunction. Five patients had paravalvular insufficiency; 4 of these patients had a Bjork-Shiley valve and one patient a Lillehei-Kaster valve. The echograms of 4 out of 5 patients with a paravalvular leak were normal from each approach. In another patient an obstructed Bjork-Shiley prosthesis was found. The pre- and postoperative echograms demonstrated that the suprasternal approach was best to visualize the obstructed valve. The study shows that the suprasternal technique is superior for evaluation of most patients with aortic valve prostheses. PMID- 6862706 TI - The Wolff-Parkinson-White syndrome--what makes the tachycardia go? PMID- 6862707 TI - The healing heart. PMID- 6862708 TI - Syntactic orphans and adoptees: unattached participles. II. Medical misconstructions. PMID- 6862709 TI - Foxglove and Fab: immunological approaches to digitalis intoxication. PMID- 6862711 TI - Valve replacement for chronic severe aortic regurgitation: when should it be done? PMID- 6862710 TI - Endomyocardial biopsies. PMID- 6862712 TI - Frequency and role of coronary artery spasm in heart disease. PMID- 6862713 TI - Regression of coronary artery lesions during lipid lowering therapy, demonstrated by scheduled serial arteriography. PMID- 6862714 TI - The hypnotic relationship--another look at coercion, compliance and resistance: a brief communication. PMID- 6862715 TI - Treatment of exhibitionism in a 38-year-old male by hypnotically assisted covert sensitization. PMID- 6862716 TI - Self-hypnosis versus hetero-hypnosis: order effects and sex differences in behavioral and experiential impact. PMID- 6862717 TI - Posthypnotic amnesia and the cognitive efficiency of schizophrenics. PMID- 6862718 TI - Involuntariness of response on the Harvard Group Scale of Hypnotic Susceptibility. PMID- 6862719 TI - Long-term treatment of bronchial asthma with pirbuterol aerosol. AB - In an open study in which 25 male outpatients with chronic obstructive pulmonary disease received pirbuterol aerosol for up to 14 months bronchodilator efficacy was maintained throughout. There were no serious side effects, and laboratory abnormalities were of little clinical relevance. Sinus bradycardia was the most frequently observed ECG change. PMID- 6862720 TI - Modifications of libido and sex drive during treatment of minor depression with viloxazine. AB - The effects of viloxazine hydrochloride on the libido and sex drive of 20 outpatients suffering from minor depression were assessed. For this purpose the Zung Self-Rating Depression Scale and a questionnaire devised by the authors to evaluate libido and sex drive were used. A dose of 300 mg viloxazine/day for 4 weeks was administered. Test-retest assessments showed a significant improvement of depression and an increase in libido and sex drive. These latter effects were marked, but did not appear to be related to the improvement of depression. PMID- 6862721 TI - Combined effect of alpha-methyldopa and a new enzyme inducer, Zixoryn, on the hepatic mixed-function monooxygenase system in humans. AB - Based on previous studies with alpha-methyldopa (inhibitor of hepatic mixed function monooxygenase system) and m-trifluoromethyl-alpha-ethylbenzhydrol, a new enzyme inducer Zixoryn, the authors studied the effect of the combined treatment of the two compounds on the hepatic drug-metabolizing enzyme activity in ten patients. There was no change in antipyrine half-life and its apparent volume of distribution (aVd) in the amount of D-glucaric acid excreted in the urine (indirect parameters of the mixed-function monooxygenase system's activity) after 1-week administration of 1000 mg alpha-methyldopa together with 300 mg Zixoryn per day. The two compounds counteracted each other's effects in the applied doses. PMID- 6862726 TI - The clinical pharmacology of drug interactions. AB - Preliminary evaluation of pre-established and extemporaneous combinations showed that any combination requires broad, precise, and scientifically valid documentation. Every drug has to be evaluated according to physical, chemical, and pharmacologic points of view, either individually or in combination, and above all be adapted to the individual needs of each patient. To make a realistic contribution to evaluating and devising new combinations, specialized centers should be instituted such as the Central Admixture Service of S. Matteo Hospital in Pavia. PMID- 6862722 TI - Intestinal absorption of S-adenosyl-L-methionine in humans. AB - S-adenosyl-L-methionine (SAM) has proven to be fairly stable in gastric and duodenal juices as well as in bile. It was, therefore, administered orally to six healthy subjects. No increase in SAM levels was observed in the systemic blood. SAM was then directly injected into a jejunal loop of nine patients undergoing cholecystectomy. SAM concentrations increased significantly in venous mesenteric and systemic blood. Infusions of methionine directly into the jejunum by the same method used for SAM did not induce any increase in SAM concentrations in the mesenteric or systemic blood. PMID- 6862727 TI - The quinidine-digoxin interaction in patients with impaired renal function. AB - Quinidine has been reported to reduce clearance and the distribution volume of digoxin. Data are presented indicating that serum digoxin concentration (SDC) is increased throughout the coadministration of quinidine. This strongly suggests that the quinidine-induced reduction of digoxin clearance is the main mechanism underlying this drug interaction. It has been suggested that beside renal clearance quinidine also reduces non-renal clearance of digoxin. Direct evidence is provided by a study in patients with impaired renal function. Irrespective of the degree of renal impairment, quinidine increases SDC to about the same amount as found in patients with normal renal function. Since quinidine does not interfere with plasma protein binding of digoxin, this implies a decrease in non renal clearance. In all patient groups the incidence of this drug interaction is rather high; however, pronounced interindividual differences occur as regards the extent of the increase in SDC. Regardless of the state of renal function careful monitoring of digitalized patients is mandatory once quinidine therapy is initiated. Since it may take a week or more until a new steady state is established in patients with impaired renal function, this period of close monitoring should be extended correspondingly. PMID- 6862724 TI - Influence of thioridazine on human cognitive, psychomotor, and reaction performance as well as subjective feelings. AB - The influence of thioridazine (1.0 and 1.5 mg/kg body wt.) on human performance was studied in healthy subjects in a double-blind trial vs placebo. Psychophysical performance was diminished dose-dependently. Reaction performance was clearly impaired only by the higher dose. The effect on cognitive performance varied, probably as a function of test-specific vigilance optima and the subjects' increase in reactive exertion. However, the subjective well-being of the subjects was impaired throughout. PMID- 6862723 TI - Effect of pindolol on serum lipoproteins in patients with coronary heart disease. AB - The effect of pindolol, a beta blocker with intrinsic sympathomimetic activity (ISA), on serum lipoprotein composition was studied in 13 patients admitted to the hospital for an attack of coronary heart disease. The control group consisted of 11 coronary patients without any beta-blocker therapy. Pindolol therapy was started during the stay in the hospital with a dose of 2.5-5.0 mg 2-3 times daily (mean dose 7.5 mg daily) and continued unaltered throughout the study. Serum samples were taken upon admission to the hospital and 4-6 months later, when the effect of acute coronary heart attack was stabilized. Initial serum cholesterol and HDL-cholesterol values were 6.82 mmol/l and 1.04 mmol/l, respectively. The ratio of HDL-cholesterol to total cholesterol (HDL/total) was 0.155 and serum triglycerides 1.78 mmol/l. During the pindolol therapy HDL-cholesterol and the HDL/total ratio increased by 12.5 and 11.2%, respectively, and the triglyceride level decreased by 16.9%. These changes, however, were not statistically significant due to interindividual variation. The results suggest that pindolol, unlike some other beta blockers, has no harmful effect on lipoprotein metabolism. This finding may have relevance when choosing a beta blocker for a patient with coronary heart disease. PMID- 6862725 TI - Influence of type of dialyzer on the pharmacokinetics of amikacin. AB - The pharmacokinetics of amikacin was studied in 18 patients with terminal renal impairment (Clcr less than 5 ml/min during the course of 4-5 h hemodialysis sessions using four different kinds of dialyzer: RP 6, RP 514, Dialix, and Ultra Flo II. All patients received a single dose of 7.5 mg amikacin/kg body wt. at the beginning of the dialysis session. The type of dialyzers influences the serum half-life, the extraction coefficient, and the percentage of dose extracted during dialysis. A linear relationship was established between the percentage of the dose extracted by dialysis and the dialysis clearance of the antibiotic. PMID- 6862728 TI - Serum protein binding of drugs is not altered in patients with severe chronic cardiac failure. AB - The aim of this study was to investigate whether serum protein binding of drugs is altered in patients with severe chronic cardiac failure. A total of 27 patients of the cardiac unit participated in the study. One group comprised 15 subjects with chronic cardiac failure (grade III-IV according to the New York Heart Association); 12 patients served as controls (grade I-II). The extent of binding was determined in the therapeutic concentration range by means of equilibrium dialysis at pH 7.4 and 37 degrees C. The binding of six marker drugs shows no difference between controls and patients with chronic cardiac failure. Furthermore, measured free fractions were in the range reported in the literature for healthy, untreated individuals. Our selection of drugs comprised substances that are representative of the three major drug-binding sites on human albumin (diazepam-digitoxin-warfarin/phenytoin). Furthermore, propranolol and imipramine represent examples of drugs binding mainly to lipo- and glycoproteins. The results suggest that the binding of most drugs encountered in clinical practice will be unchanged in patients with chronic cardiac failure. PMID- 6862729 TI - Bioavailability of sustained-release theophylline formulations. AB - Sustained-release formulations of theophylline as well as of other drugs are designed to effect a delayed but constant release of the active principle in the gastrointestinal tract, thus ensuring more prolonged blood level curves. This study was made to assess the bioavailability of two sustained-release microencapsulated formulations and one sustained-release Diffucaps formulation, in comparison with an equivalent dose of theophylline solution. As regards bioavailability, none of the three formulations differed significantly from the reference formulation. The blood levels at steady state were estimated on the basis of data obtained after a single-dose study. All three sustained release formulations showed good results after prolonged administration in terms of peaks and troughs. The time duration at which the theophylline plasma levels remain higher than 75% of the maximum steady-state levels, following 12-h dosing interval, was evaluated: for the sustained-release microencapsulated formulations this time duration reaches 100% of the dosing interval. A multiple-dose administration of the sustained-release formulations used in this study should guarantee almost complete time coverage, with blood levels sharply exceeding the minimum threshold level of the theophylline therapeutic range. PMID- 6862730 TI - Effects of pyridoxine alpha-ketoglutarate on blood glucose and lactate in type I and II diabetics. PMID- 6862731 TI - Therapy for intercurrent respiratory infections in COLD patients: report on 200 patients. AB - Over the last 2 years we have applied a therapeutic regimen with simultaneous use of cephalexin and bromhexine in therapy for infective exacerbations of COLD patients. The results obtained are positive. Bacteriologic features, the modification of sputum and, where possible, behavior of hematologic parameters and blood gases were checked. This pharmacologic combination appears to be useful in pneumology, as it yields very good results in obstructive chronic bronchitis in a bacterial relapsing phase and with alveolar hypoventilation linked to massive presence of endoluminal mucus. With the exception of two patients, in whom nausea and gastric pyrosis were observed, we observed no toxic or side effects of any kind, not even in subjects treated for a long time. PMID- 6862732 TI - Reversibility prediction of chronic airways flow limitation by a new simple spirometric parameter. AB - A new simple spirometric parameter for predicting the reversibility of bronchial obstruction is evaluated in two homogeneous groups of severe COLD patients. By combining FEV1 and MMEF, this index is practically the product of the volume expired in 1s and the corresponding flow at 50% of FVC which characterizes the emptying pattern. The parameter provides a useful method for verifying the patient's responsiveness to beta 2-bronchodilator drugs. The bronchial flow limitation depends more on the airways obstruction present than on the characteristics of the drugs administered. A threshold level for the new parameter was defined (1000 l/s); beneath this value responsiveness to beta 2 drugs must be considered practically negligible. PMID- 6862733 TI - Drug use intervention: opinions, facts, and their status. PMID- 6862735 TI - Estimating the size of subpopulations of heroin users: applications of log-linear models to capture/recapture sampling. AB - This article reviews two of the major methodologies applied to estimation of the number of heroin abusers: survey research methods and the capture/recapture technique. The main focus of the paper is to show the flexibility of the capture/recapture approach in handling not only the dependence of samples of heroin users but also the nonhomogeneity of sampling probabilities, allowing estimation in populations which are mixtures of qualitatively different heroin user types. Models with these features are illustrated using both simulated and real heroin abuse data. PMID- 6862734 TI - Drug "overdoses" among U.S. soldiers in Europe, 1978-1979. II. autopsies following deaths and near-deaths. AB - On-site investigations involving interviews with spouses, friends, coworkers, supervisors, and commanders were conducted following 37 deaths or near-deaths by drug overdose among U.S. soldiers stationed in Europe. Subjects were all active duty soldiers put on the seriously ill list at any Army hospital with an initial diagnosis which included suspected drug overdose. Victims were typically single Black males, less than 22, high school graduates in excellent health. They had been in Germany 7-24 months, liked their jobs, and were judged better than average workers by both peers and supervisors. Fifty percent played on a unit sports team, 6 of 10 had German girlfriends, and one-third had prior disciplinary problems. Although nearly half had been previously identified as having a drug or alcohol problem, only two or three could be called addicts in even the broadest sense. Six cases were suicide gestures, and only these six cases did not involve heroin and/or alcohol. The modal case followed a party, with substantial drinking. In only 25% of the cases did the victim collapse upon injection. More often he went to bed, vomited during the night, and choked on or inhaled vomitus. The data suggest reexamination of two common myths: that heroin users comprise a very unique, albeit undesirable, sample of the general population; and that "overdose" deaths are the result of ignorance, incompetence, or indifference. PMID- 6862736 TI - An empirical typology of narcotic addicts. AB - On the basis of structured interview data concerning their life-styles, behaviors, circumstances, and activities during their most recent periods of addiction, 460 male narcotic addicts (230 Black and 230 White) were empirically classified, or "typed," using factor and cluster analytic techniques in a multistage process. Mean factor score profiles for each of the eight types derived are presented, along with provisional labels and verbal descriptions. It is believed that this classification is descriptive of the major addict types to be encountered in a large urban population. PMID- 6862737 TI - A longitudinal study of life stress and social support among drug abusers. AB - A longitudinal study was conducted with 49 clients recently discharged from heroin detoxification programs. Interviews were conducted at monthly intervals for 3 months, and information was gathered on drug use, stressful life events experienced, the availability of social support, and the presence of psychiatric symptomatology. Clients who reentered treatment (i.e., methadone maintenance) reported increasing social support over the 3-month period, decreased their use of heroin and several other drugs, and evidenced decreased depression and anxiety. The remainder of the sample evidenced no significant changes over time. Cross-correlation analysis was applied to the data for males and females, separately. The results suggest that women addicts are especially sensitive to the effects of life stressors and tend to lack the support systems which are available to the males. As a means of coping with stressors, in the absence of support, the female addict appears to "self-medicate" with illegal drugs. PMID- 6862738 TI - Typologies in alcoholism: an overview. AB - There seems to be a growing consensus that the differential outcome associated with alcoholism suggests different prognoses of specific subgroupings of alcoholic patients. This paper is a review of the literature of proposed typologies based upon drinking history, psychopathology, neuropsychological assessment, and family pedigree, with implications for theories of etiology, approaches to treatment, and research methodology. It should serve as an introduction to the series of papers which will follow. PMID- 6862739 TI - Women alcoholics--are they different from other women? AB - Research to date suggests that the woman who becomes alcoholic is conflicted and ambivalent about being a woman. Yet, most of the alcoholism literature is based on men's lives; theories about why women drink are offshoots of theories about male drinking behavior. There have been no studies reported considering alcoholic women from a normal developmental perspective. This study investigates the psychological aspects of perceptual dependence, level of ego development, and female sex role perceptions in a group of alcoholic women in comparison to nonalcoholic women similar to them. Implications for prevention and treatment are discussed. PMID- 6862740 TI - Dialectics as an alcohol treatment intervention. AB - It has been reported repeatedly in the literature that treatment outcome is not related to the form of treatment. These research data do not, therefore, provide the clinician with specific treatment approaches for specific forms of alcohol use problems. It would be helpful to have an effective intervention conceptual model which can be used in a variety of settings and with a variety of clients. This article presents a model developed within clinical practice which employs a dialectical intervention process. The goal of the model is a decision by the client to do something about his/her condition. The decision is seen as the sine qua non of recovery. The model is presented as a clinically useful tool which should be tested within a variety of clinical settings. PMID- 6862741 TI - Optional versus mandatory psychotherapy in methadone maintenance. AB - Treatment outcomes of 23 methadone maintenance patients who were offered optional psychotherapy were compared with those of 31 methadone maintenance patients who received mandatory psychotherapy. There were no statistically significant differences in pretreatment characteristics between the optional group and the mandatory group. Patients in the optional group received less than half as many hours of therapy as patients in the mandatory group. Differences between the two groups in retention, employment, illicit drug use, and arrests were nonsignificant during a 1-year study period. The findings were compatible with those of most previous studies of the effectiveness of psychotherapy in methadone maintenance, which suggest that outcomes with or without psychotherapy do not differ significantly. PMID- 6862742 TI - Review and preview of psychoanalytic theory in group psychotherapy. PMID- 6862743 TI - Psychoanalysis and group analysis. PMID- 6862744 TI - Fundamental psychoanalytic concepts: past and present understanding of their applicability to group psychotherapy. PMID- 6862745 TI - The value of analytic self-experience groups in the training of psychotherapists. PMID- 6862746 TI - The mourning process in group therapy. PMID- 6862747 TI - Some problems of patient referral for outpatient group psychotherapy. PMID- 6862749 TI - Is pityriasis rosea dying? PMID- 6862750 TI - Coagulase-negative staphylococci. PMID- 6862748 TI - Some advantages of applying multidimensional thinking to the teaching, practice, and outcomes of group psychotherapy. PMID- 6862751 TI - Os penis: the plastic induration of the penis with metaplasia of fibrous connective tissue into cartilage and bone tissue. PMID- 6862752 TI - Photochemotherapy and alopecia areata. AB - Four of ten patients with alopecia areata (plaque and totalis types) showed some regrowth of hair after PUVA therapy using a light box with peak emission 365 nm. Because PUVA may have long term side effects, this therapy should be reserved for patients resistant to other treatments. PMID- 6862754 TI - Baseline studies of the global pollution VIII: the complex pattern of C1-C4 organohalogens in continental and marine background air. PMID- 6862753 TI - Investigation of the emissions of an antimony metallurgical factory with transmission electron microscopy. PMID- 6862755 TI - Extraction procedures for atomic absorption spectrometric analysis of toxic metals in urban dust. AB - A comparison has been made of eight acid extraction systems prior to the atomic absorption analysis of lead, nickel, copper, cadmium, cobalt, chromium, zinc, arsenic and mercury in street dust samples. Statistical treatment of the results enabled a valid comparison to be made in terms of overall extraction efficiency. For the purposes of carrying out large scale environmental surveys it was found that extraction with dilute nitric acid was the most suitable method. Analysis of the extracts by atomic absorption spectroscopy was shown to permit the accumulation of reliable data with the minimum requirement of apparatus and time. PMID- 6862757 TI - Unfavorable serum lipid profiles in extremely overfat women. PMID- 6862756 TI - A method for the determination of octa- and nonachloro-2-phenoxyphenols in chicken tissue. AB - A gas-liquid chromatographic method was developed capable of determining octa- and nonachloro-2-phenoxyphenols in chicken liver or muscle at 0.25 ppb and fat at 2.5 ppb. The method involves extraction with acidified acetone:hexane, cleanup with concentrated H2SO4 and Florisil column chromatography, methylation with diazomethane, and quantitation by capillary column gas-liquid chromatography with electron capture detection. Fortification of liver and muscle at 0.25 or 0.5 ppb and fat at 2.5 or 5.0 ppb and subsequent analysis yielded recoveries averaging 91% for octa- and 97% for nonachlorophenoxyphenol. PMID- 6862758 TI - The accuracy of reports of weight: children's recall of their parents' weights 15 years earlier. AB - This report describes the accuracy with which adults can recall the weights of their parents as they were 15 yr before. In 1962-65, measurements of height, weight and skinfold thickness were made in the Tecumseh Community Health Study. In 1979, 134 children of 96 mothers and 117 children of 79 fathers were asked to recall their parents' heights and weights at the earlier time and to select one of nine outline drawings, ranging from very thin to very fat, which best represented the parents at the time they were measured. The correlation between body mass index [weight in (kg)/height2 in (m)] as reported and as measured was 0.82 for mothers and 0.56 for fathers. Similar correlations were found between the selected figure and the measured body mass index: 0.74 for mothers and 0.63 for fathers. Measured values in the high range were underestimated, those in the low range were overestimated. Adding the figure selection to the report of height and weight increased the accuracy of estimation, particularly for fathers. Reports of height and weight and of figure selection were more highly correlated with measured body mass index than with skinfold thickness. None of several characteristics of the offspring had any major influence on the accuracy of their reports: age, sex, height, body mass index, skinfold thickness or the confidence of the subject in his ability to remember. Accuracy of the reports was similarly not related to age or height of the parent or to the report of the other parent's weight. We conclude that offspring reports of their parents' past weight may be a useful epidemiological tool. PMID- 6862759 TI - Behaviour therapy of obese children and results 21 months after treatment. AB - Two groups of pre-pubescent obese children were given modified behaviour therapy. A shaping procedure was used to bring about changes in quantity and quality of food eaten, physical activities, and eating behaviour. In addition, attempts were made to get the children to distinguish better between hunger and satiation and to improve the interactions between children and parents. The children were trained to effect desired behavioural changes themselves on the basis of their own observations. Four of the 11 children displayed a substantial weight reduction which was maintained in follow-up. In the case of the other children it appeared that psychopathological and constitutional factors prevented them from making use of the strategy offered. PMID- 6862761 TI - Ectopic tachycardia associated with a natural foods low-calorie diet. PMID- 6862760 TI - Effects of medium- and long-chain triacylglycerols on adipose tissue metabolism in the obese Zucker rat. AB - The influence of a diet including 18 per cent by weight of long-chain (LCT) or medium-chain (MCT) triacylglycerols on adipose tissue development, and on in vitro adipose tissue triacylglycerol (TG) synthesis from glucose and palmitic acid, was studied using genetically obese, fa/fa, and control, Fa/-, Zucker rats. The adipose tissue mass was greater with the LCT diet than with either the MCT or control diets, but there was no significant difference between the MCT and control diets. TG synthesis from labelled substrates was not modified by the MCT diet when compared with the control, but was decreased by the LCT diet. The results suggested that the use of MCT in treating human obesity would necessitate levels too high to be therapeutically practical. PMID- 6862762 TI - Lean body mass in obesity. AB - Most obese individuals, both children and adults, have an increase in lean weight (LBM) as well as fat, the former accounting for as much as 40 percent of the excess weight in some studies. Intentional overfeeding of normal individuals augments LBM as well as fat. Human obesity thus differs from some types of experimental and hereditary obesity in animals, since these are associated with a decreased LBM. Exceptions are those individuals with Cushing's syndrome. PMID- 6862763 TI - Conformational characteristics of homo-oligopeptides of O-benzyl-L-tyrosine. AB - Conformational studies of X[-L-Tyr(Bzl)-]n-series bound to polyethyleneglycol (X = H2, Nps; n = 3-8) in the solid state and in solvents of different polarities and capabilities of forming hydrogen bonds are reported. By using i.r. absorption, the occurrence of the beta-structure in the higher oligomers in the solid state was established. By means of i.r. absorption and CD the onset of that ordered conformation in solution was assessed as a function of chain length. The effects induced by the presence of the N-protecting group and added base, and by changing the nature of solvent on the conformational preferences of the [-L Tyr(Bzl)-]n homo-peptides were also examined. The 2-nitrophenylsulphenyl chromophoric derivative of the alpha-amino group is proposed as a circular dichroism sensor for beta-structure in peptides. PMID- 6862765 TI - Synthesis of polypeptide models of elastin. Synthesis and properties of a cross linked polytetrapeptide. AB - Synthesis of two copolymers, H-(phi-Pro-Gly-Gly)n-Val-OMe and H-(phi'-Pro-Gly Gly)n-Val-OMe, where phi is Val or Lys and phi' is Val or Glu is described. Cross linking between the two copolymers is achieved by a coupling reaction between the epsilon-amino groups of the lysine containing copolymer and delta-carboxyls of the glutamic acid of the other copolymer. The cross-linking reaction was performed during a temperature elicited phase separation with flow orientation of the copolymers. Coacervation of the intermediate polymers is presented, as is the scanning electron micrograph of the insoluble cross-linked product and its calcifiability as determined with electron probe microanalysis. The purity of the key intermediates and polymers is demonstrated by the usual analytical methods. Carbon-13 magnetic resonance spectra of the intermediate monomer units are included to validate the purity of their synthesis. PMID- 6862764 TI - Enkephalin analogs: synthesis and properties of analogs with lipophilic or extended carboxyl-terminus. Quantitative structure-activity relationship of analogs modified in residue position 5. AB - Four analogs of enkephalin (EK) have been synthesized by the solid-phase method and their biological activities have also been investigated. All four analogs were less active than Met-enkephalin (Met-EK) as shown by relative potencies in the guinea pig ileum (GPI) assay: Met-EK, 100; [Phe5]-EK-NH2, 59; [Trp5]-EK-NH2, 11; Met-EK-Cys(Cam)-OH, 37; and N,N'-bis(Met-EK)-cystine, 34. Two of the analogs were more potent than Met-EK as shown by relative potencies in the mouse tail flick assay for analgesia: Met-EK, 100; [Phe5]-EK-NH2, 1340; [Trp5]-EK-NH2, 1640. Quantitative structure-activity relationship calculations were carried out for GPI potencies of analogs substituted in position 5. The calculation indicated that, in this position, the bulkiness had the main influence. PMID- 6862766 TI - Synthesis and properties of equine beta-melanotropin analogs with substitution in residue position 1. PMID- 6862769 TI - Peptides containing dipropylglycine. Part 2. Preparation of tripeptides and higher homo-oligomers of dipropylglycine. AB - Using 4-heptanone in the Ugi reaction, it is possible to prepare a peptide containing a single residue of dipropylglycine (Dpg) in modest yield, but attempts to form peptides containing contiguous Dpg residues were unsuccessful. Methods of extending Dpg-Dpg to higher homo-oligomers have been examined. Carboxyl extension of N-trifluoroacetyl (Tfa)-Dpg2 is possible through its oxazolin-5(4H)-one, but only as far as the tripeptide. However, amino extension of Dpg2-OBut by successive steps of addition of 2-trifluoromethyl-4,4 dipropyloxazolin-5 (4H)-one and N-deprotection allowed preparation of Tfa-Dpg6 OBut in good yield. Removal of the Tfa group from Dpg residues is only possible using sodium borohydride reduction under conditions which lead to partial reduction of the t-butyl esters of protein amino acids. The use of the N',N' dibenzylhydrazide (DBH) group for C-protection, however, circumvents this problem. Direct regeneration of carboxyl from DBH is possible with bromine in acetonitrile, and catalytic reduction gives the free hydrazide. Tfa-Dpg--NHNH2 can be oxidatively coupled to Gly-OBut but not to Dpg-OBut. Tfa-Dpg3-N3 undergoes Curtius rearrangement in preference to peptide bond formation, and Dpg3-N3 eliminates isocyanic acid on heating to form N-(Dpg)2-heptylideneimine. PMID- 6862768 TI - Peptides containing dipropylglycine. Part 1. Preparation of protected derivatives of dipropylglycine and their incorporation into dipeptides. AB - Methods for the incorporation of the hindered amino acid 2-amino-2 propylpentanoic acid (dipropylglycine, Dpg) into peptides have been investigated. Limitations on the preparation of protected derivatives of Dpg are discussed, and common methods of coupling examined. These methods are not subject to problems when used to link protein amino acids to the amino group of Dpg, but steric hindrance severely limits efficient peptide bond formation by the carboxyl group of Dpg. Only two reagents proved useful in this respect. N-Benzyloxycarbonyl (Z) Dpg can be coupled through its derivative with 3-hydroxy-4-oxo-3,4 dihydrobenzotriazine; other methods of activation of Z-Dpg tend to lead to formation of 2-benzyloxy-4,4-dipropyloxazolin-5(4H)-one, which resists attack by nucleophiles. 2-Trifluoromethyl-4,4-dipropyloxazolin-5(4H)-one, however, which is readily prepared from N-trifluoroacetyl-Dpg and thionyl chloride, couples cleanly with other amino acids, making it the reagent of choice for introduction of a Dpg residue. PMID- 6862767 TI - Stabilization of beta-turn conformations in enkephalins. alpha-Aminoisobutyric acid analogs. AB - Stereochemical constraints have been introduced into the enkephalin backbone by substituting alpha-aminoisobutyryl (Aib) residues at positions 2 and 3, instead of Gly. 1H n.m.r. studies of Tyr-Aib-Gly-Phe-Met-NH2, Tyr-Aib-Aib-Phe-Met-NH2 and Tyr-Gly-Aib-Phe-Met-NH2 demonstrate the occurrence of folded, intramolecularly hydrogen bonded structures in organic solvents. Similar conformations are also favoured in the corresponding t-butyloxycarbonyl protected tetrapeptides, which lack the Tyr residue. A beta-turn centred at positions 2 and 3 is proposed for the Aib2-Gly3 analog. In the Gly2-Aib3 analog, the beta-turn has Aib3-Phe4 as the corner residues. The Aib2-Aib3 analog adopts a consecutive beta-turn or 3(10) helical conformation. High in vivo biological activity is observed for the Aib2 and Aib2-Aib3 analogs, while the Aib3 peptide is significantly less active. PMID- 6862770 TI - Regiospecific amine substitution into alpha-amanitin with retention of inhibitory properties against eukaryotic class II RNA polymerase. PMID- 6862775 TI - Comparative factor analysis models for an empirical study of EEG data. AB - This paper (the first in a series) applies new, empirical factor analysis methods to the problem of "banding" EEG power spectra. A measure is introduced for the comparison of factor analysis results (factor loading matrices). The measure, Ambient Matrix Coherence (AC) is "geometrically unbiased", and invariant of so called "oblique rotations." AC is used in a "stability computation" to find the dimension of the stable factor analysis solution common to several subsets of a given dataset. If the factor analysis model is appropriate, then the correct number of factors is empirically determined in this way. Stability computations were first performed on various simulated datasets to establish the robustness and efficacy of this method (for various noise levels). These techniques were then applied to EEG power spectra datasets for each of 8 leads. Comparison of these results indicated 3 stable factors in common to all 8 leads, an additional less stable factor in common to 5 leads, and weak stability for the six dimensional solution for one lead. PMID- 6862774 TI - Event-related potentials to match and mismatch letters in an immediate item recognition task. AB - During an immediate item recognition task, ERP differences to match and mismatch letters occurred in the N1 component, as well as the P3 component, of the stimulus related wave form. The pattern of ERP differences was similar to that reported previously for words in a delayed list recognition task, (Warren, 1980). The ERP differences to match and mismatch letters appeared unaffected by visual field of presentation (left, center, right) or hemisphere of recording site (P3, P4). It is suggested that the N1-P3 differences to match and mismatch stimuli may possibly reflect a pattern of neural activity associated with a two-stage recognition memory process. PMID- 6862772 TI - Event related brain electrical and magnetic activity: toward predicting on-job performance. AB - Personnel assessment has depended on paper and pencil tests. These tests are able to predict academic performance fairly well, but have been criticized for their ineffectiveness in predicting on-job performance. Research on brain function which emphasizes "process" rather than "content" variables, may be able to predict on-job performance better than traditional tests. Relationships have been found between event related brain potentials (ERPs) and performance in fighter aircraft and on a sonar simulator, as well as enlistees promotions and attrition. Research has suggested that ERP records are better able to discriminate and classify performance groups than paper-and-pencil test scores. Biomagnetic data are described from heart and brain. These data suggest increased sensitivity to individual differences, and may offer greater opportunity for improving prediction of on-job performance, than ERP records or paper-and-pencil tests. PMID- 6862771 TI - Regiospecific arylazo substitution into alpha-amanitin with retention of inhibitory properties against eukaryotic class II RNA polymerase. PMID- 6862777 TI - Changes of human blink reflex magnitude during a three second fixed foreperiod. AB - Blink reflexes were evoked at distinct times during a 3 sec foreperiod (FP) between a warning stimulus (WS) and a reaction signal (RS). Sixteen well-trained, right-handed subjects participated in the experiment. Following RS, they reacted instantaneously with a blink of the right eye. In the electrically evoked blink reflex, an early ipsilateral component (R1) with a latency of +/- 10 msec and a late bilateral component (R2) with a latency of +/- 25-40 msec could be distinguished. The peak-to-peak amplitude of R1 and the integral of R2 were computed. In the beginning of FP, R1 was enlarged as compared to control values. Toward the end of FP, a continuous rise of R1 amplitudes was seen. This increment was most pronounced in the muscle involved in the reaction following RS. R2 was inhibited immediately after WS, while no significant inhibition could be seen near the end of FP. The conclusion is that the facilitation of R1 and the disinhibition of R2 towards the end of FP reflect the preparation on the reaction after RS. The extra increment of R1 might be due to a selective extra preparation of the motoneurons of the involved muscle, although an effect of motor dominance cannot be excluded. PMID- 6862776 TI - Right cerebral hemispheric function: behavioral correlates. AB - Studies of cerebral asymmetry generally support verbal-analytic functions on the left hemisphere and nonverbal, integrative functions on the right. The hypothesis of this investigation was that right hemisphere functions have greater significance for adaptive behaviors, i.e., verbal-analytic abilities are not specifically related to environmental adjustment or coping skills. Right hemispherically strong children were compared with normal controls along six behavioral parameters. The results supported environmental awareness and adaptive skills as related more to the right hemisphere than the left. It is suggested that self-monitoring of behavior and possibly affective integration appear to be more related to the processing of spatial, sequential information on the right hemisphere than verbal-analytic functions on the left. PMID- 6862778 TI - A note on the use of serial measures in spike train analysis and their relation to the corresponding moments. AB - A spike train is a sequence of interspike intervals and should be described in terms of random variables. So, in order to recognize the information of the spike train, one usually calculates the sample mean (as the normalized sum of all intervals in one realization) or the means (of outcomes of respective intervals), an approximation of which is the PSTH. Further, the sample variance and variance, the serial correlation, and the autocovariance are utilized for evaluation. In this paper it is shown that these notions, which seem to be very similar, have little to do one with another, except for some cases (stationarity, ergodicity), which rarely occur in neurobiology. Finally, it is proposed to rename the term stationarity in spike train analysis, because it differs considerably from the definition which is used in the theory of random variables and stochastic processes. PMID- 6862773 TI - Disturbances of attention in alcohol withdrawal syndrome. AB - Disturbances of attention have often been noted clinically in the alcohol withdrawal syndrome, but no studies to date have systematically explored this phenomenon. The present study examined attentional impairment in 20 tranquilizer free alcohol withdrawal patients by using continuous performance tests assessing concentration in both an auditory and a visual mode. It was found that withdrawal patients generally evidenced poorer auditory than visual concentration. To investigate the relationship between the time-course of withdrawal and attentional impairment, the alcoholics were divided into an Early "Detox" and a Late "Detox" group, predicated on the reported amount of time since last alcohol consumption. Contrary to expectation, those alcoholics with a longer time-lapse since cessation exhibited poorer attentional performance than those with a shorter time-lapse. The possibility of an independent course for mental symptoms apart from physiological withdrawal signs was discussed. PMID- 6862779 TI - Uptake, autoradiography and release of taurine and homotaurine from retinal tissue. AB - Uptake of 3H-taurine into bovine retina was studied. Kinetic parameters of uptake were Km = 6.3 x 10(-5) mol/l with Vmax = 43 nmol/g wet tissue x min and Km = 5 x 10(-3) mol/l with Vmax = 702 nmol/g wet tissue x min. Unlabeled homotaurine, a close structural analogue of taurine, showed only a single sodium dependent low affinity uptake with mH = 1.5 x 10(-3) mol/l and Vmax = 1322 nmol/g wet tissue x min. Both taurine and homotaurine uptake were highly sensitive to temperature and inhibited equally by addition of taurine or homotaurine. The taurine content of incubated retinae was greatly altered depending on the osmolarity of the incubation medium. Autoradiography showed 3H-taurine mainly in Muller cells and certain photoreceptor cells of rat retinae, whereas 3H-homotaurine was found exclusively in Muller cells. Electrical stimulation as well as elevated external potassium concentration resulted in a substantial release of 3H-taurine and 3H homotaurine from preloaded retinae. However, unspecific release cannot be excluded. PMID- 6862780 TI - Cortical power spectral analysis of acute pathophysiological pain. AB - In the past decade, advances in quantitative EEG methods, such as the analysis of cortical power spectrum, have proven a useful tool for observing changes in brain activity as a function of physiological and behavioral states. The cortical power spectrum (CPS) is a computer-derived analysis of brain electrical activity using mathematical principles of Fast Fourier Transform function. The total energy output of specific cortical areas can be estimated over time, as a function of EEG spectral frequencies. This report describes the study of CPS in pathophysiological pain patients, using acute dental pain as a model. Seven "walk in" acute pain patients in an emergency dental clinic were recorded during 10 min of pain, before treatment. Approximately one week later, 10 min recordings during nonpain states were obtained as control. Subjective pain scales and other psychological measures were administered to all subjects before and after recording on each visit. Each 10 min stage of continuous CPS recording consisted of 10 spectra per stage, 6 epochs/spectrum, and 10.24 sec/epoch; each spectrum was stored, averaged, transformed, displayed, printed, and plotted by the Pain Microcomputer System. Results show significant cortical power reduction along all frequency bands (0.5-50 Hz) when pain-states are compared to nonpain states. The magnitude of reduction also appears to correspond to subjective pain report. Analysis for rank order may be inversely related to subjective painfulness, indicating that pain and alpha-desynchronization are closely associated. This study demonstrates that the brain activity of clinical pain patients can be measured. The feasibility of developing a pathophysiological objective pain measuring system is discussed. PMID- 6862781 TI - Elevation of visual threshold associated with eyeblink onset. PMID- 6862782 TI - Stress 201T1 scintigraphy: temporal redistribution studied by means of local-to maximum uptake ratio. PMID- 6862783 TI - Elemental contamination in Vacutainer tubes used for blood collection. PMID- 6862784 TI - Effect of conalbumin on phytomitogen stimulation and E-rosette formation of human peripheral lymphocytes in normal subjects. AB - An immunological in vitro study was carried out on conalbumin, an iron binding protein structurally similar to lactoferrin, which is a well-known bacterial inhibitor in human milk. Conalbumin itself has been proved to have bacteriostatic activity against a broad spectrum of bacteria responsible for gastrointestinal infections. The activity of conalbumin on the in vitro response to PHA, PWM and Con A and on the E-rosette formation ability of peripheral lymphocytes of 10 normal subjects was studied. The results showed that conalbumin did not affect the lymphocytes' E-rosette formation ability and did not induce blastic transformation of lymphocytes. However, conalbumin was able to produce a significant increase in the in vitro response of lymphocytes to PHA and PWM, suggesting an action on both T and B lymphocytes. PMID- 6862785 TI - The effects of D-penicillamine on non-immune responses to tissue injury. AB - D-penicillamine was found to have a pro-inflammatory effect when given to rats during the formation of carrageenan air pouch granulomas or simple air cavity linings. Unlike dexamethasone, D-penicillamine had no effect on the strength of the cavity lining in either system. D-penicillamine had no effect on the chemoattractant properties of the carrageenan-induced exudates or on the responsiveness of cells from such exudates to a chemoattractant. These results suggest that D-penicillamine has a short-term pro-inflammatory effect on non immune responses to tissue injury, but the mechanism remains unclear. PMID- 6862787 TI - Immunobiological aspects of the nude mouse model relative to human cancer chemosensitivity tests. AB - The nude mouse model (NMM) has been proposed for testing chemosensitivity of human cancer cells with encouraging results. However, nude mice cannot be considered as unreactive "test tube" recipients of allogeneic or xenogeneic tissues, since a variety of immunological functions are fully represented in these hosts. In general, graft resistance against tumour cells can be classified as: (a) elicitable responses (ER), thymus-dependent, evoked by tumour-associated antigens; (b) natural resistance (NR), T-independent, not requiring previous exposure to transplantation antigens. Graft resistance may therefore play a substantial role even in the absence of a functional T-cell system. This has been demonstrated in irradiated euthymic mice capable of rejecting Hh-incompatible lymphomas, and in nude mice, where NR-type responses are particularly efficient, either in vitro or in vivo. It is reasonable to assume that these responses could interfere with tumour responsiveness to the chemotherapeutic effects of drugs. In fact, marked synergistic effects have been observed in conventional hosts combining chemotherapy with limited ER, or with Hh-type NR present in lethally irradiated mice. Similar combined effects could occur in nude mice bearing NR susceptible human tumours in the course of chemosensitivity assays. These considerations have led to the search for privileged sites associated with low levels of NR; previous results show that these responses appear to be substantially absent in the brains of conventional mice and extremely low in the same organ of congenitally athymic hosts. It follows that the brain of the nude mouse appears to be a suitable site for human tumour cell growth, unaffected by or minimally subjected to NR. PMID- 6862786 TI - In vitro effects of conalbumin on iron transport by rat intestinal mucosa. AB - The possible effects of conalbumin (a glycoprotein closely resembling lactoferrin) on iron transport across the brush border of intestinal cells of the rat were evaluated in vitro. Iron influx was measured in proximal and distal tracts of small intestine from either normal or iron-deprived rats, both in the presence of 1 or 10 mg/ml conalbumin and in its absence. Conalbumin did not affect iron uptake at any concentration and in any intestinal segment, either in normal or in iron-deprived animals. It was concluded that the luminal presence of conalbumin, even at a relatively high concentration, does not interfere with iron intestinal transport. PMID- 6862788 TI - Influence of oxamethacin on oriented migration of rat polymorphonuclear leucocytes. PMID- 6862789 TI - The detection of fibrinogen (or FgDP)-protamine sulphate complex in vitro and in the circulating blood. AB - In order to clarify the pathophysiological significance of the fibrinogen (FgDP) protamine complex, the interaction between fibrinogen and protamine sulphate was studied in vitro and in vivo. Using the electrophoretic technique, an attempt was made to determine whether the complex could be detected in vitro and in the circulating blood. From the present studies, it has been clarified in in vitro experiments that the slower mobility of two peaks on immunoelectrophoresis represented a complex of protamine sulphate and fibrinogen (FgDP). Furthermore, the peak of slower mobility on crossed immunoelectrophoresis appeared in the circulating blood of a rabbit receiving administration of excess protamine sulphate. That is, in vivo experiments showed that a complex of protamine sulphate and fibrinogen (FgDP) could be detected in the circulating blood. PMID- 6862790 TI - Cellular ageing. AB - Ageing is characterized by several modifications at the molecular and cellular levels. Although none of the functional or structural changes can be regarded as peculiar to old age, some relevant features can be found in the cells. Cell organization becomes structurally uneven and functionally disharmonious. The onset of ageing, however, cannot be accounted for simply in terms of structural and physiological deterioration. Attempts have therefore been made to work out a comprehensive approach which might be able to provide a sensible solution to the problem. PMID- 6862791 TI - Some cytological and initial biochemical observations on photoreceptors in retinas of rds mice. AB - As a control for biochemical studies in progress, an ultrastructural study has been carried out on the deteriorating, 21-day photoreceptors of the 020/Cpb strain of mice, homozygous for retinal degeneration, slow (rds). At 21 postnatal days, outer segments were essentially lacking, but cilia erupting from the inner segments were common. A low percentage of cilia bore small cytoplasmic masses containing a few layered membranes, and rare inner segments possessed spherical aggregations of multilayered membranes. Pigment epithelial cells also possessed membranous aggregations in presumed phagosomes. While other parts of photoreceptors possessed the usual organelles of normal rods, inner segments were reduced in volume, and the layer of photoreceptor synaptic terminals was thinner. Mutant 21-day retinas possessed about two-thirds of the protein of normal 21-day retinas but 50% more protein than "rodless" (rd/rd) 21-day retinas. Surprisingly, while dark-adapted rds retinas possessed markedly lower levels of cyclic GMP as compared to controls, light-adaptation significantly reduced cyclic GMP and cyclic AMP levels, and biochemical data point to persistent light-modulated cyclic nucleotide levels in the photoreceptors. PMID- 6862792 TI - Reduced and oxidized ascorbates in guinea pig retina under normal and light exposed conditions. AB - Both reduced and oxidized ascorbates were measured in aqueous, neural retina, and pigment epithelium-choroid complex (PE-C) of pigmented guinea pigs. Normal values for total ascorbate of 16 mg/dl in aqueous, 22 mg/dl in neural retina, and 7 mg/dl in PE-C were found. After mild photic damage caused by varying lengths of exposure of 10,000 to 20,000 lux of fluorescent lighting, reduced ascorbate concentrations generally decreased in the neural retina, while oxidized ascorbate generally increased in PE-C. In both normal and light-exposed retinas, reduced ascorbate was predominant in the neural retina, and oxidized ascorbate was predominant in the PE-C. Histochemical localization of reduced ascorbate occurred in the Muller cell fibers and at the apices of the retinal pigment epithelium. PMID- 6862793 TI - Intraocular injections of nipecotic acid produce a preferential block of neuronal 3H-GABA accumulation in adult rabbit retina. AB - A procedure by which the activity of the retinal GABA uptake system can be manipulated in vivo has been developed. Intraocular injections of nipecotic acid, a proported GABA uptake blocker, were administered to adult rabbits every 48 hours for a two-week period. No behavioral or systemic changes were observed. Injections were well-tolerated with less than 10% loss of the tissue caused by physical damage or injection. Biochemical analyses demonstrated a dose-dependent inhibition of 14C-GABA uptake into retinal tissue. No effect on uptake was observed for saline-treated tissue. Autoradiographic analyses showed that in vivo treatment with nipecotic acid preferentially blocked accumulation of 3H-GABA into the amacrine cell bodies and processes in the inner plexiform layer. This treatment may be especially useful in assessing the functional significance of GABA transport in vivo. PMID- 6862794 TI - Biosynthesis of proteoglycans present in primate Bruch's membrane. AB - The proteoglycan components of Bruch's membrane have not been well characterized to date. In this study, the glycosaminoglycans present in Bruch's membrane were identified and found to be heparan sulfate with small amounts of chondroitin and/or dermatan sulfate and hyaluronic acid. The biosynthesis of glycosaminoglycans and their incorporation into proteoglycans was investigated using an eye organ culture in which the cornea, iris, and sclera had been removed. The newly synthesized proteoglycan(s) extracted with 4 M guanidine hydrochloride bound to a DEAE-cellulose column and eluted with approximately 0.44 M NaCl. The proteoglycan(s) had a molecular weight ranging from 100,000 to 150,000 daltons. After papain treatment, the glycosaminoglycan side chains had a molecular weight of approximately 44,000 daltons. The newly synthesized proteoglycan(s) contained 65% chondroitin and/or dermatan sulfate and 35% heparan sulfate. This organ culture system should be useful in studying disease states of Bruch's membrane. PMID- 6862796 TI - Retinal detachment in the cat: the outer nuclear and outer plexiform layers. AB - The retinae of cats were surgically detached for 1/2 hr to 14 months, and the outer nuclear (ONL) and outer plexiform layers (OPL) were studied by light and electron microscopy. The longer the duration or the greater the height of detachment the more likely was the occurrence of cell death. Histologic signs of degeneration were present 1 hr after detachment. The number of photoreceptor nuclei in the ONL decreased significantly by 1 month. Loss of cells in the ONL occurred by necrosis and by the migration of photoreceptor cell bodies into the subretinal space. The OPL degenerated by the necrosis of cell processes and synaptic terminals and by the retraction of the synaptic terminals. By 2 weeks most synaptic terminals were necrotic or in the process of retracting. Photoreceptor synaptic contact with second order neurons was diminished by 30 days and was essentially absent by 50 days. Muller cells proliferated and hypertrophied; their nuclei and cell processes filled the intraretinal spaces left by the degenerating photoreceptors. In addition, Muller cells protruded into the subretinal space and formed multiple layers of cell bodies and processes between the retina and retinal pigment epithelium. By 14 months these subretinal Muller cell processes covered the entire detached retina, and appeared morphologically like an astroglial scar. Similar changes in human retinal detachments may significantly influence the degree of visual recovery after retinal reattachment, especially in retinae detached for more than a few days. PMID- 6862795 TI - Retinal detachment in the cat: the pigment epithelial-photoreceptor interface. AB - Twenty-six cat retinae were surgically detached by injecting fluid into the subretinal space (SRS). The retinae were then studied by light and electron microscopy at detachment intervals ranging from 1/2 hr to 14 months. Degenerative and proliferative changes occur at the retinal pigment epithelial (RPE) photoreceptor interface very soon after detachment, and the severity of these changes depends upon both the duration and height of the detachment. The specialized apical RPE processes that ensheath the outer segments are replaced by a uniform fringe of short, undifferentiated processes. The apical RPE surface becomes mounded, and this mounding becomes more pronounced at longer detachment durations. Labeling experiments with 3H-thymidine showed that some cat RPE cells enter a phase of stimulated DNA synthesis 12-24 hrs after detachment; RPE mitotic figures are first apparent 48 hrs after detachment. In the cat, discrete regions of proliferated RPE cells usually appear in one of several configurations. A number of different cell types, including polymorphonuclear neutrophils, monocytes at various maturational stages, photoreceptor cells, Muller cells, and RPE cells, appear in the expanded SRS of detached retinae. Rod and cone outer segments degenerate rapidly and become membrane bound sacs by 3 days postdetachment; the assembly of new outer segment membrane apparently does not stop completely even at moderately long detachment intervals (ie, 2 months). Degenerative changes in the inner segments do not take place with the same rapidity as those in the outer segments. The changes that occur at the RPE photoreceptor interface are rapid, progressive, and sometimes irreversible events that have significant implications for photoreceptor recovery following retinal reattachment surgery. PMID- 6862797 TI - An in vitro investigation of x-ray sensitivity in fibroblasts from patients with retinoblastoma. AB - In vitro x-ray survival experiments were performed on fibroblast strains derived from nine patients with sporadic unilateral retinoblastoma, 26 patients with hereditary retinoblastoma, and six normal controls. The x-ray sensitivity of the strains derived from the sporadic retinoblastoma patients and normal controls did not significantly differ from one another. The fibroblast strains derived from patients with hereditary retinoblastoma were significantly more radiosensitive to killing by x-rays as measured by clonogenic survival than either the sporadic strains or the strains derived from normal controls. We hypothesize that the increased in vitro radiosensitivity observed in some hereditary retinoblastoma strains is a reflection of an as yet uncharacterized defect in DNA or DNA replication postirradiation. PMID- 6862799 TI - Hyperglycemia impairs retinal oxygen autoregulation in normal and diabetic dogs. AB - Preretinal oxygen tensions were measured continuously using microelectrodes in four normal dogs and four dogs made diabetic with alloxan. The latter were kept under poor control for 8 months. Glucose administered intravenously in 30 to 90 sec to all the dogs when they were normoglycemic caused an immediate increase in preretinal oxygen tension lasting approximately 10 min. When the dogs were given 100% oxygen to breathe, their preretinal oxygen tensions increased. This increase in preretinal oxygen tension was 36.6 +/- 8.5 mmHg (+/-SE) when the animals were normoglycemic and 63.5 +/- 9.2 mmHg when the animals were made hyperglycemic. This suggests that hyperglycemia impairs oxygen autoregulation. Moreover, the diabetic dogs appeared to exhibit a larger preretinal oxygen tension increase than normal dogs when both were given 100% oxygen to breathe. The small number of animals studied, however, makes a comparison between the two groups difficult. These data lead one to speculate that in diabetes there may be an impairment of the normal retinal vascular homeostasis. This could play a role in both the development and in the severity of diabetic retinopathy. PMID- 6862798 TI - Ultrastructure of blood-retinal barrier permeability in rat phototoxic retinopathy. AB - It has been shown previously that the blood-retinal barrier (BRB) of rats with phototoxic retinopathy is permeable to sodium fluorescein and to fluoresceinated dextrans as large as 32A ESR (Einstein-Stokes radius). The leakage presumably occurs from retinal capillaries that have invaded the retinal pigment epithelium (RPE) and become fenestrated. In this report, the ultrastructural tracers horseradish peroxidase and catalase were used to further localize the leakage site, and to evaluate the size limit of molecules penetrating the phototoxic BRB. Horseradish peroxidase (HRP: 30A ESR) freely penetrates the BRB of phototoxic rats, since it is present in the retinal extracellular space 10 min after intravenous injection. HRP penetrates the fenestrae of capillaries which invade the RPE from the retina. It then diffuses along the pericapillary space of the intraepithelial capillaries, which is confluent with that of their parent retinal capillaries, and into the retinal extracellular space. HRP thus circumvents the tight junctions between RPE cells and between capillary endothelial cells, which appear intact in thin sections. Catalase (52A ESR) does not freely penetrate the BRB of phototoxic rats. As long as 40 min after intravenous injection, catalase is still confined to the lumen of fenestrated capillaries in the RPE, retinal capillaries, and the choriocapillaris. Although present in intraendothelial vesicles, no evidence of deposition in the pericapillary space is observed. It is concluded fenestrated capillaries in the RPE are a major site where blood-borne tracers penetrate the BRB in phototoxic retinopathy. PMID- 6862801 TI - Sonography of the scrotum. PMID- 6862800 TI - Multiple cavitary alveolar opacities. PMID- 6862803 TI - Variations in the blood supply of the left ventricular apex. AB - Contraction or perfusion abnormalities of the left ventricular apex are generally assumed to result from left anterior descending (LAD) artery disease since this vessel is the usual source of blood supply to this area of myocardium. Such an assumption may be erroneous since the left ventricular apex may be supplied by the LAD alone, both the LAD and posterior descending (PD) branch of the right coronary artery, or the PD alone. Blood supply of the left ventricular apex was prospectively studied angiographically in 431 adult patients. In 77.7%, the apex was totally supplied by the LAD. In 12.1%, the apex received dual blood supply from both the LAD and PD. In 10.2%, the LAD terminated well before the apex, which was totally supplied by the PD. With the latter two anatomic variations, the LAD tended to be shorter and smaller in caliber than usual, while the PD was longer and larger than usual. A short, narrow LAD therefore does not necessarily indicate coronary disease if the left ventricular apex is partially or completely supplied by the PD. Dysfunction or perfusion abnormalities of the apex do not necessarily indicate LAD disease. PMID- 6862802 TI - Automatic analysis of left ventricular ejection fraction using stroke volume images. AB - The purpose of this study was to analyze, validate, and report on an automatic computer algorithm for analyzing left ventricular ejection fraction and to indicate future applications of the technique to other chambers and more advanced measurements. Thirty-eight patients were studied in the cardiac catheterization laboratory by equilibrium radionuclide ventriculography and concurrent contrast ventriculography. The temporal and spatial behavior of each picture element in a filtered stroke volume image series was monitored throughout the cardiac cycle. Pixels that met specific phase, amplitude, and derivative criteria were assigned to the appropriate chamber. Volume curves were generated from regions of interest for each chamber to enable calculation of the left ventricular ejection fraction. Left ventricular ejection fractions showed a good correlation (r = 0.89) between the two techniques. Ejection fractions ranged between 0.12 and 0.88, showing a wide range of application. It is concluded that automatic analysis of left ventricular ejection fraction is possible using the present algorithm and will be useful in improving the reproducibility and providing more accurate information during exercise protocols, pharmaceutical interventions, and routine clinical studies. PMID- 6862804 TI - Computed tomography of the normal pericardium. AB - Computed tomographic (CT) scans of 100 patients were reviewed to establish the normal thickness of the pericardium. The pericardium was identified in 95 of 100 patients. The mean width of the thinnest portion of the pericardium was 2.0 +/- 0.6 mm (1 SD) in males (N = 46) and 2.3 +/- 0.5 mm (1 SD) in females (N = 49). The mean width of the combined series was 2.2 +/- 0.6 mm (N = 95). In none of the 95 hearts reviewed was the width of the thinnest portion of the pericardium greater than 4 mm. Focal changes in width of the pericardium were a normal finding in patients without documented pericardial disease. PMID- 6862806 TI - Assessment of left ventricular muscle volume by digital angiocardiography. AB - By means of digital image processing, the entire myocardial wall of the left ventricle could be visualized by biplanar angiocardiography in animal experiments using 14 pigs (weight, 16-25 kg). The resulting images of the myocardial wall allowed dimensional measurement by videometry. The muscle volume was computed according to Simpson's rule for end diastole and end systole and compared with postmortem measurements. Replication of the procedure resulted in a 95% confidence interval of +/- 11% (+/- 5.6 ml) at maximum. Comparison with postmortem data showed highly significant correlations of r = 0.894 (end diastole) and r = 0.938 (end systole). This study points out that digital image processing allows a reliable assessment of myocardial volume from routine left ventricular angiocardiography. Besides early clinical applications, the method has been successfully used to visualize nonperfused segments of the myocardial wall in artificial infarction. PMID- 6862805 TI - Changes in ventricular fibrillation threshold induced by contrast agents during acute coronary artery occlusion. AB - In the first few hours after acute coronary thrombosis, clinical coronary angiography is associated with enhanced risk of ventricular fibrillation. In these experiments, the ventricular fibrillation threshold (VFT) was measured in anesthetized dogs before and during acute occlusion of the left circumflex coronary artery. Ischemia alone reduced the fibrillation threshold. Angiography with 1- or 2-ml does of Renografin 76 lowered VFT significantly more than did equal doses of iohexol or iopamidol. It is concluded that nonionic agents may be safer for coronary angiography in the presence of acute coronary insufficiency. PMID- 6862807 TI - Radiology of the diaphragm as two muscles. AB - In order to investigate the postulate that the diaphragm consists of two muscles, cineradiographic studies and plain roentgenograms were taken of the diaphragmatic movement in eight dogs. A characteristic pattern of contraction was seen following direct electric stimulation of each of the sections of the diaphragm, namely the costal muscle, mainly anterior to the central tendon, and the smaller, posterior crural muscle. Stimulation of the roots of the phrenic nerves in the neck showed that, with C5 root stimulation, contraction of the costal area occurred, but that with C6 and C7 root stimulation, contraction of the crural area occurred, although the movement was larger with C6 than with C7 root stimulation. Downward displacement of the entire diaphragm followed stimulation of the intrathoracic phrenic nerves. These results support the concept that the canine diaphragm actually consists of two muscles with a different segmental innervation of each part. PMID- 6862808 TI - Evaluation of embolization distal to arterial occlusion by transcatheter electrocoagulation (TCEC) and Gianturco coils. AB - A technique was developed to evaluate the degree of embolization distal to arterial occlusion by transcatheter electrocoagulation (TCEC) and Gianturco coils. The kidneys of mongrel dogs were used to collect emboli distal to conventional TCEC or Gianturco coil occlusion of the renal arteries. TCEC controls (TCEC setup without current), normal kidneys, kidneys embolized with autologous clot, and kidneys whose renal arteries were surgically ligated were evaluated for comparison. The renal vasculature was flushed and then fixed by glutaraldehyde infusion. The kidneys were filled with a barium gelatin mixture and examined both radiographically and pathologically. The four normal kidneys and the four ligated kidneys gave a characteristic complete filling of the vascular web, while filling defects were evident in the following conditions: 3/12 TCEC controls; 26/34 with TCEC occlusion; 6/10 with Gianturco coils; and 11/11 with autologous clot. An excellent correlation existed between radiographic intraluminal filling defects and grossly and microscopically identified emboli. PMID- 6862809 TI - Experimental hepatic artery embolization with Gelfoam powder. Microfil perfusion study of the rabbit liver. AB - After hepatic artery embolization with Gelfoam powder in five rabbits, two colors of Microfil (silicone rubber solution) were perfused into the aorta and the portal vein to study hepatic microcirculation under a dissection microscope. In three of the animals, many intrahepatic arterial branches and portions of the hepatic sinusoids were perfused with the arterial Microfil (orange color), whereas in the other two animals no orange Microfil was found in the liver. In the three animals, occlusions of the hepatic artery were random in distribution and often segmental, and arteries as small as 50 microns in diameter were involved. In the latter group, levels of arterial occlusion could not be evaluated. Microcollaterals developed through the capsular artery, peribiliary arterial plexus, and vasa vasora of the portal vein. PMID- 6862810 TI - The effect of verification on the assessment of imaging techniques. AB - In order to measure the accuracy of a diagnostic imaging technique, the correctness of each observer decision must be determined. This is often difficult in clinical cases, and various strategies are frequently used to approximate the truth. Experiments using chest radiographs as an example are reported to show the pitfalls in those strategies. To assess relative accuracies of three different radiographic techniques, chest radiographs were taken of 66 patients with each of the three techniques, and the films were evaluated by six radiologists. Their findings were then scored by comparing them with the correct decision defined by each of the following methods: majority vote, consensus opinion, expert judgment, feedback review, and clinical/pathologic proof. The findings showed that any one of the techniques could be shown to be better than the other, depending on how the truth was defined. It is concluded, therefore, that strategies that define the presence or absence of disease only by the diagnostic tests under evaluation are inadequate. The truth must be determined by clinical or pathologic proof and follow-up data. PMID- 6862811 TI - Human endothelial cell culture as an evaluation system for the toxicity of intravascular contrast media. AB - Endothelial cells in primary cultures from human umbilical cord veins were incubated with various radiographic contrast media in increasing concentrations up to approximately 60 mgI/ml for 24 hours in order to study their toxicity. Cell death was recorded with the chromium-51 (51Cr)-release method and controlled by dye exclusion tests, Coulter counting, and protein determination. The hyperosmolar, ionic contrast medium, meglumine metrizoate, was far more toxic to the endothelium than the nonionic media, metrizamide and iohexol, which are far less hyperosmolar. The 51Cr-release test on endothelial cultures provides a simple and useful technique in the evaluation of various intravascular contrast media and their components. PMID- 6862812 TI - Urographic excretion studies with nonionic contrast agents. Iopamidol vs. iothalamate. PMID- 6862813 TI - An arenavirus isolated from wild-caught rodents (Pramys species) in the Central African Republic. AB - We isolated nine arenavirus strains from blood and/or tissues of Praomys sp. rodents wild-caught in derived savannah and forest gallery areas of the Central African Republic (CAR). Convalescent serum from either humans or animals infected by Lassa, Mozambique, or lymphocytic choriomeningitis virus cross-reacted with the strains from the CAR. However, monoclonal antibodies to these three viruses gave a profile against the CAR strains suggesting major antigenic differences between each of them and the CAR virus. These data along with the fact that other African arenaviruses have been recovered from Mastomys natalensis and not Praomys suggest that this virus is significantly different from the others. PMID- 6862815 TI - Mechanisms underlying systemic invasion of pea plants by pea enation mosaic virus. AB - Leaves of Pisum sativum L.cv. 'Perfected Wales' were inoculated with pea enation mosaic virus, at the 3rd and 4th nodes as early as size permitted. Systemic virus spread was then measured over a period of approximately 9 days by assaying the infectivity of 1-cm stem pieces above the 4th and below the 3rd node. The presence of virus antigen and double-stranded (ds) RNA in these stem pieces was measured by radioimmunoassay over the same period. Relative infectivity and amounts of dsRNA in infected tissue were lowest approximately 3 days after inoculation and sharply increased thereafter. A transient plasmodesmatal abnormality was observed 4-6 days after inoculation. The transient nature of the abnormality, which was preceded (24 h) by low infectivity and dsRNA concentrations, may indicate a plant defense reaction that is subsequently overcome. The rise in dsRNA concentration, starting the 4th day after inoculation, coincided with the increase of vesicular material (cytopathological structures) in the phloem of infected plants. Vesicular material was found in sieve elements that were mature at the time of inoculation. Their presence in this tissue can only be explained by transport of the vesicles from infected sites. PMID- 6862814 TI - Thymine salvage, mitochondria, and the evolution of the herpesviruses. AB - The salvage of thymine is an apparently ubiquitous feature of free-living lifeforms as well as of mitochondria, chloroplasts and most of the large DNA viruses. Assumptions and data are described which explain the evolution of thymine salvage in prokaryotes, animal cells, and large DNA viruses, in terms of deoxythymidine kinase and its relationship to mitochondria. Specifically, it is suggested that regulation of deoxythymidine kinase (by end-product inhibition) has evolved as a means of assuring a constant supply of thymine compounds for the mitochondria and that the degree to which this regulation is present in the deoxythymidine kinases of the various herpesviruses correlates with the degree of dependence of their replicative cycle on the continued health of the mitochondria of their host cells. PMID- 6862817 TI - Traffic accidents: can eye injuries be prevented? PMID- 6862818 TI - Sports injuries and the Casualty Department. PMID- 6862816 TI - Eye injuries in road traffic accidents. PMID- 6862822 TI - Prescribing psychotropics: Part II. Adequacy of source material. PMID- 6862824 TI - Psychopathology in Irish adolescents: a preliminary report. PMID- 6862819 TI - Fractured sternum associated with the use of seat belts. PMID- 6862825 TI - Organophosphorous poisoning. PMID- 6862820 TI - A comparison of the Irish and German systems of compensation. PMID- 6862821 TI - Prescribing psychotropics: Part I. An analysis of technical information. PMID- 6862823 TI - Personality and the Irritable Bowel Syndrome. PMID- 6862827 TI - Pre-hospital coronary care. PMID- 6862828 TI - Report on the Dublin cardiac ambulance service. PMID- 6862826 TI - Cutaneous vasculitis complicating cranial arteritis. PMID- 6862832 TI - Tricuspid endocarditis: an emerging clinical problem? PMID- 6862829 TI - The diagnosis and treatment of constrictive pericarditis. PMID- 6862831 TI - Production of paradoxical chest pains by nifedipine. PMID- 6862830 TI - Diltiazem: a new calcium antagonist for the treatment of chronic stable angina. PMID- 6862833 TI - Chest percussion: help or hindrance to postural drainage? PMID- 6862834 TI - Hyperbaric oxygen therapy. PMID- 6862835 TI - Diabetes mellitus -- diagnosis and classification. PMID- 6862836 TI - Prescribing for the elderly. PMID- 6862837 TI - A case of cheiralgia paresthetica secondary to diabetes mellitus. AB - The anatomy and etiology of cheiralgia paresthetica are discussed in the light of a case of this syndrome in a diabetic. The variability of the area affected can be ascribed to anatomical variants in the innervation of the hand ("ulnar intervention" in the radical sensory distribution). In patients in whom mechanical causes have been excluded diabetes mellitus should be considered as a possible cause. PMID- 6862838 TI - Progressive bulbar paralysis in childhood: a case report. AB - The case of a progressive bulbar paresis in a nine and a half year old child is reported. The first symptoms were present at birth; however, the subsequent evolution was very low. Lesion of the motor nuclei of the V, VII, IX, XII, cranial nerves was evident on electromyographic investigation. Damage to the acoustic brain stem pathway was documented by the brain stem evoked potentials although audiometry was normal. No other neuronal systems or districts appeared to be damaged. The case suggests Fazio-Londe disease, although the involvement (albeit partial) of the auditory pathways recalls Van Laere syndrome. This supports the view that motor neuron disease in infancy is not an autonomous entity but a variant in a wide spectrum of progressive neuronal diseases. PMID- 6862839 TI - Temporal bone glioblastoma presenting as Raeder paratrigeminal syndrome. AB - In a 46 year old patient periorbital pain, miosis and ptosis, i.e. Raeder paratrigeminal neuralgia, were caused by a temporal lobe glioblastoma. This is the fifth case in the literature in which this syndrome was due to a neoplasm. PMID- 6862841 TI - CT in hepatic encephalopathy. PMID- 6862842 TI - Bromocriptine--lisuride cross tolerance. PMID- 6862840 TI - A case of repeated reversible cerebrovascular attacks caused by two hemorrhagic lesions. AB - A case of repeated reversible cerebrovascular deficit proved on computerized tomography to be hemorrhagic in origin. It would seem advisable to await the outcome of CT before classifying a case of cerebrovascular disease even though the clinical features point to ischemia as the cause. PMID- 6862843 TI - Idiopathic inflammatory polyradiculoneuropathy: evaluation of clinical and laboratory data and therapeutic considerations. AB - The clinical, immunological and neurophysiological data on 54 patients with idiopathic inflammatory polyradiculoneuropathy (IIP) are reviewed in order to reach a correct diagnostic and therapeutic approach. 49 of these patients presented acute and 5 recurrent IIP. Of the acute cases 10 patients had a severe course with paralysis of all limbs and respiratory insufficiency, and 3 died. An increase in CSF total proteins and impairment of nerve motor conduction velocities proved to be valuable tests for the diagnosis of IIP; these tests usually become more significant after 2 or 3 weeks of illness. Steroid treatment did not prove to be effective, while two patients with acute and progressive IIP, subjected to plasmapheresis, showed rapid and steady improvement. In these two patients the plasmapheresis was associated with azathioprine. PMID- 6862844 TI - Increased activation effects of succinylcholine in neurological patients. AB - Succinylcholine, a depolarizing muscle relaxant with both activating and desensitizing effects, is used to facilitate endotracheal intubation. The activating effects were found to be above-normal on induction of anesthesia in 7 neurological patients: generalized muscle spasm in 1 myotonic patient, contractures or prolonged contractions in "anatomically" denervated muscles (1 patient), in "functionally" denervated muscles (1 patient) and in "centrally" denervated muscles (4 patients). One of these four presented hyperkalemia and cardiocirculatory collapse. It is important to differentiate these anomalous responses to succinylcholine from those occurring as early signs of rhabdomyolysis or malignant hyperthermia. PMID- 6862845 TI - Value of spirometric investigations in amyotrophic lateral sclerosis. AB - The respiratory function has been studied in 37 patients with ALS. 15 of them (5 till death) were followed with serial spirometric tests. The data, as a whole, show a diminution of vital capacity, a diminution of forced expiratory volume per second, an increase of the residual volume and of the Motley index; blood gas analysis showed no significant alterations apart from slight hypoxemia. Patients with bulbar ALS presented marked abnormalities of the spirometric and blood gas analysis parameters. In the cases followed with serial spirometric tests VC, Motley index and FEV1 gradually deteriorated as the disease advanced. In the deceased patients a sudden and serious aggravation of these values occurred. This was especially true for FEV1 and Motley index during the 3 months preceding death. The variations in residual volume were less indicative. Finally, the influence of smoking and of pulmonary and bronchial pathology, present or past, was not significant. PMID- 6862846 TI - The value of computerized tomography in the diagnosis of cerebellar atrophy. AB - Computerized tomography was performed in 31 patients presenting clinical signs of cerebellar degeneration. CT abnormalities consistent with cerebellar atrophy were found in all cases but one. Specific patterns of abnormality were found in olivo ponto-cerebellar degeneration and in alcoholic atrophy. The CT findings in spino cerebellar degeneration were varied, ranging from severe diffuse cerebellar atrophy to normality, possibly according to age and duration of symptoms. PMID- 6862848 TI - Unilateral asterixis due to thalamic tumor. Case report. PMID- 6862847 TI - CT in syringomyelia: three different aspects. AB - Three different CT aspects of patients with myelographic and clinical syringomyelia patterns are presented. In the first the CT pattern was atypical. The second case is a typical example of opacification of the cavity after contrast enhancement and the third shows re-formation of the cavity 7 years after surgical damage. PMID- 6862849 TI - Diffuse cerebral cysticercosis: clinical and CT findings in a case. AB - A case of cerebral cysticercosis with both generalized and partial (multifocal) seizures is described. The diagnosis was not possible with traditional (pre-CT) procedures, but CT disclosed a very characteristic pattern. This disease, rare in our country, is very common elsewhere, particularly in South America, where epilepsy of recent onset in an adult or symptoms increased intracranial pressure always suggest this possible etiology. PMID- 6862850 TI - Fourth International Symposium on Long-Term Clinical Trials. Beersheba, Israel, 4 6 January 1982. PMID- 6862851 TI - Clinical trials in Israel. Criteria for approval. AB - Approval by the Ministry of Health is required prior to the use in man of any chemical compound, including recognized drugs that have not been registered for marketing in Israel. As a rule, drugs are permitted for use in experimental treatment of human beings only after they have been thoroughly tested in animals and when a justified rationale has been provided. General outlines regarding required animal tests are available. Indications other than those for which a drug has been registered or dosages several times exceeding those recommended are dealth with as new compounds. Only physicians licensed in Israel may apply for permission to perform clinical trials. The responsibility for conducting a trial lies with the experimenting physician and the institution under whose auspices the study is carried out. Further principles concerning clinical trials in Israel include such issues as: 1) What type of basic information (rationale, safety, quality, etc.) must be provided before approval is granted? 2) Which population groups should in principle be excluded from human experimentation? 3) Should clinical trials be restricted to those for whom therapy may be directly beneficial? A number of clinical trials considered in the past by the Ministry's Committee illustrate the Israeli approach to clinical trials. PMID- 6862852 TI - Legal aspects of clinical trials in Israel. AB - Clinical trials were mainly the concern of medical ethics until the first code on this subject was laid down in a judgment given by a military tribunal in Nuremberg in 1947. In 1964 the World Medical Association adopted the Declaration of Helsinki, which was revised in 1975, regarding clinical trials and research. The Declaration of Helsinki and the developments in the pharmacological and pharmaceutical sciences led to legislation regarding clinical trials and human experimentation. In Israel it is forbidden to use any drug that is not registered. In order to register a drug, evidence of quality, safety and efficacy is necessary, and the means by which these factors are proved is the clinical trial, which demands appropriate legislation. Developments in various medical fields, as well as new treatment techniques, brought about the need for more comprehensive legislation on experimentation on human beings and embryos. In Israel, this field is covered by two enactments, the first on drugs and the second on any other experimentation on human beings. However, these enactments are frame laws, which lay down the rule that no clinical trial may be carried out without the prior approval of the Ministry of Health. They also state the minimum conditions to be met, and provide the Ministry with the authority to add any conditions at any time, as well as the right to stop the trial. The Declaration of Helsinki serves as the minimal legal basis for clinical trials. Some legal problems relating to the clinical trial remain unsolved and are left to the discretion of the Ministry of Health. The author makes some observations and suggestions with regard to matters of consent, incompetents as subjects, the right of withdrawal, and the power of the Ministry. PMID- 6862853 TI - Infective endocarditis in Jerusalem. A comparative analysis of native and prosthetic valve endocarditis. AB - Thirty patients with prosthetic valve endocarditis (PVE) and 62 patients with native valve endocarditis (NVE) observed during a concurrent period of time (1970 80) were analyzed. Patients with PVE were also compared with 697 patients who underwent cardiac valve replacement in the same period, in an attempt to uncover risk factors for PVE. In the operated patients the overall incidence of endocarditis was 4.3%. There were several significant differences between the NVE and PVE groups. Atrial fibrillation was more prevalent in the PVE group (33.4 vs. 11.5%, P less than 0.05), while infection with gram-positive organisms was more prevalent in the NVE patients (79 vs. 47%, P less than 0.01). The outcome of combined medical and surgical treatment showed a much higher mortality rate (50 vs. 6.4%, P less than 0.01) in the PVE group. Staphylococcal endocarditis resulted in 16% mortality in NVE vs. 100% in the PVE group (P less than 0.01). Careful surveillance may hopefully lead to early detection, treatment and better outcome of PVE. PMID- 6862854 TI - Rectal temperature in the diagnosis of acute lower abdominal pain. AB - The accurate diagnosis of acute lower abdominal pain continues to be a problem. In Israel, a diagnostic sign often sought as indicating pelvic peritonitis is a rectal temperature of greater than 1.0 C higher than the simultaneous oral temperature. We established that in each of the 20 emergency rooms surveyed both oral and rectal temperatures are measured as part of the admission procedure for patients with acute lower abdominal pain. The charts of three groups of 100 patients with acute lower abdominal pain were studied retrospectively. A rectal temperature of greater than 1.0 C higher than the oral was found in about 10% of each group. Both oral and rectal temperatures were raised in 56, 69 and 37% of each group, respectively. The rectal temperature alone was elevated in 8.5% of patients with appendicitis or pelvic inflammatory disease (PID), as well as in 6% of patients with undiagnosed abdominal pain. Oral temperatures alone were elevated in 4.5% of patients with acute appendicitis or PID and also in 13% of patients with undiagnosed abdominal pain. These differences were not significant. We conclude that the common Israeli practice of measuring both rectal and oral temperatures in patients with acute lower abdominal pain gives no more information than the measurement of either one. PMID- 6862855 TI - Human epithelial cell line established from a child with juvenile laryngeal papillomatosis. AB - Papillae were removed from a 2-yr-old boy with juvenile squamous cell papillomatosis and the tissue was grown in vitro. The method leading to the establishment of a continuous laryngeal papilloma cell line is described. This epithelial cell line was benign, as judged by cell morphology and cellular inability to form colonies in soft agar or to produce growing nodules in nude mice. Papilloma virus particles were not seen through the electron microscope. In the early stages of culture, the cells contained antigen that stained specifically with autologous serum. PMID- 6862857 TI - Survey of pneumococcal types in Israel, 1978-81. AB - The most common capsular types of Streptococcus pneumoniae that prevailed among 436 cultures isolated in Israel (1978 through 1981) were: 1, 14, 6B, 23F, 19A and 5. Among the 301 isolates from significant sources, 66.1% belonged to 14 capsular types that are included in available pneumococcal vaccines. Among those that were not included in these vaccines, the most frequent types were: 5, 19A and 6B. The addition of these three capsular polysaccharide types to the vaccine used in Israel would result in a vaccine coverage of approximately 85%. PMID- 6862858 TI - Computed tomography in the diagnosis of adrenal pathology. AB - Computed tomographic diagnosis of adrenal pathology, based on experience with 13 cases, is presented. These include five pheochromocytomas, two functioning cortical adenomas and one case each of nonfunctioning adenoma, adrenal cyst with adenoma, carcinoma, metastasis, and bilateral hyperplasia. One additional case of a small adrenal tumor of undetermined nature was probably a small nonfunctioning adenoma. The smallest tumor detected was 25 mm in diam and the largest was 150 mm. Other imaging modalities employed were mainly conventional urography with tomography and ultrasonography. By these means only the larger adrenal tumors were detected. The relative merits and drawbacks of other imaging procedures are discussed and compared to computed tomography. Computed tomography should be the initial imaging procedure of choice when adrenal pathology is suspected. PMID- 6862856 TI - Histopathological features of the skin in hypopituitarism and Laron-type dwarfism. AB - Skin biopsies from children and adolescents with various syndromes of somatomedin deficiency revealed changes in structure and in distribution of the dermal elastin fibers as compared with a group of seven healthy control subjects. In 18 patients with isolated growth hormone deficiency (IGHD) and in 11 with multiple pituitary hormone deficiencies (MPHD), the number of elastin fibers was reduced; the individual fibers were shorter and slimmer than usual, and frequently arranged in groups dispersed in various directions. Skin biopsies from six patients with Laron-type dwarfism (LTD) revealed mostly thickened elastin fibers, frequently arranged in irregular bundles, but the number of elastin fibers was normal in prepubertal patients and reduced only in postpubertal patients. The reduction of elastin fibers in these patients was less prominent than in IGHD. The finding of more numerous elastin fibers in LTD than in IGHD is suggestive of a direct nonsomatomedin-mediated effect of human growth hormone on skin elastogenesis. PMID- 6862859 TI - Experience with surgical management of ectopic ureterocele. AB - We evaluated 16 children with ectopic ureterocele diagnosed and treated between 1970 and 1980. The clinical presentation, radiological findings and operative management are presented and discussed. Since ectopic ureterocele has a broad spectrum of presentation and pathophysiology, treatment must be individualized. Upper pole heminephrectomy with partial ureterectomy, thus avoiding ligation of the ureteral stump, is the preferred surgical treatment. Transurethral uncapping of the ureterocele is indicated only for extremely ill infants with severe septicemia that does not respond to conservative treatment. Unsuspected ectopic ureterocele discovered incidentally during surgery is best managed either by upper pole nephro-ureterectomy or reimplantation of both ureters in their common sheath. PMID- 6862860 TI - Indomethacin- and Moduretic--induced hyperkalemia. AB - Simultaneous administration of indomethacin and Moduretic (Merck Sharp & Dohme, USA, 5 mg of amiloride HCl, 50 mg hydrochlorothiazide) to a 78-yr-old patient resulted in severe hyperkalemia twice. When administered alone, neither drug significantly changed the normal serum potassium levels. Laboratory findings suggest an alteration of the internal balance of potassium as the main mechanism of this particular drug-induced hyperkalemia. PMID- 6862861 TI - Hypernatremic dehydration complicated by peripheral gangrene in infancy. AB - Two infants with hypernatremic dehydration (HD) who developed peripheral gangrene are described. A review of the literature revealed 10 infants who had HD and gangrene of the extremities. This combination could occur because of hypoperfusion and sluggish blood movement due to hyperviscosity, which coexist in HD, resulting in a disturbed microcirculation. We feel that the association of peripheral gangrene with HD may be a more frequent phenomenon than previously believed. PMID- 6862862 TI - Prolapse of the cord: reduction of perinatal mortality by bladder instillation and cesarean section. AB - The fetal outcome in 135 cases of cord prolapse seen during the period 1970-79 was studied. The fetus was alive at diagnosis in 127 cases. In 88 (69.3%) of the cases, the cord prolapsed during the first stage of labor and they were managed by Vago's method of rapid instillation of saline into the bladder to relieve cord pressure during preparation for cesarean section (CS). In the remaining 39 cases, the cord prolapsed during the second stage of labor and the patients were delivered vaginally. The overall perinatal mortality rate was 8.1%. The perinatal mortality rate among cases with a live fetus at diagnosis was 2.4%. In spite of a long diagnosis-delivery interval, no fetal deaths occurred in the 88 cases managed by bladder instillation and CS. Vaginal delivery of footling presentations was associated with a fetal mortality of 18.2%. The infant depression rate was significantly higher in breech vaginal deliveries than in CSs (P less than 0.001). Fetal bradycardia at the time of diagnosis was associated with an increased infant depression rate following vaginal delivery (39%) as compared with CS (10%). The CS rate in this series is the highest and the perinatal mortality among the lowest yet reported. PMID- 6862865 TI - Surgical management of secondary hyperparathyroidism in patients with renal failure. PMID- 6862864 TI - Pancytopenia--a rare complication of miliary tuberculosis. PMID- 6862863 TI - Recurrent exertional myalgia and myoglobinuria due to carnitine palmityltransferase deficiency. PMID- 6862866 TI - Effect of pindolol on renal function in hypertensive patients. PMID- 6862867 TI - Absence of Staphylococcus saprophyticus in urinary tract infections in Israel. PMID- 6862868 TI - New assessment technique for diaphragmatic movement in neuromuscular disorders. PMID- 6862869 TI - Alkaline phosphatase activity in subacute thyroiditis and hyperthyroidism. PMID- 6862870 TI - Continuous ambulatory peritoneal dialysis in end-stage renal disease. PMID- 6862871 TI - Iron deficiency and serum ferritin. PMID- 6862873 TI - Emergency medical care: updated experience in a district hospital medical unit. PMID- 6862875 TI - Measles--the effect of attitudes on immunisation. PMID- 6862874 TI - Animal and human bites as an emergency. PMID- 6862876 TI - Nursing staff ratios and their distribution in a Scottish mental hospital in relation to in-patient costs. PMID- 6862877 TI - Illness amongst travellers to Scotland: a pilot study. PMID- 6862878 TI - The chief scientist reports . . . infant nutrition in Glasgow. PMID- 6862872 TI - Surgical emergencies in the elderly: can they be prevented? PMID- 6862879 TI - Executive leadership in an organized anarchy: the case of HSOs. AB - The search for effective administrative patterns in health service organizations has heightened in the United States. The organized anarchy model depicting these organizations suggests an emphasis on certain CEO roles, and this emphasis is different from that expected of a CEO in a "rational" organization. The degree of internal influence and coherence of coupling are two indicators of CEO effectiveness within a health service organization. PMID- 6862880 TI - HMO-hospital relationships: an exploratory study. AB - Although HMOs very often obtain discounts for hospital services, there is little evidence that they create price competition among hospitals. Location and the availability of services and specialists, rather than price, appear to be the most important factors in the selection of hospitals by HMOs. PMID- 6862881 TI - Valuation: its impact on accounting measures of income and return on capital. AB - In the accounting model a return of capital can be guaranteed only in an unrealistic set of circumstances. Most organizations operate at an accounting breakeven, which guarantees bankruptcy because it results in a consumption of capital rather than a simple return of capital. Implicit in the pricing decision of many hospitals and their third party payers is the recovery of capital cost that would generate an accounting breakeven. PMID- 6862883 TI - HCMR interview: Health Frontiers, Inc. PMID- 6862882 TI - Viewpoint on boring meetings. PMID- 6862885 TI - [Mastocytosis simulating a food allergy]. AB - A patient reported that she developed various shock-like symptoms upon intake of alcohol, acetylsalicylic acid, or after injection of contrast medium. After provocation with alcohol applied orally and following endoscopy flush, tachycardia, and a severe headache followed immediately by painful diarrhea were observed. According to our diagnosis the patient had urticaria pigmentosa involving the bone marrow and an enlarged liver and spleen, respectively. The suspected intestinal mastocytosis was confirmed histologically by a biopsy from the jejunum. It was concluded that the symptoms were the result of a direct activation of the accumulated intestinal mast cells. The differential diagnosis of mastocytosis as opposed to allergic gastroenteritis, sprue, and carcinoid is discussed. PMID- 6862886 TI - [Proliferative myositis]. AB - A 86-year-old female patient is reported with myositis proliferans according to the criteria described by Enzinger and Dulcey (1967). This disease, first described by Kern (1960), impressed as a painful, firm and immovable tumor of almost 3 cm in size situated at the upper lip of our patient. Myositis proliferans can simulate a sarcoma, histologically and clinically; therefore, this disease shall be introduced to the dermatologic literature avoiding unnecessary invasive treatment. There is a relationship to fasciitis nodularis; a clinical and histological differentiation is possible as in our patient. PMID- 6862884 TI - [Giant pore and hair-shaft acanthoma. Clinical and histologic diagnosis]. AB - This report presents clinical and histological data of dilated pores of 54 biopsies from 45 patients from Munich and 39 biopsies from 36 patients from Detroit. The dilated pore of Winer is a relatively common benign adnexal tumor originating from the outer hair root sheath. Three-dimensional reconstructions of the tumor show that four different types of dilated pores can be considered. The dilated pore is a tumor sui generis and not a trichoepithelioma. A second benign adnexal tumor, the pilar sheath acanthoma of Mehregan and Brownstein, is presented in 11 biopsies from 11 patients from Munich and in nine biopsies from nine patients from Detroit. Clinical and histological features and differential diagnosis are shown. PMID- 6862887 TI - [Comparison of RePUVA and aromatic retinoid Ro 10-9359 with methotrexate in severe forms of psoriasis]. AB - Treatment of 20 PUVA-resistant patients with aromatic retinoid Ro 10-9359 resulted in a considerable improvement of psoriasis up to total recovery, and potentiated a favorable clinical effect of subsequent PUVA-treatment with reduced 8-MOP dosage. Aromatic retinoid was especially effective in patients with psoriatic eruptions on palms, soles, face, and scalp. The combination of aromatic retinoid with methotrexate was successfully used in the treatment of two patients with a particularly severe course of psoriasis, one having psoriatic erythroderma coupled with psoriatic arthritis and the other psoriatic erythroderma. No side effects were noted during retinoid treatment in any of the patients examined. PMID- 6862888 TI - [Uvula appendage]. PMID- 6862889 TI - [Cheilitis glandularis simplex]. AB - Cheilitis glandularis simplex is a rather rare disease which has to be differentiated from cheilitis granulomatosa. The histological characteristics of cheilitis glandularis simplex are hypertrophy and hyperplasia of mucous and/or heterotopic salivary glands. The therapy is the excision of the tumor. PMID- 6862890 TI - Consideration of age-dependent radium retention in people on the basis of the beagle model. AB - This paper examines in humans the proposition emanating from studies in beagles that initial retention of radium varies in proportion to the calcium addition rate at the time of intake. Human calcium addition rates were scaled from those in beagles, the relative calcium accretion rates in the two species at equivalent stages of skeletal growth providing the scaling factor. The variation of radium retention with age was determined by fitting a modified power function to data on the retention of radium from about 30 to 15000 days following a series of therapeutic injections of 226Ra in humans ranging in age from 18 to 63 yr. The fractional retention R at t days following a single injection of 226Ra was described by R = (1 + t/d)-0.44. The age-dependent parameter d in the retention function was found to be proportional to the calcium addition rate at the time of injection in subjects receiving less than 200 micrograms 226Ra. PMID- 6862891 TI - Age dependent concentration of 226Ra in human bone and some transfer factors from diet to human tissues. AB - The concentration of 226Ra in more than 1000 human bone samples, still born infants, fetuses, blood, mixed diet, drinking water and mineral water has been measured. An age dependence of 226Ra concentration in human bone could be demonstrated. Up to an age of 20 yr two maxima of 226Ra concentration in bone occur, coinciding with the increased velocity of skeleton growth. Normally, the main source for uptake of radium by man is food. In Germany the transfer factor from diet to bone is about 0.098. Compared with data from literature for other countries, mainly the U.S.A., the German value is higher by a factor of about 1.5. This difference may be due to the lower calcium uptake in Germany which leads to higher resorption of radium. Two methods for measuring natural radium concentrations is biological material and water samples are briefly described: a gamma-gamma-coincidence method for indirect measurement of 226Ra via the short lived 214Bi(RaC) and an alpha-spectrometric method for direct measurement of the alpha-emission of 226Ra. PMID- 6862892 TI - Distribution and retention in bone of 226Ra and comparison with the ICRP 20 model. AB - Analyses are presented of the ratios of 226Ra to calcium in over 650 samples of compact and cancellous bone from 66 female and 26 male subjects who had died from less than 1 to 60 yr after first exposure to radium. The 226Ra/Ca ratios were normalized to the terminal 226Ra skeletal content. The 226Ra/Ca ratios for vertebrae were essentially identical to those for other cancellous bone for a given subject. Comparisons of the data with predictions of the ICRP model of alkaline earth metabolism show that for female cancellous bone the normalized 226Ra/Ca ratios tended to be greater than predicted, while those for female cortical bone (femoral and tibial shaft) tended to be less. The data for males were fitted better by the model. A modification of the model to reduce the amount of radium deposited in soft tissue fitted the data better in some respects. A straight line linear least squares fit to the data appeared to fit as well as, or better than, the models. A radiation effect was suggested in that the normalized 226Ra/Ca ratio for vertebrae relative to the ratio expected increased with skeletal absorbed dose for vertebrae. However, no such effect was apparent for compact bone or for the cancellous bone as a whole. PMID- 6862893 TI - Cells at risk for the production of bone tumors in radium exposed individuals: an electron microscope study. AB - The endosteal cells of bone from a 75-yr-old woman who had acquired radium internally, as a consequence of her previous employment as a radium dial painter, are documented here for the first time by electron microscopy. As a result of amputation for a fibrosarcoma in the region of the right knee joint, fresh samples of bone and tumor tissue from the femur were made available. A sample of bone, also obtained at amputation from an unirradiated control patient, age 65, was examined from the same site in the femur. A comparison of the bone-marrow interface from the two patients showed that, unlike the control bone where cells were seen close to bone mineral a fibrotic layer was interposed between the marrow cells and the bone mineral in the bone from the radium case. This layer varied in thickness up to 50 microns and was often acellular, although cell remnants and cells, which appeared viable, were sometimes seen within this layer. It is suggested that irradiation of those cells proliferating within, and at the edge of, this replacement fibrotic layer may be the most important in the induction of bone tumors rather than the original cells lying within the 0-10 microns range from bone mineral which has previously been supposed. The nuclear dimensions of the endosteal bone lining cells and their distance from bone mineral have been measured in the bones from the radium and control cases. These dimensions are important not only in understanding the mechanisms by which bone tumors arise but in developing models of carcinogenic risks of other alpha particle emitting isotopes such as plutonium. PMID- 6862894 TI - Chronic radium intoxication: radium osteonecrosis and cancer in relation to 226Ra burdens. AB - Histologic examination of 35 femora from 25 New Jersey radium workers with measured preterminal 226Ra burdens between background levels (less than or equal to 0.0042) and 1.78 muCi demonstrated that 10 of the 11 whose burdens exceeded background had radium osteonecrosis, including 6 of 7 whose burdens were above background levels but below 0.1 muCi. Ten of 16 cases with radium osteonecrosis had cancer as did 5 of 9 who did not have radium osteonecrosis. The number of cases is too small to be confident of any association between bone necrosis and cancer, but the presence of changes consistent with radium osteonecrosis in 6 of 14 radium workers whose 226Ra burdens could not be measured above background levels is disturbing. PMID- 6862895 TI - Dose-response relationships for radium-induced bone sarcomas. AB - The incidence of bone sarcomas among 3055 female radium-dial workers who entered the dial industry before 1950 was used to determine dose-response relationships for the induction of bone sarcomas by radium. Two subpopulations were analyzed: all measured cases who survived at least 5 yr after the start of employment and all cases who survived at least 2 yr after first measurement. The first constituted a group based on year of entry; it contained 1468 women who experienced 42 bone sarcomas; the expected number was 0.4. The second comprised a group based on first measurement; it contained 1257 women who experienced 13 bone sarcomas; the expected number was 0.2. The dose-response function, I = (C + alpha D + beta D2)e-gammaD, and simplifications of this general form, were fit to each data set. Incidence (I) was in units of bone sarcomas per person-yr; (D) was the quantity (muCi) of radium that entered the blood. Two functions, I = (C + alpha D + beta D2)e-gammaD and I = (C + beta D2)e-gammaD, fit the data for year of entry (p greater than or equal to 0.05); both these functions and I = (C + alpha D) fit the data for first measurement. The function I = (C + beta D2)e-gammaD was used to predict the number of bone sarcomas in all other pre-1950 radium cases (medical, laboratory and other exposures); fewer were actually observed than the fit of this function to the female dial workers predicted. PMID- 6862896 TI - Comparative pathogenesis of radium-induced intracortical bone lesions in humans and beagles. AB - Morphologic changes resulting from the effects of chronic radionuclide toxicity (226Ra) in the skeletons of workers in the radioluminescent dial painting industry with preterminal body burdens ranging from about 1.5 to 0.042 muCi were compared with the pathologic alterations in the skeletons of a group of 38 beagle dogs injected with 1.12 muCi/kg. Similarities observed in the skeletal responses of the two species were the presence of (1) dead bone tissue with delayed resolution, (2) a chronic disturbance in the remodeling mechanism of bone tissue, and (3) radiation-induced bone sarcomas. A detailed analysis of sequential changes in radiographic lesions arising in the beagle skeletons, complemented by histopathologic evaluation at the time of limb amputation or at necropsy, has enabled us to examined the disturbance in the bone remodeling process. The perturbation of critical importance in the generation of primary bone tumors appears to lie in the bone tissue formation and deposition phase of the bone remodeling process and gives rise to a spectrum of histologic patterns which we have termed "radiation osteodystrophy." While some of the newly generated patterns demonstrate indolent behavior with fibrous tissue replacement and bone marrow refill, other sites of bone resorption are replaced by a unique fibro osseous tissue response resembling fibrous dysplasia or osteoblastoma. Some of these proliferative lesions may undergo progressive malignant degeneration. While the more indolent part of the spectrum was also seen in human skeletal tissues, only premalignant and early sarcomatous stages were seen in canine tissues. PMID- 6862897 TI - Plugged haversian canals and local dose in radium cases. AB - Haversian canal plugging is a common lesion in bone from human radium cases, signaling vascular damage. Its incidence is correlated with the whole body radium dose. However, since the vascular supply to bone forms an extensive anastomotic plexus facilitating propagation of vascular damage from a primary site of high radium content, we do not know if the degree of plugging is related to the local bone dose. In this report, we compare the incidence of plugging of osteons in different regions (16 sections) of humeri of three radium cases with terminal 226Ra body contents of 0.203, 1.03 and 15.4 muCi to the local dose of radium in adjacent bone sections. While the first and third subjects had received 226Ra only, the second had had a large intake of 228Ra as well. The background incidence of plugging in 35 "normal" humeri from dissecting room populations (45 90 yr) ranged from 0 to 1%, with an average of 0.3%. The least squares linear regression equation for the relation between the percent of canals plugged (PCP) and dose, PCP = (0.00214 +/- 0.00014) rad + (3.26 +/- 3.6), predicts for our three radium cases a development of about 0.002% plugs/rad. The correlation coefficient was very high (r = 0.97, n = 16, P less than 0.01). When normalized to radiation dose from the two decay series, 226Ra and 228Ra appear to be equally effective in producing plugged canals. PMID- 6862899 TI - Long-term clinical investigation of patients with ankylosing spondylitis treated with 224Ra. AB - Between 1952 and 1980 about 250 patients with ankylosing spondylitis were treated with 224Ra at the Orthopaedic University Hospital of Frankfurt/M. In 1970, 119 of them were examined and X-rayed as was another group of 40 patients in 1980. The results of those examined could be compared with a group of patients treated without 224Ra. Patients with 224Ra demonstrated a long-lasting period of subjective improvement after the treatment, with reduced consumption of antirheumatoid and analgesic drugs, on the average. Blood examinations show inflammatory activities. Nevertheless, the ankylosing spondylitis proceeded. In the final stages of the disease, neither the clinical aspects nor the X-rays showed any specific effect due to 224Ra. Blood examinations, especially blood cells and liver, had shown no specific changes. We observed no case of malignant bone tumor. Of the 169 examined patients, 22 had a total of 32 children after the treatment with 224Ra. Among these was a set of twins with cerebral palsy and diabetes insipidus renalis. In conclusion, 224Ra in ankylosing spondylitis is a recommended treatment without higher risk compared to the common therapy with drugs. PMID- 6862898 TI - Follow-up study of late effects in 224Ra treated ankylosing spondylitis patients. AB - We are following 1531 patients treated with 224Ra from 14 hospitals in the F.R.G. and 267 control patients with ankylosing spondylitis not treated with any form of ionizing radiation. Since 1970 three cases of malignant tumour in the skeleton have been found among 224Ra-treated patients with skeletal doses below 90 rad compared with 0.4-0.6 expected. Two of these three cases were tumours of the bone marrow. An effect of 224Ra on the haematopoietic system cannot be excluded. Also, seven cases of cataract were found among 274 224Ra patients. The mean time since 224Ra treatment was 26 yr. The mean age at diagnosis was 66 yr. The cataract incidence was not unusual for people of this age. PMID- 6862900 TI - Thorium concentration in human tissues from two U.S. populations. AB - The concentrations of natural alpha-emitting isotopes of thorium (228Th, 230Th and 232Th) have been determined in 22 sets of human tissue samples obtained at autopsy from Grand Junction, CO and in 10 sets from Washington, DC. Tissues included lung, pulmonary lymph nodes, liver, kidney, bone, a few gonads, spleen and thyroid. Personal data on each individual's age, sex, smoking history and occupation were obtained whenever possible. The concentrations of 228Th, 230Th and 232Th were highest in lymph nodes for both populations with 2.6 and 5.1 pCi/kg of 228Th, 4.60 and 11.10 pCi/kg of 230Th, and 2.8 and 7.8 pCi/kg of 232Th in Washington, DC and Grand Junction, CO, respectively. The order of concentrations of all three isotopes in all other organs for both populations was as follows: (formula; see text) The data suggest that the non-mining residents who lived in the vicinity of uranium mine tailings do not have elevated 230Th concentrations in their lungs, when compared to the residents of Washington, DC who are not exposed to such tailings. However, 230Th concentration in bone of Grand Junction subjects was just significantly higher (at p less than 0.1) than that for Washington, DC subjects after suitable age adjustments. The data also suggest that 230Th is more available for accumulation in skeleton than would be supposed from its relative geochemical abundance. PMID- 6862903 TI - Current (1981) status of the Danish Thorotrast study. PMID- 6862902 TI - Long term health effects of thorium compounds on exposed workers: the complete blood count. AB - Two hundred seventy-three men exposed to thorium and other rare earths between 1940 and 1973 at a plant which refined monazite sand were studied at Argonne National Laboratory from 1976 to 1980. In vivo measurements of body burden were made by counting gamma rays emitted by daughter products of retained thorium and by measuring exhaled thoron. Health status was ascertained through questionnaire, physical examination, and clinical laboratory tests. Measured body burden was found to be higher in those with a history of longer exposure. All parameters of the complete blood count were examined for evidence of an effect due to thorium. Comparisons of high and low body burden groups showed that only age and cigarette smoking had an effect on complete blood count parameters. PMID- 6862901 TI - Hepatic function in previously exposed thorium refinery workers as compared to normal controls from the health and nutrition survey. AB - The effect of thorium exposure on hepatic function was investigated in 275 former workers of a thorium refinery. Body burden of radioactivity from the decay chain of thorium was measured as 212Bi and 220Rn in the exhaled breath. Asparate aminotransferase, globulin and total bilirubin in sera were found to be associated with body burden of radioactivity at high levels of significance. Thorium-exposed workers were also compared with a population of white males from the Health and Nutrition Survey conducted by the National Center for Health Statistics from 1971 to 1975. The results showed the means of aspartate aminotransferase alkaline phosphatase to be significantly higher (P = 0.0001) in the thorium-exposed workers when corrected for age, alcohol use and weight. The changes observed in liver function may be compatible with a toxic effect of thorium or daughter products on hepatocytes. The correlation of some hepatic function tests with body burden of radioactivity suggests a radiation effect of thorium although a chemical toxic effect cannot be ruled out and further investigation of chemical toxicity of rare earths are indicated. PMID- 6862904 TI - Epidemiological follow-up study of Japanese Thorotrast cases--1980. AB - An epidemiological follow-up study was conducted on 272 Thorotrast-administered war-wounded ex-servicemen to determine their status as of 31 December 1980, after a lapse of 35-43 yr from Thorotrast injection. In the 251 cases who had been intravascularly injected with Thorotrast in the past, 40 malignant hepatic tumors, 3 blood diseases, 2 lung cancers, 1 osteosarcoma, 22 other malignant tumors, and 13 cases of liver cirrhosis were found. The mortality rates due to hepatic and other malignant tumors, blood diseases, and cirrhosis of the liver as well as the overall mortality rate were significantly higher in the intravascular Thorotrast group than in the controls. In the remaining 21 cases, who had been given Thorotrast by a route other than intravascularly, none of the deaths was found to be related to Thorotrast administration. PMID- 6862906 TI - Recent results of the German Thorotrast study--dose relevant physical and biological properties of Thorotrast equivalent colloids. AB - As a prerequisite for quantifying the non-radiation effect of Thorotrast, nonradioactive and radioactive aquasols with identical physicochemical properties and with biophysical behavior comparable to that of Thorotrast were developed and produced for a second long-term animal experiment. Comparative investigations with hafnium and zirconium (zirconotrast) dioxide aquasols showed the latter to be most appropriate considering the size of both the dispersoids and the aggregates in the liver tissue. The average particle diameters of ThO2, ZrO2 and HfO2 proved to be values of 9.3 nm, 15 nm and 45 nm, respectively. The size of the aggregates shows a slight dependence on the applied amount but no dependence on the duration of body burden of the colloid. The aggregate diameters in the 600 microliters group turned out to be 9.6 microns, 14.4 microns and 5.3 microns, respectively. Radioactive zirconotrast was prepared by radiochemical incorporation of 230Th and 228Th at dose rates which produce accumulated doses in the liver of rats equivalent to those of commercial 230Th enriched Thorotrast after 1.5 yr. Five different colloids were prepared with alpha-energy emission rates increased by factors of 1, 2.5, 5, 10 and 25 compared to Thorotrast and then injected into rats. PMID- 6862905 TI - Estimated absorbed dose in tissues and radiation effects in Japanese Thorotrast patients. AB - The absorbed dose in the liver, spleen and bone marrow of Thorotrast patients was estimated for 71 autopsy cases. 232Th amounts in tissues were determined from measurements of 228Ac gamma-rays and the activity ratio of 228Ac to 232Th. In calculating the absorbed dose, Kaul's data were used as values of the steady state activity ratio between 232Th and its daughters and the self-absorption of alpha-rays in Thorotrast aggregates. The autopsy cases in which the cumulative dose was estimated consisted of 45 cases of malignant hepatic tumor, 12 cases of liver cirrhosis, 7 cases of blood disease and 7 cases of other diseases. The estimated absorbed doses in the organs were presented and the relationship between the dose and radiation effects on organ tissues was discussed. PMID- 6862907 TI - Recent results of the German Thorotrast study--epidemiological results and dose effect relationships in Thorotrast patients. AB - The German Thorotrast Study includes 5159 Thorotrast patients and 5160 control patients. 887 Thorotrast patients and 660 control patients could be clinically and biophysically examined and followed-up. The mean age at injection or hospitalization in the case of the control group was 28 yr. The mean injected volume of Thorotrast was calculated to be 24.7 ml and the X-ray films of 249 Thorotrast patients showed paravascular deposits. In the meantime 432 Thorotrast patients and 122 patients of the control group have died. Among the deceased patients we have registered (Thorotrast vs control): hepatic tumors 152/0; myeloproliferative diseases 10/0; Hodgkin's diseases 2/0; non-Hodgkin's lymphomas 5/1; bronchogenic carcinomas 13/6; pleural mesothelioma 1/0; bone sarcoma 1/1(?); sarcoma at injection site 1/0; hepatic cirrhosis 90/6; bone marrow failure 8/1; other neoplastic diseases 46/19; other non-neoplastic diseases 151/88. The cumulative incidence of liver tumors depends on the dose rate to liver tissue and is not influenced by the age at injection. A dose effect relationship for the myeloproliferative diseases is not yet apparent. PMID- 6862908 TI - Recent results of the German Thorotrast study--pathoanatomical changes in animal experiments and comparison to human thorotrastosis. AB - A survival experiment is described in which 1920 Wistar rats were used. These rats were injected intravenously with different quantities and different alpha doses of Thorotrast. The following observations were made: The distribution of Thorotrast in the liver of the experimental animals is similar to that in human livers. Liver fibrosis and liver cirrhosis are rarely seen in experimental animals. The liver cell carcinomas, intrahepatic bile duct carcinomas and haemangiosarcomas that developed in the liver of the rats showed an identical biology and morphology with those seen in corresponding Thorotrast tumours in human patients. One particular tumour type that occurred in the liver of the rats probably represents a Kupffer cell sarcoma: the tumour cells show a positive peroxidase reaction and the metastases contained Thorotrast. Unlike human Thorotrast liver tumours, rat liver tumours include benign tumours such as liver cell adenomas and intrahepatic bile duct adenomas. The animals of the control group did not develop these benign liver tumours. The total frequency of the liver and spleen tumours in the trial groups receiving 230Th enriched Thorotrast was dependent on the dose given. The relationship between dose and effect was almost linear. The volume of the injected Thorotrast quantity, given a constant dose rate, seems to have only a slight influence on the number of tumours. PMID- 6862909 TI - Recent results of the German Thorotrast study--statistical evaluation of animal experiments with regard to the nonradiation effects in human thorotrastosis. AB - Our first long-term animal experiment made use of 1920 female Wistar rats divided into 20 groups of 96 animals each. These were injected at 12 weeks of age with different volumes and different dosages of Thorotrast which was enriched with 230Th to enhance the alpha-energy emission rate. The purpose of the study was to evaluate the effects due to the colloidal substance and the radiation. In the main experiment, 12 groups of rats were injected intravenously with 60, 120 and 300 microliters Thorotrast. 230Th was added to some Thorotrast preparations so that the total alpha-energy emission rate varied by factors of 1, 2, 5 and 10 relative to normal Thorotrast. Two groups were injected with 12 and 60 microliters of 50-fold enriched Thorotrast. One group was given 600 microliters of normal Thorotrast. In addition, we had 5 control groups, 1 NaCl and 4 Dextrin groups. The latter were injected with 60, 120, 300 or 600 microliters of Dextrin. The first animals died 8 months after injection, and the last 11 animals were killed 41 months after starting the experiment. The number of animals that developed a hepatic or splenic tumor increased by a factor of 10 in the highest dose-rate groups compared to controls. Our results demonstrated a linear correlation between the dose-rate and the number of primary hepatic and splenic tumors. It appeared that the volume of injected Thorotrast, by itself, had little influence on the number of tumors. However, at a constant dose-rate of 10, a 50 fold increase in the volume of Thorotrast (12-600 microliters) decreased the minimal tumor-appearance time by about 250 days. PMID- 6862910 TI - Lifetime bone cancer dose-response relationships in beagles and people from skeletal burdens of 226Ra and 90Sr. AB - The life-time tumor dose-response relationships observed in beagles injected with 226Ra or fed 90Sr at the University of California, Davis, provide a basis for understanding the induction of bone cancer for these bone-seeking radionuclides and for scaling to people. In these studies 385 dogs were exposed to graded dosage levels of 90Sr and 243 dogs were exposed to graded dosage levels of 226Ra with a total of 159 unexposed controls. The results show different dose-response relationships for bone cancer for the two radionuclides based upon the gravimetric average dose rates and cumulative doses to bone. These relationships were found to be well represented by three-dimensional log-normal dose-response surfaces that yield risk as a function of average dose-rate and time after beginning of exposure. All dose-rates suggested a 100% risk at some later time post-exposure but the time required to reach a given level of risk was long for low dose rates so that there exists a practical threshold in that at lower dose rates individuals may die spontaneously from causes associated with natural aging prior to the expected appearance of radiogenic cancer. The risks to people at various 226Ra body burdens (average skeletal dose rates) are estimated based on the model. PMID- 6862911 TI - Identification of 241Am in the axillary lymph nodes with an intrinsic germanium detector. AB - A routine measurement with two 200 mm-diameter phoswich detectors, placed one each side of the sternum, yielded an apparent lung content of 17 nCi 241Am for a subject. subject. Inspection of the data revealed that there were many more counts from the left side than from the right and that there was a greater number of Np L X rays observed, relative to the L gamma ray, than would be expected for a uniform lung distribution of 241Am. These observations suggested a shallow localised deposit in the left side of the chest. The subject's working history could not rule out an inhalation exposure, but he was known to have had a wound contaminated with Pu/Am in his left hand 16 yr previously. The wound had contained approx. 0.02-0.03 mu Ci 241Am initially, most of which was excised from the wound site after 50 days. Prompted by this knowledge we used a 50mm-diameter intrinsic Ge detector to examine the wound and relevant lymph node sites. The results demonstrated a localised deposit of 241Am in the axillary lymph nodes with approx. 1 nCi 241Am at the wound site. Subsequent measurements made with the phoswich detectors suggested that there was approx. 7 nCi 241Am in the lymph nodes with approx. 1 nCi 241Am in the liver, thereby accounting for most of the detectable 241Am contamination in the thorax. PMID- 6862912 TI - Comparison of radiological changes in humans and beagles with skeletal deposits of radium. AB - At the Laboratory for Energy-related Health Research at the University of California, Davis, semimonthly injections of 226Ra were given to a group of beagle dogs, and periodic skeletal radiography followed, as well as histological studies of the bones. At the Center for Human Radiobiology (Argonne National Laboratory, Massachusetts Institute of Technology, New Jersey Radium Research Project) measurements were made of radium body content in 2259 occupationally or iatrogenically exposed persons. Of these, 1768 had skeletal radiography (one or more times). In humans, the radiographic changes were, in decreasing order of frequency, osteolytic cortical and cancellous bone destruction, bone sclerosis, pathological fracture, and avascular necrosis of bone. In beagles, osteolytic destruction and pathological fractures were common, avascular necrosis was not observed, but there was frequently cortical thickening and new-bone formation in cancellous bone. In both population groups, there was a high incidence of bone sarcoma. In the beagles, one high-dosage group numbering 38 dogs had 49 malignant bone tumors. Among the 2259 measured persons, there were 60 who had bone sarcoma, and 29 who had cancer of the mastoids or paranasal sinuses. No significant skeletal effects have been diagnosed radiologically in persons with systemic intakes of 226Ra or 228Ra below about 10 mu Ci or with skeletal doses below about 100 rad. In humans, the lowest skeletal dose at which a bone sarcoma has been diagnosed is 890 rad, and the lowest intake associated with a bone sarcoma is 96 mu Ci 226Ra or about 1.7 mu Ci per kg body weight. PMID- 6862913 TI - Chromosome damage in peripheral lymphocytes from American thorium workers. AB - An analysis of the frequency of chromosome aberrations in lymphocytes from 47 thorium workers and three external controls is presented. Thirty-seven of these cases were divided into three age-matched groups based upon the means of the sums of their emanating radium-224 and bismuth-212 (Ra + Bi) burdens. The low burden group (mean Ra + Bi burden = -0.06 +/- 0.03 nCi) had two two-break chromosome aberrations in 1200 cells, the moderate burden group (mean Ra + Bi burden = 0.21 +/- 0.03 nCi) had three such aberrations in 1000 cells and the high burden group (mean Ra + Bi burden = 0.99 +/- 0.21 nCi) had five such aberrations in 1500 cells. While there is a two-fold increase in the two-break aberration frequency in pooled data from the two higher exposure groups (8/2500 cells) as compared with the lowest exposure group (2/1200 cells), the difference between these subsamples is not statistically significant (p = 0.32). The frequency of dicentrics and centric ring chromosomes (8/3300 cells) in the pooled higher body burden groups from the total sample (mean Ra + Bi burden = 0.56 +/- 0.09 nCi) does however show a very highly significant increase over the historical control frequency. A similar analysis based on total months of employment in the thorium processing industry did not show a positive relationship between duration of employment and aberration frequency. In broad outline, our results are compatible with those from similar studies on Brazilian thorium workers and Thorotrast patients. PMID- 6862914 TI - Health effects guidance for uranium in drinking water. AB - The interim regulations for radioactivity in drinking water were promulgated in 1976 (Federal Register, Friday, 9 July, 1976, p. 28402). These regulations specifically excluded uranium because of uncertainties concerning its toxicology, treatment technology and occurrence. At this time, EPA's Office of Drinking Water is considering proposing a health effects guidance level of 10 pCi/l. (0.37 Bq/l.) for uranium in drinking water. This paper describes the approach that EPAs Office of Drinking Water is considering in developing the guidance level. This value has not yet been officially determined to be EPA's formal guidance, but is presented as a working hypothesis for review and comments. Included here is a discussion of occurrence, pharmacokinetics and health effects. The calculation of doses uses the ICRP 30 model and the risk determination uses EPA's newly developed life table approach. The risk level from ingesting drinking water with a uranium content of 10 pCi/l. is estimated to be about 3 X 10(-5) excess cancers/lifetime. PMID- 6862915 TI - Uranium and thorium isotopes and their state of equilibria in lungs from uranium miners. AB - Radiochemical analysis of seven lungs obtained at autopsy show that concentrations ranged between 6 and 63 pCi/kg for 238U and 6-66 pCi/kg, for 234U. Similarly, 230Th ranged from 17 to 54 pCi/kg, two orders of magnitude higher than 230Th observed in the lungs of the general population from the Western mining region. For individual lungs, 238U and 234U were close to equilibrium with an average ratio of 238U/234U of 0.94 and a range of 0.80-1.02. Surprisingly, 230Th was close to equilibrium with 234U with a 230Th/234U ratio of 1.1 and a range from 0.54 to 2.6. Equilibrium between U and Th isotopes is in contrast to the disequilibrium reported in beagles which chronically inhaled carnotite, where the 230Th/234U ratio was observed to range from 5.4 to 7.4 with an average of 6.3. The average radiation dose rate to lung from each of the three radionuclides was calculated as follows: D = 18.7 CE where D = dose rate in mrad/year, C = activity concentration in tissue in pCi/g and E = energy absorbed per disintegration in MeV. The combined radiation dose rate (at death) due to three long-lived radionuclides 238U, 234U and 230Th varied from 2.5 to 14.2 mrad/yr with a mean of 9.6 mrad/yr. The concentration of 226Ra and daughters in the lung was not determined. An upper limit to the dose rate from the whole chain, calculated assuming 226Ra through 210Po are in equilibrium with 238U, 234U and 230Th, would be 30 mrad/yr. PMID- 6862916 TI - Retention of uranium in the chest: implications of findings in vivo and postmortem. AB - An unusually protracted retention of uranium in the chests of certain workers at a uranium processing plant has been reported in the literature. This finding has implications for the protection of current uranium workers and for health-effects studies of early workers. It is shown that the limited data obtained postmortem that have been reported do not reveal a significant unusually protracted retention of uranium in the pulmonary region or in the tracheobronchial lymph nodes. Probable explanations of the disparate findings are discussed. Data are presented on mortality from cancers of lymphatic tissues among males who worked in the period from 1943 to 1947 at the Y-12 Plant, Tennessee-Eastman Corp., Oak Ridge. No significantly increased mortality from these cancers was evident. PMID- 6862917 TI - Curium excretion studies in man and baboon: a predictive animal model. AB - A major rationale for performing metabolic research in laboratory animals is to obtain useful information which is applicable to man. Since it is usually impossible to determine many of the kinetic parameters which are responsible for the fate of a contaminant in inadvertently-exposed individuals, it is essential that well-controlled laboratory experimentation in animals be performed. In the present case, we will demonstrate how our experimental protocol, i.e. curium in the adult baboon, can provide a model from which to derive important characteristics of curium in man. To accomplish this goal, we have compared the retention and excretion patterns of curium in several men accidentally exposed via inhalation, burns, or puncture wounds with that of 243,244Cm citrate injected i.v. in nine adult baboons. Although many of the exposure conditions are different in considering the two primate species (human and non-human), biokinetic research in the baboon may serve to estimate tissue burdens and dose commitments in man. Comparison of the excretion rates of the nuclide in the urine of man and the baboon gives similar half times between days 10 and 50 post exposure. PMID- 6862918 TI - Microdosimetry of plutonium in lungs. AB - Chord length distributions for alveolar cells and cell nuclei were determined by superimposing computer-generated alpha-particle tracks on magnified images of randomly selected rat lung sections using the Quantitative Television Microscope. Specific energy distributions were then calculated by applying image analysis techniques. These microdosimetric calculations suggest that radiation carcinogenesis can be described in physical terms by the number of cells hit in a defined tissue volume, the specific energy distribution in these cells, the resulting number of non-lethally damaged cells which are susceptible to transformation, and their spatial distribution. If multicellular effects are involved in radiation carcinogenesis, then hot spots might be more carcinogenic than the uniform distribution at low doses and less carcinogenic at high doses. PMID- 6862919 TI - Differential clearance of plutonium and americium oxides from the human lung. AB - External X- and gamma-ray counting techniques have been used to study the retention of 238PuO2 and 241AmO2 in the lungs of a worker between 7 and 869 days after simultaneous exposure to aerosols of both oxides. From these data and measurements of early faecal excretion, it is concluded that approx. 50% of the amount of each nuclide initially deposited in the subject was removed during the first few days by ciliary clearance mechanisms. The lung clearance patterns of the other 50% differed for the two nuclides. The 238Pu was apparently cleared with a biological half-life of approximately 800 days, predominantly by systemic or lymphatic uptake, with at least part of the translocated material being subsequently deposited in bone. There was no evidence for the presence of a 30 day component of lung clearance, such as has been suggested elsewhere. In contrast, most of the residual 241Am was cleared relatively quickly, with a half life of approximately 11 days, although a small proportion was apparently subject to long-term retention, with a half-life of approximately 900 days. The data for both oxides conflict in important respects with the patterns of lung clearance postulated by the ICRP. PMID- 6862920 TI - Fallout 239/240Pu and 238Pu in human tissues from the Federal Republic of Germany. AB - To determine the present level of plutonium in human tissues of people in the F.R.G., due solely to fallout from weapons testing, 30 sets of tissues and bones from Munich residents were obtained at autopsy. Each set of tissues consisted of the entire lung, the entire liver, 300 g vertebrae, 300 g ribs and the lymph nodes. All subjects were males, born before 1940. Wet ashing, followed by solvent extraction, electrodeposition, and alpha-spectrometry were used to isolate and quantitate the plutonium isotopes present. The median concentrations of 239/240Pu (in fCi/kg wet weight) observed were: livers (530), vertebrae (92), ribs (73), lymph nodes (58) and lungs (28). The ratio of 238Pu/239/240Pu (in %) was livers 3.5, lungs 5.6, ribs 4.0 and vertebrae 3.2. Age trends for the plutonium concentration in livers, lungs, vertebrae and ribs were not observable. Possible correlations between the plutonium concentrations in livers, lungs and bones are discussed. The results are in many respects similar to observations in the U.S.A. and Southern Finland. PMID- 6862921 TI - Measured 234,238U and fallout 239,240Pu in human bone ash from Nepal and Australia: skeletal alpha dose. AB - Human bone samples from Nepal and Australia were analyzed for isotopic uranium and fallout plutonium. The Nepalese samples were obtained for a 3-yr period (1976 78) while the Australian samples are representative of a single year (1977). The surface air plutonium concentrations for the latitude bands of these countries were either measured and/or estimated from 1954 through 1978. With the plutonium air concentrations and age-dependent breathing rates as input data, the measured human bone results were compared with skeletal estimates derived from the ICRP Task Group Inhalation Model, and the agreement was found to be reasonably good. The measured isotopic uranium concentrations in these samples provide a benchmark against which to assess fallout plutonium based upon a comparison of the skeletal alpha radiation dose from a natural actinide to these populations. PMID- 6862922 TI - Plutonium concentration in human tissues: comparison to thorium. AB - The concentration of 238Pu, and 239,240Pu, and of 228Th, 230Th, and 232Th were measured in 10 sets of human tissues from Washington, DC, and 12 sets from Grand Junction, CO. The tissues were collected at autopsy by qualified pathologists from normal healthy persons most of whom died suddenly. The subjects had acquired plutonium from fallout of global nuclear testing and burnup of a space nuclear generator utilizing 238Pu. The median concentration of 239,240Pu was 0.08 pCi/kg in lung, 0.46 pCi/kg in tracheobronchial lymph nodes, 0.60 pCi/kg in liver, 0.02 pCi/kg in kidney and 0.17 pCi/kg in bone in Washington, DC subjects. Similarly, the concentration of 239,240Pu in Grand Junction subjects was found to be 0.17 pCi/kg in lung, 0.68 pCi/kg in lymph nodes, 0.55 pCi/kg in liver, 0.03 pCi/kg in kidney, 0.22 pCi/kg in bone and 0.08 pCi/kg in spleen. The median concentration in four gonads was 0.02 pCi/kg; the concentration in one thyroid was 0.01 pCi/kg. 238Pu was below the limit of detection in most organs except the liver where it ranged from 0.02 to 0.17 pCi/kg with a median concentration of 0.06 pCi/kg. The organ distribution pattern shows that most of the plutonium was accumulated in bone and liver with 54-60% in bone and 34-43% in liver. Only 3-6% was found in lung including lymph nodes; kidney, spleen, thyroid and gonads together contained around 1%. The analytical results show three major differences between plutonium and thorium concentrations and organ distributions: (1) for plutonium the liver is a major locus for storage (approximately 40% of that found in the total body), whereas little thorium is accumulated in the liver (around 4%); (2) the relative amounts of 230Th and 232Th are much higher in lung and lymph nodes (10-28%) than currently for plutonium (3-6%); (3) the ratio of throium concentrations in lymph nodes to lung is significantly higher than the ratio of plutonium concentration in lymph nodes to lung showing thereby that fallout plutonium is more soluble than natural thorium. PMID- 6862923 TI - A comparison of systemic burdens at autopsy to estimates based on health physics data for selected plutonium workers. AB - To obtain an estimate of the systemic burden of plutonium in a worker, the health physicist must apply bioassay data, both in vivo and excreta data to mathematical models which describe the translocation of plutonium in humans. To assist in obtaining the best estimate possible, the health physicist often utilizes field data including results of air sampling at the work location, chemical form and solubility of the material to which the worker has or may have been exposed and contamination surveys of the worker himself. The estimate made by the health physicist while the worker is alive is compared to the systemic burden based on autopsy data to evaluate the accuracy of the model used. Preliminary conclusions regarding findings of the study to date are presented. PMID- 6862924 TI - Plutonium--its behavior in natural water systems and assimilation by man. AB - There are a number of factors which must be considered in establishing whether or not the inadvertent intrusion of a sizable amount of plutonium-bearing material into a natural water system may have a significant impact on the health of those individuals who use that system as a drinking water resource. These factors include the chemical form(s) and solubility of plutonium in natural waters, its behavior in relation to natural processes (geochemical and biological), its fate in water treatment systems, and its uptake by man from drinking water. From the results obtained in our investigations of the behavior in natural water systems, it appears that (1) the chemical forms of plutonium dissolved in natural waters are Pu(IV) and Pu(V), (2) the soluble plutonium in many waters is bound to the organic constituents which probably enhances plutonium solubility, (3) the natural process responsible for the removal of plutonium from water is adsorption onto sediments, and (4) in water treatment systems, soluble plutonium is oxidized to the VI state and this form is not removed. From our investigations of gastrointestinal absorption, it appears that the value for f1, the fraction transferred from the gut to blood, is surely greater than 1 X 10(-3) and may be as high as 2 X 10(-1). Consideration of these and other factors indicates that, in the event of an accident, the concentration of plutonium could, in certain small natural water systems, approach and perhaps even exceed, the MPC for plutonium. However, the impact on the health of the affected population would not be inordinately high. PMID- 6862925 TI - An update of epidemiologic studies of plutonium workers. AB - Retrospective and prospective epidemiologic studies are being conducted as part of a national survey of plutonium workers at four Department of Energy facilities (Los Alamos, NM; Rocky Flats, CO; Mound Laboratory, OH; and Savannah River, SC). A preliminary analysis of mortality was done for all white males who have worked at the Rocky Flats Plant during the period 1952-79. The 452 observed deaths were significantly fewer than the 831 expected for all causes. The 107 deaths due to all malignant neoplasms were also significantly fewer than the 167 expected from these diseases. Expected deaths were derived from age and calendar-specific death rates for U.S. white males. Deaths reported for benign and unspecified neoplasms numbered eight versus an expected two, a significant elevation. These tumors, all intracranial, are the subject of a case-control study to be reported later. Subdividing the cohort on the basis of plutonium exposures and external radiation exposures results in similar overall findings. The benign and unspecified neoplasms, however, were not significantly high in the plutonium-exposed group. PMID- 6862926 TI - Skeletal retention and distribution of 226Ra and 239Pu in beagles injected at ages ranging from 2 days to 5 years. AB - The age at exposure significantly affects the retention and distribution of 226Ra and 239Pu, both of which deposit in the skeleton although in somewhat different patterns. Beagles aged 2 days (neonates), 90 days (juveniles), 18 months (young adults), or 5 yrs (mature) received a single subacute injection of one of these nuclides and were sacrificed serially during a 2-yr interval. Nuclide concentrations in plasma, the skeleton, individual bones and bone sections were determined and retention equations were calculated. The microanatomical skeletal nuclide distribution was studied after fission track or conventional autoradiography. Elimination of 239Pu and its translocation from bone surfaces to the bone volume caused by bone growth and turnover processes were measured. Average radiation doses and dose rates as a function of age at exposure were determined. Initial uptake and retention, skeletal nuclide concentration, proliferative activity of local cell populations and residence time of the nuclide on skeletal surfaces were affected significantly by age at exposure. The effect of these parameters on tumor induction is discussed. This study has provided early retention and distribution data which together with data from a chronic toxicity study will be used to estimate the risk of Pu exposure relative to that of Ra to humans of all ages. PMID- 6862927 TI - Dose-response relationships for bone cancers from plutonium in dogs and people. AB - The risk of bone cancers developing from internally deposited plutonium must be estimated from studies in laboratory animals because no plutonium-induced cancers have been observed in people. Studies of the effects of 226Ra and 239Pu injected into beagle dogs at the University of Utah and 238PuO2 inhaled by beagle dogs at the Inhalation Toxicology Research Institute provide a key link to understanding the longterm effects of inhaled alpha-emitting radionuclides in people. Injected radium and plutonium are rapidly deposited in bone whereas plutonium deposited in lung by inhalation is translocated to bone more slowly, depending on its chemical form. The development of bone cancers is a late occurring effect seen after either injection of plutonium or radium or inhalation of plutonium. The incidence of bone cancers from alpha radiation to the skeletons of dogs was compared to bone cancer incidences in radium dial painters to estimate bone cancer risk from inhaled plutonium in people. A risk factor of 1200 bone cancers/10(6) rad to skeleton (average dose) was estimated. PMID- 6862928 TI - A tissue distribution model for assessment of human inhalation exposures to 241AmO2. AB - A model useful for predicting lung retention and tissue distribution following human inhalation exposure to 241AmO2 has been formulated. The model is based on inhalation studies in beagles exposed to either monodisperse or polydisperse aerosols of 241AmO2. It also describes lung retention for several cases of accidental human inhalation exposure to 241Am adequately. The model incorporates an expression for solubilization of 241AmO2 deposited in lung which is based on physicochemical characteristics of the inhaled particles. Comparison of predictions from this model and those of the International Commission of Radiological Protection in ICRP Publication 30 shows some important differences. Lung retention patterns of inhaled 241Am in dogs and humans after inhalation of 241AmO2 are very similar and do not conform with predictions of the ICRP 30 model. Although use of the ICRP 30 model for calculation of annual limits of intake produces similar values to predictions made from our model, a more complete assessment of accidental human exposures to 241AmO2 and the risk to individual organs can be made using the retention and dosimetry model formulated from these studies in dogs. PMID- 6862929 TI - Bioassay model for estimating body burdens of 241Am from excretion analyses. AB - A simple bioassay model for predicting the organ burdens of 241Am from excretion rates is presented for inhalation exposures. The model uses three compartments representing lung, liver and skeleton. The model was developed using data from studies in laboratory animals of inhaled or injected 241Am and was validated for people by comparison to cases of accidental inhalation exposures to 241Am. The data for people have a large amount of variability but indicate that the retention half-time of 241Am in liver is approximately 2 yr and in skeleton is approximately 30 yr. These parameters can be used in the model to estimate body and organ burdens from excretion rates after inhalation of 241Am or the model can be fitted to an individual's measured excretion rates. PMID- 6862930 TI - Relative effectiveness of 241Am vs 226Ra approached by haemopoietic stem cell studies in various bone marrow sites of contaminated mice. AB - Haemopoietic stem cell assays allow investigation of local radiation damage at any time after contamination. These techniques were used to determine the relative effectiveness of 241Am and 226Ra in inducing damage in various cortical and trabecular bone marrow sites. Male Balb/c mice were injected with either 230 or 660 kBq 226RaCl2/kg body weight or with one of three doses of monomeric 241Am citrate at 138, 552 or 768 kBq 241Am/kg body weight. At 7 time intervals after injection (from 4 hr to 100 days) the colony-forming capacity of pluripotent stem cells (= CFU-s) and macrophage-granulocyte committed stem cells (CFU-c) was assayed in sternal marrow, marrow of lumbar vertebrae, of the trabecular distal end of the femur and of the femoral shaft (in which were distinguished axial marrow and marrow situated peripherally near the cortical bone). 226Ra retention and 241Am retention were measured in these bone sites. Skeletal doses and doses to the bone marrow sites were calculated. On the base of injected activity, 241Am was more effective than 226Ra in reducing the number of CFU-s and CFU-c but the effectiveness varied in the various bone marrow sites. CFU-s and CFU-c response is considered in relation to the retained radioactivity in the surrounding bone matrix and in relation to the mean marrow dose. PMID- 6862931 TI - A note on radium body content and breast cancer in U.K. radium luminisers. PMID- 6862933 TI - Survey of ocular cataracts in radium dial workers. AB - A survey of the medical records of 813 female radium dial workers first exposed to radium before 1930 yielded reports of 119 cataracts in the group whose radium body burden had been measured at least once. After dividing the subjects into high and low dose groups, the data were analyzed according to latency (time between first employment and first diagnosis of cataract), duration of employment and age at first exposure. Duration of employment and age at employment showed no significant correlation with dose. Latency, however, showed a significant negative correlation with dose. Since radiation cataracts tend to occur earlier than so-called senile cataracts, these preliminary data suggest the need for further investigation. PMID- 6862934 TI - Soft tissue dosimetry of radium in humans--I. Alpha-particle doses from the decay of 226Ra and 228Ra in soft tissues. AB - Estimates are presented of the alpha particle doses accumulated by individual organs and soft tissues of Reference Man in a 50-yr period following single intakes of 226Ra and 228Ra. With no decay of 226 Ra daughter products in soft tissue, the median dose is 67 mrad per muCi 226Ra intake. With no translocation of 228Ra daughter products, the dose per muCi 228Ra intake is 5.77 times the corresponding value for 226Ra. Biological variability introduces substantial uncertainty when applying these estimates to a particular individual. PMID- 6862932 TI - Distribution and dosimetry studies after incorporation of 239Np (239Pu) in mice. PMID- 6862935 TI - An age dependent model for radium metabolism in man. AB - The model developed by a Task Group of Committee 2 of ICRP to describe Alkaline Earth Metabolism in Adult Man (ICRP Publication 20) has been modified so that recycling is handled explicitly, and retention in mineral bone is represented by second compartments rather than by the product of a power function and an exponential. This model has been extended to include all ages from birth to adult man, and has been coupled with modified "ICRP" lung and G.I. tract models so that activity in organs can be calculated as functions of time during or after exposures. These activities, and age dependent "specific effective energy" factors, are then used to calculate age dependent dose rates, and dose commitments. This presentation describes this work, with emphasis on the model parameters and results obtained for radium. PMID- 6862937 TI - Head and neck cancer in a young age group: high incidence in black patients. AB - From the Tumor Registries of the East Orange, New Jersey, Veterans Administration Medical Center, and the College of Medicine and Dentistry of New Jersey/New Jersey Medical School, 1,066 cases of head and neck cancer were reviewed. Blacks comprised 32% of the population reviewed. Charts of 70 patients, 45 years old or younger, were examined. Seventy percent of this group was black. At diagnosis, the proportion of patients 45 years old or younger was 14% for blacks and 2.9% for whites, a significant difference (P less than 0.001). Seventy-six percent of lesions in black patients and 86% in white patients were situated above the hypopharynx. Sixty-one percent of all patients 45 years old or younger had Stage III or IV lesions when first diagnosed, regardless of race. Black-to-white survival rates were 23 to 40% after 2 years, and 5 to 13% for those at risk after 5 years. Prognosis is poor for younger patients, in general, and worse for young black patients than for whites. PMID- 6862936 TI - Digital subtraction angiography: applications in otolaryngology--head and neck surgery. AB - Digital electronic technology has made its most notable contribution to radiology in the form of the CT scanners which have so greatly benefited medical practice. Experience with intravenous angiography using a digital fluoroscopy unit developed at the University of Arizona gives promise of a further major benefit in the area of angiography. The majority of examinations are conducted on an outpatient basis with a risk level comparable to that of an intravenous pyelogram. The authors review their experience with this unit, including it's diagnostic and therapeutic applications to congenital and acquired vascular diseases, neoplasms, and vascular trauma of the head and neck. PMID- 6862938 TI - Surgical management of advanced scalp cancer. AB - A series of 53 advanced scalp cancer patients treated with surgery is presented. A review of these patients concludes: 1) local tumor growth--not distant metastasis--is the primary problem; 2) management is based on the tendency of a tumor to spread laterally early in its development with a deep invasion occurring later on; 3) when deep invasion occurs, radical excision and reconstruction is indicated to control the disease; 4) recurrence following adequate local therapy requires a change in treatment modality. PMID- 6862940 TI - Meningiomas presenting in the paranasal sinuses and temporal bone. AB - Head and neck meningiomas are primarily intracranial neoplasms; they rarely present in extracranial locations. Two cases of meningiomas in the paranasal sinuses and seven cases in the temporal bone are described. The pathology, pathogenesis, clinical evaluation, and therapy are discussed. It is stressed that intracranial components of such meningiomas be sought and, as appropriate, treated. PMID- 6862939 TI - Expression plasty: a new approach to esthetic surgery. AB - Training in esthetic surgery focuses on correcting crooked noses, wrinkled skin, bald scalps, and other unsightly facial structures. However, little importance is placed upon facial expressions--eg, "weak," "serious," "feminine," etc. Surgeons have discovered, through experience, that a recessed chin gives one a "dumb" expression, that a drooping nose denotes an "aging" expression, and that baggy eyelids confer a "tired" expression; yet few efforts have been made to study this area in more depth. This article explores the field of facial expression and its place in facial esthetic surgery. PMID- 6862945 TI - [Indications for interlocking nailing in the central third of the lower leg (bending and torsion fractures included)]. PMID- 6862943 TI - [Interlocking nailing. 3d International Interlocking Nailing Symposium. 2-3 April 1982, Frankfurt/Main]. PMID- 6862941 TI - Paranasal sinus radiology, Part 4A: Maxillary sinuses. AB - The maxillary sinus is frequently involved by inflammatory change. It is also the sinus that is most affected by intrinsic or nearby neoplasms. Since neoplasia and inflammatory disease may mimic each other, radiologic examination often becomes the principal means of differentiating them. Principles of radiologic diagnosis, with attention to changes in the various bony margins in maxillary disease processes, form the basis of this article. PMID- 6862944 TI - [The history of the interlocking nail]. PMID- 6862942 TI - Traumatic granuloma of the tongue. AB - The traumatic granuloma is a rare, reactive lesion that occurs primarily in the tongue of males. It can mimic other diseases, including malignancy, both clinically and histologically. It is, therefore, a lesion with which clinicians and pathologist should be familiar. PMID- 6862948 TI - [Indications for interlocking nailing in the lower leg in comminuted, fragmented and transverse fractures]. PMID- 6862946 TI - [Indications for interlocking nailing in the distal third of the lower leg]. PMID- 6862949 TI - [Post-traumatic corrections: surgical correction of malpositions in the lower leg with the interlocking nail]. PMID- 6862947 TI - [Animal experiment trials with the interlocking nail in the treatment of transverse tibial fractures]. PMID- 6862950 TI - [Results following interlocking nailing in a hospital giving standard care]. PMID- 6862951 TI - [Failures of interlocking nailing. Faulty technic and complications]. PMID- 6862952 TI - [Failures of interlocking nail osteosynthesis]. PMID- 6862953 TI - [Exceptional indications for interlocking nailing: pathologic fractures in the metastatic foci]. PMID- 6862954 TI - [Interlocking nailing in infected pseudoarthrosis]. PMID- 6862955 TI - [Principles of interlocking nailing--biomechanical principles]. PMID- 6862956 TI - [Extension table for interlocking nailing]. PMID- 6862957 TI - [Surgical technic of interlocking nailing]. PMID- 6862958 TI - [Radiation measurements during interlocking nailing]. PMID- 6862959 TI - [Indications for interlocking nailing in the thigh. Proximal femur fractures]. PMID- 6862960 TI - [Indications for interlocking nailing in the central third of the thigh]. PMID- 6862961 TI - [Indications for interlocking nailing in the distal third of the thigh]. PMID- 6862962 TI - [Indications for interlocking nailing in the thigh in comminuted, fragmented and transverse fractures]. PMID- 6862963 TI - [Interlocking nailing in the thigh: alternative or competition with other osteosynthesis technics]. PMID- 6862964 TI - ["Spongiosation" of cortical bone]. PMID- 6862966 TI - [Principles of interlocking nailing]. PMID- 6862965 TI - [Post-traumatic corrections: correction of length inequality, axial and rotational malpositions with the interlocking nail]. PMID- 6862967 TI - ["One-stage" lengthening osteotomy of femur by the interlocking nailing technic]. PMID- 6862968 TI - [Re-osteosynthesis of aseptic pseudarthroses following previous osteosynthesis in the thigh with the interlocking nail]. PMID- 6862969 TI - [Indications for interlocking nailing in the lower leg. Proximal tibial shaft fractures]. PMID- 6862970 TI - [Traumatic lesions of the urethra and bladder]. PMID- 6862971 TI - [Iatrogenic ureter injuries and peroperative diagnosis]. PMID- 6862974 TI - [Kidney injuries]. PMID- 6862973 TI - [Radiologic evaluation of kidney injuries]. PMID- 6862975 TI - [Urogenital lesions in multiple injuries. Incidence and diagnosis]. PMID- 6862972 TI - [Therapy of ureter injuries]. PMID- 6862976 TI - [Gallbladder surgery: prophylactic antibiotics, yes or no?]. PMID- 6862977 TI - [When should cholecystectomy be performed in cholecystitis?]. PMID- 6862978 TI - [Iatrogenic, lateral obstruction of the extrahepatic bile ducts]. PMID- 6862979 TI - [Non-amebic liver abscess]. PMID- 6862980 TI - [Morbidity and mortality in splenectomy for hematologic indication]. PMID- 6862981 TI - [Replantation of autologous spleen tissue in the omentum majus: an alternative to splenectomy?]. PMID- 6862982 TI - [Treatment of therapy-resistant ascites with the Leveen peritoneovenous shunt]. PMID- 6862983 TI - [Ultrasound diagnosis in abdominal traumatology]. PMID- 6862984 TI - [Relaparotomy: causes and mortality in a comparison of the literature]. PMID- 6862985 TI - [Relaparotomy due to severe complications following appendectomy]. PMID- 6862986 TI - [Initial results of 13 laparostomies: should conclusions be drawn from 7 survivals?]. PMID- 6862987 TI - [Perforation of the small intestine in minor blunt injuries]. PMID- 6862988 TI - [Mechanical ileus: analysis of 360 operations]. PMID- 6862989 TI - [3-point blitz plication of the small intestine in ileus]. PMID- 6862990 TI - [Prognostic significance of preoperative CEA titers in colorectal cancer]. PMID- 6862991 TI - [Clostridium difficile - enterocolitis as a nosocomial problem]. PMID- 6862992 TI - [Cecostomy in ileus of the large intestine: surgical technics and results]. PMID- 6862993 TI - [Emergency hemorrhoidectomy in acute hemorrhoidal thrombosis]. PMID- 6862994 TI - [Smell as a diagnostic tool. From the observant nose to mass spectrometry]. PMID- 6862995 TI - In vitro efficacy of several antibiotics against intracellular S. aureus in chronic granulomatous disease. AB - We report the case of a one-year-old boy with chronic granulomatous disease (CGD), characterized by a defect in the polymorphonuclear leukocytes (PMN) which ingest, but do not kill catalase-positive bacteria such as S. aureus. This well known observation led us to study the ability of clindamycin, rifampin, co trimoxazole (TMP-SMX), methicillin and gentamicin to kill intracellular S. aureus in CGD and in normal PMN. Clindamycin killed S. aureus more effectively when these bacteria were intracellular than in the absence of PMN; rifampin was equally active on the same microorganisms in presence and absence of PMN, whereas TMP-SMX, methicillin and gentamicin were less effective in killing intracellular S. aureus. Similar results were obtained in CGD and in normal PMN. These results suggest that clindamycin and rifampin would be a reasonable choice in the treatment of staphylococcal infections in patients with CGD. PMID- 6862996 TI - Radio-digito-facial dysplasia associated with dwarfism. PMID- 6862998 TI - Erythema nodosum associated with infectious mononucleosis. AB - Erythema nodosum is an immunoallergic epiphenomenon appearing during the course of various conditions; it has been exceptionally observed in association with infectious mononucleosis. A 9-year-old girl with clinical manifestations of infectious mononucleosis developed cutaneous nodules of erythema nodosum over the shins, which cleared after 12 days. Diagnosis was based on the presence of atypical mononuclear cells, detection of antibodies against Epstein-Barr virus, and positive ox red blood cell hemolysis. Coincidence of both diseases is not surprising because infectious mononucleosis may exhibit diverse immunologic reactions. On the other hand, commonest etiologies were excluded in this case. PMID- 6862997 TI - Multiple acyl-Co A dehydrogenation deficiency (MADD) in a boy with nonketotic hypoglycemia, hepatomegaly, muscle hypotonia and cardiomyopathy. Detection of N isovalerylglutamic acid and its monoamide. AB - A boy, aged 7 months, of consanguineous parents presented with an acute onset of vomiting, fever, nonketotic hypoglycemia and acidosis and died from cardiac arrest after ventricular fibrillation. He had hepatomegaly and echocardiographically a non-obstructive cardiomyopathy. Autopsy was not allowed. After birth the child had suffered from a severe respiratory distress syndrome, transient metabolic acidosis and had a sweaty feet odour. Later on, development was retarded with a severe muscular hypotonia. Post mortem, numerous unusual organic acids were found in high concentrations in urine, e.g. dicarbonic acids, 2-hydroxyisobutyric, isovaleric, 3-hydroxyisovaleric acid, N-acyl glycines, isovalerylglutamic acid and sarcosine. This pattern indicated deficiencies of several acyl-Co A dehydrogenases in the metabolism of leucine, isoleucine, valine, lysine, short-chain fatty acids and sarcosine. This could be confirmed using cultured skin fibroblasts which were shown to degrade the corresponding labeled substrates insufficiently to 14CO2. It is assumed that the functional multiple acyl-Co A dehydrogenation deficiency is caused by a deficiency of a common link in the electron transfer system of these dehydrogenases which is inherited autosomal recessively in this family. Among the 12 patients reported, 7 died within the first 5 days of age. PMID- 6862999 TI - Acute appendicitis in early childhood. PMID- 6863000 TI - The acquired double pylorus. PMID- 6863001 TI - Management of colonic trauma: six-year experience at Henry Ford Hospital. PMID- 6863002 TI - The other breast: indications for biopsy and/or mastectomy. PMID- 6863003 TI - The role of major hepatic resections for liver metastases from colorectal cancer. PMID- 6863004 TI - Current concepts in otitis media. PMID- 6863005 TI - Clinical note: excision of a large ovarian leiomyoma in a centenarian. PMID- 6863006 TI - The role of splenectomy in endocarditis. PMID- 6863007 TI - Determination of amino acids and polyamines in human erythrocytes. Part 1. Fundamental studies. PMID- 6863008 TI - An aneurysm associated with Moyamoya disease--a followup study by computed tomography. PMID- 6863009 TI - A case of Moyamoya disease associated with basilar aneurysm. PMID- 6863010 TI - Cardiac output in conscious one-clip, two-kidney renovascular hypertensive rats. PMID- 6863011 TI - A study on biliary lipids in a case with cholecystolithiasis after ileostomy. PMID- 6863012 TI - A case of taeniasis saginata diagnosed by radiological and endoscopical examination. PMID- 6863013 TI - Change in constituents in high density lipoprotein and its subfractions in circulation from hepatic vein to femoral artery. PMID- 6863015 TI - Selection of specimen in the determination of carboxyhemoglobin saturation by spectrophotometry. PMID- 6863014 TI - Natural killer activity of normal human peripheral blood lymphocytes. I. Inhibitory effect of ammonium chloride solution. PMID- 6863016 TI - Basic study of polyetherurethane coated bead-type activated charcoal for direct hemoperfusion. PMID- 6863017 TI - A case of fatal paraquat poisoning and a rapid method for analysis of paraquat in biological material. PMID- 6863018 TI - Tumorigenicity test of N-(5-Nitro-2-furfurylidene)-1-aminohydantoin by dietary administration in BDF1 mice. PMID- 6863020 TI - Studies of X-chromosome inactivation with an improved histochemical technique for ornithine carbamoyltransferase. AB - Studies of X-linked enzymes provide an approach to the study of tumour and normal cellular development. We have assessed the technique for the histochemical demonstration of one such enzyme, ornithine carbamoyltransferase (EC 2.1.3.3). Various stages in the Mizutani technique for ornithine carbamoyltransferase were re-examined, and the resulting improved technique applied to normal mice and to mice of the sparse fur strain (Spf) known to have an abnormal form of ornithine carbamoyltransferase inherited as an X-linked characteristic. Positive enzyme activity was present in all hepatocytes from normal mice, the strongest reaction being present in the periportal area with a gradual reduction of activity towards the centrilobular region. No activity was demonstrable in hepatocytes from hemizygous male Spf mice. In heterozygous female Spf mice, there was a clear-cut separation of ornithine carbamoyl-transferase-positive and -negative cells. These were present in very variable proportions in different liver lobes and different animals. Preliminary studies were also carried out using a high pH reaction mixture to detect the abnormal enzyme. These studies demonstrate conclusively the X-linkage of ornithine carbamoyltransferase in mice, showing the mosaic pattern of distribution predicted by the Lyon hypothesis. They show that the Spf strain of mice can be used for studies of both development and tumorigenesis in the liver, and that histochemical study of an animal strain with an X-linked enzyme abnormality provides a powerful investigative tool. PMID- 6863019 TI - Cytochemical changes in the nucleus during tumour development. AB - The general background to tumour analytic work using quantitative optical cytochemical methods is first presented. An instrument complex, constructed especially for multiparameter work in cytopathological material has been developed. Nuclear changes have been followed in cell populations during their development through different grades of atypia to cancer and conspicuous cytochemical changes were observed. In a comprehensive series of clinically verified mammary carcinomas, a large percentage of cases was found in which the DNA values were within the normal range, while the others showed pronounced aneuploidy. A clear correlation was found between DNA profile-type and patient survival, the latter of which reflects the degree of malignancy in the individual case. The shift from resting state (G0) to growth activated G1-stage is initiated by a large increase of the nuclear proteins. Mammary tumours of a high malignancy grade, as judged by their DNA profile type, showed an especially great accumulation of nuclear protein and thus a high degree of activation. DNA-profile measurements, preferably combined with determinations of nuclear proteins can thus be used for judging malignancy grades in mammary tumours, which is also of considerable clinical interest. An as yet limited observational material also indicates similar situations in some other types of tumour. PMID- 6863021 TI - Rastafarians in Britain: a preliminary study of their food habits and beliefs. PMID- 6863022 TI - The nutritive contribution of school dinners and other mid-day meals to the diets of schoolchildren. AB - In a dietary study of 112 Cambridge families, 191 primary and secondary school children kept 7-day records of measured food consumption. Of 955 weekday lunches recorded, 533 (56 per cent) were school dinners. School dinners provided less than one quarter of the recommended daily amount (RDA) for energy, iron and riboflavin, and less than one third of the RDA for protein, calcium, thiamin and ascorbic acid. School dinners provided a smaller proportion of a day's nutrient intake than did other mid-day meals. Total energy intakes were lower on school dinner days than on other week-days. Children from lower income families had larger school dinners and obtained a larger proportion of their daily nutrient intake from school dinners than did children from higher income families. School dinners played their most important nutritional role in the lower income families. PMID- 6863023 TI - Effect of large doses of ascorbic acid in man on some nitrogenous components of urine. AB - Base-line values for the excretion of urea N, amine N, creatinine, uric acid and cysteine were measured in three consecutive 24-h urine collections from 16 healthy volunteers. The subjects then took 1 g ascorbic acid three times a day after meals for 7 days. Twenty-four hour urine samples were collected on the 1st, 3rd, 5th and 7th days of the study. Where possible, a further 24-h sample was collected a minimum of 10 d after the end of the study. Administration of 3 g/d of ascorbic acid had no effect on urine volume, pH or the excretion of urea, amino N or creatinine. It caused a transient increase in uric acid excretion but an immediate and sustained increase in the excretion of cysteine. This study provides no evidence for an effect of high doses of ascorbic acid on urinary stone formation but does suggest competition for important co-factors in the metabolism of drugs. PMID- 6863024 TI - Conducting and reporting studies on human energy intake and output: suggested standards. PMID- 6863025 TI - Dietary epidemiology and gastrointestinal cancer. PMID- 6863026 TI - Some effects of a food supplement in elderly hospital patients: a longitudinal study. AB - The effect of giving a food supplement for 12 weeks to 12 elderly, clinically stable, patients was investigated longitudinally. During the period of supplementation, the mean grip strength, whole blood and plasma ascorbic acid concentration, serum and red cell folic acid and plasma vitamin D concentrations increased, and decreased when the supplement was stopped. Thiamin status, as indicated by the red cell 'TPP value', also increased in response to the supplement and decreased when the supplement was stopped. It is concluded that a food supplement of the type given in this study could be useful in preventing nutrient deficiencies in old people. PMID- 6863027 TI - Delayed hypersensitivity skin reactivity of patients with Crohn's disease: relationship with percentage ideal body weight and change after surgery. AB - Protein-energy malnutrition is common in patients with inflammatory bowel disease requiring surgery. Increased morbidity from sepsis may be associated with pre operative weight loss due to associated diminished cellular immune defence mechanisms. Eighteen patients with Crohn's disease requiring elective abdominal surgery were divided into three nutritional groups before and after surgery, defined by their weight loss. The groups were well matched for other clinical variables. Delayed hypersensitivity skin reactivity to multiple antigens was measured before operation and during convalescence. The delayed hypersensitivity skin reactivity was depressed in the malnourished patients both pre-and post operatively, although clinical outcome from surgery was not affected by nutritional status. PMID- 6863028 TI - The rate of nitrogen metabolism in the whole body of man measured with [15N] glycine and uniformly labelled [15N]-wheat. AB - Seven fed volunteers were given either [15N]-glycine or uniformly labelled [15N] wheat. The rate of nitrogen flux (turnover) in the whole body was estimated independently from the excretion of label in ammonia and urea over the following 12 h. The estimates obtained from urea took account of isotope retained within the body pool of urea at the end of the period of measurement. When [15N]-glycine was administered the rate of nitrogen flux based on the excretion of label in ammonia was, with one exception, less than that based on urea. In contrast, when 15N-labelled wheat was given the calculated rate of flux from ammonia was always higher than that from urea. Correlation of these differences was achieved by assuming a two-pool model for metabolic nitrogen in the body. The results suggest that, in the absorptive state at least, glycine is a satisfactory tracer for measuring rates of nitrogen metabolism. PMID- 6863029 TI - External adrenergic innervation of the three neuron types of Dogiel in the plexus myentericus and the plexus submucosus externus of the porcine small intestine. AB - For the simultaneous demonstration of intramural enteric ganglion cells and the adrenergic nerve fibres in the porcine small intestine a combined histochemical method was developed using a hypertonic solution, the main chemicals of which were glyoxylic acid, Nitro-BT and NADH. By means of the enzymatic histochemical method reaction for the NADH-dependent dehydrogenase activity with Nitro-BT as an electron acceptor, the identification of the three neuron types of Dogiel (i.e. type I, type II, type III) was for the first time realized in relation with the glyoxylic acid induced fluorescence (GIF) of the plexus myentericus (Auerbach) and the plexus submucosus externus (Schabadasch). Besides the close topographic relationship between the adrenergic varicose axons on the one hand and the perikarya and dendrites of the multidendritic uniaxonal type I cells characterized by radially oriented short and lamellar dendrites and the multidendritic uniaxonal type III cells, characterized by radially oriented long and tapering dendrites on the other hand, it is striking that for the adendritic multiaxonal type II cells the fluorescent varicose fibres adhere closer to the cell bodies and their processes. In principle, the relation between adrenergic varicose axons and neuron types is identical in plexus myentericus (Auerbach) and plexus submucosus externus (Schabadasch), yet with the exception that in the latter no type I neurons are observed. PMID- 6863030 TI - Elemental composition of the dense bodies of rat platelets determined by electron probe x-ray microanalysis of freeze-substituted sections. AB - A semiquantitative x-ray microanalytical study was made of dense bodies in rat and human blood platelets prepared by freeze substitution. After the freeze substitution, electron dense bodies containing 5-hydroxytryptamine(5-HT) were well preserved. Electron probe x-ray microanalyses clearly defined species differences in the cations of dense bodies of rat and man. Direct calculation of elemental concentration ratios demonstrated a high level of Mg, with lesser amounts of K and Ca in rat, while there was a negligible level of Mg in man but a high amount of Ca. These results indicate that freeze-substitution is a suitable preparation for the study of diffusible electrolytes which may open the way to quantitative analysis using appropriate standards for analytical electron microscopy of resin sections. PMID- 6863031 TI - Precursors of monoamine-storage organelles in developing megakaryocytes of the rat. AB - Identification and distribution of the precursors of amine-storage organelles in rat megakaryocytes during cell maturation were studied, using the uranaffin reaction for adenine nucleotide. The precursors of the amine-storage organelles appeared as 200-300 nm vesicles having an uranaffin electron dense granule, whereas they appeared as empty vesicles by conventional glutaraldehyde-OsO4 fixation. X-ray probe microanalysis confirmed the existence of U and P in the uranaffin reaction positive vesicles. The precursors appeared in the immature megakaryocytes, especially at the trans(mature) face of the Golgi apparatus, and rapidly increased in number in the maturing cells. The size of the uranaffin granules in the precursor organelles increased gradually during cell maturation and became almost equivalent to the dense body of blood platelets in the final stage of cell maturation. PMID- 6863032 TI - Changes in alkaline phosphatase activity in rabbit articular cartilage associated with ageing and joint contracture. AB - Changes in alkaline phosphatase (ALPase) activity in rabbit articular cartilage induced by joint contracture were studied by light and electron microscopy. The knee joint was plaster-immobilized for 3--9 weeks in the flexion position. Three different age groups of rabbits were examined, at the age of 1 month (young), 1 year (adult), and over 2.5 years (old). ALPase activity was detected in the cartilage taken from the distal end of the femur, employing the lead citrate method. Positive activity was primarily localized in the plasma membrane of the chondrocytes and also in the pericellular matrix vesicles. Before immobilization the positive cells were distributed exclusively in the deep zone of the cartilage, whereas after immobilization activity was present in cells both in the middle and deep zones. This phenomenon was most evident in the old group. PMID- 6863034 TI - Cytofluorometric nuclear DNA-determinations in infant, adolescent, adult and aging human hearts. AB - The progress of polyploidization in the human heart muscle cell was investigated by cytofluorometry, involving selective measurements of heart muscle cell nuclei. Thirty-two tissue samples, taken from the free wall of the left ventricle of each autopsied heart, were fixed in Carnoy's fluid. From thick (100--150 micrometers) paraffin sections, isolated cells for smears were obtained by enzyme digestion and ultrasonic treatment. The smears were stained with azocarmin G to eliminate background fluorescence and subsequently stained by an acriflavine-Feulgen reaction. Cytofluorometric DNA-determinations were carried out selectively on heart muscle cell nuclei, using the muscle striations revealed by azocarmin g fluorescence as specific markers. The dynamic process of polyploidization in normal hearts could be divided into four stages. In the first stage (under 1 year of age), almost all heart muscle cell nuclei (94.3 +/- 1.8%) were diploid. In the second stage (1 to 9 years of age), the number of tetraploid nuclei increased (13.6 +/- 7.1%). In the third stage (9 to 22 years of age), octaploid nuclei first appeared and the number of tetraploid nuclei increased (26.7 +/- 3.9%). The DNA pattern in the fourth stage (22 to 75 years of age) was relatively constant, with a ratio of diploid (62.4 +/- 8.7%), tetraploid (31.4 +/- 6.7%) and octaploid (5.8 +/- 3.9%) nuclei. From these results it was concluded that physiological polyploidization progresses in proportion to the increase of heart weight. The frequency of polyploid nuclei in human heart was not so high as reported by previous investigators. PMID- 6863033 TI - Quantitative X-ray microanalysis of semi-thick cryosections. AB - Methodological aspects of quantitative X-ray microanalysis of semi-thick cryosections (2--6 micrometers) of biological soft tissue were investigated. The preparation of a low background specimen holder is described. Scanning and scanning transmission images of the sections could be obtained, allowing identification and separate analysis of nuclei and cytoplasm. Parallel observations of histochemically stained adjacent sections in the light microscope allowed correlation of the microanalytical data with tissue morphology and histochemistry. Quantitative analysis could be carried out with the help of a standard: a gelatin/glycerol matrix containing mineral salts in known quantities, frozen and sectioned in the same way as the specimen. Mass loss under the electron beam was found to be comparable in specimen and standard. Comparison of various theoretical models for quantitative analysis showed that the 'P/B-method' (determination of the background intensity under the characteristic peak) is the most suitable for semi-thick sections. Factor determining the choice of accelerating voltage were analyzed. The usefulness of this specimen type is illustrated in some biological applications (human oral mucosa, rat salivary gland). PMID- 6863036 TI - Tetracycline cathodoluminescence in bone, dentine and enamel. AB - The emission of light under electron bombardment (cathodoluminescence-CL) in an SEM has been demonstrated from tetracycline and tetracycline labelled areas of bone, dentine and secretory and maturation zone enamel. CL images could be compared with backscattered (BSE) and secondary (SE) electron images in (a) fresh, air-dried or freeze-dried samples taken without fixation at a short term after labelling: (b) polished block faces of fixed, plastic embedded tissue and (c) cut section surfaces cut through fixed and unfixed tissue. These results indicate a considerable future potential for the tetracycline-CL-SEM mode in experimental studies on teeth and histopathological and growth studies of bone. PMID- 6863035 TI - Simultaneous ultrastructural localization of serotonin and cholinesterases in Mytilus byssal retractor muscle (A.B.R.M.). AB - Ultrastructural localization techniques for cholinesterases (ChE) by the Karnovsky method, for monoamines by the technique of Wood, and Tranzer and Richards, and for 5HT by the technique of Wood, were performed on the anterior byssal retractor muscle of Mytilus. Simultaneous ultrastructural localization of 5HT and ChE was obtained by the use of the false neurotransmitter 5,6-DHT, followed by the method of Karnovsky for ChE. The glio-interstitial tissue presents a constant ChE activity, mainly localized on the plasma membrane, even in those processes which accompany tryptaminergic (5HT containing) neurites. Muscle cell membrane also reacts positively to the Karnovsky method. The tryptaminergic neurites themselves do not show any ChE activity; they contain dichromate reactive large (100 nm) dense cored vesicles. The presence of differentiated tryptaminergic neuromuscular junctions, suggested by other authors, is established. It was not possible to distinguish classes of nerve endings by the typology of their vesicular content. It is concluded that one can reasonably plan to study the effect of glial ChE inhibition on the physiology of the tryptaminergic (relaxing) response of the A.B.R.M. to nerve stimulation. PMID- 6863037 TI - [Methodological critical studies of taste using chemical stimuli]. AB - Two methods of the chemical examination of taste were compared in view of its practicability. The "Three-Choice-Technique" is most profitable for the clinical use. It is carried out easily and quickly, and the results permit a sufficient and exact estimation of the taste sensitivity. The "Assorting-Technique" seems to be less useful. It provides lower thresholds, but the expense is higher. The Three-Choice-Technique, the special concentration sequences and the ascertained normal threshold for the four basic taste qualities enable a better registration of taste disturbances, at which side differences are of no consequence. PMID- 6863038 TI - [A deglutition stutterer. Contribution on psychogenic inability to swallow]. AB - Description of a patient of 63 years who developed since the age of 50 years cloni of the tongue and a contraction of the hypopharyngeal muscles in the moment of deglutition. This leads to an inanition and exsiccosis. The patient becomes dependent from infusions. The psychical exploration discovers pharyngeal spasmes in the youth which reappeared in the higher age in stress situation. The patient learned the introduction of a nasal tube for liquids. The association of physio- and psychotherapy leads to a harmonization of the personality but the autonomic troubles of deglutition did not disappear completely. PMID- 6863039 TI - [Shape and position of the jugular foramen (jugular fossa) of the carotid canal and the stylomastoid foramen and their postnatal position changes]. PMID- 6863040 TI - Mitral valve E point to septal separation as an index of left ventricular function in chronic aortic regurgitation. PMID- 6863041 TI - Key-free compression hip screw in the treatment of intertrochanteric fractures with early weight-bearing: a clinical study. PMID- 6863042 TI - Patient isolation practices at a community hospital. PMID- 6863043 TI - Ergotamine withdrawal causing "rebound headache'. PMID- 6863044 TI - Portable nocturnal penile tumescence monitoring in evaluating impotence. PMID- 6863046 TI - Microsurgical tubal reanastomosis in a community hospital: report of a 3-year study. PMID- 6863045 TI - Pediatric urolithiasis: report of a case. PMID- 6863047 TI - Nifedipine in the treatment of dysmenorrhea. PMID- 6863048 TI - Sexual anhedonia: disorders of sexual desire. PMID- 6863049 TI - Prostaglandins and menstrual blood loss. PMID- 6863050 TI - Carcinoma of the fallopian tube: a case report. PMID- 6863051 TI - Combined intrauterine and ectopic pregnancy diagnosed by ultrasonography: report of two cases. PMID- 6863052 TI - Nonrecurrent pseudotumor cerebri in pregnancy: report of case. PMID- 6863053 TI - Multi-dimensional treatment planning: I. Delineation of anatomy. AB - We discuss the scope of a multi-dimensional treatment program designed to assist in planning radiation therapy. It includes: synthesis of diagnostic information; techniques for the assessment and delineation of anatomy; fully three-dimensional simulation of therapy; calculation and assessment of dose distributions; verification of treatment delivery; and assessment of the patient during and after treatment. In this paper we present details of techniques for the assessment and delineation of anatomy, including the display of CT information in three dimensions and the ability to draw on and edit the image displays. PMID- 6863054 TI - Multi-dimensional treatment planning: II. Beam's eye-view, back projection, and projection through CT sections. AB - Three features of a fully three-dimensional treatment planning program are presented: (1) The beam's-eye-view provides the user with an accurate reproduction of anatomic features from the viewpoint of a treatment source. The source can be moved to any feasible position relative to the patient, permitting a choice which allows sensitive organs to be excluded from the beam. In this view a field defining aperture can readily be designed. (2) Back-projection of such an aperture shows the parts of the original transverse CT sections, or reconstructed sagittal or coronal sections, which may be covered by the selected beam. (3) Projection through the CT data from any desired origin provides an alignment film simulation which can be used to confirm accuracy of treatment, as well as help establish anatomic relationships relative to the margins of a treatment field. PMID- 6863055 TI - Treatment of advanced cancers of the cervix uteri with external irradiation alone. AB - The five year survival rates of 150 patients who were treated by external irradiation alone for cancers of the cervix uteri are presented. Intracavitary radium therapy had been rejected as inappropriate in all of them on account of the size and type of spread of the tumor. The average age of the selected patients was considerably higher than that of control groups. Results and incidence of side-effects are comparable with those obtained by radium-telecobalt therapy; however, rectovaginal/vesicovaginal fistulas as a reaction to radiation treatment did not occur. PMID- 6863056 TI - Treatment of cervical carcinoma employing a template for transperineal interstitial Ir192 brachytherapy. AB - The development of a template technique at this institution for transperineal interstitial-intracavitary brachytherapy employing Ir192 wire has previously been reported. In this paper we report the results of radiation treatment of 84 women with fresh, primary squamous carcinoma of the cervix admitted to the Los Angeles County--University of Southern California Medical Center from April, 1975 to September, 1979 who received at least one transperineal template implant as part of their initial treatment. The 75 evaluable patients were followed 3 to 60 months, with a median of 17 months. Recurrence rates in the pelvic treatment field by clinical (FIGO) stage grouping were 35.7% (5/14) Stage IB;0% (0/8) Stage IIA; 20% (5/25) Stage IIB; 46.2% (12/26) Stage III; and 0% (0/2) Stage IVA. The overall failure rate within the treatment field was 29.3% (22/75). The non-tumor associated rectovaginal and vesicovaginal fistula rate was 14.3% (2/14) in Stage IB; 0% (0/8) in Stage IIA; 16.0% (4/25) in Stage IIB; 15.4% (4/26) in Stage III; and 0% (0/2) in Stage IVA. The non-tumor associated fistula rate for all stages was 13.3% (10/75). Severe or grade III nonfistulous, delayed adverse effects (proctosigmoiditis, cystitis, vault necrosis) occurred in an additional 6 patients. Thus, 21.3% (16/75) of all evaluable patients experienced severe adverse radiation effects during the follow-up period. Pre-radiation staging laparotomy was performed on 31 patients. It had no obvious effect on the pattern or rate of radiation complications. The role of the interstitial-intracavitary template in the treatment of primary cervical carcinoma is discussed. PMID- 6863057 TI - Clinical data from irradiated growing long bones in children. AB - The growth retardation following irradiation of long bones during childhood has been studied. In 9 patients, irradiation was given for treatment of hemangioma localized in the extremities. In another 13 patients, irradiation was administered because of different malignancies localized either in the long bones themselves or in the soft tissues surrounding the epiphyseal plates. The deficit in growth of the irradiated extremity could, in most of the patients, be assessed at the time when the period of growth was completed. An attempt was made to derive dose-effect curves as a function of the age of the children at the moment of irradiation and the administered irradiation dose. When the parameter used for estimating the radiation effect was the shortening of the irradiated extremity as compared to the unirradiated one, the effect was greater in younger bones. However, when the growth remaining after irradiation was taken into account the age at irradiation did not influence the final effect, the dose of irradiation being the most important factor. PMID- 6863058 TI - The density of mouse lung in vivo following X irradiation. AB - The lungs of mice were irradiated with single X radiation doses of 5 to 14 Gy. Six weeks after irradiation, computed tomographic (CT) scans of the mice were performed at two-week intervals. Beyond 14 weeks after irradiation, the animals were scanned at 1-week intervals. The mice irradiated to 5 and 7 Gy exhibited no change in lung density, in comparison with the unirradiated lungs of control mice up to times of 48 weeks. The mice irradiated to doses of greater than 10 Gy exhibited marked increases in lung density at 15 weeks after irradiation. Increases in density followed a similar time course for these doses, but the magnitude of the density increase was dependent on the radiation dose. An interpretation of these findings in terms of radiation pneumonitis is presented, and the possibility of using CT to monitor lung density in radiotherapy patients is discussed. PMID- 6863059 TI - Late effects of 50 MeV d leads to Be neutron and cobalt-60 irradiation of rhesus monkey cervical spinal cord. AB - The cervical spinal cords of 30 rhesus monkeys were irradiated with 50 MeV d leads to Be neutrons or 60Co gamma rays to evaluate the dose-response relationships for radiation myelopathy. Three groups were treated with 50 MeV d leads to Be neutrons using dosage schedules of 1300 rad n gamma (Group I), 1425 rad n gamma (Group II), or 1550 rad n gamma (Group III) in nine fractions over 29 days. Three groups were irradiated with 60Co gamma rays using dosage schedules of 4620 rad (Group IV), 5390 rad (Group V), or 5940 rad (Group VI) in 22 fractions over 29 days. A significant dose-response relationship was observed for the groups treated with neutrons. Whereas none of the monkeys in Group I showed clinical evidence of neurologic dysfunction, all five animals in Group III became paralyzed. One animal in Group II developed transient neck stiffness and mild unilateral leg paresis. No definitive signs of neurologic injury were seen in any of the animals irradiated with 60Co. The histopathologic changes correlated well with the clinical observations. All of the animals in Group III exhibited moderate to severe malacia and demyelination of the white matter of the cervical spinal cord. The histologic data indicated that the RBE for five times weekly fractionation (approximately 270 rad 60Co fractions) was in the range of 4.2 to 4.6, since the malacia and demyelination in the spinal cords irradiated with 5940 rad of 60Co gamma-rays were greater than that observed in the spinal cords irradiated with 1300 rad n gamma of neutrons but less than the changes in those irradiated with 1425 rad n gamma of neutrons. PMID- 6863060 TI - The effects of preoperative x-irradiation on the survival and blood flow of pedicle skin flaps in the pig. AB - Pedicle skin flaps have been raised from pre-irradiated sites on the flanks of pigs. Radiation treatment was given as a single dose, 6 fractions in 18 days or 30 fractions in 39 days. Surgery was performed at 12, 52 or 104 weeks after irradiation. Control flaps were raised from normal skin on the other flank. The length of flap remaining viable after surgery was shorter in the irradiated than the control flaps. This reduction in flap survival was the same at the three time periods at which it was assessed and for each of the radiation doses selected for the different treatment groups. Clearance rates of an isotope (99mTechnetium) injected intradermally in the distal surviving regions of irradiated and normal flaps were compared. Clearance changes were related to those recorded in normal and irradiated skin before surgery. Isotope clearance in normal flaps was impaired after surgery (days 1-3) but then became faster than in intact skin (days 5-14). A similar pattern of changes was recorded in irradiated flaps only when the pre-operative isotope clearance rates in irradiated skin were similar to that in normal skin (i.e. for all treatment groups at 52 and 104 weeks after treatment). However, when pre-operative clearance was already slower in irradiated than in normal skin (i.e. for a single dose and 6 fraction/18 days after 12 weeks), surgery in the irradiated site did not have the usual effect of slowing the clearance rate. PMID- 6863061 TI - Magnetic induction heating of tissue: numerical evaluation of tumor temperature distributions. AB - A one dimensional (radial) numerical model based on the bioheat transfer equation has been developed and applied to the abdomen and pelvis heated by a concentric magnetic induction electrode. This model consists of four normal tissue regions: viscera, muscle, fat and skin. Each region is assigned thermal properties characteristic of that region and power deposition values consistent with those for this mode of heating. Tumors of 2, 4 and 7 cm thicknesses are positioned in five different radial locations ranging from the central axis to the skin surface. Two blood perfusion models of the tumor are considered: the uniformly perfused model and an annular model. Tumor temperature distributions are considered acceptable if the average tumor temperature plus and minus two standard deviations lie between 42 degrees C and 60 degrees C. To stimulate practical clinical restrictions, muscle and fat temperatures are not allowed to exceed 44 degrees C, significant portions of the viscera (except for a 1 cm thick band) are not allowed to exceed 42 degrees C, and the total absorbed power required to maintain steady state cannot exceed one kilowatt. Over 100 possible cases are presented in a compact form. A conclusion drawn from this study is that with few exceptions, only small tumors in the muscle annulus are heated adequately with this modality. Large tumors will have significant unheated portions if the specified limitations are not exceeded. While this heating modality can raise the necrotic core of a tumor to high temperatures, it cannot adequately heat well perfused regions of a deep seated tumor. These conclusions are borne out clinically and are discussed in a companion paper. PMID- 6863062 TI - Power deposition patterns in magnetically-induced hyperthermia: a two-dimensional low-frequency numerical analysis. AB - The electric fields and power deposition patterns generated in two-dimensional inhomogenous models exposed to the axially directed uniform magnetic fields of an infinitely long solenoid are calculated numerically. The fields are calculated using the method of moments (Galerkin procedure) with linear basis and weighting functions. This low-frequency analysis is useful for studying the power deposition patterns attributable to solenoidal inductive applicators operated at frequencies up to 13.56 MHz. For the models we have studied, the ratio of power per volume deposited into the tumor to power per volume deposited into the immediately surrounding tissue is largest for tumors in the lung, although the power per volume deposited into the outermost layer is still much larger than the power per volume deposited into the tumor; it may be possible, however, to cool this region adequately from the body surface. When the complex permittivity of the tumor model is similar to that of the region in which it is embedded, the currents in the torso and tumor circulate primarily around the center of the body, as has been previously calculated for concentric cylinders. When the complex permittivity of the tumor is much greater than the region in which it is embedded, the currents in the tumor circulate primarily around the center of the tumor. PMID- 6863063 TI - The role of CT scanning in the radiotherapy planning of pelvic tumors. AB - In order to assess the place of computed tomography (CT) in radiotherapy planning, the tumor volumes are localized both by conventional techniques and with CT scanning under conditions simulating the radiotherapy. A comparison between the two methods has been made in a group of 55 patients with tumors in the pelvis. CT scanning was found to be of such value in 64% of the treatment series, in improving both the accuracy of localization of the target volume (48% of the patients) and the calculation of the dose distribution (31% of the patients) that its use is recommended during the radiotherapy planning of pelvic tumors. PMID- 6863064 TI - Thermal tolerance to whole body hyperthermia. AB - Thermal tolerance, that is, a reduced sensitivity to a succeeding heat treatment, has been noted in vitro and following local hyperthermia in normal tissues and malignant tumors. However, information is sparse concerning thermal tolerance following systemic hyperthermia, thereby limiting our ability to design optimally fractionated systemic hyperthermia treatment protocols. A technique for reproducibly inducing systemic hyperthermia in the rat is described, and the survival curve for rats exposed at 42.5 degrees C for periods of up to 75 minutes is presented. Using this system, increased survival of rats to systemic hyperthermia at 42.5 degrees C was demonstrated 30 hours after an initial sublethal conditioning exposure (41.8 degrees C for 1 hour). The LD50 (the time of exposure lethal to 50% of the rats) at 42.5 degrees C was increased by a factor of approximately 2 in the animals exposed to the sublethal conditioning. This increase in LD50 demonstrates the development of thermal tolerance to killing by whole body hyperthermia. PMID- 6863065 TI - Treatment of cancer of the cervix with a high-dose-rate afterloading machine (the Cathetron). AB - Two hundred and ninety-one patients with invasive carcinoma of the cervix uteri were treated by a combination of external beam therapy (telecobalt or 4 Mv Linear accelerator) and a high dose-rate afterloading intracavitary apparatus (the Cathetron). All patients have been followed for a minimum of 3 1/2 years. The five year survival rates are: all patients 55%; Stage I, 81%; Stage IIA, 74%; Stage IIB, 40%; Stage III, 27%. Death was directly attributed to treatment in five patients. We found a serious complication rate of 3% for all patients treated, the major problem being radiation ileitis. It is concluded that high dose-rate treatment offers comparable results to conventional radium therapy; the choice between high and lose dose-rate afterloading systems depends on the number of patients needing treatment and associated economic factors rather than any intrinsic radiobiological advantage of either system. PMID- 6863066 TI - Radiofrequency hyperthermia: the design of coil transducers for local heating. AB - Simple and complex coils have been designed and built for use as radiofrequency transducers for local and regional hyperthermia. The heating from such coils is produced by currents generated in the dielectric by the electromagnetic field radiated from the coil elements. The heating rate profile, as a function of phantom depth, is dependent upon the size and geometry of the coil, its proximity to the dielectric, and the transducer current. Since the fields of simple pancake coils are inhomogeneous, either complex geometries or some method of smoothing is required. A simple solution is to move the coil over the region to be heated or to use multiple applicators. However, many satisfactory heating patterns have been derived for stationary coils designed to heat well-defined subcutaneous volumes to a depth of 3-5 cm. Thermometry studies in static saline-gelatin phantoms demonstrate extensive heating ranges and flexibility since the coils couple with the dielectric through air. PMID- 6863067 TI - Apples and oranges in seminoma: a comparison of U.S.A. and Canadian experience. PMID- 6863068 TI - Treatment of advanced cancer of the cervix with transperineal interstitial irradiation. AB - A pilot study using transperineal interstitial implantation to the parametrium in patients with locally advanced carcinoma of the cervix or with distorted anatomy is presented. Twenty-one consecutive patients (2 cervical stump Stage IB, 3 Stage IIB, 15 Stage IIIB, 1 Stage IVA) received one (12) or two (9) implants following 40-45 Gy whole pelvis external irradiation. In addition 8 patients underwent staging laparotomies concurrently with the first implant procedure. Control of the pelvic tumor was accomplished in 18 of 21 patients (85%) with a mean follow up of 26 months (range 15 to 48 months). Seven patients (33%) developed long term complications (fistula 3, superficial necrosis of the vagina 1, severe proctitis or cystitis 3). Six of the complications occurred in 8 patients (75%) who had radioactive sources placed on the surface of the vaginal obturator as a substitute for the lack of tandem. In contrast, only 1 in the remaining 13 patients (8%) who did not have obturator sources placed, developed long term complications. PMID- 6863069 TI - Conventional fractionated radiotherapy for 51 patients with lentigo maligna and lentigo maligna melanoma. AB - Lentigo maligna (LM) and lentigo maligna melanoma (LMM) are distinct entities from other forms of melanoma, occurring predominantly on the skin of the head and neck in elderly people, having a slow growth rate and a low metastatic potential (10%). Twenty-three patients with LM were treated with conventional fractionated irradiation, 18 were locally controlled and two failed locally both of whom, however, were salvaged with further treatment. Three patients are not evaluable because of short follow-up time. Median time to complete regression of the lesion is seven months. Twenty-eight patients with LMM have been irradiated, 23 are locally controlled, two locally recurred (both retrieved with subsequent treatment), and three are inevaluable because of short follow-up time. One patient with a level 5 LMM has developed regional and distant metastases. It is concluded that irradiation is a simple effective method of treatment for this form of melanoma. PMID- 6863071 TI - Response of mouse lung to irradiation at different dose-rates. AB - Groups of LAF1 mice were given thoracic irradiation using 60Co gamma-rays at dose rates of 0.05 Gy/min (LDR) or 1.1 Gy/min (HDR) and the death of the animals was monitored as a function of time. It was found that the time pattern of animal deaths was similar for the two different dose-rates. Dose response curves for animals dying at various times up to 500 days after irradiation were calculated and the LD50 values determined. The curves for the LD50 values, plotted as a function of the time at analysis for treatment at HDR or LDR, were essentially parallel to each other but separated by a factor (LDR/HDR) of about 1.8. This indicates that the sparing effect of LDR treatment is the same for deaths occurring during the early pneumonitis phase or during the late fibrotic phase of lung damage. The available information on the response of patients to whole thoracic irradiation, given for either palliation or prior to bone marrow transplantation, suggests that for similar dose-rates to those studied here the ratio (LDR/HDR) is only 1.2-1.3. This difference between the animal and human data may reflect the modifying effect of the large doses of cytotoxic drugs used in combination with the irradiation of bone marrow transplant patients. PMID- 6863073 TI - "Thermal mapping" in experimental cancer treatment with hyperthermia: description and use of a semi-automatic system. AB - The regions of tumor which are least adequately heated during experimental hyperthermia treatments will most likely determine the ultimate probability of tumor control. Temperature inhomogeneity during local or regional hyperthermia is often marked, and stationary temperature probes yield very little information about the adequacy or inadequacy of tumor heating. Fine catheters can be placed through the tumor bearing region and temperatures recorded at various points within these catheters, thus yielding valuable data about temperature variations within the volume of interest. The "thermal mapping system" (TMS) described herein provides a method for remotely sampling these temperature variations in a semi-automatic manner in several catheters simultaneously. Its application in conjunction with a commercial hyperthermia system is described and clinical examples of its use and importance are provided. PMID- 6863072 TI - RBE of spleen CFU-S to low dose rate Cf-252 or photon radiation in vivo. AB - The biological effects of low dose rate (LDR) Cf-252 radiation were compared to LDR Cs-137 photon radiation and acute 60Co radiation. The RBEn for endogenous CFU S in vivo was 2.1 for neutron radiation at a dose rate of 9.9 cGy/hr of Cf-252 radiation. The value was consistent with previous in vitro experiments where a value of 2.1 was found. For the low doses and low dose rates studied, we tested an acute assay dose following the LDR irradiation to determine dose-effect and RBEn. Organ size shrinkage and regeneration patterns after LDR Cf-252 and Cs-137 were also studied and showed greater growth delay for Cf-252 irradiated lympho hemopoietic tissues. PMID- 6863074 TI - Iso-effect tables and therapeutic ratios for epidermoid cancer and normal tissue stroma. AB - Available literature on radiation injury to normal tissue stroma and ablation of epidermoid carcinoma was surveyed. Computer programs (RAD3 and RAD1) were then used to derive cell kinetic parameters and generate iso-effect tables for the relevant tissues. The two tables provide a set of limiting doses for tolerance of normal connective tissue (16% risk of injury) and for ablation of epidermoid cancer (16% risk of recurrence) covering a wide range of treatment schedules. Calculating the ratios of normal tissue tolerance to tumor control doses for each treatment scheme provides an array of therapeutic ratios, from which appropriate treatment schemes can be selected. PMID- 6863070 TI - Prognostic factors of inoperable localized lung cancer treated by high dose radiotherapy. AB - A retrospective study was made of the results of high dose radiotherapy (greater than or equal to 50 Gy) given to 171 patients with inoperable, intrathoracic non small cell lung cancer from January 1971-April 1973. Local control was dependent on the total tumor dose: after one year local control was 63% for patients treated with greater than 65 Gy, the two year local control was 35%. If treated with less than 65 Gy the one year local control was less than or equal to 40%. Tumor doses correlated with the size of the booster field. If the size of the booster field was less than 100 cm2, the one year local control was 72%; the two year local control was 44%. Local control was also influenced by the performance status, by the localization of the primary tumor in the left upper lobe and in the periphery of the lung. Local control for tumors in the left upper lobe and in the periphery of the lung was about 70% after one year, and about 40% after two years. The one and two years survival results were correlated with the factors influencing local control. The dose factor, the localization factors and the performance influenced local control independently. Tumors localized in the left upper lobe did metastasize less than tumors in the lower lobe, or in a combination of the two. This was not true for the right upper lobe. No correlation between the TNM system, pathology and the prognosis were found. PMID- 6863075 TI - Gold medal acceptance speech: comprehensive patient care in radiation therapy practice. PMID- 6863076 TI - Ependymomas of the spinal cord. AB - Many patients with spinal cord ependymomas (SCE) undoubtedly benefit from post operative radiation therapy; however, because of the wide variability in the total doses given, the optimal post-operative dose for SCE remains unclear. Several recent papers recommend total doses of 4000 rad to 5000 rad in 4 1/2 to 6 weeks. Unfortunately, only a small number of patients reported in the literature have been consistently treated to these high dose recommendations. Nine consecutive adult patients with SCE have been treated in a consistent way at Yale New Haven Hospital with total doses of approximately 4500 rad to 5000 rad at 180 rad to 200 rad per day. The acute and chronic morbidity from such treatment has been minimal and no patient has had a local recurrence at 8 months to 8 years following treatment. PMID- 6863077 TI - Patterns of recurrence in adenocarcinoma of the rectum and rectosigmoid treated with surgery alone: implications in treatment planning with adjuvant radiation therapy. AB - This is an analysis of 140 patients with adenocarcinoma of the rectum and rectosigmoid treated with surgery alone at the University of Florida between May 1959 and April 1976. Patients in the study group had a complete resection, as determined by the surgeon and the pathologist, and no evidence of distant metastasis at the completion of the operation. There is a 5 year minimum follow up. Local-regional recurrence rates were noted to vary with histologic grade, length of the lesion, and pathologic stage. Approximately 60% of local-regional and distant recurrences were noted by 2 years after treatment, and 92-95% were noted by 5 years. Evaluation of patient status at 5 years revealed that 0% (Stage CIS), 0% (A), 17% (B1), 13% (B2), 17% (C1), and 28% (C2) had developed local regional recurrence without demonstrable distant metastasis. Complications and crude 5 year survival rates are presented and current treatment modifications discussed. PMID- 6863080 TI - Effect of background loads on the perception of added loads to breathing. AB - Using open-magnitude scaling, we compared the perceived magnitude of externally added resistive and elastic loads to breathing in normal subjects with that perceived when the background load (i.e., the minimum load of the circuit) was increased by the addition of either resistive or elastic loads of increasing magnitude. The study was carried out over four experimental sessions. After a control experiment (no added background load), the background load was increased by the addition of either a resistive or an elastic load for a duration of 3 min. The perceived magnitude of a further series of loads, proportionately increased, was then ascertained. This sequence was then repeated after a further increase in background. The results showed that the perceived magnitude of the load was closely related [mean r = 0.96 +/- 0.01 (SE)] to the magnitude of the physical stimulus expressed as the peak inspiratory pressure by a power function relationship in keeping with Stevens' law. After the increases in background resistance or elastance, there were no significant differences in either exponents or intercepts compared with basal conditions. There was no significant difference in the perceived magnitude of the loads after adaptation. At the smallest load, the perceived magnitude was less than expected from the control experiment. However, this reduction did not reach statistical significance. In the special senses, moderate-to-large stimuli show little change after adaptation, whereas small stimuli are reduced. Although not conclusive, we suggest that the relationship is similar with loaded breathing. PMID- 6863078 TI - Barometric pressures at extreme altitudes on Mt. Everest: physiological significance. AB - Barometric pressures were measured on Mt. Everest from altitudes of 5,400 (base camp) to 8,848 m (summit) during the American Medical Research Expedition to Everest. Measurements at 5,400 m were made with a mercury barometer, and above this most of the pressures were obtained with an accurate crystal-sensor barometer. The mean daily pressures were 400.4 +/- 2.7 (SD) Torr (n = 35) at 5,400 m, 351.0 +/- 1.0 Torr (n = 16) at 6,300 m, 283.6 +/- 1.5 Torr (n = 6) at 8,050 m, and 253.0 Torr (n = 1) at 8,848 m. All these pressures are considerably higher than those predicted from the ICAO Standard Atmosphere. The chief reason is that pressures at altitudes between 2 and 16 km are latitude dependent, being higher near the equator because of the large mass of cold air in the stratosphere of that region. Data from weather balloons show that the pressure at the altitude of the summit of Mt. Everest varies considerably with season, being about 11.5 Torr higher in midsummer than in midwinter. Although the mountain has been climbed without supplementary O2, the very low O2 partial pressure at the summit means that it is at the limit of man's tolerance, and even day-by-day variations in barometric pressure apparently affect maximal O2 uptake. PMID- 6863079 TI - Force and duration of muscle twitch contractions in humans at pressures up to 70 bar. AB - The contraction peak force (CPF) and contraction time (CT) of the soleus Hoffmann (H) reflex and motor (M) response muscle twitch were measured in three subjects during the 686-m seawater Atlantis III simulated dive at Duke University. The mean CPF of both H and M twitches was observed to be 40-60% larger during compression than in predive control studies (P less than 0.001 for M response). This effect was sustained during the first 300 m of decompression, while postdive values were normal. Rate of contraction, as measured by changes in CT, was slowed significantly but only during compression (by 23% in the H reflex at 66.4 bar, P less than 0.001). These marked effects in CPF and CT cannot be explained by the small increases observed in the muscle action potential latency and duration, or other neuronal mechanisms. It is concluded that the twitch contraction of skeletal muscle is significantly slowed and augmented at pressure due to changes in excitation-contraction coupling or in the contractile process itself. These findings may be of importance in interpreting the etiology of many neuromuscular signs of the high-pressure neurological syndrome. PMID- 6863081 TI - Comparative aspects of the dynamics of breathing in newborn mammals. AB - Static and dynamic properties of the respiratory system have been studied in anesthetized, tracheostomized newborns of six species, ranging in size from rats to piglets. Respiratory system compliance (Crs), total resistance of respiratory system (Rrs), and expiratory time constant (tau) have been measured in the paralyzed passively ventilated animals. Crs is found to be proportional to body weight (BW0.80) and Rrs to BW-0.75; tau is independent of body size, the shortest value being in kittens and guinea pigs and a value of about 0.14 s in the other species. Including the upper airway resistance, tau becomes approximately 0.22 s. This value is similar to the expiratory time of the fastest breathing species; therefore in the smallest species the high breathing rate can be regarded as a mechanism to raise end-expiratory level. On a few occasions, dynamic lung compliance and pulmonary resistance, measured in spontaneously breathing kittens, puppies, and piglets were, respectively, smaller and larger than Crs and Rrs, suggesting that the hysteresis of the pressure-volume curve may be substantial. Rrs was almost linear within the volume and flow range investigated, with the Rohrer's constant K2 always being less than 2.5% of K1. The Reynolds number increases with body size (alpha BW0.51) more than is predictable from the changes in tracheal diameter, since the tracheal flow velocity is not an interspecific constant. PMID- 6863082 TI - Dysanaptic lung growth: an experimental and allometric approach. AB - The postnatal development of the mammalian lung, which at birth has only a fraction of the adult number of alveoli, would suggest a mismatch (dysanapsis) of the changes in airway size and lung size with growth. This may have implications on the efficiency of breathing because for any given lung size the dimensions of the airways are the determinant of the amount of dead space (VD) ventilation and of airflow resistance. A comparison of the allometric functions of tracheal dimensions previously published suggests that the tracheal volume, taken as representative of VD, is smaller in newborns than in adults. This difference becomes more apparent when examined per unit of functional residual capacity (VD/FRC). The relatively smaller tracheal volume is the result of both a shorter and narrower trachea in the newborn. This latter difference implies a slightly but significantly higher resistance of the lower airways, as also demonstrated by experimental measurements of peak expiratory flows at a constant driving pressure in rats of different ages. Because the slightly higher resistance of the lower airways is probably compensated by the smaller resistance of the upper airways (J. Appl. Physiol.: Respirat. Environ. Exercise Physiol. 51: 641-645, 1981), it would seem that the structure of the newborn mammalian lung favors the alveolar ventilatory function without a substantial increase of the energetic losses. PMID- 6863084 TI - Lactic acid infusion in dogs: effects of varying infusate pH. AB - This study had two purposes: 1) to determine the effects of varying the pH of lactic acid infusion solutions on the acid-base status of anesthetized dogs, and 2) to determine the effect of elevated blood lactate concentration on muscle lactate concentration. The experiments were performed on the in situ gastro cnemius-plantaris muscle group in 14 mongrel dogs. The infusions increased the arterial blood lactate concentration to 11.0 +/- 0.5 (SE) mM after 20 min. Above an infusate pH of 4.4, the arterial pH increased by 0.118-0.167 during infusion; the arterial pH was unchanged when the infusate pH was between 3.4 and 4.0; and the arterial pH decreased as infusate pH decreased below 3.0. The effect of lactic acid infusion on blood pH appears to be the result of two opposing effects: 1) an acidifying effect due to its weak acid properties, and 2) an alkalinizing effect due to the metabolism of sodium lactate. The estimated ratio between intracellular muscle lactate and venous plasma water lactate averaged 0.647 +/- 0.038, indicative of a substantial gradient between blood and muscle. The infusion produced a significant change from lactate output to lactate uptake by the muscles. The infusion also transiently increased muscle blood flow and oxygen uptake. PMID- 6863083 TI - Effect of hindlimb immobilization on the fatigability of skeletal muscle. AB - The soleus (SOL) and extensor digitorum longus (EDL) muscles of the rat were studied in situ (33.5 degrees C) after 6 wk of disuse atrophy produced by hindlimb immobilization (IM). IM resulted in depressed peak twitch (Pt) and tetanic (Po) tension as well as a decreased rate of tension development (+dP/dt) and decline (-dP/dt) in the slow-twitch SOL. The fast-twitch EDL was affected to a lesser extent, because only Po (g . cm-2) and Po,-dP/dt (g . cm-2 . ms-1) were depressed after IM. Twitch duration, as measured by contraction time and one-half relaxation time, was shortened in the SOL and prolonged in the EDL. In both the fast and slow muscles 30 min of electrical stimulation resulted in a significant decline in Po. Relative to the prefatigued Po, the atrophied and control muscles showed a similar fatigue pattern. This occurred in spite of lower ATP and glycogen concentrations and higher lactate levels in the atrophied muscles. Our results indicate significant impairment of contractile function following IM in fast and slow muscles with preferential alterations in the slow SOL. In addition, despite a lower resting capacity and an increased dependence on glycolysis, contractile properties of atrophied muscles differed little from control muscles in their pattern of response to 30 min of electrical stimulation. PMID- 6863085 TI - Effect of diaphragm contraction on canine heart and pericardium. AB - Pericardiophrenic attachments transmit diaphragm contraction to the pericardium. We investigated this in two ways. 1) We replaced the hearts of externally perfused dogs with a balloon from which we measured pressure changes. Diaphragm contraction increased pressure from 4.6 to 5.5 Torr, equivalent to an isobaric volume decrease of 1.5%, and decreased volumetric compliance by 3%. 2) We selectively servo controlled right atrial pressure, left atrial pressure, or cardiac output in open-chest dogs and monitored the effect of diaphragm contraction on cardiovascular and abdominal pressures, cardiac output, and the volume of blood added to or withdrawn from the circulation to achieve servo control. Diaphragm contraction decreased left atrial pressure 0.4 Torr when right atrial pressure was controlled and right atrial pressure increased 0.2 Torr while controlling left atrial pressure, but there were no significant changes in cardiac output. Atrial pressure did not change significantly when output was controlled. Servo control required removal of approximately 50 ml of blood, presumably reflecting a decreased splanchnic vascular capacity at the higher abdominal pressure. We conclude that the diaphragm may slightly tense the pericardium, but this has no important primary effect on the heart. PMID- 6863086 TI - Respiratory movements of the vocal cords. AB - We examined the movements of the vocal cords during tidal breathing, panting, and large changes in lung volume in 12 normal subjects. The glottis was observed with a fiber-optic bronchoscope, and the glottic image was recorded together with flow, volume, and a time marker onto videotape. Phasic respiratory swings in glottic width (dg) and glottic area (Ag) were reproducible in all subjects but differed substantially between subjects. In the group as a whole dg and Ag increased during inspiration to 10.1 +/- 5.6 mm and 126 +/- 8 mm2 (mean +/- SE), respectively, whereas during expiration the lowest values were 5.7 +/- 0.5 mm and 70 +/- 7 mm2, respectively. These extreme dimensions corresponded closely to the midtidal volume points in the respiratory cycle. Glottic width during vital capacity (VC) expirations was nearly 30% greater at a flow of 1.2 l/s than at 0.5 l/s, but the relationship between dg and lung volume differed between subjects. When swings in dg were minimized by panting, there was no difference in dg between functional residual capacity (FRC) and a volume corresponding to midinspiratory capacity. However, tidal breathing at this lung volume was associated with a 20% decrease in dg compared with breathing at FRC. Our observations indicate a tight coupling between the pattern of glottic movement and the respiratory volume cycle. The results suggest that during voluntary respiratory maneuvers both intrinsic laryngeal and respiratory muscles are recruited, participating as effector organs in ventilatory and respiratory control. PMID- 6863087 TI - Dopamine, dobutamine, and phentolamine effects on pulmonary vascular mechanics. AB - The pressure-flow (P-Q) relationship of the pulmonary vasculature, in an isolated canine lobe perfused under classical zone II conditions, can be characterized by a rectilinear segment at high flow, a curvilinear segment at low flow, and a pulmonary arterial pressure (Ppa) that exceeds alveolar pressure at zero flow. This demonstrates the presence of critical closure in the pulmonary vascular bed. Effects of drugs on pulmonary vascular resistance (PVR) must take the normal P-Q relationship into account. We examined the effect of dopamine (D) and dobutamine (DB), alone and in combination with phentolamine (P), on the slope of the rectilinear segment of the P-Q curve (equivalent to vascular conductance), the extrapolated Ppa intercept (Ppai), and the Ppa at zero flow (Ppaz). Low-dose D (0.4-0.8 mg) and DB (1.0-5.0 mg) did not significantly alter any parameter from control. Higher-dose D (1.2-6.8 mg) and DB (13-38 mg) decreased vascular conductance 32.3 +/- 12.1 (SE) to 50.45 +/- 5.6% (P less than 0.05), and P alone increased conductance 12.0 +/- 2.6% (P less than 0.01) from control with no significant effect on Ppai or Ppaz. The change in conductance with D and DB alone was abolished when either drug was given in combination with P. Ppaz and Ppai decreased significantly from control with DB in combination with P when no significant effect on vascular conductance was noted. The results suggest that lung vessels determining changes in flow resistance are pharmacologically distinct from those subserving critical closure in the pulmonary vascular bed. PMID- 6863088 TI - Secretion of Weibel-Palade bodies observed in extra-alveolar vessels of rabbit lung. AB - We fixed rabbit lungs by perfusion of osmium into the pulmonary artery and examined in light and transmission electron microscopy a large number of extra alveolar vessels with a diameter of 0.1-0.25 mm, with emphasis on Weibel-Palade bodies (endothelial specific granules). Weibel-Palade bodies are organelles specific to endothelial cells. Their function is unknown, but they are useful markers for identification of endothelial cells in culture. We were able to observe release of the content of these bodies into the vascular lumen; this indicates that they are secretory. PMID- 6863089 TI - Molar absorptivities of human hemoglobin in the visible spectral range. AB - In a recent paper, Burkhard and Barnikol (J. Appl. Physiol.: Respirat. Environ. Exercise Physiol. 52: 124-130, 1982) claimed that the absorption spectra of human (oxy-)hemoglobin are dependent on the total hemoglobin concentration (CHb) and it is suggested that this might also be the case with cyanmethemoglobin (HiCN). Such relationships would invalidate the widely used spectrophotometric methods for the determination of total hemoglobin and the fractions of various hemoglobin derivatives in human blood. Although Burkhard and Barnikol's findings are rather improbable considering earlier data, we measured the millimolar absorptivities of oxyhemoglobin (epsilon HbO2) and cyanmethemoglobin (epsilon HiCN) at various wavelengths over a wide range of concentrations (CHb approximately equal to 0.004 10 mmol x 1(-1)), using two different types of spectrophotometers. epsilon HbO2 and epsilon HiCN proved to be independent of CHb. Moreover the values obtained confirmed those in the earlier literature, whereas those of Burkhard and Barnikol are some 30% higher. Consequently there is no reason to doubt the validity of the generally accepted millimolar absorptivities of human hemoglobin. PMID- 6863090 TI - Site of pulmonary hypoxic vasoconstriction studied with arterial and venous occlusion. AB - We applied the arterial and venous occlusion technique in an in situ, isolated left lower lobe preparation of a dog lung to compare the effects of hypoxia with the effects of airway pressure elevation, and the infusion of serotonin, norepinephrine, and histamine. The total arteriovenous pressure drop across the lobe was partitioned longitudinally into pressure drops across the relatively indistensible arteries (delta Pa) and veins (delta Pv) and across the middle distensible vessels (delta Pm). Hypoxia increased primarily delta Pm, as did elevation of airway pressure, whereas the vasoactive drugs increased either delta Pa or delta Pv. The increases in pulmonary arterial pressure (Pa) caused by hypoxia and by elevation of airway pressure were independent of blood flow rate, but increases in Pa induced by the vasoactive drugs were dependent on flow rate. We conclude that in the dog hypoxia acts primarily on small distensible vessels, whereas pulmonary vasoactive drugs constrict the relatively indistensible arteries and veins. It is possible that the increase in pulmonary vascular resistance during hypoxia did not involve smooth muscle contraction. PMID- 6863091 TI - Effect of caffeine on skeletal muscle function before and after fatigue. AB - We studied the effect of caffeine on voluntary and electrically stimulated contractions of the adductor pollicis muscle in five adult volunteers. Caffeine (500 mg) was administered orally in a double-blind fashion. Electrical stimulation of the ulnar nerve was performed at 10, 20, 30, 50, and 100 Hz before and after a sustained voluntary contraction held at 50% of the maximal voluntary contraction (MVC). A brief tetanus at 30 Hz was also performed to calculate relaxation rate in the fresh muscle. Contractile properties, relaxation rate, and endurance were then assessed after caffeine and placebo, as well as the response of the fatigued muscle to different frequencies of stimulation. There was no difference in the maximal tension obtained with electrical stimulation (T100) or in the MVC between placebo and caffeine. The tensions developed with electrical stimulation at lower frequencies increased significantly with caffeine ingestion, shifting the frequency-force curve to the left, both before and after fatigue. Mean plasma caffeine concentration associated with these responses was 12.2 +/- 4.9 mg/l. We conclude that caffeine has a direct effect on skeletal muscle contractile properties both before and after fatigue as demonstrated by electrical stimulation. PMID- 6863092 TI - Cardiovascular responses to exercise as functions of absolute and relative work load. AB - The roles of absolute and relative oxygen uptake (VO2 and percent of muscle group specific VO2 max) as determinants of the cardiovascular and ventilatory responses to exercise over a wide range of active muscle mass have not previously been defined. Six healthy men performed four types of dynamic exercise--one-arm curl, one-arm cranking, and one- and two-leg cycling at four different relative work loads--25, 50, 75, and 100% of VO2 max for the corresponding muscle group. VO2 during maximal one-arm curl, one-arm cranking, and one-leg cycling averaged 20, 50, and 75%, respectively, of that for maximal two-leg cycling. Cardiac output was linearly related to VO2 with a similar slope and intercept for each type of exercise. Heart rate at a given %VO2 max was higher with larger active muscle mass. In relation to %VO2 max, systemic resistance was lower and plasma catecholamine levels were higher with larger active muscle mass. The cardiovascular responses to exercise are determined to a large extent by the active muscle mass and the absolute oxygen uptake, with the principal feature appearing to be the tight linkage between systemic oxygen transport and utilization. PMID- 6863093 TI - Synchronized cycles in ventilation and vocal activity during spontaneous conversational speech. AB - Ventilation was monitored in 10 human subjects during spontaneous conversational speech to determine whether oscillatory patterns in vocal activity were correlated with oscillatory patterns in ventilation. The 10 subjects were studied as five pairs (or dyads), and spontaneous conversation occurred within each dyad. Patterns with cycle times ranging from 16 to 512 s were studied. Of the 10 subjects in this study, 1 subject showed a very striking pattern of mutual entrainment between low-frequency oscillations in ventilation and in vocal activity, 5 subjects showed somewhat weaker coordination between oscillations in ventilation and vocal activity, and the remaining 4 subjects showed little or no coupling between ventilation and vocal activity. Mutual entrainment between rhythms in ventilation and vocal activity can occur, but this study suggests that there may be great differences among individuals in the degree to which ventilation covaries with vocal activity in spontaneous conversational speech. We hypothesize that degree of entrainment is affected both by the strength of any spontaneous ventilatory patterns and by the extent to which any individual's spontaneous ventilatory pattern matches that of his conversational partner. PMID- 6863094 TI - Pulmonary effects of ozone exposure during exercise: dose-response characteristics. AB - Because minimal data are available regarding the pulmonary effects of ozone (O3) at levels less than 0.27 ppm, six groups of healthy young males were exposed for 2.5 h to one of the following O3 concentrations: 0.0, 0.12, 0.18, 0.24, 0.30, or 0.40 ppm. Fifteen-minute periods of rest and exercise (65 l/min minute ventilation) were alternated during the first 2 h of exposure. Coughing was observed at all levels of O3 exposure. Small changes in forced-expiratory spirometric variables [forced vital capacity (FVC), forced expiratory volume in 1 s, and mean expiratory flow rate between 25 and 75% FVC] were observed at 0.12 and 0.18 ppm O3, and larger changes were found at O3 levels greater than or equal to 0.24 ppm. Changes in tidal volume and respiratory frequency during exercise, specific airway resistance, the presence of pain on deep inspiration, and shortness of breath occurred at O3 levels greater than or equal to 0.24 ppm. In conclusion, pulmonary effects of O3 were observed at levels much lower than that for which these effects have been previously described. Stimulation of airway receptors is probably the mechanism responsible for the majority of observed changes; however, the existence of a second mechanism of action is postulated. PMID- 6863095 TI - Changes in relaxation rate with diaphragmatic fatigue in humans. AB - Maximum relaxation rate (MRR) and the time constant of relaxation (tau) of transdiaphragmatic pressure (Pdi) was measured in four male subjects and compared with the high-to-low frequency ratio (H/L) of the diaphragmatic electromyogram (EMG) as a predictor of diaphragmatic fatigue. Pdi and inspiratory time-to-total breath duration ratios (TI/TT) were varied, and TT and tidal volume were held constant; inspiratory resistances were used to increase Pdi. Studies were performed at various tension-time indices (TTdi = Pdi/Pdimax X TI/TT). Base-line MRR/Pdi was 0.0100 +/- 0.0004 (SE) ms-1, and baseline tau was 53.2 +/- 3.2 ms. At TTdi greater than 0.20, MRR and H/L decreased and tau increased, with maximum changes at the highest TTdi. At TTdi less than 0.20, there was no change in H/L, MRR, or tau. The time course of changes in H/L correlated with those of MRR and tau under fatiguing conditions. In this experimental setting, change in relaxation rate was as useful a predictor of diaphragmatic fatigue as fall in H/L of the diaphragmatic EMG. PMID- 6863096 TI - Calorimetry with heat flux transducers: comparison with a suit calorimeter. AB - Regional and total body heat loss rates of human subjects at rest were measured simultaneously by means of an array of heat flux transducers and with a tube suit calorimeter. Conditions ranged from thermal comfort to strong cooling. A high degree of correlation was found between heat loss rates determined by the two independent techniques. For the head and arms, the transducer array system measured less heat loss than the suit. For the torso and legs, measurements by the two methods were equivalent. For the whole body, the transducer system yielded a heat loss rate 87% of the suit calorimeter value. PMID- 6863097 TI - Effect of beta-adrenergic blockade on hyperventilation and exercise tolerance in emphysema. AB - Ventilation, heart rate, and arterial blood gas tensions were measured at rest and during incremental exercise in 10 patients with emphysema after intravenous placebo or 7 mg metoprolol. Metoprolol reduced heart rate by 14% (P less than 0.001) and ventilation by 11% (P less than 0.01), but there was no significant difference in arterial O2 or CO2 tension (Pao2 and PaCO2, respectively). Metoprolol increased the time to exhaustion on a cycle ergometer (P less than 0.05) but did not improve the 12-min walking distance. A double-blind randomized crossover comparison of 4 wk treatment with atenolol (100 mg/day), metoprolol (100 mg/day), or matched placebo was performed in 12 patients with emphysema. Both beta-adrenoceptor antagonists reduced resting heart rate by 33% (P less than 0.001) and resting minute ventilation by 11% (P less than 0.025). There was no change in resting or exercise Pao2 or Paco2. During steady-state exercise on a cycle ergometer, atenolol and metoprolol reduced ventilation by 14 and 4%, respectively. This was accompanied by 11 and 5% reductions in O2 consumption (P less than 0.05) and 13 and 6% falls in CO2 production (P less than 0.05). There were no significant changes in tests of exercise tolerance, but forced expiratory volume in 1 s and forced vital capacity were reduced during beta 1-adrenergic blockade. beta 1-Blocking drugs reduce hyperventilation in emphysema by reducing pulmonary gas exchange without a change in arterial blood gas tensions. Increased airflow obstruction prevents this reduction being of therapeutic value. PMID- 6863098 TI - Esophageal elastance in anesthetized humans. AB - Esophageal elastance (Ees) was measured in 13 human subjects, awake and anesthetized by halothane, in the supine and left lateral postures. Static esophageal pressure was measured by an esophageal balloon catheter, respiratory volumes by pneumotachography, and functional residual capacity (FRC) by body plethysmography. In the supine awake subject, Ees averaged 3 cmH2O/ml at FRC and increased significantly with lung volume. Ees remained unaltered at FRC during anesthesia in the supine position, but lung volume dependence was no longer observed. In the left lateral position the awake subject displayed the same Ees at FRC as in the supine position and lung volume exerted only a small influence on Ees. The latter was reduced during anesthesia and tended to diminish with increasing lung volume. All variations in Ees caused by posture, anesthesia, and lung volume were small and affected the shape of the pressure-volume curve of the lung to only a minor degree. PMID- 6863099 TI - Cardiorespiratory responses to exercise distributed between the upper and lower body. AB - The present study examined the influence that distributing exercise between upper (arm crank exercise) and lower (cycle exercise) body muscle groups had on cardiorespiratory responses to constant power output (PO) exercise. Six male volunteers completed five submaximal exercise bouts of 7-min duration at both 76 and 109 W. The arm PO/total PO (% arm) for these bouts was approximately 0, 20, 40, 60, and 100%. At 76 W, O2 uptake (VO2) did not change (P greater than 0.05) from 0 to approximately 20% arm (approximately 1.30 1 x min-1) but increased with increasing percent arm values up to 100% (1.58 1 x min-1). At 109 W, VO2 increased throughout the range of 0 (1.70 1 x min-1) to 100% arm (2.33 1 x min 1). In general, minute ventilation (VE) and respiratory exchange ratio (R) increased with increased percent arm values at 76 and 109 W. The heart rate (HR) responses remained unchanged from 0 to 60% arm at both 76 and 109 W; however, between 60 and 100% arm, a 26-beats x min-1 increase was observed at 76 W (143 beats x min-1 at 100% arm) and a 45-beats x min-1 increase at 109 W (174 beats x min-1 at 100% arm). These data suggested that during upper body exercise, the increased VO2 associated with increased percent arm values was not accompanied by an elevated HR response when at least 40% of the PO was performed by the lower body. This might be attributed to a facilitated venous return and/or a decreased total peripheral resistance when the lower body was involved in the exercise. PMID- 6863100 TI - Noninvasive quantitative imaging of shape and volume of lungs. AB - The Dynamic Spatial Reconstructor (DSR) can be used to determine detailed structure-to-function relationships or organ systems in vivo. A basic index of lung structure (shape and dimensions) is total lung volume. We checked the accuracy with which in vivo lung volumes can be measured by comparing lung volume (air plus tissue) determined by DSR scanning with that determined by excision and water displacement. Six dogs (2.5-26 kg) under morphine-pentobarbital anesthesia were scanned supine or prone at functional residual capacity and/or total lung capacity. With the trachea clamped at the lung volume scanned, a lethal dose of pentobarbital was administered, the lung excised, and its volume determined by water displacement. In vivo scan data were used to reconstruct adjacent 0.9-mm thick transverse sections over the entire axial extent of the thorax. A three dimensional surface-detection algorithm was used to generate shaded surface displays of the in situ lungs. The number of voxels (volume picture elements) of known dimensions contained within the three-dimensional image of the lung was summed to estimate total lung volume. Lung volumes calculated from the in vivo images ranged from -3.4 to +2.3% of the lung volume determined in vitro. The mean difference was 1.38 +/- 0.07% (SE). Regression analysis yielded an r value (correlation) of 1.00, a slope of 0.99, and an intercept of -4.35 ml. Multiple lung inflation steps scanned and analyzed in one dog showed similar accuracy. This technique is applicable to subjects with thorax dimensions up to 42 cm in cephalocaudal height and 39 cm in ventrodorsal and transverse diameters. PMID- 6863101 TI - Preparation of a jugular vein cannula: use with a semiautomatic blood-sampling system. AB - A method for preparation and surgical implantation of a rodent jugular vein cannula and construction and use of an automatic blood-sampling system are described. The cannula permits repeated blood sampling without disturbing the rat. The semiautomatic sampling system permits one individual to collect blood samples from three rats simultaneously. PMID- 6863102 TI - Cardiac output measurement using N2O uptake: a method to subtract cardiogenic oscillations. AB - Plethysmographic (box) methods using N2O uptake to measure pulmonary capillary blood flow, right ventricular stroke volume, and pulmonary arterial flow pulse conduction time have been complicated by the presence of so-called "cardiogenic oscillations" in the box flow records on air and N2O breathing. The exact cause of these oscillations is unknown but believed to be secondary to instantaneous changes in net blood flow into and out of the thorax during the cardiac cycle. We examined these oscillations and pulmonary capillary blood flow in normal human subjects in a flow plethysmograph using a pressure compensation circuit to extend the frequency response. The cardiogenic oscillations in flow recorded at the mouth (with glottis open) are much greater in amplitude and 90 degrees out of phase from those recorded from the plethysmograph. We derived a theoretical analysis of this and designed an analogue electrical circuit to enable us to eliminate these oscillations by electrical subtraction from the box flow record generated by N2O uptake in the pulmonary capillary bed. Measurements of pulmonary capillary blood flow and ventricular stroke volume using our method correlate with measurements made with acetylene-rebreathing blood flow measurements performed sequentially at the same sitting. PMID- 6863103 TI - Quantitative measurement of intrapulmonary and extrapulmonary right-to-left shunt. AB - We have developed a new technique that enables the shunting of blood from the right to the left side of the circulation to be partitioned into a cardiac and a lung component. The effects of recirculation are minimal, and the method does not require on-line data analysis. Quantitative estimates of these components have been made in two normal dogs and in five patients with raised pulmonary arterial pressures, some of whom were known to have a patent foramen ovale. The results were compared with oxygen shunt measured during air breathing. A poorly soluble gas, nitrogen, radiolabelled with 13N in solution is injected first into a central vein while matched samples of blood are drawn from the pulmonary artery and the aorta. A second solution containing 13N is injected into the right ventricle and sampled from the aorta only. Standardized gamma-counting techniques were used to analyze both the injected radioactivity and the radioactivity in the samples. These two measurements enable us to calculate the total right-to-left shunt, the pulmonary shunt, and by subtraction the extrapulmonary cardiac shunt. PMID- 6863105 TI - Emergency room evaluation of the adolescent who attempts suicide: compliance with follow-up. PMID- 6863104 TI - The adolescent parent: A dual developmental crisis. AB - This paper examines salient developmental characteristics of adolescents and beginning parents. In the case of many teenage parents, specific developmental tasks of adolescence affect and may potentially conflict with the tasks of early parenthood. A conceptual framework is presented which describes this conflict and serves as the basis for examining and explaining certain unique behaviors observed in young adolescent parents. PMID- 6863106 TI - Pseudocyesis in adolescent females. AB - Three adolescent patients were diagnosed as having pseudocyesis based on an assessment including pelvic examination, pregnancy tests, and pelvic ultrasound scanning. Their psychosocial evaluation demonstrate a conversion reaction in already deprived and depressed adolescents. They responded to psychotherapeutic counseling. Pseudocyesis merits consideration in the differential diagnosis of secondary amenorrhea. It occurs psychologically in vulnerable adolescents who exhibit rather primitive defense mechanisms. Once a patient acknowledges that she is not pregnant, severe depression is a possible complication. A review is presented of the current medical literature on this subject. PMID- 6863107 TI - Coping in a group of expectant adolescent fathers: an exploratory study. AB - Twenty expectant adolescent fathers were interviewed during the course of their partners' pregnancies. Ten coping strategies used by these subjects in response to the upcoming transition to fatherhood were identified. These coping strategies were categorized according to the Lazarus paradigm as direct actions, information seeking, intrapsychic processes, and inhibition of action. These strategies dealt either with the potential problem (i.e., fatherhood) or the accompanying stressful emotions. PMID- 6863108 TI - Reflex sympathetic dystrophy in a 14-year-old female. AB - Reflex sympathetic dystrophy (RSD) consists of an extremity with (1) burning or causalgic pain, (2) limitation of motion, (3) edema with or without pitting, (4) dystrophic skin changes, (5) vasomotor phenomena and (6) patchy osteoporosis on x ray. This disease is rare in adolescents, but of patients with RSD up to 8% are between 11 and 19 years of age. Most cases in this age group resolve after immobilization, analgesics or steroid therapy, surgical ganglionic blockade or sympathectomy. This case report is of a 14-year-old girl who was treated with all these measures, but continues to have significant residual deformity. PMID- 6863109 TI - Factitious renal stone as a sign of internal conflict about sexual intercourse in an adolescent. AB - Conflicts about the onset of sexual intercourse have been reported to cause a variety of symptoms. A 16-year-old black female claimed to have passed a stone in her urine. Investigation of her complaints caused some doubt that an organic cause was involved. Social history showed that she had recently begun to have sexual intercourse despite a religious belief that intercourse before marriage was wrong. After an extensive medical work-up, she was discharged with instructions to bring in another stone if passed. A stone subsequently presented by the patient proved to be a piece of lead shot. Those caring for adolescents need to be aware that conflicts about sexual intercourse may present in a number of ways, including urinary-tract complaints. PMID- 6863110 TI - Acanthosis nigricans in adolescents. Two case reports and guidelines for management. AB - Acanthosis nigricans (AN) is a dermatologic condition of the flexor surfaces of the body consisting of papular hypertrophy, hyperpigmentation, and rugae. AN is commonly associated with malignancy when in adults but is primarily associated with endocrinologic disorders and obesity when found in adolescents. A special search for occult malignancy is not warranted in adolescents with AN unless no associated benign condition is found. Careful follow-up is recommended, however, since AN may be the first indication of a serious systemic disease. PMID- 6863111 TI - Medical and psychosocial aspects of gonococcal infection in the adolescent patient: epidemiology, diagnosis, and treatment. AB - Gonorrhea has reached epidemic proportions and poses a significant health problem for teenagers. The attitudes and behavior of adolescents play a major role in the increase of gonococcal infection, interacting with characteristics of the disease and public health issues. Controlling gonorrhea among teenagers thus requires attending to the medical and psychosocial issues. Accurate diagnosis is dependent, in part, on eliciting a valid sexual history. Selection of a laboratory protocol should reflect not only the sensitivity and specificity of a test but its acceptability to teenagers. Similarly, there is no longer a single "drug of choice" for treatment. Patient acceptability, potential for noncompliance, toxicity, cost, jeopardy to other uses, and possible coexistent infection are factors to be considered in addition to efficacy. Finally, medication is only part of the treatment plan, which includes sexual abstinence, therapy for sexual partners, and returning for a test of cure. Compliance with the entire treatment plan can often be enhanced by maximizing communication and rapport with the adolescent. PMID- 6863112 TI - Adolescent medicine: origins, segmenting, synthesis. PMID- 6863113 TI - Mothers of adolescent mothers. PMID- 6863114 TI - Hypnosis for reduction of vomiting associated with chemotherapy and disease in adolescents with cancer. AB - Vomiting is often a major source of distress for adolescent oncology patients. This study evaluates the effectiveness of hypnosis in reducing the vomiting associated with chemotherapy and disease in 12 adolescents with cancer. Eight patients receiving chemotherapy demonstrated significant reductions in the frequency (p less than 0.01) and intensity (p less than 0.05) of emesis. Six of the eight patients also demonstrated a shortened duration of emesis. The ninth patient, whose vomiting was secondary to her brain tumor, showed a gradual but steady reduction in vomiting with eventual total elimination following hypnosis intervention. Three patients rejected hypnosis. Trait anxiety scores for the group were significantly lower at retest 6 months following hypnosis intervention (p less than 0.05). Significant changes in scores of health locus of control, impact of illness, or self-esteem were not found. These data support the efficacy of hypnosis for reducing vomiting when used in the context of a comprehensive clinical approach to the cancer patient. PMID- 6863115 TI - Adolescents with cancer. Hypnosis for the reduction of the acute pain and anxiety associated with medical procedures. AB - Eighteen adolescents with cancer were trained in hypnosis to ameliorate the discomfort and anxiety associated with bone marrow aspirations, lumbar punctures, and chemotherapeutic injections. Two patients rejected hypnosis. The remaining 16 adolescents achieved significant reductions in multiple measures of distress after hypnosis training. Preintervention data showed no pattern of spontaneous remission or habituation, and, in fact, an increasing anticipatory anxiety was observed before hypnotic treatment. Group reductions in pain and anxiety were significant at levels ranging from p less than 0.02 to p less than 0.002 (two tailed t-tests). Significant reductions were also found in Trait Anxiety. A non significant trend toward greater self-esteem was present. The predicted changes in the Locus of Control and General Illness Impact were not found. Comparisons between hypnosis rejectors and successful users unusually showed higher levels of pretreatment anxiety in the former. The pragmatic nature of hypnosis as part of comprehensive medical care in oncology is noted. PMID- 6863116 TI - Scalp hair morphology in normal and diabetic children and adolescents. AB - The morphological characteristics of samples of scalp hair from normal children and adolescents (8-17 years) and from a group of diabetic children (8-11 years) were determined. In normal children, there were no sex differences. Significant increases in the diameters of both bulb and shaft were found when prepubertal (8 11 years) and pubertal (12-17 years) groups were compared. Diabetic females had smaller bulb diameters and diabetics of both sexes had reduced shaft diameters in comparison to normal children of similar age. These findings suggest previous nutritional deficits in male and female diabetics and the possibility of continued nutritional problems in the females. PMID- 6863117 TI - ECG of the month: sinus tachycardia in a gelding. PMID- 6863119 TI - Castellated laryngofissure and vocal fold resection for the treatment of laryngeal paralysis in the dog. PMID- 6863118 TI - Treatment of auricular hematoma, using a teat tube. AB - Auricular hematomas in 35 dogs and 12 cats were treated with a drainage method utilizing a particular bovine teat tube. The method was easy to perform and required a minimum of expendable materials. Animals were quickly returned to normal activity, aftercare was simple, healing was rapid, and the healed ear was cosmetically acceptable. Complications that developed in 7 animals were related to the time of tube removal, and could be minimized in the future by following guidelines formulated from this study. PMID- 6863120 TI - Clinical results of lateral ear resection in dogs. AB - Twenty-six dogs had lateral ear resection performed for the treatment of chronic otitis externa. After a mean follow-up period of 4.5 years, 17 of the 26 dogs were available for physical examination. The remaining 9 dogs died prior to this review; their owners were surveyed by questionnaire. In the examined group, the resolution of clinical signs was good in 41% of the dogs, improved in 12%, and poor in 47%. A good result was defined as the elimination of clinical signs, with minimal or no care required from the owner. An improved status was assigned to dogs that experienced occasional recurrence of signs requiring professional attention. A poor result was defined as no improvement. PMID- 6863122 TI - Minimal alveolar concentrations for halothane, enflurane, and isoflurane in the cat. AB - The minimal alveolar concentrations for halothane, enflurane, and isoflurane in the domestic cat were found to be 1.19 +/- 0.05 (SEM)%, 2.37 +/- 0.06%, and 1.61 +/- 0.04%, respectively. During the potency studies, it was observed that enflurane and isoflurane resulted in shorter wake-up times, compared with halothane. However, enflurane and isoflurane produced electroencephalographic (EEG) and clinical signs of CNS irritability (EEG spiking, myoclonus) in normocapnic or mildly hypocapnic cats. In addition, enflurane and isoflurane caused greater airway irritability (coughing, salivation) than did halothane. PMID- 6863123 TI - Evaluation of mebendazole used concurrently with piperazine monohydrochloride in horses. AB - Forty horses from a herd known to have benzimidazole-resistant small strongyles were treated with mebendazole (8.8 mg/kg) or combinations of mebendazole and piperazine monohydrochloride (25, 40, or 55 mg of piperazine base/kg). Pretreatment and 7-day posttreatment fecal examinations were done. Fecal cultures and strongyle egg per gram (epg) counts, and in vitro testing for benzimidazole resistance were performed. Results of fecal examinations prior to treatment were similar in all horses, and results of testing were positive for benzimidazole resistance. Horses treated with mebendazole and piperazine at all dosages had much lower geometric mean strongyle epg counts (2 to 4) and greater percentage reduction in geometric mean strongyle epg counts (99.7 to 99.9) at 7 days after treatment, compared with those measurements for horses treated with mebendazole alone. Adverse reactions to treatment were not observed. PMID- 6863124 TI - Fatal acorn poisoning in a horse: pathologic findings and diagnostic considerations. AB - Acorn poisoning was diagnosed in an 11-year-old Quarter Horse with signs of severe colic, tachycardia, hyperpnea, abdominal borborygmus, rectal tenesmus, and hemorrhagic diarrhea. The diagnosis was based on history and predisposing factors, clinical signs, laboratory data, acorn husks in the feces, the urinary gallic acid equivalent concentration, and necropsy findings. The most striking pathologic changes were gastrointestinal and mesenteric edema, ulcerative enterocolitis, and nephrosis. PMID- 6863121 TI - Therapeutic serum concentrations of primidone and its metabolites, phenobarbital and phenylethylmalonamide in epileptic dogs. AB - Fifteen dogs with idiopathic epilepsy were included in a 9-month clinical trial to determine the therapeutic serum concentrations of primidone and its active metabolites, phenobarbital and phenylethylmalonamide. Dogs with a seizure frequency greater than 1/mo or with a record of multiple seizures greater than 1/day were chosen for the study. Each dog was given primidone 3 times daily at dosages intended to maximize seizure control and to minimize undesired side effects. Maintenance period blood samples were taken from fasted dogs 7 hours after dosing in the 3rd, 5th, 7th, and 9th months of the trial to determine therapeutic serum concentrations of primidone and its metabolites. Two blood samples also were taken from all dogs 7 hours after dosing, during an enforced drowsy period, to establish upper limits of desirable serum concentrations of the drug. Seizure frequencies during the trial were controlled in 13 dogs, 7 of which had no seizures during the 9-month trial. The mean percentage reduction in seizure frequency from pretrial frequency was 85%. Two dogs appeared refractory to primidone therapy. Serum phenobarbital was the best metabolite of primidone to use to assess therapeutic serum concentrations. The therapeutic antiepileptic serum concentration of phenobarbital was found to be between 25 and 40 micrograms/ml of serum. Serum phenobarbital concentrations greater than 40 micrograms/ml resulted in side effects in most dogs. PMID- 6863125 TI - Clinicopathologic features of brain herniation in animals. PMID- 6863126 TI - Sterility associated with an XO karyotype in a Belgian mare. PMID- 6863127 TI - Keratomycosis caused by Cladosporium sp in a cat. PMID- 6863128 TI - Ollulanus tricuspis found by fecal flotation in a cat with diarrhea. PMID- 6863131 TI - Sequelae to percutaneous fetotomy in the mare. PMID- 6863129 TI - Lag screw stabilization of Salter type IV femoral fracture in a young horse. PMID- 6863132 TI - Employment and starting salaries of 1982 graduates of US veterinary medical colleges. PMID- 6863130 TI - Hemarthrosis secondary to suspected warfarin toxicosis in a dog. PMID- 6863134 TI - Oral hydralazine therapy for chronic mitral regurgitation in the dog. PMID- 6863133 TI - What is your diagnosis? Intussusception. PMID- 6863137 TI - Cutaneous atypical mycobacteriosis in cats. AB - Cutaneous infection with atypical mycobacteria was observed in 6 cats. All cats had cutaneous or subcutaneous masses, with or without fistulous tracts. Diagnosis was determined by microbial culture. Transmission studies were done in 1 case. Treatment, which included antibiotics or surgery, or both, was usually unsuccessful, but remission without treatment did occur. In 3 cats available for long-term evaluation, there has been no recurrence of disease. PMID- 6863136 TI - Radiographic and clinical features of pelvic bladder in the dog. AB - Contrast radiography enabled identification of 17 dogs with pelvic location of the caudal portion of the urinary bladder. The caudal pole of each bladder consistently was more blunted than expected. The range of craniocaudal dimension within the pelvic canal was 6% to 26% of the distended bladder. Ten dogs were females with urinary incontinence. Seven dogs did not have incontinence; 4 were males and 3 were intact females. Six dogs had associated anatomic abnormalities: urachal diverticulum (3), bladder adhesions (1), rectovaginal fistula (1), and inverted vulva (1). Eleven dogs had urinary tract infection. In addition, urinary incontinence and pelvic bladder without urinary tract infection or other anatomic abnormalities was identified in 4 large-breed spayed females. These dogs responded poorly to diethylstilbestrol therapy. Three of the 4 subsequently were treated with ephedrine, and all had their incontinence effectively controlled by its continued use. Four of the 10 incontinent dogs in this series were Doberman Pinschers, suggesting breed predisposition. These data indicated an association between pelvic bladder and urinary incontinence in the spayed female dog, but also indicated that pelvic bladder can be found in both sexes and that it is associated with urologic abnormalities other than incontinence. PMID- 6863135 TI - Comparison of duodenal aspiration with fecal flotation for diagnosis of giardiasis in dogs. AB - In a study comparing the effectiveness of fecal flotation and duodenal aspiration for detection of Giardia sp, 18 of 47 dogs were found to be infected. The organism was identified on a single fecal flotation in 7 of the infected dogs, and on a single duodenal aspiration in 16 of the infected dogs. In 2 dogs, the organism was identified by fecal flotation, but not on duodenal aspiration. PMID- 6863138 TI - Suppurative cholangitis in cats. AB - Suppurative cholangitis in 5 aged cats was characterized clinically by weight loss, depression, dehydration, icterus, and fever. The major abnormal laboratory findings were a severe left shift of WBC and a high, conjugated bilirubin concentration consistent with an inflammatory process and cholestasis. Gross pathologic findings included periductal biliary fibrosis (4 cats), periductal pancreatic fibrosis (2 cats), cholelithiasis (2 cats), deformation of the gallbladder (2 cats), and chronic interstitial pancreatitis (2 cats). Histopathologic findings in all cases were portal hepatic fibrosis, biliary hyperplasia, and suppurative exudate within dilated intrahepatic biliary ducts. Weight loss and portal fibrosis were suggestive of chronic, intermittent illness. The pathogenesis appeared to involve invasion of the bile duct by enteric bacteria. Cholangitis was observed to occur in association with pancreatitis, cholelithiasis, or anatomic abnormalities of the biliary tract. PMID- 6863140 TI - Automatic noninvasive sphygmomanometry in horses. AB - Systolic, diastolic, and mean arterial blood pressures and heart rate were determined in 73 horses, using an indirect automatic oscillometric technique. Blood pressure and heart rate data obtained by sphygmomanometry were compared with similar data obtained from cannulation of the horses' facial or dorsal metatarsal arteries. Good correlation between direct (actual) and indirect (oscillometric) blood pressures and heart rate measurements were obtained when the heart rate was low, using high sensitivity setting. Cardiac arrhythmias or hypotension prevented oscillometric measurements from being obtained in 9 (12%) horses. PMID- 6863139 TI - Complications associated with immunotherapy of equine phycomycosis. AB - Five horses with pythiosis of the limbs were treated unsuccessfully by surgery or topical application of amphotericin B, or both. Follow-up immunotherapy resulted in 1 horse responding favorably. Three horses were cured of the fungal infection but developed osteitis or deep-seated laminitis, which necessitated their destruction. The remaining horse, which had severe anemia, died before the course of vaccination was completed. PMID- 6863141 TI - Fractures of the central and third tarsal bones in horses. AB - The case histories and follow-up data for 11 horses with slab fractures of the central or 3rd tarsal bones were examined for information pertaining to the diagnosis, which was difficult to identify, treatment, which was proven ineffective, and the prognosis, which was shown to be poor for return to racing. The purpose of the study was to define the results that could be obtained by nonoperative methods, in an attempt to determine whether surgical treatment was advisable. Nine of the horses were Standardbreds and 2 were Thoroughbreds; all horses were 2 to 4 years old and were being exercised at race speed when the injury occurred. The diagnosis usually was made at the referral examination, some time after injury. Distention of the tibiotarsal joint usually developed following fracture of the central tarsal bone. In some fractures, local anesthetic injection or multiple radiographic views were required for diagnosis. Not all fracture planes were demonstrable radiographically. Prolonged rest was ineffective in restoring athletic soundness. Lag screw fixation was used in 1 horse, the only horse in the series that raced successfully after injury. PMID- 6863142 TI - Keratolenticular dysgenesis in a kitten. PMID- 6863143 TI - Membranous glomerulopathy in two feline siblings. PMID- 6863145 TI - Hypercalcemia associated with nasal adenocarcinoma in a dog. PMID- 6863146 TI - Fatal toxicosis in pet birds caused by an overheated cooking pan lined with polytetrafluoroethylene. PMID- 6863144 TI - Gastrointestinal phycomycosis in a dog. PMID- 6863148 TI - Multiple intramedullary pin fixation of the femur of dogs and cats. PMID- 6863147 TI - A coccidial sporocyst in equine urine. PMID- 6863149 TI - Periocular dermoid cyst in a calf. PMID- 6863150 TI - What is your diagnosis? Prostatic adenocarcinoma. PMID- 6863151 TI - Induced waking fantasy. Its effects upon the archetypal content of nocturnal dreams. PMID- 6863152 TI - Middle and long latency auditory evoked potentials in cat. I. Component definition and dependence on behavioral factors. AB - Middle (10-50 ms) and long (50-600 ms) latency auditory evoked potentials (AEPs) were investigated in artificially respired, muscle-paralyzed cats. Similarity to human potentials of comparable latencies was examined in two ways: (1) the similarity of waveform features such as peak amplitude, polarity and latency, and (2) the effects of task-related variables on these various waveform features. Four behavioral variations of a classical pupillary conditioning paradigm were used to vary attention and arousal. Twelve peaks and troughs were identified in the AEP: P10, N13, P17, N22, P31, N41, P55, N70, N100, N140, P260 and N520. Principal components analysis (PCA) defined 7 AEP components, some of which spanned several peaks. Analysis both of peak latencies and amplitudes, and of principal component scores, revealed differential effects of the behavioral manipulations on these components: those with latencies longer than 50 ms were strongly influenced by behavioral variations, while earlier components were relatively immune to these effects. On the basis of these findings, several relationships between cat and human AEP components were suggested. Specifically, peaks P10-P41 in the cat were thought related to human middle latency components, cat P55 to human P50, cat N140 to human N300, and cat P260 to human P300. Cat N520 was comparable to several long latency components in humans. No obvious correspondences between cat AEP components and human N90 and P170 were identified. PMID- 6863154 TI - Sustentacular cells of the organ of Corti--the tectal cells of the outer tunnel. AB - The cells which form the roof of the outer tunnel of the organ of Corti were studied by light microscopy and scanning and transmission electron microscopy. In the mustache bat, Pteronotus p. parnellii, the cells are characterized by: (1) a unique position in the roof and along the lateral wall of the outer tunnel; (2) no contact with the basilar membrane; (3) isolation of adjacent cell bodies; (4) an extensive endolymphatic surface with a sparse population of short microvilli; (5) a loose association with the adjacent mat of polypous surface projections on the outer tunnel surface of the first row of Hensen's cells; and (6) a darkly staining cytoplasm. These cells occur in certain other mammals (cats and mice) and have been classified previously as Hensen's or Deiters' cells, but since they lack the distinct morphological characteristics of either of these types of cells, it is suggested that they be recognized as a distinct cell type, the tectal cells of the outer tunnel. PMID- 6863153 TI - Middle and long latency auditory evoked potentials in cat. II. Component distributions and dependence on stimulus factors. AB - The middle (10-50 ms) and long (50-600 ms) latency periods of the auditory evoked potential (AEP) were investigated in muscle-paralyzed, artificially respired cats with respect to two issues: (1) the distribution of components across the skull, and (2) the effects of changing stimulus intensity on component latencies and amplitudes. The distributional data were gathered during a behavioral study in which four behavioral tasks related to classical pupillary conditioning were used to vary attentional and arousal processes. The distributions across the skull surface (averaged across tasks) of 12 peaks and troughs (P10, N13, P17, N22, P31, N41, P55, N70, N100, N140, P260 and N520) and seven principal components derived from the set of waveforms collected during this experiment are reported. Both peak amplitudes and principal component scores were distributed differentially across the skull surface. In the second experiment, acoustic stimulus intensity was varied, and AEPs collected from a vertex and temporal electrode site. In general, increasing stimulus intensity had a stronger influence on the earlier portions of the AEP, where increased amplitude and decreased latency was the rule, than on later ones. The relationships between cat and human AEP components were discussed based on both the data presented in this paper and in previous papers. PMID- 6863158 TI - Estimates of heterosis for sexual activity in boars. AB - Data on 118 Duroc, Yorkshire and reciprocal cross boars were utilized to evaluate the effect of crossbreeding on mating behavior. Boars were penned with an estrous gilt on 2 consecutive days. Number of mounts (proper and improper), sexual interest score and whether a successful mating occurred were recorded. Times at which each of these events occurred were recorded also, allowing calculation of times to first mount, to final mount and to completion of mating. Most importantly, more crossbred boars completed a mating than purebred boars (69 vs 27%). Crossbreds had greater sexual interest (P less than .05), more mounts and a higher proportion of properly oriented mounts (P less than .05). Crossbreds also began mounting activity (first mount, first proper mount and final mount; P less than .05) earlier and required less time to complete a mating (P less than .05) than purebred boars. Heterosis values for number of proper and improper mounts, proportion of proper mounts and sexual interest were 2, 53, 32 and 52%, respectively. Time to first mount, to final mount and to completing mating had heterosis values of -34, -29 and -20%, respectively. Scrotal measures taken at 140 and 168 d and at post-trial castration, as well as excised testes measures and sperm numbers, showed heterosis; however, no consistent associations between these traits and behavior traits were found. These data suggest that crossbred boars were more sexually active than purebred boars, perhaps due to an advanced physiological or behavioral stage. PMID- 6863157 TI - Feedlot performance, blood metabolic profile and calcium status of steers fed high concentrate diets containing several levels of calcium. AB - Two feeding trials with Hereford X Angus steers were conducted to evaluate effects of dietary Ca level in high concentrate diets on feedlot performance, carcass traits, blood metabolic profile and Ca status. Dietary treatments of .3, .6, .9 and 1.2% Ca (10 steers treatment-1 X trial-1) were fed for 90 (Trial 1) and 114 d (Trial 2). Ground limestone was the source of supplemental Ca. Blood samples were collected weekly throughout Trial 1 and for the first 7 wk of Trial 2. In both trials .3% Ca resulted in lighter weight (P less than .10) carcasses and lower (P less than .05) blood pH and HCO-3 than the rest of the Ca levels during the first 7 wk of feeding the high concentrate diets. Average daily gain increased linearly (P less than .10) in response to increased dietary Ca level in Trial 1, but not in Trial 2. There were no significant differences among treatments in feed intake, carcass quality traits, bone ash, bone Ca, or overall characteristics in the blood metabolic profile including total serum or plasma Ca and plasma ionizable Ca. Increasing dietary Ca to .6% or more resulted in improved blood acid-base status during the initial weeks of feeding high concentrate diets, which is associated with heavier carcasses and a trend towards more rapid weight gain. I interpret these data to suggest that the Ca requirement for steers fed high concentrate diets is greater than .3%, but no greater than .6% for maximal feedlot performance. PMID- 6863156 TI - A study of cochlear innervation in the young cat with the Golgi method. AB - Individual afferent and efferent nerve fibers were identified and traced in Golgi impregnated cochleas of cats from newborn to one month old. Afferent radial fibers project radially without varicosities to terminate at the base of one or two inner hair cells. Outer spiral fibers have both radial and spiral orientations within the organ of Corti, do not form varicosities while crossing the base of the tunnel, and spiral for long distances in the outer spiral bundles. They contact many outer hair cells of more than one row both en passant and by small terminal branchlets. Two separate groups of efferent fibers are identifiable. Thin efferent fibers with many large varicosities spiral for long distances in the inner and tunnel spiral bundles; varicosities in the inner spiral bundle may contact radial afferent fibers or hair cells, depending on age. Thick radial efferent fibers course radially through the tunnel spiral bundle and across the upper part of the tunnel, often in fascicles. They contact a few outer hair cell bases by large terminals. The spiral expanse of the terminals is limited. These fibers are most common in the more basal turns of the organ. The present results confirm the anatomical separation of radial and spiral afferent fiber systems and identify two separate efferent populations beyond the neonatal period in the cat. The major features of afferent innervation discernible in Golgi-impregnated cochleas are present at birth, although some simplification of afferent fibers probably occurs during the first postnatal week. In contrast, the efferent fiber pattern undergoes important changes during the first few weeks after birth. In mature animals, the fine spiral efferents probably contact only afferent fibers, whereas the thick radial efferents may contact both outer hair cells and spiral afferent fibers. The possibility that some individual efferents branch to both inner and outer hair cell regions in the older cats cannot be ruled out. PMID- 6863155 TI - Spatial receptive fields in the cat inferior colliculus. AB - Auditory spatial receptive fields of 122 single units in the inferior colliculus of 8 anesthetised cats were studied with free-field acoustic stimuli presented in the frontal hemisphere. The best frequency and best frequency threshold were determined for each unit with the speaker located in a position where the unit responded strongly. The intensity was then raised to 10 dB above threshold at the best frequency and the boundaries of the spatial receptive field were determined. For sounds of low intensity, receptive field size appeared to be a continuum with respect to best frequency. Units of high best frequency had small circumscribed fields located in the contralateral frontal hemifield. The boundaries of receptive fields for units of progressively lower best frequency expanded in all directions. Thus for intermediate frequencies, fields typically filled the contralateral hemifield whereas for low frequencies, units could be activated by stimulation from any position tested. At higher intensities, the boundaries of the receptive fields of units expanded. Circumscribed receptive field centres lay on a line corresponding to the acoustical axis of the contralateral pinna. For these units with small receptive fields, the free-field response to low intensity sounds appeared to be attributable more to the directional properties of the contralateral pinna than to significant binaural interaction. PMID- 6863159 TI - Genotype X environment interaction in Hereford cattle: III. Postweaning trait of heifers. AB - The postweaning performance of heifers from contrasting lines of Hereford cattle was compared simultaneously at Miles City, Montana and at Brooksville, Florida in an experiment designed to evaluate the importance of genotype X environment interactions in beef cattle. During Phase 1 of the study (1964 to 1973), the performance of two unrelated lines, M1 and F6, was compared at the two locations. During Phase 2 (1967 to 1974), two related lines, M1 of Montana origin and F4 derived from M1 by selection in Florida, were compared at each of the two locations. The line X location interaction term was highly significant in either Phase 1, Phase 2 or both for weaning weight, daily gain from weaning to spring, spring yearling weight, daily gain from weaning to fall, fall yearling weight, yearling condition score, conformation score, wither height, body depth, body length, shoulder width, hook width and forecannon circumference. Daily gain of yearlings from spring to fall was the only objective measurement for which the interaction term was nonsignificant in both phases. These results, consistent with the results on performance to weaning age reported previously, indicate the existence of highly significant genotype X environment interactions in beef cattle. The results indicate that genetic adaptation to the local environment is important in beef cattle production and should be considered in designing breeding programs or performance testing procedures and in interregional transfer of breeding stock. PMID- 6863160 TI - Testicular growth in boars of different genetic lines and its relationship to reproductive performance. AB - Testicular growth of 377 boars was compared by obtaining in situ measurements of testes width and length and excised tissue weights. Two experiments involved a line selected nine generations for ovulation rate (OR) and a control line (CL), and two experiments contained boars of the OR line and two other lines; WL, a Large White-Landrace cross, and a line founded by crossing lines OR and CL and selected six generations for increased average daily gain and decreased backfat (LG line). In situ testes measurements were similar for the OR and CL lines and were curvilinearly related to age. The LG line had smaller in situ measurements than the OR line (P less than .05) when both unadjusted means and means adjusted for body weight were compared. The OR line had 10.5% heavier testes than the CL line at 90.8 kg and a 9 to 15% advantage at 120, 141, 162 and 183 d of age. The OR line had more rapid testicular development from 120 to 183 d of age (P less than .05) than the CL line. The LG line had significantly lower excised testes weights (17 to 50% less), a lower percentage of tubules that showed active spermatogenesis and lower mean diameter of the seminiferous tubules (P less than .05) than the OR line. The relative differences between lines OR, CL and LG suggest that selection for lean growth rate has resulted in less rapid testicular development and increased age at puberty. The correlations of testes weights and in situ testes measurements taken at the time of castration were between .76 and .93. The correlations of testes width and testes length with epididymides weights were slightly lower, and correlations of body weight and testes weight ranged from .51 to .70. Mean diameter of the seminiferous tubules and percentage of tubules with active spermatogenesis were correlated with measurements of testes size (r = .50 to .61) and body weight at the time of castration (r = .29 to .36). Correlations of excised testes weights with number born in the boar's contemporary litter and ovulation rate of full sibs were uniformly positive. The correlations of measurements of testes size and backfat (r = -.09 to .20) suggest that the phenotypic relationship between testes growth and body composition is small. However, the response found in the LG line suggests a negative genetic relationship between lean growth rate and testicular growth rate. PMID- 6863162 TI - Dietary calcium and phosphorus levels for growing swine from 18 to 57 kilograms body weight. AB - A randomized complete block design experiment was conducted using 408 crossbred pigs to evaluate the effects of six dietary Ca/P levels for growing swine (18 to 57 kg). Total dietary P levels ranged from .40 to .90% in .1% intervals with Ca concurrently increased at a 1.3:1 ratio in a 16% protein corn-soybean meal diet. Dicalcium phosphate and limestone were the source of inorganic Ca and P. For the overall trial, daily gain and feed intake improved as dietary Ca/P increased to an approximate level of .65/.50%. An inverse relationship occurred between serum Ca and P, with serum Ca declining and P increasing at the lower mineral levels. Femur, humerus, rib, metatarsal and metacarpal ash content increased quadratically (P less than .01) as dietary Ca/P increased with suggested dietary breakpoint inflections of .90% Ca and .70% P at 40 kg, and at .72/.55% levels at 57 kg body weight. Percentage ash of the head portion of the bone was lower than the shaft section. Bone shaft thickness and bending moments for metatarsals and metacarpals increased as dietary Ca/P levels increased, with higher values and higher dietary inflection points at 57 than at 40 kg body weight. Bone length was not influenced by dietary Ca/P level, but fat-free dried bone weight was, resulting in higher total bone ash and organic weight as Ca/P level increased. PMID- 6863161 TI - Effect of diet on chemical composition of rabbits slaughtered at fixed body weights. AB - Four hundred and thirty-two Spanish Giant rabbits were fed 12 diets of variable energy to protein ratio [kcal digestible energy (DE)/g digestible crude protein (DCP)] from weaning to slaughter, both at different ages and weights. Body composition analysis for various chemical components indicated that body weight accounted for the greatest part of the variation in these constituents. Sex influenced only the N content (P less than .05). Dietary E/P accounted for greater variability in body composition than crude protein or crude fiber content of the diet. High dietary E/P increased (P less than .001) the proportion of body fat and reduced the proportion of body protein. This effect was made more obvious by adjustment to equal rate of weight gain and it showed that there may be a greater influence of dietary E/P on body composition than previously recognized. PMID- 6863163 TI - Effect of processing of semen on capacitation time of fresh and frozen-thawed boar spermatozoa. AB - Ovulation time of gilts was controlled by oral treatment with altrenogest (17 allyl-hydroxyestra-4,9,11-trien-3-one) followed by gonadotropic hormone injections. Gilts were laparotomized 42 to 44 h after injection of human chorionic gonadotropin. Spermatozoa were surgically placed into ligated oviducts of gilts after one of the following semen treatments: frozen and thawed in Beltsville thawing solution (F-BTS) or in seminal plasma (F-SP); unfrozen, processed like the frozen semen, but not cooled, frozen or thawed, and extended in Beltsville thawing solution (U-BTS) or in seminal plasma (U-SP). Ova were recovered 5 or 24 h after insemination and their stage of development was determined. At 5 h, F-BTS and U-BTS spermatozoa had fertilized significantly more ova (45 and 69%, respectively) than the F-SP and U-SP spermatozoa (5 and 34%, respectively). Ova fertilized by F-BTS and U-BTS spermatozoa had reached a more advanced stage of development than ova fertilized by F-SP and U-SP spermatozoa at both recovery times. Unfrozen spermatozoa (U-BTS or U-SP) fertilized more ova by 5 h after tubal deposition than F-BTS or F-SP spermatozoa (P less than .005 for each comparison). By 24 h, the percentage of fertilized ova was similar for all treatments. The results indicate that semen processing reduced capacitation time of boar spermatozoa to an extent similar to passage through the uterus. The capacitation time of frozen-thawed spermatozoa appeared to be similar to spermatozoa that were processed, but not cooled, frozen or thawed. PMID- 6863164 TI - Serum luteinizing hormone in prepuberal gilts after ovariectomy or adrenalectomy. AB - Serum luteinizing hormone (LH) concentrations after ovariectomy (OVX) and adrenalectomy (ADX) were studied in the prepuberal gilt. In Exp.I, gilts, 170 to 175 d of age and 80 to 85 kg body weight, were OVX (n = 5) or sham-OVX (n = 5). Blood samples were collected via jugular vein cannulae every 30 min for 8 h on d 1, 3, 5, 7 and 21 after surgery. In Exp. II, blood samples were collected via jugular vein cannulae every 30 min for 12 h on d 3, 5, 7 and 14 after surgery from five ADX, five sham-ADX and five nonsurgical control gilts of similar ages and weights as in Exp. I. In Exp. I, basal serum LH concentrations (means +/- SE, ng/ml) over all days were greater (P less than .05) in OVX (2.9 +/- .1) than in sham-OVX (1.1 +/- .2) gilts. Average basal serum LH concentrations were greater (P less than .05) on d 1 for both treatments than all other days sampled. The frequency of LH peaks (means +/- SE/8 h) was also greater (P less than .01) for OVX (3.5 +/- .3) than sham-OVX gilts (1.7 +/- .2). Similarly, the mean concentration of the LH peaks was greater (P less than .01) for OVX (4.1 +/- .2 ng/ml) than sham-OVX gilts (2.1 +/- .2 ng/ml). In Exp. II, mean basal serum LH concentrations, frequency of LH peaks and mean concentration of the LH peaks were similar for all treatments on each day sampled. The frequency of LH peaks (means +/- SE/12 h) was greater (P less than .05) on d 3 (3.4 +/- .3) than on d 5 (2.3 +/- .3) and d 7 (2.1 +/- .4), but similar to d 14 (2.8 +/- .5) in all treatments. In prepuberal gilts, ADX failed to influence serum LH concentration, whereas OVX caused a significant increase in serum LH concentration. We suggest that the ovary is the major steroid-secreting gland having a negative feedback on pituitary gonadotropin production in the prepuberal gilt. PMID- 6863165 TI - Fertilization failure and embryonic mortality in parous and nonparous beef cattle. AB - One hundred and two nonparous females, 18 to 24 mo old, and 55 parous or multiparous beef females, 3 to 12 yr old, were mated naturally (d 0) and slaughtered on d 2 to 5, 6 to 8 or 14 to 16 of gestation. Each reproductive tract was flushed with phosphate-buffered saline, and the flushings were searched for an oocyte or embryo. Parous females had a higher (P less than .05) fertilization rate than nonparous females. In nonparous females, reproductive failure was attributed equally to fertilization failure and embryonic mortality, which had occurred or was occurring by d 8 of gestation. In parous females, reproductive failure was attributed entirely to embryonic death. About 67% of this embryonic mortality had occurred or was occurring by d 8 of gestation; the other 33% occurred between d 8 and 16 of gestation. These findings show that in both nonparous and parous beef females, a large portion of the reproductive failure occurs by d 8 of gestation and would not have any noticeable influence on length of the estrous cycle. PMID- 6863166 TI - Effect of dietary potassium on absorption of magnesium and other macroelements in sheep fed different levels of magnesium. AB - Two metabolism trials were conducted with 24 crossbred wether lambs. Two levels of Mg (.1 and .2%) and four levels of K (.6, 1.2, 2.4 and 4.8%) were fed in a 2 x 4 factorial arrangement of treatments. Each trial consisted of a 10-d preliminary period followed by a 10-d collection of feed, feces and urine. Increasing levels of dietary K resulted in a linear increase in fecal Mg excretion and a linear decrease in Mg absorption. A large depression in Mg absorption occurred when K was increased from 1.2 to 2.4% with a further decrease when K was increased to 4.8%. Lambs fed the high level of Mg (.2%) absorbed and retained more (P less than .05) total Mg (g/d, but not percentage of intake) compared with the low magnesium level (.1%). Dietary Mg did not affect the amount of K excreted, absorbed or retained. Increasing the level of dietary K resulted in a linear increase in urinary, fecal and total K excreted, absorbed and retained (P less than .05). PMID- 6863167 TI - Effect of potassium level on site of absorption of magnesium and other macroelements in sheep. AB - Eighteen wether lambs, surgically equipped with abomasal and ileal cannulae, were used in two metabolism trials. Two levels of dietary Mg (.1 and .2%) and three levels of K (.6, 2.4 and 4.8%, dry basis) were fed with a 2 x 3 factorial arrangement. Each trial consisted of a 10-d preliminary period, a 7-d collection of feed, feces and urine for determining mineral balance and a 6-d sampling of feed, abomasal and ileal fluid and feces to determine flow and site of mineral absorption. Magnesium absorption occurred before the small intestine. Feeding 2.4 and 4.8% K decreased (P less than .05) Mg absorption by 24.4 and 61.2%, respectively. Preintestinal absorption of Mg was depressed linearly with increases in dietary potassium. Larger amounts of Mg flowed to the small intestine and were excreted in the feces when the high level of Mg was fed. A net secretion of Mg into the small intestine followed by a small amount of Mg absorption in the large intestine was also found. Serum Mg was depressed 7 and 10% when diets containing 2.4 and 4.8% potassium were fed, respectively. Magnesium level did not affect K absorption or balance. Potassium absorption, retention and urinary excretion increased (P less than .05) with increasing K level. Animals fed the low K diet had a negative absorption of K preintestinally with the small intestine being the main site of absorption. Increasing K level resulted in approximately equal amounts of K being absorbed in the stomach and small intestine. PMID- 6863169 TI - A quantitative analysis of rumination patterns. PMID- 6863172 TI - Predicting job stress using data from the Position Analysis Questionnaire. PMID- 6863170 TI - Influence of body composition on energy requirements of beef cows during winter. AB - Twenty Angus-Hereford and 20 Angus-Holstein cows were individually fed 12.9 or 18.0 Mcal metabolizable energy (ME)/head daily from November 28, 1979 through February 21, 1980. Energy retentions for the winter feeding period were calculated by determining body composition at the initiation and at the termination of the feeding period. After the experimental period, all cows were managed the same through weaning. Maintenance energy requirements (Kcal/d) estimated from linear regressions of energy retentions on ME intakes per unit body weight (BW).75 were 127.6 and 140.3 kcal/BW.75 for Angus-Hereford and Angus Holstein cows, respectively. Estimates of maintenance energy requirements for thin and fat cows within each breed type indicated that fatter cows of Angus Hereford breeding had 6.1% lower energy requirements than thinner cows. Opposite trends occurred with Angus-Holstein cows, where fat cows had 2.7% higher maintenance requirements. Estimated maintenance energy requirements were higher (P less than .01) for protein than fat tissue. Maintenance energy requirements of fat was -1.55 kcal ME/kg for Angus-Hereford cows, indicating that for cows of the same lean body mass, cows with more fat have a lower daily energy requirement during winter. Angus-Holstein cows had an estimated maintenance energy requirement of fat of 51.11 kcal ME/kg. Because cattle of Holstein breeding have less subcutaneous fat than cattle of the beef breeds, and less subcutaneous fat would provide less insulation, the estimated maintenance requirements of fat in Angus-Holstein cows may be an estimate of the true maintenance requirement of fat. Estimates of the partial efficiency of ME use for tissue gain and the ME sparing effect of body tissue loss were 78.8% and .70, respectively, for Angus Hereford cows and 53.8% and .46, respectively, for Angus-Holstein cows. Regression of retained energy on cow BW.75, body fat and body protein calculated for Angus-Hereford and Angus-Holstein cows from within energy level indicated that BW.75 accounted for less variation in retained energy than weight of empty body fat or protein. Multiple regressions that contained all three variables accounted for 75% and 32% of the variation for Angus-Hereford and Angus-Holstein cows, respectively. Subsequent performance of the cow and calf was not affected by winter energy levels fed, body composition of cows before calving or body energy changes of cows during the winter. PMID- 6863171 TI - Comparison and combination of clinical and statistical predictions of recidivism among adult offenders. PMID- 6863173 TI - Judgments of relative motion in tactical displays. PMID- 6863175 TI - Effects of expertise and experience on risk judgments. PMID- 6863168 TI - Role of DL-lactic acid as an intermediate in rumen metabolism of dairy cows. AB - The role of DL-lactic acid as an intermediate in the rumen of a Friesian X Holstein dairy cow adapted to a diet of hay ad libitum plus 12 kg of a concentrate mixture was studied in vitro and in vivo. Concentrations of soluble sugars in the rumen fluid became maximal at 30 min postfeeding, but at 90 min no sugars were detectable. The DL-lactate concentration increased very rapidly to about 30 mm at 30 min after feeding, whereas the maximum total VFA concentration was reached 15 min later. More than 80% of the DL-lactate fermented to VFA was converted by Megasphaera elsdenii. Whereas only 16% of L-lactate was fermented to propionate, 75% of the D-lactate was converted to propionic acid. When all soluble sugars had been fermented, the participation of M. elsdenii to lactate fermentation declined and fermentation patterns for D- and L-lactate became similar yielding mostly acetate. Except for a brief period immediately after feeding, DL-lactate did not appear to be an important precursor of VFA in the rumen of a cow adapted to concentrate feeding. DL-lactate may become a more important intermediate in rumen fermentation temporarily when dairy cows are gradually changed from a hay diet to a diet including concentrates. The first 30 d after parturition, when the changeover takes place, is an unstable period, during which the microbial population is changing to fit the new environment. PMID- 6863174 TI - Estimation of loudness by questionnaire. PMID- 6863176 TI - High pressure liquid chromatographic determination of an O-methyl,methyl ester derivative of ochratoxin A. AB - The mycotoxin ochratoxin A (OA) was derivatized to an O-methyl,methyl ester (Me2) with diazomethane and then determined by high pressure liquid chromatography (HPLC). Both OA and OA-Me2 were chromatographed by reverse phase HPLC with a mobile phase of acetonitrile-water (60 + 40). An increase in retention time of 309 s was observed with OA-Me2 which was detectable at 254 nm at levels as low as 3 ng. Recovery of OA as OA-Me2 from chicken kidney homogenates and human plasma was quantitative following simple extraction and cleanup procedures, reaction with diazomethane, and HPLC analysis. The novel method described should prove useful for measuring and confirming OA in tissues and in further studies on the biological fate of this mycotoxin. PMID- 6863178 TI - High pressure liquid chromatographic determination of xanthomegnin in grains and animal feeds. AB - A high pressure liquid chromatographic (HPLC) method is described for the determination of xanthomegnin in grains and mixed animal feeds at levels ranging from 150 to 1200 ng/g. This is equivalent to actual amounts of xanthomegnin injected on the HPLC system at from 15 to 120 ng/injection. Xanthomegnin is extracted with chloroform and 0.1M phosphoric acid. An aliquot of the crude extract is purified by column chromatography using a commercially available silica gel cartridge. Xanthomegnin is then separated from the remaining interferences by HPLC with a reverse phase C-8 column, and subsequently determined by absorbance detection at 405 nm. Elapsed time for the method from initial extraction to final HPLC determination is approximately 1 h. Recoveries of xanthomegnin added to grains and animal feeds at levels from 150 to 1200 ng/g averaged 82% with a coefficient of variation of 10.2%. PMID- 6863177 TI - Simultaneous detection of some fusariotoxins by gas-liquid chromatography. AB - A method was developed for the simultaneous determination of 6 Fusarium mycotoxins (deoxynivalenol, diacetoxyscirpenol, HT-2 toxin, T-2 toxin, fusarenon x, and zearalenone). Cereal samples were first extracted with ethyl acetate, then with a mixture of methanol-water. The crude extracts were combined and purified by silica gel chromatography. The purified extract was reacted with BSTFA (N,O bis(trimethylsilyl)-trifluoroacetamide) to form the derivative, and chromatographed on an SE-52 wall-coated open tubular column. Kovats' retention index was determined for the 6 mycotoxins investigated. Recoveries and standard deviations were determined for pure toxin mixed in cereal. Recovery was 70-80%; relative standard deviation was 10-18%. The method developed was applied to different cereal samples. PMID- 6863179 TI - Effect of citric acid on inhibition of chlortetracycline activity by magnesium ions. PMID- 6863180 TI - Microbiological determination of lincomycin in feeds and supplements containing high concentrations of bentonite. AB - A microbiological method is described for determining lincomycin in complete feeds, supplements, and pre-mixes greater than 100 g/ton and containing high levels of bentonite. The AOAC method currently used is unsatisfactory for analyzing feeds with concentrations of bentonite greater than 5.5%. Study indicates that low lincomycin recoveries from high level bentonite feeds are a function of aqueous contact and subsequent binding. The present method involves an alternative extraction technique using formamide as the primary extractant. A binary solvent system of ethanol and phosphate buffer aids in the extraction, miscibility, and conversion to water solubility for subsequent testing. Forty-one feeds containing as high as 60% bentonite were assayed by the reported method and gave a mean recovery of 106% and a range of 94-114%. An inter-laboratory confirmation study produced a mean recovery of 103%, with a range of 93-114%. A factorial analysis of variance of the interactive effects between lincomycin level and bentonite level within the AOAC method and within the bentonite method showed no interactions which would influence percent recovery in either assay method. PMID- 6863181 TI - High pressure liquid chromatographic determination of carbadox and pyrantel tartrate in swine feed and supplements. AB - A rapid yet reliable procedure for the simultaneous extraction and assay of carbadox and pyrantel tartrate is described. The feed is extracted with water acetonitrile-methanol and cleaned up on a short alumina column. The eluant is separated by high pressure liquid chromatography and the compounds are detected at different wavelengths. The drugs of interest are well resolved in all feeds studied. The procedure has also been applied to a wide range of feeds which contained either one of the drugs or both in combination. No significant interferences were observed. Spiked sample recoveries were 97% for carbadox and 101% for pyrantel tartrate. Ruggedness test coefficients of variation were 2.0% for carbadox and 2.1% for pyrantel tartrate. PMID- 6863182 TI - High performance liquid chromatographic determination of caffeine in decaffeinated coffee, tea, and beverage products. AB - A method was developed for determining caffeine in decaffeinated coffee, tea, and beverage products by high performance liquid chromatography (HPLC). The HPLC system consisted of a Bio-Sil ODS-5S C18 column, methanol-water (25 + 75) mobile phase at 1 mL/min, and a UV detector. The method is simple and specific. Caffeine recoveries were 93.8-98.3% and coefficients of variation were 0.90-2.25%. PMID- 6863183 TI - Hot leaching of ceramic and enameled cookware: collaborative study. AB - A hot leach method published by the World Health Organization for determining Pb and Cd in ceramic and enameled ware was collaboratively studied in 14 laboratories. The method consisted of heating a solution of 4% acetic acid at the boil for 2 h in 6 samples of specially glazed ceramic ware and 6 samples of special enameled ware. The acid was allowed to cool and stand in contact with the ware for an additional 22 h. At the end of the 2 h heating period and again at the end of the 24 h period, the leach solution was assayed by atomic absorption spectrophotometry for Pb and Cd. Ruggedness testing before the collaborative study revealed that: (1) the quantity of metal released increased as the average leach temperature approached the boiling point, (2) the quantity of Pb and Cd released from enameled ware increased linearly with time during 7 h of boiling, (3) the concentration of acid could be varied from 2 to 6% with no apparent effect on the amount of metal released, and (4) the room temperature (RT) contact period lasting from 22 to 120 h (after the 2 h heating period) did not increase the amount of metal released. The quantities of Pb and Cd measured by the collaborators at the end of 2 h of heating and after 24 h of total contact were essentially identical. The amounts of Pb and Cd were not related to the quantity of acid solution required to restore the leach solution volume to its initial value after boiling. The collaborative results showed that the period of standing at RT is not necessary and probably can be eliminated from the method. The modified method, which requires analysis of the leach solution immediately after the 2 h heating period, has been adopted interim official first action by AOAC. PMID- 6863184 TI - Determination of copper, nickel, and chromium in foods. AB - A collaboratively studied method for Pb, Cd, As, Se, and Zn that uses a closed system digestion technique has now been extended to include 3 additional elements, Cu, Ni, and Cr. Cu is determined by either atomic absorption spectrophotometry or anodic stripping voltammetry, depending on the concentration. Ni and Cr are determined by differential pulse polarography. Analysis of National Bureau of Standards reference materials by this procedure gives values in close agreement with the accepted values. Recoveries from applesauce and chicken spiked at 0.6-4 micrograms/g are in the 92-101% range. The sensitivity of the multielement procedure is 0.34, 0.14, and 0.24 microgram/g for Cu, Ni, Cr, respectively, at the 90% confidence level. PMID- 6863185 TI - Automated analysis of flour extracts for uric acid and its correlation with degree of insect defilement. AB - An automated method is described for quantitating uric acid in a sodium acetate extract of flour. The difference in color intensity developed in a flour extract treated with the enzyme uricase and one that is not treated is measured spectrophotometrically. A mean recovery of 97.1% was obtained for 50 g flour samples spiked with 1 mg uric acid. The method can measure as little as 50 micrograms uric acid in 50 g flour and is used to establish a correlation between the uric acid in the flour and the number of insect fragments and excreta pellets present. A 42-data point least squares straight line having a slope of 1.62 and a correlation coefficient of 0.750 (99.9-100% valid) is used to establish the relationship of uric acid to insect defilement. PMID- 6863186 TI - Ion-pair high performance liquid chromatographic determination of inosinic acid in meat. AB - An ion-pair high performance liquid chromatographic (HPLC) technique is described for the determination of inosinic acid (IMP) in meat. The compound was extracted with perchloric acid and analyzed without cleanup. IMP is effectively separated, identified, and quantitated by using a reverse phase column, with ultraviolet detection. A C8 stationary phase and tetrabutyl ammonium as counter ion are used. Recovery of IMP added to meat at 500 or 2500 ppm levels was more than 95%; the limit of detection for IMP is 50 ppm. PMID- 6863187 TI - Determination of 2-chloroethanol in honey, beeswax, and pollen. AB - Procedures were developed and tested for the determination of residues of 2 chloroethanol (ethylene chlorohydrin, ECH) in honey, beeswax, and pollen. Recoveries of ECH from fortified samples averaged 91, 87, and 89%, respectively, for each substrate. The maximum amount of ECH found in substrate fumigated with ethylene oxide was 36 micrograms/g in honey, 124 micrograms/g in beeswax, and 132 micrograms/g in pollen. A tendency was noted for darker waxes, which contain larger amounts of naturally occurring chlorides than light-colored waxes, to contain the greater amounts of ECH. A gas-liquid chromatograph equipped with a Dohrmann halogen-specific detector was used for identification and quantitation. PMID- 6863188 TI - Gas-liquid chromatographic determination of S,S,S-tributyl phosphorotrithioate (DEF) in water and fish tissue. AB - Methods are described for determination of S,S,S-tributylphosphorotrithioate (DEF) at levels as low as 5 parts per billion in fish and 200 parts per trillion in water. Fish tissue extracts are subjected to gel permeation chromatography (GPC) and silica gel chromatography; water samples are extracted with dichloromethane. Analyses are carried out by gas chromatography in which either electron capture or thermionic specific detectors are used. The applicability of the methods is demonstrated by analyses of water and fish samples from exposure studies. PMID- 6863189 TI - Extraction and cleanup procedures for determination of diarylphosphates in fish, sediment, and water samples. AB - Methods for determination of triaryl/alkylphosphates (TAPs) in water, fish, and sediment have been extended to determination of the diarylphosphate (DAP) degradation products. DAPs were extracted from water (adjusted to pH 0.5) by use of XAD-2 resin and determined by gas-liquid chromatography as butyl esters. Recovery of diphenylphosphate (DPP) and o-, m-, p-dicresylphosphates (DoCP, DmCP, DpCP) were greater than 95% in water samples fortified at 1, 10, and 50 micrograms/L. DAPs were extracted from fish with methanol and the extracts were cleaned up on reverse phase (C18) silica cartridges. Recoveries were greater than 87% for DPP, DoCP, DmCP, and DpCP in fish muscle fortified at 50, 100, and 500 ng/g. Sediments were refluxed with aqueous methanol and DAPs were recovered by use of XAD-2 resin. Recoveries of DAPs from sediments fortified at 50 and 100 ng/g were greater than 76%. Interferences (1-10 ng/g) from phosphorus or nitrogen containing GLC peaks prevented sub- ng/g level analysis for DAPs in sediment and fish extracts. PMID- 6863190 TI - Determination of organic phosphate triesters in human adipose tissue. AB - A method of analysis has been developed for the determination of organic phosphate triesters in human adipose fat at low ng/g levels. After fat extraction from the tissue with benzene (or acetone-hexane, 15 + 85, v/v), phosphates were fractionated from fat by gel permeation chromatography with methylene chloride cyclohexane (5 + 95, v/v) as solvent. After Florisil column cleanup, the GPC extract was analyzed by capillary column gas chromatography using a nitrogen phosphorus selective detector. Recoveries at the 2.5, 10, and 25 ng/g levels were greater than 75% except for tri(2,4-xylenyl) phosphate (ca 65%). Of 16 human adipose tissue samples analyzed, 5 contained tris(1,3-dichloropropyl) phosphate in the range of 0.5 to 110 ng/g, 4 contained tributoxyethyl phosphate in the range of 4.0 to 26.8 ng/g, and one contained tributyl phosphate at 9.0 ng/g. PMID- 6863191 TI - Interlaboratory study on determination of 2,3,7,8-tetrachlorodibenzo-p-dioxin in fish. AB - An interlaboratory round robin study was carried out to estimate the reliability of data on 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) in fish. Using different methods, 13 laboratories (4 Canadian, 9 American) agreed to analyze 4 fish samples; 3 were Great Lakes salmonids containing bio-incurred levels of TCDD below 100 ppt and the fourth was an ocean fish fillet containing no measurable TCDD. Samples were sent as freeze-dried portions as it was shown that no change of TCDD occurred by this sample preparation. Results were normalized between laboratories by supplying each with an aliquot of the same 2,3,7,8-TCDD standard. Eight laboratories reported a set of results of which one set was rejected. Values from the 7 remaining laboratories for the 3 positive fish showed mean concentrations in pg/g (ppt) and (CV, %) of 61.2 (13.9), 30.4 (18.4), and 32.3 (25.4). Detection limits averaged 3.6 ppt and ranged between 1 and 10 ppt. No significant differences appeared in the concentration of 2,3,7,8-TCDD in fish samples from methods differing in the use of: (i) digestion or extraction techniques, (ii) high or low resolution mass spectrometry, and (iii) isomer specific or nonspecific separations. Overall recovery values using internal standards varied greatly (29-109%) even within the same laboratory and pointed to the need to use an internal standard to obtain precise results. Agreement among laboratories was good considering the level quantitated (ppt) and the diverse methodology. PMID- 6863192 TI - Simultaneous determination of protein (nitrogen), phosphorus, and calcium in animal feedstuffs by multichannel flow-injection analysis. AB - A 3-channel flow-injection procedure was developed, which enables the simultaneous determination of protein, phosphorus, and calcium in a wide range of animal feeds from a single digestion. Samples are digested with a block digestor, diluted, and analyzed at a rate of 82 samples/h. Protein (nitrogen) as ammonia is determined colorimetrically by the indophenol method. Phosphorus and calcium are determined by measuring the absorbances of the molybdenum blue and calcium cresolphthalein complexes at 660 and 580 nm, respectively. Protein is determined in the range from 0 to 75%, phosphorus in the range from 0 to 6%, and calcium in the range from 0 to 6%. The results obtained do not differ significantly from those obtained by proven manual methods, and considerable time, space, and reagents are saved. PMID- 6863193 TI - High performance liquid chromatographic determination of seven antioxidants in oil and lard: collaborative study. AB - A high performance liquid chromatographic procedure for the determination of propyl gallate (PG), 2,4,5-trihydroxybutyrophenone (THBP), tert-butylhydroquinone (TBHQ), nordihydroguaiaretic acid (NDGA), 2- and 3-tert-butyl-4-hydroxyanisole (BHA), 2,6-di-tert-butyl-4-hydroxymethylphenol (Ionox-100), and 3,5-di-tert-butyl 4-hydroxytoluene (BHT) was collaboratively studied by 8 laboratories. The 14 samples analyzed consisted of 10 vegetable oil samples spiked in matched pairs at about 200, 100, and 20 ppm and 4 lard samples spiked in matched pairs at about 100 and 40 ppm for each antioxidant except NDGA which was spiked only at the 2 lower levels in oil. In the method studied, the samples were dissolved in hexane and the antioxidants were partitioned into acetonitrile. The acetonitrile was concentrated and diluted with isopropanol to give isopropanol-acetonitrile (1 + 1). The antioxidants were separated by reverse phase gradient elution and detected at 280 nm. The results from one laboratory were rejected as outlying and were not considered in any calculations. For the remaining 7 laboratories, the overall mean recoveries for PG, THBP, TBHQ, NDGA, BHA, Ionox-100, and BHT were 93.2, 95.1, 95.6, 95.5, 98.3, 95.8, and 84.8%, respectively, and the overall mean coefficients of variation were 5.02, 7.74, 19.3, 4.36, 3.75, 6.33, and 3.45%, respectively. PMID- 6863194 TI - Isomerization of retinyl palmitate using conventional lipid extraction solvents. AB - The use of a chloroform-ethanol-water solvent system for the direct extraction of retinyl palmitate isomers from fortified food products was previously shown to be unsuitable because significant isomerization of all-trans-retinyl palmitate occurred during the extraction. This study investigated the extent of isomerization of retinyl palmitate in various extraction solvents when subjected to gold fluorescent laboratory light. Purified solutions of all-trans-retinyl palmitate in hexane were diluted with methyl t-butyl ether, hexane, methylene chloride, and stabilized chloroform and subjected to gold fluorescent laboratory light for 2, 4, and 6.5 h. Similar solutions were subjected to light or kept in the dark for 3.5 h. All-trans-, 9-cis-, and 13-cis-retinyl palmitate esters in the solutions were determined by using normal phase high performance liquid chromatography with fluorometric detection. Results demonstrated a noticeable increase in the 9-cis-retinyl palmitate concentration and a corresponding decrease in all-trans-retinyl palmitate concentration with time, in chloroform and methylene chloride compared with hexane. Chlorinated solvents in the absence of light did not promote isomerization of retinyl palmitate. Use of chlorinated solvents for the extraction of vitamin A esters should be avoided because they promote isomerization of retinyl palmitate when subjected to light, including gold fluorescent laboratory light. PMID- 6863195 TI - Analysis of fat-soluble vitamins. XXVIII. High performance liquid chromatographic determination of vitamin D in pet foods and feeds: collaborative study. AB - A high performance liquid chromatographic (HPLC) method for vitamin D in pet foods and feeds at low concentrations (2-8 IU/g = 50-200 ppb) was studied collaboratively. The procedure consists of the following purification steps: saponification, extraction of the unsaponifiable fraction, chromatography on alumina, cleanup on reverse phase HPLC, and quantitation with straight phase HPLC. The original method, developed by Knapstein, was simplified by deleting the quantitative TLC step. Six coded samples were distributed to 31 laboratories, along with a known sample containing 15 IU/g to allow practice of the rather complicated procedure. Eighteen collaborators returned their results. Results for the spiked samples show good recovery. The estimates of repeatability and reproducibility are 0.96 and 2.2 IU/g for spiked samples and 1.5 and 3.1 IU/g for commercial samples, respectively, which are considered acceptable for these low concentrations. The method has been adopted official first action. PMID- 6863197 TI - Gas-liquid chromatographic determination of benzoic acid and sorbic acid in foods: NMKL collaborative study. AB - A gas-liquid chromatographic method for the simultaneous determination of benzoic acid and sorbic acid in foods was collaboratively studied by 8 laboratories. Benzoic and sorbic acids are isolated from food by successive extractions with ether, sodium hydroxide, and methylene chloride, converted to trimethylsilyl (TMS) esters, and determined by gas-liquid chromatography. Phenylacetic acid and caproic acid are used as internal standards for benzoic acid and sorbic acid, respectively. Seven samples were collaboratively studied: almond paste, fish homogenate, and apple juice with benzoic and sorbic acid levels from 0.04 to 2 g/kg. Average recoveries (%) for benzoic and sorbic acids were as follows: almond paste, 99.6 and 101.2; fish homogenate, 99.2 and 97.4; and apple juice 98.2 and 106.6. The reproducibility coefficients of variation (%) for benzoic and sorbic acids at 0.5-2 g/kg levels were 3.5-6.1 and 5.2-9.0; and at the 0.04 g/kg level, 14.7 and 23.3, respectively. The method has been adopted official first action at 0.5-2 g/kg levels. PMID- 6863196 TI - Comparative analysis of meat samples prepared with food chopper and bowl cutter. AB - Analyses of meat samples after preparation with either a bowl cutter or by the official procedure with a food chopper were compared for homogeneity of comminution and for differences in fat, moisture, and protein content. Cutting time in the bowl cutter was limited to minimize temperature rise in samples. Beef chuck, pork shoulder, and beef shank, cheek, and tongue were used in the study. Variances of replicate analysis data for the 5 meat types were pooled for either cutter or chopper treatment and for each analyzed component. Sample portions cut and mixed by using the bowl cutter were more homogeneous than those ground with a food chopper. Comparative accuracy was indicated by fat and moisture means: 5 were in good agreement and 5 differed significantly; 3 of 5 paired protein means differed significantly but were within 0.3% protein. Results on precision and accuracy as well as the simplicity and convenience of the bowl cutter procedure favor its use as an alternative to a food chopper for preparing meat samples for analysis. PMID- 6863198 TI - Discussion of statistical methods for determining purity of citrus juice. AB - It is difficult to develop statistical methods to determine the purity of fruit juice because of country-to-country and environmental differences among fruit. A test of an unknown sample of citrus juice can err in 2 ways: Pure juice can mistakenly be rejected as adulterated, or adulterated juice can be accepted as pure. Many of the statistical procedures proposed may misclassify a high proportion of samples of pure juice as adulterated. It is necessary to develop a statistical test that will only rarely reject samples of pure juice, and will have a good chance of rejecting adulterated juice. PMID- 6863199 TI - Portable micro method for quantitative determination of vitamin C in fruit and vegetable juices. AB - A portable rapid and accurate micro method is described for the quantitative determination of vitamin C in fruit and vegetable juices. Chromatographic paper is impregnated with DCP by immersion in 95% ethanol solution and sprayed with a protective starch solution. Papers are usable indefinitely when protected from moisture, light, air, and high temperatures. Determinations can be completed in 60 s with an accuracy of +/- 2.0 mg/100 mL fruit or vegetable juice. Cloudy or lightly colored samples do not interfere with the determination. The method was compared with the official AOAC 2,6-dichloroindophenol (DCP) titration method and gave a linear correlation coefficient of 0.99749. PMID- 6863200 TI - "Beware of everything": the ever-present danger of anaphylaxis. PMID- 6863201 TI - Training asthmatic children to use their nebulizer correctly. PMID- 6863202 TI - IgG subclasses in asthmatic patients. PMID- 6863203 TI - Anaphylaxis to Kiwi fruit and related "exoti"" items. PMID- 6863204 TI - Asthma and severe drug-related problems. PMID- 6863205 TI - Desensitization of aspirin-sensitive asthmatics: a therapeutic alternative? AB - To identify and characterize aspirin sensitivity, over 500 oral aspirin challenges have been performed in patients since 1970. Protocols were developed, and an aspirin desensitization process was created as an extension of the challenge protocol. Without exception, desensitization has been achieved in 66 of 66 consecutive aspirin-sensitive asthmatics. There is also cross-desensitization with nonsteroidal anti-inflammatory drugs (NSAIDs) in the limited number of patients studied. After desensitization with either aspirin or NSAIDs, an interruption of continuous therapy is followed by a reappearance of sensitivity. Patients must be cautioned about this and the possibility of a severe reaction should aspirin be reintroduced after aspirin avoidance for 2-5 days. PMID- 6863206 TI - Acetaminophen and aspirin challenges in subgroups of asthmatics. AB - To determine whether the different modes of action of aspirin and acetaminophen are associated with different incidences of bronchoconstriction, and whether there is cross-reactivity in terms of intolerance, selected asthmatics were challenged with both analgesics. Clinical profiles were observed to characterize more precisely the aspirin-intolerant asthmatic. Inhalational challenges with PGF2 alpha were then performed on nine selected subjects. It was determined that a positive history of aspirin intolerance is a reliable indicator of potential for anaphylactoid reactions but is not associated with any detectable risk of acetaminophen intolerance. Inhalational PGF2 alpha tends to involve the larger airways; oral aspirin affects both large and small airways. PMID- 6863207 TI - Tactics for clinical trials of therapy in patients with chronic asthma. AB - Asthma can be conceptualized as a disease system ranging from the molecular to the social level. It is important to monitor both subjective and objective indices appropriate to different parts of the system. Objective indices alone are not enough. It is also important to distinguish disability from symptom severity or frequency and pulmonary impairment. The personality of the patient or the duration of follow-up can profoundly affect the perceived outcome of a particular treatment. It is important in controlled trials, and also in clinical practice, to take these factors into account. PMID- 6863208 TI - Hemispheric lateralization of language in autistic and aphasic children. AB - The profound language deficit in early infantile autism has led to speculation about the similarities between autistic and language-impaired children. Since aphasia in adults and many children is typically the result of left cerebral hemisphere damage, some researchers have suggested that autistic children also suffer from left hemisphere damage. So far, only indirect or unreliable evidence has been offered in support of this hypothesis. In the present experiment, autistic, language-impaired, and non-language-impaired children were compared on a dichotic listening task designed to overcome some of the deficiencies of earlier research. Language-impaired children were found to exhibit a left ear bias for language material (indicating right hemisphere lateralization for language), whereas the autistic and non-language-impaired children showed the opposite, right ear bias. As the autistic children showed a pattern similar to that of normal children, the present experiment found no evidence for either left hemisphere damage or aphasiclike performance among autistic children. The implications of these findings for understanding the autistic language deficit are explored. PMID- 6863209 TI - Proprioceptive versus visual control in autistic children. AB - The autistic child's presumed preference for proximal rather than distal sensory input was studied by requiring that autistic, retarded, and normal subjects adapt to a prism-induced lateral displacement of the visual field. Only autistic subjects demonstrated transfer of adaptation to the nonadapted hand, indicative of a reliance on proprioception rather than vision to accomplish adaptation. Such reliance on proprioception was explained as an alternative strategy compensating for an inability to use current visual control of reaching rather than as a preference for proximal information per se. PMID- 6863210 TI - Infantile autism: a total population study of reduced optimality in the pre-, peri-, and neonatal period. AB - Twenty-five autistic children, constituting a total population sample of children with infantile autism, were compared with 25 sex- and maternity-clinic-matched controls for occurrence of reduced optimality in the pre-, peri, and neonatal period, as noted in medical records. Autistic children showed greatly increased scores for reduced optimality, especially with regard to prenatal factors. The findings are at odds with early reports that children with autism had not suffered potential brain injury. The reasons for the discrepancy are discussed. PMID- 6863214 TI - Brief report: trace elements in the hair of autistic and control children. PMID- 6863213 TI - Shaping bladder and bowel continence in developmentally retarded preschool children. AB - A program to improve bladder and bowel continence was evaluated in a preschool with four developmentally retarded children. During baseline, the children were taken to the toilet on a regular schedule, once an hour. The training program increased this frequency to once every 15 minutes for the 1st week, every 30 minutes the 2nd week, every hour the 3rd week, and every 2 hours in the 4th week. Using the toilet appropriately was reinforced with social praise and liquids. Accidents resulted in a brief verbal reprimand and simple correction (i.e., going to the bathroom, changing clothes, and sitting on the toilet). All four children showed improvement in their bladder and bowel continence. Results of the program are discussed in terms of improved efficiency of toilet training programs and their use with developmentally retarded preschool children. PMID- 6863215 TI - The effect of early intervention on the diagnosis of autism. PMID- 6863211 TI - Language patterns of parents of young autistic and normal children. AB - This study examined the language patterns of parents of 10 autistic children and parents of 10 normal children who were matched with the autistic children for language age, sex, and parents' educational level. Syntatic and functional aspects of parental language were assessed during a 20-minute interaction before the parents of the autistic children participated in a behaviorally oriented treatment program. Few significant differences emerged between the language of the parents of the autistic and normal children. The parents of the autistic children used more non-language-oriented language but did not differ from the parents of the normal children in the percentage scores for any language category. Also, although the parents of the autistic children spoke more often, complexity of language, as measured by mean length of utterance, was comparable across the groups. Several differences emerged between mothers' and fathers' language patterns. These results suggest that parents of autistic children provide language environments similar to those experienced by normal children in the initial stages of language development and that mothers and fathers play different roles in their child's language environment. PMID- 6863212 TI - Auditory brainstem responses in childhood psychosis. AB - Auditory brainstem responses were compared in 24 autistic children, 7 children with other childhood psychoses, and 31 normal children. One-third of the autistic children showed abnormal ABR indicative of brainstem dysfunction and correlating with muscular hypotonia and severe language impairment. The children with other psychoses and the normal children showed normal results. PMID- 6863216 TI - Coping strategies. PMID- 6863217 TI - Increased carbohydrate substitution of lipoteichoic acid during inhibition of protein synthesis. AB - Decreases in electrophoretic mobilities of intracellular lipoteichoic acid, intracellular deacylated lipoteichoic acid, and extracellular deacylated lipoteichoic acid were observed during inhibition of protein synthesis in Streptococcus faecium after exposure to chloramphenicol or valine deprivation. Increased carbohydrate content, and thus an increased mass-to-charge ratio, rather than changes in ester alanine content or novel fatty acid substitutions, appeared to account for the decreased electrophoretic mobilities. The increase in carbohydrate content, as judged from mobility measurements, was progressive over time and appeared to occur on biosynthetically new lipoteichoic acid as well as on lipoteichoic acid made before inhibition of protein synthesis. PMID- 6863218 TI - Nitrogen metabolism in the phototrophic bacteria Rhodocyclus purpureus and Rhodospirillum tenue. AB - Studies of the nitrogen nutrition and pathways of ammonia assimilation in Rhodocyclus purpureus and Rhodospirillum tenue have shown that these two seemingly related bacteria differ considerably in aspects of their nitrogen metabolism. When grown photoheterotrophically with malate as carbon source, R. purpureus utilized only NH4+ or glutamine as sole nitrogen sources and was unable to fix N2. By contrast, R. tenue was found to utilize a variety of amino acids as nitrogen sources and was a good N2 fixer. No nitrogenase activity was detected in cells of R. purpureus grown on limiting ammonia, whereas cells of R. tenue grown under identical conditions reduced acetylene to ethylene at high rates. Regardless of the nitrogen source supporting growth, extracts of cells of R. purpureus contained high levels of glutamate dehydrogenase, whereas R. tenue contained only trace levels of this enzyme. Alanine dehydrogenase activity was absent from both species. We conclude that R. purpureus is incapable of fixing molecular nitrogen and employs the glutamate dehydrogenase pathway as the primary means of assimilating NH4+ under all growth conditions. R. tenue, on the other hand, employs the glutamine synthetase/glutamate synthase pathway for the incorporation of NH4+ supplied exogenously or as the product of N2 fixation. PMID- 6863219 TI - Plasmids in Frankia sp. AB - A method to achieve cell lysis and isolate Frankia sp. plasmid DNA was developed. A screening of Frankia sp. strains belonging to different host compatibility groups (Alnus sp., Elaeagnus sp., Ceanothus sp.) showed that, of 39 strains tested, 4 (strains Cp11, ARgN22d, ArI3, and EUN1f) possessed plasmids ranging in size from 7.1 to 32.2 kilobase pairs as estimated from agarose gel electrophoresis and electron microscopy. A total of 11 plasmids were detected. PMID- 6863220 TI - Uric acid utilization by Mycobacterium intracellulare and Mycobacterium scrofulaceum isolates. AB - Forty-nine human and environmental isolates of Mycobacterium intracellulare and Mycobacterium scrofulaceum were tested for their ability to grow on uric acid and a number of its degradation products. Nearly all (88 to 90%) strains used uric acid or allantoin as a sole nitrogen source; fewer (47 to 69%) used allantoate, urea, or possibly ureidoglycollate. Enzymatic activities of one representative isolate demonstrated the existence of a uric acid degradation pathway resembling that in other aerobic microorganisms. PMID- 6863221 TI - Regeneration of protoplasts of Clostridium pasteurianum ATCC 6013. AB - A procedure has been developed for the regeneration of Clostridium pasteurianum protoplasts with frequencies of up to 10% reversion being obtained. PMID- 6863223 TI - Frequency of seclusion in an adolescent psychiatric unit. AB - The frequency and character of seclusion and restraint use on an adolescent psychiatric ward were analyzed by examining 369 written reports and comparing characteristics of low-frequency with high-frequency seclusion years. Contributors to high-frequency use of seclusion included lack of staff response to persistent limit testing, appeals to cognitive mechanisms and dynamic understanding at times of behavioral outbursts, staff conflicts, and unduly restrictive criteria for use of antipsychotic medications. Patients with borderline personality characteristics were allowed to act in increasingly disordered fashion without staff intervention before seclusion and restraint were used, and were likely to be secluded in disproportionately large numbers during outbreaks of violence. Changes in expectations and performance by staff lowered the number of seclusions by 66% during a period when the patient load increased. PMID- 6863222 TI - Temperature dependence of growth and membrane-bound activities of Chloroflexus aurantiacus energy metabolism. AB - The temperature dependence of various activities related to the energy metabolism of isolated membranes and whole cells of the thermophilic bacterium Chloroflexus aurantiacus was determined after phototrophic growth at either 40, 50, or 60 degrees C. The data obtained were expressed by use of Arrhenius plots. Maximum activities were determined at about 65 degrees C for succinate 2,4-dichlorophenol indophenol reductase as well as NADH oxidase and at about 70 degrees C for Mg ATPase and for light-induced proton extrusion by cells. Activation energies for Mg-ATPase and light-induced proton extrusion were about 40 kJ mol-1 from 30 degrees C to about 50 degrees C and they increased significantly at higher temperatures. Essentially the same dependency was detectable with NADH oxidase, except for an increase in activation energy below 41 degrees C. All of these responses were independent of growth temperature. Succinate-2,4-dichlorophenol indophenol reductase showed a change in activation energy around 41 degrees C only with cells grown at 60 degrees C. Differences in the responses of cells grown at different temperatures were identified on the basis of changes from sigmoidal to hyperbolic kinetics for light saturation of proton extrusion. Moreover, the thermostability of proton extrusion was maximal when assayed at the corresponding growth temperatures. In any case, thermostability was lowest at the 65 and 68 degrees C assay temperatures. Differential scanning calorimetry with membranes revealed irreversible heat uptake from about 60 to 72 degrees C. The results are discussed in light of the activation energy for the specific growth rate, which is lowest at temperatures from 40 degrees C to the optimum at 60 degrees C. PMID- 6863224 TI - Onset of action of amoxapine and doxepin in outpatients with "mixed anxiety/depression". AB - In a parallel-group double-blind study, 142 outpatients with "mixed anxiety/depression" were treated with amoxapine or doxepin for 4 weeks in mean maximum daily dosages of 260 mg and 130 mg, respectively. Patients in both groups improved significantly during treatment as shown by changes in the Hamilton, Zung, Patient Self-Evaluation, and Clinical Global Impressions scales. From 24 to 31 of the 71 subjects receiving amoxapine and 16 to 24 of the 71 receiving doxepin were rated as "unquestionably improved" at the end of the treatment period on these scales. The time to achieve this degree of response was significantly shorter with amoxapine on both the CGI (p = .018) and Hamilton (p = .005) scales. Side effects were roughly comparable with two exceptions: doxepin treated patients experienced more daytime drowsiness (p less than or equal to .05) and amoxapine-treated patients experienced more constipation (p less than or equal to .01). PMID- 6863225 TI - Depression among amputees. AB - A 35% prevalence of major depressive disorder was found in a prospective study of 65 amputees evaluated in a Physical Medicine and Rehabilitation Department. The findings indicate significantly more alcohol abuse among the depressed group. Higher percentages of female than male amputees were found to be depressed and unmarried. The prevalence of smoking was significantly higher among those whose amputations were due to vascular disease rather than other causes (e.g., trauma). In addition to the physical care of amputees, their emotional needs and well being merit serious consideration. PMID- 6863226 TI - History of drug abuse and dangerous behavior in inpatient schizophrenics. AB - The alcohol and drug use histories of 85 schizophrenic inpatients were examined in relation to measures of dangerousness while in hospital (physical and verbal assaults and episodes of seclusion and restraint). Stepwise multiple regression analyses showed significant relationships between each dangerousness measure and certain drug abuse history factors. Assault was most closely related to a drug abuse factor containing a history of blackout episodes and assaultiveness while drinking, whereas seclusion and restraint were most closely related to histories of becoming "loud" while on drugs. Overall measures of dangerousness appear to relate best to histories of becoming loud or assaultive while taking drugs. PMID- 6863227 TI - Cimetidine-induced mania in depressed patients. AB - Two psychiatric patients whose illnesses were in remission became hyperactive, euphoric, and agitated following the use of cimetidine. Both patients obtained relief from these symptoms when the drug was discontinued, and one had a recurrence of symptoms when cimetidine treatment was resumed. PMID- 6863228 TI - PCP in amniotic fluid and breast milk: case report. AB - The presence of phencyclidine (PCP) in breast milk and amniotic fluid of a young drug abuser is described. Implications drawn from these data include the possible use of amniocentesis in women with well-documented histories of drug abuse who have low levels of PCP in urine, and the restriction of breast feeding in women who have abused PCP. PMID- 6863229 TI - The cortisol suppression index. PMID- 6863230 TI - Tardive dyskinesia with molindone. PMID- 6863231 TI - Kinetic analysis of actin polymerization. AB - The kinetics of actin polymerization were analyzed by measuring the changes in absorbance which accompany the G-F transformation of actin. In these studies, gel filtered actin was polymerized in the absence of shearing stress under physiological ionic conditions. Self-polymerization was found to be characterized as a process having a lag phase followed by a pseudo-first-order decay process, suggesting that actin polymerization consists of distinct nucleation and elongation phases. The size of the nucleus was estimated to be two to four monomer units by analyzing the actin concentration-dependences of the rate constant for the pseudo-first-order process, the maximal rate of polymerization and the half-polymerization time. The elongation reaction was induced by mixing actin filament seeds with actin monomers under conditions where spontaneous nucleation is slow. This elongation was also found to be a pseudo-first-order process, indicating that spontaneous nucleation was negligible. Our data suggested that the initial rate of elongation was proportional to both the number concentration of actin filaments and the actin monomer concentration above the critical concentration, and that the depolymerization rate was proportional to the number concentration of actin filaments but independent of monomer concentration. The results of direct analysis of the depolymerization reaction were consistent with this suggestion. These studies strongly support the condensation polymerization mechanism as a model for actin polymerization. PMID- 6863232 TI - Kinetic and thermodynamic analyses of outer doublet tubulin polymerization. AB - The kinetics and thermodynamics of microtubule assembly were studied using outer doublet tubulin isolated from starfish sperm. Purified tubulin was gel-filtered just prior to the experiments. The self-polymerization process was found to be characterized by a lag followed by a growth phase that did not show a single first-order decay reaction. This suggested that the nucleation and elongation steps are not completely separate. The maximal rate of polymerization and the reciprocal of the duration of lag time increased approximately in proportion to the third and second powers of tubulin concentration above the critical concentration, respectively. Measurement of temperature dependence of the critical concentration gave a linear van't Hoff plot with delta H degree = 13.5 kcal/mol and delta S degree = 69 e.u. PMID- 6863233 TI - Binding between thermolysin and talopeptin (MKI) in which the tryptophan residue was converted into kynurenine. AB - The tryptophan residue of talopeptin, which is a specific inhibitor for thermolysin, was converted into kynurenine by ozonization followed by acid catalyzed hydrolysis, and (Trp leads to Kyn) talopeptin (Kyn-talopeptin) thus obtained was purified with gel-chromatography. The inhibitor constant of Kyn talopeptin, K1, and the dissociation constant of thermolysin-Kyn-talopeptin complex, Kd, directly obtained by fluorometric titration were in good agreement with each other. These values were found to be about 10 times larger than those of intact talopeptin, but both inhibitors showed a similar pH dependence. Upon the binding of Kyn-talopeptin with thermolysin, the protein fluorescence of thermolysin decreases by about 60%, while the kynurenine fluorescence (measured at 450 nm when excited at 360 nm) of the inhibitor increases about 14 times. The measurements of the excitation and fluorescence spectra of EI complex strongly indicated the energy transfer from tryptophan residue(s) (the donor) of the enzyme to kynurenine residue (the acceptor) of the inhibitor. The distance between the donor and the acceptor was roughly estimated to be 18 A. This value is in good agreement with the one expected from the crystallography of phosphoramidon-thermolysin complex. The binding process was studied kinetically with the stopped-flow method over the pH range between 4.5 and 8.5, by monitoring the decrease in the fluorescence intensity of the enzyme tryptophan caused by the complex formation. Comparison of the data with those previously obtained for talopeptin-thermolysin system revealed that the replacement of the tryptophan residue by kynurenine of the inhibitor does not affect the apparent second-order association rate constant, kon, seriously. PMID- 6863234 TI - Changes in the profiles of rodent plasma lipoproteins and apolipoproteins after cholesterol feeding. AB - Profiling of plasma lipoprotein distribution and apolipoprotein analysis were carried out semi-quantitatively by strictly controlled gel-filtration and SDS slab-gel electrophoresis for rats (Sprague-Dawley rats and ExHC rats), mice and hamsters. The effects of cholesterol feeding on lipoprotein and apolipoprotein patterns of these animals were also studied. HDL were major lipoproteins in all the animals. Hamsters had the most abundant lower density lipoproteins among the rodents with the ratio of cholesterol content between high density lipoproteins and lower density lipoproteins being about 1:1. After cholesterol feeding, the cholesterol content of lower density lipoproteins increased in all the animals. The increase was the greatest in ExHC rats and the least in mice. The profiling methods employed should be of value in determining the changes in the lipoprotein and apolipoprotein patterns of both experimental animals and man. PMID- 6863235 TI - Use of new synthetic substrates for assays of cathepsin L and cathepsin B. AB - Efficient methods were developed for synthesizing synthetic substrates for assays of cathepsin B and cathepsin L. Several 2-naphthylamide compounds with a blocked NH2-terminus, Suc-Tyr-Met-NA, beta-Ala-Tyr-Met-NA, and D-Leu-Tyr-Met-NA, were specific and sensitive substrates for cathepsin L and cathepsin B; they were not specific for cathepsin L only, because all of them were also hydrolyzed by cathepsin B. Some kinetic constants for the hydrolyses of these three synthetic substrates by cathepsin B and cathepsin L are given. PMID- 6863236 TI - Assembly of oxyhemoglobin from isolated alpha and beta chains. AB - The kinetics of assembly of oxyhemoglobin from isolated alpha and beta chains was investigated by the use of a circular dichroism (CD) stopped-flow apparatus. The CD change in the Soret region was observed after mixing equivalent concentrations of the isolated chains. The intensity of the CD change was proportional to the protein concentration. The dilution of the isolated chains did not produce any detectable CD change. These results indicate that the CD change could be ascribed to the combination of alpha and beta monomers into alpha beta dimer. The time courses of the CD change showed a rapid phase and a slow phase. The slow phase was a first-order reaction with a rate constant of 2.8 X 10(-3) s-1 (independent of the protein concentration), which suggested that the slow phase reflected the dissociation of self-associated beta chain. The rapid phase depended on the protein concentration: (1) the ratio of the rapid phase to the total CD change decreased with increase in the protein concentration, and (2) the half-life of the rapid phase decreased with increasing protein concentration. The ratio of the rapid phase coincided with the fraction of beta monomer which was calculated from the self-association constant of beta chain. The constant was estimated to be 2.4 X 10(16) M-3 by frontal gel chromatography on the assumption that the isolated beta chain was in a monomer-tetramer equilibrium. This result indicated that the rapid phase could be ascribed to the combining of alpha and beta monomers initially present. Therefore, the half-life of the rapid phase was analyzed on the basis of a scheme which included the monomer-tetramer equilibrium of the beta chain and a second-order combination reaction of alpha and beta monomers. The analysis yielded a second-order rate constant of 7.5 X 10(5) M-1 X S-1. These results suggest that alpha and beta monomers rapidly combine to form alpha beta dimer followed by assembly into Hb, though at high protein concentration the rate of the assembly is limited by the dissociation of self-associated beta chain. PMID- 6863238 TI - Morphological aspects of thiophosphorylated and dephosphorylated myosin molecules from the plasmodium of Physarum polycephalum. AB - Electron microscopically, the myosin molecule from the plasmodium of Physarum polycephalum has a long tail of 173 nm, having a flexible region over the range of 80 to 120 nm from the head-tail junction. In 0.6 M ammonium acetate, this region of the dephosphorylated myosin molecules is more flexible than that of the thiophosphorylated ones. In 50 mM ammonium acetate, the dephosphorylated myosin molecules exist in monomeric and oligomeric forms, independently of ATP and Mg2+, whereas the thiophosphorylated myosin molecules form dense aggregates of thick filaments. The tails of the monomeric dephosphorylated myosin molecules bend sharply at the flexible region at angles of more than 120 degrees. In oligomers of the dephosphorylated myosin molecules, the molecules are all associated side to-side with straight tails and are oriented in the same direction. Based on these results, the regulation mechanism of cell motility of the plasmodium is discussed. PMID- 6863237 TI - Fluorescence probe studies on the interaction of phlorizin with rabbit intestinal brush border membranes. AB - Spectrofluorometric studies on the interaction of phlorizin with rabbit intestinal brush border membranes under various conditions were carried out using 1-anilino-8-naphthalene sulfonate (ANS) and N-(1-anilinonaphthyl-4)maleimide (ANM). The fluorescence intensity of membrane-bound ANS was markedly decreased upon addition of phlorizin. The apparent dissociation constant of phlorizin and the membranes at pH 7.4 was determined to be approximately 24 microM from the slope of a plot of the fluorescence change of membrane-bound ANS against phlorizin concentration. Addition of D-glucose diminished the quenching effect of phlorizin on the ANS fluorescence by lowering the binding affinity of phlorizin for the membranes. The interaction between phlorizin and the membranes was influenced by temperature, ionic strength and divalent cations. The binding affinity of phlorizin for the membranes is markedly reduced at higher temperature, showing a transition between 25 and 30 degrees C. Imposition of an ionic strength gradient across the membrane vesicles (out greater than in) increased the binding affinity. On the other hand, divalent cations decreased the affinity; Mg2+ was more effective than Ca2+. The binding affinity of ANS for the membranes was evidently decreased, and the reactivity of SH groups of the membrane proteins with ANM was apparently reduced, upon binding of phlorizin to the membranes. Based on these results, the relationships among modification of membrane structures, the extent of phlorizin binding and phlorizin-induced conformational changes in the membrane proteins are discussed. PMID- 6863239 TI - Synthesis and biological activity of polyriboadenylic acid: polyribo-5 dimethylaminouridylic acid hybrid (poly(A): poly(Me2N5U)). AB - Poly-5-dimethylaminouridylic acid, (poly(Me2N5U)) has been synthesized by the conversion of 5-bromouridine-5'-monophosphate to 5-dimethylaminouridine-5' monophosphate which was later made into the 5'-diphosphate and subsequently polymerized by PNPase. The polymer formed a 1:1 hybrid with poly(A) with the ability to induce the production of interferon in chick embryoes as certain doses of the hybrid protected chick embryoes against wesselsbron virus (H 10964). PMID- 6863240 TI - On the denaturation of porcine erythrocyte catalase with alkali, urea, and guanidine hydrochloride in relation to its subunit structure. AB - The dissociation of porcine erythrocyte catalase [EC 1.11.1.6] into subunits on denaturation with alkali, GuHCl and urea was investigated by following the changes in hydrodynamic properties, absorption and CD spectra in the Soret region and inactivation of the enzyme. It was found that dissociation proceeded in an "all or none" manner from the native tetramer (molecular weight, ca. 250,000) into identical 1/4-sized monomers (molecular weight, ca. 54,000 with alkali, 65,000 with urea and 71,000 with GuHCl) as estimated by ultracentrifugal analyses. On this dissociation, the sedimentation coefficient decreased from about 11S to 5.1 - 3.7S, and absorption spectra in the Soret region decreased to about 40% of the native level and showed a broad band around 365-375 nm and a shoulder around 415-420 nm; these changes were accompanied by complete loss of enzyme activity. The change in enzyme activity correlated well with that of absorption and CD spectra in the Soret region, depending on denaturation time, alkaline pH used and concentration of both denaturants. The reassociated catalase obtained by removing urea by dialysis was characterized by recovery of distinct CD bands in the Soret and near ultraviolet regions, although the partial refolding of alpha-helical conformation occurred without recovery of enzyme activity. These results indicate that the conformational changes and dissociation process of catalase into subunits can be monitored spectrophotometrically in relation to enzyme activity, and that subtle conformations near the heme groups and polypeptide backbone play an important role in maintaining full enzyme activity of the catalase molecule. PMID- 6863241 TI - Further characterization of a brain high molecular weight actin-binding protein (BABP): interaction with brain actin and ultrastructural studies. AB - Crude actomyosin fraction from porcine brain contained a large amount of high molecular weight actin-binding protein (BABP). The molar ratio of BABP to actin (BABP/actin) in the fraction was estimated to be 0.22. From this fraction, BABP and actin were solubilized with a molar ratio of 0.25, suggesting the existence of an interaction between BABP and brain actin. BABP was finally purified to 90% purity. The purified BABP was negatively stained and observed by electron microscopy; it appeared to be a slender, flexible, two-stranded molecule whose contour length was about 200 nm. The structure was very similar to those of fodrin and other high molecular weight actin-binding proteins such as filamin, spectrin, and ABP. Lattice cage-like structures composed of BABP molecules were occasionally observed at high BABP concentrations. The addition of BABP to actin filaments resulted in the appearance of many branching, filamentous bundles. The electron microscopic observations suggested that a single BABP molecule could crosslink actin filaments, that is, one BABP molecule has two actin binding sites. PMID- 6863242 TI - RNA polymerase of influenza virus. III. Isolation of RNA polymerase-RNA complexes from influenza virus PR8. AB - Ribonucleoprotein (RNP) cores with RNA-synthesizing activity were prepared in two fractions, M protein-free and M protein-associated, from detergent-treated influenza virus PR8 by centrifugation through a discontinuous triple gradient of cesium sulfate, glycerol, and NP-40. The M-free RNP was fractionated by phosphocellulose column chromatography into two major RNP forms, A and B, which differed in the content of P proteins, while the M-associated RNP gave only the low P-content Form-B RNP. Starting from the high P-content Form-A RNP, an RNA-P proteins complex virtually free from NP protein was isolated by cesium sulfate equilibrium centrifugation. The complex, containing only three P proteins (P1, P2, and P3), was still active in catalyzing RNA synthesis in vitro without addition of exogenous template, indicating that NP protein is not required for the catalysis of RNA synthesis. RNA synthesis by the isolated RNA-P proteins complex was dependent on either ApG or capped RNA primers, and required four ribonucleoside triphosphates as substrates. The RNA product in this reaction was hybridizable to viral RNA. A complex of one each of the three P proteins was separated from RNA by glycerol gradient centrifugation after ribonuclease treatment or cesium chloride equilibrium centrifugation. PMID- 6863243 TI - Biosynthesis and mitochondrial processing of the beta subunit of propionyl coenzyme A carboxylase from rat liver. AB - Propionyl-CoA carboxylase (ADP-forming) (EC 6.4.1.3), an oligomer of nonidentical subunits (alpha 4 beta 4), has been localized to the mitochondrial matrix. As a first step in examining this enzyme's biogenesis, we have investigated in vitro the cell-free, rat liver RNA-directed synthesis of the beta subunit, and its post translational transport and processing by rat liver mitochondria. The beta subunit is synthesized as a precursor approximately 7,500 daltons larger than its mature mitochondrial counterpart. The extension segment, comprising approximately 60 amino acids, is located at the NH2 terminus of the precursor. Intact mitochondria translocate the precursor across both mitochondrial membranes, and a protease localized to the mitochondrial matrix cleaves the precursor to a polypeptide identical in size and peptide composition to the mature beta subunit. PMID- 6863244 TI - Functional prothrombinase complex assembly on isolated monocytes and lymphocytes. AB - Isolated peripheral blood monocytes and lymphocytes interact with Factor Va and Factor Xa to form a functional catalytic complex which proteolytically activates prothrombin to thrombin. The kinetics of prothrombin activation were monitored continuously using the fluorescent, reversible thrombin inhibitor, dansylarginine N-(3-ethyl-1,5-pentanediyl)amide, which displays enhanced fluorescence upon binding to thrombin. Incubation of monocytes or lymphocytes with prothrombin, the cofactor (Factor Va), and the enzyme (Factor Xa) in the presence of Ca2+ generated thrombin at rates/cell exceeding those previously obtained with either bovine or human platelets. The rate of thrombin generation by monocytes exceeded that of lymphocytes and increased as monocytes adhered to a surface. Monocyte prothrombinase activity appears to be mediated through interactions, whereby Factor Va forms a receptor for Factor Xa at the monocyte surface. Monocytes possess approximately 16,100 Factor Va binding sites with a dissociation constant (Kd) of 4 X 10(-11) M. In addition, isolated, well washed monocytes and lymphocytes, respectively, contain approximately 61,400 +/- 9,900 and 24,500 +/- 4,800 molecules of Factor V/cell as determined by radioimmunoassay. Bioassay data of mononuclear cell preparations paralleled the radioimmunoassay data. The Factor V associated with washed mononuclear cells appears to be intracellular and not membrane-associated. The release of Factor V, and perhaps other sequestered coagulation factors, by these immunoreactive cells at an inflammatory site, coupled with the ability of these cells to effect thrombin generation may explain the relationship between extravascular fibrin deposition and mononuclear cell accumulation in the pathogenesis of inflammatory lesions. PMID- 6863245 TI - Mevalonolactone inhibits the rate of synthesis and enhances the rate of degradation of 3-hydroxy-3-methylglutaryl coenzyme A reductase in rat hepatocytes. AB - 3-Hydroxy-3-methylglutaryl(HMG)-coenzyme A reductase purified from rat liver in the absence of protease inhibitors is composed of two distinct polypeptides of Mr = 51,000 and 52,500. Antibody raised to enzyme purified from rats fed a diet supplemented with cholestyramine and mevinolin inactivated HMG-CoA reductase. The antibody specifically precipitated a polypeptide of Mr = 94,000 from rat liver cells that had been previously incubated with [35S]methionine. The immunoprecipitation of the 35S-labeled polypeptide of Mr = 94,000 was prevented by addition of unlabeled pure HMG-CoA reductase (Mr = 51,000 and 52,500). Incubation of rat liver cells with mevalonolactone resulted in a decreased activity of HMG-CoA reductase and in a 40% decrease in the rate of incorporation of [35S]methionine into the immunoprecipitable reductase polypeptide of Mr = 94,000. In pulse-chase experiments, mevalonolactone enhanced the rate of degradation of the Mr = 94,000 polypeptide 3-fold. We propose that endogenous microsomal HMG-CoA reductase has a subunit of Mr = 94,000 and that the synthesis and degradation of this polypeptide are regulated by either mevalonolactone or, more likely, a product of mevalonolactone metabolism. PMID- 6863246 TI - A new opine derived from nopaline. AB - Nopaline (N-[4-[(aminoiminomethyl)amino-]-1S-carboxybutyl]-2R-aminopentanedioic acid and isonopaline (N-[4-[(aminoiminomethyl)amino-1S-carboxybutyl]- 2S aminopentanedioic acid) have been synthesized and separated by crystallization. In addition, a derivative of each of these compounds that forms spontaneously from the parent compounds under the usual crystallization conditions was isolated and characterized. The chemical properties, elemental analysis, 1H-NMR spectrum, and electrophoretic behavior of the derivative from nopaline are consistent with N-[4-[ (aminoiminomethyl)amino]-1S-carboxybutyl]-2-pyrrolidone-5R-carboxylic acid, also called pyronopaline. The presence of pyronopaline in crown gall tumor tissue and the catabolism of it by the bacterium A. tumefaciens establish it as a new opine. PMID- 6863247 TI - Transformed mouse mammary epithelial cells synthesize undersulfated basement membrane proteoglycan. AB - Proteoglycans deposited in the basal lamina of [14C] glucosamine-labeled normal and [3H]glucosamine-labeled transformed mouse mammary epithelial cells grown on type I-collagen gels, were extracted in 4 M guanidinium chloride and cofractionated over Sepharose CL 4B. The heparan sulfate chains carried by these proteoglycans were isolated by treatment with alkaline borohydride, protease K, chondroitinase ABC, and cetylpyridinium chloride precipitation. Heparan sulfate isolated from transformed cell cultures consistently eluted from DEAE-cellulose at lower salt concentrations and was of smaller apparent Mr when chromatographed over Sepharose CL 6B, than heparan sulfate of normal cell cultures. Experiments using doubly labeled cultures ([3H]glucosamine and [35S]sulfate) demonstrated an approximately 30% reduction in the sulfate/hexosamine ratio in heparan sulfate derived from transformed cultures. Both N- and O-sulfate were decreased. The decreased Mr and decreased sulfation of heparan sulfate upon transformation appear sufficient to explain the altered heparan sulfate/chondroitin sulfate ratios previously observed in these cells. These changes may have implications for the molecular interactions in which these proteoglycans are normally engaged during basal lamina assembly, and cause the poor basal lamina formation displayed by these transformed cells. PMID- 6863248 TI - Muscarinic agonist binding and phospholipid turnover in brain. AB - The ability of muscarinic cholinergic agonists to interact with muscarinic receptors in nerve ending preparations and elicit an increased labeling of phosphatidate and phosphatidylinositol from 32Pi has been investigated. Two groups of brain muscarinic agonists are distinguished. Addition of acetylcholine, carbamylcholine, methacholine, or muscarine resulted in a 2-fold stimulation of phosphatidate and phosphatidylinositol labeling, while bethanechol, pilocarpine, arecoline, and oxotremorine were less effective. Simultaneous addition of two agonists from the more effective group did not result in any further increase in stimulated labeling, while the addition of agonists from the less effective group antagonized the stimulatory effect of carbamylcholine. All of the agonists could completely displace binding of [3H]quinuclidinyl benzilate, a muscarinic antagonist. The displacement of the labeled antagonist by the more effective agonists was more complex than that predicted from a simple mass action isotherm and was compatible with the interaction of the agonists with high and low affinity forms of the receptor. Conversely, the displacement data from less effective agonists did not deviate markedly from those predicted for interaction of the agonists with a single affinity form of the receptor. Dose-response curves for stimulated phosphatidate labeling obtained in the presence of acetylcholine, carbamylcholine, and methacholine were predominantly correlated with occupation of the low affinity form of the muscarinic receptor. These results suggest that the enhancement of phosphatidate and phosphatidylinositol turnover in brain is caused by agonist-mediated conformational changes in the muscarinic receptor and that the ability of an agonist to induce this conversion may be predicted by its differential binding to the high and low affinity forms of the receptor. PMID- 6863249 TI - Models for the complexes formed between cytochrome b5 and the subunits of methemoglobin. AB - Computer graphics-generated models for the electron transfer complexes formed between cytochrome b5 and the subunits of methemoglobin are proposed. For both complexes, the orientation allowing optimal hydrogen bonding involves interaction between negatively charged residues on cytochrome b5 and positively charged residues on methemoglobin. In each complex, the heme groups of the interacting species are coplanar with the edges of the heme groups separated by 7-8 A and with the iron atoms 16 A apart. For the alpha-chain X cytochrome b5 complex, alpha-chain residues 56 (Lys), 60 (Lys), and 90 (Lys) interact with cytochrome b5 residues 44 (Glu), 43 (Glu), and 60 (Asp) respectively. A fourth hydrogen bond involves alpha-61 (Lys) bridging between a heme propionate from cytochrome b5 and a heme propionate from the alpha-chain. The contacts present in the beta-chain X cytochrome b5 complex involve hydrogen-bonding between beta-chain lysyl residues 59, 61, 65, and 95, and cytochrome b5 residues 48 (Glu), 44 (Glu), 43 (Glu), and 60 (Asp) respectively. An additional hydrogen bond can be formed by bridging of the epsilon-amino group of beta-66 (Lys) between a heme propionate from cytochrome b5 and a beta-chain heme propionate. In each complex, two nonionic interactions, one on each side of the heme groups, are also suggested. These interactions appear to effectively exclude external water molecules from the center of the protein-protein interaction domain. Comparison of the proposed binding loci for cytochrome b5 on the methemoglobin subunits with those proposed on cytochrome c reveals considerable structural homology between the cytochrome b5 binding sites. PMID- 6863250 TI - Chemical modification of arginine residues of rat liver S-adenosylhomocysteinase. AB - Rat liver S-adenosylhomocysteinase (EC 3.3.1.1) is inactivated by phenylglyoxal following pseudo-first order kinetics. The dependence of the apparent first order rate constant for inactivation on the phenylglyoxal concentration shows that the inactivation is second order in reagent. This fact together with the reversibility of inactivation upon removal of excess reagent and the lack of reaction at residues other than arginine as revealed by amino acid analysis and incorporation of phenylglyoxal into the protein indicate that the inactivation is due to the modification of arginine residue. The substrate adenosine largely but not completely protects the enzyme against inactivation. Although the modification of two arginine residues/subunit is required for complete inactivation, the relationship between loss of enzyme activity and the number of arginine residues modified, and the comparison of the numbers of phenylglyoxal incorporated into the enzyme in the presence and absence of adenosine indicate that one residue which reacts very rapidly with the reagent compared with the other is critical for activity. Although the phenylglyoxal treatment does not result in alteration of the molecular size of the enzyme or dissociation of the bound NAD+, the intrinsic protein fluorescence is largely lost upon modification. The equilibrium binding study shows that the modified enzyme apparently fails to bind adenosine. PMID- 6863251 TI - A role of valency of concanavalin A and its chemically modified derivatives in lymphocyte activation. Monovalent monomeric concanavalin A derivative can stimulate lymphocyte blastoid transformation. AB - A concanavalin A (ConA) derivative of a monovalent monomeric nature, including a monomeric molecular weight at pH 7.4, significantly induces lymphocyte blastoid transformation. The derivative was recently obtained by Tanaka, I., Abe, Y., Hamada, T., Yonemitsu, O., and Ishii, S. ((1981) J. Biochem. (Tokyo) 89, 1643 1646) by a novel procedure of photochemically induced alkylation of tryptophan residues of native tetravalent ConA using a high pressure mercury lamp in the presence of chloroacetamide followed by two steps of column chromatography. This monovalent monomeric ConA (Mm-ConA) was demonstrated to be almost equally potent in producing the maximal response of lymphocytes when compared with native tetrameric ConA, although Mm-ConA was required at about 70 times as high as the concentration of native ConA on a weight basis to attain the maximal response of lymphocyte activation. The binding potency of the former to lymphocytes was about two-thirds as potent as that of the latter. Mm-ConA failed to agglutinate sheep erythrocytes at concentrations 1800-fold higher than native tetravalent ConA, but showed a weak but definite agglutinating activity against guinea pig erythrocytes at a relatively high concentration (approximately 80 micrograms/ml). Cell cluster formation was observed in lymphocyte cultures for 24 to 48 h with Mm-ConA where DNA replication in stimulated lymphocytes was observable. No significant difference was observed between sizes of cell clusters formed in the presence of Mm-ConA and of native tetravalent ConA at this phase of lymphocyte activation. The present results suggest that the multivalency of ConA with respect to sugar binding sites may not be a stringent requirement for lymphocyte activation, and that another binding site for cell membrane, which has been suggested to exist in the ConA protomer and to be hydrophobic (membranophilic), may play a subsidiary but important role in triggering lymphocyte blastoid transformation as well as hemagglutination with Mm-ConA. The biological significance in lymphocyte activation of lectin valency with respect to sugar-binding sites has been discussed, comparing the effects of various ConA derivatives of different valencies, including a monovalent monomer (Mm-ConA), divalent dimers (beta-ConA, sulfomethylamino-ConA, and succinylated ConA), and tetravalent tetramers (alpha ConA), on the cell surface. PMID- 6863252 TI - Evidence that the H+ electrochemical gradient across membranes of chromaffin granules is not involved in exocytosis. AB - The possibility that the large H+ electrochemical potential of chromaffin granules, the secretory granules of adrenal medullary chromaffin cells, plays an important role in exocytosis was investigated in cultures of chromaffin cells from bovine adrenal medulla. Methylamine uptake into the cells, [gamma 31P]phosphate nmr of ATP within intracellular chromaffin granules, O2 consumption of intracellular mitochondria, and MgATP-stimulated catecholamine uptake into chromaffin granules isolated from cultured chromaffin cells were assessed to determine whether various manipulations altered the H+ electrochemical gradients of intracellular chromaffin granules or mitochondria. Catecholamine secretion was not significantly altered by ammonium, methylamine, nigericin, carbonyl cyanide p trifluoromethoxyphenylhydrazone, or dicyclohexylcarbodiimide under conditions when the pH of intracellular chromaffin granules was reduced or when granular or mitochondrial processes were uncoupled from H+ electrochemical gradients. The data indicate that the H+ electrochemical gradient across the chromaffin granule membrane does not play a role in exocytosis. PMID- 6863254 TI - The effects of pH, ionic strength, and chemical modifications on the reaction of electron transfer flavoprotein with an acyl coenzyme A dehydrogenase. AB - The effects of pH and ionic strength on the steady state kinetic parameters for reduction of electron transfer flavoprotein (ETF) by general acyl-CoA dehydrogenase were determined. The effect of pH on the turnover number (TN) of the reaction indicates the participation of an essential base with a pK alpha of 6.9. The KmETF of the dehydrogenase is invariant between pH 5.4 and 8.5, but increases 40-fold between pH 8.5 and 9.8. The parameter TN/KmETF follows the limiting Bronsted equation (In TN/KmETF = ln ko + 2.34ZAZB I 1/2) at ionic strength values between 0.01 and 0.125 M, indicating complementary charge interactions between the two flavoproteins. Covalent modifications of amino groups of ETF with trinitrobenzene sulfonate and acetic anhydride remove positive charges and result in an increase in KmETF of the dehydrogenase with no change of TN. However, exhaustive acetimidation of ETF amino groups, which maintains cationic charge at modified loci, does not alter the steady state kinetic parameters of the reaction. These results, in conjunction with previous chemical covalent modifications of dehydrogenase carboxyl residues (Frerman, F. E., Mielke, D., and Huhta, K. (1980) J. Biol. Chem. 255, 2199-2202), indicate that general acyl-CoA dehydrogenase and ETF interact in an electrostatic manner. PMID- 6863255 TI - Concerted stimulation and inhibition of desaturation, chain elongation, and esterification of essential fatty acids by cultured neuroblastoma cells. AB - Neuroblastoma (N1E-115) cells in culture rapidly incorporated exogenous fatty acyl chains suspended as albumin complexes in the medium. The essential fatty acids, linoleic (18:2(n - 6)) and linolenic (18:3(n - 3)) acids, were converted to polyunsaturated acids by delta 6 and delta 5 desaturation and chain elongation. The major end products (20:4 from 18:2(n - 6) and 20:5 and 22:5 from 18:3(n - 3)) were preferentially esterified to phospholipids, whereas intermediates were esterified primarily or equally to triacylglycerol. The effects of unlabeled exogenous fatty acids (eg. 40 microM 18:2(n - 6), 18:3(n - 6), 18:3(n - 3), 20:3(n - 6), 20:4(n - 6), trans-18:2(n - 6), 18:1(n - 9), trans 18:1(n - 9), or 16:0) on the conversion of 2 microM [1-(14)C]18:2(n - 6), 18:3(n 3), 20:3(n - 6), 20:4(n - 6), or 16:0 and on accumulation of products and unaltered substrates in phospholipids and triacylglycerol were examined after incubations of 2-24 h. With [1-(14)C]18:2, formation and esterification of 20:4 to phospholipids was (i) stimulated 4-8-fold by 18:2(n - 6), 20:3(n - 6), or 20:4(n - 6), (ii) inhibited by 18:3(n - 3) or trans-18:2(n - 6), or (iii) unaffected by 18:3(n - 6), 18:1(n - 9), trans-18:1(n - 9), and 16:0. Specific but less marked effects were observed with the other 1-(14)C-substrate acids. Thus, various fatty acids influenced the metabolism of essential fatty acids both at the level of conversion by desaturation and elongation and at esterification to complex lipids by mechanisms specific to individual acids. Product inhibition was not a major feedback mechanism; however, the complement of available fatty acids evidently modulates the acyl chain composition of membrane phospholipids through processes in addition to acyltransferase selectivity. The data support a closely coordinated or concerted enzyme system for directed synthesis of esterified polyunsaturated acyl chains. PMID- 6863253 TI - Affinity labeling of rat liver carbamyl phosphate synthetase I by 5'-p fluorosulfonylbenzoyladenosine. AB - The ATP analog 5'-p-fluorosulfonylbenzoyladenosine (FSBA) has been used to study the interaction of MgATP with rat liver carbamyl phosphate synthetase I. Incubation of the enzyme with concentrations of FSBA as low as 0.025 mM produced considerable inactivation (41% at 120 min); identical rates and extents of reaction were produced by 0.5, 1, and 2 mM FSBA. Of the substrates for carbamyl phosphate synthetase I, only MgATP protected against FSBA inactivation. In the presence of a constant concentration of MgATP, increasing the FSBA concentration led to increased inhibition. Conversely, an increase in MgATP concentration led to decreased inhibition from a constant concentration of FSBA. Other nucleotide triphosphates provided no protection against FSBA inactivation. Addition of dithiothreitol to the FSBA-inactivated enzyme led to partial reactivation, suggesting that cysteine residue(s) were involved in the FSBA reaction. 5,5' Dithiobis(2-nitrobenzoic acid) titration of the free sulfhydryl groups on the enzyme confirmed that cysteine residues were involved in reaction with FSBA; titration of the enzyme after incubation in the absence and presence of FSBA yielded values of 21 and 18(+/- 1), respectively. Binding studies with 5'-p fluorosulfonylbenzoyl[2-3H]adenosine indicated that: 4 amino acid residues were involved in reaction with FSBA; 2 of these reaction sites were cysteine residues and 2 were noncysteine residues; MgATP protected one of the cysteine residues and one of the noncysteine residues from reaction with FSBA; the MgATP-protected noncysteine residue is essential for fully activity. These data strongly suggest that FSBA is an affinity label for two distinct MgATP sites on carbamyl phosphate synthetase I. PMID- 6863256 TI - Immunological studies of ribosomal mutants in the fungus Podospora anserina. AB - In the fungus Podospora anserina, two mutants with ribosomes apparently lacking one ribosomal protein were investigated using immunological techniques to determine whether these proteins were indeed missing. Antibodies directed against the wild type ribosomal proteins apparently absent in the mutants were raised from two-dimensional gel spots containing these proteins. These sera were used to detect cross-reacting proteins in the mutants. Immunological results have revealed in both mutants the presence of strongly altered ribosomal proteins which co-migrate with other wild type proteins on two-dimensional gel. The molecular weight of mutant proteins differs at least 25% from that of homologous wild type proteins. Furthermore, we observed that the growth of the mutants and the activity of their ribosomes are very reduced in both single mutants containing the altered proteins. PMID- 6863257 TI - Isolation of 3 S androgen receptors from salt-resistant fractions and nuclear matrices of prostatic nuclei after mild trypsin digestion. AB - The physical properties of two types of androgen-binding sites in prostatic nuclei were compared and found to be identical. The first type was released from chromatin by micrococcal nuclease digestion and solution in 0.6 M NaCl; the second resisted such treatment and remained associated with nuclear structures. After in vivo administration of [1,2-3H]testosterone to 24-h castrated rats and sonication of purified nuclei, 90% of the nuclear radioactivity was extracted with nuclease/salt treatment and was found by sucrose density gradient analysis to be associated with a 3 S androgen receptor. If sonication was omitted, 50 to 60% of the nuclear radioactivity was recovered in the nuclease/salt-resistant pellets or bound to nuclear matrices. Mild digestion of either of these particulate fractions with trypsin resulted in the release of a 3 S androgen receptor. After in vitro isotope-exchange labeling with [1,2 3H]dihydrotestosterone, the sedimentation coefficient, steroid specificity, and dissociation constant of the androgen receptors released by trypsin digestion of nuclease/salt-resistant pellets or nuclear matrices were similar to those of the receptors extracted by nuclease/salt treatment. These results indicate first, that all androgen-binding sites in prostatic nuclei can be released, either with nuclease/salt or trypsin digestion procedures to yield a 3 S androgen receptor with uniform binding characteristics, and second, that the androgen receptors are distributed between two intra-nuclear pools--one containing about 10,000 molecules/nucleus sensitive to micrococcal nuclease digestion and salt and the other containing about 8,000 to 13,000 androgen receptors tightly bound to the nuclear matrix. PMID- 6863258 TI - Dexamethasone decreases the amounts of type I procollagen mRNAs in vivo and in fibroblast cell cultures. AB - Dexamethasone treatment of neonatal chicks resulted in a time- and dose-dependent selective decrease of skin collagen synthesis. Total RNA of chick skin was isolated and hybridized to the cloned cDNAs pCg54 for pro-alpha 1 (I) mRNA and pCg45 for pro-alpha 2(I) mRNA. RNA isolated from the total skin of chicks receiving various doses of dexamethasone had dose-related decreases of pro-alpha 1 (I) and pro-alpha 2(I) mRNAs. The decrease of type I procollagen mRNAs for various doses of dexamethasone were similar to the decreases observed for collagen synthesis in vivo. Dexamethasone treatment of chick skin and chick lung fibroblasts resulted in a selective decrease of procollagen synthesis. A dose related decrease of procollagen synthesis was observed with chick skin fibroblasts. Dexamethasone-treated chick skin and chick lung fibroblasts had decreased levels of pro-alpha 1 (I) and pro-alpha 2(I) mRNAs as determined by solid support hybridization with pCg54 and pCg45. The dexamethasone-mediated decreases of type I procollagen mRNAs in skin fibroblasts and lung fibroblasts were similar to the decreases observed in procollagen synthesis. PMID- 6863259 TI - Effects of salts, temperature, and stem length on supercoil-induced formation of cruciforms. AB - The influence of cations, temperature, and stem length on the supercoil-induced transition from the linear form to the cruciform state at certain inverted repeats of pVH51 and pBR322 was investigated. In general, conditions which stabilize duplex DNA over single-stranded DNA shifted the transition to higher negative superhelical density values due to an increase in the unfavorable free energy of cruciform formation. Specifically, increasing sodium or magnesium ion concentrations brought about a corresponding increase in the negative superhelical density required to cause cruciform formation at the major inverted repeat of both plasmids. A notable exception was the inverted repeat found in both of these plasmids (at position 1009 of pVH51 and 3123 of pBR322) for which Mg(II) concentrations between 1 and 5 mM brought about a lowering of the negative supercoiling required to cause cruciform extrusion at this site, suggesting a specific complex between the cruciform and magnesium. Increasing temperatures from 15 up to 45 degrees C for the pVH51 major inverted repeat and 37 degrees C for that of pBR322 shifted the transition to lower negative superhelical densities. Further increases brought about a shift to higher negative densities. For the two inverted repeats examined within pVH51, various divalent metal ions and spermidine resulted in the following hierarchy: Mn(II) less than Zn(II) less than Mg(II) less than Co(II) less than spermidine, where the transition midpoint was at lowest negative density values for Mn(II) and highest for spermidine. This hierarchy agrees qualitatively with the relative affinity of the cations for DNA phosphates versus the bases. The influence of stem length on the supercoil induced transition to the cruciform state was studied by in vitro deletion of portions of the pVH51 major inverted repeat. Decreasing the stem length from 13 to 10 base pairs (bp) had no effect on the ability of this sequence to adopt the cruciform state. However, a further reduction of 3 bp to give a stem length of 7 bp completely abolished the ability of this region of DNA to exist in the cruciform state, at least up to a density of -0.15. Thus, a very sharp dependency on stem length exists for cruciform formation within an inverted repeat region possessing a potential loop of five nucleotides. PMID- 6863260 TI - Purification and characterization of a cell-aggregating factor (clusterin), the major glycoprotein in ram rete testis fluid. AB - Clusterin has been purified from ram rete testis fluid by conventional techniques and by immunoaffinity chromatography. The molecule is characterized as a glycoprotein having a molecular mass of approximately 80,000 Da and an isoelectric point of 3.6. The purified protein retains the capacity to elicit clustering of cells in an in vitro assay. Under reducing conditions in the presence of sodium dodecyl sulfate, clusterin dissociates into subunits of about 40,000 Da. Heterogeneities in apparent molecular mass were eliminated after treatment of clusterin with neuraminidase. Gel filtration chromatography revealed that clusterin exists in dimeric and tetrameric forms under conditions of neutral pH and low salt concentrations. In the presence of 6 M urea, only the monomeric form is evident, with an apparent molecular mass of approximately 85,000 Da. Clusterin, which was found to contain 4.5% glucosamine, binds to concanavalin A Sepharose and also to wheat germ agglutinin Sepharose. The amino acid composition of clusterin is reported. The possible cellular source of clusterin in rete testis fluid is discussed. It is shown that Sertoli cells in the seminiferous tubule are one potential source, since primary cultures of rat Sertoli cells secrete a protein having the same immunochemical and physical properties as clusterin isolated from ram rete testis fluid. Possible functions of clusterin are discussed. PMID- 6863261 TI - Synthesis of a shortened pro-alpha 2(I) chain and decreased synthesis of pro alpha 2(I) chains in a proband with osteogenesis imperfecta. AB - Synthesis of type I procollagen was examined in skin fibroblasts from a proband with a lethal variant of osteogenesis imperfecta. The fibroblasts synthesized shortened pro-alpha 2(I) chains and these shortened chains accounted for all the pro-alpha 2(I) chains synthesized by the cells. In addition, there was a decrease in the relative rate of synthesis of pro-alpha 2(I) chains. Fragmentation of the shortened pro-alpha 2(I) chains with vertebrate collagenase and cyanogen bromide demonstrated that the shortening was in alpha 2(I)-CB3,5A, a fragment from about the middle of the chain containing amino acid residues 361 to 775. Based on the relative mobility in electrophoretic gels, the shortening was about 20 amino acid residues. The decreased synthesis of pro-alpha 2(I) chains was demonstrated by an increase in the ratio for the rates of synthesis of pro-alpha 1(I):pro-alpha 2(I) chains. It was associated with an increase in the ratio of mRNAs for pro-alpha 1(I):pro-alpha 2(I) in the cells. Fibroblasts from the father also demonstrated a decreased synthesis of pro-alpha 2(I) chains as reflected by an increase in the ratio of newly synthesized pro-alpha 1(I):pro-alpha 2(I) chains. No shortened pro alpha 2(I) chains were seen in fibroblasts from either the father or the mother. The observations suggested that the proband inherited a nonfunctioning pro-alpha 2(I) gene from her father and that the gene for the shortened pro-alpha 2(I) chain probably arose from a sporadic mutation. PMID- 6863262 TI - Influence of thyroid hormone on the in vitro translational activity of specific mRNAs in the rat heart. AB - The influence of thyroid hormone on the translational activity of specific cardiac mRNA was determined by in vitro translation of RNA isolated from the heart of normal, hypothyroid, and 3,3',5-triiodo-L-thyronine-injected hypothyroid rats. Proteins synthesized in vitro in the presence of [35S]methionine were separated by two-dimensional gel electrophoresis and quantitated by a novel scanning procedure using digital matrix photometry. A total of 421 translational products were detected by fluorography and changes in the predominance of 12 of these were influenced by the thyroid state of the animals. The relative predominance of 8 species was increased in euthyroid animals, whereas 4 translational products were increased in hypothyroid animals. The majority of these thyroid hormone-related alterations occurred in spot pairs of similar molecular weights, but slightly different isoelectric points. In contrast, the relative predominance of mRNAs coding for the major contractile proteins, light chain 1, light chain 2, tropomyosin, actin, and myosin heavy chain was not altered by the thyroid status of the animals. The relative levels of these abundant mRNA species remained unaltered in spite of a thyroid hormone-related increase in total RNA levels. In vivo effects of thyroid hormone on cardiac RNA levels are complex. In addition to a general increase in total RNA and mRNA levels, increases or attenuations in the predominance of a small number of specific mRNA species are observed when euthyroid and hypothyroid animals are compared. PMID- 6863263 TI - Brain spectrin. Isolation of subunits and formation of hybrids with erythrocyte spectrin subunits. AB - Brain spectrin tetramer was purified from pig brain membranes in milligram quantities. The tetramer had subunits of Mr = 265,000 (alpha) and Mr = 260,000 (beta), Rs = 21.4 nM, S20,w = 11 S, V = 0.725 ml/g, frictional ratio of 2.9, and calculated molecular weight of 9.7 x 10(5). The subunits were isolated in greater than 95% purity by chromatography on hydroxylapatite in 7 M urea, as described for erythrocyte spectrin (Calvert, R., Bennett, P., Gratzer, W. (1980) Eur. J. Biochem. 107, 355-361). Peptide maps of the subunits revealed few if any common peptides. The subunits were visualized by rotary shadowing as single-stranded flexible rods 100 nm in length with no homodimers by lateral or end association. When the subunits were renatured together, double-stranded tetramers 200 nm in length were formed, as well as higher oligomers. These results indicate that spectrin tetramers are formed by laterally associated alpha,beta dimers attached by head-to-head linkage of each alpha chain with a beta chain. The reassembled subunits regained the ability to increase the low shear viscosity of actin, although isolated alpha or beta subunits were inactive. Hybrid molecules were formed with brain alpha and pig erythrocyte spectrin beta subunit and were visualized as double-stranded rods 100 nm long with no tetramers. 125I-labeled brain alpha chain that was hybridized with erythrocyte beta subunit acquired the ability to bind to ankyrin sites on erythrocyte membranes. 125I-labeled brain alpha chain bound only to beta subunits of erythrocyte and brain spectrin following transfer of these polypeptides to nitrocellulose paper from sodium dodecyl sulfate gels. Affinity-purified antibodies against brain spectrin cross reacted with both subunits of erythrocyte spectrin and with polypeptides of a similar molecular weight to brain spectrin in membranes of all tissues examined. Cross-reacting polypeptides were localized exclusively in plasma membranes of subcellular fractions from liver. These studies provide strong additional evidence that brain and mammalian erythrocyte spectrin belong to a closely related family of proteins with conserved functions in both subunits. PMID- 6863264 TI - The presence of intermolecular disulfide cross-links in type III collagen. AB - Bovine and lathyritic rat type III collagen preparations were analyzed for the presence and in vitro formation of intermolecular disulfide cross-links. Type III collagen from fetal bovine skin was extracted with the aid of pepsin and purified by differential salt precipitation, guanidine denaturation, and renaturation. Nearly all of the type III collagen was present as reduction-sensitive gamma components and higher molecular weight aggregates. After cleavage with CNBr, the peptides were analyzed by two-dimensional mapping. The presence of intermolecular disulfide bonds was demonstrated by the existence of a hexamer of the COOH terminal CNBr peptide, CB9B. This cross-linked peptide was completely converted to the CB9B monomer by reduction. Type III collagen from the skins of beta aminoproprionitrile-treated rats was used to test for the in vitro formation of intermolecular disulfide cross-links. This was prepared by salt extraction, differential salt precipitation, and pepsin treatment. Sodium dodecyl sulfate-gel electrophoresis of this partially purified type III collagen before reconstitution into fibers detected primarily gamma-chains. After reconstitution into fibers, the majority of the material was present as higher molecular weight aggregates. Upon reduction, these aggregates generated predominantly alpha chains. These data demonstrate the existence of intermolecular disulfide bonds in native type III collagen and their formation during in vitro fibrillogenesis. PMID- 6863266 TI - Subunit structure of submitochondrial particle membrane transhydrogenase. AB - The subunit structure of membrane-bound mitochondrial transhydrogenase was investigated. Chemical modification of bovine heart submitochondrial particles with the cleavable bifunctional cross-linking reagent, dithiobis(succinimidyl propionate), resulted in the formation of three dimeric "cross-link isomers" of the enzyme, identified by immunoautoradiography, that are characteristic of cross linked purified transhydrogenase. A limited amount of cross-linking of transhydrogenase monomer to Mr = 25,000 polypeptide was also observed. At high concentration of the cross-linker, a small amount of a higher molecular weight species was formed with both purified and membrane enzyme. Reductive cleavage of the dimeric and higher molecular weight species resulted in the regeneration of transhydrogenase monomer and several other proteolytically derived fragments. It is concluded that transhydrogenase exists in the native membrane primarily as a dimeric species. PMID- 6863265 TI - Mechanism of biosynthesis of soluble and membrane-bound forms of dopamine beta hydroxylase in PC12 pheochromocytoma cells. AB - Dopamine beta-hydroxylase was present as 2 subunit forms (apparent Mr = 77,000 and 73,000) in the PC12 pheochromocytoma cell line as detected by immunoprecipitation from [35S]methionine-labeled cultures, and analyzed by sodium dodecyl sulfate gel electrophoresis and fluorography. The Mr = 77,000 form was present in a crude membrane fraction, while the Mr = 73,000 form was soluble. Both forms appeared to be present in approximately equal amounts, and both were glycosylated. Treatment of PC12 cells with tunicamycin, a potent inhibitor of core glycosylation in the endoplasmic reticulum, completely inhibited the appearance of the Mr = 77,000 and Mr = 73,000 forms, and 2 new immunoreactive polypeptides were obtained (apparent Mr = 67,000 and 63,000). Pulse-chase experiments suggested that the Mr = 77,000 form is initially synthesized (by 5 min) and a portion is converted in 15-90 min to the Mr = 73,000 form. Thereafter, the ratio between forms remains relatively constant, at least for several hours. Translation of mRNA from bovine and rat adrenals, and immunoprecipitation, indicated that dopamine beta-hydroxylase is initially synthesized as a single polypeptide (apparent Mr = 67,000). The subcellular site of biosynthesis of dopamine beta-hydroxylase was determined by isolation of mRNA from free and membrane-bound polysomes from bovine adrenal medulla. Translation in a cell free system and immunoprecipitation localized the synthesis of dopamine beta hydroxylase on membrane-bound polysomes. These experiments suggest that both soluble and membrane-bound forms of dopamine beta-hydroxylase are synthesized and core glycosylated in the endoplasmic reticulum, and that there probably is a precursor-product relationship between the Mr = 77,000 and the Mr = 73,000 subunit forms of dopamine beta-hydroxylase. PMID- 6863268 TI - The electrochemical H+ gradient of platelet secretory alpha-granules. Contribution of a H+ pump and a Donnan potential. AB - Experiments were performed to determine the internal pH and membrane potential of platelet alpha-granules. Fluorescence microscopy showed accumulation of weak bases, indicative of an acidic interior, inside secretory vesicles in intact platelets and in isolated alpha-granules. Weak base uptake was pH-dependent and NH+4-sensitive. In isolated alpha-granules suspended in medium buffered at pH 7.2, a delta pH, the difference between internal and external pH, of 1.2 (inside acidic) was measured by [14C]methylamine distribution. Uptake of isotopic or fluorescent amines was reduced by H+/cation exchange via ionophores and by addition of NH+4, but also by increasing the ionic strength suggesting that delta pH is partly due to a Donnan potential. Transmembrane potential measurements by fluorescent or radioactive ion distribution indicated that in the absence of ATP, granules are internally negative. When measured with 86Rb+, this potential could be entirely collapsed by increasing the ionic strength. Addition of ATP X Mg in the absence of permeating anions made the intragranular space more positive, as expected from inward electrogenic H+ pumping. The results are compatible with the coexistence of sealed and leaky subpopulations of alpha-granules. Internal acidity was generated in sealed granules in vivo by a H+-pumping ATPase, whereas in leaky granules acidity is a consequence of an internally negative Donnan potential. PMID- 6863267 TI - Biosynthesis and processing of rat haptoglobin. AB - Native rat haptoglobin is an heterotetramer consisting of two alpha-subunits (Mr = approximately 9,500) and two glycosylated beta-subunits (Mr = approximately 38,000) joined by interchain disulfide bonds. We previously reported (Haugen, T. H., Hanley, J. M., and Heath, E. C. (1981) J. Biol. Chem. 256, 1055-1057) that the synthesis of rat haptoglobin is encoded by a single mRNA, and that the primary in vitro translation product is a single polypeptide, preprohaptoglobin (Mr = approximately 40,000), that contains an NH2-terminal signal sequence as well as an alpha-subunit region and a beta-subunit region. We now report that partial sequence analysis of preprohaptoglobin indicates that the protein possesses an NH2-terminal hydrophobic signal peptide of 18 amino acid residues, followed directly by the alpha-subunit region, with the beta-subunit region located in the carboxyl-terminal portion of the protein. The co-translationally processed translation product consists of a core glycosylated polypeptide, prohaptoglobin (Mr = approximately 45,000), that is devoid of the signal sequence and possesses both the alpha-subunit and beta-subunit regions of haptoglobin. Pulse-chase experiments in cultures of isolated hepatocytes, and analysis of haptoglobin biosynthetic intermediates in the various subcellular organelles of in vivo labeled rat liver indicate that: (a) in the endoplasmic reticulum, core glycosylated prohaptoglobin is dimerized and a portion of the protein is processed to form the individual alpha- and beta-subunits; (b) the carbohydrate side chains of prohaptoglobin and of core glycosylated beta-subunit (Mr = approximately 35,000) are converted to complex, sialylated side chains in the Golgi apparatus, resulting in the formation of fully glycosylated prohaptoglobin (Mr = approximately 48,000) and beta-subunit (Mr = approximately 38,000), and these forms of the protein, as well as the alpha-subunit (Mr = approximately 9,500), are secreted; (c) inhibition of glycosylation with tunicamycin does not significantly affect the rate of synthesis, processing, or secretion of the various haptoglobin polypeptides in isolated hepatocytes; (d) similar experiments conducted in the presence of colchicine also had no effect on the rate of synthesis and processing of the intermediates; and (e) the species of haptoglobin secreted in vivo and from isolated hepatocytes consist of approximately 60-70% in the form of the alpha 2 beta 2 tetramer, and the remainder as dimerized prohaptoglobin. Presumably, secreted prohaptoglobin may be processed to the native subunit structure after secretion, as we demonstrated that incubation of prohaptoglobin with either normal rat serum, rat plasma, or with the sera of other animal species results in its conversion to the corresponding alpha- and beta-subunits of the native protein. PMID- 6863269 TI - Mechanisms for the spontaneous formation of covalently linked polymers of the terminal membranolytic complement protein (C9). AB - Purified human C9 spontaneously polymerizes upon prolonged incubation at 37 degrees C, and a fraction of these C9 polymers becomes resistant to dissociation by sodium dodecyl sulfate (SDS) and reducing agents. We examined possible mechanisms for this spontaneous covalent linking of C9. The following results are consistent with the conclusion that the formation of the covalently linked C9 polymer involves disulfide linking. 1) In addition to the SDS/dithiothreitol (DTT)-resistant C9 polymer (Mr = 950,000), disulfide-linked C9 dimers and trimers were formed upon incubation of C9 at 37 degrees C for 64 h. 2) The C9 polymer formed upon incubation at 37 degrees C for 64 h was resistant to dissociation by 6 M guanidine hydrochloride, 20 mM DTT but was dissociated by 6 M guanidine thiocyanate alone, yielding disulfide-linked C9 oligomers. 3) The formation of the SDS/DTT-resistant C9 polymer was completely inhibited by 1 mM iodoacetamide and 5,5'-dithiobis-(2-nitrobenzoic acid) (DTNB), while DTNB enhanced the formation of disulfide-linked C9 oligomers. 4) A significant amount of free sulfhydryl group was detected in the polymerized C9 samples with various SH specific reagents, though native C9 reacted with none of these reagents. In addition, inhibition by 1 mM iodoacetamide of C9 disulfide linking inhibited the self-association of C9 as analyzed by gel filtration on TSK-G4000 SW, whereas enhancement by 1mM DTNB of C9 disulfide linking enhanced C9 self-association. Thus, these results indicate that C9 disulfide linking that occurs upon C9 polymerization is an intrinsic property of C9 which is of importance in the formation of the stable C9 polymer structure. PMID- 6863270 TI - Vitamin K-dependent carboxylation. Study of the hydrogen abstraction stereochemistry with gamma-fluoroglutamic acid-containing peptides. AB - Two pentapeptides Phe-Leu-X-Glu-Val where X is either the L-threo-gamma fluoroglutamic acid or the L-erythro-isomer have been synthesized and tested as substrates in the vitamin K-dependent carboxylation. Both peptides are carboxylated, but the reaction occurs exclusively on the glutamic acid of the L threo-gamma-fluoroglutamate-containing peptide, whereas both glutamic and fluoroglutamic residues of the L-erythro-gamma-fluoroglutamate-containing peptide are carboxylated. These results reveal that the enzymatic hydrogen abstraction step is stereospecific and corresponds, in the gamma-fluoroglutamate case, to the elimination of the hydrogen equivalent to the pro-S hydrogen of glutamic acid. PMID- 6863271 TI - Evidence for an alpha-mannosidase in endoplasmic reticulum of rat liver. AB - An alpha-mannosidase activity has been identified in a preparation of rat liver endoplasmic reticulum and shown to be distinct from the previously described Golgi alpha-mannosidases I and II and the lysosomal alpha-mannosidase. The enzyme was solubilized with deoxycholate and separated from other alpha-mannosidases by passage over concanavalin A-Sepharose to which it does not bind. The endoplasmic reticulum alpha-mannosidase cleaves alpha-1,2-linked mannoses from high mannose oligosaccharides and, unlike Golgi alpha-mannosidase I, is active against p nitrophenyl-alpha-D-mannoside (Km = 0.17 mM). It has no activity toward GlcNAc Man5GlcNAc2 peptide, the specific substrate of the Golgi alpha-mannosidase II. The endoplasmic reticulum alpha-mannosidase activity toward p-nitrophenyl-alpha-D mannoside is relatively insensitive to swainsonine, an inhibitor of both the lysosomal alpha-mannosidase and Golgi alpha-mannosidase II. We propose that the endoplasmic reticulum alpha-mannosidase is responsible for the removal of mannose residues from asparagine-linked high mannose type oligosaccharides prior to their entry into the Golgi. PMID- 6863272 TI - Identification of an essential histidine residue for fibrin polymerization. Essential role of histidine 16 of the B beta-chain. AB - An essential histidine residue for fibrin polymerization has been identified. It is the one located at position 16 in the B beta-chain of fibrinogen by the following experiments. Photooxidation of the activated NH2-terminal disulfide knot, which is derived from fibrin and contains the NH2-terminal binding domain, reduced the ability of this fragment to bind to fibrinogen-Sepharose conjugate. Functional and dysfunctional fragments were separated by the affinity chromatography just mentioned. Sequence analyses have revealed that the histidine residue which should be obtained in the second stage of the cleavage is missing in the dysfunctional fragment. The histidine residue which is supposed to be found at the eighth step, however, was not modified under our experimental conditions. PMID- 6863273 TI - Free energy changes in lysozyme denaturation. AB - Previous work has shown that native lysozyme (N) is completely denatured by the addition of guanidinium chloride (conformation D) but that partially denatured conformations appear in other denaturants. Conformation I appears when LiClO4 is added to the protein, and conformation II is caused by heating. We have now determined the apparent free energy changes for the reversible processes between N and the three unfolded conformations and for the process between II and D. This allows us to estimate the apparent free energy changes for a process between any two of these four conformations. PMID- 6863274 TI - Phase-lifetime spectrophotometry of membranes from ion flux mutants of Halobacterium halobium. AB - Phase-lifetime spectrophotometry has been used to study the rate processes associated with intermediates in the photocycling pigments in membrane vesicles of mutant strains of Halobacterium halobium. Vesicles deficient in bacteriorhodopsin, but containing halorhodopsin, were monitored with light at 490 nm. Two relaxation processes, with kinetic parameters largely independent of pH over the range 6.2-7.8, were found to be associated with halorhodopsin photocycling in 4 M NaCl, 10 mM buffer at 23 degrees C. The average relaxation times are 0.94 and 11.4 ms. When vesicles deficient in both bacteriorhodopsin and halorhodopsin were monitored at 370 nm, a single relaxation process with an average relaxation time of 168 ms was detected. This process is independent of pH over the range 4.7-8.8. Examination of vesicles from ion flux mutants showed this slow process to be unrelated to halorhodopsin content and to derive from another photoreactive retinal pigment, possibly the recently described slow cycling pigment s-rhodopsin. PMID- 6863275 TI - Phosphorylation of phosphatidylinositol in rat liver Golgi. AB - The phosphorylation of phosphatidylinositol in subcellular fractions from rat liver has been examined. Fractions enriched in Golgi showed by far the highest specific activity while a plasma membrane fraction depleted in Golgi, as well as rough microsomes, mitochondria, and particle-free supernatant had much lower activity. The product formed from [gamma-32P]ATP and endogenous or exogenously added phosphatidylinositol was predominantly diphosphoinositide with no more than 5% triphosphoinositide. The phosphatidylinositol kinase showed a broad pH optimum with peak activity around pH 7.8. The kinase reaction was not inhibited by the detergent Triton X-100, except at very high concentration, while it was severely inhibited by digitonin. Exogenous phosphatidylinositol did not serve as substrate for the kinase when added in the form of sonicated vesicles, but did so in the presence of Triton. In the latter form it also restored kinase activity after enzymatic depletion of endogenous substrate. The diphosphoinositide formed from endogenous phosphatidylinositol remained fairly stable in the intact membrane, while its degradation was enhanced significantly in the presence of detergent. This study indicates that the phosphatidylinositol kinase in rat liver is highly enriched in the Golgi and suggests that it can be solubilized and assayed by the use of a nonionic detergent. PMID- 6863276 TI - Simultaneous regulation of amino acid influx and efflux by system A in the hepatoma cell HTC. Ouabain simulates the starvation-induced derepression of system A amino acid transport. AB - In the cultured hepatoma cell HTC, amino acid starvation stimulated both influx and efflux of 2-(methylamino)isobutyric acid (MeAIB) across the plasma membrane with little effect on the ultimate cellular accumulation of this amino acid. In agreement, prior amino acid starvation had little effect on the cellular steady state levels reached for various natural amino acids during subsequent incubation in an amino acid-rich medium containing cycloheximide. Furthermore, efflux of [14C]MeAIB was markedly increased by amino acid starvation. These findings do not mean that adaptive regulation of neutral amino acid transport is pointless. If membrane transport rather than metabolism is the rate-limiting step for net amino acid production or consumption, or becomes so during times of elevated formation or catabolism of an amino acid, then proportionate changes of both the opposed fluxes should enhance its net generation or consumption. Amino acid starvation enhances MeAIB-dependent Na+ influx. Alteration of the external [Na+] changes the Km, not the Vmax, for MeAIB influx when the degree of System A derepression is stabilized with cycloheximide. In both starved and unstarved cells, Km/Vmax for MeAIB entry yields a linear function with the reciprocal of the external [Na+], supporting at least for influx a rapid equilibrium-ordered kinetic model in which Na+ binds to the carrier site before the amino acid. Elevated cellular [Na+] obtained by ouabain treatment increased MeAIB efflux in parallel. Trans inhibition of MeAIB influx by accumulated MeAIB, and as a related phenomenon by cellular Na+, was as effective in unstarved as in starved cells, showing independence of this kinetic phenomenon from adaptive regulation. The decreased MeAIB accumulation resulting from decreased influx and increased efflux occurring at high internal [Na+] applies both to unstarved and starved cells. We conclude that cellular Na+ accumulations, produced by increasing levels of ouabain, reversibly reduce the ability of MeAIB to repress System A because its interior concentration is prevented from rising, although transport in both directions continues; accordingly, the repressive signal appears to come from the internal amino acid levels rather than from occupation of the carrier site for System A flux. PMID- 6863277 TI - Studies on the mechanism by which exogenous glucose is converted into liver glycogen in the rat. A direct or an indirect pathway? AB - To quantify the extent to which exogenous glucose is used directly or indirectly for hepatic glycogen synthesis, fasted rats were given [U-14C,3-3H] glucose intragastrically, intravenously, or as a component of a solid diet eaten ad libitum. In all cases liver glycogen was deposited at high linear rates over a 3 h period. Portal vein glucose levels seldom exceeded 8 mM. At a time when the specific activities of 3H and 14C in circulating glucose were identical with those in the administered material their values in newly synthesized glycogen were reduced by 72-88% and 50-65%, respectively. An intragastric load of unlabeled glucose sufficient to suppress completely hepatic glucose output greatly stimulated the incorporation of intravenously infused [14C]bicarbonate, [14C]lactate, [14C]alanine, and [14C] glutamine into liver glycogen. Using an improved assay the ability of liver homogenates to phosphorylate glucose at concentrations of 5-10 mM was found to be far short of what would be needed if glucose were used directly to support hepatic glycogen synthesis in vivo. These data support the notion that in the rat a major fraction of liver glycogen deposited in response to exogenous carbohydrate is formed by a pathway involving glucose leads to C3 unit leads to glycogen, although the site of the initial steps in the sequence is not yet known. The limited capacity of the liver to utilize intact glucose for glycogen synthesis might reside in its limited capacity to phosphorylate the sugar at physiological concentrations. PMID- 6863278 TI - Spontaneous calcium release from sarcoplasmic reticulum. General description and effects of calcium. AB - A form of spontaneous calcium release from purified sarcoplasmic reticulum isolated from rabbit skeletal muscle is described. The conditions utilized for eliciting spontaneous release rely on preloading the vesicles with calcium in the presence of phosphate. Under the conditions of assay, spontaneous release begins only after a time delay following depletion of calcium ions from the extravesicular space. Release rates as high as 10-20 mumol/mg . min have been observed, but only a portion of the calcium accumulated is released. Released calcium is reaccumulated, and successive spontaneous releases of smaller amounts of calcium are observed under some conditions. Release occurs as a consequence primarily of an increase in unidirectional Ca2+ efflux and, secondarily, a decrease in unidirectional Ca2+ influx. Unidirectional efflux is enhanced by calcium preloading, enhanced by low (0.01-0.1 microM) and reduced by moderate (1 10 microM) extravesicular free calcium levels. Spontaneous Ca2+ release is favored by much lower free calcium concentrations than Ca2+-induced Ca2+ release. The inhibition of unidirectional efflux by calcium appears to involve active calcium uptake. Release is not mediated by a reversal of the calcium pump. The temperature dependence of the release process is steep, comparable with that of energized Ca2+ uptake. This may reflect a process involved in the gating of a hypothetical calcium channel in the sarcoplasmic reticulum membrane. PMID- 6863279 TI - Estriol and estrone interaction with the estrogen receptor. I. Temperature induced modulation of the cooperative binding of [3H]estriol and [3H]estrone to the estrogen receptor. AB - We investigated the calf uterine estrogen receptor's interaction with [3H]estriol and [3H]estrone and found that the receptor's cooperative binding is markedly dependent upon temperature and receptor concentration. With increasing temperature, the intensity of the estrogen receptor's cooperativity decreases: at 0 degrees C the Scatchard plot was convex and the Hill coefficient was 1.58 +/- 0.04 (n = 5), while at 30 degrees C the Scatchard plot approached linearity and the Hill coefficient was 1.03 +/- 0.02 (n = 3) for the binding of [3H]estriol with a receptor concentration of 10 to 12 nM. With increasing receptor concentration, the receptor's cooperativity gradually increased. At a receptor concentration of 1 nM, at 25 degrees C, with [3H]estriol the Hill coefficient was low, 1.03 +/- 0.02 (n = 3), while at approximately intracellular receptor concentration (20 nM) the Hill coefficient increased to 1.20 +/- 0.04 (n = 4). Similar results were observed with [3H]estrone. The cooperative interaction of the estrogen receptor with [3H]estriol or [3H]estrone is reversible and dependent upon temperature. The van't Hoff analysis of the apparent dissociation constant of the [3H]estrone- and [3H]estriol-receptor complexes indicates that a transition in the receptor's binding mechanism occurs at 15 degrees C. Therefore, measurements of ligand interactions with the estrogen receptor at 0 to 15 degrees C, may not reflect the binding mechanism of the receptor at more biologically relevant temperatures. The reduced, positively cooperative interactions of [3H]estriol and [3H]estrone with the estrogen receptor at 30 degrees C, in comparison with estradiol, decrease the presence of the activated receptor, which correlates with the partial agonist-antagonist activities of estriol and estrone observed in vivo. PMID- 6863280 TI - Estriol and estrone interaction with the estrogen receptor. II. Estriol and estrone-induced inhibition of the cooperative binding of [3H]estradiol to the estrogen receptor. AB - Kinetic analysis of the estrogen receptor's cooperative equilibrium [3H]estradiol binding (Sasson, S., and Notides, A. C., (1982) J. Biol. Chem. 257, 11540-11545) provides a sensitive method for probing the binding of partial agonists to the estrogen receptor. We studied the effects of estriol and estrone on the positive cooperativity of [3H]estradiol binding to the partially purified, calf uterine estrogen receptor. The receptor was titrated with variable concentrations of [3H]estradiol in combination with estriol or estrone, while maintaining a constant molar ratio of the estriol or estrone to the [3H]estradiol. With either a 4-fold molar excess of estriol or a 25-fold molar excess of estrone above the [3H]estradiol concentrations, the receptor's positive cooperative [3H]estradiol binding was inhibited. The Scatchard plot showed a transition from a convex to a linear curve and a decrease in the Hill coefficient value from 1.61 +/- 0.02 (n = 7) in the absence of estriol or estrone to 1.04 +/- 0.04 (n = 4) in the presence of estriol and 0.99 +/- 0.03 (n = 4) in the presence of estrone. The inhibition of the positive cooperativity of [3H]estradiol binding by estriol or estrone was shown not to be due to isotope dilution of the specifically bound [3H]estradiol by the unlabeled estriol or estrone. These kinetic analyses demonstrate that the positively cooperative equilibrium binding of [3H]estradiol by the receptor, which is characteristic of the receptor's activation process, is eliminated by estriol and estrone and consistent with their partial agonist-antagonist activities observed in vivo. PMID- 6863281 TI - Inhibition by tosyl-L-phenylalanyl chloromethyl ketone of membrane potential changes in rat neutrophils. Correlation with the inhibition of biological activity. AB - A plasma membrane-associated serine esterase (protease) has previously been reported to be required during stimulation of a variety of cell types. In this study we have examined the role of such a protease on membrane potential changes using an optical probe of membrane potential 3,3'-dipropylthiodicarbocyanine iodide. The irreversible chymotrypsin-like protease inhibitor TPCK (tosyl-L phenylalanyl chloromethyl ketone) inhibited membrane potential changes in rat neutrophils in response to phorbol myristate acetate, N formylmethionylleucylphenylalanine and the calcium ionophore A23187 in a time- and dose-dependent manner. This inhibition was correlated with the known inhibitory effects on superoxide (O-2) generation and enzyme release (lysozyme and beta-glucuronidase). High external calcium concentrations overcame the inhibitory effects of TPCK on A23187-induced stimulation but had no effect on the inhibition of N-formylmethionylleucylphenylalanine stimulation. These results suggest that a TPCK-inhibitable activity is required for the development of the membrane potential changes that are coupled to subsequent secretory events and precede a calcium requiring activity. PMID- 6863283 TI - Mechanism of the glycine cleavage reaction. Steady state kinetic studies of the P protein-catalyzed reaction. AB - Chicken liver P-protein of the multienzyme glycine cleavage system catalyzes the first partial reaction of glycine cleavage. In the partial reaction, glycine and H-protein serve as substrates and the products are CO2 (not bicarbonate) and the decarboxylated portion of glycine attached to H-protein. The reaction exhibited Michaelis-Menten kinetics with respect to both substrates. The optimum pH for the reaction is 7.1, with 6.5 for the reverse reaction. Km values for glycine and H protein are independent of the concentration of the the co-substrate, and calculated values are 5.8 mM for glycine and 3.4 microM for H-protein. Initial velocity experiments gave intersecting double reciprocal plots that conform to a sequential mechanism. Product inhibition studies revealed that both products inhibited competitively with respect to the varied substrate. Glycine methyl ester was found to be a competitive inhibitor of glycine and noncompetitive inhibitor of H-protein. H-protein whose lipoic acid prosthetic group and cysteinyl residues were modified with N-ethylmaleimide was a noncompetitive inhibitor of glycine and a competitive inhibitor of H-protein. These results are most consistent with a sequential random Bi Bi mechanism in which no abortive dead end complex is formed. This was supported by an isotope exchange experiment. PMID- 6863282 TI - Characterization of the N-demethylation reactions catalyzed by horseradish peroxidase. AB - The hydroperoxide-supported N-demethylation reactions catalyzed by horseradish peroxidase have been characterized in detail. The ethyl hydroperoxide-supported N demethylation of N,N-dimethylaniline by horseradish peroxidase resulted in the formation of equimolar amounts of N-methylaniline and formaldehyde with no other products detectable by high performance liquid chromatography analysis of the reaction mixture. One molecule of ethyl hydroperoxide was consumed for each molecule of formaldehyde formed in the reaction. Similar results were obtained for the hydrogen peroxide-supported N-demethylation of N,N-dimethylaniline. The horseradish peroxidase-catalyzed N-demethylation reaction could be supported by a variety of hydroperoxides, peroxides, and peracids. The turnover number for the hydrogen peroxide-supported demethylation reaction (7061) was larger than that for the ethyl hydroperoxide-supported reaction (5382) or for chloroperoxidase- or cytochrome P-450-catalyzed dealkylations. The demethylation reaction exhibited normal Michaelis-Menten saturation kinetics with respect to N,N-dimethylaniline (Km = 0.34 mM) and ethyl hydroperoxide (Km = 0.020 mM), as well as hydrogen peroxide (Km = 0.016 mM). The horseradish peroxidase-catalyzed N-demethylation reaction was not significantly inhibited by reagents which react with the superoxide anion, the hydroxyl radical, or singlet oxygen, suggesting that these activated oxygen species are not free intermediates in the reaction. There was no significant inhibition of the reaction by alpha-phenyl-t-butylnitrone, 5,5 dimethylpyrroline-N-oxide, or other free radical trapping agents. Substitution of D2O for H2O resulted in an inhibition of the reaction with a solvent isotope effect (VH2O/VD2O) of 1.6. Horseradish peroxidase did not catalyze the demethylation of N,N-dimethylaniline-N-oxide, indicating that the reaction does not proceed via N-oxidation of the amine. When the concentrations of both N,N dimethylaniline and ethyl hydroperoxide were varied in a constant ratio a linear double reciprocal plot was obtained, which is consistent with a ping-pong kinetic mechanism for the horseradish peroxidase-catalyzed demethylation reaction. PMID- 6863284 TI - Isolation of Chinese hamster ovary cell mutants defective in the regulation of leucine transport. AB - We have isolated mutants defective in the regulation of leucine transport by selecting temperature-resistant revertants from the CHO-tsH1 strain, a temperature-sensitive leucyl-tRNA synthetase mutant of the Chinese hamster ovary cell line. In each revertant, there is a stable 2- to 3-fold enhancement in the activity of transport System L, which serves for the uptake of branched-chain amino acids. This increased transport is reflected by an increase in the Vmax for System L transport without a significant change in the Km value and results in increased intracellular pools of leucine. The thermal stability of the leucyl tRNA synthetase activity in each of these revertants is not changed significantly from that of the starting strain, CHO-tsH1. We conclude from these studies that the temperature resistance in the revertants arises from alterations in the regulation of transport System L, leading to constitutively high System L transport and increased intracellular pools of leucine, complementing the leucyl tRNA synthetase defect. PMID- 6863286 TI - Sulfhydryl induced respiratory "shunt" pathways and their role in morphogenesis in the fungus, Histoplasma capsulatum. AB - When the mycelial to yeast transition of the dimorphic fungus Histoplasma capsulatum is induced by a temperature shift from 25 to 37 degrees C, the activities of the cytochrome system and the alternate oxidase decrease in parallel over the first 24 to 40 h (stage 1 of the transition). The decrease in activity of the cytochrome system is correlated with extensive decreases in the amounts of cytochromes b, c, and aa3, assayed spectrophotometrically. After 40 h, the cells enter a dormant phase (stage 2 of the transition) and cysteine or other sulfhydryl-containing compounds are required to reactivate mitochondrial respiration. This reactivation is due to the establishment of shunt pathways which bypass blocked segments of the electron transport system. The "shunt" pathways operate normally in mycelia grown at 25 degrees C, but are shut down during the transition, possibly because of depletion of intracellular cysteine. The longstanding observation that cysteine is required to progress beyond the initial stages of the morphological transition may be due, at least in part, to the reactivation of these "shunt" pathways. PMID- 6863285 TI - Low molecular weight aspartyl-tRNA synthetase from porcine thyroid. Purification, characterization, and heterogeneity. AB - The total low molecular weight aspartyl-tRNA synthetase activity of porcine thyroid is distributed among four distinct forms, all of which are identical in size, as determined by gel filtration. The predominant form was purified 25,000 fold to near homogeneity. A high concentration of glycerol (25%, v/v) was required throughout the procedure to maintain stability. The native enzyme was of the alpha 2-type with a Mr = 120,000 estimated by gel filtration. Its subunits were Mr = 53,000 as determined using polyacrylamide gel electrophoresis under denaturing conditions. The enzyme had an isoelectric point of pH 5.4 and pH optimum that varied from pH 7.3 to 8.8 depending on the type of buffer present. The variation in pH optimum was related to a salt effect. All salts tested were inhibitory, with the degree of inhibition dependent on the anion present. Inorganic pyrophosphate was a particularly powerful inhibitor; Km values for aspartate and tRNAAsp were significantly reduced in the presence of inorganic pyrophosphatase. Evidence is presented that the allotropism of the low molecular weight forms is not due to phosphorylation, proteolytic degradation, or stable enzyme-substrate complexes. PMID- 6863288 TI - Comparative nuclear magnetic resonance studies of high potential iron-sulfur proteins from Chromatium vinosum and Rhodopseudomonas gelatinosa. Additional hyperfine shifted resonances and pH-dependent structural perturbations. AB - Proton NMR spectra and their dependence on pH are reported for the oxidized and reduced forms of the high potential iron-sulfur proteins from Chromatium vinosum and Rhodopseudomonas gelatinosa. Spectra of the protein from both species are very similar in the regions occupied by the hyperfine shifted resonances of protons located near the [Fe4S4(S-Cys)4] cluster. The oxidized proteins exhibit three new resonances that had not been previously detected, one at very low field (about 100 ppm) and two at very high field (about -30 ppm). Since only downfield hyperfine shifted peaks have been observed in all other iron-sulfur proteins, the upfield resonances may be unique to high potential 4-Fe centers and originate from protons other than those on the cysteinyl ligands to the cluster. The pH dependencies of the chemical shifts of a large number of aromatic and hyperfine shifted resonances indicate that the ionization state of histidine-42 exerts an influence on the electronic properties of the cluster despite its being located relatively far away. The oxidation state of the cluster also affects the ionization equilibrium of the histidine; pKa values of 6.7 and 7.3 are measured in the oxidized and reduced protein, respectively. These observations support a previous proposal (Nettesheim, D. G., Johnson, W. V., and Feinberg, B. A. (1980) Biochim. Biophys. Acta 593, 371-383) based on kinetic and visible spectroscopic evidence that the ionization state of histidine-42 affects the stability and oxidation rate of the reduced cluster. PMID- 6863287 TI - Conformational studies of aqueous melittin. Characteristics of a fluorescent probe binding site. AB - The structural basis of the interaction of melittin with amphipathic molecular assemblies, i.e. membranes, was investigated by studying the binding of 2-p toluidinylnaphthalene-6-sulfonate (TNS) to melittin by ultraviolet and fluorescence spectroscopy. Monomeric melittin did not significantly bind TNS as judged by UV and fluorescent spectroscopy. Tetrameric melittin bound two TNS molecules per protomer with dissociation constants (Kd) of 4.2 X 10(-6) M. TNS binding to tetrameric melittin led to an increase in fluorescence quantum yield of 180-fold over the value for TNS alone in aqueous buffer (phi H2O = 0.004). Five independent experimental findings suggest that the arginine residues of melittin provide one portion of the TNS binding site (presumably by formation of an especially stable "ringed-structure" salt bridge between the tetrahedral sulfonyl anion of TNS and the argininyl residues of melittin): 1) the Kd for binding is independent of pH from 6.0 to 10.8, the range in which the alpha aminoglycine and epsilon-aminolysines titrate; 2) TNS binding fails to perturb the kinetics of the reaction of 2,4,6-trinitrobenzenesulfonate with Lys-21 or Lys 23; 3) 1,7,21,23-acetyl-melittin, in which the NH2 terminus and all lysines are acetylated, binds TNS with a Kd similar to that for normal melittin; 4) guanidination of the NH2-terminal glycines and lysines of melittin (forming N guanidoglycine and homoargininyl residues, respectively) increases the number of TNS molecules bound per protomer to approximately 5; 5) conversion of Arg-22 and Arg-24 to the anionic N7, N8-(2,3-dihydro(7,7-dimethyl))bicyclo[2.2.1] heptane - 1 - methanesulfonylborate complex abolishes TNS binding, as judged by fluorescence. PMID- 6863289 TI - Transient glucosylation of protein-bound Man9GlcNAc2, Man8GlcNAc2, and Man7GlcNAc2 in calf thyroid cells. A possible recognition signal in the processing of glycoproteins. AB - Calf thyroid slices incubated with [U-14C]glucose synthesized protein-bound Glc3Man9GlcNAc2, Glc2-Man9GlcNAc2, Glc1Man9GlcNAc2, Glc1Man8GlcNAc2, and Glc1Man7GlcNAc2. Although label in the glucose residues of the last three compounds could be detected within 5 min of incubation, appearance of radioactivity in the mannose residues of the alpha-mannosidase-resistant cores of Glc1Man8GlcNAc2 and Glc1Man7GlcNAc2 took more than 30 and 60 min, respectively, to appear after label was detected in the same mannose residues of Glc1Man9GlcNAc2. The glucose residues were removed upon chasing the slices with unlabeled glucose. The last compound to disappear was Glc1Man9GlcNAc2. Calf thyroid microsomes incubated with UDP-[U-14C]Glc synthesized the five protein bound oligosaccharides mentioned above. Although addition to GDP-Man to the incubation mixtures greatly diminished the formation of Glc3Man9GlcNAc2 bound either to dolichol-P-P or to protein, labeling of Glc1Man9GlcNAc2, Glc1Man8GlcNAc2, and Glc1Man7GlcNAc2 was not affected. Addition of kojibiose prevented deglucosylation of protein-bound Glc3Man9GlcNAc2 without affecting the formation of Glc1Man8GlcNAc2 and Glc1Man7GlcNAc2 and only partially diminishing that of Glc1Man9GlcNAc2. These results indicate that Glc1Man8GlcNAc2 and Glc1Man7GlcNAc2 were formed by glucosylation of the unglucosylated species and not be demannosylation of Glc1Man9GlcNAc2 and that probably part of the latter compound was formed in the same way. PMID- 6863290 TI - Factors from wheat germ that enhance the activity of eukaryotic initiation factor eIF-2. Isolation and characterization of Co-eIF-2 alpha. AB - Two factors have been isolated from wheat germ that enhance the ability of initiation factor 2(eIF-2) to form a ternary complex with GTP and Met-tRNAf. One of these factors, Co-eIF-2 beta, is a monomeric protein with a molecular weight of approximately 83,000 (Lax, S. R., Osterhout, J.J., and Ravel, J.M. (1982) J. Biol. Chem. 257, 8233-8237). The purification and properties of Co-eIF-2 alpha are described in this report. The most highly purified preparations of Co-eIF-2 alpha contain two polypeptides with molecular weights of 21,000 and 19,000. Both Co-eIF-2 alpha and Co-eIF-2 beta are heat-stable factors that stimulate ternary complex formation in the presence and absence of Mg2+ and overcome the inhibitory effect of aurintricarboxylic acid. Co-eIF-2 alpha differs from Co-eIF-2 beta in that Co-eIF-2 beta stimulates the formation of a binary complex between eIF-2 and GDP and Co-eIF-2 alpha does not. Also. The stimulatory effects of Co-eIF-2 alpha and Co-eIF-2 beta on the ternary complex formation are close to additive, strongly suggesting that the two factors function independently. Neither Co-eIF-2 alpha nor Co-eIF-2 beta enhances the rate of exchange between GDP bound to eIF-2 and free GDP, indicating that neither factor functions as a guanine nucleotide exchange factor. PMID- 6863291 TI - Identification of a La protein binding site in a RNA polymerase III transcript (4.5 I RNA). AB - Anti-La antibodies are frequently found in patients with autoimmune diseases; the antigen was reported to be a 50,000-Da protein (Rinke, J., and Steitz, J. A. (1982) Cell 29, 149-159). Because this protein was associated with many nascent RNA polymerase III transcripts, it was suggested to be an RNA polymerase III transcription factor. The present study was designed to analyze 4.5 I ribonucleoprotein, an RNA polymerase III transcript which contains the La antigen. It was found that the 3'-end 20-30-nucleotide portion was the most protected portion of 4.5 I RNA when 4.5 I ribonucleoprotein was digested with T1 RNase. When U2 RNA (an RNA polymerase II transcript) and 4.5 I RNA were incubated with the S-100 fraction of Novikoff hepatoma cells, the 4.5 I RNA bound La antigen but the U2 RNA did not. When partial and complete T1 RNase digestion fragments of 4.5 I RNA were incubated with the S-100 fraction, the 3'-end fragments bound preferentially to the La antigen. However, the fragments of 4.5 I RNA bound less efficiently to La antigen than whole 4.5 I RNA. These results indicate that the 3'-end of 4.5 I RNA is the La antigen binding site in this molecule and suggest that the overall conformation of RNA aids in the binding of La antigen. PMID- 6863292 TI - Isolation of microtubule protein from chicken erythrocytes and determination of the critical concentration for tubulin polymerization in vitro and in vivo. AB - Microtubule protein isolated from nucleated chicken erythrocytes was examined with respect to composition and assembly properties to determine its significance in a microtubule bundle called the marginal band. 1) The protein contains greater than 95% tubulin with small amounts of tau polypeptides and no high molecular weight polypeptides. 2) Microtubule assembly in vitro at 37 degrees C is characterized by low levels of nucleation, despite an abundance of ring oligomers at 5 degrees C, as indicated by long lag times, slow assembly rates, and microtubules that are twice as long as brain microtubules assembled under the same conditions. 3) By radioimmunoassay and sodium dodecyl sulfate gel analysis we determined that 0.6% of erythrocyte protein is tubulin of which three-quarters is in a nonextractable form and is associated with the microtubule bundle and the cell cortex. From these values the in vivo concentrations of total tubulin and tubulin dimer subunits are 2.4 and 0.7 mg/ml, respectively. The value of 0.7 mg/ml is close to the range of values of 0.1-0.6 mg/ml for the critical concentration of erythrocyte microtubule protein in vitro, suggesting that the assembly properties of tubulin in vitro and in vivo are similar. PMID- 6863293 TI - An RNA ligase from wheat germ which participates in transfer RNA splicing in vitro. AB - Transfer RNA half-molecules are intermediates in the splicing of tRNA precursors containing intervening sequences. We have utilized yeast tRNA half-molecules to identify and partially purify an ATP-dependent RNA ligase activity from extracts of wheat germ. This activity can complement a yeast tRNA endonuclease in vitro to efficiently splice 10 different yeast tRNA precursors. The products of in vitro splicing are a covalently joined tRNA and a circular intervening sequence RNA. The internucleotide bond formed at the splice junction is a 2'-phosphomonoester, 3',5'-phosphodiester structure. The 2'-phosphate originates from the 2',3'-cyclic phosphate at the 3' terminus of the 5' half-tRNA. The phosphodiester phosphate is derived from the gamma-phosphate of ATP. PMID- 6863294 TI - Enzymatic mechanism of an RNA ligase from wheat germ. AB - We have characterized the mechanism of action of a wheat germ RNA ligase which has been partially purified on the basis of its ability to participate in in vitro splicing of yeast tRNA precursors (Gegenheimer, P., Gabius, H-J., Peebles, C.L., and Abelson, J. (1983) J. Biol. Chem. 258, 8365-8373). The preparation catalyzes the ligation of oligoribonucleotide substrates forming a 2' phosphomonoester, 3',5'-phosphodiester linkage. The 5' terminus of an RNA substrate can have either a 5'-hydroxyl or a 5'-phosphate. The 5'-phosphate, which for a 5'-hydroxyl substrate can be introduced by a polynucleotide kinase activity in the preparation, is incorporated into the ligated junction. The 3' terminus can have either a 2',3'-cyclic phosphate or a 2'-phosphate. 2',3'-Cyclic phosphates can be converted into 2'-phosphates by a 2',3'-cyclic phosphate, 3' phosphodiesterase activity in the preparation. The 2'-phosphate of the ligated product is derived from the phosphate at the 3' terminus of the substrate. Ligation proceeds with the adenylylation of the 5'-phosphorylated terminus to form an intermediate with a 5',5'-phosphoanhydride bond. PMID- 6863295 TI - Accelerated transbilayer movement of phosphatidylcholine in sickled erythrocytes. A reversible process. AB - The transbilayer mobility of phosphatidylcholine (PC) molecules in the membrane of homozygous reversible sickle cells (RSCs) was studied using a PC-specific exchange protein from beef liver. In deoxygenated RSCs, all of the PC present in the membrane of the intact cell is rapidly available for exchange, mediated by this protein. Since a substantial amount of the PC is present in the inner membrane leaflet of these cells, this observation implies that the PC molecules in their membranes do experience rapid transbilayer movements. To determine the actual rate of transbilayer movement of the PC, radioactive PC was introduced into the outer monolayer of oxygenated RSCs using the PC-specific exchange protein. Subsequently, the cells were incubated at 37 degrees C under oxy- and deoxygenating conditions to enable the PC to equilibrate within the bilayer. At various time intervals, samples were taken and treated with phospholipase A2, which selectively degrades the PC in the outer monolayer. Analysis of the specific radioactivities of the lyso-PC thus produced, as well as of the residual PC, enabled us to follow the fate of the radioactive PC previously introduced into the outer membrane layer. The half-time value for transbilayer equilibration of the PC in deoxygenated RSCs was determined to be 3.5 h, which is about four times lower than that for oxygenated RSCs. This increased transbilayer mobility of PC, observed in deoxygenated RSCs, is immediately restored to the normal low rate upon reoxygenation of the cells, indicating a complete reversibility of this phenomenon. PMID- 6863296 TI - Amplification of the gene for 3-hydroxy-3-methylglutaryl coenzyme A reductase, but not for the 53-kDa protein, in UT-1 cells. AB - 32P-labeled cDNA probes were used to study levels of genomic DNA and regulation of mRNA for 3-hydroxy-3-methylglutaryl coenzyme A reductase in UT-1 cells, a clone of compactin-resistant Chinese hamster ovary cells that have a 100-1000 fold increase in the amount of reductase protein. Similar measurements were made for the 53-kDa protein, a cytosolic protein of unknown function that is also expressed at high levels in UT-1 cells. The number of copies of the gene for reductase was increased by 15-fold in UT-1 cells as compared to the parental Chinese hamster ovary cells, as judged from Southern gel analysis of restriction endonuclease-digested genomic DNA. In contrast, there was no detectable increase in the number of gene copies for the 53-kDa protein. The amount of cytoplasmic mRNA for both proteins was markedly elevated in UT-1 cells, as determined by filter hybridization studies using 32P-labeled cDNA probes. The amount of mRNA for both reductase and the 53-kDa protein declined in parallel after addition of low density lipoprotein, 25-hydroxycholesterol, or mevalonate to the culture medium. The decline in reductase mRNA was associated with a marked decrease in the rate of [3H]uridine incorporation into hybridizable cytoplasmic mRNA. When UT 1 cells were grown for 3-4 months in the absence of compactin, the level of reductase mRNA and enzymatic activity decreased markedly, but the number of copies of the reductase gene did not decline. When the compactin-withdrawn cells were rechallenged with compactin, high levels of reductase mRNA and enzymatic activity promptly returned. We conclude that the gene for 3-hydroxy-3 methylglutaryl coenzyme A reductase, but not for the 53-kDa protein, has been stably amplified in UT-1 cells. Despite this differential gene amplification, the levels of cytoplasmic mRNA for both gene products are markedly elevated, and both are reduced in parallel by either sterols (low density lipoprotein-cholesterol or 25-hydroxycholesterol) or mevalonate, the product of the reductase-catalyzed reaction. PMID- 6863297 TI - Methylation of erythrocyte membrane proteins at extracellular and intracellular D aspartyl sites in vitro. Saturation of intracellular sites in vivo. AB - A cytosolic protein carboxyl methyltransferase (S-adenosyl-L-methionine:protein O methyltransferase, E.C. 2.1.1.24) purified from human erythrocytes catalyzes the methylation of erythrocyte membrane proteins in vitro using S-adenosyl-L-[methyl 3H]methionine as the methyl group donor. The principal methyl-accepting proteins have been identified by sodium dodecyl sulfate-gel electrophoresis at pH 2.4 and fluorography as the anion transport protein (band 3), ankyrin (band 2.1), and integral membrane proteins with molecular weights of 45,000, 28,000, and 21,000. Many of the methylation sites associated with intrinsic membrane proteins may reside in their extracellular portions, since these same proteins are methylated when intact cells are used as the substrate. The maximal number of methyl groups transferred in these experiments is approximately 30 pmol/mg of membrane protein, a value which represents less than one methyl group/50 polypeptide chains of any methyl-accepting species. The number of methylation sites associated with the membranes is increased, but not to stoichiometric levels, by prior demethylation of the membranes. The additional sites are associated primarily with bands 2.1 and 4.1, the principal methyl acceptors in vivo, suggesting that most methylation sites are fully modified in vivo. Extracellular methylation sites are not increased by demethylation of membranes. The aspartic acid beta-methyl ester which can be isolated from carboxypeptidase Y digests of [3H]methylated membranes is in the unusual D-stereoconfiguration. Similar results have been obtained with [3H]methylated membranes isolated from intact cells (McFadden, P.N., and Clarke, S. (1982) Proc. Natl. Acad. Sci. U.S.A. 79, 2460-2464). It is proposed that the methyltransferase recognizes D-aspartyl residues in proteins and is involved with the metabolism of damaged proteins in vivo. PMID- 6863298 TI - Isoprene synthesis in isolated embryonic Drosophila cells. I. Sterol-deficient eukaryotic cells. AB - Since insects are cholesterol auxotrophs, we analyzed the apparent paradox presented by an established cell line (Kc cells) from Drosophila embryos which grew in media which contained less than 0.05 micrograms/ml of sterols. Fresh Drosophila embryos contained 3.7 micrograms of 3 beta-hydroxysterols/mg of protein; however, Kc cells had maximally 0.50 micrograms of 3 beta hydroxysterols/mg of protein. Kc cells, grown in media which contained cholesterol, showed the presence of sterol in their plasma and intracellular membranes. Kc cells did not synthesize sterols or any apparent replacement lipophilic molecule. However, two major compounds which comigrated with ubiquinone and dolichol were synthesized from radioactive mevalonate and acetate. Cholesterol incorporation into Kc cell membranes did not significantly alter total phospholipid head or acyl group composition. Similar observations were obtained with Schneider's Drosophila cell line I and a mosquito (Aedes albopictus) cell line. Our results (a) challenged current concepts that sterols or related replacement isopentenoid molecules were required for eukaryotic membrane structure, (b) demonstrated that marked alterations in eukaryotic membrane sterol composition was insufficient to change total phospholipid head and/or acyl group composition, and (c) set the stage for the use of a eukaryotic cell to examine the regulation of 3-hydroxy,3-methylglutaryl coenzyme A reductase activity independent of a requirement for sterol synthesis. PMID- 6863299 TI - Isoprene synthesis in isolated embryonic Drosophila cells. II. Regulation of 3 hydroxy-3-methylglutaryl coenzyme A reductase activity. AB - We used an established Drosophila cell line (Kc cells), which neither synthesized nor required cholesterol for growth, to determine if sterol and nonsterol modulators of vertebrate 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase activity were also active in this biological system. Drosophila HMG-CoA reductase was membrane-bound and required NADPH for catalysis. In contrast to the vertebrate enzyme, Kc cell HMG-CoA reductase activity was not modulated by cholesterol (10 micrograms/ml), human low density lipoprotein (83 micrograms of cholesterol/ml), or oxygenated sterols (5-10 micrograms/ml). However, mevalonate caused a rapid strong suppression of Kc HMG-CoA reductase activity; 18 microM R mevalonate produced 50% suppression of the enzyme within 24 h. Compactin, a competitive inhibitor, decreased HMG-CoA reductase activity in Drosophila embryo cell-free extracts with an apparent Ki of 1.0 nM. Kc cells, grown in the presence of compactin, had a HMG-CoA reductase specific activity 5- to 10-fold higher than untreated cells. Mevalonate blocked this increase. We have concluded that HMG-CoA reductase activity in Kc cells is (a) not responsive to feedback inhibition by sterols, and (b) is controlled by a fundamental sterol-independent regulatory process. The signal for modulation of HMG-CoA reductase activity may be mevalonate and/or its magnitude conversion to a nonsterol isopentenoid precursor and/or end product. These observations may have broader validity, not only for other insect cells, but for eukaryotic cells in general. PMID- 6863301 TI - Complete analysis of the cytochrome components of beef heart mitochondria in terms of spectra and redox properties. The b-type cytochromes. AB - The b-cytochromes of beef heart mitochondria have been analyzed by procedures which use optical spectra rather than two points for each cytochrome species. The analytical procedures included first derivatives for background behavior, second derivatives for peak features, and singular value decomposition (Shrager, R.I., and Hendler, R.W. (1982) Anal. Chem. 54, 1147-1152) for the entire spectra. Titrations were performed by electrical oxidation and reduction and by chemical reduction. Four b-cytochromes have been identified in terms of their unique difference spectra, midpoint potentials (Em), and number of electrons transferred (n). They are cytochrome bK, Em = 83 mV, n = 1; cytochrome bT2, Em = -17 mV, n = 2; cytochrome bT1; Em = -95 mV, n = 1; and cytochrome b562L, Em = -146 mV, n = 4. The Em values of cytochromes bT1, bT2, and b562L respond to changes in pH indicating a loss of one proton per oxidation. Antimycin and/or ATP do not affect the spectrum or Em value of any of the cytochromes. An apparent red shift for the absorption maximum of cytochrome bK caused by antimycin may be due to an increased level of reduction of cytochrome bT2. PMID- 6863300 TI - Covalently linked fatty acids in gastric mucus glycoprotein of cystic fibrosis patients. AB - Undegraded mucus glycoprotein has been isolated in highly purified form from gastric secretion of cystic fibrosis patients. The purification procedure involved gel filtrations on Bio-Gel P-100 and Bio-Gel A-50 and lipid extractions with five mixtures of the organic solvents. The final preparation represented pure glycoprotein as judged by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, cesium chloride density gradient centrifugation, and lipid analysis. Treatment of the pure and delipidated glycoprotein with methanolic KOH or hydroxylamine resulted in liberation of ester-bound fatty acids. Of the total released fatty acids, 95% were represented by hexadecanoate (36.5%), octadecanoate (48.7%), and octadecenoate (8.6%). The quantitative analysis established that, on the average, 12.2 nmol of fatty acids/mg of glycoprotein were released. The studies on cystic fibrotic glycoprotein susceptibility to proteolytic digestion indicated that fraction of glycoprotein which was resistant to pronase digestion contained on the average 33.1 nmol of fatty acids/mg of glycoprotein. After removal of the fatty acid residues from pronase-resistant glycoprotein, by treatment with hydroxylamine, the glycoprotein became susceptible to proteolytic digestion. Thus, in cystic fibrosis, the covalently bound fatty acids interfere with proteolytic degradation of mucus glycoprotein. Perhaps this is the major defect of cystic fibrosis glycoproteins and the cause of the obstruction of secretory glands and the accumulation of poorly soluble secretions. PMID- 6863302 TI - Pathways of sphingomyelin metabolism in cultured fibroblasts from normal and sphingomyelin lipidosis subjects. AB - The metabolism of endogenous sphingomyelin labeled with 32P or [methyl-3H]choline and of exogenous [choline-methyl-3H], [32P]-, or [N-acyl-1-14C]sphingomyelin was studied in normal and Niemann-Pick Type A (NP-A) cultured fibroblasts. Despite a greater than 96% decrease in lysosomal sphingomyelinase activity in the NP-A cells, they were able to degrade endogenously produced [32P]- or [methyl 3H]sphingomyelin at normal or near normal rates. Exogenous [methyl-3H]-, [methyl 3H, 32P]-, and [methyl-3H, N-acyl-1-14C] sphingomyelin was taken up intact by normal and NP-A cells, with NP-A cells accumulating 4-8 times more lipid. By 20 h, 50% of the control cell-associated 3H and 32P was recovered in lecithin, and the ratio of activities (3H/32P) indicated most of the phosphorylcholine derived from sphingomyelin had been transferred intact. By comparison in NP-A cells, after a 40-h incubation only 20% of the labeled phosphorylcholine derived from sphingomyelin was recovered in lecithin. With both cell lines, 20 to 50 times more sphingomyelin was hydrolyzed than was taken up by the cells; the reaction products in the medium were ceramide and a mixture of water-soluble compounds such as phosphorylcholine and choline. These results indicate that there are at least two metabolic pathways for sphingomyelin modification in cultured fibroblasts in addition to degradation by the lysosomal acid sphingomyelinase. One route is hydrolysis by a cellular sphingomyelinase. The second is the hydrolysis and/or transfer of phosphorylcholine from sphingomyelin and results in the synthesis of lecithin. PMID- 6863303 TI - Variable expression of the nitrogen isotope effect associated with denitrification of nitrite. AB - The overall isotopic fractionation factor observed for denitrification of NO-2 by resting cultures and cell-free extracts of Pseudomonas stutzeri varied widely with the concentration of NO-2 and reductant. The observed isotope effect (beta obs) increased linearly with velocity when the concentration of nitrite was varied and decreased with velocity when reductant concentration was varied. At any given ratio of velocity to maximum velocity, beta obs was approximately the same in intact cells and cell free extracts. These results indicate the following: (a) neither uptake (whole cells) nor enzyme-substrate association (cell-free extracts) is the sole cause of saturation of the overall rate as [NO 2] is increased; (b) a reductive step lies beyond the initial step and at or before the first unidirectional step; and (c) in intact cells, uptake of NO-2 by the cell and egress of NO-2 from it are very rapid compared to reduction at all concentrations of NO-2. A corollary of the last conclusion is that variation of beta obs in intact cells is due entirely to variation in the relative rates of intracellular steps of the denitrification process. The linear relation between beta obs and velocity imposes constraints on any proposed mechanism of denitrification. PMID- 6863304 TI - Physical studies of 13C-methylated concanavalin A. pH- and Co2+-induced nuclear magnetic resonance shifts. AB - Concanavalin A has been reductively methylated using [13C]formaldehyde and NaCNBH3 and examined by 13C NMR. The chemical modification does not alter the metal ion or saccharide binding properties of the protein nor the associating of dimers to form tetramers above pH 6. Eleven of the 12 N epsilon,N-dimethyllysines appear as a broad unresolved group of resonances at pH 5.6, while one N epsilon,N dimethyllysine (tentatively assigned to Lys 101) gives rise to two resolved methyl resonances as a result of forming a salt bridge with Asp 203 (Reeke, G. N., Jr., Becker, J. W., and Edelman, G. M. (1975) J. Biol. Chem. 250, 1525-1547). The NH2-terminal N alpha,N-dimethylalanine appears as a unique resonance and titrates with a pKa of 7.9. The chemical shift degeneracy of the N epsilon,N dimethyllysine is lifted when Co2+ is bound in the S1 site of the protein. These resonances sharpen and shift downfield differentially with increasing pH until eight of 12 N epsilon,N-dimethyllysine resonances are resolved at pH 10. A comparison of the expected Co2+-induced shift at each lysine based upon their crystal coordinates and previous Co2+-histidine shift data (Carver, J. P., Barber, B. H., and Fuhr, B. J. (1977) J. Biol. Chem. 252, 3141-3146) with those observed in the N epsilon,N-dimethyllysine resonances has allowed a tentative assignment of several resonances to a specific lysine in the sequence. PMID- 6863305 TI - Selective effects on catalysis by the multiple forms of monoamine oxidase produced by interactions of acidic phospholipids with mitochondrial membranes. AB - The effect of acidic phospholipids on the A and B multiple forms of membrane bound mitochondrial monoamine oxidase has been investigated by incubating liposomes with isolated rat liver mitochondrial outer membrane preparations at lipid:protein ratios of 0.01 to 1. A strong inhibition of monoamine oxidase B was observed with phosphatidylserine and a moderate activation of monoamine oxidase A with phosphatidylinositol, while cardiolipin had no significant effect on either form. The specificity of phosphatidylserine inhibition for monoamine oxidase B was also confirmed in mitochondrial outer membrane isolated from tissues containing exclusively the A or B form of the enzyme (human placenta and bovine liver). Levels of incorporation were comparable for all the phospholipids and tissues studied and could not account for the different effects observed. Inhibition of monoamine oxidase B was found to be similar in an intact mitochondria preparation to that observed in the isolated outer membrane. A recent report of activation of both monoamine oxidase forms in delipidated whole mitochondria by the acidic phospholipids was re-examined and found to involve release of monoamine oxidase from the mitochondria. The details of the effects of phosphatidylserine and phosphatidylinositol on membrane-bound monoamine oxidase are consistent with the concept of the multiple forms as two distinct peptides, and suggest a second possible mode of in vivo regulation of substrate specificity. PMID- 6863306 TI - Purification and properties of a 4-methylene-L-glutamine amidohydrolase from peanut leaves. AB - A 4-methylene-L-glutamine amidohydrolase has been partially purified from leaf extracts of 2-week germinated peanuts (Arachis hypogaea). Purification steps include DEAE-Sephacel and gel filtration chromatography as well as chromatofocusing; amidohydrolase purified 300- to 400-fold is obtained. The enzyme has an approximate molecular weight of 45,000 as determined by gel filtration chromatography and polyacrylamide gel electrophoresis, a broad activity optimum between pH 8.0 and 9.0, and is highly specific toward 4 methylene-L-glutamine. Of a number of amides tested as substrate, only L glutamine serves 20% as effectively as the methylene-substituted analog. Multiple bands of activity, seen when enzyme samples are electrophoresed on polyacrylamide gels, are not completely resolved but appear to be very similar in molecular weight, pK values, and subcellular localization. Activity is not affected either by added thiols, metal ions, sulfhydryl-reacting reagents, or metal-ion chelators; it is inhibited by borate ions but stimulated by sodium dodecyl sulfate. This amidohydrolase activity is absent in imbibed seeds, but on germination increases rapidly in the cotyledons and leaves for 3 weeks followed by a gradual decline as the plant matures. Activity is almost completely (95%) localized in the leaves and cotyledons. Differential centrifugation studies indicate that the enzyme is found solely in the soluble fraction of peanut leaves. PMID- 6863307 TI - Properties of the oxygenated form of liver microsomal cytochrome P-450. AB - The formation and autoxidative decomposition of the oxygenated forms of two isozymes of rabbit liver microsomal cytochrome P-450 were studied: 5,6 benzoflavone- or isosafrole-inducible P-450LM4, isolated in the high spin state, and P-450LM3b, isolated in the low spin state. When an anaerobic solution of photochemically reduced isozyme 4 was mixed with aerobic buffer in a stopped flow spectrophotometer, the dioxygen complex with absorption maxima at 555 and 418 nm was rapidly formed. The monophasic reaction had a pseudo-first order rate constant of about 58 s-1. Autoxidation of the complex, which was complete in about 20 s, exhibited biphasic first order kinetics at 580 nm with rate constants of about 0.92 and 0.22 s-1. The results obtained with isozyme 3b were similar, except that the decomposition of the ferrous oxy intermediate appeared to be triphasic. Superoxide could not be detected as a product of the autoxidative decomposition of the oxy form of P-450 isozyme 4. Hydrogen peroxide was produced in about 70% yield when oxygen was in excess, whereas in a titration in which small increments of oxygen were added to an excess of the ferrous cytochrome the reduction apparently led to the formation of water. The biphasic kinetics of some of the reactions involving purified mammalian cytochrome P-450 has in some instances been attributed to the formation of aggregates by these hydrophobic proteins. This was ruled out as an explanation of the kinetics observed for the autoxidative decay of ferrous dioxygen P-450LM4, since two phases were also observed with a preparation converted from the usual aggregated state to the monomeric state by exposure to a zwitterionic detergent. PMID- 6863308 TI - Solubilization of phospholipids by chaotropic ion solutions. AB - Phosphatidylcholine (PC) dissolves in solutions of concentrated neutral trichloroacetate and tribromoacetate, anions known to be extremely chaotropic. Solubilization of egg yolk PC occurs in Na-trichloroacetate between 2 and 3 M and in Na-tribromoacetate between 1.5 and 2 M. The resulting optically clear solutions were found by gel exclusion chromatography to consist of micelles containing of the order of 10(2) lipid molecules which, according to 31P NMR, are undergoing rapid, isotropic motion. Dipalmitoyl-PC is not solubilized below its normal phase transition temperature, although it remains in solution if first dissolved above that temperature; transition temperature and enthalpy change are both drastically depressed in 3 M Na-trichloroacetate. Na-trichloroacetate (3 M) also dissolves sphingomyelin but not phosphatidylethanolamine, acidic phospholipids, or egg PC-cholesterol mixtures of more than 33% cholesterol. Destabilization of the lamellar phase of egg PC relative to the micellar phase is promoted by trichloroacetate binding to and intercalating between the lipid molecules. Trichloroacetate was found to bind to egg PC liposomes with an affinity constant of about 1 M-1, so that nearly 1:1 association between egg PC and trichloroacetate is predicted at the concentration at which solubilization occurs. A surface area dilation by an amount (50+%) consistent with formation of micelles was confirmed by surface tension isotherms of egg PC on 3 M Na trichloroacetate. The chaotropic effect may synergize binding by reducing the energy cost of the exposure of hydrophobic portions of lipid that is necessitated by the small radius of curvature of micelles. Several chaotropic agents less potent than trichloroacetate and tribromoacetate did not solubilize egg PC. PMID- 6863310 TI - Interactions of asymmetric forms of acetylcholinesterase with basement membrane components. AB - Previous studies have indicated that the asymmetric form of acetylcholinesterase is localized in the basement membrane zone of the neuromuscular junction. We find that the collagenous subunit of the enzyme is required for interactions with basement membrane components. Acetylcholinesterase (the A12 form) binds best to the basement membrane heparan sulfate proteoglycan and type V collagen, to a lesser extent to laminin, fibronectin, and type I collagen, but not to type IV collagen. In addition, the purified A12 enzyme as prepared from electric eel is associated with a heparan sulfate-like component which appears to be responsible for the aggregation of the enzyme at low ionic strength. We observed that the purified form of the enzyme reacted with antibodies to type V collagen, and to a lesser extent with anti-type I collagen antibody, but not with anti-type IV collagen antibody. These data suggest that the collagenous subunit of the enzyme may have some similarity to type V collagen and that the interaction of the collagenous subunit with a heparan sulfate proteoglycan may be involved in its binding to basement membrane in the neuromuscular junction. PMID- 6863309 TI - The effect of substrate cycling on the ATP yield of sperm glycolysis. AB - The conversion of glucose to lactate via the Embden-Meyerhof pathway yields a maximum of 2 mol of ATP per mol of glucose degraded with lesser amounts of ATP obtained if metabolic intermediates are removed for biosynthesis or if substrate cycling occurs during carbohydrate degradation. Bull sperm are an ideal test system for a quantitative estimate of ATP yield because they contain enzymes necessary for potential substrate cycling and do not carry out significant biosynthesis. Experiments utilized specifically labeled glucose and fructose to test for substrate cycling between glucose in equilibrium glucose-6-PO4, fructose in equilibrium fructose-6-PO4, and fructose-6-PO4 in equilibrium bisphosphate. Flux through the pathway (low = less than or equal to 0.05; moderate = 0.1; high = greater than 0.5 mol of carbohydrate consumed per h/10(8) cells) was altered by changing incubation temperature and/or by adding metabolic effectors. The data (in situ rates of kinases and phosphatases and metabolite crossover plots) obtained under these conditions were used to establish if the generally accepted regulatory enzymes (hexokinase and phosphofructokinase) approach the overall flux through the glycolytic pathway, i.e. that of a classical kinetically limiting rate-determining step. In summary: (a) At low flux, the rates of phosphorylation greatly exceeded overall flux. This resulted in extensive substrate cycling at all points and a net ATP yield of less than or equal to 0 mol/mol of glucose initially phosphorylated. (b) At moderate flux, rate of hexokinase approached that of overall flux through the glycolytic pathway but "excessive" phosphofructokinase activity led to substrate cycling between fructose-6-PO4 and fructose 1,6-bisphosphate and resulted in a low net ATP yield (0-0.6 mol/mol of glucose). (c) At high flux, rates of phosphofructokinase and hexokinase approached that of the overall flux. Minimal substrate cycling occurred between fructose-6-PO4 and fructose 1,6-bisphosphate, and the net ATP yield approached 1.8 mol/mol of glucose. These experiments established that the theoretical stoichiometric ATP yield of the pathway was rarely achieved during these incubations because of extensive substrate cycling. Indeed, for cauda epididymal bull sperm isolated and incubated in vitro, the glycolytic pathway serves to generate lactate, an intermediate product that is further metabolized in the mitochondria to yield the ATP that is associated with degradation of exogenous carbohydrate. PMID- 6863311 TI - Effect of Acanthamoeba profilin on the pre-steady state kinetics of actin polymerization and on the concentration of F-actin at steady state. AB - The interaction of Acanthamoeba actin and Acanthamoeba profilin was evaluated as a function of ionic conditions. In the presence of 2 mM MgCl2 or 1 mM MgCl2 and 50 mM KCl, profilin decreased the concentration of F-actin at steady state, and inhibited the rates of filament elongation and spontaneous nucleation and polymerization. All of the experimental data were quantitatively accounted for on the basis of a 1:1 complex between profilin and monomeric actin with a Kr between 4 and 9 microM, the same value obtained previously in the absence of MgCl2. Therefore, the Mg2+ concentration did not affect the KD of the profilin-actin complex in these experiments. On the other hand, profilin did greatly amplify the decrease in concentration of F-actin at steady state caused by lowering the Mg2+ concentration. This results from the effect of Mg2+ on the critical concentration of the actin monomer with which the profilin-actin complex is in equilibrium. When the Mg2+ concentration is lowered, the critical concentration of actin monomer increases so that more profilin-actin complex is formed. Thus, appreciably more F-actin depolymerizes than in the absence of profilin. In this way, profilin could function intracellularly to convert small changes in critical concentration into large changes in the concentration of F-actin. PMID- 6863312 TI - Regio- and stereoselective metabolism of two C19 steroids by five highly purified and reconstituted rat hepatic cytochrome P-450 isozymes. AB - High pressure liquid chromatographic systems capable of resolving at least 28 known and potential metabolites of 17 beta-hydroxy-4-androsten-3-one (testosterone) and 4-androstene-3,17-dione (androstenedione) were used to quantitatively assess the metabolism of the two steroids in monooxygenase systems reconstituted with five purified rat liver cytochrome P-450 isozymes. Cytochromes P-450a, -b, -c, -d, and -e catalyzed the oxidation of testosterone at overall rates of 21, 27, 2, 0.7, and 3 nmol/min/nmol of cytochrome P-450, respectively; while the corresponding rates for total androstenedione metabolism were 12, 62, 1.5, 0.3, and 5. Cytochrome P-450a catalyzed the oxidation of testosterone and androstenedione almost exclusively to their respective 7 alpha-hydroxy metabolites. Cytochrome P-450b catalyzed the oxidation of testosterone to androstenedione and 16 alpha- and 16 beta-hydroxytestosterone in approximately equal molar ratios. However, this same hemoprotein exhibited a marked stereoselectivity in the metabolism of androstenedione since the molar ratio of 16 alpha- and 16 beta-hydroxyandrostenedione was greater than 1:10. Cytochrome P 450e catalyzed the oxidation of both steroids to the same products as cytochrome P-450b, but at approximately 10% of the rate. Cytochromes P-450c and P-450d catalyzed the oxidation of testosterone and androstenedione regio- and stereospecifically to their respective 6 beta-hydroxy metabolites. These results indicate that certain cytochrome P-450 isozymes show marked positional specificity in the metabolism of both testosterone and androstenedione, and that the rate as well as stereoselectivity of the oxidative reactions can be markedly dependent on subtle differences in the structure of the steroid substrate. PMID- 6863313 TI - 19-Hydroxylation of 18-hydroxy-11-deoxycorticosterone catalyzed by cytochrome P 45011 beta of bovine adrenocortex. AB - When 18-hydroxy-11-deoxycorticosterone was incubated with adrenocortical mitochondria fortified by adding exogenously adrenodoxin reductase and adrenodoxin in the presence of an NADPH-generating system, the steroid was converted to two products which were separated by high performance liquid chromatography. The retention time of one product was identical with that of 18 hydroxycorticosterone, an expected product of 11 beta-hydroxylation, whereas the retention time of the other was not coincident with those of any other corticosteroids examined. Production of the unidentified substance was also shown when 18-hydroxy-11-deoxycorticosterone was incubated with purified cytochrome P 45011 beta and its electron transport system. The ratio of the two products was always constant, even when various incubation conditions were employed with regard to reaction time, the substrate concentration, and the cytochrome concentration. Structural determination of the unidentified product was conducted by mass spectrometry and 1H NMR spectrometry. The results of these analyses indicated that the substance was 18,19-dihydroxy-11-deoxycorticosterone, a hitherto unreported corticosteroid. PMID- 6863314 TI - Reversal of the reaction catalyzed by glyoxalase I. Calculation of the equilibrium constant for the enzymatic reaction. AB - Glyoxalase I catalyzes the formation of S-D-lactoyl-glutathione via the hemimercaptal adduct of methylglyoxal and glutathione. This enzymatic reaction, which has been considered virtually irreversible, was found to be reversible under such conditions that glutathione liberated from the thiolester was trapped. The reverse reaction could be monitored spectrophotometrically by use of 5,5' dithiobis-(2-nitrobenzoate). In addition to 5,5'-dithiobis-(2-nitrobenzoate), 2,2'-dithiobispyridine and cystamine were used to promote the reverse reaction. S D-Lactoylglutathione did not hydrolyze in the presence of glyoxalase I under the conditions investigated, as shown by its stability in the absence of thioltrapping agents. Proof of the reversal of the reaction was obtained by demonstrating the formation of stoichiometric amounts of methylglyoxal and glutathione from S-D-lactoylglutathione. Catalysis of the reverse reaction was dependent upon the presence of a bivalent metal ion in the active site of the enzyme. Apoenzyme, obtained by removal of the essential Zn2+ from the active site, did not catalyze the reverse reaction, but catalytic activity was restored by addition of Zn2+, Mg2+, Mn2+, or Co2+. The reverse reaction was also catalyzed by glyoxalase I from yeast. Linear competitive inhibition (Ki = 0.64 mM) was obtained with 5,5'-dithiobis-(2-nitrobenzoate), which necessitated correction of the apparent kinetic parameters of the reverse reaction. The corrected values for the reverse reaction catalyzed by glyoxalase I from human erythrocytes with S-D lactoylglutathione as substrate were kcat = 3.6 s-1 and Km = 1.9 mM. Combination of these values with the corresponding parameters for the forward reaction allowed calculation, through the Haldane relation, of the equilibrium constant, Keq = 1.1 X 10(4), for the isomerization between the hemimercaptal of methylglyoxal and glutathione and S-D-lactoylglutathione. The strong reversible competitive inhibitor of the forward reaction, S-p-bromobenzylglutathione, also inhibited the reverse reaction competitively (Ki = 0.38 microM). PMID- 6863315 TI - Synthesis and transport characteristics of photoaffinity probes for the hepatocyte bile acid transport system. AB - In an effort to characterize the hepatocyte bile acid transport system, a photoreactive derivative of taurocholate, (7,7-azo-3 alpha,12 alpha-dihydroxy-5 beta-cholan-24-oyl)-2-aminoethanesulfonic acid (7-ADTC) has been synthesized and its transport properties compared to those of the natural substrate. Both the bile acid and its synthetic analog were shown to be transported against an electrochemical gradient as well as a chemical gradient. Transport as a function of concentration and the presence of sodium indicated that both substrates were taken up by a sodium-dependent and a sodium-independent route. Taurocholate had Km values of 26 and 57 microM and Vmax values of 0.77 and 0.15 nmol/mg of protein/min, respectively. In comparison, 7-ADTC had very similar kinetic properties with Km values of 25 and 31 microM and Vmax values of 1.14 and 0.27 nmol/mg of protein/min. Each compound was shown to inhibit competitively the transport of the other, suggesting that these substrates utilized a common membrane carrier. The transport properties of the photoreactive anion transport inhibitor, N-(4-azido-2-nitrophenyl)-2-aminoethylsulfonate (NAP-taurine) were also characterized in the hepatocyte system. Transport occurred via a sodium dependent and a sodium-independent route with Km values of 210 and 555 microM and Vmax values of 0.57 and 1.62 nmol/mg of protein/min. As in the case of 7-ADTC, NAP-taurine and taurocholate were also shown to be mutual competitive inhibitors. In the absence of light, 7-ADTC was a reversible inhibitor of taurocholate uptake. Upon irradiation, irreversible photoinactivation of the taurocholate uptake system was observed. These results indicate that 7-ADTC and NAP-taurine can be utilized as photoaffinity probes for the identification of the bile acid carrier protein(s) in hepatocyte plasma membranes. PMID- 6863316 TI - Characterization of the bile acid transport system in normal and transformed hepatocytes. Photoaffinity labeling of the taurocholate carrier protein. AB - The taurocholate transport system in normal and transformed hepatocytes has been characterized using transport kinetics and photoaffinity labeling procedures. A photoreactive diazirine derivative of taurocholate, (7,7-azo-3 alpha,12 alpha dihydroxy-5 beta-cholan-24-oyl)-2-amino [ 1,2-3H ]ethanesulfonic acid (7-ADTC), which has been shown to be a substrate for the bile acid carrier system, was photolyzed in the presence of intact hepatocytes, hepatoma tissue culture (HTC) cells, and plasma membranes derived from the hepatocyte sinusoidal surface. Irradiation of membranes in the presence of 7-ADTC resulted in the incorporation of the photoprobe into two proteins with Mr = 68,000 and 54,000. The specificity of labeling was confirmed by the significant inhibition of labeling observed when photolysis was carried out in the presence of taurocholate. The 68,000-Da protein was easily extracted with water and was shown to exhibit electrophoretic properties identical with rat serum albumin. The 54,000-Da protein required Triton X-100 for solubilization, indicating a strong association with the plasma membrane. Labeling of intact hepatocytes also resulted in specific labeling of the 54,000-Da protein. In contrast to hepatocytes, HTC cells derived from Morris hepatoma 7288C as well as H4-II-E cells derived from Reuber hepatoma H-35 exhibited a total loss of mediated bile acid uptake. Photolysis of 7-ADTC in the presence of HTC cells did not result in the labeling of any proteins, a result consistent with the loss of transport activity, and further supporting the specificity of the labeling reaction. The anion transport inhibitor N-(4-azido-2 nitrophenyl)-2-aminoethyl-[ 35S ]sulfonate, which has been shown to be a substrate for the bile acid carrier system also labeled the 54,000-Da plasma membrane protein when photolyzed in the presence of intact hepatocytes. These results suggest that the 54,000-Da protein is a component of the hepatocyte bile acid transport system and that the activity of this system is greatly reduced in several hepatoma cell lines. PMID- 6863317 TI - Proteoglycans from rabbit articular and growth plate cartilage. Ultracentrifugation, gel chromatography, and electron microscopy. AB - Proteoglycans are considered to be important for the mechanical properties of articular cartilage and growth plate and for the regulation of calcification of growth plate. We have used ultracentrifugation, gel chromatography, and electron microscopy to characterize and compare proteoglycans isolated from rabbit articular cartilage, uncalcified growth plate, and calcified cartilage. We found that proteoglycans from articular cartilage were more resistant to extraction than were proteoglycans from uncalcified growth plate and calcified cartilage. Long term neutral decalcification of calcified cartilage resulted in degraded proteoglycans. The chondroitin sulfate chains from all three tissues had similar size distribution. Gel chromatography and electron microscopy of proteoglycan monomers suggested that those from uncalcified growth plate were largest, those from articular cartilage intermediate, and those from calcified cartilage smallest. Proteoglycan aggregates from articular cartilage were longer than those from uncalcified growth plate. Both biochemical and quantitative electron microscopic data suggested the existence in mineralizing cartilage of at least two different sized populations of proteoglycan aggregates. PMID- 6863318 TI - New globoseries glycosphingolipids in human teratocarcinoma reactive with the monoclonal antibody directed to a developmentally regulated antigen, stage specific embryonic antigen 3. AB - Glycolipids in a cultured human teratocarcinoma cell line (2102Ep) were investigated. The major glycolipids in these cells are globoseries glycolipids having the following structures: (formula; see text) Synthesis of these structures by serial addition of galactose, fucose, and N-acetylneuraminic acid to globoside (Gb4) in this teratocarcinoma is obvious, although further elongation of Gb4 in human cells and tissues has not been previously found with the exception of the presence of a small quantity of Forssman glycolipid in some tissues in the human population (Fs+ group) and in some human cancers. The latter four glycolipids (b-e), with the common internal structure R leads to 3GalNAc beta 1 leads to 3Gal alpha 1 leads to 4R', were all reactive to a monoclonal antibody directed to the 4- to 8-cell stage of murine embryos, known as the stage specific embryonic antigen 3 (SSEA-3 (Shevinsky, L. H., Knowles, B. B., Damjanov, I., and Solter, D. (1982) Cell 30, 697-705]; structure (c) showed the strongest reactivity. These findings, together with the demonstration of the glycolipid nature of SSEA-1 antigen (Kannagi, R., Nudelman, E., Levery, S. B., and Hakomori, S. (1982) J. Biol. Chem. 257, 14865-14874), indicate that cell surface glycolipids play significant roles as differentiation antigens during the course of embryogenesis. PMID- 6863319 TI - Brain microvessels take up large neutral amino acids in exchange for glutamine. Cooperative role of Na+-dependent and Na+-independent systems. AB - Some regulatory aspects of neutral amino acid transport were investigated in isolated brain microvessels, an in vitro model of the blood-brain barrier. Preloading of the microvessels with glutamine stimulated the subsequent uptake of other neutral amino acids by way of the Na+-independent L system, but had no effect on the uptake of either basic or acidic amino acids. Moreover, this stimulation was abolished when the loading step was carried out in the absence of Na+ ions or in the presence of a high concentration of alpha methylaminoisobutyric acid, indicating that the microvessels were able to concentrate glutamine via the A system of amino acid transport. Since the presence of the A system of neutral amino acid transport has not been detected in studies of blood-brain transport performed in vivo, the A system is probably associated with the antiluminal side of brain microvessels. Our results indicate, therefore, that the concentrative Na+-dependent A system and the exchanging Na+ independent L system can cooperate in the uptake of the large neutral hydrophobic amino acids. Such a cooperation may be relevant in the pathogenesis of some neurological disturbances such as hepatic encephalopathy, in which brain glutamine concentration is unusually high. PMID- 6863320 TI - Characterization of preprorelaxin by tryptic digestion and inhibition of its conversion to prorelaxin by amino acid analogs. AB - We studied the in vitro synthesis of relaxin--an ovarian protein hormone related to the insulin subset of growth factors. RNA isolated from corpora lutea of pregnant sows directed the synthesis of a Mr = 23,000 protein in an ascites tumor cell-free system. This protein contained all of the cysteine-bearing tryptic peptides of relaxin as determined by precise co-migration of tryptic fragments of relaxin precursor generated in vitro and those of highly purified relaxin isolated from sow ovary. Based upon these data, it is likely that the primary translation product of porcine relaxin shares structural homology with preproinsulin. The Mr = 23,000 precursor to relaxin is converted to a Mr = 20,000 prohormone in the presence of ascites microsomal membranes. This conversion and the membrane translocation phenomenon which accompanies it can be inhibited in vitro by the use of beta-hydroxyleucine, an amino acid analog. Use of amino acid analogs may represent a technique to allow study of the conversion of relaxin precursors to relaxin in the luteal cell. PMID- 6863321 TI - The reactogenicity and immunogenicity of the Urabe Am 9 live mumps vaccine and persistence of vaccine induced antibodies in healthy young children. AB - The immunogenicity and reactogenicity of the Urabe Am 9 mumps virus vaccine strain were studied after the administration of different doses of the vaccine to 197 children ranging in age from seven and a half months to nine years and without a history of mumps. There was no effect of dose on the response in serum neutralizing antibodies in the range of 10(2.9) to 10(4.7) TCID50/dose. In the 90 subjects without detectable serum neutralization antibodies before vaccination seroconversion was obtained in 94.4% after 42 days. Half of a group of 34 seropositive children who were tested also showed a fourfold or greater rise in antibodies. Persistence of vaccine-enhanced haemagluttinin-inhibition (EHI) antibodies was satisfactory as only two of 46 vaccinees followed-up for between 27 and 32 months had undetectable levels of EHI antibodies and the geometric mean titre of vaccine-induced EHI antibodies had only fallen to about one-third by 32 months after vaccination. Although there was serological evidence of a subclinical re-infection in three subjects, to date none of the vaccinees has had clinical mumps indicating that the vaccine confers protection against disease. The vaccine was well tolerated. Furthermore, the majority of the few 'reactions' reported were probably not vaccine-related. It is concluded that the Urabe Am 9 is an acceptable strain for use in live mumps vaccines. PMID- 6863322 TI - The lectin neuraminidase inhibition test: a new method for the detection of antibodies to neuraminidase. AB - Two methods for the detection of neuraminidase antibodies were compared. The lectin neuraminidase inhibition test (LNI-test) gave results comparable with those provided by the conventional neuraminidase inhibition test (NI-test). Reproducibility and repeatability were better with the LNI-test which used smaller amounts of materials, was less time consuming than the NI-test and was more sensitive. PMID- 6863323 TI - A comparison of a disposable membrane filtration system with a direct inoculation system for the sterility testing of veterinary biologics. AB - A direct inoculation method for sterility testing veterinary biologics was compared with a closed membrane filtration method (Steritest). The filtration method detected extraneous contamination in 29% more batches of biologics than the direct inoculation method. Live viral biologics produced in cell culture were found to be the only product type that could be filtered; hence the filtration method cannot be recommended universally as a replacement for the direct inoculation method. PMID- 6863325 TI - The dynamics of the stress stage of osmotic haemolysis. AB - A simple physical model for the dynamics of the stress stage of osmotic haemolysis is presented. An 'elastic restitutive coefficient' for the red cell membrane is defined to relate the increase of internal pressure to the volume change during the stress stage, and it is estimated on the basis of the work of Evans et al. (1976, 1977). It is shown that the time elapsed between complete swelling and the start of haemoglobin leakage can be a substantial part of the total haemolysis time, in accordance with experimental results reported in the literature. PMID- 6863324 TI - The potency testing of diphtheria and tetanus toxoids as determined by the induction of antibody in mice. AB - An antibody induction (AI) assay in mice has been developed for the potency testing of diphtheria and tetanus toxoids. A diphtheria-pertussis-tetanus served as a reference preparation so that both toxoids could be tested within the same experiment. Results have been compared with those obtained by the conventional lethal challenge tests in guinea pigs (diphtheria) and mice (tetanus). The potency values obtained in the AI tests reflected the differences in the toxoid content of the preparations. Being an economical method, the AI test can be recommended for the potency control of DPT vaccines subject to confirmation of the authors' observations by others. PMID- 6863326 TI - A procedure for determining angular positional data relative to the principal axes of the human body. AB - This paper describes a simple computational procedure for determining angular displacement-time histories of human motion from three-dimensional cine data. The method is based on algebraic transformations of coordinates and coordinate axes. Through these coordinate transformations data was acquired for a multi-axial tumbling skill to illustrate angular displacement-time data relative to the moving coordinate system described by the human body through space. PMID- 6863327 TI - A model for the calculation of mechanical power during distance running. AB - Because widely varying estimates of mechanical power have been calculated for a given speed of running by previous investigators, the effects of various assumptions necessary for mechanical power calculations were evaluated via a segmental energy analysis using 3-D cine data from 31 well-trained subjects running overground at 3.57 ms-1. The magnitude of power calculated was very dependent upon assumptions involving the amount of between segment energy transfer occurring, the relative metabolic cost of positive vs negative work, the amount of the total negative work attributed to muscular work, the effects of elastic storage of energy and on the choice of cutoff frequency in filtering the coordinate data. Mechanical power values ranged from 273 to 1775 W depending on the particular assumptions made and computational methods employed giving efficiency ratios from 0.31 to 1.97. These results point to a need for more definitive research into the role played by energy transfer, negative work, and elastic storage of energy before confidence in measured mechanical power can be established. PMID- 6863328 TI - Geometric properties of equine metacarpi. AB - Paired equine metacarpals were harvested, cleaned and sectioned transversely every 20 mm, and the bone geometry analyzed with a computer program. The cross sectional area is largest in the middle third of the bone, and tapers off at either end. The principal axes are typically within 15 degrees of the anatomical axis, with the distal end rotated internally relative to the proximal end. At midshafts the bending stiffness in the antero-posterior plane is about 2/3 of the stiffness in the medio-lateral plane. The torsional stiffness is highest proximally. The equine third metacarpal appears to be designed to resist axial compression and mediolateral bending very well, and exhibits uniform resistance to torsion along its length. PMID- 6863329 TI - Arterial tonometry: review and analysis. AB - A review is presented of the field of arterial tonometry and of the problems involved with its application. A second generation model is developed which interprets most of the difficulties encountered in previous experimental work. The model also identifies barriers that must be overcome to allow tonometry to become a practical technique for obtaining measurement of continuous, absolute blood pressure. Problems addressed include those of calibration, positioning sensitivity, design standardization, material properties and vascular loading characteristics. Theoretical and experimental studies provide support for the application of basic biomechanical concepts for solution of these problems and suggest required design features. PMID- 6863330 TI - A constant stress creep testing machine. PMID- 6863331 TI - A simple method of measuring the footsole pressure of normal subjects using prescale pressure-detecting sheets. AB - A simple method of measuring the pressure beneath the footsole was described using 'Prescale', pressure detecting sheets. These are two sheets, one coated with microcapsules which contain a color-producing agent, and the other coated with a color-developing agent. As the applied pressure determines the amount of microcapsules that rupture, the coloring sheet reveals its density corresponding to the pressure applied. At the application of this method, normal subjects were studied quantitatively on distribution of the pressure beneath the footsole. The results were compared with the structure of the foot as revealed by X-ray examination in order to study the correlation between the two. The clinical benefits and indication of this method were discussed. PMID- 6863332 TI - Movement of interstitial water through loaded articular cartilage. AB - Water transport through articular cartilage and across the articular surface is a major factor controlling the amount and rate of tissue deformation. To study water movement concentration profiles within the tissue were determined using radiotracer techniques. Water movement was spatially and temporally mapped for unloaded, undeformed tissue, after cyclic and dead weight creep, and for recovery following dead weight creep using a uniaxial confined compression configuration to produce one-dimensional fluid movement. In unloaded tissue diffusion rapidly exchanged water by 15 minutes while the gross efflux of fluid during cyclic and dead weight creep compression effectively inhibited any external water influx. During recovery fluid inhibition was restricted when a small surface load was present, and only after complete removal of all surface traction was a large fluid efflux found. The compression and/or collapse of the uppermost surface layer of the tissue is believed responsible for controlling tissue fluid transport and mechanical response. PMID- 6863333 TI - An assessment of subject variability, subject-shoe interaction, and the evaluation of running shoes using ground reaction force data. AB - Several aspects of dynamic foot function were investigated using ground reaction forces obtained from five runners performing in five different shoes. A minimum of eight trials were necessary in order to obtain stable subject-condition values. Statistically significant subject-shoe interactions occurred for all parameters. It was therefore concluded that a knowledge of shoe characteristics independent of subject characteristics provided little useful information regarding the effects of the shoes tested on selected foot mechanics of the runners. The various subject-conditions were evaluated in an attempt to determine which was the best shoe. Selected descriptive data are presented and the 'best' shoe concept discussed. PMID- 6863335 TI - Three-dimensional visualization of velocity profiles in the ascending aorta in dogs, measured with a hot-film anemometer. AB - Three-dimensional blood velocity profiles were registered in the ascending aorta of dogs approximately 2 and 5 cm above the aortic valves by means of constant temperature hot-film anemometry. The velocity was measured at 41 predetermined points of measurement evenly distributed over the cross-sectional area. Later data analyses using a three-dimensional plotting system, visualized velocity profiles at 200 time intervals during one mean heart cycle. The overall appearance of the profiles was that of a flat transitional flow with a slight skewness. The highest velocity was found nearer to the posterior and left vessel wall. The skewness started during top systole and persisted to the beginning of diastole. Furthermore, many small velocity fluctuations were seen during top systole, but they might also be caused by secondary rotational flow phenomena. This new three-dimensional and dynamic method for visualizing velocity profiles seems to offer advantages, as it demonstrates the total velocity profile all over the cross-sectional area. PMID- 6863334 TI - Artefact encountered by the vibration detection system. AB - The use of piezo-electric accelerometers to detect sounds and vibrations emitted from joints and tissues is a significant advance on acoustic detection systems. All possible sources of artefact signal encountered by the vibration emission technique were investigated. A number of errors could be avoided by good technique. All artefact signals were easily distinguished from true vibration emission. As the accelerometer cables were part of the capacitance system it was concluded that other types of accelerometer should be investigated to reduce cable noise. PMID- 6863336 TI - Radial bulging of the annulus fibrosus during compression of the intervertebral disc. AB - An analysis of the bulging of the annulus fibrosus as a function of the height of the intervertebral disc during compression is presented. The theory was compared with the results of experimental tests on rabbit lumbar discs. When viewed in profile the ventral bulge closely resembled an arc of a circle; at each stage of compression it appeared to extend from the cranial to the caudal extremities of the annulus fibrosus. The radius of curvature of the arc was measured as a function of disc height and the results compared with theoretical predictions. Good agreement was obtained if it was assumed that about half the volume change swept out by the approach of the cranial and caudal end-plates was accommodated by the annular bulge. The lengths of the collagenous fibres reinforcing the outer lamella of the ventral annulus were estimated from the dimensions of the ventral bulge; no appreciable length increase appeared to accompany compression. PMID- 6863338 TI - A mathematical model of the cilia for pharyngeal epithelium of the frog. PMID- 6863337 TI - Normative data of knee joint motion and ground reaction forces in adult level walking. AB - A normative data base of temporal distance factors, knee joint motion and ground reaction force patterns for 148 adults during level walking is reported. The data were studied using parametric and non-parametric (Fourier series) representations to facilitate statistical analyses. Key parameters were divided according to age and sex. Individual force and motion curves of each normal subject were averaged to establish the 'typical' patterns. All typical patterns were combined to construct the 'general' patterns. The essential number and most significant Fourier coefficients were determined. It was found that the sex-related variation is more significant than the age-related variation in adult gait. This data base can serve as a common reference for comparison. PMID- 6863339 TI - A note on the theoretical basis for cast wedging. PMID- 6863340 TI - Mathematical model of the human ankle joint. AB - It has been suspected that the mechanical environment in which a particular joint functions has an effect on the initiation or progression of degenerative joint disease. The objective of this study is to define the mechanical environment of the ankle joint, specifically, the contact areas and pressure distributions, through the development and analysis of a simplified mathematical model. Since the state of pressure across articular surfaces during function is influenced by joint incongruity, cartilage thickness profile and the geometry of the opposing surfaces, these factors have been incorporated into the model formulation. Mathematical analysis of the model has resulted in pressure distributions in both the anterior-posterior and medial-lateral directions and contact area growth plots which correlate well with observed ankle contact patterns obtained from in vitro investigations. The significance of joint incongruity to these pressure distributions and to the relative immunity of the ankle joint to primary osteoarthritis is discussed. PMID- 6863341 TI - Two-dimensional dynamic modelling of human knee joint. AB - A mathematical dynamic model of the two-dimensional representation of the knee joint is presented. The profiles of the joint surfaces are determined from X-ray films and they are represented by polynomials. The joint ligaments are modelled as nonlinear elastic springs of realistic stiffness properties. Nonlinear equations of motion coupled with nonlinear constraint conditions are solved numerically. Time derivatives are approximated by Newmark difference formulae and the resulting nonlinear algebraic equations are solved employing the Newton Raphson iteration scheme. Several dynamic loads are applied to the center of mass of the tibia and the ensuing motion is investigated. Numerical results on ligament forces, contact point locations between femur and tibia, and the orientation of tibia relative to femur are presented. The results are shown to be consistent with the anatomy of the knee joint. PMID- 6863342 TI - The forces and couples in the human trunk during level walking. AB - The intersegmental force and couple exchanged between upper and lower body across a transverse section passing through the fourth lumbar vertebra were estimated during level walking on a straight line at speeds ranging from 0.99 to 2.23 ms-1. This was done using 3-D kinematic information relative to the head, upper limbs, and upper torso, obtained through a stereophotogrammetric technique, and the relevant inertial parameters obtained using anthropometric measurements and estimation techniques provided in the literature. Twenty walking cycles of five normal adult male subjects were analysed. The intersegmental force and couple components are presented as referenced to both a laboratory and pelvic set of axes. Using these results some considerations are made concerning the variations which the overall trunk muscles effort undergoes because of mean walking speed changes. The muscular action on the trunk is inferred from the intersegmental couple components. The various factors that contribute to the build-up of the intersegmental force and couple are analysed and their relative importance assessed. PMID- 6863343 TI - Abstracts of the sixth annual conference of the American Society of Biomechanics. Seattle, Washington, 13-15 October 1982. PMID- 6863344 TI - Comment on "An automated motion measurement system for clinical gait analysis". PMID- 6863345 TI - Considerations on clinical gait evaluation. PMID- 6863346 TI - In vivo and in vitro aging of orthopedic aluminas. PMID- 6863347 TI - A new approach to the design of internal fixation plates. AB - Mathematical analysis by finite element modeling methods was used in conjunction with laboratory bench experiments in selecting appropriate stiffness parameters for internal fixation plate designs. Bench experiments performed included tests of an idealized plated magnesium tube and of a plated canine femur. Finite element modeling of the plate-tube and plate-bone structures was also performed, and the computed results were compared with those obtained experimentally. Three types of internal fixation plates--one "rigid" control plate and two less rigid experimental plates--were examined using both the finite element and experimental models. These plates were further examined by finite element modeling of a plated human femur during single stance loading. In all cases, the "rigid" control plate was found to shield the underlying bone from stress, while both experimental plates were found to have significantly less bone stress shielding. Our findings suggest that an improved plate design should have a low axial stiffness but moderate bending and torsional stiffnesses to facilitate fracture healing and bone remodeling without causing osteopenia. PMID- 6863348 TI - Mechanical strength of poly(methyl methacrylate) cement-human bone interfaces. AB - A device was constructed to test the interfacial strength of PMMA-based bone cement and human cancellous bone under pure tension. Two types of tissue were used in the investigation: (1) formalin-fixed vertebral bone as an in vitro model for weak cancellous bone, and (2) freshly removed metatarsal bone. Tissue--cement joints were allowed to solidify under two different pressures (0.11 and 0.47 MPa), and cement placement time on tissue surfaces was also controlled as a variable. The higher curing pressure only seemed to enhance the strength of interfaces formed with mechanically weak fixed bone but had no significant effect for joints formed with the stronger, freshly extracted tissue. Cement placement time did not have a discernible effect on interfacial strength regardless of the tissue used or the pressure applied during setting. An analysis of fracture morphology by optical microscopy revealed largely cement cohesive failure in some cases and bone or mixed fractures in others. Joints exhibiting mainly cement fracture had the highest interfacial tensile strengths (in the order of 7.5 MPa). Once measured values of tissue porosity were taken into account, the observed joint strength correlated well with cement tensile strength. Based on experimental findings, better stress-dissipating qualities and higher tensile strength are suggested as two important necessary improvements of bone cements based on poly(methyl methacrylate). PMID- 6863349 TI - A method for the prediction of protein adsorption on implant surfaces. PMID- 6863350 TI - In vivo and in vitro studies of the stress-corrosion cracking behavior of surgical implant alloys. AB - Behavior of implant alloys exposed simultaneously to tensile stresses and corrosion environments has been examined. In the in vivo studies, a stainless steel and a titanium alloy exhibited cracklike features when loaded to the yield stress sigma y and implanted for 16 weeks. A cobalt-chromium alloy stressed beyond sigma y exhibited them in plastically deformed areas. A cobalt-chromium nickel-molybdenum alloy appeared to be immune. In vitro samples loaded to various stress levels were immersed in Ringer's solution at 37 degrees C. Half of them were subjected to applied anodic potentials; the remaining control group was not. The applied potentials were dc potentials of magnitude similar to those generated by bioelectric effects. No attempt was made to duplicate time dependence or wave forms. Cracklike features were observed in the stainless steel and in the titanium alloy loaded to or beyond sigma y and polarized for 38 weeks. None were observed below sigma y. For the controls, no cracklike features were observed at any stress level after 53 1/2 weeks. Polarization measurements and potential versus time measurements were performed to study possible mechanisms for crack propagation. These investigations suggest that the in vivo corrosion environment is more severe than a 37 degrees C Ringer's solution because of the influence of both bioelectric effects and organic constituents. The implications of these studies for the performance of prosthetic devices is discussed. PMID- 6863351 TI - In vitro electrochemical corrosion study of coupled surgical implant materials. PMID- 6863352 TI - Relationship between release rate and surface concentration for heparinized materials. AB - Mathematical models are used to predict surface concentrations that result from the release of heparin into flowing blood and stagnant or well-mixed plasma. Two release rates--4 X 10(-2) and 3 X 10(-5) micrograms/cm2 min--are considered, which describe elution from an ionically heparinized material and from an immobilized heparin-PVA hydrogel, respectively. When heparin is released at the higher rate into blood flowing in cylindrical tubes with dimensions characteristic of the vasculature, or annular tubes representative of catheter experiments, a minimum surface concentration of 0.5 micrograms/mL is attained virtually at the tube inlet. Release at the lower rate requires tube lengths of several thousand meters to attain the same critical value. Similarly, heparin released from a suspension of beads at the higher rate leads to critical surface concentrations of 0.2 micrograms/mL within a fraction of a second in stagnant plasma, or ca. 5 s in a well-mixed environment. At the lower release rate, 45 or 100 min must elapse before the same level is achieved. These results support the validity of 4 X 10(-2) micrograms/cm2 min as a reasonable minimum release rate to produce a heparin microenvironment sufficient to prevent thrombosis. The lower rate is shown to be insufficient to generate a critical concentration, thus supporting the argument that heparin-PVA does not owe its biological activity to a heparin microenvironment. The model equations can be applied to the release of any material to determine surface concentrations. PMID- 6863353 TI - Quantitative histologic evaluation of LTI carbon, carbon-coated aluminum oxide and uncoated aluminum oxide dental implants. AB - The response of mandibular bone to identical geometry LTI carbon, carbon-coated aluminum oxide, and uncoated aluminum oxide blade-type dental implants in baboons for 2 years was evaluated using histologic, microradiographic, and scanning electron microscopic methods. In addition, a quantitative histologic analysis was performed identifying the type, amount, and distribution of tissue surrounding the dental implant systems. This is the final phase of a study investigating the effect of implant elastic modulus and implant surface chemical composition on the performance of dental implants. Previous studies have utilized clinical and radiographic evaluations, postretrieval mechanical testing, and finite element stress analysis to evaluate the dental implant performance. The results of the histologic study revealed a direct implant-bone interface with no intervening soft tissue in 16 of the 21 implants (76%). A fibrous tissue interface was observed in 5 of 21 implants (24%). Quantitative histologic results for the implants with a direct implant-bone interface showed statistically larger crestal cortical plates (p less than 0.05) and greater area fraction crestal cancellous bone (p less than 0.05) in the LTI carbon implant compared to the carbon-coated and uncoated aluminum oxide implants. The carbon-coated and uncoated aluminum oxide implants demonstrated statistically greater area fraction cancellous bone at the inferior region of the implant (p less than 0.05) and thinned and reduced crestal cortical plates when compared to the LTI carbon implants. The results indicate that significant stress shielding of the crestal bone had occurred with the rigid carbon-coated and uncoated aluminum oxide implants when compared to the LTI carbon implants which had a material elastic modulus similar to cortical bone. Based upon the histologic results, it appears that the LTI carbon implants with the direct implant-bone interface exhibited a greater potential for long term successful performance compared to the aluminum oxide substrate implants. PMID- 6863354 TI - Predicting the success of reambulation in patients with Duchenne muscular dystrophy. AB - We used biochemical and clinical variables to develop a method to predict the expected duration of independent walking following surgery and bracing in patients with Duchenne muscular dystrophy. Data from the records of fifty patients were analyzed by linear and multiple regression. The most useful factors, applied in combination, in predicting the duration of walking ability after bracing were: percentage of residual muscle strength, vital capacity, creatinine coefficient, motivation of the patient at the time of bracing, and decrease in creatinine coefficient in the two years prior to bracing. This system uses readily available variables to predict the response to bracing in patients with Duchenne muscular dystrophy. Improvement in the criteria for the selection of patients for surgery and bracing is important in view of the economic cost as well as the demands on the time and energy of these children and their parents. PMID- 6863355 TI - Pelvic Ewing's sarcoma. Advances in treatment. AB - In a study of eighteen patients with pelvic Ewing's sarcoma who were treated with a multidisciplinary approach, chemotherapy was effective in controlling systemic spread of the tumor. Surgery coupled with improved methods of chemotherapy provided results that were statistically superior to those obtained with radiation and chemotherapy alone in control of the local pelvic lesion. A twofold increase in the survival rate was seen at a median follow-up of thirty-six months in the patients who had the resection. Our results suggest that pelvic Ewing's sarcoma is best treated by initial chemotherapy, followed by local wide marginal resection of the pelvic lesion coupled with perimeter radiation therapy and concluded with additional chemotherapy. Survival rates of patients with pelvic Ewing's sarcoma may then approach the excellent survival rates of patients with lesions in more favorable anatomical locations. PMID- 6863356 TI - Split posterior tibial-tendon transfer in spastic cerebral palsy. AB - Sixteen split posterior tibial-tendon transfers, usually with heel-cord lengthening, were performed on sixteen children with spastic cerebral palsy and equinovarus deformities. The patients were followed for a minimum of two years postoperatively. All of the varus deformities were corrected, although two patients required an osteotomy of the calcaneus because of fixed varus deformity. There were no recurrences of the varus deformities, nor were any valgus or calcaneal deformities produced, and the equinus element of the gait was eliminated. PMID- 6863357 TI - Adduction contracture of the thumb in cerebral palsy. A preoperative electromyographic study. AB - In twenty-three patients with cerebral palsy and functional spastic hemiplegia, the contracted thenar-adductor space of the involved hand was evaluated by electromyography. The needle electromyogram was used to determine if the patient had selective control of the adductor muscle. In eight patients only partial myotomy of the adductor muscle during z-plasty of the web was performed because selective control of that muscle was present during either grasp or release. In four patients a complete release was done, and in two of them the ability to pinch was impaired. PMID- 6863358 TI - Treatment of congenital dislocation of the hip by the Pavlik harness. Mechanism of reduction and usage. AB - The Pavlik harness was used in the treatment of complete congenital dislocation of one or both hips in a series of infants, on either an outpatient or an inpatient basis. The results in the two groups were compared. For the children treated as outpatients the incidence of avascular necrosis of the femoral head was 7.2 per cent and for the group treated as inpatients the rate was 28 per cent. Application of the Pavlik harness allowed reduction of the hip by shifting the femoral head first to the posterior part of the acetabulum through flexion of the hip, followed by movement of the femoral head anteriorly into the acetabulum through abduction of the hip, which is possible because of stretching of the adductor muscles by the weight of the lower extremity. When the reduction is obtained by forced abduction there is a greater danger of avascular necrosis of the femoral head. PMID- 6863359 TI - Terminology and measurement of spondylolisthesis. PMID- 6863360 TI - Assessment of malignancy of cartilage tumors using flow cytometry. A preliminary report. PMID- 6863361 TI - Post-traumatic avascular necrosis of the femoral head predicted by preoperative technetium-99m antimony-colloid scan. An experimental and clinical study. AB - We used technetium-99m antimony colloid to visualize the bone marrow of the head of the femur within twenty-four hours after interruption of the blood supply by subcapital osteotomy and section of the ligamentum teres in thirteen rabbits and within twenty-four hours after a subcapital fracture in thirty patients. Of the rabbits, all showed loss of marrow radioactivity over the affected femoral head. Bone-imaging with technetium-99m methylene diphosphonate, in contrast, failed to demonstrate any abnormality in the avascular head of the femur for as long as forty-eight hours after osteotomy. This difference between the marrow scan and the bone scan was attributed to earlier loss of function in the marrow cells than in the osteocytes. The thirty patients who had a preoperative scan within twenty four hours after sustaining a subcapital fracture were treated by internal fixation with a Richards screw and plate and were followed for as long as two years, or until the patient died or radiographs showed evidence of avascular necrosis. The preoperative technetium-99m antimony-colloid activity in the head of the fractured femur was normal in sixteen patients and absent in fourteen; two of the fourteen had no activity in either hip, which precluded assessment of the fractured hip in these patients. In fifteen of the sixteen hips, preservation of the uptake in the marrow of the head of the fractured femur preoperatively predicted normal healing. Late segmental collapse developed in the remaining hip. In eleven of the twelve patients who had loss of marrow activity in the femoral head preoperatively, avascular necrosis developed within two years. One patient was asymptomatic at two years, with no evidence of necrosis. The two patients who had no marrow activity in either hip both had avascular necrosis within one year after surgery. PMID- 6863362 TI - Legg-Calve-Perthes disease. Histochemical and ultrastructural observations of the epiphyseal cartilage and physis. AB - Biopsy specimens of the lateral aspect of the femoral head and neck were obtained from five children with Legg-Calve-Perthes disease and were studied using histochemistry and electron microscopy. Beneath the normal articular cartilage there was a thick zone of hyaline (epiphyseal) cartilage containing sharply demarcated areas of hypercellular and fibrillated cartilage with prominent blood vessels. The fibrillated cartilage was strongly positive to alcian blue, weakly positive to periodic acid-Schiff, and positive to aniline blue. The interterritorial matrix in the hypercellular areas was weakly positive to both alcian blue and periodic acid-Schiff. Ultrastructural examination of these areas revealed many irregularly oriented large collagen fibrils and variable amounts of proteoglycan granules. These results suggest that in the fibrillar areas there are: (1) a high proteoglycan content, (2) a decrease in structural glycoproteins, and (3) a different size of collagen fibrils from that of normal epiphyseal cartilage. The hypercellular areas had a decrease in proteoglycans, glycoproteins, and collagen. The lateral physeal margin was often irregular, with a marked reduction of collagen and proteoglycan granules, and contained numerous large lipid inclusions. CLINICAL RELEVANCE: The abnormal areas in the epiphyseal cartilage of patients with Legg-Calve-Perthes disease have different histochemical and structural properties from normal cartilage and from fibrocartilage. This suggests that the disease could be a localized expression of a generalized, transient disorder of epiphyseal cartilage that is responsible for delayed skeletal maturation. The cartilage lesions are similar to those seen in the vertebral plates in patients with juvenile kyphosis. Whether the epiphyseal cartilage abnormalities are primary or are secondary to ischemia remains uncertain; however, it appears that the collapse and necrosis of the femoral head could result from the breakdown and disorganization of the matrix of the epiphyseal cartilage, followed by abnormal ossification. PMID- 6863365 TI - Septic arthritis of the wrist. AB - Twenty-eight patients (two of them children) with septic arthritis of twenty-nine wrists were treated with early surgical drainage, parenteral antibiotics, and early motion after surgical decompression. The etiology was trauma in seventeen patients, and Staphylococcus aureus was the organism that was most commonly recovered on culture. In twenty-two patients (twenty-three wrists) who were followed for six months to nine years there were no recurrences. The results were evaluated in terms of range of motion, grip strength, and subjective complaints of discomfort and disability. Of the ten wrists with a good or excellent result, all had had the arthrotomy within ten hours after diagnosis, and of the thirteen with a fair or poor result, surgery had been delayed for sixteen hours or longer. The long-term results deteriorated in direct proportion to increasing time until treatment and the number of procedures performed. PMID- 6863363 TI - The effects of intravenous regional guanethidine and reserpine. A controlled study. AB - We investigated the effects of intravenous regional injection of guanethidine and reserpine in a prospective, randomized, double-blind study of seven volunteers. The sympatholytic activities of these drugs were assessed separately for cholinergic and adrenergic function. Cold challenge was employed to magnify the effect on digital temperatures and alterations in pulse-volume. Only guanethidine significantly increased temperature (p less than 0.025) after cold challenge, this effect lasting for three days. No anticholinergic effect was found. Intravenous regional guanethidine may be useful in the treatment of vasospastic disorders and as prophylaxis for surgically treated patients in whom this complication may be expected to occur. PMID- 6863364 TI - Proteoglycans of human scoliotic intervertebral disc. PMID- 6863366 TI - Ankle arthrodesis by chevron fusion with internal fixation and bone-grafting. AB - We evaluated the results in thirteen patients with disabling tibiotalar arthritis who underwent a new operation for ankle fusion for relief of pain. The procedure in all of these patients was a chevron (pitched-roof) tibiotalar osteotomy and excision of the joint. A bilateral approach to the ankle joint was used and the arthrodesis was supplemented by internal fixation and a tibial onlay graft applied medially. There were few complications, none of them of major importance. The after-care required only immobilization in a short cast. All but one patient had a solid fusion. The final result was a normal-looking ankle with good function. PMID- 6863367 TI - Deep-vein thrombosis in children following trauma. A report of two cases. PMID- 6863368 TI - Alveolar soft-part sarcoma. A case report. PMID- 6863370 TI - Arteriographic embolization for control of excessive blood loss complicating revision of total hip arthroplasty. A case report. PMID- 6863369 TI - Bilateral sequential tibial and fibular fatigue fractures associated with aluminum intoxication osteomalacia. A case report. PMID- 6863373 TI - Nitrogen-gas injection from a power reamer: a complication of closed intramedullary nailing of the femur. Technical note. PMID- 6863372 TI - Functional performance after excision of the vastus lateralis and vastus intermedius. A case report. PMID- 6863371 TI - Enteric fistula as a complication of a pelvic fracture. Case report. PMID- 6863374 TI - Proximal femoral focal deficiency. PMID- 6863375 TI - Congenital pelvic obliquity. PMID- 6863377 TI - Pseudo-obstruction of the colon. A postoperative complication in orthopaedic patients. PMID- 6863376 TI - Isolated, complete radial dislocation of the scaphoid. PMID- 6863378 TI - Surgical treatment of syphilitic coronary ostial stenosis with aortic regurgitation. AB - Syphilitic aortitis leads to involvement of the coronary ostia, aortic annulus and valve leaflets. Aortic valve replacement (AVR) with restoration of coronary blood flow is an essential therapeutic objective. Three different approaches were used for the treatment of syphilitic aortic regurgitation with coronary ostial stenosis; Case 1. AVR and endarterectomy, Case 2. AVR and aorto-coronary saphenous vein bypass graft and Case 3. AVR and endarterectomy using Fogarty catheter and Scanlan Aorta Punch. Special emphasis was given to the technique used in Case 3 as a therapeutic adjunct in the treatment of syphilitic coronary ostial stenosis. PMID- 6863379 TI - Chylothorax following cardiac surgery in children. AB - Eleven cases of chylothorax following cardiac surgery in children are described. Conservative treatment was carried out with success in all patients but one, who died because of the underlying cardiac pathology, with the chylothorax still present. Our results indicate that conservative treatment is effective in children, although surgery has been previously considered by some authors as the treatment of choice in this age group. PMID- 6863380 TI - The prognostic value of the noninvasive vascular laboratory in autologous vein bypasses of the lower extremities. AB - A retrospective study of 34 patients with 29 autologous vein femoropopliteal and 8 femorotibial bypasses was conducted, examining the correlation of angiographic runoff and non-invasive flow determinants as prognostic indicators of early graft occlusion of lower limb bypass grafts. The followup period was 3-27 months, with a mean of 5.8 months. Graft patency and improvement in presenting symptoms were unrelated to preoperative ankle systolic pressure indices. Preoperative and postoperative flow measurements were similar in patients with patent grafts (greater than 12 months) and in those with early graft occlusion (0-6 months, p greater than .05). Preoperative pressure indices did not correlate with calf vessel runoff (p. greater than 05). The data suggest: (1) the noninvasive flow studies are not reliable predictors of future graft patency, (2) vessel runoff is not a reliable predictor of limb flow, and (3) bypass procedures in the lower extremities should not be excluded on the basis of noninvasive flow studies when indicated by other clinical parameters. PMID- 6863383 TI - Noninvasive detection of axillary and subclavian venous thrombosis by impedance plethysmography. AB - Venous occlusion impedance plethysmography (IPG) is an objective noninvasive test which is widely employed for the detection of deep venous thrombosis (DVT) in the lower extremities. The IPG technique is easily adapted to the evaluation of upper extremity venous thrombosis, as demonstrated in 46 patients with symptoms of axillary and subclavian venous thrombosis (88 limbs) and 26 normal volunteers (52 limbs). Venograms were obtained in 18 patients (22 limbs) and correlated in all cases with the previous IPG interpretation. The test procedure and interpretation criteria for the noninvasive detection of upper extremity deep venous thrombosis are similar to those previously developed for the lower extremities, but with more emphasis on comparison with the contralateral limb. Vascular laboratories performing IPG for lower extremity DVT should be able to employ this test for the detection of upper extremity venous thrombosis as well. PMID- 6863382 TI - Diagnostic and pathological considerations in the popliteal artery entrapment syndrome. AB - Four cases of the popliteal artery entrapment syndrome including two with bilateral lesions are reported. All limbs of these patients showed classical arterial entrapment due to the anomalous course of the popliteal artery in relation to the medial head of the gastrocnemius muscle. All cases were diagnosed preoperatively, and computed tomography demonstrated apparent separation of the popliteal artery and vein at the site of the insertion of the gastrocnemius muscle. All patients complained of gradually progressive intermittent claudication except for one who revealed acute leg ischemia following long periods of driving and Japanese-style sitting. Surgical treatment resulted in complete recovery in all limbs. Pathological characteristics in the popliteal artery were: (1) the presence of longitudinal smooth muscle bundles in the medial coat adjacent to the gastrocnemius muscle, and (2) intimal thickening and/or thrombus formation adjacent to the medial condyle of the femur. PMID- 6863384 TI - Successful excision of an intramural fibroma of the left ventricle. AB - A 2-year-old boy who presented with unrelated recurrent respiratory infections was found to have an enlarged cardiac silhouette on his chest roentgenogram. Clinical evaluation, echocardiography and cardiac cineangiograms failed to provide an accurate diagnosis. A left ventricular tumor was identified by exploratory thoracotomy and successful excision of an intramural fibroma of the left ventricle subsequently accomplished. PMID- 6863381 TI - The behaviour of infected human umbilical vein arterial grafts. AB - Two patients who received Human Umbilical Vein (H.U.V.) femoropopliteal by-passes to revascularize ischemic limbs, and later underwent emergency operations for acute graft thrombosis, developed H.U.V. graft sepsis. The patients presented with haemorrhage, fever, pain and a growing mass at the site of the previous emergency procedure, one and five months later. An attempt at limited H.U.V. segment substitution (case 1) failed. We then performed successful complete graft excisions combined with extra-anatomical H.U.V. revascularization. At present both patients are asymptomatic with well-functioning H.U.V. grafts, 7 and 13 months later. In both cases Light and Scanning Electron Microscopic studies were performed. Findings of these studies have been analyzed. PMID- 6863385 TI - Biosynthesis and transport of cathepsin D in cultured human fibroblasts. AB - For study of the time order of glycosylation, formation of complex oligosaccharides and proteolytic maturation as well as the site of proteolytic maturation of cathepsin D, fibroblasts were subjected to pulse-chase labeling, and cathepsin D was isolated from either total cell extracts or subcellular fractions by immune precipitation and analyzed for its molecular forms and sensitivity to endo-beta-N-acetylglucosaminidase H. After a 10-min pulse, cathepsin D was detected in its glycosylated precursor form, indicating an early, probably a cotranslational, N-glycosylation of cathepsin D. Conversion of the high-mannose oligosaccharide side chains into forms resistant to endo-beta-N acetylglucosaminidase H started after approximately 40 min, indicating that transport of cathepsin D from the endoplasmic reticulum to the trans-Golgi apparatus requires approximately 40 min. Processing of the 53-kdalton precursor polypeptide of cathepsin D to a 47-kdalton intermediate followed about 20 min after the formation of complex oligosaccharides, and, another 30 min later, 31 kdalton mature forms of cathepsin D were detected. Processing of cathepsin D was first observed in light membranes as a partial conversion of the 53-kdalton precursor into the 47-kdalton intermediate. Both the precursor and the intermediate are transferred into the high density-class lysosomes. After 8 h, the processing to the mature 31-kdalton form of cathepsin D is mostly completed. PMID- 6863386 TI - Actin from Thyone sperm assembles on only one end of an actin filament: a behavior regulated by profilin. AB - Thyone sperm were demembranated with Triton X-100 and, after washing, extracted with 30 mM Tris at pH 8.0 and 1 mM MgCl2. After the insoluble contaminants were removed by centrifugation, the sperm extract was warmed to 22 degrees C. Actin filaments rapidly assembled and aggregated into bundles when KCl was added to the extract. When we added preformed actin filaments, i.e., the acrosomal filament bundles of Limulus sperm, to the extract, the actin monomers rapidly assembled on these filaments. What was unexpected was that assembly took place on only one end of the bundle--the end corresponding to the preferred end for monomer addition. We showed that the absence of growth on the nonpreferred end was not due to the presence of a capper because exogenously added actin readily assembled on both ends. We also analyzed the sperm extract by SDS gel electrophoresis. Two major proteins were present in a 1:1 molar ratio: actin and a 12,500-dalton protein whose apparent isoelectric point was 8.4. The 12,500-dalton protein was purified by DEAE chromatography. We concluded that it is profilin because of its size, isoelectric point, molar ratio to actin, inability to bind to DEAE, and its effect on actin assembly. When profilin was added to actin in the presence of Limulus bundles, addition of monomers on the nonpreferred end of the bundle was inhibited, even though actin by itself assembled on both ends. Using the Limulus bundles as nuclei, we determined the critical concentration for assembly off each end of the filament and estimated the Kd for the profilin-actin complex (approximately 10 microM). We present a model to explain how profilin may regulate the extension of the Thyone acrosomal process in vivo: The profilin actin complex can add to only the preferred end of the filament bundle. Once the actin monomer is bound to the filament, the profilin is released, and is available to bind to additional actin monomers. This mechanism accounts for the rapid rate of filament elongation in the acrosomal process in vivo. PMID- 6863387 TI - Increases in guinea pig small intestinal transepithelial resistance induced by osmotic loads are accompanied by rapid alterations in absorptive-cell tight junction structure. AB - In some epithelia, mucosal exposure to osmotic loads produces an increase in transepithelial resistance that is presumed to relate to the collapse of the paracellular spaces. Since proximal small intestinal epithelium may transiently encounter osmotic loads during normal digestion, we examined the short-term effect of osmotic loads on resistance and on epithelial structure of mucosal sheets prepared from guinea pig jejunum using Ussing-chamber, thin-section electron-microscopic, and freeze-fracture techniques. After equilibration of mucosal sheets in chambers, mucosal buffer tonicity was increased to 600 mosM with mannitol. This resulted in a 64% increase in resistance within 20 min. Concomitantly, 600 mosM produced a decrease in tight-junction cation selectivity as judged from dilution potentials, collapse of paracellular spaces, decreased cytoplasmic electron density in 10-40% of absorptive cells, and focal absorptive cell subjunctional lateral-membrane evaginations often associated with microfilament arrays. Freeze-fracture replicas of absorptive-cell tight junctions revealed significant increases in both strand count and depth. Preincubation with 5 micrograms/ml cytochalasin D reduced the 600 mosM resistance increase caused by 600 mosM exposure by 48% but did not prevent the collapse of paracellular spaces. Lowered temperatures that produced morphologic evidence consistent with a gel phase transition of absorptive-cell lateral membranes prevented both the resistance response and the alterations in tight-junction structure. In conclusion, transient osmotic loads produce an increase in resistance in jejunal epithelium and alter both absorptive-cell tight-junction charge selectivity and structure. These responses, which may have physiologic implications, can be reduced by cytoskeletal inhibitors and ablated by conditions that restrict mobility of absorptive-cell lateral-membrane molecules. PMID- 6863388 TI - Neural cell adhesion molecule mediates initial interactions between spinal cord neurons and muscle cells in culture. AB - Previous studies in this laboratory have described a cell surface glycoprotein, called neural cell adhesion molecule or N-CAM, that appears to be a ligand in the adhesion between neural membranes. N-CAM antigenic determinants were also shown to be present on embryonic muscle and an N-CAM-dependent adhesion was demonstrated between retinal cell membranes and muscle cells in short-term assays. The present studies indicate that these antigenic determinants are associated with the N-CAM polypeptide, and that rapid adhesion mediated by this molecule occurs between spinal cord membranes and muscle cells. Detailed examination of the effects of anti-(N-CAM) Fab' fragments in cultures of spinal cord with skeletal muscle showed that the Fab' fragments specifically block adhesion of spinal cord neurites and cells to myotubes. The Fab' did not affect binding of neurites to fibroblasts and collagen substrate, and did not alter myotube morphology. These results indicate that N-CAM adhesion is essential for the in vitro establishment of physical associations between nerve and muscle, and suggest that binding involving N-CAM may be an important early step in synaptogenesis. PMID- 6863389 TI - Evidence for a unique profile of phosphatidylcholine synthesis in late mitotic cells. AB - Evidence is presented that the structural rearrangements in late mitosis are accompanied by an alteration in membrane lipid synthesis. This evidence was derived from analyzing phospholipid classes after rapid-labeling, as well as from determining the intracellular site of incorporation of choline by HeLa S3 cells as they progressed from metaphase into early interphase (G1). Compared with postmitotic cell data, the recent mitotic cell data indicate a specific two- to threefold increase in the net synthesis of phosphatidylcholine (PC) species, which appeared to contain the more saturated fatty acids. Since this was observed with glycerol, choline, and orthophosphate labelings, and not with methyl labeling, it appears that the CDP-choline plus diacylglycerol pathway rather than the phosphatidylethanolamine to PC pathway was augmented. Electron microscope autoradiography of anaphase, telophase, and early G1 cells demonstrated that the reformed nuclear envelope was the incorporation site of a significant proportion of the newly synthesized PC. This incorporation occurred by early telophase prior to chromosome decondensation. The potential significance of PC metabolism with regard to membrane rearrangements, such as nuclear envelope reformation, is discussed. PMID- 6863391 TI - Polarity of kinetochore microtubules in Chinese hamster ovary cells after recovery from a colcemid block. AB - The polarity of kinetochore microtubules was determined in a system for which kinetochore-initiated microtubule assembly has been demonstrated. Chinese hamster ovary cells were treated with 0.3 micrograms/ml colcemid for 8 h and then released from the block. Prior to recovery, microtubules were completely absent from the cells. The recovery was monitored using light and electron microscopy to establish that the cells progress through anaphase and that the kinetochore fibers are fully functional. Since early stages of recovery are characterized by short microtubule segments that terminate in the kinetochore fibrous corona rather than on the outer disk, microtubule polarity was determined at later stages of recovery when longer kinetochore bundles had formed, allowing us to establish unambiguously the spatial relationship between microtubules, kinetochores, and chromosomes. The cells were lysed in a detergent mixture containing bovine brain tubulin under conditions that allowed the formation of polarity-revealing hooks. 20 kinetochore bundles were assayed for microtubule polarity in either thick or thin serial sections. We found that 95% of the decorated kinetochore microtubules had the same polarity and that, according to the hook curvature, the plus ends of the microtubules were at the kinetochores. Hence, the polarity of kinetochore microtubules in Chinese hamster ovary cells recovering from a colcemid block is the same as in normal untreated cells. This result suggests that microtubule polarity is likely to be important for spindle function since kinetochore microtubules show the same polarity, regardless of the pattern of spindle formation. PMID- 6863390 TI - Abundance, relative gelation activity, and distribution of the 95,000-dalton actin-binding protein from Dictyostelium discoideum. AB - We have studied the abundance, relative gelation activity, and distribution of the 95,000-dalton actin-binding protein in Dictyostelium discoideum amoebae. The 95,000-dalton protein was a prominent polypeptide as assessed using quantitative densitometry and radioimmunoassay. We estimated that this protein comprised approximately 1.2% of the protein in a soluble extract of amoebae. The molar ratio of the dimeric 95,000-dalton protein to actin in the soluble extract was 1:30. The apparent viscosities of actin mixtures with either the purified 95,000 dalton protein or the soluble extract were measured by falling ball viscometry in an attempt to assess the contribution of the 95,000-dalton protein to gelation of the soluble extract. The gelation of the soluble extract was significantly less than that expected from the contribution of the 95,000-dalton protein alone. Consequently, we questioned the validity of quantitative analyses of the contributions of specific actin-binding proteins to the gelation of cell extracts. The apparent distribution of the 95,000-dalton protein was observed in chemically fixed and extracted cells by immunofluorescence microscopy and compared with the distribution of cytoplasm and organelles visible using light microscopy. The 95,000-dalton protein was dispersed throughout the cytoplasm of fixed cells, was apparently excluded from prominent organelles, and displayed brightest fluorescence in regions of hyaline cytoplasm. These regions of hyaline cytoplasm that exhibited the brightest fluorescence were observed in the cortical region of rounded cells and in pseudopods of polarized cells. Thus, cell shape and polarity may also have influenced the apparent distribution of the 95,000 dalton protein observed by immunofluorescence microscopy. Study of the distribution of fluorescein-labeled ovalbumin injected into living cells supported the interpretation that the thickness of the cell and the distribution of organelles contributed to the apparent distribution of the 95,000-dalton protein observed in fixed cells using immunofluorescence microscopy. We suggest that the 95,000-dalton protein contributes to modulation of the consistency and contractility of the cytoplasm of D. discoideum amoebae, since it could cross link actin filaments in vitro in a reversible process that was regulated by changes in the concentration of calcium and of protons, and since it was present in large quantity in the cytoplasm of these cells. PMID- 6863393 TI - Chlamydomonas alpha-tubulin is posttranslationally modified in the flagella during flagellar assembly. AB - The principal alpha-tubulin within Chlamydomonas reinhardtii flagellar axonemes differs from the major alpha-tubulin in the cell body. We show that these two isoelectric variants of alpha-tubulin are related to one another since posttranslational modification of the cell body precursor form converts it to the axonemal form. During flagellar assembly, precursor alpha-tubulin enters the flagella and is posttranslationally modified within the flagellar matrix fraction prior to or at the time of its addition to the growing axonemal microtubules. Experiments designed to identify the nature of this posttranslational modification have also been conducted. When flagella are induced to assemble in the absence of de novo protein synthesis, tritiated acetate can be used to posttranslationally label alpha-tubulin in vivo and, under these conditions, no other flagellar polypeptides exhibit detectable labeling. PMID- 6863392 TI - Evidence for tubulin-binding sites on cellular membranes: plasma membranes, mitochondrial membranes, and secretory granule membranes. AB - We describe the interaction of pure brain tubulin with purified membranes specialized in different cell functions, i.e., plasma membranes and mitochondrial membranes from liver and secretory granule membranes from adrenal medulla. We studied the tubulin-binding activity of cellular membranes using a radiolabeled ligand-receptor assay and an antibody retention assay. The tubulin-membrane interaction was time- and temperature-dependent, reversible, specific, and saturable. The binding of tubulin to membranes appears to be specific since acidic proteins such as serum albumin or actin did not interfere in the binding process. The apparent overall affinity constant of the tubulin-membrane interaction ranged between 1.5 and 3.0 X 10(7) M-1; similar values were obtained for the three types of membranes. Tubulin bound to membranes was not entrapped into vesicles since it reacted quantitatively with antitubulin antibodies. At saturation of the tubulin-binding sites, the amount of reversibly bound tubulin represents 5-10% by weight of membrane protein (0.4-0.9 nmol tubulin/mg membrane protein). The high tubulin-binding capacity of membranes seems to be inconsistent with a 1:1 stoichiometry between tubulin and a membrane component but could be relevant to a kind of tubulin assembly. Indeed, tubulin-membrane interaction had some properties in common with microtubule formation: (a) the association of tubulin to membranes increased with the temperature, whereas the dissociation of tubulin-membrane complexes increased by decreasing temperature; (b) the binding of tubulin to membranes was prevented by phosphate buffer. However, the tubulin membrane interaction differed from tubulin polymerization in several aspects: (a) it occurred at concentrations far below the critical concentration for polymerization; (b) it was not inhibited at low ionic strength and (c) it was colchicine-insensitive. Plasma membranes, mitochondrial membranes, and secretory granule membranes contained tubulin as an integral component. This was demonstrated on intact membrane and on Nonidet P-40 solubilized membrane protein using antitubulin antibodies in antibody retention and radioimmune assays. Membrane tubulin content varied from 2.2 to 4.4 micrograms/mg protein. The involvement of membrane tubulin in tubulin-membrane interactions remains questionable since erythrocyte membranes devoid of membrane tubulin exhibited a low (one-tenth of that of rat liver plasma membranes) but significant tubulin binding activity. These results show that membranes specialized in different cell functions possess high-affinity, large-capacity tubulin-binding sites... PMID- 6863394 TI - Inhibition of DNA synthesis in SV3T3 cultures by isolated 3T3 plasma membranes. AB - 3T3 plasma membranes were added to subconfluent cultures of SV3T3 cells in the presence of fusogens. If this protocol results in the introduction into the SV3T3 cell membrane of 3T3 plasma membrane components responsible for density-dependent inhibition of growth, then the SV3T3 cell cultures would be expected to show decreased rates of DNA synthesis as they approach confluence. Results of these experiments indicate that rates of DNA synthesis in SV3T3 cultures so treated were as much as 63% less than in untreated controls. This effect could not be attributed to the fusogens or to the 3T3 plasma membranes alone. This growth inhibitory effect is specific for 3T3 membranes and is not observed when SV3T3 plasma membranes are fused with SV3T3 cell cultures. These data support the hypothesis that one aspect of the loss of density-dependent inhibition of growth in SV3T3 cells is a deletion or alteration in plasma membrane components and, further, that density-dependent inhibition of growth can be in part restored to SV3T3 cell cultures by fusing the cells with 3T3 plasma membranes. PMID- 6863395 TI - Mobility and detergent extractability of acetylcholine receptors on cultured rat myotubes: a correlation. AB - On aneurally cultured rat primary myotubes, 10% of the acetylcholine receptors (AChR) are found aggregated and immobilized in endogenous clusters. The remaining receptors are diffusely distributed over the cell membrane and the majority of these are free to diffuse in the plane of the membrane. This study correlates the mobility of AChR (as measured with the fluorescence photobleaching recovery technique, FPR) with the detergent extractability of this receptor. Gentle detergent extraction of the cells removes the lipid membrane and the soluble cytoplasmic proteins but leaves an intact cytoskeletal framework on the substrate. Two studies indicate a correlation between mobility and extractability: (a) mobility of diffusely distributed AChR decreases as myotubes age in culture; previous work showed that extractability of AChR decreases as myotubes age in culture (Prives, J., C. Christian, S. Penman, and K. Olden, 1980, In Tissue Culture in Neurobiology, E. Giacobini, A. Vernadakis, and A. Shahar, editors, Raven Press, New York, 35-52); (b) mobility of clustered AChR increases when cells are treated with metabolic inhibitors such as sodium azide (NaN3); extractability of clustered AChR also increases with this treatment. From these results we suggest the involvement of a cytoskeletal framework in the immobilization of AChR on the cell surface. PMID- 6863396 TI - Growth-promoting effects of iron- and cobalt- protoporphyrins on cultured embryonic cells. AB - The effects of hemin (Fe-protoporphyrin) and Co-protoporphyrin on cellular growth have been investigated principally in cultured fibroblasts, but also in myoblasts and hepatocytes from chick embryos. In the presence of horse serum in the culture medium, which by itself did not stimulate cell growth appreciably, Co protoporphyrin stimulated cell attachment while hemin stimulated cell proliferation of fibroblasts. When Co-protoporphyrin and hemin were added together, the most potent stimulation of cell growth, consisting of increases in cell attachment and rapid cell proliferation, was observed. These findings indicate that the two metalloporphyrins have differential and complementary effects on cellular growth in culture, with synthetic Co-protoporphyrin principally affecting cellular attachment and Fe-protoporphyrin stimulating cellular proliferation. PMID- 6863398 TI - The respiration-linked limiting step of tumor cell transition from the non cycling to the cycling state: its inhibition by oxidizable substrates and its relationships to purine metabolism. AB - The recruitment into the cycling state of resting Yoshida AH 130 hepatoma cells was studied with respect to its dependence on respiration in an experimental system wherein the overall energy requirement for this recruitment can be supplied by the glycolytic ATP. The G1-S transition of these cells, unaffected by 2,4-dinitrophenol (DNP) at concentrations which uncouple the respiratory phosphorylation, is impaired either by blocking the electron flow to oxygen by antimycin A or by adding an excess of some oxidizable substrates, chiefly pyruvate and oxalacetate. An experimental analysis, focused on pyruvate activity, showed that the inhibition of cell recruitment into S is not related to the depressing effects of this substrate on aerobic glycolysis of tumor cells, nor is it modified by forcing, in the presence of DNP, pyruvate oxidation through the tricarboxylic acid cycle as well as the overall oxygen consumption. Addition of suitable concentrations of preformed purine bases (mainly adenine), completely removes the block of the G1-S transition produced either by the excess of oxidizable substrates or by antimycin A. These findings indicate the existence of a respiration-linked step in purine metabolism, which restricts the above transition and is equally impaired by blocking the respiratory chain or by saturating it with an excess of reducing equivalents derived from unrelated oxidations. The inhibitory effects of pyruvate and antimycin A can be largely removed by the addition of folate and tetrahydrofolate, suggesting that the respiration-linked restriction point of tumor cell cycling involves the folate metabolism and its connections to purine synthesis. PMID- 6863397 TI - Evidence for monovalent phosphate transport in Ehrlich ascites tumor cells. AB - In an effort to determine whether the Na+-dependent Pi transport system of Ehrlich ascites tumor cells exhibits specificity for H2PO4- or HPO4(-2), Pi fluxes were determined by measuring 32Pi-Pi self-exchange. Three experimental approaches were employed. First, the effect of pH on steady-state Pi transport at 0.5 and 5 mM was studied. Second, the relationship between Pi transport and Pi concentration (0.25-9.2 mM) at pH 5.6 and 7.9 was determined. Third, the dependence of Pi transport on [H2PO4-] (0.05-4.2 mM) at constant [HPO4(-2)] (0.5 mM), and the converse, [HPO4(-2)] (0.06-4.5 mM) at constant [H2PO4-] (0.5 mM), was evaluated. Ks (apparent half-saturation constant) and Jmax (maximal transport rate) were calculated by two methods: weighted linear regression (WLR) and a nonparametric procedure. The dependence of Pi flux on pH indicates that optimum transport occurs at pH 6.9. Pi transport decreases as pH is reduced when extracellular Pi is either 0.5 or 5 mM. However, at pH 7.9, Pi flux is reduced only in 0.5 mM Pi. At pH 5.6, H2PO4- comprises 93% of the total Pi present, and the calculated Ks is 0.055 +/- 0.026 mM (WLR). This is the same as the Ks determined from the initial phase of the flux vs. [H2PO4-] relationship (0.056 +/ 0.020 mM). However, at pH 7.9 (where 94% of Pi is HPO4(-2)), the measured Ks is 0.58 +/- 0.11 mM (WLR), which is ten times higher than at pH 5.6. This value is also five times greater than the Ks calculated from the flux vs. [HPO4(-20)] curve (0.106 +/- 0.16 mM). Kinetic parameters calculated by the nonparametric method, though somewhat different, gave similar relative results. Taken together, these results support two conclusions: (1) H2PO4- is the substrate for the Na+ dependent Pi transport system of the Ehrlich cell, and (2) H+ can inhibit Pi transport. PMID- 6863399 TI - Comparative studies of collagen lattice contraction utilizing a normal and a transformed cell line. AB - Differences between the behavior of cultured rat skin fibroblasts and that of a line of transformed rat sarcoma cells incorporated into a polymerized collagen lattice were examined. Fibroblast-populated collagen lattices (FPCL) were manufactured. Within 24 to 48 hr after manufacture, both cell lines reduced lattice size by a process known as lattice contraction. Contraction occurred more rapidly in both cell lines when the media were supplemented with 25% serum rather than the usual concentration of 10% serum. Similar growth patterns were observed with transformed cells within collagen lattices and on plastic surfaces. Normal rat fibroblasts were found to contract lattices faster than transformed cells. At the end of a 2-week period, the final contracted size of the transformed cell lattice was the same as that of normal cell lattices. The cellular density of transformed cells within the FPCL was eight times greater than that of FPCL made with normal rat cells. Normal rat fibroblasts elongated and flattened more, and organized the collagen matrix to a greater degree, than did transformed cells. In this instance, therefore, lattice contraction was shown to be linked more to the process of fibroblast elongation and collagen fiber organization than to cell number or density. PMID- 6863400 TI - Growth-stimulating effect of catecholamines on rat aortic smooth muscle cells in culture. AB - The effect of epinephrine was tested on the proliferation of rat arterial smooth muscle cells (SMC) in secondary cultures. Epinephrine added daily to the culture medium caused a striking stimulation of growth. The effect increased with time and was dose-dependent. Maximal stimulation was observed at a concentration of 10(-5) M and after 72 hours. At higher concentrations (10(-3) M) epinephrine exhibited toxic effects on SMC. When SMC were maintained quiescent by deprivation of serum, the subsequent addition of epinephrine required serum to significantly enhance growth. This growth stimulation increased with serum concentration (from 0.1% to 10%). All the adrenergic agonists tested were found to stimulate SMC growth, with an activity classified by decreasing order as follows: norepinephrine greater than epinephrine greater than isoproterenol. Finally, this mitogenic response of SMC to catecholamines was specific since it could be blocked by adrenergic blocking agents, phentolamine being more efficient than propranolol in that connection. The results suggest that epinephrine and other catecholamines may act as growth factors for aortic SMC, at least in rat, mostly through adrenoreceptors. PMID- 6863401 TI - Metabolic characteristics of cells cultured from human umbilical blood vessels: comparison with 3T3 fibroblasts. AB - Little metabolic information is available for cells cultured from umbilical vascular tissue. These studies were undertaken to compare the metabolism of cells isolated from human umbilical arteries and veins with that of umbilical vascular segments. These studies also compared umbilical vascular cells to standard fibroblast preparations. Oxygen consumption by umbilical venous cells or tissues was greater than that for either arterial cells or tissues. Cellular adenosine triphosphate (ATP) content was greater in umbilical venous than arterial cells. However, an oxidation-phosphorylation ratio (R) was constant for either arterial or venous cells. Oxygen consumption by vascular cells was greater than that by nonvascular cells, as was cellular ATP content. R for nonvascular cells was much greater than that for vascular cells, indicating loose coupling between oxygen consumption and cellular ATP content. Finally, cellular oxygen consumption was dependent upon cell density, and upon media serum content in vascular endothelial cells. We conclude therefore that the metabolism of umbilical vascular cells in culture reflects that of the parent tissue but is different from that of either vascular or nonvascular fibroblasts. PMID- 6863402 TI - Isozymes of creatine kinase in mammalian cell cultures. AB - Previous studies on the energy metabolism of rat myocardial cells in culture supported the hypothesis that the creatine-phosphocreatine-creatine kinase system plays an important role in the intracellular transport of energy from the mitochondria to the myofibrils and in the regulation of energy production coupled to energy utilization in this model system. Effective functional compartmentation of ATP could result from the binding of creatine kinase to cellular organelles (e.g., myofibrils and mitochondria) such that high energy charge at the myofibrils is maintained by the reverse creatine kinase reaction, while phosphocreatine is synthesized mainly at the mitochondria in the forward creatine kinase reaction. It was, therefore, essential to demonstrate the presence of mitochondrial creatine kinase in the cultured myocardial cells to support this hypothesis, particularly since the mitochondrial creatine kinase was reportedly absent in fetal hearts. Using electrophoresis on cellulose acetate strips, the mitochondrial creatine kinase isozyme, as well as MM, MB, and BB isozymes, have now been demonstrated in myocardial cultures derived from neonatal rats. The mitochondrial creatine kinase increased with age in culture and with age of animal from which the culture is derived. Furthermore, the addition of creatine to culture media stimulates its synthesis. The mitochondrial creatine kinase isozyme was not detected in nonmuscle cells in culture derived from the neonatal rat hearts, nor in L6 muscle cell line. Phosphocreatine was present in all cells, but the regulation of energy metabolism and energy shuttle by creatine phosphocreatine-creatine kinase could be operative only in the cells where the mitochondrial creatine kinase is present. This regulatory mechanism provides for an efficient system concomitant with the continuous energy demand of the myocardium; it is not ubiquitous and its development in myocardial cells seems to be triggered postnatally. PMID- 6863403 TI - An estradiol-responsive mouse endometrial cell strain with inducible aryl hydrocarbon hydroxylase activity. AB - A mouse endometrial cell population has been isolated by mild tryptic digestion of the uterine lining. The cells were morphologically similar to endometrial gland cells in the intact mouse endometrial gland. The endometrial cells had a modal chromosome number of 66. The cells were adherent to glass as well as plastic and contained numerous large refractile, osmophilic, non-membrane-limited granules which stain with periodic acid-Schiff reagent but do not stain with oil red O, Sudan black, or Alcian blue. Cell growth was responsive to 17 beta estradiol; cell number increased 1.34-fold in 4 days in the presence of 10(-8) M estradiol. The cells are not tumorigenic. The cells showed induction of aryl hydrocarbon hydroxylase (AHH) activity when 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) was added to the growth media for 24 h. AHH activity and its induction were investigated with cells grown in the presence and absence 10(-8) M estradiol. Cells grown in media containing estradiol exhibited a 6.2-fold induction by TCDD; cells grown without estradiol gave an 8.4-fold induction of AHH activity. AHH activity and its induction by TCDD were demonstrated in cells grown with fetal calf serum that had been pretreated with dextran-coated charcoal to remove endogenous steroids. Benzanthracene failed to induce AHH activity significantly. PMID- 6863404 TI - Adenosine and tubercidin binding and transport in Chinese hamster ovary and Novikoff rat hepatoma cells. AB - The uptake of adenosine and tubercidin by control and ATP-deleted wild-type and adenosine kinase-deficient cells was measured by rapid kinetic techniques. Adenosine deamination was inhibited by pretreatment with 2-deoxycoformycin. Control wild-type cells phosphorylated adenosine so rapidly that the kinetics of transport per se could not be assessed unambiguously. ATP depletion and adenosine kinase deficiency did not abolish the conversion of adenosine to nucleotides, but reduced it to such an extent that initial velocities of uptake could be safely construed as transport velocities in both zero-trans and equilibrium exchange modes. The same was true for tubercidin, which was not phosphorylated in adenosine kinase-deficient cells. It accumulated intracellularly, however, to concentrations 50 to 120% higher than those in the extracellular space, apparently due to binding to some intracellular component(s). Binding was not saturated up to a concentration of 200 microM, but seemed to be slow relative to transport. Fits of appropriate integrated rate equations based on the simple carrier model to uptake time courses obtained under these conditions yielded Michaelis-Menten constants for adenosine and tubercidin transport of 100 to 200 microM and maximum velocities of 10 to 30 pmol/microliters cell H2O . sec, whereas the rate of intracellular phosphorylation was maximal at concentrations between 2 and 8 microM. The first-order rate constant (Vmax/Km) for adenosine phosphorylation, however, seemed to be appreciably higher than that for its transport. This indicates that at physiological concentrations, which fall in the first-order range for both processes, adenosine trapping is very efficient. Adenosine, tubercidin, tricyclic nucleoside, 2'-deoxyadenosine, and 3' deoxyadenosine all inhibited uridine and thymidine transport to about the same extent, whereas pyrazofurin was significantly less effective. PMID- 6863405 TI - Effects of temperature on the replication of chromosomal DNA of Xenopus laevis cells. AB - DNA fibre autoradiography has been used to study the effects of temperature on the replication of chromosomal DNA of Xenopus laevis cells in tissue culture at 18, 23 and 28 degrees C. Pulse/stepdown labelling shows that the DNA replicates bidirectionally. Origin-to-origin distances (initiation intervals) vary, but the range of and the mean initiation intervals at all three temperatures are much the same. The mean interval between initiation points is of the order of 60 to 66 microns. Staggering of initiation is evident at all three temperatures. Evidence against the existence of replication termini is provided. The rates of progress of DNA replication forks are 6 microns/h at 18 degrees C, 10 microns/h at 23 degrees C and 16 microns/h at 28 degrees C. PMID- 6863406 TI - Similarity of sister-cell trajectories in fibroblast clones. PMID- 6863407 TI - Plasma membranes, cell junctions and cuticle of the rectal chloride epithelia of the larval dragonfly Aeshna cyanea. AB - The cell membranes and cell junctions of the rectal chloride epithelia of the larval dragonfly Aeshna cyanea were examined in thin sections and by freeze fracture. These epithelia function in active ion absorption and maintain a high concentration gradient between the haemolymph and the fresh-water environment. Freeze-fracturing reveals fine-structural differences in the intramembraneous particles of the luminal and contraluminal plasma membranes of these epithelia, reflecting the functional diversity of the two membranes, which are separated by the junctional complex. The particle frequency of the basolateral plasma membranes is reduced after transfer of the larvae into high concentrations of environmental salinity. The junctional complex is located in the apical region and composed of three types of cell junctions: the zonula adhaerens, seen in freeze-fracture as a nearly particle-free zone; the extended and highly convoluted pleated septate junction and randomly interspersed gap junctions of the inverted type. Gap junctions also occur between the basolateral plasma membranes. They provide short-cuts in the diffusion pathway for direct and rapid co-ordination of the interconnected cell processes. Colloidal and ionic lanthanum tracer solutions applied in vivo from the luminal side penetrate through the cuticle via epicuticular depressions, but invade only the apical portion of the junctional complex. This indicates that the pleated septate junction constitutes a structural control of the paracellular pathway across the chloride epithelia, which are devoid of tight junctions. The structure of the pleated septate junctions is interpreted as a device for the extension of the diffusion distance, which is inversely related to the net diffusion. A conservative estimate of the total length of the junction, and the number and extension of septa reveals that the paracellular route exceeds the transcellular route by a factor of 50. PMID- 6863408 TI - Glycoconjugates from high endothelial cells. I. Partial characterization of a sulphated glycoconjugate from the high endothelial cells of rat lymph nodes. PMID- 6863409 TI - Hyperimmune human ABO blood-typing sera: reactivity with murine laminin and cytotoxicity for metastatic murine tumour cells. AB - Commercially prepared ABO blood-typing antisera have been tested for their ability to bind to murine laminin and their cytotoxic effects upon high and low metastatic variants of a murine fibrosarcoma. Previous studies have shown that alpha-D-galactopyranosyl end-groups comprise the major antigenic determinants on type B erythrocytes and that these same end-groups are present on murine laminin purified from the EHS sarcoma and on a laminin-like glycoprotein on the surface of the high, but not low, metastatic fibrosarcoma cells. In the present study we found that all sera containing anti-B activity were cytotoxic to the high, but not the low, metastatic cells and that all of these sera reacted strongly against immobilized murine laminin in an enzyme-linked immunosorbent assay. Sera lacking anti-B activity, i.e. anti-A antisera, were much less cytotoxic to either cell line and three of the four anti-A sera did not bind to murine laminin. The laminin reactivity and cytotoxic effect of the anti-B sera were specifically abrogated by preincubation of the sera with water-soluble blood group B substance or with murine laminin but not with water-soluble blood group A substance. PMID- 6863410 TI - Events in the cytoplasm during male meiosis in Lilium. AB - An electron microscopic investigation of the events associated with meiosis in Lilium has revealed a number of changes in both the organellar population and the other cytoplasmic components. Ribosome numbers decrease significantly in early prophase and are later replenished in the tetrads, a process most likely involving the newly arising cytoplasmic nucleoloids. The organelles show a cycle of de- and redifferentiation and later in meiosis unusual internal structures can be seen before these organelles enter a division phase resulting in increased numbers. The localization of acid phosphatase during these changes has also been studied using electron microscopic cytochemical methods. In early prophase, considerable amounts of acid phosphatase are found in vesicles scattered through the cytoplasm; activity is also found in association with most membranous surfaces and often markedly associated with condensing mitochondria. Later in prophase the enzyme activity decreases to normal levels. Electron microscopic autoradiography revealed that DNA is synthesized in both plastids and mitochondria during meiotic prophase with activity reaching a peak during zygotene and ceasing by diakinesis and tetrad formation. These changes point to a certain independence of organelles from nuclear control during meiosis. The events are also evaluated in relation to a cytoplasmic clearing mechanism, which may occur in preparation for the changeover from sporophytic to gametophytic control and the development of gametes. PMID- 6863411 TI - Conditioning of a culture substratum by the ectodermal layer promotes attachment and oriented locomotion by amphibian gastrula mesodermal cells. AB - We have found that ectodermal fragments of Ambystoma maculatum gastrulae deposit immense numbers of 0.1 micron diameter extracellular fibrils on plastic coverslips. When migrating mesodermal cells from A. maculatum gastrulae are seeded on such conditioned plastic substrata, they attach and begin migrating after 15-30 min in vitro. We did a detailed analysis of the relationship between fibril orientation and cell migration using time-lapse cinemicrography, scanning electron microscopy, and a microcomputer with a graphics tablet and morphometric program. We found that cells move in directions closely related to the orientation of fibrils. Usually fibrils are oriented in dense arrays with a predominance of fibrils running parallel to the blastopore-animal pole axis of the explant, and cells move preferentially along lines parallel to the blastopore animal pole axis. When fibrils are unaligned, cells move at random. We have also shown that cells move with a slightly stronger tendency towards the animal pole direction. These results are discussed concerning the mechanism of specific cell migration during amphibian gastrulation. PMID- 6863412 TI - Characterization of proteins from the cytoskeleton of Giardia lamblia. AB - Proteins from the axonemes and disc cytoskeleton of Giardia lamblia have been examined by sodium dodecyl sulphate/polyacrylamide gel electrophoresis. In addition to tubulin and the 30 X 10(3) molecular weight disc protein, at least 18 minor components copurify with the two major proteins in Triton-insoluble structures. The most prominent minor bands have the apparent molecular weights of 110 X 10(3), 95 X 10(3) and 81 X 10(3). Protein of 30 X 10(3) molecular weight accounts for about 20% of organelle protein on gels. In continuous 25 mM-Tris glycine buffer it migrates mostly as a close-spaced doublet of polypeptides, which are here given the name giardins. Giardia tubulin and giardin have been purified by gel filtration chromatography in the presence of sodium dodecyl sulphate. Well-separated fractions were obtained that could be further characterized. Both proteins are heterogeneous when examined by isoelectric focusing. Five tubulin chains were detected by PAGE Blue 83 dye-binding after focusing in a broad-range ampholyte gel. Giardin is slightly less acidic than tubulin. On gels it splits into four major and four minor chains with isoelectric points in the pI range from 5.8 to 6.2. The amino acid composition of the giardin fraction has been determined, and compared to Giardia tubulin and a rat brain tubulin standard. Giardins are rich in helix-forming residues, particularly leucine. They have a low content of proline and glycine; therefore they may have extensive alpha-helical regions and be rod-shaped. As integral proteins of disc microribbons, giardins in vivo associate closely with tubulin. The properties of giardins indicate that in a number of respects - molecular size, charge, stoichiometry - their structural interaction with tubulin assemblies will be different from other tubulin-accessory protein copolymers studied in vitro. PMID- 6863414 TI - [Duodenal ulcer eroding the papilla. 2 cases]. AB - The authors report two cases of ulcers eroding the duodenal papilla. In one case there is a spontaneous reflux into the canal of Wirsung, causing acute pancreatitis. In the other case, the erosion is not complicated, and is revealed by an opacification of the main bile duct during an X-rays examination of the stomach and duodenum in a patient with a Burnett's syndrome. The erosion of the papilla is secondary to duodenal shrinkage by sclerosis. The choice treatment is exclusion gastrectomy, but resection may be necessary. PMID- 6863413 TI - [Postoperative cholecystitis. Apropos of 9 cases (3 lithiasic and 6 alithiasic)]. AB - Postoperative cholecystitis (three cases with and six cases without associated stones) was found following 25.00 operations performed over a period of 8 years. Analysis of these cases and a literature review suggest that the onset of a postoperative lithiasic cholecystitis is probably only the result of coincidence, where as alithiasic cholecystitis is a definite postoperative complication, these affections having to be considered within the more general framework of post aggression cholecystitis. PMID- 6863415 TI - [Primary hyperparathyroidism. Diagnostic and therapeutic concepts based on 180 cases]. AB - The diagnosis of primary hyperparathyroidism, one of the many problems related to this affection, depends on results of skeletal radiographs, serial serum calcium and phosphate measurements, and mainly radioimmunological assay of parathormone levels. Pre-operative investigations to determine precise location are no longer conducted. Techniques for exploration of the neck are described, and the importance of diagnosis from gross pathological findings when compared with frozen section examinations during operation emphasized. These features are discussed in relation to 180 cases, as well as problems raised when repeat operations are necessary. PMID- 6863416 TI - [Segment I of the liver or spigelian lobe. Anatomic study and surgical value]. AB - Spigel's lobe, or segment I of the liver, currently represents the "smallest amount of hepatic parenchyma capable of regeneration". It is an autonomous lobe by virtue of its site and vasculo-biliary distribution, a true "accessory" liver connected to the "main" liver. Lesions of Spigel's lobe are rare, which is explained by the anatomy of the portal bifurcation. Hence the value of making every effort to preserve this segment during hepatectomy because of the possibilities of additional hepatic vein drainage. Segment I surgery is difficult and falls within the context of extended hepatectomies. Can Spigel's lobe be considered to be a "safety liver"? The possibility of subtotal hepatectomy, retaining only segment I, is being studied in the animal. It may be possible in man in the case of extensive hepatic lesions where only segment I is unaffected, as soon as effective artificial liver support is developed. PMID- 6863417 TI - [Splenectomy and pneumococcal septicemia]. AB - A literature review, following the observation of 4 cases of pneumococcal septicemia in splenectomized patients, demonstrated that infection was frequent in subjects with functional or anatomical asplenia, usually in the form of a pneumococcal septicemia. Infection occurs one hundred times more frequently in splenectomized patients than in the general population. The risk of developing an infection varies from one patient to another, and is related to the motive for splenectomy, the period since operation, and the age of the patient at the time of surgery. Pneumococcal septicemia in such cases is distinguished by its insidious nature and its very poor prognosis, the outcome being fatal in 50 to 70 p. cent of cases. This justifies intensive prophylactic measures: partial splenectomy, heterotopic transplantation, anti-pneumococcal vaccination, and long term antibiotic therapy. None of these methods offers absolute protection, and indications for splenectomy should therefore be limited to the strict minimum. PMID- 6863418 TI - [Chronic segmental pancreatitis caused by a foreign body in Wirsung's duct]. PMID- 6863419 TI - [Evaluation of nutritional status in surgery]. PMID- 6863421 TI - VI. International Symposium on Column Liquid Chromatography. Cherry Hill, NJ (U.S.A.), June 6-11, 1982. PMID- 6863420 TI - [Posterior approach to the rectum. Technic, indications, complications. Apropos of 41 cases]. AB - Certain lesions in the middle part of the rectal ampulla can only be approached with safety through the posterior surface of the rectum after resection of the coccyx and the last part of the sacrum. This approach was employed in 41 patients, with conservation of the sphincter in all cases. Operation was performed 39 times for excision of a large villous tumor, in 1 case for a polycystic lesion, and in 1 case for a localized epithelioma. Extensive tumors in 3 cases required rectal resection with end-to-end anastomosis, employing a circular mechanical suturing apparatus in 1 patient. Two patients died of causes unrelated to the operation, and 5 developed a fistula, three of these cases needing proximal colostomies. Delayed healing of the perineal wound was noted in 5 other patients, residual perineal pain being reported by 2 patients. The posterior approach to the rectum is an exceptional technique, mainly indicated when wide excision of a histologically doubtful tumor cannot be approached from above or below. PMID- 6863422 TI - Determination of carbofuran and its metabolites. AB - High-performance liquid chromatographic (HPLC) methods for the determination of carbofuran and its metabolites are described. Results obtained for carrot samples by HPLC are compared with those obtained using gas chromatography and nitrogen specific detection for carbofuran and 3-hydroxy carbofuran and gas chromatography mass spectrometry with selected ion monitoring for the determination of the three 7-phenol metabolites. The effect upon observed residue levels of conjugate formation by the 3-hydroxy and/or the 7-phenoxy groups of the four metabolites is demonstrated, and appropriate acid hydrolysis techniques are described. Variations in the HPLC parameters for different commodities are presented. PMID- 6863423 TI - Bioanalysis of cimetidine by high-performance liquid chromatography. AB - Cimetidine, N"-cyano-N-methyl-N'-[2[[(5-methyl-1H-imidazol-4-yl) methyl] thio]ethyl]guanidine, is a specific histamine H2-receptor antagonist drug that is widely used in medicine to treat gastric ulcer disease and other pathological hypersecretory states. To study the bioavailability of cimetidine, it was necessary to develop a rapid and reliable high-performance liquid chromatography procedure for quantitating the drug in body fluids. In this new procedure, cimetidine is adsorbed directly from urine or plasma, without prior clean-up, on to a mini-column prepacked with C18 material (Sep-Pak C18 cartridge). Acetonitrile is used to elute the drug, and the eluate is analyzed by high performance reversed-phase liquid chromatography on a Partisil 10 ODS column, with an aqueous phosphate-methanol mixture as the mobile phase and UV detection at 228 nm. This method for analyzing cimetidine in body fluids is rapid, accurate and precise and differs from previously reported methods in that it eliminates the need for performing bothersome single or multiple, dualphase solvent extractions. Moreover, slight modifications in the composition of the mobile phase permit the simultaneous determination of cimetidine metabolites. PMID- 6863424 TI - Simultaneous multiple electrode liquid chromatographic-electrochemical assay for catecholamines, indole-amines and metabolites in brain tissue. AB - To enhance the selectivity of liquid chromatographic-electrochemical assays for biogenic amines and metabolites in brain tissue, multiple electrode transducers were investigated. Two configurations of dual working electrodes were examined: parallel-adjacent and series arrangements. Using the raw detector currents with each configuration, peak-height ratios from simultaneously generated chromatograms were calculated to assess the selectivity of the instrument for direct injections of brain tissue supernatant. Ratios were consistent with injections of standards. Nearly coeluting peaks such as norepinephrine and 3 methoxy-4-hydroxyphenylglycol were resolved by using dual detector electrodes in series; only the catecholamines were detected at the downstream electrode owing to their electrochemical reversibility. The scheme was applicable to the assay of norepinephrine, 3,4-dihydroxyphenylacetic acid, dopamine, homovanillic acid, serotonin, 5-hydroxytryptophan and 5-hydroxyindole-3-acetic acid in brain tissue in less than 15 min. PMID- 6863425 TI - Structure-distribution relationships of radiopharmaceuticals. Correlation between the reversed-phase capacity factors for Tc-99m phenylcarbamoylmethyliminodiacetic acids and their renal elimination. AB - Capacity factors (k') have been obtained for twenty-eight different phenyl substituted phenylcarbamoylmethyliminodiacetic acids (HIDAs) using reversed-phase high-performance liquid chromatography (HPLC). They have been shown to be a useful measure of the lipophilicity of the ligands and their technetium-99m complexes. When k' for the ligands or log Poct for the Tc-99m complexes was plotted against theoretical lipophilicity, three groups of HIDAs were observed. The membership of each group is determined by the degree of ortho substitution. The effect of lipophilicity on protein binding allows the use of ligand capacity factors to predict the routes of elimination of various Tc-HIDAs. PMID- 6863426 TI - Chromatofocusing of sialoglycoproteins. AB - Sialoglycoproteins of different sialic acid contents have been separated from each other by chromatofocusing on the ion exchanger PBE 94 using gradients of pH 4.00 down to pH 1.00. The technique is much faster than isoelectric focusing, apparently does not result in desialylation of the sialoglycoproteins and can handle with ease 10 ng to 50 mg quantities of protein on a 22 X 0.9 cm column. The technique revealed that commercial preparations of fetuin and human acid glycoprotein contained several components. Glycophorin, desialylated by controlled neuraminidase treatment, was fractionated by chromatofocusing into several components which differed in sialic acid content and in ability to inhibit haemagglutination by wheat germ agglutinin and encephalomyocarditis and influenza viruses. PMID- 6863428 TI - Silicic acid column chromatography of phosponolipids. II. Separation of 1-O-alkyl 2-acetyl-sn-glyceryl-3-phosporyl choline, cardiolipin and other related phospholipids. PMID- 6863427 TI - Resolution by affinity chromatography: stereoselective binding of racemic oxazepam esters to human serum albumin. PMID- 6863429 TI - Identification and quantitation of Hb Olympia [beta 20(B2)Val leads to Met] and Hb San Diego [beta 109(G11)Val leads to Met] by high-performance liquid chromatography. PMID- 6863430 TI - Rapid extraction and determination of alpha- and beta-carotenes in foods. PMID- 6863431 TI - Rapid determination of spoilage fungi. AB - Mixed cultures of viable spores of fungi of the Aspergillaceae were determined rapidly by gas-liquid chromatography of the methanol released from pectin by the enzyme pectinesterase. Results obtained in 19 h were comparable with plate counts taking 48 h. Attempts to count spoilage years using this method were not successful. PMID- 6863433 TI - Effect of 2-alkanols on the separation of geometric isomers of retinol in non aqueous high-performance liquid chromatography. AB - The effects of 2-alkanols as mobile phase modifiers on the resolution of 11-cis-, 13-cis-, 9-cis- and all-trans-retinol in high-performance liquid chromatography were studied. Partisil-10-ODS and Zorbax CN columns were used in series. The retentions of 9-cis-and all-trans-retinol were significantly influenced by the presence of long-chain 2-alkanols in the mobile phase. Baseline separation of 9 cis-and all-trans-retinol was achieved when 1% 2-heptanol in hexane was used as the eluent. On the other hand, the separation of 11-cis-from 13-cis-retinol required 5% dioxane in hexane. The method is applicable to the separation of retinol isomers present in biological samples. Analysis of normal rat liver lipids showed the presence of a small amount of 13-cis-retinol in addition to all trans-retinol. PMID- 6863434 TI - Purification of spin-labelled DNA by hydroxyapatite chromatography. PMID- 6863432 TI - Formation and separation by reversed-phase high-performance liquid chromatography of fluorescent and UV-absorbing bile salt derivatives. AB - A method is described for the production of bile salt derivatives via the substituent hydroxyl groups on the steroid nucleus that permits derivatization of taurine and glycine conjugates. The method involves the oxidation of the hydroxyl groups at C-3 alpha or C-7 alpha on the nucleus by the action of hydroxysteroid dehydrogenases. The keto bile salts produced are isolated and reacted with 2,4 dinitrophenylhydrazine or Dns-hydrazine to yield ultraviolet absorbing or fluorescent derivatives, respectively. The bile salt hydrazones were separated using a reversed-phase C18 radial compression cartridge with a methanol-phosphate buffer gradient elution. Although the 3-keto derivatives of chenodeoxycholic and deoxycholic acids were not resolved, the 7-keto Dns-hydrazone of chenodeoxycholic acid was separated from 3-keto derivative of deoxycholic acid. PMID- 6863435 TI - Separation of myosin light chains by high-speed gel filtration on TSK-GEL SW columns. PMID- 6863436 TI - Rapid purification of a ribonuclease from bovine seminal plasma by DNA-affinity chromatography. PMID- 6863437 TI - Microsomal hydroxylation of 3-methylcholanthrene: analysis by computerized gas chromatography-mass spectrometry. AB - Microsomal metabolism of 3-methylcholanthrene (MC) was examined by computerized gas chromatography-mass spectrometry. Five mono-, four di- and thirteen trihydroxylated metabolites were found after incubation of MC in mouse liver microsomal fraction for 15 min, in the presence of NADPH. Among these metabolites, three mono- and three dihydroxylated metabolites were identified by means of authentic samples. The chemical structures of the other metabolites were deduced from their characteristic mass spectral fragmentations. This is the first description of trihydroxylated metabolites in MC metabolism in vitro and in vivo. PMID- 6863438 TI - Simple and rapid purification of acidic lipids from rat brains. PMID- 6863439 TI - Fractionation of Echis carinatus venom by affinity chromatography on immobilized lectins. PMID- 6863440 TI - Gas-liquid chromatography reference method for the assay of urinary creatinine. AB - The gas-liquid chromatographic measurement of urinary creatinine described in this paper employs methylation, the use of a diethylene glycol succinate stationary phase, an internal L-hydroxyproline standard and a temperature of 180 degrees C. The technique, which is specific and reproducible, is shown to be a reference method providing more precise and reliable results than a conventional colorimetric method. In addition, it can be used as a routine method because of its simplicity. PMID- 6863441 TI - High-performance liquid chromatographic determination of alpha-keto acids in plasma with fluorometric detection. AB - This paper describes a sensitive high-performance liquid chromatographic method for the quantitative determination of alpha-keto acids in plasma using a fluorescence detector. This method is about ten times more sensitive than that reported in a previous paper. Only 50 microliters of plasma are needed for the determination of alpha-keto acids. However, p-hydroxyphenylpyruvic acid could not be analysed because the quinoxalinol derived from it does not exhibit fluorescence. PMID- 6863442 TI - Direct determination of 4-hydroxy-3-methoxyphenylacetic (homovanillic) acid in urine by high-performance liquid chromatography with amperometric detection. AB - The improvement of high-performance liquid chromatographic analysis with electrochemical detection for urinary homovanillic acid is described. The method permits the chromatographic resolution of authentic homovanillic acid from coeluting interfering compounds in human and nonhuman primate, and rat urine. The electrochemically derived results are compared with post-column derivatized fluorescence results, and quality-control checks necessary to maintain assay precision in automated analysis are described. PMID- 6863443 TI - Analysis of polyamines and acetyl derivatives by a single automated amino acid analyzer technique. AB - In a single, rapid and precise analysis, monoacetylputrescine, N8 acetylspermidine, N1-acetylspermidine, putrescine, spermidine, and spermine can be separated using a five-buffer system on an automatic amino acid analyzer. This method allows, for the first time, the separation of all the known acetyl derivatives of putrescine and spermidine as well as the parent compounds in urine and tissues with a single automated procedure. The method has been applied to the analysis of biological samples from normal volunteers, cancer patients and a rat liver supernatant. Mass spectral confirmation was obtained for each compound. PMID- 6863444 TI - Determination of histamine, methylhistamines and histamine-o-phthaldialdehyde complexes by two high-performance liquid chromatographic procedures. Application to biological samples. AB - Two high-performance liquid chromatographic procedures were proposed to measure histamine. The first, with UV detection and a strong acid cation exchanger (Partisil 10, SCX Whatman), made it possible to isolate histamine and some methylated derivatives. The second, with a C18 sorbent (mu Bondapak, Waters, 10 microns particle size) eluted with ion-pairing phases, made it possible to isolate the histamine-o-phthaldialdehyde complexes. This last procedure allied with a chromatographic purification step gave lower or identical amounts of histamine than those described in human urine (16 +/- 7 micrograms per 24 h), canine whole blood (1.5 +/- 1 ng/ml) and human gastric juice (2.3 +/- 1.4 ng/ml). The two procedures gave the concentration of a histamine-like compound isolated from the antral mucosa. PMID- 6863445 TI - [Possibilities of study of the human plasma cholinesterase variants by affinity electrophoresis]. AB - Affinity electrophoresis has been applied to the study of the multiple molecular forms of three human plasma cholinesterase phenotypes (usual enzyme U, atypical enzyme A and intermediate UA). Electrophoreses were carried out in polyacrylamide gels containing a water-soluble macromolecular derivative of m-amino (substituted)-phenyltrimethylammonium immobilized within the gel network. Apparent dissociation constants (KD app) were estimated from the mobilities of the enzymes versus ligand concentration. The ratio of KD app values of the molecular forms of phenotypes A and U which is approximately 2 is consistent with the hypothesis that the anionic site is altered in atypical enzyme. PMID- 6863446 TI - High-performance liquid chromatographic method for the quantitative analysis of a synthetic copolymer with antitumor activity (copovithane) and methylamine in human blood plasma and urine. AB - A method for the determination of a synthetic polymeric compound with antitumor activity (copovithane) and methylamine in blood plasma and urine is described. Copovithane is prepared by radical polymerisation of a diurethane with N vinylpyrrolidone. The method is based on high-performance liquid chromatography of the methylamine hydrochloride which arises during the hydrochloric acid hydrolysis of the parent substance. The methylamine hydrochloride is converted to the trinitrobenzenesulphonyl derivative for the purpose of chromatographic detection. The limit of determination for copovithane in blood plasma is 1.2 mg/l and in urine 1.5 mg/day. The determination limit for methylamine in blood plasma is 0.2 mg/l and in urine 0.3 mg/day. The imprecision is dependent on the sample, and amounts to +/- 6.8% for blood plasma and +/- 6.4% for urine. PMID- 6863448 TI - Comparison of two high-performance liquid chromatographic methods for the determination of oxmetidine and its metabolites in plasma, bile and urine samples. AB - Two high-performance liquid chromatographic methods for the assay of oxmetidine are described: both utilize the same liquid extraction from plasma, urine and bile samples. A normal-phase technique is considered most suitable for the analysis of plasma extracts and a reversed-phase method is preferred for the assay of excretory fluids such as urine and bile which will contain polar metabolites in detectable quantity as well as unchanged oxmetidine The methods are sensitive enough to follow the kinetic changes in concentration for up to 8 h after the administration of recommended therapeutic doses. Both methods can be automated in respect of the high-performance liquid chromatograph and the samples can be stored for several weeks at -20 degrees C without prejudicing the accuracy of the analysis. PMID- 6863447 TI - High-performance liquid chromatographic analysis of the new hypoxic cell radiosensitiser, Ro 03-8799, in biological samples. AB - A high-performance liquid chromatographic method of analysis with UV detection has been developed to measure levels of a new radiosensitiser, Ro 03-8799 and its N-oxide metabolite, in biological fluids and tissues. The accuracy and precision of the method have been determined in both plasma and urine, where the limits of quantitation are 100 and 500 ng/ml, respectively. Typical results are presented from a human volunteer study where samples were analysed by this method. Important aspects of the method, involving both sample handling techniques and chromatographic conditions are discussed. PMID- 6863449 TI - Determination of cibenzoline in plasma and urine by high-performance liquid chromatography. AB - A rapid, sensitive and selective high-performance liquid chromatographic (HPLC) assay was developed for the determination of cibenzoline (CipralanTM) in human plasma and urine. The assay involves the extraction of the compound into benzene from plasma or urine buffered to pH 11 and HPLC analysis of the residue dissolved in acetonitrile-phosphate buffer (0.015 mol/l, pH 6.0) (80:20). A 10-microns ion exchange (sulfonate) column was used with acetonitrile-phosphate buffer (0.015 mol/l, pH 6.0) (80:20) as the mobile phase. UV detection at 214 nm was used for quantitation with the di-p-methyl analogue of cibenzoline as the internal standard. The recovery of cibenzoline in the assay ranged from 60 to 70% and was validated in human plasma and urine in the concentration range of 10-1000 ng/ml and 50-5000 ng/ml, respectively. A normal-phase HPLC assay was developed for the determination of the imidazole metabolite of cibenzoline. The assays were applied to the determination of plasma and urine concentrations of cibenzoline and trace amounts of its imidazole metabolite following oral administration of cibenzoline succinate to two human subjects. PMID- 6863450 TI - Simultaneous determination of amiodarone and its major metabolite desethylamiodarone in plasma, urine and tissues by high-performance liquid chromatography. AB - A simple and sensitive high-performance liquid chromatographic method for the simultaneous assay of amiodarone and desethylamiodarone in plasma, urine and tissues has been developed. The method for plasma samples and tissue samples after homogenizing with 50% ethanol, involves deproteinization with acetonitrile containing the internal standard followed by centrifugation and direct injection of the supernatant into the liquid chromatograph. The method for urine specimens includes extraction with a diisopropyl ether-acetonitrile (95:5, v/v) mixture at pH 7.0 using disposable Clin-Elut 1003 columns, followed by evaporation of the eluate, reconstitution of the residue in methanol-acetonitrile (1:2, v/v) mixture and injection into the chromatograph. Separation was obtained using a Radial-Pak C18 column operating in combination with a radial compression separation unit and a methanol-25% ammonia (99.3:0.7, v/v) mobile phase. A wavelength of 242 nm was used to monitor amiodarone, desethylamiodarone and the internal standard. The influence of the ammonia concentration in the mobile phase on the capacity factors of amiodarone, desethylamiodarone and two other potential metabolites, monoiodoamiodarone (L6355) and desiodoamiodarone (L3937) were investigated. Endogenous substances or a variety of drugs concomitantly used in amiodarone therapy did not interfere with the assay. The limit of sensitivity of the assay was 0.025 micrograms/ml with a precision of +/- 17%. The inter- and intra-day coefficient of variation for replicate analyses of spiked plasma samples was less than 6%. This method has been demonstrated to be suitable for pharmacokinetic and metabolism studies of amiodarone in man. PMID- 6863451 TI - A new internal standard suitable for the gas chromatographic determination of 3 methoxy-4-hydroxyphenylethyleneglycol. PMID- 6863452 TI - Determination of glycerol in biological samples. PMID- 6863453 TI - High-performance liquid chromatography of the provitamin A beta-carotene in plasma. PMID- 6863454 TI - Improved high-performance liquid chromatographic method for isolation of platelet activating factor from other phospholipids. PMID- 6863455 TI - Estimation of polyethyleneglycols in human urine for studies of intestinal absorption. PMID- 6863456 TI - Rapid micromethod for the determination of Evan's blue in human plasma by high performance liquid chromatography. PMID- 6863457 TI - Sensitive and quantitative determination of plasma doxepin and desmethyldoxepin in chronic pain patients by gas chromatography and mass spectrometry. PMID- 6863458 TI - New rapid assay of cimetidine in human plasma by reversed-phase high-performance liquid chromatography. PMID- 6863459 TI - Determination of metoclopramide in human plasma by high-performance liquid chromatography. PMID- 6863461 TI - Analysis of bopindolol and its active metabolite 18-502 in human plasma by high performance liquid chromatography. PMID- 6863460 TI - High-performance liquid chromatographic method for determination of sulfapyridine in human saliva using post-column, in-line derivatization with fluorescamine. PMID- 6863462 TI - Measurement of ornidazole by high-performance liquid chromatography. PMID- 6863463 TI - Capillary and packed column GC determination of propoxyphene and norpropoxyphene in biological specimens: analytical problems and improvements. AB - Several problems associated with the gas chromatographic determination of DPX and NDPX are discussed and an improved method for their extraction and quantification is described. The method involves two separate extractions, one for DPX with SKF 525A as the internal standard and one for NPDX with dinor-LAAM as the internal standard. The use of two internal standards improved quantitative reproducibility by almost 50%. It was also found that routine DPX and NDPX assays were better determined on packed columns than on capillary columns because the quality of the samples and of the columns was critical. The use of two IS and the double extraction procedure is recommended for general toxicological analyses. PMID- 6863464 TI - A GC method for the determination of sulphur dioxide in food headspaces. AB - A gas chromatographic procedure was developed to measure SO2 in the presence of water vapour up to saturation level in the headspace atmospheres of packaged food. A Teflon column packed with Chromosorb 108 was used to separate CO2, SO2, and H2O in that order, then SO2 was determined using an electrolytic conductivity detector operated in a non-catalytic mode. A permeation-tube apparatus, producing SO2 and modified to permit humidification of the effluent stream, was used to calibrate the instrument, and a heated syringe technique was devised which overcame problems of sampling low levels of SO2 in the presence of water vapour. In food headspaces the method was used to determine SO2 at the ng ml-1 level with relative deviations of less than 5%. PMID- 6863465 TI - Demonstration of stepwise coiling of nucleoprotein in adenovirus core by application of critical point drying. AB - Mild destruction of a virus particle to observe the organized structure of the nucleoprotein complex in a virion was achieved by application of the critical point drying method. Adenovirus type 12 (ad12) virions have been treated by this method after the particles had been fixed with glutaraldehyde on an electron microscope grid. With 15 min prefixation, the capsids (shells) and the cores were in various stages of unfolding. The core was unfolded in the filamentous structure. The thickness of these filaments was 6.7, 13.3, +23 nm, or more. Some pictures showed that the thicker filaments consisted of super-coiling of two thinner filaments, for example two 6.7-nm filaments coiled up to give the 13.3-nm filaments. This suggests that the nucleoprotein complex of a circular double stranded DNA and inner proteins of ad12 virus was folded in a stepwise fashion to produce the compacted form of the core. PMID- 6863466 TI - Comparison of intradermal and intramuscular injection for raising plant virus antisera for use in ELISA. PMID- 6863467 TI - The application of spot hybridization to the detection of DNA and RNA viruses in plant tissues. AB - A solid-phase nucleic acid hybridization technique for the detection of DNA and RNA viruses in plant tissues is described. The method involves spotting crude samples onto nitrocellulose and using 12P-labelled DNA hybridization probes. The limit of sensitivity is 5-20 pg virus/spot or approximately 5 micrograms/g leaf tissue. The method is quantitative for DNA viruses in crude homogenates, but not for RNA viruses. The amount of cauliflower mosaic virus in infected leaves and protoplasts was estimated. The amplitude of spot hybridization to screening plant material from glasshouses and field is discussed. PMID- 6863468 TI - Cigarette smoking: carboxyhemoglobin, plasma nicotine, cotinine and thiocyanate vs self-reported smoking data and cardiovascular disease. AB - Measurement of the absorption of cigarette smoke constituents were compared with self-reported daily consumption from 450 smokers to determine the most reliable dose dependent indicator of smoke inhalation and risk for coronary heart disease. A plateau of plasma nicotine and cotinine concentration at levels above 20 cigarettes per day with a continued increase of carboxyhemoglobin and thiocyanate with increasing consumption of cigarettes occurred. Classification of smokers into groups smoking cigarettes yielding more or less than 1 mg nicotine showed that smokers of low yield brands had lower plasma levels of nicotine and cotinine, but comparable levels of carboxyhemoglobin and thiocyanate. Plasma nicotine bore no relationship to smoke inhalation, while the number of cigarettes consumed per day showed a weak correlation to smoke inhalation. Despite the lower nicotine yield of cigarettes, modification in smoking behaviour enabled the smoker to derive as much carbon monoxide and thiocyanate constituents from low and high yield cigarettes; thus counteracting the advantage of low nicotine yield brands. The relationship of these parameters to the risk of coronary heart disease is discussed. PMID- 6863469 TI - Participant recruitment to the Coronary Primary Prevention Trial. AB - This report describes participant recruitment to the Coronary Primary Prevention Trial, a long-term multicenter clinical trial sponsored by the National Heart, Lung and Blood Institute to test the effect of lowering plasma cholesterol on the incidence of coronary heart disease. The study protocol limited participation to men 35--59 yr of age with fasting plasma cholesterol of at least 265 mg/dl and in good general health. Recruitment began in July 1973, with a goal of 3550 entries within 18 months using referrals from the medical community as the primary source. The yield from this strategy proved inadequate, necessitating adoption of new recruitment sources which generally involved mass screening. These strategies led to the accrual of 3810 participants, although the pre-entry phase was extended by 19 months, i.e. through July 1976. Overall Trial recruitment experience is presented as well as results obtained from each major recruitment source and center and recommendations for conducting recruitment in future clinical trials. PMID- 6863470 TI - Pre-entry characteristics of participants in the Lipid Research Clinics' Coronary Primary Prevention Trial. AB - The Coronary Primary Prevention Trial (CPPT), a double-blind, randomized clinical trial being conducted by 12 Lipid Research Clinics in North America, was initiated in 1973 to test whether long-term reduction of plasma total cholesterol in individuals with Type II hyperlipoproteinemia would reduce the incidence of coronary heart disease. The trial is scheduled to conclude in 1983. Here we document that a major requirement of the CPPT--the comparability of the control and experimental groups prior to cholesterol-lowering treatment--has been achieved. The 3810 men participating in the CPPT were allocated to either treatment group at each clinic on the basis of low density lipoprotein cholesterol, S-T segment response to graded exercise testing, and the logistic risk function of age, smoking and diastolic blood pressure. Randomization was performed separately within each of the 96 cells thereby defined. An extensive battery of tests and questionnaires also yielded other laboratory measurements, data on health habits and family history, and sociodemographic information. Mean plasma total cholesterol levels were 291.8 mg/dl for the placebo group, and 291.5 mg/dl for the cholestyramine group. The other lipid and lipoprotein cholesterol levels were very similar in the two treatment groups. Among the 83 variables examined, only five differed significantly (P less than 0.05)--height, weight, albumin, 2-hr-post-challenge glucose, and serum aspartate amino-transferase (AST, SGOT)--and these differences were deemed to be so small as to have little or no clinical importance. Inasmuch as chance alone could produce four statistically different variables, we concluded that it seemed highly likely that the observed differences were attributable to random fluctuation. Thus, we have determined that the randomization process has resulted in two very nearly identical groups. PMID- 6863471 TI - Adipose tissue fatty acid composition of adolescents in a U.S.--Greece cross cultural study of coronary heart disease risk factors. AB - Adipose tissue fatty acid composition was studied in 139 boys, a subgroup of 1521 subjects aged 8-16 participating in the United States (New York City)--Greece cross-cultural study of coronary heart disease risk factor development. Adipose tissue was obtained by an aspiration technique, followed by transmethylation of fatty acids and gas-liquid chromatographic analysis. Statistically significant differences were found among different cohorts in their adipose tissue content of saturated, monounsaturated and polyunsaturated fatty acids. All United States cohorts had significantly higher (p less than 0.0001) levels of saturated and polyunsaturated fatty acids and significantly lower (p less than 0.0001) monounsaturated fatty acids compared to the Greece cohorts. These relationships held for all three types of fatty acids whether the non-Greek cohort from New York City or the cohorts of adolescents of Greek descent who reside in New York City alone, were compared to the cohorts residing in Greece. The differences in the adipose tissue fatty acids between the cohorts may be an important expression of the biochemical milieu which contributes to the development of relatively low coronary heart disease rates in Greece compared to those in the United States. PMID- 6863472 TI - How to select medical students who will become old-fashioned docs. PMID- 6863474 TI - Epithelial peroxidase and endometrial granulocytes in the normal cyclic human endometrium. AB - Studies in animal models have clearly shown a relationship between the administration of estrogens and the appearance of peroxidase activity in growth responsive estrogen target tissues (endometrium, cervix, vagina, breast, and DMBA rat mammary tumor). We have studied the ultrastructural localization of endogenous peroxidase activity in the normal cyclic human endometrium. Endogenous peroxidase activity was not identified in proliferative phase endometria, with the exception of one very late proliferative phase endometrium. Most secretory phase endometria showed at least some ultrastructurally identified peroxidase activity in glandular epithelial cells. The number of epithelial cells showing peroxidase activity varied from less than 10% to 85%. The peroxidase activity was present throughout the endoplasmic reticulum of these epithelial cells, extending from the perinuclear cistern to the most peripheral portions of the endoplasmic reticulum adjacent to the apical lumen. Biochemical assays of peroxidase activity in these endometria were compared with the ultrastructurally identified epithelial peroxidase and the endometrial granulocyte count. Uterine granulocyte peroxidase appeared to make a substantial contribution to the total peroxidase activity assayed by biochemical methods. Standard biochemical techniques alone, therefore were not considered to be adequate to evaluate epithelial peroxidase activity. PMID- 6863473 TI - Endemic goiter in Vietnam. AB - Endemic goiter involves about 15% of the population of Vietnam. To define the role of various factors which contribute to endemic goiter in Vietnam, we surveyed 935 people in Vancon, a lowland commune with goiter appearing only in the past decade, and 619 people in Dich Giao, a highland commune with endemic goiter treated erratically with iodized salt. In Dich Giao, cassava, a goitrogenic food, constitutes half of the dietary caloric intake. The prevalence of goiter was 45% in Vancon and 28% in Dich Giao. Laboratory studies were carried out in a subgroup of 63 subjects in Vancon, 52 subjects in Dich Giao, and a control group of 46 women in Hanoi. The mean serum TSH levels were 1.4 +/- 0.1 (+/- SE) microU/ml in Hanoi, 3.6 +/- 0.5 microU/ml in Vancon (P less than 0.001), and 2.4 +/- 0.2 microU/ml in Dich Giao (P less than 0.05). The mean serum T4 concentrations were similar in the three groups, but the mean free T4 concentration was low in Vancon. Serum T3 levels and the T3 to T4 ratios were significantly elevated in the goitrous regions. The mean serum thyroglobulin (Tg) concentrations were 27 +/- 3 ng/ml in Hanoi, 101 +/- 20 ng/ml in Vancon (P less than 0.01), and 44 +/- 5 ng/ml in Dich Giao (P less than 0.01). The 4-h thyroid uptake was higher in Vancon than in Hanoi. The urinary iodine concentration was low in both goitrous regions, and urinary thiocyanate was increased in Dich Giao, reflecting the ingestion of cassava. For all regions combined, there was a direct correlation between serum TSH and T3 and between serum TSH and Tg. In Vancon, where iodine deficiency was more severe, there was an inverse correlation between thyroid uptake and the urinary iodine concentration; thyroid uptake correlated directly with serum T3, the T3 to T4 ratio, and serum Tg. In Dich Giao, there was no correlation between urinary thiocyanate and thyroid uptake or urinary iodine levels. The data show that low iodine intake is a major factor in the causation of goiter in Vancon, where iodine deficiency had not been suspected. The ingestion of cassava in Dich Giao did not cause a major change in thyroid hormone economy even though iodine intake was marginally low; the data suggest that the goitrogenic effect of cassava is easily overcome by supplementary iodine, even when it is ingested irregularly. PMID- 6863475 TI - A unique growth factor in patients with acromegaloidism. AB - Acromegaloidism is a syndrome characterized by features of acromegaly without biochemical evidence of excessive GH or somatomedin production. We searched for a growth factor in the serum of patients with this syndrome. Growth-promoting activity was measured by determining the stimulatory effect of whole and fractionated serum on colony formation by human erythroid progenitors in vitro. Sera from five subjects with acromegaloidism gave a mean (+/- SEM) stimulated colony growth of 211 +/- 4.0 colonies, in contrast to normal sera which yielded a mean colony growth of 100 +/- 11.0 (n = 9; P less than 0.001). When serum was chromatographed on a Sephadex G-200 column, the maximal stimulation of colony growth was found in the fractions coinciding with the descending slope of the second protein peak. Based on gel filtration chromatography, the estimated molecular weight was 70,000 daltons. Epidermal growth factor, nerve growth factor, fibroblast growth factor, and platelet-derived growth factor resulted in no substantial stimulation of colony growth under the conditions used. Although the erythroid progenitor cells of a Laron dwarf were unresponsive to 200 ng/ml human GH, they were clearly stimulated by serum from a patient with acromegaloidism. The present study describes the presence of a heretofore unidentified growth factor in the serum of subjects with acromegaloidism. This factor also stimulated the erythroid precursor cells of a Laron dwarf whose cells were unresponsive to GH. The physiological role of this growth factor in normal man as well as its pathogenic role in subjects with acromegaloidism remain to be established. PMID- 6863476 TI - Metabolism of 2-methoxyestrone in normal men. AB - We studied, in four normal men, the metabolism of 2-methoxyestrone (2-MeOE1) using pulse injections of either [3H]2MeOE1 (two men) or [14C]methoxy-2-MeOE1 plus [3H]2-MeOE1 (two men) by analysis of blood samples drawn at increasing time intervals after the pulse and of urine collected for 5 days. The disappearance from the blood of radioactivity as 2-MeOE1 could be characterized as a function that was the sum of three exponentials. The mean +/- SE value for the initial volume of distribution was 32 +/- 9 liters, and the mean MCR was 2470 +/- 770 liters/day. The disappearance of total 3H radioactivity from the blood was considerably slower, with a mean MCR of 290 +/- 30 liters/day, indicating the presence of a slowly turning over pool of 2-MeOE1 metabolites, probably including the 2-MeOE1 3-sulfate conjugate. The disappearance of total 14C radioactivity was slower than that of total 3H, indicating considerable demethylation of 2-MeOE1 with a very slow excretion of 14C from the released methyl group. In none of the subjects could we find in the blood radioactivity as unconjugated [3H]2 hydroxyestrone ( [3H]2-OHE1). However, examination of the urine indicated that considerable demethylation of [3H]2-MeOE1 had occurred. At least 64% of the urinary 3H-containing metabolites from the mixed dose had lost the 14C-bearing methoxylcarbon atom. The fractionated metabolites were qualitatively and quantitatively similar to those found earlier for [3H]2-OHE1. We conclude that 2 MeOE1, which of itself has little biological activity, can act as a pool of potentially active 2-OHE1 in the tissues. PMID- 6863478 TI - Testosterone and androstenedione concentrations in human testis and epididymis during the first two years of life. AB - Testosterone and androstenedione were measured in testicular and epididymal tissue of 37 previously healthy infants between 1 and 24 months of age who died suddenly. In half of the patients elevated plasma levels of cortisol and androstenedione suggested preterminal stress. Plasma testosterone levels, however, did not differ from those in healthy infants. Testicular testosterone concentrations were maximal in boys from 1-3 months of age (median, 36.6 ng/g; range, 7-380 ng/g) with peak values similar to those found in pubertal or even adult testes. Thereafter testicular testosterone concentrations decreased and after the age of 6 months all values were below 12.5 ng/g, which corresponds to the low normal range of older prepubertal boys. Plasma testosterone and testicular testosterone correlated significantly (P less than 0.001). On average the testicular concentrations were 36.4 times higher than the corresponding plasma concentrations. Testicular androstenedione was low but correlated significantly with testicular testosterone (P less than 0.001). Epididymal testosterone concentrations were surprisingly high (1-3 months: median, 10.3 ng/g; range, 4-42.7 ng/g) and averaged 30% of the testicular testosterone concentration. Thus, epididymal testosterone concentrations were significantly higher than the circulating plasma testosterone levels, indicating the capacity of the infant epididymis to accumulate androgens. These findings suggest that high local testosterone concentrations during early infancy are important not only for the testis itself but particularly for the developing epididymis. PMID- 6863477 TI - Aromatization of norethindrone to ethinyl estradiol by human placental microsomes. AB - The interaction of 19-norethindrone [4-estren-17 alpha-ethinyl-17 beta-ol,3-one (NET)] with human placental microsomes was investigated using enzymatic and spectral techniques. The incubation of [6,7-3H]norethindrone with human placental microsomes, NADPH, and molecular oxygen resulted in the production of ethinyl estradiol [1,3,5-(10)estratrien-17 alpha-ethinyl-3,17 beta-diol (EE)]. The reaction was linear with respect to time and protein concentration. Androstenedione inhibited the enzymatic aromatization of NET to EE. The product was identified by thin layer chromatography, recrystallization to constant specific activity, and derivative formation. No acid or base was used in any step of product identification. To ensure that spontaneous aromatization of metabolites of NET did not contribute to our results, representative samples were treated with sodium borohydride before processing. Sodium borohydride reduces the 4-en-3-one grouping of the A-ring, thereby preventing chemical aromatization. Sodium borohydride treatment did not reduce our observed yields of EE from NET. The addition of NET to a preparation of solubilized, partially purified placental microsomal cytochrome P-450 yielded a type I cytochrome P-450 binding spectrum. The apparent spectral dissociation constant for NET binding to cytochrome P-450 was 28 microM. These results suggest that NET is enzymatically aromatized to EE by human placental microsomes. PMID- 6863479 TI - Prolactin stimulation by meals is related to protein content. AB - To study the effect of meals on PRL secretion, serum PRL was measured after the ingestion of mixed meals and specific single macronutrients by normal men and women. In men, only protein feeding significantly stimulated PRL secretion. In women, protein meals as well as a standard mixed meal and a liquid mixed meal resulted in PRL release. Fat, glucose, and a nonnutrient meal had no consistent effect on serum PRL. Serum TSH was not altered by any of the meals, and serum GH and cortisol showed few changes. We conclude that PRL stimulation by meals may be of occasional clinical significance, principally in confusing the diagnosis of hyperprolactinemic states, especially in women. Dietary protein is probably the agent responsible for PRL secretion induced by meals. PMID- 6863480 TI - Amniotic fluid concentrations of iodothyronines and thyrotropin do not reliably predict fetal thyroid status in pregnancies complicated by maternal thyroid disorders or anencephaly. AB - In this study we report measurements of amniotic fluid (AF) concentrations of iodothyronines and TSH in 69 normal and 16 complicated pregnancies. The latter group included 2 women with untreated hyperthyroidism, 1 patient with untreated hypothyroidism, 5 hyperthyroid patients who received propylthiouracil (3 with Graves' disease, 1 with a multinodular goiter, and 1 with chronic thyroiditis), 3 women with Graves' disease who were hypothyroid after treatment, but who were receiving replacement therapy, and 5 anencephalic pregnancies. AF hormone levels could not be correlated with either maternal or cord serum values, neonatal serum measurements, and/or the clinical status of the infant. AF TSH and T4 levels were markedly elevated in 1 patient with Graves' disease and severe Rh isoimmunization and in 2 pregnancies complicated by anencephaly without identifiable pituitary tissue in the fetus. We conclude that measurements of AF concentrations of thyroid hormones and TSH do not reliably predict fetal or neonatal thyroid status. PMID- 6863481 TI - Hypoparathyroidism after I-131 therapy with subsequent return of parathyroid function. AB - A 22-year-old woman developed hypoparathyroidism in 1970, 10 months after treatment of hyperthyroidism with I-131. The hypocalcemia was corrected with Vitamin D2 and oral calcium and she remained normocalcemic for 8 yr. In 1979 hypercalcemia was found and Vitamin D2/calcium was discontinued. Because she remained normocalcemic without therapy for 3 yr, we measured the levels of immunoreactive and bioactive PTH in plasma stored since 1970 and in plasma obtained in 1982 to determine whether there had been restoration of parathyroid function. Indeed, PTH levels in 1970 while the patient was hypocalcemic were low. The bioactive PTH was 0.26 pg/ml (normal 1.5-30), whereas--COOH terminal immunoreactive PTH was 620 pg/ml (normal 600-1500) and midmolecule immunoreactive PTH was 433 pg/ml (normal 300-900). In 1982 while normocalcemic the bioactive PTH and immunoreactive PTH were normal (5.18 pg/ml;--COOH, 970 pg/ml; midmolecule, 789 pg/ml, respectively). Thus, an unusual case of hypoparathyroidism after I-131 therapy with return of parathyroid function is documented by measurements of both immunoreactive and bioactive PTH. PMID- 6863482 TI - Response to a single dose of human chorionic gonadotropin in prepubertal boys. AB - In normal men a single dose of hCG induces an increase in plasma testosterone (T) and 17 alpha-hydroxyprogesterone (17 alpha-OHP) 2-4 h after the injection; after 24-36 h a maximum increase in plasma 17 beta-estradiol (E2) and 17 alpha-OHP occurs followed by a second surge in T after 48-96 h. The present investigation focuses on the effect of a single dose of hCG (3500 IU/m2 body surface) on testicular steroid production in 12 boys aged 13 months to 12 yr. Plasma hCG, 17 alpha-OHP, androstenedione (A), T, dihydrotestosterone, and E2 were measured basally and 2, 4, 24, 48, 72, and 96 h after hCG administration. Plasma hCG was measured using a double antibody RIA technique and steroids by RIA after celite chromatography. The results show that hCG peaked 2 h after administration of the hormone and high levels persisted for up until 72 h. Plasma T and dihydrotestosterone increased after 48 h and remained significantly high for another 48 h; 17 alpha-OHP, A, and E2 did not change. These findings show that hCG stimulation in prepubertal boys induces significant production of T without affecting the precursors or aromatization product, in contrast to observation in the adult man, where 17 alpha-OHP, A, and E2 increase significantly. A response comparable to that observed in children has been recorded in adult males with hypogonadotropic hypogonadism. PMID- 6863483 TI - The extrathyroidal conversion of 3,5,3'-triiodothyronine to 3,5-diiodothyronine in patients with liver cirrhosis. AB - Simultaneous kinetic studies of 3,5-diiodothyronine (3,5-T2) and T3 were performed in 8 patients with biopsy proven cirrhosis and in 15 healthy subjects using the single injection, noncompartmental approach. The following T3 kinetic data were obtained in patients with cirrhosis and normal subjects (mean +/- SD): serum T3 (nmol/liter) 1.27 +/- 0.30 vs. 1.79 +/- 0.28 (P less than 0.001); MCR [liters X day-1 X (70 kg)-1] 22.9 +/- 5.3 vs. 26.7 +/- 4.4 (P less than 0.10); production rate [nmol X day-1 X (70 kg)-1] 29.0 +/- 9.6 vs. 47.7 +/- 9.0 (P less than 0.001). In patients with cirrhosis serum 3,5-T2 levels were reduced to 58 +/ 38% of those found in normal subjects (P less than 0.02). The MCR was unaffected, 125 +/- 85%, whereas the production rate was reduced to 57 +/- 26% (P less than 0.005). The conversion rate from T3 to 3,5-T2 was unaltered, 96 +/- 34% of that found in normals. It is concluded that reduced serum levels of 3,5-T2 in cirrhosis are due to a diminished amount of substrate, T3, and not to decreased 3'-deiodination of T3 or to an increase clearance of 3,5-T2. PMID- 6863484 TI - Androgens stimulate estradiol production in cultured human placental explants from term pregnancy. AB - Estradiol production was significantly stimulated in explants of normal human term placenta cultured in the presence of 0.01 mM methyltestosterone. Estradiol levels in the media rose significantly during the first 24 h incubation and increased more markedly over the next two successive 24 h incubations. Dexamethasone and d-norgestrel did not affect estradiol production. Neither progesterone nor hCG levels were altered by any of the three synthetic steroids. The non-aromatizable androgen, 5 alpha-dihydrotesterone (DHT), also significantly stimulated estradiol production in a dose-dependent fashion, with the maximum levels being measured in the media from the first 24 h incubation. In experiments where the explants were cultured for periods between 0.5 to 24 h, DHT elicited both a dose- and time-dependent increase in estradiol production: At all dosages of DHT, the maximum stimulation occurred at the end of 3 h incubation. Again progesterone and hCG productions were not affected. This appears to be the first report of androgens stimulating estradiol production in the human term placenta in vitro. PMID- 6863486 TI - [A study of the burpee push up test as a simple method of measuring endurance]. PMID- 6863487 TI - [The attempted suicidal cases of schizophrenia in the Critical Care Medical Center (CCM)]. PMID- 6863485 TI - Transient hyperprolactinemia: a correctable cause of idiopathic female infertility. AB - Frequent measurements of prolactin throughout the menstrual cycle were obtained in 48 women with regular menses and longstanding idiopathic infertility. Forty five of the 48 patients (94%) had a small but significant transitory preovulatory elevation in their serum prolactin levels (hPRL). These transitory elevations in hPRL to 27-70 ng/ml lasted only one to three days and coincided with the preovulatory estradiol peak. When this transient hyperprolactinemia was suppressed by treatment with an appropriate, titrated dose of bromergocriptine, 18 patients (40%) conceived within one to three months. Evidently, this transitory, relatively mild hyperprolactinemia was not sufficient to interfere with follicular maturation, ovulation, or corpus luteum function, but it may impair fertilization and/or implantation. PMID- 6863489 TI - [Studies of cerebral atrophy and regional cerebral blood flow in patients with Parkinson's disease]. PMID- 6863490 TI - [Chemical analysis of the rare components of gallstones. (1). Identification of L cystine by GC/MS or other methods]. PMID- 6863488 TI - [A histo-pathological study on the changes of the pulmonary arteries in thrombosis occurring in the main trunk of the pulmonary arterial trees and pulmonary infarction]. PMID- 6863491 TI - [A study of postoperative infections in neurosurgery]. PMID- 6863492 TI - [Characterization of protective activity in human sera against infection with Klebsiella ozaenae]. PMID- 6863494 TI - [Glucose intolerance in the aged and classification and diagnostis standard diabetes mellitus]. PMID- 6863493 TI - [Intractable diseases and experimental models]. PMID- 6863495 TI - Evaluation on multidisciplinary treatment in the carcinoma of urinary bladder. PMID- 6863496 TI - Dark-field microscopy for detection of malaria in unstained blood films. AB - Pigment present in different forms of Plasmodium species infecting humans exhibits light scattering when blood films are viewed by dark-field microscopy. This facilitates the detection of parasite-infected cells owing to their brightly illuminated appearance. The technique was described long ago for the detection of certain highly pigmented forms of malarial parasites such as schizonts and gametocytes but has not found an application in routine diagnosis. Here, modifications are described which allow the detection of all forms of human malarial parasites, including ring forms, in unstained blood films. The technique offers the distinct advantages of rapid diagnosis, increased sensitivity, and adaptability to field work. PMID- 6863497 TI - Enzyme-linked immunosorbent assay for rubella immunoglobulin G: new method for attachment of antigens to microtiter plates. AB - Many of the enzyme-linked immunosorbent assay (ELISA) techniques previously described for detection of rubella-specific antibodies employ complex technology not available in routine diagnostic laboratories. The method described allows the use of commercially available rubella hemagglutination inhibition (HI) antigen. Passive adsorption of these antigens to plastic is variable, but with the use of albumin as a bridge, it is possible to attach the antigen reliably to the plastic wells. Over 1,500 sera were tested by both HI and ELISA techniques to detect the presence of rubella antibodies. These sera were selected with a bias towards those with low levels of rubella-specific antibody, since it has been demonstrated that it is in this range that discrepancies are more likely to occur between HI and ELISA techniques. In 99% of the sera tested, the results of both techniques were in agreement. On the basis of these results, the technique offers a useful alternative to the routine rubella HI test and other ELISA techniques which need sophisticated antigen preparations. PMID- 6863498 TI - Factors affecting detection of Yersinia enterocolitica heat-stable enterotoxin by the infant mouse test. AB - With regard to the assay of heat-stable enterotoxin (ST) from Yersinia enterocolitica, we made a comparative study of the conventional infant mouse test read at 4 h and a modified infant mouse test read at 2 h. The influence of several factors, such as the medium used to prepare ST, lysing of bacterial cells from the broth cultures used to prepare ST, and the temperature at which the inoculated mice were kept during the test, was also investigated. Thus, with a few exceptions, Pai-Mors medium was more suitable than Casamino Acids-yeast extract medium, for the preparation of yersinial ST. Gut/carcass weight ratios obtained with lysed supernatants or with supernatants from whole cultures of Y. enterocolitica were similar, suggesting that most of the ST produced by this microorganism in broth cultures is extracellular. The amount of ST produced by Y. enterocolitica, as well as the ambient temperature at which inoculated mice were kept during the assay, was found to influence gut/carcass weight ratios obtained with both tests. Enterotoxigenicity and the temperature at which mice were kept were interrelated, such that for weakly enterotoxigenic strains there were no significant differences among gut/carcass weight ratios for the conventional and modified infant mouse tests carried out at 18 or 25 degrees C, but at 30 degrees C the values in the modified test were higher for most ST preparations with Pai Mors medium. The influence of ambient temperature was more pronounced at 37 degrees C, since most strains produced negative results in the conventional test at this temperature. We conclude that the conventional infant mouse test is adequate for assaying yersinial ST, provided that the temperature at which mice are kept during the assay is fixed at around 25 degrees C. PMID- 6863499 TI - Evaluation of slide agglutination methods for identifying group D streptococci. AB - Three commercial reagents for the rapid identification of group D streptococci by slide agglutination were evaluated. These included SeroSTAT (Scott Laboratories, Fiskeville, R.I.), Streptex (Wellcome Laboratories, Research Triangle Park, N.C.), and Phadebact (Pharmacia Diagnostics, Piscataway, N.J.). The methods included direct colony testing, enzyme extraction with pronase, and broth culture. A total of 72 strains of group D streptococci were tested. The SeroSTAT and Streptex reagents with pronase extraction each identified 65 (90%) of the strains. The SeroSTAT reagent was somewhat more specific since it did not cross react with other streptococci of the viridans group. The Phadebact reagent was nonreactive. We conclude that the latex reagents can be very useful for the quick recognition of group D streptococci in the clinical laboratory. PMID- 6863500 TI - Enzyme-linked immunosorbent assay for detection of measles antibody. AB - An enzyme-linked immunosorbent assay (ELISA) was developed for the detection of measles immunoglobulin G antibody (MEASELISA). This assay was found to be comparable to the measles hemagglutination inhibition (HAI) test. Approximately 500 sera from three centers were tested by MEASELISA and the HAI test. MEASELISA demonstrated values of greater than 99% for sensitivity, specificity, and accuracy. Values were very precise, with a mean coefficient of variation of 5.4%. MEASELISA values were shown by linear regression analysis to increase as HAI titers increased. A coefficient of determination of 1.00 was obtained from test center three. MEASELISA values were found to be linearly related (r2 greater than 0.97) to MEASELISA titers, thus enabling quantitation of measles antibody from a single value. Also, data are presented that show MEASELISA to be equivalent to complement fixation for evaluating paired sera for the presence of a significant increase in antibody levels to measles virus. PMID- 6863501 TI - Agar microdroplet assay for delayed hypersensitivity to Legionella pneumophila serogroup 1. AB - An agarose microdroplet technique was utilized to assess the cellular immunity of guinea pig lymphoid cells to Legionella pneumophila antigen in vitro. Both direct and indirect migration inhibition procedures were shown to be capable of detecting sensitization of guinea pigs to L. pneumophila antigens. Animals injected with adjuvant alone or unrelated antigens did not yield spleen cells responsive to L. pneumophila, indicating the specificity of the response. Migration inhibition factor induction by Legionella antigen in vitro correlated well with skin test responses in vivo. The positive reaction detected by migration inhibition occurred at times similar to that of skin reactivity but later than that of the earliest serum antibody titers. The assay appears to be useful for monitoring sensitization to Legionella and may be applicable to the study of cell-mediated immunity to this bacterium in infected individuals. PMID- 6863502 TI - Influence of age, sex, and diet on asymptomatic colonization of infants with Clostridium difficile. AB - A total of 40% of 107 stool samples from infants 1 to 52 weeks of age were found to contain Clostridium difficile antigens, detected by counterimmunoelectrophoresis. Within the group tested, there was no detectable variation by age or sex. Infants fed formula were nearly four times more likely to carry C. difficile than were those exclusively breast fed (62 versus 16%), whereas breast-fed infants also receiving formula or solids had an intermediate rate of colonization (35%). The distributions were similar when a subgroup with the highest levels of antigen was assessed separately. These data will be useful in considering potential pathogenic activities of C. difficile colonization in infancy. PMID- 6863503 TI - Enzyme-linked immunosorbent assay for immunoglobulin G and M antibodies to Chlamydia trachomatis in human sera. AB - Microimmunofluorescence methods used for detection of immunoglobulin G and M antibodies to Chlamydia trachomatis are not available to many clinical laboratories. We evaluated a simple enzyme-linked immunosorbent assay in which serotype L2 elementary bodies are used as antigen. The enzyme-linked immunosorbent assay proved satisfactory for the detection of serum IgG. A total of 160 human sera were tested, and the results correlated well with those obtained by microimmunofluorescence. Results for IgM antibody detection were not as successful, and correlation with current methods was poor. PMID- 6863504 TI - Selective enrichment broth medium for isolation of Campylobacter jejuni. AB - A new selective Campylobacter enrichment broth for the isolation of Campylobacter jejuni has been tested with fecal specimens of human, poultry, and bovine origin. We compared the isolation rate with that from the simultaneous direct plating of a duplicate specimen. Of the 380 duplicate specimens examined comparatively, we obtained a 46.3% increase in isolation of C. jejuni by using the new Campylobacter enrichment broth medium. PMID- 6863505 TI - Detection and quantitation of simulated anaerobic bacteremia by centrifugation and filtration. AB - Fresh human whole blood was inoculated with various anaerobic bacteria or with combinations of anaerobic, facultatively anaerobic, and aerobic microorganisms (3 to 28 microorganisms per ml). The seeded blood was then layered on a reduced Ficoll-Hypaque gradient (density, 1.093 g/ml) and centrifuged (400 X g) for 30 min at ambient temperature. The entire gradient (plasma, leukocytes, and Ficoll Hypaque) was removed and filtered anaerobically through a 0.45-micron membrane filter. The filters were then placed on reduced chocolate Mueller-Hinton agar plates and incubated at 35 degrees C in humidified atmosphere containing 85% N2, 10% H, and 5% CO2 or in air containing 5% CO2. No statistically significant differences were detected between the numbers of microorganisms recovered (alone or in combination) by filtration and by direct culturing of the original inoculum. All organisms were detected within 30 h after filtration. This technique has excellent sensitivity. PMID- 6863506 TI - Microtiter determination of measles hemagglutination inhibition antibody with filter papers. AB - Epidemiological studies of measles and measles immunization frequently require determination of measles antibody status. In developing countries, where venipuncture is frequently unacceptable and where refrigerated storage of serum specimens is often unavailable, microtiter techniques not requiring refrigeration are required. We developed a filter paper technique that measures measles hemagglutination inhibition antibody and meets these criteria. Comparison of separately collected venous blood and peripheral blood collected on filter paper demonstrated 97% agreement in terms of presence or absence of antibody. In 30 of 32 measles specimens, 94% of titers were the same or varied by less than 2 twofold dilutions. PMID- 6863507 TI - Microbiological and clinical evaluation of the isolator lysis-centrifugation blood culture tube. AB - In a controlled evaluation of 6,010 blood cultures, the yield of clinically significant microorganisms was greater from a lysis-centrifugation system (Isolator, Du Pont Co.) than from a nonvented vacuum bottle containing tryptic soy broth with sodium polyanetholesulfonate and CO2 and a vented bottle containing biphasic brain heart infusion medium with sodium polyanetholesulfonate. The Isolator significantly increased the frequency of isolation of Staphylococcus aureus and Candida spp. and significantly decreased the time required for the detection of S. aureus, Pseudomonas aeruginosa, and Candida spp.; however, anaerobic bacteria were recovered significantly more frequently from nonvented bottles with tryptic soy broth, and pneumococci were recovered significantly more frequently from both bottle systems. Contamination of cultures was significantly greater with the Isolator system than with either bottle system. Regardless of the number of blood cultures obtained per septic episode, the Isolator detected microbiologically proven bacteremia or fungemia in a significantly greater number of patients and significantly decreased the time required for detection. PMID- 6863508 TI - Concurrent comparability of automated systems and commercially prepared microdilution trays for susceptibility testing. AB - Susceptibility test results from 100 clinical isolates, using the AMS, MS-2, Autobac MTS, Micro-Media system, and Sensititre, were compared with results from the proposed National Committee for Clinical Laboratory Standards reference microdilution method for minimum inhibitory concentrations and with Bauer-Kirby results. Isolates were tested concurrently by each method on consecutive days to obtain duplicate results. The data were computer analyzed, using National Committee for Clinical Laboratory Standards guidelines for break point interpretation. Analysis was centered on drug-organism combinations and not on overall percent correlation. Data were analyzed for comparability to the reference methods and for reproducibility within each system. Commercial system results were very reproducible. Results from 4- to 8-h tests (AMS, MS-2, MTS) gave more very major discrepancies when compared with either reference method than did results from 15- to 18-h systems (Micro-Media, Sensititre). PMID- 6863512 TI - Group VE-1 septicemia. AB - A severely immunocompromised patient developed septicemia while under treatment for pancreatitis. An organism isolated from three separate blood cultures was identified as CDC group VE-1. The biochemical characteristics, taxonomy, and antibiotic sensitivity of this organism are presented. PMID- 6863509 TI - Detection of antibody to Staphylococcus aureus teichoic acid by enzyme-linked immunosorbent assay. AB - A sensitive, specific, and rapid enzyme-linked immunosorbent assay has been developed for the detection of immunoglobulin G to Staphylococcus aureus teichoic acid in human sera. Detection of S. aureus teichoic acid antibody is at least 800 times more sensitive than a double diffusion in gel assay, and positive titers of 1:25,600 and greater were observed with this assay. Results with the enzyme linked immunosorbent assay can be obtained within 3.5 h by using antigen-coated cuvettes. Quantitation of S. aureus teichoic acid antibody by this enzyme-linked immunosorbent assay may be useful in the initial as well as the follow-up diagnosis of serious S. aureus infections. PMID- 6863511 TI - Location of Campylobacter jejuni in infected chicken livers. AB - To determine whether chicken livers infected with Campylobacter jejuni are seeded in vivo or contaminated after slaughtering, 117 livers purchased in retail outlets in New York were examined for surface and tissue infections. Of 56 livers positive for C. jejuni, 36 yielded surface growth only, 18 both surface and tissue growth, and 2 tissue growth only. The scanty growth from tissue samples suggests a carry-over of organisms from the surface. It was concluded, therefore, that contamination is most likely due to unhygienic handling of offal. Infection rates of livers varied from retailer to retailer. PMID- 6863510 TI - Isolation of nontoxigenic Vibrio cholerae O1 from a human wound infection. AB - Vibrio cholerae serotype O1 organisms that do not produce cholera toxin and, in fact, lack the genetic material encoding the enterotoxin have recently been detected in coastal regions of the United States. Although these organisms have been assumed to be nonpathogenic, they have been considered a potential reservoir of toxigenic V. cholerae. In 1979, nontoxigenic V. cholerae O1 was isolated from a leg wound of an accident victim residing in New Orleans. The only known risk factors of the patient, besides his debilitated condition, were alcoholism and the consumption of raw oysters before recognition of his wound infection. Coincident with the identification of the isolate from the leg wound, an identical nontoxigenic V. cholerae O1 isolate was cultured from the sewage system serving the residence of this patient. Nontoxigenic V. cholerae O1 seems to be capable of multiplying in human tissue and may produce extraintestinal infection. This indigenous inhabitant of temperate coastal regions may not be avirulent and may be of public health significance. PMID- 6863515 TI - The annual Meeting on Muscle Contraction and Cell Motility in Japan, January 1983. PMID- 6863514 TI - Sepsis and empyema caused by Yersinia enterocolitica. AB - Yersinia enterocolitica is the cause of gastrointestinal infection in the overwhelming majority of recognized cases, although extraintestinal sites are occasionally involved. We report a case of Y. enterocolitica septicemia and empyema complicated by the adult respiratory distress syndrome. The organism was also recovered from the patient's feces by alkaline enrichment and persisted through at least 19 days of antibiotic treatment. PMID- 6863516 TI - Myosin polymorphism in muscles of the toadfish, Opsanus tau. AB - The superfast swimbladder muscle of Opsanus tau differs from the corresponding fast skeletal muscle not only by its greater sarcoplasmic reticulum and parvalbumin content but also by a genuine myosin LC2. The study of light chains has been extended here to other striated muscles. Myosins from fast (trunk muscle), superfast (swimbladder muscle), slow (lateral-line muscle) and cardiac (ventricle muscle) were compared, using one- and two-dimensional polyacrylamide gel electrophoresis. The results showed that the light chains all appear distinct in isoelectric point and molecular weight, except for the two LC1 and two LC3 from fast and superfast muscles. Striated muscles from the toadfish Opsanus tau exhibited at least four isoenzymic forms of the myosin, related to the light chains and corresponding to different physiological properties. PMID- 6863513 TI - Endocarditis caused by M6. AB - M6 is a Moraxella-like organism which is usually of pharyngeal origin and is generally nonpathogenic. Endocarditis caused by M6 occurred in a 31-year-old female with known mitral valve prolapse. The infection quickly responded to ampicillin, but valve replacement was required because of progressive left ventricular failure. PMID- 6863517 TI - Junctional feet and particles in the triads of a fast-twitch muscle fibre. AB - Structural details of junctional feet in triads of fish muscle are described. These feet have a less dense central core and contact both sarcoplasmic reticulum and T-tubule membranes at tetragonally disposed sites. The distribution of intramembraneous particles differs at the junctional T-membrane, and the junction is asymmetric. PMID- 6863518 TI - Pyrene actin: documentation of the validity of a sensitive assay for actin polymerization. AB - The fluorescence of pyrene-labelled actin is much higher after polymerization. We have characterized in detail the polymerization properties of pyrene actin and report that native and pyrene actin are identical using the following criteria: (1) the time course of polymerization; (2) the elongation rate constants; (3) the intrinsic viscosity; and (4) the critical concentration. Native and pyrene actin copolymerize. Fluorescence of polymerized pyrene actin is 7-10 times higher than monomer. The fluorescent signal is proportional to polymer weight concentration and is insensitive to filament length distribution. Bleaching can be minimized by appropriate filters to allow continuous monitoring of signal. Measurements do not influence polymerization kinetics. This establishes that pyrene actin fluorescence is a valid assay for actin polymerization that is more sensitive than any other current assay. PMID- 6863519 TI - New concept of and approach to clubfoot treatment: Section III--evaluation and results. AB - This final section on the new concept of and approach to treatment of clubfoot is the evaluation of 102 clubfeet treated over a 6-year period. Fifty-five unoperated feet received the surgical procedure described in Section II based on principles described in Section I. An attempt is made to evaluate the validity of correction of horizontal subtalar rotation, early ankle motion, recession of flexor tendon sheath on ankle motion and flexor hallucis longus function, early surgery, and release of the interosseous ligament. The results indicate that correction of horizontal subtalar rotation is beneficial and results in marked improvement in ankle motion by flexor tendon sheath recession and early motion. Longer follow-up is needed to determine the proper age for surgery. A rating system is developed and suggested for routine follow-up and comparison. PMID- 6863520 TI - Persistent medial deviation of the neck of the talus: a common cause of in-toeing in children. AB - We studied 117 in-toed children and found external tibial-fibular torsion and internal axial deviation of the foot from the midsagittal plane. Based on studies of newborn infants, radiographs, and anatomical specimens, we concluded that a major cause of in-toed gait in children was persistence of the fetal medial deviation of the talar neck and not internal tibial torsion. Spontaneous correction can be anticipated in children up to the age of 3 years if the internal axial rotation is less than 10 degrees. If it is greater than 10 degrees, prognosis for correction with orthoses is age related. In children over the age of 6 years, little correction seems possible. PMID- 6863523 TI - The functional anatomy of clubfoot. AB - The authors have studied anatomical specimens and findings at time of surgery to determine the functional anatomy of clubfoot. The importance of the midtarsal joints (especially of the talonavicular joint) is emphasized as well as the importance of the tibialis posterior. The findings of the authors concerning the function of these elements have allowed them to develop a new approach to the treatment of clubfoot. PMID- 6863521 TI - Long-term follow-up of Perthes disease treated with spica casts. AB - Forty adults with a history of Legg-Calve-Perthes disease treated with spica casts were clinically and radiographically evaluated an average of 30 years post treatment (range 14 to 40 years). Clinical results were 85% good, 5% fair, and 10% poor. Five percent showed significant degenerative joint disease on follow-up radiographs and 7% had undergone prosthetic replacement. Fifteen percent of the patients had a positive family history of Perthes disease. Factors associated with a better result included: diagnosis before age 9, shorter length of follow up, minimal femoral head and neck involvement, and a congruous joint. PMID- 6863522 TI - Congenital dislocation of the hip: an evaluation of closed reduction. AB - A retrospective study of 59 congenitally dislocated hips was undertaken to assess the relationship between the quality of a closed reduction and the eventual outcome. Good closed reductions were associated with rapid improvement of the acetabular angle and the center edge (CE) angle and a low incidence of avascular necrosis (AVN). Adequate reductions with up to 7 mm of widening of the joint on arthrogram had a good final outcome in 11 of 13 hips with a slower rate of improvement of the acetabular and CE angles and a low rate of AVN. Hips with poor or indeterminate reductions had an acceptable outcome in only five of 23 hips, did not benefit from prolonged closed treatment, and had a 57% incidence of AVN. Patients with marked ligamentous laxity often fared poorly, required prolonged treatment, and had a high incidence of AVN. PMID- 6863524 TI - Growth recovery zones. AB - Growth arrest lines and zones have been reinvestigated. Sequential studies after dietary deprivation reveal transformations of the physis with diminution in formation of the zone of cell columns, resorption of previously formed bone, and cessation of new bone formation. At 6 weeks post diet restriction, the physis is prominently narrowed with transversely oriented, thin bone plaque sealing it from the subjacent marrow. Initially, restoration of stock diet thickens the bony plaque, creating a growth arrest line. Later the zone of osteogenesis adds new bone as a dense metaphyseal band. PMID- 6863525 TI - Intervertebral lumbar disc prolapse in children and adolescents. AB - The radiographs and records of 58 cases of lumbar disc prolapse in children and adolescents were reviewed, and 28 cases were followed up after an average of 6.8 years. Trauma was not a significant aetiological factor, but there was a high incidence of back pain in relatives of affected patients. The clinical picture is similar to that in the adult except for a relative paucity of neurological signs. This review of patients treated by surgical or conservative methods suggests that good results may be obtained in patients with a short history who are offered surgery early. Preoperative radiculography is considered to be essential because of the inaccuracy in localising the level of disc prolapse by clinical signs. The result of treatment in patients with long histories is usually disappointing. PMID- 6863526 TI - Cartilage as an interposition material to prevent transphyseal bone bridge formation: an experimental model. AB - A rabbit model modified from the one originally used by Osterman was used to test the effectiveness of interposition materials in the prevention of epiphyseal metaphyseal bone bridge formation. Although fat was a moderately effective interposition material, cartilage was more effective in preventing growth retardation and angular deformity of the involved distal femur. None of the interposition materials, however, allowed for completely normal growth. It is theorized that the effectiveness of cartilage may be enhanced by the presence of a factor contained therein which inhibits bone formation. PMID- 6863528 TI - Surgical treatment of Osgood-Schlatter's disease. AB - This report reflects the evolution of the operative treatment of Osgood Schlatter's disease as practiced in Our Lady's Hospital for Sick Children. In the earlier portion of the series patients were treated by drilling of the tibial tubercle with or without removal of the prominence (Group A--22 operations). In the latter portion of the series loose pieces of cartilage or bone were excised without removal of the prominent tubercle or drilling (Group B--22 operations). The results showed a much higher incidence of excellent or good results in Group B. These patients had a short simple operation followed by rapid mobilization and return to full activity. We would, therefore, recommend this procedure for those who have significant symptoms from osteochondritis of the tibial tubercle. PMID- 6863527 TI - Slippage of the distal tibial epiphysis. AB - Three cases of valgus slippage of the distal tibial and fibular epiphysis that masqueraded as severe idiopathic flatfoot are described. These occurred in patients with renal osteodystrophy and were treated by osteotomies of the reverse dome type without internal fixation. All the osteotomies healed well. PMID- 6863529 TI - Pitfalls in the assessment of skeletal immaturity: an anthropologic case study. AB - Nonoperative treatment protocols in adolescent scoliosis require that growth is still occurring. The open iliac apophyses and vertebral ring apophyses are usually considered evidence that growth remains. Studies of adolescent skeletons are not consistent with this view, and one such example is presented. Of clinical importance is that determinant of immaturity should be based on the secondary sexual characteristics, not roentgenographic shadows. PMID- 6863530 TI - Evaluation of a teaching model for the early diagnosis of congenital dislocation of the hip. AB - A teaching model for the early diagnosis of congenital dislocation of the hip was evaluated. The physical signs of the dislocated hip and of the dislocatable hip closely simulated the true signs. The model was an excellent teaching aid and it enabled the students to gain practical experience in examining abnormal hips. The ability of the students to carry out the standard tests was also evaluated and, as a result, several modifications were made to these tests. A modified method of gripping the legs enabled the students with small hands to elicit the physical signs more readily. The physical signs were also easier to detect when the dislocated femoral head was scooped into the acetabulum by supination of the examiner's forearm and when the femoral head was displaced from the dislocatable hip by pronation of the examiner's forearm. The model was also useful in teaching the principles and methods of treatment of congenital dislocation and instability of the hip in the neonatal period. PMID- 6863531 TI - Surgical treatment of symptomatic chronic radial head dislocation: a neglected Monteggia fracture. AB - The treatment of the uncommon symptomatic and neglected Monteggia fracture dislocation of childhood can pose a significant clinical problem because of pain, decreased range of motion, unstable cubitus valgus, and possible nerve damage. This unusual injury is presented with a detailed description of a modified Bell Tawse annular ligament reconstruction. The modifications of the procedure simplify it and more closely duplicate the anatomy of the annular ligament. This procedure is indicated in the treatment of the symptomatic and neglected Monteggia fracture-dislocation of childhood. PMID- 6863532 TI - Spontaneous correction of angulational deformity of the proximal femoral epiphysis after cervical and trochanteric fracture. AB - This case report of a 5-year-old girl describes a severely comminuted fracture of the cervical and trochanteric areas of the left proximal femur which required open reduction and internal fixation for stable realignment. At 7 months follow up, angulational deformity was recognized due to partial growth arrest leading to valgus tilt of the proximal femoral epiphysis. After persisting 1 year, gradual spontaneous improvement occurred leading to total realignment with a normally wide growth plate at 36 months following injury. It is hypothesized that the valgus deviation of the femoral head, by causing a medial shift of the weight bearing axis, led to relative unloading of the lateral margin of the growth plate. It is suggested that this mechanical element contributed to the spontaneous release of the epiphyseal tether. PMID- 6863533 TI - Tibia valga caused by asymmetrical overgrowth following a nondisplaced fracture of the proximal tibial metaphysis. AB - Tibia valga has been described as a consequence of nondisplaced fractures of the proximal metaphysis of the tibia in children. There has been considerable speculation about the cause of this deformity. The present case is that of a child who developed a valgus deformity of her tibia after the fracture had healed in a normal position. The presence of growth arrest lines in the proximal metaphysis of the tibia demonstrates that the valgus deformity in this patient was caused by overgrowth of the medial portion of the proximal tibial epiphyseal plate. PMID- 6863534 TI - An approach to the child with structural defects. PMID- 6863535 TI - Spinal pantograph--a noninvasive anthropometric device for describing postures and asymmetries of the trunk. AB - A simple noninvasive device, "spinal pantograph," has been developed in order to describe and document the sagittal curves of the spine. The device and the method of evaluating the kyphosis and lordosis are explained. The accuracy of the reproducibility and the comparison with X-ray film findings are discussed. Even the balance of the trunk can be estimated. The sagittal curves in different positions--relaxed standing, maximally erect, and forward bending--can be studied and compared, thus describing the flexibility of the spine. This technique is demonstrated in some cases with different shapes of the sagittal curves of the spine--normal posture and round back deformities, including juvenile kyphosis and structural scoliosis. The effect of flexion braces in juvenile kyphosis and structural scoliosis is discussed. PMID- 6863536 TI - Kyphosis in an achondroplastic dwarf. PMID- 6863537 TI - Cigarette smoke inhibition of ion transport in canine tracheal epithelium. AB - Inhalation of cigarette smoke is known to impair pulmonary mucociliary clearance. Active ion transport by airway epithelium plays an important role in maintaining effective mucociliary clearance by regulating the volume and composition of the airway secretions. To determine the effect of cigarette smoke on airway epithelial ion transport, the electrical properties and transepithelial Na and Cl fluxes were measured in canine tracheal epithelium. In vivo, the inhalation of the smoke from one cigarette acutely and reversibly decreased the electrical potential difference across the tracheal epithelium. In vitro, exposure of the mucosal surface of the epithelium to cigarette smoke decreased the short circuit current and transepithelial resistance. The decrease in short circuit current was due to an inhibition of the rate of Cl secretion with minimal effect on the rate of Na absorption. The effect of cigarette smoke was reversible, was not observed upon exposure of the submucosal surface to smoke, and was most pronounced when secretion was stimulated. The particulate phase of smoke was largely responsible for the inhibitory effect, since filtering the smoke minimized the effect. The effect of cigarette smoke was not prevented by addition of antioxidants to the bathing solutions, suggesting that the inhibition of Cl secretion cannot be entirely attributed to an oxidant mechanism. These results indicate that cigarette smoke acutely inhibits active ion transport by tracheal epithelium, both in vivo and in vitro. This effect may explain, in part, both the abnormal mucociliary clearance and the airway disease observed in cigarette smokers. PMID- 6863538 TI - Effect of reduced renal mass on ammonium handling and net acid formation by the superficial and juxtamedullary nephron of the rat. Evidence for impaired reentrapment rather than decreased production of ammonium in the acidosis of uremia. AB - Papillary and surface micropuncture were used to study the handling of ammonium and the formation of net acid by surface nephrons, deep nephrons, and the terminal segment of collecting duct (CD) after renal mass was reduced by two thirds. Net acid excretion by the remnant kidney (RK) was significantly reduced, averaging 794+/-81 neq/min (SE) compared with 1,220+/-105 neq/min after sham operation (P < 0.001), due to a decrease in ammonium excretion (494+/-54 vs. 871+/-79 nmol/min in controls, P < 0.001). Urinary pH and titratable acid excretion were not different in the two groups of animals. After RK formation, ammonium delivery to the end of the proximal tubule increased nearly threefold and averaged 66.2+/-5.6 compared with 18.4+/-2.9 pmol/min in controls, (P < 0.001). This greater delivery of ammonium was primarily due to renal tubule entry rather than to changes in the filtered load and was only partially related to the differences in flow rate. Ammonium processing by deep nephrons was profoundly affected by a reduction in renal mass. Although absolute delivery of ammonium was greater to the bend of Henle's loop (BHL), the difference could be accounted for on the basis of an increase in nephron size. Thus, fractional delivery (FD(NH+4)) to this site was not different for the two groups of animals, averaging 1,567+/ 180% in controls and 1,400+/-181% in the group with the RK. Hydrogen secretion in the proximal segments of deep and surface nephrons did not increase in proportion to the decrease in renal mass and as a consequence bicarbonate delivery to the end of the proximal tubule of surface nephrons and to the BHL of deep nephrons was increased. When renal mass was reduced FD(NH+4) to the base of the terminal CD doubled but did not change by the tip. In both groups FD(NH+4) to the base of the CD was greater than to the end of the distal tubule. However, the increase was the same. On the other hand, the increase in the net acid index between the end of the distal tubule and the base of the CD was profoundly greater in rats with an RK. This difference was primarily due to bicarbonate reabsorption rather than enhanced ammonium reentry. Indeed, >400% of the fractional ammonium delivered to the end of the proximal tubule was lost from the tubule fluid. The data suggest that the decrease in acid excretion by the RK is due to two factors. First, hydrogen secretion in the proximal segments of both nephron populations fails to increase in the proportion to the reduction in renal mass. Second, a reduced reentrapment of ammonia, rather than its impaired production, causes ammonium excretion to decrease. PMID- 6863539 TI - Monogenic control of variations in antipyrine metabolite formation. New polymorphism of hepatic drug oxidation. AB - To investigate mechanisms that control large variations among normal uninduced subjects in the elimination of the model compound antipyrine (AP) and other drugs, AP was administered to 144 subjects (83 unrelated adults and 61 members of 13 families). Thereafter, at regular intervals for 72 h, the urine of each subject was collected and concentrations of AP and its three main metabolites measured. From these urinary concentrations, rate constants for formation of each AP metabolite were calculated. Trimodal curves were observed when values for each AP rate constant were plotted in 83 unrelated subjects; probit plots of these values showed inflections at the two antimodes of each trimodal distribution. All members of our 13 families were assigned one of three phenotypes determined by where their AP metabolite rate constant placed them in the trimodal distributions derived from the 83 unrelated subjects. In each family, pedigree analysis to identify the mode of transmission of these three phenotypes was consistent with their monogenic control. These results provide evidence for a new polymorphism of drug oxidation in man. PMID- 6863540 TI - Interaction of desialated guinea pig erythrocytes with the classical and alternative pathways of guinea pig complement in vivo and in vitro. AB - We examined the fate of desialated autologous erythrocytes injected intravenously into guinea pigs (GP). Desialated GP erythrocytes (E) were lysed directly or cleared by the reticuloendothelial system in normal GP (NIH-GP) and cleared by the reticuloendothelial system in GP genetically deficient in the classical complement pathway component C4 (C4D-GP), which activate complement only via the alternative pathway. Desialated E were also cleared in cobra venom factor-treated GP (CVF-GP), which had less than 1% of normal C3 levels, but were not cleared at all in C4D-CVF-GP. Preinjection of asialoorosomucoid (ASOR) and ovalbumin (OVA) had no effect on the rate of E clearance. These in vivo studies indicated that complement activation is essential for clearance of desialated E and that clearance is unaffected by blockade of galactose or mannose receptors. Inhibition of complement-mediated clearance required blockade of both classical and alternative complement pathways. In vitro studies showed that lysis of desialated E could occur in NIH-GP serum (GPS) but not in C4D-GPS. Surprisingly, CVF-GPS also caused lysis of desialated E. Lysis was dependent on both natural antibody to desialated E and classical pathway activation; natural antibody was of both the IgG and IgM classes. C3 uptake studies demonstrated that almost 10 times as many C3 molecules/E were deposited by NIH-GPS as by C4D-GPS or CVF-GPS onto desialated E. Approximately equal numbers of C3 molecules were deposited by CVF GPS, which did lyse desialated E, and by C4D-GPS, which did not. We suggest that the molecular mechanism of in vivo clearance and in vitro lysis of desialated E by CVF-GP is via classical pathway deposition of C3b into sites on the erythrocyte surface protected from inactivation by H (beta 1H) and I (C4b/3b inactivator). Deposition of C3b into these sites by alternative pathway activation is sufficient to cause clearance but not lysis of desialated E. CVF GPS may not represent an adequate reagent for testing the complement dependence of various biologic phenomena, particularly if the question involves surfaces that can provide protected sites for C3b molecules. PMID- 6863541 TI - Specific anti-influenza virus antibody production in vitro by lymphocytes from a subset of patients with hypogammaglobulinemia. AB - Specific anti-influenza virus antibody production in vitro was studied in peripheral blood mononuclear cells from 17 patients with hypogammaglobulinemia. Cells obtained from 6 of 12 patients with common variable hypogammaglobulinemia produced anti-influenza virus antibody, predominantly of the IgM isotype, when cultured in vitro with type A influenza virus. No antibody was produced in vitro, however, by cells from either of two patients with Bruton's type X-linked hypogammaglobulinemia or by cells from any of three patients with X-linked hypogammaglobulinemia and isolated growth hormone deficiency. These studies demonstrate that peripheral blood mononuclear cells from a subset of patients with common variable hypogammaglobulinemia retain the potential to produce specific antibody in response to antigenic stimulation. PMID- 6863543 TI - Prognostic value of angiographic indices of coronary artery disease from the Coronary Artery Surgery Study (CASS). AB - The Coronary Artery Surgery Study, CASS, enrolled 24,959 patients between August 1975 and June 1979 who were studied angiographically for suspected coronary artery disease. This paper compares the prognostic value for survival without early elective surgery of eight different indices of the extent of coronary artery disease: the number of diseased vessels, two indices using the number of proximal arterial segments diseased, two empirically generated indices from the CASS data, and the published indices of Friesinger, Gensini, and the National Heart and Chest Hospital, London. All had considerable prognostic information. Typically 80% of the prognostic information in one index was also contained in another. Our analysis shows that good prediction from angiographic data results from a combination of left ventricular function and arteriographic extent of disease. Prognosis may reasonably be obtained from three simple indices: the number of vessels diseased, the number of proximal arterial segments diseased, and a left ventricular wall motion score. These three indices account for an estimated 84% of the prognostic information available. 6-yr survival varies between 93 and 16% depending upon the values of these three indices. PMID- 6863542 TI - Biosynthesis of 5-aminolevulinic acid and heme from 4,5-dioxovalerate in the rat. AB - We previously demonstrated an alternate pathway for the biosynthesis of 5 aminolevulinic acid (ALA) in bovine liver mitochondria and of tetrapyrroles in suspensions of rat hepatocytes (1980. J. Biol. Chem. 255: 3742; 1981. Proc. Natl. Acad. Sci. USA. 78: 5335). This pathway involves a transamination reaction that incorporates the intact 5-carbon skeleton of 4,5-dioxovaleric acid (DOVA) into ALA. We investigated this alternate pathway in vivo by the intraperitoneal injection of DOVA into rats. Incorporation of DOVA and [5-14C]DOVA into urinary ALA and hepatic and erythroid heme was quantified and compared with the incorporation of [4-14C]ALA and [2-14C]glycine into heme. Within 3 h of injection of 175 mumol of DOVA, urinary ALA excretion increased 2.4-fold over controls. After injection of [5-14C]DOVA, 0.11% of the radioactivity was recovered as urinary ALA, which quantitatively accounted for the 2.4-fold increase in ALA excretion. After the injection 175 mumol of [5-14C]DOVA, 0.14% of the radioactivity was recovered after 3 h as hepatic heme. The injection of 1.75 mmol of [2-14C]glycine or 175 mumol of [4-14C]ALA resulted in recovery of 0.2 and 3.4%, respectively, of the radioactivity as hepatic heme after 3 h. These doses of radiolabeled DOVA, glycine, and ALA were injected into rats with phenylhydrazine-induced anemia. Recovery of radioactivity after 3 h as splenic (erythroid) heme was 0.35% for DOVA, 0.072% for glycine, and 0.25% for ALA. These studies establish that the intact 5-carbon skeleton of DOVA can be incorporated into ALA and heme in vivo. PMID- 6863544 TI - Molecular and functional changes in spectrin from patients with hereditary pyropoikilocytosis. AB - The structural and functional properties of spectrin from normal and hereditary pyropoikilocytosis (HPP) donors from the two unrelated families were studied. The structural domains of the spectrin molecule were generated by mild tryptic digestion and analyzed by two-dimensional electrophoresis (isoelectric focusing; sodium dodecyl sulfate-polyacrylamide gel electrophoresis). The alpha I-T80 peptide (Mr 80,000) is not detectable in two related HPP donors; instead, two new peptides (Mr 50,000 and 21,000) are generated and have been identified as fragments of the normal alpha I-T80. A third sibling has reduced levels of both the normal alpha I-T80 and the two new peptides. A similar analysis of spectrin from another HPP family indicates that their spectrins contain reduced amounts of the alpha I-T80 and the 50,000 and 21,000 fragments of the alpha I domain. The HPP donor also has other structural variations in the alpha I, alpha II, and alpha III domains. The alpha I-T80 domain of normal spectrin has been shown to be an important site for spectrin oligomerization (J. Morrow and V.T. Marchesi. 1981. J. Cell Biol. 88: 463-468), and in vitro assays indicate that HPP spectrin has an impaired ability to oligomerize. Ghost membranes from HPP donors are also more fragile than membranes from normal erythrocytes when measured by ektacytometry. In both the oligomerization and fragility assays, the degree of impairment is correlated with the amount of normal alpha I-T80 present in the spectrin molecule. We believe that a structural alteration in the alpha I-T80 domain perturbs normal in vivo oligomerization of spectrin, producing a marked decrease in erythrocyte stability. PMID- 6863547 TI - Antidepressant drugs in the treatment of obsessive-compulsive disorders. PMID- 6863545 TI - Human erythrocyte antigens. Regulation of expression of a novel erythrocyte surface antigen by the inhibitor Lutheran In(Lu) gene. AB - Our study describes a novel human erythrocyte protein antigen, the expression of which is regulated by the rare Lutheran inhibitor In(Lu) gene. We have produced a monoclonal antibody (A3D8) that bound strongly to erythrocytes from subjects with Lutheran phenotypes Lu(a+b+), Lu(a+b-), and Lu(a-b+) but bound negligibly to erythrocytes from subjects with the dominant form of Lu(a-b-) phenotype, reflecting inheritance of the In(Lu) gene. Importantly, erythrocytes from an individual with the recessive form of Lu(a-b-) phenotype (i.e., absence of the In(Lu) gene and absence of genes encoding for Lutheran antigens) showed reactivity with A3D8 antibody comparable to that seen with Lu(a+) or Lu(b+) erythrocytes. A3D8 antigen activity was also found on all leukocytes and in serum and plasma; this activity also appeared to be regulated by the In(Lu) gene in serum, plasma, and on a subset of leukocytes. Thus, we have identified a human erythrocyte protein whose expression is modified by the In(Lu) gene. This knowledge that such an antigen exists on erythrocytes and in normal plasma should allow further studies into the molecular genetics of the In(Lu) gene and into the functional and structural significance of the A3D8 antigen. PMID- 6863548 TI - Antidepressants and behavior therapy in agoraphobia and obsessive-compulsive disorders: a commentary. PMID- 6863549 TI - Probable superiority of behavioral interventions--I: traditional comparative outcome. AB - Several scholars have asserted that the major psychological therapies do not differ from one another in range or in degree of their effectiveness (the equivalence of therapies hypothesis). The studies by Sloane et al. (1975), Smith and Glass (1977) and Luborsky, Singer and Luborsky (1975) are most often referenced in support of this assertion. In this, the first of three articles, it is argued that in fact such evidence supports the probable superiority of behavioral interventions. PMID- 6863546 TI - Genetic heterogeneity in partial adenosine deaminase deficiency. AB - Inherited deficiency of the enzyme adenosine deaminase (ADA) results in a syndrome of severe combined immunodeficiency (SCID). Children with ADA- -SCID lack ADA in all cells and tissues. In contrast, a "partial" deficiency of ADA has been described in six immunologically normal children from four different "families." These children lack ADA in their erythrocytes but retain variable amounts of activity in their lymphoid cells. We have examined ADA activity in lymphoid line cells from four of these children, who are unrelated, for evidence of genetic heterogeneity. One child, who is Caucasian, has an enzyme with increased electrophoretic mobility, a diminished isoelectric point (pI 4.8 vs. Nl = 4.9) and very low activity (2.3 vs. Nl = 82.9 +/- 12.9 nmol/mg protein per min); as a second child has an enzyme with normal electrophoretic mobility but increased isoelectric point (pI = 5.0), markedly diminished heat stability at 56 degrees C (t1/2 = 4.2' vs. Nl = 40') and low activity (12.1); a third has an enzyme with only diminished heat stability (t1/2 = 6.5'), no detectable abnormality in charge and almost normal activity (41.9); while the fourth exhibits only diminished ADA activity (25.0) with no striking qualitative abnormalities. Thus, we have found evidence for three different mutations at the structural locus for ADA in three of these individuals, (a) an acidic, low activity heat stable mutation (b) a basic, somewhat higher activity, heat labile mutation, and (c) a relatively normal activity heat labile mutation. In the fourth, there is as yet no compelling evidence for a mutation at the structural locus for ADA and a mutation at a regulatory locus cannot be excluded. PMID- 6863550 TI - Self-stimulation and task-related responding: the role of sensory reinforcement in maintaining and extending treatment effects. AB - The present study was aimed at (a) eliminating self-stimulation and increasing task-related responding in severely handicapped children, and (b) assessing maintenance and carry-over of treatment effects following the use of sensory reinforcement. The results showed that applying sensory or edible-liquid reinforcement, contingent on low rates of task-related responses, did not increase these responses nor decrease self-stimulation. These behavior changes were obtained with the combination of reinforcement and punishment. Sensory reinforcement was effective in maintaining and extending the treatment results, while edible-liquid contingencies were not. PMID- 6863551 TI - Effects of public description on the detection and tolerance of laboratory pain. AB - Experimental procedures designed to modify an hypothesized pain detection threshold were arranged to test the notion that to describe a painful experience publicly results in subsequent increased detection of similar pain. First, subjects were pre-tested on their ability to detect and tolerate cold pressor pain. While waiting for a second test, half of the subjects were engaged in conversation by a confederate to whom the subject described his/her impressions of the pre-test. The other half waited in silence for the second test. Results showed that, relative to those who did not describe pain, subjects who publicly described the pain experience had low pain thresholds on the post-test, tolerated the pain less long and reported engaging in a greater number of thoughts indicating that the pain started sooner and was more intense on the post-test. Possible mechanisms to explain this effect are discussed, clinical implications are presented and directions for future research on the same process are outlined. PMID- 6863552 TI - Behavior therapy: the Italian way. PMID- 6863554 TI - The treatment of childhood-rooted separation anxiety in an adult. AB - This paper describes the behavioral treatment of a continuing separation anxiety experienced by a 31 yr old male with a long history of school phobia in childhood. The patient was successfully treated by using a wide variety of behavioral strategies. One novel therapeutic technique was used: the patient wore a bleeper which sounded as a regular reminder to prepare for a phobic situation and to relax in the face of anticipated fearful events. PMID- 6863553 TI - Treatment of compulsive rituals with visual screening: a case study with long term follow-up. AB - The present study reports on the use of visual screening, a mildly aversive response suppression procedure, as a treatment for reducing compulsive behaviors in a four and one-half year-old developmentally disabled boy. Two distinct patterns of compulsive responding were observed: repetitive (stereotyped) shoe related behaviors and a ritualistic shoe-related act. The effect of visual screening on repetitive shoe-related responses was initially evaluated in a laboratory setting under A-B-A-B-B1 experimental conditions and systematically extended to the classroom setting in multiple baseline fashion. Visual screening was also contingently applied as treatment for the shoe-related ritual, with the effects analyzed using a similar multiple baseline format across hospital residential unit and natural home settings. Results of the study indicated that visual screening was an effective treatment for suppressing both forms of the subject's compulsive responding and that it was an easily learned and administered procedure from both staff and parent perspectives. Follow-up data across 12 months were obtained and indicated that the effect of treatment was exceptionally durable. PMID- 6863555 TI - The "bathroom game": a systematic program for the elimination of encopretic behavior. AB - The present investigation utilized a unique, variable ratio schedule of reinforcement (the "bathroom game") to treat a 10-year-old encopretic male. Dependent measures included confirmed incidents of (a) soiling and (b) appropriate bowel movements monitored across an ABAB design (Baseline 1, "Bathroom Game 1", Baseline 2, "Bathroom Game 2") with one-year follow-up. During "bathroom game" conditions, contingent monetary rewards were provided for non instances of soiling and appropriate bowel movements. Such rewards were progressively and systematically leaned-out over the course of treatment on a pre determined variable ratio schedule. Results indicated a clear demonstration of functional control and clinically significant treatment effects during both experimental periods. These findings are discussed with regard to the positive features of the "bathroom game" procedure and recommendations are made for future investigations in the area. PMID- 6863556 TI - The use of cueing and positive practice in the treatment of tongue thrust swallowing. AB - Tongue thrust or reverse swallowing refers to the condition in which portions of the tongue rest or press against the teeth. In very severe cases the result can be dental malocclusion and/or speech difficulties. The present investigation evaluates the efficacy of cueing and positive practice in increasing the frequency of correct tongue position using a modified single subject withdrawal design with a 21 year old college student. The data indicate that the frequency of correct tongue positioning increased with the introduction of treatment. Follow-up data obtained 30 months post-treatment indicate that positive effects were being maintained. PMID- 6863557 TI - Learning plus: towards a multifactorial theory of phobias--II: cognitive dissonance. PMID- 6863558 TI - Construct validity of the Knox Cube Test as a neuropsychological measure. AB - The Knox Cube Test is used in conjunction with some neuropsychological test batteries as a measure of visual attention and memory, but no data are available regarding the validity of this measure in a neuropsychological context. The present investigation examined the construct validity of the Knox Cube Test as a measure of attention span, and also as a neuropsychological instrument. Two independent samples were administered a battery of tests including the Knox Cube Test. The test was found to be strongly related to most of the measures, and in both samples the highest correlations were found with digit span backwards, Trail Making Test and Speech Perception Test. Factor analysis in the two samples revealed that the highest loadings for the Knox Cube Test were observed on a factor interpreted as measuring attention and concentration. These findings were discussed in regard to the validity of the Knox Cube Test, and its potential use in clinical neuropsychological examination. PMID- 6863559 TI - Confirmatory factor analysis of four general neuropsychological models with a modified Halstead-Reitan battery. AB - Four theoretical factor models for a modified Halstead-Reitan battery were formulated, drawing from previous work by Swiercinsky, Royce and co-workers, Christensen and Luria, and Lezak. The relative explanatory power of these four models for this particular battery in an adult neuropsychiatric population was examined using confirmatory factor analysis. None of the models was shown to fit adequately in an absolute sense, but three of them represented substantial, statistically reliable improvements over a null model of mutual independence, and a clear pattern of relative fit was observed. Further improvements were achieved by modifying the best fitting initial model in several ways. A cross-validation with an independent sample supported the results of the model development step. Tentative theoretical and clinical implications for the overall organization of the neuropsychological abilities measured by this battery were drawn, and recommendations were made for further application of this method in neuropsychological research. PMID- 6863560 TI - Comparing different measures of laterality: do they relate to a single mechanism? AB - In the present study, a total of 126 adults were given three dichotic tasks, two half-field tasks, a peg-board task, several tapping tasks, the dynamometer, and a handedness questionnaire. A hierarchical cluster analysis was carried out on the matrix of product-moment correlations of laterality scores for all possible pairs of tasks. This analysis suggested that the laterality scores fall into three clusters: auditory (dichotic listening) scores, visual (half-field) scores, and manual (performance) scores. Canonical correlation analysis showed that these clusters must be considered to be independent of each other. The results are discussed with respect to the traditional interpretation of the concept of laterality. It is suggested that laterality phenomena may be dissociated and that this possibility deserves more attention. PMID- 6863561 TI - Cluster analysis of the WAIS on brain-damaged patients. AB - In recognition of increased usage of cluster analytic techniques, the current study attempted to examine sampling bounds for tests and subjects on one cluster analytic procedure. Specifically, the WAIS subtest scores from a heterogeneous group of subjects with CNS involvement were first, factor analyzed and then clustered by means of Ward's hierarchical procedure. This methodology had been previously applied to two different samples of aphasics and aphasia batteries. In both these aphasic studies, an underlying severity dimension of language dysfunction was found. In contrast, in the current study, salient feature groups were found. Moreover, these groups were distributed in a sequential or hierarchical model in terms of specific cognitive deficits. From these data, it is argued that two major parameters in determining the resulting cluster structures are the homogeneity/heterogeneity of the sample and test battery employed. Although such a statement is obvious, the theoretical ramifications are large, in that the cluster structure may be a function of test weighting or sample diversity, not the phenomenon of interest. However, the cluster structures found in the current study were consistent with historical models of cognitive dysfunction and also lend support to hierarchical models of sequential cognitive impairment. These findings are discussed in terms of their clinical and experimental ramifications with respect to grouping subjects in terms of WAIS profiles. PMID- 6863562 TI - Factor analysis of the WAIS and Wechsler Memory Scale: an analysis of the construct validity of the Wechsler Memory Scale. AB - The WAIS and Wechsler Memory Scale subtest scores of 256 neurologic and nonneurologic subjects were factor analyzed. The results supported the construct validity of the Wechsler Memory Scale as a measure of verbal learning and memory, attention and concentration, and orientation. Construct validity was not demonstrated for the Visual Reproduction subtest as a measure of visual memory. Suggestions are offered for future development and research on measures of visual memory. PMID- 6863563 TI - Psychometric properties of dichotic words tests. AB - The current study examined the reliability of a measure of ear advantage and the total scores derived from the dichotic listening task. The scores for both measures were found: (1) not to differ from the normal distribution, and (2) to be reliable over items, tests, and time. However, the total scores were dependent upon stimulus materials and experience. In addition, a psychometric classification model was proposed and it was found that the majority, at least 51.6% of the subjects, did not exhibit a truly measureable ear advantage. Finally, it was argued that total scores as well as ear advantage should be considered in the analysis of dichotic listening studies. PMID- 6863564 TI - An application of the background interference procedure to the Benton Visual Retention Test. AB - This study involved applying Canter's Background Interference Procedure to the Benton Visual Retention Test. In a heterogeneous sample of psychiatric and brain damaged patients, it was found that brain-damaged patients reproduced fewer designs and made more errors in reproducing those designs than did psychiatric patients. Right-hemisphere and diffusely brain-damaged patients reproduced fewer designs correctly and made more errors than did left-hemisphere damaged patients. This pattern was maintained when the effects of level of intellectual functioning and age were statistically controlled. These results suggest that the Background Interference Procedure in conjunction with the Benton Visual Retention Test may make a contribution to the assessment of brain-injured patients. PMID- 6863565 TI - The Minnesota Percepto-Diagnostic Test and presenile dementia. AB - The records of psychiatric patients seen for clinical reasons were used to examine the discriminating capacity of the rotation score of the Minnesota Percepto-Diagnostic Test. Thirty-one patients with an eventual organic diagnosis were compared with a matched group with functional diagnoses. The main organic subgroup, 17 patients diagnosed as presenile dementia, had markedly raised rotation scores, while the remaining 14 of mixed diagnoses did not differ from their controls. This high rotation in presenile dementia is in striking contrast to the moderate rotation shown by patients with Korsakov's psychosis in a recent study by Helmes, Holden, and Howe. It is suggested that this reflects the differing pathology of the two conditions. PMID- 6863566 TI - Word frequency effect and recognition memory in dementia of the Alzheimer type. AB - Normal persons show better recognition memory for rare than for common words. In the first experiment, we examined this word frequency effect in 17 patients with dementia of the Alzheimer type (DAT) and 20 normal controls of equivalent age and education. The DAT patients showed a normal tendency to false alarm to common words but failed to show the normal rare word advantage in their hit rate. In a second experiment, we examined normal memory immediately and after a delay of 1 week when it is approximately equivalent to that of DAT patients. There was no attenuation of the usual rare word advantage. These findings suggest that DAT patients fail to encode the featural and intrastructural elements of to-be remembered verbal information and that this processing deficit may contribute to their impaired recognition memory performance. PMID- 6863567 TI - Fibronectin and type III collagen in epithelial neoplasms of gastrointestinal tract and salivary gland. AB - The distribution of fibronectin (FN) and collagen type III (IIIC) have been compared in a series of epithelial neoplasms from the gastrointestinal tract and salivary gland. The difficulty of distinguishing between FN of epithelial and fibroblastic origin is emphasised and evidence is presented for the validity of this distinction. In carcinomas FN was sometimes, but not invariably, lost from epithelial cell surfaces. Both FN and IIIC were increased in reactive connective tissue stroma. It is concluded that loss of cell surface FN is unlikely to be a useful diagnostic marker for malignancy, but that the occurrence of this phenomenon in vivo as in vitro indicates that it is biologically significant. PMID- 6863569 TI - Chronic alcohol excess is associated with selective but reversible injury to type 2B muscle fibres. AB - Patients drinking more than 100 g alcohol/day for longer than three years develop atrophy of striated muscle fibres. This predominantly affects type 2B fibres which are dependent on anaerobic glycolytic metabolism. Atrophy of type 1 and type 2A fibres, which in addition use aerobic mitochondrial respiration, only occurs in the most severe cases and then only to a lesser degree. Abstention from alcohol reverses the changes in muscle which slowly return to normal. Selective injury to type 2B fibres indicates that search should be made for an alcohol induced biochemical lesion affecting the anaerobic glycolytic pathways of the muscle fibre. PMID- 6863568 TI - Liver damage with reversible portal hypertension from vitamin A intoxication: demonstration of Ito cells. AB - A patient with sudden onset of ascites and hepatosplenomegaly made a complete recovery after vitamin A was withdrawn. Fluorescence microscopy on embedded tissue provided a simple method of demonstrating the accumulation of fat storage (Ito) cells in the liver. PMID- 6863570 TI - Chronic alcoholic skeletal muscle myopathy: a clinical, histological and biochemical assessment of muscle lipid. AB - Muscle biopsy samples were analysed from five control subjects, four patients with mild to moderate fibre atrophy and four patients with severe atrophy. Patchy increase in lipid was noted with oil red O staining but there was no consistent association of lipid with selective fibre types. Ultrastructural studies demonstrated lipid droplets both subjacent to the sarcolemma and between fibrils. Quantitative analysis showed that the increased lipid was solely due to excess triglyceride. GLC analysis of free and esterified acids was performed. The profiles were essentially similar for the phospholipid and free fatty acid fractions. The triglyceride fraction showed a decrease of myristate, stearate and linoleate with an increase in oleate and arachidate in the alcoholic tissue compared with control. The cholesteryl ester fraction showed an increase in palmitate with a decrease in stearate and oleate in the alcoholic muscle. The accumulation of lipid correlated with mean daily alcohol consumption but not with degree of atrophy suggesting that the two processes probably had different pathogenic mechanisms. PMID- 6863571 TI - Comparison of serum amyloid A protein and C-reactive protein concentrations in cancer and non-malignant disease. AB - Serum amyloid A (SAA) concentrations correlate well with C-reactive protein (CRP) concentrations. However, SAA is sometimes raised in disease when CRP is normal. This appears to occur more often in certain diseases such as rheumatoid arthritis, primary biliary cirrhosis and chronic active hepatitis. SAA concentrations did not distinguish between cancer with and without metastases as previously indicated, although mean concentrations were higher in more advanced tumours. Despite the higher sensitivity of SAA over CRP in the inflammatory response, SAA has little advantage over CRP in the assessment of malignant disease. PMID- 6863572 TI - Plasma spermidine concentrations as early indication of response to therapy in human myeloma. AB - Eighteen patients with melphalan refractory myeloma were treated with vindesine and prednisone. Plasma spermidine concentrations were measured by radioimmunoassay before and after a single vindesine injection. Seven patients showed a significant rise of plasma spermidine after vindesine and five of these showed a clinical response on further evaluation. Of the 11 patients who did not show raised spermidine concentrations, 10 did not respond to the therapy. The correlation between clinical response/rise of spermidine and between non response/no rise of spermidine was statistically significant (p less than 0.05). Pretreatment spermidine concentrations did not distinguish those who responded to treatment nor did they differ in patients and controls. PMID- 6863573 TI - Effect of ammonium chloride treatment on human polymorphonuclear leucocyte iodination. AB - A discontinuous gradient of Percoll was used to remove RBCs from polymorphonuclear leucocyte (PMN) preparations. The resulting red blood cell-free preparation was used to investigate the effect of ammonium chloride on the iodination response of human PMN. Treatment of PMN with ammonium chloride for five minutes at room temperature resulted in a statistically significant increase in the iodination response of both resting and stimulated PMN. PMID- 6863574 TI - Resistance to lysis of erythrocytes containing haemoglobin C--detected in a differential white cell counting system. AB - Erythrocytes containing haemoglobin C do not lyse normally in the peroxidase channel of the Technicon H6000 automated cell counter. This interferes with the normal function of the channel and results in a characteristic abnormal pattern. This correlates with a reduced osmotic fragility of the red cells. PMID- 6863575 TI - Pseudohyponatremia and hyperviscosity. PMID- 6863576 TI - Marrow cellularity and polycythaemia. PMID- 6863577 TI - Relationship between urine flow rate and renal clearance of caffeine in man. AB - The renal clearance of caffeine was calculated following both oral and intravenous doses of 5 mg/kg caffeine in eight young and eight elderly, healthy human volunteers. There was a highly statistically significant positive correlation (P less than 0.001) between the renal clearance of both unbound (CLRu) and total (CLR) caffeine and the mean urine flow rate over the 24-hour period after dosing. Attempted correlations of CLRu and CLR with hydrogen ion concentration or creatinine clearance and of creatinine clearance with urine flow rate all proved to be statistically nonsignificant. It is suggested that the control of salt and fluid intake and other factors affecting urine flow rate may be a worthwhile endeavor in pharmacokinetic studies of drugs with properties similar to caffeine. PMID- 6863578 TI - Effects of oxaprozin alone or in combination with aspirin on hemostasis and plasma protein binding. AB - Oxaprozin, a new nonsteroidal antiinflammatory agent, was studied alone and in combination with aspirin for its effects on hemostasis and protein binding in 10 healthy adults. When both oxaprozin and aspirin were given separately for seven days and in combination for five days, both drugs prolonged bleeding time and inhibited collagen- and epinephrine-induced platelet aggregation to a similar degree. The effects of the combination of oxaprozin and aspirin were not additive. The data from the protein binding study showed that oxaprozin was more than 99 per cent bound to plasma proteins. Aspirin displaced oxaprozin from its binding sites. As a result, the rate of plasma clearance of oxaprozin significantly increased from 20 to 26 ml/min/kg (P less than 0.05), and the plasma half-life decreased from 45 to 40 hours. Platelet count and the humoral clotting mechanism were not affected by either drug alone or in combination. There was no clinical evidence of bleeding. One subject who received oxaprozin for 12 days and, in addition, aspirin for the last five days developed a rash that subsided after both drugs were discontinued; one subject treated with aspirin experienced tinnitus. These data suggest that oxaprozin, like aspirin and other nonsteroidal antiinflammatory drugs, should be used with caution when administered to patients who have suffered trauma, who undergo surgery, or who have known defects in hemostasis. PMID- 6863579 TI - Antihypertensive and metabolic effects of hydrochlorothiazide, amiloride hydrochlorothiazide, and timolol. PMID- 6863580 TI - Nifedipine kinetics and bioavailability after single intravenous and oral doses in normal subjects. AB - Nifedipine kinetics have not been described in clinically relevant detail because of difficulties in formulating a stable preparation for intravenous use and lack of a specific and sensitive assay for plasma nifedipine. We recently developed a gas-chromatographic method and determined conditions in which nifedipine could be protected from photodegradation. Therefore, we evaluated the kinetics and bioavailability of nifedipine in 12 normal subjects after single intravenous (1 mg/5 min) and oral (10 mg) doses. After intravenous dosing, the drug was eliminated with a half-time of 1.77 +/- 0.25 hour, and total clearance was calculated at 0.62 +/- 0.09 liter/kg/hr. With oral drug administration, the elimination half-time was twice as long for the group; but within these subjects, marked variability in the rate of appearance of the drug in plasma was observed, giving profiles consistent with fast and slow absorption. In the latter group, peak plasma drug concentrations were only one third the level seen in those exhibiting a faster absorption profile, although the extent of drug absorption (as derived from areas under the plasma level-time curves) did not vary. Bioavailability was 0.45 +/- 0.08. Untoward effects resulting from the drug's pharmaco-subjects after intravenous administration (flushing). PMID- 6863581 TI - Clinical experience with atenolol in patients with chronic liver disease. AB - The pharmacokinetics of atenolol were investigated following single intravenous (25 mg) and oral administration (100 mg) of atenolol in 13 patients with chronic liver disease and normal renal function and in 12 normal healthy volunteers. Four of the patients with chronic liver disease were not included in the statistical evaluation of kinetic data, since a reduction of creatinine clearance was observed during the course the study after ingestion of atenolol. A tendency to an increased distribution volume of atenolol could be observed in subjects with liver disease compared to normal volunteers. After intravenous and oral administration of atenolol, pharmacokinetic parameters such as elimination half life, plasma clearance, and renal clearance did not differ significantly between patients with chronic liver disease and healthy volunteers. Thus, plasma half life after intravenous dosing of atenolol was 6.0 +/- 0.46 hours in patients with hepatic disease and 5.0 +/- 0.4 hours in the controls, indicating absence of atenolol accumulation in hepatic failure. In the first days after starting beta blocker therapy such as atenolol administration, parameters of kidney function as plasma creatinine, or possibly creatinine clearance, should be initially monitored at regular intervals, as there may be transient changes of renal function in patients with chronic liver disease, leading to delayed elimination of the drug. PMID- 6863582 TI - Dose-independent pharmacokinetics of intravenous lidocaine in humans. PMID- 6863584 TI - Phonological process analysis from spontaneous speech: the influence of sample size. AB - Phonological process analysis is becoming a popular technique for the evaluation of unintelligible children and adults. Spontaneous speech sampling procedures have been advocated as a representative sampling base for phonological process analysis; however, little research has been reported detailing the parameters of spontaneous samples in reference to this assessment technique. The purpose of the present study was to evaluate the influence of increasing sample size on phonological process analyses from spontaneous speech. Results clearly indicated that samples of 50 words provided descriptive information similar to samples of 100 words. Additional studies are called for to investigate other variables that might influence the results of spontaneous speech analysis. PMID- 6863583 TI - Parameters of the influence of self-initiated time-out from speaking on stuttering. AB - The influence of two parameters of self-initiated time-out from speaking were investigated with 33 adolescent and adult stutterers. Subjects were assigned at random to one of three conditions which compared experimenter-administered time out of fixed duration, experimenter-administered time-out of duration determined by the subject, and self-initiated time-out of fixed duration. When given the opportunity to determine time-out duration, subjects chose a relatively brief period. In addition, when given responsibility for self-initiating time-out contingent on stuttering, subjects were significantly less reliable than was the experimenter in administering the procedure. Nevertheless, significant improvements in fluency were observed during all three time-out conditions, and the improvements were comparable across the three conditions. PMID- 6863585 TI - A comparison of the intelligibility of esophageal, electrolaryngeal, and normal speech in quiet and in noise. PMID- 6863586 TI - Comparative analysis of parent-child interactions with language-disordered and linguistically normal children. AB - Audio-recordings were made in the home environment of 20 parent-child dyads. Each parent and child participated in a 15-min structured and a 15-min free-play period of interaction. Language samples were analyzed in three areas: frequency components, sentence types, and pragmatic discourse features. Significant differences were found between the linguistic interactions of parents with a language-disordered child and parents with a linguistically normal child in all areas studied. Few differences were found between mothers and fathers within each group. The conclusion is drawn that language-disordered children may live in a different type of linguistic environment which could function to maintain the underlying language problem. PMID- 6863587 TI - Children's comprehension of six verb-tense forms. PMID- 6863588 TI - Receptive and expressive wh-question performance by language-delayed children. AB - The receptive and expressive wh interrogative performance of language-delayed children was investigated. Results indicated a series of response strategies and expressive performance strikingly similar to normal children in the early stages of language acquisition. These results suggest that the delayed children develop the same order of acquisition and rules for questioning as normal children, but at a slower rate. Therapeutic activities should therefore follow the order of interrogative development presented in the normative research. PMID- 6863589 TI - Studies on cell migration and axon guidance in the developing distal auditory system of the mouse. AB - The events that take place along the potential route of distal auditory axons (future vestibular component) prior to and during their outgrowth were examined morphologically using timed mouse embryos. During embryonic (E) day 9.5 a discrete zone of cell death appears in the rostrolateral wall of the otic cup. Necrosis is accompanied by outward migration of epitheloid cells from the same region of the otic wall. Temporally and spatially correlated with these two events is the widening of extracellular spaces between otic neuroepithelial cells and the breakdown of basement membrane. During E 10.5 migrating epitheloid cells condense to form a funnel-shaped configuration. This cellular "funnel" begins narrowly at the dorsorostrolateral wall of the otocyst and broadens as it reaches the auditory ganglion. During E 11.5 through E 12.5, "pioneer" distal auditory axons take a circuitous route and ascend from the auditory ganglion to enter the otocyst. Axons extend toward the otocyst moving along cells of the "funnel," maintaining an orientation similar to that of the cells that compose it. Axon growth cones enter the otocyst at sites devoid of basement membrane and invade the wall of the otocyst moving tangentially along radially arranged cells that bridge the otocyst and the "funnel." These observations demonstrate that a preformed, funnel-shaped tissue exists along the future route of the auditory fibers. We suggest that the "funnel" may influence the growth and directionality of distal auditory axons as they extend from the auditory ganglion to the wall of the otocyst. At the otic wall, the transition provided by "bridge" epitheloid cells, together with the absence of basement membrane at specific sites of the otic wall, provide the auditory axons with a route into the otocyst. PMID- 6863590 TI - A quantitative analysis of changes in the olfactory epithelium following bulbectomy in hamster. AB - Continuous replacement of sensory neurons is a normal process in the olfactory system of adult vertebrates. The capacity for replacement following experimentally induced degeneration of sensory neurons makes this system ideal for the study of the dynamics of neural populations. A quantitative analysis was made to determine the time course and degree of cell replacement in the olfactory epithelium following unilateral bulbectomy in adult hamsters. Histological measurements of number of cells and epithelial thickness were made for up to 194 days postoperatively. Results for each experimental animal were expressed as a percentage of the contralateral control side. There was an immediate degeneration of cells, the number decreasing to 39% by day 4. During days 4--15 new growth resulted in an increase in cell number, which was maintained at a level of 60- 70% through day 194. Epithelial thickness decreased to 60--70% during the degeneration period, but there was no recovery during subsequent days 4--194. Analysis of epithelial cells by cell type (supporting, receptor, and basal cells) showed that changes in cell numbers were limited to the neural cell populations (receptor and basal). This study confirms that olfactory sensory neurons are capable of replacement following degeneration in spite of the absence of normal target tissue. However, the observed recovery does not reach control levels and the functional capacity of replacement neurons requires further study. PMID- 6863591 TI - Atlas of catecholamine perikarya, varicosities and pathways in the brainstem of the cat. AB - By application of a modified glyoxylic acid--paraformaldehyde histofluorescence technique, catecholamine perikarya, varicosities, and pathways were delineated within the brainstem of kittens that were either untreated, pretreated pharmacologically, or injected intracerebrally with 6-OHDA. Three principle catecholamine cell groups were identified within the medulla and pons; the dorsomedial medullary cell group, the dorsolateral pontine cell group, and a ventrolateral cell group extending from the medulla into the pons. Induced axonal accumulation of catecholamines with intracerebral 6-OHDA injections revealed a major longitudinal catecholamine bundle which courses in a dorsolateral position through the entire brainstem tegmentum. The dorsomedial medullary and dorsolateral pontine cell groups contribute ascending and descending fibers to this bundle. Axons of the ventrolateral pontomedullary cells also feed into the bundle at successive levels through radially coursing transverse fibers. Via this major dorsolateral conduit and its ventrally and medially coursing tributaries, catecholamine fibers and terminals are distributed to multiple nuclei through the brainstem. The regions of the catecholamine cell groups and the serotonin raphe nuclei all receive a dense catecholamine innervation. Varicosities are also dense in the visceral cranial nerve nuclei, moderately dense in most somatic spinal and cranial nerve motor nuclei, and moderate to light in sensory cranial nerve and relay nuclei. The lateral and ventromedial reticular formation are moderately innervated by varicose catecholamine fibers that traverse these regions. The longitudinal catecholamine bundle continues caudally into the lateral funiculus to descend into and innervate the spinal cord. Rostrally it continues into the tegmental fascicles of the midbrain to ascend into and innervate the diencephalon and there join the medial forebrain bundle to ascend into the telencephalon. Thus, the catecholamine neurons utilize this dorsolateral longitudinal bundle to distribute collaterals to multiple bulbar nuclei and to travel beyond the brainstem to innervate the spinal cord and forebrain. PMID- 6863592 TI - The embryonic development of the cortical plate in reptiles: a comparative study in Emys orbicularis and Lacerta agilis. AB - From the earliest stage of its ontogenesis, the mammalian cerebral cortex displays a remarkable cytoarchitectonic organization, with its neurons oriented radially within the cortical plate (CP). It is not known whether this radial organization of cortical neurons is characteristic of every cerebral cortex or whether it reflects a progressive phylogenetic acquisition. In order to study this question, the embryonic development of the cortex has been examined in reptiles, where it is the most primitive. Two species, Emys orbicularis and Lacerta agilis, representative of the two principal reptilian orders (chelonians and squamates), have been studied with histological methods. Golgi impregnation, and electron microscopy. Very similar patterns of cell proliferation, migration, maturation, and synaptogenesis have been observed. However, important species differences are present in the cellular organization of the cortical plate. Whereas in Emys the structure of the cortical plate is rudimentary, in Lacerta it appears well developed and quite reminiscent of its mammalian counterpart. Preliminary comparisons with embryological preparations of Sphenodon and Crocodilus niloticus show that the organization of the cortical plate displays significant variations among the different reptilian groups. The present results suggest that the radial organization of cortical neurons is not an all or nothing phenomenon but has been acquired independently and is thus a case of homoplasy, probably due to convergence (Northcutt, 81). Several possible implications of these findings are discussed and a working hypothesis based on the role of radial glial cells in the formation of cytoarchitectonic patterns (Rakic, '80) is presented. PMID- 6863593 TI - Collaterals of spinothalamic cells in the rat. AB - Spinothalamic (STT) cells were investigated in the rat to determine the distribution of subpopulations with terminals in both the lateral and medial thalamus, the thalamus bilaterally, or the thalamus and the medullary reticular formation. Two or more retrogradely transported substances (fluorescent dyes, and/or horseradish peroxidase) were injected in each animal. Three combinations of injections were most commonly used: (1) injections of the medullary reticular formation and thalamus, (2) separate injections into each side of the thalamus, and (3) separate injections into the medial and lateral thalamus. The distribution of single labeled cells after each injection was compared with previously published results for rats. The distribution of cells which contained both tracers, double-labeled (DL) cells, was the focus of this study. An average of 15% of STT cells and 8% of spinoreticular cells projected to both the reticular formation and thalamus. However, only a small component of STT cells (less than 2%) projected bilaterally into the thalamus. Most DL cells were found in upper cervical segments. The laminar distribution of all three groups of DL neurons were similar. These cells were most often located in the reticulated part of lamina V and the intermediate zone, lamina VII. STT cells that had terminals in both the medial and lateral thalamus and STT cells with collaterals in the reticular formation were concentrated on the side contralateral to their terminals. These DL neurons provide an anatomical substrate for noxious stimuli to stimuli to activate the reticular formation and thalamus and/or specific sensory and intralaminar thalamus simultaneously. PMID- 6863595 TI - Ultrastructural observations of the migration and early development of trigeminal motoneurons in chick embryos. PMID- 6863594 TI - Postmetamorphic changes in the lumbar lateral motor column in relation to muscle growth in the toad, Bufo americanus. AB - Motoneuron number and size (nuclear cross-sectional area) were measured from serially sectioned spinal cords of Bufo americanus to investigate the relation between changes in the lumbar lateral motor column (L-LMC) and postmetamorphic increases in hindlimb muscle fiber number. Previous studies of neuron number in a variety of anuran species reported a correlation between number and body size, suggesting the possible addition of neurons during growth. Our results show a poor correlation between motoneuron number and body size with at most a 25% increase in neuron number occurring over the body size range where previous work had shown a hindlimb muscle fiber increase of ten to 20-fold. Thus, most new muscle fibers must be incorporated into motor units that exist at metamorphosis. Motoneurons, but not ependymal cells, showed a significant size increase with increasing body size; this is perhaps related to an increased motor unit size that results from axonal sprouting. The range of variation of L-LMC cell numbers in newly metamorphosed toads was nearly equal to that of all other toads examined. This suggests that the weak correlations between motoneuron number and size observed in this and previous studies may be due to differential survival of individuals with larger neuron populations rather than to postmetamorphic addition of motoneurons. Our findings also show a strong bilateral correlation of motoneuron numbers, a finding suggesting that factors other than peripheral size may be important in regulating motoneuron number. PMID- 6863596 TI - Structure of the piriform cortex of the opossum. II. Fine structure of cell bodies and neuropil. PMID- 6863597 TI - The morphology of corticofugal axons to the dorsal lateral geniculate nucleus in the cat. AB - The structural features of corticogeniculate axons were studied in adult cats after labeling them with horseradish peroxidase (HRP). Injections of HRP into the optic radiations near the dorsal lateral geniculate nucleus result in Golgi-like filling of both geniculate relay neurons and corticogeniculate axons. In the present material at least two main types of axons could be defined. The most common type is called the type I axon because it so closely resembles the type I axons described by Guillery ('66, '67) in Golgi preparations. These fine axons have smooth surfaces and consistent fiber diameter. Most terminal swellings are at the ends of short collateral branches and these swellings form asymmetric synaptic contacts onto small and medium-sized dendrites. Type I axons typically innervate more than one lamina as well as interlaminar zones and they clearly arise from the cerebral cortex. The second type of axon is called the beaded axon because of its numerous swellings, en passant. These swellings frequently are larger than those on type I axons and they differ from previously described corticogeniculate axon terminals in their ultrastructural features. That is, their synaptic contacts appear symmetrical and they form axosomatic contacts. Because of these differences, the possibility that beaded axons are of subcortical origin, particularly from the perigeniculate nucleus, is discussed. When type I axons and geniculate relay neurons are filled in the same region of the nucleus it is possible to identify probable sites of synaptic contact by using the light microscope. Such analyses indicate that corticogeniculate axons synapse directly onto relay cells, primarily on peripheral dendritic branches. Further, it appears that single axons contact many geniculate neurons and that single neurons are contacted by many axons. PMID- 6863598 TI - Extrinsic and intrinsic fiber connections of the telencephalon in a teleost, Sebastiscus marmoratus. AB - Extrinsic and intrinsic fiber connections of the telencephalic subdivisions of Nieuwenhuys ('62) in a teleost, Sebastiscus marmoratus, were studied by means of horseradish peroxidase (HRP) and Fink-Heimer methods. The olfactory bulb projects bilaterally to area dorsalis pars posterior, area ventralis pars ventralis, pars lateralis, pars posterior, pars intermedia, and the nucleus posterior tuberis of Peter et al. ('75) and receives fibers from ipsilateral area dorsalis pars centralis, pars posterior, area ventralis pars dorsalis, and pars supracommissuralis. Area dorsalis pars posterior sends numerous fibers to the ipsilateral ventral region of area dorsalis pars medialis, from which fibers of the medial forebrain bundle arise and terminate in the inferior lobe and nucleus posterior tuberis. Area dorsalis pars lateralis, pars dorsalis, and the dorsal region of pars medialis are the main targets of extratelencephalic ascending afferents. Area dorsalis pars lateralis receives fibers from the ipsilateral nucleus prethalamicus of Meader ('34), where tectal projections terminate massively. Area dorsalis pars dorsalis and the dorsal region of pars medialis receive afferents from the ipsilateral nucleus preglomerulosus of Schnitzlein ('62), nucleus posterior tuberis, area preoptica pars medialis of Crosby and Showers ('69), and nucleus entopeduncularis of Sheldon ('12). Raphe nuclei and locus ceruleus project bilaterally to area dorsalis pars centralis, pars dorsalis, pars lateralis, and the dorsal region of pars medialis. Area dorsalis pars centralis, pars dorsalis, and the dorsal region of pars medialis are important sources of extratelencephalic efferents. These subdivisions give rise to the lateral forebrain bundle and project to the ipsilateral nucleus prethalamicus, nucleus preglomerulosus, inferior lobe, nucleus paracommissuralis of Ito et al. ('82), optic tectum, torus semicircularis, and the bilateral mesencephalic tegmentum. Within the telencephalon, most of the ventral subdivisions project to ipsilateral area dorsalis pars centralis, pars dorsalis, pars lateralis, and the dorsal region of pars medialis. Area dorsalis pars centralis has reciprocal connections with ipsilateral area dorsalis pars lateralis, pars dorsalis, pars posterior, and the dorsal region of pars medialis. A dorsal part of the anterior commissure is composed of axons of the ventral region of area dorsalis pars medialis destined to the contralateral ventral region of area dorsalis pars medialis. A ventral part of the anterior commissure contains axons of area dorsalis pars centralis destined to contralateral area dorsalis pars lateralis. PMID- 6863599 TI - Projections of nucleus caudalis and spinal cord to brainstem and diencephalon in the hedgehog (Erinaceus europaeus and Paraechinus aethiopicus): a degeneration study. AB - In the light of hypotheses related to the evolution of pain-carrying systems in mammals, terminal projection fields in brainstem and diencephalon of efferents of nucleus caudalis (NC) of the spinal trigeminal complex and spinal cord were determined in hedgehog by using Nauta-Gygax and Fink-Heimer silver techniques for degeneration. Unilateral NC lesions resulted in medullary degeneration in the ventral portion of NC contralaterally and bilaterally in cuneate nucleus (CU) and reticular formation. Pontine degeneration was noted ipsilaterally in medial (PBM) and lateral (PBL) parabrachial, facial motor (VII), and interpolar, oral, and main sensory trigeminal nuclei; degeneration in reticular formation was bilateral. Midbrain degeneration was seen bilaterally in caudal superior colliculus (SC), inferior colliculus (IC), periaqueductal gray, and tegmentum. In thalamus, projections to ventroposterior nucleus (VP) were contralateral and concentrated in a crescent extending along the lateral one-third-to-one-half and ventral border of the nucleus. Bilateral degeneration fields were noted in a dorsomedial sector of the "ventral nuclear field," posterior complex (PO), and mediodorsal nucleus (MD), the degeneration always heavier contralaterally in these nuclei. Sparse degeneration was noted in the medial most portions of the medial geniculate nuclei bordering PO and VP. In rostral diencephalon, bilateral degeneration was traced from the inferior thalamic peduncle to the lateral hypothalamic area (LH). Unilateral spinal cord lesions made between C7 and T1 vertebrae resulted in medullary degeneration in NC contralaterally, ipsilaterally in CU and lateral cuneate nucleus, and bilaterally in gracile nucleus, inferior olivary complex, and reticular formation. Pontine degeneration was limited to ipsilateral PBL and bilaterally to VII. Midbrain degeneration was found bilaterally in IC, SC, nucleus sagulum, and tegmentum; a minor projection was noted in interpeduncular nucleus. In thalamus, projections were confined to ipsilateral PO and zona incerta. In rostral diencephalon bilateral fields were noted in LH. NC terminations in PO and VP parallel results of research in hedgehogs on thalamic projections of the dorsal column nuclei (Jane and Schroeder, '71), and particularly the location in VP of most cells responsive to stimulation of the face (Erickson et al., '67). This suggests that somatic input from NC, some of which may be pain-specific, reaches thalamic areas, a portion of whose neurons are characterized as polymodal and at least partially convergent for somatotopy. These results are consistent with the thesis that specific sensory thalamic nuclei evolved from a diffuse sensory region. Response properties of neurons in the dorsomedial portion of the ventral nuclear field, an area which are also received NC efferents, are not known. Last, NC projections to MD and LH implicate the role of "limbic" aspects of nociception. PMID- 6863600 TI - Segmental distribution and central projections of renal afferent fibers in the cat studied by transganglionic transport of horseradish peroxidase. AB - The segmental and central distributions of renal nerve afferents in adults cats and kittens were studied by using retrograde and transganglionic transport of horseradish peroxidase (HRP). Transport of HRP from the central cut ends of the left renal nerves labelled afferent axons in the ipsilateral minor splanchnic nerves and sensory perikarya in the dorsal root ganglia from T12 to L4. The majority of labeled cells (85%) were located between L1 and L3. A few neurons in the contralateral dorsal root ganglia were also labeled. Labeled cells were not confined to any particular region within a dorsal root ganglion. Some examples of bifurcation of the peripheral and central processes within the ganglion were noted. A small number of preganglionic neurons, concentrated in the intermediolateral nucleus, were also identified in some experiments. In addition, many sympathetic postganglionic neurons were labeled in the renal nerve ganglia, the superior mesenteric ganglion, and the ipsilateral paravertebral ganglia from T12 to L3. Transganglionic transport of HRP labeled renal afferent projections to the spinal cord of kittens from T11 to L6, with the greatest concentrations between L1 and L3. These afferents extended rostrocaudally in Lissauer's tract and sent collaterals into lamina I. In the transverse plane, a major lateral projection and a minor medial projection were observed along the outer and inner margins of the dorsal horn, respectively. From the lateral projection many fibers extended medially in laminae V and VI forming dorsal and ventral bundles around Clarke's nucleus. The dorsal bundle was joined by collaterals from the medial afferent projection and crossed to the contralateral side. The ventral bundle extended into lamina VII along the lateroventral border of Clarke's nucleus. Some afferents in the lateral projection could be followed ventrally into the dorsolateral portion of lamina VII in the vicinity of the intermediolateral nucleus. In the contralateral spinal cord, labeled afferent fibers were mainly seen in laminae V and VI. These results provide the first anatomical evidence for sites of central termination of renal afferent axons. Renal inputs to regions (laminae I, V, and VI) containing spinoreticular and spinothalamic tract neurons may be important in the mediation of supraspinal cardiovascular reflexes as well as in the transmission of activity from nociceptors in the kidney. In addition, the identification of a bilateral renal afferent projection in close proximity to the thoracolumbar autonomic nuclei is consistent with the demonstration in physiological experiments of a spinal pathway for the renorenal sympathetic reflexes. PMID- 6863601 TI - Nucleus rotundus in a snake, Thamnophis sirtalis: an analysis of a nonretinotopic projection. AB - Nucleus rotundus, a tectorecipient thalamic nucleus in reptiles and birds, is described for the first time in a snake. The morphology of rotundal neurons and tectorotundal axons was studied at the light microscopic level by using anterograde and retrograde filling with the horseradish peroxidase (HRP). Injections of HRP in the dorsal ventricular ridge retrogradely fill neurons in rotundus. Rotundus is situated centrally in the caudal diencephalon medial to the cell plate of the retinorecipient geniculate complex and ventrolateral to the lentiform thalamic nucleus. The dendrites of rotundal neurons are long and radiate, but are confined within the cytoarchitectonically defined borders of the nucleus. Injections of HRP into the optic tectum anterogradely fill axons that project to rotundus bilaterally via the tectothalamic tract. Small injections show that axons arising from a single tectal locus distribute to all sectors of rotundus. Thus, this projection may not be retinotopically organized. However, single axons reconstructed through serial sections form spatially restricted, sheetlike terminal fields that pass caudorostrally through the entire extent of rotundus. Several hypotheses on the functional significance of such organized but nonretinotopic visual projections are discussed. PMID- 6863602 TI - Cortical connections between rat cingulate cortex and visual, motor, and postsubicular cortices. AB - The connections of rat cingulate cortex with visual, motor, and postsubicular cortices were investigated with retrograde and anterograde tracing techniques. In addition, connections between visual and the postsubicular (area 48) and parasubicular (area 49) cortices were evaluated with the same techniques. The following conclusions were drawn. Area 29 connections: Afferents to area 29 originate mainly from cingulate areas 24 and 25, visual cortex (primarily area 18b), motor cortex area 8, area 11 of frontal cortex, areas 48 and 49, and the subiculum. Efferent connections of area 29 within cingulate cortex and to visual areas differ for each cytoarchitectural subdivision of area 29. Thus, area 29c has limited projections both within cingulate cortex and to areas 48 and 49, while area 29d projects to these areas as well as to area 8, area 18b, and medial area 17. These visual cortex afferents originate mainly from layer V neurons of areas 29b and 29d, while areas 29a and 29c have virtually no projections to visual cortex. Area 24 connections: Afferents to area 24 originate primary from cingulate areas 25 and 29 and visual area 18b and medial area 17. Efferent projections of area 24a are distributed within cingulate cortex, while area 24b has more extensive projections to posterior cingulate and visual cortices. Area 24b is the cingulate subdivision which is both the primary recipient of visual cortex afferents as well as the source of most of the projections of anterior cingulate cortex to visual areas. Visual cortex has reciprocal connections with parts of the postsubicular and parasubicular cortices. Neurons of the internal pyramidal cell layer of both areas 48 and 49 project to areas 17 and 18b, while layers I and III of these parahippocampal areas receive projections from areas 17 and 8b. In conclusion, areas 29d have particularly extensive interconnections with visual cortex, while area 29d also maintains projections to area 8 of motor cortex. This connection scheme supports the view that cingulate cortex may have a role in feature extraction from the sensory environment, as well as in sensorimotor integration. Finally, the postsubiculum may be classified as a limbic association cortex in which extensive visual and cingulate efferents converge. PMID- 6863603 TI - The evolution of an area centralis and visual streak in the marsupial Setonix brachyurus. AB - The distribution, morphology, size, and number of cells in the retinal ganglion layer of the marsupial Setonix brachyurus, "quokka," was studied from 25 days postnatal to adulthood using Nissl-stained wholemounts. The total cell population was evenly distributed up to 50 days, but by 75 days highest densities were generally observed in a broad band extending across the nasotemporal axis. At 87 days, a temporally situated area centralis was seen for the first time. This was embedded in a horizontally aligned visual streak, the nasal arm of which contained areas of high density. By 106 days, densities in the area centralis had stabilized while peripheral values were higher than adult levels even at 180 days. In the adult, the area centralis was surrounded by a weak visual streak. Retinal area increased steadily during development to reach 168 mm2 at 180 days, the adult range being 225-250 mm2. All cells in the ganglion layer appeared undifferentiated and rounded at 33 days with soma diameters of 3-6 micrometers; by 70 days diameters had increased to 4-12 micrometers and some cells had axon hillocks containing Nissl substance. From 87 days we distinguished ganglion cells, which constituted 54-63% of the total. These were identified by deeply stained Nissl substance and had diameters of 7-18 micrometers, compared to 7-23 micrometers at 143 days and 7-24 micrometers in the adult; the remaining cells, termed glia/interneurons, were 5-8 micrometers throughout. Only ganglion cells were organized into an area centralis and visual streak. Glia/interneurons were evenly distributed except at the extreme periphery, where their density increased. In sectioned material, the ganglion layer was distinct from 25 days while the neuroblastic layer separated only between 48 and 85 days. From 25 to 250 days the total number of cells in the ganglion layer remained similar to the adult range of 336,000-393,000. At both 87 days and in adults optic axon counts fell between 180,000 and 224,000, close to ganglionic cell estimates. At 25 and 34 days, respectively, optic axon numbers were 75,000 and 172,000. Myelination was absent at 25 and 34 days, 3% at 87 days, and almost 100% in adults. Mechanisms are discussed whereby the area centralis and visual streak may evolve from an even distribution of cells while their number remains constant; migration is considered likely to be important. PMID- 6863604 TI - Anatomy and electrophysiology of individual neurosecretory cells of an insect brain. AB - The structure and electrophysiological properties of individual neurosecretory cells of the pars intercerebralis, medial neurosecretory cells (MNSCs), in the brain of an insect, the cricket Teleogryllus commodus, were investigated by means of intracellular injections of the dye Lucifer Yellow and electrophysiological recordings. Action potentials recorded from these cells were of long duration, 8 50 msec. In the pars intercerebralis there are both neurosecretory cells with axons that join one of the tracts of the nervi corpori cardiaci I (NCC I) and cells without an axon or collateral that leaves the brain, local neurosecretory cells. MNSCs with axons that join NCC I and terminate in the anterior corpus cardiacum arborize extensively in the protocerebrum and to a lesser degree in the deutocerebrum. Other MNSCs have axons that pass through the corpus cardiacum and hypocerebral ganglion and join one of the oesophageal nerves. These MNSCs have sparse collateral arborizations in the protocerebrum but do have extensive terminal arborizations in the tritocerebrum. This type of cell is dye-coupled to other MNSCs. Among the local MNSCs, some have an unusual loop shape. These cells branch extensively in the protocerebrum and have massive terminal arborizations in a posterior ventromedial region of the brain. Both the long curved axons of the loop-shaped cells and their ventromedial branches are of large diameter, suitable for storage of neurosecretory material. PMID- 6863605 TI - The laminar distribution of intracortical fibers originating in the olfactory cortex of the rat. AB - In this study, the autoradiographic method for tracing axonal connections was used to identify the laminar distribution of intracortical fibers originating in the olfactory cortical areas of the rat. Most of the projections can be divided into two major fiber systems with different laminar patterns of termination. The first of these, termed the layer Ib fiber system, arises in the anterior olfactory nucleus, the anterior and posterior piriform cortex, and the lateral entorhinal cortex, and terminates predominantly in layer Ib and, in many cases, layer III of the entire olfactory cortex. The second system, termed the layer II deep Ib fiber system, originates in three relatively small olfactory cortical areas--the dorsal peduncular cortex, the ventral tenia tecta, and the periamygdaloid cortex--and terminates in and around the cells of layer II in most parts of the olfactory cortex. There is significant overlap in the laminar distribution of the two systems, although the distinction between them is readily apparent. Within the layer Ib fiber system there are relatively slight but consistent differences in the lamination of fibers from different areas. The fibers from the anterior olfactory nucleus are concentrated in the deep part of layer Ib while those from the anterior piriform cortex are concentrated in the superficial part of this layer. The fibers from the posterior piriform cortex tend to be densest in the middle of layer Ib. These differences are maintained in all areas of termination of each set of fibers, both ipsilaterally and contralaterally. In addition, intracortical fibers from the anterior cortical nucleus of the amygdala are distributed throughout layer I, including layer Ia and Ib. Fibers from the nucleus of the lateral olfactory tract terminate bilaterally around the cells of the islands of Calleja and the medial edge of the anterior piriform cortex. PMID- 6863606 TI - Leukocyte response in experimental Trypanosoma vivax infection in cattle. AB - Eight Zebu cattle were infected with Trypanosoma vivax stock Y58, while 8 served as uninfected controls. The infected animals developed early leukopenia due to concomitant lymphopenia and neutropenia. It is suggested that an increase in trypanosomal antigens and neuraminidase in the infected cattle at this time may have an effect on peripheral leukocytes. PMID- 6863607 TI - Cystic hyperplasia of the gall bladder in breeding ewes. AB - Reproduction in Finnish Landrace X Polled Dorset Horn ewes was accompanied by thickening of the wall of the gall bladder. The thickening was caused by hypertrophy of the epithelium, the presence of cysts, proliferation of blood vessels, glands and fibrous tissue in the lamina propria and hypertrophy of smooth muscle. The changes appeared to be initiated during pregnancy but to persist in a modified and chronic form in post-parturient animals. PMID- 6863609 TI - The morphogenesis of a papillomatous gastric polyp in the crab-eating monkey (Macaca fascicularis). AB - The histopathology of gastric papillomas in 17 crab-eating monkeys from Indonesia and Malaysia was investigated. The changes in the affected mucosa consisted of papillomatous proliferation with accidental heterotopia, desquamation or necrosis of the epithelium associated with eggs or adults of the small nematode Nochtia nochti, inflammatory cell infiltration and haemorrhage or oedema and fibrosis. The primary pathogenic effect of this parasite was due to its irritant action on the gastric mucosa. Hyper-regeneration, with a downward shift of the proliferating zone in the gastric gland and an inflammatory process, appeared to play a significant role in the morphogenesis of this lesion. It is concluded that the gastric papilloma associated with Nochtia nochti in the monkey is a parasitic inflammatory polyp. PMID- 6863608 TI - Fibroma in a Nine-banded armadillo (Dasypus novemcinctus). AB - An adult male Nine-banded armadillo (Dasypus nonemcintus) had a large tumour between the first and second phalanges of the right fore-foot. The tumour was of dermal origin, consisted of dense interlacing bundles of collagen, and contained numerous fibroblasts with elongate nuclei and sparse cytoplasm. Mitotic figures were not observed, there was no evidence of lipid accumulation, and there was no metastasis to regional lymph nodes or other tissues. Electron microscopy showed that the major cells of the tumour were fibroblasts. These did not contain nuclear or cytoplasmic inclusions but had dense bodies in the nucleus and there was a conspicuous absence of lysosomes. This lesion was considered to be a benign fibroma of undetermined aetiology. PMID- 6863610 TI - Infectious necrotic hepatitis caused by an unclassified anaerobic bacillus in the water snake. AB - Necrotic hepatitis resembling black disease of ruminants is described in a group of five water snakes (Natrix sipedon pictiventirs). Lesions varied from multifocal granulomas to massive coagulation necrosis. A bacterium recovered from the livers could not be classified, but closely resembled Eubacterium tarantellus. The bacterium was isolated from all snake livers and from snake mites (Ophionyssus natricis) which were probably implicated in the transmission of the disease and it is possible that trematodes were concerned in producing the initial damage to the liver. PMID- 6863611 TI - Border disease: effect of virus administered intracerebrally to newborn lambs. AB - Six BVD antibody-free Dorset Horn lambs, less than 3-days-old, were infected by intracerebral inoculation of BD virus. Three of these lambs (Group I) were killed 7 days after inoculation (p.i.) and 3 (Group II) 21 days p.i. None of the lambs showed clinical signs of disease. Of the 5 lambs in which infection was established, 3 of Group I and 2 of Group II showed lesions of non-suppurative encephalitis. Although of varying severity and extent in individual animals, the lesions in all lambs appeared to be primarily of the same nature, with the cerebral white matter being the main target. BD virus was isolated from all lambs of Group I, killed 7 days p.i., but from none of Group II, killed 21 days p.i. Thus the induced BD infection appeared to be of a transient nature. The results indicate that the CNS of newborn lambs is capable of supporting BD virus replication with subsequent development of lesions. It is suggested that some of the cases of non-suppurative encephalitis of obscure aetiology occasionally encountered in young lambs in the field may be the result of infection with BD virus. PMID- 6863612 TI - The production of zinc deficiency in the guinea pig. AB - A diet which contained less than 1 microgram Zn per g was eaten readily by guinea pigs. No signs of zinc deficiency were produced unless the animals were deprived of access to zinc-supplemented solid food from birth and were maintained on grid floors to prevent coprophagy or ingestion of sawdust bedding material. At an early stage of deficiency, plasma zinc concentration, food intake and growth were reduced and large regular variations of food intake (food cycling) were observed. More severe deficiency produced decreases in the zinc content of other tissues and characteristic epidermal lesions. The requirement of guinea pigs for zinc for growth is probably about 2.5 micrograms per g feed which is much lower than for calves, rats and pigs. PMID- 6863613 TI - The classification of feline colitis. AB - Clinical and pathological features of a variety of forms of feline colitis or enterocolitis were examined and classified into 9 separate entities: Salmonella enterocolitis, the colitis of feline infectious peritonitis, mycotic enterocolitis, acute angiopathic colitis, acute angiopathic colitis with ischaemic ulcers, feline granulomatous colitis, the colitis of feline panleucopenia, feline histiocytic colitis, and feline ulcerative, lymphocytic mucosal-submucosal colitis. PMID- 6863614 TI - Studies on the local immune response of the lactating ewe infected with Ostertagia circumcincta. AB - Changes in the flow and composition of gastric lymph were monitored in groups of lactating and non-lactating ewes which were repeatedly infected with Ostertagia circumcincta. As judged by faecal egg counts and worm burdens the lactating group was more susceptible than the non-lactating controls to the challenge infection. Increased amounts of pepsinogen as well as larger numbers of eosinophils and neutrophils entering the gastric lymph indicated considerable abomasal damage and inflammation in the lactating ewes. However, measurement of the flow of lymphocytes as well as the amount of IgA and IgA antibody in the lymph did not indicate that these aspects of the local immune response were impaired during lactation; in fact the output of IgA-containing lymphocytes as well as IgA itself was usually raised in the lactating sheep. Lymph flow was increased and lymph globulin concentrations proportionally decreased in lactating ewes, irrespectively of whether they were infected with worms. It is suggested that these changes were caused by the increase in voluntary food intake which occurs during lactation. PMID- 6863615 TI - Further studies on changes in immunoglobulin G in the sera and CSF of Herdwick sheep with natural and experimental scrapie. AB - Previous studies showed that the concentration of IgG in serum was increased in a high proportion of Herdwick sheep in the clinical stage of natural scrapie. The present paper reports similar findings in Herdwicks with experimental scrapie in which the clinical signs were different. Further studies of the natural disease showed increased concentrations of IgG in CSF due to passive filtration from serum and not to local antibody production in the CNS. Qualitative differences in serum IgG have also been found in natural scrapie, involving a shift in the major IgG isotype from IgG1 to IgG2. The significance of these changes is not known but the limited evidence available may indicate a progressive dysfunction in certain sub-populations of lymphocytes in sheep scrapie. PMID- 6863616 TI - A malignant Sertoli cell tumour in a laboratory rat. PMID- 6863617 TI - Caecal rupture in parturient mares. PMID- 6863618 TI - Pyogenic granuloma (lobular capillary hemangioma) within port-wine stains. AB - We observed two patients who developed pyogenic granulomas within port-wine stains. One had a single lesion without recurrence, whereas the second had multiple lesions that developed during a 6-year period. It has been postulated that arteriovenous anastomoses are associated with the pathogenesis of pyogenic granuloma. Formation of pyogenic granuloma within a port-wine stain, a lesion often associated with arteriovenous anastomoses, provides further support for this idea. PMID- 6863619 TI - Pilomatricoma-like changes in the epidermal cysts of Gardner's syndrome. AB - We studied fifty-seven cutaneous cysts from seven members of a kindred with Gardner's syndrome. All of the cysts had large areas indistinguishable from ordinary epidermal cysts. In addition, twenty-one (37%) contained columns of shadow cells, similar to those of pilomatricoma, that projected into the lumina. The cells at the point of attachment of the columns to the cyst lining were often indistinguishable from the hair matrix-like, basophilic cells of pilomatricoma. In twenty-nine cysts (51%), masses of shadow cells were free within lumina, unattached to the epithelial lining. Deposits of shadow cells, associated with a giant cell reaction and often calcified, were present in the pericystic connective tissue of twenty cysts (35%). Thirty-six of the fifty-seven cysts (63%) had one or more of the foregoing features, and the changes were observed in cysts from six of the seven patients studied. Our observations and similar findings recorded in the literature suggest that pilomatricoma-like changes may be a characteristic of the epidermal cysts of an undetermined number of kindreds with Gardner's syndrome. PMID- 6863620 TI - In vivo percutaneous absorption of hydrocortisone in psoriatic patients and normal volunteers. AB - Our objective was to determine the percutaneous absorption of hydrocortisone in psoriatic skin. [14C]-Hydrocortisone formulated as a 0.5% cream was applied to sharply defined erythematous plaques with silvery scales on the dorsal forearm of four hospitalized psoriatic patients. An average 2.32 +/- 1.4 (SD) percent of the applied dose was absorbed. The absorption of the same dose from the dorsal forearm of six normal subjects was 2.45 +/- 1.2%. We conclude that for presumably stable psoriatic plaques, the percutaneous absorption of hydrocortisone is the same as for normal skin. PMID- 6863621 TI - Comparison of stratum corneum thickness in children and adults. AB - We compared the thickness of the stratum corneum from abdominal skin in infants less than 3 months of age, children between 3 months and 11 years, and adults. Measurements were made with a filar micrometer eyepiece on histologic sections obtained at autopsy. No significant differences were seen; therefore, a stratum corneum of different thickness cannot be used to explain differences in percutaneous absorption, supporting previous work which suggested that term infants and children have an efficient skin barrier. The greater toxicity from percutaneous absorption of topical compounds sometimes seen in children is more likely due to their increased surface to volume ratio and/or metabolic differences. PMID- 6863622 TI - Antenatal diagnosis of genodermatoses. AB - The technics of fetoscopy and fetal skin biopsy have expanded our capabilities for antenatal diagnosis of certain hereditary skin disorders (genodermatoses). The fetus and placenta can be visualized directly and skin biopsy specimens can be obtained for light and electron microscopic studies, tissue culture, and biochemical analysis. These technics have been utilized successfully in the prenatal diagnosis or exclusion of epidermolysis bullosa, epidermolytic hyperkeratosis, and harlequin ichthyosis in fetuses known to be at risk for these disorders, and they offer tremendous potential for prenatal diagnosis in a variety of other genodermatoses. Studies of tissue obtained by this procedure will undoubtedly expand our knowledge of the morphogenesis and biochemistry of fetal skin and will provide needed baseline data for the further development of these technics. PMID- 6863623 TI - Acquired progressive lymphangioma. AB - A 5-year-old Japanese boy, who developed dark brown, erythematous lesions (two separate lesions) on his face, scalp, and left upper arm within 2 years, was reported. Biopsy specimens revealed many dilated channels lined by a single layer of endothelial cells without obvious atypicality throughout the dermis. These channels split collagen bundles, giving a "dissection of collagen" appearance. From these clinical and histopathologic findings, we have diagnosed these lesions as acquired progressive lymphangioma. Our patient is the youngest reported patient in the literature, and we were interested in that the two lesions developed separately following previous trauma and they had the tendency to regress following oral prednisolone therapy. PMID- 6863624 TI - Pemphigus foliaceus and proteinuria induced by alpha-mercaptopropionylglycine. AB - Pemphigus foliaceus and proteinuria occurred in a patient with cystinuria treated with alpha-mercaptopropionylglycine. This drug is similar to D-penicillamine in structure and function, and it is being used in patients who are unable to tolerate D-penicillamine. Although side effects of D-penicillamine are common, no major adverse reactions have been reported previously with alpha mercaptopropionylglycine. Pemphigus foliaceus and proteinuria occurring during therapy with alpha-mercaptopropionylglycine and D-penicillamine are discussed. PMID- 6863625 TI - Subcutaneous alternariosis. AB - Alternaria species are common plant pathogens, but a rare cause of human infection. Previously reported cases of cutaneous alternariosis (Alternaria alternata) in both healthy and immunosuppressed hosts have been characterized by a chronic localized ulcerative eruption in exposed sites. Dermal granulomatous infiltration and variable epidermal changes, with hyphae in both the dermis and epidermis, are characteristic. We present a case with certain unique features. This is the first reported human infection with Alternaria dianthicola. In addition, our patient showed the unusual presentation of clinically noninflammatory subcutaneous nodules of the chest wall. The subcutaneous location of the granulomatous process may have been attributable to deep traumatic inoculation. The circumscribed nodular quality of the infection allowed a surgical therapeutic approach. PMID- 6863626 TI - Methotrexate-induced necrolysis. AB - A 72-year-old woman with a long history of recalcitrant psoriasis developed severe generalized erosions after receiving low-dose (7.5 mg) methotrexate. Her clinical picture was consistent with toxic epidermal necrolysis and showed a gradual response to systemic steroids and topical therapy. Patients with underlying dermatoses or previous cutaneous insults may be particularly prone to adverse cutaneous reactions resulting from folic acid antagonists. PMID- 6863627 TI - Multicentric reticulohistiocytosis with salivary gland involvement and pericardial effusion. AB - A 60-year-old Palestinian woman developed extensive cutaneous lesions of multicentric reticulohistiocytosis. She also developed a pericardial effusion and involvement of the submandibular salivary glands. Soft tissue gallium images demonstrated this systemic involvement, and this procedure is proposed as a screening method to assess the extent of the disease. The patient showed partial remission after being treated with prednisone, vincristine sulfate, and cyclophosphamide. PMID- 6863628 TI - Cowden's disease (multiple hamartoma and neoplasia syndrome). A case report and review of the English literature. AB - Cowden's disease is a multisystem disease complex inherited as an autosomal dominant trait with incomplete penetrance and variable expressivity. Its mucocutaneous findings are the most characteristic feature of the syndrome and the key to its diagnosis. The findings of multiple facial trichilemmomas appear to be pathognomonic of the disease. Multiple extracutaneous hamartomas are a regular feature of Cowden's disease. The most important hamartomas to recognize include fibrocystic disease of the breast, thyroid goiters or adenomas, multiple polyposis of the gastrointestinal tract, and ovarian cysts. Although many developmental anomalies have been described in these patients, only adenoid facies and high-arched palates appear significant from a statistical standpoint. The most important feature of Cowden's disease, that which makes early recognition absolutely essential, is an increased prevalence of malignant neoplasia primarily in affected female patients, and principally involving the breasts and thyroid gland. All patients, however, must be screened for occult malignancies of all types. A detailed review of the English literature offers a basis for the formation of guidelines that should be helpful in making a diagnosis of the disease. PMID- 6863629 TI - Treatment of cutaneous pseudolymphoma with hydroxychloroquine. AB - A 45-year-old woman with generalized cutaneous pseudolymphoma of Spiegler-Fendt was successfully treated with hydroxychloroquine. It is felt that the suppression of lymphocyte and/or histiocyte function was responsible for the remission of the disease. This is apparently the first report of cutaneous pseudolymphoma of Spiegler-Fendt being successfully treated with antimalarials. The differentiation between cutaneous pseudolymphoma and cutaneous malignant lymphoma is also discussed. PMID- 6863630 TI - Sporotrichoid mycobacterial infections. Case report and review. PMID- 6863631 TI - Multiple agminated spindle cell nevi: unique clinical presentation and review. AB - A boy with agminated spindle cell nevi is described. Present within the area of involvement were congenital nevocellular and composite spindle/nevocellular nevi. Other unusual features included a dynamic pattern of growth and regression of the lesions, with the presence of halo nevi and background cafe au lait pigmentation. This unique presentation of multiple nevi is discussed in the context of previous reports of agminated spindle cell nevi. PMID- 6863632 TI - Red lunulae in a patient with rheumatoid arthritis. AB - Red nails, a distinctive, dusky red, blanchable erythema of the lunula area of the nail bed, has been previously reported three times in the English language literature, in each instance in association with alopecia areata. An identical case of red nails here in association with "classical" rheumatoid arthritis is reported. PMID- 6863633 TI - Liquid nitrogen cryotherapy in a case of elastosis perforans serpiginosa. PMID- 6863634 TI - Lichen aureus. AB - Lichen aureus is one of the rarest of the pigmented and purpuric dermatoses. The eruption consists of lichenoid papules and plaques with a golden to purplish color, and the histology reveals a dense and bandlike infiltrate hugging the epidermis. It consists of lymphocytes and histiocytes, often with extravasation of red cells. The eruption is asymptomatic and has a prolonged course. A case is presented which is unusual for its widespread localization, peculiar location, and rather dramatic response to topical therapy. PMID- 6863635 TI - Erythema marginatum in rheumatic fever: early diagnosis by skin biopsy. AB - Skin biopsy of a 10-year-old boy with a 3-week history of recurrent rash and fever demonstrated histologic changes suggesting a diagnosis of erythema marginatum associated with rheumatic fever. Subsequently, the patient developed classic cardiac and arthritic manifestations. Skin biopsy is recommended for the early diagnosis of rheumatic fever. PMID- 6863636 TI - Diet, nutrition, and allergy in atopic dermatitis. PMID- 6863638 TI - Necrolytic migratory erythema associated with diabetes mellitus. PMID- 6863637 TI - Monsel solution tattooing. PMID- 6863640 TI - Use of topical acyclovir. PMID- 6863639 TI - Tar vitiligo therapy. PMID- 6863641 TI - Meclofenamate (Meclomen) therapy of psoriasis. PMID- 6863642 TI - UVB is additive when repeated within an 8-hour interval. PMID- 6863643 TI - Coal tar phototherapy for psoriasis reevaluated: erythemogenic versus suberythemogenic ultraviolet with a tar extract in oil and crude coal tar. AB - Recent studies have questioned the therapeutic value of coal tar versus ultraviolet (UV) radiation and their relative necessity in phototherapy for psoriasis. In this investigation, different aspects of tar phototherapy have been studied in single-blind bilateral paired comparison studies. The effects of 1% crude coal tar were compared with those of petrolatum in conjunction with erythemogenic and suberythemogenic doses of ultraviolet light (UVB) using a FS72 sunlamp tubed cabinet. Crude coal tar was clinically superior to petrolatum with suberythemogenic ultraviolet. With the erythemogenic UVB, petrolatum was equal in efficacy to crude coal tar. Suberythemogenic UVB was also used adjunctively to compare the effects of a 5% concentration of a tar extract in an oil base to 5% crude coal tar in petrolatum or the oil base without tar. The tar extract in oil plus suberythemogenic UVB produced significantly more rapid improvement than the oil base plus UVB. The direct bilateral comparison of equal concentrations of tar extract in oil base versus crude coal tar in petrolatum in a suberythemogenic UV photo regimen revealed no statistical differences between treatments. In a study comparing tar extract in oil and the oil base without ultraviolet radiation, the tar extract in oil side responded more rapidly. This demonstrates a direct effect of tar alone in therapy. We have also studied the effects of erythemogenic and suberythemogenic UVB with and without tar extract in oil in the hairless mouse epidermal deoxyribonucleic acid (DNA) synthesis suppression assay. It was found that erythemogenic dosages of UVB produced near maximal inhibition of DNA synthesis with or without coal tars. Suberythemogenic dosages of UVB produced submaximal suppression of DNA synthesis that was enhanced by adjunctive coal tar but not by vehicle, findings which are consistent with the above clinical results. These studies suggest that coal tars combined with suberythemogenic UVB therapy is a practical alternative (to more aggressive UVB therapy without coal tar) which reduces the UVB exposure to the patient. PMID- 6863644 TI - Reduced threshold to suction-induced blister formation in insulin-dependent diabetics. AB - Diabetics may have an increased susceptibility to cutaneous blister formation clinically manifest as the bullous eruption of diabetes. We evaluated the mechanical force necessary to induce suction blisters in fifteen insulin dependent diabetics and twenty age-matched normal controls. The mean suction blister threshold for the diabetics was 31.9 minutes versus 68.0 minutes for the controls, a highly significant difference (p less than 0.01). Histologic appearance of suction blisters was similar in diabetic and normal skin, under both light and electron microscopic examination, with a noninflammatory subepidermal separation in the lamina lucida between the cell membrane and the basal lamina. These results demonstrate that insulin-dependent diabetics have a marked reduction in suction blister threshold as compared to age-matched controls. PMID- 6863645 TI - In vivo suppression of neutrophil chemotaxis by systemically and topically administered tetracycline. AB - In vivo suppression of neutrophil chemotaxis in humans by orally and topically administered tetracycline (TCN) was examined using both modified Boyden chamber and skin chamber assays. Chemoattractants were derived from serum complement and bacterial culture supernates. The results showed that oral TCN caused significant suppression of neutrophil chemotaxis when measured by both assays and both sources of chemoattractant. Furthermore, application of a commercially available topical preparation containing TCN caused local suppression of chemotaxis as measured by the skin chamber assay. These results show that TCN does suppress neutrophil migration in vivo, and they provide support for an anti-inflammatory effect of TCN mediated in part by suppression of neutrophil chemotaxis. PMID- 6863646 TI - Psoralen-containing sunscreen is tumorigenic in hairless mice. AB - Sunscreens containing 5-methoxypsoralen (5-MOP) are currently being marketed to promote tanning by inducing psoralen-mediated ultraviolet (UV) A (320-400 nm) melanogenesis. The rationale is that this may prevent UVB (290-320 nm) radiation induced skin damage. However, mouse studies have shown that 5-MOP has the same cutaneous photocarcinogenic potential as 8-methoxypsoralen. In addition, the 5 MOP--containing sunscreen Sun System III (SS III), when combined with UVA, induces epidermal ornithine decarboxylase activity, an enzyme associated with tumor promotion. Therefore, we investigated whether SS III had sufficient psoralen concentration to be tumorigenic in hairless mice exposed to chronic, intermittent UVA radiation. SS III was applied to hairless mice 5 days per week for 20 weeks. After each application the mice were exposed to 2.5 to 10 joules/cm2 UVA radiation. All test groups developed atypical squamous papillomas in direct proportion to the dosage of UVA radiation received. A shorter latency period for tumor development was seen with larger UVA doses. Test animals followed up to 1 year developed invasive squamous cell tumors. Control groups (SS III without UVA and UVA without SS III) remained free of tumors. Animals receiving SS III plus UVA developed persistent skin thickening and increased dermal cyst formation similar to that reported with chronic exposure to UVB, a known carcinogenic wavelength. Over-the-counter sunscreens containing 5-MOP do contain sufficient psoralen concentrations to cause cutaneous phototoxicity and photocarcinogenicity in mice, and their use in humans should be discouraged in the interest of preventing further UV-induced skin damage and skin cancer. PMID- 6863647 TI - Multiple large cell acanthomas. AB - Large cell acanthoma is a benign keratosis which occurs as a generally hyperkeratotic, sharply demarcated patch on actinically exposed skin. Clinically, it is usually misdiagnosed as a seborrheic keratosis or solar keratosis. The first two reports of multiple large cell acanthomas are described here. Clinical and histologic features were identical to a control series of sixteen solitary large cell acanthomas. Large cell acanthomas should be considered in the differential diagnosis of solitary and multiple keratoses on sun-exposed skin. PMID- 6863648 TI - A three-dimensional photography system for dermatologic diagnosis. PMID- 6863649 TI - Predictors of late deaths among patients with clinical stage I melanoma who have not had bony or visceral metastases within the first 5 years after diagnosis. PMID- 6863651 TI - Localized exogenous ochronosis. PMID- 6863652 TI - Delusions of parasitosis. PMID- 6863650 TI - Glaucoma following the prolonged use of topical steroid medication to the eyelids. PMID- 6863653 TI - Lay groups and the Society for Investigative Dermatology. PMID- 6863654 TI - Perilesional heparin injections for necrobiosis lipoidica. PMID- 6863655 TI - Successful therapy of ichthyosis linearis circumflexa with PUVA. PMID- 6863656 TI - Composition and SPF of Eclipse. PMID- 6863657 TI - Demodex folliculorum of Simon. PMID- 6863658 TI - The sunscreening effect of topical sunflower oil. PMID- 6863659 TI - Perianal comedones and topical corticosteroids. PMID- 6863660 TI - Serial nuclear magnetic resonance (NMR) imaging in patients with cerebral infarction. AB - Seven patients with supratentorial infarction were studied by means of serial nuclear magnetic resonance imaging using saturation recovery (SR) and proton density (PD) sequences. The earliest changes were visible in the more sensitive T1 dependent images (SR) and may reflect the cytotoxic component of ischemic brain edema. Further progress was also clearly discernible in the PD images and may mainly reflect the slower vasogenic component of ischemic brain edema. Nuclear magnetic resonance imaging seems to provide a new approach to early diagnosis of ischemic brain infarction. Furthermore, it may elucidate some aspects of the pathophysiology of ischemic stroke in man. PMID- 6863661 TI - Computed tomography of the parapharyngeal space. AB - The parapharyngeal space with its complex anatomy is of great clinical importance. Because of its location deep within the neck, this space is difficult to examine by ordinary methods but can be well demonstrated in the axial transverse plane by computed tomography (CT). This paper is primarily concerned with the normal anatomy of the parapharyngeal space as seen on CT but also includes examples of representative pathological conditions. PMID- 6863662 TI - Improved diagnostic accuracy in the TNM staging of laryngeal cancer using a new definition of regions based on computed tomography. AB - Neither laryngoscopy nor laryngography can match the accuracy with which computed tomography (CT) can display the full tumor extent or the presence of cartilage invasion. Data obtained from a CT-histologic correlative study have suggested a new definition of regions of the larynx for use with the TNM staging of laryngeal cancer. The arytenoid cartilage, readily identifiable by CT, is used for reference. The regions are as follows: (a) supra-arytenoid, (b) midarytenoid, (c) vocal process, and (d) infra-arytenoid. Tumors with a strong propensity for cartilage invasion can be distinguished from those without this tendency. In addition, tumors with different pathways of lymphatic drainage can be identified. PMID- 6863663 TI - Computed tomography of malignant pleural mesothelioma. AB - We tabulated the computed tomographic (CT) findings in 14 consecutive patients who had proven malignant pleural mesotheliomas and were studied over a 3-year period. We also staged the disease in these patients, all of whom were men, aged 40-75 years (mean, 59), and had been exposed to asbestos at work. Common presenting symptoms were shortness of breath or chest pain. Pleural thickening was found on the side of the tumor in all of the patients, characterized as nodular and circumferential (6/14 cases), plaque-like (4/14), or strictly nodular (4/14) in appearance. In addition, 86% of the patients demonstrated contralateral pleural thickening, but these lesions did not prove to be tumor deposits. Other common CT findings in the involved hemithorax included: pleural effusions (79% of cases), lung parenchymal disease (79%), decreased hemithorax size (62%), and pleural calcification (50%). Before the chest scans were performed, 13 patients were felt to have Stage I disease and one to have Stage IV. The CT information revised these opinions: four of the Stage I patients were assigned to Stage II (on the basis of chest wall involvement or enlarged hilar/mediastinal lymph nodes). Therapy was altered in these four cases. In two patients pericardial thickening was seen, but it was not possible to determine if this was due to tumor involvement. We conclude that CT can identify several abnormalities that are commonly associated with mesotheliomas. By demonstrating lesions not detectable on conventional imaging studies, CT may alter staging and therapy in many patients with this disease. PMID- 6863664 TI - Computed tomography of the diaphragm: normal anatomy and variants. AB - Computed tomographic examinations in 75 normal individuals are analyzed to define the cross-sectional anatomy of the diaphragm. Anatomic relationships among the inferoposterior portions of the lungs, the pleura, and the hemidiaphragms are clarified. The posterior pleural recess, an important potential space, is described and illustrated. The relationships of the crura, arcuate ligaments, and the hemidiaphragms are discussed as well. Awareness of these anatomic relationships forms an important basis in analyzing peridiaphragmatic fluid collections. PMID- 6863665 TI - Computed tomography of the diaphragm: peridiaphragmatic fluid localization. AB - Fifty-eight consecutive cases of peridiaphragmatic fluid collections were correctly localized by computed tomography. The key to accurate localization of peridiaphragmatic fluid is identification of the hemidiaphragms. Pulmonary consolidation and pleural fluid collections lie adjacent and peripheral to the convexity of the hemidiaphragms. Free pleural fluid distends the posterior pleural recesses, important anatomic landmarks beneath the bases of the lungs. Intra-abdominal fluid collections lie adjacent and central to the convexity of the hemidiaphragms. On the right side intraperitoneal fluid is restricted from contact with the bare area of the liver by the coronary ligaments. It is concluded that peridiaphragmatic fluid collections can generally be readily identified if one is familiar with normal cross-sectional anatomy. PMID- 6863666 TI - Computed tomography of breast lesions: comparison with x-ray mammography. AB - Thirty-three patients with breast lesions demonstrated by mammography were examined with computed tomography (CT) using a standard whole body scanner. Although the CT images were of good diagnostic quality, the amount of new information gained was limited. The diagnostic accuracy of mammography in the hands of an experienced reader was higher than that with CT. We conclude that, although technically a whole body scanner is capable of producing good images of the breast, the number of patients in whom CT should be used instead of or in addition to mammography is limited. The indication for its use was primarily for patients in whom quality mammograms could not be produced because either the breast was unusually dense or extensive breast disease caused technical difficulties in performing mammograms. Computed tomography was also useful if the interpretation of the mammogram was equivocal, regional lymph node enlargement was questioned, invasion of the chest wall by tumor was suspected, and for planning radiotherapy treatment. PMID- 6863667 TI - Clinical value of ultrasonography for the management of non-Hodgkin lymphoma patients as compared with abdominal computed tomography. AB - In 50% of 84 ultrasonographic (US) examinations ordered for staging and restaging of non-Hodgkin lymphoma (NHL) patients, the abdomen and pelvis were not sufficiently visualized to allow diagnostic conclusions, whereas nondiagnostic studies were found in only 3% of the 102 computed tomographic (CT) examinations. Discrepancy about the presence and extent of disease below the diaphragm between US and CT occurred in 74%. The US underestimated the presence or extent of disease in nodal stations caudal to the pancreas more commonly than in other areas evaluated. Because of increased cost, patient inconvenience, and delay in therapeutic intervention due to repeat examinations, it is recommended that CT be used as the initial examination for staging, restaging, or following infradiaphragmatic disease in NHL patients. PMID- 6863668 TI - Comparison of computed tomography and aortography in abdominal aortic aneurysms. AB - In a prospectively designed study of 13 consecutive patients with proven abdominal aortic aneurysm, the diagnostic accuracy of computed tomography (CT) was compared with aortography. Computed tomography was found to be a highly informative diagnostic test providing clear delineation of lesions and extent of aneurysm and its relationship to renal and iliac arteries. Furthermore one case of retroperitoneal fibrosis and one case of hydronephrosis were demonstrated by CT. The diagnosis of aneurysm by aortography was uncertain in six cases and in another three cases the relation of the aneurysm to the renal arteries was uncertain. Thus CT was found superior to aortography in examining patients for abdominal aortic aneurysm. PMID- 6863670 TI - Low attenuation nodal metastases in testicular carcinoma. AB - Abdominal and thoracic computed tomography examinations were abnormal in 23 of 57 patients (40.5%) with seminomatous and nonseminomatous testicular tumors. Lymph node metastases measuring less than 30 Hounsfield units (HU) occurred in 10 of these 23 patients (43.5%), five with seminoma, four with mixed germ cell tumors, and one patient with embryonal cell carcinoma. Biopsy material was obtained from low attenuation metastases in four patients. Three patients who had completed chemotherapy had evidence of extensive necrosis, but two of three had persistent tumor. In the fourth patient, a case of untreated mixed germ cell tumor, there were numerous small epithelial-lined cystic spaces. Biopsies from five patients with nodal masses measuring greater than 30 HU showed no necrosis or cystic change. There was no significant correlation between the attenuation characteristics of the metastases and clinical activity of the tumor. PMID- 6863671 TI - Computed tomography of ossifying fibroma of the tibia. AB - Two ossifying fibromas of the tibia were studied by computed tomography, which showed that the lesions were composed predominantly of high density tissue and that they were located in the cortex. The tissue density indicated that the tumors were diffusely ossified or calcified. The intracortical site is typical of ossifying fibroma, but it is unusual in other lesions of similar appearance. PMID- 6863672 TI - Wegener granulomatosis invading the cavernous sinus: a CT demonstration. AB - A case of localized cranial Wegener granulomatosis was imaged with high resolution computed tomography. The mass extended from the infratemporal fossa, through the basal foramina, and into the cavernous sinus, causing complete occlusion of the internal carotid artery. Computed tomography demonstrated absence of bone destruction and a normal parotid gland and nasopharynx. Although uncommon, Wegener granulomatosis should be considered in the differential diagnosis of a parapharyngeal mass with intracranial extension. PMID- 6863669 TI - Computed tomography in malignant endometrial neoplasms. AB - Malignant uterine neoplasms are the most common invasive gynecological malignancies. The prognosis depends on the history, the grade, and the stage. Recent reports have stressed that a small percentage of patients with clinically low stage disease have unsuspected metastases. We retrospectively reviewed 61 patients with known malignant uterine neoplasms. In 18 patients with preoperative computed tomographic examinations, these scans detected unsuspected omental metastases in two and pelvic adenopathy in three. There was one false positive and one false negative examination. Computed tomography was superior to the clinical examination in defining the extent of the tumor in five patients. Computed tomography was also helpful in evaluating patients with suspected recurrent disease. PMID- 6863673 TI - Computed tomography in calcification of ligamenta flava of the cervical spine. AB - A case with cervical myelopathy caused by massive calcifications of ligamenta flava is presented. The round radiopaque nodules were found on conventional cervical radiography. Following examination by computed tomography, the nodules were diagnosed as calcified ligamenta flava in the cervical spine. The findings were confirmed at surgery and by histological investigations. PMID- 6863674 TI - CT appearance of bronchial carcinoid with recurrent pneumonia and hyperplastic hilar lymphadenopathy. AB - Computed tomography in a man with recurrent right lower lobe pneumonias showed an endobronchial mass associated with hilar lymph node enlargement. Because of this combination of findings, bronchogenic carcinoma with hilar node involvement was suggested as likely. Surgery revealed a carcinoid bronchial adenoma limited to the bronchus, with hyperplastic lymph node enlargement resulting from pneumonia. Care must be taken not to assume that hilar lymph node enlargement represents tumor, even when associated with an endobronchial lesion. PMID- 6863675 TI - Pitfall in the CT diagnosis of pulmonary arteriovenous malformation. AB - A peripheral adenosquamous carcinoma of the right lung with atypical rich vascularization of the central scar was misinterpreted as an arteriovenous malformation based on a chest X-ray examination and a dynamic computed tomographic study. PMID- 6863676 TI - Chronic stridor in a child: CT diagnosis of pulmonary vascular sling. AB - A child without chronic stridor and tracheal narrowing was considered to have a primary tracheal abnormality. Computed tomography (CT) identified an aberrant left pulmonary artery originating from the right pulmonary as the cause of the tracheal abnormality. The advantages of CT over conventional studies are discussed. PMID- 6863677 TI - CT demonstration of an esophageal duplication cyst. AB - The computed tomographic (CT) appearance of an esophageal duplication cyst is reported. The value of CT in evaluating the extent of the lesion and ruling out other associated anomalies is discussed. PMID- 6863678 TI - CT demonstration of bilateral Castleman tumors in the mediastinum. AB - A case of bilateral Castleman tumors in the posterior mediastinum is described. Computed tomography proved to be an accurate, noninvasive method of investigation since it identified not only a large mass but also a smaller mass, which was not visible on standard chest X-ray film. Complete surgical excision was possible. The high attenuation values of both masses demonstrated the hypervascularity of the lesion. PMID- 6863679 TI - Infiltrating periductal neoplasm mimicking biliary dilatation on computed tomography. AB - A case is reported in which hypodense linear structures on postcontrast computed tomography were not intrahepatic biliary dilatation but periductal extension of pancreatic carcinoma. PMID- 6863680 TI - CT demonstration of an ectopic pancreatic tail causing a renal pseudotumor. AB - Renal pseudotumors may be intrinsic or extrinsic to the renal parenchyma. A case in which an ectopic position of the pancreatic tail simulated a solid left renal mass on nephrotomography and ultrasonography is presented. Computed tomography was important in confirming the etiology of the mass. PMID- 6863681 TI - Anomalous preaortic interazygous vein. PMID- 6863682 TI - CT localization and aspiration of postoperative pericardial fluid collection. AB - The authors report a case in which computed tomography (CT) was used to guide percutaneous needle aspiration of postoperative pericardial and paracardiac fluid collection. This application of CT has particular importance in postsurgical cardiac patients because of the loculated nature and occasional atypical location of fluid collections. PMID- 6863683 TI - Elevated phosphorus in psoriatic skin determined by energy dispersive x-ray micro analysis. AB - Scanning electron-microscopy in combination with secondary electron imaging and x ray energy spectrometry (electron-probe micro-analysis) was performed on the stratum corneum of involved and uninvolved, psoriatic skin. The significant, elemental alterations included an increase in phosphorus and calcium in the involved skin regions. A composite, chemical, elemental profile of normal and uninvolved, psoriatic stratum corneum is presented. PMID- 6863686 TI - Cutaneous manifestations of malignant mesothelioma of the tunica vaginalis testis. PMID- 6863687 TI - A case of elastosis perforans serpiginosa: an ultrastructural study. PMID- 6863684 TI - Proliferating trichilemmal cyst. AB - Fourteen cases (9 female, 5 male) of proliferating trichilemmal cysts are reported. The patients age-range was 40-80, 12 being over 60. The cysts wee present for 2-50 years and enlarged in the months or years before the observation. Seven were ulcerated. In 4 with multiple lesions both proliferating and ordinary trichilemmal cysts were present. The histological features were typical in all but one patient (evolution towards squamous cell carcinoma?) with some variation from lesion to lesion and from area to area in the same tumour. The microscopic features suggest that the proliferating trichilemmal cyst must be considered an hamartoma of the terminal hair follicle, not only related to the isthmic segment of the outer root sheath but with some differentiation (smaller and more variable) towards the infundibular and matricial segments. The tumour is likely to be a proliferating trichilemmal cyst from the beginning and not a peculiar evolution of an ordinary, pre-existant, trichilemmal cyst. PMID- 6863685 TI - Acral lentiginous melanoma simulating "clear cell sarcoma of tendon and aponeuroses". AB - Clear cell sarcoma was closely mimicked in metastatic tumor deposits from two patients with acral lentiginous malignant melanoma. A subcutaneous deposit composed of glycogen-laden spindle cells dominated the presenting clinical picture in one patient. In the other, primary acral melanoma resembled a histiocytic tumor and metastatic tumor simulated clear cell sarcoma. The cases illustrate the pleomorphism that may be encountered in malignant melanoma. PMID- 6863688 TI - A survey of sources of heat-resistant bacteria in milk with particular reference to psychrotrophic spore-forming bacteria. AB - Samples of winter bedding and summer pasture, rinses of teats and milking equipment, and milk samples from bulk tanks from 4 farms were analysed bacteriologically for total count (TC), thermoduric count, total spore count (TSC) and psychrotrophic spore count (PSC). In bedding and pasture samples the TSC comprised the main component of the thermoduric flora but was less than 0.1% of the TC. The PSC formed approximately 1% of the TSC in winter bedding and approximately 23% of the TSC in pasture. For pasture, the PSC:TSC ratio was highest for the upper layer of soil and lower for the grass and deeper layer of soil. The TSC formed 5% of the thermoduric flora in rinses of milking equipment and only a very low PSC was obtained. The TSC of farm bulk tank milks was higher in the winter than the summer but the PSC was similar in both seasons. This was due to an increase of approximately 9 times in the PSC:TSC ratio for milks in summer compared with winter. The PSC in raw and commercially pasteurized milks from a local creamery showed a similar seasonal trend. PMID- 6863689 TI - An evaluation of the Charm test--a rapid method for the detection of penicillin in milk. AB - Using the Charm radioactive assay technique as a rapid test for the determination of penicillin in milk in experiments with milks containing known concentrations of penicillin, the coefficient of variation was found to be 15 and 11% for raw whole and reconstituted skim-milks respectively. Storage of reagents for up to 4 d increased the variance of the test by more than 20% and the estimated penicillin concentration 0.4%/d of storage up to 25 d. In comparison with the Bromocresol Purple Test, which was capable of 100% accuracy in defining a threshold of 0.02 i.u. penicillin/ml milk, the Charm Test falsely classified 15.6% of the samples. PMID- 6863690 TI - Alkylglycerols in bovine colostrum and milk in relation to precursor levels. AB - The concentrations of dihydroxyacetone phosphate (DHAP), glycerol-3-phosphate (GP), glucose and alkylglycerols were measured in bovine colostrum and milk. Concentrations of GP were higher in colostrum than in milk, and corresponded to intracellular concentrations at the onset of lactation. This suggests that GP equilibrates over the apical membrane at onset of lactation, which is believed to occur also in full lactation. The ratio of DHAP to GP showed a peak in colostrum that was more than twice that in milk, indicating that concentration changes in colostrum/milk were not caused by dilution. DHAP was positively correlated to metabolical compounds such as glucose and alkylglycerols. As DHAP is a required precursor for alkylglycerol synthesis, the positive correlation suggests that DHAP may be limiting for alkylglycerol synthesis and thus could explain the elevated levels of alkylglycerols found in colostrum. PMID- 6863691 TI - Prediction of individual outcome in a group intervention for depression. PMID- 6863692 TI - Premorbid functioning and outcome in schizophrenia: a cumulative analysis. PMID- 6863693 TI - Use of the psychiatric evaluation form to quantify children's interview data. PMID- 6863694 TI - Classifying college students as depressed or nondepressed using the Beck Depression Inventory: an empirical analysis. PMID- 6863695 TI - A research note on the relation between the free association and experiencing scales. PMID- 6863696 TI - Recoverability of psychological functioning following alcohol abuse: prolonged visual-spatial dysfunction in older alcoholics. PMID- 6863697 TI - Children's Rorschach scores as predictors of later adjustment. PMID- 6863698 TI - Relationship between shyness in children and constricted cognitive control as measured by the Stroop Color-Word Test. PMID- 6863699 TI - Stages and processes of self-change of smoking: toward an integrative model of change. PMID- 6863700 TI - Hazards of a standardized neuropsychological test with low content validity: comment on the Luria-Nebraska Neuropsychological Battery. PMID- 6863702 TI - IQ level and performance on the Halstead-Reitan Neuropsychological Test Battery for Older Children. PMID- 6863701 TI - Methodological considerations in the assessment of depression in alcoholics. PMID- 6863703 TI - Identification of multiple sclerosis using double discrimination scales derived from the Luria-Nebraska Neuropsychological Battery: an attempt at cross validation. PMID- 6863704 TI - Circumstances surrounding the occurrence of child maltreatment. PMID- 6863705 TI - "Trance" versus "skill" hypnotic inductions: the effects of credibility, expectancy, and experimenter modeling. PMID- 6863706 TI - Discrimination of brain damage from chronic psychosis by the Luria-Nebraska Neuropsychological Battery: a closer look. PMID- 6863707 TI - Observational biases in spouse observation: toward a cognitive/behavioral model of marriage. PMID- 6863708 TI - A validation of the Leiter International Performance Scale with kindergarten children. PMID- 6863709 TI - Validity of two- and four-subtest short forms of the WAIS-R in psychiatric sample. PMID- 6863710 TI - Societal reactions to a child's death by suicide. PMID- 6863711 TI - Partner support and relapse in smoking-cessation programs. PMID- 6863712 TI - Physiological reactivity and recent life-stress experience. PMID- 6863713 TI - Validity of two scoring systems for measuring cognitive development with the Rorschach. PMID- 6863714 TI - Long-term persistence of selected insecticides in subtropical soil: their absorption by crop plants. PMID- 6863715 TI - Evaluation of sequential releases of Spalangia endius (Hymenoptera: Pteromalidae) for control of house flies and stable flies (Diptera: Muscidae) associated with confined livestock in eastern Nebraska. PMID- 6863717 TI - Susceptibility of the American dog tick (Acari: Ixodidae) to residues of acaricides: laboratory assays. PMID- 6863718 TI - An "alarming" situation in the intensive therapy unit. PMID- 6863716 TI - Survey of resistance to insecticides among screwworm (Diptera: Calliphoridae) populations from various geographical regions. PMID- 6863719 TI - Viruses and intensive care. PMID- 6863720 TI - Endotoxaemia in septic shock: clinical and post mortem correlations. AB - The Limulus amoebocyte lysate assay was used as one of a series of laboratory and clinical investigations on a group of 31 patients suffering from septic shock in order to assess the clinical significance of this assay for the detection of circulating endotoxin in clinical gram-negative sepsis. Four patients with cardiogenic shock served as controls. Endotoxin was detected in the bloodstream of all patients with septic shock during the 24 h following referral and was not detected in the control patients. Eventual clinical recovery was associated with the disappearance of endotoxin from the peripheral blood. Blood cultures were unhelpful as a prognostic indicator in these critically ill patients. A quantitative assay of endotoxin in blood may allow a more precise relationship with the clinical manifestations of major sepsis. PMID- 6863722 TI - Catheter tip embolism--a continuing iatrogenic complication of central venous catheterisation. PMID- 6863721 TI - The influence of urapidil, a new antihypertensive agent, on cerebral perfusion pressure in dogs with and without intracranial hypertension. AB - The influence of urapidil, an arylpiperazinederivate, on intracranial pressure (ICP), mean arterial pressure (MAP) and cerebral perfusion pressure (CPP) was investigated in dogs with (group II) and without (group I) intracranial hypertension. After i.v. administration of urapidil, intracranial pressure remained unchanged and cerebral perfusion pressure decreased to the same extent as mean arterial pressure (20%). As in neurosurgical patients, autoregulation of cerebral blood flow is often lost; a sudden increase in blood pressure may lead to an increase in cerebral blood flow and to a damage of the blood bain barrier with consequent cerebral edema. Urapidil seems to be suitable for treating hypertensive episodes perioperatively in neurosurgical patients. PMID- 6863723 TI - Quantitative assessment of carbon tetrachloride levels in human blood by head space gas chromatography: application in a case of suicidal carbon tetrachloride intoxication. AB - A head-space gas chromatographic method for the determination of carbon tetrachloride in human blood is described. Standard samples with 0.5 ml whole blood containing different concentrations of CCl4 were analyzed at column temperatures ranging from 50 degrees to 90 degrees C. Advantages of this method include high sensitivity, simplicity in handling, rapid achievement of reliable results, accuracy and low costs. The practicability of this analytical method was studied in a patient following suicidal oral ingestion of a lethal dose of carbon tetrachloride. PMID- 6863724 TI - Acinetobacter mediastinitis and pneumonia in a thorotrastoma patient. The oropharyngeal flora as source of infection. AB - A case of bilateral pneumonia, mediastinitis and septicaemia caused by Acinetobacter calcoaceticus and Candida albicans is described. The infections occurred after a palliative operation for an esophagotracheal fistula in a thorotrastoma patient. The oropharynx was colonized by the two microorganisms at admission and is presented as the source of these infections. Clinical management and antimicrobial policy, including oropharyngeal decontamination, leading to a good outcome are reported. PMID- 6863725 TI - Hypothermia for heart failure. PMID- 6863726 TI - Patient controlled analgesia following myocardial infarction. PMID- 6863727 TI - Abstracts of the 2nd European meeting on intensive care. Geneva, Switzerland, 17 20 May 1983. PMID- 6863728 TI - Social-environmental factors in unipolar depression: comparisons of depressed patients and nondepressed controls. PMID- 6863729 TI - Depression, alcohol use, and smoking over one year: a four-wave longitudinal causal model. PMID- 6863730 TI - Psychosocial correlates of depressive symptomatology in adult women. PMID- 6863731 TI - Causal attributions and perinatal depression. PMID- 6863732 TI - Cognitive patterns and major depressive disorder: a longitudinal study in a hospital setting. PMID- 6863733 TI - Depressive reactions and unemployment. PMID- 6863735 TI - Restraint theory and its applicability to overweight individuals. PMID- 6863736 TI - Hypnotic elimination of prism-induced aftereffects: perceptual effect or responses to experimental demands? PMID- 6863734 TI - The effects of another person's response style on interpersonal behavior in depression. PMID- 6863737 TI - Dissociation, duality, and demand characteristics in hypnosis. PMID- 6863738 TI - Amnesia observed: remembering and forgetting in a natural environment. PMID- 6863739 TI - Interference effects in autistic children: evidence for the comprehension of single stimuli. PMID- 6863740 TI - Age, socioeconomic status, severity of mental disorder, and chronicity as predictors of physical attractiveness. PMID- 6863741 TI - Time-of-day corrections in measures of aircraft noise exposure. AB - Results of a socio-acoustic study of human reaction to aircraft noise around Australian airports are described. The relative importance of night, evening, and daytime operations in determining overall reaction is assessed using a correlation analysis procedure. The results indicate that night-time weightings used in most existing noise exposure indices including NEF and DNL, are too large. However, other evidence suggests that both night and evening weightings should be greater than 0 dB. The optimal weightings found were about 3 dB for night-time operations and 9 dB for evening operations. However, other considerations indicate that in a practical noise index it may be more reasonable to apply a weighting of about 6 dB during both night and evening hours. PMID- 6863742 TI - On the undamped natural frequencies and mode shapes of a finite-element model of the cat eardrum. AB - This paper presents a three-dimensional finite-element model of the cat eardrum which includes inertial effects. The model is implemented using a hierarchical modeling scheme which permits the mesh resolution to be varied. The static behavior of the model is calculated as a function of mesh resolution in order to check the validity of an earlier model. The first six undamped natural frequencies, and the corresponding modal vibration patterns, are then calculated. They are found to lie between about 1.8 and 3.2 kHz for the standard values chosen for the model parameters. The effects on the natural frequencies of varying seven parameters of the model are described. PMID- 6863743 TI - The temperature dependency of neural and hair cell responses evoked by high frequencies. AB - A fine thermocouple, placed on the round window of the guinea pig cochlea, was used to measure temperature and electrical potentials. In acute experiments, rectal temperature was held constant at 38 degrees C while cochlear temperature was varied between 38 degrees C and 31.5 degrees C. Cochlear cooling to 36 degrees C caused elevated thresholds for the compound action potential (CAP) in response to tone bursts with frequencies above 24 kHz. CAP latencies increased for all frequencies tested (2 to 40 kHz). Cooling to lower temperatures produced larger latency increases and greater threshold shifts which extended to CAPs evoked by frequencies as low as 16 kHz. These CAP changes were fully reversible after a cochlear temperature of 38 degrees C was restored. In an attempt to create more uniform cooling of the cochlea, experiments were also conducted with round window thermo-couples chronically implanted in guinea pigs. After cooling the entire anesthetized animal to 36 degrees C, CAP thresholds were again elevated only for frequencies above 24 kHz. In other acute experiments, extracellular dc receptor potentials were recorded from the organ of Corti with micropipettes. Cooling caused a decreased sensitivity to tones at the characteristic frequency of the recording location (20 kHz) and had less effect on responses to lower frequencies. The receptor potential usually recovered after rewarming the cochlea. These data emphasize that temperature is an important parameter when electrophysiological measurements are being made. They also suggest an explanation for the reported discrepancy between behavioral and electrophysiological thresholds at high frequencies. PMID- 6863745 TI - Target detection in reverberation by an echolocating Atlantic bottlenose dolphin (Tursiops truncatus). AB - An experiment was conducted to determine the ability of an echolocating Atlantic bottlenose dolphin (Tursiops truncatus) to detect targets in the presence of reverberation. Reverberation was induced by a clutter screen consisting of forty eight 5.1-cm-diam cork spheres spaced 15.2 cm apart and arranged in a rectangular array, located behind the targets. Hollow aluminum cylinders having the same outer diameter and wall thickness and three different lengths were used as targets. The dolphin was trained to station in a hoop, 6 m from the targets, and to echolocate the target upon the reception of an audio cue. Only one of the targets would be presented in a target-present trial. Data were collected on the animal's detection performance as a function of the separation distance between the clutter screen and the targets. The animal's performance for the smallest cylinder varied from 91% to 55% correct as the separation distance decreased from 10.2 to 0 cm. The target strength of the clutter screen and the cylinders were measured both in terms of the energies and the maximum peak-to-peak amplitudes of the incident and reflected echoes. These measurements indicated that when the target-clutter screen separation distance was 0 cm, the dolphin's 50% correct detection occurred at an energy echo-to-reverberation ratio of approximately 0.25 dB and at peak-to-peak echo-to-reverberation ratio of 2.6 dB. The results also indicated that the dolphin's performance varied almost linearly with the echo-to reverberation ratio. The animal's pulse emissions were monitored by a microprocessor system and the results are presented in terms of the average number of clicks and the average response latency, as a function of the separation distance. PMID- 6863744 TI - Comparison of click responses of primary auditory fibers with minimum-phase predictions. AB - Minimum-phase impulse responses were constructed from the frequency threshold response curves of primary auditory fibers in the anesthetized cat. These impulse responses had many of the same characteristics as the experimental click responses. The two types of responses had similar inter-peak intervals as well as similar (+/- 1.5 ms) latencies to the principal mode and similar (+/- 1.0 ms) intervals from response onset to the principal mode. PMID- 6863746 TI - Forward masking patterns for harmonic complex tones. AB - Complex tones containing the first ten harmonics at equal amplitude, and with fundamental frequencies of 100, 200, or 400 Hz, served as maskers for brief sinusoidal signals (10-, 20-, or 40-ms duration) presented immediately following the maskers. Threshold was measured as a function of signal frequency, using an adaptive, two-alternative forced-choice procedure. The starting phase of the signal relative to the masker had no significant effect on threshold. The masking patterns showed clear peaks corresponding to the first 3 or 4 harmonics, but no peaks were visible for higher harmonics. It is concluded that the "ripple" in the internal spectra of the maskers amounts to 3 dB or less for harmonics above the fifth. PMID- 6863747 TI - The origin of tonality and a possible explanation of the octave enlargement phenomenon. PMID- 6863748 TI - Pitch of narrow-band signals. AB - This study investigated the pitch elicited by complex narrow bandwidth signals. These signals ranged from two-component tones to multiple-component approximations of narrow-band noise. All were contained within 10-, 20-, or 50-Hz bandwidths. Listeners were asked to adjust the frequency of a pure tone to match the pitch they heard in a given complex signal. A simple model suggests that the pitch of these complex signals should match that of a pure tone set to the center frequency. For a majority of the signals, the performance of three of our four listeners was not different from the model predictions. However, the two component signals were apparently resolved and two simultaneous pitches were heard by some listeners. Our fourth listener heard two sequential pitches in many of the complex signals. We are unable to account for that performance although the pitch matches were very repeatable. These results have implications for an understanding of pitch coding and auditory spectral resolution. PMID- 6863749 TI - Detection of interaural differences of intensity in trains of high-frequency clicks as a function of interclick interval and number. AB - Listeners were asked to detect interaural differences of intensity in trains of 4000-Hz clicks as the interclick interval (ICI) was varied from 10 to 1 ms and the number of clicks in a train (n) was varied from 1 to 32. As has previously been shown for differences of time [Hafter and Dye, J. Acoust. Soc. Am. 73, 644 651 (1983)], plots of log interaural threshold versus log n produced slopes that decrease with ICI. These results are explained in terms of a saturation model which argues that as the click rate increases, the evoked neural activity changes from what is essentially a tonic response toward one that is more phasic. PMID- 6863750 TI - Interaural time and amplitude discrimination in noise. AB - Just-noticeable differences (jnds) of both interaural time delay (ITD) and interaural intensity difference (IID) were measured for binaural tones in the presence of broadband maskers. The tones were presented at 50 dB SPL, the target frequency was 500 Hz, and the masker frequency was 100-1000 Hz, with various combinations of ITD and IID. The time and amplitude jnds exhibit similar dependencies on target-to-masker ratio and masker type. At a given target-to masker ratio, discrimination was generally best in the presence of diotic maskers and worst in the presence of the interaurally out-of-phase maskers. Results for the other masker types examined tended to fall in between these two extremes. Many of these data trends are consistent with predictions of the lateralization model and the position-variable model based on auditory-nerve activity. PMID- 6863753 TI - Further evidence of acoustic invariance in speech production: the stop-glide contrast. AB - We have conducted a detailed comparative acoustic analysis of the labial stop and glide, [b] and [w], and we have attempted to identify an invariant acoustic property which can accurately distinguish stops and glides. To this end, we conducted three experiments. In experiment I, we undertook computer analysis of the labial stop [b] and the labial glide [w] as produced in five vowel contexts by two speakers. Results indicated that transition durations and formant frequencies often differed considerably in these two classes of sounds--and to a much greater extent than suggested in previous perception experiments. In experiment II we examined a measure of amplitude--unit energy. We calculated the degree of relative amplitude change occurring in the vicinity of the stop and glide release and found reliably larger changes in energy associated with the stop release than the glide release across vowel contexts and speakers. These changes seemed to provide an invariant property characterizing the stop--glide contrast. In experiment III we tested the generality of our claims by examining a new set of data consisting of the stops [d] and [g] and the glide [y]. Results of this experiment further supported our hypothesis. We have related our findings to a general theory of acoustic invariance in speech. PMID- 6863752 TI - Declination of fundamental frequency in speakers' production of parenthetical and main clauses. AB - An experimental study was conducted to investigate fundamental frequency (F0) contours in sentences with and without parenthetical clauses. Sentences consisted of a systematically lengthened parenthetical clause inserted between the subject noun phrase and the verb phrase of the main clause. The middle portion of the parenthetical was lengthened incrementally in each sentence to test the effects of sentence length on fundamental frequency contours of seven test sentences. Computer-aided measurements were made for: F0 peaks of key stressed segments; duration of the main clause, parenthetical clause, and clause-final syllables within each; and pauses immediately preceding and following the parenthetical. Mean results demonstrate: (1) a drop in F0 for the parenthetical clause, well below the main clause declination and forming a separate contour of declination; (2) a sharp rise in F0 on return to the main clause; (3) no effect of longer parenthetical length on final segment durations of either the parenthetical or the main clause; and (4) no effect of increased parenthetical length on main clause duration or pause length. These results suggest that parenthetical clauses are mentally programmed as independent constituents, but are subject to some of the same general declination constraints as main clauses. PMID- 6863751 TI - The influence of inter- and intra-speaker tempo on fundamental frequency and palatalization. AB - A study was conducted to examine the influence of speaking rate and emphatic stress on patterns of fundamental frequency (F0) and palatalization across word boundaries. Two groups of speakers, exhibiting characteristically fast versus slow speech, uttered preselected sentences at normal, fast, and slow rates. Acoustic analysis of F0 showed somewhat higher F0 peaks for characteristically fast speakers and for fast rates of speech. Emphatic stress was accompanied by a typical heightening of F0 on the emphasized word and by a lowering of F0 on a neighboring word. Palatalization across word boundaries was more frequent among characteristically fast speakers and at fast rates of speech. In addition, palatalization was more frequent in the absence of emphatic stress at the key site. The results for F0 were discussed in terms of the influence of vocal fold tension, while the results for palatalization were discussed in terms of the incompatibility of phonological processes of lengthening versus shortening as well as possible look-ahead restrictions. PMID- 6863755 TI - Reply to "Comments on "ear dominance and sequential interactions"' by E. William Yund. PMID- 6863754 TI - Some effects of speaking rate on the production of /b/ and /w/. AB - One of the acoustic properties distinguishing the syllable-initial stop consonant /b/ from the semivowel /w/ is the duration of the initial formant transitions; syllables beginning with /b/ have shorter transitions than those beginning with /w/. This experiment investigated the way in which the transition durations of /b/ and /w/ change as a function of speaking rate by examining tokens of /ba/ and /wa/ produced by four male speakers. At any given speaking rate the /wa/ transitions were, on average, longer than the /ba/ transitions, although pooled across rates, the distributions of transition duration for /ba/ and /wa/ were overlapping. In addition, the magnitude of the difference between average /ba/ and /wa/ transition durations increased with decreases in speaking rate. This is because as rate of speech decreased so that syllable duration increased, there was little change in the initial transition duration of /ba/, but a considerable increase in the initial transition duration of /wa/. Given the overall pattern of results, the transition duration that could optimally distinguish /ba/ from /wa/ was not constant, but increased with syllable duration. This is in accord with Miller and Liberman's (1979) finding that when listeners identify /ba/ and /wa/ on the basis of transition duration, they do so in relation to the duration of the syllable. PMID- 6863756 TI - Cancer produced by nonoccupational asbestos exposure in the United States. PMID- 6863757 TI - Spontaneous remission is a frequent outcome of variant angina. AB - To assess the prevalence of spontaneous remission in variant angina, 100 patients with this diagnosis who had undergone coronary arteriography in the hospital and a follow-up of at least 1 year were studied. Patients with coronary bypass surgery or myocardial infarction were excluded. Remission was diagnosed in 45 of the 100 patients who had been angina-free and had had no treatment for more than 3 months (mean 18.3). The other 55 patients were receiving medical treatment; 37 had been angina-free for at least 6 months (mean 22.5) and angina persisted in 18. The persistent angina group had a lower prevalence of organic coronary stenoses 70% or greater: 4 of 18 versus 22 of 45 and 22 of 37 for the other two groups (p less than 0.05), and a longer history of rest angina before admission. The remission group contained more patients (17 of 45 versus 4 of 55 [p less than 0.001]) whose attacks had been documented only by provocative testing. Rest angina recurred when calcium antagonist drugs were discontinued in 15 of 51 instances, within 1 month in 11 patients and later in 4 patients. Remission was eventually attained in 35 of the 38 patients in whom these drugs were stopped. These results indicate that remission is a frequent outcome of variant angina. This fact should be considered in the evaluation of the long-term results of treatment and in the planning of care for an individual patient. PMID- 6863758 TI - Systolic function during exercise in patients with coronary artery disease. AB - Global and regional systolic function during exercise were studied at cardiac catheterization with biplane cineangiography and micromanometer pressures in three groups of patients: an ischemia group (n = 22) with exercise-induced asynergy from coronary artery disease, a control group with no or minimal cardiovascular disease (n = 5) and a "scar" group (n = 5) with prior infarction and no new asynergy with exercise. Ventricular emptying curves at rest did not distinguish patients with coronary artery disease from control subjects. During exercise, end-systolic volume increased in all patients in the ischemia group; ejection fraction decreased from 62 to 51% p less than 0.001) despite an increased end-diastolic volume. Stroke volume decreased from 65 to 58 ml/m2 (p less than 0.001) and limited the average increase in cardiac index to 65%. The scar group had no decrease in stroke volume, but end-systolic volume failed to decrease during exercise, as it did in all control subjects (35 to 28 ml/m2, p less than 0.05). An exercise-induced decrease in peak left ventricular pressure in five patients (23%) in the ischemia group was not accompanied by more severe or extensive ischemia as judged by ejection phase indexes. There was a tendency for maximal positive first derivative of left ventricular pressure (dP/dt) to be less (1,912 versus 2,446 mm Hg/s, difference not significant), suggesting an abnormality of pressure generation, not shortening. Global function during exercise in the ischemia group was determined, in part, by the extent of regional dysfunction. Those in whom between three and five regions of eight regions studied had abnormal fractional shortening during exercise had a 6% decrease in ejection fraction, while those with six to eight abnormal regions had a decrease in ejection fraction of 15% (p less than 0.05). In addition, function of nonischemic, noninfarcted myocardium was studied at the base of the left ventricle in those with exercise-induced anteroapical ischemia (n = 4) and those with anteroapical infarction (n = 4). Base fractional shortening and shortening velocity were greater at rest in those with infarction (39% and 1.6 circ/s, respectively) than in control subjects (31% and 1.0 circ/s, respectively, p less than 0.01), indicating a chronic augmentation of shortening. Base shortening velocity during exercise in those developing anteroapical ischemia increased from 1.1 to 1.4 circ/s (p less than 0.005), suggesting an acute augmentation of function balancing the deterioration of anteroapical function. Systolic function in coronary artery disease is determined by acute and chronic alterations in regional function. During exercise, there is an interplay between regional dysfunction from ischemia or infarction and regional hyperfunction of nonischemic myocardium which determines global performance. PMID- 6863759 TI - Myocardial perfusion defect on thallium-201 imaging in patients with chronic obstructive pulmonary disease. AB - Six patients with angina pectoris had reversible perfusion defects on stress and redistribution thallium imaging. Three patients had a positive electrocardiographic response to exercise. No significant coronary artery lesions were seen on coronary arteriography in any of the six patients. All had mild to moderate hypoxemia at rest and physiologic evidence of chronic obstructive pulmonary disease as defined by the decrease in the ratio of forced expiratory volume at 1 second to forced vital capacity (FEV1/FVC X 100) or decrease in the forced midexpiratory flow rate (FEF25-75), or both. None had clinical findings suggestive of any of the reported causes of positive thallium scans in patients with normal coronary arteriograms. Cellular dysfunction produced by hypoxemia affecting the uptake of thallium seems to be the most likely mechanism of this abnormality. PMID- 6863761 TI - Reciprocal ST change in acute myocardial infarction: assessment by electrocardiography and echocardiography. AB - To evaluate the incidence, time course and significance of reciprocal change, 25 consecutive patients admitted with their first acute transmural myocardial infarction were studied with serial electrocardiography and two-dimensional echocardiography. Reciprocal change was noted in all patients with inferior infarction (mean maximal ST segment depression 3.53 +/- 1.97 mm) and 70% of patients with anterior infarction (mean maximal ST depression 1.45 +/- 0.8 mm, p = 0.001). When initially present, reciprocal change had resolved within 24 hours in 59% of patients. The sum of reciprocal ST depression correlated with the sum of ST elevation in anterior (r = 0.92, p less than 0.001) and inferior (r = 0.55, p = 0.035) infarction, and this relation persisted when maximal ST depression and elevation were considered. Echocardiographic evidence of contraction abnormalities in areas of the left ventricle remote from the infarction was seen in 45% of patients. However, its presence did not correlate with the presence of reciprocal change. Although reciprocal change progressively diminished on serial electrocardiograms (maximal ST depression 2.73 +/- 1.77 mm at 19 hours after onset of symptoms; 1.0 +/- 0.92 mm at 2 to 3 days; and 0.22 +/- 0.26 mm at 7 to 10 days; p less than 0.05), the corresponding serial echocardiograms showed no change in the function of the remote wall (remote wall motion index 1.87 +/- 0.65, 1.81 +/- 0.62, 1.86 +/- 0.47, respectively, p = NS). These data, therefore, do not support the hypothesis that reciprocal ST depressions during early acute transmural myocardial infarction reflect remote ischemia. Rather, these changes are influenced by factors determining the degree of acute ST elevation, previously shown to include infarct size, shape, location, transmurality and duration. PMID- 6863760 TI - Sustained ventricular tachyarrhythmias during the early postinfarction period: electrophysiologic findings and prognosis for survival. AB - Forty patients with sustained tachycardia occurring 3 to 65 days after myocardial infarction underwent programmed ventricular stimulation within 3 months of the infarction. Patients were characterized clinically by a complicated initial 48 hours of hospitalization for their acute infarction (85% of study group). The development of bundle branch block in association with infarction occurred with an unusually high frequency (32%). Ventricular tachycardia similar in configuration to spontaneous arrhythmia was induced with programmed ventricular stimulation in 33 (83%) of the 40 patients. In 15 (45%) of these 33 patients, additional morphologically distinct ventricular tachycardia not seen clinically was initiated. The induction of ventricular tachycardia was not significantly related to the time after myocardial infarction at which spontaneous ventricular tachycardia was initially observed. Only 20 of the 40 patients are alive after a mean follow-up period of 20 +/- 15 months. Twelve of the 20 deaths were sudden cardiac deaths. Sixteen of the 33 patients with inducible ventricular tachycardia died; 8 of the 16 deaths were sudden. By comparison, four of the seven patients with no inducible ventricular tachycardia died (probability [p] = not significant), all suddenly. The mode of therapy did not influence subsequent survival. It appears that in patients with sustained ventricular tachycardia occurring more than 48 hours after a recent myocardial infarction, ventricular tachycardia similar to that clinically observed can usually be induced by programmed stimulation. In addition, multiple morphologically distinct ventricular tachycardias, some of which have not been previously observed, are frequently induced. Finally, the prognosis for survival is poor, regardless of inducibility or mode of therapy, and may in part be related to a changing arrhythmia substrate. PMID- 6863762 TI - Myocardial oxygen supply/demand ratio in aortic stenosis: hemodynamic and echocardiographic evaluation of patients with and without angina pectoris. AB - Angina pectoris is a common symptom in patients with aortic stenosis without coronary artery disease. To investigate the correlates of angina pectoris, echocardiographic and hemodynamic data from 44 patients with aortic stenosis and no coronary artery disease (mean age 56 +/- 10 years) were analyzed. Twenty-three patients had no angina pectoris and 21 patients had angina pectoris. The ratio of the diastolic pressure-time index (area between the aortic and left ventricular pressure curves during diastole) to the systolic pressure-time index (area under the left ventricular pressure curve during systole), an index of the oxygen supply/demand ratio, was not different in patients with or without angina pectoris. There were no differences between patients with and without angina pectoris in echocardiographically determined wall thickness, chamber size, systolic and diastolic wall stress and left ventricular mass; in electrocardiographically defined voltage; and in hemodynamically defined aortic valve area, transaortic gradient and stroke work index. Thus, echocardiographic and hemodynamic measurements at rest are not significantly different in the presence or absence of angina pectoris in patients with aortic stenosis. Dynamic data appear to be essential for evaluation of the mechanisms of angina pectoris in patients with aortic stenosis. PMID- 6863763 TI - Membrane action and catecholamine release action of bretylium tosylate in normoxic and hypoxic canine Purkinje fibers. AB - Electrophysiologic effects of bretylium tosylate on transmembrane action potentials of canine Purkinje fibers were studied by microelectrode methods. Perfusion of this agent (20 mg/liter) prolonged the action potential duration and the effective refractory period, but did not alter the maximal diastolic potential, upstroke phase of the action potential and membrane responsiveness curve under normal oxygenation. With a hypoxic superfusion, the action potential amplitude, maximal diastolic potential, maximal rate of depolarization and action potential duration were all decreased. Subsequent addition of bretylium antagonized all these effects of hypoxia and restored the action potential variables to control values. However, similar effects of hypoxia observed in Purkinje fibers pretreated with reserpine were not reversed by bretylium except for a prolongation of repolarization. These results suggest that antiarrhythmic effects of bretylium in hypoxic or depressed myocardium are probably due to: 1) increased maximal rate of depolarization (and conduction velocity) caused by membrane hyperpolarization, and 2) prolongation of the effective refractory period. The first electrophysiologic action appears to depend on catecholamine release by bretylium, as hyperpolarization was not observed in reserpine pretreated Purkinje fibers. The second effect may represent a direct membrane action. PMID- 6863766 TI - Effects of AR-L 115 BS (Sulmazol), a new cardiotonic agent, in coronary artery disease: improved ventricular wall motion, increased pump function and abolition of pacing-induced ischemia. AB - AR-L 115 BS (Sulmazol) is a new noncatechol, nonglycosidic cardiotonic agent. In 17 patients with significant coronary artery disease, the influence of AR-L 115 BS on hemodynamics and regional wall motion was investigated under the following conditions: 1) control, 2) the immediate postpacing period without medication, and 3) the postpacing period under the peak influence of AR-L 115 BS, 2 mg/kg intravenously. During the postpacing phase without medication, all patients developed ischemia (angina, ST segment alterations, increase of mean left ventricular end-diastolic pressure from 13 to 30 mm Hg), left ventricular pump function diminished and overall regional wall motion showed a tendency to decrease (p greater than 0.05). However, during the postpacing period with AR-L 115 BS medication, ischemia was abolished (no angina; mean left ventricular end diastolic pressure decreased to 13 mm Hg; hemodynamic variables returned to control levels and left ventricular pump function showed some improvement while overall regional wall motion showed tendencies to improve. A comparison of alterations of hemodynamics and regional wall motion during the postpacing phase without medication with those under the influence of AR-L 115 BS shows that overall left ventricular pump function and regional wall motion improved while angina and an increase in left ventricular end-diastolic pressure were prevented. It is concluded that AR-L 115 BS improves left ventricular pump function and regional wall motion in coronary artery disease without inducing ischemia, probably by means of a reduction in extravascular resistance. PMID- 6863765 TI - Long-term therapy with a new cardiotonic agent, WIN 47203: drug-dependent improvement in cardiac performance and progression of the underlying disease. AB - Seven patients with severe chronic congestive heart failure were treated with a new cardiotonic agent, WIN 47203 (an analog of amrinone), for an average of 7.4 weeks (range 2 to 15). At the initiation of therapy, hemodynamic improvement occurred in all patients as the cardiac index increased from 1.79 +/- 0.39 to 2.30 +/- 0.44 liters/min per m2 (probability [p] less than 0.05) and pulmonary capillary wedge pressure decreased from 24.1 +/- 6.7 to 16.1 +/- 7.8 mm Hg (p less than 0.05). Long-term therapy produced a substantial symptomatic improvement in five of the seven patients. This improvement was fully sustained in two patients and the remaining three experienced a partial return of their symptoms even though the initial hemodynamic improvements at rest remained evident in all seven patients. Withdrawal of WIN 47203 precipitated hemodynamic deterioration in all patients. The cardiac index decreased from 2.25 +/- 0.40 to 1.64 +/- 0.46 liters/min per m2 (p less than 0.05) while the pulmonary capillary wedge pressure increased from 17.1 +/- 7.8 to 23.2 +/- 12.0 mm Hg (p less than 0.05). Stroke volume index after withdrawal was lower than the control level before therapy (17.0 +/- 6.6 versus 20.3 +/- 4.7 ml/m2; p less than 0.05) and pulmonary capillary wedge pressure was similar. During long-term therapy, no undesirable side effects or hematologic changes were observed. Thus, drug-dependent hemodynamic benefits and apparent progression of the underlying cardiac disease were demonstrated during long-term therapy with WIN 47203. PMID- 6863764 TI - A noninvasive radiographic technique for evaluation of exercise-induced changes in cardiac function. AB - An electrocardiographic-triggered radiographic technique for obtaining a single image of the heart at both end-systole and end-diastole was used in conjunction with upright bicycle exercise to detect stress-induced changes in 1) systolic and diastolic cardiac transverse diameter, and 2) regional motion of the free left ventricular wall. Twenty-one patients were studied; 10 had normal coronary arteries and 11 had significant coronary artery disease. Twenty patients (10 with normal coronary arteries and 10 with coronary artery disease) also had multigated radionuclide blood pool scans at rest and with exercise. All patients without coronary disease showed a decrease in systolic cardiac transverse diameter with exercise and a slight increase in amplitude of motion of the left ventricular free wall. Eight (73%) of the 11 patients with coronary artery disease showed an increase in systolic transverse cardiac diameter with exercise (p less than 0.001), and 5 developed either new regional left ventricular asynergy or deterioration of segments with rest asynergy. Eight of the 10 patients with coronary artery disease who had rest and exercise radionuclide scans had an abnormal ejection fraction response to exercise. However, only 4 of the 10 control patients who had multigated scans had a normal ejection fraction response, although all showed normal regional wall motion with exercise. This new approach is inexpensive and easily performed. These preliminary data suggest that it may be a useful adjunct to cardiac stress testing and is worthy of further study. PMID- 6863769 TI - Right ventricular infarction with cardiac rupture in an infant with pulmonary valve atresia with intact ventricular septum. AB - This report describes an 8 day old infant with pulmonary valve atresia, hypoplastic and hypertensive right ventricle and myocardial sinusoid-left anterior descending coronary artery connections. A large right ventricular sinusoid complex developed that was associated with transmural right ventricular necrosis and cardiac rupture. This is the first report to document transmural myocardial infarction and rupture in pulmonary valve atresia with intact septum, and this condition should be added to the causes of myocardial infarction in infancy. A reduced number of caliber of sinusoid-coronary artery channels may be responsible for right ventricular damage in this condition. PMID- 6863767 TI - Concordance and discordance of drug responses in atrioventricular reentrant tachycardia. AB - Whether the results of some drug studies could be used to predict the results of other drug studies was examined during serial electrophysiologic drug testing in patients with sustained atrioventricular reentrant tachycardia. The drugs studied were intravenous propranolol, 0.1 mg/kg; intravenous ouabain, 0.01 mg/kg; the combination of propranolol plus ouabain; intravenous procainamide, 0.75 to 1.5 g; oral quinidine, 1.2 to 2.4 g/day; and oral disopyramide, 0.8 to 1.6 g/day. Response was inability to induce sustained tachycardia after administration of a drug. Responses due to increased anterograde limb refractoriness. Six of 10 patients with response to propranolol plus ouabain versus 0 of 9 patients without response to this combination had response to propranolol alone (p less than 0.01). Seven of 14 patients with response to the combination versus 0 of 9 patients without response to the combination had response to ouabain alone (p less than 0.05). Responses due to increased retrograde limb refractoriness. Eight of 9 patients with response to procainamide versus 2 of 17 patients without response to this drug had response to quinidine (p less than 0.01). There was not a significant relation between response to procainamide and response to disopyramide, or between response to quinidine and response to disopyramide. Anterograde limb versus retrograde limb. There was not a significant relation between response to propranolol plus ouabain and response to any class I drug. In conclusion, there are relations between drug responses during electrophysiologic studies in patients with atrioventricular reentrant tachycardia. Thus, it should be possible to simplify these studies. PMID- 6863768 TI - Investigation and management of primary cardiac tumors in infants and children. AB - Seven children with primary cardiac tumors are discussed. The diagnosis was achieved by cardiac catheterization in all seven patients. In four patients, surgical excision was undertaken with one long-term good result. One of the other three surgical patients died of acute heart failure at the discontinuation of cardiopulmonary bypass. One of the other two surgical patients died suddenly late postoperatively, presumably from arrhythmia. The other, affected by fibrosarcoma, also died suddenly while undergoing chemotherapy. The histologic findings on the tumor masses were available in six patients. There were three rhabdomyomas, one fibrosarcoma, one fibroma and one hamartomatous mass. In one patient with tuberous sclerosis, a presumptive diagnosis of rhabdomyoma was made clinically on the basis of multiple masses infiltrating the left ventricle. Two-dimensional echocardiography is the best noninvasive tool to determine the extent and location of the tumor and suitability for surgery. When surgery is indicated, cardiac catheterization for pressure data is also required. Surgery is recommended in symptomatic solitary lesions that most likely are fibromas and have an overall good surgical outcome. PMID- 6863770 TI - Coronary-bronchial artery fistula with partial absence of a pulmonary artery: association with partial anomalous pulmonary venous drainage. AB - A patient is presented with partial absence of the right pulmonary artery, left coronary artery to bronchial artery fistula and systemic arterial desaturation with a patent foramen ovale. The various aspects of the syndrome are discussed and the rationale for nonoperative closure of the foramen is described. PMID- 6863771 TI - Kawasaki syndrome in an adult: endomyocardial histology and ventricular function during acute and recovery phases of illness. AB - Kawasaki syndrome, an acute systemic inflammatory illness of unknown origin usually affecting children, may develop into a serious illness complicated by coronary artery aneurysms or myocarditis. This report describes an adult with Kawasaki syndrome studied by right ventricular endomyocardial biopsy and cardiac catheterization during the acute and recovery phases of illness. The initial biopsy specimen showed acute myocarditis and was associated with hemodynamic evidence of biventricular dysfunction, a severely depressed left ventricular ejection fraction and global hypokinesia. With time, there was spontaneous and rapid resolution of the inflammatory cell infiltrate with concurrent return to normal myocardial function. Right ventricular endomyocardial biopsy studies early in the course of the cardiac disease associated with Kawasaki syndrome may correlate with ventricular function and may be useful for monitoring immunosuppressive therapy in patients with this syndrome. PMID- 6863772 TI - Cardiac metastasis from uterine leiomyosarcoma. AB - The clinical course and echocardiographic and hemodynamic derangements in a case of uterine leiomyosarcoma metastatic to the heart are discussed. The literature on cardiac metastasis in general and cardiac involvement by leiomyosarcoma in particular is reviewed. Although the presentation of cardiac tumors is highly variable and the diagnosis is usually made postmortem, antemortem diagnosis is possible, as in this case, if a high index of suspicion is combined with information from two-dimensional echocardiography and cardiac catheterization. PMID- 6863773 TI - Atrial fibrillation: a new look at an old arrhythmia. PMID- 6863776 TI - Risk factor modification and coronary artery disease. PMID- 6863775 TI - Convocation lecture: the QRS complex revisited. PMID- 6863774 TI - The present status of body surface potential mapping. PMID- 6863777 TI - Tetrad versus tetralogy: II. PMID- 6863778 TI - Total diet study: determination of iodine intake by neutron activation analysis. AB - Composite food samples from adult, infant, and toddler market baskets of the Food and Drug Administration's (FDA) Total Diet Study for Fiscal Year 1980 were analyzed for iodine by neutron activation analysis (NAA) at the FDA NAA laboratory at the National Bureau of Standards. The mean iodine content of the total diets was 412, 397, and 410 micrograms, per day for adult (2,900 kcal per day), infant, and toddler diets, respectively. These intakes correspond with 275%, 882%, and 586% of the adult, infant, and toddler Recommended Dietary Allowances, respectively. Dairy products and iodate-containing breads were major dietary sources of iodine. The iodine values for total diets reported here, determined by NAA, are from 11% to 15% higher than those determined by colorimetric analysis at FDA's Kansas City Field Office Laboratory. PMID- 6863779 TI - The sodium and potassium content of selected vegetables. AB - Restriction of sodium intake and an increase in potassium intake are frequently recommended for patients with hypertension. The content of these minerals in 117 vegetables is presented. Processing practices and additives which affect the sodium content are discussed. PMID- 6863781 TI - Confrontation: a new dimension in nutrition counseling. AB - The advanced counseling skill of confrontation is described. Possession of this skill allows the practicing dietitian to point out clients' discrepant behaviors or thought patterns which obstruct progression toward goals. Confrontation is a positive and constructive act, not a negative, punitive one. When conducted properly, it enhances the working relationship between client and dietitian. PMID- 6863780 TI - Dietary status of Seventh-day Adventists and nonvegetarians. AB - The dietary intakes of Seventh-day Adventist (SDA) vegetarians and nonvegetarians, as well as of non-SDA nonvegetarians, were generally adequate. However, even though iron and vitamin B6 intakes exceeded 100% and 90% of the RDAs for all men, 26% and 19% of the women were consuming less than 60% of the RDAs for iron and vitamin B6. PMID- 6863782 TI - Modifications in food intake by myocardial infarct patients. AB - Post myocardial infarct (MI) patients made significant dietary changed in accordance with the principles of the Prudent Diet. Patients reported changing their intake of selected food items; specifically, consumption of eggs, high-fat meat, whole milk, and butter significantly decreased. A number of food preparation techniques changes, leading to decreases in total fat and saturated fat consumption. Patients reported frying food less, trimming fat from meat, and using more polyunsaturated fat. These changes were unaffected by the length of time since the MI. PMID- 6863783 TI - Nutritional considerations in the management of patients with amyotrophic lateral sclerosis (ALS). AB - This study examines the nutritional status of patients with ALS based on data derived from a dietary history, anthropometric measurements, and biochemical assessment. Twenty patients, 11 men and 9 women, were studied to determine nutritional status in order to differentiate appropriate therapy and monitor prognosis. The study suggests that nutritional support of these patients may help allay weight loss and retard muscle atrophy. Nutritional management involves (a) early detection and correction of inadequate nutrient intake, particularly of kilocalories; (b) concurrent modification in consistency of food intake with development of bulbar involvement; and (c) determination of optimal time to institute alternate feeding routes in cases of bulbar involvement. PMID- 6863784 TI - Dietetics training for American Indians and Alaskan natives. AB - The response to training has been enthusiastic. Even in these times of limited funds, applications to attend training exceed the available space. From the first class in October 1968 through September 1982, nearly 1,300 Indian and Alaskan native hospital food service employees and employees representing tribal programs throughout the country have received training from the courses and workshops provided by the Nutrition and Dietetics Training Program. With the increasing involvement of Native Americans in their own health care programs, the need for training in foods and nutrition will continue. PMID- 6863785 TI - Carbohydrate composition of candy bars. AB - The data in Table 1 show a wide variation among products and when added to other available data provide a more complete picture of the carbohydrate composition of candy bars. Interestingly, the sucrose content of the bars in Table 1 ranges from a low of 19.12% to a high of 56.06%. Extensive use of corn syrup is clearly evident in ingrediated bar types (categories e and f). Although the higher saccharides of corn syrup were not quantitated, we think that this article adds to the knowledge of the carbohydrate composition of the best-selling candy bars, since previously only a carbohydrate by difference value was available. This report provides the health professional with an update on carbohydrate composition of a large number of candy bars. PMID- 6863786 TI - Evaluation of a nutrient guide as an educational tool. AB - This study evaluated the usefulness of a nutrient guide as a tool for teaching nutrition and food selection. It was the basis of a nutrition education program, which consisted of a series of mailed messages. Results were reported for 92 mothers and 55 fathers. The findings of this study suggest that the nutrient guide has the potential for being a useful teaching tool. Fathers and mothers who responded to the post-test found it understandable and useful. Most important, after participating in the nutrition education program based on the nutrient guide, respondents reported changes in their diets. An analysis of those who did use the guide indicated that educational level and previous nutrition knowledge were not selective factors. PMID- 6863787 TI - Demand for dietitians: taking control of the future. PMID- 6863788 TI - Birth weight and WIC. PMID- 6863789 TI - Iron status and anemia in the elderly: new findings and a review of previous studies. AB - Iron status was determined in 280 free-living and healthy elderly men (n = 131) and women (n = 149) by assessing dietary and supplemental iron intake as well as ten biochemical measures of iron nutriture (erythrocyte count, hemoglobin level, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, plasma iron level, total iron-binding capacity, per cent transferrin saturation, and ferritin level). Subject ages ranged from 60 to 93 years with a median age of 72 years for both women and men. For comparison purposes, iron status measures in an unselected group of younger men (n = 107) and women (n = 164) between the ages of 20 and 39 years were also obtained. None of the elderly women and only two (1.2 per cent) of the younger women had low hemoglobin levels (less than 12.0 g/dl). Three (2.3 per cent) of the elderly men and none of the younger men had low hemoglobin levels (less than 14 g/dl). Other iron status measures revealed that anemia or iron deficiency was no more prevalent in the healthy elderly population than in the younger adult population when identical criteria were used to assess iron nutriture. The genesis of anemia often seen in the elderly is not completely understood. Reported evidence suggests the presence of anemia in the elderly is a result of overall reduction of hematopoietic reserves. Because of the potentially serious consequences of this assumption about anemia to the treatment of the elderly, the authors critically review some of the studies that have been designed in the past to determine the prevalence and etiology of anemia in the aged. They suggest that health status, race, socioeconomic status, diet, and region are more important than age as explanations for the high prevalence of anemia seen in many previous studies. PMID- 6863790 TI - The elderly patient in the coronary care unit: III. Factors affecting long-term prognosis. AB - Patients aged 70 years and older who were admitted to a coronary care unit in 1976 with documented acute myocardial infarction were followed to April 30, 1982. At that time, of the 46 patients who had survived initial hospitalization, 28 had died, 16 were still living, and two were lost to follow up. The actuarial survival rates were 71 per cent, 60 per cent, and 44 per cent for one, three, and five years, respectively. Only two of the variables available by history, physical examination, and clinical course of the patient in the coronary care unit had prognostic significance--complex ventricular premature beats and congestive heart failure of any degree of severity. Patients who suffered congestive heart failure during their hospitalization had a five-year survival rate of less than 25 per cent, compared with about 60 per cent for those who had neither heart failure nor complex ventricular premature beats. All five patients who had complex ventricular premature beats died within three years. PMID- 6863791 TI - Sexual incidents in an extended care unit for aged men. AB - A survey was conducted among the nursing staff of a 400-bed extended-care unit for aged men by questionnaire to find out what patient behaviors were identified as sexual by the staff and how they reacted to these behaviors. Three types of behavior were identified as sexual and as "causing problems": sex talk (e.g., using foul language); sexual acts (e.g., touching or grabbing, exposing genitalia); and implied sexual behavior (e.g., openly reading pornographic magazines). As many as 25 per cent of the residents were thought to create such incidents. Acceptable sexual behavior identified by the staff were limited to hugging and kissing on the cheek, although their answers implied that residents could need more intimate touching and affection. The survey raised questions about the nature and causes of different types of sexual behavior in the institutionalized elderly and about the roles nursing staff, physicians, and administrators can play in recognizing individual needs while safeguarding both the residents and the staff from the consequences of unacceptable incidents. PMID- 6863792 TI - Correlations between regional cerebral blood flow and age-related brain atrophy: a quantitative study with computed tomography and the xenon-133 inhalation method. AB - One hundred and two subjects (40 men and 62 women) neither having a history of neurologic deficits nor showing organic lesions on computed tomographic examination of the brain were studied. Ages of the subjects ranged from 26 to 81 years. Regional cerebral blood flow was measured by the xenon-133 inhalation method, and the volume percentage of brain with respect to the cranial cavity (craniocerebral index) was calculated by means of computer programs. Regional cerebral blood flow was computed as the fast component of two-compartmental analysis and as the initial slope index value. The percentage of each subject's craniocerebral index in relation to the standard for subjects with non-atrophied brains (brain volume index) was calculated as the indicator of brain atrophy. Both the mean brain fast component values and the mean brain initial slope index values correlated closely with the brain volume index in the elderly (r = 0.60, r = 0.62; P less than 0.0001 in each correlation coefficient). Low cerebral blood flow values coincided with loss of brain substance in the final stage of age related brain atrophy, but not in the intermediate stage. PMID- 6863793 TI - Depressive symptoms and health service utilization among the community elderly. AB - The relationship between depression and complaints of physical disease in the elderly is often discussed but has received little documentation. The authors administered questionnaires to 88 elderly volunteers to assess two common psychologic diagnoses, affective disorders and organic brain syndrome, and three common cardiovascular symptoms, pain or numbness in the jaw or arm, pressure in the chest, and difficulty in breathing. Data on utilization of health care professionals and demographic information were also obtained. A significant correlation between reports of depression and complaints of cardiovascular symptoms was seen. While the volunteers with depressive symptoms also visited their physicians more often than did the other volunteers, they did not seek the help of mental health professionals. This raises the larger issue that elderly persons who have mild to moderate depression present to our health care system. PMID- 6863795 TI - Senile cataracts and aging changes in human proteins. PMID- 6863794 TI - Aging and hypertension: hemodynamic implications of systolic pressure trends. AB - The progressive rise in systolic pressure throughout life is accepted as a phenomenon of "normative aging," although elevated systolic pressure is established as an independent risk factor for untoward cardiovascular events. An analysis of published data for many thousands of individuals indicates comparable average systolic pressure increments of approximately 20 mm Hg between the ages of 40 and 65 years for both normotensives and hypertensives. In both groups there is a disproportionate rise in systolic pressure, that is, systolic increases more than mean and diastolic pressures. In a young person with a normally elastic arterial system an increase in total peripheral resistance (TPR) produces the same increments in systolic, diastolic, and mean arterial pressures; a decrease in arterial distensibility (AD), on the other hand, increases systolic pressure and decreases diastolic pressure to the same extent, leaving mean pressure unchanged. Thus, the proportion of the systolic pressure rise resulting from increased TPR is equal to the increase in the mean pressure (delta mean); the remainder of the increase (delta systolic minus delta mean) is caused by the only other variable that could account for an additional increase in systolic pressure with advancing age, a decrease in AD. Application of this formulation to published blood pressure data shows that in normotensives the ratio of the contribution toward rising systolic pressure of reduced AD to increased TPR is 1:1 between the ages of 40 and 65 years, whereas in hypertensives it is 2:1. Thus, the natural history of essential hypertension, once established, is one of accelerated arterial stiffening, a mechanism that would contribute importantly to the increasing prevalence of "systolic hypertension" with advancing age. PMID- 6863796 TI - Effects of geriatric education on the attitudes of medical students. AB - This study investigated the effects of an educational program in geriatrics on the attitudes of a group of third-year medical students. A survey designed to measure attitudes toward geriatric patient care, aging, and older people was administered to all students before and after their participation in a 25-hour geriatrics education component of a Family Practice Clerkship. Results showed the students' attitudes were significantly improved following the geriatrics training program. Prior training in geriatrics and their specialty preference were also found to have an impact on attitude. The implications of the study for medical education and research are discussed. PMID- 6863797 TI - Rehabilitation of the elderly amputee. PMID- 6863798 TI - Isometrics can counteract the effects of disuse. PMID- 6863799 TI - Student perspective. Clerkships. PMID- 6863800 TI - Telescopic acuity in amblyopia. PMID- 6863801 TI - Aniseikonia following unilateral intraocular lens implant. PMID- 6863802 TI - Phlyctenular keratoconjunctivitis. PMID- 6863803 TI - Control of vertically polarized glare. AB - Reflected glare often interferes with vision. Since such glare is usually polarized it can be controlled with polarizers. The use of polarized filters to eliminate vertically polarized glare from blackboards and glossy printed material is presented. Practical means for the construction of such filters are discussed. PMID- 6863804 TI - An optometric approach to the treatment of a non-comitant deviation. PMID- 6863805 TI - Attention to the visually handicapped is enough being done? PMID- 6863807 TI - Bone lesions in pancreatic disease. A case report and literature review. PMID- 6863806 TI - Reconstruction of plantar heel defects. A review with case report. PMID- 6863808 TI - Bilateral tarsal tunnel syndrome. PMID- 6863809 TI - Solitary osteochondroma of the metatarsal. PMID- 6863810 TI - Paget's disease of the calcaneus. PMID- 6863811 TI - Pyoderma vegetans. Review of the literature and a case presentation. PMID- 6863812 TI - Pain in the foot during orgasm. A case report. PMID- 6863814 TI - Quality care and ethics: a conceptual view. PMID- 6863813 TI - The enigma of shoe sizes. PMID- 6863815 TI - Modification of the Lee lateral ankle stabilization. PMID- 6863816 TI - Pyogenic granuloma. A literature review and two case reports. PMID- 6863818 TI - Morton's neuroma symptoms from a rheumatoid nodule. A case report. PMID- 6863817 TI - Achondroplastic dwarfism. A literature review and a case report. PMID- 6863819 TI - Giant cell tumor of the tendon sheath. A report of two cases. PMID- 6863820 TI - Tinea pedis and erythrasma. Differential diagnosis and a case report. PMID- 6863821 TI - Man-made shoe materials and foot health. PMID- 6863822 TI - Radiological health training guide for podiatry programs. PMID- 6863823 TI - Radiation protection: a public health issue. PMID- 6863824 TI - [At what stage is tonography?]. PMID- 6863825 TI - [Ultrasonic decompression of malignant ocular hypertension secondary to traumatic hyphema]. AB - The prognosis of traumatic hyphemias in general is favorable, the blood being resorbed spontaneously in a short period. The case is different, however, where hemorrhage is abundant, and the condensed blood in the anterior chamber coagulates; here, the angle is often blocked with fibrin, the intraocular pressure rises considerably, accompanied always with severe pain. The arrest of aqueous circulation by the consolidated clot suppresses the process of resorption; thereafter, local and general therapeutic measures become ineffective. The state of "malignant hypertension" once established, surgical intervention becomes imperative. In this study are given the results of 10 cases of traumatic hyphemia complicated by malignant hypertension, treated by ultrasonic irradiation. The results are obviously favorable: rapid fall of ocular hypertension with prompt disappearance of subjective symptoms; revelation of signs of liquefaction and resumption of processes of resorption in 9 patients. Under continued treatment, complete resorption of the hyphemia was attained with accelerated pace. In one case, however, unrelenting hypertension persisted to the 12th day, despite the complete liquefaction of the coagulum. A phakotopic factor lying under the hyphemia was suspected. The visual recuperation was remarkable in 7 cases free from posterior segment alterations. PMID- 6863826 TI - [Vitrectomy for intraocular foreign bodies and their complications]. AB - Results of vitrectomy in 16 cases are reported. In one group of 7 patients the operation immediately preceded the extraction of a non-metallic or metallic capsulated foreign body by means of foreign body forceps, or a magnetized metal thread using the one- or two-way "pars plana" approach. In the second group of 9 cases a "pars plana" vitrectomy was carried out to treat sequelae from a double perforation caused by lead shot. The Douvas roto-extractor was used in all eyes. Results obtained in the first group (combined foreign body extraction and vitrectomy) were satisfactory in all but one case, which ended with-phtisis bulbi. Visual acuities were of 0,2 or more. In the second group (reparative vitrectomy) an acceptable V.A. was obtained except in two cases. Results were less satisfactory than in the first group. PMID- 6863827 TI - [Intravitreous gas injections in microsurgery for retinal detachment]. PMID- 6863828 TI - [Congenital malformation of the pigment epithelium and retina]. AB - A case of congenital malformation of the retina and of the pigment epithelium is reported, the lesion presenting as a slightly elevated greenish-blue lesion in the macular area or retinal periphery. The outer portion was hyperpigmented, the nonpigmented inner portion consisting of malformed thickened retina. Marked vascular tortuosity resulted from disturbance of the retinal layers and the presence of preretinal membrane. The lesion was detected in a boy with strabismus, loss of visual acuity and hyperopia, and is often misdiagnosed as tumor. PMID- 6863829 TI - [Choroidal metastasis of a testicular embryonal carcinoma]. AB - A rare case of choroidal metastasis of testicular embryonic carcinoma origin is described, and pathologic features illustrated. The differential diagnosis of primary and metastatic ocular tumors is discussed. Because of the possibility of a primary ocular origin of this tumor and its rapid clinical evolution, the need to perform a systematic search for a primary testicular carcinoma in young male patients is emphasized. PMID- 6863831 TI - Brachymetatarsia with brachymesodactyly. AB - A case of brachymetatarsia with congenital absence of all middle phalanges was presented. This is believed to be the first such case reported. Many surgical options are available for the correction of microdactyly. Satisfactory surgical results were achieved via bunionectomy, the implantation of a double-stemmed prosthetic joint in the fourth metatarsophalangeal joint and osteotomy of the second metatarsal bone. PMID- 6863832 TI - A literature review of congenital digiti quinti varus: clinical description and treatment. AB - Congenital digiti quinti varus is a deformity in which the fifth toe overlaps the base of the fourth; it consists of three main components: adduction, dorsiflexion, and external rotation. Treatment for this deformity may consist of conservative or surgical techniques, depending on the severity and/or age of the patient. The surgical techniques recommended by various authors may involve skin plasties, tenotomies and capsulotomies, tendon transfers and lengthenings, and bone resections. PMID- 6863830 TI - A postsurgical evaluation of hemi-implant procedures at the first metatarsophalangeal joint: review and comparison of eighteen cases. AB - This presentation summarizes the results discovered on implantation surgery of 18 digits on 16 patients for correction of hallux limitus, or hallux rigidus. Of those studied, 66.7% received excellent and good results, 22.2% had fair results, and 11.1% had poor results. Comparison with the literature shows good correlation between studies and allows for quantification of the probability of positive returns on this form of surgery. PMID- 6863833 TI - Multiple recurring plantar fibromatosis and its surgical excision. AB - Plantar fascial fibromatosis has been examined through an illustrated case presentation. The differential diagnosis must be extensive preoperatively in order to rule out many benign as well as the rare but possible malignant lesion. The illustrated surgical technique was presented to show the importance of the preoperative preparation of the plantar incision and of the meticulous surgical excision of both the entire lesion and adjacent plantar fascia. PMID- 6863836 TI - Calcinosis circumscripta presenting in the foot. PMID- 6863835 TI - Hypertensive leg ulcers. AB - A case report of hypertensive leg ulcer and its management is described. The diagnosis of hypertensive leg ulcer is primarily based upon clinical findings after other etiologies have been excluded. Microscopic arteriolar changes associated with hypertensive disease do not necessarily preclude the development of hypertensive ulcers. Therapy of these ulcers is based upon a sound understanding of their pathophysiology--control of systemic hypertension, possible enhancement of local tissue perfusion, atraumatic debridement, and skin graft closure. PMID- 6863834 TI - Postoperative gas gangrene. AB - Gas gangrene is a rare complication of elective surgery. Caused by several species of Clostridia, it is an acute, highly invasive necrotizing infection of muscle and fascia often leading to coma and death. Gas gangrene should be suspected if the patient has unremitting pain, high temperature, tachycardia, and prostration. Edema, brown watery exudate emanating from he wound, evidence of gas in tissues, and gram-positive rods on smear support the clinical diagnosis. Rapid surgical decompression and debridement is the basis of treatment. Adjuvant antibiotic, hyperbaric oxygen, antitoxin, local, and supportive therapies aid in treatment. The authors review the literature and discuss etiologies, pathogenesis, clinical features, and treatment. PMID- 6863837 TI - The secondary tendinous slip of the extensor hallucis longus (extensor ossis metatarsi hallucis). AB - In 80% of a random sample the extensor ossis metatarsi hallucis was present. In 90% of these occurrences it arose off the medial aspect of the extensor hallucis longus tendon and coursed distally, medially, and inferiorly an average of 4.0 cm., inserting into the sling portion of the extensor apparatus. Variation of this insertion occurred in 10% of the cases in which the sling portion of the extensor apparatus continued to illustrate fibers of the extensor ossis metatarsi hallucis inserting into it. There is little variation in the occurrence of this tendon between the sexes. The frequency of occurrence of the extensor ossis metatarsi hallucis from this study supports a theory that this tendon should be considered to occur as a rule rather than an exception, and because the previously suggested name of extensor hallucis capsularis is not biomechanically sound, perhaps the tendon merely be termed the secondary extensor hallucis longus. PMID- 6863838 TI - Dysplasia epiphysealis hemimelica. AB - Dysplasia epiphysealis hemimelica, a rare deformity of unknown etiology, is diagnosed by clinical and radiographic examination. Early diagnosis is important in order that the condition can be treated before the deformity becomes disabling. Surgery is considered the treatment of choice although surgical correction may lead to degenerative arthritis and instability of the ankle joint. PMID- 6863839 TI - Osteochondral lesions of the talus. PMID- 6863840 TI - Total replacement of the first metatarsophalangeal joint. PMID- 6863841 TI - Cheilectomy and hallux rigidus. PMID- 6863842 TI - Foot surgery and the systemic lupus erythematosus patient. PMID- 6863843 TI - Diagnosing osteomyelitis: evaluation and significance of multiple tracer bone imaging. AB - The use of various radioactive compounds in the diagnosis of osteomyelitis has been the topic of discussion by numerous authors. A great number of bone imaging agents have been experimented with and clinically applied with varying results. It is the intention of this article to detail and compare the use of two such agents: technetium-99m phosphonate, a phosphorus compound radioactively labeled with an isotope of technetium, and gallium citrate 67, a radioactive isotope of gallium. Both of these materials have specific indications and limitations. However, used in the proper setting, either singularly or in conjunction, they give the clinician precise information about pathologic processes. It is the clinician's careful interpretation of both positive and negative test results that enables him to make proper diagnosis and thus institute appropriate therapy. PMID- 6863844 TI - Dorsal prominence of the first metatarsal-cuneiform joint in children. AB - Dorsal prominence of the first metatarsal-cuneiform joint is a pathologic condition found commonly in children as well as adults. Faulty structural and biomechanical framework, aggravated by footgear, results in chronic inflammatory changes in the skin, underlying soft tissue and periosteum. Eventually, proliferative bony changes may take place. Treatment varies according to symptomatic subjective findings. PMID- 6863845 TI - Sinographic evaluation of fistulous lesions of the foot. AB - The authors discuss the use of sinography, which they found valuable in determining the location and extent of a sinus tract formation preoperatively. With this technique a radiopaque substance is injected into the external portion of a lesion to verify the internal dimensions. Although adverse effects are possible, the authors did not encounter any complications. PMID- 6863846 TI - Effect of metoclopramide on serum growth hormone levels in cirrhotic men. AB - Growth hormone (GH) secretory response to metoclopramide (MCP) administration was evaluated in 9 male patients with liver cirrhosis and in 6 normal controls. As expected, MCP did not modify serum GH concentrations in normal subjects. In contrast, a striking GH secretory response to MCP was observed in 5 out of 9 cirrhotics. In the other four patients serum GH levels did not show any variation after MCP. The different behavior between cirrhotic "responders" and "non responders" can not be interpreted on the basis of the medical history or the clinical and laboratory data. Three hypothesis are proposed: i) The effect of MCP could be promoted by estrogens and inhibited by androgens. ii) False neurochemical transmitters could affect dopaminergic system of some cirrhotics, allowing or inhibiting the GH response to MCP. iii) MCP could stimulate GH secretion by a serotonergic mechanism. These findings provide further evidence of a modification of the GH secretory pattern in patients with cirrhosis of the liver. PMID- 6863847 TI - Effect of metoclopramide on maternal and fetal hyperprolactinemia. AB - To investigate the effect of metoclopramide (MET), a dopaminergic antagonist drug, on serum PRL concentration in maternal and cord blood (CB) serum, the drug was injected in 94 at term pregnant women whereas 28 mothers received saline. Maternal serum (MS) samples were obtained before MET injection and at the parturition time. According to the interval of time between MET administration and birth, MS specimens were grouped in 7 groups. CB was obtained from neonates whose mothers were injected with saline, group 0 and from newborns whose mothers were treated with MET, groups 1 to 7. In the 7 groups of women the mean PRL concentration before MET ranged between 307 and 439 ng/ml. After MET injection a significant increase has been observed in all groups with a minimum and maximal mean value of 639 and 931 ng/ml. The highest net increment of PRL has been measured in group 1 sampled at 5 to 30 minutes after MET. CB PRL concentration in group 0, saline treated, was not different from the values measured in group 1 to 7, treated groups, with a range between 504 and 703 ng/ml. These findings suggest that maternal lactotropes are still responsive to MET. On the opposite, fetal pituitary does not release PRL after MET injection probably because PRL secretory activity is maximal or because the dopaminergic receptors' system is still immature. PMID- 6863848 TI - Measurement of thyroxine conversion to triiodothyronine using human lymphocytes. A useful and simple laboratory technique. AB - The deiodination of T4 to T3 has been studied after incubation of whole lymphocytes with different T4 concentrations, followed by a T3 radioimmunological determination performed on unextracted samples. The lymphocytes were isolated from blood from normal volunteers of both sexes and different age classes as well as from myxedematous subjects and patients with low T3 syndrome. The T3 production, in normal subjects, expressed as pmol/10.10(6) cells was 0.41 +/- 0.75 (T4 = 4.10(-7) M, n = 12), 1.43 +/- 0.14 (T4 = 4.10(-6) M, n = 26) and 1.65 +/- 0.29 (T4 = 8.10(-6) M, n = 11). There was no sex or age-related difference. In 3 myxedematous patients the T3 production was lower than the corresponding value obtained in normal subjects. The T3 production in patients with low T3 syndrome was lower than in controls (p less than 0.001); an inverse correlation was found between the T3 production and the serum rT3 levels, whereas no correlation could be found with serum T3 levels. PMID- 6863851 TI - Assessing the outcomes of nursing-home patients. AB - This paper describes the development of multidimensional measures of nursing-home patients' functioning. The technique was designed to gather information directly from the patients, using demonstrated ability in place of self-report wherever possible. Six domains are tapped: physiologic, activities of daily living, affective, cognitive, social, and satisfaction. Test-retest reliability ranges from .59 for social interaction to .85 for affect. Validity was tested by replication on successive waves of data as well as discriminant and content validity. PMID- 6863849 TI - Relationships between iodothyronine peripheral metabolism and ketone bodies during hypocaloric dietary manipulations. AB - Relationships between iodothyronine and metabolic substrate metabolism during undernutrition were evaluated in four normal subjects who fasted for 48h (Group I) and in four groups (II to V) of obese patients who underwent selective dietary manipulations: 360 calories [carbohydrate (CHO) 40 g/day]; 800 calories containing respectively 19 g/day - ketogenic - (K) and 112 g/day - non ketogenic (NK) of CHO; and a step-diet programme (during which total calories were progressively reduced from 2500 to 500). Serum T3 levels decreased significantly and constantly during fasting, 360 and 800 K studies, and transiently during the 800 NK diet. During the step-diet programme, a significant fall was found only when 1250 K or less were given. Conversely, serum reverse T3 rose significantly and constantly during 360 and 800 K diets, while a transient increase was found during the 800 NK diet. During the step-diet programme reverse T3 rose only when 750 calories were given. Ketogenesis developed in all studies but one (800 NK), and in the step-diet programme significantly below the 1000 calorie step. Other substrate modifications in each study were also evaluated. Serum T3 levels showed a significant correlation with ketone bodies (KB) in all the ketogenic studies, while no correlation was found in non ketogenic study (800 NK). During the step diet programme ketone bodies and iodothyronine modifications appeared to be related to the amount of calories. Based on these results, we suggest a relationship between the dietary-induced modifications of iodothyronine metabolism and the development of ketogenesis. PMID- 6863850 TI - Transient response of thyroidectomized pigs to bolus calcium injections and the effect of salmon calcitonin and parathyroid hormone. AB - The intravenous injection of calcium gluconate (0.11 mM/kg body weight) into conscious thyroidectomized pigs elicits a 30% rise in both ionized and total calcium concentrations of plasma, which return to basal levels within 180 min. The administration of calcitonin (2.5-10 MRC U/kg body weight) reduces this time to 30 to 40 min which is similar to the time obtained in thyroid intact animals. These results suggest that calcitonin may be involved in the fast calcium removal processes and thus in the short-term regulating system of calcium homeostasis. Neither parathyroidectomy nor the administration of parathyroid hormone affected the time for recovery in thyroidectomized pigs, suggesting that the short-term regulation is independent on the parathyroid gland and its hormone. PMID- 6863852 TI - The assessment of physical activity in older women: analysis of the interrelationship and reliability of activity monitoring, activity surveys, and caloric intake. AB - The interrelationship and reliability of three different activity measures were examined in 76 postmenopausal women. The women wore Large Scale Integrated (LSI) activity monitors, completed the Paffenbarger Activity Survey, and completed 3 day food logs for determination of caloric intake/expenditure. The Paffenbarger survey was assessed twice, a year apart. The results indicated that caloric intake was a very poor index of activity. The LSI activity monitoring and Paffenbarger survey were both effective, reliable measures of physical activity. However, they appeared to measure somewhat different aspects of physical activity. The LSI measured physical activity associated with movement, whereas the surveys measured the intensity component of energy expenditure. The research indicated that it is important to evaluate the characteristics of the activity of interest in order to select a physical activity tool for assessing activity patterns in older women. PMID- 6863853 TI - A mathematical model of the physiological dynamics of aging and correlated mortality selection. I. Theoretical development and critiques. AB - A number of theoretical models of aging and human mortality have been proposed. Only a few of these theoretical models, however, have been translated into statistical procedures and applied to data. In this paper we outline a theoretical model of human aging and mortality and compare it with models developed by Sacher and Trucco and Forbes and Brown. The ways in which this new model can be viewed as a generalization of these other formulations are discussed as are ways in which this model can be translated into a statistical model for empirical application. PMID- 6863854 TI - A mathematical model of the physiological dynamics of aging and correlated mortality selection: II. Application to the Duke Longitudinal Study. AB - Given that mortality risks at advanced ages (over 85) due to circulatory diseases have decreased recently and that it is likely that the effects of risk factors change with age, it is important to study the age dynamics of circulatory disease and circulatory risk factors in elderly populations. Analysis of chronic disease risks, however, is complicated at advanced ages because of the prominence of natural age increases in risk and the rapid rate at which health status changes at those ages. As a consequence, to identify the effects of putative risk factors at advanced ages one must employ appropriate analytic procedures to isolate risk factor effects from aging dynamics. Special risk assessment procedures developed to represent age-related biological processes aare applied to an analysis of circulatory disease risk in a study population with a mean age at study entry of over 70 years--the first Duke University Longitudinal Study of Aging population. PMID- 6863855 TI - Sleep apnea and nocturnal myoclonus in elderly persons in Vilcabamba, Ecuador. AB - Four men (M age 90.5 years) and four women (M age 91.2 years) in Vilcabamba, Ecuador (a community noted for people with extreme longevity) volunteered for sleep recordings using four-channel Medilog portable cassette recorder. Of the eight physically healthy persons recorded, only one man displayed sleep apnea syndrome. No nocturnal myoclonus was observed. Low incidence of sleep apnea of elderly persons in Vilcabamba may be due to a low barometric pressure and/or lack of drug abuse. PMID- 6863857 TI - Age differences in performance on two information-processing tasks: strategy selection and processing efficiency. AB - Matched groups of old and young adults were compared in two information processing tasks. In the rotated figures task the participant had to decide whether a figure displayed upright or inverted, faced forwards or backwards, held a ball in its right or left hand. In the sentence verification task the individual had to decide whether an affirmative or negative sentence was true or false as a description of a pattern. From the pattern of reaction times and from the respondents' verbal reports it was possible to identify the strategies used by individuals on each task. The numbers of participants selecting each of the different strategies were similar for old and young groups, but age differences were greater with some strategies than with others. The age difference was minimized when older adults adopted strategies that reduced the amount of processing. The older adults, however, were more disadvantaged when employing strategies that imposed greater processing demands or a heavy memory load. PMID- 6863856 TI - Age-related differences in memory for lateral orientation of pictures. AB - Two experiments examined memory for the lateral orientation of scenic pictures by young and elderly adults. In Experiment 1, an input list of pictures was followed by a test demanding discrimination between (a) targets versus reversed copies of input items, or (b) targets versus new pictures which verbally resembled input items. The age-related difference was reliably larger in the former task than in the latter. Experiment 2 compared incidental versus intentional acquisition of orientation under conditions of short (1 second) and long (5 second) presentation of pictures at input. With short presentation, though not with long presentation, intentional instructions reliably impaired orientation memory. With both presentation times, robust age-related differences were obtained. The results suggest an age-related deficit in truly non-intentional encoding of orientation, and pose a challenge for capacity theories of memory across the lifespan. PMID- 6863858 TI - Paired-associate learning in institutionalized and noninstitutionalized old people: an analysis of interference and context effects. AB - Groups of old people were impaired, relative to young adults, on a test of negative transfer involving lists of paired-associate words. Susceptibility to interference effects were greater in old people living in institutions than in old people living in their own homes. The effects of varying contextual cues on performance on this task were also assessed. All participants, regardless of age, benefitted from manipulations that were intrinsic to the task (e.g., relatedness of paired associates), but only the institutionalized aged responded to extrinsic contextual manipulations (e.g., environmental changes). In general, the performance of institutionalized old people resembled that of brain-damaged amnesic patients tested under similar conditions; old people living at home generally behaved more like normal, young people. The results were discussed in terms of specific age differences in cognitive function, declining brain function, and possible selective effects of institutionalization. PMID- 6863859 TI - Distance and contacts: interactions of black urban elderly adults with family and friends. AB - Distance is the major factor determining the frequency of social interaction with family and friends for elderly whites. Age, sex, marital status, length of residence, and income also affect the number of social contacts. These relationships have not been studied for elderly blacks. Utilizing data from a survey of 655 black urban residents 60 years old and older, this study investigated contacts with family and friends. The major finding was that the neighborhood is an important place for socializing with both family and friends for this population as is the case for working-class white elderly adults. A surprising finding is that, whereas social contacts increase with higher income for working-class elderly whites, for these black elderly adults who are of the working class and poor, social contacts decrease with higher income. PMID- 6863860 TI - The mental health of small-town rural elderly residents: an expanded ecological model. AB - This study describes the development of an expanded ecological model of rural mental health and examines its efficacy for explaining the mental health status of 358 male and 631 female (aged 65 years or older) residents of 18 small Kansas communities. Utilizing standard structured interview data, a holdout sample strategy was used to test the impact of environmental (ecological/architectural, psychosocial), well-being (activity, security, housing satisfaction, social contact), and demographic dimensions upon composite mental health scores. Tests of the model for each sex showed that different sex-specific "causal" dynamics explained similar proportions of variation in mental health for both males and females (26.4, 27.4%, respectively). Overall, a less complex model of mental health is indicated for men than for women. The relevance of the model for conceptual, empirical, and interventive pursuits is discussed. PMID- 6863861 TI - Consumption patterns of the retired household. AB - Although age differences in consumption patterns are often attributed to retirement status, previous consumption research has failed to examine this assumption. In this research, data on 4,004 elderly households were drawn from the Bureau of Labor Statistics 1972 to 1973 Consumer Expenditure Survey to test the life-stage consumption hypothesis. Using multivariate techniques, expenditure differences between the retired and nonretired family were established for most consumption categories. Compared with the nonretired family, the retired family commits a smaller proportion of additional income to necessities, a much larger proportion to gifts and contributions, and an equal proportion to transportation. Although an analysis of consumption patterns suggests that the average retired household enjoys a considerable degree of economic security, medical care and energy-related expenses emerge as major budgetary problems. Finally, this research indicates that the retired family does not rely on savings to buffer the erosion of income following retirement. PMID- 6863862 TI - [Assay of plasma hCG. Our experience with the diagnosis of extra-uterine pregnancies. Apropos of 45 cases]. AB - Two groups of patients who were admitted to hospital with a possible diagnosis of ectopic pregnancy were compared. The levels of HCG in the plasma were obtained as an emergency in the first group (45 cases). The levels were not obtained in the second group (34 cases). Only those cases in the first group where the assays had shown the presence of HCG underwent laparoscopy: 12 laparoscopies revealed 7 extra-uterine pregnancies. In the second group, on the other hand, all 34 patients had laparoscopy; only 8 extra-uterine pregnancies were discovered by this method. Because of this study we found that when HCG assays were carried out there was no false positive or negative. When we wanted to rule out an L.H. peak in a doubtful case the assay was repeated. The comparison between the two groups underlines the importance of carrying out the assay: it avoids useless laparoscopies but it also shortens the length of stay in hospital. PMID- 6863863 TI - [Cancer of the vulva. Diagnostic and therapeutic aspects apropos of a series of 90 cases]. AB - The authors present a series of 90 cases of cancer of the vulva of which 10 were intra-epithelial and 80 were invasive. These were studied from the 1st January 1962 through to the 31st December 1980. The mean age was 70.04 years, the range being from 31 to 92 years of age. Most cases however were between the ages of 70 and 80. 37.7% of the patients were debilitated. The condition was brought to notice by the discovery of a tumour in 48.8% of the cases, the onset of pruritus in 20% of cases and pain in 14.4%. Most of the tumours were found on the labia majora and minora (in 52.2%). FIGO classification was of stage I in 12% of cases, stage II in 26.6%, stage III in 33.3% and stage IV in 28%. The methods for treating these conditions have been shown according to whether the tumour was intra-epithelial or invasive. Analysing the results confirms that this kind of cancer has a poor prognosis: 57.6% of survivors after 2 years but only 37.3% after 5 years (an actuariel calculation). 30 cases of relapses were analysed and also the complications that occurred. Among these were most frequently (25%) lymphocoeles, sutures falling out because of necrosis and infection (34.2%), urinary incontinence (35.2%). The circumstances in which the patients died were determined above all by the way the disease evolved locally, but in 13.3% of the cases there was metastatic disease. Finally, the difficulties of the diagnosis and of the definition of micro-invasive cancer of the vulva are commented on. The authors point out that the prognosis depends as much as anything on the amount the lymphatics are involved, the frequency and the problems of therapy that are posed by urinary incontinence which occurs after operation. They then give their ideas for treating the patients. PMID- 6863864 TI - [Rapidly-appearing carcinoma in situ and invasive cancer of the cervix]. PMID- 6863865 TI - [Cervical pregnancy. A rare entity that should not be missed]. AB - The authors report a new case of cervical pregnancy in a primigravid woman of 31 years of age who had had 15 weeks of amenorrhoea. They review the clinical and anatomo-pathological criteria necessary to make the diagnosis. The diagnosis which had become suspected because of ultrasound was confirmed by examination under a general anaesthetic before interrupting pregnancy. Conservative treatment was made possible because there was no very heavy bleeding after the curettage to evacuate the products. PMID- 6863866 TI - [Cancer of the liver in pregnancy. Reflections apropos of a case]. AB - Primary cancer of the liver is rare in western countries. Men of a mean age of 60 tend to be more subject to it than women. In Africa, however, younger people of a mean age of 36 and more women become subject to it. 13.5% of malignant tumours of the liver are found in African women with a mean age of 34 years. Thus, the association of liver cancer with pregnancy is rare. The case which has been studied concerns a woman of 34 years of age, a para. 2 in her 4th pregnancy. There were no known pathogenic factors such as the taking of androgens or of oral contraceptives. The main symptoms were pain in the right side and in the centre of the abdomen. A tumour increasing in size was found. The alpha fetoprotein ratio was high and increased as pregnancy progressed. Ultrasound and scintography were positive. Liver cytology testing failed. The patient died soon because the disease progressed rapidly after a stillborn baby had been born prematurely and laparatomy had been undertaken. Laparatomy is the last possible method of diagnosis and treatment. Pregnancy seems to accelerate the development of liver tumours and makes them a very high risk. Since chemotherapy has not yet been demonstrated to be effective, only surgery can be considered as a possible therapy. The association of primary cancer of the liver with pregnancy is rare and of poor prognosis. PMID- 6863868 TI - [Prognosis for delivery in women with previous cesarean section. Apropos of 209 cases]. AB - The authors have attempted to show the following with the help of 209 cases of delivery in women who had previously had Caesarean sections: Vaginal delivery is possible in approximately one out of every two cases, providing certain precautions have been taken and these are: Maternal morbidity rises to about 12% when a woman is delivered after a previous Caesarean section, whether the delivery is vaginal or, a repeat Caesarean. Furthermore, morbidity rises greatly after a failure of a trial of labour for which the indications should be very carefully considered. The outlook for the fetus is better after a vaginal delivery. In fact, this result seems to be allied to pathology which results from the surgical procedure itself. All the same, respiratory distress in the newborn is more frequent after Caesarean operation, which exposes the fetus to the risks of a uterine rupture and also of increased incidence of instrumental delivery following a previous Caesarean. PMID- 6863870 TI - Hospital capital formation in the 1980s: is there a crisis? AB - Access to capital will be a serious problem for a subset of our nation's hospitals in the 1980s. Without adequate capital to modernize or maintain life safety codes, certain facilities may have no other choice than to close their doors. The consequences of closure are far-reaching and long-lasting. The hospitals that exit from the market may be forced out as a result of their location or payor mix, and not as a consequence of their inefficiency. Allowing capital formation in the hospital industry to be determined by the market criteria of bottom-line performance may lead to a serious contraction of the field, to increased financial hardships for the hospitals that remain, to reduced service provision, and to plant deterioration. PMID- 6863867 TI - [Embryonal mole: value of echography. Apropos of 9 cases]. AB - Hydatidiform embryonic mole is characterised by a special appearance of the placenta, the presence of an embryo or a fetus and a triploid caryotype. The authors report on ultrasound analysis of 9 hydatidiform moles in which the histological diagnosis was confirmed by careful anatomo-pathological examination (with suspicion of triploidy). The ultrasound diagnosis of a complete or partial hydatidiform mole can be made if the following criteria are noted: the placenta is larger and thicker than the placenta of pregnancies of the same duration and shows up with a partial molar appearance; there is the presence of an empty gestation sac or one that contains amorphous echoes suggesting a macerated fetus; a well formed fetus, which has died or is alive but has intra-uterine growth retardation; in early pregnancies, pregnancies that are usually not progressing; if there is a suspicion of a hydatidiform mole search should be made thoroughly for associated malformations (such as triploidy); the presence of lutein cysts of the ovary is a rarity. PMID- 6863871 TI - On "some pitfalls in creating competition between HMOs and fee-for-service delivery". PMID- 6863869 TI - Protecting the reproductive health of workers: problems in science and public policy. AB - This paper first reviews the scientific problems involved in assessing the effects on reproductive health of toxic substances in the work environment. It then describes the current status of regulatory policies designed to control workers' exposures to toxins believed to affect reproduction. Finally, the paper discusses the relationship between scientific uncertainty and regulatory strategies. Because demonstrating reproductive health effects is extremely difficult, the assessment of the health risks of exposures, as well as of the economic costs of regulation, is probabilistic. Therefore, uncertainty is inherent in any regulatory decision in this area. And the case of reproductive risks is illustrative of the more general problem of protecting the health of workers within a context of scientific uncertainty, and within a highly charged political environment characterized by anti-regulatory sentiment and industries in economic decline. PMID- 6863872 TI - On "economic dependency, health services, and health: the case of Lesotho". PMID- 6863873 TI - Tax and spend. PMID- 6863874 TI - Bags, buckles, and belts: the debate over mandatory passive restraints in automobiles. AB - Seatbelt-wearing occupants of motor vehicles experience a death rate that is half that of nonbelted occupants, yet fewer than 10 percent of the population regularly wear their seatbelts. The potential of effective passenger-restraint systems to substantially reduce mortality and disability has led the federal government to consider requiring all new vehicles to come equipped with restraint systems that take effect without active participation from the passenger--airbags or automatic seatbelts. Since 1969, the government has issued several rulemakings to that effect, but each has been delayed or rescinded, the result of an ongoing debate about the policy's wisdom. Political and economic interests are at stake, as are matters of principle; and disputes over basic facts remain unresolved. Both advocates and opponents of a mandatory passive-restraint requirement agree that restraints can prevent deaths and disabilities, though there are differences of opinion as to the degree of protection afforded. Opponents of the requirement concentrate their substantive concerns on the propensity of the public to disconnect passive belts and the reluctance of prospective car buyers to pay the additional cost that airbags would entail. Cost-benefit analyses of a passive restraint requirement find the requirement socially desirable; but they fail to take distributional issues into account, and several of their assumptions have been challenged by the automobile industry, the only major organized opposition to the requirement. This paper examines the central issues and evidence in the debate, including a consideration of alternative means of achieving effective, efficient passenger restraint. PMID- 6863875 TI - The economics of safety deregulation: lives and dollars lost due to repeal of motorcycle helmet laws. AB - Between 1976 and 1980, 28 state legislatures in the United States repealed or weakened their motorcycle helmet-use laws. This paper estimates the number of excess deaths attributable to this deregulatory activity, and the associated economic costs to society. Because of data limitations, no attempt was made to estimate the excess nonfatal injuries and associated costs. We applied a variant of log-linear contingency-table analysis to the monthly counts of motorcycle fatalities in the 48 contiguous states over the period 1975 through 1980. This analysis produced estimates of the total number of deaths, in each of 36 age-sex groups, that could be attributed to changes in the helmet laws. We then estimated the direct and indirect economic costs associated with fatalities in each age-sex group. Our findings indicate that 516 excess deaths occurred in 1980 in the 28 states that weakened or repealed their helmet laws. This represented 24 percent of the total motorcycle fatalities occurring in those states. Women and younger cyclists of both sexes comprised a disproportionate share of excess deaths. The economic costs to society that are associated with the excess fatalities resulting from the repeals of helmet laws total at least $180 million. PMID- 6863877 TI - A new and natural method of treatment of peptic ulcer disease. PMID- 6863876 TI - Informed consent: ambiguity in theory and practice. AB - The law of informed consent expresses in legal form the ethical principle of autonomy and respect for autonomy. It is intended to enhance self-determination and rational decision-making in medicine. Three tests might be made of whether a law is a good law: (1) Is it clear and unambiguous enough to admit of fair, equal, and consistent enforcement? (2) Does it gain compliance, and widespread ideological agreement? (3) Does it enjoy a measure of success in achieving its intended goals? The law of informed consent does not impressively pass any one of these tests. It is deeply ambiguous, both in its formal structure and its pragmatic implementation. It has not won ideological agreement, doctors having been openly hostile to it, and legislatures having written statutes limiting it. There is little evidence that it has succeeded in its goals. Paradoxically, its pragmatic value might be rooted in its ostensible weakness, its ambiguity, in that this very quality keeps the discussion going. Perhaps the essential problem lies in the fact that the philosophical notion of autonomy is not a phenomenologically accurate description of the condition of the person who seeks medical help--the map is not the territory. PMID- 6863878 TI - Does intestinal resection heal the pyoderma gangrenosum of inflammatory bowel disease? AB - A retrospective study of nine patients with active pyoderma gangrenosum at the time of operation for inflammatory bowel disease showed two patterns of postoperative skin healing: 1) prompt healing within 2 months, occurred in five patients with moderate to severe inflammatory bowel disease. 2) skin disease persisted in four others, healing only after a year. Three of these patients had mild ulcerative colitis, and in them, the operation was carried out in the hope of curing crippling pyoderma gangrenosum. The fourth patient had only an intestinal bypass for ileitis. Our observations suggest that prompt skin healing may occur after surgery in patients with severe inflammatory bowel disease, but not necessarily in those with milder bowel disease or in those in whom some bowel disease persists. PMID- 6863879 TI - What the patient wants to know about Crohn's disease. PMID- 6863880 TI - Biofeedback improvement of lower esophageal sphincter pressures and reflux symptoms. AB - During a course of 10 biofeedback sessions in a single subject, the lower esophageal sphincter pressure measured with an open-tipped perfused catheter assembly showed significant and progressive increase with each session, until it reached normal levels. There was also a decrease in symptomatic reflux episodes, from three times daily to once every 2 weeks. Macroscopic esophagitis was detected by endoscopy before the first session, but was no longer evident in the endoscopic examination after biofeedback training. After the biofeedback training program, the subject was able to control his lower esophageal sphincter without biofeedback. PMID- 6863881 TI - False-positive serum gastrin elevation during secretin stimulation due to Boots secretin. AB - Five patients with hypochlorhydria, chronic gastritis, and high serum gastrin levels and four control subjects underwent secretin stimulation testing. Gastrin determinations were made by a commercially available radioimmunoassay kit. Intravenous Boots secretin gave positive stimulation tests in all patients and controls. Positive Boots secretin stimulation tests in two of the control subjects were confirmed by a different gastrin assay kit. Synthetic secretin stimulation in two of the patients and the four control subjects showed no rise in postsecretin gastrin. Gastrin assay of pure Boots secretin from three different lots gave values ranging from 170,000 to 1,620,000 pg/ml. Gastrin assay of synthetic CCK 8 gave values of 718,600 and 1,300,000 pg/ml. Gastrin-like activity was undetectable in synthetic and GIH secretin and the normal saline used as a diluent. We conclude: 1) Boots secretin contains a contaminating substance or substances exhibiting immunoreactivity with commercially available gastrin assay kits, 2) cholecystokinin or cholecystokinin-like peptides are the leading candidates for contaminating substances in some assays, and 3) Boots secretin can cause false-positive secretin stimulation tests and should not be used in the secretin stimulation test for hypergastrinemia. We have switched exclusively to Kabi (GIH) secretin. PMID- 6863882 TI - Acute hepatitis associated with campylobacter colitis. AB - A patient with proven campylobacter fetus ss. jejuni acute colitis developed hepatocellular dysfunction, which paralleled the course of the colitis. Liver biopsy showed nonspecific reactive hepatitis. Other causes of acute hepatocellular damage were excluded. The patient made a complete recovery. PMID- 6863884 TI - Giant bile cyst following cholecystectomy. PMID- 6863885 TI - The computer revolution. PMID- 6863883 TI - Delayed hemorrhage after percutaneous liver biopsy. AB - Clinically significant hemorrhage immediately after percutaneous liver biopsy is an uncommon, although well-recognized risk of the procedure. However, hemorrhage from the biopsy site delayed a day or more after the procedure is a seldom appreciated potential complication. Delayed hemorrhage from the liver biopsy site may go unsuspected; in fact, the patient may no longer be under direct medical surveillance. We describe two cases of such delayed hemorrhage which we attribute to intrahepatic hematoma at the site of biopsy. Neither patient had a prebiopsy contraindication to the procedure. One patient suffered a fatal intraperitoneal hemorrhage 15 days after liver biopsy, the other a massive, but nonfatal intrahepatic hemorrhage 41 hours after the procedure. In the first patient, a hemorrhagic diathesis developed in the immediate period after biopsy; no predisposition to hemorrhage could be identified in the latter patient, even retrospectively. The admittedly rare possibility of delayed hemorrhage should be considered whenever a liver biopsy is performed. PMID- 6863886 TI - Extrahepatic biliary tract obstruction due to plasmacytoma. AB - In multiple myeloma, diffuse infiltration of the liver by myeloma cells can result in hepatic dysfunction and enzyme elevation. Discrete plasmacytomas are unusual and seldom disturb hepatobiliary function. We report a patient who developed jaundice due to extrahepatic biliary obstruction caused by an abdominal plasmacytoma. PMID- 6863888 TI - The gastroenterologist as a hepatitis B carrier. PMID- 6863889 TI - Starch blockers. PMID- 6863890 TI - Toxic milk, a new mutation affecting cooper metabolism in the mouse. AB - Toxic milk, tx, a new autosomal recessive mutation in mice is described. Litters produced by mutant females display a syndrome including poor growth, hypopigmentation, tremors, and ultimately death at two weeks of age. These features, consistent with copper deficiency, are attributed to failure in gestational hepatic copper accumulation exacerbated by subsistence on milk with greatly reduced copper content. Such infants can be rescued by foster-nursing on normal dams or by administered of supplemental cooper. Mutants themselves amass extraordinarily large concentrations of hepatic copper that ultimately leads to liver disease. Erroneous hepatic copper metabolism is further evidenced by reduced ceruloplasmin activity. PMID- 6863887 TI - A preliminary report of percutaneous cholecystostomy under ultrasonography and fluoroscopy guidance. AB - We carried out percutaneous cholecystostomy and cholangiography without incident under guidance of ultrasonography and fluoroscopy in three patients with obstructive jaundice, cholangitis, and acute cholecystitis. The technique appears to be safe and can be performed at the patient's bedside, which gives it an advantage over surgical drainage. Moreover, the percutaneous route can be used for biliary drainage when the transhepatic approach is not possible. PMID- 6863891 TI - Origin of X/O progeny from crosses of sex-ratio trait males of Drosophila pseudoobscura. AB - Males of Drosophila pseudoobscura carrying the sex-ratio chromosome (SR) were studied to determine the cause of X/O male progeny that they produce. It was found that among 3671 X/O progeny virtually all resulted from nullo-X sperm. The experiment also revealed a dramatic clustering of the frequency of X/O progeny among SR/Y males. This is interpreted to indicate that premeiotic events in the male germ line are the cause of nullo-X sperm. PMID- 6863892 TI - Developmental interactions of cells mutant for Strong's luxoid gene with normal cells in chimeric mice. AB - Mouse chimeras were made by fusing embryos from the albino BALB/cFo normal skeleton strain producing a slow variant isozyme of glucose phosphate isomerase (GPI) with embryos from the black pigmented SH strain carrying Strong's luxoid gene (symbol: 1st) for skeletal anomalies and producing a fast GPI variant. All chimeras were estimated to bALB/cFo mice to determine the mosaic status of their gonads. In addition, the quantitative proportions of BALB/cFo and SH cells in skin and limb muscles of chimeras were determined by visual estimation of the degree of coat pigmentation and by a serial dilution method applied to electrophoresis and GPI isozyme reaction of limb muscle homogenates. Skeletons of all chimeras and of representative samples of BALB/cFo and SH mice were examined and graded for expression of a number of normal and mutant skeletal characteristics. The most important conclusion of this study is that there was a definite quantitative effect on the development of skeletal characteristics exerted by the relative amount of BALB/ cFo and SH cells present in a chimera such that a structure could vary from normal to entirely mutant, depending on the proportion of each type of cell present. PMID- 6863894 TI - Four dominant autosomal mutations affecting skin and hair development in the mouse. AB - Four new dominant autosomal mutations influencing the development of skin and hair in the mouse were tested for allelism with each other and with hairless, hr. Three of the mutations probably constitute an allelic series and have been given the symbols Frl1, Frlb, and Frlc. The Frl series shows no evidence of linkage with hr. The fourth mutation, Hrn, is a dominant and homozygous viable allele at the hr locus. With the possible exception or Frlb, all mutants were of spontaneous origin. Because of their unique characteristics, these new mutants are of potential value as mouse model systems in studies of skin carcinogenesis and related areas of research. PMID- 6863893 TI - Effect of selection, mutation, and linkage on the equilibrium structure of selfing systems. AB - One-, two- and three-locus models of selection and mutation in completely self fertilizing populations are examined. Equilibrium frequencies can be determined for these systems. Numerical analyses indicate that random genetic drift attributable to selfing plays a major role in determining equilibrium frequencies, even when strong directional selection is operating. Linkage has no effect on marginal gene frequencies or single-locus heterozygosity at equilibrium. The only model of those examined which leads to linkage disequilibrium is disruptive selection. In that model, selection reinforced the effect of selfing in favoring the homozygous genotypes. PMID- 6863896 TI - LINKAGE-1: a PASCAL computer program for the detection and analysis of genetic linkage. PMID- 6863895 TI - Juvenile ataxia--a new behavioral mutation in the deermouse. AB - An autosomal recessive behavioral mutation designated juvenile ataxia (ja) was first isolated from F2 progeny of four blonde (bl) Peromyscus maniculatus bairdi siblings. Juvenile ataxic homozygotes exhibit an ataxic gait without an associated tremor from 15 days postpartum. This ataxia continues but does not increase noticeably in severity until between 35 and 43 days of age. Thereafter, a rapid and dramatic improvement in the behavior pattern is seen, so that juvenile ataxic deermice over 45 days of age are phenotypically indistinguishable from wild type or heterozygotes of the same age. Female juvenile ataxic homozygotes rarely breed, while male homozygotes are fully fertile. Linkage tests between juvenile ataxia and blonde suggest that these two mutations are not allelic and are not tightly linked. Testing between juvenile ataxia and a previously described neurological mutant, boggler (bg), indicates that complementation between these two mutations is incomplete, and suggests that boggler and juvenile ataxic may represent allelic mutations. PMID- 6863897 TI - Desired family size and sex of children in Nigeria. AB - During 1981, sex ratio data and preferences for family size and for combinations and permutations of children were provided by 333 Nigerian students at the University of Ilorin, Ilorin, Nigeria. For the present and parental generations combined, the secondary sex ratio was estimated to be 95.8 males:100 females. In the projected families, preferences for family sizes resulted in an average of 4.88 children per family. The most preferred family consisted of four children--a 2m2f combination in a mfmf order, whereas the second most preferred family consisted of five children--3m2f combination in a mfmfm order. Also expressed was a strong preference for permutations of sexes, resulting in a male child as first born followed by an alternation of sexes. A greater preference for male children was indicated by the combined sex ratio of 167 males:100 females for the preferred families. PMID- 6863899 TI - Genetic control of plasma cholesterol response in the rat. AB - The inheritance of the susceptibility for dietary cholesterol in the rat has been studied by testing the plasma cholesterol response in male animals from crosses between hyperresponding and hyporesponding inbred strains. Comparison of the variances of the response of genetically uniform groups (parental strains and F1 hybrid) and segregating groups (backcrosses and F2 hybrid) revealed that more than 80 percent of the observed variation can be attributed to additive genetic factors and indicated that two major genes are involved in the control of the plasma cholesterol response. PMID- 6863900 TI - Immunoelectron microscopic exploration of the Golgi complex. AB - Using immunogold labeling of ultrathin cryosections, we have studied the localization of secretory, lysosomal, and membrane proteins in the Golgi complexes of several cell types. All proteins were present in the stacks of Golgi cisternae, illustrating that the cisternae comprise a ubiquitous way station for proteins with multiple destinations. The labeling patterns support the concept that peripheral Golgi vesicles represent the main site of secretory protein concentration. Of the membrane proteins studied, the Golgi enzyme galactosyltransferase was confined to the trans-most few cisternae, whereas the receptors for asialoglycoproteins and for polymeric immunoglobulin A occurred in most cisternae, with increasing concentration approaching the trans side. The findings are discussed in relation to a cisternal cis to trans progression of Golgi cisternae and membrane specificity. PMID- 6863898 TI - Blind-sterile: a new mutation on chromosome 2 of the house mouse. AB - The inheritance and developmental effects of a new recessive mutation in the mouse, blind-sterile (bs), are described. This mutation causes lenticular cataracts and glossy coat in males and females and sterility in males due to arrested spermatogenesis. Blind-sterile is located on chromosome 2, near agouti. PMID- 6863901 TI - [Degenerative changes in the occipital neocortex in chronically amphetamine treated rats]. AB - Neurons of the Wistar-rats' occipital cortex were morphologically investigated after chronical application of amphetamine. The nerve cells impregnated according to the Golgi-Kopsch technique showed in part changes on both the dendrites and in the axonal region. Besides a partial reduction of spines and of peripheral dendritic arborizations round varicosities of different density could be observed on the dendrites and on the axon, either, which were discussed to be due to a neurotoxic effect of amphetamine. PMID- 6863903 TI - Proliferation of subependymal cells in the adult primate CNS: differential uptake of DNA labelled precursors. AB - New formation of stem cells in the subependymal brain layer of a normal adult primate has been documented by light and electron microscopy and through 3H thymidine (3H-TdR) uptake studies. Serial sections (1.5 micrometer) prepared for autoradiography were examined under the light microscope and then re-embedded for electron microscopy. In individual sections subependymal cells did not appear labeled; however, serial sections revealed that many cells were slightly labeled indicating a low level of 3H-TdR incorporating during DNA synthesis. Dividing subependymal cells were also observed by light and electron microscopy. The poor incorporation of intraperitoneally injected 3H-TdR is due to the blood-brain barrier toward 3H-TdR. Rat experiments with the thymidine analogue, 125I iododeoxyuridine (IUDR-125I) showed that after intraventricular injection of IUDR 125I about ninety times more radioactivity is incorporated into dividing stem cells of the brain than after an intraperitoneal injection of IUDR-125I. Differential corporation of 3H-TdR seems to depend on the type of stem cells, i. e., whether a stem cell may be precursor for glial or neuronal brain cells. Changes in membrane permeability, intracellular DNA activity as well as difference in locally available "cold" thymidine may be a reason for differential uptake of radioactive thymidine. Differential uptake of 3H-TdR needs consideration when autoradiography is applied on brain cells. PMID- 6863902 TI - [Retinotopic projections of the trout (Salmo gairdneri)]. AB - The retinotopic organization of the thalamic and tectal and visual centres was studied by Fink and Heimer method and radioautography. Quadratic lesions were achieved in the right retina of 21 adult trouts and 23 six month old specimens. Fourteen animals (adults) were kept alive for 20 to 25 days after operation, in running water at 13 degrees C and prepared for the Fink technique. In the remaining 7 adults and in the 23 six month specimens, we injected, 48 hours after the lesion, respectively, 2,5 microCi (in 20 microliters) and 0,5 microCi (in 1 microliter) of 14 C proline into the operated eye. The brains were prepared for radioautography. Results show that the thalamic pathways is not correlated with a peculiar quadrant. Nevertheless the temporo dorsal hemiretina sends the more numerous projections at this level. A topographic parallelism exists between retino-geniculate and retino-tectal projections. At the tectal level our data are somewhat at variance with those of electrophysiological mapping, since quadratic projections show a partial overlapping. In the optic tract, the fibres from every quadrant follow always the same pathway. PMID- 6863904 TI - Qualitative and quantitative characteristics of the synapses in the cerebral cortex of the dog after the ligation of middle cerebral artery. PMID- 6863906 TI - The cephalic neuroendocrine system in the beetle, Mylabris pustulata (thunb) (Meloidae: Coleoptera). AB - The cephalic neuroendocrine system in Mylabris pustulata includes neurosecretory cells in the brain, a pair of corpora cardiaca and corpora allata. There are three groups of the neurosecretory cells in each hemisphere of the brain-medial and lateral in the protocerebrum and central in tritocerebrum. They are classified into three types viz., A, B and C on the basis of staining affinities they exhibit. The axons of the medial, lateral and ventral neurosecretory cells constitute independently the medial, lateral and ventral neurosecretory pathways respectively inside the brain. The medial neurosecretory pathways emerge out of the brain as nervi corporis cardiaci I while the lateral and ventral neurosecretory pathways form collectively the other nerve, nervi corporis cardiaci II and innervate the CC. The CC contain two types of cells viz., the chromophilic, which are AF-positive and the chromophobic cells, which take the counterstain. The corpora allata are compact bodies and contain cells of one type but fluctuations in the nuclear size and the gland are occur frequently. PMID- 6863905 TI - The acetylcholine system in the brain of cyclostomes with special references to the telencephalon. AB - The distribution of cholinergic neurons is studied in the brains of cyclostomes (Lampetra fluviatilis and Myxine glutinosa) representing an early stage of vertebrate evolution. Histochemical localization of acetylcholinesterase (AChE) is complemented by quantitative determinations of acetylcholine (ACh), cholinacetyltransferase (ChAT) and AChE. The determinations are carried out in homogenates of whole brains, the brain regions telencephalon, diencephalon, mesencephalon and medulla oblongata. The telencephalon is further subdivided and studied in more detail.The transmitter distribution found in cyclostomes is compared to data from other vertebrates. Observations on the ACh-distribution in the telencephalon are discussed with the problems of identifying telencephalic homologies. PMID- 6863907 TI - Lamina boundaries of the human striate area compared with automatically-obtained grey level index profiles. PMID- 6863908 TI - Quantitative analysis of the laminae of the striate area in man. An application of automatic image analysis. AB - 181 cortical fields from the striate area of 11 normal, adult brains were studied using the grey level index method. The absolute and relative thickness, the relative portion of the GLI profile, and the mean absolute and relative GLI of the different laminae of the striate area were measured. The values for the laminae were analysed for correlation. Significant correlations could partly be explained by the influence of the geometrical shape of the cortex. The lamina data of one brain were examined in relation to the position in the sulcus calcarinus. PMID- 6863909 TI - A comparison of live and inactivated influenza A (H1N1) virus vaccines. 1. Short term immunity. AB - Groups of volunteers were immunized subcutaneously with one of three inactivated influenza virus A/USSR/77 (H1N1) vaccine preparations; a whole virus vaccine, a surface-antigen subunit adsorbed vaccine, or an aqueous surface-antigen subunit vaccine. The reactions to immunization were recorded, and the antibody response was measured 1 month later. A fourth group of volunteers were inoculated intranasally with live attentuated A/USSR/77 (H1N1) influenza virus; the reactions and antibody response of these volunteers were also measured. One month after immunization, the incidence of infection by challenge with homologous live attentuated virus was determined for all groups of volunteers. The results showed that all four vaccines used were relatively non-reactogenic, and that inactivated vaccines induced higher titres of serum antibody than the live attenuated vaccine. All the vaccines induced significant protection against challenge virus infection which was directly related to the level of serum HI antibody response. PMID- 6863910 TI - A comparison of live and inactivated influenza A (H1N1) virus vaccines. 2. Long term immunity. AB - Groups of volunteers were immunized with one of three influenza virus vaccines, and the resistance to challenge infection with attenuated influenza A (H1N1) virus was measured 8 months later. The vaccines were aqueous subunit influenza A/USSR/77 (H1N1) vaccine, aqueous subunit influenza B/Hong Kong/73 vaccine, or attenuated influenza virus A (H1N1) vaccine. The B virus vaccine was included as a control to assess the incidence of natural A virus infection during the study period. A proportion of the B virus vaccinees had pre-existing A (H1N1) virus antibody and were used to study the immunity conferred by natural infection to the live virus challenge. The serum antibody responses were measured at 1 and 8 months after immunization. The results showed that all the vaccines induced serum HI antibody in a proportion of the volunteers; however, after 1 month, higher titres of serum antibody were found in volunteers given inactivated A vaccine than in those given live attenuated A virus vaccine. Eight months post immunization the titres of serum antibody in volunteers given inactivated vaccine had declined significantly, but there were no changes in the antibody titres of those given live virus vaccine. The incidence of infection by the challenge virus at 8 months post-immunization was directly related to the serum antibody titres 1 month post-immunization; no evidence was obtained to suggest that those given live virus vaccine had a more solid immunity than those given inactivated vaccine. PMID- 6863911 TI - Recycling of H1N1 influenza A virus in man--a haemagglutinin antibody study. AB - Sera from people born between 1883 and 1930 and collected in 1977 were tested for the presence of HI antibodies to A/FM/1/47 (H1N1) virus and three recently (1977 and 1978) isolated influenza A-H1N1 viruses. The highest frequency of high-titred antibody to the four H1N1 viruses was detected in sera from people born in 1903 4, i.e. 42, 54, 38, and 22% had antibody against A/FM/1/47, A/Hong Kong/117/77, A/Brazil/11/78, and A/Fukushima/103/78 respectively. The birthdate groups 1896 1907 showed a higher percentage of HI antibody titres greater than or equal to 18, greater than or equal to 50, greater than or equal to 100 or greater than or equal to 1600 against the four H1N1 viruses than the birthdate groups 1907-30. This indicates the existence of an era, 1908-18, in which, apart from the H3N2 virus (1900-18), the H1N1 virus was epidemic among the human population. PMID- 6863912 TI - Rubella-specific IgM reactivity in sera from cases of infectious mononucleosis. AB - Eight sera from 125 cases of infectious mononucleosis (IM) were reactive for rubella-specific IgM in an M-antibody capture radioimmunoassay. The reactivity of individual sera varied depending upon the source of the rubella antigen used in the assay. One serum gave strongly positive results with some rubella haemagglutinating antigens but negative results with others and may have contained an IgM antibody which was capable of distinguishing between strains of rubella virus. If the diagnosis of rubella is based solely on detection in solid phase immunoassay of rubella-specific IgM, IM should be excluded. PMID- 6863913 TI - Characterization of Yersinia enterocolitica strains isolated from cattle, sheep and pigs in the United Kingdom. AB - The properties of 48 cultures identified as Yersinia enterocolitica or Y. enterocolitica-like organisms, including Y. frederiksenii, Y. intermedia and Y. kristensenii, were examined. Of these, 39 were isolated from faeces of apparently healthy pigs, five from healthy cattle, one from an aborted bovine fetus, one from an aborted lamb and one from a lamb suffering from acute enteritis. Most isolates from healthy animals were of Y. enterocolitica biotype 1 or Y. intermedia and belonged to O serogroups not usually associated with disease in man or animals. The isolates from abortion or enteritis cases were of Y. enterocolitica biotypes 3, 4 and 5 and belonged to the pathogenic serogroups 0:5b and 0:2a, 2b, 3. No organisms of serogroup 0:9 were found. PMID- 6863915 TI - Inhibition of human natural killer activity by lysosomotropic agents. AB - We have examined the effect of three lysosomotropic amines on human NK cell activity. Dansylcadaverine (DCA), diphenylamine (DPA), and lidocaine (LID) inhibited NK activity of nylon wool-purified and large granular lymphocyte (LGL) enriched cell preparations. Cadaverine (CAD), an analog of DCA that does not affect lysosomal function, had no effect on NK activity. Binding of the K562 target cells to effector cells, as assessed in a single cell assay, was not inhibited by DCA, DPA, or LID. Cytotoxicity was inhibited by DCA and DPA only when these drugs were added within 5 min after the initiation of NK assays. In contrast, LID inhibited NK activity even when added 60 min after the addition of effector cells to target cells. All three amines that inhibited NK activity also reduced the intracellular concentration of the lysosomal enzyme beta glucuronidase without affecting the activity of the cytoplasmic enzyme lactate dehydrogenase. Kinetic analysis revealed that LID inhibited both the maximum velocity (Vmax) of the cytotoxicity reaction as well as the affinity constant (Km); whereas DCA and DPA only inhibited Vmax. PMID- 6863916 TI - Circadian rhythm of thymosin-alpha 1 in normal and thymectomized mice. AB - Studies by many investigators have demonstrated that the immune system is subject to regular circadian fluctuation. Some rhythms that have been reported include circadian changes in components of the immune system, e.g., lymphocytes, and circadian variation in primary and secondary immune responsiveness. The observation that many of these rhythms are inversely correlated to the glucocorticoid rhythm has led to the suggestion that fluctuations in the immune system may be a result of the glucocorticoid circadian rhythm. This study was designed to see if thymosin-alpha 1 (Tsn-alpha 1), a 28-amino acid polypeptide isolated from bovine thymus that has been reported to influence thymocyte differentiation, might follow a circadian rhythm, and thus play a role in the periodicity of the immune system. In these experiments, groups of 10 C57BL/6 or Swiss Webster mice were sacrificed at 4- or 6-hr intervals over a 24-hr period. Serum Tsn-alpha 1 and corticosterone levels were determined by radioimmunoassay. Results from the first experiment showed that Tsn-alpha 1 undergoes a circadian rhythm (p less than 0.001) with an acrophase (time of peak levels) 1.5 hr after the onset of light, and an amplitude (amount of maximum variation from the 24-hr mean) of 0.493 ng/ml Tsn-alpha 1-like immunoreactivity. These results were confirmed in an experiment in which the animals were placed on a reversed light cycle. In a separate experiment, the Tsn-alpha 1 circadian rhythm persisted in mice thymectomized 6 mo. earlier. In this latter experiment, a significant increase in the amplitude of the corticosterone rhythm in the thymectomized relative to sham-operated controls was also observed. Although these experiments do not imply casuality, it is interesting that the time of peak Tsn-alpha 1 levels can be correlated with the time of optimal immune function. PMID- 6863914 TI - Survival of virulent Legionella pneumophila in aerosols. AB - Aqueous suspensions of virulent Legionella pneumophila grown on solid medium retained virulence and aerosol survival characteristics for several months. Significant numbers of viable organisms were recovered from aerosols held at various relative humidities (r.h.) for up to 2 h. The organisms survived best at 65% r.h. and were least stable at 55% r.h. Exponential phase broth-grown organisms survived poorly in aerosols in comparison with stationary phase broth cultures or organisms grown on solid medium, suggesting that the metabolic status of Legionella pneumophila organisms may be an important factor affecting their ability to survive in aerosols and cause respiratory disease. PMID- 6863917 TI - Immunologic and biochemical properties of several retinal proteins bound by antibodies in sera from animals with experimental autoimmune uveitis and uveitis patients. AB - Sera from guinea pigs and rabbits with and without experimental autoimmune uveitis (EAU) induced by immunization with retina, choroid, optic nerve, retinal rod outer segments (ROS) and purified bovine S-antigen were tested for the ability to immunoprecipitate 125I-labeled, detergent-solubilized bovine retinal proteins. The results demonstrate that three major protein antigens with m.w. of 50,000 (p50), 35,000 (p35) and 27,000 (p27) and several minor activities between 30,000 and 60,000 m.w. are recognized by antibodies from these animals. The p50 component was immunoprecipitated by sera from animals immunized with whole retina homogenate, the high speed supernatant of whole retina homogenate, ROS, and S antigen, and has been identified as S-antigen in competition experiments. The p35 band appeared when sera were used that were raised against antigen preparations containing membrane-bound retinal protein, i.e., whole retina homogenate, ROS, and washed ROS, and thus appears to be an ROS membrane protein. The p27 band was found when sera raised against ROS, washed ROS, optic nerve and whole retina homogenate were used, suggesting it is a membrane-bound antigen common to ROS and optic nerve. Serum from animals immunized with homologous choroid did not immunoprecipitate a detectable product. S-antigen and p35 were also precipitated by some uveitis patient sera. Because S-antigen is also an ROS protein as is rhodopsin, a putative uveitogenic retinal antigen, ROS appear to be an unusually rich source of autoantigenic proteins. S-antigen was also shown to be synthesized in the retina, and the primary translation product was indistinguishable from purified S-antigen by SDS-PAGE, thus eliminating the possibility that it is derived from or is cross-reactive with the 67,000 m.w. rhodopsin kinase. PMID- 6863918 TI - In vivo and in vitro production of anti-histone antibodies in NZB/NZW mice. AB - Anti-histone antibodies have been demonstrated in the sera of patients with both idiopathic and drug-induced lupus. We measured anti-histone antibodies in female NZB/NZW (F1) mice, which are considered to be a model of human SLE. Using a sensitive and quantitative enzyme-linked immunosorbent assay (ELISA), we detected minimal serum antibody activity in NZB/NZW mice younger than 4 mo of age and in nonautoimmune mice at all ages tested. Serum anti-histone antibodies progressively increased in NZB/NZW mice from 4 to 8 mo of age and showed an age related maturation from IgM to IgG. The predominant antibody activity in the older mice was to the individual histones H2B and H3, and the pattern of reactivity to the histone proteins was similar to that seen in human SLE. We also studied the spontaneous in vitro production of anti-histone antibodies using spleen cells from NZB/NZW mice of different ages. Culture supernatants were analyzed for antibody activity by an ELISA with total histones as the antigen. Spleen cells from older NZB/NZW mice, with elevated serum levels, produced 10 fold higher levels of antibody activity compared to age-matched nonautoimmune mice. Antibody production was maximal at 4 days of culture and was inhibited by the addition of puromycin to the culture. Surprisingly, spleen cells from 1 to 3 mo-old NZB/NZW mice, with normal serum levels, also demonstrated significantly elevated production. The antibodies produced by these young mice were mostly IgM, whereas spleen cells from older mice produced mostly IgG anti-histone antibodies. The present results provide the basis for using the anti-histone antibody system to study further the immune abnormalities that allow for autoantibody production. PMID- 6863919 TI - Frequency of responsiveness to the H-Y antigen among the B10.W lines. AB - B10.W females were immunized against syngeneic male cells (via the footpad and also i.p. in some strains) and their spleen cells were then restimulated in vitro and tested in the cell-mediated lympholysis assay for H-Y-specific killing of target cells. Only seven of the 33 tested lines were anti-H-Y responders. The effector cells obtained from each of the responder lines were then tested against male and female cells of other B10.W lines, as well as a number of classic B10 congenic lines, and the MHC molecules providing the context for H-Y recognition were identified. They were: Kk, Kw3, Kw7, Kw17, Kw27, Dk, and Dp. None of the strains generated effector cells capable of recognizing the H-Y antigen simultaneously in the context of the K and D molecules. The WOA1 females generated effector cells by using the Kw7 molecule for context of recognition, whereas the WR7 females produced cells recognizing the H-Y antigen exclusively in the context of the Dk molecule despite the fact that both lines share the Kw7 gene. Some of the effector cells cross-reacted with both male and female cells of other strains and this cross-reactivity could be attributed to the recognition of allogeneic MHC molecules controlled by K or D region genes. Interestingly, STA39 females generated Dp- but not Kw3-restricted anti-H-Y responses, whereas SAA48 females generated Kw3- but not Dw3-restricted responses; the Kw3-restricted cells cross-reacted with the Dp molecule. This cross-reaction might explain why the STA39 females do not mount a Kw3-restricted anti-H-Y response. Because the Kw3 + H-Y combination resembles Dp, the anti-Kw3 + H-Y T cells are functionally eliminated when tolerance of Dp molecules is attained in the STA39 mice. PMID- 6863920 TI - Isolation of intact Sm/RNP antigens from rabbit thymus. AB - A comparison of the immunologically reactive components of the highly conserved Sm and RNP autoantigens from various mammalian tissue sources suggested the complete absence of a major 26K to 27K Sm-specific polypeptide in rabbit thymus extracts prepared by conventional procedures. A simple modification of the solubilization protocol, achieved by sonicating a suspension of commercial rabbit thymus acetone powder in 0.35 M NaCI, gave an extract containing the full complement of immunologically reactive Sm and RNP proteins detectable in other mammalian species. Without further manipulation, extracts were immediately passed through an immunoaffinity column constructed from human SLE IgG with both anti-Sm and anti-RNP reactivities. The proteins of the purified Sm/RNP were recovered in sufficient quantities for direct analysis by protein staining or immunoblot assays. The antigenic polypeptides were recovered intact and consisted of a single 73K RNP-specific species together with Sm-specific proteins of 26K to 27K (a doublet) and 13K. These proteins were easily visible by protein stain as were nonantigenic components of 35K, 32K, 11K, and less than 10K. The same polypeptides were present in affinity-purified Sm/RNP from HeLa cells, although the RNP protein was slightly smaller. The resolution and integrity of the complexes isolated by this simple two-step procedure, requiring less than 4 hr for completion, is remarkable, and the protein composition of the product compares quite favorably with antigens isolated from other sources by considerably more lengthy and laborious procedures. PMID- 6863921 TI - Binding of phosphorylcholine by non-immunoglobulin molecules on mouse B cells. AB - Phosphorylcholine (PC), a molecule found in the cell wall of most serotypes of pneumococcus, has been used extensively as a probe for the study of network interactions during immune responses. The frequency of B lymphocytes capable of interacting with PC has not been directly examined. We used immunofluorescence to study the binding of PC and monoclonal anti-TEPC15 anti-idiotopic antibodies to murine lymphocytes. In addition to identifying PC-specific Ig molecules, PC was bound by a non-Ig molecule on the surface of a relatively large subset of B cells; this non-Ig marker shared an idiotypic determinant with the PC-binding myeloma protein HOPC8 (H8). PC-bearing R36a pneumococci bind to a similar subset of lymphocytes. This binding is inhibited specifically by PC coupled to bovine serum albumin and also by a monoclonal anti-H8 antibody. We suggest that bacterial interaction with B cells through non-Ig molecules capable of binding a dominant antigen like PC may possess functional significance, possibly during the events that lead to antibody induction by these microorganisms. PMID- 6863922 TI - Iodination and identification of surface membrane antigens in procyclic Trypanosoma rhodesiense. AB - Surface membrane proteins and glycoproteins of procyclic Trypanosoma rhodesiense were labeled with 125I by the use of the insoluble catalyst Iodo-Gen. Autoradiography of whole solubilized procyclic trypanosomes after sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) showed a minimum of 25 surface components to have incorporated radioactivity. These components ranged in m.w. from approximately 10,000 to approximately 285,000. Immunoprecipitation with rabbit antisera of Triton X-100 extracts of radiolabeled trypanosomes revealed a subset of at least 14 surface antigens. Two of these antigens (m.w. of 63,000 and 96,000) showed heavy incorporation of label and may be major proteins of the procyclic membrane. Sera from trypanosome-infected mice recognized an overlapping but different subset of surface antigens, including a doublet of very high m.w. Lectin precipitation using antilectin conjugates or bead-bound lectins indicated that many of the labeled surface components are glycoproteins including the two major proteins precipitated by rabbit antisera. Radiolabeled glycoproteins identified by these methods bear alpha-methyl-mannopyranoside and/or galactose residues but not N-acetyl glucosamine or fucose residues in quantity. The use of these methods in identifying potentially pathogenic trypanosomal antigens is suggested. PMID- 6863923 TI - Depression of natural killer cytotoxicity after in vivo administration of recombinant leukocyte interferon. AB - One hundred thirty-four patients with a variety of malignancies were treated in two phase I clinical trials of recombinant leukocyte A interferon (IFL-rA) produced by recombinant DNA methodology. IFL-rA was given by intra-muscular injection either twice daily or three times weekly for 28 days. Extensive monitoring of natural killer (NK) cell cytotoxicity was done on these patients with rigorously standardized assays and determination of the inherent variability of NK function for each individual. Interferon, as used in these two treatment regimens, failed to produce an appreciable increase in NK activity; in the majority of patients, there was no significant change in NK activity from the pretreatment baseline levels. An unexpected finding was the depression of NK activity in 30% of the patients. The data have been analyzed in terms of their possible relationship to dose and schedules of IFL-rA administration and to antitumor response. PMID- 6863924 TI - Immune properties of human teratocarcinoma. I. Human teratocarcinoma targets distinguish between natural killer and activated killer cells. AB - Four human teratocarcinoma (HT) cell lines were studied as a class of targets for natural (NK) and activated (AK) lymphocyte-mediated cytotoxicity. NK cells were found to be ineffective in lysing 51chromium-labeled HT targets. In contrast, alloactivated and mitogen-activated AK cells were highly cytotoxic for HT. The specificity of AK-mediated HT lysis was investigated by cold target competition experiments. The results showed that the target was shared by all HT lines tested but was not MHC related and was not present on lymphoblastoid cells (LBL) or on resting or activated normal lymphocytes. The demonstrated presence of unique fetal antigens on HT may provide an informative model for the study of AK target specificity and its functional relationship to differentiation. PMID- 6863925 TI - In vivo role of natural killer cells: involvement of large granular lymphocytes in the clearance of tumor cells in anti-asialo GM1-treated rats. AB - The present study was performed to further evaluate the possible in vivo involvement of natural killer (NK) cells in host resistance against tumors. Selective depression of NK activity in Wistar Furth rats was induced by i.p. or i.v. injection of rabbit anti-asialo GM1. This antiserum has previously been shown to produce a decrease in NK activity and a parallel increase in tumor growth in mice. In the present study, rats treated with this antibody showed a parallel decrease in NK activity and in the frequency of large granular lymphocytes (LGL) in the spleen and peripheral blood, indicating that the antiserum-induced depression of NK activity in these sites was probably caused by an elimination of most effector cells. To further determine the possible role of rat LGL in tumor rejection in vivo, we studied LGL involvement in the rapid clearance of radiolabeled tumor cells from the lungs, an assay previously shown to correlate well with in vitro NK activity. Animals treated with anti-asialo GM1 antiserum were found to have a substantial decrease in the in vivo rate of clearance of tumor cells from the lungs. Furthermore, the adoptive transfer of a highly enriched population of LGL into NK-depressed animals 2 hr before tumor challenge, partially restored their cytotoxic activity against established cell lines in vitro and their ability to eliminate radiolabeled cells from the lungs. These results provide direct support for the hypothesis that NK cells are involved in in vivo resistance to tumors, particularly in the elimination of potentially metastatic tumor cells from the circulation and capillary beds. PMID- 6863927 TI - Isolation and properties of a new short ragweed pollen allergen, Ra6. AB - Two chromatographic forms (A and B) of the rapidly released short ragweed (Ambrosia elatior) pollen allergen Ra6 were isolated to antigenic ultrapurity by a combination of membrane filtration and ion exchange and gel filtration chromatography. Both Ra6 forms had a m.w. of 11,500 by gel filtration chromatography and 8000 by SDS-PAGE, and each consisted of two cathodically migrating bands on agarose electrophoresis at pH 8.5. Amino-terminal amino acid sequencing analysis detected two similar sequences (sequence 1 and sequence 2), which were present in different proportions in each of the chromatographic forms of Ra6. Among a ragweed-positive population sample (n = 101), 21% had specific IgE antibody (ab) and 42% specific IgG ab toward Ra6A; among ragweed-negative subjects (n = 260), 10.8% had IgG ab. We were unable to discriminate between Ra6A and Ra6B immunologically with the use of hyperimmune animal antisera or IgE and IgG ab from five Ra6-allergic humans. It appears that Ra6 is composed of at least four closely related isoallergens of similar size but slightly different charges and amino acid sequences, which appeared to be antigenically and allergenically indistinguishable according to present evidence. PMID- 6863926 TI - Monoclonal antibodies directed against mouse macrophages in different stages of activation for tumor cytotoxicity. AB - Three rat monoclonal antibodies against mouse peritoneal macrophages in different stages of activation were produced and characterized. One of these (AcM.1) bound to activated macrophages induced by pyran and Corynebacterium parvum, but not to resident and thioglycollate medium- (TGC) or proteose peptone- (PP) elicited macrophages. On the contrary, the antigen identified by MM9 monoclonal antibody was expressed only on resident and TGC- or PP-elicited macrophages. WE15 monoclonal antibody, on the other hand, reacted with all of the macrophages described above. In the assay for function, AcM.1 and WE15 monoclonal antibodies in the presence of complement (C) abolished the capacity of activated macrophages induced by pyran or C. parvum but not the capacity of killer T cells and natural killer (NK) cells to kill tumor target cells. On the other hand, MM9 and anti-Thy 1.2 monoclonal antibodies in the presence of C, as expected, did not affect the cytotoxicity of activated macrophages. However, none of the four monoclonal antibodies in the absence of C had any blocking effect on macrophage-mediated cytotoxicity. AcM.1 antibody reacted with two polypeptides with m.w. of 70,000 and 45,000 on pyran-activated macrophages; however, the antigens recognized by WE15 and MM9 have not been determined yet. These results indicate that the three rat monoclonal antibodies define different antigens present on macrophages at different stages of activation for tumor cytotoxicity, and that these antibodies should prove to be useful probes for analyzing the mechanism of activation of macrophages for tumor cytotoxicity. PMID- 6863928 TI - Binding of cyclosporine by human lymphocytes and phospholipid vesicles. AB - The purpose of this investigation was to identify and characterize a possible plasma membrane receptor for cyclosporine (CsA) on human lymphoid cells. Binding of 3H-CsA by normal human lymphocytes and purified lymphoid subpopulations was examined using ligand concentrations ranging from 5 X 10(-7) to 10(-10) M. Specificity was determined using a 500-fold excess of unlabeled drug. No differences were observed in the uptake of 3H-CsA by B cells or T cells using Cartesian or semilogarithmic analyses. Scatchard analysis of the specific binding of CsA by normal peripheral blood lymphocytes yielded two dissociation constants: a high affinity site with a KD of 2 to 6 X 10(-9) M and a low affinity site with a KD of about 10(-7) M CsA. Scatchard analysis of specific CsA uptake by purified splenic T cells and B cells showed both populations to exhibit a low affinity site (KD = 3 to 6 X 10(-7) M and 5 to 8 X 10(-7) M, respectively), whereas only B cells bore a high affinity site (KD = 2 X 10(-9) M). Analysis of specific CsA uptake by cultured human kidney cells and phospholipid vesicles (1:1 molar ratio of phosphatidylcholine:cholesterol) showed both these targets to display a single, low affinity binding site (KD = 1 X 10(-7) M and 2 X 10(-8) M, respectively). The relevance of the low affinity site to CsA-mediated in vitro immunosuppression was suggested by the need for 10(-7) M CsA to achieve 50% suppression of lymphoproliferation during mixed lymphocyte culture. Taken together, these data argue against the existence of a specific CsA receptor on the surface of human T cells. Although a role for the high affinity B cell receptor in some types of CsA-induced immunomodulation cannot be excluded, the present study suggests that immunosuppression is achieved by the partitioning of the hydrophobic CsA molecule into the membrane lipid bilayer, thereby perturbing homeostatic control of membrane function. PMID- 6863929 TI - The internal image of IgG in cross-reactive anti-idiotypic antibodies against human rheumatoid factors. AB - A network of idiotypes and anti-idiotypes has been hypothesized to modulate antibody production against exogenous antigens. Idiotypic antigens on autoantibodies have been studied because of their potential use for specific immunomodulation. The present studies describe the preparation and characterization of rabbit anti-idiotypic antibody against human IgM anti-IgG autoantibodies (rheumatoid factors, RF) that bear the "internal image" of the human IgG-Fc fragment, and hence react specifically with the majority of RF from patients with rheumatoid arthritis. The anti-idiotype was isolated from rabbit anti-RF antisera by either immunodepletion of anti-immunoglobulin antibodies, or more simply by a single affinity purification step on a rabbit anti-human IgG Fc column. As measured by an enzyme-linked immunoassay, the anti-idiotype prepared by both methods bound to plates coated with purified IgM RF, but not to plates coated with non-RF IgM proteins. The anti-idiotype dose dependently blocked the binding to IgG of IgM-RF in 83% of sera from multiple patients with rheumatoid arthritis, Sjogren's syndrome, and macroglobulinemia. The anti-idiotype did not inhibit the activity of human IgM antibodies against DNP, tetanus toxoid, or thyroglobulin. The antigen recognized by the cross-reactive anti-idiotype was not apparently associated with a particular light or heavy chain amino acid sequence, but rather was intrinsic to most immunoglobulins with RF activity. Broadly cross reactive anti-idiotypes with the "internal image" of IgG are simple to generate, and react with most RF. They may facilitate studies on the specific regulation of the human anti-IgG autoantibody response. PMID- 6863930 TI - Studies on demyelination in vitro: the requirement of membrane attack components of the complement system. AB - Anti-spinal cord antibodies (anti-SC) cause demyelination of well myelinated mouse cerebellum cultures in the presence of fresh serum. Heating the serum for 30 min at 56 degrees C abolishes the demyelinating activity. We studied the role of complement (c) in demyelination initiated by anti-SC in well myelinated mouse cerebellum cultures. Demyelination was assessed morphologically. The extent of demyelination was correlated to the dose of whole serum C as well as the dose of antibody. To evaluate the requirement of membrane attack components of C, C5b-C9, sister cultures were treated with antibody + C8 deficient human serum (C8D-HS) with and without purified human C8. Extensive demyelination was observed in C8 reconstituted cultures whereas antibody + C8D-HS did not demyelinate, indicating the essential requirement of C5b-8, and/or C5b-9. Extensively demyelinated cultures remyelinated when fresh medium was supplied, suggesting that the process of antibody and C-mediated demyelination is selective for myelin membrane in this system. PMID- 6863931 TI - Production and characterization of antibodies to thymosin beta 4. AB - Thymosin beta 4 antibodies have been raised in rabbits by conjugating the peptide to keyhole limpet hemocyanin, and a radioimmunoassay for thymosin beta 4 has been established utilizing tritiated thymosin beta 4 as binding ligand. RIA values for thymosin beta 4 in rat tissues reveal levels ranging between 8 and 448 micrograms/g wet weight. Highest levels are observed in spleen, although the peptide is also relatively abundant in thymus, lung, and nasal epithelium. Brain, kidney, liver and testis contain only 10 to 20% the concentration of thymosin beta 4 seen in spleen, whereas heart and muscle contain only 5 to 10% that of spleen. However, thymosin beta 4 probably has a ubiquitous distribution in the rat, being present in all tissues examined. The specificity of the antiserum used in the RIA has been defined. The thymosin beta 4 molecule seemingly bears two major epitopes that lie between amino acid residues 1-8 and 22-32. The antiserum does not cross-react with other unrelated peptides. The antiserum will precipitate biosynthetically labeled beta 4 from cultured rat peritoneal macrophage. PMID- 6863932 TI - Diverse specificities of five monoclonal antibodies reactive with glycophorin A of human erythrocytes. AB - Glycophorin A (GPA), the major sialoglycoprotein of human red cells, bears blood group MN determinants, and is a useful marker of the erythroid lineage in differentiating cells. Five monoclonal antibodies that react with GPA and possess a spectrum of serologic properties and fine specificities were obtained by immunization of mice with umbilical cord erythrocytes. Three antibodies, B22A, D22 and E11B, did not agglutinate En(a-) erythrocytes, genetic variants that lack GPA, and F11 and J11A agglutinated these cells very weakly. Antibodies B22A, E11B, and F11 agglutinated protease-treated cells more strongly than untreated erythrocytes, and they appeared to react with a peptide determinant located on the C-terminal side of the site at which trypsin cleaves GPA in the intact erythrocyte. In contrast to B22A and E11B, the hemagglutinating activity of F11 was not inhibited by purified GPA, nor did it bind to GPA in a solid phase immunoassay, but it immunoprecipitated GPA. Antibodies D22 and J11A appeared to be directed against carbohydrate determinants, or conformational determinants created by hydrogen bonding or electrostatic interactions between carbohydrate and protein. A preferential reaction of antibody J11A with MM over NN GPA was demonstrated by its reactions with enzyme-treated erythrocytes, its inhibition by purified GPA or its tryptic fragments, and by an ELISA assay. PMID- 6863933 TI - Localized elaboration of IgA in normal and neoplastic murine mammary cell cultures: relationship to fibronectin matrix. AB - IgA secretion by the lactating mammary gland culminates a complex sequence of biologic events both within the gland and at distant sites. Because of the many extraglandular influences, it is difficult to investigate IgA secretion at the tissue and cellular levels in the intact animal. In this study, with the use of immunohistofluorescence, we have observed elaboration of IgA by primary monolayer cultures of mammary cells from the glands of mid-pregnant mice and from mammary tumors. In cultures of normal cells, IgA appeared first in vesicular structures on the upper surfaces of the monolayers. Vesicular IgA was maximal at day 5 in culture, and at that time, was observed only over mounds (domelike structures) that were covered with fibrillar fibronectin (FN), and eventually developed a subpopulation of fusiform cells. It appears that the IgA observed was secreted in vitro, that normal mammary epithelial cells must form multicellular FN-bearing structures to secrete IgA in culture, and that by mid-pregnancy the murine mammary gland contains all of the lymphoid cells required for IgA secretion. In contrast, primary cultures of mammary tumors displayed minimal amounts of IgA and FN. The small amount of cell-associated IgA that was detected on tumor cultures was not localized to any multicellular structures nor was it associated with FN, but instead appeared as minute, punctate accumulations on individual cells scattered across the epithelioid areas. This finding is consistent with the loss of specialized functions and the increased autonomy typical of malignant cells. The study in cultured cells of a function as specialized as IgA secretion should permit greater understanding of both the process itself and the despecializations that accompany malignancies of secretory epithelia. PMID- 6863934 TI - Activation of the fifth and sixth components of the human complement system: C6 dependent cleavage of C5 in acid and the formation of a bimolecular lytic complex, C5b,6a. AB - Acidification of C5 and C6 or serum to pH 6.4 at 0 degrees C, followed by neutralization, generates a factor-designated C(56)a that causes lysis of nonsensitized erythrocytes in the presence of C7, C8, and C9. C(56)a is functionally similar to alternative pathway-generated C5b,6 in respect to the formation of C5b,6,7 sites on cells, the potentiation of lytic activity by membrane-bound C3b or the membrane-active agent A2C, and the required species compatibilities between target membranes and terminal components for optimal activity. The formation of C(56)a complex from purified components C5 and C6 proceeds independently of the classical or alternative pathway C5 convertases and requires the simultaneous H+ ion treatment of the components. The generation of C(56)a from C5 and C6 and the physicochemical properties of the complex were studied in detail and compared with those of C5b,6. Acid generation of C(56)a is dose-dependent on C5 and C6 and its efficiency is similar to that of the conventional convertase in the production of lytic activity. Sucrose gradient ultracentrifugation of C(56)a containing activated 125I-C5 demonstrated a shift in sedimentation from that of native C5 to 11S, which is consistent with C5,6 complex formation. C(56)a sedimentation was identical to C5b,6, and both migrated coincident with lytic complex activity. These complexes, however, are not identical because unlike C5b,6, C(56)a is unstable at 37 degrees C, demonstrating a nonlinear decay curve. In the presence of C7, both complexes exhibit similar first order decay with a T1/2 of 3 min at 37 degrees C. SDS-PAGE autoradiographic analysis of the C5-subunit structure of 125I-C5 in C(56)a and the Zx-activated C5b,6 complex prepared from purified components showed similar alpha-chain cleavage to several fragments of 109,000, 100,000, and 58,000 daltons. Conversion to lower m.w. peptides by acid treatment was more extensive. Comparison of the 125I-C5 polypeptide chains in the membrane attack complex extracted from guinea pig erythrocyte membranes, prepared by acid activation or classical pathway lysis with whole serum, demonstrated similar C5 alpha-chain cleavage to a predominant subunit of 102,000 daltons. Acid activation also produced a 109,000 dalton C5 alpha'-fragment barely detectable with classical pathway activation. Low pH treatment of C5 alone did not inactivate C5 function, form a lytic complex on the subsequent addition of C6, or cleave the C5 alpha-chain. Thus, it is postulated that local high H+ ion concentration during simultaneous acidification of C5 and C6 allows complex formation with the concomitant C6-dependent cleavage of the C5 alpha-chain and the generation of lytic capacity. PMID- 6863938 TI - Two distinctive patterns of monocyte immunoregulatory and effector functions in heavy human infections with Schistosoma mansoni. AB - We evaluated the relationship between immunoregulatory and effector functions of monocytes in subjects with heavy S. mansoni infection (greater than 400 eggs/g of stool). Two main patterns were found. In seven individuals (mean 601 eggs/g), the depletion of adherent cells from peripheral blood mononuclear cells (PBMC) increased blastogenic responses to soluble worm antigenic preparation (SWAP) from a stimulation index (SI) of 3.2 +/- 1.0 to 11.0 +/- 3.0 (p less than 0.01). The presence of indomethacin (1.0 micrograms/ml) in cultures of PBMC from these subjects increased the SWAP response to 7.1 +/- 2.0 (p less than 0.05). In contrast, neither adherent cell depletion nor indomethacin affected blastogenesis induced by nonschistosome antigens or nonspecific mitogens. In this group of infected individuals, monocyte killing of schistosomula and adherence to plastic were increased 122% (p less than 0.01) and 50% (p less than 0.01) over the respective values obtained in uninfected, age-matched controls. A second pattern was found in 10 individuals with a significantly higher intensity of infection (1339 eggs/g of stool (p less than 0.02)). PBMC from these subjects failed to respond significantly to SWAP (SI = 2.0 +/- 0.5), whereas the levels of responses to other antigens and mitogens were maintained at rates comparable to controls. Adherent cell depletion did not significantly affect the blastogenic response (1.8 +/- 0.2), nor did the presence of indomethacin in cultures (2.0 +/- 0.5). Moreover, monocyte-mediated schistosomula killing was depressed in these individuals (50% of controls, p less than 0.05) as was adherence to plastic (77% of controls, p less than 0.05). PMID- 6863936 TI - The biologic activity of mast cell granules. VII. The effect of anti-neutrophil antibody-induced neutropenia on rat cutaneous late phase reactions. AB - Mast cell-dependent late phase reactions (LPR) occur in rat skin and are characterized histologically by an early (1- to 8-hr) neutrophil-rich and later (8- to 24-hr) mononuclear cell-rich infiltrate. To extend previous observations on the role of the neutrophil in the sequential histologic development of cutaneous LPR, rats were selectively depleted of circulating neutrophils using rabbit anti-rat neutrophil antibody (anti-neut), and the effects of this treatment on the histologic intensity of LPR were analyzed. In addition, the effects of neutrophil depletion on cutaneous delayed-type hypersensitivity (DTH) reactions produced by immunization with Freund's complete adjuvant followed by intradermal challenge with purified protein derivative (PPD) were assessed. Following anti-neut treatment, cutaneous DTH reactions were unaffected. In contrast, selective neutrophil depletion resulted in significant reductions in the intensity of cutaneous LPR at both 6 to 8 and 24 hr following anti-IgE or rat mast cell granule injection. Further, statistical comparison of circulating neutrophil counts with the capacity of the animal to express LPR revealed a highly significant direct correlation. These data confirm the previous observations that rat LPR are neutrophil-dependent reactions. PMID- 6863935 TI - Frequency of mast cell precursors in normal tissues determined by an in vitro assay: antigen induces parallel increases in the frequency of P cell precursors and mast cells. AB - Persisting (P) cells, homogeneous populations of cells that grow in vitro for prolonged periods provided a specific growth factor is present, resemble mast cells in many respects. An in vitro assay based on limit dilution was used to determine the frequency of precursors capable of giving rise to P cells. The incidences of P cell precursors per 10(6) cells in tissues of CBA mice in representative experiments were as follows: bone marrow, 291; spleen, 30; mononuclear blood cells, 11; popliteal lymph node, 0.5; and mesenteric lymph node, 18. P cell precursors appeared to be relatively undifferentiated, non granulated cells; no cells with metachromatically staining granules were detected in the bone marrow or peripheral blood. Furthermore, mice of the Wf/Wf genotype that were grossly deficient in mast cells had the same frequencies of P cell precursors in bone marrow and spleen as their normal +/+ littermates. In many tissues in which we found P cell precursors, pluripotential hemopoietic stem cells are present. Among nonepithelial cells from the gut mucosa, however, in which there was a 10-fold higher frequency of P cell precursors than in bone marrow cells, pluripotential hemopoietic stem cells were undetectable, indicating the existence of committed P cell precursors distinct from pluripotential hemopoietic stem cells. The frequency of P cell precursors in mesenteric lymph nodes was more than 30-fold higher than in the popliteal lymph nodes, suggesting that antigenic stimulation influences their numbers. This latter notion is supported by the observation that after immunization in the footpad, the number of P cell precursors in ipsilateral popliteal lymph nodes rose about 35-fold. Immunization was also accompanied by a rise in mast cell numbers in draining popliteal nodes. This correlation between P cell precursors and the local production of mast cells was strengthened by the observation that the frequency of P cell precursors in cells from the gut mucosa of mice of Wf/Wf genotype, which are unable to mount an intestinal mastocytosis, was more than 1000-fold lower than in wild type mice. Thus, the precursors of P cells and probably of at least the T cell-dependent subset of mast cells appear to be generated in the bone marrow and seed as non-granulated cells via the blood to peripheral tissues such as spleen, lymph node, and mucosal surfaces. P cells appear to be in vitro counterparts of the mucosal subset of mast cells. PMID- 6863937 TI - Macrophages as effector cells of protective immunity in murine schistosomiasis. V. Variation in macrophage schistosomulacidal and tumoricidal activities among mouse strains and correlation with resistance to reinfection. AB - Mice of several inbred strains previously characterized as defective in various aspects of macrophage activation for tumor cell killing were utilized to compare the genetic control of induction of macrophage tumoricidal and schistosomulacidal activity and to examine the role of activated macrophages in concomitant immunity to Schistosoma mansoni infection. In all mouse strains tested, macrophage larvicidal activity developed concurrently with tumoricidal activity after in vivo bacillus Calmette Guerin or Corynebacterium parvum treatment. Lpsd strains, A/J, and P/N mice failed to develop macrophages capable of killing either tumor cells or helminth larvae in vitro, whereas C57BL/6J, C3H/HeN, and BALB/c mice all demonstrated strongly cytotoxic cells. In fact, analysis of the reactivity of peritoneal cells from C. parvum-treated F1 hybrids between H-2 congeneic high responder (B10.A) and low responder (A) strains of mice, as well as from F1 hybrid X parent backcross animals, suggested that macrophage activation for killing of these two unrelated extracellular targets is controlled by the same autosomal dominant gene. Strains of mice that failed to develop activated macrophages after in vivo treatment with bacterial stimuli also failed to develop tumoricidal and larvicidal macrophages as a result of S. mansoni infection. The addition of antischistosome sera to the cultures did not reverse the unresponsiveness of macrophages from S. mansoni-infected C3H/HeJ, A/J, or P/N mice in in vitro larvicidal assays. Furthermore, the pattern of concomitant immunity at 6 wk after primary S. mansoni infection correlated closely with the pattern of induction of activated macrophages in these strains of mice. Whereas animals with normal macrophage function developed highly significant levels of concomitant immunity, strains with the Lps defect demonstrated lower levels of acquired resistance, and A/J and P/N mice were not significantly resistant to S. mansoni challenge infection. These results indicate that the genes controlling macrophage activation for the killing of extracellular targets also influence the development of concomitant immunity in schistosomiasis, and suggest that macrophages activated as a consequence of primary S. mansoni infection may be involved in the in vivo effector mechanism of resistance to challenge infection. PMID- 6863939 TI - Resistance to macrophage-mediated killing as a factor influencing the pathogenesis of chronic cutaneous leishmaniasis. AB - Cutaneous leishmaniasis can be either a spontaneously healing or chronic disease, depending upon the strain of parasite and the immunological status of the host. We have investigated parasite factors responsible for the variable pathogenesis observed in leishmanial infections by testing the sensitivity of several leishmanial strains to intracellular killing in lymphokine (LK) activated mouse macrophages. Significant microbicidal activity against Leishmania tropica, a strain which heals in C57BL/6 (B6) mice, was found. In contrast, a strain (Maria) which has previously been shown to induce chronic nonhealing cutaneous lesions in B6 mice was resistant to killing in activated macrophages. This resistance to killing was observed in macrophages activated by LK obtained from either Bacille Calmette-Guerin-, L. tropica, or the Maria strain infected mice. The inability of LK activated macrophages to kill the Maria strain was shown not to be due to parasite induced inhibition of killing mechanisms, since Maria strain infected, LK treated macrophages exhibited tumoricidial activity similar to uninfected macrophages. Furthermore, LK activated macrophages simultaneously infected with the Maria strain and another intracellular pathogen, Toxoplasma gondii, killed Toxoplasma, but not the Maria strain. Temperature was also found to significantly influence the multiplication and killing of Leishmania parasites. As would be expected from their cutaneous nature, L. tropica and Maria strain parasites multiplied better at 35 degrees C than at 37 degrees C. Also consistent with the failure of cutaneous strains to visceralize in immunocompetent mice was the observation that the killing of leishmanial parasites was enhanced at the higher temperature. Thus, the temperature dependent growth capacity and sensitivity to killing of a given leishmanial strain in macrophages may be important factors influencing the pathogenesis of cutaneous leishmaniasis. PMID- 6863941 TI - Involvement of lipopolysaccharide in the pathogenicity of Treponema hyodysenteriae. AB - Treponema hyodysenteriae, the etiologic agent of swine dysentery, caused gross and microscopic lesions in the large intestines of C3HeB/FeJ mice. No gross lesions were observed in the intestines of the closely related, but lipopolysaccharide-resistant, C3H/HeJ strain of mice, and microscopic lesions were mild, if present at all. In the presence of actinomycin D, 1 mg of T. hyodysenteriae lipopolysaccharide (LPS) was lethal for C3HeB/FeJ but not for C3H/HeJ mice. Also, the treponemal LPS was chemotactic for macrophages from C3H/HeJ mice but not for macrophages from C3HeB/FeJ mice. The difference between the two mouse strains in lesion development may be due to the nondestructive nature of LPS in C3H/HeJ mice, which suggests that the treponemal LPS is involved in the pathogenicity of T. hyodysenteriae. T. hyodysenteriae may prove to be a useful bacterium in the study of LPS-resistant C3H/HeJ mice, because resistance to the treponemal LPS and to the treponeme itself appear to correlate. PMID- 6863940 TI - Western Blot analysis of the antigens of Toxoplasma gondii recognized by human IgM and IgG antibodies. AB - Western Blot analysis revealed that both IgM and IgG antibodies present in the sera of humans infected with Toxoplasma gondii recognize three major antigens with apparent m.w. of 32,000, 22,000, and 6000, respectively. In addition, IgG antibodies recognized at least 17 other antigenic components. After subcellular fractionation, enrichment of the three major antigens recognized by IgM and IgG antibodies by the membrane fraction was observed. Solubilization of membrane enriched preparations with a mixture of sodium dodecyl sulfate and sodium deoxycholate did not reveal any new antigenic structures that reacted with IgM or IgG antibodies. Treatment of Toxoplasma lysate preparations and various fractions obtained after differential centrifugation with NaIO4 diminished the reactivity of the antigens with both IgM and IgG antibodies. Lipase treatment had no effect on the number or nature of antigens recognized by IgM antibody. Treatment with pronase and trypsin eliminated the 32,000 and 22,000 m.w. antigenic components detected by IgM antibodies, whereas such treatment had no effect on the 6000 m.w. component. Periodic acid-Schiff staining of polyacrylamide gels of Toxoplasma sonicates revealed the presence of three components corresponding to m.w. of 62,000, 45,000, and 6000, respectively. At least 15 components, including the 6000 m.w. component, directly bound concanavalin A. PMID- 6863942 TI - Objective evaluation of local xenogeneic graft-versus-host reaction by computerized radioisotope imaging (CRI). AB - The local xenogeneic graft-versus-host reaction (GVHR) assay has been used clinically to evaluate cellular immune competence and experimentally to monitor the immunomodulatory effects of several drugs. By employing a computerized radioisotope imaging (CRI) technique, we were able to perform the assay with smaller numbers of mononuclear cells (MNC) and to rid it entirely of any bias. Measuring the local GVHR by CRI compares well with the conventional measurement of the volume (correlation coefficient r = 0.619; P less than 0.001). A clear-cut distinction was documented between normal donors and cancer patients (P less than 0.001) when 10 X 10(6) or more MNC were used in the assay. This is an improvement over the previous, conventional testing of local GVHR which required injection of 20 X 10(6) MNC in order to achieve a similar resolution. The indications for the presence of immune competence have therefore been redefined using the local GVHR index as determined by CRI according to the scale of MNC injected. Thus, immunocompetence is considered present if the CRI index is greater than or equal to 1.2 for 10 X 10(6) MNC, greater than or equal to 2.0 for 15 X 10(6) MNC and greater than or equal to 2.6 for 20 X 10(6) MNC. PMID- 6863943 TI - A simple micromethod for leukocyte rosetting without cell purification. AB - Conventional methods for leukocyte rosetting suffer from 2 major drawbacks: the length of time required for leukocyte purification prior to rosetting, and the necessity for large volumes of blood from which to purify the leukocytes. A simple method for leukocyte rosetting is described which uses small quantities (less than 100 microliter) of heparinized whole blood, does not require prior leukocyte purification and can be completed within 1 h of blood drawing. Percentages of rosetting polymorphonuclear leukocytes in cell preparations obtained by standard purification methods showed a close correlation (P less than 0.001) with percentages obtained by the method described. Additionally, the method described can potentially be applied to other non-neutrophil rosetting leukocytes in blood or body fluids. PMID- 6863944 TI - Preparing monolayers of non-adherent mammalian cells. AB - A simple method is described for preparing monolayers of non-adherent cells, using concanavalin A to bind the cells to wells of plastic microtest plates. The method was used successfully with all 202 human cell types tested, which included 23 tissue culture lines, 165 fresh specimens of all major histological types of leukemia and lymphoma, 20 fresh myelomas, 2 fresh thymomas, normal spleen and lymph node cells, fractionated T lymphocytes and B lymphocytes from peripheral blood, and cultured fetal amniotic cells. All cell types attached firmly, and were not detached by subsequent vigorous washing. In contrast, attempted attachment of cells in serum free medium, or with poly-L-lysine or glutaraldehyde, was ineffective with many cell types. We used the monolayers as target cells for antibodies to cell surface antigens, utilizing immune rosetting or complement-mediated cytotoxicity. This procedure should simplify most assays involving non-adherent target cells. PMID- 6863945 TI - Endothelial cell growth supplement: a cell cloning factor that promotes the growth of monoclonal antibody producing hybridoma cells. AB - The efficiency of endothelial cell growth supplement (ECGS), a commercially marketed extract of bovine neural tissue, human endothelial cell supernatant (HECS) derived from freshly isolated endothelial cells, and feeder layers of murine peritoneal cells (PEC), were compared for their ability to support cell fusion, clonal growth, and monoclonal antibody production of murine hybridoma cells. ECGS at 25-100 micrograms/ml was similar to a 1:5 dilution of HECS in supporting the growth of hybridoma colonies; both ECGS and HECS were superior to PEC feeder cells. Furthermore, hybridomas cloned in ECGS produced anti lymphotoxin antibodies. The commercial availability and stability of ECGS together with its ability anti-lymphotoxin antibodies. The commercial availability and stability of ECGS a superior growth supplement for the fusion and growth of hybridoma cells in monoclonal antibody production. PMID- 6863947 TI - Chromatofocusing combined with the ELISA technique. A sensitive method for the analysis of immune complexes. AB - A sensitive method which permits analysis of IgG containing circulating immune complexes without detailed knowledge of the nature of the antigens and the specificity of the antibodies involved is described. Soluble BSA: anti-BSA were used as model immune complexes and isolated from serum. The procedure involves the use of gel chromatography for the separation of the high molecular weight fraction containing the immune complexes as measured by binding to 125I-labeled Clq, followed by absorption of the immune complex fraction to immobilized protein A-Sepharose CL-4B. After desorption from protein A-Sepharose the complexes were dissociated and separated into free antigen and antibody by chromatofocusing in the presence of urea. The isolated free antigen and antibody retained their immunological activity as shown by immunodiffusion, binding after their recombination to 125I-labeled Clq, and by recombining antigen and antibody with much enhanced sensitivity using a microplate ELISA system. By means of the ELISA recombination technique it is possible to analyze less than 1 microgram of BSA:anti-BSA model complexes. Application of this technique may provide more information about the nature of immune complex like material associated with diseases. PMID- 6863946 TI - An improved procedure for the 'dot immunobinding' analysis of hybridoma supernatants. AB - The recently introduced dot immunobinding assay is well suited as a rapid and sensitive procedure for the analysis of those hybridoma clones that are producers of a specific antibody. We present a modification of the dot immunobinding assay which utilizes a single nitrocellulose sheet for up to 96 assays. By using a single nitrocellulose sheet, sample manipulation is greatly reduced, reaction conditions can be better standardized and a comparison of background reactivities is provided. Results are presented which demonstrate the effectiveness of this modified dot immunobinding assay. PMID- 6863948 TI - Profile of acute renal failure in a general hospital. PMID- 6863950 TI - Alkaptonuria. PMID- 6863949 TI - Anaesthetic management of congenital diaphragmatic defect in children. PMID- 6863951 TI - Calcification of the gall bladder. PMID- 6863952 TI - Treatment of anorectal suppuration. PMID- 6863953 TI - Abdominal hysterectomy in a subdivisional hospital. PMID- 6863954 TI - A blood pressure survey in Simla Hills. PMID- 6863955 TI - Prevalence of respiratory symptoms among radiologically diagnosed chronic bronchitic and nonbronchitic quarrymen. PMID- 6863957 TI - Acrocephalopolysyndactyly syndrome (type II). PMID- 6863956 TI - Removal of a metal rod from abdomen employed to induce abortion. PMID- 6863958 TI - Cancer consciousness. PMID- 6863960 TI - A non-surgical approach to preventing hematogenous infections in total joint replacements. PMID- 6863959 TI - Nephrolithiasis: a controllable disease. PMID- 6863961 TI - Contact urticaria. PMID- 6863962 TI - [Urethral stenosis following cardiac surgery]. AB - 87 cases of urethral stenosis were treated over a two year period. This study was motivated by the high incidence of urethral stenosis after cardiac surgery. The patients were classified into four groups; urological surgery, cardiovascular surgery, medicine and other surgical specialties. The mean age was 60. It is easy to explain the development of urethral stenosis following endoscopic urological surgery, but rather more difficult, following cardiac surgery. The patients undergoing cardiac surgery were compared with those having a transurethral resection of the prostate. Neither traumatic catheterisation, urinary infection, prolonged catheterisation nor any factors specific to cardiac surgery could be implicated. The number of stenoses of the penile urethra was similar to the number of stenoses in the bulbar urethra. The critical period is within the first three months following surgery. Two hypotheses have been proposed to explain the pathogenesis of urethral stenosis after cardiac surgery: a hypersensitivity of the urethral mucosa combined, perhaps, with episodes of ischaemia. In order to verify the first hypothesis, the authors undertook a prospective study. Two groups of patients were chosen at random: 45 had a urethral catheter, 28 had a cystocatheter; 4 cases of urethral stenosis developed after the urethral catheter and there were no cases with the cystocatheter. PMID- 6863963 TI - [Primary malignant melanomas of the urethra. Apropos of 4 cases]. AB - The authors report four cases of primary malignant melanoma of the urethra. The rarity of these lesions can lead to their mis-diagnosis. Only histological examination of a biopsy specimen stained with Fontana stain can confirm the diagnosis. These tumours have a very poor prognosis because of their tendency to locally invade the corpus cavernosus in men and the vulva and vagina in women. These lesions carry a high risk of lymph node and metastatic dissemination. For very limited tumours, the authors recommend a relatively extensive urethrectomy (2/3 of the urethra in women and amputation of the penis in men with a perineal urethrostomy) completed by interstitial irradiation with irridium 192 (6,000 rads) and inguinal lymphadenectomy. In larger tumours, with lymph node invasion, the very brief survival time makes extensive excision inappropriate. Limited palliative surgery is to be preferred. Radiotherapy and chemotherapy have no proven effectiveness. PMID- 6863964 TI - [Disorders of acid-base equilibrium in ureterocolic implantation]. AB - Different mechanisms responsible for acidosis following ureterocolic implantation into the continuity of the colon are reviewed. An acid urine is excreted by the kidneys in patients with acidosis, as in normal subjects. The acidity of the urine emitted into the colon stimulates bicarbonate secretion by the colic mucosa, and reabsorption of chloride. Acidosis following ureterocolic implantation could be related to bicarbonate loss in the stools, a renal acidosis mechanism not being involved as an acid urine is being excreted into the colon. An interesting point is that spontaneous regulation of this acidosis occurs, the bicarbonates secreted by the colon, as well as the ammonia, being secondarily reabsorbed during stagnation of the urine in contact with the colic mucosa. Oral administration of bicarbonates provokes alkalinization and suppression of loss of bicarbonates from the colon, with resulting correction of the acidosis. PMID- 6863965 TI - [Right varicocele: contribution of spermatic phlebography. Results on 250 cases]. AB - Full details of the technique employed for right testicular vein phlebography during investigation of male sterility are exposed, and the presence of a varicocele defined among 250 cases explored. Diagnosis of a varicocele is confirmed when there is reflux filling of the pampiniform plexus veins at the scrotal level, the lesion being considered absent when a continent valve prevents any descent of the contrast medium column. Successful catheterization of the right testicular vein was accomplished in 193 cases (66%) of the last 250 bilateral testicular vein phlebographs performed, enabling data concerning the radiological anatomy of this vein to be obtained. In 95%t of cases it emptied into the inferior vena cava and in the other 5% into the renal vein, between L1 and L3, while in 7% the vein emptied into both. Anastomoses are frequent: with the exorenal circle (15 to 18% of cases); the intercostal veins; the lumbar and perivertebral system; the inferior vena cava; the peri-ureteral veins; the testicular vein itself, and finally the portal system through a colic trunk emptying into the inferior mesenteric vein (29% of cases). The frequency and characteristics of right-sided varicocele in patients with male secretory infertility is discussed in relation to findings in these 250 cases. Bilateral phlebography in 187 patients showed normal appearances in 25 cases, bilateral varicoceles in 96, and unilateral varicoceles (including 27 on the right) in 66 cases. Unilateral phlebography in 55 patients revealed the presence of an isolated right-sided varicocele in 4 patients. The question is raised as to the need for phlebography in patients with clinically evident varicoceles, and inversely, the significance of a varicocele demonstrated only on radiology. Physiopathological studies could possibly determine the effect of a varicocele on testicular function. A suggested means of treatment is by embolization of the valvular incontinent venous system. PMID- 6863966 TI - [Left varicocele and renal cancer. A radio-anatomical study of 2 cases. Pathogenic deductions]. PMID- 6863968 TI - [Treatment of anterior hypospadias. Balanoplasty]. AB - The authors present their experience of balanoplasty in the treatment of anterior hypospadias. These forms of hypospadias are defined as those where the meatus is situated at the base of the glans, at the level of the balano-preputial groove or just before, without any real chordee. The treatment involves re-siting the meatus in the penis. These forms represent 70% of all cases of hypospadias. This type of hypospadias is corrected by an extensive meatoplasty towards the tip with reconstitution of the glans and re-centering of the sheath of the penis. This gives good aesthetic and functional results. This technique was designed by J. W. Duckett who named it M.A.G.P.I. (meatal advancement and glanduloplasty incorporated) and has been used in 78 cases; the indications, the method and the results are presented. PMID- 6863967 TI - [Isolated retroperitoneal hydatid cyst. Apropos of 2 new cases]. AB - Hydatid disease in endemic countries is common but an isolated retroperitoneal localisation is rare. After a review of the aetiopathogenesis and clinical aspects, the authors express the opinion that safe, rapid and reliable technique of echotomography is the key investigation in obtaining a positive diagnosis. In terms of its course, the histopathological appearances are those of a locally malignant tumour which as a preferential and severe effect on renal function. Surgery is the only valid method for eradication of the parasite and freeing the urinary tract. PMID- 6863969 TI - [Transuretero-ureterostomy with reimplantation of the ureter in a psoitic bladder. Treatment of bilateral operative lesions of the pelvic ureters after gynecological surgery. Apropos of 4 cases]. PMID- 6863970 TI - [Cavernous hemangioma of the bladder. Apropos of 2 cases]. PMID- 6863971 TI - [Refractory urinary incontinence]. AB - The authors present 3 cases where the diagnosis of ectopic insertion of the ureter, responsible for incontinence, had been missed: -- 2 cases of refluxing urethral insertions, including 1 case of single ureter, -- 1 case of vaginal ectopic ureter with duplicity. The authors stress that an ectopic insertion of the ureter can be asymptomatic until adulthood when it may present as simply as urinary stress incontinence. The diagnosis is suggested by a history of incontinence developing since childhood, accompanied by radiological signs of pyeloureteric duplicity or a small atrophic kidney. When the diagnosis is missed, successive surgical treatments are bound to fail, while excision of the renal segment drained by the ectopic ureter results in cure. PMID- 6863972 TI - [Results of endoscopic urethrotomy in the treatment of urethral stricture. Apropos of 72 cases]. AB - Seventy-two patients with strictures of the urethra were treated by endoscopic urethrotomy over a period of 2 years, the strictures being of iatrogenic origin in 37.5% and of undetermined etiology in 22% Important features of this series were the advanced age of the patients (57% between 60 and 80 years) and the iatrogenic nature of the lesion in many cases. Strictures were perineobulbar in 36 cases, of the anterior urethra in 13, multiple or extending in 6, and of the membranous urethra in 17 cases. Retromeatal and cervical strictures were not included. Urethrotomy (at 12 o'clock) was followed by insertion of a urethral catheter retained for 5 days. Complications included one case of severe infection and 2 cases of epididymo-orchitis. Follow-up has been for from 6 to 36 months. Good results were obtained in 41 cases (57%), with absence of dysuria and lack of the need for dilatation. Results were moderate in 9 cases (12.5%), with functional improvement but altered flow and the need for less than 2 dilatations per year. Treatment was a failure in 23 cases (32%), the condition remaining unaltered and requiring either multiple dilatations or a repeat urethrotomy. Overall therapeutic efficacy was 70%, the poorest results being observed in extensive or membranous urethra strictures. PMID- 6863973 TI - A new microsporidian parasite of the mosquito Aedes taeniorhynchus. PMID- 6863974 TI - In vitro production of zoospores by the mosquito pathogen Lagenidium giganteum (Oomycetes: Lagenidiales) on solid media. PMID- 6863975 TI - A rickettsia-like microorganism similar to Wolbachia pipientis and its occurrence in Culex mosquitoes. PMID- 6863978 TI - The thymus dependency of acquired resistance to Trichophyton mentagrophytes dermatophytosis in rats. AB - Congenitally athymic "nude" (RNU/RNU) rats and euthymic (+/RNU) rats were cutaneously inoculated with Trichophyton mentagrophytes. Dermatophytosis, as evidenced by erythema and scaling, was observed in both athymic and euthymic rats by day 7 postinfection. Macroscopic lesions in +/RNU rats became intensely erythematous (climax days 10-14), were limited in spread and alopecia (days 16 20), and healed with hair regrowth by day 35. In nude rats, however, erythema peaked early (days 8-10) and a persistent, mild erythema and scaling spread over the animals' backs. Viable T. mentagrophytes was cultured from the skin of all infected nude rats for the duration of each experiment (90 days), while +/RNU rats became culture-negative by day 35. Following clearance of primary lesions, +/RNU rats manifest a delayed-type hypersensitivity skin test response to soluble trichophytin and an accelerated cutaneous inflammation and enhanced resistance to reinfection. Although T. mentagrophytes primarily invaded the keratinized layers of the epidermis in both nude and +/RNU rats, hyphae and arthrospores were also observed within the nucleated layers of the internal root sheath of hair follicles. Our observations are consistent with the hypothesis that thymus dependent cell-mediated immunity is required to limit cutaneous spread and terminate cutaneous T. mentagrophytes infection. This acquired immunity against T. mentagrophytes in +/RNU rats was characterized histologically by: (1) an intense inflammatory migration of lymphocytes, monocytes, and macrophages into the epidermis, dermis, and follicular epithelium; (2) hyperplasia of the epidermis and follicular epithelium; and (3) elimination of arthrospores and hyphae from T. mentagrophytes-infected skin. PMID- 6863979 TI - The hamster ear sebaceous glands. I. Examination of the regional variation by stripped skin planimetry. AB - A stripped skin planimetric method was developed to measure the ear sebaceous gland areas using a Numonics Graphics Calculator. The ear skin was manually separated from the cartilage and the area of the sebaceous gland units observed from the underside was determined. This procedure is less time-consuming than standard histologic techniques. Using stripped skin planimetry, it was demonstrated that the sebaceous gland size was greatest at the basal region of the ear and decreased toward the periphery. Regional variations in the density of the sebaceous gland units were also observed. In using the ear sebaceous model system it is important to standardize the site of biopsy in order to avoid sampling errors. The increase in ear sebaceous gland area from weaning to sexual maturity in the male hamster parallels the increase in flank organ area. This observation suggests that the ear and the flank organ sebaceous glands are comparable sebaceous models since they show a similarity in their response to the changing hormone levels during sexual maturation. PMID- 6863976 TI - Inhibition of a Langerhans cell-mediated immune response by treatment modalities useful in psoriasis. AB - Neither the pathogenesis of psoriasis nor the mechanism whereby seemingly diverse therapies alter the disease is understood. In this study, several antipsoriatic agents were tested for their effects on the skin cell lymphocyte reaction (SLR), an immunologic assay in which HLA-DR antigens on Langerhans cells (LC) stimulate proliferation of allogeneic lymphocytes. Every agent tested (cortisol, methotrexate, hyperthermia, anthralin) inhibited the SLR at therapeutic dose levels. By contrast, a variety of antibiotics, an anti-inflammatory agent, and lithium carbonate and propranolol, two drugs known to be ineffective in psoriasis, failed to inhibit the SLR. Finally, we have shown that hyperthermia and anthralin treatments are toxic for LC whereas they have little or no effect on keratinocyte viability. These results suggest that antipsoriatic agents may act in psoriasis by alteration or killing of LC. PMID- 6863977 TI - The effect of histamine, antihistamines, and a mast cell stabilizer on the growth of cloudman melanoma cells in DBA/2 mice. AB - The growth rate of Cloudman S91 melanoma cells was compared in groups of normal and immunologically compromised DBA/2 mice that had undergone thymectomy and treatment with antilymphocyte serum. Tumor growth was markedly accelerated in the immunosuppressed animals. Other groups of normal and immunosuppressed animals were treated with daily injections of either histamine, the H-2 antihistamine cimetidine, the H-1 antihistamine pyrilamine; or the mast cell stabilizer proxicromil. Histamine treatment accelerated tumor growth, but only in normal animals and had little effect on tumor growth in immunocompromised hosts. Cimetidine treatment tended to increase tumor growth in normal hosts but this was statistically significant in only 1 of 3 experiments. In contrast, treatment with cimetidine, pyrilamine, or proxicromil always resulted in significant retardation of tumor growth in immunosuppressed animals. These data are consistent with the notion that thymectomy and treatment with antilymphocyte serum results in enhanced tumor growth that is in part due to activation of histamine-dependent suppressor cells. In this system, histamine activation of suppressor cells may be reversed by treatment with either antihistamines or proxicromil, a drug that prevents mast cell release of histamine. However, since the effects of these drugs seem to depend on the immune status of the host, thorough evaluation of immunoregulatory function and careful testing to determine whether histamine blockers reduce or promote tumor growth would seem indicated when immunomodulatory treatment with these drugs is contemplated. PMID- 6863981 TI - In vivo mobilization of polymorphonuclear leukocytes in psoriasis: relationship to clinical parameters and serum inhibitory factors. AB - Mean migration of polymorphonuclear leukocytes (PMNL) toward autologous and homologous control sera, evaluated by quantitative skin window chamber technique, was only slightly reduced in 60 patients with psoriasis as compared to 27 normal controls (p less than 0.1). A significant decrease in cell migration was found (1) in patients with actively spreading lesions, (2) in patients with extensive lesions involving more than 40-60% of the skin surface, (3) in the first 2 months of relapse, and (4) 5-6 months after onset of new lesions. However, PMNL migration was increased when psoriatic lesions lasted 3-4 months. Seventy-one percent of psoriatic sera exerted a suppressive effect on the psoriatic and normal PMNL migration. The inhibitors were found predominantly in patients with stationary and long-standing lesions. Some of the psoriatic sera had a stimulatory effect on the chemotaxis of psoriatic PMNL. These sera originated from those patients with active spreading lesions in the first 2 months of relapse. These data indicate that neutrophil migration is abnormal in the course of psoriasis and that it could be modified by different proportions of both inhibitors and stimulators of chemotaxis. PMID- 6863980 TI - Serial cultivation of epidermal keratinocytes from psoriatic plaques. AB - Using the combined techniques of Rheinwald and Green, and Liu and Karasek, large quantities of proliferative keratinocytes from involved (PP) or uninvolved (PN) skin of psoriatic patients and from normal skin of non-psoriatic donors (NN) can be obtained. Primary cultures, initiated from a 6-mm punch biopsy, are grown on a 3T3 feeder layer seeded on a collagen surface and fed with Dulbecco's Modified Eagle's Medium containing 20% fetal calf serum, hydrocortisone, epidermal growth factor, and cholera toxin. To test the hypothesis that the mechanism(s) responsible for the abnormal proliferation of psoriatic keratinocytes may be located within the cells themselves, primary cultures are passaged onto collagen surfaces without a feeder layer and maintained with medium plus serum, but no additional supplements, and the growth profiles of the 3 cell populations compared. No difference in morphology among these cells is observed in either primary or passaged cultures. In primary cultures, PP keratinocytes, especially those isolated from active lesions, seem to initiate growth at a slower rate than do PN and NN keratinocytes. The difference in the growth rate, as determined by cell number, DNA content, and mitotic activity, is insignificant among passaged PP, PN, and NN cells. Waves observed in the mitotic index and the metabolic activity of the passaged keratinocytes from all 3 sources suggest that the cells are synchronized during subculturing. The cells have high metabolic and mitotic activities during the first week after subculturing, indicative of an initial population of actively dividing cells. We have not found the characteristic feature of hyperproliferation seen in psoriatic keratinocytes in situ, in the cultured cells; however, it is too early to reach the definite conclusion that the mechanism(s) responsible for psoriasis does not exist in the keratinocyte itself. These 3 cell types may respond differently to agents that either enhance or inhibit cell growth and, by using the culture system outlined in this report, we may study these factors and their potential role in psoriasis. PMID- 6863982 TI - Purification of human epidermal calmodulin. AB - Human epidermal calmodulin was purified by phenothiazine-Sepharose affinity chromatography. The protein stimulated activator-deficient phosphodiesterase and was identified to be calmodulin by radioimmunoassay. Epidermal calmodulin demonstrated a Mr of 17,000 on gel permeation chromatography and migrated on sodium dodecyl sulfate-urea-polyacrylamide gel electrophoresis as a single band at the same location as rat testes calmodulin. The exact role of calmodulin in the epidermis remains to be defined. PMID- 6863983 TI - Endogenous peroxidases in normal human dermis: a marker of fibroblast differentiation. AB - Incubation of unfixed and unfrozen slices of normal human skin allows visualization of a peroxidase activity associated with the perinuclear envelope and with the endoplasmic reticulum of resident dermal macrophages, dermal mastocytes, and also of some dermal fibroblasts. No peroxidase activity can be detected in fibroblasts cultivated in monolayer, while 80% of fibroblasts in an "in vitro" collagen lattice, called a dermal equivalent, express a peroxidase activity in the perinuclear envelope and the endoplasmic reticulum. Hence expression of this peroxidase activity in normal human skin fibroblasts serves as a marker of fibroblast differentiation and seems to depend on an interaction to fibroblast with the elements of a three-dimensional matrix. PMID- 6863984 TI - Recovery of skin from a single suberythemal dose of ultraviolet radiation. AB - Previous studies of exposure of normal skin to ultraviolet radiation have demonstrated a cumulative effect lasting greater than 24 h when repeated suberythemal exposures are given. However, the time course of recovery from a single suberythemal dose of ultraviolet A (UVA) or ultraviolet B (UVB) has not been determined. We show here for the first time that the period required for recovery of normal skin (as measured by delayed erythema) following a single suberythemal dose of UVA is between 30 and 48 h, and for UVB is between 24 and 30 h. Photoprotection was noted for both UVA and UVB from the fifth through the ninth day after the single suberythemal exposure, but was only statistically significant on the fourth day after UVB exposure. The curve depicting recovery from a single suberythemal dose of UVA or UVB from the first irradiation time through the fourth day after irradiation may be described as an exponential decay curve. Formulas are given for both UVA and UVB which describe the exponential nature of this curve. These formulas may be used to predict the exact difference in erythema threshold between preirradiated and normal skin. From the fourth day after exposure to the ninth day, the curve is nearly constant. The nature of the recovery curve in the first 4 days after exposure suggests that an exponential decay process occurs in UVA or UVB damage, consistent with unstable photoproduct decay, DNA repair, or constitutive enzymatic processes. PMID- 6863986 TI - Growth stimulation and tumor promotion in skin. AB - Stimulation of epidermal growth in adult mouse skin can be induced by chemical agents, such as phorbol esters and other skin mitogens, or by mechanical means, such as skin massage and skin wounding. It leads to different kinds of epidermal hyperproliferation, according to interference with mechanisms of endogenous growth control (G1 chalone) and to mediation by endogenous regulatory factors (prostaglandins). Certain phorbol esters and skin wounding induce epidermal hyperproliferation and, in addition, a metaplastic process. Another property of these metaplasiogenic mitogens is their tumor-promoting efficacy in mouse skin, which has been initiated by a carcinogen in a subthreshold dose. Tailor-made phorbol esters allow the subdivision of the process of tumor promotion into two stages. In the first--probably irreversible--stage, a single application of the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA) or wounding brings about the events critical and obligatory for promotion, whereas in the second- probably reversible--stage, repetitive applications of an "incomplete promoter" evoke epidermal hyperplasia necessary to make the tumors visible. Adult guinea pig epidermis in vivo, as well as primary cell cultures derived from adult guinea pig ear epidermis, responds to the proliferative effects of phorbol esters such as TPA along a similar sequence of biochemical events as mouse skin in vivo. The in vitro approach allows the study of the molecular events involved in the mechanism of action of phorbol esters in more detail. PMID- 6863985 TI - Specificity and inhibition of the epidermal cell detachment induced by pemphigus IgG in vitro. AB - IgG isolated from sera of patients with pemphigus vulgaris (PV) has been shown to induce cell detachment when added to primary epidermal cell cultures (PECC). We studied the specificity of this phenomenon. IgG fractions were purified from the sera of five patients with PV and control IgG fractions from the sera of normal donors and patients with bullous pemphigoid (BP), systemic lupus erythematosus (SLE), and anti-AB blood group sera (anti-AB). IgG fractions were added to PECC either at initial plating (0 hours), at media change (48 hours), or sequentially at both times, and cell detachment was quantitated at 72 and 96 hours. Significant cell detachment occurred only when PV IgG was added to the growth media sequentially at 0 and 48 hours (p = 0.001), and this effect was dose dependent for either dose. Substitution of an unrelated IgG (BP, SLE, or anti-AB) at either time points reduced cell detachment to near control values. Furthermore, cell detachment was inhibited by the addition of the proteinase inhibitors alpha 2 macroglobulin (70% inhibition of detachment), aprotinin (63% inhibition), soybean and lima bean trypsin inhibitor (62 and 64%, respectively), and pepstatin (49%), but not by the inhibitors chymostatin, leupeptin, or antipain. These data confirm that PV IgG induces increased cell detachment in PECC and shows that this effect is specific for PV IgG, is dose-dependent, and may be inhibited by certain proteinase inhibitors. PMID- 6863987 TI - Transformation of epidermal cells in culture. AB - Studies performed on mouse skin have indicated that chemical carcinogenesis can be subdivided into two distinct stages, initiation and promotion. Initiation results from exposure to a classical mutagenic carcinogen and is irreversible even after a single exposure. The permanently altered initiated cell and its progeny may never form a tumor or in any way be recognizable in the target tissue. Exposure to tumor promoters permits the expression of the neoplastic change in initiated cells, and tumors develop. In contrast to initiators, promoters must be given repeatedly to be effective; individual exposures are reversible. A similar biology is suggested by epidemiologic studies of certain human cancers, particularly lung, breast, colon, and uterine malignancies. Studies in mouse skin cell culture have provided new insights into the changes associated with initiation and promotion. Initiated cells appear to be resistant to signals for terminal differentiation and can proliferate under conditions where normal epidermal cells are obligated to cease proliferation and begin their maturation program. This change is essential for an epithelial tumor cell since it provides the ability to grow away from a basement-membrane attachment site. In cultured epidermal cells, tumor promoters are capable of selectively stimulating the growth of certain cells, including initiated cells, while simultaneously inducing terminal differentiation in other epidermal cells. The net effect of these responses to promoters is the clonal expansion of cells stimulated to proliferate. In this way, promoters are capable of increasing the clone size of initiated cells. These cell culture data provided a biological framework for understanding initiation and promotion in terminally differentiating epithelial tissues. PMID- 6863988 TI - Mutually antagonistic effects of hydrocortisone and retinyl acetate on envelope competence in cultured malignant human keratinocytes. AB - Serially propagated SCC-13 keratinocytes, derived from a human squamous cell carcinoma, are greatly influenced by culture conditions in their ability to form ionophore-inducible cross-linked envelopes. Supplementation of the growth medium with fetal bovine serum at concentrations ranging from 0.5 to 20 percent had little effect on competence to form envelopes in confluent cultures. At each serum concentration, however, addition of hydrocortisone to the medium led to an increase in competence of almost fourfold, from approximately 20 to nearly 80 percent. With the serum supplementation held at 5 percent, addition of retinyl acetate to the medium suppressed competence in a concentration-dependent manner over the range of 1 to 100 ng/ml. At the highest concentration employed, competence was reduced over fourfold in the presence of hydrocortisone and virtually eliminated in its absence. When the cells were grown using serum depleted of endogenous vitamin A, a majority were competent in the absence of hydrocortisone. Under this condition, retinyl acetate suppressed competence over fivefold in the absence of hydrocortisone, but not at all in its presence. We conclude that hydrocortisone stimulates envelope competence primarily by antagonizing the suppressive effect of vitamin A. The SCC-13 cell line may prove valuable in studying mechanisms of retinoid and corticosteroid therapeutic action on diseased human keratinocytes. PMID- 6863989 TI - DNA repair in cultured keratinocytes. AB - Most of our understanding of DNA repair mechanisms in human cells has come from the study of these processes in cultured fibroblasts. The unique properties of keratinocytes and their pattern of terminal differentiation led us to a comparative examination of their DNA repair properties. We have examined the relative repair capabilities of the basal cells and the differentiated epidermal keratinocytes as well as possible correlations of DNA repair capacity with respect to age of the donor. In addition, since portions of human skin are chronically exposed to sunlight, we have assessed the repair response to ultraviolet (UV) irradiation (254 nm) when the cells are conditioned by chronic low-level UV irradiation. The methods of Liu and Karasek were used to grow pure keratinocytes on collagen gels following their isolation from abdominal skin of newborns and adults at autopsy. Density labeling with 5-bromodeoxyuridine was used to resolve repair replication from the semiconservative mode. We found similar repair characteristics in human epidermal keratinocytes to those previously reported for cultured fibroblasts. However, the DNA repair response in basal cells was much greater than that in differentiated cells from the same skin preparation. Our comparative studies of DNA repair in keratinocytes from infant and aged donors have revealed no significant age-related differences for repair of UV-induced damage to DNA. Sublethal UV conditioning of cells from infant skin had no appreciable effect on either the repair or normal replication response to higher, challenge doses of UVL. However, such conditioning resulted in attenuated repair in keratinocytes from adult skin after UV doses above 25 J/m2. In addition, a surprising enhancement in replication was seen in conditioned cells from adult following challenge UV doses. PMID- 6863990 TI - Regeneration of organized epithelial structure. AB - The role of connective tissue in facilitating and directing the growth of epithelia during adult life is uncertain. The basic processes associated with maintenance of epithelial structure and previous work concerning the role of mesenchyme in this process in the embryo and adult are reviewed. A series of experiments examining the role of connective tissue in facilitating epithelial growth and development in vitro and after transplantation in vivo is described. These confirm the requirement for dermal elements if normal structure is to be reestablished and point to the requirement of dermal, as opposed to deep, connective tissues for facilitation of the growth of adult epithelia in vivo. The in vitro experiments suggest the presence of diffusible dermally produced factors that facilitate epithelial growth. PMID- 6863991 TI - Potassium mediation of calcium-induced terminal differentiation of epidermal cells in culture. AB - Epidermal cells cultured in low-calcium medium (0.02-0.1 mM) grow as a monolayer, in contrast to the stratified pattern of growth in medium with standard calcium levels (1.2-1.8 mM). These low-calcium cells lack desmosomes and maintain a high proliferation rate. Raising the extracellular calcium to greater than 0.1 mM induces rapid desmosome formation followed by stratification, inhibition of proliferation, formation of cornified envelopes, and sloughing of the cells from the culture dish. This calcium-induced terminal differentiation program is characterized by an increase in the intracellular levels of sodium and potassium at 12 to 24 hours and is not blocked by inhibitors of calcium or sodium flux. Of 40 to 50 agents tested as inhibitors of calcium-induced epidermal differentiation, only ouabain, harmaline, A23187, and 8(diethylamino)octyl-3,4,5 trimethoxybenzoate hydrochloride (TMB-8) were effective. These agents did not block the earliest calcium-induced effect (desmosome formation), but they did inhibit later stages in the program of terminal differentiation. Their detailed mechanism of action is unclear, although ouabain inhibits the sodium pump (Na+K+ATPase), lowering potassium and elevating sodium in the cells. The other inhibitors also prevented the calcium-induced elevation of intracellular potassium with no common effect on intracellular sodium. Reduction of potassium in the medium from the usual level of 6.5 mM to 0.1 mM lowers intracellular potassium by 60 to 70 percent and prevents calcium-induced differentiation. This result, along with the inhibitor studies, suggests that potassium plays an important role in epidermal terminal differentiation. PMID- 6863992 TI - Modulation of differentiation by retinoids. AB - At high levels of vitamin A and other retinoids (3 X 10(-6) M) attachment of human keratinocytes to 3T3-coated plastic dishes is mildly inhibited. Retinoids at this concentration in culture media seem to have an antikeratinizing effect in that cells appear to be less differentiated. Retinoid-treated cultures are less stratified, having fewer cell layers, and display larger intercellular spaces and rounder, less flattened cells. Treated cultures also contain higher percentages of saline-soluble proteins and lower percentages of proteins requiring reduction and/or denaturants for solubility. This suggests that in treated cultures, the most keratinized cells are absent. Growth curves show that those most keratinized cells are sloughed from the dish and appear in the media. Thus at 3 X 10(-6) M, the major retinoid effect is to promote desquamation. At higher concentrations, retinoids are toxic to the keratinocyte, but at lower concentrations, they may be stimulative. PMID- 6863994 TI - Membrane glycoconjugate visualization and biosynthesis in normal and retinoid treated epidermis. AB - Cell-membrane glycoconjugates can be visualized for ultrastructural and fluorescence studies with certain surface markers, such as lectins and antisaccharide antibodies. When frozen sections of mammalian epidermis are treated with a battery of rhodamine-conjugated lectins, the cell membranes display a pattern of increased sugar complexity during keratinocyte maturation. Although this vectorial sequence is disrupted following retinoid treatment, these changes occur only at high doses and late in the course of treatment, suggesting that retinoid-induced alterations may be secondary. Seemingly as a result of specific glycosidase activity within the cytosol of both granular and cornified cells, lectin staining suddenly disappears from stratum corneum cell membranes. Although lectins stain membrane glycoconjugates of cultured human keratinocytes, quantitative techniques are required to recognize differences in proliferating versus postmitotic cells and in cultures supplemented with various growth factors. Whereas retinoids consistently depress glycoprotein synthesis in cultured keratinocytes, in organ culture they stimulate epidermal glycoprotein, and particularly glycolipid, biosynthesis. These studies suggest (1) that visualization of membrane glycoconjugates with lectins can reveal important variations in normal and pathologic epidermal differentiation, (2) that lectins may reveal subtle quantitative alterations in differentiation in vitro, (3) that retinoid stimulation of glycoconjugate biosynthesis either displays important species differences or requires a higher level of organization than occurs in cell culture, and (4) that the retinoid effect on glycoconjugate biosynthesis in organ culture may provide another useful bioassay for retinoid potency. PMID- 6863995 TI - HPCI looks to 'affordability'. PMID- 6863996 TI - Formaldehyde poisoning successfully treated with hemodialysis. PMID- 6863993 TI - Population dynamics in cultures of stratified squamous epithelia. AB - Stratified squamous epithelia, such as those covering the skin, esophagus, and cervix, are normally in a dynamic steady state: production of new cells (proliferation) is matched by loss of terminally differentiated cells into the environment (desquamation). The parameters that describe population dynamics in stratified epithelia--number of dividing cells, number of cell layers, transit time, and rate of desquamation--can be closely monitored in cultures of stratified epithelial cells. Analysis of these data show that cultures of stratified epithelial cells can be maintained in a dynamic steady state for at least 1 month and thus have a dynamic behavior similar to stratified epithelia in vivo. Although this in vitro behavior may be intuitively reasonable based on the in vivo behavior of these cells, it is remarkable in that it is contrary to the general experience with other normal cell types in culture. The usefulness of measuring population dynamics in cultures is demonstrated by an analysis of the actions of retinoids on human keratinocytes. In addition, we show that because of favorable geometry and ease of manipulation, these cultures are well-suited to the analysis of heterogeneity in the proliferating population of cells. PMID- 6863997 TI - Diaphragmatic muscle flap for closure of a bronchopleural fistula. PMID- 6863998 TI - Garbage, grime and graffiti. PMID- 6864000 TI - [Vasodilator therapy with continuous hydralazine infusion after open-heart surgery]. PMID- 6863999 TI - [The results of long-term follow-up study for 445 cases of valve replacement with various kinds of cardiac prostheses--comparison of the clinical results among the groups using different types of valves and with or without postoperative anticoagulant therapy]. PMID- 6864003 TI - [Postinfarction ventricular septal perforation: pre- and postoperative hemodynamic assessments and survival rates]. PMID- 6864001 TI - [Efficacy of attempted prevention of conduction disturbance accompanying Mustard operation--consideration on internodal conduction]. PMID- 6864002 TI - [Mitral stenosis with embolic attack: clinical, hemodynamic and operative consideration]. PMID- 6864005 TI - [Differential diagnosis of ventricular septal defect using two dimensional echocardiography and its application to operative approach]. PMID- 6864004 TI - [Postoperative complications in elderly patients with lung resection]. PMID- 6864006 TI - [Successful mitral valve replacement in a 13-month-old infant with parachute mitral valve presenting pure mitral stenosis]. PMID- 6864007 TI - [A case of bilateral ductal origin of the pulmonary arteries]. PMID- 6864008 TI - [A case report of pulmonary atresia with intact ventricular septum; partial reconstruction of right ventricular outflowtract without cardiopulmonary bypass]. PMID- 6864009 TI - [A case report of bilateral multiple pulmonary arteriovenous fistulas treated surgically as one-stage procedure]. PMID- 6864010 TI - [The present status of mass population screening for cancer of the uterine cervix and the therapeutic results in the detected cases in Miyagi Prefecture]. AB - The mass screening for cervical cancer in the population of Miyagi Prefecture has covered the total 1,078,999 women by March 1981. Invasive cancer of the uterine cervix was discovered in 1032 women, carcinoma in situ in 829. 2) By methods of the examination, the institutional examination was on 72.5% of the examined in 1980. 3) With regards to the rates of examinees by age and the detection rate of the cancer of uterine cervix in 1980, the low detection rate in the age range of 30-50 years whose examination rate was over 20% compares against the high detection rate in the high age range, whose examination rate was low. 4) CAI in years 1965, 1970, 1975 and 1980 were 60.0, 116.7, 193.2 and 229.8 respectively. 5) The 302 cases of invasive cancer detected and treated before the end of 1974 were classified in clinical stages and investigated the results of treatment. The detection in Stage I was in 84.1%, this high percentage being a main factor to make the total treatment results of uterine cervical cancer pushed up to the high figure. PMID- 6864011 TI - [Comparison of variability (STV and LTV) indices by computer-simulated data]. AB - Many investigators have proposed their own formula for quantitative evaluation of STV (short term variability) and LTV (long term variability). There has even been confusion over the definition itself of STV. We compared those indices by using 'beat to beat interval' computer-simulated series and found that there is little difference between the STV indices. According to the definition of STV by the Japan Society of Obstetrics and Gynecology, it is the variance in beat to beat difference, which is determined by the variance in beat to beat intervals and the autocorrelation function of the same intervals. For all the 2,500 combinations of the variability and the autocorrelation, normal random interval series were generated by the computer and five indices (Dalton, Cabal, Yeh, Heilbron and de Haan) were compared with calculated index values using these interval series. Assigning the variability and the autocorrelation to the X-axis and the Y-axis respectively, the Z-axis was used to indicate the value of the STV. Five curved surfaces thus formed have a similar shape, which shows us that these STV indices behave the same way in accordance with the change in STV. Further, the study of LTV indices with the same simulated data showed that Yeh's LTV index indicates only the variability but has no relation-ship with the autocorrelation and both de-Haan and Heilbron's LTV indices represent the variability and the autocorrelation. However, they increase as the autocorrelation increases unlike the STV indices. PMID- 6864012 TI - Ultrasonographic observation of ovarian follicular development via vaginal route. AB - Ovarian follicular growth during periovulatory period was measured using real time ultrasound via vaginal route. In 15 patients examined preliminarily by the abdominal procedure, the mean follicular diameter increased from 15.6mm on four days before ovulation to a maximum of 21.8mm on the day of ovulation. A clear distinction of follicular development during periovulatory period could be made in 40 patients by the vaginal procedure. The mean distance between follicle and scanner was 5.6cm in the vaginal observation, which was significantly shorter than those observed in the abdominal observation. Thus, real-time ultrasound examination via vaginal route appears to be a useful technique for assessing the ovarian follicular development. PMID- 6864014 TI - [Ultrastructural observations on human endometrial stromal cells during the normal menstrual cycle--with special reference to so-called "predecidual cells"]. AB - Human endometrial stromal cells during the normal menstrual cycle were observed with the transmission electron microscope, the scanning electron microscope and the freeze-fracture replica method. In the early proliferative phase, the stromal cells had the characteristics of mesenchymal cells but in the early secretory phase, they resembled fibroblasts. In the late secretory phase, the stromal cells (so called "predecidual cells") were characterized by their large size, rounded shape, and their abundant cytoplasms with well-developed organelles. Furthermore, "predecidual cells" also had the following conspicuous features: 1. In the cytoplasms numerous membrane-bounded collagen fibers were seen, and positive acid phosphatase activity was detected in these fibers. 2. Neighbouring "predecidual cells" were often joined to each other by "gap junctions". 3. "Predecidual cells" had many "coated regions" on their cytoplasmic membranes. Structural changes in endometrial stromal cells were discussed in regard to the function of these cells. PMID- 6864013 TI - [An objective measurement of physical property of the human uterine cervix and its clinical significance]. AB - A new mechanical instrument, "Cervical Texturometer", has been developed for the objective measurement of cervical consistency by the use of TENSIPRESSER which was originally developed to evaluate the texture of food. The values obtained thereby have been found highly reproducible. 1. The anterior lip of the cervix was kept pressed between the disks to maintain the strain. Initial height, H(0), of the recorded stress-relaxation curve was defined as "Hardness" (100g load = 20 consistency units: C.U.) and the ratio H(0)/H(10)(H(10) = hardness after strain of 10 sec.) as "Viscoelastic Index (V.E.I.)" 2. The values of C.U. and V.E.I. were significantly correlated with the uronic acid/hydroxyproline ratio of the cervix. They gradually decreased with the progress of pregnancy under the possible influence of the changes of hormonal milieu irrespective of the presence or absence of uterine contraction. They did not change significantly, however, after 37 weeks of gestation or 2-3 weeks before the onset of labor. 3. Administration of DHAS improved the cervical consistency effectively in terms of the values of C.U. and V.E.I.. When the cervix is noted to have C.U. greater than or equal to 30, V.E.I. greater than or equal to 0.65 at the 37 weeks of gestation, administration of DHAS (200mg weekly X 2) is recommended to ripen the cervix. PMID- 6864015 TI - Bizarre leiomyoblastoma (epithelioid leiomyosarcoma) of the uterus--a case with a malignant clinical course. AB - A case of a bizarre leiomyoblastoma (epithelioid leiomyosarcoma) which developed in the uterus of a 64-year-old woman and showed a malignant clinical course was reported. Histologically, the tumor in the present case had a number of bizarre giant cells, while the portion showing an epithelioid pattern was minor. Since the existence of an intimate inter-relationship between tumor cells and the smooth muscles of the blood vessel wall was a characteristic finding in the present case, a possible role of vascular smooth muscles as a tumorigenic matrix was suggested. Because of the closure of the internal os of the uterus by the tumor, the uterus had a cystomorphous appearance, and contained about 800ml of intrauterine fluid. The highest number of mitosis observed was 7 per 10 HPF. In view of abundant existence of intranuclear cytoplasmic inclusions, the malignancy of the present case was strongly suspected from a histological diagnostic point of view. The patient died 5 months after surgery because of metastases to the lumbar vertebra and to the lung. PMID- 6864016 TI - An autopsy study of 306 cases of maternal death in Japan. AB - Based on autopsy findings in 306 cases of maternal death from 1964 to 1980, recent trends in maternal death in Japan were discussed. Main topics dealt with were as follows: 1. Although rate of maternal death in Japan is decreasing markedly year by year, approximately 90 per cent of our autopsy cases were direct or indirect maternal deaths. 2. The most common category of the direct maternal death was hemorrhage. Unexpectedly uterine rupture was thought to be a common etiological factor for that. 3. One of the most valuable impression obtained in this study was a high percentage of "sudden death". In our series, 85 of 306 cases (27.8 per cent) were of maternal deaths within 6 hours after their general condition began to deteriorate. The first cause of sudden death was hemorrhage, and the second and the third were ectopic pregnancy and amniotic fluid embolism respectively. 4. Although it was very difficult, 16 cases (5.2 per cent) were judged as the maternal death possibly related to drugs. The most widely suspected and used drugs were hysterotonica such as prostaglandin, oxytocin and Deliverin. In these 16 cases of maternal deaths possibly related to drugs either directly or indirectly, amniotic fluid embolism (in 6 cases), uterine rupture (in 3 cases), and cervical laceration (in 2 cases) were confirmed at autopsy and diagnosed as the direct cause of death. However, in the remaining 5 cases, no acceptable findings could be obtained and an exact cause of death had remained unsolved. 5. Fifteen cases (4.9 per cent) of amniotic fluid embolism were confirmed by autopsy. However, only in 6 out of 15 cases, a clinical diagnosis of amniotic fluid embolism was given. In the remaining 9 cases, clinical diagnoses such as "shock of unknown etiology", "septic or endotoxin shock" and "postpartum collapse" were presumed. PMID- 6864017 TI - Effect of LH on ovarian steroidogenesis in the mid-pregnant rat. AB - In order to investigate the effect of LH on the steroidogenesis of ovary in mid pregnant rats, the ovary from day 15 pregnant rats was sliced and incubated in Krebs-Ringer bicarbonate buffer containing various kinds of materials as follows; rat LH (NIAMDD-Rat LH-RP-1, 10, 100, 1,000 ng/ml); estradiol (0.1, 1.0, 10 micrograms/ml); testosterone (0.1, 1.0, 10 micrograms/ml); dihydrotestosterone (DHT, 0.1, 1.0, 10 micrograms/ml). One thousand ng/ml of LH significantly (p less than 0.01) increased progesterone release from the ovarian tissue. LH also stimulated testosterone release. One or 10 micrograms/ml of testosterone increased progesterone release (p less than 0.01), whereas DHT caused no increase in progesterone release. These results indicated that LH could stimulate progesterone release of the ovary on day 15 of pregnant rat, by affecting the production of testosterone or estradiol. PMID- 6864018 TI - A clinicopathological study on glandular cystic hyperplasia of the endometrium. AB - Biopsy specimens of the endometrium obtained from the 154 cases diagnosed as glandular cystic hyperplasia were classified into 3 types. The results obtained are as follows: 1) The number of cases thus classified was 43 for type I, 78 for type II and 33 for type III. 2) Clinical diagnosis showed that functional uterine bleeding had the highest incidence, followed by myoma of the uterus, endometrial carcinoma and abortion in this order. 3) By age, 69.0% of the cases was concentrated in the fifth decade, the average age being 44.7 years. 4) Major clinical symptoms were 1) irregular cycle of menstruation, 2) prolonged genital bleeding, 3) anemia and 4) recurrence of symptoms. These symptoms were observed most frequently in type I, followed by type II and type III. Similar tendency was observed also in the incidence of complications with some of these symptoms. 5) The degree of endometrial hypertrophy was 3.7 +/- 1.0 mm for type I, 2.8 +/- 0.9 mm for type II and 1.6 +/- 0.9 mm for type III. 6) The incidence of the endometrial glandular epithelium in its active form was 70.7% for type I, 26.7% for type II and 25.9% for type III. 7) Stromal hyperplasia was found in 70.7% of the type I, 50.0% of the type II and 29.6% of the type III respectively. PMID- 6864019 TI - [Application of antiestrogens (clomid and tamoxifen) for the treatment of corpus luteum deficiency]. PMID- 6864020 TI - [2 cases of solid ovarian teratoma with resistance to chemotherapy]. PMID- 6864022 TI - [Evaluation of measurement of maternal symphysis-fundus length as fetal growth screening method]. AB - The diagnostic value of the measurement of the symphysis-uterine fundus length in determining intrauterine fetal growth was investigated. Symphysis-uterine fundus length readings varied according to the measuring method employed, but the Ando Westin's measuring method provided reliable results and indicated fetal growth accurately. The standard curve of symphysis-fundus (SF) length during pregnancy was described from the data obtained by one doctor (M.I.) according to the Ando Westin method in 101 pregnant women who delivered AFD infants. When the measured SF distance was over the mean plus SD or 3 cm more than the mean, an LFD infant or multiple pregnancy was felt to be highly probable. On the other hand, when the SF distance was less than the mean minus SD or 2 cm less than the mean, IUGR was definitely suspected. In conclusion, the accurate measuring of the SF distance is still an excellent screening test to detect abnormal fetal growth prior to more sophisticated sonographic or biochemical tests for abnormal fetal growth are undertaken. PMID- 6864021 TI - [Studies on the cortisol levels in maternal vein, umbilical artery, and umbilical vein classified according to the mode of delivery]. AB - We measured maternal venous(MV), umbilical arterial(UA), and umbilical venous(UV) cortisol levels of 180 pregnancies at term. In vacuum extraction cases, the cortisol levels of three individual samples were significantly higher than in other modes of delivery. In cesarean section delivery the cortisol levels of three individual samples were the lowest of all modes of delivery. The cortisol level of MV was higher than that of UA and UV in all deliveries. The cortisol levels of three samples showed no difference between the induced labor group and the spontaneous onset of labor group regardless of the delivery mode. In spontaneous vaginal delivery the cortisol levels of three individual samples were significantly higher in primipara than in multipara. Positive correlation was observed in all modes of delivery between the cortisol levels of MV & UA, MV & UV, and UA & UV. There was a negative correlation between the cortisol levels of MV and umbilical arteriovenous cortisol difference in multipara spontaneous vaginal deliveries. There was also a negative correlation between cortisol levels of MV and the umbilical arterial/venous ratio. These data suggest that the fetus may produce cortisol by itself and maternal cortisol may inflow to the fetus. PMID- 6864023 TI - [Biochemical and morphological study of pregnant rat myometrium: role of steroid receptors and gap junction formation in onset of parturition]. AB - In order to understand the mechanism involved in the onset of labor in rats, a series of biochemical and morphological studies were done on pregnant rat myometrium, during the latter half of pregnancy and in the postpartum period. It was observed that plasma progesterone (P) levels gradually declined between day 15 and 20 of pregnancy as did cytosol (PRC) and nuclear P receptors (PRN). In contrast, nuclear estrogen receptors (ERN), both occupied and unoccupied, increased in number during this period of time. Between 24 to 6 hrs prior to labor, plasma P levels and PRN reached a nadir (day 15 v.s. day 21; 776 +/- 88.5 and 187.4 +/- 40.4 fmol/mg DNA, mean +/- S.E., p less than 0.01), while ERN showed an abrupt increase (day 21 v.s. day 22; 1710.6 +/- 61.1 and 3254.8 +/- 203.8 fmol/mg DNA, p less than 0.01), and remained high during labor. After delivery, ERN gradually decreased, but PRN showed a surge between 6 to 12 hrs postpartum in concert with the rise in plasma P levels due to ovulation. Electromicroscopic quantitation of gap junctions (gis) also showed a sharp increase in the number of gjs during labor (day 21 v.s. during labor; 2.0 +/- 0.4 and 17.9 +/- 1.5 gjs per 1,000mcm of plasma membrane, p less than 0.01). A large number of gjs were observed during the first 12 hrs postpartum, but they abruptly disappeared thereafter. These observations suggest that in rats, prepartum accumulation of ERN may facilitate the formation of gjs, which serve as a means for either electrical or chemical excitations to synchronize myometrial contractions and initiate/sustain labor. After delivery, on the other hand, P seems to down-regulate the number of gjs and induce rapid myometrial quiescence during postpartum ovulation which allows the myometrium to be receptive to fertilized ovum. PMID- 6864024 TI - [Evaluation of mass screening for cervical cancer in Shiga Prefecture]. AB - During 1969 and 1979 cervical cancer was found in 269 women out of a population of 166,202 who were attending mass screening for cervical cancer in Shiga Prefecture, Japan. The overall 0.162% detection rate for this disease in the mass screening was within the range reported from other prefectures in Japan. The peak prevalence of carcinoma in situ was found at ages 40 to 44 years, while invasive cancer was found evenly distributed between ages 35 and 54 years. Among 269 women with cervical cancer, 68.8% were found to have suspicious or positive smears at the time of the initial screening, and 94% were detected by the time of the third screening. Ten women with carcinoma in situ had received the screenings almost annually more than three times and were found to have suspicious or positive smears at the time of the fourth or fifth screening. Re-evaluation of previous smears in these patients revealed that 55.6% should have been diagnosed as positive smears. Also eight women with cervical cancer in stage Ia or Ib were initially found to have positive smears at the time of the second screening, and re-evaluation of their previous smears showed that 50% had been suspicious or positive smears at the initial screening. These findings indicate that annual repeat screenings for at least three years are necessary for the early detection of cervical cancer. It is also emphasized that laboratory quality and/or accuracy should be properly controlled to avoid false negative results. PMID- 6864025 TI - [Visual and neurological disturbances accompanying with pregnancies of hyperprolactinemic patients]. AB - Twenty-three hyperprolactinemic infertile cases become pregnant after surgical treatment and/or bromocriptine administration, and 18 of them accomplished normal full-term deliveries. Serial ophthalmological examination which had been performed monthly throughout pregnancy revealed that four cases bearing pituitary adenomas developed visual disturbances which manifested themselves in the latter part of gestational period. The objective signs detected in these cases were bitemporal hemianopsia, temporal and nasal visual defects and the disappearance of central isopter. Another patient with microadenoma complained of headache at 16 weeks of gestation and it became more severe as gestation progressed. Bromocriptine (1.25 mg/day) was effective in diminishing this symptom. Although all these cases recovered from visual disturbances and headache after delivery, two of them were operated on transsphenoidally when radiological evidence of pituitary enlargement was found in the postpartum period. It is generally accepted that nearly 20% of hyperprolactinemic patients have pituitary adenomas. In view of the limited accuracy of techniques used in diagnosing pituitary tumor, it is legitimate to postulate that most hyperprolactinemic infertile patients have microadenoma to some extent. For this reason, a detailed follow up of visual field and neurological signs throughout pregnancy of hyperprolactinemic patients is important in early detection of changes in pituitary size. PMID- 6864026 TI - [Virological studies on the feto-maternal tissues infected with rubella virus]. AB - In studies on the congenital rubella syndrome, trans-placental rubella virus (RV) infection was investigated in vitro with human chorionic, decidual and fetal tissues obtained by artificial abortion from RV-infected pregnant women showing high hemagglutination-inhibiting and complement-fixing RV antibodies (1:512 and 1:16). RV was isolated from both chorionic (CR) and the fetal cells (FR) derived from RV-infected pregnant woman and the neutralization test disclosed that their antigenicity and biological properties were similar to that of the standard RV strain, M-33. These CR and FR cells showed a constant release of RV ranging from 2 to 4 log10 FFU (focus forming unit)/0.1ml into the culture media. Moreover, positive staining by immunofluorescent technique (IF) over 70 days seems to indicate RV persistent infection in these cells. However, decidual cells derived from RV-infected pregnant woman gave negative results in the RV release and IF staining. The above evidence strongly indicates that the chorionic cells are easily infected and converted to the RV-carrier. One possible mode of trans placental RV infection is via an initial infection of the chorionic cells followed by the establishment of persistent RV infection. PMID- 6864027 TI - [Role of X-ray CT in diagnosis and therapy of endometrial carcinoma]. AB - Since CT images after contrast enhancement (CE) delineate endometrial carcinoma as a low density area (LDA) in the uterus, carcinoma can be differentiated from normal myometrium in the image. In 21 patients with endometrial carcinoma, myometrial invasion was evaluated using three parameters, (1) the area occupied by LDA in the uterus, (2) the minimum thickness of the myometrium and (3) the maximum-minimum ratio of myometrial thickness, and the results were compared with findings on operation and on surgical specimens. CE increased the difference between the CT number of carcinoma and that of normal myometrium from 8.14 +/- 3.90 HU (mean +/- 1SD) to 26.20 +/- 7.84 HU. The CT number of endometrial carcinoma before CE was 34.86 +/- 8.42 HU, significantly lower than that of normal myometrium, 44.00 +/- 6.94 HU (p less than 0.001), and the increase due to CE was 21.36 +/- 6.49 HU, also significantly lower than that of normal myometrium, 41.62 +/- 7.04 HU (p less than 0.001). To evaluate myometrial invasion, the extent of carcinoma in cases satisfying all three conditions, i.e., parameter (1) is 50% or less, parameter (2) is 0.5 cm or more, and parameter (3) is 0.5 or more (Group A), was compared with that in cases not satisfying these conditions (Group B). The myometrial invasion of carcinoma exceeding 1/3 of the myometrial thickness was 0% in Group A and 100% in Group B. The lymphatic invasion of carcinoma was 11% in Group A and 70% in Group B. Metastasis was positive in 0% of Group A and 67% of Group B. PMID- 6864028 TI - A quantitative study of nuclear DNA of trophoblastic cells analysis of nuclear DNA distribution and clinical outcome of hydatidiform mole. AB - Microspectrophotometric measurements of the nuclear DNA contents of Feulgen stained trophoblastic cells were made in the cases of 54 normal pregnancies, 10 missed abortions, 118 hydatidiform moles, 11 invasive moles, and 9 choriocarcinomas. The position of the main peak and the range of nuclear DNA distribution correlated well with the severity of the trophoblastic disease. A statistically significant correlation was found between the position of the main peak and the occurrence of secondary trophoblastic disease from hydatidiform mole. Histological grading of hydatidiform mole did not show a good correlation with regard to the occurrence of secondary trophoblastic disease from hydatidiform mole. PMID- 6864029 TI - Endometrial carcinoma and its precancerous lesions related with glandular cystic hyperplasia. AB - Morphological investigations were carried out on 184 cases with GCH and related diseases, and the following results were obtained: 1. Pure GCH was observed in 112 cases (60.9%), GCH with ADH in 56 cases (30.4%), and GCH with ATH in 11 cases (6.0%). ECA related with GCH was found in 5 cases (2.7%). 2. It was suggested that GCH can serve as a remote precursor of ECA. Namely, GCH in some cases was found to develop into ECA apparently through the change from ADH to ATH. 3. It was morphologically observed that in GCH, both glandular epithelium and stromal cells were proliferated by being stimulated by estrogen, and such a proliferation was interrupted by an estrogen antagonist, progesterone. On the other hand, in the case of ATH, the growth of stroma was generally decreased and the proliferation of glandular epithelium became predominant. Moreover, the action of progesterone was minimum in ADH and ATH. These findings indicate that precancerous lesions such as ADH and ATH are those capable of developing easily into carcinoma. PMID- 6864030 TI - [Syndromes of disseminated intravascular coagulation]. PMID- 6864031 TI - [Hysterosalpingography]. PMID- 6864032 TI - [Effect of the nipple stimulation on uterine contractions in near-term pregnant women]. PMID- 6864033 TI - [Action of eel calcitonin on bone tissue--experimental study on bone cell activity in fracture healing in rat]. AB - The purpose of this study is to investigate effects of calcitonin (CT) on bone tissues in fracture healing. Rats were fractured at middle of the femur and given [ASU1,7] eel CT. Following biochemical changes in the serum and histological findings of bone tissue were demonstrated. At the early stage of fracture healing process, CT activated the periostal ossification and elevated serum level of alkaline phosphatase activity. At the stage of cartilagenous callus, the number of chondroclasts were decreased and the development of cartilagenous tissue to primary cancellous bone was inhibited. After this, number of osteoclasts was decreased and bone resorption due to osteoclasts was decreased and bone resorption due to osteoclasts were suppressed. By these process, remodelling at the fractured site was suppressed and serum alkaline phosphatase activity was maintained at a low level. But as for each osteocyte in this stage, CT gave rise to periosteocytic osteoplasis. It is clear that CT accelerates the fracture healing by activating the periostal ossification in the early stage, whereas the fracture healing is suppressed after the stage of cartilagenous callus formation. PMID- 6864034 TI - [Clinical study of brachial plexus traction lesions by intraoperative somatosensory evoked potential and nerve action potential recording]. PMID- 6864035 TI - [Measurement study of anatomical shape and size in Japanese elbow joints]. AB - Recently, total elbow replacement has been developed for reconstruction of destructed elbow joints. However, various complications occurred in the constrained or semi-constrained types of elbow replacement, while unconstrained type such as surface replacement showed lower incidence of such complications. On the other hand, development of the elbow prosthesis needs anatomical measurement of the elbow for adaptation to the need of Japanese. Basically, prosthesis should be designed based on the anatomical and biomechanical analysis. In this study, elbow from 36 Japanese cadavers were measured in the outer contour and microradiograms of the sectioned samples. Midline axes of the humerus and ulna, and the center of both medial and lateral epicondyles are fixed as standardized lines for the study in the elbow measurement. The trochlea is situated slightly anteriorly from the midline of the humerus. Width of the trochlea is 21.4 +/- 2.6 mm on the right side and 21.1 +/- 2.8 mm on the left at the anterior margin. At the distal margin, the width is 23.5 +/- 2.8 mm on the right and 23.3 +/- 2.6 mm on the left, and at the posterior margin, 23.9 +/- 3.6 mm on the right and 23.5 +/- 2.8 mm on the left. Saggittal section of the humeral end shows almost complete circle in the articular surface of the trochlea. The diameter is 19.1 mm on the right and 19.3 mm on the left at the longitudinal axis of the humerus, 17.6 mm on the right and 17.7 mm on the left at the central groove, and 24.5 mm on the right, 22.6 mm on the left at the medial margin. Anterior angulation of the trochlea is about 12 degrees. Central line of the trochlea corresponds to the center of the flexion-extension of the elbow, but angulated by 8 degrees from the humeral axis from the anterior view, and internally rotated by 3 degrees from the center of the both epicondyles from the bottom view. In the measurement of the incisura trochlea, opening distance is 18.5 +/- 2.1 mm on the right, 18.5 +/- 2.0 mm on the left, and the depth is 11.8 mm on the right, 11.6 mm on the left at the mean. Forward angulation of the incisura is 30.8 degrees on the right and 28.3 degrees on the left. Width of the olecranon is 25.0 +/- 3.2 mm on the right, 25.0 +/- 2.9 mm on the left and the thickness is 18.6 +/- 1.6 mm on the right, 18.7 +/ 1.8 mm on the left. The central line of the olecranon is supero-laterally angulated about 7 degrees from the longitudinal axis of the ulna. This angulation and lateral opening of the central line of the trochlea seems to produce carring angle of the elbow. Measurement of the elbow size and shape is discussed for designing elbow prosthesis and some biomechanical problems are also represented. PMID- 6864038 TI - Boundary lubricating property of synovial fluid on artificial material and lubrication of artificial joints. AB - Boundary lubricating property of the synovial fluid on artificial materials was investigated by using a pendulum-type friction tester. The coefficient of friction between metal and metal with synovial fluid as a lubricant ranged from 0.19 to 0.30. Those between metal and plastic in the same condition ranged from 0.26 to 0.43. It is concluded from the above data that synovial fluid is a poor lubricant for artificial materials. The coefficient of friction of a metal on plastic prosthesis was approximately five times better than that of a metal on metal prosthesis in the pendulum experiments using synovial fluid as a lubricant. PMID- 6864037 TI - The hand and environment (5):--Physiological changes of digital functions in two age groups studied by three stress tests under three environmental conditions. AB - Our serial physiological studies on "the hand and environment" have been reported these last three years. As a stressor to the hand, cold water immersion was the most effective, and the lower the room temperature was, each stressor became the more effective. As a detector for the function of the hand, the digital temperature was the most valuable. However, for studying the digital temperature, the room temperature should be set at more than 20 degrees C. The counting numbers were reduced by aging and colder temperatures. The nerve conduction velocity SCV or MCV became slower in a colder room, but showed no differences between the two age groups in this study. PMID- 6864036 TI - [Anatomical and clinical study on the femoral nerve lesion]. AB - Neuralgic and paralytic symptoms due to lesions of the femoral nerve or its related nerve roots are not infrequently encountered and therefore, clinically important. In order to clarify their pathomechanism the author has done anatomical, kinesiologic, and clinical studies. The topographic course of the femoral nerve was carefully observed in 40 cadavers (80 nerves) and transverse sections of 4 cadavers cut horizontally at various levels. The interrelation between the nerve and its surrounding organs was thus analysed. The 81 cases (87 nerves) of femoral nerve lesion, including lumbar radiculopathy, femoral neuropathy, and saphenous nerve lesion, were clinically followed up and the mechanism of their production was analysed. Besides, kinesiologic studies using electromyograms of the trunk and lower extremity muscles were performed in 8 cases (9 lesions) and 20 normal male controls. The main results obtained are as follows: 1. From the embryologic and morphologic points of view, the femoral nerve runs a peculiar course and has characteristic shapes in its transverse sections at various levels. 2. As the nerve lies closely adjacent to several pelvic organs, it can easily be influenced by their pathological conditions. 3. When the adjacent organs are treated surgically, it may be rare that the nerve is injured, constituting a complication. 4. The pathomechanism of the femoral neuropathy occurring at the inguinal ligament is quite similar to that of entrapment neuropathy of the peripheral nerve that occurs at a fibro-osseous tunnel. 5. Even if the quadriceps femoris muscle is totally paralysed, extention of the knee joint is possible to some extent because of a compensatory action of the tensor fasciae latae muscle. PMID- 6864040 TI - ["Far field potentials" after stimulation of the median and tibial nerve in man]. PMID- 6864039 TI - [A clinical and radiological study of posterior nucleotomy for lumbar disc herniation-a review after ten to twenty-five years]. AB - This study was performed to clarify long-term results of posterior nucleotomy and to investigate the clinical factors which affect the end results. Sixty patients with lumbar disc herniation who underwent posterior nucleotomy at the Chiba University Hospital from October, 1954 to December, 1968 were completely reviewed. Fifty-six patients were clinically examined personally, and four patients by questionnaire. Their follow-up period ranged from 10 to 25 years, with an average 17.8 years. They consisted of 41 light, 9 moderate, and 10 heavy manual laborers. The results were as follows: 1) Over-all clinical results were excellent in 19 (32%), good in 32 (53%), fair in 5 (8%), and poor in 4 cases (7%). 2) Preoperative sciatica was completely relieved in 80 percent and straight leg raising test became negative in 88 percent. However, backache was completely relieved only in 38 percent, sensory disturbance in 43 percent, and numbness in 45 percent. 3) Generally, the follow-up X-rays showed stable narrowed intervertebral space at operated level in patients with satisfactory clinical results, while unstable and severely narrowed intervertebral space was seen in some patients with unsatisfactory clinical results. 4) Lumbar adhesive arachnoiditis was found in one fair and two poor cases. Operative trauma was thought to be one of their etiologic factors. Residual symptoms after posterior nucleotomy appeared to be correlated with this operative trauma. PMID- 6864041 TI - [An electrogoniometric study of human finger joint movement]. PMID- 6864043 TI - Lower lumbar anterior discectomy without fusion: a several year follow-up indicating usefulness of this technique in surgery of the lower lumbar spine--a report of one hundred ten cases. AB - For the surgical treatment of lumbar disc lesions, the posterior approach has often been used. It is not always easy to get good results, because one has to go through the spinal canal with irritation of the dura and the nerve root and cause bleeding. If the correct diagnosis is made by myelography or other methods, it is more logical to remove the disc from the front without disturbing the spinal canal. Under this idea, anterior discectomy has been performed on 110 patients suffering from low back pain and sciatica. The excellent results were obtained in 90.9 per cent. PMID- 6864042 TI - [Analysis of the impulse of the ground reaction force in normal gait]. PMID- 6864044 TI - Measurement of the footsole pressure distribution of normal subjects by pressure sensitive films. AB - A simple method measuring the pressure on the footsole was described using "Prescale", pressure sensitive films. Prescale consists of two films, one coated with microcapsules which contain a color-producing agent and rupture when a pressure is applied, and the other coated with a color-developing agent. Then, when a pressure is applied on the former film, the latter one display a color of various density corresponding to the pressure applied. Distribution of the pressure on the footsole was studied in normal subjects by this method. Pressure distribution in each subject was compared with his foot structure examined radiologically. And the clinical implications and indication of this method were discussed. PMID- 6864045 TI - [Correlation between antitumor effects against human mammary carcinoma (MX-1) in nude mice and clinical efficacy of human breast cancer in thirty-four antitumor agents]. PMID- 6864046 TI - [Transplantability of human adenocarcinoma in nude mice]. PMID- 6864047 TI - [Intestinal operation in patients with ovarian carcinoma]. PMID- 6864048 TI - [Clinical study by using bronchofiberscope on radiotherapy of lung cancer--with special reference to squamous cell carcinoma at the hilar region]. PMID- 6864049 TI - [80th meeting of the Japanese Society of Internal Medicine. Osaka, 6-7 April 1983. Abstracts]. PMID- 6864050 TI - [Clinical characteristics of congestive heart failure following acute myocardial infarction in patients with previous myocardial infarction]. PMID- 6864053 TI - [Motor neuron disease with presenile dementia: report of a case]. PMID- 6864054 TI - [Membranous glomerulonephritis associated with enterococcal endocarditis]. PMID- 6864051 TI - [Reiter's disease associated with paroxysmal nocturnal hemoglobinuria]. PMID- 6864052 TI - [A case of sarcoidosis with a huge tumor of the anterior cervical region]. PMID- 6864057 TI - [A case of huge retroperitoneal chondrosarcoma]. PMID- 6864056 TI - [A case of sicca syndrome associated with glomerulonephritis due to cryoglobulin]. PMID- 6864055 TI - [Case of Hodgkin's disease with cerebral infarction presumably due to cerebral angiitis]. PMID- 6864059 TI - Anorectal abscesses. Extensive manifestation with abdominal involvement. PMID- 6864058 TI - [A chronic uremic patient with coagulopathy induced by vitamin K deficiency]. PMID- 6864060 TI - Penile implants. Surgical treatment of impotence. PMID- 6864061 TI - Radiation therapy. Its role in the treatment of early breast cancer. PMID- 6864062 TI - Bezoars. A complication of diabetic gastroparesis. PMID- 6864064 TI - Congenital rubella syndrome. A review of development, diagnosis, and treatment. PMID- 6864063 TI - Pulmonary carcinoma. Means of diagnosis and treatment. PMID- 6864066 TI - Indomethacin-furosemide drug interaction. PMID- 6864065 TI - Sickle cell anemia. PMID- 6864067 TI - A new high-performance liquid chromatographic procedure for the separation and quantitation of various hemoglobin variants in adults and newborn babies. AB - A new cation-exchange HPLC method is described for the separation and quantitation of abnormal human Hbs. The method makes use of Synchropak CM 300, a silica support with carboxylic acid residues, and Bis-Tris-KCN-Na-acetate developers and allows a completion of the chromatogram in 50 to 90 min depending on the sample to be analyzed. Specific chromatographic profiles have been obtained for several beta, alpha, and delta chain variants. The method is useful not only for the quantitation of Hb F and Hb A2 (except in the presence of Hb E) but also provides easy differentiation between simple heterozygotes for a specific abnormality and persons with the same abnormality together with an additional beta-thalassemia heterozygosity. Probably the most important application of the new procedure is in the quantitation of Hb A and the beta chain variants S, C, O-Arab, and E in cord blood samples, thus facilitating the diagnosis of conditions such as AE, EE, AS, SS, S-beta +thal, AC, CC, C-beta +thal, SC, and SO in newborn babies. PMID- 6864068 TI - Application of affinity chromatography for separation and quantitation of glycosylated hemoglobins. AB - The use of m-aminophenylboronic acid immobilized on agarose as the affinity matrix for the separation and quantitation of Glyco Hb has been investigated. The glyco fraction isolated from the affinity columns contained about 10% Hb A1a + b, 52% Hb A1c, and 38% Hb A0-like glyco components. The nonglyco fraction had major portions of Hb A1a + b and Hb A0 and a small amount of Hb A1c (also contained Hb F). In normals and diabetic patients, the comparison of the affinity method with the ion-exchange chromatographic, fluorometric, and colorimetric methods showed good correlation. The affinity method also showed acceptable precision and reproducibility. The presence of labile aldimine did not influence the affinity method because it seems that only the stable ketoamine was bound to the affinity gel and thus separated by this method. Moreover, this method was less sensitive to variations in column temperature and sample age. Glyco Hb levels were determined in newborn infants and in adults with various hemoglobinopathies. The results indicated that the presence of Hb F, Hb S, and Hb C did not affect the glyco Hb determinations. Thus the affinity chromatographic approach has wider application than ion-exchange chromatography and is, at the same time, much simpler and faster than the chemical methods. PMID- 6864069 TI - Influence of phosphoenolpyruvate carboxykinase inhibition on the response of NH3 production to acute acidosis. AB - The role of PEPCK in the stimulation of NH3 production by acute acidosis was examined by perfusing isolated rat kidneys in the presence of the PEPCK inhibitor, MPA (0.15 mM). The response of kidneys perfused with physiologic quantities of glutamine to both acute respiratory (increase in pCO2) and metabolic acidosis (decrease in bicarbonate concentration) was assessed. Although MPA decreased renal NH3 production at pH 7.4, it had no effect on the stimulation of ammoniagenesis produced by either acute respiratory or acute metabolic acidosis. Thus the stimulation of NH3 production by an acute decline in pH must result from an effect on a metabolic step prior to the conversion of oxaloacetate to phosphoenolpyruvate. PMID- 6864071 TI - Hypercalcemia after nephrectomy in the dog: role of the kidneys and parathyroid glands. AB - To examine the role of the kidneys and parathyroid glands in the development of hypercalcemia after bilateral nephrectomy, changes in serum calcium and iPTH were measured in dogs after bilateral nephrectomy, bilateral ureteral ligation, bilateral nephrectomy of thyroparathyroidectomized animals, or sham operation. Total calcium increased at 24 hr after nephrectomy, remained unchanged after bilateral ureteral ligation or sham surgery, and decreased after nephrectomy of thyroparathyroidectomized dogs. Ionized calcium decreased significantly at 12 hr after nephrectomy or ureteral ligation but returned to normal after 24 to 48 hr. At 72 hr ionized calcium remained normal in the nephrectomized animals but fell significantly in the ureteral ligation animals. At 12 and 24 hr, PTH was significantly higher (4.3- and 2.0-fold, respectively) in the nephrectomized group than in the ureteral ligation group. CONCLUSIONS: (1) the increase in total serum calcium after bilateral nephrectomy in the dog is not accompanied by an increase in ionized calcium; (2) intact parathyroid function is necessary for the increase in total calcium and for the maintenance of ionized calcium after nephrectomy; (3) the presence of the kidneys in the ureteral ligation model prevents the rise in total serum calcium and allows a fall in ionized calcium. PMID- 6864072 TI - Effect of erythrocyte stroma on reticuloendothelial system phagocytic function. AB - Previous studies have demonstrated that intravenous administration of erythrocyte stroma is followed by a depression of RES phagocytic function. The present study evaluated the possibility that depression of hepatic blood flow, activation of the coagulation system, or depletion of opsonic factors mediates the RES depression induced by erythrocyte stroma. Stroma was prepared from washed rat erythrocytes and injected into rats at doses of 0.3, 0.5, 0.75, and 1.0 ml/100 gm. RES depression increased progressively after stroma doses greater than 0.3 ml/100 gm. Hepatic blood flow was decreased only after the 1.0 ml/100 gm dose. Fibrinogen levels were decreased with the 1.0 ml/100 gm dose but were unchanged with the 0.5 ml/100 gm dose of stroma, and the RES depression induced by the 0.5 ml/100 gm dose was not modified by the administration of heparin. Circulating fibronectin levels were not consistently depressed after stroma injection, and in vitro incubation of stroma with serum did not affect fibronectin levels. Erythrocyte stroma decreased hemolytic complement levels but depletion of complement with purified cobra venom factor did not depress RES phagocytic function. Preopsonization of the RES test particle did not modify the stroma induced RES depression. These results indicate that decreased hepatic blood flow, activation of the coagulation system, or depletion of opsonins did not contribute to the RES depression induced by the 0.5 ml/100 gm dose of stroma. These results suggest that impairment of phagocytic cell function may mediate the effect of erythrocyte debris on RES phagocytic function. PMID- 6864070 TI - Gentamicin-specific antiserum alters the disposition of gentamicin by the isolated perfused rat kidney. AB - Previous studies have indicated that antibodies or Fab fragments of antibodies can be used to alter the pharmacologic or toxicologic effects of drugs. The present study was conducted to determine the effect of specific antiserum administration on the renal excretion of a drug with a high nephrotoxic potential (e.g., gentamicin) using the IPK. After a perfusion period during which the renal clearance of gentamicin was determined, either serum or gentamicin-specific antiserum was added to the perfusion medium. Experiments with serum addition served as controls for a comparison of the effects of antiserum addition on gentamicin renal clearance and tissue accumulation. Addition of antiserum decreased the renal clearance and tissue accumulation of gentamicin. Increasing perfusate gentamicin concentrations at the end of the experimental time suggested that these alterations in disposition could be due to the formation of a nonfilterable gentamicin-antiserum complex. The addition of antiserum also rapidly reversed the increasing fractional excretion of potassium ion. Therefore it would appear that a commercially available antiserum is capable of decreasing renal tissue accumulation of gentamicin and that the IPK represents a viable system for studying the effects of antisera on renal drug disposition. PMID- 6864073 TI - Serum protein concentration and portal pressure determine the ascitic fluid protein concentration in patients with chronic liver disease. AB - The ascitic fluid and serum concentrations of albumin and globulin were measured simultaneously with transhepatic portal pressure determination in 56 patients with chronic liver disease to determine whether (1) portal pressure correlated with (S-Asc)A and (2) the majority of variation in ascitic fluid protein concentration between patients was related to fluid balance from serum to ascites. The mean ascitic fluid albumin concentration was 1.04 +/- 0.73 gm/dl; globulin concentration 1.31 +/- 0.80 gm/dl; and ascitic fluid total protein concentration 2.35 +/- 1.49 gm/dl. The mean serum albumin concentration was 2.58 +/- .57 gm/dl; globulin concentration 3.91 +/- .86 gm/dl; and total protein concentration 6.49 +/- 1.30 gm/dl. The (S-Asc)A was 1.54 +/- .45 gm/dl. The mean PPIVC was 14.5 +/- 4.3 mm Hg. The (S-Asc)A correlated directly with PPIVC (r = 0.73; p less than 0.0001). The ascitic fluid protein correlated with three variables that did not correlate with each other: serum albumin (r = 0.67; p less than 0.0001), serum globulin (r = 0.44; p less than 0.001), and PPIVC (r = -0.48; p less than 0.0005). The sum of the squared correlation coefficients with these latter uncorrelated variables equaled 0.87 and partial correlation coefficient analyses demonstrated an increase in the correlation of the ascitic fluid protein with the serum albumin concentration when corrected for serum globulin and (S Asc)A (r = 0.97; p less than 0.0001) or PPIVC (r = 0.90; p less than 0.0001). Thus most of the variation in ascitic fluid protein between patients in this study could be related to serum protein concentrations and PPIVC or (S-Asc)A. Furthermore, multivariate discriminant analysis of patients with an ascitic fluid protein less than or equal to 2.5 vs. greater than 2.5 gm/dl indicated that the majority of differences between the two groups could be attributed to differences in serum albumin and serum globulin in combination with the (S-Asc)A (canonical correlation = 0.808) or PPIVC (canonical correlation = 0.806). These factors could correctly identify the low or high ascitic fluid protein groups in 96% and 93% of patients, respectively. IN CONCLUSION: (1) the (S-Asc)A is associated with the degree of portal pressure elevation and (2) the majority of variation in ascitic fluid protein concentration between patients with chronic liver disease is associated with differences in portal pressure and serum protein concentrations. PMID- 6864074 TI - Hepatic production of erythropoietin in a phenylhydrazine-induced compensated hemolytic state in the rat. AB - The relative roles of the kidney and liver as a source of Ep in a fully compensated hemolytic state were investigated. A compensated hemolytic anemia was induced in rats by injections of PHZ over a 6-week period. Verification of a fully compensated hemolytic state was established by MCV, MCH, MCHC, BV, PV, CRCV, peripheral reticulocyte counts, and bone marrow counts. The kidneys and livers of the PHZ-injected rats were subjected to concurrent perfusion at weekly intervals over the treatment period and the perfusate assayed for Ep activity. The kidney was found to be the principal source of Ep during the earlier stages of the anemia and the liver became increasingly important as a source of Ep during the later stages as the anemia became progressively compensated. By the fifth and sixth weeks of treatment, when the anemia was fully compensated, the livers of the PHZ-treated rats were the principal source of Ep. During these last 2 weeks of treatment, the amount of Ep recovered from the renal effluents of PHZ injected rats was no greater than that collected from the renal effluents of saline-injected rats. The data indicate that the liver is the primary, if not the only, source of the higher titers of Ep in the fully compensated hemolytic state induced in the rat by long-term PHZ treatment. PMID- 6864075 TI - The influence of lysostaphin on phagocytosis, intracellular bactericidal activity, and chemotaxis of human polymorphonuclear cells. AB - Lysostaphin, a microbicidal enzyme that lyses Staphylococcus aureus, was introduced to study phagocytosis and ICBA (Tan et al.3) on the presumption that it does not penetrate into the phagocytic cells. It was recently suggested, however, that LS enters the cells and kills ingested bacteria. By using two methods to study phagocytosis and bactericidal activity, the old one based on disruption of PMNs and plating technique and a new one that does not require disruption, we found that LS did not influence phagocytosis or phagocytic index but altered intracellular kill of Staphylococcus. LS eliminated almost completely extracellular bacteria, but centrifugation and washing of PMN at the end of phagocytic assay were almost equally efficient. Since the method of disruption of PMN and plating of bacteria cannot distinguish penetration of LS to the cells from its adherence to the outer wall of PMN, we employed a new, recently described acridine orange/crystal violet method, which can measure simultaneously phagocytosis and ICBA and eliminates completely extracellular microorganisms. This method has shown that in the presence of LS, a significantly higher proportion of staphylococci were killed intracellularly--91% +/- 2.7 vs. 74% +/- 2.9 (p less than 0.001), i.e., that LS either penetrated to the cells or enhanced ICBA. It was also found that trypsin, which was used as an inhibitor of LS, was unable to abolish bactericidal activity of LS. It is suggested that LS should not be used for assessment of ICBA but may be employed for studies of phagocytosis over short incubation periods. A new method based on acridine orange/crystal violet staining was found to be useful for investigation of phagocytosis and ICBA of human PMNs. PMID- 6864077 TI - Rheumatoid arthritis. PMID- 6864076 TI - Iron repletion decreases maximal exercise lactate concentrations in female athletes with minimal iron-deficiency anemia. AB - We studied the effect of 2 weeks of iron therapy on exercise performance and exercise-induced lactate production in trained women athletes: six control subjects with normal parameters of iron status and nine with mild iron-deficiency anemia defined by low Fe/TIBC, ferritin, and minimally decreased Hgb values. Iron therapy improved the abnormal measures of iron status and low Hgb in the second group to normal. Exercise performance in a progressive work-exercise protocol on a bicycle ergometer to exhaustion was unchanged after iron therapy in both groups; however, blood lactate levels at maximum exercise in the iron-deficient group decreased significantly from 10.3 +/- 0.6 mmol/L before therapy to 8.42 +/- 0.7 after therapy (p less than 0.03). The control subjects did not significantly alter lactate levels after maximal exercise on iron compared to placebo: 8.3 +/- 0.8 mmol/L vs. 8.5 +/- 0.7. Although there was not a significant difference in maximum exercise performance after iron therapy, these data support animal experiments implying that iron may play a role in oxidative metabolism and that minimal decreases in Hgb may impair arterial oxygen content enough to affect aerobic metabolism. In addition, these findings may have important implications for competitive women athletes in whom mild iron deficiency may go unnoticed. PMID- 6864079 TI - Microvascular surgery in the treatment of cerebrovascular disease. PMID- 6864078 TI - Endobronchial irradiation in the treatment of recurrent non-oat cell bronchogenic carcinoma. PMID- 6864080 TI - To crossmatch or not to crossmatch: a question of effective blood utilization. PMID- 6864083 TI - Practice management. PMID- 6864081 TI - David L. Stewart, M.D.. Interview by Donna M. Young. PMID- 6864082 TI - Help for the impaired physician. PMID- 6864084 TI - Unilateral pulmonary edema. PMID- 6864085 TI - Coagulopathy associated with broad spectrum antibiotic therapy. PMID- 6864086 TI - Maternal mortality. PMID- 6864088 TI - Radiological changes associated with benign nasal polyps. PMID- 6864087 TI - Nasal mucociliary function in different diseases of the nose. AB - Two techniques, using saccharin sky-blue powder and barium sulfate particles, were used to study the nasal mucociliary clearance in 40 normal subjects and 200 patients with different nasal diseases. The transport time was measured in each test subject and a highly significant difference was observed between healthy persons and the study group (p less than 0.001). The saccharin sky-blue test serves as a valuable screening test. PMID- 6864089 TI - Adenoidectomy. A prospective study to show clinical and radiological changes two years after operation. PMID- 6864091 TI - Hoarseness in tuberculosis. AB - A study has been made of hoarseness in 26 tuberculous patients in Kandy (Sri Lanka). Tuberculous inflammation of the vocal cord or ventricular fold was its cause in 18 of them, in 17 of whom the laryngeal infection was due to direct implantation of tubercle bacilli from lung cavities through cough; in one it was probably haematogenous. Hoarseness in the other eight patients was due to recurrent laryngeal nerve palsy, the nerve being involved in tuberculous lesions, in six instances in the mediastinum and in three instances in the right apical pleura. However caused, hoarseness associated with active inflammatory disease cleared with anti-tuberculous chemotherapy, whereas that associated with fibrosis persisted. PMID- 6864090 TI - The relationship of adenoid weight to tonsillar weight. AB - Nearly 70 per cent of contemporary ENT consultants perform adenoidectomy as a routine when removing the tonsils. It has been stated in the literature that adenoid and tonsillar hypertrophy tend to co-exist and so a study was set up to investigate this hypothesis, with the possibility that it may be of diagnostic importance. A series of 45 children admitted for the operations of tonsillectomy and adenoidectomy was investigated. No correlation was found between adenoid weight and tonsil weight. In view of this, it was concluded that tonsil and adenoid hypertrophy do not necessarily co-exist and that tonsil size cannot be used to predict adenoid size. PMID- 6864092 TI - 'Still other seed fell on good soil . . .'. PMID- 6864093 TI - Traumatic luxation of the stapes. AB - A case of traumatic middle and inner ear damage due to involuntary piercing of the tympanic membrane with a knitting needle is reported. The incudo-stapedial joint was dislocated and the intact stapes was depressed into the vestibule. Exploration of the middle ear, followed by extraction of the stapes, closure of the oval window with a vein graft and interposition of a prosthesis between the incus and oval window, improved the condition but did not restore inner ear function. A second case, of unclear etiology, is also presented. The indications, timing and technique of surgical intervention in cases of traumatic luxation of the stapes are briefly discussed. PMID- 6864094 TI - Lingual thyroid, sensorineural hearing loss and mental retardation: a coincidental association? AB - A case of lingual thyroid associated with mental retardation and bilateral sensorineural hearing loss is presented. Cases of lingual thyroid are rarely reported and usually not in combination with other abnormalities. The theoretical etiology of such association as a result of an intrauterine infection is discussed. PMID- 6864096 TI - Fibro-myxoma of the maxilla. PMID- 6864095 TI - Chondrosarcoma of the paranasal sinuses and nasal septum. AB - A case of chondrosarcoma of the left antro-ethmoid region and nasal septum is presented as a second primary malignant tumour in a patient who had undergone a previous excision of a rodent ulcer in the cheek. X-ray studies and multiple biopsies of the nasal cavity were undertaken to determine as accurately as possible the extent of the tumour. The tumour was excised via a lateral rhinotomy. Chondrosarcoma of the maxillofacial region is a rare tumour. The treatment of choice is by surgical excision. Radiotherapy may be considered in non-resectable or recurrent tumours. PMID- 6864097 TI - Botryoid rhabdomyosarcoma of the nasopharynx. AB - A case report of a Stage III botryoid rhabdomyosarcoma of the nasopharynx associated with a six-and-a-half-year survival is presented. Treatment consisted of surgery, radiotherapy (6,000 rads TCT) to the nasopharynx and maxillary sinuses bilaterally, and six cycles of polychemotherapy with Vincristine, Adriamycin, Cyclophosphamide and DTIC, without major loss of function or cosmetic deformity. The histology of the lesion is discussed with reference to recent classification and prognosis. The authors suggest that the histological type and prognosis of rhabdomyosarcoma of the nasopharynx in children may be better correlated in future studies. PMID- 6864098 TI - Recurrent suppurative thyroiditis due to pyriform fossa--thyroid fistula. PMID- 6864099 TI - Traumatic oesophageal perforation treated with Mousseau Barbin tube. AB - A traumatic perforation of the oesophagus during endoscopy was managed successfully by the use of a Mousseau Barbin tube instead of by a thoractomy repair. PMID- 6864100 TI - Laryngeal tuberculosis in Tanzania. AB - The incidence of laryngeal tuberculosis in 341 patients with pulmonary tuberculosis was assessed in Dar es Salaam, Tanzania. Laryngeal involvement was present in 26.7 per cent of previously untreated cases. The clinical presentation corresponds to classical descriptions of the disease found in previous accounts. It is suggested that laryngeal tuberculosis is a common complication of pulmonary tuberculosis in developing countries. It should be the first differential diagnostic consideration in patients suffering from hoarseness, and pulmonary tuberculosis should be ruled out before a diagnostic direct laryngoscopy and biopsy are attempted. PMID- 6864101 TI - Metacognition and the adolescent passive learner. PMID- 6864102 TI - Information processing and the Slingerland Screening Tests. PMID- 6864103 TI - The personal-social characteristics of children with poor mathematical computation skills. PMID- 6864104 TI - Visual and auditory matching in learning disabled and normal children. PMID- 6864105 TI - The birthdate effect--a maturational effect? PMID- 6864106 TI - Would you like a bite of my peanut butter sandwich? PMID- 6864107 TI - Judicial diagnosis. PMID- 6864108 TI - "Straight is the bamboo tree". PMID- 6864109 TI - Developing a learning disabilities program in an overseas community school: American Community School in Athens, Greece. PMID- 6864110 TI - Selective auditory attention abilities of learning disabled and normal achieving children. PMID- 6864111 TI - Diagnosis of auditory perceptual disorders in previously undiagnosed adults. PMID- 6864112 TI - A study of nonstrategic linguistic coding on visual recall of learning disabled readers. PMID- 6864114 TI - Visual persistence and information pick-up in learning disabled children. PMID- 6864113 TI - Changing peer perceptions: effects of labels and assigned attributes. PMID- 6864116 TI - Priorities for the use of microcomputers with learning disabled children. PMID- 6864117 TI - Making the grade. PMID- 6864115 TI - Current practices in making psychoeducational decisions about learning disabled students. PMID- 6864118 TI - In praise of normalcy. PMID- 6864119 TI - The direct hematopoietic toxicity of ethyl alcohol. PMID- 6864120 TI - Guilty but mentally ill--in search of a perspective. PMID- 6864121 TI - TEFRA--what's it to you? PMID- 6864122 TI - Mild hypertension. PMID- 6864123 TI - The continuing saga of Georgia's medical malpractice statute of limitations. PMID- 6864125 TI - Why patients are angry. PMID- 6864124 TI - The cell and the celestial: spiritual needs of cancer patients. PMID- 6864126 TI - Current practice characteristics and distribution patterns of Alabama physicians. PMID- 6864127 TI - Arcades of Struthers. PMID- 6864129 TI - You could get killed. PMID- 6864128 TI - Enterolith as a cause of bowel obstruction. PMID- 6864130 TI - Energy cost of ambulation with Canadian hip disarticulation prosthesis. PMID- 6864132 TI - The 11th hour. PMID- 6864131 TI - Outpatient surgery: a proven method of cost containment. PMID- 6864134 TI - Lessons and challenges from the demise of the Department of Medical Computer Science at the University of Texas Health Science Center at Dallas. PMID- 6864135 TI - Evaluation of screening effectiveness. PMID- 6864133 TI - Preacher of the new gospel. Interview by William H. McDonald. PMID- 6864136 TI - The selection of a regional data base for planning and evaluating burn care systems using a discriminant analysis technique. PMID- 6864137 TI - Ankle pressure index in patients with lower limb atherosclerosis. A study of 40 cases. PMID- 6864139 TI - Post - anesthetic shivering. PMID- 6864138 TI - Surgery for carcinoma of the esophagus. PMID- 6864140 TI - A comparative study of pregnancy test kit produced in Thailand. PMID- 6864141 TI - Thiamphenicol in the treatment of enteric fever. PMID- 6864143 TI - Renal hamartoma (angiomyolipoma) with spontaneous massive hemorrhage in sixteen weeks pregnancy : a case report. PMID- 6864142 TI - Factor XIII and its deficiency - review literature and the case report of a Thai boy with congenital factor XIII deficiency. PMID- 6864144 TI - Oestrogen--bromocriptine interaction in the control of luteinizing hormone and prolactin secretion in the neonatally oestrogenized female rat. AB - Neonatally oestrogenized female rats showed hyperprolactinaemia (prolactin, 230 micrograms/l), normal LH levels and absence of a positive feedback effect of oestrogen on secretion of LH at 5 months of age. Bromocriptine treatment for 13 days (1 mg/kg per day) caused no changes in LH levels and prolactin levels decreased to normal values (33 micrograms/l). This decrease in prolactin concentration was not followed by the recovery of phasic LH response to oestrogens. The effectiveness of oestrogens to induce prolactin secretion was greater in the neonatally oestrogenized rats than in the control group. In both cases the effect diminished after bromocriptine treatment. These results indicate that hyperprolactinaemia is not the cause of the anovulatory state in oestrogenized rats and that neonatal treatment with oestrogens alters oestrogen- prolactin relations, probably involving dopamine. PMID- 6864145 TI - Plasma concentrations of progesterone, oestradiol-17 beta and 13,14-dihydro-15 oxo-prostaglandin F2 alpha in the pregnant wallaby (Macropus rufogriseus rufogriseus). AB - The concentrations of progesterone and oestradiol-17 beta in the maternal plasma of Bennett's wallaby, Macropus rufogriseus rufogriseus, were measured daily throughout gestation after reactivation of the diapausing corpus luteum by removal of the suckling pouch young (RPY). Progesterone increased from mean concentrations of 382-424 pmol/l (120-133 pg/ml) during lactation to reach peak concentrations of 908 +/- 172 (S.E.M.) pmol/l (285 +/- 54 pg/ml) (n = 8) 4 days after RPY and 971 +/- 220 and 971 +/- 229 pmol/l (305 +/- 69 and 305 +/- 72 pg/ml) (n = 7) 24 and 25 days after RPY respectively. The mean gestation length (RPY to birth) was 26.8 +/- 0.6 (S.D.) days (n = 6, range 25.75-27.50 days). Immediately after birth the plasma progesterone concentration declined to 299 +/- 51 (S.E.M.) pmol/l (94 +/- 16 pg/ml) (n = 6). Oestradiol-17 beta increased from mean concentrations of 291-553 pmol/l (80-152 pg/ml) during lactation to reach a peak concentration of 967 +/- 331 pmol/l (266 +/- 91 pg/ml) (n = 9) 1 day after RPY. The concentration declined from 7 days after RPY and fluctuated between mean concentrations of 273 and 480 pmol/l before reaching a minimum of 207 +/- 69 pmol/l (57 +/- 19 pg/ml) (n = 6) 19 days after RPY. A transient increase to 542 +/- 207 pmol/l (n = 7) occurred at 22 days after RPY. Plasma concentrations declined to a low of 156 +/- 55 pmol/l (43 +/- 15 pg/ml) (n = 6) 5 days after parturition. The mean concentration of plasma 13,14-dihydro-15-oxo-prostaglandin F2 alpha was less than 2.8 nmol/l (1 ng/ml) for all samples from 13 days after RPY until 4 days after parturition. The results suggest that oestradiol-17 beta may be important in the early stages of blastocyst reactivation to synergize with progesterone in stimulating uterine secretions. 13,14-Dihydro-15-oxo prostaglandin F2 alpha is unlikely to be involved in the birth process and any luteolytic effect is likely to be from a local production of PGF2 alpha. PMID- 6864146 TI - Mammary gland lactose, plasma progesterone and lactogenesis in the marsupial Macropus eugenii. AB - Mammary gland lactose concentrations in pregnant tammar wallabies remained low at 115 +/- 24 (S.E.M.) micrograms/g wet weight of tissue until immediately before parturition, then increased to 1274 +/- 262 micrograms/g after birth. Concentrations in non-pregnant cyclic animals were generally low (143 +/- 36 micrograms/g), but were raised in three animals around the time of oestrus. Removal of the corpus luteum on day 18 of pregnancy or the oestrous cycle caused an increase in lactose concentrations in both lutectomized and sham-operated animals. This occurred despite a significant lowering of peripheral plasma progesterone concentration in only the lutectomized group. Plasma cortisol concentrations were high in some of these animals, but showed no consistent relationships with the raised lactose concentrations. The increased peripartum lactose concentration normally coincides with a sharp fall in peripheral plasma progesterone concentration, but artificial maintenance of high progesterone levels had no effect on the increase of mammary gland lactose at parturition. Mammary gland lactose concentrations in tammar wallabies are therefore a useful indicator of biosynthetic activity and as an index of lactogenesis but the role, if any, of progesterone withdrawal in lactogenesis remains unclear. PMID- 6864147 TI - Reduced adrenocortical function and increased thyroid function in fasted and refed chickens. PMID- 6864148 TI - Long-term and constant release of vasopressin from Accurel tubing: implantation in the Brattleboro rat. AB - A long-lasting and constant release of vasopressin in serum solution (in vitro) for periods up to 50 days can be obtained by the use of small-diameter microporous Accurel polypropylene tubing, filled with vasopressin and covered with collodion. The potency of the preparation is shown in vivo after subcutaneous implantation in the adult vasopressin-deficient Brattleboro rat, for which normal levels of urine production and osmolality were achieved at least for 1 month. The possible use of this method for other peptides and its application in small or immature laboratory animals and in fetuses is emphasized. PMID- 6864149 TI - The acute effect of placentectomy and hysterectomy on peripheral plasma progesterone levels and ovarian progesterone secretion in the pregnant rat. AB - The role of placental luteotrophins in modulating plasma progesterone concentrations and ovarian progesterone secretion was examined in 16-day pregnant rats. In an initial experiment rats were placentectomized and their plasma progesterone concentrations monitored for 24 h; the rats were conscious within 30 min of placentectomy. Relative to control values, progesterone concentrations fell significantly within 0.5 h. A venous outflow technique was then used to monitor rates of progesterone secretion from ovaries of hysterectomized and control rats maintained under anaesthesia. Hysterectomy had no apparent effect on either progesterone secretion or plasma progesterone concentrations for at least 2 h. A final experiment was carried out to compare the effects of hysterectomy on plasma progesterone concentrations in conscious rats with those of placentectomized rats of the first experiment. Progesterone concentrations did not change significantly in hysterectomized rats for 4 h but fell to very low values by 24 h. These results suggest that placental luteotrophins do not have an acute, direct role in the control of plasma progesterone levels but are needed to maintain progesterone secretion in the longer term and possibly inhibit uterine luteolysin release. PMID- 6864150 TI - Oestrogen receptor activity and intranuclear translocation of oestradiol in rat and human mammary tumours. AB - Forty-eight rat mammary tumours and 25 human breast carcinomata were examined for (a) oestrogen receptor activity and (b) capacity for intranuclear translocation of oestrogen. Receptor activity was determined by saturation analysis using charcoal adsorption to separate free and bound hormone. The capacity for intranuclear translocation was determined by incubation of tumour slices in Krebs Ringer bicarbonate solution containing [3H]oestradiol-17 beta at a physiological concentration, in the presence and absence of a large excess of non-radioactive oestradiol, at 37 degrees C. Saturable nuclear uptake of [3H]oestradiol (= translocation) in boiled or receptor-negative tissues was minimal, i.e. less than 12 fmol/mg DNA per 2 h and in receptor-positive tissue was reduced by 85% when the temperature was lowered to 0 degree C. In 27 ovary-independent transplantable tumours and 21 dimethylbenz(a)anthracene-induced tumours (predominantly ovary dependent) saturable nuclear uptake was strongly correlated with level of oestrogen receptor activity (Spearman's rank correlation coefficient r = +0.73, P less than 0.001). Nineteen of these 48 tumours were examined further: 60-80% of the saturable uptake was precipitable with protamine sulphate and this fraction of the total saturable uptake was also highly correlated with receptor level (Spearman's r = +0.87, P less than 0.001). In the 25 human tumours studied, saturable nuclear uptake was again correlated with receptor level (Spearman's r = +0.75, P less than 0.001). These studies suggest that saturable transfer of oestradiol from the extracellular medium through the cytoplasm to the cell nucleus is mediated by the oestrogen receptor in the rat and human tumours examined. They provide no evidence for any defect of the receptor mechanism before nuclear binding in tumours which are receptor positive but hormone insensitive. PMID- 6864151 TI - Local contrast in multiple schedules: the effect of stimulus discriminability. AB - A three-ply multiple schedule assessed responding in a standard component as a function of the just-preceding schedule. The principal experimental condition was the difference among the wavelengths signaling the schedule components. Only the pigeons working in a narrow wavelength range showed persistent positive local contrast; that is, response rate during the standard component was higher when that component followed extinction than when it followed itself. Birds in both narrow- and medium-range groups showed persistent negative local contrast; that is, rate was lower following a relatively rich component. The dissipation of positive contrast appeared to be most clearly related to the establishment of differential responding. Negative contrast was inversely related to wavelength differences. Theories pertaining to contrast must account for the role of discrimination in both positive and negative types. PMID- 6864152 TI - Effects of criterion-level probing on demonstrating newly acquired discriminative behavior. AB - The purpose of the study was to determine whether probes of the final criterion level discrimination administered during and after training provided an accurate measure of acquisition. Training and probe stimuli were designed to make training and probe trials initially very discriminable and then progressively less discriminable as training progressed. Initially, the discrimination required on probe trials was more difficult than the discrimination required on training trials. However, this difference in difficulty was gradually eliminated as training stimuli were topographically altered and made identical to probe stimuli by the end of training. Results showed that while correct responding was maintained throughout training, error patterns occurred on all probe trials administered during training. Error patterns developed regardless of whether probe trials occurred only at the beginning of training sessions (temporally discriminable probes) or were randomly interspersed in the training sessions (temporally indiscriminable probes). Probe error patterns seemed to be controlled by the stimulus properties of training and probe trials. Thus, probes did not measure acquisition as it occurred during training. Probe error patterns were maintained when probes were administered after completion of training. This final measure of acquisition did not agree with the demonstration of acquisition provided by the final training trial. The results suggest that probe trials can measure a different stimulus-response relationship from that trained when training starts with an easier or known discrimination and probes involve a final or criterion test of a more difficult or unknown discrimination. Stimulus control of correct responses versus error patterns is discussed. PMID- 6864153 TI - Selective information use and perseveration in the search behavior of infants and young children. AB - Two experiments examined the early development of selective information use in search. The first experiment tested 9- and 16-month-olds on a modification of Piaget's Stage IV object permanence task. It examined infants' use of information from previous experiences with an object (prior information) and from the most recent hiding (current information) to locate a hidden object. In the second experiment, 2-, 2 1/2-, and 4-year-old children received these same sources of information along with new forms of prior and current information: information about the typical locations of objects (location specificity) and verbal information. No systematic perseveration was observed at 9 months, although previous findings related to perseveration were replicated. Perseveration was found at 16 months, but there was also evidence of selectivity at that age. When errors occurred, they tended to be to the prior location, but they were infrequent in comparison to correct searches at the current location. The preschoolers, while continuing to show perseveration, were more consistently selective than the infants. They also showed considerable generality in extending their selectivity to new sources of information. PMID- 6864154 TI - Behavioral thresholds for tones during infancy. AB - An adaptive up-down tracking procedure was used in combination with a visually reinforced head turn response to examine auditory sensitivity for 500, 2000, and 8000-Hz tone bursts in infants 6 to 18 months of age. Six- and 10-month-old infants were tested with headphone presentation of stimuli, while 10-, 14-, and 18-month-olds were tested in sound field. Infant threshold estimates for both headphone and sound field were within 15 dB of adult comparisons for all frequencies and age groups. Six-month-olds were significantly less sensitive to the 8000-Hz tone than to either of the lower frequency stimuli, but older infants demonstrated approximately equal sensitivity for all three frequencies tested. PMID- 6864155 TI - The scanning of compound figures by young infants. AB - We studied infants' scanning of two compound stimuli, in each case by presenting features inside a frame, the frame alone, and the features alone. One stimulus was composed of squares and was like that studied by P. Salapatek (in L. Cohen & P. Salapatek (Eds.), New York: Academic Press, 1975); the other was a schematic face. Newborns and 1-month-olds looked at the small square when it was presented alone, but rarely looked at it when it was framed by the larger square. In contrast, 2-month-olds looked at the small square for long periods whether or not it was framed. However, when newborns and 1-month-olds were shown a schematic face, they looked at its internal features at least half the time. Thus, young infants show no external bias when scanning a schematic face. PMID- 6864156 TI - Infant search strategies with containers that move but do not alter the location at which contents can be found. AB - A number of hypotheses about infants' delayed search accuracy have been based upon the notion that a location associated with repeated retrieval of the object attains privileged status. Infants may need strong cues to search at a new location. However, a test is reported in which performance of 12- and 15-month old infants was shown to be indifferent to the location. The results were reliable at an individual level. The data accord with previous research upon the canonicality effect in infant spatial search, an effect which is taken to index an experiential constraint on spatial discrimination. The experimental design thus serves as a discriminative test between three approaches: the original privileged location hypothesis, a newer spatial-contrast hypothesis, and a wider approach which focuses on experiential constraints on learning, including the canonicality effect. PMID- 6864157 TI - Hemispheric specialization in learning disabled readers' recall as a function of age and level of processing. AB - This study was designed to test the inadequacy of two theoretical accounts of learning disabled readers' memory deficiencies. Two age groups of learning disabled and nondisabled readers were compared on diotic and dichotic listening recall tasks for semantically organized, phonemically organized, and categorically unrelated word lists presented in either the left, right, or both ears. Dependent measures were free recall, serial recall, recall organization, and hierarchical organization. As expected, recall increases were a function of age, group, and level of word processing. However, the results clearly demonstrated that age and group recall differences were an interaction of both mode of presentation and level of processing. The recall differences between reading groups were attributed to word knowledge (superordinate categorization) rather than recall organization within cerebral hemispheres or differences in hemispheric capacity, per se. PMID- 6864158 TI - Contextual sensitivity in young children's drawings. AB - Previous research has examined the characteristic errors made by young children when drawing from a three-dimensional array. The aim of the present research was to investigate the influence of context in copying tasks. In a series of three experiments children between the ages of 4 and 7 years were presented with contrasting models to copy. These included cups and sugar bowls in various combinations and orientations. In each experiment the children's copies were scored for inclusion or omission of the occluded handle on the model. The results showed that nearly one third of the children did not respond consistently by either copying accurately or by always including the occluded handle. Instead the findings pointed to a large group of children whose responses were directed by the type of context present within the arrays. PMID- 6864159 TI - Factors affecting developmental changes in the speed of processing. AB - Although many studies have found developmental changes in the speed of various processes, they have potentially confounded the subject's age with his knowledge of the task domain and use of strategies. In this study, the strategies used by the subject and his domain knowledge were independently assessed by a number of tasks. Subsequently, processing rate measures were obtained for a task (the "same/different" judgment task of simultaneously presented stimuli) in which domain knowledge was manipulated independently of age while controlling for strategy usage. It was found that the usual adult superiority in speed of processing could be markedly reduced if children possessed equivalent amounts of domain knowledge and this effect was domain specific. Further, it was found that differences in knowledge affected processing rates in both knowledgeable adults and children and to about the same extent. It was concluded that some part of the typical adult superiority in processing rate was due to knowledge differences. PMID- 6864160 TI - Young children's understanding of displaced aggression. AB - According to previous research, young children do not understand displaced aggression. The present study examines the early phases of the understanding of the causes of moderately and extremely displaced aggression. Preschool and kindergarten children (3 to 5 years of age) viewed eight videotaped episodes of displaced aggression. Their comprehension of this aggression was assessed by means of open ended questions and forced choice picture selections. By age 5 most children had some understanding of displaced aggression, but this understanding was not complete. The early understanding revealed in the present study may be due to the use of short, simple, realistic videotaped episodes appropriate for the limited processing abilities of young children. Extreme displacement was not more difficult to understand than moderate displacement. PMID- 6864161 TI - Enhancing effect of H-2-linked NZW gene(s) on the autoimmune traits of (NZB X NZW)F1 mice. AB - To investigate the possible enhancing effect of the H-2z haplotype of the New Zealand White (NZW) strain on the production of autoantibodies and renal disease observed in B/W F1 mice, we developed the ZWD/8 strain, a NZW congenic line carrying the H-2d haplotype, produced (NZB X ZWD/8)F1 (B/WD8 F1) mice, and examined the difference in several immunological abnormalities between the B/W F1 (H-2d/H-2z) and the B/WD8 F1 (H-2d/H-2d) mice. In comparison with B/W F1 mice, the B/WD8 F1 mice showed markedly lower serum levels of the anti-DNA antibodies and the gp70 ICs, and a later onset and a lower incidence of proteinuria with a lower mortality. In contrast, there was no significant difference in the incidences and the amounts of both natural thymocytotoxic autoantibody and anti erythrocyte autoantibody between these two hybrid strains. Further, the serum levels of IgG and IgM in B/WD8 F1 mice were as high as those in B/W F1 mice. These findings indicate that the gene(s) that is within or closely linked to the H-2 complex of NZW strain specifically acts to intensify the levels of anti-DNA antibodies and gp70 ICs, and to promote the severity of renal disease in B/W F1 mice. This gene may play a role in the class conversion of anti-dsDNA antibodies from IgM to IgG. PMID- 6864162 TI - Lymphokine enhances oxygen-independent activity against intracellular pathogens. AB - To determine if mechanisms other than the generation of toxic oxygen intermediates are active against intracellular pathogens, oxidatively deficient mouse L cells and monocyte-derived macrophages from patients with chronic granulomatous disease were stimulated with soluble lymphocyte products. Despite no enhancement in oxidative activity, these cells displayed effective microbistatic activity against both T. gondii and C. psittaci. These results suggest a potential role for nonoxidative mechanisms in the mononuclear phagocyte's activity against intracellular pathogens, and indicate that lymphokines can regulate both oxygen-dependent and oxygen-independent antimicrobial responses. PMID- 6864163 TI - Complement receptor mediates enhanced flavivirus replication in macrophages. AB - Evidence is presented that M phi complement receptors (CR3) mediate IgM-dependent enhancement of flavivirus replication in the presence of complement. Enhancement is blocked by pretreatment of macrophages with monoclonal antibody Ml/70, which inhibits CR3 binding, but not by pretreatment with monoclonal antibody 2.4G2, which inhibits FcR binding. PMID- 6864165 TI - Treatment of urinary tract infection with cephalexin. PMID- 6864166 TI - Patient-satisfaction data and residents' physician-patient skills. PMID- 6864164 TI - Detection of cell surface and intracellular antigens by human monoclonal antibodies. Hybrid cell lines derived from lymphocytes of patients with malignant melanoma. AB - This study represents an initial attempt to analyze the humoral immune reactions of patients with malignant melanoma by hybridoma methodology. Using lymphocytes from regional lymph nodes, peripheral blood and tumor infiltrates, 158 fusions were performed with SKO-007 (human myeloma line), LICR-LON-HMy2 (LICR-2), GM 4672 (human lymphoblastoid lines), or NS-1 (mouse myeloma line). Fusion of lymph node lymphocytes with NS-1 resulted in a 3-4 times higher frequency of clones than fusion with LICR-2, and a 10 times higher frequency than fusion with SKO-007 or GM 4672. In the case of peripheral blood lymphocytes, fusion with NS-1 gave greater than 25 times higher frequency of clones than fusion with LICR-2 or SKO 007. Production of human mu, gamma, or alpha heavy chains was detected in 50-80% of wells containing growing clones, and the levels of immunoglobulin ranged from 0.3 micrograms to 40 micrograms/ml. NS-1-derived clones could be easily subcultured, while LICR-2 and SKO-007 clones grew more slowly on subculturing. In this study, Ig secretion appeared to be a more stable property of LICR-2-derived clones than NS-1-derived clones. A panel of 20 human cancer cell lines was used to screen 771 Ig-secreting cultures for antibody to cell surface or intracellular antigens. Reactivity with cell surface antigens was found infrequently (6 cultures), whereas reactivity with intracellular antigens was more common (27 cultures). A new cell surface antigen with properties of a glycolipid was defined with an IgM monoclonal antibody secreted by a tetraploid cell derived from a fusion of LICR-2 with lymphocytes from the axillary lymph node of a patient with melanoma. The hybrid cell line has been subcloned four times and secretes 5 micrograms IgM/ml. The antigen detected by this IgM antibody was found on 5 of 23 melanoma cell lines and 12 of 30 epithelial cancer cell lines. No reactions were found with 11 cultures derived from normal cells. Stable cell lines secreting human antibody that detected nuclei, nucleoli, cytoskeletal elements, Golgi complex, or other cytoplasmic components were also isolated in this study. One of these antibodies detected an intracellular antigen that is restricted to cells of neuroectodermal derivation, and a second antibody reacted primarily with cells of epithelial origin. Using these methods to isolate and analyze human monoclonal antibody, it should now be possible to define the repertoire of the humoral immune response to melanoma. PMID- 6864167 TI - Public policy changes and the economics of academic medicine. PMID- 6864168 TI - Rethinking prevention. PMID- 6864169 TI - Serum digoxin levels. PMID- 6864170 TI - Technique of vasectomy. PMID- 6864171 TI - Clues for suspecting giardiasis in a day-care center. PMID- 6864172 TI - The treatment of depression in elderly patients. AB - Primary care physicians provide a large proportion of psychiatric care today, especially for elderly persons with limited resources and concomitant medical diseases. To determine the frequency and type of psychiatric care provided by internists, the experience of a large academic group practice was studied. Depression was the most frequent psychiatric diagnosis among persons over 59 years of age and the fifth most common of all diagnoses made by physicians. Consultations with psychiatrists were infrequent and were used primarily for confirmation of the diagnosis. Physicians generally treated the depression with supportive counseling and often employed pharmacologic therapy with tricyclic antidepressants. Elderly patients were less likely than younger patients to receive tricyclic antidepressants, and they received lower doses. The observed response to antidepressant drugs was positive but required at least 50 mg to be taken daily. Side effects were frequent, especially at doses greater than 100 mg/d, but generally not severe. PMID- 6864173 TI - The Mini-Wright Peak Flow Meter for evaluating airway obstruction in a family practice. AB - This work reports an investigation of the usefulness of the Mini-Wright Peak Flow Meter in a family practice. The Mini-Wright Peak Flow Meter, an economical and simple tool for measuring peak expiratory flow rate, was developed in Great Britain but has found little clinical application in the United States. Its employment in quantifying airway obstruction and accurately reflecting changing patterns of obstruction over time is described. Recurrent patterns of airway obstruction in asthmatic patients are discussed. These patterns are used to individualize drug treatment regimens. The Mini-Wright Peak Flow Meter is portable and can easily be used in an office setting or lent to patients for home use. Some patients may benefit by purchasing the meter themselves and self adjusting the time and dose of their medication based on objective measurements of airway obstruction. PMID- 6864174 TI - Natural history and prognostic significance of purulent rhinitis. AB - Purulent rhinitis, or nasopharyngitis, is a common outpatient problem in children, although the recommended course of action varies and includes all modalities from observation to antibiotics. This study compared complications and duration of illness between children with clear rhinorrhea and those with purulent rhinorrhea. Nasopharyngeal and throat cultures were compared between these groups and well children. No significant difference was found between rhinorrhea groups with respect to complications or duration of illness. Children with purulent rhinorrhea did have a significant higher level of middle ear pathogens (P less than .01) isolated from nasopharyngeal cultures. Observation with throat culture is the desired method of treatment. PMID- 6864175 TI - Breast-feeding and sexual response. AB - Despite the recent trend toward more women breast-feeding their infants and extending breast-feeding for longer periods of time, there are few reports in the literature on the effects of lactation on female sexuality. A self-selected group of 121 presently or recently lactating women completed a detailed questionnaire on their breast-feeding experience and how it affected postpartum sexual response. It was found that the lactational amenorrheic period, which can last for a year or more, is a highly significant factor influencing sexual response. Compared with the prepregnancy period, 72 of the respondents (62.6 percent) reported experiencing less or no sexual desire while amenorrheic and nursing, 30 (26.1 percent) reported they had the same sexual desire, and only 13 (11.3 percent) said they experienced more sexual desire. These findings differ significantly from those of Masters and Johnson, who reported higher levels of sexual tension in all 24 of the lactating women they questioned. In addition, 39 women in this study (32.2 percent) volunteered the information in open-ended questions that they encountered a lack of vaginal lubrication and subsequent unpleasant coital experience when they were amenorrheic and lactating. PMID- 6864176 TI - Hospital privileges for family physicians: rights, rationale, and resources. AB - This review discusses the factors responsible for problems incurred by family physicians in the process of applying for hospital privileges. They include issues such as local unfamiliarity with family practice as a specialty, regional needs for primary care providers, reluctance to "make waves," and the breadth of privileges sought. Major areas of contention center on the utilization of obstetrical, surgical, and critical care facilities. If a request for privileges is denied, the applicant does, however, possess the right of due process. This right is substantiated in law and includes appeal procedures consisting of an enumeration of specific justifications for denial, adequate notice of a hearing, and the opportunity to be present, rebut the evidence, and present a defense. When dealing with such conflicts, the family physician will recognize the importance of training-content documentation, a willingness to demonstrate competence, and resources for professional assistance through both local and regional offices of the American Academy of Family Physicians. PMID- 6864177 TI - Clinical practice plans in family practice residency programs. AB - This paper examines clinical practice plans (CPPs), systems for remunerating physician faculty based on their clinical productivity, in family practice residency programs. A stratified random sample of residency directors responded to a CPP survey. CPPs were found significantly more frequently in residencies (usually operated by universities) either with CPPs in their parent institutions or with high patient volume. Residencies operated by community hospitals were more likely to distribute CPP benefits to faculty based on individual clinical activity, whereas residencies operated by universities were more likely to distribute equal benefits to all faculty or to include academic as well as clinical activities in the benefit determination. While most residency directors felt that CPPs brought financial benefits to a residency and to individual faculty, many directors who did not have CPPs feared that such a plan would create conflicts between patient care and teaching. A case report tracing the evolution of a CPP in one university-administered residency is presented. PMID- 6864178 TI - Teaching behavioral medicine by consultation in the family practice center. AB - The broad goal of the behavioral medicine rotation described here is to help residents become more effective in recognizing, evaluating, and dealing with psychological problems and issues. The preceptor, a clinical psychologist, works with one resident at a time, sees all or most of the resident's patients with the resident, and consults with him or her regarding patient care and related issues. The preceptor is guided by three considerations: (1) the rotation goals and objectives, (2) the resident's expressed learning goals, and (3) the patient's problems and needs. At the beginning of the rotation, the preceptor interviews the resident regarding background and interests in medicine, family practice, and behavioral medicine and then asks the resident to complete a self-evaluation form on interest and skills in behavioral medicine. At the end of the rotation the resident again completes the self-evaluation form. Changes in self-ratings during the rotation indicate that most residents report increased confidence and ability to deal with patients' psychological problems. PMID- 6864179 TI - Uncoordinated synthesis of histones and DNA by mouse eggs and preimplantation embryos. AB - The temporal coordination of histone and DNA synthesis in mouse eggs and preimplantation embryos were examined. In unfertilized mouse eggs arrested at metaphase II, histone synthesis was observed, but at lower rates than previously reported for fertilized zygotes. Cytosine arabinoside, an inhibitor of DNA synthesis, was used to study the relationship between DNA and histone synthesis during cleavage stages of mouse development. Cytosine arabinoside (50 microM) inhibited by 90% the incorporation of [3H]thymidine into DNA by two-cell embryos and blastocysts. At this concentration, cytosine arabinoside inhibited incorporation of [3H]lysine into blastocyst histones by only 30% and had no effect at the two-cell stage. These results are interpreted to show that DNA synthesis and histone synthesis are not coordinated temporally during early development of the mouse, but may become more so as development proceeds. PMID- 6864180 TI - Changes in subcellular elemental distributions accompanying the acrosome reaction in sea urchin sperm. AB - Energy-dispersive x-ray microanalysis was used to analyze changes in the subcellular distributions of Na, Mg, P, S, Cl, K, and Ca associated with the acrosome reaction of sea urchin sperm. Within 5 sec after induction of the acrosome reaction, nuclear Na and mitochondrial Ca increased and nuclear and mitochondrial K decreased. Uptake of mitochondrial P was detected after several minutes, and increases in nuclear Mg were detected only after 5-10 min of incubation following induction of the reaction. The results suggest that sudden permeability changes in the sperm plasma membrane are associated with the acrosome reaction, but that complete breakdown of membrane and cell function does not occur for several minutes. PMID- 6864181 TI - Parthenogenetic activation of mouse oocytes in vitro with ethanol and benzyl alcohol. PMID- 6864183 TI - Sodium ion concentrations in uterine flushings from "implanting" and "delayed implanting" mice. AB - The uteri of mice were flushed with isotonic mannitol (1) on the day of implantation during normal pregnancy or (2) during delay of implantation. The Na+ concentration in flushings was reduced during diapause but had increased by 65% 24 h after progesterone-treated ovariectomized mice received estrogen injections. The results suggest that the apparent metabolic quiescence of diapausing blastocysts may, in part, be a consequence of lower (Na+) in the uterus during delay of implantation. PMID- 6864182 TI - Functional capacity of sex-reversed (XX, Sxr/+) mouse germ cells as shown by progeny derived from XX, Sxr/+ oocytes of a female chimera. AB - Mice of the genotype X/X, Sxr/+ (Sex-reversed) are sterile phenotypic males. Testis size is reduced and there is a failure of spermatogenesis during meiosis I. A female chimeric mouse has been produced whose germ line is entirely composed of X/X, Sxr/+ germ cells. The progeny of this chimera included several XX, Sxr/+ males. The finding that X/X, Sxr/+ germ cells can produce fully functional oocytes has implications for the function of the Sex-reversed gene, the control of germ cell differentiation, and the role of germ cells in primary sex determination. PMID- 6864184 TI - Cardiac neoplasms and unexpected death. PMID- 6864186 TI - Individual characteristics of chemically modified human hairs revealed by scanning electron microscopy. PMID- 6864185 TI - Detection of accelerants on a burn victim. PMID- 6864187 TI - Sudden Infant Death Syndrome: a biochemical profile of postmortem vitreous humor. AB - Postmortem chemical analysis of vitreous humor from Sudden Infant Death Syndrome (SIDS) infants was done. The results were compared to a pediatric control group. The concentrations of potassium, calcium, phosphorus, glutamic oxaloacetic transaminase, glutamic pyruvate transaminase, creatinine phosphokinase, and lactate dehydrogenase were all significantly different from the pediatric control group. Thus it appears that SIDS infants are a different population from the pediatric control group. PMID- 6864188 TI - Accidental digoxin overdose in an infant: postmortem tissue concentrations. PMID- 6864189 TI - Laceration of the stomach by blunt trauma in a child: a case of child abuse. AB - A case of perforation of the stomach following blunt abdominal trauma is described in a two-year-old boy. The abdominal trauma was the result of a blow to the abdomen by the stepfather. The child had ingested a large meal in the hour preceding the injury. The child died from peritonitis and shock 12 h following the injury. The literature on gastric perforation by blunt trauma is reviewed. Injuries to the stomach from nonpenetrating trauma are quite rare and are most often related to vehicular accidents. Gastric injury in a child presenting with a history of a minor home or play injury should arouse suspicion of more significant and perhaps intentional trauma. PMID- 6864190 TI - Paraquat myocarditis and adrenal cortical necrosis. PMID- 6864191 TI - A paraquat fatality--the dilemma of multiple analyses. PMID- 6864193 TI - Localized adaptation within the rhabdomeral lobe of Limulus ventral photoreceptors. PMID- 6864192 TI - Transmembrane chloride flux in tissue-cultured chick heart cells. AB - To evaluate the transmembrane movement of chloride in a preparation of cardiac muscle lacking the extracellular diffusion limitations of natural specimens, intracellular chloride concentration ( [Cl] i) and transmembrane 36Cl efflux have been determined in growth-oriented embryonic chick heart cells in tissue culture. Using the method of isotopic equilibrium, [Cl]i was 25.1 +/- 7.3 mmol x (liter cell water)-1, comparable to the value of 24.9 +/- 5.4 mmol x (liter cell water) 1 determined by coulometric titration. Two cellular 36Cl compartments were found; one exchanged with a rate constant of 0.67 +/- 0.12 min-1 and was associated with the cardiac muscle cells; the other, attributed to the fibroblasts, exchanged with a rate constant of 0.18 +/- 0.05 min-1. At 37 degrees C, transmembrane Cl flux of cardiac muscle under steady-state conditions was 30 pmol x cm-2 x s-1. In K-free, normal, or high-Ko solutions, the responses of the membrane potential to changes in external Cl concentration suggested that chloride conductance was low. These results indicate that Cl transport across the myocardial cell membrane is more rapid than K transport and is largely electrically silent. PMID- 6864195 TI - Effect of cadmium on the infection of Lactobacillus lactis by bacteriophage LL-H. AB - The infectivity of Lactobacillus lactis bacteriophage LL-H was shown to be calcium-dependent. Of 10 different divalent cations screened, cadmium specifically decreased the infectivity of LL-H in the presence of calcium. At 1 to 2 mM, CdCl2 resulted in a decrease of the burst size of about 2.5- to 4-fold. Cd2+ was shown to reduce specifically the level of total phage DNA synthesis, resulting in a reduced progeny phage yield. Moreover, Cd2+ had the most profound irreversible effect on progeny phage production between 20 and 60 min after LL-H infection. This paralleled the beginning of phage DNA synthesis. Possible modes of action of Cd2+ on phage DNA replication are discussed. PMID- 6864194 TI - Mutants of sindbis virus. IV. Heterotypic complementation and phenotypic mixing between temperature-sensitive mutants and wild-type Sindbis and Western equine encephalitis viruses. AB - Heterotypic complementation between temperature-sensitive (ts) mutants of Sindbis (SIN) and Western equine encephalitis (WEE) viruses occurs under appropriate conditions. One heterotypic pair, SIN ts153 X WEE ts39 showed efficient complementation, and four other combinations gave detectable complementation, indicating that these two viruses, which are closely related serologically and biochemically, are sufficiently closely related to complement each other functionally. Cells mixedly infected with ts mutants or wild-type strains of both SIN and WEE viruses produced phenotypically mixed virions, in addition to both parental viruses. Various types of phenotypically mixed virions have been identified by neutralization with corresponding antisera, by thermal inactivation and by temperature sensitivity of replication. Some virions contained WEE genomes and envelopes containing primarily SIN proteins. Other phenotypically mixed virus yields contained primarily doubly neutralizable viruses which are presumed to have a mosaic of envelope proteins. Phenotypically mixed virions were morphologically indistinguishable from the parental types. PMID- 6864196 TI - Therapists' actions that influence their perceptions of "good" psychotherapy sessions. AB - Psychotherapists' and an independent observer's ratings of the "good" to "poor" quality of therapy sessions were correlated with their ratings of various therapist actions. As predicted, significant positive correlations were obtained between the goodness ratings and the emphasis given by therapists to actions encouraging patients' expression of thoughts and feelings and the exploration of their reactions. For a number of other actions, however, therapists and the independent observer disagreed about whether emphasis of the actions correlated with "good" or "poor" sessions. Some possible causes and implications of these differences are discussed. PMID- 6864197 TI - Is there a characteristic pattern to the treatment history of clinic outpatients with borderline personality? AB - The prior psychiatric histories, dispositions, and treatment plans for a group of patients with borderline personality, evaluated in an outpatient clinic, were compared to those of evaluated patients diagnosed as having neurotic and/or other personality disorders or schizophrenia. Variables that were found to discriminate patients diagnosed as borderline from the other two groups included a history of past hospitalizations and their duration, frequency of prior outpatient treatment, previous use of psychotropic medications, rates of dropout and referral-out of the clinic, and number of treatment sessions received during a 2 year follow-up period. Patients with borderline personality who had the most previous treatment and the most severe symptoms received the least treatment. The histories of extensive previous treatment are consistent with the frequently brief and unsatisfactory nature of the index clinic contacts. PMID- 6864198 TI - Depression in childhood and adolescence. A prospective study of six cases. AB - Two cases of recurrent major depression, three cases of dysthymic disorder (depressive neurosis), and one of adjustment disorder with depressed mood beginning in childhood or adolescence have been identified in the 133 subjects of the New York Longitudinal Study. The prospective behavioral data from early infancy to early adult life in each of the six cases are summarized. Differences in etiology are emphasized and the implications for treatment indicated. There was no evidence for a separate clinical entity of depression for the childhood period. Review of the longitudinal data did not show a significant earlier life tendency to negative mood temperamentally. The dysthymic and adjustment disorder cases also did not show significant differences in environmental stresses or parental functioning from other clinical cases in the longitudinal study without depressive symptoms. PMID- 6864199 TI - Possible defects of interhemispheric integration in children of schizophrenics. AB - The discovery of abnormalities of hemisphere function in schizophrenic patients directs attention toward possible developmental precursors in children at high risk for schizophrenia. In this preliminary investigation, monaural and binaural speech comprehension were studied in 13 children of schizophrenic parents and 13 normal schoolchildren matched for age, sex, and verbal intelligence. Like the adult schizophrenics tested previously, the high risk children showed deficits in binaural relative to monaural comprehension, impaired overall speech comprehension, and deficient speech sounds perception compared with the controls. The results may reflect abnormal interhemispheric integration in the high risk children, in whom the development of hemispheric specialization for language may also be affected. PMID- 6864200 TI - Effects of cueing on immediate and recent memory in schizophrenics. AB - Most recent studies of recall deficit in schizophrenia have varied the encoding context while the retrieval context has not been varied. Recall of an event, however, is the product of the memory trace and a retrieval cue. In the present study, nonparanoid schizophrenics, paranoid schizophrenics, depressives, and normal controls were presented categorized word lists, matched for difficulty, that were either cued or not cued at recall. Furthermore, recall was examined on a first, immediate trial and on a second, delayed trial after an intervening task. The results indicated that the interval between recall trials produced a differential deficit for both schizophrenic groups relative to depressives and normals. Two possible explanations for this deficit are deficient encoding processes or retroactive interference. The findings indicate that varying the retrieval environment can enhance the recall of schizophrenics and that future studies should manipulate both the encoding context and the retrieval context to determine whether the schizophrenic recall deficit is due primarily to encoding or retrieval dysfunction, or both. PMID- 6864202 TI - Performance of schizophrenic patients on tests sensitive to left or right frontal, temporal, or parietal function in neurological patients. AB - The performances of schizophrenic patients and normal control subjects were compared on an extensive battery of psychological tests that have been found at the Montreal Neurological Hospital to be differentially sensitive to atrophic lesions of the left or right frontal, temporal, or parietal cortex. Schizophrenic patients were significantly impaired at all tests that are disrupted by left or right frontal or temporal lobe lesions but performed within normal limits on all tests that are sensitive to parietal lobe damage. These results imply that schizophrenia results, at least in part, from a bilateral dysfunction of the frontal and temporal lobes. PMID- 6864203 TI - Intellectual performance in children of alcoholics. AB - Alcoholics tend to show some cognitive deficits relative to nonalcoholics. The present study of a sample from a Danish birth cohort examined whether these deficits might be present in children at high risk for later alcoholism. The subjects were tested at age 12 with a Danish translation of the Weschler Intelligence Scale for Children. Risk status for later alcoholism was defined by parental alcoholism as determined by interview and medical records. Results suggest that Performance IQ deficits may be consequential to alcoholism whereas Verbal deficits (characteristic of the high risk children) may be antecedent to alcoholism. PMID- 6864201 TI - Age, sex, and aphasia type. Evidence for a regional cerebral growth process underlying lateralization. AB - The incidence of motor and sensory, (nonfluent and fluent) aphasia was studied in 389 patients with a left-sided vascular lesion. The mean age of patients with motor aphasia was 45.3 years, and the mean age of patients with sensory aphasia was 56.5 years. The age difference was also found in a separate analysis of 50 cases of traumatic aphasia. Nonfluent aphasias predominate in early life in both males and females, but are more common in females in the third decade. The relationship between aphasia type and age, and sex, is explained by a process of regional specification of the left language areas that proceeds more slowly in females than males. It is hypothesized that this process reflects the effects of the sex hormones on protein synthesis and brain growth. PMID- 6864204 TI - Behavioral treatment of psychogenic vomiting in the context of social phobia. AB - A case of psychogenic vomiting in the context of social phobia was treated by a combination of exposure in vivo, social skills training, and cognitive modification. The intervention was not directly aimed at the vomiting, but at aspects of the patient's behavior hypothesized to be instrumental in maintaining it; deficits in prosocial behaviors and associated anxiety. Change was assessed on the basis of patient's records of daily frequency of: vomiting; performance of treated behaviors; and associated anxiety within a single-case multiple baseline design. Change occurred only with the introduction of treatment and not before it, ruling out effects of time or mere contact. Clinically, the vomiting was virtually eliminated after 7 weeks, and the anxiety was substantially reduced in most previously feared (and avoided) social situations; except for a 2-week depressive spell, this outcome has been maintained for an available 2-year follow up. A general improvement in the patient's personal, social, and vocational life has also occurred. PMID- 6864208 TI - Antagonism of kynurenine-induced seizures by picolinic, kynurenic and xanthurenic acids. AB - Picolinic, kynurenic, xanthurenic and anthranilic acids are metabolites of L kynurenine which, when administered intraperitoneally (i.p.) antagonized (in descending order of potency) the seizures induced by intracerebroventricular (i.c.v.) injections of l-kynurenine sulfate in SHR and C57BL/6 mice. Picolinic and anthranilic acids were also effective after oral administration. Picolinic acid completely prevented seizures. Kynurenic acid, when injected i.c.v. prior to l-kynurenine sulfate, appeared to be more effective than after i.p. administration while picolinic and anthranilic acids were less effective. This suggest that the antikynurenine effect of metabolites of kynurenine (kynurenines) is related to different brain structures, i.e. kynurenic acid predominantly affects structures adjacent to ventricles (e.g. hippocampus, caudate nucleus) while picolinic and anthranilic acids act on other brain structures or the periphery. Xanthurenic, kynurenic and picolinic acids merely prolonged the latency of seizures induced by i.c.v. quinolinic acid (another metabolite of kynurenine) or by subcutaneous strychnine sulfate and i.p. pentylenetetrazole, and did not modify seizures induced by i.p. caffeine and thiosemicarbazide. This selective antagonism of the tested kynurenines against kynurenine might be an important anticonvulsant factor in kynurenine-dependent seizures. It is suggested that increased excretion of xanthurenic, kynurenic and picolinic acids in patients with convulsive states may be manifestations of compensatory processes. PMID- 6864205 TI - Minor aesthetic blemishes: the patient's unasked request. AB - This paper describes a case representative of a group of people who are troubled by cosmetic blemishes but are unable to verbalize their feelings. After appropriate treatment, they are able to verbalize their feelings and they feel great relief. PMID- 6864207 TI - Various mental behavioral disorders in Parkinson's disease, primary degenerative senile dementia, and multiple infarction dementia. AB - Following 2-4 years of hospitalization, the mental and physical ability of 21 patients with typical idiopathic PD, 10 patients with atypical Parkinson's syndrome and signs of cerebral arteriosclerosis, 29 patients with MID. and 14 patients with senile dementia of the Alzheimer type were evaluated according to various rating scales. All idiopathic parkinsonian patients had suffered from the disease for over 8 years. All patients were over 70 years of age and continuously subjected to the same environment. EEG and CT was performed. A rating scale consisting of 18 items for evaluation of the mental and physical capacity and ability to cope with daily psychosocial demands was used for each patient. Statistically highly significant differences resulted between the relative good mental ability of patients with idiopathic Parkinson's syndrome, with the exception of some brief pharmacotoxic psychoses, and the lower rating scores of patients with senile dementia of Alzheimer type and multiple infarction dementia. A smaller subgroup of patients with Parkinson's syndrome and additional focal signs in the neurological status and EEG showed moderate mental functional loss and a more frequent incidence of pharmacotoxic psychoses than the patients with idiopathic PD. Just as few congruencies of mental ability were found between patients with idiopathic, typical PD and patients with senile dementia of the Alzheimer type as between idiopathic PD and MID. Permanent dementia is not characteristic of patients with typical idiopathic PD even in advanced age. It is, however, for patients with MID and SDAT. PMID- 6864206 TI - Relationships between brain concentrations of desipramine and paradoxical sleep inhibition in the rat. AB - Desipramine (DMI), like many antidepressant drugs, inhibit the production of paradoxical sleep (PS). In the present experiment, we have investigated the relationships between brain level of DMI and PS inhibition. Groups of rats had their sleep monitored after 1, 2 or 4 mg/kg of DMI. In other animals, the brain concentration of DMI was assayed at various times after the same treatments. The results indicate that a critical threshold concentration of 300 ng/g DMI in the brain is necessary for complete PS inhibition. This stage reappears only when the DMI level falls below this value, and its production resumes at a normal rate, provided the DMI level reached initially was not largely in excess of the threshold concentration. The results are discussed with regard to the present knowledge of specific binding of tricyclics in brain and their "ex vivo" action on norepinephrine uptake resulting in enhancement of collateral inhibiton of noradrenergic cells. PMID- 6864211 TI - Evidence for bilateral vagal innervation of postganglionic parasympathetic neurons in chicken heart. AB - Stimulation of the cervical vagus nerves caused an output of acetylcholine (ACh) from the isolated chicken heart, which almost exclusively was released from the postganglionic neurons: (+)-tubocurarine (3 X 10(-14) M) reduced the output to 12 +/- 6% (n = 7) of the control. Stimulation of the two nerve trunks ws equally effective in releasing ACh.--Evidence that a large number of postganglionic neurons receives bilateral innervation was based on two experimental series. (1). The sum of the ACh outputs evoked by unilateral (separate) nerve stimulation of the right and the left vagus was higher than the bilaterally evoked output (100%) and increased with increasing frequencies (10, 20 and 40 Hz) from 115 +/- 13% to 131 +/- 9% (n = 13). In the presence of 10(-4) M 4-aminopyridine, unilaterally evoked output (40 Hz) was further increased from 131 to 176 +/- 5% (n = 21).- (2.) In the presence of 4-aminopyridine plus hemicholinium-3 (2 X 10(-5) M), unilateral nerve stimulation at 40 Hz evoked an output of ACh that decreased from 477 to 79 pmol g-1 min-1 during a 20 min-period of stimulation due to transmitter depletion. Thereafter output of ACh evoked by stimulation of the contralateral nerve was reduced by 73% as compared to the control value (475 pmol g-1 min-1; output without the preceding 20 min-stimulation).--It is concluded that a large number of parasympathetic postganglionic neurons of the chicken heart receives a dual excitatory input from both right and left vagus nerve. PMID- 6864212 TI - Postmortem changes in binding to the muscarinic receptor from human cerebral cortex. AB - The effects of storage at 4 degrees C on the antagonist and agonist binding properties of the muscarinic acetylcholine receptor from fresh surgical and frozen autopsy samples from human cerebral cortex were studied. The number of L [3H]3-quinuclidinyl benzilate binding sites and their affinities were stable up to 51 h, both when stored as pieces of intact nonfrozen tissue and as a homogenate. The agonist binding properties as measured by the ability of the muscarinic agonist carbachol to compete with L-[3H]3-quinuclidinyl benzilate were also stable up to 51 h when the tissue was stored in the form of pieces. The affinity for carbachol decreased when the tissue was stored as a homogenate. The frozen autopsy samples showed no significant differences in binding properties in comparison with fresh neurosurgical tissue. PMID- 6864210 TI - 24-hour-variation of pineal gland volume, pinealocyte nuclear volume and mitotic activity in male Sprague-Dawley rats. AB - In two experiments carried out on two alternate days, the 24-h-rhythmicity of pineal gland volume, pinealocyte nuclear size in cortex and medulla and mitotic activity were studied in male Sprague-Dawley rats, to assess to what extent morphological parameters reflect the pronounced day/night differences in pineal melatonin formation. Pineal volume exhibited statistically significant changes in the second experiment only, with a distinct trough at 6 p.m. Karyometry revealed highly variable patterns. In the first experiment, pinealocyte nuclear changes lacked parallelism in cortex and medulla. The cortex exhibited a bimodal curve with peaks at noon of the first day and at 6 a.m. of the second day, and two troughs at 6 a.m. and midnight respectively of the first day. The medulla showed no clear-cut rhythmicity. In the second experiment, cortex and medulla reacted similarly, nuclear size decreasing from 6 a.m. to 6 p.m., remaining low thereafter. Mitotic activity of pinealocytes is low (on average 23 mitotic figures/gland). In both experiments statistically significant differences existed between certain times, pointing in the direction of 24-h-rhythmicity, but whereas the curve exhibited a peak at midnight in the first experiment, mitotic activity in the second experiment showed a trough at midnight. It is concluded that for as yet unexplained reasons morphological parameters do not appear to accurately reflect circadian rhythmicity of pineal melatonin formation. PMID- 6864209 TI - Natural and synthetic analogues of melatonin and related compounds. I. Effects on the reproductive system of the male Syrian hamster. AB - The potential antigonadotrophic properties of a number of synthetic and natural melatonin analogues were examined. Adult male hamsters received daily subcutaneous injections (25 micrograms/animal/day) each afternoon for 7 or 10 weeks. The only analogue to possess antigonadotrophic activity similar to melatonin wa 6-chloromelatonin; melatonin and 6-chloromelatonin produced a significant reduction in both testicular and accessory sex organ weights, plasma LH and pituitary prolactin. These results suggest that, in the Syrian hamster, 6 chloromelatonin acts as a melatonin agonist and may be of use to elucidate further the physiological role of melatonin. PMID- 6864213 TI - Guinea pig brain histamine N-methyltransferase: purification and partial characterization. AB - Histamine N-methyltransferase (EC 2.1.1.8) was purified 4400-fold in 12% yield from guinea pig brain. The basic steps in the purification included differential centrifugation, calcium phosphate adsorption, DEAE-cellulose chromatography, and affinity chromatography on an S-adenosylhomocysteine-agarose matrix. The resulting protein was homogeneous by gel electrophoresis and was stable for at least 3 months at -80 degrees C. It had an apparent molecular weight of 29,000 +/ 1000 as determined by both gel filtration through Sephadex G-100 and by electrophoresis in sodium dodecyl sulfate-polyacrylamide gels. The isoelectric point of the protein was found to be 5.3. The pH optima for methylation of histamine were determined to be 7.5 and 9.0; the KmS for histamine and S-adenosyl L-methionine were 13.57 +/- 0.74 microM and 6.1 +/- 0.12 microM, respectively; the Ki for S-adenosyl-L-homocysteine was 24.5 +/- 1.45 microM. PMID- 6864215 TI - Effect of alpha-fluoromethylhistidine on the histamine content of the brain of W/Wv mice devoid of mast cells: turnover of brain histamine. AB - In the brains of W/Wv mutant mice that have no mast cells, the histidine decarboxylase (HDC) level is as high as in the brain of congenic normal mice (+/+), but the histamine content is 53% of that of +/+ mice. The effects of alpha fluoromethylhistidine (alpha-FMH) on the HDC activity and histamine content of the brain of W/Wv and +/+ mice were examined. In both strains, 30 min after i.p. injection of alpha-FMH the HDC activity of the brain had decreased to 10% of that in untreated mice. The histamine content decreased more gradually, and after 6 h about half of the control level remained in +/+ mice, whereas histamine had disappeared almost completely in W/Wv mice. It is concluded that the portion of the histamine content that was depleted by HDC inhibitor in a short time is derived from non-mast cells, probably neural cells. The half-life of histamine in the brain of W/Wv mice was estimated from the time-dependent decrease in the histamine content of the brain after administration of alpha-FMH: 48 min in the forebrain, 103 min in the midbrain, and 66 min in the hindbrain. PMID- 6864214 TI - [3H]dopamine depletion from osmotically defined storage sites: effects of reserpine, 53 mM KCl, and d-amphetamine. AB - A crude synaptosome-containing fraction (P2') prepared from rat striatal slices incubated with [3H]dopamine was exposed to hypoosmotic conditions and rapidly subjected to Millipore filtration. P2'-associated [3H]dopamine trapped on the filters was defined as hypoosmotic resistant, whereas P2'-associated [3H]dopamine that washed through the filters was defined as hypoosmotic sensitive. Electron microscopic examination of sections prepared from a P2' pellet that had been exposed to hypoosmotic conditions revealed extensive synaptosomal lysis. [3H]Dopamine accumulation and retention by the hypoosmotic-resistant fraction were reduced by reserpine. The proportional distribution of [3H]dopamine between hypoosmotic-resistant and -sensitive fractions was measured following in vitro exposure of the preloaded P2' fraction to reserpine, 53 mM KCl, and d amphetamine. Each of these treatments resulted in a time-dependent loss of [3H]dopamine from the loaded P2' fraction without eliciting an alteration in the proportional distribution of [3H]dopamine between hypoosmotic-resistant and sensitive fractions. Release induced by reserpine and d-amphetamine was independent of extrasynaptosomal Ca2+, whereas 53 mM KCl-induced release was dependent on extrasynaptosomal Ca2+. These results suggest that dopamine may be rapidly equilibrated between osmotically defined storage compartments, and thus specific compartmental depletion of loaded [3H]dopamine cannot be identified on the basis of osmotic lability. PMID- 6864216 TI - Vasoactive intestinal peptide stimulation of pineal serotonin-N-acetyltransferase activity: general characteristics. AB - Vasoactive intestinal polypeptide (VIP) stimulates basal serotonin-N acetyltransferase (NAT) activity in pineals in organ culture and enhances the effects of catecholamines in inducing the enzyme. VIP appears to act postsynaptically; its action is independent of the beta receptor and is dependent upon protein synthesis. Its effects may be mediated by a receptor. The magnitude of the pineal response to VIP varies with age, is greater in pineals maintained in 48-h organ culture than in those in acute culture, and can be detected in pineals from newborns after 48-h organ culture. Intravenous administration of VIP can increase pineal NAT activity in vivo. PMID- 6864217 TI - Sodium-sensitive cocaine binding to rat striatal membrane: possible relationship to dopamine uptake sites. AB - In rat striatal membranes, NaCl induced a twofold increase in the maximal number of cocaine binding sites but did not alter the affinity of these sites for cocaine. This effect was concentration-dependent, specific to sodium ions, and occurred in membranes prepared from corpus striatum but not from other brain regions. Lesions with 6-hydroxydopamine but not with kainic acid eliminated the sodium-induced increase in binding and produced a decrease in the Bmax of binding measured in the presence of NaCl. The capacity of a series of drugs to interfere with Na+-dependent cocaine binding correlated well with their capacity to inhibit [3H]dopamine uptake into rat striatal synaptosomes. The present results suggest that Na+-dependent cocaine binding sites are localized presynaptically on dopaminergic nerve terminals in corpus striatum, and may be related to dopamine uptake sites. PMID- 6864218 TI - Acetylcholine and choline in neuronal tissue measured by HPLC with electrochemical detection. AB - A simple, rapid method is presented for the determination of acetylcholine (ACh) and choline (Ch) in neuronal tissue using HPLC with electrochemical detection. The method is based on the separation of ACh and Ch by reverse-phase HPLC and mixing the effluent as it emerges from the column with acetylcholinesterase and Ch oxidase, which converts endogenous Ch and Ch produced by the hydrolysis of ACh to betaine and hydrogen peroxide. Production of hydrogen peroxide is continuously monitored electrochemically. The sensitivity of the procedure is 1 pmol for Ch and 2 pmol for ACh. Specificity of the method is based on HPLC, two specific enzymatic reactions, and the detection of hydrogen peroxide. PMID- 6864219 TI - High-protein carboxymethylase activity and low endogenous methyl acceptor proteins in posterior pituitary lobe of rats lacking neurophysin-vasopressin (Brattleboro rats). AB - The activity of protein carboxymethylase and the endogenous protein methyl acceptor capacity were examined in the posterior, intermediate, and anterior lobes of the pituitaries of homozygous Brattleboro rats with diabetes insipidus and in heterozygous Brattleboro and Long-Evans control rats. Protein carboxyl methylation is selectively altered in the posterior pituitary lobes of homozygous Brattleboro rats. Protein carboxymethylase activity is higher (+40%) and endogenous methyl acceptor protein capacity is lower (-80%) with respect to heterozygous Brattleboro and Long-Evans control rats. This latter change is correlated with decreased methylation of proteins of a molecular weight of approximately 11K daltons, is selective for the posterior pituitary lobe, since it does not occur in the intermediate and anterior lobes, and probably reflects the absence of vasopressin-associated neurophysin in homozygous Brattleboro rats. Our results support a physiological role of protein carboxyl methylation in the neurosecretory process in the posterior pituitary gland. PMID- 6864220 TI - Observations on N alpha-deacetylation of model amino acids and peptides: distribution and purification of a specific N-acyl amino acid releasing enzyme in rat brain. AB - N alpha-Acyl amino acid releasing enzyme (NAARE), an enzyme cleaving acetylMet Ala at the Met-Ala bond was purified from rat brain cytosol to apparent homogeneity by salt precipitation, gel filtration, and several steps of ion exchange. Levels of NAARE exceeded acylase measured with acetylmethionine in all brain regions and subcellular fractions examined: 60% was associated with cytosol and the remainder with debris or the crude nuclear and mitochondrial-synaptosomal subfractions. Activity was highest in pituitary and was approximately 0.5-0.6 that of liver or kidney. The purified enzyme preferentially hydrolyzed acetylmethionyl peptides: Km for acetylMet-Ala was 0.93; Vmax, 3.5 nmol-1 (kcat, 1185) with pH optimum of 8.9 as compared with 8.2 for acylases measured in cytosol. The purified enzyme was devoid of acylase and common exo- and endopeptidase contamination. Structure-activity relationships examined with synthetic formylated or acetylated peptides indicated no significant effects for di- or tripeptides if the second substituent was Ala, Ser, Asn, or Thr, but the activity was reduced 0.5-fold for Leu, a branched-chain amino acid. No hydrolysis was observed for polypeptides with five or more residues having N-terminal acetylated Tyr (enkephalin) or Ser (alpha-melanocyte-stimulating hormone, thymosin alpha 1), supporting the notion that the enzyme plays a role only in turnover of smaller peptides formed perhaps as a result of endopeptidase cleavage of proteins or polypeptides containing acetylated Met at the N terminus. PMID- 6864221 TI - 125I-antibody autoradiography and peptide fragments of albumin in cerebral edema. AB - The regional distribution of albumin in serum extravasations of cerebral edema was visualized on intact brain slices by autoradiography of 125I-labeled antibodies directed against albumin. Following autoradiographic imaging of edema protein spread, concentrations of total serum proteins were determined by radioimmunoassay in tissue micro samples taken from various regions of the brain. Peptide fragments of albumin--produced upon proteolytic breakdown of the native protein in vivo--were separated by affinity chromatography and HPLC. The combination of techniques for imaging, direct quantification, and analysis of molecular structure of serum proteins was provided to be valid in three different types of experimental cerebral edema in the rat: cortical cryogenic lesion, brain tumors, and stroke-prone spontaneous hypertension. The results indicate differences in the reactivity of edematous tissue with respect to proteolytic activity, depending on the susceptibility of serum proteins to in vivo fragmentation. PMID- 6864222 TI - beta-N-gamma-glutamyl diaminopropionic acid, a convulsant and an inhibitor of brain glutamate decarboxylase. AB - The different isomers of the dipeptide beta-N-gamma-glutamyl diaminopropionate inhibit L-glutamate-1-carboxylyase (GAD, EC-4.1.1.15) activity in mouse brain homogenates. The L-D isomer is the most effective as an inhibitor, while the D-D isomer is least inhibitory. The different isomers are neurotoxic to mice and the chick, the L-D isomer being the most toxic. The neurotoxicity of the isomers in mice was also associated with a significant lowering in GAD activity in the brains of convulsing mice. PMID- 6864223 TI - Norepinephrine metabolism in humans studied by deuterium labelling: turnover of 4 hydroxy-3-methoxyphenylglycol. AB - D,L(+/-)-4-Hydroxy-3-methoxyphenylglycol (HMPG) labelled with three deuterium atoms was used to study turnover of plasma free HMPG following an intravenous injection. Ten healthy men were given a pulse dose of either 4.3 mumol or 2.2 mumol of labelled HMPG ([2H3]HMPG piperazine salt). Plasma and urine levels of both endogenous and labelled HMPG were subsequently followed by gas chromatography-mass spectrometry with selected ion detection. Kinetic calculations based upon a single-compartment model were consistent with a monoexponential elimination of plasma free HMPG. The half-life of HMPG was 0.46 and 0.78 h (mean values in the two dose groups). The HMPG production rate was 2.01 and 2.35 mumol/hour, and the urinary excretion rate of HMPG (free and conjugated) was 0.48 and 0.47 mumol/h. The endogenous plasma level of free HMPG was 25 and 33 nmol/L. The results show that HMPG turns over rapidly and that HMPG is further metabolized extensively. About one-fourth of the HMPG produced is excreted in urine as free and conjugated HMPG. PMID- 6864224 TI - Circadian rhythm in pineal N-acetyltransferase activity: phase shifting by light pulses (II). AB - N-Acetyltransferase (NAT) is an enzyme whose rhythmic activity in the pineal gland and retina is thought responsible for melatonin circadian rhythms. The enzyme has properties of a circadian biological clock--its rhythm persists in constant conditions and it is precisely controlled by light and dark. Experiments are reported in which light pulses of 1 to 10 h duration were imposed on chicks during their dark-time. The effect of these pulses upon the NAT was measured and the effect of the pulses on subsequent NAT was also determined. The experiments support the conclusion that the amount and/or duration of dark-time NAT is limited. This finding is interpreted as supporting the idea that a fixed amount of some substance, an initiator, is synthesized during the subjective day. PMID- 6864225 TI - Cholesterol esters in rat brain infected with acute measles encephalitis: concentration and fatty acid composition. AB - The present study deals with the concentration and fatty acid composition of cholesterol esters in rat brains infected experimentally with measles virus to induce acute encephalitis. The left side of the cerebrum, as well as other portions of the brain, when inoculated percutaneously contained a large amount of cholesterol esters. The major fatty acids from the esters in the brain were C16:0, C16:1, C18:0, and C18:1; those from the serum were C18:1, C18:2, and C20:4. This result indicates that cholesterol esters may not come from serum but can be synthesized in situ, even in the brain with acute viral infection. PMID- 6864226 TI - Depolarization-evoked release of gamma-hydroxybutyrate from rat brain slices. AB - The release of gamma-hydroxybutyrate from preloaded rat brain striatal slices was investigated. K+-induced depolarization caused an efflux of gamma-hydroxybutyrate of about 50 fmol min-1 mg-1 (wet weight), but in a Ca2+-free medium containing Mg2+, the evoked release was reduced by 50-60%. The release was higher when 100 microM veratridine was used as a depolarizing agent. The efflux of gamma hydroxybutyrate is related to veratridine and K+ concentration, and is strongly inhibited by 10 microM tetrodotoxin. The Ca2+ channel blocker verapamil induces a large decrease in the efflux of gamma-hydroxybutyrate after both K+- and veratridine-induced depolarization. These results are in favour of a possible transmitter function for gamma-hydroxybutyrate in rat striatum. PMID- 6864227 TI - Induction of a stress protein in developing cell cultures of the rat cerebellum. AB - We examined the ability of developing cerebellar cell cultures to synthesize a 71,000 MW stress protein (SP71) in response to heat shock and Cd2+ treatment. The induction of SP71 synthesis appeared to be dependent on both the age of the culture and the stressor used. Heat shock induced SP71 synthesis in freshly prepared cells and in cell cultures at each age examined, whereas Cd2+ was effective only in cultures at 7 days of age and older. These findings are discussed with reference to the development of various cell types in these cultures. PMID- 6864228 TI - Multiple molecular forms of acetylcholinesterase in the nematode Caenorhabditis elegans. AB - Extracts of the nematode Caenorhabditis elegans contain five molecular forms of acetylcholinesterase (AChE) activity that can be separated by a combination of selective solubilization, velocity sedimentation, and ion-exchange chromatography. These are called form IA (5.2s), form IB (4.9s), form II (6.7s), form III (11.3s), and form IV (13.0s). All except form III are present in significant amounts in rapidly prepared extracts and are probably native; form III is probably derived autolytically from form IV. Most of forms IA and IB can be solubilized by repeated extractions without detergent, whereas forms II, III, and IV require detergent for effective solubilization and may therefore be membrane-bound. High salt concentrations are not required for, and do not aid in, the solubilization of these forms. For all forms, molecular weights and frictional ratios have been estimated by a combination of gel permeation chromatography and velocity sedimentations in both H2O and D2O. The molecular weight estimates range from 83,000 to 357,000 and only form II shows extensive asymmetry. The separated forms have been characterized with respect to substrate affinity, substrate specificity, inhibitor sensitivity, thermal inactivation, and detergent sensitivity. Judging by these properties, C. elegans is like other invertebrates in that none of its cholinesterase forms resembles either the "true" or the "pseudo" cholinesterase of vertebrates. However, internal comparison of the C. elegans forms clearly distinguishes forms IA, III, and IV as a group from forms IB and II; the former are therefore designated "class A" forms, the latter "class B" forms. Genetic evidence indicates that separate genes control class A and class B forms, and that these two classes overlap functionally. Several factors, including kinetic properties, molecular asymmetry, molecular size, and solubility, all suggest that a molecular model of the multiple cholinesterase forms observed in vertebrate electric organs probably does not apply in C. elegans. Potential functional roles and subunit structures of the multiple AChE forms within each C. elegans class are discussed. PMID- 6864229 TI - In vitro studies on the effect of beta-carbolines on the activities of acetylcholinesterase and choline acetyltransferase and on the muscarinic receptor binding of the rat brain. AB - Acetylcholinesterase (acetylcholine acetylhydrolase, EC 3.1.1.7) activity and muscarinic receptor binding of homogenates from several brain structures were inhibited by beta-carbolines. The inhibition was of the noncompetitive type in the case of the enzyme and of the mixed type in the case of the receptor binding. This effect was most strongly manifested by pyridoindoles(harmane, norharmane), i.e., carbolines containing an aromatic C ring than by the corresponding piperidoindoles (tetrahydroharmane, tetrahydronorharmane), i.e., those with a reduced C ring. The activity of choline acetyltransferase (acetyl-CoA:choline O acetyltransferase, EC 2.3.1.6) was not altered. These data are further evidence of the interactions between indoleamine derivatives and the cholinergic system. The results are discussed in terms of their possible biological significance. PMID- 6864230 TI - Alternative pathways of glucose utilization in brain: changes in the pattern of glucose utilization and of the response of the pentose phosphate pathway to 5 hydroxytryptamine during aging. AB - The oxidation of differentially labelled glucose, pyruvate and glutamate in brain slices from rats aged 20 days to 26 months has been studied and the partition of the glucose used into the glycolytic-tricarboxylic acid cycle pathway, the pentose phosphate pathway and the glutamate-GABA shunt has been calculated. Over the time range 4 to 26 months, there is an approximately 20% decrease in the production of CO2 via the glycolytic-tricarboxylic acid cycle route, as there is in the rate of glucose phosphorylation. The glutamate-GABA pathway falls by about 50% over this same time span. The broad activity of the pentose phosphate pathway falls rapidly and cannot be detected in the brains of rats aged 18 months or more, whereas the fully stimulated pathway, i.e. in the presence of the artificial electron acceptor phenazine methosulphate, declines only marginally over this period, falling sharply only after 23 months. The pentose phosphate pathway is stimulated by the presence of 5-hydroxytryptamine and this stimulation appears to increase with age. PMID- 6864231 TI - Analytical subcellular fractionation of rat cortex: resolution of serotonergic nerve endings and receptors. AB - An analytical procedure for the subcellular fractionation of rat brain cortex is presented; it consists of a two-step procedure involving a differential centrifugation using the five-fraction scheme and an isopycnic centrifugation in continuous sucrose gradients. All fractions obtained were analyzed for their content of various constituents, such as receptor binding, uptake, and several marker enzymes. Special attention was paid to the subcellular distribution of the serotonin S2 receptors; they were mainly recovered in the microsomal P fraction, but a significant amount was also associated with the mitochondrial (M and L) fractions. After equilibration in density gradients, serotonin S2 receptors revealed two peaks, which were similarly affected after treatment with amitriptyline and/or yohimbine. There is no evidence to suggest that serotonin S2 receptors are associated with nerve endings containing the neurotransmitter serotonin. Although three main profiles, a microsomal, a mitochondrial, and a mixed one, clearly appear from the differential centrifugation, subgroups of these main profiles were also found. For instance, the microsomal distribution patterns of serotonin S2 receptors and 5'-nucleotidase are very similar, but differ from that of UDP-galactosyltransferase. Similarly, the mitochondrial profiles of cytochrome oxidase and 5-HT (serotonin) uptake are different. An analytical approach for brain fractionation, when performed with appropriate measurements (cytochrome oxidase, amine uptake, 5'-nucleotidase, and receptor binding), is rapid and clearly differentiates pre- and postsynaptic constituents. PMID- 6864233 TI - Neuroaxonal dystrophy in the autonomic ganglia of aged rats. AB - Distinctive axonal abnormalities in selected sympathetic ganglia of male and female Sprague-Dawley and male Fischer 344 rats have been characterized as a function of increasing age. Dilated intraganglionic axons contained a variety of unusual subcellular organelles, including large numbers of compact or loosely aggregated tubulovesicular profiles, layered membranous loops, and collections of normal and degenerating organelles, identical to those described in clinical and experimental neuroaxonal dystrophy. Although occasional dystrophic axons were encountered free within the ganglionic neuropil, the majority were intimately associated with the surface of major dendrites or perikarya of principal sympathetic neurons and presumably represent terminal preganglionic axons. However, neither synaptic vesicles in dystrophic axons nor the association of dystrophic axons with post-synaptic densities were demonstrated. Dystrophic axons were infrequent within the prevertebral superior mesenteric and celiac ganglia before one year of age, but increased substantially in numbers thereafter. Similar findings expressed as lesions per mm2 were approximately tenfold less frequent in the paravertebral superior cervical ganglia of the same animals. PMID- 6864232 TI - Frequency-dependent release of acetylcholine and dopamine from rabbit striatum: its modulation by dopaminergic receptors. AB - The release of [3H]dopamine (DA) and [14C]acetylcholine (ACh) was monitored from single slices of the rabbit striatum. In all cases, the evoked overflow of ACh showed a higher peak and was of shorter duration than that of 3H products. For ACh, the release per pulse showed a marked decline with increasing frequency of stimulation, whereas flat frequency-release curves were obtained for DA. At 0.1 and 1 Hz the evoked overflows of ACh were 15 and 7 times greater, respectively, than those of DA. Haloperidol (0.03 microM) and sulpiride (1 microM) produced large increases in the evoked overflow of DA and ACh at 3 and 10 Hz; little effect was observed at lower frequencies. These results indicate that the frequency-release curves for DA and ACh are different and that at high frequencies the slope of the curves is modified by activation of pre- and postsynaptic DA receptors. Apomorphine inhibited in a concentration-dependent fashion the evoked overflow of DA and ACh; greater inhibition was obtained at lower frequencies of stimulation. At 0.3 Hz the DA agonist was two times more potent in inhibiting DA than ACh overflow (IC50: 12.0 +/- 2.2 versus 22.0 +/- 2.8 nM; p less than 0.01). The greater sensitivity of pre- than postsynaptic sites to apomorphine was also seen at higher frequencies (3 Hz). Benztropine (1 microM) reduced the evoked overflow of ACh at 10 Hz, and enhanced that of 3H products at all rates of stimulation (0.3-10 Hz). These results suggest that the release of DA and ACh is regulated by dopaminergic receptors. They also indicate that the effects of DA agonists and antagonists and of uptake inhibitors on DA and ACh release are highly dependent on the frequency of stimulation used. PMID- 6864234 TI - Glial fibrillary acidic (GFA) protein-containing cells in the human pineal gland. AB - The development of human pineal astrocytes was studied in a prospective autopsy series of 115 cases with an age range of 24 weeks of gestation to 91 years. Pineal glands selected from cases with postmortem intervals of one to 24 hours were fixed in Bouin's fluid and immunostained using the peroxidase-antiperoxidase technique and an antiserum against human glial fibrillary acidic (GFA) protein. In adults, scattered, mostly angular and strongly-positive cells and processes were present. A few primary processes emanated from each astrocyte which abruptly subdivided into several secondary ones, creating a pervasive interstitial network of fibers which surrounded almost every individual pinealocyte. Astrocytic endfeet formed a limiting lamina at the periphery of the gland and a barrier between perivascular spaces and the pineal parenchyma. At 24 weeks of gestation, occasional punctate staining, mainly around vessels, was present in the pineal body, while in the surrounding white matter there was already pronounced astrocytic differentiation. Around 32 weeks of gestation, well-formed astrocytes and a weakly staining network of their processes appeared in differentiated areas of the pineal gland. Both astrocytes and their interstitial network of processes became more prominent with advancing age. There was no astrocytic hypertrophy or hyperplasia around calcified deposits. Rosenthal fibers stained negatively for GFA protein. These findings emphasize the significance of the astrocytic participation in the structure of the human pineal gland throughout life. PMID- 6864235 TI - Increased risk of experimental central nervous system listeriosis in rats with chronic serum sickness. An immunohistopathological study. AB - The incidence and severity of central nervous system (CNS) infection were increased following the intraperitoneal innoculation of Listeria monocytogenes in adult Wistar rats with experimental chronic serum sickness. The results were attributed to an alteration in the blood-cerebrospinal fluid barrier induced by immune complex deposits in the choroid plexus of animals hyperimmunized with bovine serum albumin. CNS inflammation occurred in 16 of 40 (40%) of the test animals studied; one of 36 (2.8%) controls had CNS inflammation. There were extensive pathological changes in the choroid plexus, subarachnoid space, and neural parenchyma of the test animals, as compared with only small inflammatory foci limited to the choroid plexus and subarachnoid space in the one affected control. This experimental model for inducing bacterial CNS infection simulates certain predisposing conditions in chronic immune disease, and may therefore be useful in studying the pathogenesis of CNS infection in such cases. PMID- 6864236 TI - Mechanisms of blood-brain barrier breakdown after microembolization of the cat's brain. AB - Unilateral microembolization of the cat brain with carbonized microspheres 15 microns in diameter ten minutes (min) before death induced multifocal disruption of the blood-brain barrier (BBB) to horseradish peroxidase (HRP) in nine adult cats. The gross pattern of HRP extravasates was studied: (a) after five min of in vivo circulation, (b) following infusion of HRP immediately before chemical fixation, and (c) following infusion of HRP after 60 min of aldehyde fixation. Examination of the material from the three different experimental groups revealed no qualitative differences at the light microscopic level; specific features such as ring-shaped extravasations of HRP occurred irrespective of the mode of tracer injection. Tracer-filled pinocytotic vesicles and tubular profiles were abundant in the vascular endothelium after in vivo circulation of HRP, but were virtually absent after supravital and postmortem HRP administration. The results suggest that BBB breakdown for proteins after microembolization is not an energy dependent process mediated by either pinocytosis or tubular-endothelial channel formation. PMID- 6864237 TI - Neurotropism of rabies virus. An in vitro study. AB - The relative susceptibility of neurons and glia, grown as monolayers in vitro, to rabies virus infection was explored. Established cell lines of neuronal or glial phenotype and primary cultures of cells derived from mouse dorsal root ganglia (DRC) or brain were used as homologues of the targets of rabies virus in the nervous system. Fixed rabies virus (CVS) strain was used in most experiments; other fixed rabies strains (PV, HEP, ERA) and a street rabies virus isolate were used in some. Virus-cell tropism was determined by immunofluorescence assay for rabies nucleocapsid antigen and cell permissivity was assessed by titration of virus yields. Neuronal cells always exhibited a much greater susceptibility to infection and a greater propensity to sustain viral growth. By immunofluorescence, 90-100% of neurons commonly had viral inclusion bodies, while doses of the virus three to four orders of magnitude higher still left greater than 99% of astrocytes, in brain cell cultures and 90 +/- 5% of the non-neuronal cells in DRG cultures without any obvious signs of rabies virus. Neuroblastoma cells (95 +/- 5% with viral antigens) produced viral yields about four orders of magnitude higher than glioma cells (10 +/- 5% with viral antigens). Though the overall infectivity of street virus was lower than that of fixed virus strains, a significantly higher viral tropism for neurons than for glia was maintained. Thus, primary neuronal cultures offer a means of exploring molecular events in rabies virus infection and their role in pathogenesis. PMID- 6864238 TI - Inflammatory meningeal masses of unexplained origin. An ultrastructural and immunological study. AB - Two patients with inflammatory meningeal masses were studied. Lesions in both patients showed varying proportions of meningothelial and inflammatory components. The non-neoplastic nature of the inflammation was confirmed in one case by lymphocyte surface marker study, which showed T and B cells in one to four ratio, and by immunohistochemistry, which revealed polyclonal plasma cells. The abundant histiocytes contained muramidase and often enclosed intact lymphocytes or plasma cells within their cytoplasm, i.e., emperipolesis. Their surfaces bore slender interdigitating pseudopodia, intercellular junctions, and subplasmalemmal linear densities. The derivation of these histiocytes is uncertain: mononuclear phagocytes, meningothelial cells, and multipotential meningeal cells are all possible progenitors. A comparison with eleven similar reported cases reveals a tendency for inflammatory meningeal masses to occur in the young, as well as a predilection for posterior fossa involvement. They resemble the extranodal lesions of sinus histiocytosis with massive lymphadenopathy, as well as plasma cell granulomas or inflammatory pseudotumors of lung and other tissues. However, it is possible that these lesions represent a variant of meningioma in which an unusual immunological response has been evoked. PMID- 6864240 TI - Command neurons for locomotion in Aplysia. PMID- 6864239 TI - Direct and indirect visual inputs to superficial layers of cat superior colliculus: a current source-density analysis of electrically evoked potentials. AB - 1. The spatiotemporal pattern of visual inputs to the stratum griseum superficiale (SGS) and stratum opticum (SO) of the cat superior colliculus (SC) has been determined by an analysis of the current sinks occurring during postsynaptic activity following stimulation of each optic nerve (ON) and the optic chiasm (OX). Electrolytic lesions were used to determine the locations of the five major current sinks. 2. Direct SC afferents from the contralateral ON induced three current sinks whose maxima were located a) in the upper part of the SGS, b) in the middle part of the SGS, and c) in the lower part of the SGS and upper part of the SO. These three sinks were generated by three afferent fiber groups conducting in the optic nerve with modal and maximum velocities, respectively, of a) 4 and 5 m/s (slow W-group), b) 7 and 10 m/s (fast W-group), and c) 32 and 43 m/s (Y-group). 3. Indirect SC inputs from the contralateral ON via the ipsilateral visual cortex were identified by comparing the pattern of current sinks generated by OX stimulation before and after cortical ablation. The most prominent and fastest indirect sink (Y-group) was found in ;the lower half of the SGS and uppermost part of the SO. Low-amplitude, long-latency indirect current sinks were also found in the upper and lower thirds of the SGS. 4. The principal conclusions of this report are first, that the SGS is divisible into three physiologic regions according to the spatiotemporal pattern of excitatory synaptic activity generated by the afferent inputs and second, that there is a spatiotemporal matching of the direct collicular afferents from the contralateral retina and the indirect retinal afferents relaying through the ipsilateral visual cortex. PMID- 6864241 TI - Responses of fine medial articular nerve afferents to passive movements of knee joints. PMID- 6864242 TI - Functional properties of neurons in middle temporal visual area of the macaque monkey. I. Selectivity for stimulus direction, speed, and orientation. AB - 1. Recordings were made from single units in the middle temporal visual area (MT) of anesthetized, paralyzed macaque monkeys. A computer-driven stimulator was used to make quantitative tests of selectivity for stimulus direction, speed, and orientation. The data were taken from 168 units that were histologically identified as being in MT. 2. The results confirm previous reports of a high degree of direction selectivity in MT. The response above background to stimuli moving in a unit's preferred direction was, an average, 10.9 times that to stimuli moving in the opposite direction. There was a marked tendency for nearby units to have similar preferred directions. 3. Most units were also sharply tuned for the speed of stimulus motion. For some cells the response fell to less than half-maximal at speeds only a factor of two from the optimum; on average, responses were greater than half-maximal only over a 7.7-fold range of speed. The distribution of preferred speeds for different units was unimodal, with a peak near 32 degrees/s; the total range of preferred speeds extended from 2 to 256 degrees/s. Nearby units generally responded best to similar speeds of motion. 4. Most units in MT showed selectivity for stimulus orientation when tested with stationary, flashed bars. However, stationary stimuli generally elicited only brief responses; when averaged over the duration of the stimulus, the responses were much less than those to moving stimuli. The preferred orientation was usually, but not always, perpendicular to the preferred direction of movement. 5. A comparison of the results of the present study with a previous quantitative investigation in the owl monkey shows a striking similarity in response properties in MT of the two species. 6. The presence of both direction and speed selectivity in MT of the macaque suggests that this area is more specialized for the analysis of visual motion than has been previously recognized. PMID- 6864243 TI - Functional properties of neurons in middle temporal visual area of the macaque monkey. II. Binocular interactions and sensitivity to binocular disparity. AB - 1. Electrophysiological recordings were made in the middle temporal visual area (MT) of five macaque monkeys. Binocularity and selectivity for disparity were examined using a computer-driven stimulator to activate each eye independently. Results were obtained from 91 single units in MT. 2. Most units in MT receive approximately balanced inputs from the two eyes, and very few could be driven through only one eye. 3. In one type of test for disparity selectivity, units were examined with stimuli that had different but fixed horizontal disparities, thereby simulating frontoparallel movements at different distances from the animal. About two-thirds of ;the units tested for fixed disparity selectivity (52/76) showed pronounced sensitivity to horizontal disparity. Most of these units could be grouped into the same four classes of disparity-tuned units that have previously been described in V1 and V2 of the macaque: near, far, tuned excitatory, and tuned inhibitory. 4. Twenty units were tested for sensitivity to vertical stimulus disparity, which does not normally contribute to stereopsis. Most were as sensitive to vertical disparities as to horizontal. 5. Units were also tested for selectivity for stimuli that moved with changing disparity, simulating trajectories with components of motion toward or away from the animal (motion in depth). No units were found to be truly selective for motion in depth. Units tuned for fixed disparity could appear to prefer motion in depth if tested only with trajectories whose common center point was far from the unit's optimal fixed disparity. However, we do not consider this to represent genuine selectivity for motion in depth, since 1) the responses ara adequately and more easily explained in terms of selectivity for fixed disparity and 2) the best overall response of these units is to frontoparallel motion at the optimal fixed disparity. This observation bears importantly on the interpretation of motion in depth selectivity in previous investigations. 6. The presence of a substantial degree of selectivity for fixed disparity in MT, together with previously demonstrated selectivities for direction and speed, indicates that MT is well suited for the analysis of motion in three-dimensional space. PMID- 6864244 TI - Phase-dependent influences of wing stretch receptors on flight rhythm in the locust. PMID- 6864245 TI - Stochastic properties of spontaneous unit discharges in somatosensory cortex and mesencephalic reticular formation during sleep-waking states. AB - 1. We compared renewal and Markovian characteristics of neuronal discharge sequences in deeper layers (V and VI) of the somatosensory area I (SI) and the mesencephalic reticular formation (MRF) of unanesthetized cats in the following five behavioral states: active wakefulness with movements (AW), motionless quiet waking (QW), slow-wave sleep (SWS), and paradoxical sleep with and without rapid eye movements (REM-PS and non-REM-PS). 2. The profile of the pooled renewal properties for the shorter interspike-interval component predicted by the exponential tail of interval distribution during a sleep-wakefulness cycle was quite different from that for the total intervals including the longer ones; e.g., the mean rate of the SI neuronal group for the shorter interval component during SWS was as high as that during REM-PS in spite of the lowest rate for the total intervals. 3. In the SI and MRF neurons, the group mean of the degree of Markovian characteristics of the shorter intervals was much larger during AW, SWS, and REM-PS then QW and non-REM-PS, indicating that successive interspike intervals of spontaneous activity are time dependent in the AW, SWS, and REM-PS states, while they tend to be independent during QW and non-REM-PS. This tendency was more conspicuous for SI than MRF. On the other hand, the longer intervals in the five states did not contribute to the revealment of the Markov property. 4. The time-independent activities during QW and non-REM-PS were markedly similar especially for SI, suggesting that these activities may be regarded as autochthonous ones inherent to the neuron and its surrounding network under study. 5. The degree of Markovian properties was much higher in the MRF neurons than in the SI neurons during each of the states of vigilance except for AW, suggesting that the MRF neuronal group has a tonically modulated unit activity even in the absence of external stimuli. PMID- 6864246 TI - Motor Cortex control of finely graded forces. PMID- 6864248 TI - Visual and oculomotor functions of monkey substantia nigra pars reticulata. I. Relation of visual and auditory responses to saccades. PMID- 6864247 TI - Somatosensory cortex activity related to position and force. AB - 1. The relation of somatosensory cortex (SI) neuronal activity to actively maintained limb posture was examined by recording from single neurons in the SI of monkeys trained to hold the forearm at different pronation-supination postures and to exert different directions and magnitudes of steady torque. 2. Neurons related to limb position were, in most cases (89%), also related to torque exerted by the limb. Very few neurons related to only position or only torque were found. 3. Two categories of position- and torque-related neurons were found, type 1 and type 2. Type 1 eurneuronal activity resembled the pattern of activity seen in the pronator and supinator muscles; neurons more active with supinating torque also became more active with supinated position, while neurons related to pronating torque were also related to pronated position. Type 2 neurons had a noncongruent relation to position and torque; neurons more active with supinating torque became more active with pronated position, while neurons related to pronating torque were related to supinated position. 4. Position- and torque related neurons were characterized by having predominantly noncutaneous peripheral inputs and were concentrated in two SI regions identified as area 3a and area 2. 5. It is hypothesized that during actively held limb postures, the activity of the type 1 and type 2 neuronal populations in SI is sufficient to signal uniquely the steady-state position of the limb and the force exerted by the limb. PMID- 6864249 TI - Visual and oculomotor functions of monkey substantia nigra pars reticulata. II. Visual responses related to fixation of gaze. PMID- 6864250 TI - Visual and oculomotor functions of monkey substantia nigra pars reticulata. III. Memory-contingent visual and saccade responses. PMID- 6864251 TI - Complex somatosensory receptive fields of cells in the deep laminae of the hamster's superior colliculus. AB - Responses to separate and simultaneous application of noxious and innocuous tactile stimuli were examined for neurons recorded from the deep layers of the hamster's superior colliculus. Forty-four percent of the units isolated were responsive only to innocuous, primarily cutaneous, stimuli; 10% were activated only by noxious stimulation; and 15% were characterized as having a wide dynamic range. The remaining 31% of the somatosensory cells recorded had complex receptive field properties which have not heretofore been described for tectal neurons in any species. Ten percent of all somatosensory cells had no excitatory receptive fields, but their spontaneous discharges could be suppressed by low threshold and/or noxious stimulation of discrete portions of the body. In 18% of the units which we recorded, innocuous and noxious stimuli had opposing effects upon cellular activity. Most of these neurons had small receptive fields in which innocuous tactile stimuli yielded excitation and larger fields, often including most of the body surface, where noxious stimulation suppressed both spontaneous activity and the responses normally elicited by appropriate tactile stimulation. Finally, a very small number of units (3% of all somatosensory cells recorded) had multiple receptive fields in which low threshold stimulation produced opposing effects on spontaneous activity. Somatosensory units were recorded in all of the deep laminae, but cells with complex response characteristics were isolated primarily in stratum griseum profundum. PMID- 6864252 TI - Frequency-specific projections of individual neurons in chick brainstem auditory nuclei. AB - Nucleus magnocellularis and nucleus laminaris in the avian brainstem contain second- and third-order auditory neurons thought to be homologous to the mammalian anteroventral cochlear nucleus and medial superior olivary nucleus, respectively. Nucleus laminaris in the chicken is a tonotopically organized sheet of bipolar neurons; each of these neurons receives spatially segregated bilateral innervation from the two magnocellular nuclei. In the present study, this projection was studied at the single cell level by analyzing the pattern of terminal arborizations of individual horseradish peroxidase-filled axons. Reconstruction of the terminal arborizations of nucleus magnocellularis axons revealed that each axon forms an elongated band of endings, the long axis of which is parallel to the physiologically defined isofrequency bands. Within a band, the individual terminal collaterals form distinct patches separated by areas without endings. We suggest that the elongated terminal fields provide the basis of the tonotopic organization observed in nucleus laminaris and that the trajectories of the ipsilateral and contralateral axons may provide differential conduction delays that are important for binaural integration of acoustic information. PMID- 6864253 TI - Expression of amino acid decarboxylase in proliferating cells of the neural tube and notochord of developing rat embryo. PMID- 6864254 TI - Termination of afferent axons in macaque striate cortex. AB - We used horseradish peroxidase (HRP) to orthogradely label afferent axons in macaque striate cortex. Of the 38 axons that we recovered, nine were recorded intracellularly before being filled with HRP. Light microscope and computer reconstructions of filled processes reveal highly stereotyped patterns of arborization and suggest that there are at least five discrete populations of lateral geniculate nucleus (LGN) afferent axon: (1) those to layer 4C beta, which have extremely circumscribed, dense terminal fields (small branches of which occasionally intrude into 4C alpha) but which have not been shown to project to other laminae; (2) afferents to layer 4A, which in some cases send fine ascending collaterals into layer 2-3 and which do not, apparently, send collaterals to other laminae; (3) afferents to layer 1, which are fine, extend over large distances horizontally, and send collaterals to layer 6A; (4) afferents to the lower two-thirds of layer 4C alpha, which have few or no collaterals in layer 6; and (5) afferents to the upper half of layer 4C alpha, which have arborizing collaterals in layer 6B. Of the nine axons that were recorded intracellularly, those with projections to layer 4C beta (two axons) and to layer 1 (one axon) had color-selective properties, whereas those (six axons) which arborized in 4C alpha all had transient, broad band and highly contrast-sensitive receptive fields. These properties are consistent with derivations from somata in the parvocellular and magnocellular divisions of the LGN, respectively. Afferents to 4C alpha were found to cover approximately 6 times as much surface area as afferents to 4C beta. The preterminal trunks of all axons were found to follow tortuous paths through the neuropil--paths that may derive from axon segregation during development. The wide ranging, patchy distributions of single afferents in 4C alpha suggest that individual 4C alpha axons supply more than one ocular dominance stripe. In one case where the terminal arborization of a 4C alpha axon was mapped against the transneuronally determined pattern of ocular dominance, three separate patches of terminal boutons were indeed found to coincide with the bands of one eye. PMID- 6864256 TI - Locomotion in Aplysia: triggering by serotonin and modulation by bag cell extract. PMID- 6864257 TI - An autoradiographic study of the prenatal development of benzodiazepine-binding sites in rat brain. PMID- 6864255 TI - Glutamate decarboxylase immunoreactivity in the hippocampus of the cat: distribution of immunoreactive synaptic terminals with special reference to the axon initial segment of pyramidal neurons. PMID- 6864258 TI - Pressure microinjection of nerve growth factor and anti-nerve growth factor into the nucleus and cytoplasm: lack of effects on neurite outgrowth from pheochromocytoma cells. AB - Exogenous proteins have been introduced into naive and nerve growth factor (NGF) primed pheochromocytoma cells by pressure microinjection. Microinjection of cells did affect NGF-induced neurite outgrowth by these cells over periods of up to 3 days. Injected NGF failed to elicit neurite outgrowth or regeneration in the absence of extracellular NGF and failed to enhance it in its presence. Injected anti-NGF IgG failed to inhibit neurite outgrowth or regeneration induced by extracellular NGF. Similar results were obtained for both nuclear and cytoplasmic injections. PMID- 6864259 TI - Increase in nociceptive input to spinocervical tract neurons following chronic partial deafferentation. AB - Recordings from antidromically identified spinocervical tract (SCT) cells in the partially deafferented spinal cord of chloralose-anesthetized cats have revealed reorganization of their input from peripheral receptors in the skin. Immediately after dorsal rhizotomy of segments L5, L6, S1, and S2, (sparing L7), units in L6 had a lower than normal probability of responding to moderate pressure, mechanical nociceptive, noxious heat, and cooling inputs. This persisted for about 6 weeks, after which normal or even larger than normal proportions of SCT units could be driven by these inputs. The proportion of units driven by hair deflection remained large throughout this period. Responses in the L7 segment with intact L7 dorsal root were unchanged. We suggest that afferent fibers from different receptor types differ in the extent of their normal functional projection, accounting for the selective changes after acute deafferentation. The chronic changes may reflect a differential ability of surviving afferent fibers to undergo compensatory changes in their projection (e.g., sprouting) after chronic rhizotomy. PMID- 6864261 TI - Familial form of fibromuscular dysplasia of the internal carotid artery. PMID- 6864260 TI - Neurologic manifestations revealing pulmonary arterio-venous fistulas. PMID- 6864262 TI - Tinnitus of venous origin. Surgical treatment by the ligation of the jugular vein and lateral sinus jugular vein anastomosis. PMID- 6864263 TI - Medulloblastomas and retinoblastomas. CT images of intracranial meningeal metastases. PMID- 6864264 TI - Multiple meningiomas: a long-term review. AB - Ten cases of multiple meningiomas seen over a 34-year period have been reviewed. The total case load from which these cases were selected was 566. The incidence of multiple meningiomas found prior to the introduction of computerized tomography (CT) in this series was 1.1%. The incidence since the introduction of CT was 8%. In eight cases all the tumors were found at the initial presentation and surgery; in the other two cases new tumors were discovered 1 and 4 years later. In only one case was von Recklinghausen's disease known to be present, and this patient developed new tumors. Six cases have been followed for 5 or more years, two for 16 years. Tumor recurrence has not been seen. All the patients were females. There was a higher proportion than usual of the whorling psammomatous type of tumor; papillary, angioblastic or malignant forms were not noted. The possibility of multiple meningiomas being a forme fruste of von Recklinghausen's disease is considered. PMID- 6864265 TI - Spinal metastases with neurological manifestations. Review of 600 cases. AB - The authors have studied 600 cases of spinal metastasis causing a neurological syndrome. The most significant statistical data are reviewed. The cases are examined according to clinical characteristics, type of primary tumor, site of lesion, and survival. Each of these factors influenced the choice and results of treatment. As a general rule, combined treatment (surgery and radiotherapy) was used. Preliminary surgery was performed as an emergency, designed to halt progression of the neurological syndrome and to prevent its more serious manifestations. The technique and usefulness of surgery are discussed for different situations and the short-term results of treatment are related to the various factors involved. PMID- 6864266 TI - Sensory responses from stimulation of the inferior Rolandic and Sylvian regions in man. AB - During the course of 134 craniotomies under local anesthesia, 274 sensory responses to electrical stimulation were recorded as to cortical site, type of sensation, and the site and lateralization of peripheral referral. The region of cortex exposed was largely the sensorimotor region near the Sylvian fissure and the temporal lobe. Differences in the type of sensation were seen on either side of the central fissure. Sensation of movement and specific sensations were reported more commonly from stimulation in the precentral region and crude sensation from the postcentral area. "Pain" was reported only once and taste not at all despite the large somatic sensory representation of the tongue. About 30% of the responses were referred to the ipsilateral side or bilaterally, with a somewhat higher percentage in the pre- than in the postcentral region. In general, the expected somatotopic sequence was followed, with tongue and mouth having the largest representation. An unexpected number of referrals to the head/face were found in the suprasylvian region, and it was uncertain whether this was part of Somatosensory area II. Eleven cases with sensory referrals to trunk/limbs in the suprasylvian area were found predominantly in the precentral region. No somatotopic pattern could be seen in these or on review of Penfield's material. Possible anatomical pathways for transmission of these responses were reviewed and questions raised as to the mechanisms involved. PMID- 6864267 TI - Syndrome of the incidental herniated lumbar disc. AB - Lumbar myelographic defects consistent with herniated disc were found in 108 asymptomatic patients undergoing myelography for other reasons. Within 3 years, 64% of these patients developed symptoms of lumbosacral radiculopathy. The clinical features of these patients comprise a syndrome significantly different from that typically associated with classical lumbar disc herniation: the syndrome described here carries a much higher incidence of silent root compression with minimal pain. Incidental lumbar myelographic defects are not necessarily benign findings, and patients in whom they are encountered deserve close clinical follow-up review and appropriate treatment if the defects become symptomatic. PMID- 6864268 TI - Disseminated intravascular coagulation as a complication of ruptured intracranial aneurysms. Report of two cases. AB - Two patients with recently ruptured intracranial aneurysms underwent surgical repair of these vascular lesions. Postoperatively, they showed clinical and laboratory evidence of disseminated intravascular coagulation (DIC). In both patients severe cerebral ischemic complications occurred. In one case the ischemic complications and the hematological changes were successfully reversed. This syndrome is a potential complication of aneurysmal subarachnoid hemorrhage (SAH), which requires prompt diagnosis and appropriate management. The relationship between hematological changes suggesting DIC and the ischemic complications of SAH should be extensively investigated. PMID- 6864270 TI - Brain-stem hemangioma calcificans. Case report. AB - A case of brain-stem hemangioma calcificans is described. The few cases reported in the literature prove the rarity of this tumor, which is considered a benign variant of cerebral cavernous hemangioma. Diagnosis and treatment of these tumors are briefly discussed with a review of the literature including 11 previous cases. PMID- 6864269 TI - Correlation of transient neurological deficit and somatosensory evoked potentials after intracranial aneurysm surgery. Case report. AB - A patient is reported in whom intraoperative somatosensory evoked potential (SEP) changes occurred in response to temporary clipping of the right middle cerebral artery. A period of 10 minutes elapsed before changes in SEP's in response to contralateral nerve stimulation were noted and, during the following 2 minutes, the waves decreased in amplitude and then were unrecordable. Waves of SEP, with amplitude similar to those recorded before clipping but with abnormal latency, returned within 45 seconds of removal of the clip, and the latency abnormalities persisted until the end of the operation. The patient awakened promptly at the end of the procedure with a dense left hemiparesis which resolved over 24 hours. At the end of 24 hours, the SEP's in response to median nerve stimulation were symmetrical in both latency and amplitude. This report demonstrates the accuracy of intraoperative evoked potential monitoring in demonstrating alterations of cerebral perfusion during aneurysm surgery. It also suggests that a prolonged period of observation may be necessary to assess the effects of temporary vessel occlusion during surgery on aneurysms or arteriovenous malformations. PMID- 6864271 TI - Intraventricular cavernous hemangioma. Case report. AB - A case of intraventricular cavernous hemangioma in a neonate is reported. In over 200 previously reported cases of intracranial cavernous hemangioma, 11 histologically verified cases have been collected and analyzed. The present case is the second occurring in a neonate. PMID- 6864272 TI - Cerebral chromoblastomycosis complicated by meningitis and multiple fungal aneurysms after resection of a granuloma. Case report. AB - Cerebral chromoblastomycosis is a rare intracranial lesion. This lesion was found in a 23-year-old man, who presented with right proptosis and fainting attacks. Computerized tomography revealed a moderately enhanced irregular mass in the right frontal region. Angiography disclosed that the mass was avascular. At surgery, a hard elastic avascular tumor was totally removed piecemeal. Histological diagnosis was a granuloma of fungal origin. Characteristic brown pigments in the hyphae of fungus in the granuloma strongly suggested that the fungus was chromoblastomycosis. The postoperative course was complicated by meningitis and rupture of fungal aneurysms. The patient remained vegetative and died 2 1/2 years later. The literature on such fungal aneurysms is briefly reviewed; no previous case of fungal aneurysms associated with cerebral chromoblastomycosis could be found. PMID- 6864273 TI - Collagen deficiency and ruptured cerebral aneurysms. A clinical and biochemical study. AB - Skin and temporal arterial biopsies were obtained from 17 patients undergoing surgery for ruptured cerebral aneurysm, and specimens were taken from six age- and sex-matched control surgical patients. Radioactively labeled and control tissue collagen patterns were studied by interrupted polyacrylamide gel electrophoresis (PAGE), using the trisborate buffer system or by carboxymethyl cellulose (CMC) chromatography. Type III/I collagen ratios were then measured from autoradiographs of the radioactively labeled samples using the Joyce Loebl gel scanner adapted for flat bed gels. In the case of the CMC labeled material, the ratios were measured by the ratios of the summed radioactively labeled alpha 1(III), alpha 2(II), and alpha 2(I) peaks. Eleven of the 17 patients were Type III collagen-deficient while all of the six control patients had normal collagen ratios. The implications of these findings are discussed. PMID- 6864274 TI - Moyamoya disease associated with persistent primitive trigeminal artery. Report of two cases. AB - Two cases of moyamoya disease associated with persistent primitive trigeminal artery (PTA) are reported. The first patient was a 44-year-old man who experienced a sudden severe headache brought about by an intracerebral hematoma in the left temporoparietal lobe. Four-vessel study showed a right-sided PTA and moyamoya disease. The second patient was a 56-year-old woman with similar symptoms and a hematoma in the right temporoparietal lobe. Four-vessel study showed a left-sided PTA and moyamoya disease. Among the 212 PTA cases reported in the literature, none has been associated with moyamoya disease. Moreover, there are no cases of moyamoya disease among the 119 cases of persistent primitive hypoglossal artery (PHA), which is thought to be a vascular anomaly fundamentally similar to PTA. None of the 907 cases of moyamoya disease reported in Japan has been associated with either PTA or PHA. Nonetheless, the embryonic stage when PTA or PHA normally disappears partially overlaps that period when moyamoya-like vascular anomalies have been thought to arise. The possible developmental relationship between these two varieties of vascular abnormality is discussed. PMID- 6864275 TI - Congenital hydrocephalus due to villous hypertrophy of the telencephalic choroid plexuses. Case report. AB - A case of villous hypertrophy or bilateral papilloma of the choroid plexus of the lateral ventricles is reported. The child exhibited known features associated with overproduction of cerebrospinal fluid, hydrocephalus that was difficult to control, ascites after ventriculoperitoneal shunting, and relief after surgical removal of the papillomatous tissue. A unique feature is the complexity of the telencephalic choroid plexuses as shown by computerized tomography and ultrasound in the newborn period. PMID- 6864277 TI - Spondylitic spinal stenosis. PMID- 6864278 TI - Balloon embolus. PMID- 6864276 TI - Intrachiasmatic craniopharyngioma. Case report. AB - A patient with bitemporal hemianopsia was found to have an enlarged optic chiasm. Biopsy of the intrachiasmatic tissue revealed craniopharyngioma. PMID- 6864280 TI - The surgical approach to arteriovenous malformations of the lateral and sigmoid dural sinuses. AB - Arteriovenous malformations (AVM's) of lateral and sigmoid sinuses are acquired lesions evolving from a previously thrombosed dural sinus. Their natural history is usually that of gradual progression and hence surgery is frequently necessary. The preferred surgical treatment is complete excision coupled with packing of the sigmoid sinus. The operative approach is illustrated and discussed in detail. Results and complications are reviewed in 27 patients whose symptomatology had progressed under conservative management; 22 of these cases harbored primary lesions and five had recurrences. There were 22 excellent, one good, and two poor results (both of the latter from blindness that preceded surgery). There were two deaths, both in patients previously operated on with incomplete removal or obliteration of the AVM by attempted embolization. PMID- 6864279 TI - Xenon-enhanced CT CBF measurements in cerebral AVM's before and after excision. Contribution to pathogenesis and treatment. AB - Unlike neurological deficits resulting from intracranial hemorrhage in patients with cerebral arteriovenous malformation (AVM), which have well defined etiology, the pathogenesis and treatment of progressive and/or fluctuating non-hemorrhagic neurological and psychological deficits require clarification. Values for local cerebral blood flow (LCBF) and local partition coefficients (L lambda) were measured by the method using stable xenon (Xe)-computerized tomography (CT-CBF) scanning, and were compared to 133Xe inhalation values using external probes in 16 patients with cerebral AVM's. Values were measured by both methods before and after total excision of AVM's in five cases. Neurological and mental status assessments were compared with LCBF results. Clinical improvement was most evident after total excision of AVM's. Other procedures, such as clipping of vessels, partial excision, and ventriculoperitoneal shunting for hydrocephalus, were associated with frequent complications. Embolization carried risks of cerebral infarction and was not efficacious unless combined with excision. Medical treatment resulted in poor or unsuccessful seizure control, with neurological deterioration despite anticonvulsant therapy. Compared with age matched normal individuals, LCBF values in patients with AVM's were significantly reduced, particularly adjacent to the AVM's. Mean L lambda values for gray and white matter were normal. After excision, LCBF values in gray and white matter increased significantly up to normal. Due to overestimation of CBF by shunt flow with the 133Xe method of measurement, no correlation was found with results of the CT-CBF method before AVM excision, but significant correlation of the two methods resulted after excision. If accurate LCBF values are obtained by high resolution, direct measurement of tracer clearance from brain tissue, progressive and/or fluctuating neuropsychological deficits correlate with the degree of cerebral steal. PMID- 6864281 TI - Ocular pneumoplethysmography in carotid-cavernous sinus fistulas. AB - Pulsatile exophthalmos in association with carotid-cavernous sinus fistulas has been well defined anatomically, by angiography. This paper presents the physiological assessment of this entity, as measured with ocular pneumoplethysmography (OPG-Gee). The abnormal arteriovenous communication lowers resistance to arterial flow. This is characterized by a lowered ophthalmic systolic pressure and an increased ocular blood flow. The OPG readily documents the physiological result of therapeutic intervention. PMID- 6864282 TI - Ocular pneumoplethysmography in head-injured patients. AB - Severe head injury is frequently associated with multiple trauma. In the comatose patient, endotracheal intubation and ventilator support are often required, if there is associated dyssynchronous spontaneous effort. The latter is managed with therapeutic (drug) paralysis. An elaborate life-support and monitoring system coupled with controlled paralysis limits the mobility of the patient for diagnostic procedures, and a continuing reevaluation of neurological status is difficult. Under these circumstances the ocular pneumoplethysmograph provides a simple rapid noninvasive assessment of ocular blood flow, and this reflects cerebral blood flow and alterations in brain compliance. Alterations in the therapeutic regimen can be based on these observations. PMID- 6864283 TI - Cortical artery pressure in normotensive and hypertensive aneurysm patients. AB - Cortical artery pressure (CAP) and systemic pressure (SP) were measured in eight normotensive and six hypertensive patients with anterior circulation aneurysms. In the hypertensive patients significant gradients developed between CAP and SP as these pressures were lowered. The relationship between CAP and SP was expressed by the best-fit equation CAP = 1.02 SP -9.27 in the normotensive patients and by CAP = 1.54 SP -65.60 in the hypertensive patients. In the latter, the cycle of decreasing and increasing pressures formed a hysteresis loop suggesting prolonged cortical vasoconstriction despite recovery of systemic pressure. Selective pressure measurements in the distal (D) and proximal (P) segments of the cortical arteries were also obtained. The D/P ratio describes the relative contribution of the collateral circulation to cortical artery pressure. In normotensive patients, the D/P ratio was maintained down to an SP of 48 mm Hg. In hypertensive patients this ratio decreased with lowered SP, and a critical closing pressure of 40 mm Hg was predicted for the distal circulation. These studies described the limited capacity of the cortical circulation to maintain perfusion pressure in hypertensive patients. These responses should be considered when assessing the risks associated with such procedures as carotid ligation or hypotensive anesthesia. PMID- 6864284 TI - Cortical oxidative metabolism under conditions of ischemia, hypoxia, and asphyxia in the rabbit. AB - The purpose of this investigation was to compare the effects of hypoxia, asphyxia, and ischemia on brain cortical oxidative metabolism. This study was carried out using 14 New Zealand White rabbits. The effects of episodic stress were measured simultaneously on brain functional metabolism by monitoring cortical oxygen tension (brain pO2), cortical cerebral blood flow (cCBF), cortical blood volume, and mitochondrial oxidative metabolism. During hypoxia (when the fraction of inspired O2 (FiO2) was reduced to 10%) and asphyxia (induced by turning the respirator off), there was a decrease of brain pO2 but an increase of cCBF and blood volume. Similarly, there was a reduction of cortical oxidative metabolism. In post-asphyxic conditions, an overshoot of brain pO2 and post-asphyxic oxidation of cytochrome (Cyt.) aa3 were usually shown. Under ischemic conditions (induced by sudden severe hypotension plus bilateral common carotid occlusion), cCBF and blood volume were decreased. There was also a decrease of brain pO2 and a reduction of Cyt. aa3 following ischemia. These techniques are applicable in intraoperative monitoring of patients. PMID- 6864285 TI - Ruptured cerebral aneurysms: early and late prognosis with surgical treatment. A personal series, 1958-1980. AB - An account is given of a personal prospective series of 815 patients with the syndrome of spontaneous subarachnoid hemorrhage (SAH) due to ruptured cerebral aneurysm. It concerns all aneurysm patients at risk, both surgical and nonsurgical cases, referred to the author during two main periods: 606 patients were treated during the earlier period of 15 years, and 209 in the subsequent 7 years. The early mortality rate was determined at 3 months, and all survivors in the first period were followed for a mean of 9 years. Only operation survivors were observed during the second period, for 3 years on average. Patients alive at 3 months were studied in detail with respect to disabilities, work capacity, and later mortality. Of the 815 patients, 613, or 75%, were operated on. Comment is made on the influence of certain factors on early mortality. These include age, hypertension, condition of the patient at admission, and number of hemorrhages. From the results of this series, it is suggested that the preferable time to operate is between the 2nd and the 4th day after a single SAH. In this period, the early mortality rate is in the order of 10%. In this subgroup, a high proportion of the patients were in Botterell Grades 1 and 2, with only a few being in Grade 3. Also evident from the results was the protective value of operation against further aneurysm rupture in the 501 patients surviving at 3 months. However, the propensity of a second aneurysm to rupture in patients with multiple aneurysms has resulted recently in a change of operation policy. The early mortality in the whole series and later mortality in patients surviving 3 months is shown in tabular and histogram form. From these, it is clear the majority of later deaths are from causes unrelated to aneurysm rupture. PMID- 6864287 TI - Correlation between angiographic vasospasm, hematoma, and ischemic brain damage following SAH. AB - The correlation between angiographic vasospasm, hematoma, and ischemic brain damage was studied in 29 patients who died as a result of subarachnoid hemorrhage following rupture of a saccular aneurysm. None of these patients was treated surgically. A comprehensive neuropathological examination was undertaken in each case. A significant relationship between the presence and degree of vasospasm and ischemic brain damage was found. Furthermore, even though intracerebral hematoma probably increased the risk of infarction associated with vasospasm, hematoma per se did not increase the incidence of ischemic brain damage. PMID- 6864286 TI - Immunobiology of primary intracranial tumors. Part 7: Active immunization of patients with anaplastic human glioma cells: a pilot study. AB - Twenty patients with malignant gliomas were selected for active immunization within 4 weeks following surgery. Each patient had a Karnofsky Functional Rating equal to or greater than 70, a peripheral blood lymphocyte count equal to or greater than 1000 cells/cu mm, skin test responses to one or more of four recall antigens, peripheral blood T-cells equal to or greater than half that of control, and was not receiving steroid therapy at the time of entry into the study. Each patient received subcutaneous inoculations with one of two human glioma tissue culture cell lines (D-54MG or U-251MG) monthly, with 500 micrograms of bacillus Calmette-Guerin cell wall (BCG-CW) being included with the first inoculation. Each patient also received levamisole, 2.5 mg/kg 3 days per week every other week. Radiotherapy and chemotherapy with BCNU were begun after the first month of immunization. Follow-up evaluations included computerized tomography brain scans, neurological examinations, Karnofsky Functional Ratings, and studies of general immune competence. No evidence of allergic encephalomyelitis was noted clinically, nor was any gross or microscopic evidence of such pathology obtained upon autopsy of three of these patients. Serial studies of general immune competence showed no alterations from those previously described with non immunized patients. Patients who were inoculated with the U-251MG cell line have had a longer survival time compared to those inoculated with the D-54MG cell line (p less than 0.0590) or compared to 58 historical cases of glioma patients treated with levamisole, radiation therapy, and chemotherapy alone (p less than 0.02). PMID- 6864288 TI - The role of hemoglobin in the etiology of cerebral vasospasm. An in vivo study of baboons. AB - Oxyhemoglobin was injected intracisternally into three baboons, and methemoglobin into one baboon, in an attempt to mimic the prolonged cerebral arterial spasm sometimes seen after subarachnoid hemorrhage due to aneurysm rupture. Cerebral angiography was performed for up to 7 days after injection of hemoglobin, and the degree of vasospasm was estimated from the angiograms. Oxyhemoglobin caused slight arterial narrowing, which lasted for 3 days. Methemoglobin had no significant effects. Motor neurological deficits and histopathological signs, characteristic of prolonged cerebral vasospasm, were not observed. It was concluded that hemoglobin alone is not capable of causing the cerebral vasospasm syndrome in these experimental animals. PMID- 6864290 TI - The surgical correction of coronal and metopic craniosynostoses. AB - Procedures for relief of coronal synostosis and metopic synostosis have resulted in some undesirable sequelae. The authors present combined neurological and plastic surgical modifications to prevent additional synostoses, forehead ridging, and lateral orbital wall step-off. They recommend bifrontal craniotomy with lateral wall osteotomy into the body of the zygoma and self-retaining grafts. PMID- 6864292 TI - Lactate and pyruvate metabolism in injured cat spinal cord before and after a single large intravenous dose of methylprednisolone. AB - The lactate content and the lactate/pyruvate ratio of the acutely traumatized cat spinal cord have been studied and were found to rise rapidly following a 400 gm cm injury. Lactate levels rose nearly twofold within 5 minutes after injury, peaked at 2 hours after injury, and remained significantly elevated for at least 8 hours compared to an adjacent uninjured segment of traumatized cord. Pyruvate levels, on the other hand, fell acutely in the injured section of cord during the 1st hour after injury then rose slowly over an 8-hour period. The changes in tissue lactate and pyruvate metabolism in the spinal cord following injury are consistent with a marked injury-induced reduction in blood flow. The elevation in lactate and the fall in pyruvate levels observed at 1 hour after injury were completely prevented by the intravenous administration of a single 30-mg/kg dose of methylprednisolone sodium succinate at 30 minutes after injury. Lower or higher doses of methylprednisolone were far less effective. The effects of the 30 mg/kg dose of methylprednisolone on tissue lactate content were associated with high tissue levels of the glucocorticoid and were short-lived, paralleling the accumulation and elimination pattern of steroid from the injured tissue. The results suggest that, in addition to other reported beneficial actions of large intravenous doses (30 mg/kg) of methylprednisolone on the injured cord, the glucocorticoid may also improve blood flow to the injured segment as has been suggested by others. The use of high glucocorticoid doses, early therapy initiation, and rigorous maintenance dosing is discussed. PMID- 6864291 TI - Anterior cervical discectomy with and without fusion. A prospective study. AB - A prospective randomized study to compare discectomy without (DE) and with fusion (DEF) included 63 patients operated on with DE returned to work during the first 9 weeks postoperatively than patients operated on with DEF (p less than 0.005 to 0.05). The prognosis is significantly better for men than for women after DEF (p less than 0.005), while no difference can be shown after DE. PMID- 6864293 TI - Electrophrenic respiration following anastomosis of phrenic with branchial nerve in the cat. AB - Patients with high spinal cord injuries may be totally dependent on artificial ventilation. Prolonged use of mechanical devices requires intensive care, which restricts the mobility of these patients. Electrophrenic respiration has been used with success to overcome this difficulty. However, a prerequisite for electrophrenic respiration is a viable phrenic nerve. Patients with spinal cord injuries at the C-3 to C-5 levels do not have a viable phrenic nerve due to gradual degeneration of axons in these nerves. In the present study on cats, the authors caused degeneration in one of the phrenic nerves by sectioning it low in the neck. Then the distal end of the phrenic nerve was anastomosed to the proximal segment of a sectioned brachial nerve. Sixteen to 32 weeks were allowed for the growth of brachial axons into the anastomosed phrenic nerve. Each cat served as its own control because one of the phrenic nerves was left intact. It was observed that pacing of the anastomosed phrenic nerve produced respiration comparable to spontaneous respiration or to respiration induced by pacing the intact phrenic nerve. Lack of rhythmic bursts of electrical activity in the anastomosed phrenic nerve and electromyographic activity in the ipsilateral hemidiaphragm confirmed that the anastomosed phrenic nerve remained disconnected from the respiratory motoneurons. Abundance of collagen matrix in the electron micrographs of the anastomosed phrenic nerve indicated that degeneration of the axons of phrenic motoneurons had occurred and the brachial nerve had grown into the phrenic nerve stump. These results indicate that electrophrenic respiration may be possible in patients with spinal cord injuries at the C-3 to C-5 vertebral levels if the phrenic nerve is kept viable by anastomosing it to a branch of the brachial nerve. PMID- 6864294 TI - A reproducible spinal cord injury model in the cat. AB - Allen's weight-drop method for producing experimental spinal cord injuries was improved by placing a curved stainless steel plate anterior to the spinal cord to provide a smooth, hard surface for the receipt of posterior cord impact. In addition, an electronic circuit was used to ensure that cord injury was produced by a single impact, thereby enhancing the reproducibility of the injury mechanism. Using a spinal cord injury model with these modifications, the author found that the recovery of hindlimb function and the histopathological appearance of the injured cord 6 weeks after upper lumbar injury were closely related to injury magnitude. The curve of functional recovery versus injury magnitude has a sharp transition centered at 10 gm X 15 cm, and indicates that an injury of 10 gm X 20 cm produces a "threshold" lesion suitable for the future evaluation of spinal cord treatment methods. PMID- 6864289 TI - Failure of naloxone to affect focal incomplete cerebral ischemia and collateral blood flow in cats. AB - Focal incomplete cerebral ischemia was created in 20 adult cats by retro-orbital middle cerebral artery (MCA) occlusion under halothane anesthesia. Arterial blood flow (CBF), bilateral electroencephalographic (EEG) recordings, and systemic arterial blood pressure (SABP) were monitored for the 1st hour of occlusion. Ten animals were treated with 10 mg/kg of naloxone within 10 minutes of MCA clipping, followed by a continuous infusion of naloxone at 2 mg/kg/hr for the duration of the occlusion (8 hours). Ten animals were treated in a similar fashion with physiological saline (control). Blood flow was restored after 8 hours. The brains were examined at the time of death or 7 days after the occlusion period. There was no difference between the two groups regarding cerebral infarction size or distribution, neurological outcome, SABP, PaCO2, or CBF. Minor changes in EEG amplitude observed in the naloxone-treated group appear to represent interaction of the drug with halothane after prolonged administration. The authors conclude that naloxone did not modify the outcome of focal cerebral ischemia in the cat. PMID- 6864296 TI - Effects of intraparenchymal hemorrhage on extracellular cortical potassium in experimental head trauma. AB - A model of intraparenchymal hemorrhage was created in 11 cats. The development of the parenchymal hemorrhage was accompanied by a massive cellular depolarization and K+ release in anatomically intact areas in the vicinity of the hematoma. The K+ clearance was rapid and in most instances total. This initial K+ release was not ischemic in origin but was the result of mechanical and chemical factors of the extravasated blood on cellular membranes. In contrast, an increased water content of the white matter did not affect the cellular function or levels of K+ in the extracellular space of the cerebral cortex in the recording area. The experimental results suggest that K+ release takes place at the onset of trauma in subcritically injured cellular areas in the vicinity of a hemorrhage. The cellular elements undergo massive depolarization which is accompanied by a number of chemical and biochemical changes that lead to cellular swelling. Cellular depolarization and K+ release appear to be the initial response of the central nervous system to trauma. The extent of this response may strongly influence the final degree of cellular damage and, thus, the neurological deficit in patients with head trauma. PMID- 6864295 TI - The National Traumatic Coma Data Bank. Part 2: Patients who talk and deteriorate: implications for treatment. AB - The records of the first 325 patients entered into the pilot phase of the National Traumatic Coma Data Bank were reviewed. Thirty-four severely head injured patients who talked prior to deteriorating to a Glasgow Coma Scale (GCS) score of 8 or less were identified. Of those 34 patients, 18 died or were left vegetative and 16 recovered. While there were certain common factors between those who talked and died and those who talked and recovered, there were also significant differences. The common factors between the two groups were the length of time to deterioration or operative intervention (16 versus 18 hours, respectively), and the initial GCS scores (12.6 versus 12.4, respectively). The primary differences between the groups included the mean age, the degree of midline shift seen on computerized tomography (CT), and the presence of subdural hematoma. Those who talked at some point postinjury, but who subsequently died, had a mean age of 50 years. Those who talked, deteriorated, and then recovered were found to have a mean age of 32 years. Seven of the 18 patients who talked and died had a shift of greater than 15 mm on CT, while this degree of shift was demonstrated in only one of 16 patients who talked, deteriorated, and recovered. Subdural hematomas were significantly more common in the "talk and die" group, as was the overall need for operation. Since the overwhelming majority of patients with marked shift on CT have surgical lesions, early operative intervention is strongly recommended in these patients, prior to their inevitable deterioration. PMID- 6864297 TI - Chart for outcome prediction in severe head injury. AB - An analysis of clinical and demographic data of 264 patients with severe head injury showed that a combination of the Glasgow Coma Scale (GCS) score, oculocephalic responses, and age can provide a simple but reliable prediction of outcome in severe head injury. Addition of other clinical data, excluding intracranial pressure and evoked potentials, improved the predictability only negligibly. A simple chart, which is constructed from the application of the logistic regression model, can be used to determine the odds of a good outcome from the combination of the three factors. A method is given by which the GCS score of a patient with a missing verbal response score can be accurately approximated in order to complete the chart. Among other values, the odds of a good outcome provide the clinician with a reliable measure of the relative severity of a patient's injury. The accuracy of the chart in prediction is expected to be 80% or above. PMID- 6864298 TI - The role of endothelial gap junctions in the enlargement of chronic subdural hematomas. AB - The structure of macrocapillaries (also called 'sinusoids") in the outer membrane of chronic subdural hematomas was investigated by electron microscopy, with particular attention paid to vascular permeability. One characteristic of macrocapillaries is the frequent formation of gap junctions between adjacent endothelial cells. In endothelial gap junctions 0.6 to 8 microns in diameter, numerous blood components, including red blood cells and plasma, can be seen squeezing or spilling into the interstitial space of the outer membrane. Irregularly deformed erythrocytes are located around the macrocapillaries, and amorphous material is seen among scattered thin collagen fibers. It is suggested that endothelial gap junctions of macrocapillaries play an important role in the leakage of blood, causing enlargement of chronic subdural hematomas. PMID- 6864299 TI - Changes of the blood-brain barrier in experimental metastatic brain tumors. AB - An experimental model for blood-borne cerebral metastases was developed by introducing Walker 256 carcinoma cells selectively into the intracranial internal carotid artery of rats. This model was used to study the regional capillary permeability of rat brain and metastatic brain tumors of various sizes with the aid of 14C alpha-aminoisobutyric acid (AIB) quantitative autoradiography. The regional capillary permeability varied with the anatomical location and size of the tumor. Intraparenchymal tumors less than 1 mm in diameter showed no increased permeability to AIB. As the tumors enlarged over 1 mm in diameter, the permeability in the intraparenchymal tumors increased proportionally, but remained less than one-third of capillary permeability of subcutaneously transplanted tumors. Capillary permeability in the peripheral invasive part and necrotic center was less than in the viable part of large tumors. Capillary permeability in metastatic tumors of the choroid plexus and meninges was significantly higher than in tumors of the brain parenchyma. The results suggest that the uptake of chemotherapeutic agents that do not cross the blood-brain barrier easily varies with the anatomical location and size of the metastatic tumors. PMID- 6864300 TI - Giant-cell tumor of the sphenoid bone. Review of 10 cases. AB - Giant-cell tumor rarely affects the sphenoid bone. Ten cases of this tumor seen at the Mayo Clinic are reviewed, bringing the number of cases in the world literature to 31. These tumors, which present in the second and third decades of life and are slightly more frequent in women than in men, may present with various symptoms, including headache, visual field defects, blindness, and diplopia. The symptom complex and roentgenographic findings are seldom, if ever, sufficiently characteristic to allow preoperative diagnosis. The microscopic differential diagnosis of giant-cell tumor of the sphenoid region includes giant cell reparative granuloma, aneurysmal bone cyst, fibrous dysplasia, and "brown tumor" of hyperparathyroidism. Interesting features of this series include the presence of multifocal giant-cell tumor in one case, and the absence of Paget's disease of bone in every case. Complete follow-up review in these cases allowed a discussion of therapy and prognosis; it appears that subtotal excision with postoperative radiation therapy is the treatment of choice. While the histological appearance of giant-cell tumor is characteristic, caution must be exercised in interpreting small samples, and various reparative and metabolic disorders must be considered in the differential diagnosis. PMID- 6864302 TI - Cerebellar neoplasm of mixed mesenchymal and neuroepithelial origin. Case report. AB - A 3 1/2-year-old boy had a neoplasm of mixed mesenchymal and neuroepithelial origin in the cerebellar vermis. The tumor was composed of rhabdomyosarcoma and medulloblastoma. There was additional differentiation within the neuroepithelium, including neoplastic neurons, neuroblasts, astroglia, oligodendroglia, ependymal cells as well as foci of glioblastomatous transformation. It is suggested that this combined tumor arose from the neural crest or combined neural crest and neural tube. The rhabdomyosarcoma could have arisen from the mesenchymal portion of the neural crest, and the medulloblastoma from the neuroectodermal part of the neural crest or from the neural tube itself. The two tumor types formed a neoplasm of mixed mesenchymal and neuroepithelial origin. PMID- 6864301 TI - Cerebral histoplasmoma. Case report. AB - A 55-year-old man presented with dementia and seizures of recent onset. A computerized tomography scan revealed a ring-like lesion in the left occipital lobe, which on resection was found to be a histoplasmoma. Cerebral histoplasmoma is rare and simulates a metastatic brain tumor. Only eight cases of this entity have been reported. PMID- 6864304 TI - Possible significance of juvenile oral venous angioma as marker of intracerebral vascular lesion. AB - This 10-year-old child suffered a hemorrhage into the right parietal lobe, the result of a ruptured arteriovenous angioma. From birth, the boy had a venous angioma of the mucous membrane of the cheek, lower lip, and hypoglossal area on the right side. The coexistence of these two vascular defects is most unusual, and venous angioma in early life may suggest the presence of cerebral angioma. PMID- 6864305 TI - Concurrent delayed temporal and posterior fossa epidural hematomas. Case report. AB - A case of delayed epidural hematoma presenting in two different intracranial compartments is described. The presumptive mechanism of the lesion is discussed and the value of early reevaluation by computerized tomography is stressed. PMID- 6864303 TI - Septate bifrontal ependymal cyst. Case report. AB - The authors describe the case of a septate ependymal cyst involving both frontal lobes. The clinicopathological features, treatment, and results of previously reported cases are reviewed, and the etiology and pathogenesis of these cysts discussed. PMID- 6864309 TI - Failure of Gallium-67 scintigraphy to identify reliably noninfectious interstitial nephritis: concise communication. AB - Gallium-67 scintigraphy has been reported to be useful in the diagnosis of noninfectious interstitial nephritis. We studied 12 patients with Ga-67 citrate that were diagnosed as having noninfectious interstitial nephritis on renal biopsy. Only seven of the twelve patients with interstitial nephritis on biopsy were scan-positive. Gallium-67 scintigraphy may not reliably identify noninfectious interstitial nephritis. PMID- 6864306 TI - A microsucker for use in neurosurgery. Technical note. AB - A microsucker for use in microneurosurgery is described. It has a small-caliber tip, is of light weight, and has the special feature of infinitely variable suction from zero to maximum pressure, achieved by thumb movement only. PMID- 6864308 TI - Radionuclide evaluation of left-ventricular function in chronic Chagas' cardiomyopathy. AB - Left-ventricular ejection fraction (LVEF) and abnormalities of regional wall motion (WMA) were studied by means of radionuclide ventriculography in 41 patients prospectively diagnosed as having chronic Chagas' disease. Thirteen patients were asymptomatic (ASY), 16 were arrhythmic (ARR), and 12 had congestive heart failure (CHF). Mean LVEF was normal in ASY (0.64 +/- 0.06) but markedly depressed in CHF (0.28 +/- 0.08). Regional WMAs were minimal in ASY and their severity increased in ARR. Most CHFs (75%) had diffuse hypokinesia of the left ventricle. The region most frequently affected was the infero-apical (63%). Seven patients had a distinct apical aneurysm. Correlation between radionuclide and contrast ventriculography data was good in 17 patients. For LVEF, r = 0.90. For WMA there was agreement between the two techniques in 77% of 65 segments compared. Best agreement occurred with infero-apical lesions (88%), and worst with septal (69%). Selective coronary arteriography showed normal arteries in all patients. Therefore, chronic Chagas' heart disease joins ischemic heart disease as a cause of regional WMA. PMID- 6864310 TI - A scintigraphic method for the assessment of intraluminal volume and motility of isolated intestinal segments. AB - The isolated in vivo intestinal segment is a popular experimental preparation for the investigation of intestinal function, but its value has been limited because no method has been available for measuring changes in intraluminal volume under experimental conditions. We report a scintigraphic technique for measuring intraluminal volume and assessing intestinal motility. Between 30 and 180 ml, the volume of a 75-cm segment of canine jejunum, perfused with Tc-99m-labeled tin colloid, was found to be proportional to the recorded count rate. This method has been used to monitor the effects of the hormone vasopressin on intestinal function. PMID- 6864311 TI - Bone and gallium scans in mastocytosis: correlation with count rates, radiography, and microscopy. AB - Mastocytosis (urticaria pigmentosa) was proven in a patient suffering from severe back pain. A bone scan showed diffusely increased bone activity. Count rates were also abnormally elevated over several areas of the skeleton. Radiographs were consistent with mastocytosis in bone. PMID- 6864307 TI - Value of selective spleen scintigraphy when liver/spleen image shows equivocal spleen defects: concise communication. AB - A retrospective review was performed to determine the utility of selective spleen scintigraphy (SSS) in the evaluation of equivocal defects on liver/spleen (LS) image. Six of seven questionable features on LS image were classified on SSS to be definite defects in three, and normal in three. Three of seven patients had defects on SSS that were not seen on LS image. The inability of the LS image to exclude or delineate an abnormality in the spleen was attributed to an overlying left lobe of the liver in five, and to technique in one. The SSS is a valuable diagnostic tool in the further evaluation of equivocal spleen defects on LS image, and SSS may demonstrate abnormalities not demonstrated on LS image. PMID- 6864312 TI - Bone imaging in infections: artefacts from spectral overlap between a Tc-99m tracer and In-111 leukocytes. AB - In three patients with skeletal infectious disease, scintigrams with a Tc-99m bone-seeker and In-111-tagged leukocytes, made within 24 hr of each other, showed striking similarities. In two cases, the findings from the In-111 WBC images were ultimately determined to be artefacts due to Tc-99m crosstalk within the 173-keV photopeak of In-111. In the second case, the error was traced to failure to use a pure In-111 source for energy calibration: the camera had been peaked on the radiation from the patient himself, who had had an earlier Tc-99m bone scan. PMID- 6864313 TI - In vitro transfer of Ga-67 from transferrin to ferritin. AB - Equilibrium dialysis was used to examine the binding of Ga-67 to horse spleen ferritin (HFE), and the ability of this protein to remove Ga-67 originally bound to human transferrin (TF). Seventy hours were required for the HFE to bind 70% of the activity. When HFE was placed in competition with preformed TF-Ga-67 complex, little nuclide was translocated to HFE. Upon the addition of compounds of low molecular weight that occur intracellularly, this transfer was dramatically enhanced. In the presence of 1 mM adenosine triphosphate (ATP), the most effective mediator examined, the final distribution was 17% bound to TF and 62% to HFE, with 16% not protein-bound. In the absence of any mediator, the same distribution was 84, 6, and 3%. Control experiments with ATP showed that little radionuclide was transferred from TF to albumin. These results add support to the previous suggestions of the potential role of ferritin in Ga-67 localization. PMID- 6864314 TI - Labeling with indium-111 has detrimental effects on human lymphocytes: concise communication. AB - When lymphocytes from human peripheral blood were labeled with In-111 oxinate, several of their properties appeared to be affected. The spontaneous release of the radionuclide was found to be relatively high. Labeled lymphocytes showed a decreased proliferative capacity, dependent on the dose of the label. Cytogenetic studies revealed that In-111 oxinate induces severe chromosomal aberrations. These results emphasize the need for great caution in the use of the In-111 label for studies on lymphocyte traffic in humans. PMID- 6864316 TI - Rapid digital filtering. AB - Image filtering with the larger, and potentially most valuable, digital filters is very time-consuming, thus precluding use of these filters in routine clinical applications. A recently developed algorithm for spatial-domain filtering is described, and its speed is compared with those of conventional methods with and without an array processor. Using the new Chebyshev method, a 64 by 64 pixel image can be filtered on a standard 16-bit minicomputer with filters of size 3 by 3 to 23 by 23 in 1.4-9.2 sec. The conventional spatial-domain algorithm requires 3.8-71 sec. With an array processor, filtering is accomplished in 0.19-0.54 sec. Filtering in the frequency domain requires 34 sec without an array processor and 0.12 sec with one. Thus with this new Chebyshev algorithm, clinically practical digital filtering can be performed with large filters even without an array processor. PMID- 6864315 TI - Radionuclide kinetics in MIRD dose calculations. AB - A recent case report is reviewed and an alternative model for the radionuclide kinetics is presented; it estimates in an absorbed dose differing by a factor of two from the published calculation. Both models are consistent with observed data. Within a compartment model, one may choose to monitor a compartment of interest directly, or to monitor another compartment and (indirectly) solve for the activity in the compartment of interest. Advantages and disadvantages are reviewed. PMID- 6864317 TI - Personnel exposure from flood phantoms and point sources during quality assurance procedures. AB - Nuclear medicine technologists routinely use flood phantoms containing 5 to 10 mCi (185-370 MBq) of Tc-99m to perform quality assurance tests on scintillation cameras. This paper presents the results of a study that measured the radiation exposure received by three individuals from a Tc-99m flood phantom during the daily performance of flood-field uniformity tests on three scintillation cameras. The extrapolated annual personnel exposure to the anterior trunk and the back of the hand were 172 mR and 220 mR, respectively. Additional measurements indicate that personnel performing these tests with a 10-mCi Co-57 flood disk source or a 200-muCi point source would receive approximately 25% and 1%, respectively, of the exposure from a 10-mCi Tc-99m flood phantom. These exposure levels should be considered when evaluating personnel radiation exposure in a nuclear medicine clinic. PMID- 6864318 TI - Cell labeling: radiation dose and effects. PMID- 6864319 TI - Re: Preoperative technetium-99m imaging of a substernal parathyroid adenoma. PMID- 6864320 TI - Re: Thyroid uptake measurements with I-123: problems and pitfalls: concise communication. PMID- 6864321 TI - The uncertain specific gamma-ray constant for T1-201. PMID- 6864322 TI - Relation between lung mechanics, hemodynamics and regional distribution of blood flow and ventilation in left to right intracardiac shunt. PMID- 6864323 TI - In vivo distribution of 67gallium and 111Indium complexes with transferrin: uptake by DS sarcoma tumors. PMID- 6864324 TI - An improved method for the direct determination of apparent free cortisol concentration in plasma samples. PMID- 6864325 TI - Guidelines on the provision of Nuclear Medicine services. Report of the Intercollegiate Standing Committee on Nuclear Medicine 1982. PMID- 6864327 TI - Chemical radiation protection of ovarian follicles of mice by MPG (2 mercaptopropionylglycine). PMID- 6864326 TI - Relapsing polychondritis: gallium-67 uptake in recurrent lung lesions. PMID- 6864329 TI - The effect of weight loss and weight maintenance on high density lipoprotein cholesterol and selected tissue cholesterol levels in lean and obese Zucker rats. AB - Obese and lean Zucker rats were studied to compare the effects of a 6-week weight loss regimen (period 1) and a subsequent 4-week weight maintenance period (period 2) on high density lipoprotein (HDL2, d = 1.063-1.125 g/ml) cholesterol, plasma, adipose tissue, liver, and total body cholesterol. The effects of weight loss were compared with animals not subjected to weight reduction (control, period O). Weight loss was achieved by reducing food intake below maintenance levels. Plasma cholesterol did not change significantly among the three periods in obese and lean rats. HDL2 cholesterol was higher (P less than 0.05) in obese and lean rats at period 2 compared with the other periods. Adipose tissue cholesterol (per cell) did not differ among the three periods in obese and lean rats. Liver cholesterol (milligrams/gram liver) decreased significantly (P less than 0.05) at period 1 and sustained this level at period 2 in lean rats, whereas liver cholesterol was unchanged among the three periods in obese rats. Carcass cholesterol (milligrams/gram carcass) in obese rats increased significantly (P less than 0.05) after period 1 and sustained this level after period 2. Carcass cholesterol concentration was unchanged in lean rats. These data suggest that consideration must be given to homeostatic mechanisms of carcass and liver cholesterol concentrations in studies examining changes in plasma HDL2 cholesterol levels. PMID- 6864328 TI - Transketolase, pyruvate and oxoglutarate dehydrogenase activities and [14C]thiamin turnover in tissues of mice fed thiamin-deficient diet. AB - A study was made of turnover of [14C]thiamin (5 or 2 micrograms/mouse) in mice fed a thiamin-deficient diet. Simultaneously the activities of the thiamin dependent enzymes (transketolase, pyruvate and oxoglutarate dehydrogenases) were measured as an index of efficiency of fulfilling the coenzyme function of the vitamin under conditions of different thiamin status. After [14C]thiamin injections of 5 micrograms/mouse, kidney, spleen, stomach and pancreas tissue stores turned over completely on day 9, whereas by day 13 this process had not yet been finished in liver, heart and brain. On administration of 2 micrograms [14C]thiamin/mouse, turnover of the tissue stores proceeded at a slower rate. The tissue transketolase activity decreased after the 2-microgram injections as compared to that in the mice administered 5-microgram injections. With 2 micrograms of [14C]thiamin, the pyruvate dehydrogenase activity lowered gradually in all the tissues studied, whereas the oxoglutarate dehydrogenase decreased in liver and kidneys. The pattern of the depression of the thiamin-dependent enzyme activities after the 2-microgram [14C]thiamin injections suggests a regularity in the vitamin redistribution in different organs and subcellular fractions. PMID- 6864330 TI - The effect of interactions between dietary egg white protein and zinc on body weight, bone growth and tissue trace metals in the 30-day-old rat. AB - Nine groups of 30-day-old rats were fed different diets, which contained 8, 15 or 20% egg white (equivalent to 6.0, 11.3 and 15.0% protein, respectively) each at 3 levels of zinc (6, 12 and 18 ppm zinc) for 30 days. The rats consuming the 6.0% protein, regardless of zinc intake, gained less weight than the groups fed 11.3 or 15.0% protein. Plasma zinc was not influenced by dietary egg white protein content, whereas, plasma zinc levels were lower in the rats fed 6 ppm dietary zinc compared to those fed 12 or 18 ppm zinc. Of the liver trace metals measured, only iron appeared to be influenced by an egg white protein-zinc interaction. Increasing dietary egg white protein led to increased concentrations of liver zinc and magnesium. Dietary zinc levels had no effect on the concentration of these metals in the liver. Liver calcium and copper concentrations were not significantly influenced by either dietary zinc or egg white protein. Femur weights and lengths were lower in the rats fed 6.0% than in those fed 11.3 or 15.0% protein diet but were unaffected by dietary zinc. Femur width was related to dietary protein and zinc. Dietary protein and zinc were interrelated in their affect on femur zinc levels. Femur zinc concentrations increased with increasing dietary zinc levels. Also femur zinc levels decreased with increasing dietary protein content. Other femur metal (copper, iron and calcium) concentrations were higher in rats fed the low level versus the higher levels of protein, but were not influenced by dietary zinc. These results show that dietary zinc and egg white protein are interrelated with regard to their effect on body and femur growth and tissue trace metal content. PMID- 6864331 TI - Effects of bone fracture and starvation-refeeding on lipogenesis in rats. AB - The effects of trauma and/or starvation-refeeding on lipogenesis in rats was studied. Male Sprague-Dawley rats were subjected to fracture of the right femur and either ad libitum fed or starved for 48 hours and refed a 65% glucose diet for 48 hours. Lipogenesis was assessed in terms of glucose-6-phosphate dehydrogenase activity or the incorporation of 3HOH into lipids by liver and adipose tissue. Traumatized rats differed little from control rats in their lipogenic activity, whereas starved-refed and starved-refed-traumatized rats had greatly increased lipogenic activities. These results suggest that the fatty liver that frequently develops as a consequence of trauma in humans may be due to their decreased food intake rather than to the trauma itself. PMID- 6864332 TI - Effect of sucrose or starch feeding on the hepatic mitochondrial activity of BHE and Wistar rats. AB - The hypothesis that the effects of dietary sucrose on hepatic lipogenesis could be explained by an effect on mitochondrial respiration was tested. Two groups of male BHE and Wistar rats were fed, from weaning, either a 65% starch or a 65% sucrose diet. Rats were killed at 50-60 days of age by decapitation, and hepatic mitochondria were isolated. Simulated state 3 and state 4 respiration with succinate, pyruvate, or alpha-ketoglutarate as substrates was determined as were the activities of the alpha-glycerophosphate and malate-aspartate shuttles. Mitochondria from Wistar rats had higher ADP:O ratios than BHE rats for all three substrates. Respiratory control ratios with succinate or alpha-ketoglutarate as the substrates were affected by both diet and strain. Respiratory control ratios with pyruvate as a substrate were affected by diet such that sucrose feeding lowered the respiratory control ratio in both BHE and Wistar rats. Shuttle activities were not as markedly affected by strain or diet. We conclude that mitochondrial respiration may be more sensitive to dietary manipulation than mitochondrial shuttle activity. PMID- 6864333 TI - Absorption of zinc by the rat ileum: effects of histidine and other low-molecular weight ligands. AB - The role of certain amino acids, dipeptides and organic acids as ligands to facilitate the intestinal absorption of zinc was investigated by using an in vivo procedure on ileal segments of adult rats. Ligand:zinc ratios equal to or less than 3:1 were optimal for amino acids and dipeptides such as L-glutamate, glycine, L-histidine, L-tryptophan and glycylglycine. An excess of ligand reduced zinc absorption. At a 130:1 L-histidine:zinc ratio the absorption of zinc was less than one-fourth that obtained at a 3:1 ratio. Picolinate was a less effective ligand. The kinetics of the complex L-histidine:zinc at a 2:1 ratio and at pH 7.5 were determined in the absence and presence of a 20 mM excess of amino acid in a zinc concentration range between 0.038 mM and 6.00 mM. In both cases the Vmax was 2200 pmol/(minute . cm), but the Kt increased from 0.54 mM to 1.46 mM in the presence of the L-histidine excess. These data suggest a competitive inhibition of the L-histidine:zinc complex by the amino acid. Such an effect was dependent on the stereoisomerism of histidine, since the unnatural D-isomer was far less effective than the natural L-isomer in facilitating zinc absorption. The presence of an intact protein (bovine serum albumin) sharply decreased the ileal absorption of the L-histidine:zinc complex. PMID- 6864334 TI - Effects of variation in the dietary supply of cysteine and methionine on liver concentration of glutathione and "active sulfate" (PAPS) and serum levels of sulfate, cystine, methionine and taurine: relation to the metabolism of acetaminophen. AB - Amounts of the sulfur-containing amino acids methionine and cysteine in synthetic diets were decreased from 22.8 mmol methionine (= 100 Met) and 26.4 mmol cysteine (= 100 Cys) per kilogram diet in the control group to (Met/Cys) 100:0, 75:0, 50:0, 25:0 and 25:25, respectively, in experimental diet groups, in order to evaluate effects of limiting sulfur supply on the availability of cosubstrates for conjugation. Below a Met level of 22.8 mmol/kg growth rates decreased. Urinary excretion of inorganic sulfate decreased to 10-20% of control values in all groups. Feeding diets 100:0 and 75:0 for 14 days resulted in a decrease of the concentration of inorganic sulfate in serum; on diets 25:25 and 25:0 an increase was found. A decreased content of methionine/cysteine resulted in an increase in cystine, a decrease in taurine and no change in methionine concentration in serum. In all experimental groups the glutathione concentration in the liver diminished to about 20% of control values, and the hepatic concentration of "active sulfate" (PAPS: adenosine 3'-phosphate 5' phosphosulfate) decreased in most rats. At the lowest methionine supply, sulfate conjugation of acetaminophen decreased to 50% of control. The formation of the acetaminophen glutathione conjugate remained unaffected, in spite of a decreased hepatic glutathione availability. PMID- 6864335 TI - Long-term effects of excess protein and phosphorus on bone homeostasis in adult mice. AB - In adult human subjects, an interaction between dietary protein and phosphorus has been reported, in which the hypercalciuric effect of excess protein is counteracted by the hypocalciuric effect of phosphorus, with restoration of calcium balance. In adult rodents, bone homeostasis is maintained over a wide range of protein intakes, whereas high phosphorus diets cause bone loss, despite their hypocalciuric effect, as the result of an overriding increase in the excretion of endogenous fecal calcium. The present study was designed to determine whether there is an interaction between dietary protein and phosphorus with respect to bone homeostasis in adult mice. Four-month-old 45Ca-labeled B6D2F1 female mice were fed for 52 weeks the following diets (in percent): control, Ca, 0.6; P, 0.3; protein, 15; high P, Ca. 0.6; P, 1.2; protein, 15; high protein, Ca, 0.6; P, 0.3; protein, 30; and high P + high protein, Ca, 0.6; P, 1.2; protein, 30. Urinary calcium was persistently increased in the high protein group, depressed in the high P group and transiently depressed in the high P + high protein group. Excess dietary protein prevented phosphorus-induced kidney calcinosis. 45Ca loss was increased in the high P groups, but not in the high protein group. There were significant decreases in the mass of the femurs and tibias in both high P groups, whereas there was no effect of high protein intake. These results show that bone homeostasis in adult mice is sensitive to excess dietary phosphorus but not to excess protein, and that there is no interaction between these nutrients with respect to their effects on bone. PMID- 6864336 TI - Role of corticoids independent of food intake in premature increase of pancreatic enzyme activities following early weaning in rats. AB - The effects of early weaning and food deprivation on the development of pancreatic exocrine enzymes were compared in a rat model. Suckling rats, 15 days old, were weaned onto powdered laboratory diet. Within 24 hours, early weaned rats increased their pancreatic enzyme activities with amylase increased to twice that of the continuous suckling nonweaned littermates. During this period, early weaned rats lost weight and pancreatic growth ceased. Suckling rats of the same age (15 days old), when fasted or injected with hydrocortisone had similar increases in pancreatic enzyme activities within 24 hours. Serum corticosterone levels were increased in early weaned and fasted rats to three to four times that found in continuously suckling littermates. An additional 48 hours of treatment (up to day 18) maintained the high pancreatic enzymes in fasted and early weaned rats. These results show that the increase in pancreatic enzyme activities following early weaning was independent of food intake. The close relationship between serum corticosterone levels and pancreatic enzyme activities together with the ability of hydrocortisone to induce pancreatic enzyme concentrations in pups of the same age suggests the involvement of corticosteroid as a mediator of pancreatic development in early weaning. These experiments demonstrated the importance of endocrine factors in the pancreatic "adaptive" response to early weaning in the rat, and further emphasized the importance of evaluating endocrine changes following any nutritional alterations during the development period. PMID- 6864337 TI - Energy balance, diet-induced thermogenesis and brown adipose tissue in lean and obese (fa/fa) Zucker rats after adrenalectomy. AB - Five-week-old male, lean (+/?) and genetically obese (fa/fa) Zucker rats received either bilateral adrenalectomy or sham operations, and energy balance was measured over the subsequent 21 days. Body weight and energy intake were similar for intact lean and obese rats, but the latter group showed a marked increased in body energy gain and energetic efficiency, and reduced energy expenditure. Adrenalectomy did not significantly influence energy balance in lean rats but caused decreases in food intake and body weight gain in obese rats, and restored their energetic efficiency and body energy gain to the level of lean animals. The lower thermic response to a single meal (40 kJ) in intact obese rats was restored to normal by adrenalectomy. Brown adipose tissue (BAT) mass was larger in sham operated obese rats, but tissue protein concentration, mitochondrial yield and mitochondrial GDP binding were all markedly reduced in obese rats. BAT mass, composition and GDP binding were almost identical in adrenalectomized obese and all lean rats. These findings demonstrate that the reduced fat deposition in Zucker rats after adrenalectomy is mainly due to the large decrease in the efficiency of energy utilization associated with a restoration of brown fat activity. PMID- 6864338 TI - Comparison of heat production of chickens measured by energy balance and by gaseous exchange. AB - An open-circuit respiration calorimeter suitable for chickens or other small animals has been constructed. The system contains two animal chambers and is capable of determining heat production of two animals or groups of animals independently and simultaneously with gas collection apparatus for continuous sampling of chamber gases. The operation of the system was tested in two experiments by determining heat production of two groups of 10-week-old, full-fed cockerels over a 4-day period both by energy retention (body balance) and gaseous exchange. Heat production (kilocalories per bird per 24 hours) as determined by energy balance versus gaseous exchange was 359 versus 348 in one experiment and 395 versus 393 in the other. The agreement was sufficiently close to support the use of respiration calorimetry to measure heat production of chickens under experimental conditions in this laboratory without killing the experimental subjects. On the basis of metabolic body weight (in kilograms, W0.75) heat production measured in this manner was 161 and 173 kcal (day . W0.75) in experiments 1 and 2, respectively. PMID- 6864339 TI - Dietary NaCl loads promote calciuria and bone loss in adult oophorectomized rats consuming a low calcium diet. AB - This study was undertaken to determine whether dietary supplements of NaCl would exaggerate osteopenia in oophorectomized (OOPX) rats consuming a low calcium (0.01% Ca) diet. Thirty 300 g OOPX rats with 45Ca-labeled bones were studied. Animals in group 1 were killed at the start of the experiment, whereas those in groups 2 and 3 were fed a low calcium diet for 2 months. Group 3 rats received NaCl (8 g/100 g diet). Salt increased the urinary excretion of sodium, calcium, phosphate, cyclic AMP, 45Ca and hydroxyproline but did not augment fecal excretion of calcium or 45Ca. Salt caused bone loss. The femora of NaCl-treated rats contained less 45Ca, less calcium, less phosphate and less mineral ash than those of rats killed at the start of the experiment. It is suggested that in OOPX rats consuming a low calcium diet, increased NaCl intake causes decreased renal tubular reabsorption of calcium and consequently lowered plasma Ca++. This results in stimulation of parathyroid hormone secretion and thus increased bone resorption. We conclude that NaCl supplements exacerbate osteopenia in adult OOPX rats consuming a low calcium diet. The effects of high dietary salt intakes on bone loss in postmenopausal women deserve further study. PMID- 6864340 TI - Influence of dietary protein type on the immune system of mice. AB - The effect of graded amounts of dietary lactalbumin (L), casein (C), soy (S), wheat (W) protein and Purina rodent chow (stock diet) on the immune responsiveness of C3H/HeN mice has been investigated by measuring the specific humoral immune response to sheep red blood cells (SRBC), and horse red blood cells (HRBC) as well as the nonspecific splenic cell responsiveness to phytohemagglutinin (PHA) and concanavalin A (Con A) after stimulation with Mycobacterium bovis, strain BCG. The nutritional efficiency of these diets was normal and similar. The immune response of mice fed the L diets, was found to be almost five times higher than that of mice fed the corresponding C diets. The humoral immune response of mice fed C, S, and W diets was substantially lower than that of mice fed stock diet, whereas that of mice fed L diet was higher. The above-described immune effect of all tested proteins was obtained at 20 g/100 g concentration with no further increments with 30- and 40 g/100 g protein in the diet. Mitogen responsiveness to PHA and Con A in L diet-fed mice was only slightly higher than that of C diet-fed mice. Little difference in immune responses was noted among mice fed C, S or W protein diets. The principal factor responsible for the observed immune effect does not appear to be the availability or concentration of single essential amino acids but rather the composite effect of the specific amino acid distribution in the protein. PMID- 6864341 TI - Zinc transport by brush border membrane vesicles from rat intestine. AB - Zinc uptake into isolated brush border membrane vesicles from rat intestine was investigated by using a rapid filtration technique. Uptake was saturable at 0.2 mM extravesicular zinc, while at 1.0 mM zinc uptake was nonsaturable. ATP and Na+ did not stimulate uptake. Some binding of zinc was noted at zero intravesicular space indicating some membrane binding may occur during transport. Initial rates of uptake were linear up to 0.3 and 0.45 mM extravesicular zinc with vesicles prepared from rats fed adequate and deficient amounts of zinc, respectively. Kinetic analysis of uptake data yielded a Km of 0.38 mM and Jmax of 5.4 nmol X minute-1 X mg protein-1 with vesicles from zinc-adequate rats. With vesicles from zinc-depleted rats the Km was 0.44 mM and Jmax was 12.0 nmol X minute-1 X mg protein-1. These uptake data suggest the brush border membrane transport system for zinc is influenced by zinc status. PMID- 6864342 TI - Influence of maternal magnesium deficiency on tissue lead content of rats. AB - Diets containing 150 or 600 ppm magnesium with or without 200 ppm lead were fed to rats throughout gestation and lactation to determine the influence of moderate magnesium deficiency on tissue lead content of maternal and offspring tissue. During lactation it was necessary to increase the lowest dietary magnesium level to 225 ppm. Lead caused a significant depression in both gestational weight gain and average pup weight regardless of the level of dietary magnesium. Maternal magnesium deficiency was evidenced by significant reductions in serum and tibia magnesium, a 17-fold increase in kidney calcium, and hyperemia of the ears. In offspring, however, only growth and tibia magnesium were significantly affected by the magnesium deficiency, and the maternal-fetal difference in serum and tibia magnesium concentration was maintained. Maternal magnesium deficiency resulted in significantly higher lead concentrations in dam liver, and offspring erythrocytes, liver and tibia. A mechanism for the enhanced accumulation of lead in maternal and offspring tissue as a result of maternal magnesium deficiency is not defined, but it is likely to involve enhanced intestinal lead absorption. PMID- 6864343 TI - Comparative aspects of dietary copper and zinc deficiencies in pregnant rats. AB - The utilization and distribution of copper during dietary copper deficiency was studied in the pregnant rat, and the effects of maternal copper deficiency on fetal development were compared with those of maternal zinc deficiency. Sprague Dawley rats were fed from mating to term (per gram diet): 1) a control diet (10 micrograms copper, 100 micrograms zinc) or 2) a copper-deficient diet (0.7 micrograms copper, 100 micrograms zinc) or 3) a zinc-deficient diet (10 micrograms copper; 0.7 micrograms zinc). Dams fed the copper-deficient diet deposited only 15.5% of the dietary copper consumed during pregnancy into the products of conception (fetuses, uterus and placentas); in comparison dams fed the zinc-deficient diet deposited more zinc into their litters than was consumed (240%). Copper concentration in the fetuses of copper-deficient dams was 30% of that of controls, but the size and number of live fetuses was unaffected. The zinc concentration of the zinc-deficient fetuses was 78% of that of the controls, and both the size and number of live fetuses were considerably lower than normal. Accumulation of copper in the products of conception may be accounted for by dietary copper intake, whereas accumulation of zinc in fetuses of zinc-deficient females is dependent in part on catabolism of maternal tissues. PMID- 6864344 TI - Effects of aging on intracellular transport of vitamin B12 (B12) in rat enterocytes. AB - To elucidate the effect of aging on the vitamin B12 (B12) transport in enterocytes, young and old (3-4 months and over 1.5 years, respectively) female rats were studied. Two units of rat intrinsic factor (IF), saturated with 57Co labeled cyanocobalamin were orally administered, and the amount of B12 absorbed into each subcellular fraction of enterocytes was assayed. Concentration of endogenous B12 in each subcellular fraction was also studied. Absorption of radioactive B12 in the lysosomal fraction was maximum between 2 and 4 hr in each age group. In the older rats, the amount absorbed was lower than in the young rats. The older rats showed a significantly lower value of endogenous B12 in the mitochondria. It has already been reported by us that there exist two B12 binders in enterocytes: lysosomal and microsomal binders. The concentrations of lysosomal and microsomal binders as well as B12 uptake in the mitochondria were significantly lower in the older rats than in the young rats. These data might help to explain the lower B12 absorption in the lysosomal fraction and lower B12 contents in the mitochondrial fraction. PMID- 6864346 TI - Effects of the long-term (7-9 months) feeding of iodine-enriched eggs on lipid metabolism of rats. PMID- 6864345 TI - Dietary effect of omega-3 type polyunsaturated fatty acids on serum and liver lipid levels in rats. AB - The dietary effect of omega-3 type highly polyunsaturated fatty acid concentrate (PUFA mix) was investigated on cholesterol and triglyceride levels in the serum and liver, and high density lipoprotein cholesterol (HDL-cholesterol) levels in the serum. The PUFA mix prepared from squid liver oil contained about 75% of total omega-3 type fatty acids. In rats fed the normal diet to which 3% PUFA mix was added, the levels of triglyceride, total cholesterol and phospholipid in the serum markedly decreased as compared to rats fed a 3% methyl-oleate diet. However, lipid peroxide values in the liver and serum increased in rats fed PUFA mix-diets. In the hypercholesterolemic rats, a 5% PUFA mix-diet caused growth retardation and a corresponding reduction in food intake. Lipid peroxide in the liver and serum were more elevated in rats fed diets containing 1, 3 and 5% PUFA mix than in rats fed diets containing 5% oleate or 5% linoleate. In all the rats on PUFA mix-diets, there were depression of serum total cholesterol and elevation of serum HDL-cholesterol. The ratio of HDL-cholesterol to total cholesterol increased in proportion to the amounts of dietary PUFA mix. Total cholesterol level in the liver was depressed after PUFA mix feeding. PMID- 6864347 TI - Hypocholesterolemic effect of triterpene alcohols with soysterol on plasma cholesterol in rats. AB - To identify the synergistic hypocholesterolemic substance found in soybean oil unsaponifiable matter, rats were fed diets containing various fractions of the unsaponifiable matter prepared by silicic acid column chromatography. The plasma cholesterol level of the group fed the alcohol fraction, which mainly consisted of triterpene alcohols, was significantly lower and the effect was synergistic with soysterol. So the effect of cycloartenol and 24-methylenecycloartanol, which are main constituents of triterpene alcohols in soybean oil unsaponifiable matter, was investigated. Both compounds were prepared from gamma-oryzanol (ferulate) and were added (0.05%) respectively to the experimental diet containing 0.5% cholesterol and 1% soysterol. It was observed that both cycloartenol and 24-methylenecycloartanol in combination with soysterol greatly reduced the plasma cholesterol and enhanced cholesterol excretion. This suggests that the hypocholesterolemic activity of dietary vegetable oils may account for not only their fatty acid compositions and sterol contents but also the synergistic hypocholesterolemic effect of triterpene alcohols. PMID- 6864348 TI - Enhanced glycogen repletion in liver and skeletal muscle with citrate orally fed after exhaustive treadmill running and swimming. AB - A possibility whether an oral feeding of citrate, which has been reported to inhibit phosphofructokinase in vitro, following exercise to exhaustion could increase the rate of glycogen repletion in liver and soleus muscle was tested in treadmill running trained (experiments 1 and 2) and swimming trained rats (experiment 3). An exhaustive running or swimming was loaded at the end of the experiments, resulting in a significant reduction in liver and soleus muscle glycogen stores. The feeding of 1.0 and 0.5 g of citrate per kg of body weight just after the exhaustive running could significantly increase the liver glycogen repletion during a 2-hr recovery period, but this was not observed in soleus muscle (experiment 1). As compared with a single feeding of 3.3 g of glucose per kg of body weight, a mixed feeding of 0.5 g of citrate and 3.0 g of glucose after an exhaustive running (experiment 2) and swimming (experiment 3) could significantly enhance the repletion of glycogen stores in both liver and soleus muscle. These results clearly indicate that the postexercise feeding of citrate can stimulate the glycogen repletion in liver and skeletal muscle during an early period of recovery. PMID- 6864350 TI - Difference in the inductions of duodenal alkaline phosphatase by casein feeding and by starch feeding. AB - Feeding of starch or casein to rats that had been starved for 4 days resulted in marked increase in duodenal alkaline phosphatase activity in a few hours. In rats with a duodenal blind loop, the enzyme was induced by feeding starch, but not casein. Conditions leading to hyperglycemia, such as an intragastric administration and an intravenous infusion of glucose, induced duodenal alkaline phosphatase to the same extent and in the same period as starch feeding. Subcutaneous injection of insulin alone did not induce the enzyme. In chemically sympathectomized rats, the enzyme was induced by starch feeding. In vagotomized or hexamethonium-treated rats, the enzyme was not induced by starch feeding or intragastric administration of glucose solution. On the contrary, subcutaneous injection of carbachol alone induced the enzyme. These results suggest that stimulation of the parasympathetic nervous system via hyperglycemia is important for induction of duodenal alkaline phosphatase by starch feeding. The mechanism of enzyme induction by casein feeding is still unknown. PMID- 6864349 TI - Toxic effects of Kintoki bean (Phaseolus vulgaris) lectin on cultured animal cells. AB - Effects of a toxic lectin from Kintoki beans (Phaseolus vulgaris, cultivar, Kintoki) on four types of animal cells were investigated. The cells used in this study were mouse L 929, human HeLa S3, and tendon and liver cells from chick embryo. The Kintoki bean lectin agglutinated these cells not only in suspension but also in monolayer, resulting in the marked growth inhibition of these cells. The incorporations of 3H-thymidine and 3H-leucine into trichloroacetic acid insoluble fraction of the cells were considerably inhibited by this lectin. There was, however, some lag period before the revelation of the inhibition. Kintoki bean lectin bound to these cells within 1 hr. The type of the lectin receptor seemed uniform for each cell type and the number of the binding sites per cell was different from cell type to cell type. When Kintoki bean lectin was removed from the culture medium, these cells slowly recovered back to normal growth. PMID- 6864351 TI - Memory of the rhythmic change in activity of duodenal alkaline phosphatase in rats. AB - Studies were made on memory of the rhythmic change in activity of duodenal alkaline phosphatase in rats. During starvation, the peak enzyme activity decreased gradually disappearing in 4 days. The peak activity of duodenal alkaline phosphatase was retained by feeding starch diet for 4 days instead of starvation for 4 days, but not by feeding casein diet for the same period. Starvation for one day after feeding casein diet for 4 days resulted in disappearance of the peak activity. However, the peak activity was still retained after one day of starvation after 4 days on starch diet. Therefore, starch feeding appears to be important in the memory of the rhythmic change in activity of duodenal alkaline phosphatase. PMID- 6864352 TI - Convergence accommodation. AB - Steady-state accommodation responses were measured in both eyes as a function of vergence angle and direction of lateral gaze. The measurements were made with a binocular laser optometer. Small speckle patterns were used as fusional stimuli in an otherwise dark field. These patterns have the advantage of providing no blur stimulus to accommodation. Convergence accommodation for vergence angles ranging from 0 to 25 deg was measured for lateral-gaze angles of +32, -32, and 0 deg. The average accommodation of the two eyes was linearly related to vergence angle over the observer's accommodation range but was independent of the angle of lateral gaze. The mean convergence accommodation/convergence ratio for three subjects, in diopters per meter-angle, was 0.9. Our measurements of convergence accommodation using laser-speckle targets are in good agreement with previous studies that used small pupils. Accommodation responses for binocular viewing of letters of a Snellen chart were also measured. When luminance was reduced, night myopia was observed. No similar effect was found for convergence accommodation. Accommodation to a dim target corresponded closely to the convergence accommodation. PMID- 6864353 TI - Information in optical flows induced by curved paths of observation. AB - For a moving observer it is essential to foresee the locomotor course with respect to structures in the environment. Optical flows that are available to a moving observer contain powerful information for visual kinesthesis. In general, optical flows consist of separable translational and rotational components. The information examined here is contained completely in the translational component and its time derivatives. Curved paths of observation are specified by different orientations of the translational components of optical velocity and acceleration fields. Obstacles and their temporal separation from a curvilinearly moving observer are specified in the optical flow, as is the angle of collision. PMID- 6864354 TI - Time thresholds for increments and decrements in luminance. AB - Time thresholds, i.e., the minimal durations necessary to just detect a change in brightness, were measured for light increments and decrements of a 1 degree test spot centered on a background of 20 degrees. Background luminance varied from -1 to 3 log td and retinal eccentricity from 0 degree to 50 degrees. Step size ranged from 0.04 to 1.5 log units and was the same in absolute units for both directions. Two types of stimuli were used: Type A, in which increments and decrements emerge from the same uniform background, and Type B, in which increments are the same as in Type A but decrements consist of a brief interruption of the test spot. Type A stimulation resulted in similar time thresholds for increments and decrements or, under some conditions, slightly shorter decrement thresholds. Type B stimulation resulted in similar thresholds for foveal vision. However, with increasing step size, decreasing background luminance, and increasing eccentricity, the time threshold for the decrement progressively exceeded that for the increment (up to 80 msec). This difference is attributed to different rise and fall times of the photoreceptor response as well as to Troxler's effect. PMID- 6864356 TI - Suprathreshold spatiotemporal response characteristics of the human visual system. AB - The apparent contrasts of suprathreshold stationary gratings, countermodulated gratings, and homogeneous flickering fields were assessed with a contrast matching procedure. Results show that, as stimulus amplitude is increased relative to threshold, variations in apparent contrast with spatiotemporal frequency content become much less pronounced. In other words, the contrast matching functions are more uniform across both spatial and temporal frequency at levels of contrast well above threshold. These data are interpreted in terms of a compensatory stage in the visual system that varies its gain characteristics according to the detectability of the stimulus. PMID- 6864357 TI - Effect of conicoid asphericity on the Tscherning ellipses of ophthalmic spectacle lenses. AB - One of the criteria in ophthalmic spectacle lens design is the elimination of oblique astigmatism. For a range of equivalent powers, Seidel (primary or third order) astigmatism can be eliminated, and the solutions of back- (or front-) surface power are commonly displayed graphically in the form of ellipses (Tscherning ellipses). The Tscherning ellipses apply only to lenses constructed from spherical surfaces. If one or both surfaces are made aspheric, the solutions for zero astigmatism are no longer in the form of ellipses. If one surface, usually the front surface, is made as a conicoid aspheric, the solutions for zero astigmatism can be presented graphically similarly to the Tscherning ellipses. For any given equivalent power, there are two or no solutions for spherical lenses. However, there is always one and up to three solutions for conicoid aspheric lenses. PMID- 6864355 TI - Sensitivity to countermodulating gratings following spatiotemporal adaptation. AB - Contrast sensitivities to countermodulating gratings were measured with a two alternative temporal forced-choice procedure following adaptation to a static grating of the same spatial frequency, a homogeneous flickering field of the same temporal frequency, or a countermodulating grating of identical spatial and temporal frequencies. At high spatial frequencies, the temporal-frequency content of the adaptation was not critical, that is, a countermodulating adaptation grating was only slightly more effective at raising threshold than was a static adaptation grating. At low spatial frequencies, the sensitivity to countermodulating test gratings could not be reduced by either a high-contrast stimulus matching the test in the spatial domain only or by one matching the test in the temporal domain only. Adapting to a high-contrast stimulus matching the countermodulating test grating in both spatial- and temporal-frequency domains was effective at reducing test sensitivity for one observer but not for another. PMID- 6864358 TI - Health care priorities in high-need populations. PMID- 6864359 TI - Medical manpower in Oklahoma in the decade of the eighties. PMID- 6864360 TI - A performance evaluation of the microbiology and immunology course for second year medical students. PMID- 6864361 TI - [Bell's palsy and stapedius reflex. 1. Prognosis based on the presence or absence of the reflex or its restoration]. PMID- 6864362 TI - [Aging changes in the human inferior nasal turbinate--a histopathological study]. PMID- 6864364 TI - [Carcinoma of the nasal cavity and paranasal sinuses except the maxillary sinus- a clinical statistical observation]. PMID- 6864365 TI - [A rare case of choristoma of the external auditory canal--clinical, histopathological and scanning electron microscopic studies]. PMID- 6864366 TI - [Metastasizing neck cancer with unknown primary sites--with special reference to its therapeutic guidelines]. PMID- 6864363 TI - [Statistical analysis of malignant melanoma of nasal cavity and paranasal sinuses in Japan]. PMID- 6864367 TI - [Modification of saccade by various central nervous system dysfunctions: comparative analysis of saccade, smooth pursuit and optokinetic nystagmus in patients with central nervous system disorders]. PMID- 6864368 TI - The effects of maternal influenzal viraemia in late gestation on the conceptus of the pregnant ferret. AB - Pregnant ferrets were inoculated intra-cardially on day 30 of gestation with influenza virus. The animals were sacrificed on days 5 to 11 after inoculation and the products of conception including the uterus were examined virologically and histopathologically. The results indicate that the initial site of infection of the conceptus is the haemophagous organ and that spread occurs from this site to the endometrium, placental labyrinth and fetus. Lesions in the fetus are confined to the liver and respiratory tract. In the liver they may represent either a viral hepatitis or a secondary response to placental damage resulting in the stimulation of erythropoiesis. In the respiratory tract they first occur in the nasal sinuses and upper airways suggesting that infection is via the amniotic fluid rather than via the blood stream. The relevance of these findings to human pregnancy is discussed. PMID- 6864369 TI - Lymph node hypervascularity: haemangiomatoid lesions and pan-nodal vasodilatation. AB - A retrospective survey to study vascular abnormalities was conducted on 1073 lymph nodes from 250 patients. Two haemangiomatoid lesions, found in axillary lymph nodes, are described. They are uncommon, localised lesions which appear to be associated with local malignancy. A more frequent vascular abnormality was pan nodal vasodilatation, which tends to affect many nodes in a single group and is especially associated with ulcerative colitis. Both types of lesion appear to be reactive in nature. Their characteristics suggest responses to different stimuli. PMID- 6864370 TI - Tissue culture of guinea-pig gall-bladder epithelium. AB - Tissue culture of gall-bladder was attempted in the following media: Dulbecco, Eagle's minimum essential medium, NCTC 135, medium 199 and Ham's F12. Growth occurred in all of them for up to 2 weeks assessed by light microscopy. No enhancement of growth was induced by collagenase trypsin insulin or hydrocortisone. Scanning electron microscopy confirmed that new cells colonised the free surface of the explant. Transmission electron microscopy showed good preservation of the original tall epithelial cells for the period of study. The new migrating cells were flatter, but retained the morphological features of the columnar cells. Secretory granules were absent after 1 day in culture but increased amounts of glycogen and lipid began to appear in the epithelium. PMID- 6864372 TI - Membrane-bound structures at the interface between tumour and dermis in basal cell carcinoma. An ultrastructural study. AB - During an ultrastructural study of the interface area between tumour and dermis in 23 basal cell carcinoma (BCC), membrane-bound structures were noted in the dermis adjacent to the basal lamina in 12 tumours (52 per cent), but none of the controls. Serial sectioning demonstrated cytoplasmic connections between these structures and tumour cells. Their formation and interaction with adjacent stromal cells is discussed. PMID- 6864371 TI - Peritoneal cell responses to acute gastro-intestinal inflammation. AB - Cell changes in the peritoneal exudate induced by an acute localised inflammation due to a small intestinal anastomosis have been studied. The maximum response occurs on the second day. The neutrophil polymorphonuclear leucocyte output on the second is seven times greater in the peritoneal exudate than in the effluent lymph from the gastro-intestinal tract. The fate of the inflammatory cell response of the peritoneal exudate has been studied using thymidine-labelled cell transfer experiments. Some neutrophil polymorphonuclear leucocytes and eosinophils are phagocytosed by monocyte/macrophage cells in the peritoneal cavity. The majority of the neutrophil polymorphonuclear leucocytes and eosinophils migrate through diaphragmatic "stomata" to the parathymic lymph glands via the mediastinal lymphatics. PMID- 6864373 TI - Growth achievement in low-birth-weight premature infants: relationship to neurobehavioral outcome at one year. AB - Previously published studies present conflicting conclusions about the growth of small, premature infants. To provide further data on these infants, a well defined group of 86 premature infants appropriate for gestational age, weighing less than 1501 gm at birth, was observed until 12 months after their expected dates of delivery. Length, weight, and head circumference were measured at one, three, six, nine, and 12 months postterm. At 12 months postterm, infants were evaluated by neurologic examination and the Bayley Scales of Infant Development. Premature infants with mean Bayley scores greater than or equal to 85 were found to be significantly larger than infants with mean Bayley scores less than 85 by three months postterm. Birthweight, gestational age, duration of hospitalization in the neonatal intensive care unit, pneumonia, hypoglycemia, perinatal neurologic impairment, acidosis, and hypoxemia were found to be associated with reduced growth at one year. Conflicting results in previous studies may be a result of failure to separate infants with good neurobehavioral outcome from those with poor outcome. PMID- 6864374 TI - Use of nerve conduction velocity to determine gestational age in infants at risk and in very-low-birth-weight infants. AB - Nerve conduction velocity was used to measure gestational age in at risk and very low-birth-weight neonates. The method gave highly significant correlations with gestational estimates by the Dubowitz score and with confirmed maternal dates; 86% of the estimates agreed within two weeks with confirmed maternal dates. The method is valid in babies 30 weeks old or younger and is reproducible after the first postnatal week. There was no difference in babies small for gestational age. The technique was estimated to predict gestation with a standard deviation of +/- 1.14 weeks. PMID- 6864376 TI - Management of persistent pneumothorax: an innovative approach. PMID- 6864377 TI - Dose-response characteristics of nebulized fenoterol in asthmatic children. AB - Fenoterol hydrobromide, a beta 2-selective bronchodilator, was administered by aqueous nebulization to 31 children with stable asthma. An initial comparison of 0, 100, 300, and 1000 micrograms drug in 20 of these patients showed a significant change in forced expiratory volume in 1 second for all three doses compared with change after placebo (P less than 0.0001). However, the differences in peak pulmonary response from 100 to 1000 micrograms were not large (P greater than 0.2). Assessment of spirometric responses of 11 children to 3, 10, 30, or 100 micrograms nebulized fenoterol clearly revealed the dose-response effect (P less than 0.01). When all the FEV1 data were plotted over the entire range of 3 to 1000 micrograms, the resultant log dose vs response curve could be characterized by the ED50, the amount of drug producing half-maximal response. At 15, 30, or 60 minutes, the ED50 was in the range 8 to 10 micrograms. With increasing time there was a parallel shift of the entire dose response curve to the right, manifested by ED50 of 47 and 150 micrograms at two and three hours, respectively, after administration. This decreasing potency of a sympathomimetic drug with time shows that duration of effect and dosage are interdependent variables and must be evaluated simultaneously. Such considerations cannot be derived from cumulative dose-response studies. In our patients, 100 to 300 micrograms fenoterol delivered by aqueous nebulization achieved optimal bronchodilation with no detectable cardiovascular side effects. PMID- 6864375 TI - Spontaneous elevation in arterial blood pressure during the first hours of life in the very-low-birth-weight infant. PMID- 6864379 TI - Tobramycin kinetics in newborn infants. PMID- 6864378 TI - Tobramycin sulfate elimination in premature infants. AB - The elimination pharmacokinetics of tobramycin sulfate was studied in 25 newborn infants of birth weight 0.7 to 4.7 kg during 31 treatment episodes. The peak serum concentrations after a 2.5 mg/kg dose were usually within the therapeutic range of 5 to 10 micrograms/ml; however, the serum predose trough values were elevated above the theoretical safe limit of 2 micrograms/ml. Because of the prolonged serum elimination half-lives, a calculated extended dosage interval, sometimes greater than 24 hours, was necessary to obtain a predose trough of less than or equal to 2 micrograms/ml. The serum elimination half-lives inversely correlated with gestational age, extrauterine age, birth weight, and creatinine clearance. The very low ratio of tobramycin renal clearance to creatinine renal clearance was virtually constant and indicated a probable tubular reabsorption of tobramycin. A general dosage schedule based on birth weight was derived from the data. An alternative formula was derived to enable prediction of the tobramycin elimination half-life based on a combination of birth weight, gestational age, and extrauterine age for an infant younger than 7 days of age. PMID- 6864380 TI - Locus of control in juvenile diabetic campers: changes during camp, and relationship to camp staff assessments. AB - Locus of control was measured at the beginning and end of a three-week camp experience in 156 children with juvenile diabetes. The results were compared with those of 30 diabetic children who did not attend camp. Both the Nowicki Strickland Children's Locus of Control and the Parcel Health Locus of Control scales were used. In addition, subjective assessments of diabetes management skills were made in all campers by several staff members. Significant changes toward internal locus of control on the NSLC but not the CHLC were found. The changes in NSLC seem to have persisted for at least one year in a small subsample of 23 children who were retested. Initial scores on both scales correlated moderately with the diabetes management skills ratings made at the end of camp. In view of the apparent importance of the locus of control construct in the self care expected of most children with juvenile diabetes, the results should stimulate further efforts to examine the usefulness of this measure in relationship to achievement of good control of diabetes. PMID- 6864381 TI - Child snatching: a new epidemic of an ancient malady. AB - Eighteen children kidnapped successfully or abortively by a parent were psychiatrically evaluated; 16 were found to have one or more of five functional changes: (1) aftereffects of severe fright or psychic trauma, (2) effects of mental indoctrination, (3) grief or rage about parental abandonment, (4) rejection of the offending parent, and (5) exaggerated identification with a parent or wish fulfillment about a parent. There are serious problems at the law psychiatry interface regarding stolen children. Both fields must direct their efforts to the prevention of these family tragedies. Psychiatric evaluation is indicated for every child who returns from a child-stealing experience. Pediatricians and child psychiatrists may help the courts to understand the child's point of view by testifying regarding medical findings as well as by interpreting the child's testimony and behavior to the court. PMID- 6864382 TI - Autoerythrocyte sensitization. AB - We have seen six examples of autoerythrocyte sensitization in children that allow a definition of the disorder in the pediatric age group. The typical skin lesion is a painful, erythematous bruise that starts after minor trauma or surgery and often involves an area away from the injury site. The skin manifestations can be debilitating, and reappear unpredictably for an indefinite period. Somatic symptoms can be associated with the bruising. Usually the children have a disturbed psychological background. Characteristically, multiple detailed investigations are performed before the diagnosis is made. An intradermal injection of autologous red cells may or may not give a "positive" ecchymotic reaction. Pediatric patients seem to respond well to psychotherapy, which is usually the only effective form of treatment. PMID- 6864383 TI - Relationship of nutrition and pulmonary function in cystic fibrosis. PMID- 6864384 TI - Effects of dobutamine in shock. PMID- 6864385 TI - Complication of nasal endotracheal intubation. PMID- 6864386 TI - Therapeutic choices by children with cancer. PMID- 6864387 TI - A family with histidinemic parents. PMID- 6864388 TI - Vitamin E and bronchopulmonary dysplasia. PMID- 6864389 TI - Complications of mastoiditis. PMID- 6864390 TI - Bone infarction in sickle cell disease. PMID- 6864391 TI - Radionuclide angiography in evaluation of PDA. PMID- 6864392 TI - Prostaglandin inhibitors in treatment of nephrogenic diabetes insipidus. PMID- 6864393 TI - Heparin resistance in newborn infants. PMID- 6864394 TI - Cerebral perfusion pressure in central nervous system infections of infancy and childhood. AB - Central nervous system infections may be complicated by development of severe brain edema, which can be a significant factor in mortality and morbidity. Increased intracranial pressure can cause additional damage to the central nervous system by impairment of cerebral blood flow, which is dependent on cerebral perfusion pressure. A reduction of cerebral perfusion pressure, caused by elevation of intracranial pressure, may cause cerebral ischemia. We studied cerebral perfusion pressure in 17 patients, ages 45 days to 11 years, with severe central nervous system infections and who were in deep coma. Meningitis was diagnosed in 64.7%, and encephalitis in 29.4%. The patients who survived (64.7%) did not differ significantly from those who died (36.5%) in severity of disease and maximal intracranial pressure during the course of the illness. A striking difference in minimal cerebral perfusion pressure recorded was found between survivors and nonsurvivors: all patients with minimal cerebral perfusion pressure greater than 30 mm Hg survived, whereas those with lower pressure died. In survivors, cerebral perfusion pressure could be maintained adequately by reduction of intracranial pressure, but nonsurvivors developed noncompliance of brain tissue, and cerebral perfusion pressure could not be maintained at levels that ensure adequate cerebral blood flow, resulting in cerebral ischemia and death. Continuous monitoring of mean arterial blood pressure and intracranial pressure in children with severe central nervous system infections will enable rapid diagnosis and initiation of treatment when cerebral perfusion pressure is reduced to critical levels. Such treatment might improve the prognosis. PMID- 6864398 TI - Locus of control in juvenile diabetic campers. PMID- 6864396 TI - Identification of female carriers of adrenoleukodystrophy. AB - The concentrations of very long chain fatty acids in plasma and cultured skin fibroblasts were studied in 96 women who were obligate heterozygotes for X-linked adrenoleukodystrophy, in 34 women who were mothers of single probands with ALD, and in 32 normal women of comparable age. Discriminant analysis was used to develop a classification function for the plasma values. With this function, plasma values in 88% of the women who were obligate heterozygotes for ALD and 77% of the mothers of single probands were identified as abnormal. With subsequent inclusion of the fibroblast assay data, abnormal plasma values were found in 93% of the obligate heterozygotes. PMID- 6864395 TI - Increased hypoxanthine concentrations in cerebrospinal fluid of infants with hydrocephalus. AB - Hypoxanthine, the end product of purine metabolism, is usually very elevated in body fluids during severe hypoxia. We measured hypoxanthine in the cerebrospinal fluid of hydrocephalic preterm infants (12 with posthemorrhagic, one with congenital hydrocephalus) to determine whether hydrocephalus is associated with anaerobic metabolism of brain tissue. Cerebrospinal fluid hypoxanthine was undetectable in normal infants. In hydrocephalic infants, the concentration of hypoxanthine ranged from 7.5 mumol/L to 28 mumol (means = 14.3 mumol/L). The hypoxanthine concentrations fell from a mean of 12.8 mumol/L to a mean of 2.0 mumol/L (P less than 0.05) with successful treatment of the ventriculomegaly by lumbar puncture or by ventriculoperitoneal shunt. Patients with acute posthemorrhagic hydrocephalus had similar concentrations of hypoxanthine (means = 14.5 mumol/L) as patients with late or with congenital hydrocephalus (means = 13.8 mumol/L), indicating that brain hypoxia is probably a consequence of the ventriculomegaly and not of the hemorrhagic insult. PMID- 6864397 TI - Dysplastic nevi on the scalp of prepubertal children from melanoma-prone families. AB - Four prepubertal children, all members of melanoma-prone families, developed pigmented scalp lesions that were diagnosed as dysplastic nevi. In three cases, the scalp lesions were the only evidence that the children were affected by the dysplastic nevus syndrome, a distinctive clinicopathologic entity that identifies persons at increased risk of malignant melanoma. In general, the skin of family members with dysplastic nevus syndrome does not show characteristic lesions until just prior to or with the onset of puberty. The presence of dysplastic nevi on the scalp may permit identification of at least some high-risk family members well prior to puberty. This should facilitate the early implementation of a melanoma prevention program for susceptible individuals and help ensure that melanomas are diagnosed early in their natural history, at a time when they are surgically curable. PMID- 6864399 TI - Acute rhabdomyolysis associated with hemolytic-uremic syndrome. PMID- 6864401 TI - Primary oxalosis presenting as anuric renal failure in infancy: diagnosis by x ray diffraction of kidney tissue. PMID- 6864402 TI - Acute myelofibrosis in a child. PMID- 6864403 TI - Growth, metabolic response, and development in very-low-birth-weight infants fed banked human milk or enriched formula. I. Neonatal findings. AB - Banked human milk has been widely used, although its composition and nutritional adequacy for preterm infants are uncertain. We randomized 76 healthy infants of less than or equal to 1500 gm birth weight to ad lib feedings of frozen BHM or a protein-mineral-calorie-enriched formula (Similac Special Care) designed to sustain intrauterine accretion rates; BHM contained 2.2 gm fat/100 ml and 60 kcal/100 ml (gross energy). Infants fed BHM ingested more milk (197 vs 165 ml/kg/day) but less gross energy (118 vs 143 kcal/kg/day); grew less rapidly in weight (15 vs 30 gm/day), length (0.7 vs 1.1 cm/wk), and head circumference (0.8 vs 1.2 cm/wk); and were discharged at a lower weight (2200 vs 2348 gm) and older age (61 vs 47 day) than infants fed formula (P less than 0.02). At 37 weeks' postmenstrual age, infants fed BHM were less responsive to Brazelton inanimate stimuli (mean total score 5.0 vs 7.5; P less than 0.02). With few exceptions, blood amino acids, pH, and serum electrolyte values were similar in both groups. The different caloric intake of our feeding groups may explain only part of the large difference in growth rate. Donor milk should not be fed to preterm infants unless it has been analyzed and the feedings shown to provide a nutrient intake considered appropriate to the needs of these infants. PMID- 6864400 TI - Pedal hemangiomas in Turner syndrome. PMID- 6864405 TI - Entrapment of bioactive compounds within native albumin beads. PMID- 6864404 TI - Making the drug approval process work better. PMID- 6864406 TI - Physicochemical stability of pharmaceutical phosphate buffer solutions V. Precipitation behavior in phosphate buffer solutions. PMID- 6864407 TI - Sterilization of corticosteroids by 60Co irradiation. PMID- 6864409 TI - Evaluating different inspection parameters. PMID- 6864408 TI - Validation of the steam-in-place sterilization of disc filter housings and membranes. PMID- 6864410 TI - Early surgical alignment for congenital esotropia. AB - To provide sufficient numbers of patients varying in age of initial adequate surgical alignment for congenital esotropia, 154 patients managed by seven ophthalmologists in three countries were personally examined by the author and the results compiled for a clinical study. Examiner bias was minimized by having the examination performed without prior knowledge of the clinical history and the tests were standardized in both method of examination and test devices. From this population group 106 patients were chosen who had reliable answers, satisfactory alignment and an ophthalmologist's exam of the congenital nature of the problem by at least one year of age. The results of sensory testing showed that those adequately aligned by the age of 6 months versus 12 months versus 24 months were not statistically different, but those patients aligned after 24 months of age demonstrated a significantly lower percentage with evidence for binocularity (p less than .001). PMID- 6864411 TI - Management of periocular molluscum contagiosum in children. AB - Because there are no data concerning the association between periocular molluscum contagiosum (POMC) and toxic conjunctivitis, and since there are no established guidelines of acceptable treatment, we surveyed pediatric ophthalmologists in North America in order to analyze the results of their cumulative experience dealing with the disease. Approximately half of 341 cases of POMC were not associated with conjunctivitis; however the majority of cases were treated, occasionally with chemical ablatives or cautery. Many ophthalmologists preferred to use general anesthesia in the treatment of POMC. POMC was noted not only to regress spontaneously, but was also noted to recur after treatment. Because of the benign nature of the infection, indications to treat asymptomatic POMC are not clearly established. PMID- 6864413 TI - Assessment of gestational age by examination of the anterior vascular capsule of the lens: value in multiple pregnancy (quintuplets). PMID- 6864412 TI - Safety and efficacy of tobramycin and gentamicin sulfate in the treatment of external ocular infections of children. PMID- 6864414 TI - Benign episodic bilateral juvenile internal ophthalmoplegia. AB - A case of benign episodic bilateral juvenile internal ophthalmoplegia in a nine year-old female is presented. Two separate episodes of sudden onset of bilateral mydriasis and accommodative loss accompanied by headache occurred, without any other physical, neuroophthalmic, or third nerve involvement. Complete resolution occurred over a period of months in both episodes. The differential diagnosis of isolated internal ophthalmoplegia is reviewed, and the episodic unilateral mydriasis syndrome of Hallett and Cogan appears to be similar to the bilateral involvement in the case presented. PMID- 6864415 TI - Ocular lesions in incontinentia pigmenti. AB - Incontinentia pigmenti is a component of the Bloch-Sulzberger syndrome, which consists also of several major anomalies involving the central nervous system, skeleton, teeth, and the eye. Important manifestations include seizures, mental retardation, microcephaly, deformities of the skull and vertebrae, cleft palate, dystrophy of the nails, and abnormal or missing teeth. Although usually listed as a disease with which congenital cataract is associated, the more important ocular findings are those of the posterior segment, resembling lesions that enter into the differential diagnosis of the white pupil. The skin disturbance is characteristic and occurs very early in life; it may disappear entirely, obscuring the diagnosis if the ocular lesions are discovered later. The Bloch Sulzberger syndrome usually is inherited as an X-linked dominant with lethality for males. It is a rare but important entity to the pediatric ophthalmologist. PMID- 6864416 TI - Intraocular pressure in children up to five years of age. AB - We established a value scale (Figure) of IOP for children without glaucoma. Under the age of 4 months the IOP was measured with topical anesthesia; halothane anesthesia was used in children from 4 months to 5 years. In 30 children under the age of 4 months the IOP is 8.4 +/- 0.6 mm Hg. In 44 children from 4 months to 5 years, the IOP measured under halothane general anesthesia is 7.8 +/- 0.4 mm Hg at the age of 1 year, and it gradually increases by about 1 mm Hg per year of age to 11.7 +/- 0.6 mm Hg at the age of 5 years. PMID- 6864417 TI - Surgery of infantile esotropia: a critical evaluation of marginal myotomy of the medial recti as a primary and secondary procedure. AB - Seventeen cases of marginal myotomy were compared to 88 conventional procedures in treatment of infantile esotropia. Successful alignment (within 10 prism diopters of orthophoria) was less frequently attained in the marginal myotomy group than in the conventional group, both after one surgery (18% versus 40%, respectively) and finally (24% versus 65%, respectively). Motor and sensory findings were similar in each group, although fusion and stereopsis were less frequent with marginal myotomy. Even though nearly all patients receiving marginal myotomy were successfully aligned immediately following surgery, a gradual return of esotropia was noted in 12 of 17 patients. The significantly inferior ability of marginal myotomy to produce stable successful alignment in infantile esotropia should incontrovertibly lead to the abandonment of marginal myotomy in favor of the vastly superior recession and/or resection procedures. Twenty-one cases of marginal myotomies of the medial recti performed as secondary procedures were also analyzed. The group receiving myotomy with resection had much better results (4 of 5 successfully aligned, average exo-shift 27.6 P.D.) than the myotomy only group (2 of 17 successfully aligned, average exo-shift 6.6 P.D.). Three of 17 were actually made more esotropic by the myotomy procedure alone. It is concluded that isolated myotomy is an ineffective reoperative procedure, and that by combining myotomy with resection, a fair rate of successful alignment may be achieved. PMID- 6864418 TI - Vertical strabismus associated with plagiocephaly. PMID- 6864420 TI - Recurrent esotropia following early successful surgical correction of congenital esotropia. AB - A study was conducted using a group of congenital esotropes who had an adequate surgical alignment prior to 18 months of age, to determine how many of them would redevelop esotropia. In the group that redeveloped the condition, a high percentage of the esotropia was accommodative in nature and was therefore able to be corrected with spectacles. Both the initial refractive error and changes in refractive error were noted to be significant. This study emphasizes the importance of monitoring the refractive state continuously, especially in children with subnormal fusion. PMID- 6864419 TI - Afferent pupillary defects in amblyopia. AB - We detected mild afferent pupillary defects with the "swinging flashlight" test in 4 out of 45 amblyopic patients. Our study was designed to minimize the effect of observer bias and to control for the difficulty of testing the pupils in young children. We found afferent defects in both strabismic and anisometropic amblyopes. There was no apparent relationship between pupillary response and visual acuity: afferent defects were noted in association with better than 20/100 vision in three cases but were absent in a majority of patients with profound visual loss. Vision was improved by occlusion therapy in two amblyopes with pupillary abnormalities. We regard the occurrence of afferent pupillary defects as evidence for a physiological disturbance at the retinal level in at least some cases of amblyopia. Our findings suggest that the extent of retinal involvement in amblyopic eyes is independent of reduction in acuity, to which primary cortical abnormalities may contribute as well. PMID- 6864422 TI - "Trilateral retinoblastoma". PMID- 6864421 TI - A new stereotest. PMID- 6864423 TI - Ocular manifestations in diffuse neonatal hemangiomatosis. PMID- 6864426 TI - Superior oblique recession versus tenotomy: a comparison of surgical results. AB - Past experience with weakening the superior oblique muscle by tenotomy has been complicated by unpredictable results. Superior oblique recession has been advocated as a more controlled and reliable procedure. We retrospectively studied 20 cases of superior oblique tendon recession and tenotomy from the Bascom Palmer Eye Institute over the last ten years. All cases were compared with respect to the amount of deviation corrected, ability to eliminate "A" pattern strabismus, preservation of muscle function, and complications. Both procedures were equally effective in eliminating "A" pattern strabismus regardless of the initial size of the pattern. Unilateral superior oblique recessions were less erratic than tenotomies but tended to result in a slight undercorrection. The complications were similiar for each procedure. We could not demonstrate a clear advantage of bilateral superior oblique recession over tenotomy. Unilateral recession needs further investigation and may have prove useful when combined with the adjustable suture technique. PMID- 6864424 TI - Conjunctival scarring in Kawasaki disease: a new finding? PMID- 6864427 TI - Monofixation or bifixation: physiological and clinical considerations. PMID- 6864425 TI - Intraosseous hemophilic pseudotumor of the orbit. AB - Intraosseous hemophilic pseudotumor involving the orbit has not been described previously. A 14-year-old white male presented with a rapidly progressive, expansile right orbital mass consisting of hematoma contained within bony cortex. Computerized tomography revealed findings consistent with intraosseous hemophilic pseudotumor. The patient responded to conservative therapy of factor VIII replacement. PMID- 6864428 TI - Leukemic ophthalmopathy detected by ultrasound. AB - Contact A- and B- scan ultrasonography was performed on 40 patients with acute lymphocytic leukemia at initial diagnosis, during therapy, during remission, and in patients with recurrences. This technique simply and consistently reveals tumor in the choroid, despite the fact that leukemic involvement may cause only 1 2 mm of choroidal thickening. Leukemic involvement may be diffuse or localized, detected with or without visual symptoms, and can be monitored repeatedly. Leukemic involvement of the choroid is difficult to see ophthalmoscopically, but easy to detect with contact ultrasound. PMID- 6864429 TI - Additional lacrimal findings in the syndrome of blepharoptosis, blepharophimosis, epicanthus inversus, and telecanthus. AB - The syndrome of blepharoptosis, blepharophimosis, epicanthus inversus, and telecanthus has become recognized as a distinct tetrad based upon clinical and hereditary characteristics. Since its collation only the increased association with amenorrhea has been added to its spectrum of features. Presented is a case of this syndrome with the additional findings of posterior ectopia of the lower puncta and aplasia of the upper puncta, previously unreported. PMID- 6864430 TI - Inferences of mental illness from noninvolvement. AB - These studies continue the exploration of variables related to a person's use of the mental illness categorization. The central concern in the present studies was the effect of perceived variation in a target person's level of involvement in a social situation. While a low level of involvement, as portrayed in videotaped scenarios, prompts attribution of mental illness, other features of implicit personality theories also relate to greater or lesser attribution of mental illness. Those participants who gave evidence of having attributed lower levels of involvement, regardless of filmed information, also attributed higher levels of mental illness. Social workers, compared to general population participants, attributed higher levels of mental illness at all levels of target involvement. We discuss the implications of these findings for dissemination and assignment of the mentally ill role. PMID- 6864431 TI - Children's use of defense mechanisms in reaction to displeasure caused by others. AB - Two groups of children (mean ages = 7-0 and 10-1) were presented with eight video vignettes depicting unpleasant child-related situations. The child's defensive reaction was evaluated by means of an open-ended free response and by choice of one of four response alternatives: turning against the object, turning against the self, projection, and reversal. Sex- and age-related differences were predicted, and found in the younger age group: Boys chose turning against the object more often than did girls, who chose reversal more often than did boys. PMID- 6864432 TI - Risk taking as motivation for volunteering for a hazardous experiment. AB - Army male enlisted personnel were tested in two experiments to assess the psychological correlates of volunteering for a hazardous combat simulation, (Experiment 1) and a riskless, psychological experiment (Experiment 2). Subjects were given a biographical and personal habit questionnaire, the IPAT Anxiety Scale, Rotter's Locus of Control Scale, and Torrance and Ziller's life experience inventory. Results from Experiment 1 indicated that volunteers were significantly less anxious, and more willing to take risks than were nonvolunteers. Noncommissioned officers, smokers, laterborn children, and children of lower socioeconomic class parents were significantly overrepresented among the volunteers for this hazardous experiment. In Experiment 2, which solicited volunteers for a routine, nonhazardous experiment, the only variable to discriminate the volunteers from the nonvolunteers was mothers' education level. Results are in agreement with findings, using college students, that volunteer samples differ significantly from nonvolunteer samples, and that the characteristics that discriminate these two groups vary as a function of situational factors. PMID- 6864433 TI - [Opiate addiction. Technics for withdrawal and substitution therapy]. PMID- 6864435 TI - Proceedings of the 6th Symposium on Molecular Biology of Microorganisms and its application to pharmaceutical sciences, Sapporo. PMID- 6864434 TI - [Biopharmaceutical study of new oral dosage forms of indomethacin]. PMID- 6864436 TI - Improvement of oral bioavailability of prednisolone by beta-cyclodextrin complexation in humans. AB - Inclusion complex of prednisolone with beta-cyclodextrin (beta-CyD) in 1:2 molar ratio was prepared and its dissolution, membrane permeation and oral absorption behaviors were examined. The rates of dissolution and permeation through a cellophane membrane in water were significantly increased by beta-CyD complexation. A crossover bioavailability study was performed using human subjects with lower doses of prednisolone tablets, where the plasma levels of the drug were determined by radioimmunoassay. The enhanced bioavailability of prednisolone by beta-CyD complexation suggested the possibility of smaller doses and fewer side effects in prednisolone therapy. PMID- 6864439 TI - Potentiation of chemotherapeutic effect of vincristine in vincristine resistant tumor bearing mice by calmodulin inhibitor clomipramine. AB - Clomipramine, which is used as antidepressant and possesses calmodulin inhibitory activity, circumvented partly the vincristine resistance in vivo. Although vincristine alone at 30-200 micrograms/kg did not confer a significant therapeutic effect in vincristine resistant P388 leukemia (P388/VCR)-bearing mice, clomipramine at doses of 20 to 50 mg/kg administered daily for 10 d with vincristine enhanced the chemotherapeutic effect of vincristine in P388/VCR bearing mice. Approximately a 30% increase in life span occurred. Although the circumvention of vincristine resistance was not achieved perfectly, it could be speculated that more than 98-99% of vincristine resistant tumor cells which could not be killed by vincristine alone could be killed by this approach. PMID- 6864438 TI - Effect of N-formyl-L-methionyl-L-leucyl-L-phenylalanine and its analogues on blood pressure. AB - Effects of N-formyl-L-methionyl-L-leucyl-L-phenylalanine (FMLP), the synthetic chemotactic peptide, and its analogues on blood pressure were investigated in the rabbit, rat, mouse, dog, cat and guinea pig. The administration of FMLP (5 micrograms/kg i.v.) induced the depressor effect in the rabbit but no effect was observed in the other animal species. The only peptide which showed a similar effect as FMLP was N-formyl-L-methionyl-L-methionyl-L-phenylalanine (FMMP) among the peptides relating to FMLP. Tachyphylaxis was observed in the hypotensive action induced by the two peptides. PMID- 6864437 TI - Brain distribution of hydrazine and its GABA elevating effect in rats. AB - After the intravenous administration of isoniazid (INH; 0.37 mmol/kg) or hydrazine (Hz; 0.16 mmol/kg), the minor metabolite of INH, gamma-aminobutyric acid (GABA) and Hz were measured by means of gas chromatograph-mass spectrometer (GC-MS) using deuterium labeled GABA (d2-GABA) and nitrogen fifteen labeled Hz (15N-Hz) as internal standards. In both cases, we successfully detected Hz and GABA in the brain. The brain GABA elevating effect of Hz was much higher than that of INH in spite of low dose. PMID- 6864440 TI - Intensification of host's immunity by squalene in sarcoma 180 bearing ICR mice. AB - Effect of highly purified squalene (HP-SQ) obtained from liver of a shark, Centrophorus atromarginative Garman, on antitumor activity and host's immune response was studied in sarcoma 180 bearing female ICR mice. HP-SQ was administered intraperitoneally (i.p.) to solid tumor-bearing or healthy mice at the dose of 0.1 ml/mouse/d for consecutive 10 d. The administration of HP-SQ exerted the host's resistance against challenging 5 x 10(4) cells of ascites sarcoma 180, and it resulted in marked prolongation of survival of the mice (ILS; 110%). Function of the reticuloendothelial system estimated by a carbon clearance test was enhanced by i.p. administration of HP-SQ in both the healthy and the tumor-bearing mice. Number of IgM antibody forming cells against sheep red blood cells (SRBC) in the spleen was counted 4 d after intravenous injection of 2 x 10(7) cells of SRBC. The number of the IgM antibody forming cell increased by HP SQ administration in the tumor-bearing and the healthy mice. Delayed hypersensitivity reaction against SRBC measuring swelling of the foot pads of mice was also stimulated by the i.p. administration of the material. PMID- 6864441 TI - Study on hydroxamic acids and their urease inhibitory potency by quantum chemistry calculation. AB - The electronic structures of 34 hydroxamic acids [R-(CONHCH2(n-CONHOH, R = aromatic or aliphatic, n = 1 or 0] were calculated by the INDO method and their urease inhibitory potencies were discussed in terms of the calculated electronic parameters and molar refraction. The charge distribution of -CONHOH residue which has been expected as a functional group for inhibition slightly be affected by the change of R - moiety and by the presence or absence of the -CONHCH2- residue. The best improved regression equation indicated that the inhibitory potency of hydroxamic acids was parabolically varied with the molar refraction and that the increase of the inhibitory potency by the presence of -CONHCH2- residue was explained by the variation of the charge density of a carbon atom directly bonding the -CONHOH group. PMID- 6864442 TI - Pharmacologic effects of metformin in relation to its disposition in alloxan diabetic rats. AB - The purpose of this investigation is to elucidate the relationship between the time course of pharmacologic effects and drug disposition after administration of metformin, an oral antidiabetic drug of biguanides. Alloxan diabetic rats and normal rats were used in the experiments. After administration of metformin, plasma glucose levels, blood pyruvate levels, blood lactate levels, plasma pancreatic glucagon immunoreactivity (pancreatic GI) and plasma gut glucagon like immunoreactivity (gut GLI) were determined as well as serum concentrations of metformin. In alloxan diabetic rats, gut GLI levels were significantly correlated to the logarithm of tissue metformin levels, calculated from serum metformin levels. The blood lactate, pyruvate and plasma glucose levels were also linearly related to gut GLI levels, after metformin administration. It was also clarified that metformin did not inhibit the intestinal absorption of glucose and that metformin presumably inhibited the hepatic gluconeogenesis. It is reasonable to consider that the effect of metformin on the gut GLI level is the primal effect, and that other pharmacologic effects such as plasma glucose lowering, blood lactate and pyruvate increasing effects are the consequences of the primal effect, at least in alloxan diabetic rats. While in normal rats, plasma gut GLI levels were not significantly related to metformin tissue levels, however, plasma glucose levels were considerably correlated with the logarithm of the plasma or tissue metformin levels. These results indicated that the effect of gut GLI was entirely masked by endogeneous insulin, which might be secreted by metformin administration. PMID- 6864444 TI - Self-monitoring and sex as moderator variables in the statistical explanation of self-reported marijuana and alcohol use. AB - Self-monitoring and sex are examined as likely moderators of some of the known effective predictors of self-reported use of marijuana and alcohol. The theory of self-monitoring implies that in comparisons between low and high self-monitors, dispositional predictors account for more of the variance in reported use among low self-monitors and environmental predictors account for more of the variance among high self-monitors. With the two classes of predictors established via principal-components analysis and with subgroups defined by scores on Snyder's Self-Monitoring Scale, data from 807 college students showed that self-monitoring does not affect the action of either dispositional or environmental predictors. Thus, the self-monitoring construct promises explanatory leverage that in these tests, the scale is not able to deliver. When subgroups are defined by sex, analyses of reported alcohol use yield small but significant moderator effects: Women's use is more predictable from environmental variables, whereas men's use is more predictable from dispositional variables. These effects are consistent with the conclusions of recent meta-analyses of results from studies of sex differences in conformity to group pressures. PMID- 6864443 TI - Alienation and drinking motivations among adolescent females. AB - The present study examined a hypothesized relation between alienation and stated motivations for alcohol use. It was predicted that such a relation would emerge more clearly among adolescent females than among adolescent males, and this prediction was confirmed. Among females, problem-related drinking motivations correlated positively with alienation, whereas social-convivial motivations correlated negatively with this attribute. No comparable correlations were found among the male subjects. It was concluded that important sex differences in the dynamics of problem drinking in our society are worthy of additional study. PMID- 6864447 TI - [Pain caused by the administration of 3-acetoxymethylcephalosporin and its degradation products]. PMID- 6864445 TI - Mitigating the imitation of aggressive behaviors by changing children's attitudes about media violence. AB - A sample of 169 first- and third-grade children, selected because of their high exposure to television violence, was randomly divided into an experimental and a control group. Over the course of 2 years, the experimental subjects were exposed to two treatments designed to reduce the likelihood of their imitating the aggressive behaviors they observed on TV. The control group received comparable neutral treatments. By the end of the second year, the experimental subjects were rated as significantly less aggressive by their peers, and the relation between violence viewing and aggressiveness was diminished in the experimental group. PMID- 6864446 TI - [Attempt to analyze disposition of furosemide in rats using a compartment model]. PMID- 6864448 TI - [Interaction between cinepazide maleate, a new cerebral vasodilator, and water]. PMID- 6864449 TI - [The principles of Tetragonia tetragonoides having an antiulcerogenic activity. I. Isolation and identification of sterylglucoside mixture (compound A)]. PMID- 6864450 TI - [Studies on beta-lactam antibiotics for medicinal purpose. XIV. Stability and degradation pattern of sodium 7 beta-[(2R, 3S)-2-(4-ethyl-2, 3-dioxo-1 piperazinecarboxamido)-3-hydroxybutanamido]-7 alpha-methoxy-3-[(1-methyl-1H tetrazol-5-yl)thiomethyl]-3-cephem-4- carboxylate (T-1982) in aqueous solution]. PMID- 6864451 TI - [Studies on antibacterial peptide. XVI. Synthesis and antibacterial activity of alpha-decanoylpentapeptides related to colistin. V]. PMID- 6864452 TI - [Studies on antibacterial peptide. XVII. Synthesis and antibacterial activity of cyclic alpha-acylpentapeptides related to colistin. VI]. PMID- 6864453 TI - [Effects of additives contained in injections on coagulation and fibrinolysis of blood]. PMID- 6864454 TI - [Studies on pyridinol derivatives. II. Synthesis and pharmacological activity of 2H-pyrido[3,2-b]-1,4-oxazin-3-one derivatives]. PMID- 6864455 TI - [Studies on pyridinol derivatives. III. Synthesis and pharmacological activity of 2H-pyrido [3,2-b]-1,4-oxazin-3-one derivatives]. PMID- 6864456 TI - [Synthesis and their antimicrobial activities of benzo[a]-phenazines from naphthoquinone]. PMID- 6864457 TI - [Studies on human urinary arginine esterases]. PMID- 6864458 TI - [Physico-chemical properties of glycyrrhizic acid in aqueous media. IV. Emulsification of oleic acid]. PMID- 6864459 TI - [Wet grinding (pulverization by intervention) of solid drugs during compounding]. PMID- 6864460 TI - [Gastric emptying in chemical-administered and ulcerated rats]. PMID- 6864463 TI - [Piezoelectricity in polyimine derivatives]. PMID- 6864461 TI - [Liquid-solid chromatography resolution system for capsaicin analogues in cosmetic preparation]. PMID- 6864462 TI - [Retention behavior of pyridine, pyrazine homologues and N-oxide derivatives in normal and reversed phase liquid chromatography]. PMID- 6864464 TI - [Mannich reaction on o- or p-hydroxyacetophenone. II]. PMID- 6864465 TI - Further studies on the catalysis of hydrolysis and aminolysis of benzylpenicillin by metal chelates. AB - It was suggested previously that the very rapid catalysis of benzylpenicillin hydrolysis and aminolysis by zinc ion and tris(hydroxymethyl)aminomethane (tromethamine) was mediated by a ternary complex in which the metal ion not only held the substrate and tromethamine in close proximity but also lowered the pKa of a bound tromethamine hydroxyl group making it a very powerful nucleophile. In this study the scope of this reaction was explored further by examining the effects of changes in substrate side chain, metal ion, and amino alcohols. All of the penicillins studied showed about the same rate of reaction. Of the other metal ions examined Cu2+ and Ni2+ showed no activity, Mn2+ very slight activity, and Cd2+ and Co2+ somewhat greater activity. The latter was the most effective of this group but was 40 times slower than zinc. The results with a number of amino alcohols provided additional evidence for the ternary complex mechanism. Studies with the methyl ester of benzylpenicillin indicated that the metal ion is bound to the antibiotic at the carboxylate site and that a different mechanism is involved in the slower catalysis observed with the ester. Some comparison is made with a zinc-dependent beta-lactamase. PMID- 6864467 TI - Unloading and postcompression viscoelastic stress versus strain behavior of pharmaceutical solids. AB - The viscoelastic properties of several compacts composed of drugs and direct compression excipients have been measured during the stress unloading and postcompression phases of the tablet compression process. Measurements of applied strains and the resultant stresses, generated in the tablet structure under compaction, were made using a rotary press. The press was instrumented to measure punch and die wall stresses at normal operating speeds. The three-dimensional viscoelastic theory, used in data analysis, provides for the separate characterization of tablet behavior into its dilation and distortion components. The tablets investigated were found to behave elastically in dilation, but to have both viscous and elastic contributions to their stress/strain relaxation in distortion. This latter behavior could be modeled well as a Kelvin solid. Data derived from an elastic-in-dilation, Kelvin-in-distortion analysis of tablets, compressed at similar machine speeds but at various peak pressures, were found to vary widely depending on tablet composition. Dependence of the viscous and elastic parameters on compression conditions was found to be predictive of conditions under which capping or lamination of the compact would occur. PMID- 6864466 TI - Liquid crystal solubilization of cholesterol: potential method for gallstone dissolution. AB - Solubilization rate and phase equilibrium studies were conducted for cholesterol in aqueous sodium oleate solutions. The components interacted to form a lamellar liquid crystalline phase, and this phenomenon was investigated as a potential method for cholesterol gallstone dissolution. Phase equilibria data for cholesterol-sodium oleate-water showed that the mesophase contained approximately equimolar amounts of cholesterol and oleate with large amounts of water. The cholesterol solubilization rate from a static pellet in sodium oleate solutions was much faster than dissolution in sodium cholate solutions and was independent of oleate concentration from 2.5 to 10%. In these experiments, the medium became a cloudy dispersion of liquid crystalline phase in the micellar solutions. The rate-limiting step in the solubilization process appears to be dispersion of fragments from the liquid crystalline layer on the cholesterol surface. This hypothesis was consistent with the kinetic effects of viscosity, stirring rate, and oleate concentration. By converting cholesterol to a liquid crystalline phase, the solubilization process avoids the limitations for micellar solubility and interfacial resistance which control cholesterol dissolution in bile salt containing media. PMID- 6864468 TI - Inhibition of oral lead absorption in rats by phosphate-containing products. AB - Recent studies indicate that elevated blood lead levels in children are largely a result of exposure to this metal via the oral route. A logical approach to decrease or prevent lead intoxication would be to reduce its absorption as soon as lead ingestion is known or suspected. Presently, however, there are no readily available products recommended to accomplish this goal. It was found that a phosphate-buffered, saline laxative reduced lead absorption over 50% in rats administered a single oral lead acetate dose, presumably by promoting the formation of less soluble lead salts. A popular phosphate-containing carbonated beverage also decreased lead absorption approximately 30% after oral lead acetate or lead-based paint doses, possibly by decreasing solubility, dissolution rate and/or GI motility. It is possible that these household products, and those with similar ingredients, may be safely used to reduce lead absorption in humans. PMID- 6864469 TI - Zn(II)-theophylline-ethylenediamine: structure and pH stability. AB - A zinc-containing salt of theophylline, Zn(II)-aminophylline, was synthesized and its structure determined by X-ray diffraction techniques. The zinc ion is coordinated to two theophylline anions and a molecule of ethylenediamine in a tetrahedral arrangement. The solubility of the compound in water at 30 degrees (0.047 mg/ml) is 180-fold lower than that of theophylline (8.40 mg/ml). The complex is relatively stable in the alkaline pH range, but it hydrolyzes, releasing theophylline in acidic environments. The rate of theophylline release is pH dependent. These properties are useful in formulating chewable tablets and liquid suspension dosage forms that overcome the characteristic bitter taste of theophylline, yet provide for efficacious treatment of diseases involving the respiratory tract. PMID- 6864470 TI - Factorial designs in pharmaceutical stability studies. AB - An approach to analyzing and interpreting kinetic data from stability studies using factorial designs is presented. This may be useful for screening purposes or as an aid in identifying significant effects in complex systems. A typical 2n factorial experiment is discussed, and methods of variance estimation and statistical testing are presented. An example of simulated data is used to demonstrate how typical results may be analyzed, as well as the potential and limitations of this design in interpretation and construction of kinetic models. PMID- 6864471 TI - Kinetics and mechanism of hydroxy compound cinnamoylation in acetonitrile catalyzed by N-methylimidazole and 4-dimethylaminopyridine. AB - The kinetics of reaction of the acylating agents trans-cinnamic anhydride and trans-cinnamoyl chloride with the hydroxy compounds n-propyl alcohol and water in the presence of N-methylimidazole and 4-dimethylaminopyridine were studied spectrophotometrically in acetonitrile solution at 25 degrees. The acid chloride reacted via the intermediate formation of the N-acyl catalyst, which underwent general base-catalyzed reaction with the hydroxy compound. The anhydride did not form the N-acyl intermediate, but instead underwent direct general base catalysis. In the presence of water, all systems formed the N-acyl intermediate. The mechanistic route followed by the system was determined by the nucleophilicity of the catalyst, the ability of the leaving group, and the polarity of the solvent. PMID- 6864472 TI - Solvent effects on the cinnamoylation of n-propyl alcohol catalyzed by N methylimidazole and 4-dimethylaminopyridine. AB - The kinetics of reaction of trans-cinnamic anhydride or trans-cinnamoyl chloride with n-propyl alcohol, catalyzed by N-methylimidazole or 4-dimethylaminopyridine, were studied spectrophotometrically at 25 degrees in methyl ethyl ketone, ethylene dichloride, methylene chloride, and toluene. The acid chloride reacted in all solvents via the intermediate formation of the N-acyl catalyst, which underwent reaction with the alcohol catalyzed by another molecule of the base. The anhydride did not form the intermediate in any of the solvents, but underwent direct general base catalysis. The rate of the anhydride reactions was not sensitive to solvent polarity, whereas the rate of the chloride reactions tended to increase as the solvent polarity decreased. A kinetic analysis is given of the effect of ion-pair formation on the kinetics of acyl transfer in systems where the charged N-acyl catalyst intermediate is formed. PMID- 6864473 TI - Sustained release of theophylline from hydroxypropylcellulose tablets. AB - Compressed tablets were prepared from theophylline and hydroxypropylcellulose. Effects of the viscosity grades of the polymer, the mixing ratios of two polymers with different viscosity grades, and the polymer contents in the tablets on release patterns of theophylline were examined in vitro. Release rate was decreased with increasing viscosity designation and polymer contents in the tablets. In salivary level profiles of theophylline following oral administration of sustained-release tablets to five human volunteers, a low but sustained level was noted indicating sustained release of the drug from the tablets in vivo. PMID- 6864474 TI - Characterization of spray patterns of inhalation aerosols using thin-layer chromatography. AB - The spray pattern of an inhalation aerosol was characterized using photography and by observing the impaction pattern on a TLC plate. The aerosol plume was conical in shape, and its cross section increased with increasing distance from the actuator. Three puffs of the aerosol, at a distance of 3 cm between actuator and the TLC plate, produced a spot that had approximately the same diameter as the cross section of the aerosol plume at that distance from the actuator. The TLC technique with these parameters was selected to develop an assay characterizing the spray pattern of an inhalation aerosol because of its specificity, simplicity, and speed. PMID- 6864475 TI - Esterase-like activity of human serum albumin II: reaction with N-trans cinnamoylimidazoles. AB - To elucidate the details of the esterase activity of human serum albumin, the reaction of N-trans-cinnamoylimidazoles with albumin was investigated kinetically at various pHs at 25 degrees. The reaction consisted of the acylation of albumin (probably the tyrosine-411 residue) by the substrate and the deacylation of cinnamoyl-albumin. The acylation was approximately 10--100-fold faster than the spontaneous hydrolysis of the substrate over the pH range examined. The pH profile for the deacylation rate constant indicated the participation of a group having a pKa of approximately 9.4. The deacylation was subjected to the effect of deuterium oxide. The electron-withdrawing substituent facilitated the deacylation; the Hammett rho value was 1.63. These results suggest that the deacylation proceeded via general base catalysis by this group. PMID- 6864476 TI - Stability constants for complex formation between alpha-cyclodextrin and some amines. AB - Complex formation of alpha-cyclodextrin with 15 amines (including seven 4 substituted anilines) was studied by the potentiometric method, supplemented by direct UV spectrophotometry and a competitive indicator spectrophotometric method. The data were analyzed in terms of 1:1 and 1:2 complexes (amine cyclodextrin ratios) and the stability constants K11a, K12a, K11b, and K12b were evaluated; the subscripts indicate the stoichiometry and conjugate acid-base form. For all amines K11b was greater than K11a and K12a was 0. On the basis of the relationship of complex stability to amine structure, it was concluded that the primary binding site in anilines is the 4-substituent. PMID- 6864477 TI - Permeation of skin and eschar by antiseptics I: baseline studies with phenol. AB - To assess how the permeability of phenol is altered by thermal injury, it was first necessary to have baselines of comparison on normal skin. Using in vitro diffusion cells and the skin of the hairless mouse, [14C]phenol was applied to skin in an aqueous medium with a reference copermeating species, [3H]methanol, and 37 degrees permeability coefficients of the pair were evaluated as functions of animal age, skin hydration, stripping of the skin, dermis isolation, and phenol concentration. Age proved to be of little consequence to permeability over a wide age range. Prolonged aqueous soaking of the skins was also without much effect. Stripping of the skin and isolating the dermis by soaking techniques allowed assessment of individual skin strata diffusion resistances. When applied to skin in trace radiochemical concentrations, phenol behaved diffusionally as an alkanol with a chain length of six. But at concentrations greater than 2% w/v, phenol facilitated the permeation rates of itself and methanol; the effect was markedly concentration sensitive and only fractionally reversible. Concentration studies using silicone rubber membranes proved that the effects on the skin were the results of destroyed barrier integrity. At 6% phenol concentration there was an essentially instantaneous, 10-fold increase in the phenol permeability coefficient, raising it to two-thirds that observed with fully stripped skin. Overall, the data suggest that the stratum corneum is proportionally impaired as the phenol concentration is increased. PMID- 6864480 TI - Computation of in-house quality control limits for pharmaceutical dosage forms based on product variability. AB - A method for establishing sampling plans for in-house limits that fix both the producer's and consumer's risks is presented for pharmaceutical systems in which both between-batch and within-batch variations are present. Such plans can always be constructed and require more or less sample assays depending on the variability of the process. The computations involve a numerical approximation to the bivariate normal distribution. PMID- 6864479 TI - Low-melting phenytoin prodrugs as alternative oral delivery modes for phenytoin: a model for other high-melting sparingly water-soluble drugs. AB - Phenytoin is a high-melting, weakly acidic, and sparingly water-soluble drug. Because of these physicochemical properties, phenytoin is subject to erratic bioavailability in a variety of dosage forms both in its acidic as well as sodium salt forms. A homologous series of 3-acyloxymethyl derivatives of phenytoin (acetyl through decanoyl) were synthesized and various physicochemical properties measured. The prodrugs were more readily soluble in various metabolizable glycerol esters such as tributyrin, trioctanoin, and triolein than phenytoin. The solubility of the prodrugs in the various organic vehicles studies was closely correlated to the melting point of the prodrug: the lower the melting point the greater the solubility. The cleavage rates of the prodrugs in plasma and tissue homogenates followed a parabolic relationship with chain length. The prodrug, 3 pentanoyloxymethyl-5,5-diphenylhydantoin when administered in tributyrin gave superior oral phenytoin bioavailability in rats when compared with sodium phenytoin administered as an aqueous solution. PMID- 6864481 TI - Solubility of hydrocortisone in organic and aqueous media: evidence for regular solution behavior in apolar solvents. AB - The solubility of hydrocortisone was determined experimentally in a wide variety of solvents. Groups of solvents were selected to emphasize different solute solvent interactions which can influence the solubility profile of such a large, polyfunctional solute. Regular solution theory for a crystalline solute was shown to be applicable to the solubility behavior of hydrocortisone in solvents that lack strong dipoles and the ability to hydrogen bond. A best-fit solubility parameter of 12.4 (cal/ml)1/2 for hydrocortisone was determined from the latter solubilities and the ideal solubility of hydrocortisone. This solubility parameter estimate was significantly higher than estimates calculated from molar attraction constants. Even though molar volume ratios between hydrocortisone and the solvents ranged from 2.25 to 3.28, the associated Flory-Huggins entropy term did not seem to be a significant solubility-determining factor. In all cases, the solubility of hydrocortisone in solvents capable of dipole-dipole interactions and hydrogen bonding was shown to be higher by logarithmic orders when compared with regular solution theory predictions. Thus, for this solute, regular solution theory was shown to be appropriate only for solvents where London dispersion forces dominate the interactions between solute and solvent molecules. PMID- 6864482 TI - Phenomenological viscoelasticity of a heterogeneous pharmaceutical semisolid. AB - This study presents the results of an investigation of the viscoelastic properties of anhydrous lanolin USP, as determined by dynamic mechanical testing. The elastic shear modulus (G'), viscous shear modulus (G"), and loss tangent (tan delta) were determined as a function of shear frequency, nu, (0.01--10.0 Hz) and temperature, T, (0--30 degrees). These viscoelastic parameters were found to be temperature and shear frequency dependent. Up to 100-fold changes in shear moduli and tan delta values were observed with appropriate changes in T and nu. Many of the observed properties are also characteristic of high molecular weight polymers and can be attributed to a high degree of molecular structure. It was found that dynamic mechanical testing was a sensitive tool for measuring structural changes, and was especially useful in detecting a major structural transition well below the accepted melting temperature of anhydrous lanolin. PMID- 6864478 TI - Permeation of skin and eschar by antiseptics II: influence of controlled burns on the permeation of phenol. AB - The safe antiseptic use of phenol over the burn-traumatized surface depends on knowledge of how the systemic accumulation of phenol is affected by burn processes. To gain insight into the underlying permeation phenomenon, the diffusion of phenol and a reference cosolute, methanol, through both scalded and branded dorsal skin sections of the hairless mouse was studied as a function of burn temperature using in vitro diffusion cells. Temperatures up to 100 and 150 degrees were used for scalding and branding, respectively, using a 60-sec; exposure time. Permeability coefficients of the traumatized skins were assessed at 37 degrees and compared with control values. Coefficients of both permeating species were not increased significantly by burn temperatures up to 70 degrees applied either by scalding or branding, however, at higher temperatures exaggerated increases in permeation rates were noted. A limiting increase of approximately 7 times the control value was noted for phenol irrespective of the burn method. Permeability of methanol was altered even more dramatically and at 100 degrees by scalding and 150 degrees by branding was over 50 times the control rate. At 80 and 100 degrees for methanol and at 80 degrees for phenol, scalding produced larger increases in the permeability coefficients than branding. Since contact for 1 min at 60 degrees is capable of producing a full-thickness burn injury, it is clear that eschar permeability to phenol immediately postburn is not related to the clinical degree of burning, but is a function of the thermal intensity (hotness) of the burn stimulus. Full-thickness wounds can be expected to have highly variable rates of systemic absorption as a direct consequence of the wide-ranging permeability possible for such burns, with the risks of topical application varying accordingly. PMID- 6864483 TI - Temperature-frequency equivalence of the viscoelastic properties of anhydrous lanolin USP. AB - Methods of data analysis novel to pharmaceutical semisolids have been applied to the dynamic mechanical data obtained for anhydrous lanolin USP. It was found that the viscoelastic parameters determined over a wide range of temperatures and shear frequencies could be superposed. Elastic moduli (G') and viscous moduli (G") obtained at low temperatures (T) and frequencies (nu), were equivalent to moduli obtained at high T and nu. Empirical shifts of modulus versus shear frequency data obtained at different temperatures were used to produce G' and G" versus nu master curves (complete log modulus versus log frequency behavior at a constant temperature). A method of reduced variables, in conjunction with an Arrhenius-type relation, proved useful in calculating the energy of activation for the structural processes involved in a major mechanical transition. PMID- 6864484 TI - Reverse permeation of salicylate ion through cellulose membrane. AB - The reverse permeation of salicylate ion and the effect of bovine serum albumin on the permeation were studied in a sodium salicylate-sodium oxalate-water system. In passive transport the permeation flux of an ion is expressed by the linear combination of the two terms which represent the concentration and electric potential gradients. Because the mobility of the sodium ion is greater than the oxalate ion, salicylate ion moves against the concentration gradient, and follows the electric potential gradient in the initial stage of permeation. The reverse permeation of salicylate ion through a cellulose membrane was accelerated with a high concentration ratio of oxalate to salicylate ions and reached a maximum value after 10 hr in the absence of bovine serum albumin. After reaching a maximum value, the salicylate ion permeated along the concentration gradient. The maximum concentration efficiency was 11.2%. In the presence of bovine serum albumin, the reverse permeation of salicylate ion reached a maximum value after 3 hr. PMID- 6864485 TI - Determination of the dissociation constant of a weak acid using a dissolution rate method. AB - Based on theories of diffusion-controlled mass transport for dissolution processes of weak acids in aqueous alkaline media, a method for the determination of the dissociation constant of a weak monoprotic acid is described. The method includes measurements of the initial dissolution rate as a function of pH, using the rotating-disk technique, and determination of the intrinsic solubility. The method was applied to determine the apparent dissociation constant (mu = 0.1) of 5,5-dimethyl-3-(alpha,alpha,alpha,4-tetrafluoro-m-tolyl)hydantoin, a new schistosomicide. For comparison, a spectrophotometric method for the pKa determination was developed. Due to rapid hydrolysis of the compound in the pH range required for the determination of the pKa, the development of the latter method turned out to be complicated and tedious. The results of both methods were in good agreement. For compounds with unfavorable properties for titrimetric or spectrophotometric determination of the pKa value, the dissolution rate method can be a useful alternative. PMID- 6864486 TI - Kinetics of the rapid modification of human serum albumin with trinitrobenzenesulfonate and localization of its site. AB - The rapid reaction of human serum albumin with trinitrobenzenesulfonate (I) and the location of the reactive site were investigated to characterize the chemical modification of albumin by I. The modification proceeds through trinitrophenylation of a lysine residue of albumin and monoaddition of the byproduct, sulfite ion, to the trinitrophenylalbumin, as reported previously. The individual kinetic parameters for both reactions were determined at various pH values and 25 degrees. The epsilon-amino group of the lysine residue which has a pKa value of approximately 8.9 was the reactive group involved in the trinitrophenylation. The dissociation constant of the sulfite monoadduct was about 10-fold smaller than that of the monoadduct of the model compound trinitrophenyl alpha-acetyllysine. The modification of albumin by I reduced the fluorescence intensity of the tryptophan-214 residue in the albumin amino acid sequence. Acetylation of the lysine-199 residue with aspirin and 5-nitroaspirin decreased the trinitrophenylation rate of albumin with I. These results on the fluorescence spectroscopy and the effect of the acetylation suggest that the reactive group for I is the lysine-199 residue located near the tryptophan-214 residue. PMID- 6864487 TI - Quantitative investigation on renal handling of drugs in rabbits, dogs, and humans. AB - A renal clearance method based on a computer analysis after administration of a single dose of drug was developed for measuring the renal handling of several drugs in rabbits, dogs, and humans. Secretion and reabsorption of sulfamethizole, sulfanilamide, cephalexin, and ampicillin in the nephron were analyzed quantitatively using the plasma concentration and the urinary excretion rate of the drugs. The validity of the proposed model was demonstrated. It appears that tubular secretion of sulfamethizole, cephalexin, and ampicillin depend on the active transport system which is described by Michaelis-Menten kinetics; the tubular reabsorption of these drugs is expressed by first-order kinetics. The maximum velocity of renal secretion per unit weight of these drugs was much higher in rabbits than in dogs or humans. Reabsorption showed similar values in dogs and humans. These findings suggest that an analysis of the renal handling of drugs in dogs might provide useful information when considering the appropriate therapeutic dose in humans. PMID- 6864488 TI - Thermodynamics of distribution of p-substituted phenols between aqueous solution and organic solvents and phospholipid vesicles. AB - The distribution of p-substituted phenols between 0.15 M NaCl and a range of organic solvents (including 1-octanol) was examined over a range of temperatures. The thermodynamic parameters of transfer, delta G, delta H, and delta S, were determined and the values examined in the light of Hildebrand and Scott's solubility parameter theory, and the collision complexes between solute and organic solvent. Delta H of transfer was positive for nonpolar solvents and negative for 1-octanol; the transfer processes were entropy and enthalpy dominated, respectively. The distribution of the phenols into phospholipid vesicles was examined below the phase-transition temperature. Although delta G of transfer for vesicle-water systems was similar to that for octanol-water systems, the full thermodynamic analysis indicated that the two systems were dissimilar. The use of vesicle distribution data in structure-activity studies is discussed. PMID- 6864489 TI - Influence of premicellar and micellar association on the reactivity of methylprednisolone 21-hemiesters in aqueous solution. AB - Self-association of drug molecules at formulation concentrations can have a major impact on formulation properties. In this study a homologous series of methylprednisolone 21-hemiesters were found to undergo self-association in aqueous solution. The effect of aggregate formation on the solution degradation of these compounds was examined. To determine the nature and extent of association of these steroidal esters, partition coefficients between butyronitrile and aqueous buffer (pH 8.5) were measured as a function of ester concentration. The partitioning data were found to be consistent with dimer formation at low concentration followed by true micelle formation at higher concentration. Chain length increases favored micelle formation, but appeared to have little effect on dimerization. The first-order rate constants for ester hydrolysis and 21 leads to 17 acyl migration in aqueous buffer (pH 8.5) were also found to be dependent on ester concentration. The kinetic data are consistent with a model which assumes stabilization by both dimer and micelle formation, the limiting factor at high concentration being the reactivity of the ester in the micelles. The degree of stabilization due to self-association was found to increase with chain length. PMID- 6864490 TI - Correlation between the psychotropic potency of cannabinoids and their effect on the 1H-NMR spectra of model membranes. PMID- 6864491 TI - Experimental evidence for concentration-dependent plasma protein binding effects on the apparent half-lives of restrictively cleared drugs. PMID- 6864492 TI - The "weak link" in new drug research. PMID- 6864493 TI - Pharmacokinetic relationships between cinromide and its metabolites in the rhesus monkey I: 3-Bromocinnamamide, an active metabolite. AB - Fifty percent of a cinromide dose was metabolized to an active metabolite in the rhesus monkey. The steady-state concentration of this metabolite was 3-6 times that of the parent drug, depending on the route of administration. Cinromide is a medium-extraction ratio drug with a short half-life (0.92 +/- 0.23 hr) when compared with the active metabolite, which has a low extraction ratio and a longer half-life (4.43 +/- 0.76 hr). Incomplete oral bioavailability of cinromide is a result of first-pass metabolism rather than incomplete absorption. PMID- 6864494 TI - Use of isosorbide dinitrate saliva concentrations for biopharmaceutical investigations. AB - The concentration of isosorbide dinitrate in paired samples of plasma and mixed saliva was monitored for up to 24 hr after oral administration of 60 mg of sustained-release isosorbide dinitrate to eight healthy volunteers. Measured isosorbide dinitrate plasma concentrations were mainly in the range of 0.1-10 ng/ml. Isosorbide dinitrate was excreted into saliva resulting in a mean (+/- SD) saliva-plasma concentration ratio of 0.68 +/- 0.37. A significant correlation between concentrations of isosorbide dinitrate in saliva and plasma was found (p less than 0.01). The sustained-release properties of the administered formulation were confirmed from the concentrations of isosorbide dinitrate found in both saliva and plasma. Saliva-plasma ratios were independent of the absolute concentrations of isosorbide dinitrate but showed a slight tendency to decrease with time. The principal factor relating saliva and plasma isosorbide dinitrate concentrations appeared to be the degree of plasma protein binding of the drug. PMID- 6864495 TI - Densitometric determination of the solubility parameter and molal volume of compounds of medicinal relevance. AB - A procedure is described for the simultaneous determination of molal volumes (v02) and solubility parameters (delta) of compounds of medicinal interest. These include alkanoic acids of various chain length and branching (some solid at room temperature), cholesterol, and cholesteryl esters. The procedure is based on the determination of partial molal volumes (v2) from high-precision density measurements of dilute solutions of these compounds in reference solvents, which range in polarity from carbon tetrachloride (delta = 8.6) to nitrobenzene (delta = 10.0). In some cases, the present results do not agree with values of delta published in the literature. Values calculated from group contributions proposed by other authors are prone to error particularly in the case of branched acids and cholesteryl esters. PMID- 6864497 TI - Direct preparation of solid particulates of aminopyrine-barbital complex (pyrabital) from droplets by a spray-drying technique. AB - Aqueous slurries of aminopyrine and barbital (molecular ratio 2:1) containing various excipients such as colloidal silica, synthetic aluminum silicate, montmorillonite clay, corn starch, microcrystalline cellulose, hydroxypropylcellulose, methylcellulose, gelatin, and chitosan were spray-dried by a centrifugal wheel atomizer with various rotation speeds (10,000-40,000 rpm) at various temperatures (85-145 +/- 5 degrees). The spray-dried products were a mixture of aminopyrine-barbital complex (molecular ratio 1:1), aminopyrine, and the excipient used. The flowability and the packing property of the products were improved by compounding colloidal silica into the formulation used for spray drying. The products with montmorillonite clay, chitosan, and a corn starch colloidal silica mixture were compressed directly into tablets. It was found that aminopyrine in the products was oxidized during spray-drying. The oxidation products were assumed to be a trace mixture of 5-oxo-2-methyl-4-dimethylamino-1 phenyl-3-pyrazoline carboxyaldehyde and miscellaneous oxidation products. Montmorillonite clay compounded in the formulation considerably prevented the oxidation of aminopyrine during spray-drying. The present study proposes an improved method for the preparation of solid particulates of aminopyrine-barbital complex for tableting, which combines the synthesis, drying, and agglomeration processes into a single process. PMID- 6864496 TI - Comparison of high-performance liquid chromatography and radioimmunoassay in the determination of content uniformity of digoxin tablets. AB - Digoxin 0.25-mg tablets were dissolved and assayed by the standard high performance liquid chromatography (HPLC) method specified in USP XX and by a radioimmunoassay (RIA) method modified for the assay of tablet solutions. For the RIA method, the filtrate was diluted to a theoretical concentration of 5 ng/ml. Aliquots of this dilution were then assayed for digoxin content using a commercial digoxin 125I RIA kit. Results from both methods were extrapolated to total tablet content and compared with the labeled amount for 20 individual tablets. All tablet assay results were within the USP standards for content uniformity of individual tablets. The individual tablet deviations from labeled amount by the RIA method were smaller when compared with the USP XX-specified HPLC method. Comparison of individual tablet assays show the RIA method to be both as precise and as accurate as the USP XX-specified HPLC method. PMID- 6864498 TI - Determination of benzalkonium chloride in the presence of interfering alkaloids and polymeric substrates by reverse-phase high-performance liquid chromatography. AB - A specific assay for the analysis of benzalkonium chloride in the presence of interfering substances was conducted. The approach involved complexing benzalkonium chloride in an ophthalmic system with methyl orange, extraction of the complex into 1,2-dichloroethane, and subsequent analysis by reverse-phase high-performance liquid chromatography. Since the method separates each homologue of benzalkonium chloride, homologues not resident in the ophthalmic system were added as internal standards to improve both recovery and precision in the method. PMID- 6864499 TI - Gas chromatographic-mass spectrometric quantitation of theophylline and its metabolites in biological fluids. AB - In premature infants, theophylline is converted to caffeine, and the biological half-life is prolonged. To assess the metabolic alterations of theophylline during development of premature infants, a sensitive and simple method was developed which quantitated all theophylline metabolites in plasma, urine, and red blood cells. Theophylline and its metabolites in the sample were converted to the N-propyl derivative using n-propyl iodide in dimethylformamide with potassium carbonate catalysis and were analyzed under isothermal conditions on a gas chromatograph-mass spectrometer with a 3% methylsilicone-phenylsilicone column. Deuterated caffeine (caffeine-d3) was used as the internal standard. A selected ion-monitoring technique, together with 70-eV electron impact ionization mode, was used. The ion current ratios between caffeine-d3 (m/z 197) and caffeine (m/z 194), theophylline (m/z 222), 3-methylxanthine (m/z 250), 1,3-dimethyluric acid (m/z 280), and 1-methyluric acid (m/z 308) were monitored. The total analysis time was 12 min with a detection limit ranging from 500 pg to 10 ng, depending on the metabolites. With this sensitivity, sample sizes of 50-100 microliters of plasma and 0.5 ml of urine were sufficient for the analysis of all theophylline metabolites. The coefficient of variation of this method was less than 5% for the analysis of biological samples. PMID- 6864500 TI - Comparison of granule strength and tablet tensile strength. AB - The granule strength (crushing load) of lactose granulated with 1-9% povidone was measured initially and at intervals during a 1-year period. The granule strengths of dibasic calcium phosphate dihydrate granulated with various concentrations of starch and povidone were measured. The axial and radial tensile strengths of tablets compressed from these granules were determined and related to concentration of binder and granule strength. The effect of compressional force on the integrity of granules in a tablet matrix is shown in scanning electron photomicrographs of the fractured tablets which had undergone a diametral compression test. It appears that the compressional force and the concentration of binder contribute more than granule strength to tablet tensile strength. PMID- 6864501 TI - High-performance liquid chromatographic determination of vincristine sulfate in preformulation studies. AB - A fast and simple procedure was developed for the quantitative determination of vincristine sulfate for use in preformulation studies. The procedure involves the use of high-performance liquid chromatography with a reverse-phase column and a mobile phase containing the sodium salt of 1-pentanesulfonic acid for ion pairing. The procedure has been shown to be specific for vincristine sulfate in the presence of forced degradation products of this substance, vinblastine (a structurally similar Vinca alkaloid), and several possible formula excipients. The procedure is linear from 10-200% of the normal injection concentration, and has an assay precision (relative 2 sigma) of +/- 1.6%. Recovery of known samples averaged 99.7%. PMID- 6864502 TI - Furosemide binding by human albumin: comparison of two methods of fluorescence quenching analysis. AB - Disagreement exists over the primary-site binding constant for the interaction of furosemide with human albumin. Disagreement also exists over which experimental methods are accurate in this particular interaction. Therefore, furosemide binding by human albumin was examined using albumin fluorescence quenching by both the method of Levine and the method of Steiner et al. The binding constants obtained by each method differed greatly, with the results of the latter method being similar to those of other experimental methods. It was concluded that the method of Levine overestimates the binding constant for this drug-protein interaction. PMID- 6864503 TI - Thermal and photolytic degradation studies of promethazine hydrochloride: a stability-indicating assay. AB - A stability-indicating GLC method for the analysis of promethazine hydrochloride in polyethylene glycol delivery systems is reported. This method is capable of distinguishing the intact drug from its thermal and photodegradation products. A linear relationship between peak height ratio (promethazine-promazine) and promethazine concentration is found up to a concentration of 600 micrograms/ml. Kinetic studies were performed to determine the photolytic and thermal degradation rates of promethazine hydrochloride as a function of pH. The activation energies at pH 2.98, 3.94, and 5.12 were obtained from linear Arrhenius plots and were found to be 6601, 5888, 5570 cal/mole, respectively. The first-order rate constant increased with increasing pH. The photolytic degradation of promethazine hydrochloride does not follow simple first-order kinetics. PMID- 6864504 TI - Aspects of the chemical stability of mitomycin and porfiromycin in acidic solution. AB - Aspects of the degradations of mitomycin and porfiromycin were studied. The initial degradation processes of the compounds in an acidic medium were investigated. Influences of pH, buffers, and other additives such as halogenides and dioctyl sodium sulfosuccinate [sodium 1,4-bis(2-ethylhexyl)sulfosuccinate] were studied. The hydrogen ion catalyzes the degradation of both the uncharged and the protonated species. Anions also promote the degradation of the compounds in an acidic medium. Rate constants for all of the catalytic reactions could be determined. From the pH profiles, after correction for buffer influences, accurate pKa values for the aziridine nitrogens could be obtained. The protective influence of the dioctyl sulfosuccinate ion could be explained. From the data obtained a plausible mechanism for the initial acidic degradation reactions was developed. PMID- 6864505 TI - Tissue distribution of [14C]bretylium tosylate in rats. AB - The distribution of [14C]bretylium tosylate in the body and the relationship between tissue and plasma concentrations was determined following intravenous administration of the drug to Charles River rats. The renal excretion of bretylium was rapid in rats and follows an active process. On the average, 50% of the administered dose was excreted in the urine within 1 hr. In the postequilibrium phase, the plasma concentration declined with a half-life of 5 hr. Bretylium concentrations in all tissues, except the heart, declined rapidly according to a triexponential equation. The liver and kidney bretylium concentrations declined in parallel to the plasma concentration with mean tissue plasma concentration ratios of 6.04 and 12.3, respectively, in the beta phase. However, the concentration of bretylium in the heart increased gradually and peaked at 2 hr, with a tissue-plasma concentration ratio of 121, which, in turn, declined to a value of greater than 60 after 8 hr. The data indicated that (a) bretylium is rapidly distributed into the liver and kidney immediately after reaching the systemic circulation; (b) the distribution into the heart occurs at a slower rate compared with the other organs, and the drug has a high affinity to the myocardium; and (c) since the heart is the site of action and there is no direct correlation between the concentrations in myocardium and plasma, the antiarrhythmic effect of bretylium may not be related to the plasma concentration. PMID- 6864507 TI - Convenient method of simultaneously analyzing aluminum and magnesium in pharmaceutical dosage forms using californium-252 thermal neutron activation. AB - A commercial antacid suspension containing aluminum hydroxide and magnesium hydroxide products was used as a model sample to study the use of a californium 252 thermal neutron activation as a method for quantifying aluminum content as well as for the simultaneous assay of aluminum and magnesium. A 3.5-micrograms californium-252 source was used for the activation, and the induced aluminum-28 and magnesium-27 activity was simultaneously measured by sodium iodide crystal gamma-ray spectrometry using dual single-channel analyzers and scalers. The antacid suspension was contained in a chamber designed with the unique capability of serving as the container for counting the induced radioactivity in addition to being the irradiation chamber itself. Ten replicate irradiations were performed, and the precision was compared with 10 replicate analyses of the antacid suspension using the official ethylenediaminetetraacetic acid titration method. For aluminum the precision was 1.4 versus 0.62% for the titration method. For the magnesium the precision was 5.3 versus 0.79% for the titration method. This pilot study demonstrated that use of more intense californium-252 sources, which are commonly available, would provide a method that is competitive with the ethylenediaminetetraacetic acid titration method in precision and in other aspects as well. PMID- 6864506 TI - Room temperature phosphorescence determination of propranolol in pharmaceutical formulations. AB - A simple, rapid, and specific procedure was used for the analysis of propranolol in pharmaceutical formulations. The procedure consisted of dissolving (diluting) appropriate quantities of preparations and standards in (with) a 2 M potassium iodide-ethanol-water solution, spotting 5 microliter of each resultant solution onto filter paper disks, determining the phosphorescence intensities at room temperature, and comparing sample signal levels with those of standards. The results indicated that room temperature phosphorescence can be easily applied to the analysis of pharmaceutical formulations where active ingredients are generally contained in a wide variety of matrices. PMID- 6864508 TI - (-)-alpha-Isosparteine from Lupinus argenteus var. stenophyllus. AB - Combined GLC-mass spectrometry revealed that an unidentified sparteine isomer was the major component of an alkaloid extract of the aboveground portions of Lupinus argenteus Pursh. var. stenophyllus (Rydb.) Davis (Leguminosae). After isolation, this alkaloid was characterized as the least common of the known sparteine isomers, (-)-alpha-isosparteine. A preliminary pharmacological study showed (-) alpha-isosparteine to have a more rapid onset and a shorter duration of action when compared with (-)-sparteine on rat myocardium. PMID- 6864509 TI - Synthesis of isopromethazine hydrochloride. PMID- 6864511 TI - Nonlinear regression approach for determining whether absorption and elimination rate constants are equal in the one-compartment open model with first-order processes. PMID- 6864510 TI - Determination of serum tulobuterol concentrations by mass fragmentography: comparison with an electron-capture gas chromatographic method. AB - A simple and sensitive method is reported for the quantitative determination of the bronchodilator tulobuterol in human serum. Tulobuterol and an internal standard were extracted from alkalinized serum with ether and then back-extracted into dilute hydrochloric acid. After alkalinization and extraction of the aqueous solution, the extract was evaporated to dryness. The residue was silylated and subjected to mass fragmentography. PMID- 6864512 TI - Kinetic interpretation of the microparameters in compartmental modeling when adjoining compartments are sampled. PMID- 6864513 TI - Predicting the dose-dependent bioavailability of hydrocortisone and chlorothiazide in humans. PMID- 6864514 TI - Modified Wagner-Nelson absorption equations for multiple-dose regimens. PMID- 6864515 TI - Disruption of brightness discrimination in a shock avoidance task by phencyclidine and its antagonism in rats. AB - Rats were trained to make a simultaneous brightness discrimination in order to avoid or escape foot shocks in an automated Y-maze. Brightness discrimination was completely disrupted by phencyclidine (PCP, 3 mg/kg), ketamine (30 mg/kg) and dexoxadrol (10 mg/kg). At these doses, there was increased locomotor activity between trials. The number of movement attempts to avoid shock during a trial were either unchanged or reduced. Several drugs with various clinical applications (chlorpromazine, haloperidol, diazepam, pentobarbital, d amphetamine, propranolol, clonidine and prazosin) did not impair brightness discrimination in behavioral stimulant or depressant doses. The levoisomer of dexoxadrol, levoxadrol, was also inactive. Daily administration of PCP for 5 consecutive days produced progressive increases in locomotor stimulation with no tolerance to effects on brightness disruption. The disruption of brightness discrimination by PCP was not reversed by chlorpromazine, haloperidol, diazepam, propranolol or apomorphine at doses which reduced the locomotor stimulation by PCP. Both locomotor stimulation and discrimination disruption were blocked by prazosin and clonidine. A central adrenergic mechanism is implicated for some behavioral effects of PCP. PMID- 6864516 TI - Stereoselective behavioral effects of cocaine and a phenyltropane analog. AB - Intramuscular injections of the stereoisomers of cocaine and of its phenyltropane analog were compared for their effects on schedule-controlled behavior of squirrel monkeys. Monkeys responded by pressing a lever under a multiple schedule with alternating fixed-interval and fixed-ratio components; responding was maintained by presentation of food in some monkeys and by termination of a stimulus associated with electric shock in other monkeys. The levorotatory isomers, (-)-cocaine (0.09-2.7 mg/kg) and WIN 35,065-2 (0.006-0.2 mg/kg), had qualitatively similar effects which depended primarily on the type of component schedule (fixed-interval or fixed-ratio) that maintained responding. In the fixed interval components, intermediate doses of each drug increased responding, whereas higher doses decreased responding. In the fixed-ratio components, each drug only decreased responding in a dose-related manner. The minimal effective dose of (-)-cocaine was about 10 times that of WIN 35,065-2. Although the dextrorotatory isomers, (+)-cocaine and WIN 35,065-3, also increased responding in the fixed-interval components and decreased responding in the fixed-ratio components in some monkeys, the doses required were 100 to 622 times the minimal effective doses of their enantiomers. The results show a high degree of stereoselectivity in the behavioral effects of both cocaine and its phenyltropane analog. PMID- 6864517 TI - Tetrabenazine, an amine-depleting drug, also blocks dopamine receptors in rat brain. AB - Tetrabenazine (TBZ) is used in the treatment of hyperkinetic movement disorders. Its effect is thought to be mediated by depletion of dopamine (DA) stores. We studied other possible mechanisms of action of this drug. TBZ decreased DA concentration in rat striatum and nucleus accumbens in a dose-dependent manner with an IC50 of approximately 1.2 mg.kg-1. Maximal depletion was obtained within 30 min with only partial recovery at 8 hr. TBZ induced (at 40 mg . kg-1) 5- to 8 fold increases in 3,4-dihydroxyphenylacetic acid and homovanillic acid concentrations in both brain regions. Unlike reserpine, TBZ completely abolished the apomorphine-induced inhibition of DA synthesis under conditions in which this effect is mediated by presynaptic DA receptors. Both TBZ (5 mg . kg-1) and reserpine (5 mg . kg-1) depleted, at 1 hr, striatal DA content by approximately 90%. However, TBZ, but not reserpine, significantly stimulated in vivo tyrosine hydroxylase activity. TBZ also inhibited [3H]spiperone binding in the striatum with Ki = 2.1 X 10(-6) M. In rats, with unilateral destruction of the nigrostriatal pathway with 6-hydroxydopamine, pretreatment with TBZ significantly reduced the number of rotations induced by apomorphine. Finally, in rats treated with either TBZ (5 mg . kg-1) or reserpine (5 mg . kg-1), prolactin levels significantly increased as compared to control values. TBZ, but not reserpine, blocked apomorphine inhibition of prolactin secretion. We conclude that, in addition to depleting monoamines, TBZ also blocks both presynaptic and postsynaptic DA receptors in rat brain. PMID- 6864518 TI - Inhibition by concanavalin A, dansylcadaverine and bacitracin of muscarinic receptor-mediated desensitization in guinea-pig Ileal smooth muscle. AB - The muscarinic agonist, cis-2-methyl-4-dimethylaminomethyl-1,3-dioxolane methiodide (CD), and histamine desensitize the responses of guinea-pig ileal longitudinal smooth muscle to subsequently administered CD or histamine, respectively. Desensitization by CD, but not by histamine, was inhibited by concanavalin A (Con A) and this protection was prevented by co-administration of succinyl-Con A or by cytochalasin B or colchicine at concentrations which alone did not affect desensitization. Dansylcadaverine and bacitracin, inhibitors of transglutaminase, both protected against CD desensitization but were without effect on desensitization mediated by histamine. Benzilylcholine mustard, which reduced muscarinic receptor density, significantly reduced CD-induced desensitization. The effects of Con A and the transglutaminase inhibitors suggest that agonist-induced changes in muscarinic receptor distribution or receptor effector coupling, via cytoskeletal and transglutaminase-sensitive mechanisms, are a component of CD-induced desensitization. These processes do not appear to be involved in histamine receptor-mediated desensitization. Although desensitization by CD or histamine is nonspecific in this preparation, both agonists cross-desensitizing, the effects of Con A, dansylcadaverine and bacitracin clearly indicate differences in the desensitization process elicited by these two stimulants. PMID- 6864519 TI - Ammonium chloride and methylamine hydrochloride antagonize clostridial neurotoxins. AB - Ammonium chloride (1-8 mM) and methylamine hydrochloride (1-16 mM) produce concentration-dependent antagonism of the onset of neuromuscular blockade caused by botulinum toxin types A, B and C (all at 1 X 10(-11) M) and by tetanus toxin (3 X 10(-10) M). Neither drug antagonizes the onset of paralysis caused by beta bungarotoxin (1 X 10(-7) M) or by taipoxin (1 X 10(-8) M). At concentrations that produce antagonism of clostridial neurotoxins, ammonium chloride and methylamine hydrochloride (8-10 mM) do not inactivate toxin molecules, nor do they produce irreversible changes in tissue function. When studied under conditions that impose partial synchrony on the mechanism of clostridial neurotoxin action, ammonium chloride and methylamine hydrochloride do not inhibit ligand binding and do not reverse neuromuscular blockade. The drugs act solely to antagonize internalization of toxins by cholinergic nerve endings. As a result of inhibiting the process of internalization, the drugs trap the toxins at an antitoxin sensitive site. PMID- 6864520 TI - Inhibition of fast- and slow-phase depolarization-dependent synaptosomal calcium uptake by ethanol. AB - Uptake of 45Ca++ by synaptosomes isolated from cerebral cortex, cerebellum, midbrain and brain stem of male, Sprague-Dawley rats was measured at 1-, 3-, 5-, 15-, 30- and 60-sec time periods. At 1 sec, the Ca++ uptake rate by cerebrocortical synaptosomes was 1.45 mumol/sec/g of protein, whereas the 60-sec rate was 0.03 mumol/sec/g of protein. In vitro addition of ethanol, 80 mM, inhibited depolarization-dependent (65 mM KCl) 45Ca++ uptake by synaptosomes but the time-response relationships varied depending upon the brain region studied. In cerebrocortical synaptosomes, ethanol significantly inhibited only the fast phase component of 45Ca++ uptake (1 and 3 sec). Ethanol inhibited 45Ca++ uptake by midbrain synaptosomes at all measurement times studied (1, 3, 5 and 15 sec), whereas in cerebellum and brain stem ethanol inhibited 45Ca++ uptake at 3- and 5 sec time periods. Ethanol at concentrations of 25, 50, 100 and 150 mM inhibited 45Ca++ uptake by 9.0, 15.9, 24.8 and 30.7%, respectively, in cerebrocortical synaptosomes. In vitro ethanol, 80 mM, added to cerebrocortical synaptosomes isolated from rats fed a nutritionally adequate liquid ethanol diet did not significantly inhibit depolarization-dependent 45Ca++ uptake. The results of this study show that pharmacologically relevant ethanol concentrations inhibit voltage dependent 45Ca++ uptake into synaptosomes. This inhibitory action may, at least in part, underlie some of the intoxicating effects of ethanol. In addition, chronic administration of ethanol resulted in an apparent adaptive response such that addition of ethanol no longer blocked 45Ca++ uptake. This adaptive response involving the calcium channel may represent a cellular mechanism for functional tolerance development. PMID- 6864521 TI - Antibiotic efficacy against Vibrio vulnificus in the mouse: superiority of tetracycline. AB - Seven antimicrobial agents, all effective against Vibrio vulnificus in vitro, were compared for in vivo efficacy in mice experimentally infected with V. vulnificus strain B3547. Mice were injected s.c. with 1 X 10(8) cells, and i.p. injection of antimicrobials was begun 1.5 hr later when mice were bacteremic and had edematous lesions at the injection site. The study was done in two phases. Phase I was a dose-ranging experiment, using single injections within the range (on a body weight-adjusted basis) clinically useful in humans. Of 12 mice treated with tetracycline (4 mg/kg), 12 survived at 24 hr, compared to 0 of 21 saline treated controls, 3 of 10 given ampicillin (32 mg/kg) and 2 of 3 given cefotaxime (20 mg/kg). There were no survivors at 24 hr in groups of 5 to 10 mice treated with cefazolin (32 mg/kg), carbenicillin (80 mg/kg), erythromycin (8 mg/kg) or gentamicin (8 mg/kg). Phase II was designed to simulate clinical conditions using multiple dosing for 30 hr and scoring for survival at 96 hr. Of 12 mice given tetracycline (3 mg/kg every 12 hr), 12 survived, compared to 1 of 10 given cefotaxime (20 mg/kg every 6 hr), 0 of 12 given carbenicillin (40 mg/kg every 6 hr) and 0 of 12 given saline every 6 hr. Tetracycline thus appears to be the agent of choice among those tested for in vivo efficacy against V. vulnificus in the mouse model. PMID- 6864522 TI - Aminophylline inhibits renal vasoconstriction produced by intrarenal hypertonic saline. AB - An intrarenal infusion of hypertonic saline to sodium-depleted dogs causes an acute reduction in renal blood flow (RBF) which has been postulated to be due to tubuloglomerular feedback (TGF). Adenosine has been suggested as a mediator of TGF, as adenosine receptor blockade with methylxanthines inhibits TGF. In order to test further the hypothesis that the renal response to hypertonic saline is mediated by TGF, the RBF response to intrarenal hypertonic saline infusions have been investigated in sodium-depleted dogs before and after either an infusion of vehicle or an intrarenal infusion of aminophylline. Aminophylline (2.5 mg/min), at a dose which did not change basal RBF or responses to bolus doses of angiotensin II, inhibited the responses to intrarenal bolus doses of adenosine. In control dogs (n = 5), a 10-min intrarenal infusion of hypertonic saline significantly (P less than .05) reduced RBF both before (-27 +/- 4%) and during ( 16 +/- 9%) an infusion with aminophylline vehicle. In a second group of animals (n = 5), an intrarenal hypertonic saline infusion reduced RBF before (-33 +/- 8%; P less than .05), but not during an intrarenal aminophylline infusion (2.5 mg/min). We conclude that aminophylline inhibits the renal vascular response to hypertonic saline and that the renal response to hypertonic saline might be mediated by intrarenal adenosine release. PMID- 6864523 TI - Release of norepinephrine from organ-cultured superior cervical ganglia: effects of the norepinephrine uptake inhibitor xylamine. AB - After preloading with [3H]norepinephrine (NE), organ-cultured superior cervical ganglia released increased amounts of [3H]NE when incubated with depolarizing K+ concentrations, tyramine or amphetamine. K+-induced release was Ca++-dependent, whereas tyramine- and amphetamine-induced release were not. Analysis of the released radioactivity by high-pressure liquid chromatography showed that these releasing stimuli caused primarily an increase in NE release, with little increase in the release of NE metabolites. Incubation with 10 microM xylamine, an irreversible inhibitor of NE uptake, caused a small increase in [3H]NE efflux, but no reduction in the endogenous NE and dopamine levels in superior cervical ganglia. After xylamine treatment, tyramine-induced release was greatly inhibited, whereas release by amphetamine and K+ was not. The neuronal uptake inhibitor desipramine (1 microM), affected K+-, tyramine- and amphetamine-induced release in a manner similar to xylamine. It is concluded that xylamine is a very weak releasing agent in this tissue and that its effects on other release processes are consistent with its action as a NE uptake inhibitor. Amphetamine induced release appears not to require the NE uptake system for either the uptake of amphetamine, as shown by the accumulation of [3H]amphetamine, or the efflux of NE. PMID- 6864524 TI - Sex differences in rats in the metabolism of phenytoin to 5-(3,4-dihydroxyphenyl) 5-phenylhydantoin. AB - Phenytoin (DPH) is metabolized in isolated hepatocytes from male rats by hydroxylation to 5-(4-hydroxyphenyl)-5-phenylhydantoin, 5-(3,4-dihydroxy-1,5 cyclohexadien-1-yl)-5-phenylhydantoin (dihydrodiol) and a catecholic metabolite, 5-(3,4-dihydroxyphenyl)-5-phenylhydantoin, which is further metabolized by methylation of one of the phenolic hydroxyl groups. Isolated hepatocytes from female rats convert DPH to the initial metabolites, but only trace amounts of the catechol are formed. Similar results were obtained in vivo and with liver homogenate preparations. Incubation of possible precursor metabolites to the catechol indicate that the sex difference in catechol formation is due to differences in 5-(4-hydroxyphenyl)-5-phenylhydantoin hydroxylation rather than to differences in oxidation of the dihydrodiol metabolite. It is postulated that different isozymes of cytochrome P-450 catalyze the hydroxylation of DPH and its p-phenol metabolite because sex differences are observed only in the second hydroxylation step. Furthermore, the sex difference may be due to lower activity of one or more cytochrome P-450 isozymes in female rats than in male rats. These results may have important implications in the pharmacological activity and toxicity of DPH. PMID- 6864525 TI - Effects of biogenic amines on raphe-spinal tract cells. AB - Stimulation in the nucleus raphe magnus produces analgesia in behavioral paradigms and inhibits spinal cord nociceptive neurons. Similar effects result from stimulation of the periaqueductal gray (PAG). Such actions may be mediated via a synaptic link between PAG and nucleus raphe magnus or the adjacent reticular formation. In this study we have examined the effects of biogenic amines applied iontophoretically in the vicinity of nucleus raphe magnus neurons that project to the spinal cord in monkeys. Raphe-spinal tract (RST) neurons were identified by antidromic activation after stimulation of the dorsolateral funiculi at an upper lumbar level. The actions of serotonin, quipazine, norepinephrine, dopamine and acetylcholine (ACh) were tested against the background activity, the activity evoked by glutamate pulses or the excitation of RST cells by stimulation in the PAG. Serotonin, quipazine, norepinephrine and dopamine produced a current-dependent inhibition of background activity and the responses to glutamate pulses in all RST cells tested. No cases of excitation were found. By contrast, ACh enhanced activity produced by glutamate pulses in all RST cells observed. ACh also enhanced the background activity of all but one of the RST cells; however, ACh did not activate cells with little or no background discharge. Serotonin and norepinephrine often inhibited PAG excitation of RST cells. No facilitation of PAG excitation was observed. We conclude that the actions of serotonergic and catecholaminergic agonists on raphe-spinal cells are inhibitory whereas the effect of ACh is facilitatory. PMID- 6864526 TI - Tolerance to phencyclidine in pigeons: cross-tolerance to ketamine. AB - In order to determine whether tolerance developed to the behavioral effects of phencyclidine, pigeons were trained to respond under a multiple fixed-ratio 30, fixed-interval 600-sec schedule of food presentation. When rates and patterns of responding reached stability, dose-response curves for phencyclidine (0.1-10 mumol/kg i.m.), ketamine (3-56 mumol/kg i.m.) and pentobarbital (1-75 mumol/kg i.m.) were determined. Phencyclidine, ketamine and pentobarbital all decreased fixed-ratio 30 responding in a dose-related manner and increased fixed-internal 600-sec. responding at immediate doses. At higher doses, pentobarbital decreased responding. High doses of phencyclidine and ketamine suppressed responding in the early portions of the session, but when responding returned, it returned at a high rate. After 35 daily injections of phencyclidine (3 mumol/kg/day i.m.), dose response curves were redetermined for all three drugs. A tolerance was observed for moderate doses of phencyclidine, and a moderate cross-tolerance was observed to ketamine. No tolerance was observed for the total suppression of responding produced by high doses of phencyclidine and ketamine early in the test sessions. No cross-tolerance to pentobarbital was observed. After 215 days of daily phencyclidine administration, no withdrawal signs were observed upon the discontinuation of daily injections. PMID- 6864527 TI - Alterations in dopaminergic function after subacute ethanol administration. AB - The in vivo and in vitro effects of d-amphetamine were assessed in rats after subacute (24 hr) administration of ethanol vapor (28 mg/l). Forty-eight hours after the termination of ethanol vapor inhalation, when the animals were tolerant to the hypothermic effect of ethanol, a decreased hypothermic response to d amphetamine was detected, suggesting that functional changes in dopaminergic activity might be associated with ethanol tolerance. The hyperthermic effect of d amphetamine was similar in the ethanol-tolerant and control animals. The d amphetamine-stimulated release of [3H]dopamine from crude synaptosomal (P2) fractions of striatum was nearly abolished immediately after subacute ethanol administration. Samples prepared from ethanol-tolerant animals released less [3H]dopamine in response to d-amphetamine perfusion compared to samples prepared from control animals when tested 48 hr after ethanol vapor exposure. Subacute ethanol administration appears to produce long-acting changes in d-amphetamine sensitive dopaminergic mechanisms. PMID- 6864528 TI - Saturable accumulation of the anionic herbicide, 2,4-dichlorophenoxyacetic acid (2,4-D), by rabbit choroid plexus: early developmental origin and interaction with salicylates. AB - Transport of the anionic herbicide, 2,4-dichlorophenoxyacetic acid (2,4-D) was examined in vitro via the isolated choroid plexus of adult and neonatal rabbits and in vivo via ventriculocisternal perfusion. In vitro, the facilitated transport of 2,4-D by the choroid plexus was established in the rabbit by as early as 3 days of age. Uptake in both adults and neonates took place against a concentration gradient via a saturable process that was inhibited by ouabain and hypothermia (0 degrees C). Probenecid and hippuric acid were effective dose dependent inhibitors of 2,4-D transport in vitro. The major metabolite of salicylate, salicyluric acid, was also an effective inhibitor, more than its precursor, salicylate, or gentisic acid, a second salicylate metabolite. Neither phenol, acetaminophen nor glycine inhibited 2,4-D transport. Thus, the effects appear specific for those compounds which share the organic acid transport system. The role of carrier-mediated transport in the clearance of 2,4-D from cerebrospinal fluid (CSF) was also evaluated in vivo by ventriculocisternal perfusion. Steady-state clearance of 2,4-D from CSF exceeded that of inulin and was reduced in a dose-dependent fashion in the presence of salicylate. Neither CSF formation nor absorption rates were changed. These results indicate that 2,4 D is transported from the CSF via the organic anion transport system, and that inhibitors of this transport system may block its elimination from the brain in vivo, just as they block its transport by the isolated choroid plexus. PMID- 6864529 TI - Drug interactions. II. Formation of nitrosamines from therapeutic drugs. Properties and kinetics of the formation of N-nitrosopropranolol from nitrite and the secondary amine propranolol hydrochloride. AB - In the presence of hydrochloric acid, nitrosamines may be generated from amines and nitrite. Most nitrosamines are carcinogens and many commonly used drugs contain potentially nitrosatable amine groups. Beta-adrenergic blockers, which have such amine groups, are widely prescribed and are often ingested for the lifetime of the patients, but their safety with respect to the intragastric formation of nitrosamines has not been established. The studies in this and the following report were designed to assess the potential risk posed by the endogenous formation of a nitrosamine in the stomach to individuals receiving longterm treatment with propranolol hydrochloride. The putative nitrosamine, N nitrosopropranolol (NNP), was synthesized and its stability was examined under various experimental conditions. A high-pressure liquid chromatographic method was developed which detects a minimum of 7 X 10(-11) mol of NNP in the presence of large quantities of unreacted drug. Preparations of propranolol hydrochloride were found to contain several non-nitrosamine contaminants, which were removed before kinetic studies. At 37 degrees C, in solutions of HCl within the pH range found in the stomach, the optimum pH for the formation of NNP was 3. The yield of NNP increased linearly as incubation time and concentration of propranolol increased and exponentially as the concentration of nitrite was raised. Under optimal conditions in hydrochloric acid, the minimum concentration of nitrite required for the production of detectable amounts of NNP was 10(-5) M. PMID- 6864530 TI - Renal tubular secretion of piretanide and its effects on electrolyte reabsorption and tubuloglomerular feedback mechanism. AB - Piretanide [HOE 118; 4-phenoxy-3-(1-pyrrolidinyl)-5-sulfamoxylbenzoic acid] is a new diuretic with a saluretic effect similar to that of furosemide. The present experiments were undertaken to investigate if transport of piretanide into the tubular lumen determines the diuretic response and what effect piretanide has on the tubuloglomerular feedback control and loop of Henle electrolyte transport. To study the first question, five healthy subjects were investigated. Piretanide, inulin and p-aminohippuric acid were continuously infused. After equilibration, 1 g of probenecid was given which reduced the tubular secretion of piretanide to one-sixth of control level. The reduction in diuresis was 41.4% while it was 59.5, 63.9 and 45.8% for the urinary excretion of chloride, sodium and potassium, respectively. In a second series of experiments in rats a proximal tubular stop flow pressure response at increased distal delivery of fluid was measured when Ringer's solution, Ringer's solution plus furosemide (10(-4) M) or bumetanide (5 X 10(-5) M) or piretanide (10(-4) M and 5 X 10(-5) M) was added to the tubular perfusion solution. The results indicate that the feedback could be completely blocked by any of these diuretics. The fluid absorption in the loop of Henle was studied in separate experiments and the addition of piretanide (10(-4) M) greatly reduced chloride and absolute fluid absorption from this nephron segment. The present results indicate that tubular secretion of piretanide is important for the diuretic response and that piretanide inhibits the fluid absorption in the loop of Henle and the tubuloglomerular feedback control which would otherwise blunt the diuretic response with a reduction in glomerular filtration rate. PMID- 6864531 TI - Structure-pharmacokinetic relationships among the barbiturates in the rat. AB - The pharmacokinetics of a congeneric series of barbituric acids were determined after i.v. administration of individual barbiturates or multicomponent barbiturate mixtures to chronically cannulated male rats. The concentration of barbiturate in plasma and urine was determined using reversed-phase high performance liquid chromatography. A biexponential equation adequately fitted the plasma-concentration time data. The volume of distribution remained relatively constant within the series. Binding to plasma proteins varied enormously, increasing with lipophilicity. Accordingly, the volume of distribution based on unbound drug also increased with lipophilicity, reflecting a corresponding greater tissue affinity. Total clearance formed a relatively complex nonlinear relationship with lipophilicity. Although the affinity of the barbiturates for erythrocytes increased with lipophilicity, the relationship between total blood clearance and lipophilicity offered no simplification. Renal clearance, the minor route of elimination for the majority of the homologs, decreased with increasing lipophilicity, due to increased tubular reabsorption, whereas nonrenal (hepatic) clearance produced a nonlinear relationship with lipophilicity similar in form to that of total clearance. The nonlinearity of the hepatic clearance within the series was explained by a hepatic blood flow limitation, for the highest homologs, and by the stereochemistry of position 5 on the barbituric acid ring, for the lowest homologs. PMID- 6864532 TI - Effects of acetylcholine on large and small coronary arteries in conscious dogs. AB - The effects of acetylcholine, 10 microgram/kg i.v., were examined in nine conscious dogs on measurements of left ventricular pressure, dP/dt, aortic pressure, heart rate, coronary blood flow, left circumflex external coronary arterial diameter, arterial and coronary sinus O2 content and calculations of late diastolic coronary resistance and left circumflex internal coronary cross sectional area. In conscious dogs in the absence of autonomic blockade, acetylcholine induced a rapid, transient response characterized by hypotension and peak increases in coronary blood flow (+135 +/- 14%) and coronary sinus O2 content (+5.0 +/- 0.5 volume percent) and decreases in late diastolic coronary resistance (-65 +/- 3%). The peak large coronary arterial effects were observed 60 sec later at a time when arterial pressure, left ventricular end-diastolic pressure, left ventricular dP/dt and heart rate were not significantly different from control. At this time, large coronary cross-sectional area was increased by 36 +/- 4%, whereas late diastolic coronary resistance was not significantly different from control. Beta adrenergic or combined alpha and beta adrenergic receptor blockade did not alter the responses significantly. However, the effects were abolished by muscarinic blockade with atropine methylbromide, 0.1 mg/kg. Thus, acetylcholine dilates large coronary arteries as well as coronary resistance vessels. These effects are independent of metabolic and adrenergic mechanisms, and are mediated by muscarinic receptors, inasmuch as the effects are abolished by prior muscarinic receptor blockade. PMID- 6864533 TI - Competitive inhibition of methotrexate accumulation in rabbit kidney slices by nonsteroidal anti-inflammatory drugs. PMID- 6864534 TI - Antitussive effect of the optical isomers of mu, kappa and sigma opiate agonists/antagonists in the cat. AB - The optical isomer of mu and kappa opiates, when given i.v., inhibited the cough reflex in the lightly anesthetized cat, the levoisomers being, in general, 2 to 14 times more potent than the dextro-isomers. The optical isomers of the sigma agonist, SKF 10,047, did not show any antitussive activity up to near lethal or lethal doses (5 mg/kg i.v.). Naloxone (1 mg/kg i.v.) did not block or reverse the antitussive effects of (-)- and (+)-codeine but completely antagonized the effects of an ED84 of (-)-, (+)-morphine, (-)-, (+)-methadone, levomethorphan and dextromethorphan. The cough suppressant effects of the kappa opiates were partially blocked by naloxone, (+/-)-ketocyclazocine being more sensitive to the effect of naloxone than (-)-cyclazocine. (-)-SKF 10,047 at 3.0 mg/kg i.v. and the ED16 of (-)-cyclazocine did not inhibit the antitussive effect of codeine but blocked that of morphine, behaving like naloxone. (+)-SKF 10,047 and (+) cyclazocine did not show in vivo antagonistic effect vs. codeine or morphine. The ED16 of ketocyclazocine partially antagonized codeine but not morphine. The optical isomers of opiates showed good correlation between the in vivo antitussive potencies and their in vitro inhibitory potencies against (-)-codeine binding in homogenates of the guinea-pig medulla. The data confirm the hypothesis that the cough suppressant effects of opiates are mediated by receptors which are less stereoselective and less naloxone-sensitive than the analgesic receptors. The possible involvement of mu and kappa sites as well as their interactions are discussed. PMID- 6864535 TI - Gastric antisecretory and cytoprotective activities of SCH 28080. AB - SCH 28080 (2-methyl-8-(phenylmethoxy)imidazo[1,2-a]pyridine-3-acetonitrile) is a novel antiulcer agent which has both antisecretory and cytoprotective activities. The antisecretory ED50 values in the pylorus-ligated rat were 3.7 mg/kg p.o. and 2.8 mg/kg i.p., being 7 and 10 times more potent than cimetidine, respectively. In dogs, SCH 28080 was effective in inhibiting acid secretion stimulated by histamine (ED50 of 0.09 mg/kg i.v. and 4.4 mg/kg p.o.), dimaprit, pentagastrin, insulin and feeding. The cytoprotective activity of SCH 28080 was demonstrated by inhibition of ethanol-induced gastric lesions in a dose-dependent manner in rats (ED50:3.0 mg/kg p.o.). SCH 28080 was active in similar dose ranges (1-10 mg/kg) by both p.o. and i.v. routes of administration. This gastric cytoprotective activity was not affected by indomethacin pretreatment. Furthermore, the gastric potential difference was effectively sustained by SCH 28080 (3, 10 and 30 mg/kg p.o.) after intragastric ethanol. SCH 28080 (1-30 mg/kg p.o.) also inhibited gastric ulcers provoked by aspirin, aspirin + acid, indomethacin and stress (cold restraint) in rats. The data support the concept that it is possible to have combined antisecretory and cytoprotectant actions in a single molecule which is not a prostaglandin. PMID- 6864536 TI - Relationship of the biodisposition of the stereoisomers of nicotine in the central nervous system to their pharmacological actions. AB - The stereoisomers of nicotine were evaluated for their effectiveness in producing antinociception and altering spontaneous activity and Rotarod performance in rats. (-)-Nicotine was found to be 6, 15 and 30 times more active than its unnatural enantiomer, (+)-nicotine, in the spontaneous activity, Rotarod and antinociceptive tests, respectively. Biodispositional studies revealed that the time course (-)-[3H]nicotine closely paralleled the time course of effects on spontaneous activity and Rotarod performance but not antinociception, which suggested that multiple mechanisms were involved in the actions of nicotine. In addition, the distribution studies showed the brain and plasma levels of (-) [3H]nicotine were higher than those of (+)-[3H] nicotine, which indicate that the pharmacological stereoselectivity of nicotine is less than originally determined. Finally, the greatest difference in the regional localization in brain of the stereoisomers was found in cerebral cortex, hippocampus and corpus striatum. PMID- 6864537 TI - Direct analgesic effects of Z-prolyl-d-leucine and Z-prolyl-L-leucine in the rat yeast-paw test. PMID- 6864538 TI - Tolerance to morphine bradycardia in the rat. AB - Intravenous injection of opiate agonists produces in the rat a precipitous but transient fall in heart rate. This bradycardia, which may be a vagal chemoreflex, appears to originate from peripheral opiate receptors because the onset is faster after injections of morphine into the peripheral circulation than after central injections. The bradycardia is blocked by i.v. administration of tertiary and quaternary naloxone at doses which are not effective centrally. Tolerance develops to morphine bradycardia after s.c. infusions of morphine sulfate (e.g., 74 nmol/hr/rat s.c. for 2 days elevated the morphine ED50 by 22 times), but not after central infusions of morphine at doses which are sufficient to produce physical dependence and tolerance to morphine analgesia. Subcutaneously infused morphine animals are cross-tolerant to FK33,824 (Tyr-D-Ala-Gly-NMePhe-Met(O)-ol), a potent enkephalin analog, and vice versa, but are not tolerant to serotonin or phenyldiguanide. Vagal bradycardia may be a convenient index for studying the peripheral action of opioid agonists. PMID- 6864539 TI - Effects of divalent cations and sulfhydryl reagents on the p-aminohippurate (PAH) transporter of renal basal-lateral membranes. AB - A specific system of transport for p-aminohippurate (PAH) is demonstrated in rabbit renal basal-lateral membrane vesicles. The PAH uptake into an intravesicular space is inhibited by probenecid in concentrations above 0.2 mM. The transport is saturable and is also temperature-dependent with an optimum between 37 and 45 degrees C. Divalent cations are able to enhance the uptake 2- to 3-fold. The stimulatory effect of the divalent cations diminishes in the following order: Mg++ = Mn++, Ba++, Ca++ and Sr++. Maximum stimulation occurs between 2.5 and 5 mM Mg++. The divalent cation stimulatory effect is not the result of changes in the size of the vesicles, in the degree of vesiculation, in the net charge of the membrane or of a transient potential difference across the membrane. Several inhibitors, more inhibitory than probenecid, were found. These are: lithium diiodosalicylate; 4-acetamido-4'-isothiocyano 2,2'-disulfonic acid stilbene; the mercurials, mersalyl acid, p-chloromercuriphenyl sulfonate and Hg++; and 5,5'-dithiobis(nitrobenzoate). Among these, mersalyl acid is the most potent inhibitor for PAH uptake. Its inhibitory effect is probably a combination of its reactivity toward sulfhydryl groups and its anionic character. The results with sulfhydryl reagents indicate that the PAH transport system contains sulfhydryl groups which are essential for the uptake activity. These sulfhydryl groups are probably buried in a hydrophobic region within the lipoprotein matrix of the basal-lateral membrane. PMID- 6864540 TI - Disposition of hexobarbital in the rat. Estimation of "first-pass" elimination and influence of ether anesthesia. AB - The disposition of hexobarbital was studied in rats after i.v. and i.a. administration. In addition to sleeping times, plasma concentration profiles were measured. No significant differences were found in sleeping times, volumes of distribution, elimination half-lives or systemic clearances between these different routes. The average elimination half-lives were 13.5 +/- 0.8 (n = 17) and 11.6 +/- 1.9 min (n = 21) (means +/- S.E.M.), respectively, whereas the systemic whole blood clearance values were 75.4 +/- 3.4 (n = 17) and 85.8 +/- 3.5 ml/min/kg (n = 21) (means +/- S.E.M.). The values of the latter parameter approach hepatic blood flow in the rat (i.e., 100 ml/min/kg) and therefore the oral availability of hexobarbital was established by comparing areas under plasma concentration time curves, after i.v. and oral administration to the same rat. Oral availability was found to be only 36%, which corresponds to an extraction ratio of 64%. The consequences of such a "first-pass" effect are discussed in view of the use of hexobarbital as a model substrate for measuring drug metabolizing enzyme activity. Furthermore, it was found that anesthesia as induced by diethylether during the experiments resulted in a very significant inhibition of the rate of hepatic metabolism of hexobarbital; the elimination half-life increased by about 50% due to a similar decrease in the systemic clearance. The protein binding of hexobarbital in rat plasma amounted to 51.4 +/- 1.2% (mean +/- S.E.M., n = 15) and it was found not to be dependent on the plasma concentration of hexobarbital in the range encountered in vivo. PMID- 6864541 TI - Renal histological and biochemical changes induced in the rat by dibekacin. AB - Among presently available aminoglycosides, dibekacin has the least toxic effect on the functions of the cochlea and the vestibule. We investigated the potential nephrotoxicity of dibekacin at various dose levels and durations of treatment. In the rat, the injection of high doses (50 mg/kg for 8 days) produced: 1) a reduction in renal function and the onset of cellular necrosis; 2) the appearance of myeloid bodies in the cells of the proximal tubule; 3) accumulation of the drug in the renal cortex at a concentration of 4.4 micrograms/mg of protein; 4) a reduction in the lysosomal latency of N-acetyl-beta-D-glucosaminidase; and 5) disorders of the activity of cortical enzymes cathepsin B and sphingomyelinase. The effect of dibekacin is similar to that of the other aminoglycosides, but it would seem to be less nephrotoxic than gentamicin. PMID- 6864542 TI - Effects of nifedipine on smooth muscle cells of the rabbit mesenteric artery. AB - The effects of nifedipine on electrical and mechanical responses of smooth muscle cells of the rabbit mesenteric artery were investigated using microelectrode and isometric tension recording methods for intact cells. The effects of nifedipine on the mechanical response on saponin-treated skinned muscles were also studied. Nifedipine inhibited the Ca spike evoked by outward current pulses in the presence of tetraethylammonium and that by perivascular nerve stimulation without affecting the amplitude of excitatory junction potentials. Nifedipine (less than 3 X 10(-7) M) modified neither the amplitude of excitatory junction potentials nor the facilitation process. This drug inhibited the contractions evoked by direct muscle stimulation under conditions of treatment with guanethidine and tetrodotoxin, excess concentrations of [ K ]O, exogenously applied norepinephrine (NE) and perivascular nerve stimulation. The K-induced contraction was markedly inhibited by nifedipine (greater than 3 X 10(-9) M) and the potency of the inhibitory action of nifedipine appeared in the following order: direct muscle stimulation greater than perivascular nerve stimulation greater than exogenously applied NE. Nifedipine inhibited the NE-induced oscillatory contractions more than the NE-induced tonic and phasic contractions. In Na-free solution, the tissue generated a small tonic contraction after 20 to 30 min superfusion. This contraction ceased with application of nifedipine. In the saponin-treated skinned muscles (50 micrograms/ml for 20 min), Ca accumulation into and Ca release from the store sites, as well as the contractile proteins including calmodulin, were not affected by nifedipine (1 X 10(-7) M). These results indicate that nifedipine only acts on the myoplasmic membrane of smooth muscles of the mesenteric artery. The nifedipine-induced relaxation appears to be due to inhibition of the voltage dependent Ca channel. PMID- 6864543 TI - Effects of 4-aminopyridine on the cat superior cervical ganglion. AB - These experiments tested the effect of 4-aminopyridine (4-AP) on acetylcholine (ACh) release, 45Ca++ accumulation and transmission in the perfused superior cervical ganglion of the cat. The 4-AP increased the amount of ACh released during preganglionic nerve stimulation, but it did not alter spontaneous ACh release. The 4-AP-induced increase of ACh release was compensated for by increased ACh synthesis because stimulation in the presence of the drug did not deplete tissue ACh content. When ACh release was suppressed by Mg++ or by low Ca++, 4-AP restored release to normal, but it did not do so when Ca++ was absent. This is interpreted as consistent with the idea that 4-AP increases Ca++ influx into nerve terminals and this was supported by measures of 45Ca++ accumulation by ganglia. Thus, preganglionic nerve stimulation increased 45Ca++ accumulation by ganglia and 4-AP increased this measure; Mg++ decreased the stimulation-induced change in 45Ca++ accumulation and 4-AP reversed this effect of Mg++. Depression of ganglionic transmission caused by Mg++ was readily antagonized by 4-AP, but the compound did not as readily augment transmission depressed by tubocurarine or by trimethaphan. PMID- 6864544 TI - Diltiazem protects the isolated rabbit heart from the mechanical and ultrastructural damage produced by transient hypoxia, low-flow ischemia and exposure to Ca++-free medium. PMID- 6864545 TI - Effect of grayanotoxin on the frog neuromuscular junction. AB - The effect of alpha-dihydrograyanotoxin II (alpha-H2-GTX II) on the neuromuscular junction of the frog was examined by the intracellular microelectrode technique. alpha-H2-GTX II (6 microM), with a latency of about 20 min, caused a depolarization of both the end-plate and non-end-plate region of the muscle fiber. Concomitantly, alpha-H2-GTX II caused a marked increase in the frequency of m.e.p.p.s, which persisted for 1 hr; thereafter m.e.p.p.s were gradually abolished. In end-plates which had become quiescent after treatment with alpha-H2 GTX II, synaptic vesicles could no longer be recognized histologically, suggesting that alpha-H2-GTX II depleted the store of vesicles. alpha-H2-GTX II did not affect the iontophoretically evoked acetylcholine potential, suggesting that the toxin did not greatly alter the sensitivity of the end-plate membrane to acetylcholine. Removal of Ca++ from the external medium prevented alpha-H2-GTX II from discharging synaptic vesicles. Application of tetrodotoxin or removal of Na+ ions before exposure to alpha-H2-GTX II prevented both the toxin-induced depolarization and increase in m.e.p.p. frequency. It is concluded that the action of GTX on the neuromuscular junction is probably due to an increase in membrane permeability to Na+, resulting in depolarization of both the presynaptic and postsynaptic membranes. PMID- 6864546 TI - Indomethacin-furosemide interaction: the importance of renal blood flow. PMID- 6864547 TI - Inhibition of asparagine-linked glycosylation of pro-opiomelanocortin in mouse pituitary cells by DL-threo-beta-fluoroasparagine. AB - The actions of DL-threo-beta-fluoroasparagine (DL-beta-F-Asn) on the glycosylation of proteins were examined in AtT-20/D16v cells which synthesize several forms of the glycoprotein prohormone, pro-opiomelanocortin (POMC). Treatment with threo-beta-F-Asn(5-10 mM) resulted in: 1) a reduction in the amount of the more highly glycosylated form of POMC (Mr = 32,000) relative to the less glycosylated form (Mr = 29,000) and 2) the appearance of a new species of POMC (Mr = 27,000). 35S]Methionine-labeled tryptic peptides prepared from 27,000 POMC were identical to those from 29,000 and 32,000 POMC; however, 27,000 POMC was found to contain 10% as much [3H]glucosamine relative to [35S]methionine as the 32,000 molecule. Furthermore, 27,000 POMC comigrated with a previously characterized unglycosylated form of this prohormone produced by treatment of cells with tunicamycin. These findings indicate that treatment of cells with threo-beta-F-Asn results in the production of a species of POMC which contains little or no carbohydrate. The effects of beta-F-Asn were specific for the threo diastereomer, were reversible by equimolar concentrations of Asn, but not Asp, and were dose-dependent. Evidence that threo-beta-F-Asn can replace Asn in proteins was obtained by showing that an identified Asn-containing tryptic peptide from threo-beta-F-Asn-treated cells displayed an altered mobility during electrophoresis consistent with threo-beta-F-Asn substitution within this peptide. We conclude that threo-beta-F-Asn can inhibit the glycosylation of proteins in intact cells and that this effect is due to its ability to replace Asn at glycosylation sites. PMID- 6864548 TI - Genetics of nicotine response in four inbred strains of mice. AB - The effects of nicotine on five behavioral and physiological measures were determined in four inbred mouse strains (BALB, C57BL, DBA and C3H). In addition, the binding characteristics of nicotine and alpha-bungarotoxin, two ligands which appear to label different nicotinic receptors, were measured in seven discrete brain regions, as well as in whole brain. A number of differences in response to nicotine were found among the four inbred strains. Whereas nicotine depressed open-field activity of BALB, C57BL and DBA mice in a dose-dependent manner, low doses of nicotine increased locomotor activity in C3H mice. The doses of nicotine tested reduced Rotarod performance in DBA and C57BL mice but not in C3H and BALB mice. All four strains displayed a dose-dependent decrease in body temperature after nicotine administration. The BALB mice were more sensitive to the drug than were the C3H, whereas the effects on C57BL and DBA mice were intermediate. All four strains showed a transient increase in respiration only after a high (2.0 mg/kg) nicotine dose. No dose of nicotine was found to have an effect on the startle response after auditory stimulation in three of the strains; only the C3H mice exhibited enhanced startle after nicotine was administered. Differences in DL-[ 3H ]nicotine binding among the seven brain regions were noted in each strain, but no differences among strains were observed. The IC50 values for inhibition of this binding by nicotine did not differ among brain regions within any strain or within any region among strains. Similarly, nicotine inhibited alpha-[125I]bungarotoxin binding with equal potency in all brain regions of each of the four strains; however, the binding of this ligand was significantly lower in the midbrain and hippocampus of DBA mice than it was in these regions in the other three strains. Thus, genetic factors influence response to nicotine, but variation in response is not easily explained by differences in brain nicotinic receptors. PMID- 6864549 TI - Cardiovascular effects of LY134046, an inhibitor of norepinephrine N methyltransferase, in spontaneously hypertensive rats. PMID- 6864550 TI - Comparison of yohimbine, mianserin, chlorpromazine and prazosin as antagonists of the suppressant effect of clonidine on operant behavior. PMID- 6864551 TI - Metabolism and cardiac actions of a polar aminocardenolide and digoxin in the conscious dog. AB - We studied the metabolism and cardiac actions of a polar aminocardenolide, 3-beta O-(4-amino-4,6-dideoxy-beta-D-galactopyranosyl) digitoxigenin (ASI-222), in conscious, chronically instrumented dogs and compared the cardiac actions of this compound with those of digoxin. Chloroform-soluble metabolites and the excretion patterns of ASI-222 in urine and feces were identified and measured using thin layer chromatography. The deaminated metabolite of ASI-222 appeared both in the urine and the feces together with the genin, digitoxigenin and the parent drug which constituted the majority of the radioactivity excreted. There was a secondary rise in the plasma concentration of ASI-222 starting 2 hr after the i.v. administration, which strongly suggests its enterohepatic recycling. The secondary increase in the plasma concentration was not seen in the dogs receiving digoxin. ASI-222 produced increases in cardiac contractility and systolic blood pressure which were more rapid in onset and shorter in duration than those produced by an equimolar dose of digoxin. Amplitudes of these physiologic responses to these two compounds in conscious dogs were approximately 2 times higher than the effects previously reported to similar doses in anesthetized dogs. PMID- 6864552 TI - Chronic fluphenazine and clozapine elicit opposite changes in brain muscarinic receptor binding: implications for understanding tardive dyskinesia. PMID- 6864553 TI - A pH-dependent, carrier-mediated system for transport of 5-methyltetrahydrofolate in rat jejunum. AB - The intestinal transport of the naturally occurring folate coenzyme, 5 methyltetrahydrofolate, was studied using everted sacs of rat jejunum. The study provides evidence that intestinal transport of 5-methyltetrahydrofolate is composed of two systems: 1) an active, carrier-mediated system which is demonstrable at low concentrations; and 2) a diffusion system which is demonstrable at high concentrations. The active system is characterized by: 1) saturation kinetics with Km congruent to 0.3 microM; 2) accumulation against a concentration gradient with a serosal-to-mucosal ratio of 1.8; 3) inhibition by metabolic poisons; 4) inhibition by oxidized and reduced folate analogs; 5) temperature dependence; 6) sodium dependence; 7) glucose dependence; and 8) specificity for the jejunum. These features are strongly pH-dependent, and demonstration of active transport of 5-methyltetrahydrofolate requires a buffer pH of 6, glucose in the incubation medium and a substrate concentration of less than 10(-6) M. The diffusion process is characterized by: 1) linear increase in the mucosal-to-serosal transport of 5-methyltetrahydrofolate with increasing mucosal concentration to 10(-6) M and above; 2) energy independence; 3) pH independence; and 4) temperature independence. These studies clarify the mechanism of intestinal transport of 5-methyltetrahydrofolate, show the similarities to transport of other folate compounds and provide a unified concept of intestinal folate transport. PMID- 6864554 TI - The effects of low concentrations of cardiotonic steroids on membrane currents and tension in sheep Purkinje fibres. AB - 1. Simultaneous measurements of voltage-clamp currents and tension were made in shortened sheep Purkinje fibres exposed to various concentrations of strophanthidin, ouabain and digoxin.2. In 5.4 mM-K moderate doses (mean 2.4 x 10( 7)M) of the drugs produced an inward shift of the current-voltage relationship at very negative potentials, consistent with an increase in cleft K concentration (Cohen, Daut & Noble, 1976b), which was always accompanied by an increase in tension. This change, which has been attributed to Na-K pump inhibition, was often better correlated with an increase in voltage-dependent tonic tension than in twitch tension.3. Exposure to dihydro-ouabain gave a monotonic increase in tension but a delayed increase in inward current. This suggests (cf. Lee, Kang, Sokol & Lee, 1980) that minor changes in pump activity may not always change the current-voltage relationship.4. Low concentrations of strophanthidin (5 x 10(-9) to 5 x 10(-7) M) produced an outward current shift at very negative potentials, this change becoming smaller with a more rapid onset and reversing on increasing the dose. This change is attributed to pump stimulation.5. The outward current shift was often associated with a negative inotropic effect, which always reversed either spontaneously or on removal of the drug.6. The alternative response at a narrower dose range (1 x 10(-8) to 2 x 10(-7) M) was an increase in twitch (not tonic) tension, termed the low-dose positive inotropic effect.7. After a low concentration of cardiotonic steroid had given an early negative inotropic effect the bulk Ca concentration was reduced and the drug re-applied. The low-dose positive inotropic mechanism was then observed.8. Outward current shifts and negative inotropy were also obtained with low concentrations of the clinically used glycosides digoxin and ouabain.9. Low concentrations of strophanthidin applied to externally stimulated sheep ventricular trabeculae produced negative inotropy with lengthening of the action potential duration. Positive inotropy and action potential shortening occurred with higher doses.10. A computer model of ionic currents and distributions in Purkinje fibres satisfactorily reproduced the changes in membrane currents and ionic gradients observed with cardiotonic steroids. The only perturbations capable of explaining our results were Na pump stimulation and inhibition.11. It is concluded that cardiotonic steroids possess two inotropic mechanisms. The first is a low-dose positive inotropic mechanism causally unrelated to changes in sodium pump activity and possibly a direct release of a membrane-associated calcium fraction. Should this mechanism be unavailable then net pump stimulation at low doses will produce negative inotropy. The second mechanism is the well known Na-lag process. PMID- 6864555 TI - The effect of a natriuretic atrial extract on renal haemodynamics and urinary excretion in anaesthetized rats. AB - 1. An extract of cardiac atrial tissue, when injected intravenously into anaesthetized rats, caused a large and rapid increase in renal excretion of sodium chloride. 2. The renal response to atrial extract was associated with increases in total and medullary blood flow in the kidney, as measured by microsphere and albumin uptake methods, respectively. 3. The data suggest that these changes in renal haemodynamics may contribute to, but are unlikely to be the complete cause of, the natriuresis and chloriuresis following injection of atrial tissue extract. PMID- 6864556 TI - Neural units in the superior cervical ganglion of the guinea-pig. AB - The size and arrangement of the set of neurones innervated by individual preganglionic axons (the neural unit) has been investigated in the superior cervical ganglion of the guinea-pig. 1. Based on the ratio of preganglionic neurones to ganglion cells, and the average number of axons contacting each ganglion cell, we estimated that individual preganglionic axons innervate on the order of 50-200 superior cervical ganglion cells. 2. Of 562 pairs of ganglion cells examined with intracellular recording, forty-seven (8.4%) were innervated by one or more common axons. 3. Pairs of ganglion cells innervated by the same axon were not necessarily near each other. Although nearby cells were more likely to share innervation than neurones far apart, cells sharing innervation were often found several hundred micrometers apart, and were occasionally separated by the largest dimension of the ganglion (about 1-2 mm). 4. The incidence of cell pairs that shared innervation from more than one axon was greater than expected from the frequency of pairs sharing at least one axon. 5. Extracellular recordings from small fascicles of the cervical sympathetic trunk showed that preganglionic axons from different segmental levels intermingle extensively en route to the superior cervical ganglion. 6. Taken together, these findings support the view that sets of ganglion cells are innervated in common not because of any special topographic relationship within the ganglion, but because they share one or more properties that make them especially attractive to particular preganglionic axons. PMID- 6864557 TI - Innervation of individual guinea-pig superior cervical ganglion cells by axons with similar conduction velocities. AB - 1. Individual neurones in the guinea-pig superior cervical ganglion were studied to determine whether they are innervated by preganglionic axons with similar conduction velocities. 2. Latencies of synaptic responses recorded intracellularly in ganglion cells after stimulation of individual ventral roots varied from 28 to 430 msec. Most of this variability arose from differences in preganglionic conduction velocity. 3. The twelve different axons that on average innervate each ganglion cell tended to have broadly similar conduction velocities; a neurone receiving a rapidly conducting input was usually contacted by other rapidly conducting axons, and vice versa. 4. Preferential innervation of individual neurones by axons with similar conduction velocities was evident even when only axons arising from the same spinal segment were compared. Thus preferential innervation by axons of similar conduction velocity cannot be simply a manifestation of segmental preferences. 5. These results suggest that the mature pattern of innervation in mammalian sympathetic ganglia reflects the functional as well as the positional qualities of the synaptic partners. PMID- 6864558 TI - Effects of extracellular potassium concentration on the excitability of the parallel fibres of the rat cerebellum. AB - 1. Field potentials and extracellular potassium concentration, [K+]o, were recorded from the rat cerebellar cortex using ion-selective micro-electrodes, following micro-stimulation of the cerebellar surface. The compound action potential of the parallel fibres (p.f.s) showed changes indicative of a supernormal period (s.n.p) when conditioned by a previous p.f. volley, and was studied in relation to [K+]o. 2. Repetitive stimulation of the p.f.s (greater than 10 Hz) elicited an alternation in p.f. excitability from supernormality to subnormality simultaneous to a steady increase in [K+]o. 3. Superfusion with various levels of K+ led to changes in the p.f. conduction properties. Small increases in [K+]o above the resting 3.0 mM level led to an increase in p.f. conduction velocity while greater increases led to conduction slowing and eventually block. 4. Repetitive activation of a row of p.f.s elicited increases in [K+]o in the vicinity of neighbouring non-activated fibres. These fibres displayed an increase in excitability that was quantitatively related to [K+]o. 5. After introduction of 4-aminopyridine (4-AP; 100 microM) into the superfusate, a single stimulus would elicit relatively large (up to 15 mM) increases in [K+]o around neighbouring non-activated p.f.s. The excitability of the adjacent non activated fibres was either increased or decreased, and was quantitatively related to [K+]o. 6. Strophanthidin application (15 microM) led to a slow and continuous increase in [K+]o. The excitability of the p.f.s initially increased as [K+]o increased, but subsequently decreased, eventually resulting in conduction block. 7. These experiments are consistent with the hypothesis that small increases in [K+]o may elicit an increase in p.f. excitability while greater increases lead to a decrease in p.f. excitability. PMID- 6864561 TI - Blood flow through arteriovenous anastomoses and its thermal function in the laying hen. AB - 1. Total (arteriovenous anastomoses + capillary) blood flow (t.b.f.) and capillary blood flow (c.b.f.) distribution were determined by 52 and 15 micron microspheres respectively, in body organs of six unanaesthetized laying hens, exposed to thermoneutral air temperatures. 2. Statistically significant differences between t.b.f. and c.b.f. were only found in the unfeathered metatarsal skin, comb and wattles. The c.b.f. constituted 22, 42 and 45% of t.b.f. respectively, indicating significant arteriovenous anastomoses (a.v.a.) blood flow. Differences between t.b.f. and c.b.f. were small in the two larger ovarian follicles and digestive tract and were negligible in reproductive tract, liver and kidney. 3. Microspheres of different size have been injected into the external ischiadic artery in order to examine the vasomotor responses of leg tissues in twenty-one hens kept in thermoneutral, cold or hot conditions. 4. In cold, thermoneutral and hot conditions 1, 16 and 35% of whole leg blood flow respectively passed through a.v.a. Only c.b.f. was present in bone and muscle in either treatment; cold and heat reduced it in bones and cold increased it in muscles. Arteriovenous anastomoses blood flow appeared mostly in unfeathered skin; it constituted 17, 53 and 83% of t.b.f. to this tissue in cold, thermoneutral and hot conditions, while t.b.f. increased from 1.4 to 14% and 30% of whole leg blood flow respectively. Blood flow to feathered skin decreased during heat and cold. PMID- 6864559 TI - Recovery from decamethonium in rat muscle and denervated guinea-pig diaphragm. AB - 1. In denervated guinea-pig diaphragm the depolarization produced by decamethonium (100 microM) was followed by an initial phase of recovery, and then by a slow restoration of membrane potential in the presence of the drug, with hyperpolarization. Membrane potentials were measured by repeated insertions. The slow phase of spontaneous recovery was not found in the absence of potassium or in the presence of ouabain (100 microM). 2. With 1 microM-decamethonium the net loss of potassium from denervated muscle was 17% by wet weight in 20 min as compared with controls, which represents a loss of over 30 mM in internal concentration. Similar results were obtained with 100 microM-decamethonium. Spontaneous recovery of potassium occurred in the succeeding 2 h in the presence of 1 microM and 100 microM-decamethonium. With 5 nM-decamethonium muscles exposed for 20 min had a potassium content which was not reduced as compared with controls. 3. In rat diaphragm decamethonium (100 microM) also produced depolarization and slow spontaneous recovery which was not seen in the absence of potassium or the presence of ouabain. With 3 mM-decamethonium spontaneous recovery of potential was complete in 5 min. 4. Change from 5 mM-potassium to potassium-free solution produced consistent hyperpolarization in denervated guinea-pig diaphragm. In rat diaphragm at 38 degrees C the results were variable, with some fibres showing hyperpolarization while others showed depolarization. PMID- 6864562 TI - Responses of abdominal vascular resistance and capacitance to stimulation of carotid chemoreceptors in anaesthetized dogs. AB - 1. In anaesthetized dogs the regions of the carotid bifurcations were isolated vascularly and perfused at constant non-pulsatile pressures. The abdominal circulation was isolated vascularly, perfused at constant flow and drained through the inferior vena cava at constant pressure. Vascular resistance and capacitance responses were determined from the changes in perfusion pressure and changes in venous outflow. 2. Stimulation of carotid chemoreceptors with venous blood resulted in an increase in arterial perfusion pressure of 38% (S.E. +/- 4.6) and a decrease in vascular capacitance of 24.4 +/- 2.5 ml. (1.05 +/- 0.24 ml. kg-1). 3. When carotid perfusion pressure was higher than 17 kPa, stimulation of chemoreceptors resulted in significantly (P less than 0.05) smaller resistance responses but significantly (P less than 0.05) greater capacitance responses than those obtained at lower carotid pressures. 4. These results show that abdominal resistance and capacitance vessels constrict in response to stimulation of carotid chemoreceptors. We suggest that the larger responses of capacitance and the smaller responses of resistance obtained at higher carotid sinus pressures may be due to different sensitivities of resistance and capacitance vessels to efferent sympathetic nerve activity. PMID- 6864560 TI - Renal function during lactation in the rat. AB - 1. Glomerular filtration rate (g.f.r.), renal plasma flow (r.p.f.), salt and water reabsorption and plasma concentrations of progresterone and prolactin were measured in virgins, 19 day pregnant and lactating rats. 2. G.f.r. was raised by about 40% in animals at 6-7 days of lactation when compared with virgins but towards the end of lactation returned to virgin levels. Salt and water reabsorption followed a similar pattern. 3. At the time of maximum change of g.f.r. during lactation r.p.f. was raised by about 30% and so filtration fraction rose by about 10% when compared with virgins. 4. Plasma prolactin and progesterone concentrations rose early in lactation but remained elevated when the renal changes had returned to normal. 5. Factors other than changes in prolactin and progesterone concentrations must be implicated in the changes in renal function that occur during lactation. PMID- 6864563 TI - Effects of stimulation of aortic chemoreceptors on abdominal vascular resistance and capacitance in anaesthetized dogs. AB - 1. Dogs were anaesthetized with chloralose, ventilated artificially, and the regions of the aortic arch and carotid sinuses were isolated vascularly and perfused with blood. The abdominal circulation was isolated vascularly, perfused at constant flow and drained from the inferior vena cava at constant venous pressure. Changes in vascular resistance were determined by calculating changes in abdominal aortic perfusion pressure, and changes in capacitance by integrating the changes in venous outflow. 2. Stimulation of aortic body chemoreceptors, either by changing the aortic arch perfusate from arterial to venous blood at constant perfusion pressure or by injection of sodium cyanide into the aortic arch, resulted in an increase in abdominal vascular resistance and a decrease in abdominal vascular capacitance. 3. After both cervical vagosympathetic trunks had been cut, stimulation of aortic chemoreceptors no longer resulted in resistance or capacitance responses. 4. These results indicate that stimulation of aortic chemoreceptors, like carotid chemoreceptors, results in reflex constriction of both resistance and capacitance vessels in the abdominal circulation. PMID- 6864564 TI - Compensatory increases in milk secretion in response to unilateral inhibition by colchicine during lactation in the goat. AB - 1. Milk secretion in one mammary gland of goats was temporarily inhibited by intramammary treatment with colchicine at weeks 6, 12, 18, 24 and 30 of lactation. The magnitude of the inhibition was similar at all stages when compared with milk yield before the experiment. 2. The untreated gland partially compensated for the decreased rate of milk secretion by significantly increasing its own rate of secretion. There was no significant effect of stage of lactation on this response. 3. The rapidity of the compensatory response suggests that existing secretory cells increased their rate of secretion, and therefore that the mammary secretory cells are not secreting at their intrinsic maximum at any stage of lactation. 4. In later stages of lactation (weeks 18, 24 and 30) the increases in the untreated gland were more pronounced in afternoon milkings (8 h milking interval) than in morning milkings (16 h interval. At week 30 only, the rate of secretion before treatment was similarly lower in the 16 h period. It is proposed that an additional limitation is imposed on secretion during the relatively long period of milk accumulation as lactation advances and declines. 5. The results are discussed in relation to rate-limitations on milk secretion with respect to substrate supply and possible systemically active mammary factors. PMID- 6864565 TI - The synthesis and release of acetylcholine in normal and denervated rat diaphragms during incubation in vitro. AB - 1. Normal and denervated rat diaphragms and neural (central) and aneural (peripheral) parts of normal diaphragms were incubated under several different conditions likely to affect the metabolism of acetylcholine (ACh), with the aim of discovering specific features of the control of neural and aneural ACh in the muscle. The concentrations of ACh in the tissue and the medium were measured at the end of the incubations using a radioenzymatic assay, and the amount of ACh synthesized during the incubations was calculated by subtracting the initial amount of ACh present in the tissue from that found in the tissue plus the medium at the end of the incubations.2. Confirming earlier results obtained with bioassays, it was found that, in a medium with 5 mM-K(+) and 2.5 mM-Ca(2+), denervated diaphragms released ACh into the medium at a rate equal to 47% of that observed in normal diaphragms; the amount of ACh released from aneural parts of normal diaphragms was 51% of that released from their neural parts. The release from normal diaphragms was increased (83%) in a Ca(2+)-dependent manner by raising the concentration of K(+) to 30 mM. In the denervated diaphragms, 30 mM K(+) brought about a Ca(2+)-independent increase (67%) in the rate of ACh release. The elevation of K(+) was without effect on the release of ACh from aneural parts of normal diaphragms.3. The results indicate that a Ca(2+) dependent mechanism of ACh release, known to function in the nerve terminals, is not likely to participate in the efflux of ACh from the muscle fibres. The K(+) induced but Ca(2+)-independent enhancement of ACh release from the denervated diaphragms probably occurs by diffusion of ACh along the altered electrochemical gradient. It is suggested that the surface membranes of the muscle fibres become more permeable to ACh after denervation.4. During incubations with 30 mM-K(+) and 10 muM-hemicholinium-3 (HC-3), an inhibitor of the carrier-mediated transport of choline, the rates of ACh release and synthesis in normal diaphragms were diminished to the levels found in the denervated diaphragms, in which the concentration, release and synthesis of ACh were not affected by HC-3. The synthesis of aneural ACh thus appears to be independent of the carrier-mediated supply of choline across cell membranes.5. The release of ACh from normal diaphragms incubated with 5 mM-K(+) was increased in the presence of 100 muM ouabain, whereas the release from denervated diaphragms was not affected. This finding suggests that the mechanism of ACh release that is activated by ouabain in the nerve cells involves, in addition to the inhibition of Na(+)-K(+)-ATPase, some other steps which are not operative in the muscle fibres.6. The results corroborate earlier evidence indicating that aneural ACh is produced, stored and released in the diaphragms. They fit the view that the aneural ACh is located in the cytoplasm of the muscle fibres and that it leaves the muscle fibres by molecular ;leakage' rather than by a specialized release mechanism. The efflux of ACh from the muscle fibres is likely to constitute about 50% of the total resting efflux (release) of ACh from normal diaphragms. PMID- 6864567 TI - Glomerular filtration rate and salt and water reabsorption during pregnancy in the conscious rat. AB - 1. Glomerular filtration rate (g.f.r.) and salt and water reabsorption were measured in age-matched conscious virgin rats and rats at different stages of pregnancy that were infused with saline at 40 and 200 microliters min-1. 2. G.f.r. and salt and water reabsorption were significantly higher at all stages of pregnancy irrespective of the the rate of infusion. 3. The similarity in both time course and magnitude, of changes in renal function between conscious and anaesthetized rats at the two infusion rates suggests that the detection of differences in the anaesthetized rat during pregnancy is not dependent on either the anaesthetic/surgery employed or the rate of expansion of the extracellular fluid volume. 4. During the induction of the diuresis in 20-day pregnant rats infused at 40 microliters min-1 urine flow was higher and osmolality lower than in virgin rats and rats at earlier stages of pregnancy, suggesting that late pregnant rats have an altered ability for elaborating concentrated or dilute urine. PMID- 6864566 TI - Reduction of long-term potentiation in the dentate gyrus of the rat following selective depletion of monoamines. AB - 1. Brief, high-frequency stimulation of the perforant path results in a long-term potentiation (l.t.p.) of the field response evoked in the dentate gyrus by single shocks to the perforant path. We have compared the magnitude and duration of l.t.p. in normal, anaesthetized rats with animals depleted of noradrenaline (NA), 5-hydroxytryptamine (5-HT), or both. 2. All animals were exposed to an identical sequence of eight high-frequency trains of increasing intensity given over a period of 140 min to the perforant path of one hemisphere. The potential evoked by test shocks to the perforant path was monitored in both hemispheres throughout this period and for a further 96 min after the last train. 3. Plots of the mean potentiation of the population e.p.s.p. as a function of time were computed for all animals in each group. L.t.p. in the NA-depleted group was about 50% of that in the non-depleted control group throughout the course of the experiment. L.t.p. in the 5-HT-depleted group was more severely affected; mean potentiation did not exceed 30% of that in the control group at any time. 4. The duration of l.t.p. was unaffected by NA depletion and reduced by 5-HT depletion. 5. The threshold for the intensity of high-frequency current pulses necessary to elicit l.t.p. was unaffected by NA depletion and raised by 5-HT depletion. 6. Short-term potentiation of the population e.p.s.p. was unaffected by either NA depletion or 5-HT depletion. 7. The effect of monoamine depletion on granule cell excitability was investigated. 5-HT depletion, but not NA depletion, induced an increase in the excitability of the granule cell population, in the sense that a population e.p.s.p. of a given size was associated with a larger population spike. 8. Long term potentiation of granule cell excitability was not affected by NA depletion, but was reduced by 5-HT depletion. 9. These results show that monoamines can modulate long-term changes in synaptic function in the dentate gyrus, and suggest that 5-HT is more potent in this respect than NA. PMID- 6864568 TI - Uptake and action of a disulphonic stilbene (SITS) in the perfused guinea-pig liver: a comparison with bromsulphthalein. AB - 1. Livers were perfused with a Krebs-Ringer bicarbonate buffer in a single-pass perfusion system. Bile secretion was maintained by infusion of secretin. 4 Acetamido-4'-isothiocyano-2,2'-stilbene disulphonic acid (SITS) was added to the perfusate to give concentrations ranging between 5 x 10(-6) and 10(-4) M. 2. SITS was extracted from the perfusate by the liver (V, 0 . 15 mumol/min per g liver; Km 8 . 6 x 10(-5) M) and excreted in bile in a modified form (bile/plasma ratio: 50-170; maximum rate of excretion: 25 nmol/min per g liver wet wt). 3. The rates of uptake and excretion of bromsulphthalein (BSP) were similar to those for SITS, with the exception that the affinity of BSP for hepatic uptake was greater (Km 1 . 8 x 10(-5) M). 4. Both SITS and BSP decreased the rate of bile flow. A 50% reduction in bile flow was attained in each case at an estimated drug content of the liver of 1 . 5 mumol/g wet wt. 5. Unlike other cells the hepatocyte appears to be readily penetrated by SITS, and it is suggested that SITS inhibits bile secretion by inhibiting an intracellular mechanism which could be mitochondrial in location. PMID- 6864569 TI - The effects of papaverine on the electrical and mechanical activity of the guinea pig ureter. AB - 1. The effects of papaverine (10(-5)-2 X 10(-4) M) were studied on the evoked electrical and mechanical activity of the guinea-pig ureter smooth muscle. In normal conditions the action potential consists of an initial spike followed by further spikes superimposed on a plateau phase. Papaverine reversibly decreased the duration of the plateau of the action potential, blocked the associated spikes, greatly reduced the amplitude of the contraction but enhanced the initial component of the action potential. 2. Papaverine did not change the membrane potential and had little effect on the membrane resistance. 3. Tetraethylammonium (5 mM), which blocks the delayed outward K current, did not prevent the decrease in the duration of the plateau nor the decrease of the contractile response caused by papaverine. 4. In Na-free solution the duration of the action potential was decreased until only a single spike was seen, due to suppression of the plateau. An effect of papaverine could not be observed under these conditions. 5. Mn2+ ions (1 mM) completely suppressed the spike component and tension while the plateau component was substantially increased. Papaverine in the presence of Mn2+ reversibly blocked the generation of the action potential. When Mn2+ ions were added to Na-free solution the duration as well as the amplitude of the spike was increased. Again, papaverine reversibly blocked the generation of the action potential. 6. Noradrenaline (10(-4) M) and histamine (10(-5) M) in normal conditions prolonged the duration of the action potential plateau and increased both the duration and amplitude of the concentration. Papaverine again blocked the plateau and greatly reduced the contractile response. 7. Papaverine caused the relaxation of KCl-induced contractures, preferentially blocking the tonic component. 8. It is suggested that the inhibitory action of papaverine on ureter smooth muscle results from its specific blockade of the 'slow' Na/Ca channels responsible for the generation of the plateau component of the action potential. PMID- 6864570 TI - Inhibition of gastric secretion by fat and hypertonic glucose in the dog: role of gastric inhibitory peptide. AB - 1. The gastric and intestinal phases of gastric secretion were selectively evoked by 'meals' of 5% liver extract or saline in five dogs provided with a special cannula that allowed complete separation of the stomach from the duodenum. 2. The gastric phase in response to liver extract administered into the stomach amounted to an increase in acid output equivalent to about 70% of the maximum output in response to histamine. There was also a significant rise in the concentration of gastrin but not of gastric inhibitory peptide (GIP) in the serum. 3. The addition of fat (2 or 4% corn oil) or glucose (20%) to this liver extract meal inhibited secretion of gastric acid by 50 and 30%, respectively, without affecting the concentration of gastrin or GIP in the serum. 4. The 5% liver extract in the duodenum stimulated an increase in gastric acid output amounting to about 40% of the maximum response to histamine. Serum gastrin and GIP levels were not affected. Additional fat (0.5-4.0%) or glucose (10-20%) reduced acid secretion under these conditions by between 50 and 80% without affecting serum gastrin concentrations. Significant increases in the concentration of GIP in the serum occurred in response to intraduodenal glucose (5%), and to fat at the highest dose used (4%). 5. Intraduodenal infusions of glucose (5-20%) significantly increased serum GIP levels. Gastric secretion in response to 5% liver extract in the stomach was significantly inhibited at the highest dose (10 or 20%) although gastrin release was unaffected. 6. These results show that intraduodenal fat and glucose both exhibit potent inhibitory effects on post-prandial gastric acid secretion but that there is no correlation between the changes in serum GIP concentration and the inhibition of gastric secretion under these conditions. 7. We conclude that GIP is unlikely to mediate fat-induced inhibition of gastric secretion, but it is still possible that it might be involved in the inhibition that occurs during intestinal perfusion with hypertonic glucose solutions. PMID- 6864571 TI - [Cholecystokinin as a brain-gut peptide]. PMID- 6864573 TI - Usefulness of urinary bladder biopsies--study of 98 cases. PMID- 6864572 TI - Coarctation of aorta. PMID- 6864574 TI - Accelerated clotting time (ACT): a simple test to assess foetal maturity. PMID- 6864576 TI - Predominence of S. aureus phage type-47 among the isolates from cardiac and neurosurgical patients. PMID- 6864575 TI - Management of small bowel perforation with intra- and post-operative lavages with povidone iodine. (A prospective study). PMID- 6864577 TI - Emphysematous infection of the urinary tract. (Report of 3 cases). PMID- 6864578 TI - Acute arterio-mesenteric duodenal compression. (A report of 2 cases). PMID- 6864580 TI - Myocarditis and pulmonary edema following scorpion bite. (A case report). PMID- 6864581 TI - Giant prostatic urethral calculus. (A case report). PMID- 6864579 TI - Air gun pellet in the sphenoid sinus. (A case report). PMID- 6864582 TI - "Behr disease". (Report of two cases in one family). PMID- 6864583 TI - Biliary cystadenoma of the liver. (A case report). PMID- 6864584 TI - Malignant neuroleptic syndrome due to haloperidol. (A case report). PMID- 6864585 TI - Ossiculoplasty: a new prosthesis. (A preliminary report). PMID- 6864586 TI - Sleep patterns in patients with cancer and patients with cardiac disease. AB - Thirty cancer out-patients, 28 out-patients with cardiac disease, and 24 controls matched for age, sex, race, religion, and marital status were administered a 38 item questionnaire on sleep habits. Patients with cardiac disease perceived that they had more difficulty falling asleep, awakened earlier than planned, and felt sleepy during the day more often than the other two groups. Patients with cancer differed from controls only in feeling that they had more difficulty staying asleep. The findings demonstrate that while patients with two different chronic diseases have altered sleep patterns, the patterns are disturbed in different ways. This has important implications for therapy as a different approach is needed for the patient who has difficulty falling asleep as compared with the patient who has difficulty staying asleep. PMID- 6864587 TI - The effects of social setting, perceived weight category, and gender on eating behavior. AB - Four hundred and sixteen male and 233 female subjects were observed in a university cafeteria at lunch time. They were categorized according to five perceived weight groups with category one being underweight and category five being overweight. The number of calories in the food bought for lunch by each subject was calculated and recorded. Males bought food containing more calories than females but for males the amount of calories did not differ by perceived weight category. Females purchased food with fewer calories than males but the heavier females bought food with higher caloric content. PMID- 6864588 TI - Moral judgment maturity of process and reactive schizophrenics. AB - Premorbid adjustment, paranoid symptomatology, and role orientation were examined as major predictors of moral judgment maturity in 40 male schizophrenics. In addition, control predictors included age, intelligence (block design and vocabulary), length of hospitalization, length of illness, social position (education and occupation), and severity of illness. A multiple regression equation of premorbid adjustment, block design and vocabulary combined, and education was the best predictor of moral judgment maturity. These results suggest the importance of cognitive and social skills in the development of moral judgment maturity in schizophrenics. PMID- 6864589 TI - Test performance of language-handicapped children with familiar and unfamiliar examiners. AB - The importance of examiner familiarity to children's performance on tasks requiring high or low levels of symbolic mediation was investigated. Thirty-four handicapped preschool children were examined within a repeated measures crossover design, once by one of two familiar classroom teachers and once by one of four strange teachers. Subjects performed significantly better with familiar than with unfamiliar examiners on high symbolic mediation tasks; no such differential performance was obtained on low symbolic mediation items. Findings are related to current efforts to identify procedural and situational variables in assessment, uncontrolled by present standard test administrations, that may preclude children's optimal performance. PMID- 6864590 TI - Drinking motivations and alcohol consumption among adolescent females. AB - The relationship between motivations for alcohol use and drinking patterns was investigated within a sample of 188 adolescent American female high school students. Previous research has revealed a positive correlation between problem solving drinking motivations and alienation among similar samples. It was predicted that such stated motivations for drinking would correlate positively with heavier rates of drinking in this population. This hypothesis was supported in terms of quantity and frequency of wine, beer, and liquor intake. PMID- 6864591 TI - Cognitive abilities of language-delayed children. AB - The performance and verbal IQ scores for the WPPSI and WISC-R were compared for two groups of children aged 5 to 8 1/2 years, one normal and one specifically language delayed (SLD). There 34 to 38 children in each group. In accordance with selection procedures, performance IQ scores were not significantly different across the two groups. Both verbal and full scale IQ were significantly lower for the SLD than for the normal group. Profiles of verbal subtest scores differed for normal and SLD children but profiles for performance subtest scores did not. Variability of performance subtest scores was not greater for the SLD than for the normal children. The results do not support the hypothesis that language delay in children is related to a nonverbal cognitive deficit. PMID- 6864592 TI - Transmission electron microscopy of intracellular sporozoites of Eimeria vermiformis (Apicomplexa, Eucoccidiida) in the mouse. AB - Sporozoites of Eimeria vermiformis from the mouse were first seen in the epithelial cells of villus tips and the crypts of Lieberkuhn four hours after inoculation (HAI). They were always within a parasitophorous vacuole. By 12 HAI, most were in crypt epithelial cells between the basement membrane and host cell nucleus. The sporozoites in the villus tips had 26 subpellicular microtubules, two polar rings, two preconoidal rings, two refractile bodies surrounded by amylopectin-like granules, a lamellar Golgi apparatus, numerous micronemes, and rhoptries. The sporozoites in the crypt cells had fewer amylopectin-like granules, micronemes, and rhoptries. A nucleolus was visible, as were pieces broken off from the posterior refractile body. Later, the sporozoites folded over to become U-shaped; the infolded membranes fused; and then the inner membranes disappeared so that spherical meronts were formed. Folding sporozoites were first seen 16 HAI and persisted until 52 HAI. PMID- 6864593 TI - The biochemical identification of vahlkampfiid amoebae. AB - Isoenzyme electrophoresis of three different enzymes was used to compare 16 strains of vahlkampfiid amoebae and a strain identified as a slime mold. The strain designated as an Echinostelium sp. was found to be an isolate of Naegleria fowleri on the basis of zymogram type and other characters, confirming Cursons & Brown's similar conclusion drawn in 1975. The N. fowleri strains examined expressed the typical zymograms of the species. The N. gruberi strains in this study presented two distinctive groups of patterns that were different from the two previously reported types for N. gruberi. Each of the remaining species studied formed single distinctive groups by which they could be identified. PMID- 6864594 TI - Characteristics of an uptake system for alpha-aminoisobutyric acid in Leishmania tropica promastigotes. AB - Leishmania tropica promastigotes transport alpha-aminoisobutyric acid (AIB), the nonmetabolizable analog of neutral amino acids, against a substantial concentration gradient. AIB is not incorporated into cellular material but accumulates within the cells in an unaltered form. Intracellular AIB exchanges with external AIB. Various energy inhibitors (amytal, HOQNO, KCN, DNP, CCCP, and arsenate) and sulfhydryl reagents (NEM, pCMB, and iodoacetate) severely inhibit uptake. The uptake system is saturable with reference to AIB and the Lineweaver Burk plots show biphasic kinetics suggesting the involvement of two transport systems. AIB shares a common transport system with alanine, cysteine, glycine, methionine, serine, and proline. Uptake is regulated by feedback inhibition and transinhibition. PMID- 6864595 TI - An assessment of chronic pain behavior in a structured interview. AB - The current study evaluated the effects of several situational contexts on the behavior of 25 chronic pain patients. Subjects participated in a 20-minute interview in which questions relevant to both pain and non-pain related experiences were asked. Another part of the interview involved a behavioral task in which the patient was asked to walk, bend and pick up a small object. Target behaviors were measured throughout the interview and included gestures of pain, grimacing, touching, smiles, laughter, changing the topic of conversation, ratings of affect, fluency and loudness, and the duration of eye contact and speech. The results showed a clear differentiation between the frequency of gestures, touching and grimacing between the pain and non-pain events. Behavior during the motor task was similar to the pain situations. Ratings of affect, fluency and loudness did not significantly differ across the situations. Slightly more eye contact and longer speech was observed during pain questions. PMID- 6864596 TI - Anxiety states: a preliminary report on the value of connective tissue massage. AB - Five patients who presented with symptoms of tension and anxiety were subsequently referred to a physiotherapist and treated with Connective Tissue Massage. Psychophysiological recordings of heart rate, frontalis EMG, skin resistance and forearm extensor EMG were taken before and after treatment. All patients showed a significant response to treatment in one or more of the psychophysiological parameters. Results are discussed in relation to the hypothesis that each individual has a unique stress response pattern. Preliminary findings proved interesting and supported clinical findings with regard to the effectiveness of this treatment for some patients suffering from Anxiety States. PMID- 6864597 TI - Young adults at risk for hypertension: effects of family history and anger management in determining responses to interpersonal conflict. AB - An experiment was conducted with young adults to study the effects of two hypothesized risk factors for essential hypertension, namely, having (1) a positive family history of essential hypertension, and (2) anger inhibition. Subjects were tested in a dyadic role play task designed to simulate mundane and conflictual social interactions. Heart rate and blood pressure were recorded, reports of emotion were obtained, and role play behavior was coded for assertiveness. Although family history of essential hypertension and anger inhibition were not associated with one another, both variables were related to cardiovascular activity. These results provide new information about the relationship between these two hypothesized risk factors and extend previously observed differences between at-risk and low-risk subjects for hypertension to a more naturalistic, interpersonal stressor. PMID- 6864598 TI - Breast feeding and post-natal depression. AB - Hormonal factors have been suggested as a cause of post-natal depression, but suckling frequency which is the major influence on hormone levels post-partum has not been considered in previous studies. Eighty-nine women who had taken part in a prospective study of post-natal depression were asked about their feeding patterns 18 months after childbirth. Half the mothers who were breast feeding introduced solids or artificial milk feeds before 12 weeks and were likely to have lowered prolactin levels and increased ovarian follicular activity. Mothers who totally breastfed their babies for at least 12 weeks or who were on the pill, had a higher incidence of post-natal depression than those who were not on the pill or who partially breastfed. Among the 62 women who attempted breast feeding those most likely to have normal levels of endogenous hormones were those least likely to have depressive symptoms. PMID- 6864600 TI - The development of psychosomatic medicine during the past 25 years. AB - The past 25 yrs has seen the evolution from concepts based on specificity of stimulus, mediating pathway and target organ response to concepts embodying the multifactorical nature of psychosomatic disorders in which various combinations of causal factors operate within a particular disorder which is therefore heterogeneous rather than homogeneous. The recognition of the importance of social and psychological factors in all varieties of illness attests not only the psychosomatic unity of the organism, but a dynamic continuum of organism- environmental interaction. Many illnesses involve not only psychosomatic sequence of events in their productions but also somato-psychic sequences as well, sometimes resulting in a vicious circle. The wider recognition of the role of social and psychological factors in all illness has led to the remarkable expansion of consultation and liaison psychiatry in all branches of medicine and surgery. Further notable developments are the more precise and appropriate application of various forms of individual and group psychotherapy and therapies based on learning theories such as behaviour therapy, biofeedback and various relaxation techniques. We may conclude by hoping that further advances may be expected with the application of rigorous scientific methodology especially in longitudinal studies of random and representative samples of the disorder and the general population in which genetic and constitutional factors, neurophysiological, biochemical, endocrinological and other intrinsic changes interact with a variety of social and environmental factors in the multifactorial aetiology of disease. PMID- 6864599 TI - Psychosomatic aspects in idiopathic infertility: effects of treatment with autogenic training. AB - It has long been recognised that there is a relationship between emotional stress and some forms of infertility. We have endeavoured to estimate "stress' levels before and after Autogenic Training in 15 couples with infertility of at least two years' duration. Potential stress markers were: plasma prolactin, total urinary free cortisol and catecholamines, and four psychological tests: Spielberger State-Trait anxiety scale, Taylor Manifest Anxiety Scale, the Cattell 16 personality factor questionnaire, and the Eysenck Personality Questionnaire. A control group of ten normal couples was included for comparison. The biochemical finding of higher mean prolactin levels in the female patients vs their controls was of particular interest. The significant reduction of the prolactin level, in parallel with decreased anxiety scores following treatment, supports the hypothesis that the elevated prolactin levels in these patients are indeed linked with emotional stress. PMID- 6864603 TI - Pulmonary hydatid disease in childhood. PMID- 6864601 TI - Massive intraperitoneal arterial haemorrhage secondary to "uncomplicated" acute pancreatitis. PMID- 6864602 TI - Peristomal cutaneous tubular adenomas following proctocolectomy for polyposis coli. PMID- 6864604 TI - The surgical treatment of associated axillary and palmar hyperhidrosis. PMID- 6864606 TI - Congenital haemangiopericytoma of the face with early distant metastasis. PMID- 6864605 TI - Acute asphyxia due to simultaneous bilateral aspiration of stones. PMID- 6864607 TI - Disintegration of an intracolonic metallic foreign body. PMID- 6864609 TI - Small is beautiful. Cardiac surgery in an isolated community. PMID- 6864608 TI - Recurrent spontaneous idiopathic rupture of the renal calices. PMID- 6864610 TI - Percutaneous trigeminal radiofrequency rhizotomy. PMID- 6864611 TI - Prophylactic antimicrobial management of compound depressed skull fracture. PMID- 6864613 TI - Operative cholangiography in gallstone associated acute pancreatitis. PMID- 6864612 TI - Surgical treatment of primary hyperparathyroidism. PMID- 6864614 TI - [Normal hepatic angioscan. Methodology and results]. PMID- 6864615 TI - [Association of pulmonary arteriovenous fistulas and hepatic angiomatosis]. PMID- 6864616 TI - [Dorsolumbosacral agenesis. Apropos of 2 cases. Review of the literature]. PMID- 6864617 TI - [Dose evaluation during radiographic examinations of the pelvis in pediatrics]. AB - Dosimetry studies, employing a model, were conducted under the technical conditions established by one of the authors for exploration of the infant and child pelvis during diagnosis and treatment of congenital dislocation of the hip. Based on this data, it was confirmed that the dose applied to the various organs of a patient can be evaluated by using a relation identical to that employed for calculating the dose during radiotherapy. The results measured experimentally or calculated from the proposed formula, were comparable to those in the published literature. This method of dose assessment is valid not only in pediatric radiology, and whatever the region explored, but also for radiodiagnosis in adults. PMID- 6864618 TI - [Post-traumatic multiradicular lumbosacral meningoceles]. PMID- 6864619 TI - [Hemangiopericytoma of the kidney]. PMID- 6864620 TI - [Value of the use of a guiding forceps for punctures under radioscopic control]. PMID- 6864621 TI - Study of mortality and autopsy findings amongst former prisoners of the Japanese. PMID- 6864622 TI - Exercise testing in servicemen with asthma and its application to the assessment of potential recruits. PMID- 6864623 TI - A medical audit for TA units. PMID- 6864624 TI - Rubella screening and immunisation of Army recruits. PMID- 6864625 TI - Medical miscellanea in lighter vein. PMID- 6864626 TI - Recent medical history--cataract surgery. PMID- 6864627 TI - Boxing injuries in the Army. PMID- 6864628 TI - The incidence and effect of insect bites on servicemen in Belize. PMID- 6864629 TI - The use of contact lenses by Army air crew. PMID- 6864630 TI - Incidence of instrumental deliveries in primigravidae of three different ethnic groups. PMID- 6864633 TI - Near fatal asthma after eating deeply frozen ice cream. PMID- 6864631 TI - "Floor layers foot'--an occupational bursa. PMID- 6864634 TI - Scintigraphic evidence of improvement in myocardial perfusion associated with improvement in physical fitness in a patient with angina. PMID- 6864632 TI - Intracranial infection complicating chronic ear disease. PMID- 6864635 TI - The battle for Goose Green--the RMO's view. PMID- 6864637 TI - Decision-making in acute asthma. AB - The management of an eight-year-old child with acute asthma was investigated by putting a semi-structured patient management problem (PMP) to 618 general practitioners. Of the 321 (52 per cent) who replied, 112 (35 per cent) would arrange for immediate admission to hospital and a further 154 (48 per cent) would have the child admitted after 30 minutes when initial home treatment appeared not to be working. Among those who would treat at home there was considerable variation in the type and intensity of treatment given. The more recently qualified were more likely to admit immediately or to treat vigorously at home (with intravenous steroids and/or aminophylline); no other characteristic of the doctor or the practice was related to admission decision or to treatment. Expectations concerning the immediate hospital management of the patient also varied widely. Comparison of the expected hospital management with actual management recorded in hospital case-notes suggested that general practitioners overestimate the use of intensive treatments (steroids, intravenous drip, oxygen) and investigations (blood gases, lung function tests, chest radiograph). PMID- 6864636 TI - Language and communication problems in an Asian community. AB - A survey of general practitioners working in an area of immigrant concentration was undertaken to find out about their contacts with the Asian community. An earlier study had shown that Pakistani women mostly spoke little or no English and that they had strict ideas of modesty, which suggested problems for the health services.Questionnaires were sent to 44 doctors and 39 (89 per cent) replied. To the question of language difficulty, 11 doctors answered that they could speak at least one Asian language, the remainder said they relied on patients' relatives to interpret. On frequency and length of consultations, more than half the doctors felt that Asians consulted more often and took up more time than English patients. Reluctance on the part of Asian women to be examined was reported by 30 doctors. However, the commonest comments volunteered by the general practitioners were not about language or modesty but about their Asian patients' tendency to complain of trivial ailments, while on the other hand they presented less often with psychosocial problems. A connection between the language barrier and apparently unnecessary complaining is postulated. It is also recommended that interpreting facilities and liaison workers should be made known to general practitioners. PMID- 6864639 TI - The prevalence of intermittent digital ischaemia (Raynaud's phenomenon) in a general practice. AB - The prevalence of intermittent digital ischaemia (IDI) has been determined in a sample of 520 patients aged 20-59 selected from the list of a Hampshire general practice. Sixtythree cases were identified using a postal questionnaire (response rate 87 per cent) and, where possible (69 per cent), histories were confirmed by interview. The estimated prevalence of IDI was 8.3 per cent in men and 17.6 per cent in women. A minimum estimate based only on histories confirmed at interview was 5.0 per cent in men and 10.4 per cent in women. Of the 63 cases identified, 12 had consulted their general practitioner because of the problem but only two had been referred to hospital. We conclude that the course of IDI is generally benign. PMID- 6864638 TI - Incidence of arterial disease among oral contraceptive users. Royal College of General Practitioners' Oral Contraception Study. PMID- 6864640 TI - Current opinion concerning the treatment of heart disease. Report of a postal survey among Tayside general practitioners. AB - Using a postal questionnaire method of investigation, the views of Tayside general practitioners were examined with respect to the management of three hypothetical patients with ischaemic heart disease. In the case of a man showing symptoms suggestive of infarction, hospital care was preferred by the majority of doctors. Of three categories of employment, the person in a manual occupation would be advised by most doctors to change his job after a second serious infarction. The advice given to patients was orientated towards the risk factors associated with ischaemic heart disease. Such advice was general rather than specific and emphasized restriction of activities rather than return to normal life. Commonly held social stereotypes appeared to affect the advice which practitioners said they would offer. The implications of these findings are discussed. PMID- 6864641 TI - Inhibitory influence of uterine secretions on mouse blastocysts decreases at the time of blastocyst activation. AB - Uterine flushings from artificially 'pseudopregnant', pseudopregnant and pregnant mice and those with 'diapausing' embryos were tested for their effect on [3H]uridine incorporation by mouse blastocysts. An inhibitor of [3H]uridine incorporation was detected in the uterine fluid of the mice with diapausing embryos and the activity of the inhibitor was significantly reduced 6.25 h after an injection of oestrogen. This reduction of the inhibitory activity was dependent on the presence of blastocysts in utero, since a similar reduction did not occur in uterine fluids of pseudopregnant mice. The results support the suggestion that 'delayed' implantation in mice is caused by the presence of inhibitors of blastocyst metabolism and that activation, after an increase in oestradiol, is due to an embryo-dependent loss of activity of the inhibitors. PMID- 6864642 TI - Factors in seminal plasma of bulls that affect the viability and motility of spermatozoa. AB - When ejaculated bovine semen was washed twice with Ficoll the spermatozoa, resuspended in buffer, became immotile. Motility could be restored by addition of seminal plasma from vasectomized bulls and by addition of both bovine serum albumin (BSA) and theophylline. Motility could be restored and maintained at 37 degrees C to a variable extent with BSA alone. When this motility ceased it could be revived with theophylline or seminal plasma. When spermatozoa, inactivated by washing with Ficoll, were reactivated with seminal plasma the time that motility lasted at 37 degrees C before it was irreversibly lost depended on the concentration of seminal plasma: the more seminal plasma added, the shorter the duration of motility. This suggested that seminal plasma contained separate factors which restored motility and led to permanent inactivation of the spermatozoa. A motility-stimulating factor was present in the low molecular weight fraction of seminal plasma which had been passed through an ultrafilter of retention Mr 500 and the damaging effect was confined to molecular weight non dialysable fraction. PMID- 6864643 TI - Role of the adrenals in the maintenance of pregnancy in cows. AB - On Day 215 of gestation, cows were treated as controls (Group 1), bilaterally ovariectomized (Group 2), bilaterally adrenalectomized (Group 3) or bilaterally adrenalectomized and ovariectomized (Group 4). The mean +/- s.e.m. lengths of gestation (days) were 278 +/- 3 (N = 5), 270 +/- 2 (N = 7), 277 +/- 1 (N = 5) and 219 +/- 1 (N = 3) in Groups 1, 2, 3 and 4 respectively. In Group 4, serum progesterone concentrations declined to undetectable levels within 24 h after surgery and all the cows aborted 3-6 days later. All the cows in Groups 1, 2 and 3, except 1 cow in Group 2, completed gestation and delivered live calves. Progesterone concentrations in Group 2, cows declined to approximately one-third those of cows in Groups 1 or 3. All 3 cows in Group 4 and 7/8 in Group 2 had a retained placenta. At 1 and 2 days after surgery there were no significant differences in plasma levels of oestradiol-17 beta, but by the third day this difference was significant (P less than 0.01). Oestrogen levels were high before parturition in cows in Groups 1 and 3 but were not noticeably elevated in those in Groups 2 and 4. The abrupt termination of pregnancy and negligible concentrations of progesterone in adrenalectomized-ovariectomized cows indicate that the bovine adrenals contribute to progesterone production and are capable of maintaining pregnancy after ovariectomy at 215 days of gestation. PMID- 6864644 TI - Comparison of the survival of fertilized eggs from adult ewes in the uteri of adult ewes and ewe lambs. AB - Fertilized eggs, obtained from mature donor ewes, were transferred into the uteri of adult ewes and ewe lambs (1 or 2 eggs per recipient). The survival rate to term of the transferred eggs was similar in the two classes of recipients. The percentage of adult ewe and ewe lamb recipients which gave birth to twins was 45.3 and 41.1 respectively. Gestation length was shorter (P less than 0.01) and lamb birth weight lower (P less than 0.01) for ewe lamb recipients. The results indicate that the generally lower lambing rate of ewe lambs compared to adults is unlikely to be due to unfavourable uterine conditions. PMID- 6864645 TI - Effect of oestradiol and tamoxifen on the testosterone response in male rats to a single injection of hCG. AB - A single s.c. injection of hCG (100 i.u.) produced a biphasic serum testosterone response in adult male rats, peaks being noted at 2 h (24 ng/ml) and 3 days (16 ng/ml). The levels fell to control during the intervening interval (8 ng/ml), although there were elevated levels of serum hCG. Maintenance of high oestradiol levels by a s.c. injection of 50 micrograms oestradiol benzoate given on Day 2 after the initial hCG injection failed to prolong the refractory period and the secondary peak of testosterone (16 ng/ml) occurred on Day 3. Administration of the antioestrogen, tamoxifen (2 mg or 3 micrograms), 24 h before or simultaneously with hCG did not prevent testicular refractoriness in vivo because serum testosterone levels still declined after 2 h to reach a nadir at 2 days. The basal in-vitro testosterone production by decapsulated testes from animals injected with hCG was enhanced at 2 h. Stimulation by hCG increased the amount of testosterone produced (X 1.5 that in controls). By 12 h basal production decreased and there was no further increment in testosterone in the presence of hCG. This refractoriness to further hCG stimulation prevailed until Day 3, but the total production of testosterone fell so that at 24 h and 2 days testes were producing basal amounts of testosterone. Testes recovered from refractoriness at 4 and 5 days, when basal and stimulated testosterone production were greater than in controls. Injection of 50 micrograms oestradiol benzoate at 2 days did not prolong the in-vitro refractory period and 2 mg or 3 micrograms tamoxifen had no effect on the in-vitro steroidogenic activity, since testes were still refractory to further hCG stimulation from 12 h to 3 days. The results of the present study do not support the hypothesis that oestradiol is involved in the hCG-induced refractoriness of the Leydig cell. The nadir between the peaks of serum testosterone in vivo corresponds to the period during which the testis is refractory to in-vitro stimulation by hCG. PMID- 6864646 TI - A sperm-specific enolase. AB - An unusual enolase isoenzyme, ENO S, was found in human, ram and mouse spermatozoa. This isoenzyme is unique to spermatozoa and distinguished from the somatic enolases ENO 1, ENO 2 and ENO 3 by electrophoretic mobility, high thermostability and ability to undergo structural alteration at high temperatures. The pattern of expression of ENO S during sperm differentiation suggests that this isoenzyme is synthesized relatively late in the presence of a haploid genome. PMID- 6864647 TI - Electron microscopic study of the chorioallantoic placenta of the rock hyrax (Heterohyrax brucei). AB - The interhaemal membrane consisted of only two cellular elements: a single layer of cellular trophoblast and the fetal capillary endothelium. The hyrax is therefore one of the few mammals known to possess the cellular haemomonochorial type of placenta. The trophospongium was also cellular while the basal trophoblastic cells were strongly phagocytic. The giant multinucleate cells at the feto-maternal junction were ultrastructurally different from the trophoblast cells and showed no signs of degeneration. Their appearance suggests that they are of maternal rather than fetal origin. PMID- 6864648 TI - Factors influencing pre-natal fertility in the brown marsupial mouse, Antechinus stuartii. AB - The number of eggs ovulated per ovary, estimated as the number of corpora lutea in histological sections, was 6.1 +/- 1.4 (s.d.) in 100 sides of the reproductive tract in 53 female Antechinus stuartii during 5 breeding seasons. Post-ovulatory fertility, estimated as the number of normal embryos divided by the number of corpora lutea, was 74 +/- 25% (s.d.). By analysis of variance the number of corpora lutea per ovary did not vary significantly with the year of breeding or the origin of the female but did decline significantly (P less than 0.05) with increasing age of the female to 5.4 +/- 1.1 (s.d.) in females in their second breeding season. Analysis of variance showed that the mean percentage of surviving embryos did not vary significantly with the year of breeding, origin or age of the female, the stage of development or whether the female had been mated 1, 2 or 3 times. Failure of development was most marked during fertilization and cleavage to the unilaminar blastocyst and only 79 +/- 21% (s.d.) of embryos reached the latter stage. Additional mortality occurred mainly during implantation. PMID- 6864650 TI - Zinc binding properties of human prostatic tissue, prostatic secretion and seminal fluid. AB - When studied by gel filtration, zinc in prostatic cytosol (10(5) g, 1 h) was associated with high (greater than 80000), medium (3000-80000) and low molecular weight (less than 3000) molecules in approximately equal proportions. The molecules of high and medium Mr were not secreted into the prostatic fluid where all the zinc was associated with molecules of low Mr (probably citric acid). After ejaculation much of the zinc is redistributed and becomes bound to molecules of high and medium Mr of vesicular origin. PMID- 6864649 TI - Prostaglandin F and 13,14-dihydro-15-keto prostaglandin F in the endometrium and uterine flushings of sheep before implantation. AB - The concentrations of prostaglandin F (PGF) and its major metabolite, 13,14 dihydro-15-keto prostaglandin F-2 alpha (PGFM), were measured in caruncular and intercaruncular endometrium of pregnant and non-pregnant ewes on Days 9, 11, 13 and 15 after mating (Day 0) and related to the content of PGF and PGFM in the uterine flushings. The tissue concentrations of PGF and PGFM increased with time after mating particularly on Days 13 and 15 and to a greater extent in pregnancy. However, the ratio of PGF to PGFM remained constant at 0.7, except on Day 15 in non-pregnant endometrium when it fell to 0.3 (P less than 0.05), suggesting that synthesis rather than metabolism was limiting tissue concentrations of PGs. The changes in tissue concentrations of PGF and PGFM were reflected in the contents of PGF and PGFM in the uterine flushings of non-pregnant, but not pregnant ewes. Pregnant ewes had relatively more PGF and less PGFM than did non-pregnant ewes on Day 15. Moreover, there was always 5-10-fold less PGFM than PGF in the uterine flushings. It is concluded that the increase in PG in the uterine lumen in pregnancy has its origin in the blastocyst, and that pregnancy may be associated with an increase in the synthesis and retention of PGs in the endometrium, rather than a redistribution towards the uterine lumen away from the uterine venous drainage. PMID- 6864651 TI - Cytofluorometric study of nuclear sulphydryl and disulphide groups during sperm maturation in the mouse. AB - The amount of nuclear sulphydryl and disulphide groups was determined by cytofluorometry on single mouse spermatozoa from the caput, corpus and cauda epididymidis, and the vas deferens. N-(7-Dimethylamino-4-methylcoumarinyl) maleimide was used as a specific and quantitative fluorescent reagent for thiols. The sperm nuclear content of free sulphydryl groups decreased sharply from the caput epididymidis to the vas deferens. The amounts of cysteine residues present as the thiol form in the spermatozoa from the caput, corpus and cauda epididymidis and vas deferens were 50, 15, 5 and 3% respectively. PMID- 6864652 TI - Protective effect of sucrose on the survival of mouse and rat embryos stored at 0 degree C. AB - Mouse and rat embryos were stored at 0 degree C for 24-120 h in PBS containing sucrose. Higher proportions of mouse morulae developed into expanded blastocysts in culture when they were stored in 0.25, 0.5 or 0.75 M-sucrose than in 0, 0.1 or 1.0 M-sucrose. The greatest survival rates were obtained with 0.75 M-sucrose when examined after 48 (72%), 72 (62%) and 96 (41%) h of storage. No rat morulae developed after storage at 0 degree C for 24 h in PBS, but when 0.5 or 0.75 M sucrose was added to the storage medium, 50-68% of embryos developed into blastocysts in culture, the proportions decreasing until they reached 15-21% after 120 h of storage. Mouse and rat embryos stored at 0 degree C for 3-4 days were transferred to recipients, and 2/2 mice and 1/2 rats delivered full-term young. When mouse embryos stored in 0.75 M-sucrose were frozen to -196 degrees C or when freshly collected frozen-thawed embryos were stored at 0 degree C, embryonic survival was improved when the embryos were incubated for 1-6 h between the two treatments. PMID- 6864653 TI - XO monosomy is associated with reduced birthweight and lowered weight gain in the mouse. AB - The growth of XO mice and their XX sisters was followed from the day of birth up to 15 weeks post partum. XO mice were underweight at birth, and grew more slowly than XX mice in the preweaning period. Some, but not all, of this decrease in growth rate was attributable to an effect of the reduced birth weight. PMID- 6864654 TI - Retarded development of XO conceptuses during early pregnancy in the mouse. AB - The growth and development of XO and XX mice were compared from 7 1/4 to 18 1/2 days of gestation. The 7 1/4-day XO egg cylinders were retarded in development (and consequently small) when compared with XX egg cylinders, and this lag in development remained until 10 1/2 days. By 12 1/4 days there was a considerable degree of 'catch-up', but this was not fully maintained. A subgroup of very severely retarded XO fetuses were preferentially located near the cervix. The placentas of XO fetuses were of normal size until 18 1/2 days when they were significantly larger than those of XX controls. PMID- 6864655 TI - Effect of embryo removal on concentrations of progesterone and LH in the rabbit. AB - Embryos were removed by flushing the oviducts or uterine horns on Days 1, 2, 3, 4, 5, or 6 of pregnancy or pseudopregnancy. Progesterone profiles of pregnant, flushed pregnant, pseudopregnant and flushed pseudopregnant does were identical until Day 12 post coitum regardless of the day of flushing. After Day 12, the profiles of intact pregnant does were different from those of the other three groups (P less than 0.01). LH levels were low (less than 1 ng/ml) in all groups before and after surgery and there were no significant differences between treated and control rabbits. These data demonstrate that removal of embryos at any time before implantation results in progesterone levels identical to those of pseudopregnancy and does not alter serum LH levels. PMID- 6864656 TI - Androgenic control of the cyclic AMP-dependent protein kinase isoenzymes of the rat epididymis. AB - The specific activity of the type I and type II isoenzyme forms of the cAMP dependent protein kinase (EC 2.7.1.37) in the caput epididymidis of the intact rat was less than that of the caudal region while the isoenzyme ratio (type II:type I) of the former was greater than that of the latter, with type II being the predominant form in both regions. By 7 days after castration, the specific activities in both regions had decreased to the same levels. The isoenzyme ratio of the caudal region increased to that of the caput region which remained unchanged after castration. The change in the isoenzyme ratio in the caudal region was mainly due to loss of the type I isoenzyme. The castration effects were reversed by testosterone administration. PMID- 6864658 TI - Prediction of bovine ovulation by a rapid radioimmunoassay for plasma LH. AB - A commonly used and specific plasma LH radioimmunoassay was modified to provide reliable results for cow LH concentrations in blood within 4-5 h. Blood samples were collected at 2- or 4-h intervals from at least 24 h before the expected oestrus until after its onset. Thereafter, samples were collected at intervals of 2 or 4 days until the next oestrus. For the assay, the antigen-antibody reaction took place during a 2-h incubation at 37 degrees C. The immune complex was precipitated by addition of rabbit anti-gamma-globulin and polyethylene glycol followed by an incubation at 22 degrees C for 30 min. The coefficient of variation between this assay and the standard assay was less than 15%. From a study of 25 cycles from 12 animals, we obtained intervals of congruent to 27.3 h between the beginning of the LH peak and ovulation and congruent to 17.5 h between the end of the peak and ovulation. This modified technique can be used to predict rapidly and precisely the time of ovulation in cattle. PMID- 6864657 TI - In-vitro ovulation of rabbit ovarian follicles isolated after the endogenous gonadotrophin surge. AB - Follicular rupture was never observed when preovulatory rabbit follicles were isolated from the ovary before the ovulatory gonadotrophin discharge and placed in hormone-free culture for 10-14 h (n = 48). However, if the follicles were taken 1 h post coitum and cultured under the same conditions, 11/24 (45.8%) ruptured spontaneously. Follicular rupture under these conditions appeared to be chronologically and histologically comparable to that of ovulation in vivo. Culture in the presence of progesterone increased the proportion of follicles ovulating in vitro (17/23 = 73.9%; P less than 0.05). Inhibition in vitro of the synthesis of steroids or prostaglandins suppressed ovulation, although meiotic maturation of the oocyte did take place. These findings indicate that the follicle constitutes an independent entity within the ovary from 1 h post coitum. PMID- 6864659 TI - Effects of relaxin on the intrauterine distribution and antimesometrial positioning and orientation of rat blastocysts before implantation. AB - An i.v. infusion of porcine relaxin was administered to rats from the afternoon of Day 4 of pregnancy to the morning of Day 6, a time by which implantation has normally occurred. Implantation sites were irregularly distributed and confined to the cranial half of each uterine horn. Histological sections of uteri fixed by vascular perfusion with osmium tetroxide revealed that the blastocyst was no longer invariably positioned antimesometrially within the lumen and that embryonic disc orientation was often abnormal. A reduced decidual cell reaction was observed around several of the implanting blastocysts. PMID- 6864661 TI - Sperm maturation, fluid transport, and secretion and absorption of protein in the epididymis of the echidna, Tachyglossus aculeatus. AB - Extratesticular sperm maturation in the echidna mainly occurs in the initial segment of the ductus epididymidis. The process involves the development of motility, migration and loss of the cytoplasmic droplet, a decrease in permeability to Congo red and the formation of sperm bundles. The spermatozoa are supported in the bundles by a matrix of electron-dense material; the bundles are very motile is undiluted samples of luminal fluids. Micropuncture studies of anaesthetized echidnas showed that the ductuli efferentes absorb 74% of the fluid and 46% of the soluble protein that enters them. The initial segment of the ductus epididymidis absorbs 83% of the fluid which enters it, and its secretions increase the concentration of protein in luminal fluid by 107%. Denatured, linear gradient polyacrylamide gel electrophoresis of micropuncture samples showed that 1 protein (apparent M4 = 100 500) which is not present in blood plasma is present in rete testis fluid, and a glycoprotein which is present in rete testis fluid (apparent Mr = 78500) is absorbed by the ductuli efferentes. Six proteins which are not present in blood plasma are secreted into the initial segment of the ductus epididymidis; 5 are glycoproteins (apparent Mr = 48500, 39000, 32000, 20500 and 19000) and one (apparent Mr = 82500) is not. The most prominent electrophoresis bands corresponded to the glycoproteins with apparent molecular weights of 48500, 20500 and 19000. PMID- 6864660 TI - Effect of inhibitors of polyamine synthesis on activation of diapausing mouse blastocysts in vitro. AB - Diapausing mouse blastocysts were cultured in vitro with inhibitors of polyamine synthesis and/or the polyamines, putrescine, spermidine and/or spermine. Attachment of blastocysts to the culture dish, the onset of trophoblastic outgrowth and the extent of outgrowth were retarded by methylornithine (10 mM) or methylglyoxal bis(guanylhydrazone) (50 or 200 microM) and apparently blocked by a combination of these inhibitors. The embryos appeared to make no progress towards activation in the presence of both inhibitors but became active and grew normally when transferred to inhibitor-free medium. The inhibition of growth was also reversed when polyamines (10(-5) M) were supplied in the medium along with the inhibitors (P less than 0.01). These results suggest that polyamine synthesis is required for activation, growth and development of diapausing blastocysts in vitro. PMID- 6864662 TI - An appraisal of the mouse uterine weight assay for the bioassay of chorionic gonadotrophin in the macaque term placenta. AB - The results obtained in this investigation have shown that the increase in uterine weight of 21-day-old mice, injected with monkey CG, was affected significantly by the number of injections made, the interval between injections and the time of autopsy after the first injection. Failure to take account of these factors may explain why some investigators, using the increase in mouse uterine weight as the index of response, do not find CG in macaque placentae after the 10th week of pregnancy. The present investigation confirmed that extracts of term placentae from rhesus and stump-tailed monkeys contained measurable amounts of CG whose biological activity could be neutralized by an anti-hCG serum. PMID- 6864663 TI - Regional variations in transport of the luminal contents of the rat epididymis in vivo. AB - The speed of transport of the luminal contents of the epididymis was studied by injecting small droplets of stained paraffin oil into the lumen in 10 different regions of the epididymal duct of 64 anaesthetized rats and measuring the distances the droplets moved in 2 h. The oil droplets became dispersed, and there was much variation between the animals. The dispersion distances were longest in the proximal caput and shortest in the corpus. The distributions of the transport distances of the oil droplets were discontinuous and multimodal in the proximal caput, and bimodal in the cauda. The transport speed decreased steeply from 420 mm/2 h in the most proximal caput to 64.2 mm/2 h in the beginning of the distal caput. In the rest of the caput, corpus and cauda, speed was quite similar although it declined slightly towards the ductus deferens, being 25.5 mm/2 h in the most distal region of the cauda. PMID- 6864664 TI - Luteal concentrations of oxytocin decline during early pregnancy in the ewe. AB - The concentration of oxytocin in ovine corpora lutea dropped during pregnancy from 373 ng/g wet weight on Day 14 to less than 5 ng/g between Day 50 and term. The major decrease occurred before Day 20 after mating. Circulating concentrations of oxytocin also decreased between Days 10 and 15 after mating, and were low in late gestation; however, concentrations of oxytocin in plasma on Days 16 and 17 were raised. Mean luteal concentrations of oxytocin ranged from 730 to 2482 ng/g between Days 8 and 14 of the oestrous cycle in non-pregnant sheep. Secretion of oxytocin by the corpus luteum is thought to be one of the mechanisms leading to luteal regression; therefore loss of oxytocin from the corpora lutea in early gestation may contribute to their maintenance. PMID- 6864665 TI - Changes in oestrone sulphate concentrations in peripheral plasma of Pony mares associated with follicular growth, ovulation and early pregnancy. AB - A simple and rapid (less than 2 h) immunoassay method has been developed based upon a novel separation technique called LIDIA (Ligand Differentiation Immunoassay), enabling direct estimation of the concentration of oestrone sulphate in ethanolic extracts of blood plasma. An antiserum raised against oestrone-3-glucuronyl-BSA was used which showed a higher cross-reaction with the sulphate than the glucuronide metabolite. The assay had a sensitivity of 5.2 pg/tube and acceptable inter-(less than 18%) and intra-(less than 8.5%) assay precision. Analysis of samples of peripheral venous plasma obtained daily from Pony mares showed that the mean concentration of oestrone sulphate started to rise from a baseline value (less than 300 pg/ml) at 6 days and reached a peak (greater than 850 pg/ml) at 2 days before follicular rupture as determined by rectal palpation. Progesterone concentrations only started to rise above baseline (less than 0.5 ng/ml) on the day of ovulation and reached a peak 8 days later. Analysis of samples obtained during the first 30 days of pregnancy showed that there was no increase in oestrone sulphate at the time oestrus would have been expected had the mares not conceived. PMID- 6864666 TI - Localization of human seminal plasma No. 7 antigen (Ferrisplan) in accessory glands of male genital tract and spermatozoa. AB - The establishment of a hybridoma (1C4) producing sperm immobilizing monoclonal antibody to human seminal plasma No. 7 antigen (HSP No. 7 Ag.) and the isolation of the pure antigen by immunoaffinity chromatography bound monoclonal antibodies have been reported previously. In the present investigation, HSP No. 7 Ag. has been termed 'Ferrisplan' and its distribution in male genital organs, spermatozoa and body fluids has been studied. The amount of Ferrisplan in the body fluids was determined by radioimmunoassay. Large amounts were detected in seminal plasma and milk, trace amounts in saliva, and none in the serum and urine. The concentration of Ferrisplan was highest in the seminal plasma of azoospermic patients and gradually decreased from oligospermia to normospermia. Using an immunofluorescent method with anti-Ferrisplan monoclonal antibody, strong staining was observed on the epithelial layers of human seminal vesicles, no staining on testes and bright staining on the post-nuclear cap and mid-piece segment of spermatozoa. These results indicate that Ferrisplan is excreted mainly from the seminal vesicle and adheres to the post-nuclear cap and mid-piece of the spermatozoa as a sperm coating antigen. PMID- 6864667 TI - The microenvironment of the ovarian follicle. AB - Observations on the steroid and peptide concentrations and interactions in the microenvironment of the human ovarian follicle have led to an understanding of three important issues in reproductive biology: (1) how the oocyte-granulosa-cell complex matures, (2) how a single follicle is selected and prepared for ovulation and (3) how the events are synchronized so that an ovum ready for fertilization is extruded at ovulation. These findings have clinical significance. PMID- 6864668 TI - Modern management of prolactinoma. AB - Hyperprolactinemia can cause amenorrhea, oligomenorrhea, galactorrhea and infertility. Prolactin (PRL) increase can have pharmacologic, neoplastic and nonneoplastic causes. The clinical approach to such patients should include both static and dynamic evaluation of PRL levels and radiographic imaging of the sella turcica and pituitary gland. PMID- 6864669 TI - Osteoarthrosis--the mystery crippler. PMID- 6864670 TI - Problems associated with the measurement of radiologic progression of disease in rheumatoid arthritis. PMID- 6864671 TI - An approach to developing criteria for the clinical diagnosis and classification of osteoarthritis: a status report of the American Rheumatism Association Diagnostic Subcommittee on Osteoarthritis. PMID- 6864673 TI - Modulation of phagocytosis and bactericidal activity of human polymorphonuclear and mononuclear phagocytes by antiarthritic agents. AB - The influence of 9 antiarthritic drugs on phagocytosis and intracellular bactericidal activity of human polymorphonuclear (PMN) and mononuclear phagocytes was investigated using gram-positive and -negative microorganisms and latex particles. With the exception of prednisone all the other agents suppressed phagocytosis and/or phagocytic index of PMN. Whereas naproxyn suppressed phagocytosis of all 3 particles used, other drugs had more pronounced inhibitory activity on phagocytosis of E. coli than of S. aureus or latex particles. Monocytes were less influenced by antiarthritic agents. Intracellular bactericidal activity was markedly suppressed by phenylbutazone, oxyphenbutazone, naproxyn and gold sodium thiomalate. In suboptimal conditions when serum was omitted from the assay, dual action of some drugs was observed. It may be concluded that antiarthritic agents may modulate phagocytosis and intracellular bactericidal activity. The modulation was most pronounced in conditions similar to those in vivo i.e., with added serum and when the cells were exposed to antiarthritic agents for longer time. It should be taken into consideration while assessing defense mechanisms and susceptibility to infection in rheumatic diseases. PMID- 6864672 TI - Chemiluminescence of polymorphonuclear leukocytes from rheumatoid joints. AB - Chemiluminescence (CL) was used to measure the oxidative burst of polymorphonuclear leukocytes (PMNL) from peripheral blood (PB) and synovial fluid (SF) of patients with inflammatory arthritis. The basal CL of SFPMNL was greater than that of PBPMNL. Opsonized zymosan, N-formyl methionyl-leucyl-phenylalanine (FMLP), cell-free inflammatory SF and heat aggregated human IgG (HAIG) all stimulated PMNL CL but the response of SFPMNL to HAIG or to reexposure to SF was greater than that of PBPMNL. This enhanced responsiveness of SFPMNL to HAIG could be induced in PBPMNL by preincubation with chemotactic concentrations of FMLP. These studies suggest a mechanism by which PMNL migrating to sites of inflammation may become sensitized to a subsequent stimulation by soluble immune complexes at the inflammatory site. PMID- 6864674 TI - Local synthesis of IgM and IgM rheumatoid factor in rheumatoid pleuritis. AB - Pleura from 3 patients with rheumatoid pleuritis and from 5 patients with other diseases was examined for its capacity to synthesize IgM and IgM rheumatoid factor (RF). IgM was synthesized by pleura from all 3 patients with rheumatoid pleuritis and IgM RF by 2. Pleura from each of the control patients synthesized less than or equal to 1 ng/mg of IgM and IgM RF. Moreover, pleura from a 4th patient with rheumatoid pleuritis incorporated 3H-leucine into newly synthesized IgM. Simultaneously obtained pleural fluid mononuclear cells (MNL) and pleural tissue from a patient with rheumatoid pleuritis synthesized identical proportions of IgM and IgM RF whereas IgM RF production was not observed with peripheral blood MNL from the same patient. The results support the view that local production of IgM and IgM RF occurs in rheumatoid pleuritis and suggest that local immune events contribute to the pathogenesis of this disorder. PMID- 6864676 TI - Observer differences in detecting erosions in radiographs of rheumatoid arthritis. A comparison of posteroanterior, Norgaard and Brewerton views. AB - This study shows no significant advantage of Brewerton or Norgaard radiographs in detection of erosions at metacarpophalangeal joints in patients with polyarthritis over the conventional posteroanterior view. The observer agreement for detection of exact number of erosions/pair of hands is uniformly low. Therefore, erosion index cannot be reliably used in epidemiologic surveys or therapeutic trials as an outcome measure unless steps are taken to improve the observer agreement. PMID- 6864675 TI - Relationship between rheumatoid arthritis and monoclonal gammopathy. AB - The incidence of monoclonal gammopathy (MG) developing after the onset of rheumatoid arthritis (RA) was found to be 4.1%. Comparison of 12 patients with both diseases and a group of 215 control cases of RA showed the age of onset of RA was higher when MG was going to develop. In such cases, MG was heralded by lower or diminishing serum rheumatoid factor titers. Comparison of these 12 patients with 971 control cases of MG showed the same high frequency of patients with IgM-MG as that recently reported for a series in Western France. An unusually high but not significant incidence of patients with lambda light chains was observed. The reasons for this remain to be elucidated. PMID- 6864677 TI - Comparison of clinical and serologic markers in systemic lupus erythematosus and overlap syndrome: a review of 247 patients. AB - To evaluate the relationship between clinical manifestations and serologic markers in patients with systemic lupus erythematosus (SLE) and patients with an overlap syndrome, we reviewed the charts of 247 such patients who had been examined between 1975 and 1979. All patients with an overlap syndrome had a high frequency of arthritis and Raynaud's phenomenon and a low frequency of renal disease regardless of the presence or absence of antibody to nuclear ribonucleoprotein (anti-nRNP) and antibody to Sm antigen (anti-Sm). The presence or absence of anti-nRNP and anti-Sm did not distinguish whether a patient had SLE or an overlap syndrome and could not be used to predict clinical manifestations of disease. PMID- 6864678 TI - Ultrastructural and crystallographic study of calcifications from a patient with CREST syndrome. AB - An ultrastructural and crystallographic study was done on calcium deposits obtained from a patient with the CREST syndrome. Optical microscopy showed that large calcific cutaneous deposits seemed to have developed in a dense connective tissue without any inflammatory reaction. The oldest lesions contained heterotopic bone. Electron microscopy showed that calcium deposit, in the slightly mineralized fibers, was located at the center of the elastic fibers. The calcifications were surgically removed and studies were performed on the rough products and, after heating, using x-ray crystallography, differential thermal analysis and quantitative chemical analysis. Our results showed that this cutaneous calcification is a B type carbonated apatite. PMID- 6864679 TI - Partial algodystrophy of the knee. An anatomico-radiological study of one case. AB - A 62-year-old man presented with intense pain in the right knee experienced immediately after slipping. The radiograph taken during the following weeks showed the development of a localized radiotranslucence of the lateral femoral condyle. Bone biopsy excluded an infectious process or tumor and revealed the histological characteristics of Sudeck's bone dystrophy. The clinical, radiological and histological data considered together were consistent with a diagnosis of "partial algodystrophy", a term considered preferable to "transient osteoporosis". The diagnosis was confirmed on clinical and radiological followup. PMID- 6864681 TI - A survey of osteoarthritis of the knee in the elderly. AB - We evaluated the signs and symptoms suggestive of osteoarthritis (OA) of the knee in 682 elderly people. The results suggest that both the frequency of signs and symptoms and the degree of severity remain constant in the 7th, 8th and 9th decades. Differences between men and women and between blacks and whites were also noted--women and blacks tending to have more frequent and more severe evidence of OA of the knee. These data suggest that OA of the knee is a specific disease that affects only a portion of the population and is not inevitably progressive. PMID- 6864680 TI - Avascular necrosis of bone with rheumatoid vasculitis. AB - A 76-year-old woman with classical rheumatoid arthritis presented with a left groin mass associated with radiologic erosion of the adjacent bony public ramus. The hip joint was not involved. Computerized tomography showed an encapsulated cyst of the pubic ramus that was surgically excised and measured about 6 x 8 cm. Histologic examination of the cystic mass and adjacent bone showed marked avascular necrosis, surrounded by an acute necrotizing vasculitis with fibrinoid necrosis. We postulate that, in this case, rheumatoid vasculitis caused an avascular necrosis of the pubic ramus. PMID- 6864682 TI - The polyarticular features of osteoarthritis requiring hip and knee surgery. AB - A review of 62 operated cases with osteoarthritis (OA) indicated clinical evidence of polyarthritis in over 80%. In most cases features of generalized osteoarthritis (GOA) were found. Hand joint arthritis was prominent but, along with the other affected joints, usually asymptomatic. The coexistence of knee disease in cases with hip arthritis and the low incidence of hip changes in those with knee involvement suggest differences in cause for hip disease. These data indicate that the concept of OA as an oligoarticular lesion induced by mechanical or aging processes is inappropriate in a major proportion of knee and hip cases that present for joint replacement. They support the notion that an intrinsic tissue defect is involved in the etiopathogenesis of GOA. PMID- 6864683 TI - Rapidly progressive idiopathic chondrolysis simulating tuberculosis of the shoulder. PMID- 6864684 TI - Bilateral aseptic necrosis of calcanei in an adult male with sickle cell disease treated by a surgical coring procedure. PMID- 6864685 TI - Rheumatoid arthritis and antecedent tonsillectomy. AB - The association of antecedent tonsillectomy (T) and subsequent development of rheumatoid arthritis (RA) was investigated in a population of 405 patients with RA and 223 controls with low back syndrome (LBS) or osteoarthritis (OA). A similar matched pair analysis of 113 RA patients and 113 community controls was also conducted. All patients were matched for age and sex. All groups were similar in demographic characteristics. T(+) and T(-) RA patients were similar in severity and disease characteristic parameters. No differences were found in the frequency of tonsillectomy in either of the RA or control groups. These data suggest that antecedent tonsillectomy is not causally related to the development of RA. PMID- 6864686 TI - Preceding tonsillectomy and appendicectomy in rheumatoid and degenerative arthritis. AB - One hundred and sixty-eight patients with rheumatoid arthritis (RA) and 87 patients with degenerative arthritis (osteoarthritis, OA) were questioned regarding appendicectomy and tonsillectomy surgery. Thirty point four % of patients with RA and 33.3% of those with OA had had a tonsillectomy preceding the onset of their arthritis. Preceding appendicectomy had been performed in 18.5% of RA and 32.2% of OA patients. These results do not support the hypothesis either of inherent or acquired susceptibility to infection in patients with RA. PMID- 6864687 TI - D-penicillamine treatment of progressive systemic sclerosis (scleroderma): a comparison of clinical and in vitro effects. AB - Punch biopsies of skin were obtained from the forearms of 3 patients with progressive systemic sclerosis with diffuse scleroderma before and after treatment for 1 year or more with D-penicillamine. While on therapy, each patient studied had demonstrated a marked reduction in skin thickening. Collagenase sensitive protein and glycosaminoglycan accumulation were measured in fibroblast cultures derived from these biopsies. No differences were observed pre- and post treatment. We conclude that although D-penicillamine may exert its effect in vivo on connective tissue synthesis, maturation and/or turnover, fibroblasts remaining in the thinned dermis retain their potential for increased synthesis of connective tissue. PMID- 6864689 TI - Arthritis in the national TV news: 1971-1981. AB - Millions of Americans get virtually all of their current events information from the national nightly television news programs. The purpose of this study was to learn via the Vanderbilt Television News Archives what arthritis-related information had been broadcast over the last 11 years by the network news programs. In the last 11 years there have been 23 arthritis-related news segments. In comparison there were 32 about diabetes, 215 about heart diseases, and 925 dealing with cancer. A compilation of the non-overlapping segments has been shown to health professionals and patients, who felt the stories were generally accurate. PMID- 6864690 TI - Necrotizing vasculitis as the initial manifestation of rheumatoid arthritis. AB - A 64-year-old Black woman presented with high titer serum rheumatoid factor (RF), pelvic girdle weakness, sensory mononeuropathy, pulmonary fibrosis, and muscle histologic evidence of small artery necrotizing vasculitis. High dose corticosteroid therapy was followed by clinical improvement and reduction in serum RF titer. Four years later, and 9 months after discontinuance of corticosteroids, she developed an inflammatory polyarthritis, recurrent muscle weakness, and left foot drop, concomitantly with circulating immune complexes and extremely high titer serum RF. Necrotizing vasculitis is a distinctly rare presenting manifestation of rheumatoid disease. PMID- 6864688 TI - Penicillamine compared to previous chrysotherapy in rheumatoid arthritis. AB - Of 331 patients in our 3 penicillamine clinics, 312 had been taking chrysotherapy previously. In 232 patients, responses to both drugs could be determined: there was no difference in the response rate to penicillamine when patients in the largest clinic with good and those with poor responses to gold were compared. Adverse reactions to penicillamine were more frequent in patients who had reacted adversely to gold in 2 of the 3 clinics. Proteinuria tended to occur more frequently in patients who had had proteinuria when taking gold than in patients who had not had gold-induced proteinuria. PMID- 6864691 TI - Giant cell arteritis involving the breasts. PMID- 6864692 TI - Articular amyloid. PMID- 6864693 TI - Ankylosing spondylitis, selective IgA deficiency and systemic amyloidosis with intrasynovial amyloid deposition. PMID- 6864694 TI - The use of plasmapheresis in a patient with systemic lupus erythematosus and necrotizing cutaneous ulcers. PMID- 6864695 TI - Eosinophilic fasciitis--a new disease dilemma? PMID- 6864696 TI - Eosinophilic fasciitis and sarcoidosis: a case report. PMID- 6864697 TI - Noninvasive evaluation of right ventricular function. PMID- 6864698 TI - Wernicke's encephalopathy. PMID- 6864699 TI - Contemporary problems in philosophy. PMID- 6864700 TI - Effects of anterior temporal lobectomy apart from the relief of seizures: a study of 40 patients. AB - The effect of temporal lobectomy, apart from the relief of seizures, is described in 40 patients undergoing the operation and followed up for between 2 and 6 years. Changes in their intellectual performance and mental state are described, and the possible mechanisms of these changes are discussed. PMID- 6864703 TI - Atypical (endometrial) carcinoma of the prostate. AB - Three cases of atypical (endometrial) carcinoma of the prostate are reported. In the light of the uncertain response to oestrogen therapy, all three patients were treated with radical radiotherapy. PMID- 6864701 TI - Detection of isolated mammary carcinoma cells in marrow of patients with primary breast cancer. AB - Single cells from mammary carcinoma infiltrating bone marrow can be detected in marrow aspirates using immunocytochemical stains for epithelial membrane antigen (EMA). This technique has been used to examine marrow aspirates taken from multiple sites from 24 patients at surgery for breast cancer. Ten of these patients had EMA-positive cells in their marrow, while 32 marrow samples from patients who did not have carcinoma were negative. These results have been combined with those obtained by taking aspirates from single sites from 47 breast patients without known skeletal deposits. Follow up showed that the patients with EMA-positive cells in their marrow developed bone metastases at a significantly faster rate. PMID- 6864702 TI - Intravenous glycopyrrolate and atropine at induction of anaesthesia: a comparison. AB - In unpremedicated patients presenting for general anaesthesia for electroconvulsive therapy (ECT), the use of atropine combined with methohexitone as an intravenous induction agent was found to produce a significantly greater increase in heart rate than glycopyrrolate in similar combination. There was no difference in the antisialogogue effect of the two drugs at the doses used, and both drugs provided similar protection against the effects of suxamethonium and ECT on heart rate. PMID- 6864704 TI - Whooping cough immunization in France and Britain: discussion paper. PMID- 6864707 TI - Scapholunate diastasis associated with a Barton fracture treated by manipulation, or Terry-Thomas and the wine waiter. PMID- 6864705 TI - Orientation failures in medicine and psychiatry: discussion paper. PMID- 6864708 TI - Ichthyosis and osteopetrosis. PMID- 6864709 TI - Hairy cell leukaemia presenting as aplastic anaemia. PMID- 6864706 TI - Pathogenesis and treatment of acute intermittent porphyria: discussion paper. PMID- 6864710 TI - Panniculitis mimicking Degos' papulosis. PMID- 6864711 TI - Data on lung cancer in radiation workers. PMID- 6864712 TI - Lyophilized human amniotic membranes used in reconstruction of the ear. PMID- 6864713 TI - Autosomal recessive inheritance of intestinal atresia. PMID- 6864714 TI - Extrapyramidal symptoms following mefenamic acid. PMID- 6864715 TI - Arthroscopy of the knee: some problems. PMID- 6864716 TI - Myoclonic encephalopathy of infants: 'the dancing eyes syndrome'. PMID- 6864717 TI - Effect of different corticosteroid regimens on hypothalamic-pituitary-adrenal axis and growth in juvenile chronic arthritis. AB - Linear growth was recorded in 36 children with juvenile chronic arthritis. In 20, the hypothalamic-pituitary-adrenal axis (HPA axis) was assessed by insulin induced hypoglycaemia, the results of which correlated well with resting cortisol levels. Three groups were identified according to type of corticosteroid regimen administered. Group 1 (6 children), receiving daily corticosteroid therapy, were clearly suppressed and failing to grow. Group 2 (13 children) had received an alternate-day regimen from the initiation of corticosteroid therapy; they were not suppressed and growth was satisfactory in 11. Group 3 (17 children) were receiving alternate-day therapy, but had had daily corticosteroid in the past; they showed no clear pattern of suppression or growth. Factors influencing the recovery of the HPA axis and resumption of growth were assessed. No difference was found in the individual growth of 7 children who commenced alternate-day therapy before the age of 5, compared with matched controls. It is suggested that daily divided doses of corticosteroid should not be used. Ideally, a single morning dose (up to 2 mg/kg) alternate-day regimen should be employed, as this regimen has minimal effects on HPA function and growth, even in young children. For very severe systemic features, it may be necessary to add a small single dose on the alternate day. PMID- 6864719 TI - Bowel disease after radiotherapy. AB - The clinical presentation, operative findings and outcome in 40 patients who required surgery for bowel disease after radiotherapy are presented. The type of presentation varied according to the time after radiotherapy. In the first month, many patients had a proctitis but none required surgery. Five patients were operated on within one month, 2 for radiation-induced acute ileitis and 3 for exacerbations of pre-existing disease (diverticular disease 2, ulcerative colitis 1). The commonest time of presentation was between 3 and 18 months after radiotherapy, when 20 patients needed surgery for bowel disease caused by radiation-induced local ischaemia. Twelve of these patients had chronic perforation, 6 had severe rectal bleeding and 2 had painful anorectal ulceration. Fifteen patients presented between 2 and 24 years after radiotherapy, usually with incomplete intestinal obstruction due to a fibrous stricture, but 2 patients had rectal carcinoma. Wide resection of the involved bowel was the principal method of treatment but any anastomosis was protected by a proximal defunctioning stoma. There was no operative mortality but 10 patients have died subsequently. The danger of dismissing these patients as having incurable malignancy is stressed because, although the condition is infrequent, it is usually amenable to adequate surgery. PMID- 6864718 TI - Double-ended pigtail polyethylene stents in management of benign and malignant ureteric obstruction. AB - Surgical urinary diversion for incurable pelvic malignancy has a high morbidity and mortality, and external drainage provides less than ideal palliation. Six patients with ureteric obstruction caused by cancer have been managed by operative or endoscopic insertion of self-retaining polyethylene tubes. These techniques also have applications in non-malignant disease, and the treatment of two patients with benign ureteric stricture is described. PMID- 6864720 TI - Chemotherapy of chemically-induced colorectal tumours. AB - Benign and malignant tumours were induced in the large bowel of rats by the carcinogen 1,2-dimethylhydrazine (DMH). Benign tumours appeared from week 20 onwards and malignant tumours from week 30. 5-Fluorouracil was administered intraperitoneally in maximally tolerated doses from week 26 onwards and failed to influence significantly the development of either benign or malignant tumours. Tumours induced by DMH are a close model of human colorectal cancer and suitable for testing anticancer drugs. Agents with greater activity against colorectal cancer are required. PMID- 6864721 TI - Use of hypnosis in criminology: discussion paper. AB - Memories of events which are unremarkable may pass unrecorded or may fade with the passage of time. In any situation of stress, anxiety may cloud the memory of the incident and in the case of some intensely frightening or humiliating experience such material may not be subject to voluntary conscious recall and may be repressed. A technique for uncovering certain 'forgotten' or repressed memories with the use of hypnosis is described. A similar method has been used in order to retrieve such memories in the investigation of witnesses and victims of serious crime. Nevertheless, various aspects of the overall validity of such a procedure have been called into question and for this reason the results of numerous experiments and the conclusions arrived at in many papers are discussed. It is emphasized that a rigid code of conduct be followed if hypnosis is to be used as an investigatory tool. PMID- 6864722 TI - Thermogenesis in stress-susceptible pigs: a review. PMID- 6864723 TI - Type III collagen deficiency with normal phenotype. PMID- 6864724 TI - Hajdu-Cheney syndrome associated with intrauterine fractures and arachnoid cysts. PMID- 6864725 TI - Florid fibrosclerotic infiltration of pelvis without ureteric obstruction. PMID- 6864727 TI - Territories and frontiers in paediatrics. PMID- 6864726 TI - Milia, increased nail growth and hypertrichosis following treatment with benoxaprofen. PMID- 6864728 TI - Substituent effects in cephalosporins as assessed by molecular orbital calculations, nuclear magnetic resonance, and kinetics. AB - For cephalosporins with different side chains at position 3, the quantum mechanically computed charge distribution in the beta-lactam carbonyl group can be correlated with observables, such as carbon-13 chemical-shift differences at C3 and C4 of the dihydrothiazine ring and alkaline rates of hydrolysis of the beta-lactam. The relationship of these properties and the theoretical transition state energy (TSE) corroborate the fact that chemical reactivity is one important determinant affecting inhibitory activity of cephalosporins against peptidoglycan regulating enzymes. PMID- 6864729 TI - A simplified high-pressure liquid chromatography method for determining lipophilicity for structure-activity relationships. AB - A highly deactivated octadecyl-bonded silica column and a mobile phase consisting of an water-methanol mixture in the range of blood pH and ionic strength are used to correlate log kappa' with biological activity for a series of sulfonamides and barbiturates. The results were compared to literature methods by using retention volume (VR) and retention indexes (I). For the nine sulfonamides tested, log VR and log kappa' were used with and without correction for ionization. For each biological end point (protein binding and minimum inhibitor concentration against Eschericia coli from two sources) and each independent variable (log kappa' and log VR) the residual standard derivation for the regression was determined. the standard derivations were compared in an F test for each of 12 relevant regressions. Log kappa' was statistically superior in for cases, while log VR was superior in one case. Overall, the methods were statistically indistinguishable. Log kappa' values and I values for 15 barbiturates were regressed against three biological end points [hypnotic activity (the minimum effective dose in rabbits), inhibition of Arbacia egg cell division, and inhibition of rat brain respiration]. Standard deviations were compared by an F test, and the two methods were indistinguishable as far as the goodness of biological correlations are concerned. Procedures for controlling the column's activity are presented. Choices for an appropriate mobile phase are discussed, and a method of calculating pH and ionic strength in a methanol-aqueous mobile phase is presented. PMID- 6864731 TI - Synthesis and monoamine oxidase inhibitory activities of alpha-allenic amines in vivo and in vitro. Different activities of two enantiomeric allenes. AB - A series of 15 alpha-allenic amines, including primary, secondary, and tertiary ones, was synthesized, partly by organocopper chemistry. Their ability to inhibit mouse and rat brain mitochondrial monoamine oxidase (MAO) in vivo and in vitro, respectively, was evaluated. Almost all compounds were quite potent inhibitors of MAO, some as potent as deprenyl. Like deprenyl, most of the compounds were selective inhibitors of the B form of MAO. the two enantiomeric forms of N-methyl N-(2,3-pentadienyl)benzylamine (2) were prepared and the R-(-) form was found to be 2.7 times as active as the (+) form in vivo and 25 times as active in vitro. Most of the compounds were tested for their ability to potentiate the phenylethylamine (PEA) response in mice, and a good correlation between the potency of MAO inhibition and PEA potentiation was found. Compound 5, as the only compound tested, did not potentiate the blood pressure response to tyramine. PMID- 6864732 TI - Analgesic narcotic antagonists. 15. Potent narcotic agonist 7 beta-(arylalkyl) 4,5 alpha-epoxymorphinans. AB - Structure-activity correlations in 7 beta-(arylalkyl)-3-methoxy- or hydroxy-4,5 alpha-epoxymorphinans have been investigated. 6 beta-Hydroxy-7 alpha hydroxymethyl compounds 7 with 7 beta-substituents CH2CH2R [a, R = H; b, R = CH2CH3; c, R = C6H5; d, R = CH2C6H5; f, R = CH2CH2C6H5; g, R = (CH2)3C6H5; h, R = (CH2)4C6H5] were prepared. Wittig condensations with previously reported 4,5 alpha-epoxy-7 beta-formyl-7 alpha-(hydroxymethyl)-6 beta, 7 alpha-O isopropylidene-3-methoxy-17-methylmorphinan-6 beta-ol (3), followed by dilute acid removal of the blocking group and then hydrogenation, gave saturated compounds 7. Compounds with a 6 alpha, 7 alpha-oxymethylene ring. 18c,d,f,g, were prepared from 7 beta-formyl derivative 16 and the appropriate Wittig reagent, followed by hydrogenation. Both the 6 beta-hydroxy-7 alpha-hydroxymethyl and 6 alpha, 7 alpha-oxymethylene series containing 7 beta-arylalkyl groups with an alkyl chain length of 2 to 4 ar potent narcotic agonists. The most potent 17 methyl compound, 4,5 alpha-epoxy-7 alpha-(hydroxymethyl)-17-methyl-17 beta-(4 phenylbutyl)morphinan-3,6 beta-diol (8f) was 700 times more potent than morphine in the acetic acid induced mouse writhing assay. 17-Methyl compounds in the c, d, f, g series were converted to 17-cyclopropylmethyl (P series) or 17 cyclobutylmethyl (B series) derivatives. Narcotic antagonistic activity could not be demonstrated for these potent agonist 17-cycloalkylmethyl derivatives. These pharmacological results parallel those previously reported for tertiary alcohol derivatives of the endo-ethenotetrahydrooripavines. Structureal considerations confirm the existence of a lipophilic site extending upward and outward from where the C ring of morphine and congeners bind to opiate receptors. PMID- 6864730 TI - Phenylenebis(oxy)bis[2,2-dimethylpentanoic acid]s: agents that elevate high density lipoproteins. AB - A series of phenylenebis(oxy)bis[2,2-dimethylpentanoic acid]s have been synthesized and evaluated as potential hypolipidemic agents. Compound 18 (CI-924) was found to be the most potent compound in this series. In rats, compound 18 not only reduced low-density lipoprotein cholesterol but also increased high-density lipoprotein (HDL) cholesterol. Comparative studies in rats indicated 18 produced an equal elevation of HDL cholesterol at one-third of the dose required of gemfibrozil. Structure-activity relationships are discussed. PMID- 6864733 TI - Interaction of conformationally flexible agonists with the active site of sweet taste. A study of arylureas. AB - The conformation of tolylureas has been studied by means of X-ray diffraction, NMR spectroscopy, and semiempirical quantum-mechanical calculations. The flat shape of meta and para isomers allows a good interaction with the model sites for bitter and sweet taste, respectively, whereas the ortho isomer cannot fit the sites because of the relative arrangements of the aryl and amide planes and because of poor hydrophobic interactions. The consistency of the conformational results with the sweet taste model site, previously proposed by the authors, is emphasized by the good fit of dulcine, a sweeter para-substituted arylurea. PMID- 6864734 TI - Synthesis of hypoxanthine, guanine, and 6-thiopurine nucleosides of 6-deoxy-D allofuranose. AB - Hypoxanthine, guanine, and 6-thiopurine nucleosides of 6-deoxy-D-allofuranose have been prepared as potential antitumor agents. Thus, reaction of 6-deoxy-beta D-allofuranosyl bromide (1) with the trimethylsilyl derivatives of hypoxanthine and guanine afforded mixtures of the 9- and the 7-substituted bases, which were separated and deblocked with ammonia to give 9-(6'-deoxy-beta-D allofuranosyl)hypoxanthine (6), 7-(6'-deoxy-beta-D-allofuranosyl)hypoxanthine (7), 9-(6'-deoxy-beta-D-allofuranosyl)guanine (8), and 7-(6'-deoxy-beta-D allofuranosyl)guanine (9). The two nucleosides with the purine joined at the N-9 position, namely, 6 and 8, are easily distinguished from the other two nucleosides (7 and 9), having N-7 junctions, by their NMR spectra. Reaction of 1 with the trimethylsilyl derivative of 6-chloropurine afforded 10, which upon treatment with thiourea and deblocking gave 9-(6'-deoxy-beta-D-allofuranosyl)-6 thiopurine (12). The hypoxanthine and guanine nucleosides showed no inhibition of mouse leukemia L1210 when tested in vivo, but the thiopurine nucleoside 12 showed strong inhibition of growth of L1210 both in vivo and in vitro. Compound 7 strongly inhibited purine nucleoside phosphorylase (KI = 8.8 X 10(-5) M), while compounds 8, 9, 6, and 12 were inactive. PMID- 6864736 TI - Sulfonyliminoimidazolidines. A new class of oral hypoglycemic agents. 1. 1-[[p-[2 (acylamino)ethyl]phenyl]sulfonyl]-2-iminoimidazolidines. AB - A series of 1-[[p-[2-(acylamino)ethyl]phenyl]sulfonyl]-2-iminoimidazolidines has been synthesized. Compounds from this new class of oral hypoglycemic agents lower blood glucose in normal and in streptozotocin-diabetic rats. Potent analogues were obtained by modification of the acyl residue. 1-[[p-[2 (Crotonylamino)ethyl]phenyl]-sulfonyl]-3-cyclohexyl-2-iminoimidazolidine (44) turned out to be the most potent compound in the normal rat (20 times tolbutamide), and 1-[[p-[2-(5-methylisoxazole-3 carboxamido)ethyl]phenyl]sulfonyl]-3-cyclohexyl-2-imino-imidazolidine (30) displayed the highest potency in the diabetic rat (similar to phenformin). PMID- 6864737 TI - Synthesis and anticonvulsant activity of some tetracyclic indole derivatives. AB - Several related series of cycloalkyl[4,5]pyrrolo[3,2,1-ij]quinolines 7a-g, 8a-c, 10a-3, and 16a-f and indolo[3,2,1-hi]indoles 22a-c and 23a,b were synthesized and tested for anticonvulsant activity. The key preparative step, a Fischer indole reaction between a bicyclic hydrazine and a cyclic ketone, gave the compounds in 34-96% yield. The products were tested in rat maximal electroshock for anticonvulsant activity. Several compounds showed good activity, with 6 [(dimethylamino)methyl]-4,5,6,8,9,10-hexahydrocyclopenta[4,5]pyrrolo[3,2,1 ij]quinoline (7d) and N-methyl-4,5,6,8,9,10,11,12 octahydrocyclohepta[4,5]pyrrolo[3,2,1-ij]quinoline- 6-carboxamide (10c) having ED50's of 12.5 and 12.9 mg/kg po, respectively. PMID- 6864738 TI - Combined distance geometry analysis of dihydrofolate reductase inhibition by quinazolines and triazines. AB - Guided by the success of distance geometry in explaining the inhibition of dihydrofolate reductase by 68 quinazolines, we have made a combined analysis on the inhibition of rat liver dihydrofolate reductase by 33 triazines and 15 quinazolines. The model gave a fit having the correlation coefficient 0.892 and root mean square (rms) deviation 0.596 in log (1/C50) units. The model was applied to predict the biological activity of 91 compounds. The predicted values showed an rms deviation of 0.907 and a correlation coefficient of 0.790. The present study suggested the synthesis of some triazines as possible potent dihydrofolate inhibitors. The site geometry was compared with the crystal structure of a triazine bound to chicken liver dihydrofolate reductase, and a good correlation has been found. PMID- 6864735 TI - New selenium-75 labeled radiopharmaceuticals: selenonium analogues of dopamine. AB - Selenium-75 labeled selenonium analogues of dopamine, [2-(3,4 dimethoxyphenyl)ethyl]dimethylselenonium iodide (4) and its dihydroxy analogue (7), were prepared by reducing [75Se]selenious acid with sodium borohydride at pH 6.0 and reacting the NaSeH produced with 1-(3,4-dimethoxyphenyl)-2-(p toluenesulfonyloxy)ethane. Tissue distribution studies in rats given the 75Se labeled selenonium agents intravenously demonstrated high initial heart uptake (2.38% dose/g at 5 min). Prolonged adrenal retention (t1/2 = 10 h) and high adrenal to blood ratio of compound 4 (21/1 at 4 h after injection) were observed. The high uptake and adrenal to blood ratio suggest the potential use of compound 4 as a radiopharmaceutical for the adrenal gland. PMID- 6864739 TI - Factors influencing program selection among family practice residents. AB - Factors on which family practice residents base their judgments about ranking programs are identified. Questionnaires were mailed to 1,810 first-year family practice residents who participated in the 1981 matching program; 830 (46 percent) responded. The questionnaire items were factor analyzed, and nine factors accounting for 59.4 percent of the variance emerged. Reliability for the questionnaire was estimated to be .82 using coefficient alpha. Factor scores for the nine subscales were computed and employed as dependent variables in several multivariate analyses of variance. Significant differences for sex, age, race, and geographical region were found on various factors; these findings indicated differences in what those groups considered important when selecting a residency. PMID- 6864740 TI - Women as physicians. AB - Whatever qualities are ascribed to femininity and whether these are attributed to nature or to nurture, the characteristics women display as physicians are primarily determined by the impact of their professional education, by their socialization into medical roles, and by the organization of their practices. Women physicians more nearly resemble men physicians in professional attributes than they do other women in the population. Women merit more opportunities in medicine, both on grounds of equity and in order to enlarge the pool of medical talent. However, women, in themselves, are not likely to alter the perceived shortcomings of medical practice. For that to take place, it will be necessary to modify admission criteria, to broaden the narrow focus of medical education, and to change the reward systems which govern medical practice for both women and men. PMID- 6864742 TI - The timing of career decisions in internal medicine. AB - The creation of new residencies in primary care internal medicine is aimed at increasing the number of individuals entering careers as general internists. This strategy assumes that final career decisions are made prior to application for residency training. A survey of all graduates of internal medicine residencies at the University of California, San Diego, during 1969-1979 resulted in 155 respondents (an 86 percent response rate) and revealed that only 30 percent had no change in career plans regarding general versus subspecialty practice since medical school and 41 percent had made final decisions during residency training. Inpatient care experiences, peer interactions, and faculty role models were the training factors which most influenced final career choice. The goal of increasing the number of general internists may be better served by strengthening the role of generalist faculty members in traditional internal medicine residencies rather than creating new programs which force trainees to make premature career choices. PMID- 6864741 TI - Availability of personal counseling in medical schools. AB - The deans of student affairs at 114 medical schools were surveyed about the availability of counseling services for medical students. There were 85 respondents (75 percent), all of whom indicated that some counseling services were available at their schools. One-third felt the services were not adequate. In addition, student representatives at these 114 schools were surveyed on the same topic, 53 responded (46 percent), and most said there was underutilization due to poor communication, problems resulting from initial contacts through the administration, and concern about confidentiality. Recommendations are made to help increase the utilization of counseling resources. PMID- 6864743 TI - Medical education in the People's Republic of China. AB - The People's Republic of China is in the process of developing a comprehensive system of health care for one-quarter of the world's population. A continually evolving system of medical education that presently operates on three levels for the education and training of (a) "barefoot" or worker doctors, (b) "assistant" doctors, midwives, and nurses, and (c) both traditional and Western-style physicians has been a key factor in the process. Three aspects of Chinese medical education are noteworthy for the contrast they provide to medical education in the United States. In the first place, Chinese students enter medical college and become committed to a medical career immediately upon completion of secondary school. Second, Chinese medical colleges are independent of their universities, and all education for the health professions is integrated under a single college. A common curriculum and faculty are used for a considerable portion of each educational program. Finally, the entire medical curriculum is five to six years in duration, and postgraduate education is not required for the practice of medicine in China; nor is it available to the majority of graduates. PMID- 6864744 TI - Suicide management skills and the medical student. AB - To determine the suicide management skills of medical students at different levels of training, 141 medical students were administered the Suicide Intervention Response Inventory (SIRI), a self-report instrument assessing skills in responding to the self-destructive patient. As predicted, third-year students having completed a course in medical interviewing scored higher on the SIRI than first-year students who had not. Additional improvement in suicide management skills was evidenced for third-year students who completed a six-week inpatient psychiatry rotation. Whether or not students believed that suicide was ethically acceptable in some circumstances had no impact on their ability to select an appropriate response to the self-destructive patient. Several additional findings are discussed, and the potential utility of the SIRI in evaluating medical student skills in this important area is highlighted. PMID- 6864745 TI - Retention of cardiopulmonary resuscitation skills by medical students. AB - Performance in and knowledge of cardiopulmonary resuscitation (CPR) were assessed in a group of preclinical medical students who had received CPR certification either two or three weeks (group 0), one year (group 1), or two years (group 2) prior to the study. Assessment, ventilation, compression, and complications caused by incorrect technique were evaluated. A written examination was also given. There was significantly higher rate of failure to perform adequate CPR by students in groups 1 and 2 when compared with group 0 (p less than .05). There was no significant difference between the failure rates of groups 1 and 2. The most frequent errors related to chest compression rate and an inability to adhere to the recommended single-rescuer compression-to-ventilation ratio. Written test scores were also higher in group 0 than either group 1 or 2 (p less than .001). Written examination scores were not reliable predictors of CPR skill in individual cases. PMID- 6864746 TI - Adult immunization: the medical record design as a facilitator for physician compliance. AB - A three-year prospective chart audit of a family practice residency program was performed to measure physician compliance in following the recommendations of an adult immunization program. Despite curriculum changes, performance self evaluation, and reminders by faculty members to residents about the need for adult immunization, physician compliance was poor in the second year of the study. It was thought that components of the medical record might be improved to facilitate physician compliance in the adult immunization program. At the beginning of the third year of the audit, tetanus and pneumococcal vaccines were preprinted on the health maintenance inventory (HMI), but influenza was not. The chart design also was changed to put the HMI in a more prominent place. In the third year of the audit, physician compliance with tetanus and pneumococcus immunization improved significantly. The results of the chart review suggest that physician compliance with adult immunization programs can be improved with appropriate chart design. PMID- 6864747 TI - Simple adding versus differential weighting of MCAT subtest scores. PMID- 6864748 TI - Training internal medicine residents in geriatrics. PMID- 6864749 TI - Computer analysis of residency training. PMID- 6864751 TI - Evaluation of medical student performance in summer academic activities. PMID- 6864750 TI - Family medicine: reassessment of two educational objectives. PMID- 6864752 TI - Stability and change of medical specialty choice in U.S. medical schools. PMID- 6864753 TI - Problems with initiating a structured clinical examination. PMID- 6864755 TI - Integrity in medical education. PMID- 6864754 TI - Students as attending physician: an instructional innovation. PMID- 6864757 TI - Comment: data protection legislation and medical records. PMID- 6864756 TI - Medical writing. PMID- 6864758 TI - The Health Service Supply Council. PMID- 6864759 TI - Correlation between walking energy expenditure and tachographic gait parameters. PMID- 6864760 TI - Electrocardiographic recording in high-intensity electric fields: an application of radio-telemetry. PMID- 6864761 TI - Evaluation of ECG recorders. PMID- 6864762 TI - Evaluation of blood-pressure transducers. PMID- 6864764 TI - Characterization of the circulating immune complexes in acute and chronic liver diseases. AB - The composition of immune complexes (IC) found in 28 patients with HBsAg positive and negative acute and chronic hepatitis was analysed. Components were defined in PEG-precipitated material isolated by preparative ultracentrifugation on linear sucrose density gradients and analysed by the Ouchterlony plate technique and by the radioimmunoassay of hepatitis B virus markers. Sedimentation rate ranged from 8 to 19s in the serum of patients with chronic hepatitis, whereas heavier IC (greater than 19s) were present in the active phase of the disease. The participation of hepatitis B virus in acute hepatitis was shown by the presence of its antigens. In contrast, a low incidence of vital components was seen in IC of chronic active hepatitis and liver cirrhosis. Thus, other causes must contribute to the formation of IC in chronic liver disease. PMID- 6864765 TI - Studies on cell-mediated immunity in women using different fertility regulating methods. AB - Cell-mediated immunity (CMI) was assessed in women using fertility regulating methods for 1-5 months, 6-11 months or 12-18 months. The CMI as assessed by phytohaemagglutin in (PHA)-induced lymphocyte transformation of treated groups were compared with that of normal subjects who were not using any contraceptive methods and women on conventional methods of contraception. The data obtained indicates that there is no significant alteration of CMI in women fitted with IUCD or women on estrogen progestogen combination. However, a significant suppression of CMI is observed in women in progestogen pills for 12-18 months. The short term therapy did not affect the CMI. In a prospective study it was found that the CMI in women before and after the use of combination therapy for 1 5 and 6-11 months revealed no change. Estradiol and progesterone at concentration on 1 microgram/ml in culture medium suppressed PHA-induced lymphocyte transformation. PMID- 6864763 TI - A microcomputer-based multithermocouple system for use in microwave fields. PMID- 6864766 TI - Transport of L-cysteine by rat renal brush border membrane vesicles. AB - Brush border membranes were isolated from rat renal cortex by a divalent cation precipitation method. L-35S-cysteine uptake into the vesicles was measured by a rapid filtration method. Only minimal binding of the amino acid to the vesicles was observed. Sodium stimulates L-cysteine uptake specifically. Anion replacement experiments, experiments in the presence of potassium/valinomycin-induced diffusion potential as well as experiments with a potential-sensitive fluorescent dye document an electrogenic sodium-dependent uptake mechanism for L-cysteine. Tracer replacement experiments as well as the fluorescence experiments indicate a preferential transport of L-cysteine. Transport of L-cysteine is inhibited by L alanine and L-phenylalanine but not by L-glutamic acid and the L-basic amino acids. Initial, linear influx kinetics provide evidence for the existence of two transport sites. The results suggest (a) sodium-dependent mechanism(s) for L cysteine shared by other neutral amino acids. PMID- 6864767 TI - Intracellular potassium activity measurements in single proximal tubules of Necturus kidney. PMID- 6864768 TI - Effects of acid base disturbances on basolateral membrane potential and intracellular potassium activity in the proximal tubule of Necturus. AB - The effects of extracellular acid-base disturbances on intracellular potential (Em) and potassium activity (aiK) in the early proximal tubule of Necturus were examined. Using conventional and double barreled potassium ion selective microelectrodes it was possible to measure both the transient and steady-state responses to various states of extracellular acidosis and alkalosis. The results show that (i) when extracellular [HCO-3] is varied at constant pCO2, Em and aiK decrease in acidosis and increase in alkalosis. The greatest sensitivity in Em is between pH 7.6 and 6.8 with apparent saturation above and below these extremes; (ii) decreased [HCO-3] at constant pH = 7.6 also causes a depolarization of Em and reduces aiK, suggesting a major effect of extracellular [HCO-3] on intracellular potential and aiK; (iii) rapid perfusions and transient delta Em analysis suggest a high basolateral conductance for K+ and HCO-3 and a low Cl- conductance; (iv) increasing extracellular [K+] decreases the response of both Em and aiK to reduced [HCO-3] at constant pCO2. The results of this study demonstrate the important role of extracellular pH and/or [HCO-3] on the maintenance of cellular K+ homeostasis. PMID- 6864769 TI - Ionic selectivity of the paracellular shunt path across rabbit corneal endothelium. AB - We have measured the dilution and biionic potentials across the isolated rabbit corneal endothelium in order to learn about the ionic selectivity of its intercellular junctions. Single-salt dilution potentials have been measured as a function of [NaCl] or [NaHCO3] gradients across the tissue. Biionic potentials were similarly measured by replacing Na+ with K+ on either side of the tissue. The potentials thus measured were fit to the constant field equation and to an approximation of it to obtain the ionic permeabilities for K+, HCO-3 and Cl- relative to Na+. The permeability sequence obtained was PK greater than PNa greater than PHCO3 approximately equal to PCl. Potentials were also measured after imposing an osmotic gradient across the preparation using sucrose. The results obtained with all these methods are consistent and suggest that this tissue is slightly more permeant to cations than anions, but that the selectivity of the intercellular junction is relatively low. From these experiments, a 30 mM gradient of salt across the endothelial layer would be needed in order to explain the observed spontaneous potential difference (about 1 mV, aqueous negative) across that layer if the potential was due to the selectivity of the intercellular junctions. Such a value for the gradient is much larger than theoretical estimates of it; therefore, we favor electrogenic transport of HCO-3 as a better explanation for the origin of the spontaneous potential difference. PMID- 6864770 TI - Potassium-dependent chloride and water transport across the seawater eel intestine. AB - Simultaneous measurements of net ion and water fluxes and transepithelial potential difference (PD) were made in the stripped intestine of the seawater eel, and it was examined whether Cl- was driven following electrochemical gradient for Na+ across the brush border membrane of the epithelium or not. When mucosal Na+ was completely replaced with K+, while the serosa was being bathed with normal Ringer's solution, net Cl- and water fluxes were maintained as high as those in normal Ringer's solution. After serosal Na+ was completely replaced with choline+ while the mucosa was being bathed with Na+-free KCl Ringer's solution, 80% of the original Cl- and water fluxes still persisted, indicating significant Na+-independent Cl- and water transport. These results are against a hypothesis that Cl- is driven by electrochemical gradient of Na+ across the brush border membrane. The Na+-independent Cl- and water fluxes were a saturable function of mucosal K+ concentration, suggesting K+-dependent Cl- and water transport. A possible mechanism of Cl- transport is discussed in relation to K+ transport. On the other hand, a good correlation was observed between the net Cl- and water fluxes. This suggests that water transport depends on Cl- transport system; NaCl and/or KCl cotransport. PMID- 6864771 TI - Localization of ATP-dependent calcium transport activity in mouse pancreatic microsomes. AB - Electron-dense deposits representing calcium oxalate crystals which result from ATP-dependent calcium uptake have been localized within vesicles of of a heavy microsomal fraction prepared from mouse pancreatic acini. In the absence of either ATP or oxalate, no electron-dense deposits could be observed. By subfractionation of microsomes on discontinuous sucrose gradients, it could be shown that the highest energy-dependent calcium transport activity was associated with the rough endoplasmic reticulum. In rough microsomes, the 45Ca2+-uptake measured was 7 times greater than that of smooth microsomes in the presence of ATP and oxalate and about 3 times greater in he presence of ATP alone. When ribosomes were released from the rough endoplasmic reticulum vesicles by treatment with KCl in the presence of puromycin, the stripped microsomes showed a 40% increase in the specific 45Ca2+-uptake activity measured in he presence of ATP and oxalate and an increase of 80 to 90% in the presence of ATP alone. From these results it can be concluded that the calcium transport activity of microsomes prepared from mouse pancreatic acini is located predominantly in the rough endoplasmic reticulum membrane. PMID- 6864772 TI - Intracellular chloride activity and apical membrane chloride conductance in Necturus gallbladder. AB - Open-tip and Cl--selective microelectrodes were used to study the effect of external pH on apical membrane potential (Va) and intracellular chloride activity (aiCl) in epithelial cells of Necturus gallbladder. Increasing the pH from 7.2 to 8.2 in the mucosal, the serosal, or in both bathing solutions simultaneously, hyperpolarized Va (control value -60 +/- 5 mV) by about -6, -10 and -17 mV, respectively, but did not significantly change the transepithelial potential (VT = 0.3 +/- 0.5 mV). Identical hyperpolarizations were recorded with Cl--selective microelectrodes, even 40 min after changing external pH. Thus, aiCl (12 +/- 2 mM) remained essentially constant. The ratio fVa between the deflections in Va and VT produced by transepithelial current pulses, which is an approximate measure of the fractional resistance of the apical membrane, decreased when mucosal pH was increased, and increased when serosal pH was raised. The changes in Va and fVa are due, in part at least, to the known pH dependence of cell membrane K+ conductance (PK) in this tissue. The constancy of aiCl, despite significant increases in Va, indicates that cell membrane Cl- conductance (PCl) is virtually zero or decreases, with increased external pH, in a way that compensates for the increased driving force for Cl- exit. Experiments in which 90 mM gluconate or 90 mM methylsulfate were substituted for an equivalent amount of luminal Cl- did not provide any evidence for a significant contribution of Cl- ions, per se, to the emf or conductance of the apical membrane. They suggested, rather, a dependence of apical membrane cation permeability on luminal Cl- concentration. Since basolateral membrane PCl is known to be very low, the insensitivity of aiCl to Va is the consequence of a negligible electrodiffusive Cl- permeability at both cell membranes. Thus, overall, transcellular Cl- transport in Necturus gallbladder is, in large measure, effected by electroneutral processes. PMID- 6864773 TI - Electrophysiology of Necturus urinary bladder: I. "Instantaneous" current-voltage relations in the presence of varying mucosal sodium concentrations. PMID- 6864774 TI - Electrical properties of cultured epithelioid cells (MDCK). AB - This is a study of the intracellular electrical potential, membrane resistance, and capacity of MDCK cells (epithelioid of renal origin) cultured in monolayers on a collagen couch. These monolayers have a transepithelial resistance of 256 +/ 12 (22) ohm cm2 (mean +/- standard error, and number of observations), and the cells have 61.6 +/- 6.3 (92) M omega across their plasma membrane. The electrical capacity of the cells is 45.1 +/- 2.9 (63) pF and is much higher than expected for a cell of its size (diameter 14 micrometers, height 5 micrometers) and cannot be attributed to intercellular coupling, as no evidence of this type of connection was found in 20 pairs of neighboring cells. On the contrary, the high capacity is in keeping with previous studies using electron microscopy showing microvilli and a high degree of lateral infolding. The relationship between resistance and capacity was 1981 +/- 177 (61) omega . microF. The cells have an intracellular potential of -40.5 +/- 15 (120) mV. Yet the shape of the distribution curve suggests that the actual value may be somewhat higher (some 50 mV). The current/voltage curve of the distribution curve suggests that the actual value may be somewhat higher (some -50 mV). The current/voltage curve shows a marked asymmetry, and in some cells the voltage becomes time-dependent for large, depolarizing current pulses. PMID- 6864775 TI - Different sodium chloride cotransport systems in the apical membrane of rabbit gallbladder epithelial cells. AB - The kinetics of Cl- influx from the lumen to the cell and the paracellular pathway was examined in isolated rabbit gallbladder by measuring 36Cl uptake (45 s) and by correcting it for the extracellular space with 3H-sucrose. The paracellular fraction of the influx was studied by incubating the tissue in Na+ free saline or in solutions containing 25 mM SCN-; the kinetics turned out to be hyperbolic. The cellular fraction of the influx comprised three components. The first was immediately Na+-dependent and insensitive both to exogenous and endogenous cell bicarbonate; its sigmoidal kinetics revealed the presence of a carrier with three Cl- binding sites cooperating positively with one another, with strong interaction factors. The second cellular component was immediately Na+-dependent and sensitive to endogenous cell bicarbonate; the kinetics was hyperbolic with a maximum at 20 mM Cl- concentration and a substrate inhibition from 20 to 130 mM; it was completely inhibited by 10(-4)M acetazolamide. The third cellular component was slowly Na+-dependent and slowly sensitive to exogenous bicarbonate; its kinetics was hyperbolic, without substrate inhibition in the tested Cl- concentration range. On this basis, the presence of three Na+ Cl- cotransports is suggested: i) on a single carrier without any exchange with H+ and HCO3-, ii) on a single carrier with an exchange with H+ and HCO-, and, and iii) on two separate carriers in exchange with H+-and HCO3-. PMID- 6864776 TI - Thiol-dependent passive K/Cl transport in sheep red cells: I. Dependence on chloride and external ions. AB - Treatment with 2 mM N-ethylmaleimide (NEM) caused a marked increase in K+ permeability of low K+ but not of high K+ sheep red cells suspended in isosmotic Cl- media with 10(-4) M ouabain. The Na+ permeability was unaltered. Kinetic analysis by K+ efflux and K+ or Rb+ influx measurements suggests that NEM primarily increased the bidirectional fluxes of K+ and Rb+, since (a) no significant change in the apparent external affinities of these ions was found, and (b) below unity, the observed flux ratios were close to those calculated from the Ussing relationship. Replacement of Cl- by NO3 abolished the NEM-stimulated and reduced the basal K+ flux rates. Similarly, 10(-3) M furosemide inhibited Cl- -dependent K+ fluxes in both control and NEM-treated LK red cells. Exposure of LK cells to hyposmotic but not to hyperosmotic salt solutions increased the basal Cl dependent K+ flux twofold as reported by Dunham and Ellory (J. Physiol. (London) 318:511-530, 1981) but did not affect its fractional stimulation by NEM. The action of NEM is interpreted as a stimulation of a temperature-dependent and Cl- requiring K+ transport pathway genetically preserved in adult LK but turned off in HK sheep red cells. In addition, common to both LK and HK sheep red cells was a basal K+ flux that operated in the presence of either Cl- or NO3-. PMID- 6864777 TI - Thiol-dependent passive K/Cl transport in sheep red cells: II. Loss of Cl- and N ethylmaleimide sensitivity in maturing high K+ cells. AB - A fraction of the passive, ouabain-insensitive K+ fluxes in mature low Kr(LK) but not in high K+ (HK) sheep red cells requires the presence of Cl- anions and can be stimulated by volume expansion (Dunham, P.B., Ellory, J.C., J. Physiol (London) 318:511-530, 1981) or treatment with 2 mM N-ethylmaleimide (NEM) (Lauf, P.K., Theg., B.E., Biochem. Biophys. Res. Commun. 92:1422-1428, 1980). In the present study it is shown that reticulocytes of both anemic LK and HK sheep possess the Cl- -dependent K+ transport system which subsequently remains functional in mature LK but not in HK red cells. Kinetically, Cl- -mediated K+ fluxes of reticulocytes of LK sheep are different from mature red cells only in their Vmax values as measured in Na+ or choline+ media, while there is an apparently much lower affinity for external K+ ions in reticulocytes of HK sheep. N-ethylmaleimide stimulated K+ transport in the reticulocytes of both sheep genotypes suspended in Cl- but failed to do so in NO3- media. The data are interpreted in terms of their biochemical, physiologic, and genetic implications for the HK/LK transition in sheep red cells. PMID- 6864778 TI - Thiol-dependent passive K/Cl transport in sheep red cells: III. Differential reactivity of membrane SH groups with N-ethylmaleimide and iodoacetamide. AB - Treatment with N-ethylmaleimide (NEM) is known to stimulate ouabain-insensitive, Cl- -dependent K+ transport in low K+ (LK) but not in high K+ (HK) sheep red cells (Lauf, P.K., and Theg, B.E., 1980, Biophys. Biochem. Res. Commun. 92:1422 1428). The dependence of this effect on the pH of pretreatment with NEM and/or iodoacetamide (IAA) was studied. Maximum stimulation of Cl- -dependent K+ transport in LK red cells was produced by prior treatment with 1-5 mM NEM at pH 6 at which only about 30-40% of the 10(7) SH groups present per membrane reacted. At pH 6 no NEM effect was seen on Nap K+ fluxes in HK red cells. Treatment with NEM below pH 6 enhanced Cl- -independent K+ transport in both LK and HK red cells. At higher pH values or higher concentrations the NEM-stimulation of K+ transport was reduced and absent at pH 8.7. Exposure of LK cells to 5 mM IAA prior to NEM abolished the stimulatory effect of NEM on K+ transport. Hence at least two different chemical groups were reacting with NEM, and more alkaline SH or NH2 groups whose reaction with NEM leads to an inhibition of the NEM effect brought about at pH 6. PMID- 6864779 TI - Cellular and paracellular pathway resistances in the "tight" Cl- -secreting epithelium of rabbit cornea. AB - The high transverse resistance of the isolated rabbit cornea (6-12 l omega . cm2) is associated with the corneal epithelium, a Cl- -secreting tissue which is modulated by beta-adrenergic and serotonergic receptors. Three methods were employed to determine the resistances for the apical membrane, basolateral membrane, and paracellular conductive pathways in the epithelium. In the first method, the specific resistance of the apical membrane was selectively and reversibly changed. Epinephrine was used to increase apical cation permeability. The second method utilized a direct measure of the spontaneous cellular ionic current. The third method obtained estimates of shunt resistance using transepithelial electrophysiological responses to changes in apical membrane resistance. The results of the first method were largely independent of the agent used. In addition, the three methods were in general agreement, and the ranges of mean values for apical membrane, basolateral membrane, and shunt resistances were 23-33, 3-4, and 12-16 k omega . cm2, respectively, for the normal cornea. The apical membrane was the major, physiologically-modulated barrier to ion permeation. The shunt resistance of the corneal epithelium was comparable to that found previously for other "tight" epithelia. Experiments using Ag+ in tissues that were bathed in Cl- and HCO3-free solutions indicated that under resting conditions the apical membrane is anion-selective. PMID- 6864780 TI - What next? PMID- 6864781 TI - A clinical note on food preference of individuals with Prader-Willi syndrome: the need for empirical research. AB - The results have important heuristic value for several reasons. First, they indicate that contrary to popular belief, individuals with Prader-Willi syndrome do indicate a definite and, in fact, consistent food preference. Further, the degree of food preference seems to be related to the level of cognitive ability. Finally, these subjects consistently chose a lesser amount of preferred food over a greater amount of non-preferred food. This finding has many potential implications for contingent dietary management. These results which are contradictory to many reported observations, also indicate the importance of collecting objective data regarding the eating behaviour of this population. PMID- 6864782 TI - The Martin-Bell syndrome: a psychological, logopaedic and cytogenetic study of two affected brothers. PMID- 6864783 TI - Organicity and mental retardation: organic mental syndrome battery. AB - Fifteen mentally retarded children were tested and compared to 10 normal school children. They were administered a battery of tests reflecting organic brain disease, consisting of the Face-Hand, Midline Crossing and Independent Eye Movements Tests. Normals performed correctly 98% of the time on the three combined tests, while the mentally retarded scored only 34% correct. There was a significant correlation between IQ and this battery of tests (the 'OMSB'). When the IQ and OMSB were conflicting, a repeat of the former indicated that the IQ value was erroneous. The OMSB may be useful along with IQ testing as a rapid screening method to evaluate the presence of organicity and its severity. PMID- 6864784 TI - Combining accurate defocus with low-dose imaging in high resolution electron microscopy of biological material. AB - High resolution (less than 2 nm) electron microscopy of biological specimens requires three exacting conditions to be met simultaneously: (a) fine specimen detail must be protected from destruction by the electron beam (low dose), (b) the electron optics must be adjusted to be capable of imaging that detail interpretably (accurate defocus), and (c) a suitable field of interest must be identified. We describe a method encompassing all three with an 80% success rate using only minor modifications to a transmission electron microscope, and no expensive on-line computing. PMID- 6864785 TI - Splenorraphy, not splenectomy. PMID- 6864786 TI - Congenital syphilis. PMID- 6864787 TI - Trauma associated with three-wheeled recreational vehicles. PMID- 6864788 TI - The status of high blood pressure control in central Mississippi. PMID- 6864789 TI - Radiologic seminar CCXXVIII: acute emphysematous cholecystitis--a case report. PMID- 6864790 TI - Complete nucleotide sequence of bacteriophage T7 DNA and the locations of T7 genetic elements. PMID- 6864791 TI - Estimation of protein secondary structure from the laser Raman amide I spectrum. AB - A new method for estimating protein secondary structure from the laser Raman spectrum has been developed whereby the amide I Raman band of a protein is analyzed directly as a linear combination of amide I bands of proteins whose secondary structures are known. For 14 proteins, analyzed by removing each one from the reference set and analyzing its structure in terms of the remaining proteins, the average correlation coefficients between the Raman and X-ray diffraction estimates of helix, beta-strand, turn, and undefined were 0.98, 0.98, 0.82 and 0.35, respectively. Significant correlations were also observed for distinctions between alpha-helix (0.98) and disordered helix (0.82), and between parallel (0.82) and antiparallel (0.97) beta-sheets. The average standard deviation of these Raman estimates from the X-ray values is less than 4%. In addition, a singular value analysis of 20 Raman amide I spectra indicates that there may be as many as nine significant independent pieces of information present in the amide I region. PMID- 6864792 TI - Helical disorder and the filament structure of F-actin are elucidated by the angle-layered aggregate. AB - Angle-layered aggregates of F-actin are net-like structures induced by Mg2+ concentrations below that used to form paracrystals. These aggregates incorporate the angular disorder of subunits, which has been described elsewhere for isolated actin filaments. Because this disorder is incorporated into the aggregates in solution at the time they are formed, the possibility of negative stain preparation being responsible for the disorder is excluded. The simple two layered geometry of the angle-layered aggregate provides information about the shape of the component actin filaments free from the superposition of large numbers of layers. A model for the filament shape, derived from single filaments and confirmed by the angle-layered aggregate, is different from those that have previously emerged from paracrystal studies. An understanding of the interfilament bond in both the angle-layered aggregate and the paracrystal allows one to reconcile these different models. We have found a bipolar bonding rule, with staggered crossover points in the angle-layered aggregate, which we suggest is also responsible for Mg2+ paracrystals. This bonding rule can explain the apparent alignment of crossover points in adjacent filaments in paracrystals as a consequence of the superposition of staggered filaments. PMID- 6864793 TI - Reinvestigation of the C-terminal end in the amino acid sequence of the proteinase inhibitor IIA from bull seminal plasma. PMID- 6864794 TI - Preliminary structural comparison of the proteinase isoinhibitors IIA and IIB from bull seminal plasma based on individual assignments of the 1H nuclear magnetic resonance spectra by two-dimensional nuclear magnetic resonance at 500 MHz. AB - By combined use of amino acid analysis, chemical sequence determination for the N terminal decapeptide and two-dimensional 1H nuclear magnetic resonance at 500 MHz the amino acid sequence of bull seminal inhibitor IIB was found to coincide with that of the isoinhibitor IIA, except that the N-terminal tripeptide Pyrl-Gly2 Ala3- in HA is replaced by the dipeptide H-Leu2-Phe3- in IIB. Nearly complete, individual proton assignments were obtained for the isoinhibitor IIB, and comparison with the previously obtained corresponding nuclear magnetic resonance data for the isoinhibitor IIA showed that the two proteins must adopt closely similar secondary and tertiary structures in aqueous solution. The individual resonance assignments provide a basis for future, more detailed investigations of the influence of the local primary structure differences on the protein conformation. PMID- 6864795 TI - Studies of human hemoglobin intermediates. The double mixing method for studying the reactions of the species Hb4(CO) and Hb4(CO)2. AB - Using the double mixing method we have studied the reactions of the partially liganded species (Hb4, Hb4L1, Hb4L2, Hb4L3) of normal human hemoglobin with carbon monoxide. In the first mixing, oxygen is removed from the species Hb4(O2) chi (CO) gamma and at the second mixing the species Hb4(CO) gamma reacts with CO. At 90% saturation of oxyHb with CO the main intermediate species are Hb4(CO)3 and Hb4(CO)2, and at 10% saturation Hb4 and Hb4(CO). The four CO-combination rate constants determined are: l'1 = 1 X 10(5) M-1 S-1, l'2 = 7 X 10(5) M-1 S-1, l'3 = 2 X 10(5) M-1 S-1 and l'4 = 4.8 X 10(6) M-1 S-1. The results indicate that there is no monotonic increase in the successive CO-combination rate constants. It is difficult to explain these results on the basis of the two-state model (Monod et al., 1965) or the stereochemical model of Perutz (1970). PMID- 6864796 TI - Crystals of a catalytically defective, semisynthetic ribonuclease isomorphous with those of the fully active parent enzyme. AB - The enzymically active, semisynthetic, non-covalent complex formed by residues 1 through 118 and residues 111 through 124 of bovine pancreatic ribonuclease A crystallizes at pH 5.2 from (NH4)2SO4/CsCl solution with space group P3(2)21 and unit cell dimensions a and b = 67.7 A, c = 65.1 A and gamma = 120 degrees. The catalytically defective enzyme that results from the replacement of phenylalanine 120 by leucine crystallizes isomorphously with the parent structure (a and b = 67.2 A, c = 64.7 A, gamma = 120 degrees). PMID- 6864797 TI - Structural studies of adenovirus type 2 by neutron and X-ray scattering. AB - Small-angle neutron and X-ray scattering have been used to investigate various aspects of the structural organization of adenovirus type 2. Neutron scattering allows the determination of the radial distribution of DNA and protein, which because of the highly icosahedral form of the virus allows it to be described in terms of three icosahedral shells. X-ray scattering shows that the distance between the major coat proteins (hexons) in the capsid is 100 +/- A. Evidence was also observed for an organization in the nucleoprotein core that gives rise to a maximum in the X-ray scattering at 1/29 A-1. PMID- 6864798 TI - Varigated chromatin structures of mouse ribosomal RNA genes. AB - We have employed a chromatin fractionation procedure on micrococcal nuclease digested nuclei to examine the chromatin structure of mouse ribosomal RNA genes in two systems that differ by at least 14-fold in the level of ribosomal RNA transcription. In a cultured cell line enriched in transcriptionally active ribosomal chromatin, most ribosomal sequences are preferentially sensitive to digestion by micrococcal nuclease, reside in an insoluble chromatin fraction, and lack typical nucleosomal packaging; only minor amounts of ribosomal sequences are packaged into soluble, nucleosomal chromatin. By contrast, in adult liver, which is enriched in transcriptionally inactive ribosomal chromatin, the majority of ribosomal genes are packaged into soluble, nucleosomal chromatin. However, a significant fraction of liver ribosomal chromatin is insoluble and possesses a non-nucleosomal structure. Therefore, within a single cell population or tissue, mouse ribosomal RNA genes are organized into both nucleosomal and non-nucleosomal chromatin structures. We suggest that these structures have functional significance. PMID- 6864799 TI - X-ray diffraction study of DNA complexes with arginine peptides and their relation to nucleoprotamine structure. AB - It is shown that the formation of complexes with several arginine peptides stabilizes the B-form of DNA with 10 (+/- 0.15) base-pairs per turn at all relative humidities, even upon complete dehydration. From an analysis of the packing arrangement and from the calculated diffraction patterns, it is concluded that arginine is associated with DNA in its major groove. It is also shown that the diffraction pattern of nucleoprotamine can be interpreted by placing the protamine on the major groove of DNA. The strong intensity on the first layer line is due to the influence of neutral residues on the diffraction pattern. Thus, we conclude that protamine is bound to the major groove of DNA. PMID- 6864800 TI - Structure of tubulin rings studied by X-ray scattering using synchrotron radiation. AB - X-ray patterns have been obtained from solutions of microtubules and tubulin rings using synchrotron radiation. They are interpreted on the basis of the oriented fiber X-ray diagram of microtubules, and by comparing them with the calculated scattering traces of model structures. The data are consistent with models in which rings consist of coiled protofilaments. This is in agreement with some published ring models while it excludes others. PMID- 6864801 TI - Polymorphism in clathrin light chains from different tissues. AB - Two types of light chains were observed in clathrins from different bovine tissues. Clathrin was purified from seven different bovine tissues using immunoaffinity columns prepared from a monoclonal antibody specific for the heavier light chain (LCa) of bovine brain clathrin. The LCa equivalent in clathrin from non-brain tissue was identified by monoclonal antibody binding to electrophoretic blots of these clathrins. The LCa and LCb light chains of bovine brain clathrin are, respectively, 4 X 10(3) daltons and 3 X 10(3) daltons heavier than their corresponding light chains in other tissues. The light chains from tissues other than brain are similar in molecular weight. PMID- 6864803 TI - Mapping the fodrin molecule with monoclonal antibodies. A general approach for rod-like multidomain proteins. AB - Fodrin is an axonally transported F-actin crosslinking rod-shaped multidomain protein having a length of 200 nm. It is though to be related to erythroid spectrin (220,000 and 240,000 Mr) as it is built as a tetramer derived from a heterodimer comprised of two large subunits (235,000 and 240,000 Mr). A panel of 24 monoclonal antibodies has been used to probe the fodrin structure by direct microscopical decoration and identification of large tryptic fragments retaining antigenicity. The combined results unambiguously define the fodrin organization and show it to be strongly related to erythrocyte spectrin. They demonstrate the heterodimer organization, the head-to-head association of dimers, the protease resistant domain structure of each subunit and indicate that different termini of the polypeptides are localized at the free F-actin binding ends and the heterodimer association sites. They also show that within the same mammalian species even the highly related 240,000 Mr subunits of fodrin and spectrin are immunologically distinct, most likely reflecting different gene products. PMID- 6864802 TI - Crystals of polyglycine in the beta form. AB - Well-defined lamellar crystals of polyglycine I (the beta modification of polyglycine) have been grown from a solution of a sample of 5000 molecular weight. The crystals are elongated and have an average thickness of 40 to 50 A. The unit cell is monoclinic and the crystals have a twined structure. Electron diffraction reveals that the polypeptide chains are normal to the basal plane of the crystals and that the hydrogen bonds are parallel to their long sides. From these data we conclude that crystals of polyglycine I have a folded beta structure. PMID- 6864804 TI - Amino and carboxy-terminal regions in globular proteins. AB - The structural, dynamic and functional aspects of amino and carboxy-terminal regions in proteins of known structure have been analysed. Terminal regions are usually located on the surface of the protein, accessible to solvent, and are often flexible. There is a significant preference for terminal regions in single domain proteins, and within individual domains of larger proteins, to be in close proximity. This partially reflects the compact globular nature of proteins, but the preference for spatial proximity is stronger in native proteins than in randomly generated structures. In addition in multi-domain and multi-subunit proteins we find that the terminal regions are commonly involved in the interface between domains and subunits. In the 18 multi-domain structures analysed, 19 terminal regions provide a link between domains. Subunit links are also frequently observed. In contrast, the distribution of active site residues along the sequence, indicates that the terminal regions are less frequently involved in activity. These data suggest that in many globular proteins the terminal regions fulfil a structural role, stabilizing the tertiary or quaternary structure to provide a framework for the active site. PMID- 6864805 TI - Transformation of the structure of collagen. A time-resolved analysis of mechanochemical processes using synchrotron radiation. AB - Mechanochemically induced molecular transformations of collagen fibres were analysed using time-resolved small-angle diffraction spectra and histomechanical measurements. In particular, the influence of aqueous and methanolic perchlorate solutions was examined. According to a transformation continuing from the periphery towards the centre, the macroscopic contraction that is completed less than five minutes after incubation with perchlorate is caused by peripherally transformed fibrils only, whereas the centrally situated fibrils first undergo an accordion-like folding, but after more than 20 minutes are transformed similarly. The triple-helical transformation is preceded by a structure-breaking effect on structural water that can be monitored in time-resolved diffraction spectra. The combined loss of meridional low-angle reflections and cross-striated fibrils in micrographs is irreversible. By dialysis of colloidally dissolved collagen against a solution of ATP, however, segment-long spacing aggregates are obtained. Under isometric conditions, an instantaneous transformation of intermittent regions leads to an increase in the long period of adjacent, still structured regions of the same fibril that is correlated with a delayed increase in tension in the fibre. Increase of tension under isometric conditions as well as the flow properties of a fibre relaxed in perchlorate are interpreted in terms of the parallel sliding of subunits of varying lengths, which has been demonstrated by diffraction analysis. PMID- 6864806 TI - Two conformational states of didansylcystine-labeled rabbit cardiac tropomyosin. AB - The fluorescence properties of rabbit cardiac tropomyosin specifically labeled at Cys190 with didansylcystine has been correlated with its unfolding transitions. Circular dichroism studies at 222 nm showed that for both didansylcystine-labeled tropomyosin and reduced tropomyosin under physiological conditions, a small thermal pretransition near 30 degrees C was present before the main unfolding transition at 48 degrees C. In the absence of added salt there was only one unfolding transition near 33 degrees C for both the native and the labeled tropomyosin. Thus, conformational perturbation by the probe was minor. Despite the specific labeling, the fluorescence decay of didansylcystine-labeled tropomyosin was composed of two components; a major component with a short lifetime (6 ns) and a minor blue shifted component with a relatively long lifetime (17 ns), due to the sampling by the probe of both a polar and a hydrophobic environment, respectively, near Cys190. The fluorescence contribution of the long-lived component increased in the pretransition before decreasing in the main unfolding transition. The increase of the long-lived component appears to be a consequence of a shift in conformational equilibrium of tropomyosin from a "chain-closed" toward a localized "chain-open" state, which allows greater access of the probe to the exposed hydrophobic region. PMID- 6864807 TI - Molecular conformation and packing in collagen fibrils. AB - New X-ray diffraction data have been collected from specimens of tendon collagen stained with phosphotungstic acid. Measurements of the positions of the Bragg reflections associated with the crystalline lattice provide, for the first time, a complete description of the unit cell. A strong band of intensity in the molecular transform associated with the pitch of the molecular helix can be identified and a detailed analysis of the intensities and positions of the Bragg reflections in this band has been carried out. The principal conclusions are that the portions of the collagen molecule that contribute to these reflections have a common direction; that they have a length very much less than that of a complete molecule; that the paths of the individual portions through the crystal are incompatible with a completely straight molecule, and that the molecule is therefore crimped. No evidence was obtained for a second series of Bragg reflections attributable to a second set of molecular portions linking the first set, and it is concluded that the linking set is more mobile and subject to positional variation from cell to cell. The most plausible explanation of our finding is that the first set corresponds to the portions of the molecules in the overlap zone and the second set to the portions in the gap zone. A detailed analysis of the Bragg reflections in the strong band of intensity associated with the pitch of the molecular helix has provided information about the relative azimuthal orientations and the lateral positions in the unit cell of the five molecular segments in the overlap zone. None of the existing models for fibril structure accounts satisfactorily for all the results obtained in the present studies and alternative models are developed and tested. PMID- 6864808 TI - Cytological study of the cellular changes after transection of the proximal radix of the rat trigeminal ganglion. AB - Cytological changes following transection of the proximal root of the trigeminal ganglion in adult rats were assessed by light and electron microscopy. Radices were transected about 3-5 mm from the ganglia and animals were killed from 1 to 60 days after the operation. Light microscopically, it was found that all Nissl granules became uniformly stained and evenly distributed throughout the cytoplasm within 3 days. Three types of cell alteration involving Nissl granules occurred within 3 to 12 days after the operation: 1) chromatolysis, 2) dark staining of the cytoplasm accompanied by an increase of Nissl granules, and 3) faint staining of the cytoplasm accompanied by dispersion of Nissl granules. Electron microscopically, the chromatolysis pattern was characterized by peripheral concentration of the granular endoplasmic reticulum (gER) and ribosomes in the cytoplasm. Neurons of the dark-staining type showed an increased number of polysomal complexes throughout the cytoplasm, whereas those of the faint-staining type had diffusely dispersed cisternae of the gER which were shortened and bore reduced numbers of attached ribosomes. Perinuclear localization of profiles of Golgi complexes disappeared temporarily 1-3 days after the operation, but the normal perinuclear pattern appeared to return after 1 week. Enzyme histochemistry of acid phosphatase activity revealed an increase in the number of very fine reaction products in the cytoplasm up to 14 days following the operation. Cells recovered the normal pattern of Nissl staining by 48 days. Myelin figures, which are rarely observed in normal ganglia, were still observed in dense lysosomal bodies after 30 days. Nuclear size in affected neurons steadily increased up to about 2 weeks postoperation but returned to normal by 48 days. PMID- 6864809 TI - Cochlear hair-cell populations and limits of resolution of hearing in two vespertilionid bats, Nyctalus noctula and Eptesicus serotinus. AB - A comparison of the population of cochlear hair cells with known hearing resolution capabilities in two species of bats (Nyctalus noctula and Eptesicus serotinus of the family Vespertilionidae) has revealed a close correlation between morphological and functional parameters. Data on number and densities of hair cells in the examined bat species are presented. Even though the species are of a comparable body size, N. noctula has a longer basilar membrane, a higher density, and hence also a higher total number of hair cells than E. serotinus. This is in good agreement with hearing resolution capabilities, which are better in N. noctula than in E. serotinus. These findings have implications on differences in feeding ecology and hunting strategies between these species. PMID- 6864810 TI - A possible mechanism of rapid luteolysis in white-footed mice, Peromyscus leucopus. AB - Adult female white-footed mice, Peromyscus leucopus, were exposed to long (LP) or short (SP) photoperiods for 6 weeks (experiment I). Another group of animals was kept for 6 weeks in SP, then injected SC with 30 micrograms prolactin twice daily for 2, 3, 4, or 6 days (experiment II). Ovaries from the mice in both experiments were weighed and serially sectioned for light microscopic examination of regressing corpora lutea. In experiment I, it was observed that vessels supporting corpora lutea were dilated, and that their endothelium was either undergoing necrosis or it was missing. Pronounced changes of luteal capillaries led to rupture and intraluteal hemorrhage, thus opening the capillary bed. Regressing luteal cells became segregated and seemed to invade the vascular system passively. They were seen as luteal cell thrombi in medullary veins. This luteolytic course termed "rapid luteolysis" was most apparent in SP ovaries. It differed from "retarded luteolysis," which represents the well-established luteolytic model of auto- and heterophagocytosis. In experiment II, there was a statistically significant decrease in ovarian weight 4 days after prolactin treatment in comparison with saline-treated controls. At the light microscopic level, signs of both rapid and retarded luteolysis were present, but not intensified. It is concluded: (1) The concept of rapid luteolysis represents a reasonable working hypothesis. (2) Prolactin, though luteolytic at the macroscopic level, failed to produce evidence of increased rapid or retarded luteolysis at the light microscopic level. PMID- 6864811 TI - Myocardial metabolism and regional myocardial blood flow in the canine left ventricle following twenty minutes of circumflex artery occlusion and reperfusion. AB - The recovery of high energy phosphate stores (ATP plus phosphocreatine) was examined following various periods of reperfusion after 20 min circumflex artery occlusion in the open-chest dog. Transmural tissue samples were obtained from the posterior wall of the left ventricle of control dogs, after 20 min occlusion and after 1, 5, 10, 15 and 20 min reperfusion. Significant reductions in high energy phosphate stores were observed in the subepicardium (41.6% of control) and subendocardium (31.3% of control) after occlusion. Upon reperfusion, recovery was rapid and exceeded control by 65.4% (91.0 v. 55.0 microns/g dry wt) in the subendocardium, but only by 2.6% (72.2 v. 70.4, mumg/g dry wt) in the subepicardium and was due mainly to recovery of phosphocreatine. Regional myocardial blood flow was studied in a separate, but identical, series of experiments. During occlusion, posterior wall blood flow was reduced by 54% (0.85 +/- 0.04 to 0.37 +/- 0.04, ml/g/min) in the subepicardium and by 94.7% (1.13 +/- 0.05 to 0.06 +/- 0.005, ml/g/min) in the subendocardium. Reperfusion produced a rapid recovery including overshoot of blood flow compared to control blood flow. Peak blood flow occurred one minute after release of the occlusion becoming 3.34 +/- 0.16 ml/g/min in the subepicardium and 2.39 +/- 0.13 ml/g/min in the subendocardium. Blood flow in both levels returned to control flow after 15 min reperfusion. These results indicate that metabolic recovery of high energy phosphate stores occurred within 5 min of restoration of blood flow in this model. PMID- 6864812 TI - High extracellular sodium and digoxin-induced arrhythmias in guinea-pig ventricular myocardium. AB - Oscillatory fluctuations in diastolic potential [4, 10] and triggered rhythmical activity [4] are well known manifestations of digitalis intoxication and are attributed to intracellular Ca2+ overload consecutive to an elevated intracellular Na+ [7]. In the present paper we report the electrophysiological effects of elevated extracellular Na+ on the spontaneous rhythmical activity and oscillatory fluctuations in digoxin-intoxicated ventricular cells. Our results show that by increasing extracellular Na+ from 135 mM to 175 mM, we were able to abolish spontaneous rhythmical activity but were not able to suppress the damped sinusoidal oscillations in the resting membrane potential. We suggest that Na+ Ca2+ exchange would be stimulated by a greater Na+ gradient, resulting in an enhanced Ca2+ extrusion. PMID- 6864813 TI - Measurement of glycosylated hemoglobins in black diabetic patients: a note of caution. AB - Inspection of chromatography columns used for measurement of glycosylated hemoglobins revealed that blood samples from certain black diabetic patients produced two residual hemoglobin bands after chromatography rather than one. The levels of glycosylated hemoglobin were significantly lower in these subjects than in other diabetics. Further investigation revealed that each of these subjects had the hemoglobin AS or AC phenotype. The presence of hemoglobin S or C appears to cause spuriously low levels of glycosylated hemoglobin as determined by ion exchange chromatography. Other means to assess diabetic control should be used for patients with these abnormal hemoglobins. PMID- 6864815 TI - Laser therapy of glaucoma. AB - The introduction of argon-laser iridotomy and argon-laser trabeculoplasty have had a beneficial impact on the treatment of glaucoma. Recent attention has been given to complications of anterior segment laser therapy. Of most concern is an acute rise in intraocular pressure which may be as great as 20 mmHg. Since patients undergoing anterior segment laser therapy usually have pre-existing visual compromise, this rise in intraocular pressure may be detrimental. This pressure rise rarely requires surgery. Until long-term follow-up is available, and complications are better understood, these new treatment modalities should be employed with caution. PMID- 6864816 TI - Psychological aspects of chronic pain. AB - Since its inception in June 1979, over 500 patients have been treated at the King/Drew Pain Center in Los Angeles. Based upon the treatment and observations of this patient group, this paper describes the psychologic aspects in patients suffering from chronic abdominal pain, low back pain, phantom limb pain, chest pain, and arthritic pain. PMID- 6864814 TI - Precursors of hypertension: a review. AB - Recent advances in hypertension therapy have been remarkable; however, much less is known about those precursors that facilitate preventive and early intervention measures. This review of the literature indicates that relevant precursors are early elevated casual systolic blood pressures, positive family history, and obesity in females. Additional predisposing or enhancing factors point to high sodium ingestion, heavy smoking, and high socioecologic stress. Evidence for a high-risk hypertensive personality is not conclusive. There is a paucity of longitudinal data on hypertension in the black population. PMID- 6864817 TI - Volvulus of the stomach. AB - Volvulus of the stomach is a rare condition, but when acute it requires prompt diagnosis and treatment. Chronic volvulus occurs more frequently and does not always require treatment. Certain predisposing factors, such as abnormalities of the diaphragm, ulcers, or neoplasms, may be present. PMID- 6864819 TI - Computerization of procedural requests and reports of clinical laboratory data: a case study. AB - A case study describing the use of a computer system in handling clinical laboratory data is presented. Effective coordination between clinical laboratory personnel and the nursing staff is emphasized as being essential for success of the system. PMID- 6864818 TI - Thyroid carcinoma: criteria in selection of patients for total and subtotal thyroidectomy. AB - Surgical management of patients with thyroid carcinoma continues to be a controversial subject among surgeons throughout the nation. The authors have recently treated patients with differentiated thyroid carcinoma using a selective surgical approach based on criteria classifying patients into high- and low-risk subgroups. Categorization is based on patient age, size and invasiveness of the tumor, and the presence or absence of distant metastatic disease. Women older than 50 and men over the age of 40 were classified as "high-risk" patients. Other criteria qualifying patients for high-risk categorization included lesion size greater than 3 cm and/or the presence of distant metastases. For patients with follicular tumors, histologic evidence of significant vascular invasion also constituted a high-risk criterion. Patients with high-risk criteria are associated with a significantly poorer prognosis. The records of 136 patients treated from 1958 to 1978 were reviewed. The findings and research from the literature suggest that these high-risk patients, when treated by total thyroidectomy, have an overall increased rate of survival when compared with those under-going lesser surgical procedures. PMID- 6864821 TI - A descriptive study of Kaposi's sarcoma in south Florida. AB - A larger-than-expected incidence of Kaposi's sarcoma in women is observed in south Florida. The possibility of a shift in cancer experience to groups previously considered at low risk (eg, women and blacks) or tumors (eg, Kaposi's sarcoma) is suggested. PMID- 6864820 TI - Emergency service nursing staff: a survey of knowledge, attitudes, and concerns. AB - A survey of the nursing staff in an emergency service was completed by anonymous questionnaire. The results of the survey indicate satisfaction and confidence in the triaging group, a wish for more staff and specific inservice course content, good perception of emergency situations, misperception about restraint policy and the life-threatening nature of opiate withdrawal, and the need to focus on a clearer definition of those patients who do not require acute care. PMID- 6864822 TI - Sickled hypochromic red blood cells. PMID- 6864823 TI - Ritodrine use in placenta previa. PMID- 6864824 TI - Hypothyroidism causing macrocytic anemia unresponsive to B12 and folate. AB - A patient with pernicious anemia who developed a mild macrocytic anemia after many years of monthly vitamin B(12) therapy is presented. There was no response to the addition of folic acid and multivitamins. Evaluation for causes of elevated mean corpuscular volume and consideration of associated autoimmune disorders led to the diagnosis of primary hypothyroidism. Treatment with levothyroxine led to correction of the hematologic abnormalities over a four month period. The anemia of hypothyroidism may present with macrocytic indices and this diagnosis should be suspected when this finding is noted. PMID- 6864825 TI - Renal angiomyolipoma with retroperitoneal adenopathy. AB - To date, only two cases of renal angiomyolipoma with associated lymph node involvement have been described. The authors report a third instance of this unusual entity. PMID- 6864826 TI - Cesarean section: a seven-year study. AB - This paper reports a seven-year study of cesarean section practices at the Queen of Angels Hospital, Los Angeles, California. Indications for this procedure are listed in detail and an attempt is made to explain its increasing frequency. Practicing physicians were interviewed and testimony seemed to indicate, as was suspected, that fear of malpractice suits was one of the reasons for cesarean section. The conventional wisdom of "once a section always a section" is questioned with regard to an increasing number of trials of labor and vaginal deliveries, when they are considered feasible and safe. The federal government is manifesting serious interest in this increased number of operative deliveries in the light of cost effectiveness. PMID- 6864829 TI - Growth of Trichinella spiralis larvae in rats receiving folic-acid-deficient diet. AB - A study of the effect of growth of Trichinella spiralis in rats fed a folic-acid deficient diet is described. Trichinella spiralis larvae encysted in the diaphragms of two groups-rats fed a folic acid-deficient diet and rats fed a complete (normal) diet-were examined. In rats fed a folic-acid-deficient diet, the number of the encysted larvae was larger than that in the controls. However, the encysted larvae were substantially longer in the control group of rats fed complete (normal) diets. PMID- 6864828 TI - Alcoholism in the elderly: an analysis of 50 patients. AB - The personal, demographic, and socioeconomic aspects of alcoholism in 50 elderly and 50 young alcoholics were examined. A higher number of elderly alcoholics were veterans, widowed, and had a long history of alcoholism when compared with younger alcoholics. During drinking bouts, the younger alcoholics had more blackouts, hallucinations, sleeping difficulties, and loss of appetite than did the elderly alcoholics. These findings must be interpreted with caution in view of the small sample size and the fact that geriatric alcoholics are not a homogeneous group. PMID- 6864830 TI - Effect of storage on insulin receptor binding in human erythrocytes. AB - The authors established the specificity, reliability, and precision of human erythrocyte insulin radioreceptor assay. On the basis of insulin binding, cell viability, and degree of hemolysis, heparin sodium was found to be a more suitable anticoagulant than sodium fluoride, ethylenediaminetetraacetic acid, sodium oxalate, or sodium citrate. In two sets of experiments carried out at 4 degrees C and 23 degrees C, human erythrocytes were stored as whole blood or isolated erythrocytes suspended in Tris-{4-(2-hydroxyethyl)-1-piperazine ethanesulfonic acid} buffer. The effect of storage under these conditions was evaluated by erythrocytespecific insulin binding. Human erythrocytes can be stored for 72 hours at 4 degrees C without any change in insulin binding, insulin receptor sites per cell, or average affinity constant at the empty sites. Isolated erythrocytes can also be stored in plasma for 72 hours or in buffer G for 24 hours at 4 degrees C without any change in insulin binding. It is not advisable to store human erythrocytes in plasma or as whole blood for more than 24 hours at 23 degrees . These findings are useful in preserving insulin receptor activity when storage of erythrocytes is unavoidable. PMID- 6864831 TI - An analysis of skin prick test reactions on asthmatics in Lagos. AB - Skin tests were administered to 221 asthma patients at the Lagos University Teaching Hospital between 1977 and 1980. Of these, 168 patients (76 percent) had positive skin tests to one or more allergens and 53 (34 percent) had negative skin tests. Patients with positive tests tended to have a positive family history of asthma and an earlier age of onset of asthma.There was, however, no observed difference in the groups in the incidence of other allergies of urticaria, eczema, and allergic rhinitis. Results showed that 89 percent of asthmatics with positive skin tests were allergic either to house dust or to the house dust mite. Pollen allergy was comparatively rare. There is a need to prepare desensitizing antigens specific to this environment. PMID- 6864827 TI - Evaluation of clinical severity in sickle cell disease. AB - For a severity classification of sickle cell disease to be accepted, it is necessary that clinicians agree upon relative disease severity between patients. This condition was shown to be satisfied for a randomly selected group of patients evaluated by four persons. All rank correlation coefficients between observer pairs were highly significant. Representative severity indices based on history and recent hospital events also correlated significantly with evaluator ranking. The results show that, in principle, a classification of sickle cell disease patients by severity is possible. Such a classification would be most useful to evaluate the prognostic significance of particular signs or symptoms, or the success of various treatments in affecting severity of disease. PMID- 6864833 TI - Intrathoracic thyroid. AB - A case of intrathoracic or substernal thyroid is presented. The anatomical and radiological features and differential diagnoses are discussed. PMID- 6864832 TI - Traumatic pancreatic pseudocysts. AB - At the Martin Luther King, Jr, General Hospital in Los Angeles, during the period from June 1972 to April 1981, seven patients underwent surgery for traumatic pancreatic pseudocysts. The overall average age was 28 and the average hospital stay was 31 days. Ultrasound was the most useful test for diagnosis and follow up. Preoperatively, serum amylases were not consistently elevated. Overall recurrences and complications totaled 57 percent. There were no deaths. The authors consider a large cystogastrostomy the treatment of choice for mature cysts that are satisfactorily adherent to the stomach. The second preference is a Roux-en-Y cystojejunostomy. External drainage was employed for acute cysts that required drainage. A distal pancreatectomy was performed for patients with small pancreatic tail pseudocysts. Patients who underwent acute drainage were usually drained externally and had a poorer outcome than patients who were operated on later with internal drainage. When compared with another group of 15 alcoholic patients who were operated on for pancreatic pseudocysts, patients with traumatic pseudocysts had a poorer outcome. PMID- 6864834 TI - Human histocompatibility antigens and organ transplantation. AB - The success of organ transplantation depends not only upon the degree of skill employed in the execution of the technical procedure, but equally upon the proper antigenic matching of the donor and the recipient. Although there does not exist at the present time a perfect test for performing tissue typing-as in the case of blood transfusions-the most promising tests are those of leukocyte typing. This is possible because the histocompatibility antigens that determine the success or failure of tissue allografts are also found on the leukocytes. The problem concerns itself with developing an exact, specific, monosera test-simple and uncumbersome-that can be used to type the leukocytes and thus select a donor who corresponds antigenically to the recipient. PMID- 6864835 TI - Secretory response of glucagon to hemorrhage. AB - Glucagon has been implicated in the hormonal-metabolic response to injury and in the restitution of blood volume. Evidence for this has been obtained largely from observations of peripheral glucagon concentrations. The secretory response to mild or moderate hemorrhage remains undefined. Experiments have been conducted in conscious dogs surgically prepared with indwelling catheters in the portal vein (PV), femoral artery (FA), and femoral vein (FV). In addition, electromagnetic flow probes were placed about the PV and the hepatic artery (HA). Animals were subsequently subjected to either a 10% (7.5 ml/kg), 20% (15 ml/kg), or 30% (22.5 ml/kg) 3-min hemorrhage. The portal venous delivery rate (PVDR) of immunoreactive plasma glucagon (IRG), portal venous IRG concentration (PVIRG), and peripheral arterial IRG (AIRG) demonstrated variable changes following hemorrhage. When hemorrhage resulted in marked deterioration in PVBF, then PVDR did not correlate with either changes in PVIRG or AIRG. These preliminary results suggest that inferences regarding changes in PVDR of IRG cannot reliably be based solely on changes in hormonal concentrations, especially when measured only in the periphery. Moreover, since marked increases in peripheral plasma glucose levels were observed at times when PVDR of IRG was severely depressed following 20% and 30% hemorrhage it is suggested that glucagon may not play the dominant role in the early hyperglycemic response to hemorrhage. PMID- 6864837 TI - Efficacy of cervical spine immobilization methods. AB - Cervical spine immobilization devices are widely used to stabilize the cervical spine and prevent neurologic deficits associated with unstable fractures. In order to quantitate their efficacy we measured controlled cervical spine motion in three axes, using six different immobilization methods in 25 volunteers instructed to actively move their necks as much as possible in the directions of flexion, extension, rotation, and lateral bending while lying supine. Control measurements were made with no device and measurements were repeated following immobilization with: soft collar (SC), hard collar (HC), extrication collar (EC), Philadelphia collar (PC), bilateral sandbags joined with 3-inch cloth tape across the forehead (ST), and the combination of sandbags, tape, and the Philadelphia collar (ST/PC). Neck movements were reported in degrees recorded on a hand-held goniometer. There were no significant differences between control and SC measurements except in rotary movement. PC was not significantly better than the other two types of hard collars, except in limiting extension. ST immobilization was significantly better than any of the other four methods used alone, for all four movements. The addition of PC to ST was significantly more effective in reducing extension only. PMID- 6864836 TI - Rationale for selective application of Emergency Department thoracotomy in trauma. AB - The indiscriminate application of thoracotomy in the resuscitation of trauma has recently been challenged. Since 1 May 1974 400 consecutive trauma patients have undergone resuscitative thoracotomy in our Emergency Departments (ED). The mechanism of injury was blunt in 195 (49%) patients, gunshot wound in 147 (37%), and stab wound in 58 (14%) Upon arrival in the ED, 352 (88%) patients had no obtainable blood pressure (BP), 334 (84%), fixed pupils, and 315 (798%) failed to exhibit agonal respirations or other waning signs of life. One hundred six (27%) patients reached the operating room and 28 (7%) survived to be admitted to the intensive care unit. Sixteen were eventually discharged from the hospital, but four of these survivors had sustained irreversible cerebral damage. Overall, 12 of 400 (3%) patients survived ED thoracotomy with intact neurologic function. Four factors appeared predictive of poor prognosis. There were no survivors with intact neurologic function among: 150 patients sustaining blunt trauma and arriving in the ED without signs of life (BP, pupil reactivity, respiratory effort); or 87 patients with penetrating torso injuries who had no signs of life at the scene. Following thoracotomy, in the absence of cardiac tamponade, there were no intact survivors of 124 patients without cardiac activity or of aortic occlusion. We believe the above factors should militate against initiating resuscitative thoracotomy in the ED or in deciding to continue heroic measures following thoracotomy. PMID- 6864838 TI - Fractures of the femoral shaft in a regional hospital setting. AB - We reviewed the efficacy of treatment techniques for femoral shaft fractures in our regional rural hospital setting. One hundred fifty consecutive primary femoral shaft fractures were managed at the Medical Center Hospital of Vermont during the period 1974 through 1979. The method of treatment was determined by the attending orthopedic faculty. Each case was evaluated at the time of initial hospital treatment, at 30 days postinjury, and at 1 year postinjury. Patient profiles, methods of injury, types of fracture, and associated injuries were reviewed. The choice of operative or nonoperative treatment in the first 30 days was the most important factor in the result at 1 year. Results were graded as "good' if angulation was 0-5 degrees in the A-P and/or lateral views; "fair', 6 10 degrees; and "poor', greater than 10 degrees or any need for supplemental surgery to achieve union. Shortening, infection, and thrombophlebitis were infrequent in this series. (formula: see text) Overall rate of supplemental surgery was 37% for the initially nonoperative treated femoral shaft fractures. In this series operative intervention gave surer results with an earlier return to full ambulation and more anatomic repair than nonoperative methods. PMID- 6864839 TI - Significance of hypocalcemia following hypovolemic shock. AB - Changes in calcium levels during and after resuscitation from severe shock were studied in 22 seriously injured patients who received an average of 21 blood transfusions and 26 mEq supplemental calcium. Total serum proteins (TSP), serum albumin (SA), total calcium (TC), and ionized calcium (CA++), were studied intraoperatively after the tenth transfusion and postoperatively at 5 hours, 15 hours, day 2, day 4, and during convalescence (day 25). The intraoperative TSP fell to 3.7 gm%; the TC and Ca++ fell to 7.2 mg% and 1.4 mEq/L. The TSP and SA remained low throughout day 4 (4.8 and 2.6 gm%); the TC was also low on day 4 (7.5 mg%), whereas the Ca++ rose to normal (2.1 mEq/L) by day 2. The severity of hypocalcemia paralleled the hypoproteinemia, the number of transfusions given during resuscitation, and the duration of shock; paradoxically, hypocalcemia correlated inversely with Ca++ supplementation of blood transfusions during resuscitation, suggesting increased extravascular Ca++ flux with more severe shock. Further studies in comparably injured patients are needed to identify the concomitant responses of the calcium homeostatic factors such as parathormone in order to help identify the optimal role of calcium manipulation during resuscitation from hypovolemic shock. PMID- 6864840 TI - Effect of acute ethanolism on the hospital course and outcome of injured automobile drivers. AB - Acute ethanolism in automobile drivers is purported to be both protective and detrimental in susceptibility to injury from an accident. The potential influence of acute intoxication (serum ethanol greater than 100 mg/dl) on pattern and severity of injury, hospital course, and long-term outcome, including mortality, was examined in 182 consecutive automobile drivers requiring admission to a regional university trauma center during 1980. Significantly more drivers were intoxicated than not, 61% vs. 39%. Similarly, more than 75% of the intoxicated drivers were young males and more than 80% of the intoxicated drivers were felt to be negligent and at cause for the accident. However in this series, the patterns and severity of injuries, hospital course, and late outcome were unaffected by the patient's blood alcohol level. Acute alcohol intoxication apparently neither protected nor hindered the response to injury in these motor vehicle drivers. PMID- 6864841 TI - Patients with abdominal trauma and fatal outcome: analysis of a 30-year series. AB - Patients with blunt abdominal trauma and fatal outcome during 30 years in a well defined rural Swedish area have been analyzed. There were 127 patients. Several facts indicate that more severe trauma has been appearing more often during this period The mortality rate has, however, been stable, but the patients have become older. More patients die from pulmonary complications than from the trauma itself. One very important development is the significant decrease in mortality among children. PMID- 6864842 TI - Patterns of death, complication, and error in the management of motor vehicle accident victims: implications for a regional system of trauma care. AB - A nonautopsy, retrospective analysis of severe motor-vehicle accident trauma can provide valuable information in regard to volume of trauma and quality of care. In a 6-county region surrounding a large metropolitan area trauma care, as reviewed by this method, had deficiencies at all levels of delivery. Patients were taken to the nearest hospital. Hospitals then had not been classified or designated according to capability. Twenty-five per cent of the fatalities and 16% of all outcomes were considered inappropriate for the severity of injury incurred. A regional trauma system with categorization and designation of hospitals providing trauma care would have eliminated or improved these deficiencies, resulting in improved outcomes for a significant percentage of these patients. PMID- 6864843 TI - Interactions between ethanol and the responses to injury. AB - After finding changes in the biochemical response to injury in patients who had consumed ethanol (27) we have examined the effect of acute ethanol intoxication on the outcome of injury using the bilateral hindlimb ischemia model in the rat. Technical difficulties were encountered but it was possible to devise an experiment in which realistic plasma ethanol levels and a lowered redox state were present during the response to a standard 4-hr period of bilateral hind-limb ischemia. Acute intoxication had little effect on the mortality rate or survival time. Extrapolating the findings to man it would seem that if ethanol intoxication increased the dangers associated with trauma its effect would be in increased risks of airway obstruction due to vomit, etc., rather than in altered biochemical responses. PMID- 6864844 TI - The effect of thermal injury on drug metabolism in the rat. AB - Because of previously reported hepatic abnormalities in burns, the activity of the hepatic drug metabolizing system was assessed in burned Sprague-Dawley rats. In 16% burned male rats, pentobarbital sleeping times were significantly prolonged from day 1 to day 24 postburn, and trichloroethanol sleeping times were significantly prolonged from day 1 to day 10 postburn. The activity of p nitroanisole O-demethylase was significantly depressed in male rats at 5, 10, and 17 days post-16% burn. In female rats, this enzyme was more depressed at 10 days post-16% burn than in male rats. A direct relationship was found between per cent burn and impairment of enzyme activity. The depression of drug metabolizing enzymes was inducible by phenobarbital pretreatment. Pretreatment with the immunosuppressive drug azathioprine prevented the enzyme depression at 5 days postburn, a result which possibly implicates a postburn hyperimmune response as the mechanism for the depressed enzyme levels. PMID- 6864845 TI - Critical analysis of results of 53 Malgaigne fractures of the pelvis. AB - Critical analysis of 53 cases of Malgaigne fracture of the pelvis was undertaken at Hennepin County Medical Center, Minneapolis, over a 10-year period (1968-1978) with particular emphasis to immediate and late complications. Thirty patients were followed from 2 to 12 years after injury. Eleven patients were asymptomatic. Eleven had paresthesias of the lower extremity on the same side as the fracture. Nine had gait disturbance, eight had severe low back pain, four had groin pain, and two had fecal incontinence. Low back pain as a late sequela was related to sacral or sacroiliac injury. There appeared to be a correlation between the amount of displacement of the detached hemipelvis and the frequency of subsequent low back pain. Reduction of the upward displacement of the hemipelvis, by whatever means, to anatomic configuration can be of help in reducing late sequelae. In the later years of this study external fixation was successful. PMID- 6864846 TI - Bilateral fracture of the first ribs. AB - Fractures of the first rib are uncommon. Bilateral fractures of the first rib are still rarer. A case of bilateral fracture of the first rib due to indirect trauma is reported because of its rarity. Pain at the base of the neck was the presenting symptom in our case and analgesia was the only treatment. PMID- 6864847 TI - The surgical complications of thyroidectomy. AB - The surgical complications of thyroidectomy are relatively few but still need to be carefully considered before an operation is recommended. The major problems that lead to continuing morbidity are those of permanent hypoparathyroidism and recurrent laryngeal nerve damage. The incidence of both rises dramatically whenever a total thyroidectomy is performed, particularly when this is for a malignancy, or when the patient has undergone previous surgery to the thyroid or parathyroid glands. Other complications of thyroidectomy are relatively uncommon. PMID- 6864848 TI - The thyroid nodule--an approach to management. PMID- 6864849 TI - The thyroid nodule: evaluation of fine-needle biopsy. AB - Sixty-three consecutive unselected patients with a solitary cold nodule of the thyroid were submitted to surgery. Prior to surgery they all had clinical evaluation and a fine-needle aspiration (FNA) biopsy of the nodule. Results of this study show that the FNA biopsy was correct in predicting cancer in 12 of 13 cancers for a sensitivity of 92%. When the nodule was benign, the FNA biopsy was right in 42 of the 50 benign nodules for a specificity of 84%. In comparison the clinical criteria alone were correct in suspecting only eight of the 13 cancers for a sensitivity of 62%, while correctly identifying 39 of the 50 benign nodules for a specificity of 72%. An association of the clinical criteria with the results of the FNA biopsy would have identified all the cancers in our group. PMID- 6864850 TI - [Parapharyngeal tumors]. AB - Parapharyngeal tumors are neoplasms which protrude beyond the parapharyngeal wall. The anatomy of the cephalic parapharyngeal space allows the identification of four sites - one retropharyngeal and three lateropharyngeal - each having its own particular pathological characteristics. Clinical examination and paramedical testing permit an exact determination of tumor configuration and will often permit diagnosis of tumor type. With the pre-operative diagnosis established, the surgeon can choose his approach and formulate a plan for excision according to the tumor site. PMID- 6864852 TI - Neutrophil disorders in a child with necrotizing external otitis. AB - A two year old child presented with a history of cyclic fever since the sixth week of life, and otorrhea of six weeks' duration, unresponsive to treatment. Surgical removal of massive granulation tissue and sequestrated bone, combined with parenteral administration of pipellacillin and dibekacin successfully resolved the Pseudomonas infection. Neutropenia and the decreased chemotactic activity of neutrophils were observed in this patient. This neutrophil disorder seemed to be primary and a contributing factor. PMID- 6864851 TI - Carcinoma of the oropharynx: tonsil. AB - This review presents the Toronto experience with carcinoma of the tonsil. Treatment policies and results for the 10 year period, 1970-1979, are given. The overall survival for all patients treated is 38% at five years. Patients with advanced local disease (T3) and advanced nodal disease (N2/3) had a high failure rate. Over 85% of relapses occurred by two years. After this time deaths from intercurrent disease were more common than deaths from carcinoma of the tonsil. PMID- 6864853 TI - Minor and major lip reconstruction. AB - Lip reconstruction has made significant advances over the past two decades with refinement of some old techniques and the introduction of new innovative methods. Small and medium defects can be repaired in a variety of ways with similar results. Local lip switch flaps are far superior to any distant tissue. Total lip loss is probably best handled with nasolabial flaps. Extensive resections including the lip, premaxilla, mandible, and skin of the chin and upper neck remain a challenge with all modern techniques, including myocutaneous flaps and free flaps, having little advantage over the standard visor forehead flap. PMID- 6864854 TI - The effect of hearing protection on narrowband signal detection in industrial noise. AB - A method for evaluating the effectiveness of insert protectors at suprathreshold intensities was developed. Normal listeners and workers with clinically diagnosed, bilateral, noise-induced hearing loss attempted to detect a 1 or 3 kHz narrowband signal, 500 msec in duration. The signal was presented binaurally over headphones, either in quiet or against a background of industrial noise taped on site. The level of the noise was fixed at 84 dBA. The level of the signal was varied across blocks of 50 trials from near threshold to clearly audible. Comparisons were made between the detectability of the signal when insert protectors were worn, and listening without protection. The results indicated that in both normal and hearing impaired listeners the slopes of the psychometric functions were fairly steep, covering a range of only about 5 dB. The value of attenuation of the insert protector derived from the displacement of the function for listening in quiet with the protector, relative to listening with the open ear was constant throughout the range of suprathreshold signal intensities used. In 84 dBA of background noise normal subjects showed an improvement of about 3 dB when they wore protectors. By contrast the wearing of protectors in noise by hearing impaired listeners resulted in substantial decrements in signal detection. PMID- 6864855 TI - [An electrophysiological study of frequency selectivity in audiology]. PMID- 6864857 TI - Development of the nematocyte junctional complex in hydra tentacles in relation to cellular recognition and positioning. AB - Formation of the nematocyte-battery cell-mesoglea (NBM) junctional complex of hydra was studied. Normal animals were grafted to nematocyte-free animals and the tentacles of the repopulating host were examined by transmission electron microscopy. Migrating nematocytes extend cytoplasmic processes between battery cell myonemes to contact the mesoglea. Tufts of extracellular filaments radiate from the base of the battery cell adjacent to some of these regions of contact. The fascial desmosome of the NBM complex develops from a lateral fusion of macular desmosomes which often lie near a condensation of extracellular filaments. Microtubules within the intervening battery cell process become oriented perpendicularly to form the apposing half of the desmosomal junction and connect it with the hemidesmosomal portion of the NBM complex. These findings suggest that a migrating nematocyte receives environmental cues associated with the mesoglea-battery cell interface which may serve to direct the nematocyte to its definitive position and induce the subsequent formation of the complete NBM complex. PMID- 6864856 TI - Technique of thyroidectomy. PMID- 6864858 TI - Phylogenetic branching of Trichoptera and Lepidoptera: an ultrastructural analysis on comparative spermatology. AB - The divergence during the evolution of the sister orders of Trichoptera (caddisflies) and Lepidoptera (moths and butterflies) from their common ancestors is still subject to disagreement. This is partially due to lack of clarity concerning the phylogenetic position of Zeugloptera which is considered to be either a very primitive suborder of Lepidoptera or an order of its own, more archaic than both Trichoptera and Lepidoptera. The ultrastructural analysis on comparative spermatology reported here shows that dichotomous spermatogenesis producing concomitant, normal, anucleate (apyrene) and nucleate (eupyrene) spermatozoa: (1) is generalized in Lepidoptera as it occurs, in addition to higher Lepidoptera, also in the primitive Hepialoidea, (2) is present in Zeugloptera, and (3) is absent from Trichoptera which produce only nucleate spermatozoa. It is concluded that dichotomous spermatogenesis is an evolutionary novelty of Lepidoptera (including Zeugloptera) that was established at the origin of the order, after the divergence of Trichoptera and Lepidoptera. PMID- 6864859 TI - Cell migration in the ruminant placenta: a freeze-fracture study. AB - In the ruminant placenta, binucleate cells normally migrate out of the trophectodermal epithelium throughout pregnancy to fuse with the syncytium bounding the maternal connective tissue. This study shows that they form part of the trophectodermal tight junction as they migrate, thus maintaining the barrier function while penetrating the junction. This method of migration seems to be unique and the means by which it is achieved is briefly discussed. PMID- 6864860 TI - Distribution of anionic binding sites in extravascular space of skeletal muscle demonstrated with polycationized ferritin. AB - Polycationized ferritin (PCF) and native ferritin (NF) were microinjected into rat muscle interstitium. The injection site was fixed in situ and processed for electron microscopy. PCF decorated the external aspect of the lamina densa of pericapillary and muscular basal lamina as quasi-regular aggregates, up to approximately 200 nm wide, separated with spaces greater than 20 nm wide. The internal aspect of the lamina densa possessed negative binding sites with a similar distribution, whereas PCF was never retained within the lamina densa. PCF bound very closely to the sarcolemma but did not approximate intimately the endothelial plasmalemma including vesicles. PCF also interacted with strict regularity with collagen fibrils (at an axial repeat of greater than 60 nm) forming transverse bands of PCF across collagen bundles. No ordered interaction between NF and extracellular structures was observed. The ordered distribution of negative binding sites in interstitium, as revealed with PCF, should affect the blood-lymph movement of macromolecules. PMID- 6864861 TI - The fine structure of spermatozoa of Hydrolagus colliei (Chondrichthyes, Holocephali). AB - The ultrastructure of spermatozoa in Hydrolagus colliei is described. Basic similarities of structure to the sperm of the related elasmobranch fish are noted. The most significant features of sperm structure in Hydrolagus that differ from those of elasmobranch fish occur in the tail. The axoneme is eccentrically located and forms a double helix with a single longitudinal column. A second longitudinal column is reduced to a short remnant at the base of the tail. Microtubules within the axoneme are also helically disposed, a feature that is consistent with the rotating motion of the sperm. Abundant glycogen reserves are stored along the length of the tail. PMID- 6864862 TI - The contraction of collagen matrices by dermal fibroblasts. AB - Floating collagen gel cultures containing human foreskin fibroblasts have been observed to undergo a rapid contraction process. The initial rate of contraction (i.e., within the first 2 hr) was observed to be a linear function of cell number within the concentration range of 10(5)-10(6) cells/gel. Observation of thick, deresined sections of such contracting gels in the SEM, as well as observation of thin sections in the TEM, suggest that the fibroblasts exert a tension upon the surrounding collagen fibers. These observations further indicate that the fibroblasts migrate from the interior regions of the gel matrix and eventually form a monolayer of cells encapsulating the contracted collagen disc. These observations are discussed in terms of the possible mechanisms involved in gel contraction. PMID- 6864864 TI - Technical topics: sound speed. PMID- 6864863 TI - Preservation of ultrastructure of cells cultured on protein hydroxyethylmethacrylate hydrogels. AB - A method for studying the ultrastructure of cells grown on hydroxyethylmethacrylate (HEMA) hydrogels is described. Under normal conditions, HEMA hydrogels tend to swell when placed in hypotonic solutions and to shrink during alcohol dehydration. To overcome this severe swelling and/or shrinking, all solutions used during the fixation procedure are made in Puck's saline G, and dehydration is accomplished with a graded series of ethanol solutions prepared with Puck's saline G and polyethylene glycol. Infiltration of the sample with embedding material is achieved with the aid of a vacuum oven. Our findings suggest that the cells cultured on collagen hydrogels are ultrastructurally indistinguishable from those cultured on tissue-culture plastic. In addition, the unusual crater-like topography of the hydrogel can be utilized as an experimental aid in the study of cell attachment and spreading. PMID- 6864865 TI - Case of the month. Splenic candidiasis. PMID- 6864866 TI - Particle image-resolution test object. AB - A blur definition and measurement technique for high-subject-contrast image resolution is proposed. A new test object utilizing the blur principle has been developed and feasibility tested. In developing this new test object, tests of various sizes and concentrations of small plastic particles in a gelatin base were performed. Optimum particle sizes and concentrations were selected for the popular clinical transducer frequencies. Test images were obtained with static and real-time transducers of various focal properties. In all cases the proposed test object clearly indicated the zone (focal zone) of optimum high-subject contrast image resolution. The advantages of the proposed blur definition and measurement technique of high-subject-contrast image resolution include: test object simplicity, ease of performing and interpreting the measurement, usefulness for all types of real-time scanners, and the need for only one scan for both axial and lateral resolution information at all image depths. PMID- 6864867 TI - The appearance of the therapeutically irradiated breast on whole-breast water path ultrasonography. AB - The sonographic appearance of the breast on whole-breast water-path ultrasonography in 30 patients with prior therapeutic irradiation for carcinoma is described. Skin thickening, a nonspecific increase in echogenicity of the subcutaneous fat, loss of volume, and architectural asymmetry are the prominent features. PMID- 6864868 TI - Real-time vs. static scanning in the diagnosis of abdominal and pelvic abscesses. AB - The authors prospectively compared real-time and static scanning in 39 patients (44 examinations) suspected clinically of having abdominal or pelvic abscesses. In every case, real-time and static scanning agreed as to the presence or absence of an abscess. In 17 of 19 instances in which abscesses were diagnosed on the basis of ultrasonographic examinations the diagnoses were verified by surgery. Twenty-four of 25 negative ultrasonographic results were confirmed by clinical follow-up. The use of portable real-time ultrasonography to examine seriously ill patients who are unable to be transported to the ultrasound laboratory does not diminish the diagnostic accuracy for suspected abdominal or pelvic abscesses. PMID- 6864869 TI - Clinical manifestations of the comet tail artifact. AB - The comet tail artifact appears as a dense tapering trail of echoes just distal to a strongly reflecting structure. This reverberation type of artifact occurs when there is a marked difference in acoustic impedances between an object and its surround. This paper presents a spectrum of comet tail artifacts seen in clinical practice and discusses their usefulness in decision making. PMID- 6864870 TI - Ultrasonographic diagnosis of an aneurysm of the vein of Galen in utero by duplex scanning. PMID- 6864871 TI - Ultrasonographic diagnosis of a hemorrhagic hepatic cyst clinically mimicking acute cholecystitis. PMID- 6864872 TI - The sonographic appearance of hepatic hemangioma in utero. PMID- 6864873 TI - Advantages of coronal ultrasonography in evaluating the neonatal retroperitoneum. AB - Good demonstration of retroperitoneal structures in the neonate can be obtained with real-time coronal ultrasonography. Advantages of coronal scanning include limited manipulation of the infant, less hindrance from monitoring devices or tubes when positioning the scanning probe, and improved visualization of retroperitoneal structures due to less interference by bowel gas. Retroperitoneal structures are displayed in conventional frontal anatomic relationships, which may facilitate recognition of renal ectopia and evaluation of abdominal masses. The authors' experience in evaluation of the neonatal retroperitoneum with coronal ultrasonography is presented. PMID- 6864874 TI - Placental grading in the complicated or high-risk pregnancy. AB - A classification of the changes seen in the placentas of nondiabetic, non-high risk obstetrical patients, and its relationship to fetal pulmonary maturity, has been the subject of two recent reports. Successful (100 per cent) correlation has been concluded from these studies when a Grade III placenta has been demonstrated in gestations of 33 weeks to term. To determine whether the same high degree of reliability would hold for the diabetic and high-risk obstetrical patient, 78 such patients were analyzed. All except one delivered at 33 weeks to term, and all had amniotic fluid lecithin-sphingomyelin (L/S) ratio determinations within 48 hours of sonographic placental grading and within seven days of delivery. Of the Grade III placentas (n = 13), 23 per cent had "immature" L/S ratios. However, there was no case of infantile respiratory distress syndrome (IRDS) in infants of patients with Grade III placentas. These findings suggest that placental grading may need to be part of a multifactorial assessment of fetal maturity in the diabetic or high-risk pregnancy. PMID- 6864875 TI - Ultrasonographic findings in peptic ulcer disease and pancreatitis that simulate primary gallbladder disease. AB - The ultrasonographic findings in two patients with peptic ulcer disease and one patient with acute pancreatitis are reported. In each case, the sonographic appearance simulated intrinsic gallbladder disease. Two patients had focal pericholecystic fluid collections and one had an inflammatory mass adjacent to the gallbladder. Each patient also demonstrated gallbladder wall thickening. Findings of a pericholecystic fluid collection or an inflammatory mass adjacent to the gallbladder appear to be nonspecific for cholecystitis, and should also suggest inflammation of adjacent organs. PMID- 6864876 TI - Ultrasonographic evaluation of fetal paranephric pseudocysts. AB - Ultrasonographic evaluation of the fetus with urinary tract obstruction requires not only precise delineation of the level of obstruction but also differentiation from other nonobstructive renal entities. The authors evaluated five fetuses in which large unilocular paraspinous fluid collections were seen at ultrasonography. While these masses simulated the appearance of large hydronephrotic sacs, they actually represented paranephric pseudocysts. In four of the five cases in which a paranephric pseudocyst was seen the ipsilateral kidney was nonfunctioning. PMID- 6864877 TI - Ultrasonic evaluation of the size of the trigone of the fetal ventricle. AB - A well-demarcated hypoechoic area seen on routine fetal biparietal diameters (BPDs) was retrospectively reviewed in 101 routine obstetrical ultrasonograms. This region has been confirmed to represent the hippocampus with its lateral borders formed by the trigone of the lateral ventricle. Recognition of this structure in conjunction with other previously described structures is a useful method of obtaining easily reproducible BPD measurements. Measurements of the distance of the lateral wall to the midline and the diameter of the hypoechoic area are presented as possible useful indicators in predicting fetal intracranial abnormalities such as hydrocephalus. PMID- 6864878 TI - Ultrasonography of torsion of normal uterine adnexa. PMID- 6864879 TI - Ultrasonic localization of biliary decompression catheters. PMID- 6864880 TI - Aortic root dissection: M-shaped echocardiographic appearance of the dissecting intima. PMID- 6864881 TI - Diagnosis of cervical pregnancy by ultrasonography. PMID- 6864882 TI - Nonoverlapping antigenic sites of woodchuck hepatitis virus surface antigen and their cross-reactivity with ground squirrel hepatitis virus and hepatitis B virus surface antigens. AB - Five nonoverlapping antigenic sites (sites I through V) of woodchuck hepatitis virus surface antigen were identified with competitive binding assays involving monoclonal antibodies. Site I contributed to cross-reactions among surface antigens of hepatitis B-like viruses infecting woodchucks, ground squirrels, and humans. At least three distinct sites (sites I, II, and III) are responsible for cross-reactions between woodchuck and ground squirrel hepatitis virus surface antigens. Sites IV and V of woodchuck hepatitis virus surface antigen are not major cross-reactive sites, suggesting that these elicit virus-specific antibodies. There were no cross-reactions with duck hepatitis B virus surface antigen. PMID- 6864883 TI - Genetic mapping of the mouse oncogenes c-Ha-ras-1 and c-fes to chromosome 7. AB - The mouse homologs of the cellular oncogenes c-Ha-ras-1 of Harvey sarcoma virus and c-fes of feline sarcoma virus were both mapped to chromosome 7 by Southern blot analysis of hamster-mouse somatic cell hybrid DNAs. PMID- 6864885 TI - Nosocomial urinary tract infections: secular trends, treatment and economics in a university hospital. AB - During a 71-month interval 3,024 nosocomial urinary tract infections were identified by prospective surveillance at our hospital. The annual attack rate varied between 2.0 and 3.1 per 100 admissions. Gram-negative bacilli caused 74 per cent of all urinary infections and recurrent infections in the hospital accounted for only 1 per cent. The most frequent pathogens were Escherichia coli (24 per cent), Pseudomonas aeruginosa (8 per cent), Streptococcus faecalis (7 per cent), Klebsiella pneumoniae (6 per cent) and Proteus mirabilis (6 per cent). Candida species caused 10 per cent of the infections and may represent a hospital acquired pathogen of increasing importance. The burn unit had a significantly higher proportion of Enterobacter infections (21 per cent) than any other service (p less than 0.05). The plastic surgery service had more Serratia infections (24 per cent), whereas obstetrics and gynecology had more Escherichia coli infections (47 per cent) relative to other hospital services. More than 99 per cent of the patients with nosocomial urinary tract infections received antimicrobial drugs; in 63 per cent the chart documented that drug therapy was prescribed specifically for treatment of the urinary infections. Hospital-acquired urinary infections added approximately 1 million dollars to hospital expenses during the study interval. Estimates were made of the economic benefits of successful control programs. PMID- 6864884 TI - Reduced synthesis of Sindbis virus negative strand RNA in cultures treated with host transcription inhibitors. AB - Host cell involvement in Sindbis virus (SB) RNA synthesis was examined in cells which had been treated before infection with actinomycin D or alpha-amanitin (alpha-A). Overall synthesis of SB RNA was reduced significantly in CHO cells treated for 18 h before infection with alpha-A. However, SB RNA was produced at near normal levels in CHOama-1 cells, a line which contains an alpha-A-resistant RNA polymerase II. In BHK or CHO cells infected with SBamr, a mutant which replicates normally in cells pretreated with either actinomycin D or alpha-A, viral RNA synthesis was not decreased. The levels of negative strand RNA and of replicative forms I, II, and III in SB-infected cells were progressively reduced with increasing times of pretreatment with host transcription inhibitors, indicating fewer functional replicative intermediates in treated cells. Replicative events after replicative intermediate formation also were inhibited but only to the extent predicted by the reduction in replicative intermediates. Similarly, events preceding negative strand synthesis, adsorption, penetration, uncoating, and translation of nonstructural proteins, apparently were not impeded in treated cells. Therefore, our results are consistent with the involvement of a host component after translation of the nonstructural proteins but before or during the synthesis of SB negative strand RNA. PMID- 6864886 TI - The effect of abdominal pressure on urinary flow rate. AB - We examined the effect of abdominal pressure on urinary flow rate and urethral closure pressure in 46 subjects, ranging in age from 26 to 82 years. An increase in urinary flow rate caused by abdominal straining was not found when organic obstruction was present in the prostatic urethra in men or the proximal urethra in women, or when dysuria is caused by the lowered detrusor pressure. An increase in urinary flow rate caused by straining was noted when anterior urethral stricture or stress incontinence was present. The increase in urinary flow rate owing to straining was undetermined in the control group. The urethral closure pressure on the anti-stress incontinence zone increased as a result of straining at the same time and to the same degree as did the intravesical pressure. When the anti-stress incontinence zone was subjected to transurethral resection for canal formation urination became possible as a result of straining. The patients who were able to urinate with straining sometimes suffered temporary stress incontinence. The degree of straining did not determine whether the patient could urinate with straining. Therefore, it was concluded that abdominal pressure should be excluded from intravesical pressure in performing several urodynamic studies on the lower urinary tract, such as pressure flow studies, and that it is important to have a sufficient canal formation in the anti-stress incontinence zone when urination with straining is expected when performing an operation on patients with urethral obstruction in the anti-stress incontinence zone. PMID- 6864887 TI - Conservative or immediate surgical management of blunt renal injuries. AB - From 1969 to 1981, 1,176 blunt renal injuries were recorded in 1,166 patients (10 patients had bilateral injuries). Conservative management of 27 patients with severe renal injuries resulted in a delayed renal operation in 30 per cent and total renal loss in 22 per cent. A review of the published series of the conservative management of patients with severe renal injuries (laceration, rupture and pedicle injury) shows a renal surgery rate of 13 to 68 per cent, a renal loss rate of 3 to 33 per cent and a significant complication/renal surgery rate of 13 to 76 per cent. In our patients 88 per cent with severe renal injuries had associated injuries and 73 per cent of these underwent immediate laparotomy for intra-abdominal injury. Immediate renal surgery in 59 patients with severe renal injuries resulted in a nephrectomy rate of 6.5 per cent of 31 renal lacerations, 100 per cent of 14 renal ruptures and 50 per cent of 14 pedicle injuries. Of the 14 patients with pedicle injuries 6 (43 per cent) had immediate vascular repair, with salvage of the kidney. Immediate surgical management of the patients with severe renal injuries obviated the need for a second exploration in a severely injured patient, reduced morbidity and resulted in increased renal salvage. PMID- 6864888 TI - Acute urinary retention in female patients: diagnosis and treatment. AB - Acute urinary retention in female patients often is attributed to psychogenic disturbances. However, it is apparent that this problem may be the harbinger of significant organic illness. Our experience with 27 patients reveals that careful evaluation and appropriate treatment prevent further urological complications and aid in the diagnosis of underlying pathological conditions. PMID- 6864889 TI - Genitourinary rhabdomyosarcoma. AB - Rhabdomyosarcoma is the most common soft tissue malignant neoplasm involving the pelvis of children. Debate still exists over whether the best treatment is pelvic exenteration, radiation and chemotherapy or chemotherapy as the cornerstone to treatment, with diminished needs for extensive surgery and prolonged radiotherapy. Contrariwise, there is little debate over the combined treatment modality for paratesticular rhabdomyosarcoma. We have evaluated and treated 19 children with rhabdomyosarcoma, including 17 with pelvic rhabdomyosarcoma and 2 with paratesticular rhabdomyosarcoma. This retrospective study was done to evaluate treatment regimens for patients with genitourinary rhabdomyosarcoma. For patients with pelvic rhabdomyosarcoma the study was divided into 2 series. In an early series 6 of 7 children had a pelvic exenteration with or without chemotherapy. Of these 7 children 3 are well 15 to 27 years following diagnosis. In a later series of 10 children, when chemotherapy was used more commonly, none underwent pelvic exenteration. Of these 10 patients 7 had chemotherapy or chemotherapy and biopsy only. Only 1 child, who presented with stage IV disease, died in this series. Another child with stage III disease had progressive disease despite chemotherapy and subsequent cystoprostatectomy. Thus, of 9 remaining patients 8 are well from 1 to 8 years. It appears that pelvic rhabdomyosarcoma can be treated effectively with chemotherapy, and limited surgery and radiation. Fortunately, pelvic exenteration can now be limited to a select few. PMID- 6864890 TI - Burkitt's lymphoma presenting as urinary outflow obstruction. PMID- 6864891 TI - Air embolism: a potential complication of retrograde pyelography. AB - We report 2 cases of venous air embolism as a complication of retrograde pyelography. The pyelovenous route of embolization was documented radiographically. The mechanisms of pyelovenous backflow are reviewed and the clinical implications of this phenomenon are discussed. Pyelovenous backflow may provide the mechanism for air embolism when gas is present in the urinary tract. PMID- 6864892 TI - Renovascular hypertension in an infant with segmental renal artery stenosis and hypoplasia of the abdominal aorta. AB - Hypoplasia of the abdominal aorta is a rare cause of renovascular hypertension. Arteriographic studies of the renal vasculature are presented from an infant with hypoplasia of the abdominal aorta and segmental renal artery stenosis. The renovascular hypertension was cured by partial nephrectomy. There was no difference in the parenchymal histology in the tissue from the congenitally ischemic lower pole of the kidney and the vascularized upper pole. In this unique case with decreased renal blood flow during fetal development there was no evidence that parenchymal ischemia can cause renal parenchymal hypoplasia. PMID- 6864893 TI - Sexuality after urinary undiversion. AB - We report on the sexuality of 2 young men following urinary undiversion. One patient reported improved sexual experience due to loss of the appliance and improved self-image. Urine leakage during sexual activity can be prevented only by catheterization before intercourse. The other patient has undergone rediversion after a technically satisfactory undiversion because of urine leakage during intercourse that did not respond to intense pharmacologic therapy and bladder emptying before sexual activity. Sexuality following undiversion has not been studied previously. Additional guidelines in preoperative evaluation and patient education are suggested. PMID- 6864894 TI - A rare complication in pediatric surgical urology: the ileoileal intussusception. AB - We report a case of intussusception following pyeloplasty. Intussusception is a rare complication after surgery for the genitourinary system through the extraperitoneal approach. PMID- 6864895 TI - Management of the bladder by augmentation ileocecocystoplasty. AB - Use of cecum and ileum to construct a large capacity, urinary reservoir with provision for easy intermittent catheterization is described. The technique is useful in the management of hypertonic or hyperreflexic vesical dysfunction. PMID- 6864896 TI - Kinked ureter with unilateral obstructive uropathy complicating Burch colposuspension. AB - Burch colposuspension is a simple retropubic approach for the management of stress incontinence. Major complications are rare but kinking of the ureter can occur in such a procedure, especially in patients who previously have undergone hysterectomy. Careful dissection of the vagina and identification of the ureters are necessary before colposuspension is attempted. PMID- 6864897 TI - Central nervous system lesion causing urethral instability and urinary incontinence. AB - We report on a girl in whom urinary incontinence developed after surgery for a cerebral arteriovenous fistula. Urodynamic evaluation demonstrated periodic decreases in urethral pressure and external anal sphincter electromyographic activity. These episodes were associated with entry of radiographic contrast material into the urethra and urinary incontinence. Treatment with ephedrine sulfate prevented entry of urine into the proximal urethra and resulted in complete daytime continence, despite persisting urodynamic evidence of urethral and electromyographic abnormalities. PMID- 6864898 TI - Gonococcal infection of the median penile raphe. AB - Atypical involvement of the male genitourinary tract by Neisseria gonorrhoeae, such as isolated accessory glandular infection without urethritis, is a rare presentation of a common disease. We report a case of gonococcal abscess of the median raphe of the penis. PMID- 6864900 TI - Torsion of intrascrotal malignant testis tumors. AB - We report 2 cases of torsion of scrotal malignant tumors of the testis. A review of the literature disclosed several instances of torsion of intra-abdominal testicles with malignant tumors and only 1 case of a scrotal testis. The association of torsion and tumor in these cases may represent 2 manifestations of a dysplastic gonad. PMID- 6864899 TI - Treatment of sequential bilateral germ cell tumors of the testis following interval retroperitoneal lymph node dissection. AB - Modification in lymphatic drainage following retroperitoneal lymph node dissection, such as a collateral circulation or lymph node and lymphatic vessel regeneration, was observed in 2 patients in whom a second tumor developed in the remaining testicle. Such alterations of the lymphatic system are difficult to evaluate for the possible presence of metastatic disease. The presence of extensive collateral circulation rules out lymph node dissection or radiation therapy as an appropriate treatment in these patients. A short course of systemic chemotherapy, regardless of the histological type of the second malignancy, seems to be the safest adjunctive treatment in such cases. PMID- 6864901 TI - Cedecea davisae isolated from scrotal abscess. AB - A strain of Cedecea davisae was isolated as the predominant organism from a patient with a scrotal abscess as well as chronic heart and liver diseases. PMID- 6864903 TI - Xanthine calculi in the Lesch-Nyhan syndrome. AB - Urinary tract calculi composed primarily of xanthine are rare in adults and children. However, there is risk of xanthine calculi formation in children with hereditary xanthinuria and children on xanthine oxidase inhibitor therapy for hyperuricemia. We describe the clinical presentation and management of 2 children with the Lesch-Nyhan syndrome (a congenital disorder of purine metabolism) and xanthine calculi. Little information has been available to direct the urologic management of such patients. We have based a plan for management upon our clinical experience with these children, as well as upon in vitro dissolution studies of the calculi. We have had some clinical success using an alternating acid/base dissolution therapy developed in the laboratory. PMID- 6864904 TI - Blastomycosis presenting with prostatic involvement: report of 2 cases and review of the literature. AB - We report on 2 patients who presented with prostatic involvement as the first prominent clinical manifestation of systemic blastomycosis. The clinical symptoms of both patients began with dysuria and urinary retention. In 1 patient skin lesions developed 4 weeks later and the initial chest x-ray findings were positive. The other patient became aware of skin lesions concurrently with the urinary symptoms and had negative chest x-ray findings. Successful treatment consisted of amphotericin B in 1 case and ketoconazole in the other case. A review of the literature revealed 8 well documented cases of blastomycosis with the initial presenting symptom of prostatic involvement. A summary of the previously reported cases is presented and the importance of recognition of skin lesions in such patients is stressed. PMID- 6864902 TI - A possible etiology of the infertile 46XX male subject. AB - We report on an infertile male patient with the predominant 46XX female karyotype. A testicular biopsy revealed widely separated testicular tubules, absence of sperm formation and large numbers of Leydig cells. Chromosome studies, including measurements of the X chromosomes, showed a significant difference between the lengths of the short arm of the 2 X chromosomes. This information lends support for an X-Y chromosome interchange as the etiology of this syndrome. The clinical features of this rare syndrome and other theories of etiology of XX male subjects are discussed. PMID- 6864905 TI - The contractile and metabolic effects of acute ischemia on the rabbit urinary bladder. AB - The present study determined the effect of 1 hour of in vivo ischemia on the response of the rabbit urinary bladder to specific autonomic agonists and on the intracellular adenosine triphosphate content. A 48 per cent decrease in the contractile response of the base to the alpha agonist methoxamine was noted. A 42 per cent decrease in the response of the bladder body to bethanechol was found. Neither tissue improved significantly after a 1-week recovery period. Ischemia caused an immediate 80 per cent decrease in the intracellular adenosine triphosphate content that improved to 50 per cent of control with a 1-week recovery period. Although the site of the defect is not definitely identified, acute ischemia resulted in a decreased contractile response that could result in bladder dysfunction. PMID- 6864906 TI - Prognostic indicators in renal adenocarcinoma. AB - From 1968 to 1978, 246 patients underwent surgical exploration for renal adenocarcinoma at our clinic. Of these patients 241 had complete tumor excision and 5 had biopsy only. Correlation of the clinical and pathological data of these patients with the clinical course identified prognostic parameters. Disease progression was uncommon when the tumor was contained within the capsule of the kidney (9 of 80 patients). Perinephric tumor extension indicated a worse prognosis (11 of 40 patients with progression) that was not altered significantly by the presence of renal vein involvement (17 of 35 patients with progression). Inferior vena caval involvement or regional lymph node metastases worsened the prognosis markedly, with 8 of 11 and 8 of 9 patients demonstrating progressive disease, respectively. The worst prognosis was seen in patients with metastatic disease at operation (66 of the 71 patients dying of the disease by the end of followup). The disease was classified according to the tumor, node and metastasis system of the American Joint Committee and a stage grouping system has been suggested. PMID- 6864907 TI - Treatment of renal cancer patients by transcatheter embolization and its effects on lymphocyte proliferative responses. AB - The effects of transcatheter embolization on lymphocyte proliferation in patients with renal cancer were investigated. Prognosis was good in 12 patients who underwent preoperative transcatheter embolization and 2 of 5 patients with distant metastases survived for 2 years or more. The remaining 9 patients underwent transcatheter embolization as a conservative procedure and 4 of 7 with distant metastases survived more than 1 year. Lymphocyte response to phytohemagglutinin before treatment in the presence of autologous or homologous serum was significantly lower in all patients than in healthy persons (p less than 0.01 and less than 0.05, respectively). The response after transcatheter embolization decreased slightly only in the presence of autologous serum for a short interval but recovered to the pre-treatment level 1 month after embolization. However, only in the presence of autologous serum was the response significantly higher at 2 months after nephrectomy than before treatment in patients who underwent preoperative transcatheter embolization (p less than 0.05). The serum inhibitory factor levels changed in inverse proportion to the post-treatment lymphocyte response. In patients who underwent preoperative transcatheter embolization the serum inhibitory factors essentially disappeared 2 months after nephrectomy. PMID- 6864909 TI - Transurethral removal of large ureteral and renal pelvic calculi using ureteroscopic ultrasonic lithotripsy. AB - Transurethral ultrasonic fragmentation of stones allows successful endoscopic removal of upper urinary calculi that otherwise would be considered too large to extract. We successfully extracted endoscopically 2 large renal pelvic and 5 large ureteral stones using transurethral ureteropyeloscopy and ultrasonic lithotripsy. The stone is visualized first with the ureteropyeloscope, and then engaged in a basket and either fragmented or disintegrated with the ultrasonic transducer. Any remaining small stone fragments can be retrieved with a stone basket or forceps. There has been little morbidity with this procedure and patients can return to normal activity after discharge from the hospital. PMID- 6864908 TI - Analgesics and tobacco as risk factors for cancer of the ureter and renal pelvis. AB - In a case-control study of 36 men with cancer of the ureter and 307 male controls with the same age distribution tobacco smoking conferred a relative risk for this cancer of 2.9, whereas consumption of analgesics of any kind did not increase the risk. The relative risk for cancer of the renal pelvis, determined for 29 men, was 2.4 for tobacco and 6.0 for phenacetin-containing analgesics. Analgesics containing no phenacetin conferred no increased risk for cancer at this site. Data for 13 women with ureteral cancer, 5 of whom had taken phenacetin, are presented but not analyzed. PMID- 6864910 TI - Multiple ureteral tubation for stones. AB - Multiple ureteral tubation is a technique for removal of ureteral calculi, involving 2 to 9 ureteral catheters that are left indwelling for 12 hours to 10 days. In 317 patients the technique has been applied for 7 upper third, 47 middle third and 263 lower third ureteral calculi, ranging in size up to 2.2 cm. in diameter. Satisfactory extractions were accomplished in 300 of 317 cases (95 per cent). Complications were encountered in 6.0 per cent of the patients, chiefly in the earlier cases when experience with the technique was being gained. PMID- 6864912 TI - Vesicoureteral reflux in the adult. II. Nephropathy, hypertension and stones. AB - The level of renal function, presence of hypertension or characteristics of nephrolithiasis were analyzed in relation to the severity of renal scarring and other clinical parameters in 67 patients with primary bilateral vesicoureteral reflux. A significant positive correlation was observed between impairment of renal function and severity of renal scarring. Renal insufficiency occurred only in patients with bilateral scarring. Significant proteinuria was found more often in patients with depressed renal function. Hypertension was observed in 34 per cent of the patients, mostly in those with bilateral scarring or depressed renal function. Radiopaque calculi were noted in 18 per cent of the patients. In all but 1 case these calculi occurred in scarred kidneys. PMID- 6864913 TI - Anatomy of the retroperitoneal connective tissue. AB - For the urologist, especially, a knowledge of the anatomy of the retroperitoneum is important. Anatomical and surgical texts frequently do not describe the retroperitoneal anatomy, particularly the retroperitoneal connective tissue, clearly enough to facilitate clinical applications. The anatomy of the retroperitoneal connective tissue is reviewed and clinical applications are provided. PMID- 6864911 TI - Vesicoureteral reflux in the adult. I. Factors in pathogenesis. AB - The morphologic and functional findings in 67 adults with primary bilateral vesicoureteral reflux were analyzed. A significant correlation was found between the severity of vesicoureteral reflux and the extent of renal scarring but the position and shape of the ureteral orifices did not influence the degree of reflux or scarring. Large bladder capacity was a common finding, especially in patients with residual urine or with renal insufficiency. However, bladder capacity did not correlate with the grade of vesicoureteral reflux. Patient age at the time of the first recognized urinary tract infection, and the frequency and pattern of subsequent infections did not have any influence on the severity of the renal scarring. The interpretation of these findings in the light of the current hypotheses on the pathogenesis of reflux nephropathy is discussed. PMID- 6864914 TI - Transitional cell carcinoma of the bladder in children and adolescents. AB - A review of our records between 1950 and 1980 identified 12 patients with transitional cell carcinoma of the bladder who were less than 21 years old. The tumors were low grade and low stage, and were associated with an excellent prognosis. Only 1 patient had a solitary recurrence. This study supports the contention that transitional cell carcinoma of the bladder is a less aggressive disease in patients who are in the first 2 decades of life than in older patients. PMID- 6864915 TI - Bladder cancer: factors affecting survival. AB - The identification of factors present at the time of initial evaluation may be important to predict the prognosis in patients with bladder tumor. Attempts were made to identify predictive factors of recurrence involving comparisons based on the 12-month recurrence rate and time to recurrence in a prospective clinical investigation of 468 patients with bladder tumor observed during a 5-year interval. In newly diagnosed bladder cancer patients stage, grade and size of the largest tumor at initial evaluation were significant factors affecting survival, and these factors acted independently. Age and stage were significant factors in patients with a history of bladder tumor. We herein estimated survival curves using the product-limit estimate. Comparisons of survival curves and analyses involving more than 1 potential prognostic factor were accomplished using Cox's proportional hazards model. PMID- 6864917 TI - Acetylator phenotype in human bladder cancer. AB - The acetylator phenotype of 26 bladder cancer patients and 26 controls was determined by the sulfamethazine method to evaluate whether patients with the slow acetylator phenotype have a greater susceptibility for bladder cancer. This hypothesis has been suggested by experimental animal and human epidemiological observations. Of the 26 bladder cancer patients 12 (46 per cent) had the slow acetylator phenotype compared to 18 of 26 controls (69 per cent). Within the bladder cancer group there was no striking excess of the slow acetylator phenotype when subgrouped by occupational and smoking history. Our results show no significant association between the slow acetylator phenotype and human bladder cancer. PMID- 6864916 TI - Invasive bladder cancer: support for screening. AB - Of 297 patients with bladder cancer treated between 1975 and 1981, 90 (30 per cent) had histologic documentation of muscle invasion, 82 of whom (91 per cent) had invasion into the muscle at the time of presentation. Of these 82 patients 51 (62 per cent) had tumor localized to the bladder after clinical staging. Of 36 patients undergoing radical cystectomy 9 (25 per cent) had microscopic pelvic lymph node involvement. Nine patients underwent urinary diversion alone and 31 presented with perivesical or pelvic nodal tumor extension, or distant metastases. Only 8 of the 90 patients (9 per cent) had prior superficial bladder cancer. The mean survival for patients with stage B to C disease at diagnosis was 23 months and for those with stage D tumor it was 11 months. This experience indicates that the majority of patients with advanced bladder cancer are not identified at a stage when definitive therapy offers an excellent prognosis. More resources must be devoted to earlier detection. PMID- 6864918 TI - Hematoporphyrin derivative and laser photoradiation in the diagnosis and treatment of bladder cancer. AB - Diagnosis and treatment of 8 patients with malignant bladder tumors were performed with intravenous administration of hematoporphyrin derivative, followed by krypton-ion laser violet light photoradiation and argon-dye laser red light photoradiation therapy. Fluorescence permitting localization and evaluation of the lesion was recognized in all 8 patients. Photoradiation with red argon-dye laser light obtained complete remission in 6 patients, with followup from 6 to 18 months. To our knowledge this is the first report describing total regression of bladder tumors obtained by photoradiation. Swelling and edema were noted within 20 minutes after argon-dye laser photoradiation therapy of bladder tumors. Necrosis and partial covering of the tumor by a whitish necrotic mass were noted after 3 days. The whitish mass covered the entire tumor at 7 to 14 days. Gradual exfoliation of the mass was followed by disappearance of the tumor and regeneration of normal mucosa at 9 to 10 weeks. PMID- 6864919 TI - The value of ultrasound as a screening procedure for urological disorders in renal failure. AB - Renal ultrasound was evaluated as a screening procedure for urological conditions (hydronephrosis or space-occupying lesions) in 175 patients (316 kidneys) with renal failure. The final diagnosis of renal disease was based on excretory urography, ascending or translumbar pyelography, open surgical findings, clinical and laboratory test results or renal biopsies. Ultrasonic images suggestive of renal disease requiring surgery were obtained in 83 kidneys and subsequently confirmed in 67. There were 16 falsely positive and 2 falsely negative results. Assuming a 22 per cent prevalence of renal disease requiring surgery in the azotemic population, Bayes' theorem predicts that an abnormal ultrasonic test will increase the probability of surgery in a patient with renal failure from 0.22 to 0.81, while a negative test will reduce the probability from 0.22 to 0.013. Renal ultrasound is a highly effective method to screen for patients with renal failure who require contrast studies. With this means the risks and cost of contrast investigations can be reduced markedly. PMID- 6864920 TI - Bladder cancer: Part VI. PMID- 6864921 TI - Nocturnal penile tumescence with stamps: a comparative study under sleep laboratory conditions. AB - The usefulness of nocturnal penile tumescence with stamps to measure erections during sleep has been evaluated under laboratory conditions and compared to strain gauge recording. If the ring of stamps does not break a diagnosis of organic dysfunction is supported. However, if breakage occurs at the perforations no diagnostic conclusion can be made. The diagnostic importance of nocturnal penile tumescence with stamps is limited. PMID- 6864922 TI - Penile elongation: a method for the screening of impotence. AB - Circumferentially assessed penile responses less than 10 per cent of maximal tumescence usually are regarded as random variation. However, several investigators have hypothesized that one of the initial responses to sexual stimulation is a lengthening of the penile shaft. Circumferential measurements detect this lengthening as a decrease in penile circumference. Two experiments were conducted to investigate this hypothesis. During the first experiment penile circumference changes were monitored at 2 levels of voltage sensitivity. A reliable voltage decrease was observed for all subjects immediately after the introduction of an erotic stimulus. In the second experiment the penis was videotaped to determine the magnitude of penile lengthening that occurred during the circumferential decrease. The results indicated that a substantial penile length change occurred (mean 34.5 per cent of the total erection length change) before any diameter increase was evident. A small number of impotent patients with a clear etiology were investigated using this new test. The results suggest that penile elongation occurs in the absence of full erections in patients with psychogenic impotence, while circumferential and longitudinal changes do not appear after visual erotic stimuli in organically impotent patients. The penile elongation test may prove useful in the etiological screening of impotent patients. PMID- 6864924 TI - Hormonal treatment at time of radical retropubic prostatectomy for stage D1 prostate cancer. AB - We classified 70 prostatic cancers as stage D1 at the time of pelvic lymphadenectomy and radical prostatectomy. For retrospective analysis after 1 to 14 years of followup, the patients were divided into 32 in whom endocrine therapy had been given immediately postoperatively and 38 in whom it had not. These 2 groups did not differ substantially in patient age, Gleason grade, pathologic stage, tumor volume or seminal vesicle involvement. The mean number of involved nodes per patient was higher in the hormone-treated group (2.9 versus 1.8). According to Kaplan-Meier projections 88 per cent of such patients without hormonal treatment will have progression within 5 years, compared to only 14 per cent of those given hormonal treatment immediately. However, projected survival differed little between the groups, most likely since 17 of the 18 patients with progression in the nontreated group were given hormonal treatment as soon as progression was substantiated. Definitive assessment of the impact of the timing of endocrine therapy on patient survival and time to disease progression awaits a randomized trial with long-term followup. PMID- 6864923 TI - Testicular torsion in the adult. AB - Testicular torsion in men more than 21 years old seems to be as common as in prepubertal boys, accounting for 26 per cent of our cases. Of these patients 10 per cent were more than 30 years old. A previous similar episode will have occurred in nearly half of the patients and is the only helpful historical data. A negative urinalysis is the rule and, while not diagnostic, testicular torsion should be the presumptive diagnosis. Doppler examination and radionuclide scans are accurate and reliable but in our series these studies added little to the plan of management. Manual detorsion can be accomplished with local anesthesia in approximately 70 per cent of the patients and always should be attempted. Delay in operation beyond 12 hours resulted uniformly in loss of the testicle, primarily by orchiectomy or secondarily by atrophy. While correction of the torsion before 6 to 8 hours does not ensure success the rate of salvage is higher. Scrotal exploration for testicular torsion is simple and has little morbidity. Exploration should be done in any patient with acute unilateral scrotal swelling and a negative urinalysis, regardless of age. PMID- 6864925 TI - And for now: two innovative methods. PMID- 6864927 TI - NK cell activity decreases in thermal injury. PMID- 6864928 TI - Leads from the MMWR. Pertussis--Maryland, 1982. PMID- 6864926 TI - For the future: polymer-drug systems. PMID- 6864929 TI - Leads from MMWR. Niacin intoxication from pumpernickel bagels--New York. PMID- 6864931 TI - Dialume-Diabinese disaster. PMID- 6864930 TI - The dangers of cooking with bay leaves. PMID- 6864932 TI - Laboratory test ordering: a syndrome affecting clinicians. PMID- 6864933 TI - Fees. PMID- 6864935 TI - Addition applications for cyclosporine? PMID- 6864934 TI - Psychosocial impact of acquired immune deficiency syndrome. PMID- 6864937 TI - Defusing adverse effects of anticancer drugs. PMID- 6864936 TI - Panel ponders organ procurement problem. PMID- 6864938 TI - Leads from the MMWR. Heroin-related deaths--District of Columbia, 1980-1982. PMID- 6864940 TI - Cancer and serum cholesterol levels. PMID- 6864939 TI - Leads from MMWR. Human plague--United States, 1983. PMID- 6864941 TI - WBC differential counts. PMID- 6864942 TI - Factitious asthma. PMID- 6864943 TI - Theophylline exacerbating spasticity. PMID- 6864944 TI - Microcytosis. PMID- 6864945 TI - Antitrust and professional activities. PMID- 6864946 TI - Chemical-biological warfare in Asia. PMID- 6864947 TI - Cigarette smoking and dysplasia and carcinoma in situ of the uterine cervix. AB - We conducted a case-control study of cigarette smoking and dysplasia and carcinoma in situ of the uterine cervix. Cases were black women 17 to 55 years of age who were attending a dysplasia clinic and had biopsy-confirmed cervical pathologic conditions. Controls were women who were attending the family planning clinic at the same hospital and who had at least two normal Papanicolaou smears. Results were adjusted for age, number of sexual partners, age at first intercourse, socioeconomic status, and oral contraceptive use. Cigarette smoking was significantly associated with carcinoma in situ, severe dysplasia, and mild moderate dysplasia (relative risks, 3.6, 3.3, and 2.4, respectively). Cumulative exposure to cigarette smoking (as measured by pack-years smoked) was strongly related to the risk of these conditions; women with 12 or more pack-years of exposure had relative risks of 12.7, 10.2, and 4.3, respectively, for the three conditions. There was some evidence that the risk was greatest in women who began smoking in their early teenage years. A reduction in the risk of cervical cancer appears to be another inducement for young women not to smoke. PMID- 6864948 TI - Skin markings in malignant melanoma. AB - Photographic analysis of the skin markings in 92 malignant melanomas (66 superficial spreading, seven nodular, 12 acral lentiginous, and seven lentigo maligna melanomas) was undertaken. Skin markings are uniformly eradicated in areas of vertical growth phase disease and sometimes in areas of regression. Not only were skin markings always preserved in areas of radical growth phase disease, but they were sometimes accentuated. For all types of melanoma, loss of skin markings is a poor diagnostic criterion because it is a late sign associated with invasion of the dermis and thus a deteriorating prognosis. PMID- 6864951 TI - Lethal congenital anomalies as a cause of birth-weight-specific neonatal mortality. AB - The percentage of neonatal mortality caused by lethal congenital anomalies and the distribution of specific anomalies in various birth-weight groups are presented. State vital statistics data and autopsy-confirmed data from a single hospital are compared. Of neonates who died, less than 5% who were born weighing between 500 and 999 g died of a congenital anomaly, and nearly 45% who were born weighing more than 2,500 g died of a congenital anomaly. Most deaths associated with congenital anomalies in infants born weighing more than 2,500 g are cardiac in origin. Twenty-three percent of all neonatal deaths in Alabama are attributed to a lethal congenital anomaly. Use of these data to define limits to future improvements in neonatal mortality by standard medical care is discussed. PMID- 6864949 TI - A methodological critique of the 'ideal weight' concept. AB - This article raises several objections to the procedures that were employed to determine ideal (optimal, desirable) weights in the 1959 and 1979 Build and Blood Pressure studies, the Framingham (Mass) study, and the recent study of the relationship between weight and mortality carried out by the American Cancer Society. The new height-weight tables based on the 1979 Build and Blood Pressure study are also criticized. The article concludes with the recommendation that the concept of ideal weight be abandoned and that attention be devoted to the morbidity and mortality experience of "outliers" (the very thin and the very obese). PMID- 6864952 TI - Smoking and cervical cancer. PMID- 6864950 TI - Nitrous oxide analgesia for refractory pain in the terminally ill. AB - Nitrous oxide analgesia was used in the management of the terminal hospitalization of four adolescents and one child with disseminated cancer. All patients had severe pain that was unresponsive to standard regimens of narcotics and various narcotic analgesia-stimulant combinations. In each case, the addition of nitrous oxide led to an obvious improvement in symptoms of pain, anxiety, and agitation, while simultaneously improving appetite, mood, and the capacity to communicate. There were no side effects except those related to the discomfort of wearing a mask. Acceptance of the procedure by patient, family, and staff was universal and enthusiastic. The procedure is safe, easily administered, and noninvasive. Nitrous oxide can be useful in managing terminal illness refractory to standard pain control measures. PMID- 6864953 TI - Lethal congenital anomalies. PMID- 6864954 TI - Studies show the obese may prefer fats to sweets. PMID- 6864955 TI - Leads from the MMWR. Rubella outbreaks among office workers--New York City. PMID- 6864956 TI - Leads from the MMWR. Alcohol use and teenage drivers, fatal vehicle accidents- United States. PMID- 6864957 TI - Diagnosis of brain death. PMID- 6864958 TI - Dengue in the Caribbean. PMID- 6864960 TI - Endoscopic retrograde cholangiopancreatography. PMID- 6864962 TI - The effect of type of delivery on neonatal outcome in singleton infants of birth weight of 1,000 g or less. AB - To evaluate the relationship between management of delivery and neonatal outcome in singleton neonates with birth weights between 501 and 1,000 g, a retrospective analysis was performed. In the 54-month period ending June 30, 1981, a total of 109 singleton neonates were born at Vanderbilt University Hospital, Nashville, Tenn, with birth weights between 501 and 1,000 g, 31 weighing 501 through 750 g, and 78 weighing 751 through 1,000 g. The overall neonatal survival rate was 60%, 39% in the group weighing 501 through 750 g and 69% in the group weighing 751 through 1,000 g. In terms of morbidity and mortality, there was no difference between neonates delivered by cesarean section compared with those delivered vaginally. The only significant factor found relating to neonatal mortality was the occurrence of labor. In the 17 newborns delivered without occurrence of labor, the frequency of neonatal death was significantly decreased, although this difference may be caused by differing risk factors in the infants delivered without occurrence of labor. When labor was present and the fetus had a cephalic presentation, cesarean section was not found to be superior to vaginal delivery in terms of neonatal morbidity or mortality for neonates of 1,000 g or less. PMID- 6864961 TI - Cholestasis and rubeola. PMID- 6864959 TI - Treatment of colleagues. PMID- 6864963 TI - Mercury intoxication simulating amyotrophic lateral sclerosis. AB - A 54-year-old man had a syndrome resembling amyotrophic lateral sclerosis after a brief but intense exposure to elemental mercury. The syndrome resolved as his urinary mercury levels fell. Mercury toxicity must be considered not only in individuals with recent anterior horn-cell dysfunction but also with otherwise unexplained peripheral neuropathy, tremor, ataxia, and a gamut of psychiatric symptoms including confusion and depression. PMID- 6864964 TI - Dapsone treatment of a brown recluse bite. PMID- 6864965 TI - Hospital-bed deaths, injuries force down-switch modifications. PMID- 6864966 TI - FDA approves aspartame as soft-drink sweetener. PMID- 6864968 TI - Leads from the MMWR. Influenza surveillance summary--United States, 1982-1983 season. PMID- 6864969 TI - Leads from the MMWR. Update: poliomyelitis outbreak--Taiwan. PMID- 6864970 TI - Can the intensive care unit be harmful? PMID- 6864967 TI - Disability evaluation: a fledgling science? PMID- 6864971 TI - Passive inhalation of marijuana smoke. PMID- 6864972 TI - Toxicity of mediastinal irrigation with bacitracin. PMID- 6864974 TI - Our art, our heritage. PMID- 6864973 TI - The battle for hospital privileges. PMID- 6864975 TI - Drug abuse in anesthesia training programs. A survey: 1970 through 1980. AB - Experience at our institution with drug dependence among anesthesia residents, coupled with a lack of published data, prompted us to survey US anesthesia training programs. Two hundred eighty-nine programs were surveyed, 247 (85.5%) responded, and 184 (74%) of these programs had at least one suspected incident of drug dependence to report. Three hundred thirty-four confirmed persons were reported, including a substantial number of instructors. Meperidine and fentanyl were the most frequently mentioned drugs. Behavior changes were frequently noted by staff personnel, and in general such changes led directly to detection. After confirmation of abuse, the majority of impaired anesthetists were referred for psychiatric care, with few in need of actual detoxification. Detailed follow-up was available for about 40% of the total; 71 persons were offered a return to their original place of employment, while 30 persons died of drug overdose. Chemical impairment may be more common than usually thought in anesthesia, perhaps in part because of drug availability. PMID- 6864976 TI - Herpes zoster infection and use of oral anticoagulants. A potentially dangerous association. PMID- 6864977 TI - Hypouricemia in the hypereosinophilic syndrome. Response to treatment. PMID- 6864978 TI - Hypertension and its treatment. PMID- 6864979 TI - Quantitative relationships between thallium-201 estimated myocardial infarct size and left ventricular function in the acute or convalescent phase of the first attack of myocardial infarction. PMID- 6864980 TI - Two-dimensional echocardiographic demonstration of so-called aneurysm of the membranous ventricular septum in adults--value of combined "manual scanning". AB - Using two-dimensional (2-D) echocardiography we evaluated the applicability of the left ventricular (LV) short axis view combined with manual scanning technique for the detection and evaluation of aneurysms of the membranous ventricular septum (AMS). In 12 patients with angiographically proven AMS, we recorded from the left sternal border the short axis view of the left ventricle continuously displayed from the aortic to the ventricular level by tilting the transducer manually along the LV long axis plane. We then compared the detectability of AMS by this method with that by other standard fixed 2-D echocardiographic views. This method proved to be best for the detection of AMS (12/12), followed by an apical four-chamber view (10/12), a parasternal LV long axis view (8/12) and an apical two-chamber (2/12) view. For the detection of AMS and for three dimensional evaluation of the structure of the AMS and the original orifice of ventricular septal defect the method was shown to be clinically applicable. PMID- 6864981 TI - Right ventricular function in patients with mitral stenosis. PMID- 6864982 TI - Noninvasive evaluation of arterial occlusive disease. AB - A procedure for observing blood flow during early reactive hyperemia, which uses prolonged venous occlusion following 3 min of arterial occlusion, is described. A mercury strain gauge was applied around the mid-calf and 3 tracings were simultaneously recorded during reactive hyperemia: the change in venous volume, its derivative and amplified pulse waves. The method was evaluated in animals, normal volunteers and in patients with symptoms of arterial insufficiency. This bedside procedure was found to be convenient and practical. Peak flow during reactive hyperemia was found to have an accuracy comparable to the ankle/arm pressure index in distinguishing between normal, stenotic or occluded lower extremity arterial systems. In addition, it proved more accurate than pressure measurements in diabetic patients with incompressible calcified vessels. PMID- 6864983 TI - Circadian rhythm of blood pressure in primary aldosteronism and renovascular hypertension--analysis by the cosinor method. AB - The circadian rhythm of blood pressure in 11 patients with primary aldosteronism (ALD) and 15 patients with unilateral renovascular hypertension (RVH) was analyzed using the cosinor method which fits a cosine function to a series of data. In ALD, both systolic (SP) and diastolic blood pressures (DP) increased in the late evening; the amplitude and acrophase of the circadian rhythm for SP were 7.3 (5.3 to 9.3, mean and 95% confidence limits) mmHg and 20:47 (19:42 to 21:52) hours, respectively, and for DP 2.6 (1.3 to 3.9) mmHg and 21:34 (19:40 to 23:28) hours, respectively. After excision of an adrenal adenoma in 6 patients, the circadian rhythm of SP and DP was abolished. In RVH, the acrophase of the circadian rhythm of SP and DP differed by about 12 hours; the amplitude and acrophase for SP were 5.7 (3.9 to 7.5) mmHg and 17:49 (16:35 to 19:02) hours, respectively, and for DP 1.5 (0.2 to 2.7) mmHg and 6:08 (2:44 to 9:31) hours, respectively. After various surgical interventions in 8 patients, the circadian rhythm of SP persisted with little change in acrophase, while that of DP disappeared. The difference in circadian rhythm suggests a difference in mechanisms of blood pressure control in ALD and RVH. PMID- 6864984 TI - Increased response of blood pressure to rest and handgrip in subjects with essential hypertension. AB - The blood pressure (BP) response to supine rest for one hour and to an isometric handgrip exercise (3 min, 30%, of maximum) was investigated in 18 healthy normotensive men (N) (casual BP 117 +/- 6 / 73 +/- 5 mmHg, 39 +/- 3 years old) (mean +/- SD) and 50 men with essential hypertension (H) (162 +/- 13 / 105 +/- 9 mmHg, 41 +/- 4 years old). Casual BP was decreased by rest to resting BP (113 +/- 7 / 70 +/- 7 in N and 140 +/- 15 / 93 +/- 11 mmHg in H). H was divided into 3 groups of H-1 (resting BP of 124 +/- 7 / 80 +/- 4 mmHg), H-2 (137 +/- 9 / 92 +/- 4) and H-3 (154 +/- 10 / 104 +/- 4). The decreases in BP with rest were significantly greater in Groups H-1 (30 mmHg in systole / 20 mmHg in diastole, p less than 0.001), H-2 (23/11, p less than 0.001) and H-3 (16/8, p less than 0.001/0.05) as compared with those in N (4/3), and this decrease significantly correlated with the resting systolic BP in H (r = -0.601, p less than 0.001) and with diastolic BP (r = -0.604, p less than 0.001). The handgrip exercise increased BP (42/28, 55/35, 39/26 and 30/26 mmHg in Groups H-1, H-2, H-3 and N, respectively). The increase in systolic BP was significantly greater in Groups H 1, H-2 and H-3 than in N (p less than 0.001, p less than 0.001 and p less than 0.01, respectively), and the increase in diastolic BP was significantly greater in Group H-2 than in N (p less than 0.05), but not in Groups H-1 and H-3. The significant decrease in BP with rest and the significant increase in BP by the exercise may represent the pathophysiological nature of the cardiovascular response in the early stage of essential hypertension. PMID- 6864985 TI - Clinical significance of systolic time intervals for the evaluation of left ventricular function in patients with coronary artery disease. PMID- 6864987 TI - The failure of oxygen breathing to decrease the myocardial contractile force in denervated dogs. AB - This study was done to discover whether or not the oxygen-induced depression of sympathoadrenal activity contributes to a reduction of myocardial contractile force during oxygen breathing. In 10 open-chest dogs, myocardial contractile force was measured using a myocardial strain gauge arch during air and oxygen breathing before denervation (intact heart) and after bilateral vagotomies, sympathectomies and adrenalectomies with the intravenous administration of propranolol, phenoxybenzamine and atropin (denervated heart). One hundred percent oxygen breathing caused similar increases in arterial pO2 in both the intact (from 94 +/- 10 to 442 +/- 25 mmHg) and the denervated dogs (from 113 +/- 11 to 456 +/- 15 mmHg). Coronary blood flow measured at the left anterior descending coronary artery was reduced by oxygen breathing from 28.4 +/- 3.4 to 21.7 +/- 2.3 ml/min in the intact dogs, and from 19.4 +/- 3.4 to 14.9 +/- 2.6 ml/min in the denervated dogs. Myocardial contractile force was significantly reduced by oxygen breathing in the intact dogs (a reduction of 5.8 +/- 1.4%). In the denervated dogs, on the other hand, no significant changes in myocardial contractile force was seen. This study suggests that the reduction in myocardial contractile force is mediated through sympathoadrenal activity, and thus, is abolished by sympathoadrenal blockade. PMID- 6864986 TI - Electrophysiological effects of nicardipine hydrochloride on the isolated sinoatrial and atrioventricular nodes of the rabbit. AB - The electrophysiological effects of nicardipine-HCl, a new calcium antagonist and potent vasodilator, were studied in the isolated sinoatrial (SA) and atrio ventricular (AV) nodes of the rabbit in an oxygenated Tyrode solution at 35 degrees C using an intracellular microelectrode technique. Nicardipine-HCl decreased the spontaneous rate of the SA node and prolonged sinus recovery time, dose-dependently. The effective refractory period (ERP) and functional refractory period (FRP) of the AV node and AV conduction time (A-H interval) were also prolonged by nicardipine-HCl in a dose-dependent manner. In conclusion, nicardipine-HCl has electrophysiological effects on the SA and the AV node similar to those of other calcium antagonists in the excised and superfused rabbit heart. PMID- 6864988 TI - The effects of verapamil on mitochondrial dysfunction associated with coronary reperfusion. AB - In order to clarify the protective mechanism of verapamil, the following experiment was performed. Twenty-four anesthetized dogs were divided into 3 groups of 8 animals each. In the first, the left anterior descending coronary artery (LAD) was occluded for 15 min; in the second, 5-min reperfusion was done following a 15-min occlusion; in the third, prior to 5-min reperfusion, verapamil (0.4 mg/kg) was infused for 5 min. In each group, heart mitochondria were prepared from the normal and occluded or reperfused areas and their functions were estimated polarographically. The contents of calcium, phospholipids and fatty acids in the mitochondria were also measured by atomic absorption spectrophotometry, Allen's method and gas chromatography, respectively. Although occlusion induced mitochondrial dysfunction, the dysfunction was exacerbated by reperfusion. Occlusion alone did not alter the contents of calcium, phospholipids and fatty acids in mitochondria, while occlusion and subsequent reperfusion increased calcium and fatty acids and decreased phospholipids in mitochondria. Verapamil prevented these reperfusion responses. These results suggest that reperfusion injury of mitochondria is based on the degradation of mitochondrial phospholipids, which is caused by an activation of phospholipase, being triggered by a calcium increase. Verapamil, a calcium antagonist, might protect against reperfusion injury by inhibiting the activation of phospholipase. PMID- 6864990 TI - [Regional meetings of the Japanese Circulation Society 1982: Abstracts]. PMID- 6864989 TI - The inhibitory effect of lipid peroxide on the activity of the membrane-bound and the solubilized lipoprotein lipase. AB - The effects of lipid peroxide (15-hydroperoxy arachidonic acid) on the activity of lipoprotein lipase was investigated. The activities were examined in 2 enzyme species: the lipoprotein lipase bound to the coronary vessels of the rat heart and that solubilized in the human post-heparin plasma. As a substrate, 3H labelled human chylomicron was used. Lipid peroxide decreased the maximal velocity of the reaction between the chylomicron and lipoprotein lipase on the vascular surface. In the post-heparin plasma, the lipid peroxide decreased the maximal hydrolysis rate, but did not change the half life time in the unsaturated reaction. It is suggested that lipid peroxide directly damages a part of the membrane-bound lipoprotein lipase, and that the degeneration of cell membranes and the vasoconstriction caused by lipid peroxide will additionally disturb the hydrolysis of the plasma triglyceride on the vascular surface. PMID- 6864992 TI - [The effects of cervical epidural anesthesia on baroreceptor reflexes]. PMID- 6864991 TI - [Study of anaphylactic shock using ovalbumin-sensitized dogs. 1. Hemodynamics]. PMID- 6864993 TI - [Systemic accumulation of mepivacaine during continuous extradural analgesia]. PMID- 6864994 TI - [Prevention of pre-relaxation fasciculation induced by succinylcholine chloride]. PMID- 6864995 TI - [Application of cyclazocine in modified neuroleptanesthesia]. PMID- 6864996 TI - [Clinical evaluation of alcohol-induced pituitary neuroadenolysis for cancer pain]. PMID- 6864997 TI - [Cardiopulmonary cerebral resuscitation]. PMID- 6864999 TI - [Indirect ignition of the endotracheal tube and the elastic part of the bronchofiberscope during endoscopic laser surgery]. PMID- 6864998 TI - [Atypical malignant hyperthermia]. PMID- 6865000 TI - [2 cases of tracheomegaly]. PMID- 6865002 TI - [Fluctuations in serum calcitonin levels and anesthesia during excision of the ectopic parathyroid gland]. PMID- 6865001 TI - [Effect of anesthesia and surgery on glucagon level in a glucagon deficient patient]. PMID- 6865003 TI - [Coronary flow patterns and factors affecting the flow]. PMID- 6865004 TI - [Metabolic changes of the ischemic myocardium]. PMID- 6865005 TI - [Discovery of coronary spasm and subsequent developments]. PMID- 6865006 TI - [Coronary spasm and intravascular coagulation]. PMID- 6865007 TI - [The role of blood viscosity]. PMID- 6865008 TI - [Risk factors of coronary spasm]. PMID- 6865009 TI - [X-ray diagnosis of coronary spasm]. PMID- 6865010 TI - [Coronary spasm and cardionuclear medicine]. PMID- 6865011 TI - [Therapy and prognosis of intravascular coagulation]. PMID- 6865012 TI - [Risk factors affecting the prognosis of coronary spasm]. PMID- 6865013 TI - [Electron microscopic findings and cellular immunity of the lacrimal gland in Sjogren's disease]. PMID- 6865014 TI - [ADCC (antibody-dependent cell-mediated cytotoxicity) in Sjogren's disease]. PMID- 6865015 TI - [Lymphocyte cytotoxicity actions (antibody-dependent cell-mediated cytotoxicity and NK function) in Sjogren's disease]. PMID- 6865016 TI - [Antilymphocyte antibody in Sjogren's disease]. PMID- 6865017 TI - [PWM (pokeweed mitogen)-induced in vitro antibody production by peripheral lymphocytes of patients with Sjogren's syndrome]. PMID- 6865018 TI - [Case of Sjogren's syndrome with IgA deficiency showing a positive reaction to the salivary gland and spleen-related antigen in the leukocyte migration inhibition test]. PMID- 6865019 TI - [Clinical statistics in Japan: information and numerical values]. PMID- 6865020 TI - [I. Principles and applications of immunoassay: radioimmunoassay]. PMID- 6865021 TI - [I. Principles and applications of immunoassay: basic knowledge of antigen antibody reactions]. PMID- 6865022 TI - [Colorimetric determination of coagulation factor XII in blood plasma]. PMID- 6865024 TI - [Cardiac catheterization --pulmonary blood flow analysis by a multisensor catheter]. PMID- 6865025 TI - [Ultrasonic diagnosis in the circulatory system]. PMID- 6865026 TI - [Progress and problems in cardiovascular function tests--exercise test]. PMID- 6865027 TI - [Assay of glycosylated hemoglobin]. PMID- 6865023 TI - [Influence of the protein induced by vitamin K absence on thrombotest and hepaplastintest in the patients treated with oral anticoagulant]. PMID- 6865028 TI - [Leiomyogenic tumors of the intestine]. PMID- 6865029 TI - [Study on Lp-X. (1) Relation between semiquantitative values of Lp-X and various chemical components]. PMID- 6865030 TI - [Immunoturbidimetric assay of fibronectin in plasma and synovial fluid]. PMID- 6865031 TI - [The variation of serum lipoperoxide in liver diseases]. PMID- 6865032 TI - [A histopathological and statistical study of pulmonary mycosis in the autopsied cases]. PMID- 6865033 TI - [Clinical application of monoclonal antibodies in laboratory medicine]. PMID- 6865034 TI - [Production and clinical applications of monoclonal antibodies against measles virus and HBs antigen]. PMID- 6865035 TI - [Latex photometric immunoassay (LPIA)]. PMID- 6865036 TI - [At conclusion of the symposium to explain the revised WHO histological classification of lung and breast tumors]. PMID- 6865037 TI - [Surgical pathology of vaginal and vulvar diseases]. PMID- 6865038 TI - [Determination of fibrinogen subfractions by glycine method and SDS disc electrophoresis]. PMID- 6865039 TI - [An improved colorimetric assay of plasma plasminogen with chromogenic peptide substrate]. PMID- 6865040 TI - [Correlation between saponin hemolysis and hypotonic hemolysis]. PMID- 6865042 TI - [A simple analysis of apoprotein C of human very low density lipoproteins by polyacrylamide gel plate isoelectric focusing and its clinical applications]. PMID- 6865043 TI - [Occult rupture and delayed rupture of the spleen]. PMID- 6865041 TI - [Clinical significance of serum C reactive protein in leukemia]. PMID- 6865044 TI - [Preoperative tumor localization of primary hyperparathyroidism]. PMID- 6865046 TI - [ROC analysis applied to the evaluation of breast image diagnosis]. PMID- 6865045 TI - [CT diagnosis and treatment of lymph node metastases from carcinoma of the cervix]. PMID- 6865048 TI - [A case of pulmonary varix]. PMID- 6865047 TI - [Indication for radiation therapy as treatment of breast cancer patients upon the postoperative recurrent and positive parasternal cases]. PMID- 6865049 TI - [Computed tomography of three cases of hepatic hemangioma]. PMID- 6865050 TI - [An autopsy case of squamous cell carcinoma arising from the pancreas]. PMID- 6865051 TI - [A case of splenic hemangioma]. PMID- 6865052 TI - [A case of primary carcinoma of the ileum]. PMID- 6865053 TI - [Anastomosis of inferior mesenteric vein and left spermatic vein in a case of portal hypertension]. PMID- 6865055 TI - [Adult cretinism]. PMID- 6865054 TI - [The new study on stereographic displays]. PMID- 6865056 TI - [Technetium-99m stannous pyrophosphate myocardial scintigraphy]. PMID- 6865057 TI - [Experimental studies on metastatic skin cancer]. PMID- 6865058 TI - [Cutaneous lymphatic vessels of 12-week-old human embryos--light and electron microscopic observations]. PMID- 6865059 TI - [Leukocytoclastic vasculitis with pustular formation: two cases caused difficulty in diagnosing whether they belonged to Schonlein-Henoch purpura or acute generalized pustular bacterid]. PMID- 6865061 TI - [Scanning electron microscopic observation of the gastric mucosa of rats given water immersion stresses]. PMID- 6865060 TI - [Clinical significance of serum group I pepsinogen level in gastric duodenal diseases]. PMID- 6865062 TI - [A rat's model of neurogenic stress gastric ulcer--studies on distribution of produced ulcers, and on effect of cimetidine and atropine]. PMID- 6865063 TI - [Plasma secretin levels and gastric pH after a meal]. PMID- 6865064 TI - [A new method of testing for carbohydrate absorption--D-xylose absorption by ileal perfusion technic]. PMID- 6865065 TI - [Clinical study of limy bile--report of 12 cases]. PMID- 6865067 TI - [Measurement of gastric mucosal blood flow with hydrogen clearance technic: a new method for fixation of electrode using gastric fistura]. PMID- 6865068 TI - [Serum bile acid profile in total gastrectomy]. PMID- 6865066 TI - [A case of splenic abscess]. PMID- 6865069 TI - [Reconsideration of hydrogen clearance method--influence of residual hydrogen in the arterial blood]. PMID- 6865070 TI - [Effects of hematoporphyrine derivative (HpD) and laser irradiation on rat hepatoma cells in vitro]. PMID- 6865071 TI - [Gastrin of the gastrointestinal lumen. Luminal gastrin of the duodenal origin: evaluation of the conditions for its release and molecular types]. PMID- 6865072 TI - [The effects of exogenous and endogenous glucagon on gastric emptying, small bowel transit time and plasma motilin concentration]. PMID- 6865073 TI - [Use of 15 N in tests for digestive and absorptive functions. 1. Digestion and absorption tests using 15 N-labelled rice]. PMID- 6865074 TI - [Severe liver injuries with cognition disorders during pregnancy and parturition]. PMID- 6865075 TI - [Evaluation of alcoholic liver diseases by multiple regression analysis of the results of liver function tests]. PMID- 6865076 TI - [Ultrasonically guided percutaneous drainage of the gallbladder in acute suppurative cholecystitis]. PMID- 6865077 TI - [Effects of long-term intravenous administration of ethanol on rat pancreas]. PMID- 6865078 TI - [Acquired double pylorus caused by gastroduodenal ulcer]. PMID- 6865079 TI - [Case of progressive systemic sclerosis with marked gastrointestinal lesions but with sparse skin conditions]. PMID- 6865082 TI - [69th meeting of the Japanese Society of Gastroenterology. Osaka, 11-13 April 1983 [Abstracts]. PMID- 6865080 TI - [Specificity of 2 types of antibodies against liver cell membrane (anti-LM and anti-LSP) in sera of patients with chronic active liver diseases]. PMID- 6865081 TI - [Case of cholelithiasis with formation of hollow calcified structures following ursodeoxycholic acid treatment]. PMID- 6865083 TI - Priority pollutants in the Kitakyushu water supply. PMID- 6865085 TI - [The prevalence of itai-itai disease and the mean cadmium concentration in rice produced by individual villages]. PMID- 6865084 TI - [The distribution of lead in rat organs with relation to the levels of iron, zinc and copper]. PMID- 6865086 TI - [The effects of noise on rat psychomotor activity]. PMID- 6865087 TI - [Studies on metabolism of mercury compounds in mouse, rat and carp--with special reference to biological half lives and distribution of mercury compounds in whole body and in individual organs]. PMID- 6865088 TI - [Temporal distribution of REM and stage 4 sleep in different time periods]. PMID- 6865089 TI - [A study of pulmonary functions in elderly men and women by flow-volume curve]. PMID- 6865090 TI - Promoting effects of long-term administration of barbital on spontaneous hepatic tumorigenesis in B6C3F1 mice. PMID- 6865091 TI - [Studies of bacterial aerosols. Part 8. Bacteria dispersal from humans into air comparing the rates at rest and during physical exercise]. PMID- 6865092 TI - [Effects of tricyclohexyltin hydroxide on carbohydrate and lipid metabolisms]. AB - Male Japan white rabbits were given orally with two doses of tricyclohexyltin hydroxide (TCHT, 250 mg/kg body weight) at 48 hr intervals and their carbohydrate and lipid metabolisms were investigated 48 hr after the last administration. Elevated fasting blood glucose levels and a significant inhibition of insulin (IRI, immunoreactive insulin) release in response to the intravenous glucose infusion were observed. Microscopic examination of pancreatic islets did not reveal any histological alteration. Plasma triglyceride levels were elevated in the TCHT-treated rabbits. Ultracentrifugation of plasma lipoproteins revealed a marked increase in chylomicron + VLDL (very low density lipoprotein) fraction. Rates of triglyceride secretion into plasma were not different between the TCHT treated and the control animals. These data suggest that TCHT induces hyperglycemia and hyperlipidemia in rabbits, and the disturbance of metabolism seems to be related to the inhibition of insulin release from the pancreatic islets by TCHT. PMID- 6865093 TI - [The effect of triphenyltin fluoride on aggregation, ATP secretion and malondialdehyde formation of rabbit platelets in vitro]. AB - Recent studies have demonstrated that triphenyltin fluoride (TPTF), widely used as an agricultural chemical and a marine antifoulant, inhibits collagen-induced platelet aggregation and ATP secretion in rabbits ex vivo. The aim of the present investigation was to elucidate the mechanism of the inhibitory action of TPTF by investigating platelet malondialdehyde (MDA) formation, aggregation and ATP secretion following the stimulation by various stimuli of rabbit platelets treated in vitro with TPTF, other triphenyl metals and aspirin. Although no inhibitory effect of TPTF was found on sodium arachidonate-induced platelet aggregation and ATP secretion, TPTF inhibited dose-dependently both platelet aggregation and ATP secretion induced by collagen. The antiaggregating (IC50) concentration of TPTF was 6.0 X 10(-6) M against collagen. In addition, TPTF prevented the collagen-, and thrombin-induced formation of MDA, but had little inhibitory effect on the conversion of exogenous arachidonic acid to MDA in platelets. In contrast, aspirin (10(-3) M) inhibited platelet aggregation, ATP secretion and MDA formation induced by all the stimuli tested. Other triphenyl metals did not any inhibitory effect on collagen-, and sodium arachidonate induced platelet aggregation and ATP secretion even at a final concentration at 10(-3) M. These results suggest that TPTF has a specific inhibitory effect on platelet aggregation and ATP secretion by acting at some step(s) of platelet membrane between the binding site of collagen and thrombin and the release of arachidonic acid. PMID- 6865094 TI - [Olfactory disorders in chemical plant workers exposed to SO2 and/or NH3]. PMID- 6865095 TI - [2 cases of "green tobacco disease" among tobacco harvesters and percutaneous nicotine absorption in rats]. PMID- 6865096 TI - [Simple method of analysis of beta-naphthylamine contained in commercial alpha naphthylamine using high speed liquid chromatography]. PMID- 6865097 TI - [Case of probable Behcet's disease in an automobile painter]. PMID- 6865098 TI - Immunological characteristics of anti-A and anti-B blood group antibodies in the cynomolgus monkey. AB - Anti-A and anti-B blood group antibodies in the cynomolgus monkey sera were serologically characterized. 2-Mercaptoethanol (2-ME) inactivated these antibodies of both group-A and group-B sera. Furthermore, soluble human ABH substances neutralized these antibody activities. However, these activities were not inhibited by anti-human IgG or IgA serum but by anti-human IgM serum. By gel filtration on Sephacryl S-300, the anti-A and anti-B antibodies reacting readily in saline media were detected in the fractions corresponding to the IgM antibodies. Thus, anti-A and anti-B antibodies in group-B and group-A sera were judged to be mainly of IgM. In contrast to group-A and group-B sera, group-O serum contained IgG antibodies of high titers besides IgM antibodies. Neither 2 ME nor anti-human IgM serum affected these antibody activities. On the basis of the results of the inhibition test using anti-human immunoglobulin sera as well as of gel filtration, group-O sera were divided into the following two categories, the one having only IgG reacting well in the Coombs method and the one having both IgM and IgG. PMID- 6865099 TI - Isolation and pathogenicity of provisional serovar 1621-54 of "Shigella" from imported cynomolgus monkeys. AB - The provisional serovar 1621-54 of "Shigella" was isolated from 36 (13.2%) of 273 cynomolgus monkeys newly imported into Tsukuba Primate Center for Medical Science (TPC) from Indonesia during the period from 1980 through 1981. The biochemical properties of the isolates were in good agreement with those of previously described provisional "Shigella" serovar 1621-54. Clinically, 13 (36.1%) of 36 monkeys being positive for the organisms excreted diarrheal stools on arrival at TPC. In addition, the organisms were isolated also from three other monkeys contracting dysentery during the quarantine period at TPC. One of them died 2 days after the onset of dysentery. Histopathological findings of this case were essentially the same as those of Shigella-infected monkeys. Pathogenicity of the isolates was examined in three experimental infection models; (1) the infection model using cultured HeLa-S3 cells, (2) the keratoconjunctival infection model of the guinea pig, and (3) the intestinal infection model of the cynomolgus monkey. All the strains tested showed positive results in these experimental models, causing intracellular penetration and multiplication in HeLa-S3 cell cultures, keratoconjunctivitis in guinea pigs, and dysentery in cynomolgus monkeys. These results indicate that provisional "Shigella" serovar 1621-54 is a causative agent of dysentery in man as well as in monkeys. PMID- 6865100 TI - Correlation of blastogenesis and DNA synthesis by the murine lymphocytes during in vivo activation with Concanavalin A. PMID- 6865101 TI - A new Salmonella serovar: Salmonella ibaragi (21:y:1,2). PMID- 6865102 TI - Effect of orally administered polysaccharide from kefir grain on delayed-type hypersensitivity and tumor growth in mice. AB - The effect of oral administration of a polysaccharide (KGF-C), isolated from the kefir grain, on delayed-type hypersensitivity (DTH) induced by picryl chloride and on the growth of solid tumor was examined in mice. KGF-C caused an increase in DTH response in intact mice and also tumor-bearing mice. The growth of tumor inoculated after the DTH test was markedly inhibited in the groups with high DTH response. A significant correlation between the DTH response and the antitumor activity was observed in intact mice. PMID- 6865103 TI - Nutritional aspect of methionine isomers studied by pulmonary exhalation of dimethyl sulfide and urinary excretion of alpha-keto-gamma-methiolbutyrate in humans. AB - With the view of evaluating the relative utilization of methionine isomers, the pulmonary exhalation of dimethyl sulfide and methyl mercaptan and the urinary excretion of alpha-keto-gamma-methiolbutyrate were studied in normal healthy subjects following oral or intravenous administration of L- or D-isomer of methionine. Dimethyl sulfide concentration in the expired alveolar gas (mean +/- SD) before methionine loading was 2.1 +/- 1.4 ng/dl (N = 23). Maximum concentrations of dimethyl sulfide in oral methionine loading tests were: 56.0 +/ 24.9 ng/dl (D-2g) (n = 4), 66.0 +/- 42.1 (D-1g) (N = 6) and 4.6 +/- 2.6 (L-2g) (N = 4); and in intravenous loading tests: 60.0 +/- 19.9 (D-Ig) (N = 4) and 4.2 +/- 2.1 (L-2g) (N = 3), respectively. The changes in methyl mercaptan in the expired alveolar gas were small and were disproportional to the changes in dimethyl sulfide following administration of both isomers. Preloading concentration of alpha-keto-gamma-methiolbutyrate in urine was 0.15 +/- 0.10 microgram/mg Creatinine (mean +/- SD) (N = 5). Postloading values during the initial two hours were 578 and 156 micrograms/mg Creatinine following 3g of D- and 0.20 and 29.7 micrograms/mg Creatinine following 3g of L-methionine ingestion. In view of the results obtained, significant amounts of D-methionine seem to be metabolized through the transaminative pathway of methionine metabolism. PMID- 6865104 TI - Plasma cell dyscrasia in 105 Japanese patients with systemic amyloidosis. AB - Total 105 Japanese cases of systemic amyloidosis were analysed in terms of Congo red staining with potassium permanganate, anti-amyloid serum staining by immunoperoxidase and the occurrence of monoclonal proteins (ie. plasma cell dyscrasia, PCD). Thirty three cases of primary type amyloidosis and 22 cases of myeloma-associated amyloidosis were mostly associated with PCD, with 3 exceptional cases without PCD. In contrast, 45 cases of secondary type amyloidosis were demonstrated as AA type, with no association of PCD. Predominance of lambda light chain in amyloidosis was contrasted to kappa chain predominance among the non-amyloidotic myeloma cases. PMID- 6865105 TI - Generalized epilepsy in a patient with hypokalemic periodic paralysis and cardiac arrhythmia. AB - A 17-year-old female who had Hypokalemic periodic paralysis with arrhythmia developed syncopal attacks. Although syncope in this rare disorder has been attributed to ventricular tachycardia or ventricular fibrillation, the clinical manifestation, electroencephalogram, serum electrolytes and blood sugar at the attack, and the results of lumbar puncture indicated that idiopathic generalized epilepsy was the cause of the syncopal attacks in the present case. To our knowledge, this is the first case report of the association of epilepsy with periodic paralysis and arrhythmia in the literature. PMID- 6865107 TI - A case of hypercalcemic crisis with resistant hypertension due to hyperthyroidism. PMID- 6865106 TI - Eosinophilic fasciitis with prominent immunologic abnormalities. PMID- 6865108 TI - Acute hepatic failure--in special relation to treatment. PMID- 6865109 TI - Symposium on blood disorder in systemic diseases. PMID- 6865111 TI - [A study on simultaneous and successive Delboeuf illusions from the standpoint of the theory of set]. AB - An attempt was made to examine whether or not the simultaneous Delboeuf illusion and the successive one were based on the same perceptual process. By the method of the fixed set, the subject's inner process (set) during the occurrence of the illusions was investigated in Experiment I. The results indicated that his set toward the Delboeuf illusion figure was not changed when only the inducing circle was presented first, but that his set was changed at the moment the inducing circle disappeared and the two circles of identical size were presented. Experiment II examined his perception when there was a time delay between the presentations of the inducing circle of the Delboeuf illusion figure and the other two circles. In that situation, the simultaneous Delboeuf illusion and the successive one should occur successively. The results of Experiment III suggested that the transitional change from the simultaneous Delboeuf illusion to the successive one, which had been observed in the previous study, was due to a change in the judgement of the subject who experienced these two different phenomena successively. PMID- 6865110 TI - A clinical study on gallstones in Bolivia. AB - To clarify the prevalence of gallstone disease in Bolivia, all the X-ray films of the biliary system in a total of 656 cases taken during 10 months in La Paz were checked. Gallstones were found in 103 cases (15.7%). The ratio of male to female was 1:1.9. Cholecystolithiasis comprised 76.7% of them, while choledocholithiasis was rare. The analysis of gallstones removed surgically by an infrared absorption spectroscopy revealed that cholesterol was main constituent of stones in 62 cases (93.9%) out of 66 cases. PMID- 6865113 TI - [Effects of time estimation precision on Auditory Evoked Potentials in a tone duration discrimination task]. AB - It has been widely reported that the late positive component (P3) of Auditory Evoked Potentials (AEP) was elicited by the onset of task-relevant stimulus. It also has been reported that when the stimuli differ only in duration, the offset of task-relevant tone evokes the AEP with P3. In this study, it was hypothesized that P3 can be evoked by a task-irrelevant tone as well as by a task-relevant one if subject starts processing every tone as the task-relevant one from its onset. The task-relevant tone was a medium-duration tone and prior to the task, the subject was trained to anticipate the cessation of the medium-duration tone (600 ms) without actual offset. Results showed that when the duration was short (300 ms), P3 was evoked by the offset of tone. However, when it was long (1200 ms), P3 was elicited at the time of the offset of the task-relevant tone. These findings were interpreted to mean that the termination of time estimation activity for the task-relevant tone evoked P3 component. PMID- 6865112 TI - [An experimental study on the parallel operation of image: a case of mental rotation]. AB - The parallel operation of images using mental rotation task was examined from the following two points of view: (1) Whether or not a pair of letter images could be mentally rotated in parallel (Exp. 1), and (2) Whether or not an image pattern composed of two letters could become an object of a single mental rotation (Exp.2). Exp. 1 showed that two images were serially rotated in group S which was slower in rotation of two letter images, while they were rotated in parallel in group F which was faster (Fig. 4). This result was interpreted as a trade-off between the correctness and the speed of response. Exp. 2 showed that the velocity of mental rotation was the same for two-letters image as for one-letter image in both groups, S and F (Fig. 5). This result indicated that the image pattern of two-letters could be an object of a single rotation, and suggested that image processing would include an image register in which multiple images are stored in parallel. PMID- 6865115 TI - [Developmental changes in attributes of memory in children]. AB - The present study investigated the developmental changes in dominance of memory attributes between second and sixth graders. Subjects studied a familiar word list followed by a recognition test; dominance was inferred from the types of false recognition error (semantic and acoustic) on the test. The results showed dominance of the semantic attribute for sixth graders, but no difference of dominance level between the semantic and the acoustic attribute for second graders. The evidence also indicated no effect of the stimulus mode on dominance of memory attributes for both graders. PMID- 6865114 TI - [Practice effect and transfer in orientation discrimination reaction time]. AB - Two experiments were carried out measuring DRT. Two stimuli, horizontal-vertical and oblique ones were used, and four subjects were required to discriminate them in two categories as quickly as possible. In Experiment 1, the stimulus was presented in peripheral retina, every subjects showed a marked oblique effect at the outset. This effect decreased with proceeding sessions. After six sessions (600 trials), the results of these subjects were compared with those of naive control subjects in direct vision, in Experiment 2. The Experimental Group showed only a little oblique effect as contrasted with the Control Group. Such practice effect and the transfer effect couldn't be attributed to the functional anisotropy of the orientation analyzers in the visual cortex, and consequently, a cognitive approach was suggested. PMID- 6865116 TI - [Independence of startle elicitation from lead-stimulus inhibition in man]. AB - In the present study, the relationship between startle elicitation and lead stimulus inhibition was examined. The amplitude of the human startle eyeblink reflex increased linearly with increases in the intensity of reflex-eliciting noise (S2). A lead-stimulus (S1), a pip tone of 70 dB, inhibited the reflex at both conditions with lead times of 100 ms (Experiment 1) and 250 ms (Experiment 2). The amplitude of the reflex was reduced by an equal amount regardless of the intensity of S2 in both experiments. The results show that the lead-stimulus inhibition is independent of the reflex elicitation. PMID- 6865117 TI - [Pulmonary function in chronic renal failure]. PMID- 6865118 TI - [Interaction between the lung and liver]. PMID- 6865119 TI - [Autoimmunity and lung diseases]. PMID- 6865121 TI - [The flow-volume curve findings with reference to uneven ventilation]. PMID- 6865120 TI - [Two cases of primary pulmonary cryptococcosis diagnosed by transbronchial lung biopsy--significance of latex agglutination test for cryptococcal antigen]. PMID- 6865122 TI - [A case of pulmonary alveolar proteinosis--morphology and function of the alveolar macrophages obtained by bronchopulmonary lavage]. PMID- 6865123 TI - [A case of occupational asthma caused by Reactive Yellow 4]. PMID- 6865124 TI - [Experimental investigation on hypersensitivity of canine airways--effect of various drugs on bronchoconstriction induced by vagosympathetic nerve stimulation]. PMID- 6865126 TI - [Lung function tests in asbestos workers--effect of asbestos exposure and smoking]. PMID- 6865125 TI - [Effects of 100% oxygen ventilation, phenoxybenzamine (POB) and sodium nitroprusside (SNP) on pulmonary circulation in pulmonary air embolism]. PMID- 6865127 TI - [A new method for classifying discontinuous adventitious lung sounds]. PMID- 6865129 TI - [A case of pneumonia due to Mycoplasma pneumoniae with eosinophilic pleural effusion]. PMID- 6865128 TI - [A case of pulmonary metastasis 14 years after resection of a renal cell tumor]. PMID- 6865131 TI - [Proceedings of the 23rd meeting of the Japanese Society of Chest Diseases. 13-15 April 1983, Kyoto]. PMID- 6865132 TI - [Simultaneous surgery for Wolff-Parkinson-White syndrome combined with acquired heart disease]. PMID- 6865130 TI - [A case of relapsing polychondritis with various chest shadows and erythematous skin lesions]. PMID- 6865133 TI - [Five year experience with the Carpentier-Edwards porcine heterograft cardiac valve]. PMID- 6865134 TI - [Tricuspid annuloplasty--De Vega's and Carpentier's method]. PMID- 6865136 TI - [A case of large mediastinal leiomyoma]. PMID- 6865137 TI - [Surgical treatment of spontaneous pneumothorax]. PMID- 6865135 TI - [The protective effect of coenzyme Q10 on myocardial metabolism and hemodynamics in open heart surgery]. PMID- 6865138 TI - [Experience with percutaneous intra aortic balloon; special reference to our method of insertion]. PMID- 6865139 TI - [Ligation of patent ductus arteriosus in premature infants weighing less than 700 g at birth-selection of surgical instruments]. PMID- 6865140 TI - [Intraoperative technique to evaluate mitral valve function]. PMID- 6865141 TI - [Three cases of acute renal failure after open heart surgery]. PMID- 6865142 TI - [Bronchogenic cyst--a review of 14 cases]. PMID- 6865143 TI - [Severe hemolytic anemia following a prosthetic valve replacement--an unusual cause of hemolysis]. PMID- 6865144 TI - [An experience of infected catheter removal with continuous traction method and silicon rubber wearing]. PMID- 6865145 TI - [A case of intradiaphragmatic cysts]. PMID- 6865146 TI - [A surgical case report of combined valvular disease which led to the functional disturbance of Bjork-Shiley aortic valve due to a large amount of left ventricular thrombus in the early postoperative period and to the sudden death of patient]. PMID- 6865147 TI - [Diagnostic value of diuresis renography]. PMID- 6865148 TI - [3 cases of primary sarcoma of the bladder and review of the literature in Japan]. PMID- 6865150 TI - [Drug sensitivity test of cultured human bladder cancer cells]. PMID- 6865149 TI - [Electromyographic study on evoked response of the bulbocavernosus reflex]. PMID- 6865151 TI - [Urinary excretion and tissue distribution of acid mucopolysaccharides in patients with malignant urinary tract cancer]. PMID- 6865152 TI - [Experimental and clinica studies on antineoplastic agent sensitivity of bladder cancer cells based on their nucleic acid metabolism]. PMID- 6865153 TI - [A histological study of the dilated ureters in children]. PMID- 6865154 TI - [Occupational cancer of the urinary bladder: the diagnostic value of urinary cytology in dyestuff workers exposed to aromatic amine]. PMID- 6865155 TI - [Study on uranyl nitrate-induced acute renal failure]. PMID- 6865156 TI - [Biochemical study of lipids in the prostate gland. 3. A study of the cholesterol and phospholipids concentrations in the human prostatic fluid in relation to age and prostatic disease]. PMID- 6865157 TI - [Progression of chronic pyelonephritis. 1. Extratubular materials and interstitial and glomerular changes]. PMID- 6865158 TI - [Penile hemodynamics in man observed by oxygen polarography. 1: Observation in normal subjects]. PMID- 6865159 TI - [Clinical evaluation of the significance of vascular invasion in bladder cancer]. PMID- 6865160 TI - [A study of urinary cytology by scanning electron microscopy (1) --a simple method for scanning electron microscopic observation of exfoliated epithelial cells from the urinary bladder]. PMID- 6865162 TI - [A case of perirenal encysted hematoma]. PMID- 6865161 TI - [The studies on familial occurrence of vesicoureteral reflux]. PMID- 6865163 TI - A new nematode, Mammanidula siamensis n. sp., from the mammary gland of Tupaia glis and Rattus surifer of Thailand. PMID- 6865164 TI - Spontaneous glomerulonephritis in chickens of the field flocks. PMID- 6865165 TI - Incidence of Angiostrongylus siamensis in small mammals at Nakorn Nayok, Thailand. PMID- 6865166 TI - Pathogenicity of Negishi virus in mice characterized by age of susceptibility, routes of inoculation and growth of the virus in tissues. PMID- 6865167 TI - Pathology of degenerative osteoarthritis in laying hens. PMID- 6865169 TI - Relationship between amylopectin and viability of Eimeria tenella sporozoite. PMID- 6865168 TI - Experimental infection of feline panleukopenia virus in specific pathogen-free cats. PMID- 6865170 TI - Effect of bile salts on in vitro excystation of Eimeria-tenella oocysts. PMID- 6865171 TI - Chromosome polymorphism in Japanese sika, Cervus (Sika) nippon. PMID- 6865172 TI - Effects of ovariectomy and progesterone treatment on the maintenance of pregnancy in bitches. PMID- 6865173 TI - Alteration with age in cardiac activities of rat. PMID- 6865174 TI - Serotherapy for dogs infected with canine parvovirus. PMID- 6865175 TI - Comparative morphological studies on the vomeronasal organ in rats, mice, and rabbits. PMID- 6865178 TI - Karyotype of a lung fluke, Paragonimus westermani filipinus Miyazaki, 1978. PMID- 6865177 TI - Pregnancy-associated leporine serum proteins: immunochemical studies on pregnancy associated proteins in rabbit serum. PMID- 6865176 TI - [The effect of copper and copper . o-phenanthroline complex on cattle erythrocytes]. PMID- 6865179 TI - X-ray microanalysis of intact and regenerated vessel wall of the canine abdominal aorta. PMID- 6865180 TI - [The Q-T interval of the ECG in hypertension]. PMID- 6865181 TI - [Transient auscultative syndrome of mitral valve prolapse in hypertension]. PMID- 6865182 TI - [Systemic hemodynamics in patients with bronchial asthma complicated by systemic arterial hypertension]. PMID- 6865183 TI - [Hemodynamics of pulmonary circulation in patients with hypertension complicated by chronic ischemic heart disease]. AB - Pulmonary circulation hemodynamics were studied in 175 patients with essential hypertension (EH), coronary disease (CD), atherosclerotic and post-infarction cardiosclerosis and combinations thereof. Pulmonary hemodynamic disorders were found both in cases of EH and CD, being more pronounced in EH patients. When the two diseases are combined, changes reflecting the state of pulmonary hemodynamics are more marked than those occurring in patients with EH or CD alone. When combined, EH and CD mutually aggravate each other's clinical course and symptomatology. PMID- 6865184 TI - [Sex and age-dependent differences in the circulatory response to the exercise test]. AB - The testing of normal males and females of different age revealed no intersexual differences in circulatory response to the orthostatic test. During exercise, female subjects showed lower systolic arterial pressure, cardiac and stroke indices, and greater diastolic arterial pressure, heart rate and peripheral resistance to blood flow, irrespective of their age. Parameters of physical efficiency are higher in males as compared to females. Exercise tolerance decreases with age in subjects of both sexes, the decrease, however, being more pronounced in males. PMID- 6865185 TI - [Systemic and renal hemodynamics in hypertension]. AB - The hemodynamic profile of essential hypertension affects renal function. Renal hemodynamics tend to deteriorate as systemic circulation changes from hyper- to hypokinetic type, mainly due to increased renal vascular resistance and reduced minute blood volume. Under hypokinetic circulation, transition to the next stage of essential hypertension takes form: renal ischemia develops during the formative stage of the disease (stage I), glomerular filtration decreases during its stabilization (stage II) in the presence of renal circulatory insufficiency. Renal hemodynamic changes due to reduced cardiac output take root and are manifested during the next stages of essential hypertension irrespective of systemic circulation variant, thus determining a new level of renal functioning. PMID- 6865186 TI - [Therapeutic effect of the cardioselective beta-blocking agent tenormin and its action on the indices of systemic, intracardiac and regional hemodynamics in patients with hypertension]. AB - Cardioselective beta-blocking agent tenormin (atenolol) was used in 55 patients with essential hypertension, Stage II; in 20 of those, central, intracardiac and regional hemodynamics were assessed echocardiographically and rheographically. Tenormin produced a pronounced hypotensive effect within 2-4 weeks of treatment (BP decreasing by 26.8/22.8%). A significant decrease was noted in cardiac index (by 26.8%), heart rate (by 24%), intramyocardial tension (by 21.9%), the myocardial circular fibre shortening rate (by 6.5%), left-ventricular myocardial wall thickness and weight (by 4.5%). Total vascular peripheral resistance did not change significantly (it dropped in half of the patients). Stroke index, output fraction and left-ventricular size remained unchanged. Cerebral and femoral arterial tone also decreased. Tenormin was effective in 5 patients with hypertension combined with bronchial asthma. Owing to its prolonged action, tenormin can be administered once or twice daily, a factor that facilitates considerably prolonged out-patient treatment. PMID- 6865187 TI - [Changes in water-sodium balance in patients with hypertension subjected to different types of hypotensive therapy]. AB - The parameters of water-electrolyte metabolism and central hemodynamics were studied in 44 patients with essential hypertension (stage II-III) after 3-week treatment with sympatholytics and diuretics. Patients with hyperkinetic type of hemocirculation had a sodium lack at the stage of stable hypertension, therefore the diuretic treatment is not indicated for such patients. The treatment with the diuretic oxodolin was accompanied by the decrease in the peripheral resistance of blood vessels, in sodium metabolism and its extracellular fraction, and by the increase of the deposit sodium fraction. The elevation of the renin-angiotensin system activity due to the diuretic therapy did not influence the blood pressure level and the central hemodynamics parameters. PMID- 6865188 TI - [The fate of patients with renovascular hypertension after surgical and drug therapy]. AB - The results of treatment of 328 patients with renovascular hypertension, including 235 cases of surgical correction, are analyzed. Late results (6-month to 14-year follow-up) are examined in 160 surgical cases. The incidence of hypertensive relapses was shown to increase with the duration of follow-up; its major causes were identified. Five-year success rate was estimated at 68%, using actuarial techniques, and five-year postsurgery survival rate was 83.7%. The outcomes of conservative treatment were reviewed in 45 cases followed up for up to 7 years. The results suggest that conservative treatment for renovascular hypertension is not advisable as it aggravates vital prognosis and results in stable loss of working capacity in 60% of the patients, while operations provide an opportunity to maintain working capacity as a long-term perspective in 58% of the patients. PMID- 6865189 TI - [Results of a 2-year prospective study of patients with ischemic heart disease with stable angina pectoris]. AB - Data of dynamic control of 278 coronary patients with stable angina pectoris are presented. Coronarography was performed in all cases to determine changes in the heart coronary arteries which were of varying markedness. The anginal syndrome, ECG at rest, exercise tolerance, incidence of myocardial infarction and mortality rate were assessed after one and two years of dynamic observation. The incidence of nonfatal myocardial infarction was estimated at an average of 6.3% per year, whereas the mortality rate was 3.8%. The prognosis for patients with stenosing coronary atherosclerosis depends on the number of affected coronary arteries, the functional class of angina pectoris and exercise tolerance. Data on the efficiency of long-term pharmacological treatment of patients with stable angina and stenosing coronary atherosclerosis are obtained. PMID- 6865190 TI - [Hemodynamic relations between systemic and pulmonary circulation in hypertension]. AB - Central and pulmonary circulation was studied in 111 patients with essential hypertension, stages I, IIa, IIb, using radio- and polycardiographic techniques. Pulmonary circulation changes associated with output hypertension were manifested in increased systolic pressure in the pulmonary artery and vascular volume of the lungs with increased venous return, and high blood flow rate combined with relatively normal pulmonary vascular resistance (total pulmonary resistance). Decreased cardiac output in vasoconstrictive pressor mechanism results from high total pulmonary resistance and reduced venous return, in addition to high peripheral resistance. Pulmonary hemodynamic changes were particularly pronounced in patients with normokinetic circulation. A quantitative assessment of relationships between major parameters of systemic and pulmonary circulation brought out close functional bonds within one circulatory variant. The findings obtained revealed similar patterns in the mechanisms of systemic and regional pressure formation in essential hypertension. PMID- 6865191 TI - [Pathogenesis of cardiovascular disorders in acute experimental arterial obstruction]. AB - Agents producing toxic myocardial effects are shown to appear in systemic blood flow as a result of acute occlusion of aortal trifurcation with subsequent recovery of blood flow in the limbs. The most pronounced effect was noted following blood infusion in dogs whose ischemia of the limbs had lasted for nine hours, instead of twelve, which must be due to specific features of circulation recovery in the ischemic area. PMID- 6865192 TI - [Total plasma aldosterone content in hypertension]. PMID- 6865193 TI - [Uncontrolled increase of blood pressure after surgery for symptomatic hypertension]. PMID- 6865194 TI - [Pathobiochemistry of diseases in childhood]. PMID- 6865195 TI - [Contraception in adolescence]. PMID- 6865196 TI - [Liver-kidney, kidney-liver (involvement of one organ in diseases of the other)]. PMID- 6865197 TI - [Bilirubin in the cerebrospinal fluid of newborn infants. III. Functional and neurologic developmental diagnosis]. PMID- 6865198 TI - [Mesenteric chylaus cysts--an unusual cause for intra-abdominal space-occupying masses]. PMID- 6865199 TI - [The significance of ultrasonic diagnosis (B-scan) in childhood]. PMID- 6865201 TI - [Fluorescence angiography for the early diagnosis of diabetic retinopathies in childhood]. PMID- 6865200 TI - [Lymphogranulomatosis in children--a partial report of the cooperative therapy study conducted by the Council of Economic Cooperation of the European socialist countries, 1980/1981. Results from the GDR]. PMID- 6865202 TI - [Diabetes mellitus and diabetes insipidus associated with optic atrophy (DIDMOAD syndrome)]. PMID- 6865204 TI - [Current treatment procedure in acute cholecystitis]. PMID- 6865203 TI - [Mortality and morbidity studies by the pediatrician?]. PMID- 6865206 TI - [Principles for the combined treatment of patients with acute ulcerative gastroduodenal hemorrhages]. PMID- 6865205 TI - [Relaparotomies after operations for acute cholecystitis]. PMID- 6865208 TI - [External hypothermia in the combined treatment of acute pancreatitis]. PMID- 6865207 TI - [Postoperative complications in patients with hemorrhaging stomach and duodenal ulcers and their relation to immunity status]. PMID- 6865209 TI - [Analysis of the complications and mortality in acute appendicitis in children]. PMID- 6865210 TI - [Endoscopy of the vermiform appendix in acute appendicitis]. PMID- 6865211 TI - [Acute cholecystitis complicated by peritonitis in middle-aged and elderly patients]. PMID- 6865212 TI - [Seasonal paradoxes of acute appendicitis]. PMID- 6865213 TI - [Anaerobic bacteria in the origin of peritonitis in acute appendicitis]. PMID- 6865215 TI - [Prevention of pulmonary artery thromboembolism in emergency medicine]. PMID- 6865214 TI - [Algorithm for the diagnosis of postoperative intra-abdominal hemorrhages]. PMID- 6865216 TI - [Early planned operation in acute cholecystitis in middle-aged and elderly patients]. PMID- 6865217 TI - [Syndrome approach to rendering emergency medical care to victims with combined chest and abdominal injuries]. PMID- 6865218 TI - [Diagnosis and treatment of early postoperative intestinal obstruction]. PMID- 6865219 TI - [Diagnostic and procedural errors in closed abdominal injuries and their prevention]. PMID- 6865220 TI - [Errors in the diagnosis of perforated gastroduodenal ulcers combined with destructive appendicitis]. PMID- 6865221 TI - [Recurrence of acute appendicitis after appendectomy]. PMID- 6865222 TI - [Ovarian apoplexy simulating acute appendicitis]. PMID- 6865223 TI - [Rare case of chest and abdominal wounds with injury of the internal organs and vessels]. PMID- 6865224 TI - [Thymus neoplasms with myasthenic syndrome]. PMID- 6865225 TI - [Surgical treatment of recurrences and metastases of lung cancer]. PMID- 6865226 TI - [Surgical restoration of the costal framework in closed chest injury]. PMID- 6865227 TI - [Early forms of stomach cancer detected during preventive medical examination]. PMID- 6865228 TI - [Cardial insufficiency and its role in the clinical course of peptic ulcer and postgastrectomy syndromes]. PMID- 6865229 TI - [Causes of disorders of the motor-evacuation function of the gastric stump in the early period after resection]. PMID- 6865230 TI - [Excision of the lesser curvature of the stomach in the surgical treatment of peptic ulcer]. PMID- 6865231 TI - [Substantiation of the surgical treatment of patients with bronchial asthma and chronic pneumonia]. PMID- 6865232 TI - [Drainage of the thoracic duct and lymph reinfusion in patients with destructive pancreatitis and diffuse peritonitis]. PMID- 6865233 TI - [Pyloric dilatation in combined surgical treatment of duodenal ulcer]. PMID- 6865234 TI - [Survival of patients after radical surgery of rectal cancer]. PMID- 6865235 TI - [Inflammatory lesions of the skin of the perineum and sacrococcygeal region]. PMID- 6865236 TI - [Surgical treatment of complications in the region of distal anastomoses after aorto-femoral reconstruction]. PMID- 6865237 TI - [Results of the surgical treatment of nonspecific empyema]. PMID- 6865238 TI - [Late complication of blunt abdominal injury]. PMID- 6865239 TI - [Comparative evaluation of gastrostomy methods]. PMID- 6865240 TI - [Ascending jejunojejunal invagination after gastrectomy]. PMID- 6865241 TI - [Leiomyoma of the stomach]. PMID- 6865242 TI - [Thrombosis of the superior vena cava after catheterization of the subclavian vein]. PMID- 6865243 TI - [Petrified hematoma of the distal anastomosis as a cause of thrombosis of arterial iliac-femoral transplant]. PMID- 6865244 TI - [Multiple melanoma of rare localization]. PMID- 6865245 TI - [Experiences with different artificial lenses]. AB - Since 1977 intraocular lenses of 4 different types have been implanted in a total of 963 eyes at Frankfurt University Eye Clinic: the 4-loop lens (Binkhorst), the 2-loop lens (Binkhorst) and the posterior chamber lenses designed by Shearing and Simcoe. Implantation of a posterior chamber lens after extracapsular cataract extraction produced very good results with no severe complications. PMID- 6865246 TI - [Experiences with secondary implantation of the Choyce Mark IX anterior chamber lens in unilateral aphakia]. AB - Choyce Mark IX lenses were implanted in 72 patients between 71 and 86 years of age suffering from unilateral aphakia, who could not be helped with contact lenses; 38 of the patients were observed for a period of more than 16 months. The lenses were attached in the angle of the anterior chamber. None of the patients showed signs of the previously feared complications such as corneal decompensation, secondary glaucoma or iridocyclitis. The Choyce lens is ideally suited for secondary implantation. The operation is simple and post-operative reactions disappear in less than a week. The lens sits firmly in the eye; it cannot be dislodged against the endothelium of the cornea. The pupil is dilatable and its condition is unimportant. There is no contraindication for implantation in cases in which vitreous is present in the anterior chamber. The marked subjective improvement, which all the patients remarked on, is especially worth noting. PMID- 6865247 TI - [Healon as an emergency aid]. AB - Sodium hyaluronate (Healon) was used in follow-up surgery of the anterior segment. In addition to the uses of Healon already documented in the literature the author points out that very early synechiolysis with it can be beneficial especially in cases of distortion of the pupil after cataract extraction with insufficient cleaning of the vitreous. So far Healon has not caused any problems with regard to tissue compatibility, viscosity, resorption or its optical quality in the anterior chamber. The examples of secondary treatment given after injuries are intended to encourage the use of Healon in risky situations as a means of stabilizing the anterior chamber with a viscous fluid. PMID- 6865249 TI - [Incision procedure in cataract extraction after filtering glaucoma operations]. AB - The authors report on 72 cataract extractions following filtering procedures for glaucoma. In 45 cases they performed a purely corneal incision in the upper part of the globe (in 17 cases the classical von Graefe knife incision was used; in 28 cases a three-plane incision ab externo using a razor blade and scissors was done). In the other 27 cases the globe was opened from the outer surface by performing a corneoscleral incision with a limbus-based conjunctival flap. With regard to postoperative intraocular pressure and intraoperative and postoperative complications the two techniques - the ab interno incision and the ab externo incision - produced equally good results. Moreover, a slightly higher residual astigmatism was observed after the purely corneal incisions. The advantages and disadvantages of the two techniques for opening the globe following a filtering procedure for glaucoma are discussed. Finally the authors describe the procedure they currently use, depending on the preoperative situs. PMID- 6865248 TI - [Clinical observations of choroidal hemorrhage and choroidal effusion. A contribution on expulsive bleeding]. AB - A prospective study covering a period of 10 years is presented, which deals in particular with expulsive and nonexpulsive hemorrhages after intracapsular cataract extraction and with massive choroidal hemorrhage. In 7230 intracapsular cataract operations 2 expulsive and 6 nonexpulsive hemorrhages were seen, as well as 1 case of choroidal effusion. During the same period 9 cases of spontaneous massive choroidal hemorrhage were referred for inpatient treatment. The importance of choroidal effusion must be pointed out, even though it is much less common than choroidal hemorrhage. The precise mechanism of choroidal effusion seems to be unknown. On the other hand a massive hemorrhage will probably lead to an expulsive hemorrhage when it coincides with opening of the bulbus. In the light of the author's statistics it appears to be a change occurrence. PMID- 6865250 TI - [Clinical experience with iridencleisis]. AB - The authors report on 120 patients who underwent iridencleisis (155 eyes). Of these, 36 had open-angle glaucoma, 26 congestive glaucoma and 54 were suffering from acute glaucoma of long standing. Two patients had exfoliation syndrome and two, secondary glaucoma. The kind of filtration bleb, postoperative complications such as flat anterior chamber or loss of anterior chamber, hyphema, choroidal detachment and postoperative and final regulation of IOP are discussed in detail. Since 1975, the authors have preferred Fronimopoulos' method of goniotrepanation to iridencleisis for treating open-angle and congestive glaucoma. However, in cases of protracted, uninterrupted acute glaucoma iridencleisis can still be recommended as a dependable procedure. PMID- 6865252 TI - [Bilateral recurrent uveitis, retinitis and papillitis. A complication of thromboangiitis obliterans?]. AB - Frequently relapsing acute bilateral uveitis, retinitis and papillitis were observed in a young male smoker. Long-term therapy with azathioprine (150 mg/day), fluocortolone (15 mg every other day) and phenprocumarol proved to be the only means of suppressing the ocular symptoms and achieving a relatively steady condition. Simultaneously relapsing thrombophlebitis of the lower extremities indicated that thrombangiitis obliterans might be the basic disease. The ophthalmic literature on this condition is critically reviewed. PMID- 6865254 TI - [Variability of iris fluorescence angiograms]. AB - Fluorescein angiography of the iris vascular system is more difficult in heavily pigmented irides of the coloured races; in light skinned patients it is easy to perform and even more details are demonstrated in patients with atrophies of the mesodermal iris structure. In congenital albinism very fine vascular structures are demonstrated in younger patients; a similar picture is seen in pupillotonia if there is atrophy of the iris stroma. In senile iris atrophies, Adie's syndrome and congenital albinism the iris vascular structure is basically normal, but atrophy of the iris stroma may lead to increased fluorescein permeability in the elderly. PMID- 6865255 TI - [Lymphographic and morphological studies of the conjunctiva in onchocerciasis patients in Liberia]. AB - Conjunctival lymphographies in patients infected with Onchocerca volvulus in Liberia showed normal or only slightly dilated lymphatics. The light microscopical studies of conjunctival specimens revealed microfilariae predominantly in edematous dilated interstitial channels. Microfilariae in lymphatics and interstitial channels without endothelium of the conjunctivae were demonstrated by scanning and transmission electron microscopy. No signs of inflammatory cellular reaction were found in the vicinity of the parasites. In conclusion, the dilatation of lymphatics and interstitial channels as well as the pathways along which the microfilarial penetrated the cornea and the anterior segments of the eye are discussed. PMID- 6865256 TI - [Refraction in the 1st year of life and the development of astigmatism]. AB - Retinoscopy was performed in 205 children under atropine cycloplegia during the first year of life. In 22% an astigmatism (minimum 1.0 D) was found with a small peak of incidence between the 31st and 40th week. In a follow-up study (45 children) the incidence and degree of astigmatism were found to increase slightly. During the first 3 years of life esotropic children developed an astigmatic anisometropia (minimum 1.0 D difference in the astigmatism of the two eyes) more frequently the non-esotropic children. The hypothesis that astigmatic anisometropia is produced by visual deprivation in esotropic individuals is discussed. PMID- 6865253 TI - [Significance of elevated hemoglobulin A1c for the pathogenesis of diabetic retinopathy]. AB - The hemoglobin of 70 diabetics with retinopathy was analysed. 56 patients had pathologically elevated values, 12 values were within the upper normal limit and in 2 cases the findings were normal. This hemoglobin variant is characterized by an increased affinity of oxygen. Clinically and pathologically speaking the elevated HbA1c value could be a causal factor in diabetic retinopathy. Comparisons with sickle cell anemia and thalassemia seem to indicate that hemoglobinopathy and retinopathy are pathogenetically related. PMID- 6865251 TI - [Cerebral-induced vision disorders as the initial symptom in subacute sclerosing panencephalitis (SSPE)]. AB - SSPE, the incidence of which is highest in children of school-age, is relatively frequently associated with bilateral acute central chorioretinitis (30%). Less common are initial visual disturbances in SSPE resulting from inflammatory processes of the encephalitis affecting cortical (occipital) areas and the visual pathways. We report on 2 cases detected after the patients had difficulty in reading and non-characteristic visual field defects. The diagnosis of panencephalitis may be confirmed by electrophoresis of spinal tap and of the EEG. The course of the disease is delayed and frequently lethal. Undefined, and at times seemingly psychogenic visual disturbances in children should always prompt immediate and intensive diagnostic efforts including pediatric and neurologic examination. PMID- 6865257 TI - [Ophthalmodynamometry in senile macular degeneration]. AB - The pressure in the ophthalmic artery was measured in two groups of patients - a group of 69 with "dry" and one of 78 with "wet" senile macular degeneration. The pressure was measured during posture change from supine to sitting, with Muller's ophthalmodynamometer. The findings were compared with those obtained in 57 healthy elderly subjects. In the group of 69 patients the drop in pressure was greater than in the control group, and in the group of 78 patients it was much greater, averaging 18.6% in systole and 20.2% in diastole. PMID- 6865258 TI - [Surgical treatment of malignant endocrine exophthalmos]. PMID- 6865259 TI - [Chalcosis corneae caused by self-administration of copper sulfate drops]. PMID- 6865260 TI - [Cataract formation after the intravitreal injection of SF6 gas]. PMID- 6865261 TI - [Impairment of retinal function in acute thallium poisoning]. AB - In case of an acute intoxication by thallium accompanied by a severe loss of visual acuity and deficiency of the visual field, ERG changes were found, even though the fundus appeared to be normal. The scotopic b-wave amplitude was hypernormal and the amplitude-intensity relation of the b-wave component was pathologic. Therefore, it seems that the toxic action of thallium is also concentrated in the retina, possibly resulting in an ascendent (retinal) atrophy of the optic nerve. PMID- 6865262 TI - [Tryptophan loading test as a function parameter in liver diseases]. AB - Because of its specific hepatic degradation tryptophan was orally administered (50 mg/kg) to patients with various chronic liver diseases (n = 30) and to healthy volunteers (n = 8) as a test for hepatic function. The plasma half life of tryptophan was determined between 4 and 8 h after the amino acid load. It was found that in patients with cirrhosis (n = 25) the half life of tryptophan was prolonged to 4.7 +/- 0.4 h (means +/- SD), compared to 2.0 +/- 0.1 h in the controls. The tryptophan half life also correlated with the plasma concentration of albumin, bilirubin, cholinesterase and prothrombin time in these patients. In addition a significant correlation was observed with the galactose elimination capacity and the 45 min retention of BSP. Thus, the oral tryptophan loading test may be suitable for a more specific determination of functional impairment of the liver in chronic liver disease. In decompensated cirrhotic patients alterations of the tryptophan metabolism seen to be related to indicators of hepatic encephalopathy. The test may therefore be used to assess the degree and risk of hepatic encephalopathy in such patients. PMID- 6865264 TI - [Reversible inhibition of thrombocyte stimulation by acetylsalicylic acid and its role in antithrombotic therapy]. PMID- 6865263 TI - Ultrasound, computed tomography and endoscopic retrograde cholangiopancreatography in the morphologic diagnosis of pancreatic disease. AB - From February to November 1981 the diagnostic relevance of ultrasound (US), computed tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP) was compared prospectively in 75 patients with suspected pancreatic disease. Final diagnosis was confirmed by autopsy, surgery, clinical course, and further laboratory data. Thus it was possible to exclude pancreatic disorders in 32 patients. By ERCP we diagnosed all tumors; sensitivity was 100%. Sensitivity of US and CT were 63% each. In five cases US made the false positive diagnosis" pancreatic malignant tumor" (specificity 93%), CT and ERCP in two cases (specificity 97% each). In chronic pancreatitis specificity of US and ERCP were 100% and specificity of CT was 98%. Sensitivity of ERCP amounted to 93%, CT and US revealed 74% and 52%, respectively. We conclude that ERCP is the best morphologic diagnostic tool in differentiating chronic pancreatitis from pancreatic carcinoma. US is a good screening method and CT reveals good diagnostic results in acute pancreatitis. PMID- 6865265 TI - Hypokalemic rhabdomyolysis with myoglobinuria due to licorice ingestion and diuretic treatment. AB - A 54-year-old man was admitted to hospital with acute rhabdomyolysis and myoglobinuria due to hypokalemia. The hypokalemia was due to chronic licorice ingestion and diuretic treatment. The myoglobinemia led to a glomerulopathy and tubulopathy. There was, however, no clinical evidence of acute renal failure (ARF). We propose that the volume expansion caused by the steroid-like actions of licorice might have prevented the development of an ARF. PMID- 6865266 TI - [Incidence and importance of renal artery stenoses in patients with peripheral arterial occlusive disease]. PMID- 6865267 TI - [Importance of cerebrospinal fluid lactate determination in neurological diseases]. AB - Lactic acid concentration has been determined in the cerebrospinal fluid (CSF) of 715 patients suffering from various neurological diseases. It was found to be most often elevated in cases of ischemic cerebral infarction, cerebral contusion, arteriosclerotic dementia, metastatic encephalitis, bacterial meningitis, menigiosis carcinomatosa and after epileptic seizures. In fewer cases lactate levels were increased with brain tumors, encephalitis, viral meningitis and radiculitis. Diagnostic relevance of CSF lactic acid determination is discussed with regard to ischemic cerebral disorders, differential diagnosis of viral and bacterial meningitis and for the confirmation of epileptic seizures. PMID- 6865269 TI - Potentially toxic serum lidocaine concentrations following spray anesthesia for bronchoscopy. AB - Serum lidocaine concentrations were measured in a series of ten patients during and after topical lidocaine spray anesthesia used for diagnostic fiberoptic bronchoscopy. Mean total dose of lidocaine ranged from 480-720 mg. Peak serum lidocaine concentrations averaged 3.6 micrograms/ml (range: 1.9 to 7.4 micrograms/ml), and were attained shortly after the start of the procedure. Repeated topical administration of lidocaine spray therefore may lead to large cumulative doses and serum concentrations which are in the therapeutic or potentially toxic range. PMID- 6865268 TI - Drug intoxication: influence of hemoperfusion on human plasma fibronectin. AB - Fibronectin is a glycoprotein belonging to the opsonic system and able to mediate phagocytosis by the reticuloendothelial system (RES). Severe intoxications are often followed by a diminished capacity of RES-clearance. Patients with severe drug intoxications have lower concentrations of fibronectin in plasma than healthy persons. Charcoal hemoperfusion lowers plasma fibronectin by an average of 4.7 mg/dl. Initial values below 15 mg/dl did not undergo a significant decrease in the case of hemoperfusion. Regarding these findings, determination of plasma fibronectin seems a useful parameter for monitoring RES function during treatment of drug-intoxicated patients by hemoperfusion. PMID- 6865272 TI - Steroid economising effects of a calf thymus extract in three patients with juvenile chronic arthritis. AB - Recent therapeutic trials in rheumatology using different immunomodulating agents have given encouraging results. In this study an aqueous calf thymus extract (CTE) was administered to three patients, two with systemic juvenile chronic arthritis (JCA), Still's disease, who could not be weaned from steroids during 2 years of conventional therapy, and one girl with a chronic juvenile monarthritis who had responded unsatisfactorily to nonsteroidal antirheumatics for 19 months. A striking clinical improvement was observed in all three patients. Prednisone (PRED) was discontinued in one case with systemic (JCA) and 0.25 mg/kg body weight/day is presently being given to the other patient. The girl is doing well on 4 mg chloroquin kg body weight/day; indomethacin (IND) was discontinued. Laboratory data including cellular immunoreactivity normalized in all three patients. PMID- 6865271 TI - [Does long term treatment with high dose nitrates affect prognosis in coronary heart disease?]. AB - The daily dose of nitrates was determined in 293 patients who had undergone coronary angiography seven years earlier. A questionnaire was filled out by those still living; medical records and information provided by family physicians were used for those who had died during the intervening period. The dose could be ascertained in a total of 168 patients. Patients were divided into two groups: in group I were those with a daily isosorbide dinitrate dose of less than 40 mg (n = 46), in group II those with a dose greater than 40 mg (n = 72). 56 patients had died. Two-thirds of them had been on the low-dose regimen, whereas only one-third were in the high-dose group. The extent of ventricular impairment was comparable in both groups. Seven-year mortality in group I was 39% with a mean daily nitrate dose of 14 mg. In group II, however, only 26% died with a mean daily dose of 55 mg. The difference can already be seen during the first year. Age, extent of coronary sclerosis, degree of ventricular damage, and cardiac size were identical in both groups. Thus mortality rate in group II was reduced by 30-40%. A causal relation to the height of the nitrate dose should be considered. PMID- 6865270 TI - [Correlations between hemodynamic parameters and plasma catecholamines in normo- and hypertensive subjects at rest and during physical exercise]. PMID- 6865274 TI - [Transbronchial lung biopsy in sarcoidosis]. AB - In patients with suspected sarcoidosis histological confirmation is generally desired. In 40 patients with the ultimate diagnosis of sarcoidosis transbronchial lung biopsy during fiberoptic bronchoscopy revealed in 83% noncaseating granulomas. With 5 biopsies per patient a positive result was obtained in 20 of 25 patients (80%) with radiographic stage I disease, in 6 of 7 (85%) with stage II disease and in 7 of 8 (87%) with stage III disease. The only complications were two small pneumothoraces and two hemorrhages. Transbronchial biopsy with its low morbidity and high diagnostic yield can be recommended as an initial procedure in diagnosing sarcoidosis. PMID- 6865273 TI - [Non-Hodgkins's lymphomas - current aspects of clinical diagnosis and therapy]. AB - Non-Hodgkin-Lymphomas (NHL), classified according to "Kiel" or Rappaport", may be subdivided into those with low or with high malignancy. Corresponding to clinical stage and to histological subtype, therapeutic recommendations are discussed. 1. Limited stage: An irradiation with curative intention seems possible. In cases with unfavourable histology relapses are frequent, and an additional or exclusive therapy with cytostatics appears to be of increasing importance. 2. Advanced stages and favourable histology: The value of an early and intensive use of cytostatics is questioned. 3. Advanced stages and unfavourable histology: Cure of the lymphoma seems feasible when intensive cytostatic regimes are applied. PMID- 6865275 TI - Determination of TPA levels in breast cancer and controls. AB - The clinical significance of radioimmunological determination of Tissue Polypeptide Antigen (TPA) has been studied on patients with breast cancer (n = 376), on "normal subjects" (n = 92), on benign diseases of the breast as well as on patients with inflammatory diseases (n = 98). TPA levels were elevated (120 U/l or higher) in the group with inflammatory diseases in 68% and in the group with breast cancer (stage IV with progression of disease) in 85%. In all other groups (healthy controls, benign diseases of the breast, breast cancer before operation, breast cancer stage I (NED), breast cancer stage II and III (NED), and breast cancer stage IV (PR/CR), TPA was higher only in 5-22%. TPA determinations seem not to be very useful for diagnostic purposes in breast cancer, but it can be regarded as suitable for monitoring proliferative processes in advanced breast cancer. Limitations result from lack of tumor specificity of the proliferation marker TPA. So far, follow-up studies after mastectomy in breast cancer and in patients with advanced breast cancer under chemotherapy have shown that CEA and TPA are concordant. There is no cross reactivity between CEA and TPA. The main component of the labeled tracer has an isoelectric point of 4.4 but there is some impurity in the tracer as it was shown in chromatofocusing. PMID- 6865276 TI - [Effect of phorbolmyristate acetate and bacterial lipopolysaccharides on the luminal chemiluminescence of neutrophil granulocytes]. AB - Measurement of emitted photons by means of luminol dependent chemiluminescence enables to evaluate the oxidative metabolism of polymorphonuclear leukocytes (PMN). The effect of phorbol myristate acetate (PMA) and bacterial lipopolysaccharides (LPS) on the luminol dependent chemiluminescence of resting and phagocytosing PMN has been investigated. Both substances stimulate the emission of photones in resting PMN. In contrary an inhibitory effect on the emission of photones is found in dependence on the concentration and duration of influence on phagocytosing PMN. This phenomenon of inhibition is caused by an accelerated and shortly lasting reaction if PMA is added and by a delayed but prolonged reaction if LPS is added. The shape of emission curve of phagocytosing PMN from healthy adults influenced by LPS correspond closely to that of premature and mature newborns suffering from severe bacterial infections. PMID- 6865277 TI - An immunoelectron microscopic study of Mycoplasma hyosynoviae in primary swine kidney cell culture. PMID- 6865278 TI - Incomplete particles of Chikungunya virus produced in BHK-21 cells cultivated with low ionic strength media. PMID- 6865279 TI - [Unsolved problems in Beck's disease]. PMID- 6865281 TI - [Acute kidney failure following chemical burns of the digestive tract]. PMID- 6865282 TI - [Renal glycosuria]. PMID- 6865280 TI - [Clinical manifestations of polyneuropathies in chronic kidney failure]. PMID- 6865283 TI - [New stage in the development of mass physical culture and disease prevention]. PMID- 6865284 TI - [Echocardiographic diagnosis of liver and kidney echinococcosis]. PMID- 6865285 TI - [Prophylactic examination as the chief method of early detection of stomach cancer]. PMID- 6865286 TI - [Current aspects of clinical manifestations and diagnosis of diverticula of the large intestine]. PMID- 6865287 TI - [Clinical manifestations, diagnosis and treatment of dyskinesia of the large intestine and chronic nonulcerative colitis]. PMID- 6865288 TI - [Various aspects of the clinical manifestations and treatment of an acute appendicitis-like variant of Crohn disease]. PMID- 6865289 TI - [Use of alpha-tocopherol acetate (vitamin E) and sodium nucleinate in the treatment of patients with stomach and duodenal ulcer]. PMID- 6865290 TI - [Work capacity evaluation in patients with peptic ulcer]. PMID- 6865291 TI - [Clinico-roentgenological diagnosis of adhesions following appendectomy]. PMID- 6865292 TI - [Serum thyrotropin and thyroxine in patients with peptic ulcer]. PMID- 6865293 TI - [The effect of diamicron on various blood coagulation indices in patients with type II diabetes mellitus]. PMID- 6865295 TI - [Use of anti-inflammatory therapy in diabetes mellitus]. PMID- 6865296 TI - [Acute kidney failure in a patient with iliocaval thrombosis]. PMID- 6865297 TI - [Three cases of skin variant of Yersinia infection]. PMID- 6865294 TI - [Microcirculation and its correction in patients with diabetes mellitus]. PMID- 6865298 TI - [Cases of campylobacteriosis in humans]. PMID- 6865300 TI - [Clinical variants and differential diagnosis of glomerulonephritis]. PMID- 6865301 TI - [Diagnosis and treatment of bronchial asthma]. PMID- 6865299 TI - [A case of Madelung's syndrome]. PMID- 6865302 TI - Improvements in diet stability through processing. PMID- 6865303 TI - Brown fat tumours (hibernomas) in rats: histopathological and ultrastructural study. PMID- 6865304 TI - Regional differences in blood flow in relation to tumour growth in the mouse. AB - The regional distribution of radio-isotopes was used to estimate regional differences in the cutaneous and mammary gland blood flow in the mouse. The observed values were greater in the cranial than caudal regions. The association of these findings with the reported higher tumour growth rate in the cranial than caudal aspect of the mouse is discussed. PMID- 6865305 TI - Suboccipital puncture of guinea pigs. AB - Cisternal cerebrospinal fluid (CSF) was tapped from anaesthetized guinea pigs by an improved technique. This method allowed repeated weekly punctures of the same animal without any cellular or neurochemical changes in CSF or changes in behaviour. About 60% of the punctures produced enough CSF (30-330 microliters) with no or a sufficiently low blood contamination for neurochemical analysis. The CSF space in the spinal canal, cisterna magna and basal cisterns was demonstrated by myelography. PMID- 6865306 TI - A fail-safe aquarium for aquatic laboratory animals. PMID- 6865307 TI - Catheterization of the sagittal sinus in the neonatal pig. PMID- 6865308 TI - Dermatitis in nude mice (nu/nu) associated with Staphylococcus pyogenes. AB - Nude mice (nu/nu on BALB/cAn background), maintained under conventional conditions, developed an acute moist dermatitis of the nose and occasionally the ears, with heavy contamination with Staphylococcus pyogenes. Only homozygotes over 10 weeks old were affected. Treatment with parenteral ampicillin or oral oxytetracycline was ineffective. Other conditions associated with the same organism were conjunctivitis and periorbital abscesses. PMID- 6865311 TI - 3 cases of persistent urachus with umbilical abscess in Wistar rats. PMID- 6865309 TI - Relationships of volatile components and bacterial flora in mouse caecum. AB - The relations between volatile components and bacterial flora in mouse caecum were studied in germ-free, gnotobiotic and SPF mice and in gnotobiotes given heated caecal homogenate from SPF mice. Anaerobic fusiform bacteria were present in SPF mice and ex-gnotobiotic (gnotobiotic plus SPF caecum) mice only. Low concentrations of furfural correlated with the presence of intestinal fusiform bacteria, suggesting that furfural may be decomposed by these organisms. Fusiform bacteria were also associated with the highest concentrations of acetic and butyric acids and may play an important role in regulating the composition of the mouse caecal flora. PMID- 6865310 TI - A simple method for oral administration of drugs in solid form to fully conscious rats. AB - The design and application of a simple capsule administration tube for miniature capsules are described. Experiments with rats have shown that the tube is capable of depositing capsules at the distal end of the oesophagus. Regardless of the location of the capsule in the oesophagus, provided normal peristaltic action occurs, the capsule will have reached the stomach and discharged its contents within 10 min. After a short training period of 3-4 days the insertion of the tube does not appear to cause the rats undue discomfort, nor does it cause tissue damage. The procedure, which can be performed rapidly by 1 technician, is ideally suited for dispensing solid materials to fully conscious animals. PMID- 6865312 TI - Control of an outbreak of mouse coccidiosis in a closed colony. AB - In 1979 severe coccidiosis occurred within a closed colony of C57bl/6J Bom mice. The coccidiosis caused diarrhoea, weight loss and deaths. Pathogenicity and response to chemotherapy were studied in experimentally infected Bor: CFW1 (SPF) mice. Histological and other studies indicated that infection was caused by more than 1 Eimeria species which have not yet been determined. Treatment with different anticoccidial drugs was unsuccessful, but use of 2 triazinone derivatives (Bay g 7183, Bay i 9142) added to the food (15 ppm) succeeded in completely eradicating the organisms from the breeding houses. Experimental findings on the sensitivity of the coccidia to other anticoccidial drugs are described. PMID- 6865313 TI - Biphasic enteritis in imported cynomolgus (Macaca fascicularis) monkeys infected with Shigella, Salmonella and Campylobacter species. PMID- 6865314 TI - Strain differences in inbred rats: influence of strain and diet on haematological traits. AB - 5 inbred strains of rats maintained on 3 commercial pelleted diets were investigated for differences in haematological traits on the 154th day of age. Number, size and haemoglobin content of the erythrocytes were shown to be strongly influenced by strain and diet. While the strain AS/Ztm was always found in a high position within the ranking order of strains, the strain DA/Ztm was always found in a low position. For nearly all haematological traits, diet II (Altromin C1000) resulted in the highest values. This was not due to a difference in the content of iron (Fe), because even though diet III (Altromin 1534) contained only 50% of the Fe in diet I (Altromin 1324), differences between these two diets were small. Significant interactions between strain and diet were shown to exist for the mean corpuscular volume (MCV) and the mean corpuscular haemoglobin (MCH). Strong genetic correlations were found between haematocrit (HCT) and haemoglobin (Hb) and between MCV and MCH, while the number of red blood cells (RBC), Hb, HCT, MCV and MCH correlated significantly within each strain. However, these environmental correlations have to be interpreted with caution, because these variables are not determined independently. PMID- 6865315 TI - Neuroleptanalgesia in the rabbit. AB - The efficacy of the neuroleptanalgesic combinations of fentanyl-fluanisone with diazepam; and etorphine-methotrimeprazine, either alone, or with diazepam, was investigated in the rabbit. The effects of these drugs on some cardiovascular variables were studied in chronically catheterized rabbits. Fentanyl-fluanisone and diazepam produced good surgical anaesthesia. Although respiratory depression occurred, this had little effect on blood gas values. In contrast, etorphine methotrimeprazine and diazepam produced severe respiratory depression with consequent hypercapnia and acidosis. PMID- 6865316 TI - Incidence of bites from cynomolgus monkeys in attending animal staff--1975-80. PMID- 6865318 TI - Surgical manipulation of the developing chick embryo in ovo after the 4th day of incubation. AB - Surgical manipulations were performed on the eyes of the developing chick embryo between 6 1/2-12 days of incubation at stages when operations had to be performed through the shell and the extra-embryonic membranes. A sufficient proportion of the embryos survived a postoperative incubation period of 6-10 days to analyse the effects of surgical intervention on development. PMID- 6865317 TI - Acid-base status of pregnant guinea pigs during neuroleptanalgesia with diazepam and fentanyl-fluanisone. AB - Neuroleptanalgesia was induced in late pregnancy in guinea pigs with diazepam and fentanyl-fluanisone. Hypotension occurred, but the arterial acid-base status after 45-60 min was near normal. When repeated injections of fentanyl-fluanisone were given to maintain neuroleptanalgesia, the blood pressure fell further and severe metabolic acidosis developed. Placental blood flow determined with radioactive microspheres was much lower during maintained neuroleptanalgesia than in guinea pigs anaesthetized with diazepam and pentobarbitone. PMID- 6865319 TI - Mycobacterium tuberculosis in a closed colony of baboons (Papio ursinus). AB - An outbreak of tuberculosis in a nonhuman primate colony involved 11 of 91 (12.1%) baboons (Papio ursinus). Tuberculin tests identified 80%, X-ray screening 10% and throat swab bacteriology 30% of diseased animals. Cough was a misleading indicator of tuberculosis. Stress resulting from experimental interference with animals was unrelated to disease development. Twice as many females as males were attacked. Screening and prophylactic, therapeutic and preventive measures are discussed. PMID- 6865320 TI - A tandem cage for individually handling group-living monkeys. PMID- 6865321 TI - Further observations on the potoroo (Potorous tridactylus) in captivity. AB - The maintenance and breeding performance of potoroos in captivity over a 7-year period is described. By removing offspring from the pouch and allowing 29 days for completion of embryonic development and birth to occur, pouch young of known ages can be obtained. PMID- 6865323 TI - Anatomy of fetal rabbit gonads and the sexing of fetal rabbits. AB - Fetal sex can be accurately and rapidly assessed in fetuses of 24 days gestation to term (31 days) by examination of the gonads. At 24 days both testis and ovary are a few millimeters below the kidney. With advancing gestation the testis descends markedly so that by 28 days it lies in the lowest region of the retroperitoneum. The ovary descends only slightly, never reaching a position more than halfway between the kidney and the bottom of the retroperitoneal space. The testis is larger, thicker, kidney-bean shaped and has an epididymis. The ovary is longer, thinner, rice grain-shaped and has a Fallopian tube. The character of the blood supply to the gonads also provides useful supporting information in determining fetal sex. Histological examination was used in 127 fetuses to evaluate the accuracy of anatomical identification of fetal sex and detected 2 errors (1.6%). PMID- 6865322 TI - Hydronephrosis in the inbred mouse strain DDD. AB - The inbred mouse strain DDD was found to have an extremely high incidence of hydronephrosis (37/37 in adult males and 12/32 in adult females). The hydronephrosis was classified as open with no definite cause for obstruction. The condition was either unilateral in the right kidney or bilateral. Another feature of the hydronephrotic kidney was circulatory failure. Hydronephrosis in strain DDD mice is considered to be a useful experimental animal model with additional possible use, in investigating disturbances of renal haemodynamics and function. PMID- 6865325 TI - The influence of minerals and protein on the nephrocalcinosis potential for rats of semisynthetic diets. PMID- 6865324 TI - Influence of bleeding procedure and some environmental conditions on stress dependent blood constituents of laboratory rats. AB - The influence of experimental conditions on 10 haematological and blood chemical constituents were investigated in male Han:Wistar rats. Significant differences existed between values of haematological and chemical constituents of blood, sampled within 10 s, between 10 and 30, or between 30 and 60 s after decapitation respectively, The leucocyte count decreased quickly but the lactate concentration rose after decapitation. The interindividual coefficient of variance for the majority of the blood constituents was reduced markedly if blood was sampled within 10 s of decapitation. Significant differences in plasma protein and blood lactate concentrations existed between 2 rats kept in one cage, when the first rat was decapitated 20 s before the second one. Plasma protein concentrations differed significantly between rats bled at 9.00 am and 11.00 am. Significant differences in blood glucose and lactate concentrations existed between rats bled on 5 different days within a period of 10 days. Packed cell volume, eosinophilic granulocytes and plasma protein concentration differed significantly between rats kept in a room with a 12:12 light: darkness (LD) cycle and those living in a room with a 2.3:2.3 LD cycle. PMID- 6865326 TI - Criteria for the evaluation of laboratory animal bedding. PMID- 6865327 TI - Differences in the microenvironment of a polycarbonate caging system: bedding vs raised wire floors. AB - The microenvironment of polycarbonate cages housing rats with and without various types of bedding was compared with that of cages that utilized wire floor inserts with different bedding types. Parameters monitored were temperature, humidity, ammonia concentrations and particulates. No differences were noted in the various caging types in relation to temperature and humidity measurements. Significant differences in ammonia concentrations existed in some of the cages when bedding material was used. The use of raised floorwalk inserts also demonstrated significant differences in particulate counts to cages without inserts. The data obtained demonstrated that contact bedding was useful in controlling ammonia generation and that a raised floorwalk insert reduced significantly the aerosolization of bedding particles that could be ingested or inhaled by the rats. PMID- 6865328 TI - Energy/protein ratio in natural ingredient diets for weanling rats. AB - The effect of 3 levels of Digestible Energy (DE; 100, 90 and 80% of NRC Recommendations) and 3 different Energy/Protein ratios (EPR; 63, 71 and 79 kJ DE/g Crude Protein [CP]) were studied in a 3 X 3 factorial design using 8 weanling rats per group and diets formulated with natural ingredients. A 20% reduction in DE level decreased significantly energy and protein intake and daily weight gain, and increased the feed intake/body weight gain ratio without affecting protein or energy conversion ratios. Wider values of EPR brought about a decrease in protein intake and CP/body weight gain ratio, with no effect on feed and energy intakes, conversion ratios, nor weight gain. At the protein levels used, energy but not protein concentration of diet, determined growth rate; with the natural ingredient diets used, up to 10% reduction in DE level may be compensated for; wider EPR values led to more efficient utilization of dietary protein. PMID- 6865329 TI - Laminin in glomerular basement membranes of aminonucleoside nephrotic rats. Increased proteinuria induced by antilaminin immunoglobulin G. AB - The amount and distribution of the glycoprotein laminin was investigated in the glomerular basement membranes (GBM) of rats made nephrotic by 10 daily subcutaneous injections of the aminonucleoside of puromycin (AMN). Affinity purified, sheep antilaminin immunoglobulin G (S alpha L) was injected intravenously into AMN rats, and kidney-bound S alpha L was compared with normals. Photometric measurements of glomerular-bound S alpha L showed that intravenous injections of 1.5 mg of S alpha L saturated laminin in normal glomeruli. The same amount of glomerular S alpha L was present in 10-day AMN nephrotic rats after injection of a saturating dose. In nephrotic rats, approximately 4.4% of a dose of 0.1 to 0.9 mg of 125I-S alpha L bound in the kidneys as compared with approximately 3.8% in normals. By immunofluorescence microscopy, S alpha L bound in a linear pattern to the GBM in nephrotic and normal rats and remained similarly bound throughout all stages of nephrosis. Conjugates of S alpha L and horseradish peroxidase (S alpha L-HRP) injected into normal and 10-day nephrotic rats bound to all three layers of the GBM, to fibrillar structures within the laminae rarae, and to the plasma membranes of epithelial cells below the slit diaphragms. In nephrotic rats, S alpha L-HRP was also bound to the epithelial plasma membrane where it had detached from the GBM. Rats given S alpha L before the induction of AMN nephrosis (S alpha L-AMN) developed significantly greater proteinuria on day 10 than rats given AMN alone (372 versus 274 mg/24 hours, p less than 0.05) and on day 12 (603 versus 453 mg/24 hours, p less than 0.05). In addition, there was greater epithelial detachment from the GBM in S alpha L-AMN rats than simple AMN rats. We conclude that (a) large amounts of laminin are neither lost nor redistributed during AMN nephrosis, (b) laminin is present as fibrils within the GBM as well as on the epithelial plasma membrane adjoining the GBM, and (c) GBM-bound S alpha L promotes proteinuria during late stages of AMN nephrosis, possibly by enhancing epithelial detachment. PMID- 6865330 TI - Pituitary dwarfism in mice persistently infected with lymphocytic choriomeningitis virus. AB - Most strains of mice injected intracerebrally with lymphocytic choriomeningitis virus grow to adulthood maintaining a persistent virus infection associated with chronic virus-induced immune complex disease. However, mice on a k background are highly susceptible to neonatal infection and develop the clinical syndrome of pituitary dwarfism and hypoglycemia. Examination of pituitary tissue fails to reveal morphologic alteration by light and electron microscopy. Within the pituitary, viral antigens are exclusively distributed within the cells of the adenohypophysis. Using ultrastructural colloidal gold-labeling techniques, we demonstrate the presence of mature virus particles budding from the surface of growth hormone containing cells from the pituitary. This study indicates that persistent lymphocytic choriomeningitis virus infection of the growth hormone cells in susceptible mice is associated with pituitary dwarfism without producing visible structural damage. PMID- 6865331 TI - Transcapillary movement of cationized ferritin in the isolated perfused rat lung. AB - We have identified the ultrastructural localization of anionic sites on the luminal surface of the pulmonary microvascular endothelium by perfusing isolated rat lungs with polycationized ferritin (CF). The ligand decorated preferentially the luminal plasmalemma, coated pits, intercellular clefts, and about half of the plasmalemmal vesicles open to the lumen. Decoration of the plasmalemma was not uniform particularly in the nonvesiculated regions of the endothelium. Perfusion of the lung with high salt solution completely abolished binding of CF to the plasmalemma, coated pits, and intercellular clefts but did not significantly decrease binding of CF to the diaphragm of the luminal plasmalemmal vesicles. This indicates the presence of highly charged anionic sites on these regions of the endothelium. CF was taken up by vesicles and discharged on the capillary membrane. Perfusion of the lungs at 4 degrees C completely abolished transport of CF across the endothelium but did not modify the pattern of binding to the luminal endothelial surface. These findings are regarded as evidence for a functional subspecialization of plasmalemmal vesicles in the pulmonary microvascular endothelium. PMID- 6865332 TI - Freeze fracture morphology of the tight junctions of the eccrine sweat gland from patients with cystic fibrosis. AB - The resorption of Na+ and Cl- across the duct of the human eccrine sweat gland is markedly decreased in individuals with cystic fibrosis (CF). Conceivably, a defective transcellular ion transport mechanism or an increased paracellular backflux of ions could account for the abnormal salt resorption in the sweat gland duct and other organs affected in CF. Tight junctions are thought to regulate paracellular ion flow. Specifically, the number of junctional elements observed by freeze fracture are believed to correspond with the extent of paracellular transport. We compared the freeze fracture morphology of tight junctions of eccrine sweat glands taken from 11 control and seven CF patients. In an attempt to "fingerprint" the junctions morphometrically, the following parameters were measured: the number of strands, the depth of the junction from the apical to the basal strand, the angle of intersection between strands, and the mean distance along a strand between intersections with two other strands. No significant difference was observed between control and CF sweat glands in the freeze fracture morphology of the tight junctions of the duct, the segment where the net reabsorption of Na+ and Cl- is abnormally decreased in CF. Significant changes were observed, however, in the means of the number of strands, the depth, and the distance between intersections for the tight junctions of the intercellular canaliculus of the secretory coil, which appears to function normally in CF. PMID- 6865333 TI - Centrilobular distribution of diethylnitrosamine-induced hepatocellular foci in the mouse. AB - Hepatocellular foci, considered possible precursors of trabecular hepatocellular carcinomas, were induced after 10 weeks by injecting male B6C3 F1 mice with diethylnitrosamine, 5 mg/kg, when they were 15 days old. The locations of 41 of the foci with diameters between 80 and 112 microns were determined in serial sections of blocks of liver from five mice. The average distance between centers of foci and closest hepatic vein branches (143 microns) was 40% less than that between randomly selected points and veins (243 microns). The centrilobular distribution of the foci might have facilitated the infiltration of hepatic vein branches, which was a prominent feature in animals killed after 20 weeks. This is the first stereologic study documenting the nonrandom distribution of neoplastic or preneoplastic foci in the rodent liver. PMID- 6865334 TI - Quantitative glomerular morphology of the normal human kidney. AB - We determined glomerular basement membrane (GBM) width (as the harmonic mean) and relative volumes of the glomerular mesangium and of its cellular and matrix components in 59 male (73% living-related) and 59 female (93% living-related) donors of kidneys for transplantation. The GBM, consistently wider in male (mean, 373 nm.) versus female (mean, 326 nm.) donors, increased in width in all donors until the fourth decade of life when it appeared to decrease in width. The relative volume of the mesangium did not differ as to sex or age (mean, 14.2% of the glomerular volume), nor did either of its components (mean cellular mesangium, 7.1%; mean matrix mesangium, 7.1%). We found no correlations among renal index, GBM width, or the mesangium. No parameter differed in diabetic related compared with nondiabetic-related donors. Results in cadavers for GBM width and the mesangium were no different from those of living-related donors. These observations yield insights into the development of the human kidney and its glomerular components, and in addition the GBM and mesangial measures will serve as normative values to which surgical or biopsy specimens can be related. PMID- 6865336 TI - Chemical composition of oat seed epicuticular wax. PMID- 6865335 TI - Effects of excessive sodium chloride on the juxtaglomerular apparatus and blood pressure of uninephrectomized rats. AB - To clarify the functions of the agranular cells in the polar cushion of the juxtaglomerular apparatus, the effects of drinking 1% NaCl or eating a diet containing 8% NaCl were examined on the numbers of granular and agranular cells in the polar cushions, the kidney weights, and the blood pressures of male Sprague-Dawley rats after uninephrectomy. Only 11.8% of the cells in the polar cushions of control rats in this study were granular; hence, 88.2% of the cells were agranular. After uninephrectomy of rats on a normal diet with tap water, the maximal increase in relative weight of the remaining kidney occurred within 2 weeks, and the degree of hypertrophy was estimated as 64%. Rats with a high salt intake after uninephrectomy had a similar increase, indicating that a high salt intake after uninephrectomy did not affect the degree of hypertrophy of the remaining kidney. The mean juxtaglomerular cell count (JGCC) showed moderate increases 2 weeks after uninephrectomy. Drinking 1% NaCl for 2 weeks after uninephrectomy produced about twice as much increase in the JGCC. Maximal initial increases in JGCCs occurred at 2 weeks, well before an increase in blood pressure. Drinking 1% NaCl had no significant effect on blood pressure within 2 weeks, but there was a definite hypertension at 8 weeks, with no further increase in JGCC. On an 8% NaCl diet hypertension developed between 8 and 16 weeks, when the JGCC was greater than previous levels. Clipping the renal artery of a solitary kidney produced hypertension but no increase in JGCC within 2 weeks. Uninephrectomy lowered the mean granular cell count, and drinking saline lowered it even more. Hence, the proliferation involved agranular cells. In summary, excessive NaCl intake was associated with a rapid proliferation of agranular cells which was maximal at 2 weeks and occurred before any significant increase in blood pressure. This suggests that the agranular cells in the polar cushion of the juxtaglomerular apparatus are concerned more directly with sodium chloride metabolism than with blood pressure regulation. PMID- 6865337 TI - Organic acids, biochemical oxygen demand and chemical oxygen demand in the soluble fraction of piggery slurry. PMID- 6865338 TI - A study of the variability of the endogenous energy output by adult roosters and a determination of the available energy of nine different feedstuffs. PMID- 6865339 TI - The effect of harvest date on the DOMD, crude protein, SMCO and SCN contents of the lamina, petiole and stem of fodder kale. PMID- 6865341 TI - The isolation and purification of indole glucosinolates from Brassica species. PMID- 6865342 TI - Interactions between the kernel N sink, grain yield and protein nutritional quality of maize. PMID- 6865340 TI - Effects of extracts from bean (Phaseolus vulgaris) and field bean (Vicia faba) varieties on intestinal D-glucose transport in rat in vivo. PMID- 6865343 TI - Determination of purine alkaloids and trigonelline in instant coffee and other beverages using high performance liquid chromatography. PMID- 6865344 TI - Occupational high-pressure injection injuries: pathogenesis and prevention. PMID- 6865345 TI - Poisoning on the farm. PMID- 6865347 TI - Manufacturing processes: sheepskin and fur processing. PMID- 6865346 TI - The health of welders in naval dockyards: proportional mortality study of welders and two control groups. PMID- 6865348 TI - Organizing a Group Occupational Health Service in County Durham. PMID- 6865349 TI - Certification of food handlers. A system to fulfill EEC requirements. PMID- 6865350 TI - Stresses in a Harrington distraction rod: their origin and relationship to fatigue fractures in vivo. AB - As illustrated by the case study described in this paper, in-vivo fractures of distraction rods often occur by metallurgical fatigue at the junction between the smooth and ratcheted parts of the rod (i.e., at the first ratchet junction, FRJ). To clarify causative factors of fatigue at the FRJ, stresses are analyzed in a standard 11-in. rod using both experimental and theoretical methods. The analyses reveal how distraction force, eccentricity of loading, rod geometry and material determine the stresses at the FRJ. These stresses can exceed the fatigue endurance limit for certain clinically encountered conditions. PMID- 6865351 TI - Impulse and moment of impulse in the leg joints by impact from kicking. AB - In a previous paper we have given a theoretical analysis of the impulsive motion of the leg, modeled as a double pendulum. This analysis made it possible to estimate the impulsive reactions in the knee joint as a function of the measured initial and final velocities of the leg, when an impact was given to the lower leg, e.g., by means of a kick. This estimation was made under the assumption that no impulsive moments occur in the hip and the knee joints, i.e., that no muscles were stretched during the time of impact. In the present paper it is shown how such impulsive moments, should they occur, can be determined by means of an additional measurement, i.e., of the velocity of the ball after the impact. The results from a series of experiments are reported, showing that such impulsive moments in the joints occur in an appreciable number of the kicks, especially in the hip joint, indicating that muscles, acting on this joint, are prestressed during the impact. PMID- 6865352 TI - Pulsatile flow in tapered tubes: a model of blood flow with large disturbances. AB - Blood flow-through segments of large arteries of man, between adjacent bifurcations, can be modeled as pulsatile flow in tapered converging tubes, of small angle of convergence, up to 2 deg. Assuming linearity, rigid tube and homogeneous Newtonian fluid, the physiological flow field is governed by the Navier-Stokes equation with dominant nonlinear and unsteady terms. Analytical solution of this problem is presented based on an integral method technique. The solution shows that even for small tapering the flow pattern is markedly different from the flow obtained for a uniform tube. The periodic shear stresses at the wall and pressure gradients increase both in their mean value and amplitude with increased distance downstream. These results are highly significant in the process of atherogenesis. PMID- 6865353 TI - Monitoring fracture site properties with external fixation. AB - An in-vitro system has been devised to monitor the properties of an idealized fracture site immobilized with a Hoffman-Vidal external fixator. A dial gage was used to measure the relative pin displacements under controlled axial loading. The displacement measurements were then used in conjunction with a finite element model to predict the modulus of an idealized fracture site. Five fracture sites made of neoprene disks of different mechanical properties were monitored in order to simulate the increasing modulus of a healing fracture. Good agreement was observed between directly measured mechanical properties of the neoprene and those inferred from the combined finite element and pin displacement tests. PMID- 6865354 TI - Error analysis of a system for measuring three-dimensional joint motion. AB - In the past ten years there has been increased use of six-degree-of-freedom instrumented spatial linkages for the measurement of biological joint motions. In spite of the increased popularity, little information has been reported on the accuracy of these devices. In this paper, we present a two-part investigation of the accuracy of the instrumented spatial linkage when used to measure knee joint kinematics. In the first part, we present the results of a theoretical analysis and an experimental determination of the errors associated with spatial linkage systems. In the second part, we describe the errors associated with a bi-planar X ray system used to obtain the coordinate transformation between the linkage ends and coordinate systems located in the bones comprising the joint. We found that the theoretical error analysis consistently overestimated the actual measurement error, thus providing an unreliable estimate of errors. The experimental study of both the linkage system and the bi-planar X-ray system demonstrated that the accuracy of displacement measurement is insensitive to large systematic errors in position measurement. PMID- 6865355 TI - A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. AB - The experimental study of joint kinematics in three dimensions requires the description and measurement of six motion components. An important aspect of any method of description is the ease with which it is communicated to those who use the data. This paper presents a joint coordinate system that provides a simple geometric description of the three-dimensional rotational and translational motion between two rigid bodies. The coordinate system is applied to the knee and related to the commonly used clinical terms for knee joint motion. A convenient characteristic of the coordinate system shared by spatial linkages is that large joint displacements are independent of the order in which the component translations and rotations occur. PMID- 6865356 TI - An analytical technique for modeling knee joint stiffness--Part II: Ligamentous geometric nonlinearities. AB - An analytical technique previously developed to evaluate the contribution of the ligaments to the nonlinear, coupled stiffness characteristics of the human knee joint [1] is extended here to include geometric nonlinearities. In [1], we assumed that the ligaments act as tensile bands running in a straight line between tibial and femoral insertion sites. Here, two forms of geometric nonlinearities are introduced and analyzed: ligaments wrapping around bone surfaces, such as occurs with the medial collateral ligament, the posterior capsule, and the anterior cruciate in hyperextension, and wrapping of ligaments around each other, such as occurs with the cruciate ligaments as the knee is flexed and internally rotated. PMID- 6865357 TI - Tension-torsion characteristics of the canine anterior cruciate ligament--Part I: Theoretical framework. AB - It has been observed that the fascicles in the canine anterior cruciate ligament do not follow a straight line path between the tibial and femoral attachment sites, but rather their path is approximately helical about the ligament axis. Thus, a mathematical model for the mechanical response of a ligament was developed from the observed geometrical configuration of the fascicle. The principal result of the model indicated that a torque must always accompany the force during elongation of a ligament. The relationships between the ligament and fascicle variables are also examined in detail. PMID- 6865358 TI - Tension-torsion characteristics of the canine anterior cruciate ligament--Part II: Experimental observations. AB - An experimental program was devised to determine whether the canine anterior cruciate ligament (ACL), with an apparent helical twist of its component fiber bundles, could support a torque during axial loading to failure. At the point of first significant failure, the anterior cruciate was found to develop an average maximum torque of 122 +/- 26 N-mm (mean +/- SEM) for the nine tension-torsion tests performed. A nearly linear axial force-torque curve was also observed where the average slope of all tests was 5.2 +/- 0.2 mm-1 (mean +/- SEM). The experimental axial force data was then used to determine material parameters in the constitutive equation for the fascicle and underlying bone. A nonlinear ligament model based on this response was found to reproduce the axial force data adequately and to reasonably predict the observed ligament torque over the entire subfailure loading range. The presence of a ligament torque during axial loading has implications in the design and selection of a ligament substitute. Such a substitute has already been examined in the canine in another study. The results also suggest more refined experiments which could relate the mechanical properties of a ligament to its detailed macrostructure and insertion site geometries. PMID- 6865359 TI - Cycle-dependent and time-dependent bone fracture with repeated loading. AB - Fatigue tests of human cortical bone (up to 1.74 X 10(6) cycles) were conducted under tension-compression (T-C) and zero-tension (O-T) modes with a 2Hz, stress controlled, sinusoidal loading history. Tensile creep-fracture tests at constant stress levels were also performed. The relationship between the initial cyclic strain range and cycles to failure with the T-C specimens were consistent with that derived previously in low-cycle fatigue under strain control. Using a time dependent failure model, the creep-fracture data was found to be consistent with previous studies of the influence of strain rate on the monotonic tensile strength of bone. The model also predicted quite well the time to failure for the O-T fatigue specimens, suggesting that creep damage plays an important role in O T fatigue specimens. PMID- 6865360 TI - Pre-collapse stress redistributions in femoral head osteonecrosis--a three dimensional finite element analysis. AB - Three-dimensional finite element analysis is used to explore the influence of several lesion characteristics upon mechanical stress distributions in segmentally necrotic human femoral heads. Variables studied parametrically included apparent modulus deficits within the lesion proper, as well as the depth, width, and location of the infarcted head regions. The detailed patterns of stress redistribution were complex and were found to be a strong function of the specific lesion characteristics. The salient phenomenon, however, was one of preferential load uptake by the stiffer bone surrounding the lesion. Since computed stress reductions within the infarctions were usually much smaller than experimentally observed strength reductions, the data suggest a strong tendency for an elevated incidence of trabecular fatigue fractures in the affected regions. PMID- 6865361 TI - Measurement of turbulence intensity in the center of the canine ascending aorta with a hot-film anemometer. AB - The blood flow velocity near the central axis of the canine ascending aorta was measured with a hot-film anemometer. The cardiac output and the heart rate were controlled at will by means of an extracorporeal circulation and by atrial pacing. The turbulent component of the blood flow velocity was calculated using an ensemble average technique. Ensemble average turbulent intensity was also calculated to show the time course of turbulence in the aorta. The ratio of the mean turbulence intensity to the time mean sectional average velocity in the aorta was constant in most animals regardless of the changes in fluid mechanical parameters. The correlation between the frequency parameter and the relative mean turbulence intensity was weakly positive. The power spectrum of the turbulence was also calculated. PMID- 6865363 TI - Poisson's ratio and incompressibility. PMID- 6865362 TI - Model simulation of heat and water transport dynamics in an airway. AB - Heat and water transport processes in the respiratory tract depend on environmental conditions, breathing patterns, and the physiological state of the respiratory system. To study these processes, we have developed a mathematical model of the dynamics of temperature and water vapor in the radial and axial directions of an idealized trachea. The model is expressed as two implicit finite difference equations and solved using an alternating-direction algorithm. Using these equations, we simulated the effects of inspired gas temperature and humidity, velocity profile, and flow rate on heat and water transport between the gas and airway wall. Under inspired gas conditions of low temperature or high relative humidity, supersaturation occurs. Increasing either the velocity gradient at the wall or the flow rate increases the heat and water transport rates. However, these rates change by only 10 percent when the velocity gradient is doubled, and by about 35 percent when flow rate undergoes a two-fold change. The model can be used with in-vivo data from the trachea to test hypotheses concerning normal and abnormal heat and water transport. PMID- 6865364 TI - Phonatory and manual reaction times of women with idiopathic spasmodic dysphonia. AB - This investigation compared the simple reaction times of 10 idiopathic spasmodic dysphonic women and 10 normal-speaking women matched individually for age and handedness. The reaction time stimulus in all response conditions was the offset of a 1000-Hz pure tone. Two of the experimental conditions required right and left forefinger button pressing. The remaining four experimental conditions required phonatory responses. The nonspeech phonatory responses consisted of inspiratory phonation and expiratory throat clearing; the speech-like phonatory responses required abrupt initiation of the isolated vowel and the word. The spasmodic dysphonic patients differed (p less than or equal to .05) from their matched controls only during production of. The results are compared to previous reaction time investigations and are related to factors which potentially can influence sensory-motor pathways prior to and during speech. PMID- 6865365 TI - Oral vs. manual tapping with delayed auditory feedback as measures of cerebral dominance. AB - Two sets of findings have been reported which make contradictory claims about the cerebral lateralization of mechanisms for coordinating auditory feedback with motor control. One difficulty in evaluating the two sets of claims is that they result from experiments involving methodologies which are different enough to make direct comparisons difficult. The present study reports results of an experiment using a technique which partially bridges the gap between two of these paradigms. This technique involves examining the effect of delayed auditory feedback (DAF) on performance of both an oral and a manual tapping task. Ear of delivery of DAF, subject language background, and nature of the auditory stimulus were the experimental variables. The findings support the claim that the left hemisphere is differentially involved in the use of auditory feedback to control oral, but not manual, motor activity. No evidence was found to indicate that this functional cerebral asymmetry is stimulus- or language-dependent. PMID- 6865366 TI - The influence of stress, position, and utterance length on the pressure characteristics of English /p/ and /b/. AB - This study examines pressure characteristics of /p/ and /b/ as a function of position with regard to stress and position within the utterance. Eight female talkers produced utterances which varied in length from one to five disyllables ([pape] or [babe]). Results demonstrate the importance of utterance position for the magnitude of supraglottal pressure in stops. Except in voiceless stops found in the first words of utterances, pressure was greater in the prestressed than in the poststressed position. The pressure difference distinguishing /p/ and /b/ was reduced considerably when these stops occurred in absolute utterance-initial position. A post hoc analysis revealed that pressure increased much more slowly in initial than in noninitial stops and that /p/ and /b/ were not distinguished by the rate at which supraglottal pressure increased when these stops occurred in utterance-initial position. Finally, it was found that the pressure of stops in the first words of utterances increased as a function of utterance length, suggesting preplanning for sentence production at the respiratory level. PMID- 6865367 TI - Voice onset time in young and 70-year-old women. AB - This study was conducted to determine the effect of aging on voice onset time (VOT). Ten women between 20 and 30 years old and 10 women between 70 and 80 years old read CVC syllables embedded in a carrier phrase. Spectrograms were used to measure VOT for voiced and voiceless bilabial and velar stops in the context of high and low vowels. Findings revealed that VOT was generally the same in older and younger subjects, and both age groups maintained similar voiced/voiceless and bilabial/velar distinctions. Older subjects demonstrated significantly shorter VOTs only in certain contexts involving place of consonant production and vowel context. The effects of aging on VOT, therefore, seem to appear only in selected phonetic contexts. PMID- 6865368 TI - Performance of articulation-disordered children on language and perception measures. AB - Five-year-old articulation-disordered children were classified as syllable reducers or as substituters. They were compared to each other and to normal controls on measures of expressive and receptive language and on preception of word-initial and word-final voicing contrasts. There were significant differences among the groups on several imitative expressive language measures, with the syllable reducers making both deletion and substitution errors and the substituters making substitution errors for functors. There were no significant differences on a receptive language measure, nor in perception of final voicing contrasts, but the articulation-disordered groups performed more poorly than the controls in perception of initial voicing contrasts. Children's familiarity with the stimulus words of the perception task was related to their performance on language measures. Word familiarity appeared to interact with the intrinsic difficulty of stimulus pairs in the case of word-final voicing contrasts. PMID- 6865369 TI - A 3-year longitudinal study of school-aged children's fundamental frequencies. AB - This report describes the longitudinal changes that took place in the average fundamental frequencies (fo) of 25 boys and girls over a 3-year period (means age range = 8:2-11:2). Results showed that developmental changes in the central tendency of fo can be detected over a 1-year period. For the group, the amount of decrease per 12-month interval averaged about 12 Hz, with a standard deviation of about 8 Hz. Cross-sectional observations of 7-11-year-old children's fundamental frequency characteristics do not reflect accurately the developmental course of fo, in large part because the between-subject standard deviations are larger than the age-related changes that occur in children's voices at this stage of development. PMID- 6865370 TI - Perception of intonational contrasts in alaryngeal speech. AB - The achievement of intonational contrasts by 4 normal and 16 laryngectomized speakers was assessed in this project. The laryngectomized subjects represented four clinical subgroups of alaryngeal speech: esophageal, tracheoesophageal, Western Electric #5 electrolarynx, and Servox electrolarynx. High-quality tape recordings of each subject's productions of two pairs of sentences (Bev loves Bob) spoken in statement and question from were presented to 40 listeners for evaluation using a two-interval-alternative-forced-choice procedure. Intonational contrasts were achieved in a highly effective manner by the normal, esophageal, and tracheoesophageal speakers. In contrast, users of electronic artificial larynges were generally unable to achieve these intonational distinctions except for one user of the Western Electric #5 electrolarynx. PMID- 6865371 TI - Audiologic correlates of hearing handicap in the elderly. AB - This investigation was conducted to determine the relationship between self assessed hearing handicap and audiometric measures in a large sample of noninstitutionalized elderly individuals. Eighty subjects underwent a complete audiological evaluation and responded to the Hearing Measurement Scale (HMS). Each of the correlations between measures of sensitivity and the HMS score was statistically significant. The speech discrimination scores showed a somewhat lower correlation with the HMS score than did pure-tone measures. The implications of the above findings are discussed. PMID- 6865372 TI - Iris pigmentation and AC thresholds. AB - Data from 160 White children were used to analyze possible associations between iris pigmentation and AC pure-tone thresholds. Iris pigmentation was graded from iris color using glass models of eyes, and AC thresholds were obtained under carefully controlled conditions. Analyses of variance using two groupings of iris color grades showed no evidence of an association between iris color grade and AC thresholds. Furthermore, inspection of arrays of the actual glass eye models, in conjunction with the order of mean thresholds at each test frequency, did not indicate the presence of an association between iris color grades and thresholds. It was concluded that while iris pigmentation may be related to some aspects of hearing ability, it does not appear to be related to AC thresholds in children. PMID- 6865373 TI - A reply to Costello and (Roemer) Hurst. PMID- 6865374 TI - Selected acoustic characteristics of pathologic and normal speakers: a reanalysis. PMID- 6865375 TI - Assessment of electromagnetic characteristics of the Willeford Central Auditory Processing Test Battery. AB - Electromagnetic characteristics of eight tape recordings of the Willeford Central Auditory Processing Test Battery were assessed. Measurements indicate that when recording levels are referenced to the calibration tone preceding a given subtest of that battery, significant intertape differences, interest differences, and interchannel differences in the recording levels of test items exist. Mean recording levels of items used in the Rapidly Alternating Speech Perception, Low Pass Filtered Speech, and Competing Sentences subtests typically were within 10 dB of the reference tone. Recording levels for the Binaural Fusion subtest yielded intertape differences of as much as 26.5 dB. Given the large intertape inconsistencies in recording levels, extreme caution should be exercised in the use of these recordings. PMID- 6865376 TI - Visual evoked-response correlates of speechreading performance in normal-hearing adults: a replication and factor analytic extension. AB - The relationship between the latency of the negative peak occurring at approximately 130 msec in the visual evoked-response (VER) and speechreading scores was investigated. A significant product-moment correlation of -.58 was obtained between the two measures, which confirmed the fundamental effect but was significantly weaker than that previously reported in the literature (-.90). Principal components analysis of the visual evoked-response waveforms revealed a previously undiscovered early VER component, statistically independent of the latency measure, which in combination with two other components predicted speechreading with a multiple correlation coefficient of .84. The potential significance of this new component for the study of individual differences in speechreading ability is discussed. PMID- 6865377 TI - Effects of physiological aging on selected acoustic characteristics of voice. AB - The relationship between age-related changes in body physiology and certain acoustic characteristics of voice was studied in a sample of 48 men representing three chronological age groupings (25-35, 45-55, and 65-75) and two levels of physical condition (good and poor). A fundamental frequency analysis program (SEARP) was used to measure mean fundamental frequency, jitter, shimmer, and phonation range from samples of connected speech and sustained vowel production. Subjects in good physical condition produced maximum duration vowel phonation with significantly less jitter and shimmer and had larger phonation ranges than did subjects of similar chronological ages who were in poor physical condition. These differences were most apparent in the productions of the elderly subjects. While chronological aging is undoubtedly a contributor to such changes in the acoustic characteristics of voice, these results suggest that age-related changes in body physiology, or physiological aging, also must be considered. PMID- 6865378 TI - Contextual effects in the measurement of hearing-impaired speakers' intelligibility. AB - Previous research has indicated that hearing-impaired speakers' intelligibility scores are better when sentences are used than when word lists are used as speech material in word identification tests. The speech intelligibility of 20 hearing impaired speakers was measured with word identification tests using isolated words (W-22 monosyllables) and words in sentence context (CID sentences). Analysis of individual speakers' intelligibility data revealed that sentence intelligibility scores were higher than word intelligibility scores only for the better speakers and that no differences were apparent between sentence and single word intelligibility for the poorer speakers. These findings agree with the results of research with normal speech degraded in intelligibility by noise or filtering and indicate that an interaction may exist between context and overall intelligibility in which only speech that has a certain degree of overall intelligibility may show further intelligibility improvement with increased contextual clues. PMID- 6865380 TI - Dichotic listening performance, language impairment, and lesion location in aphasic listeners. AB - This investigation sought to identify relations between dichotic listening performance and both specific language functions and CT scan evidence of lesion location in order to determine whether the nature of these relations would support either "dominance effect" or "lesion effect" interpretations of the dichotic scores. Twenty-five aphasic patients completed our digit dichotic listening test, the Boston Diagnostic Aphasia Examination (BDAE), an experimental sentence comprehension test, and a digit immediate memory span test. Right ear scores (and the ear advantage) accurately reflected the integrity of the central auditory structures for all but one of the patients, and thus were interpreted as "lesion effects." These same right ear scores also were related more strongly to performance on phrase repetition subtests of the BDAE and to scores obtained on our sentence comprehension test than to the other language measures analyzed. These relations were maintained even when general measures of auditory comprehension and immediate memory were held constant through the use of partial correlations. Both "dominance" and "lesion" effect interpretations were discussed, but the "lesion effect" interpretation more adequately characterized the data. That is, the integrity of the posterior, superior temporal area seemed to be essential for perception of right ear stimuli on the digit dichotic test and for accurate performance on specific language tests. PMID- 6865379 TI - A cinefluorographic investigation of repeated fluent productions of stutterers in an adaptation procedure. AB - Cinefluorography was used to study three stutterers and two nonstutterers repeating a passage made up of monosyllables. CVC target words of the form/caet/ were embedded in the passage and were analyzed to determine the effects of repeating the passage on velocities, displacements, and durations of movements of the tongue, jaw, and lower lip. Coordination among the articulators was also assessed. The investigation was undertaken to test the hypothesis that decreases in velocities and displacements, increased movement durations, and decreased latency between the onsets of jaw movements and of tongue tip movements would be associated with the repeated readings. The hypothesis was not supported by the results. A post hoc analysis showed that a decrease in the variability of instantaneous velocities (and by inference a decrease in variation in muscle stiffness) was associated with practice for the three stutterers but not for the nonstutterers. Inferences about the adaptation effect are made related (a) to the stabilization of tonic muscle activity which may be associated with a decrease in arousal, and (b) to the effects of practice. PMID- 6865381 TI - Speech identification in Spanish- and English-learning 2-year-olds. AB - English- and Spanish-learning 2-year-olds were tested for speech skills in a real speech context. Each child was tested in his/her native language on one native and one nonnative contrast. The nonnative contrast consisted of a real native word paired with a nonsense word containing a nonnative element. The native contrast consisted of a native word paired with a nonsense word containing a minimally paired native element. The results showed that both groups of children found identification of native contrasts much easier than identification of nonnative contrasts. The results suggest that by age 2, normal children may have achieved an awareness of their native phonology, an awareness that encourages them to ignore certain distinctions that are not part of their language's contrastive meaning system. PMID- 6865382 TI - Threshold inaccuracies in an elderly clinical population: ear canal collapse as a possible cause. AB - In a sample of 80 persons in the 60-79-year age range, threshold shifts suggestive of collapsible ear canals were found in over one third of the subjects. A very conservative interpretation of the data suggests that at least 10-16% of these 60-79-year old elderly subjects have collapsible ear canals. Neither sex nor age was related significantly to prevalence. Results of this study indicate that in testing elderly persons there are threshold inaccuracies, relating possibly to collapsible ear canals, which, if not taken into account, may cause unacceptably large errors in both clinical and research applications. PMID- 6865384 TI - The annoyance of tinnitus and the noise required to mask it. AB - For 11 patients with tinnitus and sensorineural hearing loss, the intensity of bilateral broad-band noise required to mask the tinnitus increased by as much as 41 dB over a 30-minute period. A significant correlation was obtained between the rate of change in the noise over time and reported annoyance of the tinnitus as measured on a 5-point rating scale. The total change in the noise level and the initial noise level required to mask the tinnitus were not significantly correlated with the annoyance of the tinnitus. PMID- 6865383 TI - The determination of tinnitus loudness considering the effects of recruitment. AB - We have attempted to determine a meaningful measure of tinnitus loudness that considers loudness recruitment. Sixteen subjects with sensorineural tinnitus adjusted the level of a pure tone so that it was (a) at threshold, (b) equal in loudness to the tinnitus, and (c) uncomfortably loud. The pure-tone frequency was (a) at the frequency of the tinnitus pitch, and (b) at the octave frequency between 500 and 4000 Hz having the pure-tone threshold closest to 0 dB HL. In addition, the subjects adjusted the level of a broadband noise so that it (a) was at threshold, (b) just masked the tinnitus, and (c) was uncomfortably loud. These measurements were performed both in the ear ipsilateral and in the ear contralateral to the tinnitus. Formulae based on abnormal loudness functions and uncomfortable loudness levels are presented that convert equal-loudness matches in dB sensation level (SL) into loudness in sones. The level of broadband noise (in dB SL) required to mask tinnitus was about the same in the ipsilateral and in the contralateral ear for most of our subjects, regardless of the ear in which the tinnitus was localized. This noise level (in dB SL) required to mask the tinnitus correlated well with the level (in dB SL) of a tone at the most normal frequency judged equal in loudness to the tinnitus. PMID- 6865385 TI - Training generative repertoires within agent-action-object miniature linguistic systems with children. AB - This study investigated processes responsible for generative language acquisition through the use of a miniature linguistic system. The miniature linguistic system consisted of nonsense syllables and concrete-enactive, agent-action referents. The purpose of Experiment 1 was to determine (a) whether children would recombine agent and action constituents to produce novel utterances and (b) whether children would generate further extensions of the linguistic system (e.g., agent action-object sentences) following training of a novel syntactic construction. Four children (aged 8:8, 7:4, 4:9, and 4:5) produced novel utterances to describe untrained agent-action referents. They also progressed from agent-action learning to producing agent-action-object sentences after training on only one or two examples of this sentence type with the appropriate referents. Experiment 2 explored conditions more likely to facilitate recombinative generalization among preschoolers. In particular, how a history of lexical learning affects subsequent language learning was investigated with seven 4-year-olds. Results indicated that a history of lexical learning greatly enhanced generative production of untrained agent-action utterances. In addition, all seven children learned new syntactic rules to generate three-word utterances, regardless of the orderings of agent, action, and object words. Implications for developing efficient language remediation programs are discussed. PMID- 6865386 TI - Performative and presuppositional skills in language-disordered and normal children. AB - The presuppositional and performative abilities of language-disordered and normal children were compared, controlling for the children's ability to use the lexical items required in the experimental tasks. Subjects were 36 children, 18 normal and 18 language-disordered, functioning at a single-word level of linguistic development. Results revealed that both the language-disordered and the normal children showed a tendency to encode changing rather than unchanging situational elements. The two groups of children also demonstrated similar levels of imperative and declarative performance intent. For both groups, performative and presuppositional behaviors were usually in the form of word productions. Discrepancies between the findings of this and other investigations are discussed with respect to the size of the children's lexicons, their expressive command of the lexicon, chronological age, and representational skills. PMID- 6865387 TI - The pathogenesis of systemic loxoscelism following brown recluse spider bites. PMID- 6865388 TI - Staged reversal of venous flow for revascularization of the severely ischemic limb. PMID- 6865390 TI - Prolonged partial cardiopulmonary bypass in rats. AB - Membrane oxygenators have been shown to be atraumatic during cardiopulmonary bypass. A novel design for a membrane tubing oxygenator originated in this laboratory was used for prolonged partial supportive cardiopulmonary bypass in lambs and displayed excellent biocompatability characteristics. This was miniaturized, to result in a prime volume of 12 ml, in order to investigate the feasibility of prolonged partial supportive cardiopulmonary bypass in rats. The performance of this miniaturized circuit over perfusion periods up to 6 hr is described, with particular reference to hematological changes. PMID- 6865389 TI - Effects of brain hypoxia on pulmonary hemodynamics. AB - The effects of acute brain hypoxia on pulmonary hemodynamics were investigated in anesthetized dogs with the vagus and carotid sinus nerves intact and cut. Following ligation of collateral vessels, brain hypoxia was induced by pumping arterial blood through a ventilated extracorporeal lung to the external carotid arteries for 5 min. In the intact-nerve group brain hypoxia caused no change in pulmonary and systemic vascular pressures and resistances. In the cut-nerve group brain hypoxia caused an increase in mean pulmonary artery, left atrial, pulmonary artery pulse, and mean aortic pressures. Cardiac output, dP/dt, central blood volume, and total peripheral resistance increased but pulmonary vascular resistance and lung extravascular thermal volume were unchanged. It is concluded that acute brain hypoxia does not increase pulmonary vascular resistance but may increase pulmonary blood volume resulting from increased left ventricular afterload. PMID- 6865391 TI - The protective effects of nifedipine in the isolated cat heart. AB - The calcium channel blocking agent, nifedipine, was studied during global ischemia and reperfusion in isolated cat hearts perfused with Krebs-Henseleit solution. Nifedipine was added to the reservoir and 0.1 micrograms/ml perfusate/hr of nifedipine was infused for 150 min. After 120 min of ischemia (flow at 1% of control), the heart was reperfused with nifedipine-containing perfusate for 20 min and with nifedipine-free perfusate for an additional 25 min. In control hearts, nifedipine significantly reduced the percent free activity of the lysosomal protease cathepsin D (P less than 0.01). In ischemic hearts, nifedipine protected against the increased myocardial tissue edema (P less than 0.01), the increased percent free cathepsin D activity (P less than 0.02) and the postreperfusion increased creatine kinase activity (P less than 0.01). Thus, nifedipine showed membrane stabilizing and cytoprotective activities in myocardial cells, after postischemic reperfusion. These data suggest that calcium ions contribute to the lysosome labilization and cytoplasmic enzyme leakage observed in ischemia and reperfusion, and that calcium channel blockade may protect myocardial cellular integrity during both ischemia and reperfusion. PMID- 6865392 TI - Cardioplegic arrest in isolated blood-perfused working rat hearts. AB - An isolated working rat heart model designed for function studies after elective cardiac arrest is described. Before and after a cold ischemic period (induced with St. Thomas' cardioplegic solution) of 30 min, hemodynamic and metabolic variables were assessed in a group of 13 hearts perfused with a modified Krebs Henseleit solution and in a group of 13 hearts perfused with reconstituted blood. Functional recovery was about 90% in the nonblood-perfusate group and 98% in the blood-perfused group. Functional deterioration in time due to edema formation and limited oxygenation in electrolyte-perfused hearts was found to be of the same magnitude as the function loss ascribed to deleterious effects of cardioplegic arrest. The blood-perfused hearts showed hemodynamic stability during a 75 min continuous working period, and complete recovery of function after 30 min arrest. PMID- 6865393 TI - Bile absorption occurs during disruption of the esophageal mucosal barrier. AB - The role of bile salt absorption in bile-induced disruption of the esophageal mucosal barrier was determined using the continuously perfused rabbit esophagus model. Mucosal barrier disruption was determined by measuring net flux of hydrogen ion, potassium, and glucose. Bile salt absorption was measured by determining net flux of radiolabeled bile salt solution using liquid scintillation counting. Bile salt-containing solutions were prepared with varying concentrations of two bile salts, taurocholate and deoxycholate. The pH of the bile salt exposure also was varied to vary the extent of mucosal injury. The results show that changes in bile salt concentration and in pH of exposure were associated with significant differences in both extent of mucosal barrier disruption and bile salt absorption. Bile salt absorption was associated by direct linear correlation with each index of mucosal barrier function studied. These findings suggest that bile salt absorption plays a role in bile-induced disruption of the esophageal mucosal barrier. PMID- 6865394 TI - A new approach to the induction of duct epithelial hyperplasia and nesidioblastosis by cellophane wrapping of the hamster pancreas. AB - There is ample evidence that a relationship exists between duct epithelial hyperplasia and carcinoma of the pancreas. However, no experimental system exists to investigate the mechanisms involved. A new model is described in the Syrian golden hamster for inducing duct epithelial hyperplasia and nesidioblastosis. The head of the pancreas is wrapped with cellophane tape; ligation of the duct is not involved and there is no evidence of diffuse pancreatitis. Preliminary studies have revealed that this model results in periductal fibrosis in relation to the cellophane thus producing partial duct obstruction. Concomitant with the fibrosis there is duct epithelial hyperplasia in the head of the gland, while peripherally there is ductular proliferation and the initiation of nesidioblastosis. It is believed that this model will be of use in studies of pancreatic carcinogenesis and will thus enhance our knowledge of the interrelationships between etiologic factors, precursor lesions, and pancreatic cancer. This is of particular importance in the early recognition of this neoplasm in man. PMID- 6865395 TI - The effect of stellatectomy on gastric acid secretion in the dog. AB - The stellate ganglion is the major contributor of adrenergic fibers to the vagus nerve and stellatectomy causes a degeneration of vagal adrenergic fibers. The purpose of this experiment was to evaluate the effect of stellatectomy on gastric acid secretion (GAS) and gastrin levels in the dog. GAS in response to pentagastrin stimulation was measured in six gastric fistula dogs before and after stellatectomy. Likewise, blood was collected for basal and meat meal stimulated serum gastrin levels before and after stellatectomy. After bilateral stellatectomy acid secretion increased in response to submaximal doses of pentagastrin stimulation whereas maximal secretion was unchanged. Resting and meal-stimulated gastrin levels did not change. A Horner's syndrome developed in each dog. It is concluded that bilateral stellatectomy increases GAS in response to submaximal stimulation while not altering gastrin release. These results suggest that the vagal adrenergic innervation of the stomach has an inhibitory role in the control of GAS in the dog. PMID- 6865396 TI - Laryngeal blastomycosis. PMID- 6865397 TI - Closed malpractice claims against Tennessee physicians, 1975-1978. PMID- 6865398 TI - Thoracic aortic aneurysm with spontaneous rupture. PMID- 6865399 TI - EKG of the month: first degree block and QT abbreviation due to hypercalcemia in the setting of IgG myeloma. PMID- 6865400 TI - Training in the administration of epinephrine in anaphylaxis now available to EMTs and the lay public. PMID- 6865401 TI - Painless thyroiditis with hyperthyroidism. PMID- 6865402 TI - Glucocorticoid receptor stabilization: relative effects of molybdate ion on inactivation by alkaline phosphatase and phospholipase A2. AB - Glucocorticoid receptors in cytosol preparations from rat liver or mouse L cells are inactivated by phospholipase A2 or calf intestine alkaline phosphatase. Molybdate ion, an inhibitor of a variety of phosphatase enzymes, does not prevent inactivation of glucocorticoid binding capacity by alkaline phosphatase but it blocks inactivation by phospholipase A2. In neither case is the enzyme itself inhibited, and the effect of molybdate on phospholipase-mediated inactivation appears to reflect the ability of molybdate to prevent receptor inactivation by the detergent action of lysophosphatides. PMID- 6865403 TI - Glucocorticoid binding in cytosol of cultured rat myoblasts. PMID- 6865405 TI - Specific estimation of fifteen unconjugated, non-metabolized steroid hormones in human urine. AB - A method for the specific determination of 15 free, non-metabolized steroid hormones in human urine is described. The steroids progesterone (P), androstenedione (AD), pregnenolone (PL), 5 alpha-dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA), testosterone (T), 11-deoxycorticosterone (DOC), 17 OH-progesterone (17-OHP), 17-OH-pregnenolone (17-PL), 11-deoxycortisol (S), 18-OH 11-deoxycorticosterone (18-OH-DOC), corticosterone (B), aldosterone (Aldo), cortisol (F), and 18-OH-corticosterone (18-OH-B) were extracted from 2 ml urine samples by a solid-phase technique, subjected to automatic high performance liquid chromatography (HPLC) and finally quantitated by radioimmunoassay (RIA). The combination of HPLC and RIA provides a high specificity of steroid estimates. The automatic mode of HPLC renders the method quite suitable for series analyses in research or for routine purposes. Precision and accuracy are satisfactory, and comparable with the level commonly achieved in RIA techniques. The mean values (nmol/24 h) of reference ranges established from 32 normal males were as follows: P: 0.36; AD: 9.76; PL: 0.90; DHT: 0.61; DHEA: 6.76; T: 1.43; DOC: 0.35; 17-OHP: 1.03; 17-PL: 0.20; S: 0.24; 18-OH-DOC: 2.11; B: 1.49; Aldo: 0.46; F: 68.3; 18-OH B: 5.41. This highly practicable method may be particularly useful for the further investigation of the physiological or diagnostic significance of the non conjugated, non-metabolized fraction of steroid hormones in urine. PMID- 6865404 TI - Sulfhydryl sensitivity and [125I]-16 alpha-IODO-17 beta-estradiol binding of estrogen receptor in ovarian epithelial carcinomas. AB - We find that estrophilin from either the cytosolic or nuclear fractions of ovarian epithelial carcinomas (OVCA) binds irreversibly to controlled-pore glass beads (CPG). The CPG-adsorbed estrophilin releases [3H]-estradiol at 4 degrees C in the presence of 1.25 mM AgNO3; estradiol binding capacity from the nuclear fraction is restored by 10 mM dithiothreitol. The number of available estradiol binding sites in cytosol that are sensitive to AgNO3 correlate with (a) the number of estradiol-inhibitable binding sites found in the 8S region in low-salt sucrose gradients (r = 0.9) but not with (b) estradiol-inhibitable binding in the 4S region (r = 0.3) and thus, as expected, only poorly with (c) estimates of available cytoplasmic estrogen binding sites using a standard dextran-coated charcoal analysis (r = 0.7). Total estrogen binding extracted from the nuclear fraction with 0.5 M KCl and adsorbed to hydroxylapatite agreed with the sulfhydryl blocking reagent sensitive moiety (r = 0.9). Estrophilin from OVCA cytosol or nuclear fractions bound [125I]-16 alpha-iodo-estradiol indistinguishably from [3H]-estradiol. The two forms of radiolabelled-estradiol yielded equivalent data that demonstrated a shift in the estrogen binding moiety from the 8S region to the 4-5S region when 0.5 M KCl was added to gradient analyses of OVCA cytosols. From these observations we conclude that the estrophilin found in OVCA is similar to that found in normal and cancerous tissues of other female reproductive organs and that this estrophilin can bind a biologically active radiohalogenated estrogen potentially useful for imaging or treating these tumors. PMID- 6865406 TI - Synthesis and characterization of the anomeric pair of 17 beta-glucuronides of ethynylestradiol. AB - The alpha- and beta-anomers of the 17 beta-D-glucuronide conjugate of ethynylestradiol were synthesized by the SnCl4-promoted reaction between beta acetoxy GAM and the t-17 beta-hydroxyl group of EE2-3-acetate. The conjugates were resolved by crystallization and HPLC. Positive identification was established by u.v. spectrophotometry, i.r. and mass spectrometry and 1H- and 13C n.m.r. The structure of the beta-anomer was confirmed by X-ray crystallographic analysis. In addition, the alpha-anomer was refractory to hydrolysis by bovine beta-glucuronidase, establishing a biochemical difference between the conjugate pair. PMID- 6865407 TI - Structure-activity relationship of estrogens: a study involving cyclofenyl as the model compound. AB - Bis-(p-acetoxyphenyl)cyclohexylidenemethane [cyclofenyl] has been shown to resemble triarylethylene estrogens quite closely in its receptor binding specificity as well as activity profile. Mono-pyrrolidinoethyl ether of cyclofenyl thus acts as a more potent receptor binder but less potent estrogen than its parent. Like triarylethylene antiestrogens, this derivative of cyclofenyl also acts as an antiuterotrophic agent. This finding would substantiate the proposition that the geminal diaryl residue and not the 1,2 diarylethylene moiety is mainly responsible for the receptor binding and activity profile characteristic of triarylethylenes. This understanding can form a basis for the rationalization of the structure-activity-relationship of estrogens at the molecular level. PMID- 6865408 TI - Substituted derivatives of A-nor-5 alpha-androstane and A-nor-5 alpha-estrane- structure and affinity for hormonal receptors. AB - The interactions of A-nor-5 alpha-androstane and A-nor-5 alpha-estrane derivatives with the estrogen and androgen receptors, have been evaluated by measuring their relative binding affinities (RBAs), under two sets of incubation conditions in order to discriminate between potent agonists from weak agonists with potential antagonist activities. Surprisingly some of these compounds which do not possess a phenolic hydroxyl group interact somewhat markedly with the estrogen receptor. This interaction is characteristic of weak estrogens, with potential anti-estrogenic activity (RBA values decreasing when increasing time and temperature of incubation). Results are in good agreement with data obtained in vivo. Moreover, some of these compounds interact also to some extent with the androgen receptor. Results will be discussed in order to outline some structure activity relationships in these series. PMID- 6865409 TI - Activation and changes in the sedimentation properties of rat liver glucocorticoid receptor. AB - The glucocorticoid receptor in rat liver cytosol was studied by sucrose gradient sedimentation, DEAE-Sephadex A-50 column chromatography and DNA-cellulose binding in order to assign specific hydrodynamic properties to both the unactivated and the activated glucocorticoid--receptor complex with [3H]-dexamethasone. Activation was effected by heat, NaCl (0.4 M) or KSCN (0.1 M) treatment. The state of activation was judged by both DNA-cellulose binding and DEAE-Sephadex A 50 anion exchange chromatography. In isotonic phosphate buffer, unactivated and activated glucocorticoid--receptor complex sedimented as a 5 S and a 4 S peak, respectively. This 5 S-4 S transformation was blocked by sodium molybdate. In hypotonic phosphate buffer, both the unactivated and the activated glucocorticoid -receptor complex assumed higher s values due to aggregation. The activated complex (4 S) yielded aggregates of 5-6 S in a reversible manner, neither complex being affected by sodium molybdate. The unactivated complex was shown to assume two distinct aggregation states of 6 S and 8-9 S, which yielded a 10-11 S heavy aggregate upon addition of molybdate. This effect on the unactivated glucocorticoid--receptor complex was readily reversed by removing the molybdate. Aggregation at low ionic strength was promoted by a low mol. wt. component(s), separated from cytosol by gel filtration through Sephadex G-10. The state of aggregation had no pronounced effect on the DNA binding properties of the activated forms or on the sensitivity of the unactivated forms to molybdate. PMID- 6865410 TI - The effect of calcium on the hepatic glucocorticoid receptor. AB - The unbound glucocorticoid receptor of rat hepatic cytosol was very unstable at 25 degrees C. This receptor instability was increased by the addition of 1-10 mM Ca2+ such that the unbound glucocorticoid receptor was completely inactivated within 30 min at 25 degrees C in the presence of 5 mM Ca2+. Interestingly, Ca2+ inactivation was blocked approximately 80% by simultaneous addition of either 10 mM molybdate or 10 mM molybdate plus 5 mM dithiothreitol. Ten millimolar leupeptin or 10 mM alpha 2-macroglobulin did not inhibit Ca2+ inactivation of the receptor. In fact, leupeptin alone slightly inactivated the receptor. Prior treatment of cytosol with 10 mM molybdate plus 5 mM DTT at 25 degrees C for 30 min offered a complete protection against the subsequent addition of 5 mM Ca2+. The effects of Ca2+ were found to be irreversible since addition of molybdate or molybdate plus dithiothreitol after 5 mM Ca2+ treatment (20 min for 25 degrees C) did not reactivate partially inactivated receptors but did stabilize the remaining receptor binding at the time of molybdate or molybdate plus dithiothreitol addition. Addition of 1-5 mM Ca2+ to preformed [3H]-dexamethasone- receptor complexes slightly inhibited steroid--receptor complex transformation into a nuclear binding form at 25 degrees C. In addition, 10 mM Ca2+ altered the agarose gel filtration profile of the complex. Control cytosol or cytosol treated with 10 mM EDTA or 10 mM leupeptin showed three distinct macromolecular bound radioactivity peaks having Stokes radii of 65, 40 and 20 A. On the other hand, Ca2+-treated cytosol showed a single large aggregated component which was excluded in the void volume of the column. Trypsin (0.5 microgram/ml) generated a small steroid--receptor fragment of 20 A when added alone, but interestingly when added with 10 mM Ca2+ the [3H]-dexamethasone--receptor complex eluted in the agarose gel exclusion volume. These results show that Ca2+ has a profound effect on rat hepatic glucocorticoid receptors and that molybdate can block Ca2+ dependent receptor inactivation. PMID- 6865411 TI - The structures of two potential antitumor steroid--base adducts. AB - Steroids have been coupled to pyrimidines to give potentially target-specific anti-tumor agents. We report here on the molecular structures of two such adducts. 21-(1H-uracil-1-yl)-pregn-4-ene-3,20-dione and 21-(1H-thymin-1-yl)-pregn 4-ene-17 alpha-ol-3,20-dione. The structures of these have been determined by X ray crystallographic techniques. The uracil substituent of the former compound is observed to be oriented below the alpha-face in the plane of the steroid skeleton. In contrast, upon introduction of a 17 alpha-hydroxyl group, as in the latter compound, the base substituent is found to be in a perpendicular orientation bent towards the beta-face of the steroid skeleton. In the uracil derivative the bases stack between steroid portions of other molecules. In the thymine adduct this does not occur. Only steroid--steroid stacking is observed. The molecule conformations are correlated with the differences in receptor affinity for these two steroid adducts. PMID- 6865412 TI - Glucocorticoid effects on thymidine incorporation into the DNA of S49 lymphoma cells. AB - The effects of glucocorticoids on lymphoid cell growth and thymidine incorporation into DNA were studied using the S49 mouse lymphoma cell line. Glucocorticoid-mediated lymphocytolysis in these cells is preceded by an arrest in the G1 phase of the cell cycle [1]. However, this arrest is only partial, and is reversible by washing out the hormone. Thus, although the overall impression is that these cells are arrested in G1 and then begin to die, they apparently can escape the arrest and proceed through the cell cycle, albeit at a relatively low level. The mode of DNA synthesis in these glucocorticoid-treated cells is replicative and not repair. The importance of the inhibition of thymidine incorporation to the cell death process in S49 cells is evident from experiments in which cells are treated with both the hormone and various DNA synthesis inhibitors; a synergistic killing of the cells is obtained. Thus, the inhibition of DNA synthesis and cell proliferation is a rapid, and perhaps primary effect of glucocorticoids on the complex process of hormone-mediated lymphocytolysis in this mouse cell line. PMID- 6865413 TI - Estimation of molecular parameters of the endogenous inhibitor to progesterone- receptor binding in rat trophoblast. AB - This study was undertaken to investigate molecular properties of an endogenous substance which inhibits progesterone--receptor binding. The inhibitor was isolated from the cytosol of rat trophoblast by ammonium sulfate precipitation. Further purification was achieved by gel filtration and sucrose density gradient centrifugation. These techniques revealed that the inhibitor had a Stokes radius of 2.8 +/- 0.1 nm and an s of 4.9 +/- 0.2. For a protein exhibiting normal density and solvation, these parameters indicated that the inhibitor molecule has a mol. wt of 56,000 +/- 2000 g/mol and a frictional coefficient of 1.11 +/- 0.01. In order to obtain an additional independent estimate of molecular weight, the migratory pattern of the inhibitor was studied on SDS-polyacrylamide gels after identification and purification by polyacrylamide gel electrophoresis. The inhibitor-active fraction was resolved into two principle bands (Band 1 and 2) by SDS-gel electrophoresis having mol. wt of 59,000 +/- 700 g/mol and 51,000 +/- 300 g/mol (n = 6), respectively. The molecular weight thus determined was in excellent agreement with the value obtained by calculation. Thus, molecular parameters of the inhibitor indicate that it is a very symmetrical molecule of approx. 56,000 mol. wt. Characterization of the molecular properties of the inhibitor substance should facilitate future studies concerning the biological significance of this molecule and its role in progesterone--receptor binding interactions. PMID- 6865414 TI - Precursor of 27-nor-5 beta-cholestane-3 alpha, 7 alpha, 12 alpha, 24,25-pentol in man. AB - Cholesterol was shown to be the precursor of 27-nor-5 beta-cholestane-3 alpha, 7 alpha, 12 alpha, 24,25-pentol which is the major bile alcohol in human urine. 4 [14C]-Labelled cholesterol and beta-sitosterol were administered to patients with primary biliary cirrhosis. Urine was extracted with Amberlite XAD-2 and sterol glucuronides and bile acid conjugates were isolated by ion exchange chromatography on Lipidex-DEAP. Following hydrolysis and further purification on Lipidex-DEAP, the C26 bile alcohol and methyl esters of cholic and chenodeoxycholic acids were isolated by HPLC. The specific radioactivity of the C26-pentol was the same as that of cholic acid after administration of [14C] cholesterol. In contrast, little if any radioactivity could be detected in the C26-pentol after administration of labelled beta-sitosterol. PMID- 6865415 TI - Endocrine aging in C57 BL mice--II. Dynamics of estrogen receptors in the hypothalamic-pituitary axis. AB - Specific cytosolic and nuclear binding sites for estrogens were measured in the hypothalamic-pituitary axis (HPA) of young (4-8 months) and old (16-18 months) C57 BL mice in order to determine any age-related alteration in hormone-receptor interaction. Our results indicated no age differences in the affinity (KD = 0.89 +/- 0.03 (SEM) vs 1.09 +/- 0.2 X 10(-9) M), the specificity, the sedimentation profile (6 s) or in the number (98.9 +/- 4.9 vs 84.4 +/- 2.3 fmol/mg protein) of unoccupied estrogen binding sites in the cytosols. Estradiol administration to young mice induced a complete translocation of cytosolic estrogen receptors to the nucleus, and two types of nuclear binding sites were observed: Type I were specific for estrogens with high affinity (KD = 0.51 +/- 0.06 X 10(-9) M) and low binding capacity (115.1 +/- 22.7 fmol/mg DNA) and sedimented in the 4.0 s area, while Type II binding sites showed a much higher capacity and lower affinity for R2858. HPA nuclear suspensions of aged untreated mice showed undetectable (less than 50 fmol/mg DNA) levels of nuclear estrogen receptors and E2 pre-treatment resulted in a significant increase in both types of binding sites. While no significant changes in the physicochemical characteristics of these nuclear receptors were observed, when compared to young animals, aging was manifested by a translocation defect in the HPA of C57 BL mice. These results suggest aging changes in the endocrine regulating centers of the brain with defective activation of estrogen receptors. PMID- 6865416 TI - Effects of chronic smoking on testosterone metabolism in dogs. AB - The effects of long-term cigarette smoking on androgen hydroxylases and peripheral hormones were studied in male beagles. In the testis, chronic smoking of high nicotine/tar cigarettes was associated with decreased activity of the 7 alpha-hydroxylase active on testosterone (68% of control, P less than 0.05). Testicular 6 beta and 16 alpha-hydroxylases were not altered. The hepatic androgen 6 beta-hydroxylase activity in control animals was approximately 6 times the testis levels and was stimulated markedly by smoking. This increase ranged from 221% in the low nicotine/tar group (P less than 0.02) to 304% in the high nicotine/tar group (P less than 0.006). Serum testosterone levels were reduced to 54% of control (P less than 0.02) and prostate size to 44% (P less than 0.001) of control with heavy smoking. Serum LH levels were elevated with smoking. These results suggest that chronic cigarette smoking increased hepatic metabolism of testosterone. In addition, serum testosterone levels and prostate size decreased and LH levels increased. Whether the hepatic and the endocrine effects are causally related cannot be determined from this preliminary study. PMID- 6865417 TI - The synthesis and metabolism of [6-3H]-25-hydroxycholesterol in rat adrenal tumor cells. AB - The synthesis of [6-3H]-25-hydroxycholesterol from 26-norcholest-5-en-3 beta-ol 25-one is described. The metabolism of the radiolabeled hydroxysterol in rat adrenocortical carcinoma cells and in mitochondria-enriched preparations of rat adrenal tissue was investigated. We found that [6-3H]-25-hydroxycholesterol was metabolized efficiently to [3H]-pregnenolone in both preparations of rat adrenal tissue. PMID- 6865418 TI - Physicochemical characterization and transformation of the cytosolic glucocorticoid receptor from rabbit liver. AB - Characterization of the glucocorticoid receptor from rabbit liver cytosol was studied in vitro. Binding of [3H]-dexamethasone showed a high affinity (KD = 2.4 . 10(-9)M) and a concentration of binding sites of 0.3 . 10(-12) mol/mg proteins. Association and dissociation rate constants for [3H]-dexamethasone were respectively 1.6 . 10(5)M-1 . min-1 and 2.5 . 10(-4) min-1. Competition experiments showed that dexamethasone and triamcinolone acetonide were the most effective competitors while progesterone and aldosterone competed very poorly. The stabilities of bound and unbound forms were investigated with and without molybdate and other oxyanions. Calibrated gel filtration gave a stokes radius of 5.6 nm and an apparent mol. wt of 280,000. The untransformed complex sedimented at 9 s in 5-20% sucrose density gradients and the transformed species sedimented near 4 s. The behaviour of the three forms of receptor, untransformed, transformed and molybdate-stabilized was studied on ionic exchangers. Transformation of the [3H]-dexamethasone--receptor complex was shown to occur both with high ionic strength and elevated temperature. The transformation step was almost completely inhibited by tungstate and molybdate while vanadate revealed a very slight inhibitory effect. PMID- 6865420 TI - Problem drinking in adolescence and young adulthood. A follow-up study. AB - Men and women classified as problem drinkers while adolescents or college students (1972-1973) tended to be nonproblem drinkers as young adults (1979), although young men tend to be at greater risk than young women to maintain problem drinking. Those whose earlier personality, perceived-environment and behavior scores indicated greater theoretical proneness for problem behavior were significantly more likely as young adults to be involved in problem drinking. PMID- 6865419 TI - The effects of ethanol and acetaldehyde on dog arterial smooth muscle. PMID- 6865421 TI - Changes in alcohol sales and drinking problems in Iowa, 1961-1979. PMID- 6865423 TI - Alcohol and mortality. Diagnostic considerations. AB - Two hundred fifty of 1289 alcoholics died within eight years of treatment of alcoholism or its complications. Gastrointestinal and cardiovascular disorders were significantly greater among the group who died within one year of treatment. Other sex, age and racial differences were also significant. PMID- 6865422 TI - Direct-mail techniques and the prevention of alcohol-related problems among college students. AB - A university-based program to prevent alcohol-related problems tested a direct mail campaign designed to increase program participation, increase knowledge and reduce drinking and driving. Survey data indicated that 93% read the letter and that knowledge was increased but that behavior was not changed. PMID- 6865424 TI - Prediction of discharges against medical advice from an alcohol and drug misuse treatment program. AB - A discriminant function method of data analysis revealed that statistically significant predictions could be made regarding AMA discharge, and that certain variables emerge consistently as predictors: a diagnosis involving personality disorder, admission after regular hours, age 20-29, intoxicated on admission, and less likely to have been referred by relatives or legal authorities. PMID- 6865425 TI - Developmental trends of adolescent drinking. PMID- 6865426 TI - Communication, social support and alcohol use in first-year medical students. AB - Increased communication from significant others and perceived interpersonal support correlated with reduced student drinking during the first 12 weeks of medical school. Writing brief essays on any subject of personal interest which were read, annotated and quickly returned by a faculty member correlated with reduced student drinking during the final 12 weeks of the first year. PMID- 6865427 TI - Liquor control and consumption. PMID- 6865428 TI - Alcohol misuse and posttraumatic stress disorder (delayed); an alternative interpretation of the data. PMID- 6865429 TI - Cognitive impairment and perceived risk from alcohol. Laboratory, self-report and field assessments. AB - Forty subjects who were pretested on their beliefs and attitudes toward drinking and driving were later tested in a laboratory on the extent of their subjective and objective cognitive impairment from placebo, low and high alcohol doses. A second study conducted at college drinking parties validated some of the laboratory findings. PMID- 6865430 TI - Drunken drivers in Denmark. A nationwide epidemiological study of psychiatric patients, alcohol and traffic accidents. PMID- 6865431 TI - Controlled drinking. A history and a critical review. PMID- 6865432 TI - Medical histories of problem drinkers during their first twelve years of naval service. PMID- 6865433 TI - Repeat admissions for perceived problem drinking. A social resources perspective. AB - Several propositions derived from a social resources perspective regarding differences in first and repeat admissions are examined using data taken from persons being treated for alcohol misuse and from persons not receiving treatment. Although objective behavior (drinking level) is very important as a predictor of first admissions, it is of less consequence in predicting repeat admissions. The data indicate a complex pattern of interaction effects among social resources and between them and drinking behavior in determining who comes to receive treatment and who is readmitted to treatment. PMID- 6865435 TI - The role of pentoxifylline in the prevention of tumor cell implantation. AB - Short-term administration of pentoxifylline concurrent with intraportal or intravenous instillation of W163 adenocarcinoma was ineffective in preventing tumor cell implantation in adult male rats. PMID- 6865436 TI - Latent childhood thyroid carcinoma in diffuse lymphocytic thyroiditis. AB - Diffuse thyroid enlargement in a child is a rare presenting symptom of thyroid carcinoma. A papillary carcinoma may be hidden in a diffuse lymphocytic thyroiditis and should be carefully searched for during surgery. Furthermore, the finding, in frozen sections, of psammoma bodies in a lymphocytic thyroiditis should raise the suspicion of an occult malignant neoplasm. A case illustrating these diagnostic difficulties in a 5-year-old child is presented. PMID- 6865434 TI - Operative finding, treatment, and prognosis of carcinoma of the pancreas: an analysis of 267 cases. AB - Two hundred sixty-seven laparotomized patients with pancreatic cancer during the period 1947 to 1980 were retrospectively analyzed. In 199 histologically confirmed cases of pancreatic carcinoma the tumor was only local with no invasion to neighboring tissues or distant metastases in 15% of the cases at the primary laparotomy and diagnosis stages, and the survival rates after 1, 3, and 5 years were 22%, 3% and 1%, respectively. The prognosis was a little better if a patient was over 70 years old, duration of symptoms was more than one year, the reason for laparotomy was cholecystopathy, the tumor was stage I, the treatment was a combination therapy of pancreatic resection and postoperative irradiation (with a depth dose of greater than or equal to 4,000 rad). We concluded that, excluding the extremely rare cases of pancreatic carcinoma which are cured with pancreatic resection, the survival of patients after primary operation is correlated nearly in the same way with the given treatment and the stage of the disease. It seems that at present the only possibility of improving the results of treatment in pancreatic carcinoma is to develop the combined treatment of surgery, irradiation, and chemotherapy. PMID- 6865437 TI - Serum sialic acid is a biologic marker for malignant disease. AB - Serial serum sialic acid (N-acetylneuraminic acid) was measured in 16 patients with advanced cancer of various histologic types. In the 15 evaluable patients serial changes in sialic acid correlated with the clinical course. Isolated sialic acid values were not predictive of clinical response. Serial determination of serum sialic acid appears to be a useful monitor of tumor burden. PMID- 6865438 TI - Small primary de novo adenocarcinoma of the colon with mesenteric lymphatic metastasis. AB - It is felt that the majority of colorectal carcinomas develop by malignant degeneration of previously benign adenomatous polyps. A small primary colon carcinoma, thought to have developed de novo directly from the colonic mucosa without the usual polyp-cancer sequence, is reported. This small nonulcerated lesion did not have the gross endoscopic appearance of a carcinoma and was associated with lymphatic metastasis. The need to include fiber-optic colonoscopy as part of the routine preoperative work-up and postoperative follow-up to rule out synchronous and metachronous lesions not detected by barium contrast x-ray studies is stressed. PMID- 6865440 TI - Small bowel intussusception by metastatic chondrosarcoma: a case report. PMID- 6865439 TI - Prognostic factors in invasive gallbladder carcinoma. AB - The medical records of 52 patients from the University of Wisconsin Hospital and Clinics with carcinoma of the gallbladder were examined retrospectively. The cases were reviewed for factors in their medical history, presenting physical examination, laboratory data, therapy, pathological grade, and histology that might effect median survival. Only a prior complaint of anorexia, an elevated lactic dehydrogenase (LDH), or advanced pathologic stage at time of diagnosis provided significant prognostic information. Combining pathologic stage and histologic grade additively provided the most significant prognostic information [1]. Division of gallbladder carcinoma patients in future clinical trials by this combined (stage and grade) stratification scheme may prove helpful in assessing the efficacy of new therapies. The knowledge that anorexia and elevated LDH are poor prognostic findings may assist physicians in counseling patients with this malignancy. PMID- 6865441 TI - Gastric cancer-survival at the Pennsylvania Hospital with and without adjuvant chemotherapy. AB - From 1964 to 1974, 122 patients were treated for gastric cancer; none of these patients received chemotherapy; 13 of this group were lost to follow-up. In 34 patients, the disease was too far advanced for surgical resection. Their survival ranged from 0.1 month to 7.5 months with a median survival of 1.1 months. Seventy four patients were resected for cure; 60 patients underwent a subtotal gastrectomy. Survival ranged from 0 to 72 months with a median of eight months. Fourteen patients had total gastrectomies; survival ranged from 0.1 to 72 months with a median of 5.5 months. Only six of the resected patients had negative lymph nodes; their survival ranged from four to 36 months. In this series there were 11 operative deaths and only seven patients survived five years. Thirty-one patients who had resections were treated with adjuvant chemotherapy consisting of 0.5 g 5 fluorouracil (5-FU) IV on days 1, 8, 15, etc, and hydroxyurea (HU), 80 mg/kg per os (p.o.), on days 4, 11, 18, etc. This group has a range of survival from three to 164 months and a median survival of 25 months. Fifteen consecutive patients with nonresectable gastric cancer were treated with HU-FU with a survival of one to 30 months and a median survival of eight months. In patients with measurable disease, objective regression was clearly demonstrated. PMID- 6865442 TI - Noninvasive cardiac evaluation of patients receiving adriamycin-containing adjuvant chemotherapy (FAC) for stage II or III breast cancer. AB - Cardiac function was evaluated by noninvasive methods in 55 patients with stage II or III breast cancer treated with adjuvant Adriamycin containing combination chemotherapy (FAC). None of the 44 patients who remained free of disease for a median follow-up period of 36 months, or those who were retreated with Adriamycin up to a median cumulative total dose of 450 mg/m2 (nine patients), developed clinical evidence of cardiac decompensation. The median electrocardiographic QRS voltage and ejection fraction decreased by 11% and 5%, respectively, in the former and by 21% and 10% in the latter group at the conclusion of chemotherapy. These parameters tended to return to the baseline at the time of the last visit. The decreases in QRS voltage and ejection fraction were greater in patients who received radiotherapy and had prior cardiovascular disease than in those without such risks. The remaining two patients were retreated with higher total doses of Adriamycin. Both showed clinical evidence of cardiac decompensation and gradual deterioration of the noninvasively measured parameters of cardiac function. One patient was alive six months after the discontinuation of Adriamycin at a total dose of 842 mg/m2, and the other died of pulmonary embolism two months after receiving a total of 892 mg/m2. Our study shows that Adriamycin can be included in adjuvant therapy without inducing clinically significant alterations in cardiac function; however, patients who have additional risk factors should be monitored closely with noninvasive studies while they receive this drug. PMID- 6865444 TI - The role of the adrenal medulla in the antihypertensive action of bromocriptine in neurogenic hypertensive dogs. AB - The effects of bromocriptine, a dopaminergic agent, on blood pressure were compared in normal and adrenal demedullated acute neurogenic hypertensive anesthetized dogs. The antihypertensive effect of bromocriptine (0.3 mg/kg IV) observed in intact dogs was not found in the absence of adrenal medulla. Since, in previous studies, it was found that this antihypertensive effect of bromocriptine was due to a dopaminergic mechanism the present results suggest the existence in adrenal glands of inhibitory dopaminergic receptors involved in the release of catecholamines. PMID- 6865443 TI - [Hepatic clearance of drugs. Physiological and pharmacokinetic considerations]. AB - The aim of the first part of this work is to present elements of hepatic cytology and physiology in order to demonstrate the organisation of the liver for the metabolisation of drugs: the cytology of hepatocytes, their arrangement in the parenchyma, the hepatic microvascularisation, the distribution of the metabolic reactions in the hepatic acinus and the structure of the biliary tract involved in the elimination of some metabolites. 2. The second part is devoted to the concept of hepatic clearance. A few considerations are presented about physiological aspects (hepatic uptake), followed by a more extensive chapter about pharmacokinetics. The following points are explained: mathematical terms of clearance, physiological models, hepatic first-pass effect, influence of the hepatic clearance on half-life of a drug and area under the curve of concentration versus time, the use of clearance or half-life as index of hepatic metabolism and a classification of the drugs in correlation with their hepatic clearance. 3. The conclusions present some contradictions and unresolved points persisting, at the present time, in the hepatic clearance theories and propose new approaches for future investigations. PMID- 6865445 TI - [Circadian variations in the intraerythrocytic transport of lidocaine]. AB - 1. We previously reported circadian variations of pharmacokinetic parameters of lidocaine in the rat after a single 50 mg.kg-1. I.M. dose of this drug administered at four different fixed time points of a 24-hours period (i.e.: 10.00, 16.00, 22.00 or 04.00 h). As diurnal variations of membrane permeability was one of the suggested hypothesis, we investigated this possibility through the search of an eventual influence of the hour of administration of lidocaine on its intraerythrocytic passage. 2. Plasmatic and intraerythrocytic levels of lidocaine were determinated during 6 hours after each administration (10.00, 16.00, 22.00 or 04.00 h). 3. Our data show a circadian variation of the intraerythrocytic passage of lidocaine higher intraerythrocytic levels of this drug are observed when lidocaine is administered at 22.00 h; at this time the red blood cell level of the drug represent 73,6% of the plasmatic level. 4. The circadian variation of the intraerythrocytic passage of lidocaine in the rat may reflect circadian variations of membrane permeability, explaining in part the circadian fluctuations of lidocaine pharmacokinetics. PMID- 6865446 TI - Effect of viscosity on enzyme-ligand dissociation. II. Role of the microenvironment. AB - A theoretical treatment, describing a novel viscosity effect on decomposition of enzyme-ligand complexes, recently appeared (Somogyi et al., 1978). From this approach emerged a mechanistic picture of the manner in which increased viscosity lowers the value of the decomposition rate constant. A refined version of this model is presented herein. The analysis is extended to the molecular microenvironment ultimately responsible for mediating the "viscosity effect." Consideration is given to two major factors: (1) the role of viscosity in attenuating the excess chemical energy and (2) the statistical features of the microviscosity. In view of spatiotemporal inhomogeneity in the liquid structure, the concept of averaged microviscosity is introduced to parametrize the enzyme ligand recombination probability. Quantitative predictions are consistent with models of liquid structure and with results from enzyme studies. The "viscosity effect" may contribute to substrate compartmentation in organized multi-enzyme systems in vivo. PMID- 6865447 TI - Dynamics of fluid movement between intravascular and interstitial spaces. PMID- 6865448 TI - Physico-chemical model for DNA alkaline elution: new experimental evidence and differential role of DNA length, chain flexibility and superpacking. AB - For a better understanding of data provided by DNA alkaline elution technique, a new analytical model has been developed which takes into consideration both the physicochemical properties of in situ DNA strand (length and flexibility/superpacking) and the geometric and hydrodynamic configuration of the elution apparatus (flow and filter conditions). Simulation by this model of experimental data previously obtained before and after carcinogens administration, has shown that for constant flow and filter conditions elution profiles are dependent, not only from DNA molecular weight, but also from a parameter critically related to modifications in chain flexibility/superpacking. This has been confirmed by several independent observations, including the time dependent changes in non-denaturing lysing solution monitored by hydroxylapatite and alkaline elution techniques. PMID- 6865449 TI - Abortifacient effects of the roots of Momordica angustisepala. AB - Aqueous extract of the root of Momordica angustisepala (Cucurbitaceae) has been studied for abortifacient effects in albino female mice. The aqueous extract containing 0.8 mg dry matter/ml at dosages of 3.5 ml and 4 ml per kg body wt. of the female mice and guinea pig, respectively, was administered i.p. Several hours after administration, the pregnant animals aborted their fetuses. The drug appears to be effective at all stages of pregnancy confirming its use by herbalists to induce abortion in humans in some parts of Nigeria. The mechanism of action appears to be similar to the actions of oxytocics and ergot alkaloids. However, hormonal influence may be implicated. PMID- 6865450 TI - The hypoglucemic effect of Opuntia streptacantha studied in different animal experimental models. AB - Studies performed with Opuntia streptacantha sap in three different animal species using several experimental conditions are described. The Opuntia sap induced hypoglucemic effects when orally administered to intact animals under induced states of moderate increase of blood sugar. In normoglucemic and pancreatectomized animals the effect of the product was not detected. The results validate the popular use of this plant for treatment of Diabetes mellitus symptomatology. PMID- 6865451 TI - Enzyme changes and glucose utilisation in diabetic rabbits: the effect of Gymnema sylvestre, R.Br. AB - The administration of the dried leaf powder of Gymnema sylvestre regulates the blood sugar levels in alloxan diabetic rabbits. G. sylvestre therapy not only produced blood glucose homeostasis but also increased the activities of the enzymes affording the utilisation of glucose by insulin dependent pathways: it controlled phosphorylase levels, gluconeogenic enzymes and sorbitol dehydrogenase. The uptake and incorporation of [14C] glucose into the glycogen and protein are increased in the liver, kidney and muscle in G. sylvestre administered diabetic animals when compared to the untreated diabetic animals. Pathological changes initiated in the liver during the hyperglycemic phase are reversed by controlling hyperglycemia by G. sylvestre. G. sylvestre, a herb used for the control of diabetes mellitus in several parts of India, appears to correct the metabolic derangements in diabetic rabbit liver, kidney and muscle. PMID- 6865452 TI - Piperovatine, the tongue-numbing principle of Ottonia frutescens. PMID- 6865453 TI - Pangamic acid, a stamina building, antistress and anti-hyperlipidemic principle from Cicer arietinum L. PMID- 6865454 TI - Regional and overall pulmonary function changes in lung cancer. Correlations with tumor stage, extent of pulmonary resection, and patient survival. AB - Spirometry and regional pulmonary function studies using xenon 133 gas were performed in 251 patients who had primary lung cancer. Surgical resection was undertaken in 150 while the remainder were treated with nonsurgical modalities. Pulmonary function studies were repeated postoperatively in 54 patients. Regional ventilation and perfusion of the tumor-bearing lung were decreased in patients with larger primary tumors and in those with involvement of ipsilateral hilar lymph nodes. Reduced regional function was also directly related to the proximity of the primary tumor to the hilum. Significant hypoperfusion did not contraindicate operation in 14 patients; however, 13 of them required pneumonectomy. Estimated postoperative forced expiratory volume in 1 second (FEV1.0), derived from preoperative spirometry and regional function of the tumor bearing lung, correlated well with the measured postoperative values. These estimations were valuable in determining the extent of safe resection and correlated well with short-term survival. Long-term survival correlated better with the stage of disease. PMID- 6865455 TI - Surgical management of prosthetic valve endocarditis. AB - Operative mortality in patients with prosthetic valve endocarditis (PVE), who already have severe hemodynamic failure, is extremely high (35% to 84%). Over a period of 10 years, between 1972 and 1981, fourteen consecutive urgent operations were performed for PVE in 12 patients. On thirteen occasions the patients were in severe hemodynamic failure (NYHA Functional Class IV), and five of them had early PVE (within 60 days of previous operation). In all patients at least two of the other recognized risk factors, such as presence of non-streptococcal organisms, detachment of the prosthesis, and myocardial invasion, were present. All of the patients but one were operated upon within 48 hours of their hemodynamic deterioration, and there was one postoperative death (operative mortality 7%). Our results indicate that an acceptable surgical mortality in patients with intractable heart failure due to early and late PVE can be achieved by prompt surgical intervention despite the presence of multiple risk factors. PMID- 6865456 TI - Role of mechanical stress in calcification of aortic bioprosthetic valves. AB - Calcification of bioprostheses used for heart valve replacement is a serious problem, since it causes bioprosthetic dysfunction. In vivo, bioprostheses are subjected to large mechanical stresses during each cardiac cycle. We investigated whether stresses play a major role in calcification of bioprostheses. Previous studies of Carpentier-Edwards porcine, Hancock porcine, and Ionescu-Shiley pericardial bioprostheses indicated that the highest stresses occurred in the areas of greatest flexion of the leaflet. In porcine bioprostheses, stresses were greater in the commissural region than at the base, and were compressive on the aortic surface of the leaflet. The pericardial tissue showed shear deformation in the zone of flexion. In the present study, the three types of bioprostheses were implanted in the aortic position in calves to investigate the development, location, and distribution of calcification. Visual, radiographic, and histologic techniques were used. All bioprostheses showed calcification which began in the area of leaflet flexion. In porcine bioprostheses, calcification occurred earlier in the commissural region than at the base. The earliest calcific deposits were localized within collagen cords on the aortic surface of the leaflets. In pericardial bioprostheses, calcification occurred at multiple foci along the zone of leaflet flexion and was located between and within layers of collagen along planes parallel to the leaflet surface. Hence calcification in all bioprostheses began in the areas of greatest stress. In porcine bioprostheses, calcification was present where collagen fibers are likely to have been damaged by compressive stresses. In pericardial bioprostheses, calcification was found along the planes of shear where structural integrity is likely to have been disrupted by the sliding of individual layers of collagen over each other. It is concluded that mechanical stresses initiate calcification by damaging the structural integrity of the leaflet tissue. Therefore, calcification of bioprostheses can be inhibited by reducing functional stresses through the modification of design and tissue properties to duplicate those of the natural aortic valve. PMID- 6865457 TI - Computer-assisted design of pivoting disc prosthetic mitral valves. AB - This paper describes the use of the new technique of computer testing to study the simulated performance of flat and curved pivoting disc prosthetic mitral valves. The design parameters considered are the radius of curvature of the occluder and the position of the pivot point. The performance criteria are the net stroke volume, the mean forward pressure difference, and the peak anterior velocity. The last of these criteria may be important in the prevention of small orifice valve thrombosis. The best overall valve in the study has a radius of curvature equal to 1.5 times the diameter of the occluder and a pivot point located 0.39 mitral-ring diameters from the anterior border of the mitral anulus. The maximum angle of opening of this optimal valve is limited to about 70 degrees by fluid-mechanical forces. Nevertheless, the inclusion of a redundant stop in the mechanical design of the valve is indicated, since the computer experiments also reveal excessive opening and failure to close in valves with nearby parameter values. These studies illustrate the usefulness of computer testing in prosthetic valve design. PMID- 6865458 TI - Physical analysis of the Bjork-Shiley prosthetic valve sound. AB - The closing sound of an implanted Bjork-Shiley heart valve prosthesis can be heard clearly in the proximity of the patient. A clinical interrogation of 35 patients showed that 16 (46%) were disturbed by the clicking noise and 10 (29%) reported disturbance of those nearby. A silent prosthesis would be preferred by 15 (43%) patients, eight (23%) declined such a valve for reasons of their own security, and 12 (34%) patients were undecided. The frequency spectrum of the metallic closing sound and its loudness were measured by noninvasive techniques in 20 patients. In the aortic as well as in the mitral position, a high peak of the sound pressure level was registered at 9.8 kHz. In 20 patients the average value of the sound pressure level was 35 dbA measured at a distance of 10 cm from the patient's chest. In vitro studies demonstrated a high peak of the sound pressure level at 9.5 kHz for the Bjork-Shiley valve when recorded in free air and at 7 kHz in a standardized valve chamber of a mock circulatory system filled with blood or water. A decrease of the sound pressure level could be achieved by a textile wrap around the chest which damps frequencies around 10 kHz. This protects those nearby but not the patient, who hears the clicking mainly through internal conduction. This unpleasant valve noise can be eliminated only during construction of a new prosthesis provided that such "minor" side effects are measured and taken into consideration. PMID- 6865459 TI - Avoiding anastomotic leakage following esophagogastrostomy. AB - The most serious complication following esophagectomy and conventional intrathoracic esophagogastrostomy is anastomotic leakage, which contributes to both a high mortality and morbidity postoperatively. The incidence of anastomotic leakage reported in a recent 10 year period ranged from 3% to 18%, with a mean of 4.9%. A series of 433 esophagogastrostomies were performed in our institute from 1954 to 1981 for various esophageal lesions, including 414 cases of carcinoma of the esophagus. A conventional esophagogastrostomy was carried out in 319 patients and 12 leaks occurred postoperatively, an incidence of 3.7%. In comparison, another group of 114 patients underwent "tunnel" esophagogastrostomy, a technique that we designed. There was only one leak, an incidence of 0.87%. The "tunnel" esophagogastrostomy is therefore recommended as a reliable operative procedure for minimizing the incidence of anastomotic leakage. The operative technique is described in detail. PMID- 6865460 TI - Scavenging of cardioplegic solution from right heart to prevent hyperkalemia. AB - The present study was designed to test the hypothesis that hyperkalemia can be prevented if the cardioplegic solution returning to the right heart from the coronary sinus is aspirated. In the control group (15 patients without aspiration), the potassium concentration rose from 3.5 +/- 1 (SD) mEq/L to 6.3 +/ 0.4 mEq/L (p less than 0.001) 10 minutes after the administration of cardioplegic solution and was still high before the patient was weaned from cardiopulmonary bypass (5.2 +/- 0.3 mEq/L (p less than 0.001). Electromechanical recovery time was delayed. In the second group (15 patients with aspiration), serum potassium did not change. Our data indicate that scavenging of cardioplegic solution may prevent hyperkalemia in most patients. PMID- 6865461 TI - Massive air embolus due to Pall filter malfunction. PMID- 6865462 TI - A new variation of the Damus-Stansel-Kaye procedure for correction of the Taussig Bing anomaly. PMID- 6865463 TI - Vascular consequences of subclavian artery transection for the treatment of congenital heart disease. AB - The acute and chronic consequences of subclavian artery transection were analyzed in the noninvasive vascular laboratory. Twenty-eight patients (aged 1 day to 4 2/12 years, median 2 months) underwent subclavian artery transection (23 Blalock Taussig, four subclavian aortoplasty for coarctation or interrupted arch, and one division of aberrant left subclavian). Bilateral systolic brachial artery pressure (BAP) was measured by Doppler instrumentation to obtain a "BAP index": BAP1 = (operated side BAP/control side BAP). Velocity waveform tracings and bilateral forearm skin temperatures were also obtained during studies before and sequentially after operation (4 hours to 12 years). Five patients underwent exercise testing of the upper extremity. Nine patients were studied for manual preference and limb development. Before operation, mean BAP1 was 0.99. Immediately (4 to 48 hours) after operation, mean BAP1 was 0.39. Three weeks postoperatively, BAP1 was 0.62, and thereafter it remained at 0.70. All differences between preoperative, immediate postoperative and late postoperative BAP1 are significant (p less than 0.001). Exercise resulted in a significant (p less than 0.01) increase in BAP bilaterally. Forearm skin temperature was initially lower (p less than 0.01) on the operated side but approximated the control side by 1 week. Limb girth was less on the operated side (p less than 0.01), without evidence of altered manual preference. In conclusion, subclavian artery transection causes permanent reduction in BAP1. The affected limb appears to respond to increased metabolic demand by increasing limb blood flow. PMID- 6865464 TI - Interrupted aortic arch. A conservative approach for the sick neonate. AB - Interrupted aortic arch with associated ventricular septal defect is a congenital cardiovascular defect which, untreated, is lethal in nearly 100% of the cases. We have treated nine patients by reconstructing the aorta with endogenous arch vessels; in five of them, concomitant pulmonary artery banding was also done. If two infants with preoperative complete renal failure are excluded, the mortality with this approach is only 29%. Long-term follow-up of these patients demonstrates excellent hemodynamic results with marked reduction of the anastomotic gradient in the older survivors. Growth of the anastomosis has been noted in the older survivors. PMID- 6865465 TI - Post-myocardial infarction ventricular septal defect. Improved outlook. AB - Eight patients (mean age 63.75 years) were operated upon for post-myocardial infarction ventricular septal rupture (PMI-VSD) within 1 to 21 days of the infarction and 8 hours to 18 days of rupture. All but one were in low cardiac output syndrome necessitating intra-aortic balloon pumping; all had cardiac catheterization. The VSD was closed via a transinfarct ventriculotomy with an oversized folded double patch, the folded edge being incorporated in the ventriculotomy closure. Five patients received seven saphenous vein coronary bypass grafts. None had recurrent shunts. Six patients (anterior VSD, five; posterior VSD, one) are survivors (18 months to 2.5 years) in Class I (five) or Class II (one). Two patients died postoperatively, one (anterior VSD) of an arrhythmia and the other (posterior VSD) while on biventricular bypass support. Two survivors in whom prolonged preoperative stabilization was attempted required emergency operation before the planned waiting period of 3 weeks had elapsed, and both had postoperative multiorgan complications. Our present approach is to operate as soon as clinical and catheterization diagnosis of VSD is made. PMID- 6865467 TI - Alterations in regional myocardial function after heterogeneous cardioplegia. AB - Coronary stenoses lead to heterogeneous delivery of cardioplegic solution during cardiac operations. This situation was simulated by occlusion of the circumflex artery during cardioplegic infusion in canine right heart bypass preparations. Regional myocardial function (systolic shortening by sonomicrometer) was often diminished, despite preservation of global function. The correlation between recovery of circumflex regional function and recovery of stroke work or dP/dt (at constant aortic pressure, heart rate, and left atrial pressure) was poor (r = 0.17 and 0.07). The response of damaged regions to hemodynamic manipulations was studied. Increases in afterload after arrest did not lead to further deterioration of damaged regions. Volume loading (cardiac output 2 to 5 L/min) improved regional function even in severely damaged, bulging regions (p less than 0.05). Regional distensibility (delta length/delta left atrial pressure) decreased by 41% (p less than 0.02) in regions with poor protection and by 22% (p less than 0.01) in regions with good cardioplegic protection. There was also an increase in resting length (p less than 0.001) in both circumstances (5.2% and 3.7%). These changes in diastolic properties have not always been apparent in other experimental studies with less precise hemodynamic control. Heterogeneous cardioplegia causes heterogeneous changes in both diastolic distensibility and systolic function. These changes are poorly detected by examination of global ventricular function. PMID- 6865466 TI - Transmural myocardial flow distribution during hypothermia. Effects of coronary inflow restriction. AB - Hypothermic coronary perfusion and blood cardioplegia have been used clinically to minimize intraoperative myocardial damage. However, pressure-flow characteristics in regions supplied by inflow-limiting collateral coronary arteries have not been investigated during hypothermic conditions. In this study tracer microspheres determined transmural myocardial blood flow distribution during cardiopulmonary bypass in normothermic empty, beating dog hearts (EBH), during hypothermic sanguineous perfusion at 15 degrees C (HP), and after hemodilution of cooled (15 degrees C) hearts to a hematocrit value of 20 vol% (HDL). Animals in Group I (N = 8) had normal hearts. Group II dogs (N = 9) had one region supplied predominantly by narrow collateral vessels (CR) and another nourished by normal coronary arteries (NR). Retrograde circumflex pressures were measured continuously for Group II as an additional index of CR perfusion. Flow characteristics in Group I hearts were always similar to the NR of Group II dogs. With HP, endocardial blood flow in the NR decreased from approximately 0.80 to 0.50 ml/min/gm. Subsequently, following HDL this flow increased to approximately 1.70 ml/min/gm, or over twice control levels. In comparison, flow to CR endocardium decreased even more during HP (0.12 ml/min/gm). Even though control flow levels were reestablished in CR endocardium by adding HDL, an unfavorable endocardial/epicardial ratio persisted. With both HP and HDL, retrograde circumflex pressure never changed from EBH values. These data suggest that a significant endocardial flow defect exists during periods of hypothermic sanguineous perfusion and may become more prevalent in regions subserved by inflow-limiting coronary vessels. Similar flow maldistributions may occur in patients if blood-containing cardioplegic solutions are used and during systemic hypothermia. Significant hemodilution helps minimize these imbalances and permits salutary effects of hypothermia to be delivered more evenly across the ventricular wall. PMID- 6865469 TI - Coarctation in the first year of life. Patterns of postoperative effect. AB - From 1975 to 1982, 31 infants were operated upon in the first year of life for aortic coarctation and congestive heart failure. Operations performed were resection and end-to-end anastomosis (RETE) in 14, subclavian flap aortoplasty (SFA) in six, patch aortoplasty (PA) in five, and other procedures in six. Thirty of the thirty-one (97%) survived the operation. To assess the effect of operation, 26 infants were studied noninvasively with Doppler arm-to-leg pressure measurements at rest and with stress. Preoperatively, the median arm-to-leg gradient at rest was 77 mm Hg. Serial postoperative Doppler studies demonstrated progressive changes in arm-to-leg pressure gradients: 69% had residual arm-to-leg gradients that spontaneously resolved, 13% had residual gradients that persisted, 13% had progressive increase in gradient, and one child had neither early nor late gradient. Stress testing often unmasked gradients not present in the resting state. No differences were noted among the three surgical groups: RETE, SFA, and PA. From our experience, we have made four conclusions with regard to repair of coarctation of the aorta in infants. First, surgical survival is expected. Second, the effect of the operation is dynamic, with four patterns defined: (1) complete relief of coarctation, (2) transient residual coarctation, (3) persistent residual coarctation, and (4) recurrent coarctation. Third, optimal surgical therapy seems to be an eclectic approach. Fourth, physiological evaluation of coarctation in infants can be obtained by Doppler techniques in conjunction with stress testing. PMID- 6865468 TI - Comparison of distribution beyond coronary stenoses of blood and asanguineous cardioplegic solutions. AB - In seven dogs on cardiopulmonary bypass, a critical stenosis (75% to 90%) of the left anterior descending coronary artery (LAD) was produced. Alternate 250 ml/min infusions of asanguineous and blood cardioplegic (4 degrees C) solutions were made for 3 to 5 minutes. Poststenotic flow (flowmeter), intramyocardial temperature, and aortic pressure were measured. During cardioplegic infusions of 250 ml/min, aortic pressure was 34 +/- 4 mm Hg higher with blood cardioplegia than with asanguineous cardioplegia (82 +/- 7 versus 48 +/- 8 mm Hg). Poststenotic cardioplegic flow was 39% +/- 9% higher (29 +/- 5 versus 18 +/- 5 ml/min) with blood cardioplegia. Consequently, blood cardioplegia resulted in more rapid arrest (20 +/- 2 versus 45 +/- 5 seconds) and lower myocardial temperature (6 degrees +/- 1 degree C) in the region of LAD blood supply; posterior ventricular myocardial cooling was similar (unobstructed vessels) with both solutions. These data show that the reduced viscosity of asanguineous cardioplegia compared to blood cardioplegia results in lower aortic pressure. Consequently, the higher aortic pressure with blood cardioplegia results in superior cardioplegic delivery beyond obstructed coronaries and better myocardial cooling. We conclude that the decreased viscosity of 4 degrees C asanguineous cardioplegia causes diversion of cardioplegic solution from the obstructed to the normal coronary bed. PMID- 6865471 TI - An application of neutron activation analysis to small biological samples: simultaneous determination of thirty elements in rat brain regions. AB - Thirty elements in 7 rat brain regions were determined by instrumental neutron activation analysis (INAA). The samples were irradiated by thermal neutrons using 3 different sets of conditions, depending on the nuclear characteristics of the elements. Analysis of the resulting radionuclides was by gamma-ray spectrometry using a high resolution Ge(Li) detector and Nuclear Data 6600 multichannel analyzer, which was fully computerized to give quantitative results for the gamma ray spectra. This paper demonstrates the use of INAA for small biological samples and to show its potential elements, 7 rat brain regions are listed. It is interesting to note that certain elements, e.g. fluorine and potassium showed high and low regional differences respectively, and hypothalamus and hippocampus had higher elemental concentrations than other brain regions. However, since this paper is essentially an analytical one, no attempt is made to assess these data, which are preliminary, and the possible functional role of these elements will be discussed elsewhere. PMID- 6865470 TI - Chemical reduction of silver chromate: a procedure for electron microscopical analysis of Golgi-impregnated neurons. AB - A procedure is described by which the solid silver chromate precipitate present in Golgi-impregnated neurons is reduced by a photographic developer into metallic silver grains or particles. The remaining silver chromate is subsequently removed, and the fine structure and synaptic relationships of the impregnated neurons can be studied with the electron microscope. Three developers, Hydrochinone, Kodalith and D 19 were tested on cortical neurons in Vibratome sections of rapid Golgi-impregnated rat brains. Considerable differences were observed as regards penetration of the developer into the sections, uniformity of development, size and location of the silver particles produced during the development, and the quality of preservation of the ultrastructural details both in the impregnated neurons and the surrounding neuropil. Following the chemical reduction procedure the metallic silver deposit can be converted into metallic gold by a gold toning technique. Of the 3 tested developers, Kodalith and D 19 met the demands: good ultrastructural preservation, high contrast at both light microscopic (LM) and electron microscopic (EM) levels, reliable and easy to perform, minimum of test runs. Because of the high contrast provided by Kodalith and D 19, these substances are well suited for neuroanatomical tracing studies which make use of a transport or degeneration technique combined with Golgi-EM. In contrast to Kodalith, D 19 has little effect on the ultrastructure of the impregnated cells. Therefore, this developer can also be used for ultrastructural studies of Golgi-impregnated, light microscopically identified neurons. PMID- 6865472 TI - Bovine adrenal chromaffin cells: high-yield purification and viability in suspension culture. AB - A method for purifying chromaffin cells from adult, bovine, adrenal medullae and the techniques for maintaining the cells in suspension culture for at least 14 days are presented. Perfusion of medullae with a collagenase-containing medium produced a cell fraction that contained, in addition to chromaffin cells, a significant percentage of non-chromaffin cells. These cells were found to attach more rapidly than chromaffin cells to glass and tissue-culture plasticware. Using this property, we devised a selective plating procedure that yielded approximately 1-2 x 10(8) chromaffin cells per adrenal medulla at a purity of 95% or higher. On the basis of catecholamine levels and enzyme activities, suspension (as opposed to monolayer) cultures were chosen to further investigate their potential as a model system for the regulation of adrenergic function. In contrast to chromaffin cells cultured in monolayer, chromaffin cells in suspension had a more rounded appearance and formed multicellular aggregates with time in culture. Very few neurite-like structures, commonly observed in monolayer cultures, were present in the suspension cultures. Also, inhibitors of mitosis were not necessary to prevent overgrowth by non-chromaffin cells as there was little or no cell division in the suspension cultures. Catecholamine levels were relatively stable for at least 2 weeks, although a gradual decline in epinephrine occurred after day 5. Unlike other enzymes involved in catecholamine metabolism, phenylethanolamine N-methyl transferase activity declined significantly with time in culture in parallel to the gradual loss of epinephrine. In addition, both oxygen consumption and amino acid incorporation into proteins were relatively stable. Thus, the primary suspension cultures of adult, bovine chromaffin cells seem to offer several advantages for studying long-term regulation of chromaffin cell function and provide a stable source of adrenergic cells for examining short term regulatory processes. PMID- 6865474 TI - Storing brain slices. PMID- 6865473 TI - A simple microcomputer-based three-dimensional serial section reconstruction system (MICROS). AB - We have developed a computer system which enters and aligns serial sections and displays the completed reconstructions at different rotations in space. The system uses commercially available hardware, including a Hewlett-Packard 9845T microcomputer and an H-P 9874A digitizer. The software for the system is written in the BASIC language. The system consists of two programs, one for section digitization, the other for rotation and display of the reconstructions. Sections are digitized directly from micrographs or back-projected slides. The outlines of cells or other structures are traced from these media using a hand-held cursor on the digitizer. The positions of elements (inputs) which contact the structure and fiducials are also digitized. The sections are aligned by simultaneously displaying two consecutive sections on the graphics CRT screen. The sections are coarsely superimposed by centering around screen center using a centering algorithm. They are precisely aligned by rotating and translating the images with a reference cursor. Special functions for inserting and deleting sections and rapid section scanning are available for editing. The aligned sections are stored using a linked-list file structure on either floppy disks or tape cartridges. The rotation program replots the completed reconstructions on the graphics CRT or digital plotter. The program will reproduce the reconstructions at any scale and at any rotation in the x-, y- or z-planes. A hidden line algorithm removes hidden lines to give a 3-dimensional (3-D) perspective to the reconstructions. The positions of inputs and fiducials are represented by symbols. We use the system to reconstruct cells and neural processes. The 3-D reconstructions allow us to: (a) examine the spatial distribution and density of synaptic contacts on neurons; (b) study complex neuronal shapes; (c) examine the vectors of neural processes. The computer reconstruction system, which is moderately priced, should also prove useful for reconstructing many other types of biological profile. PMID- 6865475 TI - Minimal pathologic expression of a mutant gene for hereditary motor and sensory neuropathy. AB - Transverse sections of the sural nerve of a 46-year-old woman without neuropathic symptoms or abnormalities on nerve conduction, electromyography, or computer assisted sensory examination contained minute regions with large onion bulbs intermingled with normal-appearing myelinated fibers and surrounded by fields of normal myelinated fibers. This woman's 19-year-old daughter had long-standing hypertrophic neuropathy with diffusely distributed large onion bulbs. Computer imaging reconstruction of myelinated fibers and teased myelinated fiber studies of fascicles containing focal regions with onion bulbs of the mother's nerve provided evidence that onion bulbs surrounded atrophic axons with short internodes and demyelination. This is the least expression for inherited neuropathy which has been reported. These findings therefore suggest that an inherited neuropathy may be minimally expressed by a pathologic alteration of only selected neurons (axons). PMID- 6865478 TI - Ictal tachycardia during temporal lobe seizures. AB - A seldom-recognized accompaniment of temporal lobe seizures is tachycardia. This phenomenon was observed in 12 consecutive patients in whom spontaneous seizures were recorded with simultaneous electroencephalographic, electrocardiographic, and videotape monitoring; this finding indicates with a 99% confidence level that this phenomenon may occur in at least 64% of temporal lobe seizures. The autonomic influences responsible for ictal tachycardia during temporal lobe seizures may be inconsequential in patients without cardiac disease but can have serious consequences in patients with cardiac disease. PMID- 6865476 TI - Linkage evidence for genetic heterogeneity among kinships with hereditary motor and sensory neuropathy, type I. AB - Previous reports have shown linkage of hereditary motor and sensory neuropathy, type I (HMSN I), a dominantly inherited hypertrophic neuropathy, to the locus for the Duffy blood group on the long arm of chromosome 1. Two kinships that were extensively studied and reported almost 20 years ago and used to show heterogeneity among kinships with peroneal muscular atrophy and to characterize HMSN I were investigated for linkage to various blood erythrocyte and lymphocyte (HLA) antigens. Strong evidence against linkage to the Duffy blood group locus was found for one kinship, whereas suggestive evidence for linkage was found for the other. These data imply that HMSN I is heterogeneous--that is, caused by different genetic mechanisms. The HMSN I that is not linked to the Duffy locus might be identified as HMSN IA, and the HMSN I that is linked to the Duffy locus might be designated as HMSN IB. HMSN IA was not linked to other blood types or HLA antigens. In addition, no evidence for linkage to blood types and HLA was found for spastic paraplegia with peroneal muscular atrophy and sensory loss (HMSN V). PMID- 6865477 TI - Incidence and trend of herpes progenitalis. A 15-year population study. AB - A population-based epidemiologic study of herpes progenitalis was conducted in residents of Rochester, Minnesota, for the 15-year period 1965 through 1979. Three hundred ninety-two patients (129 males, 263 females) were identified. The average annual incidence rate of herpes progenitalis was 50 per 100,000 population. A continuous increase in incidence was demonstrated throughout the study period (P less than 0.0005, trend test). In 1979, the incidence peaked at 128 per 100,000 population. The median age at onset was 24 years, and more than 80% of the patients were 18 to 36 years of age. Females predominated by 1.5:1 (P less than 0.001) and were, on the average, 4 years younger than the male patients. Although 15 pregnancies in the series were affected by herpes progenitalis, no neonatal herpes was noted, nor was the number of unfavorable outcomes of pregnancy unusual. No invasive or in situ genital carcinoma developed in patients after 1,544 person-years of follow-up. PMID- 6865481 TI - Inherited neuropathies. PMID- 6865479 TI - Outcome of dual-chamber pacing for the pacemaker syndrome. AB - Symptomatic hypotension induced by VVI pacing (ventricular paced, ventricular inhibited) is characteristic of the pacemaker syndrome. Recent observations indicate that it is due to atrioventricular dyssynchrony. Since 1980, we have used the approach of converting the ventricular pacing to a dual-chamber pacing system in patients with this syndrome. The clinical course, hemodynamics, and response to dual-chamber pacing were evaluated in nine patients with the pacemaker syndrome whose ages ranged from 41 to 78 years. The indication for initial implantation of a pacemaker was symptomatic sinus node dysfunction in eight patients and intermittent Mobitz II block in one patient. One patient had a history of heart failure. The mean cardiothoracic ratio was 0.44. After initial implantation of a VVI pacemaker, all patients had syncope or near-syncope (mean duration, 10 months; mean frequency, one episode per month) despite normal pacemaker function. Eight of the nine patients had a symptomatic decrease in systolic blood pressure of greater than 20 mm Hg and ventriculoatrial conduction during VVI pacing. Dual-chamber pacing was instituted in all nine patients. This mode abolished pacing hypotension and its related symptoms. During a mean follow up of 10 months, no patient has had recurrent syncopal or near-syncopal attacks related to pacemaker function. Dual-chamber pacing is an effective approach for treatment of the pacemaker syndrome. PMID- 6865480 TI - Treatment of aortic graft infection with providone-iodine irrigation. AB - Considerable morbidity and mortality are associated with infections of vascular prosthetic grafts. Most vascular surgeons believe that once vascular prosthetic graft infections occur, any form of therapy short of removal of the prosthesis will fail. Although recent reports have noted the successful conservative treatment of vascular prosthetic graft infections in the groin, most surgeons have been hesitant to use such therapy for aortic prosthetic graft infections. We describe an 88-year-old woman with an aortic graft infection 2 months after abdominal aortic aneurysmectomy who was treated successfully with local debridement and continuous irrigation of the graft bed with providone-iodine solution. Such local therapy is an alternative and sometimes effective method of managing patients with infected aortic grafts in whom the risk of resection of the prosthesis and revascularization would be prohibitive. PMID- 6865482 TI - Physician/patient communication: transmission of information and patient effects. PMID- 6865483 TI - Interpersonal communication skills for enhancing physician-patient relationships. PMID- 6865484 TI - Prevention in primary medical care: the INSURE Project. PMID- 6865485 TI - Physician involvement in health education: needs, problems, solutions. PMID- 6865486 TI - The physician's role in improving patient outcome in high blood pressure control. PMID- 6865487 TI - Patient education: working toward a common goal. PMID- 6865488 TI - Patient education: the importance of a reciprocal relationship. PMID- 6865489 TI - Health education: role of the physician in schools. PMID- 6865490 TI - Pertussis outbreak, Maryland 1982. PMID- 6865492 TI - Extra-adrenal pheochromocytoma in pregnancy. PMID- 6865491 TI - Limitations in use of the medical record face sheet to determine appropriateness of permanent pacemaker insertion. PMID- 6865494 TI - Splenic injuries in children: the philosophy of conservative management. PMID- 6865493 TI - Cavernous hemangioma of the adrenal gland. PMID- 6865495 TI - Age-dependent variations in the distribution of rat lens water-soluble crystallins. Size fractionation and molecular weight determination. AB - In order to obtain deeper insights into the mechanisms that are responsible for the age-related changes in the eye lens, the water-soluble proteins of 6-day-old to over 3-year-old rat lenses were analyzed by high-performance gel-permeation chromatography. Using this technique eleven crystallin fractions could be discerned: HM-, alpha-, three beta H-, two beta L-, beta S- and three gamma crystallins. The concentrations of the higher molecular weight crystallins (HM-, alpha- and beta H-crystallin) seem to increase with age while those of the lower molecular weight (beta L- and gamma-crystallin) decrease. Taking into account the gradual increase of water-insoluble protein with aging, the relative amount of alpha-crystallin decreases from an age of 0.5 year after an initial increase. Additionally, an age-dependent increase in its molecular weight was found: from 7 . 10(5) to over one million. It appears that the gamma-crystallins are directly involved in the insolubilization process, while alpha- and beta L-crystallin first take part in aggregation processes leading to HM- and beta H-crystallin aggregates. These aggregation and insolubilization processes proceed gradually with increasing age. A steep decrease in gamma-crystallin concentration in the early phase of life, which also causes the relative increase in alpha-crystallin content in this period, may originate from a decrease in biosynthesis of certain gamma-crystallins. PMID- 6865497 TI - Some biochemical parameters of ageing in relation to dietary protein. AB - An investigation was undertaken to study the effect of dietary protein level on some age-related biochemical processes in mice. Weanling mice were fed a laboratory diet containing protein at 6, 12 or 24% and adequate in all other nutrients, for up to 52 weeks. Although the rate of gain in body weight of the animals between 3 and 6 weeks was related to the dietary level of protein, the final body weights of mice in different groups were not significantly different. Lipid peroxidation in liver homogenate, free activities of some lysosomal enzymes of brain, liver and intestine, and the accumulation of lipofuscin pigments showed an increase with the dietary level of protein. On the other hand, the activity of superoxide dismutase in liver showed an inverse relationship to the protein level of the diet. The findings are discussed in relation to the free-radical theory of ageing. PMID- 6865496 TI - DNA chain growth as a function of age in intact and permeabilized WI-38 and MRC-5 cells. AB - The rate of incorporation of deoxythymidine triphosphate (dTTP) into acid precipitable material of permeabilized MRC-5 and WI-38 cells as well as the rate of DNA chain growth in both intact and permeabilized cells was examined as a function of cell age. Although both the total rate of dTTP incorporation and the percentage of labeled cells decreased as cultures aged, we could detect no decrease in the rate of DNA chain growth from passages 29 to 53 for MRC-5 and from passages 34 to 50 for WI-38 cells. Since the older passages were in phase III growth and since, in our hands, the WI-38 cells used for this study senesced at passage 51, we conclude that a decrease in the rate of DNA chain growth is not related to in vitro aging. PMID- 6865498 TI - Mechanisms for the removal of senescent human erythrocytes from circulation: specificity of the membrane-bound immunoglobulin G. AB - Direct antiglobulin (Coombs') tests of erythrocyte (RBC) subpopulations confirmed the presence of membrane-bound immunoglobulin G (IgG) on old (density greater than 1.110) human RBCs but not on the young (density less than 1.110) RBCs. After thermal elution of the bound IgG, this Coombs' reaction was negative, but incubation of thermally eluted IgG (He-IgG) with heat-treated RBCs induced a positive antiglobulin test. A positive direct antiglobulin reaction was also obtained after incubation of heat-treated RBCs with anti-T antibody. Similar results were obtained when young RBCs treated with Vibrio cholerae neuraminidase (VCN) were incubated with anti-T or with IgG eluted by heat from old RBCs. Nevertheless, pre-absorption of heat-eluted IgG with T and/or Tn antigen, did not prevent it from binding to either heat-treated old or VCN-treated young RBCs as assessed by the antiglobulin consumption assay. Pre-treatment of either VCN treated young or heat-treated old RBCs with anti-T and/or anti-Tn antibodies had no significant effect on the binding of radiolabeled He-IgG (eluted from old RBCs). The results indicate that even though desialylation of the erythrocyte membrane is required for binding of both anti-T-Tn and He-IgG, the specificity and consequently the RBC binding sites for He-IgG and anti-T seem to be different. PMID- 6865499 TI - Cyclophosphamide-induced in vivo sister chromatid exchange in Mus Musculus. II: Effect of age and genotype on sister chromatid exchange, micronuclei and metaphase index. AB - In vivo cyclophosphamide-induced sister chromatid exchanges (SCEs) micronuclei, and metaphase indices were assessed in two age groups (10.8 +/- 0.9 weeks' an 33.1 +/- 1.3 weeks' old) of female mice from three genetic strains (C3H/S, C57BL/6J, and Balb/c). In general, older animals showed diminished SCE induction over their younger counterparts. The relative difference between individuals of the two ages is strain-dependent. Unlike C57BL/6J and Balb/c, strain C3H/S showed significantly lower SCE values in the older animals at every cyclophosphamide treatment. It may reflect on the possible involvement of genetic determinant(s) for the component(s) of SCE formation during aging. Frequencies of micronuclei, however, were consistently higher in older animals than in their younger counterparts. Furthermore, cytotoxicity of cyclophosphamide, as reflected in metaphase indices, was also higher in older animals. Lower metaphase indices associated with higher micronuclei levels in older individuals may suggest a decline in the rate of cellular replication in these animals. Furthermore, the lower metaphase indices associated with lower SCE values, and increasing micronuclei levels accompanied by decreasing SCE frequencies in older animals, may reflect reduced DNA repair ability during aging. These results support the hypothesis of genotype-dependent decline in the rate of DNA repair and replication during aging, particularly under stressed conditions. PMID- 6865500 TI - A return to time, cells, systems and aging: rethinking the concept of senescence in mammalian organisms. PMID- 6865501 TI - DNA repair by articular chondrocytes. I. Unscheduled DNA synthesis following ultraviolet irradiation in monolayer culture. AB - The hypothesis that aging of articular chondrocytes at a cellular level results from loss of DNA repair capability was studied by measuring unscheduled DNA synthesis (UDS). Cultured rabbit and human articular chondrocytes were irradiated with 254 nm ultraviolet light (20 J/m2) following treatment with 10 mM hydroxyurea. Neither the "in vitro senescence" nor spontaneous transformation that developed during serial passage of rabbit chondrocytes was accompanied by diminution of UDS. Synthesis of sulfated glycosaminoglycans declined more rapidly than the ability of the cells to divide. Levels of UDS by chondrocytes from old donors, rabbit or human, were comparable to those of younger individuals. UDS was greater in human than rabbit chondrocytes. Similar data have been reported previously for dermal fibroblasts but do not necessarily indicate that there is a direct or causative relationship between UDS capability and the longevity of mammalian species. X-Irradiation of rabbit chondrocytes or cartilage explants, in doses up to 40 000 rads, yielded no measurable UDS. PMID- 6865502 TI - DNA repair by articular chondrocytes. II. Direct measurements of repair of ultraviolet and X-ray damage in monolayer cultures. AB - The abilities of human and rabbit articular chondrocytes to repair ultraviolet (UV) and X-ray damage were measured in terms of the removal of UV--endonuclease sensitive sites (pyrimidine dimers) and single-strand breaks, respectively. The initial 3-h rate of dimer repair in human cells, incubated in medium containing 10% human serum, was about 2.5 times as large as in rabbit cells incubated in medium containing 10% or 20% fetal bovine serum. Similar results have been previously reported for unscheduled DNA synthesis (UDS), indicating that UDS is a valid quantitative measure of repair in this cell system. The repair of single strand breaks was rapid (approx. 50% completed in less than 10 min). An estimate, from the measured numbers of lesions and patch sizes, indicated that the amount of UDS following 20 krad would be 100 to 300 times less than that in 3 h following 10 J/m2 of 254 nm and hence would not be detectable radioautographically. PMID- 6865503 TI - Age-related changes in the composition of proteins in the trabecular meshwork of the human eye. AB - The composition of the trabecular meshwork proteins of human eyes ranging in age from 36 days to 84 years was examined by polyacrylamide gel electrophoresis and amino acid analysis. Proteins of different molecular weights could be extracted from the tissue with acetic acid. Although their electrophoretic patterns became less distinct with increasing age, proteins of molecular weights ranging from 50 000 to 69 000 always prevailed. The amino acid compositions of the acetic acid insoluble trabecular meshwork residues revealed the prevalence of collagenous proteins. The peptide maps produced by treatment with cyanogen bromide indicate that most of the fragments solubilized from the trabecular meshwork of younger eyes are derived from type I collagen. Beyond 40 years of age, the trabecular meshwork was resistant to cyanogen bromide and pepsin digestion. A rough estimate of the distribution of collagen types in the trabecular meshwork was based on 3 hydroxyproline/4-hydroxyproline ratios, indicating an age-related increase of type I collagen from about 55 to 70 per cent, and of type IV collagen from about 2 to 5 per cent of the total protein present. During ageing, some of the protein bound methionine is oxidized to methionine sulfoxide, reaching about 35 per cent of the total methionine content at the age of 20 years and, with a slower rate of oxidation, a mean value of 40 per cent at 80 years of age. Electron-microscopic analysis of specimens remaining undissolved after cyanogen bromide cleavage and pepsin treatment no longer revealed regular collagenous fibrils but rather elastic-like fibers surrounded by wide sheaths consisting of fine fibrils with a regular cross-banding periodicity of 40-50 nm. In addition, clusters of so-called curly (lattice) collagen were found. The amino acid composition of this insoluble material suggests that altered collagen-like molecules prevail among the proteins of the residues. PMID- 6865504 TI - Age-dependent decrease in the activity of protein-synthesis initiation factors in rat brain. AB - The age-dependent reduction of brain protein synthesis was examined at the initiation step of translation in the rat. Activity of brain initiation factor 2, as well as that of other eukaryotic initiation factors that contribute to the binding of initiator aminoacyl-tRNA to ribosomes, was found to decrease with age and to decline parallel to the decrease in total protein synthesis and brain elongation factor 1 activity. Change in the activity of initiation factors was demonstrated by the results of two different assays which compared favorably with each other. Decreased activity of preparations of initiation factors derived from older animals was observed in: (1) saturating conditions; (2) mixtures of preparations from different ages; and (3) both major cell fractions, i.e. cell sap and microsomes. PMID- 6865505 TI - Possible role of neuromelanin in the pathogenesis of Parkinson's disease. AB - The numbers of nerve cells in the substantia nigra and locus caeruleus were counted, and the volume of their nucleolus and the amount of neuromelanin pigment they contain measured, in patients with Parkinson's disease and in age-matched and elderly individuals free from neurological illness. The number of pigmented nerve cells of both types is reduced by about 20% in the elderly when compared with age-matched controls. The melanin content of the remaining cells in the elderly is lessened (by 11% in substantia nigra and 21% in locus caeruleus) in such a way as to indicate that this age depletion in cell number results from a preferential loss of those nerve cells which contain the greatest amounts of melanin pigment. In Parkinson's disease there is a greater overall reduction in the amount of melanin within remaining cells (15% in substantia nigra, 25% in locus caeruleus) because of a more severe (80%) loss of the heavier pigmented cells. The basis for Parkinson's disease may therefore lie with an aggravation, possibly by secondary factors, of changes that occur within neurones of substantia nigra and locus caeruleus as part of their "normal" process of ageing. PMID- 6865507 TI - Calibration of entrainment raster scans. PMID- 6865506 TI - Hydrogel based in vivo reference electrode catheter. PMID- 6865509 TI - Zero-drift connection device for a respiratory pneumotachograph. PMID- 6865508 TI - Ultrasound apparatus for the measurement of facial movement. PMID- 6865510 TI - Development and in vitro assessment of a new two-leaflet replacement heart valve designed using computer-generated bubble surfaces. PMID- 6865511 TI - Assessment of a parametric identification procedure of simple models for left ventricular afterload. PMID- 6865512 TI - Response of the visual system evoked by an alternating current. PMID- 6865513 TI - Anisotropy in the dielectric properties of skeletal muscle. PMID- 6865514 TI - A mathematical model and some measured characteristics of the carotid baroreceptor control of blood pressure in man. PMID- 6865515 TI - Analysis of human movements: spatial localisation with multiple perspective views. PMID- 6865516 TI - Body surface potential mapping system equipped with a microprocessor for the dynamic observation of potential patterns. PMID- 6865517 TI - Technical description and performance characteristics of a human whole-body calorimeter. PMID- 6865518 TI - Infrared reflectance from whole blood soaked filter paper and implications in haemoglobinometry. PMID- 6865519 TI - Measuring the impact of programs for mothers and infants on prenatal care and low birth weight: the value of refined analyses. AB - During the past two decades, intervention strategies designed to improve the health status of mothers and infants have been widely disseminated, yet relatively few have been evaluated for effectiveness. Moreover, most reported investigations have involved straightforward comparisons of aggregate data, employing various degrees of methodological control. In this study, vital statistics data were used to assess the effects of the North Carolina Maternity and Infant Care (MIC) Project on use of prenatal care and low birth weight. A weighted least squares procedure was used to control for selected maternal characteristics and identify significant interactions. Analyses of total population data indicated only minor MIC effects. However, more careful scrutiny of subpopulation data suggests that MIC impacts differed across categories of maternal risk status, with the greatest influence observed among mothers and infants at greatest risk. These findings raise several questions regarding the genesis of differential effects and suggest areas of special concern in conducting, interpreting, and using evaluations of programs for mothers and infants. PMID- 6865520 TI - Substitution between formally and informally provided care for the impaired elderly in the community. AB - This article assesses the extent to which formally provided comprehensive community care tends to substitute for informal care provided by family and friends to impaired elderly persons living in the community. Using simultaneous equations causal modeling techniques to control for selective targeting and other intervening factors, results, indicate a substantial tendency for formally provided care to be substituted for informal care. Other results indicate that unmet need appears to be the major variable predicting both informal and formal support levels, with informal care providers appearing to be somewhat more precise in conditioning support levels on need than formal care providers. Policy implications of these findings are discussed. PMID- 6865522 TI - "The best laid plans . . .": an evaluation of a patient education program. AB - Graphic instructions for the collection of clean-voided urine specimens were posted in outpatient clinic bathrooms. These signs were intended to supplant clinic staff verbal instructions and to improve patients' ability to perform this procedure correctly. To assess the impact of the signs, the contamination rates were determined for urine culture specimens for the 6-month periods immediately preceding and following their introduction. The contamination rate for 306 consecutive specimens submitted before the signs were hung (12 per cent) was significantly lower (p = 0.004) than for the 360 specimens submitted afterward (20.6 per cent). Further, the incidence of true bacteriuria was significantly higher before the signs were posted (21.8 per cent) than afterward (15.2 per cent) (p = 0.02). There was no reported change in the provision of verbal instructions by clinic personnel, and the signs provoked some negative reactions from patients and visitors. This unexpected adverse outcome of a well-intended patient education effort is reported so that others may profit from the authors' mistakes. PMID- 6865521 TI - Sibling data and the family background influence on child health. AB - This study, using sibling data for the first time in health economics, explores the effects of family background on child health. The method used estimates the proportion of variance due to family influences via a correlation coefficient for sibling data for two child health measures: approximately 22 per cent of the variance in days missed from usual activities and 43 per cent of the variance in visits to the medical facilities may be attributed to family influences on child health status. These estimates are compared with those obtained by multivariate regression analysis, the customary method employed in exploring child health determination. The comparison underscores the value of the sibling information utilized in the first method: the regression analysis explains only one seventh of the total family background effect revealed through the sibling data. The estimates further indicate that the residual, nonfamilial determinants are a major source of influence on child health. PMID- 6865523 TI - [Risk factors in cerebrovascular disease. A study of 162 patients]. PMID- 6865524 TI - [Acute anemia in a hemodialysis program caused by the appearance of high chloramine levels in the water]. PMID- 6865525 TI - [Is biliary lithiasis always a surgical condition?]. PMID- 6865526 TI - [Dissolving biliary calculi: reality or myth?]. PMID- 6865527 TI - [Familial hemochromatotic cardiomyopathy]. PMID- 6865528 TI - [Cure of a case of childhood intrahepatic cholestasis using phenobarbital and cholestyramine]. PMID- 6865529 TI - [Clinical applications of monoclonal antibodies]. PMID- 6865530 TI - [Nail pigmentation caused by antimalarials]. PMID- 6865531 TI - [Pleural aspergillosis]. PMID- 6865532 TI - [Calcified aneurysm of the sinus of Valsalva mimicking a left atrial calcification]. PMID- 6865533 TI - [Pyogenic hepatic abscess: description of a series of 20 cases]. PMID- 6865534 TI - [Clinical application of the measurement of digoxin in blood]. PMID- 6865536 TI - [Acquired cellular immunodeficiency syndrome]. PMID- 6865537 TI - [Generalized fibromuscular dysplasia and calcified aneurysm. Sepsis caused by Cardiobacterium hominis]. PMID- 6865538 TI - [Acute asphyxic syndrome caused by paralysis of both vocal cords as a manifestation of polyradiculoneuritis of the Guillain-Barre type]. PMID- 6865535 TI - [Porphyria hepatocutanea tarda. Clinical, biological and histological manifestations in a series of 32 patients]. PMID- 6865539 TI - [Hypoxemia in hemodialysis. Consequence of alveolar hypoventilation and intra dialysis leukopenia]. PMID- 6865540 TI - [Anaphylactic shock caused by spontaneous rupture of hepatic hydatid cysts]. PMID- 6865542 TI - [Right ventriculography or superior cavography in the diagnosis of tricuspid insufficiency]. PMID- 6865541 TI - [Probability of bacteremia in Salmonella gastroenteritis]. PMID- 6865543 TI - [Education for diabetic patients: a profitable investment]. PMID- 6865544 TI - [The problem of carrier detection in Duchenne disease]. PMID- 6865545 TI - [Familial diffuse interstitial pulmonary fibrosis]. PMID- 6865546 TI - [Intracoronary fibrinolysis using streptokinase]. PMID- 6865548 TI - [Pericardial diseases: old problems without present solutions]. PMID- 6865547 TI - [Familial angioedema (I). Clinical and immunological study of 18 cases]. PMID- 6865549 TI - [The Internal Medicine Department in the Social Security Health Centers]. PMID- 6865550 TI - [Primary pulmonary actinomycosis. Apropos of a case]. PMID- 6865551 TI - [Chylothorax secondary to chronic lymphatic leukemia]. PMID- 6865552 TI - [Brucellar epidural abscess]. PMID- 6865553 TI - [Aortic coarctation with an anterior spur]. PMID- 6865554 TI - [The value of neurophysiologic tests in the diagnosis of multiple sclerosis]. PMID- 6865555 TI - [Ischemic myocardiopathy in diabetics]. PMID- 6865556 TI - [Q fever. Apropos of 13 case reports]. PMID- 6865557 TI - [Thyroid cancer in adolescence]. PMID- 6865558 TI - [Hypercholesterolemia: when and how much to treat it?]. PMID- 6865559 TI - [Uremic pericarditis]. PMID- 6865560 TI - [An early electrocardiographic sign of acute myocardial infarction]. PMID- 6865561 TI - [Reiter's syndrome and Yersinia enterocolitica infection]. PMID- 6865563 TI - [Temporal arteritis and aortic arch syndrome]. PMID- 6865562 TI - [Urination disorders in geriatrics: physiopathology, diagnosis and treatment]. PMID- 6865564 TI - [Radiology of pulmonary tuberculosis in diabetic patients]. PMID- 6865565 TI - The administration of medical records in Japanese hospitals: a status report. AB - We performed the nation-level investigation, the aim of which is to grasp the present status of the administration of medical records in Japanese hospitals. There have been conducted such few investigations as this one yet in Japan. We made a report of the administration of medical records, the use of medical records, and the use of advanced tools like microfilms, computers, broken down by some attributes like establishments and bed sizes. As a result of statistical analysis of 446 hospitals, 10% hospitals showed considerably advanced administration of medical records. The remaining hospitals depend on the manual administration as an initial stage. We would generally say that private hospitals are the most delayed, however the difference is small. With respect to the classification of bed sizes, the degree of advancement in the administration of medical records is parallel to the direction of the more bed sizes. PMID- 6865566 TI - Digital filtering and regression algorithms for an accurate detection of the baseline in ECG signals. PMID- 6865567 TI - [Application of a Markov model to the follow-up of hyperthyroid patients treated with radioactive iodine]. PMID- 6865568 TI - Evaluation of AMHTS for the early detection of gastric cancer--with special reference to blood tests. PMID- 6865569 TI - Status and analysis of medical computing in The Netherlands. PMID- 6865571 TI - [Physical and psychological effects of social activities in the elderly]. PMID- 6865570 TI - [Dizziness]. PMID- 6865572 TI - [Fasting and vegetarian diet in rheumatoid arthritis--does new experience explain short-time remission?]. PMID- 6865573 TI - [Appendicitis caused by Campylobacter]. PMID- 6865574 TI - [Laymen specially trained as ambulance personnel, can save lifes in circulatory collapse]. PMID- 6865575 TI - [Only a third of all women use a contraceptive method correctly]. PMID- 6865576 TI - [Fewer cases of symptomatic gallstone diseases are behind the decreased need for biliary surgery]. PMID- 6865577 TI - [Immobilization of the vocal cords following endotracheal intubation]. PMID- 6865578 TI - [A case of late manifestation of congenital diaphragmatic hernia]. PMID- 6865579 TI - [Immunization against diphtheria and tetanus]. PMID- 6865580 TI - [Procto- and rectoscopy in general practice]. PMID- 6865581 TI - [The benefits of physical training--justified or not?]. PMID- 6865582 TI - [Safety release bindings on skis do not give sufficient protection against knee injuries]. PMID- 6865583 TI - [Considerably decreased amount of soccer injuries after introduction of a preventive program]. PMID- 6865584 TI - [Age determination by teeth in suspected misinformation about the age of adopted children]. PMID- 6865585 TI - [Aging and senile dementia - epidemiologic and etiologic aspects]. PMID- 6865586 TI - [A new conception of the action of penicillins. The bursting theory had to be reevaluated]. PMID- 6865587 TI - [Abdominal aortic coarctation--an unusual cause of hypertension in younger patients]. PMID- 6865588 TI - [Harmful effect of ice packs used in the treatment of athletic injuries--warning against cold injuries]. PMID- 6865589 TI - [Otitis media in children]. PMID- 6865590 TI - [Pubic symphysis surgery--symphysiotomy in developing and in developed countries]. PMID- 6865591 TI - [Prostasomes--a newly discovered organelle that increases sperm motility]. PMID- 6865592 TI - [Lack of consideration of psychiatric aspects in hospital plans for medical disasters]. PMID- 6865593 TI - [Pneumopericardium--a review of the literature and report of a case complicated by tamponade]. PMID- 6865594 TI - [Favism in Sweden. Are there more cases top be expected?]. PMID- 6865595 TI - [Gas embolisms (apropos of 44 cases)]. PMID- 6865596 TI - [Peripheral tuberculous adenopathies. Clinical, diagnostic and therapeutic aspects apropos of 43 cases]. PMID- 6865597 TI - [Gougerot-Sjogren syndrome with systemic manifestations: myopathy, cutaneous vasculitis, thyroiditis and tissue deposits of IgA]. PMID- 6865598 TI - [Constitution 48, XXYY or the double-male syndrome]. PMID- 6865599 TI - [Semiology and pitfalls in the echographic examination of gallbladder calculi]. PMID- 6865600 TI - [Compression of a motor branch of the radial nerve]. PMID- 6865601 TI - [Neurologic complications of bacterial endocarditis]. PMID- 6865602 TI - [Mitosis - chromosomes - karyotypes]. PMID- 6865603 TI - [Variations in fecal elimination of uric acid in 8 patients treated with benzbromarone]. PMID- 6865604 TI - [Cancer screening in otorhinolaryngology. A summary report]. PMID- 6865605 TI - [Auditory canal lesions caused by self manipulation]. PMID- 6865606 TI - [Purpose and initial results of training courses for hearing-aid users]. PMID- 6865607 TI - [Comparison of different charts for determining the percentage of hearing loss]. AB - Different methods are being employed at present to determine the percentage of hearing loss, on the basis of speech-and-tone audiometry. We scrutinized 1000 expertises on noise, and we were able to show the comparative mutual relationships between the methods employed, on the basis of regression analysis. The methods according to Trautmann/Oeken were relatively better than the other methods, but none of these methods yielded optimal relations. PMID- 6865608 TI - [Computed tomographic diagnosis of epidural abscess, subdural empyema, meningitis and brain abscess]. AB - Computerised tomography cannot be of great help in diagnosing meningitis. Examination of the cerebrospinal fluid remains essential. After the inflammation of the meninges has progressed to some stage of encephalitis, the formation of an abscess can be located via computed tomography. It is characterised by the ring type abscess capsule. Computed tomography for diagnostic purposes is superior to cerebral scanning, which demonstrates enhanced activity, but does not show the formation of a membrane, so essential for differential diagnosis. Furthermore, computed tomography shows the adjacent anatomical structures and answers the questions of displacements and threatening invasion of the ventricle system. Epidural and subdural abscesses can also be located by computed tomography. Therapy can begin directly after computerised tomography, whereas in scintigraphy only a non-specific enhanced activity is present, which often does not allow differentiation between epidural and subdural location. PMID- 6865609 TI - [Age-dependent prognosis of ischemic facial paralysis]. AB - 345 patients with Bell's palsy showed that the curing results get worse with increasing age. The analysis of a 3-dimensional contingency table shows that neither a worse recovery nor a worse starting point can explain this fact. Each of these influences points to only a weak but not significant tendency. Only both together exhibit such a clear relation. PMID- 6865611 TI - [Functional plastic surgery of the nose]. AB - The authors emphasize the importance of the extramucosal approach to the septum and the cartilaginous and bony vault in the correction of the crooked nose, for elongation of the pig-snout nose with retracted tip, and for closure of septal perforation. Furthermore, they present their own procedure for surgical treatment of stenoses of the nares as well as for huge tissues losses of the septum. PMID- 6865610 TI - [A new wound drainage system. 1st results with the sponge suction bag]. PMID- 6865614 TI - [Operation on the saddle nose]. AB - Most of the saddle deformities are due to trauma; less frequently, they may be a racial characteristic and in rare cases they follow chronic specific inflammatory diseases. The author considers the alternatives for surgical correction: 1. The small saddle requiring no graft 2. the saddle requiring little graft for which septal or aural cartilage will suffice and 3. more severe saddles requiring graft tissues taken from elsewhere. In a recent series using silastic, good results were obtained when the silastic was inserted via a mid-line vertical columella incision and not via an intra-nasal or intra-oral approach. PMID- 6865613 TI - [Frequent mistakes in corrective rhinoplasty]. AB - The choice of special techniques and a certain flexibility of the surgeon in performing his personal methods, and also the preoperative and intraoperative evaluation of specific characteristics of the nasal structures, are important factors in the prevention of mistakes and complications in rhinoplasty. Typical mistakes in septoplasty and the surgical treatment of the turbinates and the dermal and soft tissue structures are discussed. Septal subluxation, deviations of the nasal tip or postoperative scar formation often result in difficult postoperative corrective problems. Lack of care in the removal of bony or cartilaginous humps can lead to very bad nasal deformations. Precise control of all structures at the end of the operation and eventual final correction or "finishing" will often help to avoid secondary septo-rhinoplasties. PMID- 6865615 TI - [Squeezed connective tissue in tympanic membrane repair]. PMID- 6865612 TI - [Complications of rhinoplasty]. AB - Following a consequent outline of his communication, the author subsequently describes his experiences, the possibilities of managing and personal techniques available in case of operative problems or postoperative complications such as bleeding, haematoma, dermal necrosis or scar formation or infection. The nasal physiology and its relation to the operative treatment, and the importance of a thoroughly preoperative evaluation of certain tissue characteristics are discussed. Postoperative skeletal alterations, such as insufficient or excessive removal of humps, cartilages and soft tissues as well as their surgical management are pointed out. Remarks about nasal tip correction conclude the presentation of the subject. PMID- 6865616 TI - [Fluorescence angiography in the pathological findings of the tympanic membrane]. AB - Vascularity changes in certain pathological findings of tympanic membranes were examined via a newly developed technique of fluorescence angiography. Characteristic pictures of fluorescence-stained vasculature were found in chronic inflammations or in neoplastic processes. Around the margins of perforations or over sclerotic plaques, there was decreased vascular marking with obviously increased vascular permeability. A lack of vascularisation was observed in cases of atrophic membranes. So-called glomus tumours showed an early onset of strong hyperfluorescence, representing the dense vascularisation of these neoplasms. Our findings in chronic inflammatory lesions such as perforations, sclerotic plaques, and atrophies strongly suggest disturbances of the blood supply. In consequence, areas with such vascularity changes should be excised widely during tympanoplasties and undercovered e.g. with temporal fascia. The high staining ability of the so-called glomus tumours may be of differential diagnostic value in certain cases. PMID- 6865617 TI - [Tracheotomy in children. Complications and late results]. PMID- 6865618 TI - [The role of the cricopharyngeal muscle in phonation]. AB - Intraluminal esophageal manometry has been employed to study cricopharyngeal muscular function at different pitch levels. The activity of the cricopharyngeal muscle (CP) increases continually with rising pitch but is not influenced by the vocal sound pressure level. In the lower part of the chest register, the muscular pressure is lower than the pharyngo-esophageal pressure at rest. At high pitch levels, the pressure is higher than during swallowing. The CP has a dual function: With increasing pitch, the CP cooperates synergistically with the cricothyroid muscle (CT), indicated by increasing muscular pressure in the upper esophageal sphincter. On the other hand, the CP shortens the vocal cords by rotating the cricoid cartilage in anterior direction, thus acting antagonistically to the CT. PMID- 6865619 TI - [Phonatory airflow in the supraglottal space]. AB - The phonatory airflow can be measured by means of a hot wire tube placed in the supraglottic space without tying down the tongue. The velocity of airflow above the glottis reaches values around c = 50 to 150 cm/s. The variations in airflow oscillations were recorded. The voice of the person under examination was picked up by a condenser microphone (Bruel & Kjaer No. 2112). According to D'Alembert's wave equation, the sound intensity is related to the velocity of the phonatory air stream. The validity of this statement has been confirmed by repeated testing. The fundamental frequency of voice and of the airflow were analysed synchronously by means of the Nicolet analyser. The air consumption is not utilized for sound production in phonation by breathing. A "hard" or "pressed" voice is associated with diminished or irregular air consumption. The method can be employed in assessing the conditions of phonetic airflow in normal and dysphonic voices. PMID- 6865620 TI - Rhinoscleroma--a diagnostic challenge. AB - Rhinoscleroma is a rare chronic granulomatous infection predominantly affecting the upper respiratory tract. The patient presented here exemplifies several features of the disease, including the fact that diagnosis may elude the clinician for years, and this delay may increase morbidity substantially. The most common initial complaint is nasal obstruction, and physical examination frequently reveals erythematous granular or nodular swellings covered with crusts. Its tumor-like appearance and local spread arouses suspicion of malignancy, but differential diagnosis also includes fungal infections and numerous granulomatous diseases. The classic histopathology consists of large vacuolated Mikuliz's cells and transformed plasma cells with Russell bodies. Numerous antibiotics have been used for treatment of this infection with varying degrees of success. Long-term follow-up is important because these patients can have numerous relapses. Geographic distribution is also discussed. PMID- 6865621 TI - Nasal turbinate resection for relief of nasal obstruction. AB - Surgical correction of mechanical nasal airway obstruction is commonly attempted by means of septoplasty or submucous resection. In spite of these procedures, patients continue to present postoperatively with inadequate nasal airflow due to hypertrophied turbinates. Partial resection of turbinate mucosa, submucous turbinate resection, electrocautery and outfracture of turbinates provide additional improvement but are incomplete procedures. Total inferior turbinectomies have been performed on 40 patients over the past 5 years; 29 of these patients have been followed from 2 to 60 months postoperatively by clinical examination and by formal questionnaire. Twenty-five patients described a marked improvement of their nasal breathing, 3 had mild improvement, and 1 had no improvement at all. Only 1 patient, 1 year postoperatively, described excessive dryness, 2 described mild dryness, 3 described excessive secretions and none complained of foul smell or pain postoperatively. All patients had patent airways by clinical examination by at least 2 otolaryngologists. The inferior turbinates play a role in humidification and temperature regulation of inspired air. The removal of them, however, does not seem to be fraught with the morbidity which has heretofore been attributed to this procedure. PMID- 6865622 TI - Office treatment by cryotherapy for severe posterior nasal epistaxis--update. AB - We have used cryotherapy as an office treatment for severe posterior nasal epistaxis for 15 years. In 1971 we reported a retrospective study on 42 consecutive patients with severe posterior nasal bleeding; 26 had cryotherapy and 16 had anterior and posterior nasal packing. Our data showed that cryotherapy controlled epistaxis with less morbidity. We have now used cryotherapy for posterior epistaxis in over 450 patients. In this presentation we review the history of cryotherapy, rationale for treatment with cryotherapy, experimental tissue changes in cryotherapy, and the method for freezing in cryotherapy. We then discuss 50 recent patients with severe posterior nasal bleeding whom we have treated with cryotherapy. We have found that cryotherapy is a successful way to manage patients with severe posterior nasal bleeding. PMID- 6865623 TI - Sicca syndrome--diagnostic perplexities. AB - Patients presenting with xerostomia and other signs of Sjogren's syndrome pose diagnostic problems. Many other underlying diseases cause these symptoms and a systematic evaluation is necessary to make an accurate diagnostic assessment. There are immunological tests and histological studies which help make them distinctive and are herein outlined. Patients with this information presenting with sicca syndrome, therefore, can be more accurately assessed and have better treatment regimens instituted. The "sicca syndrome," which is a disorder discussed primarily in the rheumatology literature, is rarely a topic in the otolaryngology literature, although there are often presenting symptoms of this problem in the head and neck. This paper reviews this problem, discusses the confusion regarding terminology, and outlines a practical method of diagnosis for the clinician. PMID- 6865624 TI - Hurthle cell tumors of the thyroid gland. AB - Hurthle cell lesions of the thyroid gland, which are derived from follicular cells, occur in a variety of thyroid diseases. Hurthle cell neoplasms are generally easy to differentiate from non-neoplastic lesions, but the separation of benign from malignant Hurthle cell tumors is difficult on a purely histologic basis unless capsular or vascular invasion or metastases are present. Since this distinction is so difficult to make, the authors recommend treating all Hurthle cell neoplasms as potentially malignant. Treatment includes total thyroidectomy, peritracheal node dissection and if palpable jugular nodes are present, a regional node dissection. A series of 11 patients with this disease and the literature are reviewed to document these recommendations. PMID- 6865625 TI - Warthin's tumor: a review indicating no male predominance. AB - There is probably no other head and neck group of tumors as those found in the parotid gland that constitute such a diversity of growths, both benign and malignant. Warthin's or papillary cystadenoma lymphomatosum is the second most common benign tumor of the parotid gland. One universally held clinical characteristic of this tumor is its high male ratio. Because of a high frequency of female Warthin's tumor seen at Geisinger Medical Center, a review of all primary parotid gland tumors from 1971 to 1981 was carried out. Sixty-two cases out of 204 primary neoplasms were classified as Warthin's. There was no significant difference in the number of male and female cases with 32 males and 30 females. The clinical characteristics of Warthin's tumor and this unusually high female occurrence are discussed. PMID- 6865626 TI - Diagnosis and cure of venous hum tinnitus. AB - Sounds arising from abnormalities of or abnormal communications between blood vessels in the neck or cranial cavity may result in objective tinnitus. It is audible to patient and examiner alike. Contrary to the usual subjective tinnitus of non-vascular origin, it is low pitched and pulsatile in character. That tinnitus which arises from and within the internal jugular vein is particularly important, as it may be loud enough to interfere with sleep, and result in some loss of hearing. Diagnosis is important as it can be cured by simple ligation of the internal jugular vein. Such a case is reported. PMID- 6865627 TI - Reliability and validity of industrial audiometry: implications for hearing conservation program design. AB - Hearing conservation in industry relies heavily on monitoring audiometry to detect early noise-induced hearing loss in workers who are exposed to potentially damaging noise, with or without hearing protectors. The "real-world" reliability and validity of these measurements, as well as otoscopic observations in industry, have not been extensively investigated. In addition, there is considerable controversy over the selection of a definition of "significant threshold shift" in industrial audiometry. These and related issues were considered in a series of three studies utilizing data from an active hearing conservation program. Test-retest variability in industry is much higher than has been reported for clinical settings; this variability is reduced by pure-tone averaging. Workers referred for otologic evaluation were found to have hearing levels which were, on the average, about 5 dB better than indicated by plant audiometry, even without excluding 4% of referred workers who had unilateral deafness and showed "shadow curves" on the plant audiograms. Otoscopic data obtained by the plant audiometrists were uncorrelated with the results of otoscopy by consultant otologists. Techniques borrowed from decision theory and signal detection theory were used to evaluate possible criteria for significant threshold shift. Criteria based on pure-tone averaging were superior to those based on a certain amount of threshold shift for any frequency tested. It is proposed that a significant threshold shift be defined as a 10 dB or greater change for the worse for either the 0.5, 1, 2 kHz pure-tone average or the 3, 4, 6 kHz pure-tone average, in either ear, and that such shifts be validated by prompt retesting. Even with this criterion, a substantial number of shifts (most shifts, in some situations) will be either spurious or attributable to disorders other than noise-induced hearing loss, such as presbycusis. Otologic referral in cases of large or repeated shifts may prevent unjustified administrative actions, to the advantage of both workers and management. A practical consequence of the use of monitoring audiometry may be a de facto lowering of the permissible exposure level to 85 dBA TWA. PMID- 6865628 TI - Complications of pectoralis myocutaneous flaps. AB - The myocutaneous pectoralis major flap has recently caught the attention of head and neck surgeons. Over the last 12 months, our service has used this flap in 14 patients. Reconstruction in the oral cavity and larynx as well as closure of large areas of skin necrosis of the neck have been the indications. Our complications occurred in 4 of the 14 patients and included neck abscess and fistula, flap necrosis, and chest wall hematoma or abscess. The flap is an eminently useful and successful flap when designed and performed as indicated in the body of the paper. PMID- 6865629 TI - Bacteriological study in chronic maxillary sinusitis. AB - The bacterial findings of 73 maxillary sinuses in 48 patients with chronic maxillary sinusitis, together with 7 non-inflamed sinuses, are reported. Employing an intraoperative technique and simultaneous collection of 3 different types of specimens in the present investigation made possible comparison of their bacterial characteristics. The results indicated that intraoperative culture of antral mucosa seems to provide the most reliable finding of bacterial flora in chronic maxillary sinusitis. The anaerobic bacteria were never found in the mucosal culture of non-inflamed sinus. The anaerobes appeared to invade the sinus cavity following the sealing of the ostium through the lymphatic or venous system and maintain the inflammatory process. Microbiological analysis of the results between the infected and non-inflamed sinuses established anaerobic bacteria as the most important pathogen in chronic maxillary sinusitis. The predominant anaerobes recovered in descending order of frequency were Veillonella sp., Peptococcus sp., Propionibacterium acne and anaerobic nonspore-forming GPB. Statistical analysis of the results of mucosal culture of inflamed and control materials demonstrated that those aerobic and faculatative bacteria recovered in the inflamed sinus appeared to be the normal inhabitants of non-inflamed sinus mucosa. The presence of normal flora in the normal healthy sinus mucosa may explain the chain of events that follows the occlusion of the ostium. These aerobic bacteria may become pathogenic and play a role in the pathogenesis of sinusitis. PMID- 6865630 TI - Benign lipoblastoma in the neck causing respiratory insufficiency. PMID- 6865631 TI - Angioleiomyoma of the larynx. Report of a case and review of the literature. AB - A rare case of angioleiomyoma in a 76-year-old man is presented. The main symptoms were hoarseness and dyspnea. The tumor originated in the subglottic surface of the right vocal cord and there was only 3 mm of the laryngeal inlet free of the tumor. Histopathologically it was well circumscribed and composed of proliferating smooth muscle fibers and dilated blood vessels. The tumor was partially removed endoscopically, and subsequent cryotherapy was instituted. After two courses of cryotherapy the tumor had completely disappeared. Laryngeal function was restored to normal, and no signs of recurrence were observed after follow-up of 8 months. PMID- 6865632 TI - Use of injectable collagen for cosmetic lines of the face: preliminary report. PMID- 6865633 TI - Laryngectomee nose-blowing. PMID- 6865634 TI - Meatoplasty using inferiorly based island pedicle flap for congenital aural atresia. PMID- 6865635 TI - A technique for placement of the PORP prosthesis. PMID- 6865636 TI - Endoscopic laser arytenoidectomy. AB - Most patients with bilateral vocal cord paralysis have a fairly satisfactory voice, but their airway is usually inadequate for day-to-day exertion. In some patients, the airway may be inadequate for even quiet respiration and an indwelling tracheotomy is required. Solution to this problem has involved the following techniques: tracheotomy, lateralization of the vocal cord by either endoscopic or external routes, or vocal cord reinnervation by the nerve-muscle transposition technique. Endoscopic laser arytenoidectomy has been mentioned in the literature. However, the actual technique as well as the attendant morbidity associated with this procedure has not been highlighted. Four patients with bilateral vocal cord paralysis of the larynx have been treated by endoscopic laser arytenoidectomy at Northwestern University Medical School. The technique, problems, and results are discussed. PMID- 6865637 TI - The power density of a surgical laser beam: its meaning and measurement. AB - This paper discusses the fundamental concepts of matter, energy, power, and power density, with specific emphasis on the power density of a laser. It points out that a laser beam does not have a single, unique value of diameter within which all of its radiation is confined. Therefore, a computation of power density requires both a value of diameter, and the value of the fraction of total power which is transmitted within that diameter. Some possible means of measuring diameter, power, and power density are presented. PMID- 6865638 TI - Research and development of additional aids for dermatologic and plastic surgery. AB - Increasing numbers of accessories continue to be found to make laser surgery more effective for dermatologic and plastic surgery. Argon laser surgery aids are available to increase the dilatation of the superficial vessels and to localize increasing numbers of red cell masses. Laser probes for intravascular thrombogenesis and thrombolysis have now been adapted for intradermal and deep dermal tissues and for cardiology. Studies on laser effects on platelets and heat transmission and thromboembolic phenomena are lacking. Investigative studies are developing for laser fiber optic probes for laser-induced fluorescence, not only for oncology, but also for studies of metabolism of tissues and also for spectroscopy. The use of different wavelengths and shorter pulses, more flexible fiber-optics transmission for all laser systems, combinations of laser systems into a single operating probe, as well as the increased use of lasers for diagnosis and treatment will all stimulate the development of new aids for laser surgery. Cooperative programs developed jointly by dermatologic and plastic surgeons will make for great progress in skin and soft-tissue laser surgery. PMID- 6865639 TI - Analysis of complications of argon laser treatment for port wine hemangiomas with reference to striped technique. AB - Argon laser treatment of port wine hemangiomas has evolved greatly in technique. Since 1979, we have treated 150 patients with the "zebra strike" technique in order to enhance fading and lessen the incidence of complications or side effects. Eighty-one such patients are studied in depth with at least an 18-month follow-up on all patients. The "zebra stripe" technique is described in detail. Analysis of fading shows a 64% excellent or good result in all patients and analysis of sponginess shows that a marked reduction of sponginess is possible by the laser. Side effects and complications including hypopigmentation, texture change, and indentation are discussed in detail. Analysis of scarring shows an overall scar rate of 15% with a general scar rate of 7.4% if you exclude the lip and nasolabial area. Residual striping was present to a slight degree in 34% of the patients and to a major degree in 7% of the patients. All factors are discussed as far as age, complexion, sex, color or port wine stain and related to stripe technique. PMID- 6865641 TI - Effect of blood high density lipoprotein cholesterol concentration on fecal steroid excretion in humans. AB - Daily excretion of fecal total bile acids and neutral steroids were compared in five controls and two patients with extremely low concentrations of plasma high density lipoprotein (3 to 11 mg/dl) and severe atherosclerosis. There was no significant difference in steroid excretion rates in the groups. The predominant bile acid excreted in control feces was deoxycholic acid; lithocholic acid was predominant in the patients. The patients showed no signs of significant liver disease. PMID- 6865640 TI - Laser oncology in Italy: experimental research and clinical applications at the National Cancer Institute, Milan. AB - CO2, Nd:YAG, and argon lasers have been used for 5 years for experimental and clinical procedures at the National Cancer Institute of Milan under the auspices of the National Research Council. Experimental data regarding tumor cell spread through lymphatic and hematic channels and cell viability in the fumes after CO2 laser irradiation are reported. New advantages in the combined treatment modalities have been demonstrated, since the synergism between the low power argon laser beam and chemotherapeutic agents (anthracyclines) was assessed on cell cultures and the least toxic and the most effective doses of the drugs were identified. Due to the optical properties of the laser beam, physical measurements of the delivered energy and mathematical calculation of the energy per tissue volume unit to be ablated increase the precision in microsurgery especially when conservative managements are indicated. Main applications in surgical oncology, and comparison versus conventional methods, both with vaporization and excisional techniques, according to specific therapeutic protocols, in general surgery, otolaryngology, gynecology, and endoscopy, even on an outpatient basis, are finally illustrated in a series of 600 cases. PMID- 6865642 TI - Activities of five antidepressants in a behavioral pain test in rats. AB - Various clinical and experimental reports indicate that antidepressant drugs can have analgesic properties. The authors tested successively the anti-nociceptive activity of desipramine, clomipramine, maprotiline, viloxazine and nomifensine on the acute experimental pain model designed by Charpentier. At 25 mg/kg, desipramine showed a marked antalgic action. Clomipramine and maprotiline had a similar though much weaker action. On the other hand, nomifensine and viloxazine did not reduce pain perception; their effects on the parameters studied were variable. The usefulness of the test itself is discussed and suggestions are made regarding the relations between the analgesic potency of the drugs and the main neurotransmitter system they are assumed to act on. PMID- 6865643 TI - Metabolism of zinc and copper in the neonate: zinc thionein in developing rat brain, heart, lung, spleen, and thymus. AB - In a continuing study of the importance of metallothionein (MT) in the growth and development of neonates, zinc and copper metabolism in rat brain, heart, lung, spleen, and thymus has been analyzed in 5, 10, 15, 20, and 25 day old rats. Total, cytosol, and MT zinc and copper concentrations and organ contents were determined. Zinc, but very little, if any copper was associated with MT in these organs. Concentrations ranged from 0.03 to 3.3 micrograms Zn in MT/g; organ contents ranged from 0.003 to 2.2 micrograms Zn in MT/organ. Brain exhibited the highest concentrations and contents of zinc in MT, approaching the levels found in kidneys. Rank order of organ contents of zinc in MT was brain greater than lung greater than heart, spleen, thymus, during this neonatal growth period. When organ growth was rapid, a large percentage (20-95%) of the cytosolic zinc present in these organs was associated with MT, as has been previously observed with liver, kidneys, and testes. None of these organs undergoes the dramatic changes in zinc and copper metabolism previously observed in neonatal rat liver and gastrointestinal tract, and in maturing testes. They are more comparable to kidneys in their concentrations of zinc in MT. Like testes, little copper is found in these organs. PMID- 6865644 TI - Ethynylestradiol-17 beta D-ring glucuronide conjugates are potent cholestatic agents in the rat. AB - 17 alpha-Ethynylestradiol-17 beta (beta-D-glucuronide) [EE217 beta (beta G)], a metabolite of 17 alpha-ethynylestradiol (EE2) identified in urine of women taking EE2 in oral contraceptives, and its synthetic anomer, 17 alpha-ethynylestradiol 17 beta (alpha-D-glucuronide), [EE217 beta (alpha G)], were administered intravenously to female rats in order to determine their effects on bile flow. Both agents induced an immediate, profound and dose-dependent decrease in bile flow which returned to control levels within 1-8 hr. The logarithm of the dose vs the cholestatic response curves for the two anomers were not parallel. EE217 beta (alpha G) was significantly more potent than EE217 beta (beta G) such that the doses inhibiting bile flow by 50% were 1.25 and 11 mumol/kg for the alpha-and beta-anomer respectively. PMID- 6865645 TI - Alpha-chloralose suppression of neuronal activity. AB - Alpha-chloralose, an anesthetic agent widely used in neurophysiologic studies, caused a significant and long-lasting suppression of single neuron activity recorded from two areas of the central nervous system in decerebrate cats. A 50 mg/kg dose (an average anesthetic dose used in many neurophysiologic studies) caused suppression of spontaneous and evoked activity of neurons in the dorsal horn of the spinal cord and greater suppression of neurons in the nucleus reticularis gigantocellularis (NRGC) of the medial medullary reticular formation. Many researchers are of the opinion that alpha-chloralose causes less suppression of the central nervous system (CNS) than other commonly used anesthetic agents. The neuronal suppression recorded in this study appears similar in many ways to suppression caused by other anesthetic agents in the same two areas of the CNS. The results of the present study suggest that alpha-chloralose may be capable of producing significant suppression of neurons in the dorsal horn of the spinal cord and NRGC. Its ability to influence other areas of the CNS should not be inferred from these results, but the data do indicate the importance of evaluating the effects of anesthetics upon neurophysiologic systems under study. PMID- 6865646 TI - Prevention of lithocholate--induced cholestasis by cycloheximide, an inhibitor of protein synthesis. AB - Our previous investigations have shown that lithocholic acid (LCA)-induced cholestasis is associated with an increased synthesis of microsomal cholesterol which is transported with LCA and incorporated in the bile canalicular membrane. As the significance of these changes remains unknown the effect of interference with microsomal protein synthesis and/or with the cellular transport of cholesterol was studied. Male Wistar rats were injected i.p. with cycloheximide at the dose of 15 micrograms/100 g BW 3 times over a 24-hour period. After cannulating the common bile duct and collecting bile for one hour, the animals were either injected i.v. with 12 mumoles C14-LCA/100 g BW or with a 7.5% albumin solution and bile was collected for another hour. LCA injection in untreated animals reduced bile flow by more than 90% of control values. In contrast, bile flow in the group treated with cycloheximide and LCA was normal and did not differ from that of animals given cycloheximide alone. Bile salt secretion rate was increased in the cycloheximide-LCA group over the control groups. This was mainly due to the secretion of more than 80% of the injected LCA and was confirmed by the distribution of the radioactivity. By electron microscopy, the liver in the cycloheximide-LCA group did not show any of the well defined changes associated with LCA-induced cholestasis. These data suggest that microsomes play an important role in the pathogenesis of LCA cholestasis and that inhibition of microsomal protein synthesis can prevent its development. PMID- 6865647 TI - Yohimbine induced anxiety and increased noradrenergic function in humans: effects of diazepam and clonidine. AB - Yohimbine (30 mg) produced significant increases in subjective anxiety, autonomic symptoms, blood pressure, and plasma 3-methoxy-4-hydroxy-phenylethyleneglycol (MHPG) in ten healthy subjects. The effects of pretreatment with diazepam (10 mg) or clonidine (5 micrograms/kg) on these yohimbine induced changes was examined. Both diazepam and clonidine significantly antagonized yohimbine-induced anxiety, but only clonidine significantly attenuated the yohimbine induced increases in plasma MHPG, blood pressure, and autonomic symptoms. When given alone, clonidine significantly decreased plasma MHPG and blood pressure, whereas diazepam did not. These findings indicate that: (1) noradrenergic hyperactivity may be a factor in the production of some anxiety states; (2) the anti-anxiety effects of clonidine appear to result from its actions on receptors which decrease noradrenergic activity; (3) diazepam reverses yohimbine-induced anxiety without effects on several physiological or biochemical indicators of noradrenergic activity in humans. PMID- 6865648 TI - Prolonged intermittent footshock stress decreases Met and Leu enkephalin levels in brain with concomitant decreases in pain threshold. AB - The influence of a 21 day intermittent footshock regimen upon enkephalin levels in brain and adrenals was examined in the rat. Changes in pain sensitivity as well as analgesic and hyperthermic responsiveness to morphine (7.5 mg/kg) were also monitored. Following the stress regimen, Met and Leu enkephalin levels were decreased by 40 to 50% in brain, but were unchanged in adrenals. Post-stress pain thresholds were markedly decreased in stressed animals while the analgesic properties of morphine were enhanced. Core body temperature of stressed animals was significantly raised, but the hyperthermic response to morphine was unchanged. PMID- 6865649 TI - Cycloamylose complexation of adamantane derivatives. AB - Spectrophotometric and pH potentiometric studies indicate that cyclohexaamylose (alpha-cyclodextrin) and cycloheptaamylose (beta-cyclodextrin) form aqueous complexes with all adamantane derivatives examined to date. Thermodynamic complex formation constants are reported for the substrates 1-adamantaneamine (amantadine), 1-adamantaneammonium ion, 1-adamantanemethylamine, 1-adamantane methylammonium ion, 1-adamantanecarboxylic acid, 1-adamantane-carboxylate ion, 1 adamantaneacetic acid and 1-adamantaneacetate ion. The existence of these complexes implies that cycloamylose might serve as a therapeutic sequestering agent for adamantane derivatives. PMID- 6865650 TI - An artifactual component of drug-protein binding generated in vitro. AB - In the course of investigating the binding of imipramine to soluble cellular fractions from brain and leukocytes using equilibrium dialysis, an artifactual binding component was produced. On Scatchard and double-reciprocal plots of the data, the component appeared as a homogenous population of sites displaying a binding affinity of 170 nM. The obtained pattern of biphasic interaction bore a marked resemblance to reported Scatchard plots representing the interaction of drugs with bovine serum albumin, and depicting two components of widely differing binding affinity and capacity. The artifact occurred when solutions were transferred after dialysis and before quantitation to intermediate containers, and resulted from binding of 3H-imipramine to the walls of these containers. The latter interaction decreased the concentration of radiolabeled drug in the dialysate but not in the dialyzed solution, and thus mimicked increased imipramine binding to the biological material under study. The effect was particularly pronounced at low drug concentrations, and was particularly pronounced at low drug concentrations, and was prevented by the presence of either proteinaceous material, or of an excess of another basic compound such as methadone. The concentration dependence of the phenomenon led to its appearance as a discrete binding component. The artifact was eliminated either by applying an appropriate correction factor, or by transferring the dialyzed solutions directly into scintillation vials for counting. PMID- 6865651 TI - Effects of a high-fat diet on energy intake and expenditure in rats. AB - The effects of a high-fat diet supplying a constant energy/protein ratio, with and without overeating, on energy intake and expenditure was studied in mature male rats. A control group (LF) received ad libitum access to a low-fat diet. Body weight gain, efficiency of food utilization, and dietary-induced thermogenesis were increased relative to controls in a group with ad libitum access to the high-fat diet (HF-A), but not in a group which was pair fed the diet (HF-P) in amounts (kcal) equal to that of LF animals. However, the individual variability within the HF-A group was high for each measure. An arbitrary separation of that group into 2 subgroups (based on high vs low weight gain) produced one subgroup with increased efficiency, greater weight gain and no change in dietary-induced thermogenesis (HF-AH), and another with no difference in efficiency or in weight gain from the LF group but which had higher dietary induced thermogenesis (HF-AL). Food intake was slightly, but not significantly, greater for the HF-AH subgroup than for the HF-AL subgroup. We conclude that rats can increase thermogenesis in response to overeating but that the increase is highly variable. The thermogenic response appears to be related to the overeating rather than to the fat content of the diet. PMID- 6865652 TI - Kinetic analysis of anaerobic metabolism in rats during acute cyanide poisoning. AB - In order to investigate the changes in energy metabolism during acute anoxia, blood levels of various metabolites were analysed in cyanide-poisoned rats. After intraperitoneal injection of a sublethal dose of potassium cyanide (5 mg/kg), blood samples were obtained by cervical dislocation at intervals of 5 min until 30 min. Lactate and lactate/pyruvate ratio (L/P) in plasma concomitantly changed with cyanide; increased rapidly at 5 min, remained fairly constant until 20 min and then began to decrease at 25 min. In contrast, the products of ATP degradation, oxypurines and inorganic phosphate (Pi), increased gradually until 25 min and then began to decrease at 30 min. Allantoin in plasma scarcely increased throughout the experiments. The results indicate that the rapid activation of anaerobic ATP formation by glycolysis was followed by the increase in ATP degradation in cyanide-poisoned rats, Thus, increase in plasma oxypurines could be regarded as an indicator for severe anoxic states in tissues with massive ATP degradation. PMID- 6865653 TI - Lithium attenuates dopamine depleting effects of reserpine and tetrabenazine but not that of alpha methyl-p-tyrosine. AB - Concurrent administration of lithium (Li) significantly attenuates the dopamine (DA) depleting effects of reserpine and tetrabenazine, but does not change alpha methyl-p-tyrosine (AMPT) induced DA depletion in rat brain. This effect of Li is probably mediated, in part, by inhibiting the magnesium-dependent binding of both reserpine and tetrabenazine to their specific receptor sites. Such interaction between these drugs may attenuate the beneficial effects of tetrabenazine and reserpine on patients with tardive dyskinesia or tardive dystonia who are treated concurrently with lithium for their psychiatric disorder. PMID- 6865654 TI - Lateralization of spatial preference in the female rat. AB - Female rat pups were either left undisturbed in infancy and raised in lab cages or were handled in infancy and raised in enriched environments. In adulthood, animals underwent brain surgery consisting of: 1) a right neocortical ablation, 2) a left neocortical ablation, 3) a sham operation, or 4) no surgery. After recovering, they were tested for the initial direction of movement (left or right) in the open field. Nonhandled intact females were biased to move leftward indicating an asymmetrical brain organization. The intact handled-enriched group was unbiased. The right and left lesions caused the animals to move ipsilateral to the lesion, but there was no difference in the magnitude or response in either early experience group. Thus, early experience in the female rat has a different effect then in the male, and the nature of the brain organization in the two sexes is markedly different. PMID- 6865656 TI - Inhibitory effect of a new opioid agonist on reproductive endocrine activity in rats of both sexes. AB - Morphine and other opioid compounds such as the new benzomorphan derivative, bremazocine, inhibit the secretion of luteinizing hormone in rats of both sexes (1, 2, 3, 4). The aim of our work was to compare in rats the LH-secretion inhibiting properties of bremazocine, a putative opiate kappa agonist (5), with those of the mu agonist morphine. Acute administration of bremazocine (0.005 - 1 mg/kg s.c.) or of morphine (10 - 20 mg/kg s.c.) diminished serum LH levels and spontaneous ovulation in female rats in a dose-dependent manner. Chronic treatment with bremazocine significantly diminished LH and testosterone secretions in male rats which in turn led to a fall in weight of the prostate gland; prolactin and FSH secretions were not influenced significantly. The mu antagonist naloxone, which increases LH release in rats, in acute experiments significantly antagonized the inhibiting effect of morphine, but not that of bremazocine on LH secretion. Neither the basal nor the LHRH-stimulated secretion of LH in pituitary cell cultures were changed by bremazocine (10(-11) to 10(-5) M), however the release of LHRH-like activity from hypothalamic fragments was significantly impaired by 10(-7) M bremazocine. In conclusion, the data presented here show that bremazocine is a new non-morphine-like opioid agonist which selectively inhibits LH release in rats. PMID- 6865655 TI - In vivo acetylcholine turnover in rat heart. AB - The in vivo uptake of choline (Ch) and synthesis of acetylcholine (ACh) in rat heart were studied using a pyrolysis mass fragmentography (PMF) method. Deuterium labeled Ch was pulse injected (i.v.) into anesthetized rats. Labeled and unlabeled Ch and ACh were measured by PMF in hearts at various times following injection. From these data we calculated the specific activities of Ch and ACh, rate constants for ACh and turnover rates of ACh. After an initial equilibration period of approximately 2 min, the specific activities of Ch and ACh decayed in a parallel manner with half-times of 28.2 and 28.8 min respectively. Between 2 and 60 min the calculated ACh turnover rate was 0.144 nmol/g/min. Unlike brain Ch, heart Ch levels are very stable with time following sacrifice. No advantage was found in using microwave irradiation to stabilize heart ACh and Ch content. PMID- 6865657 TI - Impaired lymphocyte function in depressive illness. AB - Mood states and immunity may be related. To investigate the immune status of patients with primary depressive illness, we compared in-vitro lymphocytic responses to three different mitogens in 26 drug-free depressed patients and 20 normal controls of comparable age and sex. We observed a generalized and marked decrease in the lymphocyte mitogenic activity among the depressive group. This defect in lymphocyte function may be indicative of an impairment in cell-mediated immunity in patients with primary depressive illness. PMID- 6865658 TI - Induction of lauric acid hydroxylation and maintenance of cytochrome P-450 content by clofibrate in primary cultures of rat hepatocytes. AB - The hypolipidemic agent clofibrate at a concentration of 0.5 mM in the culture medium maintained the cytochrome P-450 content of rat hepatocytes for up to 96 hr. This effect was associated with a marked induction of lauric acid hydroxylation whereas little effect was observed on the metabolism of three other cytochrome P-450 dependent mixed function oxidase substrates. The results suggest that clofibrate induces similar form(s) of cytochrome P-450 in cell culture to those observed in vivo and that primary cultures of rat hepatocytes may be useful for studies on both the peroxisomal and microsomal effects of hypolipidemic agents. PMID- 6865660 TI - Receptor-like stereospecific binding of a pyrethroid insecticide to mouse brain membranes. AB - A heterogeneous particulate fraction of mouse brain homogenates binds NRDC 157 (3 phenoxybenzyl [1R, cis]-3-(2,2-dibromovinyl)-2,2 dimethylcyclopropanecarboxylate), a potent pyrethroid insecticide, stereospecifically and with high affinity. Stereospecific binding is a minor component of total binding (2.8%); the remainder of observed binding is predominantly nonspecific and unsaturable. Stereospecific binding is half saturated at 4 X 10(-8)M and fully saturated at concentrations in excess of 1 X 10(-7)M. The stereospecific binding capacity of this preparation was 200-250 pmoles of NRDC 157 per gram equivalent of brain tissue (2.3-2.8 pmol/mg protein). This binding site may represent the neural receptor involved in the stereospecific toxic action of pyrethroids. PMID- 6865659 TI - Enhanced natriuretic effect of ADH in rats loaded with NaCl. AB - ADH at doses 20 microU/100 g and 100 microU/100 g or 20 microU/100 g and 200 microU/100 g was injected intravenously into pentobarbital and alcohol anaesthetized rats loaded with either water or isotonic solution consisting of NaCl, glucose and ethanol. At the dose of 20 microU/100 g ADH retained water in both water and NaCl loaded animals. At high doses 100 microU/100 g in NaCl loaded rats and 200 microU/100 g in water loaded rats, ADH retained water and increased the renal excretion of Na+. That the natriuretic effect of ADH at the dose 20 microU/100 g was enhanced in NaCl loaded rats suggests that ADH is probably important in the regulation of Na+ content in the body when it is loaded with NaCl. PMID- 6865661 TI - Mesencephalic dopamine modulation of pituitary and central beta-endorphin: relation to food intake regulation. AB - Pituitary and central beta-endorphin have been implicated in the regulation of food intake. It has been suggested that an elevation in hypophyseal beta endorphin represents the genetic defect in the obese mutant Zucker rat. Both pituitary and central beta-endorphin systems appear to interact with dopamine. We have therefore examined hypophyseal, hypothalamic, and basal forebrain levels of beta-endorphin in the obese Zucker rat, its lean littermate, and lean littermates sustaining neurotoxic lesions of the A10 dopamine cell group in the ventral mesencephalon. The obese mutant exhibits elevated pituitary, but not central, beta-endorphin levels relative to lean littermates. A10 lesions result in a marked increase in both pituitary and hypothalamic beta-endorphin levels, and tend to decrease the amount of the peptide in the basal forebrain. These lesions do not result in either increased food intake or body weight. These data therefore suggest that elevated pituitary beta-endorphin levels do not mediate obesity in the Zucker rat, and also demonstrate that both central and pituitary beta-endorphin are modulated by a dopamine system originating in the ventral mesencephalon. PMID- 6865662 TI - The effect of vitamin C on in vivo lipid peroxidation in guinea pigs as measured by pentane and ethane production. AB - Measurements of pentane and ethane as indices of in vivo lipid peroxidation were made on samples of breath from vitamin C-sufficient and vitamin C-deficient guinea pigs injected with 23 microliters carbon tetrachloride (CCl4)/100 g body wt. Vitamin C-deficient animals produced significantly more pentane and ethane after CCl4 treatment than did vitamin C-sufficient guinea pigs. Pretreatment of vitamin C-deficient animals with 75 mg ascorbic acid/100 g body wt significantly lowered both pentane and ethane evolution. Protection against in vivo lipid peroxidation similar to that provided by ascorbic acid was also found when vitamin C-deficient guinea pigs were pretreated with isoascorbic acid, reduced glutathione, alpha-tocopherol or beta-carotene. When animals were pretreated with the radical scavenger mannitol, a protective effect was also observed as measured by pentane evolution. PMID- 6865665 TI - Toxicology of brominated fatty acids: metabolite concentration and heart and liver changes. AB - Rats were fed for 35 days diets containing 2% of either brominated corn oil (BCO), monoglyceride of dibromostearate (DBS), monoglyceride of tetrabromostearate (TBS) or a mixture of the two monoglycerides (BMG) which provided proportions of brominated acids comparable to that of the BCO. Hearts from all animals fed BCO were yellow colored and firm in texture. Myocardial cellular degeneration, mild to moderate edema and occasional small necrotic foci were observed. Hearts from animals fed DBS showed moderate edema and some slight necrosis. All diets produced an increase in lipid content of heart. Animals fed the experimental diets developed enlarged livers and showed elevated liver lipid content. The tetrabromostearate appeared to be the more active in producing these changes, in particular a severe intracellular fatty degeneration. Shorter-chain (C-16, C-14) metabolites of di- and tetrabromostearate were identified and the concentration of brominated fatty acids in heart, liver and adipose tissue determined and found to account for 80% of the bromine detected in these tissues by neutron activation analysis. TBS accumulated in liver while the highest concentration of DBS was observed in heart lipids. Although the concentrations of brominated acids in heart and liver lipids were comparable in rats fed BCO or BMG, BCO produced the more pronounced effects. This differential could be due to additional active components in BCO or to a variation in response associated with changes in the location of the fatty acid on the glycerol molecule. PMID- 6865663 TI - Increases in hyperlipoproteinemia, disturbances in cholesterol metabolism and atherosclerosis induced by dietary restriction in rabbits fed a cholesterol-rich diet. AB - The influence of dietary restriction on cholesterol transport and metabolism was investigated in rabbits given standard or cholesterol-rich diets (0.2 g cholesterol/kg body weight daily) either ad libitum or with 50% caloric ration. Dietary restriction which has only a slight influence in control rabbits markedly aggravated the disturbances induced by exogenous cholesterol. With limited feeding, control rabbits presented a moderate increase in plasma cholesterol, whereas marked aggravation of hypercholesterolemia was observed in cholesterol fed rabbits. Analysis of the lipoprotein profile showed that the excess of plasma cholesterol with the restricted cholesterol-rich diet corresponded to an increase in the concentration of very low density lipoprotein (VLDL) and low density lipoproteins (LDL) without any additional changes in the composition of these lipoproteins. No significant change appeared in the high density lipoprotein (HDL) concentration. The parameters of cholesterol metabolism were determined, from the curves of [3H]cholesterol radioactivity decrease, using a two-pool model. The increase in cholesterol turnover rate induced by the cholesterol-rich diet was accentuated by dietary restriction, whereas rabbits on standard restricted diet showed a slight decrease. The large increase in the size of both pools A and B in cholesterol-fed rabbits was even more pronounced with limited feeding. Dietary restriction induced additional accumulation of cholesterol in the aortic wall and the grade of the lesions was also aggravated. PMID- 6865664 TI - Bromine levels in tissue lipids of rats fed brominated fatty acids. AB - Rats have been fed diets containing either 0.8% brominated corn oil or 0.5% of the ethyl ester of 9,10-dibromostearate or 9,10,12,13-tetrabromostearate. The brominated compounds were incorporated into semisynthetic diets and animals were observed after feeding periods of 5 days to 3 months. With the exception of adipose tissues, the highest concentration of lipid-bound bromine was observed after 5 days on the experimental diets. It was also observed that feeding of the dibromostearate resulted in the highest levels of lipid-bound bromine in heart, whereas the tetrabromostearate tended to result in higher levels of lipid-bound bromine in liver. Brominated corn oil produced more substantial changes than the brominated fatty acid esters, inducing fatty livers and enlarged yellow hearts. Microscopic examination indicated myocardial degeneration and occasional early necrosis. PMID- 6865666 TI - Altered microsomal phospholipid composition in the streptozotocin diabetic rat. AB - Streptozotocin diabetes in the rat alters liver microsomal membrane fatty acid composition. The present study was undertaken to determine if such changes in fatty acid composition were due to changes in the amount of individual phosphoglycerides or to disproportionate changes in fatty acid composition in any of the individual phosphoglycerides. The diabetic animals showed a small increase in total microsomal phospholipid, which is due to a selective increase in the phosphatidylethanolamine fraction. The changes in fatty acid composition in the total lipid extract (decreased palmitoleic, oleic and arachidonic acids and increased linoleic and docosahexaenoic acids) from the diabetic animals were present in both the major phosphoglycerides, phosphatidylcholine and phosphatidylethanolamine, with very little change in fatty acid composition in the phosphatidylserine and inositol fraction. Further studies are necessary to delineate the cause of the abnormal membrane phospholipid composition in the diabetic animal. PMID- 6865667 TI - Uniform requirements for manuscripts submitted to biomedical journals. International Committee of Medical Journal Editors. PMID- 6865668 TI - Effect of chemical preservation of urine on routine urinalysis and non-culture tests for bacteriuria. PMID- 6865669 TI - Production of PNH-like red cells using 2-mercaptobenzoic acid. PMID- 6865670 TI - Hepatitis B surface antigen testing of blood donors: an evaluation of the BPL bead radioimmunoassay. PMID- 6865671 TI - The status of the Mccoy/Knops antigens. PMID- 6865672 TI - A simple method for Ch and Rg testing. PMID- 6865673 TI - A shielded, sterile apparatus for iodinating proteins. PMID- 6865674 TI - Erroneous platelet counts on the Coulter Model S Plus counter after correction for hyperlipaemia. PMID- 6865675 TI - Automated blood grouping in a hospital laboratory with the Minigroupamatic. PMID- 6865676 TI - A solid-phase radioimmunoassay for detection of tetanus antibodies. PMID- 6865677 TI - A semi-automated washing and aspirating procedure for solid phase immunoassays. PMID- 6865678 TI - RIA for free thyroxine. PMID- 6865679 TI - Assay of vitamin B12. PMID- 6865680 TI - [Dosimetric control of the dose fields in the irradiation of oral cavity tumors]. AB - The authors have worked out a technique of control over depth dose fields of the maxillofacial area by placing detectors of a hermoluminescent dosimeter and an ionisation chamber on an individual protective cast in preset points. This simple device makes it possible to exercise an effective and multiple computerized control over the distribution of depth doses. PMID- 6865681 TI - [Prognostic significance of a morphological variant of lymphogranulomatosis in children]. AB - An analysis of the clinical data on 183 children who were treated for Hodgkin's disease, and and 7-year follow-up have shown that the determination of a morphological variant is an indispensable part of clinical diagnosis. However prognosis, long- and short-term results depend not on a morphological variant but on the degree of dissemination of a pathological process by the time of the initiation of treatment. PMID- 6865682 TI - [Method of gamma teletherapy in prostatic cancer]. AB - Three variants of gamma-beam therapy of prostatic cancer were worked out on the basis of a thorough topometric preparation, an analysis of dose distributions using computer, and taking account of tumor dissemination. It has been shown that moving one- or two-field gamma-beam therapy is indicated in cases when tumor lies within the limits of the prostate only. When it affects regional lymph nodes the combination of moving gamma-beam therapy with static 4-field cross irradiation with the ratio of doses from the front and back fields 2:1 is recommended. When tumor involves the nearest lymphatic collectors gamma-beam therapy is supplemented by estrogens with stage-by-stage irradiation of primary tumor, regional lymph nodes (by the above schemes) and the paraaortal group of lymph nodes from 2 opposite shaped fields, a focal dose to these nodes being 30-40 Gy only. The summary focal dose to the regional lymph nodes is 45-50 Gy, to primary tumor 65-70 Gy. The above variants of gamma-beam therapy were used for the treatment of 69 patients with prostatic cancer, Stages II-IV. Not a single patient developed marked reactions and late complications 6-36 mos. after therapy, 61% of the patients lived over 3 yrs. PMID- 6865683 TI - [Prospects for the technical equipping of medical radiology and the tasks of clinical dosimetry]. PMID- 6865684 TI - [X-ray evaluation of the results of combined radiation treatment of cancer of the corpus uteri]. AB - Histerography was performed to determine the effect of concomitant radiation therapy provided to 46 patients with corpus uteri cancer. Stages I-II. It should be noted that histerography combined with clinical and pathomorphological data makes it possible to control the time course of a neoplastic process in the uterine cavity following radiation exposure. Histerography performed 3-6 mos. after radiation therapy is an objective method for the evaluation of therapeutic results. PMID- 6865686 TI - [Pathogenesis of late radiation necrosis of the brain]. AB - The pathogenesis of late radiation necroses remains still unsolved in the problem of cerebral radiation injuries. The problem of primary site: vessels or medulla is a disputable one. In this case cerebral radiation nectosis developed in a 32 year-old woman 1.5 yrs. after the last course of radiotherapy for hypophyseal adenoma was over. The authors give an irradiation scheme and a detailed histological description of the foci of late radiation necrosis in the temporal lobe and in the substance of the Varolii pons which is not the zone of direct exposure. The histological picture described in the above foci is similar in many details to the process that takes place in experimental allergic encephalomyelites developing in sensitized animals. The time course of histological changes in the foci of radiation necroses shows that the process does not develop steeply but increases gradually affecting the adjoining zones of the medulla that cannot be accounted for by the direct involvement of the medullary tissue only during radiation. Thus it can be assumed that the process develops like an allergic reaction where the role of the allergen is played by the decomposition products of myelin that appear in the affected focus. PMID- 6865685 TI - [2-dimensional ultrasonic scanning for irradiation planning]. AB - The paper is concerned with the results of the utilization of echotomography in the topometric preparation of patients with malignant tumors for irradiation. Proceeding from the examination of 600 cancer patients in the All-Union Cancer Research Center. USSR AMS, it has been established that echotomography makes it possible not only to define the borders of pathology in the peritoneal cavity and retroperitoneal space but also to specify the relative position of the adjacent internal organs. Some practical aspects of the use of ultrasound for topometry are discussed. A possibility of using this method for the three-dimensional planning of irradiation is indicated. Using an echotomoscope one can obtain a contour of the section of a soft phantom with an accuracy of 5 +/- 1 mm that significantly exceeds the limits of precision of a contour measured with the help of a lead band where it equals 10 +/- 7 mm. Echotomography makes it possible to get a contour in any plane. In view of certain limitations of the echotomographic method one should also resort to x-ray methods for the topometric planning of irradiation to specify the position and size of the bearing osseous structures. While converting reduced ultrasound images in the scale of 1:1 the optic method with an episcope proved to be the most accurate one where an error of reproducibility of a contour reaches 1 mm. In the use of an optical-electronic device this value exceeds 10 mm and corresponds to 4 mm while utilizing a pantograph. PMID- 6865687 TI - [Effect of preoperative radiation therapy on intravascular blood coagulation in the combined treatment of kidney cancer patients]. AB - Hemostasis has been studied over time in 137 patients with renal cancer. Of these, 69 underwent surgery only, 68 received combined treatment with preoperative large fractionation radiotherapy. It has been established that renal cancer development in the body stimulates intravascular blood coagulation (IVBC). In the patients with renal cancer who were radiation treated, IVBC activation was more noticeable than in those who had surgery only. To prevent IVBC activation and the development of the DIVC-syndrome, it is proposed to prescribe deaggregates in the period of preoperative therapy and heparin in the postoperative period. PMID- 6865689 TI - [Brain hemodynamics in the late period of acute human radiation sickness (clinico electrophysiological study)]. AB - It has been shown that the most marked changes of hemodynamics are found in patients with acute radiation disease of severe and moderate forms. They manifest in an increased resilient-viscous state of small arterial vessels. It may result in a reduced intensity of the blood content of cerebral vessels causing changes in the nature of the cerebral bioelectrical activity. PMID- 6865688 TI - [Stomach motor evacuatory function in duodenal ulcer patients following selective proximal vagotomy]. AB - Motor-evacuatory stomach function by using continuous radiogastrography was studied in 89 patients with duodenal ulcers. Altogether 131 radiogastrograms were analyzed, of them 57 before operation, 84 on the 7th-15th day after selective proximal vagotomy performed either independently or in combination with draining operations. A faster evacuation of food from the stomach prevailed in an uncomplicated form of duodenal ulcer and compensated stenosis of the pyloroduodenal zone, evacuatory stomach function was retarded or absent in subcompensated and decompensated stenosis. Discoordinated gastric peristalsis and a reverse food input were noted in patients with subcompensated stenosis. At early time after operations temporary inhibition of evacuatory stomach function occurred in 94.2% of the patients; it could be corrected with conservative therapeutic measures. PMID- 6865690 TI - [Senear-Usher syndrome as a complication of radiotherapy of laryngeal cancer]. PMID- 6865693 TI - The value of forensic examination in child abuse and neglect. PMID- 6865692 TI - A casualty ward analysis of bus passenger accidents. PMID- 6865691 TI - [Radionuclide studies with a dynamic kidney phantom]. AB - Altogether 120 studies with a dynamic kidney phantom (DKP) were conducted permitting one to imitate the normal functioning of the kidneys or different pathological states of the organ. The studies were conducted with the help of a gamma-chamber of MV-9100 type using a computer system SEGAMS (Hungary) and a chronoscope RIKh-5M-01. On completion of the experiment the activity-time curves were plotted characterizing the time course of the passage of a radioactive tracer through phantom cylinders that imitate the kidneys. The results obtained have demonstrated DKP potentialities for the imitation of various renal functional states. Studies with a DKP make it possible to select an optimum regimen for research and to assess the quality of performance of nuclear medical diagnostic equipment. PMID- 6865694 TI - Sudden fatty liver death: a case report and overview. PMID- 6865695 TI - Acute myasthenia gravis--post-mortem diagnosis in the case of sudden death. PMID- 6865696 TI - Sudden death in an 11-year-old boy due to rupture of a colloid cyst of the third ventricle following 'disco-dancing'. PMID- 6865698 TI - A review of peptic ulceration in coroners' autopsies. PMID- 6865697 TI - Fire fatalities and deaths from burns in Denmark in 1980. PMID- 6865699 TI - Estimation of postmortem interval from rectal temperature by use of computer (IV) -thermal diffusivity of the rabbit. PMID- 6865700 TI - The decision process of the mental health review tribunal--I. Review of literature and research. PMID- 6865701 TI - Lung irritance and inflammation during and after exposures to thermal decomposition products from polymeric materials. PMID- 6865702 TI - The care of the psychiatric prisoner--discharge into the community and its implications. PMID- 6865703 TI - Pesticides. PMID- 6865704 TI - A case of fatal electrocution during an unusual autoerotic practice. PMID- 6865706 TI - 1983 American College of Sports Medicine annual meeting. May 18-21, 1983 Montreal, Quebec, Canada. Abstracts. PMID- 6865705 TI - Medical hazards of flying. PMID- 6865707 TI - [Evaluation of the health status of nomadic and semi-nomadic populations of the Gourma-Mali: epidemiologic approach. I. Introduction, material and methods]. AB - The authors set out the methodology and the practical way used in transverse epidemiological investigation with a descriptive aim which was made in natural area: Gourma-Mali. This part of the Sahel, hard to reach, is placed deep in the bend of the Niger river. The population is estimated at 100.000. The weather, ecological and human conditions have been unsettled by the drought. Sometimes, it was difficult to collect the data among the nomadic and seminomadic populations (Tamacheques, Peuls, Maures, Bellahs, Sonrais). This investigation shows well the practical problems that this kind of study sets out in difficult bioclimatological and ethnological conditions. PMID- 6865708 TI - [Leptospiroses in New Caledonia]. PMID- 6865709 TI - [Epidemic of Neisseria meningitidis cerebrospinal meningitis in the Ruhengeri health district (Rwanda)]. AB - Rwanda is a central african country where mean altitude is high (1,800 m), dwelling scattered, and population density important (372/km2). In 1978, a CSM epidemic broke out and raged for 4 years. Death incidence was very noticeable: 223/100 000. Treatment by an unique doses of chloramphenicol proved to be effective. As a consequence of an experimental immunization campaign, limited to one township, local population immunity is still solid after three years. PMID- 6865710 TI - [Diagnostic and therapeutic aspects of pneumococcal meningitis in Africa (apropos of 119 cases)]. AB - This study shows the extreme gravity of pneumococcal meningitis in Abidjan. The factors of bad prognosis are: male sex, coma, protein rate of the cerebral fluid equal to or higher than 3 g. Our statistical study shows evident superiority of cephacetrile to penicillin G and ampicillin. PMID- 6865712 TI - [Various sociocultural findings concerning sexual impotence in Senegal]. AB - This study emphasizes the role of the socio-cultural status and consequently of psychologic factors in sexual impotence of the black African in Senegal: --role of age, related to the perception of a dual status; --role of the ethnic group giving or not preeminence to sex; --rank in the brotherhood which may raise a conflict with ancestor; --matrimonial situation having significance of an acceptance of the cultural code about sex; --somatizations expressing the sexual potentialities; --non structured neurosis as expression of psychic and sexual inhibition; --religious behaviour with opportunities of conflicts with the religious authorities. PMID- 6865713 TI - [Pathomorphology of infections of the respiratory tract]. PMID- 6865711 TI - [Ricefield project in the Mbos plain (Cameroon). Potential change in health status]. PMID- 6865714 TI - [The divided pancreas--a cause of pancreatitis?]. PMID- 6865715 TI - [Ultrasound-directed fine-needle puncture as a complementary method in the diagnosis of pancreatic cancer]. PMID- 6865717 TI - [Rehabilitation methods in coronary heart disease. Diagnosis, indications and counterindications]. PMID- 6865716 TI - [Acinar cell tumor of the pancreas. A solid cystic benign neoplasm of young females]. PMID- 6865718 TI - [Value of physical therapy in coronary heart disease]. PMID- 6865719 TI - [Sociomedical aspects of rehabilitation and expert opinion]. PMID- 6865720 TI - [Surveillance and follow-up care of heart pacemaker patients]. PMID- 6865721 TI - [Current views of diagnosis and long-term therapy of heart insufficiency]. PMID- 6865722 TI - [Cough - a trivial matter?]. PMID- 6865723 TI - [Current status of puncture cytology in thyroid gland diagnosis]. PMID- 6865724 TI - [Sublingual nifedipine in the therapy of hypertensive crisis]. PMID- 6865725 TI - [Functional results of oral dusodril therapy of obliterating arteriopathy of the lower extremities. Comparison of the angiogram, plethysmogram and Doppler ultrasound]. PMID- 6865726 TI - [Sauerkraut or liberty cabbage? Native country and reality]. PMID- 6865727 TI - [Benign tumors of the heart. Clinical course and pathology of myxomas and rhabdomyomas of the heart]. PMID- 6865728 TI - [Roentgen anatomy and incidence of popliteal cysts in the double contrast arthrogram]. PMID- 6865729 TI - [Endoscopic findings in the operated stomach. Recurrent ulcer and cancer of the stump]. PMID- 6865730 TI - [Results of postoperative chemotherapy of squamous cell carcinoma of the lung]. PMID- 6865731 TI - [Mucinous cystadenoma of the ovary]. PMID- 6865732 TI - [Clitoridectomy and excision of the labia minora among the Kisii (Gusii) in western Kenya]. PMID- 6865733 TI - [Uvulectomy in Dar es Salaam (Tanzania)]. PMID- 6865734 TI - [Possible decrease of nonspecific immunity in wounds contaminated by copper ore minerals]. AB - Continuing the research--started in 1973--on the influence of wounds contamination by copper ore minerals upon the living organism the authors conducted experiments on 30 animals. The experiments covered: phagocytic and metabolic activity of peripheral blood phagocytes, oxidoreductase activity of granulocytes, lysosyme level in sera of the examined animals and total hemolytic activity of the complement. The experiments demonstrated--since the 20th day after their start--a considerable decrease in phagocytic and metabolic activity of peripheral blood granulocytes in the animals with wounds contaminated by copper ore minerals. Those disturbances may decrease nonspecific cellular immunity of the organism, which entails organism's susceptibility to infections. PMID- 6865736 TI - [Evaluation of the workload of weavers based on the analysis of cardiac function and changes in heart rate]. AB - The paper is aimed at an analysis of the dependences between occupational work performance and heart rate. The examinations covered weavers working on two different types of looms, using a telemetric measurement of pulse rate with a simultaneous precise analysis of the structure activities performed. The results indicated statistically significant differences in pulse rate mean values and in the duration of activities performance. It was also demonstrated that the structure of activities significantly affects the workload, as evidenced by the heart rate. PMID- 6865735 TI - Effect of inhalation exposure to cadmium oxide on arterial blood pressure, lipid metabolism and tissue cadmium concentration in rats. AB - The arterial blood pressure, lipid content in serum and some organs, cadmium level in blood, aorta wall, lung and liver have been examined in rats repeatedly exposed to cadmium oxide fume 5 hours daily, 5 days a week, during 6 months. The blood pressure in rats exposed to cadmium oxide at concentration 0.02 mg Cd/m3 and 0.16 mg Cd/m3 was not changed, but it was slightly lowered at concentration 1.0 mg Cd/m3, which has been found lethal for rats. The concentration of total cholesterol, phospholipids and cholesterol esters in serum of female rats exposed at concentration of 0.16 mg Cd/m3 for 3 months was decreased, but was not affected after 6 months of exposure. The content of cholesterol and triglycerides in aorta wall, heart and liver was unchanged, although the content of cholesterol was decreased in adrenals of rats exposed for 3 months at concentration of 0.16 mg Cd/m3. Inhalation of cadmium oxide brought about the marked increase of Cd content in lung and kidney of rats exposed at all concentrations an increase of Cd blood level in rats exposed at concentrations of 0.16 mg Cd/m3 and 1.0 mg Cd/m3 and no increase of Cd content in aorta wall. PMID- 6865738 TI - [Poisoning wit organic solvents based on data of the Clinic of the Institute of Occupational Medicine in Lodz 1971-1980]. AB - During 1971-1980, 128 patients were hospitalized at the Clinic of Occupational Diseases, Institute of Occupational Medicine, Lodz, for disease resulting from chronic exposure to organic solvents. The authors analyzed diseases syndromes, exposure duration prior to the disease occurrence, and professions and workplaces constituting sources of exposure to solvents. Most significant in occupational health were found to be: benzene and its homologues, chlorinated hydrocarbons and naphtha. However, exposure to solvents occurs not only in industry but also in small service and cottage--work workshops, which fairly hampers preventive measures. PMID- 6865740 TI - [Epidemiology of occupational diseases in the shipyard in 1968-1979]. AB - 717 cases of occupational disease diagnosed in the shipyard during 1968-1978 were analysed epidemiologically. High incidence of occupational diseases was found in the population examined, with a decreasing tendency during recent two years. Results of measurements of hazards concentrations and intensities, exhibiting often exceeded MAC values, along with quantitative distribution of particular occupational diseases, indicated evident impact of the shipyard working environment on the occurrence of those diseases, the morbidity risk being the highest at the workstations of forgemen, welders, and painters. Welders were Most frequently afflicted with pneumoconioses (45.9%), forgemen--with occupational hearing impairments (78.5%) and painters--maintenance technicians with dermatoses (44.6%). Occupational diseases prevalence was 6.5 fold higher among workers aged over 40 than among younger workers. PMID- 6865739 TI - [Health status of the workers exposed to strong, constant magnetic fields]. AB - Forty two workers underwent examinations under clinical conditions. The workers were affected by the magnetic field of intensities ranging between 112-190 Gauss, depending on the workplace. They underwent internal, ophthalmological, psychological, psychiatric and analytical examinations and the health status of those exposed was compared to that of twenty controls. Most subjects, mainly those of long length of employment in e-m fields exposure, exhibited nonspecific abdominal pains, general weakness, insomnia, increased thirst and conjunctivitis. PMID- 6865737 TI - [Evaluation of health hazards of workers of the textile industry working in contact with latex substances on the acrylic compound base]. AB - The paper is aimed at quantitative and qualitative determination of acrylic compounds that may occur in air at the "Lentex" Plant in Lubliniec, along with microclimate parameters measurements. The initial method was that of the Polish Standard PN-78/z-04113, which was subsequently modified. Pursuant to this standard, acrylic compounds were determined by gas chromatography with new column pack and changed parameters of gas chromatograph. The conditions of acrylic esters and acrylonitrile separation on column with LAC-1R-296 phase were considered the best and were used for quantitative and qualitative estimation. The investigations were carried out at workstations, basing on the production stage. The obtained results of identified acrylates concentrations are indicative of a very little content of those compounds in workstations air, implying that those workstations are safe in respect of chemical risk to workers. Certain deviations from mandatory standards were exhibited by almost all microclimatic parameters which might result in workers' worse general feeling. PMID- 6865741 TI - [Preventive gynecological examinations of women employed in the cement industry]. AB - Prophylactic gynecologic examinations were carried out in 218 women-workers of a cement plant. The most frequent diseases were: retroflexion of the uterus (55.5%), inflammation of the ovary (50.45%), erosion of the vaginal part of the uterus (41.8%), prolapse of the vaginal walls (39.45%), incontinence (35.32%) and Trichomonas vaginalis (18.7%). The extensive prevalence of the diseases imposes a need to carry on preventive examinations of women employed in cement industry. The authors indicate that certain diseases are obviously due to deficient hygiene. PMID- 6865742 TI - [Social factors intensifying therapeutic rehabilitation of industrial workers]. PMID- 6865743 TI - Inconsistency in spatial knowledge. PMID- 6865744 TI - Since the eruption of Mt. St. Helens, has anyone beaten you up? Improving the accuracy of retrospective reports with landmark events. PMID- 6865746 TI - Memory scanning of described images and undescribed images: hemispheric differences. PMID- 6865745 TI - Recognition memory for pictorial events. PMID- 6865747 TI - Tacit knowledge and the effect of pattern configuration on mental scanning. PMID- 6865749 TI - From SOFA to LOUCH: lexical contributions to pseudoword pronunciation. PMID- 6865748 TI - What is the role of affect in the spacing effect? PMID- 6865750 TI - A direct comparison of recognition failure rates for recallable names in episodic and semantic memory tests. PMID- 6865751 TI - The effects of recall and recognition test expectancies on the retention of prose. PMID- 6865753 TI - Cue redundancy and extra logical inferences in a deductive reasoning task. PMID- 6865752 TI - Effect of letter orientation and sequential redundancy on the speed of letter search. PMID- 6865754 TI - A model for determination of total body protein synthesis based upon compartmental analysis of the plasma [15N] glycine decay curve. AB - A model for whole body glycine nitrogen flux based on the compartmental analysis of plasma [15N] glycine decay curves is described and used for the measurements of (1) total body glycine nitrogen flux and the components of this flux in three healthy young adults and (2) total body protein synthesis based on the conversion of 15N to excretory products, ie, the sum of urinary [15N] urea and 15NH3 and the amount of labeled urea remaining in the body at five hours following administration of [15N] glycine. The mean glycine nitrogen flux was 3.93 +/- 0.42 mg N X kg-1 X h-1 (SEM). The major components of this flux are de novo synthesis of glycine, which accounts for 18% to 27%, and release from protein breakdown, which accounts for 62% to 73%. The outward pathways of glycine from the total body free glycine pool are conversion to other amino acids and oxidation to excretory end products (30% to 42%) and incorporation into protein, which accounts for 45% to 61% of glycine N loss from the metabolic pool. The mean rate of total body protein synthesis as determined by compartmental analysis was 3.56 g protein X kg-1 X day-1. The results that were obtained for protein synthesis and whole body glycine kinetics accord well with previous studies in normal adults, using the stochastic model. PMID- 6865755 TI - Leukocyte endogenous mediator alters protein dynamics in rats. AB - Leukocyte endogenous mediator (LEM), a low-molecular-weight peptide synthesized by monocytic cells during phagocytosis, has been implicated as the host's initiator of the protein metabolic response to infection and inflammation. To determine whether administration of LEM would alter protein kinetics, appearance and oxidation of plasma tyrosine as well as the rates of protein synthesis in liver and skeletal muscle were determined in fasted rats that received a 30-hour continuous infusion of either physiologic saline, LEM, or heat-inactivated LEM. The LEM was obtained from rabbit peritoneal exudate and the treatment solutions supplied 2.8 X 10(8) cell equivalents/100 g of body weight (BW) per day. Endogenous tyrosine oxidation increased from 4.0 +/- 0.4 mumol/100 g BW/h to 5.4 +/- 0.7 mumol/100 g BW/h in animals infused with heat-inactivated LEM and to 7.5 +/- 1.5 mumol/100 g BW/h in rats receiving LEM (P less than 0.01). Nonsecretory protein synthesis in the liver was greatest in rats administered LEM (2239 +/- 325 mg/d) when compared with control groups receiving physiologic saline (1122 +/ 195 mg/d) or heat-inactivated LEM (1374 +/- 62 mg/d; P less than 0.01), whereas skeletal protein synthetic rates were unchanged. Rates of muscle and collagen protein breakdown were estimated from the urinary excretion rate of Nt methylhistidine and hydroxyproline, respectively, and their excretion rose by 30% (P less than 0.05) and 42% (P less than 0.05) with LEM administration. These results suggest that administration of LEM stimulates a mobilization of amino acids from peripheral tissues to support increased visceral protein anabolism while whole body amino acid oxidation is also enhanced. Since similar effects follow fever and infection, these results suggest that LEM may play an underlying role in the protein metabolic response to infection and inflammation. PMID- 6865756 TI - Oleate metabolism in isolated hepatocytes from lean and obese Zucker rats. Influence of a high fat diet and in vitro response to glucagon. AB - The uptake and metabolism of [1-14C]oleate (0.3 mmol/L) were studied in isolated hepatocytes from lean and obese Zucker rats fed either a control (low-fat) diet or a high-fat diet. With the control diet, [1-14C]oleate uptake was increased by 70% in the obese rats, and fat-feeding decreased this uptake to values comparable to that of their lean littermates. Interestingly, the hepatocyte mean surface area was increased in the obese mutants by 21% with the control diet and by 30% with the high-fat diet. The possible reasons for the differences in oleate uptake are discussed. With the control diet, cells from the obese rats showed a four fold rise in [1-14C]oleate esterification, while ketogenesis (beta hydroxybutyrate + acetoacetate production) as well as the radioactive acid soluble products were greatly depressed. Production of CO2 was very low and similar in both groups of animals. Adaptation to the high-fat diet in the obese rats resulted in a reversal between esterification and oxidation of oleate: the latter became the major metabolic pathway as in the lean rats. The ketogenic capacity was greatly if not completely restored. In the lean animals, glucagon stimulated ketogenesis both in the presence or absence of oleate and decreased [1 14C]oleate esterification. In the obese rats, the hormone exerted a significant ketogenic effect only if oleate was present and did not influence its esterification. The data demonstrate the following abnormalities in the hepatocytes of obese Zucker rats: (1) an enlargement of cell size, (2) an increased oleate uptake, (3) a virtual absence of a ketogenic response to exogenous oleate, and (4) a markedly increased esterification of the latter. The metabolic defects, but not the cell size, appear to be largely corrected by an adaptation to a high-fat diet. The hepatic response to glucagon was decreased in the obese rats at the level of endogenous ketogenesis. PMID- 6865757 TI - Lipogenesis in primary cultures of adipoblasts derived from genetically obese Zucker rats. AB - Adipocyte precursor cultures prepared from the epididymal fat pads of genetically obese (fa/fa) and lean (Fa/Fa) Zucker rats grow similarly in culture. Addition of enriched medium (EM) containing human serum, insulin, and glucose stimulated lipid filling of the adipocyte precursors in both cultures. However, [3H] H2O incorporation into total lipids, fatty acid synthetase and lipoprotein lipase activities, and cytosolic protein contents are all decreased in the fa/fa compared with the Fa/Fa cultures. Substitution of lean or obese rat serum for human serum in the enriched medium does not alter the decreased lipogenic capacity of the fa/fa adipocyte precursor cultures. PMID- 6865758 TI - The excretion of sulfur compounds in the urine of newborn infants. AB - The excretion of sulfur-containing compounds was determined on the third and sixth day of life in male infants and the results were compared with those previously obtained on fed and fasting men. The output of total sulfur and inorganic sulfate was very low on the third day of life but had increased by the sixth day to levels found in the fasting men, whereas the excretion of mercaptolactate in the newborns decreased from the third to the sixth day of life. These results may be explained by the initial fasting state of neonates followed by an anabolic phase. Neonates excreted acid-labile ester sulfate and mercaptoacetate at levels similar to those found in adults, but the neonatal urine also contained sulfate esters (probably steroid sulfates) that required more drastic acid conditions for hydrolysis. Raised concentrations of sulfur containing amino acids (methionine, cystathionine, cyst(e)ine and taurine) were found in neonatal urine in confirmation of earlier reports. The excretion of thiosulfate could only be determined in newborns on the sixth day and was low in comparison with that of adults. High urinary thiocyanate concentrations were found in newborns fed by tobacco-smoking mothers, whereas the excretion of thiocyanate was low in other newborns. The possible medical hazards from the exposure of neonates to thiocyanate are emphasized. PMID- 6865759 TI - The Juvenile Diabetes Foundation workshop on the spontaneously diabetic BB rat: its potential for insight into human juvenile diabetes. Banff, Alberta, Canada, September 8-10, 1982. PMID- 6865760 TI - Workshop on the BB rat. PMID- 6865761 TI - Neuropathy-functional abnormalities in the BB rat. AB - The spontaneously diabetic rat gets a decreased motor-nerve conduction velocity after the onset of diabetes as compared with age- and weight-matched controls. This finding has indicated that these rats develop a neuropathy; but morphological investigations have failed to show structural abnormalities that could explain the decrease in conduction velocity. Measurements of the nervous function revealed a decreased excitability of isolated fibers from sciatic nerves of rats with diabetes duration ranging from 18 days to 6 months. Voltage-clamp analysis of the membrane of the node of Ranvier showed (1) decreased Na equilibrium potential, reflecting an axoplasmic Na accumulation; (2) decreased specific Na permeability, related both to an increased inactivation of the permeability of the resting node and also a decreased permeability when inactivation had been removed by hyperpolarization of the membrane; and (3) in some nodes a marked increase in the delayed K permeability, which is an early sign of paranodal demyelination. The decrease in Na permeability was the most important factor for the decreased nodal excitability and the decreased conduction velocity. This mechanism may also be involved in the reversible dysfunction found in human diabetic neuropathy. PMID- 6865762 TI - Glomerular manifestations of diabetes in the BB rat. AB - Morphologic characteristics of the renal glomeruli and tubules of BB rats with spontaneous diabetes mellitus were studied at 30 weeks' duration of diabetes. Whereas the glomerular basement membrane (GBM) was significantly thickened, no changes in the diabetic glomeruli were seen in the peripheral capillary wall area and in the fractional volumes of the mesangial cells or of the mesangial matrix. Light microscopy of the diabetic kidneys were normal, and immunofluorescent examination of diabetic glomeruli showed no increased accumulation of albumin, C3, or IgG. Diabetic rats had increased renal blood flow and glomerular filtration rates. Diabetic rats at 7, 17, and 30 weeks excreted normal amounts of urinary albumin. Thus kidneys of the BB diabetic rat differ from other experimental models of diabetes in that GBM thickening occurs in the absence of mesangial changes and of increased albuminuria. These studies suggest that the mesangium may influence glomerular permeability in diabetes, while thickening of the GBM in diabetes does not necessarily coincide with increased urinary albumin excretion. Furthermore, these results are consonant with the hypothesis that genetic factors may influence the pathological expression of diabetic nephropathy in rats. PMID- 6865763 TI - The BB Wistar rat: an experimental model for the study of diabetic retinopathy. AB - Diabetic retinopathy was studied in the spontaneously diabetic BB Wistar rat with respect to qualitative and quantitative structural changes. Trypsin-digested retinal preparations revealed after 8 to 11 months of diabetes a decrease in the pericyte/endothelial cell ratio. Quantitative ultrastructural examinations showed no increase in the vascularity or in basement-membrane thickness in diabetic animals. However, retinal capillaries showed not infrequently occlusions by fibrin and platelet thrombi. PMID- 6865764 TI - Gonadal dysfunction in the spontaneously diabetic BB rat. AB - Diabetes which occurs spontaneously in the BB Wistar rat is associated with reduced fertility, predominantly in breeding males. In the first month of diabetes, there is a significant (p less than 0.05) reduction in serum testosterone associated with a transient decrease of serum LH and the accumulation of lipid in Leydig cells. Between one and three months of diabetes, there is an increase in both serum testosterone and LH and a further deposition of lipid droplets in Leydig cells. From three to six months of diabetes, there is a reduction of serum testosterone similar to age-matched controls, but high serum LH levels persist. Similar levels of LH and testosterone are noted after six months of diabetes, and all BB rats show marked changes in seminiferous tubules. These morphological changes in tubules consist of increased tubular wall thickness, severe germ-cell depletion, and Sertoli-cell vacuolization. Similar morphological changes of testes associated with generalized atrophy are noted in all control rats after 16 months of age. Decreased fertility in the BB rat appears to be associated with a primary disorder of Leydig cells, which precedes changes in seminiferous tubules consistent with accelerated aging. Preliminary data in impotent diabetic men suggest that the BB rat may be a valuable model for investigating human diabetic impotence and infertility. PMID- 6865765 TI - The effects of maternal diabetes on fetal maturation and neonatal health. AB - This investigation focused on the relation between metabolic control of maternal diabetes in pregnancy and the health status of the fetus and newborn in the spontaneously diabetic BB rat. The basic hypothesis tested was that "tight" control of maternal diabetes before conception and during pregnancy should result in diminished fetal and neonatal morbidity and mortality. Behavioral teratologic tests were employed to evaluate the possible long-term effects of diabetes in pregnancy on postnatal development. The results demonstrated that approximation to glucose homeostasis in diabetic BB dams was associated with increased litter and fetal size, decreased perinatal mortality, and a significant reduction in the incidence of congenital malformation. Postnatal growth and neurologic function were also enhanced. These findings are supportive of efforts to initiate diabetic control prior to conception and especially during the critical period of fetal organogenesis during the first 8 weeks of human pregnancy. PMID- 6865766 TI - Low-temperature cryopreservation of BB rat embryos of spontaneously diabetic rats. AB - Cryopreservation of BB rat embryos would ensure perpetuation, at greatly reduced cost, of this model of nonobese, insulin-dependent, juvenile-onset diabetes in man. Immature prediabetic female BB rats were ovulated hormonally. The embryos were removed at the 8- to 16 cell and blastocyst stages and cryopreserved, and after thawing were assayed for viability in vitro or transplanted into pseudopregnant foster mothers of a nondiabetic strain. The highest rate of viability in vitro (100%) and development into normal fetuses (31%) was obtained with blastocysts transplanted into day-4 foster mothers. The results indicate the feasibility of low-temperature banking of this clinically important strain of rats. PMID- 6865767 TI - Lessons from studies with genetic forms of diabetes in the mouse. AB - Genetically defined animal models of diabetes have many advantages over models in which the genetic component has not been established. Such models permit predictable numbers of normal and afflicted animals, differing by only a single gene, to be produced at will. Maintenance of these individual mutations in inbred strains of mice permits an evaluation of any gene-host interactions that act by modifying the severity of the diabetic condition. These genetic models provide precision tools for research in which the mutant gene itself, the inbred background, and the environment can be manipulated at will. In addition there is sufficient knowledge about the arrangement of individual genes in chromosomes in the mouse to permit one to identify, and use, closely linked markers in order to predict with confidence the mice destined to become diabetic. Such studies on the preclinical stages are of utmost importance and cannot be undertaken conveniently in any other model. Our studies with genetic mouse models have established that there are at least six genes in the mouse that can cause diabetes and obesity syndromes. The severity of the diabetes produced depends on the interaction of the mutant gene with the host inbred background as well as with other environmental factors. Establishing the nature of these interactions and the possible primary lesions involved in each genetic syndrome should have major ramifications in studies dealing with human diabetes. PMID- 6865769 TI - Recommended nomenclature for the spontaneously diabetic syndrome of the BB rat. AB - In order to standardize the nomenclature of the spontaneously diabetic BB rat, the following are recommended. All rats obtained directly from the Ottawa colony should be designated BB. The term Wistar should not be used, and W should not be added to denote the Wistar derivation. When breeding is commenced elsewhere, each center should add a letter to identify its colony, such as BB/W for the colony in Worcester, Mass. No other colony should use such a designation if it has been published previously. Use of supplementary nomenclature to indicate BB rat lines of high and low incidence or to refer to different stages of the syndrome (potential diabetes, impaired glucose tolerance, overt insulin-dependent diabetes) should remain the discretion of the individual breeder, but should be rigorously defined. PMID- 6865768 TI - The effect of inbreeding on the BB/W diabetic rat. AB - The Worcester colony of BB/W diabetic rats has been inbred by brother X sister matings for 12 generations. The litter size at both birth and weaning was dependent on whether the female was normal or diabetic. At the beginning of the inbreeding, the normal females produced 2.1 more young per litter than did the diabetic females, but the eleventh generation of inbreeding this difference had been reduced to 0.68 young. Diabetic males had little influence on litter size. At weaning, the normal mothers had raised litters that had 3.64 more young than the diabetics in the early generations, but this had dropped to 1.48 in later generations. After 11 generations of inbreeding, there was a 1.95 decrease in litter size from normal matings, but only a 0.86 decrease from diabetic matings. The average loss from birth to weaning was one pup for normal females and two pups for diabetic females. The time of onset (median 85 days) has not changed with inbreeding, nor is the onset pattern and severity different in any of the nine inbred lines. The penetrance in the D X D matings did change from 45% in the first five generations to 60% in the next six, but there has been no significant change in generations 6 through 11. Inbreeding changed the results obtained from outcrossing to nondiabetic lines. All crosses produced no diabetics in the F1, but noninbreds produced less than 2% in the F2 and 4% in the BC, whereas inbreds produced 18 to 32% in the BCs. These latter figures are consistent with the ratio of 7:3 expected with 60% penetrance. PMID- 6865770 TI - Cyclosporine: action, pharmacokinetics, and effect in the BB rat model. AB - Cyclosporine (Cy) was given to BB rats in an attempt to prevent the onset of diabetes. A dose of 15 to 20 mg/kg/d given orally or subcutaneously was associated with high Cy trough serum levels and caused nephrotoxicity and severe weight loss. Ten mg/kg/d of Cy was tolerated well. Forty rats were treated with Cy starting at 34 days of age. No Cy-treated rats developed diabetes by day 121, compared with 70% of the control rats. Once Cy was discontinued on day 121, 38% of female and 13% of male rats developed diabetes by day 169. Transient, spontaneously remitting hyperglycemia developed in nine rats. This occurred both in control rats and in rats on Cy, but it was more common in females than in males. Thus, Cy prevents diabetes mellitus in the BB rat when trough Cy serum levels greater than 100 ng/mL are achieved. Diabetes occurs in some rats after Cy is discontinued. In all treatment subgroups, diabetes occurred more frequently in females than in males. PMID- 6865771 TI - The discovery and development of the BB rat colony: an animal model of spontaneous diabetes mellitus. AB - The BB rat model of spontaneous diabetes mellitus was discovered in 1974 in Ottawa in a colony of specific pathogen-free Wistar rats. Investigations to determine the cause of rapid weight loss and death in a few weanling rats from this colony revealed polydypsia, polyuria, glucosuria, ketonuria, and hyperglycemia. These signs regressed and normal weight gain occurred when daily insulin therapy was given. Histologic studies of the pancreas of affected animals showed fibrosis and absence of beta cells. The original colony was established by crossbreeding the clinically normal parents of the diabetic animals. Approximately 10% of the offspring of these matings became diabetic. This incidence was increased to approximately 25% by father-daughter mating, suggesting a genetic component in the etiology. PMID- 6865772 TI - Lymphocyte abnormalities in the BB rat. AB - The BB rat has a marked T cell lymphocytopenia, with a near absence of peripheral "helper" T cells recognized by monoclonal antibody W3/25 (W3/25+ T cells). The lymphocytes of the BB rat's spleen and thymus were examined for the presence of W3/25+ T cells, which were found to be absent in the spleen but present in normal amounts in the thymus. Concanavalin A (Con A) responsiveness was absent in the BB's peripheral blood and spleen but present in the thymus. Thus, in these three lymphoid compartments, Con A responsiveness directly correlated with the presence or absence of W3/25+ T cells. These lymphocyte abnormalities in the BB rat are notably different from lymphocyte changes present in human type I diabetes. PMID- 6865773 TI - Lymphoproliferative lesions in BB Wistar rats. AB - Fifteen percent of long-term diabetic BB Wistar rats developed abdominal B cell lymphoproliferative lesions which ranged from minute mesenteric aggregates of plasma cells and lymphocytes to malignant lymphoma with features of immunoblastic sarcoma or plasma-cell lymphoma. Lymph nodes in younger BB Wistar rats, both diabetic and nondiabetic, demonstrated variable degrees, often extensive, of paracortical and medullary replacement by plasmacytoid lymphocytes and/or plasma cells. This study documents morphologic abnormalities in lymph nodes of BB Wistar rats, thus providing additional evidence of altered immunity in this model. PMID- 6865774 TI - Serum T4, T3, and TSH levels in primary hypothyroidism during replacement therapy with thyroxine. AB - Forty-five patients with primary hypothyroidism were studied during the first 4 to 36 months of replacement therapy with thyroxine. All became clinically euthyroid (23 patients while taking 0.1 mg/d, 14 patients while taking 0.15 mg/d, 7 patients while taking 0.2 mg/d, and 1 patient while taking 0.25 mg/d) over a period of three to six months. The patients were then divided for data analysis into two groups. Group I had normal serum T3 levels, normal (or elevated) serum T4 levels, and normal serum TSH levels. Group II had normal serum T3 levels, normal (or elevated) serum T4 levels, but high serum TSH levels. Group II was subdivided further into a group of 13 patients (group IIa) whose dose of thyroxine was deliberately increased until the serum TSH level was normalized; five of these patients became clinically and biochemically hyperthyroid. Group IIb consisted of eight patients with normal serum T3 and T4 levels and high serum TSH levels who were followed up without attempting to normalize their serum TSH levels. None became thyrotoxic, and their serum TSH levels showed little change. These findings suggest that serum TSH levels alone are not adequate to assess the required dose of thyroxine replacement therapy. PMID- 6865775 TI - The human metabolic response to chronic ketosis without caloric restriction: physical and biochemical adaptation. AB - To study the metabolic effects of ketosis without weight loss, nine lean men were fed a eucaloric balanced diet (EBD) for one week providing 35-50 kcal/kg/d, 1.75 g of protein per kilogram per day and the remaining kilocalories as two-thirds carbohydrate (CHO) and one-third fat. This was followed by four weeks of a eucaloric ketogenic diet (EKD)--isocaloric and isonitrogenous with the EBD but providing less than 20 g CHO daily. Both diets were appropriately supplemented with minerals and vitamins. Weight and whole-body potassium estimated by potassium-40 counting (40K) did not vary significantly during the five-week study. Nitrogen balance (N-Bal) was regained after one week of the EKD. The fasting blood glucose remained lower during the EKD than during the control diet (4.4 mmol/L at EBD, 4.1 mmol/L at EKD-4, P less than 0.01). The fasting whole body glucose oxidation rate determined by a 13C-glucose primed constant infusion technique fell from 0.71 mg/kg/min during the control diet to 0.50 mg/kg/min (P less than 0.01) during the fourth week of the EKD. The mean serum cholesterol level rose (from 159 to 208 mg/dL) during the EKD, while triglycerides fell from 107 to 79 mg/dL. No disturbance of hepatic or renal function was noted at EKD-4. These findings indicate that the ketotic state induced by the EKD was well tolerated in lean subjects; nitrogen balance was regained after brief adaptation, serum lipids were not pathologically elevated, and blood glucose oxidation at rest was measurably reduced while the subjects remained euglycemic. PMID- 6865776 TI - The human metabolic response to chronic ketosis without caloric restriction: preservation of submaximal exercise capability with reduced carbohydrate oxidation. AB - To study the effect of chronic ketosis on exercise performance in endurance trained humans, five well-trained cyclists were fed a eucaloric balanced diet (EBD) for one week providing 35-50 kcal/kg/d, 1.75 g protein/kg/d and the remainder of kilocalories as two-thirds carbohydrate (CHO) and one-third fat. This was followed by four weeks of a eucaloric ketogenic diet (EKD), isocaloric and isonitrogenous with the EBD but providing less than 20 g CHO daily. Both diets were appropriately supplemented to meet the recommended daily allowances for vitamins and minerals. Pedal ergometer testing of maximal oxygen uptake (VO2max) was unchanged between the control week (EBD-1) and week 3 of the ketogenic diet (EKD-3). The mean ergometer endurance time for continuous exercise to exhaustion (ENDUR) at 62%-64% of VO2max was 147 minutes at EBD-1 and 151 minutes at EKD-4. The ENDUR steady-state RQ dropped from 0.83 to 0.72 (P less than 0.01) from EBD-1 to EKD-4. In agreement with this were a three-fold drop in glucose oxidation (from 15.1 to 5.1 mg/kg/min, P less than 0.05) and a four-fold reduction in muscle glycogen use (0.61 to 0.13 mmol/kg/min, P less than 0.01). Neither clinical nor biochemical evidence of hypoglycemia was observed during ENDUR at EKD-4. These results indicate that aerobic endurance exercise by well trained cyclists was not compromised by four weeks of ketosis. This was accomplished by a dramatic physiologic adaptation that conserved limited carbohydrate stores (both glucose and muscle glycogen) and made fat the predominant muscle substrate at this submaximal power level. PMID- 6865777 TI - Stimulation of hepatic and renal ornithine decarboxylase activity by selected amino acids. AB - The activity of ornithine decarboxylase (ODC), the rate-limiting enzyme in polyamine synthesis, increases after a protein meal. The effect of amino acid mixtures on hepatic and renal ODC activity and polyamine content was studied in postabsorptive and 72-hour fasted rats. Fasting decreased ODC activity in liver and in kidney by approximately 50%. Hepatic ODC activity increased tenfold 4 hours after intraperitoneal injection of either 1 g/kg of a synthetic mixture of 17 amino acids or of casein hydrolysate to fed rats and about 20-fold in fasted rats. Renal ODC activity increased four- and tenfold respectively. A mixture of glutamate, aspartate, and alanine at concentrations given in the hydrolysate reproduced the full amino acid effect. No amino acid was effective when given alone, nor were mixtures of the other amino acid constituents of the hydrolysate. Glutamate + alanine was ineffective as were glucose or various combinations of arginine, ornithine, aspartate and NH3. Ornithine + glutamate or aspartate + glutamate were active but stimulated less than aspartate + glutamate + alanine. Hepatic and renal putrescine content increased in parallel with ODC activity. The data suggest that specific amino acids possess the full ODC-stimulating capability of a high quality protein and that polyamine synthesis is linked to urea cycle activity. PMID- 6865778 TI - Carnitine and carnitine esters in plasma and adipose tissue of chronic uremic patients undergoing hemodialysis. AB - Carnitine concentrations were measured in the plasma and adipose tissue of seven chronically uremic and hyperlipidemic patients undergoing hemodialysis. Plasma levels of carnitine had dropped by the end of dialysis. The clearance of free carnitine was greater than that of acylcarnitine. Fasting plasma free carnitine, long-chain acylcarnitine, D-beta-hydroxybutyrate and free fatty acid concentrations were normal but short-chain acylcarnitine values were elevated. In adipose tissue, total carnitine concentrations were normal but long-chain acylcarnitine concentrations were increased. These findings may indicate a hypermetabolic state in which the acute removal of carnitine during hemodialysis may lead to a critical shortage of this substance. PMID- 6865780 TI - The consequences of inappropriate treatment because of failure to recognize the syndrome of pituitary and peripheral tissue resistance to thyroid hormone. PMID- 6865779 TI - Heterogeneity of very-low-density lipoprotein metabolism in hyperlipidemic subjects. AB - Very-low-density lipoproteins (VLDL) are triglyceride-rich lipoproteins that have been shown, by physicochemical means, to comprise more than one group of particles. Because of the potential atherogenicity of catabolized VLDL, we used the technique of heparin-affinity chromatography to separate VLDL into two classes of particles, one of which appears to contain partly catabolized VLDL. This observation is based on the higher cholesterol/triglyceride and higher apoprotein E/apoprotein C ratios in VLDL particles that are bound to heparin, resembling in this way intermediate-density lipoproteins (IDL), which are certainly derived in the main through VLDL catabolism. Further studies showed separate metabolic characteristics for the unbound and heparin-bound VLDL particles. Radiolabeled whole VLDL or unbound particles were reinjected into seven hypertriglyceridemic subjects and the kinetics studied in serial samples of plasma over the next 18-48 hours. The specific radioactivity-time curves of apoprotein B in the unbound and bound particles showed that the bound particles were derived wholly or partly from the unbound particles and in turn, were the precursors of IDL. This confirmed that heparin-bound VLDL particles represented VLDL undergoing catabolism, although in one subject about one-half of the bound particles appeared to have an origin other than through VLDL catabolism. These studies show that VLDL metabolism is heterogeneous, that the kinetics of total VLDL must be interpreted accordingly, and that the technique of heparin-affinity chromatography can be used for more detailed studies of VLDL. PMID- 6865782 TI - Quantitative fluorometric assay for detection and characterization of Fc receptors. PMID- 6865781 TI - Comparison of age-related decreases in the basal and carbohydrate inducible levels of lipogenic enzymes in adipose tissue and liver. PMID- 6865784 TI - Immunochemical techniques. Part F: Conventional antibodies, Fc receptors, and cytotoxicity. PMID- 6865783 TI - Quantitation of cell surface antigens by antibody-complement-mediated cytotoxicity. PMID- 6865785 TI - Preparation and isolation of specific antibodies to complement components. PMID- 6865786 TI - Methods for the analysis of antibody responses to vaccines or other immune stimuli. PMID- 6865787 TI - Preparation of polyclonal antisera to tumor-associated antigens using agarose entrapped immune complexes as immunogens. PMID- 6865788 TI - Role of diffusion regulation in receptor--ligand interactions. PMID- 6865790 TI - Digital picture analysis as an integral part of the information system for experimental oncopathology of the German Cancer Research Center. PMID- 6865789 TI - Health informatics for all by the year 2000. PMID- 6865791 TI - A video information system in an operating unit. PMID- 6865792 TI - An operational approach to record linkage. PMID- 6865794 TI - How to detect and prevent errors in computer-supported statistical analysis: an example. PMID- 6865793 TI - How clinicians recall experiences. PMID- 6865795 TI - Comparison between five methods for the separation of IgM. AB - Five serum fractionation methods were examined with regard to their suitability for use in the demonstration of specific IgM antibodies. It was found that Protein A - Sepharose CL - 4B chromatography leads to higher IgM recovery than absorption with whole Staphylococcus aureus (58% as opposed to 40%). It is also cheaper, since this absorbent can be reused. Contamination with 2-5% IgG and about 70% IgA is encountered with both methods. Quaternary aminoethyl (QAE) - Sephadex chromatography gives excellent IgM recovery (97%) and its cost and execution time are the lowest. IgG and IgA residues are 2% and 53% respectively. Ultrafiltration results in poorer recovery of IgM (31%). However, the sample volume can be brought back to its initial value, or concentrated still further. IgG and IgA residues are 2% and 14%. The cost of the method and the time needed for its execution are relatively high. Gel chromatography is the only method to give a completely IgG- and IgA-free IgM fraction. The percentage of IgM recovered varies in accordance with the ratio between the volume of the sample and that of the column. Very high values may be obtained, but at the expense of heavy dilution. The cost is low, but the method requires a considerable amount of time. In short, none of the five methods is clearly superior to the others. Whether or not a given method is chosen will thus depend on the relative importance attached to the percentage of IgM recovered, the presence or otherwise of IgA, sample dilution, cost, and rapidity of execution. PMID- 6865796 TI - Plasmids and phages in Bifidobacterium longum. AB - Fourteen strains of Bifidobacterium longum were tested for phage production with UV and mitomycin C as inducing agents. Only four strains released phage-like particles; of these four strains, two harbour plasmids, while two are apparently plasmid free. The induced phages have heads of dimensions ranging from 49 to 56 nm and tails from 76 to 268 nm long. No correlation is evident between any of the large variety of plasmids of B. longum and induced phages. PMID- 6865797 TI - MSMS legislative package seeks to alleviate malpractice costs. PMID- 6865798 TI - Financial planning/investment perspectives. Mutual funds are back! PMID- 6865800 TI - Here is the final FTC order, interpreted and printed in entirety. PMID- 6865799 TI - There is much you and I can do about medical care cost containment. PMID- 6865801 TI - Occurrence screening--what do you think? PMID- 6865802 TI - Worth sharing. Strong MD/patient relationship may not preclude a suit. PMID- 6865803 TI - Tissue culture contamination with nontuberculous mycobacteria. PMID- 6865805 TI - Transmission of R plasmids in vibrio anguillarum to Vibrio cholerae. PMID- 6865804 TI - Chemical and biological properties of Lipopolysaccharides from symbiotic luminous bacteria from several luminous marine animals. AB - The chemical and biological properties of lipopolysaccharides (LPS) in five strains of symbiotic luminous bacteria isolated from four species of luminous marine fishes, Coelorhynchus kishinouyei (CK-1), Chlorophthalmus albatrossis (CA 1), Ventrifossa garmani (VG-1), and Acropoma japonicum (AJ-1b), as well as from a luminous squid, Doryteuthis kensaki (DK-1) were examined. The LPS isolated from these symbiotic luminous bacteria were characterized by the absence of 2-keto-3 deoxyoctonate, known to be a basic component of the usual gram-negative bacterial LPS. All LPS from these symbiotic luminous bacteria upon electrophoresis in sodium dodecylsulfate polyacrylamide gel exhibited one or two clear main bands with high mobility, and one or two obscure minor bands with low mobility when stained with periodate-Schiff reagent. LPS from CA-1 and VG-1 exhibited similar electrophoretic patterns, whereas the electrophoretic patterns of the LPS from CK 1, AJ-1b, and DK-1 were easily distinguishable from each other. All these LPS also had similarly potent and diverse biological activities in regard to their adjuvanticity, immunosuppression, polyclonal effect, B-cell mitogenicity, and activation of the phagocytic function of macrophages. PMID- 6865806 TI - Fecal excretion associated with Ca2+ dependency of Yersinia enterocolitica O3 and O9 and Yersinia pseudotuberculosis in mice. PMID- 6865807 TI - Cold-adapted reassortants of influenza A virus in MDCK cells. II. Role of the temperature-sensitive property of cold-adapted reassortants in mice. PMID- 6865808 TI - [Incorporation of radioactive precursors into the lipopolysaccharide-protein complex from Yersinia pseudotuberculosis]. PMID- 6865809 TI - [Affinity chromatography of galactose oxidase of Fusarium graminearum IMV-F 1060 on Sepharose 6B]. PMID- 6865810 TI - The place of primary health care in medical education in the United Kingdom: a survey. AB - Primary health care has been held to be the foundation of any rational health system. The principle was fully endorsed by the Alma-Ata Conference in 1978, and has become the main policy of the World Health Organization. Important implications are involved for the education and training of doctors and other health care professions. An enquiry was conducted by personal interviews of those most responsible for the teaching of primary health care in the United Kingdom, to enquire about the status of primary health care in the curricula of U.K. medical schools, and about the standing of general practice. The enquiry also explored the degree of awareness among medical educators about the Alma-Ata Declaration. The leading representatives of primary health care in the medical schools made it clear that the teaching of primary health care varied greatly in the importance accorded to it and the resources made available for it by medical schools. Almost half the respondents were unaware of the support for greater emphasis on primary health care that had been specified in the Alma-Ata Declaration. PMID- 6865811 TI - The maintenance of curriculum-development activities in government medical schools in Indonesia. AB - This paper reports information obtained from 499 participants during the course of a national series of workshops conducted in eleven government medical schools in Indonesia. The information analysed provided an independent check of claims made by previous investigators relating to the extent to which Indonesian medical schools had progressed towards curriculum re-organization consistent with national policy for the reform of undergraduate medical training. The majority of participants had developed and completed course programmes based on instructional objectives, which was seen as being broadly consistent with previous claims. Evidence is presented of continued curriculum-development activity several years after the cessation of external intervention through the national workshop programme. Findings are discussed in relation to national policy and strategies for maintenance of curriculum-development activities after cessation of intervention programmes. PMID- 6865812 TI - Changes in students' perceptions of clinical teaching as a result of general practice clerkships. AB - This study investigated whether a 3-week clerkship for third-year medical students in general-practice doctors' offices changed the students' perceptions of clinical teaching. The Preceptor Evaluation Questionnaire was administered to 138 junior medical students before and after their clerkships. The result of the study indicated that the clerkship had a positive effect on the students' perceptions. This finding was not related to their experiences in other clerkships nor to the grades they received for the clerkship. The results indicate that the teaching relationship established between student and family doctor significantly affects students' perceptions of aspects of effective clinical teaching. PMID- 6865813 TI - Medical students' attitudes towards women: a sex-linked variable? AB - Two hundred and ten (95%) second-year clinical students at the London Hospital Medical College answered a questionnaire before and after their 2-month attachment in obstetrics and gynaecology, in an attempt to measure their attitudes to women and the subject being studied. In only six of the thirty-two questions were there significant changes in the pre- and post-course responses, and these related to abortion, sterilization and obstetric practice. Students did not often answer 'don't know' to the questions, and the most striking finding was that the responses of male and female students differed, with statistical significance at the 1% level in twenty-six of the thirty-two questions. The male students were more likely to agree with statements which stereotyped women in a negative way and this suggests that, unless active steps are taken by medical teachers to help students to question their attitudes, women will continue to complain about the way they are treated by the medical profession, and women doctors will not fulfil their potential. PMID- 6865815 TI - Incremental validity of noncognitive tests for medical school academic achievement. AB - This paper reports an investigation of the incremental validity of noncognitive tests. Incremental validity is the predictive ability of a measure when entered into a regression equation after the routine predictors have first been included. Three noncognitive tests--Rotter Locus of Control, Adjective Check List, and Student Orientations Survey--were administered to a first-year medical school class. When entered after the usual academic predictors of success in medical school--Undergraduate Grade Point Average and Medical College Admission Test--the three noncognitive tests added little to the prediction of first-year medical school Grade Point Average. It is concluded that while noncognitive measures are useful in characterizing a medical school class and in discovering nonacademic correlates of academic success in medical school, limited incremental validity related to first-year academic performance was demonstrated. PMID- 6865814 TI - The effect of assessments and examinations on the learning of medical students. AB - This paper describes a situation where an alteration in the final-year assessment scheme led to changes in student learning activities which were the exact opposite of those intended. Students were seen to be spending a disproportionate amount of time studying the theoretical components of the course relative to the practical and clinical aspects. The paramount importance of the assessments and examinations in influencing student learning behaviour led the departments concerned to develop a new clinical examination which more clearly reflected the objectives of the course. A questionnaire survey was undertaken to determine how the different sections of the final assessment affected the students' approach to studying. The questionnaire was administered to graduates during their intern year for the 3 years following the introduction of the new clinical examination. Results were also obtained for the year preceding the change. The survey showed that the students developed a high regard for the new examination and its validity as a test of clinical competence. The students found that an increase in ward-based learning activities was essential for success in the final examinations. The new clinical examination has thus influenced students' learning and successfully restored the balance of their learning activities between the clinical and theoretical components of the course. PMID- 6865816 TI - Difficulty and discrimination capacity of examinations estimated on the basis of repeated student failure. PMID- 6865817 TI - Admission process and final qualification of medical students. AB - Several ways of admission are compared as to their effect on the final drop-out rate under an unlimited system of examinations within the Medical School. Out of 8260 students admitted during 10 years via several admission systems, 5927 graduated within 16 years from enrollment. A larger drop-out rate (as well as a longer delay in graduating) was observed with students admitted without entrance examinations. An important number of students entering after examinations (45%) were also late in graduating. Among the admission systems used the findings point to the fact that a closed system provides the school with a majority of competent students but excludes a number of students who proved capable of graduating when enrolled in the same school. The findings also point to the need of improvement of the admission process in the closed system or the need for strict first- or second-year evaluation of students in the open system. PMID- 6865818 TI - Haemorrhagic and haemolytic anaemias in the rabbit: a clinically relevant laboratory project in physiology. AB - Study of animal models of human anaemias has been part of a laboratory curriculum in physiology for several years. Bleeding or phenylhydrazine injection of rabbits produced anaemias simulating important clinical disorders. Data obtained by the students are given, showing the course over a 14-day period of haemoglobin concentration, hematocrit and reticulocyte counts. Expected and unexpected laboratory findings posed problems that could only be solved by drawing on knowledge within wide areas of physiology. The attitude of the students to this exercise was evaluated with a questionnaire method and found to be very favourable. PMID- 6865819 TI - The presence of distinct and stable skills among students assessed for clinical competence in oncology. AB - Several aspects of clinical competence in oncology were assessed among sixty-one fourth-year medical students, and results correlated with success in other areas of the curriculum as well as the extent of previous exposure to cancer patients. The inter-relationships identified by factor analysis among the outcome and predictor measures suggest that several distinct competencies were being assessed. In addition, certain skills, such as the ability to generate appropriate diagnostic hypotheses and to perform well on multiple-choice exams, appear to have been stable across time. These findings imply that there are distinct components to clinical competence, and that various methods of evaluation reflect these competencies differently. PMID- 6865820 TI - The optimal age for repair of secundum atrial septal defect. PMID- 6865821 TI - Cholecystocolic fistula in a young woman. PMID- 6865822 TI - Plumbism in pets and people. PMID- 6865823 TI - Detection of primary and secondary sucrose malabsorption in children by means of the breath hydrogen technique. AB - Eighty-one breath hydrogen tests were performed in 72 children who were investigated either because of chronic diarrhoea or recurrent abdominal pain, or because they were relatives of patients with congenital sucrase-isomaltase deficiency. The results of tests on 16 patients were positive (sucrase-isomaltase deficiency, seven patients; secondary sucrose malabsorption, nine patients). Hydrogen production was higher in patients with sucrase-isomaltase deficiency (mean, 96 ppm; range, 20 ppm to 432ppm) than in those with secondary sucrose malabsorption (mean, 21 ppm; range, 12ppm to 51ppm). All patients with positive test results responded to sucrose restriction, and those with secondary malabsorption subsequently became well. The breath hydrogen test is a sensitive, non-invasive method for detecting sucrose malabsorption, whether due to a primary deficiency or secondary to other bowel disorders. Guidelines for improving the accuracy and reproducibility of the breath hydrogen test are discussed. PMID- 6865824 TI - Birth defects and the father. PMID- 6865825 TI - Cortical hearing deficit. A deaf brain. AB - Deafness occasionally results from bilateral lesions of the temporal lobes. Conventional methods of assessing hearing are not helpful in the diagnosis of this condition. We describe the case of a patient who exhibited the hallmark of a cortical hearing disorder--he was able to hear simple sounds, but could not make sense of complex sounds such as speech and music. PMID- 6865827 TI - Recurrent agranulocytosis induced by two different antithyroid agents. AB - A 45-year-old woman with thyrotoxicosis developed agranulocytosis after treatment with propylthiouracil. When the thyrotoxicosis recurred, accompanied by a severe psychotic reaction, administration of antithyroid medication was recommenced. The patient was given methimazole instead of propylthiouracil but, 10 weeks later, agranulocytosis again occurred. This is, to the best of our knowledge, the first report of a case in which agranulocytosis followed treatment with both propylthiouracil and methimazole in the same patient. PMID- 6865826 TI - Intra-abdominal pneumococcal abscess. AB - A 25-year-old woman with the adrenogenital syndrome was admitted to hospital because of abdominal pain. Streptococcus pneumoniae was present in pus obtained from an abscess in the appendix area. PMID- 6865828 TI - A probable case of Chromobacterium violaceum infection in Australia. AB - A case of a north-Queensland Aboriginal child, who died of a septicaemic illness probably caused by Chromobacterium violaceum, is reported. This organism is a Gram-negative bacillus found in soil and water. Human and animal infections are very rare, but have been reported from various tropical and subtropical areas of the world. Most of these have been fatal, although survival after recognition, appropriate antibiotic therapy, and surgical intervention has also been reported. PMID- 6865829 TI - Acupuncture. Why we don't use it more often. PMID- 6865830 TI - Profound hypocalcaemia associated with oestrogen treatment of carcinoma of the prostate. AB - A case of profound hypocalcaemia which occurred in a patient with osteoblastic metastatic carcinoma of the prostate after treatment with oestrogens is reported. Although there may have been other contributory factors, it was felt that the administration of oestrogens was the most important causative element. Treatment with high doses of oestrogens in patients with osteoblastic metastatic carcinoma of the prostate should be accompanied by frequent measurements of plasma calcium levels. PMID- 6865831 TI - Ileopopliteal fistula in Crohn's disease. AB - A patient with Crohn's disease is reported, in whom a fistula, which originated in the terminal ileum, ultimately reached the skin behind the right knee. PMID- 6865832 TI - Carcinogenesis. PMID- 6865833 TI - Health services for agricultural workers. PMID- 6865834 TI - Paucity of 47,XXX and 46,XX/47,XXX among routine diagnostic cytogenetic referrals. PMID- 6865835 TI - NHMRC workshop on non-pharmacological methods of lowering blood pressure. Sodium restriction. AB - Data on the effects of severe salt restriction suggest that some, but by no means all, patients with severe hypertension respond well. The effects of less severe salt restriction on blood pressure are inconclusive, but suggest that diuretics are more effective than dietary salt restriction in reducing blood pressure. The possibilities of variation between individuals in sensitivity to sodium intake has not been adequately explored. PMID- 6865836 TI - NHMRC workshop on non-pharmacological methods of lowering blood pressure. Is alcohol use a preventable cause of hypertension? AB - There is good evidence that hypertension is more frequently observed in alcohol users than in non-users, and that the prevalence of hypertension is proportional to the average dose of alcohol consumed. If this association is causal, the 20% to 50% of hypertension in middle-aged Australian men which is attributable to alcohol use could prove to be entirely preventable. On the other hand, if the association is largely secondary, that is, if alcohol use and hypertension share genetic and other causes in common, then intervention to reduce alcohol consumption could have little effect on the prevalence of hypertension. Further work is needed to study the mechanisms by which alcohol use may cause hypertension, to identify the genetic factors which may determine susceptibility to hypertension in alcohol-users, and to carry out controlled intervention studies to test the hypothesis that alcohol use is a reversible cause of hypertension. PMID- 6865837 TI - Health hazard for hospital workers from exposure to formaldehyde. PMID- 6865838 TI - [N-hexane-induced polyneuropathy in the shoe and leather goods industry. Changes in the clinico-epidemiologic picture in the face of partial primary prevention measures]. PMID- 6865839 TI - Hepato-renal involvement in acute occupational trichloroethylene intoxication. PMID- 6865840 TI - Lung function tests and early prediction of byssinosis. PMID- 6865842 TI - [Diagnostic contribution of the study of pulmonary diffusing capacity for steady state carbon monoxide in asbestos workers]. PMID- 6865841 TI - Indicators of asbestos exposure in autopsy routine. 2. Pleural plaques and occupation. PMID- 6865843 TI - [Comments on the EEC directive on the protection of workers exposed to inorganic lead]. PMID- 6865844 TI - [Neoplastic pathology and wood manufacture]. PMID- 6865845 TI - [Incidence of malignant tumors of the nasal cavity in 91 communities of Brianza]. PMID- 6865846 TI - [Tumors of the nasal fossae and paranasal sinuses and occupations in Trieste from 1968 to 1980]. PMID- 6865847 TI - The importance of clothing in death investigation - II. PMID- 6865848 TI - Netilmicin sulfate (Netromycin). PMID- 6865849 TI - Sodium cellulose phosphate (Calcibind). PMID- 6865850 TI - Oral contraceptives and the risk of cardiovascular disease. PMID- 6865851 TI - Etomidate for induction of anesthesia. PMID- 6865852 TI - Branched-chain amino acids for the treatment of hepatic encephalopathy. PMID- 6865853 TI - Dose calibrator response to brachytherapy sources: A Monte Carlo and analytic evaluation. AB - It is well known that the dose calibrator response/unit exposure rate depends significantly upon source energy. However, investigation of 137Cs, 192Ir, and 226Ra brachytherapy sources by empirical, analytical, and Monte Carlo techniques shows that source filtration significantly affects the calibrator reading to exposure rate conversion factor. The results demonstrate that for each clinically used filtration thickness an exposure calibrated standard source is required to establish the response of the well chamber. An interesting consequence of this analysis is that the Sievert point dose algorithm for clinical sources overestimates the dose on the order of 3% at distances of approximately 3.5 cm from the source. PMID- 6865855 TI - Absorbed dose determination for interstitial 125I boost therapy. AB - Iodine-125 implants are being used to boost external beam treatments of unresectable pancreas and lung tumors. Calculations of the 125I activity required to achieve a specific average peripheral dose are presented as a function of the average tumor dimension for spherical, ellipsoidal, and cylindrical implants. Both uniform and random seed spacings are investigated. The results indicate that the average peripheral dose is relatively insensitive to the seed distribution as well as to the seed activity. The average tumor dose is typically 20% greater than the average peripheral dose. PMID- 6865854 TI - Measurement of activity yields for 12C(gamma, n)11C, 14N(gamma, n)13N, and 16O(gamma, n)15O reactions as a function of electron beam energy and angle from the electron beam using thick target produced bremsstrahlung. AB - The calculation of activity yields from practical photonuclear target systems designed to produce short-lived positron emitting radionuclides for nuclear medicine purposes requires certain basic information. These include a knowledge of the photon source (bremsstrahlung energy spectrum and intensity as a function of angle from the electron beam) and the gamma, n activation cross section of the secondary target element. A lack of adequate information concerning these parameters motivated the present study in which activity yields for the reactions 12C(gamma, n)11C, 14N(gamma, n)13N, and 16O(gamma, n)15O were measured as a function of energy of and angle from the electron beam between 16 and 30 MeV and 0 degree and 30.5 degrees, respectively. The data indicate highly complex relationships between the activity yield and the experimental variables. Also indicated are possible applications of the data to indicate the energy of an electron beam producing a given bremsstrahlung field in which activation measurements are made. PMID- 6865856 TI - Some theoretical derivations relating to the tissue dosimetry of brachytherapy nuclides, with particular reference to iodine-125. AB - Using a Monte Carlo computer technique, tables of parameters have been derived which are of use in the dosimetry of brachytherapy nuclides in a variety of tissues and organs. From the results, it has been possible to derive relationships linking the composition of a tissue with the dose received at any location around an implanted source. Other factors, such as the relative importance of scattered radiation, spectral degradation, and integral dose, are also discussed. In particular, attention is drawn to possible dosimetric problems arising from the clinical use of 125I. PMID- 6865858 TI - Saturation curves of parallel-plate ionization chambers. AB - A new analytical expression is presented to describe the full saturation curve of parallel-plate ionization chambers. In contrast to the presently known expressions, which hold only for the near saturation region, this empirically determined expression is in excellent agreement with measurements in the whole collection efficiency range from 0 to 1 for x-ray sources with effective energies from 20 to 150 keV and cobalt-60 gamma rays. The dependence of the ion collection efficiency and the extrapolated electric field, which is a parameter in the new saturation curve expression, on electric field, dose, dose rate, beam quality, and chamber volume, is discussed. The effect of photoemission from the chamber polarizing electrode for low-energy x-ray beams on the saturation current is demonstrated. A universal ionization chamber constant is derived experimentally. It is shown that all parameters of the saturation curve equation and thus the saturation curve itself, can be calculated from one single measurement of ionization current at a given electric field and air gap thickness. PMID- 6865859 TI - Monte Carlo estimates of specific absorbed fractions for an I-125 point source in water. PMID- 6865857 TI - Bubble dissolution physics and the treatment of decompression sickness. AB - The treatment of decompression sickness often involves both recompressing the victim and administering hyperbaric oxygen in the hope of more rapidly dissolving the bubbles which cause this malady. Although many hundreds of such treatments are conducted each year in the United States alone, the underlying physical principles governing the dissolution of such bubbles are not well understood and only empirically tested. In this paper, we present a mathematical theory of bubble dissolution that is verified by comparison with laboratory experiments. This theory suggests that the commonly employed treatment techniques would be only marginally effective, and that in many situations the bubbles that cause the disease cannot be adequately dissolved using existing techniques and facilities. PMID- 6865860 TI - A new approach to CT pixel-based photon dose calculations in heterogeneous media. AB - The effects of small cavities on dose in water and the dose in a homogeneous nonunit density medium illustrate that inhomogeneities do not act independently in photon dose perturbation, and serve as two constraints which should be satisfied by approximate methods of computed tomography (CT) pixel-based dose calculations. Current methods at best satisfy only one of the two constraints and show inadequacies in some intermediate geometries. We have developed an approximate method that satisfies both these constraints and treats much of the synergistic effect of multiple inhomogeneities correctly. The method calculates primary and first-scatter doses by first-order ray tracing with the first-scatter contribution augmented by a component of second scatter that behaves like first scatter. Multiple-scatter dose perturbation values extracted from small cavity experiments are used in a function which approximates the small residual multiple scatter dose. For a wide range of geometries tested, our method agrees very well with measurements. The average deviation is less than 2% with a maximum of 3%. In comparison, calculations based on existing methods can have errors larger than 10%. PMID- 6865861 TI - A detailed experimental and theoretical comparison of the angular and energy dependencies of grid transmission. AB - Grid transmission characteristics have been predicted, with good agreement demonstrated between experiment and theory. Differences between the present work and an earlier theoretical analysis have been noted. It is shown that comparison between experiment and theory can lead to a sensitive method for determining grid parameters. Generally, the derived grid parameters deviate somewhat from manufacturer supplied data. Use of the manufacturer's nominal parameters can lead to large errors in predicting grid transmission. PMID- 6865862 TI - Equipment for the clinical application of local microwave hyperthermia. PMID- 6865863 TI - On competitive failure modes and the usefulness of a "survival curve point of view". PMID- 6865864 TI - Quantitative determination of tolerance doses for preoperative and postoperative radiotherapy of bones. AB - A method has been developed for the quantitative determination of the tolerance doses for preoperative and postoperative radiotherapy of bones in New Zealand white rabbits. The midshaft osteotomy was carried out on both ulnae of each rabbit. Localized radiation of 2000, 3000, and 4000 rad (20, 30, and 40 Gy) was given in daily fractions of 500 rad to different groups of rabbits. The diaphyseal area of one forearm of each rabbit was irradiated and the other forearm was used as a control. After healing, the mechanical strength of each ulna was measured. The end point is defined as "strength reduction dose-63" (SRD63), i.e., the dose which would be expected to reduce the mechanical strength of the irradiated, fractured, and healed bone compared with the contralateral unirradiated diaphysis by 63%. The SRD63's for preoperative and postoperative radiotherapy were 4350 rad (43.5 Gy) and 6200 rad (62 Gy), respectively, with a 500 rad (5 Gy)/fraction schedule. Through the use of the nominal standard dose (NSD) formula at 300 rad (3 Gy)/fraction and five fraction per week, these SRD63's are equivalent to 5700 rad (57 Gy) and 8100 rad (81 Gy), respectively. PMID- 6865865 TI - Regional silver content of radiographic film determined by x-ray fluorescence compared with optical densitometry. AB - The regional silver content of radiographic film measured by x-ray fluorescence is compared to light absorption measured by a densitometer. Silver content analysis appears to permit a greater dynamic range of useful exposure levels than does light absorption densitometry. This improvement in latitude, however, is not considered great enough to warrant development of a complex system for scanning silver distribution in radiographic applications. PMID- 6865867 TI - A study of problems with inventory control of I-125 seeds. PMID- 6865866 TI - Feasibility of noninvasive analysis of lead in the human tibia by soft x-ray fluorescence. AB - A postmortem study was conducted to assess the feasibility of measuring bone lead concentrations noninvasively in vivo. Characteristic L x rays were induced with an external source of 125I in the superficial tibial cortex of the intact legs of six adults who had no history of occupational exposure to lead. Tibial lead concentrations in the same bones subsequently determined by flameless atomic absorption spectroscopy varied from 15 to 35 micrograms Pb/g wet weight. The upper limit for the modern normal range of lead in the bone is about 25 mg Pb/g wet tissue. The linear correlation coefficient (r) between the measurements made with x-ray fluorescence and lead concentration by absorption spectroscopy was 0.90. Radiation doses of 10 mGy (1 rad) to 1 cm2 of skin, with associated doses to the marrow of adjacent bone of about 0.6 mGy (60 mrad), yielded net lead fluorescence signals ranging from one to seven times the standard deviation of background. PMID- 6865868 TI - Repair of the energy slit on an AECL Therac-20 accelerator. PMID- 6865869 TI - [Blood sodium and febrile convulsions. Study on 92 children]. PMID- 6865870 TI - [Analysis of urinary hexoseaminidases for the determination of Tay-Sachs disease]. PMID- 6865871 TI - [Plagiocephaly. A rare form of craniosynostosis]. PMID- 6865872 TI - [Diagnosis of XO-XX mosaicism with coarctation of the aorta]. PMID- 6865873 TI - [Description of an unusual case of congenital mitral-aortic valvulopathy]. PMID- 6865874 TI - [Pseudoxanthoma elasticum]. PMID- 6865875 TI - [Biochemical study of variations of collagen and elastin in arthrogryposis multiplex congenita]. PMID- 6865876 TI - [Megapolycalicosis. Report of a new case]. PMID- 6865877 TI - [Methylmalonic acidemia. A new method of diagnosis]. PMID- 6865878 TI - [Abdominal echography in childhood]. PMID- 6865879 TI - [Lymphatic cysts of the mesentery in childhood]. PMID- 6865882 TI - [A case of the Kawasaki syndrome]. PMID- 6865881 TI - [Changes in cardiac rhythm and conduction of a familial hereditary nature. Apropos of a case]. PMID- 6865880 TI - [Right of the adolescent to health protection according to Italian legislation]. PMID- 6865883 TI - [Gold salts in the therapy of juvenile rheumatoid arthritis]. PMID- 6865884 TI - Spontaneous umbilical cord hematoma. A rare cause of fetal death. PMID- 6865887 TI - Detachable balloon occlusion of carotid-cavernous fistulas. PMID- 6865886 TI - Evaluation of recurrent respiratory tract infections in children. PMID- 6865885 TI - Recurrent episodes of spontaneously resolving hyperthyroidism due to thyroiditis. PMID- 6865888 TI - Cardiac involvement in progressive systemic sclerosis (scleroderma). PMID- 6865889 TI - Headache due to spontaneous low spinal fluid pressure. PMID- 6865890 TI - Neonatal resuscitation in high-risk deliveries. A prospective study. PMID- 6865892 TI - Use of Ender nails for peritrochanteric fractures of the hip. PMID- 6865891 TI - Hypertension in the elderly. PMID- 6865893 TI - The effect of phenylalanine derivatives on the solubility of deoxyhemoglobin S. A model class of gelation inhibitors. AB - Among the class of non-covalent inhibitors of deoxyhemoglobin S gelation, the aromatic amino acids have been shown to be the most effective. We have examined several synthetic chemical modifications of phenylalanine in order to determine the stereospecific constraints for inhibition of gelation by this class of compounds. The phenylalanine derivatives with ring modification by electron donating groups (NH2, CH3, or OH) inhibited gelation to the same order of magnitude as phenylalanine (10-20% increase in deoxyhemoglobin S solubility at 32 mM). The phenylalanine derivative with the electron-withdrawing group NO2 in the p-position behaved similarly, but the inhibitory effect was eliminated by NO2 in the m- and possibly o-positions. Furthermore, side-chain modifications also eliminated the inhibitory effect. These studies, in conjunction with crystallographic analyses of the binding sites of gelation inhibitors, may provide a rational strategy for finding suitable compounds (whether covalent or non-covalent inhibitors) with appropriate physicochemical and biological properties to pursue as potential therapies with sickle cell disease. PMID- 6865895 TI - Prostaglandins and cannabis. XII. The effect of cannabinoid structure on the synthesis of prostaglandins by human lung fibroblasts. AB - Earlier findings indicated that several other cannabinoids in addition to delta 1 tetrahydro-cannabinol (THC) were able to stimulate the synthesis of prostaglandins in cell culture systems. The present study was initiated to delineate the structural requirements for this effect within the cannabinoid series. Among the primary cannabinoids, we found that the trend was for more planar structures to show greater activity. In the case of THC metabolites, the order of activity was delta 1-THC greater than 7-oxo-delta 1, 6-THC greater than 7-OH-delta 1-THC greater than 3"-OH-delta 1-THC = 6 beta-OH-delta 1-THC = 6 alpha OH-delta 1-THC greater than delta 1, 6-THC-7-oic acid. The latter sequence compares favorably with the available data on the behavioral assay in the rhesus monkey and the subjective "high" in humans. We also observed a good correlation between the release of arachidonic acid and the production of prostaglandin E, over a series of eight cannabinoids. This gives further support that the site of action in this effect is the elevation of activity of the phospholipase(s) responsible for supplying precursor arachidonic acid for prostaglandin synthesis. PMID- 6865894 TI - Metabolic clearance rate of dopamine beta-hydroxylase in the rat. AB - The metabolic clearance rate (MCR) of both bovine and rat dopamine beta hydroxylase (DBH) preparations was measured using two complementary procedures, pulse-dose injection and constant infusion of enzyme into the rat circulation. Rats that received injections of DBH activity had plasma DBH activity levels similar to those of controls by 24 hr after a pulse dose of rat DBH. The DBH MCR computed by stochastic analysis of the disappearance curve of injected DBH activity was about 1.0 ml/hr/100 g body weight; the mean transit time of DBH was about 8 hr. The disappearance curve of heterologous enzyme (bovine DBH) was more rapid than that of the rat, yielding an MCR of about 8 ml/hr/100 g body weight. MCR values obtained with the constant-infusion technique were similar to those obtained with the pulse-dose technique. These kinetic parameters are consistent with the time frame for altered plasma DBH activity observed with pharmacological and endocrinological factors. These data support the conclusion that plasma DBH turnover time is measured in hours, not days. PMID- 6865896 TI - Conformations of fortimicins and three-dimensional structure-activity relationship in the aminoglycoside antibiotics. AB - The fortimicins are pseudodisaccharide antibiotics consisting of purpurosamine and fortamine moieties which are connected through an alpha-linkage. NMR spectra indicate that the fortamine ring in fortimicin A takes a chair conformation which corresponds to an inverted one in the conformation of fortimicin B free base. Fortimicin A is unstable in solution, and we were unable to obtain any crystals of it. To elucidate the structure of fortimicin A and to clarify the stereochemistry of fortimicins, we have undertaken to calculate their empirical force-fields starting from the X-ray structures of fortamines and fortimicin B free base. Nuclear Overhauser enhancement data were also employed to confirm the calculated relative orientation of the two rings around the glycosidic linkage. The 3-dimensional structure-activity relationship of aminoglycoside antibiotics is discussed on the basis of these results. PMID- 6865897 TI - Correlation of structure and activity in ansamycins. Molecular structure of sodium rifamycin SV. AB - The crystal and molecular structure of the sodium salt of rifamycin SV (clinically known as rifacin) as the monohydrate ethanol solvate has been determined to study the conformation of the ansa chain in unsubstituted rifamycins and also to clarify the metal complexation with rifamycins. The crystals belong to the space group P2(1)2(1)2(1) with cell dimensions (estimated standard deviations in parentheses) of a = 12.061 (2), b = 13.936 (2), and c = 24.731 (4) A. The structure was solved by direct methods and refined to an R factor of 0.069. The conformation of the ansa chain differs from that of other active rifamycins, e.g., rifampcin and rifamycin B at the joining point of the ansa chain to the naphthohydroquinone chromophore. The conformation of the middle part of the ansa chain, which is essential for activity against DNA-dependent RNA polymerase, remains the same. The sodium ion is penta-coordinated and has a trigonal bipyramidal geometry. The intermolecular hydrogen bonding involves O(9), O(10), O(5), and O(6) through water and ethanol molecules. A two-step mode of action of rifamycins has been postulated, and the conformations of antibiotics suitable for penetration of the membrane barrier and that for antibiotic-enzyme complex formation have been suggested. PMID- 6865898 TI - 3-O-methyl-D-glucose uptake in isolated rat hepatocytes. Effects of dexamethasone. AB - We examined the uptake of 3-O-methyl-D-glucose, a nonmetabolizable hexose, by isolated rat hepatocytes. The uptake of 3-O-methyl-D-glucose was linear for 1 min at 22 degrees, and Lineweaver-Burk analysis demonstrated an apparent Km of approximately 6 mM. Cytochalasin B (40 microM) and phloridzin (2 mM) inhibited 3 O-methyl-D-glucose uptake by 88% and 63%, respectively. D-Glucose (20 mM) inhibited the initial rate of 3-O-methyl-D-glucose uptake by 55% (p less than 0.001), whereas L-glucose was without any significant effect. The uptake of 3-O methyl-D-glucose remained unchanged in the presence of Na+ (0-150 mM) in the incubation medium. After 30 min dexamethasone inhibited glucose uptake (the maximal effect being achieved in a time- and concentration-dependent manner) at 2 microM and 0.5 microM concentrations by 50% and 25%, respectively. Dexamethasone produced a decrease in the Vmax but did not change the Km. Insulin, glucagon, gastric inhibitory polypeptides, and pancreozymin had no effect on 3-O-methyl-D glucose uptake in isolated hepatocytes. These findings are consistent with the conclusion that 3-O-methyl-D-glucose uptake in isolated rat hepatocytes occurs via a stereospecific, carrier-mediated, facilitated diffusion process. Dexamethasone decreases this process of facilitated diffusion in the isolated hepatocyte. PMID- 6865900 TI - Quantitative structure-activity study on the mechanism of inhibition of microsomal p-hydroxylation of aniline by alcohols. Role of steric factors. PMID- 6865899 TI - Differential destruction of cytochrome P-450-dependent monooxygenases in rat and mouse kidney following hexachloro-1:3-butadiene administration. PMID- 6865901 TI - Xylene induces a cytochrome P-450 isozyme in rat liver similar to the major isozyme induced by phenobarbital. AB - Rats pretreated with xylene or phenobarbital, and then exposed to n-hexane, exhibited a markedly increased peak serum concentration of the neurotoxic metabolite 2,5-hexanedione. In order to elucidate the mechanism underlying this synergistic effect, the major liver microsomal cytochrome P-450 isozymes induced by xylene and phenobarbital, respectively, were purified. In a reconstituted system both isozymes showed a high enzymatic activity with n-hexane as the substrate. Turnover numbers for the formation of 2-hexanol were 24 and 27 for the xylene- and phenobarbital-induced isozyme, respectively. The turnover numbers for 7-ethoxycoumarin, benzo[a]pyrene, and 1,1,2,2-tetrachloroethane were also in the same range for the two cytochrome P-450 preparations. The isozyme induced by xylene had an amino acid composition very similar to that of the phenobarbital induced isozyme, and the purified proteins had identical electrophoretic mobilities on polyacrylamide gels in the presence of sodium dodecyl sulfate. Furthermore, similar peptide maps were obtained following digestion with alpha chymotrypsin and papain, and each isozyme yielded a single immunoprecipitin band upon reaction with the immunoglobulin G fraction from rabbits immunized with the phenobarbital-induced enzyme. We conclude that xylene induces a rat liver microsomal cytochrome P-450 isozyme very similar to the major isozyme induced by phenobarbital and that this induction is the probable explanation for the enhanced formation of 2,5-hexanedione from n-hexane in vivo. PMID- 6865903 TI - Changes in synaptic membrane order associated with chronic ethanol treatment in mice. AB - The fluidity of brain synaptosomal plasma membranes (SPM) from ethanol-treated mice and control mice was investigated by a sensitive EPR technique. Mice were made tolerant to and physically dependent on ethanol by 3 days of continuous exposure to ethanol vapor. Daily injections of pyrazole were used to stabilize the blood alcohol levels. At the time of withdrawal, SPM were prepared and spin labeled with 5-, 12-, or 16-doxylstearic acid. "Baseline" order parameters were measured in the absence of added alcohol. The chronic ethanol treatment produced a significant increase in the baseline order parameter that could be detected with the 12-doxyl probe. This indicates a more rigid membrane associated with the withdrawal hyperexicitability. Baseline order parameters measured with the 5 doxyl probe (near the bilayer surface) or with the 16-doxyl probe (near the bilayer interior) were not affected by the chronic ethanol treatment. When ethanol or t-butanol was added in vitro to membranes labeled with the 5- or 12 doxyl probe, a membrane component of tolerance was revealed; that is, the SPM from ethanol-treated mice required more alcohol to reduce the membrane to a given disordered state. The SPM content of cholesterol and phospholipid was not affected by the chronic ethanol treatment. PMID- 6865902 TI - Effect of calmodulin and calmodulin antagonists on the Ca2+ uptake by the intracellular Ca2+-accumulating system of guinea pig peritoneal macrophages treated with saponin. PMID- 6865904 TI - Phospholipase A2 inhibitors block catecholamine secretion and calcium uptake in cultured bovine adrenal medullary cells. AB - Phospholipase A2 is a calcium-dependent enzyme which produces membrane fusogens. The possibility that it may be involved in exocytosis of catecholamine from primary dissociated cultures of bovine adrenal medullary cells was investigated by studying the effects on catecholamine secretion and 44Ca2+ uptake of three phospholipase A2 inhibitors: p-bromophenacyl bromide (BPB), Upjohn Compound 1002, and mepacrine. The three compounds completely inhibited catecholamine secretion induced by the nicotinic agonist 1,1-dimethyl-4-phenylpiperazinium (DMPP), elevated K+, and Ba2+. The inhibition of nicotinic agonist-induced secretion by mepacrine may have been caused by direct nicotinic antagonist activity of the drug. The phospholipase inhibitors also inhibited 45Ca2+ uptake into the cells stimulated by DMPP and elevated K+. Inhibition of 45Ca2+ uptake and catecholamine secretion exhibited identical dose-response curves. Other effects of the inhibitors were also investigated. Compound 1002 had no effect on 45Ca2+ efflux from the cells in the presence of either normal or reduced Na+ concentrations. BPB inhibited DMPP-stimulated phosphorylation of tyrosine hydroxylase which, like exocytosis, is dependent on a rise in cytosolic Ca2+. The data suggest that phospholipase A2 inhibitors block catecholamine secretion from intact chromaffin cells by blocking Ca2+ influx. PMID- 6865905 TI - Modification of the binding properties of muscarinic receptors by gallamine. AB - The interaction of gallamine with muscarinic receptors from different tissues has been investigated. Gallamine binds to a site distinct from the conventional muscarinic ligand binding site and modulates the binding of agonists and antagonists to the conventional binding site. In agreement with reported pharmacological studies, the effects of gallamine on the binding of muscarinic ligands are much greater in heart than in other tissues. These findings suggest the possibility of developing novel and selective muscarinic drugs. PMID- 6865906 TI - [3H]tetrahydrotrazodone binding. Association with serotonin binding sites. AB - High (17 nM) and low (603 nM) affinity binding sites for [3H]tetrahydrotrazodone ([3H] THT), a biologically active analogue of trazodone, have been identified in rat brain membranes. The substrate specificity, concentration, and subcellular and regional distributions of these sites suggest that they may represent a component of the serotonin transmitter system. Pharmacological analysis of [3H]THT binding, coupled with brain lesion and drug treatment experiments, revealed that, unlike other antidepressants, [3H] THT does not attach to either a biogenic amine transporter or serotonin binding sites. Rather, it would appear that [3H]THT may be an antagonist ligand for the serotonin binding site. This probe may prove of value in defining the mechanism of action of trazodone and in further characterizing serotonin receptors. PMID- 6865907 TI - A portion of [3H]cocaine binding in brain is associated with serotonergic neurons. AB - Three lines of evidence are brought forward in support of an association in the brain cortex of some, but not all, of the cocaine binding sites with serotonergic nerve terminals. The first is based upon the significant correlation observed between the inhibition of cocaine binding by various drugs and the inhibition of neuronal uptake of serotonin in the mouse cerebral cortex. The second is based upon the demonstration of cocaine binding in human blood platelets, a model system for central serotonergic neurons. The third comes from experiments in which rats were treated with p-chloroamphetamine and 5,7-dihydroxytryptamine (serotonin neurotoxins), 6-hydroxydopamine (catecholamine neurotoxin), or p chlorophenylalanine (inhibitor of tryptophan hydroxylase). Only the serotonin neurotoxins decreased the binding of [3H]cocaine in the rat cerebral cortex, but to a lower extent than the binding of [3]imipramine, which is known to be associated with serotonergic terminals. In contrast to the cocaine binding in the mouse cerebral cortex, the binding in the rat cerebral cortex included a considerable portion of low-affinity binding that was relatively unaffected by lesions of serotonergic neurons. PMID- 6865908 TI - Ionization processes of some harmala alkaloids. AB - The ionization and UV-visible spectral properties of some harmala alkaloids have been investigated spectrophotometrically. Harmaline and harmine were found to have pKa values of 9.55 +/- 0.04 and 7.45 +/- 0.03, respectively. The ionization of harmalol was characterized by two processes which could be spectrophotometrically isolated from one another, allowing pKa values of 8.62 +/- 0.15 and 11.30 +/- 0.23 to be determined. The lower of these was ascribed to the phenolic group and the higher to the enamino site. Support for this assignment lay in the yellow color (lambda max 433 nm) at intermediate pH values, which was typical of a formally neutral quinone-methide structure. For harmol, pKa values of 7.90 and 9.47, reported at 21 degrees by Perrin [N.Z.J. Sci. Technol. 388:688 694 (1957)], were reassigned with the lower value reflecting phenolic ionization, as opposed to the original literature assignment. Partition coefficients at pH 7.4 (n-heptane/water) were determined. The comparative pharmacology of these alkaloids is discussed and related to both their pKa values and the relative stability of the neutral quinone-methide structure. PMID- 6865909 TI - High-affinity dextromethorphan binding sites in guinea pig brain. II. Competition experiments. AB - Binding of dextromethorphan (DM) to guinea pig brain is stereoselective, since levomethorphan is 20 times weaker than DM in competing for DM sites. In general, opiate agonists and antagonists as well as their corresponding dextrorotatory isomers are weak competitors for tritiated dextromethorphan ([3H]DM) binding sites and display IC50 values in the micromolar range. In contrast, several non narcotic, centrally acting antitussives are inhibitory in the nanomolar range (IC50 values for caramiphen, carbetapentane, dimethoxanate, and pipazethate are 25 nM, 9 nM, 41 nM, and 190 nM, respectively). Other antitussives, such as levopropoxyphene, chlophedianol, and fominoben, have poor affinity for DM sites whereas the antitussive noscapine enhances DM binding by increasing the affinity of DM for its central binding sites. Additional competition studies indicate that there is no correlation of DM binding with any of the known or putative neurotransmitters in the central nervous system. DM binding is also not related to tricyclic antidepressant binding sites or biogenic amine uptake sites. However, certain phenothiazine neuroleptics and typical and atypical antidepressants inhibit binding with IC50 values in the nanomolar range. Moreover, the anticonvulsant drug diphenylhydantoin enhances DM binding in a manner similar to that of noscapine. Preliminary experiments utilizing acid extracts of brain have not demonstrated the presence of an endogenous ligand for DM sites. The binding characteristics of DM sites studied in rat and mouse brain indicate that the relative potencies of several antitussives to inhibit specific DM binding vary according to species. High-affinity, saturable, and stereoselective [3H]DM binding sites are present in liver homogenates, but several differences have been found for these peripheral binding sites and those described for brain. Although the nature of central DM binding sites is not known, the potent interaction of several classes of centrally acting antitussives with DM sites suggests that they may be related to the mechanism of action of this drug. PMID- 6865910 TI - Ion movements in isolated bovine adrenal medullary cells treated with ouabain. AB - In the previous paper [Mol. Pharmacol. 23:671-680 (1983)] it was shown that ouabain enhances the exocytotic release of catecholamines from isolated bovine adrenal medullary cells. This effect is dependent upon extracellular sodium, but persists in the nominal absence of calcium. In this paper the study has been extended to include an investigation of the effects of ouabain on the fluxes of 86Rb, 42K, 24Na, and 45Ca in these cells. The basic features of the chromaffin cell sodium pump are characterized, and it is shown for the first time that both the pump itself (i.e., the kinetics and properties of transport) and its inhibition by ouabain resemble those of squid axons and erythrocytes. However, serious doubts are cast upon the often-stated possibility that there is a direct link between sodium pump inhibition and exocytotic secretion because parallel measurements of both phenomena have, for example, shown that while the secretory effect of ouabain is sodium-dependent, pump inhibition is not. Instead, an entirely different explanation is suggested by the discovery that ouabain produces a marked decrease in the rate of active calcium extrusion from chromaffin cells, under all conditions in which catecholamine secretion is enhanced. This inhibition seems not to be accompanied by any change in calcium influx, and may therefore provide a direct explanation for the rise in free calcium which is required to stimulate exocytosis in this tissue. PMID- 6865911 TI - Interaction of metal-complexing compounds with lymphocytes and lymphoid cell lines. AB - A variety of metal-complexing flavonoids (beta-hydroxyethyl rutoside, catechin, naringin, taxifolin, and quercetin) as well as several compounds which form mainly iron complexes (bathophenathroline, bathophenanthrolinebisulfonic acid, desferri-ferrioxamine B, ethylenediamine-di-o-hydroxyphenylacetic acid) were tested for their effects on mitogen-free and mitogen-activated mouse splenocyte cell cultures and on two human cell lines (Daudi, Bristol-8). The compounds strongly inhibited the incorporation of [3H]thymidine into DNA at agent concentrations ranging from 10 to 500 microM. On the other hand, at subinhibitory concentrations, slightly enhancing or synergistic effects were observed. We conclude that immune cell behavior can be bidirectionally influenced by the presence of metal-complexing agents, depending on their concentration in the medium. PMID- 6865912 TI - Tumor-promoting and nonpromoting proinflammatory esters act as human lymphocyte mitogens with different sensitivities to inhibition by cyclosporin A. AB - Ten closely related tumor-promoting and nonpromoting, proinflammatory phorbol derivatives were tested for stimulation of [3H]thymidine ( [3H]TdR) incorporation into human mononuclear cells. Co-mitogenic activity was assessed with maximally effective concentrations of phytohemagglutinin (PHA) or mixed-lymphocyte reactions (MLR) in the presence of phorbol esters. Tetradecanoyl phorbol acetate (TPA), two 4-deoxyphorbol esters, and two 12-deoxyphorbol monoesters stimulated [3H]TdR incorporation in a dose-related manner. Two established nonpromoting 12 deoxyphorbol diesters were also mitogenic, although less effective than TPA, and produced lower maximal responses. TPA, the 4-deoxyphorbol esters, the 12 deoxyphorbol monoesters, and the two nonpromoting diesters were able to increase MLR-induced incorporation to the same level. When conditions were used where PHA and phorbol esters were optimally mitogenic, inhibition resulted. With the exception of co-mitogenic activity of the nonpromoting diesters, the mitogenic, co-mitogenic, and PHA-inhibiting activities were correlatable. Phorbol, a 4 alpha deoxyphorbol ester, and resiniferatoxin had no effects. Mitogenic activity of the phorbol esters was inhibited by dexamethasone, chloroquine, and p-bromophenacyl bromide. TPA, the 4-deoxyphorbol esters, and the 12-deoxyphorbol monoesters were resistant to inhibition of activity by cyclosporin A, whereas the noncorrelating diesters exhibited sensitivity to cyclosporin A inhibition comparable to that of PHA. MLR-induced [3H] TdR incorporation was susceptible to cyclosporin A, but the phorbol ester-enhanced responses were cyclosporin A-resistant. PMID- 6865914 TI - Inhibition of brain carboxylesterases by neurotoxic and nonneurotoxic organophosphorus compounds. AB - Carboxylesterases (EC 3.1.1.1) of chicken brain were investigated by applying kinetic analysis of organophosphorus inhibition. By iterative elimination of exponential inhibition curves and by sequential inhibition experiments using a combination of two organophosphorus inhibitors, 11 different carboxylesterases of chicken brain were characterized with respect to their phenyl valerate hydrolyzing activity (milliunits per gram of brain) and their inhibition by O,O diethyl O-4-nitrophenyl phosphate (Paraoxon), O,O-diisopropylphosphorofluoridate, and N,N'-diisopropylphosphorodiamidic fluoride (Mipafox). The bimolecular inhibition rate constants (liters . mole-1 . min-1) were calculated for the 11 enzymes and 3 organophosphorus compounds. The corresponding data for acetylcholinesterase (EC 3.1.1.7) in chicken brain were determined. The importance of inhibition rate constants for the development of acute cholinergic symptoms, delayed neurotoxicity, and atypical organophosphate effects is shown. PMID- 6865913 TI - Modulation of the metabolism and cytotoxicity of iododeoxyuridine by 5'-amino-5' deoxythymidine. AB - In HeLa and Vero cells the antiproliferative effects of iododeoxyuridine (IdUrd) were modulated in a biphasic manner by 5'-amino-5'-deoxythymidine (5'-AdThd). Low concentrations of 5'-AdThd increased the cytotoxicity of IdUrd whereas high concentrations of 5'-AdThd were antagonistic. Opposing effects on two enzymes, thymidine kinase (EC 2.7.1.21) and thymidylate kinase (EC 2.7.4.9), account for this unusual biphasic interaction. In the case of thymidine kinase, 5'-AdThd was found to antagonize the feedback inhibition which is normally exerted by the 5' triphosphates of thymidine and IdUrd. Consequently, 5'-AdThd increased the rate of IdUrd phosphorylation. This stimulation (deinhibition) of enzyme activity was demonstrable in cell-free extracts and with a purified preparation of thymidine kinase provided that the 5'-triphosphates of IdUrd or thymidine were present. In their absence only enzyme inhibition was detected. In intact cells this stimulatory effect of 5'-AdThd was seen as a rapidly apparent, sustained increase in the steady-state levels of the phosphorylated IdUrd metabolites. As a result, IdUrd cytotoxicity was increased. Under these conditions, 5'-AdThd did not alter the relative abundance of the mono-, di-, and triphosphates of IdUrd. However, as the concentration of 5'-AdThd was raised, the percentage of IdUrd nucleotides present as iododeoxyuridylate increased dramatically. Corresponding reductions in the incorporation of IdUrd into cellular DNA and the associated cytotoxic effects were seen. These data suggested a second site of interaction, thymidylate kinase, the enzyme responsible for the conversion of iododeoxyuridylate to the diphosphate. In experiments measuring thymidylate kinase activity in cell-free extracts, 5'-AdThd effectively inhibited the phosphorylation of iododeoxyuridylate but not that of thymidylate. Additionally, 5'-AdThd did not produce an accumulation of thymidylate in intact cells. Thus, the ability of high concentrations of 5'-AdThd to antagonize the cytotoxicity produced by IdUrd without concomitantly inhibiting the phosphorylation of thymidylate and, thereby, reducing DNA synthesis was explained. Although the modulation of IdUrd metabolism produced by 5'-AdThd was qualitatively similar in Vero and HeLa cells, key quantitative differences were evident. Thus, 100 microM 5'-AdThd stimulated the uptake of 3 microM IdUrd in Vero cells but it was inhibitory in HeLa cells. Perturbation of nucleoside metabolism by agents such as 5'-AdThd may provide an important new way to achieve selective toxicity in cancer chemotherapy. PMID- 6865915 TI - Effects of nitrous oxide and methotrexate administration on hepatic methionine synthetase and dihydrofolate reductase activities, hepatic folates, and formate oxidation in rats. PMID- 6865916 TI - Identification of 2-imidazolines as anti-sickling agents. AB - The drugs tolazoline, clonidine, lofexidine, and fenmetozole were found to inhibit the gelation of hemoglobin S in the order of increasing effectiveness. Only the latter, however, reduced the sickling of red cells significantly and normalized the oxygen affinity of SS blood at 5-10 mM concentrations. Since this level of drug is lower than those reported for many other anti-sickling agents to achieve comparable effects, the 2-imidazoline class of compounds may provide important clues for the development of therapy for sickle cell anemia. PMID- 6865917 TI - Interaction of constitutive and phenobarbital-induced cytochrome P-450 isozymes during the sequential oxidation of benzphetamine. Explanation for the difference in benzphetamine-induced hydrogen peroxide production and 455-nm complex formation in microsomes from untreated and phenobarbital-treated rats. AB - The following pathway for benzphetamine (Bz) metabolism in rat hepatic microsomes was established: Bz leads to norbenzphetamine (NorBz) leads to N hydroxynorbenzphetamine leads to N-benzylethyl-alpha-phenylnitrone leads to 2 nitroso-1-phenylpropane. The last product forms a complex with cytochrome P-450 with an absorbance maximum at 455 nm. Steps 1, 2, and 4 are cytochrome P-450 dependent; Step 3 appears to involve the flavoprotein, mixed-function amine oxidase. Step 2 is partially uncoupled, producing H2O2 at approximately 3 times the rate of N-hydroxylation. Bz is oxidized to NorBz in microsomes from both untreated rats (U-microsomes) and phenobarbital (PB)-treated rats (PB microsomes), but the 455-nm peak does not appear in U-microsomes until almost all of the Bz has been converted to NorBz; i.e., Bz inhibits the oxidation of NorBz in U- but not in PB-microsomes. The inhibition is competitive. Bz inhibits the oxidation of the nitrone to 2-nitroso-1-phenylpropane in both U- and PB microsomes; NorBz inhibits this reaction in U-microsomes only. These results can be explained as follows. The substrate affinities of the cytochrome P-450 primarily responsible for the N-demethylation of Bz in U- and PB-microsomes differ markedly. The constitutive cytochrome(s) in U-microsomes has a high affinity for Bz; PB induces both this form and a cytochrome(s) with a lower affinity for Bz. The substrate affinities of these two cytochromes P-450 for NorBz do not differ appreciably. Thus, although both forms of cytochrome P-450 can oxidize Bz and NorBz in PB-microsomes, Bz is primarily oxidized by the constitutive form, whereas NorBz is oxidized primarily by the induced form, thereby relieving competition and increasing the over-all sequential oxidation of Bz. The nitrone appears to be oxidized exclusively by the constitutive form in both U- and PB-microsomes. The current study shows that PB induction of monooxygenase activity need not be due entirely to an increase in the amount of cytochrome P-450 or the substrate selectivity of cytochrome P-450 isozyme(s) responsible for that activity, but that, in at least one case, the metabolism of Bz, PB-induced activity can be due, at least in part, to the induction of a cytochrome P-450 isozyme that relieves substrate inhibition. PMID- 6865918 TI - Cysteine conjugate beta-lyase. AB - Cysteine conjugate beta-lyase from rat liver, an enzyme participating in a shunt from mercapturic acid synthesis, has been purified and found to be active with a number of compounds that bear nonpolar leaving groups on the beta-carbon of an amino acid substrate. Pyridoxal phosphate is considered to be a participant in the reaction. In addition to aromatic thioethers of cysteine, the enzyme is also active with two aliphatic amino acid derivatives, S-1,2-dichlorovinyl-L-cysteine and beta-chloroalanine. Evidence is presented that catalysis results in "suicide" inhibition with a partition ratio of about 600 for each of the substrates. PMID- 6865919 TI - Biosynthesis of tetrahydrobiopterin in the presence of dihydrofolate reductase inhibitors. AB - Since there is no nutritional requirement for the biopterin cofactor, we attempted to create a drug-induced deficiency in rats in order to study the role of tetrahydrobiopterin in regulating the biosynthesis of dopamine and serotonin. The hypothesis that dihydrofolate reductase (EC 1.5.1.3) mediates the final step in the de novo synthesis of tetrahydrobiopterin was tested by treating rats with methotrexate along with leucovorin as a protective agent; there was no reduction in total biopterin or in the fraction present as tetrahydrobiopterin in adrenal medulla, adrenal cortex, pituitary, brain, or pineal glands. Similar results were obtained with metoprine, a lipid-soluble inhibitor of dihydrofolate reductase which readily enters the central nervous system. Treatment with loading doses of phenylalanine along with methotrexate reduced the level of tetrahydrobiopterin in liver. Neuroblastoma N115 cells growing in medium supplemented with thymidine and hypoxanthine continued to form normal amounts of tetrahydrobiopterin in the presence of concentrations of methotrexate which completely inhibited dihydrofolate reductase; higher concentrations of methotrexate increased the tetrahydrobiopterin content of the cells 2-fold and the total biopterin in the medium 3-fold. Although attempts to create a drug-induced deficiency were unsuccessful, the evidence indicates that the de novo synthesis of tetrahydrobiopterin proceeds by a pathway independent of dihydrofolate reductase and that folate antagonists, such as methotrexate are unlikely to impair the hydroxylation of tyrosine and tryptophan, which is dependent upon the availability of the biopterin cofactor. PMID- 6865920 TI - Regioselectivity and stereoselectivity in the metabolism of trans-1,2-dihydroxy 1,2-dihydrobenz[a]anthracene by rat liver microsomes. AB - Metabolism of [3H]-(+/-)-trans-1,2-dihydroxy-1,2-dihydrobenz[a] anthracene by liver microsomes isolated from control, phenobarbital-treated, and 3 methylcholanthrene-treated Long-Evans rats and from 3-methylcholanthrene-treated Sprague-Dawley rats was examined. Liver microsomes from both control and phenobarbital-treated rats metabolized the dihydrodiol at a rate of 0.5 nmol/nmole of cytochrome P450 per minute, whereas prior treatment of rats with 3 methylcholanthrene stimulated the rate of metabolism by 4-fold. Prior treatment of the rats caused marked differences in the regio- and stereoselectivity of the metabolism of this pseudo-diaxial dihydrodiol. In each case, the major metabolites were three bis-dihydrodiols and a pair of diastereomeric 1,2-diol-3,4 epoxides in which the benzylic 1-hydroxyl group is either cis or trans to the epoxide oxygen (diol epoxides-1 and -2, respectively). The presence of the diol epoxides in the incubation medium was inferred from the identification of their corresponding tetraols, which arise by hydrolysis of the diol epoxides on chromatography. Hepatic microsomes from control and phenobarbital-treated rats metabolized the 1,2-dihydrodiol predominantly to 1,2-diol-3,4-epoxides (68-85% of the total metabolites) whereas bis-dihydrodiols represented 28% and 13% of the total metabolites, respectively. In contrast, liver microsomes from 3 methylcholanthrene-treated rats of either strain metabolized the 1,2-dihydrodiol primarily to isomeric bis-dihydrodiols (51-56% of total metabolites), with diol epoxides accounting for only 36-38% of the total metabolites. Bis-dihydrodiol-1 (32-35% of the total metabolites) was formed in greater amounts (2- to 4-fold) than either bis-dihydrodiols-2 or -3, which were formed in about equal amounts and have identical absorption spectra. The ratio of the diastereomeric 1,2-diol 3,4-epoxides-1 and -2 was highly dependent upon the preparation used. For microsomes from control and phenobarbital-treated rats, this ratio was between 3:1 and 4:1 whereas microsomes from 3-methylcholanthrene-treated rats (greater than 70% cytochrome P-450c) gave a ratio of between 1:1.5 and 1:2. The basis for this ratio in the latter case was explained by examination of the products formed from the (+)-(1S,2S)-and (-)-(1R,2R)-enantiomers of the dihydrodiol on metabolism by a highly purified system reconstituted with cytochrome P-450c. The (-)-isomer is a 3-fold better substrate than the (+)-isomer and forms only the diol epoxide 2 diastereomer, whereas the (+)-isomer forms much more diol epoxide-1 than diol epoxide-2 diastereomer. PMID- 6865922 TI - Structure-activity relationships in the interactions of alkoxymethylenedioxybenzene derivatives with rat hepatic microsomal mixed function oxidases in vivo. AB - Following in vivo administration to rats of equimolar amounts of a series of 4-n alkoxymethylenedioxybenzene (AMDB) derivatives, hepatic microsomal aryl hydrocarbon hydroxylase (AHH) activities, total cytochrome P-450 levels, and AMDB metabolite-cytochrome P-450 spectral complex (455 nm) formation were well correlated in parabolic relationships with pi, the hydrophobic constant of the n alkoxy substituent. Each of these parameters increased progressively over control values with increasing carbon chain length of the alkoxy substituent, passed through an optimal value in compounds containing five or six carbon atoms, and subsequently decreased with the higher homologues. AHH activity was highly correlated in linear relationships with total (complexed plus uncomplexed) cytochrome P-450 content and intensity of the 455-nm spectral complex. Aminopyrine N-demethylase activities in microsomes from AMDB-treated rats were not well correlated with cytochrome P-450 levels or spectral complex formation. AMDB metabolite-ferricytochrome P-450 complexes varied considerably in their relative ease of displacement following treatment with 2-n-heptylbenzimidazole, those derived from the n-butoxy to n-hexoxy derivatives being particularly stable toward the displacer. The results are discussed in relation to the possible mechanisms involved in the interactions of methylenedioxyphenyl compounds with cytochrome P-450 and drug oxidation. PMID- 6865921 TI - Effect of nitrous oxide and methionine treatments on hepatic S-adenosylmethionine and methylation reactions in the rat. AB - Nitrous oxide administration to experimental animals leads to significant alterations in the hepatic folate pathway. This pathway is closely linked to the metabolism of methionine and S-adenosylmethionine (AdoMet), two compounds that play a central role in biologically important methylation reactions. This study was carried out to assess whether nitrous oxide administration to animals can affect the metabolism of AdoMet and the AdoMet-dependent methylation reactions. Exposure of rats to a mixture of nitrous oxide and oxygen (50:50) for 2 hr reduced hepatic AdoMet levels. However, when methionine was administered to these rats, hepatic AdoMet rapidly increased to levels that were significantly higher than those observed in air-exposed animals. Concomitant with this increase, there was a significant and marked increase in the rate of methylation of phospholipids and carboxymethylation of proteins. Thus, nitrous oxide, in addition to its inhibitory effect on 5-methyltetrahydrofolate:homocysteine methyltransferase (methionine synthase, EC 2.1.1.13) activity, possesses another effect. It increases the rate of conversion of exogenously administered methionine into AdoMet with a subsequent increase in the rate of methylation of key cellular constituents. PMID- 6865923 TI - The relationship between increases in the hepatic content of cytochrome P-450, form 5, and in the metabolism of aromatic amines to mutagenic products following treatment of rabbits with phenobarbital. AB - Treatment of rabbits with phenobarbital is followed by increases in the hepatic microsomal concentration of cytochrome P-450, form 5, and in the hepatic microsomal metabolism of aromatic amines to mutagenic products. Inhibition by antibodies to form 5 of the activation of 2-aminoanthracene and 2-aminofluorene demonstrates that these increases are directly related. The extent of the apparent induction of form 5 by phenobarbital is determined from single radial immunodiffusion, immunostaining of form 5 on nitrocellulose sheets containing microsomal proteins transferred from polyacrylamide gels, and the amount of antibody required for 50% of maximal inhibition of activity. The results indicate that phenobarbital increases the hepatic microsomal concentration of cytochrome P 450, form 5, to the same extent that it increases form 5-mediated metabolism of aromatic amines to mutagenic products: 10- to 12-fold. In contrast to the effects of phenobarbital, treatment of rabbits with beta-naphthoflavone decreases the hepatic microsomal concentration of cytochrome P-450, form 5, to less than detectable levels and has little effect on the metabolism of aromatic amines to mutagenic products. Our findings, along with the known effects of phenobarbital on cytochrome P-450, form 2, and the known catalytic activity of cytochrome P 450, form 4, lead to the following conclusions: (a) treatment of rabbits with phenobarbital results in increases in the hepatic microsomal concentrations of at least two structurally, immunochemically, and catalytically distinct isozymes of cytochrome P-450, forms 2 and 5; (b) the metabolism of aromatic amines to mutagenic products in rabbit hepatic microsomal preparations depends on the relative concentrations of at least two isozymes of cytochrome P-450, forms 4 and 5, that change in response to different inducers. PMID- 6865924 TI - The interaction between full and partial inhibitors acting on a single enzyme. A theoretical analysis. AB - A theoretical analysis has been made of multiple inhibition systems involving a full and a partial inhibitor. This analysis applies to single- and multisubstrate enzyme systems obeying Michaelis-Menten kinetics. It has been shown that a plot of the reciprocal of the enzyme velocity versus the concentration of the full inhibitor, at constant substrate concentration, is linear in either the presence or the absence of a fixed level of the partial inhibitor. If the slope of the plot is increased or unaltered in the presence of a fixed concentration of the partial inhibitor, the two inhibitors are mutually nonexclusive. If the slope of the plot is decreased, the two inhibitors may be either mutually exclusive or nonexclusive. When a decrease in slope is observed, mutual exclusivity can be distinguished from nonexclusivity by the use of secondary plots based on the effect of the partial inhibitor on the slope or the abscissal intercept of the primary plot. The rules proposed for distinguishing mutually exclusive from nonexclusive inhibitors hold irrespective of the type of inhibition (competitive, noncompetitive, uncompetitive, mixed), so that a knowledge of the kinetic nature of the inhibitors is not required. The results of such an analysis are also discussed in terms of summation, antagonism, and synergism between inhibitors. It has been pointed out that independent inhibitor binding does not necessarily result in independent inhibitor effects, and the conditions necessary for observation of independent inhibitory effects have been defined. PMID- 6865925 TI - Pharmacological characterization of the acetylcholine transport system in purified Torpedo electric organ synaptic vesicles. AB - A wide variety of pharmacologically active compounds was surveyed for effects on active transport of [3H]acetylcholine by synaptic vesicles isolated from the electric organ of Torpedo californica. In over 80 compounds tested, inhibitors of a wide range of potencies were found. The most potent inhibitor was 2-(4 phenylpiperidino)cyclohexanol (AH5183), which half-inhibited transport at 40 nM. This compound had been predicted by Marshall [Br. J. Pharmacol. 38:503-516 (1970)] to block acetylcholine storage by vesicles in vivo. The synaptic vesicle active transport system is shown to be pharmacologically distinct from other cholinergic systems. The site of action of AH5183 and other potent inhibitors is not certain, but the possibility of trivial action on the vesicle ATPase or a vesicle proton gradient was eliminated. The results constitute new evidence supporting vesicle exocytosis as the source of evoked acetylcholine release by nerve terminals. AH5183 appears to be the prototype for a new family of anticholinergics. The possibility that some drugs that exhibit secondary anticholinergic effects act in part by antagonizing acetylcholine storage is discussed. PMID- 6865926 TI - Inhibition of [3H]acetylcholine active transport by tetraphenylborate and other anions. AB - The effects of tetraphenylborate and other anions on the active uptake of [3H]acetylcholine by synaptic vesicles isolated from Torpedo californica electric organ were studied. Tetraphenylborate completely inhibits active uptake with a half-inhibitory concentration of 0.3 microM. Dipicrylaminate also half-inhibits at 0.3 microM, phenyldicarbaundecaborane at 14 microM, fluoride at 2 mM, thiocyanate at 3 mM, and azide at 16 mM. Tetraphenylborate had no effect on the vesicle ATPase activity or the transmembrane electric potential at low concentrations where it inhibits [3H]acetylcholine active transport. The mechanism for tetraphenylborate inhibition is uncertain, but it might be similar to that of its action as a mitochondrial uncoupler. Solubility products for the acetylcholine, choline, and potassium salts of the tetraphenylborate and dipicrylaminate anions also were measured. The inhibition results confirm the hypothesis of Marshall and Parsons [Br. J. Pharmacol. 54:333-338 (1975)] that tetraphenylborate acts on intact neuromuscular preparations to inhibit transmitter storage, and constitute new pharmacological evidence that evoked release of acetylcholine is mediated by synaptic vesicles. PMID- 6865927 TI - The interaction of dihydropyridine calcium channel blockers with calmodulin and calmodulin inhibitors. AB - The calmodulin inhibitors R24571 and trifluoperazine were found to inhibit competitively the binding of [3H]nitrendipine to a 48,000 X g particulate fraction of rat brain with IC50 values of 1.0 and 18.8 microM, respectively. Equilibrium dialysis was used to test the ability of the dihydropyridines nitrendipine, felodipine, and nicardipine to inhibit the binding of [3H]chlorpromazine, [14C]pimozide, and 45Ca2+ to calmodulin. At dihydropyridine concentrations near the limit of solubility (10 microM), the only significant effect in these three binding experiments was a 26% inhibition of [14C]pimozide binding to calmodulin by nicardipine, indicating that the dihydropyridines do not bind to the same site on calmodulin as chlorpromazine, pimozide, or calcium. Equilibrium dialysis was also used to determine the ability of the dihydropyridines to interact directly with calmodulin. [3H] Nitrendipine bound to calmodulin in a calcium-dependent manner; however, this binding was of a low affinity, unsaturable nature. These results suggest that the dihydropyridine drugs do not interact with calmodulin at concentrations that are pharmacologically significant. PMID- 6865928 TI - Hepatic estrogen responsiveness. Possible mechanisms for sexual dimorphism. AB - In addition to estrogen receptors, liver contains a second class of estrogen binding proteins referred to as higher-capacity, lower-affinity (HCLA) binding sites which are distinct from estrogen receptors. HCLA sites comprise two classes of proteins: moderate-affinity (KD = 0.45 microM and 0.24 microM) estrogen binding sites unique to male cytosol and a low-affinity, nonsaturable estrogen binding site present in both sexes. The sex differences observed in HCLA sites are apparently a consequence of imprinting by testicular androgen during a critical neonatal period. Neonatal castration causes a reduction in the concentration of HCLA sites in the subsequent adult male. Furthermore, the moderate-affinity sites detected by Scatchard analysis in adult male liver are not observed in neonatal castrates. Cell-free nuclear translocation assays demonstrate that nuclear uptake of cytosolic receptor-ligand complexes is more efficient in females than in males. This sex difference in nuclear uptake can be minimized when the concentration of the ligand is increased to a level necessary to saturate the estrogen receptor in the presence of HCLA sites. Nuclear uptake of receptor-ligand complexes in neonatally castrated males (deficient in HCLA sites) is similar to that seen in adult females. Elevations of serum triglyceride following estradiol exposure have been monitored as an indicator of hepatic responses to estrogen. Our studies have shown that female liver appears more responsive to estrogen exposure than does male liver. While a dose of 20-30 micrograms of estradiol per kilogram of body weight per day was sufficient to produce a 3- to 4-fold increase in the concentration of triglyceride associated with the very low-density lipoprotein fraction in females, a dose of 100 micrograms of estradiol per kilogram of body weight per day was needed to obtain a similar response in males. However, following neonatal castration, estrogen responsiveness in the subsequent adult male rat was similar to that in females, suggesting a role for neonatal androgens in regulating sex differences in the action of hepatic estrogen. PMID- 6865929 TI - Growth inhibition and metallothionein induction in cadmium-resistant cells by essential and non-essential metals. AB - Essential and non-essential metal ions were compared on the basis of their growth inhibitory potency and their mediation of metallothionein induction in a Chinese hamster ovary cell line resistant to cadmium. Cadmium-resistant cells were found to be 20-fold and 6-fold more resistant than wild-type Chinese hamster ovary cells to the non-essential metals CdCl2 and HgCl2, respectively. In contrast, cadmium-resistant cells showed 2-fold or less resistance to growth inhibition due to the metals with known or possible biological essentiality, ZnCl2, CuSO4, CoCl2, and NiCl2. Resistance to either cadmium or mercury was not due to decreased uptake as measured isotopically or by X-ray fluorescence. At concentrations near the threshold of growth inhibition, CdCl2 and ZnCl2 induced metallothionein 8- to 10-fold above background levels in cadmium-resistant cells within 8-10 hr. A 2- to 3-fold induction of this protein was produced in resistant cells by levels of HgCl2, CuSO4, and CoCl2 near the threshold of growth inhibition whereas NiCl2 produced no measurable elevations of metallothionein at concentrations below, near, and above those that inhibit cell growth. Induction of metallothionein was measured by a modified 203Hg binding assay and by [35S]cysteine incorporation. No measurable induction of metallothionein was evident in wild-type cells with any metal treatment using a reasonable quantity of cells consistent with our assay. These results in cadmium-resistant cells demonstrate selective induction of metallothionein by various metals and suggest that induction of this protein alone is not solely responsible for differences in the growth-inhibitory potential of these elements. PMID- 6865932 TI - [Kinetics of glucose accumulation during depolymerization of polysaccharides by enzymes with different mechanisms of action]. PMID- 6865930 TI - The NADPH oxidase of guinea pig polymorphonuclear leucocytes. Properties of the deoxycholate extracted enzyme. AB - NADPH oxidase from stimulated guinea pig granulocytes was extracted with deoxycholate. The solubilized enzyme was stable in 20% glycerol. Solubilized enzyme was free of myeloperoxidase activity. The properties of the deoxycholate solubilized enzyme indicated that it is a high molecular weight complex with a flavoprotein, calmodulin and cytochrome b possibly forming part of the complex. Maximum activity was between pH 7.0 and 7.5. The Km value was 15.8 microM for NADPH and 434 microM for NADH indicating that NADPH is the preferential substrate. PMID- 6865931 TI - On the mechanism of estrogen receptor replenishment: recycling, resynthesis and/or processing. AB - Estrogen receptor replenishment has been extensively studied after a single injection of estradiol-17 beta in the rat. Most studies indicate that replenishment, under these conditions, is due both to recycling and to resynthesis of receptor. In the case of short-acting estrogens, total replenishment occurs in the absence of protein synthesis and loss of nuclear receptor closely corresponds to an increase in cytoplasmic receptor. After estradiol-17 beta injection, there is a loss of nuclear receptor without a corresponding increase in cytoplasmic receptor, leading to a loss in total receptor content or 'processing'. Since little processing occurs with the active, short-acting estrogen, we propose that processing is not essential for estrogen action. Evidence is accumulating to indicate that processing may be due to a reversible inactivation of the steroid binding capacity of the receptor. We discuss a model in which there are two routes for replenishment: a simple equilibrium scheme where no processing occurs and a second route where the receptor is processed to a form with low affinity for estrogen which must be reactivated before binding can occur. PMID- 6865933 TI - [Flip-flop mechanism of the amplification of specificity of aminoacyl-tRNA synthetases]. PMID- 6865935 TI - [Small angle diffuse scattering of x-rays of subunits of fibrillar protein]. PMID- 6865936 TI - [Transformation of excitation energy in a system of hydrogen bonds interacting with atomic vibrations]. PMID- 6865934 TI - [Proton induced compaction of DNA. Conductometric titration of isoionic solutions and ion-exchange properties of immobilized DNA]. PMID- 6865937 TI - [Nonrandom distribution of histone H1 and H5 in pigeon erythrocyte chromatin]. PMID- 6865938 TI - [Functional role of plastocyanin in electron transport fragments of photosystem 1 in higher plants. Mathematic model and physical phenomena]. PMID- 6865939 TI - [Determination of the model parameters for regulatory enzymes from kinetic data]. PMID- 6865940 TI - Construction and characterization of Chinese hamster cell EmtA EmtB double mutants. AB - Starting with hybrid cell lines between a Chinese hamster cell EmtA mutant and a Chinese hamster cell EmtB mutant, we have constructed cell lines that are homozygous for mutant alleles at both the emtA locus and the emtB locus, by using a two-step segregation protocol. The EmtA EmtB double mutants are approximately 10-fold more resistant to emetine inhibition than either of the parental mutants. Having both the EmtA mutation and the EmtB mutation expressed in the same cell also results in a level of resistance to cryptopleurine that is significantly higher than a simple additive effect of the two mutations alone. Analysis of ribosomal proteins by two-dimensional polyacrylamide gel electrophoresis demonstrated that a parental hybrid and a first-step segregant, which has lost the wild-type emtA allele, synthesize both a normal and an altered form of ribosomal protein S14, whereas an EmtA EmtB double mutant synthesizes only the altered form of this ribosomal protein. This result confirms that the emtB locus is the structural gene for ribosomal protein S14. Our results also suggest that the products of the emtA and emtB loci interact directly, indicating that the emtA locus, like the emtB locus, encodes a component of the ribosome. PMID- 6865941 TI - Growth regulation of melanoma cells by interferon and (2'-5')oligoadenylate synthetase. AB - We report that endogenous, as well as exogenous, interferon (IFN) regulates the growth of human melanoma cells in culture. When antibodies directed against human fibroblast IFN were incorporated into the media of high-density cells stimulated to proliferate with serum, the cells entered the cell cycle earlier than did the controls. In investigating the biochemical basis for this finding, we have found that there is an inverse relationship between the (2'-5')oligoadenylate synthetase levels and the percentage of cells in S in untreated cultures. Upon IFN treatment, the relationship is obliterated and (2'-5')oligoadenylate synthetase levels increase throughout all phases of the cell cycle. This increase in enzyme levels correlates well with the decreased probability of the IFN treated cells to cycle. These findings suggest a biological role for IFN as a negative growth factor for cells in culture. PMID- 6865942 TI - Isolation and characterization of full-length cDNA clones for human alpha-, beta , and gamma-actin mRNAs: skeletal but not cytoplasmic actins have an amino terminal cysteine that is subsequently removed. AB - cDNA clones encoding three classes of human actins have been isolated and characterized. The first two classes (gamma and beta, cytoplasmic actins) were obtained from a cDNA library constructed from simian virus 40-transformed human fibroblast mRNA, and the third class (alpha, muscle actin) was obtained from a cDNA library constructed from adult human muscle mRNA. A new approach was developed to enrich for full-length cDNAs. The human fibroblast cDNA plasmid library was linearized with restriction enzymes that did not cut the inserts of interest; it was then size-fractionated on gels, and the chimeric molecules of optimal length were selected for retransformation of bacteria. When the resulting clones were screened for actin-coding sequences it was found that some full length cDNAs were enriched as much as 50- to 100-fold relative to the original frequency of full-length clones in the total library. Two types of clones were distinguished. One of these clones encodes gamma actin and contains 100 base pairs of 5' untranslated region, the entire protein coding region, and the 3' untranslated region. The second class encodes beta actin, and the longest such clone contains 45 base pairs of 5' untranslated region plus the remainder of the mRNA extending to the polyadenylic acid tail. A third class, obtained from the human muscle cDNA library, encodes alpha actin and contains 100 base pairs of 5' untranslated region, the entire coding region, and the 3' untranslated region. Analysis of the DNA sequences of the 5' end of the clones demonstrated that although beta- and gamma-actin genes start with a methionine codon (MET-Asp-Asp Asp and MET-Glu-Glu-Glu, respectively), the alpha-actin gene starts with a methionine codon followed by a cysteine codon (MET-CYS-Asp-Glu-Asp-Glu). Since no known actin proteins start with a cysteine, it is likely that post-translational removal of cysteine in addition to methionine accompanies alpha-actin synthesis but not beta- and gamma-actin synthesis. This observation has interesting implications both for actin function and actin gene regulation and evolution. PMID- 6865943 TI - Control of cellular gene expression during adenovirus infection: induction and shut-off of dihydrofolate reductase gene expression by adenovirus type 2. AB - Infection of human cells by adenovirus results in multiple alterations of host gene expression. To examine the effects of viral infection on the expression of a single gene, a line of human cells was developed which is resistant to growth in methotrexate and which contains amplified RNA and protein specific for dihydrofolate reductase (DHFR). Cytogenetic evidence indicated the presence of amplified DNA. Adenovirus infection of these cells caused an induction and subsequent decline in the synthesis of DHFR protein. The maximum DHFR induction occurred 16 to 19 h after infection and reached a level 2.5-fold greater than that observed in uninfected cells. Induction of DHFR protein synthesis was accompanied by concomitant increases in the level of steady-state DHFR-specific cytoplasmic RNA. The relative rate of DHFR mRNA production (i.e., the appearance of DHFR-specific mRNA sequences in the cytoplasm) also increased 2.5-fold during induction. Later in infection, the relative rate of DHFR protein synthesis declined, reaching a level below that observed in uninfected cells. This decline was accompanied by a similar decline in the steady-state levels of DHFR RNA and in the relative rate of synthesis of DHFR mRNA. These data suggest that adenovirus infection controls DHFR gene expression by increasing and subsequently decreasing the relative rate at which DHFR-specific mRNA sequences appear in the cytoplasm and enter the pool of mRNA available for translation. PMID- 6865945 TI - Neoplastic conversion of preneoplastic Syrian hamster cells: rate estimation by fluctuation analysis. AB - Analysis of the role of gene mutations in the multistep process of neoplastic transformation requires that the discrete steps in carcinogenesis first be dissected. Toward this end, we have isolated and characterized preneoplastic Syrian hamster cells which exhibit in vitro a trait highly correlated with neoplastic conversion in vivo. Previous findings (J. C. Barrett, Cancer Res. 40:91-94, 1980) indicate that spontaneous neoplastic transformation of Syrian hamster cells occurs in at least two steps. An intermediate stage, characterized by an aneuploid established cell line which has a propensity to become neoplastic spontaneously upon further growth in vitro, has been described. These preneoplastic cells differ from diploid early-passage Syrian hamster cells in becoming capable of anchorage-independent growth in semisolid agar, as well as becoming neoplastic in vivo when attached to a solid substrate. Evidence presented here demonstrates that anchorage-independent conversion in vitro is a reliable marker for neoplastic conversion in this cell system. Fluctuation analyses, patterned after those described by Luria and Delbruck for microbial genetics, demonstrate that anchorage-independent variants are generated randomly from clonally derived preneoplastic cells at the rate of 10(-8) to 10(-7) variants per cell per generation. These results establish a multistep stochastic process for transformation in vitro and indicate that conversion to anchorage independence may be necessary for Syrian hamster cells to become tumorigenic. The possible role of gene mutation in this step during neoplastic progression is discussed. PMID- 6865947 TI - Procaryotic genomic DNA inhibits mammalian cell transformation. AB - Ltk- mouse cells were transformed to thymidine kinase prototrophy in the presence of carrier DNAs isolated from different organisms. Procaryotic genomic and phage DNA was consistently less effective as a carrier than was eucaryotic DNA. Mixing experiments indicate that DNA of procaryotic origin inhibits mammalian cell transformation. PMID- 6865944 TI - Identification of two human beta-tubulin isotypes. AB - The sequence of a human beta-tubulin cDNA clone (D beta-1) is described; our data revealed 95.6% homology compared with the sequence of a human beta-tubulin processed pseudogene derived by reverse transcription of a processed mRNA (Wilde et al., Nature [London] 297:83-84, 1982). However, the amino acid sequence encoded by this cDNA showed less homology with pig and chicken beta-tubulin sequences than the latter did to each other, with major divergence within the 15 carboxy-terminal amino acids. On the other hand, an independently isolated, functionally expressed genomic human beta-tubulin sequence (5 beta) possessed a very high degree of homology with chicken and pig beta-tubulins in this region. Thus, human cells appear to contain two distinct beta-tubulin isotypes. Both the intact beta-tubulin cDNA clone and a subclone containing only the 3' untranslated region detected two mRNA species in HeLa cells; these mRNAs were 1.8 and 2.6 kilobases long and were present in about equal amounts. Two independently subcloned probes constructed from the 3' untranslated region of the 5 beta genomic sequence also detected a 2.6-kilobase beta-tubulin mRNA. However, the 3' untranslated-region probes from the cDNA clone and the genomic sequence did not cross-hybridize. Thus, at least two human beta-tubulin genes, each specifying a distinct isotype, are expressed in HeLa cells, and the 2.6-kilobase mRNA band is a composite of at least two comigrating beta-tubulin mRNAs. PMID- 6865946 TI - Myogenic differentiation of L6 rat myoblasts: evidence for pleiotropic effects on myogenesis by RNA polymerase II mutations to alpha-amanitin resistance. AB - To assess the functional role of RNA polymerase II in the regulation of transcription during muscle differentiation, we isolated and characterized a large number of independent alpha-amanitin-resistant (AmaR) mutants of L6 rat myoblasts that express both wild-type and altered RNA polymerase II activities. We also examined their myogenic (Myo) phenotype by determining their ability to develop into mature myotubes, to express elevated levels of muscle creatine kinase, and to synthesize muscle-characteristic proteins as detected by two dimensional polyacrylamide gel electrophoresis. We found a two- to threefold increase in the frequency of clones with a myogenic-defective phenotype in the AmaR (RNA polymerase II) mutants as compared to control ethyl methane sulfonate induced, 6-thioguanine-resistant (hypoxanthine, guanine phosphoribosyl transferase) mutants or to unselected survivors also exposed to ethyl methane sulfonate. Subsequent analysis showed that about half of these myogenic-defective AmaR mutants had a conditional Myo(ama) phenotype; when cultured in the presence of amanitin, they exhibited a Myo- phenotype; in its absence they exhibited a Myo+ phenotype. This conditional Myo(ama) phenotype is presumably caused by the inactivation by amanitin of the wild-type amanitin-sensitive RNA polymerase II activity and the subsequent rise in the level of mutant amanitin-resistant RNA polymerase II activity. In these Myo(ama) mutants, the wild-type RNA polymerase II is normally dominant with respect to the Myo+ phenotype, whereas the mutant RNA polymerase II is recessive and results in a Myo- phenotype only when the wild type enzyme is inactivated. These findings suggest that certain mutations in the amaR structural gene for the amanitin-binding subunit of RNA polymerase II can selectively impair the transcription of genes specific for myogenic differentiation but not those specific for myoblast proliferation. PMID- 6865948 TI - Unusual class of Alu sequences containing a potential Z-DNA segment. AB - A potential Z-DNA sequence, (dA-dC)9, has been found to replace the customary A rich region in the middle of an Alu family member in the African green monkey genome. This Alu, bounded by imperfect direct repeats, also contains an unusual 3' end and may be a member of a large subfamily of such sequences. PMID- 6865949 TI - Monoclonal IgA J539 binds galactopyranosyl antigens on its surface. AB - Murine monoclonal IgA J539 binds to methyl beta-D-galactopyranoside. With nearly the same affinity, it binds to methyl 6-O-pivaloyl-beta-D-galactopyranoside (4) and to methyl 6-O-beta-D-gentiobiosyl-beta-D-galactopyranoside (7). These observations confirm that the combining area of J539 is of the surface-, and not of the cavity-type. PMID- 6865950 TI - Mouse IgG antibodies have subclass associated affinity differences. AB - Subclasses of IgG were separated from pools of mouse sera by letting immunoglobulins absorb on protein A-Sepharose and by eluting with buffers of decreasing pH. Most donor mice were immunized with a conjugate of a hapten (NIP) and chicken gamma globulin 20 days previously. The results indicate that concentrations of IgG varied from 5.1 to 8.6 mg/ml in the pools of immune sera and was 3.0 mg/ml in one normal serum tested. One half of this was IgG1, ca. 20% of IgG2a and IgG2b each, and 10% IgG3 in the pools of BALB/c sera. IgG2a and IgG3 could not be separated from C57BL sera (due to allotype b), but their combined share of IgG appears to be higher than in BALB/c. Immune sera contained 0.5-1.6 mg/ml of anti-NIP antibodies. Of this 90-98% was IgG1 and the remainder was split between the other subclasses. Up to one half of the protein in the IgG1 fraction was anti-NIP antibody. This surprising finding was confirmed by demonstrating that nearly 50% of the u.v.-light absorption was specifically removed by a NIP immunosorbent. Subclass-associated affinity-differences were observed. IgG1 anti NIP had a greater average affinity than IgG2a anti-NIP antibodies. The difference was ca. 1.5-fold when the equilibrium dialysis was focusing on the high-affinity bracket of the total population (concentration of free hapten 16-200 nM). At higher hapten concentrations the trend was the same but the data are fewer. Antibodies in subclasses IgG2b and IgG3 appear to share the lower affinity of IgG2a. PMID- 6865951 TI - Influence of amino acid deficiency and tRNA aminoacylation on DNA synthesis and DNA polymerase activity during the secondary immune response in vitro. AB - DNA synthesis and DNA polymerase activity are increased when KLH-primed guinea pig lymphocytes are restimulated in vitro with the homologous antigen. This response can be modulated by glutamine deficiency and by an inhibitor of the histidyl-tRNA synthetase. PMID- 6865952 TI - Immunochemical studies of yellowjacket venom proteins. AB - The major proteins of yellowjacket venoms have been isolated and characterized immuno-chemically. They consist of hyaluronidase, phospholipase, and antigen 5. Venoms from three species of yellowjacket were studied. Vespula germanica, V. maculifrons, and V. vulgaris. The phospholipases could be isolated in good yield only when affinity chromatography was used to minimize limited proteolysis. A kallikrein-like peptidase was found present in the yellowjacket venom. Phospholipases from these three species were immunochemically indistinguishable from each other, as were their antigen 5s. Sera from individuals sensitive to yellowjacket venom contained IgE and IgG specific for antigen 5 and phospholipase. PMID- 6865953 TI - Characterization of human lymphocyte derived chemotactic factors for mononuclear phagocytes--I. Production and detection. AB - Human peripheral blood mononuclear cells were isolated on a large scale by leukapheresis of either individual donors or pooled cell concentrates supplied by a local blood bank. Optimal conditions with respect to cell density, lectin (soluble and insoluble Concanavalin A; phytohemagglutinin) concentration and culture time were established for monocyte chemotactic factor (LMCF) production. LMCF was assayed on highly purified human monocytes/macrophages which had been kept in culture up to 4 days for optimal expression of response to LMCF. Chemotaxis assays were performed in a novel type multichamber assembly and migrated cells were enumerated by enzyme-linked immunosorbent assay. Based on the described methodology it is possible to produce litre quantities of LMCF and assay large numbers of samples both of which are prerequisites for chemical and functional characterizations of LMCF. PMID- 6865954 TI - Characterization of human lymphocyte derived chemotactic factors for mononuclear phagocytes--II. Chemical characterization. AB - Supernatants of PHA-stimulated human mononuclear cells were fractionated by Sephadex G-100 chromatography and isoelectric focusing. Chemotactic activities for human mononuclear phagocytes were identified at various molecular weight ranges. Major activities were found at mol. wt 45, 30, 25, 18, 12.5, 8 and 6 K. After isoelectric focusing chemotactic activities were recovered predominantly at pH 3.7-5.5 and 7.8-8.5. Fractionation by high performance liquid chromatography (HPLC) on the molecular sieve column I-125 and basic ion exchange column SAX 300 confirmed these results. Furthermore, after absorption of crude supernatants on the reversed-phase column RP 300, chemotactic activity was recovered quantitatively and thus could be separated from the bulk of other materials. In kinetic experiments supernatants were harvested after 5, 27, 42 and 63 hr and fractionated on a molecular sieve column. It was found that only low molecular weight chemotactic activity was released after 5 hr. After 27 hr most activity was found between 10-20,000 after 42 hr activity was found over the whole fractionation range. It is concluded that multiple molecular species of chemotactic factors acting on mononuclear phagocytes are released by activated lymphocyte cultures, whose chemical nature and function remains to be studied. PMID- 6865956 TI - Inter- and intramolecular disulfide bonding among lymphocyte plasma membrane proteins and glycoproteins. AB - The disulfide bonding characteristics of the pig lymph node plasma membrane (PM) proteins and glycoproteins have been examined by 1- and 2-dimensional sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Reaction of the purified PM vesicles with N-ethyl maleimide (NEM) prior to detergent solubilization was found to markedly reduce the extent of intermolecular disulfide bonding subsequently observed. Thus the blocking of free sulfhydryl groups with NEM prevented the detergent-induced disulfide bonding of numerous components, including PM-bound actin. The extent of intermolecular disulfide bonding among the NEM-pretreated PM glycoproteins purified by lentil lectin affinity chromatography was found to be relatively limited, with only 3% of the total glycoprotein present as intermolecular disulfide-bonded complexes. In contrast, the degree of intramolecular disulfide bonding revealed by a modified 1 dimensional SDS-PAGE technique was quite striking. Among those polypeptides demonstrating a clearly altered mobility upon reduction was the heavy chain of class I and beta-chain of class II major histocompatibility complex (MHC) antigens. The class II alpha-chain, however, was much less affected. These changes have been compared with those observed for proteins containing intramolecular disulfide-bonded domains of known size and number, and considered in the light of recent information on the structure of MHC antigens. PMID- 6865957 TI - Binding and activation of C1 by cell bound IgG: activation depends on cell surface hapten density. AB - We have investigated the binding and activation of C1 by IgG-anti methotrexate antibody at cell surfaces. Under conditions where variation in cell surface hapten density had no effect on binding of IgG, the number of C1 (or its active form, C1) bound by the IgG was independent of hapten density. The ability of the C1 binding IgG complex to activate C1, however, was decreased with decreasing density of the hapten. The decreased ability to activate bound C1 was paralleled by decreased ability to activate the hemolytic sequence in whole complement. The results were interpreted to mean that binding of C1 was the result of aggregation (doublet formation) by IgG while activation of the bound C1 depended on changes induced in the IgG molecule by straddling hapten molecules at varying distances. PMID- 6865955 TI - The membrane attack complex of complement and its precursor proteins lack phospholipase activity. AB - The membrane attack complex of human complement and its highly purified precursor proteins have been analyzed for phospholipase activity. Using three different sensitive assays, phospholipase A1, A2, C or D activity could not be detected. Based on the sensitivity of the assays employed, these results indicate the complement-mediated membrane damage is not enhanced by covalent breakdown of membrane phospholipids, but is entirely caused by physical action of the membrane attack complex. The results also imply that the putative serine esterase sites of C6 and C7 are not acting on phospholipids. PMID- 6865958 TI - Immunochemical characterization of a high molecular weight basic allergen (HMBA) of rye grass (Lolium perenne) pollen. AB - A high molecular weight basic allergen (HMBA) was isolated from the mixture of non-dialysable components of the aqueous extract of defatted rye grass pollen by a combination of gel filtration and isoelectrofocusing, HMBA, a glycoprotein of mol. wt 56,800 (17% carbohydrate) contained all naturally occurring amino acids. A hyperimmune rabbit anti-HMBA serum gave only a single precipitin band with the crude extract of the rye grass pollen in crossed immunoelectrophoresis. Thus, it was concluded that HMBA was a unique and highly purified antigen. The allergenicity of HMBA was revealed by its ability to elicit immediate skin reactions in grass allergic patients. Moreover, all patients' sera tested had IgE antibodies to HMBA detectable by direct RAST with HMBA allergosorbent discs. These observations indicated that HMBA was a major allergenic constituent of rye grass pollen. Treatment of HMBA by 6 M guanidine HCl led to a significant reduction in its ability to combine with human IgE antibodies. The treatment also resulted in the complete loss of allergenicity (i.e. inability to elicit PCA reactions with a murine reaginic antiserum to HMBA) and antigenicity (inability to form precipitins with rabbit anti-HMBA); hence, it would appear that the allergenic and antigenic determinants of HMBA are 'conformational'. PMID- 6865959 TI - Destruction of antibody idiotopes with ultra-low concentrations of reducing agents. AB - The nature of the idiotopes present on F(ab')2 fragments prepared from rabbit anti-micrococcal carbohydrate antibodies and the loss of idiotypic reactivity of these F(ab')2 fragments upon iodination were examined. Rabbit anti-micrococcal idiotopes were shown to be exquisitely sensitive to treatment with very low concentrations of sodium metabisulfite or 2-mercaptoethanol. The treatment destroyed anti-micrococcal idiotopes, as shown by the loss of idiotopes on F(ab')2 fragments after reduction; the allotype epitopes and the antigen binding capacity of the F(ab')2 fragments were unaffected. The destruction of the idiotopes by very low concentrations of reducing agents indicated that an extremely labile disulfide bond is involved in the structure of the idiotope or in the maintenance of the conformation of the anti-micrococcal idiotopes. Identical reduction-sensitive anti-micrococcal idiotopes have been demonstrated in a number of related outbred rabbits, and in each case they induced a natural auto-anti-idiotype (AAI) antibody response. Recognition of the existence of these reduction-sensitive idiotopes and their properties could provide a basis for further study of these idiotopes and may lead to a better understanding of the idiotope network. PMID- 6865962 TI - Monoamine oxidase and its selective inhibitors. Satellite symposium of the International Brain Research Organization, Mannheim, March 29-30, 1982. PMID- 6865961 TI - Activation of the alternative complement pathway by IgM antibody reacted on paragloboside incorporated into liposome membrane. AB - Liposomes containing paragloboside (PG) on their membrane were readily lysed by C4 deficient guinea pig serum (C4D-GPS). On the other hand, guinea pig serum from specific pathogen free Hartley guinea pigs (SPF-GPS) did not lyse PG-liposomes in Mg-EGTA-GVB (gelatin veronal buffered saline containing MgCl2 and ethyleneglycol bis(beta-aminoethyl ether)N,N'-tetraacetate) which permits complement activation via the alternative pathway but not via the classical pathway. However, the SPF GPS could lyse the liposomes in Mg-EGTA-GVB when heated (56 degrees C, 30 min) C4D-GPS or other guinea pig serum (GPS) was added. Gel filtration of Hartley (Htl)-GPS through a Sephadex G-200 column revealed that IgM antibody to PG in Htl GPS was responsible for sensitization of the liposomes to lysis by complement of SPF-GPS via the alternative pathway. This result indicated that guinea pig IgM antibody can initiate the activation of the alternative pathway of homologous complement on liposome membrane. PMID- 6865960 TI - Characterisation of Concanavalin A-binding glycoproteins from mouse splenic leukocytes by two-dimensional electrophoresis: preferential binding of incompletely glycosylated forms of H-2 antigen to the lectin. AB - Concanavalin A (Con A)section-binding proteins from mouse spleen leukocytes were characterised by two-dimensional electrophoresis of material precipitated, by Con A plus anti-Con A, from lysates of biosynthetically-labelled cells. Although most cell surface (iodinatable) proteins are known to bind Con A, some of the major Con A-binding proteins detected by immunoprecipitation, after a four-hour biosynthetic labelling period, are not iodinatable and are probably intracellular. Thus the major biosynthetically labelled Con A-binding species are: (i) a non-iodinatable, high molecular weight glycoprotein (C-145); (ii) intracellular precursors of secretory immunoglobulins (IgM and, probably, IgA); (iii) immature (not fully-sialylated) forms of H-2 D and K antigens; and (iv) Ia antigens. In the case of the H-2 antigens, (and possibly of other cell surface proteins) the selection of immature forms by Con A is not due to lack of biosynthetic labelling of mature products, but to preferential binding of Con A to incompletely glycosylated molecules. PMID- 6865964 TI - Effect of tranylcypromine stereoisomers on depressive syndromes. PMID- 6865965 TI - MAO inhibition as antidepressive mechanism reevaluated. A controlled study with tranylcypromine isomers. PMID- 6865963 TI - Tranylcypromine isomers in Parkinson's disease. Effect of low doses on monoamine oxidase inhibition and blood pressure response. PMID- 6865966 TI - Neurochemical effects in vitro and in vivo of the antidepressant Ro 11-1163, a specific and short-acting MAO-A inhibitor. PMID- 6865967 TI - Platelet monoamine oxidase activity in alcoholics. PMID- 6865969 TI - Biological high-risk paradigm and platelet MAO activity in community samples. PMID- 6865968 TI - Methodological problems of using platelet MAO in psychiatric research. PMID- 6865970 TI - Platelet MAO activity and high risk for psychopathology in a German population. PMID- 6865971 TI - Changes in MAO activity during estrogen treatment of females with endogenous depression. PMID- 6865973 TI - A new assay of monoamine oxidase activity for selective substrates and inhibitors. PMID- 6865972 TI - Monoamine oxidase activity in platelets before and after sleep deprivation as predictor for antidepressive drug response. PMID- 6865974 TI - Changes in the pituitary-testicular axis with age. AB - A large number of endocrinological studies of testicular function in men of different ages suggest that primary testicular failure becomes common and more severe with aging. There is an increasing frequency of impotence, reduced secondary sex hair and testicular atrophy. Serum LH and FSH levels rise, androgen production rates and levels fall and oestrogen levels rise. The clearance of oestradiol falls but the production rate is maintained, in part, through increased peripheral conversion of testosterone to oestradiol. The levels of SHBG rise and free testosterone levels are reduced. Leydig cell responsiveness to hCG is probably reduced but gonadotrope responsiveness to GnRH reasonably maintained in the elderly. There are histological changes in the seminiferous epithelium of old men but these are non-specific. Senescent testicular failure is mainly a primary gonadal disorder but its cause and significance are only poorly understood. PMID- 6865976 TI - [Effect of hyperbilirubinaemia on cerebellar development in Gunn rats]. AB - The influence of bilirubin on cerebellar growth was studied in homozygous Gunn rats by measuring weight, DNA concentration and histochemical enzyme reactions at different ages and under different conditions. High bilirubin levels cause persistent reduction in cerebellar size and loss of Purkinje and granular cells. Sulfonamide application results in an almost complete cessation of cerebellar growth. Phototherapy can prevent these neurotoxic effects of bilirubin. The vulnerability of the cerebellum is particularly high during the period of rapid growth. PMID- 6865977 TI - [Determination of irradiation intensity from the time-dependence of serum bilirubin concentration during phototherapy of Gunn rats]. PMID- 6865978 TI - [Heart catheterization in newborn and young infants. Description of the method]. AB - The data of 343 newborns and young infants were reviewed who, from 1968 until August 1982, had undergone heart catheterization. Variations in frequency of catheterization and diagnoses as well as lethality were investigated. The first rise of heart catheterization performances could be noted in the years of 1968 and 1969 (by routine application of the Rashkind procedure), another remarkable rise took place in the years from 1971 to 1975, probably due to better feasibilities of modern cardiac surgery. Later on, a new dynamic plateau was developed. With the utilization of echocardiography, a significant decrease of heart catheterization performances in certain diagnostic groups (HLH, PFC) was registered. Nowadays, however, new diagnostic challenges (infants with low gestational age, respiratory problems, PDA) require heart catheterization. Comparison of the different diagnostic groups' lethality rate reveals that children undergoing heart catheterization, in order to rule out TGA, demonstrate a remarkably higher lethality rate (27%) than children suffering from TGA (3.7%). Introduction of echocardiography has decreased this risk significantly. PMID- 6865975 TI - [Neonatal hyperbilirubinemia]. PMID- 6865979 TI - [Intra-abdominal ligament remnants of the vitelline duct and vessels]. AB - Intraabdominal bands of the vitelline vessels and vitelline duct are discovered as a congenital disturbance any time in life. In more than 75% they cause an acute abdominal disease. In this paper we discuss the cause and the clinical picture in 19 children seen in our department together with 83 cases from the literature. In 70% of the cases we find remnants of the right and left vitelline artery, in a third remnants of the vitelline vein and vitelline duct. The characteristic course is the acute strangulation of the intestine with gangrene of the bowel and endotoxine shock. The best treatment in every case is the operation as soon as possible. PMID- 6865980 TI - [Familial hypogonadism with anosmia: Kallmann Syndrome]. AB - The familial occurrence of hypogonadism and anosmia (Kallmann-Syndrome) is reported in a 15 5/12 year old boy and his 20 7/12 year old sister, who in addition has a ventricular septal defect. To establish the diagnosis it is important to examine the patient with hypogonadism for anosmia since voluntary information is rarely obtained. Quite often there are additional, associated anomalies which have to be searched for carefully. PMID- 6865981 TI - [The Aase syndrome: hereditary autosomal recessive congenital erythropoiesis insufficiency and triphalangeal thumbs]. PMID- 6865982 TI - [Detection of intracytoplasmic immunoglobulins]. PMID- 6865983 TI - [Fatal errors in potassium therapy]. PMID- 6865984 TI - [Possibilities and limits of the detection of peptide hormones by light- and electron microscopy]. PMID- 6865985 TI - Dominant lethal mutation rate after gamma-irradiation of the fish, Oryzias latipes. AB - When laying females or males of the small fish Oryzias latipes were irradiated with gamma-rays and then mated with a non-irradiated partner, the fertility and hatchability of the embryos were reduced as the doses increased. In respect to hatchability (the induction of dominant lethality), the male was more sensitive than the female, and mature sperm were most sensitive among the various stages of spermatogenetic cells. The dose-rate effects on the production of the dominant lethality were observed in spermatogonia and spermatocytes. The inbred strain of the fish, HB-1, was sensitive to gamma-rays. Since the relationship between dose and the decrease in hatchability was almost linear, at least within a limited range, we think that this system would be useful for monitoring mutagenic factors in an aquatic environment. PMID- 6865986 TI - X-ray-induced reciprocal translocations in stem-cell spermatogonia of the rhesus monkey: dose and fractionation responses. AB - Rhesus monkeys received total body or local testes X-irradiation with unfractionated (50, 300, 400, 800 and 850 rad) or fractionated (200 + 200 rad with 24-h interval) exposures. At different times after irradiation, chromosomal analysis was made of C-banded dividing spermatocytes. The observed frequencies of translocation configurations confirmed earlier results about the low induction rate of reciprocal translocations in stem-cell spermatogonia of the rhesus monkey. The absence of any translocation induction at doses of 400 rad and higher indicates an extreme insensitivity of surviving radiation-resistant stem cells for the induction of this type of genetic damage. The frequency of translocations following a fractionated exposure to 400 rad, which is above the peak yield for single exposures, was clearly higher than that obtained when the same dose was applied as a single exposure (0.71 versus 0%), but significantly lower than expected on the basis of additivity of the two fractions (0.71% versus 1.98%). PMID- 6865987 TI - Ultraviolet light-induced mutation of diploid human lymphoblasts. AB - Ultraviolet irradiation (254 nm) of immortal diploid human lymphoblasts killed cells, caused mutation at three genetic loci studied, and transiently inhibited 3H-TdR uptake into DNA. A shoulder of about 6 J/m2 and a D0 of 6 J/m2 was observed for survival. Mutation rose in a monotonic non-linear fashion through 6 J/m2; above 6 J/m2, complex behavior approximating a plateau in induced mutation was observed. Irradiation at 4.4 J/m2 caused a transient increase in the number of cells synthesizing DNA and a decrease in the rate of DNA synthesis relative to mock-irradiated controls. The parameter of rate of DNA synthesis per cell in DNA synthetic phase showed a rapid recovery toward control values between 2 and 4 h after irradiation and a slower recovery to control values by 22 h post irradiation. Fractionated dose schedules were used to measure the effects of allowing a time interval between doses at nontoxic fluences (2.2 J/m2), moderately toxic fluences (8.8 J/m2) and toxic fluences (17.6 J/m2). These measurements indicate that in the non-toxic range of fluences common to human exposure, mutational response is mediated by a post-irradiation process which seems to show an enhanced ability to protect against mutation induced by subsequent irradiation. However, at moderately toxic fluences there was little effect of dose fractionation, and at toxic fluences, a time-dependent increase in mutation fraction was observed at separation times greater than 7 h. We suggest that these latter observations arise primarily from cell cycle heterogeneity with regard to sensitivity to UV killing and mutation. PMID- 6865988 TI - Differential features of sister-chromatid exchange responses to ultraviolet radiation and caffeine in xeroderma pigmentosum lymphoblastoid cell lines. AB - Sister-chromatid exchange (SCE) induced by ultraviolet (UV) irradiation and viability after UV irradiation were studied in lymphoblastoid cell lines derived from 7 patients with xeroderma pigmentosum (XP) and 6 normal donors. UV irradiation caused significant increases of SCEs in both XP and normal cells. In 3 XP cell lines, which were deficient in unscheduled DNA synthesis (UDS) and sensitive to the killing effect of UV, very high SCE frequencies were observed after UV irradiation. Cells from a patient with the De Sanctis-Cacchione syndrome were the most sensitive to UV in terms of both SCE induction and cell killing. In 2 of 4 UDS-proficient XP cell lines tested, the incidences of UV-induced SCEs were similar to those in normal cell lines, but in 2 other UDS-proficient lines from 2 XP patients with skin cancer, the frequencies of UV-induced SCEs were significantly higher than in normal cells. Continuous post-UV treatment with 1 mM caffeine markedly enhanced UV-induced SCEs in 3 of 4 UDS-proficient XP cell lines but had only slight effects on cells from the 4th UDS-proficient XP patient and from normal individuals. PMID- 6865989 TI - 8-Azaguanine versus 6-thioguanine: influence on frequency and expression time of induced HGPRT- mutations in Chinese hamster V79 cells. AB - Chinese hamster V79 cells were mutagenized with ethyl methanesulfonate at various concentrations. Clones resistant to 8-azaguanine (20 and 80 micrograms/ml) or 6 thioguanine (4 micrograms/ml) were selected at different times after the treatments. The total yield of induced mutations was only slightly affected by the kind and concentration of purine analog used in the selection. However, full phenotypic expression of the mutants selected with 8-azaguanine was achieved earlier than that of mutants resistant to 6-thioguanine. This result seems to be best explained by the reported lower affinity of 8-azaguanine for the wild-type HGPRT enzyme, thus providing evidence that, in this gene-mutation assay, the phenotypic expression time has a physiological component. PMID- 6865990 TI - Characterization of chloramphenicol- and 8-azaguanine-resistant mutants isolated from a continuous rat-liver epithelial cell line. AB - 2 non-tumorigenic, chloramphenicol- and 8-azaguanine-resistant strains have been isolated from the rat-liver cell line K-22, by a 2-step mutagenesis procedure. Their chromosome composition and growth properties have been characterized. Failure of chloramphenicol to inhibit mitochondrial protein synthesis in one of the clones, F1, strongly suggests that resistance to the antibiotic in this strain is due to a mutation in mitochondrial DNA. PMID- 6865991 TI - Microcell-mediated transfer of carcinogen-induced ouabain resistance from C3H/10T1/2 Cl 8 mouse fibroblasts to human cells. AB - We previously developed a quantitative assay for measuring the induction of ouabain-resistant (Ouar) variants in transformable C3H/20T1/2 Cl 8 mouse fibroblasts following treatment of the cells with chemical carcinogens. To further define the nature of the Ouar phenotype, we conducted microcell-mediated chromosome transfer studies using Ouar cell lines induced by chemical carcinogens in C3H/10T1/2 Cl 8 cells as donors and 8-azaguanine-resistant (Azgr) derivatives of the human cell lines, D98/AH2 and HT 1080, as recipients. Microcells prepared from one spontaneous and two carcinogen-induced Ouar mouse cell lines were able to transfer resistance to 0.01 and 1 mM Oua to ouabain-sensitive D98 and HT 1080 cells. The frequency of microcell hybrid formation ranged from 10(-6) to 10(-5). Karyotypic analysis of the microcell hybrids indicated that the Ouar phenotype of C3H/10T1/2 Cl 8 derivatives mapped to mouse chromosome 3, the chromosome to which the wild-type murine Oua-1 allele had previously been assigned. These studies show that both spontaneous and chemically induced high level Ouar phenotypes of C3H/10T1/2 Cl 8 mouse fibroblasts can be transferred via microcell-mediated chromosome transfer, and provide strong genetic evidence that chemically induced Ouar phenotypes of C3H/10T1/2 Cl 8 cells arise from mutations at Oua-1. In addition, this study sufficiently standardizes microcell-mediated chromosome transfer in the C3H/10T1/2 Cl 8 cell line so that this technique can be used to investigate the nature of other phenotypic changes in these cells, such as the chemically transformed phenotype. PMID- 6865992 TI - Blood lymphocyte culture system: quantitative analysis of X-ray-induced chromosome aberrations in man, muntjac and cattle. AB - Peripheral blood lymphocytes of 3 mammalian species, man, muntjac and cattle, which have various amounts of DNA and divergent karyotypes, were exposed to 100 400 rad of X-rays, and frequencies of dicentrics and other aberrations were analysed at first post-irradiation metaphases. During experiments, various preparative or physical and biological factors that could influence the yield of chromosome aberrations were taken into account. The frequency of dicentrics scored at first post-irradiation metaphases showed best fit to both linear and quadratic dose-response curves, y = a + bD and y = bD + cD2 with a high correlation coefficient of 0.98 (P less than 0.001). The frequency of dicentrics obtained at different post-irradiation fixation times did not show significant variation, indicating a homogeneous sensitivity of peripheral lymphocytes to X irradiation. BrdU incorporation following X-irradiation showed no increase in the frequency of chromosome aberrations. The frequency of dicentrics in man, muntjac and cattle showed a close correlation with their DNA content, but no meaningful correlation was found between the yield of dicentrics and the chromosome arm number or the nuclear volume. The ratio of dicentric yields, 1.00:0.67:1.04 obtained in man, muntjac and cattle were comparable to the ratio of their DNA contents, 1.00: 0.65: 1.07. The base-line frequency of SCEs was similar in the 3 species and no significant variation in SCE frequency was noticed even after administration of 400 rad of X-rays. PMID- 6865993 TI - SCE, X-radiation sensitivity and mutation rate in multiple sclerosis. AB - In order to detect any underlying DNA abnormality that may be present in multiple sclerosis (MS), the incidence of SCE, X-radiation sensitivity and the frequency of 6-thioguanine-resistant cells were determined in the lymphocytes of 34 MS patients. As a group, MS patients showed an increase in the SCE rate compared to control. However, there was no increase in X-radiation sensitivity. The frequency of 6-thioguanine-resistant mutant cells was also normal. PMID- 6865994 TI - Evaluation of a mutation test using S49 mouse lymphoma cells and monitoring simultaneously the induction of dexamethasone resistance, 6-thioguanine resistance and ouabain resistance. AB - A test for the detection of chemically induced mutants in S49 mouse lymphoma cells is described. These cells can be plated in parallel in several selective media; the induced frequencies of dexamethasone-resistant, 6-thioguanine resistant and ouabain-resistant mutants were compared. The first two selection systems permit the detection of all kinds of mutation that result in alteration or partial or complete loss of the gene product concerned, whereas ouabain resistant mutants can only be induced with strong point mutagens in these cells. Dexamethasone resistance is the marker induced at the highest frequency among these three. Data obtained from this selection system are therefore the most amenable to statistical analysis. Dexamethasone resistance is expressed within a short time after mutagenesis (3 days), and because S49 cells do not display metabolic co-operation, large numbers of cells can be screened. A metabolizing system in vitro with rat-liver homogenate may be included in tests of indirectly acting mutagens. These features make the S49 mutation test system using dexamethasone resistance as the main marker and other markers as internal controls an attractive tool in mutation testing in somatic cells in vitro. PMID- 6865995 TI - Effect of growth rate on phenotypic expression of 6-thioguanine resistance in human diploid fibroblasts. AB - The influence of growth rate on the kinetics of phenotypic expression of 6 thioguanine resistance has been investigated by establishing 3 protocols for the maintenance of mutagenized stock cultures of human diploid fibroblasts. These protocols differed in the frequency with which subculture was performed during the phenotypic expression period. The resultant growth kinetics varied widely from continual exponential proliferation to density-inhibited growth for much of the expression period. With all of the subculture protocols, a maximum mutation frequency was reached by 9 days after exposure of confluent cultures to 6 J/m2 of 254 nm UV light. The maximum frequency was similar in all experimental groups and remained stable up to 17 days after irradiation, the last time point tested. These results indicate that continual proliferation is not required for optimal expression of 6-thioguanine resistance. PMID- 6865996 TI - Correlation between specific DNA-methylation products and mutation induction at the HGPRT locus in Chinese hamster ovary cells. AB - Suspension cultures of Chinese hamster ovary (CHO) cells were exposed to methyl methanesulfonate (MMS) or methylnitrosourea (MNU) and assayed for mutation induction (6-thioguanine resistance) and for specific DNA adducts. DNA methylation at the 1-, 3- and 7-positions of adenine, the 3-, O6- and 7-positions of guanine, and phosphate was detected in cultures exposed to MMS, while MNU produced 3- and 7-methyladenine, 3-methylcytosine, 3-, O6- and 7-methylguanine, O4-methylthymidine and methylated phosphodiesters. When mutations induced by MMS and MNU were compared by linear correlation analysis with levels of each of these adducts, only O6-methylguanine displayed a strong correlation with mutations (r = 0.879, p less than 0.001). The relationship between O6-methylguanine and induced mutations in CHO cells is similar to that previously reported in CHO cells for O6 ethylguanine and mutations (Heflich et al., 1982) and indicates that alkylation induced mutations at the HGPRT locus in CHO cells are primarily associated with O6-alkylguanine formation. PMID- 6865997 TI - Effect of low-dose acute X-irradiation on the frequencies of chromosomal aberrations in human peripheral lymphocytes in vitro. AB - In a coordinated research programme sponsored by the International Atomic Energy Agency, the frequencies of chromosomal aberrations induced in peripheral blood lymphocytes (in vitro) by 250 kV X-rays at low doses (0.4, 1, 2, 3, 5, 10 and 30 rad) were determined. Blood from 2 donors was used to conduct one master experiment at these dose levels. The culture time used was 48 h and all samples including the controls were processed according to a standard protocol. The coded slides were scored by investigators from 10 participating laboratories. The main results are the following: (1) the frequencies of all types of chromosome aberrations at 0.4 rad are significantly lower than the control values; (2) there is no increase in the frequencies of dicentrics up to 2 rad and in those of terminal deletions up to 5 rad; (3) the mean frequencies of all aberrations considered together are not significantly different from one another at 1, 2 and 3 rad (P = 0.05); and (4) over the entire dose range the dose-effect relationship is clearly non-linear. A fit of these data to a linear quadratic model (E(D) = c + alpha D + beta D2) showed that the observed total aberration frequencies at doses 1, 2, 3 and 5 rad are below the curve defined by the model. The deviations can be explained by an altered kinetics of aberration production at very low doses probably due to DNA repair mechanisms operating these cells. PMID- 6865998 TI - Activation of nitrosamines and other carcinogens by mouse-liver S9, mouse hepatocytes and in the host-mediated assay produces different mutagenic responses in Salmonella TA1535. AB - 5 indirect alkylating carcinogens, namely, dimethylnitrosamine (DMNA), methylethylnitrosamine (MENA), diethylnitrosamine (DENA), 1,2-dimethylhydrazine (DMH) and cyclophosphamide (CP), were tested in liquid incubation assays for their mutagenic activity towards Salmonella TA1535 in the presence of mouse-liver homogenate (S9) or freshly isolated, single liver-cell preparations. The capacity of these mouse-liver preparations to activate the compounds to mutagens for TA1535 was compared with the mutagenic effect of low doses of the carcinogens in intrasanguineous host-mediated assays, with the same strain of mice as host. Although the mouse hepatocytes retained their activating capacity longer than S9 preparations did during incubation at 37 degrees C, the latter gave much higher yields of mutants with 10 mM (DMNA, MENA, DMH) and 5 mM (CP) of 4 out of the 5 compounds. DENA was not mutagenic in either assay. These differences between whole cell and disrupted cell preparations were reduced or absent when the concentrations of the test compounds were reduced by a factor of 10. It was concluded that hepatocytes at the maximal concentration of cells have a limited capacity to metabolize the mutagens. On the basis of protein concentration, hepatocytes are more effective (nitrosamines) or equally effective (CP and DMH) in activating the compounds. Compared with the host-mediated assays, both liver fractions have only a marginal potential to activate equal low amounts of the carcinogens. The present results do not indicate that hepatocytes take an 'intermediate' position between existing in vitro and in vivo activation systems, although they do suggest that these mouse hepatocyte preparations activate the nitrosamines DMNA and MENA in a quantitatively or qualitatively different way than do mouse-liver homogenates. PMID- 6865999 TI - Comparative mammalian in vitro and in vivo studies on the mutagenic activity of rhodamine WT. AB - Rhodamine WT, a xanthene dye used in the tracing of pollutants in water and in related studies, was tested for its mutagenicity in a battery of in vitro and in vivo mammalian assays. Using Chinese hamster ovary cells in the absence of metabolic activation mix, small dose-related increases in cytotoxicity, DNA damage (as detected by alkaline sucrose-gradient sedimentation) and sister chromatid exchanges were detected, but an increase in the level of chromosomal damage was not seen. In the presence of metabolic activation a small, but statistically significant dose-related increase in sister-chromatid exchanges was evident, with no increase in cytotoxicity, DNA damage or chromosome aberrations. Furthermore, no increase in bone marrow micronuclei or sperm abnormalities was observed in male B6C3F1 mice. The data from all these mammalian assays, although involving different end-points, are in contrast to the mutagenic effects previously seen in Salmonella. PMID- 6866000 TI - In vivo induction of sister-chromatid exchange in Umbra limi by the insecticides endrin, chlordane, diazinon and guthion. AB - Central mudminnows, Umbra limi, were exposed to the insecticides endrin, chlordane, diazinon and guthion at concentrations of 5.4 X 10(-12) M to 5.4 X 10( 9) M in the aquaria water. Endrin, chlordane and diazinon caused significant increase in the frequencies of SCE. The results of these tests in part are in contrast to previous work which did not find endrin to be mutagenic. Our results suggest that the in vivo SCE test is an efficacious method of detecting mutagenic pesticides in water. PMID- 6866001 TI - Clastogenic effects of heroin in pregnant monkeys and their offspring. AB - Heroin was administered daily i.v. to pregnant Macaca mulatta monkeys, for 3 months, and after birth of their babies, was continued for 3 months post-partum. The dose was gradually increased to as high as 1.5 mg/kg/day. Pregnant control animals were given saline injections following the same design. WBC cultures for analysis of sister-chromatid exchanges (SCEs) and chromosome aberrations were taken from all adult animals, prior to heroin or saline administration, and also after 6 months, at time of sacrifice. Cultures were also done for all babies, and bone marrow analyses of aberrations were done on all animals at sacrifice. Both heroin mothers and babies showed a doubling in SCE level over their respective controls, and the heroin mothers demonstrated an almost 3-fold increase over their initial cultures. Heroin babies had 10 times as many chromosome aberrations in their WBC cultures as did their controls, and an equivalent increase in their bone marrow cells. The heroin mothers' final WBC cultures showed an increase in chromosome aberrations both over that of their initial cultures and those of their controls. The heroin babies demonstrated greater sensitivity to heroin, compared with their mothers, as measured by chromosome aberrations, but a corresponding sensitivity to SCE induction. No correlation in SCE levels was detected between individual pairs of mothers and babies, but there was one between the groups of mothers and babies. The route(s) through which the chromosomal alterations were inflicted in the babies could be transplacental, through the mother's milk, or both. The results of this investigation correspond with those of several previous studies on addict populations, and demonstrate that under these conditions, heroin is a chromosomal mutagen. PMID- 6866002 TI - Induction of chromosomal alterations as an assay for cytostatic drug activity in plasma. AB - Information about the extent and persistence of cytostatic activity in blood plasma after administration of a cytostatic drug into the body is needed for a better evaluation of the inter-individual variations in drug metabolism and disposition. As an assay for cytotoxic activity, a test system was chosen in which Chinese hamster ovary cells (CHO) were incubated with plasma containing active metabolites of cyclophosphamide (from human patients or rats), after which the frequencies of induced sister-chromatid exchanges per cell were determined. The treatment with plasma increased the frequencies of SCEs very effectively at concentrations of metabolites that were negative in the Salmonella typhimurium back-mutation test with strain TA100. The results obtained indicate that the SCE test system offers the possibility to follow the cytotoxic activity of plasma at various time intervals after administration of cyclophosphamide. PMID- 6866003 TI - X-ray-induced germ-line mutation leading to tumors. Its manifestation in mice given urethane post-natally. AB - Treatment of parental ICR mice with X-rays resulted in a significant increase of lung tumors in F1 offspring, which were inherited dominantly with about 40% penetrance. If germ-line mutation leads to heritable tumors, all cells composing the lungs must be mutated and have an equal likelihood of forming tumors. After treatment with carcinogenesis-promoting agents, unusually large clusters of tumor nodules developed in the lungs. When urethane was given to F1 offspring of parents that had been irradiated with 216 rad of X-rays, a large number of offspring (18.0%) developed large clusters of tumor nodules in the lung, whereas only 2.8% did so in the non-irradiated control, an indication of germ-line mutations. The incidence of the affected tumor clusters was more than twice (2.4 fold) that of affected progeny without urethane treatment postnatally, indicating enhancement of penetrance. If increased penetrance after urethane treatment (the multiplying ratio being 2.41) was taken into account in the dose-response data of the previous report, doubling doses were estimated to be about 25 and 50 rad for spermatids and spermatogonia respectively. These values are similar to those for other types of gonial mutation. Curiously, no tumors were produced by radiation in the offspring when exposure of male patterns was in utero (day 15 of gestation). The F1 offspring, which had no lung-tumor-causing mutations, were also highly resistant to post-natal treatment with urethane, developing no clusters of tumor nodules in the offspring. This suggests that, without tumor mutations, carcinogens rarely produce tumors. PMID- 6866004 TI - Phagocytosis-induced mutagenesis in bacteria. AB - Dark mutants of the luminous bacteria Photobacterium fischeri reverted to hereditary stable luminescent forms when incubated with human polymorphonuclear neutrophils (PMN). The maximal mutagenic effect occurred during the first 15 min of phagocytosis, and was dependent on the phagocyte:bacterium ratio as well as on the integrity of the PMN cells. Heat-killed phagocytes or disintegrated phagocytes did not show any mutagenic activity, whereas the supernatant of the phagocytosis reaction exerted mutagenic activity. Scavengers of hydroxyl radical such as mannitol or benzoate and scavengers of singlet oxygen such as beta carotene, as well as the presence of superoxide dismutase, prevented the mutations. The role of reactive oxygen metabolites in the phagocyte-mediated mutagenic process is discussed. PMID- 6866006 TI - Evidence for a motor nerve growth factor. AB - We review the evidence that a motor nerve growth factor released from muscle has wide ranging effects on the development and maintenance of muscle innervation. The actions of this putative factor on motor neurons are analogous to the actions of the well known nerve growth factor (NGF) on sympathetic and sensory neurons. PMID- 6866005 TI - Inability of several mutagen-blocking agents to inhibit 1,2-dimethylhydrazine induced DNA-damaging activity in colonic epithelium. PMID- 6866007 TI - Effects of graded duration of stretch on normal and dystrophic skeletal muscle. AB - Daily passive stretch for six weeks ranging from 30 minutes to 24 hours per day was studied in the patagialis (PAT) muscle of normal and dystrophic chickens. Significant increases in wet weight, cross-sectional area, and mean fiber cross sectional area occurred in both normal and dystrophic PAT in response to stretch of all daily durations tested. More than 50% of the growth occurring in response to continuous stretch was elicited by as little as 30 minutes of stretch per day. Oxidative enzyme capacity increased proportionately with increasing durations of stretch in the normal PAT. Similarly, increasing duration of stretch progressively retarded the onset of histopathological signs in the dystrophic PAT. We conclude that daily stretching for as little as 30 minutes per day is a powerful inducer of growth in normal and dystrophic muscle and that the progress of the histopathology in dystrophic muscle is delayed in proportion to the daily duration of stretch. PMID- 6866008 TI - Neuropathy in the hypereosinophilic syndrome. AB - Peripheral nerve dysfunction was a prominent clinical feature in each of three patients with the hypereosinophilic syndrome (HES). The neuropathy, occurring at the onset of marked eosinophilia or at a time of its worsening, had a painful onset, evolved over 1-4 weeks, and affected both sensory and motor function. Electrodiagnostic studies demonstrated both multifocal and generalized nerve involvement, with the former predominating (multiple mononeuropathy). Nerve and muscle biopsies from two patients revealed severe axonal degeneration with neurogenic atrophy of muscle. The eosinophilia decreased dramatically with corticosteroid treatment and the neuropathy gradually improved, but all three patients manifested residual neurologic disability 17-22 months after onset. The neuropathy may be on an ischemic basis or may be related to neurotoxicity of eosinophil products. PMID- 6866009 TI - Reinnervation in Duchenne muscular dystrophy. AB - Motor neuron abnormalities have been implicated in the pathogenesis of Duchenne muscular dystrophy. Evidence concerning the effect of injury on motor neurons of human Duchenne muscular dystrophy (DMD) is lacking. We report a DMD patient having, in addition, an obstetric paresis on his left arm. EMG and muscle histochemistry showed signs of reinnervation superimposed on myopathy in his left arm. This suggests that sprouting is preserved in DMD motor neurons and that muscle fibers retain the capability of accepting reinnervation. PMID- 6866010 TI - Interaction of monoclonal antibodies to Torpedo acetylcholine receptor with the receptor of skeletal muscle. AB - Several monoclonal antibodies (mcAbs) elicited against the nicotinic acetylcholine receptor (AChR) from Torpedo react also with skeletal muscle AChR. Such mcAbs were used to define antigenic determinants on muscle AChR and to elucidate their effect on muscle AChR functions. Primary chick muscle cultures were used as a model for skeletal muscle. Of the four mcAbs studies only mcAb 5.5, which is directed against the cholinergic site in Torpedo AChR, blocks the binding of alpha-bungarotoxin (alpha-Bgt) to AChR in chick muscle cultures and inhibits carbamylcholine-induced sodium transport in these cells. The interaction of mcAb 5.5 with the cholinergic site on muscle AChR demonstrates the conservation of this site. Two mcAbs, 5.5 and 5.34, each of a different antigenic specificity but both directed against conformation-dependent antigenic determinants, accelerate the degradation of AChR in muscle cultures. From the reactivity of the various mcAbs with Triton-solubilized and membranous AChR it appears that there are some antigenic differences between the detergent solubilized and membranous forms of the receptor. PMID- 6866011 TI - [Topical therapy of aspergilloma of the lung--a trial of endobronchial treatment]. PMID- 6866012 TI - Grade I Reye's syndrome. A frequent cause of vomiting and liver dysfunction after varicella and upper-respiratory-tract infection. AB - In a one-year prospective study we assessed the incidence of Reye's syndrome in children presenting with the acute onset of vomiting after a prodromal upper respiratory-tract infection or varicella, and with serum alanine or aspartate aminotransferase levels at least three times higher than normal, and a paucity of neurologic findings. Of 25 patients meeting the above criteria, 19 had liver biopsies yielding adequate tissue for diagnostic purposes. Biopsy specimens from 14 of these 19 patients (74 per cent) were diagnostic of Reye's syndrome, according to rigorous light-microscopical, histochemical, and ultrastructural criteria. None of the biopsy specimens contained evidence of other acute pathologic processes, including hepatitis. A wide spectrum of mitochondrial alterations existed at the ultrastructural level, ranging from mild to severe lesions that were indistinguishable from those seen in comatose patients with Reye's syndrome. Our findings suggest that the clinical complex of vomiting, hepatic dysfunction, and minimal neurologic impairment after varicella or an upper-respiratory-tract infection usually represents Reye's syndrome. This syndrome occurs more frequently than previously recognized. PMID- 6866013 TI - Smokers of low-yield cigarettes do not consume less nicotine. AB - Advertisements suggest that smokers of cigarettes low in nicotine are exposed to less nicotine and tar. Nicotine yields are measured with smoking machines, but machines do not smoke cigarettes as people do. We therefore measured the actual nicotine content of commercial cigarettes with different nicotine and tar yields as determined with smoking machines, and also measured actual nicotine intake as indicated by blood concentrations of its metabolite, cotinine, in 272 subjects smoking various brands of cigarettes. We found that low-yield cigarette tobacco did not contain less nicotine; in fact, the nicotine concentration in tobacco inversely correlated (r = -0.53, P less than 0.05) with the concentration measured by smoking machines. Blood cotinine concentrations correlated with the number of cigarettes smoked per day but not with the nicotine yield measured by smoking machines. Only 3.8 to 5.0 per cent of total variance in blood cotinine was contributed by nicotine yield. We conclude that smokers of low-nicotine cigarettes do not consume less nicotine. PMID- 6866014 TI - Mitochondrial inheritance in a mitochondrially mediated disease. AB - Mendelian inheritance involves the transmission to successive generations of DNA contained in genes in the nucleus, but DNA is also contained in mitochondria, where it is believed to be responsible for the encoding of certain mitochondrial enzymes. Since nearly all mitochondrial DNA is maternally transmitted, one might expect a nonmendelian pattern of inheritance in mitochondrial cytopathy, a syndrome in which there are abnormalities in mitochondrial structure and deficiencies in a variety of mitochondrial enzymes. We studied the pedigrees of 6 affected families whose members we had examined personally and of 24 families described in the literature. In 27 families, exclusively maternal transmission occurred; in 3 there was also paternal transmission in one generation. Altogether, 51 mothers but only 3 fathers had transmitted the condition. These results are consistent with mitochondrial transmission of mitochondrial cytopathy; the inheritance and enzyme defects of mitochondrial cytopathy can be considered in the light of recent evidence that subunits of respiratory-enzyme complexes are encoded solely by mitochondrial DNA. The occasional paternal transmission may be explained if certain enzyme subunits that are encoded by nuclear DNA are affected. PMID- 6866016 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 29-1983. A 46-year-old man with a pericardial abnormality and a right atrial mass. PMID- 6866017 TI - How common is Reye's syndrome? PMID- 6866015 TI - The clinical importance of a protein-bound fraction of serum bilirubin in patients with hyperbilirubinemia. AB - A directly reacting fraction of bilirubin that is probably covalently bound to albumin (albumin-bound bilirubin) has recently been described. To determine its clinical importance we used a new high-performance liquid-chromatography technique to measure it in the serum of 200 patients with hyperbilirubinemia from various causes. Albumin-bound bilirubin was an important fraction (8 to 90 per cent) of total bilirubin in patients with hepatocellular and cholestatic jaundice as well as in patients with the Dubin-Johnson syndrome. It was not detected in normal volunteers, neonates with physiologic jaundice, or patients with Gilbert's disease or hemolysis. Thus, albumin-bound bilirubin appears in serum when hepatic excretion of conjugated bilirubin is impaired. It becomes a larger component of serum bilirubin as jaundice subsides, delaying resolution of this disorder and causing bilirubin to persist in plasma after it has disappeared from the urine. PMID- 6866018 TI - Are "low-yield" cigarettes really safer? PMID- 6866020 TI - Not two, but three bilirubins. PMID- 6866019 TI - Mitochondria--structure, function, and replication. PMID- 6866021 TI - The prognostic value of histopathology in persistent generalized lymphadenopathy in homosexual men. PMID- 6866022 TI - Breast cancer and cigarette smoking. PMID- 6866023 TI - Phototoxic reactions to piroxicam and other nonsteroidal antiinflammatory agents. PMID- 6866024 TI - Irritability in autistic children treated with fenfluramine. PMID- 6866025 TI - Cimetidine and polymyositis. PMID- 6866026 TI - Caution on handling antineoplastic drugs. PMID- 6866027 TI - alpha-Thalassemia reduces the hemolytic rate in homozygous sickle-cell disease. PMID- 6866028 TI - Nerve conduction velocity in diabetes. PMID- 6866029 TI - Prognosis in primary biliary cirrhosis. PMID- 6866030 TI - Health care in Nicaragua. PMID- 6866031 TI - The stress of playing God. PMID- 6866032 TI - A prospective evaluation and follow-up of patients with syncope. AB - We prospectively evaluated and followed 204 patients with syncope to determine how often a cause of syncope could be established and to define the prognosis of such patients. A cardiovascular cause was established in 53 patients and a noncardiovascular cause in 54. The cause remained unknown in 97 patients. At 12 months, the overall mortality was 14 +/- 2.5 per cent. The mortality rate (30 +/- 6.7 per cent) in patients with a cardiovascular cause of syncope was significantly higher than the rate (12 +/- 4.4 per cent) in patients with a noncardiovascular cause (P = 0.02) and the rate (6.4 +/- 2.8 per cent) in patients with syncope of unknown origin (P less than 0.0001). The incidence of sudden death was 24 +/- 6.6 per cent in patients with a cardiovascular cause, as compared with 4 +/- 2.7 per cent in patients with a noncardiovascular cause (P = 0.005) and 3 +/- 1.8 per cent in patients with syncope of unknown origin (P = 0.0002). Patients with syncope can be separated into diagnostic categories that have prognostic importance. Patients with a cardiovascular cause have a strikingly higher incidence of sudden death than patients with a noncardiovascular or unknown cause. PMID- 6866033 TI - Fluctuating cerebral blood-flow velocity in respiratory-distress syndrome. Relation to the development of intraventricular hemorrhage. AB - We studied whether changes in cerebral blood-flow velocity occur during the respiratory-distress syndrome and whether, if present, they are related to the subsequent occurrence of intraventricular hemorrhage. Fifty infants weighing less than 1500 g at birth who required mechanical ventilation for the respiratory distress syndrome were studied from the first hours of life. Blood-flow velocity in the anterior cerebral artery was measured at the anterior fontanel by means of the Doppler technique. At 12 hours of age, the infants had blood-flow velocity patterns that were either stable or fluctuating and that reflected the patterns of simultaneously recorded blood pressure. Intraventricular hemorrhage subsequently developed in 21 of 23 infants with the fluctuating pattern (in most of them, within the next 24 hours), but in only 7 of 27 infants with the stable pattern. Preliminary data suggest that the cerebral hemodynamic fluctuations are related to the respiratory disease and particularly to the mechanics of respiration. We conclude that the fluctuating pattern of cerebral blood-flow velocity in infants with the respiratory-distress syndrome indicates an extreme risk of the development of intraventricular hemorrhage and may represent a major and potentially preventable etiologic factor. PMID- 6866034 TI - Connective-tissue disease, antibodies to ribonucleoprotein, and congenital heart block. AB - The relation between congenital heart block and maternal connective-tissue disease was studied by antibody screening of serum samples obtained in connection with 45 cases of isolated congenital complete heart block. Serum was available from 41 mothers (17 who had connective-tissue disease and 24 who were healthy) and 21 children. Thirty-four mothers had antibody to a soluble tissue ribonucleoprotein antigen called Ro(SS-A), which was identified by immunodiffusion. Anti-Ro(SS-A) was found in seven of eight serum samples collected from affected children when they were less than three months old but in none of 13 samples obtained when these children were older. It appears that maternal anti-Ro(SS-A) antibody crosses the placenta and is a marker for risk of congenital complete heart block; its absence from maternal serum suggests that a child is unlikely to be affected. Anti-Ro(SS-A) or a related antibody is probably involved in the pathogenesis of congenital complete heart block. PMID- 6866035 TI - The effects of competition on prescription-drug-product substitution. AB - Almost all states have enacted legislation, that allows pharmacists to substitute drug products when filling prescriptions. We studied the effects of competition in the drugstore service area on the use of less costly drug products and the pricing of prescriptions under the drug-product-selection law in Minnesota. In 38 drugstores in the Minneapolis-St. Paul area, rates of substitution of generic or less-costly brands and prescription prices were analyzed according to the degree of competition in the drugstore's service area, as measured by the pharmacists' perceptions and the number of competing drugstores within a 1-mile radius. Although higher levels of competition were associated with increased use of generic drugs for prescriptions written generically, competition did not appear to affect either dispensing patterns for prescriptions written for brand-name products or the retail prices of brand-name or generic products. These findings do not support the hypothesis that competition reduces prescription-drug prices through improved selection of drug products at the retail pharmacy level. PMID- 6866036 TI - Human monoclonal autoantibodies that react with multiple endocrine organs. PMID- 6866038 TI - A familial syndrome of pericarditis, arthritis, and camptodactyly. PMID- 6866039 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 30-1983. A 76-year-old man with seizures and a right frontal mass. PMID- 6866037 TI - Coronary spasm producing coronary thrombosis and myocardial infarction. PMID- 6866040 TI - Congenital complete heart block and connective-tissue disease. PMID- 6866041 TI - Coronary-artery spasm and myocardial infarction. PMID- 6866042 TI - Immunosuppression for multiple sclerosis. PMID- 6866043 TI - Evoked potentials after hyperbaric oxygen treatment of multiple sclerosis. PMID- 6866044 TI - Fatal myocardial necrosis associated with prothrombin-complex concentrate therapy in hemophilia A. PMID- 6866045 TI - Long-term survival in multiple myeloma. PMID- 6866046 TI - Amyotrophic lateral sclerosis and pet exposure. PMID- 6866047 TI - Effect of granulocyte transfusion on phagocytic function in neutropenic patients. PMID- 6866048 TI - Treatment of digitalis intoxication with digoxin-specific Fab antibody fragments. PMID- 6866049 TI - The 250-TU PPD and second-strength skin tests. PMID- 6866051 TI - Steroid-induced fractures and bone loss in patients with asthma. AB - To study the association between bone disease and long-term steroid administration in asthmatics, we reviewed the hospital records of 128 patients over 40 years of age who had taken daily or alternate-day adrenal corticosteroids for at least a year and compared them with the records of 54 other asthmatics of similar age who had not required long-term administration of steroids. We found evidence in the records of a total of 58 fractures of the ribs or vertebrae in 14 of the patients who had received long-term steroid treatment (11 per cent) and no evidence of fractures in the patients who had not received long-term treatment. We also prospectively studied 30 hospitalized asthmatic patients between 20 and 70 years of age who had been screened for medications (other than steroids) or complicating diseases known to affect bone mineralization. Eight of 19 asthmatic patients receiving long-term steroid therapy had rib or vertebral fractures, whereas none of 11 matched patients not receiving such therapy had fractures. Furthermore, bone-density measurements of the distal and proximal radius by photon absorptiometry revealed that the trabecular, but not the cortical, bone mass was below normal in the former group of patients but not in the latter. Within the long-term steroid group, there was no significant correlation between bone density and dose or duration of steroid treatment. We conclude that long term steroid therapy in asthmatic patients is associated with decreased trabecular bone density and an increased prevalence of rib and vertebral fractures. PMID- 6866052 TI - Recurrence of hyperprolactinemia after selective transsphenoidal adenomectomy in women with prolactinoma. AB - To assess the long-term prognosis for women with prolactinoma after selective transsphenoidal adenomectomy, we followed 44 patients for 6.2 +/- 1.5 years. Group 1 (28 patients) had microprolactinomas, and Group 2 (16 patients) had macroprolactinomas. After surgery, normal plasma prolactin levels, resumption of menses, and cessation of galactorrhea were observed in 24 Group 1 patients (85 per cent) and 5 Group 2 patients (31 per cent). Hyperprolactinemia recurred in 12 of the 24 Group 1 patients and in 4 of the 5 Group 2 patients after 4 +/- 1.3 and 2.5 +/- 1.6 years of remission, respectively. There was no radiologic evidence of tumor recurrence in any patient, and no relation was found between the occurrence of pregnancy after surgery and the recurrence of hyperprolactinemia. Clinical and biologic features before surgery could not predict the long-term outcome. However, the immediate postoperative level of plasma prolactin was significantly lower in patients in whom normal prolactinemia (6.4 +/- 1.1 ng per milliliter) was maintained than in those who relapsed (11.7 +/- 1.5 ng per milliliter) (P less than 0.02). We conclude that recurrence of hyperprolactinemia after successful surgery is frequent but delayed. The immediate postoperative level of plasma prolactin may be a predictive risk factor. PMID- 6866050 TI - Why not rate health and life insurance by risks? PMID- 6866053 TI - Prenatal diagnosis of beta-thalassemia. Detection of a single nucleotide mutation in DNA. AB - We investigated a method employing synthetic oligonucleotides for the prenatal diagnosis of beta-thalassemia due to a single nucleotide mutation. The beta 0 thalassemia we tested is produced by a nonsense mutation and is commonly found in Sardinia and other parts of the Mediterranean. In this DNA lesion, the glutamine codon CAG at the beta 39 position is mutated to TAG, which results in a stop codon and premature termination of the beta-globin chain. We synthesized two oligonucleotides: one homologous to the normal beta A gene and the other to the beta 0 thalassemia gene at the beta 39 location. The oligonucleotides were labeled with 32P and used as hybridization probes for normal and thalassemic DNA. The beta A probe hybridized only to the normal DNA, and the beta-thalassemia probe only to thalassemic DNA, thus providing a technique for direct demonstration of the mutation. The method is sensitive enough to be applied directly to DNA that is isolated from uncultured cells obtained from only 20 ml of amniotic fluid as early as the 16th gestational week. PMID- 6866054 TI - Glucocorticoid-induced osteoporosis. PMID- 6866055 TI - Frequent doses of intravenous colchicine can be lethal. PMID- 6866056 TI - Congenital malformations. PMID- 6866057 TI - Marked B12 deficiency in alpha-thalassemia. PMID- 6866058 TI - Pleural effusions in congestive heart failure and in pericardial disease. PMID- 6866059 TI - Primary infection by Epstein-Barr virus presenting as aplastic anemia. PMID- 6866060 TI - Obstructive sleep apnea and testosterone. PMID- 6866062 TI - Long-lasting visual aftereffect from viewing a computer video display. PMID- 6866063 TI - Mortality statistics in the United States. PMID- 6866064 TI - Book review: the Health of China. PMID- 6866061 TI - Effect of gluten in dermatitis herpetiformis--implications for psychosomatic medicine. PMID- 6866065 TI - More on the Journal's book reviews. PMID- 6866066 TI - United Nations principles of medical ethics. PMID- 6866068 TI - Risk stratification and survival after myocardial infarction. AB - We assessed the role of physiologic measurements of heart function in predicting mortality after myocardial infarction. Most of the 866 patients enrolled in our multicenter study underwent 24-hour Holter monitoring and determination of the resting radionuclide ventricular ejection fraction before discharge. Univariate analyses showed a progressive increase in cardiac mortality during one year as the ejection fraction fell below 0.40 and as the number of ventricular ectopic depolarizations exceeded one per hour. Only four risk factors among eight prespecified variables were independent predictors of mortality: an ejection fraction below 0.40, ventricular ectopy of 10 or more depolarizations per hour, advanced New York Heart Association functional class before infarction, and rales heard in the upper two thirds of the lung fields while the patient was in the coronary-care unit. Various combinations of these four factors identified five risk subgroups with two-year mortality rates ranging from 3 per cent (no factors) to 60 per cent (all four factors). PMID- 6866067 TI - Absence of parathyroid hormone messenger RNA in nonparathyroid tumors associated with hypercalcemia. AB - We used a sensitive and specific hybridization assay that detects evidence of parathyroid hormone synthesis in tumors to investigate whether this hormone mediates the hypercalcemia of malignant disease. The assay uses radiolabeled, cloned parathyroid hormone DNA to hybridize selectively with parathyroid hormone messenger RNA. We assayed 13 human and 3 animal tumors of diverse cell origins that are frequently associated with the hypercalcemia of cancer. Five of the human tumors were obtained from patients known to be hypercalcemic at the time of tumor excision, two were from normocalcemic patients, and six were from patients with breast cancer whose serum calcium levels were unknown. Messenger RNA was prepared from cultured cell lines or tumors; active RNA fractions were hybridized with either human or bovine cloned parathyroid hormone DNA that had been labeled to a high specific activity with [32P]nucleotide. We were unable to detect parathyroid hormone RNA transcripts in any of the tumors. Our results indicate that parathyroid hormone rarely, if ever, causes hypercalcemia in malignant disease. PMID- 6866069 TI - The usefulness of chest radiographs in first asthma attacks. AB - To assess the value of routine chest radiography during acute first attacks of asthma, we studied 371 consecutive children over one year of age who presented with an initial episode of wheezing. Three hundred fifty children (94.3 per cent) had radiographic findings that were compatible with uncomplicated asthma and were considered negative. Twenty-one (5.7 per cent) had positive findings: atelectasis and pneumonia were noted in seven, segmental atelectasis in six, pneumonia in five, multiple areas of subsegmental atelectasis in two, and pneumomediastinum in one. The patients with positive films were more likely to have a respiratory rate above 60 or a pulse rate above 160 (P less than 0.001), localized rales or localized decreased breath sounds before treatment (P less than 0.01), and localized rales (P less than 0.005) and localized wheezing (P less than 0.02) after treatment; also, these patients were admitted to the hospital more often (P less than 0.001). Ninety-five per cent (20 of 21) of the children with positive films could be identified before treatment on the basis of a combination of tachypnea, tachycardia, fever, and localized rales or localized decreased breath sounds. Most first-time wheezers will not have positive radiographs; careful clinical evaluation should reveal which patients will have abnormal radiographs and will therefore benefit from the procedure. PMID- 6866071 TI - Sounding board. New approaches to using the determination-of-need process to contain hospital costs. PMID- 6866070 TI - Thiazide effect on the mineral content of bone. AB - The thiazide diuretics are known to cause calcium retention. In order to study the effect of thiazides on bone mineralization, we have measured the mineral content of bone at five sites (the distal radius, the distal ulna, the proximal radius, the proximal ulna, and the os calcis) in 1368 men with a mean age of 68 years, including 323 who were taking thiazides for hypertension. The results were adjusted for age and body-mass index. Thiazide users had significantly more bone mineral content at all five sites than did non-users. Untreated hypertensive patients and persons without hypertension had comparable bone mineral content, indicating that the higher mineral content found among thiazide users is related to the drug and not to the underlying hypertension. These findings suggest the possibility of a preventive or therapeutic role for thiazides in osteoporosis. PMID- 6866072 TI - Right-heart catheterization in the critically ill patient. PMID- 6866073 TI - Ventricular arrhythmias in congestive cardiomyopathy. PMID- 6866074 TI - Cardiac effects of mediastinal irradiation. PMID- 6866075 TI - Digoxin in infants with a congestive circulatory state. PMID- 6866076 TI - One cancer gene: two mutations. PMID- 6866077 TI - What cloned genes can tell us about nerve growth factor. PMID- 6866078 TI - 'Hormonal' risk factors, 'breast tissue age' and the age-incidence of breast cancer. AB - For most cancer sites there is a linear log-log relationship between incidence and age. This relationship does not hold for breast cancer, and certain 'key' breast cancer risk factors suggest that breast tissue does not 'age' in step with calendar time. A quantitative description of 'breast tissue age' is suggested which brings the age-incidence curve of breast cancer into line with the common log-log cancers and explains quantitatively the known key risk factors. The model also explains the 'anomalous' finding that although early first birth is protective, late first birth carries a higher risk than nulliparity. US breast cancer rates are some four to six times the rates in Japan--the model suggests that the key risk factors, when considered jointly with weight, can explain about 85% of the difference. PMID- 6866079 TI - Acquisition of transforming properties by alternative point mutations within c bas/has human proto-oncogene. AB - The transforming gene of a human lung carcinoma-derived cell line, Hs242, has been cloned in biologically active form, and identified as c-bas/has (otherwise known as c-Ha-ras). The genetic lesion responsible for the transforming activity of the Hs242 oncogene has been localized to a point mutation in the second exon which results in the substitution of leucine for glutamine as amino acid 61 of the predicted protein. No changes were observed in the first exon, the region of c-bas/has in which a point mutation is responsible for activation of the T24 and EJ bladder carcinoma oncogenes. PMID- 6866080 TI - Possible relationship of morphogenesis in pathogenic fungus, Histoplasma capsulatum, to heat shock response. AB - Histoplasma capsulatum, like many other fungal pathogens, is dimorphic: it exists as mycelia in the soil and yeast in animal hosts. Because only the yeast phase is parasitic, factors which affect morphogenesis have been of interest for understanding and controlling pathogenicity. In culture, the mycelial to yeast transition of H. capsulatum is induced by a temperature shift from 25 to 37 degrees C (ref. 1). The transition occurs over several days and is accompanied by marked changes in metabolic processes, including respiration and cysteine metabolism. Here, we show that the triggering event for these morphological and biochemical changes is a rapid decline in intracellular ATP levels that follows uncoupling of oxidative phosphorylation when mycelia are shifted from 25 to 37 degrees C. We also show that respiration in the yeast phase is coupled at 37 degrees C and thus that the morphological transition may be viewed as a heat shock followed by cellular adaptation to higher temperature. PMID- 6866081 TI - A new function for platelets: IgE-dependent killing of schistosomes. AB - Several killing mechanisms against schistosomes have been described in vitro, involving cellular and humoral factors. Neutrophils, eosinophils--with an accessory role for mast cells--monocytes and macrophages have been shown to exhibit cytotoxic properties against Schistosoma mansoni larvae, in association with antibodies of various isotypes or with complement (reviewed in ref. 1). Lymphocyte participation in effector functions is mediated mainly through lymphokines inducing cytotoxic macrophages, and, in certain cases, directly by T cells. The experiments reported here show that platelets, taken from rats after specific periods of infection with S. mansoni, were able to kill schistosomula, and that normal human or rat platelets acquired toxic properties towards the same target in the presence of serum from infected individuals. The humoral factor involved in this process was shown to be IgE, and evidence was obtained of a Fc receptor for IgE on human and rat platelets. The passive transfer of immune platelets to normal rats conferred a high degree of protection towards a challenge infection by the parasite. PMID- 6866082 TI - Goose lysozyme structure: an evolutionary link between hen and bacteriophage lysozymes? AB - During evolution, the amino acid sequence of a protein is much more variable and changes more rapidly than its tertiary structure. Given sufficient time, the amino acid sequences of proteins derived from a common precursor may alter to the point that they are no longer demonstrably homologous. The ability to make meaningful comparisons between such distantly related proteins must therefore come primarily from structural homology, and only secondarily (if at all) from sequence homology. On the other hand, structural homology in the absence of sequence homology might be attributed to convergent rather than divergent evolution. (A common fold might be dictated by functional or folding requirements.) We have previously argued, on the basis of structural and functional similarities, that the lysozymes of hen egg-white and bacteriophage T4 have a common evolutionary precursor, even though their amino acid sequences have no detectable similarity. Here we report the structure of the lysozyme from Embden goose, a representative of a third class of lysozymes that has no sequence homology (or perhaps very weak homology) with either the hen egg-white or the phage enzyme. The structure of goose egg-white lysozyme has striking similarities to the lysozymes from hen egg-white and bacteriophage T4. However, some parts of goose lysozyme resemble hen lysozyme while other parts correspond only to the phage enzyme. The nature of the structural correspondence strongly suggests that all three lysozymes evolved from a common precursor. PMID- 6866084 TI - Facts, not rhetoric on yellow rain. PMID- 6866083 TI - Single-copy DNA sequences specific for the human Y chromosome. AB - Detailed studies of the role of the mammalian Y chromosome in primary sex determination are limited by the lack of available specific markers and by the fragmentary knowledge of its molecular organization. Y-derived unique DNA sequences could provide powerful analytical tools to probe directly the structure of the Y chromosome and provide a means of searching for specific expressed sequences. We report here the construction of a partial cosmid library of the human Y chromosome. From independent clones we have isolated 30 unrelated DNA probes that are free of highly repetitive sequences, and have examined their reaction pattern on male and female genomic blots. Of the 30 probes tested, six were specific for the Y chromosome. In addition, four probes gave a male-female differential hybridization pattern and the remaining 20, although Y-derived, reacted similarly with both male and female DNA. PMID- 6866085 TI - Immunology. Roving lymphocytes. PMID- 6866087 TI - Acid rain. Demands for action multiply. PMID- 6866086 TI - A cell-surface molecule involved in organ-specific homing of lymphocytes. AB - Lymphocytes migrate from the bloodstream by recognizing and binding to specialized endothelial cells lining the high endothelial venules (HEV) in lymph nodes and Peyer's patches. We describe here a monoclonal antibody, MEL-14, specific for a lymphocyte surface molecule that appears to mediate recognition of lymph node HEV, and to be required for lymphocyte homing into lymph nodes in vivo. PMID- 6866089 TI - Rapid motion aftereffect seen within uniform flickering test fields. AB - Prolonged viewing of a moving pattern selectively elevates the threshold for a pattern moving in the same direction and induces the classical motion aftereffect (MAE). The aftereffect is seen as a slow drift in the opposite direction, which is visible even with the eyes shut or while viewing a uniform field. However, as we report here, a strikingly different aftereffect is seen when the test field is uniform and sinusoidally flickered: the field is filled with rapid motion in the direction opposite the adapting motion. This flicker MAE has distinct properties: the adapting grating must be of low spatial frequency; the effect is promoted by high contrast and high temporal frequencies of both adapting and test stimuli; and the aftereffect does not transfer interocularly. In all these respects the flicker MAE differs from the traditional MAE. Motion detectors have been identified in human vision by the threshold detectability and discriminability of moving patterns and by selective adaptation. The flicker MAE selectively taps a class of transient motion mechanisms that are selective for rapid motion and low spatial frequency. Uniform flicker is an effective stimulus for these mechanisms. It thus appears that the human visual system contains at least two distinct classes of mechanisms for sensing motion. PMID- 6866088 TI - Dioxin lawsuits. Agent Orange in the courts. PMID- 6866090 TI - Pioneer axons lose directed growth after selective killing of guidepost cells. AB - The first nerve cells to appear in the limb buds of embryonic grasshoppers are a pair which lie at the distal tip and project axons along the length of the limb to the central nervous system (CNS). The stereotyped route navigated by these 'pioneer' axons is followed by other neurones and eventually becomes that of a major adult nerve trunk. The guidance cues which delineate this route are unknown, but it has been suggested that guidance is provided by a set of nonadjacent 'guidepost' cells along which the pioneers grow (Fig. 1). We have now tested this suggestion by selectively destroying identified guidepost cells and observing pioneer axon trajectories in their absence. Our results support the guidepost cell hypothesis. PMID- 6866092 TI - Malaria vaccine: conflicting interests at work. PMID- 6866091 TI - Malignant conversion of mouse skin tumours is increased by tumour initiators and unaffected by tumour promoters. AB - Multi-stage carcinogenesis (initiation-promotion) was first demonstrated in mouse skin. The first stage, initiation, is accomplished by a low dose of carcinogen that causes no tumours. Promotion by repeated treatment of initiated mice with certain non-carcinogenic hyperplastic agents results in the rapid production of numerous benign papillomas, a few of which progress to squamous cell carcinomas. Although this models system produces mostly benign tumours, many of the concepts concerning carcinogenesis in epithelial tissues have been derived from mouse skin studies. The permanent change in growth potential accomplished by tumour initiators is generally considered to be a mutagenic event; cell selection and clonal expansion of initiated cells may be involved in promotion. In initiation promotion experiments, more than 90% of the squamous cell carcinomas develop from papillomas, but the conversion rate is low. The factors necessary for this conversion of benign to malignant tumours have not been defined but tumour promoters have been assumed to be involved. However, we report here that the tumour promoter 12-O-tetradecanoylphorbol-13-acetate (TPA) is ineffective in the conversion of papillomas to carcinomas whereas three initiators, urethane, N methyl-N'-nitro-N-nitrosoguanidine (MNNG) and 4-nitroquinoline-N-oxide (4-NQO) are effective. This suggests that malignant conversion may result from a further genetic change in papilloma cells and that the ineffectiveness of TPA may be due to its inactivity as a mutagen. PMID- 6866093 TI - Fluoridation. Reluctant ban in Scotland. PMID- 6866094 TI - Hepatoma secretory proteins migrate from rough endoplasmic reticulum to Golgi at characteristic rates. AB - In eukaryotic cells, secretory proteins and glycoproteins migrate from the rough endoplasmic reticulum, their site of synthesis, through Golgi vesicles before being released from the cell. Cellular and viral integral plasma membrane glycoproteins are co-translationally inserted into the rough endoplasmic reticulum membrane and follow a similar pathway to the cell surface. Previous studies using endoglycosidase H (Endo H) suggested that in rat hepatoma cells the vesicular stomatitis virus (VSV) G protein, albumin and transferrin migrate from the rough endoplasmic reticulum to the Golgi apparatus at different rates. Here we show directly that in human hepatoma HepG2 cells, five secreted proteins mature from the rough endoplasmic reticulum to Golgi vesicles at characteristic rates which differ at least threefold. The results are incompatible with bulk phase movement of the luminal contents of the endoplasmic reticulum, and suggest that there is a membrane-bound receptor that selectively mediates the transport of secretory proteins from the rough endoplasmic reticulum to the Golgi. PMID- 6866096 TI - UK nutrition. Government chokes on report. PMID- 6866095 TI - Left-handed helical conformation of poly[d(A-m5C).d(G-T)]. AB - Poly[d(G-C)] serves as the prototype for the right-to-left (B to Z) transition in he helical sense of DNA, both in solution and inthe crystal form. However, the question remains as to which other synthetic and natural DNAs have the potential to adopt left-handed conformations. One logical candidate is the canonical alternating purine-pyrimidine sequence d(A-C)n.d(G-T)n which seems to be widely disseminated in eukaryotic genomes. Our approach to this question is based on the enzymatic synthesis of poly[d(A-C).d(G-U)] derivatives with systematic methyl and halogen substitutions in the C-5 position of the pyrimidines C and U. Such modifications in poly[d(G-C)] have previously been shown to potentiate the B to Z transition. Here we report a highly cooperative, reversible, salt- and temperature-dependent transition for poly[d(A-m5C).d(G-T)], a repeat of the d(A m5C) sequence which may occur in natural DNA. Spectroscopic studies and the demonstrated ability to bind anti-Z-DNA antibodies suggest that the new helical conformation is left-handed and shares structural features with known Z-DNA. However, a novel property, not exhibited by poly[d(G-C)], is the profound temperature dependence of the conformational equilibrium. PMID- 6866097 TI - Formaldehyde cancer risk. Court not convinced of dangers. PMID- 6866098 TI - Oncogene discovery. Priority by press release. PMID- 6866099 TI - Biotechnology. Still on the up and up? PMID- 6866100 TI - Marine animal killing. PMID- 6866101 TI - The function of dream sleep. AB - We propose that the function of dream sleep (more properly rapid-eye movement or REM sleep) is to remove certain undesirable modes of interaction in networks of cells in the cerebral cortex. We postulate that this is done in REM sleep by a reverse learning mechanism (see also p. 158), so that the trace in the brain of the unconscious dream is weakened, rather than strengthened, by the dream. PMID- 6866102 TI - Animal behaviour. From Skinner box to the field. PMID- 6866104 TI - Neurobiology. Peptides and the microregulation of blood flow in the brain. PMID- 6866103 TI - Neurobiology: contractile proteins in brain cells. PMID- 6866105 TI - Reproductive immunology. Early pregnancy factor. PMID- 6866106 TI - Soil analysis. Mapping human activity in soil. PMID- 6866107 TI - Vision. New depths in stereopsis. PMID- 6866108 TI - Cultural evolution. Anthropology and cultural transmission. PMID- 6866110 TI - A language-specific comprehension strategy. AB - Infants acquire whatever language is spoken in the environment into which they are born. The mental capability of the newborn child is not biased in any way towards the acquisition of one human language rather than another. Because psychologists who attempt to model the process of language comprehension are interested in the structure of the human mind, rather than in the properties of individual languages, strategies which they incorporate in their models are presumed to be universal, not language-specific. In other words, strategies of comprehension are presumed to be characteristic of the human language processing system, rather than, say, the French, English, or Igbo language processing systems. We report here, however, on a comprehension strategy which appears to be used by native speakers of French but not by native speakers of English. PMID- 6866111 TI - Sleep deficits in rats with hereditary diabetes insipidus. AB - Interest in the Brattleboro diabetes insipidus rat has resurged with the recent increase in research on brain peptides. Various reports have suggested that in these rats, the impaired ability for memory consolidation is due essentially to a chronic lack of vasopressin. On the other hand, sleep stages and particularly the paradoxical phase of sleep have been shown to have a key role in the processes of learning and memory consolidation. Curiously, the possible involvement of sleep deficits in the impairment of memory function in the Brattleboro rat has never been suspected. Here I report a significant reduction (38%) in the daily duration of paradoxical sleep (PS) in the homozygous diabetes insipidus (HODI) rat compared to the heterozygous Long Evans strain. Normal or increased durations of PS were observed after intravenous (i.v.) administration of vasopressin but also when the normal daily water intake (240 ml) was infused i.v. These results provide direct evidence that PS deficits in the HODI rat are not due to the absence of vasopressin. They also suggest that the impaired ability for learning and memory processes are probably due to the impairment of PS rather than to some direct consequence of the hereditary lack of vasopressin. PMID- 6866109 TI - 'Unlearning' has a stabilizing effect in collective memories. AB - Crick and Mitchison have presented a hypothesis for the functional role of dream sleep involving an 'unlearning' process. We have independently carried out mathematical and computer modelling of learning and 'unlearning' in a collective neural network of 30-1,000 neurones. The model network has a content-addressable memory or 'associative memory' which allows it to learn and store many memories. A particular memory can be evoked in its entirety when the network is stimulated by any adequate-sized subpart of the information of that memory. But different memories of the same size are not equally easy to recall. Also, when memories are learned, spurious memories are also created and can also be evoked. Applying an 'unlearning' process, similar to the learning processes but with a reversed sign and starting from a noise input, enhances the performance of the network in accessing real memories and in minimizing spurious ones. Although our model was not motivated by higher nervous function, our system displays behaviours which are strikingly parallel to those needed for the hypothesized role of 'unlearning' in rapid eye movement (REM) sleep. PMID- 6866112 TI - Chromosomal sublocalization of human c-myb and c-fes cellular onc genes. AB - The transforming genes of acutely transforming retroviruses are derived from conserved cellular genes (c-onc genes) which are believed to be important in normal cell growth and differentiation. Recent studies indicate that altered expression of c-onc genes, for example, by insertion of viral genomes, gene amplification or chromosomal translocation, can lead to development of malignant diseases in man and animals. c-myb and c-fes are homologues of the transforming genes of avian myeloblastosis virus and feline sarcoma virus (Gardner and Snyder Theilen strains), respectively. c-myb is transcribed preferentially in immature haematopoietic cells and probably codes for a protein important in differentiation of these cells. The viral fes gene, like several other viral onc genes, encodes a tyrosine-specific protein kinase. However, c-fes transcripts have not been detected in the types of human cells examined so far. c-myb and c fes have been assigned to human chromosomes 6 and 15, respectively. Specific aberrations involving these chromosomes have been observed at high frequency in several human neoplasms. We have now sublocalized c-myb to 6q22-24 and c-fes to 15q25-26 by in situ hybridization of the human c-onc probes to human mitotic chromosome preparations. These chromosomal segments are indeed involved in nonrandom translocations in several human tumours. The results encourage further investigation into the role of onc genes in the pathogenesis of specific neoplasms. PMID- 6866116 TI - Radiation exposure: Japanese veterans cleared. PMID- 6866115 TI - Air quality standards: arsenic and jobs trade-off. PMID- 6866114 TI - Asymmetric ligand binding by haemoglobin. PMID- 6866113 TI - Myositis autoantibody inhibits histidyl-tRNA synthetase: a model for autoimmunity. AB - In autoimmune disorders such as rheumatoid arthritis and systemic lupus erythematosus (SLE), autoantibodies are generated against a variety of macromolecules. Myositis is a human autoimmune disease characterized by weakness and wasting of muscle. In American studies, antibodies directed against soluble cellular constituents were detected by immunodiffusion in about 60% of cases; the commonest of these, found in 25% of patients, was antibody to the Jo-1 antigen. An antibody system referred to as PL-1 was recognized at a similar frequency in a series of patients studied at Hammersmith Hospital, London. We show here that this system is identical with the Jo-1 system and demonstrate that the antigen is a polypeptide of molecular weight (Mr) 50,000. The protein is immunoprecipitated with tRNA His and appears to be histidyl-tRNA synthetase. The identity of the Jo 1 antigen, the first of the RNA-associated antigens familiar in autoimmune disease to be characterized as a specific enzyme, suggests a model for virus involvement in autoantibody generation. PMID- 6866118 TI - African famine: can science help in time? PMID- 6866117 TI - AIDS: Moral Majority intervenes. PMID- 6866119 TI - Psychiatry and ethics: what cuckoo's nest next? PMID- 6866121 TI - Decision-making. PMID- 6866120 TI - Goitre in India: iodine prophylaxis falters. PMID- 6866122 TI - To be or not to be. PMID- 6866123 TI - Intelligence, guesswork, language. AB - A satisfactory definition of intelligence has never been found, and as a result it means different things to different people. What it is may remain too complex for a succinct definition, but the theory and practice of information handling have clarified what it does for us: it enables us to guess better, and the discovery of unexpected orderliness is the chief means of doing this. PMID- 6866124 TI - Genetics. Sex is simple. PMID- 6866125 TI - Immunology. Molecular biology of the major histocompatibility complex. PMID- 6866126 TI - Two types of sex determination in a nematode. AB - Sex in the nematode Caenorhabditis elegans is normally determined by a genic balance mechanism, the ratio of X chromosomes to autosomes, so that XX animals are self-fertilizing hermaphrodites and X0 animals are males. However, recessive mutations of the autosomal gene tra-1 III cause both XX and X0 animals to develop into males, and a linked dominant mutation causes both XX and X0 animals to develop into females. Here I show that these two kinds of mutation are allelic, and that stable mutant strains can be constructed in which sex is determined not by X-chromosome dosage but by the presence or absence of a single active gene. In these strains the autosomes carrying the tra-1 locus are in effect homomorphic Z and W sex chromosomes, and the sexes are homogametic ZZ males and heterogametic ZW females, in contrast to the wild-type arrangement of homogametic XX hermaphrodites and heterogametic X0 males. PMID- 6866127 TI - Muscarinic receptors of rabbit irides. PMID- 6866128 TI - Critical assessment of noradrenaline uptake in synaptosomal preparations. AB - Synaptosomes and other subcellular organelles were prepared from rat brain using a vertical rotor. The preparation time was reduced by up to 60% compared to conventional techniques. Uptake of [3H]-(-)-noradrenaline into subcellular fractions was characterized. The characteristics of this uptake were dependent on the subcellular composition and anatomical origin. Various methods of correction for energy independent processes were compared, but only sodium ion removal from the medium selectively inhibited the energy dependent uptake mechanism. Kinetic analysis of data revealed that high and low affinity uptake systems were dependent on the fraction under analysis. Noradrenaline uptake was not exclusively localised in noradrenergic terminals. Selective inhibitors of the noradrenaline uptake process (tricyclic antidepressants) inhibited energy dependent uptake completely only in purified synaptosomes prepared from cortex. In whole brain synaptosomal fractions, noradrenaline was partially accumulated into dopaminergic neurones; this uptake process was not inhibited by tricyclic antidepressants. PMID- 6866129 TI - Pharmacokinetics of tetrahydronorharmane (tetrahydro-beta-carboline) in rats. AB - The distribution, metabolism and elimination into the urine of (14C) tetrahydronorharmane (THN) as well as of (14C)-6-hydroxy-tetrahydronorharmane (6 OH-THN) are investigated in female and male rats. Following intravenous injection of (14C)-THN radioactivity was detected in all organs examined, namely blood, brain, lung, adrenal gland, small intestine, fat tissue, kidney and liver. In the brain the elimination half life of THN was calculated to be 1.8 h, the elimination half life of the radioactivity in the blood 6.24 h, and the accumulation half life in the urine 9.24 h. The elimination of 6-OH-THN into the urine is faster than that of THN. At least four metabolites of (14C)-THN were found in the urine of female rats. Two different metabolic pathways are discussed, firstly, hydroxylation followed by conjugation with glucuronic and sulfuric acids and secondly, dehydrogenation, followed by oxygenation. In female rats only traces of the conjugated metabolites are hydrolysed by arylsulfatase, whereas in male rats approximately 2/5 are cleaved by this enzyme. Pretreatment of male rats with 3-methylcholanthrene induced conjugation, whereas phenobarbital had no obvious effect on the pattern of metabolites. SKF 525 A and CFT 1201 both prevented almost completely the formation of conjugates from THN. PMID- 6866130 TI - Characterization of a common binding site for basic drugs on human alpha 1-acid glycoprotein (orosomucoid). AB - The interaction of chlorpromazine, DL-propranolol, and imipramine with isolated alpha 1-acid glycoprotein is characterized by relatively high association constants and only one binding site per protein molecule. The mutual displacement between the three drugs indicates that all three compounds are bound to the same binding site. Several other basic drugs from different pharmacological and chemical classes also displace chlorpromazine, DL-propranolol, and imipramine with potencies, one would predict from their association constants or from the degree of their plasma binding in humans. It is concluded that displacement phenomena like those observed in this study in vitro are likely to occur also in vivo. PMID- 6866131 TI - Affinity spectra: a novel way for the evaluation of equilibrium binding experiments. AB - For equilibrium binding isotherms of radioreceptor assays, the affinity spectrum is defined as a plot of the number of binding sites against their corresponding dissociation constants. A numerical procedure for direct calculation of affinity spectra from untransformed binding data is presented and illustrated with experimental values. The advantage of the new method in comparison to non-linear regression analysis is the fact that no starting values and mathematical models have to be supplied and that statistical assessment of the results is straightforward from a detailed graphical display of a likelihood function. Affinity spectra thus show directly all information formerly obtained by means of both graphical plots and regression analysis. PMID- 6866132 TI - Effects of short-lasting and long-lasting blood pressure changes on the release of endogenous catecholamines in the hypothalamus of the conscious, freely moving rabbit. AB - In anaesthetized rabbits guide cannulae were stereotaxically inserted into the anterior hypothalamic area and into the posterior hypothalamic nucleus. Additionally, catheters were inserted into the carotid artery and the jugular vein. Some days after the operation push-pull cannulae were inserted through the guide cannulae into the hypothalamic regions of the conscious, freely moving animal. The areas were superfused with artificial CSF and the release of the endogenous catecholamines dopamine, noradrenaline and adrenaline was determined in the superfusates. In the two hypothalamic regions the resting release of the catecholamines rhythmically varied with time at approximately 70 min cycles. A rise in blood pressure induced by the intravenous injection of noradrenaline or tramazoline enhanced the rates of release of the catecholamines in the anterior hypothalamic area. A fall of blood pressure elicited by the intravenous injection of nitroprusside or chlorisondamine decreased the release of the catecholamines in this hypothalamic area. The changes in blood pressure coincided with the changes in the rates of release of the catecholamines in the anterior hypothalamic area. These and previous results concerning changes in the release of endogenous catecholamines in the posterior hypothalamic nucleus also indicate that in the conscious, freely moving rabbit changes in blood pressure lead to counteracting alterations in the release of catecholamines in the two hypothalamic regions. PMID- 6866134 TI - Drug absorption by the rat jejunum perfused in situ. Dissociation from the pH partition theory and role of microclimate-pH and unstirred layer. AB - In anaesthetized rats the rate of appearance of benzoic acid and aminopyrine in jejunal venous blood was measured; the pH of the luminal perfusion solution was varied between 4 and 10.5. The pH-absorption curves were less steep than predicted by the unmodified pH-partition theory. A reduction of the mucosal unstirred layer thickness by means of the segmented-flow technique considerably increased the absorption rate without essentially changing the shape of the pH absorption curves. The pH at the surface of the jejunal mucosa was 6.0, 6.5, 6.6, and 8.0 for luminal solutions of pH 4.0, 6.0, 8.0, and 10.8, respectively. From the absorption data the microclimate-pH was calculated which would explain best the observed pH-absorption curves. These calculated pH-values correspond well to the values measured at the mucosal surface. Therefore, it was concluded that a microclimate-pH caused the deviation of the intestinal pH-absorption curves of benzoic acid and aminopyrine from the prediction of the unmodified pH-partition theory. The mucosal unstirred layer represented only a considerable permeation resistance and was not responsible for the deviating shape of the pH-absorption curves. PMID- 6866133 TI - Inotropic and electrophysiological effects of dantrolene on guinea-pig papillary muscle. PMID- 6866136 TI - Therapeutic doses of erythromycin esteolate is not cholestatic in rats in vivo. AB - The effect of erythromycin esteolate (EE) on bile flow and bile acid secretion was studied in male Wistar rats in vivo. Daily oral treatment with a dose of up to 100 mg/kg for 1 week increased the bile flow and the bile acid secretion. Increasing the days of treatment to 4 weeks with a dose of 20 mg/kg did not alter the measured parameters significantly. Acute intravenous injection of erythromycin lactobionate (50 mg/kg) also increased bile flow and biliary bile acid secretion temporarily. The increase in bile flow may partly be due to the osmotic effect of the drug and its metabolites in bile. Since EE failed to produce cholestasis in the range of therapeutic doses, rats do not seem to be a suitable experimental model for studying EE-cholestasis. PMID- 6866135 TI - Serotonergic mechanisms in the hypothalamus mediate thermoregulatory responses in rats. AB - 1. Either electrical stimulation of midbrain raphe nuclei or administration of 5 hydroxytryptamine (5-HT; serotonin) into the preoptic anterior hypothalamus caused hypothermia in conscious rats at ambient temperatures (Ta) of both 8 degrees C and 22 degrees C. The hypothermia was due to decreased metabolic heat production at Ta = 8 degrees C, while at Ta = 22 degrees C the hypothermia was due to both decreased metabolism and increased heat loss (cutaneous vasodilatation). However, at Ta = 30 degrees C, electrical stimulation of midbrain raphe or intrahypothalamic injection of 5-HT caused an insignificant change in the thermoregulatory responses. There was no changes in respiratory evaporative heat loss in response to these treatments at various Ta's. 2. Direct administration of the serotonergic receptor antagonists such as cyproheptadine and methysergide into the preoptic anterior hypothalamus caused hyperthermia in conscious rats at Ta's of 8 degrees C, 22 degrees C and 30 degrees C. The hyperthermia was due to increased metabolism and cutaneous vasoconstriction. 3. The hypothermia induced by intrahypothalamic administration of 5-HT was antagonized by pretreatment with an intrahypothalamic dose of either cyproheptadine or methysergide in rats at Ta = 22 degrees C. 4. Inhibition of 5 HT neuronal activity with administration of 5-HT into the midbrain raphe regions also caused hyperthermia, increased metabolism and cutaneous vasoconstriction in rats at Ta's of 8 degrees C, 22 degrees C and 30 degrees C. 5. These observations tend to suggest that the functional activity of serotonergic receptors in the preoptic anterior hypothalamus mediates thermoregulatory responses in the rat. Activation of serotonergic receptors in the hypothalamus decreases heat production and/or increases heat loss, while inhibition of serotonergic receptors in the hypothalamus increases heat production and/or decreases heat loss in the rat. PMID- 6866137 TI - Morphological studies on selective acinar liver damage by N-hydroxy-2 acetylaminofluorene and carbon tetrachloride. PMID- 6866139 TI - [A family drama]. PMID- 6866140 TI - [The increasing number of hysterectomies in the Netherlands: the influence on incidence of and mortality due to cervix carcinoma]. PMID- 6866141 TI - [Mesenteric fibromatosis: a rare form of the Gardner syndrome]. PMID- 6866138 TI - Heterogeneity of rat hepatocytes in bile acid and DBSP transport studied after induction of selective acinar damage by N-hydroxy-2-acetylaminofluorene and carbon tetrachloride. PMID- 6866142 TI - [Warning against the use of diphenoxylate (Reasec) by children with diarrhea]. PMID- 6866143 TI - [Mucoepidermoid carcinoma of the major airways]. PMID- 6866144 TI - [Reaction to: Clinical judgment: can it be taught?]. PMID- 6866145 TI - [Fatal liver cell necrosis after short-term administration of isoniazid and rifampicin to a patient already under treatment with anti-epileptic agents]. PMID- 6866146 TI - [Active euthanasia]. PMID- 6866147 TI - [Bacterial coxitis in infants; early diagnosis, treatment and late sequelae]. PMID- 6866148 TI - [Infections in adults and in the elderly caused by respiratory syncytial virus]. PMID- 6866149 TI - [Cystic adventitia degeneration of the popliteal artery]. PMID- 6866150 TI - [How does the general practitioner learn to live with euthanasia?]. PMID- 6866151 TI - [The responsible performance of euthanasia; observations on the discussion of the subject]. PMID- 6866152 TI - [Certificate of death, euthanasia and assistance with suicide]. PMID- 6866153 TI - [The admission of drugs in the Netherlands]. PMID- 6866154 TI - [Medical education. From coordination to integration]. PMID- 6866155 TI - Non-operative treatment of large common bile duct stones and hepatic abscess. PMID- 6866156 TI - Intensive monitoring of epileptic patients. PMID- 6866157 TI - Nebraska physicians in the nuclear age. PMID- 6866158 TI - Delayed displacement of an unrecognized odontoid fracture. PMID- 6866159 TI - "Miscarriage": a diagnostic dilemma. PMID- 6866160 TI - Stillbirth secondary to G Streptococcal infection. PMID- 6866161 TI - Transforming activities of methotrexate, hydroxyurea and 5-fluorouracil in different cell systems. AB - The transforming ability of methotrexate, hydroxyurea and 5-fluorouracil was studied in mass cultures of embryo cells from BN/a, DBA/2 and Swiss mice. As estimated by virological methods the cells from BN/a mice were infected persistently with ectromelia virus. In parallel a quantitative transformation assay with a cloned BALB/3T3 cell line was employed. Oncogenic transformation could be induced repeatedly in mass cultures from BN/a mice after treatment with every of chemotherapeutic agents studied. Neither of the drugs induced transformation in the cultures deriving from two other strains of mice. In the cloned BALB/3T3 cell line from the three drugs tested only methotrexate induced the appearance of transformed foci, however, the yield of transformants was very low. It has been concluded that under the employed experimental conditions the transforming ability of hydroxyurea and 5-fluorouracil could be expressed exclusively in the cells infected with ectromelia virus. The transforming ability of methotrexate seems to depend either on the presence of viral infection or on the properties of cells enabling additional events necessary for transformation. PMID- 6866162 TI - Comparison of lipids between tumor and normal hamster melanosomes. AB - A study of lipid components of melanosomes isolated from eye pigment tissues and pigmented melanoma type Bomirski line Ma of Syrian hamster by thin-layer chromatography is described. Tumor melanosomes contained 8-10% of total lipids, approximately one half of which were phospholipids. Eye melanosomes contained only 3-4% of total lipids, among which no phospholipids could be detected. Cholesterol, cholesteryl esters, free fatty acids and triacylglycerols were found in the fraction of neutral lipids. Phosphatidylcholine, phosphatidylethanolamine and sphingomyelin constituted 70-80% of the phospholipid fraction. PMID- 6866163 TI - Cumulative effect of nonstandard radiation. AB - Experimental data on cumulative effect of nonstandard beams are evaluated and analyzed in terms of cell kinetic model. The dependence of RBE on the dose per fraction is derived. The repopulation is shown to diminish RBE. The ratio of RBEs for late and acute injury is discussed. The "neutron TDF" proposed for clinical purposes is criticized. PMID- 6866165 TI - [Borderline syndrome: borderline area or no-man's land? On the clinico psychiatric relevance of borderline diagnoses]. PMID- 6866164 TI - Cancer of the larynx in Warsaw and in selected rural areas. AB - Incidence of the laryngeal cancer especially in males, dramatically increased in Poland. Patterns and time trend of the laryngeal cancer, based on the data from Warsaw Cancer Registry from 1963-1977 have been presented. Tobacco and alcohol consumption in Poland has been discussed considering the observed increase in laryngeal incidence. PMID- 6866166 TI - [General and special disease concepts in psychiatry]. PMID- 6866167 TI - [Psychiatric disease in an elderly population. An epidemiologic field study in Mannheim]. PMID- 6866168 TI - [Catatonic symptoms as a side effect of neuroleptic treatment]. PMID- 6866169 TI - [Clinical use of the schizophrenia concept in case histories in the years 1950, 1965 and 1979]. PMID- 6866170 TI - [A case of secondary buprenorphine (Temgesic) dependence]. PMID- 6866171 TI - [Psychiatric basic documentation. A short report on the activity of a task force and recommendations of the German Society of Psychiatry and Neurology as well as of the Federal Society of Carriers of Psychiatric Hospitals on the standardization of symptom classification]. PMID- 6866172 TI - Fatal acute intoxication with verapamil. PMID- 6866173 TI - An acquired antithrombin III deficiency in the course of toxic shock syndrome after elective orthopaedic surgery. PMID- 6866174 TI - Effects of lithium on the structure of the rat kidney. AB - Light and electron microscopy were used to study the effects of a lithium supplemented diet on renal structure in the rat. At the end of a 7-week experimental period serum lithium levels were 1.14 +/- 0.20 mM. Lesions consisting of groups of dilated tubules were found in the immediate vicinity of the interlobular arteries in all experimental animals. These tubules were identified as the connecting tubule or the initial portion of the collecting tubule. The epithelium of these tubules was generally flattened but was punctuated by markedly swollen epithelial cells. PAS-positive deposits found in both types of cells were identified as glycogen. Electron microscopy revealed considerable lithium-induced damage in the swollen cells including increased numbers of mitochondria, many of which were swollen or otherwise damaged, dilated cisternae of endoplasmic reticulum and vacuolization of the apical cytoplasm. The flattened cells of these tubules were similar to the dark or intercalated cells of normal collecting tubules. Some detachment of epithelial cells from their basement membrane was evident in these tubules. Damage was less severe in distal convoluted tubules. Lithium-induced changes were not observed in glomeruli, proximal tubules or ascending thick limbs of Henle. In medullary collecting tubules damage was less severe than in cortical collecting tubules, but detachment of epithelial cells was a common finding. The interstitial tissue of the papilla exhibited histochemical and ultrastructural changes consistent with lithium blockade of the action of antidiuretic hormone. The ultrastructural damage to cortical tubules is similar to that found in patients receiving therapeutic lithium for long periods of time. The anatomic sites of lithium induced pathology correspond to the location of lithium-induced pathophysiology. PMID- 6866175 TI - Right-sided hydrothorax complicating peritoneal dialysis. Report of 2 cases. PMID- 6866176 TI - Direct photon absortiometry for long-term monitoring of uremic osteodystrophy. PMID- 6866177 TI - Fibronectin during hemodialysis. PMID- 6866178 TI - Renal function in patients with cystic fibrosis. AB - Renal handling of sodium, potassium, calcium and phosphorus was investigated in 9 patients with cystic fibrosis (CF). Both under baseline conditions and during saline-induced diuresis, urinary excretion rate of sodium (UNaV), potassium, phosphorus and calcium did not differ significantly from control values although the fractional excretion of sodium was significantly higher in patients with CF during saline diuresis. When distally acting diuretics were administered, this difference between CF patients and controls was magnified and in addition, UNaV in CF patients was also significantly higher than in controls. Following saline loading the increment in glomerular filtration rate (GFR) in patients with CF was significantly lower than that of controls. We conclude that patients with CF when subjected to volume expansion demonstrate a lower tubular reabsorptive capacity of sodium as well as a reduced ability to increase their GFR. The defect in sodium reabsorption is probably located in the proximal tubule. PMID- 6866179 TI - The role of trace elements in uremic heart failure. AB - In a postmortem study of 8 uremic patients (mean age 63.0), the concentration of 23 trace elements was determined in heart tissue with neutron activation analysis. The concentration was significantly increased in 10 elements - e.g. Co (p less than 0.001), As, Br, Ce, La, Sb, Sc (p less than 0.01), Fe, K and P (p less than 0.05) - compared to a control group of non-uremic individuals. As some of these elements are cardiotoxic, the results support our opinion that an excess of certain trace elements, cobalt in particular, may be etiological agents of importance in uremic heart failure. PMID- 6866180 TI - [Diagnosis and therapy of lateral intervertebral disk displacements. I. Normal roentgen anatomy of the lumbar nerve roots in computer tomography]. AB - As a basis for the CT diagnosis of lateral disc herniations, the normal anatomy of the nerve roots from L4 to S1 within the lateral recess, is described and compared with the myelographic and CT findings. In myelograms, the roots can be demonstrated from where they leave the dural sac, for about the height of one vertebral body as far as the spinal ganglion in the upper part of the intervertebral foramen, where the subarachnoid space terminates. By non-enhanced CT, the roots can be distinguished from the surrounding fat only in the widening lower part of the lateral recess. The ganglion and the spinal nerve can be shown in the intervertebral foramen and further distally where they can no longer be seen on the myelogram,. Thus, of both these complementary techniques, CT s more suitable for the diagnosis of lateral disc herniations. PMID- 6866181 TI - Non-traumatic intracerebral haemorrhage. Prognostic implications of neurological and computer-tomographical findings in 100 consecutive patients. AB - One hundred cases of non-traumatic intracerebral haemorrhage were studied retrospectively. The mortality was 41%, although however, the cause of death in 10% of the cases was not directly related to the intracerebral haemorrhage. Clinical neurological and CT findings available in the first few hours after the admission of the patients were selected for the statistical analysis, using a linear stepwise discriminant analysis including jack-knife classification and a simple independence model for the variables. The results indicate that the outcome can be predicted with relatively great accuracy in individual patients, and that the level of consciousness on admission and the age of the patient are the most important factors for prognosis. The addition of CT-based variables did not achieve any significant improvement in the accuracy of the prediction of the outcome. PMID- 6866183 TI - [Sural nerve removal using a nerve stripper]. AB - In 19 patients the sural nerve was removed for nerve grafting by a specially designed nerve stripper. This technique provides a safe and time-saving removal of the nerve in length up to 34 cm (depending on the length of the stripper used). From a single short incision at the level of the lateral malleolus the nerve is stripped proximally tearing some small branches of the distal nerve. The relatively blunt tip avoids inadvertent transection of the nerve at a lower level or dissection of the nerve at a point where branching occurs. Finally the nerve is cut by the divided cylinder at the tip of the stripper. PMID- 6866182 TI - [Exeresis in occipital neuralgia]. AB - 31 patients, suffering from an occipital neuralgia, were treated surgically by section of the n. occipitalis major or minor. The retrospective study of these cases extends over a period of one to nine years. In 26 patients (84%) a good result was achieved initially, and 16 patients (52%) are completely free of any complaint up to the present. In five patients (16%) no improvement has occurred. In two of these five patients an epipharyngeal cancer was discovered later; in one of the patients trigeminal neuralgia was established later on. Contrary to earlier published intradural rhizotomy this operation is simple and without risk (it is performed under local anaesthesia), and in long-standing, obstinate and tormenting cases very good results can thus be achieved. The unclear aetiology of the neuralgia was observed anatomically by the atypical course of the nerves. Other methods for the treatment of occipital neuralgia were not considered here. PMID- 6866184 TI - [Intramedullary subarachnoid epidermoid cyst with secondary purulent infection]. PMID- 6866185 TI - Aneurysm of azygos anterior cerebral artery. AB - A case of an aneurysm of an azygos anterior cerebral artery operated on successfully is reported. The embryo-genetic features of this rare vascular malformation and the diagnostic and surgical problems are discussed. PMID- 6866186 TI - [A partly thrombosed basilar artery aneurysm simulating a tumor of the 3d ventricle]. AB - The article reports on a giant aneurysm of the bifurcation of the basilar artery simulating a tumour of the third ventricle and producing a marked diencephalic syndrome. It was diagnosed and treated as a tumour. The symptoms are discussed and noteworthy similar cases are reviewed. PMID- 6866187 TI - [Spinal aneurysmal cyst. Therapeutic considerations apropos of 6 cases]. PMID- 6866188 TI - [Spinal extradural meningeal cysts. Apropos of 4 cases]. PMID- 6866190 TI - [Elements predicting respiratory complications after total excision of neurinomas of the 8th nerve. Consequences on the postoperative treatment (study of 12 cases)]. AB - Pulmonary complications are observed after radical surgery of acoustic neurinomas. This study, performed on 12 patients was undertaken to appreciate central respiratory activity by measuring the respiratory response to CO2 before and after the operation and to find out whether they could be used to predict post-operative respiratory complications. The patients who developped pulmonary or bronchial infections had increased PaCO2 (45.1 +/- 3.0 mmHg--mean +/- S.D.) and decreased ventilatory response to CO2 (VE/PACO2: 0.65 +/- 0.37 1/min/mmHg) before the operation. After the operation, all these patients developped swallowing difficulties and a decreased vigilance; therefore we assumed that swallowing troubles and decrease of vigilance could be responsible for bronchopulmonary infection. Patients with a low respiratory response to CO2 have higher risk of developping pulmonary complications and can be detected before surgery by this non-invasive test and by the measure of PaCO2. PMID- 6866189 TI - [Functional prognosis in skull injuries with signs of axial damage. Value of the quality of the arousal phase (series of 80 cases)]. AB - In a series of 80 diffuse brain injuries with early clinical signs of brainstem dysfunction without shift of the midline on the first CT SCAN investigation; the authors have studied the time course of recovery. Among several neurological parameters, they have choosen two steps: first one the spontaneous opening of the eyes, which marks a restoration of vigilance, second one the capacity to execute simple commands which marks the end of unconsciousness). The duration of the period of recovery (delta) (between the eyes opening and the obays commands) was variable from 0 to 173 days. But it was a good statistic correlation (p less than 0,001) between the length of this period and the functional outcome at one year. PMID- 6866191 TI - [Use of real time ultrasonography in neurosurgery. Peroperative value in adults]. AB - The authors present their beginning experience in the use of a new technique applied to neurosurgery: that is real-time echography. A preliminary non operative experience has first been carried on. It concerned five adults who have been studied through surgical defects. Then, eight patients, were explored intra operatively: concerning three cerebral abscesses, one intra-cerebral haematoma, two subcortical tumors and two biopsies. In these cases, the ultrasonographic study was performed through a 3 centimeters diameter craniotomy--in case of abscess or haematoma aspiration or of biopsy--or through a classic bone flap--in case of tumor extirpation. Echography allowed an easy study of intracerebral structures and lesions. Its permits to visualize subcortical neoplasms and thus to aim them with accuracy. In the treatment of brain abscess, real time echography gives the possibility of guiding and following the progression of the probe. It, also, allows to appreciate the reduction of the suppurated cavity and thus assures a more reliable efficacity. Such a procedure indeed facilitates brain tumor biopsy; but we think that such a technique should be used only if a classic stereotactic procedure is not considered as necessary and if the mass lesion is large enough (over 1.5 cm) and not too profondly seated. PMID- 6866192 TI - [Traumatic elongation-traction lesions of the roots of the sciatic nerve, secondary to fractures of the pelvis]. AB - Three cases of complex pelvic fractures associated with lumbo sacral roots lesions are reported. The authors stress this possible association should be suspected through clinical and conventional radiological findings. The contrast sacco-radiculography brings up confirmation. However the so called pseudo meningocele is by far of less topographical value than the same myelographic findings at cervical level (for brachial plexus avulsion injuries). Direct and concise evaluation is performed by surgical approach of roots during a homolateral hemi-laminectomy. This procedure allows to appreciate the anatomical lesions and to clarify the anatomo-radiological discrepancies. Moreover endodural closure and reduction of volume of meningoceles and removal of arachnoidal adhesions is to pain relief value and may prevent delayed complications of neighboring roots compression related to increase in volume of meningocele. According to the literature and our findings, in future, the aim should be microsurgical repair of such roots lesions as they ar not avulsed from the conus but merely more distally ruptured on the cauda equina. We could not so far achieve this procedure, because of difficulties to identify the distal part of root, often retracted far away from its spinae foramen. PMID- 6866195 TI - [Treatment of severe traumatic comas]. PMID- 6866194 TI - [Spontaneous intraventricular hemorrhage secondary to meningioma]. PMID- 6866193 TI - [Optochiasmatic diastasis in tumors with suprasellar extension and duplication of the chiasma]. AB - The opto chiasmatic diastasis whose extreme form is a duplication of the chiasma, corresponds to a longitudinal cleavage, using the well known fasciculation of the optic fibres. It has been noticed four times in the sellar and para sellar expanding processes (two adenomas, one craniopharyngioma and one metastasis). Generally, this lesion of the chiasma goes with big tumors (grade II); it has been detected four times in frontal approaches (15%) while the rhinoseptal approach represents 85% of our cases. The diastasis of the optic fibers with tendency to form double chiasma, instead of being an exception, happens in 4% of sellars tumors. It is perfectly identified by the frontal surgical approach, but is really hard or impossible to be recognized by the rhinoseptal surgical way. The mechanisms and the prognosis of this lesion are discussed. PMID- 6866196 TI - Gender differences in peak acetaldehyde concentration after an acute dose of ethanol. AB - Acetaldehyde, the first metabolite of ethyl alcohol, is found in higher concentrations in alcoholics and heavy drinkers after alcohol ingestion than in social drinkers or abstainers. This experiment investigated gender differences related to acetaldehyde. Seventy-nine adult social drinkers (38 females and 41 males) were tested after an overnight fast and at least 4 hours food deprived with 0.52 g/kg ethanol in water (20% alcohol by volume). Blood alcohol and acetaldehyde concentrations from breath samples were determined every 5 minutes post-drink for 40 minutes with a gas chromatograph. The drink was consumed over a 5-minute period. Half of each group ran 30-140 miles per week. The other half were controls. A significant overall gender difference in peak acetaldehyde concentration was obtained (p less than 0.5), with males showing higher values than females. Among athletes, these gender differences were greater (p less than 0.002). Among controls the gender differences were in the same direction but they were not significant. Groups did not differ reliably on age (M = 32.88 years, F = 31.13 years), drinking history (M = 2.07, F = 1.92) or lean body mass (M = 43.1, F = 43.1). Groups did not differ on time to peak blood alcohol concentrations (M = 30.98 min, F = 31.58 min). The results have implications for gender differences in alcoholism and biological sensitivity to alcohol. PMID- 6866197 TI - Effect of alcohol and Cannabis sativa consumption on handwriting. AB - This study reports on the separate effect of Cannabis sativa smoking and of alcohol consumption on handwriting performance in Cannabis users and in alcoholic volunteers, respectively. Handwriting samples were obtained prior to, during, and after 1 hr of Cannabis or alcohol consumption. Handwriting was evaluated for speed, letter forms, size, slant, and alignment. Cannabis sativa smoking exerted greater effect on handwriting than did alcohol drinking. This effect was noted during Cannabis smoking and lasted for 1 hr thereafter. Changes noted in handwriting performance test, which reflect involuntary muscular movement and tremor, suggest a differential CNS depressant action of the compounds used under the experimental trials listed. The results suggest possible forensic application, i.e., the use of handwriting for the purpose of signature comparison obtained under the influence of alcohol or under Cannabis intoxication. PMID- 6866198 TI - The homeostatic reflex and addictive drugs. PMID- 6866200 TI - [Surgical technic of the foramen magnum tumors]. PMID- 6866199 TI - [Pseudotumor cerebri]. AB - Although pseudotumor cerebri is not the primary subject for the neurosurgical treatment, it is of clinical significance on differentiating from brain tumors and other similar lesions. The literatures concerning its clinical features and pathophysiology are reviewed with short summary of our eighteen cases. The incidence of pseudotumor cerebri, based on the clinical reports and our experience, seems to be low in Japan, which may be due to difference on races and/or diet. The visual acuity impairment is not always "benign" on its course, in contrast to other symptoms related to the increased intracranial pressure. CT scan is most useful for evaluating the ventricular size and abnormal densities. Contrast enhancement is required for detecting abnormal enhanced lesions. Angiography may disclose the dural sinus occlusion and/or dural arteriovenous malformation. Continuous measurement of intracranial pressure can show irregular change from high pressure to normal with or without episodic elevation in each case and on each day. It is reported that there is no rise of intracranial pressure in some cases. There are also some reported cases without papilledema. Various factors including increased blood volume, brain edema and impaired absorption of cerebrospinal fluid may play some role on the development of pseudotumor cerebri. The precise mechanism of small ventricle associated with impaired absorption of cerebrospinal fluid is still unclear. Further study about absorption and outflow resistance of cerebrospinal fluid, and alteration of blood volume and brain water content may resolve the pathophysiology of pseudotumor cerebri. PMID- 6866201 TI - [CT scan in severe head injury with special reference to Glasgow coma scale]. AB - CT scan demonstrates the invaluable information about the parenchymal lesions of head injuries. The parenchymal lesions were classified into 6 categories; 1) isodensity without mass effect: I(-), 2) isodensity with mass effect: I(+), 3)high density: H, 4) high-low density complex: H-L, 5) low density: L, 6) diffuse cerebral swelling: DCS. Glasgow coma scale (GCS) and outcome scale (GOS) were international practical scales for the evaluation of severity and prognosis of severe head injuries. One hundred and seventy-four cases with severe head injury were analysed. I(+), H and H-L were common findings in the group of GCS 3 6, and I(-) was in GCS 7-12 and GCS 13-15. H and H-L were not related with GCS. DCS was most common in GCS 7-12. Acute epidural hematoma was frequent in the group of GCS 13-15, and acute subdural hematoma was in GCS 3-6. The prognosis was significantly poor in the group of GCS 3-6, with the mortality of 72 percents. On the other hand, the prognosis was quite good in GCS 7-12 and GCS 13-15. There were few reports about the traumatic subarachnoid hemorrhage (SAH). SAH was one of the important risk factors in severe head injuries and it was frequently associated with I(+), H and H-L. The prognosis of the patients with SAH was most unfavorable in the presence of I(+). Number of analyses were reported about the traumatic intraventricular hemorrhage (IVH). IVH was also one of the powerful risk factors and this was commonly associated with H and H-L. The prognosis of the patients with IVH was very poor. Finally, the groups of the patients, whose prognoses turned out to be unexpected results from GCS on admission, were analysed. First, the age was an important factor. In the patients, whose prognoses were good in spite of low GCS, I(-) was a mostly common finding, while SAH, IVH and obscured cisterns, esp. basal and quadrigeminal, were less common. In the patients, whose prognoses were poor despite of favorable GCS, H and H-L were common findings. SAH and IVH were also common. The poor prognosis was induced by secondary systemic complications, such as pneumonia and meningitis, etc. PMID- 6866202 TI - [One piece silastic lumboperitoneal shunt]. PMID- 6866203 TI - [Spreading osteomyelitis of the skull following complete scalp avulsion: case report]. PMID- 6866204 TI - [Optic nerve glioma report of two cases]. PMID- 6866205 TI - [Acute epidural hematoma of the posterior fossa--a patient aged 1 year and 2 months]. PMID- 6866206 TI - [A case of arachnoid cyst associated with chronic subdural hematoma]. AB - An 11-year-old boy was admitted to our clinic with complaint of headache. On admission he was in drowsy state and neurological examination revealed minimal motor weakness of the right hand. Plain skull roentgenogram demonstrated a thinning of the left temporal bone and elevation of the left sphenoidal wing. CT showed marked displacement of the midline structures from left to right. The left lateral ventricle was collapsed. A well circumscribed, homogenous, high density area was delineated in the left middle fossa. Contrast enhancement was negative. A-P view of left CAG showed a crescent shaped subdural avascular area in the parietal region. The anterior cerebral artery was roundly shifted from left to right. Chronic subdural hematoma due to bleeding of arachnoid cyst was most likely. Subdural collection was evacuated by trephination. The postoperative course was uneventful. Postoperative CT 3 week after operation delineated the arachnoid cyst more clearly as round low density area. Follow-up CT 6 months later showed the arachnoid cyst markedly reduced in size. PMID- 6866207 TI - A model of chronic spinal cord compression in the cat. AB - An experimental method of producing chronic compression of the cat spinal cord is described. A ligature placed around the lumbar spinal cord of 3-month-old kittens restricts the growth of the spinal cord to produce compression with a slow onset and an insidious progression. The methods of following the clinical progress of affected animals and of sampling the spinal cord after perfusion fixation are presented. The sampling method used allowed analysis of the three dimensional distribution of the pathological changes caused by the compression. These changes were not symmetrically distributed: the spinal cord caudal to the ligature became swollen and extensive partial demyelination occurred under the ligature and caudal to it, in the swollen region of the cord, whereas cranial to the ligature there was only minimal damage. It is concluded that the method produces a useful model of chronic compression of the spinal cord, which will be of value in studying partial demyelination. PMID- 6866208 TI - Denervation caused by tullidora (Karwinskia humboldtiana). AB - Crude homogenate of the seed of the tullidora (Coyotillo, buckthorn; Karwinskia humboldtiana) fruit or a purified neurotoxin extracted from it was administered orally to male Wistar rats. Three to 5 weeks later, gait disturbances and progressive flaccid paralysis of the hindlimbs appeared in these animals which were then submitted to acute experiments. Single twitch and tetanic contractions of the soleus muscle were studied in the tullidora treated rats. The twitch tension elicited by direct stimulation of the muscle was greater than that produced by nerve stimulation. In addition, the tension of nerve-elicited twitches diminished as the stimulating electrode was moved towards the spinal cord, suggesting failure of nerve conduction. When the muscle was directly stimulated, contraction and relaxation were slower than normal and the tetanus/twitch tension ratio was subnormal. These data suggest partial denervation of the soleus muscle under the action of the toxin. Electron microscopy revealed abnormal motor-nerve endings with few synaptic vesicles and denervated end-plates. Degenerative changes of axons and myelin disturbances were frequently seen in the intramuscular branches of the soleus nerve. However, alterations of this type were less severe in the nerve sections closer to the spinal cord and no significant changes were detected at the upper portion of the sciatic nerve. It is concluded that the paralysis produced by the tullidora toxin is the result of both conduction block of the nerve impulses and muscle denervation. PMID- 6866210 TI - Structural change in muscles of the dystrophic chicken. II. Progression of the histopathology in the pectoralis muscle. AB - Dystrophic (D) and normal (N) chicken pectoral muscle was analysed for histopathological differences from the embryo (day 20) through to the mature adult stage. A variety of indices of structural changes were used, to express the progression quantitatively. At the embryonic stage, fibroblast numbers (but not satellite cell numbers) are increased in D. D shows fibre hypertrophy discernible from about 4 days after hatching. Other abnormalities of fibre size and shape appear in D from about 2 weeks onwards. Nuclei numbers and location change characteristically in D, compared to N, from about 4 days, and these differences subsequently become very prominent. Fibre splitting and phagocytosis become significant in D from about 2 weeks onwards and increase noticeably thereafter. The later stages in D, with gross loss of muscle fibres, are also described, in the pectoral and posterior latissimus dorsi muscles. The analyses show that some of the structural changes in D precede the discernible difference in fibre type composition which develops between D and N. The changes in the muscle used provide a basis for assessing the effects of drug treatments at various stages, including the early post-hatch period. PMID- 6866209 TI - A quantitative method for comparing the distribution of cerebral trauma in closed head injuries with and without tentorial herniation. AB - Damage to the cerebral and cerebellar hemispheres and brain-stem was investigated in forty-seven cases of closed-head injury of which twenty-four had undergone tentorial herniation. The damage was assessed by eye in coronal sections as well as microscopically using celloidin and paraffin techniques. All cases had damage to the hemispheres and brain stem. The types and positions of the damage were plotted on charts and quantified by using a cm2 grid system. The quantity of the haemorrhage and ischaemia in the hemispheres was found by Student's t-test to be statistically greater (P less than 0.001) for cases which had herniated. Haemorrhage and ischaemia were most frequently seen on the ventral aspect of the hemispheres and particularly the frontal lobes. The distribution of the haemorrhage and ischaemia was the same for both the herniated and non-herniated brains. In a subsample of sixteen cases statistically significant differences were found using the X2 test for the positions of brain-stem damage per se in herniated and non-herniated brains. In a second subsample of thirty-two cases a statistical difference in the position of haemorrhage was also found. The greatest damage to the brain-stem was medial and rostral in herniated brains and paralateral and rostral but extending further caudally in non-herniated brains. The variation in quantity of the five types of damage with length of survival was compared for herniated and non-herniated brains. PMID- 6866211 TI - The morphological effects of lead on the developing central nervous system. AB - The pathological changes found in the central nervous system of lead-exposed humans and laboratory animals are reviewed. Data in man relate to relatively high exposure levels. In human childhood lead encephalopathy, which occurs with blood lead levels in the range 100-800 micrograms Pb/100 ml, oedema, vacuolation, haemorrhage and reactive glial changes appear to be secondary to microvascular lesions. No primary neuronal lesions have yet been clearly identified. Neurological signs and a pathological picture closely resembling that seen in human lead encephalopathy are obtained in young lead-exposed rats with blood lead levels above 500 micrograms Pb/100 ml. Oedema and haemorrhage, cyst formation, reactive glial changes and nerve cell alterations are observed consequent to changes in capillary endothelial cells and basement membranes. High-level lead exposure in rats also produces disturbances in myelinated axons and may affect neural network formation in the central nervous system. With intermediate lead levels (200-500 microgram Pb/100 ml blood), vascular changes and their sequelae are not seen, but nutritional effects occur which may produce neuropathological changes. Data from recent studies on developing rats with low blood levels (up to 100 microgram Pb/100 ml) appear to show effects of lead on maturing and differentiated nerve cell populations. The relevance of these changes to human subclinical lead intoxication remains to be seen. However, the overall correspondence of findings in lead-poisoned man and rat would make further investigation in this area appear necessary. PMID- 6866212 TI - Extrahypothalamic brain luteinizing hormone: characterization by radioimmunoassay, chromatography, radioligand assay and bioassay. AB - We have recently reported that luteinizing hormone (LH) is present in the hypothalamus of rats. It has chromatographic and biologic characteristics similar to pituitary LH. In this report we focus on extrahypothalamic LH that is widely distributed in the rodent central nervous system. This material has a chromatographic profile similar to that of pituitary LH. Serial dilution of this material is parallel with dilutions of rat pituitary LH in the immunoassay. Brain extracts are active in the testis LH radioligand receptor assay and in the rat interstitial cell testosterone secretion bioassay. Prior incubation of extract with LH antibody significantly attenuated both of these activities. Thus, extrahypothalamic LH has immunologic, chromatographic, and biologic characteristics similar to hypothalamic and pituitary LH. PMID- 6866213 TI - Effect of N-acetylserotonin on the serum level of thyroid-stimulating hormone in the male rat. AB - The effect of N-acetylserotonin (NAS) on serum levels of thyroid-stimulating hormone (TSH) in the male rat was investigated. In the first experiment, NAS and carrier were injected intraperitoneally into rats. The animals were sacrificed 30 and 60 min after injection. It was found that NAS (100 micrograms/rat) significantly depressed serum TSH 60 Min after injection when compared with saline-injected controls. In another experiment in which samples were obtained from rats at 0, 30, 60, 90 and 120 min after injection, significant decrease in serum TSH was observed at all time intervals after NAS (100 micrograms/rat) injection while no such difference was observed in the saline-injected groups. It is suggested that NAS may exert an inhibitory effect on TSH secretion. PMID- 6866214 TI - Normal differentiation of masculine sexual behavior in male ferrets despite neonatal inhibition of brain aromatase or 5-alpha-reductase activity. AB - Male ferrets born in the laboratory received subcutaneous Silastic capsules containing either the aromatase inhibitor, androst-1,4,6-triene-3, 17-dione (ATD), the 5 alpha-reductase inhibitor, testosterone-17 beta-carboxylic acid (17 beta C), or no hormone, for 15 days beginning on the day of birth; an additional group of females received empty Silastic capsules. All ferrets were gonadectomized when 11 weeks of age and were subsequently tested for masculine sexual behavior after a latin-square sequence of treatments with subcutaneous Silastic capsules containing testosterone (T), estradiol (E), or dihydrotestosterone (DHT). After T, control males displayed significantly more neck gripping, mounting and pelvic thrusting than control females, and males treated neonatally with ATD or 17 beta C were no less responsive than control males. After DHT, little masculine sexual behavior was shown by any group. After E, the duration of mounting was significantly longer in control and ATD males than in control females or 17 beta C males. Subsequently, however, there were no differences between control and 17 beta C males on any parameter of masculine sexual performance, when they were retested sequentially after subcutaneous implantation of E followed by E + DHT. Additional groups of newborn male and female ferrets received subcutaneous capsules containing either ATD, 17 beta C, or no hormone and were killed on postnatal day 7. Administration of ATD, but not 17 beta C, strongly inhibited aromatase activity in the hypothalamus + preoptic area. In all groups, the formation of significantly inhibited cortical 5 alpha reductase activity. Plasma concentrations of T were equivalent on postnatal day 7 in males given each of the neonatal treatments. These results suggest that behavioral masculinization in the male ferret results primarily from the neonatal action in brain of T itself, and not from its estrogenic or 5 alpha-reduced androgenic metabolites. PMID- 6866215 TI - Elevation of serum corticosterone in rats by dopamine agonists related in structure to pergolide. AB - Two chemical analogs of pergolide were examined to test further the idea that pergolide elevates serum corticosterone concentration in rats by activation of brain dopaminergic receptors. LY116467, which contains an N-methyl substituent in place of the N-n-propyl substituent in pergolide, was less potent than pergolide in lowering brain levels of 3,4-dihydroxyphenylacetic acid (Dopac), the metabolite of dopamine. LY116467 increased serum corticosterone concentration in rats at a dose of 3 mg/kg (a higher dose than is required for pergolide), and the effect was prevented by spiperone pretreatment. LY141865, which has been reported to differ from pergolide in not activating dopamine-sensitive adenylate cyclase and which was found in this study to have much less affinity for serotonin receptors than does pergolide, increased serum corticosterone in much the same manner as pergolide, only slightly higher doses being required. The effect of LY141865 was prevented by pretreatment with haloperidol but not domperidone. Both haloperidol and domperidone increased serum prolactin concentration when given alone or in combination with LY141865, indicating they were both capable of blocking peripheral (pituitary) dopamine receptors. In contrast, haloperidol but not domperidone caused a marked elevation in brain levels of Dopac and of homovanillic acid and prevented the lowering of these brain dopamine metabolites by LY141865. The ability of LY141865 to increase serum corticosterone concentration was attenuated in rats that had received four daily injections of pergolide mesylate, indicating corss-tolerance had occurred. These results strengthen the hypothesis that activation of brain dopaminergic receptors leads to increased serum corticosterone concentration in rats. PMID- 6866216 TI - Further biochemical characterization of the polyneuropeptide h3 recently isolated from human brain material, and its identification in human liver. AB - Recently (1) we reported the isolation and partial biochemical characterization of a novel polypeptide from human brain. Now we report the isolation of an almost identical polypeptide from human liver tissue and further biochemical characterization of both polypeptides. Thorough analytical investigation with several methods, fully described hereafter, of both polypeptides, leads on the one hand to a more complete picture of the polypeptide and on the other hand to the correction of earlier assumptions. The monomeric polypeptide, now identified as a glycopolypeptide, is indeed an independent chain of approximately 220 amino acid residues and possesses 2 free sulphydryl groups. From the almost complete identity between the CNS and liver polypeptide it is concluded that they are most probably one and the same polypeptide and consequently, that h3 is not brain specific. PMID- 6866218 TI - Biochemical characterization of a vasopressin-like neuropeptide in Locusta migratoria. Evidence of high molecular weight protein encoding vasopressin sequence. AB - The biochemical characterization of a diuretic neurohormone, immunologically related to the mammalian vasopressin (AVP) and present in Locusta migratoria has been performed. The results have been obtained using an AVP radioimmunoassay as method of detection and quantification. The "AVP like" molecule exhibits the same C terminal moiety: the tetrapeptide 1/2 Cys-PrO-Arg-Gly NH2. 125I-radiolabelling allows us to demonstrate the presence of a tyrosyl residue. The molecular weight of this molecule is estimated by gel filtration to 2500 +/- 400 Daltons. The isoelectric point is 7.5 and the electrophoretic migration lead to conclude to the presence of amino acid residues lacking in the vasopressin hormone. We have demonstrated the presence of a vasopressin sequence included in high molecular weight protein which have been quantified in suboesophageal ganglion (biosynthetic site) and in the nervous ventral cord (release site). PMID- 6866217 TI - Chemical identification of the vasopressin immunoreactive materiaL present in the rat suprachiasmatic nucleus. AB - Whole tissue homogenates and acid-ethanol extracts of rat suprachiasmatic nuclei were subjected to SDS-gel electrophoresis and gel isoelectric focusing, respectively. Fractions were tested for vasopressin (VP) immunoreactivity by means of radioimmunoassay (RIA). SDS-gel electrophoresis showed one distinct Vp immunoreactive peak in the peptide range (Mr less than 10,000). Isoelectric focusing revealed one VP immunoreactive peak as well, having the same pH position as synthetic VP. These results further substantiate the presence of VP-containing neurons in the suprachiasmatic nucleus. PMID- 6866219 TI - [Development of social function in premature infants. Observations on the development of mimicry and interaction with the attending milieu]. PMID- 6866220 TI - [From observation to the psychiatry of babies]. PMID- 6866222 TI - [Sultopride, treatment of choice for agitation in severe encephalopathies. Apropos of 33 cases in a neuropediatric milieu]. PMID- 6866221 TI - [When a baby refuses to sleep...]. PMID- 6866223 TI - [Neonatal behavior evaluation scale]. PMID- 6866224 TI - [Round table. Early affective deficiencies]. PMID- 6866225 TI - [Tics in children]. PMID- 6866226 TI - [Alopecia areata: a psychosomatic disease? Role of life events]. PMID- 6866227 TI - [Encopresis]. PMID- 6866228 TI - Head injury in the Pacific Northwest. AB - This report describes 451 consecutive patients admitted to a regional trauma center with head injury over 1 year's time. Our results replicate findings from other hospital- and population-based studies of head trauma. Males exceeded females by 3 to 1; the most frequent age of patients was between 15 and 24 years; and motor vehicles were the most common cause of injuries. Mortality was related inversely to Glasgow coma scale (GCS) scores and directly to age. This study also points out two current problems in head trauma research. One is the difficulty in using the GCS in a community with highly sophisticated emergency medical services. In 38% of the patients, one or more GCS components could not be assessed directly. In 17% of cases, GCS scores could not be confidently assigned. This was principally because endotracheal tubes were in place before arrival at the hospital, precluding determination of the verbal response. A second problem is the influence of chronic pre-existing central nervous system conditions on head outcome. Twenty-nine per cent of our patients had one or more such conditions at the time of their injury. Minimal estimates of prevalence ranged from 1% (mental retardation) to 18% (alcoholism). PMID- 6866229 TI - Pituitary portal blood flow in primates: a Doppler study. PMID- 6866230 TI - Brain stem auditory evoked potentials in posterior circulation surgery. AB - The objectives of this study were to evaluate the use of brain stem auditory evoked potentials (BAEPs) in 10 adult patients with vascular disorders of the posterior circulation that were treated surgically and to compare the BAEPs with the neurological findings. The vascular lesions included basilar artery stenosis in 3 patients, vertebral artery stenosis in 1 patient, brain stem/cerebellar arteriovenous malformation in 2 patients, and basilar artery aneurysm in 4 patients. Measurement of BAEPs were carried out during operation in all cases. Eight patients had BAEPs measured before operation, and 9 patients had BAEPs measured after operation. Repeat postoperative studies were performed in patients with changes in neurological status. In general, BAEP abnormalities correlated with the neurological findings before and after operation. Six patients had normal intraoperative studies. None of them had clinical findings of pontomesencephalic dysfunction after operation. Three patients with significant BAEP abnormalities during operation had neurological findings of pontomedullary ischemia after operation. Transient BAEP changes in 1 patient were thought to be the result of brain stem retraction. The BAEPs were lost in 3 patients who died. The use of BAEP measurement did not lengthen the operative procedures. However, the technique used in this study required 4 to 8 minutes for the accumulation and interpretation of each average, thereby delaying feedback to the surgeon. The results of this study suggest a potential role for BAEP monitoring in identifying brain stem injury during posterior circulation surgery. PMID- 6866231 TI - Surgical treatment of incidental intracranial aneurysms. AB - A 6-year retrospective analysis of incidental intracranial aneurysm surgery was conducted at 12 medical centers (1975-1981). The surgical facilities and techniques were comparable at the institutions surveyed. From a total of 1671 aneurysms operated upon, 119 in 107 patients were unruptured and were discovered incidentally. Among these 107 patients, there was no operative mortality. Operative morbidity occurred in 7 cases (6.5%). Surgical treatment of large aneurysms in less accessible locations incurred the greatest operative morbidity. Presenting symptoms of cerebral ischemia seemed to be associated with increased operative morbidity, whereas repair of aneurysms incidental to other ruptured aneurysms had a uniformly low morbidity. These surgical results compare favorably with the risks of hemorrhage from unruptured intracranial aneurysms as defined by recent reports. The low morbidity without mortality supports a recommendation for surgical management of incidental aneurysms in the anterior circulation at centers equipped for modern aneurysm surgery. PMID- 6866232 TI - Solvent systems for intracarotid 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) infusion. AB - The agent, 1,3-bis(3-chloroethyl)-1-nitrosourea (BCNU), when given by arterial infusion for brain tumor chemotherapy is usually dissolved in an alcohol/saline solution. The authors compared the osmolality of and drug recovery from solvent systems of alcohol/saline, dimethyl sulfoxide (DMSO)/water, and dextrose/water. Recovery of drug was adequate from all solvent systems, although variability of drug recovery from the alcohol/saline and DMSO/water systems was greater than from the dextrose/water system. The alcohol/saline system was significantly hyperosmolar. The alcohol/saline and DMSO/water solvent systems offer no advantage over the dextrose/water system and may be associated with significant disadvantages. PMID- 6866233 TI - Surgical treatment of common carotid artery occlusion. PMID- 6866235 TI - Intracranial extension of nasal dermoids. AB - Nasal dermoid cysts with intracranial extension have been thought to be a rare entity. Seven new cases of nasal dermoid cyst with intracranial involvement were treated from 1975 through 1982 by combined otolaryngological-neurosurgical management. Preoperative radiological studies were helpful in predicting intracranial extension in only three cases. The extracranial lesion was resected by the otolaryngologist using surgical hemoclips to tag the dermoid remnant entering the cranium. These hemoclips were a helpful landmark for the neurosurgeon when resecting the intracranial extension through a bifrontal craniotomy approach. In four cases, the dermoid cyst entered the cranium through a persistent foramen cecum and lay within the falx in association with a bifid crista galli. We think that this entity is more common than was previously appreciated. Patients with a diagnosis of nasal dermoid should undergo polytomography or computed tomography of the glabellar area. Even when all x-ray studies are negative, neurosurgical preoperative evaluation and operative standby should be obtained before the otolaryngologist attempts the resection of a nasal dermoid cyst. PMID- 6866234 TI - Temporary clipping during early operation for ruptured aneurysm: preliminary report. AB - Temporary arterial occlusion was performed in 16 patients undergoing early aneurysm operation. Ten patients had a ruptured middle cerebral artery (MCA) aneurysm, and 6 had a ruptured anterior communicating artery aneurysm. Premature aneurysm rupture during operation necessitated temporary arterial occlusion in 10 patients. In 5 patients, temporary arterial occlusion was performed to facilitate dissection of the aneurysm. In 1 patient with a large MCA aneurysm, temporary occlusion was performed to provoke collapse of the completely exposed aneurysm sac, thus making clipping of the base possible. The results do not indicate that temporary occlusion by the standard aneurysm clips now in general use leads to angiographically detectable arterial wall changes or increased thromboembolic complications. Temporary clipping of the MCA proximal to the perforating arteries may be well tolerated for up to 20 minutes during early aneurysm operation. Temporary occlusion of one or both anterior cerebral arteries or temporary pericallosal clipping need not unconditionally lead to disastrous consequences if rendered necessary during aneurysm operations performed in the acute stage. PMID- 6866236 TI - Radioimmunoassay of the brain type isoenzyme of creatine phosphokinase (CK-BB): a new diagnostic tool in the evaluation of patients with head injury. PMID- 6866237 TI - Vasospasm of the vertebrobasilar system in cases of ruptured intracranial aneurysm. PMID- 6866238 TI - Orbital floor fracture: an unusual complication of trans-septal trans-sphenoidal hypophysectomy. PMID- 6866239 TI - Ipsilateral symptoms caused by an arteriovenous malformation of the second or supplementary sensory area of the island of Reil. AB - A report of a patient with an arteriovenous anomaly stresses the correlation of clinical findings with a neuroanatomical basis for ipsilateral sensory symptoms. The significance of the second or supplementary motor and sensory patterns existing in the island of Reil, as demonstrated by the experimental work of Crosby and Augustine, is presented. At present, the evidence is that the discharges from the island of Reil are through the extrapyramidal system, a part of the ansa lenticularis system. The actual anatomical basis for such ipsilateral symptoms should be sought in more patients who are perhaps often designated as "hysterical" because they do not fit the much more commonly known pattern of contralateral symptoms. PMID- 6866240 TI - Clinical evaluation of a depth electroencephalography electrode. AB - Stereo depth electroencephalography (EEG) is of proven benefit in lateralizing and localizing seizure origin in select cases of epilepsy. There are potential hazards and technical considerations inherent with depth EEG, however, that have limited the general applicability of this technique. A new depth EEG electrode with materials and design features that facilitate safe insertion and artifact free recording has been developed. The design features and technique for inserting the electrode are described. The electrode was evaluated during 2600 hours of implantation and recording in seven patients. With the use of stereotactic techniques, the electrode could be positioned accurately within precise anatomical landmarks such as the amygdaloid nucleus and the hippocampus. After insertion, no hemorrhage or edema was detected along the electrode tracts by third generation computed tomographic scanning. There was no evidence of pyrogenicity or infection. Electrode migration was not observed. A large electrical field could be sampled because of the relatively large surface of the cylindrical depth electrode contacts. PMID- 6866241 TI - Intradiploic meningioma of the orbital roof. PMID- 6866242 TI - Traumatic decerebrate rigidity and neurological recovery: a case report. AB - Trauma is the most common cause of decerebrate rigidity (DR). DR has been incorrectly equated with extensor posturing alone, however, and the "classical" criteria of decerebration generally have not been incorporated in the neurological evaluation of head-injured patients. A high mortality rate is associated with extensor posturing in head injury, and there have been few reports detailing neurological recovery and the quality of survival of patients with traumatic DR. The criteria of Sherrington are applied to a case of DR caused by midbrain injury, accompanied by mild, diffuse, hemispheric white matter changes shown on computed tomographic scan. The neurological examination and recovery are discussed. The literature is reviewed and the potential of DR in the prognosis of head injury is suggested. PMID- 6866243 TI - Ventricular obstruction secondary to vascular malformations. AB - Enlarged veins in two vascular malformations blocked the cerebrospinal fluid outflow pathways, causing hydrocephalus. Both patients presented not with the usual clinical picture (hemorrhage, seizure, etc.), but with signs of increased intracranial pressure. Computed tomography and angiography were necessary to understand the pathophysiology. An arteriovenous malformation was responsible for the first patient's headache, and a venous varix was the causative lesion in the second patient. Hydrocephalus caused by a venous varix has not been reported before. PMID- 6866244 TI - Dural plasmacytoma. AB - Dural plasmacytoma is an unusual form of myeloma. We describe a woman with plasmacytoma of the tentorium cerebelli that was managed successfully with surgical decompression and radiotherapy. Computed tomography, not previously reported in cases of dural plasmacytoma, was useful in her management. Another unique feature was the restoration of a normal immunoglobulin G content in the blood and cerebrospinal fluid after local treatment of the neoplasm. Two previously reported cases showed similar normalization of cerebrospinal fluid immunoglobulin G after local radiotherapy. Dural plasmacytoma presents a characteristic clinical syndrome. The typical patient is a woman (92% of the reported cases) in the 5th decade of life. Clinical findings reflect intracranial hypertension, often with focal neurological signs, consistent with the usual dural or tentorial origin of the tumor. Immunoglobulin abnormalities may be found in serum or cerebrospinal fluid. The prognosis is good after surgical decompression and local radiotherapy. PMID- 6866245 TI - Chronic disseminated intravascular coagulation and metastatic brain tumor: a case report and review of the literature. AB - A patient who had a primary lung carcinoma in remission but had a solitary metastatic lesion to the cerebellum was referred to the neurosurgery service. He was noted to be thrombocytopenic, and further hemostatic evaluation revealed chronic disseminated intravascular coagulation. He was treated with heparin and platelet transfusions. Although the fibrinogen levels improved, the thrombocytopenia persisted. Four weeks after admission, repeat chest x-ray films and tomograms indicated progressing metastatic nodules. A review of the literature reveals a variety of hemostatic defects associated with tumor metastatic to the brain. This current case indicates the need for careful hemostatic evaluation in all patients with brain lesions. PMID- 6866246 TI - A rare complication of a ventriculoperitoneal shunt system. PMID- 6866247 TI - The effects of Depo-Medrol and polyethylene glycol 4000 on myelin and neural function. PMID- 6866248 TI - The role of viruses in the induction of human intracranial tumors. PMID- 6866249 TI - Brain stem compression caused by the trapping of air within the fourth ventricle. PMID- 6866250 TI - Circulatory changes caused by a closed, negative pressure drainage system after craniotomy. PMID- 6866251 TI - The effect of human chorionic gonadotropin hormone on functional recovery of the spinal cord in the rat after acute spinal cord sectioning. PMID- 6866252 TI - Intracerebral hematoma after evacuation of chronic extracerebral fluid collections. PMID- 6866254 TI - Handwriting position and hemispheric asymmetry in right-handers. AB - Right-handers who write with an inverted writing posture (N = 8) were compared to right-handers who write in the normal fashion (N = 16) on tests of handedness and hemispheric asymmetry. Inverted writers showed the same laterality effects as normal writers for dot location and the recognition of visually-presented nonsense syllables. In dichotic listening, inverted writers were much more likely to show a left-ear superiority than were normal writers. They also were more strongly right-handed on a speeded performance test, but not in hand preference. This pattern is quite different from that obtained with left-handers, and suggests that the inverting handwriting posture has a different basis in right handers than in left-handers. PMID- 6866253 TI - Predictive eye movements do not discriminate between dyslexic and control children. AB - Pavlidis has suggested that predictive saccadic tracking eye movements distinguish between reading disabled and normal children. We have examined saccadic eye movement tracking in 34 dyslexic and 33 control subjects, between 10 and 12 yr old. The subjects were equivalent in performance IQ (WISC-R), with differences between verbal and performance IQ of less than 30 points. Children with neurological, visual or auditory deficits or histories of emotional problems and hyperactivity were excluded. There were no differences between the groups on the eye movement tracking task when scored objectively by computerized analysis of the eye movement records, or by ranking of the records by an experienced observer. Our results (and those of other recent studies) fail to support Pavlidis' contention that eye movements hold the key to dyslexia. PMID- 6866255 TI - The influence of sex on the development of lateralization of speech. PMID- 6866256 TI - Aesthetic preference in dextrals and sinistrals. PMID- 6866257 TI - Hemisphere differences in the recognition of closed and open class words. AB - The distinction between closed and open class words--of interest in the first instance because of claims about the support of structural analysis during comprehension--has its reflection in word recognition. For normal speakers, performances over these types give evidence of the operation of separate recognition devices, while for agrammatic speakers, performance indicates no such separation. A study of recognition accuracy with tachistoscopic presentation lateralized to the visual hemifields suggests some parallel between left and right hemisphere processing and the contrast of normal and agrammatic speakers: with direct input restricted to the left hemisphere, the vocabulary types show different levels of accuracy; no such differences are evident with presentations to the right. PMID- 6866258 TI - Disturbances of spatial perception in a patient with agenesis of the corpus callosum. PMID- 6866259 TI - Intra- and interhemispheric processing of visual information in callosal agenesis. AB - Two siblings with total callosal agenesis were compared with two control groups on a number of tachistoscopic tasks involving unilateral and bilateral presentation of verbal and nonverbal stimuli. Acallosals were able to effect intra- and interhemispheric comparisons and to correctly identify all kinds of stimuli in either visual field. However, they responded more slowly, especially in the bilateral condition where they also made more errors than the controls. The results are interpreted in terms of increased use of extra-callosal commissures. PMID- 6866260 TI - Evoked field potential analysis of dopaminergic mechanisms in the isolated turtle olfactory bulb. AB - Dopaminergic mechanisms were analyzed in an isolated preparation of the turtle olfactory bulb. Field potentials were evoked by antidromic or orthodromic stimulation, and the effects determined of pharmacological manipulations of the bathing medium. In the presence of dopamine or a dopamine agonist, apomorphine, there was a reduction of amplitude and delay of onset of the component of the field potentials due to granule cell responses; fluphenazine, a dopamine antagonist, had generally opposite effects. Using paired volleys, it was found that the suppression of the response to the second test volley was reduced in the presence of dopamine or apomorphine, but enhanced in the presence of fluphenazine. The most likely explanation of these results is that exogenous dopamine depresses the response of mitral cells, which in turn decreases the dendrodendritic synaptic excitation of granule cells and reduces their inhibitory feedback onto mitral cells. This suggests that the dopaminergic cells in the bulb may suppress mitral cells by modulating excitable mechanisms in the mitral dendritic membrane, or modulating long-lasting synaptic potentials. PMID- 6866261 TI - Golgi, electron-microscopic and combined Golgi-electron-microscopic studies of the mitral cells in the goldfish olfactory bulb. AB - The local neuronal circuitry of goldfish olfactory bulb was analyzed in Golgi preparations combining light- and electron-microscopy, as well as in routinely prepared ultrastructural preparations. Mitral cells were identified with the light-microscope in Golgi-impregnated thick sections according to the following criteria: (1) cell bodies were distributed irregularly in a wide layer between 100 and 200 micrometer from the surface, (2) cell bodies were larger than other neurons (10-20 micrometer in diameter), and (3) the dendrites were directed toward the superficially-located olfactory nerve layer where they ended as highly branched glomerular tufts. These impregnated cells were examined by electron microscopy in serial section. The results demonstrate synaptic organization in relation to the mitral cells. (1) Glomerular tufts received afferent input from primary olfactory axons which made Gray's Type I synaptic contacts. These dendrites also had reciprocal dendrodendritic synapses with dendrites of certain non-mitral cells. (2) Dendritic shafts of mitral cells made reciprocal dendritic synapses with dendrites of certain non-mitral cells. (3) Cell bodies and their initial axon segments had reciprocal synapses with certain dendrites but occurred infrequently. In reciprocal synapses, the direction of the Gray Type I (asymmetrical) is away from the mitral cell while those with Gray Type II synapses (symmetrical) are toward the mitral cell. Assuming that the type I synapse is excitatory and Type II is inhibitory, these findings explain the electrophysiological demonstration of self-inhibition discharge found in mitral cells. PMID- 6866262 TI - Effects of unilateral electrical stimulation of various thalamic nuclei on the release of dopamine from dendrites and nerve terminals of neurons of the two nigrostriatal dopaminergic pathways. AB - The role of several motor and intralaminar thalamic nuclei in the regulation of dopamine release from terminals and dendrites of the nigrostriatal dopaminergic neurons was investigated in halothane-anaesthetized cats. For this purpose, the effects of the unilateral electrical stimulation of various thalamic nuclei on the release of newly synthesized [3H]dopamine were simultaneously determined in both substantiae nigrae and caudate nuclei using the push-pull cannula method. The electrical stimulation of the motor nuclei was the only one to induce asymmetric changes in the four structures since [3H]dopamine release was enhanced in the ipsilateral caudate nucleus and reduced in the contralateral structure while opposite responses were observed in the corresponding substantiae nigrae. A reduction of [3H]dopamine release occurred in the four structures or only in the contralateral substantia nigra and caudate nucleus following the stimulation of the parafascicularis nucleus and the adjacent posterior part of the nucleus centrum medianum or of the nucleus centralis lateralis and the adjacent paralaminar part of the nucleus medialis dorsalis, respectively. The stimulation of the anterior part of the nucleus centrum medianum, which in contrast to other thalamic nuclei examined, receives few nigral inputs, selectively enhanced [3H]dopamine release in the contralateral substantia nigra. No significant changes in [3H]dopamine release were seen either in the substantiae nigrae or in the caudate nuclei following the stimulation of midline thalamic nuclei. These results indicate that the motor and intralaminar thalamic nuclei exert multiple and selective influences on the release of dopamine from terminals and/or dendrites of the dopaminergic neurons. They also further support a role of thalamic nuclei in the transfer of information from one substantia nigra to the contralateral dopaminergic neurons. The possible involvement of connections between paired thalamic nuclei was underlined by the observations of evoked potentials in contralateral homologous nuclei following unilateral stimulation of motor, or some intralaminar, nuclei. The present report provides new insights on the mechanisms contributing to the reciprocal and/or bilateral regulations of nigrostriatal dopaminergic pathways. PMID- 6866264 TI - Partial quantification of the associative synaptic learning rule of the dentate gyrus. PMID- 6866263 TI - Intracellular labelling of rat subthalamic neurones with horseradish peroxidase: computer analysis of dendrites and characterization of axon arborization. AB - Neurones of the rat subthalamic nucleus were identified by their response to cortical stimulation and then intracellularly labelled with horseradish peroxidase. After fixation, the brains were cut serially in sagittal plane and processed by the cobalt chloride-diaminobenzidine procedure. The morphology of nine of the twenty stained neurones strictly located inside the subthalamic nucleus is described by means of quantitative parameters following light microscopic examination and three-dimensional computer reconstruction. They were all identified as Golgi type I neurones. The somata were ovoidal in shape. A mean of four dendritic stems arose from the soma and gave rise to a mean of 27 tips. The dendrites were thin with long and pedunculated spines. The dendritic fields were ellipsoidal in shape (100 x 600 x 300 micrometer) and were parallel to the principal plane of the nucleus. The dimensions of the dendritic fields are very close to those of the nucleus, and some dendrites cross its limits. The axons gave off two branches, one going caudally and the other rostrally. The caudal going branch of the axon of one neurone, followed into the substantia nigra, divided into several collaterals coursing dorsoventrally. The rostral-going branch was never followed up to its termination. An intranuclear axonal collateral was observed in only one case. The present data are compared with those obtained from the primate subthalamic neurons. In spite of slight differences in the pattern of dendritic branching, the neurones are similar in both species. However, major differences in the internal organization of the dendritic fields are observed. Dendrites mixing with other neuronal populations were never observed in the primate. Moreover, the relative sizes of the dendritic fields and of the nucleus are strikingly different. This gives to the primate subthalamic nucleus specific and more precisely organized afferent connections. PMID- 6866265 TI - Effects of unilateral flocculus lesions on vestibulo-ocular responses in the cat. AB - Unilateral lesions of the cerebellar flocculus were performed in three chronically-implanted adult cats. Following the lesion a spontaneous nystagmus was observed in the dark, with the fast phase directed to the lesioned side. Vestibulo-ocular responses in the dark became asymmetrical. Responses to velocity steps exciting the labyrinth ipsilateral to the lesion were strongly increased. A decrease, although less marked, was observed in the opposite direction. Responses to sinusoidal oscillations in the dark were also asymmetric with respect to both the cumulative eye displacement during rotation in the two directions and the interval between two consecutive reversals of eye movement. These differences were greater at the lower tested frequencies (0.01 HZ) than at the higher (0.1 HZ). Spontaneous nystagmus disappeared in about 10 days and a complete symmetry of the vestibulo-ocular responses was restored in about 3 weeks. It is concluded that a unilateral lesion of the flocculus leads to two separate, but interacting, effects upon vestibulo-ocular responses. PMID- 6866267 TI - Selective uptake of [3H]glutamine and [3H]glutamate into neurons and satellite cells of dorsal root ganglia in vitro. AB - The uptake of [3H]glutamate and [3H]glutamine into rat dorsal root ganglia has been examined by autoradiography and thin-layer chromatography. [3H]glutamate was selectively accumulated by satellite glial cells and after 10 min, 53% of this had been converted to [3H]glutamine. [3H]glutamine, on the other hand, entered neuronal perikarya and 40% was converted to [3H]glutamate. It is suggested that these selective uptake processes provide supporting evidence for the existence of a neuronal-glial glutamine cycle in dorsal root ganglia. Small dark (B) cells accumulated 6 times as much [3H]glutamine as did large light (A) cells. The reasons for this marked difference in the metabolism of the two main types of dorsal root ganglion neurone are discussed. PMID- 6866268 TI - [Monitoring blood coagulation parameters in shock]. PMID- 6866266 TI - Effects of morphine and opioid peptides on sensitivity to acetylcholine of dialysed snail neurons. AB - The effects of intracellular and extracellular applications of morphine (in concentrations from 10(-3) to 10(-5) M), leucine-enkephalin and methionine enkephalin (10(-6) to 10(-8) M) were studied in unidentified acetylcholine sensitive dialysed neurons of a snail under voltage clamp. Morphine produced inward membrane currents, while enkephalins did not. Both morphine and enkephalins altered the effect of acetylcholine on postsynaptic acetylcholine receptors; intracellular application of these substances being much more effective than extracellular application. This suggested that opioid peptides take part in the regulation of cholinergic synaptic transmission. PMID- 6866269 TI - [Effects of crystalloid, colloid and plasma priming on coagulation after extracorporeal circulation]. PMID- 6866270 TI - [Piracetam treatment of pseudohallucinatory phenomena induced by ketamine]. PMID- 6866271 TI - [Anesthesiological problems in hypophysectomy operations in acromegalic patients]. PMID- 6866272 TI - [Ketamine and enflurane anesthesia for cardiac catheterization in congenital cardiopathy. Experience with 190 cases]. PMID- 6866273 TI - [Medio-lumbar spinal analgesia in transurethral resection of the prostate]. PMID- 6866274 TI - [Internal jugular vein catheterization as an alternative to subclavian and femoral vein catheterization]. PMID- 6866275 TI - [Indications for the surgical treatment of hiatal hernia]. PMID- 6866281 TI - [Intermittent idiopathic edema]. PMID- 6866276 TI - [Special problems in ileostomy]. PMID- 6866279 TI - [Sigmoid volvulus. 2 case reports]. PMID- 6866278 TI - [Case of a rare complication of Meckel's diverticulum]. PMID- 6866280 TI - [A case of gastric tuberculosis]. PMID- 6866277 TI - [Microsurgery of Vater's papilla]. PMID- 6866282 TI - [Preventive cholecystectomy in hemolytic jaundice? Apropos of 2 unusually rare cases]. PMID- 6866283 TI - [Is drainage useful in emergency appendectomy? Statistical study of homogeneous groups of patients]. PMID- 6866284 TI - [Meckel's diverticulum: diverticulectomy as a principle?]. PMID- 6866286 TI - [Rupture of the diaphragm caused by closed thoraco-abdominal trauma. Presentation of 14 cases]. PMID- 6866285 TI - [Pancreatic pseudocysts. Retrospective study of 23 cases]. PMID- 6866288 TI - [Proximal selective vagotomy in our personal experience]. PMID- 6866287 TI - [Results of surgical treatment of reflux esophagitis using the Lind technic. Study of 412 cases]. PMID- 6866289 TI - [The Milligan-Morgan operation in the surgical treatment of hemorrhoids. Long term results]. PMID- 6866292 TI - [Porcelain gallbladder. Case contribution]. PMID- 6866290 TI - [Leiomyosarcoma of the jejunum. Case report]. PMID- 6866291 TI - [Primary carcinoma of the gallbladder]. PMID- 6866294 TI - The value of cervical mediastinoscopy. AB - The reliability of mediastinoscopy as described by Carlens was evaluated in 170 patients with lung cancer. When the primary tumour was located in the left upper lobe, the result of the mediastinoscopy was false-negative in 12 (31%) out of 39 patients. Other invasive procedures, such as left parasternal mediastinoscopy, might be more accurate in these patients. PMID- 6866295 TI - The value of parasternal mediastinotomy. AB - Parasternal mediastinotomy was performed in 28 patients. Positive findings were obtained in 12 patients (43%). The indications and findings are described. It has been found to be a simple and safe diagnostic, therapeutic and lung cancer staging procedure with a low morbidity. PMID- 6866296 TI - Operative repair of ruptured achilles tendon and functional after-treatment--I. Acute rupture. AB - The results are described of primary operative repair of acute achilles tendon rupture with a simple suture technique and functional after-treatment, followed by immobilisation after a few days in a lower leg walking plaster with the foot in right angle position. In our experience with two groups of patients (64 cases) the described method appeared simple and safe, after-treatment is convenient for the patient and the results are good. PMID- 6866293 TI - [Perforation of gastroduodenal ulcer. Personal experience]. PMID- 6866297 TI - Operative repair of ruptured achilles tendon and functional after-treatment--II. Delayed rupture. AB - Purpose of surgical treatment of delayed rupture of the achilles tendon is repair of normal continuity with restoration of original length and muscle tension. Our experiences are described with 10 patients, using different surgical techniques, all based on the three-tissue bundle procedure (sandwich-technique). After treatment was functional, followed by immobilisation in a lower leg walking plaster. Wound healing disturbances influenced healing time, but not the end results. In secondary reconstruction of achilles tendon rupture, simple operative repair is the best prevention of complications. PMID- 6866298 TI - Incidence and sex distribution of proximal femoral fractures in children and adolescents. AB - During the period 1909-1981, proximal femoral fractures were treated in 2632 adults and 74 children and adolescents in the age group of 0-18 years. The incidence of these fractures in children and adolescents in relation to that in adults is higher than so far indicated in the literature, and in this series amounts to 1:36. Proximal femoral fractures show a male predominance in children and adolescents, and the age of predilection is 11-18 years. PMID- 6866299 TI - Fecal continence after subtotal to total excision of the rectum. AB - From a technical and oncologic point of view, low anterior resection of the rectum can be performed in selected patients, but fecal continence after these procedures is often questioned. Therefore we have investigated the mechanism of continence, i.e. the internal and external sphincters, anal and rectal sensibility, and rectal capacity in 17 patients who had undergone anterior or low anterior resection. Normal anal and rectal sensation was found in all patients. Adequate sphincteric function was maintained to guarantee normal sphincteric continence postoperatively. Rectal capacity was reduced in patients with very low rectal resections. This caused an increase in bowel actions, and a reduced ability to delay imminent evacuation. It was concluded that fecal continence is reduced after very low rectal resections. PMID- 6866300 TI - A missed opportunity: two fractures of the lateral humeral condyle in a girl aged 5 years. PMID- 6866301 TI - [Epidemiological study on tremor in the aged]. AB - 203 hospitalized old-aged patients were examined for the presence of tremor. This physical sign was found in 58.6% of cases. By far the largest diagnostic category resulted that of essential tremor: 46.7% of all patients investigated and 77.8% of all cases of tremor. The frequency of this type of tremor was found to increase proportionally to age. The conclusion is drawn that also tremor, as well as other neurological signs frequently demonstrable in "normal" old people (for example, the so-called primitive reflexes), should be inscribed in the group of the phenomena due to the ageing process itself. PMID- 6866302 TI - [Comparative diagnostic value of echography and oral radiologic examination of the gallbladder in relation to surgical findings]. AB - For nearly 60 years, since it was introduced by Graham and Cole (1924), oral cholecystography (OCG) has been used as the imaging technique of choice in investigation of gallbladder disorders. Recently, the future of OCG has come into doubt, principally as a result of ultrasonography, with the advent of high resolution real-time scanning. Stones are seen as echoes within the lumen of the gallbladder and are associated with an acoustic shadow, findings which are highly specific. On this basis, to evaluate the accuracy of ultrasonography in detecting cholelithiasis, the A. have performed by real-time cholecystosonography 60 patients with not diagnostic OCG in a group of 546 patients affected by gallbladder diseases. Our results have confirmed that sonography revealed 4 normal gallbladders, 51 gallstones and 1 primary gallbladder cancer, with 5 cases of false positive. The true false negative rate has been difficult to determine, as surgery is usually not performed after a negative study. The accuracy of cholecystosonography for gallstone diagnosis was found to be 88,1% for all three Crade's categories. PMID- 6866304 TI - [Biliary ileus. Diagnostic problems]. AB - A case of biliary ileus in association with successfully operated cholecystoduodenal fistula is reported. The importance for prognosis of preoperative diagnosis of the condition is emphasised. The diagnostic importance of echotomography in cases where there is a history of cholelithiasis is underlined. PMID- 6866303 TI - [Diagnostic and prognostic value of the carcinoembryonic antigen in colonic cancer]. AB - A group of 50 patients operated for carcinoma of the colon in June 1980-December 1981 with a follow-up period of min. 2 months-max. 15 months is presented. C.E.A. measurements were taken in all patients pre and post-operatively and then every 2 months in an attempt to establish its diagnostic and prognostic value. In immediate diagnostic and prognostic terms, pre-operative C.E.A. appears to be insignificant. However both pre-operative C.E.A. and C.E.A. at a distance of 6 months were found to be reliable for long term (max. 15 months) prognosis. PMID- 6866305 TI - [Enzymatic reaction of the follicular cell population in the human appendix]. AB - Histochemical techniques were employed to determine acid phosphatase and alpha naphthylesterase activities in follicular cells from the mucosa of surgically removed human appendixes. These very reactive cells are found in two areas: in the middle of the light centre and in the surroundings of this centre. The former are globose, arranged with a certain degree of order, and have a reticular anchorage that does not appear to be particularly affected by the physiological and pathological events that occur in the appendix, whereas those of the border vary in number or may even be absent. They have an elongated shape and are also anchored in a reticulum that in this case is more consistent. The result is that in certain forms of appendiceal disease the pale centre of the follicle is closed in a kind of shell formed of very reactive cells. The identification and significance of these two groups of cells of the light centre are discussed. PMID- 6866306 TI - [Low-dose calcium-heparin prophylaxis in thoracic surgery. Bleeding, changes in coagulation and fibrinolysis]. AB - In a controlled, randomized study of patients undergoing thoracic surgery, calcium heparin prophylaxis is confirmed to prevent activation of the coagulation and fibrinolysis system, by determining plasmatic kallikrein, antitrombin III, and plasmin. In a further study calcium heparin, 5000 I.U. s.c. every 8 hr, is statistically proved not to increase post-operatory bleeding. PMID- 6866307 TI - [Acid lysuride maleate in the prevention of migraine headache. Clinical experience]. AB - Clinical experience of lysuride maleate acid in the treatment of 88 patients with occasional and 12 patients with chronic headache is reported. After 3-5 months observations the treatment was judged effective (excellent, good, satisfactory) in 72% of the cases and ineffective (poor, nil) in 28%. Side effects were few and short-lived, consisting mainly of slight nausea and asthenia. In 2 cases treatment was suspended as ineffective (in the patient's opinion). PMID- 6866308 TI - [Minor anal pathology. Suggestions for ambulatory and hospital treatment]. AB - A series of cases of anorectal pathology treated at the out-patient level or after hospitalisation in the course of the last five years is reviewed. Deference is made to subjects with haemorrhoids operated according to Milligan-Morgan or Parks in accordance with varying indications, or treated cryosurgically as out patients, patients with upper or lower transsphincteric perianal fistula treated by means of the lay-open technique or elastic tourniquet under general or local anaesthesia, patients with acute anal fissures treated by means of internal lateral sphincterotomy under local anaesthesia, and those with inveterate forms subjected to Arnous posterior leiomyotomy. From a critical assessment of the hospital and out-patient activities carried out suggestions and indications are drawn with regard to cases that must be treated in hospital and those for which outpatient management is correct. PMID- 6866309 TI - [The effects of Levissima oligomineral water on diuresis and water exchange]. AB - Research on healthy and diseased subjects and laboratory animals have shown that Levissima oligomineral water: a) has no unpleasant or harmful subjective and/or objective side-effects even when taken at high doses for long periods. b) Encourages diuresis. Comparison with saline solution of the same osmolality showed: 1) mean increase in diuresis: 16%; 2) more rapid elimination of water; 3) significant increase in free water clearance; 4) no change in the stock of electrolytes during protracted administration. c) Influences purine exchange: 1) by increasing uric acid clearance (same comparison); 2) by reducing the hyperuricaemising effect of a rapid i.v. fructose load; 3) by opposing hyperuricaemia due to depression of mechanisms responsible for the increase of uric acid owing to enhancement of serum lactic acid after the administration of alcohol. d) Results in a characteristic change in certain coagulation parameters when compared with saline solution and tap water. It is suggested that this method be used to recognise the persistence over time of the biological activities of bottled mineral waters. PMID- 6866310 TI - [Dysmyelopoietic syndrome 7 years after melphalan treatment of multiple myeloma. Clinical case]. AB - A case of myelodysplasia (refractory anaemia with excessive blasts) arising 7 years after a 3 year period of intermittent monthly treatment cycles with melphalan for multiple myelomas is reported. This is another example of preleukaemic syndrome possibly caused by melphalan. Among the possible pathogenetic mechanisms, the incidence of cyclic episodes of medullary hypoplasia are emphasised. PMID- 6866311 TI - [Atmospheric pollution. Biological aspects and role of meteorologic factors in the distribution of respiratory hazards in the environment and relative prognostic and preventive measures]. AB - The biometeorological factors underlying atmospheric pollution are discussed, together with its biological effects and its direct and indirect damage to human health. Damage is particularly likely when particularly adverse ambient and climatological conditions result in a massive and persistent concentration of contaminants in the ambient air. In this case, since the highly biologically interesting phenomenon of physicochemical reaction between pollutants and atmospheric components prevails over that of the dilution and dispersion of such contaminants, nature's major processes of removal and self-purification may be rendered nugatory and insufficiently prompt. The effects of atmospheric pollution, primarily with respect to urban background pollution, on human health make their appearance in the respiratory system, where there is a continuous relation between man and his environment throughout his life, in the form of immediate or short, medium and long-term damage. The desirability of preparing a meteorological map showing the distribution of the risk of atmospheric pollution is discussed. For this purpose, use could be made of meteorological data, and the hi-tech observations now made possible, inter alia, by the employment of satellites and aerospace data. A map of this kind would give more precise information concerning the part played by the weather in distributing the risk of respiratory damage caused by environmental pollution. It would also provide the knowledge required for the purpose of prediction and prevention in an organised struggle against such pollution. This would be of great social significance and value. Its practical applications could be enormous consequence to humanity. PMID- 6866312 TI - [Fear of flying within the framework of the agoraphobia syndrome]. PMID- 6866313 TI - [Preventive medicine in secondary spondyloarthrosis caused by chronic microtraumatism in helicopter personnel]. AB - After an examination of the three operational stages in the modern concept of preventive medicine, the main pathogenetic cofactors in secondary arthrosis following chronic microtraumatisation are identified, described and evaluated in order to establish the correct preventive approach to the condition in helicopter pilots. PMID- 6866316 TI - [Ionizing radiation in the aeronautics industry. Non-destructive testing]. AB - The constant increase in the non-military use of nuclear energy in various fields induced this study of one particular field: the aero industry. Alitalia has been using gammagraphy and industrial metallography for nondestructive testing for over 20 years. Workers exposed to ionising radiations at work are protected by precisely detailed standards based on extremely rigorous national and international legislation. The health and protection of these workers is entrusted to a Company Doctor and a Qualified Specialist. The latter is thought to be indispensable since he is responsible for primary preventions as well as prompt diagnosis. PMID- 6866314 TI - [Physiokinetic therapy in the prevention of cervical disk arthrosis in helicopter personnel]. AB - Helicopter pilots subjected to "chronic microtraumatism" related to the constant vibration present in this type of aircraft are considered. The most suitable physiokinetic treatment in the prevention of cervical spondylodiscarthrosis is discussed. Spondylodiscarthrosis is the most common and debilitating problem affecting helicopter personnel. PMID- 6866315 TI - [Vision testing: a method for the correct estimation of visual acuity]. AB - The errors and deficiencies of current sight testing due to lack of adequate tools or training are highlighted. Some useful techniques and methods, especially for non-specialist personnel, are suggested as a way of improving the evaluation of eyesight. PMID- 6866317 TI - [Hygiene in airline catering. I. Microbiologic study of meals distributed on aircrafts]. AB - A preliminary microbiological survey, conducted in the Italian national airlines Catering Department is reported. Precooked,, frozen meals reheated on medium and long distance flights were examined. The results indicate that hygiene standards are satisfactorily maintained. The presence of staphylococcus aureus in some samples highlights the importance of preventive and prophylactic measures in healthy carriers. In view of the growing concern about Salmonella poisoning in airline passengers the absence of this bacterium is extremely satisfying. PMID- 6866318 TI - [Preventive vaccination of tourists in the tropics]. PMID- 6866319 TI - [Smallpox vaccination]. PMID- 6866320 TI - [Immunology of tumors]. PMID- 6866321 TI - [Neoplasms in chronic kidney failure]. PMID- 6866322 TI - [Clinical aspects of tumors in the course of dialysis]. PMID- 6866323 TI - [Italian studies on neoplasms in the course of dialysis]. PMID- 6866325 TI - A combined vascular-catecholamine fluorescence method reveals the relative vascularity of rat locus coeruleus and the paraventricular and supraoptic nuclei of the hypothalamus. AB - Vascular perfusion with a fluorescent dye, Pontamine sky blue, was combined with glyoxylic acid-induced catecholamine fluorescence to produce simultaneous staining of intracerebral blood vessels and catecholamine-containing cells and fibers. Quantitative measurements of blood vessels per unit area revealed that the vascular density of rat locus coeruleus did not differ from the surrounding neuropil but was significantly lower than that of the hypothalamic supraoptic and paraventricular (PVN) nuclei. Moreover, the density of blood vessels in the magnocellular portion of PVN was not uniform throughout its rostrocaudal extent but was dense only in a specific subdivision of lateral PVN, which is predominantly vasopressinergic and is also heavily innervated by catecholamine terminals. PMID- 6866324 TI - Terminations of olfactory afferents on layer II and III neurons in the entorhinal area: degeneration-Golgi-electron microscopic study in the rat. AB - The degeneration-Golgi-electron microscopy technique was used to study the termination of olfactory afferents in the entorhinal area (EA) in the rat. Following resection of the olfactory bulb, degenerating axon terminals can be observed in a superficial lamina of layer I of both medial (MEA) and lateral (LEA) part of EA. Twenty-one Golgi-impregnated cells of 7 neuronal types located in LEA were investigated with the electron microscope. Of these cells, two layer II spinous multipolar neurons and one layer III spinous pyramidal cell, all located in the ventral part of LEA (VLEA), and one layer II sparsely spined multipolar cell, located in the dorsal part of LEA (DLEA), were observed to form synaptic contact with degenerating axon terminals. Based on these findings the possibility of a 3-member neuronal chain is discussed: mitral cell of the olfactory bulb - layer II or III neuron of EA-CA3 cell or granule cell in the hippocampus. PMID- 6866326 TI - Instruction-related changes of neuronal activity in area 5 during a simple forearm movement in the monkey. AB - Unit recordings were made in area 5 of monkeys during the performance of a sound triggered movement of the forearm. Changes in neuronal activity prior to the movement were observed in 188 neurons recorded in both normal and deafferented animals. When the discharge of these cells was analyzed as peristimulus histograms, it was seen that 152 neurons presented a pattern of discharge which was characterized by a brief modification in activity with a relatively constant latency after the auditory cue. Similar changes were observed in normal and deafferented animals but the latency was not the same for the two groups. These neurons may reflect the presence of a sensorimotor interface for the integration of instructions for movement and the subsequent genesis of motor commands. PMID- 6866327 TI - Choline acetyltransferase immunohistochemistry in brains of Alzheimer's disease patients and controls. AB - Choline acetyltransferase (ChAT)-containing neuronal structures of the basal forebrain were studied by ChAT immunohistochemistry in the brains of persons dying with Alzheimer's disease (SDAT), as well as age-matched controls dying without neurological disorder. A loss of greater than 50% in ChAT-containing neurons was found in the substantia innominata in the SDAT group. In contrast, there was no reduction in the number of ChAT-containing neurons of the putamen as compared with controls. The data confirm the reason for the reduction of ChAT as measured biochemically in the neocortex of SDAT cases, and support the cholinergic hypothesis of memory. PMID- 6866328 TI - Cholinergic neurons in the rat cerebral cortex demonstrated by immunohistochemical localization of choline acetyltransferase. AB - The presence of cholinergic neurons in rat cerebral cortex was demonstrated by immunohistochemical localization of choline acetyltransferase, the enzyme synthesizing the neurotransmitter acetylcholine. The stained neurons were found throughout the entire cortex and were present in layers II--VI. Two morphological distinct classes of cholinergic neurons have been identified and compared with those neurons containing acetylcholinesterase. PMID- 6866329 TI - A transient component of the developing corticospinal tract arises in visual cortex. AB - Following injections of tritiated leucine restricted to occipital (visual) regions of cerebral cortex during the first postnatal week (days 3--6), labeled corticofugal axons were followed caudally through the pons, medullary pyramid, pyramidal decussation and into the cervical spinal cord. However, when similar injections were made into visual cortex during the second postnatal week, labeled corticofugal axons could not be traced beyond mid-pontine levels where abundant axon terminal labeling was evident in the basilar pontine nuclei. Since axonal labeling did not subsequently appear at levels caudal to the pons during later stages of development or in the adult, it is suggested that the contribution to the corticospinal system made by visual cortical axons in the first postnatal week is a transient connection which is eventually lost either by a process of selective axon collateral elimination or cell death. PMID- 6866330 TI - Intravitreal kainic acid permanently eliminates off-pathways from chicken retina. AB - Kainic acid rapidly suppresses both ON- and OFF-visually evoked responses in the tectum after injection into the vitreous of chicken eyes. One week after injection the OFF-responses were still suppressed, while ON-responses were detected of similar magnitude but of simplified form to those of control eyes. It is suggested that kainic acid selectively destroys OFF- rather than ON-bipolar cells, while the simplification of the ON-responses is due to the destruction of amacrine cells. PMID- 6866331 TI - Evidence that the early postnatal reduction in the number of rat retinal ganglion cells is due to a wave of ganglion cell death. AB - Horseradish peroxidase (HRP) was injected into the retino-recipient nuclei of each hemisphere in newborn rats. The animals were perfused 3--9 days after the injections; the number of retinal ganglion cells in retinal wholemounts was estimated by counting cells containing granules of HRP reaction product. The mean number (150,500) of labelled cells in 3-day-old rats was significantly higher than those in older animals (117,000, 121,000, 113,000 respectively on 6th, 8th and 9th postnatal days). However, in animals of any of the ages studied, the estimated numbers of ganglion cells were virtually the same as those in the animals of the same age but injected with HRP only 15--20 h before the perfusion. Thus, the reduction in the number of retinal cells projecting to the central visual nuclei observed during the first few postnatal days is due to a wave of retinal ganglion cell death; ganglion cell death induced by the neonatal removal of the contralateral superior colliculus has a similar time course. PMID- 6866332 TI - Increase in synaptic sites in goldfish tectum after partial tectal ablation. AB - In young goldfish after partial ablation of the tectum, the number of synaptic contacts and terminals in a column through the stratum fibrosum et griseum superficiale of the tectum was increased to an extent corresponding to the greater input of optic axons projecting to the remaining tectum. This finding is consistent with previous results based on counting degenerating optic terminals, and therefore establishes that the optic axons make approximately normal numbers of terminals in the remaining tectum. The conflict between this finding and results obtained on older fish suggests that tectal cells of younger fish can more readily accept an increased number of optic terminals. PMID- 6866333 TI - Autoradiographic localization of a calcium channel antagonist, [3H]nitrendipine, binding site in rat brain. AB - [3H]Nitrendipine, a calcium antagonist, binds in a saturable fashion (Kd = 1.4 nM, Bmax = 28 pmol/g tissue) to an apparent single class of sites in rat brain sections. Nifedipine and nitrendipine are potent displacers of [3H]nitrendipine binding while verapamil and D-600 are almost inactive. The autoradiographic distribution of [3H]nitrendipine binding shows high concentrations of sites in the hippocampus, in superficial layers of the cortex, in the external plexiform layer of the olfactory bulb and in the cerebellum. Lower levels are found in the striatum and the hypothalamus. Very low densities are observed in most of the remaining areas. The characteristic distribution of[3H]nitrendipine binding sites may help to reveal the mechanism by which calcium regulates brain functions. PMID- 6866334 TI - The evening rise in the rat pineal N-acetyltransferase activity under various photoperiods. AB - The evening rise in the rat pineal N-acetyltransferase (NAT) activity was studied under various photoperiods. After the onset of darkness, NAT increased more rapidly under longer than under shorter photoperiods. Since following the evening administration of isoproterenol the rates of NAT induction and NAT responses to various doses were similar in short and in long photoperiods, it is suggested that the different times courses of the NAT increase may be due to the time of noradrenaline release from pineal nerve endings and to the quantity of the released noradrenaline. PMID- 6866335 TI - Raphe unit activity in freely moving cats: lack of diurnal variation. AB - Activity of presumed serotonin-containing neurons in the dorsal raphe nucleus of the cat was recorded across the sleep--waking cycle every 4 h, for 24 or 48 h. These neurons showed no diurnal variation in activity independent of behavioral state. This suggests that reports of diurnal fluctuations in serotonin metabolism are due either to differential patterns of sleep--wakefulness across the 24 h cycle and/or to a lack of tight coupling between neuronal activity and neurotransmitter metabolism. PMID- 6866336 TI - Angiotensin II stimulates changes in the norepinephrine content of primary cultures of rat brain. AB - Interactions between norepinephrine and angiotensin II were investigated in neuron-enriched primary brain cell cultures, which have been demonstrated to contain catecholamines, angiotensin II-like immunoreactivity and specific receptors for angiotensin II. Angiotensin II (7.5 and 15.0 micrograms/ml) caused significant increases in both neuronal and growth media norepinephrine levels, which were inhibited by saralasin. These observations suggest that angiotensin acts at its specific receptors to alter neuronal norepinephrine levels. PMID- 6866337 TI - [3H]Leu-enkephalin binding following chronic swim-stress in mice. AB - Warm water swimming produces in mice an opiate-like antinociceptive response. Chronic swimming produces tolerance to the antinociceptive response and, depending on the schedule, cross-tolerance with morphine and naloxone intensified withdrawal signs. Low affinity [3H]Leu-enkephalin binding to brain homogenates at low temperature was significantly reduced in acutely swum mice and chronically swum mice whether or not they were swum. Preincubation at 37 degrees C abolished all between-group differences. Results following chronic swimming were similar whether or not the schedule produced morphine cross-tolerance. These results were discussed in terms of the interpretation that reduced binding reflects increase in vivo occupation of opioid binding sites. PMID- 6866338 TI - Radioactive deoxyglucose uptake into the prefrontal cortex during a delayed response task of the monkey. PMID- 6866339 TI - Nutritional supplementation and growth restoration in juvenile Crohn's disease: a new approach. PMID- 6866340 TI - The enigma of anorexia nervosa. PMID- 6866342 TI - Variables affecting nurse practitioner salaries. PMID- 6866341 TI - Acute rheumatic fever. AB - The classic dramatic clinical presentation of acute rheumatic fever (ARF), with high fever, severe carditis and acute polyarthritis, is changing to an asymptomatic, milder form. The cardiac damage potential of the disease remains high. It is the responsibility of the primary care nurse practitioner to 1) provide primary prevention of ARF through appropriate treatment of streptococcal pharyngitis; 2) be cognizant of the manifestations of the disease; and 3) provide secondary prevention of subsequent attacks through prophylaxis. PMID- 6866343 TI - The states' challenge to provide maternal and child care. AB - President Reagan's federalist policies have resulted in changes in maternal and child services. Public programs are now administered by states instead of by the federal government. The reduction in available funds poses a challenge to state health program administrators and care providers. This dilemma is reviewed in the context of the development of existing programs and the evolution of federalism. The impact of these changes on services and on nursing are discussed. PMID- 6866344 TI - Oral contraception: selection and management. PMID- 6866345 TI - Lipoproteins and heart disease. AB - Elevations of LDL and plasma cholesterol are established predictive risk factors for predisposing to early coronary heart disease. Conversely, HDL has a protective anti-atherogenic effect. The hyperlipidemias are classified according to a genetic basis (primary) and the result of other diseases (secondary). Diet is an important and modifiable determinant of the lipid concentration in plasma. Restricting saturated fat consumption, increasing intake of polyunsaturated fat and reducing dietary cholesterol are key to hyperlipidemias with elevated LDL. Weight reduction, decreased alcohol consumption, and in some individuals, restriction of simple sugar intake are the primary means for treating hyperlipidemias. PMID- 6866346 TI - Strategies for coping with role stress. PMID- 6866347 TI - Part 1: Data collection methods. Psychiatric vs. psychosocial concepts. PMID- 6866348 TI - Sickle cell disease in pregnancy: an update. PMID- 6866349 TI - Systemic medication during labor and delivery. PMID- 6866350 TI - Recurrent abortion. AB - The causes of recurrent reproductive failure are diverse. Many of them are not evident in routine clinical practice and some are still unknown to sophisticated researchers in the field of reproduction. A rational clinical evaluation of the couple will identify the known causes and suggest the unknown causes. More recently the unknown causes have been further classified because of advances in cytogenetic techniques. Abortion material can now be divided into aneuploid and euploid conditions. Heteromorphic banding techniques are useful in exploring both the parental source and the mechanism responsible for recurrent aneuploidy. Delays in ovulation and fertilization may be closely linked to these cytogenetic errors. Identification of euploid abortuses in this unknown group will allow for diagnosis of endocrine, immunologic, and teratologic causes yet to be discovered. With identification of known causes, the treatment is clear cut. All other couples are at the present time dependent upon the availability of techniques to identify unknown causes. Treatment must center on normalization of ovulation, synchronization of sperm deposition and ovulation, and optimization of the maternal environment in which fertilization will occur for these couples of unknown causes. PMID- 6866351 TI - Donor insemination. PMID- 6866352 TI - Epithelial carcinoma of the ovary. PMID- 6866353 TI - The role of sex steroid receptors in obstetrics and gynecology. PMID- 6866354 TI - Risk factors in cesarean section infection. AB - Factors associated with risk of postoperative infection after cesarean section were studied in 321 patients not given antibiotic prophylaxis. Infections occurred in 56 (25%) of the 228 patients who were delivered by emergency cesarean section and in eight (9%) of the 93 patients who underwent elective surgery (P less than .01). These frequencies corresponded well with the infection rates reported after administration of antibiotics in other studies. Risk factors were: duration of operation more than one hour; blood loss more than 800 ml; presence of Staphylococcus aureus in the nares; signs of intrauterine infection before surgery; and failure of progress in labor. The results indicated that obstetric interventions had been performed more frequently in patients at risk of infection, rather than being the real cause of the infections. The importance of strict preoperative hygienic routine is discussed. PMID- 6866355 TI - Perioperative antimicrobials for cesarean delivery: before or after cord clamping? AB - To determine neonatal risk of exposure to intrapartum antimicrobials given to reduce maternal infection following cesarean delivery, 642 mother-infant pairs were evaluated. In 464, the mother was given an initial dose of antimicrobial(s) before cord clamping, whereas in the remaining 178 administration of these drugs was not begun until after delivery. Despite the facts that all infants were at equivalent risk for infection and that none were proved to have bacteremia, 28% of those exposed to intrapartum maternal antimicrobials were evaluated for sepsis whereas only 15% of those not exposed were evaluated (P less than .001). Excess hospital charges for infants in whom sepsis workup was initiated was $127 greater than that for infants not suspected of having sepsis (P less than .025). Of 305 women given three-dose perioperative antimicrobial therapy, 255 were given the initial dose before cord clamping and 24% experienced a subsequent uterine infection. This was not significant when compared with a uterine infection rate of 22% in 50 women in whom three-dose therapy was not initiated until after cord clamping. As maternal benefits that accrue from such intrapartum therapy are equivalent regardless of the timing of three-dose treatment, and as fetal exposure to these drugs has significant clinical and economic impacts, it is concluded that antimicrobials given to these women at high risk should be withheld until after cord clamping. PMID- 6866356 TI - Genetic counseling before prenatal diagnosis for advanced maternal age: an important medical safeguard. AB - Genetic counseling before amniocentesis has been advocated by many geneticists with little evidence to support their contention. Records of patients referred exclusively for advanced maternal age were evaluated for additional diagnostic information obtained from the genetic counseling process that could place these patients at additional risks for previously unsuspected fetal abnormalities. A significant number of patients (43.3%) were at additional risk or had significant concerns regarding one or more hereditary or congenital disorders requiring extensive genetic counseling. The results of the present study provide a scientific basis for the consideration of genetic counseling as a standard part of all prenatal diagnostic procedures. PMID- 6866358 TI - Prognosis for future childbearing after midcavity instrumental deliveries in primigravidas. AB - The frequency of subsequent childbearing and the method of subsequent delivery among 149 primigravidas who required instrumental delivery for midcavity arrest of the fetal head in the second stage of labor and 1258 primigravidas who delivered spontaneously were compared. The frequency of subsequent childbearing was similar in the two groups, but operative delivery for cephalopelvic disproportion (CPD) in a second pregnancy was six times greater in the instrumentally delivered group (11.2 versus 2%; P less than .005). Nevertheless, more than 75% of instrumentally delivered primigravidas who delivered heavier infants in their second pregnancy did so spontaneously. It is concluded that relative CPD is not a common factor necessitating midcavity deliveries, even if cases in which peridural anesthesia is used and deliveries for fetal bradycardia are excluded from consideration. This probably accounts for the fact that over 97% of instrumentally delivered infants suffered no birth trauma or birth asphyxia. PMID- 6866357 TI - Intrapartum external version of the second twin. AB - Twenty-five external cephalic versions were attempted on 14 transverse and 11 breech malpositioned second twins. In ten of 14 (71%) transverse presentations and eight of 11 (73%) breech presentations, version was successful and resulted in subsequent vertex vaginal delivery. Successful version was not associated with parity, gestational age, or birth weight but was associated with mode of anesthesia and disparity in twin size. Among the 25 attempted versions, seven (28%) had one-minute and two (8%) had five-minute Apgar scores below 7. Analysis by birth weight and mode of delivery is presented. Time interval between delivery of twins had no association with outcome. One neonatal death occurred in a 28 week, 1100-g infant. The authors believe that external version is useful in the management of the second twin who has an abnormal presentation, and that routine cesarean section is not always necessary. Further investigation, especially at lower birth weights, is necessary to confirm the safety and efficacy of this method of management. PMID- 6866359 TI - The unfavorable cervix in prolonged pregnancy. AB - One hundred ninety-seven women who had completed 42 weeks of gestation underwent weekly evaluation of the cervix according to the Bishop score until the spontaneous onset of labor. Confirming the clinical impression that the cervix is seldom favorable in prolonged pregnancy, the initial Bishop score was only 3.6, and in only 8.2% was the score 7 or more. The degree of dilatation at the last predelivery examination was significantly related to an infant's Apgar score at one and five minutes; effacement was significantly related to the Apgar score at one minute. The Bishop score at 42 weeks and more was not related to the patient's parity or to the infant's birth weight. Finally, dilatation and effacement of the cervix and station of the head were more predictive of the interval from examination until delivery than were other elements of the Bishop score. PMID- 6866360 TI - Asphyxia and gestational age. AB - Perinatal asphyxia at term is a major cause of mortality and morbidity. In many instances obstetric or maternal complications during pregnancy, labor, or delivery account for the asphyxia, but there is a group of infants in whom asphyxia occurs without any recognizable risk factors. The histories of 1602 infants were evaluated with these problems in mind. There were 547 infants without any complicating factors, 329 with obstetric complications, and 356 with miscellaneous maternal, fetal, and neonatal problems. The mean gestational age of these infants was 277.4 days. Fetal distress was noted in 183 cases without subsequent neonatal disease; the mean gestation of these infants was 282.7 days. Unexpected intrapartum asphyxia was observed in 187 instances with a mean gestation of 288.8 days. Those who died or had neurologic symptoms had the longest mean gestation, 291 days. Only 5% of the infants dying of unexpected perinatal asphyxia and less than 16% of those with neurologic symptoms were born before their due dates; approximately 64% of the infants with obstetric complications, miscellaneous problems, or no complications or morbidity were born before 280 days. The implications for management of pregnancy at or beyond 280 days are discussed. PMID- 6866361 TI - Risk factors for complications of interval tubal sterilization by laparotomy. AB - The complication rate among 282 women undergoing interval tubal sterilization by laparotomy was studied as part of the prospective multicenter Collaborative Review of Sterilization. Using a standard definition of major complications, the overall complication rate was 5.7 per 100 procedures. Women experiencing complications had a significantly lengthened postoperative recovery period before the resumption of normal activities. Important risk factors for complications included diabetes, cigarette smoking, previous abdominal or pelvic surgery, and a history of pelvic inflammatory disease. Women with an initial abdominal incision of 7 cm or longer had three times the complication rate of women with shorter incisions. These results provide objective evidence that, for tubal sterilizations, minilaparotomy (laparotomy with a small abdominal incision) is associated with lower morbidity than is conventional laparotomy. PMID- 6866362 TI - Second-trimester abortion by dilatation and evacuation: an analysis of 11,747 cases. AB - The dilatation and evacuation procedure was explored in 1971 as an alternative method of second-trimester abortion. The results in 11,747 cases from 1972 through 1981 are presented. Although complications do occur--most notably hemorrhage, cervical laceration, fever, and perforation--the overall complication rate was lower than that reported for saline or prostaglandin in other large series. Further study and refinement of technique may help bring this shorter, safer, and more convenient procedure within the reach of larger numbers of women seeking second-trimester abortion. PMID- 6866363 TI - Factors affecting the pregnancy rate in clomiphene citrate induction of ovulation. AB - During the five years ending on December 31, 1981, 159 anovulatory and oligomenorrheic patients were treated with clomiphene citrate for induction of ovulation. Overall, 86% of these patients ovulated, and 49% of the patients who ovulated conceived. Life table analysis was employed to investigate factors contributing to reduced conception rates, including abnormal semen analysis, pelvic or tubal abnormalities, and poor cervical mucus. Elevated serum testosterone levels did not affect conception rates. The most significant factor contributing to reduced overall pregnancy rates was patient discontinuation of therapy. Cumulative pregnancy rates corrected for discontinuation approach 100% after ten cycles of therapy. During this period, the monthly probability of pregnancy (monthly fecundability) remained constant. Optimal pregnancy rates are attained if other infertility factors are corrected and treatment is continued for ten to 12 ovulatory cycles. PMID- 6866364 TI - Computed tomography in invasive carcinoma of the cervix: an appraisal. AB - The clinical staging, computed tomographic scans, and surgical findings in 42 patients with cervical carcinoma were compared prospectively to determine the accuracy and clinical utility of computed tomography in demonstrating extent of disease and involvement of paraaortic lymph nodes. Computed tomography was of limited value in stage IB and IIB tumors, but was comparable in accuracy to clinical examination in the assessment of IIB disease. Computed tomography was of value in radiation therapy and may detect unsuspected bony metastases (stage IVB). Retroperitoneal adenopathy can be detected by computed tomography with an overall accuracy of 83% and a specificity of 86%. Computed tomography is an important adjunct in determining tumor extent in more advanced disease (stages IIIB and IVB) and in detecting paraaortic adenopathy. PMID- 6866365 TI - Diagnostic reliability of Mi-Mark helix technique in endometrial neoplasia. AB - To evaluate the diagnostic reliability of the Mi-Mark helix technique in endometrial neoplasia, 138 women with abnormal uterine bleeding underwent a prospective study of Mi-Mark sampling of the uterine cavity before dilatation and curettage. Of one hundred thirty-eight patients, 42% had postmenopausal bleeding and 18% had perimenopausal bleeding. The acceptability of this procedure by patients and physicians was remarkable. All invasive endometrial carcinomas were detected by Mi-Mark cytology. The most serious limitation of this technique was its failure to detect a large number of hyperplasias without atypia. Examination of a cell block along with cytology would facilitate the histopathologic diagnosis, especially of hyperplasia. The results of this study appear to justify the use of this procedure in high-risk patients. PMID- 6866366 TI - Antibody-recognized [125I]estradiol-receptor complex in ovarian epithelial carcinoma. AB - Monoclonal antibody against human breast cancer estrogen receptor was used to demonstrate binding of a gamma- and Auger electron-emitting estrogen to the estrogen receptor in ovarian epithelial carcinomas. When cytosols of estrogen receptor-rich ovarian adenocarcinomas were analyzed on sucrose gradients containing 0.4 M KCl, the presence of monoclonal antibody against breast cancer estrogen receptor caused a binding peak for [125I]- and [3H]estradiol to shift from the 4S to the 8-9S region, indicating antibody complex formation with ovarian adenocarcinoma estrogen receptor. The antibody-shifted peak of 8-9S [125I]- and [3H]estradiol binding was totally inhibited by a 100-fold molar excess of diethylstilbestrol (DES), but not by testosterone or progesterone, indicating a preference for estrogen binding by the antibody-shifted estrogen receptor. When estrogen receptor from the nuclear fraction of ovarian adenocarcinomas was incubated with [125I]estradiol at 1C, in the presence of 0.4 M NaSCN to facilitate exchange with endogenous ligand, binding occurred that was inhibitable by DES and restricted to the 4S region. Under these conditions the nuclear estrogen receptor was also shifted to the 8-9S region by the presence of the monoclonal antibody against estrogen receptor. PMID- 6866367 TI - Ultrasonic dilatation of the uterine cervix: morphologic evaluation of a new device in the sow. AB - The present study demonstrates that low-power ultrasonic activation of Hegar dilators reduces the mechanical force required for dilatation of the cervix. The acute and possible late effects of an ultrasonic dilator on the cervical mucosa in the sow were evaluated by histologic study and compared to the effects of similar mechanical dilatation. In both groups early effects were mild to moderate edema and vascular congestion of the cervical mucosa. The immediate changes were comparatively more pronounced after ultrasonic dilatation. No significant pathologic differences were noted five weeks after ultrasonic dilatation of the endocervical canal. Further study may prove the device useful for dilatation of the stenosed cervix and urethra in women. PMID- 6866368 TI - Fetal hiccups: an associated fetal heart rate pattern. AB - Fetal hiccups are commonly diagnosed during the antepartum period, and they have a tendency to recur. The reflex of hiccuping is similar to that of gasping, except hiccuping efforts are made against a closed airway. An episode of intrapartum hiccups was confirmed via real-time ultrasound scanning during monitoring with a direct fetal scalp electrode. A neonatal heart rate pattern during hiccuping is also included. Distinctive fetal and neonatal heart rate patterns were observed during the hiccuping episode. It is speculated that the fetal heart rate pattern seen with hiccups may resemble that of fetal gasping. PMID- 6866369 TI - Listeriosis and borreliosis as causes of antepartum fever. AB - Fever of unknown origin in the pregnant woman presents special diagnostic, therapeutic, and obstetric problems. Two such clinically ill, febrile third trimester patients, one presenting with maternal septicemia and transplacental fetal listeriosis and the other with borreliosis, are discussed. Although the neonatal outcome in such infections historically is poor, the infants of these mothers survived. It is suggested that special diagnostic procedures, timely administration of parenteral antibiotics, and vigilant antepartum testing be considered in all similar pregnant patients. PMID- 6866371 TI - Endometrial carcinoma diagnosed by examination of peritoneal dialysate. AB - Well-differentiated adenocarcinoma of the endometrium was diagnosed by cytologic examination of peritoneal dialysate during continuous ambulatory peritoneal dialysis in a 70-year-old woman. The patient had undergone estrogen therapy for 16 years. The carcinoma was localized, noninvasive, and apparently at an early stage of development. Surgical removal was followed by megestrol acetate chemotherapy and the patient currently remains on peritoneal dialysis, free of recurrence, at 14 months. This case suggests that cellular material from the endometrium can be retrieved from intraperitoneal dialysate in patients undergoing peritoneal dialysis. Therefore, cytologic examination should be performed on peritoneal fluid with elevated counts associated with sterile cultures or atypical features. PMID- 6866370 TI - Pain during sex response due to occlusion of the Bartholin gland duct. AB - The greater vestibular glands produce a secretion during the plateau stage of sexual response. If the duct of the gland is partially or completely occluded, the secretion cannot be released and pain results from the pressure of the entrapped secretion. The pain is specific in its location and is elicited regardless of the mode of sexual stimulation. Four cases are presented in which duct occlusion appears to be the cause of pain during sex response. The gland was removed in 3 cases. In the fourth a marsupialization procedure was performed. The procedures were curative in all 4 cases. Relevant anatomy and sexual physiology are discussed. PMID- 6866372 TI - Antepartum FHR testing in preterm pregnancy. PMID- 6866373 TI - Hemoglobin SD disease? PMID- 6866374 TI - Safety of sodium nitroprusside. PMID- 6866375 TI - Experiences in 467 cases of hepatic resection. PMID- 6866376 TI - [Acupuncture as a diagnostic principle incompatible with Western medicine? Diagnostic determination of thermic and electric parameters of the skin surface in normal subjects and patients with lung diseases]. PMID- 6866377 TI - A comparative study of two-dimensional echocardiography and systolic time intervals in the evaluation of left ventricular function in coronary heart disease. PMID- 6866378 TI - Studies and clinical application of radiographic localization of intraocular foreign body. PMID- 6866379 TI - Experimental studies on the antitumor action of free radicals: antitumor action of galvinoxyl. PMID- 6866381 TI - The effect of iontophoretically administered GABA and glycine on the neuronal activity of mesencephalic reticular formation. PMID- 6866382 TI - An unusual case of malignant lymphoma developed from prolonged reactive lymphofollicular hyperplasia. PMID- 6866380 TI - [Detection of anti-LSP by SPA-ELISA in sera of hepatitis patients]. PMID- 6866383 TI - The receptor-mediated accumulation of triglyceride in macrophage exposed to very low density lipoproteins. PMID- 6866384 TI - Health and safety measures for working in extremely hot environments. PMID- 6866386 TI - The interaction between tetrandrine, calcium ion and cardiac glycosides on various heart preparations. PMID- 6866385 TI - Studies on some parameters of tricuspid valve echocardiogram in the early diagnosis of chronic cor pulmonale. PMID- 6866387 TI - The hypotensive effect of dauricine and its mechanism of action. PMID- 6866388 TI - [Hemoglobinopathies in 24,825 persons in the province of Hubei]. PMID- 6866389 TI - An ultrastructural study of degeneration of articular cartilage caused by experimental articular mechanical changes. PMID- 6866390 TI - Surgical treatment of the extracranial carotid artery aneurysm. PMID- 6866391 TI - [Surgical treatment of aneurysms of the extracranial carotid artery]. PMID- 6866392 TI - [Incidence of coronary disease in patients with and without peripheral arterial occlusive disease]. PMID- 6866393 TI - [Demonstration of circulating immune complexes in liver and kidney diseases and in disseminated lupus erythematosus]. PMID- 6866394 TI - Effects of seven insecticides on rat hepatic microsomal enzymes. PMID- 6866395 TI - An investigation of the relationship between the concentration of sodium and potassium in erythrocytes and plasma and blood pressure in 270 normal children and adolescents in Wuhan. PMID- 6866396 TI - [Our experience with the diagnosis of various orbital tumors by computed tomography]. PMID- 6866398 TI - [Indications for and methods of surgical removal of choroid melanoblastomas]. PMID- 6866397 TI - [Role of determination of serum thiol groups in children with retinoblastoma]. PMID- 6866399 TI - [Transcranial approach in retrobulbar tumors]. PMID- 6866400 TI - [Clinical course, treatment and prognosis of orbital fibrosarcomas]. PMID- 6866401 TI - [Topographo-anatomical changes in the anterior chamber and in the vitreous body after cataract extraction]. PMID- 6866403 TI - [Role of refraction in the etiopathogenesis of unilateral amblyopia in orthotropia and microtropia]. PMID- 6866402 TI - [Comparative evaluation of the efficacy of various methods in the treatment of diabetic retinopathies]. PMID- 6866404 TI - [Cytochemical examinations of the cornea in keratoconus]. PMID- 6866405 TI - [Characteristic ophthalmoscopic picture of the macular and paramacular regions]. PMID- 6866406 TI - [Improvement of the technic of external dacryocystorhinostomy]. PMID- 6866408 TI - [Illuminating attachment for the ShchL-56 slit lamp for the microphotography of the conjunctival vessels]. PMID- 6866407 TI - [Improvement of the illuminator in the surgical microscope OM-2 model 178]. PMID- 6866409 TI - [Outcomes and prognosis of uveal melanoblastomas following different variants of combined treatment]. PMID- 6866410 TI - [Comparative evaluation of the treatment of hemangiomas of the protective apparatus of the eye in children]. PMID- 6866411 TI - [Results of intraocular administration of gentamicin in suppurative endophthalmitis]. PMID- 6866413 TI - [Neuro-ophthalmological symptomatology in patients with transient disorders of the vertebro-basilar system]. PMID- 6866412 TI - [Diagnostic possibilities of the phenomenon of dynamic disadaptation scotoma in macular dystrophies and lesions of the papillomacular bundle]. PMID- 6866414 TI - [Treatment of fistulas by subconjunctival injections of autologous blood]. PMID- 6866415 TI - [Modernization of a surgical microscope for micrometric measurements during surgery]. PMID- 6866416 TI - [Device for emergency illumination of surgical microscopes]. PMID- 6866417 TI - [Surgical treatment of far-advanced glaucoma]. PMID- 6866418 TI - [Use of information systems in the control of scientific research in the field of medicine]. PMID- 6866419 TI - [Surgical treatment of recurrent uveitis]. PMID- 6866420 TI - Sinophobic growth in oestrogen receptor-negative metastatic breast cancer. AB - The mode of growth of tumour cells from primary breast carcinoma in the axillary nodes is shown to be related to the oestrogen receptor (ER) status of the primary tumour. ER-positive primaries are described as tending to show sinophilic growth, the tumour cells spreading along the nodal sinuses; while the ER-negative are sinophobic, spreading more diffusely in the lymphoid tissue. PMID- 6866421 TI - Human tumor antigens inducing in vivo delayed hypersensitivity and in vitro mitogenic activity. AB - Significant immunogenic properties were observed with an antigen extracted from tumor-liberated particles (TLP). Several different tumors were used to obtain antigens by such cell analysis and purification procedures as: gel filtration on Sephadex G-100, ion-exchange chromatography, affinity chromatography, and gel filtration on Sephadex G-200. The molecular weight determined on SDS-PAGE was about 214,000 daltons. In vivo, TLP yields delayed hypersensitivity reactions both in autologous and homologous hosts. TLP does not seem to have any nonspecific mitogenic activity, but it does have specific mitogenic activity, since lymphocyte blastogenesis (TLP-induced in presensitized patients) could mean its ability when intradermally inoculated to sensitize a lymphocytic clone. PMID- 6866422 TI - Interference with energy production as a means of causing injury to a human pancreatic carcinoma. AB - The ATP content of a human pancreatic carcinoma, cultured as a xenograft in athymic nude (nu/nu) mice, dropped by 70% within 1 h of treating the hosts with hydralazine (10 mg/kg s.c.), while the energy charge fell from 0.79 to 0.53. By 24 h, the pattern of adenine nucleotides, as shown by the energy charge, had reverted to normal; meanwhile, the ATP level recovered somewhat, showing an eventual loss of 41%. A second administration (also 10 mg/kg s.c.) 23 h after the first produced no further effect on energy metabolism 1 h later, indicating that a state of drug refractoriness had been established. Losses of adenine nucleotides from the carcinoma 24 h after the initial treatment with hydralazine amounted to 37%, from which it was estimated that 35-40% necrosis could be expected from the procedure. PMID- 6866423 TI - Serial determination of serum ferritin levels in patients with malignant melanoma. AB - In a pilot study, serum ferritin levels of patients with malignant melanoma were found to be increased in stage III of the disease. Therefore, serial determinations were carried out up to 24 months in patients at various stages of the disease undergoing either chemo- or immunotherapy. Serum ferritin was determined by a two-site IRMA technique. Serum samples of 91 patients in different clinical stages of histologically verified malignant melanoma were included in these investigations. 80 healthy individuals were also investigated to determine normal ranges of serum ferritin. In stage III serum ferritin levels were significantly elevated (p less than 0,0005), whereas in stages I and II the values were within the normal range. Repeated serum ferritin levels of 10 patients in stage I and 13 patients in stages II and III without evidence of tumor progression were within the normal range. In 9 patients in stage III the increases in serum ferritin concentration correlated with the degree of dissemination of metastasis. Because of the occurrence of increased ferritin levels only in melanoma patients with progressive metastatic disease, the measurement of serum ferritin might have limited utility in clinical evaluation of melanoma patients as well as in the prediction of recurrence and in monitoring response to therapy. PMID- 6866424 TI - Activity of 3 beta-hydroxy-13 alpha-amino-13,17-seco-5 alpha-androstan-17-oic 13,17-lactam-p-bis(2-chloroethyl)aminophenoxyacetate (NSC 294859) on experimental animal tumor and leukemia systems. AB - 3 beta-hydroxy-13 alpha-amino-13,17-seco-5 alpha-androstan-17-oic-13,17-lactam-p bis(2-chloroethyl)amino-phenoxyacetate, a modified steroidal alkylating agent, is active in the treatment of colon 26 tumor, B16 melanoma and P388 leukemia. PMID- 6866425 TI - Effect of tamoxifen citrate on a murine renal cell adenocarcinoma. AB - High-dose tamoxifen citrate (80 mg/kg), or estradiol (100 micrograms/kg) was administered to intact or castrated Balb/C male and female mice with implanted murine renal cell adenocarcinoma. 100% tumor growth occurred, and tumor weights in tamoxifen treated (mean 3.69 g) and untreated (mean 3.11 g) groups were relatively the same. All estradiol-treated groups had slightly lower tumor weights (mean 2.31 g). This was, however, not statistically significant. Metastases occurred in all groups: control groups had 24-50%, tamoxifen-treated groups had 22-61%, and the estradiol-treated groups had 30-75%. In this murine renal adenocarcinoma model, tamoxifen did not appear to retard tumor growth or metastatic spread. PMID- 6866426 TI - Cytostatic activity of inorganic heterocycles in an in vitro screening system. AB - Six representatives of inorganic cyclic systems (NPAz2)2 NSOX(Az = aziridino, X = F, Az, Ph) and (NPAz2)2 NPAzR [R = Az, Morph (morpholino), Pyr (pyrrolidino)] show cytostatic activity in an in vitro screening system. The technique of the in vitro screening system used is described. L5178Y and Ehrlich ascites cells are grown as suspension cultures in concave-bottomed wells in microtiter test plates using serial dilutions of the drugs in the medium. The diameter of the cell sedimentation spots, which can be compared visually is taken to determine the lowest active dose. The results of this test correspond with the cytostatic activities observed in former in vivo experiments. PMID- 6866427 TI - Functional architecture of the human superior mesenteric vein. PMID- 6866428 TI - Displaced amacrine cells in the chick retina: developmental and experimental observations. PMID- 6866429 TI - An autopsy case of double inferior vena cava accompanied by atypical lateral branches of the abdominal aorta--with special consideration to the embryology. PMID- 6866430 TI - Surgical considerations for dacryocystorhinostomy with special emphasis on hemostatic techniques. AB - Thirty patients were treated. All surgical procedures were carried out without technical difficulty. Estimated blood loss varied between 5 ml and 25 ml. In no case did bleeding obscure the operative field. Two patients did experience transient hypertension after injection of lidocaine with epinephrine. This was easily controlled by the anesthesiologist. After follow-up periods ranging from one year to five years, all patients have achieved a satisfactory result. No recurrent epiphora or infection has been noted. The technique described in this communication involves drugs, instruments, and equipment which have made our dacryocystorhinostomy rapid (35 to 45 minutes), controlled, and predictable. Surgical morbidity is negligible. Hemorrhage is no longer a fearsome problem. Exposure is always adequate. And, above all, uniform success has been very gratifying to surgical patients and surgeons. PMID- 6866431 TI - Complications of the Simcoe flexible loop phacoprosthesis in the anterior chamber. AB - A preliminary study of the use of a Simcoe 101-J implant in the anterior chamber after pars plana lensectomy by ultrasonic fragmentation showed initially good results. Further observations of these and additional eyes showed 20/20-20/40 vision in 86.9%, retinal detachment in 3.5%, retinal hole in 1.5%, clinical cystoid maculopathy in 13%, and so-called UGH syndrome in 5%. Pars plana lensectomy alone in the last 136 eyes resulted in vision of 20/20-20/40 in 98.5%, a retinal detachment rate of 0.73%, retinal hole rate of 0.73%, no UGH syndrome, and no clinical cystoid maculopathy. Pars plana lensectomy alone appears to be a far safer procedure than pars plana lensectomy plus a Simcoe implant in the anterior chamber. Implantation of the Simcoe 101-J manufactured by IOLAB Corp. in the anterior chamber is not recommended. PMID- 6866432 TI - Cryotherapy and photocoagulation in the management of retinoblastoma: treatment failure and unusual complication. AB - Ophthalmologists treating children with retinoblastoma need to be aware of the limitations of new forms of therapy and their complications. For this reason the following case of a child with a small peripheral retinoblastoma that failed to respond to treatment with both cryotherapy and photocoagulation is recorded. The development of a rapidly growing juxtapapillary lesion prompted immediate enucleation. Histological examination revealed viable tumor cells remaining in the areas that were previously treated. The juxtapapillary mass consisted of optic nerve and detached peripapillary retina that were "dragged" towards the tumor by a thick fibrocellular membrane containing many myofibroblasts. PMID- 6866433 TI - Surgical therapy of traumatic hyphema. AB - The usual management of traumatic hyphemas in our institution has been to avoid or delay surgery until absolutely demanded by the clinical course. Despite this, most (73%) of our in-patients with total hyphema underwent surgery before leaving the hospital. In those who required surgery, 43% developed corneal staining. Optic nerve damage occurred in half of the patients whose surgery was performed eight or more days after the hyphema occurred, but was absent in those undergoing earlier surgery. The usual procedure used in this series was a trabeculectomy with iridectomy and gentle irrigation of the anterior chamber, and no surgical complications occurred. We believe that surgery, being relatively safe, should be performed early in cases of total hyphema unless the elevated intraocular pressure is controlled medically and spontaneous resolution is clearly imminent. For cases in which surgery is nearly inevitable, we suggest that earlier surgery might reduce the incidence of optic nerve damage and corneal staining. PMID- 6866435 TI - Use of stereo headphones for patient relaxation and surgical drape support during local anesthesia. PMID- 6866434 TI - Accidental intraocular tobramycin injection: a case report. PMID- 6866436 TI - Microsurgery of aphakic retinal detachment. AB - 73 consecutive aphakic retinal detachments were operated on by microsurgery combined with intra-operative biomicroscopic control of the ocular fundus. Retinal reattachment was achieved in 60 cases (82%), 59 eyes had only one operation. A visual acuity of 0.5 or better was achieved in 50% of all cases and in 57% of the cases which were not failures of previous conventional surgery. 69% of the eyes recovered the same visual acuity after surgery as before the occurrence of retinal detachment. One macular pigment migration and one cystoid macular edema were the only postoperative macular complications observed in this series. PMID- 6866437 TI - Electroretinogram and electrooculogram of eyes with intravitreously injected silicone oil. AB - In clinical and in vitro conditions, the effect of intravitreously injected silicone oil upon the electroretinogram and electrooculogram was investigated. The recorded potentials were lower in the eyes with silicone oil compared to those in which the retinas were reattached without silicone. Retinal changes, caused by the previously existing detachment and the operations already performed, are discussed as possible factors responsible for lower values of the recorded potentials. No arguments could be found in favor of silicone retinopathy. PMID- 6866438 TI - Posterior ischemic optic neuropathy. I. Blood supply of the optic nerve. AB - The blood supply of the posterior optic nerve was investigated in 10 monkeys after an injection of synthetic resin into the carotid arteries. The posterior intraorbital and intracanalicular optic nerves were supplied by a centripetal vascular system, formed by the pial vessels arising from the first branches of the ophthalmic artery. Superior and inferior vascular semicircles were detected in the intracanalicular optic nerve. The intracranial optic nerve was supplied by branches of the internal carotid artery, anterior cerebral artery and/or anterior communicating artery, and ophthalmic artery. PMID- 6866439 TI - [Retinal changes in cystinosis]. AB - Cystinosis is a rare autosomal recessive hereditary enzymopathy which leads to accumulation of cystine in the reticuloendothelial system of the liver, spleen, lymph nodes, etc. The pathognomonic alterations of the cornea are characterized by multiple crystalline deposits, chiefly in the limbus area and in the anterior corneal stroma. The retinal changes are seldom described in the literature; they are characterized by a fine-grained pigment shift which intensifies from the macula toward the preequator area and which gives the fundus a 'salt and pepper' appearance. PMID- 6866440 TI - Unusual misdiagnosis of choroidal melanoma. AB - A papillary, white mass observed in a 45-year-old man was diagnosed as an optic nerve glioma. The histological examination revealed a juxtapapillary amelanotic choroidal malignant melanoma, extending over the optic disc and infiltrating the optic nerve. This clinical picture is quite infrequent in malignant melanoma of the choroid. PMID- 6866442 TI - Ophthalmic prisms. Measurement errors and how to minimize them. AB - Variable results of strabismus surgery may be due in part to errors in prism measurement. The amount of deviation neutralized by an ophthalmic prism is variable depending on how the prism is held. For example, a 40 delta glass prism with the posterior face held in the frontal plane gives only 32 delta of effect. Glass prisms are calibrated for use in the Prentice position. Plastic prisms are calibrated for use in the frontal plane position. Surprisingly large errors in prism measurement are produced when adding a small prism to a large prism. For example, adding a 5 delta glass prism to a 40 delta glass prism gives not 45 delta of effect, but 59 delta. This error can be minimized but not eliminated by holding one prism in front of each eye. The error can also be calculated so that the appropriate correction can be made. PMID- 6866441 TI - Bacterial periorbital and orbital cellulitis in childhood. AB - The clinical features, microbiologic data, complications, and treatment in 137 children with periorbital cellulitis and 21 children with orbital cellulitis is presented. Periorbital cellulitis was more frequent (87%) than orbital cellulitis (13%). Periorbital cellulitis is a heterogeneous disease that may complicate trauma of the eyelids, external ocular infection, and upper respiratory infection. Children with periorbital cellulitis related to trauma or external infection tended to be less than 5 years old with negative blood cultures (99%) and positive cultures of percutaneous aspirates (42%); while children with periorbital cellulitis related to upper respiratory infection also tended to be less than 5 years of age, but blood cultures were frequently positive (42%) and cultures of percutaneous aspirates were usually negative (92%). Three children in the latter group developed meningitis. Intravenous antibiotic alone was effective treatment in most patients (90%). Orbital cellulitis was more frequent in children older than 5 years and frequently associated with sinusitis (90%). Blood and skin cultures were usually negative. Intravenous antibiotics alone were effective management in many patients (62%), but a significant proportion required paranasal sinus or orbital surgery (38%). PMID- 6866443 TI - Eye movement recording as a clinical tool. PMID- 6866444 TI - Lower eyelid blepharoplasty by the anterior approach. Prevention of complications. AB - Most complications in lower eyelid blepharoplasty by the anterior approach can be prevented if the surgeon has a thorough knowledge of the anatomy and physiology of the lower eyelid and anterior orbit, selects the proper procedure to correct the patient's specific problems, is meticulous in his technique, and provides appropriate postoperative management. Particular attention should be paid to hemostasis prior to wound closure and to avoiding postoperative ectropion or retraction of the lower eyelid. PMID- 6866445 TI - Use of sclera and liquid collagen in the camouflage of superior sulcus deformities. AB - The cosmetic deformities following enucleation are often unavoidable. Loss of orbital volume and atrophy of orbital fat create significant enophthalmos. The literature is filled with numerous procedures that add to the orbital volume of the anophthalmic socket. An outline of three procedures to the upper eyelid to camouflage an enophthalmic appearance are presented. These can be used alone or in conjunction with an "orbital volume increasing" procedure. Two procedures can be used in an office setting to alleviate small deformities; 19 patients have been treated in this manner with a follow-up period of up to 26 months. PMID- 6866446 TI - Exenteration of the orbit in selected cases of severe orbital contracture. AB - Severe orbital contracture is treated with graft-covered conformers fixed to the orbit with wires, pins or a headcap. In spite of these vigorous techniques, failures occur. Exenteration was used in four cases of severe orbital contracture with deformity and restricted function of the eyelids. The patient was fitted in six to eight weeks with a prosthesis made from methyl methacrylate and silicone. The margins of the prosthesis were inconspicuous in contrast to older prostheses made entirely of methyl methacrylate. The flexible silicone was well tolerated by the skin of the orbital margins. Patient acceptance and cosmetic appearance has been excellent. PMID- 6866448 TI - Repeat radial keratotomy in monkeys. PMID- 6866447 TI - New corneal shapes in keratorefractive surgery. AB - The corneal shape change as measured by the Humphrey keratometer and the corneascope after radial keratotomy in 50 patients was compared. The Humphrey keratometer analyzes a unique curve fit algorithm of the aplanatic corneal surface and designates this comparison as a shape factor. Both the corneascope photographs and the Humphrey keratometer demonstrated central corneal flattening after successful radial keratotomy. In addition, the normal "plus" shape factor was routinely converted to a "negative" shape factor after the procedure. This is analogous to converting the aplanatic central cornea, which normally approximates the end of an ellipse, to a topography which appears in cross section as the side of an ellipse. This alteration in topography is directly correlated to the magnitude of cycloplegic refractive change seen with this operation. The corneascope map topography of the cornea confirms this alteration in curvature. PMID- 6866449 TI - Increased pressure of dilated episcleral veins with open-angle glaucoma without exophthalmos. AB - Six unilateral cases and one bilateral case of dilated episcleral veins with elevated intraocular pressure without exophthalmos are described. Episcleral venous pressure measured on six unilateral cases showed increased pressure in the affected eye compared to the other eye and to normal controls. Two eyes had typical glaucomatous disc and visual field changes. Five had more optic disc cupping and pallor in the eye with the elevated episcleral venous pressure and intraocular pressure. A thorough work-up, including orbital venography in two unilateral cases, carotid arteriography in one and episcleral fluorescein angiography in five cases, failed to show venous obstruction or direct arterio venous communications. The different diagnoses are discussed. This condition should be considered in unilateral or asymmetrical intraocular pressure elevation and in those patients with chronically red eyes without discharge. PMID- 6866450 TI - Linear array multiple transducer ultrasonic examination of the eye. AB - Dynamic ultrasonic imaging adds a time dimension to the clinical diagnosis of ocular pathology. A recent development in this area of ophthalmic sonography has been the introduction of an electronically scanned, multiple transducer system that provides improved real-time imaging of ocular tissue motion. This paper discusses clinical observations made in a variety of ophthalmic conditions with a high speed, linear array ultrasound system and discusses briefly the apparatus and special examination techniques needed to make these observations. Clinical subjects include vitreo-retinal adhesions: the clear cortical vitreous network; vitreous hemorrhage, opacities and membranes; shallow, fixed, and mobile retinal detachments; blood vessels within ocular tumors and the evaluation of intraocular foreign bodies. PMID- 6866451 TI - Defense mechanisms against your partner. PMID- 6866452 TI - Evaluation and care of lumbar spine problems. PMID- 6866453 TI - Psychological evaluation: patients with chronic pain. PMID- 6866454 TI - When to operate and what to operate upon. AB - It is apparent that the results of spinal surgery are less than optimal. The three major causes appear to be as follows: Patient selection. There are some patients who, owing to psychological change or secondary gain, are unable to respond to correction of a spinal problem. This is probably a very small percentage of the 25 to 35 per cent failure rate listed in the literature. Many of these patients have had the wrong operation for an unknown structural diagnosis. It is too tempting and easy for the spinal surgeon to blame poor results on the psyche. Structural diagnosis. It has been 40 years since Dandy published a report on "the hidden disc," but the world of spinal surgery still has not recovered from it. Poor Dandy is also credited with introduction of the method of shaking the spinous process as a test for instability and hence fusion. It would seem obvious that any disc surgery based on a premise of exploration for a hidden problem is antiquated in the day of the CT scan. One should be further chagrined by decision making for fusion based on shaking the spine with a towel clip. It would defy any spinal surgeon to define in rational terms how much observed motion is "abnormal." Until a structural diagnosis is made on the basis of clinical and laboratory testing, there is no indication for surgery. This is the single most important factor in spinal surgery. The success rate will not change until this function is universally recognized. Proper operation. There is little room, in modern spinal surgery, for the surgeon who is a "one trick pony." Uniform application of an operative technique to a variety of deforming forces will result in a high failure rate. It is the duty of the spinal surgeon to have all the techniques available and be able to apply them with precision and skill. Specific surgical response must be made to a specific structural diagnosis. The foregoing three principles should greatly enhance surgical results. PMID- 6866455 TI - The role of microdiscectomy. PMID- 6866456 TI - The role of the physical therapist before and after lumbar spine surgery. AB - In summary, the role of the physical therapist before and after surgery depends upon the type of care that the surgeon desires. In aggressive care, the physical therapist is involved in the biomechanical assessment of the patient and preoperative education. Postsurgically, the rehabilitation process involves early movement, exercise, stretching and ambulation. Each surgical procedure has been described with its subsequent recommended activities and exercises. This active regimen will assist in decreasing postsurgical complications such as scarring. The program has worked well, and early findings indicate it is superior to extremely conservative care in which activity is restricted. PMID- 6866457 TI - [The fate of untreated hip dysplasias]. PMID- 6866458 TI - [Various organization-tactical problems in the early diagnosis of acute hematogenic osteomyelitis in children]. PMID- 6866460 TI - [Evaluation of the blood and lymph circulation disorders in experimental gunshot fractures of the tibia]. PMID- 6866459 TI - [Surgical treatment of intra-articular fractures of the bones of knee]. PMID- 6866461 TI - [Variants of thoracoplasty in funnel chest]. PMID- 6866462 TI - [Development of the hip joint during the conservative treatment of congenital hip dislocation in children]. PMID- 6866466 TI - [Guiding apparatus for osteosynthesis of the femoral neck]. PMID- 6866464 TI - [Pelvic acetabuloplasty--osteotomy as a method of reconstruction of dysplastic acetabulum]. PMID- 6866463 TI - [Combined arthrodesis of the hip joint with pelvis osteotomy]. PMID- 6866467 TI - [A pin for tibia osteosynthesis]. PMID- 6866465 TI - [Endoprosthesis of the knee joint]. PMID- 6866468 TI - [Fixation splint for the treatment of congenital hip dislocation in children with elevated torsion of the proximal region of the femur]. PMID- 6866469 TI - [Orthopedic morbidity in children in big city]. PMID- 6866470 TI - [Specialized aid to patients with combined and multiple injuries of the locomotor apparatus, abdominal organs and pelvis]. PMID- 6866472 TI - [Roentgenoanatomical characteristics of the hip joint in dysplastic coxarthrosis]. PMID- 6866473 TI - [Effectiveness of introducing research results into traumatology and orthopedics and prospects for its further improvement]. PMID- 6866471 TI - [Limited hip abduction and diagnosis of hip dysplasia in the newborn infant]. PMID- 6866474 TI - [Reparative bone tissue regeneration in treating pseudarthroses with simultaneous lengthening in the area of the pathological focus (an experimental study)]. PMID- 6866476 TI - [Treatment of congenital pseudarthrosis of the clavicle]. PMID- 6866475 TI - [Dynamics of the functional indices of the lengthened leg using Ilizarov's mono- and bilocal distraction osteosynthesis]. PMID- 6866477 TI - [Treatment of fractures and pseudarthroses of the tubular bones with the Volkov Oganesian reposition-compression apparatus]. PMID- 6866478 TI - [Treatment of fractures of the long bones in victims of multiple and combined injuries]. PMID- 6866479 TI - [Inveterate traumatic dislocations and their sequelae]. PMID- 6866480 TI - [Hormonal disorders in patients with spontaneous epiphysiolysis]. PMID- 6866481 TI - [Liver function in osteomyelitis patients undergoing surgical treatment]. PMID- 6866482 TI - [Treatment, using an optical quantum generator, of infected wounds, trophic ulcers and the sequelae of fractures of the extremities]. PMID- 6866483 TI - [Surgical results in metastases to the bones]. PMID- 6866484 TI - [Experience in using a system of combined rehabilitation for machinery plant workers with an injury of the locomotor apparatus]. PMID- 6866485 TI - [A device for measuring summary circular movements in the thoracic and lumbar spine]. PMID- 6866486 TI - [An apparatus for the periosteal fixation and repositioning of fragments of tubular bones]. PMID- 6866488 TI - [Proteinuria]. PMID- 6866487 TI - [A device for the temporary shunting of blood vessels]. PMID- 6866489 TI - [Blood circulation in the gastric mucosa in man measured by the 99mTc-4 methylaminoazophene clearance method]. PMID- 6866490 TI - [Initial experience with hemofiltration in Hungary]. PMID- 6866491 TI - [Prognostic value of the P wave in acute myocardial infarct]. PMID- 6866492 TI - [Cancer and the superoxide dismutase system]. PMID- 6866493 TI - [Enhancing decreased natural lymphocytotoxicity in tumor patients by transfer factor therapy]. PMID- 6866494 TI - [Treatment of scoliosis in the pre-school age]. PMID- 6866495 TI - [Treatment of essential tremor with Sertan]. PMID- 6866496 TI - [Congenital cystic adenomatoid malformation of the lung]. PMID- 6866497 TI - [Congenital toxoplasmosis causing diabetes insipidus]. PMID- 6866498 TI - [The value of fluoride in caries prevention]. PMID- 6866500 TI - [Successfully treated Reye syndrome]. PMID- 6866499 TI - [Clinical and epidemiological examination of tumors of the renal pelvis and the ureter]. PMID- 6866501 TI - [Disappearance of diabetes insipidus caused by a metastasis tumor in the anterior pituitary gland]. PMID- 6866502 TI - [Systemic streptokinase therapy of myocardial infarct]. PMID- 6866503 TI - [Endometrial cancer and cytosol steroid receptors]. PMID- 6866504 TI - [Alkaline (bile) reflux esophagitis following different types of gastric resections]. PMID- 6866505 TI - [Diurnal changes in lipid and lipoprotein parameters in children with normal weight and in obese children]. PMID- 6866506 TI - [Surgical operations performed for tubercular changes in the intestines]. PMID- 6866507 TI - [Symptom complex developing after the withdrawal of psychotropic drugs]. PMID- 6866508 TI - [The significance of exanthema subitum in community pediatric practice]. PMID- 6866509 TI - [Resurgence of malaria]. PMID- 6866510 TI - [The hereditary nature of situs inversus]. PMID- 6866511 TI - [Cervicofacial actinomycosis]. PMID- 6866512 TI - [Biochemical and physico-chemical studies on osteoarthrosis in relation to some clinical aspects]. PMID- 6866513 TI - [Inflammatory progressive joint destructions in the view of the orthopedist]. PMID- 6866515 TI - [Pathogenesis and morphology of progressive joint destruction]. PMID- 6866516 TI - [Pathobiochemistry of the progressive joint diseases and its therapeutic relevance]. PMID- 6866517 TI - Measurement of visual performance. PMID- 6866514 TI - [Therapeutic aspects in degenerative joint destruction]. PMID- 6866518 TI - The stability of the fixation disparity curve. PMID- 6866519 TI - The effects of moderate doses of ethanol on heterophoria and other aspects of binocular vision. AB - It has been known for many years that ethanol has an impairing effect on binocular vision and the co-ordination of the ocular motor balance. Various parameters were compared before and after imbibition of a moderate dosage of ethanol. The results show an increase in esophoria (or decrease in exophoria) at 6 m, with a reduction in the negative fusional ability. They also show an increase in exophoria (or decrease in esophoria) at near, with a decrease in both the AC/A ratio and near point of convergence. There was no significant effect on the amplitude of accommodation. This study raises the possibility of an ophthalmic practitioner attempting to correct a transient, ethanol-induced ocular motor imbalance. PMID- 6866521 TI - The working threshold approach to Friedmann visual field analyser screening. AB - Central visual field screening of 2223 eyes without field defects was conducted with the Friedmann Visual Field Analyser Mark II. There was wide variation in the filter setting at which all stimuli were seen and in the working threshold relative to the recommended age filter. The ability to see all stimuli at settings higher than the age filter was found in 803 eyes (36.1%). The difference between mean working threshold and the age filter ranged from 0.22 to 0.40 log units, being greatest in middle age groups. The performance of the screener in correctly identifying normal eyes was thus improved with the working threshold approach, as the criterion for depression of sensitivity was an individually determined threshold. PMID- 6866520 TI - Corneal transparency changes resulting from osmotic stress. AB - Corneal thickness and transparency changes were measured following exposure of the cornea to various levels of osmotic stress. Bathing the cornea in hypotonic solutions of NaCl caused an increase in corneal thickness and light scatter within the cornea. Transparency changes with hypotonicity were determined by comparing the relative brightness of haloes around a bright lamp source for the various concentrations of NaCl solutions. Corresponding corneal thickness changes were determined by pachometry. A nearly linear relationship was found between solution hypotonicity and the degree of corneal swelling, whilst an exponential relationship was found between hypotonicity and relative halo brightness. The rate of corneal recovery from osmotic stress was found to be constant with different degrees of tonicity, although the rate of thickness recovery was much slower than the recovery from haloes. PMID- 6866522 TI - Changes in spatial resolution for pattern and movement detection in clinical cases. AB - A simple and relatively fast method was used to evaluate visual performance: gratings of sinusoidal luminance profile, generated on the face of an oscilloscope, were reversed in contrast at a rate of 2 Hz. Under these conditions the patients could set separate contrast thresholds for seeing either the structure of a grating or its apparent movement. The grating resolution limit (maximum spatial frequency) for each task was determined by extrapolation from thresholds measured at several spatial frequencies. The resulting ratios of pattern/movement resolution limits (P:M) are usually between 1.6 and 2 for normals and for patients with pathological changes located distally (probably prior to the chiasma). On the other hand in patients suspected of multiple sclerosis the P:M ratios were reduced to below 1.3. It is considered that such results may suggest a central site for the damage, although they do not exclude pre-chiasmal defects which may occur simultaneously during the acute stages of the disease. PMID- 6866523 TI - Flash and pattern VEPs: examples of cases of hysterical amblyopia and provoked visual impairment (Uhthoff's sign). AB - The diagnostic application of averaged visual evoked potentials (VEPs) is illustrated in the investigation of hysterical amblyopia and multiple sclerosis. Averaged VEPs elicited either by a flash of light or a presentation of a grating lasting 100 ms were recorded from the occiput of patients. All the VEPs in hysterical amblyopia were normal. In multiple sclerosis the flash VEPs looked normal for both eyes, whereas the VEPs elicited by grating (2 and 5 c/deg) showed an increase in the latency of the first positive wave, again for both eyes. After physical exercise the VEPs from the right eye were dramatically reduced in amplitude (Uhthoff's sign). PMID- 6866524 TI - Optical therapy in Steele--Richardson--Olszewski syndrome. PMID- 6866525 TI - [Acceleration of selected body measurements in 7 to 14-year-old Jena schoolchildren over the past 100 years]. PMID- 6866526 TI - [Significance of electrophoretic studies of the cerebrospinal fluid in neuropediatric diagnosis]. PMID- 6866527 TI - [Current views on the diagnosis, etiology and genetics of the most frequent non metabolic congenital myopathies]. PMID- 6866528 TI - [Haptoglobin typing in diseases in childhood]. PMID- 6866529 TI - [Mastoiditis in childhood--a current disease]. PMID- 6866530 TI - [Optimization of cognitive development in day-nursery children]. PMID- 6866531 TI - [Climbing steps as a test method for the pediatrician--1st results from a study of 12 to 13-year-old and 14 to 15-year-old students]. PMID- 6866532 TI - [Psychologically evoked blood pressure reactions in 6th-grade school children]. PMID- 6866533 TI - [Preservation and improvement of health of children in nurseries from the medico hygienic and pedagogic viewpoints]. PMID- 6866534 TI - Low dose of morphine strongly depresses responses of specific nociceptive neurones in the ventrobasal complex of the rat. AB - Effects of low intravenous doses of morphine (30, 100 and 1000 micrograms/kg) upon unitary responses of 22 'nociceptive' and 5 'non-nociceptive' units recorded in the ventrobasal (VB) complex of the rat were analyzed. The responses of the 'non-noxious' neurones were not depressed by morphine. By contrast, for all these doses there was a decrease of the total number of spikes and of the maximal firing rate of the responses of the noxious neurones. The depressive effect was significantly dose-related (with linear semi-logarithmic dose-response curve) and naloxone-reversible. Similar effects were observed upon responses to pinches and noxious heat. The ED50 which was close to 90 micrograms/kg for these thalamic responses to pinches is much more lower than that evaluated for spinal dorsal horn responses under the same anaesthetic conditions. Therefore the depressive effect of low doses observed for VB neurones seems to be mainly of supraspinal origin. PMID- 6866535 TI - Dental nerve regeneration in rats. II. Autoradiographic studies of nerve regeneration to molar pulp and dentin. AB - The autoradiographic technique was used to analyze the degeneration and regeneration of sensory nerves to rat molars and gingiva following cut or crush injury to the right inferior alveolar nerve. At 2 days after nerve injury there was almost complete denervation of the first molar, partial denervation of the second molar, and minimal effect on the innervation to the third molar and gingiva. The degree of sensory deficit and recovery for these same rats had been previously determined. Reinnervation of the first molar was analyzed in terms of axon number and location, intensity of axon labeling, and type of nerve injury. At 6 days, neither the cut injury nor crush injury rats had any reinnervation of their first molars. By 7 days, 3 of 4 rats had axons reinnervating first molars; in those teeth there was approximately one-fourth of the normal number of axons in the pulp, and very few axons in the dentin. These rats still had as large a molar sensory deficit as the 7 day rat and 6 day rats that had no reinnervation. By 3 weeks there were one-half to three-fourths of the normal axon numbers in the pulp, one-fourth to one-half of the normal axon numbers in dentin; and sensitivity was at least half-recovered. By 6 weeks, numbers of axons in the pulp and dentin were either normal or slightly less than normal; axons had grown back into dentin to the same depth as in normal teeth; and complete recovery of sensitivity had occurred. The regenerating axons had greater than normal labeling intensity at 1 week and 3 weeks in all rats. Those with the crush nerve injury had somewhat greater numbers of reinnervating axons at 1 week and 3 weeks than the cut injury rats. A structure-function comparison for the molars showed that return of sensitivity correlated with reinnervation of both pulp and dentin. PMID- 6866536 TI - Non-pain and pain sensations evoked by tooth pulp stimulation. AB - This study investigated the quality and magnitude of sensations evoked by electrical tooth pulp stimulation. Detection threshold (the minimum current intensity that evoked a sensation) and pain threshold were determined for tooth pulp stimuli varying in frequency from 5 to 500 Hz. The effect of frequency and intensity of tooth pulp stimulation on the magnitude of sensations was assessed using visual analog scales and verbal descriptor scales. Detection thresholds were stable over experimental sessions and independent of the frequency of the stimulating current. Pain threshold varied as a function of frequency with a minimum value at 100 Hz. Stimuli that evoked non-pain sensations at low frequencies evoked pain sensations when frequency was increased from 5 to 100 Hz. Subjects were able to scale non-pain sensations over a range of stimulus intensities and frequencies. The lowest currents evoked sensations that were non painful and were of constant magnitude despite changes in the frequency of stimulation. Higher stimulus currents evoked sensations that were non-painful at low stimulus frequencies and painful at high stimulus frequencies. Sensation magnitude at each stimulus intensity increased as a function of frequency. Temporal summation occurred in proportion to stimulus intensity. These findings suggest that the non-pain sensations evoked in tooth pulp are mediated by a distinct population of afferents that are not involved in the coding of pain. High frequency stimulation that increased the discharge rate of the lowest threshold pulpal afferents resulted in no summation of non-pain sensation and never produced pain. However, high frequency stimulation evoked greater magnitude sensations at higher stimulus currents, indicating that central summation mechanisms were critical for higher threshold afferents signaling more intense non-pain and pain sensations. PMID- 6866538 TI - A review of follow-up studies of multidisciplinary pain units. AB - Chronic pain is a major public health problem in the United States. Estimates from the National Institutes of Health put the cost of chronic pain at 40 billion dollars a year. They estimate that as many as 15 million adults suffer from low back pain with a minimum cost of 5 billion dollars in direct medical costs and 93 million work days lost every year. In an attempt to cope with this massive problem, multidisciplinary pain units have arisen which attempt to address the complex, multi-faceted aspects of a chronic pain problem. The importance of this new treatment approach is made evident by the 1981 overview of multidisciplinary pain centers published by the National Institutes of Health. In this publication, the history and success of these units since their first development by Bonica are evidenced. The purpose of the present paper is to briefly, critically summarize one small aspect of these programs, specifically follow-up analysis of the patients after discharge. PMID- 6866537 TI - Semantic functional measurement of pain: integrating perception and language. AB - This study used Functional Measurement (FM) scaling procedures to demonstrate that subjects can scale and average the intensity or unpleasantness of pain sensations produced by an electrical tooth pulp stimulus and symbolized by a word. Unlike conventional psychophysical scaling methods, FM includes a testable validity criterion that must be met before the resultant scales are accepted. Twenty subjects used a handgrip dynamometer to rate all possible pairs of (1) 5 tooth pulp stimuli ranging in equal log steps from pain threshold to tolerance, and (2) 5 descriptors of sensory intensity or unpleasantness, twice each for a total of 50 stimulus pairs. The results show that subjects can average the pain magnitude produced by a tooth pulp stimulus with pain magnitude symbolized by a word and that this ability varies with the type of words used. FM produces separate scales of pain intensity, verbal magnitude and psychophysical ability. This method may provide a new and promising tool for the assessment of pain experience. PMID- 6866539 TI - Naloxone fails to reverse pain thresholds elevated by acupuncture: acupuncture analgesia reconsidered. AB - We were unable to demonstrate the reversal of dental acupunctural analgesia following the injection of 0.4 mg naloxone using evoked potential methodology. Since our findings differed from those of Mayer, Price and Rafii who used pain threshold methods, we attempted to replicate their study. Subjects who demonstrated acupunctural analgesia during electrical stimulation of the LI-4 point on the hands received either 1.2 mg naloxone or normal saline under double blind conditions. Pain thresholds elevated by acupuncture failed to reverse when naloxone was given. Review of experimental design issues, other related human subjects research, and animal studies on acupunctural analgesia provided little convincing evidence that endorphins play a significant role in acupunctural analgesia. Because endorphins can be released in response to a stressor, endorphin presence sometimes correlates with acupunctural treatment in animal studies and some human studies, especially those involving pain patients. The primary analgesia elicited by acupunctural stimulation seems to involve other mechanisms. PMID- 6866541 TI - Pain treatment on outpatient basis utilizing extradural opiates. A Danish multicentre study comprising 105 patients. AB - Previous to October 1st, 1981, 8 major Danish anaesthesiological departments registered 105 patients treated with extradural opiates for a period of more than 7 days, partially or completely on outpatient basis. Ninety-four suffered from painful malignant diseases and 11 patients from various painful benign diseases. The mean period of treatment was 65 days (range: 7-283 days) and of these 49 days (2-266 days) as outpatients. The total number of inserted epidural catheters was 215, equivalent of an average of 2 per patient (range 1-5). Reasons for removing an extradural catheter were injection-related pain, difficulty in injecting the desired volume, and displacement of catheter. Morphine chloride, in a solution of 0.4 mg/ml of normal saline, was the main choice as analgesic agent (90 patients). The mean daily dose of this drug totalled 12.6 +/- 4.8 mg (S.D.) (range: 4-30 mg) distributed as 2.7 +/- 0.9 (S.D.) (range: 1-6) daily injections. Twelve patients were treated with buprenorphine extradurally. Satisfactory pain relief was achieved for 70 patients (67%) who managed with extradural opiates as sole analgesic treatment. One patient developed septicaemia with a non-fatal outcome probably originating from some other focus. Apart from this no serious side effects were reported. Medically unskilled persons or relatives were responsible for instillation of all extradural opiates with 42 patients and partially responsible with 14 patients. Eleven patients managed injections without assistance. District nurses took care of medication for 46 patients, aided by a general practitioner in 5 cases. Three patients were supplied with continuous extradural infusion by means of a Mill Hill microinfusion pump. PMID- 6866540 TI - The study of the central grey matter in mechanisms of different kinds of analgesia: effects of lesions. AB - The effect of the central grey matter (CG) on pain sensitivity has been investigated in rats. It has been demonstrated that baseline pain thresholds, tested by the hot plate method (HPM) after surgical operation, were significantly greater in CG-lesioned rats than in controls. Baseline tail flick latencies did not differ from those in the control group of animals. In the CG-lesioned rats, the latencies of pain responses, measured by the hot plate and tail flick tests after stress and auricular electroacupuncture, were significantly shorter than in the control group. The analgesia in the CG-lesioned rats after auricular electrostimulation was less than that after stress. Obtained data suggest: (1) significance of the CG in the regulation of baseline pain sensitivity, tested by different methods, is variable. CG mechanisms do not play a leading role in producing the tail flick response, whereas hind paw licking is mediated through CG-dependent mechanisms. (2) Antinociceptive effect of stress and acupuncture is mediated by the CG. (3) The role of the CG in analgesic mechanisms is greater in acupuncture than in stress. (4) Apart from the CG, other antinociceptive systems are involved in the mechanisms of stress-induced analgesia. PMID- 6866542 TI - The prevention of the cardiotoxic effects of adriamycin by means of strophanthin. Preclinical study (chick embryo test). PMID- 6866544 TI - A case report of congenital amegakaryocytic thrombocytopenia. PMID- 6866543 TI - Risk factors for the progression of renal insufficiency in essential hypertension. PMID- 6866545 TI - Hypogonadotropic hypogonadism in a patient with thalassemia major. Case report. PMID- 6866546 TI - Association between Hb O Padova [alpha 30 (B 11) Glu leads to Lys] and Rendu Osler disease. PMID- 6866547 TI - Serum ferritin concentration in rheumatoid arthritis. PMID- 6866548 TI - Marfan's syndrome: diagnostic criteria and personal observations. PMID- 6866549 TI - Effect of labour stress on serum lipid levels. PMID- 6866550 TI - Radiation induced neoplasm following X-ray therapy of the neck. PMID- 6866551 TI - Eutony means balance of tensions. Psychophysical education, re-education and therapy. PMID- 6866552 TI - Evidence for two groups in hirsute females with regard to free testosterone levels (dialyzable fraction). PMID- 6866553 TI - The weightbearing shoulder. AB - To determine the effect of the swing-through crutch-walking gait on shoulder degeneration, 20 shoulders were examined in ten patients who had used the swing through gait for a mean of 8.7 years. No degenerative changes were found in the 20 examined shoulders either clinically or radiographically. A special X-ray view was determined to assess potential degenerative changes. The patients showed a mean increase in the forearm bone density as a result of their crutch-walking gait. PMID- 6866554 TI - Intermittent self-catheterisation--a new female catheter. PMID- 6866555 TI - The use of innervated flaps for the closure of ischial pressure sores. AB - Since 1971 we have been covering pressure sores and unstable scars with transposition-rotation--muscle and musculocutaneous flaps, thereby padding the cavity resulting from excision of bone and scar tissue. The long term results compare favourably with classical random pattern skin flaps. From the beginning of 1980 we have been using the sensory innervated tensor fascia lata myodermal flap for the ischial region. This provides sensation for a formerly insensitive area in patients suffering from a spinal cord lesion below L3/4. PMID- 6866556 TI - A driving adaptation for triplegic persons and a travelling adaptation device for paraplegic persons. PMID- 6866557 TI - Percutaneous lumbar rhizotomy for spasms in paraplegia. AB - Twenty-one patients with myelopathy causing uncontrollable spasms of the legs underwent percutaneous lumbar rhizotomy. There were two groups: active, otherwise healthy people with spinal lesions whose rehabilitation was hampered by spasms of flexion or extension of the hips and knees; and a second group of hospitalised, debilitated paraplegic patients with unhealing decubitus ulcers. Fourteen of the 16 active patients had excellent results initially, as did all five of the patients with pressure sores. Six have undergone repeat procedures in 7 to 18 months for recurrences of some component of the spasms. All have had at least minor recurrences. Of six patients with significant sensory preservation pre operatively, four found the resulting numbness disturbing and two did not achieve good relief from the spasms. The procedure is recommended when uncontrollable spasms interfere with rehabilitation or healing of pressure sores in patients with spinal lesions with complete motor and sensory loss. PMID- 6866560 TI - Low cost wheelchair. AB - This wheelchair is a new concept in wheelchair design, made entirely of readily available plastic materials and rear bicycle wheels. The chair does not require a cushion, weights only 12 kg with 100 mm front castors or 13 kg with 175 mm castors. It is easy to manoeuvre. The design allows this wheelchair to be used as a conventional wheelchair and a shower/commode chair. Side arms and brakes can be attached if required. The necessary materials are relatively inexpensive and generally available in most countries. PMID- 6866559 TI - Traumatic paraplegia in Zaria, Nigeria: the case for a centre for injuries of the spine. AB - This is a review of 48 patients with traumatic paraplegia treated at the Ahmadu Bello University Teaching Hospital, Zaria, Nigeria in the period June 1973 to June 1982. The records are unfortunately incomplete. All but three of the patients were treated conservatively. The mean hospital stay was 3 months. Facilities for adequate management including rehabilitation were lacking. Twelve patients (25 per cent) died within 10 weeks of admission, 30 developed bed sores and all had urinary tract infection beginning whilst in hospital. Wheelchairs could not be provided by the hospital for those who did not recover motor function and most of the patients could not afford to buy them. Most of the patients treated earlier in the series were lost to follow up. In the last 12 months of the period under review, 15 patients were treated using much the same facilities as existed in previous years. There was no hospital mortality during this period, and although urinary tract infection could not be prevented, only two of the patients (13 per cent) developed bed sores. It is suggested that the establishment of a Centre for Injuries of the Spine, with the direct involvement of the Government through the Ministry of Social Welfare, in the management of these patients will definitely improve the overall results. PMID- 6866558 TI - Orthostatic vasomotor response in spinal man. AB - The cardiovascular adaptation of tetraplegics to the upright position has been previously demonstrated to be deficient. Presumably this is due to the interruption of the spinal pathways linking supraspinal control centres with the peripheral sympathetic motor neurons. Review of previous studies of this phenomenon reveals that vasomotor responses have been determined primarily from blood flow measurements in the extremities. Contradictory conclusions have been drawn. Study of the visceral circulation, in particular renal blood flow, could shed more light on this poorly understood area. Renal clearance tests were carried out on seven healthy controls and eight chronic, clinically complete tetraplegic patients. Renal blood flow, mean arterial pressure, and total renal vascular resistance in both supine and passive head-up tilt positions were calculated from collected data. Renal blood flow and total renal vascular resistance showed significant decrease and increase respectively during tilting in controls and tetraplegic subjects. Although the renal circulation is autoregulated, postural change causes profound alteration of the renal blood flow mediated through the haemodynamic effects of the renal nerves. Sympathetic renal vasoconstriction is mediated by the carotid sinus reflex through the vasomotor centre in the brainstem. In the absence of supraspinal influence the renal vasculature is shown to respond to an orthostatic stimulus with a vigorous vasoconstriction. The adaptation of spinal man to the upright position may involve the recovery of a spinal vasomotor reflex involving the splanchnic circulation. PMID- 6866561 TI - Long term pressure recordings under the ischial tuberosities of tetraplegics. AB - Five ulcer free tetraplegic subjects who are unable to do lift-offs were studied on four separate days on two types of wheelchair cushions to measure the pressures underneath the ischial tuberosities. Small electrical pressure transducers and a tape-recorder were utilised. The average pressures on the ROHO and foam cushions were 71.5 and 105.4 mmHg respectively. The average time between push-ups greater than 1 second and greater than 5 seconds was 72.1 and 96.2 minutes. The average pressures and the time between push-ups was greatly in excess of the usually suggested skin care regime. The data would suggest that the relative importance of pressure and pressure relief in the aetiology of decubitus ulcers should be re-examined. PMID- 6866562 TI - Action of leishmanial excreted factor (EF) on human lymphocyte blast transformation. AB - The effect of Leishmania tropica major excreted factor (EF) on human immune and normal mononuclear peripheral blood cells has been studied. The response of lymphocytes to stimulation either specifically with leishmanial antigens or non specifically with phytohemagglutinin (PHA) in the presence of EF was tested by the uptake of 3 [H]thymidine. The results showed that EF inhibits the response of cells from immune donors to leishmanial antigens and from normal donors to PHA or PPD. Adherent and non-adherent cells were separated and the effect of EF on both populations was analysed. The results showed that EF inhibited blast transformation if both EF and antigen were presented to each of the separate populations. The inhibition of the adherent cells (mainly monocytes) was more marked than the inhibition of the non-adherent population (mainly lymphocytes). PMID- 6866563 TI - The detection and measurement of coproantibodies to Nippostrongylus brasiliensis in rats following a primary infection. AB - Investigations were initiated to study the possible detection and measurement of coproantibodies in animals infected with a gastrointestinal nematode parasite. Faecal extracts, extracts of small intestinal mucosa and sera of rats infected with intestinal nematode Nippostrongylus brasiliensis were examined for total IgA, IgM and IgG levels and haemagglutinating and precipitating antibodies specific to parasite antigens over a 30-day-period following infection. It was found that in both faecal and mucosal extracts immunoglobulin concentrations increased after a primary infection. In faecal extracts there was a seven-fold increase of IgA, a three to six-fold increase of IgG and about a fifty-fold increase of IgM. Haemagglutinins in faecal extracts detected by adult worm excretory-secretory (ES) products and adult worm and infective larvae somatic extracts were observed from 3 days after infection (DAI). Haemagglutinins detected by ES products reached their highest titres on 11-12 DAI while those reacting with adult worm somatic extracts showed the highest level between 15 and 19 DAI. A similar pattern of response was found in the antibody levels of the intestinal mucosa. Haemagglutinins detected in faeces during the first 12 DAI reacted with the same antigens as antibodies present in the sera at that time but coproantibodies from 18, 24 and 30 DAI were different from those circulating in sera at that stage of the infection. The results suggest that measurement of coproantibody levels may provide a convenient and useful index of local immune responses to gastrointestinal helminths. PMID- 6866564 TI - The measurement of antigens released by radiation-attenuated Trichinella spiralis larvae. AB - A radioimmunoassay has been developed that uses antisera raised to different excretory-secretory antigens of infective larvae of Trichinella spiralis (LESA) to measure accurately the output of these antigens following gamma irradiation at doses from 10 to 120 Krads. In the lower range (up to 20 Krads) irradiation results in the increased export of antigens to the culture supernatant in a subsequent 3 h period, without obvious or gross damage to the worms. Higher doses (greater than 40 Krads) suppress antigen release over the same period compared with the activity of untreated (control) cultures. This work makes two contributions. It describes a sensitive assay system which detects and measures parasite antigens that may be important both in protection and in serodiagnosis, and it offers for the first time an explanation for the special properties of the lower dose range larval irradiation-attenuated vaccine in inducing a high degree of reinfection resistance, as reported in older literature and recently confirmed by us. PMID- 6866566 TI - The reproductive biology of parasites. PMID- 6866565 TI - Genetic association of murine susceptibility to Brugia malayi microfilaraemia. AB - The influence of host genetics on susceptibility of mice to Brugia malayi microfilariae and its possible mechanism were studied. There was a strain association for duration and peak level of microfilaraemia: CBA/CaJ, C3H/HeJ, DBA/1J, AuSs/J and A.S.w/Sn had a short duration (3-5 days) and low parasitemia (19-26 parasites/100 microliters blood) compared to C57Br/cdJ, AKR/J, C57BL/6J, 129/J, BALB/cJ, DBA/2J, B10.D2/NSn, B10.D2/OSn and SJL/J (duration of 58-73 days, peak parasitaemia of 58-74 parasites/100 microliters blood). Relative resistance to microfilariae was not related to the H-2 complex as determined in studies of congenic C3H.B10 (H-2b) and B10.H-2k mice and their background strains. This trait was inherited in a dominant fashion and involved a single or small number of genes. Serum anti-microfilarial antibodies reached highest levels in strains with a long duration compared to those with a short duration of parasitaemia (geometric mean titres of 1:13450 vs 1:284). The distribution of 51Cr-labelled microfilariae among the livers, spleens, lungs and kidneys of a resistant (CBA/CaJ) and a susceptible (C57BL/6J) strain was similar. Transfer of immune lymphoid cells or sera between histocompatible (H-2k) resistant CBA/CaJ mice and susceptible C57Br/cdJ animals did not alter the duration of microfilaraemia. PMID- 6866567 TI - Pattern and paradox in parasite reproduction. AB - Parasites are more fecund than free-living relatives. The traditional explanation of this is that parasites have to compensate for massive mortality in the transmission phase of their life cycles, but there are neo-Darwinian problems with this interpretation. Similarly, parasites invest more resources in reproduction than free-living relatives but often live longer as adults, and yet negative correlations are expected between fecundity and longevity. These patterns and paradoxes are discussed within the context of a general life-cycle theory. The theory is also used to address questions concerning the influence of age-specific mortality on life-cycle patterns, the trade-off between gamete size and numbers, and the relative merits of gametic and non-gametic reproduction. Wherever possible, the theory is related to facts about parasites. PMID- 6866568 TI - Pseudocysts of the pancreas in children: which cases require surgery? AB - The need for surgery in pancreatic pseudocysts in children is directly related to the status of the duct of Wirsung. Clinical deterioration was often the factor leading to surgery. The retrospective study of ten cases of pancreatic pseudocyst pointed to the value of ultrasound as an indicator of pancreatic duct involvement. CT was also of help in one case. ERCP, performed only in one patient before surgery, may be indicated in difficult cases. PMID- 6866570 TI - Multifocal chronic osteomyelitis of unknown etiology. Report of five cases. AB - Five cases of chronic, inflammatory, multifocal bone lesions of unknown etiology are reported. Although bone biopsy confirmed osteomyelitis in each case in none of them were organisms found inspite of an extensive work up. Different clinical course of the disease reflects different aetiology in respective cases. These cases present changing aspects of osteomyelitis emerging since introduction of antibiotics. PMID- 6866573 TI - Practical techniques for pediatric computed tomography. PMID- 6866572 TI - The value of NMR imaging in pediatric practice: a preliminary report. AB - Twenty-eight children between the ages of 9 weeks and 17 years have been examined by nuclear magnetic resonance (NMR) imaging. Twelve had images of the brain made, the remainder having either chest, abdomen or pelvis examined. NMR imaging does not utilize ionising radiation to produce an image. Instead, it relies on measuring the response of hydrogen protons to an applied radiofrequency pulse and is a safe non-invasive imaging technique. In all cases studied NMR gave a clear demonstration of the gross anatomy as well as physiological and pathological information. Since NMR does not employ ionising radiation to produce its images, it is believed that it should become the method of choice for the evaluation of the child with suspected intracranial pathology, chronic lung disease, and suspected intra-abdominal or pelvic mass lesions. The unique information about proton concentration and proton spin-lattice relaxation time should prove to be useful in developmental research. PMID- 6866571 TI - Gallium-67 scintigraphy in children with chronic granulomatous disease. AB - Gallium-67 has been extensively used to diagnose and localize adult and pediatric inflammatory, infectious and malignant disease. Its mechanism of localizing in pathologic foci, although the subject of numerous studies both in vitro and in vivo, has not been clearly understood yet. The presence of normal polymorphonuclear leukocytes has been reported to be important in the accumulation of the tracer in inflammatory sites. We reviewed our experience with Gallium scintigraphy in three children with chronic granulomatous disease, an entity characterized by defective neutrophils and recurrent infection. Radiogallium was found to localize in inflammation in these patients. Hematologic disorders with specific structural or biochemical defects in their polymorphonuclear leukocytes may provide important information as to how these cells contribute to the accumulation of Gallium-67 in inflammation. PMID- 6866574 TI - Double right tracheal bronchus. A case report in an infant. AB - An apparently unique case of double right tracheal bronchus supplying the whole right upper lobe is described in a 12-month-old infant presenting with a right paratracheal opacity, persisting cough, and ventricular septal defect. The two tracheal bronchi, initially discovered on tomography, were confirmed by tracheobronchography, which demonstrated also the absence of other upper lobe branches. At surgery, the upper lobe was atelectatic, and its blood supply was abnormal. PMID- 6866569 TI - Sonographic evaluation of the normal ureteral submucosal tunnel in infancy and childhood. AB - Sonography was used to evaluate in vivo the length of the submucosal segment of the intravesical ureter in 35 normal infants, children and adults. Age varied between 3 and 30 years. Sonographic measurements were plotted against, age, height and weight. Analysis of the statistical data shows an almost linear growth profile in this age group. The dimensions obtained in vivo by ultrasound technique are comparable to the published dimensions obtained in vivo by endoscopic calibration or in vitro on fresh specimens. Although promising, ultrasound of the vesico-ureteral junction is because of technical limitations not yet applicable in neonates and infants in which measurement of the submucosal tunnel could be of clinical importance. PMID- 6866575 TI - Calcified congenital aneurysm of the left sinus of Valsalva associated with coarctation of the aorta. PMID- 6866576 TI - Cirrhosis: an unusual pattern of enhancement on CT. AB - A previously unreported pattern of enhancement of the liver on CT in a 7-month old female with cirrhosis is illustrated. Precontrast scans showed the liver to have a normal homogeneous density throughout. Scans performed immediately after rapid bolus injection of contrast showed an uneven enhancement of the entire liver. Bands of enhancing tissue (thought to represent vascular fibrous tissue) surrounded more extensive areas that enhanced less markedly. Delayed post injection scans revealed again an even level of density throughout the liver. PMID- 6866577 TI - Acromesomelic dwarfism in a child with an interesting family history. AB - Acromesomelic dwarfism is a rare skeletal disorder characterized by recessive autosomal transmission. A case is described in a boy 2 1/2 years old whose relatives (in a large number) showed a peculiar aspect of the upper extremities, and whose two grandparents were second cousins. Early diagnosis is important because it makes it possible to advise the parents with regard to the infant's prospects and the genetic implication. PMID- 6866578 TI - Ovarian torsion cyst presenting as a wandering tumor in a newborn: antenatal diagnosis and post natal assessment. AB - A case of an in-utero torsion ovarian cyst is reported. The diagnosis was made antenatally and the 4-cm cystic mass was followed by US from birth until the age of 3 months. Surgery was delayed until the baby reached a satisfactory weight. In the meanwhile, the follow-up studies showed the mass to wander in the abdomen. Surgery revealed an ovarian cyst. Ovarian torsion cysts should be considered in the differential diagnosis of wandering tumors. PMID- 6866579 TI - Azarcon por empacho--another cause of lead toxicity. AB - A new source of toxic lead ingestion has been identified roentgenologically in Mexican-American children and adults. Azarcon is an orange powder that contains 86% to 95% lead tetroxide (Pb3O4). At least three children have been treated with this substance by folk healers for relief of abdominal symptoms. Other Hispanic medical folklores may include this toxic "remedy." PMID- 6866581 TI - Sanctity of life or quality of life? PMID- 6866580 TI - Acute hyponatremia and seizures in an infant after a swimming lesson. PMID- 6866582 TI - Revisited: aerosol corticosteroids in the treatment of childhood asthma. PMID- 6866584 TI - Value of child maltreatment tests. PMID- 6866583 TI - Prophylactic and remedial therapy for the intellectual ailments of 'biostatistics'. PMID- 6866585 TI - More on newborn screening for phenylketonuria: recommendations of the Committee on Genetics. PMID- 6866586 TI - Parental information and circumcision: another look. PMID- 6866587 TI - Some pediatricians uninformed. PMID- 6866588 TI - Febrile children. PMID- 6866589 TI - Iron status and infant feeding practices in an urban ambulatory center. AB - The relationship of infant feeding practices to iron status was examined in a group of 280 infants, 9 to 12 months of age, attending a "well-baby" clinic. Of this group, 7.6% were found to be iron depleted, 19.7% were iron deficient without anemia, and 8.2% were iron deficient with anemia. The incidence of iron deficiency anemia was significantly greater in the black infants than the white infants (14.3% v 2.7%). The introduction of whole cow's milk into the diet had occurred prior to 6 months of age in 29.2% of the infants, and 62.1% of these infants had laboratory evidence of nutritional iron inadequacy, as contrasted with only 21.8% of those with iron deficiencies fed cow's milk after 6 months of age. Of the 21 infants with iron-deficiency anemia, 19 (90.5%) had been fed whole cow's milk prior to 6 months of age. Iron deficiency remains a nutritional problem for infants in an urban setting and is largely a result of the early introduction of whole cow's milk into the diet. PMID- 6866590 TI - Nutrient and mineral retention and vitamin D absorption in low-birth-weight infants: effect of medium-chain triglycerides. AB - A randomized prospective study of the effect of medium-chain triglycerides (MCT) upon the absorption and retention of major minerals and nutrients, as well as upon 25-hydroxy vitamin D levels, was performed in low-birth-weight infants. Ten infants received a high-calcium and vitamin D-containing formula, which contained 50% of its fat as MCT, while ten other infants received a similar formula in which all the fat was in long-chain triglycerides. There was a five-day delay in reaching full oral feeding volumes, and therefore there was a delay in the onset of the balance study in the MCT group, primarily due to gastrointestinal symptoms. There was a significant improvement in the percent of fat absorption (P less than .05) with MCT, but no difference in the percent of absorption or retention of calcium, phosphorus, sodium, or nitrogen. 25-Hydroxy vitamin D levels decreased in both groups after full oral feeding volumes had been established, but all values were within normal ranges. At the high intake levels of calcium and vitamin D given to the infants, MCT did not increase major mineral or nutrient absorption. PMID- 6866591 TI - Methylphenidate hydrochloride given with or before breakfast: I. Behavioral, cognitive, and electrophysiologic effects. AB - Methylphenidate HCl (Ritalin) is usually given for the treatment of hyperactivity or attention deficit disorder (ADD) at 30 minutes to one hour before meals. This schedule is based on the assumption that, when taken with meals, its absorption or metabolism is altered. However, no behavioral or pharmacologic data exist to support this recommendation. Eleven patients with attention deficit disorder were tested to evaluate this hypothesis using a double-blind crossover design (methylphenidate with or before breakfast) with a placebo control condition. Parents' ratings, performance on a paired-associate learning test, and cortical auditory-evoked potentials were measured. All of these measurements showed clear differences between the placebo condition and conditions when medication was given. However, none of the measurements showed a significant difference between the conditions when methylphenidate was given with breakfast and the condition when methylphenidate was given 30 minutes before breakfast. PMID- 6866592 TI - Methylphenidate hydrochloride given with or before breakfast: II. Effects on plasma concentration of methylphenidate and ritalinic acid. AB - Methylphenidate HCl (Ritalin) is often prescribed for the treatment of hyperactivity and is usually administered orally 30 minutes to 1 hour before meals, based on an assumption that meals may interfere with the absorption or metabolism of the drug. Seven boys who were taking methylphenidate regularly for the treatment of hyperactivity were hospitalized and given their established dose of the drug intravenously or orally, either with breakfast or in a fasted state. Blood samples were taken to determine the pharmacokinetics of the drug in each condition. Few differences between the "fed" and "fasted" states were noted, but the statistically significant differences indicated that meals accelerate rather than impede the absorption of methylphenidate. PMID- 6866593 TI - Effect of inhaled beclomethasone dipropionate on hypothalamic-pituitary-adrenal axis function in children with asthma. AB - The hypothalamic-pituitary-adrenal axis was investigated in 15 asthmatic children treated with inhaled beclomethasone dipropionate (mean 490 micrograms/day) and 11 asthmatic control subjects receiving no corticosteroid therapy. Measurements of 24-h urinary free cortisol and 17 hydroxy corticosteroids, serum cortisol, response to ACTH, and the oral metyrapone test showed no significant difference between the two groups. All the patients' results were within normal limits, and carbohydrate metabolism, as shown by blood glucose and hemoglobin A1c, was not affected by beclomethasone therapy. Thus, in the above dose, inhaled beclomethasone does not cause suppression of the hypothalamic-pituitary-adrenal axis. PMID- 6866595 TI - Biostatistical trends in Pediatrics: implications for the future. PMID- 6866594 TI - Enhancing infant development and parent-practitioner interaction with the Brazelton Neonatal Assessment Scale. AB - Studies performed in low socioeconomic populations have shown that the demonstration of a newborn's developmental capacity to his mother during the first few days post partum enhances subsequent mother-infant interactions. This study was undertaken to determine whether demonstrating the Brazelton Neonatal Assessment Scale to white middle-class mothers would result in similar outcomes. Mothers of 75 neonates were randomly assigned to either an experimental group or to one of two control groups. Direct observation, subjective assessment of mother infant interactions, and maternal questionnaires were used 1 and 3 months later to assess outcomes on several dimensions. Mothers in the experimental group spent more time playing with, talking to, and looking at their infants than did those in either control group, and were less likely to use feeding as a method of interacting with their infants. Experimental group mothers also were more likely to ask developmentally related questions. However, no differences were found in most indices of maternal-infant interaction used. The results of this study and a review of the literature indicate that the recommendation that such a demonstration be performed with all neonates must be weighed against the other methods available for enhancing infant development and healthy parent-child interaction. PMID- 6866596 TI - Neutrophils and zinc in infection-prone children with sickle cell disease. AB - Neutrophils can be distinguished as EA negative (EA-N) or EA positive (EA+N), according to rosette formation with sheep erythrocytes. EA- neutrophils show a bactericidal activity 50% to 70% lower than EA+ neutrophils. Thirty children with sickle cell disease were studied during steady state and crises/infections, together with matched control children. EA+ and EA- neutrophils, zinc levels in the body, and frequency of previous bacterial infection were evaluated. Sixty percent of the patients (18/30) had zinc deficiency (zinc less than 8.5 micrograms/10(10) RBC): of this group, more than three fourths (14/18) had a high frequency of infections (greater than or equal to 3/yr) and most of those (11/14) also had an increased percentage of EA- neutrophils (80% to 85% v 35% to 45% in control subjects). Only 4/18 of patients with zinc deficiency had a low frequency of infections, and only one of these four had a higher percentage of EA- neutrophils. In patients with normal zinc levels (12/30 or 40%), only three had frequent infections, but only one of these had an increased percentage of EA- neutrophils. The number of EA+ neutrophils increased after stimulation with epinephrine or during crises/infections. In six patients with more pronounced zinc deficiency and more severe crisis/infection, a delay in the increase of EA+ neutrophils occurred and was corrected by treatment. These findings suggest that a higher percentage of neutrophils with less bactericidal activity in many children with sickle cell disease and zinc deficiency may be a factor in the higher incidence of infections noted in these patients, and zinc might play a role in the formation, release, and activity of neutrophils. PMID- 6866597 TI - Unusual manifestations of histoplasmosis in childhood. AB - Nine previously healthy children were seen with unique, and in several instances, unreported manifestations of acute histoplasmosis. Presenting manifestations included: obstructive airway disease; subacute parotitis; unilateral cervical lymphadenopathy; anterior mediastinal mass-simulating neoplasm; immune hemolytic anemia; a cutaneous lesion with regional lymphadenopathy; mediastinal mass and pericardial effusion; pulmonary infarction; and a symptom complex of cervical lymphadenopathy, CSF pleocytosis, arthritis, and interstitial nephritis. In eight children histoplasmosis was not initially considered, and the correct diagnosis was made only after complex, and sometimes invasive, diagnostic evaluation and considerable delay. All patients recovered fully without antifungal therapy. Reports of uncontrolled trials of new antifungal agents for treatment of histoplasmosis in immunocompetent hosts should be cautiously evaluated. PMID- 6866598 TI - Superficial lumps in children: what, when, and why? AB - Deciding whether a visible or palpable lump should be excised in a trivial problem if one believes that every unexplained mass in an infant or a child must be promptly removed. But with the present increased public awareness of cancer, this approach would unnecessarily raise parental anxiety. This review of superficial lumps excised in infants and children shows that approximately 1% are malignant. Although a precise diagnosis on the basis of clinical findings remains imperfect, four fifths of the malignant lesions can be recognized on the basis of five risk factors: onset in the neonatal period, a history of rapid or progressive growth, skin ulceration, fixation to or location deep to the fascia, and a firm mass greater than 3 cm in diameter. In the absence of any of these risk factors, parents can be reassured with a 99.7% accuracy about the benign nature of their child's lump at the initial consultation. Approximately 6% of these lumps will spontaneously regress and, therefore, do not require excision. However, more than 90% of superficial lumps will persist or slowly enlarge and should be electively excised for cosmetic reasons, to prevent late infection or inflammation, and to diagnose the remaining three malignant lesions per thousand lumps that would not be recognized using the above five risk factors. PMID- 6866599 TI - Endemic giardiasis and day care. AB - Five surveys of 1,731 children for stool ova and parasites (1971 to 1981) in a rural county provide a unique perspective on naturally occurring, nonepidemic giardiasis. Currently white children in day care centers in Hampton County, South Carolina, experience attack rates of 26%. They enter the first grade with at least six times as much infection as those who do not attend day care. A trend toward more giardiasis linked to working mothers and day care is evident among white preschool children. This has not yet occurred among black preschool-aged children. These and other epidemiologic data indicate that as few as 100 children can maintain endemic levels of infection in a county of 18,000 residents. Person to-person transmission in the day care setting is sufficient to explain this county's rising rate of stool positivity of infection (8% of all stool specimens submitted to the state laboratory). PMID- 6866600 TI - Effectiveness of a regional poison center in reducing excess emergency room visits for children's poisonings. AB - A study was done to assess the necessity of hospital care for poisoning episodes in children less than 5 years old and to evaluate the impact of a regional poison center on the use of emergency rooms for pediatric poisonings. Of the pediatric patients seen in emergency rooms for acute poisonings, 63% did not require the services of a hospital; 95% did not contact the regional poison center before going to the hospital. When all poisoning episodes were considered, the regional poison center was found to reduce significantly pediatric visits to emergency rooms. Of parents who did not call the poison center, 44% went to an emergency room whereas less than 1% of parents who called the poison center went to a hospital (P less than .001). Moreover, 28% of those who did not call made unnecessary visits to the hospital compared with only 0.5% of parents who called the poison center (P less than .001). A regional poison center was found to be an effective means of decreasing unnecessary hospital visits for pediatric poisonings. Regional poison centers, however, need to further their impact by addressing outreach efforts to parents who do not call poison centers, emergency rooms, and pediatricians. PMID- 6866601 TI - A ten-year retrospective study of pink and yellow neonatal hyaline membrane disease. AB - Since it was first described several years ago, yellow bilirubin staining of the pulmonary membranes in neonatal hyaline membrane disease has apparently become more common. In a retrospective study of neonatal autopsy experience, it was found that as more of the premature infants survived longer, yellow hyaline membrane disease was a more frequent finding, increasing from 7% of all newborns having hyaline membrane disease at autopsy in 1970 to 50% in 1980. In comparing 499 cases with eosinophilic hyaline membranes with 168 cases of yellow membranes, newborns with bilirubin staining of the pulmonary membranes were found to be more premature (P less than .02), had smaller autopsy weight (P less than .002), and survived longer (P less than .00001). When multiple clinical parameters were compared between a group of infants with yellow membranes and a group of infants with pink membranes who were matched for gestational age, year of birth, and length of survival, no differences were found between the two groups. No correlation was found between kernicterus and yellow staining of the pulmonary hyaline membranes in the first years of the study, but there was a strong correlation in the last 5 years, coincident with the increase in the rate of yellow hyaline membrane disease found at autopsy. The gross bilirubin staining of the brain was the secondary type of kernicterus, not toxic bilirubin encephalopathy. The observation of bilirubin staining in the lung and in the brain correlates with prolonged survival in some very small premature infants. This does not appear to be a manifestation of bilirubin toxicity, but rather a marker of prior tissue damage. PMID- 6866602 TI - 'Reactive gliosis' in the medulla oblongata of victims of the sudden infant death syndrome. AB - A current hypothesis that the sudden infant death syndrome (SIDS) is a sleep apnea syndrome precipitated by defective control of involuntary respiration prompted the present study in which "reactive gliosis" in sections of the medulla oblongata of 45 SIDS victims was quantitated and compared with that in 20 control infants. Six anatomic regions were studied; five are related and one is unrelated to neural control of involuntary respiration. Increased numbers of "reactive" astrocytes were found in the SIDS group when the counts for all regions were combined (P = .04). Counts were also significantly higher in the SIDS victims for each of three regions alone: (1) the hilum of the inferior olivary nucleus (P = .01); (2) a lateral region (P = .02); and (3) the nucleus of the tractus solitarius (P = .03). The region with the greatest statistical difference, the inferior olivary hilum, has no recognized role in the control of involuntary respiration. There were no consistent associations between reactive astrocyte counts and specific clinical, socioeconomic, and pathologic variables. Characterization of the SIDS group whose counts exceeded that of the highest control infant also did not uncover distinguishing features. This study reinforces previous observations that, at least statistically, an abnormality of the brainstem occurs in a group of SIDS victims in contrast to a group of control infants, but also discloses considerable overlap in the numbers of such cells between these two groups. PMID- 6866603 TI - Childhood migraine and motion sickness. AB - The incidence of motion sickness among 222 children in four diagnostic categories -migraine, nonmigraine headaches, seizure disorders, and learning disabilities- was compared. Motion sickness was found to be an associated feature in 45% of the cases of childhood migraine, in contrast to a 5% to 7% incidence in the other groups. Therefore, it is suggested that motion sickness be regarded as an additional reliable minor criterion in the diagnosis of childhood migraine. Hypotheses of common central and peripheral mechanisms underlying both conditions are offered. PMID- 6866604 TI - Homicide as a cause of pediatric mortality in the United States. AB - Homicide is a major cause of pediatric mortality. National law enforcement data were analyzed to characterize and differentiate neonaticide, infanticide, filicide, and overall child homicide. Results include the following: Neonaticides often involved parents or unidentified perpetrators and occurred proportionately more in rural areas than did other types of child homicide. Infanticide appeared to be one end of the spectrum of child homicide and not a distinct entity. Filicide rates were higher for sons than daughters and the crime was committed by more fathers than mothers. Overall child homicide predominately involved young male offenders who were acquaintances of the victim. At remarkably early ages, homicide characteristics began to resemble those of adult homicide. Further research in this area should attempt to gain detailed information concerning the child, his family, and their social network. Pediatricians should be actively involved in determining risk factors for child homicide and in screening children for risk when these factors are determined. PMID- 6866605 TI - Direct computer recording of premature infants and nursery care: distress following two interventions. AB - Prematurely born neonates are born with an immature central nervous system. Temporal associates between care-giver interventions and infant biobehavioral responses can be recorded. A new methodology for continuous naturalistic computer assisted recording of infants in nursery care is described. To illustrate a clinical implication of this recording, an infant's responses to two seemingly contrasted care-giver interventions were analyzed: chest physical therapy and close social interaction. There was significantly increased subtle as well as gross behavioral and physiologic distress following both chest physical therapy and close social interaction when compared with base line distress incidence. Perhaps timing of interventions is as consequential as their content toward safeguarding a preterm infant's developing autonomic regulation, motor patterns, and sleep/wake state. PMID- 6866606 TI - Comparison of the ileal conduit and clean intermittent catheterization for myelomeningocele. AB - Clean intermittent catheterization has been shown to be a safe and effective means of regular vesical emptying in children with neurogenic bladders secondary to myelomeningocele. The major benefits appear to be the protection of the upper urinary tract, and in many children, improved urinary control. In contrast, the ileal conduit has been shown to produce significant long-term complications; the major one is deterioration of the upper urinary tract. Most children with myelomeningocele begin life with normal kidneys. Our goal of therapy, therefore, is a continent independent child with normal renal function. With proper patient selection, clean intermittent catheterization offers an excellent means of achieving this result in many children; the ileal conduit for permanent urinary diversion in children is outmoded. PMID- 6866607 TI - Polymicrobial bacteremia due to Polle syndrome: the child abuse variant of Munchausen by proxy. AB - Infectious disease due to multiple organisms results from underlying disease or invasive procedures and is uncommon in the pediatric age group. We report a case of polymicrobial bacteremia in an infant in whom no underlying disease was substantiated despite extensive evaluation. The presence of Polle syndrome--an adult-induced illness--was subsequently proved. This diagnosis should be considered early in the evaluation of children for whom repeated blood culturing indicates polymicrobial bacteremia. PMID- 6866608 TI - Screening for iron deficiency with the erythrocyte protoporphyrin test. AB - Elevation of erythrocyte protoporphyrin (EP) level is one of the consequences of iron deficiency. As the EP test has been established to be a screening test for lead poisoning, the screening capability of the EP test for iron deficiency was investigated. A total of 4,160 children between ages 6 months to 12 years had EP determined together with serum ferritin and hematocrit. Comparing the relationship of EP to serum ferritin and using a serum ferritin value less than or equal to 15 micrograms/L as the criterion of iron deficiency, the optimal cutoff limit for the EP test appears to be 35 micrograms/dL of whole blood. At this level, 88% of the subjects with low levels of serum ferritin can be detected (sensitivity), in contrast to the 53% detected at a higher cutoff value (greater than or equal to 50 micrograms/dL) used to screen for lead toxicity, or to the 59% detected by age-related hematocrit value. At an EP screening level of 35 micrograms/dL of whole blood, 90% of the subjects with normal serum ferritin level are correctly determined to be screen negative (specificity). The predictive value of low levels of serum ferritin for all subjects above screening level is 38%. In general, an elevated EP level, by itself, represents inadequate iron supply for hematopoiesis and signals iron deficiency regardless of whether the serum ferritin value is below the diagnostic level or not. A trial course of orally administered iron is suggested for children who are found to have an elevated EP value, with an increase in hemoglobin or hematocrit value serving, retrospectively, as confirmation of prior iron deficiency. PMID- 6866609 TI - Medical cure of apparent brain abscesses. AB - Two children with apparent brain abscesses were cured with antibiotic therapy. Review of the literature reveals clinical and experimental evidence that both cerebritis and an encapsulated abscess may appear as an enhancing ring lesion on cranial computed tomography. Patients reported to have had brain abscesses cured without surgery actually may have had cerebritis. There are only preliminary hints as to how to differentiate patients with cerebritis from those with an abscess. More experience is necessary to develop criteria to determine which patients may be appropriately treated with antibiotic therapy alone. PMID- 6866611 TI - A new 'gravity-flow' nipple for feeding infants with congenital cleft palate. PMID- 6866610 TI - Assessment of antifungal therapy in an 800-gram infant with candidal arthritis and osteomyelitis. AB - A 720-g premature newborn developed disseminated candidiasis during treatment with systemic antibiotics and total parenteral nutrition through an umbilical arterial catheter. Clinical features were typical for candidal skeletal infection at this age and included warmth and fusiform swelling of the lower extremities together with radiographic evidence of osteolysis and cortical bone erosion. Candida albicans was cultured from blood, urine, joint fluid, and a bone aspirate. The infection was cured with a 44-day course of amphotericin B and flucytosine (5-fluorocytosine). Antifungal therapy was monitored closely with serum drug levels and laboratory tests for bone marrow toxicity and renal dysfunction. Serum levels of both drugs were comparable to those achieved in older patients treated with similar doses. Significant concentrations of amphotericin B were detected in serum four and 17 days after completion of therapy, indicating a slow rate of elimination similar to that which occurs in adults. There was no evidence of drug-induced toxicity other than transient elevation in the fractional urinary excretion of sodium. This suggests that antifungal therapy may be effectively and safely administered to infants in dose schedules similar to those used for older patients. PMID- 6866612 TI - Augmented ventricular rate following verapamil treatment for atrial fibrillation with Wolff-Parkinson-White syndrome. PMID- 6866614 TI - Homosexuality and adolescence. PMID- 6866613 TI - Acute psychogenic stridor in an adolescent athlete treated with hypnosis. PMID- 6866615 TI - The role of the pediatrician in substance abuse counseling. PMID- 6866616 TI - 'Look-alikes'. PMID- 6866617 TI - Selecting appropriate normal limits for transcutaneous screening for hyperbilirubinemia. PMID- 6866618 TI - Screening for hypothyroidism. PMID- 6866619 TI - Nurse practitioners and the intensive care unit. PMID- 6866620 TI - Mothers and hepatitis B. PMID- 6866621 TI - Infectivity of anti-hepatitis Be-positive hepatitis B carrier mothers. PMID- 6866622 TI - Obstructive sleep apnea. PMID- 6866623 TI - The death setting. PMID- 6866624 TI - [Tolerance to physical exercise in children with bronchial asthma]. PMID- 6866625 TI - [Changes in the production of endogenous erythropoiesis regulators in glomerulonephritis and pyelonephritis in children]. PMID- 6866626 TI - [Pathogenesis of metabolic nephropathies during heat exposure in children]. PMID- 6866627 TI - [Objectives of a children's arthrological service (the data from a specialized department for children with joint diseases)]. PMID- 6866628 TI - [Effect of therapy on various indices of hemostasis in glomerulonephritis in children]. PMID- 6866629 TI - [Comparative characteristics of various treatment regimens in chronic nonobstructive pyelonephritis in children]. PMID- 6866630 TI - [Echocardiographic diagnosis of Ebstein's anomaly]. PMID- 6866631 TI - [Male infertility as a sequel of epidemic parotitis]. PMID- 6866632 TI - [Characteristic clinical manifestations of acute erythema nodosum in children]. PMID- 6866633 TI - [The data from cardiological departments on renal hypertension in children]. PMID- 6866634 TI - [Use of alpha-tocopherol in the combined treatment of perinatal cerebral hypoxia in premature infants]. PMID- 6866635 TI - [Conservative treatment of esophagitis in children]. PMID- 6866636 TI - [Dispensary care for patients with chronic bronchitis]. PMID- 6866637 TI - [Forms and methods of medical care of young children born to mothers at perinatal risk]. PMID- 6866638 TI - [Two cases of Pierre Robin syndrome in one family]. PMID- 6866639 TI - [Anomalies of hemostasis during the neonatal period in 4 cases of congenital galactosemia]. PMID- 6866640 TI - [A case of acute reversible dysautonomia in an adolescent]. AB - A 16 years old male presented with orthostatic hypotension with constant pulse, associated with severe constipation, decrease of sudoral secretions, weight loss and asthenia. This dysautonomia evolued during a period of 6 months and disappeared completely leaving no sequellaes. The symptoms appeared after a rubella. The authors discuss the originality of this observation among the pure pan-dysautonomia and the modes of exploration of the autonomic nervous system. Its mechanisms is probably auto-immune. PMID- 6866641 TI - [Urothorax caused by traumatic rupture of the subpyelic ureter. Apropos of a case in a 5-year-old]. AB - The authors report the observation of a five years old boy who presents after a polytraumatism a chronic pleural effusion who stop only after decortication and which is caused by a ruptur of sub-pyelic uretere. Echography is a good procedure for diagnosis. Laboratory studies of pleural fluid (protein, urea nitrogen, creatinine) could give information for diagnosis. PMID- 6866642 TI - [Status epilepticus caused by accidental isoniazid poisoning]. AB - A case of acute poisoning in a 32 months old child, with generalised and uncontrollable seizures is reported. Pyridoxine IV is efficacely used in such poisoning. PMID- 6866643 TI - [Hepatitis B with a fatal outcome in a 3-month-old infant of a healthy chronic carrier mother]. AB - A 81 day old male infant developed an acute hepatitic failure and died shortly thereafter. Determinations of HBs antigen and antibody (AB) and HBeAg and AB were performed in the parents and sibling of the infected child. The mother and a sister were an asymptomatic carrier of HBsAg, the first HBeAg positive and the second HBeAB positive. An elder sibling was HBsAg and HBeAg positive in this serum. The father was anti-HBs positive. In the family of the sister, the man and two childs were HBsAg and anti-HBsAB negative. A new baby in the family of the propositus born and a combination of HB vaccine and HBIg (hepatite B immuno globulin) was started at birth. Unfortunately the child died of S.D.I.S. (Sudden Death Infant Syndrome). The HB vaccine was immuno-genetic in this infant and the anti-HBs in the immuno-globulin M (IgM) was positive as in several adults controls. This case allow us to discuss vertical transmission of hepatitis B, the clinical aspect of neonatal hepatitis and the preventing HB infection by combinaison of HB vaccine and HBIg. PMID- 6866644 TI - [Maternal and perinatal antecedents of encephalopathies: their contribution to a trial classification of encephalopathies of unknown origin]. AB - We had a sample of 135 mentally retarded children, whose case history (maternal, obstetrical and perinatal) was known before their mental retardation was suspected. This analysis made it possible to pinpoint characteristic anamnesic giving rise to mental retardation by comparison with a check population. It appears that these factors differ according to the supposed origin of mental retardation (genetic, embryonic, foetal, perinatal and postnatal periods) therefore, they can be considered "explicative" of these origins. A multivariate analysis of these factors indicates that the majority of cases of mental retardation with unknown origin are due to disorders during foetal life, which had not been detected. PMID- 6866645 TI - Tests of a two-stage model of visual matching. AB - Predictions from a model of visual matching were tested in two experiments. The model consists of a wholistic comparison process followed by an element-by element comparison process. All stimuli are processed by the first stage but only those that permit a decision based on a wholistic comparison produce responses. When discrimination is difficult and a decision cannot be reached by a wholistic comparison, the second stage of processing is initiated. Degree of discriminability and stimulus duration (100 and 1000 msec.) were varied in both experiments. In Exp. 1, the stimulus elements were arranged in a square configuration to facilitate a wholistic comparison. As predicted, the hard different stimuli took longer to match than the same or easy-different stimuli. The hard-different stimuli presented for 1000 msec. took longer to match than those presented for 100 msec. There was no difference in accuracy between responses to hard-different pairs at the two durations. In Exp. 2, the stimulus elements were arranged in a horizontal row and placed one above the other to facilitate element-by-element comparison. As predicted, these stimuli produced slower and more accurate responses for same and hard-different stimulus pairs only when they were exposed for 1000 msec. Responses to easy-different stimulus pairs were made quickly and accurately. PMID- 6866646 TI - Target location and visual feedback as variables determining accuracy of aiming movements. AB - The accuracy of a long aiming movement was studied as a function of whether it was performed toward or away from the midline of the subject's body in the presence or absence of visual feedback. 30 right-handed, male university students (19-26 yr.) served as subjects. With movement distance and duration controlled, the mean percentage of error was 6.34% less for movements made toward the body's midline than for those performed away from the midline. The mean percentage of error was also 48% less in the presence of visual feedback than in its absence. However, contrary to our expectation, movements executed toward the body's midline were not appreciably less disrupted in the absence of visual feedback than movements performed away from the midline. PMID- 6866647 TI - Immediate reproduction of temporal information under four cognitive strategies. AB - The main purpose was to determine the retention characteristics of temporal information when subjects experienced time under a retention interval of immediate reproduction and various cognitive strategies for time estimation. Four levels of cognitive strategy were used, viz., conscious, mental counting, counting aloud without auditory cues, and counting aloud with auditory cues. The latter three cognitive strategies were experimenter-defined, time-aiding techniques. Subjects were instructed to refrain from employing time-aiding techniques under a conscious cognitive strategy for time estimation. Visual durations of 1, 2, and 4 sec. were estimated by 12 subjects under the method of reproduction. Two measures of performance were computed, viz., variable and constant errors. The general conclusions were: (a) the effectiveness of mental counting, counting aloud without auditory cues, and counting aloud with auditory cues as cognitive strategies over conscious cognitive strategy in terms of variability depends on the duration used, and (b) in terms of accuracy and variability an increase in the number of cues under time-aiding techniques does not necessarily produce better performance. PMID- 6866648 TI - Comparison of auditory and visual feedback for EMG training. AB - 27 undergraduate students participated in an experiment on EMG biofeedback. Three groups were employed (visual feedback, audio biofeedback, and control) to determine which group learned to reduce frontalis muscle tension more quickly. All subjects were trained during a 30-min. period for five days. The time consisted of a 10-min. baseline and a 20-min. biofeedback session. Over a 5-day period relaxation in the forehead due to biofeedback improved significantly. More training time yielded an increased relaxation in this area, and most learning occurred during the first two days. The significant interaction of training and time illustrated that the two biofeedback groups produced a more pronounced relaxation in the forehead muscle than did the control group. No significant difference was found between the two biofeedback groups. PMID- 6866649 TI - Recall of story schema categories by reading disabled adults: effect of mode of presentation. AB - Stein and Glenn's (1979) story schema provided the framework for testing reading disabled adults' recall of stories that they had heard on tape, read orally, or read silently. For each category of proposition in the story schema, no significant difference was found in the proportion of statements recalled across the three modes of presentation. Further, the pattern of recall of different categories was similar to that which had been exhibited in previous research by normally reading children who heard stories on tape. The findings provide further evidence that the pattern of recall of story schema categories is similar across a variety of subject groups and situations. A possible explanation of this is discussed, as are possible explanations of the specific recall pattern obtained. PMID- 6866650 TI - Locus of control of unwed adolescent fathers versus adolescent nonfathers. PMID- 6866652 TI - Sanctions and the aged woman. PMID- 6866651 TI - Awareness and control of pain. PMID- 6866653 TI - Learning disabled boys' performance and self-assessments on physical fitness tests. AB - 30 learning disabled boys drawn from a segregated private school for learning disabled children and 22 from a public school mainstream program and 22 nondisabled boys performed two physical fitness tests, sit-ups and shuttle run in one of two conditions. While normal achievers performed significantly better on one of the tests, there were no differences between the two samples of learning disabled youngsters. However, students' comparisons of their performance with classmates' indicated that learning disabled youngsters in the private school ranked themselves more favorably than those in mainstream classrooms. PMID- 6866654 TI - The modified GATB (M) as a measure of recovery from general anesthesia. PMID- 6866655 TI - Divergence thresholds as functions of temporal separation, spatial separation, and retinal locus. AB - Human thresholds were measured for the detection of angular divergence between straight lines using pairs of line segments. The dependence of these thresholds on temporal separation between the two lines, spatial separation, and retinal locus was assessed. Results were comparable to prior divergence thresholds obtained by Harrington and Harrington in their study of "blur patterns." In blur patterns motion parameters may be processed partly or wholly as form information rather than as motion information per se. Harrington and Harrington had used moderate blurring velocities, for which information on both motion and form were present. Observers may have been responding either to motion or to form. The study reported here used briefly presented two-line "blur patterns" with only form information. Analysis suggested that the form components of fast motion produced blur patterns could be processed by the human visual system. Neither temporal nor spatial separation was a significant determiner of thresholds in accordance with Harrington and Harrington who found no effect of blur-line density in the range studied. Retinal locus was a factor as it was with blur patterns. Some possible mechanisms for the detection of divergence indicated by these results are discussed. PMID- 6866656 TI - Facing a communicative obstacle: pragmatics of language-impaired children. AB - The ability of school-age, language-impaired children to respond when faced with a communicative obstacle was investigated. 18 language-impaired children were compared to 2 control groups, age-mates and language-mates. Language-impaired differed from both controls. They communicated more effectively than younger language-mates and less effectively than age-mates. PMID- 6866657 TI - Recognition processes and occurrence of the dot Poggendorff illusion. AB - The occurrence of the dot Poggendorff illusion was assessed in two groups of naive subjects (N = 48). One group was given information on the line Poggendorff figure while a second group was not. The line Poggendorff illusion was assessed in a third group of 24 subjects. The experiment is presented in the context of the proposal that recognition of the line Poggendorff figure in the dot-figure can be a factor determining the occurrence of the dot Poggendorff illusion. PMID- 6866658 TI - Aerodynamic measures of coarticulation in /VNC/ sound sequences. AB - Simultaneous measurements were made of voice, oral air flow, and nasal air flow for two speakers producing seven repetitions of 12 differing contexts containing Vowel + Nasal + Oral Consonant sequences in a search for the temporal pattern of nasal coarticulation. Analysis indicated a rather stereotyped degree of overlap of nasal air flow during the oral consonant, about 36% of the duration of the oral consonant. Carryover of nasal air flow into the oral consonant appears to reflect mechano-inertial limitations of a sluggish velum. PMID- 6866659 TI - Visual and acoustic processing in making same-different judgments. PMID- 6866660 TI - Inter- and intra-modal processing of sensory-specific stimuli. AB - Inter- and intra-modal processing was compared with modality-specific forms in two experiments on a group of 40 university students. In Exp. I, the RTs for tactual-to-visual and visual-to-visual processing were compared for 20 subjects, and in Exp. II, the visual-to-tactual and the tactual-to-tactual processing were compared for another group of 20 subjects. Analysis showed that intra-modal processing is faster than inter-modal processing. Further, the "same" RT is faster than the "different" RT. The inter- and intra-modal processing differences are based on the delay in retrieval and recognition across sensory-specific areas. PMID- 6866661 TI - The language of pain intensity and complexity: new methods of scoring the McGill Pain Questionnaire. AB - In Part I the McGill Pain Questionnaire was administered to 25 cancer patients, scored and analyzed in the traditional manner. Results indicated that patients with cancer pain appear to be similar in terms of intensity of the pain and the kind of pain which they experience with respect to sensory, affective, and evaluative qualities. Part II presents a new method of administering, scoring, and analyzing responses to the questionnaire, which allows for a more comprehensive interpretation of pain. In Part III the data from Part I are reanalyzed using the new scoring system. As hypothesized, the intensity of cancer pain is higher along the affective dimension than along the sensory. With regard to complexity of the experience of cancer pain, neither the sensory nor the affective dimension is more salient. The new system of scoring and analysis may enable future investigators to specify a unique pain intensity-complexity relationship for each clinical pain syndrome. PMID- 6866662 TI - Low lead and cadmium levels and childhood visual-perception development. AB - This study investigated possible relationships of lead and cadmium levels to childhood visual-perceptual development. Hair-metal concentrations of lead and cadmium were analyzed in 25 children who were having learning problems. They were also administered the Bender Visual-motor Gestalt Test. Lead and cadmium levels correlated significantly and negatively with age-deviations of Bender errors. A continuing reexamination of lead and cadmium levels is needed because levels previously thought harmless may be associated with decrements in childhood visual perceptual development. PMID- 6866663 TI - Type A (coronary-prone) behavior and self-reported physical and cognitive reactions to actual life stressors. PMID- 6866664 TI - Fingertip number writing errors in hospitalized non-neurologic patients. PMID- 6866665 TI - Neonatal filming methodology. PMID- 6866666 TI - Speech disfluencies under normal and delayed auditory feedback conditions. AB - 20 male and 20 female adults, matched by age, read under conditions of normal and 113-, 152-, 200-, 253-, 307-, and 347-msec. delayed auditory feedback. Disfluency counts were correlated with delayed auditory feedback reactions which were changes in disfluencies under delay conditions. Pearson product-moment and Spearman's rbos were negative and significant for delay times of 113, 153, 200, and 253 msec. The Pearson product-moment correlation for 307 msec. was also negative and significant. Two groups of 11 adults were selected from the original sample on the basis of high and low initial disfluency counts. Their reactions to delayed auditory feedback were compared, using a 2-way analysis of variance with repeated measures (groups X delay times). Both main effects were significant but not their interaction. PMID- 6866667 TI - Behavioral management of exceptional children using video games as reward. PMID- 6866668 TI - Scale of aversiveness of behavioral decelerators. PMID- 6866669 TI - Relationship between WAIS-R and wide range achievement test in a sample of mixed patients. AB - Correlations between the WAIS-R Verbal, Performance, and Full Scale IQs, WAIS-R subtest scaled scores, and Wide Range Achievement Test Reading, Spelling, and Arithmetic standard scores were computed for a sample of 60 patients at a V.A. medical center who were referred for routine psychological evaluation. The Full Scale IQ and Verbal IQ yielded large correlations with the three achievement area standard scores (rs of .60 to .76). However, Performance IQs correlated moderately with reading and spelling scores (rs of .41 and .42), but a larger correlation obtained with arithmetic scores (r = .66). The results support the concurrent validity of the WAIS-R. PMID- 6866670 TI - Relationship between hypnotic susceptibility and thermal regulation: new directions for research. AB - This study examined the relationship between hypnotic susceptibility and thermal regulation using biofeedback. 30 subjects were given the Stanford Hypnotic Susceptibility Scale, Form C. Immediately after the susceptibility score was determined, all subjects were given instructions to lower the peripheral skin temperature on the right middle finger. Subjects remained under hypnosis while they performed this task. A significant negative correlation (-.38) was found, in that the higher subjects' susceptibility, the better they were able to maintain a lower dermal temperature over trials. A 2 X 6 analysis of variance for low and high susceptibility with repeated measures yielded a significant main effect for subjects and a significant interaction of group X trials; highly susceptible subjects maintained a lower mean temperature over trials than subjects of low susceptibility. Issues for future research concerning the role of susceptibility in research on hypnosis are outlined. PMID- 6866671 TI - Peabody Picture Vocabulary Test-Revised and luria-Nebraska Neuropsychological Battery for Children: intercorrelations for normal youngsters. AB - The relationship between scores on the PPVT-R and Luria-Nebraska Neuropsychological Battery for Children was examined utilizing 86 normal children, including 55 females and 31 males from middle-class families. Correlation coefficients were computed between the standard scores obtained on the PPVT-R and the T scores from the summary scales on the Luria-Nebraska. Significant relationships were predicted between the PPVT-R and the Receptive scale on the Luria-Nebraska. Significant but small correlations were found between the PPVT-R and this scale as well as the Intelligence, Visual, Arithmetic, Memory scales on the Luria-Nebraska. PMID- 6866672 TI - Parental supervision and delinquency. AB - A review of the literature suggests that parental supervision over their children is a significant variable in controlling the amount of delinquent behaviour; high supervision is associated with low delinquency. The relationship remains when variables such as mother's affection, parental conflict, parental aggression, mother's self-confidence, father's deviance, father's absence, father's occupation are controlled. And it appears to be effective under extremely adverse conditions such as poverty and authoritarian and repressive methods of child rearing. Training packages providing basic information about processes of child development and emphasizing positive techniques of child management, with parental supervision as an essential ingredient, need to be further developed and evaluated as a means of reducing delinquency. PMID- 6866673 TI - Color priming affects Stroop interference. AB - The effect of prior word and/or color activation on subsequent color naming was examined in a discrete-trials Stroop task. Both word and color primes increased color-word interference, and the magnitude of the priming effect increased as the number of priming dimensions increased. The maximal interference usually produced by incongruent Stroop stimuli was reduced when such stimuli were preceded by primes which activated both word and color dimensions. The results were discussed in terms of models which attribute color-word interference to the relative speed of word reading and color naming. PMID- 6866675 TI - The filled-duration illusion: limits of duration of interval and auditory fillers. AB - Two experiments were conducted to explore parameters of the filled-duration illusion, i.e., intervals filled with stimuli are perceived as longer than empty intervals of equal physical duration. It was hypothesized that the illusion would be found only for intervals of short duration, i.e., a few seconds, and that filled intervals would vary in perceived duration as a function of the type of "filler." Auditory tones were used as boundary and filler stimuli in a counterbalanced (Exp. I) and randomized (Exp. II) design that covered 9 intervals ranging from 1 to 60 sec. A psychophysical method of verbal estimation with single stimuli was employed. The first hypothesis was supported in that only with the short intervals (1 and 3 sec.) was there any evidence of a filled-duration illusion. The type of filler stimulus was important only in the 1-sec. intervals. Results are interpreted in terms of information-processing models for time perception. PMID- 6866676 TI - Magnitude of the Zollner illusion as a function of the perceived length of the obliques. PMID- 6866674 TI - Technique for estimating task completion time from partial data. PMID- 6866677 TI - Measurement bias in memory for movement by mentally retarded and nonretarded children. AB - This study examined short-term motor memory of 100 mildly retarded and 100 nonretarded children during the recall of a preselected, arm movement. The focus was to determine the effects of anatomical differences in arm lengths between subjects on the measurement of movement accuracy. Absolute Error (AE) in its linear form was analyzed in a 2 (groups) X 5 (retention conditions) X 5 (trials) factorial yielding significant main effects for both groups and retention but not for trials. The analysis performed on the same data transposed to angular form (AE') gave a significant main effect for retention only. These results generally support the premise that differences between groups using a linear representation of movement error resulted in part from inaccuracy in estimating the actual anatomical (angular) movement. PMID- 6866678 TI - Retention of EMG biofeedback relaxation training. AB - This study investigated how much subjects could retain ability to reduce muscle tension without daily practice and the extent to which periodic re-training would be a practical and effective way of retaining the skill. 19 male and 29 female subjects were given standard frontalis muscle biofeedback relaxation training. After initial training, 34 subjects in the experimental group were further randomly assigned to 3 different re-training groups: re-training once every 2 wk., re-training once every 4 wk., and none. All three groups maintained their ability to reduce muscle tension, and the group given re-training once every 2 wk. further improved that ability. PMID- 6866679 TI - Effects of three experimental conditions on preschool children's ability to coordinate visual perspectives. AB - 60 3-, 4-, and 5-yr.-old children were asked to coordinate visual perspectives in three conditions: (1) Piaget and Inhelder's "Three Mountain Task," (2) identify objects a doll could see against the side of two intersecting walls, and (3) choose a picture which represented which objects the doll could see. Both condition and age effects were significant. For all age groups there were significant differences between the "Three Mountain Task" and the other two tasks, with significantly more children responding correctly on the two object identification conditions. No significant differences between the two object identification conditions were found. While 5-yr.-olds performed significantly better on both object-identification conditions, no differences were found between the 3- and 4-yr.-olds on these tasks. No age effect was found on the "Three Mountain Task." Children of all groups found this task too difficult. 3-, 4-, and 5-yr.-olds seem better at coordinating visual perspectives than suggested earlier. Greater success on present tasks may be due to the reduced number of visual cues that represented alternate visual perspectives. Differences in cognitive demands of each condition were analyzed. PMID- 6866680 TI - Consistency of individual exponents in cross-modal matching. PMID- 6866682 TI - Intelligibility of interrupted meaningful and nonsense speech with and without intervening noise. PMID- 6866681 TI - Perception of movement in American Sign Language: effects of linguistic structure and linguistic experience. PMID- 6866684 TI - Taste-quality recognition and forced-choice response. PMID- 6866683 TI - Surface tilt (the direction of slant): a neglected psychophysical variable. PMID- 6866685 TI - Apparent movement in phenomenal space. PMID- 6866687 TI - Stimulus-response compatibility affects auditory Stroop interference. PMID- 6866686 TI - Stability of line-length estimates using the method of absolute magnitude estimation. PMID- 6866688 TI - Acquisition and decision in visual same-different search of letter displays. PMID- 6866690 TI - Pouting and smiling distort the tactile perception of facial stimuli. PMID- 6866689 TI - An interpretation of age-related differences in letter-matching performance. PMID- 6866692 TI - Effect and artifact in the auditory discrimination of rise and decay time: speech and nonspeech. PMID- 6866691 TI - The cutaneous saltatory area and presumed neural basis. PMID- 6866693 TI - Development of clinical tests of vision: initial data on two hyperacuity paradigms. PMID- 6866694 TI - The role of "chirp" identification in duplex perception. PMID- 6866695 TI - Duplex perception: confirmation of fusion. PMID- 6866697 TI - Amodal completion as a basis for illusory contours. PMID- 6866696 TI - Two-state versus continuous-state stimulus representations: a test based on attentional constraints. PMID- 6866698 TI - The rubber pencil illusion. PMID- 6866699 TI - Perceived force in fatiguing isometric contractions. PMID- 6866700 TI - The effect of temporal waveform upon temporal darkness enhancement. PMID- 6866702 TI - Differences in temporal appearance associated with activity in the chromatic and achromatic systems. PMID- 6866703 TI - A conditioned weight illusion: reafference learning without a correlation store. PMID- 6866705 TI - The public character of scientific medicine. PMID- 6866704 TI - Identical stimuli are judged differently in the orientation and position domains. PMID- 6866701 TI - Vibrotactile masking: effects of one- and two-site stimulation. PMID- 6866706 TI - Cancer: reexpression of procaryotic replication units--the "procaryote hypothesis" of oncogenesis. PMID- 6866707 TI - The face of death: case history, literary histories. PMID- 6866708 TI - Equity in medical care: are the deserving poor eligible? PMID- 6866709 TI - Perspectives in scientific communication: past, present, and future directions. PMID- 6866710 TI - The lesion and the function: setting up the reductionist problem. PMID- 6866711 TI - Transcellular cell movement and the formation of metastases. PMID- 6866712 TI - Through the looking glasses of physicians, dentists, and patients. PMID- 6866713 TI - Medical decisions in perspective: applied research in cognitive psychology. PMID- 6866714 TI - The effect of the molecular structure of closely related N1-substituents of sulfonamides on the pathways of elimination in man. The acetylation-deacetylation equilibrium and renal clearance related to the structure of sulfadiazine, sulfamerazine and sulfadimidine. AB - Sulfadiazine, sulfamerazine, sulfadimidine and their corresponding N4-acetyl derivatives were administered to man. The percentages of acetylation and deacetylation, protein binding, half-lives of elimination and apparent and true renal clearance values were measured. Methyl substitution in the N1-pyrimidine ring favours acetylation by an additional N-acetyltransferase isoenzyme present in 'fast' acetylators only. Methyl substitution in the N1-pyrimidine ring favours renal clearance of the N4-acetylsulfonamide derivatives. The N1-substituent probably reinforces the binding of the N4-acetyl group to the active tubular transport mechanism. The renal clearance of these sulfonamides is not dependent on the structure of the N1-substituent. PMID- 6866715 TI - Formulation of a stable vidarabine infusion fluid. AB - Decomposition of vidarabine in a 5% glucose infusion fluid after steam sterilization was measured by HPLC and TLC analysis. After sterilization for 60 minutes at 100 degrees C and 20 minutes at 120 degrees C no degradation could be observed. A slight but significant degradation was observed after sterilization for 60 minutes at 120 degrees C followed by storage for eight months. Assuming 5% loss of content to be acceptable, it was concluded that a vidarabine infusion fluid can be sterilized for 20 minutes at 120 degrees C and stored at room temperature for at least eight months afterwards. PMID- 6866716 TI - Novel techniques for determination of antibacterial activity of silver sulfanilamides. AB - By means of suspension techniques, MIC's of ten silver sulfanilamides against fifty-six different strains of bacteria were determined. The only two bacteria which were sensitive were Streptococcus pyogenes and Escherichia coli. The local application of these drugs in burn patients only reduces colonization. The cream base is probably also involved in the anticolonization effect. PMID- 6866717 TI - In vitro testing of controlled release theophylline preparations: Theolair, Theograd and Theolin. AB - Three dissolution methods, i.e. a paddle type, the USP disintegration and a column method, were used to characterize the release from three controlled release theophylline preparations, i.e. Theolair Retard 250, Theolin Retard 300 and Theograd 350. The release profiles proved to be dependent upon agitation intensity and pH or a combination of both, but the sensitivity towards these variables differed markedly between the products tested. PMID- 6866718 TI - Determination of phenol in the presence of resorcinol applying substitution with excess bromine water; structure of the bromination products. AB - Bromination with a large excess of bromine results in the formation of a tetrabromo product for phenol and a pentabromo derivative for resorcinol. It is possible to determine the active bromine in the tetrabromo product after its isolation by filtration. This can also be done in the presence of resorcinol as its pentabromo derivative does not precipitate. The method gives good results (96 97% +/- 1%) for quantities of 8 mg and higher of phenol in the presence of a maximum of 25 mg resorcinol. From the 1H- and 13C-NMR spectra of the bromination products it could be concluded that they have a quinoidal structure. PMID- 6866719 TI - Distinction between the tautomeric forms of sulfanilamide derivatives by 13C-NMR. AB - The application of 13C-NMR for the distinction between amido and imido tautomers of sulfanilamide derivatives in DMSO solution is described. The differentiation is based on delta delta, the change in chemical shift of a sulfanilamide from the neutral form (in DMSO solution) to the anion (in aqueous alkaline solution). The delta delta values of three C atoms (C1, C1', C4) are suitable for the differentiation between the tautomers. The conclusions confirm previous results. PMID- 6866720 TI - Glomerular filtration in the isolated perfused kidney. II. Glomerular hemodynamics. AB - Glomerular hemodynamics were studied of isolated perfused kidneys of 12-wk-old normotensive (NR) and spontaneously hypertensive (SHR) rats, using Pluronic F108 (BASF, Wyandotte, MI, USA) as a plasma expander. Glomerular filtration rate (GFR), proximal tubular hydrostatic pressure (PT) and glomerular capillary hydrostatic pressure (PGC) were approximately linearly related with renal perfusion pressure. PGC measured directly by micropuncture was comparable to PGC calculated from other parameters of glomerular dynamics using pore theory. We conclude that GFR in isolated kidneys perfused with Pluronic F108 is lower than in vivo, mainly as a result of an increase in PT. This rise in tubular pressure is due to an increased urine flow rate and an elevated tubular fluid viscosity. The difference in glomerular dynamics between NR and SHR kidneys is the result of an increased preglomerular vascular resistance in SHR, possibly due to an adaptive hypertrophic reaction to a sustained hypertension. PMID- 6866721 TI - Calmodulin-dependent Ca2+ transport in erythrocytes of spontaneously hypertensive rats. AB - Ca2+ transport in inside-out vesicles of the erythrocyte membranes of spontaneously hypertensive rats (SHR) was studied. In the presence of calmodulin, the rate of 45Ca uptake by the erythrocyte membranes of SHR was half that of erythrocyte membranes of the normotensive control group. It is suggested that the decrease of the rate of calmodulin-dependent calcium transport across the plasma membrane may be a cause for the increased intracellular calcium content found in some tissues of spontaneously hypertensive rats in previous studies. PMID- 6866723 TI - Primary lateral line response to water surface waves in the topminnow Aplocheilus lineatus (Pisces, Cyprinodontidae). AB - 1. The function of supraorbital organ II/2 of the head lateral line system of the surface feeding fish Aplocheilus lineatus is characterized here by the lateral line nerve response evoked by biologically relevant surface wave trains. 2. A single organ is particularly sensitive to the high frequency, low amplitude cycles at the beginning of a click evoked wave train. By using gated sinusoidal signals it was shown that the following mechanisms are responsible: a. a strong phasic component superimposed on the tonic response component, b. high sensitivity of the organ in the frequency range between 70 and 120 Hz (corresponding to the frequency range of the first cycles of a prey evoked wave), c. the organ is responsive to the acceleration component of wave stimulation (b approximately f2). 4. As the time structure of a surface wave is encoded in a corresponding discharge pattern in the lateral line nerve it is probable that the time structure ('stimulus pattern') of a signal is used by A. lineatus to estimate the distance to its source. PMID- 6866722 TI - Force-velocity relation in chemically skinned rat portal vein. Effects of Ca2+ and Mg2+. AB - Rat portal veins were chemically skinned using Triton X-100 and mounted for isometric and quick release experiments at 20 degrees C. The skinned preparations were activated by Ca2+ (EGTA-buffered) in solutions containing 2mM free-Mg2+ and 1 microM calmodulin. Half maximal isometric force was obtained at pCa = 6.2. Maximal force of the skinned preparations, at pCa = 4.5, was 8.2 +/- 0.8 mN/mm2 (n = 6). Force-velocity relations were determined at varied Ca2+-concentrations. Maximal shortening velocity (Vmax) was 0.10 +/- 0.01 lengths/s at pCa = 4.5. At decreasing Ca2+-levels Vmax decreased (at pCa = 6.25, Vmax = 0.051/s). At pCa = 9 an increased level of free-Mg2+ (15 mM) induces a slow and submaximal increase in tension. Force velocity relations of Mg2+-induced contractures were not different from those of Ca2+-contractures of similar magnitude (pCa = 6.3). The results indicate that the degree of activation of the contractile system, as regulated by Ca2+ and Mg2+, influences the kinetic properties of the actomyosin interaction as well as the force development. PMID- 6866724 TI - Circadian changes in heart rate in unanesthetized normotensive and spontaneously hypertensive rats. AB - Circadian changes in heart rate and heart rate variability were measured in spontaneously hypertensive (SHR) and normotensive (WKY) rats. Electrocardiograms (ECG) were continuously recorded, over a 24 hour period from freely moving conscious rats via three small metallic subcutaneous electrodes which were positioned a week before the recording period. The findings reported here show: 1/ Mean heart rate calculated over 24 hours were lower in both strains than previously reported. This difference probably reflects the lack of anesthesia and minimal stress in the present study. 2/ The timing of the circadian variations in both strains were the same, suggesting that were both entrained to the light-dark cycle. 3/ The 24 hours mean heart rate variability was significantly higher in SHR than in WKY but in each strain it was similar throughout the 24 hours. This suggests that the vagal tone in SHR was higher by a fairly constant amount throughout the light-dark cycle. PMID- 6866725 TI - Influence of muscle architecture on the length-force diagram. A model and its verification. PMID- 6866726 TI - Transport of adenosine by renal brush border membranes. AB - The transport of adenosine into brush border membrane vesicles from rat kidney is demonstrated. A first, rapid stage of transport is completed by 20 s. It is stimulated by a gradient of sodium. The effect of the concentration of adenosine in the low micromolar range on the initial rate of uptake indicates a saturability. An apparent Km of 1.48 microM and a Vmax of 215 pmol/mg protein/min have been calculated. In the rapid stage of uptake, adenosine is transported into the intravesicular space with no significant binding to the membrane. The following slow uptake is not stimulated by sodium and reaches steady state after about one hour. PMID- 6866727 TI - Endothelial cells are involved in the vasodilatory response to hypoxia. AB - The role of endothelial cells in the dilatory response of arteries to hypoxia was studied in vitro using perfused arterial segments of rat and dog. The pO2 of the intra- and extraluminal perfusate could be varied separately. Intraluminal hypoxia (pO2 of 40 mmHg) induced a dilation irrespective of extraluminal pO2 level. On the contrary extraluminal hypoxia could not elicit a dilation during intraluminal normoxic perfusion. Dilation during extraluminal hypoxia could only be induced if the segment was not intraluminally perfused. The dilatory response to intraluminal hypoxia was abolished after enzymatical or mechanical removal of the endothelium. While theophylline and lipoxygenase inhibitors did not influence this endothelium-induced dilation, a significant reduction of the response could be observed after incubation with indomethacin. These results support the concept that prostacyclin (PGI2) might be involved in the hypoxic endothelium-induced dilation. PMID- 6866728 TI - Topographical distribution of the secretin- and VIP-stimulated adenylate cyclase system in the heart of five animal species. AB - Adenylate cyclase stimulation by secretin and VIP was compared to the effect of glucagon, D,L-isoproterenol, Gpp[[NH]p, and NaF in atria and ventricles from rat, guinea pig, rabbit, dog and Cynomolgus monkey. In rat ventricular membranes, secretin was a better stimulant than VIP and was as active as D,L-isoproterenol. In rat auricular membranes both peptides were inactive. In guinea pig and rabbit heart membranes (ventricular and auricular) VIP and secretin were inactive. In dog and monkey atria, VIP stimulation of adenylate cyclase was comparable to that of D,L-isoproterenol, secretin being inactive. In dog ventricles, VIP was less efficient than D,L-isoproterenol, secretin being inactive. In monkey ventricles, by contrast, VIP was slightly more efficient than D,L-isoproterenol, secretin having a small effect only in left ventricles. The present results established a clear difference between animal species with respect to the efficacy of the peptides of the secretin/VIP family: the presence of "secretin-preferring" receptors in rat heart contrasted with the presence of "VIP-preferring" receptors in dog and monkey heart. Our results in dog and monkey hearts suggest that VIP might be a candidate for a physiological control of heart function. PMID- 6866729 TI - Effect of tetracaine on veratrine-mediated influx of sodium into rat brain synaptosomes. AB - Depolarization of synaptosomes with veratrine (0.1 mg/ml) or 50 mmol/l of KCl results in the release of radioactivity from 14C-choline loaded synaptosomes with partial dependence on external Ca2+. Like tetrodotoxin, tetracaine prevented veratrine but not KCl action, with a half-maximal effect at approximately 10(-5) mol/l of anesthetic. A similar half-maximal value was obtained for tetracaine blockade of veratrine-stimulated tetrodotoxin-sensitive 22Na influx into synaptosomes, complete blockage being achieved at 10(-4) mol/l. At this concentration tetracaine failed to modify Ca2+ channels measured by KCl-induced 45Ca uptake. Microviscosity of a lipid bilayer in synaptic membranes evaluated with 5- and 16-doxylstearate spin labels decreased at tetracaine concentrations exceeding 10(-3) mol/l. It is suggested that Na+ channels of synaptosomes are blocked by direct action of anesthetic or through changes in the channel annular lipids. PMID- 6866730 TI - The influence of guar gum on the movements of inulin, glucose and fluid in rat intestine during perfusion in vivo. AB - A two-stage perfusion technique was used to study the effect of guar gum on the inulin-accessible space and the uptake of water and glucose in rat intestine. Pre perfusion of test loops with low concentrations of guar, dispersed in saline, modified the rate of equilibration of inulin with the mucosal fluid space during a subsequent perfusion. The glucose absorption rate in such loops was reduced at a concentration of 50 mM, but not at 100 or 150 mM glucose. Fluid absorption was inhibited by pre-treatment with guar gum at all glucose concentrations tested. These results suggest that guar forms a layer closely associated with the mucosal surface which modifies the viscosity of the immediate fluid compartment, so that its resistance to diffusion is increased by means of an unstirred layer effect. PMID- 6866731 TI - Thermogenesis due to noradrenaline in muscles under different rates of perfusion. PMID- 6866732 TI - Effect of denervation on the hepatic haemodynamic response to hypercapnia and hypoxia in the dog. AB - The effect of hepatic and mesenteric arterial denervation on the hepatic haemodynamic response to hypercapnia and hypoxia was studied in 13 pentobarbitone anaesthetized greyhounds. Electromagnetic flowmeters were used to measure blood flow in the hepatic artery (HA) and portal vein (PV). Hypercapnia of 100 mm Hg PaCO2 increased PV blood flow and decreased HA blood flow, with opposite changes in mesenteric and HA vascular resistances. All parameters tended to return slightly towards baseline with extended periods of hypercapnia. HA denervation eliminated the changes in HA flow and resistance, while mesenteric arterial denervation appeared to prevent the secondary changes in PV blood flow and mesenteric vascular resistance. It is concluded that the sympathetic nervous system is responsible for the HA vasoconstriction observed during hypercapnia and that it exerts a delayed slight inhibitory influence on a predominantly direct vasodilatory effect of carbon dioxide on the mesenteric vasculature. Hypoxia of 40 mm Hg PaO2 produced sustained increases in HA and mesenteric vascular resistances and a small increase in PV blood flow, together with a pronounced increase in systemic arterial blood pressure. HA denervation eliminated the HA resistance increase and caused the HA blood flow to increase during hypoxia. Mesenteric arterial denervation prevented the increases in mesenteric resistance. PV flow and arterial blood pressure from being sustained throughout the hypoxic period. It is concluded that hypoxia produces a sympathetically mediated mild vasoconstriction of both the HA and mesenteric vascular systems. PMID- 6866733 TI - A simple method for controlling the fluid level in a small experimental chamber during slow and rapid fluid exchange. AB - A simple and cheap method is devised for controlling the fluid level in an open chamber for physiological or other experiments. Fluid is pumped into the chamber at variable flow rate using a conventional pump. Autoregulated drainage is achieved through a capillary tube whose bevelled opening is covered with a net with fine meshes. Part of the opening dips into the fluid surface. The correct amount of fluid is sucked out of the chamber by a constant negative pressure at the back of the tube. The 1 mm depth of a 2 microliters volume stays within +/- 2% when the normal flow of 1 microliters/s is doubled and halved, respectively. A 100-fold increase of flow, as needed for flushing the chamber, causes a rise of the surface level by 0.5 mm only. PMID- 6866734 TI - Technique for producing heart block in closed-chest dogs without electrical recording. AB - An instrument and technique have been devised for the production of complete atrioventricular heart block in anesthetized, closed-chest animals. The instrument is inserted into the right atrium via the right external jugular vein. Localization of the atrioventricular node region by the visualization of intracardiac landmarks with fluoroscopy makes electrical recording unnecessary. Discrete injections of a radiopaque necrosing solution produces the heart block. Procedure time is under 30 min a success rate of 90%. PMID- 6866735 TI - A possible Ca2+-induced Ca2+ release mechanism mediated by norepinephrine in vascular smooth muscle. AB - In vascular smooth muscle, the norepinephrine-sensitive Ca2+ store is distinct from the sarcoplasmic reticulum. Under physiological conditions, Ca2+ released from the norepinephrine-sensitive store may induce Ca2+ release from the sarcoplasmic reticulum, i.e. norepinephrine mediated activation may involve a Ca2+-induced Ca2+ release mechanism. PMID- 6866737 TI - [Measurement system of bone mineral content by coherent/Comptom scattering method]. PMID- 6866736 TI - [A successfully treated case of malignant pheochromocytoma by arterial embolization using absolute ethanol]. PMID- 6866739 TI - [An investigation on coating effects of angiographic guide wires. II. Anticoagulability]. PMID- 6866738 TI - Early glottic carcinoma: an analysis of dose-time-volume factors affecting radiation failure and late complications. PMID- 6866741 TI - [Image diagnosis of renal angiomyolipoma]. PMID- 6866740 TI - Sequential metrizamide computed tomographic myelography in syringohydromyelia. PMID- 6866742 TI - [CT diagnosis of tumors of the mediastinum]. PMID- 6866743 TI - [CT images of brain metastases of the primary lung cancer]. PMID- 6866744 TI - Diagnosis of chronic pancreatitis by endoscopic retrograde pancreatic parenchymography (ERPP). PMID- 6866745 TI - [A Study on regional cerebral blood flow measurement by 133Xe inhalation method]. PMID- 6866746 TI - [Localized irradiation on tumors and immune cell reactions--histoenzymatic evaluation using MM 46 tumor and Ehrlich tumor-bearing C3H/He mice]. PMID- 6866747 TI - [Experimental study on imaging diagnosis. I. Determination of cerebral circulation in a cerebral infarction model using an autoradiographic method]. PMID- 6866749 TI - The role of anesthesia in surgical mortality in horses. PMID- 6866748 TI - Epidemiologic factors in puerperal diseases of sow. AB - The frequency of puerperal diseases was studied in a single, large, closed herd. Over a period of 24 months, treatment was given in connexion with 31% of 1360 farrowings. 25% of these treatments were based on the diagnosis mastitis and 75% on the less specific diagnosis farrowing fever. Statistical associations were investigated between these groups of diseases and factors such as time (season), disease and mortality in offspring, litter size, parity, and breed combinations. Major differences were found between the two syndromes, and, consequently, the common term MMA (Mastitis-Metritis-Agalactia) should not be applied. The major associations were found between farrowing fever and age and breed of the sow. Prospects of a frequency reduction are discussed. PMID- 6866750 TI - A method for quantitative assessment of bone formation using double labelling with tetracycline and calcein. An experimental study in the navicular bone of the horse. PMID- 6866751 TI - A new approach to meat inspection. PMID- 6866752 TI - Diagnosis of mycoses on histological slides. PMID- 6866754 TI - 22d meeting of the Study Group on Hemostasis and Thrombosis. Strassburg, 25-26 November 1982. Abstracts of poster sessions. PMID- 6866753 TI - [Monitoring anticoagulant treatment with the KEM-O-MAT 2HP autoanalyzer]. AB - Synthetic chromogenic substrates were adapted to KEM-O-MAT 2HP for an automated monitoring of anticoagulant treatments, determination of factor X (S 2337) in oral anticoagulation, anti-Xa (Hepachrom) and anti-lla (S 2238) activities of heparin in prophylactic and curative heparin therapies. In all cases, these methods revealed high sensitivity, reproducibility, and a good correlation of their results with those of classical clotting assays. The present cost of synthetic substrates seriously limits the potential value of chromogenic assays for routine controls. However, the development of automated amidolytic techniques should provide an easier standardization in the laboratory control of anticoagulant treatments. PMID- 6866755 TI - [Cytogenetics and acute non-lymphoblastic leukemias. Value of short-term cultures]. AB - Normal and abnormal results of chromosome studies performed on 101 acute nonlymphoblastic leukemia (ANLL) patients were compared according to the bone marrow and/or blood cell culture times. A higher proportion of abnormal karyotypes was observed after culture than on direct preparations in acute promyelocytic leukemia and in acute myeloblastic leukemia with t(8-21) translocation; in some cases the chromosome abnormality seen after culture was not detected with the direct technique. No clear-cut differences in chromosome studies resulted when the differing techniques were applied to other forms of ANLL. In contrast the classification of individual patients into AA and AN categories differed in some cases when determined by direct or culture techniques. These results have to be taken into consideration in the study of relationships between chromosome anomalies and prognosis. PMID- 6866756 TI - [Prognostic value of chromosome anomalies in acute non-lymphoblastic leukemias]. AB - The results of a cytogenetic study on 240 acute nonlymphocytic leukemia patients (187 adults and 53 children) were classified in NN (normal), AN (abnormal and normal) and AA (abnormal). Pronostic value of the classification was presented. A higher proportion of complete remission failures was observed in chromosomally abnormal patients (AN and AA). Survival of patients with complete remission was significantly shorter in AN and AA patients than in NN patients. An excess of constitutional chromosome abnormalities was observed in children. PMID- 6866757 TI - [Pharmacokinetic study of doxorubicin in the treatment of malignant non-Hodgkin's lymphomas]. AB - We have studied the plasma kinetics of doxorubicin treatment in nine patients with non-Hodgkin's malignant lymphoma. Four patients were studied following the first two injections of this drug, the other five patients were studied only after the first injection. Our results corroborate the existence of three successive phases of doxorubicin plasma decay, with mean half-lives of 3.81 min, 1.19 h and 29 h. We observed an important variation of the pharmacokinetic parameters related to the distribution volumes. The total plasmatic clearance ranged between 32 and 67 l/h. The kinetics of doxurubicin are time-dependent, i.e. an important variation of the pharmacokinetic parameters related to the distribution volumes. The total plasmatic clearance ranged between 32 and 67 l/h. The kinetics of doxurubicin are time-dependent, i.e. an important variation of the pharmacokinetic parameters existed after the 2nd injection of the drug in three out of four patients. These 3 patients showed either an increase of the elimination half-life (1 case) or an increase of the distribution volume (1 case) or a decrease of the distribution volume (1 case) after the 2nd injection. We observed a significant correlation between the age of the patients and the early clearance of the drug, the youngest patients eliminating the drug more rapidly than the oldest ones. This observation may lead to the administration of different dosages of doxorubicin according to the age of the patient. PMID- 6866758 TI - Adherence properties of hairy cells. AB - The Hairy Cells (HC) from four patients with Hairy Cell Leukemia (HCL) were studied. These cells exhibited membrane properties of B-lymphocytes; quantitation of surface membrane immunoglobulins by the peroxidase labeled antibody technique showed an average number of 20,000 to 40,000 immunoglobulin molecules per marked cell. Observations by scanning electron microscopy (SEM) showed that HC have a great capacity to adhere quickly to glass coverslips, to phagocytose latex particles, and to resist trypsin treatment. These cells possess numerous inter cellular connections forming a network on the glass-coverslip, and thin cytoplasmic projections enabling them to adhere. When cells adhering to a support are stimulated by latex particles, they are able to phagocytose these particles and this results in the swelling of the cell due to the unpleating of numerous folds of the membrane. After this stimulation, HC appeared smooth. Our SEM analysis provides an explanation of the disappearance of the hairy appearance classically described. After trypsin treatment, the adhering HC remain on the glass even if they have suffered membrane damage. In conclusion, SEM examination of adhering cells and phagocytosis demonstrate the variability of the membrane aspect of the HCL cells under various culture conditions. PMID- 6866759 TI - Compilation of tRNA sequences. PMID- 6866761 TI - Compilation of sequences of tRNA genes. PMID- 6866760 TI - Collection of published 5S and 5.8S ribosomal RNA sequences. PMID- 6866762 TI - Polyribosome binding of rabbit globin messenger RNA and messenger ribonucleoprotein labelled with bacteriophage-T4 RNA ligase and 5'-[32P] phosphocytidine 3'-phosphate. AB - Rabbit polyribosomal globin messenger RNA (mRNA) and messenger ribonucleoprotein (mRNP) were labelled at the 3' poly(A) tail to high specific activity with T4 RNA ligase and [5'-(32)P]pCp without consequent loss of functional activity. Labelled message was translated in both micrococcal nuclease treated and untreated rabbit reticulocyte lysates, as shown by the formation of labelled polyribosomes. The utilisation of labelled messenger was abolished by T2 toxin or sodium fluoride which are known to inhibit protein synthesis.Images PMID- 6866763 TI - Subspecies of DNA polymerase alpha from calf thymus with different fidelity in copying synthetic template-primers. AB - Three different subspecies of DNA polymerase alpha from calf thymus sedimenting at 9 S, 7 S and 5.7 S have been investigated with respect to their accuracy of in vitro DNA synthesis on poly (dA) (dT)16 and poly d(AT) as template-primers. Our results indicate that the structure of DNA polymerase alpha has a strong influence on the accuracy of DNA synthesis. The 9 S enzyme shows a misincorporation frequency of about 1:100 000. An error rate of 1:15 000 is measured for the 7 S species. The 5.7 S enzyme for which an error rate of 1:3 000 is determined, has to be considered as error prone. Lowering the rate of DNA synthesis leads to a decrease in fidelity. The single stranded DNA binding protein from E.coli increases the accuracy of the 5.7 S and the 7 S enzyme by a factor of two. Mn2+ decreases the fidelity of all three subspecies in a concentration dependent manner. PMID- 6866764 TI - Control of 5S RNA transcription in Xenopus somatic cell chromatin: activation with an oocyte extract. AB - A chromatin fraction enriched for Xenopus 5S RNA genes has been isolated by restriction endonuclease digestion and sucrose gradient velocity sedimentation. Soluble chromatin sedimenting at 70-80S contains approximately 50% of the oocyte expressed 5S RNA genes and only 1.5-3% of total chromatin DNA; this represents a 15- to 30-fold purification of the 5S genes. Such chromatin isolated from somatic cells (blood and cultured kidney cells) retains the transcriptionally-inactive state of the oocyte-expressed 5S genes. Soluble chromatin from somatic cells prepared by micrococcal nuclease digestion also retains the inactive state of the oocyte-type 5S genes. It is likely that the level of chromatin structure responsible for inactivity of the oocyte genes in somatic cells is the nucleosome or short chains of nucleosomes and not supranucleosomal structures. The oocyte type genes can be rendered transcriptionally active in somatic cell chromatin either by salt extraction of some chromosomal proteins or by treatment with the ion exchange resin Dowex A50W-X2. Alternatively, activation of these genes can be achieved by incubating somatic cell chromatin or nuclei with an extract prepared from Xenopus oocytes. This effect is not specific for 5S RNA genes as the transcription of other small RNAs (including pre-tRNA) is stimulated by the oocyte extract. The activating factor(s) is resistant to micrococcal nuclease, nondialyzable, heat labile and sensitive to trypsin; thus it is highly likely to be a protein or a group of proteins. Partial purification of the activating factor(s) has been achieved by ion exchange chromatography. PMID- 6866765 TI - Size fractionation of Trypanosoma brucei DNA: localization of the 177-bp repeat satellite DNA and a variant surface glycoprotein gene in a mini-chromosomal DNA fraction. AB - We have size-fractionated intact DNA from Trypanosoma brucei into a major large DNA fraction (greater than 350S) and minor middle-sized (60-250S) and small (less than 60S) DNA fractions. Large DNA contains the rRNA genes, the basic copy genes for several variant surface glycoproteins (VSGs), including one which lies near a telomer, and the expression-linked copies of the two VSG genes. The middle-sized DNA contains at least one VSG gene, but the hybridization of this fraction with probes for the conserved repetitive sequences that mark the edges of the transposed segments of VSG genes, suggests that it may contain many VSG genes. The 177-bp repeat satellite DNA is also exclusively found in this fraction. PMID- 6866766 TI - Histone hyperacetylation has little effect on the higher order folding of chromatin. AB - HeLa cells were grown in the presence of 10 mM sodium butyrate and soluble chromatin containing hyperacetylated histones was prepared by mild micrococcal nuclease digestion and sucrose gradient fractionation. Sedimentation and electric dichroism were used to study the cation-induced folding of this acetylated chromatin from the 10 nm filament to the 30 nm solenoid conformation. Although under some conditions acetylated chromatin appears slightly less condensed than control chromatin, the major conclusion is that hyperacetylation of histones does not in itself prevent the formation of the higher order chromatin solenoid. PMID- 6866767 TI - Nucleotide sequences of H1 histone genes from Xenopus laevis. A recently diverged pair of H1 genes and an unusual H1 pseudogene. AB - Four clones containing H1 histone gene sequences were previously isolated from a Xenopus laevis genomic library (1) and we now present the complete nucleotide sequences of these H1 genes and their flanking regions. Two of these genes code for minor H1 proteins, probably H1C, when expressed in the oocyte transcription/translation system and are present on clones with almost identical overall organization. However, at the nucleotide level these genes differ in showing base insertions and deletions, as well as substitutions. A third gene sequence which is more related to the major X. laevis H1A, corresponds to the 3' two thirds of an H1 gene. This gene has in place of a 5' coding region at least 1800 bp of apparently noncoding sequence, some of which is A-T rich. The junction does not correspond to the consensus sequence of an intron/exon boundary and therefore this H1 sequence is more likely to represent a pseudogene. Comparisons of the coding and flanking regions of these X. laevis H1 genes indicate the kind of differences which can occur among H1 subtypes within a species. A region of homology noted in the 3' noncoding portion of vertebrate histone genes is discussed in relation to the mechanism of termination of transcription. PMID- 6866769 TI - The incorporation of O6-methyldeoxyguanosine and O4-methyldeoxythymidine monophosphates into DNA by DNA polymerases I and alpha. AB - The modified nucleoside 5'-triphosphates O6-MedGTP ad O4-MedTTP have been synthesised and their acceptability as DNA-precursors investigated using DNA polymerases I and alpha in an in vitro assay. O6-MedGMP is only incorporated into newly-synthesized DNA-like material in the presence of templates containing thymine bases. Similarly O4-MedTMP is only incorporated in the presence of templates containing guanine bases. The results confirm the promutagenic nature and base-pairing properties of O6-MeG ad O4-MeT. PMID- 6866770 TI - Spectroscopic studies of (m5dC-dG)3: thermal stability of B- and Z-forms. AB - The hexanucleoside pentaphosphate d(m5CpGpm5CpGpm5CpG) has been studied in solution by ultra-violet absorption, circular dichroism and 31P nuclear magnetic resonance under various experimental conditions. In 0.2 M NaClO4 at low temperature, an hexamer duplex is formed which has a B or B-like conformation. As the salt concentration is increased, a transition from a B-form to the Z-form occurs and is complete in 3 M NaClO4. In 3 M NaClO4, the behavior of the Z double helix is complex as a function of temperature. The variation of the circular dichroism at 295 nm is biphasic. A first transition occurs over a large range of temperature and corresponds to a conformational change due to a non-cooperative intramolecular process. Ultra-violet absorption and 31P nuclear magnetic resonance show that the new conformation arising from a distortion of the backbone is not similar to that observed in low salt conditions (B-form). At high hexanucleotide concentration, aggregates are formed. The second transition is cooperative and corresponds to the melting of a double stranded helix into single strands. PMID- 6866768 TI - Heteronomous DNA. AB - A fibrous form of poly d(A):poly d(T) has a heteronomous secondary structure which is the first to be confirmed for a polynucleotide duplex: although both chains are 10(1) helices, mutually hydrogen-bonded in the standard (Watson-Crick) fashion, each has a quite different conformation. One chain -- probably poly d(A) -- has C3'-endo-puckered furanose rings characteristic of the A family of polynucleotide secondary structures while the other -- probably poly d(T) -- has the C2'-endo-puckered rings of the B family. Since analogous heteronomous structures could be assumed by DNA-DNA or DNA-RNA duplexes containing more general base sequences the polymorphic range of polynucleotide double-helices may be even greater than we have come to suppose. PMID- 6866772 TI - Conformational characteristics of the trinucleoside diphosphate xyloA2'-5'xyloA2' 5'xyloA. A nuclear magnetic resonance and CD study. AB - In this paper the conformational analysis of the 2'-5' linked xylotrinucleotide xA2'-5'xA2'-5'xA is reported. The title compound is an analogue of A2'-5'A2'-5'A, which compound was shown to display inhibitive effects on protein synthesis. The complete 1H-NMR assignment of the high field spectral region of the xylose trimer is given. Modes of base-base stacking are extracted from coupling constant data at various temperatures. Circular dichroic (CD) spectra confirm the presence of stacked states at low temperature. Xylonucleosides are known to prefer the N-type sugar conformation. However, in the present trimer the S-type conformer is suggested to partake in stacked conformations. Two types of stacking in the two constituent dimer fragments of the trimer are proposed to rationalize the NMR data: xA(1)N-xA(2)S and xA(2)N-xA(3)S. PMID- 6866771 TI - 1H NMR study of an ethidium dimer poly(dA-dT) complex: evidence of a transition between bis and monointercalation. AB - Comparative 1H NMR and optical studies of the interaction between poly(dA-dT), ethidium bromide (Et) and ethidium dimer (Et2) in 0.7 M NaCl are reported as a function of the temperature. Denaturation of the complexes followed at both polynucleotide and drug levels leads to a biphasic melting process for poly(dA dT) complexed with ethidium dimer (t1/2 = 75 degrees C; 93 degrees C) but a monophasic one in poly(dA-dT): ethidium bromide complex (t1/2 = 74 degrees C). In both cases drug signals exhibit monophasic thermal dependence (Et = 81 degrees C; Et2 = 95 degrees C). Evidence is presented showing that the ethidium dimer bisintercalates into poly(dA-dT) in high salt, based on the observation that i) dimer and monomer ring protons exhibit similar upfield shifts upon DNA binding, ii) upfield shifts of DNA sugar protons are twice as large with the dimer than with ethidium bromide. Comparison between native DNA fraction and bound drug fraction indicates that ethidium covers, n = 2.5-3 base pairs. The dimer bisintercalates and covers, n = 5.7 base pairs when the helix fraction is high but as the number of available sites decreases the binding mode changes and the drug monointercalates (n = 2.9). PMID- 6866773 TI - Conformational analysis of the trinucleoside diphosphate 3'd(A2'-5'A2'-5'A). An NMR and CD study. AB - A 500 MHz and 300 MHz NMR study of the trinucleoside diphosphate 3'd(A2'-5'A2' 5'A) is presented. In addition, circular dichroism is used to study base stacking in the title compound. The complete 1H-NMR spectral assignment of the sugar ring proton signals is given. Information about the sugar ring (N- or S-type conformation) and about the backbone geometry along C4'-C5' and C5'-O5' bonds is obtained from the NMR coupling constants. It is shown that the trimer mainly occurs in the N-N-N stacked state at low temperatures; the presence of a minor amount of N-N-S conformational sequence is indicated. PMID- 6866774 TI - Conformational analysis of oligoarabinonucleotides. An NMR and CD study. AB - A 500 and 300 MHz proton NMR study of the series of oligoarabinonucleotides 5'aAMP, 3'aAMP, aA-aA, (aA-)2aA and (aA-)3aA is presented. In addition, circular dichroism is used to study the stacking behaviour of aA-aA. The complete 1H-NMR spectral assignment of the compounds (except the tetramer) is given. Proton proton and proton-phosphorus coupling constants, obtained by computer simulation of the high-field region of the spectra, yield information on the conformation of the arabinose rings (N- or S-type) and on the intramolecular stacking properties of the dimer and the trimer. The monomers 5'aAMP and 3'aAMP exhibit a preference for N- and S-type sugar conformation, respectively. It is shown that the dimer aA aA at low temperature prefers a mixed stacked state of the type aA(S)-aA(N). In the trimer the aA(2)-aA(3) fragment exhibits a conformation similar to that found in the dimer, whereas the aA(1) residue prefers to adopt S-type sugar and has some tendency to stack upon residue aA(2). PMID- 6866775 TI - An efficient method for finding repeats in molecular sequences. AB - The problem of finding repeats in molecular sequences is approached as a sorting problem. It leads to a method which is linear in space complexity and NlogN in expected time complexity. The implementation is straightforward and can therefore be used to handle large sequences with relative ease. Of particular interest is that several sequences can be treated as a single sequence. This leads to an efficient method for finding dyads and for finding common features of many sequences, such as favorable alignments. PMID- 6866776 TI - Should treatment of highly differentiated thyroid carcinoma be conservative? AB - On the basis of three selected cases (one with clinically occult follicular and two with metastatic papillary carcinoma) the necessity of a comprehensive therapeutic concept even in highly differentiated thyroid cancer is stressed. Thyroid tissue and regional metastases should be eliminated by surgery, followed by radioiodine therapy in any event. Radiation teletherapy should be reserved to patients with invasive tumor growth exceeding the organ capsule, with lymph node metastases, and with massive angioinvasive growth. PMID- 6866777 TI - Scintigraphic myocardial imaging with 99mTc-labelled gluconate of experimentally produced cardiomyopathy in dogs. AB - In 10 dogs experimental cardiomyopathy was produced using high intravenous doses of adrenaline and theophylline. The possibility of scintigraphic detection of this non-ischaemic damage was tested by means of 99mTc-gluconate. In 5 dogs the scintigraphic examination was carried out 4 hrs following the production of the damage. In all 5 cases a marked positivity of the heart scan was observed. The finding was confirmed by the radioactivity of tissue samples from all sections of the heart. In 3 out of 5 dogs the histological examination of the myocardium (PAS and HBFP staining) was positive. In the remaining 5 dogs the scan was performed 24 hrs following the development of the damage. A positive scintigraphic finding was observed in 4 cases, the degree of accumulation being lower than at 4 hrs. The radioactivities of tissue samples were also significantly lower as compared with the 4-hr values. In contrast, the histological findings were markedly positive in all 5 dogs. It follows that 99mTc-gluconate is capable of detecting in addition to infarctions non-ischaemic damages to the myocardium, too. The normalization of the finding is very quick. This experimental finding appears to be of importance in clinical practice. PMID- 6866778 TI - [Significance of background correction in the determination of left ventricular ejection fraction by the gated blood pool method]. PMID- 6866779 TI - [Further development in the quantitative analysis of myocardial scintigraphy with 201Tl]. PMID- 6866780 TI - [Non-invasive determination of pressure and volume parameters of left ventricular function]. AB - The volume parameters of cardiac function, obtained by gated-blood-pool scintigraphy, were supplemented by the ventricle dimensions and by the medium arterial pressure, measured non-invasively after Riva-Rocci. From this, the systolic effect as a load-dependent parameter of contractility and the global effect of the left ventricle were derived. If the latter is related to the volume effect, information about the relative efficiency of the heart action is obtained. By studying three collectives of patients with different performance abilities of the left ventricle it was shown that, by including the ventricle geometry and the medium arterial pressure, the myocardial contractility can be better assessed quantitatively as well as qualitatively and that useful data about the performance economy of the heart can be obtained. PMID- 6866781 TI - [Origin and life cycle of human monocytes]. PMID- 6866782 TI - [Effect of the plan of therapy on prognosis in thyroid cancer]. AB - The therapeutic concept used in our Department for the treatment of thyroid cancer is characterized by a facultative external irradiation of the neck region and by a mandatory and intense treatment with radioiodine. The latter includes a complete elimination of remaining normal thyroid tissue and a combined diagnostic add therapeutic radioiodine application in the follow-up of the disease. The therapeutic effect of surgery, hormone substitution, radioiodine treatment and external irradiation combined with the prognosis of thyroid cancer was obvious, but that of individual steps was difficult to separate and quantitate. External irradiation of the neck improved the prognosis of patients with anaplastic carcinoma but no significant effect was observed in patients with follicular carcinoma. Even after prophylactic treatment with high doses of radioiodine the prognosis of differentiated thyroid cancer remained to be highly dependent on biological factors. Radioiodine treatment is recommended in all patients with follicular carcinoma and in patients older than 30 years with papillary carcinoma, but prophylactic treatment should only be performed for a period of 5 years. PMID- 6866783 TI - Interview with Frank A. Oski: prevention of pneumococcal infection in children with sickle cell hemoglobinopathies. PMID- 6866784 TI - Significance of viral infections in severe combined immunodeficiency disease. AB - An analysis of a prospective study of viral infections in 12 patients with severe combined immunodeficiency is presented. Infections of viral etiology were common, with pulmonary and gastrointestinal infections being most frequent. Fourteen of 25 infections (56%) were nonsocomially acquired and 10 of 25 (40%) were community acquired. The period of symptomatology and the duration of viral excretion were usually prolonged beyond those associated with disease in the general pediatric population. Pulmonary infections were associated with considerable morbidity and mortality. Gastrointestinal infections disrupted gastrointestinal function and possibly played a role in enteric Gram-negative bacillary sepsis. The inability of these patients to eradicate these viruses in the absence of immunologic reconstitution resulted in significant morbidity, often with a fatal outcome. PMID- 6866785 TI - Etiology and treatment of facial cellulitis in pediatric patients. AB - By a retrospective chart review patients with buccal cellulitis were divided into groups with and without a probable portal of entry of infection at the time of diagnosis. Tooth abscesses or breaks in the skin were the usual portals of entry. Patients with a portal of entry were significantly older (P less than 0.001), had lower white blood cell counts on admission (P less than 0.01) and recovered more rapidly (P = 0.001). Haemophilus influenzae type b was recovered only from those with no portal of entry. Staphylococcus aureus and Streptococcus pyogenes caused infection in both groups but were more frequent in those with a portal of entry. Bacteremia was proved only in the group with no portal, and H. influenzae b grew from 14 to 15 positive blood cultures. All cultures of cerebrospinal fluid yielded no growth. We suggest that patients with no portal of entry on presentation receive initial parenteral therapy for H. influenzae b and Gram positive cocci. Our current regimen is a combination of a semisynthetic penicillinase-resistant penicillin such as oxacillin and chloramphenicol. Oxacillin alone is indicated for those with a break in the skin leading to infection, whereas penicillin is appropriate for patients with dental infection. This initial therapy should be altered depending upon culture results when available. PMID- 6866786 TI - Acquired syphilis in prepubertal children. PMID- 6866787 TI - Tuberculosis of the middle ear and mastoid. PMID- 6866788 TI - Tuberculous mesenteric lymphadenitis in children. PMID- 6866789 TI - Neonatal suppurative thyroiditis. PMID- 6866791 TI - Management of the child with a red and swollen eye. PMID- 6866790 TI - Postanginal sepsis in adolescence. PMID- 6866793 TI - Pertussis vaccine. PMID- 6866794 TI - Mixing rifampin. PMID- 6866792 TI - The cefaclor-amoxicillin controversy. PMID- 6866795 TI - Tularemic pharyngitis. PMID- 6866797 TI - Fungi: friends and foes. PMID- 6866796 TI - Neutropenia and fever. PMID- 6866798 TI - Infections associated with upper airway obstructive findings. PMID- 6866799 TI - Bacterial endocarditis in infants and children: incidence and pathogenesis. PMID- 6866800 TI - Bone and joint infections. PMID- 6866801 TI - Penicillin allergy. PMID- 6866802 TI - Panel on immunizations. PMID- 6866803 TI - A practical approach to office identification of the immunodeficient child. PMID- 6866804 TI - Cholecystokinin and bombesin effects on rewarded and nonrewarded operants. AB - Rats were food-rationed (15 g/day) and trained to bar-press for food. In Experiment 1, the animals were injected with cholecystokinin octapeptide (CCK, 2 micrograms/day), bombesin (BBS, 12 micrograms/kg), normal saline, or prefed with 20 Noyes 45 mg pellets. The animals were then tested for one hour for bar pressing responses with food reward. In Experiment 2, the animals were similarly trained, treated, and tested for bar-pressing responses without food reward. The results showed that BBS and prefeeding decreased bar-pressing, rewarded or non rewarded, but the CCK effect was greatly decreased when food was withheld. It appeared that the CCK effect was more dependent upon the presence of food than the BBS or prefeeding effects. The results were discussed in terms of involvement of the food and reward-related oropharyngeal stimuli for the CCK effect and the drive-related stimuli for the BBS and prefeeding effects. PMID- 6866805 TI - Radioimmunoassay for Lys8, Asn9, neurotensin 8-13: tissue and subcellular distribution of immunoreactivity in chickens. AB - A sensitive and specific radioimmunoassay (RIA) for Lys8, Asn9, neurotensin 8-13 (LANT-6) has been developed which utilizes 125I-labeled LANT-6 and rabbit antisera raised towards conjugates of synthetic LANT-6 and bovine thyroglobulin. The antiserum described (TG-22) allows the detection of ca 100 fmol of LANT-6 and crossreacts less than 0.01% with chicken or bovine NT. Dose-response relationships for the native (chicken) and synthetic peptides were indistinguishable. Using this assay the distribution of immunoreactive LANT-6 (iLANT-6) through various tissues of the chicken was studied and compared with that of chicken NT (iNT) determined by RIA. Both iNT and ILANT-6 were found primarily in the brain and gastrointestinal tract, however, their regional distributions were found to differ. Subcellular distribution studies in homogenates of chicken brain indicated that both iNT and iLANT-6 were associated with synaptosome-like and vesicle-like particles. In homogenates of small intestine, pancreas and colon iNT and iLANT-6 appeared to be within osmotically sensitive, sedimentable particles. Analyses using high pressure liquid chromatography established that chicken iLANT-6 co-eluted with the synthetic peptide and that similar substances were present in extracts of rat brain and intestine. These results are consistent with "messenger' roles for these peptides. PMID- 6866807 TI - Vasopressin analog delays extinction of classically conditioned bradycardia. AB - Albino rabbits were subjected to Pavlovian (classical) conditioning and extinction of concomitant heart rate and eyeblink responses. Sixty minutes before each of three extinction sessions animals were treated with 5 or 20 micrograms/kg of deamino-dicarba-arginine-8-vasopressin or saline. Vasopressin treatment delayed extinction of bradycardiac conditioned responses but did not affect concomitant eyeblink conditioned responses. It was concluded that classically conditioned autonomic responses may be useful tools for studying the effects of peptides on learning. PMID- 6866806 TI - Enkephalin-containing polypeptide levels in normal tensive and SHR rat adrenal glands. AB - The levels of enkephalin-containing polypeptides (ECPs) in the adrenal glands of normal tensive rats (WKY) and spontaneously hypertensive rats (SHR) were compared. Innervated and denervated adrenals from both types of rats showed very similar levels of ECPs. The only difference observed was a small increase in the 18 kdal ECP and a concomitant decrease in the 12 kdal and 5.3 kdal ECPs in the innervated SHR rat adrenal gland. From these data it appears that the adrenal ECPs are not a major contributor to hypertension in the SHR rat nor does hypertension, at this age, affect the ECP levels. PMID- 6866808 TI - Neurotensin interacts with dopaminergic neurons in rat brain. AB - Neurotensin (NT) injected intracerebroventricularly in rat increases dopamine (DA) turnover in the corpus striatum and nucleus accumbens. Significant increases in 3,4-dihydroxyphenylacetic acid (DOPAC) levels occurred within 15 minutes after injection with peak levels at 60 minutes. The effect on NT on DOPAC and homovanillic acid (HVA) accumulation was dose-dependent at 3-100 micrograms. NT, like haloperidol, stimulated 3,4-dihydroxyphenylalanine (DOPA) accumulation in striatal neurons, in the presence of DOPA decarboxylase inhibitor, after injection of gamma-butyrolactone (GBL). NT had a similar stimulatory effect on DOPA levels in the accumbens while haloperidol (0.25 mg.kg-1) had no significant effect in this brain region. NT did not block the inhibitory effect of apomorphine on DOPA accumulation in both the striatum and accumbens, while haloperidol inhibited apomorphine effect in both regions. NT also failed to displace 3H-spiperone from DA receptors and the presence of NT in the binding assay did not alter the ability of DA to displace 3H-spiperone in either brain region. These experiments demonstrate that NT increases DA turnover in both the nigrostriatal and mesolimbic pathways. PMID- 6866809 TI - Absorption of alpha-MSH from subcutaneous and intraperitoneal sites in the rat. AB - Pentobarbitone anesthetized rats were injected with 30 nmol (50 micrograms) alpha MSH administered intraperitoneally (IP) and subcutaneously (SC) in an acid-saline vehicle, or SC in a zinc phosphate vehicle. Concentrations of alpha-MSH in plasma were measured by radioimmunoassay. The pharmacokinetic parameters for the three modes of administration were determined by fitting a one-compartment open model to the plasma level data. The t1/2 for absorption using the saline vehicle was 7.3 and 5.6 min from the IP and SC sites, respectively. The t1/2 for absorption from the zinc phosphate complex of 17.7 min was significantly longer. Five percent of the IP dose was absorbed into the systemic circulation giving a peak plasma level of 14.1 nmol/l. The absorption of 2-3 percent was significantly lower following SC administration; peak plasma levels were 8.3 and 4.8 nmol/l for the saline and zinc phosphate vehicles, respectively. The low percentage absorption values indicated a high degree of metabolism of the peptide by peripheral tissues on its passage from the injection sites into the circulation. PMID- 6866810 TI - Central and peripheral components of dermorphin's effect on rat intestinal propulsion in comparison to morphine. AB - Dermorphin, injected intracerebroventricularly (ICV) to rats, provokes, like to morphine, an inhibition of intestinal propulsion linearly related to the log of the administered doses (in the range from 0.06 to 0.56 micrograms/rat), but it is 143 times more active than morphine. Naloxone, ICV or IP, antagonizes dermorphin less effectively than morphine. Quaternary naloxone ICV administered antagonizes the intestinal effect of ICV dermorphin, while IP administered it is not effective until 8 mg/kg. The dose of dermorphin maximally active by the ICV route (0.56 micrograms/rat) is completely inactive when injected IP. Increasing doses of dermorphin IP (from 12 to 6400 micrograms/kg) inhibit intestinal propulsion to the same extent irrespectively of the doses employed, but never by more than 50%. Only a high dose of naloxone (30 mg/kg/IP) antagonizes this IP effect. The central and peripheral components of this intestinal effect of dermorphin are discussed. PMID- 6866811 TI - Calcitonin--C.N.S. action to control the pattern of intestinal motility in rats. AB - Synthetic calcitonin injected into the lateral ventricles (ICV) of rats at picomolar concentration restores the "fasted' motility pattern of the small intestine in fed rats at doses as low as 0.083 picomoles. This effect which appeared in less than 5 min and persisted at least 2 hours for 0.83 picomole, was blocked by a previous intraventricular administration of 10 micrograms/ of calcium gluconate. At 0.83 picomole ICV, calcitonin also suppressed the disruption of the "fasted' pattern induced by intravenous infusion of Pentagastrin (6 micrograms.kg-1.h-1) but not that induced by insulin (0.5 U.kg 1). These findings support the hypothesis that calcitonin acts centrally to control the pattern of intestinal motility by inhibiting the digestive influences responsible for the "fed' pattern. All of these peripheral influences are mediated by a Ca++ sensitive central structure. PMID- 6866814 TI - [Accidental hypothermia]. PMID- 6866812 TI - Action of anorexigenic peptide injected into the brain: dissociation of effect on body weight and feeding in the rat. AB - Previous reports on the effect of anorexigenic peptide (AXP) administered systemically in the rodent are inconsistent in terms of the effect of the tri peptide on food intake and body weight. The purpose of this study was to examine the effect of AXP infused into the brain on these measures. In post-pubescent female rats of the Sprague-Dawley strain, guide cannulae were permanently implanted in the lateral cerebral ventricle for repeated intracerebroventricular (ICV) infusion. Postoperatively, measures of food and water intake and body weight were obtained every day at the same time. After a 7-day base-line period, AXP was infused bilaterally in a total volume of 15 microliter and in a dose of either 0.25 microgram (n=7) or 1.25 micrograms (n=5), with artificial CSF vehicle serving as the control solution (n=6). ICV infusions were given once daily for 20 consecutive days, after which the same intake and body weight measures were recorded for another 7-day period. The rats given 0.25 micrograms AXP showed a significant suppression in weight gain with the overall slope of the growth curve being 0.358. In contrast, the growth slope of the rats given the 1.25 micrograms dose of AXP was 0.621, whereas those given the CSF was 0.823. Although the trends of intake of food tended to follow the curves of the rats body weight, the difference between g/kg food intake of rats during ICV infusions of either dose of AXP was not significantly different from that of the CSF controls. Water intake also was unaffected by either dose of AXP. These results demonstrate that this tri-peptide derived from urine of patients afflicted with anorexia nervosa exerts a direct effect on the brain. Since the 0.25 micrograms dose of AXP infused acutely ICV caused a sustained hyperthermia, its mechanism of action is apparently a metabolic one; that is, the interruption in the gain in body weight of the rat is independent of the amount of food it ingests. PMID- 6866813 TI - Arginine vasotocin induces sexual behavior of newts by acting on cells in the brain. AB - To investigate whether arginine vasotocin (AVT) acts on target cells in the brain of Taricha granulosa (a urodele amphibian), the behavioral effects of intracerebroventricular (ICV) and intraperitoneal (IP) injections of AVT were compared. Male newts exhibited the greatest sexual activity (amplectic clasping) following an ICV injection of 0.1 microgram AVT. Another study showed that nanogram quantities of AVT, administered ICV, stimulated the behavior. An ICV injection of an antagonist to arginine vasopressin, d(CH2)5Tyr(Me)AVP, or an anti AVT immune serum significantly inhibited the sexual behavior. Intracranial implants of 17 beta-estradiol (E2) or 5 alpha-dihydrotestosterone (DHT) in castrated males maintained the behavioral response to an injection of AVT. Another study found that an IP injection of DHT or E2 did not increase the incidence of newt sexual behavior during the 8 hours following the injection. PMID- 6866817 TI - [Cardiotoxicity of drugs used in the treatment of malignant neoplasms]. PMID- 6866816 TI - [Deep accidental hypothermia. Case report]. PMID- 6866818 TI - [Therapeutic controversies in Hodgkin's disease]. PMID- 6866815 TI - [Analysis of poisoning based on 20-year data from the 3d Internal Disease Clinic in Gdansk]. PMID- 6866820 TI - [Comparison of the significance of psychogenic factors in the etiopathogenesis of vasomotor rhinitis and hay fever]. PMID- 6866819 TI - [Study of the hematopoietic system in the population from industrialized areas]. PMID- 6866821 TI - [Immediate hypersensitivity in patients with gastric or duodenal ulcer]. PMID- 6866822 TI - [Generalized edema in a 65-year-old patient]. PMID- 6866823 TI - [Effect of clinical status on the fate of patients with multifascicular block]. PMID- 6866824 TI - [Hay fever. Clinical and immunological data]. PMID- 6866825 TI - [Remarks with regard to the differential diagnosis of stroke]. PMID- 6866826 TI - [Clinical course of puerperal cardiomyopathy (our observations)]. PMID- 6866827 TI - [Acebutolol in the treatment of coronary disease - ergometric and polycardiographic studies and evaluation of liver metabolism]. PMID- 6866828 TI - [Calcium antagonists in the treatment of arterial hypertension]. PMID- 6866829 TI - [Clinical and diagnostic aspects of chronic brucellosis]. PMID- 6866831 TI - [Hospitalization in drug-induced iatrogenic diseases]. PMID- 6866830 TI - [Biliary gastritis]. PMID- 6866832 TI - [Studies on the changes in the size and blood supply of the kidneys in selected liver and pancreatic diseases and in obstruction of the portal system]. PMID- 6866833 TI - [Hepatological news (3). Primary biliary bile cirrhosis (chronic nonsuppurative destructive cholangitis)]. PMID- 6866834 TI - [Diagnostic value of cholesterol levels in the HDL lipoprotein fraction]. PMID- 6866836 TI - [Gastric stenosis as an early complication of sulfuric acid burns]. PMID- 6866835 TI - [Desmofibrinogenic activity of factor XIII and thiol group levels of the plasma of patients with rheumatoid arthritis treated with levamisole]. PMID- 6866837 TI - [Fever of several months' duration in a 60-year-old patient. Case for discussion]. PMID- 6866838 TI - [Abdominal injuries--diagnosis and treatment]. PMID- 6866839 TI - [Problems of surgery of the large veins]. PMID- 6866840 TI - [Use of phentolamine in hypertensive crises]. PMID- 6866841 TI - [Treatment of arterial hypertension with orally administered atenolol]. PMID- 6866842 TI - [Main indicators of lung function and parameters of pulmonary hemodynamics in patients with chronic bronchitis]. PMID- 6866843 TI - [Experimental studies on the use of autologous veins with heparin-saturated walls in surgery of the large veins of the abdominal cavity]. PMID- 6866844 TI - [Examples of errors in expert testimony with regard to injuries in forensic medicine]. PMID- 6866845 TI - [Remarks on Greek-Latin terminology]. PMID- 6866846 TI - [Blood platelet function in patients with coronary disease after administration of acetylsalicylic acid and dipyridamole]. PMID- 6866847 TI - [Effect of manganese on the phagocytic activity of the leukocytes]. PMID- 6866848 TI - [Congenital Intralaryngeal and intratracheal focal thyroid ectopia (ectopia falsa)]. PMID- 6866849 TI - Epidemiologic observations from the American College of Surgeons' survey on prostate cancer. AB - Data on the incidence and mortality from prostate cancer are available in this country and others, but there are few sources of information relating to widely prevalent clinical practices. The long- and short-term prostate cancer surveys conducted by the Commission on Cancer of the American College of Surgeons offer a system of assessing patterns of cancer patient care in a large number of hospitals in the United States. Data from the Surveillance, Epidemiology, and End Results (SEER) System indicate that at every age blacks experience greater rates of incidence and mortality than whites. Comparisons of modes of diagnosis reported for black and white patients for 1974 and 1979 from the American College of Surgeons surveys show little difference between these groups, indicating that the excess in incidence among blacks is not attributable to differential patterns of diagnosis. The survey results also indicate that white patients appear to have a slight survival advantage in stages B, C, and D. The lower survival appears to be the product of relatively advanced stage of the disease rather than the result of biologically more malignant nature of prostate cancer in the blacks. PMID- 6866850 TI - Prostatic structure and function in relation to the etiology of prostatic cancer. AB - In this paper, studies by a large series of independent investigators are reviewed with regard to the basic structure and function of the prostate in an attempt to examine their relationship to prostatic cancer etiology. These studies demonstrate that the functional activities of the prostate involve secretion, transport, and reabsorption of a variety of materials into and out of the glandular lumen and that these activities are directly related to the basic structural organization of the gland. These functional activities are constantly occurring in the prostate even under basal (ie, nonejaculating) conditions. Due to these functional activities, the prostatic fluid in the glandular lumen is a complex mixture of a variety of components derived, not only from the synthetic activity of the glandular epithelial cells of the gland itself, but also from the blood serum. The levels of these components are continuously modulated, not only by the frequency of active ejaculation, but also, under basal conditions by the continuous interaction with the glandular prostatic cells lining the acinar lumen and ducts. A concept is presented that the initiation and/or promotion of prostatic carcinogenesis may well involve the chronic modulation/interaction of the prostatic glandular cells with their lumenal fluid. PMID- 6866851 TI - Autoradiographic localization of androgen binding in the developing mouse prostate. AB - The ontogeny of expression of [3H]dihydrotestosterone (3H-DHT) binding in the developing mouse prostate was studied using steroid autoradiography. At all prenatal stages examined, 3H-DHT binding in the urogenital sinus was restricted to the stromal tissue compartment. This pattern of binding continued until approximately day 4 of postnatal life, when some epithelial cells began to exhibit nuclear localization of 3H-DHT. The pattern of binding was asynchronous within the prostate, with the onset of nuclear labeling seemingly correlated with canalization of prostatic ducts. By 3 weeks of age, virtually all prostatic epithelial cells exhibited nuclear labeling with 3H-DHT. The significance of these results, with respect to the role of epithelial-mesenchymal interactions in hormone-induced development, are discussed. PMID- 6866852 TI - Suppression of antibody response of male mice exposed to diethylstilbestrol or estramustine phosphate (Estracyt). AB - The effects of treatment of male mice with diethylstilbestrol (DES) or estramustine phosphate (EMP) on the primary antibody response to sheep red blood cells (SRBC) and lipopolysaccharide (LPS) were investigated using a hemolytic plaque assay for enumeration of antibody-producing cells. DES treatment at a daily dose of 1.4 or 5.6 mg/kg from 2 days prior to and up to 3 days after immunization significantly reduced the number of anti-SRBC as well as anti-LPS producing cells per 10(6) spleen cells. The 100 mg/kg EMP given as daily intraperitoneal injections significantly diminished the antibody response to both SRBC and LPS. No alteration in the number of anti-SRBC-producing cells per 10(6) spleen cells was detected in spleens from mice receiving 30 mg/kg/day EMP, while the number of anti-LPS-producing cells was reduced. The immunoregulatory effects of EMP are apparently not a pure estrogen effect, since treatment with doses of estradiol-17 beta equivalent to the amounts of estradiol linked to the cytotoxic moiety in 100 mg/kg/day of EMP were without effect. EMP-induced functional impairment in the T-cell population is inferred from the reduced ability of adoptively transferred T cells from EMP-exposed animals to support an antibody response to SRBC in syngeneic nude mice. PMID- 6866854 TI - Childhood enuresis. Important points in assessment, trends in treatment. PMID- 6866855 TI - Cervical degenerative arthritis. Possible cause of neck and arm pain. PMID- 6866857 TI - Alcoholism. PMID- 6866856 TI - Chromium supplementation. Can it improve glucose and cholesterol metabolism? PMID- 6866853 TI - Effect of castration and steroid treatments on the activity of some hydrolytic enzymes in dog prostate. AB - Adult mongrel dogs were castrated and treated by intramuscular injections of 5 alpha-androstane-3 alpha,17 beta-diol (androstanediol) alone or in combination with estradiol in order to find convenient enzymatic markers of hormone action in prostate. The activities of 15 hydrolytic enzymes were determined. Arginine esterase, acid sulfatase, and acid phosphatase were found to be the most sensitive markers of testicular hormones since they were decreased 18-, 5- and 5 fold respectively after 1 month of castration. The enzyme activities returned to precastration levels after 2 weeks of injection of androstanediol to castrated animals. The effect of androstanediol on the majority of the remaining enzymes was small. In general, the activities obtained after androstanediol treatment in combination with estradiol were similar to those obtained with androstanediol alone. Finally, beta-glucuronidase and neutral sulfatase were increased after castration, a finding that suggests that these enzymes are constituents of stromal cells. These studies will provide a basis for future studies of hormone action in the dog prostate. PMID- 6866858 TI - Early intervention. A clinician's guide to secondary prevention of alcoholism. PMID- 6866859 TI - Alcoholism in the elderly. A serious but solvable problem. AB - Alcoholism is a more common problem in the elderly than has been recognized. Manifestations are more subtle than in younger alcoholics, and problems are primarily social rather than medical. Treatment approaches directed at the psychosocial stresses associated with aging are the most successful. The principles of the therapeutic community have also been effective in eliminating alcoholism and other behavioral disorders in elderly alcoholics. PMID- 6866860 TI - Alcoholism in physicians. Tactics to improve the salvage rate. PMID- 6866861 TI - Compartment syndromes. Early recognition and treatment. PMID- 6866862 TI - The comatose patient. A systematic diagnostic approach for you to follow. AB - Coma is a frightening state requiring immediate medical attention. Because the patient's history may be unavailable and the possible causes of coma are numerous, the physician must concurrently support and protect the patient and evaluate the cause of coma. A systematic, orderly approach to diagnosis, using modern diagnostic tools to complement thorough physical examination, can help illuminate and alleviate this often perplexing problem. PMID- 6866863 TI - Why and how to drain a sinus. AB - The main reason for draining a sinus is removal of pus in subacute or chronic maxillary sinusitis. A sinus wash is also useful for diagnosis. I recommend the anterior maxillary sinus puncture because it is the easiest technique to perform and master. PMID- 6866864 TI - Altitude illness. The dangers of the heights and how to avoid them. AB - Altitude illness, caused by lack of oxygen, manifests itself in several forms, including acute mountain sickness, high-altitude pulmonary edema, and high altitude cerebral edema. The first of these is usually minor, but the second and third can be fatal unless promptly diagnosed and treated (descent being the most effective management). Other, more specific, problems such as high-altitude retinal hemorrhage and thrombophlebitis can also occur in some individuals. Even so, there are only a few medical reasons to deprive an ambulatory, well compensated patient of a visit to moderate altitude, and the conscientious physician will weigh carefully the risks against the benefits of a vacation in a beautiful and inspiring mountain setting. PMID- 6866866 TI - Computers on medicine's doorstep. PMID- 6866867 TI - Taming the medical literature "monster". PMID- 6866865 TI - Psychiatric symptoms in cancer patients. Is the cause organic or psychologic? AB - Because cancer and its treatment have so many effects on the CNS, the diagnosis of psychiatric symptoms in cancer patients is problematic. Naturally there are psychologic and psychosocial issues that often sufficiently explain why a patient appears distressed. Dealing with psychologic adjustment is always an important part of the management of patients with severe medical, as opposed to psychiatric, illness, whether or not biologic components of the psychologic problem can be identified and addressed. The most frequent error physicians make in evaluating psychiatric symptoms is to assume that a psychologic explanation is sufficient. Expressions such as "Wouldn't you be depressed if you had cancer?" are often used to excuse failure to pursue further evaluation. Careful reviews of cases in which cancer patients were labeled as having psychologic problems have consistently shown a high incidence of misdiagnosis. Correct diagnosis and treatment of an underlying organic disorder can alleviate symptoms that impair the patient's innate coping resources, allowing him or her to grapple more effectively with adverse circumstances. PMID- 6866868 TI - Genitourinary trauma. Early versus late recognition and management. AB - Early diagnosis and immediate surgery, if necessary, permit optimal management of genitourinary trauma. Intravenous pyelograms (IVPs) and cystograms are important tools in assessing the extent of injury. Early surgical repair avoids serious sequelae. PMID- 6866869 TI - The aetiology of oligomenorrhoea and/or hirsuties: a study of 467 patients. AB - An analysis of 467 patients with oligomenorrhoea and/or hirsuties in respect to duration of the menstrual cycle, body hair growth, ovarian size and the presence of psychological factors has revealed some useful pointers to diagnosis in this syndrome. Some 70% probably suffered from polycystic ovarian disease. Hirsuties and post-pill amenorrhoea are strong pointers to such a diagnosis. Some 10% of the cases may have been psychogenic in origin and are notably found among non hirsute patients with normal sized ovaries. Another 10% may have been physiological in nature. All other disorders accounted for no more than 10% of the cases. Anorexia nervosa and ovarian dysgenesis are particularly to be found among amenorrhoeic, non-hirsute patients with normal sized (or small) ovaries accounting for no less than 37% of this group in our series. PMID- 6866870 TI - Primary peritonitis in children and adults. AB - Five cases of primary peritonitis are presented, with a sixth related case of pneumococcal peritonitis secondary to a ruptured ovarian cyst. The patients comprised 4 young girls who recovered, and 2 elderly females who died. Pneumococci were isolated in 3 patients; no organism was found in the other 3. One case of primary measles peritonitis has no apparent precedent. PMID- 6866872 TI - Hairy cell sarcoma. PMID- 6866871 TI - Blood dyscrasias and mianserin. AB - Four cases are described in which the drug mianserin was implicated in the development of leucopenia. In one case this was accompanied by fatal aplastic anaemia. In a second, generalized bone marrow depression occurred, although leucopenia was the only clinically significant manifestation. Mianserin may depress bone marrow function and haematological surveillance is appropriate for patients taking this drug. PMID- 6866874 TI - Neurotensin-secreting carcinoma of the bronchus. AB - Neurotensin, a neuroendocrine peptide present in gut and brain has previously been found in pancreatic tumours secreting several other peptides. We report here the first case of a patient with a neurotensin-secreting adenocarcinoma of the bronchus. PMID- 6866873 TI - Aspergillus epidural abscess in a patient with obstructive airway disease. AB - A 54-year-old Chinese man with episodic bronchial asthma since 25 years of age was treated for pulmonary tuberculosis in 1976 because of left upper lobe lesions on chest radiograph. In 1981 he presented with an extradural mass compressing the thoracic spinal cord, thought to be tuberculosis but which on biopsy was found to be aspergillosis. Sputum culture, type on skin-prick reactivity and serum precipitating antibodies were positive for Aspergillus. Amphotericin B intravenously, then ketoconazole orally did not substantially improve his clinical course. He died about four months post-laminectomy. PMID- 6866875 TI - Monodermal cystic ovarian teratoma composed of respiratory epithelium. PMID- 6866876 TI - Hypertrophic osteoarthropathy without radiographic evidence of new bone formation. AB - A 70-year-old man with florid symptoms of hypertrophic osteoarthropathy for over a year presented without radiographic evidence of new bone formation. His symptoms improved after exploratory thoracotomy, but recurred with lesser severity a year later with tumour recurrence on the chest wall. Absence of new bone formation was again demonstrated radiologically as well as by isotope scan. PMID- 6866877 TI - Fatal renal haemorrhage following haemodialysis in a patient with obstructive uropathy. AB - A 22-year-old male with obstructive uropathy and renal failure was given pre operative haemodialysis. He collapsed five hours later. Autopsy revealed massive intrarenal haemorrhage and rupture of a dilated superior calyx intraperitoneally. Anticoagulation employed during haemodialysis was probably responsible for this spontaneous renal haemorrhage and subsequent calyceal rupture. PMID- 6866878 TI - Spontaneous rupture of an epithelial cyst of the spleen. PMID- 6866879 TI - Hepatic granulomata associated with adenocarcinoma. PMID- 6866880 TI - Appendix vermiformis duplex. PMID- 6866881 TI - Eradicating sources or removing results. AB - With few exceptions, the prevalence of disease has never been reduced by improved treatment. Success has followed identifying and eliminating, or reducing, causative factors. This has been true of infective disease in the West and of the great tropical epidemics. Yet vastly greater endeavour and expenditure are devoted to the treatment of non-infective diseases than to efforts to identify and tackle their causes. This in spite of the fact that they are increasingly recognized as characteristic of modern western culture. PMID- 6866882 TI - Cryosurgery in the treatment of rectal carcinoma. PMID- 6866883 TI - Aneurysm of the mitral valve complicating Streptococcus milleri endocarditis. PMID- 6866884 TI - Hypertrophic osteoarthropathy: two unusual causes. AB - Two patients with hypertrophic osteoarthropathy of unusual aetiology are described. The first patient developed the condition in association with oesophageal carcinoma and the second as a complication of active pulmonary tuberculosis. In the second case, substantial resorption of new bone was seen following treatment. PMID- 6866885 TI - Kaposi's sarcoma associated with hairy cell leukaemia. PMID- 6866886 TI - Cryptogenic cirrhosis in relapsing polychondritis. PMID- 6866887 TI - Toxic shock syndrome complicated by laryngeal oedema. AB - A 50-year-old woman was admitted as an acute medical emergency and was diagnosed as having toxic shock syndrome. Thirty-six hours after admission she went into hepato-renal failure and had disseminated intravascular coagulation. She developed severe laryngeal oedema, a complication which has not been reported previously, and was intubated with great difficulty. She recovered from this, but died 5 weeks after the presentation of a pulmonary embolus. PMID- 6866888 TI - Vaginal bleeding due to leech. PMID- 6866889 TI - [Surgery of pulmonary metastases. Critical analysis of a series of 55 cases]. AB - Critical analysis of a series of 55 cases of pulmonary metastases of various origins, treated surgically, included successive study of the circumstances of discovery of the pulmonary lesions, the free interval, and the characteristics and mode of therapy of the metastases. Overall survival was 41% at 2 years and 21% at 5 years. The effect of surgery on overall therapeutic strategy of cancer is discussed. PMID- 6866890 TI - [Pulmonary arterial hypertension and generalized scleroderma. A propos of 10 cases]. AB - Whereas pulmonary fibrosis is a very frequent manifestation of scleroderma, pulmonary hypertension of the precapillary type is a much rarer occurrence in this affection. Two cases of scleroderma with subsequent development of a pulmonary hypertension are reported. Various hypotheses have been advanced to explain the origin of this disorder during the course of scleroderma. Rather than a direct consequence of the sclerodermic pulmonary fibrosis it probably arises secondary to the specific, diffuse, primary pulmonary vascular lesions. PMID- 6866891 TI - [Value of thoracoscopy in the diagnosis of solid tumors extending into the pleural cavity]. AB - Thoracoscopy examinations in 5 cases of solid tumors of the pleura: 1 case of Pancoast's and Tobias' tumors of neoplastic origin, 1 case of asbestosis-induced fibrohyaline plaques, and 2 cases of benign pleural tumors, 1 neurinoma emphasized the diagnostic value of thoracoscopy for tumors of this type. Direct visualization of the lesion is possible, its precise site and extent can be determined, and biopsy samples obtained for pathology under direct visual guidance. PMID- 6866892 TI - [Re-expansion pulmonary edema after iatrogenic pneumothorax. A propos of 1 case]. AB - Re-expansion pulmonary edema (RPE) due to pneumothorax aspiration can lead to a fatal outcome, as in the case reported, the chronic nutritional deficiency and hypoproteinemia that it provokes probably playing a contributing role. Pathogenesis and factors affecting prognosis of RPE are discussed. These include the duration of the pulmonary collapse, though this is not an essential factor, the alterations in alveolar surfactant activity possibly related to the chronicity of the collapse, and the abruptness of aspiration which is, in contrast, a determining mechanical factor. Finally, the hypoproteinemia present in certain cases could facilitate fluid extravasation towards the alveolus. It is concluded that aspiration should be a gentle procedure in all cases, and should be conducted with extreme caution in the presence of hypoproteinemia. PMID- 6866893 TI - [Purulent Pseudomonas pleurisy. A propos of 2 cases]. PMID- 6866894 TI - [Clinical aspects and course of 38 cases of malignant pleural mesothelioma observed in the Marseilles region]. AB - Epithelial or mixed mesotheliomas were detected in 38 patients in the region of Marseilles over a period of 9 years. Though an occupational element was involved in 80% of cases, no history of contact with asbestos could be obtained in certain of the patients. Confirmation of diagnosis requires wide pleural biopsies, because of the high level of false negatives and false positives from cytology and pleural needle biopsy. Hyaluronic acid levels are significant only when they are markedly enhanced. Local and regional tumor spread provides an aid to prognosis, but authentic metastases, with further worsening of prognosis, were detected in more than 75% of patients while still alive. Nodules appeared along the course of punctures of drainage tubes or in thoracotomy scars in 56% of cases, and appear to be a very frequent and characteristic feature of mesothelioma. Their therapy involves preventive irradiation. PMID- 6866895 TI - Genetic analysis of primary and secondary immune responses in the chicken. PMID- 6866896 TI - Ontogeny and line differences in the mitogenic response of chicken lymphocytes. AB - Ontogeny of mitogen response was studied using Regional Poultry Research Laboratory lines 6 and 7 and Cornell lines JM-N and -P chickens over a 30-week experimental period. Purified lymphocyte assay and sequential monitoring with whole-blood assay show lines 6 and N to be low responders compared to lines 7 and P, respectively. The difference in phytohemagglutinin (PHA) response between lines 6 and 7 increased with age, whereas that between lines N and P remained consistent for all ages. An association seems to exist between the low PHA responsiveness of lines 6 and N and resistance to Marek's disease (MD), a lymphoproliferative disease caused by MD virus in susceptible chickens. The fact that lines 6 and 7 have the same B2-haplotype but differ in PHA response seems to substantiate the evidence by others that the genetic control of PHA response is not linked to the Ea-B locus of the MHC complex. This does not preclude, however, the possibility that the response of lines N and P is MHC-linked. PMID- 6866897 TI - The use of permethrin to control an outbreak of hen fleas (Ceratophyllus gallinae). AB - Complaints from workers suffering from insect bites led to the investigation of three broiler breeder houses. These houses were found to be infested with the hen flea, Ceratophyllus gallinae. Large numbers of adult fleas and larvae were extracted by Tullgren funnel from samples of wood shavings used as nest box material. Lower numbers were extracted from the litter under these nest boxes. A pilot trial using infested nest boxes and floor litter showed good control of adult fleas and larvae could be obtained using a .25% spray prepared from a permethrin water dispersable powder. In more extensive trials the following year, almost complete control of hen fleas and larvae was obtained following monthly treatments of nest boxes with a .125% permethrin spray or a 1% permethrin powder. PMID- 6866899 TI - Effect of various dietary factors and age on plasma alpha-tocopherol concentration of turkeys. AB - Plasma alpha-tocopherol concentration of 15- to 22-week-old turkeys was found to be linearly related to dietary all-rac-alpha-tocopheryl acetate at levels ranging from 10 to 100 mg/kg. However, in 4-week-old poults a plateau was observed at a level of 30 mg alpha-tocopheryl acetate/kg diet. Increasing soybean oil level in diets containing 10, 50, and 100 mg alpha-tocopheryl acetate/kg from .5 to 3.0% significantly (P less than .05) elevated plasma alpha-tocopherol. The latter was not affected by the type of dietary fat (soybean vs. tallow). Supplementary cholic acid (.075 - .1%) in diets containing 20 mg alpha-tocopheryl acetate/kg elevated plasma alpha-tocopherol slightly but significantly (P less than .05); however, higher levels of this bile acid had no effect. Increasing dietary selenium supplementation from .1 to 1.1 ppm did not affect this parameter either. alpha-Tocopherol and alpha-tocopheryl acetate, when dissolved in soybean oil or in ethoxyquin at levels equivalent to 40 mg/kg diet, had a similar effect on plasma alpha-tocopherol concentration. PMID- 6866900 TI - Excess manganese ingestion in the chick. AB - Two experiments were conducted with young chicks to investigate effects of excess manganese, (Mn) ingestion and to compare MnCl2 . 4H2O, MnSO4 . H2O, MnO2, and MnCO3 as sources of dietary Mn activity. Each source of Mn was added to a conventional corn-soybean meal diet to supply 3000, 4000, or 5000 mg/kg Mn. High levels of dietary Mn from MnSO4 . H2O and MnCl2 . 4H2O depressed growth slightly; MnO2 and MnCO3 did not affect chick performance. Manganese dioxide contained less Mn activity than MnCO3, MnSO4 . H2O, or MnCl2 . 4H2O as assessed by relative depressions in hemoglobin and hematocrit and by relative increases in bile, liver, and bone Mn concentrations. Neutralization of the chloride ion in MnCl2 . 4H2O with NaHCO3 did not ameliorate the adverse effects of excess, MnCl2 . 4H2O ingestion. Bone and bile Mn concentrations reflected Mn intake better than liver Mn concentration or rate and efficiency of weight gain. PMID- 6866901 TI - Partial alleviation of phenylalanine toxicity in the chick by supplemental dietary tryptophan. AB - Studies were conducted to determine the physiological effects of feeding diets containing high levels of phenylalanine to chicks. Marked reductions in weight gain and feed conversion were observed in birds fed a diet containing 2.52% L phenylalanine and .47% L-tyrosine. Excess dietary phenylalanine caused elevations of phenylalanine and tyrosine in serum and brain, whereas cerebral concentrations of free isoleucine, leucine, and valine were generally decreased. Supraoptimal amounts of glycine, arginine, and tryptophan were fed in an attempt to alleviate the toxic symptoms observed in birds fed high phenylalanine diets. Only tryptophan supplementation proved successful in partially alleviating the growth depressive effects of phenylalanine toxicity. Both serum and brain levels of tryptophan were increased by tryptophan supplementation. Results of two radiotracer studies with 14C-tryptophan suggested that brain uptake of tryptophan was inhibited by hyperphenylalaninemia. PMID- 6866898 TI - Comparative efficacy of plastic strips impregnated with permethrin and permethrin dust for northern fowl mite control on caged laying hens. AB - Established populations of northern fowl mites, Ornitonyssus sylviarum (Canestrini and Fanzago), on caged laying hens were effectively controlled within 77 days by application of two plastic strips impregnated with permethrin per cage. Such strips contained 9.6% active ingredient (wt/wt), were ca. 20.5-cm long, and were affixed to the top cage wires. Use of only one strip per cage resulted in less control, approximating that obtained with .25% permethrin dust. Egg mass, expressed as gram egg per hen per day, was significantly greater in all treated groups. PMID- 6866902 TI - Adrenergic and cholinergic activity of the Japanese quail oviduct in vitro. AB - The responses to isoprenaline, phenylephrine, and carbachol in different segments of isolated intact oviduct were studied. Smooth muscle electrical activity was recorded with suction electrodes placed, one electrode in each, in the infundibulum, proximal magnum, distal magnum, isthmus, shell gland, and vagina. The drugs were added cumulatively. Only in the magnum did isoprenaline cause a significant change in the frequency of spike discharges; the decrease was about 20%. The effects of phenylephrine were not so clear, although the frequency of the electrical activity increased 30% in the shell gland. With the exception of the infundibulum, carbachol significantly increased the frequency of the oviductal electrical activity. It was concluded that adrenergic nerves have only a minor role in controlling quail oviductal smooth muscle because the oviduct was rather insensitive to adrenergic drugs whereas the cholinergic drug carbachol caused a strong response. PMID- 6866903 TI - The effect of aging on the ovarian follicular growth in laying hens. AB - Two kinds of the fat-soluble dye, Sudan black and red, were intravenously injected on alternate days into layers aged from 5 to 23 months to study the growth pattern of the ovarian follicle in relation to aging. Results indicated: 1) the length of the rapid growth period showed a tendency to shorten during 5 to 11 months, then to lengthen from 15 to 23 months of age; 2) there was a continuous increase in follicular volume at ovulation with the progress of age; 3) the growth rate (degree of curvature of the growth line calculated in each follicle) was low at 5 months, increased from 8 to 11 months, and remained constant thereafter; 4) during the first year of age, the number of growing follicles in the ovary decreased gradually, whereas the total amount of daily yolk deposition increased. During the second year of age, both the number of growing follicles and total yolk deposition remained constant. PMID- 6866904 TI - Gross appearance of turkey cloacae before and after single or multiple manual semen collections. AB - The gross appearance of the turkey cloaca was examined before and after single or multiple semen collections. All cloacae exhibited some degree of hemorrhage formation, the extent of which was dependent upon 1) frequency of semen collection, 2) number of cloacal strokes, and 3) individual differences in semen collectors' techniques. Cloacae of males subjected to multiple semen collections of more than four cloacal strokes per semen collection were the most severely injured. Cloacae examined three days after the last semen collection were nearly normal in appearance. It is suggested that cloacal hemorrhages resulting from semen collection can be minimized by 1) reducing the number of cloacal strokes per semen collection to one or two and 2) using the correct hand placement and pressure on the cloaca during the cloacal strokes. PMID- 6866905 TI - Histology of turkey papillae after manual semen collection. AB - Papillae from mature turkey males were removed before and after semen collection and examined by light microscopy. The surface mucosa consisted of deeply folded columnar epithelial cells and a discontinuous layer of basal cuboidal cells. Underlying this layer was a lamina propia of loose connective tissue containing fibroblasts, fibrous elements, and to a lesser extent, plasma cells, lymphocytes, and macrophages. A pseudostratified columnar epithelium consisting of nonsecretory cells lined the lumen of the papillae. The accompanying lamina propria was thin but highly vascular and included fibroblasts and macrophages. Occupying most of the space between the two mucosae was a smooth muscle layer. Immediately after semen collection capillaries throughout the papillae were dilated and congested with red blood cells (RBCs). Scattered throughout the papillae were extravascular RBCs, suggestive of extensive primary hemorrhage. Although heterophils and macrophages were observed throughout the papillae 24 hr after semen collection, only macrophages were involved in the phagocytosis of extravascular RBCs. Macrophage phagocytic activity was evident at 48 hr and occasionally 72 hr after semen collection. By 72 hr few extravascular RBCs were observed. PMID- 6866906 TI - Effects of declawing and cage shape on productivity, feathering, and fearfulness of egg-type chickens. AB - Declawing day-old egg-type chicks did not significantly (P less than .05) alter 20-week body weight. However, declawed hens tended to mature earlier and lay more eggs than the intact hens. Hens housed in shallow cages tended to be better feathered than those housed in deep cages. Neither declawing nor cage shape had a significant effect on the time required for birds to return to feeding after exposure to a noise stimulus, which was used as an indicator of fearfulness. PMID- 6866907 TI - Dissociation between allergy and immunity in leprosy. PMID- 6866908 TI - Practical issues of tuberculin testing. PMID- 6866909 TI - The child, his parents and the illness. PMID- 6866910 TI - Asthma in general practice. PMID- 6866911 TI - Children's accidents. New hope for prevention. PMID- 6866912 TI - Obesity in childhood. PMID- 6866913 TI - The child in hospital. PMID- 6866914 TI - Colostomy complications in children. PMID- 6866915 TI - A training project in community paediatrics. PMID- 6866916 TI - Ketotifen in childhood asthma. PMID- 6866917 TI - Child health surveillance in general practice. PMID- 6866918 TI - Avoidable visual disability in young children. PMID- 6866919 TI - An audit of the care of asthma in a general practice. PMID- 6866920 TI - Whooping cough vaccination. A worrying decision for parents. PMID- 6866921 TI - Children still suffer from social class. PMID- 6866922 TI - The challenge of preventive paediatrics. PMID- 6866923 TI - Hospital outreach in paediatrics. PMID- 6866924 TI - [Expert opinion in sarcoidosis]. PMID- 6866925 TI - [Early detection of bronchial carcinoma with roentgen mass screening]. PMID- 6866926 TI - [Optimizing of therapy with theophylline preparations in obstructive respiratory diseases. 4. Effect of theophylline on mucociliary clearance and maximal inspiratory mouth occlusion pressure]. PMID- 6866927 TI - [Personality of adolescents attempting suicide: sample comparison and classification]. PMID- 6866928 TI - [Unresolved grief in families with a psychosomatically ill child]. PMID- 6866929 TI - [Prognosis of encopretic children in inpatient treatment]. PMID- 6866930 TI - [Combined treatment of a 12-year-old child with sceno material and the catathymic picture experience]. PMID- 6866931 TI - [Institutional aspects of family therapy work in ambulatory care of children and adolescents]. PMID- 6866932 TI - [Cutaneous manifestation of systemic diseases. I. Dermatoses providing a clue]. PMID- 6866934 TI - [Sinus tarsi syndrome]. PMID- 6866933 TI - [Balneology in today's medicine]. PMID- 6866935 TI - [Acute cholecystitis of the stone-free gallbladder as a complication following abdominal surgery]. PMID- 6866936 TI - [Adjuvant therapy in Operable non-small cell lung cancer]. PMID- 6866937 TI - [Pregnancy following microsurgical operation, aspiration of oocytes, in vitro fertilization and embryo transfer]. PMID- 6866938 TI - [Conventional radiology of the spine]. PMID- 6866939 TI - [Computer tomography of the spine. Criteria for its application; pathological aspects]. PMID- 6866940 TI - [Clinical importance of creatine kinase isoenzymes]. PMID- 6866941 TI - [Tuberculosis in a rural hospital - a case report]. PMID- 6866942 TI - [Advances in the surgical treatment of gastrointestinal diseases]. PMID- 6866943 TI - [Evaluation of the elderly driver. A current problem]. PMID- 6866944 TI - [Exercise-induced asthma: an often misinterpreted form of bronchial asthma]. PMID- 6866946 TI - [Practical aspects of local corticotherapy]. PMID- 6866945 TI - [Interaction: Modifast--oral anticoagulation]. PMID- 6866947 TI - [Pruritus. Physiopathology and treatment]. PMID- 6866948 TI - [Eczema molluscum associated with molluscum contagiosum]. PMID- 6866949 TI - [Hyperlipoproteinemias in diabetes mellitus]. AB - Hyperlipoproteinemia (HLP) incidence and its character were studied in 1343 patients with diabetes mellitus, depending on age, diabetes type and carbohydrate metabolism. It was found that HLP is more often observed in patients over 35 years as compared to the one in children and juveniles (in 51 and 30% of cases, respectively). The IV type of HLP is prevalent, regardless of age, diabetes type and carbohydrate metabolism. An increased HLP incidence is seen in patients of any age with the I diabetes type during carbohydrate metabolism decompensation. Such a dependence is not observed in patients with the II type of the disease. PMID- 6866950 TI - [Osmotic homeostasis and blood antidiuretic activity in diabetes mellitus in children]. AB - Clinical and biochemical findings, obtained in 76 diabetic children aged 3 to 15 years, were analyzed. Osmolarity of the plasma and plasmic components (electrolytes, glucose and urine) as well as blood antidiuretic activity (ADA) were studied. Osmolarity and plasmic ADA indices increased and water-electrolyte balance deteriorated as metabolic disorders developed. No exact linear correlation between osmolarity and the blood ADA indices was observed in diabetes decompensation. A high blood ADA level is considered to be a manifestation of the pronounced organism dehydration. It was shown that blood coagulation, accumulation of active osmotic substances in the blood, i.e. glucose, urine and other products of the disordered metabolism, as well as a decrease in renal glomerular filtration cause the hyperosmolaric syndrome in diabetic children. PMID- 6866951 TI - [Arterial hypertension as a marker for hyperglycemia in the glucose tolerance test]. AB - A randomized representative group of 1119 males (aged 20 to 69 years), living in one of the Moscow districts, was examined. Carbohydrate metabolism was evaluated by means of the standard glucose tolerance test (GTT). The arterial blood pressure was measured 4 times using an ordinary sphygmomanometer and "floating zero" apparatus. The average values of 4 measurements were analyzed. It was found that in epidemiological studies arterial hypertension may mark only hyperglycemia 1 hour after glucose load. In mass examination on detecting diabetes cases in persons with arterial hypertension the glycemia determination on an empty stomach or 2 hours after glucose load is apparently sufficient, not influencing the information on carbohydrate metabolism condition of persons under examination. The significance of this method for epidemiological studies of diabetes mellitus is discussed. PMID- 6866952 TI - [Familial forms of chromaffinomas]. AB - The familial chromaffinoma forms were seen in 13 members of 4 families. Eight of these patients (6 females and 2 males), aged 15 to 43 years old, were operated for disseminated bilateral chromaffinomas. Seven patients had malignant tumors. In 3 families there were patients with Sipple's syndrome. Extensive laparatomy is rather preferential by surgeons. In view of the autosomal-dominant form of the disease transmission it is necessary to investigate thoroughly the familial history and to examine purposefully the children and relatives of patients with chromaffinomas, especially, with Sipple's syndrome. PMID- 6866953 TI - [Effect of cyproheptadine on the ultrastructure of the neurons of the arcuate nucleus in the hypothalamus of the rat]. AB - The data are presented on changes in the rat arcuate nuclear neuron ultrastructure after using cyproheptadine (peritol, Egyt Pharmaceutical Works, Hungary) in a water suspension at a dose of 20 mg/kg once daily during 7 successive days and twice a day within 10 days. It was shown that cyproheptadine decreases the functional activity of the arcuate nuclear neurons, depending on the total amount of the drug used. Cyproheptadine-induced inhibition of the forming neurohormone release from neurons is likely to be one of the mechanisms of its therapeutic effect in Itsenko-Cushing's disease. PMID- 6866954 TI - [Neurotropic effect of hypophyseal somatotropin and its fragment]. AB - The effect of sei whale somatotropin and its biologically active fragment 77-107 (under conditions of microionophoresis) on the cortical, caudate nucleus and amygdala single neuron electrical activity of the rat brain as well as on the neuron sensitivity to noradrenaline was studied. The neurons, responded to somatotropin and its fragment inhibitory action, were revealed in all the brain regions examined. The majority of neurons did not react to noradrenaline, part of them responded to noradrenaline, decreasing the impulse activity and a very small part--increased the impulse effect. The preliminary use of somatotropin or its fragment sharply increased the number of noradrenaline-activated neurons. The data obtained indicate that somatotropin exhibits the neurotropic (neuromodulative) activity, preserved by its fragment 77-107. This effect may be caused by the initial somatotropin and its fragment capacity to increase phosphodiesterase-produced catalyzing cAMP destruction in some neural structures. PMID- 6866955 TI - [Negative feedback in the epiphyseal-thyroid system]. AB - The negative feedback mechanism in the epiphyseal-thyroid system was studied. The activating thyroxin influence upon hydroxy-indole-O-methyl-transferase, being the main enzyme of melatonin biosynthesis, was found in experimental Wistar rats. The "dose-response" curves were examined at varying times after thyroxin injections. The results obtained confirm the previous data concerning the activating effect of rat chronic hyperthyroidization on hydroxy-indole-O-methyl-transferase and intensified melatonin excretion with the urine in patients with pronounced thyrotoxicosis. PMID- 6866956 TI - [Mechanism of the diuretic action of parathormone]. AB - The effect of parathyroidin, calcium chloride and parathyroidin combined with verapamil (blocking the inclusion of calcium ions into cells) on diuresis and electrolyte excretion with the urine was studied in experiments on dogs. It was shown that after a single intravenous injection of parathyroidin in a dose of 2 U/kg body weight diuresis and natriuresis twice augmented and potassium excretion increased 1.6 times one hour following the drug injection. The intravenous injection of 10% calcium chloride solution or parathyroidin combined with verapamil did not produce such an effect. The mechanism of parathyroid hormone diuretic action is likely to be due to intensified calcium ion inclusion into the renal tubular cells. PMID- 6866957 TI - [Means of correcting blood coagulation disorders in diabetes mellitus]. PMID- 6866958 TI - [Role of the thymus in producing the endocrine function of the testes in mice]. AB - The thymic effect on the mouse gonadal endocrine function was studied. The serious gonadal endocrine dysfunction was seen in mice with genetically determined absence of the thymus. Thymectomy of healthy animals aged 3 days induces similar disorders. Transplantation of the thymus to the genetically thymus-free animals during the first days of the life returns this function to normal. It is concluded that the thymus plays an important role in the formation of the mouse gonadal endocrine function. PMID- 6866959 TI - [Blood rheological properties and the oxygen balance of the tissues in experimental alloxan diabetes]. AB - The whole blood viscosity and the tissue oxygen balance were studied in rats and rabbits with alloxan diabetes. An augmentation of the blood viscosity was seen in female rats during diabetes latent period after injecting alloxan in a dose of 100 mg/kg. The blood viscosity is 3 times as high in diabetes, produced by the injection of alloxan in a dose of 200 mg/kg, and is characterized by severe hyperglycemia, simultaneously the tissue oxygen balance alteration is observed. Similarly the blood rheological properties and oxygen-transport functions are changed in female rabbits after injecting alloxan in a dose of 150 mg/kg. The blood viscosity of male rabbits with alloxan diabetes does not differ from that of the controls. PMID- 6866961 TI - [Clinico-radiologic characteristics of patients who died of tuberculosis]. PMID- 6866960 TI - [Analysis of the specific binding of 3H-estradiol by the uterus of androgen sterile rats using biochemical and autoradiographic methods]. AB - Experiments were performed on neonatal rats, given different doses of androgen testosterone propionate (25-50-100 micrograms). A decrease was seen in the concentration of estrogen receptors in cytosol and nuclear fractions of the uterine tissue comparatively to those of the normal rats regardless of the estrous cycle stage. These changes were less pronounced in rats with the open vagina, given testosterone (25 micrograms). The reduction of specific estradiol 3H binding by different fractions of the uterine tissue occurs in androgen sterile rats under the action of testosterone (50 to 100 micrograms) due to epithelial cells, as it was shown by autoradiography. The role of this effect for infertility of the animals under study is discussed. PMID- 6866963 TI - [Feasibility of pathogenetic treatment of pulmonary tuberculosis patients with and without complicating diseases]. PMID- 6866962 TI - [Organizational forms of tracking bronchial asthma patients in Hungary]. PMID- 6866964 TI - [Intrabronchial administration of rifampicin in the complex treatment of patients with destructive pulmonary tuberculosis]. PMID- 6866965 TI - [Results of complex chemotherapy of pulmonary tuberculosis using rapid intravenous injections of isoniazid]. PMID- 6866966 TI - [Current status and prospects for improvements in antituberculosis services in the autonomous okrugs of the Far North]. PMID- 6866967 TI - [Effect of triiodothyronine on treatment efficacy and recovery of respiratory functions in patients with pulmonary tuberculosis]. PMID- 6866968 TI - [Effect of vitamins on sensitization of pulmonary tuberculosis patients to tuberculin]. PMID- 6866969 TI - [Clinical picture, treatment and outcome of spontaneous pneumothorax in patients with fibro-cavernous pulmonary tuberculosis]. PMID- 6866970 TI - [Air diffusion through the wall of subpleural bullous formations in spontaneous pneumothorax]. PMID- 6866971 TI - [Early surgery to prevent osteochondrosis in tuberculous spondylitis]. PMID- 6866972 TI - [Articular cartilage of the head of the femur in tuberculous coxitis and aseptic necrosis in adults]. PMID- 6866973 TI - [Sodium hydroxybutyrate--effective antidote to the toxic action of isoniazid on the central nervous system]. PMID- 6866974 TI - [Late results of treatment of newly diagnosed cases of tuberculosis]. PMID- 6866975 TI - [Features of the diagnosis of amyloid of the internal organs in patients with tuberculosis of the lungs and pleura]. PMID- 6866976 TI - [Determination of isoniazid, PAS and ethionamide in urine]. PMID- 6866977 TI - [Simultaneous surgery for fibro-cavernous pulmonary tuberculosis and echinococcosis of the liver]. PMID- 6866978 TI - [Treatment of patients with pulmonary aspergillosis by means of inhalation of amphotericin B aerosols]. PMID- 6866979 TI - [Disability and vocational rehabilitation of patients with fibro-cavernous tuberculosis]. PMID- 6866980 TI - [Work experience of a psychiatric hospital for tuberculosis patients]. PMID- 6866981 TI - [Dynamics of fibrosis formation in the lungs in tuberculosis patients]. PMID- 6866982 TI - [Development and course of coniotuberculosis in coal miners]. PMID- 6866983 TI - [Rifampicin in the treatment of newly detected adolescent pulmonary tuberculosis patients]. PMID- 6866984 TI - [Contingents of tuberculous spondylitis patients and their surgical treatment]. PMID- 6866985 TI - [Pathology of the middle lobe and lingular segments of the lungs based on resection data]. PMID- 6866986 TI - [Tuberculin rosette test in determining tuberculosis of the female genitalia]. PMID- 6866987 TI - [Development of cancer in the wall of a tuberculous cavern]. PMID- 6866988 TI - [Computer tomography in the diagnosis of mediastinal tumors and cysts]. PMID- 6866989 TI - [Role of patient registration group II in the system of the observation of dispensary contingents]. PMID- 6866991 TI - Poorly differentiated epidermoid carcinoma of the lung metastasing to oral tissues. A case report. PMID- 6866992 TI - Acid penetration through Ca(OH)2 liners. PMID- 6866990 TI - Variability of linear and angular cephalometric variables. PMID- 6866994 TI - [Secondary cartilages in the facial bones of the rat]. PMID- 6866993 TI - [Cell interactions in early tooth development]. PMID- 6866995 TI - [Fluoride varnishes in caries prevention]. PMID- 6866996 TI - Developmental course of 27 late-developing second premolars. PMID- 6866997 TI - Spirogermanium: effects on hematopoietic stem cells and survival of normal and tumor-bearing mice. AB - The effect of spirogermanium (SG) on hematopoietic stem cells, tumor burden, and survival times was investigated in C3H mice with transplanted mammary carcinoma. Compared to normal mice, the number of hematopoietic stem cells, or colony forming units per spleen (CFU-S), was lower in the marrow of tumor-bearing mice. Spirogermanium at 15 and 30 mg/kg was not toxic to the normal hematopoietic cells in the marrow of either normal or tumor-bearing mice. In contrast to animals treated with cyclophosphamide, SG did not decrease the tumor growth rate or prolong the survival times of tumor-bearing C3H mice. Doses of 35-40 mg/kg SG did not prolong the survival times or decrease the tumor burden of AKR/J mice with a long-passaged lymphoma. These studies demonstrate that SG has minimal inhibitory effects to the marrow of normal mice and may promote the maintenance of normal marrow cells in tumor-bearing animals. However, in two different transplanted tumor cell lines, SG did not inhibit tumor growth or prolong host survival time. PMID- 6866998 TI - Sweetness of diet and food consumption by infants. AB - Normal female infants were studied from 8 to 112 days of age to determine the effect on food consumption of feeding formulas that differed widely in sweetness. One formula contained sucrose and the other a bland-tasting cornstarch hydrolysate. In a balanced, crossover design, it was found that food consumption was significantly greater during intervals in which the sweeter formula was fed. PMID- 6866999 TI - Human bone morphogenetic protein (hBMP). AB - Human bone morphogenetic protein (hBMP) was chemically extracted from demineralized gelatinized cortical bone matrix by means of a CaCl2 X urea inorganic-organic solvent mixture, differential precipitation in guanidine hydrochloride, and preparative gel electrophoresis. hBMP is isolated in quantities of 1 mg/kg of wet weight of fresh bone, and has the amino-acid composition of an acidic polypeptide. The mol wt is 17 to 18 k-Da (kilodaltons). Implants of the isolated 17-kDa protein are very rapidly adsorbed and produce a smaller volume of bone than protein fractions consisting of 24-, 17-, and 14-kDa proteins. Since the isolated 24- and 14-kDA components lack hBMP activity, the kinetics of the bone morphogenetic processes including the function of other proteins as carrier molecules, await investigation. PMID- 6867000 TI - Amrinone dilates pulmonary vessels and blunts hypoxic vasoconstriction in isolated rat lungs. AB - The direct effects of the cardiotonic agent amrinone (WIN 40680) on pulmonary vasoreactivity were studied in isolated, blood-perfused, rat lungs. Lungs were perfused at constant flow and ventilated with normoxic gas, while mean pulmonary arterial pressure was monitored. Pressor responses to hypoxic gas (3% O2, 5% CO2) and angiotensin II (0.25 microgram/0.1 ml) were elicited after amrinone or saline was added to the perfusate. Pressor responses were blunted when calculated amrinone perfusate concentration was increased to 10 micrograms/ml. Pressor responses to hypoxia fell from 8 +/- 1 mm Hg (mean +/- SE, n = 8) before, to 2 +/ 1 mm Hg after amrinone (10 micrograms/ml), while responses to angiotensin II fell from 7 +/- 1 to 3 +/- 1 mm Hg (n = 8). Pressor responses in saline controls did not change. Pulmonary arterial pressure dropped within minutes following injection of amrinone (300 micrograms) into the pulmonary arterial cannula, with a greater drop during hypoxia than during normoxia. Meclofenamate did not prevent blunting of pressor responses by amrinone. Amrinone is a rapidly acting vasodilator which blunts vasoconstriction due to hypoxia or angiotensin II. Since it combines cardiotonic and pulmonary vasodilator actions, amrinone may have therapeutic potential for patients with cor pulmonale and pulmonary hypertension. PMID- 6867001 TI - Adaptations of lactate metabolism in iron-deficient rats. AB - Effects of dietary iron deficiency on lactate metabolism were studied in weanling female rats. Following an iron-deficient diet for 5 weeks, mean hemoglobin concentration was lowered to 6.4 g/dl relative to 12.2 in the control group. Mean plasma iron levels were 58 and 162 micrograms/dl, respectively. Significantly elevated resting lactate levels were observed in whole blood and plasma from iron deficient anemic (relative to control) rats. Total activity of lactate dehydrogenase (LDH) was elevated in soleus and gastrocnemius muscles in response to iron deficiency from 269 +/- 51 to 364 +/- 60 (Mean +/- SD) and from 265 +/- 65 to 372 +/- 61 IU . 10(-3) . g-1, respectively. The LDH activity in heart was lowered from 700 +/- 61 to 593 +/- 45 IU . 10(-3) . g-1. The M3H and M2H2 isozymes in soleus were increased from 12.7 +/- 2.8 to 20.4 +/- 5.8% and from 19.4 +/- 6.1 to 28.2 +/- 3.6%, respectively. Similar increase was observed in M2H2 and MH3 in gastrocnemius from 9.8 +/- 0.9 to 14.8 +/- 2.0% and from 17.4 +/- 2.0 to 20.5 +/- 2.3%, respectively. The H4 isozyme was significantly reduced in soleus, gastrocnemius, and plantaris muscles from 27.7 +/- 4.7 to 12.4 +/- 4.4, from 15.8 +/- 1.9 to 7.2 +/- 2.9, and from 10.5 +/- 2.9 to 3.9 +/- 2.1%, respectively. It was suggested that iron-deficiency anemia induces an elevation of lactate production following an increase in total LDH activity and change in LDH isozyme patterns. PMID- 6867003 TI - Segmental nephron sodium and potassium reabsorption in newborn and adult dogs during saline expansion. AB - Studies were carried out in 23 anesthetized neonatal dogs aged 2 to 20 days and in 16 adult dogs to compare the effects of saline volume expansion on renal tubular Na and K reabsorption between newborn and adult animals. Proximal- and distal-tubule function was estimated by the distal-nephron-blockade technique using ethacrynic acid and amiloride. During saline infusion, which increased extracellular volume by approximately 30% for both age groups, total nephron fractional Na reabsorption was 0.91 for the adult but 0.98 for the puppy (P less than 0.01). However, proximal tubule fractional Na reabsorption was greater in the adult (0.64) than in the puppy (0.48, P less than 0.01) whereas distal nephron fractional Na reabsorption was much greater in the newborn (0.51) than in the adult (0.26, P less than 0.01). Sodium reabsorption normalized to kidney weight was lower in all segments of the neonatal kidney than in the adult kidney. The filtered sodium load was lower in the newborn (27.0 mueq min-1g-1) than in the adult (105.0, P less than 0.01), and the Na load to the distal nephron was also lower in the newborn (14.0 mueq min-1g-1) than in the adult (37.2, P less than 0.01). Fractional K excretion was similar in both age groups even though the fraction of filtered K escaping proximal-tubule reabsorption was greater in the newborn than in the adult, indicating greater net K fractional reabsorption in the distal nephron of the newborn than in the adult kidney. These results indicate that in response to saline expansion there is a greater proximal tubule natriuresis in the neonate than in the adult but overall renal Na excretion is less in the newborn animal due to enhanced fractional Na reabsorption in the neonatal distal nephron, particularly in Henle's Loop. This increase in distal nephron fractional sodium reabsorption may be related in part to the relatively small absolute Na load presented to the distal nephron of the neonatal kidney. PMID- 6867002 TI - Induction of hepatic alkaline phosphatase by colchicine: role of cholestasis and bile acids. AB - We studied the induction of hepatic alkaline phosphatase by colchicine, a drug which impairs bile flow. By analogy to bile duct obstruction, where retained bile acids induce alkaline phosphatase, we hypothesized that the mechanism of induction involves the drug's cholestatic property and subsequent intrahepatic retention of bile acids. After administering colchicine to bile-fistula rats, we monitored bile flow. In colchicine-treated rats which did not develop cholestasis, we varied the transhepatic flux of taurocholate 15-fold over the physiologic range in order to study the role of intrahepatic bile acids. Induction of alkaline phosphatase was observed when cholestasis was absent and the bile acid flux was 5% of normal. The magnitude of enzyme induction was not augmented by increasing the transhepatic flux of taurocholate. The results demonstrate that colchicine induces hepatic alkaline phosphatase by a mechanism which operates independently of cholestasis and is not modified by the level of bile acid in the liver. PMID- 6867004 TI - Ovariectomy-induced tubulin polymerization in pregnant rat mammary gland. AB - The pool of polymerized (microtubular) tubulin in the mammary glands of pregnant rats, ovariectomized (OVX) at 18 days, increased approximately threefold between 18 and 24 hr following ovariectomy, as determined by 3H-colchicine binding assay, while that of the sham-operated animals showed no change. Total tubulin content did not change in either OVX or sham animals. The polymerized pool and the total tubulin in 9-day lactating mammary glands were significantly greater than in the mammary glands of OVX or sham rats. PMID- 6867005 TI - Long-term persistence of antibody following immunization with pneumococcal polysaccharide vaccine. AB - Thirty-seven healthy volunteers who received a pneumococcal polysaccharide vaccine were tested 4, 5, or 6 years after immunization for circulating type specific pneumococcal antibody by radioimmunoassay of their sera. Each volunteer was immunized with one of four different pneumococcal vaccines containing 50 micrograms of each of 6, 8, 9, or 13 capsular polysaccharides; a few volunteers received octavalent or tridecavalent pneumococcal vaccines combined with bivalent influenza virus vaccine in a single syringe. Four years after immunization, the mean antibody level was 90% of the level achieved 4 weeks after vaccination. Among volunteers tested 5 years after immunization (including three 6 years after vaccination), the mean antibody level was 76% of that 4 weeks after inoculation. These findings confirm the long-term persistence of vaccine-induced type-specific pneumococcal antibodies and suggest that the interval between repeated doses of pneumococcal vaccine should be at least 5 years. PMID- 6867006 TI - Triphenylmethylphosphonium (TPMP+) as a probe for peritubular membrane potential in the kidney slice. AB - The present work was undertaken to assess the validity of the use of TPMP+, a lipophilic cation, as a basolateral membrane-potential probe in the rabbit kidney slice. Cortical slices incubated in media containing 3H-TPMP+ reached an equilibrium slice/medium concentration ratio (S/M) for TPMP+ after 90 min. The equilibrium S/M TPMP+ was approximately 20 at TPMP+ concentrations between 30 and 50 microM. Concentrations of TPMP+ above 50 microM resulted in changes in tissue electrolytes and O2 consumption. Anaerobic incubation of slices in the presence of iodoacetamide decreased the S/M TPMP to approximately 3. When medium K+ was progressively increased, the S/M TPMP+ decreased continuously. There was a linear correlation between cell water/medium concentration ratios (C/M) for TPMP+ and K+ (r = 0.629, P less than 0.01). However, the C/M TPMP+ was 29.0 even at C/M K+ of 1.0, strongly suggesting the presence of a tissue binding component for TPMP+. When corrections are made for the above binding, the average C/M TPMP+ in slices incubated in the normal medium was approximately 13, equivalent to a Nernst potential of -64 mV. This value compared favorably to -54.3 mV obtained by microelectrodes in slices treated in the same fashion. It is concluded that the C/M TPMP+ corrected for binding may be used as a measure of the basolateral membrane potential in the steady state. PMID- 6867007 TI - Environmental heat effects on growth, plasma T3, and postheat compensatory effects on Holstein calves. AB - Five Holstein heifers, 5 months of age, were housed in the Missouri Climatic Laboratory and subjected to an experiment to measure the effects of heat stress on rates of growth, plasma triiodothyronine (T3) levels, and ability to compensate in rate of gain and thyroid function following the stress period. The experiment consisted of 3 weeks at thermoneutral (TN1), followed by 5 weeks of individually controlled heat stress conditions (32.5 to 34 degrees C) dependent on heat tolerance of individual animals. This was followed by a 4-week thermoneutral, postheat compensatory period (TN2). Average daily gains were significantly depressed during the heat stress period (HS). Following heat stress the average body weights attained the projected or expected levels within a 21- to 28-day period following return of animals to thermoneutral conditions. Ratios of feed intake/body weight (w0.75) were reduced during heat stress treatment indicating the thermal inhibition. Ratios or amount of feed intake per unit of gain were greater during HS treatment indicating less weight gain per unit of daily feed intake. Plasma T3 was reduced during heat treatment similarly to daily weight gain. Following the postheat treatment period (TN2) plasma T3 increased markedly as did daily weight gains to demonstrate strong compensatory responses in both measures. In summary, these results demonstrated parallel and positive changes of plasma T3 with daily weight gain during thermoneutral, heat, and postheat compensatory periods, and an inverse relationship of rectal temperature to weight gain and plasma T3. PMID- 6867008 TI - Acute cardiovascular response to a single large intravenous dose of methylprednisolone and its effects on the responses to norepinephrine and isoproterenol. AB - The cardiovascular actions of single 10-micrograms/kg iv doses of norepinephrine (NE) and isoproteronol (ISO), before and after the administration of a single 30 mg/kg iv dose of the glucocorticoid methylprednisolone (MP) (sodium succinate ester), were compared in adult cats. Methylprednisolone increased both systolic and diastolic pressures as well as the pulse pressure by approximately 50%. These steroid effects persisted unabated for the duration of the experiment (40 min). Heart rate was unaffected by MP. MP treatment significantly reduced the increase in systolic and diastolic pressures caused by NE. This MP effect was unrelated to the higher baselines for these two parameters caused by the steroid. The systolic blood pressure and positive chronotropic effects of ISO were also significantly blunted by MP. These observations suggest that a single large dose of MP may cause a depression of cardiovascular alpha- and beta-1-receptor sensitivity. The results are discussed in relation to the actions of massive dose glucocorticoid administration in certain shock states and central nervous system trauma and stroke. PMID- 6867009 TI - Compliance of the extramural portion of the canine common bile duct. AB - The physiologic characteristics of the biliary tract cannot be adequately evaluated without analyzing both the resistive and compliant characteristics of the common bile duct. We studied the compliance of the common bile duct in six anesthetized dogs. Saline was infused continuously while pressure was monitored with the sphincter of Oddi intact and tied off. The mean opening pressure of the sphincter was 8.45 cm H2O. In the obstructed duct, compliance was found to decrease with increasing pressure. The mean compliance for all five dogs at low pressures (below opening pressure) was 11.0 X 10(-2) microliter/cm H2O/mm2, and at high pressures was 1.7 X 10(-2) microliters/cm H2O/mm2. Changes in flow rate did not affect the compliance of the duct. Although the compliance of the duct was found to be nonlinear overall, it was nearly linear in both the high- and low pressure ranges. PMID- 6867010 TI - Effect of AY-25,712 and other lipid-lowering agents on liver catalase and liver carnitine acetyltransferase in rats. AB - The effect of the hypolipidemic agent AY-25,712 on liver catalase and carnitine acetyltransferase was studied in rats. At 250 mg/kg/day for 2 or 4 weeks, i.e., at least 125 times the minimum effective hypolipidemic dose, AY-25,712 had no effect on liver weight or liver catalase. Liver catalase was elevated after a 2 week treatment with clofibrate (+ 30%), bezafibrate (+71%), and fenofibrate (+77%) at doses of 250 mg/kg/day, and with ciprofibrate (+111%) at 25 mg/kg/day. Gemfibrozil at 250 mg/kg/day for 4 weeks increased catalase by 86%. The relative increase in liver weight induced by these compounds showed a good correlation to increased catalase. Nicotinic acid (250 mg/kg/day for 2 weeks) did not alter liver weight or catalase. Clofibrate increased carnitine acetyltransferase by 176% while AY-25,712 had no effect. The results show that AY-25,712 and nicotinic acid did not induce changes in the livers of rats which are associated with treatment by various other hypolipidemic agents. PMID- 6867011 TI - Gastric inhibitory polypeptide (GIP) release by actively transported, structurally similar carbohydrates. AB - Six awake adult dogs prepared with a duodenocutaneous fistula were infused intraduodenally with one of the following solutions: 3% saline, 10% glucose, 20% glucose, 20% galactose, 20% fructose, 20% mannose, 20% sorbitol, 20% maltose, 20% lactose, or 20% sucrose. Both 10 and 20% glucose stimulated GIP release, and the response appeared to be dose related. Actively transported galactose (C-4 epimer) stimulated GIP release, but less than glucose. Fructose (C-2 keto sugar) which is absorbed by facilitated transport did not stimulate GIP release. Mannose (C-2 epimer) which is passively absorbed by diffusion did not release GIP. Sorbitol (reduced alcohol of glucose) which is not absorbed did not release GIP. Of the disaccharides tested, only maltose stimulated the release of GIP. The results suggest that structural integrity of the glucose molecule from the C-1 to C-4 carbon atoms, a free aldehyde group on the C-1 carbon atom, and a cyclic structure are all necessary for both the active transport of glucose and the release of endogenous GIP. It would appear that structurally similar receptors exist for both the active transport of glucose and for the release of GIP. PMID- 6867013 TI - Changes in serum, liver, and tumor zinc levels during plasmacytoma growth in BALB/c mice. AB - The effect of a zinc-deficient diet on serum and liver zinc levels was studied in BALB/c mice in the presence and absence of the IgM-secreting plasmacytoma, TEPC 183. While serum zinc levels were significantly decreased in the zinc-deficient (ZD) mice by Week 2, there was no change in the level of zinc in the liver of this group compared to ad libitum (AL) or pair-fed (PF) controls even after 4 weeks on the respective diets. The presence of the tumor itself resulted in a significant decrease in serum zinc levels in mice maintained on a normal-chow diet. This decrease was not seen in the serum from tumor-bearing AL or PF control mice which were fed a synthetic diet containing 50 ppm zinc. There was, however, an increase in the liver weights of mice in these groups in the presence of TEPC 183 which was not seen in the ZD tumor-bearing mice. Although total zinc levels increased in the livers of AL and PF mice reflecting this increase in liver weight, there was no difference among the groups when the amount of zinc was determined per gram of liver tissue. There was also no difference in the amount of zinc per gram of tumor tissue in the tumors obtained from AL, PF, or ZD mice. PMID- 6867012 TI - Nerve-stimulated secretion of calcium by rat submandibular gland. AB - The comparative effects of electrical stimulation of parasympathetic (chorda tympani nerve) and sympathetic innervation to the rat submandibular gland on calcium secretion were examined. The separate roles of alpha- and beta-adrenergic receptors in the regulation of calcium secretion during sympathetic nerve stimulation were also determined. The present study shows that the parasympathetic and sympathetic innervations to rat submandibular gland have very different effects on [Ca] of saliva; the regulatory influence of the sympathetic is more prominent than that of the parasympathetic innervation; [Ca] of submandibular saliva evoked by chorda stimulation was about 25 times less than that of saliva evoked by sympathetic stimulation. However, since total volume of chorda-evoked submandibular saliva was about 20 times greater than that of sympathetically evoked saliva, the total output of calcium following stimulation of either autonomic branch was similar. Glandular depletion of calcium for both kinds of nerve stimulation was also similar. Comparison with previous studies on the rat parotid gland shows that the role of the parasympathetic innervation in regulation of [Ca] of saliva and glandular depletion of calcium differed in the two glands while that of the sympathetic innervation was generally similar for both submandibular and parotid glands. Calcium secretion from rat submandibular gland was decreased during sympathetic nerve stimulation in the presence of propranolol, a beta-adrenergic blocker, while it was greatly increased when the sympathetic nerve was stimulated in the presence of phentolamine, an alpha adrenergic blocker. Thus, it was concluded that with both glands beta adrenoceptors play the major role in the regulation of calcium secretion. PMID- 6867014 TI - Autoimmune granulomatous thyroiditis in inbred mice: resemblance to subacute (de Quervain's) thyroiditis in man. AB - Mice in various inbred strains were immunized with mouse thyroglobulin emulsified in Freund's complete adjuvant. Granulomatous thyroid lesions were observed only in RF and SJL mice. These lesions were studied ultrastructurally and showed similarities with subacute (de Quervain's) thyroiditis in man. Thyroid function tests, e.g., the concentration of serum thyroxine and thyroid radioiodine uptake showed similarities between these two diseases. Such findings have not been previously described in experimental thyroiditis. PMID- 6867015 TI - Influence of malnutrition and alterations in dietary protein on murine rotaviral disease. AB - The possible correlation between malnutrition and degree of severity of rotavirus associated infantile diarrhea which appears to occur in human populations was studied using a mouse model. To determine the effects of general malnutrition or altered levels of dietary protein, female mice were fed throughout pregnancy and infection periods with diets diluted with 0, 300, or 600 g glucose/kg, designated as normal nutrient to calorie ratio (N/C) diet, 70% N/C diet, or 40% N/C diet or with diets containing 75, 150, or 300 g casein/kg, as low-, normal-, or high protein diets. Murine rotavirus was given by gavage to the 2-day-old offspring of these dams, and the extent of infection determined. Marked increases in severity of diarrheal disease were seen in the infants from dams receiving the 40 and 70% N/C diets and the low-protein diet. Severity of infection was seen as increased deaths, reduced weight gain, and increased passage of diarrheic feces. Intestinal viral levels and intestinal diarrhea scores did not vary appreciably. Serum interferon remained below detectable limits throughout the studies, but serum antibody was determined in dams 30 days post-virus exposure. The latter titers were lower in the infected mice from dams fed the 40 and 70% N/C diets, but were essentially the same in all the protein diet groups. Cross-fostering was done using the 40 and 100% N/C diets, wherein mice from dams fed either diet were placed on mothers fed the opposite diet. Increased severity of infection was again seen when the virus was given 2 days after the exchange, although the greatest infection occurred in animals from dams fed 40% N/C diet which were then fostered by other similarly fed dams. The increased host sensitivity to the rotaviral infection appeared to be a result of both pre- and postnatal dietary effects. PMID- 6867016 TI - Long-term effects of deendothelialization of rabbit aorta: in vitro synthesis of DNA, protein, and lipid. AB - To study the long-term local effects of a single balloon catheter deendothelialization of the aorta in the rabbit, the incorporation of [3H]leucine and [3H]thymidine into protein and DNA, respectively, and [14C]acetate and [14C]mevalonate into sterols was measured in incubations of intima-media sections prepared from vessels taken 1 year following the procedure. The uptake of [3H]thymidine by the tissue was essentially the same as in the nonballooned controls, but the incorporation of [3H]leucine and [14C]acetate into tissue residue (proteins and glycoproteins) was approximately nine times and four times control values, respectively. At the same time, sections from the ballooned animals incorporated over six times the amount of radioactive acetate into nonsaponifiable lipids and cholesterol than did controls. In animals ballooned 3 months before sacrifice, when about half of the aortic luminal surface was covered with endothelium, intima-media tissue from both covered and uncovered areas showed increased uptake of labeled precursors into protein, nonsaponifiables, and cholesterol but there was no significant difference in incorporation between reendothelialized and nonendothelialized areas. The persistence of increased metabolic activity in the vessel following the loss of endothelium could be a contributing factor in the atherogenic process. PMID- 6867018 TI - Evidence of prolactin short loop feedback in the postpartum lactating rat. AB - Serum prolactin was studied in lactating and nonlactating rats after restraint stress, chronic estradiol benzoate treatment, and acute L-tryptophan treatment. As expected, these treatments evoked increases in serum prolactin in nonlactating rats. In lactating rats these treatments did not increase basal serum prolactin when litters were removed for 4 hr. Daily estradiol benzoate treatment increased pituitary gland prolactin content after 14 days, but there was no effect on basal serum prolactin. Daily estradiol treatment did not augment prolactin release in response to 30 min of suckling. It is suggested that the short loop feedback by prolactin (i.e., prolactin inhibiting its own secretion) makes the lactating rat refractory to these stimuli of prolactin secretion. PMID- 6867019 TI - Effects of feeding a carboxypeptidase inhibitor from potatoes to newly hatched chicks. AB - For the first time, the effects on animal growth and protein digestion of a specific inhibitor of the pancreatic digestive exopeptidases carboxypeptidases A and B were studied. Carboxypeptidase inhibitor from potato tubers was fed to newly hatched chicks at a level equal to that present in a diet containing 50% raw potato solids, which was severely growth depressing. At this level the effect of the carboxypeptidase inhibitor on growth was insignificant but the following effects were noted: (1) 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 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 the diet containing 50% raw potato, was severely growth depressing. The inhibitor produced significantly increased fecal protein and caused pronounced pancreatic hypertrophy. Thus, the growth depressing effects of raw potato tubers is probably due in part to the trypsin inhibitor, with only a small contribution originating from the carboxypeptidase inhibitor. PMID- 6867017 TI - Thyroid response in fetuses of calorie-restricted pregnant rats given goitrogen. AB - The growth of fetuses of 50% calorie-restricted (R) rats was retarded by approximately 1 day as compared with that of ad libitum fed control (C) rats. Nevertheless, the thyroid glands in such growth-retarded fetuses developed in proportion to the size of fetuses, as did the thyroid follicular cell height and the follicular diameter. Pregnant rats were treated with 40 mg propylthiouracil (PTU) each day for 2 days and autopsied on the third day in various gestational periods of Days 17-19, 18-20, 19-21, and 20-22. PTU given to C rats on Days 17 and 18 of gestation did not alter the fetal thyroid weight and histology on Day 19. When given on Days 18 and 19, or later, PTU caused a significant increase in the thyroid weight and follicular cell height. However, when given to R rats on Days 18 and 19, PTU did not influence the fetal thyroid. When given on Days 19 and 20, or later, PTU was effective in R rats. Thus, in fetuses of the R rats, the reciprocal relationship between the pituitary and the thyroid appears to be established with a 1-day delay as compared with the C rats, similar to the 1-day retardation in body weight gain. PMID- 6867020 TI - Molecular and cellular aspects of shock and trauma. Proceedings of the U.S.A. Japan Binational Conference. Kona, Hawaii, June 21-24, 1982. PMID- 6867021 TI - MDF: its participation in the pathophysiology of shock. PMID- 6867022 TI - Regulation of lysosomal membrane stabilization via cyclic nucleotides and prostaglandins: the effects of steroids and indomethacin. PMID- 6867023 TI - Energy metabolism in trauma and sepsis: the role of fat. AB - There seems little doubt that there are signals for the increased mobilization of fat in shock, trauma, and sepsis. Whether those signals are reflected by an actual increase in mobilization is dependent on many variables including cardiovascular status. A hypothetical scheme based on our own experiments in the hyperdynamics phases of response to burn injury and to sepsis is presented in Figure 8. According to this scheme, catecholamines stimulate lipolysis in the adipose tissue, resulting in the release of glycerol and FFA into the plasma at increased rates. The glycerol is cleared by the liver and converted into glucose- a process stimulated by, among other things, glucagon. Some of the increased flux of FFA is also cleared by the liver, whereupon the fatty acids are incorporated into VLDL and released again into the plasma. The increased FFA levels also exert a dampening effect on the factors stimulating hepatic glucose production. At the periphery, plasma FFA as well as VLDL fatty acids are taken up at an increased rate. The tissues are attuned to the oxidation of fat, and as a consequence most of the energy production is derived from fat oxidation. The increased fatty acids exert an inhibitory effect on the complete oxidation of glucose, so although glucose may be taken up at an accelerated rate, the relative contribution of glucose oxidation to total energy production may fall. Rather than being completely oxidized, pyruvate is reduced to lactate and released into the plasma at an accelerated rate. The lactate then contributes to the production of glucose in the liver, completing a cyclical process called the Cori Cycle. Although all aspects of this scheme are supported by data highlighted in this paper, it certainly must be an oversimplification of the overall response of substrate metabolism to trauma and sepsis. It is presented for the purpose of highlighting the potential role of fat as a controller of the metabolic response, and to suggest that the enhanced mobilization and oxidation of fat is one of the fundamental responses to stress. PMID- 6867024 TI - Molecular lesions associated with neoplasia: an introduction to proviruses, retroviruses, LTR's and onc genes. PMID- 6867025 TI - Oncogenes and retroviruses. Evaluation of basic findings and clinical potential. Proceedings of a workshop, Roswell Park Memorial Institute, Buffalo, New York, September 2-3, 1982. PMID- 6867027 TI - The serological analysis of human cancer. Identification of differentiation antigens on melanoma and melanocytes. PMID- 6867026 TI - The role of host c-onc genes in viral and non-viral neoplasia. PMID- 6867029 TI - California serogroup viruses. Proceedings of an international symposium, Cleveland, Ohio, November 12 and 13, 1982. PMID- 6867028 TI - Using retroviruses as insertional mutagens to identify cellular oncogenes. AB - Three criteria have been used to identify cellular genes that might play a role in oncogenesis: (i) homology with known viral transforming genes (v-onc's); (ii) activated expression in tumor cells; and (iii) transforming activity in cultured mouse cells. We have been exploring the hypothesis that retroviruses lacking oncogenes activate cellular oncogenes by insertional mutagenesis. Our approach is to locate proviruses within the chromosomal DNA of clonal populations of tumor cells, and to identify activated transcriptions of tumor cells, and to identify activated transcriptional units in flanking cellular DNA. The central findings that have emerged from such studies in our laboratory and others indicate that: (i) insertion of avian leukosis virus (ALV) DNA can activate c-myc, a previously identified cellular homologue of a viral transforming gene, by various arrangements of proviral and c-myc DNA; (ii) most mammary carcinomas in C3H mice carry new mouse mammary tumor virus (MMTV) proviruses within an unidentified 20 kilobase region of the mouse genome that contains at least one activated transcriptional unit; (iii) proviruses of three viruses (ALV), chicken syncytial virus (CSV), and myeloblastosis-associated virus (MAV) are present in the c-myc locus in avian B cell lymphomas, suggesting that the same gene is activated during induction of a single type of tumor by different viruses; and (iv) MAV induced nephroblastomas do not contain proviral insertions near c-myc, implying that the same virus may affect different genes in different types of tumor. PMID- 6867030 TI - Bunyavirus gene structure - function relationships and potential for RNA segment reassortment in the vector: La Crosse and snowshoe hare reassortant viruses in mosquitoes. AB - Modern technology now permits the elucidation of viral gene contributions to virus-vector interactions. Such knowledge will undoubtedly permit determination of those mechanisms which function to preserve vector-borne virus disease cycle specificity and integrity in nature. In addition, the application of genetic techniques to reassortant virus generation in vectors should permit prediction of the evolutionary and epidemic potential of viruses in nature. PMID- 6867033 TI - Pathology of La Crosse virus infection in humans. PMID- 6867032 TI - Clinical aspects of La Crosse encephalitis: preliminary report. PMID- 6867031 TI - California serogroup gene structure-function relationships: virulence and tissue tropisms. PMID- 6867034 TI - Neurologic aspects and treatment of La Crosse encephalitis. PMID- 6867035 TI - Clinical aspects of La Crosse encephalitis: neurological and psychological sequelae. AB - Only rarely will a child continue to have focal neurologic findings, such as paresis, for as long as 8 years after LAC encephalitis. Most of the other focal neurologic findings, such as Babinski reflexes, pathologic reflexes, aphasias, choreas, dysarthrias and ataxias, resolve completely. Abnormal electroencephalographic findings during the acute period were note in 86-100% of the cases. On 1-8 year follow-up, EEG abnormalities were noted in approximately 33% of the subjects tested. Seizures are present at high frequency during acute illness and recurrent seizures may occur in 6-13% of the cases 1-8 years after infection. The cognitive and intellectual functioning of children following LAC encephalitis is not significantly different from that of the normal population. As a group, LAC encephalitis victims also function in the normal range in terms of their academic performances. There are individuals, however, who will have suffered permanent destructive lesions resulting in lowered IQ and lowered school performance. Behavioral abnormalities are difficult to measure and when present, difficult to ascribe to a definitive cause. PMID- 6867036 TI - La Crosse encephalitis: occurrence of disease and control in a suburban area. AB - Fifteen (6.4%) of 233 residents sampled in State Road Coulee (SRC) during 1972-73 had antibodies neutralizing La Crosse (LAC) virus, 9 (3.9%) trivittatus (TVT), 12 (5.2%) Jamestown Canyon (JC) and 2 (0.9%) Bunyamwera serogroup virus. Six of seven youths who had antibodies to LAC virus had been ill: three were serologically confirmed as cases of LAC encephalitis and three had possibly related illnesses. The other reported no illness. Possibly related illnesses were reported by 1 of 10 adults with antibody to LAC; also by 3 of 6 youths who had antibodies to TVT or JC viruses, and by 4 of 39 youths who did not have these antibodies. In prospective studies, 4 of 132 sampled again during 1977 had acquired antibodies, including 2 to LAC and 2 to JC virus. The LAC disease infection rate was 50%. One of those with antibody to LAC virus was a girl with encephalitis who had a serologically confirmed infection a year after she had moved away from SRC. Her exposure to mosquitoes was not in SRC. The other was a boy who remained a resident but did not have encephalitis or other severe illness. The two who had acquired antibody to JC virus were boys who reported histories of undiagnosed febrile illnesses while attending summer camps in central Wisconsin. Control measures, including closure of treeholes, removing old tires and education, were applied. LAC infections in SRC were reduced from six during 1965 thru 1972, to only one during 1973 thru 1977. No cases have been found in SRC since 1977. Following expansion to a county-wide control program, LAC encephalitis in La Crosse County has been reduced from seven and eight cases during 1978 and 1979 to only one and two during 1980 and 1981. No cases have been found in La Crosse County so far during 1982. PMID- 6867037 TI - California serogroup viruses in Iowa. PMID- 6867038 TI - Reported encephalitis associated with California serogroup virus infections in the United States, 1963-1981. PMID- 6867039 TI - A systems approach to the control of LaCrosse virus. PMID- 6867040 TI - Control of Aedes triseriatus in La Crosse, Wisconsin. PMID- 6867041 TI - The preparation and properties of tablets containing indomethacin and polyethylene glycol 6000. PMID- 6867042 TI - The effect of mixing time of magnesium stearate on the tableting properties of dried microcrystalline cellulose. PMID- 6867043 TI - Depressant and anti-convulsant properties of some 2,2,2-trichloroethyl esters. PMID- 6867044 TI - [(3-Alkylhydroxy)phenylsulfides with antilipemic activity]. PMID- 6867045 TI - [Effect of operative conditions during use of the revolving paddle dissolution apparatus]. PMID- 6867046 TI - [Lead and cadmium determination in drugs using atomic absorption spectroscopy. 2]. PMID- 6867047 TI - Clearance concept in salivary drug excretion. Part II: Experiments. PMID- 6867048 TI - Compression properties of formulations containing matrix and drug. PMID- 6867049 TI - Release of hydroxybenzoic acids from a triglyceride vehicle containing surfactants. PMID- 6867051 TI - [Specific agents in dermatologic therapy III]. PMID- 6867050 TI - A retrospective study on epileptic patients treated with carbamazepine: interaction between age and co-medication on the drug disposition. PMID- 6867053 TI - [LCS--liquid scintillation counting]. PMID- 6867052 TI - [Natural hallucinogens]. PMID- 6867054 TI - Ethanol intake increases during continuous administration of amphetamine and nicotine, but not several other drugs. AB - Groups of rats, acclimated to drinking both water and 10% v/v ethanol were implanted with a variety of slow-release devices containing d-amphetamine (d amp), nicotine, caffeine, phencyclidine (PCP), secobarbital, LSD, mescaline or haloperidol. Ethanol intake was elevated only during treatment with d-amp or nicotine; none of the other drugs affected ethanol consumption even though the amounts of all drugs released were pharmacologically sufficient to affect behavior. Nicotine treated rats were not simply seeking calories provided by the EtOH solution, since nicotine treatment did not enhance intake of a distinctively flavored solution isocaloric to 10% ethanol. These results support a self medication model of ethanol intake. PMID- 6867055 TI - Restraint alters the thermic response to morphine by postural interference. AB - The effects of morphine on body temperature have been shown to be altered by restraint. The purpose of this study was to determine how the type of restraint alters body temperature measurements and whether restraint alters the effects of morphine on body temperature by interfering with the ability of the rats to adjust their posture. The thermic effects of 5 doses of morphine (3.8 to 45 mg/kg) were compared in two types of restraint and confinement to a 13 X 20 X 20 cm pan without restraint. In unrestrained rats, morphine caused predominantly hyperthermia, but with restraint morphine caused hyperthermia at low doses and hypothermia at higher doses. Morphine hypothermia was greater in rats restrained in a wire-mesh restrainer which prevented heat and humidity build-up than in the commonly used plastic restrainer. In the unrestrained rats, morphine treatment was associated with a posture characterized by exophthalmos, immobility, a hunched position and increased muscle tone. Restrained rats could not assume a compact posture. These results suggest that restraint alters the thermic effect of morphine mainly by interfering with postural mechanisms which reduce heat loss. PMID- 6867056 TI - Anorexic activity of cocaine and coca extract in naive and cocaine tolerant rats. AB - Dose response curves for reducing limited access food consumption were determined for cocaine HCl IP, cocaine HCl PO, and whole Erythroxylum coca extract PO. The ED50's for cocaine HCl in drug naive rats were 19.6 mg/kg (IP) and 34.6 mg/kg (PO). When the dose of E. coca extract was expressed in terms of cocaine HCl content, the ED50 was 52.6 mg/kg (PO). When dose response curves were determined in rats that had received cocaine (45 mg/kg, PO) for 30 days, a shift to the right in the cocaine HCl curve (an ED50 of 98.4 mg/kg PO) indicated tolerance. However, the shift to the right was less for E. coca extract than for cocaine HCl. Although the anorexic activity of E. coca extract was less than that of an equivalent amount of cocaine in naive rats it was often more than that of equivalent doses of cocaine HCl in tolerant rats. Interaction with other constituents of E. coca extract appears to alter the potency of the cocaine content of the extract in different directions in naive and tolerant rats. PMID- 6867058 TI - Alteration of response patterning by d-amphetamine on repeated acquisition in rats. AB - The acute effects of d-amphetamine on response patterning in a repeated acquisition baseline were investigated with rats. Each session the animals acquired a different four-member response sequence on three levers. Each sequence (trial) completion produced a food pellet. Errors produced a brief timeout that was reset by responses made during the timeout. Acute doses of d-amphetamine (0.5 4.0 mg/kg) and saline were administered 30 min presession. The response patterns analyzed were perseverative responses to a single lever (runs), and a response to each lever in either a left-to-right or right-to-left direction (traverses). The trial position, frequency, and lever location of error and timeout responses that occurred in the context of runs and traverses were studied. In contrast to control sessions, higher doses of d-amphetamine produced increases in the number of error and timeout responses emitted. The majority of these responses occurred as runs; traverse responding did not exceed control levels. Furthermore, the run error and timeout responding tended to occur early in the session and on a single response lever. The results are consistent with the view that d-amphetamine disrupts stimulus control and produces perseverative responding which may account for previous reports of disruption in repeated acquisition tasks following d amphetamine administration. PMID- 6867057 TI - Studies on memory: the cerebral spread of an engram in mice as affected by inhibitors of dopamine beta-hydroxylase. AB - Bitemporal injections of puromycin that primarily affect the hippocampal entorhinal areas consistently cause amnesia of maze-learning in mice for 3 days after training but become consistently ineffective if given 6 or more days after training. At these later times, additional puromycin injection sites covering widespread areas of the forebrain are necessary to induce amnesia. These observations are interpreted to indicate that the locus of the engram has become more widespread within the 6-day period. Treatment with inhibitors of dopamine beta-hydroxylase for 3 days following training, retarded the spread of memory from a matter of days to a period of weeks. Repeated treatment with the inhibitors restricted engram spread for about 3 months; again spread was evident about a month after the last treatment. These observations imply that the mechanisms responsible for engram spread are capable of surviving for extraordinarily long periods of time. PMID- 6867059 TI - Facilitation of estrogen-induced receptivity through metyrapone administration in ovariectomized rats. AB - Previously it has been established that adrenalectomy facilitates lordosis in estrogen-primed ovariectomized female rats and that corticosterone administration restores lordosis to preadrenalectomy levels. The present study examined the effects of an inhibitor of the synthesis of corticosterone, metyrapone, upon lordosis in ovariectomized females. In Experiment 1, chronic administration of moderate doses of metyrapone was found to facilitate lordosis. In Experiment 2, a single metyrapone administration at various doses and time intervals before testing had a mild facilitatory effect on lordosis. Experiment 3 compared the effects of metyrapone on ovariectomized and adrenalectomized-ovariectomized females. The absence of a facilitatory effect in adrenalectomized females suggests that the drug's effect on lordosis is mediated by its established inhibitory effects on 11 beta-hydroxylation in the adrenal. These data are consistent with indications that corticosterone titer modulates female receptivity. PMID- 6867060 TI - Effects of methylphenidate on the fixed-ratio performance of mentally retarded children. AB - The effects of methylphenidate on the lever-pressing of 12 mentally retarded children maintained under fixed-ratio 5, 10 and 20 schedules of food delivery were examined. For five children, methylphenidate at oral doses of 0.3, 0.7 and 1.0 mg/kg produced generally dose-dependent decreases in response rates, whereas for the other seven children the two lower doses increased response rates while the highest dose decreased responding. The differential effects of methylphenidate across participants could not be attributed to differences in control response rates or demographic factors. However, each child whose rate of fixed-ratio responding was increased by methylphenidate also demonstrated a therapeutic response to the drug. PMID- 6867061 TI - Ovarian hormones influence brown adipose tissue. AB - Adult female rats were ovariectomized (OVX) or sham-operated and 4-5 weeks later OVX groups were treated with estradiol benzoate (EB), progesterone, both hormones, or the oil vehicle. All rats were sacrificed on the 4th day of hormone treatment following an overnight fast and a terminal meal. Interscapular brown adipose tissue (BAT) pads of EB-treated groups were heavier and contained more lipid than those of the other OVX groups. Lipid content of adipose tissue differed according to site (BAT less than inguinal less than parametrial = retroperitoneal), but only BAT exhibited differential responsiveness to hormonal treatments. There was also a trend for increased oxygen consumption by BAT from EB-treated rats. It is concluded that BAT may be involved in the process of increased energy expenditure by estrogen-treated rats. PMID- 6867062 TI - Morphine and acceptability of putative reinforcers. AB - Rats were given the opportunity to take one of five concentrations of saccharin solutions. Intake across concentrations generated a preference-aversion curve. Morphine, 2 mg/kg, increased intake of saccharin solutions when rats were 12-hr water deprived or were not deprived. These effects with morphine are opposite to those of naloxone and strengthen the idea that there is opioid involvement in incentive motivation. PMID- 6867063 TI - Self-stimulation of the nucleus accumbens and some comparisons with hypothalamic self-stimulation. AB - Rats were trained to respond for electrical stimulation of the nucleus accumbens (ACB) or lateral hypothalamus (HYP) in a shuttle-box apparatus. Whereas the HYP rats showed rapid acquisition and stabilization of performance, the ACB rats were slow to learn the task and commonly took longer than 20 daily sessions to stabilize. Once stabilized, both groups responded with similarly vigorous performance. All rats displayed a predominantly locomotor behaviour, which was almost totally devoid of exploratory behaviours typically associated with self stimulation. The absence of stimulus-bound behaviours was particularly notable in the ACB group. These rats, but not the HYP rats, showed an increase in the latency to initiate stimulation during the daily 25-min test sessions. Depriving the animals of a single self-stimulation session caused a decrease in the latency of ACB rats to initiate on the following day while having no effect on the HYP rats. All ACB rats gradually developed convulsive seizures during the first 3 weeks of testing which subsequently became more frequent and severe. None of the HYP rats showed any involuntary motor effects. The results show that ACB self stimulation is a very different phenomenon to HYP self-stimulation, and suggest that, in addition to reward and aversion, ACB self-stimulation may involve a stereotyped ritual controlled partly by adaptation and conditioning. PMID- 6867064 TI - Dietary quinine has a nongustatory effect on food intake in rats. AB - Recent data suggests that quinine adulteration of rats' maintenance diets may suppress food intake by postingestional (i.e., pharmacological or toxicological) mechanisms. This possibility was tested by increasing rats' rates of drug excretion prior to presentation of quinine maintenance diets. This treatment increased consumption of 3 concentrations (0.1, 0.2, 0.4%) of quinine diet in 2 separate experiments. In a third experiment, the same treatment did not alter consumption of quinine water in a 2 bottle test, suggesting that the increased consumption of quinine adulterated food was not due to a generalized decrease in the gustatory aversiveness of quinine. The data directly support the idea that quinine has postingestional effects which account for at least part of the suppression of food intake seen with quinine adulterated diets. The data further suggest that at least some of these effects occur postabsorptively. PMID- 6867065 TI - Chronic administration of cholinergic agents: effects on behavior and calmodulin. AB - Rats were implanted subcutaneously with Alza pumps and 0.9% saline, physostigmine, or scopolamine were continuously infused for 15 days. Twenty-four hours after removal of the pumps all animals were trained on a single trail passive avoidance task. Twenty-four hours after training they were tested for retention. Following behavioral testing, animals were sacrificed, brain regions dissected, frozen and stored (-20 degrees C) for calmodulin determinations. Animals which had previously received chronic infusions of scopolamine performed significantly better than controls, while those which previously received chronic infusions of physostigmine performed significantly worse during the retention test. No significant differences in calmodulin levels (soluble or particulate) were detected across brain regions or drug groups. These results indicate that continuous chronic infusion of drugs which can facilitate or inhibit CNS cholinergic activity can induce performance changes on a learning task opposite to those resulting following the acute administration of these same drugs. PMID- 6867066 TI - Drug discrimination in rats: evidence for amphetamine-like cue state following chronic haloperidol. AB - Two groups of male Sprague-Dawley rats were trained to discriminate which of two levers to press for milk reinforcement on a VI-20 sec schedule of reinforcement on the basis of whether they were injected intraperitoneally with d-amphetamine (0.50 mg/kg or 1.50 mg/kg) or saline 15 min prior to daily 30 min training sessions. Following acquisition of the discrimination, dose-response functions were generated for both training-dose groups during 5 min test sessions. All subjects were then injected with 1.0 mg/kg of haloperidol for ten consecutive days and retested on either saline or intermediate doses of amphetamine on days 1, 2, 4 and 7 following the final haloperidol injection. The results indicated that chronic haloperidol enhanced the discriminative stimulus properties of amphetamine in both training groups. More importantly, when tested on saline, subjects in both training groups made significantly more responses on the d amphetamine lever than observed prior to chronic haloperidol. On the basis of linear regression analysis of the dose-response curves it was shown that rats in both groups responded as though they had been injected with 0.18 mg/kg of d amphetamine. In a second experiment this increase in amphetamine-lever responding when animals were tested with saline following chronic haloperidol was replicated and in addition it was observed that chronic amphetamine had the opposite effect on this measure. PMID- 6867067 TI - Prior training and intermittent retraining attenuate pimozide-induced avoidance deficits. AB - Although the effects of neuroleptics on avoidance behavior have been studied extensively, no studies have systematically investigated the possible relationship between these effects and prior training. This paper reports the effects of prior training and intermittent retraining on pimozide-induced avoidance deficits. Experiment 1 investigated the effects of pimozide (0.5 or 1.0 mg/kg IP) on one-way avoidance responding in groups of rats (n = 15 or 16) that had received 0, 2, 3, or 10 prior sessions of training (10 trials per session). All trained groups were more resistant to the disruptive effects of the drug than the groups receiving no prior training but the 2, 3, and 10 session pretrained groups did not differ significantly from one another. However, the avoidance responding of the pretrained groups eventually was impaired across the 15 sessions of testing under the drug condition; this effect was shown not to be attributable to an accumulation of the drug with repeated dosing. Experiment 2 showed that periodic retraining in the absence of pimozide reversed the cumulative session-to-session disruptive effects of the low and high dose of pimozide on avoidance responding, a finding not previously reported. The results suggest that dopaminergic systems play a role in the acquisition and maintenance of operant response learning. Avoidance learning fails to occur if training is conducted in untrained, pimozide-treated animals. Pretrained animals, when injected with pimozide, can maintain avoidance responding for several sessions but lose this ability in the continued absence of normal dopamine function; however, intermittent retraining can prevent this eventual loss of avoidance responding. PMID- 6867069 TI - Vasopressin potentiation in the performance of a learned appetitive task: reversal by a pressor antagonist analog of vasopressin. AB - Rats were tested in a simple one-trial water-finding task for the effects of arginine vasopressin (AVP) on performance of an appetitive task. On the training day, each animal was exposed for 5 min to a novel open-field environment that contained a water-tube located in an alcove set into one of the walls of the enclosure. Immediately upon removal from the enclosure, the animals received a subcutaneous injection of either AVP (1 microgram/rat) or vehicle solution. When water-deprived and tested 48 hr later, vasopressin-treated rats found the water tube reliably faster than controls. In other groups of animals, this potentiation in learned performance was prevented by concurrently treating the rats with a vasopressin analog having potent pressor antagonist properties. These results are consistent with the notion that vasopressin may play a role in memory consolidation, but peripheral visceral factors may mediate this action. PMID- 6867068 TI - Time course of changes in nociception after 5,6-dihydroxytryptamine lesions of descending 5-HT pathways. AB - Intrathecal injection of 5,6-dihydroxytryptamine (5,6-DHT) in rats produced selective lesions of the descending 5-HT pathways. Spinal 5-HT levels gradually fell to less than 10% of controls within 10 days of 5,6-DHT administration with no recovery evident within 4 weeks. The uptake of 14C-5-HT into crude spinal synaptosomes was similarly reduced. The uptake of 3H-NA into spinal synaptosomes was unaffected, as was the uptake of 14C-5-HT and 3H-NA into cortical synaptosomes. Following 5,6-DHT, tail-flick latencies were reduced by 20-30% during the first post-injection week, but returned to control levels during the second week. Intrathecal or systemic administration of the 5-HT receptor antagonist metergoline significantly reduced latencies of normal rats and of 5,6 DHT treated rats tested after the second week when the response was normalized. Metergoline did not, however, further reduce the latencies of lesioned rats during the first post-injection week. It is concluded that functional adaptation involving 5-HT neurotransmission compensated for the selective lesion of descending 5-HT pathways induced by 5,6-DHT. PMID- 6867070 TI - Choline administration: lack of effect on plasma catecholamines in rats. AB - Choline chloride (35 or 70 mg/kg, IP) or saline was administered daily for 3 consecutive days to adult male Sprague-Dawley rats. Before and 30, 60 and 120 minutes after the third injection of choline chloride or saline, blood samples were collected from a chronic tail artery catheter and later analyzed for levels of norepinephrine (NE) and epinephrine (EPI). Plasma levels of both catecholamines did not differ between choline- and saline-injected rats at either of the four sampling points. When insulin (10 IU/kg, SC) was administered to stimulate the sympathetic-adrenal medullary system reflexly, plasma levels of NE and EPI increased significantly above basal values but were similar for choline- and saline-injected rats. These findings do not support a role for choline availability in the regulation of catecholamine secretion from the adrenal medulla. PMID- 6867071 TI - Time course of pimozide effects on brain stimulation reward. AB - Lever pressing for brain stimulation reward (BSR) was tested at hourly intervals following 0.5 or 1.0 mg/kg of pimozide given intraperitoneally. Response suppression was seen within one or two hours and peak effects occurred 5-8 hours after injection. Recovery approached completion within about 24 hours. Since peak brain levels of pimozide are reached quickly, the time course of peak action suggests a complex mechanism of pimozide action. PMID- 6867072 TI - Effect of Silybin on biliary lipid composition in rats. AB - The authors studied the influence of Silybin in rats, administered i.p. for 7 days (daily dose of 100 mg/kg/b.w.) on the biliary lipid composition and on the maximal excretory rate of bile salts. Following this treatment, biliary cholesterol excretion was reduced, while the other lipids and bile flow were not significantly modified. After sodium cholate infusion (1.6 mumol/min/100 g b.w. i.v. for 80 minutes), the Tm of bile salts and bile flow remained unchanged in Silybin pretreated rats. The mechanism by which Silybin treatment reduces cholesterol excretion, is discussed. PMID- 6867074 TI - Effects of antihypertensive drugs on sexual behaviour of male rats. AB - Equiactive antihypertensive doses of clonidine, alpha-methyldopa, hydralazine, propranolol and of a novel compound 355-1057 were tested in an experimental model in which sexual activity was stimulated pharmacologically by lisuride. It was found that those antihypertensive drugs known to cause disturbances in sexual function in men, i.e., clonidine, alpha-methyldopa, hydralazine and propranolol, inhibited lisuride-induced mounting behaviour in male rats, as measured by a decrease in the percentage of animals mounting or in the number of mounts per active animal. The novel antihypertensive compound 355-1057, that seemed in preliminary clinical trials to be devoid of sexual side-effects in men, had no significant effect on the mounting behaviour. It seems, therefore, that the present experimental model could be predictive for antihypertensive drug-induced sexual side-effects in man. PMID- 6867075 TI - Mechanism of lithium action on the adrenergic function. AB - The intravenous injection of Lithium chloride (LiCl) in two dose levels (25 & 50 mg/kg) has led to a significant potentiation of the pressor response of rabbits to the i.v administration of both epinephrine and norepinephrine. The i.v injection of LiCl (50 mg/kg) resulted in a marked depression of the carotid occlusion reflex in rabbits. In vitro experiments revealed that LiCl (1.6 mcg/ml) and guanethidine (0.8 mcg/ml) exert the same action on the rabbit mesenteric nerve-intestine preparation and abolish the intestinal relaxation induced by electrical stimulation of the mesenteric nerve. Results confirm the assumption that Li might display a pre-synaptic, guanethidine-like, adrenergic neuronal blocking activity. PMID- 6867073 TI - Amrinone relaxing effect on the isolated guinea pig trachea and its interaction with aminophylline. AB - The relaxing effect of Amrinone, an inotropic and vasodilating agent, was investigated on the isolated guinea pig tracheal smooth muscle in comparison and in association with Aminophylline. Amrinone (pD2 = 5.02 +/- 0.07) resulted more active than Aminophylline (pD2 = 4.25 +/- 0.08) in relaxing the isolated guinea pig trachea. The interaction curves of the two drugs showed the pattern typical for "competitive synergism", thus suggesting that Amrinone may act on tracheal muscle through inhibition of phosphodiesterase. PMID- 6867076 TI - [Synthesis of N alpha-(4-methylbenzoyl)-4-amidinophenyl-alaninamides and esters]. AB - To test their inhibitory activity against serine proteinases, especially thrombin, in comparison to the very potent N alpha-tosyl-4 amidinophenylalaninamides, the authors synthetized the compounds named in the title, which contain the p-toluoyl residue in place of the tosyl residue. These compounds were prepared from 4-cyanophenyl-alanine (1) by N-acylation to 2 and formation of the active ester 3 which was aminolyzed. The amides thus obtained were converted, via the thioamides and the thioimidic acid ester salts, to the amidine hydroiodides 16-19. The methyl ester 21 was afforded from 2 by means of the Pinner reaction. PMID- 6867078 TI - [Effects of the pH value and of drug-adjuvant interactions on the dissolution rate and the liberation of drugs]. AB - It is reported of the effects of the pH value and of drug-adjuvant interactions on the dissolution profile of chlorpromazine hydrochloride and theophylline, as well as on their liberation from triturations with sodium carboxy-methylcellulose and microcrystalline celluloses. The binding of chlorpromazine hydrochloride to sodium carboxymethylcellulose and (less markedly) to micro-crystalline celluloses acts on the drug liberation only in those pH ranges where the dissolution rate of the drug remains constant. In a pH range where the dissolution rate decreases, the binding is of negligible significance. A prolongation of the dissolution time is sufficient to dissolve out the sodium carboxymethylcellulose-bound chlorpromazine hydrochloride from the associate and to produce an increase in liberation. The binding of the drug to the adjuvant weakens with increasing ionic strength of the liberation medium, which leads to a considerable rise of the liberation rate. Owing to the slight sorption of the drug on microcrystalline celluloses, the drug liberation equalizes the dissolution rate in pH ranges greater than 4.8. The dissolution rate of theophylline and the rate of its liberation from triturations showed no differences since there were no drug adjuvant interactions. PMID- 6867077 TI - Syntheses of some 4,4'-biphenylenedihydrazone-3-(3-methyl)-2-pyrazolin-4,5-dione derivatives and their antimicrobial potentialities. AB - A new series of bispyrazolones were obtained upon treating the bishydrazone derivative 1 with dimethylsulphate, acetic anhydride, benzenesulphonyl chloride, piperidine, morpholine, N-methylaniline and formaldehyde respectively. A Mannich base was prepared from the interaction of 4-phenylhydrazone-3-methyl-2-pyrazolin 5-one and n-butylamine. The condensation of an N-hydroxy methyl derivative with ethyl acetoacetate and diethyl malonate led to the formation of the corresponding N-methyl derivatives. Some of the new bispyrazolones were screened to test their antimicrobial potentialities against Fusarium oxysporum fsp. hycopersici. PMID- 6867079 TI - Formulation and bioavailability of directly compressed oxytetracycline hydrochloride tablets. AB - Different tablet formulations containing various vehicles were selected for this study. These tablets were prepared using different proportions of either single or binary vehicles, and were found to possess different disintegration times. A significant correlation was obtained between the dissolution time (T50) and the urinary excretion data as well as their disintegration time. The dissolution rate of the produced tablets therefore can affect their physiological availability which in turn was dependent upon the type of vehicle used and its actual concentration in the formula. Other factors such as the type and concentration of the lubricant(s), hardness values of the tablets prepared, solubility of the drug as well as interactions between the drug and vehicles used may also play a part. PMID- 6867081 TI - Inverse structure-activity relationships. PMID- 6867080 TI - Preparation, properties and biological activity of beta-cyclodextrin inclusion complex of menadione. AB - The molar ratio of menadione (vitamin K3) to beta-cyclodextrin in the microcrystalline inclusion complex showed this to be 1:3 with a menadione content of approximately 4.1-4.3%. Complexes with higher vitamin content could not be prepared. Bound and free vitamin can be readily separated by sublimation in vacuum. The menadione is highly stable in complexed form; in dry state it is released only when cyclodextrin is destroyed by heating to about 300 degrees C. Complexed menadione does not react with amino acids. Solubility and dissolution rate are strongly increased. Treating hypovitaminotic chickens with equivalent doses of menadione or menadione-beta-cyclodextrin complex and monitoring blood clotting times, recalcification times and prothrombin times the complex proved to be at least as effective as--or even somewhat more potent than--free vitamin. 1.5 2.0 micrograms/animal/d free or complexed menadione was sufficient to cover the daily vitamin K needs of chickens. PMID- 6867082 TI - [Problems in the fluorometric determination of ampicillin]. PMID- 6867083 TI - [Applicability of the activation theory to the tabletting of polymorphic substances]. PMID- 6867084 TI - Application of PMR spectrometry in pharmaceutical analysis. AB - Noramidopyrine-methansulfonate sodium (dipyrone), in bulk drug and its Novalgin ampules, has been assayed by a new, rapid, accurate and specific method. It involves the use of PMR Spectrometry; in which the integral of the five aromatic protons present in dipyrone is compared to that of the two protons of a known amount of maleic acid used as internal standard. PMID- 6867085 TI - Comparison of two dissolution apparatuses: rotating basket versus rotating flask. AB - The U.S.P./N.F. dissolution test (method I or rotating basket method) and the rotating flask technique (RESO-TEST dissolution method) were applied to four commercial prolonged release theophylline dosage forms. The dissolution data obtained were converted into dissolution efficiencies and submitted to a correlation analysis, the result of which demonstrates the equivalency of both methods with respect to the characterization of the dissolution behaviour of the dosage forms tested. It is suggested to consider replacement of the official dissolution technique, the shortcomings of which are well-known from the literature, by the rotating flask technique. PMID- 6867086 TI - The effects of using different grades of PVP and gelatin as binders in the fluidized bed granulation and tabletting of lactose. AB - The effects of using different grades of PVP and gelatin binders on three sieve fractions of lactose granulated in a fluidized bed granulator and tablets have been studied. Increasing the molecular mass of PVP or bloom number of gelatin resulted in a decrease in granule friability but in an increase in their average size and porosity and in the tensile strengths of the resulting tablets when compressed to a fixed apparent density. The results have been explained in terms of the effects of moist and dry binder bridges on bonding of particles in granules and tablets. PMID- 6867087 TI - [Antihypoxic effect of tisochromide (16-244) in comparison with piracetam]. AB - The antihypoxic activity of Tisochromide (3-[4'-dimethylamino-4'-methylpentyl(2') carbamoyl]-6,7-dimethoxy-1-thiaisochroman-1,1-dioxide), a substance of clinically antidepressant action, is studied on three hypoxia models and compared with that of the nootropic agent Piracetam: -- Tisochromide produces a dosis-dependent prolongation of the survival time of mice exposed to nitrogen hypoxia. -- The hypoxia-induced increase of lactate and pyruvate in the mouse brain is inhibited by this preparation. -- As to anoxia-induced electroencephalographic changes in the rat. Tisochromide increases the cerebral resistance against anoxia and shortens the isoelectric part of the encephalogram as well as the postanoxic phase of normalization. PMID- 6867089 TI - [Saturated heterocyclics. 45. Synthesis of 2-substituted-5,6-trimethylene- and 5,6-tetramethylenepyrimidine-4(3H)-ones for pharmacologic testing]. PMID- 6867090 TI - QSAR applied to aging of phosphylated acetylcholinesterase. PMID- 6867088 TI - [Enzyme activities in the blood serum from rats with chronic liver damage. part 3: Effect of thioacetamide]. AB - Liver damage was produced in male Wistar rats aged 15 weeks by daily oral administration of 40 mg/kg thioacetamide over a period of 24 weeks. All of the animals were weighed once a week. Furthermore, the duration of hexobarbital anaesthesia and the activities of the enzymes ASAT, ALAT, GIDH, LDH, LAP and alkaline phosphatase in the serum were determined in 6 experimental and 4 control animals after 3 d and 1, 2 and 4 weeks, and then at intervals of 4 weeks. For the purpose of comparison the same investigations were performed (under identical experimental conditions) both in rats fed normally and rats starved for 24 h to which a single dose of thioacetamide was applied. The histological study of the livers revealed destruction of the lobule architecture and profuse bile-duct proliferations after 12 weeks. Cirrhosis was observed after 16 weeks. The activities of ASAT, ALAT, GIDH and LDH increased for a short time and then returned closely to normal. During the whole experimental period, the LAP and alkaline phosphatase activities remained in the pathological range, as well as the duration of hexobarbital anaesthesia. Enzyme diagnosis is not suitable for assessing the degree of severity of a liver damage produced by thioacetamide. PMID- 6867091 TI - [Biopharmacy of otorhinolaryngologic drugs]. PMID- 6867092 TI - Drug prescribing pattern of a psychiatric university hospital in Germany. AB - 1. The drug treatment of 1,263 psychiatric patients (= 96% of all in-patients admitted during a period of 2 years) was analyzed by means of case histories. During hospitalization 7.4% of all patients were treated completely drug-free; 12.5% received no psychoactive drugs. 2. The patients were hospitalized for 50 days on the average, and received psychoactive drugs on 43 days. During the total treatment period, they were prescribed an average of 4.3 (median 3.8) different drugs; of these, 2.7 (median 2.3) were various psychoactive drugs. Neuroleptics were the most frequently used drugs; they were prescribed at least once during treatment for 62% of all patients. Antidepressants were prescribed for almost 30% of the patients. 3. For the neuroleptics prescriptions decreased with patient's age; they increased for the antidepressants. Antiparkinsonian agents were prescribed to 51% of neuroleptic-treated patients under 45 years of age, and to 26% of these patients over 45. 4. Neuroleptics were prescribed more frequently in male patients, antidepressants in female patients. 5. Among the individual prescriptions, perazine was the most favoured of the neuroleptics, and amitriptyline of the antidepressants. Clozapine was prescribed for the longest period among all psychotropic agents except lithium salts. Antiparkinsonian agents were used for shorter periods than the neuroleptics administered simultaneously. One-fifth of the patients were given analgesics for brief periods. 6. Medication pattern is related to specific nosology. 95% of schizophrenic patients received neuroleptics for at least an average of 41 days; every second patient in this group received antiparkinsonian agents. 90% of unipolar depressed patients were given antidepressants; during one course of treatment at least 2 different antipressant drugs were prescribed for 32% of these patients. 43% of unipolar depressed patients received neuroleptics for an average of 33 days. Lithium salts were administered for an average of 45 days to 43% of the patients with affective disorders. 7. Treatment surveys of this kind supplement the collection of data on adverse drug reactions by drug monitoring systems. The relationship between the side effects of drugs and the prescription pattern of individual drugs allows one to determine the incidence rates of drug side effects. PMID- 6867093 TI - Effect and efficacy - on the function of models for the assessment of therapeutic efficacy. AB - Whilst the "effect" of a drug can be observed or deduced from observational data, the concept of "therapeutic efficacy" represents mainly a theoretical construction of a high degree of abstraction which is inconceivable without reciprocal combination with other theoretical constructs. The "therapeutic efficacy" of drugs can be investigated only via clinical-pharmacological or clinical models. Several examples are given. The strength of evidence of models is discussed as well as the necessity to continually test them empirically. PMID- 6867095 TI - [Transitory cerebellar ataxia from high dosage combination thymoleptic therapy]. AB - Transitory ataxias have repeatedly been observed and reported in connection with antidepressant medication. However, it is remarkable that exact descriptions of this particular form of ataxia are rarely included. Also, hypotheses concerning the etiology and pathophysiology of these disorders are generally lacking. They are usually given the imprecise designation of "extrapyramidal" ataxias. Two cases are presented here in which therapy-resistant endogenous depressions were treated with maprotiline/dibenzepine and maprotiline/clomipramine, respectively. In both cases, marked neurological side effects in the form of cerebellar ataxia developed. The symptoms, which occurred despite usual dosage, remitted after maprotiline treatment was discontinued for one patient and after dose reduction of both drugs for the other. The atactical and dysmetric symptoms described here are thought to result from a reversible intoxication of mainly cerebellar structures. In an attempt to explain the genesis of these ataxias, a neurophysiological and a neuropharmacological hypothesis are considered and predisposing factors as well as therapeutic consequences are discussed. PMID- 6867096 TI - When trouble comes: administrative process at a time of stress. PMID- 6867097 TI - On rereading "The Origin of Species". PMID- 6867098 TI - Limitations of the autonomy model for the doctor-patient relationship. PMID- 6867094 TI - DBH inhibitory factors of brain tissue. AB - In vivo turnover of NA in the brain is considerably high, but in vitro only a low activity of the enzyme DBH is detectable. It is supposed that this effect is brought about by endogenous enzyme inhibitors. It was demonstrated that the addition of rat brain homogenate, as well as different subcellular fractions from rat brain, inhibit the human serum DBH. Inhibitory activity is resistant to heat and acid but does not seem to be uniformly distributed within the cell. Pretreatment of brain homogenate with pronase reduced its inhibitory activity. In conclusion, pronase sensitive peptides are partially responsible for the inhibitory potency of tissue homogenates. PMID- 6867099 TI - Apologia pro vita sua: an interim report. PMID- 6867100 TI - Reflections on medicine: time and communication. PMID- 6867101 TI - Nuclear war: can it be stopped? A panel discussion. PMID- 6867102 TI - The validity of Monte Carlo simulation in studies of scattered radiation in diagnostic radiology. AB - A computer program using Monte Carlo methods has been developed for the simulation of photon scattering in tissue-equivalent phantoms for incident x-rays in the diagnostic energy range. The study verified that the sampling schemes used in the program can produce random samples according to the theoretical probability distribution functions which describe the photon-scattering process. The Monte Carlo program was applied to determinations of the scatter fractions and edge responses for various phantom sizes, X-ray energies, and recording systems. These quantities were also measured experimentally under comparable imaging conditions. Excellent agreement was obtained between the predicted and experimental results. This investigation established the validity of our Monte Carlo calculations for studies of the physical characteristics of scattered radiation in diagnostic radiology. PMID- 6867103 TI - A 195Hgm-195Aum generator for use in first-pass nuclear angiocardiography. AB - The development of a mercury-195m/gold-195m radionuclide generator system is described, together with the results of preliminary experiments in animals and in man. The daughter radionuclide has a half-life of 30.5 s with a principal gamma emission at 262 keV, ideal for use with the multicrystal camera but suitable also in conjunction with the Anger design. The half-life of the parent radionuclide is 40 h. The eluant in current use is 2.5 mM sodium cyanide, the column being stored under 2% sodium nitrate solution when not in use to prevent radiation damage. Generators capable of delivering 550 MBq of 195Aum in a 0.4 ml bolus have been used for first-pass nuclear angiocardiography, the half-life being long enough to permit administration via peripheral intravenous injection. The radiation dose associated with this radionuclide is much lower than that from conventional 99Tcm labelled radiopharmaceuticals, permitting multiple sequential studies, even on children. PMID- 6867105 TI - A UVA meter for monitoring the irradiance within a photochemotherapy unit. PMID- 6867104 TI - Whole-body and part-body turnover of 85Sr in Paget's disease. AB - The whole-body and part-body retention of 85Sr has been measured over a period of 150 days in 12 patients with Paget's disease, seven of whom were treated with calcitonin, starting 60 days after the 85Sr administration. Retentions were compared with those in a group of seven control subjects. The retention data were analysed using multiple exponential, single and double power-law and combined power law and exponential functions. The mean retention of 85Sr over a long period was greater in the Paget's patients than in the controls, 1.9 times at two months. No significant effect of calcitonin treatment was demonstrated. Part-body measurements based on profile scanning demonstrated a significantly increased uptake of 85Sr in sites where disease was present. The longer-term rate of disappearance from such sites was faster than from unaffected bones. PMID- 6867107 TI - Alpha-particle autoradiography in CR-39: a technique for quantitative assessment of alpha-emitters in biological tissue. AB - The techniques for alpha-particle autoradiography based on the plastic nuclear track detector CR-39, previously reported, have been developed considerably. The techniques are applied to alpha-autoradiography of human lung tissue in particular but are applicable to any biological tissue. The most important developments are: (i) Improvements in the manufacture and pre-etching of the plastic. These allow activities as low as approximately 10(-15) Ci g-1 to be determined. (ii) High resolution alpha-particle spectroscopy in CR-39 plastic based on the analysis of the structure of the etched track. This enables the energy of individual alpha-particles to be determined to approximately 35 keV. (iii) Calculation of the effective thickness of tissue sampled by the plastic. This relates the tissue activity to the track density on the plastic. (iv) A deconvolution analysis which takes the distributions of track length and dip angle in the plastic and determines the alpha-particle range spectrum and distribution of tissue activity with height above the plastic surface. This enables both the absolute abundance and the microdistribution of alpha-active nuclides present to be determined. (v) The analysis of radon diffusion in tissue to determine the mean radon diffusion distance in tissue and plastic. PMID- 6867109 TI - Estimation of a single property of low LET radiations which correlates with biological effectiveness. AB - The biological effectiveness of ionising radiation is believed to be related to the initial structure of the radiation tracks. In this paper, an attempt is made to identify a single physical property of the radiation field that correlates with relative biological effectiveness. This property has been sought in terms of a minimum amount of energy deposition in a certain volume. In order to quantify this approach detailed Monte Carlo track structure simulations have been made of x-rays of widely differing energies and the results have been compared with previously reported experiments of cell killing by these radiations. In terms of the above threshold energy concept, we have thus identified a putative critical property of radiations of low ionisation density such as x-rays, namely the rare occurrence of energy deposition of greater than or equal to 100 eV in a volume of about 3 nm diameter. PMID- 6867108 TI - Further experiments to study whether localised fission fragment irradiation of rat lung causes tumours. AB - Male albino rats inhaled an aerosol of 235UO2 (mass median aerodynamic diameter = 2.8 micrometers and geometric standard deviation = 1.6). Approximately 20 h or 7 d post-inhalation the rats were exposed briefly to 10(12) slow neutrons cm-2 in a nuclear reactor, causing the retained 235UO2 particles of approximate mass 40 or 400 micrograms to emit fission fragments which irradiated the lungs. The mean absorbed doses from the fission fragments were either 80 ot 800 cGy approximately and in addition the lungs were exposed to a background of alpha-rays throughout the rats' life-time from the retained 235UO2 which gave mean doses of about half that from the fission fragments. The animals were kept for their life-time and killed when they became moribund. Malignant tumours were found in the lungs (squamous cell carcinoma and adenocarcinoma) which were probably induced by the alpha-rays rather than the fission fragments. Because of insufficient numbers of animals in the experimental groups, however, some statistical uncertainty exists as to whether the fission fragments were in fact less effective than the alpha rays per unit absorbed dose in causing malignant tumours of the lung. PMID- 6867111 TI - A theoretical concept for measuring doses from external radiation sources in radiation protection. AB - A physically consistent concept is presented for monitoring individual exposures from external radiation, giving quantitative relations between 'fitted' dosemeters satisfying this relation, and 'non-fitted' dosemeters which do not. The calibration of both types is discussed in detail. For non-fitted dosemeters, procedures to determine the error limits are given. The application to accident dosimetry is briefly discussed. PMID- 6867110 TI - Dosimetry with tissue-equivalent ionisation chambers in fast neutron fields for biomedical applications. AB - The use of calibrated tissue-equivalent (TE) ionisation chambers is commonly considered to be the most practical method for total absorbed dose determinations in mixed neutron-photon fields for biomedical applications. The total absorbed dose can be derived from the charge produced within the cavity of an ionisation chamber employing a number of physical parameters. To arrive at the charge produced in the cavity several correction factors have to be introduced which are related to the operational characteristics of the chambers. Information on the operational characteristics of four TE ionisation chambers is presented in relation to ion collection, density and composition of gas in the cavity, wall thickness and effective point of measurement. In addition, some recent results from an ionisation chamber operated at high gas pressures (up to 8 MPa(80 bar)) are presented. The total absorbed doses derived from TE ionisation chambers show agreement within the uncertainty limits with results from other independent dosimetry methods, i.e., differential fluence measurements and a TE calorimeter. Conscientious experimentation and a common data base can provide dosimetry results with TE ionisation chambers with variations of less than +/- 2%. PMID- 6867112 TI - Wiener spectral effects of spatial correlation between the sites of characteristic x-ray emission and reabsorption in radiographic screen-film systems. AB - When characteristic x-rays are generated and reabsorbed in the phosphor of a radiographic screen-film system, the positions at which light is emitted from the initial and secondary interactions are correlated. A simple statistical model is developed to account for the effect of this correlation on the Wiener spectrum of quantum mottle. Unlike previous models, which ignore spatial correlation, the new model predicts that not only noise magnitude but also noise texture is changed as the incident x-ray energy exceeds the phosphor K-edge. PMID- 6867106 TI - Mechanical damage to small spherical 137Cs sources in a pneumatically operated remote afterloading brachytherapy unit. PMID- 6867113 TI - Energy and angular dependence of x-ray absorption and its effect on radiographic response in screen--film systems. AB - The relationship between the film density and the x-ray energy absorbed in the screens, and the effect of the components of a screen--film system on x-ray absorption in the screen phosphor has been studied. It is concluded that, to a good approximation, the total absorbed x-ray energy can be calculated ignoring components other than the phosphor, and that the absorbed energy is related to the film density through the characteristic curve of the film. This simple relationship provides a basis for the theoretical prediction of the radiographic performance of an imaging system. Analytical expressions have been derived for the energy absorbed in model screens containing one or two high-atomic-number elements. For incident energies above the K-edge of the high-Z elements, the contribution of the K x-rays to energy absorption was included by use of a K reabsorption factor. This factor was determined for eight screen pairs as a function of incident photon energy and incident angle. PMID- 6867114 TI - Measurement of daylight UVA in Glasgow. AB - Measurements of daylight UVA have been carried out in Glasgow using a UVA-band detector and a spectroradiometer, both with the aperture window horizontal. Daily energy densities, defined as the total UVA energy each day per unit area, were obtained for the period November 1980 to May 1982. Levels rose from a mean December daily energy density of 4 J cm-2 to an average of 69 J cm-2 in June, with considerable fluctuations from day to day and with up to seven-fold changes observed on consecutive days. The UVA level sometimes varied rapidly during the day, with differences of up to a factor of six in successive 10 min periods. The daily temporal distribution of UVA for summer and winter, and the measured daylight spectra are presented. The spectroradiometer contained a double-grating monochromator used at a band-width of 1 nm. Measurements made by the spectroradiometer were compared with earlier published findings o solar UVA doses received by 56 patients who were photosensitized by 8-MOP in the course of PUVA therapy. It is shown that the median dose represented only 12 min daylight exposure and this indicates that the majority of patients to take care to avoid unnecessary exposure. However, the maximum dose was equivalent to some 84 min exposure to daylight UV and so there is clearly scope for a considerable reduction in exposure in some cases. PMID- 6867115 TI - The effect of radiation on bioluminescent bacteria: possible use of luminescent bacteria as a biological dosemeter. PMID- 6867116 TI - The protection of human subjects in biomedical experimentation. PMID- 6867117 TI - Hamstring muscle tightness. Reliability of an active-knee-extension test. AB - The purpose of this study was to examine intratester reliability of a test designed to measure tightness in the hamstring muscles. The test measures the angle of knee flexion with a pendulum goniometer after active knee extension with the hip stabilized at 90 degrees flexion. The angle of knee flexion represents hamstring tightness. After an instruction session for the subjects, the hamstring muscle tightness of both extremities of 15 men was measured during test and retest sessions. The reliability coefficients for test and retest measurements were .99 for the left extremity and .99 for the right extremity. High reliability resulted from strict body stabilization methods, a well-defined end point of motion, and accurate instrument placement. If conducted properly, the test should provide therapists with an objective and reliable tool for measuring hamstring muscle tightness. PMID- 6867118 TI - Physical therapists in burn care. Role and staffing patterns. AB - The purpose of this study was to identify the role and the staffing patterns of physical therapists in 42 major burn care facilities in the United States. A questionnaire designed by the investigators was used to collect the data. Completed questionnaires were returned from 34 (81%) of the burn care facilities, almost all (91%) of which employed physical therapists. Physical therapy was provided six or seven days a week in 74 percent of the facilities and five days a week in 26 percent of the facilities. The work roles of physical therapists and occupational therapists were compared, and significant differences are reported. The primary treatment provided by the physical therapists was exercise (90%), and the primary treatment by occupational therapists was splinting (96%). The most frequently used methods of contracture control and methods of physical therapy follow-up care are reported, as well as the respondents' perceptions about adequacy of physical therapy coverage and turnover of therapists in burn care. PMID- 6867119 TI - Effect of arm ergometry training on physical work capacity of individuals with spinal cord injuries. AB - The purpose of this study was to evaluate arm cycle ergometry as an aerobic training method in the rehabilitation of individuals with spinal cord injuries. Four male subjects with spinal cord injuries trained for five weeks with arm cycle ergometry. Training sessions were 30 minutes long three times a week at an intensity of 60 to 80 percent of maximal heart rate. Pretraining and posttraining maximal exercise testing consisting of noncontinuous, multistage graded arm ergometry was completed by each subject. Heart rates, oxygen consumption, and work loads were measured. Mean increases of 64.32 percent and 60.54 percent were found for posttraining maximal work loads and maximal oxygen consumption values, respectively. A paired t test (p less than .05) revealed that only the change in posttraining mean maximal oxygen consumption value to be statistically significant. That only this value was significant may be attributable to the small sample size and the large intersubject variability. Implications of these results for clinicians and the limitations of the study are discussed. PMID- 6867121 TI - A clinical method of quantitative gait analysis. Suggestion from the field. PMID- 6867120 TI - Utilization of physical therapy personnel in one hospital. A work sampling study. AB - The purpose of this study was to illustrate the adaptability and use of work sampling, an industrial engineering technique, as a dependable method for collecting personnel utilization data in the physical therapy department of a general hospital and to demonstrate the concept of work sampling to physical therapy supervisors and personnel unfamiliar with this approach. Over a six-week period, a total of 5,824 observations were made at randomly selected 15-minute intervals during the 40-hour work week. Percentages of total time used in observed activities for all physical therapy personnel were divided as follows: 1) direct care, 20.38 percent; 2) indirect care, 11.18 percent; 3) administration, 2.27 percent; 4) communication, 3.28 percent; 5) clerical, 9.56 percent; 6) personal time, 24.60 percent; and 7) out-of-department, 28.72 percent. Physical therapists were most likely to be involved in personal duties from 8 AM to 9 AM (35%) and from 4 PM to 4:30 PM (41%). They showed greatest productivity from 9 AM to 10 AM (59%) and spent time in out-of-department activities rather consistently throughout the day. A conclusion of this study was that work sampling may be used successfully to collect personnel utilization data in a physical therapy department. PMID- 6867122 TI - Profile of physical therapy educators in five countries. AB - Physical therapy educators in Australia, Britain and Ireland, New Zealand, Nigeria, and South Africa were surveyed to develop a profile of physical therapy educators in these countries and to permit comparison with data on US and Canadian educators. Faculty members (N = 154) from 18 programs responded to a questionnaire consisting of 22 items related to education, experience, and professional activities. Most of the respondents (79%) held an entry-level qualification at the diploma or certificate level, and compared with US educators, a much lower percentage held academic degrees of any kind. Similarities between the respondents and US and Canadian educators were found in percentages of women, of those under 40 years of age, of those currently enrolled in academic programs, and of those with tenure; differences were found in hours spent teaching and number of faculty members who had published in the last two years. Understanding these similarities and differences may facilitate international faculty exchange programs and employment. PMID- 6867123 TI - [Hemorrhagic ulcer in Rendu-Osler disease: embolization in the area of the tibial artery]. PMID- 6867125 TI - [Hemorrhoids. Etiopathogenesis and therapeutic inferences]. AB - Etiopathoganeic and physiopathological conceptions of hemorrhoidal illness underline the importance of the mechanical factor in hemorrhoidal prolapse, arteriovenous shunts of sections of circulatory blockage, in surface mucous in hemorrhoidal bleeding; the role of shunts in mid-channel mucous, in neuro vegetative dependence in the regulation of pressure and flow; the clinical factor manifest in the appearance of hemorrhoidal disorders, muscular straining, notably in constipation, genital phases, and stress-linked disorders. The therapeutic possibilities determined by these factors are clear: the advantage of a medical treatment that will link the correction of transit disorders, alimentary regularity, decongestive action of the venotropes, the value of instrumental ambulatory therapy such as sclerotherapy, elastic dressings, controlled freezing in the cases of proctorrhagia and limited prolapse. It is quite clear that the most radical treatment of hemorrhoids is surgery, as long as it is complete, and high up, which can be achieved by the techniques that treat separate clusters, with or without sphincterectomy. PMID- 6867126 TI - [Rehabilitation of cervico-thoraco-brachial outlet syndromes]. AB - The author analyses the results of the reeducation of 26 patients suffering from a syndrome of vasculo-nervous compression in cervico-thoraco-brachial leakage. The treatment involves sessions of kinesitherapy, the technology of which is described in detail; daily exercises which the patient does on his own; and a passive elevation device of the scapulatory band, using adhesive elastic bandage. This treatment does produce a most significant improvement in the arterio-venous and nervous factors as well as in the rachidian pain syndrome. PMID- 6867127 TI - [What should be done in the case of an accidental injection of a sclerosant into an artery? Apropos of a case]. AB - The authors report a case of severe ischaemia following an injection of sclerosant for varicose veins in the legs and discuss the pathophysiology of this accident. It seems that such an accident requires the immediate injection of a massive dose of cortisone; an intravenous infusion containing 400 mg of hydrocortisone hemisuccinate, 400 mg of heparin, 400 mg of Praxilene and 4 ampoules of injectable Tranxene 50; admission to a competent unit, i.e. with experience of this type of accident and the techniques of haemodilution combined with steroid therapy and the use of calcium inhibitors, for example Aldalate, as peripheral antispasmodics. Finally, the authors discuss the precautions which need to be taken in order to avoid such accidents, even in the hands of experts. PMID- 6867129 TI - Static mechanical properties of lungs and chest wall of the dog. PMID- 6867128 TI - [Pelvic varices in women]. PMID- 6867124 TI - [Limping and muscle hypertonia concentrated in the calves. Relation to spasmophilia. Clinical and electromyographic study and treatment plan]. AB - The authors report several cases of patients who presented with pain in one or both calves and a limping gait. Clinical examination and the EMG confirmed that these disorders were of musculo-tendinous origin, maximal at the level of the gemellus tendon, frequently forming a tendinitis. The syndrome consists of a hypertonia of the calves which is maximal on waking and which improves on stretching the muscles. Most of the subjects examined suffered from a syndrome of restless legs and presented alterations of the autonomic nervous system and spasmophilia (simultaneous EMG recording of the left and right soleus muscles). Examination of the pathogenesis reveals the possibility of a phenomenon of tonic muscular training synchronous with variations in an elevated and unstable autonomic tone. The authors discuss a possible relationship with spasmophilia and algodystrophy. Finally, they propose a plan of treatment. PMID- 6867131 TI - The effects of testosterone and its metabolites on sexual behavior and morphology in male and female Japanese quail. AB - Adult Japanese quail are sexually dimorphic. Even when implanted with testosterone (T), ovariectomized females fail to copulate and their cloacal glands are smaller than those of males. This may be due to a reduced capacity of the females to transform testosterone into active metabolites (estradiol-17 beta and 5 alpha-dihydrotestosterone). Indeed, in the male quail, estradiol-17 beta (E2) activates copulation whereas 5 alpha-dihydrotestosterone (5 alpha-DHT) activates crowing, strutting and the development of the cloacal gland. To test this hypothesis, we studied the effects of in vivo treatments of male and female quail with the different T-metabolites. Forty-one castrated male and female quail were implanted with subcutaneous silastic implants of T, 5 alpha-DHT, E2 and E2 in combination with 5 alpha-DHT. When implanted with these metabolites, females failed to copulate and their cloacal glands remained less developed than those of males. Sexual differences in behavior and morphology thus cannot be entirely explained by sexual dimorphism of the metabolism. PMID- 6867130 TI - The effect of naloxone on feeding and spontaneous locomotion in the wolf. AB - The effect of naloxone on food intake and activity levels was studied in the wolf (Canis lupus). Naloxone decreased food intake at both the 1 mg/kg and 5 mg/kg dose. There was no quantitative difference in the magnitude of the decrease in food intake produced by naloxone in winter or summer. Wolves ate significantly greater amounts of deer meat than dog chow after naloxone when expressed on a mass basis but there was no difference when the amounts of food ingested were expressed in calories. This suggests a role for endogenous opiates in the regulation of energy intake. The putative satiety factor, cholecystokinin octapeptide, had no effect on food intake in wolves. Naloxone decreased spontaneous locomotion and increased time spent resting in wolves. The effects of naloxone on activity were significantly more marked in winter compared to summer. PMID- 6867132 TI - Small effect of brown adipose tissue and major effect of photoperiod on body weight in hamsters (Mesocricetus auratus). AB - It has been suggested that brown adipose tissue plays a special role in the control of body weight. This hypothesis was investigated by measuring the body weight of female hamsters over a two month period following removal of interscapular brown adipose tissue. Two groups of animals were used, one maintained on a short day (10:14 light: dark ratio) and the other on a long day (16:8 light: dark ratio) photoperiod. Under both photoperiod conditions hamsters with interscapular brown adipose tissue removed gained somewhat more weight than their corresponding sham operated controls. Photoperiod, however, had a much larger effect on body weight. Hamsters maintained on short days increased their body weight by about 60 percent during the two months of the experiment whereas the hamsters maintained on long days increased their body weight by only about 17 percent. It was concluded that brown adipose tissue plays a small non special role in the control of body weight in the female hamster, but that the light-dark ratio is quantitatively much more important under these experimental conditions. PMID- 6867133 TI - Circadian feeding and drinking rhythms in the rat under complete and skeleton photoperiods. AB - Feeding and drinking rhythms were studied in rats maintained under 24-hr light dark (LD) cycles with various photoperiods, under two-pulse (2P) and one-pulse (1P) skeleton photoperiods, and under constant dark (DD). Rhythmic waveforms were similar under complete LD cycles and corresponding skeleton photoperiods, indicating that these rhythms mainly reflect the entrainment of underlying circadian pacemakers. Little or no role was found for masking effects of light on circadian feeding and drinking waveforms. Entrainment was found to depend mainly on the timing of the dawn light signal, whether it was a 15-min light pulse or a dark-to-light transition initiating a complete photoperiod. Furthermore, the use of 1P schedules revealed that a dawn signal was sufficient for entrainment. These results closely match those obtained for motor activity measures in other nocturnal rodent species, and generally conform to the predictions of Pittendrigh's nonparametric theory of entrainment. Furthermore, the close correspondence of the two rhythms during entrainment, phase-jumps, and free running (DD) conditions indicates that they are controlled by common circadian pacemakers. PMID- 6867134 TI - Learning and memory impairment in adult rats due to severe zinc deficiency during lactation. AB - In a series of three experiments, adult rats who suffered severe zinc deficiency and/or undernutrition during lactation were tested in a 17-arm radial maze for working memory, reference memory, forgetting and learning. In Experiment 1, eight out of 17 arms were baited. The zinc deficient (ZD) and undernourished (PF) rats revealed a learning deficit when compared to adequately nourished rats (AL). ZD rats also appeared to display a loss of working memory. No evidence of loss of reference memory was observed among any of the groups. A reverse learning procedure was used in Experiment 2 to test the same rats used in Experiment 1. ZD rats were significantly inferior in performance of the reverse learning task compared to the AL and PF rats. No significant differences in performance were noted between the AL and PF rats. Although all groups displayed forgetfulness from Experiment 1 to Experiment 2, no significant differences in forgetfulness were evidenced among the groups. In Experiment 3, all 17 arms were baited. The ZD rats displayed a significant working memory deficit as compared to the AL and PF rats. No significant differences in working memory between the AL and PF rats occurred. The possibility that the differences in performance were due to differences in food motivation or attention was considered and rejected. It was concluded that ZD rats experienced a severe learning deficit and some working memory deficit while the PF rats experienced a mild learning deficit as compared to the AL rats. PMID- 6867135 TI - Basis for the hypoactivity that accompanies rapid weight gain in hamsters. AB - The pattern of hypoactivity that accompanies rapid weight gain following septal lesions in hamsters was characterized. Lesioned hamsters displayed reduced levels of running, shorter and slower running bouts, and longer pauses. We examined whether this hypoactivity was due to reassignment of metabolic fuels from supporting physical activity to anabolism, or due to reduced capacity of running to induce psychomotor arousal and mobilize metabolic fuels. Septal lesions were associated with increased rate of ponderal growth and higher titers of circulating growth hormone and insulin. No difference in concentrations of muscle and liver glycogen, percentage of body fat, or the capacity of muscle homogenates to oxidize substrates were identified. Lesioned hamsters ran as fast and as long as control animals on electrical-shock reinforced treadmill, but were unable to generate as much heat in response to injection (0.8 mg/kg) of norepinephrine. We concluded that hypoactivity that accompanies rapid weight gain in hamsters results either from a reduced capacity of running to induce psychomotor arousal and provide incentives that normally motivate that behavior, or from a failure of running to mobilize metabolic fuels at a rate necessary to sustain normal running speed and duration, and not from reduced availability of metabolic fuels or reduced muscle capacity to oxidize metabolic substrates. PMID- 6867136 TI - Response to NaCl taste in mixture with sucrose by sodium deficient rats. AB - Sodium deficient, adrenalectomized rats and nondeficient control rats were offered, for 20 min, either a mixture of 0.15 M sodium chloride and 0.3 M sucrose, or a 0.3 M sucrose solution. The sodium deficient rats drank about 3 times more of the mixture than of the sucrose alone. Nondeficient control animals showed no differential preference for the mixture over the sucrose solution. Subsequent tests indicated that the amount of mixture ingested by the sodium deficient group was comparable to the intake of a much weaker (1/5 as strong) sodium chloride concentration given alone. These results are discussed in the context of taste component analysis of mixtures and suggest that the rodent taste system can specifically respond to sodium chloride in a sodium chloride-sucrose mixture. PMID- 6867138 TI - Variation of fat intake with estrous cycle, ovariectomy and estradiol replacement in hamsters (Mesocricetus auratus) eating a fractionated diet. AB - Intakes of fats, proteins, and carbohydrates were measured daily for a 3 month period in female hamsters maintained on a fractionated diet consisting of the dietary constituents, dextrose, fat and soybean meal. In the first study, hamsters showed variations in body weight and fat intake across the estrous cycle and following ovariectomy, with elevations during diestrous and after ovariectomy when endogenous estrogens are reduced. In the second study, the effects of exogenous estradiol or cholesterol on intake patterns of ovariectomized hamsters were determined. Hamsters lost weight and decreased fat intake when implanted with a silastic containing estradiol and gained weight and increased fat intake when exposed to cholesterol treatment. In neither of the two studies were the intakes of protein or carbohydrates significantly affected by the animals' hormonal status. These results suggest that in the hamster, estrogenic effects on food intake are specific to some dietary constituents and not to others. PMID- 6867140 TI - Effect of ambient temperature on the 24-hour sleep-wake cycle in normal and capsaicin-treated rats. AB - The 24-hour sleep-wake cycle of untreated, normal rats and of capsaicin-treated rats was continuously recorded by telemetry. Recordings were made on two baseline days at 22 degrees C, two days at 29 degrees C, and two final days at 22 degrees C. In untreated animals the daily amount of waking was reduced by the elevated ambient temperature and nonREM sleep was enhanced. This effect was mainly due to the frequent interruption of the dark-time waking episodes by sleep. In capsaicin treated animals, raising the ambient temperature did not significantly enhance sleep. However, in both groups of rats the slow wave sleep (SWS) fraction of nonREM sleep was increased after elevating the temperature to 29 degrees C. REM sleep showed a minor increase which was significant only for the capsaicin treated group. The results suggest that a moderate increase of ambient temperature has two effects: (1) It causes an enhancement of sleep by a reduction in the duration of waking episodes, an effect that may represent a heat-defense response. The attenuation of this response in capsaicin-treated rats may be a consequence of the impairment of warm-receptors. (2) It favors the occurrence of SWS and REM sleep. PMID- 6867137 TI - Passive avoidance performance of mice fed marginally or severely zinc deficient diets during post-embryonic brain development. AB - Swiss-Webster outbred mice were fed marginally or severely zinc deficient diets (9 or 2 ppm zinc) from day 16 gestation to day 15 postnatal. Control mice were fed a 100 ppm diet either ad lib or in amounts equal to the diet intake of deprived mice (pair fed controls). Male and female offspring were tested at 70 days of age in a one-trial passive avoidance task with a 30 min train-test interval. Both marginally and severely zinc deprived offspring (but not pair fed controls) had shorter avoidance latencies than offspring of ad lib fed zinc replete controls. Zinc deprived offspring did not differ from control mice when either baseline or "stressed" (exposure to novel environment) plasma corticosterone levels were quantitated. Further, zinc staining patterns of the hippocampus (Timm-sulfide stain) were not altered in the nutritionally deprived offspring. Thus marginal dietary zinc deficiency during development can lead to impaired passive avoidance performance in adult mice. This behavioral effect is not associated with altered pituitary-adrenocortical activity or with a permanent reduction in hippocampal zinc staining. This result has significant implications for the influence of zinc deprivation in utero and in the neonatal animal on adult behavior characteristics. PMID- 6867141 TI - Superior colliculus involvement in the locomotor effects of ambient noise and the stimulants. AB - Partial destruction of the superior colliculus (45%) significantly decreased the normal facilitatory effect of ambient white noise on locomotor activity levels in young rats. As recovery from surgery occurred and as test experience increased, the loss observed immediately following surgery was reduced. Presumably because of the age of the rats examined, destruction of the superior colliculus failed to potentiate the stimulant effects of d-amphetamine or methylphenidate on locomotion. These data suggest that the superior colliculus is involved in changes in general activity that result from manipulation of auditory stimuli in the environment in addition to the documented involvement of the superior colliculus in alterations of general responsivity resulting from manipulations of visual stimuli in the environment. Moreover, the superior colliculus is implicated in maintaining both excitatory and inhibitory changes in response to the environment of the organism. PMID- 6867139 TI - Increases in plasma glycerol levels precede the hypophagia following subcutaneous glycerol injection in rats. AB - Cumulative food intake and plasma glycerol levels following subcutaneous glycerol injections were investigated in rats, because increases in plasma glycerol have been suspected to contribute to glycerol-induced hypophagia. Besides plasma glycerol, plasma non-esterified fatty acids (NEFA), plasma D-(-)-3 hydroxybutyrate (3-HB), blood glucose, and liver glycogen content were also measured. Two daily injections of 80 mg/kg body wt. glycerol did not affect food intake and failed to increase plasma glycerol 30 min after the injection. A single injection of 660 mg/kg body wt. glycerol reduced food intake and increased plasma glycerol 1-2 hours after the injection. This glycerol dose also increased liver glycogen content 1-2 hours after the injection but did not affect plasma NEFA and 3-HB. Rats injected with 660 mg/kg body wt. glycerol did not reduce feeding within the first 2 hours following the injection, when plasma glycerol levels were increased. Inhibition of feeding began at about 3 hours and continued up to 6 hours although plasma glycerol levels had declined to control values 5-6 hours after the injection. It is concluded that metabolic consequences of elevated plasma glycerol levels rather than increases in plasma glycerol levels per se elicit the food intake reduction following exogenous glycerol loads in rats. PMID- 6867143 TI - "Stick out your tongue": tongue protrusion in neocortex and hypothalamic damaged rats. AB - Easily administered tests, analogues to the human neurological "stick out your tongue" tests, were devised to assess tongue use in normal, lateral hypothalamic (LH) and decorticate rats. LH and decorticate rats showed loss of tongue protrusion and licking immediately after surgery. Even though LH rats did not recover spontaneous eating dry food and drinking water, they showed extensive recovery of tongue protrusion and use. Decorticate rats regained the ability to eat dry food and drink water, but they showed minimal recovery of tongue protrusion and use. Comparisons of rats with variously located circumscribed neocortical lesions showed maximal tongue protrusion deficits followed orbital frontal cortex ablations. The results show: (1) that the tests developed and described are useful for routine examination of rats that have feeding abnormalities; (2) the feeding abnormalities of decorticate and LH rats can be dissociated; and (3) the orbital frontal cortex and corticofugal pathways passing through or adjacent to the LH may play a special role in the control of tongue and mouth use. PMID- 6867144 TI - A solid state device for measuring sensitivity to thermal pain. PMID- 6867142 TI - Cost and meal patterns in wild-caught rats. AB - The effect of domestication upon behavior is not clearly understood and thus generalizations from domesticated laboratory animals to nondomesticated animals must be made with caution. Laboratory free-feeding studies with a variety of domesticated species have demonstrated that these animals reduce meal frequency and increase meal size as the cost of procuring access to food increases. The present experiment was conducted to determine if the same relations would be obtained with wild-caught rats. The results showed that laboratory-tested, wild caught rats respond to changes in the cost of obtaining food in the same manner as domesticated rats. Wild-caught rats did, however, take longer to train and were less efficient than domesticated rats have proven to be in earlier research. In general, the results affirm the validity of laboratory simulations as a means of exploring parameters associated with foraging in natural settings. PMID- 6867145 TI - Exposure to ethanol during pregnancy in mice: potential importance of dose for the development of tolerance in offspring. AB - CD-1 albino mice were given Portagen-10 percent ethanol (ETOH) or isocaloric Portagen-sucrose during pregnancy to determine if tolerance developed in utero and to describe the temporal pattern of its decline postnatally. ETOH mothers did not significantly increase their consumption of ETOH but gained in body weight during pregnancy, showed no signs in the open field of withdrawal from ETOH shortly after delivery and showed less pup-caring behavior than pair-fed controls (PFC). Among offspring 1, 3, 10, 25 and 60 days old, only 25-day old ETOH pups metabolized and cleared an anesthetic dose of ETOH more efficiently than PFC animals, suggesting the absence of Dispositional Tolerance in the other animals. PFC offspring 10 days old took significantly longer to lose the righting reflex than their ETOH counterparts following the anesthetic dose of ETOH, the difference being opposite that which would suggest the occurrence of Adaptive Tolerance. Data are discussed primarily in terms of decreases in dose of ETOH to which mothers and fetuses were exposed during pregnancy. PMID- 6867146 TI - A video interface for behavioural recordings with applications. AB - An interface which can transmit information from a TV camera to a minicomputer is described. The interface delivers addresses significant for the position of an animal in an observation arena. These addresses are then treated by a minicomputer assembler program. In our application, the length of visiting (duration), frequency of visits and latency of first visit to a specified field are recorded, together with an activity variable. The high IR sensitivity of the camera makes it possible to record the position of the animal relative to certain environmental objects under conditions of dimmed light. PMID- 6867148 TI - Influence of diet composition on the weight gains of Wistar rat. AB - The composition of diets used for breeding and experimentation on laboratory animals is one of the important factors affecting the quality of the animals and the comparison of experimental data between different laboratories. Six diets used either at the Institute of Physiology, Czechoslovak Academy of Sciences in Prague, or in the Research Centre of Molecular Biology and Medicine, Academy of Sciences GDR in Berlin were analysed for moisture, crude protein, fat, fibre, ash, sodium, potassium, calcium, magnesium, phosphorus and chloride and fed to Wistar rats for 70 and 112 days. Weight gains of the animals were compared and statistically evaluated. The greatest weight gains were achieved with animals fed on the DOS 2b diet. PMID- 6867147 TI - Overtraining reduces morphine abolition of classically conditioned responses. PMID- 6867149 TI - An attempt to activate the spontaneous motility in chick embryos with tetanus toxin. AB - The effect of tetanus toxin on spontaneous motor activity was studied in chick embryos between the 11th and 19th day of incubation. The toxin--dose 20 mg/kg egg weight ( = 2.86 X 10(3) mouse MLD) in 25 microliters isotonic NaCl solution--was injected into the tibial or the wing muscles. Tetanus toxin induced demonstrable activation of embryonic motility from the 15th day of incubation onwards. Activation attained 155-200% of resting activity. The activating effect was manifested for the first time by motor paroxysms in 17-day and particularly 19 day embryos. Tetanus toxin activation was effectively depressed by glycine (100 mg/kg e.w.) and GABA (100 mg/kg e.w.), the former having a stronger effect than the latter. The effect of tetanus toxin on spinal embryos was relatively more pronounced, while the depressant effect of the inhibitory amino acids (especially glycine) was weaker. The results are evaluated as further evidence that central inhibitory mechanisms are connected up in regulation of the spontaneous motor output activity of chick embryos on about the 15th day of incubation. PMID- 6867150 TI - Distribution of choline acetyltransferase and acetylcholinesterase in the nervous system of the dog. AB - Choline acetyltransferase (ChAT) and acetylcholinesterase (AChE) activity were determined in 23 selected parts of the dog CNS and 4 parts of the peripheral nervous system. Maximum ChAT activity was found in the caudate nucleus and the ventral roots of the spinal cord. High activity was also present in the thalamus, the pons, the cerebral cortex, the medulla oblongata, the ventral spinal horns and the sciatic nerve. The lowest activity was measured in the cerebellum, the dorsal cord roots and the spinal ganglia. Maximum AChE activity was found in the caudate nucleus and the cerebellum. Relatively high activity was also present in the thalamus, the pons, the medulla oblongata, the grey matter of the spinal cord and the spinal ganglia. The lowest AChE activity was measured in the ventral and dorsal spinal roots. PMID- 6867151 TI - Sex-dependent effect of a dorsal septal lesion on the blood pressure of laboratory rats. AB - The role of the septum in the regulation of blood pressure was studied in adult female and male laboratory (Alderley Park strain of Wistar) rats allowed a free choice between water and a 0.9% or 3% NaCl solution or simply given water. A lesion was formed in the dorsal septum and 30-66 days afterwards the mean arterial pressure was measured in the unanaesthetized animals' tail. In females the blood pressure was not affected either by the lesion itself, or by the lesion combined with a raised NaCl intake. In males, combination of the lesion with a raised salt intake was accompanied by elevation of the blood pressure, which attained values considered to be hypertensive (over 20 kPa). The increase occurred after 9 days' free choice between water and 3% NaCl solution preceded by 14 days' free choice between water and saline. At the same time, the computed NaCl concentration in the total fluids intake was higher in the control and septal females than in the control and septal males for both the salt regimens. Three days after changing from a free choice regimen to plain water intake, the blood pressure of septal males had fallen to normal values. After a protracted water regimen (43 days after discontinuing free choice), these animals had a lower blood pressure than sham-operated males after the same interval. The determinant variable in the effect of a dorsal septal lesion on the blood pressure in the presence of a hypertensogenic stimulus (NaCl) was the sex of the experimental animals. PMID- 6867152 TI - Reticulospinal regulative commands in the cat evoked at the segmental level: the effect of repetitive stimuli. AB - The reticular formation of the brain stem participates in the neuronal activity which is evoked by an unexpected or intense stimulus and results in a generalized (startle) reaction of the organism. If this reaction is evoked from the segmental receptor level, it comprises a spino-reticulo-spinal (i.e. spino-bulbo-spinal- SBS) reflex. Repetition of the stimulus leads to a habituation of the startle reaction. We studied the effect of repetition and the frequency of the stimulus on the SBS reflex response in somatic nerves of chloralose-anaesthetized cats. A series of 60 stimuli with a low stimulus repetition frequency (less than or equal to 0.2 Hz) did not induce any trend in changes in SBS responses. Frequencies of 0.5 and 1 Hz in some cases led to sensitization or depression of SBS discharges, while higher frequencies (2 and 5 Hz) caused a depression and a decrease in the incidence of SBS response in efferent discharges in every case. These changes occurred promptly (in the course of 5-15 stimuli at a given frequency); continued stimulation did not induce a habituation trend in the changes of SBS responses. When a series of stimuli with a frequency causing a change in the functional state of the SBS system ended, SBS responses returned to control values in the course of the first 5 stimuli at the basic stimulation frequency (0.2 Hz), except for a few cases in which a persistence of the change in SBS responses was observed. The findings showed that a protracted repetition of the stimulus did not lead to the disappearance of the reticular formation reactions resulting in reticulospinal regulative commands in the form of SBS activity. The level of this activity is adapted promptly in correlation to the change in the stimulation parameters; with constant parameters, SBS activity is relatively constant. PMID- 6867153 TI - The proportion of fatty acids in mammary secretion of cows lactating after calving and hormonal induction of lactation. AB - The changes in the proportion of fatty acids in lacteal fat of cows induced into lactation by 7-day treatment with oestradiol and progesterone were characterized by an increases in the proportion of fatty acids C6--C13: the proportions of C14, C15, C17, C19 fatty acids changed slightly if at all; the proportions of C16, C20 and C22 fatty acids decreased during the first 28 days of lactation. Similar changes in fatty acid composition were found in lacteal fat of cows lactating after calving. These results demonstrated that the hormonal induction of lactation in nonpregnant cows initiates mammary secretion similar to the fatty acid composition in normal cow milk. PMID- 6867154 TI - Localization of the origin of metrazol-induced rhythmic electrocorticographic activity in rats. AB - In acute experiments we studied the structures essential for the genesis of rhythmic electrocorticographic activity composed of spike-and-wave rhythm of 5 Hz frequency evoked in rats by the systemic administration of pentamethylenetetrazol. Brain stem transection at intercollicular level did not prevent this rhythmic activity from developing. Episodes of this activity were suppressed during a wave of thalamic spreading depression--in every case on the side of depression and in more than half the cases also in the contralateral hemisphere. We further observed that the effect on rhythmic activity in the sensorimotor and visual region was unequal. It can be concluded that the thalamocortical system is essential for the development of rhythmic metrazol spike-and-wave activity, but that this system is not functionally homogeneous. PMID- 6867156 TI - Oscillations of serum and tissue lipids in rats X-irradiated at different times of day. AB - Young male Wistar rats (mean body mass 200 g) adapted to a 12: 12 h light: dark regimen (7 a.m.--7 p.m., 7 p.m.--7 a.m.) were X-irradiated at 3-h intervals during one day with doses of 2.39 or 14.25 Gy and were killed 48 or 24 h afterwards. Non-esterified fatty acids were determined in their serum and white and brown adipose tissue, and triacylglycerols, phospholipids and total cholesterol in their serum and liver. The reaction of serum and tissue lipids during the day varied after both non-lethal and lethal irradiation. After non lethal exposure, most of the curves, as regards their course, the presence of rhythm and their oscillation properties, concurred with the lipid indicator curves in the control series and indicated that the organism's response is dependent on the time of day. Circadian variation of serum and adipose tissue non esterified fatty acid levels, the liver triacylglycerol concentration and the adrenal cholesterol concentration in lethally irradiated animals showed no significant dependence on the time of application of the stimulus. An analysis of circadian variation of the effectiveness of a stimulus facilitates an understanding of the organism's reactivity better than a single examination in the morning. PMID- 6867155 TI - Effect of short-term immobilization at different times of day on circadian blood glucose and tissue glycogen oscillations in the rat. AB - Male Wistar rats (body mass 200-250 g) kept under standard vivarium conditions with an artificial illumination regimen (12 h light, 12 h dark) and fed ad libitum were immobilized in boxes 90 min prior to being decapitated at 3-h intervals over a 24-h period. The controls, which were examined at the same times, were deprived of food and water 90 min before being decapitated. The glucose concentration in the animals' blood and the glycogen concentration in their liver, heart, skeletal muscle and white and brown adipose tissue were determined. The experiment was carried out at the end of the autumn; the results were evaluated by an analysis of variance and a cosinor test. The effect of short term immobilization was manifested in a marked increase in the blood glucose and heart and skeletal muscle glycogen mesor values and in a drop in the liver glycogen mesor value. The main characteristics of circadian oscillations of the liver, heart and white and brown adipose tissue glycogen were the same as in unstressed animals, but marked changes occurred in circadian skeletal muscle glycogen and blood glucose levels. The results indicate that the response of the rat blood glucose and tissue glycogen level to immobilization is differentiated and that the organism's response is correlated to the time of application of the stressor. PMID- 6867157 TI - Effect of phenobarbital on thalamocortical processes in the rat. PMID- 6867158 TI - Intake of maternal milk by young rats deprived for a few days of the lactating female. PMID- 6867159 TI - Standing and walking for the T6 paraplegic. PMID- 6867160 TI - Evaluation of rehabilitation bicycles. PMID- 6867161 TI - Referral. PMID- 6867162 TI - The 3'-terminal region of mosquito mitochondrial small ribosomal subunit RNA: sequence and localization of methylated residues. AB - The 3'-terminal 101 residues of the small ribosomal subunit (SSU) RNA of mosquito cell mitochondria have been determined. This stretch includes the four methylated residues of the molecule: an m4C, an m5C, and two m26A residues. The m26A's occur in a typical m26A "arm," and the methylated Cs in the unique subsequence G x m4C . C . m5C . A, which is homologous in position to a conserved methylated GCCCG subsequence of other SSU RNA classes. There is fairly good overall homology between the mosquito mitochondrial sequence and corresponding regions of other SSU RNA classes, except that a domain of 50-100 residues, previously considered universal, is absent. Comparison with mammalian mitochondrial sequences revealed a marked preponderance of transitional base substitutions, supporting earlier evidence that the 3'-terminal region of SSU RNA is under special structural constraints. The extreme 3' end of the mosquito sequence is heterogeneous, three fourths of the molecules ending in ... GA and one-fourth ending in ... GAA. Evidence is presented indicating that some, at least, of the 3'-terminal A residues may be added post-transcriptionally, as occurs in mammalian mitochondrial systems. Taken together, the results provide modest support for the monophyletic evolutionary origin of insect and mammalian mitochondria from a primitive procaryotic ancestor. PMID- 6867164 TI - Influence of ergot alkaloids on growth of streptomyces purpurascens and production of its secondary metabolites. PMID- 6867163 TI - First DNA sequence of a chloroplast mutation: a missense alteration in the ribulosebisphosphate carboxylase large subunit gene. AB - Sequence comparison of the chloroplast genes of the large subunit of ribulosebisphosphate carboxylase from wild-type and from a uniparental mutant of the green unicellular alga Chlamydomonas reinhardii has revealed a single nucleotide change. The corresponding Gly to Asp amino acid substitution would introduce a negative charge into the presumptive substrate binding region of the enzyme and would explain the inactivity of the mutant protein. This is the first chloroplast mutation whose DNA sequence is known. Our results establish the first exact point of correlation between the physical map of the chloroplast genome of C. reinhardii and a specific genetic locus. PMID- 6867165 TI - Uterotonic activity of extracts of the seeds of Abrus precatorius. PMID- 6867166 TI - Inhibition of rat heart phosphodiesterase by some rotenoids and isoflavonoids. PMID- 6867167 TI - Antispasmodic effect of Hagenia abyssinica. PMID- 6867168 TI - Levator muscle reconstruction: does it make a difference? AB - Eighty-five children from 6 to 8 months of age underwent palatal reconstruction between 1972 and 1978. Forty had palatal repair without levator reconstruction, and 45 had an intravelar veloplasty. Speech assessment was performed at 2 years after surgery. Any nasal escape or hypernasality, whether consistent or not, was included as abnormal speech. The data revealed that 70 percent (28 of 40) had abnormal speech when no muscle reconstruction was performed compared with 63 percent (24 of 45) after having had an intravelar veloplasty. We conclude that the added operative dissection adds no morbidity to the procedure and that the improved speech results probably justify performing an intravelar veloplasty when doing a palatal repair. PMID- 6867169 TI - Documentation of flap delay by a fluorescein uptake: a preliminary report. PMID- 6867170 TI - CAT scan for facial fractures. PMID- 6867171 TI - Polyurethane-covered prostheses. PMID- 6867172 TI - Diamonds are forever? PMID- 6867173 TI - Scarlet red. PMID- 6867174 TI - Patient acceptance of dissociative anesthetics. AB - A prospective study was undertaken to evaluate the efficacy, safety, and patient acceptance of low-dose ketamine when used to diminish the pain of local anesthetic injections. The role of diazepam in preventing the untoward psychological effects of ketamine was also investigated. Our findings, derived from a postoperative questionnaire, reinforce the assertions of others, that ketamine is safe and effectively prevents pain in 85 percent of patients. While 13 percent of our patients hallucinated, most found the experience pleasant, and there were no "bad trips" or emergence reactions. Adequate premedication appears to be important in the successful use of ketamine. Whether sedation is augmented with diazepam or achieved with other medications does not appear to matter. A close supportive relationship with the surgeon and operating room personnel is probably as important as any pharmacologic manipulation in avoiding psychological mishap with low-dose ketamine. PMID- 6867175 TI - Long-term comparison of patients with gel and saline mammary implants. AB - Following augmentation mammaplasty, 169 patients with saline and silicone-gel implants placed in the subglandular position were observed over a period of 10 years. It was found that the palpable capsule rate in patients with gel implants was 36 percent; in patients with inflatable implants it was 24 percent. Of the total number of patients in the study who received inflatable implants, deflation occurred in 15.5 percent. PMID- 6867176 TI - Absence of visible bacteria in capsules around silicone breast implants. PMID- 6867178 TI - Gluteal plication closure of sacral pressure ulcers. AB - A technique for closure of gluteal pressure sores is described. It has been successfully used on 19 of 21 patients during the last 58 months. Median follow up time is 23 months. Muscular and vascular integrity are preserved for future myocutaneous flap coverage if required. It is recommended as a relatively conservative method of early repair of sacral pressure defects not in excess of 8 cm in diameter. PMID- 6867177 TI - Making the most of the gastrocnemius muscles. AB - The two heads of the gastrocnemius muscle are easily mobilized and very dependable. It is our first choice for local muscle transpositions in and about the knee. Thirty-four consecutive gastrocnemius muscle flaps performed on one service are evaluated. Seven maneuvers and some technical points are presented and illustrated to enable the surgeon to get the most possible use of these two reliable structures. PMID- 6867179 TI - Wound geometry and the kinetics of wound contraction. AB - Contraction of an excisional wound can be described by a decaying exponential with a non-zero asymptote between days 6 and 39 after wounding. Regardless of size or shape, the contraction-rate constant is invariant within age- and species matched animals. Differently shaped wounds of the same size contract at the same rate during the exponential period. Shape exerts its effect prior to the onset of contraction by defining the size of the wound entering the exponential period. Perimeter is the factor by which shape determines size. PMID- 6867180 TI - Propranolol-epinephrine interaction: a potential disaster. AB - Presented here are six examples of potentially life-threatening propranolol epinephrine interactions. The only report found that warns of a deleterious clinical interaction between propranolol and epinephrine appeared in 1980. With widespread use of propranolol for approved and unapproved conditions, the population at risk is significant. All physicians and dentists using local anesthetic with epinephrine should be aware of this interaction. PMID- 6867182 TI - The effects of nasal surgery on airflow. AB - Although nasal surgery for form and function is commonplace, knowledge of its effects on nasal airflow has been scanty. This study was undertaken to clarify that relationship. Prior to our investigation, we reviewed the pertinent physics of airflow. We noted that during laminar flow, the air in contact with the walls of a tube is motionless, whereas the air in the center moves. Moreover, according to Poiseuille's law, as the radius of the tube increases, the flow increases to the fourth power. Finally, tubes that are irregular, such as the nose, cause turbulent flow. When air passes through the nose, the flow is regulated by four values: the external valve, the internal valve (the angle formed by the junction of the upper lateral cartilages and the septal cartilages are the most important), the nasal turbinates, and the septum. Using anterior rhinomanometry, the nasal airflow was measured in 69 control subjects and in 329 patients who underwent a rhinoplasty, septoplasty, septectomy (submucous resection), or inferior turbinate resection, alone or in combination. We found that a rhinoplasty does not adversely affect the nasal airflow, and those patients who had procedures to improve their nasal airflow did indeed obtain it. These data were statistically significant. The data from our airflow studies frequently failed to correlate with patient assessments of their own nasal airways as well as our evaluations by rhinoscopy. Furthermore, rhinomanometric findings varied considerably even within the same testing session. At present, on the basis of our investigations, we cannot recommend rhinomanometry with enthusiasm because of its questionable reliability and validity. PMID- 6867183 TI - Scleredema adultorum: the surgical implications of a rare dermatologic disorder. AB - A case report of nonpitting induration of the skin, scleredema adultorum of Buschke, is presented. Although it may be a benign, self-limited disease, its complications may require drainage of abscesses or soft-tissue coverage, which may result in delayed wound healing. In the reconstruction of tissue defects, skin grafts are preferred, since the skin is unyielding. PMID- 6867184 TI - Excision from a distance: a technique for removal of benign subcutaneous lesions. AB - When benign subcutaneous lesions in highly visible areas are excised directly, the resulting scar may be more disfiguring than the original lesion. In this series of 29 patients, subcutaneous lesions were excised through incisions located in areas that usually heal with minimal disfigurement. Incisions commonly employed in aesthetic surgery can be utilized to remove lesions of the face and breast with minimal complications and superior cosmetic results. PMID- 6867185 TI - The nonmetropolitan plastic surgeon. AB - A questionnaire survey was conducted of 54 board-eligible or board-certified plastic surgeons practicing outside urban or suburban areas. Marketplace forces were determined to have been important in the choice of nonmetropolitan practice locations. The practitioners surveyed tended to participate in a broad spectrum of plastic surgical practice. On the whole, the surgeons reported themselves busy professionally and contented personally. A characteristic pattern of problems often accompanied the practice style. PMID- 6867186 TI - [CT study in Alzheimer's disease]. PMID- 6867181 TI - Factitious vesicocutaneous fistula: an enigma in diagnosis and treatment. AB - A case report of a patient with a recurrent factitial vesicocutaneous and a tensor fasciae latae musculocutaneous flap were employed in reconstruction. Difficulty in diagnosis and treatment of this patient with factitial disease is emphasized. Excessive hospitalization and cost reflect these difficulties. A life threatening disease was modified by planned reconstruction coordinated with antidepressant medication and psychotherapy. Treatment centered on avoiding insight and maintaining denial ASA defense mechanism. The transference of self mutilation in the suprapubic region to the donor thigh was most important in this patient's survival. PMID- 6867187 TI - [A case of spike--wave stupor coincided with the menstruation]. PMID- 6867189 TI - [Comparative study of attempted suicide among young persons in Germany and Japan]. PMID- 6867188 TI - [Disturbances of selective attentional functioning in schizophrenics as shown in abnormalities of event--related potentials during dichotic detection tasks]. PMID- 6867190 TI - [National survey of prevocational system for the mentally disabled by local governments]. PMID- 6867191 TI - [A comment to Mr. Nakayama's argument on the Schneider's first-rank symptoms]. PMID- 6867192 TI - [Some comments on Schneider's first rank symptoms]. PMID- 6867193 TI - [Kindling in the split-brain cat]. PMID- 6867194 TI - [Attacks on delusional persecutors. Considerations on violence committed by schizophrenics]. PMID- 6867195 TI - [Value of small cystic supratentorial PEG changes]. AB - Small solitary or multiple cystic lesions were found in the hemispheres of 3.6% of all patients suffering from cerebrovascular disorders, seizures, system degeneration or skull or brain injuries who were examined by PEG. Such lesions were especially frequent in patients in their forties to sixties. The absence of corresponding changes in the results of electroencephalographic, scintillation scanning and angiographic examination makes PEG an indispensable tool for prognosis in such cases. PMID- 6867196 TI - [Aneurysms of the left vertebral artery with an arteria lusoria]. PMID- 6867198 TI - [Value of single case studies in psychotherapy]. AB - The authors explain the value and different kinds of single-case study and the conditions indicating when such studies are called for. They show the necessity of using the patient-centered approach to a greater extent than hitherto in psychotherapy practice and research. Studies performed by the authors are used as a basis for discussing questions relating to applications, and the authors present learning curves of successfully and unsuccessfully treated psychotherapy patients which have never been shown before in literature dealing with psychotherapy. PMID- 6867199 TI - [Clinical contribution to so-called homilopathy]. AB - Twenty cases are presented as a basis for reopening the discussion concerning the homilopathy concept introduced by Kraepelin. The authors describe three different degrees of expression of the homilopathic syndrome. The investigations suggest that homilopathic impediments are much more common than the usage of the term indicates. Possibilities of therapy and prophylaxis are discussed. PMID- 6867197 TI - [Electromyographic studies of the blink reflex in patients with multiple sclerosis]. AB - The latencies of two components of the blink reflex in 90 patients with multiple sclerosis have been compared with these of 30 healthy subjects. Early response R1 was absent in 33,33% of the patients and was with prolonged latency in 41,11%. The late ipsilateral response was absent in 20,00% of the patients and in 32,22% was with prolonged latency. The late contralateral response was absent in 25,55% of the patients and was with prolonged latency in 40,00%. The latencies of all components of the reflex may be prolonged in patients with no clinical brain-stem signs as well. PMID- 6867200 TI - [The narrow lumbar spinal canal]. PMID- 6867201 TI - [Cognitive and situational change measurements in neurotic patients in intended dynamic group psychotherapy. A pilot study]. PMID- 6867202 TI - [Combination of music therapy methods in dynamic group psychotherapy]. AB - The use of different forms of music therapy in the course of dynamic group centered psychotherapy is described and discussed on the basis of the author's clinical experience. The choice of the form is governed by the objectives of therapy for the particular group situation. Close cooperation between the therapists dealing with the group is a prerequisite. As long as the therapists work to a strictly defined plan both active and reactive music therapy can be used to augment the other forms of treatment by encouraging experience and, by awakening particularly the emotions of the patients, help in coping with the unconscious intrapsychic confliction. PMID- 6867203 TI - [Experiences with combined group psychotherapy in adolescents]. AB - Adolescents in need of psychotherapy have, due to their defiant behaviour, little motivation to take part in group-centered psychotherapy although, since they are experiencing a crisis of identity, they are most in need of it. The tastes of this age group are catered for at the outset by the use of music typical of that popular among young people, arrangement of the group sessions to give the impression of a party and combining patient-centred treatment with communicative movement therapy. This is followed by training in social behaviour commensurate to the individual social situation and the deficits in the behavioural inventories of the different members of the group. PMID- 6867204 TI - [Differential diagnostic delineation of endogenous depressions from premature failure conditions]. PMID- 6867205 TI - [Minutio existimationis. On the question of therapy of psychologically traumatized, deformed patients]. AB - Short case histories of twin sisters with progressive juvenile kyphoscoliosis who were incorrectly brought up and finally scorned as "witches" by their parents are used as examples to explain that Minutio existinationis (M.e.) can be regarded as a severe psychological trauma. The article seeks an approach for therapy. Rehabilitation of the two patients concerned proved, regrettably, unsuccessful. This again confirms that the life of sickly children after childhood is formed by the behaviour of the parents. PMID- 6867206 TI - [Iron deficiency causing psychological aberration: clay inhalation (pulverem argillae in nasum ducit)]. PMID- 6867207 TI - [Psychiatric problems in Polish epileptology in the last 35 years]. PMID- 6867209 TI - [Factor structure of multidimensional personality inventories MMPI, 16-PF, FPI and GT]. AB - Results on factoranalyses over MMPI-, 16-PF-, FPI-, and GT-scales are presented. The FPI (Freiburg Personality Inventory) revealed to measure neurotic complaints, lamentation, extra- vs introversion, candidness vs lie-tendency, and emotional stability vs instability. The GT (Giessen-Test) alone measures a special psychosocial, the MMPI likewise an unspecific psychoticism dimension. The desideratum remains to create a clinically more differentiating instrument on item basis. PMID- 6867213 TI - [Integrative therapy concept in inpatient treatment of sex offenders]. AB - First a number of aspects are mentioned that should be given special attention in the treatment of sex offenders. This is followed by a review of those treatment studies in which therapy was primarily either psychoanalytic or behavioral and which included a relatively large number of patients. Since the authors of the present study found that either a given treatment approach was indicated for a very limited group of patients only or the long-term outcome was poor, they developed an integrative approach for inpatient treatment of sex offenders. This approach includes behavior therapy, psychoanalytically oriented therapy and social therapy. The procedures are described briefly and the role of each is in the overall therapeutic concept pointed out. PMID- 6867214 TI - [Therapy of sex offenders in a psychiatric regional hospital]. AB - A treatment concept for sexual delinquents convicted and referred to psychiatric treatment in accordance with Section 63 of the German Penal Code, has been worked out at the Psychiatric Hospital in Weissenau. Among the manifold therapeutic measures, group therapy was found to be of paramount importance. The members of the group are described in detail according to their social characteristics, type of offence, psychiatric diagnoses, and major personality traits. Therapies derived from these basis conditions, with the corresponding therapeutic aims, are presented and discussed. At the conclusion of the article, catamnestic data are given of 18 sexual delinquents dismissed since 1978. 14 Patients were dismissed; 2 of these subsequently committed criminal offences, which, however, were not sexual offences; 2 patients each were transferred to another hospital or returned to prison. PMID- 6867211 TI - [Effects of recent psychoanalytic theories and therapy concepts on the treatment technics of sex offenders]. AB - Recently developed psychoanalytic theories on the pathogenesis and psychodynamics of sexual perversions are described and their effects on treatment technique discussed. Then a proposal based on these theories its put forth for a comprehensive treatment plan for sex offenders, among person with sexual perversions an especially difficult group to treat. Special emphasis is placed on the problems and possibilities associated with such a psychoanalytically oriented approach, and the author then argues that during the initial phase of treatment two approaches, both psychoanalytically oriented therapy and behavior therapy, should be used parallel to each other. PMID- 6867208 TI - [Pathogenetic variance and diagnostic criteria in neurotoxoplasmosis]. AB - With reference to the special position of neurotoxoplasmosis in regard of the detection of postnatal infection with Toxoplasma gondii the authors present 18 cases of this illness. The main factor responsible for the diagnostic uncertainty proves to be the blood-brain-liquor barrier which is responsible both for the behaviour of the parasite in the CNS and for immunological reactivity. Attention is drawn to the advisability of considering all anamnestic, clinical and paraclinical data and of long-term observation of the patient. Cases treated by the authors are discussed in greater detail as examples of basis pathogenetical variants. PMID- 6867212 TI - [Behavior therapy in sex deviations--an orienting overview]. AB - Behaviour therapy is a successful form of treatment for many neurotic patients. The literature on treatment of paraphilias consists mainly of single case studies. The ideas of learning theory on which this treatment is based, have not changed in the last 10 years, but treatment goals are being considered much more carefully. Each patient needs an individual treatment program which usually consists of methods to change sexually deviant behaviour and strategies to reinforce or buildup usual heterosexual behaviour. Almost always deficiencies in social and communicative behaviour exist and have to be incorporated into the treatment as well. Although results seem to be favourable so far research on therapy outcome is of great necessity. PMID- 6867215 TI - [Treatment of especially severe sex offenses]. AB - "Therapy" is a currency with two different notations, as far as court practice is concerned. If the offences are of a minor nature, such as exhibitionism, the judge will usually expect the expert to mention the word, which prompts him to refer the delinquent to a therapist without delay, even if he is not at all hopeful that therapy may be successful. "Therapy" is an inflationary currency. In severe cases, its notation is correspondingly lower. This development has been promoted by the increasing division between forensic and therapeutic perspectives in psychiatry. The difficulties resulting therefore are discussed, taking the example of expertise and therapy of a patient accused of attempted murder as basis. Suggestions are advanced in what manner this division between forensic and therapeutic psychiatry could be avoided or even reduced in future. PMID- 6867210 TI - [Criminologic aspects in the treatment of sex offenders]. AB - The conditions determining statutory offences as represented by indictable sex offences, have been amended and revised by the 4th Penal Reform Law of the Federal German Penal Code, in 1973, under the heading "Indictable Offences against Sexual Self-Determination". This heading, which is meant to convey a programme, however, does not agree with the actual contents or core of various paragraphs. These new statutes have been violently criticised by opponents coming from quite different camps. The development of sexual delinquency shows a rather decreasing crime rate since the end of World War II, compared to the increase in other categories of crime. The most frequently recorded sexual offences concern the performance of sexual acts with children, rape and exhibitionism. It is in these groups of criminal offences that we are most likely to find delinquents in whom psychotherapy seems indicated. Criteria for indicating such treatment are the desire of the person in question to receive treatment, and the presence of a personality disturbance; it is not the deed by itself. The article then cites the paragraphs under German penal legislation which are important when arriving at a decision to refer a delinquent to psychotherapeutic treatment; these are Sections 56 c, 63, 64 German Penal Code, Section 10 Penal Code for Adolescents, and Section 9 of the Federal Law Enforcement Act. PMID- 6867216 TI - The interpretation of detection data through direct multivariate frequency analysis. PMID- 6867217 TI - A cognitive-social learning model of social-skill training. PMID- 6867218 TI - Reassessing the automaticity-control distinction: item recognition as a paradigm case. PMID- 6867219 TI - Cognitive activity, sleep disturbance, and stage specific differences between recorded and reported sleep. PMID- 6867220 TI - The cardiac and vascular components of pulse transmission time: a computer analysis of systolic time intervals. PMID- 6867221 TI - "...'Twas ten to one; and yet we ventured...": P300 and decision making. PMID- 6867222 TI - Skeletal muscular patterning: topographical analysis of the integrated electromyogram. PMID- 6867223 TI - Task difficulty, heart rate reactivity, and cardiovascular responses to an appetitive reaction time task. PMID- 6867224 TI - Forty hertz EEG activity in Alzheimer's type dementia. PMID- 6867225 TI - Does aerobic fitness affect sleep? PMID- 6867226 TI - The effect of prolonged stimulus repetition on autonomic response and EEG activity in normal subjects, schizophrenic, and nonschizophrenic patients. PMID- 6867227 TI - Type A behavior and psychophysiological response in adult women. PMID- 6867228 TI - Influence of total sleep deprivation on event-related potentials in man. PMID- 6867229 TI - Hostility, risk of coronary heart disease, and mortality. AB - Level of hostility (Ho) was assessed by a 50-item subscale of the Minnesota Multiphasic Personality Inventory at the initial examination of 1877 employed middle-aged men who were free of coronary heart disease (CHD). Ten-year incidence of major CHD events (myocardial infarction and CHD death) was lowest in the first quintile of the Ho scale's distribution, highest in the middle quintile, and intermediate in the other three quintiles. After adjustment for age, blood pressure, serum cholesterol level, cigarette smoking, and intake of ethanol, the relative odds of a major CHD event was 0.68 for men with Ho scores less than or equal to 10 points in comparison to men with higher scores. The Ho scale was positively associated with crude 20-year mortality from CHD, malignant neoplasms, and causes other than cardiovascular--renal diseases and malignant neoplasms. After adjustment for the risk factors listed above, the Ho scale had a statistically significant, positive, monotonic association with 20-year risk of death from all causes combined. A difference of 23 points on the Ho scale, i.e., the difference between the means of the first and the fifth quintiles, was associated with a 42% increase in the risk of death. These results support the previous findings of Williams et al. with respect to the Ho scale and coronary atherosclerosis, and also suggest that the Ho scale may be associated with factors having broad effects on survival. PMID- 6867230 TI - Sleep mechanisms and pathophysiology: some clinical implications of the reciprocal interaction hypothesis of sleep cycle control. PMID- 6867231 TI - Well-being of cancer survivors. AB - One hundred and four cancer survivors 3 years past their last cancer treatment reported a significantly lower sense of self-control and more general health worries than a matched sample of healthy controls. The two groups did not differ on variables of anxiety, depression, positive well being, and vitality or on two composite scores of mental and general well-being. The well-being scores of the survivors from three geographically distinct cancer centers revealed no significant differences among centers on the composite or any of the individual subscores. Sociodemographic and treatment variables revealed only marriage and no change in job were significantly related to the amount of general well-being experienced. PMID- 6867233 TI - Geriatric psychopharmacology: progress in the past decade and directions for the next. PMID- 6867232 TI - Stress-induced heart failure. AB - Stress produced heart failure in cardiomyopathic hamsters (CMHs) with subclinical heart disease. CMHs exhibited a variety of peripheral manifestations of heart failure including subcutaneous edema, fluid in the abdominal and thoracic cavities, and increased organ weight. In contrast, stress did not produce heart failure in healthy hamsters. These data indicate that the presence of covert heart disease can dramatically alter the pathogenic consequences of stress. PMID- 6867234 TI - Adverse drug reactions--vital statistics (unavailable, yet essential). PMID- 6867235 TI - Lithium-induced behavior changes in children with symptoms suggesting manic depressive illness. PMID- 6867236 TI - A rating scale for tardive dyskinesia and Parkinsonian symptoms. PMID- 6867237 TI - A tardive dyskinesia monitoring policy for applied facilities. PMID- 6867238 TI - [Music therapy with psychiatric problem patients]. PMID- 6867239 TI - [Age dependence of psychosocial factors and possible erroneous conclusions from case control studies in cancer research]. PMID- 6867240 TI - [Superficial and depth aspects of interaction behavior. Studies on the evaluation of families with a psychiatrically disordered child]. PMID- 6867241 TI - [Are there as many left-handed humans as right-handed? (The erroneous right handed society)]. PMID- 6867242 TI - [Vertigo as a psychosomatic phenomenon]. PMID- 6867243 TI - [Significance of resistance in psychotherapy education and practice]. PMID- 6867244 TI - [Categories of psychotherapeutic goal setting]. PMID- 6867246 TI - Psychological regression with illness. PMID- 6867245 TI - Evaluation of suicidal patients: the SAD PERSONS scale. PMID- 6867247 TI - Stressful life events and the decision for surgery for obesity. PMID- 6867249 TI - Alcoholic neuropathy associated with the eighth cranial nerve. PMID- 6867248 TI - Rescuing the angel within: PCP-related self-enucleation. PMID- 6867250 TI - Toward a philosophy of aging for the public health professions. PMID- 6867251 TI - FDA's dietary sodium initiative--in the war against hypertension, a new weapon. AB - The Food and Drug Administration is engaged in a broad-based program to make consumers more aware of the potential impact on health of sodium consumption well in excess of dietary needs; to encourage food manufacturers to lower the amounts of sodium they add to their products, where this is safe and feasible; and to provide information to consumers about the sodium content of the foods they buy and use. This program is expected to be a significant preventive public health measure against hypertension. PMID- 6867252 TI - Surveillance and control of infectious diseases: progress toward the 1990 objectives. AB - Great progress has been made in the United States in reducing infectious disease mortality. However, infectious diseases remain the greatest cause of morbidity in this country. Newer infectious diseases or agents have been recognized, but newer tools for surveillance and control have also been made available. Specific objectives for the reduction of infectious diseases by 1990 have been set by the Public Health Service. The opportunities appear to be good for achieving by 1990 objectives for nosocomial infections, Legionnaires' disease, tuberculosis, and surveillance and control of infectious diseases. Achievement of the 1990 objectives for hepatitis B, pneumococcal pneumonia, and bacterial meningitis, however, will require both scientific advances and additional resources. PMID- 6867253 TI - The United States--The Netherlands Round Table Conference on immunization. Summary report. AB - A group of public health scientists from the United States and The Netherlands met at a Bicentennial Round Table Conference December 1-2, 1982, to discuss the latest developments in immunization against infectious diseases, focusing on pertussis, poliomyelitis, measles, and rubella. The major differences in immunization practices in the two countries are: (a) In The Netherlands, inactivated polio vaccine is used exclusively; in the United States, the oral polio vaccine is used. Polio-myelitis has virtually disappeared from both countries. (b) In The Netherlands, the pertussis component of DTP (diphtheria, tetanus, pertussis) is not given to children over the age of 1 year, whereas in the United States, it is given to children up to their seventh birthday. (c) Rubella vaccine is given only to girls at ages 11-12 years in The Netherlands, but to all children at ages 12-15 months in the United States. (d) Mumps vaccine is not administered to children in The Netherlands, but in the United States it is given routinely to children at 12-15 months (in combination with measles and rubella vaccine). The participants concluded that both the United States and The Netherlands have effective immunization programs that have significantly reduced the impact of these diseases. PMID- 6867254 TI - HMO members and clinicians rank health education needs. AB - Before expanding a health education program, the staff of the George Washington University Health Plan conducted a needs assessment of members. Patients in the HMO's adult care and parents in pediatric waiting areas answered survey questions, and a random sample of members was polled by mail. Patients rated their interest in a list of 45 topics, and plan clinicians chose from the same list topics which "would be of greatest help in your practice." Anxiety/stress was the most popular topic among patients and those who responded by mail. Depression, physical fitness, CPR, and nutrition also rated high. Only 4 topics appeared among the top 10 choices of both plan members and clinicians. After discussion of the patients' choices, the clinicians were asked, several weeks later, to rate the topics again. Clinicians' choices in the second round much more closely approximated the choices of the members. The most frequently chosen method of instruction was "written material," although videotape and other, more expensive media were also listed. When seminars geared to the members' top choices in the survey were offered, the response was so enthusiastic that additional seminars--a total of 12 in 6 weeks--were held. PMID- 6867256 TI - National health and nutrition examination I--epidemiologic follow-up survey. AB - An epidemiologic follow-up of the first National Health and Nutrition Examination Survey (NHANES I), being conducted from 1982 to 1984, is expected to provide estimates of the risks of certain health conditions for a sample of the U.S. population and to make it possible to relate these conditions to the nutritional, social, demographic, and behavioral characteristics of the sample. As part of the followup study, the baseline data obtained in NHANES I have been reviewed to define hypotheses and to identify pertinent variables that can be used in studying changes over time and the relationships of these variables to outcome measures. Because the followup study provides cohort data on a large sample of the U.S. population, it presents a unique opportunity for epidemiologists. PMID- 6867257 TI - Mortality among minority populations: a review of recent patterns and trends. AB - The mortality experiences of blacks, Native Americans, and Hispanics are reviewed. Evidence recently made available shows the Hispanic experience to be only slightly less favorable than the Anglo (other white) experience, suggesting remarkable progress in recent years. Native Americans have also made remarkable progress in recent years, especially in reducing infant mortality. Blacks have shown less improvement than the other two groups. Reasons for these trends, for differences among the groups in mortality rates and life expectancy, and for patterns of mortality by cause are discussed. PMID- 6867255 TI - Source, significance, and control of indoor microbial aerosols: human health aspects. AB - The usual profile of indoor microbial aerosols probably has little meaning to healthy people. However, hazardous microbial aerosols can penetrate buildings or be generated within them; in either case, they can have significant adverse effects on human health. These aerosols can be controlled to some extent by eliminating or reducing their sources. In this regard, careful consideration should be given in building construction to the design of ventilation and air conditioning systems and to the flooring material, so that these systems and the flooring material will not act as microbial reservoirs. It is evident that in spite of the considerable body of data available on indoor microbial aerosols, little is known of their true significance to human health except in terms of overt epidemic disease. Continued research is needed in this area, particularly in respect to situations of high risk in such locations as hospitals and schools for young children. PMID- 6867258 TI - The childbearing Haitian refugee--cultural applications to clinical nursing. AB - As a result of the recent influx of Haitian refugees, referred to as the "boat people," the large county-owned hospital in Miami, Fla., reported that, of the 8,000 births for 1980, approximately 1 in 5 deliveries was of a Haitian woman. One hundred fourteen Haitians gave birth at that institution during July 1980, and this pattern continues to date. Although some research investigations have been conducted in relation to Haitians, none have had the specific focus of this study which used an assessment tool to develop a cultural profile of the refugee Haitian childbearing client as a basis for deriving culturally appropriate nursing goals and interventions. Ten pregnant refugee women, born in Haiti and residing in Miami, were interviewed in their homes by a Haitian (Creole-speaking) interviewer. Areas of respondent consensus and individual responses of interest are discussed in this paper. The authors have compiled a list of care givers' goals and interventions directed toward specific beliefs, values, and practices. Assumptions held by nursing personnel that all Haitian childbearing clients who have recently arrived in south Florida are so different as to have few characteristics in common with the American culture are not supported by the findings of this investigation. Rather, the findings suggest that the 10 Haitian women who were interviewed generally perceived pregnancy and its particular needs and characteristics in much the same way and with similar concerns as their American counterparts. The variations in their responses reemphasized the need for accurate culture-specific assessment of each client in order to provide appropriate health care. Replicating the study among the other cultures in the Miami area would extend the interpretations of this study and be an exciting challenge. PMID- 6867259 TI - High-frequency hearing loss in male farmers of Missouri. AB - Farmers are exposed to noise that is potentially hazardous to hearing. We measured the hearing of 161 male farmers and 75 male nonfarmers at the 1979 Missouri Farmers Association Agri-Fair and compared it with the hearing of 129 office workers from central Missouri. Fixed-level screening tests were conducted in both ears at three stimulus frequencies: 1000 and 2000 hertz at 20 decibels hearing level and 4000 hertz at 25 decibels hearing level. Audiometers were calibrated in accordance with the ANSI-1969 standard. The results show that farmers are at risk for hearing loss at 2000 and 4000 hertz when compared with office workers. The prevalence of hearing loss was greater for farmers at both frequencies in every decade age group from 25 to 64 years. Using screening failure at 2000 and 4000 hertz in both ears as a criterion for a loss that would affect communication ability, we found that the failure rate was 16.8 percent for farmers and 6.2 percent for office workers. As other investigators have found, the prevalence of high-frequency hearing loss in male nonfarmers who associate with farmers was nearly as great as for farmers. PMID- 6867260 TI - Increasing the effectiveness of community workers through training of spouses: a family planning experiment in Guatemala. AB - As community-based distribution (CBD) systems for the delivery of contraceptive methods are implemented in developing countries around the world, there is growing interest in making these programs more effective. Previous research on the CBD program in Guatemala indicated the importance of the role of the spouse: those community volunteers (called "distributors") who received assistance from their spouses were more effective in selling contraceptives than those who did not. The current experiment was designed to test the effect of providing the spouses of distributors with a formal 3-day training course on family planning and contraceptives. "Effect" was operationally measured in terms of the level of contraceptive sales. To this end sales data were compared for the experimental group (33 distributors whose spouses received the training) and the control group (33 distributors whose spouses wanted to attend the training but could not because their primary occupation did not allow them to be absent) for periods of 6 months prior to and 6 months following the training. The results indicate that sales among the experimental group increased significantly, whereas no such increase was found among the controls. This suggests a strategy for increasing the effectiveness of community volunteer workers that has received relatively little attention in the literature to date. PMID- 6867261 TI - The Health Careers Opportunity Program: one influence on increasing the number of minority students in schools of health professions. AB - Certain U.S. racial and ethnic minority groups traditionally have been underrepresented in the health professions. There have been significantly smaller proportions of health professionals who are blacks, Hispanics, and American Indians than members of those groups in the population at large. In the 1960s and 1970s various pieces of legislation were passed that were intended to increase the total number of health professionals and address the underrepresentation of minorities and other disadvantaged persons. The Special Health Careers Opportunity Grant (SHCOG) Program and its successor, the Health Careers Opportunity Program (HCOP) have had, as their specific charge, responsibility for awarding funds to undergraduate colleges, health professions schools, and other entities to increase the number of minority students admitted to, and graduated from, health professions schools. Since 1972, during the existence of the SHCOG and HCOP Programs, the number of black students in health professions schools has risen from 4,099 to nearly 6,000. The number of Hispanic students has doubled to more than 2,360 and that of American Indian health professions students has increased from 125 to 355. Minority student applicants to medical school have improved their scores on the medical college admission test (MCAT) and their mean grade point average (GPA) at a higher rate than nonminority students. Students from HCOP-supported schools had higher acceptance rates--even with lower MCAT and GPA scores--than students from schools lacking HCOP support. PMID- 6867263 TI - Lung cancer. PMID- 6867264 TI - Legionnaires' disease. PMID- 6867262 TI - Dental care needs of Army recruits. AB - To determine the prevalence amng current U.S. Army recruits of dental conditions requiring treatment, an assessment was done of the dental care needs of a 3 percent sample (N = 5,613) of incoming recruits at all seven U.S. Army reception stations that operate under a dental treatment planning concept. Both the treatment needs of the total sample and of each Army component--that is, Regular, Reserve, and National Guard forces--were quantified. The results indicated that the requirement for dental care among Army recruits currently being processed for training is approximately the same as it was for such recruits at the time that the Selective Service System draft was in effect, although the types of care needed have changed. Like the draft-based recruits, current Army recruits enter active-duty status with a substantial backlog of unmet dental care needs. PMID- 6867266 TI - Increased radioresistance of cells in cultured multicell spheroids. II. Kinetic and cytogenetic studies. AB - Using the Chinese hamster cell line B14 FAF28, several specific properties of the contact effect (CE) of radiation action in spheroids were investigated. CE was found to "protect" the spheroid cells against several types of radiation-induced cytogenetic misfunctions such as blockage in S and G2+M-phase, mutagenesis, and chromosome damage. However, repair of DNA strand-breaks was the same in monolayers and spheroids. Furthermore, CE is a property of the single cell and does not depend on the proliferative status (cycling or non-cycling) of the cells. We conclude that CE is the result of a physiological modification of the cells occurring during growth in the three-dimensional spheroid matrix and requiring metabolic cooperation and cyclic AMP for its induction. PMID- 6867265 TI - Response of mouse small intestine to fractionated doses of pions. AB - The effect of single or fractionated doses of stopping pions or 200 kV X-rays on the mouse jejunal crypt cells was used to determine in vivo RBE values. For single fraction, the pion/X-ray RBE was 1.27 and it increased to about 1.31 when two fractions were applied at 3 or 24 h interval. When four fractions were given at 3 h intervals, the RBE was 1.46. This is because the fraction of "dose repaired" was always higher for X-rays than for pions and this difference was enhanced when more dose fractions were used. The data presented is, in general, consistent with the biological effects of pions reported for other in vivo end points. PMID- 6867267 TI - RBE of spleen CFU-S to low dose rate Cf-252 neutron or photon radiation. AB - The RBE of Cf-252 neutron irradiation was determined for hemopoietic tissue using spleen CFU-S. Radiosensitivity was compared to acute Cobalt-60 radiation and low dose rate Cesium-137 under identical irradiation conditions. The RBE for the neutron component of the Cf-252 radiation was 2.1. No dose rate effect was observed for hemopoietic CFU-S to acute doses or low dose rate photon irradiation. PMID- 6867269 TI - Measurements of the annual variation of the erythema dose of global radiation. AB - The share of erythema dose of global radiation (Der/G) shows significant diurnal and annual variations. This is the result of the dependence of the ratio Der/G on optical air mass. Maximum values of Der/G are found at times of low optical air mass, i.e., at noon and in summer, minimum values at sunrise and sunset hours as well as in winter. Another reason for the annual variation of the ratio Der/G is the changing amount of total atmospheric ozone. Therefore values of Der/G in fall are about 50% higher than in spring despite the same solar declination. Comparing measurements of erythema dose at two stations with different altitudes, a difference of 14% per 1,000 m is obtained. PMID- 6867268 TI - Lipid peroxidation by ultraviolet light and high energy alpha particles from a cyclotron. AB - High energy alpha-particles (approximately 16 MeV) and 254 nm ultraviolet light produced dose dependent linear increase of lipid hydroperoxides in the dried thin film state. For both types of radiation, an inverse dose-rate effect, i.e., a protracted radiation dose was more effective than a shorter, more intense one of larger size, was observed. Ultraviolet light (254 nm) produced higher yields of hydroperoxides in the aqueous liposomal suspension of lipid than in its dried thin film state. PMID- 6867270 TI - Evidence for radiation-induced bulky lesions in DNA. PMID- 6867271 TI - [Increased DNA radiosensitivity as affected by reduced derivatives of nitroimidazole and nitrofuran]. AB - It was shown that active radiosensitizers, nitroimidazole and nitrofuran, reduced chemically and enzymatically under anaerobic conditions in the presence of DNA, cause singlestrand breaks in the latter. When this modified DNA is exposed to ionizing radiation the yield of single-strand breaks increases as compared to control (unmodified) DNA. PMID- 6867272 TI - [Mechanism of the radiation damage to the secondary structure of DNA]. AB - The authors describe the mechanism of radiation-induced damage of a secondary DNA structure suggesting that a double-helical brim conformation adjacent to a local defect in the secondary structure, and the thermoactivated threshold process of a "confluence" of the defects are present in the irradiated DNA. It is supposed that the major type of the radiation damage to the spatial DNA structure is a triple helix repaired with the aid of the specific endonuclease. PMID- 6867274 TI - [Chromosomal reaction of human lymphocytes to fractionated neutron doses in in vitro irradiation]. AB - A comparative study was made of the yield of chromosome aberrations in a human lymphocyte culture after a single and fractionated exposure to neutron radiation at the beginning of the G1 phase and during the S phase of the mitotic cycle. It was shown that the degree of the chromosome affection in both phases does not depend upon the irradiation schedules. PMID- 6867273 TI - [Problem of enhancing the biological action of ionizing radiation. 11. Comparative evaluation of the radiosensitizing action of metronidazole on newborn and adult mice]. AB - The radiosensitizing effect of metronidazole is most pronounced in conditions of acute hypoxia (mature mice, 5% O2) or anoxia (neonatels, 100% N2) and decreases with increasing O2 content in a gas mixture. The preparation is less effective in neonatal mice, adapted to oxygen deficiency, than in mature animals. The data obtained are discussed with respect to the problem of overcoming the radioresistance of tumours that is conditioned by hypoxic cells. PMID- 6867275 TI - [Relative biological effectiveness of neutrons in mixed gamma-neutron irradiation]. AB - Experimental animals (mice and rats) were exposed to mixed gamma/neutron radiation. Relative biological effectiveness of a neutron component (RBEn/x) was shown to decrease with decreasing share of neutrons in the combination. This is considered as a manifestation of nonadditivity of the effects of neutrons and sparsely ionizing radiation. PMID- 6867277 TI - [Potential chromosome radiation damages in mammalian cells studied by chemical modification and premature condensation of the chromosomes]. AB - Chinese hamster cells in culture, exposed to a dose of 2 Gy during the G2 phase of the cell cycle, were used to compare the results obtained from investigations of chromosome lesions after chemical modification by caffeine (10(-3) and 10(-2) M) and after premature condensation of chromosomes. The data obtained exhibited a similarity not only in the total yield of aberrations (which was thrice as high as that in metaphases with the same radiation dose), but also in the frequency of aberrations of different types. On the basis of the data obtained the potential radiation-induced chromosome lesions could be quantitated. PMID- 6867276 TI - [Radioprotective action of a gas hypoxic mixture GHM-10 in multiple irradiations of rat and human skin]. AB - Gas hypoxic mixture (GHM-10) decreased significantly the occurrence and duration of radioepidermitis after local therapeutic fractionated irradiation of Wistar rat skin with a cumulative dose of 66 Gy. In patients subjected to radiation therapy and protected with GHM-10 erythema and epidermitis developed at a much higher cumulative dose than in the controls. With erythema dose modifying coefficient was 1.38 +/- 0.06. PMID- 6867278 TI - [Circulating macromolecular complexes in rats which have undergone radiation, thermal and combined injuries]. AB - In experiments on rats it was shown that radiation and thermal traumas caused reduction in number of circulating macromolecular complexes, determined by the nephelometric method, by the end of the first 24 h following the damaging effect; on the 3d day, the amount of these complexes was minimum. The combined radiation and-thermal damage produced the additive effect. The authors discuss the nature of the observed decrease in the number of circulating macromolecular complexes. PMID- 6867279 TI - [Changes in the brain water-electrolyte metabolism of rats in gamma irradiation of the head at high doses]. AB - The biochemical and morphological methods were used to study the direct damaging effect of radiation (5.16 C/kg) on the rat brain structures and the reaction of the astrocytic-capillary complex leading to disturbances in the trophism and water-electrolyte exchange. PMID- 6867280 TI - [Dependence of the frequency of radiation-induced iso-labels on the colchicine concentration]. AB - In experiments on human lymphocytes it was demonstrated that the frequency of iso labels induced by irradiation of cells at the G2 phase decreases with increasing concentration of colchicine used for accumulation of metaphases. This might be explained by the possible influence of colchicine on the pattern of chromosome replication. PMID- 6867281 TI - [Effect of adrenalectomy and irradiation on protein metabolic indices in the rat erythrocyte]. AB - The amount of residual and amino nitrogen in erythrocytes increases considerably 24 h after irradiation (5 Gy, 25 MeV betatron) of intact and sham ectomized rats. Adrenalectomy followed by irradiation with the same dose reduces the activity of proteolytic processes in rat erythrocytes. PMID- 6867282 TI - [Results of a cytogenetic analysis of the peripheral blood lymphocytes of patients at different times after radiation therapy (up to 9 years)]. AB - A study was made of the changes in the chromosome apparatus of peripheral blood leukocytes after radiotherapy of patients with uterine cervix cancer (a cumulative dose 70-90 Gy). Cells with the chromosome apparatus lesions and total amount of chromosome aberrations were intensively eliminated during the first 3-5 years following irradiation. Later (up to 7-9 years) their level stabilized to be 5-6 times higher than the control. PMID- 6867283 TI - [Modifying effect of different irradiation conditions on sodium and water transport in the small intestine of the rabbit]. AB - A study was made of the effect of X-radiation on sodium and water transport within a section of rabbit small intestine. The effects induced by radiation doses of 0.21 and 0.39 C/kg were compared. The authors discuss the possibility of modification of the radiation lesions by the administration of cystamine prior to irradiation. PMID- 6867284 TI - [Modification of the intestinal syndrome using a hypoxic gas mixture under different conditions of animal irradiation]. AB - In experiments on 1152 CBA mice and SHK colony and on 1180 Wistar rats it was demonstrated that a gas hypoxic mixture containing oxygen (10%) and nitrogen (90%) (GHM-10) reduced the intestinal syndrome of the acute radiation sickness in animals exposed to ionizing radiation at rest, during physical exercises, after radiation sickness endured earlier, after exposure to SHF, after fractionated irradiation, and after radiation-and-thermal damage. PMID- 6867286 TI - [Changes in small intestine function after radiation and thermal injury]. AB - A study of the small intestine functions after radiation and thermal affection of rats has revealed an inhibited absorption of carbohydrates, fats and proteins. The disturbance of the resorption of these substances results from a change in the motor-evacuator function and a decrease in the activity of the appropriate enzymes in the small intestine mucosa. PMID- 6867287 TI - [Changes in immunobiological reactivity under the combined action of microwave, infrasonic and gamma irradiation]. AB - In experiments on rats and rabbits a study was made of the combined effect of 9.3 gHz and 0.1 gHz (200 and 1530 muW/cm2, respectively), infrasound (8 Hz, 115 db), and gamma-radiation (cumulative dose of 5.5 Gy) on cell and humoral immunity, and on autoimmune processes. It was shown that preirradiation with microwaves increased the resistance of the organism to gamma-radiation, and microwaves combined with infrasound enhanced the biological effect of gamma-radiation. PMID- 6867288 TI - [Prediction of radiation injury based on body response to acute hypoxia]. AB - A comparative study was made of the resistance of rats to acute hypoxia and their radiosensitivity. It was shown that the outcome of radiation affection could be predicted, with the accuracy of 57.7-65.8%, on the basis of the resistance of rats to hypoxia. PMID- 6867285 TI - [Effect of a physiological solution on the hematopoietic stem cell pool in healthy and irradiated mice]. AB - It was shown on (CBA X C57Bl)F1 mice that a single intraperitoneal injection of a physiological solution (0.2 ml) reduced the number of haemopoietic stem cells in the bone marrow and increased concurrently the radioresistance of CFU. PMID- 6867290 TI - [Use of the LUE-25 linear electron accelerator for studying the radiobiological effects of high doses of fast electrons]. AB - In order to study the early biological effects of whole-body and partial exposure of biological objects to high doses of fast electrons a simple and reliable method has been developed for the purposes of the control and correction of the dose-rates. The measurements were made of spatial distribution, in air and water, of the doses used for irradiation of the laboratory animals and cell suspensions with the indicated nonuniformity coefficients. PMID- 6867289 TI - [Influence of an alternating magnetic field on the bactericidal effect of ionizing radiation]. AB - A study was made of the effect of alternating magnetic field (AMF) and ionizing radiation delivered separately or in a combination on the microorganisms differing in radio-resistance. AMF (240 and 750 E) had no pronounced bactericidal action. A synergistic increase in the sterilizing effect of ionizing radiation was demonstrated after incubation of irradiated bacteria in AMF. The radiation magnetic technique is proposed for sterilization of preparations and articles made of non-thermoresistant materials which permits to decrease by 1.5 times the bactericidal dose of ionizing radiation. PMID- 6867291 TI - [Formation of a fast-neutron beam for radiobiological experiments on the U-240 isochronous cyclotron and a study of its dosimetric characteristics]. AB - The paper submits the description of the channel equipped for radiobiological experiments with fast neutrons at the isochronous cyclotron U-240. A study was made of some dosimetric characteristics of a mixed gamma-and-neutron beam. PMID- 6867292 TI - The College viva voce examination: is it a valid test? PMID- 6867294 TI - Quality assurance: a practical programme. PMID- 6867293 TI - Measurement of absorbed skin dose in tomography. PMID- 6867295 TI - Xeroradiography for foreign body detection. PMID- 6867296 TI - Design for a paediatric chest-stand. PMID- 6867297 TI - Aid for the orthopantomograph unit. PMID- 6867298 TI - [Immediate and early results with the contact irradiation of tumors using 252Cf sources]. PMID- 6867299 TI - [Jena control unit for the Decatron afterloading device]. PMID- 6867300 TI - [Mechanism of the effect of small doses of ionizing radiation on plants and their use in agriculture]. PMID- 6867301 TI - Radioprotective effect of 2-mercaptopropionylglycine on the testes of prenatally irradiated mice. PMID- 6867302 TI - MPG modification of the gamma ray sensitivity or ovarian follicles of mice. PMID- 6867304 TI - Modification of acid phosphatase activity in the liver of Swiss albino mice by 2 mercaptopropionylglycine against gamma irradiation. PMID- 6867305 TI - Population kinetic studies in mouse jejunum under continuous beta-exposure from tritiated water. PMID- 6867303 TI - Chemical protection of mice against radiation induced sickness and mortality by 2 mercaptopropionylglycine. PMID- 6867307 TI - [RIA Quick, Ausria II-125 and Ausab: comparative study on the isolated and simultaneous determination of hepatitis B surface antigen land antibodies]. PMID- 6867308 TI - Symposium on CT of the lumbar spine. PMID- 6867306 TI - Role of MPG in the postnatal growth of intrauterine 131I irradiated mice. PMID- 6867309 TI - Clinical usefulness of CT scanning in the diagnosis and treatment of lumbar spine disease. AB - CT scanning of the lumbar spine is in its infancy. Nevertheless, it has had a remarkable effect on the way we evaluate and treat patients. The principal advantages are the following: (1) If the scan alone in the diagnostic work-up of patients with lumbar disc herniation and correlative neurologic deficit. (2) The CT scan aids in the screening of patients with back and leg pain who did not have a neurologic deficit. It may determine the need for further studies such as myelography. (3) CT has become helpful in the evaluation of patients with lumbar spinal stenosis and may replace myelography when greater experience is garnered. (4) CT is of great value in the evaluation of the lumbar spine previously operated on and may provide diagnostic information unavailable on the myelogram because of dural scar formation, arachnoiditis, and so on. (5) Future comparative studies probably will indicate greater accuracy with CT scanning than with myelography, and consequently, the overall diagnostic acumen in the treatment of patients with lumbar spine disease will be improved. PMID- 6867310 TI - Anatomy of the lumbosacral spine. PMID- 6867311 TI - Evaluation of the lumbar spine. A comparison between computed tomography and myelography. AB - The CT scan and the metrizamide myelogram are compared in evaluating multiple disorders of the spine. Examples are shown of degenerative disc disease, including lateral discs, isodense discs, and degenerative changes, which cause varying degrees of stenosis of the spinal canal and neuroforamina. Examples of discitis and neoplastic involvement of the vertebral bodies and spinal canal are also shown. Finally, several examples of dysraphic conditions of the spine are presented. CT examination for disc disease is still most often used as an adjunct to the myelogram. However, as knowledge and experience is gained about its value in diagnosing all abnormalities of the spine, its use will increase, and CT may become the primary method of evaluation, after ordinary radiographs. PMID- 6867312 TI - CT and lumbar disc herniation. PMID- 6867313 TI - CT diagnosis of degenerative disc disease. The bulging annulus. AB - Computed tomography can accurately distinguish a bulging disc with intact annulus from a herniated nucleus pulposus in most patients. A bulging annulus should be diagnosed when CT scans demonstrate generalized extention of the disc margins beyond the adjacent vertebral body margins. A herniated nucleus may be diagnosed by a CT scan when there is focal protrusion of the disc margin beyond the vertebral body margins. However, correlation between clinical and CT findings remains a critical factor in determining the significance of an abnormality detected by a CT scan. PMID- 6867314 TI - Spinal stenosis. PMID- 6867315 TI - The use of computed tomography in spinal trauma. PMID- 6867316 TI - Surgical management of lumbar disc disease. AB - The normal and pathologic anatomy and biochemistry of lumbar disc disease have been discussed. The use of various diagnostic modalities to support the clinical diagnosis has been assessed. Details of a conservative care program are outlined. A discussion of surgical indications and techniques for laminectomy, reoperative laminectomy, and posterolateral spinal fusion is also presented. The use of chymopapain is briefly described in anticipation of its imminent usage. PMID- 6867317 TI - CT of the postoperative lumbar spine. PMID- 6867318 TI - [Some pathologico-anatomic substrates of hypertensive lesions]. AB - After some introductory remarks on the definition of the various forms of hypertension, a short description of the changes in arterial vessels associated with hypertension is given. Hypertension is by no means a prerequisite for atherosclerosis and arteriolosclerosis, but hypertension enhances such vascular changes. In malignant hypertension, typical fibrinoid arteriolonecroses occur. Hypertension leads to hypertrophy of the left ventricle through enlargement of individual muscle fibres, but numeric hyperplasia also occurs. At the same time, coronary atherosclerosis may be aggravated by systemic hypertension. Hypertrophy together with coronary sclerosis may result in various forms of ischemic heart disease among which myocardial infarction and its complications are the most important ones. There are intimate mutual interactions between hypertension and ischemic renal damages, the most important of which are briefly discussed. Again, many of these changes do not necessarily require hypertension as a prerequisite. Massive haemorrhage into the substance of the brain is usually associated with systemic arterial hypertension, but requires predisposing atherosclerosis and arteriolosclerosis: Walls of healthy arteries do not give way, however high the blood pressure may be. PMID- 6867319 TI - [Digital function angiography. A method of measuring arterial blood flow]. AB - Digital image processing techniques can be effectively used for the quantitative evaluation of angiograms. In this study, the principle of parameter extraction from digitized image series was utilized. The procedure of parametric analysis was based on mathematical calculations of density-time-curves of the contrast medium according to each picture element of a digital image matrix (256 x 256 picture elements). Flow measurements were calculated from time parameter data and the subsequent segmentation of vessels indicating the propagation of the contrast medium within given time intervals. Flow velocity and volume flow studies will provide additional quantitative information to the evaluation of conventional angiograms. PMID- 6867320 TI - 55 degrees posterior oblique tomography of the pulmonary hilum in the evaluation of lung tumors. AB - Findings at 55 degrees posterior oblique tomography and chest films were compared to those at thoracotomy in 53 patients with malignant lung tumor. A correct evaluation of presence of lymph node metastases was made by tomography in 44 of the patients. Lack of tissue diagnosis at tomography makes mediastinoscopy better as a staging procedure. Oblique hilotomography is mainly indicated as a method for accurate evaluation of the questionably large hilum. PMID- 6867322 TI - [Megacolon as a rare complication of diabetes mellitus]. AB - The clinical and radiological features of diabetic megacolon and gastroparesis occurring in a 48-year-old woman are presented. The only two other well documented cases of diabetic megacolon from the literature are reviewed. The predominant dilatation of the sigmoidal colon in the setting of a generalized megacolon may be, especially if associated with bladder atony, a clue to the diagnosis of the diabetic nature of a megacolon. PMID- 6867321 TI - [Malignant pyloric stenosis caused by cancer in para-pyloric ectopic pancreas]. AB - Gastrointestinal symptoms with epigastric pain, nausea and loss in weight occasionally occur in patients with ectopic pancreas. Although ectopic pancreas is often found in the stomach, carcinoma in this ectopy is rare. This paper reports a case of pancreatic carcinoma arising in ectopic pancreas located in the gastric wall and causing pyloric obstruction. Malignant pyloric obstruction was the only radiographic sign. Microscopic examination led to the final diagnosis. PMID- 6867324 TI - [Right-sided ureteral obstruction in a young female]. PMID- 6867323 TI - [Reflections on computer tomographic demonstration of extensive brain calcinosis in hyperparathyroidism]. AB - An observation in our department showing vast calcifications of the brain proved by computertomography is compared to similar cases described in literature. Typical localisations of such calcifications are brought into relation with given anatomical conditions of the regions of calcifications. The spatial appearance of the structures of brain, their relative capillary density and the respective presence of an absolute amount of capillaries favour comprehension of chalc by computed tomography. PMID- 6867325 TI - Adult-onset pulmonary tuberculosis. AB - Medical records and radiographs of 103 adults with primary tuberculosis were reviewed. The shift toward delayed presentation appears to be related to decreasing childhood exposure and an increasing number of compromised hosts. Compared with classic "childhood" tuberculosis, there is a higher incidence of lower-lobe disease, but infiltrates also commonly involve the upper lobe or upper segments of the lower lobe. Adenopathy, cavitation, and tuberculoma are rare. If a pleural effusion is present and tuberculosis is suspected, pleural biopsy is mandatory. Adult respiratory distress syndrome can be a complication, particularly in miliary tuberculosis, and disseminated intravascular coagulopathy usually follows. A normal chest radiograph or clinical improvement of the patient with bed rest and penicillin does not exclude tuberculosis. Increased awareness of adult-onset tuberculosis on the part of radiologists could lead to a more rapid diagnosis and successful management. PMID- 6867327 TI - Radiation-induced injury of the esophagus. AB - Forty patients with functional or morphologic esophageal abnormalities following radiotherapy were identified. Abnormalities included abnormal motility with and without mucosal edema, stricture, ulceration and pseudodiverticulum, and fistula. Abnormal motility occurred 4 to 12 weeks following radiotherapy alone and as early as 1 week after therapy when concomitant chemotherapy had been given. Strictures developed 4 to 8 months following completion of radiotherapy. Ulceration, pseudodiverticulum, and fistula formation did not develop in a uniform time frame. Radiation-induced esophageal injury is more frequent when radiotherapy and chemotherapy are combined than it is with radiotherapy alone. PMID- 6867326 TI - Scanned projection radiography of the chest versus standard film radiography: a comparison of 250 cases. AB - Two hundred fifty patients who had 240 pathological changes of the lungs or mediastinum were examined using both scanned projection radiography (SPR) and standard film radiography, and the diagnostic accuracy of the procedures was compared. The use of standard film radiography led to diagnostic findings in 90.1% of the cases, while 94% of the images obtained at SPR provided diagnostic findings. The equivalent performance and, in part, the slight superiority obtained with the digital technique is a result of the better contrast resolution for objects with diameters greater than 2 mm. A further improvement in the diagnosis of thoracic disease with digital radiography may occur because of the use of special mathematical algorithms for image reconstruction and with the use of dual-energy subtraction radiography rather than by an increase of spatial resolution. PMID- 6867328 TI - Arthrography of the cervical facet joints. AB - Arthrography was performed during steroid injection in 14 patients (22 joints) with noninflammatory conditions of the cervical facet joints. Two isolated spines were also studied. The capsular recesses were found to be quite large, especially near the intervertebral foramen. Though the appearance of the arthrogram was not clinically useful, it was helpful in positioning the needle for the steroid injection and confirming that the joint in question was abnormal. Distension of the capsule provoked pain in about 50% of cases; rupture of the distended capsule was rare but could account for leakage into the epidural space or foramen. Nine patients had significant relief of pain for three days to thirteen months. PMID- 6867329 TI - Occult fractures of the knee: tomographic evaluation. AB - Seven adults with painful effusions of the knee were examined for occult fractures using pluridirectional tomography in the coronal and lateral planes. Six patients (ages 50-82 years) were osteopenic and gave histories ranging from none to mild trauma; one 26-year-old man was not osteopenic and had severe trauma. In all cases, routine radiographs were interpreted as negative, but tomography demonstrated a fracture. Five fractures were subchondral. Bone scans in 2 patients were positive. The authors conclude that osteopenic patients with a painful effusion of the knee should be considered to have an occult fracture. While bone scans may be helpful, tomography is recommended as the procedure of choice to define the location and extent of the fracture. PMID- 6867331 TI - Arteriographic measurement of the abdominal aorta, iliac, and femoral arteries in women with atherosclerotic occlusive disease. AB - Arteriographic measurements were made in 73 consecutive women undergoing arterial reconstruction for aorto-iliac occlusive disease. The anatomical distribution of atherosclerosis was unaffected by arterial size. Women with isolated aorto-iliac atherosclerosis had the same size arteries as those with concomitant outflow disease. Aortic, iliac, and femoral artery diameters were distributed as a single group, with no distinct subgroup of "small arteries." However, women whose aorta was less than 1 S.D. below the mean were younger and had less cardiovascular disease even when the effects of age and body size on arterial diameter were excluded. Women with this statistical definition of "small aorta" were clinically analogous to those previously identified anecdotally. The authors propose that a "small aorta" in a women with aorto-iliac atherosclerosis be defined as less than 19 mm in diameter above and less than 13 mm below the renal arteries and less than 10 mm at the bifurcation. PMID- 6867330 TI - Pelvic actinomycosis. AB - A case of actinomycosis involving the pelvic cavity is reported. The patient had a pelvic mass clinically and radiographically. Barium enema examination showed a mass with extrinsic compression and fixed narrowing of the rectum with mucosal irregularity. A computed tomographic scan showed a pelvic mass displacing the rectum. PMID- 6867332 TI - Analysis of mammography: a blind interpretation of BCDDP radiographs. AB - An ROC curve analysis of mammography is presented. This study is based on a blind interpretation of radiographs of patients who underwent screening during the Oklahoma Breast Cancer Detection Demonstration Project (BCDDP). In particular, we evaluated the accuracy of mammography based on 38 incidence cancer cases. Incidence cases are those that develop in a patient after an initial visit and at least one additional annual visit before a biopsy is performed. Using 40 normal subjects, a sensitivity of 72% was attained at a 28% false positive rate. We also evaluated the contribution of viewing radiographs of both breasts (right and left) simultaneously as compared with viewing radiographs of the individual breasts singly. In cases on the threshold of detectability, the breast that did not result in the cancer diagnosis was occasionally identified as the most suspicious for cancer. When mammograms of the two breasts were compared, the false positive rate was lower. These results can be used to assess various screening strategies and to yield a more realistic accuracy estimate of mammography on a rescreened population than is currently available. PMID- 6867333 TI - Endovascular electrocoagulation with a bipolar electrode and alternating current: a follow-up study in dogs. AB - Endovascular electrocoagulation of the anterior tibial artery in dogs was performed with two different bipolar electrodes. Follow-up showed revascularization when a short-tip electrode was used, but no revascularization when a long-tip electrode was used. Histologic study showed complete occlusion of the artery by an organized thrombus adherent to the vessel wall. PMID- 6867334 TI - Postasphyxial encephalopathy in full-term infants: ultrasound diagnosis. AB - Abnormal cranial ultrasound findings are described in 18 infants with severe asphyxia. The examinations performed within the first 7 days after the asphyxial episode frequently showed obliteration of the ventricles and extra-axial fluid spaces with mildly increased cerebral echogenicity, presumably representing cerebral edema. Others showed diffusely abnormal parenchymal echogenicity with normal ventricles and sulci. Ultrasound findings seen after the first week of life included increased size of the ventricles and extra-axial fluid, the result of cerebral atrophy. The sensitivity, specificity, and accuracy of both early and late abnormal ultrasonograms were calculated for predicting an abnormal neurological outcome. While the sensitivity of the abnormal early (performed within 7 days of birth) ultrasonogram was relatively low (46%), the sensitivity of an abnormal late (performed after 7 days) ultrasonogram was high (86%). The specificity for both abnormal early and late ultrasound was 100%. These findings suggest that cranial ultrasonography can be used as a screening procedure to provide information about the neurologic outcome to clinicians caring for these infants. PMID- 6867335 TI - Infant apnea: findings on the barium esophagram. AB - Barium esophagrams of 160 infants who were being examined for apneic episodes were obtained at a referral center for the investigation of sudden infant death syndrome (SIDS). The studies were standardized as closely as possible to evaluate swallowing, esophageal function and anatomy, and the gastroduodenal regions. The level and frequency of gastroesophageal reflux were carefully assessed. The most common abnormality identified was gastroesophageal reflux (54%). Other abnormalities included nasopharyngeal reflux (27%), aberrant right subclavian artery (3%), and aspiration into the airway (3%). Swallowing dysfunction, esophageal dysmotility, antral dysmotility, chalasia, and tracheoesophageal fistula were each found in less than 1% of the infants. PMID- 6867336 TI - The effect of contrast media on immature renal function. Comparison of agents with high and low osmolality. AB - Contrast media having high osmolality (methylglucamine diatrizoate; 1,510 mOsm/kg) and low osmolality (triiodoisophthaldiamide, 616 mOsm/kg) were compared in 15 functionally immature rabbits 2-3 weeks of age. Renal function was assessed with a gamma camera and whole-body counter, using excretion of technetium-99m-tin DTPA as an index of glomerular filtration rate. Both DTPA and the contrast agent (2 ml/kg) were injected as a single intravenous bolus in 15 seconds. After 40 minutes, per cent DTPA excreted was 33.0 +/- 2.3 for triiodoisophthaldiamide and 28.2 +/- 1.5 (p less than 0.01) for methylglucamine diatrizoate. Excretion of DTPA was reduced with the latter (p less than 0.005) but not the former agent (p greater than 0.6). Thus contrast materials with high osmolality depress renal function in immature rabbits, suggesting that agents with low osmolality are preferable for use in newborns. PMID- 6867337 TI - Brief clinical communication: neurogenic perineal prolapse in neonates. AB - Disturbed innervation of the pelvic muscular diaphragm from lumbosacral myelodysplasia and other osseous dysplasias results in flaccid paralysis of the perineum. This permits excessive downward herniation, most noticeable in neonates, of the lower abdominal and pelvic organs. The radiographic changes occurring with organ descensus may be transitory and diverse, and recognition of these various findings is important to avoid misdiagnosis and unnecessary further investigations. Several examples of the radiographic changes are presented. PMID- 6867339 TI - Cerebral dysplastic vascular malformation: a developmental arrest. AB - A cryptic malformation of the brain was found to represent an arrest in vascular development. Microscopy showed plump endothelium of blood vessels, which did not have a normal lumen and consisted of solid cords of cells. The microscopic, angiographic, and computed tomographic appearance of this anomaly are discussed and compared with cavernous angiomas, arteriovenous malformations, and venous angiomas. PMID- 6867338 TI - Brachiocephalic vessel: selective and superselective catheterization. AB - The development of a catheter for easy and reproducible selective and superselective catheterization of the distal branches of the brachiocephalic arteries is reported. The catheter consists of a proximal 6- or 7-F braided wire shaft and a distal, nonbraided 10 cm made of thin-walled polyurethane with a 4- or 5-F diameter. The most distal 1 cm has a 105-degree curve and is not tapered at the tip. In this series, 209 patients were embolized in 277 separate procedures. Catheterization of the desired vessel was achieved in more than 95% of cases. PMID- 6867340 TI - Retrosomatic clefts: computed tomographic appearance. AB - A case of bilateral clefts in the pedicles of the L1 vertebra, diagnosed by computed tomography, is presented. The differentiation from other clefts located laterally in the neural arch is briefly summarized, and the possible origin of this entity is discussed. It is improbable that the clefts represent persistent neurocentral synchondroses. PMID- 6867341 TI - High-resolution computed tomography of the middle ear and mastoid. Part I: Normal radioanatomy including normal variations. AB - The use of high-resolution computed tomography (CT) to examine the middle ear and mastoid is discussed. Exceptional detail of the viscera of the middle ear was attained in almost all cooperative patients with proper technique. Important anatomical structures are illustrated and discussed, and the appropriate projection for depicting specific structures is emphasized. Normal variations, preoperative knowledge of which is important to the otologic surgeon, are also illustrated. PMID- 6867342 TI - High-resolution computed tomography of the middle ear and mastoid. Part II: Tubotympanic disease. AB - Of more than 200 patients who underwent high-resolution computed tomography (CT) of the middle ear, the vast majority had tubotympanic disease in one of its forms: middle ear effusion, tympanosclerosis, granulation tissue, tympanic membrane retractions, or acquired cholesteatoma. The CT appearance of each of these conditions is discussed and illustrated. Emphasis is placed on the differential diagnosis of tubotympanic disease by determining dependent from nondependent soft-tissue opacity using two CT projections. PMID- 6867343 TI - High-resolution computed tomography of the middle ear and mastoid. Part III: Surgically altered anatomy and pathology. AB - High-resolution computed tomography (CT) provides an excellent method for examination of the surgically altered middle ear and mastoid. Closed-cavity and open-cavity types of mastoidectomy are illustrated. Recurrent cholesteatoma in the mastoid bowl is easily diagnosed. Different types of tympanoplasty are discussed and illustrated, as are tympanostomy tubes and various ossicular reconstructive procedures. Baseline high-resolution CT of the postoperative middle ear and mastoid is recommended at approximately 3 months following the surgical procedure. PMID- 6867344 TI - Computed tomography of the middle ear in the evaluation of cholesteatomas and other soft-tissue masses: comparison with pluridirectional tomography. AB - Computed tomographic (CT) scans and tomograms of 60 patients with various soft tissue masses of the middle ear, including 30 with cholesteatomas, were studied. CT produced excellent images of middle ear soft-tissue masses and appears to be the diagnostic method of choice for cholesteatomas, glomus tympanicum tumors, and other soft-tissue masses. In one patient CT demonstrated pneumolabyrinth resulting from postsurgical fracture of the footplate of the stapes. Pneumolabyrinth is a newly reported CT finding in stapes footplate fracture. PMID- 6867345 TI - Epiglottic motion: video recording of muscular dysfunction. AB - Progression of epiglottic movement was demonstrated on video tape during a pharyngeal swallow in 618 patients. Dysfunction of extrinsic laryngeal musculature and restriction of normal epiglottic motion produced the most significant changes. Intrinsic muscular dysfunction creates minor abnormalities in epiglottic motion but may lead to laryngotracheal aspiration. Alterations in normal movement should be recognized as such and significant neuromuscular and malignant disease considered. PMID- 6867346 TI - Inferior pulmonary ligament: computed tomographic appearance. AB - A total of 129 normal computed tomograms of the chest was retrospectively reviewed to determine the appearance and frequency of visualization of the inferior pulmonary ligament. The ligament was seen on the left in 67.4% of patients, on the right in 37.2% of patients, on both sides in 27.1% of patients, and on neither side in 22.4% of patients. Of those ligaments seen, 92% on the left and 92% on the right demonstrated a posterior orientation. Examples are shown emphasizing the importance of the inferior pulmonary ligament in relation to lower lobe collapse, pleural effusion, extension of a mediastinal abnormality into the ligament, and the possible intraparenchymal appearance of an abnormality located within the ligament. PMID- 6867347 TI - CT pancreatogram in carcinoma of the pancreas and chronic pancreatitis. AB - CT has made it possible to determine the contour of the pancreatic duct, to measure its caliber, and to detect dilatation of the duct. CT scans of 75 patients with pancreatic carcinoma and of 45 patients with chronic pancreatitis were obtained. Dilatation of the pancreatic duct was seen in 56% of patients with carcinoma, and in 70% of those with tumors confined to the pancreatic head and body. Smooth dilatation (43%) or beaded dilatation (40%) were most commonly associated with carcinoma. Ductal dilatation was present in 58% of the patients with chronic pancreatitis, and irregular dilatation was seen in 73% of the patients in this group. About half of the patients who had irregular dilatation had calculi within the ducts. The duct contour was similar to that seen in carcinoma in 27% of the cases of chronic pancreatitis. There was a significant difference in the caliber of the duct (P = .01) with larger ducts seen in patients with carcinoma. The width of the pancreatic gland (P = .005) and the ratio of duct caliber to gland width differed (P = .001) between the two diseases: the gland was wider in cases of chronic pancreatitis, and the ratio of duct to gland was larger in cases of carcinoma. Eight cases of dilatation of the duct with no detectible pancreatic mass were seen in a subgroup of 13 patients who had small carcinomas of the pancreas (tumor size of 3 cm or less). Our findings indicate that a dilated pancreatic duct with a smooth contour and a ratio of duct to total gland width of 0.50 or greater suggests carcinoma as the underlying pathology. PMID- 6867348 TI - Non-functioning adrenal adenomas discovered incidentally on computed tomography. AB - Eighteen patients with unilateral non-metastatic, non-functioning adrenal masses were studied with computed tomography (CT). Pathological examination in 6 cases revealed benign adrenal adenoma. The others were followed up with serial CT scans and found to show no change in tumor size over a period of six months to three years. On the basis of these findings, the authors suggest certain criteria of a benign adrenal mass, including (a) diameter less than 5 cm, (b) smooth contour, (c) well-defined margin, and (d) no change in size on follow-up. Serial CT scanning can be used as an alternative to surgery in the management of many of these patients. PMID- 6867349 TI - Pheochromocytoma: value of computed tomography. AB - A review of 60 histologically proved pheochromocytomas confirmed the value of computed tomography (CT) in the evaluation of this tumor. CT was found to be an accurate means of locating the tumor in 52 patients presenting for the first time and 8 patients with evidence of recurrence. PMID- 6867350 TI - Psoas compartment disease studied by computed tomography. Analysis of 50 cases and subject review. AB - Fifty patients with disease involving the psoas compartment were analyzed. There were 27 patients with inflammation, 17 with tumor, and 6 with hemorrhage. In all but 3 cases the disease did not originate in the psoas but spread there from neighboring structures. Disease processes followed the fascial planes in patients with abscesses and hemorrhage but were less predictable with tumors. All three types of lesions were similar radiographically and were often indistinguishable. Asymmetry of the muscle mass, regions of decreased density, and opacification of fat in the peri- and pararenal compartments were the most frequent signs of disease. Computed tomography is recommended as the diagnostic procedure of choice. PMID- 6867351 TI - Intraoperative neurosurgical ultrasound: transdural and transfontanelle applications. AB - High-resolution real-time ultrasound scanning of 54 patients was performed with a sector scanner during a variety of neurological procedures. Scans obtained at the time of craniotomy were successful in characterizing and localizing tumors, abscesses, arteriovenous malformations, and hematomas within the brain of 15 of 16 adult patients. One attempt to visualize a brain cyst through a 15-mm burr hole was unsuccessful. Scanning of 37 infants and young children was performed through the anterior fontanelle during placement of ventricular shunts. This allowed for the accurate placement of shunts in all patients and resulted in fewer short-term and long-term complications. Intraoperative ultrasound is a practical and highly effective means of providing intraoperative localization of intracranial anatomy and disease. PMID- 6867352 TI - Intraoperative neurosurgical ultrasound in the localization and characterization of intracranial masses. AB - Seventy-two lesions were demonstrated in 70 patients who were examined using intraoperative real-time ultrasonography. Fifty-five lesions were supratentorial and 17 were infratentorial. The neurosurgeon used ultrasonography to evaluate his operative field before, during, and after resection. Nineteen lesions contained cystic components. In eight cases, ultrasonography added information not provided by CT including definitive characterization of cystic components and loculations or localization of solid masses within the cysts. Biopsy of 13 lesions was performed under ultrasonic guidance. In all cases, the biopsy probe could be seen passing through the lesions leaving an echogenic trail, possibly blood filled, after the probe had been removed. Three lesions with diameters of less than 1 cm were localized and successfully removed under ultrasonic guidance. Intraoperative real-time ultrasonography is a safe and reliable technique, and it can be a valuable aid to the neurosurgeon. PMID- 6867353 TI - Work in progress. Intraoperative neurosurgical ultrasound: localization of brain tumors in infants and children. AB - Intraoperative real-time ultrasonic sector scanning was performed through the unincised dura mater or the intact brain surface of eight patients (aged six months to 13 years), each of whom had a previously documented mass lesion (four supratentorial, three infratentorial, one intraventricular). In each case, there was a clear definition of the location, configuration, and tissue consistency of the mass. With the exception of a choroid plexus papilloma, all lesions demonstrated both solid and fluid components. The location of a subcortical parietal lobe mass (ependymoma) was apparent only by prior sonography. All neoplastic tissue of one cerebellar astrocytoma that was identified at gross examination was removed, but additional intraoperative scanning following removal of the neoplasm suggested the presence of residual abnormal tissue. This was confirmed during further exploration, and additional gross tumor tissue was excised. PMID- 6867354 TI - Work in progress: common carotid artery contours reconstructed in three dimensions from parallel ultrasonic images. AB - Three-dimensional sonograms of the common carotid artery were obtained using a device which takes images in parallel planes. Tests in phantoms simulating atherosclerotic vessels the same size as the common carotid artery indicated that the coefficient of variation of a single luminal measurement was 2-5%. PMID- 6867355 TI - Coronary artery disease: detection by phase analysis of rest/exercise radionuclide angiocardiograms. AB - Thirty-six patients with chest pain but no myocardial infarction or conduction defects and 4 volunteers (3 normals and 1 with asymptomatic aortic insufficiency) underwent radionuclide angiocardiography. Phase analysis was performed and the standard deviation (SD) ("spread") and skewness ("asymmetry") of the left ventricular (LV) phase histogram determined at rest and during maximum exercise. The SD of the LV phase histogram was of no value; however, when -0.1 was taken as the upper limit of normal skewness at maximum exercise, skewness was equally as sensitive as conventional criteria for coronary artery disease (CAD) and also more specific. The authors conclude that LV histogram skewness during maximum exercise may be superior to conventional criteria for detection of CAD with rest/exercise radionuclide angiocardiograms. PMID- 6867356 TI - Work in progress: intra-arterial P-32 chromic phosphate for prevention of postoperative liver metastases in high-risk colorectal cancer patients. AB - Eight patients with locally extensive colorectal cancer were treated with colloidal P-32 chromic phosphate via the superior mesenteric artery following resection to prevent development of liver metastases. Less than 2% of the injected dose was found in the right atrial blood following the first pass through the liver and less than 1% in the urine. Therapy was tolerated well by all patients, with no acute complications. Long-term follow-up is needed to determine the effect of P-32 on the liver and the frequency of hepatic metastases. PMID- 6867357 TI - Hydrocephalus in adults. Ultrasound detection through surgically created cranial defects. AB - For 15 men who had undergone neurosurgery, ultrasound of the brain through the surgically created cranial defects identified the status of the ventricles in 15 of 17 total examinations (88%). Two failures involved patients with cranial defects in the frontal region. Assessments were all correct when correlated with computed tomography. PMID- 6867359 TI - Catheter angiography through prosthetic vascular grafts using a Teflon sheath. AB - A technique for complex catheter angiography through prosthetic vascular grafts is described. A Teflon sheath is inserted percutaneously; angiographic catheters can then be introduced easily through this sheath. The technique has been performed in 15 instances with only one subsequent complication. PMID- 6867358 TI - Control of swallowing by use of topical anesthesia during digital subtraction angiography. AB - Involuntary swallowing and other forms of patient motion are the greatest source of image degradation in digital subtraction angiograms of the extracranial carotid and vertebral arteries. If a patient gargles with a recommended dose of 2% viscous lidocaine, the urge and ability to swallow are reduced and image quality is improved. PMID- 6867360 TI - Biopsy of the right adrenal gland by the transhepatic approach. AB - A transhepatic computed-tomographic-guided biopsy of a right adrenal mass is described. This method is simpler to perform than the usual posterior biopsy carried out with the patient prone and is less likely to cause a complicating pneumothorax. In seven of eight patients with right adrenal masses, adrenal tissue was obtained and an accurate diagnosis was possible. No complications resulted. PMID- 6867361 TI - Detachable stainless-steel spider. A new device for vessel occlusion. AB - A new device for transcatheter vessel occlusion consists of a stainless-steel spider which can be screwed onto a threaded guide wire. Since the spider can be retrieved after it is extruded from the catheter, accurate placement is possible. The device was tested in the aorta and pulmonary artery of dogs. The spider blocked the movement of steel coils and wool streamers and occluded the vessel. This device is particularly useful for occlusion of large arteriovenous fistulas in the lungs. PMID- 6867362 TI - Should the radionuclide skeletal survey be used as a screening procedure in suspected child abuse victims? PMID- 6867363 TI - Ultrasonic diagnosis of primary hyperoxaluria in infancy. PMID- 6867364 TI - Synthesis and antifertility activity of 13-aza 14-oxo-prostaglandins. AB - Some 13-aza-14-oxo prostaglandin analogues of PGF2 alpha, PGE2 and PGA2 have been synthetized in optically active form, starting from Corey's intermediate and evaluated for antifertility activity in the hamster. The C-15 absolute configuration was established and found critical for the biological activity, but unexpectedly the highest potency was always associated with the 15 epi derivatives. Among the PGF2 alpha analogues the 15 epi derivative was about one tenth as potent as PGF2 alpha. The preparation of a few 16-phenoxy 17,18,19,20 tetranor-derivatives led to more potent compounds with the p-fluorophenoxy analogue having the same potency as PGF2 alpha. PMID- 6867365 TI - [Self and identity]. PMID- 6867366 TI - [Psychoanalytic approach to alcoholism]. PMID- 6867367 TI - [Subject and life history. Position of biography in psychoanalysis and behavior therapy]. PMID- 6867368 TI - [True scientific demand on psychoanalysis for objectifiability]. PMID- 6867371 TI - New aspects of hypertension research and medical application in the GDR. PMID- 6867369 TI - [Psychoanalysis versus family therapy]. PMID- 6867372 TI - [Evaluation of the similarity of the results of the stomatological studies for epidemiological purposes]. PMID- 6867370 TI - [The aborted abortion counselor]. PMID- 6867373 TI - [Correlations of lipid content of the body, relative body weight and hemoglobin level]. PMID- 6867374 TI - [Serum lysozyme activity in patients with diabetes mellitus]. PMID- 6867375 TI - [Job satisfaction and temporary absence from work]. PMID- 6867376 TI - [Effect of age on serum IgA, IgG and IgM concentrations]. PMID- 6867378 TI - Pancreatic polypeptide response to ethanol in humans and dogs. PMID- 6867379 TI - The reactivity of mononucleotides with cholecystokinin/gastrin antisera. AB - Dibutyryl cyclic GMP has been reported to interact with antisera specific for C terminal tetrapeptide amide common for cholecystokinin (CCK) and gastrin. Moreover, cyclic nucleotides elute by gel chromatography in the same position as the free CCK/gastrin tetrapeptide. Therefore, we have examined the reactivity of 25 mononucleotides with eight CCK and gastrin antisera. The results show that the nucleotides all bind poorly to the antisera (nucleotide concentration required greater than 1 mM). Hence, endogenous cyclic nucleotides, which are present in biological extracts in pM to nM concentrations, do not interfere with immunochemical CCK or gastrin measurements. The antisera displayed highly individual patterns of reactivity without preferential binding of di- or monobutyryl cyclic nucleotides (AMP, GMP or IMP). Thus, the present results do not support the idea of structural resemblance between the C-terminus of CCK/gastrin peptides and butyryl derivatives of cyclic GMP. Enzymatic treatment of the antral tetrapeptide-like immunoreactivity showed that nucleotides do not contribute to this material, which appears exclusively peptidergic. PMID- 6867380 TI - [Investigation of tin and chromium grain boundary diffusion in iron by microautoradiography]. AB - Microautoradiography using conversion electron and Auger electron of the isotopes 119mSn and 51Cr which were diffused from the surface in pure iron was investigated. The surface layers were removed successively by chemical reagents to prepare the specimen for microautoradiographs. The density of silver particles was measured in the boundary region and was normalized by comparing with the density near the triple point of the grain boundary. Differences of the diffusion coefficients in the grain boundary were investigated from the frequency diagram of the isotope concentrations near the boundary in individual specimens. PMID- 6867381 TI - [Determination of silver and cerium in the liver and the kidney from a severely burned infant treated with silver sulfadiazine and cerium nitrate]. AB - Silver and cerium in the liver and the kidney from severely burned infant were analyzed by neutron activation method. The patient was treated topically with cerium nitrate/silver sulfadiazine cream and cerium nitrate solution for 3 months. Then, the treatment with these drugs was stopped because of abdominal distention. The patient died 1 month after the cessation of the treatment with these drugs. The tissue specimens, blank liver sample and reference standards were irradiated with TRIGA MARK II Reactor of Rikkyo University. About 1 month after the irradiation, the activities were measured with a Ge(Li) detector coupled to a 4096 channel pulse height analyzer. A large amount of silver was detected both in the liver and in the kidney and a trace of cerium only in the liver. A considerable amount of silver was detected in the liver and its quantity was about 1600 times more than that of normal livers reported by Hamilton, Minski and Cleary (1972-73). Neither silver nor cerium were detected in the blank liver. These results suggest that prolonged topical chemotherapy of cerium nitrate/silver sulfadiazine cream and cerium nitrate solution for the extensive burn injuries causes considerable absorption of silver and cerium into the liver and the kidney. PMID- 6867377 TI - [Case of duodenal ulcer perforation in uncompensated liver cirrhosis]. PMID- 6867382 TI - Correction for loss of radon-222 in water sample caused by the use of a polyethylene bottle. AB - Loss of radon-222 in water sample stored in a polyethylene bottle was analyzed. The radon content was measured by a liquid scintillation spectrometer. The radon content (corrected for radioactive decay) was plotted against the storage period in the polyethylene bottle, and the decrease with the lapse of time was observed. The loss of radon was caused by adsorption on polyethylene surface. The radon content decreased according to the first order kinetics. Apparent rate constant of the adsorption was proportional to the surface area of the polyethylene and to the reciprocal of the sample water volume. The proportionality constant was obtained as a function of temperature, K = 10200 exp (-4382/T) cm X h-1. Apparent activation energy was 36 kJ X K-1 X mol-1. The result supports physical adsorption. On the basis of the result, correction for radon content of a sample water stored in a polyethylene bottle was made possible. PMID- 6867383 TI - [Daily fluctuation of background count rate of a liquid scintillation counter]. AB - 3H channel count rate of 3 background samples were measured for 8 days. Sample A and C were different scintillators in 100 ml teflon vials and sample B in a 20 ml glass vial. Count rate of sample A fluctuated from 3 to 7 cpm, and that of C from 6 to 12 cpm, respectively. However, count rate of sample B was about 6 cpm and rather constant. Trend of fluctuation in count rate of sample A and C were observed to be similar. On weekdays, count rate increased at night and decreased in day time. At weekend, count rate increased from Saturday evening and was constant from Sunday noon till Monday morning. Tritium Research Center where LSC is placed is ventilated from 9 a.m. to 6 p.m. on weekdays, and the ventilation is suspended on Sunday. The observed fluctuation of background was apparently related to the operation and suspension of ventilation. When ventilation was operated continuously, count rates of sample A (4 cpm) and sample C (6 cpm) became constant and corresponded to their minimum value. The fluctuation of background may be caused by radon, concentration of which varies in association with the operation and suspension of ventilation. PMID- 6867385 TI - [Methods of evaluation of commercial kits--solid phase T3 RIA as examples]. PMID- 6867384 TI - Arsenic, antimony, gold, and mercury levels in the soft tissues of intertidal and terrestrial molluscs and trace element composition of their shells. AB - The concentration levels of As, Au, Hg, and Sb in the fleshy tissues of the giant African land snails (Archachatina Marginata) and periwinkles (Littorina littorea) have been measured by neutron activation analysis (NAA). Post-irradiation separation of 76As, 198Au, 197Hg, and 122Sb as bromides after wet-ashing the samples in a concentrated H2SO4-HBr medium was employed. The concentration ranges of 0.015 approximately 2.48, 0.037 approximately 0.091, 0.018 approximately 0.072, and less than 0.01 approximately 0.25 microgram/g wet weight were determined for As, Au, Hg, and Sb, respectively. The periwinkles showed higher concentrations of As, Au, and Hg than the snails. The concentrations of 16 elements, Al, Br, Ca, Cl, Co, Eu, Fe, K, La, Mn, S, Sc, Si, Sm, Sr, and Zn also have been determined in the calcareous shells of these molluscs. PMID- 6867386 TI - A new method for the determination of iodide ion in seawater. PMID- 6867387 TI - [ICRU recommendations on quantities and units of radiation--their past, present, and future]. PMID- 6867388 TI - [A brief survey on progress and trends in nuclear radiation detectors (I)--Gas counters and liquid detectors]. PMID- 6867389 TI - [Use of the stable isotopes in life science (XV). The accurate determination of 15N with an emission spectrometer]. PMID- 6867390 TI - [A hepatorenal syndrome]. PMID- 6867391 TI - [Free erythrocytic protoporphyrin (FEP) in different types of anemia]. PMID- 6867393 TI - [Major clinical aspects of Friedreich ataxia. Study of 23 cases]. PMID- 6867392 TI - [Effects of nortriptyline on intracardiac conduction in 30 patients]. PMID- 6867394 TI - [Primary cerebellar degenerations. Clinico-radiologic correlates]. PMID- 6867397 TI - [Effect of heparin on thrombocytosis in thrombophilic states]. PMID- 6867395 TI - [Coronary arteriosclerosis, ischemic cardiopathy and lipoproteins: their relationship]. PMID- 6867396 TI - [Hydrocarbon metabolism in hepatocutaneous porphyria tarda]. PMID- 6867398 TI - [Non-vascular causes of ictus. Study of a series of 156 patients]. PMID- 6867399 TI - ["Spontaneous" hematoma of the rectal sheath. Apropos of 3 cases]. PMID- 6867400 TI - [Aeromonas hydrophila septicemia in a multiple myeloma patient]. PMID- 6867401 TI - [Problems of ectopic pinealomas]. PMID- 6867402 TI - [Alcoholic cardiomyopathy. II. Current concept. Metabolism of ethanol]. PMID- 6867403 TI - [Disseminated intravascular coagulation syndrome. Clinical, diagnostic, prognostic and therapeutic aspects of 121 cases]. PMID- 6867404 TI - [Analysis of a series of 153 cases of non-traumatic coma]. PMID- 6867405 TI - [Correlations between glomerular ultrastructural changes and proteinuria in pregnancy toxemia]. PMID- 6867407 TI - [Nephropathy in Schonlein-Henoch purpura in childhood. Incidence and clinical and evolutionary aspects apropos of 151 cases]. PMID- 6867406 TI - [Mycobacteriosis caused by species of group III (Runyon). Personal experience]. PMID- 6867408 TI - [Effect of bromocriptine on brain levels of noradrenaline, dopamine and serotonin in experimental portosystemic encephalopathy]. PMID- 6867409 TI - [Evaluation of prazosin in chronic cardiac insufficiency by external chronometry of the left ventricle]. PMID- 6867410 TI - [Plasma cell granuloma (inflammatory pseudotumor) located in the mesentery and having significant systemic manifestations]. PMID- 6867411 TI - [Hepatic lesion caused by acetaminophen. Apropos of a case with unusual portal involvement]. PMID- 6867412 TI - [Sarcoidosis, pancreatic adenocarcinoma and granulomas of undetermined origin in a patient with xeroderma pigmentosum]. PMID- 6867413 TI - [Diabetic amyotrophy. An infrequent form of diabetic neuropathy]. PMID- 6867414 TI - [Autotransplantation of the large intestine]. PMID- 6867416 TI - [Microsurgery of the bile ducts]. PMID- 6867415 TI - [Changes in carbohydrate metabolism in liver cirrhosis. I. Carbohydrate intolerance]. PMID- 6867417 TI - [Cancer of the rectum and colon]. PMID- 6867418 TI - [Transferrin, blood iron and total iron-binding capacity in the differential diagnosis of jaundice]. PMID- 6867419 TI - [Duodenal carcinoids. Presentation of 2 cases and review of the literature]. PMID- 6867420 TI - [Chilaiditi syndrome. Review apropos of a case]. PMID- 6867421 TI - [Amplified ano-rectoplasty in ano-rectal cancer]. PMID- 6867422 TI - [Non-invasive diagnosis of hepatobiliary disease using Tc-99m-HIDA. Experimental study]. PMID- 6867424 TI - [Effect of aluminum chloride on the motility of guinea pig ileum in vitro]. PMID- 6867423 TI - [Effects of intestinal ischemia on the in vitro glucose absorption in rat intestine]. PMID- 6867425 TI - [Primary cancer of the gastric stump]. PMID- 6867427 TI - [Echography in the diagnosis of acute cholecystitis, hydrops and gallbladder cancer]. PMID- 6867426 TI - [Echographic diagnosis of biliary lithiasis]. PMID- 6867428 TI - [Manometric evaluation of drug therapy in gastroesophageal reflux]. PMID- 6867429 TI - [General consideration concerning intestinal leiomyoblastomas with special reference to one located in the stomach]. PMID- 6867430 TI - [Spontaneous enterogluteal fistula as the initial clinical manifestation of regional ileitis. Apropos of a case]. PMID- 6867431 TI - [Submucosal lipomas of the colon]. PMID- 6867432 TI - [Agenesis of the gallbladder and the cystic duct. Report of 2 cases]. PMID- 6867433 TI - [Hypogenesis of the gallbladder. Apropos of a case]. PMID- 6867434 TI - [Hydatidosis. Notes on preventive planning]. PMID- 6867435 TI - [Peritoneal lesions caused by starch]. PMID- 6867436 TI - Calcium-induced ATP release from Torpedo cholinergic nerve endings isolated in calcium-free solutions. PMID- 6867437 TI - [Study of the gastrointestinal motility of the chicken using phenol red]. PMID- 6867438 TI - [Variations in plasma ferritin during the transition from immature hens to mature ones in relation to laying]. AB - The mobilization of iron stores during the transit from non laying to laying hen has been studied. A series of parameters related to iron metabolism (hemoglobin, hematocrit, plasma iron, transport iron binding capacity and plasma ferritin) have been determined during six consecutive weeks in which the setting percentage increased from 0 to 83%. Five male samples had been previously estrogenized to obtain a quick answer for the same parameters determined in the females. A decrease in plasma ferritin levels has been observed in both experiments, suggesting a mobilization of iron stores to the egg especially during the two weeks in which the setting percentage increase was highest (16-60%). PMID- 6867439 TI - [Ca-P interaction at the nutritional and bone levels in male quail (Coturnix coturnix japonica)]. AB - Five experiments were conducted in which various levels of calcium (Ca) and phosphorus (P) were fed to adult male quail (diets D-1: Ca = 1.54%, p = 0.80%; D 2: Ca = 3.20%, P = 0.81%; D-3: Ca = 1.57%, P = 1.66%; D-4: Ca = 3.40%, P = 1.71%; D-5: Ca - 2.20%, P = 0.81%). The interaction between Ca and P, and the effect on some nutritive hematic and osseous parameters were investigated for each diet. Feeding high P caused a body weight decrease in D-4 adult quail (P less than 0.05) and diminished food intake in the birds of trial D-3 (P less than 0.05). The results indicated that the excretion of Ca or P is a lineal function of its own intake. Neither the pattern of relationship between the intake and excretion of Ca was altered by the levels of phosphorus in the diets, nor the levels of calcium altered the pattern of P. With these levels of Ca and P interaction between both nutrients were not demonstrated. Plasma Ca levels and dry weight of femur as well as the ash content in them, were not significantly decreased, although the levels of the latter components were inferior in the groups fed non-adjusted diets in the Ca:P ratio (diets D-1, D-2, D-3 and D-4). PMID- 6867440 TI - [Effect of arsanilic acid on various growth parameters and sugar transport in the rat]. AB - The effects of arsanilic acid as promoter of faster growth on the nutrition index and intestinal absorption of galactose and arabinose has been studied in growing rats. The rats that received arsanilic acid 0.7 mg/day added to water showed gain in body weight and feed intake, I.T. (feed conversion ratio) decrease and P.E.R. (protein efficiency ratio) increase. A dose of 1.4 mg/day produced harmful effects. The in vitro intestinal transport of galactose and arabinose decreased and increased respectively in animals that received additive in comparison with controls. PMID- 6867441 TI - Intralipid and free plasmatic tryptophan in vitro. AB - In an attempt to investigate the role of the lipidic emulsion Intralipid in the development of metabolic encephalopathy in a patient showing high free tryptophan levels, the relationship between lipidic emulsion and free tryptophan was examined in in vitro experiments. The addition of intralipid to normal serum produces an immediate increase in non-esterified fatty acids and a parallel rise in free tryptophan. Moreover, when serum with intralipid is incubated at 37 degrees C, the lipases release new non-esterified fatty acids and the free tryptophan increases proportionally. The non-esterified fatty acid content of intralipid was found to be 12 +/- 2 mEq X 1(-1). An inverse correlation was seen between free tryptophan and different serum albumin concentrations. It is concluded that intralipid causes an increase in free tryptophan levels. It is known that in vivo free tryptophan modulates 5-hydroxytryptamine synthesis and thus may be considered a possible causal agent for encephalopathy. PMID- 6867442 TI - Purification and partial characterization of a Fucus Vesiculosus agglutinin. AB - Fucus vesiculosus agglutinin has been purified to homogeneity by conventional chromatographic procedures and characterized as a mucopolysaccharide with 90% carbohydrate content. Estimated molecular weight is about 2 X 10(6) daltons. It has no sub-unit structure and its isoelectric point is 3.2. It contains 1.23% S, 0.24% Ca and 0.06% P. Agglutinin mediated sheep red blood cell agglutination was inhibited only by glycoproteins with complex lateral oligosaccharide chains resembling some of the oligosaccharide chains found in the erythrocyte membrane glycoproteins. Metaperiodate treatment of the sheep red cells rendered them non agglutinable. Sequential degradation of the oligosaccharide chains with glycosidases suggests that inner mannose residues are implicated in the receptor binding-sites for the agglutinin. Consequently we think that this agglutinin can be a lectin or a lectin-like molecule with complex saccharide specificity. PMID- 6867443 TI - Biliary excretion of bromosulfthalein in rabbit. AB - The effect of bromosulfthalein (BSP) infusions at different doses on bile secretion was investigated in anaesthetized rabbits. The patterns of biliary excretion were found to be similar to other mammals, maximal biliary excretion being achieved by an infusion of 0.50 mg X kg-1 body weight X min-1. Bromosulfthalein administered at low doses under the maximum hepatic transport capacity resulted in a clear increase of bile flow which was mainly due to an osmotic mechanism. Supramaximal doses produced no effect on bile flow. PMID- 6867444 TI - Influence of bile salts on the endogenous excretion of bile pigments. AB - Effect of the infusion of glycodeoxycholate (GDC), taurocholate (TC) and dehydrocholate (DHC) on bile flow and on bile salt, biliary lipid and bile pigment secretion, has been studied in pentobarbital-anesthetized rabbits. GDC increased bile flow the most, while DHC increased it more than TC. The different choleretic actions of these bile salts cannot be explained by means of variations in their capacity to form micelles. Only GDC and TC were able to stimulate biliary lipid secretion, which suggests that both bile salts increase the formation of mixed micelles. GDC and TC to a lesser extent increased bile pigment excretion, DHC being without effect. These results favour the hypothesis that micellar binding could be an important factor responsible for the effect of bile acids on bile pigment excretion and should not be completely ruled out. PMID- 6867445 TI - The impairment of mitochondrial function by Triton X-100. A study of mitochondrial respiration and energy-dependent swelling. AB - Coupled and uncoupled respiration, and energy-dependent phosphate swelling have been studied in rat liver mitochondria in the presence of various concentration of Triton X-100. Detergent concentrations up to 10(-5) M do not affect any of the processes under study. At 10(-5) M, Triton X-100 produces a slight decrease of coupled respiration and a considerable inhibition of mersalyl-induced shrinking in swollen mitochondria. Increasing the surfactant concentration to 10(-4), coupled as well as uncoupled O2 consumption is decreased, succinate-dependent phosphate swelling is inhibited and an energy-dependent phosphate swelling in the absence of valinomycin is observed. At 2 X 10(-4) M. Triton X-100, ATP- dependent phosphate swelling is abolished, and passive swelling may be induced by various ions. Higher detergent concentrations do not allow observation of any of these events. On the basis of these results, a model of membrane-detergent interaction is proposed. PMID- 6867446 TI - [Current concepts of the mechanism of action of ethanol on the central nervous system]. PMID- 6867447 TI - [The prostaglandin system and essential arterial hypertension]. PMID- 6867448 TI - [Anti-hepatitis B vaccination with H B VAX and HEVAC B vaccine. Results after the first 3 doses in 2 different risk groups]. PMID- 6867449 TI - [The heart in the diabetic]. PMID- 6867450 TI - [Atrial dissociation]. PMID- 6867451 TI - [Causes of cancer: preventable risks today]. PMID- 6867452 TI - [Association of primary biliary cirrhosis and systemic sclerosis. A new case]. PMID- 6867453 TI - [Non-Hodgkin lymphoma localized in the pancreas. Description of a case]. PMID- 6867454 TI - [Assessment and therapy of ascites in liver cirrhosis. The physiopathological bases and complications]. PMID- 6867455 TI - [Polyvalent pneumococcal vaccine]. PMID- 6867456 TI - [Biological interactions between cadmium and selenium]. PMID- 6867457 TI - [Basilar thrombosis--an example of comprehensive rehabilitation of a 26-year-old female patient]. AB - Medical elimination/reduction of a more or less acute functional disorder may be something considerably different from restoration to good health, or the ability to lead an independent life. The form this discrepancy may take; what it can mean to the patient, not least in terms of time consumed; which possibilities there are in view of a new beginning, a re-orientation; which ways and means there exist on the part of the patient as on that of the therapeutic personnel involved, or in the light of the legislative provisions; which role is played by society through the employer; how difficult it is to give a prognosis; these are the issues the authors intend to illustrate by describing the rehabilitation process a young woman of 26 years of age underwent following successful re canalization of a previously thrombosed basilar artery by urokinetic fibrinolysis. It is also underlined that any rehabilitative measure taken should be oriented towards attainable goals, and be based on consultation (but not necessarily general agreement) among the rehabilitative team. This approach will help the patient comprehend the purpose of the measures taken, and serve to prevent hard feelings that may develop. PMID- 6867458 TI - [Physical capacity of schizophrenic patients]. AB - Reduced physical capacity in schizophrenic illness has been described in medical literature, but so far not been substantiated empirically. The findings of progressive bicycle ergometry confirm the assertion, with the following main results having been obtained: 1. As opposed to a matched comparison group of untrained healthy clients, the schizophrenically ill patients demonstrated significantly lower endurance levels in respect of the aerobic-anaerobic threshold. 2. Relative to the load maximum attainable highly significant differences existed between the groups. Particularly noteworthy had been early exercise termination already at submaximal loads by the schizophrenic patients. 3. The patients under study obtained values one third below standard compared to the maximum load target for untrained persons, with age and weight being taken into account. The findings are discussed as regards the possible causes of the performance reductions found as well as possibilities for improvement, demanding in particular that sports therapy programmes receive greater emphasis in the rehabilitation process. Also, the results obtained should be taken into consideration in the design of vocational rehabilitation measures. PMID- 6867459 TI - [Boarding school for young diabetics in Ludenscheid]. PMID- 6867460 TI - [Seminars for persons with severe hearing disability and deafness planned in Rendsburg]. PMID- 6867461 TI - Using a computer to control stuttering. PMID- 6867462 TI - Developing a dialogue between rehabilitation practitioners and researchers: a research dissemination approach. PMID- 6867463 TI - Effect of intraluminal PGE2 and systemic indomethacin on sodium chloride transport in the rat distal tubule. PMID- 6867464 TI - Relationship between sodium transport and oxygen consumption in the isolated perfused rat kidney. AB - The purpose of the present experiments was to determine the relationship between Na+ transport and O2 consumption of the perfused rat kidney in vitro. The delta Na/delta O2 ratio was calculated from the change in Na+ transport and the change in O2 consumption. Na+ transport was varied by lowering perfusion pressure or adding ouabain. Previous investigators have calculated the delta Na/delta O2 ratio for the kidney in vivo by combining all data points in each group of experiments. Using this approach, the delta Na/delta O2 ratio of the perfused kidneys was 66.3 +/- 22.0 for the low pressure perfusion experiments and 29.1 +/- 3.1 for the ouabain experiments. These values are at least as great as those reported for the kidney in vivo. The delta Na/delta O2 ratios were also calculated by determining the regression line for each individual kidney, and then obtaining the mean of these regressions. Using this approach, the delta Na/delta O2 ratio for the low pressure perfusion experiments was 37.0 +/- 7.4 and the delta Na/delta O2 ratio for the ouabain experiments was 20.3 +/- 1.7. These values are significantly lower than the ratios obtained by combining all data points. The ratio of absolute Na+ transport to absolute O2 consumption (Na/O2 ratio) was 13.1 +/- 0.5 for control experiments. This value is considerably less than that obtained for the kidney in vivo. The extrapolated rate of O2 consumption in the absence of sodium transport (i.e. nontransport metabolism) was 40-63% of the control rates of oxygen consumption; this is a much higher fraction of 'nontransport' metabolism than in the kidney in vivo. It is concluded that the metabolic efficiency of the perfused kidney is considerably less than that of the kidney in vivo. Furthermore, the present results cast doubt on the usefulness of the delta Na/delta O2 ratio as in index of efficiency of Na+ transport by the kidney. PMID- 6867465 TI - Difference in urinary N-acetyl-beta-D-glucosaminidase activity between male and female beagle dogs. AB - Urinary N-acetyl-beta-D-glucosaminidase (NAG) activity differed greatly between male and female beagle dogs in an age-matched group. The NAG activity in males per animal, per body weight, or per 16-hour urine sample was approximately double that in females and was 2.4-fold higher when the activity was considered relative to urinary creatinine. On the other hand, alanine aminopeptidase activity relative to urinary creatinine was not significantly different between males and females. These findings indicate that when using urinary NAG activity to detect drug nephrotoxicity in dogs, some consideration must be given to different control levels between males and females before starting drug administration. PMID- 6867466 TI - Partial characterization of a renotropic factor. AB - In 70 experiments, the existence of a circulating renal growth factor was confirmed by 9.3% stimulation of 3H-thymidine into the DNA of renal fragments incubating for 90 min in the presence of sera from 20-hour unilaterally nephrectomized rats compared to sera from 20-hour sham-operated rats (p less than 0.001). Dialysis (7.4%, p less than 0.01) or removal of albumin (11.8%, p less than 0.001) from sera of both sham-operated and unilaterally nephrectomized rats did not appreciably change the magnitude of the statistically significant stimulation. When albumin-free sera were placed in boiling water for 1-3 min to coagulate protein, the stimulation was still significantly different from control (5%, p less than 0.05). Addition of sera from unilaterally nephrectomized rats (20 h) to isolated nuclei, even isolated nuclei removed from growing kidneys (72 h after unilateral nephroctomy), failed to enhance DNA synthesis significantly. PMID- 6867467 TI - Renal denervation and sodium balance in young spontaneously hypertensive rats. AB - In 7-week-old male, spontaneously hypertensive rats (SHR) and matched normotensive control rats, Wistar Kyoto Rats (WKY), a bilateral renal denervation was performed. In two additional groups of rats a sham denervation was done (SHRS, WKYS). The animals were then kept in metabolic cages during a 10-day period during which sodium intake, urine volume, urinary sodium excretion, fecal sodium excretion, urinary aldosterone excretion and plasma renin activity were determined. Fractional urinary excretion of sodium was higher in the denervated SHR (p less than 0.1) and WKY (p less than 0.05) during the first 3 days after denervation, but during the following 3-day periods no difference between denervated and sham-operated groups was noted. The difference in fractional urinary excretion of sodium initially was due to a diminished urinary sodium excretion in the sham-operated groups since both SHRS and WKYS exhibited a significant increase between the first and the last 3-day period. Urine volume increased significantly in both SHR and WKY after denervation. Urinary aldosterone excretion on the 7th day after denervation was significantly lower in SHR compared to WKY, but there was no significant difference between the denervated and sham-operated groups. PRA was also significantly lower in SHR but no significant decrease was seen after denervation. PMID- 6867468 TI - Metabolic activation of paracetamol by highly purified forms of cytochrome P-450. AB - The metabolic activation of paracetamol (acetaminophen) to reactive intermediate(s) which bind covalently to proteins was studied in reconstituted systems, employing highly purified preparations of cytochromes P-450 and P-448 isolated from the liver of rats pretreated with phenobarbitone and beta naphthoflavone respectively. Cytochrome P-448 readily catalysed the activation of paracetamol, but in contrast no activation was observed when cytochrome P-450 was used at the same concentration. Addition of purified epoxide hydratase to the incubation system had no effect on the extent of covalent binding to proteins, indicating that an arene oxide is unlikely to be the reactive intermediate responsible for the paracetamol-induced hepatotoxicity. PMID- 6867470 TI - Pharmacokinetics of verapamil and norverapamil during long-term oral therapy. AB - Serum concentrations of verapamil and its pharmacologically-active metabolite, norverapamil, were measured in six patients with angina at rest after six to fifteen months of therapy. Optimal daily doses were selected during a previous in hospital titration period and ranged from 240 to 640 mg per day. There was no significant relationship between dose, corrected for body weight, and area under the verapamil serum concentration-time curve (AUC). The mean apparent oral clearance of verapamil was highly variable with a mean of 21.9 +/- 9.1 ml/min/kg and a range of 7.7 to 32.0 ml/min/kg. The ratio of verapamil AUC to norverapamil AUC, used to assess accumulation kinetics of parent drug and metabolite, was less than 1.0 in five of six patient (mean 0.93). However, one patient with verapamil concentrations ranging from 300 to 900 ng/ml had a ratio of 1.37 suggesting saturation of the enzymes that convert verapamil to norverapamil. When the relationship between serum concentration at the end of the dosing interval and angina frequency was studied, it was observed that patients in whom angina was completely suppressed had concentrations greater than 160 ng/ml and patients with poor control (greater than 5 anginal episodes per week) had concentrations less than 60 ng/ml. The findings suggest that the oral clearance of verapamil following long-term (greater than 6 mo.) administration may be different than after short-term therapy and that it is difficult to predict verapamil serum concentrations and antianginal effect during long-term oral therapy. Individualizing verapamil therapy to maintain serum concentrations greater than 100 ng/ml may improve therapeutic response and appears to more reliably predict response than daily dose. PMID- 6867469 TI - Impairment of erythropoiesis in rats exposed to environmental pollutants. AB - The extent to which halogen compounds interfere with erythropoiesis is still unclear. This paper reports an evaluation of the effect of repeated exposure to carbon tetrachloride (CCl4) in air on red blood cell (RBC) creatine concentration. Creatine is neither synthetised nor metabolised in circulating RBC and decreases over the lifespan of red cells. It can thus be taken as a reliable indicator of mean RBC age, and hence of cell viability and bone marrow efficiency. Following inducement of hemolysis with phenylhydrazine (PHH) to stimulate erythropoiesis, creatine levels rose in the controls. This increase was significantly less in the CCl4-treated animals. It is not yet certain whether this inhibition reflects impaired marrow efficiency, enhanced RBC destruction in the marrow, or block of the release of mature RBC. The fact that such inhibition takes place, however, is of importance as a predictive factor in environmental toxicology, since it appears before changes in other blood parameters or signs of liver toxicity are observed. PMID- 6867471 TI - Cardiac arrhythmias in sensitized hearts - primary mechanisms involved. AB - The primary locus of the sensitizing action of hydrocarbon anesthetics to the arrhythmogenic action of catecholamines has now been shown to be the heart itself. It has been demonstrated in the completely isolated heart perfused with an artificial medium. The induction of ventricular arrhythmias, which begins with a shift in the site of the primary pacemaker from the sinus node to the A-V junctional area, requires the development of a significant intraventricular pressure. It is facilitated by a marked reduction in the refractory period of Purkinje fibers with little concomitant effect on regular myocardial fibers. PMID- 6867472 TI - 3H-imipramine uptake into rat striatal slices and imipramine-induced 3H-dopamine efflux. AB - The effect of imipramine on spontaneous efflux of radiolabelled dopamine (DA) from slices of rat striatum was examined by a superfusion method. Imipramine at concentrations of 10 - 100 microM enhanced the efflux of DA accumulated in a high affinity uptake system in a concentration-dependent manner. This efflux of 3H-DA was not affected by conditions (Ca2+-free medium, 100 microM bretylium and 30 microM tetrodotoxin) which inhibited the release of 3H-DA by electrical stimulation. Furthermore, this imipramine-induced 3H-DA efflux was temperature dependent. The uptake of 3H-imipramine into striatal slices was determined. This uptake was concentration- and temperature-dependent and increased linearly. These results are discussed in relation to the hypothesis that 3H-DA efflux by imipramine is connected with uptake of imipramine. PMID- 6867473 TI - Conversion of a novel 5-fluorouracil (5-FU) derivative to 5-FU in rats. AB - The converting efficiency of a novel 5-FU derivative, 1, 3-didecanoyl-2-[6-[(5 fluorouracil-l-yl) carbonylamino] hexanoyl]glyceride (DFUG), to 5-FU was investigated in rat plasma. The degradation half-life of DFUG was 4.04 min when DFUG was incubated in rat plasma at 37 degrees C, though DFUG was considerably stable in buffers having different pH values, pH 1, 5 and 7.4. After iv administration, DFUG disappeared rapidly from rat plasma and considerable amount of 5-FU was detected in rat plasma. By comparing the AUC (area under the plasma 5 FU concentration vs. time curve from time zero to infinity) values with that obtained after iv injection of 5-FU, the fraction of 5-FU formed from DFUG was estimated to be about 80% in rats. PMID- 6867474 TI - Experimental right-ventricular infarction in rats by abdominodiaphragmal access to the heart. A new technique in the study of infarcted myocardium. AB - An abdominodiaphragmal way of producing right-ventricular myocardial infarction is introduced, allowing of ligation of the right-coronary artery and vein without further manipulation of the heart. Of the rats operated upon, 22% died perioperatively. Of the surviving part, 89% had myocardial infarction macroscopically. This method was used to study enzyme decreases in infarcted myocardium. Our biochemical results correlate very well with histological and histobiochemical findings reported by other investigators. Therefore, we conclude that right-coronary artery ligation in rats by transabdominal, transdiaphragmal access to the heart can be a useful way to study biochemical aspects of infarcted myocardium. PMID- 6867476 TI - Experimental hemorrhagic shock in dogs: standardization. AB - The purpose of the present study was to design a standardized model of hemorrhagic shock in dogs as a prerequisite for future studies on the pathogenesis of this syndrome. Hemorrhagic shock was induced in 86 mongrel dogs submitted to a systemic hypotension of 45 mm Hg by means of a constant pressure reservoir procedure. The following blood volumes (ml/kg) were measured during the evolution of shock: (1) initial bleeding volume, (2) secondary bleeding volume, (3) maximum bleeding volume, (4) automatic reinfusion volume, and (5) duration of the hypotensive period (min). The corresponding mortalities were submitted to a statistical analysis which yielded the following conclusions: (a) the initial, secondary, and maximum bleeding volumes do not correlate with mortality, (b) the duration of the hypotensive period is of only relative importance, and (c) the automatic reinfusion volumes shows a high degree correlation with the fatal outcome. PMID- 6867475 TI - The influence of non-coronary collateral blood supply on the electively arrested heart during ischemia and reperfusion. AB - To study the influence of non-coronary collateral blood circulation (NCCBC) on the integrity of the ischemic myocardium a right-sided thoracotomy was performed on 15 anesthetized dogs. Following a total cardiopulmonary bypass (CPB), ventricular fibrillation was induced, during which 2,000 ml calcium-free cardioplegic solution LK 352 was given at the aortic root over an 8-10 min period. Precautions were taken to prevent retrograde blood flow into the coronary system via the coronary sinus. After 90 min of ischemia, ten of the dog hearts were reperfused with systemic blood for the next 30 min. Transmural biopsies were taken from the apex of the left ventricle at the following intervals: (1) before CPB, (2) immediately after the infusion of LK 352, (3) following 90 min of ischemia, (4) after 5 min, (5) after 15 min, and finally (6) after 30 min of reperfusion and were then studied ultrastructurally. The presence of NCCBC was documented by the observation of erythrocyte-filled blood vessels in the biopsies corresponding to nos. 2 and 3 of the above. To assess the degree of ischemic injury and the extent of myocardial recovery during reperfusion, a scoring system based on a semiquantitative assessment of the characteristic morphological changes was used. The average result of the separately assessed subendo- and subepicardial layers represented the score, which was plotted on the ischemic injury and the recovery scale, thus making a direct comparison of the hearts possible. All the hearts generously supplied with blood via extracoronary routes during ischemia showed minimal and reversible ischemic injuries. They recovered more quickly and more completely following reperfusion than those hearts without NCCBC. From these results we conclude that despite its warming-up effect on the myocardium and its tendency to wash out the cardioplegic solution, the NCCBC generally protects the myocardium from serious ischemic injuries and shortens the period of recuperation during the reperfusion. PMID- 6867479 TI - Collateral arterial capacity following acute iliac occlusion in the rat. AB - The development of collateral circulation after ligation of the left iliac artery was studied in 46 rats by means of microsphere distribution in muscles of both lower limbs. The radioactive microspheres were injected into the aortic root in the hyperemic phase after 5 min of cuff-induced ischemia of the lower extremities. The hyperemic response to cuff-induced ischemia as well as microsphere distribution between both lower limbs in control animals were studied separately in 23 rats. The largest hyperemic response occurred 15-30 s after cuff induced ischemia. After iliac artery ligation, flow in the thigh increased from 43% of control value 20 min after ligation to 70% after 26 days of recovery. Flow in calf muscles increased correspondingly from 4% to 33%. This study quantifies the capacity of collateral formation following acute iliac artery occlusion. PMID- 6867478 TI - A new model for testing therapeutic interventions during myocardial ischemia. AB - An open-chest dog heart model is presented which shows highly reproducible hemodynamic, electrophysiologic, and metabolic changes during and after short term coronary occlusions. We repeatedly performed 3-min coronary ligations of the proximal ramus interventricularis anterior followed by reperfusion periods of 45 min. Thus, hemodynamic, metabolic, and electrophysiologic parameters of myocardial damage were fully reversible. The experimental model presented seems well suited to evaluate interventions which aim at influencing the extent and damage of myocardial ischemia without needing a large number of separate experiments. PMID- 6867477 TI - Peroperative studies of S-calcitonin in thyroid and peripheral venous samples from patients with normal C-cells, C-cell hyperplasia, and medullary carcinoma on the thyroid. AB - The calcitonin (Ct) secretion was studied during surgery in 11 patients with benign thyroid and/or parathyroid disorders and in six patients with familial medullary carcinoma of the thyroid (MCT) and C-cell hyperplasia (CCH). The preoperative diagnosis of MCT and CCH was established by S-Ct determinations before and after pentagastrin provocation. During surgery blood samples were collected from thyroid and peripheral veins before and after injection of 0.6 micrograms pentagastrin . kg-1 in the inferior thyroid artery. In the control group the thyroid venous concentration of S-Ct increased from 395 +/- 42 pmol . l 1 to 2,692 +/- pmol . l-1 after intra-arterial (i.a) pentagastrin. The basal value for S-Ct in thyroid venous samples from patients with MCT and CCH was distinctly elevated in five of six patients. After pentagastrin stimulation a very prompt and striking S-Ct peak in thyroid venous samples was demonstrated (range 11,500-2,700,000 pmol . l-1), which in all cases widely exceeded that in the control group. Varying responses were registered in peripheral vein samples. S-Ct values obtained in the present investigation constitute valuable information for the interpretation of S-Ct values obtained in thyroid venous catheterization studies. PMID- 6867480 TI - Effect of a protein-bound polysaccharide PS-K on the complement system. AB - A protein-bound polysaccharide from mycelia of Coriolus versicolor PS-K, clinically used as an immunomodulator, has been shown to restore the decreased cellular immune response and to exhibit host-mediated antitumor activity. In this experiment, PS-K was found to increase serum complement level in guinea pig and in human without malignancy, when hemolytic assay of complement was performed using sensitized sheep erythrocytes for the classical pathway activity and unsensitized rabbit erythrocytes for the alternative pathway activity. Assay of complement components revealed increase in C3 level in guinea pig, but no significant changes in C1q, C4, C3, properdin, C3 activator, and C1-inhibitor in human, while C5 and C9 were depressed. Conversion of beta 1C to beta 1A was observed in the 7th day's plasma of these patients by crossed immunoelectrophoresis. Biosynthesis of guinea pig C3 was accelerated by administration of PS-K, but that of C4 was not affected. These evidences suggested that PS-K might potentiate immune response of the host by elevating serum complement level, in addition to the activation of the complement system. PMID- 6867481 TI - [Relationship between reduced pulmonary elasticity in smokers and peripheral airway obstruction and pulmonary emphysema]. PMID- 6867482 TI - [Non-invasive evaluation of pulmonary artery pressure in chronic obstructive lung diseases--with special reference to prediction of the pulmonary artery pressure using multiple regression analysis]. PMID- 6867483 TI - [Determination of the effect of a new anti-anginal drug, isosorbide dinitrate tape (TY0081), by Holter electrocardiography]. PMID- 6867484 TI - [Atrial vasodepressor reflex in patients with sick sinus syndrome]. PMID- 6867485 TI - [Clinical usefulness of systolic time intervals and A-wave ratio in coronary artery disease--correlation with coronary angiographic and left ventriculographic findings]. PMID- 6867486 TI - [Morphological determination of the heart by cardiac scintigraphy--comparison with echocardiography and biventricular imaging]. PMID- 6867490 TI - [A case of aortitis syndrome associated with atrioventricular block and stenosis of the left main coronary ostium]. PMID- 6867488 TI - [Case of variant angina with syncopal attacks]. PMID- 6867487 TI - [A case of ventricular tachycardia with non-ischemic apical aneurysm]. PMID- 6867491 TI - [Pneumotachographs based on new principle]. PMID- 6867489 TI - [Case of autonomic dystonia with "ischemic" ST-T abnormalities]. PMID- 6867492 TI - [Prevention of postoperative venous thrombosis]. PMID- 6867494 TI - [Development of a system monitoring cerebral circulation and metabolism. IV. An on-line data processing system]. PMID- 6867493 TI - [Treatment of adrenaline-induced pulmonary edema by nitroprusside, with special reference to hemodynamic studies]. PMID- 6867495 TI - [Detection and quantitation of myocardial infarction by CT--evaluation by an animal experiment]. PMID- 6867496 TI - [Effects of coenzyme Q10 injections on exercise tolerance in patients with stable angina pectoris]. PMID- 6867497 TI - [Esophageal echocardiography for the study of the dynamics of both atria of normal subjects]. PMID- 6867498 TI - [Effectiveness of left ventricular endomyocardial biopsy with Sone's catheter using a long sheath as a guide]. PMID- 6867499 TI - [Radiographic imaging of aortic coarctation--analysis of its morphology and evaluation of the etiology]. PMID- 6867500 TI - Organ growth in chick embryos incubated in 40% or 70% oxygen. AB - Incubation of eggs in 60% oxygen has been shown to enhance growth of the chick embryo. To determine whether oxygen accelerates growth over a range of concentrations, eggs were incubated in 40% or 70% O2. Control eggs, pair-matched by initial weight, were simultaneously incubated in room air (21% O2). Embryo and organ weights from matched pairs of eggs were compared on incubation days 14, 16 and 18 (40% O2) or 10, 12, 14, 16 and 18 (70% O2). Embryos incubated in 40% O2 displayed a pattern of growth enhancement similar to that previously reported for 60% O2. Accelerated embryonic growth was maintained through day 18. The heart showed the greatest percentage increase in weight over control, exceeding that of the whole embryo on days 16 and 18. The brain displayed significant enhancement only on day 16. Weight of the liver was unaffected by hyperoxia. Embryos in 70% O2 exhibited accelerated growth in all of the tissues examined early in incubation. Growth rate of the hyperoxic embryos then declined, so that embryo weight on day 18 did not differ from control. The brain, heart, eye, and proventriculus plus gizzard from 70% O2 embryos weighed significantly less than controls on day 18. Growth inhibition was most striking in the heart; heart/body weight ratio of 70% O2 embryos was significantly less than control throughout the observation period. The results confirm the growth accelerative effect of oxygen and suggest that the degree of growth enhancement is proportional to the ambient oxygen concentration. Accelerated growth cannot be maintained, however, in 70% O2. PMID- 6867502 TI - A consideration of density dependence of maximum expiratory flow. AB - Density dependence of maximum expiratory flow was considered in terms of equal pressure point and wave speed theories of flow limitation. It appears likely that the sites of flow-limitation, patterns of flow, and airway geometry differ with the density of the gas being expired. Because the conditions which determine maximum expiratory flow for helium-oxygen and for air differ, measurement of density dependence is of questionable value as a test for peripheral airways dysfunction. PMID- 6867501 TI - Influence of airway geometry on expiratory flow limitation and density dependence. AB - In a study of individuals of the same sex and similar age and size, between subject variability was noted in lung recoil, lung size, density dependence of maximum expiratory flow, tracheal cross-sectional area, and anatomic dead space. No significance was observed in the relationships to one another of lung size or either estimate of airway size, nor did the magnitude of the change in flow with changes in gas density show a consistent relationship to any of the size variables. The results indicate that there is a dissociation between tracheal dimensions and anatomic dead space as well as between airway size and lung size, suggesting that dysanapsis is a general phenomenon. This introduces additional sources of interindividual variability of maximum expiratory flow and measurements of density dependence of flow. PMID- 6867504 TI - Intercostal and abdominal muscle afferent influence on pneumotaxic center respiratory neurons. AB - The experiments were performed on mid-collicular decerebrated, vagotomized, paralyzed, artificially ventilated cats. Phrenic (PA) and pneumotaxic center (PC) respiratory neuron (extracellular) activities were recorded during electrical stimulation of intercostal nerve proprioceptor afferents (external, internal or lateral intercostal nerves). Intercostal nerve stimulation (INS) of sufficient intensity to reduce PA also reduced the activity of phasic PC I-neurons and the I modulated portion of tonic firing I-neurons. The stimulus-response latency for the reduction in PA was always shorter than the latency for the reduction in I neuron activity. Baseline tonic activity (during E-phase) was unaffected by INS in most tonic I-neurons. The predominant response of PC IE- and E-neurons to INS was augmentation of their activity. Stimulus-response latency studies showed that the increase in IE- and E-neuron activity occurred after the decrease in PA. It is concluded that: (1) the reduced PC I-neuron activity following INS is due primarily to disfacilitation resulting probably from decreased activity in medullary I-neurons that drive the PC I-neurons, (2) PC IE- and E-neurons are not the primary neurons mediating the inspiratory inhibitory effects of intercostal and abdominal muscle proprioceptors on medullary I drive, (3) the changes in PC IE- and E-neuron activity is not due secondarily to changes in DRG and VRG IE- or E-neuron activities, and (4) the reflex effects are due to stimulation of low threshold Group I afferent fibers. PMID- 6867503 TI - Simultaneous O2 and CO diffusing capacity estimates from assumed lognormal VA, Q and DL distributions. AB - O2 and CO pulmonary transfer data obtained in dogs under steady-state conditions in hypoxia by Savoy et al. (Respir. Physiol. 42: 43-59, 1980) have been submitted to reevaluation and have yielded new estimates of the lung diffusing capacity, DL. For the proposed DL computation it has been assumed that functional inhomogeneity can be considered as resulting from lognormal distributions of the VA/Q and VA/DL ratios. The standard deviation, sigma, of the VA/Q distribution is computed from the measured (PA -Pa)CO2, and the same sigma value is assumed to prevail for the VA/DL distributions. This is equivalent to assume constant DL/Q ratios in the entire lung. With the so defined distributions, DL values, called D sigma O2 and D sigma CO, were sought, for which the model calculations yielded O2 partial pressures and CO fluxes equal to those measured. Compared with DL estimates computed with conventional procedures, these results show that D sigma O2 is twice as large as DLO2 computed with ideal alveolar PO2 and that D sigma CO lies between DLCO computed with the mean alveolar PCO and that computed with the ideal alveolar PCO. The D sigma O2/D sigma CO ratio was on the average 1.2, a value which, unlike the ratios obtained with conventional DLO2 and DLCO estimates, is in good agreement with the characteristics of diffusion and of chemical association of O2 and CO with blood. PMID- 6867505 TI - [Excessive body weight and other risk factors in the clinical manifestation of degenerative changes in the knee joint]. PMID- 6867506 TI - [Raynaud's phenomenon in systemic rheumatic diseases of the connective tissue]. PMID- 6867507 TI - [Classification of the dyshemopoietic anemias]. PMID- 6867508 TI - [Diagnosis and treatment of pancreatic pseudocyst. Report of 37 cases]. PMID- 6867509 TI - [Demographic characteristics, wish and intent to procreate, and the use of contraception in a group of women in Mexico City]. PMID- 6867510 TI - [Study Group for Thyroid Cancer in Mexico (CATIMEX). Collaborative study of 194 cases]. PMID- 6867511 TI - [Cause of death in acute leukemia. Analysis of 224 cases]. PMID- 6867512 TI - [Interstitial lymphoid pneumonia]. PMID- 6867513 TI - Differences in recurrence risk for siblings for cleft lip and/or palate depending on the degree of the malformation and on family history. PMID- 6867514 TI - [Lithophagy. An unusual cause of incomplete colonic obstruction]. PMID- 6867515 TI - [Evaluation of the accuracy of a portable device for blood cytology]. PMID- 6867516 TI - [Fever in cancer of the kidney in adults]. PMID- 6867517 TI - [Vasculitis and pulmonary granulomatosis. Comments on a case with colonic localization]. PMID- 6867518 TI - [Epidemiologic relations between arteriopathy of the lower extremities and chronic gastroduodenal ulcer]. AB - The authors report the results of a study of 3 565 consecutive patients over 30 years of age, of French nationality living in the Paris region, hospitalised over a 5 year period in a Department of internal medicine and vascular pathology. The incidence of gastroduodenal ulcer was compared in each sex in 10 year age groups in 764 patients with arterial disease and 2 801 patients without arterial disease. The incidence of ulcers was higher in patients with occlusive arterial disease in men in the 50 to 59 year age group (20,4 p. 100 compared to 9 p. 100, p less than 0,01), and in the 60 to 69 year age group (20,3 p. 100 compared to 9,8 p. 100, p less than 0,001), and after 70 years of age in females (12,8 p. 100 compared to 4 p. 100, p less than 0,01). The overall incidence in all patients with arterial disease (16,7 p. 100 of all 591 males, and 12,1 p. 100 of all females) was higher than in a corresponding control group (9,7 p. 100, p less than 0,0001, and 4,8 p. 100, p less than 0,001 respectively). These results only concern chronic ulcers. There was no difference in the incidence of acute ulcers. PMID- 6867519 TI - [Hereditary deficiency of C1 esterase inhibitor. Lupus and glomerulonephritis]. AB - Congenital deficit of the inhibitor of C1 esterase (C1 INH) usually presents by oedema of the lower limbs, abdomen and glottis (sometimes lethal), which explains its clinical denomination of angioneurotic oedema. The association of this condition with disseminated lupus erythematosis has been reported in 4 cases and with discoid lupus in 4 cases. Antinuclear factors were found in all these cases but there were only two documented cases of nephropathy (one diffuse proliferative glomerulonephritis and one local glomerulonephritis). The association of a deficit of C1 INH and membrano-proliferative glomerulonephritis has only been reported in 2 cases (one lobular glomerulonephritis and one glomerulonephritis with dense basal membrane deposits). Our case had C1 INH deficiency and proliferative lupic glomerulonephritis in the absence of other clinical and immunological signs of DLE. Nephropathy was not looked for in 9 cases of association of C1 INH deficiency and C3-shearing autoantibody (C3 NEF). A common genetic mechanism for these associations seems very improbable. The aptitude of patients with C1 INH deficiency to synthesise autoantibodies under the influence of infections factors, for example, could explain the higher incidence of lupus and glomerulopathies in these patients. PMID- 6867520 TI - [Biermer's anemia and disseminated lupus erythematosus]. PMID- 6867521 TI - [A new case of rheumatoid nodulitis]. AB - A new case of rhumatoid nodulitis is reported in a 28 year old man presenting with rapidly regressive arthralgia, numerous rhumatoid nodules and metatarsal lesions without signs of associated arthritis. The biochemical profile was non specific; serology was weakly positive for rhumatoid factor; there was no obvious immunological disorder (no circulating immune complexes, total complement and its various fractions within normal limits). The clinical findings, treatment and classification of this condition are discussed with reference to six other published cases with a similar clinical and paraclinical features. PMID- 6867523 TI - [Cardiac involvement in Friedreich's disease: importance of non-invasive cardiologic investigations. Apropos of 13 cases]. PMID- 6867525 TI - [Intravenous fibrinolysis in the acute phase of myocardial infarction. 21 cases]. PMID- 6867524 TI - [Aortic insufficiencies in ankylosing spondylarthritis. Clinical study and prognosis of 12 cases]. PMID- 6867522 TI - [Systolic pressure and the arterial wall]. PMID- 6867526 TI - [Antibiotics and diarrhea, "Clostridium difficile"]. PMID- 6867527 TI - [Treatment of bone metastases]. PMID- 6867528 TI - [Recent developments in hip joint replacement]. PMID- 6867530 TI - [When should a physician think of requesting an echocardiogram? What can he expect from this examination?]. PMID- 6867529 TI - [Bromocriptine (Parlodel) in the treatment of Parkinson's disease. Summary of 7 years' experience]. PMID- 6867531 TI - [New therapeutic developments]. PMID- 6867532 TI - [Spasmophilia]. PMID- 6867533 TI - [Cerebral ischemic attacks in the young adult]. PMID- 6867535 TI - [Pre- and postoperative cares for an operative procedure of bronchoplasty]. PMID- 6867534 TI - [Mediastinal lymph node dissection]. PMID- 6867536 TI - [A sump drainage system using high negative pressure after cardiac surgery]. PMID- 6867537 TI - [The summation theory of inputs from the atria into the atrioventricular node and its surgical implication]. PMID- 6867538 TI - [Vomiting and severe epigastral pain referred to left shoulder]. PMID- 6867539 TI - [Sino-atrial node transplantation: an experimental study]. PMID- 6867540 TI - [Surgical experiences of non-ischemic ventricular tachycardia]. PMID- 6867541 TI - [Conduction system and classification of ventricular septal defect]. PMID- 6867542 TI - [Study on postoperative arrhythmia following the cardiac valve replacement: especially on St. Jude Medical prosthetic valve]. PMID- 6867543 TI - [New pacers and electrodes]. PMID- 6867544 TI - [A case report of left ventricular-right atrial communication with infective endocarditis]. PMID- 6867545 TI - [The surgical experiences of plication and annuloplasty for Ebstein's anomaly]. PMID- 6867546 TI - [Primary right axillary and subclavian vein thrombosis]. PMID- 6867547 TI - [Stress ulcer after open heart surgery]. PMID- 6867549 TI - [Details on a new surgical technic, Ivalon sponge occlusion]. PMID- 6867548 TI - [Surgical correction of the pectus excavatum--STO-O & SCE]. PMID- 6867550 TI - [Surgical treatment of acute aortic dissection]. PMID- 6867551 TI - [Surgical treatment of acute dissecting aneurysms of the aorta]. PMID- 6867552 TI - [Surgical treatment of acute aortic dissection using a double-ringed graft]. PMID- 6867553 TI - [Complication and treatment of acute aortic dissection]. PMID- 6867554 TI - [The postsurgical fate of the dissecting lumen observed by CT]. PMID- 6867555 TI - [Surgical diseases of the venae cavae and their treatment]. PMID- 6867556 TI - [Enlargement of the small aortic annulus by the radical removal of the sclerotic fibrous aortic ring]. PMID- 6867558 TI - [Successful aortic valve replacement in rupture of an aneurysm of the sinus of Valsalva into the left ventricular cavity and aortic valve insufficiency associated with a complete form of Behcet's disease]. PMID- 6867557 TI - [Correction of a fistula between the coronary and pulmonary arteries associated with an abnormal communication between the descending aorta and pulmonary trunk]. PMID- 6867559 TI - [Successful treatment of bronchiectasis with multiple pulmonary cysts]. PMID- 6867560 TI - [Application of a pig-tail catheter for removal of a dislodged IVH silicone tube from the right ventricle]. PMID- 6867561 TI - [New methods for bone suturing and fixation]. PMID- 6867562 TI - [Decision for pneumonectomy of pulmonary nodules detected by thoracic radiography]. PMID- 6867563 TI - [Dermatitis herpetiformis]. PMID- 6867564 TI - [Bullous epidermolyses]. PMID- 6867565 TI - [Cutaneous porphyria]. PMID- 6867566 TI - [Medical statistics used by the practitioner: hazard or necessity?]. PMID- 6867567 TI - [Controlled therapeutic trials: justification]. PMID- 6867568 TI - [Controlled therapeutic trials: elaboration of the protocol]. PMID- 6867569 TI - [Evaluation of diagnostic mean values: informational indices]. PMID- 6867570 TI - [Evaluation of diagnostic mean values: the pitfalls]. PMID- 6867571 TI - [The rheumatic hand]. PMID- 6867572 TI - [Ewing's sarcoma]. PMID- 6867573 TI - [Scoliosis in the adult]. PMID- 6867574 TI - [Temporomandibular luxations]. PMID- 6867575 TI - [Epidemiology of bronchial cancer]. PMID- 6867576 TI - [Screening for bronchial cancers]. PMID- 6867577 TI - [Anatomo-pathological forms of primary cancers of the bronchi]. PMID- 6867578 TI - [Treatment of epidermoid cancers and primary bronchial adenocancers]. PMID- 6867579 TI - Ongoing blood clotting in recent cerebral thrombosis: presence of fibrin monomers in the circulation demonstrated by the ethanol gelation test (EGT). PMID- 6867580 TI - Administration of synthetic vasotocin into various spaces of the brain ventricular system and the sleep-wake cycle of the cat. PMID- 6867581 TI - Epidemiologic aspects of schizophrenias, schizotypal disorders and schizoaffective psychoses in the student population. PMID- 6867582 TI - Some thoughts on the genetic risks of a possible nuclear war. PMID- 6867583 TI - EEG and clinical survey during biofeedback treatment of epileptics. PMID- 6867584 TI - Photic-evoked responses in photosensitive epilepsy. PMID- 6867585 TI - Responsiveness disturbances in patients with night terrors. PMID- 6867586 TI - Contribution of the erythrocytes physical qualities (deformability and aggregability) to the viscoelastic properties of the blood clot in patients with acute cerebral thrombosis. PMID- 6867587 TI - [Experimental cortisone osteonecrosis. Early stages of bone marrow and trabecular lesions. Preliminary study in pigs]. PMID- 6867588 TI - [The problematical painful knee. An arthroscopic study of 300 cases]. AB - The diagnosis of internal derangements of the knee sometimes presents a graft deal of difficulty. If today the expression "Internal derangement of the knee" is much more rare, it is due to the progress made in the field of diagnosis thanks, in particular, to arthrography and arthroscopy. The authors report the results of 300 arthroscopies of the knee. They present the most significant forms of the problem knee: hypertrophy of the adipose tissue, hypertrophy of the synovial folds, villo-nodular synovitis, synovial chondromatosis, radiolucent mobile foreign bodies, osteochondritis dessicans hidden meniscal lesions and specific and non-specific mono-arthritis. In the majority of cases, the clinical suspicion was confirmed, but in 29% of cases arthroscopy corrected the diagnosis. Arthroscopy, is judged to be of great value in the diagnosis of doubtful forms of the painful knee syndrome. Often it eliminates the need to open the joint and almost always directs the incision to the most appropriate region and, above all, it prevents the risk of unnecessary operation. PMID- 6867589 TI - [Assay of rheumatoid factor by laser nephelometry. A study of 1,000 sera]. AB - The detection and assay of Rheumatoid Factor (RF) are possible using laser nephelometry as the reaction between circulating RF and aggregated human IgG results in the formation of soluble immune complexes which scatter the light emitted by the laser. The use of this new method in 1,000 sera shows that this test is more sensitive, positive earlier and more reproducible than the usual reactions of passive agglutination. Its complete automation makes it very rapid and very reliable. PMID- 6867590 TI - [Echopolycardiography in the detection of cardiac lesions in rheumatoid polyarthritis]. AB - In order to verify the extent and the frequency of cardiac complications in rheumatoid arthritis (RA), the authors performed mechanophonocardiographic studies and simultaneous mono- and bi-dimensional echocardiography in 28 patients with RA, 2 men and 26 women aged between 38 and 65 (mean = 51) (history of the disease ranging from 1 to 37 years). One case showed an increase in the PEP:LVET ratio on the polycardiogram and 18 cases showed echocardiographic alterations (64.3%), in particular: pericardial effusion in 6 cases (21.4%), thickening of the epicardium and the pericardium in 4 cases (14.3%), alterations in the mitral valve (reduction in the protodiastolic closing velocity of the anterior edge of the large mitral valve) in 10 cases (35.7%) and thickening of the interventricular septum in 5 cases (17.9%). These examinations are therefore good indicators of the cardiac complications of rheumatoid disease and allow a group of patients to be identified who would not otherwise be detectable. These patients can be followed up subsequently, in the light of the positive correlation between echocardiographic alterations and the duration and severity of the disease. The authors conclude that simultaneous mono-and bi-dimensional echocardiography represents the optimal investigation for defining the nature, the severity and the frequency of rheumatoid cardiac abnormalities. PMID- 6867591 TI - [Stenosis of the lumbar canal. Apropos of 50 surgically-treated patients]. PMID- 6867593 TI - [Circumscribed nontraumatic myositis ossificans. Diagnostic difficulties. Apropos of a case]. PMID- 6867592 TI - [Clinical case: a curious epitrochleitis]. PMID- 6867594 TI - [Osteolysis disclosing a lymphoma developed on a pagetic bone]. PMID- 6867595 TI - [A case of a single tibial metastasis disclosing cancer of the endometrium]. PMID- 6867597 TI - An improved procedure for the preparation of the human thyroglobulin and the development of a thyroglobulin autoantibody kit. AB - Human thyroglobulin has various applications as a diagnosis reagent or for studying the physiopathology of the protein and hormonal biosynthesis in the thyroid gland. The previous preparation procedure for isolating the human thyroglobulin currently used in our laboratory, has some inconveniences as regards the low yield and the noxious influence of the ammonium sulfate precipitation upon its molecular integrity. Therefore, we describe an improved fractionation and purification procedure whose main steps are extraction of the thyroid tissue homogenate in 0.15 M NaCl followed by a double gel filtration on Sephadex G-200 column. In this way are obtained thyroglobulins A and B grade using the two chromatographic steps, respectively. Thyroglobulin B grade is further submitted to preparative polyacrylamide gel electrophoresis for separating some thyroglobulin isomers as recognized by other groups using the analytical ultracentrifugation procedure. The different fractionation and purification steps were checked by double diffusion in gel using rabbit anti thyroglobulin serum and horse antihuman serum protein. The homogeneity and the molecular weight of the different fractions we evidenced were analyzed by the aid of disc and plate electrophoresis in polyacrylamide gel. The authors developed the technique for thyroglobulin autoantibody detection by the passive haemaglutination method using stabilized erythrocytes coated with thyroglobulin A grade. Thyroglobulin B-grade used as a tracer and a reference preparation in a RIA system offered a sensitivity of 1.5 micrograms/liter for thyroglobulin detection in biological fluids. PMID- 6867596 TI - [Sternocostoclavicular hyperostosis. Apropos of a case with vertebral hyperostosis]. PMID- 6867598 TI - Studies of the reproduction function in hyper- and hypoadrenocorticism. AB - The investigation was carried out on 66 patients with hypo- or hyperfunctional syndromes of adrenocorticism, hospitalized and treated by our team. The patients were grouped into 5 lots according to their diseases. Lot one consisted of 34 female patients with Cushing's syndrome, lot two of 10 males with Cushing's syndrome, lot three of 10 males with Addison's disease and lot four, of 6 females with androgenic hypercorticism. The morphofunctional disorders of reproduction were followed up clinically and by complex hormone assays, before and after treatment. The incidence of these disorders is very high, and the results of clinical observations and of laboratory data demonstrate that both the excess of adrenocortical hormones and the decrease in their circulating level have a negative influence on the reproduction function or represent a risk factor in cases of pregnancy. By the curative treatment of the adrenal cortex a preventive treatment of abortion and/or sterility is achieved. PMID- 6867599 TI - Considerations on the role of lithium and Levamisol in the cyclic nucleotide regulation of immune processes. PMID- 6867600 TI - Romanian contributions to the development of neuroendocrinology. PMID- 6867601 TI - Effect of urinary gonadotropin-inhibiting substance on rat prolactin. AB - Administration of the partially purified urinary gonadotropin inhibiting substance (GIS) to the rat induced the following effects on prolactin: a) under basal conditions, 4 hrs after a single dose, or after 3 days of treatment, serum prolactin decreased by 36%, 35% respectively (p less than 0.05) and was associated with a nonsignificant decrease in pituitary content and concentration of this substance; b) under endogenous stimulation (castration) the 49% (p less than 0.05) decrease in serum prolactin was associated with a decrease to the limit of statistical significance of its pituitary content and concentration; c) under exogenous stimulation with TRH, the significant decrease in serum prolactin was associated with a nonsignificant decrease in its pituitary content and concentration. The action of lowering prolactin serum in relation to the similar effect of the pineal extract is discussed with reference to the possible pineal origin of GIS. PMID- 6867602 TI - [Ecological aspects of leishmaniasis americana. 3. Natural observations on the daily rhythm of the Psychodopygus intermedius activity in forest and non forest environment]. PMID- 6867603 TI - [Occurrence of meningococcal disease in the Japanese and their descendants in the municipality of Londrina, Parana, Brazil (1965-1975)]. PMID- 6867604 TI - [Respiratory symptoms in the population of the city of Ribeirao Preto, SP (Brazil). Results of the use of a standardized questionnaire]. PMID- 6867605 TI - [Epidemiological and immunity aspects of poliomyelitis in children less than a year old in an area in the region of Greater Sao Paulo, Brazil]. PMID- 6867606 TI - Why concentration of serum ferritin does not in all circumstances reflect storage iron but is still of value in its estimation. AB - We describe a 10-year-old girl with familial haemochromatosis which is associated with a normal concentration of S-ferritin, myocardial disease and diabetes mellitus. We speculate that iron is accumulated primarily in the heart and pancreas as such isoferritins are not detected by the routine assay of serum ferritin based on antispleen or placenta ferritin. Further, this condition is compared with lysinuric protein intolerance, an inborn error of diamino-acid transport where an opposite discrepancy between S-ferritin and storage iron is seen. PMID- 6867607 TI - Hydrocortisone--a possible physiological regulator of human granulopoiesis. AB - The effect of hydrocortisone (HC) on the formation of granulocyte-macrophage (GM) colonies was assessed in vitro in cultures of normal human bone marrow. Subphysiological concentrations (less than or equal to 10(-8) mol/l) of HC had no impact on GM colony formation, but at physiological and therapeutic levels (10( 7) mol/l-10(-5) mol/l) the hormone stimulated the production of an increased number of colonies. By contrast, physiological concentrations of progesterone (10(-9) mol/l-10(-7) mol/l) were without effect and even at 10(-6) mol/l there was no influence of progesterone alone on GM colony formation. However, progesterone at 10(-6) mol/l inhibited the stimulant effect of HC to a degree which was related inversely to the concentration of HC and the duration of the culture interval. The data from this study suggest that the neutrophilia which accompanies glucocorticosteroid therapy is matched by an increase in the production of granulocytes and that HC may play a role, which is mediated by steroid receptors, in the physiological regulation of human granulopoiesis. PMID- 6867608 TI - Prognostic value of serum lactic dehydrogenase in non-Hodgkin's lymphoma. AB - Lactic acid dehydrogenase (LDH) is a glycolytic enzyme that may be elevated in the serum of patients with non-Hodgkin's lymphoma (NHL). In this investigation LDH was assayed in sera from 155 untreated patients with NHL. Serum LDH (S-LDH) was found to be significantly correlated both to the spread of the disease and to the histological grade of malignancy i.e. more advanced disease or more aggressive histopathology was associated with higher S-LDH values. A high pretreatment S-LDH level (greater than 8.0 mukat/l) in stages III and IV correlated significantly to a decreased survival time. The patients with a pretreatment level of less than 8.0 mukat/l had an actuarial 2-year survival of 80%, compared to 30% in the patients with levels greater than 8.0 mukat/l (P less than 0.001). In stages I and II all 6 patients with a high pretreatment level (greater than 8.0 mukat/l) relapsed during or a short time after radiotherapy. In a longitudinal study of 24 patients it was found that S-LDH reflected in the clinical course. In patients treated to partial or complete remission, S-LDH decreased and at relapse it rose again. It is concluded that S-LDH might be useful both as a prognostic marker and to monitor the course of the disease. PMID- 6867609 TI - Long term therapy of pernicious anaemia with the depot cobalamin preparation betolvex. AB - The value of a depot cobalamin preparation Betolvex (cyanocobalamin-tannin complex suspended in a sesame-oil aluminum-monostearate gel) in the maintenance therapy of pernicious anaemia was investigated in 120 patients followed up for between 8 and 15 years. Complete haematological remission was maintained in all patients, and none developed B12 neuropathy after the start of treatment. No side effects were observed. The mean values of S-cobalamin were above the reference limits when 1 mg cobalamin was given every 2 months, and high within the reference limits when given at 3 monthly intervals. The cobalamin content in the liver tissue in 2 patients who had received 1 mg cobalamin every 3 months for 6 years revealed normal values. Thus, 1 mg of the depot cobalamin preparation given at intervals of 3 months should provide adequate maintenance therapy in pernicious anaemia. PMID- 6867610 TI - An association of pregnancy and autoimmune haemolytic anaemia. AB - 14 cases of pregnancy-associated autoimmune haemolytic anaemia were analyzed. 4 cases were diagnosed during pregnancy; 10 cases became pregnant during the remission period of the disease. 6 cases were secondary to systemic lupus erythematosus. In the first group, the anaemia developed in the third trimester whereas in the second group the Hb fell slightly in the first trimester and rapidly between the third and fourth month of gestation. Only 1 case could withstand the hazard of pregnancy uneventfully; 4 needed corticosteroid and delivered normal infants; 2 developed toxaemia of pregnancy; in 5, either therapeutic or spontaneous abortion was noted and 1 death occurred due to renal complication. Abortion was induced in 1 case due to socio-economic indications. PMID- 6867611 TI - Comparative studies of the function and morphology of 111In- and 51Cr-labelled human platelets. AB - Comparative studies of the aggregability in vitro and ex vivo, and of the surface/volume ratio of 111In- and 51Cr-labelled human platelets were carried out. The ADP-induced aggregation in vitro of 111In-platelets was superior to that of 51Cr-platelets, as was that of 51Cr-platelets labelled in plasma as compared to 51Cr-platelets labelled in buffer. These differences seemed to be reversed in vivo, as identical collagen-induced aggregation responses were observed ex vivo when comparisons were made between 111In- and 51Cr-platelets, and between labelled and unmanipulated platelets. Morphometric determination of the surface/volume ratios of the labelled platelets indicated a higher degree of platelet activation of 51Cr-platelets labelled in buffer as compared to those labelled in plasma. In this respect, no difference seemed to be present between 111In- and 51Cr-platelets. The results of the ex vivo aggregation studies were unaffected by the time spent by the platelets in the circulation within 24 h post injection, by platelet isolation yield, and by the medium used in 51Cr-labelling. Our results indicate that it will be possible to conduct comparative studies of simultaneously induced aggregation ex vivo of different platelet populations labelled with 111In and 51Cr. PMID- 6867613 TI - Treatment of urethral stricture by urethroplasty or direct vision urethrotomy. A comparative retrospective study. AB - The outcome of treatment for urethral stricture is evaluated in two groups of patients in a retrospective study: 51 patients were treated with urethroplasty and 41 with direct vision urethrotomy. The groups did not differ greatly as regards primary success. It was 59% in the urethroplasty group and 61% in the urethrotomy group. This favours the view that the primary treatment of a urethral stricture should be direct vision urethrotomy whenever possible. PMID- 6867612 TI - CCNU toxicity after an overdose in a patient with Hodgkin's disease. Effects on colony-forming cells (CFU-C) and colony-stimulating activity (CSA). AB - An overdose of CCNU (600 mg over a 15-d period) was unintentionally ingested by a patient with advanced Hodgkin's disease subjected to combination chemotherapy. A severe bone marrow depression occurred 3 weeks after the start of the CCNU treatment. The nadir of the platelet count was reached after 4 weeks and that of the granulocyte count after 5 weeks. At the nadir of the white blood cell count, colony-forming cells (CFU-C) were found in significantly reduced numbers in the bone marrow, and were not found at all in the peripheral blood; the amount of colony-stimulating activity (CSA) produced by peripheral blood cells was reduced. However, the cells producing CSA recovered earlier than the CFU-C, and the CSA peak value was reached about 1 week before the peak value for CFU-C in the bone marrow. Thus, in vivo CSA-producing cells appeared to be more resistant to CCNU than were CFU-C, and their recovery appeared to be a prerequisite for the recovery of CFU-C and myelopoietic cells. PMID- 6867615 TI - Dynamic ultrasound evaluation of tumor thrombus in the inferior vena cava. PMID- 6867614 TI - Diagnosis of hyperparathyroidism in patients with urolithiasis using measurement of serum immunoreactive parathyroid hormone and serum calcium. AB - Serum immunoreactive PTH (iPTH) was measured in 74 patients with urolithiasis and correlated to the corresponding serum calcium values. Serum iPTH was measured using a rooster antibovine iPTH antiserum which crossreacted with the human hormone within the 44-68 amino acid residue region. Sixty-six of these patients had normal serum iPTH and calcium concentrations. Their calcium values varied from 2.2 mmol/l to 2.6 mmol/l and their serum iPTH concentrations were less than 0.6 micrograms/l. The remaining 8 patients with urolithiasis were judged to have primary hyperparathyroidism because of an abnormal iPTH/calcium relationship. These patients had serum calcium concentrations varying from 2.6 mmol/l to 3.4 mmol/l and iPTH concentrations between 0.35 micrograms/l and 3.03 micrograms/l. The diagnosis was verified histologically in 7 patients after operation. In the last patient iPTH was reduced from 1.01 micrograms/l to 0.21 micrograms/l after surgery, and serum calcium changed from 2.6 mmol/l to 2.2 mmol/l. The combined evaluation of serum iPTH and calcium may improve the diagnosis for hyperparathyroidism and was in our series helpful in making a correct diagnosis in 2 out of 7 patients who had histologically verified disease. In addition, iPTH measurements are valuable to rule out hyperparathyroidism as the cause of hypercalcaemia. PMID- 6867616 TI - Morphological changes in the aorta of rabbits with chronic renal failure. AB - The morphological changes in the thoracic aorta induced by chronic renal failure (CRF) were studied in female albino rabbits after seven weeks of CRF. The effect of three and eight months duration of CRF was studied in the proximal part of the abdominal aorta. Renal impairment was induced by electrocoagulation of part of the renal parenchyma of one kidney and subsequent contralateral nephrectomy two weeks later. In the media wavy elastic membranes were the first histological change observed. After long-term CRF necrosis and calcifications with thickening of the vessel wall became frequent and in some rabbits the aorta was changed grossly into a stiff calcified tube. In the intima focal thickenings were found with increasing frequency and severity with increasing duration of the renal insufficiency. PMID- 6867617 TI - Latency of thorotrast-induced renal tumours. Survey of the literature and a case report. AB - A case of thorotrast-induced renal tumour is reported. The relevant literature is briefly surveyed. The latency periods to tumour detection in the published cases were analyzed. Latency was longer in transitional cell carcinoma than in the other histological tumour types. The difference was statistically significant. It is concluded that discovery of more cases of thorotrast-induced renal tumour is to be expected. The importance of bearing this possibility in mind when confronted with roentgenograms showing 'calcifications' in or near the kidney is pointed out. PMID- 6867618 TI - Improvement of detrusor instability following repeated bladder distension with cystomat. A case report. AB - Treatment of idiopathic detrusor instability with drugs and prolonged distension of the bladder is often unsatisfactory. Some amelioration of symptoms was previously described after 24-hour bladder distension with use of the cystomat. A case is presented in which detrusor instability was successfully treated with continuous infusion via the cystomat, and thereby repeated bladder distension, for one week. The symptoms subsided, the cystometric bladder capacity was increased and there was no side effects. The improvement has persisted for six months. Though the mechanism by which the bladder distension exerts its effect is poorly understood, the technique of repeated distension offers an alternative in the treatment of patients with idiopathic detrusor instability. PMID- 6867620 TI - Xanthogranulomatous pyelonephritis with renocolic fistula and coexistent contralateral renal carcinoma. AB - The presence of contralateral renal tumour in a case eventually found to have Xanthogranulomatous Pyelonephritis (XP) resulted in a wrong preoperative diagnosis of tumour with bowel fistula. The patient's prior history of bladder tumour and multiple renal cysts is also discussed, along with the retrospective finding of very minor changes in an early angiogram. PMID- 6867621 TI - Follow-up of female patients complaining of urinary incontinence. AB - Sixty-three of 303 patients complaining of urinary incontinence and referred to hospital for examination were not treated, but followed for a median period of 33 months. Eighteen did not wish for treatment. The remaining were followed either because they had few subjective symptoms or because of concomitant bronchitis, or obesity, or owing to the fact that urinary incontinence could not be demonstrated during the objective examination. The patients were followed in order to offer treatment should this become necessary and to register the spontaneous progress of the condition. Fifteen of the 18 patients not wanting treatment were seen at follow-up and none had changed their minds with regard to treatment. In the other group, only 8 of 35 patients complaining of urinary incontinence without concomitant disease wished to have treatment and required re-evaluation. Urinary incontinence had been verified primarily in four only. The finding underlines the importance of a careful history and emphasizes the fact that patients with slight symptoms and no objective findings of urinary incontinence rarely develop more severe symptoms. PMID- 6867619 TI - Renal malacoplakia. Conservative surgery and prophylactic long-term antibiotic treatment. PMID- 6867622 TI - The simplified Lapides' operation for stress incontinence. AB - Forty-one women were operated on for stress incontinence using the simplified Lapides' operation. Twenty-six had pure stress incontinence and fifteen had mixed stress and urge incontinence. Follow-up studies, 2-6 years after surgery, included interviews according to a special protocol and urodynamic analyses. The cure rate was high in the patients with pure stress incontinence (all cured or improved), while the results were not satisfactory in the patients with mixed stress and urge incontinence (7 of 15 cured or improved). A variety of urodynamic abnormalities were found in the group of failures. In some patients who considered themselves cured or improved there was a discrepancy between the result of the interview and the urodynamic findings. The technical advantages and disadvantages of the simplified Lapides' operation are discussed. PMID- 6867624 TI - Mapping of cell cycle distribution in normal human urinary bladder epithelium. AB - A method is described by which urothelial cells from well defined areas in the urinary bladder mucosa can be obtained. At cystoscopy epithelial cells are aspirated by means of a ureteral catheter. The cells obtained by this selective sampling technique are well suited for morphology and for quantitative single cell measurements by flow cytometry (FCM). In the present study the cell cycle distribution has been measured by FCM. Twenty-five patients (13 males and 12 females) had urothelial cells collected from well defined areas in the mucosa and the DNA content measured from different sites separately. The distribution of bladder mucosa cells in the different parts of the cell cycle (G1, S-phase and G2 + M) is reported. No significant differences were found with regard to sex and age of the patients. Also, a low regional variation was found in the bladder mucosa indicating that the method should enable the discrimination of even small abnormal cell populations in tumour disease. No evidence of polyploidy in the human urothelium was found. PMID- 6867623 TI - Visual internal urethrotomy with postoperative cystostomy or urethral catheter. AB - Visual internal urethrotomy is nowadays considered by many to be a very useful method of treating urethral strictures. There is still controversy, however, about how long the postoperative urethral catheter should be left in situ. A prospective randomised study was therefore performed to evaluate the influence on the results of urethral catheterisation versus a suprapubic cystostomy for 5 weeks. After 12-36 months of follow-up (mean 25 months) there was a significant difference in result in favour of the urethral catheter. In the catheterised group, 13 out of 20 patients were without recurrence, compared to 4 out of 17 patients in the cystostomy group. Of the total number of 76 patients treated by postoperative urethral catheterisation, 37 (48%) had a normal or slightly subnormal flow-rate 12-60 months after the urethrotomy. Young patients and patients with stricture treated for the first time showed significantly better results than older patients or patients who had previously been treated twice or more. The stricture diameter-prestenotic urethral diameter ratio, obtained by combined retrograde and antegrade urethrography, provided a fairly accurate measure of the functional significance of a stricture. PMID- 6867626 TI - Erythrocyte limits in haematuria. AB - The boundary-line between gross haematuria and microscopical haematuria is estimated to be at 5000 erythrocytes/mm3 of urine. The quantification is made by counting red blood cells in freshly voided non-centrifuged urine. A naked eye estimation of the colour of each tube was performed with a light beam from both in front (Fig. 1) and behind (Fig. 2). The colour observed can be correlated to the quantity of RBC/mm3. PMID- 6867625 TI - Concealed haematuria--whence cometh the bleeding? A new method of localisation. AB - Concealed haematuria is often a difficult diagnostic problem. A method for collecting isolated urine specimens from different areas of the urinary tract and subjecting them to quantitative analysis for RBCs is described. A more accurate localisation of the source of bleeding with, in the upper urinary tract, side differentiation, is thus possible. Some examples are presented as case reports. PMID- 6867627 TI - Evaluation of renal concentrating ability with DDAVP and pitressin. AB - This paper reports an attempt to develop a rapid test of the renal concentrating ability using a newly synthetized vasopressin analogue, DDAVP (1-desamino-8-D arginine-vasopressin), which was given intravenously in a dose of 2 micrograms. Patients investigated for various endocrinological disorders were evaluated with both DDAVP and pitressin. There was a good correlation between the maximal urine osmolalities with both tests. Since DDAVP has fewer side effects and a more rapid onset of action it appears advantageous for investigations of renal concentrating ability. PMID- 6867628 TI - Effects of indomethacin on central, renal and coronary hemodynamics. An experimental study in swine with unilateral ureteral obstruction. AB - The circulatory effects of intravenously administered indomethacin, a potent prostaglandin synthesis inhibitor (0.8 mg/kg bw) were investigated in pigs with unilateral ureteral obstruction. The drug induced a marked but transient increase in systemic arterial pressure (+53%, p less than 0.02) and pulmonary arterial (+81%, p less than 0.02) pressure without any changes in left or right sided filling pressures, cardiac output or heart rate. Coronary blood flow remained unchanged and renal venous blood flow decreased (-26%, p less than 0.02). Renal pelvic pressure decreased (-20%, p less than 0.02). Thus systemic (SVR), pulmonary (PVR) and coronary vascular resistance (CVR) and renal vascular resistance (RVR) on the obstructed side increased (SVR + 73%, p less than 0.02; PVR + 140%, p less than 0.02; CVR + 53%, p less than 0.02 and RVR + 107%, p less than 0.02 respectively). Even if one takes into consideration other factors than ureteral obstruction contributing to these reactions, e.g. low volume load, anaesthesia, surgical trauma and species differences, care is advised in treating patients with coronary artery disease or obstructive lung disease with indomethacin. PMID- 6867629 TI - Permanent impairment of renal function demonstrated by renographic follow-up in ureterolithiasis. AB - In a prospective study, 358 consecutive patients with radiopaque ureteral stone, verified by intravenous urography were renographically followed up until the stone had left the ureter. Impairment of the renal parenchymal function was revealed in 91 patients. In 24 of them--7% of the total series--the impairment was still demonstrable after the latest examination, on average 17 months after passage of stone. Patients with large stone, or with stone lodged for a long time in the ureter, elderly patients and women predominated in the group with persistent impairment of renal function. The impairment was fairly mild in most cases. In some patients the renal function was severely impaired while the stone remained in the ureter, but subsequently normalized. Increased vigilance to prevent persistent renal damage is recommended, especially in patients with frequently recurrent ureteral stone. PMID- 6867630 TI - Crystalline composition of urinary stones in Norwegian patients. AB - During a 5 year period, 500 stones from the upper urinary tract and 100 from the urinary bladder of as many unselected and consecutive patients were obtained in one hospital and analysed crystallographically. 90.4% of the upper urinary tract stones and 65% of the bladder stones belonged to the groups of calcium stones, while 6.6% and 24%, respectively, were triple phosphate stones. The contribution of calcium stones to this material is higher and that of triple phosphate stones lower than in comparable materials. Frequency variations between materials also exist within the groups of calcium stones, and for uric acid, urate and cystine stones. On the basis of published material, it is not possible to say if these differences are renal or reflect variations in the selection of stones and the methods of analysis. Reports on stone materials should include information on these aspects in order to allow meaningful comparison. Distinction between stones from the upper urinary tract and from the bladder is mandatory. The composition pattern reported here is believed to be as representative as is possible to obtain. A major part of stones from the upper urinary tract is, however, lost for analysis following spontaneous passage. Such stones are more often pure calcium oxalate and less often triple phosphate stones than those which are obtained by surgical methods, and the extent to which they are obtained will influence the findings in stone materials. PMID- 6867631 TI - Orotic acid sodium salt in kidney stones and urinary deposits. AB - Kidney stones from a plaice, Pleuronectes platessa, have been shown to consist of the sodium salt of orotic acid. Precipitation of orotic acid in human kidneys and urine samples has previously been reported but the precipitates must have been salts, most likely the sodium salt, of orotic acid and not the free acid. This reinterpretation is based on the acid strength of orotic acid and on data for the solubilities of sodium orotate and orotic acid. Sodium orotate is therefore a member on the list of compounds present in human urinary deposits and calculi. X ray powder diagrams and d-values and IR-spectra of the sodium salt are recorded to facilitate future identifications. PMID- 6867632 TI - Evidence for distinct verbal memory pathologies in severely and mildly disturbed schizophrenics. AB - It is well known that schizophrenics have difficulty in effectively encoding verbal materials into their long-term memories and consequently show a deficit in recall. Recently, orienting tasks were introduced as a method for achieving equivalent to normal encoding and mnemonic organization in schizophrenics; consequently, their deficit in recall disappeared. A detailed review of the literature, however, showed that such effective orienting tasks had only been applied to mildly disturbed schizophrenics (nonchronic, in a good condition). This report presents three experiments which show that more severely disturbed (chronic, hospitalized) schizophrenics, unlike mildly disturbed patients, have memory deficits that cannot be located at the encoding stage. Severely disturbed schizophrenics show (1) a recall deficit, even after effective encoding and mnemonic organization are induced; (2) excessive forgetting over 24- and 48-hour periods; and (3) a recognition memory deficit. These deficits are in addition to their encoding deficit. The use of a matched-tasks check in experiments 2 and 3 suggests that this postencoding deficit is a differential deficit and does not is a differential deficit and does not simply reflect the schizophrenic generalized deficit. Theoretical implications, also supported by the use of various organizational indices (e.g., clustering, hierarchical clustering schemes, and hierarchical grouping analysis), are discussed. PMID- 6867634 TI - First person account: a glimmer of light in the dark. PMID- 6867633 TI - CT scans and schizophrenia--report on a workshop. PMID- 6867635 TI - Predictors of physical activity one year after myocardial infarction. AB - A number of factors predicting habitual physical activity, duration of night's rest, return to work and exercise tolerance one year after acute myocardial infarction (AMI) are studied in fifty-five male patients. Except for exercise tolerance three months after AMI, the results of this prospective study suggest that psychologic factors are more important predictors of the four outcome variables than angina pectoris, infarction size and participation in a physical training program. The most important predictor appears to be the patient's subjective opinion of his physical capabilities, measured by the perceived exercise tolerance scale. The expectation of the eventual return to work three months after MI plays also a significant role as a predictor. Both are predictors of the exercise tolerance and return to work one year after AMI. These findings suggest that physical activity--defined as exercise tolerance, habitual physical activity and duration of night's rest--and return to work are closely related. PMID- 6867636 TI - Sexuality after stroke with hemiplegia. I. Aspects of sexual function. AB - In a consecutive series of 51 one-stroke hemiplegics some aspects of sexuality were investigated using structured interviews. Findings were related to treatment with anti-hypertensive drugs. In most subjects the site of brain lesion was visualized by X-ray methods. Moreover, in a sub-sample of 15 consecutive males LH, FSH and prolactin were assessed using standard clinical radioimmunoassay techniques. Serum testosterone including response to HCG-stimulation was also measured. Both in males and females frequency of intercourse and durations of foreplay and of intercourse were markedly reduced. For the males erectile problems were rare before but occurred for the majority after stroke. For the females, but not for the males, orgastic dysfunction was relatively common pre stroke. After the stroke such dysfunction occurred for 75% of the females and 64% of the males. Partnership sexual drive also decreased. Each of the 15 males hormonally screened had values within the predicted normal and responses to HCG stimulation were also adequate. Moreover, actual levels of hormones were associated neither with change in sexual function nor with the sexual function per se at the time of the investigation. Thus, in this sample hormonal disarrangement did not appear to be the cause of sexual dysfunction. Surprisingly, no association between erectile dysfunction and use of anti hypertensive drugs occurred. We believe that sexual dysfunctions in hemiplegics may rather be explained in terms of coping than by endocrine deficits or by anti hypertensive treatment. PMID- 6867637 TI - Sexuality after stroke with hemiplegia. II. With special regard to partnership adjustment and to fulfilment. AB - Aspects of sexual function, partnership responsiveness and fulfilment after stroke were, together with sexually performance orientated and stigmatic attitudes, investigated in 51 subjects. Erectile and orgastic spectatoring were frequent after stroke and were in the males significantly associated. Retarded ejaculation occurred for no males before but for 15% after the stroke. Marked decreases in different kinds of caressive behaviour were followed by discontentment and up to and about half the subjects felt that sexual partnership responsiveness had deteriorated. After the stroke the commonly occurring reduction in general sexual satisfaction was significantly associated with symptoms of increased sexual dysfunction, disturbed partnership responsiveness and reduced sexual fulfilment. The high prevalence of sexual maladjustment in stroke victims appears mostly to be psychogenic. Important precipitating factors are performance orientation and sexual stigmatism. Moreover, lack of sexual information and counselling may contribute to deterioration of partnership sexuality. PMID- 6867638 TI - Influence of knee flexion on isometric hip extensor strength. AB - The maximum isometric extensor muscle strength was measured in 10 healthy subjects of different combinations of hip and knee angles. An ordinary exercise device was used for the measurements and the method could be useful in clinical work. The results revealed that the knee angle does not affect the hip extensor strength. The highest extensor muscular moments occurred at 90 degrees hip flexion, decreasing with decreasing hip angle. The distribution of the strength over the motion sector differed between male and female. The weight of the body segments was found to utilize 10-24% of the maximum strength at hip angles 60 degrees-0 degrees with subjects in a prone position. PMID- 6867639 TI - Multicentre investigation of myocardial protection with cold cardioplegia. AB - In order to analyze factors of importance for the efficiency of myocardial protection during open-heart surgery, a study was made of 144 patients undergoing isolated aortic valve replacement with various cardioplegic techniques. The cardioplegia was of Bretschneider type in 54 cases, St Thomas in 31 and Ringer potassium type in 11 cases. Single or multi-dose blood cardioplegia was used in 11 cases and continuous blood cardioplegia in 30 cases. Local cardiac hypothermia was additionally employed in all patients. The efficiency of myocardial protection was assessed mainly from the incidence of postoperative conduction disturbances, myocardial enzyme release and need for inotropic support. All patients survived the operation. In 20% surgery was followed by transient or persistent disturbance of conduction, in 9% by abnormally increased CK-MB release and in 5% by requirement for inotropic support. Preoperative risk factors such as high age or severe left ventricular (LV) hypertrophy or dysfunction had little influence on the results. Patients in whom aortic stenosis (AS) was dominant in the complex with aortic insufficiency (AS + AI) showed 20-hour postoperative CK MB enzyme activity twice as high as those with pure aortic insufficiency. The most important factors in myocardial protection were the duration of aortic occlusion and the myocardial temperature during cardioplegia. When the aortic occlusion lasted more than 80 min there was a 32% incidence of conduction disturbances and 20-hour CK-MB activity thrice as high as after shorter occlusion. Patients with mean myocardial temperature below 18 degrees C during cardioplegia invariably had low enzyme activities, which indicated good myocardial protection. The best overall results were obtained in patients operated on during hypothermia at 25-27 degrees C, with single or multi-dose blood cardioplegia and with efficient local cooling of the heart. PMID- 6867640 TI - Decreased red cell deformability following open-heart surgery. AB - Red blood cell deformability is essential for a normal microcirculation. The effect of extracorporeal circulation on red cell deformability was evaluated with a filtration technique in 25 patients undergoing open-heart surgery. During extracorporeal circulation there was a significant decrease in deformability, by on average 31% (p less than 0.001). No correlation was found between decrease in deformability and duration of the extracorporeal circulation procedure. In a subgroup of patients, deformability was followed also postoperatively. During the first postoperative day there was a further decrease of 17%. By the second to third postoperative days, deformability had decreased by another 23%, so that now it was less than half of the preoperative value. On the fifth to sixth postoperative days the values remained equally low. A reduction in red blood cell damage during extracorporeal circulation may be an important factor for improving nutritional blood flow. This in turn could reduce the number of complications in various organs following open-heart surgery. PMID- 6867641 TI - Erectile function before and after reconstructive arterial surgery in men with occlusive arterial leg disease. AB - Erectile impotence is a well-known complication of vascular surgery in the aorto iliac area. So far the pathogenesis has not quite been understood, but peroperative damage to the autonomous nerves has been suggested. Ninety-eight men with arterial insufficiency in their legs underwent an additional sexual evaluation including penile blood pressure measurement and cystometric examination. The arterial insufficiency necessitated arterial reconstruction involving aorta or the common iliac arteries in 28 patients. When possible, improvement of the penile blood supply was aimed at during the operation, but no nerve-sparing techniques were employed. The seven potent patients remained potent, while nine patients became potent after the operation. The cases remaining impotent after the operation could all be explained considering the arteriography, the operation and the changes in penile blood pressure. The erectile function is related to the condition of the penile blood supply and it may be possible to reduce the rate of postoperative impotence by considering the penile blood supply when planning the operative strategy. PMID- 6867642 TI - Peroperative fine needle aspiration biopsy of lung tumors. AB - The feasibility and reliability of peroperative fine needle aspiration biopsy of lung tumors were studied in a series of 54 patients. The postoperative histologic examination confirmed that 47 of the lesions were malignant. The cytologic examination also showed malignancy in 45 of these cases. The accuracy of fine needle cytology thus was 96%. In the two false negative reports the classification was Papanicolaou grades II and III. The cytologic classification of the histologically benign lesions was only grades I or II. Thus there were no false positive cytologic results. No complications arose from the needle biopsies. Peroperative fine needle aspiration biopsy at thoracotomy is rapid, simple and safe, and has a high degree of accuracy. It is diagnostically useful in cases without preoperative confirmation of suspected lung tumor if excisional biopsy is judged to be hazardous or unlikely to yield a definite diagnosis. The method permits the surgeon to assess the extent of a malignancy and can specify the cell type of the tumor. PMID- 6867643 TI - New instrument: a modified Kocher's sound for Heller's myotomy. PMID- 6867644 TI - Congenital lobar emphysema of left upper lobe. A case report. AB - In a 2 1/2-year-old boy chest X-ray examination because of dyspnoea revealed hyperlucency of the left upper lobe with herniation of the hyperinflated lobe into the right hemithorax. Surgical exploration showed the upper lobe of the trilobed lung to be the site of congenital lobar emphysema, while the lingula and left lower lobe were collapsed. Left upper lobectomy was successfully performed. PMID- 6867645 TI - Results of surgical treatment for lung cancer. AB - A review is presented of 233 patients who were surgically treated for bronchial carcinoma during a five-year period. The survival time was determined in relation to operative procedure and to cell type and anatomic extent of the tumours. Staging according to the TNM classification gave five-year survival rates of 51.6% in Stage I, 12.0% in Stage II and 8.4% in Stages III-IV. Among the Stage I cases, tumours classified as T1N0M0 were associated with longer survival than were T1N1M0 or T2N0M0 tumours. It is concluded that the stage of the disease as defined by TNM classification should be regarded as the most important prognostic factor. PMID- 6867647 TI - Galvanic element produced by defective electrode insulation--a possible cause of abnormal pulse generator inhibition. AB - In patients with pacemaker, abnormal inhibition with prolongation of pacing intervals may cause alarming clinical symptoms. A case is described in which high current threshold in relation to voltage threshold indicated probability of an insulation defect with current leakage. Electrograms from the electrode disclosed false signals, which had appeared after replacement of a pulse generator six months earlier. A sharp bend of the wire in the tricuspid area was shown by X-ray and was accentuated by movements of the valve. Experimentally it was demonstrated that similar potentials, sufficient to inhibit a pulse generator, can be obtained from an electrode with defective insulation. A galvanic element forms between the metals of the electrode tip and the non-insulated cable, and potential variations are elicited by movement of the wire. PMID- 6867648 TI - [Trust and the law in the relations of patients and surgeons. Civil law aspects]. PMID- 6867646 TI - Chylothorax. Clinical experience in nine cases. AB - Clinical experience in nine cases of chylothorax is presented. In five cases the cause was iatrogenic, in two cases idiopathic and in two cases the chylothorax was secondary to an advanced malignant disease. Iatrogenic chylothorax occurred after mediastinoscopy, thoracic sympathectomy, pneumonectomy, resection of an aneurysm of the thoracic aorta and closure of a patent ductus arteriosus. Only one of these patients needed an operative closure of the thoracic duct. In one of the two cases of a neoplastic origin the chylothorax was caused by a malignant mesothelioma and thoracic duct ligation was needed while in the other case it was due to an inoperable pancreatic carcinoma and was treated by thoracocentesis. In one of the idiopathic cases supradiaphragmatic ligation of the thoracic duct was necessary. It is concluded that in most iatrogenic or traumatic cases chylothorax can be cured by conservative therapy (diet, thoracocentesis); in other cases the operative therapy should be adjusted to the primary disease, and the ligation of the thoracic duct should be performed at a level where it is able to prevent the chylous leak without unnecessarily interfering with the collateral lymphatic circulation. Abundant and prolonged chylous leakage should be always treated operatively to prevent disastrous nutritional and immunological deficiencies. PMID- 6867649 TI - [Trust and the law in the relations of patients and surgeons. Common law and criminal law aspects]. PMID- 6867650 TI - [Gastrointestinal manifestations of Henoch-Schoenlein purpura. Apropos of 7 cases]. PMID- 6867651 TI - [Abdominal typhus following vaccination with the live vaccine Vivotif]. PMID- 6867652 TI - [Legionella dumoffii pneumonia with adult respiratory distress syndrome]. PMID- 6867654 TI - [Dissolution of gallstones based on 6 months treatment with a single daily dose of ursodeoxycholic acid]. AB - 51 patients with radiolucent gallstones of diameter less than or equal to 15 mm were treated for 6 months with a new form of ursodeoxycholic acid (UDCA) in a single dose of 450 mg at bedtime. This new form has 3 components with fractionate liberation. The rate of partial and complete dissolution after 6 months was 63.4%, reaching 85% for gallstones of less than 5 mm diameter. The results show that a single dose of 450 mg UDCA at bedtime is as effective as UDCA at mealtimes in the dissolution of radiolucent gallstones. Administration of the drug once a day should be more acceptable to patients. PMID- 6867653 TI - [Preoperative localization diagnosis of parathyroid adenomas in 72 cases of primary hyperparathyroidism by selective catheterization of neck veins and parathyroid hormone determination]. AB - In 72 cases of primary hyperparathyroidism, selective venous catheterization was performed preoperatively to localize parathyroid adenomas. Diagnosis of primary hyperparathyroidism was proved by operation in all but 5 cases, in which no adenomas could be found intraoperatively. By venous catheterization of the neck and upper region of the thorax, an average of 10 blood samples per patient were taken. Parathyroid hormone was estimated by radioimmunoassay with high sensitivity against the intact PTH-molecule and carboxy-terminal fragments. Only in 24 out of 72 cases was localization of parathyroid adenomas prognosticated correctly with respect to side and height, while in a total of 38 cases localization on the right or left side only could be determined preoperatively. These unsatisfactory results can be improved only by a much more extensive catheterization technic which would be justified only in patients already operated on before without success. The final evaluation of non-invasive methods, e.g. ultrasonics and computerized tomography, is still under discussion. PMID- 6867656 TI - [Does PVP-iodine disinfection of newborn infants cause transient hypothyroidism? Report on 6 cases and prospective study of 19 early operated infants using T4 and TSH determinations of dried blood samples]. PMID- 6867655 TI - ["Aquarium allergy": fish food, another domestic allergen]. AB - The authors report 7 cases of allergic respiratory diseases such as asthma, allergic rhinitis and bronchitis, induced by non-occupational contact with pet fish food. Food for pet fish contains proteins of a variety of arthropod species (larvae and adult forms) --e.g. Chironomus, Daphnia, brine shrimps and others - as well as fresh-water worms such as Tubifex, Enchytraea etc. Thus far only hemoglobins of Chironomus have been well studied with regard to their antigenic role; sensitization against Chironomus was noticed in most of our patients. Daphnia is also known to be a specific allergen. Atopic patients often become sensitized against further respiratory allergens (5 out of the 7 patients had a previous allergy against pollen). Accordingly, patients with respiratory diseases of already known allergic origin should, in our opinion, give up not only mammals or birds as household pets but also an aquarium. PMID- 6867657 TI - [Course spectrum of hepatitis A. Relation to epidemiologic, biochemical and histological findings in hospitalized patients]. PMID- 6867658 TI - [Causes of death in cases of lymphoma, myeloma and Hodgkin disease. Study of 218 cases]. AB - An autopsy study of 218 cases of lymphoproliferative disease was performed to establish the cause of death. It covered 144 cases of malignant nonHodgkin's lymphoma, 23 cases of Hodgkin's disease and 51 cases of myeloma. It was established that infection is by far the most frequent cause (34% of cases) followed by tumor invasion (11.5% of cases), hemorrhage (9% of cases) and other pathologies linked to the basic process (10% of cases). The proportion of patients who die from intercurrent illness is still considerable (62 cases, 28%). Infection is most often pulmonary or systemic; gram-negative bacteria play a predominant role. Toxicity of treatment is obvious in causing neutropenia and thrombocytopenia among other side effects with fatal consequences. PMID- 6867659 TI - [Findings in the upper gastrointestinal tract in Crohn disease]. AB - The features, frequency and clinical significance of Crohn's lesions in the upper gastrointestinal tract have been investigated. In 11 out of 28 randomly selected patients, lesions which may be caused by Crohn's disease were found on panendoscopy. These were serpiginous ulcerations in the pars II of the duodenum, as well as aphthous-like lesions and polypoid mucosal folds in the esophagus, antrum and duodenum. In 2 cases each of polypoid folds and aphthous-like lesions, the diagnosis was corroborated by histological finding of a granulomatous inflammation. The lesions suspected to be caused by Crohn's disease were found especially in younger patients and were accompanied by upper abdominal symptoms, but showed no correlation with the clinical activity of the disease. PMID- 6867660 TI - [Endoscopic papillotomy--analysis of complications]. AB - Complications were observed in 19 out of 250 patients undergoing endoscopic papillotomy. In 215 patients in whom papillotomy was successful the frequency of complications was 2.8%, in contrast to 37% in 35 patients with failed therapy (p less than 0.0001). Furthermore, the complications of successful papillotomy were observed immediately, except in one patient with gallstone ileus. The following 19 complications were observed: cholangitis (5), pancreatitis (5), bleeding (5), perforation (2), impaction of the Dormia basket (1), and gallstone ileus (1). Three patients died, all as a result of cholangitis (mortality 1.2%). All patients with pancreatitis had previously had a precutting. PMID- 6867661 TI - [Pregnancy and labor in a mother with Silver-Russel syndrome]. AB - A 23-year-old primigravida admitted to the labor room one week prior to term because of bleeding was known to have a congenital asymmetry, but a heart defect, which decisively affected the course of delivery, had been undiagnosed up to that time. Secondary caesarean section was necessary for fetal and maternal indications. In women with congenital hemihypertrophy or hemihypotrophy (Silver Russel syndrome), any associated malformations should be ruled out prior to pregnancy. PMID- 6867662 TI - [History of the use of antimicrobial substances in animal nutrition]. PMID- 6867664 TI - [Antimicrobial therapy through fodder]. PMID- 6867663 TI - [Growth-promoting antimicrobial substances]. PMID- 6867665 TI - [Current use of growth promoters for the calf]. PMID- 6867666 TI - [Use of growth promoters for swine]. PMID- 6867667 TI - [Production and use of medicated feed]. PMID- 6867668 TI - [Use of medicated feed for the calf]. PMID- 6867669 TI - [Use of medicated feed for swine]. PMID- 6867670 TI - [Effects and consequences of antibiotic supplementation on the resistance of Enterobacteriaceae in livestock]. PMID- 6867671 TI - [Antimicrobial residues in slaughtered animals]. PMID- 6867672 TI - [Legal aspects and control of the use of growth promoters]. PMID- 6867673 TI - [Legal regulation and control of the use of medicated feed]. PMID- 6867675 TI - [Nutrition in bicycle racing]. PMID- 6867674 TI - [Ideas on the future use of antimicrobial substances from the microbiologist's viewpoint]. PMID- 6867676 TI - [Effort thrombosis of the lower extremities in athletes]. PMID- 6867677 TI - [Evaluation of a new knee bandage]. PMID- 6867678 TI - [Swimming for infants]. PMID- 6867679 TI - [Nutrition for the athlete: general principles and special problems]. PMID- 6867680 TI - Regeneration of re-covered bark in Eucommia ulmoides. AB - The girdled trunk of Eucommia ulmoides, sometimes could not regenerate a new bark due to ringed surface necrosis. But, if an extension of 10cm of the bark on each end of the necrotic part was removed in time and re-covered with new bark taken from another tree, the re-covered bark and the newly girdled part could heal together one week after. Opposite to the necrotic surface the loose part of the re-covered bark regenerated callus from the phloem ray cells. If the re-covered part was very close to the necrotic surface, no callus was regenerated. However, many scattered tracheid-like elements derived from phloem were found. And then groups of cells including several tracheid-like elements were discernible. There was a ring of meristematic cells around that group of cells. Finally these meristems gradually became normal and had usual activities of vascular cambium. PMID- 6867681 TI - Changes on electroencephalogram under acute hypoxia and relationship between tolerant ability to hypoxia and adaptation ability to high altitudes. PMID- 6867683 TI - A new method for calculating the absorption amount of drug. AB - In this paper, a new method is suggested for calculating the absorption amount of drug. The method is based on the general linear compartment model for pharmacokinetics, hence applicable to any proper linear compartment model for pharmacokinetics. For the linear one compartment model, it is in agreement with the Wagner-Nelson method which is often used nowadays. For the linear two compartment model, it has advantages over the Loo-Riegelman method, which is also in common use in, for example, simplicity in mathematical derivation, less computation, etc. And it can be easily extended to some particular nonlinear compartment model. PMID- 6867682 TI - Study of inhibitory effect of amygdaloid stimulation on auditory response of medial geniculate body (MGB) and analysis of transmissive pathway of the said effect. AB - Experiments performed on 103 rabbits immobilized with Flaxedil, and the recording of the electrical discharges of single MGB neuron caused by clicks, burst or sustained tone showed marked inhibition of the reaction of 47 out of 75 (62.7%) MGB units responding to sound stimuli, when the amygdaloid complex was stimulated. The latent period of such an inhibitory effect was 5-12 msec and its duration about 2-13 msec. Evoked responses with the latency of 1-2 msec for the stimulation of medial, central and lateral nuclei of amygdala could be recorded from the temporal and parietal cortex. The largest response was recorded from Woolsey's AI area of the temporal cortex. Stimulation of the Woolsey's AI auditory area could also result in a distinct inhibition of the spontaneous as well as the evoked discharges of MGB neurons in response to sound stimulation. Moreover, application of 1% procaine to the surface of auditory cortex could block the inhibitory effect of the amygdala on the MGB neurons. Based on the facts mentioned above, the authors have reason to believe that the inhibitory effect of the amygdaloid complex on the activity of MGB units might be transmitted via the amygdala-auditory cortex-MGB circuit. The biological significance of such an suppressive effect has been discussed. PMID- 6867684 TI - Responses of neurons in parafascicular nucleus to severe radiant heat stimulation. AB - On radiant heat stimulation of the sole of the hind foot of rat, the neurons in the parafascicular nucleus of thalamus would not respond until the skin temperature was raised to 45 degrees C. If there had been existing discharges in these neurons prior to the test, these discharges may be inhibited by the innocuous heat stimulus at temperatures below 45 degrees C. The warmth, or the heat below the innocuous level was unable not only to produce but also to inhibit the nociceptive neuronal discharges incurred by previous nocuous stimulation. This phenomenon is regarded as a manifestation of one of the general principles on which the interpretation of acupuncture analgesia is based. PMID- 6867685 TI - Time-lapse microcinematographic and phase contrast studies on the cell reformation of Chirocephalus yolk granules in vitro. AB - In this article we report on a time-lapse microcinematographic and phase contrast study of the cell reformation of yolk granules which were isolated from mature oocytes in the genital sac of the middle female intersex of Chirocephalus nankinensis. The observations on yolk granules were made in fixed positions and the morphological changes of cell reformation were continuously recorded in vitro. The transformation of yolk granules into cellular structures may be tentatively described as follows: At the early stages in culture, it can be seen that the granular or bubbly structures gradually appear within the hyaloid and homogeneous yolk granules; the appearance of yolk granules gradually changes from elliptical into round shape. With further transformation, their appearances in general take the shape of oblate spheroids, their size is smaller than before and inside the yolk granules their granular and bubbly structures become more and more obvious. Finally, the nuclear and cellular structures can be seen in these transforming yolks. By means of time-lapse microcinematographic and phase contrast examinations in fixed positions, single yolk granules obtained from the mature oocyte with little amounts of adhering cytoplasm are continuously recorded and have been shown to occur, steadily and gradually build up cellular structures by self-organization and self-assembly. Up to the present, we have cultured these kinds of cellular organizations repeatedly. Therefore, it can be concluded that the existence of cell reformation on the basis of yolk granules according to the dynamic morphological changes is an objective reality. PMID- 6867686 TI - Management of heart failure. PMID- 6867688 TI - Radiation under phototherapy and its relationship to clinical effectiveness in moderately severe neonatal jaundice. AB - Radiation under four commercially available phototherapy units was measured over the visual spectrum and demonstrated that between 69 and 87 per cent of the radiation was irrelevant to the photodegradation of bilirubin. When infants with moderately severe physiological jaundice were exposed to three of the same phototherapy units under the same conditions there was no demonstrable difference in the apparent rate of decline of serum bilirubin or in length of treatment required. PMID- 6867687 TI - Phototherapy: current status and future prospects. PMID- 6867689 TI - The pre-operative electrocardiogram: an assessment. AB - Electrocardiography is of limited value in pre-operative screening for cardiac disease. A short questionnaire has been shown to be helpful in assessing cardiac status and could permit a 30% reduction in the number of pre-operative ECGs performed. PMID- 6867690 TI - Perinatal paroxysmal supraventricular tachycardia. AB - Three cases of perinatal paroxysmal supraventricular tachycardia are described. In two patients the tachycardia was present prior to delivery; in the third baby, who also had the Wolf-Parkinson-White Syndrome, the time of onset of tachycardia is not known. The risks of this condition to the foetus are largely unknown but severe intra-uterine cardiac failure can occur. Possible lines of management are discussed. PMID- 6867691 TI - Skull X-rays in minor head injury. A review of their use and interpretation by casualty officers. AB - A retrospective review of the value of skull X-rays in the management of 1379 patients presenting to an accident and emergency department with minor head injuries was made. Ten skull fractures were identified in this group (an incidence of 0.7%) of which only four were identified by the casualty officer, the remainder being subsequently identified by the radiologist. Some 90 per cent of patients had no history of concussion, and 33 per cent had no external evidence of head injury. All patients with fractures were admitted because of clinical criteria so that skull X-rays played no part in determining whether patients were admitted for observation or not. Only one patient required operative intervention for a compound depressed fracture, and no patient developed an intracranial haematoma. It is concluded that there is need to educate casualty officers on the indications for, and interpretation of skull X rays. It is hoped that this might decrease the cost to the Health Service of needless skull X-rays, without detriment to the standards of patient care. PMID- 6867692 TI - Improved vascular access for patients receiving chemotherapy. AB - Indwelling central venous catheters were used for vascular access in 25 oncology patients. The lines were used for sampling, administration of blood products, chemotherapeutic agents, parenteral nutrients and occasionally plasmapheresis. The complication rate was no higher than in reported series in which the catheters were reserved for parenteral nutrition. We believe that a central venous cannula can be safely used as the sole means of vascular access in those patients with consequent psychological and practical benefits. PMID- 6867693 TI - Acute haematogenous osteitis--a ten year review. AB - Sixty-four cases of acute haematogenous osteitis have been reviewed. The majority of these patients have been treated by high dose intravenous bolus injection of Cloxacillin. With this regime a primary healing rate of 96.8 per cent was achieved with a surgical intervention rate of 4.6 per cent. It is concluded that routine surgery is not required in the treatment of this condition and that the mainstay of treatment should be vigorous antibiotic therapy. PMID- 6867695 TI - The localisation of parathyroid tumours--a comparison of computed tomography with cervical vein hormone assay. AB - Computed tomography has been employed for the localisation of parathyroid tissue in 26 patients with primary hyperparathyroidism. In 14 of these selective venous catheter studies with parathyroid hormone assay were also undertaken. Computed tomography proved unreliable, identifying only 39 per cent whereas the cervical venous hormone assay studies localised 69 per cent of lesions correctly--a figure which is in agreement with several other groups. On balance our results suggest that neither technique should be routinely employed pre-operatively but that, following unsuccessful parathyroid surgery, the most useful localisation technique remains venous hormone assay. PMID- 6867694 TI - Pre-operative localisation of parathyroid tumours using neck vein catheterisation and radioimmunoassay for parathyroid hormone: the Glasgow experience. AB - Reliable pre-operative localisation of parathyroid tumours can be of value in surgery for primary hyperparathyroidism, and particularly so where re-exploration of the neck is required. Neck vein catheterisation and parathyroid hormone radioimmunoassay have been suggested as a sensitive means of tumour localisation, and we report our experience of the technique over the last five years. A total of 46 patients with primary hyperparathyroidism had 50 studies performed with positive localisation and a pre-operative prediction made on 38 occasions (76%). Forty-two operations were carried out and a parathyroid tumour confirmed in 39 cases for a localisation efficiency of 69 per cent. No negative neck exploration followed a positive localisation. Twelve studies were performed in patients with renal osteodystrophy and localisation to a single site was achieved on only three occasions. It is concluded that neck vein catheterisation and parathyroid hormone assay can correctly localise parathyroid tumours in most cases of primary hyperparathyroidism, but it is suggested that its use be restricted to selected cases such as those subjects with previous negative neck exploration or patients for whom prolonged or repeated surgery may be a particular hazard. PMID- 6867696 TI - ECHO virus type 30 meningitis in Edinburgh. AB - Fifty-five patients with ECHO virus type 30 meningitis were admitted to the Infectious Diseases Unit, Edinburgh City Hospital between August and December 1980. There was a preponderance of males and patients aged 10-15 years. The peak admission rate was about two weeks earlier than that recorded for Scotland as a whole. Helpful diagnostic findings were headache, fever, photophobia, vomiting and nuchal rigidity but not Kernig's sign. Only one patient had a rash. The majority of patients were admitted within 48 hours of the onset of symptoms. The CSF pleiocytosis was high and tended to be polymorphonuclear in type. CSF glucose concentrations were all normal. There were no serious sequelae. The considerable morbidity reported after leaving hospital emphasises the importance of adequate convalescence. PMID- 6867697 TI - Cimetidine in primary duodenal ulcer in children. AB - Of 16 children with primary duodenal ulcer, 11 had complete relief of symptoms with initial full dose cimetidine therapy. After stopping cimetidine two of these 11 relapsed, six are in remission and three occasionally complain of abdominal pain requiring antacids. The remaining five children showed no improvement at all. Only one out of the 16 children showed side-effects due to cimetidine. Although there was wide variation in dosage of cimetidine and duration of therapy, no significant difference was noted in the dosage regimen of responders and non-responders to cimetidine. We suggest, full dose cimetidine 20 to 40 mg/Kg/day for 4 to 8 weeks, followed by 8 mg/Kg nocte daily for another 4 to 8 weeks. PMID- 6867698 TI - Group meetings for parents in a children's burns unit. AB - Thermal injuries in childhood occur mainly in the first three years of life and often lead to hospital admission: most are due to scalds in the home. The distress and anxiety of parents bears on the management of the young sick child in hospital, on his subsequent recovery at home and on the welfare of the whole family. To help parents, a weekly meeting was held with a small group of staff in the Burns Unit at which there was free and open discussion of all problems and worries connected with the child's accident. This paper describes the working of the group and the contribution it made to the care of 149 children admitted with burns and scalds during one year. PMID- 6867699 TI - Total body potassium in patients receiving chlorthalidone and metoprolol for hypertension. AB - Measurements of potassium status were reviewed in 23 hypertensive patients receiving metoprolol either alone or in combination with chlorthalidone or chlorthalidone plus potassium over an average period of nine months. There was no statistically significant change in plasma potassium, total blood cell or total body potassium in patients on long-term metoprolol. Four subjects (17%) in the diuretic groups developed hypokalaemia (serum potassium less than 3.0 mmol/l) in the absence of significant falls in total blood cell or total body potassium. Thus the use of chlorthalidone plus potassium did not provide adequate prophylaxis against hypokalaemia even in metoprolol recipients. The study confirms that monitoring parameters of potassium handling is still necessary in beta-blocker recipients who also receive diuretics alone or in a fixed-dose combination with potassium. PMID- 6867700 TI - Salmonella virchow: a cause of significant bloodstream invasion. AB - Salmonella virchow, a food poisoning strain previously only sporadically responsible for disease, has recently been isolated with increasing frequency in Scotland. The experience of infections due to this organism in 1980 in an infectious diseases unit is reported. Nine of 15 patients consecutively admitted with infection due to this organism were found to be septicaemic on blood culture thus highlighting the invasive propensity of this serotype. PMID- 6867701 TI - Staphylococcal septicaemia complicated by probable cloxacillin neurotoxicity and by jaundice induced by fusidic acid. AB - Two weeks following a renal arteriogram a 56-year-old man with severe hypertension developed a staphylococcal septicaemia. After six weeks treatment with intravenous fusidic acid and cloxacillin he became icteric, confused and disorientated. The fusidic acid was stopped and the serum bilirubin fell to normal. His confusion persisted and serum cloxacillin levels were found to be grossly elevated. The patient's mental state returned to normal following withdrawal of cloxacillin. We attribute his jaundice to treatment with fusidic acid and his acute confusional state to cloxacillin neurotoxicity. PMID- 6867702 TI - Anaemia in the hydrallazine-induced Lupus syndrome. PMID- 6867703 TI - Eosinophilic gastroenteritis presenting as acute intestinal obstruction. AB - Eosinophilic gastroenteritis is an uncommon condition which usually affects the antrum of the stomach and may occasionally involve the small or large intestine (1). The main clinical feature is usually that of chronic colicky abdominal pain. We report a case presenting as acute small intestinal obstruction due to isolated involvement of the distal small intestine. PMID- 6867704 TI - Comparison of measured and modelled mesoscale SO2-patterns in the Benelux. PMID- 6867705 TI - Relationship between trace element concentrations in human blood and atmospheric aerosol. AB - Trace element concentrations in human blood from the U.K., measured by Hamilton et al., are found to be correlated to those of atmospheric aerosol from the U.K., or to an aerosol composition averaged over the globe. The correlation to aerosol is much stronger than to crustal rock or sea water. Elemental enrichment factors for blood are all equal to or greater than those for aerosol. Two possible reasons for the correlation are advanced: aerosol is probably a major source of the trace elements which enter the food chain, and aerosol samples the earth's surface where the food chain originates. The present finding suggests that aerosol plays a major role in the global cycling of the trace elements which enter the blood, with important implications for human health. PMID- 6867709 TI - Human cancer research. PMID- 6867708 TI - Body burden of cadmium in man at low level of exposure. AB - Specimens of heart, kidney, liver, lung, pancreas and skeletal muscle were collected at autopsy from 86 traumatic accident victims. The concentration of cadmium in the samples was determined by atomic absorption spectrophotometry. Tissue burdens and the body burden of cadmium were calculated using individual weights of different organs as a function of age. Total body burden reached its maximum level of approximately 8 mg, in the 30-39 year age group. The highest value (8.3 mg) was measured in the 40-49 year age group. The highest average value of tissue burdens at 40-49 years of age was in kidney (4.9 mg), the amount of cadmium diminishing in different tissues in the following order: liver (1.8 mg), muscle (0.15 mg), lung (0.09 mg), pancreas (0.06 mg) and heart (less than 0.01 mg). At a low level of exposure, kidneys and liver alone contain on an average 85% of the total body burden of cadmium. This value differs greatly from earlier reported figures of 45-50%. PMID- 6867710 TI - Potassium iodide: policy in New York. PMID- 6867707 TI - Concentrations of morphologically normal, motile spermatozoa: Mg, Ca and Zn in the semen of infertile men. AB - Semen from infertile men (n = 23) has been compared with that of control subjects (n = 25). Whereas the concentrations of morphologically normal, motile sperms, Mg, Ca and Zn fell within the acceptable limits for all the control subjects, only two infertile men qualified by all five parameters. Of the patient group, seven were abnormal on all counts; sperm motility, Mg and Zn were low in 16, Ca in 19 and abnormal morphology was encountered in 12. Since there was no linear correlation between any two parameters, it is possible that each factor may singly or jointly influence the physiological integrity of the spermatozoa. The results are discussed from a consideration of pathological manifestations known to occur in deficiency of these trace elements a propos their role in determining the fertility index of the semen. PMID- 6867711 TI - High-resolution scanning transmission electron microscopy. PMID- 6867712 TI - Funding more NIH research grants. AB - Because of the prospect of a serious decline in the nation's biomedical research capacity owing to diminished federal appropriations, temporary measures should be initiated promptly by the National Institutes of Health to preserve the stability of resources and diversity of research required for future productivity. It is recommended that the available funds be distributed in such a way as to permit some support for 50 percent of competing grant applications approved by the National Institutes of Health study sections. Measures proposed for consideration are a sliding scale for funding, a greater across-the-board reduction, a limit on support for an individual laboratory, and a review of indirect costs. PMID- 6867706 TI - Infants with a congenital anomaly and the concentration of Mo, As, Mn, Zn and Cu in the mother's milk. AB - Thirty-one samples of mothers' milk were analysed by neutron activation analysis for the concentrations of Mo, As, Mn, Zn, Cu 1.5 to 3 months post-partum. Group I consisted of 6 mothers having infants with neonatal obstructive jaundice and exhibited lower mean values of Cu and Mn at 0.18 microgram/g and 11.7 micrograms/g as compared with 16 control subjects with 0.34 microgram/g Cu and 23.0 micrograms/g Mn;Mo levels were approximately twice as high (12.2 micrograms/g) as the control values (6.4 micrograms/g); Zn and As were grossly comparable. Group II consisted of 9 mothers who had delivered infants with either a congenital hydrocephalus (n = 7) or meningomyelocoele (n = 2), exhibited a mean Cu level of 0.27 microgram/g, Zn 1.7 micrograms/g, Mn 25.3 micrograms/g and As 0.45 microgram/g. These findings are discussed in the light of the patho physiology of the congenital anomaly of the infant. PMID- 6867713 TI - Gestural communication in deaf children: noneffect of parental input on language development. AB - Young deaf children who were unable to acquire oral language naturally and who had not been exposed to a conventional manual language were found to use spontaneously a gesture system that has some of the structural characteristics of early child language. The structural aspects of this gesture system appeared to be neither modeled for the child by the gestures of an adult nor shaped by the responses of an adult. These findings suggest that the child may contribute to structural aspects of the system. PMID- 6867715 TI - Forms of memory failure. AB - Memory may fail in a variety of ways. Patients with Korsakoff's syndrome demonstrate global memory deficits similar to those seen in patients with early progressive dementia. Korsakoff's patients, however, may recall rules and principles for organizing information and can gain access to their previously acquired knowledge (semantic memory), whereas recent memory may be grossly impaired. In contrast, dementia patients may have little access to previously acquired knowledge and therefore have great difficulty in organizing and encoding ongoing events. These contrasting forms of memory failure have implications for understanding the structure and mechanisms of memory and learning, particularly the relationship between episodic and semantic memory, as well as the development of therapeutic strategies for cognitive impairments. PMID- 6867714 TI - Magnesium deficiency-induced spasms of umbilical vessels: relation to preeclampsia, hypertension, growth retardation. AB - Isolated umbilical arteries and veins, obtained from normal women at the end of pregnancy, were incubated in krebs-Ringer bicarbonate solution and exposed to magnesium at concentrations ranging from 0 to 9.6 millimoles per liter. The basal tension of the vessels increased when magnesium was withdrawn and decreased when the concentration of magnesium was raised. Absence of magnesium in the medium significantly potentiated the contractile response of the vessels to bradykinin, angiotensin II, serotonin, and prostaglandin F2 alpha. It appears that magnesium deficiency may be responsible for spasms of umbilical and placental vasculature. Our findings may provide a rationale for why magnesium sulfate is an effective therapy in preeclamptic syndromes in pregnant women. PMID- 6867716 TI - Spectral consequences of photoreceptor sampling in the rhesus retina. AB - Optical transforms were used to compute the power spectra of rhesus cones treated as arrays of image sampling points. Spectra were obtained for the central fovea, parafovea, periphery, and far periphery. All were consistent with a novel spatial sampling principle that introduces minimal noise for spatial frequencies below the Nyquist limits implied by local receptor densities, while frequencies above the nominal Nyquist limits are not converted into conspicuous moire patterns, but instead are scattered into broadband noise. This sampling scheme allows the visual system to escape aliasing distortion despite a large mismatch between retinal image bandwidth and the Nyquist limits implied by extrafoveal cone densities. PMID- 6867717 TI - Consequences of spatial sampling by a human photoreceptor mosaic. AB - The short wavelength color mechanism in the human visual system can distinguish gratings from uniform fields of the same average radiance at spatial frequencies that are twice as high as the highest at which it can resolve bars in the grating. This discrimination above the resolution limit is associated with a splotchy or mottled appearance of the grating similar to two-dimensional noise. The most plausible explanation for the mottled pattern is that it is a moire pattern produced by aliasing (spatial undersampling) by an irregular and sparse mosaic of short wavelength cones. PMID- 6867718 TI - Interactions among converging sensory inputs in the superior colliculus. AB - The responses of superior colliculus cells to a given sensory stimulus were influenced by the presence or absence of other sensory cues. By pooling sensory inputs, many superior colliculus cells seem to amplify the effects of subtle environmental cues in certain conditions, whereas in others, responses to normally effective stimuli can be blocked. The observations illustrate the dynamic, interactive nature of the multisensory inputs which characterize the deeper laminae of the superior colliculus. PMID- 6867720 TI - AIDS fears spark row over vaccine. PMID- 6867719 TI - Congress, NIH open coffers for AIDS. PMID- 6867721 TI - FDA draws criticism on prenatal test. PMID- 6867722 TI - Calcium-dependent stress maintenance without myosin phosphorylation in skinned smooth muscle. AB - Stress development depended on calcium-stimulated myosin phosphorylation in an arterial smooth muscle preparation in which the concentration of calcium was controlled. However, developed stress was maintained at a concentration of calcium that did not support phosphorylation. These results, in conjunction with other evidence, suggest that the interaction of two regulatory mechanisms with different calcium sensitivities regulate both stress and the rate and energetics of contraction. PMID- 6867723 TI - Electrical synapse formation depends on interaction of mutually growing neurites. AB - A neuron's competence to form electrical synapses depends on its growth status. Experiments in situ and in cell culture with identified neurons of the snail Helisoma demonstrate that active neurite outgrowth from both potential partners must be spatially and temporally coincident for electrical synapse formation to occur. PMID- 6867724 TI - Endogenous inhibitors of monoamine oxidase present in human cerebrospinal fluid. AB - Inhibitory activity against the enzyme monoamine oxidase is present in low molecular weight fractions (less than 100,000) of human cerebrospinal fluid. These endogenous substances of different molecular weights (3000 to more than 35,000) act like monoamine oxidase inhibitor drugs to inhibit both type A and type B monoamine oxidase. PMID- 6867725 TI - Evidence for olfactory function in utero. AB - Pregnant rats received 2-[14C]deoxy-D-glucose (2DG) intravenously on the last day of gestation, and their fetuses were delivered 1 hour later by cesarean section. Fetal brains showed high 2DG uptake spread throughout the accessory olfactory bulb and little or no differential uptake in the main olfactory bulb. These findings demonstrate that functional activity occurs in the accessory olfactory bulb in utero and suggest that the accessory olfactory system may be the pathway by which fetal rats detect the odor quality of their intrauterine milieu. PMID- 6867727 TI - Delaware battles Hughes Institute. PMID- 6867726 TI - Accurate visual measurement of three-dimensional moving patterns. AB - Human observers discriminated relative three-dimensional distances in simple patterns of motion parallax with an acuity similar to vernier acuity under comparable conditions. Accurate visual measures of three-dimensional distance can be derived from the structural invariance of patterns undergoing perspective transformations. PMID- 6867728 TI - Cell surgery to reconnect nerves. PMID- 6867729 TI - The immune response evokes changes in brain noradrenergic neurons. AB - A decreased noradrenaline turnover in the hypothalami of rats was observed at the peak of the immune response to sheep red blood cells. The decrease in noradrenergic neuronal activity was mimicked by injection of soluble r mediators released by immunological cells activated in vitro. Noradrenaline also tended to decrease in the brainstem but not in the residual brain. It is suggested that products released from activated immunological cells during the immune response may induce the previously described autonomic and endocrine mechanisms that contribute to immunoregulation. PMID- 6867731 TI - Local cerebral blood flow increases during auditory and emotional processing in the conscious rat. AB - Local cerebral blood flow was measured in rats by the 14C-labeled iodoantipyrine technique with quantitative autoradiography during the processing of environmental stimuli. Presentation of a tone increased blood flow in the auditory but not the visual pathway. When the animal had previously been conditioned to fear the tone, blood flow additionally increased in the hypothalamus and amygdala. Local cerebral blood flow can thus be used to detect patterns of cerebral excitation associated with transient (30- to 40-second) mental events in experimental animals. PMID- 6867730 TI - Rate of synaptic replacement in denervated rat hippocampus declines precipitously from the juvenile period to adulthood. AB - Synaptic contacts per unit area in the rat dentate gyrus reach adult numbers by the end of the first month after birth and remain constant thereafter. This experiment demonstrated that the rate at which synapses were replaced by sprouting after a lesion declined dramatically from 35 to 90 days of age. Thus, the juvenile period of the rat's life is marked by a considerable change in neuronal plasticity. This may be related to age-dependent effects in recovery from brain damage. PMID- 6867733 TI - Nuclear magnetic resonance blood flow measurements in the human brain. AB - Timed sequences of nuclear magnetic resonance imaging signals in the human head were used to quantitatively measure blood flow in the internal jugular veins. The procedure can be straightforwardly applied to any vein or artery in the body. PMID- 6867732 TI - Choline and cholinergic neurons. AB - Mammalian neurons can synthesize choline by methylating phosphatidylethanolamine and hydrolyzing the resulting phosphatidylcholine. This process is stimulated by catecholamines. The phosphatidylethanolamine is synthesized in part from phosphatidylserine; hence the amino acids methionine (acting after conversion to S-adenosylmethionine) and serine can be the ultimate precursors of choline. Brain choline concentrations are generally higher than plasma concentrations, but depend on plasma concentrations because of the kinetic characteristics of the blood-brain-barrier transport system. When cholinergic neurons are activated, acetylcholine release can be enhanced by treatments that increase plasma choline (for example, consumption of certain foods). PMID- 6867734 TI - 5-hydroxytryptophan elevates serum melatonin. AB - Daytime administration of 5-hydroxytryptophan to sheep elevated serum melatonin more than sevenfold within 2 hours. This suggests that administration of 5 hydroxytryptophan could be used as the basis of a clinical test of pineal function and that melatonin might mediate some clinical effects of 5 hydroxytryptophan. PMID- 6867735 TI - Chromosomal mosaicism confined to the placenta in human conceptions. AB - Placental and fetal tissues from 46 human pregnancies were cultured and cytogenetically analyzed in an attempt to document the existence of chromosomal mosaicism confined strictly to tissues of extraembryonic origin. In two gestations in which chromosomal mosaicism was found, it was expressed exclusively in placental chorionic cells and was not detected in cells derived from the embryo proper. This demonstration of confined chorionic mosaicism may have implications for the understanding of the fetoplacental unit and for prenatal diagnosis. PMID- 6867736 TI - Hepatitis B virus infection in cultured human lymphoblastoid cells. AB - Since it has been postulated that liver hepatocytes may become infected by hepatitis B virus (HBV) in vivo through direct contact with infected macrophages, the possibility that a circulating cell of hematopoietic origin might be susceptible to infection with HBV was investigated. Cells positive for HBV surface antigen were identified in aspirates of bone marrow cells from people infected with HBV. These cells were used to prepare a lymphoblastoid suspension culture that contains HBV-infected cells. PMID- 6867737 TI - Naltrexone modulates tumor response in mice with neuroblastoma. AB - Naltrexone, an opiate antagonist, had both stimulatory and inhibitory effects, depending on the dosage, on the growth of S20Y neuroblastoma in A/Jax mice. Daily injections of 0.1 milligram of naltrexone per kilogram of body weight, which blocked morphine-induced analgesia for 4 to 6 hours per day, resulted in a 33 percent tumor incidence, a 98 percent delay in the time before tumor appearance, and a 36 percent increase in survival time. Neuroblastoma-inoculated mice receiving 10 milligrams of naltrexone per kilogram, which blocked morphine induced analgesia for 24 hours per day, had a 100 percent tumor incidence, a 27 percent reduction in the time before tumor appearance, and a 19 percent decrease in survival time. Inoculation of neuroblastoma cells in control subjects resulted in 100 percent tumor incidence within 29 days. These results show that naltrexone can modulate tumor response and suggest a role for the endorphin-opiate receptor system in neuro-oncogenic events. PMID- 6867738 TI - Ventral posterior thalamic neurons differentially responsive to noxious stimulation of the awake monkey. AB - Of 76 cutaneously activated neurons recorded from the ventral posterior thalamus of awake, behaving monkeys, nine were weakly excited by innocuous skin stimulation and responded maximally only when noxious mechanical cutaneous stimuli were delivered within small, contralateral receptive fields. These results show that neurons capable of encoding the spatial and temporal features of noxious stimuli are located in the ventral posterior thalamus of the awake primate. PMID- 6867739 TI - Alcohol self-administration disrupts reproductive function in female macaque monkeys. AB - Female macaque monkeys self-administered high doses of alcohol (2.9 to 4.4 grams per kilogram per day) for 3 to 6 1/2 months. Amenorrhea, atrophy of the uterus, decreased ovarian mass, and significant depression of luteinizing hormone levels were associated with chronic alcohol intoxication. Reproductive system failure in female primates following self-induced dependence on alcohol parallels the results of clinical studies of alcoholic women. PMID- 6867740 TI - Radioisotopic labeling of platelets: a historical perspective. PMID- 6867742 TI - The modern thrust of manipulation and traction therapy. PMID- 6867741 TI - What do we know about the sacroiliac joint? PMID- 6867743 TI - Radionuclide evaluation of peripheral vascular injuries. AB - Radionuclide techniques have become an important modality for the detection and evaluation of peripheral vascular trauma. The presence of significant vascular injury can be diagnosed using essentially noninvasive procedures. A normal radionuclide angiogram reliably indicates the absence of injury to the major peripheral arterial vessels. An abnormal study suggests that further diagnostic maneuvers may be indicated. PMID- 6867744 TI - Bilateral visualization on adrenal cortical scintigraphy. PMID- 6867745 TI - Causes of focal hepatic portal defect on 99mTc-sulfur colloid scintigraphy. PMID- 6867746 TI - Photon-deficient areas around the heart. PMID- 6867747 TI - "Ring" sign in gallium-67 abdominal imaging. PMID- 6867748 TI - A surgeon's view of the role of radionuclide imaging in evaluating trauma. PMID- 6867749 TI - Complementary roles of radionuclide and computed tomographic imaging in evaluating trauma. AB - For 6 consecutive months all triage acceptable emergency room patients at the St. Francis Medical Center with blunt or penetrating trauma involving the abdomen were included in this review. Computed tomography and radionuclide imaging of the abdomen and urinary tract was performed in addition to the usually indicated diagnostic procedures. In our hospital the Radiology Department is adjacent to the Emergency Department. Close cooperation of the trauma team, the imaging physician and the technologists, has provided a stable, reproducible pattern in the performance and evaluation of nuclear medicine and radiographic techniques. Teleradiologic techniques of image transmission over the telephone lines permits immediate availability of the expertise of the radiologist. This correlation has provided an opportunity for improving patient care and refining our protocol in the care and management of the acutely traumatized patient. One-hundred-twenty seven patients classed as acute trauma cases were processed during those 6 mo. Forty-two of these patients were not included in this study. They were triaged as immediate surgical emergencies, had incurred injury limited to the head, extremities or thorax, or were not injured sufficiently to require the special care of the designated trauma team. The 85 patients in this study included 56 males and 29 females. The patient age ranged from 3- to 71-yr-of-age. The median age was 29.3 yr. The author feels the findings in this evaluation of the complementary roles of radionuclide imaging and computed tomography should be of value to others in the formulation of their acute trauma care protocol. Nuclear medicine techniques retain an important role in the diagnosis of several sequelae of head trauma. Sensitivity and accuracy for detection of subdural hematoma are not as high as those of transmission computed tomography even if proper techniques are employed. Other important applications, however, include the diagnosis of normal pressure hydrocephalus, location of cerebrospinal fluid leakage, and confirmation of brain death. PMID- 6867750 TI - Roentgenographic techniques for the diagnosis and management of liver tumors. PMID- 6867752 TI - Nursing issues for hepatic arterial infusion therapy. PMID- 6867751 TI - Ambulatory pump infusion devices for hepatic artery infusion. PMID- 6867753 TI - Determination of response in treatment of hepatic neoplasia. AB - The determination of objective antitumor response by therapeutic modalities is a complex process limited by the resolution of available tools. Nonetheless, within these limitations objective measurements are critical to the identification of effective therapies. The determination of complete regression of hepatic metastases should not be difficult clinically, but such an event occurs only rarely. More commonly, there is no clinically measurable response, although some degree of tumor cell kill may be achieved. The recognition of such effects is limited by the inadequacy of clinical assessment tools, and the concomitant application of multiple parameters is necessary if not essential. Of the presently employed methods to measure objective antitumor response as outlined in Table 1, only the monitoring of hepatomegaly and the quantitative criteria indicated in Fig. 7 has met the critical requirement of correlation with survival. Nonetheless, the method is a relatively gross estimate and subject to major interobserver variation. Radiologic studies have similar limitations and resolution power precludes adequate assessment of small lesions. The biochemical parameters are indirect tumor effects and may modulate as a consequence of therapy on normal tissue without tumor effects. Tumor antigens and particularly sequential monitoring of plasma CEA is theoretically the most optimal means of measuring tumor growth or regression. Practical clinical application is preliminarily encouraging, but precise quantitative guidelines must be established and meet the standards of a cost-benefit analysis. The high tumor response rate in hepatic artery infusion programs offers the opportunity to determine the usefulness of plasma CEA as a specific determinant of tumor activity, and such studies are ongoing. PMID- 6867754 TI - Sequential methotrexate and 5-fluorouracil: mechanisms of synergy. AB - The finding that 5-fluorodeoxyuridylate (FdUMP), the active metabolite of 5 fluorouracil (5-FU) or 5-fluorodeoxyuridine (FUdR), requires the folate cofactor N5,N10-methylene tetrahydrofolate for tight binding to thymidylate synthetase (TS) had important potential consequences for the clinical use of these drugs. The lack of sufficient folates in the tumor cell, especially N5,N10-methylene tetrahydrofolate, would thus result in less than optimal cell kill by FUdR and possibly by 5-FU. Methotrexate (MTX) pretreatment would also decrease the level of this coenzyme by reducing tetrahydrofolate synthesis and thus could antagonize 5-FU and FUdR action. However, MTX and its polyglutamate forms also enhance binding of FdUMP to TS. In addition, we have shown that dihydrofolate polyglutamates also markedly enhance binding of FdUMP to TS. Thus, in mice bearing the sarcoma 180 tumor, pretreatment with MTX results in synergy; the opposite sequence gives less than additive antitumor effects. MTX also enhances 5 FU uptake into cells, as a consequence of increased FUra nucleotide formation that results from increased levels of intracellular phosphoribosylpyrophosphate (PRPP); PRPP is generated due to inhibition of purine synthesis by MTX. The increase in 5-FU nucleotide levels results in elevated levels not only of FdUMP but also of fluorouracil triphosphate (FUTP); this latter compound is incorporated into RNA. In addition, deoxyuridylatetriphosphate (dUTP) is incorporated into DNA when dUMP and dUTP levels increase as a consequence of MTX and/or 5-FU treatment. Biochemical data are thus beginning to accumulate, providing an understanding of the MTX/5-FU synergy that has been well documented in several experimental systems. PMID- 6867755 TI - Current studies of methotrexate and 5-fluorouracil and their interaction in human tumor cells. AB - Cell culture studies have indicated that the sequence of methotrexate (MTX) and 5 fluorouracil (5-FU) exposure influences cytotoxicity. Sequential MTX/5-FU shows synergistic effects in many cell lines, but the concentration of purines and thymidine are critical modulators of the outcome. Sequential 5-FU/MTX usually shows antagonistic cytotoxicity, and simultaneous MTX/5-FU is usually additive. The biochemical basis for the complex interaction of sequential MTX/5-FU is described, and studies of MTX/5-FU in tumor-bearing mice are reviewed. Sequential MTX/5-FU shows enhanced toxicity compared to other treatment sequences, but some studies suggest that the therapeutic index is not enhanced. Preliminary results of a randomized trial of sequential MTX/5-FU versus sequential 5-FU/MTX in cancer patients are presented. PMID- 6867756 TI - Tumors of the liver. PMID- 6867757 TI - Case of the spring season. PMID- 6867758 TI - A diagnostic algorithm for liver masses. PMID- 6867759 TI - Acute renal failure. Some new thoughts. PMID- 6867760 TI - Extended nephrolithotomy under regional hypothermia for staghorn stones. PMID- 6867761 TI - Colposcopy as a screening procedure in the evaluation of abnormal Pap smears. PMID- 6867762 TI - Continuous intra-venous Althesin as an adjunct in neuro-anaesthesia--a nine month experience. PMID- 6867763 TI - Anti-thrombin III levels in some Malaysian patients suspected of having acquired coagulation disorders. PMID- 6867764 TI - The acceptance of home glucose monitoring by diabetic children. PMID- 6867765 TI - Stable blood glucose test strips and reflectance meters. PMID- 6867766 TI - Pulmonary hydatid cyst in Singapore--a case report. PMID- 6867767 TI - Choreoathetosis and seizures associated with systemic lupus erythematosus--a case report. PMID- 6867768 TI - Traumatic dislocation of the hallucal sesamoid--a case report. PMID- 6867769 TI - Mental illness in the elderly. PMID- 6867770 TI - Unilateral calcified fibrothorax with cor pulmonale: failure to improve with decortication. PMID- 6867771 TI - Ewing tumor of rib: radiologic findings and computed tomography contribution. AB - The ribs are frequent sites of primary Ewing tumor accounting for about 10-12% of all cases. The lesions may be predominantly lytic or sclerotic or show a combination of bone destruction and secondary reactive changes. In some patients bony changes are subtle and are obscured initially by frequently associated large extrapleural masses or pleural fluid. These patients may present clinically with findings secondary to compression of mediastinal structures by the soft tissue masses. Computed tomography (CT) is of great value in the diagnosis of such difficult cases and better demonstrates the tumor extent and relationships than other available imaging modalities. CT is also of considerable help in determining the optimal time for en bloc tumor resection. Many tumors are initially considered non-resectable due to extensive involvement of the lung, the mediastinum, or the diaphragm. CT accurately documents tumor regression during preoperative courses of chemotherapy. PMID- 6867772 TI - Extraskeletal Ewing sarcoma with computed tomography correlation. AB - Extraosseous Ewing sarcoma--a rare clinical entity--is described and the radiographic and histologic features discussed. Histologically this type of tumor may be differentiated from other soft tissue malignancies, but the ultrastructural glycogen content of the cytoplasm makes it frequently inseparable from the conventional osseous form of Ewing sarcoma. In spite of the presence of a huge paraosseal mass with bone erosion or periosteal new bone, computed tomography was the only preoperative modality able to provide evidence of non involvement of the marrow cavity. However, histologic documentation is necessary to prove that one is dealing with a totally extraosseous Ewing sarcoma. PMID- 6867774 TI - Radionuclide bone scan as an aid in localizing lesions for bone biopsy. AB - Two cases are cited as examples of the usefulness of bone scan-guided bone biopsies, using a lead marker for lesion localization, especially when the lesions are otherwise difficult to localize. This technique is quite useful in evaluating new solitary bone lesions in patients with a known primary malignancy. PMID- 6867776 TI - Unilateral spondylolysis of the cervical spine. PMID- 6867773 TI - Dynamic computed tomography scanning of benign bone lesions: preliminary results. AB - The majority of benign bone lesions can be evaluated adequately using conventional radiologic techniques. However, it is not always possible to differentiate reliably between different types of benign bone lesions on the basis of plain film appearances alone. Dynamic computed tomography (CT) scanning provides a means for further characterizing such lesions by assessing their degree of vascularity. Thus, it may help in distinguishing an osteoid osteoma, which has a hypervascular nidus, from a Brodie's abscess, which is avascular. Dynamic CT scanning may also help in the differentiation between a fluid containing simple bone cyst, which is avascular, and other solid or semi-solid benign bone lesions which show varying degrees of vascularity. However, because of the additional irradiation involved, dynamic CT scanning should be reserved for evaluation of selected patients with benign bone lesions in whom the plain film findings are not definitive and in whom the CT findings may have a significant influence on management. PMID- 6867775 TI - Congenital aggressive lipomatosis. AB - Three cases of congenital lipomatosis involving the thoracic region posteriorly are presented delineating the natural history of the disease and depicting underlying bone and soft tissue changes. The rib widening and pleural thickening appear to be related to increased intercostal vascularity feeding the overlying tumor, as delineated by angiography. This entity is not described in the radiologic literature. PMID- 6867777 TI - Case report 226: isolated Cryptococcus neoformans osteomyelitis of femur. PMID- 6867779 TI - Case report 228: congenital venous dysplasia of the index finger involving soft tissues and bone. PMID- 6867780 TI - Case report 229: multiple (multicentric) giant cell tumors of bone. PMID- 6867778 TI - Case report 227: primary hyperoxaluria (oxalosis). PMID- 6867781 TI - Health professionals as stigmatizers and destigmatizers of diseases: alcoholism and leprosy as examples. AB - Two disease entities are used for the analysis of stigmatization processes within the health care system. It is shown how overall cultural norms, specific professional role interpretations and certain characteristics of the disease are contributory factors. Cultural norms of devaluating persons with disabilities are considered. The relative power of the medical profession within the health care system is assessed in order to evaluate their potentially stigmatizing impact. Previously formulated theoretical concepts and findings of empirical studies provide the overall framework for the discussion. The conclusions include implications which might lead to the improvement of treatment and rehabilitation of currently stigmatizing diseases. PMID- 6867782 TI - The family-illness intermesh: theoretical aspects and their application. AB - Illness analysis, according to one aspect of the Parsons deviance framework, proposes dysfunction to the family system and society. Largely accepted for many years, there are important deficiencies of the conceptualization which are not present in another theoretical stance. This latter formulation focuses on adaptive responses of families to stress and can be envisioned as adding an emphasis on mutuality of family-illness encounters. It is offered as a tool for theoretical enrichment which can supplement the original framework, broaden the analytic base and be applied in clinical settings by practitioners in medical and therapy fields who wish to investigate positive versus negative consequences of the family-illness intermesh. PMID- 6867783 TI - Tips, status and sacrifice: gift giving in the doctor-patient relationship. AB - This study examines the gifts physicians receive from their patients. Internists in a hospital-based group practice kept diaries of gifts received and were interviewed about their responses and the reasons which they ascribed to the patient's gift-giving. It describes how physicians avoid reciprocating, categorizes the nature of gifts and, for the special instance of manipulative gifts, how these may be defused. Patient gifts are found to be reciprocations for some action on the part of the physician, which the patient, in turn, perceives as a gift. Three categories of gifts, according to their nature and timing, are: (1) gifts as 'tips', given to promote personalized service, to assure the continued interest and the tolerance of the physician; (2) gifts to address the status imbalance in the doctor-patient relationship, either by imposing a non professional identity on the physician or by redeeming status lost in the sick role; (3) gifts as a sacrifice to the physician who exercises his power on the patient's behalf. PMID- 6867784 TI - 'Core' and 'extended' social networks in relation to health and illness. AB - This paper considers several models of the nature of the association that has been found between characteristics of social networks and health. Such an association does not appear to be adequately accounted for by a deleterious effect of illness on social contact, nor by the role of social networks in mediating health-related practices or in buffering the effects of stress. Thus the proposition is tentatively warranted that the social network is more directly and causally involved in health outcomes--perhaps through the impact of social feedback as mediated by the network. It is argued that the social processes that affect the association between networks and health involve a larger social unit than the small core networks that have generally been the focus of study. Assuming that the individual's susceptibility to illness is affected by the adequacy of the core network, we must deal with the fact that the vulnerability of the core network to loss without adequate replacement is, in turn, affected by the structure of the larger, extended network in which the core network is embedded. By shifting attention to these extended networks, it should also become possible to integrate findings from network studies with more traditional epidemiological findings relating such macro-variables as social class to illness. PMID- 6867785 TI - Intra-professional marriage: mate choices of medical students in India. AB - The desire to marry a doctor varied between male and female students at a medical school in India. The females' inclination was significantly stronger than that of males. Also, females were more likely than males to perceive their parents desire to arrange such a marriage for them. The correlation between students' desire to find a marriage match and the students' perception of such a desire in their parents, was higher for females than for males. A follow-up of the selected women students showed that a majority of those who expressed a desire to marry a doctor were in fact so married. Three explanations are advanced for this marriage pattern: (a) Status-congruency, which assumes that the higher status conferred on females by a medical education can best be maintained by marrying within the profession. (b) The second refers to the perceived complementarity between intra professional marriage and the enactment of professional role (c) The third refers to the socialization of women medical students to prefer this marriage pattern. PMID- 6867786 TI - Women and health care in rural Pakistan. AB - The provision of medical facilities to rural areas is a major objective of development in Pakistan and the government has undertaken several programs to train and deploy auxiliary health workers on a large scale. Programs to train lady health visitors, dispensers and sanitary inspectors, have been in operation for decades and their graduates have a place in the workforce. Currently the Government is developing a Basic Health Program to train auxiliary health workers and to establish a network of rural health facilities throughout the country. The research here reported was meant to help plan this program. The 4 week study was conducted in four districts of the Punjab and North West Frontier Provinces. We first interviewed women patients of rural dispensaries in the four districts to determine their views of their needs and of the constraints of the purdah system when seeking health care. We then interviewed principals of medical colleges and training institutes, who were in a position to assess the availability of women to enter the medical workforce and female mid-level health workers who were currently serving in their posts. Finally, since allopathic medical institutions compete with indigenous medical specialists, we interviewed two hakims and a homeopathic physician to obtain their view of rural health needs, as well as their potential for contributing to a broad based rural health care system. PMID- 6867787 TI - Modeling consumer choices of health plans: a comparison of two techniques. AB - This paper has two objectives. First, we will describe how conjoint measurement, a multivariate marketing research technique, can be applied in health care marketing. Second, we will compare the validity of results from two conjoint measurement techniques--the full profile approach and the tradeoff approach. A convenience sample of 97 university students was used in the study. Fifty-two students supplied data by using the full profile approach. Each respondent provided a complete rank order of 26 profile cards which included the following ambulatory health service attributes: charge for routine visit, travel time, office hours, length of time needed to make an appointment, waiting time in physician's office, practice arrangement/freedom of physician choice, parking arrangements and type of hospital. A fractional factorial design was used to determine different attribute levels (e.g. charge for routine office visit could be set at $10, $20 or $30) for each card. Forty-five students performed ranking tasks for the trade-off approach to conjoint measurement. These respondents ranked 28 grids which represent all combinations of factors taken two at a time. From the data collected in the ranking tasks, utilities or part-worth values for each level of each attribute were estimated by using dummy variable regression. Relative importance of ambulatory service attributes was inferred from the range of utility values of the attributes. Three measures of validity were assessed- adherence of estimated utility scores to monotonic assumptions, plausability of importance rankings and comparative validity. The results from the full-profile approach satisfied all three criteria. In contrast, the tradeoff approach results satisfied the first two criteria, but its comparative validity was only marginal. Valid conjoint data can be used for: simulations of market responses to different health services configurations; market segmentation studies; and development of promotional efforts. PMID- 6867788 TI - Symptom distress, current concerns and mood disturbance after diagnosis of life threatening disease. AB - This study describes the level of symptom distress, current concerns and mood disturbance in persons with a diagnosis of one of two life-threatening diseases at two occasions. The sample included 56 lung cancer patients and 65 heart attack patients who completed interviews at 1 and 2 months post diagnosis. Data were obtained using a modified version of the McCorkle and Young Symptom Distress Scale, the Weisman and Worden Inventory of Current Concerns and the Profile of Mood States. One conclusion that can be drawn from the study is that the plight of newly diagnosed lung cancer patients appears to be bleaker than that of heart attack patients. Cancer patients experienced more symptom distress of all kinds than heart attack patients. They also reported more health and existential concerns and they suffered more mood disturbances, on the average, than heart attack patients did. The most striking finding of the mean differences analysis was that, although symptom distress remained the same between occasions for both groups, both kinds of patients reported fewer concerns and better mood at the second interview. Although the plight of neither type of patient improved, patients reported being in better spirits and less worried at the second measurement occasion. This reduction in concerns and mood disturbance between interviews suggests that patients assimilate that their situation is not as immediately life-threatening as they had feared. PMID- 6867789 TI - The effects of compensation on psychiatric disability. AB - Psychiatrically impaired veterans who were receiving 100%, partial or no compensation for their psychiatric disabilities were compared on type and level of psychopathology, self-esteem, locus of control and treatment utilization. All groups were highly elevated on measures on measures of psychopathology. There were no differences between groups on psychopathology measures, except that the 100% group scored significantly higher than the uncompensated group on hostility. Differences in locus of control were not found. On 3 of 10 subscales, partially compensated patients reported higher levels of self-esteem than patients in one or both of the other groups. Uncompensated patients required the most hospitalization. Those who were receiving 100% disability compensation required less hospitalization and the number of days they spent in the hospital was significantly reduced following attainment of full compensation. PMID- 6867790 TI - Impact of a maternal transport program on a newborn service. AB - We reviewed the maternal transfers for one year (1980) to the Emory Perinatal Center, a tertiary care center for North Georgia. Of 445 telephone consultations or patient referrals, 150 women gave birth at the tertiary center. Indications for maternal transfer were predominantly based on the needs or anticipated needs of the fetus. There were a total of 163 births, 10 of them stillborn and 153 live born. Three infants expired in the delivery room. Sixty infants (40%) required 580 days of intensive care. A total of 1,439 days of care in the intermediate unit was required and 1,077 days of care in other areas of the nursery. Adjusting these figures for a 0.8 occupancy rate revealed that two intensive care beds, 4.9 intermediate care beds, and 3.6 minimal care beds were required for just these maternally transported infants. Maternal transfers will result in a disproportionate increase in the workload of a nursery because of the immaturity and small size of these infants. When considering a maternal transfer service, appropriate planning must be made to meet the special needs of both the infants and their mothers. PMID- 6867791 TI - Maternal deaths associated with antepartum fetal death in utero, United States, 1972 to 1978. AB - Little is known about the overall incidence of fetal death in utero (FDIU) in the United States or about the risks associated with its management. To address these questions, this study provides nationwide incidence data and reviews nine deaths of women with FDIU in the United States from 1972 to 1978. The crude death-to case rate associated with FDIU is at least 4.5 deaths per 100,000 cases (95% confidence limits, 2.1 to 8.5). Existing information from comparative studies is inadequate to evaluate the comparative safety of different methods of evacuating the uterus after FDIU occurs at different gestational ages. Management of such cases should be determined by both the experience of the physician with uterine evacuation techniques and the medical and psychologic needs of the woman. PMID- 6867792 TI - Use of quinine for self-induced abortion. AB - We present four recent cases in which quinine was used for self-induced abortion. Abortion was achieved in only one of these cases. Literature review suggests that quinine is an ineffective abortifacient, even when taken in toxic doses. Adverse effects of quinine include cinchonism, potentially fatal renal failure, and possible teratogenesis. Quinine is available over-the-counter, but it has few legitimate medical indications. Health care personnel treating women with undesired pregnancies should be alert to the signs and symptoms of quinine toxicity. PMID- 6867793 TI - Ultrasonic guidance of liver biopsy and fine-needle aspiration in difficult cases. AB - Liver biopsy under the guidance of ultrasonography, rather than ordinary liver biopsy, appears to be the procedure of choice in patients with ascites, small liver, hepatic focal defect, jaundice, and chronic lung disease. Moreover, fine needle aspiration of liver masses under ultrasonic guidance is as good as liver biopsy under ultrasonic guidance and superior to regular liver biopsy. Guided fine-needle aspiration is the procedure of choice in cases of malignant metastases of the liver because of its simplicity and safety, and because it can be performed on an outpatient basis. Our rate of success with positive diagnosis in guided liver biopsy was 97%, with one false-negative; in guided fine-needle aspiration, it was 96.5% with 9.5% false-negative for malignant lesions. PMID- 6867794 TI - Campylobacter enterocolitis in New Orleans. AB - Campylobacter is being increasingly recognized as a common pathogen producing acute diarrheal illness. During 1981, all stool cultures at Charity Hospital were routinely screened for Campylobacter. Twenty-nine of 2,233 total cultures were positive. We performed a retrospective study to evaluate the disease's clinical picture and epidemiologic features. Campylobacter-positive cultures comprised 1.3% of all stool specimens and 21.6% of all positive cultures. Age, sex, and race in the Campylobacter group did not differ significantly from a comparison group. The distribution of the rates of Campylobacter-positive cultures did not show temporal trends. The clinical symptoms were nonspecific and the disease was usually self-limited, with diarrhea lasting from seven to ten days in untreated patients. The disease may occasionally be confused with a nonspecific inflammatory bowel disease. Thus, it is important that stool cultures be routinely screened for Campylobacter so that appropriate therapy can be administered. PMID- 6867796 TI - Two-step tuberculin testing in a veterans domiciliary population. AB - Seven hundred ninety-six veterans were scheduled for tuberculin testing during a hospital/domiciliary employee health program in southern Ohio. The Mantoux test, using 5 TU of commercial purified protein derivative (PPD) was used. Nonsignificant reactors were retested at one week to detect and quantitate the "booster phenomenon," following Centers for Disease Control (CDC) recommendations. Cost data were recorded. The initial frequency of 39.3% reactions greater than 10 mm in 740 tested subjects increased to 46.7% on two step testing. Fifty-five of 414 subjects exhibited the booster effect, a rate intermediate between that reported in Alabama and no boosting reported in Rochester, New York. Costs of two-step testing exceeded, by a small margin, estimated costs of isoniazid preventive therapy for apparent converters detected by two-step testing. PMID- 6867795 TI - Giardiasis: a common, sexually transmissible parasitic diarrhea with pitfalls in diagnosis. AB - Giardia lamblia is the number one intestinal parasite in the United States. Symptoms of giardiasis include upper abdominal pain and distress, flatulence, nervousness, and diarrhea. Multiple stool specimens examined for ova and parasites by nonexpert parasitologists will frequently not provide the diagnosis, and special studies must then be done. Antibiotics, antidiarrheals, certain enema preparations, and oily laxatives can cause a temporary disappearance of parasites from the stool. Treatment of choice is a five-day course of quinacrine hydrochloride. Recently, attention has been brought to the fact that oral sex may be responsible for transmission in a significant number of cases of giardiasis. PMID- 6867797 TI - High school football injuries in Birmingham, Alabama. AB - To investigate high school football injuries, we analyzed 1,877 injuries (661 game, 1,216 practice) treated from 1976 through 1979 at the Sports Medicine Clinic at the University of Alabama in Birmingham. The common injury types were sprain (32.2%), contusion (24.8%), strain (12.4%), fracture (11.0%), tear (3.8%), dislocation (2.1%), myositis ossificans (1.4%), tendinitis (1.3%), and concussion (1.0%). Position of the player injured was quarterback (8.7%), running back (19.6%), receiver (12.4%), offensive lineman (23.7%), defensive lineman (10.2%), defensive back (9.2%), and linebacker (9.0%). Body areas affected included head/neck (7.6%), shoulder (13.3%), upper arm (1.4%), elbow (3.4%), lower arm (2.0%), wrist (2.9%), hand/fingers (11.9%), chest/ribs (3.4%), back (4.9%), abdomen (0.7%), groin (0.7%), hip (2.4%), upper leg (4.6%), knee (22.2%), lower leg (4.0%), ankle (10.9%), and foot/toes (4.2%). These data are similar to those in previous reports, although subtle differences suggest variations in injury patterns due to rule changes and equipment modification. PMID- 6867798 TI - Experience with a multidisciplinary emergency medicine clerkship. AB - In 1979 a required emergency medicine clerkship was added to the senior curriculum at the Medical College of Virginia. Coordinated by the Department of Surgery but receiving active support from other disciplines, the emergency medicine clerkship combined clinical participation in emergency care with a balanced academic program of lectures, conferences, and advanced cardiac life support training. The program evolved into a popular and productive experience and stimulated positive changes in the emergency unit at other levels. PMID- 6867799 TI - Adhesive capsulitis of the shoulder: arthrographic diagnosis and treatment. AB - Thirty-one patients (33 shoulders) had clinical adhesive capsulitis confirmed by arthrography and simultaneously treated by intra-articular injection of lidocaine and long-acting corticosteroid introduced with the contrast material during the examination. The routine arthrographic procedure was modified to include gentle passive manipulation of the joint while under the effect of the local anesthetic agent. The patients were instructed to continue exercises at home. The clinical follow-up has averaged eight months. In 31 of the 33 shoulders (94%) excellent relief of symptoms and restoration of function were obtained. There are several advantages to this approach: (1) an accurate diagnosis is made, (2) accurate intra-articular injection of steroid is assured as opposed to blind clinical injections, which often deposit medication in the periarticular soft tissues, (3) the morbidity is much lower than with operative techniques involving general anesthesia, and (4) the therapeutic result has been far better than with the usual program of analgesics and physical therapy. PMID- 6867800 TI - Pulmonary arteriovenous fistula simulating a vanishing tumor. AB - In a patient with an asymptomatic left upper lobe pulmonary arteriovenous fistula, preoperative chest roentgenograms simulated bronchogenic carcinoma, but no overt feeding vessel was demonstrated. Intraoperatively no lesion could be palpated. Postoperative evaluation revealed a pulmonary arteriovenous fistula. This entity should be considered in the differential diagnosis of single or multiple pulmonary nodules. Careful review of chest roentgenograms for feeding arteries, or draining veins, and observation under fluoroscopy for changing size will aid in diagnosis, and potentially avoid bronchoscopy and possible transbronchoscopic biopsy of these vascular lesions. PMID- 6867801 TI - Epidemiology of a thermonuclear bomb-burst over Nashville, Tennessee: a theoretic study. AB - A thermonuclear bomb explosion over any city in the world would have a devastating effect on the population and environment. For those who survive, with or without injuries, life would become primitive with little or no uncontaminated food or water, and with inadequate housing, fuel, and medical care, resulting in a breakdown of family and interpersonal relationships. This theoretic study of the potential outcome of a thermonuclear bomb-burst over Nashville, Tennessee, discusses epidemiologically the wide range of medical and psychologic effects from the direct trauma of blast and fire, widespread epidemics of otherwise controlled disease, long-term chronic illness, genetic damage, and catastrophic environmental havoc. PMID- 6867802 TI - Commitment to teaching: myth or reality? PMID- 6867803 TI - Hypocalcemia and "toxic" syndrome associated with streptococcal fasciitis. AB - A 35-year-old man suffered a small puncture wound of the right hand and within four days had acute fasciitis of the right upper extremity. Cultures of wound and blood grew a group A beta-hemolytic Streptococcus. Persistent hypocalcemia was recognized daily, and he died ten days after the injury in cardiac failure. Preliminary studies have shown that the organism elaborated two streptococcal pyrogenic exotoxins (SPE-C and a new exotoxin, SPE-D). It is suggested but not proven that the cause of the patient's "toxic" illness may have resulted from the action of these exotoxins. PMID- 6867804 TI - Normokalemic nonazotemic adrenal insufficiency. AB - Two patients had adrenal insufficiency with severe hyponatremia and profound central nervous system symptoms. In both adrenal insufficiency was diagnosed clinically. Neither patient had either hyperkalemia or azotemia. PMID- 6867805 TI - Portal vein thrombosis shown by ultrasonography. AB - While alcoholic cirrhosis is the most common cause of portal hypertension and associated gastrointestinal bleeding, portal vein occlusion can produce similar clinical manifestations. Ultrasonography is an accurate, noninvasive procedure for detecting portal vein thrombosis and distinguishing infrahepatic venous obstruction from intrahepatic obstruction due to cirrhosis. PMID- 6867806 TI - Phalangeal metastasis: first clinical sign of bronchogenic carcinoma. AB - A 67-year-old man without any pulmonary symptoms had a swollen and tender finger initially treated as infection. It was later found to be a metastatic lesion from an undetected bronchogenic carcinoma. PMID- 6867809 TI - Middle lobe syndrome due to accessory cardiac bronchus. AB - A patient had recurrent middle lobe syndrome and was found to have a congenital accessory cardiac bronchus. Inflammation in its blind pocket was believed to be the underlying cause of recurrence. PMID- 6867808 TI - Tracheobronchial mucoid pseudotumors. AB - A collection of mucus, indistinguishable from tumor, can be shown in the tracheobronchial tree, particularly during tomography. These "mucoid pseudotumors" may be distinguished from true tumors by documenting their disappearance after having the patient cough. PMID- 6867807 TI - Sudden complete ophthalmoplegia associated with pituitary adenoma. AB - A 20-year-old asymptomatic woman suddenly had complete right ophthalmoplegia associated with right ptosis and impairment of the sensory and motor functions of the right papillary cranial nerve. These symptoms were found to be caused by a chromophobe adenoma of the pituitary gland. Complete resolution of the patient's symptoms followed surgical aspiration of the tumor with subsequent radiation therapy. PMID- 6867810 TI - Fate of ovary transposed during treatment of Hodgkin's disease. AB - Although successful transposition of the ovaries at the time of staging laparotomy for Hodgkin's disease is well documented, little comment has been made on potential complications. This case report of a primary ovarian neoplasm (benign) developing in a transposed ovary serves to alert physicians as to possible ovarian problems in such patients. Ultrasonography or computed tomography is invaluable in following up the patient with laterally transposed ovaries no longer accessible to routine bimanual clinical evaluation. PMID- 6867811 TI - Unusual presentation of carcinoid tumor as acute cholecystitis. AB - The patient described had signs, symptoms, and laboratory data consistent with acute cholecystitis. A sonogram also suggested cholecystitis, and the gallbladder was not displayed by nuclear imaging. Cholecystectomy revealed the absence of stones but showed carcinoid tumor metastatic to the gallbladder. PMID- 6867812 TI - Profuse diarrhea induced by Campylobacter. AB - A 31-year-old woman with a five-day prodrome of fever, chills, and diarrhea was hospitalized with severe dehydration and profuse diarrhea due to infection with Campylobacter jejuni. Stool volumes were as high as 8,800 ml per 24 hours. Treatment with intravenous fluids, trimethoprim-sulfamethoxazole, and an oral isotonic glucose-sodium solution produced rapid improvement, suggesting a possible role for oral fluid and electrolyte replacement in Campylobacter enteritis. PMID- 6867813 TI - Protothecosis in the southeastern United States. AB - A case of olecranon bursitis due to the achlorophyllic algae Prototheca species in an otherwise healthy 74-year-old man prompted our review of reported cases occurring in the southeastern United States. Most cases have involved the olecranon bursa, have occurred in otherwise healthy individuals, and were cured by simple excision. Intensive therapy with amphotericin B has been used successfully in a few cases that required systemic antibiotic therapy. The histologic features of this infection are predominantly those of granulomatous inflammation, with relatively easy demonstration of organisms using routine fungal stains. PMID- 6867814 TI - Antibiotic susceptibility of S aureus isolates in a community hospital. PMID- 6867815 TI - Assessment of life events in depressive disorders. A comparison of three methods. PMID- 6867816 TI - Attitudes towards mental illness: influence of data collection procedures. PMID- 6867817 TI - Higher incidence of physical and mental ailments in future psychiatrists as compared with future surgeons and internal medical specialists at military conscription. PMID- 6867818 TI - The law of sociocultural demoralization. PMID- 6867819 TI - Does marital maladjustment lead to mental illness? PMID- 6867821 TI - Development of an alternative, efficient, low-cost mental health delivery system in Cali, Colombia. Part II: The urban health center. PMID- 6867820 TI - [Significance of the first suicide attempt]. PMID- 6867822 TI - [Complex diagnosis of various forms of diffuse mastopathy]. PMID- 6867823 TI - [ECG and physical work capacity in patients with hypertension]. PMID- 6867824 TI - [Modification of the method of esophagometry]. PMID- 6867825 TI - [Simultaneous operations on the biliary tract and the stomach]. PMID- 6867826 TI - [Clinico-morphological manifestations in spinal anomalies and Foix-Alajouanine disease]. PMID- 6867827 TI - [Roentgenological studies in the differential diagnosis of pulmonary thromboembolism and lung cancer]. PMID- 6867828 TI - [Echography in the diagnosis of voluminous masses in the adrenal glands]. PMID- 6867829 TI - [Clinical characteristics of Lyell's syndrome caused by drug hypersensitivity]. PMID- 6867830 TI - [Cytological changes in extensive purulent wounds during treatment in a controlled abacterial medium]. PMID- 6867831 TI - [Functional state of the urinary system in benign tumors of the uterus and adnexa uteri]. PMID- 6867832 TI - [Neoplasm staging in multiple primary breast cancer]. PMID- 6867833 TI - [Treatment of spondylogenic transient circulatory disorders in the vertebrobasilar basin]. PMID- 6867834 TI - [Endoprosthesis of the finger joints in injuries and their sequelae]. PMID- 6867835 TI - [Thromboembolic complications in injuries of the lower limbs]. PMID- 6867836 TI - [Prevention of thromboembolic complications in cancer patients]. PMID- 6867837 TI - [System of regulation of blood coagulation in patients with ischemic heart disease]. PMID- 6867838 TI - [Kinetics of hematopoiesis and its clinical significance]. PMID- 6867839 TI - [Treatment of peptic ulcer]. PMID- 6867841 TI - [Problems of development of the dispensary method]. PMID- 6867840 TI - [Organizational problems in the production of therapeutic preparations using donors' blood]. PMID- 6867842 TI - [Methods of reducing mortality in acute cholecystitis]. PMID- 6867843 TI - [Staphylococcal pneumonia]. PMID- 6867844 TI - [Surgical interventions in congenital cysts of the pancreas]. PMID- 6867845 TI - [Early diagnosis of acute intestinal obstruction]. PMID- 6867846 TI - Canal diameter, anteroposterior compression ratio, and spondylotic myelopathy of the cervical spine. AB - Nine patients with cervical spondylotic myelopathy, diagnosed during life, were subjected to detailed clinicopathologic study. The degree of cord destruction was in good correlation with the ratio of the anteroposterior diameter to the transverse diameter, designated as an anteroposterior compression ratio. Within the factors responsible for decrease in the ratio, developmental narrowing of the spinal canal was the most significant, and multiplicity of spondylotic protrusion less so. The former resulted in an extensive demyelination of the posterolateral funiculus and infarction of the gray matter. Recurrent trauma proved to cause distinct manifestations and cord pathology. Clinicopathologic correlations were also examined from the neurologic findings at the terminal stage. PMID- 6867847 TI - Modified Brooks fusion for an os odontoideum associated with an incomplete posterior arch of the atlas. A case report. PMID- 6867848 TI - Early isolated paraspinal EMG abnormalities in occult carcinoma with spinal metastases. A case report. PMID- 6867849 TI - Diastematomyelia and scoliosis. Usefulness of CT examination. PMID- 6867850 TI - Two-stage spondylectomy for giant cell tumor of L4. A case report. PMID- 6867851 TI - Arachnoiditis ossificans. A case report diagnosed with computerized axial tomography. PMID- 6867852 TI - Rhysolysis of the nerves of the zygoapophyseal joints. PMID- 6867853 TI - The developmental segmental sagittal diameter of the cervical spinal canal in patients with cervical spondylosis. AB - The role of the narrow cervical spinal canal in the expression of clinical syndromes in the cervical spine was investigated in a retrospective review of 63 patients with symptomatic cervical spondylosis refractory to conservative therapy. The measurement of the developmental segmental sagittal diameter, determined at the level of the pedicle, and of the spondylotic segmental sagittal diameter, determined at the level of the disc, were applied. When divided into groups based on anatomic variance around an average size midcervical diameter of 17 mm, 40 patients were found to have less than the average size of midcervical canal. A spondylosis index was computed for the narrow canal group at 2.08 mm per segment and for the wide canal group at 3.29. Canal dimensions are determinants of symptom production and neurologic compromise. PMID- 6867854 TI - Reduction of radiation dose in radiologic examination of patients with scoliosis. AB - In an attempt to reduce the radiation dose during the examination of scoliotic patients, several screen-film combinations have been compared with a conventional system used at present. Kodak's Lanex Regular screen with Kodak Ortho H film enables the dose to be reduced eight times without significant deterioration of the image quality. The dose to the mammary glands can be reduced further by a factor of five if posterior--anterior instead of anterior--posterior projection is used. PMID- 6867855 TI - The mechanical consequence of failure of ossified union in attempted posterior spinal fusion. A canine model. AB - The mechanical behavior of pseudarthrosis in posterior spinal fusion was investigated. A canine model was developed in which an incompletely ossified posterior fusion mass was consistently produced. The spines were excised, and the motion segments were mechanically tested using a specially developed loading apparatus. Tests were performed to evaluate stiffness of the segments to loading with compression, torsion, and anterioposterior and lateral bending shear stiffness. Changes in other modes of loading were less consistent. The motion characteristics of the pseudarthrosis could not be predicted from the extent of the osseous defect noted on roentgenograms. These findings correlate clinically with the progression of curvature seen with pseudarthrosis in scoliosis surgery and the unpredictable results of pseudarthrosis in posterior fusion performed in treatment of degenerative disc disease. PMID- 6867856 TI - The application of pelvic pins in halo-pelvic distraction. An anatomic study. AB - The application of the pelvic hoop for halo-pelvic distraction, as described by O'Brien, has led to serious abdominal complications. A study of mature Caucasian pelves as compared to the smaller East Indian pelves has shown that in the larger pelvis, when the gluteal tubercle and posterior superior iliac spine are used as landmarks, as advocated by O'Brien, the pins will invariably pass within the soft tissue elements of the inner pelvis instead of being entirely within the bony ilium, as O'Brien noted in the Chinese pelves. On the basis of pelvic measurements and observations, the authors recommend an open technique for passage of the pins. PMID- 6867857 TI - Segmental spinal instrumentation for congenital scoliosis. A report of two cases. AB - Two patients with congenital scoliosis underwent surgical correction with segmental spinal instrumentation and fusion. This technique, coupled with spinal monitoring, provides greater correction of a curve than does cast treatment and eliminates the risk of neurologic injury associated with distraction. PMID- 6867858 TI - Congenital absence of the thoracic pedicle. A case report. PMID- 6867859 TI - Anatomic study of the interrelation between lumbosacral nerve roots and their surrounding tissues. AB - In order to clarify the mechanism of symptom production of sciatica or intermittent claudication, the interrelation between lumbosacral nerve roots and their surrounding tissues was analyzed in 75 cadavers. The running course of nerve roots can be changed by congenital anomalies and by acquired lesions, such as compression by articular facets. Ossification of spinal ligaments may also cause nerve root compression. The space around the nervous tissue, both in the spinal canal and in the intervertebral foramen, is narrower in the male than in the female. Membranous structures, an epidural membrane, and an epiradicular sheath can be found around nerve roots. Their existence is correlated with a serpentine figure of the roots observable by selective radiculography. PMID- 6867860 TI - Bilateral laminotomy and discectomy for segmental lumbar disc disease. Decompression with stability. AB - A type of bilateral laminotomy with discectomy for segmental lumbar discogenic disease is presented. The procedure includes wide bilateral decompressive laminotomies and radical partial discectomies, partial V-ostectomy of the adjacent spinous processes, partial facetectomies of the inferior and superior articular processes, and foraminotomies as indicated. One hundred patients who underwent this procedure were evaluated by an independent examiner in follow-up an average of six years postoperatively. The patients were evaluated by utilizing a scale which included back and leg pain relief, restriction of physical activities, analgesic use, and return to work. Seventy patients were graded as good, 12 as fair, and 18 as poor. Preoperative factors which were highly significantly correlated with a good postoperative result included occupation other than heavy labor, present employment or less than 12 months of unemployment, unilateral subjective paresthesias, symptoms of spinal claudication, unilateral restriction of straight leg raising, a positive Cram or bowstring test, the severity of the myelographic defect, elevation of spinal fluid protein, and the severity of the disc pathology noted at surgery. Several other preoperative factors were noted to be of somewhat lesser significance and were correlated with a poor surgical outcome, including job-related injury, compensation or litigation, previous unsuccessful surgery, subjective weakness, calf atrophy, and sensory deficit. PMID- 6867861 TI - [Subjective tolerance in peripheral arteriography. Ioglicinate-lidocaine- and ioglicinate-prilocaine-combinations versus ioxaglate]. PMID- 6867862 TI - [Direct magnification radiography using a highly intensifying screen]. PMID- 6867864 TI - [Routine monitoring of tube voltage with edge filters for purposes of quality control]. PMID- 6867863 TI - [Dose measurements in pediatric excretory urography using a new film-screen combination]. PMID- 6867865 TI - [Study on psychological tests applied to patients with systemic lupus erythematosus]. PMID- 6867866 TI - [Pattern of wear on the tibial component from retrieved total knee prostheses]. PMID- 6867867 TI - [A case of SLE complicated with Jaccoud's syndrome]. PMID- 6867868 TI - Studies on the pathogenesis of rheumatic carditis--cytotoxicity of serum and lymphocytes sensitized to streptococcal M protein fraction on cultured myocardial cells. PMID- 6867869 TI - [A case of Sjogren's syndrome with pseudofracture]. PMID- 6867871 TI - The need for genetic services. PMID- 6867870 TI - [Clinical aspects of Sjogren's syndrome]. PMID- 6867872 TI - The natural history of minimal-change nephritis. PMID- 6867873 TI - Endogenous digoxin-like material. PMID- 6867874 TI - Genetic services in the State Health Department of the RSA. Development and structure. AB - Most developing countries have genetic counselling services. Although research and expertise in human genetics have reached unprecedented heights, health authorities have only recently acknowledged the practical application and economic value of genetic services in community health care. The development of community-based genetic services in the RSA since 1971 and the current organization and structure of the services in the State Health Department are described. PMID- 6867875 TI - Oxygen therapy--a case of abuse. PMID- 6867876 TI - Intractable skin disorders treated with the aromatic retinoid etretinate (Tigason). Two and a half years' experience in the Transvaal. AB - A trial of etretinate (Tigason) for keratinizing disorders of the skin yielded prolonged improvements beyond any results hitherto obtained. The disorders included psoriasis of severe degree, keratosis obturans, ichthyosis vulgaris, follicular ichthyosis, porokeratosis of Nekam, disseminated superficial actinic porokeratosis. Darier's disease, palmoplantar keratoderma, Oudtshoorn disease, lamellar ichthyosis, 'badpak' ichthyosis, epidermolytic hyperkeratosis, the 'half baby' syndrome, exfoliative dermatitis, hair dystrophy and selected precancerous conditions. A method of management which worked well under local conditions is outlined. PMID- 6867877 TI - Diagnostic value of trephine biopsy in bone disease. AB - A clinical diagnosis of myeloma was made in a 44-year-old woman with anaemia, a markedly raised erythrocyte sedimentation rate, osteolytic lesions in the pelvis, and a pathological fracture of the femur. Confirmatory trephine biopsy showed, instead of plasma cell infiltration, destruction of the normal micro-anatomy of the marrow with bridging fibrosis, gross osteoclastic proliferation, and areas of new bone formation. These are the features of hyperparathyroidism. Subsequently, a solitary adenoma of the parathyroid glands was demonstrated and resected. This case illustrates the value of examination of the trabeculae in trephine biopsy specimens in the diagnosis of bone disease. PMID- 6867878 TI - Rupture of sinus of Valsalva aneurysm into the right ventricle. AB - A young Black woman presented with acute severe right ventricular and moderate left ventricular cardiac failure secondary to rupture of a sinus of Valsalva aneurysm originating from the right coronary sinus. The rupture into the right ventricle was accompanied by severe aortic valve insufficiency. The aortic valve showed congenital myxomatous degeneration with no evidence of infective endocarditis or syphilis. Right ventricular endomyocardial biopsy revealed no evidence of any specific cardiac disease such as amyloidosis. Successful closure of the fistula, together with aortic valve replacement and a De Vega tricuspid annuloplasty, was carried out. M-mode and two-dimensional echocardiography delineated the fistula, as well as the most unusual binding of tricuspid valve fluttering, which persisted after operation. Slight insufficiency of the Bjork Shiley aortic prosthesis was noted at postoperative cardiac catheterization. The patient was discharged from hospital asymptomatic and with no abnormal clinical features. PMID- 6867879 TI - Cavitating pulmonary sarcoidosis. AB - Sarcoidosis is a multisystem disorder and protean pulmonary manifestations which may mimic a number of other diseases, occasionally leading to misdiagnosis and inappropriate management. We report a case of cavitating sarcoidosis which, although rate, is important in that it may be radiologically indistinguishable from tuberculosis. PMID- 6867880 TI - Scorpion sting producing severe muscular paralysis. A case report. AB - A case of scorpion (Parabuthus species) envenomation causing severe respiratory failure is presented. Systemic effects, which included muscular weakness, hypertonus and bulbar dysfunction, developed 8 hours after poisoning; this emphasizes the importance of close observation of victims of envenomation. Treatment included the administration of scorpion antivenom (SAIMR) and mechanical ventilation for 4 days. PMID- 6867881 TI - Sudden death due to intravenous avapyrazone and dipyrone. PMID- 6867882 TI - The Waardenburg syndrome in southern Africa. PMID- 6867883 TI - Pleural biopsy. A report of 750 biopsies performed using Abrams's pleural biopsy punch. AB - We present the results of 750 consecutive pleural biopsies performed with the Abrams pleural biopsy punch to indicate the effectiveness, safety and ease of the procedure. The biopsies were performed by 27 members of our medical staff. Pleural tissue was obtained in 90% of the biopsy specimens taken from patients with pleural effusions and in 79% of those taken in the absence of pleural fluid. These 'dry' biopsies were restricted to those operators with a minimum experience of 50 previous biopsies. Inclusion of tissue other than pleura occurred more frequently in the 'dry' biopsies (16.6%) than in those with pleural fluid (0.8%). There were no complications which required intervention. The problem of 'idiopathic' pleural disease is discussed. We emphasize the biopsy technique and the need for a constant and interested histologist. PMID- 6867884 TI - [Pitfalls in the diagnosis of spinal injuries]. AB - Injury to the spinal cord remains one of the great disasters which can disrupt any person's life. Although tremendous progress has been made concerning treatment and rehabilitation, our inability to change the irreversible nature of these injuries still underlines the vital importance of their prevention. Saving a patient from potential neurological damage depends upon the early recognition of unstable spinal injuries. Unfortunately, prompt diagnosis is not always the rule. We have identified the following seven diagnostic pitfalls in this regard, and again emphasize a few basic rules in dealing with them: (i) the 'sprained neck'; (ii) the normal radiograph; (iii) head injuries; (iv) multiple injuries; (v) the low cervical region; (vi) high dorsal lesions; and (vii) double spinal injuries. PMID- 6867885 TI - Associated sternal and spinal fractures. Case reports. AB - Fractures of the upper thoracic spine due to flexion-compression trauma may be associated with sternal injuries of a specific type. The sternal or spinal component of such injuries may easily be overlooked, as illustrated by the 2 case reports presented. Sternal injuries due to direct and indirect trauma are described with particular reference to the anatomy of the manubriosternal joint. The importance of routine radiographic examination of the thoracic spine in the presence of sternal injury --and vice versa--is emphasized. PMID- 6867887 TI - Fever and new lung infiltrate in a patient with fibrosing alveolitis. PMID- 6867888 TI - The incidence and nature of rugby injuries experienced at one school during the 1982 rugby season. AB - Schoolboy rugby injuries are a cause for concern in medical and non-medical circles, but few scientific investigations into their nature and frequency have been undertaken. We therefore decided to carry out a prospective study of the pattern of injuries occurring during one rugby season among boys in age groups ranging from under 10 to under 19 at one school, and to relate them to age, team level, time of season, position played and phase of play. Results showed that there are well-defined physical factors and conditions of play most likely to cause injury, and suggestions are made as to how these injuries could be minimized. PMID- 6867886 TI - Immunological abnormalities in South African homosexual men. AB - Immunological tests of cell-mediated immunity (CMI), serological tests for antibodies to sexually transmitted and possibly immunosuppressive viruses, determination of serum immunoglobulin levels, full blood counts and serotyping for the HLA-DRw5 antigen were performed in 10 homosexual men with a mean age of 35 years (range 21-59 years). Five of these were associates of a patient who had died of confirmed acquired immunodeficiency syndrome (AIDS). At the time of investigation 9 of the men were apparently healthy and 1 had active pulmonary tuberculosis. Only in 2 subjects were no abnormalities of CMI found; they were 23 and 28 years of age and, interestingly, were also the only 2 whose sera were negative for antibodies to cytomegalovirus (CMV) and for the other viruses investigated. Of the remainder, 1 was lymphopenic, 6 had increased numbers of circulating suppressor T lymphocytes, 4 had reduced delayed-type hypersensitivity skin responses to recall antigens, and in 6 mitogen-induced lymphocyte transformation was decreased. Of these 8 subjects, 4 and 2 had antibodies to hepatitis B surface and core antigens respectively and 1 was positive for hepatitis B surface antigen and HBe antigen. The most severe abnormalities were observed in individuals who were seropositive for both CMV and hepatitis B virus. These findings indicate the existence of acquired immunosuppression in some members of the South African homosexual community. On the basis of these findings an immunological classification of potential sufferers of AIDS in the male homosexual community is proposed. PMID- 6867889 TI - Serious cervical spine injury in the older rugby player. An indication for routine radiological examination. AB - There appears to be premature onset of cervical spondylosis in the cervical spines of rugby players who are then at increased risk of hyperextension injury to the spinal cord with resultant paralysis. An illustrative case report is presented. The value of and necessity for routine radiological examination of the cervical spines of all rugby players is stressed. PMID- 6867891 TI - Hemichorea-hemiballismus caused by lacunar infarction in the basal ganglia. PMID- 6867890 TI - Amiodarone and hyperlipidemia. PMID- 6867892 TI - Motorcycling morbidity and mortality--an unstudied epidemic. AB - South Africa has the highest motorcycle accident and associated casualty rate in the world. In dealing with the problem South Africa lags far behind other countries where rider training programmes have had astonishing success. Accident statistics, problems relating to motorcycling and protective clothing are discussed. Recommendations are made which if implemented should reduce the accident and casualty rate by at least 50%; this indicates the size of the problem in this neglected field of automotive preventive medicine. PMID- 6867893 TI - Motorcycle accidents and alcohol. A survey of fatalities in the Cape Peninsula. AB - Autopsy was performed on a total of 48 motorcycle accident victims (39 riders and 9 passengers) in Cape Town during 1982. Thirty-nine (81%) were under 30 years of age, while 61,3% of the riders tested were found to have alcohol in their blood, 42% having a blood alcohol level of more than 0,10 g/dl. PMID- 6867894 TI - The incidence of motorcycle accidents in South Africa--an alarming increase. AB - There has been a dramatic rise in the number of motorcycle accidents in South Africa. The need for prophylaxis is emphasized and the way in which the problem has been tackled in Japan (with striking results) is presented for serious consideration. PMID- 6867895 TI - Percutaneous catheter drainage of abdominal abscesses. AB - Eleven patients with 12 abdominal abscesses underwent percutaneous insertion of tube drains into the abscess cavities under radiographic control. Once inserted the catheters were managed in the same way as surgically placed drains. Broad spectrum antibiotic cover was provided. Of the abscesses 10 resolved and 2 required open drainage; 1 of the latter patients improved dramatically on percutaneous drainage. There were 2 deaths, neither of which was related to the procedure. PMID- 6867896 TI - Assessment of a geriatric exercise programme using ambulatory electrocardiography. AB - The purpose of this study was to assess the efficacy as well as the immediate possible cardiovascular risk of a geriatric exercise programme, administered without prior medical screening or evaluation of the exercise capacity of the participants, in improving cardiorespiratory fitness. Ambulatory electrocardiography performed during exercise on 6 randomly selected male participants in a physiotherapist-controlled geriatric exercise programme revealed heart rates of 72-97/min, values unlikely to produce significant improvements in cardiorespiratory fitness. This low-intensity exercise session did not induce any ischaemic ST-segment displacements, or arrhythmias displaying the generally accepted criteria for premonitory arrhythmias known to precede the development of ventricular fibrillation. However, subsequent stress testing, performed at the lower threshold intensity of exercise needed to elicit a significant physiological training effect, resulted in an adverse cardiac response in 3 subjects, of whom 2 were asymptomatic. We conclude that the geriatric exercise programme under investigation would be unlikely to result in improved cardiorespiratory fitness in the majority of participants, but if such a programme is to be implemented in a safe manner in a geriatric population, prior medical screening including exercise testing is mandatory. PMID- 6867897 TI - Pre-infarction Prinzmetal's angina. A case report and review of the literature. AB - A 45-year-old White man presented with the classic history of Prinzmetal's variant angina, culminating in a transmural inferior myocardial infarction despite intensive treatment with continuous nitroglycerin infusion and the oral calcium antagonist nifedipine. During the frequent episodes of 'pre-infarction' Prinzmetal's variant angina intermittent second-degree atrioventricular heart block as well as ventricular tachycardia was witnessed, necessitating the insertion of a temporary transvenous right ventricular pacemaker. Selective coronary angiography performed approximately 1 week after the infarction in an attempt to elucidate the cause of continuing chest pain unresponsive to medication showed subtotal occlusion of the distal part of the dominant right coronary artery proximal to the origin of the artery to the atrioventricular node, while only very minor narrowings of the internal lumen were evident in the left coronary artery. The well-known angiographic features of a resolving intracoronary thrombus were visualized without any superimposed reversible coronary vasospasm. After catheterization the angina settled down and the patient was discharged on oral nifedipine and isosorbide dinitrate treatment. The place of coronary artery spasm in the pathophysiology of acute myocardial infarction, one facet of the clinical spectrum of ischaemic heart disease, is reviewed. PMID- 6867898 TI - Bickerstaff's brainstem encephalitis in Johannesburg. A case report. AB - Bickerstaff's brainstem encephalitis is a condition in which the brainstem is affected out of proportion to the rest of the brain. Despite severe involvement of brainstem structures, complete recovery over a period ranging from weeks to months is the rule. We describe a case suggestive of this condition which occurred in Johannesburg and in which the progression of neurological signs and symptoms culminated in complete recovery. To our knowledge there has been no previous report of such a case in South Africa. PMID- 6867899 TI - [Iron, folates and vitamin B 12 transport from the mother to the fetus]. PMID- 6867900 TI - [Sensitivity of different reagents used in anti-prothrombinase detection]. PMID- 6867901 TI - [Adult acute respiratory distress syndrome associated with leukoagglutinins. Report of a case and review of the literature]. PMID- 6867902 TI - [Asociacion Nacional de Hematologia y Hemoterapia: 25th national meeting, Arrecife de Lanzarote, 3-5 November 1982. Abstracts]. PMID- 6867903 TI - Low-Income Energy Assistance Program. AB - In fiscal year 1981, Congress appropriated $1.85 billion for home heating assistance to help low-income households meet rapidly rising energy costs. Eligibility for payments was based on income and energy-cost criteria. This procedure represented a departure from the earlier Federal focus of assisting households facing emergency hardships. Funds for the Low-Income Energy Assistance Program were allocated to the 50 States and District of Columbia, six territories, and 55 Indian tribal organizations. This article presents program data and information on the characteristics of the more than 17 million persons who received aid under this program. PMID- 6867905 TI - Special age-72 Social Security benefits awarded in 1981. PMID- 6867904 TI - Relative importance of various income sources of the aged, 1980. AB - This article looks at the extent to which aged couples and nonmarried persons rely on earnings, retirement pensions, assets, and public assistance. The study notes the importance of these various sources to aged units with different levels of both total money income and retirement income, then examines changes in the relative importance of the different sources over time. The data indicate that 23 percent of all aged units had some income from earnings in 1980 and that 90 percent had income from Social Security. Asset income also was widely received. Twenty-two percent of the aged units had private pension income, and 12 percent had government-employee pensions. Public assistance was received by 10 percent of the aged units. PMID- 6867906 TI - Current operating statistics. Monthly tables. PMID- 6867907 TI - Farmers' pensions and the Polish economic crisis. AB - The Polish Government, in 1977, inaugurated a new pension program that made old age and invalidity benefits available for the first time to most farmers in that country. The evolution and eventual failure of that program were closely intertwined with a growing national economic crisis, manifested in widespread popular unrest and culminating in emergence of the Solidarity movement. The farmers' pension program was originally presented as both a social security measure and a vehicle for improving agricultural efficiency. The economic situation was expected to benefit as farms of older owners were passed to younger, presumably more efficient, successors, with the state sometimes acting as intermediary. A further step to bind the social security concept to agricultural efficiency came through relating the pension amount to the quantity of produce the individual farmer sold to the state over a number of years. The failure of these provisions and other unpopular features of the new program was aggravated by inflation and continuing deterioration of the Polish economy. PMID- 6867908 TI - Beneficiaries affected by the annual earnings test in 1978. PMID- 6867910 TI - Aid to Families with Dependent Children: good cause claims for refusing to cooperate in establishing paternity or securing child support. PMID- 6867909 TI - 1981 and 1982 changes in the unemployment insurance program. PMID- 6867911 TI - Slowing down pension indexing: the foreign experience. AB - Between 1975 and 1983, Canada, Finland, Sweden, the United Kingdom, and the Federal Republic of Germany--countries faced with immediate or long-term financing difficulties in their social security systems--modified their social security pension adjustment procedures. These changes in pension adjustments very often were made in conjunction with other restrictive measures such as increased contribution rates and/or contribution ceilings, or tightened criteria for eligibility of benefits. Four types of changes, applied separately or in combination, were made to slow down the rate of pension growth: (1) changing to a different index or modifying the index in use (Finland, Sweden, and the United Kingdom); (2) delaying implementation of pension adjustments (Finland and Sweden); (3) capping annual pension increases (Canada and West Germany); and (4) changing the index review period (the United Kingdom). Generally, these changes have had the desired effect of reducing pension growth. Finland, however, changed its indexing procedure in 1977 only to find that the new index grew faster than the old index for both 1978 and 1979. Since 1980, however, Finland's new pension adjustment index has been growing less rapidly than its old index. PMID- 6867912 TI - Symposium on orthopedic surgery. PMID- 6867913 TI - Venous thromboembolism in the orthopedic patient. PMID- 6867914 TI - The use of bone scanning for the diagnosis and management of musculoskeletal trauma. AB - Bone scanning provides a unique way of monitoring early metabolic changes in bone and its adjacent soft tissues after trauma. An abnormal scan may often precede radiographic changes by days or weeks. This accounts for its usefulness in the early diagnosis of occult fractures and in fractures not clinically suspected or seen on initial x-ray films in the patient with multiple trauma. Dynamic imaging along with static imaging can be used to evaluate fracture healing and predict delayed union and nonunion. The combined technique is useful in assessing many of the complications arising after trauma and provides a reliable method of observing their treatment. It is also a useful noninvasive technique in the evaluation of pathologic fractures. Bone scanning is becoming an increasingly useful adjunctive procedure in the diagnosis and management of musculoskeletal trauma. However, as with any diagnostic technique, it provides only part of the overall picture and must always be carefully correlated with the history, physical findings, radiographic changes, and other laboratory data. PMID- 6867915 TI - Computed tomography in orthopedics. AB - The enormous interest in CT scanning appears fully justified as this remarkable technique continues its development. In orthopedics, it has a variety of roles to play: in trauma, tumor management, and developmental disorders. As experience with the CT scan in musculoskeletal disease is accumulated, new applications will undoubtedly become apparent, adding to the already impressive list. PMID- 6867916 TI - Diagnostic and operative arthroscopy. PMID- 6867917 TI - Management of fractures in children. PMID- 6867918 TI - Surgical theory, staging, definition and treatment of musculoskeletal sarcomas. PMID- 6867919 TI - Total joint replacement in the upper extremity. AB - Prosthetic replacement of the joints of the upper extremity relieves pain, mitigates deformity, and improves function. As newer designs of prostheses are tested, we expand our knowledge of the biomechanics of each joint. Newer materials are rapidly changing the variety of implants on the market and improving prosthetic function. The problem of fixation of the noncemented prostheses to viable bone tissue remains one of the major unanswered questions for orthopedic surgeons today. Extensive research around the world is underway; different means of providing the environment that allows biologic ingrowth with fixation of a prosthesis are being investigated, thus avoiding the use of methyl methacrylate and its inherent problems. PMID- 6867920 TI - Amputations. PMID- 6867922 TI - Acute obstructive hydrocephalus caused by cerebellar infarction. Treatment alternatives. AB - The treatment alternatives for the patient who becomes comatose following nontraumatic infarction of the cerebellum are discussed. The acute hydrocephalus produced by the swollen cerebellum is readily diagnosed by computed tomography scan and is identified as a hypodense mass without contrast medium uptake that obliterates the fourth ventricle. Two typical cases are described, one managed medically and one surgically. All available reports in the world literature of similar patients treated surgically are reviewed. Based on the outcome analysis of the foregoing, a strategy is offered for the handling of future cases. PMID- 6867921 TI - Somatosensory evoked potentials in lumbar stenosis. AB - The present findings suggest that, in patients with similar symptoms and findings, both physical and roentgenographic, the radiculopathy in those whose evoked potentials became abnormal after walking or change in posture had a mechanical cause. Consequently, operation designed to correct a mechanical problem was associated with a better result than in those patients in whom the evoked potentials were unaffected by these maneuvers. The recording of somatosensory evoked potentials is a noninvasive, painless, safe and relatively inexpensive procedure which appears to be a useful adjunct in the diagnosis and treatment of patients with lumbar stenosis and may help differentiate neurogenic from vascular claudication when these conditions cannot be clearly distinguished clinically. PMID- 6867923 TI - Moyamoya disease associated with intracranial aneurysms. AB - A case of moyamoya disease associated with multiple intracranial aneurysms is reported. The aneurysms were located at the bifurcation of the basilar artery and at the precommunicating segment of the right posterior-cerebral artery. They were found to be unruptured and clipped successfully through a right frontotemporal craniotomy. Outcome of the operation was satisfactory. We propose the operative indication for these cases on the basis of operative and radiological findings, and also discuss characteristic aspects of this disease. PMID- 6867924 TI - Clinical value of serial computed tomography with severe head injury. AB - Serial computed tomography (CT) scanning was performed on 138 patients suffering from severe head injuries (i.e., with scores of 8 or less on Glasgow Coma Scale). Standard practice called for scans to be done upon admission (within hours of the injury) and after 1, 3, and 7 days and 1 month. Subsequent CT scans depended on the patient's condition. Clinical results at the time of discharge were graded according to the Glasgow Outcome Scale. During the serial CT scan, there were new findings (not visualized on the initial CT scan but appearing on subsequent scans) in 91 of the 138 patients. These new findings were classified into seven types: (1) decreased density collection in the subdural space; (2) ventricular dilatation; (3) intracerebral hematoma; (4) intraventricular hemorrhage; (5) extracerebral hematoma; (6) edema; and (7) infarction. We defined intracerebral hematoma, intraventricular hemorrhage, extracerebral hematoma, edema, and infarction as new lesions. Of the 60 patients with new lesions, 12 had a good outcome and 48 had a poor outcome. Of 78 patients who did not have any new lesions, 60 had a good outcome and 18 had a poor outcome. A significant correlation was found between good outcome and the absence of new lesions and between bad outcome and the development of new lesions (p less than 0.001; X2 = 44.038). We conclude that serial CT scanning can help predict the outcome of patients with severe head injuries and may be very important in their examination and care. PMID- 6867925 TI - Intrasellar meningioma. AB - Two purely subdiaphragmatic intrasellar meningiomias are described. The rarity of this unusual intrasellar tumor is stressed, and the differential diagnosis of intrasellar meningioma versus pituitary adenoma is discussed. The good results of the rhinoseptal route for surgery are emphasized. PMID- 6867926 TI - Ruptured cerebral aneurysms associated with arterial occlusion. AB - Seven cases of ruptured cerebral aneurysm associated with an occlusion of a large cerebral artery are reported. All seven patients had never suffered from ischemic cerebrovascular disease before the aneurysmal rupture. All nine aneurysms, including the two unruptured ones, arose on the artery serving as an important collateral pathway, and eight of the nine were found in locations where saccular aneurysms are known to occur infrequently. The role of hemodynamic factors in the pathogenesis of these aneurysms is stressed. PMID- 6867927 TI - Estrogen and progesterone receptors in meningiomas in relation to clinical and pathologic features. AB - Tumor estradiol and progesterone binding sites were studied in 34 patients with meningioma. Twenty of the meningiomas contained very low titers (mean, 45 fmol/g of tumor; range, 0-201 fmol/g of tumor) of a nonspecific cytoplasmic [3H]estradiol binding component, whereas 26 of the tumors contained high titers of specific high-affinity cytosol [3H]promegestone (R5020; progesterone) binding sites (mean, 1476 fmol/g of tumor; range, 0-8328 fmol/g of tumor). No nuclear binding activity for [3H]estradiol could be detected in 12 of the 34 meningiomas studied, irrespective of the progesterone binding activity. There was no correlation between high progesterone binding activity and the age or the sex of the patient, nor between tumor location and cellular mitotic index. However, progesterone binding activity was present more frequently in meningothelial (95%, 18/21 patients) than in transitional (55%, 5/9 patients) or fibroplastic (25%, 1/4 patients) tumor histologic types. These data suggest that the cellular biosynthesis of the progesterone binding component in meningiomas is not estrogen regulated as it is in other classic estrogen target tissues, such as the breast. PMID- 6867928 TI - Regional, cellular, and subcellular distribution of [3H]dexamethasone in rat brain edema. AB - The regional, cellular, and subcellular distribution of [3H]dexamethasone in brain edema of rats was studied. Edema was induced either by occlusion of the right carotid artery or by a cold lesion of the right temporal lobe. [3H]dexamethasone (0.3 mCi) was injected intravenously. After 30 minutes (unless otherwise stated) the brains and other desired organs were removed. In the control animals, 51% of the total [3H]dexamethasone activity was found in the cerebral hemispheres (27% in the right, 24% in the left), 24% in the cerebellum, and 24% in the brainstem. Time-course studies revealed a rapid decline of [3H]dexamethasone content in all regions of the brain. After 48 hours of ligation of the right carotid artery, 80% of the [3H]dexamethasone could be found in the cerebral hemispheres (48% in the right, 32% in the left), 10% in the cerebellum, and 9% in the brainstem. In the series in which cold lesions were induced, 74% of the [3H]dexamethasone was recovered in the cerebral hemispheres (40% in the right (lesion), 34% in the left (control]. Before the trauma, 75% of the dexamethasone was found in astrocytes and 25% in neurons; after the trauma, 48% was bound to astrocytes and 42% to neurons. At the subcellular level, accumulation took place in the microsomal, lysosomal, and cytoplasmic fractions of the damaged cells. These data demonstrate an increased uptake of dexamethasone into ischemic damaged brain tissue and into neurons, microsomes, and lysosomes. PMID- 6867929 TI - Lumbar hemangioendothelioma. AB - A case of hemangioendothelioma encountered in the lumbar region of a child is presented. Clinically, the tumor could not be differentiated from a dermoid cyst. This lesion must be included in the differential diagnosis of benign lumbar tumors. PMID- 6867930 TI - Unusual spinal cord injury by a speargun. AB - Penetrating injury of the upper cervical spinal cord is usually caused by missiles. An unusual case of injury to the upper cervical spinal cord by a speargun is reported. Surgical treatment was uneventful, and the patient made good neurological progress within 2 days after the operation. On the fifth day he became confused and had a temperature of 40 degrees C. A diagnosis of Branhamella catarhalis meningitis was made. The patient's condition continued to deteriorate despite parenteral broad-spectrum antibiotic therapy, and he died 15 days after the injury. PMID- 6867931 TI - Rupture of anterior communicating artery aneurysm during transsphenoidal surgery for pituitary adenoma. AB - The case of a 55-year-old man with a nonfunctioning pituitary adenoma associated with an anterior communicating artery aneurysm that ruptured during transsphenoidal surgery is presented. This small aneurysm was not detected on bilateral angiography of the carotid artery before surgery. Computed tomography (CT) scans showed the pituitary adenoma extending to the suprasellar region and the sphenoid sinus. After intracapsular removal of the tumor, cerebrospinal fluid from an intraspinal catheter became bloody and CT scans disclosed massive subarachnoid hemorrhage. Repeated angiography revealed a tiny anterior communicating artery aneurysm, which was clipped on the 37th day after the operation. Risk factors in the procedure of transsphenoidal surgery, especially of a pituitary adenoma with suprasellar extension, are discussed. PMID- 6867932 TI - Unilateral subdural hematoma without midline shift. AB - Two cases of radiographically isodense subdural hematoma are presented in which absence of displacement of midline cerebral structures was due not to bilateral lesions, but rather to "balancing" of the volumetric effect of a unilateral lesion by preexisting encephalomalacia. Attention to the past medical history and the computed tomography scan which showed evidence of unilateral loss of brain substance led to the proper diagnosis. PMID- 6867933 TI - Aneurysm growth and hemodynamic stress. AB - Two cases of intracranial saccular aneurysm related to an arteriovenous malformation (AVM) are illustrated, in which a remarkable growth of the sac over the years was demonstrated angiographically. According to the relevant literature, aneurysm enlargement is correlated to the flow toward the AVM, increasing the intrasaccular turbulence and stress on the wall to which "solitary" aneurysms are usually subjected. The presence of bilateral infundibular widening at the origin of the posterior communicating artery is noted in one of the cases. This finding possibly confirms further the effects of hemodynamic stress. PMID- 6867934 TI - Neurosurgery--where is it going? PMID- 6867936 TI - Decrease of learning capacity in offspring with increasing paternal age in the rat. AB - The same 15 male Wistar rats at the ages of 2.5, 6, 10, 14, 18, and 22 months were successively randomly mated with 2.5-month-old females. In a separate experiment, 15 male Wistar rats at the age of 2.5 months and 15 at the age of 23 months were simultaneously randomly mated with 2.5-month-old females. Offspring were evaluated in regard to the mean number per litter, sex ratio, frequency of gross external malformations, growth pattern, and mortality in the first 13 weeks of life and reproductive capacity at 13 weeks of age. They were also evaluated for spontaneous activity and emotionality with an open field test and for learning capacity with an avoidance conditioning test, both carried out between 10 and 13 weeks of age. Only learning capacity of the offspring, expressed in percentage of success for male or female, decreased consistently and significantly as the father's age increased. But females did not seem to be affected in the same way as males. The genetic implications are briefly discussed. PMID- 6867935 TI - Lumbosacral meningocele. PMID- 6867938 TI - Peripheral nerves do not play a trophic role in limb skeletal morphogenesis. AB - Research was undertaken to test the hypothesis that thalidomide-induced limb defects resulted from damage to the neural crest or peripheral nerves and that normal limb development depends upon either the quality (level specific) or quantity of peripheral nerves. Barriers which were placed into early chick embryos to block brachial plexus-level neural crest cells from reaching the limb resulted in normal limb skeletons. These data agree with previous work in suggesting that skeletal morphology is independent of innervation. PMID- 6867937 TI - Behavioral outcome after prenatal exposure to phenytoin in rats. AB - The long-term behavioral outcome subsequent to prenatal exposure to phenytoin was examined in an animal model for the Fetal Hydantoin Syndrome. Behavioral outcome was determined by two different techniques--the residential maze, which provided a 24-hour measure of horizontal movement frequency in a group of animals, and time-lapse photography, which allowed quantification of frequency, duration, distribution, and sequencing of 15 motor acts performed by individual rats. Phenytoin induced significant, sex-related changes in motor behavior. Ten-week old females exposed in utero to phenytoin displayed hypoactivity comprised of a longer duration, greater frequency, and more random distribution of grooming behaviors. Prenatally exposed males at that age displayed an opposite effect of hyperactivity consisting of a longer duration and greater frequency of exploratory behaviors. It appears that prenatal exposure to phenytoin may affect normal maturational changes in motor behavior so that immature activity levels are maintained in the adult animal. PMID- 6867939 TI - Congenital tibial aplasia with preaxial polydactyly: soft tissue anatomy as a clue to teratogenesis. AB - We performed preoperative arteriography and postamputation dissection on a human limb having complete tibial aplasia and preaxial polydactyly. The tibia was replaced by a tendinous band with an attached connective tissue mass. In the leg, the muscles were normal. Muscles usually arising from the tibia arose from the tendinous band, Intrinsic muscles of the foot were absent where skeletal elements were absent and there were supernumerary muscles where there were supernumerary skeletal elements. The tendinous insertions of the muscles that originated in the leg followed the skeletal pattern of the foot. The nerves were normally distributed with the exception that extra branches innervated the supernumerary toes. Both the anterior tibial and peroneal arteries were smaller than normal and progressively reduced in size as they coursed distally and could not be identified below the ankle. The dorsalis pedis artery was absent. The other arteries of the leg and foot were normal with the exception of extra branches supplying the supernumerary toes. The anatomy indicates that the foot is probably a double posterior duplication. Such a defect implies abnormal specification of the foot pattern due to a prespecification event. The tibial remnant with normal leg soft tissues indicates normal specification of the leg pattern and subsequent interruption of tibial morphogenesis due to a postspecification event. The presence of these different types of malformations in the same limb may seem to be contradictory. We suggest, however, that a single teratogenic event occurring at one moment in time could cause combined pre- and postspecification malformations. We further suggest that a diminished anterior tibial artery reduced the number of vessels available for collateral circulation and thus put the limb at risk for subsequent malformation. PMID- 6867940 TI - Structural teratogenicity evaluation of methyl chloride in rats and mice after inhalation exposure. AB - One hundred bred Fischer-344 female rats were exposed daily for 6 hours to atmospheres containing 0, 100, 500, or 1,500 ppm methyl chloride, 25 females per exposure concentration, from gestation day (gd) 7 through gd 19. On gd 20, the females were sacrificed for evaluation of maternal reproductive and fetal parameters. Maternal and fetal toxicity was apparent at the highest exposure concentration. There were no methyl chloride-induced external, skeletal, or visceral abnormalities seen in the fetuses. One hundred thirty-two C57BL/6 female mice bred to C3H males to produce B6C3F1 offspring were exposed daily for 6 hours to atmospheres containing 0, 100, 500, or 1,500 ppm methyl chloride, 33 females per exposure concentration, from gd 6 through gd 17. Exposure to the entire 1,500 ppm group was terminated on gd 10-14, with the animals killed in extremis. Selective necrosis of neurons in the internal granular layer of the cerebellum, ranging from individual cell involvement to focal areas comprising large numbers of neurons, was found in all females. On gd 18, the females from the other treatment groups, all of which survived, were killed for evaluation of maternal reproductive and fetal parameters. No evidence was seen of maternal or fetal toxicity in these exposure groups. There were no significant alterations in external appearance in fetuses from any of the exposure groups. Visceral examination of mouse fetuses revealed a small, but statistically significant, incidence of heart defects in litters of the 500-ppm group. The anomaly, a reduction or absence of the atrioventricular valve, chordae tendineae, and papillary muscle, was observed on the left side (bicuspid valve) in three fetuses and the right side (tricuspid valve) in six fetuses: three males and six females. It is concluded that methyl chloride inhalation exposure in pregnant rats, during critical periods of embryo and fetal development, is not teratogenic at concentrations which elicit maternal and fetal toxicity. In pregnant mice, methyl chloride was severely toxic to dams following 4 days or more of exposure to 1,500 ppm in air. Methyl chloride, at 500, but not 100 ppm, was teratogenic in mice, leading to a malformation in the heart. No embryo-fetal toxicity or teratogenicity was associated with exposure of mice, during critical periods of embryo and fetal development, to 100 ppm of ethyl chloride. PMID- 6867941 TI - Evaluation of heart malformations in B6C3F1 mouse fetuses induced by in utero exposure to methyl chloride. AB - C57BL/6 female mice impregnated by C3H males mice to produce B6C3F1 fetuses were exposed daily for six hr to atmospheres containing 0, 250, 500, or 750 ppm methyl chloride, from gestation day 6 to gestation day 18. There were 74 to 77 females with copulation plugs per exposure concentration. Females exposed to 750 ppm ethyl chloride exhibited ataxia commencing on the seventh day of exposure (gestation day 12). They also showed hypersensitivity to touch or sound, tremors and convulsions. Six females in the 750 ppm group died and one was euthanized in extremis prior to scheduled sacrifice. On gestation day 18, all other females were euthanized for evaluation. Only dams exposed to 750 ppm exhibited significant decrease in body weight by gestation day 18, weight gain during the gestation period, and absolute weight gain (weight gain minus gravid uterine weight) versus controls. There were no treatment related-effects on these parameters in the other exposure groups. None of the groups exhibited exposure related differences in pregnancy rate, gravid uterine weight, or maternal liver weight. There were no differences in the numbers of implantations, resorption, dead fetuses, nonlive (dead plus resorbed) fetuses, live fetuses, sex-ratio, or mean fetal body weight per litter. There was a significant exposure-related increase in the number and percentage of affected (nonlive plus malformed) fetuses per litter with the incidence of affected fetuses in the 750 ppm group significantly higher than controls. There was a statistically significant increase in the incidence of heart defects in the 500 and 750 ppm group relative to controls. Of the 37 fetuses in the study with heart defects, 23 were females, 14 were males. The heart defects observed included: absent or abnormal tricuspid valve, reduced number of papillary muscles and/or chordae tendineae on the right side, small right ventricle, globular heart, and white spots in the left ventricular wall. Multiple malformations were observed in one fetus from the 500 ppm group and in three fetuses in the 750 ppm group. It is concluded that methyl chloride inhalation exposure to pregnant C57BL/6 mice from gestation day 6 through gestation day 17 resulted in maternal toxicity only at the 750 ppm exposure concentration and was teratogenic to B6C3F1 conceptuses at exposure concentrations of 750 and 500 ppm, leading to fetal heart malformations. No evidence of embryo or fetotoxicity other than teratogenicity was seen at any of the exposure concentrations employed. No maternal, embryo or fetotoxicity or teratogenicity was associated with exposure of mice, during critical periods of embryo and fetal development, to 250 ppm of methyl chloride. PMID- 6867942 TI - Induction of feather malformations in chick embryos by cadmium: protection by zinc. AB - Various doses of cadmium chloride were injected to chick embryos between the seventh and 14th day of incubation. Doses over 15 micrograms/egg produced high mortality and, when injected between the tenth and 11th day, widespread curling of the feathers in the surviving embryos. A different type of malformation, consisting of hemorrhagic atrophy of the distal part of the feathers, was observed in the embryos injected with similar doses during the 12th day. No feather malformations were observed in embryos injected before the ninth or after the 12th day of incubation. The simultaneous injection of an equimolar amount of zinc sulfate prevented the feather malformations. PMID- 6867943 TI - Embryotoxicity of Norlestrin, a combined synthetic oral contraceptive, in rhesus macaques (Macaca mulatta). AB - Thirty timed-mated pregnant rhesus monkeys received Norlestrin (Norethindrone acetate, 2.5 mg, and ethinyl estradiol, 0.05 g per tablet, Parke-Davis) orally at four different dose levels. The dose levels were 5, 10, 25 and 50 mg/day/monkey and the doses were administered during early (days 21-35), late (days 33-46), and throughout (days 21-46) organogenesis, except for the 50-mg-dose-group animals, which were treated only during early organogenesis (days 21-35). All except the animals in the 60-mg-dose group were allowed to go to term (165 days gestation). Pregnancy for the animals in the 50-mg-dose group was terminated by cesarean section on day 50 of gestation and the fetuses were fixed, serially sectioned, and examined histologically. No teratogenicity was observed. However, the prenatal mortality rate (38.5%) was higher for the Norlestrin-treated animals than in the control colony (21%). Eight animals aborted between days 40 and 78 of gestation and two other cases resulted in stillbirths at 139 and 165 days of gestation. There was a higher incidence of abortion (44.4%) in the 25-mg-dose group. Norlestrin treatment during early organogenesis also resulted in a higher abortion rate (37.5%) compared to treatment during late organogenesis (22.2%) abortions). No morphological abnormalities were found in infants observed at birth or in juvenile monkeys which died of natural causes or in those that were sacrificed over a period of two years. No histopathology was observed in the 50 day-old fetuses examined by serial section. Examination of endogenous maternal serum estrogen and progesterone levels in Norlestrin-treated monkeys (25 mg/day, days 21-35) suggested that placental steroidogenesis was not affected; however, the lower levels of estrogen in maternal serum suggested that the ovarian steroidogenesis was affected. Although the precise pathogenesis of this selective embryolethality is not known, several observations in this study suggest a direct generalized embryotoxic effect. Thus, this study for the first time has demonstrated that, while Norlestrin may be embryolethal at 100 times the human contraceptive dose equivalent (25 mg/day) in the rhesus monkey, nevertheless it does not affect the offspring which survive the exposure. PMID- 6867945 TI - Some teratogenic properties of ethanol and acetaldehyde in C57BL/6J mice: implications for the study of the fetal alcohol syndrome. AB - To investigate the teratogenic effect of acute alcohol exposure, pregnant C57BL/6J mice were exposed to 25% ethanol (either two doses of 2.9g/kg or one dose 5.8g/kg) during the organogenic period either by intraperitoneal injections or by intubation. The incidence of malformations varied according to (1) the stage of embryonic development at the time of exposure, (2) the route of administration of the alcohol, and (3) the amount of alcohol given and the time period over which it was administered. Oral doses of alcohol were teratogenic although less so than the same dose given intraperitoneally, and two intraperitoneal doses four hours apart produced significantly more malformation than the same two doses six hours apart. The primary metabolite of alcohol, acetaldehyde, was also investigated for its teratogenicity. It was found that one or two doses of four percent acetaldehyde (0.32g/kg), administered intraperitoneally were teratogenic. A further attempt was made to raise blood acetaldehyde levels by exposing mice to disulfiram, an inhibitor of acetaldehyde dehydrogenase, prior to administration of alcohol. The disulfiram pretreatment did not increase the malformation rate. Treatment with alcohol on day 7 or 8 caused a variety of facial abnormalities, some of which were comparable to those seen in children with fetal alcohol syndrome. Exposure on day 9 or 10 resulted in limb defects. The results suggest that one or more episodes of heavy maternal drinking at critical periods in pregnancy may severely damage the embryo and may produce many features of the fetal alcohol syndrome. PMID- 6867944 TI - Maternal exposure to exogenous sex hormones in relation to birth weight of offspring. AB - Birth weight was analyzed among singleton live births (N = 665) in Upstate New York in 1974 to women who used oral contraceptives (OC) in comparison to live births to women who used no contraceptives (N = 716), within 11 months prior to last menstrual period (LMP). In addition, birth weight was examined among live births to women who received hormone support therapy (N = 97) and hormone pregnancy tests (N = 75) during pregnancy. There was no evidence for a reduction in mean birth weight, or an increase in frequency of lower weights, among births to OC users, including those who stopped using OC within 2 months of LMP. Generally similar findings held within three maternal age groups (less than 25, 25-29, and 30-39 years). There was no evidence for a reduction in birth weight among offspring of women who received hormone pregnancy tests. Mean birth weight was relatively low among male and female births to women who received hormone therapy for "threatened abortion," but this may reflect the selection of women for such treatment rather than an effect of exogenous hormones on fetal growth. PMID- 6867946 TI - The embryotoxic effects of ultrasound exposure in pregnant ICR mice. AB - The embryotoxicity of ultrasound exposure during pregnancy was investigated in DUB:(ICR) mice. On day 0 of gestation (day of plug), pregnant mice were assigned to one of five groups: cage control, sham exposed (0 W/cm2), 0.05 W/cm2, 0.50 W/cm2. or 1.00 W/cm2. Females were anesthetized on day 8 of gestation and their abdomens were shaved to assure good acoustic coupling. The animals were strapped on a lucite board and placed vertically into a distilled degassed water bath (30 degrees C) so that the abdomen was fully submerged and centered in the axis of the ultrasonic beam. Insonation was carried out using a PZT transducer with a radius of 1.27 cm and a frequency of 1 MHz under continuous wave conditions. Each animal was placed at a distance of 25 cm from the transducer and exposed to the appropriate intensity for 120 seconds. On day 17 of gestation, the maternal animals were killed, the uterine contents were examined, and live fetuses were weighed and then shipped in cold lactated Ringer's solution from Maryland to Arkansas. Fetuses were examined on the day following maternal sacrifice for external and visceral defects and skeletons were prepared and examined subsequently. Slight but significant differences were detected between the cage control and sham-exposed groups. No statistically significant changes were seen that could be attributed to ultrasound exposure, although there was a slight increase in the incidence of malformed fetuses and the occurrence of multiple malformations in individual fetuses as intensity of the ultrasonic exposure increased. PMID- 6867947 TI - Pharmacology of dextroamphetamine-induced cardiovascular malformations in the chick embryo. AB - We have observed dextroamphetamine sulfate to cause cardiovascular malformations in the 4-day-old chick embryo. Essentially all malformations were of the heart and great vessels. About one-half of these were the abnormal persistence of the left fourth aortic arch. Ventricular septal defects comprised the vast majority of the other malformations. Since d-amphetamine has both a direct and, more importantly, an indirect mode of alpha and beta adrenergic stimulation, three drugs were used to try to inhibit malformation production: alpha-methyl-p tyrosine (AMT), a catecholamine synthesis inhibitor; metoprolol, a beta 1 blocker; and phentolamine, an alpha blocker. When given with d-amphetamine, all three drugs significantly reduced the malformation rate resulting from d amphetamine alone. We speculate that the embryonic chick is capable of responding to the alpha and/or beta properties of dextroamphetamine sulfate. These properties may be causally related to the malformations observed. PMID- 6867948 TI - The Fourth Annual Meeting of The Behavioral Teratology Society. Abstracts. PMID- 6867949 TI - Combined embryotoxic action of toluene, a widely used industrial chemical, and acetylsalicylic acid (aspirin). AB - CFY rats were exposed to inhalation of fresh air at days 10-13 of gestation; at day 12 the dams were given 0, 125, 250, 500, or 1,000 mg/kg acetylsalicylic acid (ASA) by gavage. During the same period of gestation (days 10-13) further groups of rats were exposed to toluene at 1,000, 2,000, and 3,600 mg/m3 atmospheric concentration and were given 250 mg/kg ASA by gavage; two subgroups of animals treated with 250 mg/kg ASA in combination with 3,600 mg/m3 toluene inhalation were given 0, 2.5, or 5 gm/kg glycine 2 hours before the ASA dose. At day 21 the animals were killed and examined for teratogenic effects and histological changes. After 48 hours toluene exposure other groups of rats were treated with ASA or with ASA plus glycine (administered 2 hours earlier) on day 20 of gestation. These animals were killed 2 hours later and the salicylic acid concentration in maternal and embryonic plasma and in amniotic fluid was measured by gas chromatography. With the rising ASA doses both maternal toxicity (increased mortality, decreased food consumption, and weight gain) and embryonic toxicity (postimplantation loss, increased incidence of weight-retarded fetuses, increased minor anomalies and malformations, decreased average weight of fetuses) increased. Toluene was found to potentiate the toxic effect of ASA and to increase both maternal and embryonic toxicity. The type of ASA-induced minor anomalies and malformations was also found to be altered under the effect of toluene pretreatment. By raising the toluene concentration the salicylic acid level in the maternal and embryonic plasma and in the amniotic fluid was increased above the expected concentration. The mechanism of the potentiating interaction should be looked for in the depletion of the glycine pool by toluene (and its metabolites) and in the resultant increase of salicylic acid level. Increasing ASA embryotoxicity caused by toluene can be warded off by glycine administration. PMID- 6867950 TI - Erythropoiesis in the fetal trisomy 19 mouse. I. Characterization of erythrocyte populations in peripheral blood. AB - Changes in the type, size, and relative percentage of different erythrocyte populations in the peripheral blood of individual trisomy 19 and normal littermate mouse fetuses were studied from 12 gestational days to term. Large nucleated erythrocytes of yolk-sac origin comprise the first population of cells and are gradually diluted out of the circulation by nonnucleated erythrocytes of hepatic origin. This transition occurs between 12 and 16 gestational days. The rate of decline of the nucleated erythrocytes in the trisomic animals lagged by approximately 1 day behind the normal littermates, so that they did not completely disappear from the peripheral circulation until day 17. A slight decrease in size of the nonnucleated erythrocytes which occurs with increasing gestational age was also delayed by approximately 1 day in the trisomic fetuses. These observations are consistent with an hypothesis that one effect of the murine trisomy 19 genome is to retard by 1 day the growth and development of the affected animal. PMID- 6867951 TI - The Bendectin Saga: another American tragedy (Brent, '80). PMID- 6867952 TI - What's new: the laser in gynecologic fertility surgery. PMID- 6867953 TI - Recent advances in cardiac pacing. PMID- 6867955 TI - Conservative management of fingertip amputations in children. PMID- 6867954 TI - Death on Texas roads: the picture worsens for young adults. PMID- 6867956 TI - Institute for the Medical Humanities: plans and prospects. PMID- 6867957 TI - Medicine and the law. Before the doctor dies--a planning checklist. PMID- 6867958 TI - [The intravenous line]. PMID- 6867959 TI - [What is the ideal anesthesia system?]. PMID- 6867960 TI - [Air pollution in the operating room from subanesthetic concentrations of inhalation anesthetics]. PMID- 6867961 TI - [New aspects of regional anesthesia]. PMID- 6867962 TI - [Coronary circulation monitoring in the operating room and intensive care unit]. PMID- 6867963 TI - [Ventilatory assistance: new technics]. PMID- 6867964 TI - [Coronary heart disease and anesthesia]. PMID- 6867965 TI - [The patient with renal insufficiency]. PMID- 6867966 TI - [Anesthesia and primary care in craniocerebral injuries]. PMID- 6867967 TI - [Problems of intra-operative intensive care in pediatric cardiovascular surgery]. PMID- 6867968 TI - [Anesthesia in gynecology and obstetrics]. PMID- 6867970 TI - [Anesthesia in orthopedics]. PMID- 6867971 TI - [Clinical aspects, treatment and prevention of urinary tract infections in children]. PMID- 6867972 TI - [Hematuria and proteinuria]. PMID- 6867969 TI - [Anesthesia for ear, nose and throat (ENT) operations]. PMID- 6867974 TI - Coal and the lung. PMID- 6867973 TI - [Blood pressure measurement and hypertension in childhood]. PMID- 6867975 TI - Management of neonatal posterolateral diaphragmatic hernia. AB - From March 1978 to April 1982 13 neonates with a left posterolateral diaphragmatic hernia were seen in respiratory distress within 12 hours of birth. Each had severe acidosis and hypoxia. They were immediately intubated and ventilated. Arterial and central venous lines were inserted, the acidosis was partially corrected, and a dopamine infusion of 4-8 micrograms/kg/min was begun immediately. Continuous monitoring of arterial and venous pressures, core and skin temperatures, blood gases, and pH was instituted. Diaphragmatic defects were repaired by direct suture in nine neonates and by Gore-Tex patches in four. The left lung in all patients was hypoplastic. Ventilation and inotropic support were continued for four to five days after operation and close control of acid-base balance was maintained. All but one survive and are doing well. We consider the key to survival to be management of the dangerous combination of acidosis (by enhancing peripheral and renal perfusion with dopamine) and hypoxia (by prolonged assisted ventilation). PMID- 6867976 TI - Reproducibility of histamine challenge tests in asthmatic children. AB - The measurement of bronchial reactivity by histamine challenge testing is of increasing clinical importance in paediatrics. By means of a simple tidal breathing technique for the measurement of histamine sensitivity (expressed as PC20--the concentration of histamine which produces a 20% fall in peak flow rate) in childhood asthma, the reproducibility of pairs of tests was estimated over one hour and 24-hour intervals in 22 children. Under carefully controlled conditions the 95% confidence limits of PC20 were 0.8-1.25 X baseline PC20 after one hour and 0.36-2.8 X baseline PC20 after 24 hours. PMID- 6867977 TI - Role of lung scanning in assessing the resectability of bronchial carcinoma. AB - Ventilation and perfusion lung scans were performed in 58 patients before operation for bronchial carcinoma to determine in which patients the lung scan was most useful for assessing mediastinal spread and resectability of the tumour. Perfusion of the affected lung was less with larger and more centrally situated tumours. Perfusion was also less for left-sided than for right-sided tumours but this is explained by the normal differential perfusion of the right and left lungs. The lung scan was unhelpful in predicting resectability of peripheral tumours, but with central tumours if perfusion of the affected lung was less than 25% of the total perfusion the lesion was likely to be non-resectable because of spread to the mediastinum. Airways obstruction was present in 67% of the patients but did not interfere with the interpretation of the scans. In most cases ventilation scans provided no additional information, and the use of krypton-81 m as a sensitive indicator of regional ventilation did not improve on the predictive value of the perfusion scan. PMID- 6867978 TI - Role of fibreoptic bronchoscopy in the diagnosis of mycobacterial diseases. AB - From January 1976 to December 1981 mycobacteria were recovered for the first time from the respiratory tract of 179 patients. Twenty-three patients had undergone fibreoptic bronchoscopy during initial investigation after three or more expectorated sputum specimens were negative for acid-fast bacilli. Three of these patients had nodular lesions on the chest radiograph and the diagnosis of mycobacterial disease was made only after thoracotomy. In the remaining 20 patients bronchial brushings yielded a positive culture in 19, while bronchial brushing was negative in one patient in whom culture of sputum before bronchoscopy had been positive. In eight of these 19 patients (group A) bronchial brushing was the only source that gave a positive result from culture, while in 11 patients (group B) both bronchial brushing and prebronchoscopy sputum yielded positive cultures. When these two groups were compared no difference was seen in their clinical presentation or radiographic findings but there was a notable difference in the quality of the presentation or radiographic findings but there was a notable difference in the quality of the prebronchoscopy sputum. Six of eight patients in group A had poor prebronchoscopy sputum, while 10 of 11 in group B had good prebronchoscopy sputum. It is concluded that, if a patient is unable to produce sputum or is able to produce only a poor specimen, fibreoptic bronchoscopy may be a useful means of obtaining additional material for culture. PMID- 6867979 TI - Pulmonary infection with Mycobacterium kansasii in Wales, 1970-9: review of treatment and response. AB - Thirty-five patients (88% male) with pulmonary infection caused by Mycobacterium kansasii have been reviewed. Sixty-six per cent had pre-existing lung disease, chronic bronchitis and emphysema accounting for half of the disorders. Unilateral lesions were present in 69% of patients whose chest radiographs were reviewed and 90% had cavitating disease. The development of unilateral or bilateral disease appeared to be independent of any delay in starting treatment. Five patients died while receiving treatment, but none of these deaths was due to M kansasii infection. The remaining 30 patients were successfully treated with drug regimens, all of which included rifampicin and 86% of which included ethambutol. There was 100% sputum conversion, with no relapses after a mean follow-up period of five-and-a-half years. Rifampicin and ethambutol given for a mean period of 15 months appeared to be a non-toxic, effective combination. PMID- 6867980 TI - Silicosis in surface coalmine drillers. AB - Surface coalminers are generally thought to be at minimal risk of developing pneumoconiosis. Biopsy-proved silicoproteinosis was found in a 34-year-old surface coalmine driller, and two of nine other drill crew members who worked for the same company had chest radiographic findings compatible with simple silicosis. Reanalysis of data from a previous United States Public Health Service survey of surface coalminers, after exclusion of those with underground mining experience, showed that 38% of the cases of pneumoconiosis occurred in drill crew members, a group comprising only 11% of the study population. On the basis of these data surface coalmine drillers appear to have an increased risk of developing occupational lung disease. PMID- 6867981 TI - Results of surgical treatment of ventricular septal defects with pulmonary hypertension. AB - Two hundred and twenty-five consecutive patients with interventricular septal defect and associated pulmonary hypertension have undergone corrective surgery at the Christian Medical College Hospital. The mean preoperative systolic pulmonary artery pressure was 70.5 (range 31-136) mm Hg and the calculated pulmonary vascular resistance ranged from 300 to 1680 dyn/s cm-5. A paracoronary right ventriculotomy was the approach of choice. Profound hypothermia and circulatory arrest were not used, even in 12 patients weighing under 10 kg. Among the older children and young adolescents there were 27 who had a calculated pulmonary vascular resistance of over 800 dyn/s cm-1 and their mortality was 22%, which is good when compared with that of other series. It is evident that both the early and the late death rate after surgery increase with the age of the patient, especially in those with associated pulmonary hypertension. In 69 patients studied after repair recatheterisation showed no residual defect by oximetry. The fall in the pulmonary artery pressures after surgery has been striking in most patients. The late death rate was 2.5%. The surviving patients are leading normal, active lives. PMID- 6867982 TI - Evaluation of ultrasonically nebulised solutions for provocation testing in patients with asthma. AB - The airway response to the inhalation of ultrasonically nebulised distilled water was determined in 55 asthmatic patients and 16 normal subjects. We calculated the dose of water required to induce a 20% reduction (PD20) in forced expiratory volume in one second (FEV1) by measuring the output of the nebuliser and the volume ventilated by each subject. Forty-eight of the asthmatic patients had a PD20 of 9 ml or less but three patients required as much as 24 ml. A PD20 was not recorded in the normal subjects and the challenge was stopped after 33 ml. In 12 patients the challenge was repeated within six months and the airway response was shown to be reproducible at equivalent doses of water. In a separate group of 11 patients there was, however, a highly significant reduction in the percentage fall in FEV1 when equivalent doses of water were given on two occasions 40 minutes apart. When the temperature of the inhaled water was increased from 22 degrees C to 36 degrees C eight of 10 patients had a similar change in FEV1 with equivalent doses of water. The airways obstruction induced by the inhalation of water was readily reversed with salbutamol administered by aerosol. In some patients a challenge with water or 3.6% saline was repeated after pretreatment with sodium cromoglycate, atropine methonitrate, and verapamil hydrochloride, all given as aerosols. The airway response to the equivalent dose of water or saline was significantly reduced after treatment with sodium cromoglycate but not atropine or verapamil. PMID- 6867983 TI - Dose-response study of inhaled salbutamol powder in chronic airflow obstruction. AB - Dose-response relationships for salbutamol were studied in eight patients suffering from chronic airflow obstruction with no asthmatic features. Each inhaled, double blind, in randomised order 0, 200, 400, 800, and 1600 micrograms salbutamol on five successive mornings. Before and at intervals up to six hours after the inhalation FEV1, vital capacity, maximum inspiratory and expiratory flow-volume curves, and 12-minute walking distances were measured. Analysis of variance of the results indicated significant dose-response relationships and showed the larger doses to have a longer duration of action. Simple spirometric tests were as useful in providing objective evidence of benefit as maximum inspiratory flows or the 12-minute walking distance. PMID- 6867984 TI - Breathlessness and portable oxygen in chronic obstructive airways disease. AB - Breathlessness was measured in 20 patients with severe chronic obstructive lung disease by the use of a visual-analogue scale. Severe resting arterial hypoxaemia was not a feature. The severity of breathlessness measured in this way did not correlate well with the results of spirometric tests or with walking ability. The use of portable oxygen was studied during simple walking tests for its effect on walking ability and the sensation of breathlessness. Portable oxygen improved exercise capacity but a placebo effect of the system probably accounted for some of the improvement. A clear improvement of distressing breathlessness was observed and represented a useful therapeutic response. Breathlessness and simple exercise ability were shown to respond independently to oxygen breathing. The value of short-term intermittent oxygen in patients with severe chronic obstructive lung disease needs to be evaluated in terms of both exercise ability and breathlessness. PMID- 6867985 TI - Primary Hodgkin's disease of the lung: case report. PMID- 6867986 TI - Stress fracture of the first rib. PMID- 6867987 TI - Palliation of intrathoracic tracheal compression with a silastic tracheobronchial stent. PMID- 6867989 TI - Pulmonary eosinophilia in identical twins. PMID- 6867988 TI - Relapsing organising pneumonitis in a man with primary biliary cirrhosis, CREST syndrome, and chronic pancreatitis. PMID- 6867990 TI - [Hemorrhagic complications due to beta-lactam]. PMID- 6867991 TI - [The dihydralazine test in the treatment of primary pulmonary arterial hypertension. Apropos of a case]. PMID- 6867992 TI - [Digestive absorption of barium after oral administration of barium sulfate for a radiologic study]. PMID- 6867993 TI - [Severe pneumopathy and amiodarone]. PMID- 6867996 TI - [Assay technic for 3 tricyclic antidepressants using high performance liquid chromatography]. PMID- 6867994 TI - [Myocardium and plasma levels of amiodarone and its N-monodeethylated metabolite]. PMID- 6867995 TI - [Elimination half-life of 3-hydroxyquinidine in man]. PMID- 6867997 TI - [Calculation of initial values of pharmacokinetic using a programmable calculator]. PMID- 6867998 TI - [Pharmacokinetics of lithium in hyperthyroid patients. Comparison of results before and after treatment of the acute phase of hyperthyroidism]. PMID- 6867999 TI - [Phenobarbital concentrations in the cerebrospinal fluid and blood of newborn infants after administration of a single dose]. PMID- 6868000 TI - [Clinical pharmacology of amoxapine]. PMID- 6868001 TI - [Effect of an antacid on the bioavailability of prednisolone]. PMID- 6868002 TI - [Treatment of fetal tachyarrhythmia and the dosage of digoxin]. PMID- 6868003 TI - [Probable acute intracranial hypertension after minocycline ingestion in infants. Apropos of 3 cases]. PMID- 6868004 TI - The half life of factor XIII in the management of inherited deficiency. AB - Following the injection of a large dose of factor XIII concentrate the in vivo half life of factor XIII was estimated in a patient with inherited deficiency. Factor XIII activity and enzyme concentration were measured quantitatively, and a qualitative assessment of the crosslinking of fibrin was also made for upto 6 weeks after the injection. The half life was found to be about 9--10 days. This is longer than most previous reports suggest. An explantation for this finding is offered. The relevance of the long half life of factor XIII to the prophylactic treatment of patients with inherited deficiency is demonstrated. PMID- 6868006 TI - Covalent complexes between low molecular weight heparin fragments and antithrombin III - inhibition kinetics and turnover parameters. AB - Two high affinity heparin fragments (Mr 4,300 and Mr 3,200) were covalently coupled to antithrombin III (J. Biol. Chem. 1982; 257: 3401--3408) with an apparent 1:1 stoichiometry and a 30--35% yield. The purified covalent complexes inhibited factor Xa with second order rate constants very similar to those obtained for antithrombin III saturated with these heparin fragments and to that obtained for the covalent complex between antithrombin III and native high affinity heparin. The disappearance rates from plasma in rabbits of both low molecular weight heparin fragments and their complexes could adequately be represented by two-compartment mammillary models. The plasma half-life (t1/2) of both low Mr-heparin fragments was approximately 2.4 hr. Covalent coupling of the fragments to antithrombin III increased this half-life about 3.5 fold (t1/2 congruent to 7.7 hr), approaching that of free antithrombin III (t1/2 congruent to 11 +/- 0.4 hr) and resulting in a 30 fold longer life time of factor Xa inhibitory activity in plasma as compared to that of free intact heparin (t1/2 congruent to 0.25 +/- 0.04 hr). PMID- 6868005 TI - Reduction of gastric haemorrhage by fibrinolysis inhibition - an experimental study in rats. AB - Gastric ulcerations were induced in rats by pyloric ligature and instillation of 1.0 N HCl. After four hours all rats had developed ulcerations. Increased release of plasminogen activators from the mucosa during these conditions has previously been demonstrated. In the present study we investigated the role of fibrinolysis inhibition versus H2-receptor blockade on the gastric bleeding. Tranexamic acid - a synthetic inhibitor of the fibrinolytic system - was found to significantly (p less than 0.01) reduce blood loss into the gastric juice by 30% measured by 51Cr labelled red blood cells; cimetidine did not reduce the gastric haemorrhage under the experimental conditions used. Both treatment regimes significantly (p less than 0.02) reduced the secretion of gastric juice. These results indicate a contribution of the fibrinolytic system in gastric bleeding from experimentally induced gastric ulcerations. PMID- 6868008 TI - A new dysfibrinogenemia: fibrinogen Oslo IV. AB - A family with dysfibrinogenemia is described. The abnormal fibrinogen occurred in three successive generations indicating a dominant hereditary pattern. Thrombin and reptilase times were about twice the normal value. This was shown to be caused by a polymerization defect, fibrinopeptide release being normal. Platelet aggregation was undisturbed, indicating normal platelet-fibrinogen binding. The bleeding time was normal and there was no bleeding tendency. However, an obscure recurrent pulmonary ailment may, or may not, be related to the dysfibrinogenemia. The abnormal fibrinogen was tentatively termed Oslo IV. PMID- 6868007 TI - Isolation o human fibrinogen of high purity and in high yield using polyethylene glycol 1000. AB - Fibrinogen was isolated from human plasma using a polyethylene glycol 1000 fractionation procedure that eliminates problems of denaturation, degradation and contamination encountered with other procedures (1). The technique is simple, rapid, gives a high yield and gram amounts of fibrinogen can be readily obtained. PMID- 6868009 TI - Antithrombin III infusion in patients undergoing peritoneovenous shunt operation: failure in the prevention of disseminated intravascular coagulation. AB - Five patients with chronic liver disease and acquired antithrombin III (AT III) deficiency undergoing peritoneovenous (LeVeen) shunting for ascites, resistant to medical therapy, were studied prospectively for the development of disseminated intravascular coagulation (D.I.C.) after selective correction of the plasma AT III activity. This was accomplished by continuous infusion of purified human AT III concentrate beginning one day prior to surgery and continuing five to seven days post-operatively. This rigorous transfusion scheme of AT III concentrate could not prevent D.I.C. and bleeding. PMID- 6868010 TI - Exercise-induced fibrinolysis--fact not fiction. PMID- 6868011 TI - Alterations in plasma proteins and platelet functions with aging and cigarette smoking in healthy man. PMID- 6868012 TI - Anticoagulant activity and plasma phosphatidylserine hydrolysis by snake venom phospholipases A2. PMID- 6868014 TI - Platelets stimulate thromboplastin synthesis in human endothelial cells. AB - Human umbilical vein endothelial cells in culture synthesize thromboplastin upon stimulation with phytohaemagglutinin (PHA) or the tumor promotor 12-O tetradecanoyl-phorbol-13-acetate (TPA). The thromboplastin activity is further strongly enhanced in a time dependent reaction by the presence of gel-filtered platelets or platelet aggregates. This effect was demonstrable at platelet concentrations lower than those normally found in plasma, it may thus be of pathophysiological relevance. The thromboplastin activity increased with increasing number of platelets added. Cycloheximide inhibited the increase, suggesting that de novo synthesis of the protein component of thromboplastin, apoprotein III, is necessary. When care was taken to remove monocytes no thromboplastin activity and no apoprotein III antigen could be demonstrated in suspensions of gel-filtered platelets, platelets aggregated with thrombin or homogenized platelets when studied with a coagulation assay and an antibody neutralization technique. PMID- 6868013 TI - High affinity of anticoagulant phospholipases A2 for negatively-charge phospholipid. PMID- 6868016 TI - Influence of platelet activation of erythrocyte deformability. AB - Erythrocyte deformability was demonstrated to be influenced by platelet activation. Deformability of erythrocytes suspended in autologous platelet poor plasma (PPP), obtained from platelet rich plasma (PRP), was significantly reduced when PRP had previously been incubated with a platelet activating substance (arachidonic acid, adrenaline or ADP). The possibility of a direct influence of the activating substance on erythrocyte deformability was examined and malondialdehyde formation was determined as an indicator of platelet activation. Erythrocyte deformability was not impaired when endoperoxide formation in platelets was blocked by an inhibitor of cyclooxigenase (acetylsalicylic acid). Plasma viscosity was not influenced by platelet activation as demonstrated by filtration and viscosimetry. Recent studies showed that prostacyclin (PGI2) increases erythrocyte deformability (1). The antagonistic action between prostacyclin released by vessel walls and products of platelet metabolism being well known, we discuss possible mechanisms of this effect and pathophysiological relevance of our results. PMID- 6868015 TI - Effect of alpha-tocopherol administration on platelet function in man. AB - The effect of vitamin E administration on platelet function was evaluated in a group of normal, healthy volunteers. Platelet aggregation induced by collagen, ADP and epinephrine and platelet adhesion to collagen were measured at weekly intervals in 20 men and 27 women divided into 3 experimental groups of 12 individuals each and one control group of 5 men and 6 women. One experimental group was on a 6-week regimen of vitamin E in increasing dosages (400 I. U.- 1,200 I. U.), the second group received aspirin, 300 mg every other day, and the third group was on a combination of vitamin E and aspirin. In the control group, platelet function was measured at weekly intervals. In women, vitamin E by itself produced a small but significant reduction of collagen-induced platelet aggregation. A similar trend was seen in men. However, the reduction never reached statistical significance. Adhesiveness to collagen was not affected by aspirin ingestion but showed a highly significant reduction in vitamin E and vitamin E + aspirin treated individuals. These results suggest that vitamin E administration could have a beneficial effect in patients suffering from arterial thromboembolic diseases. PMID- 6868017 TI - The alkylacyl and alkenylacyl glycerophospholipids of human platelets. AB - The phospholipids of human platelets were isolated and analysed for their constituent 1-0-alkyl- and 1-0-(1'-alkenyl)glycerol species. The serine and inositol phospholipids contained only small amounts (0.5-1.6%) of both alkylacyl and alkenylacyl species; the ethanolamine phospholipids contained little alkylacyl (1.7%) but much more alkenylacyl (45.3%) species, while the choline phospholipids contained 4.5% and 1.4% of these compounds, respectively. Because choline phospholipids amount to 41% of the total phospholipids of human platelets, it appears that they could provide a sufficient supply of alkylacyl glycerophosphocholine for the generation of the alkylacetyl analog (platelet activating factor) by a deacylation-acetylation pathway. PMID- 6868018 TI - The role of the GSH-disulfide status in the reversible and irreversible aggregation of human platelets. AB - Disturbance of cellular SH/SS status of blood platelets by diminution of the level of reduced glutathione is very sensitively reflected in changes of the in vitro aggregation. Additionally, disulfide-linked protein polymers are formed. One of these polymers participates in mediating platelet disaggregation. PMID- 6868019 TI - Activation of human and rabbit blood platelets by synthetic structural analogs of platelet activating factor. AB - The proaggregatory potencies of synthetic analogs of platelet activating factor (PAF-acether: 1-0-alkyl 2-0-acetyl sn-glycero-3-phosphorylcholine) were tested in rabbit and human platelet rich plasma (PRP). For activation of human compared to rabbit platelets about 30 to 100 times higher concentrations of the compounds were needed, but the relative potencies of the analogs tested were quite similar in both species. The absolute stereospecificity required for platelet activation could be confirmed and extended also to the pair of enantiomers with a cis-9 double bond in the 0-alkyl chain and to the enantiomers with the 0-alkyl chain at C-2 of glycerol. The propionyl ester at C-2 of glycerol proved to be as potent as the acetyl ester but replacement by the formyl as well as by the butyryl ester reduced the activity to less than three per cent. Variations at the 3 phosphorylcholine substituent all abolished the activity. It appears that the correct stereochemistry and a phosphorylcholine group in a strictly defined position towards the asymmetric C-2 of the glycerol backbone are absolute requirements for activity whereas variations in the alkyl and the short chain acyl groups have not as dramatic consequences. PMID- 6868020 TI - The relationship between the age and density of circulating 51-Cr labelled platelets in the sub-human primate. AB - Change in the density of circulating platelets in monkeys was studied by using a method that removed greater than 90% of the platelet population from whole blood. These were labelled with 51-Cr and reinjected, having been protected by prostacyclin while in vitro. Platelets were separated into density subpopulations the following day by continuous linear gradients of polyvinyl pyrrolidone coated silica (Percoll) under conditions that approximated well to equilibrium centrifugation. The 51-Cr labelled platelets were then found to be distributed equally throughout all density subpopulations. When the same procedure was repeated at 5 days after re-injection an average of 5% of the density range increase in platelet density had occurred in the reinjected platelets compared to the circulating population (p less than 0.001). Lighter platelets may have a slightly shorter survival time than dense ones. Monkey platelet volume is log normally distributed. PMID- 6868021 TI - Further studies of the turnover of dog antithrombin III. Study of 131I-labelled antithrombin protease complexes. AB - Fresh plasma containing 131I-antithrombin III (*I-AT) was coagulated and incubated at 37 degrees C for 2 hr. A "complex peak," separated on heparin agarose contained AT and *I-AT antigen but no heparin cofactor activity. Crossed immunoelectrophoresis showed only AT complexes. SDS PAGE showed 80% of the *I-AT in a major band (approximately 80,000 daltons), 15% in a minor band (approximately 100,000 daltons) and the rest in trace bands (approximately 60,000 and/or 115,000 daltons). Ammonia treatment of the complex peak released alpha thrombin. After i.v. injection 80% of the complexed *I-AT, chiefly as the major band, left the plasma with t 1/2 approximately 15 min and was almost immediately catabolized to low molecular weight breakdown products. A major catabolic site was the liver. A simple kinetic model describes the findings approximately. PMID- 6868022 TI - Effect on haemostasis of intravenous injection of alpha 2-antiplasmin in cats treated with streptokinase. AB - The effect in cats of an intravenous injection of purified human alpha 2 antiplasmin on changes in the haemostatic system, caused by administration of streptokinase was investigated. The decrease in fibrinogen and plasminogen caused by streptokinase infusion was immediately inhibited by the alpha 2-antiplasmin infusion. The increase in vascular permeability and the prolongation of coagulation times were efficiently inhibited. PMID- 6868023 TI - Evaluation of thrombogenicity of beta-propiolactone/ultraviolet (beta-PL/UV) treated PPSB in chimpanzees. AB - The thrombogenicity of beta-PL/UV-treated PPSB (factor IX concentrate) was evaluated in chimpanzees. PPSB isolated from beta-propiolactone-treated and UV irradiated plasma was injected into chimpanzees at a dose of approximately 100 units/kg body weight. An FDA licensed PPSB preparation served as the negative control, and a preparation containing activated as well as precursor clotting factors served as the positive control. 15 minutes, 1 h, 4 h, and 24 h after the PPSB application the following parameters were determined in the chimpanzee blood: factors II, VII, IX, X, VIII, fibrinogen, AT III, thrombin coagulase, Quick value, APTT and platelet count. Neither the untreated control preparation, nor the PPSB isolated from beta-propiolactone-treated and UV-irradiated plasma, showed signs of thrombogenicity in the chimpanzee model. The positive control indicated that the chimpanzee is a suitable model for the thrombogenicity testing of activated clotting factors. PMID- 6868024 TI - Synthesis of thromboxane B2 in uraemia and the effects of dialysis. AB - The generation of thromboxane B2 (TxB2) from its natural precursor, arachidonic acid, was studied in vitro in order to assess further the prostaglandin pathway in the platelets of patients with chronic renal failure. Some, but not all patients with conservatively treated uraemia synthesised significantly less TxB2 then controls and the same patients were also hypo-aggregable to arachidonic acid. The synthesis of TxB2 appeared normal in a group of patients on chronic ambulatory peritoneal dialysis (CAPD). In contrast, a group of patients on long term maintenance haemodialysis produced significantly greater amounts of TxB2 and were hyper-aggregable to arachidonic acid, a finding which may be relevant to the high incidence of atherosclerosis and vascular disease in these patients. PMID- 6868025 TI - Arachidonate induced aggregation of rat platelets may not require prostaglandin endoperoxides or thromboxane A2. AB - Platelet aggregation was measured in rat and human platelet-rich plasma (PRP) after the addition of various amounts of arachidonic acid (AA), prostaglandin H2 (PGH2), adenosine diphosphate (ADP), or collagen. AA but not PGH2 caused rat platelets to aggregate in citrated or heparinized PRP. Both AA and PGH2 produced significant amounts of thromboxane A2 (TxA2) measured as thromboxane B2 (TxB2). The lack of aggregation of rat platelets with PGH2 was not due to the formation of an inhibitor of aggregation such as a prostaglandin. Thus, the formation of TxA2 may not be necessary for aggregation of rat platelets. Human platelets were aggregated by PGH2 with the concomitant formation of TxB2. PMID- 6868026 TI - [Hyperosmolar nonketotic diabetic coma]. PMID- 6868027 TI - [Isopaque Amin 200 (meglumine metrizoate) a contrast medium in hysterosalpingography. A study of late sequelae]. PMID- 6868028 TI - [Sedimentation rate and the contrast medium Isopaque]. PMID- 6868030 TI - [Nursing homes--how efficient are they?]. PMID- 6868029 TI - [Working with parents in child abuse and neglect]. PMID- 6868031 TI - [Prescriptions as means of communication]. PMID- 6868032 TI - [Long-term prognosis of patients resuscitated during myocardial infarction. Follow-up study 57 years after resuscitation]. PMID- 6868033 TI - [Thermography in thrombosis. Used as a screening method in patients with suspected deep vein thrombosis]. PMID- 6868034 TI - [Temporal arteritis. A prospective study with special reference to the course of the disease]. PMID- 6868035 TI - [Fecal incontinence treated by transplantation of the gracilis muscle. A follow up study]. PMID- 6868036 TI - [Successfull reconstruction after subtotal penis amputation]. PMID- 6868037 TI - [Senile dementia or depression? A differential diagnosis]. PMID- 6868039 TI - [Doppler ultrasound examination of the precerebral arteries. A limited resource demanding non-invasive method in the diagnosis of cerebral circulatory insufficiency]. PMID- 6868038 TI - [Delayed discharge from hospitals. An evaluation of patients following completed hospital treatment]. PMID- 6868040 TI - [Acidosis with fatal outcome in a patient with renal insufficiency and glaucoma after treatment with acetazolamide]. PMID- 6868042 TI - [A model for evaluation of infertility. Pregnancy rate after 6 years observation]. PMID- 6868041 TI - [Adverse effects following piroxicam (Felden)]. PMID- 6868045 TI - [Clinical aspects on hypernatremia]. PMID- 6868044 TI - [Incidence of ventricular fibrillation in acute myocardial infarction with and without the use of lidocaine]. PMID- 6868043 TI - [Acute myocardial infarction. Cases from the Gjovik County Hospital]. PMID- 6868046 TI - [Stomach cancer. Retrospective analysis of 276 patients]. PMID- 6868048 TI - [Primary pyogenic psoas myositis]. PMID- 6868047 TI - [Blood concentrations in acute fatal poisoning. Experiences with forensic cases]. PMID- 6868049 TI - [Neonatology: immunological features]. AB - In the present paper which was inspired by a paper that was previously read, the title 'Neonatology: Immunological Features' is interpreted rather more widely to the extent that the entire field of perinatology including functioning of the mother during gestation and lactation will be reviewed. The following subjects are discussed in succession: (1) the mother - fetus relationship (maternal immunocompetence during gestation and lactation, fetal immunocompetence, the fetus as a 'semi-allograft'); (2) passive immunization produced by maternal antibodies (mode of transfer of antibodies and immunopathological features of this transfer, enteromammary link, feed-back due to maternal antibodies); (3) neonatal infection and (4) artificial rearing (differences with conventional rearing and consequences in the field). In the final conclusions, new insights into the problems of neonatal infection gained by immunological studies and their use in the prevention and control of these infections are evaluated. PMID- 6868050 TI - [Immunoprophylaxis and pathology of parasitic infection]. AB - In the present paper, a brief introductory part concerned with a number of general concepts of the host-parasite relationship is followed by a discussion of the current situation regarding immunoprophylaxis of infestation by protozoa and helminths. Subsequent speculations on the possibilities of immunological interference in the host-parasite relationship in view of recent developments in the manufacture of vaccines are engaged in. The complicated character of interactions of host and parasite is illustrated in a number of instances of mechanisms utilized by parasites to avoid resistance by the host. PMID- 6868051 TI - [Useful stimulation of the immune system]. AB - 'Useful stimulation of the immune system is that type of stimulation which results in an immune response (particularly in the mucosae) that will reduce possible pathological effects following exposure to pathogenic organisms and/or toxins over prolonged periods'. Stimulation of the immune system, such as follows a 'natural supply' of antigen at the side of the mucosa and the question whether, on the whole, vaccination will result in useful stimulation of the immune system, are briefly discussed against the background of this definition. A number of instances are cited to illustrate differences and similarities between 'natural' stimulation and stimulation produced by vaccination. Finally, speculations on the use of a more natural system of vaccination are engaged in, a system which utilizes the predictable presence of antigen at the side of the mucosa in conjunction with generalized stimulation of the immune system by administration of adjuvants not including antigen. PMID- 6868053 TI - [Histometric study of meat products. A literature review]. AB - In the present paper, the literature on the development of methods for histometric monitoring the quality of meats is reviewed. The value of specific techniques, statistical interpretation of results and the practicability of automation of histometric analysis are examined more closely. It is concluded from the study of the literature that histometric examination of meats allows an objective assessment of volume percentages of tissue components. When a distinct difference in contrast between various tissues is achieved by specific staining methods, developments in the field of image analysis systems will allow automation of the quantitative histological examination of meats. PMID- 6868052 TI - [Rhododendron poisoning: clinical aspects, treatment and course in a herd of sheep]. PMID- 6868055 TI - [Treatment of bacterial infections in commercial poultry]. AB - Several aspects of antibacterial drug therapy in poultry are reviewed and field as well as experimental findings are reported. The relatively very brief elimination half-life of antibacterial agents in poultry and the fact that the entire flock is treated orally during a short period accounts for the fact that a satisfactory therapeutic effect is only achieved in a limited number of systemic diseases. In view of the findings reported, a re-assessment of possibilities and limitations of antibacterial therapy in this field is recommended. PMID- 6868054 TI - [A plainly apparent cause of urethral obstruction]. AB - Some mariginal notes regarding possible forms of treatment are made with reference to acute urethral obstruction appearing in a male dog. Although this obstruction was due to a rare cause, the procedure adopted may serve as guidance in planning a scheme of treatment in common cases of urethral obstruction caused by urinary calculi in male dogs. PMID- 6868056 TI - HLA antigens and maternal antibodies in allo-immune neonatal thrombocytopenia. PMID- 6868057 TI - HLA-A, -B, -C and -DR antigen profile in pulmonary tuberculosis in North India. AB - Investigations for the HLA-A, -B, -C and -DR antigens were conducted on 124 random North Indian patients with confirmed diagnosis of pulmonary tuberculosis by the demonstration of acid fast bacilli in the sputum. 109 appropriately matched controls from the same ethnic background were also tissue typed. No significant deviation was observed in the HLA-A, -B, and -C locus antigens. With the HLA-DR typing, there was a marginal increase in DR2 and a concurrent significant decrease in DRw6 in the patient group. These deviations were, however, insignificant when correction for the P value was made. ABO blood group typing results indicate that blood group 'O' may afford protection against TB. The involvement of both DR2 and DRw6 is interesting as it is also implicated in leprosy, another mycobacterial disease. The results suggest the possibility of a common gene in the MHC for both tuberculosis and leprosy. PMID- 6868058 TI - Complete heart block--another HLA B27 associated disease manifestation. AB - An increased prevalence of ankylosing spondylitis and other HLA B27-associated rheumatic diseases has recently been demonstrated in a group of men with permanent pacemaker-treatment. The purpose of the present study was to find out if HLA B27 was associated with severe bradyarrhythmias also in the absence of rheumatic disease. The frequency of B27 was determined in 83 permanently paced men with complete heart block, in whom presence of radiological or clinical signs of a B27-associated rheumatic disease had been excluded. Eighty-four healthy subjects were HLA typed for comparison. HLA B27 was found in 17% of the patients and in 6% of the controls, a significant difference with P = 0.017 (Fisher's exact test). The present study suggests that, in a subgroup of patients with complete heart block, the development of heart block is B27-associated, and that the pathophysiological mechanism is similar to that leading to ankylosing spondylitis. Another B27-associated disease manifestation has been demonstrated. PMID- 6868059 TI - A linkage study of HLA and maturity onset type diabetes of the young (MODY). PMID- 6868060 TI - HLA and keratoconus. AB - HLA-A and -B antigens were determined in 64 Caucasoid patients with keratoconus. A highly significant increase in the frequency of HLA-B5 was found among the patients. Thus keratoconus is the third eye disease after recurrent herpetic keratitis and Behcet's disease showing an association with HLA-B5. PMID- 6868061 TI - HLA-A3 and serum iron. A study in an Irish control population. AB - In a control population of 127 healthy adults in the West of Ireland, the possession of the HLA-antigens associated with idiopathic haemochromatosis (IH), i.e. HLA-A3, B7 and B14 was not accompanied by higher levels of serum iron, total iron binding capacity (TIBC) or transferrin saturation (TS%). HLA-A3 does not appear to confer enhanced ability to absorb dietary iron. PMID- 6868065 TI - [Maltreatment of slaughtering animals during transportation]. PMID- 6868064 TI - [Relation between maintenance and fertility in dairy cattle]. PMID- 6868063 TI - [Feeding for production in dairy animals]. PMID- 6868062 TI - [Experiences and current knowledge of Coxiella burnetii infection (Q fever). 2]. PMID- 6868066 TI - [Implantation of an ocular prosthesis in a gray parrot]. PMID- 6868068 TI - [Acetylcysteine (Fluimucil) in the treatment of COPD of the horse]. PMID- 6868067 TI - [Gasterophilosis (gastric myiasis) in the horse]. PMID- 6868070 TI - [Aujeszky's disease in the dog and cat. Contribution from veterinary practice]. PMID- 6868071 TI - [Movement disorders in the kangaroo. Differential pathomorphological diagnosis]. PMID- 6868069 TI - [Histopathology of chronic obstructive bronchitis in clinically sick horses]. PMID- 6868072 TI - [Spread of tuberculosis in ornamental fishes]. PMID- 6868073 TI - Hepatic venography in portal hypertension by balloon catheter. AB - The hepatic venography and wedged hepatic venous pressure measurement were performed in 35 patients with portal hypertension using a balloon catheter, and the results were compared with those obtained by the conventional method. It was revealed that the balloon catheter visualized a broader area of the liver and showed more accurate wedged hepatic venous pressure than the conventional catheter, thereby demonstrating that this is an excellent diagnostic tool for patients with portal hypertension. PMID- 6868074 TI - A new cell line (TE-3) derived from human squamous cell carcinoma of the esophagus. AB - A new epithelial cell line (TE-3) has been established from a metastatic lesion at the right chest wall which was originated from a well differentiated human squamous cell carcinoma of the esophagus. TE-3 has been subcultured more than 150 times for 3 years and 1 month. Cultured cells have grown as isolated colonies of epithelial cells. The average doubling time of the TE-3 cell line was 48 hr and the plating efficiency was 10 to 40% in MEM supplemented with 8% fetal calf serum. Distinctive marker chromosomes and a male karyotype were present in TE-3. Electron microscopic examination of the TE-3 cells disclosed the presence of desmosomes and microvilli in connection of the cells which were rich in cell organelles. In early passages of culture, the cytoplasm of cells was slightly positive with PAS stain but negative with Sudan III or mucicarmin stain. Heterotransplantation of the culture cells to BALB/c nude mice produced tumors, the histological appearance of which was similar to that of the original one. The carcinoembryonic antigen level of the medium in the confluent culture of TE-3 was 2 ng/10(4) cells. PMID- 6868076 TI - Ultrastructural study on the granule-containing cells in the rat autonomic ganglia. AB - In the rat superior cervical ganglion, small granules, 100-150 nm in diameter, and large granules, 80-280 nm in diameter, were seen in the granule-containing (GC) cells. Most GC cells contained almost exclusively the small granules (SG type cell), while a few cells almost exclusively the large granules (LG type cell). The GC cells formed both efferent and cholinergic afferent synapses. The efferent synapses were about four times as many as the afferent ones. In the major pelvic ganglion of rats, SG type and LG type cells were present in comparable numbers. Cells with both types of granules were also noticed. Ovoid shaped granules, 60 X 140 nm with a core of moderate electron density, were observed in some SG type cells. Both afferent and efferent synapses were noted on GC cells in this ganglion. The latter were more numerous than the former. SG type cells formed more synapses than LG type cells. Based on these observations, the physiological significance of GC cells was discussed. PMID- 6868075 TI - Oxygen-dependent growth declining and effect of vitamin E for human diploid fibroblasts in serum-free, BSA-containing culture. AB - Growth promoting activity of bovine serum albumin for human diploid fibroblasts was affected by oxygen environment. When cells (2 X 10(4) cells/35 mm dish) were cultured with BSA of 5 g/liter supplemented RITC 80-7 under hypoxic (7%) environment, excellent growth was maintained during the period of culture, while the growth under aerobic environment markedly declined after 3 days of culture. The culture challenged with BSA under aerobic environment generated a relatively large amount of malondialdehyde (MDA) as a product of lipid peroxidation. Vitamin E restored the declining of growth and inhibited MDA formation. Also in vitro lifespan of the cells challenged with BSA markedly decreased under aerobic environment as compared with that of the cells under hypoxic environment. Vitamin E did not restore the oxygen-dependent decreasing of in vitro lifespan. On the other hand, the cells cultured with serum supplemented medium grew and phased out similarly under both oxygen environment as well as the case with BSA supplemented RITC 80-7 under hypoxic environment. These results suggest that the extent of cell proliferation is controlled in part by lipid peroxidation and serum antioxidant activity is not identical from that of vitamin E. PMID- 6868077 TI - Dietary therapy in a girl with propionic acidemia: supplement with leucine resulted in catch up growth. AB - A 15-month-old girl with propionic acidemia presented a failure to thrive and muscular hypotonia, who had been treated with diets low in leucine, valine, isoleucine, threonine and methionine. Supplementation with leucine gave her a catch up growth and brought about an improvement in muscular hypotonia in parallel with restoration of plasma leucine which had been below normal range during the treatment with the above diets. Oral loading test of leucine produced no ketoacidosis. These findings indicate that the restriction of leucine is not necessary in the dietary management of propionic acidemia. PMID- 6868078 TI - An in vitro evaluation of leukocyte-poor red blood cell concentrates prepared by reconstitution with phosphate buffer solution. AB - An effective method for removing leukocytes and platelets from red blood cell concentrates (RBC) reconstituted with phosphate buffer solution was investigated in vitro. Reconstituted RBC were warmed at 37 degrees C for 1 hr. Neither leukocyte count nor platelet count was decreased by the treatment. When compared with whole blood, leukocytes present in the fractions below the buffy coat layer were significantly less than those of whole blood, while the distribution of platelets in reconstituted RBC was unchanged. It is suggested that the reduction of leukocytes in red blood cells below the buffy coat layer may contribute to the preparation of RBC with a poor leukocyte. PMID- 6868079 TI - Effects of homopantothenic acid on intestinal smooth muscles. AB - The effects of homopantothenic acid (HOPA) on intestinal smooth muscles were investigated and compared with those of gamma-aminobutyric acid (GABA). HOPA contracted the rat ileum and produced a biphasic response (relaxation followed by contraction) in the guinea-pig ileum and taenia coli. Half-maximal effects were obtained with 0.3-0.9 nM HOPA and maximal responses with 2-4 nM in the rat and the guinea-pig ileum. In the guinea-pig taenia, half-maximal effects were obtained with 0.2-0.25 microM HOPA and maximal responses with 2-4 microM HOPA. Tachyphylaxis occurred with higher concentrations. All these responses were not significantly affected by tetrodotoxin (TTX), atropine, diphenhydramine or metiamide. The relaxation elicited by HOPA was not reduced by simultaneous application of phentolamine and propranolol. Unlike HOPA, GABA produced a biphasic response (a relaxation followed by a contraction) in the guinea-pig ileum, which was almost abolished by TTX. These results suggest that HOPA mainly acts on intestinal smooth muscle directly, whereas GABA does indirectly through nerves. PMID- 6868080 TI - Effects of nifedipine on the renal vascular responses and blood pressure responses to norepinephrine and angiotensin II in the anesthetized rabbit. AB - Effects of a Ca-antagonist, nifedipine, on renal vascular responses and systemic pressor responses to angiotensin II and norepinephrine were studied in anesthetized rabbits. The changes of renal blood flow were estimated by an electromagnetic flowmeter. After the intravenous administration of nifedipine (50 micrograms/kg), mean blood pressure decreased from 116 +/- 3.1 mmHg to 102 +/- 3.4 mmHg (p less than 0.001). Renal vascular responses to angiotensin II were attenuated significantly after the administration of nifedipine, but not changed to norepinephrine. Pressor responses to angiotensin II at a low dose were significantly diminished after the administration of nifedipine (p less than 0.05), whereas it had no effect at higher doses. Nifedipine tended to suppress the increase in arterial pressure induced by norepinephrine, but the changes were not statistically significant. These results suggest that calcium influx in the vascular smooth muscle cells is not likely to be a common pathway in the vasoconstrictor reaction to angiotensin II and norepinephrine in anesthetized rabbit. PMID- 6868081 TI - Influences of sex and age on serum ascorbic acid. AB - The concentrations of total ascorbic acid, reduced and oxidized forms of ascorbic acid, the ESR intensity of ascorbate radical, and the ratio of oxidized form of ascorbic acid to total ascorbic acid (DAsA/AsA) were estimated on 217 healthy controls, whose ages ranged from 12 to 96 years, in order to examine influences of sex and age. The concentration of total ascorbic acid was higher in females than in males throughout all age classes, but the oxidized form did not show a sex difference. Then it was found that the reduced form was higher in females than in males throughout all age classes. The concentrations of total ascorbic acid and reduced and oxidized forms of ascorbic acid, and the ESR intensity declined with age, but the DAsA/AsA ratio increased with age. PMID- 6868082 TI - Evaluation of amitrole (aminotriazole) for potential carcinogenicity in orally dosed rats, mice, and golden hamsters. AB - Amitrole was evaluated for carcinogenic potential in lifespan studies on Wistar rats, NMRI mice, and golden hamsters. At the start of the studies the animals were 6 weeks old. Amitrole was administered, mixed with pulverized chow, at dietary concentrations of 0, 1, 10, and 100 micrograms/g (ppm). Each treated group and control group consisted of 75 male and 75 female rats and mice and of 76 male and 76 female golden hamsters. Additional animals were used to evaluate the functional state of the thyroid. Somewhat lower body weights, slightly reduced survival times, and transient effects on thyroid function were observed in golden hamsters at 100 ppm. In mice, a slight increase in pituitary gland hyperemias was seen at 100 ppm; also an effect on thyroid function usually occurred at the same concentration. In rats, a very large number of cystic dilatations of follicles in the thyroid at 100 ppm and a dose-unrelated increase in hemorrhages and hyperemias in the pituitary gland were indicative of an effect of amitrole on these organs. The strongest effect of amitrole on thyroid function, as compared to golden hamsters and mice, was seen in rats at 100 ppm. At this concentration a highly increased number of thyroid and pituitary gland tumors was observed in rats. In golden hamsters and mice, no tumor induction was seen. PMID- 6868083 TI - Metabolic disposition and irreversible binding of 1-phenylcyclohexene in rats. AB - The metabolic disposition of 1-[14C]phenylcyclohexene ([14C]PC) was examined in rats after ip or iv drug administration. Radioactivity, which was accumulated by various organs, peaked within 30 min after ip administration of [14C]PC (0.21 mg/kg). A significant amount of this radioactivity was not extractable by repeated methanol extractions, indicating irreversible binding of [14C]PC metabolite(s) to tissue proteins. Following iv administration of [14C]PC (0.42 mg/kg), [14C]PC concentrations in blood declined biphasically with time; the blood elimination half-life of [14C]PC is 77 min. About 83% of the dose given was excreted in urine and feces within 54 hr of administration. About 35% of the dose was excreted in the bile in 1 hr. At least four [14C]PC metabolites were detected in the urine or bile. The bulk of the urinary radioactivity was composed of metabolites since less than 6% of [14C]PC given was excreted unchanged in the urine. PMID- 6868085 TI - Determinants of resistance to the cardiotoxicity of isoproterenol in rats. AB - Induction of myocardial necrosis by isoproterenol produces resistance to the necrogenic effects of subsequent doses of the drug. A series of experiments were performed to further define the determinants of resistance. Myocardial necrosis was induced in male Sprague-Dawley rats by sc injection of isoproterenol at 50 micrograms/kg daily for 10 consecutive days or as a single dose at 50, 5, or 0.5 micrograms/kg. These preconditioning doses were followed, at various times, by a challenge dose of 50 micrograms/kg. The rats were killed 48 hr after the challenge dose, and their hearts were analyzed morphometrically to determine the amount of acute necrosis and scarring. The amount of scar tissue was a reflection of necrosis caused by the preconditioning dose whereas acute necrosis reflected response to the challenge dose. Resistance occurred and lasted longer than 19 to 20 weeks after both single or multiple isoproterenol injections of 50 micrograms/kg, but it was not observed 5 days after administration of a single preconditioning dose. Isoproterenol at 0.5 micrograms/kg produced only very minimal or no myocardial necrosis and did not produce resistance. The resistance was not dependent on the size of the area of necrosis produced during the preconditioning period, showing that it was not due to destruction of all vulnerable muscle by the preconditioning dose(s). The preexistence of lesions, however, was necessary for the development of resistance. It is concluded that development of resistance to the necrogenic effects of isoproterenol reflects an adaptive alteration in the myocardium which survives after a necrogenic dose. PMID- 6868086 TI - Cd2+ responses of cultured human blood cells. AB - Cd2+ cytotoxicity, uptake, and partitioning, and Cd2+-induced metallothioneine synthesis were studied in cultured peripheral human blood cells. Mononuclear cells were found to resist relatively high levels of Cd2+. Few cells were killed below 50 microM Cd2+. Above this value, survival decreased exponentially with dose. The mean LD50 for mononuclear cells cultured in Cd2+ for 40 hr was 100 microM. Polymorphonuclear cells (granulocytes) were found to be more resistant, with a significantly higher threshold and LD50, and a more complex dose response. Most of the Cd2+ incorporated by blood cells was taken up by nucleated cells. Despite their greater resistance, polymorphonuclear cells incorporated more Cd2+ at higher doses (50 to 150 microM) than did mononuclear cells. No Cd2+ was bound to metallothioneine in polymorphonuclear cells following exposure to Cd2+ for even extended periods of time (18 hr) at high doses of 109Cd2+ (25 microM). Instead Cd2+ appeared in a Sephadex G-75 peak of approximately 60,000 Da, as well as in the void peak. No significant amount of preexisting metallothioneine (MT) or metallothioneine mRNA was found in the mononuclear cells. However, MT synthesis was induced rapidly following exposure to Cd2+. [109Cd2+]MT appeared within 1 hr following exposure to 50 microM 109Cd2+, and MT synthesis rates measured from [35S]cysteine incorporation were found to be maximal within 4 hr. PMID- 6868084 TI - Inhalation of 1-nitropyrene associated with ultrafine insoluble particles or as a pure aerosol: a comparison of deposition and biological fate. AB - A large number of the environmental particulate pollutants in the atmosphere, including diesel engine exhaust, have a complex mixture of organic compounds associated with them. Organic solvent extracts of many of these particulate pollutants have been shown to contain mutagenic activity which does not require metabolic activation in the Ames bioassay. Much of this direct-acting mutagenic activity has been attributed to nitroaromatic compounds present in these extracts. In the studies reported here, the direct-acting mutagen, [3H]nitropyrene (3H-NP), was used as a model nitroaromatic compound. Rats were exposed to this radiolabeled compound by nose-only inhalation either as a coating (approximately 6% by mass) on relatively inert, ultrafine 67Ga2O3 particles or as a homogeneous ultrafine aerosol. The tissue deposition, retention, and biological fate of each aerosol were investigated and compared. Respiratory tract clearance of 3H radioactivity from each exposure was very rapid with no apparent differences seen in the lung retention of this inhaled compound between each exposure over the course of these studies. Higher 3H-radioactivity levels were seen in stomach and large intestines of rats exposed to the 67Ga2O3-associated 3H NP than in the same tissues from rats exposed to the pure 3H-NP aerosol. Rats exposed to the 3H-NP-67Ga2O3 aerosol excreted the majority of the deposited 3H radioactivity in the feces (75 +/- 18%), whereas pure 3H-NP exposed animals excreted a major portion of the radiolabeled in the urine (76 +/- 18%). It appeared that the major portion of the pure 3H-NP aerosol was cleared from the respiratory tract by direct absorption into blood, while the 67Ga2O3-associated 3H-NP was cleared by both blood absorption and mucociliary clearance followed by ingestion and fecal excretion. These differences in the deposition and biological fate between the particle-associated NP and the pure NP aerosol may have important implications in terms of the metabolic fate of inhaled nitroaromatic compounds and the health risks associated with human exposures to particulate environmental pollutants that contain this class of compounds. PMID- 6868087 TI - Halothane hepatotoxicity in hyperthyroid rats as compared to the phenobarbital hypoxia model. AB - Halothane hepatotoxicity was observed after exposing hyperthyroid rats to 0.625% halothane for 4 hr under hypoxic conditions (10% O2). In this model, increases in serum enzyme activities of the alanine aminotransferase (GPT) and the sorbitol dehydrogenase (SDH) were evident immediately following exposure and were six-fold higher than in the phenobarbital-hypoxic model. Plasma free-fluoride levels estimated immediately after exposure to halothane were increased twofold in halothane-exposed hyperthyroid rats under hypoxic conditions as were increased twofold in halothane-exposed hyperthyroid rats under hypoxic conditions as compared to a sixfold increase in the phenobarbital-hypoxic model. The concentration of glutathione in liver was more markedly decreased in hyperthyroid rats than in phenobarbital-induced rats. The fact that no clear-cut correlation was found between defluorination and hepatotoxicity in both models may favor the hypothesis that a non-defluorinated metabolite of halothane, e.g., 2-chloro-1,1,1 trifluoroethyl radical, is the reactive intermediate responsible for the liver lesions. On the other hand, intracellular hypoxia due to hypermetabolism during the hyperthyroid state may be the reason for the higher sensitivity of hyperthyroid rats. PMID- 6868089 TI - Effect of low-level lead exposure on antibody-dependent and natural killer cell mediated cytotoxicity. AB - Splenic antibody-dependent, cell-mediated cytotoxicity against chicken red blood cell targets [ADCC (CRBC)] and natural killer cell-mediated cytotoxicity (NKMC) were determined in C57BL/6 mice given 1300 ppm lead acetate (827 ppm lead) in their drinking water for 8 weeks. ADCC in lead exposed mice was significantly lower than controls at effector to target cell ratios of 100:1, 50:1, and 25:1. In contrast, no significant difference in unstimulated NKMC was seen in lead exposed mice and control mice at effector to target cell ratios of 200:1, 100:1, and 50:1. Moreover, in vivo poly I:C-enhanced NKMC in lead-treated mice was similar to controls at an effector to target cell ratio of 200:1. Blood lead levels averaged 40.5 +/- 1.2 micrograms% in lead-exposed mice and 1.9 +/- 0.3 micrograms% in controls. These findings suggest that chronic low-level lead exposure in mice results in significant suppression of ADCC (CRBC) but does not alter natural killer activity. PMID- 6868088 TI - Effects of thiosulfate on cyanide pharmacokinetics in dogs. AB - One method to treat cyanide poisoning involves the administration of a combination of sodium thiosulfate and sodium nitrite. Sodium thiosulfate is believed to exert its antidotal effect by serving as a sulfur donor, thereby increasing the rate of rhodanese catalyzed biotransformation of cyanide to thiocyanate. To gain insight into the mechanism of action of thiosulfate on cyanide toxicity, a pharmacokinetic analysis of cyanide distribution and metabolism with and without sodium thiosulfate was conducted in mongrel dogs. A compartmental model for thiocyanate, the major metabolite of cyanide, was developed from plasma concentrations determined at various times after iv administration of thiocyanate; sodium thiosulfate did not alter thiocyanate-model parameters. The model for thiocyanate was coupled to a model for cyanide, and model based equations were fitted to the blood levels of both cyanide and thiocyanate that were measured after iv administration of cyanide. This kinetic analysis showed that thiosulfate increased the rate of conversion of cyanide to thiocyanate over 30-fold. The mechanism of thiosulfate protection appeared to be due to extremely rapid formation of thiocyanate in the central compartment, which thereby limited the amount of cyanide distribution to sites of toxicity. PMID- 6868090 TI - Isotope effects on the metabolism and pulmonary toxicity of butylated hydroxytoluene in mice by deuteration of the 4-methyl group. AB - A comparative test in mice for pulmonary toxicity between butylated hydroxytoluene (2,6-di-tert.-butyl-4-methylphenol, BHT) and 2,6-di-tert.-butyl-4 [alpha, alpha, alpha-2H3]methylphenol (BHT-d3) showed a significantly lower toxic potency of the latter. The rate of in vitro BHT metabolism to 2,6-di-tert.-butyl 4-methylene-2,5-cyclohexadienone (BHT-QM) was slowed by deuterating BHT in the 4 methyl group. On the other hand, the rate of in vitro metabolism to 2,6-di-tert. butyl-4-hydroxy-4-methyl-2,5-cyclohexadienone (BHT-OH) was increased with the deuteration. A similar isotope effect of the deuterium substitution on the in vivo metabolic rates of BHT was observed. These observations support the concept that the lung damage caused by BHT is mediated by BHT-QM. The pulmonary toxicity of 2-tert.-butyl-4-ethylphenol (4-EP) and their deuterated analogs was also compared. 2-tert.-Butyl-4-[1,1-2H2]ethylphenol (4-EP-d2) showed a significantly lower toxic potency than 4-EP, whereas 2-tert.-butyl-4-[2,2,2-2H3]ethylphenol (4 EP-d3) showed a toxic potency comparable to that of 4-EP. This result is consistent with the hypothesis that a quinone methide metabolite is responsible for the onset of lung damage produced by 4-EP as well as BHT. PMID- 6868091 TI - Acetaminophen nephrotoxicity in the rat. I. Strain differences in nephrotoxicity and metabolism. AB - Acetaminophen (APAP) produced renal necrosis restricted to the straight segment of the proximal tubule in Fischer 344 (F344) rats but not in Sprague-Dawley (SD) rats. APAP-induced renal functional changes (elevation in blood urea nitrogen and reduction in the accumulation of p-aminohippurate by renal cortical slices) also correlated with strain-dependent histopathological changes. Such strain differences have been attributed to differences in renal P-450 activation of APAP or the deacetylation of APAP to the nephrotoxic metabolite, p-aminophenol (PAP). Kidneys from F344 rats displayed greater concentrations of P-450 and greater ethoxycoumarin-o-deethylase activity than kidneys from SD rats. However, covalent binding of [ring-14C]APAP to renal and hepatic microsomal protein in vitro was similar for both SD and F344 rats. Deacetylation of APAP to PAP was similar in renal and hepatic homogenates from SD and F344 rats. Furthermore, isolated kidneys from SD and F344 rats perfused with APAP excreted PAP at similar rates. PAP excretion, over a 24-hr period following APAP administration, was greater in F344 rats than in SD rats only at the highest dose (900 mg/kg) of APAP. Thus, strain differences in APAP-induced nephrotoxicity apparently cannot be attributed to differences in P-450 activation of APAP or in deacetylation to the nephrotoxic metabolite, PAP. PMID- 6868092 TI - Acetaminophen nephrotoxicity in the rat. II. Strain differences in nephrotoxicity and metabolism of p-aminophenol, a metabolite of acetaminophen. AB - Acetaminophen (APAP) produces renal necrosis restricted to the straight segment of the proximal tubule in Fischer 344 (F344) rats. On the other hand, Sprague Dawley (SD) rats are extremely resistant to the nephrotoxic effects of APAP. Such strain differences may be due to different susceptibilities to the nephrotoxic metabolite, p-aminophenol (PAP). PAP administration in both strains of rats resulted in a renal lesion indistinguishable from the APAP-induced renal lesion in F344 rats. The PAP-induced renal lesions in F344 rats, however, were generally more severe than those in SD rats. PAP-induced renal functional changes (elevation in blood urea nitrogen and reduction in the accumulation of p aminohippurate by renal cortical slices) correlated with strain-dependent histopathological changes. Analysis of urinary metabolites over a 24-hr period following PAP administration (200 and 400 mg/kg) indicated that more PAP was excreted as APAP in SD than in F344 rats. Covalent binding of PAP to renal microsomes in vitro was much greater in F344 rats than in SD rats at substrate concentrations less than 5 mM. These results suggest that strain differences in PAP-induced nephrotoxicity may be related to differences in the intrarenal activation of PAP. Furthermore, strain differences in APAP-induced nephrotoxicity may be related to strain differences in the activation of the nephrotoxic metabolite, PAP. PMID- 6868093 TI - Leishmaniasis in The Gambia. 2. A study of possible vectors and animal reservoirs, with the first report of a case of canine leishmaniasis in The Gambia. AB - Following the detection of two cases of leishmaniasis in The Gambia, the possible vectors and animal reservoirs were studied. A total of 5, 158 phlebotomine sandflies, in 20 species and subspecies were captured, including 98 males and 61 females of Phlebotomus duboscqi. This species is a vector of cutaneous leishmaniasis in Senegal and must be suspected as a vector in The Gambia; it was captured close to the dwellings of both patients and from rodent burrows, including those of Mastomys erythroleucus, a known reservoir of cutaneous leishmaniasis in Senegal. We report the first finding in The Gambia of visceral leishmaniasis in a dog captured near the house of the patient with visceral leishmaniasis. This strongly suggests that dogs could be a reservoir of this infection in this area. The vector was not determined. PMID- 6868094 TI - Raised erythrocyte sedimentation rate (ESR) in hydatid disease. PMID- 6868095 TI - Onchocerciasis in Zambia: report of O. volvulus in a child and its differentiation from O. dukei in cattle. PMID- 6868096 TI - Evaluation of diamidine compound (pentamidine isethionate) in the treatment resistant cases of kala-azar occurring in North Bihar, India. AB - Pentamidine isethionate was found to be a very effective therapeutic agent in the treatment of pentavalent antimonial-resistant cases of kala-azar. Cardiotoxicity and metabolic disturbance (diabetes mellitus-like state) were found to be limiting factors in the use of this drug. Frequent clinical, electrocardiographic and biochemical observations are required during and after course of treatment and pentamidine treatment should be restricted to in-patients in hospitals. PMID- 6868099 TI - A study on the usefulness of counter immuno-electrophoresis for the detection of Salmonella typhi antigen in the sera of suspected cases of enteric fever. AB - Counter immuno-electrophoresis (CIE) was used to detect the presence of Salmonella typhi antigen and antibodies in the sera of 123 suspected cases of enteric fever. Of these, 68 had been incompletely treated with various antibiotics before establishing the diagnosis. The sera of 31 (25%) of the 123 cases showed the presence of S. typhi antigen. Blood culture was positive for S. typhi in only one case. Antigen could be demonstrated in sera of patients with fever ranging from two to ten days. Antigen could also be demonstrated after ten days in sera of patients who had taken some antibiotics. There is no apparent relationship between the presence of antigen and antibodies in the sera, and no apparent relationship between the CIE antibody and Widal antibody titres. PMID- 6868097 TI - Measles immunization with further attenuated heat-stable measles vaccine using five different methods of administration. AB - Further attenuated heat-stable measles vaccine Attenuvax was administered randomly to 109 children using five different methods and a control group (24). Vaccine administration by syringe and needle (0.5 ml) and by jet-injector (0.1 ml) resulted in a high percentage of significant HAI measles antibody titres (greater than or equal to 1:24). Vaccine administration by nose drops (0.5 ml), bifurcated needle or needle planted cylinder did not yield satisfactory levels of serum antibody. Morbidity measured over a period of four weeks after administration showed a moderate increase of respiratory symptoms over the controls. Children who showed a positive tuberculin PPD reaction after BCG immunization did not differ from children with a negative tuberculin reaction in regard to their ability to produce a Kenya. The aim was to find a simpler method of administration of this improved vaccine, suitable for community health workers. The vaccine was shown to be less stable under field conditions than suggested by previous reports. PMID- 6868098 TI - Streptococcal antibodies and complement components in tropical post-streptococcal glomerulonephritis. AB - Anti-deoxyribonuclease "B' was elevated in 94.9% of 59 cases of post streptococcal glomerulonephritis studied, whereas ASO was elevated only in 54.4% of cases showing that the ADNB titre is a more sensitive indicator of antecedent streptococcal infection than ASO, in tropical countries with a high prevalence of pyoderma. Serum C3c (beta 1A) levels were significantly decreased, especially in the early phase of the illness and returned to normal with remission. C4 levels were decreased only in the early phase of the illness, suggesting involvement of the alternate pathway subsequent to classical pathway activation. PMID- 6868100 TI - Dengue haemorrhagic fever--case report. AB - A 29-year-old Dutch tourist of the Caucasian race had to break her return journey from Indonesia as she developed dengue haemorrhagic fever. She appeared to have been infected on Bali. Serological investigation revealed very high antibody titres against dengue virus types 1 and 3 and a moderately high titre against type 4 virus in the serum sample collected two weeks after onset of disease. In the sample taken 14 weeks after onset only more normalized antibody titres against type 1 and type 3 remained detectable. Although during earlier trips to the tropics she never showed signs of dengue fever, the timing of her first infection remains uncertain. The influence of age, race and double infections is discussed with relation to the cause of dengue haemorrhagic fever. PMID- 6868102 TI - Evaluation of allopurinol in the treatment of kala-azar occurring in North Bihar, India. AB - Allopurinol, at doses of 300 to 1,200 mg per day for at least 14 days, was tested on 17 hospital patients with confirmed kala-azar. 14 of these were considered "cured" on clinical grounds and eight of these were confirmed by the absence of amastigotes in the bone marrow. Four were not examined parasitologically and two remained infected. Before further clinical trials of allopurinol are undertaken it is important to assess the role of its metabolites. PMID- 6868101 TI - Copper, zinc, magnesium and cadmium levels of breast milk of Indian women. PMID- 6868103 TI - Plague in South African rodents 1972-1981. AB - Sera from 3012 rodents of 24 species captured in South Africa during the period 1972-81 were tested for antibody to the Fraction 1 antigen of Yersinia pestis by passive haemagglutination. Antibodies were found in seven (0.23%) rodents of three species. These were Desmodillus auricularis and Tatera brantsii in the northern Cape Province and Rhabdomys pumilio in the eastern Cape Province. Rodents were found positive in 1972, 1974, 1975 and 1979, indicating that plague continues to circulate in rodent populations apparently without causing human cases. The significance of the results is discussed in relation to plague outbreaks in neighbouring countries and to the 1982 outbreak in South Africa. PMID- 6868104 TI - Distribution pattern of microfilariae in relation to sex and age in Guatemalan onchocerciasis. PMID- 6868105 TI - Tropical splenomegaly syndrome (T.S.S.) in a European. AB - A case of tropical splenomegaly syndrome in a 66-year-old white man who had lived in Tanzania for 34 years is described. He had taken anti-malarial prophylaxis continuously and regularly. He had had malaria in 1955 but there was no history of alcoholism or jaundice. He was treated with proguanil hydrochloride and, after return to Tanzania, took paludrine as prophylactic. One year later he had no further complaints, the spleen was no longer palpable and the liver only just palpable. PMID- 6868106 TI - Isolation and axenic growth of fresh Giardia intestinalis strains in TPS-1 medium. PMID- 6868107 TI - A comparison of the prevalence of campylobacter, Shigellae and Salmonellae in faeces of malnourished and well nourished children in The Gambia and Northern Nigeria. AB - The proportion of children in whom bacterial pathogens were isolated in faeces was compared in 59 malnourished and 59 age-matched well nourished children in Fajara, The Gambia, with 38 malnourished and 38 age-matched well nourished children in Malumfashi, Northern Nigeria. Campylobacters were identified more frequently in malnourished (10.2%) and well nourished (6.8%) children in The Gambia than in malnourished (2.6%) and well nourished (2.6%) children in Nigeria. Salmonellae were more frequently isolated in the malnourished Nigerian children (28.9%) than in the malnourished Gambian children (3.4%) and were present in similar proportions (5.1% and 5.3%) in well nourished children in both communities. Shigellae were isolated in a few individuals in each group. The differences in the epidemiology of these enteropathogens are discussed with respect to the differences in ecology between these two sub-Saharan, savanna communities. PMID- 6868108 TI - Distribution of microfilariae in Guatemalans with onchocerciasis. AB - Ten Simulium ochraceum were allowed to feed at 10 different sites on 12 Guatemalans with onchocerciasis, and skin snips were taken from six of these sites. Numbers of microfilariae (mff) ingested by the flies and mff emerging from skin snips were highly correlated and showed that concentrations were greatest on the torso and decreased peripherally. S. ochraceum ingested the number of mff present in 1.0 mg or under 1.5 mm2 of skin. Numbers of mff in skin snips from the head, shoulder and upper arm correlated with over-all levels of infection but were frequently negative in subjects with light infections. Two or more skin snips were best able to detect and quantify infections. PMID- 6868109 TI - Measles in Tanzania: antibody response in children after vaccination and antibody state of mothers and newborns. AB - The antibody response to attenuated live measles vaccines was studied in two groups of 29 (A) and 53 (B) African children. In group A 22 sera and in group B 34 sera showed no pre-immunization haemagglutination inhibition (HI) titres. Vaccination resulted in seroconversion in 64 and 85% of groups A and B, respectively. The difference in antibody response between the two groups could be traced to children in the age group seven to eight months, where seroconversion was absent in 67% of group A children and in 0% of group B children. Antibody levels were studied in 234 mothers and their newborns. In 131 serum pairs the antibody levels of mother and child were similar. 78 (33%) of mothers showed a higher titre and 25 (11%) a lower titre than their babies. All newborns except one and all mothers except one possessed antibody titres above 10. Children in the age groups seven to eight months and nine to ten months showed antibody in 12 and 7%, respectively. Over 90% of these children had not been infected in the first ten months of life. PMID- 6868110 TI - A laboratory infection with Leishmania braziliensis braziliensis. PMID- 6868111 TI - Influence of pregnancy on mouse immunity to Trypanosoma musculi. PMID- 6868112 TI - Measles immunization in the Zambian Copperbelt: "cause for concern"? PMID- 6868114 TI - Australasian malaria vectors. PMID- 6868113 TI - Field application of the miniature anion-exchange/centrifugation technique in the Bugosa sleeping sickness epidemic. PMID- 6868115 TI - Detection of larva-specific IgE in human toxocariasis. PMID- 6868116 TI - Anthropophilic sandflies of Nicaragua, Central America. PMID- 6868117 TI - Enterotoxigenicity and invasiveness in clinical isolates of Yersinia enterocolitica. PMID- 6868118 TI - Treatment of Eritrean schistosomiasis mansoni with oxamniquine. PMID- 6868119 TI - Production of Onchocerca volvulus infective larvae from cryopreserved microfilariae in a surrogate vector. PMID- 6868120 TI - Visceral leishmaniasis in a dog introduced into Costa Rica. PMID- 6868122 TI - Histological versus morphological assessment of graft rejection in invertebrates. PMID- 6868123 TI - Posttransfusion pulmonary edema. PMID- 6868121 TI - Recovery of renal function after warm ischemia. I. The effect of chlorpromazine and phenoxybenzamine. AB - The effects of treatment with chlorpromazine (4 mg/kg) and phenoxybenzamine (1 and 5 mg/kg) on renal function and morphology after warm ischemia and contralateral nephrectomy were studied. Chlorpromazine pretreatment by intravenous injection 15 min before warm ischemia of 60 min resulted in the survival of all animals (cf. 75% in untreated group), with better renal function in the first week. Necrosis of the proximal convoluted tubule and ultimate residual cortical damage were less severe than in the untreated groups. Chlorpromazine was also beneficial after 75 min warm ischemia, although mortality was not reduced. Administration of chlorpromazine just prior to revascularization was ineffective, suggesting that sufficient concentration of the drug must be present in the kidney during the ischemic period or immediately after revascularization. Chlorpromazine probably protects the proximal tubular cells from ischemic damage. Phenoxybenzamine (1 mg/kg) was ineffective when administered 15 min before warm ischemia. A higher (5 mg/kg) dosage of the drug proved to be detrimental. PMID- 6868124 TI - Kidney preservation failure using combined Collins' solution and plasma perfusion. AB - High levels of magnesium can reverse the anticoagulation of cryoprecipitated plasma (CPP), resulting in fibrin formation. When pig cadaver kidneys were flushed with Collins' C2 solution containing a high concentration of magnesium, clotting of CPP perfusate occurred when the CPP initial magnesium level was high, but not with low magnesium levels. Flushing with C2 and preservation with an albumin perfusate, or flushing with Ringer's solution before CPP perfusion, did not result in fibrin formation. Small amounts of heparin added to CPP did not prevent fibrin formation. C2-preserved kidneys should not be additionally preserved with CPP perfusion preservation without special consideration of magnesium levels. PMID- 6868126 TI - Immunology of giardiasis. PMID- 6868125 TI - Primary lymphomas of the gastrointestinal tract. PMID- 6868127 TI - Antibiotic associated colitis. PMID- 6868128 TI - Pancreatic function and intestinal absorption in patients with alcoholic cirrhosis. PMID- 6868129 TI - Ctenocephalides canis infestation of goats. PMID- 6868130 TI - Gastro-intestinal parasites in calves in Colombia. AB - This study was conducted at Carimagua Research Centre in a high savanna area in the eastern plains of Colombia. The objectives were to identify the pathogenic parasites prevalent in the area and to study their seasonal variations and ecological conditions for use in planning control measures. The calves from two groups of 50 cows each (zebu crossbred) were used. Group I calves were born at the beginning of the rainy season and Group II calves later in the same period. The highest faecal egg counts observed were of trichostrongylid eggs. In necropsied animals Cooperia had high populations followed by Haemonchus. Throughout the rainy season there were favourable conditions for development and transmission of calf nematodes; animals born towards the end of the rainy season developed a lower infestation level which is probably easier to control. The animals were particularly susceptible to infestation with gastro-intestinal parasites at weaning. From these observations and in view of the relatively low stocking rate and the sequential burning of the savanna it is suggested that deworming be done at eight and 18 months of age. PMID- 6868131 TI - Importance of gastro-intestinal helminths in calves in Papua New Guinea. AB - Gastro-intestinal nematodes caused poor growth rates and high mortality in undrenched calves when weaning preceded the wet season. Cooperia punctata and Haemonchus placei were the dominant species throughout the year with worm burdens and pasture contamination being highest during the wet season and lowest in the dry season. Histotropic stages occurred throughout the year in weaner calves but with a clear peak during the wet season. The development of host resistance against the most important worm species generally followed the pattern described by others but a breakdown in resistance against Cooperia occurred amongst some calves during the wet season. The number of H. placei, together with Bunostomum phlebotomum, was sufficiently large in some calves to cause death. It is likely that the even larger burdens of C. punctata observed would have contributed to if not caused death. PMID- 6868132 TI - Tick paralysis in Brazil. AB - From July to December 1977 and from June to November 1978 the toxic effects of Amblyomma cajennense were studied in cattle sheep and goats. Locomotor disturbances commencing as hind-limb paralysis ascended to the upper nervous centres causing paralysis. This was observed in natural infections and confirmed experimentally. Tick paralysis is reported for the first time in Brazil, manifesting itself in a different form to that usually attributed clinically to the disease. Also for the first time reference is made to tick paralysis induced by all developmental stages of A. cajennense. PMID- 6868133 TI - Reproductive efficiency of heifers in the New Guinea highlands. AB - Bos indicus x Bos taurus heifers were exposed to bulls at four different liveweights. The age and weight at first and second conception and first calf growth rates were studied to examine the effects of uncontrolled mating prior to or at a target mating weight of 295 kg. Initial conception rate was not affected although lighter conception weights were recorded for three groups of heifers that were served when below the target weight. However, at subsequent calving only the two heavier groups calved within the 36-month trial period. The results indicated a seasonal effect on conception, 94% of the heifers conceiving during the "wet" season. The effect of season also influenced post-partum body weight loss, calf growth rate to weaning and subsequent conception. It is therefore an advantage to have heifers conceiving during the latter part of the wet season so that they calve early in the following wet season, provided a minimum target weight of 285 kg is reached prior to initial conception. PMID- 6868134 TI - Epidemiology of tick-borne diseases of cattle in Zimbabwe. I. Babesiosis. AB - A survey on the incidence of antibodies to Babesia bigemina and Babesia bovis in one to three year old calves at 274 localities in Zimbabwe revealed that B. bigemina occurred throughout the country together with its main vector, Boophilus decoloratus. The distribution of B. bovis followed closely that of its vector Boophilus microplus which is limited to the eastern part of the country. Enzootic stability for B. bigemina was recorded in most of the communal tribal areas where regular dipping of cattle had been interrupted for several years but was less common on commercial farms where regular dipping is practised. Enzootic stability for B. bovis was restricted to a few localities in communal areas and the parasite was rare on commercial farms. PMID- 6868135 TI - Toxic, DNA-damaging and mutagenic activity of epichlorohydrin on human cells cultured in vitro. AB - Epichlorohydrin (ECHH) highly inhibited the tritiated thymidine uptake by human lymphocytes cultured in vitro, although the corresponding cell viability was unaffected. Furthermore, it elicited unscheduled DNA synthesis, acting as a DNA damaging agent after its metabolic activation. ECHH also showed a clear toxic and mutagenic activity toward a human epithelial-like cell line, causing a decrease in cell viability and an increase in mutants resistant to 0.05 Lf/ml of diphtheria toxin. PMID- 6868137 TI - Red blood cell hexokinase in tumor bearing mice. AB - Red blood cell hexokinase of tumor-bearing BALB/c mice was found to be 35% higher than in the normal controls, whereas glucose 6-phosphate-dehydrogenase and other red blood cell glycolytic enzymes were in the normal range. This hexokinase increase cannot be explained by a mean younger red cell population because normal hematological data and normal red cell enzymes, known as red cell age-markers, have been found in tumor-bearing mice. The isozymic pattern of red cell hexokinase is not modified in the tumor-bearing mice. PMID- 6868136 TI - Testicular mesotheliomas in rats exposed to N-2-fluorenylacetamide (FAA). AB - The incidence of testicular mesotheliomas after exposure to the carcinogen N-2 fluorenylacetamide (FAA) was studied in Fischer 344 rats. The animals were fed a carcinogenic diet (containing 0.06% FAA) for 4 weeks and then a control diet for 1 week. This schedule was carried out for 3 complete cycles (12 weeks). A smaller group of rats was treated with FAA for 1 complete cycle only (4 weeks). One group of untreated controls was also available. The surviving rats were sacrificed at 59 weeks of age. The administration of FAA for 3 complete cycles resulted in a high incidence of liver, testis and Zymbal-gland tumors. The testicular tumours were mesotheliomas and occurred in 9/25 rats. No such tumour was observed in animals treated for 1 cycle only or in untreated controls. The high incidence of testicular mesotheliomas, a rare type of tumour in this and other rat strains, suggests an association with the treatment. The present experimental model may be useful in elucidating the mechanisms of the induction of mesothelial tumours of the testis by chemical carcinogens. PMID- 6868138 TI - Primary malignant tumors of the thyroid gland. Histology, age and sex distribution and pathologic correlations in 139 cases. AB - The classification proposed by Woolner et al. (1961, 1971) has been applied to 139 cases of primary malignant tumors of the thyroid gland diagnosed in one of the largest hospitals of Rome, Italy, over a period of 5 years, from 1977 to 1981. These cases come from 1418 patients with enlargement of the thyroid surgically treated at the 5th Surgical Clinic of the University of Rome. All the histologic slides were re-examined, and the pathology records were reevaluated. Of these tumors, 56.8% were papillary, 30.9% follicular, 9.3% anaplastic or undifferentiated, and 2.1% medullary. There was a female predominance in all age groups and for all types of tumors, reflecting a total female to male ratio of 1.9:1. Papillary carcinoma occurred most commonly in young and young-adult patients, follicular in the middle-age group, and anaplastic in the elderly. The extent of the primary tumor, the presence of regional metastases, and the association with other thyroid nonneoplastic diseases such as lymphocytic and Hashimoto's thyroiditis, and nontoxic and toxic goiter were also recorded. Multicentric tumors were found in 38.9% of cases principally represented by papillary carcinomas. Regional lymph node metastases were observed mainly in young patients, and no correlation was found between thyroid cancer incidence and other nonneoplastic thyroid diseases. PMID- 6868139 TI - Impairment of antipyrine metabolism in urinary tract cancer. AB - The metabolism of antipyrine was studied in 13 patients with cancer and bladder papillomas and in 11 control subjects, matched for interfering factors like smoking, diet, age and sex. The mean antipyrine half-life was significantly longer in patients with urinary tract cancer (14.7 +/- 1.32 h SE) than in control subjects (11 +/- 0.55 h SE) (P less than 0.025); other clinical parameters did not vary. PMID- 6868140 TI - Plasma calcitonin and tumors. AB - Plasma levels of calcium, phosphorus, immunoreactive calcitonin (iCT), immunoreactive parathyroid hormone (iPTH), and carcinoembryonic antigen (CEA) were measured in patients affected by tumors of various organs: 22 breast, 41 lung, 23 kidney, 16 gastrointestinal tract, and 8 other types, iCT plasma level was elevated in 53.6% of patients with bronchogenic cancer, in 31.8% with breast cancer, in 65.3% with renal cancer, in 31.2% with gastrointestinal cancer, and in 62.5% with other tumors. Blood calcium level was increased in 6 patients suffering from lung cancer; iCT plasma level was increased in all but one of these subjects. iPTH plasma level, measured in 35 patients, was elevated only in one case, in which normo-calcemia was present. Our results demonstrate that plasma iCT is increased in a high percentage of cancer patients and that it is probably a good tumor marker. The simultaneous measurement of CEA increases the diagnostic probability of the individual marker. The incidence of laboratory findings suggestive of primary or ectopic hyperparathyroidism was very low in our series of patients. PMID- 6868141 TI - Gastric juice nitrite and bacteria in gastroduodenal disease and resected stomach. AB - The N-nitroso-compounds and the bacteriological contamination of gastric juice could represent a risk factor for cancer of the stomach when the mucosal barrier is altered. In the unresected stomach and gastric stump, the hypo-achlorhydria and bilopancreatic reflux permit the development of bacterial flora and the production of N-nitroso-compounds in the presence of nitrite. A survey was performed on 71 patients: 15 normal controls, 31 with gastroduodenal disease (9 gastrites, 10 gastric ulcers, 10 duodenal ulcers, 7 neoplasias), 20 patients with gastric resection (8 BI, 12 BII), using an endoscopic-histopathologic control and a chemical-bacteriological analysis of the gastric juice. We studied the gastric juice for the following parameters: pH, concentration of nitrite, identification of bacterial type, count and nitrate-reductase activity. An inverse relationship was found between the concentration of nitrite and the hydrogen ion concentration. In the alkaline gastric juice, we identified aerobic bacteria with nitrate-reductase activity and anaerobic bacteria. The latter has the ability to transform biliary salts into carcinogenic and cocarcinogenic compounds and to catalyze the nitrosations. The chemicobacteriological characteristics of the gastric juice from gastric ulcers (Johnson type I), atrophic gastrites, and resected stomachs lead one to think that there is a risk of carcinogenesis brought about by the N-nitroso-compounds. PMID- 6868142 TI - Recurrences in the soft tissues of the neck after surgery or radiotherapy plus surgery on regional lymph nodes in patients bearing carcinomas of the head and neck. AB - A series of 45 recurrences in the soft tissues of the neck following lymph node dissection in 497 patients bearing carcinoma of the upper aerodigestive passages is reported. Only 22 cases that presented perilymph node metastases and/or in which there were reasons to indicate insufficient surgical radicality had been subjected to radiotherapy after surgical lymph node dissection; the other 23 cases had not been subjected to radiotherapy because the aforementioned premises had been lacking. All the recurrences therefore occurred in patients with clinically and histologically ascertained metastatic lymph nodes. The presence of perilymph node metastases and the judgment of surgical radicality was thus found insufficient criteria to plan future complementary postoperative radiotherapy. However, even in those cases in which postoperative radiotherapy was performed, there was a rather high incidence of recurrences, as high as 64.7% in patients with carcinoma of the tongue. Our data indicate the opportunity of a clinical trial with preoperative radiation therapy in patients with clinically evident lymph node metastases. Thirty-six of these recurrences were situated in the upper parts of the cervical region. The prognosis is very poor in such cases, so much so that only 2 of our series were disease free at 3 years after the treatment. PMID- 6868143 TI - Strumal carcinoid of the ovary: an immunohistochemical and electron microscopic study. AB - A case of strumal carcinoid of the ovary is reported. The follicles contained T4 immunoreactive substance, whereas the carcinoid component of the tumor had a trabecular structure and showed argyrophilic elements. Pancreatic-polypeptide and enteroglucagon were localized in these cells by an immunocytochemical method. The same cells displayed small electron-dense endocrine-like granules. A common precursor for the thyroid and carcinoid components is postulated. PMID- 6868144 TI - Father-son testicular cancer, case report. AB - A case of familial testicular malignancy in a father and his son is reported. This represents the seventh described case of father-son testicular cancer. The father had seminoma and the son had teratocarcinoma. Both patients' peripheral blood lymphocytes were tested for 52 HLA specificities: the father's antigens were HLA A3, B13, B14, Cw6, Cw8 and the son's were HLA A2, A3, B14, Cw8. (Common haplotype: A3, B14, Cw8). The association between HLA antigens and testicular cancer is discussed. PMID- 6868145 TI - Renal oncocytoma: report of two cases. AB - The clinico-radiologic, gross, microscopic and ultrastructural findings in 2 cases of renal oncocytoma are reported. The diagnosis of renal oncocytoma has important clinical and prognostic implications, since the neoplasia is usually benign despite its often large size. The differential diagnosis with other renal neoplasms, in particular renal cell carcinoma, is discussed. The problem of the pre-operatory diagnosis of renal oncocytoma is explored on the basis of clinico radiologic findings and/or histologic examination of pre- or intraoperatory biopsy. In view of the tumor's benign nature, this diagnosis implies tumorectomy, but its close resemblance to renal cell carcinoma at present counsels nephrectomy. A final diagnosis of oncocytoma may be formulated only after histologic examination of several specimens and ultrastructural confirmation. PMID- 6868146 TI - [Differences between the complexes formed by monomeric fibrin with fragment D and dimer D]. AB - The paper is concerned with studies in formation of monomeric fibrin (fm) complexes with fragment D (D) of fibrinogen and dimer D (DD) of stabilized fibrin. The complexes are shown to be essentially different. The fm-D complexes are unstable, their composition is a function of D concentration in the mixture, the ultimate molar D/fm ratio is equal to 3. The fm-DD complexes are quite stable, their composition is constant: the molar DD/fm ratio is equal to 1. In mixtures containing fm, DD and different amounts of D complexes of different composition are formed but the total number of D-units in them approaches 3. A model is suggested showing interaction of fm molecules in protofibril formation with allowance for the retention of binding centres which provide the lateral link between protofibrils. PMID- 6868147 TI - [Study of fibrinogen-fibrin cryocomplexes by a quantitative analysis of N terminal amino acids]. AB - The reaction between fibrinogen (F) and thrombin (0.003 NIH/ml) has been investigated under physiological conditions. The action of thrombin was inhibited in various time intervals including gel point (4 h), and the reaction mixtures were allowed to stand 0 degrees C. The F-to-des-AA-fibrin (f) ratios were determined both in the initial reaction mixtures and in corresponding cryoprecipitants by the method of N-terminal amino acids quantitative analysis. It is found that the F/f ratio in the cryoprecipitant depends on the F/f ratio in the initial mixture at 37 degrees C. The F/f = 1 ratio in cryoprecipitant previously found by Shainoff and Page is valid only for the initial F/f = 7 ratio. But the F/f value in cryoprecipitants varies in favour of F or f components, if the F/f ratio increases or decreases in the initial mixture at 37 degrees C, respectively. A possible mechanism of various fibrinogen-fibrin cryocomplexes formation is discussed. PMID- 6868148 TI - [Analysis of the stability of the intermediate fibrin polymers formed in a fibrinogen-thrombin system]. AB - Intermediate fibrin polymers formed from fibrinogen at low thrombin concentrations under physiological conditions are studied for their stability. Smith's statement that intermediate fibrin oligomers are inert molecules whose further self-assembly is possible only under additional thrombin activation was not supported. It is shown that the intermediate fibrin polymer stability at pH 7.4 is not high because of a strong tendency to aggregation and the higher molecular weight of the polymer the less its stability. The polymer stability in solution increases with pH. Stability of soluble fibrin complexes in solution depends on their size, defined by environmental conditions and on the quantity of fibrinogen present. PMID- 6868150 TI - [Analysis of the relationship between the reactivity of synthetic substrates and thrombin inhibitors and their structure]. AB - Kinetics of thrombin- and trypsin-catalyzed hydrolysis of diphenylacetyl-L arginine esters was studied at pH 8.5 and 25 degrees C, and the antithrombin activity of in vitro synthesized compounds was examined. The anticlotting activity of arylsulphonyl-L-arginine methyl esters appeared to be higher than that of the derivatives of diphenyl arginine. Relations were found connecting polar (delta) and steric (Es) characteristics of substituent (R) in R-C6H4-SO2 Arg-OCH3 esters with their antithrombin activity in vitro or with efficiency of their thrombin-catalyzed hydrolysis. This gives supplementary possibilities for synthesis of new substrates and more potent thrombin inhibitors. PMID- 6868149 TI - [Inhibitor of fibrin self-assembly]. AB - The thermostable inhibitor with a molecular mass 1750 +/- 100 was found in human, bovine and albino rat blood sera. A ninhydrin-positive product containing no carbohydrates, lipids, nucleic acids was obtained while purifying the inhibitor by combining column ion-exchange chromatography and partition thin layer chromatography. An analogous inhibitor is extracted from the tissue of liver, kidneys, lungs, spleen, duodenum, heart, m. striatum, brain, aorta, where its content is higher than in the blood serum. The inhibitor differs from the already known ones in molecular mass, resistance to heating and dialysis. An assumption is advanced on its participation in maintaining the liquid blood state under conditions providing a possibility of accelerated thrombinogenesis and thrombin fibrinogen interaction. PMID- 6868151 TI - [The effect of dithiothreitol on the thrombin coagulating activity]. AB - Partial dithiothreitol-reduction of the disulphide thrombin bonds when denaturating agents are absent lowers significantly enzymic activity of thrombin relative to fibrinogen coagulation. This permits supposing that at least one of the disulphide bridges in a thrombin molecule is necessary for stabilization of the space structure important for a specific hydrolysis of fibrinogen. PMID- 6868152 TI - [Use of disc electrophoresis in a linear gradient of polyacrylamide gel concentrations for simultaneous fractionation of total serum proteins, haptoglobins and lipoproteins]. AB - Conditions are developed for fractionation of total proteins of blood serum and lipoproteids within a linear gradient of the polyacrylamide gel concentration. Optimal separation of the proteins was observed at initial concentrations of acrylamide 3 and 10%: lipoproteids--2 and 15%. The composition of haptoglobins should be taken into consideration when analyzing the spectrum of human serum proteins. For this purpose samples fractionated simultaneously in one gel plate should be subjected to differential staining with amide black and benzidine. It is established that the efficiency of alpha-lipoproteids subfractions separation is reached by electrophoresis of this class lipoproteids after polyethylene glycol precipitation. The method described broadens essentially potentialities of electrophoretic fractionation of blood serum proteins due to an increase in the resolving power and sensitivity. PMID- 6868153 TI - [Study of serum protein aggregation after treatment with urea]. AB - Gel chromatography and electrophoresis in polyacrylamide gel show that urea in vitro induces aggregation of blood proteins, with their content unchanged. The aggregation does not depend on the fibrinogen available. Comparison of the data on the effect of urea, DS-Na and thermal denaturation on the protein aggregation suggests that the aggregation is induced by local conformation transformations in the structure of certain protein molecules. At the same time, the data obtained do not permit neglecting the role of denaturation in the aggregation. PMID- 6868154 TI - [125I-fibrinogen scanning, perfusion/ventilation scintigraphy and prevention with low-dosage heparin in acute diseases]. PMID- 6868155 TI - [Urination disorders and hysterectomy]. PMID- 6868156 TI - [Imported multiresistant pneumococci]. PMID- 6868160 TI - [Treatment of injuries and minor surgery in general practice]. PMID- 6868159 TI - [Hospitalization of children in Denmark. Statistics and points of view]. PMID- 6868158 TI - [What do we know about occupational movement disorders of the extremities?]. PMID- 6868157 TI - [Estrogen therapy for the hyperprolactinemic postmenopause woman]. PMID- 6868162 TI - [Nasal cancer in Denmark. Neoplasm statistics 6]. PMID- 6868161 TI - [Occupational accidents. Reliability of accident statistics based on management surveys in relation to individual departments, nature of the industry, safety regulations and severity of injuries]. PMID- 6868163 TI - [Serum aluminum in hemodialysis patients. Relation to osteodystrophy, encephalopathy and aluminum hydroxide consumption]. PMID- 6868164 TI - [The value of lymphographic follow-up in the diagnosis of recurrent malignant lymphoma and testicular cancer]. PMID- 6868166 TI - [Benign amyotrophic lateral sclerosis]. PMID- 6868165 TI - [The lactose provocation test. An easy and cheap screening method for lactose malabsorption]. PMID- 6868167 TI - [Myelodysplastic syndrome (preleukemia)]. PMID- 6868168 TI - [Methaqualone poisoning treated with hemoperfusion]. PMID- 6868169 TI - [Direct litholysis of an obstructing urate calculus in the ureter]. PMID- 6868170 TI - [Rupture of the adductor longus muscle. Differential diagnosis from incarcerated inguinal hernia]. PMID- 6868171 TI - [Incorrect installation of a Schneider air regulator]. PMID- 6868172 TI - [Attempted suicide and psychiatric supervision]. PMID- 6868173 TI - [Attempted suicide. Characteristics of a total patient population admitted after attempted suicide]. PMID- 6868174 TI - [Cerebral paresis in Eastern Denmark 1965-1974. IV. The significance of perinatal factors in dyskinetic cases. Report number X from the Cerebral Palsy Registry]. PMID- 6868175 TI - Decompression incidence in air- and liquid-breathing hamsters. AB - The effects of hyperbaric compression on heart rate, rectal temperature, respiratory rate, bubble formation, and survival were studied in three groups of anesthetized golden hamsters (Mesocricetus auratus). Group I (15 animals) breathed air while exposed to 7 ATA of pressure for 1 h in a hyperbaric chamber; Group II (13 animals), at the same pressure level (7 ATA) and for the same time period (1 h), breathed an oxygenated fluorocarbon liquid (temperature 27 degrees C) that was open to the chamber atmosphere; Group III (10 animals), at the same pressure and time period as the other groups, were sealed in a flexible plastic bag filled with oxygenated fluorocarbon as a breathing mixture. A fourth, Group IV (12 animals), breathed oxygenated fluorocarbon for 1 h at 1 ATA. Survival after rapid decompression in each group varied, 9 animals died in Group I, 12 animals in Group II, whereas none of the animals died in either Groups III or IV. Thirty minutes after decompression postmortem examinations of all the animals demonstrated the presence of large amounts of gas bubbles in the right ventricle and some gas bubbles in the left ventricle of all the hamsters in Groups I and II. No gas bubbles were found in the hearts of the Group III animals. Group III animals, breathing a liquid unsaturated by an inert gas, survived rapid explosive decompression without the signs and symptoms of decompression sickness. Immersion in the liquid fluorocarbon produced a profound decrease in heart rate, rectal temperature, and respiration in Groups II, III, and IV. PMID- 6868176 TI - Hyperbaric exposure during pregnancy in sheep: staged and rapid decompression. AB - Hyperbaric exposure during pregnancy in sheep: staged and rapid decompression. Undersea Biomed Res 1983; 10(1): 11-15. --Twelve sheep with dated pregnancies were exposed for 20 min to hyperbaric pressure comparable to 165 feet of sea water weekly between the 49th and 133rd days of pregnancy. Six were decompressed in stages and six directly without decompression stops. Those that were decompressed gradually delivered normally at or near term. One lamb was abnormal, but the relationship to pressurization is unclear. Three of those decompressed rapidly aborted dead fetuses, and two others delivered mature, but affected, lambs. Under the conditions of this study staged decompression after repeated hyperbaric exposures protected the fetuses from the destructive effects of rapid decompression. Hyperbaric pressure did not alter gross anatomic development. PMID- 6868177 TI - Velocity of ultrasound as an indicator of bubble content. AB - The principle has been evaluated of detecting stationary tissue gas bubbles simply by measuring the velocity of ultrasound. Agar gel has been used to simulate tissue. At wavelengths appreciably larger than bubble diameter (at least 10:1) the ultrasound seems to "view" the gel-gas mix as though it were one medium, when the velocity of pulsed ultrasound is reduced approximately as predicted theoretically from the decreased modulus. The velocity of sound shows an appreciable (10%) decrease for only 0.65% of the gas phase as bubbles of 20 200 microns diameter and drops to about one-third of the bubble-free value for only 0.79% gas by volume--values well in excess of those theoretically predicted to elicit the symptoms of limb bends. These large changes in the velocity of sound can probably be measured with a much less expensive unit than the one used in this study and would seem to warrant further investigation as a very simple method for detecting bubbles in tissue--whether intravascular or extravascular. PMID- 6868178 TI - Dentin permeability under hyperbaric conditions as a possible cause of barodontalgia. PMID- 6868179 TI - Mean skin temperature in hyperbaric oxyhelium--its measurement and limitations. PMID- 6868180 TI - Comparison of diving experience factors between divers classified as positive and negative for bone cysts. AB - Official U.S. Navy diving records for enlisted divers who were 35 years of age and older were examined for differences in diving experience between those who were classified as positive or negative for bone cysts. One-third of the divers (n = 31) were classified as positive, and two-thirds (n = 62) as negative, for bone cysts. Diving experience factors included total years of diving experience, frequency of dives between 15 and 31 m, frequency of dives deeper than 31 m, number of saturation dives, number of dives involving decompression, and number of cases of decompression sickness. None of these factors differed significantly between the two groups. While previous findings showed that bone cysts are twice as prevalent among divers as among a comparison group of Navy enlisted men matched to divers for age, rank, and occupational specialty, these results indicate that this high prevalence rate does not appear to be related to specific types of diving exposure. Other environmental factors such as long-bone injury, disease, or exposure to hazardous or toxic substances may account for differences in the prevalence of bone cysts between the two groups. PMID- 6868181 TI - [Macroscopic and microscopic findings in the femur head following acetabular fractures]. PMID- 6868182 TI - [Elbow joint contusions]. PMID- 6868183 TI - [Stability tests of a new ventral clamp fixation device for the tibia. II: Bending load]. PMID- 6868184 TI - [Fractures of the talus in children]. PMID- 6868185 TI - [The value of computerized tomography in the diagnosis of cranio-cerebral injuries]. PMID- 6868186 TI - [Cranio-cerebral injuries from skiing and their prevention]. PMID- 6868187 TI - [A new holding device for the preparation of stress roentgenograms of the knee joint]. PMID- 6868188 TI - [Wound-healing disorders and osteitis following osteosynthesis with special reference to risk factors]. PMID- 6868189 TI - [At the confines of music and medicine]. PMID- 6868190 TI - [Surgical treatment of supracondylar fractures of the femur. Retrospective study on the application of the A.S.I.F. (Association for the Study of Internal Fixation) technic]. PMID- 6868191 TI - [Rigid osteosynthesis frees the joints]. PMID- 6868192 TI - [Chronic compartment syndrome: causes, diagnosis and treatment]. PMID- 6868193 TI - [Supracondylar fractures of the humerus in children. Review of 217 cases]. PMID- 6868194 TI - [Lapidus operation for the correction of quintus varus]. PMID- 6868195 TI - [Value of bone scintigraphy in the diagnosis and follow up of "Shin Splint"]. PMID- 6868196 TI - [Psychological effects of foot races: a survey of the 1981 Montreal marathon]. PMID- 6868197 TI - [Auscultatory and phonocardiographic variations of the athlete's heart in relation to aerobic capacity]. PMID- 6868198 TI - [Neural control of respiration. IV-dyspnea]. PMID- 6868199 TI - [Neuromusicology, an integral part of clinical neuropsychology]. PMID- 6868200 TI - [Intrauterine growth retardation: maternal factors encountered and importance of arterial hypertension. A retrospective study]. PMID- 6868201 TI - [Treatment of fractures and dislocations of the upper cervical spine with steel wire and methyl methacrylate: analysis of 27 cases]. PMID- 6868202 TI - [Splendors and misery of surgical pathology. Errare humanum est. . ]. PMID- 6868204 TI - Increased platelet volume in manifest diabetic rats. AB - Platelet function, evaluated as in vitro aggregability, has been reported to be disturbed in diabetes, both in humans and animals. Platelet number and mean volume greatly influence these aggregation tests. The present study was designed to evaluate the impact of two different degrees of experimentally induced glucose intolerance on platelet number and mean volume. For this purpose, we used manifest diabetic and chemically diabetic rats. In the control group, the female rats showed a significantly lower number of platelets compared to the males. The chemically diabetic rats exhibited a tendency towards increased mean platelet volume, whereas the platelet volume of the manifest diabetic females was significantly greater than all other groups. This increase was found to be mainly due to a general shift towards larger volumes of the individual platelets of the manifest diabetic females. It is suggested, that the enlargement of the mean platelet volume induced by increased severity of the diabetic state may reflect decreased mean age of the circulating platelets. This implies shorter survival time and an increased turnover of the platelet population in diabetes mellitus. PMID- 6868203 TI - [Reflections on "medicinal drugs or magic potions"]. PMID- 6868205 TI - Composition of surface layers in unfixed autologous fascia lata heart valve grafts. A transmission electron microscopical study. AB - Sixty-nine patients underwent aortic valve replacement with frame mounted non fixated fascia lata grafts. Nine patients still have their fascia lata valve in place after a period of between 9 to 11 years. Fifty-two grafts were available for histo-pathologic examination. The mechanism of valve thickening was studied by transmission electron microscopy (TEM). The major factor contribution to the thickening seems to be a surface accumulation of complex proteins, fibrin and platelets. Within the valvular tissue itself, subcellular degenerative products in cell cytoplasm, the interstitium and in the sub-surface layer also contributed. The thickening never exceeded one fifth of the original thickness of the valve. PMID- 6868206 TI - Intraarterial and intraportal in vivo catheterization of the regenerating rat liver. Effects upon body and liver weights and DNA synthesis. AB - A method for concomitant partial hepatectomy and catheterization of the arterial and portal systems of the liver in the rat is described. Catheters were inserted into the gastroduodenal artery and the ileocolic vein. Continuous saline perfusion was performed during 36 hours. In catheterized rats recovery of liver and body weight lagged behind that of non-catheterized rats. The more extensive surgery and the presence of catheters also caused decreased incorporation of 3H thymidine into liver DNA 24 hours postoperatively. The variation in thymidine incorporation between animals was large. It was shown that by pre-labelling liver DNA with 14C-thymidine the rats can serve as their own controls during acute experiments involving 3H-thymidine, thus reducing the inconsistency of individual variation. PMID- 6868207 TI - Irradiation effects upon ischemic regenerating rat liver cells. AB - Starch particles injected into the arterial and portal systems of the liver of the rat caused a temporary blockage of the liver circulation and consequent hypoxia in the liver cells. In the regenerating liver this resulted in a 30-40% decrease of thymidine incorporation into DNA, when analysed 1.5 hours after injection. Irradiation-induced cell damage, evaluated by thymidine incorporation 1.5 hours after irradiation with a single dose of X-rays, was not ameliorated by the ischemic condition. It is suggested that this depends on an inhibited nucleotide metabolism and DNA synthesis leading to an additive metabolic hypoxic effect of the starch particles on radiation damage. An equal level of thymidine incorporation, however, was found in an ischemic and a non-ischemic group of animals 16 hours after irradiation. In this case the liver cells in the ischemic group had overcome the additional inhibition of DNA synthesis caused by temporary hypoxia. PMID- 6868208 TI - On cerebrovascular deaths in middle-aged men during a 7--10-year follow-up. PMID- 6868209 TI - Cord blood platelet aggregation; quality control by a two-sample technique. AB - Two blood samples were taken from the cords at 17 normal deliveries 2-4 min and 5 8 min after birth, respectively. The difference in platelet count between early and late samples in platelet-rich plasma was less than 5% in nine cords (Group A), and greater in eight cords (Group B). Platelet aggregation studies on the early and the late blood samples showed consistent results within each cord in Group A but not in Group B. The correlations between the responses were high for Group A. The aggregation responses were also slightly but significantly higher in the late samples in this group (p less than 0.01 in Group A; n.s. in Group B). The differences between responses in early and late blood samples could not be explained by acid-base dissimilarities. The variability in cord blood platelet aggregation results can be greatly reduced by platelet counting in PRP of two independent blood samples, accepting only samples with concordant platelet counts (less than 5% difference). PMID- 6868210 TI - Determination of carcinoembryonic antigen in tissue, serum and urine in patients with transitional cell carcinoma of the urinary bladder. AB - Carcinoembryonic antigen (CEA) is elevated in urine and/or serum of patients with transitional cell carcinoma (TCC) of the urinary bladder. A group of 26 patients with TCC of the urinary bladder were evaluated with regard to urine/serum CEA levels and CEA tissue content. CEA could be detected in normal, metaplastic and pre-neoplastic urothelium as well as tumor tissue. CEA was mainly localized on cell membranes, but with increasing tumor malignancy and infiltration a shift to cytoplasmatic localized CEA was noted. There was also a decrease in CEA content in the latter group. CEA urine levels were elevated above normal in more advanced tumor stages; however, the values varied greatly between individuals. All serum levels were within normal limits. No correlation could be established between urine/serum CEA levels and CEA tissue content. PMID- 6868211 TI - [Reflex anuria reaction]. PMID- 6868212 TI - Erection and priapism: a new physiopathological concept. AB - For normal erection two mechanisms are essential: the first provides increased arterial inflow, most probably this is obtained due to the activity of the intimal cushions within the arteriae helicinae and within the shunt vessels. The second mechanism uses increased arterial blood flow; this could be obtained due to the activity of the trabecular muscle fibers of the corpora cavernosa. In consequence, we would deal with two different types of priapism: one type--high flow priapism--occurs at the level of the arteriae helicinae and the intimal cushions and provokes a high-flow situation, and the second type, with blood stasis in the corpora cavernosa, occurs at the level of the trabeculae due to persistent contraction of the smooth muscle fibers. The prognosis of the second type is much less favorable and should be cured by surgery within the first 48 h. PMID- 6868213 TI - [Microsurgical splinted tubulovasostomy in rats]. AB - Due to unsatisfactory results from conventional epididymovasostomies for treating male infertility because of the obstruction of the ejaculatory tract, a new method was tried by splinting the tubulovasostomy. This was first described by Ozdiler and Kelami. After 3-6 months, a total of 33% of the anastomoses were patent. With the surgeon's increased skill and practice of the operation, the patency of the anastomoses of the last group increased to 50% (15/30). PMID- 6868214 TI - Morphology of the urinary bladder following long-term experimental irritation of the urothelium. AB - 10 female beagle whelps received an artificial urinary calculus (1.5 ml of a rapidly polymerizing methyl-methacrylate) by means of a transurethral procedure. The X-ray, cytological, endoscopic and bioptic findings were followed in a long term experiment. After a period of 61 months, precancerous urothelial changes (n = 1) and invasive urothelial microcarcinomas were found (n = 2). Typical changes from earlier controls were pseudopapillary follicular cystites. Chronic irritation of the urothelium is shown to be an important factor in the pathogenesis of urinary bladder carcinoma. Decisive is the length of the period of irritation rather than the actual material used in making the pellet. PMID- 6868215 TI - Raising urinary citrate lowers calcium oxalate and calcium phosphate crystal formation in whole urine. AB - Crystal formation in whole urine was studied by the technique of rapid evaporation to 1,250 mosmol/l with and without raising citrate concentration by 40-50%. The added citrate reduced calcium oxalate crystal formation at pH 5.3 by about 25% and reduced calcium phosphate crystal formation at pH 6.8 by some 42%. These results support the view that citrate is important in maintaining calcium in solution in whole urine, and that raising the urinary citrate could be effective treatment for calcium oxalate/phosphate urolithiasis. PMID- 6868216 TI - Metastatic breast carcinoma of prostatic origin. PMID- 6868217 TI - Angiomyolipoma causing spontaneous rupture of the kidney. PMID- 6868219 TI - Lymph node proliferation in patients with urological tumours. AB - Reactivity of regional lymph node cells was determined in 87 patients with urological cancer by measuring the S-phases of the cell cycle using flow cytophotometry. Compared with a control group of 28 individuals with and without infectious disease regional to the extirpated lymph nodes, analysis of 250 lymph nodes in tumour patients exhibited either normal, reduced, or elevated S-phases. No relation could be established between the reduced or elevated pattern of reactivity of regional lymph node cells and any known tumour parameter, such as organ manifestation, histology, stage, and grade. Whether the determined S-phases correlate with the prognosis remains to be determined. PMID- 6868218 TI - A comparison between the combination emepronium bromide/flavoxate and emepronium bromide in the treatment of detrusor instability. AB - Emepronium bromide and flavoxate have both and separately been used with success in the treatment of detrusor instability. In this study we have combined the two drugs emepronium bromide and flavoxate and compared the results with emepronium bromide. 20 consecutive patients with an uninhibited bladder, 12 men and 8 women, were randomly allocated to treatment with either emepronium bromide/flavoxate or emepronium bromide. In this trial we found that treatment with the combination is significantly better than treatment with emepronium bromide only. PMID- 6868220 TI - Relapse of androgen-dependent tumour of mouse (Shionogi Carcinoma 115) after castration and oestrogen treatment. AB - To elucidate relapse of hormone-dependent tumour, mice bearing androgen-dependent carcinoma (SC 115) underwent castration or received oestrogen treatment. Since SC 115 consisted of two types of cells, androgen-sensitive round cells and insensitive spindle-shaped cells, changes in the ratio of the cellular population were examined. After castration, spindle-shaped cells increased temporarily as the tumour regressed, then the round cells increased significantly along with an increase in size of the tumour. Oestrogen treatment did not influence the population. Androgen dependency and the growth rate of round cells were generally preserved in the next generation. Therefore, relapse may occur by an increase in the number of androgen-sensitive round cells. PMID- 6868221 TI - Ultrastructural analysis of rat testes after gossypol acetic acid (GAA) treatment. AB - The present investigations were carried out to show the histological and ultrastructural alterations in rat testes 10 weeks after gossypol acetic acid treatment (dose: 30 mg gossypol acetic acid/kg/day). the morphological findings in the interstitial compartment were compared with the data from studies carried out to investigate the testosterone biosynthesis in gossypol acetic acid treated rats. No morphological changes in the epididymal and vasal epithelia were found; however, the germinal epithelial cells showed vacuolisation, pycnosis, disconnections of junctions, cytolysis and exfoliation of germ cells from the epithelium. The Sertoli cells were affected, too. Gossypol acetic acid seemed to stimulate the physiological activity pathologically; cellular organelles as mitochondria, endoplasmic reticulum, lysosomal vacuoles, pigment granules and nuclei were either enlarged in size and number or malformed in shape. The cellular contact was often restricted to spots or completely disconnected. If gossypol acetic acid was administered for a longer period of time some Sertoli cells were found to be unable to withstand the toxic stimulus, and the cells became necrotic too. In contrast to the toxic process in the germinal and Sertoli cells the Leydig cell compartment did not show any changes in fine structure, and therefore testosterone biosynthesis is presumed to be intact. PMID- 6868222 TI - An optical micromethod for the determination of relative crystallisation rates of calcium oxalate in gels: method and preliminary results. AB - This paper describes a new, highly efficient micromethod for the determination of relative crystallisation rates of calcium oxalate (CaOx). Crystallisation is performed in the upper layer of a gel (bactoagar, agarose) which contains one component (oxalate) of the sparingly soluble salt. Precipitation is started by pipetting Ca++ containing solutions (in the presence and absence of crystallisation inhibitors) onto the gel. The process is followed quantitatively as a function of time by means of vertical light path photometry carrying out quasi-simultaneous multideterminations within a 50-fold multicuvette. The test volume is 0.1 ml. The method is suitable for large scale determinations. About 50 single crystallisation kinetics can be measured within 5-15 min. Testing three known inhibitors of CaOx crystal formation, relative inhibitory activities were obtained with standard errors of 1%-4%. PMID- 6868224 TI - Endocrine treatment of prostatic cancer. AB - Data are drawn from the pertinent literature supporting diethylstilbestrol for initial endocrine treatment of advanced prostatic cancer. When diethylstilbestrol is given in a dosage of 2 mg daily, the risk of cardiovascular complications is low. Bilateral orchiectomy is reserved for high-risk patients or those intolerant of estrogen. To prevent possible complications of uncontrolled tumor growth and perhaps to increase survival time, endocrine treatment of advanced prostatic cancer should be started early. PMID- 6868223 TI - Rabbit bladder-surface mucin: a thermodynamic mechanism for inhibiting bacterial adhesion. AB - A possible thermodynamic mechanism for the inhibition of bacterial adhesion to the epithelial bladder surface was investigated in rabbits. Contact angles of aqueous polymeric droplets were measured to assess the relative hydration and surface-free energy, of normal and mucin-free bladder surfaces. We measured an angle of 91.2 +/- 1.2 degrees (SEM), n = 37 for the intact mucin surface and an angle of 120.5 +/- 1.2 degrees, n equal 46 for the epithelium after the mucin was removed with acid. These results indicate that mucin makes the epithelial surface significantly more hydrophilic and so produces a very low free energy interface with the urine environment. Such a low energy surface would inhibit bacterial adhesion because the surface already exists at its free energy minimum. PMID- 6868225 TI - Impact of symptomatic interval on prognosis of patients with stage III testicular cancer. AB - In patients with testicular cancer, the interval from the onset of symptoms to histologic diagnosis has been correlated with extent of disease. To determine whether or not the symptomatic interval was related to response to chemotherapy and extent of disease in patients presenting with metastatic disease, the charts of 253 patients treated with chemotherapy were reviewed. In the 123 patients presenting with metastatic disease, for whom the symptomatic interval was known, complete response was significantly associated with the symptomatic interval (P = 0.039). A trend was noted between the symptomatic interval and the extent of retroperitoneal metastases (P = 0.065). The survival of patients with testicular cancer in all stages may be improved by heightening public awareness through educational programs. PMID- 6868227 TI - Prognostic value of poorly differentiated prostatic adenocarcinoma. AB - One hundred patients with prostatic adenocarcinoma surgically staged were evaluated. Their clinical stage and surgical findings were assessed especially with respect to their original histopathologic grading. It was found that patients with poorly differentiated adenocarcinoma of the prostate presented with advanced clinical stage and were at high risk of distant metastases developing within a short time after their initial diagnosis and treatment. PMID- 6868226 TI - Management of patients with concurrent primary tumors of bladder and prostate. AB - The clinical course of 33 male patients presenting with concurrent primary tumors of the bladder and prostate was reviewed. Twenty-four of 33 patients were treated by radical cystoprostatectomy. The remaining 9 patients were treated by more conservative means. Seventy-four per cent of the patients survived five years. A rationale for management of concurrent primary tumors of the bladder and prostate is presented. PMID- 6868228 TI - Testicular metastasis from carcinoma of prostate. AB - Metastatic involvement of the testis from prostatic carcinoma is rare despite the high frequency of the primary tumor and its ability for wide dissemination. We report 2 cases discovered after therapeutic orchiectomy in patients with advanced disease. The clinical implications of this lesion and a review of the literature on secondary testicular tumors are presented. PMID- 6868230 TI - Peyronie disease treated with ultrasound and hydrocortisone. AB - Thirty patients with Peyronie disease were treated with ultrasound using hydrocortisone ointment as the conducting vehicle. Twenty-five patients completed at least one course of treatment. Of those 25, 19 had at least some benefit with evidence that multiple courses of treatment were more beneficial than a single course. We conclude that ultrasound with hydrocortisone is beneficial in relieving pain, relieving deviation, and reducing the size of the fibrous plaque. It has the advantages of being noninvasive, repeatable, and without any side effects. PMID- 6868229 TI - Urologic manifestations of Laurence-Moon-Biedl syndrome. AB - Although uremia is the major cause of death in more than 30 per cent of patients with Laurence-Moon-Biedl syndrome, little attention has been paid to this rare syndrome in the urologic literature. We herein report on 3 patients with this syndrome. PMID- 6868231 TI - Cortical evoked potentials on stimulation of pudendal nerve in women. AB - Somatosensory evoked potentials were recorded in five normal women on percutaneous stimulation of the pudendal nerve. A consistent response was obtained over the scalp 2 cm behind the Cz electroencephalographic recording site. The latency of onset of this response had a mean value of 33 msec, and the mean latency of the first positive peak was 39.6 msec. This test has potential clinical value in the evaluation of patients with bowel, bladder, or sexual dysfunction when a neurologic causation is suspected. PMID- 6868232 TI - Ureteral seminal vesicle anomaly. Gross hematuria as presenting symptom. AB - An ectopic ureter ending in a seminal vesicle and associated with renal agenesis is a rare occurrence. There are no reports of this anomaly occurring with gross, total, painless hematuria as presenting symptom. Sonography and catheterization of the ejaculatory duct were the most helpful diagnostic studies used to demonstrate the abnormality. Surprisingly, on pathologic examination, the cystic area was not seminal vesicle but a dilated hemorrhagic ureter. PMID- 6868234 TI - Late bladder complications with use of external fixator device for pelvic fractures. AB - The management of unstable, open-book fractures by reduction and immobilization with the external fixator device resulted in late bladder complications in 2 patients. PMID- 6868233 TI - Renal artery stenosis and hypertension after abdominal irradiation for Hodgkin disease. Successful treatment with nephrectomy. AB - Hypertension secondary to stenosis of the left renal artery developed in a thirteen-year-old male six years after completion of inverted Y irradiation (3,600 rad) for abdominal Hodgkin disease. Surgical treatment with nephrectomy resulted in control of the hypertension without the use of antihypertensive agents. We review the literature for this unusual complication of abdominal irradiation, and recommend that a 99mTc-DMSA renal scan, selective renal vein sampling for renin determinations, and renal arteriography be performed on any patient in whom hypertension develops following abdominal irradiation in childhood. PMID- 6868235 TI - Pyogenic cyst of adrenal gland. AB - A case of cystic lesion of the adrenal gland is presented. Ultrasonography and computerized tomography greatly facilitate the diagnosis of these lesions. The cause, differential diagnosis, and treatment of adrenal cysts are discussed. PMID- 6868236 TI - Phenazopyridine-induced hemolytic anemia. AB - An elderly man was seen with hemolytic anemia due to the urinary tract analgesic, phenazopyridine hydrochloride. The mechanisms underlying this toxic reaction are presented. Cautious use of this drug in elderly patients and in those with renal insufficiency is emphasized. PMID- 6868238 TI - Autophotography in evaluation of functional penile disorders. PMID- 6868237 TI - Use of Foley catheter to obtain transvaginal tamponade. PMID- 6868239 TI - Renal immunoblastic sarcoma complicating immunosuppressive therapy for Wegener granulomatosis. AB - A renal tumor developing in a patient receiving cyclophosphamide (Cytoxan) therapy for Wegener granulomatosis is reported. The tumor was similar histologically to the "immunoblastic" sarcoma that develops in renal allograft recipients as a complication of immunosuppressive therapy. This case report strengthens the cause and effect relationship between immunosuppressive drug usage and the subsequent development of neoplasia. PMID- 6868240 TI - Renal carcinoma with staghorn calculus, perinephric abscess, and xanthogranulomatous pyelonephritis in same kidney. Subcutaneous abscess of thigh as initial presentation. AB - A case is reported of the simultaneous occurrence of renal carcinoma with staghorn calculus, perinephric abscess, and xanthogranulomatous pyelonephritis in the same kidney, with subcutaneous abscess of the thigh as the initial presentation. The coexistence of these diseases in the same kidney would seem to be important since they are frequently confused with each other. PMID- 6868241 TI - Case profile: computed tomography in retroperitoneal liposarcoma. PMID- 6868242 TI - Urodynamic evaluation in women with frequency, urgency symptoms. AB - Urinary frequency, urgency, bladder discomfort, and incontinence are among the most common causes for women to seek urologic evaluation. The value of endoscopy and radiographic studies is limited because they define only structural problems. This study presents 325 women who, in addition, underwent multifunction urodynamic study to identify functional problems. The merits and role of this investigation in the workup of this population group is discussed, together with the therapeutic implications of the various results. PMID- 6868243 TI - Acid phosphatase for monitoring prostatic carcinoma. Comparison of radioimmunoassay and enzymatic techniques. AB - We compared a commercial radioimmunoassay kit with an enzymatic assay for prostatic acid phosphatase in monitoring the progression or remission of disease in 27 patients with prostatic cancer. In 5 of the 18 patients whose disease progressed, and in 4 of the 9 whose disease responded to treatment, the change was reflected better by the radioimmunoassay. In no case was the enzymatic assay better. Radioimmunoassay for prostatic acid phosphatase may be an effective and sensitive way to monitor the course of carcinoma of the prostate. PMID- 6868244 TI - Seminal vesicle tissue in "resectate" of transurethral resection of prostate. AB - We reviewed the histologic specimens from 123 consecutive patients undergoing transurethral resection of the prostate to determine the presence of seminal vesicle tissue. Additionally, relevant patient data were collected from the records, and a questionnaire regarding pre- and postoperative sexual function was given. The incidence of seminal vesicle tissue in the resectate was 23 per cent. No significant morbidity such as acute epididymitis or impairment of sexual function was associated with the occurrence of seminal vesicle tissue in the specimens. Consequently, no prophylactic measures seem indicated in patients undergoing partial resection of the seminal vesicles in connection with transurethral resection of the prostate. PMID- 6868245 TI - Optical magnification and Doppler ultrasound probe for varicocelectomy. AB - Varicocelectomy is usually considered a simple urologic operation. However, it is most frequently difficult to visualize and identify the 0.5 mm internal spermatic artery and tiny lymphatic channels when cutting and ligating the internal spermatic veins. The internal spermatic artery and tiny lymphatic channels can be damaged easily, cut, or ligated during this procedure. This occurs surprisingly more often than is realized by the surgeon. By introducing optical magnification or the operating microscope at the time the veins are identified, the surgeon can easily find and dissect off adherent lymphatics or the internal spermatic artery with some microsurgical instruments, and thereby preserve these vessels rather than cut or damage them inadvertently. The sterile Doppler probe also can be utilized to help identify and confirm the location of the internal spermatic artery if it is not easily found in the spermatic cord. PMID- 6868246 TI - Nonoperative management of bladder rupture from external trauma. AB - Nonoperative (catheter) management was used in 18 patients with extraperitoneal rupture of the bladder with limited extravasation of dye found by retrograde cystogram. Complications occurred in 4 of the 18 patients. A review of the literature shows a 20 to 25-per cent complication rate with nonoperative management of bladder rupture. However, with a small extraperitoneal rupture with limited extravasation, especially in a female, the nonoperative (catheter) management will give a satisfactory result. PMID- 6868247 TI - Atraumatic perforation of bladder. Necessary differential in evaluation of acute condition of abdomen. AB - Perforation of the urinary bladder without history of antecedent trauma is a rare clinical occurrence. However, in patients with acute conditions of the abdomen, especially those with previous voiding symptoms, the diagnosis should be considered. Three cases are reported. Patients presented with an atraumatic bladder perforation and peritonitis secondary to chronic inflammation, bladder outlet obstruction, and transitional cell carcinoma. After review of the literature, a classification of atraumatic bladder perforation has been revised to include presently available reports of this entity. PMID- 6868248 TI - Visual internal urethrotomy in management or urethral strictures. AB - Visual internal urethrotomy was used in the treatment of urethral strictures in 103 patients. The procedure was performed mostly under local anesthesia. Urethral catheter for forty-eight hours or urethral splinting for two weeks was used as complementary treatment in some cases. We obtained an overall success rate of 95.1 per cent. PMID- 6868249 TI - Penile corporoplasty with polytetrafluoroethylene (PTFE) grafts. AB - Ten male dogs underwent segmental excision of tunica albuginea of corpus cavernosum penis and replacement with polytetrafluoroethylene grafts. None of the dogs exhibited acute or chronic adverse reaction to the graft. These findings suggest that PTFE may have a role in human reconstructive phalloplasty. PMID- 6868250 TI - Persistent cloaca in adult with satisfactory renal function. AB - A case of persistent and uncorrected cloaca in a twenty-five-year-old woman is presented. In spite of the anomaly not being corrected, no deterioration of her kidney function was noted. She is continent for both urine and stools. In addition to two uteri which were removed at different times, she has only one kidney on the right which is ectopic and malrotated, and an abnormal left thumb. The question of doing electromyographic studies of the pelvic muscles prior to the repair of the anomaly, together with the timing of the latter, is raised. PMID- 6868251 TI - Vasal vesical communication. PMID- 6868252 TI - Trifid obstructed megaureter. AB - A case report of trifid obstructed megaureter in a young girl is presented. Triplication of ureters is one of the rarest malformations of the upper urinary tract and commonly presents with associated urinary tract infections. Obstructed megaureters in a triplicate system is even more uncommon, and only a few cases have been recorded in the world literature. PMID- 6868253 TI - Bilateral retroperitoneal liposarcoma in immunosuppressed patient with systemic lupus erythematosus. AB - A rare case of a patient with a diffuse, infiltrating retroperitoneal myxoid liposarcoma is presented. The patient had been treated for thirteen years with corticosteroids for systemic lupus erythematosus (SLE). The increased risk of cancer in SLE and in the immunosuppressed patient is documented. PMID- 6868255 TI - Silastic foam dressing--the ideal penile dressing. PMID- 6868254 TI - Suprapubic approach to ureteral catheterization. PMID- 6868256 TI - Case profile: ureteral polyps. PMID- 6868257 TI - Ultrasonic examination of scrotum. Review of 108 cases. AB - Ultrasound is a reliable and safe method for the evaluation of scrotal anatomy. The usual method of ultrasonic examination has been contact scanning with a conventional articulated arm scanner. We herein report our experience in 108 cases using an ultrasonic technique which provides panoramic scans of the entire scrotum and precision tomographic plane placement without distorting the scrotum or causing patient discomfort. PMID- 6868258 TI - Cryosurgery in prostatic cancer: elimination of local lesion. AB - From 1969 through 1976, we performed cryosurgery in 229 cases of prostatic cancer. Most of these patients had bulky, locally extensive primary tumors, and one-half had disseminated disease. Through the open perineal approach, which gives exposure for an adequate freeze, cryosurgery has been well tolerated. The primary surgical goal has been to reduce or eliminate the local lesion to minimize subsequent cancer-related lower urinary tract problems and to cure those patients with truly localized disease. In every case cryosurgery produced dramatic shrinkage of the local lesion. After four to eight weeks a local recurrence was suspected in 13 per cent, and 41 per cent eventually had some evidence of a recurrent cancer nodule or persistent cancer in the bladder neck. In a series of statistical analyses we have related these recurrences to other clinical factors. Cryosurgery has been a safe, effective way to reduce or eliminate the primary prostatic cancer, even in patients with large local lesions. PMID- 6868259 TI - Hematuria secondary to left peripelvic and gonadal vein varices. AB - The nutcracker syndrome refers to compression of the left renal vein between the aorta and superior mesenteric artery which results in renal vein and left gonadal vein varices. This is an unusual but well accepted cause of hematuria. We report a case of the nutcracker syndrome and present the radiologic workup including computerized tomography (CT) and renal venography with venous pressure measurements. PMID- 6868260 TI - Computed tomography of intrathoracic kidney. AB - We report a case of congenital intrathoracic kidney, a rare developmental anomaly, which may present as an asymptomatic posterior mediastinal mass. The evaluation of such lesions can be performed expeditiously with computed tomography and obviate the need for any further clinical studies or operation. PMID- 6868261 TI - Urologic terminology and misnomers. PMID- 6868262 TI - Is oxytetracycline obsolete in treatment of urinary tract infections? PMID- 6868263 TI - [Acoustic interference during speech audiometry and its diagnostic value]. PMID- 6868264 TI - [Ultrasonic lateralization test in the diagnosis of early forms of sensorineural hearing loss]. PMID- 6868265 TI - [Prevention of early forms of drug-induced experimental ototoxicosis]. PMID- 6868266 TI - [Role of blood serum osmolarity in the pathogenesis of Meniere's disease]. PMID- 6868267 TI - [Diagnostic value of the otolith reflex in patients with chronic suppurative otitis media]. PMID- 6868268 TI - [Serum immunoglobulins in patients with recurrent polypous rhinosinusitis treated by local cryotherapy]. PMID- 6868269 TI - [Functional results of endolaryngeal microsurgery]. PMID- 6868270 TI - [Work capacity evaluation in patients with digestive tract disorders after complete, extended and reconstructive laryngectomy]. PMID- 6868271 TI - [Fibroendoscopy in otorhinolaryngologic oncology]. PMID- 6868272 TI - [Prognosis in the combined treatment of malignant neoplasms of the pharynx]. PMID- 6868273 TI - [Determination of the tissue resection area in laryngeal cancer based on lysozyme content of the tumor growth zone]. PMID- 6868274 TI - [Neuritis of the facial nerve as a complication of local anesthesia and tonsillectomy]. PMID- 6868275 TI - [Complete congenital lateral fistula of the neck]. PMID- 6868276 TI - [Case of successful treatment of extensive esthesioneuroblastoma of the nasal cavity invading the ethmoid labyrinth, maxillary and frontal sinuses and the orbit]. PMID- 6868277 TI - [Metastasis of lung cancer into the cerebellum in a patient with chronic suppurative epimesotympanitis]. PMID- 6868278 TI - [Malignant carcinoid tumor of the trachea]. PMID- 6868279 TI - [Hemosorption and ultraviolet irradiation of the blood in the treatment of acute septicemia]. AB - On the basis of analysis of results of the treatment of 115 patients with acute sepsis the authors have established that hemosorption and transfusion of the autoblood irradiated by UV rays when used in the complex therapy allow reducing lethality almost three times. PMID- 6868280 TI - [Use of the system with the sorption element in transfusions of preserved blood]. AB - The experimental investigations have shown that using the sorption elements allows to purify the blood from toxic substances, part of leukothrombocyte microaggregates reducing the possibility of pulmonary complications. PMID- 6868282 TI - [Subcutaneous phlebotomy with laminar scalpel in varicose veins of the lower limbs]. PMID- 6868281 TI - [The painful form of an abdominal syndrome in various diseases of the thoracic organs]. AB - The author gives some recommendations on differential diagnosis of eight clinical observations in which acute abdominal pains were due to different diseases of organs of the thoracic cavity (pleuropneumonia, diaphragm pleuritis, pericarditis). PMID- 6868283 TI - [Factors determining the degree of physical work capacity in patients operated on for congenital heart defects]. AB - The physical working capacity was investigated in 25 men operated on for congenital heart disease and in 12 healthy men not accustomed to heavy physical load. It was shown that the main factor responsible for lower physical efficiency of the operated patients was their less pronounced ability to increase the minute circulation volume under conditions of the maximum physical load. PMID- 6868284 TI - [Substantiation of the extent of radical operations in cancer of the gastric stump]. AB - The author shows that a characteristic feature of metastazing carcinoma of the gastric stump is frequent lesions of the mesenterial lymph vessels. The isolated lesion of this group of lymph vessels is also shown to be possible. A conclusion is made about the absence of the "intestinal barrier" and a necessary removal of the intestine loop and its mesenterium involved in anastomosis when performing radical operations for carcinoma of the gastric stump. PMID- 6868285 TI - [Hepatic, biliary, and pancreatic complications after stomach resection]. PMID- 6868286 TI - [Roentgenomorphological substantiation of drainage of the thoracic duct in patients with liver cirrhosis]. AB - On the basis of an analysis of rentgeno-morphological investigations of the thoracic lymphatic duct (TLD) in 115 patients with complications of hepatocirrhosis and 50 postmortem observations the authors make a conclusion that one of the main factors of the development of insufficiency of TLD in hepatocirrhosis is an excess of lymph resulting in congestion in the duct. It may be considered as a cause for drainage of the TLD in patients with hepatocirrhosis. PMID- 6868287 TI - [Reparative and reconstructive operations on the bile ducts]. AB - The authors have analyzed the causes and results of 469 repeated operations on bile ducts performed on 350 patients for strictures of the inflammatory and accident origins, retained bile duct stones and recurrent cholelithiasis. Recommendations are given for preventing repeated operations on bile ducts and choosing the method of reparative and reconstructive operations. PMID- 6868288 TI - [Activity of lipolytic enzymes and the possibility of their inhibition in the complex treatment of acute pancreatitis]. PMID- 6868289 TI - [Diagnostic significance and treatment of the pain syndrome in extensive forms of cancer of the rectum and the female genital organs]. PMID- 6868290 TI - [Organ-sparing surgical treatment of retention-inflammatory diseases of the kidneys]. AB - The analysis of results of organ-preserving operations in 46 patients with the retention-inflammatory diseases of the kidneys has shown the complex urologic examination, renal angiography included, to be necessary for choosing the operation volume. It was established that obstruction can be frequently caused by a subsidiary polar-inferior vessel (artery or vein). PMID- 6868291 TI - [Primary and recurrent retroperitoneal neoplasms of non-organic origin]. AB - Having analyzed results of the treatment of 216 patients the authors came to a conclusion that recurrencies of tumors, repeat ones included, can not be considered as contraindications for operations. The most favourable results were obtained in the operative treatment of recurrent lymphosarcomas. PMID- 6868292 TI - [Suppurative diseases of the skin and subcutaneous tissue in patients with diabetes mellitus]. PMID- 6868293 TI - [Treatment of acute suppurative infection in patients with diabetes mellitus]. AB - Results of the treatment of 165 patients with acute purulent surgical infections and diabetes mellitus are analyzed. In the postoperative period injections of small doses of simple insulin are recommended for the correction of diabetes mellitus. PMID- 6868294 TI - [Classification and treatment of diffuse suppurative peritonitis]. PMID- 6868295 TI - [Classification and principles of the treatment of peritonitis]. PMID- 6868296 TI - [Madelung's syndrome]. PMID- 6868297 TI - [Abscess of the greater omentum after appendectomy]. PMID- 6868298 TI - [Doppler ultrasonography in injuries of the major arteries of the limbs]. AB - On the basis of examination of 14 healthy people and 23 patients with injured main arteries of extremities it was shown that the Doppler ultrasonic detection was of great importance in diagnosis of injuries of arteries, assessment of the collateral blood circulation and efficiency of reparative vascular operations. PMID- 6868299 TI - [Pathogenesis of tension in the lung cavities in children]. AB - Congenital and acquired lung cavities complicated by tension were studied in 44 children. The author considers that in the basis of the mechanism of tension there lies a loss of elasticity of bronchi and bronchioles resulting from an inflammatory process. PMID- 6868301 TI - Osteodystrophia fibrosa in young goats. AB - Three goats with osteodystrophia fibrosa are described. The main lesions were confined to the mandibles, although in two of the three all bones were rarefied and there were longbone fractures. In two of the three goats, there was evidence of a dietary cause due to selective feeding. In the third, the history was insufficient to indicate a likely cause. PMID- 6868302 TI - Post anaesthetic forelimb lameness in a cow. PMID- 6868300 TI - Selection of students for veterinary training. AB - The difficulties facing admissions committees and prospective students in the selection of veterinary undergraduates are described. An attempt is made to evaluate the current selection procedures which are based on the applicant's academic record and previous practical experience and on interview. A correlation is drawn between these factors and a student's subsequent performance. A number of alternative selection methods are discussed. PMID- 6868303 TI - Urinary formiminoglutamic acid in lambs. PMID- 6868304 TI - Supplementary biotin for sows: effect on reproductive characteristics. AB - Eighty female pigs were fed from 25 kg liveweight either basal diets calculated to provide 32 micrograms available biotin/kg (control diet) or basal diets supplemented with 350 micrograms biotin/kg. Reproductive performance was studied over four parities. Sows receiving supplementary biotin returned to oestrus 2.9 +/- 1.7 and conceived 6.1 +/- 1.4 days sooner than controls (P less than 0.05). Of those sows receiving supplementary biotin, more returned to oestrus and conceived within 10 days of weaning (83.2 per cent v 74.6 per cent and 80.6 per cent v 71.8 per cent respectively) and fewer were treated for anoestrus (7.3 per cent v 17.0 per cent) than those on the control diet. Supplementing diets increased the annual productivity of sows completing four parities by 1.42 +/- 1.02 pigs/sow/year (P less than 0.05) and increased the total weight of weaner produced/sow/year by 17.3 +/- 7.4 kg (P less than 0.05). It was concluded that the majority of commercial dietary formulations would require supplementation with biotin in order that sows may express their full reproductive potential. PMID- 6868305 TI - Chromosome instability in a calf affected by congenital malformation. AB - High rates of structural chromosome aberrations were associated with increased yields of sister chromatid exchanges (SCE) in metaphase chromosomes of a new born female calf affected by a congenital malformation. The frequency of abnormal cells was 25 per cent in the abnormal calf, 8 per cent in its dam and 3 per cent in a group of four healthy cows. Chromatid and chromosome breaks were the most frequent types of chromosome aberration found in the malformed calf; centric fusions, chromosome fragments and deletions were much less common. The mean rate of SCE/cell in the malformed calf was nearly twice that of the control and the difference was statistically significant. Possible factors involved in the occurrence of such a malformation are discussed. PMID- 6868307 TI - Alopecia in calves associated with milk substitute feeding. AB - Outbreaks of alopecia with unusually high morbidity occurred among calves reared on milk substitutes on two unrelated farms in Suffolk. On one farm alopecia occurred for three consecutive years; during the winter of 1981-82 there were also clinical signs of muscular dystrophy among the same calves. On the second farm calves with alopecia also showed signs of muscular dystrophy. The apparent relationship between alopecia and milk substitute feeding is discussed together with the possible involvement of vitamin E. PMID- 6868306 TI - Efficacy of fenbendazole against nematodes of captive birds. AB - Fenbendazole was used to treat nematode infestations (Ascaridia species and Capillaria species) in 230 birds of six orders and 38 different species. Using a single dose of 100 mg/kg bodyweight initial treatment eliminated parasitic nematodes from 221 birds. A further course of treatment at a dose rate of 30 mg/kg daily for seven days eliminated the infestation from the remaining nine birds. PMID- 6868308 TI - Isolation of a hamster lethal strain of Leptospira interrogans serotype hardjo. PMID- 6868309 TI - Incidence of clinical mastitis in dairy herds in a mastitis control scheme. PMID- 6868310 TI - Marijuana toxaemia. PMID- 6868311 TI - Ureaplasmas in ewes. PMID- 6868312 TI - Magnesium and milk fever. AB - There is clinical, experimental and theoretical evidence for a connection between the occurrence of subclinical hypomagnesaemia and the incidence of milk fever. Clinically, pregnant dry cows in dairy herds with a high incidence of milk fever have often been observed to have subnormal blood magnesium concentrations. Experimentally, it has recently been shown that subclinical hypomagnesaemia reduced the ability of cows to mobilise calcium in response to hypocalcaemia; a response which is essential if cows are to avoid milk fever. And theoretically there are several points in the biochemical pathways for calcium where a need for magnesium has been demonstrated in laboratory rodents. These connections between subclinical hypomagnesaemia and milk fever are explored and their consequences for the prevention of milk fever are considered. PMID- 6868313 TI - Causes of culling and mortality in three flocks of broiler chickens in Victoria during 1979. AB - A mortality survey was carried out on three flocks of broiler chickens on a Victorian grower farm. A total of 61,400 chicks were placed and 2883 (4.7 per cent) died or were culled during rearing. Only 1028 (36 per cent) dead and culled birds were available for autopsy and interpretation was based on figures extrapolated from the findings. The most common condition encountered was death in good condition associated with congestion of the lungs (39 per cent of chickens autopsied). Inclusion body hepatitis was diagnosed in 30 per cent of chickens over 21 days of age which died. Mortality during the first 10 days was 1.1 per cent of chicks placed. The incidence of various other conditions is presented with relevant observations and comments. PMID- 6868314 TI - Functional stenosis of the sigmoid curve of the duodenum in cattle. AB - The symptoms and treatment of 18 cattle suffering from functional stenosis of the sigmoid curve of the duodenum are described. Side to side anastomosis between the proximal part of the duodenum and the descending duodenum is the most successful treatment for this previously undescribed syndrome. PMID- 6868315 TI - Feline central retinal degeneration in the United Kingdom. PMID- 6868316 TI - Diagnosis of botulism in water birds. PMID- 6868317 TI - Episodic falling in the cavalier King Charles spaniel. PMID- 6868318 TI - Aerotolerant campylobacter strain isolated from a bovine preputial sheath washing. PMID- 6868319 TI - Poisoning by Pteridium aquilinum in pregnant sows. PMID- 6868320 TI - Haemophilus somnus in semen from Danish bulls. PMID- 6868321 TI - Prevalence of cattle lice on calves. PMID- 6868322 TI - Key-Gaskell syndrome. PMID- 6868323 TI - Monitoring and testing for residues of therapeutics in meat. AB - Any programme for determining the incidence of residues of therapeutic substances in meat requires an effective programme of sampling which ensures that the data obtained from a sample are representative of the population from which the sample was drawn. The organisation of such a system in the UK has been achieved in the past two years and a routine testing programme is now possible. Apart from general microbiological screening tests which can be used to detect the presence of most antibiotics in meat, the development of an effective programme of testing meat for residues of therapeutics has also been limited, until recently, by the lack of suitable methods for their detection. However, the use of immunoassay methods now enables very low levels of anabolic growth promoters to be detected and multiresidue tests for anthelmintics are being investigated. In the case of certain important antibiotics such as chloramphenicol, neomycin and the sulphonamides, the microbiological screening tests used at present are insensitive and individual chemical or other methods will have to be used for their detection. PMID- 6868324 TI - Isolation of avian paramyxovirus other than Newcastle disease virus from commercial poultry in Great Britain. PMID- 6868325 TI - Cutaneous application of levamisole to cattle: variations in bioavailability related to season and ambient temperature. PMID- 6868326 TI - Isolation of Mycoplasma bovoculi and Acholeplasma oculi from outbreaks of infectious bovine keratoconjunctivitis. PMID- 6868327 TI - Dosing exotic species. PMID- 6868328 TI - Urinary formininoglutamic acid in lambs. PMID- 6868329 TI - Successful production and radioactive labeling 2 14C-acetate of "T-2" toxin on a liquid medium. PMID- 6868330 TI - Determination of the oral toxicity of Cassia obtusifolia seeds in chickens. AB - Chickens were fed dried seeds of Cassia obtusifolia, either whole or ground, mixed in with regular chicken ration. Other chickens were dosed at 2% of body weight with either an aqueous extract of seeds, or the pellet or supernatant from an 18,000 X g centrifugation of the extract. Weight gains were only slightly lower in chickens treated with up to 10% seeds in the feed. This was attributed to reduced food intake rather than to toxic effects of the plant. Necropsy examinations of chickens from all groups revealed none of the lesions typical of intoxication with Cassia. Histologic examinations revealed no lesions. PMID- 6868331 TI - The passage of thiamphenicol and chloramphenicol into human milk after single and repeated oral administration. PMID- 6868332 TI - The French Poison Control Centers' computer system. Part 1: Computer organization in French Poison Control Centers. PMID- 6868333 TI - Interactions of porcine alveolar macrophages and bone marrow cells with African swine fever virus and virus-infected cells. AB - Virus yields from porcine alveolar macrophages (AM) infected with African swine fever virus (ASFV) were greater and were achieved more rapidly, when inoculated at a high multiplicity of infection (MOI) than at low MOI. The difference was related to a lower percentage of cells becoming infected after low MOI inoculation. The reduced yields after low MOI were not caused by prolongation of the culture time, by bacterial endotoxins or by production of inhibitory substances by infected AM. Virus-infected AM were not susceptible to lysis in antibody-dependent cell mediated cytotoxicity (ADCC) assays and this was apparently due to a paucity of viral antigen expressed on the cell surface. Uninfected AM did not act as effectors in ADCC. Porcine bone marrow (PBM) cells were effective in mediation of ADCC and their activity was reduced after ASFV infection. Cells separated into adherent and non-adherent populations, depleted by carbonyl iron treatment or separated by Ficoll-Hypaque centrifugation, all showed effector activity in ADCC. The effector cells were not mature neutrophils or lymphocytes and were probably granulocytic precursors. PMID- 6868334 TI - A radiolabeled staphylococcal protein A assay for detection of anti-erythrocyte IgG in warm agglutinin autoimmune hemolytic anemia of dogs and man. AB - A cell wall protein from Staphylococcus aureus, Protein A, (SpA) has been shown to have the ability to bind the Fc region of most mammalian IgG molecules. This study uses this unusual property as the basis for a quantitative assay for erythrocyte (RBC) bound antibodies. Test serum is incubated in a suspension of normal RBC's. The cells are then washed and incubated with 125Iodine-labeled SpA (125I-SpA). After incubation cells are pelleted and bound radiolabeled SpA counted. This procedure has been performed using canine anti-goat RBC (DagRBC) serum and human anti-D serum (positive controls) to establish the kinetics of the SpA reaction in the above system. The results indicate that SpA binds to red blood cells as a function of membrane bound antibody. RBC's incubated with indirect Coombs positive sera bound 42.6% and 43.3% of the 125I-SpA, as compared to 19.2%, the upper limit of the 95% confidence interval (n = 9) for normal sera. Furthermore, significant binding was observed for certain indirect Coombs negative (direct Coombs positive) sera indicating that the SpA assay is more sensitive than the indirect Coombs test. The SpA system should provide the clinician with an inexpensive, sensitive, quantitative assay for the diagnosis of warm agglutinin autoimmune hemolytic anemia, as well as other autoimmune disorders involving membrane bound IgG. PMID- 6868335 TI - Fetal and maternal immunologic manifestations of intrauterine Adenovirus SV-20 infection. AB - Rhesus monkey fetuses of either immune or nonimmune dams were inoculated in utero with Adenovirus SV-20 (AdSV-20), a virus capable of inducing fetal pneumonia, and studied immunologically at various intervals. AdSV-20 infection at 90-100 days gestational age resulted in absolute lymphopenia in a few fetuses, reduced numbers of peripheral blood lymphocytes (PBL) which formed rosettes with sheep erythrocytes (ERL) and reduced complement-receptor lymphocytes (CRL) in a majority, while Fc fragment-receptor lymphocytes (FcRL) were occasionally increased. There was a tendency for depression of ERL and CRL early in infection of 120-130-day fetuses, followed by stimulation of these populations and FcRL in later phases. Maternal immunity did not protect against these effects of AdSV-20 infection in fetuses. Immune and nonimmune dams were spared adverse clinical effects and had no changes in lymphoid cell populations following inoculation of their fetuses. Despite precocious production of circulating IgM, fetuses of nonimmune dams had little or no demonstrable anti-AdSV-20 serum neutralizing (SN) antibody, indicating that the ability to develop an effective immune response was suppressed or had not been acquired at the gestational ages studied. Nonimmune dams displayed little evidence of seroconversion following inoculation of their fetuses with AdSV-20, except in those dams whose fetuses died in utero, whereby there was a significant antibody response. SN antibody titers of immune dams were not boostered substantially subsequent to inoculation of their fetuses, and fetal SN titers were lower than maternal titers, suggesting absence of an active fetal antibody response in this group also. Direct inoculation of AdSV-20 into 90-130 day rhesus monkey fetuses provided a model system for immunologic study of fetal infection, probably involving complex fetal-maternal interactions, in a situation where the infected, viable fetus and its dam appeared to be microbiologically isolated from one another. PMID- 6868336 TI - Luminol-dependent chemiluminescence analysis of the variables of the phagocytic response by canine granulocytes. AB - Variables which influence the oxygen-dependent chemiluminescence (CL) response of canine polymorphonuclear leukocytes (PMN) to zymosan were examined in a luminol dependent CL assay system. Maximal CL responses were obtained when 5 x 10(6) canine PMN, isolated from heparinized blood, were assayed at 37 degrees C in a Luminometer. The response was enhanced by the addition of 0.05 mM Luminol and inhibited by the addition of 0.06 mM sodium azide and 60 micrograms superoxide dismutase. Repeatability on a given day was very good; however, day to day variations in CL activity prevented direct comparison of phagocytic activity between days. Opsonization of zymosan in equine serum significantly reduced the CL response by canine PMN as compared to opsonization of zymosan in autologous or homologous canine serum and bovine serum. The present results show that luminol dependent CL analysis can be used to measure phagocytosis by canine granulocytes in a luminometer and has potential use in clinical situations. PMID- 6868337 TI - The chemiluminescent response of bovine polymorphonuclear leucocytes isolated from milk and blood. AB - Polymorphonuclear leucocytes (PMN) were isolated from milk and blood of healthy cows, and the generation of reactive oxygen by the two cell populations was compared by measuring chemiluminescence (CL) after stimulation with zymosan. The ratio of milk to blood PMN CL was relatively constant in a given animal, but varied widely between different cows, ranging from 0.3 to 1.3. The relative contributions of various oxygen species to CL was studied by measuring quenching using different oxygen scavengers. While the relative contributions of H202, -02 and '02 seemed to be similar in both milk and blood PMN, the OH. radical was clearly more prominent in PMN isolated from milk than from blood. In addition, blood PMN CL was more dependent on the presence of glucose in the reaction medium than milk PMN CL. Furthermore, the CL response to phorbol myristate acetate, to the Ca ionophore A23187 and to Sendai virus was different in the two cell types. The results suggest that CL generation in milk PMN differs from that in blood PMN in quantitative as well as qualitative aspects. PMID- 6868339 TI - A low molecular weight immunosuppressive factor produced by Onchocerca gibsoni. AB - An immunosuppressive factor(s) which is heat stable, and dialysable, with a molecular weight less than 10,000 molecular weight, and is not species specific, has been shown to be produced during the in vitro culture of Onchocerca gibsoni microfilariae. The factor(s) is capable of abolishing lymphocyte mitogenesis induced by Con A in bovine lymphocytes and PHA in human lymphocytes. The factor(s) may play a role in establishing the microfilariae in the tissues of the host by depressing cell mediated immune reactions during invasion. PMID- 6868338 TI - Peripheral lymphocyte function in dogs with Brucella canis infection. AB - Peripheral lymphocyte function in dogs with Brucella canis infection was evaluated using in vitro lymphocyte stimulation with the mitogens PHA, Con A and PWM, and killed Brucella canis organisms. Bitches with naturally occurring Brucella canis infection were compared to negative controls. There was no difference in the response to Con A and PWM between these two groups. Lymphocytes from infected dogs were less responsive (p less than .05) to PHA than were lymphocytes from controls. There was a significant (p less than .005) difference in response to Brucella canis antigen between the two groups. Lymphocytes from infected dogs were stimulated by Brucella canis antigen, whereas those from controls did not respond. PMID- 6868340 TI - Effects of intravenous injection of BCG or Freund's complete adjuvant on swine alveolar macrophages. AB - The intravenous injection of killed mycobacteria in oil (Freund's Complete Adjuvant) or BCG produces an accumulation of macrophages in swine alveolar airspaces. The collected alveolar macrophages were studied in vitro: expression of Fc and complement surface receptors, uptake of chicken red blood cells and in vitro spreading were not modified by either treatment, whereas the cytostatic activity of alveolar macrophages decreased following administration of high doses of BCG or Adjuvant. These "treated" cells have a lower thymidine incorporation rate, which suggests that cell accumulation is related to an influx of blood monocytes and not to an in situ cell multiplication. PMID- 6868342 TI - The humoral immune response of the spiny-tailed agamid lizard (Agama caudospinosum) to injection with Leishmania agamae promastigotes. AB - Spiny-tailed agamid lizards (Agama caudospinosum) were given a single intraperitoneal injection of Leishmania agamae promastigotes. Direct agglutinins (DA), indirect haemagglutinins (IHA) and complement-fixing antibodies (CFA) produced against the parasites were non-precipitating, relatively thermostable and dithiothreitol sensitive. Antibodies were also detected by the immobilisation test (IMM) and by enzyme-linked immunosorbent assay (ELISA). The most sensitive method was the ELISA one. Antibodies were detected 7 days post-injection and maximum IMM (2(-6)), DA (2(-8)), CFA (2(-10)), IHA (2(-12)) and ELISA (2(-16)) titres were obtained from 35 to 49 days. In all cases, the levels of antibody following antigenic stimulation were significantly different from the controls (P less than 0.001). Serum lysozyme levels increased three-fold (P less than 0.001) with the highest value of 46 micrograms/ml occurring after 42 days. PMID- 6868341 TI - A study of the sensitivity of erythrocytes to lysis by heterologous sera via the alternative complement pathway. AB - In order to get insight in the distribution of alternative complement pathway activities as detected by lysis of xenogeneic erythrocytes in the presence of magnesium and ethyleneglycol-bis-(2-aminoethyl)-tetra-acetic acid (EGTA) over the species, the 156 heterologous combinations of erythrocytes and sera out of thirteen animal species were tested. An order could be noticed in the species with respect to serum complement activity tending to negative correlation with the sensitivity of the corresponding erythrocytes to lysis by heterologous sera. So far, the most sensitive erythrocyte for each individual serum must be considered to be the target cell of choice for developing assays for alternative complement pathway activity in the serum involved. In this series of animals only for rabbit serum no sensitive target cell was found. The order observed, in connection with the failing lysis of erythrocytes by homologous sera, suggests further that in restriction of heterologous hemolysis in general one erythrocyte associated, species-nonspecific regulatory principle may be involved, whereas in homologous restriction, most probably, also species-specific factors play a role. PMID- 6868343 TI - A reagin-like antibody in horse serum: 1. Occurrence and some biological properties. AB - The demonstration of a reagin-like antibody against Culicoides pulicaris extract in the serum of horses and ponies affected with recurrent seasonal dermatitis (sweet itch) is reported. This antibody can confer Prauznitz-Kustner (P-K) sensitivity on homologous skin for up to 5 days and, like human IgE, is thermolabile and susceptible to 2-mercaptoethanol reduction. It is eluted on diethylaminoethyl dextran-52 anion exchange chromatography independently of IgG, IgG(T) and IgM, and its elution characteristics indicate similarity in net molecular charge to human IgE. The P-K response observed in horse skin is biphasic, and is morphologically similar to the late cutaneous anaphylactic response in man. Both phases of the P-K response are dependent upon the reagin like antibody, although other serum factors appear involved in the delayed phase of the response. PMID- 6868344 TI - A study of antibody levels in wild ruminants vaccinated against rabies. AB - The authors have vaccinated 22 fallow deer (Dama dama) and 10 mouflons (Ovis ammon musimon) against rabies with an inactivated vaccine: 4 fallow deer with 1 ml, 14 fallow deer and 10 mouflons with 2 ml, 4 animals were kept as controls (fallow deer). The antibody responses were checked by fluorescent foci inhibition carried out on blood samples collected during a two-year period. All the animals developed antibody titres and were still protected after 24 months. PMID- 6868345 TI - Preliminary observations on the presence of visna-maedi in Italy. AB - The presence of visna-maedi in Italy is reported for the first time. History, clinical findings and gross and microscopic lesions typical of the disease were observed in two sheep flocks in Central Italy. Affected animals were afebrile, lacked energy, lost condition and had progressively worsening dyspnoea which ended fatally. A few showed locomotor disturbances but remained alert. Anaemia and leukopenia were present. The lungs were affected with fleshy consolidation. Histologically, the pulmonary lesions included bronchiolar epithelial hyperplasia, peribronchiolar lymphoid cuffing, alveolar epithelialization and very marked interstitial changes. In agar gel diffusion tests on sera from 106 animals from the two flocks, 44 were positive. Furthermore, when the same test was conducted as a preliminary screening procedure on 682 animals randomly chosen from 94 flocks in five Regions, 93 positive animals were revealed in 39 flocks, involving all of the Regions. The infection is likely to be widespread in Italy and to constitute a problem in at least some flocks or areas. PMID- 6868346 TI - Kinetics of four metabolites of Febantel in cow's milk. AB - The mammary elimination of four potentially toxic metabolites of Febantel has been investigated by HPLC methods in the cow after the administration of a 7,5 mg/kg single oral experimental dose of this anthelmintic. The total of the four metabolites is equal to about 0.4 ppm 12 hours after the treatment. The individual levels fall down under the detection limit between the third and the sixth milking. PMID- 6868347 TI - The effects of caerulein on exocrine pancreatic secretion in pigs. AB - Caerulein administered to anaesthetized pigs by slow i.v. infusions at doses of 0.5, 1.0 and 2.0 ng kg-1 min-1 for 30 min, stimulated pancreatic juice production, increased the protein content of the juice and enhanced its amylolytic, lipolytic and proteolytic activities. In a single experiment, an i.v. infusion of secretin (0.001 U kg-1 min-1) lasting through the whole experimental time, provoked potentiation of the caerulein stimulatory effects on pancreatic juice production, protein content and amylolytic activity. PMID- 6868348 TI - The phase of hair growth in hypothyroidism in the dog. AB - The stage of hair growth which predominated in dogs not affected with hypothyroidism appeared to be breed-dependent. For example, in boxers, Labradors and collies, the resting stage (telogen) predominated, whereas in West Highland White terriers and cairn terriers the active stage (anagen) predominated. However, even in pet dogs kept mainly indoors, the proportion of hairs in anagen tended to increase during the winter months. In dogs affected with hypothyroidism, the proportion of hairs in anagen or telogen in members of a particular breed was the same as in the normal dogs of the breed. From this, it appeared that breed was more influential than hypothyroidism in determining the predominant phase of hair growth. PMID- 6868349 TI - Preliminary report on the pulmonary pathology associated with subcutaneous injections of Dirofilaria immitis antigen. PMID- 6868351 TI - Stimulation techniques and response characteristics of the M and F waves and H reflex in dogs. AB - The voltage and duration of electrical rectangular pulsed stimuli needed to produce an F wave and a monosynaptic reflex (H wave) and the characteristics of these responses were recorded in clinically normal dogs. Optimal stimulus to produce H waves was 0.1 to 0.2 ms and less than 80 volts. F waves were variable in appearance and were most evident following 0.5 ms and 125 to 150 volt stimulation. F waves had shorter latency than comparable H waves. PMID- 6868350 TI - Breed and sex influences on porcine haematological picture under hot humid climatic conditions. AB - An investigation was undertaken of some haematological characteristics of one indigenous and five exotic breeds of pigs kept on a farm in the hot, humid climate of Ibadan, Nigeria. The total white blood cell counts were not affected by breed and sex but the other parameters exhibited various degrees of response to these two variables, the males of each breed tending to have higher values than the females. The indigenous pigs generally had higher values than the exotic breeds. Of the latter, only the Landrace and Large White had haematological values somewhat similar to those of the West African indigenous pig. This suggests that the Landrace and Large White breeds may be more suited than the other exotic breeds investigated to the climatic conditions prevalent in Ibadan. PMID- 6868352 TI - The excretion of campylobacter, salmonellae and Giardia lamblia in the faeces of stray dogs. AB - Faecal samples were collected from impounded stray dogs, classified as under or over six months of age, on their arrival in kennels and again 5-7 days later. The faeces were examined for the presence of campylobacters, salmonella and Giardia lamblia. No significant difference was found in the rate of isolation of these organisms between the two age groups. There was, however, a significant increase in the rate of isolation at days 5-7 compared with day 1. It is suggested that while dogs may acquire campylobacter infection in kennels, excretion of the organism may be intermittent and may be precipitated by stress. A low incidence of salmonellae and Giardia lamblia excretion was detected. PMID- 6868353 TI - Experimental contact transmission of contagious pleuropneumonia of goats (Abu Nini) in the Sudan. PMID- 6868354 TI - Infectivity of cell-free malignant catarrhal fever virus in rabbits and cattle. PMID- 6868355 TI - The splayleg disease: a form of congenital glucocorticoid myopathy? AB - In countries with modern pig industries an increasing percentage of newborn piglets is affected by congenital myofibrillar hypoplasia, also called splayleg or spraddleleg. The main pathomorphological features of this disease are myofibrillar hypoplasia and degeneration. Glucocorticoid myopathy induced in immature muscles of early postnatal rats and rabbits has a pathomorphology very similar to that of splayleg disease. Also in other respects the splayleg disease resembles the glucocorticoid myopathy, as summarized in this contribution. It is suggested that splayleg might represent a congenital form of glucocorticoid myopathy resulting from stress and hormonal imbalance of pregnant sows which affect the fetuses. PMID- 6868356 TI - [Immunoprophylaxis of Salmonella infection caused by S. dublin in calves]. AB - Studied is the active immunoprophylaxis of calves on farms with a Salmonella dublin infection, using a live vaccine produced with a S. dublin attenuated strain. The disease was fully suppressed among calves through vaccination after the tenth day following birth. However, the source of infection was not done away with, and it was most likely to be found in adult cattle. This was reasonable to believe as there was a second outbreak of the disease in a group of unvaccinated, newborn calves. The regular vaccination is suggested of all newborn calves up to the time when the adult population would occasionally be replaced. PMID- 6868357 TI - [Selection of cows for control of the metabolic state in the herd by biochemical blood analyses]. AB - Four consecutive biochemical analyses (July and November 1975 and July and November 1976) of the blood serum were carried out of 100 cows on one farm and 50 cows on another farm. The study made use of data on the inorganic phosphorus content. The test cows of farm I were divided into two groups -- A, consisting of 50 animals of two entire subgroups in one barn, and B, consisting of 50 animals proportionately distributed by subgroups in the remaining four barns. It was established that the proper selection of the control cows was essential as demonstrated by the dependable differences between the level of inorganic phosphorus in the serum of the animals of both groups. The cows had to be equated in terms of productivity and distributed proportionally in the groups of all attendants. The test cows of farm II were likewise divided into two groups of 25 animals each. The changes were followed up in the content of inorganic phosphorus in the two possible variants -- with the successive investigation either of two different groups of animals or individually of one and the same animals. It was demonstrated that the study of one and the same animals individually yielded more precise information on the status of the herd and made it possible to follow up more accurately the changes that had taken place in the metabolic processes under the effect of external factors. Stated is the diagnostic value of the differences in the index values obtained from two consecutive analyses. PMID- 6868359 TI - [Morphological changes in the placenta and in fetuses in cows with hypovitaminosis A]. AB - Studied were morphologically 12 aborted fetuses of cows, 12 placentas of cows that miscarried, 6 placentas of cows with normal birth but with certain lesions, and 6 uteri of cows that miscarried, originating from various regions of the country. No organisms were found in both the placentas and fetuses. Carotenes in cows that miscarried gave the following values: 0.123 mg%, 0.287 mg%, 0.342 mg%, 0.684 mg%, 0.160 mg%, 0.168 mg%, 0.231 mg%, 0.430 mg%, and 0.484 mg%. Six grams of liver tissue of one of the slaughtered cows contained as many as 36 UI of vita. A. Gross investigations of the placentas revealed gray-whitish to gray yellowish, round or oblong bulgings of 1-2 cm length. Histologically, hyperplasia and metaplasia of the surface epithelium were established, which from a monolayer one changed through metaplasia into a multilayer, flat, and cornificating one. In the lung, tongue, intestines, and vesical bladder of the fetus as well as in the endometrium of the cows that miscarried there were hyperplasia and metaplasia of the epithelium. PMID- 6868360 TI - [The effect of subclinical bovine mastitis on the lipolytic changes in milk]. AB - Studied was the extent to which lipolytic changes took place in milk in dependence on the subclinical diseases and the secretory alterations of the mammary gland in cows. A copper saponifying method was employed to determine the amount of the free fatty acids in the milk from the affected and normal quarters of a total of 60 cows. It was found that there was a definite correlation between subclinical mastitis and the extent up to which lipolytic changes took place in milk fats. The average content of the free fatty acids in the milk obtained from the diseased quarters of the under was 7.28 mg%, while the milk from the normal quarters contained them in an average amount of 3.96 mg%. In cows having secretory disturbances of the mammary gland there was certain rise of the free fatty acids as against the cows with normal quarters, however, the higher values were mathematically insignificant (P=0.1). It is believed that the lipolysis of milk fats is effected within the mammary gland as the result of the action of serum factors, and not of the effect of cellular lipase. PMID- 6868361 TI - [Cefacetril in treatment of clinical bovine mastitis]. AB - The dynamic of the reconvalescence process was followed up in the udder of cows treated with the intramammary preparation Cefacetril. Complete therapeutic effect was recorded with 93.10 per cent of the cases, elimination of the infection -- with 86 per cent, and normalization of the cell content -- with 37.93 per cent. It was also established that during recovery the chlorine content of milk dropped, while lactose rose. The percent content of the protein fractions changed, whereupon the serum albumin and the immunoglobulins decreased, and the beta-lactoglobulin and the gamma-lactoglobulin increased. PMID- 6868362 TI - [Need for development and implementation of a program of standardizing cattle breeding]. AB - The problems associated with the intensification of cattle breeding in this country are successively dealt with. It is stated that the successful solution of all problems of the intensification of production and the intelectualization of public labour in cattle breeding requires the working out of a package of normative and technical documents on the standardization of terms, which are to implemented into practice along with the definitions, technologies, pedigree and selection work, diagnostics of diseases, output of meat and milk and products thereof, protection of natural environment, and reproduction of natural resources. The tasks could be successfully fulfilled only with the aid of an overall, perspective, and anticipating standardization as well as after favourable conditions are developed for the complex scientific service in cattle breeding, and the building up of a scientific and methodical approach to resolve the problems in animal husbandry. PMID- 6868358 TI - [Changes in calf digestion depending upon age and type of feed]. AB - Calves were surgically supplied with double fistular anastomoses (duodenal and ileal) to study the dynamic of digestive processes. The experiment was carried out in three periods: sucking, transitive (milk and vegetative feed), and fully vegetative. It was found that both the duodenal and the ileal chyme of sucking calves is by its physical and chemical properties substantially different from the chyme of adult cattle. With the transition from the milk type on to the vegetative type of feeding the composition of chyme of calves changes in colour, consistency, dry matter, organic matter, and crude fibers. With the vegetative type of feeding the digestion organs of calves were found to work more actively than with the feeding with milk with added plant feed. In the transition period 10 to 20 per cent of the dry and organic matter was digested and utilized before coming to the duodenal anastomosis. In this period beside the abomasum the forestomach with its three compartments was also shown to be involved in the digestion processes. With the increase in the amount of course feed in the diet of calves the amount of dry matter, organic matter, and crude fibers digested in the forestomach reached 45-52 per cent. PMID- 6868363 TI - [Prophylactic use of drugs in sows in industrial swine breeding]. AB - Four scientific-and-economic experiments were carried out with 4 groups of sows each, the animals being equated in terms of age and period of farrowing (+/- 4 days). Both test and control groups were offered rations of one and the same composition and amount. The feed of the test groups contained medicated premixes MNDm (neomycin and dimetridazol) or MODm (oxatetracyclin and dimetridazol) at the rate of 1 per cent. The medicated feed was fed to the sows 3 days prior to and 7 days after farrowing. At the time of weaning newborn pigs were given combined feed in the course of 5-6 days with the inclusion of medicated premixe MOSdf (oxatetracyclin, sulfadimezin, and furazolidan) also at the rate of 1 per cent. A total of 1774 pigs were obtained from all 182 test sows at an average fertility rate of 9.8 pigs per sow. The control of 182 cows yielded 1747 pigs (fertility rate of 9.7). The average weight gain of the test pigs during the suckling period amounted to 212 g against 197 g for the controls (an increase of 15 g -- 7.6 per cent). Mortality ranged from 78 pigs for the test groups to 101 pigs for the control ones. Up to 7 cases of diseased sows were established with the test animals against 24 ones with the controls. The number of impregnated sows up to the 20th day after weaning the newborns was 90 for the test animals against 77 for the control ones, and the number of returns was 27 and 34, respectively. Owing to sterility 5 sows of the test groups and 11 sows of the control groups were culled (4.2 vs. 9.0 per cent). Conclusions were drawn that the medicated premixes MNDm and MODm, used in amounts of 1 per cent with the combined feed prevented endometritis, mastitis, agalaxia, enteritis, and other diseases in sows. The treated animals exhibited joint estrus by groups after weaning the newborns, manifesting a higher conception rate. Parallel to this, the weight development of newborn pigs was improved, and mortality during the sucking period was reduced. PMID- 6868365 TI - [Zinc and manganese transport in ram sex cells]. AB - The atomic absorption spectrophotometer AAS1 was used to determine the concentration of Zn and Mn in the spermatozoa and ejaculate plasma of rams, having different percent of motile spermatozoa. A reverse correlation was found between the Zn and Mn content of spermatozoa and the percent of their motility. Seminal fluid with a higher percent of motile cells had plasma with a higher Zn and Mn content as compared with ejaculates having plasma with a lower percent of motile spermatozoa. PMID- 6868364 TI - [A method of production of concentrated and purified vaccine against Chlamydia abortion in sheep and its testing in guinea pigs]. AB - A method was developed for the production of a new, present day, concentrated depot-vaccine against the chlamydial abortion of sheep. Employed were a number of methods -- those with chick embryos, freezing and thawing with the use of liquid nitrogen, inactivation with formalin, purifying and concentration through differential centrifugation and supercentrifugation, with the use of an aluminum hydroxide ingredient, electron microscopy, and the respective control series, etc. The vaccine is characterized by low dosing, complete innocuity, and unreactiveness. Guinea pigs immunized singly responded with the production of complement-fixing antibodies on the 30th day of an average titer ranging from 1:32 to 1:64. Two-fold immunization on the 1st and 30th day led to the production of antibodies of average titers within the 1:256-1:512 range as established by means of CFT. The vaccine was shown to have a low prime cost. PMID- 6868366 TI - [Pharmacology--an active contributor to the implementation of the agricultural program of the USSR]. PMID- 6868367 TI - Characterization of human adenovirus type 5 early region 1A polypeptides using antitumor sera and an antiserum specific for the carboxy terminus. PMID- 6868368 TI - mRNA species and proteins of adenovirus type 12 transforming regions: identification of proteins translated from multiple coding stretches in 2.2 kb region 1B mRNA in vitro and in vivo. AB - Analysis of cytoplasmic RNA in Ad12-infected and -transformed cells showed that more than 20 mRNA species are transcribed from regions 1A and 1B. These mRNA species could be classified into four classes according to the extent to which they were expressed in infected and transformed cells under various conditions. The proteins synthesized from the major species of each of these mRNAs were identified by in vitro translation. In region 1A, the 40K (and 38K) proteins were synthesized from three mRNA species that differed from one another in their 5' ends, and in region 1B three proteins with molecular weights of 19,000 (19K), 50K, and 17K were synthesized from a single species of 2.2 kb mRNA. Only the 19K protein was immunoprecipitated by anti-T serum (G serum) from rats bearing GY1 cell tumors, [GY1 cells are rat cells transformed by the Ad12 HindIII-G fragment (0-6.8 map units).] The 19K protein was also detected by immunoprecipitation in extracts from both transformed and infected cells. The 17K protein was immunoprecipitated by anti-T serum (C serum) derived from rats bearing CY1 cell tumors, but was not by G serum. [CY1 cells are rat cells transformed by the Ad12 EcoRI-C fragment (0-16.5 map units).] The 17K protein was also translated in vitro from the 0.5 kb region 1B mRNA. These results suggest that the 19K and 17K proteins correspond to Ad12 T antigen f and polypeptide IX, respectively, and that these two proteins are translated in vivo from different coding regions in 2.2 kb mRNA in CY1 cells. PMID- 6868370 TI - Receptor determinants of human and animal influenza virus isolates: differences in receptor specificity of the H3 hemagglutinin based on species of origin. AB - The binding of influenza virus to erythrocytes and host cells is mediated by the interaction of the viral hemagglutinin (H) with cell surface receptors containing sialic acid (SA). The specificity of this interaction for 19 human and animal influenza isolates was examined using human erythrocytes enzymatically modified to contain cell surface sialyloligosaccharides with the sequence SA alpha 2,6Gal beta 1,4GlcNAc; SA alpha 2,3Gal beta 1,4(3)GlcNAc; SA alpha 2,3Gal beta 1,3GalNAc; or SA alpha 2,6GalNAc. Although none of the viruses agglutinated cells containing the SA alpha 2,6GalNAc linkage, differential agglutination of cells containing the other three sequences revealed at least three distinct receptor binding types. Several virus isolates exhibited marked receptor specificity, binding only to cells containing the SA alpha 2,6Gal or the SA alpha 2,3Gal linkage, while others bound equally well to cells containing either linkage. Moreover, some viruses could distinguish between two oligosaccharide receptor determinants containing the terminal SA alpha 2,3Gal linkage when present in the SA alpha 2,3Gal beta 1,4(3)GlcNAc sequence or the SA alpha 2,3Gal beta 1,3GalNAc sequence binding cells containing only the former. The observed receptor specificities were not significantly influenced by the viral neuraminidases as shown by the use of the potent neuraminidase inhibitor 2-deoxy-2,3-dehydro-N acetylneuraminic acid. Receptor specificity appeared, to some extent, to be dependent on the species from which the virus was isolated. In particular, human isolates of the H3 serotype all agglutinated cells containing the SA alpha 2,6Gal linkage, but not cells bearing the SA alpha 2,3Gal beta 1,3GalNAc sequence. In contrast, antigenically similar (H3) isolates from avian and equine species preferentially bound erythrocytes containing the SA alpha 2,3Gal linkage. This is of particular interest in view of the identification of the avian virus H3 hemagglutinin as the progenitor of the H3 hemagglutinin present on the current human Hong Kong viruses. PMID- 6868369 TI - Isolation of a unique retrovirus, MNV-1, from Macaca nemestrina. AB - Cell cultures established from the spleen of a Macaca nemestrina with enzootic retroperitoneal fibromatosis (ERF) spontaneously released a unique retrovirus. Throughout 14 serial passages, the spleen cell cultures remained fibroblastic and no cytopathic effect was evident. The virus incorporates [3H]uridine, contains an RNA-dependent DNA polymerase (RDDP), has a buoyant density of 1.15 g/cm3 in sucrose, and was designated MNV-1. Virion-associated reverse transcriptase showed no preference for either Mg2+ or Mn2+ in standard RDDP assays. Complementary DNA (cDNA) transcribed from polyadenylated MNV-1 RNA hybridized to genomic DNA and RNA extracted from diseased tissues but not to nucleic acids from normal tissues of a healthy Macaca nemestrina or a Macaca mulatta. MNV-1 is therefore exogenous to these species. MNV-1 had no detectable homology to the endogenous macaque virus isolates MAC-1 and MMC-1. Liquid hybridization of MNV-1 cDNA to viral RNA derived from exogenous and endogenous subhuman primate retroviruses (SiSV(SSAV), GALV-SF, BaEV-M7, and BILN) did not reveal any significant sequence homologies. In addition, MNV-1 does not share homology with bovine leukemia virus or Mason Pfizer monkey virus as determined by Southern blot hybridization. We conclude that MNV-1 is a unique retrovirus which has not previously been described. As the ultrastructure of virions in in vitro cell cultures, as well as disease involved tissue, show some particles with type C morphology and others with type D morphology, MNV-1 may be comprised of more than one component. PMID- 6868371 TI - Characterization of phi 6 mutants that are temperature sensitive in the morphogenetic protein P12. AB - P12 is a morphogenetic protein necessary for the envelopment of the bacteriophage phi 6 nucleocapsid with the viral membrane. Gene 12 is located along with three other genes on the smallest chromosome of the virion. ts mutants in P12 were obtained by first characterizing the isoelectric focusing behavior of phi 6 proteins and then screening ts mutants of phi 6 that had previously been assigned to chromosome C for changes in the behavior of P12. In this manner, three independently isolated mutants were identified and were found to have morphogenetic consequences at restrictive temperatures similar to gene 12 nonsense mutants in nonsuppressor cells in that only unenveloped nucleocapsids were formed. When infected cells were labeled at restrictive temperature, 27 degrees, and then shifted to 21 degrees, normal phage particles were formed; however, the hydrophobic membrane proteins in the particles were not labeled, indicating that functional P12 must be present at the time of synthesis of the membrane proteins for them to assemble into virions or that the defective P12 leads the membrane proteins into a nonfunctional pathway. PMID- 6868373 TI - The structure of bacteriophage phi 6: protease digestion of phi 6 virions. AB - Proteolysis experiments with phi 6 virions show that the adsorption protein, P3, is digested by both trypsin and chymotrypsin. In addition, chymotrypsin also removes P6, a protein thought to be the anchor for P3 in the phi 6 membrane. PMID- 6868372 TI - Morphogenesis of bacteriophage phi 6: a presumptive viral membrane precursor. AB - Bacteriophage phi 6 has a lipid- and protein-containing membrane as its outer covering. Two phi 6-coded proteins are known to be required to produce enveloped phage particles: one is P9, the major phi 6 membrane structural protein, and the other is P12, a nonstructural protein without which membrane fails to assemble around phage nucleocapsids. A particle containing phospholipid, P9, and two minor phi 6 membrane proteins has been found in cells pulse labeled with protein precursors at late times after infection. The P9 particle can be chased into phage and is dependent on active P12 for its formation. Models are presented in which the role of the P9 particle in phi 6 membrane assembly is discussed. PMID- 6868374 TI - Sensitivity to spatiotemporal colour contrast in the peripheral visual field. AB - Contrast detection thresholds for spatiotemporal colour modulation were determined at several retinal locations. Colour discrimination is studied for red green modulation of a yellow field and for yellow-blue modulation of a white field. For constant target size colour vision deteriorates if the stimulus is moved away from the fovea, but if the shift is combined with a suitable enlargement of the target size colour discrimination at the periphery is comparable to that at the fovea. We did not find any retinal location along the horizontal meridian which was red-green or yellow-blue colour blind. Chromatic bars were detected in the nasal peripheral retina at eccentricities of up to at least 50 degrees, temporal colour contrast was perceptible at nasal eccentricities of up to at least 90 degrees. PMID- 6868376 TI - Vertical disparities lead to the "induced effect". PMID- 6868375 TI - Perceived size of letters depends on inter-letter spacing: a new visual illusion. PMID- 6868377 TI - LED's: convenient, inexpensive sources for visual experimentation--a modified circuit. PMID- 6868378 TI - The accuracy of binocular vergence for peripheral stimuli. AB - Two experiments were conducted to investigate the roles of dark vergence and retinal eccentricity as factors influencing binocular vergence responses. A nonius alignment technique was used to measure vergence responses in total darkness (dark vergence) and for dim binocular stimuli presented at retinal eccentricities ranging from 2 degrees to 8 degrees over distances ranging from 28.5 to 342 cm. The results indicate that vergence was progressively less accurate with stimuli at increasing retinal eccentricities, and that errors of fixation were biased toward the individual's dark vergence position. The hypothesis that dark vergence represents the functional resting state of the vergence system which influences oculomotor fusional responses under a variety of conditions is discussed. PMID- 6868379 TI - The effects of age on normal saccadic characteristics and their variability. AB - Age effects on human saccadic eye movements were tested with infrared reflectance oculography in 34 subjects. In contrast to a prior report, only a slight non significant change was observed in saccadic velocity and duration. An increase in saccadic latency comparable to that found in several previous reports was observed, however. All parameters showed considerable intersubject variability for both age groups. Decreased velocities or increased durations outside of these normal, broad ranges should be regarded as pathological for all subjects; they are not physiological effects of the aging process. PMID- 6868380 TI - Probing the spatial frequency spectrum for orientation sensitivity in stochastic textures. PMID- 6868381 TI - Purity discrimination: successive vs simultaneous comparison method. AB - Purity discrimination thresholds (delta p) were measured with successive (SOA = 3 sec) and simultaneous (SOA = 0 sec) comparison methods for seven dominant wavelengths; 410, 480, 500, 530, 570, 600 and 650 nm. The stimulus duration was 1 sec. The delta p values with the successive comparison method were found to be about 1.5-2.0 times larger than those obtained in the simultaneous case. The degree of purity discrimination deterioration shown in this study is similar to that of wavelength discrimination deterioration previously reported (Uchikawa and Ikeda, 1981, Vision Res. 21, 591-595). Saturation shifts of stimuli with the successive comparison method were also observed; these were toward increased saturation direction for most dominant wavelengths. PMID- 6868382 TI - Shifts in perceived size as a function of contrast and temporal modulation. AB - It has been suggested that perceived size depends upon the distribution of responses among a localized population of different size-tuned mechanisms. If so, then manipulations which alter this distribution should also affect perceived size. We therefore studied the effects of luminance contrast and mode of temporal presentation on size perception. Both manipulations produce significant shifts in perceived size. The results suggest that at least two factors contribute to the size percept. For small and intermediate size patterns, perceived size depends primarily on the local distribution of size-tuned mechanism responses, whereas for wide patterns, the spatial distribution of mechanism responses plays a major role. PMID- 6868383 TI - Extrapolation of motion path in human visual perception. PMID- 6868384 TI - Contrast sensitivity: psychophysical and evoked potential methods compared. PMID- 6868385 TI - Mechanisms responsible for the assessment of visual location: theory and evidence. AB - Vernier acuity demonstrates a fine sense of relative visual location, which can be exploited to examine the question of mechanisms for the extraction of position information. By determining the appearance and location of composite stimuli consisting of a number of unresolved parallel bars of different luminances, we have demonstrated that vernier acuities of the order of 5 sec arc are due to mechanisms with an inflexible manner of encoding local intensity changes in the retinal image. The results are compared and contrasted with current theoretical approaches to the problems of early visual coding, and are best described by a model which encodes only the occurrence and location of zero-crossings in the second derivative of the retinal light distribution. PMID- 6868386 TI - Electrophysiological evidence for spatial frequency selective mechanisms in adults and infants. PMID- 6868387 TI - Discrimination thresholds in the two-dimensional spatial frequency domain. AB - In two experiments we have determined the discriminability between two sinusoidal gratings as a function of orientation and spatial frequency differences. Twelve orientation (15 degrees steps) and four spatial frequencies (2, 4, 8, 12 c/deg) were considered and corresponding discrimination thresholds were determined. Results indicated that: (a) spatial frequency discrimination thresholds did not significantly vary over all frequency and orientation positions, and averaged at +/- 1/8 octave limits. (b) Orientation thresholds only slightly increased with spatial frequency (from +/- 5 degrees at 2 c/deg to +/- 6 degrees at 12 c/deg). (c) A large and consistent anisotropy occurred with orientation thresholds showing most sensitivity in the horizontal and vertical directions, with largest thresholds at the oblique angles. No oblique effect was observed with spatial frequency thresholds. These results confirm past observations, providing an extensive set of threshold measurements in the two-dimensional spatial domain. PMID- 6868388 TI - Visual evoked potentials to double-pulse pattern presentation. AB - The temporal resolution and summation characteristics of human cortical processes were investigated by recording an individual VEP component, C1, to the double pulse presentation of pattern pairs of both the same (+ve/+ve; -ve/-ve) and of opposite (+ve/-ve; -ve/+ve) contrast polarity at varying onset-to-onset intervals (SOA). The results show that comparable limiting SOA values of 40-50 msec are needed for the C1 components to the two patterns to separate out to form a double peaked response and for the stimulus to be seen as two distinct events. Also, the amplitude variations of the single-peaked response obtained at shorter SOAs show evidence of complete precortical response integration for SOA values below 5-10 msec and partial integration for values up to 30-40 msec, which again correspond to the results of related psychophysical studies. These VEPs show no reflection, however, of the inhibition/summation effects reported for subjective responses to pattern pairs of the same/opposite contrast polarity at SOA values between 40 and 70 msec. The implications of these findings are discussed. PMID- 6868389 TI - Effects of practice and the separation of test targets on foveal and peripheral stereoacuity. AB - The improvement in stereoacuity of two inexperienced, normal subjects was compared at foveal and at 2.5 degrees and 5 degrees peripheral target locations as a function of practice. Outlines of two squares differing only in binocular disparity were used as test stimuli and estimates of stereoacuity were obtained by application of the method of constant stimuli with feedback. The peripheral thresholds of both subjects improved 60-80% over the course of the first 3000 4000 responses at each stimulus location. Foveal improvement followed an identical time-course with a 73% improvement in one subject and only 23% in the other. This difference was reflected in the peripheral/foveal threshold ratios of the two subjects and underlines the necessity of ensuring the stability of thresholds. Stereoacuity measurements were also obtained using several different square separations at the fovea and at 2.5 degrees, 5 degrees and 10 degrees peripheral locations along the horizontal and vertical retinal meridians of two other normal subjects. Practice-stabilized disparity thresholds using optimal target separations revealed a steeper deterioration between the fovea and 2.5-5 degrees eccentricities than did measurements of the same subjects' minimum angles of resolution (MAR). The decrease of optimal stereoacuity at the more peripheral test locations was more gradual than has been previously reported but was not clearly related to that of the MAR. PMID- 6868390 TI - Contribution of two movement detecting mechanisms to central and peripheral vision. AB - Two mechanisms, one for the detection of fast, and the other for slow movement of a sinusoidal grating are identified, and investigated under central, parafoveal, and peripheral viewing conditions. The fast movement data is considered in terms of the Reichardt model, in which signals from two adjacent inputs are cross correlated leading to halving of the spatial resolving power for movement detection, compared with that for pattern detection. The mechanism underlying slow movement detection is regarded as being closely related to pattern detection, probably at the single unit level. The characteristics of this mechanism are discussed in the light of recent electrophysiological experiments describing clusters of simple cells in the visual cortex with "directional preference" properties. PMID- 6868391 TI - Separate motion aftereffects from each eye and from both eyes. AB - Monocular and binocular motion aftereffects (MAEs) are described, which were contingent upon which eye(s) was (were) exposed to the adapting motion. Subjects viewed clockwise rotation of a patterned disc with their left eye, alternating every 5 sec with anticlockwise rotation seen with their right eye, for a 10-min adapting period. RESULT: they saw an anticlockwise motion aftereffect with their left eye, and a clockwise MAE with their right eye. These monocular MAEs lasted for only 2-20 sec, but could be elicited repeatedly over a 2-6 min period, and could still be re-elicited two hours later. In a second experiment, subjects adapted for 10 min to the following cycle of 5-sec rotations: left eye, clockwise: right eye, clockwise: and both eyes together, anticlockwise. RESULT: they saw an anticlockwise MAE with their left eye only or with their right eye only, and a clockwise MAE when both eyes were open. A model of monocular and binocular inputs to motion sensitive neural channels is proposed. PMID- 6868392 TI - Luminance-dependent visual latency for the Hess effect, the Pulfrich effect, and simple reaction time. AB - The Hess effect, a monocular, latency-based illusion in which the more intensely illuminated of a pair of laterally-moving targets appears displaced ahead of the other, was studied with white targets on black background at scotopic and photopic levels. The magnitude of the Hess effect was about the same as that of the Pulfrich effect under similar photopic conditions. Reaction time declined more rapidly with increasing stimulus intensity than would have been predicted either by the Hess or the Pulfrich effect. Theoretical time-constants, computed for the Hess effect by assuming a first-order diffusion process followed by a more central non-linearity (temporal centroid), ranged between 0.145 and 0.165 sec for three observers. PMID- 6868393 TI - Detection of visual forms in space and time. AB - Stationary and moving target forms were composed of 5 equally spaced dots embedded in a background of 600 noise dots; the spatial and temporal separations between the target dots were varied independently. Target detectability decreased linearly with both spatial and temporal separations between the target dots. Detectability of both stationary and moving targets obeyed the same quantitative dependence on total separations, invariant under orientation in space-time. Detection also depended primarily on the relative density of the target and noise rather than on the absolute spatial or temporal separations between target dots. Thus, space and time had interchangeable effects on the detection of both stationary and moving targets. PMID- 6868395 TI - Stationary phantoms: a completion effect without motion and flicker. PMID- 6868394 TI - The spatial requirements for fine stereoacuity. AB - The finest human stereoacuity, which in some gifted individuals amounts to the detection of binocular disparities of less than 5 arc sec, is found with isolated vertical target lines 10-15 min of arc in length. Summation along the vertical dimension of the lines is physiological in origin, and is not due to probability summation of disparity signals from multiple point targets. What is being summed is not the quantity of light, but rather information about its distribution- positional signals leading to finer judgments of disparity. Increasing target length beyond 20 arc min produces little improvement in disparity thresholds because stereoacuity decreases at even small eccentricities. The threshold at 30 min away from the fixation point is nearly twice its value at the very center of the fovea. Fine stereoacuity has one additional constraint: the compared features should be disjoint. Connecting lines between test and reference targets can increase the stereo threshold markedly. PMID- 6868397 TI - Shared characteristics of stereopsis and the purely binocular process. AB - Wolfe and Held (1981) Vision Res. 21, 1755-1759 demonstrated the existence in the human visual system of a purely binocular process. A purely binocular process is defined as a process that responds only to binocular stimulation and not to stimulation of either eye alone. In this paper, some of the characteristics of the purely binocular process are investigated. We find: (1) the process is less sensitive to high spatial frequencies than is the visual system as a whole. (2) It is insensitive to stimuli near the detection threshold for the visual system as a whole. (3) It makes a greater contribution to the appearance of vertically oriented stimuli than to the appearance of horizontally oriented stimuli. (4) The function of the purely binocular process can be disrupted by blurring the image in one eye (artificial anisometropia). Each of these properties of the purely binocular process is similar to the known characteristics of stereopsis. This suggests that the purely binocular process is a necessary stage in stereopsis. PMID- 6868396 TI - Some research needs in aging and visual perception. PMID- 6868398 TI - Detection and identification of moving targets. PMID- 6868399 TI - Within-species variations in visual capacity among squirrel monkeys (Saimiri sciureus): sensitivity differences. AB - Earlier observations suggested there might be significant within-species variations in visual sensitivity among squirrel monkeys (Saimiri sciureus). Reported here are the results from measurements of increment-threshold spectral sensitivity in 41 squirrel monkeys of Peruvian origin. As determined in a forced choice discrimination task, no large variations were found among these animals in sensitivity to a 540 nm test light. However, there were large individual variations in sensitivity to a 640 nm light, the result being that, across this sample of monkeys, the differences in sensitivity to the 540 and 640 nm lights are bimodally distributed. This variation in sensitivity is gender related in that the more sensitive mode in this distribution is made up exclusively of female monkeys. The less sensitive animals include all of the males tested and a minority (7 out of 22) of the females examined. Additional experiments involving the measurement of sensitivity to monochromatic lights under conditions of dark and chromatic adaptation indicate that (a) the variation in sensitivity is not due to the variable presence of an intraretinal filter, and (b) the more sensitive squirrel monkeys have two differentially adaptable spectral mechanisms in the green to red portion of the spectrum, while the less sensitive monkeys do not. PMID- 6868400 TI - Adaptation-induced alteration of the relation between response amplitude and contrast in cat striate cortical neurones. AB - The activity of neurones in cat striate cortex in response to laterally moving sinusoidal gratings has been examined. The effect of prolonged visual stimulation with a high contrast moving grating stimulus of optimal orientation and spatial frequency was investigated in terms of the changes wrought in the relationship between response amplitude and stimulus contrast. The adaptation which resulted was characterized by an elevation of contrast threshold by about 0.4 log units and a reduction in the steepness of the relation between response and contrast by about 0.36 log units. Both simple and complex cells exhibited this behaviour. The similarity of these values to the size of contrast threshold elevations demonstrated psychophysically suggests a possible physiological basis for the perceptual phenomenon. PMID- 6868401 TI - Dynamic properties of cat horizontal cell light responses. AB - The presented sinewave/squarewave light flicker responses of cat horizontal cells confirm the classification into Hn and Hm-units described by Foerster et al. (1977a,b) Expl Brain Res. 29, 347-385. However, we find somewhat higher order filter properties and develop a refinement of the model proposed by Foerster et al. to explain our new results. Using this model further analysis of Hm-unit responses suggests that cat retinal receptors have a smaller temporal bandwidth the smaller the spatial extent of the stimulus. Finally results from Gaussian white noise (GWN) stimulation are compared with those from classical flicker stimuli and Bode-plots. There are strong similarities in the results of these two types of analysis but some interesting differences are also found and discussed. PMID- 6868402 TI - Global interactions in perceptual completion at the blind spot. AB - Nonlinearity and asymmetrical property in the filling-in process at the blind spot are investigated. Perceptual completion of a pattern with a gap is deteriorated, i.e. gap information inhibits completion across the gap. Filled-in patterns, observed from complementary patterns, are not the same in complementary sense. These suggest that perceptual completion cannot simply be predicted from a superimposition of completions, obtained from local stimulus conditions, and seems to be mediated by global processes. PMID- 6868403 TI - Contrast detection and direction discrimination of drifting gratings. AB - Observers performed simple detection and left/right discrimination of drifting sinusoidal gratings. Ratio of detection to discrimination sensitivities was measured under variations in several experimental parameters. In the first experiment, it was found that combinations of spatial and temporal frequency which resulted in the same velocity produced similar detection-discrimination ratios. At an exposure duration of 800 msec, the relationship between the ratio and velocity described a power function with the intercept at 0.6 sec-1. Decreasing duration shifted the curve to higher velocities. I examined the effect of grating orientation in a second experiment. Visual sensitivity was poorer for oblique than for vertical gratings with detection and discrimination exhibiting similar size anisotropies. In a third experiment, observers viewed gratings presented to different retinal loci. Visual performance in both detection and discrimination fell with greater eccentricity. However, motion discrimination fell more steeply resulting in an increase in the ratio. The results demonstrate that form and motion analyzing mechanisms cannot be distinguished by their response to changes of spatial frequency, orientation or retinal locus. PMID- 6868404 TI - The unreliability of nonius line estimates of vertical fusional vergence performance. PMID- 6868405 TI - Dietary intake source data: United States, 1976-80. PMID- 6868406 TI - [Circulating blood platelet aggregates in various diseases]. PMID- 6868407 TI - [Repolarization of the atrium and its effect on the ST segment]. PMID- 6868408 TI - [Analysis and the results of treatment of patients with bronchial cancer]. PMID- 6868409 TI - [Levels of plasma digoxin in relation to kidney function]. PMID- 6868410 TI - [Deformability of erythrocytes and heart surgery with extracorporeal circulation]. PMID- 6868411 TI - [Immunologic findings in Crohn's disease. I. Levels of immunoglobulins and circulating immune complexes]. PMID- 6868412 TI - [Directed thin-needle aspiration biopsy in gastroenterological diagnosis]. PMID- 6868413 TI - [Esterolytic activity of the blood serum in lung diseases]. PMID- 6868414 TI - [Piroxicam in the treatment of active progressive polyarthritis]. PMID- 6868415 TI - [Current problems in surgical treatment of gunshot wounds]. PMID- 6868416 TI - [Methods of carying-out military scientific works. 2]. PMID- 6868417 TI - [Organization of intensive care units]. PMID- 6868419 TI - [Rehabilitation and its place in a system of therapeutico-prophylactic measures]. PMID- 6868418 TI - [Transfusion programs for correction of postoperative blood loss]. PMID- 6868420 TI - [Use of beclomethasone dipropionate in allergic rhinosinusopathies]. PMID- 6868422 TI - [Hygienic evaluation of the chemical composition of the air in residential facilities]. PMID- 6868421 TI - [Epidemic parotitis in adults]. PMID- 6868424 TI - [Treatment and prophylaxis of acute purulent gonitis]. PMID- 6868423 TI - [Changes in the microcirculation of the conjunctiva in Air Force personnel with early manifestations of cerebral atherosclerosis]. PMID- 6868427 TI - [Treatment of patients with spinal cord injuries in a sanatorium]. PMID- 6868425 TI - [Fluorescein angiographic diagnosis of changes in eye vessels and membranes]. PMID- 6868426 TI - [Team approach to organization of dental care for adolescents]. PMID- 6868429 TI - [Efficacy of physical therapy in patients with pathologic functional rearrangement of the tibia]. PMID- 6868428 TI - [Use of liquid crystal thermography in diagnosis of acute inflammatory bronchopulmonary diseases]. PMID- 6868430 TI - [Ambulatory treatment of local purulent infections]. PMID- 6868431 TI - [Errors in diagnosis of diphtheria in adults]. PMID- 6868433 TI - [Training of nurses for work in specialized centers for patients with acute radiation sickness]. PMID- 6868432 TI - [Clinico-morphological characteristics of injuries inflicted by fragmentation bombs]. PMID- 6868434 TI - [Changes in the hemostasis system after general anesthesia in patients older than 60 years]. PMID- 6868435 TI - [A case of severe meningococcal meningitis]. PMID- 6868436 TI - [Abscess of the root of the tongue and phlegmon of the mouth floor]. PMID- 6868438 TI - [Severe pernicious anemia caused by diphyllobothriasis]. PMID- 6868437 TI - [A case of laryngeal sarcoma]. PMID- 6868439 TI - [Pulmonary blood flow in patients with nonspecific lung diseases]. PMID- 6868440 TI - [A method of recording the pulse in the carotid artery]. PMID- 6868441 TI - [Methods of evaluating balneological procedures in animal experiments]. PMID- 6868442 TI - [Effects of sodium chloride and sodium bromide content of mineral water on iodine penetration into the body (experimental study)]. PMID- 6868443 TI - [Mechanism of action of various physical factors (SMC, DMW and peloid) on pancreas function]. PMID- 6868444 TI - [Problem of adaptation and health resort treatment]. PMID- 6868445 TI - [Effects of ganglerone electrophoresis and sine-modulated currents on the urodynamics of the lower urinary tract in patients with chronic cystitis]. PMID- 6868446 TI - [Combined sanatorium and health resort treatment in patients with different variants of vibration disease]. PMID- 6868447 TI - [Efficacy of gymnastics in a swimming pool in patients with neurological manifestations of osteochondrosis and vegetative polyneuritis (electroencephalographic data)]. PMID- 6868448 TI - [Effect of ultrasonic therapy on pyridoxine levels in patients with stomach and duodenal ulcer]. PMID- 6868449 TI - [Blood protease inhibitors in children with duodenal ulcer and gastroduodenitis during health resort therapy]. PMID- 6868450 TI - [Choice of the optimum frequency of current impulses during electrosleep treatment in children with biliary tract diseases]. PMID- 6868451 TI - [Effect of decimeter short waves on the state of microcirculation in patients with chronic arterial insufficiency of the legs]. PMID- 6868452 TI - [Recovery of the function of the autotransplanted extremity after exposure to magnetic fields]. PMID- 6868453 TI - [Postoperative rehabilitation of patients with varicose leg ulcers]. PMID- 6868455 TI - [Approaches and methods in increasing the efficacy of physical therapy in pediatrics]. PMID- 6868454 TI - [Effect of mud therapy in the early period after vessel injury on the recovery of collateral circulation (experimental study)]. PMID- 6868456 TI - [The effects of mud applications on bioenergetic processes (experimental study)]. PMID- 6868457 TI - [Acupuncture--a method of reflex puncture physiotherapy]. PMID- 6868458 TI - [Changes in the blood hormone spectrum as affected by centimeter-range microwaves]. PMID- 6868459 TI - [Effect of direct current on the course of an inflammatory process in the lungs (an experimental study)]. PMID- 6868460 TI - [Combined treatment of recurrent allergic bronchitis in children including ultrasound]. PMID- 6868461 TI - [Effect of ultrasound on the physicochemical properties of hydroxyprogesterone capronate (an experimental study)]. PMID- 6868462 TI - [Physicochemical basis for proserine electrophoresis using sinusoidal modulated currents]. PMID- 6868463 TI - [Cardiorespiratory reactions of chronic bronchitis patients to a single exposure to therapeutic hyperthermia in a sauna]. PMID- 6868464 TI - [Effect of vibration massage of the chest cavity on pulmonary ventilation and gas exchange following operations on abdominal organs]. PMID- 6868466 TI - [Experimental and clinical study of sodium oxybutyrate electrophoresis]. PMID- 6868465 TI - [Radon baths and the drinking of radon water in treating obese diabetics]. PMID- 6868467 TI - [Fenibut electrophoresis as a treatment method in muscle spasticity of central origin]. PMID- 6868468 TI - [Use of proserine electrophoresis (direct and sinusoidal modulated currents) on patients with flacid paralysis]. PMID- 6868469 TI - [Effect of decimeter waves on the physicochemical state of membranes, thymocyte chromatin and immunological reactivity of the body]. PMID- 6868470 TI - [Development of mineral water sites]. PMID- 6868471 TI - [Statistical basis for the absence of a threshold of action for carcinogenic factors on a population level]. PMID- 6868472 TI - [Effectiveness of prophylactic irradiation of the cervical lymphatics in malignant tumors of the nasopharynx]. AB - The effectiveness of prophylactic irradiation of areas of the neck commonly involved in metastatic spread was studied in 276 patients with nasopharyngeal malignancies who were followed up during 5 and more years. The analysis was carried using such criteria as the decrease in the frequency of recurrent regional metastases, distant metastases and increase in 5-year survival. The absorbed doses ranged 45-50 Gy. The procedure was followed by a decrease in the frequency of regional metastases (3.4% versus 32.7% in untreated patients). The frequency of distant metastases decreased nearly by half (19.5% versus 31.7%). Five-year survival rates increased significantly from 49 to 65.5%. This relationship was recorded for all histological types of tumors. Application of prophylactic irradiation in doses of 45-50 Gy prevents local subclinical metastasis development in most patients. PMID- 6868473 TI - [Complex diagnosis of stomach polyps]. AB - 130 patients suffering from gastric polyps were examined; in 22 cases, malignancies were detected. According to the results of endoscopic and X-ray examination, malignant transformation of gastric polyps does not produce pathognomonic symptoms. It was found that the nature of polyps cannot be properly identified unless, at least, three or four roentgenologic and endoscopic symptoms are considered. Each procedure has proved to be of high diagnostic value. Correct diagnosis was established in 92.5% of cases following the complex application of X-ray and endoscopic methods and in 100% when it was supplemented with cytological examination. These findings suggest a complex application of the said diagnostic procedures. PMID- 6868474 TI - [Changes in the hypophyseal somatotropic hormone (STH) levels in cancer patients]. AB - Somatotropin levels were compared in 337 cancer patients and controls, using radioimmunological methods. Lung and gastric cancer patients revealed relatively greater variations in its basal levels. This proved to be a paradoxical reaction to operative stress. The said reaction is attributed to disturbances which develop in the somatotropin self-regulation system of cancer patients. PMID- 6868476 TI - [Clinical characteristics of metastases of thyroid cancer to the lungs]. AB - Metastases were detected in 120 out of 598 cancer patients (20.2%). 96 patients underwent a close clinical examination. Symptoms produced by mediastinal and lung metastases were the first clinical manifestations of the disease in 23% of cases, whereas in 38.5%, both metastases and primary tumor were detected simultaneously. Metastatic cancer of lung and mediastinum was mostly symptom-free. Metastases most frequently occurred in lungs, less frequently in mediastinal lymph nodes and rarely in the pleura. Lung metastases usually disseminated in foci. Spherical metastases and foci of shadowed lung tissue were less frequent. In cases of thyroid cancer disseminated into mediastinum, all groups of lymph nodes were involved. If slightly enlarged, regional lymph nodes located behind manubrium sterni were most difficult to detect. PMID- 6868477 TI - [Lennert's lymphoma (2 cases)]. PMID- 6868475 TI - [Tumor regression rate and the effectiveness of the radiation therapy of cervical cancer patients]. AB - The paper deals with a correlation between the rate of tumor regression in response to radiation and the results of radiation treatment of cancer of the uterine cervix. The period of 50% decrease in tumor size in response to radiation treatment was established in 116 patients with cervical carcinoma by means of a dynamical cytological examination. Acceleration of tumor regression was followed by an increase in 5-year survival rates. A reverse correlation was established between growth and regression rates of cervical carcinoma. Thanks to the determination of tumor regression rates, various modalities of radiation treatment could be evaluated in the course of therapy and their efficacy predicted. PMID- 6868478 TI - [Successful treatment of a Kaposi's sarcoma patient]. PMID- 6868479 TI - [Problem of the threshold value and the hygienic regulation of environmental carcinogenic factors]. PMID- 6868480 TI - [Arguable aspects of the problem of the threshold value in connection with regulating chemical carcinogens]. PMID- 6868481 TI - [Further comment on the threshold of the harmful action of chemical carcinogens]. PMID- 6868482 TI - [Factors modifying sensitivity to carcinogens and the problem of threshold in chemical carcinogenesis]. PMID- 6868483 TI - [Patterns of the dose-effect dependence of chemical carcinogens]. PMID- 6868484 TI - [Dermatoglyphic patterns in patients with tuberculosis]. PMID- 6868485 TI - [Miliary lung carcinoid mimicking myocardial disease in stomach cancer]. PMID- 6868486 TI - [Clinical manifestations and the course of spastic torticollis]. PMID- 6868487 TI - [Personality characteristics in patients with early manifestations of schizophrenia]. PMID- 6868488 TI - [Morpho-functional changes in the kidneys after combined exposure to UHF-field and hypoxia]. PMID- 6868489 TI - [Diagnosis of sporadic leptospirosis in adults]. PMID- 6868490 TI - [Effect of riboxin on hemodynamics and microcirculation in patients with chronic ischemic heart disease]. PMID- 6868491 TI - [Nitrosorbide in the treatment of cardiac insufficiency in patients with ischemic heart disease]. PMID- 6868493 TI - [Treatment of patients with hypertension with an extract of the leaves of Eucommia ulmoides]. PMID- 6868492 TI - [Psychotherapy in the preparation of patients with ischemic heart disease for invasive examinations]. PMID- 6868494 TI - [Adaptation of the oxygen transport system to the physical load in patients with borderline hypertension]. PMID- 6868496 TI - [Bicycle ergometry tests in the evaluation of coronary circulation in patients with torpid rheumatism]. PMID- 6868495 TI - [Use of chrysanol in rheumatoid arthritis]. PMID- 6868497 TI - [Changes in heart structures after administration of various antigens to animals]. PMID- 6868498 TI - [ECG, cardio- and hemodynamic indices in patients with esophageal and stomach cancers]. PMID- 6868499 TI - [Clinico-morphological comparisons during combined treatment of stomach ulcer]. PMID- 6868500 TI - [Long-term results of the conservative treatment of patients with peptic ulcer]. PMID- 6868501 TI - [Functional state of the pancreas and biliary tract in patients with peptic ulcer]. PMID- 6868502 TI - [Therapeutic effect of pentagastrin]. PMID- 6868503 TI - [Blood levels of glutathione in patients with chronic gastroduodenitis and peptic ulcer]. PMID- 6868504 TI - [Vitamins B1 and C metabolism in patients with chronic cholecystitis]. PMID- 6868505 TI - [Risk factors in cholelithiasis and inflammatory biliary tract diseases]. PMID- 6868506 TI - [Hypolipidemic properties of the cholagogue agents cholosas and flamin]. PMID- 6868507 TI - [A case of prolonged hepatic coma with favorable outcome]. PMID- 6868508 TI - ["Inhibition" of the iodine-accumulating capacity of the thyroid gland in patients with nodular euthyroid goiter after surgical treatment]. PMID- 6868509 TI - [Pathogenetic therapy in the combined treatment of patients with chronic pyelonephritis]. PMID- 6868510 TI - [Effect of aldactone on kidney function, electrolyte metabolism and acid-base equilibrium in people of various ages]. PMID- 6868511 TI - [Heterotopic hormone-active kidney tumors]. PMID- 6868512 TI - [Role of smoking in the etiology of bronchopulmonary diseases]. PMID- 6868513 TI - [Respiration in patients with chronic lung diseases in association with systemic arterial hypertension]. PMID- 6868514 TI - [Interrelation between the physiological and occupational characteristics of the severity and strain of work]. PMID- 6868515 TI - [Morbidity of workers engaged in the cultivation and processing of hops]. PMID- 6868516 TI - [Cardiovascular function in those who have had influenza and acute respiratory diseases]. PMID- 6868517 TI - [Antibiotic treatment of patients with intestinal diseases of staphylococcal etiology]. PMID- 6868518 TI - [Potentiation of the antimicrobial activity of furazolidone with bile acids]. PMID- 6868519 TI - [Experience in treating patients with gastroenterological diseases at a polyclinic day hospital]. PMID- 6868520 TI - [Modifications of the chart of a patient discharged from the hospital for computer processing]. PMID- 6868521 TI - [Role of the urology office of the polyclinic in the medical rehabilitation of urolithiasis patients following surgery]. PMID- 6868522 TI - [Complex bronchological study of middle-aged and elderly patients]. PMID- 6868524 TI - [Mechanism of the occurrence of rales]. PMID- 6868523 TI - [Differential diagnosis of tuberculosis and lung cancer]. PMID- 6868526 TI - [Pulmonary gas exchange and oxygen tension in the tissues in Addison's disease]. PMID- 6868525 TI - [Pharmacokinetics of isoniazid in chronic kidney failure]. PMID- 6868527 TI - [Indications for the removal of metal fragments from the lung]. PMID- 6868528 TI - [Case of a chronic course of tuberculosis of the sternum complicated by suppurative fistulae]. PMID- 6868530 TI - [Clinico-endoscopic parallels in peptic ulcer and chronic primary gastroduodenitis]. PMID- 6868531 TI - [Use of dimedrol in the combined treatment of peptic ulcer patients]. PMID- 6868529 TI - [Gastroscopy in the diagnosis of stomach and duodenal diseases]. PMID- 6868532 TI - [Intravital diagnosis of hyperplasiogenic gastric polyposis]. PMID- 6868533 TI - [Clinico-anatomic parallels in acute pancreatitis]. PMID- 6868534 TI - [Comparative evaluation of laboratory methods for detecting exocrine failure of the pancreas]. PMID- 6868535 TI - [Methods and organizational forms for integrating phthisology with pulmonology]. PMID- 6868536 TI - [Case of acute intermittent porphyria simulating acute abdomen]. PMID- 6868537 TI - [Fibrinogen-bound sterols in diabetes mellitus patients]. PMID- 6868538 TI - [Personality reactions of patients undergoing surgical treatment for obesity]. PMID- 6868540 TI - [Thyroid function and hypophyseal thyrotropic function in psoriasis patients]. PMID- 6868539 TI - [Extent of the manifestation of autoimmune disorders in thyrotoxicosis patients in localities endemic for goiter]. PMID- 6868541 TI - [Rehabilitation of calculous pyelonephritis patients at the Shklo Sanatorium]. PMID- 6868542 TI - [Blood coagulation and fibrinolysis in acute glomerulonephritis]. PMID- 6868544 TI - [Compensation of hypoxia under physical loading in ischemic heart disease patients]. PMID- 6868545 TI - [Physical training results with patients who have had a myocardial infarct]. PMID- 6868546 TI - [Significance of the syndrome of premature repolarization of the heart ventricles]. PMID- 6868547 TI - [Diagnosis and treatment of nonspecific inflammatory lung diseases]. PMID- 6868548 TI - [Diagnostic potentials of studying visual and somatosensory evoked potentials in disseminated sclerosis]. PMID- 6868543 TI - [Changes in the hemodynamic indices of hypertension patients]. PMID- 6868549 TI - [Lyell's syndrome]. PMID- 6868551 TI - [Varying stability of the disulfide bond linking the heavy and light polypeptides subunits of influenza A virus hemagglutinin]. AB - Two-dimensional electrophoresis of influenza virus proteins in polyacrylamide gel under nonreducing (1st direction) and reducing (2nd direction) conditions showed some hemagglutinin polypeptides to lack the disulphide bond linking the heavy and light subunits. According to the results obtained, various influenza virus strains may be differentiated by the criterion of stability of disulphide polypeptides of hemagglutinin. PMID- 6868550 TI - [Oligopeptide mapping of the proteins of animal influenza virus nucleoproteins]. AB - Oligopeptide mapping showed the viruses H1N1 and H3N2 isolated from animals, unlike the majority of animal viruses with "animal" subtypes of the surface antigens, to have NP proteins typical of human H1N1 and H3N2 viruses which confirms their origin from human viruses. PMID- 6868552 TI - [Comparative study of the biological properties of influenza virus preparations purified by centrifugation and chromatography]. AB - A comparative study of chromatography and centrifugation as applied to purification of 2 influenza virus strains with different antigenic structure (H0N1 and H2N2) and of some biological properties of the resulting preparations was carried out. Certain strain-specific differences manifested in their chromatographic behaviour and in the degree of purification of virions from the allantoic fluid proteins were found. Some quantitative differences observed in the capacity of the resulting virus preparations to infect chick embryos and primary and continuous cells are insignificant and cannot be used for judgement of advantages of one or the other of the methods used for influenza virus purification. PMID- 6868553 TI - [Antineuraminidase serum antibodies in natural influenza A and immunization with influenza vaccines]. AB - Parallel HI and virus-elution-from-erythrocytes-inhibition (a simplified method for titration of neuraminidase antibody) tests were used for examinations of 1117 blood serum specimens from 440 adults and children under study, 5250 single serum specimens from healthy subjects from birth to 65 years of age, 38 paired serum specimens from children who experienced influenza A/Texas/1/77 disease in the epidemic of 1979-1980, and 590 paired serum specimens from subjects immunized with influenza vaccines. In 7%-23% of influenza patients and immunized subjects antibody rise was observed to only one of the influenza A virus surface antigens, hemagglutinin or neuraminidase. The protective activity of antibody to influenza A virus neuraminidase was as good as that of antihemagglutinins. Both kinds of antibody interacted in protection against the disease. Antineuraminidase antibody was found to affect the decrease in severity of the infectious process in natural infection with influenza A. The formation of immunological memory in the system of synthesis of antihemagglutinins and antineuraminidase antibodies was shown to have features in common. The pattern of heterologous immune responses in immunized subjects and patients with influenza showed all antigenic varieties of neuraminidase N2 as well as neuraminidases N1 and N2 to share common cross reacting determinants. PMID- 6868554 TI - [Intermolecular covalent (disulfide) bonds in the peplomers of influenza virus hemagglutinin]. PMID- 6868555 TI - [Influence of influenza epidemics on the urban population]. AB - The results of studies carried out in 1974-1979 according to the programme of epidemiological survey of influenza among the population of Houston (USA) developed by the Research Center for Influenza at the Baylor Medical College are reviewed. The data of selective virological and epidemiological surveys of the population were used for comparative analysis of several epidemic outbreaks caused by different antigenic variants of influenza virus. The analysis has been aimed at the detection of "high risk" groups of the population, investigation of the effect of influenza on the health of the population, determination of the factors conducive to virus spread, development of methods for the evaluation of the efficacy of influenza control measures, as well as determination of the earliest signs of activity of influenza viruses among the population and search for the best method of prediction of an epidemic virus for the following season. PMID- 6868556 TI - [Procedures for estimating transmission parameters from influenza epidemics: use of serological data]. AB - A maximum likelihood procedure is given for estimating household and community transmission parameters from observed influenza infection data. The mathematical model used does not require the specification of infection onset times and, therefore, can be used with serological data which detect asymptomatic infections. Infection data was derived by serology and virus isolation from the Tecumseh Respiratory Illness Study and the Seattle Flu Study for the years 1975 1979. Influenza A (H1N1), A (H3N2), and B viruses were found to be in descending order both in terms of ease of spread in the household and intensity of the epidemic in the community except when two strains co-circulate. Children are found to be the main introducers of influenza into households. PMID- 6868557 TI - [Membrane structure of remantadine-sensitive and remantadine-resistant influenza virus studied with fluorescent phospholipid probes]. AB - Significant differences in the molecular organization of lipid bilayer in remantadin-resistant and remantadin-sensitive strains of influenza virus were demonstrated by means of fluorescent phospholipid probes, analogues of phosphatidylcholine and sphingomyelin. The data on fluorescence polarization and transfer of excitation energy from protein tryptophanes on probe fluorophores showed phosphatidylcholine and sphingomyelin to be segregated in influenza virion membrane. Gradients of mobility of lipid chains in virion membrane and in phospholipid vesicles have opposite directions. The results indicate that M protein coming inside virion into contact with the lipid bilayer does not penetrate further than its middle. In virions of the resistant strain remantadin destroys the array of the entire bilayer whereas in the sensitive strain the addition of remantadin results in a marked decrease of mobility of the chains in the surface area. It is suggested that the molecular organization of lipids is one of the factors determining influenza virus sensitivity to remantadin. PMID- 6868559 TI - [Characteristics of a low-molecular nonvirion ("soluble") antigen from the tick borne encephalitis virus]. AB - Pig embryo kidney and BHK-21 cells infected with tick-borne encephalitis virus synthesize a nonvirion antigen differing in its immunological properties from the virion antigens. The antigen has a high thermostability. According to the results of ultrafiltration and gel filtration, its molecular weight is approximately 70 100 kilodaltons. Electrophoretic analysis in polyacrylamide gel showed the molecular weight of a polypeptide isolated from the precipitation band formed by this low molecular antigen to differ from molecular weights of virion and high molecular virus-specific nonvirion proteins and to be about 20 kilodaltons. This polypeptide is assumed to be a subunit of the analyzed nonvirion low molecular antigen. PMID- 6868558 TI - [Biological properties of live and inactivated influenza vaccines under experimental conditions]. AB - Biological properties of influenza vaccines were studied on experimental animals inoculated intraperitoneally with regard to the vaccine effect on peritoneal exudate cells. The development of neutrophilia and inhibition of acid phosphatase activity in macrophages within the first 24 hours after intraperitoneal inoculation of influenza viruses or influenza vaccines were used for determination of the toxic effect of the inoculum. The values of subsequent later activation of acid phosphatase in macrophages allowed the immunogenic properties of the vaccines under study to be evaluated. The sensitizing properties of the virus antigens were assessed by the reaction of the lymphoid-macrophage system after multiple inoculations of the preparations. A correlation of changes observed in the experimental animals with reactogenicity and values of immunity against influenza in man and animals was established. PMID- 6868560 TI - [Viremia in children with rheumatoid arthritis]. AB - The blood specimens from 22 children with rheumatoid arthritis, 57 children with other chronic diseases and 30 apparently normal children were tested for the presence of Coxsackie A and B, adeno, and rubella viruses by the method of co cultivation of patient's lymphocytes with continuous HEp-2 cell culture. Children with chronic diseases were found to have viremia much more frequently than normal children. The frequency of finding of different viruses in patients with rheumatoid arthritis (86.4%) significantly exceeded that in healthy children (20%). These patients had rubella and adeno 5 viruses in their blood more frequently than children in the other groups under study. Repeated examinations of 14 patients with rheumatoid arthritis at intervals of 1 year or longer revealed in 11 of them the same viruses as those identified in initial examinations. Persistence of some viruses in patients with rheumatoid arthritis is discussed. PMID- 6868561 TI - [Use of a BCG vaccine from a Soviet substrain for the immunotherapy of tumors caused by SA7 (C8) virus]. AB - The oncolytic and immunotherapeutic effect of the national BCG vaccine with respect to undifferentiated sarcoma of hamster induced by the highly oncogenic adenovirus of green monkeys SA7(C8) was studied. Preliminary data on significant positive effect of the vaccine inoculated before tumor formation were obtained. A single inoculation of the vaccine into tumors did not result in tumor regression in any of the cases. PMID- 6868562 TI - [Physicochemical characteristics of a vaccinal strain of the Leningrad-3 mumps virus (L-3)]. AB - Purified virions of the vaccine strain Leningrad-3 of mumps virus propagated in Japanese quail embryo cell cultures had a buoyant density 1.18-1.19 g/ml in sucrose gradient, contained 50 S RNA and showed variable sizes in electron microscopy as manifested by heterogeneity of the virus zone in sedimentation analysis. Purified L-3 virus contained 5 major polypeptides with molecular weights of 74,000, 68,000, 58,000, 45,000, and 39,000 daltons. Each polypeptide had an individual oligopeptide composition. PMID- 6868563 TI - [Correlation between the frequency of the occurrence of temperature reactions and humoral immunity indices in persons inoculated with a concentrated tick-borne encephalitis vaccine]. PMID- 6868565 TI - The urgent need for the establishment of a Cancer Investigation and Treatment Centre at the University of the West Indies, Jamaica. PMID- 6868564 TI - [Use of the indirect hemagglutination reaction in diagnosing herpetic keratitis]. PMID- 6868566 TI - Methodology and cost of cardiopulmonary by-pass for open-heart surgery at the University Hospital of the West Indies. Review of a 14-year experience (1968 1982). PMID- 6868568 TI - Chronic effects of marihuana extract on thyroid-gonad relationship in rats. PMID- 6868569 TI - Serological study of the distribution of Leptospira interrogans (serotype jules) and five other leptospires in Jamaica. PMID- 6868570 TI - Bacteriological study of sources of infection in the operating theatre at a teaching hospital. PMID- 6868567 TI - Vitreous humor analytes in assessing the postmortem interval and the antemortem clinical status. PMID- 6868571 TI - Primary infantile haemangioendothelioma of the liver. PMID- 6868572 TI - Carcinoma of the colon in an adolescent. PMID- 6868573 TI - Kawasaki disease in Barbados. PMID- 6868574 TI - A case of imported plasmodium ovale infection in Trinidad, West Indies. PMID- 6868577 TI - New and old concepts in sarcoidosis. 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- 6868576 TI - Results of neurosurgical microvascular extracranial-intracranial bypass for stroke: a decade of experience. AB - In 400 patients who have had neurosurgical microvascular bypass operations by one surgeon for problems of cerebrovascular occlusion disease, the results are encouraging, particularly in those who had transient ischemic attacks with hemodynamic lesions previously considered inoperable or inaccessible. The permanent neurologic morbidity rate is 2 percent and the present operative mortality is 2.5 percent. The incidence of stroke to date on the side of a functioning bypass is 0.9 percent per year. Average duration of follow-up is 43 months. PMID- 6868575 TI - Hepatitis among hospital employees. AB - The risk of acquiring hepatitis associated with work in a moderate-sized acute care teaching hospital was determined by a seroepidemiologic survey of hepatitis B surface antigen and antibody. A blood specimen and a completed questionnaire were obtained from 76 percent of the staff members involved in patient care activities and all preemployment applicants (a total of 767 persons). One employee was found to have transiently positive tests for hepatitis B surface antigen, whereas 94 (12.2 percent) were found to have hepatitis B surface antibodies. Using the national incidence rate for volunteer blood donors of 4.4 percent as a norm, significantly higher antibody incidence was seen in nursing personnel (16.9 percent), laboratory workers (14.0 percent), surgeons (37.5 percent) and dental workers (40.0 percent). Rates were not significantly raised among house officers, internists, respiratory therapists or housekeeping employees. Increased incidence was statistically related to age and known history of hepatitis, but not to sex, known needle-stick exposure, contact with patients having hepatitis, prior blood transfusion, blood handling or nonhospital exposure to hepatitis. In persons whose tests were positive for antibodies there was a 4 percent increment per decade of age among long-term employees; duration of employment approached significance as a risk factor. Of those with hepatitis B antibody, only 16 percent were aware of a prior bout of hepatitis. PMID- 6868578 TI - Hypothyroidism induced by continuous ambulatory peritoneal dialysis. PMID- 6868580 TI - Chest wall stimulator for pacemaker inhibiton. PMID- 6868579 TI - Corticosteroid therapy and death in cases of adult bronchial asthma. PMID- 6868582 TI - Steroid therapy and the risk of gastrointestinal injury. PMID- 6868581 TI - Anaphylaxis following zomepirac ingestion. PMID- 6868583 TI - The alcohol-withdrawal syndrome. PMID- 6868584 TI - The effect of an individualized practice-based CME program on physician performance and patient outcomes. AB - The Professional Competence Assurance Program (PROCAP) is an individualized educational program that examines physicians' performance in ambulatory practice. It uses medical record review to identify deficiencies in the care process that guides development of the educational intervention. Medical care is reassessed one year later. This program was used with 51 private practitioners to assess the care of 1,229 hypertensive patients. The educational program included a computer printout comparing one physician's performance with that of peers, readings targeted to management problems, and a conference call or group seminar with an expert stressing issues relevant to each physician's performance. Postintervention assessment showed that physicians prescribed beta-blockers (P<.01) and vasodilators (P<.01) more often. Improvement (P<.05) occurred in the control of diastolic blood pressure (